RPT Pasien Masuk BULAN 11

PEMERINTAH KABUPATEN DOMPU
RSUD DOMPU
Jl. Kesehatan No. 1 Dompu Telp. (0373) 21411 - 21118
LAPORAN PASIEN MASUK

No No. RM No. Registrasi Nama Pasien Tgl Reg. No. Kamar
INSTALASI GAWAT DARURAT

1 590801 RS161100005 ALIM SHAFIUUR RAHMAN 11/1/2016 Z. ANAK (DORAEMON)
2 631022 RS161100006 SAMA AS 11/1/2016 Z. DALAM 14A
3 072256 RS161100007 Bambang Supryadi 11/1/2016 V. A Cempaka
4 520870 RS161100047 MIFTAHUL ANAM 11/1/2016 V.A
5 490401 RS161100081 SUHARTI 11/1/2016 KBR 3B.7
6 051994 RS161100098 SITI MISBAH 11/1/2016 V.A
7 075735 RS161100104 Misbah M. Nor H. Jafar 11/1/2016 V. B. Seroja
8 631020 RS161100111 JUBAIDAH 11/1/2016 KBR EXTRA 3C.4
9 960466 RS161100115 11/1/2016 KBR EXTRA 3C.2
10 820988 RS161100126 IFFAHTUNISA AYENDA 11/1/2016 Z. ANAK III A5
11 631000 RS161100132 NYOMAN SULATRI 11/1/2016 Z. DALAM 09
12 501097 RS161100139 MANSYUR 11/1/2016 Z. DALAM 13C

13 601061 RS161100155 NURATUL ISNAIN 11/1/2016
14 410200 RS161100162 WINDARTI 11/1/2016 Z. DALAM 02
15 960116 RS161100163 Yusuf Rajak 11/1/2016 P
16 990510 RS161100164 ST. MARIAM YAKUB 11/1/2016 Z. Bdh 3b1
17 641027 RS161100165 MUHAMMAD IRFAN 11/1/2016 P
18 641026 RS161100166 YUDIANSYAH 11/1/2016 Z. DALAM 13C
19 087583 RS161100167 SAIDAH 11/1/2016 P
20 068210 RS161100169 IFAID 11/1/2016 P
21 641023 RS161100170 RANDI PENGGEILA 11/1/2016 P
22 641022 RS161100172 UDWAN 11/1/2016 Z. DALAM 13E
23 641024 RS161100173 FATIMAH 11/1/2016 Z. DALAM 15B
24 088605 RS161100174 SITI MASDAH 11/1/2016 Z. DALAM 06
25 641014 RS161100176 ABI SAPUTRA 11/1/2016 P
26 058095 RS161100177 MARDIANA 11/1/2016 KBR
27 340238 RS161100178 MUSTARUDIN 11/1/2016 ODC
28 340279 RS161100179 Drs. A. Karim Jamaludin 11/1/2016 P
29 078385 RS161100180 SITI MARJO 11/1/2016 Z. DALAM 09
30 810409 RS161100181 HARTATI 11/1/2016 Z. Bdh 3a4
31 052772 RS161100183 JULIANTI 11/1/2016 P
32 870354 RS161100184 Abdul Azis 11/1/2016 VIP. A II

33 840697 RS161100185 NURHAYATI 11/1/2016 KBR 3B.1
34 641017 RS161100186 NANDA MARDIAH 11/1/2016 Z. DALAM 15F
35 641018 RS161100187 FANNY 11/1/2016 Z. DALAM 13E
36 641011 RS161100190 syafruddin 11/2/2016 V. B. Bongenvil
37 350230 RS161100191 Bahtiar 11/2/2016 VIP.B II
38 340279 RS161100192 Drs. A. Karim Jamaludin 11/2/2016 VIP. A V kls1
39 521093 RS161100193 ALWIN MEYLANO PUTRA DIMU 11/2/2016 P
40 910675 RS161100194 ST. SALMAH 11/2/2016 P
41 830187 RS161100195 PRAWIRA WIBAWA PUTRA JAYA 11/2/2016 P
42 641012 RS161100196 Yeni Rahamawati 11/1/2016 P
43 641013 RS161100197 M. IZZUL ISLAM 11/2/2016 Z. ANAK III A2
44 631014 RS161100198 Hj. NURBAYA 11/2/2016 Z. DALAM CADANGAN 8
45 631012 RS161100200 MISBAHYANI ROSYID 11/2/2016 Z. Bdh 3a4
46 641009 RS161100210 SUKRIN 11/2/2016 Z. DALAM 12E
47 470814 RS161100218 Muhamad Aslam 11/2/2016 Z. ANAK (HELLO KITTY)
48 700010 RS161100225 MUHTAR AHMAD 11/2/2016 Z.DLM
49 561030 RS161100226 SYAMSI MUHTAR 11/2/2016 Z.DLM
50 950755 RS161100248 RAODAH 11/2/2016 KBR EXTRA II A
51 089107 RS161100269 HADIJAH H. BASALI 11/2/2016 V. B. Kemuning
52 051556 RS161100274 Anuriah 11/2/2016 P
53 280289 RS161100280 SALMAH 11/2/2016 V. A Mawar
54 641010 RS161100282 ADNAN 11/2/2016 Z. DALAM ISOLASI 3

55 631012 RS161100290 MISBAHYANI ROSYID 11/2/2016 P
56 631031 RS161100304 IRMA HANDAYANI 11/2/2016 KBR EXTRA 3C.7
57 631032 RS161100312 NUNUNG 11/2/2016 KBR. Anggur 1
58 930117 RS161100317 Reni Kurniati 11/2/2016 V. A Bonsai
59 631034 RS161100332 LESTI KURNIATI 11/2/2016 Z. ANAK III A2
60 631035 RS161100335 H. MANSYUR 11/2/2016 Z. DALAM 06B
61 631036 RS161100344 MUKMIN 11/2/2016 KBR. Anggur 3
62 500301 RS161100345 LESTARI 11/2/2016 P
63 480174 RS161100346 KISMAN,S.PdI 11/2/2016 P
64 800716 RS161100347 SRI WAHYUNI WULANDARI 11/2/2016 KBR 3B.5
65 520657 RS161100348 ERLINDA SASMITA 11/1/2016 P
66 069879 RS161100349 A.TALIB.S 11/2/2016 V. B. Sakura
67 631037 RS161100350 RUGAYA, Sanaàh 11/2/2016 Z.DLM
68 850075 RS161100351 ST. AISAH SAHARI 11/2/2016 P

69 631038 RS161100352 MULIANA 11/2/2016 KBR EXTRA 3C.8
70 601034 RS161100353 LUKMAN 11/2/2016 P
71 480023 RS161100354 SIMEAO SOARES 11/2/2016 ICU
72 260289 RS161100356 USWATUN HASANAH 11/2/2016 V. A Adenium
73 441064 RS161100357 FITRIANI 11/2/2016 KBR
74 631042 RS161100360 INDRA ARIF BESMANTORO 11/2/2016 ICU 8
75 631043 RS161100361 EDY ARSYAD 11/2/2016 V. B. Kenangan
76 210910 RS161100362 IHWAN 11/2/2016 V. A Anterium
77 270708 RS161100363 MAÀWIAH ILYAS 11/2/2016 Z. DALAM 15E
78 061775 RS161100364 MOH. UDIN SYAH RANI 11/2/2016 ODC
79 890878 RS161100365 SENI ASMAWATI 11/2/2016 Z. Bdh CADANGAN 6
80 380599 RS161100366 NURIANINGSIH 11/2/2016 KBR EXTRA 3C.6
81 631044 RS161100367 ALITA 11/2/2016 KBR
82 631045 RS161100368 Aziza Tausia Putri 11/2/2016 VA
83 920226 RS161100369 ABDUL MUNAWAR 11/2/2016 P

84 470151 RS161100370 ROSYIDAH, A.MA 11/2/2016 P
85 620412 RS161100371 RAHMA DEWI 11/2/2016 V. B. Melati
86 631046 RS161100372 ROSDIANA 11/2/2016 KBR
87 600211 RS161100373 IIN NURJAIN 11/2/2016 P
88 890623 RS161100374 BUKHARI 11/2/2016 Z. DALAM 09
89 790251 RS161100375 MARCELINO AXCEL 11/2/2016 Z. ANAK III B4
90 600273 RS161100376 JULHIJAH 11/2/2016 ZDLM
91 840074 RS161100377 HAMDAN JULFAH 11/2/2016 Z. ANAK III D2
92 631047 RS161100378 ASINAH 11/2/2016 KBR
93 080983 RS161100380 HALIMAH MAHMUD 11/2/2016 KBR
94 780787 RS161100381 YATI 11/3/2016 z.dlm
95 660535 RS161100382 HERIANTO 11/3/2016 P
96 960907 RS161100383 NURUL ISLAMIYAH 11/3/2016 Z.DLM
97 160123 RS161100384 SITI SALMAH 11/3/2016 KBR
98 610420 RS161100393 FAIRURIZAL 11/3/2016 Z. ANAK III D1
99 250335 RS161100417 KARMILA 11/3/2016 Z. ANAK III D5
100 631048 RS161100423 YANTI 11/3/2016 P

101 064747 RS161100426 H. ISMAIL AR. S. Sos 11/3/2016 ICU
102 631049 RS161100427 IRWANSYAH 11/3/2016 THT Elang.2
103 561032 RS161100429 AGANI 11/3/2016 P
104 500482 RS161100446 AISAH IBRAHIM 11/3/2016 Z.DLM
105 051556 RS161100465 Anuriah 11/3/2016 VIP.B II
106 631051 RS161100469 AMIRULLAH 11/3/2016 VIP.B V
107 001026 RS161100478 YUSUF MAULANA 11/3/2016 P
108 071682 RS161100483 Nurhaidah 11/3/2016 Z.DLM
109 611099 RS161100485 FATMAWATI 11/3/2016 KBR. Melon 2
110 611098 RS161100486 ABAKAR 11/3/2016 Z. DALAM 12E
111 078289 RS161100487 KHARSANIN, SE 11/3/2016 P
112 360582 RS161100488 HASNAH 11/3/2016 Z.DLM
113 580670 RS161100489 EFI KUSMAWATI 11/3/2016 Z. DALAM 11D
114 080607 RS161100490 AROS ARISTA DIANANDRA 11/3/2016 P
115 170112 RS161100491 SUHARDIN H. A. RAHMAN 11/3/2016 P
116 611097 RS161100492 NURAINI JUMRATUN 11/3/2016 KBR
117 611096 RS161100494 RAMLA 11/3/2016 Z.DLM

118 611093 RS161100495 RAMLAH 11/3/2016 Z. DALAM 09
119 440974 RS161100496 MUHAMMAD ABID AQILA P 11/3/2016 VA
120 611092 RS161100497 JUNAIDIN 11/3/2016 P
121 611091 RS161100498 ABDUL LATIF 11/3/2016 P
122 270648 RS161100499 ST. AISYAH 11/3/2016 VA
123 611090 RS161100500 SAHIR SAPUTRA 11/3/2016 Z. ANAK III C4
124 160985 RS161100501 ARAFAT 11/3/2016 VA
125 611051 RS161100502 NURMA 11/3/2016 KBR EXTRA 3C.6
126 611089 RS161100503 MISBA 11/3/2016 Z. DALAM 11A
127 180291 RS161100504 ABDUL GAFAR 11/3/2016 P
128 052956 RS161100505 MARLINCE MILA 11/3/2016 Z. DALAM 12E
129 611088 RS161100506 BISUKDORUM 11/3/2016 ODC
130 350380 RS161100507 DEA RAHMAWATI 11/3/2016 VA
131 850359 RS161100508 HJ SURYATI 11/3/2016 ODC
132 990427 RS161100509 ALFISYAKHAR, S.PD 11/4/2016 KBR INTENSIF
133 270137 RS161100510 EVA PATRIANI.SPD 11/4/2016 VIP.B III
134 520491 RS161100511 IKA LESPINI UTAMI 11/4/2016 KBR
135 450090 RS161100549 SUKMAN 11/4/2016 Z. DALAM 13C
136 920667 RS161100564 NURYADIN 11/3/2016 P
137 541020 RS161100566 SRI WAHYUNI 11/4/2016 KBR 3B.3
138 611079 RS161100582 SURYANSYAH 11/2/2016

139 930921 RS161100614 MOH RIDHO 11/4/2016 P
140 740077 RS161100621 SRI ISWANI 11/4/2016 V. B. Tulip
141 611082 RS161100636 MARJUNI 11/4/2016 Z. DALAM 15B
142 081048 RS161100639 DRA. SRI HARTATI M. YAKUB 11/4/2016 P
143 631068 RS161100641 NURDAHLIA 11/4/2016 ODC
144 720024 RS161100642 AISAH 11/4/2016 Z. DALAM 12C
145 611083 RS161100643 USMAN 11/4/2016 Z. DALAM 11D
146 950114 RS161100645 MAHMUD H USMAN 11/4/2016 V. B. Lili
147 039026 RS161100646 ST. Saleha 11/4/2016 VIP.B VII
148 611041 RS161100647 SASAN 11/4/2016 KBR EXTRA 3C.2
149 910675 RS161100648 ST. SALMAH 11/4/2016 P
150 611040 RS161100649 RAFKAH SYAKIR 11/4/2016 P
151 700510 RS161100650 DEWI SARTIKA 11/4/2016
152 611042 RS161100651 SACIAN NIARAMADHANI 11/4/2016 Z. ANAK III D3

153 990014 RS161100652 M. Ario Faturahman 11/4/2016 P
154 072435 RS161100653 ASPRIYANTI 11/4/2016 P
155 073403 RS161100654 AYIB HUSNUL HUDA 11/4/2016 P
156 611043 RS161100655 ABDURRAHMAN 11/4/2016 P
157 530623 RS161100656 IJO H. BASA 11/4/2016 VB
158 611044 RS161100657 RAFIÀH 11/4/2016 Z. Bdh CADANGAN 3
159 470909 RS161100658 FARIDA 11/4/2016 KBR EXTRA 3C.1
160 520067 RS161100659 SITI NUR AINI 11/4/2016 VIP. B IIIa
161 611045 RS161100660 MUHAMMAD AKBAR 11/4/2016 Z. ANAK III E3
162 069955 RS161100661 IMRAN 11/4/2016 Z. DALAM 13E
163 611046 RS161100662 HAMZAH 11/4/2016
164 611047 RS161100663 HABIBAH 11/4/2016
165 611048 RS161100664 HJ. AMINAH 11/4/2016 VB
166 660800 RS161100666 MUHAMMAD DUDE 11/4/2016 P
167 611050 RS161100667 FARIDAH 11/4/2016 KBR. Anggur 2
168 631053 RS161100668 KHAIRUNNISAH 11/4/2016 Z. ANAK III B3
169 631054 RS161100669 USWATUN HASANAH 11/4/2016 Z. ANAK (DORAEMON)
170 260645 RS161100670 MULIDAWATI 11/4/2016 VA
171 065776 RS161100671 Nurhidayah 11/4/2016 P
172 631055 RS161100672 MUHAMMAD AFDIATUL RIZKI 11/4/2016 Z. ANAK III E1
173 360016 RS161100673 M. LASAD 11/4/2016 Z. DALAM 15F
174 631056 RS161100674 M. GUNAWAN 11/4/2016 P
175 170917 RS161100675 YOLANDA 11/4/2016 THT Garuda2

176 690386 RS161100676 MUH. FITRAH UDDIN 11/4/2016 P
177 750028 RS161100677 RATIH MULYANI 11/4/2016 Z.DLM
178 440778 RS161100678 SARIFUDIN 11/4/2016 Z.DLM
179 390827 RS161100679 ROSDIANA 11/4/2016 KBR. Melon 2
180 110478 RS161100681 YUYUN PRATIWI 11/5/2016 Z. ANAK (UPIN-IPIN)
181 631058 RS161100682 GEDE ASWIN KENZI P 11/5/2016 VA
182 920603 RS161100683 NASARUDIN 11/5/2016 Z. Bdh 3a4
183 820527 RS161100685 SUKRIN 11/5/2016 Z. Bdh 3a11
184 079458 RS161100686 TAQWA 11/3/2016 P
185 611085 RS161100687 MUCHAMAD ANDI PRASETIO 11/4/2016 P
186 800762 RS161100690 HARTATI 11/5/2016 VA
187 441070 RS161100705 MUHAMMAD RAKA PUTRA NIRWANA 11/5/2016 VIP.B VI
188 370861 RS161100720 AISYAH PUTRI KEYLA 11/5/2016 VA
189 290143 RS161100726 MISBAH JAMALUDIN 11/5/2016 Tindakan Bdh
190 611073 RS161100733 MURAFIÀH RAMADHANI 11/5/2016 V. A Anggrek
191 160897 RS161100760 AISYAH PUSPITASARI 11/5/2016 Z. ANAK III A2
192 611060 RS161100769 USMAN 11/5/2016 Z. Bdh 3a7
193 600796 RS161100773 LINDA NINGSIH 11/5/2016 P
194 611062 RS161100801 MURNIATI, HADNE 11/5/2016 KBR 3B.5
195 100524 RS161100811 UTARI RAHMAWATI 11/5/2016 P
196 611059 RS161100814 HAMZAH 11/5/2016 ICU 4
197 072597 RS161100815 SYAMSU 11/5/2016 P
198 860465 RS161100816 GAMAR SALMIN 11/5/2016 VA

199 870806 RS161100818 JUNARI 11/5/2016 Z. Bdh 3a6
200 730675 RS161100820 AYUSKIA GUNTUR 11/5/2016 KBR 3A.2
201 621090 RS161100821 NURINDAH 11/5/2016 KBR 3B.2
202 160992 RS161100823 RAHMAN TULLAH 11/5/2016 Z. ANAK III E5
203 011039 RS161100824 MASRUHIN 11/5/2016 VA
204 079924 RS161100826 ROSMIYATI, S. Pd 11/5/2016 Z. DALAM 08
205 140922 RS161100827 DARMI 11/5/2016 KBR
206 062415 RS161100828 HAERUL M ALI 11/5/2016 VB
207 641040 RS161100829 M. RAIHAN 11/5/2016 ODC
208 641039 RS161100830 SARUJI 11/5/2016 Z.DLM
209 641038 RS161100831 NADIYATUL HANIFAH 11/5/2016 P
210 180359 RS161100832 ELFI SUKAISIH 11/5/2016 KBR
211 180653 RS161100833 SUHARNI 11/5/2016 V. A Mawar
212 641037 RS161100834 DANDI RAMADHAN 11/5/2016 Z. ANAK III B3
213 641036 RS161100835 RAMLAH 11/5/2016 Z. DALAM 12A
214 540909 RS161100836 ST. KHAIRUNISYA 11/5/2016 P
215 066254 RS161100837 LENA SUSILAWATI 11/5/2016 P
216 641035 RS161100838 LINDA 11/5/2016 KBR EXTRA 3C.4

217 069721 RS161100839 Nurhidayati 11/5/2016 KBR
218 059640 RS161100841 H. ARAHMAN ALI 11/5/2016 P
219 270989 RS161100842 SYAHRUL RIZAL 11/6/2016 P
220 390034 RS161100844 SYAFRUDIN 11/6/2016 P
221 641032 RS161100845 SALIMAH AINIL QALBI 11/6/2016 Z. ANAK (UPIN-IPIN)
222 641031 RS161100846 HABIBAH 11/6/2016 VA
223 641030 RS161100847 TIRA WATI 11/6/2016 Z. DALAM 11B
224 930867 RS161100848 KURNIAWATI 11/6/2016 ODC
225 750196 RS161100849 MIFTAHUL HAYAT 11/6/2016 Z. ANAK III D3
226 570751 RS161100850 NURHAEDAH 11/6/2016 KBR 3B.7
227 600839 RS161100851 M. ISNAINI 11/6/2016 VA
228 641029 RS161100852 IBADATIL KARIMAH 11/6/2016 Z. ANAK III A4
229 470686 RS161100853 MUHAMAD HIZBATUL AMAR 11/5/2016 P
230 120396 RS161100854 ABID IZZAT FAJRABY 11/5/2016 P
231 300690 RS161100855 MUHAMMAD ALDO JAINUDIN 11/6/2016 P
232 631098 RS161100856 M. DIN 11/6/2016 Z. DALAM 14A
233 540087 RS161100857 SUHARTONO 11/5/2016 Z. Bdh Merpati
234 631099 RS161100858 SYAFRUDIN 11/6/2016 Z. Bdh 3b5
235 611071 RS161100859 WILDAN KANDANI 11/6/2016 Z. DALAM 09
236 078197 RS161100860 SUHARTINI 11/6/2016 P

237 050666 RS161100861 H. Muhammad Saleh Bakar 11/6/2016 VIP.B III
238 460983 RS161100862 RUBIYAH 11/6/2016 KBR 3B6
239 631097 RS161100863 SRIYATI 11/6/2016 KBR EXTRA 3C.4
240 920443 RS161100864 SYAMSIAH 11/6/2016 Z. DALAM 06B
241 631096 RS161100865 PUTRI AYU 11/6/2016 VB
242 810667 RS161100866 Syamsudin 11/6/2016 V. B. Sakura
243 890595 RS161100867 SALMAH 11/6/2016 KBR. Melon 1
244 641003 RS161100868 NURAENI 11/6/2016 KBR
245 900915 RS161100869 GHAISAN ABYAN TSABIT 11/6/2016 VIP.B I
246 370912 RS161100870 SABRINA 11/6/2016 P
247 611077 RS161100871 SUMARNI 11/5/2016 P
248 040516 RS161100872 SARAFIAH 11/6/2016 Z. DALAM 11B
249 910140 RS161100873 MARIAM 11/6/2016 Z.DLM

250 611086 RS161100874 DESI LESTARI 11/6/2016 KBR INTENSIF
251 631095 RS161100875 MAHMUD M SALEH 11/6/2016 Z. DALAM 13C
252 261067 RS161100877 SYAMSUDIN 11/6/2016 Z. Bdh CADANGAN 1
253 611075 RS161100878 SUSILO BAMBANG Y 11/6/2016 Z. ANAK III B4
254 611070 RS161100879 NIKMAH 11/6/2016 ICU
255 065692 RS161100880 Zulkarnain H. Jamaluddin 11/6/2016 P
256 461027 RS161100881 RENI ANGGRIANI 11/6/2016 Z. Bdh CADANGAN 2
257 056861 RS161100882 HADIJAH ANWAR 11/6/2016 P
258 270743 RS161100883 NURHAYATI 11/6/2016 P
259 631094 RS161100884 RATNAH NINGSIH 11/6/2016 KBR EXTRA 3C.8
260 920226 RS161100885 ABDUL MUNAWAR 11/6/2016 P
261 631093 RS161100886 RADIATUL AL 11/6/2016 P
262 900583 RS161100887 SALMAH YASIN 11/6/2016 P
263 611074 RS161100888 YATI OKTAFIA 11/6/2016 VA
264 611072 RS161100889 BQ MASBAN 11/6/2016 THT Nuri.1
265 580615 RS161100890 SUCI CAHAYATI 11/6/2016 Z. DALAM 15F
266 087527 RS161100892 SRI SUDARINA 11/6/2016 KBR
267 611057 RS161100893 SYAFRUDDIN 11/6/2016 V. B. Kemuning
268 230257 RS161100895 BURHANUDIN 11/7/2016 P
269 500145 RS161100896 RENI JUNARI 11/7/2016 KBR EXTRA II B
270 410004 RS161100897 SRI RAHMAWATI 11/7/2016 P
271 740697 RS161100898 FAUZIN 11/7/2016 Z. Bdh 3a8
272 241020 RS161100899 ADAM 11/7/2016 Z. ANAK III A5

273 089018 RS161100912 Suciyani Syamsidar S.Kep 11/7/2016 P
274 611061 RS161100916 RIDWAN 11/7/2016 Z. Bdh 3b1
275 970925 RS161100923 AKINA FATIA 11/7/2016 Z. ANAK III A4
276 631072 RS161100932 ST. SANDORA BY 11/5/2016 NICU 13
277 540909 RS161100940 ST. KHAIRUNISYA 11/7/2016 VA
278 481096 RS161100948 SAFRATUL HAIRIAH 11/5/2016 Z. DALAM 13B
279 361028 RS161100952 ABYAN JALALUDIN AKBAR 11/7/2016 ICU 1
280 611066 RS161100959 A. MAJID 11/5/2016 Z.DLM
281 611065 RS161100973 YULI RAHMAWATI 11/5/2016 Z. DALAM 13B
282 640879 RS161100983 H. ABUBAKAR JAKARIA 11/7/2016 VB
283 611063 RS161100985 HARIJAH 11/7/2016 Z. Bdh CADANGAN 4
284 641042 RS161100987 YULIA PATRIANI 11/5/2016 KBR
285 641044 RS161100995 SRI RAHMAWATI 11/5/2016 Z. DALAM 14B
286 641043 RS161101002 VIRGINIA EKA MAHESA 11/5/2016 P
287 641045 RS161101008 SUSI 11/7/2016 Z. ANAK III C3
288 641099 RS161101033 H. M. SIDIK 11/7/2016 Z.BDH
289 641097 RS161101037 RAHMAWATI 11/7/2016 Z. ANAK III B2
291 641093 RS161101067 TOFAN PERDANA 11/7/2016 Z. ANAK III D1
292 461074 RS161101068 NOVI INDRAWATI 11/7/2016 Z. Bdh Kaswari.1
293 420665 RS161101069 HALIMAH 11/7/2016 P
294 510111 RS161101070 ASYUWANTO FITRAH 11/7/2016 P

295 641092 RS161101071 MOH. ARIF ADIYATNA 11/7/2016 VIP.B II
296 790375 RS161101072 MAÀNI 11/7/2016 Z.BDH
297 360329 RS161101073 ASIAH 11/7/2016 V. B. Melati
298 180039 RS161101074 DARMAN 11/7/2016 VA
299 641098 RS161101075 KAHARUDIN 11/7/2016 Z. DALAM 05A
300 210029 RS161101076 KAMALA SOSILAWATI 11/7/2016 VB
301 181083 RS161101077 FATIMAH 11/7/2016 Z. DALAM 13A
302 201078 RS161101078 ANITA 11/7/2016 KBR EXTRA 3C.1
303 480348 RS161101079 SAMSUDDIN 11/7/2016 VB
304 641091 RS161101080 M. ALGIFARI 11/7/2016 P
305 550988 RS161101081 MUHAMMAD ZIDAN MARASTA 11/7/2016 P
306 074133 RS161101082 mahani 11/7/2016 Z. DALAM 11E
307 200752 RS161101083 SUAEB M. TAHER 11/7/2016 V. B. Palem
308 180291 RS161101084 ABDUL GAFAR 11/7/2016 P
309 350804 RS161101085 MURDIONO 11/7/2016 P
310 601013 RS161101086 MARLINA 11/7/2016 Z. DALAM 12C
311 641089 RS161101087 ULFA YAENI 11/7/2016 VA
312 351079 RS161101088 MUHAMAD SYAIFULLAH 11/7/2016 P
313 750028 RS161101089 RATIH MULYANI 11/7/2016 Z. DALAM 15E

314 990162 RS161101090 SUKRIN 11/7/2016 P
315 641088 RS161101091 ERFINA 11/7/2016 P
316 641087 RS161101092 JAMILAH 11/7/2016 KBR 3A.2
317 641084 RS161101094 SRI WAHYUNINGSIH 11/7/2016 KBR
318 390354 RS161101097 st hajar 11/7/2016 KBR EXTRA 3C.5
319 641080 RS161101100 BAMBANG 11/8/2016 Z. DALAM 14B
320 641078 RS161101102 RATIFA 11/8/2016 ICU 5
321 580344 RS161101103 Ummul Khaerani 11/8/2016 VA
322 052145 RS161101104 Yeni Suryani 11/8/2016 V. B. Sakura
323 830933 RS161101137 MUKMIN 11/8/2016 Z. DALAM 12A
324 660650 RS161101151 IQBAL 11/7/2016 Z. DALAM 05A
325 790415 RS161101154 RAFIEDAH 11/7/2016 VA
326 641049 RS161101160 WARDASIFA ANGELIKA/JELITA 11/7/2016 VA
327 641071 RS161101171 RAODAH 11/8/2016 Z.DBDH
328 950119 RS161101182 NADIRA 11/7/2016 VA
329 641053 RS161101195 JUNAIDIN 11/8/2016 Z. DALAM 11A
330 063622 RS161101203 DRS. BURHANUDIN 11/8/2016 VIP.B I

331 068451 RS161101204 M. YASIN SIDIK 11/7/2016 V. B. Seroja
332 680345 RS161101205 HJ.ST HAJAR 11/7/2016 VA
333 220970 RS161101214 MAHANI 11/5/2016 Z. DALAM 02
334 570231 RS161101228 HARYATI 11/8/2016 VA
335 641050 RS161101233 SARIFA 11/7/2016 KBR 3B.3
336 250990 RS161101235 M. JEVAN FADILLAH 11/8/2016 VIP.B V
337 680644 RS161101238 SUBARI NURDIN 11/7/2016 P
338 641051 RS161101239 BARI 11/7/2016 Z. ANAK III B3
339 641048 RS161101240 ISMAIL 11/8/2016 Z. DALAM 11B
340 641072 RS161101241 HASINAH 11/8/2016 P
341 062595 RS161101242 BAMBANG 11/8/2016 VA
342 641054 RS161101243 HAERUDIN 11/8/2016 Z. Bdh CADANGAN 7
343 641075 RS161101244 FATIAH 11/7/2016 Z. Bdh CADANGAN 6
344 810667 RS161101245 Syamsudin 11/8/2016 Z. DALAM 08
345 090944 RS161101246 BAGAS FIRGO HANDOKO 11/8/2016 P

346 641077 RS161101247 Muhdar 11/8/2016 Z.BDH
347 641076 RS161101248 MUHAMMAD RAMLI 11/8/2016 NICU 13
348 820951 RS161101249 ADRIAN PRATAMA 11/8/2016 Z.A
349 210294 RS161101250 ARYA SABARANI 11/8/2016 VIP. B Ia
350 400774 RS161101251 SYAHRINI 11/8/2016 P
351 070625 RS161101252 Ahmad A. Bakar 11/8/2016 P
352 641074 RS161101253 SRI MERYATI 11/8/2016 P
353 600996 RS161101254 SRI ATIANINGSIH 11/8/2016 Z. DALAM 09
354 641073 RS161101255 JENAB 11/8/2016 Z. DALAM 12C
355 641070 RS161101256 CITRA 11/8/2016 V. B. Tulip
356 641069 RS161101257 ILIAS EMAN 11/8/2016 P
357 054286 RS161101258 Abdul sahid 11/7/2016 VIP.B IV
358 641068 RS161101259 ARI DWI SUSANTI 11/8/2016 KBR 3A.6
359 580486 RS161101260 IMADUDDIN 11/8/2016 P
360 810147 RS161101261 SUHARSONO, DRS 11/8/2016 P
361 550606 RS161101262 LAILA FARAS 11/8/2016 VA
362 641066 RS161101263 ALMUHAJAR 11/8/2016 Z. Bdh CADANGAN 3
363 910675 RS161101264 ST. SALMAH 11/8/2016 P

364 641061 RS161101265 RESPATI 11/8/2016 Z.DLM
365 190977 RS161101284 SALAHUDDIN 11/9/2016 VB
366 052963 RS161101291 MOH. DIAULAKBAR, ST 11/9/2016 P
367 641047 RS161101297 M IKBAL 11/9/2016 Z. ANAK III C4
368 641052 RS161101306 M ILHAM PUTRA 11/9/2016 Z.D
369 641067 RS161101318 MUKIS 11/8/2016 P
370 062280 RS161101320 YUSRIL 11/9/2016 ICU
371 410525 RS161101330 FATIMAH 11/9/2016 P
372 850777 RS161101342 FARAH RAHMAYANTI 11/9/2016 Z. ANAK III B1
373 280000 RS161101350 Maria fatima 11/7/2016 Z. DALAM 15F
374 641046 RS161101353 ZAINAL ARIFIN 11/9/2016 VA
375 530400 RS161101361 HUSNUL FAHMI ALAZIZI 11/9/2016 P
377 641055 RS161101375 M. ARDIANSYAH 11/9/2016 Z. ANAK III D4
378 770018 RS161101381 M. YASIN 11/9/2016 Z. DALAM 14A
379 321077 RS161101383 UMRAN 11/9/2016 P
380 641056 RS161101395 RAODAH 11/8/2016 KBR 3A.1
381 641057 RS161101406 RUKMINI 11/9/2016 Z. DALAM 15F
382 970914 RS161101409 BETY, S.PD 11/9/2016 KBR 3B.8
383 120592 RS161101410 ASMAH 11/9/2016 VA

384 150295 RS161101411 SENDI APRILIA 11/9/2016 KBR
385 300351 RS161101412 WIWIEK LESTARI NINGSIH 11/9/2016 KBR
386 210838 RS161101413 ST RAODAH 11/9/2016 Z.D
387 058283 RS161101414 SAFITRI 11/9/2016 P
388 641065 RS161101415 ADE TEGUH PUTRA 11/9/2016 ICU 8
389 630830 RS161101416 SRI RAHAYU 11/9/2016 P
390 700393 RS161101417 MARYAM 11/9/2016 VIP.B V
391 990979 RS161101418 FALISHA SHAMIM NIBRAS 11/9/2016 Z. ANAK (UPIN-IPIN)
392 401086 RS161101419 SASAL PUTRI NINGSIH 11/9/2016 Z. ANAK III A5
393 750560 RS161101421 JAKARIA MAHMUD 11/9/2016 Z. Bdh 3a11
394 641058 RS161101422 AGUS RAMADHAN 11/9/2016 ICU 4
395 641059 RS161101423 MARNUM 11/9/2016 KBR. Anggur 1
396 651030 RS161101424 Asni 11/9/2016 KBR EXTRA 3C.2
397 651031 RS161101425 MUHLIS ADI MAULANA 11/9/2016 ICU 5
398 057671 RS161101427 YASIN 11/9/2016 V. A Cempaka
399 680867 RS161101429 MUHAMMAD MITSAQON GHOLIZHUN 11/10/2016 V. B. Tulip
400 641060 RS161101430 Izul Najihul Fauzan 11/10/2016 VB

401 050036 RS161101431 INTAN ERNAWATI 11/10/2016 VIP.B IV
402 079262 RS161101432 MARJAN 11/10/2016 VA
403 710103 RS161101435 WIRDA NAFISATUL FITRI 11/10/2016 P
404 340279 RS161101438 Drs. A. Karim Jamaludin 11/10/2016 P
405 960278 RS161101441 VATDYLAH PUTRI NAYLI 11/10/2016 P
406 590682 RS161101444 HANUM TUNGGA DEWI 11/10/2016 P
407 076574 RS161101446 ESA AGEl 11/9/2016 P
408 770793 RS161101477 NUJRAH 11/10/2016 KBR
409 089544 RS161101486 SYAHRU RAMADHAN 11/9/2016 VIP.B II
410 180039 RS161101495 DARMAN 11/9/2016 VIP.B VII
411 651032 RS161101502 NURFISAN 11/9/2016 Z. ANAK III C2
412 060168 RS161101505 AMNAH ARSYAD 11/10/2016 P
413 410525 RS161101509 FATIMAH 11/10/2016 P
414 260442 RS161101511 ASIFA KHAERUNISA 11/9/2016 Z. ANAK III B2
415 651034 RS161101517 M. ZIDAN MANGAR 11/9/2016 Z. ANAK III C3
416 651035 RS161101522 KOMANG MANIS 11/9/2016 KBR
417 631092 RS161101525 M. ALI 11/10/2016 THT Nuri.1
418 830484 RS161101542 SUHARNI 11/9/2016 KBR 3B.8
419 651036 RS161101545 NAJMAH 11/9/2016 Z. B

420 651037 RS161101552 SRI ROHANI 11/9/2016 KBR
421 661030 RS161101555 BAHRUDIN 11/10/2016 P
422 071892 RS161101557 KASTURI 11/10/2016 Z. DALAM CADANGAN 2
423 830470 RS161101558 ASNI 11/10/2016 Z. DALAM ISOLASI 3
424 072595 RS161101559 SITI NURBAYA 11/10/2016 P
425 680632 RS161101560 H. IMAM PRIYATNO 11/10/2016 P
426 850944 RS161101561 MURNI 11/10/2016 Z. Bdh 3a4
427 052204 RS161101563 SITTI AISYAH, SAODAH 11/10/2016 P
428 661075 RS161101564 TURAYA USMAN 11/10/2016 Z. D
429 661076 RS161101565 MAEMUNAH 11/10/2016 Z. DALAM 14B
430 064012 RS161101566 M. SALEH HAMID 11/10/2016 ICU
431 900718 RS161101567 MAMAN SURIAMAN 11/10/2016 P
432 661033 RS161101568 ST. NUR 11/10/2016 P
433 441043 RS161101569 MELI DIAWATI 11/10/2016 P
434 870648 RS161101570 ROHANI IDRIS 11/10/2016 Z. D
435 800246 RS161101571 NURSAH 11/10/2016 P
436 661032 RS161101572 ROSDIANAH 11/10/2016 KBR
437 890010 RS161101573 BAHMIS M TAHIR 11/10/2016 VB
438 540506 RS161101574 ASTUTI 11/10/2016 KBR EXTRA 3C.4
439 870870 RS161101575 NURHAYATI 11/10/2016 Z. DALAM 13B
440 990975 RS161101576 MAMAN 11/10/2016 P

441 150723 RS161101577 ALFIAN SETIADIN 11/10/2016 P
442 661034 RS161101578 ARSAD 11/10/2016 THT Elang.1
443 210234 RS161101579 DESI 11/10/2016 Z. Bdh CADANGAN 7
444 080527 RS161101580 Siti Ante 11/10/2016 Z. D
445 770953 RS161101581 ANISA FITRI 11/10/2016 Z. ANAK III D3
446 491058 RS161101582 ANTIKA 11/10/2016 Z. ANAK III E2
447 661077 RS161101583 H. HAKIM 11/10/2016 VB
448 870068 RS161101584 EVI SUSANTI 11/10/2016 VA
449 661035 RS161101585 KALISOM 11/10/2016 Z. DALAM 11A
450 661036 RS161101586 JUMANI 11/10/2016 KBR
451 770584 RS161101587 FIRMANSYAH 11/10/2016 P
452 850754 RS161101588 ST HAWA 11/10/2016 KBR
453 840673 RS161101591 KURNIAWAN 11/10/2016 P
454 661053 RS161101595 NUR ARIFIN 11/10/2016 P
455 280813 RS161101608 FARIDAH 11/10/2016 ODC
456 661078 RS161101628 ST MARYAM 11/9/2016 Z. DALAM 12E
457 180878 RS161101746 ILIAS 11/9/2016 Z. D
458 661027 RS161101771 SURIANI 11/10/2016 KBR
459 990209 RS161101809 ABDUL KHAIR,S.SOS 11/8/2016 P
460 120302 RS161101810 SITI SALIHAH 11/8/2016 P
461 661084 RS161101816 NURMI 11/5/2016 P

462 641085 RS161101874 WIWIK PRATIWI 11/8/2016 KBR
463 661050 RS161101991 JUNGGIA 11/9/2016 P
464 661047 RS161101992 MUH RAF SANJANI 11/9/2016 P
465 910675 RS161101993 ST. SALMAH 11/7/2016 P
466 920922 RS161101994 BILAL 11/8/2016 P
467 480186 RS161101995 ROSDIANA YUSRAN 11/8/2016 P
468 910339 RS161102193 M.RAHMATUL AGUS 11/10/2016 P
469 600909 RS161102728 RAHMAWATI 11/9/2016 P
470 661059 RS161102913 USMAN 11/7/2016 P
471 068451 RS161104818 M. YASIN SIDIK 11/4/2016 P
472 501019 RS161104821 A. AZIS 11/7/2016 P
473 054286 RS161104822 Abdul sahid 11/7/2016 P
474 651026 RS161104824 HAWSAH IBRAHIM 11/3/2016 P
475 840921 RS161104825 ST HALIMAH 11/6/2016 P
476 841030 RS161104832 M. FAJRIN 11/5/2016 P
477 841066 RS161104835 AMIN 11/5/2016 P
478 821031 RS161104837 SYAFIQ HUSNULHUDA 11/8/2016 P
479 065776 RS161104838 Nurhidayah 11/8/2016 P
480 450484 RS161104839 HERU ISWANDI 11/7/2016 P
481 661007 RS161104840 IRWANSYAH 11/9/2016 P
482 470170 RS161104841 Dr. SITI SUWARNI 11/5/2016 P
483 860937 RS161104842 NURWAHIDAH 11/7/2016 P
484 871048 RS161104850 Eka Romantis 11/7/2016 P
Tipe Pasien Cara Bayar

Pasien Baru : 187 UMUM : 78
Pasien Lama : 297 DEBIT : 0
BPJS : 311
JAKKAD : 82
JAMKESMAS : 0
GRATIS : 1
TEN DOMPU
U
373) 21411 - 21118
IEN MASUK
Dokter Cara Byr Tipe Pasien
dr. H.Ahmad Faisal, SpA BPJS LAMA
Dr. Putri Maharani BPJS BARU
Dr. Putri Maharani BPJS LAMA
Dr. St Suwarni BPJS LAMA
dr. Nurmiftahul Islamiyah BPJS LAMA
dr. Nurmiftahul Islamiah BPJS LAMA
dr. Nurmiftahul Islamiah BPJS BARU
dr. H.Ahmad Faisal, SpA JAKKAD LAMA
dr. Nurmiftahul Islamiah UMUM BARU
Dr. St Suwarni JAKKAD LAMA

dr. Nurmiftahul Islamiah UMUM LAMA
Dr. St Suwarni BPJS BARU
Dr. St Suwarni UMUM BARU
Dr. St Suwarni JAKKAD BARU
dr. Nurmiftahul Islamiyah BPJS BARU
dr. Nurmiftahul Islamiyah UMUM BARU

dr. Nurmiftahul Islamiah JAMPERSA LAMA
L
dr. Nurmiftahul Islamiah JAKKAD BARU
dr. Nurmiftahul Islamiah JAKKAD LAMA
dr. Nurmiftahul Islamiah JAKKAD BARU
Dr. St Suwarni UMUM LAMA
dr. I Wayan Sudiharta, SpPD UMUM LAMA
Dr. Sanoko Tjandra, SpOg BPJS LAMA

Dr. St Suwarni JAMPERSA BARU

L

L
Dr. St Suwarni JAMPERSA LAMA

L
Dr. Endri Wati M.H BPJS BARU

L
dr. Muarif Ramadhan BPJS LAMA
dr. Muarif Ramadhan BPJS BARU
dr. I Wayan Sudiharta, SpPD UMUM LAMA
dr. Muarif Ramadhan JAMPERSA LAMA

L

dr. Muarif Ramadhan UMUM BARU
dr. Muarif Ramadhan JAKKAD LAMA
dr. H.Ahmad Faisal, SpA BPJS BARU

Dr. Arie Susilawati BPJS LAMA
Dr. Arie Susilawati BPJS BARU

Dr. Arie Susilawati UMUM BARU
Dr. Arie Susilawati UMUM LAMA
dr. H.Ahmad Faisal, SpA JAKKAD BARU
Dr. Arie Susilawati JAKKAD LAMA
dr. Yohanes Putu Arianta, SpOG BPJS LAMA
Dr. Arie Susilawati GRATIS LAMA

Dr. Sanoko Tjandra, SpOg BPJS BARU
dr. Nurmiftahul Islamiah JAKKAD LAMA
dr. Rini BPJS LAMA

dr. Rini BPJS LAMA
dr. Rini BPJS LAMA
dr. Rini BPJS LAMA
dr. Rini UMUM BARU
dr. Rini UMUM LAMA
dr. Rini BPJS BARU
dr. Rini BPJS LAMA
dr. Rini BPJS LAMA
dr. Rini JAKKAD LAMA
dr. Rini UMUM BARU
dr. Rini UMUM BARU
dr. Rini UMUM BARU
dr. Rini BPJS BARU
dr. Rini UMUM BARU
dr. Rini BPJS LAMA
dr. Rini BPJS LAMA
dr. H.Ahmad Faisal, SpA UMUM BARU
dr. Rini BPJS LAMA
dr. Rini BPJS BARU
dr. Rini BPJS LAMA

dr. Rini BPJS LAMA
dr. Rini BPJS LAMA
dr. Rini BPJS LAMA
dr. Rini BPJS LAMA
dr. Rini BPJS BARU
dr. Rini BPJS BARU
dr. Rini BPJS LAMA
dr. Rini BPJS LAMA
dr. Rini UMUM LAMA
dr. Nurmiftahul Islamiyah UMUM BARU
dr. Nurmiftahul Islamiyah UMUM LAMA

Dr. Putri Maharani UMUM BARU
Dr. Putri Maharani JAKKAD BARU
dr. Rini BPJS LAMA

Dr. Putri Maharani JAKKAD LAMA
Dr. Putri Maharani UMUM BARU
Dr.Adhar BPJS LAMA
Dr.Adhar BPJS BARU
Dr. Putri Maharani UMUM LAMA
Dr.Adhar UMUM BARU
Dr.Adhar JAKKAD LAMA

dr. I Wayan Sudiharta, SpPD BPJS LAMA
Dr.Adhar BPJS LAMA
Dr.Adhar UMUM BARU
Dr.Adhar BPJS BARU
Dr.Adhar UMUM BARU
Dr.Adhar BPJS LAMA
Dr.Adhar BPJS LAMA
Dr.Adhar BPJS LAMA
Dr.Adhar BPJS LAMA
Dr.Adhar BPJS LAMA
Dr.Adhar BPJS LAMA

Dr.Adhar UMUM BARU
Dr.Adhar BPJS BARU
Dr.Adhar BPJS LAMA
Dr.Adhar BPJS BARU
Dr.Adhar JAKKAD BARU
Dr.Adhar BPJS LAMA
Dr.Adhar BPJS LAMA
Dr.Adhar BPJS LAMA
Dr.Adhar BPJS LAMA
Dr.Adhar BPJS BARU
Dr.Adhar BPJS LAMA
Dr.Adhar UMUM BARU
Dr.Adhar BPJS LAMA
Dr.Adhar BPJS LAMA
Dr.Adhar BPJS BARU
Dr.Adhar BPJS LAMA
Dr.Adhar BPJS LAMA
Dr.Adhar BPJS LAMA
Dr.Adhar BPJS LAMA

Dr.Adhar BPJS BARU
Dr.Adhar BPJS LAMA

L

Dr. Endri Wati M.H JAKKAD LAMA
Dr. Endri Wati M.H UMUM BARU
Dr. Endri Wati M.H BPJS LAMA
Dr. Endri Wati M.H JAMPERSA LAMA

L
Dr. Endri Wati M.H UMUM LAMA

dr. M. Arista BPJS BARU
Dr. Endri Wati M.H JAMPERSA LAMA

L
Dr. Endri Wati M.H JAKKAD BARU
dr. Nurmiftahul Islamiyah JAKKAD LAMA

dr. Muarif Ramadhan UMUM LAMA
dr. Wirza BPJS BARU

Dr. Sanoko Tjandra, SpOg UMUM BARU
dr. Rini BPJS LAMA

dr. Nurmiftahul Islamiyah JAKKAD LAMA
dr. Nurmiftahul Islamiyah JAKKAD BARU
dr. Nurmiftahul Islamiyah JAKKAD BARU
dr. Nurmiftahul Islamiah JAMPERSA LAMA

L

Dr. Arie Susilawati JAMPERSA BARU

L

dr. I Made Sumariana, Sp.B BPJS LAMA

dr. Rini BPJS LAMA
dr. Rini BPJS BARU
dr. Rini BPJS BARU
dr. Rini BPJS LAMA
dr. Rini BPJS LAMA
dr. Rini BPJS BARU
dr. Rini BPJS LAMA
dr. Rini UMUM LAMA
dr. Rini BPJS LAMA
dr. Rini BPJS BARU
dr. Rini BPJS LAMA
dr. Rini BPJS LAMA
dr. Rini BPJS LAMA
dr. Rini UMUM LAMA

dr. Rini BPJS LAMA
dr. Rini JAKKAD BARU
dr. Rini BPJS LAMA
dr. Rini BPJS LAMA
dr. Rini UMUM BARU
dr. Rini UMUM BARU
dr. Rini BPJS BARU
dr. Rini JAMPERSA BARU

L
dr. Rini UMUM BARU
dr. Rini BPJS LAMA
dr. Rini UMUM LAMA
dr. Rini UMUM BARU

Dr. Fitratul Ramadhan BPJS LAMA
Dr. Fitratul Ramadhan JAKKAD LAMA
Dr. Fitratul Ramadhan UMUM BARU
Dr. Fitratul Ramadhan BPJS BARU
Dr.Adhar BPJS BARU

1/1
PASIEN RAWAT INAP LEWAT IGD

1 590801 RS161100005 ALIM SHAFIUUR RAHMAN 11/1/2016 Z. ANAK (DORAEMON)
2 631022 RS161100006 SAMA AS 11/1/2016 Z. DALAM 14A
3 072256 RS161100007 Bambang Supryadi 11/1/2016 V. A Cempaka
4 520870 RS161100047 MIFTAHUL ANAM 11/1/2016 V.A

5 490401 RS161100081 SUHARTI 11/1/2016 KBR 3B.7
6 051994 RS161100098 SITI MISBAH 11/1/2016 V.A
7 075735 RS161100104 Misbah M. Nor H. Jafar 11/1/2016 V. B. Seroja
9 960466 RS161100115 11/1/2016 KBR EXTRA 3C.2

10 820988 RS161100126 IFFAHTUNISA AYENDA 11/1/2016 Z. ANAK III A5
11 631000 RS161100132 NYOMAN SULATRI 11/1/2016 Z. DALAM 09
12 501097 RS161100139 MANSYUR 11/1/2016 Z. DALAM 13C

13 601061 RS161100155 NURATUL ISNAIN 11/1/2016
14 410200 RS161100162 WINDARTI 11/1/2016 Z. DALAM 02

15 990510 RS161100164 ST. MARIAM YAKUB 11/1/2016 Z. Bdh 3b1
16 641026 RS161100166 YUDIANSYAH 11/1/2016 Z. DALAM 13C
17 641022 RS161100172 UDWAN 11/1/2016 Z. DALAM 13E
18 641024 RS161100173 FATIMAH 11/1/2016 Z. DALAM 15B
19 088605 RS161100174 SITI MASDAH 11/1/2016 Z. DALAM 06
20 058095 RS161100177 MARDIANA 11/1/2016 KBR
21 078385 RS161100180 SITI MARJO 11/1/2016 Z. DALAM 09
22 810409 RS161100181 HARTATI 11/1/2016 Z. Bdh 3a4
23 870354 RS161100184 Abdul Azis 11/1/2016 VIP. A II
24 840697 RS161100185 NURHAYATI 11/1/2016 KBR 3B.1
25 641017 RS161100186 NANDA MARDIAH 11/1/2016 Z. DALAM 15F
26 641018 RS161100187 FANNY 11/1/2016 Z. DALAM 13E
27 641011 RS161100190 syafruddin 11/2/2016 V. B. Bongenvil
28 350230 RS161100191 Bahtiar 11/2/2016 VIP.B II

29 340279 RS161100192 Drs. A. Karim Jamaludin 11/2/2016 VIP. A V kls1
30 641013 RS161100197 M. IZZUL ISLAM 11/2/2016 Z. ANAK III A2
31 631014 RS161100198 Hj. NURBAYA 11/2/2016 Z. DALAM CADANGAN 8
32 631012 RS161100200 MISBAHYANI ROSYID 11/2/2016 Z. Bdh 3a4
33 641009 RS161100210 SUKRIN 11/2/2016 Z. DALAM 12E
34 470814 RS161100218 Muhamad Aslam 11/2/2016 Z. ANAK (HELLO KITTY)
35 700010 RS161100225 MUHTAR AHMAD 11/2/2016 Z.DLM
36 561030 RS161100226 SYAMSI MUHTAR 11/2/2016 Z.DLM

37 950755 RS161100248 RAODAH 11/2/2016 KBR EXTRA II A
38 089107 RS161100269 HADIJAH H. BASALI 11/2/2016 V. B. Kemuning
39 280289 RS161100280 SALMAH 11/2/2016 V. A Mawar
40 641010 RS161100282 ADNAN 11/2/2016 Z. DALAM ISOLASI 3

41 631031 RS161100304 IRMA HANDAYANI 11/2/2016 KBR EXTRA 3C.7
42 631032 RS161100312 NUNUNG 11/2/2016 KBR. Anggur 1
43 930117 RS161100317 Reni Kurniati 11/2/2016 V. A Bonsai
44 631034 RS161100332 LESTI KURNIATI 11/2/2016 Z. ANAK III A2
45 631035 RS161100335 H. MANSYUR 11/2/2016 Z. DALAM 06B
47 800716 RS161100347 SRI WAHYUNI WULANDARI 11/2/2016 KBR 3B.5
48 069879 RS161100349 A.TALIB.S 11/2/2016 V. B. Sakura
49 631037 RS161100350 RUGAYA, Sanaàh 11/2/2016 Z.DLM
50 631038 RS161100352 MULIANA 11/2/2016 KBR EXTRA 3C.8
51 480023 RS161100354 SIMEAO SOARES 11/2/2016 ICU
52 260289 RS161100356 USWATUN HASANAH 11/2/2016 V. A Adenium
53 441064 RS161100357 FITRIANI 11/2/2016 KBR
54 631042 RS161100360 INDRA ARIF BESMANTORO 11/2/2016 ICU 8
55 631043 RS161100361 EDY ARSYAD 11/2/2016 V. B. Kenangan
56 210910 RS161100362 IHWAN 11/2/2016 V. A Anterium
57 270708 RS161100363 MAÀWIAH ILYAS 11/2/2016 Z. DALAM 15E
58 890878 RS161100365 SENI ASMAWATI 11/2/2016 Z. Bdh CADANGAN 6
59 380599 RS161100366 NURIANINGSIH 11/2/2016 KBR EXTRA 3C.6
60 631044 RS161100367 ALITA 11/2/2016 KBR
61 631045 RS161100368 Aziza Tausia Putri 11/2/2016 VA
62 620412 RS161100371 RAHMA DEWI 11/2/2016 V. B. Melati

63 631046 RS161100372 ROSDIANA 11/2/2016 KBR
64 890623 RS161100374 BUKHARI 11/2/2016 Z. DALAM 09
65 790251 RS161100375 MARCELINO AXCEL 11/2/2016 Z. ANAK III B4
66 600273 RS161100376 JULHIJAH 11/2/2016 ZDLM
67 840074 RS161100377 HAMDAN JULFAH 11/2/2016 Z. ANAK III D2
68 631047 RS161100378 ASINAH 11/2/2016 KBR
69 080983 RS161100380 HALIMAH MAHMUD 11/2/2016 KBR
70 780787 RS161100381 YATI 11/3/2016 z.dlm
71 960907 RS161100383 NURUL ISLAMIYAH 11/3/2016 Z.DLM
72 160123 RS161100384 SITI SALMAH 11/3/2016 KBR
73 610420 RS161100393 FAIRURIZAL 11/3/2016 Z. ANAK III D1
74 250335 RS161100417 KARMILA 11/3/2016 Z. ANAK III D5
75 064747 RS161100426 H. ISMAIL AR. S. Sos 11/3/2016 ICU

76 631049 RS161100427 IRWANSYAH 11/3/2016 THT Elang.2
77 500482 RS161100446 AISAH IBRAHIM 11/3/2016 Z.DLM
78 051556 RS161100465 Anuriah 11/3/2016 VIP.B II
79 631051 RS161100469 AMIRULLAH 11/3/2016 VIP.B V
80 071682 RS161100483 Nurhaidah 11/3/2016 Z.DLM
81 611099 RS161100485 FATMAWATI 11/3/2016 KBR. Melon 2
82 611098 RS161100486 ABAKAR 11/3/2016 Z. DALAM 12E
83 360582 RS161100488 HASNAH 11/3/2016 Z.DLM
84 580670 RS161100489 EFI KUSMAWATI 11/3/2016 Z. DALAM 11D
85 611097 RS161100492 NURAINI JUMRATUN 11/3/2016 KBR
86 611096 RS161100494 RAMLA 11/3/2016 Z.DLM
87 611093 RS161100495 RAMLAH 11/3/2016 Z. DALAM 09
88 440974 RS161100496 MUHAMMAD ABID AQILA P 11/3/2016 VA
89 270648 RS161100499 ST. AISYAH 11/3/2016 VA
90 611090 RS161100500 SAHIR SAPUTRA 11/3/2016 Z. ANAK III C4
91 160985 RS161100501 ARAFAT 11/3/2016 VA
92 611051 RS161100502 NURMA 11/3/2016 KBR EXTRA 3C.6
93 611089 RS161100503 MISBA 11/3/2016 Z. DALAM 11A

94 052956 RS161100505 MARLINCE MILA 11/3/2016 Z. DALAM 12E
95 350380 RS161100507 DEA RAHMAWATI 11/3/2016 VA
96 990427 RS161100509 ALFISYAKHAR, S.PD 11/4/2016 KBR INTENSIF
97 270137 RS161100510 EVA PATRIANI.SPD 11/4/2016 VIP.B III
98 520491 RS161100511 IKA LESPINI UTAMI 11/4/2016 KBR
99 450090 RS161100549 SUKMAN 11/4/2016 Z. DALAM 13C
100 541020 RS161100566 SRI WAHYUNI 11/4/2016 KBR 3B.3
101 611079 RS161100582 SURYANSYAH 11/2/2016
102 740077 RS161100621 SRI ISWANI 11/4/2016 V. B. Tulip

103 611082 RS161100636 MARJUNI 11/4/2016 Z. DALAM 15B
104 720024 RS161100642 AISAH 11/4/2016 Z. DALAM 12C
105 611083 RS161100643 USMAN 11/4/2016 Z. DALAM 11D
106 950114 RS161100645 MAHMUD H USMAN 11/4/2016 V. B. Lili
107 039026 RS161100646 ST. Saleha 11/4/2016 VIP.B VII
108 611041 RS161100647 SASAN 11/4/2016 KBR EXTRA 3C.2
109 611042 RS161100651 SACIAN NIARAMADHANI 11/4/2016 Z. ANAK III D3
110 530623 RS161100656 IJO H. BASA 11/4/2016 VB

111 611044 RS161100657 RAFIÀH 11/4/2016 Z. Bdh CADANGAN 3
112 470909 RS161100658 FARIDA 11/4/2016 KBR EXTRA 3C.1
113 520067 RS161100659 SITI NUR AINI 11/4/2016 VIP. B IIIa
114 611045 RS161100660 MUHAMMAD AKBAR 11/4/2016 Z. ANAK III E3
115 069955 RS161100661 IMRAN 11/4/2016 Z. DALAM 13E

116 611046 RS161100662 HAMZAH 11/4/2016
117 611047 RS161100663 HABIBAH 11/4/2016
118 611048 RS161100664 HJ. AMINAH 11/4/2016 VB
119 611050 RS161100667 FARIDAH 11/4/2016 KBR. Anggur 2
120 631053 RS161100668 KHAIRUNNISAH 11/4/2016 Z. ANAK III B3
121 631054 RS161100669 USWATUN HASANAH 11/4/2016 Z. ANAK (DORAEMON)
122 260645 RS161100670 MULIDAWATI 11/4/2016 VA

123 631055 RS161100672 MUHAMMAD AFDIATUL RIZKI 11/4/2016 Z. ANAK III E1
124 360016 RS161100673 M. LASAD 11/4/2016 Z. DALAM 15F

125 170917 RS161100675 YOLANDA 11/4/2016 THT Garuda2
126 750028 RS161100677 RATIH MULYANI 11/4/2016 Z.DLM
127 440778 RS161100678 SARIFUDIN 11/4/2016 Z.DLM
128 390827 RS161100679 ROSDIANA 11/4/2016 KBR. Melon 2
129 110478 RS161100681 YUYUN PRATIWI 11/5/2016 Z. ANAK (UPIN-IPIN)
130 631058 RS161100682 GEDE ASWIN KENZI P 11/5/2016 VA
131 920603 RS161100683 NASARUDIN 11/5/2016 Z. Bdh 3a4
132 820527 RS161100685 SUKRIN 11/5/2016 Z. Bdh 3a11
133 800762 RS161100690 HARTATI 11/5/2016 VA
134 441070 RS161100705 MUHAMMAD RAKA PUTRA NIRWANA 11/5/2016 VIP.B VI
135 370861 RS161100720 AISYAH PUTRI KEYLA 11/5/2016 VA
136 290143 RS161100726 MISBAH JAMALUDIN 11/5/2016 Tindakan Bdh
137 611073 RS161100733 MURAFIÀH RAMADHANI 11/5/2016 V. A Anggrek
138 160897 RS161100760 AISYAH PUSPITASARI 11/5/2016 Z. ANAK III A2
139 611060 RS161100769 USMAN 11/5/2016 Z. Bdh 3a7
140 611062 RS161100801 MURNIATI, HADNE 11/5/2016 KBR 3B.5

141 611059 RS161100814 HAMZAH 11/5/2016 ICU 4
142 860465 RS161100816 GAMAR SALMIN 11/5/2016 VA
143 870806 RS161100818 JUNARI 11/5/2016 Z. Bdh 3a6
144 730675 RS161100820 AYUSKIA GUNTUR 11/5/2016 KBR 3A.2

145 621090 RS161100821 NURINDAH 11/5/2016 KBR 3B.2
146 160992 RS161100823 RAHMAN TULLAH 11/5/2016 Z. ANAK III E5
147 011039 RS161100824 MASRUHIN 11/5/2016 VA
148 079924 RS161100826 ROSMIYATI, S. Pd 11/5/2016 Z. DALAM 08
149 140922 RS161100827 DARMI 11/5/2016 KBR
150 062415 RS161100828 HAERUL M ALI 11/5/2016 VB
151 641039 RS161100830 SARUJI 11/5/2016 Z.DLM
152 180359 RS161100832 ELFI SUKAISIH 11/5/2016 KBR
153 180653 RS161100833 SUHARNI 11/5/2016 V. A Mawar

154 641037 RS161100834 DANDI RAMADHAN 11/5/2016 Z. ANAK III B3
155 641036 RS161100835 RAMLAH 11/5/2016 Z. DALAM 12A
156 641035 RS161100838 LINDA 11/5/2016 KBR EXTRA 3C.4
157 069721 RS161100839 Nurhidayati 11/5/2016 KBR
158 641032 RS161100845 SALIMAH AINIL QALBI 11/6/2016 Z. ANAK (UPIN-IPIN)
159 641031 RS161100846 HABIBAH 11/6/2016 VA
160 641030 RS161100847 TIRA WATI 11/6/2016 Z. DALAM 11B
161 750196 RS161100849 MIFTAHUL HAYAT 11/6/2016 Z. ANAK III D3

162 570751 RS161100850 NURHAEDAH 11/6/2016 KBR 3B.7
163 600839 RS161100851 M. ISNAINI 11/6/2016 VA
164 641029 RS161100852 IBADATIL KARIMAH 11/6/2016 Z. ANAK III A4
165 631098 RS161100856 M. DIN 11/6/2016 Z. DALAM 14A

166 540087 RS161100857 SUHARTONO 11/5/2016 Z. Bdh Merpati
167 631099 RS161100858 SYAFRUDIN 11/6/2016 Z. Bdh 3b5
168 611071 RS161100859 WILDAN KANDANI 11/6/2016 Z. DALAM 09

169 050666 RS161100861 H. Muhammad Saleh Bakar 11/6/2016 VIP.B III
170 460983 RS161100862 RUBIYAH 11/6/2016 KBR 3B6

171 631097 RS161100863 SRIYATI 11/6/2016 KBR EXTRA 3C.4
172 920443 RS161100864 SYAMSIAH 11/6/2016 Z. DALAM 06B
173 631096 RS161100865 PUTRI AYU 11/6/2016 VB
174 810667 RS161100866 Syamsudin 11/6/2016 V. B. Sakura
175 890595 RS161100867 SALMAH 11/6/2016 KBR. Melon 1
176 641003 RS161100868 NURAENI 11/6/2016 KBR
177 900915 RS161100869 GHAISAN ABYAN TSABIT 11/6/2016 VIP.B I
178 040516 RS161100872 SARAFIAH 11/6/2016 Z. DALAM 11B
179 910140 RS161100873 MARIAM 11/6/2016 Z.DLM
180 611086 RS161100874 DESI LESTARI 11/6/2016 KBR INTENSIF
181 631095 RS161100875 MAHMUD M SALEH 11/6/2016 Z. DALAM 13C
182 261067 RS161100877 SYAMSUDIN 11/6/2016 Z. Bdh CADANGAN 1
183 611075 RS161100878 SUSILO BAMBANG Y 11/6/2016 Z. ANAK III B4
184 611070 RS161100879 NIKMAH 11/6/2016 ICU
185 461027 RS161100881 RENI ANGGRIANI 11/6/2016 Z. Bdh CADANGAN 2
186 631094 RS161100884 RATNAH NINGSIH 11/6/2016 KBR EXTRA 3C.8
187 611074 RS161100888 YATI OKTAFIA 11/6/2016 VA
188 611072 RS161100889 BQ MASBAN 11/6/2016 THT Nuri.1
189 580615 RS161100890 SUCI CAHAYATI 11/6/2016 Z. DALAM 15F
190 087527 RS161100892 SRI SUDARINA 11/6/2016 KBR
191 611057 RS161100893 SYAFRUDDIN 11/6/2016 V. B. Kemuning
192 500145 RS161100896 RENI JUNARI 11/7/2016 KBR EXTRA II B
193 740697 RS161100898 FAUZIN 11/7/2016 Z. Bdh 3a8
194 241020 RS161100899 ADAM 11/7/2016 Z. ANAK III A5
195 611061 RS161100916 RIDWAN 11/7/2016 Z. Bdh 3b1

196 970925 RS161100923 AKINA FATIA 11/7/2016 Z. ANAK III A4
197 631072 RS161100932 ST. SANDORA BY 11/5/2016 NICU 13
198 540909 RS161100940 ST. KHAIRUNISYA 11/7/2016 VA

199 481096 RS161100948 SAFRATUL HAIRIAH 11/5/2016 Z. DALAM 13B
200 361028 RS161100952 ABYAN JALALUDIN AKBAR 11/7/2016 ICU 1

201 611066 RS161100959 A. MAJID 11/5/2016 Z.DLM
202 611065 RS161100973 YULI RAHMAWATI 11/5/2016 Z. DALAM 13B
203 640879 RS161100983 H. ABUBAKAR JAKARIA 11/7/2016 VB

204 611063 RS161100985 HARIJAH 11/7/2016 Z. Bdh CADANGAN 4
205 641042 RS161100987 YULIA PATRIANI 11/5/2016 KBR
206 641044 RS161100995 SRI RAHMAWATI 11/5/2016 Z. DALAM 14B
207 641045 RS161101008 SUSI 11/7/2016 Z. ANAK III C3

208 641099 RS161101033 H. M. SIDIK 11/7/2016 Z.BDH
209 641097 RS161101037 RAHMAWATI 11/7/2016 Z. ANAK III B2

211 641093 RS161101067 TOFAN PERDANA 11/7/2016 Z. ANAK III D1
212 461074 RS161101068 NOVI INDRAWATI 11/7/2016 Z. Bdh Kaswari.1

213 641092 RS161101071 MOH. ARIF ADIYATNA 11/7/2016 VIP.B II
214 790375 RS161101072 MAÀNI 11/7/2016 Z.BDH
215 360329 RS161101073 ASIAH 11/7/2016 V. B. Melati
216 180039 RS161101074 DARMAN 11/7/2016 VA
217 641098 RS161101075 KAHARUDIN 11/7/2016 Z. DALAM 05A
218 210029 RS161101076 KAMALA SOSILAWATI 11/7/2016 VB
219 181083 RS161101077 FATIMAH 11/7/2016 Z. DALAM 13A
220 201078 RS161101078 ANITA 11/7/2016 KBR EXTRA 3C.1
221 480348 RS161101079 SAMSUDDIN 11/7/2016 VB
222 074133 RS161101082 mahani 11/7/2016 Z. DALAM 11E
223 200752 RS161101083 SUAEB M. TAHER 11/7/2016 V. B. Palem
224 601013 RS161101086 MARLINA 11/7/2016 Z. DALAM 12C
225 641089 RS161101087 ULFA YAENI 11/7/2016 VA
226 750028 RS161101089 RATIH MULYANI 11/7/2016 Z. DALAM 15E
227 641087 RS161101092 JAMILAH 11/7/2016 KBR 3A.2

228 641084 RS161101094 SRI WAHYUNINGSIH 11/7/2016 KBR
229 390354 RS161101097 st hajar 11/7/2016 KBR EXTRA 3C.5
230 641080 RS161101100 BAMBANG 11/8/2016 Z. DALAM 14B
231 641078 RS161101102 RATIFA 11/8/2016 ICU 5
232 580344 RS161101103 Ummul Khaerani 11/8/2016 VA
233 052145 RS161101104 Yeni Suryani 11/8/2016 V. B. Sakura
234 830933 RS161101137 MUKMIN 11/8/2016 Z. DALAM 12A
235 660650 RS161101151 IQBAL 11/7/2016 Z. DALAM 05A

236 790415 RS161101154 RAFIEDAH 11/7/2016 VA
237 641049 RS161101160 WARDASIFA ANGELIKA/JELITA 11/7/2016 VA
238 641071 RS161101171 RAODAH 11/8/2016 Z.DBDH

239 950119 RS161101182 NADIRA 11/7/2016 VA
240 641053 RS161101195 JUNAIDIN 11/8/2016 Z. DALAM 11A

241 063622 RS161101203 DRS. BURHANUDIN 11/8/2016 VIP.B I
242 068451 RS161101204 M. YASIN SIDIK 11/7/2016 V. B. Seroja
243 680345 RS161101205 HJ.ST HAJAR 11/7/2016 VA
244 220970 RS161101214 MAHANI 11/5/2016 Z. DALAM 02
245 570231 RS161101228 HARYATI 11/8/2016 VA
246 641050 RS161101233 SARIFA 11/7/2016 KBR 3B.3
247 250990 RS161101235 M. JEVAN FADILLAH 11/8/2016 VIP.B V

248 641051 RS161101239 BARI 11/7/2016 Z. ANAK III B3
249 641048 RS161101240 ISMAIL 11/8/2016 Z. DALAM 11B

250 062595 RS161101242 BAMBANG 11/8/2016 VA
251 641054 RS161101243 HAERUDIN 11/8/2016 Z. Bdh CADANGAN 7
252 641075 RS161101244 FATIAH 11/7/2016 Z. Bdh CADANGAN 6
253 810667 RS161101245 Syamsudin 11/8/2016 Z. DALAM 08
254 641077 RS161101247 Muhdar 11/8/2016 Z.BDH
255 641076 RS161101248 MUHAMMAD RAMLI 11/8/2016 NICU 13
256 820951 RS161101249 ADRIAN PRATAMA 11/8/2016 Z.A
257 210294 RS161101250 ARYA SABARANI 11/8/2016 VIP. B Ia
258 600996 RS161101254 SRI ATIANINGSIH 11/8/2016 Z. DALAM 09

259 641073 RS161101255 JENAB 11/8/2016 Z. DALAM 12C
260 641070 RS161101256 CITRA 11/8/2016 V. B. Tulip
261 054286 RS161101258 Abdul sahid 11/7/2016 VIP.B IV
262 641068 RS161101259 ARI DWI SUSANTI 11/8/2016 KBR 3A.6
263 550606 RS161101262 LAILA FARAS 11/8/2016 VA

264 641066 RS161101263 ALMUHAJAR 11/8/2016 Z. Bdh CADANGAN 3
265 641061 RS161101265 RESPATI 11/8/2016 Z.DLM
266 190977 RS161101284 SALAHUDDIN 11/9/2016 VB
267 641047 RS161101297 M IKBAL 11/9/2016 Z. ANAK III C4
268 641052 RS161101306 M ILHAM PUTRA 11/9/2016 Z.D

269 062280 RS161101320 YUSRIL 11/9/2016 ICU
270 850777 RS161101342 FARAH RAHMAYANTI 11/9/2016 Z. ANAK III B1
271 280000 RS161101350 Maria fatima 11/7/2016 Z. DALAM 15F
272 641046 RS161101353 ZAINAL ARIFIN 11/9/2016 VA

274 641055 RS161101375 M. ARDIANSYAH 11/9/2016 Z. ANAK III D4
275 770018 RS161101381 M. YASIN 11/9/2016 Z. DALAM 14A
276 641056 RS161101395 RAODAH 11/8/2016 KBR 3A.1

277 641057 RS161101406 RUKMINI 11/9/2016 Z. DALAM 15F
278 970914 RS161101409 BETY, S.PD 11/9/2016 KBR 3B.8
279 120592 RS161101410 ASMAH 11/9/2016 VA
280 150295 RS161101411 SENDI APRILIA 11/9/2016 KBR
281 300351 RS161101412 WIWIEK LESTARI NINGSIH 11/9/2016 KBR
282 210838 RS161101413 ST RAODAH 11/9/2016 Z.D
283 058283 RS161101414 SAFITRI 11/9/2016 P
284 641065 RS161101415 ADE TEGUH PUTRA 11/9/2016 ICU 8
285 700393 RS161101417 MARYAM 11/9/2016 VIP.B V
286 990979 RS161101418 FALISHA SHAMIM NIBRAS 11/9/2016 Z. ANAK (UPIN-IPIN)
287 401086 RS161101419 SASAL PUTRI NINGSIH 11/9/2016 Z. ANAK III A5
288 750560 RS161101421 JAKARIA MAHMUD 11/9/2016 Z. Bdh 3a11
289 641058 RS161101422 AGUS RAMADHAN 11/9/2016 ICU 4
290 641059 RS161101423 MARNUM 11/9/2016 KBR. Anggur 1
291 651030 RS161101424 Asni 11/9/2016 KBR EXTRA 3C.2
292 651031 RS161101425 MUHLIS ADI MAULANA 11/9/2016 ICU 5
293 057671 RS161101427 YASIN 11/9/2016 V. A Cempaka
294 680867 RS161101429 MUHAMMAD MITSAQON GHOLIZHUN 11/10/2016 V. B. Tulip
295 641060 RS161101430 Izul Najihul Fauzan 11/10/2016 VB
296 050036 RS161101431 INTAN ERNAWATI 11/10/2016 VIP.B IV
297 079262 RS161101432 MARJAN 11/10/2016 VA
298 770793 RS161101477 NUJRAH 11/10/2016 KBR
299 089544 RS161101486 SYAHRU RAMADHAN 11/9/2016 VIP.B II
300 180039 RS161101495 DARMAN 11/9/2016 VIP.B VII

301 651032 RS161101502 NURFISAN 11/9/2016 Z. ANAK III C2
302 260442 RS161101511 ASIFA KHAERUNISA 11/9/2016 Z. ANAK III B2
303 651034 RS161101517 M. ZIDAN MANGAR 11/9/2016 Z. ANAK III C3
304 651035 RS161101522 KOMANG MANIS 11/9/2016 KBR
305 631092 RS161101525 M. ALI 11/10/2016 THT Nuri.1
306 830484 RS161101542 SUHARNI 11/9/2016 KBR 3B.8
307 651036 RS161101545 NAJMAH 11/9/2016 Z. B
308 651037 RS161101552 SRI ROHANI 11/9/2016 KBR
309 071892 RS161101557 KASTURI 11/10/2016 Z. DALAM CADANGAN 2

310 830470 RS161101558 ASNI 11/10/2016 Z. DALAM ISOLASI 3
311 850944 RS161101561 MURNI 11/10/2016 Z. Bdh 3a4
312 661075 RS161101564 TURAYA USMAN 11/10/2016 Z. D

313 661076 RS161101565 MAEMUNAH 11/10/2016 Z. DALAM 14B
314 064012 RS161101566 M. SALEH HAMID 11/10/2016 ICU
315 870648 RS161101570 ROHANI IDRIS 11/10/2016 Z. D
316 661032 RS161101572 ROSDIANAH 11/10/2016 KBR
317 890010 RS161101573 BAHMIS M TAHIR 11/10/2016 VB
318 540506 RS161101574 ASTUTI 11/10/2016 KBR EXTRA 3C.4
319 870870 RS161101575 NURHAYATI 11/10/2016 Z. DALAM 13B
320 661034 RS161101578 ARSAD 11/10/2016 THT Elang.1
321 210234 RS161101579 DESI 11/10/2016 Z. Bdh CADANGAN 7
322 080527 RS161101580 Siti Ante 11/10/2016 Z. D
323 770953 RS161101581 ANISA FITRI 11/10/2016 Z. ANAK III D3
324 491058 RS161101582 ANTIKA 11/10/2016 Z. ANAK III E2
325 661077 RS161101583 H. HAKIM 11/10/2016 VB
326 870068 RS161101584 EVI SUSANTI 11/10/2016 VA
327 661035 RS161101585 KALISOM 11/10/2016 Z. DALAM 11A
328 661036 RS161101586 JUMANI 11/10/2016 KBR
329 850754 RS161101588 ST HAWA 11/10/2016 KBR
330 661078 RS161101628 ST MARYAM 11/9/2016 Z. DALAM 12E
331 180878 RS161101746 ILIAS 11/9/2016 Z. D
332 661027 RS161101771 SURIANI 11/10/2016 KBR
333 641085 RS161101874 WIWIK PRATIWI 11/8/2016 KBR

Dokter Diagnosa Cara Byr Tipe Pasien
dr. H.Ahmad Bronchopneumonia, BPJS LAMA
Faisal, SpA unspecified
Dr. Putri GASTRITIS BPJS BARU
Maharani
Dr. Putri Hypertensive renal disease BPJS LAMA
Maharani with renal failure
Dr. St Suwarni Gastro-oesophageal reflux BPJS LAMA
dr. Nurmiftahul disease
Placentawithout
praeviaoesophagitis
with BPJS LAMA
Islamiyah haemorrhage, Delivery by
emergency caesarean section,
Dr. Putri Hipertensi
Maternal care due to uterine BPJS LAMA
Maharani scar from previous surgery,
dr. Nurmiftahul Single live birth
Hipertensi, + Zoster with other BPJS LAMA
Islamiah nervous system involvement, *
Postzoster neuralgia (B02.2+),
dr. Nurmiftahul Maternal
Urinary care
tract for breech
infection, site not BPJS BARU
Islamiah presentation, Delivery
specified, Diabetes mellitus by
emergency
non-dependen caesarean
insulin section,
dengan
Dr. St Suwarni Prematurerupture
Premature rupture ofof BPJS LAMA
komplikasi
membranes, YTTonset
dr. H.Ahmad membranes, onset of
Bronchopneumonia, of labour
labour JAKKAD LAMA
Faisal, SpA after
after 24
24 hours,
hours, Delivery
unspecified Single live bybirth
dr. Nurmiftahul Demam
Single liveDengue,
birth GASTRITIS UMUM BARU
Islamiah
Dr. St Suwarni Peptic ulcer, unspecified as JAKKAD LAMA
dr. Nurmiftahul acute or chronic,
Observation without
for other UMUM LAMA
Islamiah haemorrhageor
suspected diseasesperforation,
and
Other chronic renal failure
conditions
Dr. St Suwarni Hereditary haemolytic BPJS LAMA
Dr. St Suwarni anaemia,
Low backunspecified, Acute
pain, Hipertensi BPJS BARU
upper respiratory infection,
Dr. St Suwarni Hypertensive renal disease
unspecified JAKKAD BARU
dr. Nurmiftahul with renal failureand Colitis Of
Gastroenteritis BPJS BARU
Islamiyah Unspecified origin
dr. Nurmiftahul Stroke, tidak dirinci sebagai BPJS BARU
Islamiyah perdarahan (hemoragi) atau
infark
dr. Nurmiftahul Peptic ulcer, unspecified as BPJS LAMA
Islamiyah acute or chronic, without
haemorrhageor perforation,
dr. Nurmiftahul Placenta praevia with
Hipertensi BPJS LAMA
Islamiyah haemorrhage, Delivery by
dr. Nurmiftahul Gastroenteritis
Single live birth and Colitis Of BPJS LAMA
Islamiah Unspecified origin, Hipertensi
dr. Nurmiftahul Placenta praevia with BPJS LAMA
Islamiah haemorrhage, * Anaemia in
neoplastic disease (C00-D48+)
dr. Nurmiftahul Malignant melanoma of skin, BPJS LAMA
Islamiah unspecified
dr. Nurmiftahul Maternal care due to uterine JAMPERSAL LAMA
Islamiah scar from previous surgery,
Delivery by emergency
dr. Nurmiftahul DYSPEPSIA
caesarean section, Moderate BPJS BARU
Islamiah pre-eclampsia, Anaemia
dr. Nurmiftahul complicating
DYSPEPSIApregnancy, JAKKAD BARU
Islamiah childbirth and the puerperium,
Single live birth
dr. Nurmiftahul Plasmodium falciparum BPJS BARU
Islamiah malaria, unspecified, Demam
berdarah dengue (DHF),
dr. Nurmiftahul Gastroenteritis and Colitis Of
DYSPEPSIA BPJS LAMA
Islamiah Unspecified origin, Hipertensi
dr. Nurmiftahul Gastroenteritis and Colitis Of BPJS LAMA
Islamiah Unspecified origin, Hipertensi,
Arthrosis, unspecified
dr. Nurmiftahul Gastroenteritis and Colitis Of UMUM BARU
Islamiah Unspecified origin
dr. Nurmiftahul Gastroenteritis and Colitis Of UMUM BARU
Islamiah Unspecified origin
dr. Nurmiftahul Concussion JAKKAD BARU
Islamiah
dr. Nurmiftahul Low back pain BPJS BARU
Islamiah
dr. Nurmiftahul Epilepsy, unspecified, Other BPJS LAMA
Islamiah somatoform disorders
dr. Nurmiftahul Tuberkulosis Paru lainya BPJS LAMA
Islamiah
Dr. St Suwarni Sekuele tuberkulosis saluran BPJS LAMA
Dr. St Suwarni napas lainnya dan gravidarum,
Mild hyperemesis YTT BPJS LAMA
Dr. St Suwarni Unspecified
Gastroenteritis infection of urinary
and Colitis Of UMUM LAMA
tract in pregnancy
Unspecified origin
Dr. Sanoko Anaemia complicating BPJS LAMA
Tjandra, SpOg pregnancy, childbirth and the
puerperium, Unspecified
Dr. St Suwarni Peptic ulcer,
infection unspecified
of urinary tract inas BPJS BARU
Dr. St Suwarni acute or chronic,
Maternal
pregnancy care due without
to uterine JAMPERSAL BARU
haemorrhageor
scar fromby previous perforation
surgery,
Dr. St Suwarni Delivery emergency JAMPERSAL BARU
Delivery
caesarean bysection,
emergency Premature
Dr. St Suwarni Demam berdarah
caesarean section, dengue
Placenta BPJS LAMA
rupture Urinary
(DHF), of membranes,
tract onset
infection,
Dr. St Suwarni Gastroenteritis
praevia
of labour with
after and Colitis
haemorrhage,
24 hours, Of JAKKAD BARU
site not
Unspecified
Single specified,
live origin,
birth Other
Prolonged
specified andand
first stage
diseases Colitis
(of Of UMUM BARU
Bronchopneumonia,
Unspecified
labour), origin,
Anaemia Hipertensi
complicating
Dr. St Suwarni Delivery
conditions
unspecified,by emergency
complicating
Conjunctivitis, BPJS BARU
pregnancy,
caesarean childbirth
section,
pregnancy,childbirth andthe
Severe
and the
Dr. St Suwarni Vaginal delivery
unspecified following JAMPERSAL LAMA
puerperium,
pre-eclampsia,
puerperi Single live birth
Maternal care
Dr. St Suwarni previous
Stroke, caesarean section,
for signstidak
Premature
dirinci
of rupture
fetal sebagai
hypoxia,
of atau
UMUM BARU
Dr. St Suwarni perdarahan
Gastroenteritis (hemoragi)
Single live
membranes,
infark onset ofColitis
birth and labourOf BPJS BARU
Prolonged origin
first stage
after 24 hours, Prolonged (of first JAMPERSAL BARU
Dr. St Suwarni labour),
stage (ofSingle
labour) spontaneous
Gastroenteritis and Colitis Of BPJS LAMA
delivery, unspecified,
Unspecified origin, Single
Traumatic
dr. Muarif Thalassaemia,
live birth unspecified BPJS LAMA
Ramadhan shock
dr. Muarif Maternal care for BPJS LAMA

Ramadhan disproportion due to deformity
of maternal pelvicbones,
dr. Muarif Hypertensive
Delivery renal disease
by emergency BPJS BARU
Ramadhan with renal failure,
caesarean section,Anaemia,
Prolonged
unspecified,
first stage (ofOedema
labour), Single
dr. Muarif UNSPECIFIED
pulmonar viral invection BPJS BARU
Ramadhan live birth nervous system,
of central
Hipertensi
dr. I Wayan Low back pain, Calculus of UMUM LAMA
Sudiharta, SpPD kidney, Kolik ginjal YTT
dr. Muarif Low back pain, Sakit kepala BPJS LAMA

Ramadhan
dr. Muarif Urinary tract infection, site not BPJS LAMA
Ramadhan specified
dr. Muarif Maternal care due to uterine JAMPERSAL LAMA
Ramadhan scar from previous surgery,
dr. Muarif Delivery bysection,
caesarean emergencyAnaemia BPJS BARU
Ramadhan caesarean
complicatingsection, Pre-
pregnancy,
existing secondary
childbirth and the puerperium,
dr. Muarif ACUTE APPENDICITIS,
hypertension complicating BPJS BARU
Ramadhan Other
OTHER specified
AND diseases and
UNSPECIFIED
pregnancy,childbirth
conditions complicating and the
dr. Muarif puerperium, Single
Gastroenteritis andlive
pregnancy,childbirth andbirth,
Colitis
theOf BPJS LAMA
Ramadhan Premature
Unspecified rupture
origin
puerperi, Single of
live birth
membranes, onset of labour
after 24 hours
dr. Muarif Other immediate postpartum BPJS BARU
Ramadhan haemorrhage, Single live birth
dr. Muarif Urinary tract infection, site not BPJS LAMA
Ramadhan specified, GASTRITIS
dr. H.Ahmad Demam Dengue BPJS LAMA
Faisal, SpA
dr. Muarif GASTRITIS, Acute upper BPJS LAMA
Ramadhan respiratory infection,
unspecified
dr. H.Ahmad Demam Dengue JAKKAD LAMA
Faisal, SpA
dr. Muarif Placenta praevia with BPJS BARU
Ramadhan haemorrhage,
Oligohydramnios, Diseases of
dr. Muarif Maternal
the care for
respiratory transverse
system BPJS LAMA
Ramadhan and oblique
complicating lie, Delivery by
emergency caesarean
pregnancy,childbirth section,
dr. Muarif DYSPEPSIA stage (of the
Prolonged
and BPJS LAMA
Ramadhan puerperium,first Asthma,
labour),
unspecifiedPremature rupture of
dr. Muarif membranes, onset of labour
Other acute gastritis, JAKKAD LAMA
Ramadhan after 24 hours,
Diseases of theSingle live birth
digestive
system complicating
dr. Muarif Delivery bychildbirthand
pregnancy, emergency the BPJS LAMA
Ramadhan caesarean
puerperium section, Prolonged
first stage (of labour), Single
dr. H.Ahmad Malaria
live birth,YTT, Anaemia,
Maternal care due to BPJS BARU
Faisal, SpA unspecified
uterine scar from previous
dr. H.Ahmad surgery
Demam Dengue, Acute BPJS LAMA
Faisal, SpA pharyngitis, unspecified
Dr. St Suwarni Peptic ulcer, unspecified as BPJS LAMA
Dr. St Suwarni acute
Snakeorvenom
chronic, without BPJS BARU
Dr. St Suwarni Pneumonia,
Diabetes unspecified,
mellitus non- BPJS LAMA
Dr. St Suwarni Diabetes
dependen mellitus
Anaemia, insulin non-
unspecified
tanpa UMUM LAMA
dependen
komplikasi, insulin tanpa heart
Hypertensive
Dr. St Suwarni Gastroenteritis and Colitis Of
komplikasi BPJS BARU
disease withorigin
Unspecified (congestive)
Dr. St Suwarni Otherfailure,
heart and unspecified
Chronic renal BPJS LAMA
Dr. St Suwarni abdominal
Premature pain
rupture of BPJS BARU
failure, unspecified
Dr. St Suwarni membranes, onset ofdan
Sirosis hati lainnya labour
YTT, BPJS BARU
after 24 hours,
CHRONIC Delivery by
KIDNEY
Dr. St Suwarni Hypertensive
emergency heart DISEASE,
caesarean disease
section, BPJS LAMA
STAGE
without 3, Other disorders
(congestive) heart of BPJS
Dr. Arie Other
Single acute
live
lipoprotein gastritis
birth LAMA
Susilawati failure, Lowmetabolism
back pain
Dr. Arie Premature rupture of BPJS BARU

Susilawati membranes, onset of labour
after 24 hours, Delivery by
Dr. Arie Peptic ulcer,caesarean
emergency unspecified as
section, BPJS BARU
Susilawati acute or chronic,
Single live birth without
Dr. Arie Other acute
Diabetes gastritis,
mellitus non- UMUM BARU
Susilawati Gastroenteritis
dependen insulin and Colitis Of
tanpa
Unspecified
komplikasi, origin tidak
Bronkitis,
Dr. Arie Fever, unspecified, Acute UMUM LAMA
Susilawati dirinci sebagai
pharyngitis, akut atau kronis
unspecified
Dr. Arie Hipertensi BPJS LAMA
Susilawati
dr. H.Ahmad Gastroenteritis and Colitis Of JAKKAD BARU
Faisal, SpA Unspecified origin
Dr. Arie ACUTE APPENDICITIS, BPJS LAMA
Susilawati OTHER AND UNSPECIFIED
Dr. Arie Mild hyperemesis gravidarum, UMUM BARU
Susilawati Unspecified infection of urinary
tract in pregnancy
Dr. Arie Tuberkulosis Paru lainya BPJS BARU
Susilawati
Dr. Arie Nepritis tubulo-interstisial, JAKKAD LAMA
Susilawati tidak dirinci sebagai akut /
kronis, Other specified
Dr. Arie GASTRITIS
diseases and conditions BPJS LAMA
Susilawati complicating
Dr. Arie pregnancy,childbirth
Spontaneous abortion, and the BPJS LAMA
Susilawati puerperi
incomplete, without
complication
dr. Yohanes Delivery by emergency BPJS LAMA
Putu Arianta, caesarean section, Pre-
SpOG existing diabetes mellitus,
unspecified, Single live birth
Dr. Arie Delivery by emergency GRATIS LAMA
Susilawati caesarean section, Anaemia
complicating pregnancy,
dr. Nurmiftahul Tuberkulosis
childbirth Parupuerperium,
and the lainya BPJS LAMA
Islamiyah Anaemia, unspecified,
dr. Nurmiftahul Premature
Hydatidiformrupture
mole,of BPJS LAMA
Islamiyah membranes,
unspecified onset of labour
after 24 hours, Single live birth
dr. Muarif UMUM BARU
Ramadhan
Dr. St Suwarni Hypertensive heart disease BPJS LAMA
Dr. St Suwarni without (congestive)
Liver cell carcinoma heart JAKKAD BARU
failure, Diabetes mellitus non-
Dr. St Suwarni Plasmodium
dependen falciparum
insulin tanpa BPJS LAMA
Dr. St Suwarni malaria withPure
cerebral
Gastroenteritis
komplikasi, and Colitis Of BPJS BARU
complications,
Unspecified * Other
origin,
dr. Nurmiftahul Concussion,
specified OpenHipertensi,
hypercholesterolaemia
disorders wound
of brain ofin BPJS LAMA
Islamiah Arthrosis,
ankle, unspecified
Fracture of other finger
diseases classified elsewhere,
dr. Nurmiftahul Anaemia,
+ Diabetesunspecified,
mellitus non-Other BPJS LAMA
Islamiah specified
dependendiseases and
insulin dengan
conditions complicating
komplikasi ginjal, * Glomerular
dr. Nurmiftahul Prematurein rupture
diabetesofand
disorders the
mellitus BPJS BARU
Islamiah membranes,
puerperi with
(E10-E14+ onset of labour
commonfourth
after 24 hours,
character Delivery by
.2),unspecified,
Anaemia,
dr. H.Ahmad Pneumonia,
emergency caesarean section, JAKKAD BARU
Faisal, SpA unspecified, Hipertensi
Gastroenteritis and Colitis Of
Anaemia complicating
Unspecified
pregnancy, origin and the
childbirth
dr. Rini Gastroenteritis and Colitis Of UMUM LAMA
puerperium,
Unspecified Single live birth
origin,
dr. Rini Acute appendicitis, BPJS BARU
DYSPEPSIA
unspecified
dr. Rini Spontaneous abortion, BPJS LAMA
dr. Rini incomplete, without
Kolik ginjal YTT, Observation BPJS LAMA
complication,
for other Anaemia
suspected diseases
dr. H.Ahmad Gastroenteritis
complicating and Colitis Of
pregnancy, JAKKAD BARU
Faisal, SpA and conditions
Unspecified origin
childbirth and the puerperium
dr. Rini Demam Dengue JAKKAD LAMA
dr. Rini UMUM BARU
dr. Rini UMUM BARU
dr. Rini Bronchopneumonia, UMUM BARU
dr. Rini unspecified
Menstruasi ireguler YTT BPJS BARU
dr. Rini Gastroenteritis and Colitis Of UMUM BARU
dr. H.Ahmad Unspecified
Demam Dengue origin, BPJS BARU
Faisal, SpA Bronchopneumonia,
unspecified
dr. Rini Other specified diseases and BPJS LAMA
dr. H.Ahmad conditions complicating
Bronchopneumonia, UMUM BARU
Faisal, SpA pregnancy,childbirth
unspecified and the
puerperi, Lip, oral cavity and
dr. Rini Sekuele tuberkulosis saluran BPJS
pharynx LAMA
dr. Rini napas lainnyaInjury
Concussion, dan YTT
of BPJS LAMA
dr. Rini unspecified pelvic organ
Bronkitis, tidak dirinci sebagai JAKKAD LAMA
dr. Rini akut atauDengue,
Demam kronis Tension- BPJS LAMA
dr. Rini type headache
Spontaneous abortion, BPJS LAMA
dr. Rini incomplete, without
Asthma, unspecified BPJS LAMA
complication
dr. Rini Viral infection, unspecified BPJS BARU
dr. Rini Cutaneous abscess, furuncle JAKKAD LAMA
and carbuncle of limb
dr. Rini Urinary tract infection, site not JAKKAD LAMA
dr. Rini specified
Other peripheral vertigo BPJS LAMA
dr. Rini Demam Dengue UMUM LAMA
dr. Nurmiftahul Viral infection, unspecified BPJS BARU
Islamiyah
dr. Nurmiftahul Diabetes mellitus YTT dengan BPJS LAMA
Islamiyah komplikasi multipel
dr. Nurmiftahul Observation for other UMUM BARU
Islamiyah suspected diseases and
conditions
dr. H.Ahmad Gastroenteritis and Colitis Of JAKKAD LAMA
Faisal, SpA Unspecified origin, Acute
bronchiolitis, unspecified,
dr. Nurmiftahul Multiple injuries
Dermatitis popokof(diaper)
thorax,/ BPJS BARU
Islamiyah Fractures involving other
serbet (napkin)
combinations of body regions,
Dr. St Suwarni Prolonged
Injury first stage (of
of kidney BPJS BARU
Dr. St Suwarni labour), Delivery
Concussion by UMUM BARU
dr. Nurmiftahul Urinarylive
Single tract
birthinfection, site not UMUM LAMA
Islamiyah specified, Bacterial meningitis,
unspecified, Somatoform
dr. Nurmiftahul Secondarydysfunction
autonomic malignant BPJS LAMA
Islamiyah neoplasm of skin, Hipertensi,
Diabetes mellitus non-
Dr. St Suwarni Prematureinsulin
dependen rupturetanpaof UMUM LAMA
dr. Nurmiftahul membranes,
Other specified
komplikasi labour delayed
diseases andby BPJS LAMA
Islamiyah therapy
conditions complicating
pregnancy,childbirth and the
dr. H.Ahmad Gastroenteritis and Colitis Of
puerperi JAKKAD LAMA
dr. Nurmiftahul Urinary calculus, unspecified, BPJS LAMA
Islamiah Follow-up examination after
surgery for other conditions
dr. Nurmiftahul Gastro-oesophageal reflux BPJS LAMA
Islamiah disease without oesophagitis
Dr. Putri Prolonged first stage (of BPJS LAMA
Maharani labour), Single spontaneous
delivery, unspecified, Single
Dr. Putri GASTRITIS
live birth BPJS LAMA
Maharani
Dr. Putri Sirosis hati lainnya dan YTT JAKKAD BARU
Maharani
Dr. Putri Maternal care due to uterine BPJS LAMA
dr. Rini Gastroenteritis
caesarean andOther
section, Colitis Of BPJS LAMA
dr. H.Ahmad Unspecified
Acute origin
bronchitis, unspecified,
diseases of the blood and JAKKAD BARU
Faisal, SpA Gastroenteritis and Colitis
blood-forming organs and Of
Unspecified origininvolving the
certaindisorders
Dr. Putri Peptic ulcer, unspecified as JAKKAD BARU
im, Single live birth
Maharani acute or chronic, without
haemorrhageor perforation
Dr. Putri Premature rupture of BPJS BARU
Maharani membranes, unspecified,
Anaemia complicating
Dr. Putri Placenta praevia
pregnancy, withand the
childbirth BPJS LAMA
Maharani haemorrhage,
puerperium Delivery by
dr. H.Ahmad Acute bronchitis,
Anaemia complicatingunspecified BPJS BARU
Faisal, SpA pregnancy, childbirth and the
Dr. Putri puerperium, Single
Gastroenteritis andlive birthOf UMUM
Colitis BARU
Maharani Unspecified origin
Dr. Putri GASTRITIS JAKKAD BARU
Maharani
dr. H.Ahmad Gastroenteritis and Colitis Of JAKKAD LAMA
Dr. Putri Maternal care due to uterine BPJS LAMA
Dr. Putri Viral infection,
caesarean unspecified,
section, Premature BPJS LAMA
Maharani Acute pharyngitis,
rupture of membranes,unspecified
onset
dr. H.Ahmad ofNausea
labour (mual)
after 24dan
hours,
vomitus JAKKAD BARU
Faisal, SpA Anaemia
(muntah) complicating
pregnancy, childbirth and the
Dr.Adhar Diabetes mellitus
puerperium, Singlenon-
live birth BPJS BARU
Dr. Putri dependen
Fracture ofinsulin
other tanpa
and UMUM LAMA
Maharani komplikasi,
unspecified Tuberkulosis
parts of lumbarParu
lainya and pelvis
spine
Dr. Putri BPJS BARU
Maharani
Dr.Adhar Peptic ulcer, unspecified as UMUM BARU
dr. I Wayan acute or chronic,
Diabetes mellituswithout
non- BPJS LAMA
Sudiharta, SpPD haemorrhageor
dependen insulinperforation
tanpa
komplikasi, Cellulitis,
unspecified, Septicemia,
Dr.Adhar Single spontaneous
Disorders delivery,
of plasma-protein BPJS LAMA
Dr.Adhar unspecified,
Spontaneous abortion, first
metabolism, Prolonged
not elsewhere UMUM BARU
stage (of labour),
classified,
incomplete, Single live
Cardiomegaly
without
Dr.Adhar GASTRITIS,
birth, Premature Urinary tract
rupture of BPJS BARU
complication
infection, siteonset
not specified
Dr.Adhar GASTRITIS,
membranes, Migraine,
of labour UMUM BARU
Dr.Adhar unspecified
within 24 hours and Colitis Of
Gastroenteritis BPJS LAMA
Dr.Adhar Unspecified
Maternal care origin,
due Hipertensi,
to uterine BPJS LAMA
DYSPEPSIA
scar fromrenal
previous surgery,
Dr.Adhar Chronic failure, BPJS LAMA
unspecified, Pepticunspecified,
ulcer,
Dr.Adhar Acute bronchitis,
caesarean BPJS LAMA
unspecifiedsection,
Gastroenteritis as acute
and or Of
Colitis
Dr.Adhar GASTRITIS
Oligohydramnios,
chronic, without Single live BPJS LAMA
Unspecified
birth origin
Dr.Adhar Diabetes mellitus
haemorrhageor non-
perforation, BPJS LAMA
Dr.Adhar dependen
Arthrosis, insulin
rupturetanpa
Prematureunspecified, of Other UMUM BARU
komplikasi,
disorders ofHipertensi,
membranes, lipoprotein Other
Dr.Adhar Calculus of kidney delayed by
disorders
labour BPJS BARU
therapy of lipoprotein
metabolism, Hyperosmolality
Dr.Adhar Hyperplasia
metabolism,
and of prostate
Acute
hypernatraemia hepatitis B BPJS LAMA
Dr.Adhar without
Demamdelta-agent
berdarah dengue and BPJS BARU
without
(DHF) hepatic coma
Dr.Adhar Concussion, Observation for JAKKAD BARU
Dr.Adhar other suspected
Urinary diseases
tract infection, siteand
not BPJS LAMA
conditions, Open wound of
specified
Dr.Adhar Delivery by emergency
unspecified body region BPJS BARU
Dr.Adhar caesarean
Observation section, Single live
for other UMUM BARU
birth
suspected diseases andlainnya
Dr.Adhar Gangguan telinga luar JAKKAD BARU
conditions
Dr.Adhar GASTRITIS BPJS LAMA
Dr.Adhar Maternal care due to uterine BPJS LAMA
Dr.Adhar scar fromtuberkulosis
Sekuele previous surgery, saluran BPJS BARU
Delivery
napas by
lainnyaemergency
dan YTT,
Dr.Adhar Blighted
caesarean ovum and
section, Anaemia BPJS LAMA
Haematemesis
nonhydatidiform mole of head
Dr.Adhar Multiple openpregnancy,
complicating wounds BPJS LAMA
dr. H.Ahmad childbirth and theand
Gastroenteritis puerperium,
Colitis Of JAKKAD LAMA
Faisal, SpA Single live birth,
Unspecified originAntepartum
haemorrhage, unspecified
Dr.Adhar Gastroenteritis and Colitis Of BPJS BARU
Dr.Adhar Unspecified
Pneumonia,origin
unspecified, Left JAKKAD LAMA
dr. H.Ahmad ventricular
Fever, unspecified,Ventricular
failure, Singleton, JAKKAD BARU
Faisal, SpA tachycardia
born outside hospital
Dr.Adhar Gastroenteritis and Colitis Of BPJS LAMA
Dr. Putri Unspecified origin
Chronic kidney disease,stage BPJS LAMA
Maharani 5, Efusi pleura (pleural
effusion), tanpa kode lain,
Dr. St Suwarni Bronchopneumonia,
Pneumonia, unspecified BPJS LAMA
Dr. Putri unspecified
Gastroenteritis and Colitis Of BPJS BARU
Maharani Unspecified origin
Dr. Putri Typhoid fever, GASTRITIS BPJS BARU
Maharani
Dr. St Suwarni Pneumonia, unspecified, UMUM LAMA
Chronic obstructive pulmonary
disease, unspecified, Other
and unspecified symptoms
and signs involving
cognitivefunctions and
awareness
Dr. St Suwarni Urinary tract infection, site not BPJS BARU
Dr. Putri specified
Placenta praevia with BPJS BARU
Maharani haemorrhage, Delivery by
Dr. Putri GASTRITIS
Single live birth BPJS BARU
Maharani
Dr. St Suwarni Gastroenteritis and Colitis Of UMUM BARU
Dr. St Suwarni Unspecified originunspecified UMUM
Urinary calculus, BARU
dr. H.Ahmad Gastroenteritis and Colitis Of JAKKAD BARU
Dr. St Suwarni Single spontaneous delivery, JAMPERSAL BARU
dr. H.Ahmad unspecified,
GastroenteritisProlonged firstOf
and Colitis BPJS BARU
Faisal, SpA stage (of labour),
Unspecified originSingle live
birth
Dr. St Suwarni Urinary calculus, unspecified, BPJS LAMA
Dr. St Suwarni Nutritional anaemia,
Paralytic ileus BPJS BARU
unspecified
Dr. St Suwarni DM dependen insulin dng UMUM BARU
Dr. St Suwarni komplikasi pembuluh
Diabetes mellitus non-darah BPJS LAMA
perifer
dependen (gangren,
insulin ulkus,
dengan
Dr. Endri Wati Observation
angiopati) for other JAKKAD LAMA
M.H komplikasi YTT, Anaemia,
suspected diseases and
unspecified, Hypertensive
conditions, Injury of muscles
Dr. Endri Wati Typhoid
heart
and feverofwith
disease
tendons unspecified UMUM BARU
M.H (congestive)
body region, heart failure
Hipertensi
Dr. Endri Wati GASTRITIS BPJS LAMA
M.H
Dr. Endri Wati Tuberkulosis Paru lainya, BPJS LAMA
M.H Peptic ulcer, unspecified as
acute or chronic, without
Dr. Endri Wati Anaemia complicating
haemorrhageor perforation JAMPERSAL LAMA
M.H pregnancy, childbirth and the
puerperium, Unspecified
Dr. Endri Wati Demam of
infection berdarah
urinary dengue
tract in BPJS LAMA
M.H (DHF)
pregnancy, Tuberculosis
Dr. Endri Wati complicating pregnancy,
Sekuele tuberkulosis saluran BPJS LAMA
M.H childbirth
napas lainnya the
and danpuerperium
YTT
Dr. Endri Wati Injury of muscles and tendons BPJS LAMA
M.H of unspecified body region
Dr. Endri Wati Demam berdarah dengue BPJS LAMA
M.H (DHF), Urinary tract infection,
site not specified
Dr. Endri Wati Venom of other arthropods UMUM LAMA
M.H
Dr. Endri Wati Plasmodium falciparum JAKKAD LAMA
M.H malaria, unspecified, Typhoid
fever
dr. M. Arista Delivery by emergency BPJS BARU
Dr. Endri Wati caesarean
Delivery bysection, Premature
emergency JAMPERSAL LAMA
M.H rupture of membranes,
caesarean section, Premature onset
of labourofafter
rupture 24 hours,onset
membranes,
Dr. Endri Wati ofMaternal
Anaemia care 24
duehours,
complicating
labour after to uterine
Single BPJS LAMA
M.H scar from previous
pregnancy,
live birth surgery,
childbirth and the
Delivery
puerperium, by emergency
Single live birth
Dr. Endri Wati Pneumonia,
caesarean unspecified
section, Prolonged JAKKAD BARU
M.H first stage (of labour), Single
Dr. Endri Wati live
Otherbirth
pneumonia, organism UMUM BARU
M.H unspecified, Gastroenteritis
and Colitis Of Unspecified
Dr. Endri Wati Demam Dengue, Typhoid
origin BPJS LAMA
M.H fever
Dr. Endri Wati Rheumatism, unspecified, JAKKAD LAMA
M.H Somatoform disorder,
unspecified
dr. Nurmiftahul Peptic ulcer, unspecified as JAKKAD LAMA
Islamiyah acute or chronic, without
Dr. St Suwarni GASTROENTERITIS AKUT, BPJS BARU
Gastro-oesophageal reflux
disease without oesophagitis
Dr. Endri Wati Other peripheral vertigo BPJS LAMA
M.H
Dr. Endri Wati Gastroenteritis and Colitis Of UMUM BARU
M.H Unspecified origin
Dr. St Suwarni DM non-dependen insulin dng JAKKAD BARU
Dr. Endri Wati komplikasi
Observation pembuluh
for otherdarah BPJS LAMA
M.H perifer
suspected (gangren,
diseasesulkus,
and
angiopati)
conditions
Dr. St Suwarni Other specified sites BPJS BARU
Dr. St Suwarni Diabetes mellitus non- BPJS LAMA
Dr. St Suwarni dependen
Sirosis hatiinsulin
lainnyadengan
dan YTT, BPJS LAMA
komplikasi
Melaena, multipel
Anaemia,
Dr. Endri Wati Hyperemesis gravidarum with BPJS LAMA
M.H unspecified, Diabetes mellitus
metabolic disturbance,
non-dependen
Diseases of theinsulin dengan
respiratory
Dr. Putri Diabetes
komplikasi
system mellitus non-
YTT, Sekuele
complicating BPJS LAMA
Maharani dependen
tuberkulosis insulin dengan
saluran
pregnancy,childbirth napas
and the
komplikasi
lainnya
puerperium, danmultipel
YTT,
Acute Acute
upper
dr. Muarif Menstruasi
hepatitis ireguler
B without YTT
delta-agent UMUM LAMA
Ramadhan respiratory infection,
and without hepatic coma
unspecified
Dr. Endri Wati Delivery by emergency BPJS BARU
M.H caesarean section, Prolonged
first stage (of labour), Single
Dr. St Suwarni Acute
live birthpharyngitis, UMUM LAMA
Dr. Endri Wati unspecified,
Gastroenteritis Sakit
andkepala
Colitis Of JAKKAD BARU
M.H Unspecified origin,
Pneumonia, unspecified
Dr. St Suwarni Peptic ulcer, unspecified as BPJS BARU
Dr. St Suwarni acute or chronic,
Pneumonia, without +
unspecified, BPJS LAMA
haemorrhageor
Diabetes mellitusperforation
non-
dependen insulin dengan
dr. Wirza Abscess ofginjal,
komplikasi liver, *Nepritis
Glomerular BPJS BARU
Dr. St Suwarni tubulo-interstisial
GASTROENTERITIS
disorders akut,mellitus
in diabetes Other
AKUT, BPJS LAMA
pneumonia,
Unspecified
(E10-E14+ organism
haemorrhoids
with and
commonfourth
unspecified Colitis Of UMUM BARU
without
character
Unspecified complication
.2)origin
dr. H.Ahmad Flatulens dan kondisi terkait JAKKAD BARU
Faisal, SpA
Dr. Arie Marasmus gizi, Ventricular BPJS LAMA
Susilawati septal defect, Nausea (mual)
dan vomitus (muntah), Other
Dr. Arie Gastroenteritis
iron and Colitis Of
deficiency anaemias, BPJS LAMA
Susilawati Unspecified origin,
Epilepsy, unspecified Nausea
(mual) dan vomitus (muntah)
Dr. St Suwarni Typhoid fever, GASTRITIS JAKKAD LAMA
Dr. St Suwarni Hipertensi, Peptic ulcer, BPJS BARU
Dr. St Suwarni unspecified as acute
Acute obstructive or
laryngitis UMUM BARU
chronic,
[croup] without
Dr. St Suwarni Gastro-oesophageal
haemorrhageor reflux
perforation BPJS LAMA
Dr. Sanoko disease
Maternalwithout oesophagitis,
care due to uterine UMUM BARU
Tjandra, SpOg Hepatitis
scar fromBprevious
kronis tanpa delta-
surgery,
agent,
Delivery by emergency not
Sequelae of stroke,
Dr. St Suwarni Demam Dengue
specified
caesarean assection,
haemorrhage
Maternal or JAKKAD LAMA
Dr. St Suwarni infarction,
ACUTE
care Other disorders
APPENDICITIS,
for transverse and of BPJS BARU
lipoprotein
OTHER
oblique AND
lie, metabolism
UNSPECIFIED
Prolonged firstas
Dr. St Suwarni Peptic ulcer, unspecified JAKKAD BARU
stage or
acute (ofchronic,
labour), without
Dr. St Suwarni Nepritis tubulo-interstisial BPJS LAMA
Oligohydramnios,
haemorrhageor Single live
perforation
dr. H.Ahmad akut,
Demam
birth Oedema
Dengue pulmonar, BPJS BARU
Faisal, SpA Hipertensi
Dr. St Suwarni Gastroenteritis and Colitis Of JAKKAD BARU

Malaria YTTorigin BPJS LAMA
Dr. Endri Wati GASTRITIS BPJS LAMA
M.H
dr. Muarif Acute transmural myocardial UMUM BARU
Ramadhan infarction of inferior wall,
Gastroenteritis and Colitis Of
dr. Muarif Severe pre-eclampsia,
Unspecified origin, Other BPJS LAMA
Ramadhan specified diseases
Observation for other and
conditions
suspected complicating
diseases and
conditions and the
puerperi
dr. Nurmiftahul Bronchopneumonia, JAKKAD BARU
Islamiyah unspecified
dr. Muarif Sekuele tuberkulosis saluran JAKKAD LAMA
Ramadhan napas lainnya dan YTT
Dr. St Suwarni Premature rupture of JAKKAD BARU
dr. Nurmiftahul membranes,
GASTRITIS onset of labour JAKKAD BARU
Islamiyah after 24 hours, Delivery by
dr. Nurmiftahul Single spontaneous
Prolonged first stage delivery,
(of JAMPERSAL LAMA
Islamiah unspecified,
labour), AnaemiaProlonged first
complicating
stage (of labour),
pregnancy, Single
childbirth andlive
the
dr. Nurmiftahul Tuberkulosis Paru lainya
birth BPJS LAMA
puerperium, Single live birth
Islamiah
dr. Nurmiftahul Blighted ovum and BPJS LAMA
Islamiah nonhydatidiform mole
dr. Nurmiftahul Hyperemesis gravidarum with BPJS LAMA
Islamiah metabolic disturbance
dr. Muarif GASTRITIS BPJS LAMA
Ramadhan
Dr. Arie Other acute gastritis, Fever, JAKKAD LAMA
Susilawati unspecified
Dr. Arie Hypertensive heart disease UMUM BARU
Susilawati with (congestive) heart failure,
Supraventricular tachycardia
Dr. Arie Hipertensi, Tension-type BPJS LAMA
Susilawati headache, Bronkitis kronis
YTT, Other disorders of
dr. H.Ahmad Acute bronchitis,
lipoprotein unspecified BPJS
metabolism LAMA
Faisal, SpA
Dr. Arie Nausea (mual) dan vomitus JAKKAD LAMA
Susilawati (muntah), Gastroenteritis and
Colitis Of Unspecified origin
Dr. Arie Fracture of femur, part BPJS BARU
Dr. Arie Stroke, tidak dirinci sebagai UMUM BARU
Susilawati perdarahan (hemoragi) atau
infark, Old myocardial
Dr. Arie Single spontaneous delivery,
infarction JAMPERSAL BARU
Susilawati unspecified, Severe pre-
eclampsia, Single live birth
Dr. Arie Delivery by emergency BPJS BARU
Susilawati caesarean section, Prolonged
first stage (of labour), Severe
Dr. Arie Nonopioid analgesic,
pre-eclampsia, Premature BPJS BARU
Susilawati antipyretic and antirheumatic,
rupture of membranes, onset
unspecified,
ofSmall
labour afterConcussion,
24Peptic
hours,ulcer,
Single
Dr. Arie Peptic intestine,
ulcer, acute with BPJS LAMA
Susilawati live birth
chronic or unspecified with
haemorrhage
haemorrhage, Hypoglycaemia,
Dr. Arie Bronchopneumonia,
unspecified BPJS LAMA
Dr. Arie Bronchopneumonia, UMUM BARU
Dr. Arie Diabetes mellitus non- BPJS LAMA
Susilawati dependen insulin dengan
komplikasi multipel,
Dr. Arie Typhoid feverheart disease
Hypertensive BPJS LAMA
Susilawati without (congestive) heart
dr. Nurmiftahul failure
Maternal care for transverse BPJS LAMA
Islamiyah and oblique lie, Delivery by
Dr. Arie Allergiclive
Single and dietetic
birth BPJS LAMA
Susilawati gastroenteritis and colitis
Dr. Arie Injury of muscles and tendons UMUM LAMA
Susilawati of unspecified body region,
Diabetes mellitus YTT tanpa
komplikasi
dr. H.Ahmad Constipation BPJS BARU
Faisal, SpA
Dr. Arie Nasofaringitis akut (common JAKKAD LAMA
Susilawati cold)
Dr. Arie Gastroenteritis and Colitis Of UMUM BARU
Susilawati Unspecified origin
Dr. Arie Maternal care due to uterine BPJS BARU
Susilawati scar from previous surgery,
dr. I Made Skin
caesarean section, Placenta BPJS LAMA
Sumariana, Sp.B praevia with haemorrhage,
Diseases of the digestive
system complicating
Dr. Arie Hyperemesis gravidarum with UMUM LAMA
pregnancy, childbirthand the
Susilawati metabolic disturbance
puerperium, Single live birth
Dr. Arie Concussion, Fracture of UMUM BARU
Susilawati forearm, part unspecified
Dr. Arie Single spontaneous delivery, BPJS BARU
Susilawati unspecified, Maternal care for
intrauterine death, Single live
Dr. St Suwarni Chronic kidney disease,stage
birth JAKKAD BARU
Dr. St Suwarni 5,GASTROENTERITIS
Other disorders of AKUT JAKKAD LAMA
lipoprotein metabolism,
dr. Nurmiftahul Neoplasma
Diabetes jinak non-
mellitus payudara BPJS BARU
Islamiyah dependen insulin tanpa
dr. Rini komplikasi, Hipertensi
Diabetes mellitus non- BPJS BARU
dr. Rini dependen
GASTRITIS insulin dengan BPJS BARU
komplikasi YTT
dr. Rini Stroke, tidak dirinci sebagai BPJS LAMA
dr. Rini perdarahan
Hypertensive (hemoragi)
renal disease atau UMUM LAMA
infark,
with Bradycardia,
renal failure, Anaemia,
dr. Rini Delivery by emergency
unspecified BPJS BARU
unspecified,section,
caesarean GASTRITIS
dr. Rini Gastroenteritis andPremature Colitis Of BPJS LAMA
rupture
Unspecifiedof membranes,
origin onset
dr. Rini ofOligohydramnios,
labour after 24 hours, Delivery by
Single BPJS LAMA
dr. Rini emergency
Asthma,
live caesarean
birth, unspecified,
Prolonged firstsection,
stage BPJS LAMA
Unspecified
Pneumonia,
(of labour) infection
unspecified of urinary
dr. Rini Internal
tract haemorrhoids
in pregnancy, Singlewithout
live JAKKAD BARU
dr. Rini complication,
ACUTE APPENDICITIS, of
birth Hyperplasia BPJS LAMA
prostate AND UNSPECIFIED
OTHER
dr. Rini Polyarthrosis, unspecified, BPJS LAMA
dr. Rini Observation
Bronchopneumonia, for other JAKKAD LAMA
suspected
unspecified, diseases and
Gastroenteritis
dr. Rini Pneumonia, unspecified
conditions JAKKAD LAMA
and Colitis Of Unspecified
dr. Rini Chronic renal failure,
origin UMUM BARU
dr. Rini unspecified,
Urinary tractDemam infection,Dengue
site not UMUM BARU
dr. Rini specified
Tuberkulosis Paru lainya, BPJS BARU
dr. Rini Hipertensi
Single spontaneous delivery, JAMPERSAL BARU
dr. Rini unspecified,
Blighted ovum Prolonged
and first BPJS LAMA
stage (of labour),mole
nonhydatidiform Premature
Dr. St Suwarni Peptic ulcer,
rupture unspecified as
of membranes, BPJS BARU
Dr. Arie acute or
unspecified,chronic,
Demam Dengue, Singlewithout
Bronkitis,
live birth BPJS LAMA
Susilawati haemorrhageor
tidak dirinci sebagai perforation
akut atau
kronis, GASTRITIS
dr. Nurmiftahul Maternal care for breech BPJS BARU
Islamiah presentation, Spontaneous
breech delivery, Moderate pre-
Dr. St Suwarni Maternal care
eclampsia, Single duelive
to uterine
birth BPJS BARU
scar from previous surgery,
caesarean section, Premature
rupture of membranes, onset
of labour after 24 hours, Single
live birth
PASIEN ODC

340238 RS161100178 MUSTARUDIN 11/1/2016 ODC
1
061775 RS161100364 MOH. UDIN SYAH RANI 11/2/2016 ODC
2
611088 RS161100506 BISUKDORUM 11/3/2016 ODC
3
850359 RS161100508 HJ SURYATI 11/3/2016 ODC
4
631068 RS161100641 NURDAHLIA 11/4/2016 ODC
5
641040 RS161100829 M. RAIHAN 11/5/2016 ODC
6
930867 RS161100848 KURNIAWATI 11/6/2016 ODC
7
280813 RS161101608 FARIDAH 11/10/2016 ODC
8
Dokter Diagnosa Cara Byr Tipe Pasien
dr. Injury of eye and orbit, part BPJS LAMA
Nurmiftahul unspecified
Islamiyah
dr. Muarif DYSPEPSIA, Myalgia BPJS LAMA

Ramadhan
Dr. Arie Concussion, Unspecified UMUM BARU
Susilawati injury of abdomen, lower
back and pelvis
Dr. Arie Other peripheral vertigo, UMUM LAMA
Susilawati GASTRITIS
Dr. Sanoko Spontaneous abortion, BPJS BARU
Tjandra, incomplete, without
SpOg complication
Dr. Putri GASTROENTERITIS AKUT UMUM BARU

Maharani
Dr. Putri Concussion, Observation for JAKKAD LAMA
Maharani other suspected diseases
and conditions
Dr. St Neoplasma jinak ovarium UMUM LAMA
Suwarni
PASIEN PULANG
No No. RM No. Registrasi Nama Pasien Tgl Reg. No. Kamar Dokter
960116 RS161100163 Yusuf Rajak 11/1/2016 P Dr. St

1 Suwarni
641027 RS161100165 MUHAMMAD IRFAN 11/1/2016 P Dr. St
2 Suwarni
087583 RS161100167 SAIDAH 11/1/2016 P dr.
Nurmiftahul
Islamiyah
3
068210 RS161100169 IFAID 11/1/2016 P dr.
Nurmiftahul
Islamiyah
4
641023 RS161100170 RANDI PENGGEILA 11/1/2016 P dr.
Nurmiftahul
Islamiyah
5
641014 RS161100176 ABI SAPUTRA 11/1/2016 P dr.
Nurmiftahul
Islamiyah
6
340279 RS161100179 Drs. A. Karim Jamaludin 11/1/2016 P dr.
Nurmiftahul
Islamiah
7
052772 RS161100183 JULIANTI 11/1/2016 P dr.
Nurmiftahul
Islamiah
8
521093 RS161100193 ALWIN MEYLANO PUTRA DIMU 11/2/2016 P dr.
Nurmiftahul
Islamiah
9
910675 RS161100194 ST. SALMAH 11/2/2016 P dr.
Nurmiftahul
Islamiah
10
830187 RS161100195 PRAWIRA WIBAWA PUTRA JAYA 11/2/2016 P dr.
Nurmiftahul
Islamiah
11
641012 RS161100196 Yeni Rahamawati 11/1/2016 P dr.
Nurmiftahul
Islamiah
12
051556 RS161100274 Anuriah 11/2/2016 P dr. I Wayan
Sudiharta,
SpPD
13
631012 RS161100290 MISBAHYANI ROSYID 11/2/2016 P Dr. St
14 Suwarni
500301 RS161100345 LESTARI 11/2/2016 P Dr. St
15 Suwarni
480174 RS161100346 KISMAN,S.PdI 11/2/2016 P Dr. St
16 Suwarni
520657 RS161100348 ERLINDA SASMITA 11/1/2016 P dr.
Nurmiftahul
Islamiyah
17
850075 RS161100351 ST. AISAH SAHARI 11/2/2016 P Dr. Endri Wati
18 M.H
601034 RS161100353 LUKMAN 11/2/2016 P Dr. St
19 Suwarni
920226 RS161100369 ABDUL MUNAWAR 11/2/2016 P dr. Muarif
20 Ramadhan
470151 RS161100370 ROSYIDAH, A.MA 11/2/2016 P dr. Muarif
21 Ramadhan
600211 RS161100373 IIN NURJAIN 11/2/2016 P dr. Muarif
22 Ramadhan
660535 RS161100382 HERIANTO 11/3/2016 P dr. Muarif
23 Ramadhan
631048 RS161100423 YANTI 11/3/2016 P Dr. St
24 Suwarni
561032 RS161100429 AGANI 11/3/2016 P dr. Muarif
25 Ramadhan
001026 RS161100478 YUSUF MAULANA 11/3/2016 P Dr. St
26 Suwarni
078289 RS161100487 KHARSANIN, SE 11/3/2016 P Dr. St
27 Suwarni
080607 RS161100490 AROS ARISTA DIANANDRA 11/3/2016 P Dr. Arie
28 Susilawati
170112 RS161100491 SUHARDIN H. A. RAHMAN 11/3/2016 P Dr. Arie
29 Susilawati
611092 RS161100497 JUNAIDIN 11/3/2016 P Dr. Arie
30 Susilawati
611091 RS161100498 ABDUL LATIF 11/3/2016 P Dr. Arie
31 Susilawati
180291 RS161100504 ABDUL GAFAR 11/3/2016 P Dr. Arie
32 Susilawati
920667 RS161100564 NURYADIN 11/3/2016 P dr. Muarif
33 Ramadhan
930921 RS161100614 MOH RIDHO 11/4/2016 P Dr. St
34 Suwarni
081048 RS161100639 DRA. SRI HARTATI M. YAKUB 11/4/2016 P dr.
Nurmiftahul
Islamiyah
35
910675 RS161100648 ST. SALMAH 11/4/2016 P dr.
Nurmiftahul
Islamiah
36
611040 RS161100649 RAFKAH SYAKIR 11/4/2016 P dr.
Nurmiftahul
Islamiah
37
38 700510 RS161100650 DEWI SARTIKA 11/4/2016 dr. Rini
39 990014 RS161100652 M. Ario Faturahman 11/4/2016 P dr. Rini
40 072435 RS161100653 ASPRIYANTI 11/4/2016 P dr. Rini
41 073403 RS161100654 AYIB HUSNUL HUDA 11/4/2016 P dr. Rini
42 611043 RS161100655 ABDURRAHMAN 11/4/2016 P dr. Rini
43 660800 RS161100666 MUHAMMAD DUDE 11/4/2016 P dr. Rini
44 065776 RS161100671 Nurhidayah 11/4/2016 P dr. Rini
45 631056 RS161100674 M. GUNAWAN 11/4/2016 P dr. Rini
46 690386 RS161100676 MUH. FITRAH UDDIN 11/4/2016 P dr. Rini
47 079458 RS161100686 TAQWA 11/3/2016 P dr. Rini
48 611085 RS161100687 MUCHAMAD ANDI PRASETIO 11/4/2016 P dr. Rini
600796 RS161100773 LINDA NINGSIH 11/5/2016 P Dr. Putri
49 Maharani
100524 RS161100811 UTARI RAHMAWATI 11/5/2016 P Dr. St
50 Suwarni
072597 RS161100815 SYAMSU 11/5/2016 P Dr. St
51 Suwarni
641038 RS161100831 NADIYATUL HANIFAH 11/5/2016 P Dr. Putri
52 Maharani
540909 RS161100836 ST. KHAIRUNISYA 11/5/2016 P Dr. Putri
53 Maharani
066254 RS161100837 LENA SUSILAWATI 11/5/2016 P Dr. Putri
54 Maharani
059640 RS161100841 H. ARAHMAN ALI 11/5/2016 P Dr. Putri
55 Maharani
270989 RS161100842 SYAHRUL RIZAL 11/6/2016 P Dr. Putri
56 Maharani
390034 RS161100844 SYAFRUDIN 11/6/2016 P Dr. Putri
57 Maharani
470686 RS161100853 MUHAMAD HIZBATUL AMAR 11/5/2016 P Dr. Putri
58 Maharani
120396 RS161100854 ABID IZZAT FAJRABY 11/5/2016 P Dr. St
59 Suwarni
60 300690 RS161100855 MUHAMMAD ALDO JAINUDIN 11/6/2016 P Dr.Adhar
61 078197 RS161100860 SUHARTINI 11/6/2016 P Dr.Adhar
62 370912 RS161100870 SABRINA 11/6/2016 P Dr.Adhar
611077 RS161100871 SUMARNI 11/5/2016 P Dr. Putri
63 Maharani
64 065692 RS161100880 Zulkarnain H. Jamaluddin 11/6/2016 P Dr.Adhar
65 056861 RS161100882 HADIJAH ANWAR 11/6/2016 P Dr.Adhar
66 270743 RS161100883 NURHAYATI 11/6/2016 P Dr.Adhar
67 920226 RS161100885 ABDUL MUNAWAR 11/6/2016 P Dr.Adhar
68 631093 RS161100886 RADIATUL AL 11/6/2016 P Dr.Adhar
69 900583 RS161100887 SALMAH YASIN 11/6/2016 P Dr.Adhar
70 230257 RS161100895 BURHANUDIN 11/7/2016 P Dr.Adhar
71 410004 RS161100897 SRI RAHMAWATI 11/7/2016 P Dr.Adhar
089018 RS161100912 Suciyani Syamsidar S.Kep 11/7/2016 P Dr. St
72 Suwarni
641043 RS161101002 VIRGINIA EKA MAHESA 11/5/2016 P Dr. Putri
73 Maharani
420665 RS161101069 HALIMAH 11/7/2016 P Dr. St
74 Suwarni
510111 RS161101070 ASYUWANTO FITRAH 11/7/2016 P Dr. St
75 Suwarni
641091 RS161101080 M. ALGIFARI 11/7/2016 P Dr. Endri Wati
76 M.H
550988 RS161101081 MUHAMMAD ZIDAN MARASTA 11/7/2016 P Dr. Endri Wati
77 M.H
180291 RS161101084 ABDUL GAFAR 11/7/2016 P Dr. Endri Wati
78 M.H
350804 RS161101085 MURDIONO 11/7/2016 P Dr. Endri Wati
79 M.H
351079 RS161101088 MUHAMAD SYAIFULLAH 11/7/2016 P Dr. Endri Wati
80 M.H
990162 RS161101090 SUKRIN 11/7/2016 P Dr. Endri Wati
81 M.H
641088 RS161101091 ERFINA 11/7/2016 P Dr. Endri Wati
82 M.H
680644 RS161101238 SUBARI NURDIN 11/7/2016 P Dr. Endri Wati
83 M.H
641072 RS161101241 HASINAH 11/8/2016 P Dr. St
84 Suwarni
090944 RS161101246 BAGAS FIRGO HANDOKO 11/8/2016 P Dr. St
85 Suwarni
400774 RS161101251 SYAHRINI 11/8/2016 P Dr. Arie
86 Susilawati
070625 RS161101252 Ahmad A. Bakar 11/8/2016 P Dr. Arie
87 Susilawati
641074 RS161101253 SRI MERYATI 11/8/2016 P Dr. St
88 Suwarni
641069 RS161101257 ILIAS EMAN 11/8/2016 P Dr. St
89 Suwarni
90 580486 RS161101260 IMADUDDIN 11/8/2016 P dr. Rini
810147 RS161101261 SUHARSONO, DRS 11/8/2016 P Dr. St
91 Suwarni
910675 RS161101264 ST. SALMAH 11/8/2016 P Dr. St
92 Suwarni
052963 RS161101291 MOH. DIAULAKBAR, ST 11/9/2016 P Dr. St
93 Suwarni
641067 RS161101318 MUKIS 11/8/2016 P Dr. St
94 Suwarni
410525 RS161101330 FATIMAH 11/9/2016 P dr.
Nurmiftahul
Islamiyah
95
530400 RS161101361 HUSNUL FAHMI ALAZIZI 11/9/2016 P dr.
Nurmiftahul
Islamiyah
96
321077 RS161101383 UMRAN 11/9/2016 P Dr. St
97 Suwarni
630830 RS161101416 SRI RAHAYU 11/9/2016 P Dr. Arie
98 Susilawati
710103 RS161101435 WIRDA NAFISATUL FITRI 11/10/2016 P Dr. Arie
99 Susilawati
340279 RS161101438 Drs. A. Karim Jamaludin 11/10/2016 P Dr. Arie
100 Susilawati
960278 RS161101441 VATDYLAH PUTRI NAYLI 11/10/2016 P Dr. Arie
101 Susilawati
590682 RS161101444 HANUM TUNGGA DEWI 11/10/2016 P Dr. Arie
102 Susilawati
076574 RS161101446 ESA AGEl 11/9/2016 P Dr. Arie
103 Susilawati
060168 RS161101505 AMNAH ARSYAD 11/10/2016 P Dr. Arie
104 Susilawati
410525 RS161101509 FATIMAH 11/10/2016 P Dr. Arie
105 Susilawati
661030 RS161101555 BAHRUDIN 11/10/2016 P Dr. St
106 Suwarni
072595 RS161101559 SITI NURBAYA 11/10/2016 P Dr. St
107 Suwarni
680632 RS161101560 H. IMAM PRIYATNO 11/10/2016 P Dr. St
108 Suwarni
109 052204 RS161101563 SITTI AISYAH, SAODAH 11/10/2016 P dr. Rini
110 900718 RS161101567 MAMAN SURIAMAN 11/10/2016 P dr. Rini
111 661033 RS161101568 ST. NUR 11/10/2016 P dr. Rini
112 441043 RS161101569 MELI DIAWATI 11/10/2016 P dr. Rini
113 800246 RS161101571 NURSAH 11/10/2016 P dr. Rini
114 990975 RS161101576 MAMAN 11/10/2016 P dr. Rini
115 150723 RS161101577 ALFIAN SETIADIN 11/10/2016 P dr. Rini
116 770584 RS161101587 FIRMANSYAH 11/10/2016 P dr. Rini
117 840673 RS161101591 KURNIAWAN 11/10/2016 P dr. Rini
118 661053 RS161101595 NUR ARIFIN 11/10/2016 P dr. Rini
990209 RS161101809 ABDUL KHAIR,S.SOS 11/8/2016 P Dr. Endri Wati
119 M.H
120302 RS161101810 SITI SALIHAH 11/8/2016 P Dr. St
120 Suwarni
661084 RS161101816 NURMI 11/5/2016 P Dr. St
121 Suwarni
661050 RS161101991 JUNGGIA 11/9/2016 P Dr. St
122 Suwarni
661047 RS161101992 MUH RAF SANJANI 11/9/2016 P Dr. Endri Wati
123 M.H
910675 RS161101993 ST. SALMAH 11/7/2016 P Dr. Endri Wati
124 M.H
920922 RS161101994 BILAL 11/8/2016 P Dr. St
125 Suwarni
480186 RS161101995 ROSDIANA YUSRAN 11/8/2016 P Dr. St
126 Suwarni
910339 RS161102193 M.RAHMATUL AGUS 11/10/2016 P Dr. Endri Wati
127 M.H
600909 RS161102728 RAHMAWATI 11/9/2016 P dr.
Nurmiftahul
Islamiyah
128
661059 RS161102913 USMAN 11/7/2016 P dr.
Nurmiftahul
Islamiyah
129
068451 RS161104818 M. YASIN SIDIK 11/4/2016 P Dr. St
130 Suwarni
501019 RS161104821 A. AZIS 11/7/2016 P Dr. St
131 Suwarni
054286 RS161104822 Abdul sahid 11/7/2016 P Dr. Endri Wati
132 M.H
651026 RS161104824 HAWSAH IBRAHIM 11/3/2016 P Dr. Fitratul
133 Ramadhan
840921 RS161104825 ST HALIMAH 11/6/2016 P Dr. Fitratul
134 Ramadhan
841030 RS161104832 M. FAJRIN 11/5/2016 P Dr. St
135 Suwarni
841066 RS161104835 AMIN 11/5/2016 P Dr. Fitratul
136 Ramadhan
821031 RS161104837 SYAFIQ HUSNULHUDA 11/8/2016 P Dr. Fitratul
137 Ramadhan
065776 RS161104838 Nurhidayah 11/8/2016 P Dr. St
138 Suwarni
450484 RS161104839 HERU ISWANDI 11/7/2016 P Dr. Endri Wati
139 M.H
661007 RS161104840 IRWANSYAH 11/9/2016 P Dr. Arie
140 Susilawati
470170 RS161104841 Dr. SITI SUWARNI 11/5/2016 P Dr. St
141 Suwarni
860937 RS161104842 NURWAHIDAH 11/7/2016 P Dr. St
142 Suwarni
143 871048 RS161104850 Eka Romantis 11/7/2016 P Dr.Adhar
Diagnosa Cara Byr Tipe Pasien
LAMA
GASTRITIS, Hipertensi, BPJS LAMA
Acute gingivitis
Open wound of unspecified UMUM BARU
body region
Other acute gastritis, Fever, BPJS LAMA
unspecified
Crushing injury and BPJS LAMA

traumatic amputation of
unspecified body region
Prepusium berlebihan, BPJS BARU

pimosis dan parapimosis
UMUM BARU
Nausea (mual) dan vomitus BPJS LAMA

(muntah), Hipertensi
Benda asing (corpus BPJS BARU

alienum) pada telinga
Asthma, unspecified JAKKAD LAMA
Other and unspecified BPJS LAMA

abdominal pain
Asthma, unspecified BPJS BARU
UMUM LAMA
JAKKAD LAMA
Observation for other BPJS LAMA

conditions
GASTROENTERITIS AKUT BPJS LAMA
Acute bronchiolitis, BPJS LAMA
unspecified
Fracture of other and BPJS LAMA

unspecified parts of wrist and
hand

conditions
Halogenated insecticides UMUM BARU
Other acute gastritis JAKKAD LAMA
Other acute gastritis, BPJS BARU

Gastro-oesophageal reflux
Asthma, unspecified, BPJS LAMA
Hipertensi
GASTROENTERITIS AKUT JAKKAD LAMA
Otitis externa, unspecified BPJS LAMA

conditions
Other acute gastritis BPJS LAMA
Chronic maxillary sinusitis BPJS BARU
Other acute gastritis BPJS BARU
BPJS LAMA
GASTRITIS, Hipertensi BPJS LAMA
Pneumonia, unspecified JAKKAD LAMA

abdominal pain, Hipertensi
Open wound of head, part BPJS BARU

unspecified
Maternal care due to uterine BPJS LAMA

scar
Acutefrom previous
upper surgery,
respiratory BPJS LAMA
Delivery
infection, by emergency
unspecified
Acute upper
caesarean respiratory
section, Single BPJS LAMA
infection,
Acute
live unspecified
birthupper respiratory BPJS LAMA
infection, unspecified
Injury of muscles and UMUM BARU
tendons
Asthma,ofunspecified
unspecified body JAKKAD LAMA
region
suspected
Open wound diseases
of otherand
parts
BPJS BARU
conditions
ofOpen
foot wound of other parts BPJS LAMA
of foot BPJS BARU
Open wound of other parts BPJS LAMA
ofDysmenorrhoea,
foot unspecified BPJS LAMA

of foot
of foot
Typhoid fever BPJS LAMA

conditions
Gastro-oesophageal reflux BPJS LAMA
Nausea (mual) dan vomitus JAKKAD LAMA
(muntah)
Petroleum products JAKKAD LAMA
Conjunctivitis, unspecified BPJS LAMA
Open wound of head, part BPJS LAMA

unspecified
Cutaneous abscess, JAKKAD BARU
furuncle and carbuncle of
limb
Acute pharyngitis, BPJS LAMA
unspecified,
Tension-typeTidak enak
headache BPJS LAMA
badan (malaise) dan letih
Asthma, unspecified,
(fatigue) BPJS LAMA
DYSPEPSIA
Open wound of toe(s) JAKKAD BARU
without
Asthma,damage to nail
unspecified JAKKAD LAMA
Anxiety disorder, BPJS LAMA
unspecified
GASTRITIS BPJS LAMA
Demam Dengue BPJS BARU
Asthma, unspecified, Other JAKKAD LAMA

acute gastritis
Disorders of initiating and BPJS LAMA
maintaining sleep
[insomnias]
Asthma, unspecified, Acute UMUM BARU
unspecified
Open wound of head, part JAKKAD LAMA

unspecified
Muscle strain BPJS LAMA
Hipertensi, Myalgia BPJS LAMA
JAKKAD BARU
Multiple open wounds of UMUM BARU

head
GASTROENTERITIS AKUT JAKKAD LAMA
Other acute gastritis JAKKAD LAMA
Other acute gastritis, BPJS LAMA

Hipertensi
body region, Concussion
Foreign body on external UMUM BARU
eye, part unspecified
Fever, unspecified, Peptic BPJS LAMA
ulcer, unspecified
Asthma, as acute or BPJS
unspecified LAMA
chronic, without
Acute bronchitis, unspecified BPJS LAMA
Open wound of wrist and UMUM BARU

hand part, part unspecified
Nausea (mual) dan vomitus JAKKAD LAMA

(muntah), Bronkitis, tidak
dirinci sebagai akut atau
kronis
Gastro-oesophageal reflux JAKKAD LAMA
Hipertensi, Open wound of JAKKAD LAMA
wrist and hand part, part
unspecified
of foot
Hipertensi, Other peripheral BPJS LAMA
vertigo
GASTROENTERITIS AKUT, BPJS LAMA

Other acute gastritis
Asthma, unspecified, Acute BPJS LAMA
unspecified
Foreign body in other and UMUM BARU

multiple parts of external eye
Open wound of other parts BPJS BARU

of foot
Benda asing (corpus BPJS LAMA
alienum) padagastritis
Other acute telinga BPJS BARU
Fever, unspecified BPJS LAMA
Hipertensi, Observation for BPJS LAMA
other suspected diseases
DYSPEPSIA UMUM LAMA
and conditions
Open wound of finger(s) BPJS LAMA
without damage to nail
Fever, unspecified UMUM BARU
Injury of muscles and UMUM LAMA
tendons of unspecified
Open wounds involvingbody UMUM BARU
region
other combinations of body
Hyperplasia of prostate BPJS LAMA
regions, Injury of muscles
and tendons of unspecified
Conjunctivitis,
body region unspecified, BPJS LAMA
Other acute gastritis, Myalgia
Injury of muscles and UMUM BARU
tendons of unspecified body
region
body region
Other and unspecified UMUM BARU
abdominal pain
BPJS LAMA
GASTRITIS BPJS LAMA
Fever, unspecified, Tidak BPJS LAMA

enak badan (malaise) dan
letih (fatigue)
Epistaxis BPJS LAMA
BPJS LAMA
Concussion BPJS LAMA
BPJS LAMA
BPJS LAMA
Tension-type headache, JAKKAD LAMA

Hipertensi
Open wound of head, part BPJS BARU
unspecified
UMUM BARU
Nasofaringitis akut (common BPJS BARU

cold)
BPJS LAMA
Urticaria, unspecified BPJS LAMA
Open wound of wrist and BPJS LAMA

hand part, part unspecified
abdominal pain

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INSTALASI GAWAT DARURAT

2 631022 RS161100006 SAMA AS 11/1/2016 Z. DALAM 14A

3 072256 RS161100007 Bambang Supryadi 11/1/2016 V. A Cempaka

4 520870 RS161100047 MIFTAHUL ANAM 11/1/2016 V.A

5 490401 RS161100081 SUHARTI 11/1/2016 KBR 3B.7

6 051994 RS161100098 SITI MISBAH 11/1/2016 V.A

7 075735 RS161100104 Misbah M. Nor H. Jafar 11/1/2016 V. B. Seroja

8 631020 RS161100111 JUBAIDAH 11/1/2016 KBR EXTRA 3C.4

9 960466 RS161100115 11/1/2016 KBR EXTRA 3C.2

10 820988 RS161100126 IFFAHTUNISA AYENDA 11/1/2016 Z. ANAK III A5

11 631000 RS161100132 NYOMAN SULATRI 11/1/2016 Z. DALAM 09

12 501097 RS161100139 MANSYUR 11/1/2016 Z. DALAM 13C

14 410200 RS161100162 WINDARTI 11/1/2016 Z. DALAM 02

15 960116 RS161100163 Yusuf Rajak 11/1/2016 P

16 990510 RS161100164 ST. MARIAM YAKUB 11/1/2016 Z. Bdh 3b1

17 641027 RS161100165 MUHAMMAD IRFAN 11/1/2016 P

18 641026 RS161100166 YUDIANSYAH 11/1/2016 Z. DALAM 13C

19 087583 RS161100167 SAIDAH 11/1/2016 P

20 068210 RS161100169 IFAID 11/1/2016 P

21 641023 RS161100170 RANDI PENGGEILA 11/1/2016 P

22 641022 RS161100172 UDWAN 11/1/2016 Z. DALAM 13E

23 641024 RS161100173 FATIMAH 11/1/2016 Z. DALAM 15B

24 088605 RS161100174 SITI MASDAH 11/1/2016 Z. DALAM 06

25 641014 RS161100176 ABI SAPUTRA 11/1/2016 P

26 058095 RS161100177 MARDIANA 11/1/2016 KBR

27 340238 RS161100178 MUSTARUDIN 11/1/2016 ODC

28 340279 RS161100179 Drs. A. Karim Jamaludin 11/1/2016 P

29 078385 RS161100180 SITI MARJO 11/1/2016 Z. DALAM 09

30 810409 RS161100181 HARTATI 11/1/2016 Z. Bdh 3a4

31 052772 RS161100183 JULIANTI 11/1/2016 P

32 870354 RS161100184 Abdul Azis 11/1/2016 VIP. A II

34 641017 RS161100186 NANDA MARDIAH 11/1/2016 Z. DALAM 15F

35 641018 RS161100187 FANNY 11/1/2016 Z. DALAM 13E

36 641011 RS161100190 syafruddin 11/2/2016 V. B. Bongenvil

37 350230 RS161100191 Bahtiar 11/2/2016 VIP.B II

38 340279 RS161100192 Drs. A. Karim Jamaludin 11/2/2016 VIP. A V kls1

39 521093 RS161100193 ALWIN MEYLANO PUTRA DIMU 11/2/2016 P

40 910675 RS161100194 ST. SALMAH 11/2/2016 P

41 830187 RS161100195 PRAWIRA WIBAWA PUTRA JAYA 11/2/2016 P

42 641012 RS161100196 Yeni Rahamawati 11/1/2016 P

43 641013 RS161100197 M. IZZUL ISLAM 11/2/2016 Z. ANAK III A2

44 631014 RS161100198 Hj. NURBAYA 11/2/2016 Z. DALAM CADANGAN 8

45 631012 RS161100200 MISBAHYANI ROSYID 11/2/2016 Z. Bdh 3a4

46 641009 RS161100210 SUKRIN 11/2/2016 Z. DALAM 12E

47 470814 RS161100218 Muhamad Aslam 11/2/2016 Z. ANAK (HELLO KITTY)

48 700010 RS161100225 MUHTAR AHMAD 11/2/2016 Z.DLM

49 561030 RS161100226 SYAMSI MUHTAR 11/2/2016 Z.DLM

50 950755 RS161100248 RAODAH 11/2/2016 KBR EXTRA II A

51 089107 RS161100269 HADIJAH H. BASALI 11/2/2016 V. B. Kemuning

52 051556 RS161100274 Anuriah 11/2/2016 P

53 280289 RS161100280 SALMAH 11/2/2016 V. A Mawar

54 641010 RS161100282 ADNAN 11/2/2016 Z. DALAM ISOLASI 3

56 631031 RS161100304 IRMA HANDAYANI 11/2/2016 KBR EXTRA 3C.7

57 631032 RS161100312 NUNUNG 11/2/2016 KBR. Anggur 1

58 930117 RS161100317 Reni Kurniati 11/2/2016 V. A Bonsai

59 631034 RS161100332 LESTI KURNIATI 11/2/2016 Z. ANAK III A2

60 631035 RS161100335 H. MANSYUR 11/2/2016 Z. DALAM 06B

61 631036 RS161100344 MUKMIN 11/2/2016 KBR. Anggur 3

62 500301 RS161100345 LESTARI 11/2/2016 P

63 480174 RS161100346 KISMAN,S.PdI 11/2/2016 P

64 800716 RS161100347 SRI WAHYUNI WULANDARI 11/2/2016 KBR 3B.5