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DAFTAR KUNJUNGAN PESERTA SAKIT

Kantor Cabang : SAMARINDA - 1601

FKTP : SEGIRI - 16010205

NO TANGGAL NO KUNJUNGAN NO KARTU NAMA PESERTA SEX JENIS PESERTA DIAGNOSA DIRUJUK

1 29-09-2018 160102050918Y001286 0000120281398 SjAMSUL HADI L PENERIMA PENSIUN Glaucoma, unspecified Rujuk Lanjut
PNS
2 29-09-2018 160102050918Y001308 0000120571154 ARBAINAH P PENERIMA PENSIUN Superficial injury of lower Berobat Jalan
PNS leg, unspecified
3 29-09-2018 160102050918Y001312 0000120614444 PAYAMAN SINAMBELA, DRS L PENERIMA PENSIUN Vertigo of central origin Berobat Jalan
PNS
4 29-09-2018 160102050918Y001307 0000120655743 Mery Diana SIMANUNGKALIT P PENERIMA PENSIUN Surgical follow-up care, Berobat Jalan
PNS unspecified
5 29-09-2018 160102050918Y001284 0000120668049 MUHAMMAD ANDRIANUR L PENERIMA PENSIUN Acute nasopharyngitis Berobat Jalan
SAPUTRA PNS [common cold]
6 29-09-2018 160102050918Y001316 0000120686848 MUKANI L PENERIMA PENSIUN Essential (primary) Berobat Jalan
PNS hypertension
7 29-09-2018 160102050918Y001302 0000120686859 ANI HAIRIAH P PENERIMA PENSIUN Essential (primary) Berobat Jalan
PNS hypertension
8 29-09-2018 160102050918Y001301 0000120841288 WIDYA EKA AGUSTINA WULAN P PNS DAERAH Impacted cerumen Berobat Jalan

9 29-09-2018 160102050918Y001289 0000121098464 ACHMAD BASRUN L PENERIMA PENSIUN Chronic ischaemic heart Rujuk Lanjut
PNS disease, unspecified
10 29-09-2018 160102050918Y001299 0000123030505 NOOR FATHONI L PNS DAERAH Viral warts Rujuk Lanjut

11 29-09-2018 160102050918Y001288 0000123118828 HUMAIRA PERMATA P PNS DAERAH Pulpitis Rujuk Lanjut

12 29-09-2018 160102050918Y001282 0000123257485 M.YELIANA P PNS DAERAH Essential (primary) Rujuk Lanjut
hypertension
13 29-09-2018 160102050918Y001297 0000123680878 HALIPAH P PNS DAERAH Low back pain Rujuk Lanjut

14 29-09-2018 160102050918Y001300 0000123688991 ANISA PURNAMA P PNS DAERAH Pulpitis Rujuk Lanjut

15 29-09-2018 160102050918Y001325 0000123726341 TUKIMIN L PNS DAERAH Non-insulin-dependent Berobat Jalan


diabetes mellitus without

16 29-09-2018 160102050918Y001311 0000165586206 DEMSI SIREGAR P PNS PUSAT Essential (primary) Berobat Jalan
hypertension
17 29-09-2018 160102050918Y001276 0000166051495 PALAS TUMPAL DOLY LUMBAN L PNS DAERAH Disorders of refraction and Rujuk Lanjut
TOBING accommodation
18 29-09-2018 160102050918Y001292 0000174098193 KURNIAH P PNS DAERAH Conjunctivitis, unspecified Berobat Jalan

19 29-09-2018 160102050918Y001294 0000900598544 FITRI RIYANTI P PBI (APBN) Acute nasopharyngitis Berobat Jalan
[common cold]
20 29-09-2018 160102050918Y001303 0000902019251 GALANG L PBI (APBN) Cutaneous mycobacterial Berobat Jalan
infection
21 29-09-2018 160102050918Y001281 0000902131356 ANDI MISDAR L PBI (APBN) Schizophrenia, unspecified Rujuk Lanjut
DAFTAR KUNJUNGAN PESERTA SAKIT

Kantor Cabang : SAMARINDA - 1601

FKTP : SEGIRI - 16010205

22 29-09-2018 160102050918Y001310 0000902531305 MANSYAH L PBI (APBN) Pain localized to other Berobat Jalan
parts of lower abdomen
23 29-09-2018 160102050918Y001291 0000902738351 AINI ASTUTI P PBI (APBN) Cervical root disorders, not Rujuk Lanjut
elsewhere classified
24 29-09-2018 160102050918Y001280 0000903544558 NIAM ZAINUR ROMADHON L PBI (APBN) Epilepsy Rujuk Lanjut

25 29-09-2018 160102050918Y001319 0000903941818 DARIYAH P PBI (APBN) Dyspepsia Berobat Jalan

26 29-09-2018 160102050918Y001320 0000903943383 AZIZAH NOR OCTAVIA P PBI (APBN) General examination and Berobat Jalan
investigation of persons
without complaint and

27 29-09-2018 160102050918Y001318 0001066473685 SITI NOVIA SARI P PBI (APBN) Dyspepsia Berobat Jalan

28 29-09-2018 160102050918Y001313 0001066478578 DAHLIANA P PBI (APBN) Cystitis, unspecified Berobat Jalan

29 29-09-2018 160102050918Y001322 0001066479873 NURDIN BARUS L PBI (APBN) Allergic contact dermatitis, Berobat Jalan
unspecified cause

30 29-09-2018 160102050918Y001277 0001066479884 RIATUN P PBI (APBN) Essential (primary) Berobat Jalan
hypertension
31 29-09-2018 160102050918Y001298 0001323588936 fatmawati P PNS DAERAH Disorders of refraction and Rujuk Lanjut
accommodation
32 29-09-2018 160102050918Y001287 0001382175246 A. SYAFI'I L PEKERJA MANDIRI Gastritis, unspecified Berobat Jalan

33 29-09-2018 160102050918Y001328 0001445400821 ABDUL MANAF L PEKERJA MANDIRI Chronic ischaemic heart Berobat Jalan
disease, unspecified
34 29-09-2018 160102050918Y001315 0001666630247 SYAIFUL HAYADI L PEGAWAI BUMN Cellulitis, unspecified Berobat Jalan

35 29-09-2018 160102050918Y001323 0001706141272 MUKHAMAD YUNUS L PEGAWAI SWASTA Dental caries, unspecified Rujuk Lanjut

36 29-09-2018 160102050918Y001314 0001851493735 diana kartikawati P PNS PUSAT Other and unspecified Berobat Jalan
abdominal pain
37 29-09-2018 160102050918Y001305 0001877096586 RAKHA FATHAN ATALLAH L PNS DAERAH Allergic contact dermatitis, Berobat Jalan
unspecified cause

38 29-09-2018 160102050918Y001279 0001925212994 USMAN L PBI (APBD) Chronic ischaemic heart Berobat Jalan
disease, unspecified
39 29-09-2018 160102050918Y001296 0001925232568 DINDA AZZAHRA P PBI (APBD) Acute tonsillitis, Berobat Jalan
unspecified
40 29-09-2018 160102050918Y001295 0001928652939 SAMIRAN L PBI (APBD) Cataract, unspecified Rujuk Lanjut

41 29-09-2018 160102050918Y001306 0001929263962 SITI YULAINAH P PBI (APBD) Hyperlipidaemia, Berobat Jalan
unspecified
42 29-09-2018 160102050918Y001278 0001929264129 SANIAH P PBI (APBD) Senile cataract, Rujuk Lanjut
unspecified
DAFTAR KUNJUNGAN PESERTA SAKIT

Kantor Cabang : SAMARINDA - 1601

FKTP : SEGIRI - 16010205

43 29-09-2018 160102050918Y001285 0002039632391 fitriah P PNS PUSAT Asthma Berobat Jalan

44 29-09-2018 160102050918Y001326 0002060451191 SAMSIAH P PEKERJA MANDIRI Non-insulin-dependent Berobat Jalan


diabetes mellitus without

45 29-09-2018 160102050918Y001324 0002073949255 MUJIATEN P PEKERJA MANDIRI Essential (primary) Berobat Jalan
hypertension
46 29-09-2018 160102050918Y001290 0002092377993 YULIANA PALIN P PEKERJA MANDIRI Blighted ovum and Rujuk Lanjut
nonhydatidiform mole
47 29-09-2018 160102050918Y001283 0002213496966 SHELA NOVIANI NUR AZIZAH P PEKERJA MANDIRI Cutaneous mycobacterial Berobat Jalan
infection
48 29-09-2018 160102050918Y001321 0002245028613 ANDI AZIS L PEKERJA MANDIRI Non-insulin-dependent Berobat Jalan
diabetes mellitus without

49 29-09-2018 160102050918Y001327 0002262899698 DUDY RAHMAN L PEKERJA MANDIRI Essential (primary) Berobat Jalan
hypertension
50 29-09-2018 160102050918Y001317 0002279199633 SRI SUPARMIATI P PEKERJA MANDIRI Essential (primary) Berobat Jalan
hypertension
51 29-09-2018 160102050918Y001293 0002309323206 SIRAMIATI P PEKERJA MANDIRI Chronic gingivitis Rujuk Lanjut

52 29-09-2018 160102050918Y001309 0002322632553 HASANAH P PEKERJA MANDIRI Surgical follow-up care, Berobat Jalan
unspecified
53 29-09-2018 160102050918Y001304 0002438745974 MUHAMMAD AL-FATIH L PEKERJA MANDIRI Acute nasopharyngitis Berobat Jalan
[common cold]
54 28-09-2018 160102050918Y001268 0000120013132 SALAFUDDIN S.PD L PNS DAERAH Acute pharyngitis, Berobat Jalan
unspecified
55 28-09-2018 160102050918Y001264 0000120042595 JAMIRAH P PNS DAERAH Other chest pain Berobat Jalan

56 28-09-2018 160102050918Y001227 0000120528314 BAHARUDDIN L PEGAWAI SWASTA Other disorders of urinary Rujuk Lanjut
system
57 28-09-2018 160102050918Y001245 0000120549317 MAS`UD L PNS DAERAH Myalgia Berobat Jalan

58 28-09-2018 160102050918Y001232 0000120636213 ARIAH P PENERIMA PENSIUN Non-insulin-dependent Berobat Jalan


PNS diabetes mellitus without

59 28-09-2018 160102050918Y001228 0000120652907 THAMRIN RAHMAN L PENERIMA PENSIUN Non-insulin-dependent Berobat Jalan
PNS diabetes mellitus without

60 28-09-2018 160102050918Y001249 0000120670323 NUKMAN.SJ, DRS L PENERIMA PENSIUN Headache Berobat Jalan
PNS
61 28-09-2018 160102050918Y001242 0000120684971 H. MUSTAFA L PENERIMA PENSIUN TNI Hyperplasia of prostate Rujuk Lanjut

62 28-09-2018 160102050918Y001238 0000120721803 DRS.E.DING JIU HONG L PNS DAERAH Chronic ischaemic heart Rujuk Lanjut
disease, unspecified
63 28-09-2018 160102050918Y001237 0000120818654 DIAN ANGGRENI P PNS DAERAH Paroxysmal tachycardia Rujuk Lanjut
DAFTAR KUNJUNGAN PESERTA SAKIT

Kantor Cabang : SAMARINDA - 1601

FKTP : SEGIRI - 16010205

64 28-09-2018 160102050918Y001251 0000120887289 ERNAWATY P PNS PUSAT Non-insulin-dependent Berobat Jalan


diabetes mellitus without

65 28-09-2018 160102050918Y001244 0000123032035 EMMELLYA NURTININGSIH P PNS DAERAH Schizophrenia, unspecified Rujuk Lanjut

66 28-09-2018 160102050918Y001272 0000123062804 KLAWU ELING WASPODO L PNS DAERAH Essential (primary) Berobat Jalan
hypertension
67 28-09-2018 160102050918Y001231 0000123110379 EMI YUSNITA P PNS DAERAH Excessive, frequent and Rujuk Lanjut
irregular menstruation
68 28-09-2018 160102050918Y001234 0000123111191 RAHAYU MULYANINGSIH P PENERIMA PENSIUN Essential (primary) Berobat Jalan
PNS hypertension
69 28-09-2018 160102050918Y001275 0000201887289 MUHAMMAD ZABDAN ZAHIR L PNS DAERAH Disturbances in tooth Berobat Jalan
eruption
70 28-09-2018 160102050918Y001233 0000897727241 LUKAS MUYA L PBI (APBN) Surgical follow-up care, Rujuk Lanjut
unspecified
71 28-09-2018 160102050918Y001243 0000902077773 NASIAH P PBI (APBN) Schizophrenia, unspecified Rujuk Lanjut

72 28-09-2018 160102050918Y001261 0000902346355 SUBUHAN L PBI (APBN) Fever of other and Berobat Jalan
unknown origin
73 28-09-2018 160102050918Y001258 0000902346535 ROHAYAH P PBI (APBN) Dyspepsia Berobat Jalan

74 28-09-2018 160102050918Y001253 0000902458574 HERLINA SUSANTI P PBI (APBN) Acute pharyngitis, Berobat Jalan
unspecified
75 28-09-2018 160102050918Y001265 0000902703993 WAHYU ARBAININGSIH P PBI (APBN) Burns classified according Berobat Jalan
to extent of body surface

76 28-09-2018 160102050918Y001247 0000903221763 AJI ISKANDAR L PBI (APBN) Acute pharyngitis, Berobat Jalan
unspecified
77 28-09-2018 160102050918Y001260 0000903247929 SAMINTEN P PBI (APBN) Headache Berobat Jalan

78 28-09-2018 160102050918Y001255 0000903645101 MISIYAH P PBI (APBN) Non-insulin-dependent Berobat Jalan


diabetes mellitus without

79 28-09-2018 160102050918Y001248 0000937472613 SISKA P PBI (APBN) Acute pharyngitis, Berobat Jalan
unspecified
80 28-09-2018 160102050918Y001267 0000937474143 NUR AINI P PBI (APBN) Acute nasopharyngitis Berobat Jalan
[common cold]
81 28-09-2018 160102050918Y001246 0001066481739 SUPRAPTI P PBI (APBN) Disorders of refraction and Rujuk Lanjut
accommodation
82 28-09-2018 160102050918Y001259 0001134464174 LA MENTE L PEKERJA MANDIRI Non-insulin-dependent Berobat Jalan
diabetes mellitus without

83 28-09-2018 160102050918Y001271 0001313805521 wahamu P PEKERJA MANDIRI Chest pain, unspecified Berobat Jalan
DAFTAR KUNJUNGAN PESERTA SAKIT

Kantor Cabang : SAMARINDA - 1601

FKTP : SEGIRI - 16010205

84 28-09-2018 160102050918Y001256 0001434211277 longsat L PEKERJA MANDIRI Non-insulin-dependent Berobat Jalan


diabetes mellitus without

85 28-09-2018 160102050918Y001270 0001436135027 ATI TOPANG P PNS DAERAH Acute nasopharyngitis Berobat Jalan
[common cold]
86 28-09-2018 160102050918Y001266 0001478196292 SITI FAJARIAH P PEGAWAI SWASTA Acute nasopharyngitis Berobat Jalan
[common cold]
87 28-09-2018 160102050918Y001241 0001550686037 ROBET AJANG L PBI (APBD) Other benign neoplasms Rujuk Lanjut
of connective and other

88 28-09-2018 160102050918Y001235 0001551188777 WILIAM NENSEN L PEKERJA MANDIRI Benign neoplasm of bone Rujuk Lanjut
and articular cartilage,

89 28-09-2018 160102050918Y001250 0001644858729 DAUD SRI SEMBILAN L PEGAWAI SWASTA Other arthrosis Berobat Jalan
BUMBUNGAN
90 28-09-2018 160102050918Y001230 0001723636765 DELIA HASANAH PUTRI L PBI (APBD) Asthma Rujuk Lanjut

91 28-09-2018 160102050918Y001254 0001924779925 AHMAD FAJRI L PEKERJA MANDIRI Hordeolum and other deep Berobat Jalan
inflammation of eyelid

92 28-09-2018 160102050918Y001236 0002064018756 NAMIRAH P PEKERJA MANDIRI Other arthrosis Rujuk Lanjut

93 28-09-2018 160102050918Y001229 0002069303556 AIDA RUSLIAH P PEKERJA MANDIRI Chronic ischaemic heart Rujuk Lanjut
disease, unspecified
94 28-09-2018 160102050918Y001273 0002075918793 NOERMA FITRIANI P PEKERJA MANDIRI Necrosis of pulp Berobat Jalan

95 28-09-2018 160102050918Y001274 0002079071921 MUINAH P PEKERJA MANDIRI Acute periodontitis Berobat Jalan

96 28-09-2018 160102050918Y001252 0002215302996 MUHAMMAD DAFFA ZUHDI L PEKERJA MANDIRI Dyspepsia Berobat Jalan

97 28-09-2018 160102050918Y001263 0002219930583 WA HARI P PEKERJA MANDIRI Non-insulin-dependent Berobat Jalan


diabetes mellitus without

98 28-09-2018 160102050918Y001257 0002238223241 TOMMY MASHOER L PEKERJA MANDIRI Essential (primary) Berobat Jalan
hypertension
99 28-09-2018 160102050918Y001262 0002269904499 abraham saputra L PEGAWAI SWASTA Acute nasopharyngitis Berobat Jalan
[common cold]
100 28-09-2018 160102050918Y001240 0002317792937 RIFKI ALMUHARRAM L PEKERJA MANDIRI Superficial injury of hip Rujuk Lanjut
and thigh
101 28-09-2018 160102050918Y001269 0002435890509 HAMKA L PEKERJA MANDIRI Otitis media, unspecified Berobat Jalan

102 28-09-2018 160102050918Y001239 0002477101443 RIDHO SAPUTRA L PEKERJA MANDIRI Bronchopneumonia, Rujuk Lanjut
unspecified
103 27-09-2018 160102050918Y001209 0000120263499 LILISTIATI P PNS DAERAH Surgical follow-up care, Rujuk Lanjut
unspecified
DAFTAR KUNJUNGAN PESERTA SAKIT

Kantor Cabang : SAMARINDA - 1601

FKTP : SEGIRI - 16010205

104 27-09-2018 160102050918Y001194 0000120317466 JUMANI L PNS DAERAH Stroke, not specified as Rujuk Lanjut
haemorrhage or infarction
105 27-09-2018 160102050918Y001205 0000120361713 MOHAMAD ABDUL SODEK L PENERIMA PENSIUN Non-insulin-dependent Berobat Jalan
PNS diabetes mellitus without

106 27-09-2018 160102050918Y001216 0000120445773 INDRIANI NURDIN P PNS DAERAH Low back pain Rujuk Lanjut

107 27-09-2018 160102050918Y001198 0000120513914 RIBUT SUKIDJO L PENERIMA PENSIUN TNI After-cataract Rujuk Lanjut

108 27-09-2018 160102050918Y001226 0000120549352 MERY TANDIARANG P PNS DAERAH Low back pain Rujuk Lanjut

109 27-09-2018 160102050918Y001200 0000120655056 ASKAMAN MASDAR L PENERIMA PENSIUN Senile cataract Rujuk Lanjut
PNS
110 27-09-2018 160102050918Y001196 0000120656237 DANTES HUTAHAEAN SH. L PENERIMA PENSIUN Hyperplasia of prostate Rujuk Lanjut
PNS
111 27-09-2018 160102050918Y001215 0000120670064 NANANG HASAN L PENERIMA PENSIUN Hyperplasia of prostate Rujuk Lanjut
PNS
112 27-09-2018 160102050918Y001221 0000120678131 ABIDINSYAH L PENERIMA PENSIUN Zoster without Berobat Jalan
PNS complication
113 27-09-2018 160102050918Y001210 0000120684971 H. MUSTAFA L PENERIMA PENSIUN TNI Chronic ischaemic heart Berobat Jalan
disease, unspecified
114 27-09-2018 160102050918Y001201 0000120704095 RAMIN REDJO L PENERIMA PENSIUN Insulin-dependent Berobat Jalan
PNS diabetes mellitus
115 27-09-2018 160102050918Y001224 0000120903783 DARIYAH P PENERIMA PENSIUN Essential (primary) Berobat Jalan
PNS hypertension
116 27-09-2018 160102050918Y001225 0000122036635 NAVA SHEILASIA FASYA P PNS DAERAH Acute pharyngitis, Berobat Jalan
unspecified
117 27-09-2018 160102050918Y001203 0000123677919 BERLIANA P PNS DAERAH Essential (primary) Berobat Jalan
hypertension
118 27-09-2018 160102050918Y001202 0000123677921 PARLINDUNGAN PASARIBU, SH L PNS DAERAH Essential (primary) Berobat Jalan
hypertension
119 27-09-2018 160102050918Y001199 0000123680564 DEYMANTER SIANTURI L PNS DAERAH Senile cataract Rujuk Lanjut

120 27-09-2018 160102050918Y001193 0000123680913 HAMDAN L PNS DAERAH Essential (primary) Berobat Jalan
hypertension
121 27-09-2018 160102050918Y001214 0000123682959 JEMMI ANGGRAINI P PNS DAERAH Thyrotoxicosis Rujuk Lanjut
[hyperthyroidism]
122 27-09-2018 160102050918Y001217 0000902443443 SIDAR P PBI (APBN) Pulpitis Berobat Jalan

123 27-09-2018 160102050918Y001218 0000902464942 KURNIAWATI P PBI (APBN) Spontaneous abortion, Rujuk Lanjut
complete or unspecified,

124 27-09-2018 160102050918Y001223 0000902744177 NURHAYATI P PBI (APBN) Non-insulin-dependent Berobat Jalan
diabetes mellitus without
DAFTAR KUNJUNGAN PESERTA SAKIT

Kantor Cabang : SAMARINDA - 1601

FKTP : SEGIRI - 16010205

125 27-09-2018 160102050918Y001222 0000902766418 MUJIATI P PBI (APBN) Dyspepsia Berobat Jalan

126 27-09-2018 160102050918Y001213 0001066482189 TUKINEM P PBI (APBN) Essential (primary) Berobat Jalan
hypertension
127 27-09-2018 160102050918Y001207 0001066483945 RUSBIYANTI P PBI (APBN) Chronic periodontitis Berobat Jalan

128 27-09-2018 160102050918Y001211 0001264941022 APRIADINATA L PEKERJA MANDIRI Retinal detachments and Rujuk Lanjut
breaks
129 27-09-2018 160102050918Y001197 0001270801629 NURUL AINI P PEKERJA MANDIRI Chronic ischaemic heart Rujuk Lanjut
disease, unspecified
130 27-09-2018 160102050918Y001212 0001428508258 ELIS YULISA P PEKERJA MANDIRI Other specified Rujuk Lanjut
orthopaedic follow-up care

131 27-09-2018 160102050918Y001204 0001832431026 PONCO HEKSA SKIDATINI P PEKERJA MANDIRI Haemorrhage in early Rujuk Lanjut
pregnancy, unspecified
132 27-09-2018 160102050918Y001206 0001925233211 SUWATI P PBI (APBD) Cystitis, unspecified Rujuk Lanjut

133 27-09-2018 160102050918Y001220 0001928661671 MULYANIANTO L PBI (APBD) Disorders of refraction and Rujuk Lanjut
accommodation
134 27-09-2018 160102050918Y001195 0001930552828 AHMAD M L PBI (APBD) Essential (primary) Berobat Jalan
hypertension
135 27-09-2018 160102050918Y001219 0002093483676 J SUTRA P PEKERJA MANDIRI Thyrotoxicosis Rujuk Lanjut
[hyperthyroidism]
136 27-09-2018 160102050918Y001208 0002245943272 SUHARTIK P PEKERJA MANDIRI Benign neoplasm of Rujuk Lanjut
unspecified site
137 26-09-2018 160102050918Y001164 0000120655956 SITI SYAMSIAH P PENERIMA PENSIUN Non-insulin-dependent Berobat Jalan
PNS diabetes mellitus without

138 26-09-2018 160102050918Y001157 0000120658061 MURDJANI PATHUR L PENERIMA PENSIUN Pulpitis Berobat Jalan
PNS
139 26-09-2018 160102050918Y001156 0000120659398 EDDY MOHJID L PENERIMA PENSIUN Hypertensive heart Berobat Jalan
PNS disease with (congestive)

140 26-09-2018 160102050918Y001180 0000120661839 H.AWANG JOENANI, DR L PENERIMA PENSIUN Chronic ischaemic heart Rujuk Lanjut
PNS disease, unspecified
141 26-09-2018 160102050918Y001181 0000120661841 TJANDRA KIRANA YUdHA P PENERIMA PENSIUN Cardiac arrhythmia, Rujuk Lanjut
SUBRATA PNS unspecified
142 26-09-2018 160102050918Y001191 0000120674081 SUHADI L PENERIMA PENSIUN Nonorganic insomnia Berobat Jalan
PNS
143 26-09-2018 160102050918Y001150 0000120685893 IR TL TOBING L PENERIMA PENSIUN Hyperplasia of prostate Rujuk Lanjut
PNS
144 26-09-2018 160102050918Y001154 0000120719924 RIZALY L PNS DAERAH Chronic renal failure, Rujuk Lanjut
unspecified
DAFTAR KUNJUNGAN PESERTA SAKIT

Kantor Cabang : SAMARINDA - 1601

FKTP : SEGIRI - 16010205

145 26-09-2018 160102050918Y001178 0000120913615 RATRI SUNDARI P PNS PUSAT Tuberculosis of lung, Rujuk Lanjut
confirmed by sputum
microscopy with or without

146 26-09-2018 160102050918Y001184 0000123084988 FARID WAJDI RAHIM L PNS DAERAH Chronic obstructive Berobat Jalan
pulmonary disease,

147 26-09-2018 160102050918Y001162 0000123692049 SUMARNI MARIMAN P PNS DAERAH Chronic ischaemic heart Berobat Jalan
disease, unspecified
148 26-09-2018 160102050918Y001166 0000123692051 MUHAMMAD YUNUS L PNS DAERAH Chronic ischaemic heart Berobat Jalan
disease, unspecified
149 26-09-2018 160102050918Y001174 0000123719343 M RUSLIAN NOOR L PENERIMA PENSIUN Chronic lymphocytic Berobat Jalan
PNS leukaemia
150 26-09-2018 160102050918Y001176 0000158053386 SUMARDI L PNS PUSAT Chronic ischaemic heart Rujuk Lanjut
disease, unspecified
151 26-09-2018 160102050918Y001160 0000158694399 ARMANIYAH SY P PENERIMA PENSIUN Hypertensive heart Rujuk Lanjut
PNS disease
152 26-09-2018 160102050918Y001163 0000195003819 MASOLA BALISA L PNS DAERAH Hyperplasia of prostate Rujuk Lanjut

153 26-09-2018 160102050918Y001179 0000735425032 LISNOWATI P PBI (APBN) Other specified Rujuk Lanjut
noninflammatory disorders

154 26-09-2018 160102050918Y001172 0000896963477 YOHANA HIROH P PBI (APBN) Follicular cyst of ovary Rujuk Lanjut

155 26-09-2018 160102050918Y001188 0000902015717 ADE RIZKI FADILAH L PBI (APBN) Headache Berobat Jalan

156 26-09-2018 160102050918Y001167 0000902461522 AHMAD SAUKANI L PBI (APBN) Dental caries, unspecified Berobat Jalan

157 26-09-2018 160102050918Y001159 0000902593923 DIAN TANIAR P PBI (APBN) Acute nasopharyngitis Berobat Jalan
[common cold]
158 26-09-2018 160102050918Y001158 0000902610393 DARWADI L PBI (APBN) Insulin-dependent Rujuk Lanjut
diabetes mellitus with

159 26-09-2018 160102050918Y001190 0000902691257 TOLE P PBI (APBN) Diarrhoea and Berobat Jalan
gastroenteritis of
presumed infectious origin

160 26-09-2018 160102050918Y001169 0000903124708 ZAINAL ABIDIN L PBI (APBN) Chronic obstructive Rujuk Lanjut
pulmonary disease,

161 26-09-2018 160102050918Y001173 0001263559241 MUHAMMAD RAMADHAN L PEGAWAI SWASTA Other and unspecified Rujuk Lanjut
KRISNA ANANDA abdominal pain
162 26-09-2018 160102050918Y001182 0001325266637 muhammad abraham indrawan L PEKERJA MANDIRI Asthma, unspecified Berobat Jalan
DAFTAR KUNJUNGAN PESERTA SAKIT

Kantor Cabang : SAMARINDA - 1601

FKTP : SEGIRI - 16010205

163 26-09-2018 160102050918Y001187 0001434211277 longsat L PEKERJA MANDIRI Non-insulin-dependent Berobat Jalan
diabetes mellitus with
peripheral circulatory

164 26-09-2018 160102050918Y001183 0001775281779 HERLINA L. SITUMORANG P PEGAWAI SWASTA Myalgia, hand Berobat Jalan

165 26-09-2018 160102050918Y001165 0001844843455 OTONG SUKARNA L PEKERJA MANDIRI Acute periodontitis Berobat Jalan

166 26-09-2018 160102050918Y001170 0001871929517 ARIFIN L PEKERJA MANDIRI Chronic ischaemic heart Rujuk Lanjut
disease, unspecified
167 26-09-2018 160102050918Y001155 0001923899837 MUHAMAD DERLY L PBI (APBD) Other orthopaedic Rujuk Lanjut
follow-up care
168 26-09-2018 160102050918Y001168 0001925214232 SABINAH P PBI (APBD) After-cataract Rujuk Lanjut

169 26-09-2018 160102050918Y001171 0001925222769 NENENG TRIANA P PBI (APBD) Other specified headache Rujuk Lanjut
syndromes
170 26-09-2018 160102050918Y001189 0001925271551 MULYATI P PBI (APBD) Essential (primary) Berobat Jalan
hypertension
171 26-09-2018 160102050918Y001177 0001931885559 JIUL L PBI (APBD) Bronchitis, not specified as Rujuk Lanjut
acute or chronic
172 26-09-2018 160102050918Y001192 0002082332147 SUTATIK P PBI (APBD) Diarrhoea and Berobat Jalan
gastroenteritis of
presumed infectious origin

173 26-09-2018 160102050918Y001186 0002211560662 SUSANTI P PEKERJA MANDIRI Supervision of normal first Berobat Jalan
pregnancy
174 26-09-2018 160102050918Y001185 0002328216671 SUKADI L PEKERJA MANDIRI Myalgia, shoulder region Berobat Jalan

175 26-09-2018 160102050918Y001161 0002421838653 ACHMAD BASRI L PEGAWAI BUMD Hyperplasia of prostate Rujuk Lanjut

176 26-09-2018 160102050918Y001175 0002485912421 MUHAMMAD RIDWAN KAMIL L PEGAWAI SWASTA Tetralogy of Fallot Rujuk Lanjut

177 25-09-2018 160102050918Y001126 0000119701596 SUKAPTI P PNS DAERAH Malignant neoplasm of Rujuk Lanjut
cervix uteri, unspecified
178 25-09-2018 160102050918Y001151 0000119982508 AYUB L PNS DAERAH Unspecified injury of wrist Berobat Jalan
and hand
179 25-09-2018 160102050918Y001137 0000120413518 NURDA AGUSTINI P PNS PUSAT Excessive and frequent Rujuk Lanjut
menstruation with irregular

180 25-09-2018 160102050918Y001116 0000120427064 HAMISYAH P PENERIMA PENSIUN Asthma Berobat Jalan
PNS
181 25-09-2018 160102050918Y001148 0000120433961 ADITYA KOESPRAYOGI L PNS DAERAH Acute pharyngitis, Berobat Jalan
unspecified
182 25-09-2018 160102050918Y001127 0000120490975 hm AGUS SUTOPO, mba L PENERIMA PENSIUN TNI Chronic ischaemic heart Berobat Jalan
disease, unspecified
DAFTAR KUNJUNGAN PESERTA SAKIT

Kantor Cabang : SAMARINDA - 1601

FKTP : SEGIRI - 16010205

183 25-09-2018 160102050918Y001125 0000120532948 TOMMY BUSTOMI, S.KOM L PNS PUSAT Non-insulin-dependent Berobat Jalan
diabetes mellitus without

184 25-09-2018 160102050918Y001101 0000120603137 MASRAH P PENERIMA PENSIUN Chronic ischaemic heart Rujuk Lanjut
PNS disease, unspecified
185 25-09-2018 160102050918Y001096 0000120604386 MISRANSYAH L PENERIMA PENSIUN Non-insulin-dependent Berobat Jalan
PNS diabetes mellitus without

186 25-09-2018 160102050918Y001097 0000120604397 ASNAH P PENERIMA PENSIUN Non-insulin-dependent Berobat Jalan
PNS diabetes mellitus without

187 25-09-2018 160102050918Y001140 0000120615208 RACHMINAWATI P PENERIMA PENSIUN Disorders of refraction and Rujuk Lanjut
PNS accommodation
188 25-09-2018 160102050918Y001111 0000120616143 RIDWAN SYAHRANI L PENERIMA PENSIUN Hyperplasia of prostate Rujuk Lanjut
PNS
189 25-09-2018 160102050918Y001114 0000120658072 HENNY P PENERIMA PENSIUN Chronic ischaemic heart Rujuk Lanjut
PNS disease, unspecified
190 25-09-2018 160102050918Y001112 0000120664056 MISRIATY P PENERIMA PENSIUN Chronic ischaemic heart Rujuk Lanjut
PNS disease, unspecified
191 25-09-2018 160102050918Y001110 0000120671032 SITI SUTIJANTI P PENERIMA PENSIUN Chronic ischaemic heart Berobat Jalan
PNS disease, unspecified
192 25-09-2018 160102050918Y001117 0000120674733 SUPANTO.H.DRS L PENERIMA PENSIUN Hyperplasia of prostate Rujuk Lanjut
PNS
193 25-09-2018 160102050918Y001095 0000120689425 NURACHMAN, BSC L PENERIMA PENSIUN Essential (primary) Berobat Jalan
PNS hypertension
194 25-09-2018 160102050918Y001152 0000120775105 PUSPAWATI P PNS DAERAH Dental caries, unspecified Berobat Jalan

195 25-09-2018 160102050918Y001104 0000120882868 MARDIONo L PNS DAERAH Chronic renal failure, Rujuk Lanjut
unspecified
196 25-09-2018 160102050918Y001136 0000123676953 RESSA SALSSA AULIA P PNS DAERAH Mucocele of salivary gland Rujuk Lanjut

197 25-09-2018 160102050918Y001138 0000123682037 BASYARIAH P PENERIMA PENSIUN Non-insulin-dependent Rujuk Lanjut
PNS diabetes mellitus without

198 25-09-2018 160102050918Y001094 0000123692523 SUPRIYATI P PNS DAERAH Essential (primary) Berobat Jalan
hypertension
199 25-09-2018 160102050918Y001124 0000123693873 WAHYU ADHIANTO L PNS DAERAH Hypertensive heart Rujuk Lanjut
disease
200 25-09-2018 160102050918Y001141 0000133256698 GUSTI SRI ANDARNI P PNS DAERAH Myalgia, shoulder region Berobat Jalan

201 25-09-2018 160102050918Y001128 0000162954843 BAKERI L PNS DAERAH Malignant neoplasm of Rujuk Lanjut
nasopharynx, unspecified
DAFTAR KUNJUNGAN PESERTA SAKIT

Kantor Cabang : SAMARINDA - 1601

FKTP : SEGIRI - 16010205

202 25-09-2018 160102050918Y001099 0000195003819 MASOLA BALISA L PNS DAERAH Non-insulin-dependent Rujuk Lanjut
diabetes mellitus with
neurological complications

203 25-09-2018 160102050918Y001149 0000902026067 KHALIF OKTIFAN YANI L PBI (APBN) Dental caries, unspecified Berobat Jalan

204 25-09-2018 160102050918Y001143 0000902382794 MURNIFAH P PBI (APBN) Acute nasopharyngitis Berobat Jalan
[common cold]
205 25-09-2018 160102050918Y001144 0000902463917 WA RASA P PBI (APBN) Myalgia, shoulder region Berobat Jalan

206 25-09-2018 160102050918Y001102 0000903222854 SAID UMAR UMAYAH L PBI (APBN) Essential (primary) Berobat Jalan
hypertension
207 25-09-2018 160102050918Y001129 0000903768513 MUT MAINAH P PBI (APBN) Fever, unspecified Berobat Jalan

208 25-09-2018 160102050918Y001107 0001066474822 DESI MARYATI P PBI (APBN) Foreign body in ear Rujuk Lanjut

209 25-09-2018 160102050918Y001122 0001066474901 ACHMAD YANI L PBI (APBN) Ascites Rujuk Lanjut

210 25-09-2018 160102050918Y001121 0001066480536 ENDANG SUPRIATI P PBI (APBN) Tinnitus Rujuk Lanjut

211 25-09-2018 160102050918Y001118 0001384795056 AQILA RAISA RAMADHANI P PEGAWAI SWASTA Zoster without Berobat Jalan
complication
212 25-09-2018 160102050918Y001098 0001426694253 ARYA ARDHIKA L PEGAWAI SWASTA Acute pharyngitis, Berobat Jalan
unspecified
213 25-09-2018 160102050918Y001135 0001546817736 ROBIYANTO L PEGAWAI SWASTA Thyrotoxicosis, Rujuk Lanjut
unspecified
214 25-09-2018 160102050918Y001132 0001775281779 HERLINA L. SITUMORANG P PEGAWAI SWASTA Essential (primary) Berobat Jalan
hypertension
215 25-09-2018 160102050918Y001134 0001923457004 MARTA SUE JALUNG P PEKERJA MANDIRI Malignant neoplasm of Rujuk Lanjut
nasopharynx
216 25-09-2018 160102050918Y001145 0001970066226 SUPARMI P PEKERJA MANDIRI Acute nasopharyngitis Berobat Jalan
[common cold]
217 25-09-2018 160102050918Y001131 0002037708099 JULIANUS HERU L PNS DAERAH Epilepsy, unspecified Rujuk Lanjut

218 25-09-2018 160102050918Y001120 0002061384153 ZAINAB P PEKERJA MANDIRI Non-insulin-dependent Rujuk Lanjut
diabetes mellitus without

219 25-09-2018 160102050818Y001003 0002062940163 ROSIDAH P PEKERJA MANDIRI Non-insulin-dependent Berobat Jalan
diabetes mellitus without

220 25-09-2018 160102050918Y001093 0002077217504 BAMBANG SUHARTONO L PEKERJA MANDIRI Myalgia, ankle and foot Berobat Jalan

221 25-09-2018 160102050918Y001147 0002085477963 ANISSA PATRICIA WAHAB P PEKERJA MANDIRI Fever, unspecified Berobat Jalan

222 25-09-2018 160102050918Y001139 0002088110171 ARSIFAH P PEKERJA MANDIRI Sequelae of stroke, not Rujuk Lanjut
specified as haemorrhage
DAFTAR KUNJUNGAN PESERTA SAKIT

Kantor Cabang : SAMARINDA - 1601

FKTP : SEGIRI - 16010205

223 25-09-2018 160102050918Y001123 0002197540866 SUMARDI HARTOYO L PEKERJA MANDIRI Sequelae of stroke, not Berobat Jalan
specified as haemorrhage

224 25-09-2018 160102050918Y001133 0002201374225 WINDARI P PEKERJA MANDIRI Malignant neoplasm of Rujuk Lanjut
cervix uteri, unspecified
225 25-09-2018 160102050918Y001113 0002203276037 SUPRAPTO L PEKERJA MANDIRI Cervical root disorders, not Rujuk Lanjut
elsewhere classified
226 25-09-2018 160102050918Y001100 0002204132962 DWI RETNO WULANDARI P PEKERJA MANDIRI Myopia Rujuk Lanjut

227 25-09-2018 160102050918Y001142 0002244498039 FAYYADH ABIMANYU SYAWAL L PEKERJA MANDIRI Acute nasopharyngitis Berobat Jalan
[common cold]
228 25-09-2018 160102050918Y001153 0002254960642 AGUSTAN L PEKERJA MANDIRI Necrosis of pulp Berobat Jalan

229 25-09-2018 160102050918Y001130 0002323805117 HENDRIKUS GANING L PBI (APBD) Other specified headache Rujuk Lanjut
syndromes
230 25-09-2018 160102050918Y001119 0002469421315 DESI NURYATI P PEKERJA MANDIRI Acute pharyngitis, Berobat Jalan
unspecified
231 25-09-2018 160102050918Y001146 0002479997417 NUR HASNAINI P PEKERJA MANDIRI Malignant neoplasm of Berobat Jalan
breast, unspecified
232 24-09-2018 160102050918Y001067 0000119718911 DWI TUGAS IRIANTO UTOMO L PNS DAERAH Chronic renal failure, Rujuk Lanjut
unspecified
233 24-09-2018 160102050918Y001058 0000120615208 RACHMINAWATI P PENERIMA PENSIUN Other disorders of ear, not Rujuk Lanjut
PNS elsewhere classified
234 24-09-2018 160102050918Y001062 0000120634402 ULZULKIPLI L PENERIMA PENSIUN Low back pain Rujuk Lanjut
PNS
235 24-09-2018 160102050918Y001044 0000120640599 THABRANIE NAWAWI L PENERIMA PENSIUN Chronic ischaemic heart Rujuk Lanjut
PNS disease, unspecified
236 24-09-2018 160102050918Y001075 0000120672674 SAMLAN,DRS, BCHK, H L PENERIMA PENSIUN Gastritis, unspecified Berobat Jalan
PNS
237 24-09-2018 160102050918Y001036 0000120704095 RAMIN REDJO L PENERIMA PENSIUN Hyperplasia of prostate Rujuk Lanjut
PNS
238 24-09-2018 160102050918Y001082 0000120800744 NANING ASMINAWATY P PNS DAERAH Essential (primary) Berobat Jalan
hypertension
239 24-09-2018 160102050918Y001038 0000120897426 PIRAWATI P PNS DAERAH Schizophrenia, unspecified Rujuk Lanjut

240 24-09-2018 160102050918Y001065 0000120927958 SYARIFUDDIN L PNS PUSAT Chronic ischaemic heart Rujuk Lanjut
disease, unspecified
241 24-09-2018 160102050918Y001064 0000120950008 TAPPE PIETER SUNDUN L PENERIMA PENSIUN Chronic ischaemic heart Rujuk Lanjut
PNS disease, unspecified
242 24-09-2018 160102050918Y001086 0000123111617 SIMON SAUNG L PENERIMA PENSIUN Dysphagia Berobat Jalan
PNS
243 24-09-2018 160102050918Y001105 0000123241893 PARTINEM P PENERIMA PENSIUN Necrosis of pulp Berobat Jalan
PNS
DAFTAR KUNJUNGAN PESERTA SAKIT

Kantor Cabang : SAMARINDA - 1601

FKTP : SEGIRI - 16010205

244 24-09-2018 160102050918Y001040 0000123285778 ERAWATY P PNS DAERAH Non-insulin-dependent Berobat Jalan
diabetes mellitus with
neurological complications

245 24-09-2018 160102050918Y001048 0000123676773 ANI MURDIANI P PNS DAERAH Low back pain Rujuk Lanjut

246 24-09-2018 160102050918Y001051 0000123677133 hj. ARPAH MASDALI, s.sos. P PNS DAERAH Necrosis of pulp Rujuk Lanjut
m.,kes
247 24-09-2018 160102050918Y001041 0000123678933 SYLVANA YOEDYANTO P PENERIMA PENSIUN Hemiplegia, unspecified Rujuk Lanjut
PNS
248 24-09-2018 160102050918Y001066 0000123679629 ELISABETH P PENERIMA PENSIUN Essential (primary) Berobat Jalan
PNS hypertension
249 24-09-2018 160102050918Y001061 0000210397206 NADYA ELIZABETH NAULI P PNS DAERAH Disorder of refraction, Rujuk Lanjut
LUMBAN TOBING unspecified
250 24-09-2018 160102050918Y001046 0000896846736 RINTAK L PBI (APBN) Chronic ischaemic heart Rujuk Lanjut
disease, unspecified
251 24-09-2018 160102050918Y001056 0000897730255 MARIMA ROSALIA DAHAI P PBI (APBN) Benign neoplasm of other Rujuk Lanjut
and unspecified sites

252 24-09-2018 160102050918Y001070 0000898416617 WARDANIAH P PBI (APBN) Malignant neoplasm of Rujuk Lanjut
endometrium
253 24-09-2018 160102050918Y001054 0000900398439 PASINAH P PBI (APBN) Malignant neoplasm of Rujuk Lanjut
cervix uteri, unspecified
254 24-09-2018 160102050918Y001080 0000902006559 NURUL IDAYANTI P PBI (APBN) Non-insulin-dependent Berobat Jalan
diabetes mellitus without

255 24-09-2018 160102050918Y001076 0000902128476 RATNA P PBI (APBN) Myalgia, shoulder region Berobat Jalan

256 24-09-2018 160102050918Y001103 0000902332956 NOOR INDAH MEI RIRIN .M P PBI (APBN) Necrosis of pulp Berobat Jalan

257 24-09-2018 160102050918Y001037 0000902626299 MARLIN CHRSITINA P PBI (APBN) Other specified headache Rujuk Lanjut
syndromes
258 24-09-2018 160102050918Y001092 0000902716391 ALIANSYAH ZULKARNAEN L PBI (APBN) Chronic ischaemic heart Berobat Jalan
disease, unspecified
259 24-09-2018 160102050918Y001083 0000903258819 FITRI P PBI (APBN) Acute nasopharyngitis Berobat Jalan
[common cold]
260 24-09-2018 160102050918Y001060 0000903436964 YATI MINATI P PBI (APBN) Asthma, unspecified Rujuk Lanjut

261 24-09-2018 160102050918Y001073 0000903450611 ADAM SAPUTRA L PBI (APBN) Superficial injury of lower Berobat Jalan
leg, unspecified
262 24-09-2018 160102050918Y001090 0000903924911 SAMIDE P PBI (APBN) Acute nasopharyngitis Berobat Jalan
[common cold]
263 24-09-2018 160102050918Y001042 0001066125802 HAMIYAH P PBI (APBN) Disorders of refraction and Rujuk Lanjut
accommodation
DAFTAR KUNJUNGAN PESERTA SAKIT

Kantor Cabang : SAMARINDA - 1601

FKTP : SEGIRI - 16010205

264 24-09-2018 160102050918Y001077 0001066474135 ADELIA ADINDA P PBI (APBN) Pain localized to other Berobat Jalan
parts of lower abdomen
265 24-09-2018 160102050918Y001088 0001066479873 NURDIN BARUS L PBI (APBN) Dermatophytosis, Berobat Jalan
unspecified
266 24-09-2018 160102050918Y001081 0001098172179 Muhammad RIZq MUHTAROM L ANGGOTA POLRI Acute nasopharyngitis Berobat Jalan
[common cold]
267 24-09-2018 160102050918Y001072 0001148628701 RONY TANDIARRANG L PEGAWAI BUMN Fever, unspecified Berobat Jalan

268 24-09-2018 160102050918Y001087 0001268373688 NASAN JONY SILALAHI raja L PEKERJA MANDIRI Non-insulin-dependent Berobat Jalan
diabetes mellitus without

269 24-09-2018 160102050918Y001043 0001283120008 NUR HANA P PEKERJA MANDIRI Spondylolysis, lumbar Rujuk Lanjut
region
270 24-09-2018 160102050918Y001049 0001445013977 SAIMAH P PEKERJA MANDIRI Malignant neoplasm of Rujuk Lanjut
cervix uteri, unspecified
271 24-09-2018 160102050918Y001089 0001549966623 SURIYATI P PEGAWAI SWASTA Essential (primary) Berobat Jalan
hypertension
272 24-09-2018 160102050918Y001053 0001553544832 BALE NJUK L PBI (APBD) Hodgkin lymphoma Rujuk Lanjut

273 24-09-2018 160102050918Y001106 0001925221779 SISWANTI P PBI (APBD) Necrosis of pulp Berobat Jalan

274 24-09-2018 160102050918Y001039 0001925223107 LUDIA PIRADE P PBI (APBD) Essential (primary) Rujuk Lanjut
hypertension
275 24-09-2018 160102050918Y001074 0001927055981 SITI RAMLAH P PEKERJA MANDIRI Low back pain Rujuk Lanjut

276 24-09-2018 160102050918Y001091 0001927205278 SRI PRAPTI P PEKERJA MANDIRI Myalgia, ankle and foot Berobat Jalan

277 24-09-2018 160102050918Y001079 0001972019362 NUR ASNI ASYARI P PEKERJA MANDIRI Headache Berobat Jalan

278 24-09-2018 160102050918Y001063 0002044194884 ALEXANDER PITER LUMBAN L PNS DAERAH Disorder of refraction, Rujuk Lanjut
TOBING unspecified
279 24-09-2018 160102050918Y001057 0002065034711 ROSITAH P PEKERJA MANDIRI Insulin-dependent Rujuk Lanjut
diabetes mellitus without

280 24-09-2018 160102050918Y001078 0002071329355 MUHAMMAD ARIS L PEKERJA MANDIRI Acute tonsillitis, Berobat Jalan
unspecified
281 24-09-2018 160102050918Y001059 0002073378622 GUNAWAN L PEKERJA MANDIRI Chronic ischaemic heart Rujuk Lanjut
disease, unspecified
282 24-09-2018 160102050918Y001055 0002081639092 WAHYU DIANA WATI P PEKERJA MANDIRI Supervision of high-risk Rujuk Lanjut
pregnancy
283 24-09-2018 160102050918Y001045 0002083965434 M. SYAIFUDIN ANWAR L PEKERJA MANDIRI Thalassaemia Rujuk Lanjut

284 24-09-2018 160102050918Y001109 0002194063749 RINA ASTUTI P PBI (APBD) Dental caries, unspecified Berobat Jalan

285 24-09-2018 160102050918Y001084 0002196404684 PANTI ASTUTI P PEKERJA MANDIRI Myalgia, shoulder region Berobat Jalan
DAFTAR KUNJUNGAN PESERTA SAKIT

Kantor Cabang : SAMARINDA - 1601

FKTP : SEGIRI - 16010205

286 24-09-2018 160102050918Y001069 0002229870071 YOHANI MATIAS P PEKERJA MANDIRI Malignant neoplasm of Rujuk Lanjut
cervix uteri, unspecified
287 24-09-2018 160102050918Y001052 0002231754311 NANI MISNAWATI P PEKERJA MANDIRI Primary arthrosis of other Rujuk Lanjut
joints, lower leg
288 24-09-2018 160102050918Y001108 0002245419191 SUGENG L PBI (APBD) Dental caries, unspecified Berobat Jalan

289 24-09-2018 160102050918Y001085 0002270330346 SUKARNI L PEKERJA MANDIRI Myalgia, shoulder region Berobat Jalan

290 24-09-2018 160102050918Y001068 0002290488276 DEVUNG P PBI (APBD) Abdominal and pelvic pain Rujuk Lanjut

291 24-09-2018 160102050918Y001047 0002299507367 WA INI P PBI (APBD) Spondylolysis, lumbar Rujuk Lanjut
region
292 24-09-2018 160102050918Y001050 0002325081835 NITA OKTAVIA L PEKERJA MANDIRI Psoriasis Rujuk Lanjut

293 24-09-2018 160102050918Y001071 0002446635161 PURWATI NINGSIH P PEKERJA MANDIRI Malignant neoplasm of Rujuk Lanjut
cervix uteri, unspecified
294 22-09-2018 160102050918Y001000 0000005421712 ARIFIN WAGIMAN L PENERIMA PENSIUN Other chronic renal failure Rujuk Lanjut
PNS
295 22-09-2018 160102050918Y001001 0000006198996 WINARTI MUKIYAT P PENERIMA PENSIUN Non-insulin-dependent Rujuk Lanjut
PNS diabetes mellitus without

296 22-09-2018 160102050918Y001014 0000120292637 MATOYAH P PNS PUSAT Non-insulin-dependent Berobat Jalan
diabetes mellitus with
neurological complications

297 22-09-2018 160102050918Y001012 0000120346211 D.TITO YOUMINARTO L PENERIMA PENSIUN Hyperplasia of prostate Rujuk Lanjut
PNS
298 22-09-2018 160102050918Y001027 0000120383965 RUSMINAH P PENERIMA PENSIUN Hypertensive heart Berobat Jalan
PNS disease
299 22-09-2018 160102050918Y001025 0000120590649 LAILIDA MOCHDAR P PENERIMA PENSIUN Chronic ischaemic heart Rujuk Lanjut
PNS disease, unspecified
300 22-09-2018 160102050918Y001004 0000120661121 SUDARMI P PENERIMA PENSIUN Chronic ischaemic heart Berobat Jalan
PNS disease, unspecified
301 22-09-2018 160102050918Y001020 0000120913604 KUKUH L PNS PUSAT Essential (primary) Rujuk Lanjut
hypertension
302 22-09-2018 160102050918Y001023 0000120914199 LA LORE L PNS PUSAT Essential (primary) Berobat Jalan
hypertension
303 22-09-2018 160102050918Y001018 0000121653573 AKMAL AJI RAHMADIN L PNS DAERAH Acute nasopharyngitis Berobat Jalan
[common cold]
304 22-09-2018 160102050918Y001022 0000126801898 SYAFINAR MUCHTARUDIN P PENERIMA PENSIUN TNI Other anxiety disorders Rujuk Lanjut

305 22-09-2018 160102050918Y001029 0000147877929 HAIRUNNISYAH WATI P PNS DAERAH Disorders of refraction and Rujuk Lanjut
accommodation
DAFTAR KUNJUNGAN PESERTA SAKIT

Kantor Cabang : SAMARINDA - 1601

FKTP : SEGIRI - 16010205

306 22-09-2018 160102050918Y001028 0000901934673 BAMBANG L PBI (APBN) Non-insulin-dependent Berobat Jalan
diabetes mellitus without

307 22-09-2018 160102050918Y001003 0000902036665 BARLIANG P PBI (APBN) Sequelae of stroke, not Berobat Jalan
specified as haemorrhage

308 22-09-2018 160102050918Y001011 0000902500402 MISNIADI L PBI (APBN) Other disorders of lens Rujuk Lanjut

309 22-09-2018 160102050918Y001016 0000902679041 ERYANI P PBI (APBN) Abdominal and pelvic pain Rujuk Lanjut

310 22-09-2018 160102050918Y001034 0000902795185 EKO HANDOYO L PBI (APBN) Fever, unspecified Berobat Jalan

311 22-09-2018 160102050918Y001015 0000903213584 SUKMA P PBI (APBN) Other spondylosis with Rujuk Lanjut
myelopathy, lumbar region

312 22-09-2018 160102050918Y001017 0000903230864 RASMADI L PBI (APBN) Chronic ischaemic heart Berobat Jalan
disease, unspecified
313 22-09-2018 160102050918Y001002 0000903544558 NIAM ZAINUR ROMADHON L PBI (APBN) Epilepsy Berobat Jalan

314 22-09-2018 160102050918Y001013 0000948459914 KAMSUDIN L PBI (APBN) Cough Rujuk Lanjut

315 22-09-2018 160102050918Y001006 0000976689257 SOFIE FARISTINA P PNS PUSAT Supervision of high-risk Rujuk Lanjut
pregnancy
316 22-09-2018 160102050918Y001033 0001925222534 SUMARI L PBI (APBD) Acute nasopharyngitis Berobat Jalan
[common cold]
317 22-09-2018 160102050918Y001019 0001929375641 PUTRI APRILLIANIK P PBI (APBD) Impacted cerumen Rujuk Lanjut

318 22-09-2018 160102050918Y001024 0002054914615 YULIANI P PEKERJA MANDIRI Abrasion of teeth Rujuk Lanjut

319 22-09-2018 160102050918Y001035 0002060451191 SAMSIAH P PEKERJA MANDIRI Allergic contact dermatitis, Berobat Jalan
unspecified cause

320 22-09-2018 160102050918Y001008 0002060903079 HAPSYAH P PEKERJA MANDIRI Non-insulin-dependent Rujuk Lanjut
diabetes mellitus with

321 22-09-2018 160102050918Y001026 0002072851018 M. MARSILAN L PEKERJA MANDIRI Diarrhoea and Berobat Jalan
gastroenteritis of
presumed infectious origin

322 22-09-2018 160102050918Y001030 0002079162123 MUHAMMAD KENZHI AL MAJID L PEKERJA MANDIRI Surgical follow-up care, Berobat Jalan
unspecified
323 22-09-2018 160102050918Y001032 0002194783659 JIHAN RAYYA ZULFA L PEGAWAI SWASTA Pain localized to other Berobat Jalan
parts of lower abdomen
324 22-09-2018 160102050918Y001009 0002201822313 MARIAM P PEKERJA MANDIRI Low back pain Rujuk Lanjut

325 22-09-2018 160102050918Y001005 0002203276037 SUPRAPTO L PEKERJA MANDIRI Hypertensive heart Berobat Jalan
disease
DAFTAR KUNJUNGAN PESERTA SAKIT

Kantor Cabang : SAMARINDA - 1601

FKTP : SEGIRI - 16010205

326 22-09-2018 160102050918Y001007 0002203276307 MUSINAH P PEKERJA MANDIRI Stroke, not specified as Rujuk Lanjut
haemorrhage or infarction
327 22-09-2018 160102050918Y001021 0002225691505 JUNAEDI L PEKERJA MANDIRI Surgical follow-up care, Rujuk Lanjut
unspecified
328 22-09-2018 160102050918Y001115 0002229796721 AULIA NAFISAH P PEKERJA MANDIRI Acute nasopharyngitis Berobat Jalan
[common cold]
329 22-09-2018 160102050918Y001031 0002443456765 ELO LINAWATI P PEKERJA MANDIRI Hyperlipidaemia, Berobat Jalan
unspecified
330 22-09-2018 160102050918Y001010 0002464327901 raFITRI L PEKERJA MANDIRI Low vision, both eyes Rujuk Lanjut

331 21-09-2018 160102050918Y000963 0000106578099 NAJAMUDDIN L PNS PUSAT Essential (primary) Berobat Jalan
hypertension
332 21-09-2018 160102050918Y000993 0000120549159 ASTINI P PNS DAERAH Chronic ischaemic heart Berobat Jalan
disease, unspecified
333 21-09-2018 160102050918Y000935 0000120612813 RUSMINI P PENERIMA PENSIUN Chronic ischaemic heart Rujuk Lanjut
PNS disease, unspecified
334 21-09-2018 160102050918Y000945 0000123681813 BASO TURUN BUA L PENERIMA PENSIUN Hyperplasia of prostate Rujuk Lanjut
PNS
335 21-09-2018 160102050918Y000988 0000123682307 IDA RUSMI P PNS DAERAH Non-insulin-dependent Berobat Jalan
diabetes mellitus without

336 21-09-2018 160102050918Y000990 0000123682318 RUSTAM L PNS DAERAH Sequelae of stroke, not Berobat Jalan
specified as haemorrhage

337 21-09-2018 160102050918Y000994 0000123684658 MARSONO L PNS DAERAH Sequelae of stroke, not Berobat Jalan
specified as haemorrhage

338 21-09-2018 160102050918Y000967 0000123693399 THERESIA SRI LESTARI P PNS DAERAH Low back pain Rujuk Lanjut

339 21-09-2018 160102050918Y000949 0000518648995 RUSIMIN L PBI (APBN) Convulsions, not Rujuk Lanjut
elsewhere classified
340 21-09-2018 160102050918Y000978 0000898770082 FETTY FAJRIANTI P PBI (APBN) Fracture of femur, part Rujuk Lanjut
unspecified
341 21-09-2018 160102050918Y000932 0000901899369 FEBRI LAILATUL HUSNA P PBI (APBN) Mucocele of salivary gland Rujuk Lanjut

342 21-09-2018 160102050918Y000936 0000902035269 MASNIAH P PBI (APBN) Essential (primary) Berobat Jalan
hypertension
343 21-09-2018 160102050918Y000928 0000902502516 FAUZI L PBI (APBN) Decubitus ulcer Berobat Jalan

344 21-09-2018 160102050918Y000997 0000902739723 MUHAMMAD ABDUL AZIS L PBI (APBN) Acute nasopharyngitis Berobat Jalan
[common cold]
345 21-09-2018 160102050918Y000933 0000903360857 MASMINAH P PBI (APBN) Senile cataract Rujuk Lanjut

346 21-09-2018 160102050918Y000956 0000903395294 SALEH L PBI (APBN) Acute nasopharyngitis Berobat Jalan
[common cold]
DAFTAR KUNJUNGAN PESERTA SAKIT

Kantor Cabang : SAMARINDA - 1601

FKTP : SEGIRI - 16010205

347 21-09-2018 160102050918Y000943 0001066476396 KAMISAH P PBI (APBN) Myalgia, shoulder region Berobat Jalan

348 21-09-2018 160102050918Y000938 0001066476914 SUNARSIH P PBI (APBN) Essential (primary) Berobat Jalan
hypertension
349 21-09-2018 160102050918Y000989 0001066478804 WARSINI P PBI (APBN) Myalgia, ankle and foot Rujuk Lanjut

350 21-09-2018 160102050918Y000964 0001066479873 NURDIN BARUS L PBI (APBN) Low back pain Rujuk Lanjut

351 21-09-2018 160102050918Y000985 0001203050283 FARIDA P PEGAWAI SWASTA Other benign neoplasm of Rujuk Lanjut
connective and other soft

352 21-09-2018 160102050918Y000980 0001445777864 NOOR AISYAH P PEKERJA MANDIRI Chronic ischaemic heart Rujuk Lanjut
disease, unspecified
353 21-09-2018 160102050918Y000999 0001484377582 AHMAD AFFANTIAN L PEGAWAI SWASTA Impacted cerumen Berobat Jalan

354 21-09-2018 160102050918Y000984 0001611811192 PETRUS HIBAU LIAH L PBI (APBD) Chronic ischaemic heart Rujuk Lanjut
disease, unspecified
355 21-09-2018 160102050918Y000996 0001725146717 MELI ANDRI YANI P PEGAWAI SWASTA Diarrhoea and Berobat Jalan
gastroenteritis of
presumed infectious origin

356 21-09-2018 160102050918Y000998 0001742977361 LUSLI YANDI L PEGAWAI SWASTA Diarrhoea and Berobat Jalan
gastroenteritis of
presumed infectious origin

357 21-09-2018 160102050918Y000937 0001925224896 NURAENI P PBI (APBD) Dyspepsia Rujuk Lanjut

358 21-09-2018 160102050918Y000952 0001925230454 ZAINAL ABIDIN L PBI (APBD) Schizophrenia, unspecified Rujuk Lanjut

359 21-09-2018 160102050918Y000962 0001963314112 RA.IRIANDI WARGANEGARA L PEKERJA MANDIRI Hyperplasia of prostate Rujuk Lanjut

360 21-09-2018 160102050918Y000955 0002203276037 SUPRAPTO L PEKERJA MANDIRI Chronic obstructive Rujuk Lanjut
pulmonary disease with
acute exacerbation,

361 21-09-2018 160102050918Y000951 0002203276307 MUSINAH P PEKERJA MANDIRI Stroke, not specified as Berobat Jalan
haemorrhage or infarction
362 21-09-2018 160102050918Y000965 0002270330346 SUKARNI L PEKERJA MANDIRI Myalgia, ankle and foot Berobat Jalan

363 21-09-2018 160102050918Y000973 0002290488175 AMIR L PBI (APBD) Psoriasis, unspecified Rujuk Lanjut

364 21-09-2018 160102050918Y000987 0002305389835 ELSA SYAVINA KUSUMAWARDI P PEKERJA MANDIRI Disorders of refraction and Rujuk Lanjut
accommodation
365 21-09-2018 160102050918Y000966 0002319876191 SLAMET L PEKERJA MANDIRI Dyspepsia Berobat Jalan

366 21-09-2018 160102050918Y000941 0002419593489 KARSINI P PEKERJA MANDIRI Non-insulin-dependent Berobat Jalan
diabetes mellitus without
DAFTAR KUNJUNGAN PESERTA SAKIT

Kantor Cabang : SAMARINDA - 1601

FKTP : SEGIRI - 16010205

367 21-09-2018 160102050918Y000992 0002425544076 ADULLAH L PEKERJA MANDIRI Acute nasopharyngitis Berobat Jalan
[common cold]
368 21-09-2018 160102050918Y000991 0002425544469 SITI AISYAH P PEKERJA MANDIRI Oedema, unspecified Berobat Jalan

369 21-09-2018 160102050918Y000995 0002438204545 KANZANA AHMAD P PEKERJA MANDIRI Allergic contact dermatitis, Berobat Jalan
unspecified cause

370 20-09-2018 160102050918Y000912 0000120658061 MURDJANI PATHUR L PENERIMA PENSIUN Non-insulin-dependent Berobat Jalan
PNS diabetes mellitus without

371 20-09-2018 160102050918Y000895 0000120672674 SAMLAN,DRS, BCHK, H L PENERIMA PENSIUN Chronic ischaemic heart Berobat Jalan
PNS disease, unspecified
372 20-09-2018 160102050918Y000901 0000120739961 SOFIANSYAH L PNS DAERAH Chronic ischaemic heart Rujuk Lanjut
disease, unspecified
373 20-09-2018 160102050918Y000896 0000121111727 ZAINAL ARIFIN. BE L PENERIMA PENSIUN Hyperplasia of prostate Rujuk Lanjut
PNS
374 20-09-2018 160102050918Y000894 0000123692523 SUPRIYATI P PNS DAERAH Gonarthrosis [arthrosis of Rujuk Lanjut
knee]
375 20-09-2018 160102050918Y000909 0000898414255 SENATI P PBI (APBN) Intracranial Rujuk Lanjut
space-occupying lesion
376 20-09-2018 160102050918Y000918 0000899277491 HENNI WATI P PBI (APBN) Low back pain Rujuk Lanjut

377 20-09-2018 160102050918Y000905 0000902015245 SUDARMI P PBI (APBN) Presbyopia Rujuk Lanjut

378 20-09-2018 160102050918Y000913 0000902744627 RAUDAH P PBI (APBN) Cough Rujuk Lanjut

379 20-09-2018 160102050918Y000924 0000902870021 NORMA SARI P PBI (APBN) Essential (primary) Berobat Jalan
hypertension
380 20-09-2018 160102050918Y000904 0000903837644 SUPATIAH P PBI (APBN) Chronic ischaemic heart Rujuk Lanjut
disease, unspecified
381 20-09-2018 160102050918Y000902 0001100521967 YEtTI SUSANTI P ANGGOTA POLRI Chronic ischaemic heart Berobat Jalan
disease, unspecified
382 20-09-2018 160102050918Y000917 0001473974166 HAMSAH L PEKERJA MANDIRI Chronic kidney disease Rujuk Lanjut

383 20-09-2018 160102050918Y000899 0001923352446 MERKURIUS L PNS DAERAH Epilepsy Rujuk Lanjut

384 20-09-2018 160102050918Y000923 0001925222286 ABDUL RAZAK MUSTAFA L PBI (APBD) Essential (primary) Berobat Jalan
hypertension
385 20-09-2018 160102050918Y000908 0001925232579 YULI SUPIANI P PBI (APBD) Submucous leiomyoma of Rujuk Lanjut
uterus
386 20-09-2018 160102050918Y000925 0002035524846 NAURA ZERLITA ADIBA P PNS DAERAH Allergic contact dermatitis, Berobat Jalan
unspecified cause

387 20-09-2018 160102050918Y000900 0002063784701 SAHRUL TAJUDIN L PEKERJA MANDIRI Chronic ischaemic heart Rujuk Lanjut
disease, unspecified
DAFTAR KUNJUNGAN PESERTA SAKIT

Kantor Cabang : SAMARINDA - 1601

FKTP : SEGIRI - 16010205

388 20-09-2018 160102050918Y000914 0002086109976 NOR RAHMAWATI P PEKERJA MANDIRI Deposits [accretions] on Rujuk Lanjut
teeth
389 20-09-2018 160102050918Y000915 0002196395572 DWI ROSO PRASETYO L PEKERJA MANDIRI Other orthopaedic Rujuk Lanjut
follow-up care
390 20-09-2018 160102050918Y000897 0002201822313 MARIAM P PEKERJA MANDIRI Myalgia, multiple sites Berobat Jalan

391 20-09-2018 160102050918Y000916 0002215302546 GADIS RISMA SEPTIANANDA P PEKERJA MANDIRI Superficial injury of lower Rujuk Lanjut
leg, unspecified
392 20-09-2018 160102050918Y000910 0002269904499 abraham saputra L PEGAWAI SWASTA Diarrhoea and Berobat Jalan
gastroenteritis of
presumed infectious origin

393 20-09-2018 160102050918Y000919 0002284818647 NORSIAH P PEKERJA MANDIRI Dental caries, unspecified Berobat Jalan

394 20-09-2018 160102050918Y000921 0002299531285 FITA DWI RATNAWATI P PEKERJA MANDIRI Delivery by caesarean Rujuk Lanjut
section, unspecified
395 20-09-2018 160102050918Y000907 0002317500821 JUWITA HB P PEKERJA MANDIRI Non-insulin-dependent Berobat Jalan
diabetes mellitus without

396 20-09-2018 160102050918Y000898 0002327931718 KEMAL AHMAD L PEKERJA MANDIRI Periapical abscess without Rujuk Lanjut
sinus
397 20-09-2018 160102050918Y000920 0002378081452 ANDRIANE M SAKUDU P PEKERJA MANDIRI Benign paroxysmal vertigo Rujuk Lanjut

398 20-09-2018 160102050918Y000906 0002430191766 DJAMAH P PEKERJA MANDIRI Non-insulin-dependent Berobat Jalan
diabetes mellitus without

399 20-09-2018 160102050918Y000911 0002443579031 SUMARI L PEKERJA MANDIRI Heart failure, unspecified Rujuk Lanjut

400 20-09-2018 160102050918Y000903 0002456631347 MUHAMMAD RASKA MAHESYA L PEKERJA MANDIRI Acute nasopharyngitis Berobat Jalan
PRATAMA [common cold]
401 20-09-2018 160102050918Y000922 0002465755446 BADARUDDIN L PEKERJA MANDIRI Tuberculosis of other Rujuk Lanjut
specified organs
402 19-09-2018 160102050918Y000878 0000119672572 AMNAH.B P PENERIMA PENSIUN Chronic ischaemic heart Rujuk Lanjut
PNS disease, unspecified
403 19-09-2018 160102050918Y000856 0000119934955 PERIDA P PENERIMA PENSIUN After-cataract Rujuk Lanjut
PNS
404 19-09-2018 160102050918Y000888 0000120066941 MAULANA RIQI RIZQI L PEKERJA MANDIRI Unspecified haemorrhoids Berobat Jalan
without complication

405 19-09-2018 160102050918Y000848 0000120366088 JAWAKIN SIMANJUNTAK L PENERIMA PENSIUN Non-insulin-dependent Rujuk Lanjut
PNS diabetes mellitus without

406 19-09-2018 160102050918Y000855 0000120513251 RUSMINI P PENERIMA PENSIUN TNI Essential (primary) Berobat Jalan
hypertension
DAFTAR KUNJUNGAN PESERTA SAKIT

Kantor Cabang : SAMARINDA - 1601

FKTP : SEGIRI - 16010205

407 19-09-2018 160102050918Y000851 0000120656698 TUKIRAH P PENERIMA PENSIUN Essential (primary) Berobat Jalan
PNS hypertension
408 19-09-2018 160102050918Y000877 0000120659343 E.A. SYARWANI BBA L PENERIMA PENSIUN Acute nasopharyngitis Berobat Jalan
PNS [common cold]
409 19-09-2018 160102050918Y000864 0000120666611 KASPOEL BASRAN L PENERIMA PENSIUN Non-insulin-dependent Rujuk Lanjut
PNS diabetes mellitus without

410 19-09-2018 160102050918Y000845 0000120666868 LEGIMAN L PENERIMA PENSIUN Cough Berobat Jalan
PNS
411 19-09-2018 160102050918Y000843 0000120674542 SUMARDJI L PENERIMA PENSIUN Polycythaemia vera Rujuk Lanjut
PNS
412 19-09-2018 160102050918Y000850 0000120678131 ABIDINSYAH L PENERIMA PENSIUN Zoster without Berobat Jalan
PNS complication
413 19-09-2018 160102050918Y000871 0000121789427 SUHERaWATI P PNS DAERAH Malignant neoplasm of Rujuk Lanjut
breast, unspecified
414 19-09-2018 160102050918Y000883 0000123039933 ROLAM SIMANULLANG L PNS DAERAH Non-insulin-dependent Berobat Jalan
diabetes mellitus without

415 19-09-2018 160102050918Y000891 0000198560799 DARMAWATI P PNS PUSAT Acute nasopharyngitis Berobat Jalan
[common cold]
416 19-09-2018 160102050918Y000868 0000897391113 YULI KARMILA P PBI (APBN) Dyspepsia Berobat Jalan

417 19-09-2018 160102050918Y000857 0000902035269 MASNIAH P PBI (APBN) Essential (primary) Berobat Jalan
hypertension
418 19-09-2018 160102050918Y000890 0000902481456 WA NDEPA P PBI (APBN) Myalgia, shoulder region Berobat Jalan

419 19-09-2018 160102050918Y000863 0000902566776 YUSRANSYAH L PBI (APBN) Other disorders of urinary Rujuk Lanjut
system
420 19-09-2018 160102050918Y000882 0000902601595 YUSNANIK P PBI (APBN) Benign paroxysmal vertigo Berobat Jalan

421 19-09-2018 160102050918Y000881 0000902676947 SANTI HIDIANTI P PBI (APBN) Dyspepsia Berobat Jalan

422 19-09-2018 160102050918Y000847 0000902927215 FASTABIQUL KHAIRAT L PBI (APBN) Acute nasopharyngitis Berobat Jalan
[common cold]
423 19-09-2018 160102050918Y000884 0000903894467 MAIMUNAH P PBI (APBN) Vertiginous syndromes in Berobat Jalan
diseases classified

424 19-09-2018 160102050918Y000880 0001066477983 ISMAIL L PBI (APBN) Other peripheral vertigo Berobat Jalan

425 19-09-2018 160102050918Y000886 0001066478916 SITI AMINAH P PBI (APBN) Essential (primary) Berobat Jalan
hypertension
426 19-09-2018 160102050918Y000861 0001066483315 MASRANI L PBI (APBN) Chronic ischaemic heart Rujuk Lanjut
disease, unspecified
427 19-09-2018 160102050918Y000858 0001100351384 DJAFAR PRASMONO L ANGGOTA POLRI Chronic viral hepatitis B Rujuk Lanjut
without delta-agent
DAFTAR KUNJUNGAN PESERTA SAKIT

Kantor Cabang : SAMARINDA - 1601

FKTP : SEGIRI - 16010205

428 19-09-2018 160102050918Y000893 0001150843454 BELLA RAHMA DWI PUTRI L PEGAWAI SWASTA Acute nasopharyngitis Berobat Jalan
[common cold]
429 19-09-2018 160102050918Y000867 0001177237991 YASINTA P PEGAWAI SWASTA Headache Berobat Jalan

430 19-09-2018 160102050918Y000865 0001177238002 GILANG EKA RENDRA GRAHA L PEGAWAI SWASTA Superficial injury of head, Rujuk Lanjut
part unspecified
431 19-09-2018 160102050918Y000873 0001619875765 SULISTYOWATI P PEKERJA MANDIRI Hypertensive heart Rujuk Lanjut
disease
432 19-09-2018 160102050918Y000879 0001725420216 RAHEL MARIA SAPUTRI P PEKERJA MANDIRI Dyspepsia Berobat Jalan

433 19-09-2018 160102050918Y000844 0001925222995 USNEIDI L PBI (APBD) Chronic ischaemic heart Rujuk Lanjut
disease, unspecified
434 19-09-2018 160102050918Y000866 0001925232557 RUSDIANSYAH L PBI (APBD) Cough Berobat Jalan

435 19-09-2018 160102050918Y000862 0001925232579 YULI SUPIANI P PBI (APBD) Secondary amenorrhoea Rujuk Lanjut

436 19-09-2018 160102050918Y000887 0001926723868 SUKINAH P PEKERJA MANDIRI Benign neoplasm of Berobat Jalan
unspecified site
437 19-09-2018 160102050918Y000869 0001928653255 SRI WIDIASTUTI P PBI (APBD) Pain localized to other Berobat Jalan
parts of lower abdomen
438 19-09-2018 160102050918Y000846 0001970066226 SUPARMI P PEKERJA MANDIRI Chronic ischaemic heart Rujuk Lanjut
disease, unspecified
439 19-09-2018 160102050918Y000854 0002001383616 SITI MASNAH P PBI (APBN) Essential (primary) Berobat Jalan
hypertension
440 19-09-2018 160102050918Y000874 0002061302084 SAMAIYAH P PEKERJA MANDIRI Hyperlipidaemia, Berobat Jalan
unspecified
441 19-09-2018 160102050918Y000849 0002077217504 BAMBANG SUHARTONO L PEKERJA MANDIRI Hyperplasia of prostate Rujuk Lanjut

442 19-09-2018 160102050918Y000889 0002083722489 RUBIYANTI P PEKERJA MANDIRI Essential (primary) Berobat Jalan
hypertension
443 19-09-2018 160102050918Y000872 0002203276037 SUPRAPTO L PEKERJA MANDIRI Cervical root disorders, not Rujuk Lanjut
elsewhere classified
444 19-09-2018 160102050918Y000885 0002210925677 MUHAMMAD TIRTA HASAN L PEGAWAI BUMD Acute nasopharyngitis Berobat Jalan
RIFA'I [common cold]
445 19-09-2018 160102050918Y000892 0002211599755 WA NIA P PEKERJA MANDIRI Myalgia, shoulder region Berobat Jalan

446 19-09-2018 160102050918Y000860 0002217136735 MOH NURYADIN L PEKERJA MANDIRI Myalgia, ankle and foot Berobat Jalan

447 19-09-2018 160102050918Y000876 0002222776427 RESKI UTAMI P PEKERJA MANDIRI Impacted teeth Rujuk Lanjut

448 19-09-2018 160102050918Y000875 0002233101756 JUMAIDAH P PBI (APBD) Acute nasopharyngitis Berobat Jalan
[common cold]
449 19-09-2018 160102050918Y000870 0002235819126 ARKANA PUTRA RAIHAN L PEKERJA MANDIRI Fever, unspecified Berobat Jalan

450 19-09-2018 160102050918Y000859 0002294990122 YATIM P PEKERJA MANDIRI Benign neoplasm of Rujuk Lanjut
unspecified site
DAFTAR KUNJUNGAN PESERTA SAKIT

Kantor Cabang : SAMARINDA - 1601

FKTP : SEGIRI - 16010205

451 19-09-2018 160102050918Y000852 0002327464517 NOR HAMALAH P PEKERJA MANDIRI Acute nasopharyngitis Berobat Jalan
[common cold]
452 19-09-2018 160102050918Y000853 0002327470806 NURUS SYIFA INAYAH P PEKERJA MANDIRI Mumps without Berobat Jalan
complication
453 18-09-2018 160102050918Y000820 0000120040345 HERMIN TATTO P PNS DAERAH Chronic ischaemic heart Rujuk Lanjut
disease, unspecified
454 18-09-2018 160102050918Y000815 0000120109948 PAYA PANGKUNG P PNS DAERAH Loss of teeth due to Rujuk Lanjut
accident, extraction or

455 18-09-2018 160102050918Y000823 0000120277686 SUSILAWATI P PNS PUSAT Disorder of refraction, Rujuk Lanjut
unspecified
456 18-09-2018 160102050918Y000822 0000120427053 MATNOH ASRA L PENERIMA PENSIUN Disorder of refraction, Rujuk Lanjut
PNS unspecified
457 18-09-2018 160102050918Y000835 0000120554559 ABDILLAH L PENERIMA PENSIUN Chronic ischaemic heart Rujuk Lanjut
PNS disease, unspecified
458 18-09-2018 160102050918Y000817 0000120561322 BURING P PENERIMA PENSIUN After-cataract Rujuk Lanjut
PNS
459 18-09-2018 160102050918Y000806 0000120671662 RUSLI L PENERIMA PENSIUN Non-insulin-dependent Berobat Jalan
PNS diabetes mellitus without

460 18-09-2018 160102050918Y000841 0000120674081 SUHADI L PENERIMA PENSIUN Acute nasopharyngitis Berobat Jalan
PNS [common cold]
461 18-09-2018 160102050918Y000805 0000120674362 SUKIRNO L PENERIMA PENSIUN Essential (primary) Berobat Jalan
PNS hypertension
462 18-09-2018 160102050918Y000818 0000120684971 H. MUSTAFA L PENERIMA PENSIUN TNI Chronic ischaemic heart Rujuk Lanjut
disease, unspecified
463 18-09-2018 160102050918Y000808 0000120685893 IR TL TOBING L PENERIMA PENSIUN Non-insulin-dependent Berobat Jalan
PNS diabetes mellitus without

464 18-09-2018 160102050918Y000836 0000120907945 FADJAR PAMBUDHI L PNS PUSAT Non-insulin-dependent Rujuk Lanjut
diabetes mellitus without

465 18-09-2018 160102050918Y000831 0000123682487 INDRA JAYA L PENERIMA PENSIUN Acute pharyngitis, Berobat Jalan
PNS unspecified
466 18-09-2018 160102050918Y000809 0000123726341 TUKIMIN L PNS DAERAH Unstable angina Rujuk Lanjut

467 18-09-2018 160102050918Y000842 0000147818351 ACHMAD ZAKKI MUBARROK L PNS DAERAH Surgical follow-up care, Berobat Jalan
unspecified
468 18-09-2018 160102050918Y000839 0000204966268 PENSIUS L PNS DAERAH Chronic ischaemic heart Rujuk Lanjut
disease, unspecified
469 18-09-2018 160102050918Y000807 0000211198127 SURATMI P PNS DAERAH Non-insulin-dependent Berobat Jalan
diabetes mellitus without
DAFTAR KUNJUNGAN PESERTA SAKIT

Kantor Cabang : SAMARINDA - 1601

FKTP : SEGIRI - 16010205

470 18-09-2018 160102050918Y000828 0000735425032 LISNOWATI P PBI (APBN) Supervision of normal Rujuk Lanjut
pregnancy, unspecified
471 18-09-2018 160102050918Y000840 0000895896235 RUDI PURNOMO L PBI (APBN) Acute pharyngitis, Berobat Jalan
unspecified
472 18-09-2018 160102050918Y000827 0000896453943 YULIA WATI P PBI (APBN) Malignant neoplasm of Rujuk Lanjut
cervix uteri, unspecified
473 18-09-2018 160102050918Y000821 0000896776852 SITI RAHMAH P PBI (APBN) Thyrotoxicosis, Rujuk Lanjut
unspecified
474 18-09-2018 160102050918Y000804 0000901882923 SUGENG HARYANTO L PBI (APBN) Non-insulin-dependent Berobat Jalan
diabetes mellitus without

475 18-09-2018 160102050918Y000819 0000902137825 SUKAMTO L PBI (APBN) Surgical follow-up care, Rujuk Lanjut
unspecified
476 18-09-2018 160102050918Y000801 0000902621507 WA SETI P PBI (APBN) Acute pharyngitis, Berobat Jalan
unspecified
477 18-09-2018 160102050918Y000816 0001066475496 WA TUI P PBI (APBN) Disorder of refraction, Rujuk Lanjut
unspecified
478 18-09-2018 160102050918Y000825 0001071602728 MAHMUD L PBI (APBN) Chest pain, unspecified Rujuk Lanjut

479 18-09-2018 160102050918Y000802 0001725503073 ANIP SUSANTO L PEKERJA MANDIRI Superficial frostbite of Berobat Jalan
other and unspecified sites

480 18-09-2018 160102050918Y000813 0001734278106 BEN AHMAD HAFIZ L PEKERJA MANDIRI Acute nasopharyngitis Berobat Jalan
PANOTOGOMO [common cold]
481 18-09-2018 160102050918Y000811 0001925221825 PAINO L PBI (APBD) Other headache Rujuk Lanjut
syndromes
482 18-09-2018 160102050918Y000812 0001925240038 BAMBANG SURYONO L PBI (APBD) Chronic ischaemic heart Berobat Jalan
disease, unspecified
483 18-09-2018 160102050918Y000826 0002054914615 YULIANI P PEKERJA MANDIRI Spinal enthesopathy, Rujuk Lanjut
cervicothoracic region
484 18-09-2018 160102050918Y000838 0002064033606 GT. SAIBATUL ASLAMIAH P PEKERJA MANDIRI Essential (primary) Berobat Jalan
hypertension
485 18-09-2018 160102050918Y000803 0002069303556 AIDA RUSLIAH P PEKERJA MANDIRI Chronic ischaemic heart Rujuk Lanjut
disease, unspecified
486 18-09-2018 160102050918Y000837 0002071328973 SADDIAH P PEKERJA MANDIRI Essential (primary) Berobat Jalan
hypertension
487 18-09-2018 160102050918Y000830 0002086109976 NOR RAHMAWATI P PEKERJA MANDIRI Chronic post-traumatic Rujuk Lanjut
headache
488 18-09-2018 160102050918Y000824 0002236646575 AZRINA RAZIYA SHAZFA P PEGAWAI SWASTA Cytomegaloviral Rujuk Lanjut
mononucleosis
489 18-09-2018 160102050918Y000814 0002260057645 ABD. LATIF L PEKERJA MANDIRI Hyperplasia of prostate Rujuk Lanjut

490 18-09-2018 160102050918Y000833 0002261547314 ZAKIYA P PEGAWAI SWASTA Other acute sinusitis Rujuk Lanjut
DAFTAR KUNJUNGAN PESERTA SAKIT

Kantor Cabang : SAMARINDA - 1601

FKTP : SEGIRI - 16010205

491 18-09-2018 160102050918Y000810 0002317500573 HAMRAN AB L PEKERJA MANDIRI Non-insulin-dependent Rujuk Lanjut
diabetes mellitus with

492 18-09-2018 160102050918Y000834 0002433696366 YUWANDI YUNUS L PEGAWAI SWASTA Tuberculosis of lung, Rujuk Lanjut
without mention of
bacteriological or

493 18-09-2018 160102050918Y000829 0002437496831 USMAN L PEKERJA MANDIRI Chronic renal failure, Rujuk Lanjut
unspecified
494 18-09-2018 160102050918Y000832 0002476597566 YUNITA EKA SRI MULYANTI P PEKERJA MANDIRI Headache Berobat Jalan

495 17-09-2018 160102050918Y000717 0000120217397 E.A. SURYANTO, DRS L PENERIMA PENSIUN Essential (primary) Berobat Jalan
PNS hypertension
496 17-09-2018 160102050918Y000755 0000120281398 SjAMSUL HADI L PENERIMA PENSIUN Non-insulin-dependent Berobat Jalan
PNS diabetes mellitus without

497 17-09-2018 160102050918Y000739 0000120292839 NURKHOIRIAH HARAHAP P PNS PUSAT Adhesive capsulitis of Rujuk Lanjut
shoulder
498 17-09-2018 160102050918Y000699 0000120442487 WISBAR ALDAR L PNS DAERAH Chronic ischaemic heart Berobat Jalan
disease, unspecified
499 17-09-2018 160102050918Y000730 0000120488984 SYAPRUDDIN L PEGAWAI PEMERINTAH Chronic ischaemic heart Rujuk Lanjut
DENGAN PERJANJIAN disease, unspecified

500 17-09-2018 160102050918Y000781 0000120549172 ERNAWATI P PNS DAERAH Other disorders of urinary Berobat Jalan
system
501 17-09-2018 160102050918Y000723 0000120659343 E.A. SYARWANI BBA L PENERIMA PENSIUN Chronic ischaemic heart Rujuk Lanjut
PNS disease, unspecified
502 17-09-2018 160102050918Y000735 0000120666701 RUSNIAH P PENERIMA PENSIUN Cardiac arrhythmia, Rujuk Lanjut
PNS unspecified
503 17-09-2018 160102050918Y000757 0000120674057 SUGIARTO L PENERIMA PENSIUN Acute nasopharyngitis Berobat Jalan
PNS [common cold]
504 17-09-2018 160102050918Y000714 0000120705006 SITI FATIMAH P PENERIMA PENSIUN Asthma, unspecified Rujuk Lanjut
PNS
505 17-09-2018 160102050918Y000700 0000120905289 padjriansyah L PENERIMA PENSIUN Hyperplasia of prostate Rujuk Lanjut
PNS
506 17-09-2018 160102050918Y000799 0000120905291 TINI KARTINI P PENERIMA PENSIUN Myalgia, shoulder region Berobat Jalan
PNS
507 17-09-2018 160102050918Y000740 0000123297344 SULISTYOWATI P PENERIMA PENSIUN Low back pain Rujuk Lanjut
PNS
508 17-09-2018 160102050918Y000724 0000169343583 HERMAWATI P PNS PUSAT Non-insulin-dependent Berobat Jalan
diabetes mellitus without

509 17-09-2018 160102050918Y000773 0000518648995 RUSIMIN L PBI (APBN) Fever, unspecified Berobat Jalan
DAFTAR KUNJUNGAN PESERTA SAKIT

Kantor Cabang : SAMARINDA - 1601

FKTP : SEGIRI - 16010205

510 17-09-2018 160102050918Y000783 0000755596495 M AGUS RIZKY L PBI (APBN) Surgical follow-up care, Berobat Jalan
unspecified
511 17-09-2018 160102050918Y000764 0000897730255 MARIMA ROSALIA DAHAI P PBI (APBN) Acute lymphadenitis of Berobat Jalan
upper limb
512 17-09-2018 160102050918Y000762 0000899277491 HENNI WATI P PBI (APBN) Myalgia Berobat Jalan

513 17-09-2018 160102050918Y000778 0000902249886 AYU NURJANAH P PBI (APBN) Acute nasopharyngitis Berobat Jalan
[common cold]
514 17-09-2018 160102050918Y000791 0000902338097 UMAMI P PBI (APBN) Myalgia, shoulder region Berobat Jalan

515 17-09-2018 160102050918Y000754 0000902499491 MUNTIWA P PBI (APBN) Essential (primary) Berobat Jalan
hypertension
516 17-09-2018 160102050918Y000794 0000902502055 JARIYATIN P PBI (APBN) Essential (primary) Berobat Jalan
hypertension
517 17-09-2018 160102050918Y000796 0000902502516 FAUZI L PBI (APBN) Decubitus ulcer Berobat Jalan

518 17-09-2018 160102050918Y000759 0000902751456 AHMAD MISRANSYAH L PBI (APBN) Essential (primary) Berobat Jalan
hypertension
519 17-09-2018 160102050918Y000709 0000902751827 YUNITA AMELIA PUTRI P PBI (APBN) Schizophrenia, unspecified Rujuk Lanjut

520 17-09-2018 160102050918Y000704 0000903226432 SASTRO SAIDI L PBI (APBN) Non-insulin-dependent Berobat Jalan
diabetes mellitus without

521 17-09-2018 160102050918Y000792 0000903360104 HAERATI DAENG SIMBA P PBI (APBN) Asthma, unspecified Berobat Jalan

522 17-09-2018 160102050918Y000776 0000903427975 SITI SUPARTI P PBI (APBN) Non-insulin-dependent Berobat Jalan
diabetes mellitus without

523 17-09-2018 160102050918Y000769 0000903453219 BAYAH. S P PBI (APBN) Surgical follow-up care, Berobat Jalan
unspecified
524 17-09-2018 160102050918Y000753 0001066471828 SITI NURAINI P PBI (APBN) Essential (primary) Berobat Jalan
hypertension
525 17-09-2018 160102050918Y000696 0001066483113 SYAHRUDDIN L PBI (APBN) Other chest pain Rujuk Lanjut

526 17-09-2018 160102050918Y000772 0001066483282 WATINI P PEKERJA MANDIRI Superficial injury of lower Berobat Jalan
leg, unspecified
527 17-09-2018 160102050918Y000733 0001095294576 NATALIS TUSIN L ANGGOTA POLRI Hyperplasia of prostate Rujuk Lanjut

528 17-09-2018 160102050918Y000750 0001169151164 AHMAD BINSAR PARSAOROAN L PEGAWAI SWASTA Varicella without Berobat Jalan
BATUBARA complication
529 17-09-2018 160102050918Y000756 0001202626102 RAFIAH P PEGAWAI PEMERINTAH Malignant neoplasm of Rujuk Lanjut
DENGAN PERJANJIAN cervix uteri, unspecified

530 17-09-2018 160102050918Y000785 0001226521271 DWI SANDI ARIFIANTO L PEGAWAI SWASTA Acute pharyngitis, Berobat Jalan
unspecified
DAFTAR KUNJUNGAN PESERTA SAKIT

Kantor Cabang : SAMARINDA - 1601

FKTP : SEGIRI - 16010205

531 17-09-2018 160102050918Y000706 0001261838597 MAULIDA ALYA NISA P PEKERJA MANDIRI Low vision, both eyes Rujuk Lanjut

532 17-09-2018 160102050918Y000702 0001268373688 NASAN JONY SILALAHI raja L PEKERJA MANDIRI Hyperplasia of prostate Rujuk Lanjut

533 17-09-2018 160102050918Y000768 0001480770279 HOTIMAH P PEKERJA MANDIRI Malignant neoplasm of Rujuk Lanjut
cervix uteri, unspecified
534 17-09-2018 160102050918Y000767 0001550022221 AHMAD SAHRUL L PEGAWAI SWASTA Gonococcal infection, Berobat Jalan
unspecified
535 17-09-2018 160102050918Y000765 0001551827485 ADE JULIA P PBI (APBD) Other injuries of lower Berobat Jalan
limb, level unspecified
536 17-09-2018 160102050918Y000795 0001649069853 NABILA EKA PUTRI P PEGAWAI SWASTA Acute nasopharyngitis Berobat Jalan
[common cold]
537 17-09-2018 160102050918Y000758 0001743886528 LANGGENG BRAMANTYO L PEGAWAI SWASTA Acute nasopharyngitis Berobat Jalan
[common cold]
538 17-09-2018 160102050918Y000707 0001812958323 JAMILAH P PEKERJA MANDIRI Non-insulin-dependent Berobat Jalan
diabetes mellitus without

539 17-09-2018 160102050918Y000741 0001820224664 YOANNITA RINI P PEKERJA MANDIRI Malignant neoplasm of Rujuk Lanjut
cervix uteri, unspecified
540 17-09-2018 160102050918Y000793 0001881581646 TIMBUL WAHYUDI L PEKERJA MANDIRI Sequelae of stroke, not Berobat Jalan
specified as haemorrhage

541 17-09-2018 160102050918Y000800 0001924843421 ANITA RAHMAH P PEKERJA MANDIRI Myalgia, shoulder region Berobat Jalan

542 17-09-2018 160102050918Y000770 0001925047225 NUR TINA SARI HARTATI P PEKERJA MANDIRI Dyspepsia Berobat Jalan

543 17-09-2018 160102050918Y000788 0001925214309 PAIMAN L PBI (APBD) Epilepsy, unspecified Berobat Jalan

544 17-09-2018 160102050918Y000705 0001925217955 YULIONO L PBI (APBD) Schizophrenia, unspecified Rujuk Lanjut

545 17-09-2018 160102050918Y000775 0001925253753 ADI FADLI L PBI (APBD) Acute nasopharyngitis Berobat Jalan
[common cold]
546 17-09-2018 160102050918Y000780 0001929375685 RANI KUSUMA P PBI (APBD) Non-insulin-dependent Berobat Jalan
diabetes mellitus with

547 17-09-2018 160102050918Y000751 0001963314112 RA.IRIANDI WARGANEGARA L PEKERJA MANDIRI Chronic viral hepatitis, Rujuk Lanjut
unspecified
548 17-09-2018 160102050918Y000738 0002060447646 SUKANTI P PEKERJA MANDIRI Chronic ischaemic heart Rujuk Lanjut
disease, unspecified
549 17-09-2018 160102050918Y000710 0002062414517 DWI ATMODJO L PEKERJA MANDIRI Essential (primary) Berobat Jalan
hypertension
550 17-09-2018 160102050918Y000797 0002062414809 SRI ASIH P PEKERJA MANDIRI Myalgia, shoulder region Berobat Jalan

551 17-09-2018 160102050918Y000698 0002062453689 ABDUL HAKIM L PEKERJA MANDIRI Essential (primary) Rujuk Lanjut
hypertension
DAFTAR KUNJUNGAN PESERTA SAKIT

Kantor Cabang : SAMARINDA - 1601

FKTP : SEGIRI - 16010205

552 17-09-2018 160102050918Y000789 0002064033606 GT. SAIBATUL ASLAMIAH P PEKERJA MANDIRI Essential (primary) Berobat Jalan
hypertension
553 17-09-2018 160102050918Y000736 0002064043181 ENDANG SRI ASTUTIK P PEKERJA MANDIRI Other specified Rujuk Lanjut
orthopaedic follow-up care

554 17-09-2018 160102050918Y000779 0002065980126 RUSLI SIREGAR L PEKERJA MANDIRI Cough Rujuk Lanjut

555 17-09-2018 160102050918Y000701 0002070585235 SULAIKAH P PEKERJA MANDIRI Non-insulin-dependent Berobat Jalan
diabetes mellitus without

556 17-09-2018 160102050918Y000749 0002073187282 EDY PURWANTO L PEKERJA MANDIRI Congestive heart failure Rujuk Lanjut

557 17-09-2018 160102050918Y000748 0002075717474 ABDUL SAMAD L PEKERJA MANDIRI Chronic ischaemic heart Rujuk Lanjut
disease, unspecified
558 17-09-2018 160102050918Y000703 0002076778293 SYAEPIDIN L PEKERJA MANDIRI Unspecified injury of lower Rujuk Lanjut
leg
559 17-09-2018 160102050918Y000766 0002082322642 HARIONO L PEKERJA MANDIRI Acute pharyngitis, Berobat Jalan
unspecified
560 17-09-2018 160102050918Y000771 0002082323417 PUTRIASA EWIN P PEKERJA MANDIRI Acute pharyngitis, Berobat Jalan
unspecified
561 17-09-2018 160102050918Y000787 0002082929499 ADHE SAFITRI PURBA P PEGAWAI PEMERINTAH Acute nasopharyngitis Berobat Jalan
DENGAN PERJANJIAN [common cold]

562 17-09-2018 160102050918Y000782 0002085477434 SANTARI WAHAB L PEKERJA MANDIRI Headache Berobat Jalan

563 17-09-2018 160102050918Y000742 0002085477963 ANISSA PATRICIA WAHAB P PEKERJA MANDIRI Fever, unspecified Rujuk Lanjut

564 17-09-2018 160102050918Y000697 0002203130924 SADEMI P PEKERJA MANDIRI Senile cataract, Rujuk Lanjut
unspecified
565 17-09-2018 160102050918Y000777 0002203870127 ABDUL SAKIL L PEKERJA MANDIRI Non-insulin-dependent Berobat Jalan
diabetes mellitus without

566 17-09-2018 160102050918Y000761 0002205473073 RAHWONO L PEKERJA MANDIRI Essential (primary) Berobat Jalan
hypertension
567 17-09-2018 160102050918Y000763 0002205473859 JAINAB MISNAWATI P PEKERJA MANDIRI Acute nasopharyngitis Berobat Jalan
[common cold]
568 17-09-2018 160102050918Y000760 0002205474581 JAIRA ALMIRA DEVI ILONA P PEKERJA MANDIRI Acute nasopharyngitis Berobat Jalan
[common cold]
569 17-09-2018 160102050918Y000752 0002245028613 ANDI AZIS L PEKERJA MANDIRI Non-insulin-dependent Berobat Jalan
diabetes mellitus without

570 17-09-2018 160102050918Y000774 0002290730477 MASDUKI L PEKERJA MANDIRI Essential (primary) Berobat Jalan
hypertension
571 17-09-2018 160102050918Y000798 0002317061575 NURUL KHUMAIROH L PEKERJA MANDIRI Dyspepsia Berobat Jalan
DAFTAR KUNJUNGAN PESERTA SAKIT

Kantor Cabang : SAMARINDA - 1601

FKTP : SEGIRI - 16010205

572 17-09-2018 160102050918Y000786 0002317500573 HAMRAN AB L PEKERJA MANDIRI Fever, unspecified Berobat Jalan

573 17-09-2018 160102050918Y000784 0002326067548 MUHAMMAD SENDY PRASETYA L PEGAWAI SWASTA Fever, unspecified Berobat Jalan

574 17-09-2018 160102050918Y000986 0002327980015 RHEVA WILDA MAHESTRI P PEKERJA MANDIRI Fever, unspecified Berobat Jalan

575 17-09-2018 160102050918Y000725 0002378081452 ANDRIANE M SAKUDU P PEKERJA MANDIRI Xanthelasma of eyelid Rujuk Lanjut

576 17-09-2018 160102050918Y000790 0002422731183 KISWATI P PEKERJA MANDIRI Acute nasopharyngitis Berobat Jalan
[common cold]
577 17-09-2018 160102050918Y000734 0002479997417 NUR HASNAINI P PEKERJA MANDIRI Malignant neoplasm of Rujuk Lanjut
breast, unspecified
578 15-09-2018 160102050918Y000648 0000120292694 drs. MOHD FAIZAL., apt.,mppm L PNS PUSAT Non-insulin-dependent Berobat Jalan
diabetes mellitus without

579 15-09-2018 160102050918Y000641 0000120452567 SUGIJONO L PENERIMA PENSIUN Non-insulin-dependent Berobat Jalan
PNS diabetes mellitus without

580 15-09-2018 160102050918Y000668 0000120488973 SALMAH TIMA P PENERIMA PENSIUN Non-insulin-dependent Berobat Jalan
PNS diabetes mellitus without

581 15-09-2018 160102050918Y000679 0000120528191 LA BESA L PNS PUSAT Acute nasopharyngitis Berobat Jalan
[common cold]
582 15-09-2018 160102050918Y000670 0000120549317 MAS`UD L PNS DAERAH Myalgia Berobat Jalan

583 15-09-2018 160102050918Y000666 0000120559779 SJAHRIL AIDA P PENERIMA PENSIUN Non-insulin-dependent Berobat Jalan
PNS diabetes mellitus without

584 15-09-2018 160102050918Y000671 0000120560883 SITI AMANAH P PENERIMA PENSIUN Hyperlipidaemia, Berobat Jalan
PNS unspecified
585 15-09-2018 160102050918Y000643 0000120584788 RONIAH, HJ P PENERIMA PENSIUN Superficial injury of lower Rujuk Lanjut
PNS leg, unspecified
586 15-09-2018 160102050918Y000640 0000120634277 DJALEHA P PENERIMA PENSIUN Superficial injury of Rujuk Lanjut
PNS forearm, unspecified
587 15-09-2018 160102050918Y000680 0000120666295 JUMIATY P PENERIMA PENSIUN Essential (primary) Berobat Jalan
PNS hypertension
588 15-09-2018 160102050918Y000642 0000120671032 SITI SUTIJANTI P PENERIMA PENSIUN Chronic ischaemic heart Rujuk Lanjut
PNS disease, unspecified
589 15-09-2018 160102050918Y000651 0000120756688 SURYANIWATI P PENERIMA PENSIUN Naevus, non-neoplastic Rujuk Lanjut
PNS
590 15-09-2018 160102050918Y000669 0000120776376 SAKILA P PNS DAERAH Cystitis, unspecified Berobat Jalan

591 15-09-2018 160102050918Y000639 0000120791158 HALIMATUSAKDIAH P PNS DAERAH Essential (primary) Berobat Jalan
hypertension
592 15-09-2018 160102050918Y000688 0000120826089 MARJONO L PNS DAERAH Otitis externa, unspecified Berobat Jalan
DAFTAR KUNJUNGAN PESERTA SAKIT

Kantor Cabang : SAMARINDA - 1601

FKTP : SEGIRI - 16010205

593 15-09-2018 160102050918Y000665 0000121050393 MARGIRISWANTO L PNS PUSAT Essential (primary) Berobat Jalan
hypertension
594 15-09-2018 160102050918Y000675 0000123126142 SUKANTI P PENERIMA PENSIUN Non-insulin-dependent Berobat Jalan
PNS diabetes mellitus without

595 15-09-2018 160102050918Y000658 0000199546176 SALMARIAH P PNS DAERAH Acute nasopharyngitis Berobat Jalan
[common cold]
596 15-09-2018 160102050918Y000655 0000728261256 MUTMAINAH P PBI (APBN) Dyspepsia Berobat Jalan

597 15-09-2018 160102050918Y000667 0000759640296 TITIN SULIAWATI P PBI (APBN) Cough Rujuk Lanjut

598 15-09-2018 160102050918Y000681 0000899171515 ODA DEA P PBI (APBN) Surgical follow-up care, Berobat Jalan
unspecified
599 15-09-2018 160102050918Y000674 0000902546482 MUHAMMAD RIZKY L PBI (APBN) Dyspepsia Berobat Jalan

600 15-09-2018 160102050918Y000676 0000902655494 SUCI MAYA RANTI P PBI (APBN) Superficial injury of lower Berobat Jalan
leg, unspecified
601 15-09-2018 160102050918Y000684 0000902738351 AINI ASTUTI P PBI (APBN) Fever, unspecified Berobat Jalan

602 15-09-2018 160102050918Y000654 0000902922557 NUR ZAKIAH P PBI (APBN) Non-insulin-dependent Berobat Jalan
diabetes mellitus without

603 15-09-2018 160102050918Y000689 0000903192693 TINA P PBI (APBN) Haemoptysis Berobat Jalan

604 15-09-2018 160102050918Y000653 0000903394809 DARSILAN L PBI (APBN) Presbyopia Rujuk Lanjut

605 15-09-2018 160102050918Y000686 0000903458902 TIROHMAH P PBI (APBN) Other disorders of urinary Berobat Jalan
system
606 15-09-2018 160102050918Y000646 0000976689257 SOFIE FARISTINA P PNS PUSAT Supervision of high-risk Rujuk Lanjut
pregnancy
607 15-09-2018 160102050918Y000690 0001066519181 NURUL SUSANTI P PBI (APBN) General medical Berobat Jalan
examination
608 15-09-2018 160102050918Y000687 0001132080592 NURUL INDAH P PEKERJA MANDIRI Acute nasopharyngitis Berobat Jalan
[common cold]
609 15-09-2018 160102050918Y000673 0001267206873 KASTIAH P ANGGOTA POLRI Non-insulin-dependent Berobat Jalan
diabetes mellitus without

610 15-09-2018 160102050918Y000649 0001445777447 ACHMAD ZUHRI L PEKERJA MANDIRI Benign neoplasm of Rujuk Lanjut
unspecified site
611 15-09-2018 160102050918Y000652 0001545195835 AJENG KHALISA MAHARANI P PEGAWAI SWASTA Impacted cerumen Berobat Jalan

612 15-09-2018 160102050918Y000656 0001734272662 RATNA SARI P PEKERJA MANDIRI Essential (primary) Berobat Jalan
hypertension
613 15-09-2018 160102050918Y000677 0001880611953 rezky nur hidayat L PNS PUSAT Acute tonsillitis, Berobat Jalan
unspecified
DAFTAR KUNJUNGAN PESERTA SAKIT

Kantor Cabang : SAMARINDA - 1601

FKTP : SEGIRI - 16010205

614 15-09-2018 160102050918Y000659 0001923462303 MARLEN UDAU P PEKERJA MANDIRI Somatoform disorder, Rujuk Lanjut
unspecified
615 15-09-2018 160102050918Y000647 0001925222139 SURATMI P PBI (APBD) Hydronephrosis with renal Rujuk Lanjut
and ureteral calculous

616 15-09-2018 160102050918Y000644 0001925234785 KOLETA SAIMAN P PBI (APBD) Other and unspecified Rujuk Lanjut
ovarian cysts
617 15-09-2018 160102050918Y000664 0001928653042 JAMILAH P PBI (APBD) Essential (primary) Berobat Jalan
hypertension
618 15-09-2018 160102050918Y000672 0002060451191 SAMSIAH P PEKERJA MANDIRI Non-insulin-dependent Berobat Jalan
diabetes mellitus without

619 15-09-2018 160102050918Y000661 0002081219185 MUHAMMAD REZKI SANTOS L PEKERJA MANDIRI Cutaneous mycobacterial Berobat Jalan
infection
620 15-09-2018 160102050918Y000645 0002084625134 PARIDA P PEKERJA MANDIRI Thyroiditis, unspecified Rujuk Lanjut

621 15-09-2018 160102050918Y000663 0002194783064 MUHAMMAD HAFIZH L PEGAWAI SWASTA Acute nasopharyngitis Berobat Jalan
RAMADHANI [common cold]
622 15-09-2018 160102050918Y000685 0002204132962 DWI RETNO WULANDARI P PEKERJA MANDIRI Hordeolum and other deep Berobat Jalan
inflammation of eyelid

623 15-09-2018 160102050918Y000657 0002205357851 fazli nur parisi L PNS DAERAH Acute nasopharyngitis Berobat Jalan
[common cold]
624 15-09-2018 160102050918Y000692 0002209714514 MELANI P PEKERJA MANDIRI Supervision of pregnancy Berobat Jalan
with history of infertility
625 15-09-2018 160102050918Y000683 0002219945084 KADINEM P PEKERJA MANDIRI Essential (primary) Berobat Jalan
hypertension
626 15-09-2018 160102050918Y000682 0002230285678 MIKAILA P PEKERJA MANDIRI Diarrhoea and Berobat Jalan
gastroenteritis of
presumed infectious origin

627 15-09-2018 160102050918Y000650 0002296627446 IKE YUWAN AFRIDAY APRILIA P PEKERJA MANDIRI Bell's palsy Rujuk Lanjut

628 15-09-2018 160102050918Y000678 0002322632553 HASANAH P PEKERJA MANDIRI Surgical follow-up care, Berobat Jalan
unspecified
629 15-09-2018 160102050918Y000660 0002477485686 MUHAMMAD JUSTVIN FEBRIAN L PNS DAERAH Disorder of refraction, Rujuk Lanjut
ARHAM unspecified
630 15-09-2018 160102050918Y000662 0002477876049 ARIFA NUR FATIMAH P PBI (APBN) Routine child health Berobat Jalan
examination
631 14-09-2018 160102050918Y000584 0000120509526 ZUBAIDAH P PENERIMA PENSIUN TNI Senile cataract Rujuk Lanjut

632 14-09-2018 160102050918Y000564 0000120522813 HJ.NOORHIDAYAH, SE, M.KES P PNS PUSAT Congestive heart failure Rujuk Lanjut
DAFTAR KUNJUNGAN PESERTA SAKIT

Kantor Cabang : SAMARINDA - 1601

FKTP : SEGIRI - 16010205

633 14-09-2018 160102050918Y000600 0000120549453 SAIDAH P PNS DAERAH Non-insulin-dependent Berobat Jalan
diabetes mellitus without

634 14-09-2018 160102050918Y000599 0000120549464 NANANG RIDUAN L PNS DAERAH Non-insulin-dependent Berobat Jalan
diabetes mellitus without

635 14-09-2018 160102050918Y000560 0000120561311 APUK BILUNG L PENERIMA PENSIUN Hyperplasia of prostate Rujuk Lanjut
PNS
636 14-09-2018 160102050918Y000612 0000120561322 BURING P PENERIMA PENSIUN Conjunctivitis, unspecified Berobat Jalan
PNS
637 14-09-2018 160102050918Y000568 0000120590177 DJOEAIRIYAH, HJ P PENERIMA PENSIUN Non-insulin-dependent Rujuk Lanjut
PNS diabetes mellitus without

638 14-09-2018 160102050918Y000569 0000120614444 PAYAMAN SINAMBELA, DRS L PENERIMA PENSIUN Hyperplasia of prostate Rujuk Lanjut
PNS
639 14-09-2018 160102050918Y000566 0000120655361 ASNIAH P PENERIMA PENSIUN Non-insulin-dependent Rujuk Lanjut
PNS diabetes mellitus with

640 14-09-2018 160102050918Y000559 0000120657464 DRS. ENCIK ACHMAD FAIZAL L PENERIMA PENSIUN Hyperplasia of prostate Rujuk Lanjut
PNS
641 14-09-2018 160102050918Y000577 0000120660478 ROCHANA P PENERIMA PENSIUN Hypertensive heart Rujuk Lanjut
PNS disease with (congestive)

642 14-09-2018 160102050918Y000556 0000120666947 LUDIA PUDI P PENERIMA PENSIUN Tinnitus Rujuk Lanjut
PNS
643 14-09-2018 160102050918Y000563 0000120666958 MARKUS ROMBE L PENERIMA PENSIUN Chronic ischaemic heart Berobat Jalan
PNS disease, unspecified
644 14-09-2018 160102050918Y000555 0000120672066 SUKARSIH P PENERIMA PENSIUN Epilepsy, unspecified Rujuk Lanjut
PNS
645 14-09-2018 160102050918Y000583 0000120756688 SURYANIWATI P PENERIMA PENSIUN Senile incipient cataract Rujuk Lanjut
PNS
646 14-09-2018 160102050918Y000572 0000120913479 KHEMASILI KOSALA P PNS DAERAH Essential (primary) Berobat Jalan
hypertension
647 14-09-2018 160102050918Y000574 0000120913481 JOHANES NONO JUWONO,IR L PNS DAERAH Chronic ischaemic heart Berobat Jalan
disease, unspecified
648 14-09-2018 160102050918Y000592 0000123132396 AJI DESI INDRAWATI P PNS DAERAH Presbyopia Rujuk Lanjut

649 14-09-2018 160102050918Y000565 0000123238168 SAMSIYAH P PENERIMA PENSIUN Congestive heart failure Rujuk Lanjut
PNS
650 14-09-2018 160102050918Y000558 0000123684851 MASITAH P PNS DAERAH Chronic ischaemic heart Rujuk Lanjut
disease, unspecified
651 14-09-2018 160102050918Y000573 0000164273804 MEUTIA FARIDA P PENERIMA PENSIUN TNI Thyroiditis, unspecified Rujuk Lanjut
DAFTAR KUNJUNGAN PESERTA SAKIT

Kantor Cabang : SAMARINDA - 1601

FKTP : SEGIRI - 16010205

652 14-09-2018 160102050918Y000594 0000897476679 MULYANI P PBI (APBN) Cardiomyopathy, Rujuk Lanjut
unspecified
653 14-09-2018 160102050918Y000579 0000897727241 LUKAS MUYA L PBI (APBN) Benign neoplasm of other Rujuk Lanjut
specified sites
654 14-09-2018 160102050918Y000590 0000898165427 NUR SANIAH P PBI (APBN) Injury of conjunctiva and Rujuk Lanjut
corneal abrasion without

655 14-09-2018 160102050918Y000586 0000899127101 HJ JAMIAH P PBI (APBN) Blindness, one eye, low Rujuk Lanjut
vision other eye
656 14-09-2018 160102050918Y000610 0000899218102 RAHMAWATI P PBI (APBN) Acute nasopharyngitis Berobat Jalan
[common cold]
657 14-09-2018 160102050918Y000596 0000899356083 DIKIE CANDRA L PBI (APBN) Epilepsy, unspecified Rujuk Lanjut

658 14-09-2018 160102050918Y000605 0000902001835 NURHAYATI P PBI (APBN) Essential (primary) Berobat Jalan
hypertension
659 14-09-2018 160102050918Y000607 0000902393561 FIKRIANSA L PBI (APBN) Dysphagia Berobat Jalan

660 14-09-2018 160102050918Y000582 0000902546752 IIN NOVI YANI P PBI (APBN) Supervision of high-risk Rujuk Lanjut
pregnancy
661 14-09-2018 160102050918Y000693 0000902593923 DIAN TANIAR P PBI (APBN) Supervision of normal first Berobat Jalan
pregnancy
662 14-09-2018 160102050918Y000608 0000902703475 NUR ROHMANI P PBI (APBN) Non-insulin-dependent Berobat Jalan
diabetes mellitus without

663 14-09-2018 160102050918Y000578 0000903213584 SUKMA P PBI (APBN) Systemic lupus Rujuk Lanjut
erythematosus,

664 14-09-2018 160102050918Y000609 0001066471503 ENDANG SULASTRI P PEKERJA MANDIRI Essential (primary) Berobat Jalan
hypertension
665 14-09-2018 160102050918Y000585 0001066472245 M. SAIRI L PBI (APBN) Chronic ischaemic heart Berobat Jalan
disease, unspecified
666 14-09-2018 160102050918Y000580 0001323587261 baharuddin L PNS DAERAH Other and unspecified Rujuk Lanjut
cirrhosis of liver
667 14-09-2018 160102050918Y000576 0001545884651 NURHAYATI P PEGAWAI SWASTA Malignant neoplasm of Rujuk Lanjut
sigmoid colon
668 14-09-2018 160102050918Y000589 0001548746133 HARLIATI P PEKERJA MANDIRI Chronic viral hepatitis, Rujuk Lanjut
unspecified
669 14-09-2018 160102050918Y000593 0001553675973 DEVIONA CAROLENSA P PBI (APBD) Allergic contact dermatitis, Berobat Jalan
unspecified cause

670 14-09-2018 160102050918Y000613 0001725503073 ANIP SUSANTO L PEKERJA MANDIRI Superficial frostbite of Berobat Jalan
other and unspecified sites

671 14-09-2018 160102050918Y000601 0001734278051 MOHAMMAD IRHAM L PEKERJA MANDIRI Chronic ischaemic heart Rujuk Lanjut
HIDAYANTO disease, unspecified
DAFTAR KUNJUNGAN PESERTA SAKIT

Kantor Cabang : SAMARINDA - 1601

FKTP : SEGIRI - 16010205

672 14-09-2018 160102050918Y000602 0001844845481 SUMIATI P PEKERJA MANDIRI Acute nasopharyngitis Berobat Jalan
[common cold]
673 14-09-2018 160102050918Y000570 0001923266046 ASENG L PEKERJA MANDIRI Sequelae of stroke, not Rujuk Lanjut
specified as haemorrhage

674 14-09-2018 160102050918Y000557 0001925217336 MOCHAMAD ARYA YUDISTIRA L PBI (APBD) Acute tonsillitis, Rujuk Lanjut
unspecified
675 14-09-2018 160102050918Y000554 0001925222995 USNEIDI L PBI (APBD) After-cataract Rujuk Lanjut

676 14-09-2018 160102050918Y000567 0001925231837 MUHAMMAD ZEINULLOH L PEKERJA MANDIRI Nephrotic syndrome, Rujuk Lanjut
unspecified
677 14-09-2018 160102050918Y000604 0001929263962 SITI YULAINAH P PBI (APBD) Hyperlipidaemia, Berobat Jalan
unspecified
678 14-09-2018 160102050918Y000587 0002060756177 JUSRIADI L PEGAWAI SWASTA Chronic viral hepatitis, Rujuk Lanjut
unspecified
679 14-09-2018 160102050918Y000553 0002061008267 ARDIANSYAH L PEKERJA MANDIRI Schizophrenia, unspecified Rujuk Lanjut

680 14-09-2018 160102050918Y000588 0002077780421 SUSI P PEKERJA MANDIRI Excessive and frequent Rujuk Lanjut
menstruation with irregular

681 14-09-2018 160102050918Y000591 0002227046275 FERRY IRAWAN L PEGAWAI SWASTA Tuberculosis of lung, Berobat Jalan
without mention of
bacteriological or

682 14-09-2018 160102050918Y000597 0002232638087 RIZKA NURYANTI TANJUNG P PBI (APBD) Asthma, unspecified Berobat Jalan

683 14-09-2018 160102050918Y000611 0002238223241 TOMMY MASHOER L PEKERJA MANDIRI Essential (primary) Berobat Jalan
hypertension
684 14-09-2018 160102050918Y000606 0002238907599 NAURAH NABILAH P PNS DAERAH Acute tonsillitis, Berobat Jalan
unspecified
685 14-09-2018 160102050918Y000691 0002249201147 ROSHITA SARI P PEKERJA MANDIRI Supervision of normal Berobat Jalan
pregnancy, unspecified
686 14-09-2018 160102050918Y000562 0002281711274 aurellia azzahra putri P PEKERJA MANDIRI Acute nasopharyngitis Berobat Jalan
[common cold]
687 14-09-2018 160102050918Y000603 0002285234054 NAURA ANINDYA SUSANTO P PEKERJA MANDIRI Acute nasopharyngitis Berobat Jalan
[common cold]
688 14-09-2018 160102050918Y000595 0002308662753 SITI HANIFAH L PBI (APBD) Disorder of refraction, Rujuk Lanjut
unspecified
689 14-09-2018 160102050918Y000561 0002317792937 RIFKI ALMUHARRAM L PEKERJA MANDIRI Superficial injury of lower Rujuk Lanjut
leg, unspecified
690 14-09-2018 160102050918Y000571 0002451658037 ALVINO KENZO RAFAEL L PBI (APBN) Acute bronchiolitis, Rujuk Lanjut
unspecified
691 14-09-2018 160102050918Y000575 0002456074629 NATHANAEL MICHAEL GILBERT L PEKERJA MANDIRI Disorder of refraction, Rujuk Lanjut
unspecified
DAFTAR KUNJUNGAN PESERTA SAKIT

Kantor Cabang : SAMARINDA - 1601

FKTP : SEGIRI - 16010205

692 14-09-2018 160102050918Y000598 0002482165135 SURYADI L PEKERJA MANDIRI Sequelae of stroke, not Rujuk Lanjut
specified as haemorrhage

693 13-09-2018 160102050918Y000507 0000119645133 YOGI HADIPUTRA L PNS DAERAH Benign neoplasm of Rujuk Lanjut
unspecified site
694 13-09-2018 160102050918Y000529 0000120067479 GINA ATIKA P PNS DAERAH Presbyopia Rujuk Lanjut

695 13-09-2018 160102050918Y000489 0000120512013 ACHMAD FADLY L PENERIMA PENSIUN TNI Non-insulin-dependent Rujuk Lanjut
diabetes mellitus with

696 13-09-2018 160102050918Y000497 0000120528314 BAHARUDDIN L PEGAWAI SWASTA Other forms of stomatitis Rujuk Lanjut

697 13-09-2018 160102050918Y000536 0000120549025 ACHMAD FAIZIN L PNS DAERAH Acute nasopharyngitis Berobat Jalan
[common cold]
698 13-09-2018 160102050918Y000537 0000120549172 ERNAWATI P PNS DAERAH Non-insulin-dependent Berobat Jalan
diabetes mellitus without

699 13-09-2018 160102050918Y000540 0000120549396 MUS'IFAH P PNS DAERAH Dyspepsia Berobat Jalan

700 13-09-2018 160102050918Y000541 0000120549475 SUGENG WAHONO L PNS DAERAH Essential (primary) Berobat Jalan
hypertension
701 13-09-2018 160102050918Y000495 0000120629136 BADARIAH P PENERIMA PENSIUN Chronic ischaemic heart Rujuk Lanjut
PNS disease, unspecified
702 13-09-2018 160102050918Y000502 0000120652863 RACHMATIAH P PENERIMA PENSIUN Essential (primary) Berobat Jalan
PNS hypertension
703 13-09-2018 160102050918Y000488 0000120655056 ASKAMAN MASDAR L PENERIMA PENSIUN Essential (primary) Berobat Jalan
PNS hypertension
704 13-09-2018 160102050918Y000485 0000120672674 SAMLAN,DRS, BCHK, H L PENERIMA PENSIUN Chronic ischaemic heart Rujuk Lanjut
PNS disease, unspecified
705 13-09-2018 160102050918Y000513 0000120756295 SAWUDI L PNS DAERAH Superficial injury of lower Berobat Jalan
leg, unspecified
706 13-09-2018 160102050918Y000528 0000122089735 NANI PURWATI P PNS PUSAT Hyperlipidaemia, Berobat Jalan
unspecified
707 13-09-2018 160102050918Y000510 0000123120099 ASMUNI SABRAN L PENERIMA PENSIUN Sequelae of stroke, not Rujuk Lanjut
PNS specified as haemorrhage

708 13-09-2018 160102050918Y000516 0000123285295 NURDIN THAYIB L PENERIMA PENSIUN Non-insulin-dependent Rujuk Lanjut
PNS diabetes mellitus with
other specified

709 13-09-2018 160102050918Y000487 0000123677098 AROME BERNADETTA SILALAHI P PNS DAERAH Leiomyoma of uterus, Rujuk Lanjut
unspecified
710 13-09-2018 160102050918Y000524 0000123686638 NILA ROSANAH P PNS DAERAH Acute nasopharyngitis Berobat Jalan
[common cold]
DAFTAR KUNJUNGAN PESERTA SAKIT

Kantor Cabang : SAMARINDA - 1601

FKTP : SEGIRI - 16010205

711 13-09-2018 160102050918Y000486 0000123729827 MUZAIYID L PNS DAERAH Hordeolum and other deep Berobat Jalan
inflammation of eyelid

712 13-09-2018 160102050918Y000491 0000123729838 DALIAH P PNS DAERAH Cellulitis of other sites Rujuk Lanjut

713 13-09-2018 160102050918Y000500 0000158221001 HJ. MUSLICHAH P PENERIMA PENSIUN Non-insulin-dependent Berobat Jalan
PNS diabetes mellitus without

714 13-09-2018 160102050918Y000519 0000159257733 JEANNE CORNELIA BURKENS P PENERIMA PENSIUN Myalgia Berobat Jalan
PNS
715 13-09-2018 160102050918Y000522 0000727598417 IQBAL AFIN HIDAYATULLAH L PBI (APBN) Fracture of lower end of Rujuk Lanjut
both ulna and radius
716 13-09-2018 160102050918Y000531 0000759640296 TITIN SULIAWATI P PBI (APBN) Acute nasopharyngitis Berobat Jalan
[common cold]
717 13-09-2018 160102050918Y000496 0000898429331 AMRI L PBI (APBN) Chronic ischaemic heart Rujuk Lanjut
disease, unspecified
718 13-09-2018 160102050918Y000512 0000898929999 MUKRANSYAH L PBI (APBN) Hyperplasia of prostate Rujuk Lanjut

719 13-09-2018 160102050918Y000538 0000902547742 WAAJID VAHREZA L PBI (APBN) Allergic contact dermatitis, Berobat Jalan
unspecified cause

720 13-09-2018 160102050918Y000530 0000902601595 YUSNANIK P PBI (APBN) Benign paroxysmal vertigo Rujuk Lanjut

721 13-09-2018 160102050918Y000532 0000902748115 NORAIDAH P PBI (APBN) Myalgia, shoulder region Berobat Jalan

722 13-09-2018 160102050918Y000508 0001066478916 SITI AMINAH P PBI (APBN) Essential (primary) Berobat Jalan
hypertension
723 13-09-2018 160102050918Y000501 0001081898155 SUPRIATI DWI LESTARI P PNS DAERAH Atopic dermatitis, Rujuk Lanjut
unspecified
724 13-09-2018 160102050918Y000521 0001263188856 FARISTIA FATIMAH L PEGAWAI SWASTA Acute tonsillitis, Berobat Jalan
unspecified
725 13-09-2018 160102050918Y000534 0001296661239 RUSTAM SYAH L PNS DAERAH Acute nasopharyngitis Berobat Jalan
[common cold]
726 13-09-2018 160102050918Y000494 0001446895697 GUNAWAN WIBISONO L PEGAWAI SWASTA Blindness, one eye, low Rujuk Lanjut
vision other eye
727 13-09-2018 160102050918Y000517 0001611786576 AGUSTINUS LIAH SONG L PBI (APBD) Malignant neoplasm of Rujuk Lanjut
oesophagus, unspecified
728 13-09-2018 160102050918Y000506 0001724606458 UMI KULSUM AS P PBI (APBD) Superficial injury of lower Berobat Jalan
leg, unspecified
729 13-09-2018 160102050918Y000484 0001795315667 SOVIAWATY P PEKERJA MANDIRI Non-insulin-dependent Rujuk Lanjut
diabetes mellitus with

730 13-09-2018 160102050918Y000509 0001822062813 isnayati P PEKERJA MANDIRI Surgical follow-up care, Rujuk Lanjut
unspecified
DAFTAR KUNJUNGAN PESERTA SAKIT

Kantor Cabang : SAMARINDA - 1601

FKTP : SEGIRI - 16010205

731 13-09-2018 160102050918Y000493 0001925232017 LIA AYU RACHMAWATI P PNS DAERAH Disorder of refraction, Rujuk Lanjut
unspecified
732 13-09-2018 160102050918Y000511 0001925238407 IMAM TURHADI L PBI (APBD) Dyspepsia Berobat Jalan

733 13-09-2018 160102050918Y000525 0001926701155 RUSNA WATI P PEKERJA MANDIRI Other endometriosis Rujuk Lanjut

734 13-09-2018 160102050918Y000515 0001968769045 SUMIATI. A P PEKERJA MANDIRI Surgical follow-up care, Rujuk Lanjut
unspecified
735 13-09-2018 160102050918Y000514 0002001421596 AMBARYATUN P PBI (APBN) Essential (primary) Berobat Jalan
hypertension
736 13-09-2018 160102050918Y000498 0002077217504 BAMBANG SUHARTONO L PEKERJA MANDIRI Myalgia Berobat Jalan

737 13-09-2018 160102050918Y000533 0002083502553 SUHAEMA P PBI (APBD) Tuberculosis of bones and Rujuk Lanjut
joints
738 13-09-2018 160102050918Y000518 0002196457727 rafa putra mering hanafi L PEKERJA MANDIRI Epilepsy, unspecified Rujuk Lanjut

739 13-09-2018 160102050918Y000504 0002219585894 MUHAMMAD EFFENDI L PEKERJA MANDIRI Schizophrenia, unspecified Rujuk Lanjut

740 13-09-2018 160102050918Y000503 0002223960333 CHERRY SUNDARI L PBI (APBD) Cutaneous abscess, Berobat Jalan
furuncle and carbuncle of

741 13-09-2018 160102050918Y000527 0002231971536 CAHYO PRASETYO L PEKERJA MANDIRI Acute nasopharyngitis Berobat Jalan
[common cold]
742 13-09-2018 160102050918Y000520 0002231971942 RUDI SETIAWAN L PEKERJA MANDIRI Acute pharyngitis, Berobat Jalan
unspecified
743 13-09-2018 160102050918Y000499 0002254563595 RINA ARIANI P PEKERJA MANDIRI Schizophrenia, unspecified Rujuk Lanjut

744 13-09-2018 160102050918Y000492 0002294662533 JAINAH P PEKERJA MANDIRI Stroke, not specified as Rujuk Lanjut
haemorrhage or infarction
745 13-09-2018 160102050918Y000505 0002310387625 nusuk L PEKERJA MANDIRI Hyperplasia of prostate Rujuk Lanjut

746 13-09-2018 160102050918Y000523 0002442203379 MASROKAN L PEKERJA MANDIRI Non-insulin-dependent Berobat Jalan
diabetes mellitus without

747 13-09-2018 160102050918Y000526 0002471537024 MUH WILDAN ZAKIYA DARAJAT L PEKERJA MANDIRI Benign neoplasm of other Rujuk Lanjut
specified sites
748 13-09-2018 160102050918Y000535 0002474488866 REHANDIKA ADE SAPUTRA L PBI (APBD) Surgical follow-up care, Berobat Jalan
unspecified
749 12-09-2018 160102050918Y000433 0000120054328 DENI DULNAMUS L PNS DAERAH Otitis media, unspecified Berobat Jalan

750 12-09-2018 160102050918Y000418 0000120059853 AMALIA ASWIN P PNS DAERAH Impacted teeth Rujuk Lanjut

751 12-09-2018 160102050918Y000396 0000120100173 AGUSTINA ARRUAN P PNS DAERAH Essential (primary) Berobat Jalan
hypertension
DAFTAR KUNJUNGAN PESERTA SAKIT

Kantor Cabang : SAMARINDA - 1601

FKTP : SEGIRI - 16010205

752 12-09-2018 160102050918Y000391 0000120352443 SRI HASTUTI P PNS DAERAH Non-insulin-dependent Rujuk Lanjut
diabetes mellitus without

753 12-09-2018 160102050918Y000430 0000120428684 RIZALI NOOR L PNS PUSAT Headache Berobat Jalan

754 12-09-2018 160102050918Y000406 0000120492279 BACHRUN L PENERIMA PENSIUN TNI Hyperplasia of prostate Rujuk Lanjut

755 12-09-2018 160102050918Y000417 0000120492281 SALMIAH P PENERIMA PENSIUN TNI Crystal arthropathy, Rujuk Lanjut
unspecified
756 12-09-2018 160102050918Y000377 0000120513014 SALAMAH P PENERIMA PENSIUN TNI Non-insulin-dependent Berobat Jalan
diabetes mellitus without

757 12-09-2018 160102050918Y000376 0000120513172 SITTI ROHANI P VETERAN Senile cataract, Rujuk Lanjut
unspecified
758 12-09-2018 160102050918Y000375 0000120513914 RIBUT SUKIDJO L PENERIMA PENSIUN TNI Non-insulin-dependent Rujuk Lanjut
diabetes mellitus with
neurological complications

759 12-09-2018 160102050918Y000373 0000120513925 SURATMI P PENERIMA PENSIUN TNI Non-insulin-dependent Rujuk Lanjut
diabetes mellitus with
neurological complications

760 12-09-2018 160102050918Y000370 0000120549071 TRI URBA NURYANTO L PNS DAERAH Intrahepatic bile duct Rujuk Lanjut
carcinoma
761 12-09-2018 160102050918Y000404 0000120571143 DRS. HADRANSYAH SALMAN L PENERIMA PENSIUN Chronic ischaemic heart Rujuk Lanjut
PNS disease, unspecified
762 12-09-2018 160102050918Y000414 0000120571154 ARBAINAH P PENERIMA PENSIUN Non-insulin-dependent Rujuk Lanjut
PNS diabetes mellitus with
other specified

763 12-09-2018 160102050918Y000393 0000120588164 HELMY SULAIMAN, BA L PENERIMA PENSIUN Chronic obstructive Rujuk Lanjut
PNS pulmonary disease with
acute exacerbation,

764 12-09-2018 160102050918Y000381 0000120615985 SINTA DIANA SIAHAAN P PENERIMA PENSIUN Non-insulin-dependent Berobat Jalan
PNS diabetes mellitus without

765 12-09-2018 160102050918Y000412 0000120659343 E.A. SYARWANI BBA L PENERIMA PENSIUN Hyperplasia of prostate Rujuk Lanjut
PNS
766 12-09-2018 160102050918Y000402 0000120672066 SUKARSIH P PENERIMA PENSIUN After-cataract Rujuk Lanjut
PNS
767 12-09-2018 160102050918Y000379 0000123279568 HERMIATI M P PNS DAERAH Dyspepsia Berobat Jalan

768 12-09-2018 160102050918Y000419 0000123677954 BERTHA P PNS DAERAH Malignant neoplasm of Rujuk Lanjut
breast, unspecified
DAFTAR KUNJUNGAN PESERTA SAKIT

Kantor Cabang : SAMARINDA - 1601

FKTP : SEGIRI - 16010205

769 12-09-2018 160102050918Y000371 0000123681295 SUYANTO L PNS DAERAH Essential (primary) Berobat Jalan
hypertension
770 12-09-2018 160102050918Y000413 0000123726341 TUKIMIN L PNS DAERAH Non-insulin-dependent Berobat Jalan
diabetes mellitus without

771 12-09-2018 160102050918Y000384 0000158009253 MUKMINAH P PENERIMA PENSIUN Non-insulin-dependent Berobat Jalan
PNS diabetes mellitus without

772 12-09-2018 160102050918Y000427 0000896467904 MARYANI P PBI (APBN) Acute nasopharyngitis Berobat Jalan
[common cold]
773 12-09-2018 160102050918Y000383 0000898668235 DINAH P PBI (APBN) Tuberculous peripheral Rujuk Lanjut
lymphadenopathy
774 12-09-2018 160102050918Y000407 0000901935044 LENAH P PBI (APBN) Myalgia Berobat Jalan

775 12-09-2018 160102050918Y000401 0000902438662 SAFRI YADI L PBI (APBN) Dental caries Rujuk Lanjut

776 12-09-2018 160102050918Y000372 0000902650307 RUSMINI P PBI (APBN) Other and unspecified Rujuk Lanjut
abdominal pain
777 12-09-2018 160102050918Y000445 0000902703475 NUR ROHMANI P PBI (APBN) Headache Berobat Jalan

778 12-09-2018 160102050918Y000395 0000903229885 DAROJI L PBI (APBN) Insulin-dependent Rujuk Lanjut
diabetes mellitus with
peripheral circulatory

779 12-09-2018 160102050918Y000385 0000903442634 NANANG L PBI (APBN) Essential (primary) Berobat Jalan
hypertension
780 12-09-2018 160102050918Y000374 0001066481627 SUKATLIN P PBI (APBN) Chronic ischaemic heart Rujuk Lanjut
disease, unspecified
781 12-09-2018 160102050918Y000415 0001152600884 SHOLEH ANGGORO L PEKERJA MANDIRI Surgical follow-up care, Rujuk Lanjut
unspecified
782 12-09-2018 160102050918Y000388 0001268373688 NASAN JONY SILALAHI raja L PEKERJA MANDIRI Chronic ischaemic heart Rujuk Lanjut
disease, unspecified
783 12-09-2018 160102050918Y000389 0001268375229 HERBINA SIMANJUNTAK P PEKERJA MANDIRI Chronic ischaemic heart Rujuk Lanjut
disease, unspecified
784 12-09-2018 160102050918Y000411 0001296661239 RUSTAM SYAH L PNS DAERAH Cough Berobat Jalan

785 12-09-2018 160102050918Y000394 0001445778369 FERDI IBRAHIM L PEKERJA MANDIRI Chronic viral hepatitis B Rujuk Lanjut
with delta-agent
786 12-09-2018 160102050918Y000400 0001548686801 HERNI P PEGAWAI SWASTA Malignant neoplasm of Rujuk Lanjut
breast
787 12-09-2018 160102050918Y000369 0001795314374 MUSA ALWIE L PEKERJA MANDIRI Non-insulin-dependent Rujuk Lanjut
diabetes mellitus with

788 12-09-2018 160102050918Y000480 0001795315667 SOVIAWATY P PEKERJA MANDIRI Non-insulin-dependent Berobat Jalan
diabetes mellitus without
DAFTAR KUNJUNGAN PESERTA SAKIT

Kantor Cabang : SAMARINDA - 1601

FKTP : SEGIRI - 16010205

789 12-09-2018 160102050918Y000386 0001895690981 ACHMAD GAZALI L PEGAWAI SWASTA Chronic ischaemic heart Rujuk Lanjut
disease, unspecified
790 12-09-2018 160102050918Y000409 0001924827445 MINA P PEKERJA MANDIRI Psoriasis vulgaris Rujuk Lanjut

791 12-09-2018 160102050918Y000423 0001925214309 PAIMAN L PBI (APBD) Epilepsy, unspecified Rujuk Lanjut

792 12-09-2018 160102050918Y000390 0001925224997 MULYANTORO L PBI (APBD) Schizophrenia, unspecified Rujuk Lanjut

793 12-09-2018 160102050918Y000387 0001925231253 SLAMET RIDUAN L PBI (APBD) Schizophrenia, unspecified Rujuk Lanjut

794 12-09-2018 160102050918Y000446 0001925232107 MARTIYEM P PBI (APBD) Myalgia, hand Berobat Jalan

795 12-09-2018 160102050918Y000378 0001925232658 DIRMAN MUHAMMAD L PBI (APBD) Other disorders of Rujuk Lanjut
conjunctiva
796 12-09-2018 160102050918Y000539 0001928653154 FITRI YANTI P PBI (APBD) Supervision of normal first Berobat Jalan
pregnancy
797 12-09-2018 160102050918Y000399 0002001403574 SAMURI L PBI (APBN) Myalgia, shoulder region Berobat Jalan

798 12-09-2018 160102050918Y000422 0002065980126 RUSLI SIREGAR L PEKERJA MANDIRI Chronic ischaemic heart Rujuk Lanjut
disease, unspecified
799 12-09-2018 160102050918Y000425 0002066742167 AJI SYARIFAH BAIDURI P PEKERJA MANDIRI Dyspepsia Berobat Jalan
PERTIWI
800 12-09-2018 160102050918Y000398 0002075293427 TAMRIN L PBI (APBD) Chronic ischaemic heart Rujuk Lanjut
disease, unspecified
801 12-09-2018 160102050918Y000454 0002085477434 SANTARI WAHAB L PEKERJA MANDIRI Non-insulin-dependent Berobat Jalan
diabetes mellitus without

802 12-09-2018 160102050918Y000392 0002087629266 sanusi L PEKERJA MANDIRI Acute nasopharyngitis Berobat Jalan
[common cold]
803 12-09-2018 160102050918Y000403 0002194235289 ANNISA DWI RAMADHANI P PBI (APBD) Convulsions, not Rujuk Lanjut
elsewhere classified
804 12-09-2018 160102050918Y000382 0002219929301 RAHMANSYAH L PEKERJA MANDIRI Fever, unspecified Berobat Jalan

805 12-09-2018 160102050918Y000420 0002254958144 UPE ANI SODDIN P PEKERJA MANDIRI Benign neoplasm of Rujuk Lanjut
unspecified site
806 12-09-2018 160102050918Y000424 0002254960642 AGUSTAN L PEKERJA MANDIRI Chronic apical Berobat Jalan
periodontitis
807 12-09-2018 160102050918Y000416 0002268754018 SYAMSUDIN L PEKERJA MANDIRI Parkinson's disease Rujuk Lanjut

808 12-09-2018 160102050918Y000408 0002290270882 AURA MISYA RAHMADANI P PBI (APBD) Epilepsy, unspecified Rujuk Lanjut

809 12-09-2018 160102050918Y000410 0002322632553 HASANAH P PEKERJA MANDIRI Infection following a Berobat Jalan
procedure, not elsewhere

810 12-09-2018 160102050918Y000405 0002421836526 TI'AMAH P PEKERJA MANDIRI Headache Berobat Jalan
DAFTAR KUNJUNGAN PESERTA SAKIT

Kantor Cabang : SAMARINDA - 1601

FKTP : SEGIRI - 16010205

811 12-09-2018 160102050918Y000397 0002438204545 KANZANA AHMAD P PEKERJA MANDIRI Lack of expected normal Rujuk Lanjut
physiological

812 12-09-2018 160102050918Y000380 0002453842901 NURSAM P PEKERJA MANDIRI Essential (primary) Berobat Jalan
hypertension
813 10-09-2018 160102050918Y000334 0000119775644 NURJALI L PNS DAERAH Chronic ischaemic heart Rujuk Lanjut
disease, unspecified
814 10-09-2018 160102050918Y000320 0000119934955 PERIDA P PENERIMA PENSIUN After-cataract Rujuk Lanjut
PNS
815 10-09-2018 160102050918Y000337 0000119991262 PARJIEM,A.MA.PD P PENERIMA PENSIUN Benign neoplasm of Rujuk Lanjut
PNS unspecified site
816 10-09-2018 160102050918Y000331 0000120215373 SILVIAWAN P PENERIMA PENSIUN Presbyopia Rujuk Lanjut
PNS
817 10-09-2018 160102050918Y000336 0000120287755 SYARIFUL L PENERIMA PENSIUN Chronic ischaemic heart Rujuk Lanjut
PNS disease, unspecified
818 10-09-2018 160102050918Y000363 0000120313247 SAJIAH P PNS DAERAH Acute pharyngitis, Berobat Jalan
unspecified
819 10-09-2018 160102050918Y000976 0000120342936 ZULKIPLI L PENERIMA PENSIUN Chronic ischaemic heart Berobat Jalan
PNS disease, unspecified
820 10-09-2018 160102050918Y000354 0000120419921 HERRY MULYANI P PNS PUSAT Myalgia, shoulder region Berobat Jalan

821 10-09-2018 160102050918Y000316 0000120431924 SUPONO L PENERIMA PENSIUN Chronic renal failure, Rujuk Lanjut
PNS unspecified
822 10-09-2018 160102050918Y000325 0000120500943 RUKIYAH P PENERIMA PENSIUN TNI Noninflammatory disorders Rujuk Lanjut
of ovary, fallopian tube
and broad ligament

823 10-09-2018 160102050918Y000318 0000120512698 I WAYAN NASA ADHI,BA L PENERIMA PENSIUN TNI After-cataract Rujuk Lanjut

824 10-09-2018 160102050918Y000315 0000120572537 NORSIAH YUSRAN P PENERIMA PENSIUN Chronic ischaemic heart Rujuk Lanjut
PNS disease, unspecified
825 10-09-2018 160102050918Y000324 0000120578848 M.ARPAN L PENERIMA PENSIUN After-cataract Rujuk Lanjut
PNS
826 10-09-2018 160102050918Y000323 0000120578859 MARGARETHA THERESIA P PENERIMA PENSIUN Asthma, unspecified Rujuk Lanjut
SARAUN PNS
827 10-09-2018 160102050918Y000333 0000120614444 PAYAMAN SINAMBELA, DRS L PENERIMA PENSIUN Glaucoma, unspecified Rujuk Lanjut
PNS
828 10-09-2018 160102050918Y000979 0000120629665 NENENG KRISTIANI ROCHJIATI P PENERIMA PENSIUN Chronic ischaemic heart Berobat Jalan
PNS disease, unspecified
829 10-09-2018 160102050918Y000440 0000120656237 DANTES HUTAHAEAN SH. L PENERIMA PENSIUN Acute nasopharyngitis Berobat Jalan
PNS [common cold]
830 10-09-2018 160102050918Y000327 0000120660287 HJ. AJI DJUWITA KIRANA P PENERIMA PENSIUN Non-insulin-dependent Rujuk Lanjut
PNS diabetes mellitus without
DAFTAR KUNJUNGAN PESERTA SAKIT

Kantor Cabang : SAMARINDA - 1601

FKTP : SEGIRI - 16010205

831 10-09-2018 160102050918Y000330 0000120673225 SITI SYARAH P PENERIMA PENSIUN Chronic ischaemic heart Rujuk Lanjut
PNS disease, unspecified
832 10-09-2018 160102050918Y000366 0000120739972 RAHMANIAH P PNS DAERAH Acute nasopharyngitis Berobat Jalan
[common cold]
833 10-09-2018 160102050918Y000351 0000120756295 SAWUDI L PNS DAERAH Superficial injury of lower Berobat Jalan
leg, unspecified
834 10-09-2018 160102050918Y000971 0000120917564 MONIKA FEBRI PAEMBONAN P PNS PUSAT Acute pharyngitis, Berobat Jalan
unspecified
835 10-09-2018 160102050918Y000342 0000123084347 WA INDU P PNS DAERAH Other and unspecified Rujuk Lanjut
abdominal pain
836 10-09-2018 160102050918Y000352 0000123677133 hj. ARPAH MASDALI, s.sos. P PNS DAERAH Chronic ischaemic heart Berobat Jalan
m.,kes disease, unspecified
837 10-09-2018 160102050918Y000358 0000123684041 HELDA SUSANTI P PENERIMA PENSIUN Acute nasopharyngitis Berobat Jalan
PNS [common cold]
838 10-09-2018 160102050918Y000362 0000123686223 MARTIN JUANDA L PNS DAERAH Essential (primary) Berobat Jalan
hypertension
839 10-09-2018 160102050918Y000326 0000123691408 SRI UTAMININGSIH P PNS DAERAH Low back pain Rujuk Lanjut

840 10-09-2018 160102050918Y000332 0000123693399 THERESIA SRI LESTARI P PNS DAERAH Amenorrhoea, unspecified Rujuk Lanjut

841 10-09-2018 160102050918Y000347 0000159027333 HAMDANAH P PNS DAERAH Non-insulin-dependent Rujuk Lanjut
diabetes mellitus with
neurological complications

842 10-09-2018 160102050918Y000350 0000194227931 DR.IRA PUSPA RACHMAWATI P PNS DAERAH Asthma, unspecified Berobat Jalan

843 10-09-2018 160102050918Y000348 0000901926213 TAJUDDIN NOOR L PBI (APBN) Essential (primary) Berobat Jalan
hypertension
844 10-09-2018 160102050918Y000359 0000902076693 HANI RAHMAWATI P PBI (APBN) Headache Berobat Jalan

845 10-09-2018 160102050918Y000338 0000902379339 M RIZKY A L PBI (APBN) Dyslexia and other Rujuk Lanjut
symbolic dysfunctions, not

846 10-09-2018 160102050918Y000983 0000902504744 RUGAIYAH P PBI (APBN) Essential (primary) Berobat Jalan
hypertension
847 10-09-2018 160102050918Y000367 0000902613609 YUNIATI P PBI (APBN) Headache Berobat Jalan

848 10-09-2018 160102050918Y000357 0000902628922 WA SUNTI P PBI (APBN) Essential (primary) Berobat Jalan
hypertension
849 10-09-2018 160102050918Y000981 0000902794893 SLAMET RUDIANTO L PBI (APBN) Chronic obstructive Rujuk Lanjut
pulmonary disease,

850 10-09-2018 160102050918Y000970 0000903254196 RUDIANSYAH BJ L PBI (APBN) Allergic contact dermatitis, Berobat Jalan
unspecified cause
DAFTAR KUNJUNGAN PESERTA SAKIT

Kantor Cabang : SAMARINDA - 1601

FKTP : SEGIRI - 16010205

851 10-09-2018 160102050918Y000968 0000903275379 PAITUN P PBI (APBN) Non-insulin-dependent Berobat Jalan
diabetes mellitus without

852 10-09-2018 160102050918Y000969 0000903427503 RAFKA AVRIAN FAUZI L PBI (APBN) Fever, unspecified Berobat Jalan

853 10-09-2018 160102050918Y000340 0001066449835 MARDIANA P PBI (APBN) Hypertensive renal Rujuk Lanjut
disease
854 10-09-2018 160102050918Y000322 0001066476971 MULYANTI P PBI (APBN) Adjustment disorders Rujuk Lanjut

855 10-09-2018 160102050918Y000339 0001314102003 RUSDIANA P PEGAWAI SWASTA Hypertensive renal Rujuk Lanjut
disease
856 10-09-2018 160102050918Y000975 0001408515129 DWI KASIYATI P PEGAWAI SWASTA Dermatophytosis, Berobat Jalan
unspecified
857 10-09-2018 160102050918Y000321 0001433246916 ISKANDAR L PEKERJA MANDIRI Haemoptysis Rujuk Lanjut

858 10-09-2018 160102050918Y000364 0001611847765 IGIT ALUNG P PBI (APBD) Dyspepsia Berobat Jalan

859 10-09-2018 160102050918Y000441 0001649089798 FATHIR AZKA JIBRANI L PEGAWAI SWASTA Allergic contact dermatitis, Berobat Jalan
unspecified cause

860 10-09-2018 160102050918Y000343 0001724627935 RINA ASTUTI P PEKERJA MANDIRI Malignant neoplasm of Rujuk Lanjut
breast
861 10-09-2018 160102050918Y000365 0001775281779 HERLINA L. SITUMORANG P PEGAWAI SWASTA Essential (primary) Berobat Jalan
hypertension
862 10-09-2018 160102050918Y000328 0001823509416 ROBBY VADILLAH ZURIN L PEGAWAI SWASTA Benign neoplasm of Rujuk Lanjut
unspecified site
863 10-09-2018 160102050918Y000317 0001923462303 MARLEN UDAU P PEKERJA MANDIRI Tinnitus Rujuk Lanjut

864 10-09-2018 160102050918Y000335 0001924996847 AJI SETIAWAN L PEKERJA MANDIRI Benign neoplasm of Rujuk Lanjut
unspecified site
865 10-09-2018 160102050918Y000341 0001925217358 CHERLY AGUSTIN P PBI (APBD) Benign neoplasm of Rujuk Lanjut
unspecified site
866 10-09-2018 160102050918Y000360 0001925235977 KHUSNUL KHOTIMAH P PEGAWAI SWASTA Conjunctivitis, unspecified Berobat Jalan

867 10-09-2018 160102050918Y000349 0001929264096 ERNA DWI ASTUTIK P PBI (APBD) Supervision of normal Rujuk Lanjut
pregnancy, unspecified
868 10-09-2018 160102050918Y000974 0002049810726 rahardi L PEKERJA MANDIRI Sequelae of stroke, not Berobat Jalan
specified as haemorrhage

869 10-09-2018 160102050918Y000319 0002063145666 NURHAIDAH P PEKERJA MANDIRI Chronic ischaemic heart Rujuk Lanjut
disease, unspecified
870 10-09-2018 160102050918Y000977 0002073949255 MUJIATEN P PEKERJA MANDIRI Essential (primary) Berobat Jalan
hypertension
871 10-09-2018 160102050918Y000346 0002083722489 RUBIYANTI P PEKERJA MANDIRI Fracture of other parts of Rujuk Lanjut
forearm , closed
DAFTAR KUNJUNGAN PESERTA SAKIT

Kantor Cabang : SAMARINDA - 1601

FKTP : SEGIRI - 16010205

872 10-09-2018 160102050918Y000982 0002087826581 MASITAH P PEKERJA MANDIRI Non-insulin-dependent Berobat Jalan
diabetes mellitus without

873 10-09-2018 160102050918Y000344 0002194372877 ARNOLDUS TONI L PBI (APBD) Leukaemia of unspecified Rujuk Lanjut
cell type
874 10-09-2018 160102050918Y000972 0002226755845 DAVA DYLOVA PRAMONO L PEKERJA MANDIRI Superficial injury of lower Berobat Jalan
leg, unspecified
875 10-09-2018 160102050918Y000356 0002231971942 RUDI SETIAWAN L PEKERJA MANDIRI Acute nasopharyngitis Berobat Jalan
[common cold]
876 10-09-2018 160102050918Y000345 0002241872122 ARIYONO L PEKERJA MANDIRI Hyperplasia of prostate Rujuk Lanjut

877 10-09-2018 160102050918Y000443 0002253033314 SAPTIKA MAHARANI P PNS DAERAH Acute nasopharyngitis Berobat Jalan
[common cold]
878 10-09-2018 160102050918Y000361 0002290183097 LINdA SUSANTI P PEKERJA MANDIRI Dyspepsia Berobat Jalan

879 10-09-2018 160102050918Y000447 0002290189634 devan arcadia L PEKERJA MANDIRI Varicella without Berobat Jalan
complication
880 10-09-2018 160102050918Y000353 0002290730477 MASDUKI L PEKERJA MANDIRI Essential (primary) Berobat Jalan
hypertension
881 10-09-2018 160102050918Y000442 0002293592152 MUHAMMAD AZKA RAMADHAN L PEKERJA MANDIRI Acute nasopharyngitis Berobat Jalan
[common cold]
882 10-09-2018 160102050918Y000355 0002376998122 RINDU ANINDHIKA HASIBUAN P PEKERJA MANDIRI Supervision of normal Rujuk Lanjut
pregnancy, unspecified
883 10-09-2018 160102050918Y000444 0002456467097 KHAYRA FATIMAH IZMI P PEGAWAI PEMERINTAH Acute nasopharyngitis Berobat Jalan
DENGAN PERJANJIAN [common cold]

884 10-09-2018 160102050918Y000329 0002477485337 SUSI AGUS SUSANTI P PNS DAERAH Low vision, both eyes Rujuk Lanjut

885 08-09-2018 160102050918Y000459 0000102364266 EYVAMIA VERIKA VASHTI P PNS DAERAH Acute pharyngitis, Berobat Jalan
unspecified
886 08-09-2018 160102050918Y000473 0000119868816 SRI WAHYUNI,SP P PNS DAERAH Low vision, both eyes Rujuk Lanjut

887 08-09-2018 160102050918Y000456 0000120419921 HERRY MULYANI P PNS PUSAT Myalgia Berobat Jalan

888 08-09-2018 160102050918Y000960 0000120431913 WAGIYEM P PENERIMA PENSIUN Acute nasopharyngitis Berobat Jalan
PNS [common cold]
889 08-09-2018 160102050918Y000469 0000120488973 SALMAH TIMA P PENERIMA PENSIUN Non-insulin-dependent Berobat Jalan
PNS diabetes mellitus without

890 08-09-2018 160102050918Y000467 0000120549352 MERY TANDIARANG P PNS DAERAH Non-insulin-dependent Berobat Jalan
diabetes mellitus without

891 08-09-2018 160102050918Y000465 0000120550601 B. MUSA UNYA L PNS DAERAH Acute nasopharyngitis Berobat Jalan
[common cold]
892 08-09-2018 160102050918Y000958 0000120658061 MURDJANI PATHUR L PENERIMA PENSIUN Chronic ischaemic heart Berobat Jalan
PNS disease, unspecified
DAFTAR KUNJUNGAN PESERTA SAKIT

Kantor Cabang : SAMARINDA - 1601

FKTP : SEGIRI - 16010205

893 08-09-2018 160102050918Y000472 0000120664866 HP. SIREGAR L PENERIMA PENSIUN Chronic ischaemic heart Rujuk Lanjut
PNS disease, unspecified
894 08-09-2018 160102050918Y000421 0000120672066 SUKARSIH P PENERIMA PENSIUN Senile cataract, Rujuk Lanjut
PNS unspecified
895 08-09-2018 160102050918Y000954 0000120674057 SUGIARTO L PENERIMA PENSIUN Essential (primary) Berobat Jalan
PNS hypertension
896 08-09-2018 160102050918Y000961 0000120674081 SUHADI L PENERIMA PENSIUN Acute pharyngitis, Berobat Jalan
PNS unspecified
897 08-09-2018 160102050918Y000959 0000120686848 MUKANI L PENERIMA PENSIUN Essential (primary) Berobat Jalan
PNS hypertension
898 08-09-2018 160102050918Y000947 0000120686859 ANI HAIRIAH P PENERIMA PENSIUN Essential (primary) Berobat Jalan
PNS hypertension
899 08-09-2018 160102050918Y000934 0000120926204 SUMARDI L PNS PUSAT Essential (primary) Berobat Jalan
hypertension
900 08-09-2018 160102050918Y000453 0000123024082 DARTI P PENERIMA PENSIUN Non-insulin-dependent Berobat Jalan
PNS diabetes mellitus without

901 08-09-2018 160102050918Y000451 0000123297625 MARLINA AIDHA P PENERIMA PENSIUN Chronic ischaemic heart Berobat Jalan
PNS disease, unspecified
902 08-09-2018 160102050918Y000471 0000123711041 SRI NGATIN P PNS DAERAH Hyperlipidaemia, Berobat Jalan
unspecified
903 08-09-2018 160102050918Y000942 0000165586206 DEMSI SIREGAR P PNS PUSAT Essential (primary) Rujuk Lanjut
hypertension
904 08-09-2018 160102050918Y000946 0000170565669 IRWAN HERMAWAN L PEKERJA MANDIRI Chronic ischaemic heart Rujuk Lanjut
disease, unspecified
905 08-09-2018 160102050918Y000950 0000171613271 HJ.UMMU AIMANUL P PNS PUSAT Chronic ischaemic heart Berobat Jalan
KHOBASYIAH disease, unspecified
906 08-09-2018 160102050918Y000939 0000206978141 CHIKA SYIFANA PUTRI P PNS PUSAT Acute tonsillitis, Berobat Jalan
unspecified
907 08-09-2018 160102050918Y000476 0000902524397 OLIVIA BAYU FEBRIANTI P PBI (APBN) Acute tonsillitis, Berobat Jalan
unspecified
908 08-09-2018 160102050918Y000461 0000902592371 ROHATI P PBI (APBN) Cystitis, unspecified Berobat Jalan

909 08-09-2018 160102050918Y000944 0000903222854 SAID UMAR UMAYAH L PBI (APBN) Essential (primary) Berobat Jalan
hypertension
910 08-09-2018 160102050918Y000450 0000903275379 PAITUN P PBI (APBN) Non-insulin-dependent Berobat Jalan
diabetes mellitus without

911 08-09-2018 160102050918Y000746 0001066476025 FENI NOVITASARI P PBI (APBN) Urticaria, unspecified Berobat Jalan

912 08-09-2018 160102050918Y000957 0001066477408 DWI BAMBANG PURNAMA L PBI (APBN) Chronic obstructive Rujuk Lanjut
pulmonary disease,
DAFTAR KUNJUNGAN PESERTA SAKIT

Kantor Cabang : SAMARINDA - 1601

FKTP : SEGIRI - 16010205

913 08-09-2018 160102050918Y000745 0001066477836 RUSMINI P PBI (APBN) Dermatophytosis, Berobat Jalan
unspecified
914 08-09-2018 160102050918Y000463 0001066479917 ARBAIN L PBI (APBN) Surgical follow-up care, Rujuk Lanjut
unspecified
915 08-09-2018 160102050918Y000449 0001066483383 NUR RIPANI L PBI (APBN) Dyspepsia Berobat Jalan

916 08-09-2018 160102050918Y000470 0001066484507 SUHAIMI L PBI (APBN) Essential (primary) Berobat Jalan
hypertension
917 08-09-2018 160102050918Y000744 0001066484531 DHAFA RISKY MAULANA L PBI (APBN) Acute pharyngitis, Berobat Jalan
unspecified
918 08-09-2018 160102050918Y000930 0001150843454 BELLA RAHMA DWI PUTRI L PEGAWAI SWASTA Headache Berobat Jalan

919 08-09-2018 160102050918Y000452 0001283120008 NUR HANA P PEKERJA MANDIRI Chronic ischaemic heart Berobat Jalan
disease, unspecified
920 08-09-2018 160102050918Y000737 0001378350257 AFIFAH NUR SYAHRAJANI P PEGAWAI SWASTA Glaucoma, unspecified Rujuk Lanjut

921 08-09-2018 160102050918Y000931 0001546230352 TAMYES L PEGAWAI SWASTA Benign neoplasm of Rujuk Lanjut
unspecified site
922 08-09-2018 160102050918Y000747 0001725146706 SALMA DJEJA P PEKERJA MANDIRI Myalgia Berobat Jalan

923 08-09-2018 160102050918Y000474 0001802796131 AFIF OMAR AHMAD L PNS DAERAH Hiccough Berobat Jalan

924 08-09-2018 160102050918Y000953 0001819917437 DIAN WAHYUNING FITRI P PEGAWAI SWASTA Acute pharyngitis, Berobat Jalan
unspecified
925 08-09-2018 160102050918Y000468 0001826839315 ELLISA P PEKERJA MANDIRI Non-insulin-dependent Berobat Jalan
diabetes mellitus without

926 08-09-2018 160102050918Y000927 0001865580939 helen sintice silaban L PEKERJA MANDIRI Acute pharyngitis, Berobat Jalan
unspecified
927 08-09-2018 160102050918Y000926 0001925214309 PAIMAN L PBI (APBD) Localization-related (focal) Rujuk Lanjut
(partial) idiopathic epilepsy
and epileptic syndromes
with seizures of localized
onset
928 08-09-2018 160102050918Y000929 0001925232311 MUHAMMAD ZAKKY ZAMANY L PBI (APBD) Acute pharyngitis, Berobat Jalan
unspecified
929 08-09-2018 160102050918Y000455 0001925232592 ZAINUL SHOLIKHIN L PBI (APBD) Constipation Berobat Jalan

930 08-09-2018 160102050918Y000457 0001926835885 NASUHA P PEKERJA MANDIRI Myalgia Berobat Jalan

931 08-09-2018 160102050918Y000464 0002072381916 SIE MOIJ P PEKERJA MANDIRI Chronic renal failure, Rujuk Lanjut
unspecified
932 08-09-2018 160102050918Y000466 0002091668589 HASNAH P PEKERJA MANDIRI Non-insulin-dependent Berobat Jalan
diabetes mellitus without
DAFTAR KUNJUNGAN PESERTA SAKIT

Kantor Cabang : SAMARINDA - 1601

FKTP : SEGIRI - 16010205

933 08-09-2018 160102050918Y000743 0002225133909 SUMIATI P PEKERJA MANDIRI Non-insulin-dependent Berobat Jalan
diabetes mellitus without

934 08-09-2018 160102050918Y000462 0002226982746 AHMAD MAULANA L PNS DAERAH Dyspepsia Berobat Jalan

935 08-09-2018 160102050918Y000940 0002257862229 LA PITIHA L PEKERJA MANDIRI Acute nasopharyngitis Berobat Jalan
[common cold]
936 08-09-2018 160102050918Y000458 0002299507367 WA INI P PBI (APBD) Sciatica Rujuk Lanjut

937 08-09-2018 160102050918Y000948 0002322632553 HASANAH P PEKERJA MANDIRI Infection following a Berobat Jalan
procedure, not elsewhere

938 08-09-2018 160102050918Y000695 0002442633557 FAR SUMIATI P PEKERJA MANDIRI Benign neoplasm of Rujuk Lanjut
unspecified site
939 07-09-2018 160102050918Y000548 0000037445657 SITI ALBAROROH P PNS PUSAT Non-insulin-dependent Berobat Jalan
diabetes mellitus without

940 07-09-2018 160102050918Y000619 0000120470005 MOEDJIONO L PNS PUSAT Hyperplasia of prostate Rujuk Lanjut

941 07-09-2018 160102050918Y000694 0000120545199 EDWARD SURYATMANTO L PNS DAERAH Non-insulin-dependent Berobat Jalan
diabetes mellitus without

942 07-09-2018 160102050918Y000475 0000120549352 MERY TANDIARANG P PNS DAERAH Presbyopia Rujuk Lanjut

943 07-09-2018 160102050918Y000625 0000120561311 APUK BILUNG L PENERIMA PENSIUN Presbyopia Rujuk Lanjut
PNS
944 07-09-2018 160102050918Y000624 0000120561322 BURING P PENERIMA PENSIUN Essential (primary) Berobat Jalan
PNS hypertension
945 07-09-2018 160102050918Y000718 0000120629654 SYAHRUDDIN TARMIDZI L PENERIMA PENSIUN Chronic ischaemic heart Rujuk Lanjut
PNS disease, unspecified
946 07-09-2018 160102050918Y000626 0000120636415 LAILIYAH P PENERIMA PENSIUN Stroke, not specified as Rujuk Lanjut
PNS haemorrhage or infarction
947 07-09-2018 160102050918Y000617 0000120641073 HATTA SIDIK L PENERIMA PENSIUN Chronic ischaemic heart Rujuk Lanjut
PNS disease, unspecified
948 07-09-2018 160102050918Y000549 0000120642063 ILHAMSYAH L PENERIMA PENSIUN Headache Rujuk Lanjut
PNS
949 07-09-2018 160102050918Y000479 0000120657014 WIJANA MULJOWIDODO L PENERIMA PENSIUN Sequelae of stroke, not Rujuk Lanjut
PNS specified as haemorrhage

950 07-09-2018 160102050918Y000623 0000120661119 SISWOJO L PENERIMA PENSIUN Chronic ischaemic heart Berobat Jalan
PNS disease, unspecified
951 07-09-2018 160102050918Y000728 0000120668782 HATIPAH P PENERIMA PENSIUN Non-insulin-dependent Rujuk Lanjut
PNS diabetes mellitus without

952 07-09-2018 160102050918Y000630 0000120782147 NOR HASANAH P PENERIMA PENSIUN Pleural condition, Rujuk Lanjut
PNS unspecified
DAFTAR KUNJUNGAN PESERTA SAKIT

Kantor Cabang : SAMARINDA - 1601

FKTP : SEGIRI - 16010205

953 07-09-2018 160102050918Y000636 0000123079149 ALFARET DAPEN SIMBOLON L PNS DAERAH Essential (primary) Berobat Jalan
hypertension
954 07-09-2018 160102050918Y000620 0000123678922 DR.FREDDY YOEDYANTO L PENERIMA PENSIUN Non-insulin-dependent Berobat Jalan
PNS diabetes mellitus without

955 07-09-2018 160102050918Y000622 0000123687167 FATIMAH P PNS DAERAH Epilepsy, unspecified Rujuk Lanjut

956 07-09-2018 160102050918Y000618 0000170565669 IRWAN HERMAWAN L PEKERJA MANDIRI Tension-type headache Rujuk Lanjut

957 07-09-2018 160102050918Y000368 0000893878705 noorsehan P PBI (APBN) Hodgkin lymphoma Rujuk Lanjut

958 07-09-2018 160102050918Y000637 0000897253784 ABDUL HAMID L PBI (APBN) Other and unspecified Rujuk Lanjut
cirrhosis of liver
959 07-09-2018 160102050918Y000715 0000897270682 MIHAI P PBI (APBN) Surgical follow-up care, Rujuk Lanjut
unspecified
960 07-09-2018 160102050918Y000638 0000898629096 YUDA PRAWIJAYA L PBI (APBN) Tuberculous peripheral Berobat Jalan
lymphadenopathy
961 07-09-2018 160102050918Y000720 0000901935213 TINA HASISEH P PBI (APBN) Essential (primary) Berobat Jalan
hypertension
962 07-09-2018 160102050918Y000713 0000902377495 TOTO AGUS PURWANTO L PBI (APBN) Hyperlipidaemia, Berobat Jalan
unspecified
963 07-09-2018 160102050918Y000628 0000902379339 M RIZKY A L PBI (APBN) Dyslexia and other Rujuk Lanjut
symbolic dysfunctions, not

964 07-09-2018 160102050918Y000719 0000902411921 HASAN L PBI (APBN) Essential (primary) Berobat Jalan
hypertension
965 07-09-2018 160102050918Y000721 0000902586969 ERIFADIN SABUR L PBI (APBN) Essential (primary) Berobat Jalan
hypertension
966 07-09-2018 160102050918Y000448 0000902626299 MARLIN CHRSITINA P PBI (APBN) Other specified headache Rujuk Lanjut
syndromes
967 07-09-2018 160102050918Y000629 0000902629809 ELISABETH DEBORA P PBI (APBN) Pain localized to other Rujuk Lanjut
parts of lower abdomen
968 07-09-2018 160102050918Y000731 0000902926743 ARDIA NUR CAHYANI P PBI (APBN) Diarrhoea and Berobat Jalan
gastroenteritis of
presumed infectious origin

969 07-09-2018 160102050918Y000550 0000903427503 RAFKA AVRIAN FAUZI L PBI (APBN) Fever, unspecified Berobat Jalan

970 07-09-2018 160102050918Y000631 0001281680741 DANIEL SANG NYUK L PEKERJA MANDIRI Chronic ischaemic heart Rujuk Lanjut
disease, unspecified
971 07-09-2018 160102050918Y000711 0001291124305 KHUSNAINI P PBI (APBD) Benign neoplasm of Rujuk Lanjut
unspecified site
972 07-09-2018 160102050918Y000481 0001445777447 ACHMAD ZUHRI L PEKERJA MANDIRI Chronic ischaemic heart Rujuk Lanjut
disease, unspecified
DAFTAR KUNJUNGAN PESERTA SAKIT

Kantor Cabang : SAMARINDA - 1601

FKTP : SEGIRI - 16010205

973 07-09-2018 160102050918Y000581 0001445780103 WAHYU DRAJAT L PEKERJA MANDIRI Chronic viral hepatitis, Rujuk Lanjut
unspecified
974 07-09-2018 160102050918Y001329 0001477357852 MUHAMMAD RIZAL KURNIA L PEGAWAI SWASTA Epilepsy, unspecified Rujuk Lanjut

975 07-09-2018 160102050918Y000616 0001553441534 YEHEZKIEL UNCAN L PBI (APBD) Epilepsy, unspecified Rujuk Lanjut

976 07-09-2018 160102050918Y000634 0001611802574 JUNAIDI L PBI (APBD) Calculus of gallbladder Rujuk Lanjut
with other cholecystitis
977 07-09-2018 160102050918Y000632 0001796465496 MARIA ULFAH P PEGAWAI SWASTA Chronic viral hepatitis, Rujuk Lanjut
unspecified
978 07-09-2018 160102050918Y000729 0001924514796 WIGIARTI P PEKERJA MANDIRI Benign neoplasm of Rujuk Lanjut
unspecified site
979 07-09-2018 160102050918Y000490 0001924931766 SUNARTIN P PEKERJA MANDIRI Unspecified viral hepatitis Rujuk Lanjut
without hepatic coma

980 07-09-2018 160102050918Y000708 0001925217336 MOCHAMAD ARYA YUDISTIRA L PBI (APBD) Acute tonsillitis, Berobat Jalan
unspecified
981 07-09-2018 160102050918Y000712 0001925217358 CHERLY AGUSTIN P PBI (APBD) Benign neoplasm of Rujuk Lanjut
unspecified site
982 07-09-2018 160102050918Y000726 0001925221915 HERI MULYONO L PBI (APBD) Essential (primary) Berobat Jalan
hypertension
983 07-09-2018 160102050918Y000483 0001925222095 MUJIATI P PBI (APBD) Heart failure, unspecified Rujuk Lanjut

984 07-09-2018 160102050918Y000614 0001925224806 MULYONO L PBI (APBD) Hyperplasia of prostate Rujuk Lanjut

985 07-09-2018 160102050918Y000722 0002059620434 FADJRI L PEKERJA MANDIRI Chronic ischaemic heart Rujuk Lanjut
disease, unspecified
986 07-09-2018 160102050918Y000621 0002059621334 FIRDA P PEKERJA MANDIRI Chronic ischaemic heart Rujuk Lanjut
disease, unspecified
987 07-09-2018 160102050918Y000635 0002068061927 LASI L PEKERJA MANDIRI Chronic viral hepatitis, Rujuk Lanjut
unspecified
988 07-09-2018 160102050918Y000551 0002075293686 RISKI HARDIYANTI P PBI (APBD) Dyspepsia Berobat Jalan

989 07-09-2018 160102050918Y000627 0002083722489 RUBIYANTI P PEKERJA MANDIRI Fracture of other parts of Berobat Jalan
forearm , closed
990 07-09-2018 160102050918Y000552 0002200275224 PANIYEM P PEKERJA MANDIRI Acute nasopharyngitis Berobat Jalan
[common cold]
991 07-09-2018 160102050918Y000727 0002230354157 KIPANG P PBI (APBD) Malignant neoplasm of Rujuk Lanjut
cervix uteri, unspecified
992 07-09-2018 160102050918Y000460 0002236646575 AZRINA RAZIYA SHAZFA P PEGAWAI SWASTA Paraplegia, unspecified Rujuk Lanjut

993 07-09-2018 160102050918Y000615 0002268754211 MARIAMA P PEKERJA MANDIRI Chronic ischaemic heart Rujuk Lanjut
disease, unspecified
994 07-09-2018 160102050918Y000633 0002287018462 PAINO L PEKERJA MANDIRI Other and unspecified Berobat Jalan
cirrhosis of liver
DAFTAR KUNJUNGAN PESERTA SAKIT

Kantor Cabang : SAMARINDA - 1601

FKTP : SEGIRI - 16010205

995 07-09-2018 160102050918Y000716 0002317500821 JUWITA HB P PEKERJA MANDIRI Essential (primary) Berobat Jalan
hypertension
996 07-09-2018 160102050918Y000732 0002463561336 LA TEPU L PEKERJA MANDIRI Superficial injury of lower Rujuk Lanjut
leg, unspecified
997 06-09-2018 160102050918Y000311 0000119705286 WILSON NIAS LENSUIT L PNS DAERAH Senile cataract, Rujuk Lanjut
unspecified
998 06-09-2018 160102050918Y000307 0000120317466 JUMANI L PNS DAERAH Chronic periodontitis Berobat Jalan

999 06-09-2018 160102050918Y000308 0000120381039 NORHASANAH P PNS PUSAT Low back pain Rujuk Lanjut

1000 06-09-2018 160102050918Y000314 0000120495429 MUYASSAROH P VETERAN Chronic ischaemic heart Berobat Jalan
disease, unspecified
1001 06-09-2018 160102050918Y000266 0000120549352 MERY TANDIARANG P PNS DAERAH Presbyopia Rujuk Lanjut

1002 06-09-2018 160102050918Y000309 0000120549453 SAIDAH P PNS DAERAH Caries of dentine Berobat Jalan

1003 06-09-2018 160102050918Y000478 0000120598762 M. NUR ARTHA, BC.HK L PENERIMA PENSIUN Non-insulin-dependent Rujuk Lanjut
PNS diabetes mellitus with

1004 06-09-2018 160102050918Y000313 0000120601809 MARIJATI P PENERIMA PENSIUN Dyspnoea Rujuk Lanjut
PNS
1005 06-09-2018 160102050918Y000276 0000120607863 MUHAMMAD YUSUF. A L PENERIMA PENSIUN Sequelae of stroke, not Berobat Jalan
PNS specified as haemorrhage

1006 06-09-2018 160102050918Y000299 0000120629193 SYAHRAN L PENERIMA PENSIUN Non-insulin-dependent Rujuk Lanjut
PNS diabetes mellitus with
neurological complications

1007 06-09-2018 160102050918Y000300 0000120629248 JAMRUD P PENERIMA PENSIUN Sequelae of stroke, not Rujuk Lanjut
PNS specified as haemorrhage

1008 06-09-2018 160102050918Y000428 0000120636415 LAILIYAH P PENERIMA PENSIUN Sequelae of stroke, not Rujuk Lanjut
PNS specified as haemorrhage

1009 06-09-2018 160102050918Y000542 0000120672055 SABAN L PENERIMA PENSIUN Non-insulin-dependent Berobat Jalan
PNS diabetes mellitus without

1010 06-09-2018 160102050918Y000278 0000120672674 SAMLAN,DRS, BCHK, H L PENERIMA PENSIUN Hyperplasia of prostate Rujuk Lanjut
PNS
1011 06-09-2018 160102050918Y000301 0000120684969 HJ.HADIDJAH muhidin P PENERIMA PENSIUN Sequelae of stroke, not Rujuk Lanjut
PNS specified as haemorrhage

1012 06-09-2018 160102050918Y000281 0000120727506 KAMSIAH P PENERIMA PENSIUN Chronic ischaemic heart Berobat Jalan
PNS disease, unspecified
1013 06-09-2018 160102050918Y000297 0000120756295 SAWUDI L PNS DAERAH Superficial injury of lower Berobat Jalan
leg, unspecified
DAFTAR KUNJUNGAN PESERTA SAKIT

Kantor Cabang : SAMARINDA - 1601

FKTP : SEGIRI - 16010205

1014 06-09-2018 160102050918Y000432 0000121926712 KRISTIAN PILIPUS L PNS PUSAT Malignant neoplasm of Rujuk Lanjut
nasopharynx, unspecified
1015 06-09-2018 160102050918Y000305 0000123118828 HUMAIRA PERMATA P PNS DAERAH Pulpitis Berobat Jalan

1016 06-09-2018 160102050918Y000280 0000123693423 THOMAS ALVA EDISON L PNS DAERAH Acute hepatitis B without Rujuk Lanjut
delta-agent and without

1017 06-09-2018 160102050918Y000275 0000211198127 SURATMI P PNS DAERAH Non-insulin-dependent Rujuk Lanjut
diabetes mellitus without

1018 06-09-2018 160102050918Y000547 0000902006559 NURUL IDAYANTI P PBI (APBN) Non-insulin-dependent Berobat Jalan
diabetes mellitus without

1019 06-09-2018 160102050918Y000310 0000902363567 JOKO SUKISNO L PBI (APBN) Other soft tissue disorders Rujuk Lanjut
related to use, overuse

1020 06-09-2018 160102050918Y000304 0000902501379 SAUDJI L PBI (APBN) Hyperplasia of prostate Rujuk Lanjut

1021 06-09-2018 160102050918Y000439 0000902684215 SUTRISNO L PBI (APBN) Acute nasopharyngitis Berobat Jalan
[common cold]
1022 06-09-2018 160102050918Y000431 0000903218084 KUSRINI P PBI (APBN) Chronic ischaemic heart Berobat Jalan
disease, unspecified
1023 06-09-2018 160102050918Y000312 0000903399816 WARSINAH P PBI (APBN) Benign neoplasm of Rujuk Lanjut
unspecified site
1024 06-09-2018 160102050918Y000545 0001066476993 WA UHA P PBI (APBN) Haemoptysis Berobat Jalan

1025 06-09-2018 160102050918Y000436 0001066478499 RUSFASIYAH P PBI (APBN) Hyperlipidaemia, Berobat Jalan
unspecified
1026 06-09-2018 160102050918Y000426 0001143771232 LAWAI LEJIU L PEGAWAI SWASTA Malignant neoplasm of Rujuk Lanjut
nasopharynx, unspecified
1027 06-09-2018 160102050918Y000435 0001303268499 BUDI SANTOSO L PEKERJA MANDIRI Malignant neoplasm of Rujuk Lanjut
larynx, unspecified
1028 06-09-2018 160102050918Y000477 0001433246916 ISKANDAR L PEKERJA MANDIRI Haemoptysis Berobat Jalan

1029 06-09-2018 160102050918Y000429 0001444650096 HERIBERTUS BELAWA OPEN L PEGAWAI SWASTA Diarrhoea and Berobat Jalan
gastroenteritis of
presumed infectious origin

1030 06-09-2018 160102050918Y000303 0001611571678 RUSLI L PBI (APBD) Calculus of kidney with Rujuk Lanjut
calculus of ureter
1031 06-09-2018 160102050918Y000293 0001925224896 NURAENI P PBI (APBD) Dyspnoea Rujuk Lanjut

1032 06-09-2018 160102050918Y000434 0001926347163 MUHAMMAD SYAMSURIADI L PEKERJA MANDIRI External haemorrhoids Rujuk Lanjut
without complication
1033 06-09-2018 160102050918Y000279 0001928654919 AISYAH P PBI (APBD) Asthma, unspecified Berobat Jalan
DAFTAR KUNJUNGAN PESERTA SAKIT

Kantor Cabang : SAMARINDA - 1601

FKTP : SEGIRI - 16010205

1034 06-09-2018 160102050918Y000438 0001929263962 SITI YULAINAH P PBI (APBD) Hyperlipidaemia, Berobat Jalan
unspecified
1035 06-09-2018 160102050918Y000298 0001930552828 AHMAD M L PBI (APBD) Myalgia, other site Berobat Jalan

1036 06-09-2018 160102050918Y000282 0002024612381 SUHARTI P PBI (APBN) Uterovaginal prolapse, Rujuk Lanjut
unspecified
1037 06-09-2018 160102050918Y000306 0002075293541 SUBAIDAH P PBI (APBD) Myalgia, multiple sites Berobat Jalan

1038 06-09-2018 160102050918Y000543 0002075293686 RISKI HARDIYANTI P PBI (APBD) Dyspepsia Berobat Jalan

1039 06-09-2018 160102050918Y000284 0002075293798 MUHAMMAD SURYA HAJAR L PBI (APBD) Dyspepsia Berobat Jalan
HASWAD
1040 06-09-2018 160102050918Y000546 0002196404684 PANTI ASTUTI P PEKERJA MANDIRI Non-insulin-dependent Berobat Jalan
diabetes mellitus without

1041 06-09-2018 160102050918Y000285 0002201822313 MARIAM P PEKERJA MANDIRI Hypokalaemia Rujuk Lanjut

1042 06-09-2018 160102050918Y000302 0002203276037 SUPRAPTO L PEKERJA MANDIRI Dyspnoea Rujuk Lanjut

1043 06-09-2018 160102050918Y000283 0002225691505 JUNAEDI L PEKERJA MANDIRI Acute pharyngitis, Berobat Jalan
unspecified
1044 06-09-2018 160102050918Y000296 0002243350631 MERE ULENG P PEKERJA MANDIRI Myalgia, ankle and foot Berobat Jalan

1045 06-09-2018 160102050918Y000544 0002243364322 ANGGA L PEKERJA MANDIRI Acute pharyngitis, Berobat Jalan
unspecified
1046 06-09-2018 160102050918Y000277 0002262899698 DUDY RAHMAN L PEKERJA MANDIRI Diarrhoea and Berobat Jalan
gastroenteritis of
presumed infectious origin

1047 06-09-2018 160102050918Y000482 0002268754211 MARIAMA P PEKERJA MANDIRI Chronic ischaemic heart Rujuk Lanjut
disease, unspecified
1048 06-09-2018 160102050918Y000295 0002275127493 SITI SA'IMAH L PBI (APBD) Epilepsy, unspecified Rujuk Lanjut

1049 06-09-2018 160102050918Y000437 0002304223389 ANDI HERY WIJAYA AS L PEKERJA MANDIRI Surgical follow-up care, Berobat Jalan
unspecified
1050 05-09-2018 160102050918Y000263 0000058656868 ULYANA PURI P PNS PUSAT Dental caries, unspecified Berobat Jalan

1051 05-09-2018 160102050918Y000260 0000120132832 WINARTI P PNS DAERAH Chronic periodontitis Berobat Jalan

1052 05-09-2018 160102050918Y000205 0000120421012 SUDJATMIKO L PENERIMA PENSIUN Essential (primary) Rujuk Lanjut
PNS hypertension
1053 05-09-2018 160102050918Y000290 0000120431924 SUPONO L PENERIMA PENSIUN Hyperlipidaemia, Berobat Jalan
PNS unspecified
1054 05-09-2018 160102050918Y000251 0000120459363 SA'AMAH P VETERAN Sequelae of stroke, not Rujuk Lanjut
specified as haemorrhage
DAFTAR KUNJUNGAN PESERTA SAKIT

Kantor Cabang : SAMARINDA - 1601

FKTP : SEGIRI - 16010205

1055 05-09-2018 160102050918Y000288 0000120549069 AGUSTIN RAHMAWATI P PNS DAERAH Acute pharyngitis, Berobat Jalan
unspecified
1056 05-09-2018 160102050918Y000292 0000120549104 ANI ENDANG SRI SUMARNI P PNS DAERAH Essential (primary) Berobat Jalan
hypertension
1057 05-09-2018 160102050918Y000206 0000120549172 ERNAWATI P PNS DAERAH Non-insulin-dependent Rujuk Lanjut
diabetes mellitus without

1058 05-09-2018 160102050918Y000232 0000120549227 HAIRINI P PNS DAERAH Non-insulin-dependent Berobat Jalan
diabetes mellitus without

1059 05-09-2018 160102050918Y000200 0000120549352 MERY TANDIARANG P PNS DAERAH Presbyopia Rujuk Lanjut

1060 05-09-2018 160102050918Y000286 0000120569139 DR. ROBBY CAHYA BK L PENERIMA PENSIUN Insulin-dependent Berobat Jalan
PNS diabetes mellitus without

1061 05-09-2018 160102050918Y000218 0000120570513 ROHANA P PENERIMA PENSIUN Senile incipient cataract Rujuk Lanjut
PNS
1062 05-09-2018 160102050918Y000244 0000120666958 MARKUS ROMBE L PENERIMA PENSIUN Chronic ischaemic heart Rujuk Lanjut
PNS disease, unspecified
1063 05-09-2018 160102050918Y000221 0000120668602 MASTORA P PENERIMA PENSIUN Myalgia, ankle and foot Berobat Jalan
PNS
1064 05-09-2018 160102050918Y000254 0000120672066 SUKARSIH P PENERIMA PENSIUN Non-insulin-dependent Rujuk Lanjut
PNS diabetes mellitus with
neurological complications

1065 05-09-2018 160102050918Y000201 0000120674362 SUKIRNO L PENERIMA PENSIUN Hyperplasia of prostate Rujuk Lanjut
PNS
1066 05-09-2018 160102050918Y000289 0000120777377 SITI WAHIDAH P PNS DAERAH Allergic contact dermatitis, Berobat Jalan
unspecified cause

1067 05-09-2018 160102050918Y000219 0000120847634 UMAR AZZAM ABDURRAHMAN L PNS DAERAH Acute nasopharyngitis Berobat Jalan
[common cold]
1068 05-09-2018 160102050918Y000245 0000123038908 DJURIANTI P PENERIMA PENSIUN Chronic ischaemic heart Rujuk Lanjut
PNS disease, unspecified
1069 05-09-2018 160102050918Y000240 0000123039933 ROLAM SIMANULLANG L PNS DAERAH Non-insulin-dependent Rujuk Lanjut
diabetes mellitus with
neurological complications

1070 05-09-2018 160102050918Y000258 0000123108445 FADHILLA PUTRI SOFIANITA P PNS DAERAH Dental caries, unspecified Berobat Jalan

1071 05-09-2018 160102050918Y000231 0000123258082 AHMAD HERWANSYAH L PNS DAERAH Low vision, both eyes Rujuk Lanjut

1072 05-09-2018 160102050918Y000249 0000123272864 ILMANSYAH L PNS DAERAH Retention of urine Rujuk Lanjut

1073 05-09-2018 160102050918Y000236 0000123676064 AKHMAD TAUFIK L PNS DAERAH Orthostatic proteinuria, Rujuk Lanjut
unspecified
DAFTAR KUNJUNGAN PESERTA SAKIT

Kantor Cabang : SAMARINDA - 1601

FKTP : SEGIRI - 16010205

1074 05-09-2018 160102050918Y000237 0000123676558 ANA HIVUI P PENERIMA PENSIUN After-cataract Rujuk Lanjut
PNS
1075 05-09-2018 160102050918Y000253 0000123685762 MUHAMMAD LUTFHI L PNS DAERAH Sequelae of stroke, not Rujuk Lanjut
WIDYASTONO specified as haemorrhage

1076 05-09-2018 160102050918Y000242 0000123687742 RADIANAH RAGA P PENERIMA PENSIUN Essential (primary) Berobat Jalan
PNS hypertension
1077 05-09-2018 160102050918Y000211 0000123726374 DEWI RIZKI RAMADHANI P PEGAWAI SWASTA Supervision of other Berobat Jalan
normal pregnancy
1078 05-09-2018 160102050918Y000241 0000159257733 JEANNE CORNELIA BURKENS P PENERIMA PENSIUN Chronic ischaemic heart Rujuk Lanjut
PNS disease, unspecified
1079 05-09-2018 160102050918Y000287 0000164796816 SRI AFTARI PUJI ASTUTI P PENERIMA PENSIUN Acute nasopharyngitis Berobat Jalan
PNS [common cold]
1080 05-09-2018 160102050918Y000259 0000196170614 EVANSYAH, SE L PEGAWAI SWASTA Chronic apical Berobat Jalan
periodontitis
1081 05-09-2018 160102050918Y000223 0000207821215 KARSUMI P PENERIMA PENSIUN TNI Non-insulin-dependent Berobat Jalan
diabetes mellitus with
neurological complications

1082 05-09-2018 160102050918Y000247 0000735425032 LISNOWATI P PBI (APBN) Abdominal pregnancy Rujuk Lanjut

1083 05-09-2018 160102050918Y000235 0000901935382 DEVILIA ANGRAINI P PBI (APBN) Nephrotic syndrome, Rujuk Lanjut
unspecified
1084 05-09-2018 160102050918Y000272 0000902393561 FIKRIANSA L PBI (APBN) Acute pharyngitis, Berobat Jalan
unspecified
1085 05-09-2018 160102050918Y000207 0000902464773 JUHAIDA P PBI (APBN) Sequelae of stroke, not Berobat Jalan
specified as haemorrhage

1086 05-09-2018 160102050918Y000227 0000902511516 SAIYAH P PEKERJA MANDIRI Non-insulin-dependent Rujuk Lanjut
diabetes mellitus without

1087 05-09-2018 160102050918Y000261 0000902733467 ADAM BACHTIAR L PBI (APBN) Chronic apical Berobat Jalan
periodontitis
1088 05-09-2018 160102050918Y000270 0000902933515 FANI FAHRIZAL L PBI (APBN) Acute pharyngitis, Berobat Jalan
unspecified
1089 05-09-2018 160102050918Y000225 0000902934911 RACHMAWATI P PBI (APBN) Other and unspecified Rujuk Lanjut
abnormalities of breathing
1090 05-09-2018 160102050918Y000239 0000903213584 SUKMA P PBI (APBN) Epilepsy, unspecified Rujuk Lanjut

1091 05-09-2018 160102050918Y000217 0000903229885 DAROJI L PBI (APBN) Myalgia, multiple sites Berobat Jalan

1092 05-09-2018 160102050918Y000212 0000903241282 LA HASI L PBI (APBN) Essential (primary) Berobat Jalan
hypertension
1093 05-09-2018 160102050918Y000209 0000903243273 WA KACI P PBI (APBN) Chronic ischaemic heart Berobat Jalan
disease, unspecified
DAFTAR KUNJUNGAN PESERTA SAKIT

Kantor Cabang : SAMARINDA - 1601

FKTP : SEGIRI - 16010205

1094 05-09-2018 160102050918Y000202 0000936794373 AMBO TANG L PBI (APBN) Unilateral or unspecified Rujuk Lanjut
femoral hernia, without

1095 05-09-2018 160102050918Y000274 0001066476407 HADI NUGROHO L PBI (APBN) Diarrhoea and Berobat Jalan
gastroenteritis of
presumed infectious origin

1096 05-09-2018 160102050918Y000226 0001723581617 MAIJO L PEKERJA MANDIRI Chronic periodontitis Berobat Jalan

1097 05-09-2018 160102050918Y000256 0001816395513 KETUT EVI TRISNAWATI P PEGAWAI SWASTA Ascites Rujuk Lanjut

1098 05-09-2018 160102050918Y000243 0001833651483 H.RISAL PRATAMA L PEKERJA MANDIRI Orthopaedic follow-up Rujuk Lanjut
care, unspecified
1099 05-09-2018 160102050918Y000250 0001840891331 FILIPE'E YODLIN NAINGGOLAN L PEKERJA MANDIRI Impacted teeth Rujuk Lanjut

1100 05-09-2018 160102050918Y000291 0001925222286 ABDUL RAZAK MUSTAFA L PBI (APBD) Essential (primary) Berobat Jalan
hypertension
1101 05-09-2018 160102050918Y000269 0001925222973 SUPARTI P PBI (APBD) Myalgia, ankle and foot Berobat Jalan

1102 05-09-2018 160102050918Y000224 0001925232535 NGATEMAN L PBI (APBD) Hyperplasia of prostate Rujuk Lanjut

1103 05-09-2018 160102050918Y000246 0001925235415 LUKMAN L PBI (APBD) Benign neoplasm of Rujuk Lanjut
unspecified site
1104 05-09-2018 160102050918Y000264 0001925236203 RAHMAWATI P PBI (APBD) Chronic apical Berobat Jalan
periodontitis
1105 05-09-2018 160102050918Y000230 0001925240152 UMI MUALIFAH MASYHURI P PBI (APBD) Fever, unspecified Berobat Jalan

1106 05-09-2018 160102050918Y000268 0001928666452 MUHAMMAD AQASYAH L PBI (APBD) Allergic contact dermatitis, Berobat Jalan
SAPUTRA unspecified cause

1107 05-09-2018 160102050918Y000267 0001933754837 M.YUSUF L PEKERJA MANDIRI Acute nasopharyngitis Berobat Jalan
[common cold]
1108 05-09-2018 160102050918Y000228 0002039632391 fitriah P PNS PUSAT Low vision, both eyes Rujuk Lanjut

1109 05-09-2018 160102050918Y000220 0002061586517 MUHAMMAD KOSIM L PEKERJA MANDIRI Non-insulin-dependent Berobat Jalan
diabetes mellitus with
neurological complications

1110 05-09-2018 160102050918Y000265 0002066741695 AJI SYARIFAH MALAHAYATI L PEKERJA MANDIRI Low vision, both eyes Rujuk Lanjut
PERWITA
1111 05-09-2018 160102050918Y000234 0002069102698 ADIBA NUR AZ ZAHRA P PEGAWAI SWASTA Acute nasopharyngitis Berobat Jalan
[common cold]
1112 05-09-2018 160102050918Y000255 0002072851132 ALIYAH P PEKERJA MANDIRI Myalgia, multiple sites Berobat Jalan

1113 05-09-2018 160102050918Y000252 0002083722489 RUBIYANTI P PEKERJA MANDIRI Fracture of upper end of Rujuk Lanjut
radius, closed
1114 05-09-2018 160102050918Y000208 0002208847858 SRI GANTINI P PEKERJA MANDIRI Gastritis, unspecified Rujuk Lanjut
DAFTAR KUNJUNGAN PESERTA SAKIT

Kantor Cabang : SAMARINDA - 1601

FKTP : SEGIRI - 16010205

1115 05-09-2018 160102050918Y000262 0002214196356 PRIYO AGUNG WICAKSONO L PEKERJA MANDIRI Dental caries, unspecified Berobat Jalan

1116 05-09-2018 160102050918Y000271 0002226789371 MELYA SHAVIRA P PEKERJA MANDIRI Acute nasopharyngitis Berobat Jalan
[common cold]
1117 05-09-2018 160102050918Y000233 0002230048337 WIWIK P PEKERJA MANDIRI Non-insulin-dependent Berobat Jalan
diabetes mellitus with
neurological complications

1118 05-09-2018 160102050918Y000294 0002233102522 MUHAMMAD ADJI ISMOE L PBI (APBD) Acute pharyngitis, Berobat Jalan
YAHYA unspecified
1119 05-09-2018 160102050918Y000248 0002233102779 MUHAMMAD HAFIDZ L PBI (APBD) Acute nasopharyngitis Berobat Jalan
RAMADHAN [common cold]
1120 05-09-2018 160102050918Y000273 0002240230048 MOCH. MUWAFFAQ L PEKERJA MANDIRI Non-insulin-dependent Berobat Jalan
diabetes mellitus without

1121 05-09-2018 160102050918Y000222 0002251424237 SITI AISAH P PEKERJA MANDIRI Headache Rujuk Lanjut

1122 05-09-2018 160102050918Y000216 0002263910049 MUHAMMAD RIYAN FACHRIZAL L PEKERJA MANDIRI Surgical follow-up care, Berobat Jalan
unspecified
1123 05-09-2018 160102050918Y000213 0002267040767 SISKA APRIL JURU P PEKERJA MANDIRI Leprosy, unspecified Berobat Jalan

1124 05-09-2018 160102050918Y000229 0002315048051 ANINDYA FAUZIAH P PBI (APBN) Diarrhoea and Berobat Jalan
gastroenteritis of
presumed infectious origin

1125 05-09-2018 160102050918Y000238 0002320642372 ERICHA OZHAWA ZHILFA P PEGAWAI SWASTA Allergic contact dermatitis, Berobat Jalan
unspecified cause

1126 05-09-2018 160102050918Y000257 0002454844544 AJI ILYAS AL HANAN L PBI (APBN) Surgical follow-up care, Rujuk Lanjut
unspecified
1127 05-09-2018 160102050918Y000214 0002480515029 ABDUL MUIN L PEKERJA MANDIRI Acute nasopharyngitis Berobat Jalan
[common cold]
1128 05-09-2018 160102050918Y000215 0002480523928 KEYLA ADHIRA RASHA P PEKERJA MANDIRI Diseases of lips Berobat Jalan

1129 04-09-2018 160102050918Y000128 0000006198996 WINARTI MUKIYAT P PENERIMA PENSIUN Chronic ischaemic heart Rujuk Lanjut
PNS disease, unspecified
1130 04-09-2018 160102050918Y000183 0000037445657 SITI ALBAROROH P PNS PUSAT Surgical follow-up care, Berobat Jalan
unspecified
1131 04-09-2018 160102050918Y000184 0000119811633 AGUS SALIM L PEKERJA MANDIRI Schizophrenia, unspecified Rujuk Lanjut

1132 04-09-2018 160102050918Y000132 0000120248008 MISYE ARSITA LESTARI P PNS DAERAH Low vision, both eyes Rujuk Lanjut

1133 04-09-2018 160102050918Y000130 0000120352432 SUNARSO L PNS DAERAH Chronic ischaemic heart Rujuk Lanjut
disease, unspecified
1134 04-09-2018 160102050918Y000197 0000120383807 SARBEN PURBA L PNS PUSAT Essential (primary) Berobat Jalan
hypertension
DAFTAR KUNJUNGAN PESERTA SAKIT

Kantor Cabang : SAMARINDA - 1601

FKTP : SEGIRI - 16010205

1135 04-09-2018 160102050918Y000168 0000120490975 hm AGUS SUTOPO, mba L PENERIMA PENSIUN TNI Hyperplasia of prostate Rujuk Lanjut

1136 04-09-2018 160102050918Y000145 0000120528314 BAHARUDDIN L PEGAWAI SWASTA Dental caries, unspecified Berobat Jalan

1137 04-09-2018 160102050918Y000144 0000120549115 SLAMET SUMEDI L PNS DAERAH Chronic apical Berobat Jalan
periodontitis
1138 04-09-2018 160102050918Y000156 0000120585161 H.SYACHDAN ILHAM L PENERIMA PENSIUN Essential (primary) Berobat Jalan
PNS hypertension
1139 04-09-2018 160102050918Y000117 0000120605141 MOHAMMAD FARIED. SA,BSC L PENERIMA PENSIUN Insulin-dependent Rujuk Lanjut
PNS diabetes mellitus with

1140 04-09-2018 160102050918Y000199 0000120655743 Mery Diana SIMANUNGKALIT P PENERIMA PENSIUN Hyperlipidaemia, Berobat Jalan
PNS unspecified
1141 04-09-2018 160102050918Y000196 0000120656316 MUNTIYANAH P PENERIMA PENSIUN Non-insulin-dependent Berobat Jalan
PNS diabetes mellitus without

1142 04-09-2018 160102050918Y000114 0000120666947 LUDIA PUDI P PENERIMA PENSIUN Non-insulin-dependent Rujuk Lanjut
PNS diabetes mellitus with

1143 04-09-2018 160102050918Y000152 0000120668433 MASMAR P PENERIMA PENSIUN Essential (primary) Berobat Jalan
PNS hypertension
1144 04-09-2018 160102050918Y000137 0000120668771 MIMI ROSMIDI AKIS L PENERIMA PENSIUN Hyperplasia of prostate Rujuk Lanjut
PNS
1145 04-09-2018 160102050918Y000147 0000120670817 DINAR SITORUS P PENERIMA PENSIUN Non-insulin-dependent Berobat Jalan
PNS diabetes mellitus without

1146 04-09-2018 160102050918Y000133 0000121098464 ACHMAD BASRUN L PENERIMA PENSIUN Hyperplasia of prostate Rujuk Lanjut
PNS
1147 04-09-2018 160102050918Y000195 0000121111727 ZAINAL ARIFIN. BE L PENERIMA PENSIUN Acute nasopharyngitis Berobat Jalan
PNS [common cold]
1148 04-09-2018 160102050918Y000163 0000123039933 ROLAM SIMANULLANG L PNS DAERAH Unstable angina Rujuk Lanjut

1149 04-09-2018 160102050918Y000157 0000123087194 GHOZALI SAPUTRA L PEKERJA MANDIRI Schizophrenia, unspecified Rujuk Lanjut

1150 04-09-2018 160102050918Y000194 0000123118839 ABDUL KADIR L PENERIMA PENSIUN Myalgia, other site Berobat Jalan
PNS
1151 04-09-2018 160102050918Y000180 0000123677109 JUPENSIUS SINAGA L PNS DAERAH Hyperplasia of prostate Rujuk Lanjut

1152 04-09-2018 160102050918Y000138 0000123677133 hj. ARPAH MASDALI, s.sos. P PNS DAERAH Asthma, unspecified Berobat Jalan
m.,kes
1153 04-09-2018 160102050918Y000164 0000123678437 DERMAWAN MINAULI PURBA P PNS DAERAH Sciatica Rujuk Lanjut

1154 04-09-2018 160102050918Y000170 0000123681813 BASO TURUN BUA L PENERIMA PENSIUN Non-insulin-dependent Rujuk Lanjut
PNS diabetes mellitus with
neurological complications
DAFTAR KUNJUNGAN PESERTA SAKIT

Kantor Cabang : SAMARINDA - 1601

FKTP : SEGIRI - 16010205

1155 04-09-2018 160102050918Y000154 0000123684039 MUHAMMAD KURNIADI L PENERIMA PENSIUN Sequelae of stroke, not Berobat Jalan
PNS specified as haemorrhage

1156 04-09-2018 160102050918Y000172 0000123685727 MUHAMMAD JUHDI L PNS DAERAH Chronic ischaemic heart Rujuk Lanjut
disease, unspecified
1157 04-09-2018 160102050918Y000160 0000123866199 TAUFIKURRAHIM L PENERIMA PENSIUN Essential (primary) Berobat Jalan
PNS hypertension
1158 04-09-2018 160102050918Y000123 0000202840896 DIAF DJAFAR L PNS DAERAH Hyperplasia of prostate Rujuk Lanjut

1159 04-09-2018 160102050918Y000198 0000211028229 ARDINA CLARISSA RUMENGAN P PNS DAERAH Cutaneous abscess, Berobat Jalan
PONGMAKAMBA furuncle and carbuncle of

1160 04-09-2018 160102050918Y000143 0000893260214 HAPIJAH P PBI (APBN) Supervision of high-risk Rujuk Lanjut
pregnancy, unspecified
1161 04-09-2018 160102050918Y000161 0000899480665 ASMIN SYURYANTO L PBI (APBN) Orthopaedic follow-up Rujuk Lanjut
care, unspecified
1162 04-09-2018 160102050918Y000173 0000902592382 HANIAH P PBI (APBN) Myalgia, multiple sites Berobat Jalan

1163 04-09-2018 160102050918Y000174 0000902592797 KHORI ATUL AZIZAH P PBI (APBN) Dyspepsia Berobat Jalan

1164 04-09-2018 160102050918Y000131 0000902610639 MUTINI P PBI (APBN) Fever, unspecified Berobat Jalan

1165 04-09-2018 160102050918Y000177 0000902674192 AULIA KHUSNUL KHOTIMAH P PBI (APBN) Allergic contact dermatitis, Berobat Jalan
unspecified cause

1166 04-09-2018 160102050918Y000159 0000903343037 KAMSIDA P PBI (APBN) Cystitis, unspecified Berobat Jalan

1167 04-09-2018 160102050918Y000191 0000903427975 SITI SUPARTI P PBI (APBN) Non-insulin-dependent Berobat Jalan
diabetes mellitus without

1168 04-09-2018 160102050918Y000121 0000903827114 TONI KAHAR L PBI (APBN) Non-insulin-dependent Rujuk Lanjut
diabetes mellitus with
neurological complications

1169 04-09-2018 160102050918Y000140 0000903832424 INDY HARIYANTI P PBI (APBN) Acute apical periodontitis Berobat Jalan
of pulpal origin
1170 04-09-2018 160102050918Y000179 0000903941458 SUCI LESTARI P PBI (APBN) Dental caries, unspecified Berobat Jalan

1171 04-09-2018 160102050918Y000162 0001066474809 ENDANG SULASTRI P PBI (APBN) Chronic ischaemic heart Rujuk Lanjut
disease, unspecified
1172 04-09-2018 160102050918Y000129 0001066476115 TUNIK P PBI (APBN) Adhesive capsulitis of Rujuk Lanjut
shoulder
1173 04-09-2018 160102050918Y000192 0001066477904 FEBRIANA DWI JULIANTI P PBI (APBN) Acute pharyngitis, Berobat Jalan
unspecified
1174 04-09-2018 160102050918Y000139 0001066478005 MUHAMMAD SHOLAHUDDIN L PBI (APBN) Disorder of external ear, Berobat Jalan
SANJAYA unspecified
DAFTAR KUNJUNGAN PESERTA SAKIT

Kantor Cabang : SAMARINDA - 1601

FKTP : SEGIRI - 16010205

1175 04-09-2018 160102050918Y000116 0001071313391 laSIGA L PBI (APBN) Chronic renal failure, Rujuk Lanjut
unspecified
1176 04-09-2018 160102050918Y000151 0001262605329 PUTRI WAHYUNI P PEKERJA MANDIRI Supervision of high-risk Rujuk Lanjut
pregnancy, unspecified
1177 04-09-2018 160102050918Y000204 0001445954354 AZIDAH P PEKERJA MANDIRI Supervision of other Berobat Jalan
normal pregnancy
1178 04-09-2018 160102050918Y000142 0001551621701 RIFKI ADITYA L PEGAWAI SWASTA Fracture of shaft of femur, Rujuk Lanjut
closed
1179 04-09-2018 160102050918Y000193 0001673341222 MAWAR R.Z. ERSATI EKA P. P PBI (APBD) Varicella without Berobat Jalan
complication
1180 04-09-2018 160102050918Y000178 0001802154677 DESY LINTIN P PEGAWAI SWASTA Acute apical periodontitis Berobat Jalan
of pulpal origin
1181 04-09-2018 160102050918Y000203 0001866984873 MUSDALIFAH.Z P PEGAWAI PEMERINTAH Supervision of other Berobat Jalan
NON PNS normal pregnancy
1182 04-09-2018 160102050918Y000134 0001875933167 GAFAR KASIM L PEKERJA MANDIRI Chronic ischaemic heart Rujuk Lanjut
disease, unspecified
1183 04-09-2018 160102050918Y000136 0001925221836 REZA KURNIAWAN L PBI (APBD) Epilepsy, unspecified Rujuk Lanjut

1184 04-09-2018 160102050918Y000135 0001925222512 SRI SURYA NINGSIH P PBI (APBD) Schizophrenia, unspecified Rujuk Lanjut

1185 04-09-2018 160102050918Y000166 0001925263934 SUWANDI L PBI (APBD) Essential (primary) Berobat Jalan
hypertension
1186 04-09-2018 160102050918Y000153 0001925264935 ADITYA RIZQI L PBI (APBD) Acute nasopharyngitis Berobat Jalan
[common cold]
1187 04-09-2018 160102050918Y000181 0001928649115 ASMA P PBI (APBD) Headache Berobat Jalan

1188 04-09-2018 160102050918Y000169 0001928653255 SRI WIDIASTUTI P PBI (APBD) Non-insulin-dependent Rujuk Lanjut
diabetes mellitus without

1189 04-09-2018 160102050918Y000187 0001978924151 SITI NUR HALIZAH P PBI (APBN) General medical Berobat Jalan
examination
1190 04-09-2018 160102050918Y000120 0002059621334 FIRDA P PEKERJA MANDIRI Acute apical periodontitis Rujuk Lanjut
of pulpal origin
1191 04-09-2018 160102050918Y000158 0002071328973 SADDIAH P PEKERJA MANDIRI Essential (primary) Berobat Jalan
hypertension
1192 04-09-2018 160102050918Y000115 0002074805425 LA SALIPA L PEKERJA MANDIRI Chronic ischaemic heart Rujuk Lanjut
disease, unspecified
1193 04-09-2018 160102050918Y000141 0002083115226 ABDUL HAMID L PEKERJA MANDIRI Soft tissue disorder, Rujuk Lanjut
unspecified, ankle and foot

1194 04-09-2018 160102050918Y000146 0002087825501 PURNAMAWATI P PEKERJA MANDIRI Acute apical periodontitis Berobat Jalan
of pulpal origin
1195 04-09-2018 160102050918Y000150 0002253429821 FAISAL ADITIYA PRATAMA L PEKERJA MANDIRI Acute nasopharyngitis Berobat Jalan
[common cold]
DAFTAR KUNJUNGAN PESERTA SAKIT

Kantor Cabang : SAMARINDA - 1601

FKTP : SEGIRI - 16010205

1196 04-09-2018 160102050918Y000189 0002261547314 ZAKIYA P PEGAWAI SWASTA Bronchitis, not specified as Rujuk Lanjut
acute or chronic
1197 04-09-2018 160102050918Y000167 0002271822074 SANIAH P PENERIMA PENSIUN Sequelae of stroke, not Rujuk Lanjut
PNS specified as haemorrhage

1198 04-09-2018 160102050918Y000190 0002282551198 WANCEHI P PEKERJA MANDIRI Chronic obstructive Rujuk Lanjut
pulmonary disease,

1199 04-09-2018 160102050918Y000149 0002284916231 YASINTHA DIVYANA ZAHRA P PBI (APBN) Acute nasopharyngitis Berobat Jalan
[common cold]
1200 04-09-2018 160102050918Y000155 0002304446027 DEA ANANDA P PEKERJA MANDIRI Impacted teeth Rujuk Lanjut

1201 04-09-2018 160102050918Y000182 0002314120151 HEDNIYATI MANULLANG P PEGAWAI SWASTA Dental caries, unspecified Berobat Jalan

1202 04-09-2018 160102050918Y000186 0002318226917 SLAMET RIYADI L PEKERJA MANDIRI Fever, unspecified Berobat Jalan

1203 04-09-2018 160102050918Y000185 0002322632553 HASANAH P PEKERJA MANDIRI Foreign body in colon Berobat Jalan

1204 04-09-2018 160102050918Y000148 0002422135899 MUHAMMAD ZAYAAN SAPUTRA L PEKERJA MANDIRI Acute nasopharyngitis Berobat Jalan
[common cold]
1205 04-09-2018 160102050918Y000188 0002430133367 RONA DEWI FAYANI P PEGAWAI SWASTA Surgical follow-up care, Berobat Jalan
unspecified
1206 04-09-2018 160102050918Y000171 0002435064153 SYAHRIL L PEKERJA MANDIRI Hyperplasia of prostate Rujuk Lanjut

1207 04-09-2018 160102050918Y000176 0002463562236 LA JODI L PEKERJA MANDIRI Surgical follow-up care, Rujuk Lanjut
unspecified
1208 04-09-2018 160102050918Y000175 0002475832151 SUGIANTO L PEKERJA MANDIRI Sequelae of stroke, not Rujuk Lanjut
specified as haemorrhage

1209 03-09-2018 160102050918Y000112 0000119642534 TIUR SIAHAAN P PNS DAERAH Other and unspecified Rujuk Lanjut
abdominal pain
1210 03-09-2018 160102050918Y000074 0000119645133 YOGI HADIPUTRA L PNS DAERAH Benign neoplasm of Rujuk Lanjut
unspecified site
1211 03-09-2018 160102050918Y000043 0000120268089 AMIRULLAH SIAHAAN L PNS DAERAH Non-insulin-dependent Berobat Jalan
diabetes mellitus without

1212 03-09-2018 160102050918Y000054 0000120292648 AMIR MARYONO L PNS PUSAT Essential (primary) Berobat Jalan
hypertension
1213 03-09-2018 160102050918Y000119 0000120293087 SITTI RUSDIANA H P PNS PUSAT Essential (primary) Berobat Jalan
hypertension
1214 03-09-2018 160102050918Y000050 0000120352432 SUNARSO L PNS DAERAH Hyperplasia of prostate Rujuk Lanjut

1215 03-09-2018 160102050918Y000210 0000120371949 ENI HERAWATI P PNS DAERAH Supervision of other Berobat Jalan
normal pregnancy
1216 03-09-2018 160102050918Y000070 0000120417502 ARIF RAKHMANTO L PNS PUSAT Malignant neoplasm of Rujuk Lanjut
brain, unspecified
DAFTAR KUNJUNGAN PESERTA SAKIT

Kantor Cabang : SAMARINDA - 1601

FKTP : SEGIRI - 16010205

1217 03-09-2018 160102050918Y000059 0000120471276 KHOIRUL SOLIKHIN L PNS PUSAT Chronic ischaemic heart Rujuk Lanjut
disease, unspecified
1218 03-09-2018 160102050918Y000126 0000120533861 NETANIELLA NOVRIN P PNS PUSAT Tuberculosis of lung, Berobat Jalan
PANGNGAROAN without mention of
bacteriological or

1219 03-09-2018 160102050918Y000124 0000120549069 AGUSTIN RAHMAWATI P PNS DAERAH Acute nasopharyngitis Berobat Jalan
[common cold]
1220 03-09-2018 160102050918Y000125 0000120549071 TRI URBA NURYANTO L PNS DAERAH Cough Berobat Jalan

1221 03-09-2018 160102050918Y000086 0000120554864 SITI ARBAYAH P PENERIMA PENSIUN Chronic ischaemic heart Rujuk Lanjut
PNS disease, unspecified
1222 03-09-2018 160102050918Y000094 0000120559779 SJAHRIL AIDA P PENERIMA PENSIUN Essential (primary) Berobat Jalan
PNS hypertension
1223 03-09-2018 160102050918Y000075 0000120581188 YUSRAN MAWAN L PENERIMA PENSIUN Chronic ischaemic heart Berobat Jalan
PNS disease, unspecified
1224 03-09-2018 160102050918Y000076 0000120581199 BAHARIAH ZAILANI P PENERIMA PENSIUN Hypertensive heart Berobat Jalan
PNS disease with (congestive)

1225 03-09-2018 160102050918Y000040 0000120629654 SYAHRUDDIN TARMIDZI L PENERIMA PENSIUN Non-insulin-dependent Berobat Jalan
PNS diabetes mellitus without

1226 03-09-2018 160102050918Y000109 0000120657161 SOEMIJATI P PENERIMA PENSIUN Other and unspecified Berobat Jalan
PNS abdominal pain
1227 03-09-2018 160102050918Y000069 0000120659139 SjARIFULLAH L PENERIMA PENSIUN Chronic ischaemic heart Rujuk Lanjut
PNS disease, unspecified
1228 03-09-2018 160102050918Y000078 0000120664844 MUHAMMAD SYARWANI L PENERIMA PENSIUN Hyperplasia of prostate Rujuk Lanjut
RAMLIE PNS
1229 03-09-2018 160102050918Y000067 0000120666339 JUSUF ATJIL, H. L PENERIMA PENSIUN Allergic contact dermatitis, Berobat Jalan
PNS unspecified cause

1230 03-09-2018 160102050918Y000068 0000120677196 ZAINAL ABIDIN,SH L PENERIMA PENSIUN Chronic ischaemic heart Rujuk Lanjut
PNS disease, unspecified
1231 03-09-2018 160102050918Y000046 0000120689302 NOOR ALIAH P PENERIMA PENSIUN After-cataract Rujuk Lanjut
PNS
1232 03-09-2018 160102050918Y000099 0000120714669 MURDIANSYAH L PENERIMA PENSIUN Chronic ischaemic heart Rujuk Lanjut
PNS disease, unspecified
1233 03-09-2018 160102050918Y000101 0000120714671 NURDIANA P PENERIMA PENSIUN Chronic ischaemic heart Rujuk Lanjut
PNS disease, unspecified
1234 03-09-2018 160102050918Y000063 0000120756295 SAWUDI L PNS DAERAH Superficial injury of lower Berobat Jalan
leg, unspecified
1235 03-09-2018 160102050918Y000085 0000123085541 MUHAMAD REZA ADHA L PNS DAERAH Follow-up care involving Rujuk Lanjut
removal of fracture plate
and other internal fixation
DAFTAR KUNJUNGAN PESERTA SAKIT

Kantor Cabang : SAMARINDA - 1601

FKTP : SEGIRI - 16010205

1236 03-09-2018 160102050918Y000065 0000123678729 DARMA GEDOAN L PNS DAERAH Essential (primary) Berobat Jalan
hypertension
1237 03-09-2018 160102050918Y000087 0000123682498 INDRA TAMBOEN L PENERIMA PENSIUN Non-insulin-dependent Rujuk Lanjut
PNS diabetes mellitus without

1238 03-09-2018 160102050918Y000090 0000123682509 RENOKASIH P PENERIMA PENSIUN Non-insulin-dependent Rujuk Lanjut
PNS diabetes mellitus without

1239 03-09-2018 160102050918Y000102 0000123694075 WENDA ELVIANA P PNS DAERAH Essential (primary) Berobat Jalan
hypertension
1240 03-09-2018 160102050918Y000108 0000897069969 USWATUN P PBI (APBN) Acute nasopharyngitis Berobat Jalan
[common cold]
1241 03-09-2018 160102050918Y000106 0000899651002 MOHSARIF L PBI (APBN) Epilepsy, unspecified Rujuk Lanjut

1242 03-09-2018 160102050918Y000095 0000902442734 ALVIANO ALBIANSAH L PBI (APBN) Dental caries, unspecified Berobat Jalan

1243 03-09-2018 160102050918Y000062 0000902452307 ANNISA RAMADHINI SAMSURI P PBI (APBN) Disorder of ear, Berobat Jalan
unspecified
1244 03-09-2018 160102050918Y000105 0000902527773 SUMINI P PBI (APBN) Superficial injury of lower Rujuk Lanjut
leg, unspecified
1245 03-09-2018 160102050918Y000088 0000902528199 ASTUTIK P PBI (APBN) Essential (primary) Berobat Jalan
hypertension
1246 03-09-2018 160102050918Y000103 0000902529123 FRISCA RIRIS APRILIA WATI P PBI (APBN) Acute pharyngitis, Berobat Jalan
unspecified
1247 03-09-2018 160102050918Y000096 0000902718911 MUHAMMAD ANDI L PBI (APBN) Dental caries, unspecified Berobat Jalan

1248 03-09-2018 160102050918Y000057 0000902766565 HAMSYAH L PBI (APBN) Disorder of lens, Rujuk Lanjut
unspecified
1249 03-09-2018 160102050918Y000083 0000903377597 TRANINGSIH P PBI (APBN) Myalgia, multiple sites Berobat Jalan

1250 03-09-2018 160102050918Y000056 0000903453219 BAYAH. S P PBI (APBN) Other cholelithiasis Rujuk Lanjut

1251 03-09-2018 160102050918Y000118 0000903866016 SUNARSIH P PBI (APBN) Essential (primary) Berobat Jalan
hypertension
1252 03-09-2018 160102050918Y000051 0001313797487 WA LICE P PEKERJA MANDIRI Non-insulin-dependent Rujuk Lanjut
diabetes mellitus with
neurological complications

1253 03-09-2018 160102050918Y000107 0001387982046 LIATI P PEKERJA MANDIRI Allergic contact dermatitis, Berobat Jalan
unspecified cause

1254 03-09-2018 160102050918Y000110 0001462723345 MARIA MARLIANI P PENERIMA PENSIUN TNI Hordeolum and other deep Berobat Jalan
inflammation of eyelid

1255 03-09-2018 160102050918Y000113 0001470309208 HELDIYANI P PEKERJA MANDIRI Impacted teeth Rujuk Lanjut
DAFTAR KUNJUNGAN PESERTA SAKIT

Kantor Cabang : SAMARINDA - 1601

FKTP : SEGIRI - 16010205

1256 03-09-2018 160102050918Y000049 0001549150694 SALSABILA RAHMADANI P PEGAWAI SWASTA Fever, unspecified Berobat Jalan

1257 03-09-2018 160102050918Y000071 0001609489168 SIA SAVANG P PBI (APBD) Non-insulin-dependent Rujuk Lanjut
diabetes mellitus with
neurological complications

1258 03-09-2018 160102050918Y000093 0001614490615 M. HAFID ANNADORI L PBI (APBD) Allergic contact dermatitis, Rujuk Lanjut
unspecified cause

1259 03-09-2018 160102050918Y000092 0001614490648 MUHAMMAD RIDWAN KAMIL L PBI (APBD) Allergic contact dermatitis, Rujuk Lanjut
unspecified cause

1260 03-09-2018 160102050918Y000111 0001923462303 MARLEN UDAU P PEKERJA MANDIRI Dyspepsia Berobat Jalan

1261 03-09-2018 160102050918Y000104 0001924986058 BAYU SETIAWAN L PEKERJA MANDIRI Headache Berobat Jalan

1262 03-09-2018 160102050918Y000055 0001925212994 USMAN L PBI (APBD) Chronic ischaemic heart Berobat Jalan
disease, unspecified
1263 03-09-2018 160102050918Y000082 0001925223131 RADIYANTO L PBI (APBD) Thyrotoxicosis, Rujuk Lanjut
unspecified
1264 03-09-2018 160102050918Y000084 0001925223153 BESTINA B TURNIP P PBI (APBD) Myalgia, ankle and foot Rujuk Lanjut

1265 03-09-2018 160102050918Y000044 0001925232118 SITI AMINURYATI P PBI (APBD) Schizophrenia, unspecified Rujuk Lanjut

1266 03-09-2018 160102050918Y000165 0002038642637 MASTIANI P PEKERJA MANDIRI Non-insulin-dependent Rujuk Lanjut
diabetes mellitus without

1267 03-09-2018 160102050918Y000060 0002047729397 dinda ayu hariyanti L PNS DAERAH Myalgia, multiple sites Berobat Jalan

1268 03-09-2018 160102050918Y000098 0002059561642 PUTRI AZZAHRA P PEGAWAI SWASTA Constipation Rujuk Lanjut

1269 03-09-2018 160102050918Y000045 0002065176099 MURIYATI P PEKERJA MANDIRI Chronic ischaemic heart Berobat Jalan
disease, unspecified
1270 03-09-2018 160102050918Y000064 0002066504837 MASTORA P PEKERJA MANDIRI Non-insulin-dependent Berobat Jalan
diabetes mellitus without

1271 03-09-2018 160102050918Y000047 0002066679641 SULIS SETIOWATI P PEKERJA MANDIRI Chronic ischaemic heart Rujuk Lanjut
disease, unspecified
1272 03-09-2018 160102050918Y000122 0002197540866 SUMARDI HARTOYO L PEKERJA MANDIRI Sequelae of stroke, not Berobat Jalan
specified as haemorrhage

1273 03-09-2018 160102050918Y000042 0002204041454 SUTRISNO L PBI (APBD) Acute nasopharyngitis Berobat Jalan
[common cold]
1274 03-09-2018 160102050918Y000097 0002222931835 MULYADI L PEKERJA MANDIRI Chronic viral hepatitis B Rujuk Lanjut
without delta-agent
DAFTAR KUNJUNGAN PESERTA SAKIT

Kantor Cabang : SAMARINDA - 1601

FKTP : SEGIRI - 16010205

1275 03-09-2018 160102050918Y000053 0002226123371 TUNI P PEKERJA MANDIRI Non-insulin-dependent Berobat Jalan
diabetes mellitus without

1276 03-09-2018 160102050918Y000077 0002232069377 SAMINYO L PEKERJA MANDIRI Non-insulin-dependent Berobat Jalan
diabetes mellitus with
neurological complications

1277 03-09-2018 160102050918Y000100 0002232489802 HASRIANTI P PEKERJA MANDIRI Primary generalized Rujuk Lanjut
(osteo)arthrosis
1278 03-09-2018 160102050918Y000091 0002244558701 HARITS UWAIS TSARWAN L PNS DAERAH Fever, unspecified Berobat Jalan

1279 03-09-2018 160102050918Y000066 0002245028613 ANDI AZIS L PEKERJA MANDIRI Non-insulin-dependent Berobat Jalan
diabetes mellitus without

1280 03-09-2018 160102050918Y000041 0002246200997 LA UNE L PEKERJA MANDIRI Non-insulin-dependent Rujuk Lanjut
diabetes mellitus with
neurological complications

1281 03-09-2018 160102050918Y000073 0002247516549 JAMALUDIN L PEKERJA MANDIRI Superficial injury of lower Rujuk Lanjut
leg, unspecified
1282 03-09-2018 160102050918Y000061 0002253670582 MARLIN NATTY P PEKERJA MANDIRI Other and unspecified Rujuk Lanjut
ovarian cysts
1283 03-09-2018 160102050918Y000089 0002260999383 AMINA P PEKERJA MANDIRI Acute nasopharyngitis Berobat Jalan
[common cold]
1284 03-09-2018 160102050918Y000080 0002263910049 MUHAMMAD RIYAN FACHRIZAL L PEKERJA MANDIRI Surgical follow-up care, Berobat Jalan
unspecified
1285 03-09-2018 160102050918Y000058 0002317500821 JUWITA HB P PEKERJA MANDIRI Senile cataract, Rujuk Lanjut
unspecified
1286 03-09-2018 160102050918Y000072 0002426405139 M. ZAINUDIN L PEKERJA MANDIRI Angina pectoris, Rujuk Lanjut
unspecified
1287 03-09-2018 160102050918Y000048 0002436961768 ATHABINA RAMADHANI VANIA P PEGAWAI SWASTA Ptosis of eyelid Rujuk Lanjut
ANDRIANSYAH
1288 03-09-2018 160102050918Y000052 0002469231944 SAVIERA NURUL LAYLI P PEKERJA MANDIRI Constipation Berobat Jalan

1289 03-09-2018 160102050918Y000079 0002477485337 SUSI AGUS SUSANTI P PNS DAERAH Headache Berobat Jalan

1290 03-09-2018 160102050918Y000081 0002481241937 ABDUSSALAM L PEKERJA MANDIRI Keratitis, unspecified Rujuk Lanjut

1291 01-09-2018 160102050918Y000034 0000120403708 YANUAR RAMDANI L PNS PUSAT Adhesive capsulitis of Rujuk Lanjut
shoulder
1292 01-09-2018 160102050918Y000021 0000120490975 hm AGUS SUTOPO, mba L PENERIMA PENSIUN TNI Chronic ischaemic heart Rujuk Lanjut
disease, unspecified
1293 01-09-2018 160102050918Y000004 0000120513014 SALAMAH P PENERIMA PENSIUN TNI Non-insulin-dependent Rujuk Lanjut
diabetes mellitus without
DAFTAR KUNJUNGAN PESERTA SAKIT

Kantor Cabang : SAMARINDA - 1601

FKTP : SEGIRI - 16010205

1294 01-09-2018 160102050918Y000029 0000120533861 NETANIELLA NOVRIN P PNS PUSAT Tuberculosis of lung, Berobat Jalan
PANGNGAROAN without mention of
bacteriological or

1295 01-09-2018 160102050918Y000025 0000120549453 SAIDAH P PNS DAERAH Nausea and vomiting Berobat Jalan

1296 01-09-2018 160102050918Y000019 0000120659354 AJI AGUSTINA P PENERIMA PENSIUN Essential (primary) Berobat Jalan
PNS hypertension
1297 01-09-2018 160102050918Y000010 0000120674081 SUHADI L PENERIMA PENSIUN Acute nasopharyngitis Berobat Jalan
PNS [common cold]
1298 01-09-2018 160102050918Y000023 0000120756295 SAWUDI L PNS DAERAH Chronic ischaemic heart Berobat Jalan
disease, unspecified
1299 01-09-2018 160102050918Y000016 0000120837115 DRA. SRI SUTANTI P PNS DAERAH Myalgia, ankle and foot Rujuk Lanjut

1300 01-09-2018 160102050918Y000001 0000120850896 SUHARJI L PNS DAERAH Non-insulin-dependent Rujuk Lanjut
diabetes mellitus without

1301 01-09-2018 160102050918Y000037 0000123018772 NIKEN RAIHANA KUSUMA P PNS DAERAH Headache Berobat Jalan
NINGRUM
1302 01-09-2018 160102050918Y000009 0000123030505 NOOR FATHONI L PNS DAERAH Allergic contact dermatitis, Berobat Jalan
unspecified cause

1303 01-09-2018 160102050918Y000017 0000123679326 EDI IWAKUSUMA L PENERIMA PENSIUN Atrial fibrillation and flutter Rujuk Lanjut
PNS
1304 01-09-2018 160102050918Y000002 0000123726341 TUKIMIN L PNS DAERAH Pterygium Rujuk Lanjut

1305 01-09-2018 160102050918Y000006 0000902114414 SUGIYAH P PBI (APBN) Essential (primary) Berobat Jalan
hypertension
1306 01-09-2018 160102050918Y000012 0000902249886 AYU NURJANAH P PBI (APBN) Dysmenorrhoea, Berobat Jalan
unspecified
1307 01-09-2018 160102050918Y000014 0000902501379 SAUDJI L PBI (APBN) Congestive heart failure Rujuk Lanjut

1308 01-09-2018 160102050918Y000039 0000902794983 YAYUK SRININGSIH P PBI (APBN) Essential (primary) Berobat Jalan
hypertension
1309 01-09-2018 160102050918Y000013 0000903213584 SUKMA P PBI (APBN) Otitis media, unspecified Rujuk Lanjut

1310 01-09-2018 160102050918Y000008 0000903229885 DAROJI L PBI (APBN) Diarrhoea and Berobat Jalan
gastroenteritis of
presumed infectious origin

1311 01-09-2018 160102050918Y000028 0000903873104 TUGINAH P PBI (APBN) Acute nasopharyngitis Berobat Jalan
[common cold]
1312 01-09-2018 160102050918Y000033 0001066472245 M. SAIRI L PBI (APBN) Tinnitus Rujuk Lanjut

1313 01-09-2018 160102050918Y000026 0001551778683 ADE L PEGAWAI SWASTA Cough Berobat Jalan
DAFTAR KUNJUNGAN PESERTA SAKIT

Kantor Cabang : SAMARINDA - 1601

FKTP : SEGIRI - 16010205

1314 01-09-2018 160102050918Y000020 0001723636787 FAISAL HISYAM TRIYADI L PBI (APBD) Impacted cerumen Berobat Jalan

1315 01-09-2018 160102050918Y000032 0001736725544 Yuliana Andayani Rinding P PEGAWAI SWASTA Essential (primary) Rujuk Lanjut
hypertension
1316 01-09-2018 160102050918Y000030 0001742888024 RANO L PEGAWAI SWASTA Lepromatous leprosy Berobat Jalan

1317 01-09-2018 160102050918Y000035 0001925307551 MUHAMMAD ALZAHRAN ALHAM L PBI (APBD) Acute nasopharyngitis Berobat Jalan
[common cold]
1318 01-09-2018 160102050918Y000007 0002060451191 SAMSIAH P PEKERJA MANDIRI Non-insulin-dependent Berobat Jalan
diabetes mellitus without

1319 01-09-2018 160102050918Y000015 0002061587035 SUWATI P PEKERJA MANDIRI Hypertensive renal Rujuk Lanjut
disease with renal failure
1320 01-09-2018 160102050918Y000003 0002062122221 DJUMANSYAH L PEKERJA MANDIRI Chronic ischaemic heart Rujuk Lanjut
disease, unspecified
1321 01-09-2018 160102050918Y000018 0002203276037 SUPRAPTO L PEKERJA MANDIRI After-cataract Rujuk Lanjut

1322 01-09-2018 160102050918Y000024 0002203276948 SAHLAN L PEKERJA MANDIRI Bronchitis, not specified as Rujuk Lanjut
acute or chronic
1323 01-09-2018 160102050918Y000036 0002219945084 KADINEM P PEKERJA MANDIRI Essential (primary) Berobat Jalan
hypertension
1324 01-09-2018 160102050918Y000027 0002290006326 NAZHIERA SHYAQILA CARISSA P PEGAWAI SWASTA Acute tonsillitis, Berobat Jalan
unspecified
1325 01-09-2018 160102050918Y000031 0002304223389 ANDI HERY WIJAYA AS L PEKERJA MANDIRI Surgical follow-up care, Berobat Jalan
unspecified
1326 01-09-2018 160102050918Y000011 0002375417125 TOWIYAH P PEKERJA MANDIRI Acute nasopharyngitis Berobat Jalan
[common cold]
1327 01-09-2018 160102050918Y000127 0002375417147 FITRI RAMADHANI P PEKERJA MANDIRI Diarrhoea and Berobat Jalan
gastroenteritis of
presumed infectious origin

1328 01-09-2018 160102050918Y000038 0002430191766 DJAMAH P PEKERJA MANDIRI Non-insulin-dependent Berobat Jalan
diabetes mellitus without

1329 01-09-2018 160102050918Y000022 0002436961768 ATHABINA RAMADHANI VANIA P PEGAWAI SWASTA Hordeolum and other deep Rujuk Lanjut
ANDRIANSYAH inflammation of eyelid

1330 01-09-2018 160102050918Y000005 0002451167717 SUKARTI P PEKERJA MANDIRI Dyspepsia Berobat Jalan