Kantor Cabang: BANJARMASIN - 1701 FKTP: Kertak Hanyar - 17040601

Kantor Cabang : BANJARMASIN - 1701
FKTP : KERTAK HANYAR - 17040601

NO TANGGAL NO KUNJUNGAN NO KARTU
1 31-08-2018 170406010818Y000511 0000889469684
2 31-08-2018 170406010818Y000519 0000889779047
3 31-08-2018 170406010818Y000518 0000890212026
4 31-08-2018 170406010818Y000517 0000890836435
5 31-08-2018 170406010818Y000510 0000890886341
6 31-08-2018 170406010818Y000514 0001302569829
7 31-08-2018 170406010818Y000506 0001460053989
8 31-08-2018 170406010818Y000507 0001460055453
9 31-08-2018 170406010818Y000512 0001660140292
10 31-08-2018 170406010818Y000516 0001833652293
11 31-08-2018 170406010818Y000509 0001833652394
12 31-08-2018 170406010818Y000508 0002229571269
13 31-08-2018 170406010818Y000505 0002229571541
14 31-08-2018 170406010818Y000520 0002251470666
15 31-08-2018 170406010818Y000513 0002286718806
16 31-08-2018 170406010818Y000515 0002482520681
17 30-08-2018 170406010818Y000432 0000122733303
18 30-08-2018 170406010818Y000437 0000889697338
19 30-08-2018 170406010818Y000438 0000889764671
20 30-08-2018 170406010818Y000441 0000890038899
21 30-08-2018 170406010818Y000433 0000890043535

NAMA PESERTA SE JENIS PESERTA DIAGNOSA
X
ANANG L PBI (APBN) Asthma
NUR FAIJAH P PBI (APBN) Acute upper respiratory infection,

unspecified
SYARIFUDINOOR L PBI (APBN) Diarrhoea and gastroenteritis of
presumed infectious origin
RUSMAWATI P PBI (APBN) Conjunctivitis
LAILA P PBI (APBN) Hordeolum and chalazion
MANSYAH L PEKERJA MANDIRI Cough
M. SUBLI MAKSUM L PEGAWAI SWASTA Urinary tract infection, site not

specified
RUSMILAWATI P PEGAWAI SWASTA Gout
RIDAYATI P PEGAWAI SWASTA Varicella [chickenpox]
M. AINI L PEKERJA MANDIRI Gastritis, unspecified
ARSIAH P PEKERJA MANDIRI Foreign body in ear
DANIANSYAH L PEKERJA MANDIRI Dyspepsia
SITI SARAH P PEKERJA MANDIRI Stroke, not specified as

haemorrhage or infarction
FARHAN KHAZIN L PNS PUSAT Necrosis of pulp
FEBRIYANDI L PEGAWAI SWASTA Retained (old) foreign body

following penetrating
BAYI NY RUSNANI L PBI (APBN) Other low birth weight
H. IBERAHIM TUKACIL L PENERIMA PENSIUN PNS Atherosclerotic cardiovascular

disease, so
HALIMATUS SADIAH P PBI (APBN) Acute periodontitis
MURSIDAH P PBI (APBN) Cutaneous abscess, furuncle and

carbuncle
FATMAWATI P PBI (APBN) Contraceptive management,
unspecified
TAUFIK AKHMAD L PBI (APBN) Atherosclerotic cardiovascular
disease, so
DIRUJUK
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22 30-08-2018 170406010818Y000440 0000890749574
23 30-08-2018 170406010818Y000439 0000890888488
24 30-08-2018 170406010818P000525 0000895294956
25 30-08-2018 170406010818P000522 0001266036219
26 30-08-2018 170406010818Y000435 0001441794846
27 30-08-2018 170406010818Y000436 0001796551615
28 30-08-2018 170406010818Y000434 0002216875634
29 30-08-2018 170406010818Y000446 0002304843478
30 29-08-2018 170406010818Y000424 0000122330698
31 29-08-2018 170406010818Y000421 0000122714864
32 29-08-2018 170406010818Y000429 0000122719026
33 29-08-2018 170406010818Y000425 0000122756591
34 29-08-2018 170406010818Y000426 0000122824855
35 29-08-2018 170406010818Y000414 0000123209379
36 29-08-2018 170406010818Y000410 0000123313689
37 29-08-2018 170406010818Y000416 0000889455251
38 29-08-2018 170406010818Y000418 0000889979725
39 29-08-2018 170406010818Y000409 0000890043535
40 29-08-2018 170406010818Y000420 0000890236337
41 29-08-2018 170406010818Y000430 0000890450561

RAUDAH P PBI (APBN) Antenatal screening, unspecified
ICA PUTRI KIRANA P PBI (APBN) Cough
DEWI LESTARI P PBI (APBN) Antenatal screening
MURNIATI SARI P PEKERJA MANDIRI Complications of anaesthesia

during the
ANNI NURHIDAYAH P PEKERJA MANDIRI Essential (primary) hypertension
SITI AMINAH P PEKERJA MANDIRI Necrosis of pulp
LIANI P PEKERJA MANDIRI Acute pharyngitis
DEWI KARMILAWATI P PEKERJA MANDIRI Antenatal screening, unspecified
HASANAH P PNS PUSAT Other disorders of breast
FATIH NARA YASFI L PNS DAERAH Disturbances in tooth eruption
H SAIBATUL HAMDI L PNS DAERAH Diseases of pulp and periapical

tissues
ABDUL HADI L PENERIMA PENSIUN PNS Spondylolysis
NOORLENA P PNS DAERAH Vaginitis, vulvitis and vulvovaginitis

in infectious and parasitic diseases
classified elsewhere
ANITA P PENERIMA PENSIUN PNS Gout
ABDULLAHKARIM L PNS PUSAT Non-insulin-dependent diabetes

mellitus with
MA'UNAH P PBI (APBN) Stomatitis and related lesions
ERNAWATI P PBI (APBN) Dyspepsia
TAUFIK AKHMAD L PBI (APBN) Atherosclerotic cardiovascular

disease, so
ATIKAH P PBI (APBN) Fever of other and unknown origin
HELDA RIANI P PBI (APBN) Contraceptive management,

unspecified
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42 29-08-2018 170406010818Y000412 0000890679058
43 29-08-2018 170406010818Y000411 0000890872716
44 29-08-2018 170406010818Y000427 0001271659454
45 29-08-2018 170406010818Y000422 0001328026138
46 29-08-2018 170406010818Y000423 0001385980176
47 29-08-2018 170406010818Y000413 0001868732335
48 29-08-2018 170406010818Y000415 0002229564835
49 29-08-2018 170406010818Y000419 0002263699708
50 29-08-2018 170406010818Y000428 0002286718806
51 29-08-2018 170406010818Y000417 0002292581294
52 28-08-2018 170406010818Y000391 0000123114969
53 28-08-2018 170406010818Y000390 0000123807036
54 28-08-2018 170406010818Y000407 0000163775867
55 28-08-2018 170406010818Y000399 0000889469684
56 28-08-2018 170406010818Y000444 0000889706283
57 28-08-2018 170406010818Y000385 0000889786359
58 28-08-2018 170406010818Y000405 0000889928842
59 28-08-2018 170406010818Y000398 0000890199988
60 28-08-2018 170406010818Y000397 0000890540087
61 28-08-2018 170406010818Y000404 0000890650427
62 28-08-2018 170406010818Y000392 0000890781287
63 28-08-2018 170406010818Y000393 0000890843826
64 28-08-2018 170406010818Y000443 0001065413788

ACHMAD RAMADHAN L PBI (APBN) Cough
NOORJANAH P PBI (APBN) End-stage renal disease
ASFIANOOR BAHRAN L PEKERJA MANDIRI Acute pharyngitis
SALAMAH P PEKERJA MANDIRI Hyperlipidaemia, unspecified
RUSMAH P PEKERJA MANDIRI Necrosis of pulp
ALWI SALEH L PEKERJA MANDIRI Allergic contact dermatitis
YUSRAN L PEKERJA MANDIRI Hyperplasia of prostate
MUHAMMAD LUTHFI L PEKERJA MANDIRI Nausea and vomiting
FEBRIYANDI L PEGAWAI SWASTA Retained (old) foreign body

TEGUH RAHAYU SLAMET L PEKERJA MANDIRI Cough
AINI P PNS DAERAH Essential (primary) hypertension
NORMI ULFAH P PENERIMA PENSIUN PNS Myalgia
EDISON SITORUS L PNS PUSAT Caries of dentine
ANANG L PBI (APBN) Other anxiety disorders
RISNAWATI P PBI (APBN) Contraceptive management,

unspecified
NOOR JANNAH P PBI (APBN) Unspecified abortion
YANA P PBI (APBN) Contraceptive management,

unspecified
RAHMAT ARIANSYAH L PBI (APBN) Retained (old) foreign body
SITI MARIYAM P PBI (APBN) Gout
MUJALIFAH P PBI (APBN) Antenatal screening, unspecified
HAFIZ ANSYARI L PBI (APBN) Conjunctivitis
KHAIRUDIN L PBI (APBN) Headache
SYAIBAH P PBI (APBN) Contraceptive management,

unspecified
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65 28-08-2018 170406010818Y000400 0001065417333
66 28-08-2018 170406010818Y000394 0001065673618
67 28-08-2018 170406010818Y000408 0001079882188
68 28-08-2018 170406010818Y000388 0001264049471
69 28-08-2018 170406010818Y000401 0001425352072
70 28-08-2018 170406010818Y000389 0001484006861
71 28-08-2018 170406010818Y000396 0001791970097
72 28-08-2018 170406010818Y000395 0001810491085
73 28-08-2018 170406010818Y000406 0001827797466
74 28-08-2018 170406010818Y000386 0001889939777
75 28-08-2018 170406010818Y000387 0002250656627
76 28-08-2018 170406010818Y000402 0002293208019
77 28-08-2018 170406010818Y000403 0002321576403
78 28-08-2018 170406010818Y000442 0002432836901
79 27-08-2018 170406010818Y000381 0000122654801
80 27-08-2018 170406010818Y000368 0000122756927
81 27-08-2018 170406010818Y000367 0000122824269
82 27-08-2018 170406010818Y000370 0000123114969
83 27-08-2018 170406010818Y000373 0000123329542
84 27-08-2018 170406010818Y000372 0000123587021
85 27-08-2018 170406010818Y000366 0000200778669
86 27-08-2018 170406010818Y000383 0000889956854
87 27-08-2018 170406010818Y000450 0000890555253

SITI RAHMAH P PBI (APBN) Cough
riska HASANAH P PBI (APBN) Haemorrhoids
MUSTAFA KAMAL L PNS DAERAH Pulpitis
RUSINAH P PEKERJA MANDIRI Low back pain
SYUKRAN L PEKERJA MANDIRI Hypotension, unspecified
NOOR JUBAIDAH A.A P PEKERJA MANDIRI Cholelithiasis
rahma agustina P PEKERJA MANDIRI Allergic contact dermatitis
MURSILAH P PEKERJA MANDIRI Gout
MUHAMMAD NABIL L PEGAWAI SWASTA Disturbances in tooth eruption
SAPIAH P PEKERJA MANDIRI Hypertensive heart disease
YULIANTO PONGTULURAN L PEGAWAI SWASTA Other benign neoplasms of skin
NOR AISYA MUFIA P PBI (APBN) Cough
REHANSYAH L PBI (APBN) Diarrhoea and gastroenteritis of

NORJAIDAH P PEKERJA MANDIRI Antenatal screening, unspecified
ERNAWATI P PENERIMA PENSIUN PNS Tinea barbae and tinea capitis
ROKHANA P PENERIMA PENSIUN PNS Presence of intraocular lens
MASRIAH P PNS DAERAH Malaise and fatigue
AINI P PNS DAERAH Gout
CHAIRUL ANWAR L PNS DAERAH Hyperplasia of prostate
ITA AS P PENERIMA PENSIUN PNS Insulin-dependent diabetes

mellitus
NORLIANI P PEKERJA MANDIRI Diabetes mellitus arising in
pregnancy
BAHRUL BASRI L PBI (APBN) Essential (primary) hypertension
SUTIMAH P PBI (APBN) Headache

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88 27-08-2018 170406010818Y000376 0000890681038
89 27-08-2018 170406010818Y000448 0000891603437
90 27-08-2018 170406010818Y000375 0000891677283
91 27-08-2018 170406010818Y000384 0001266035848
92 27-08-2018 170406010818Y000380 0001302569829
93 27-08-2018 170406010818Y000451 0001319216321
94 27-08-2018 170406010818Y000374 0001381947052
95 27-08-2018 170406010818Y000449 0001385980176
96 27-08-2018 170406010818Y000371 0001465179524
97 27-08-2018 170406010818Y000377 0001484006861
98 27-08-2018 170406010818Y000369 0001821774969
99 27-08-2018 170406010818Y000382 0002216875634
100 27-08-2018 170406010818Y000445 0002304843478
101 27-08-2018 170406010818Y000379 0002322241255
102 27-08-2018 170406010818Y000447 0002431209993
103 27-08-2018 170406010818Y000378 0002431210961
104 27-08-2018 170406010818Y000452 0002456954627
105 25-08-2018 170406010818Y000350 0000122622085
106 25-08-2018 170406010818Y000454 0000122654801

BAHJAH P PBI (APBN) Essential (primary) hypertension
MURSIDI L PBI (APBN) Other and unspecified diseases of

pulp and
MUHAMMAD RASID L PBI (APBN) Myalgia
MASTAYAH P PEKERJA MANDIRI Diarrhoea and gastroenteritis of

MANSYAH L PEKERJA MANDIRI Cough
SITI MARIAM P PEKERJA MANDIRI Pterygium
KEVIN ROYDEN DANENDRA L PEGAWAI PEMERINTAH Cough

DENGAN PERJANJIAN
RUSMAH P PEKERJA MANDIRI Other and unspecified diseases of

pulp and
AMIR L PEKERJA MANDIRI Cough
NOOR JUBAIDAH A.A P PEKERJA MANDIRI Influenza due to other identified

influenza virus
NUR AINA P PEKERJA MANDIRI Acute pharyngitis
LIANI P PEKERJA MANDIRI Allergic rhinitis due to pollen
DEWI KARMILAWATI P PEKERJA MANDIRI Contraceptive management,

unspecified
NUN HAYATI P PEKERJA MANDIRI Dyspnoea
SITI RAHMAH P PEKERJA MANDIRI Contraceptive management,

unspecified
AHMAD ALFIAN NOOR L PEKERJA MANDIRI Retained (old) foreign body
BY.NY.MARDANITA SARI L PEKERJA MANDIRI Diarrhoea and gastroenteritis of

MUHAMMAD TAAT NOOR L PNS DAERAH Congestive heart failure
ERNAWATI P PENERIMA PENSIUN PNS Examination of blood pressure

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107 25-08-2018 170406010818Y000455 0000122695571
108 25-08-2018 170406010818Y000456 0000122718791
109 25-08-2018 170406010818Y000457 0000122718971
110 25-08-2018 170406010818Y000458 0000122718982
111 25-08-2018 170406010818Y000459 0000122718993
112 25-08-2018 170406010818Y000460 0000122719026
113 25-08-2018 170406010818Y000461 0000122719037
114 25-08-2018 170406010818Y000462 0000122719151
115 25-08-2018 170406010818Y000463 0000122719195
116 25-08-2018 170406010818Y000464 0000122719206
117 25-08-2018 170406010818Y000352 0000122756725
118 25-08-2018 170406010818Y000362 0000122824258
119 25-08-2018 170406010818Y000361 0000122824269
120 25-08-2018 170406010818Y000465 0000122849267
121 25-08-2018 170406010818Y000466 0000204782804
122 25-08-2018 170406010818Y000363 0000889777113
123 25-08-2018 170406010818Y000353 0000889823586
124 25-08-2018 170406010818Y000364 0000890465016
125 25-08-2018 170406010818Y000357 0000890769521
126 25-08-2018 170406010818Y000356 0000890780196
127 25-08-2018 170406010818Y000359 0000978029818

ERNI RAHMI P PNS DAERAH Examination of blood pressure
DENI ELFENI P PNS DAERAH Examination of blood pressure
FARIDAWATY P PNS DAERAH Examination of blood pressure
FAULIAH P PNS DAERAH Examination of blood pressure
BURHANUDDIN L PNS DAERAH Examination of blood pressure
H SAIBATUL HAMDI L PNS DAERAH Examination of blood pressure
MAHDIATUL WAHDAH P PNS DAERAH Examination of blood pressure
JOHNY RAMOON L PNS PUSAT Examination of blood pressure
MAULANA IBRAHIM L PNS DAERAH Examination of blood pressure
NOOR ASLIANI P PNS DAERAH Examination of blood pressure
AS'ARI ISFANI L PENERIMA PENSIUN PNS Insulin-dependent diabetes

mellitus with
AMRULLAH L PNS DAERAH Cough
MASRIAH P PNS DAERAH Myalgia
MEGAWATI P PNS DAERAH Examination of blood pressure
SITI PATIMAH P PENERIMA PENSIUN PNS Examination of blood pressure
PUTRI MAHARANI P PBI (APBN) Acute tonsillitis
FATMAWATI P PBI (APBN) Dyspepsia
RUSMINAH P PBI (APBN) Diarrhoea and gastroenteritis of

MAULIDA ANGGRAINI P PBI (APBN) Acute tonsillitis
ANANG SAHRI L PBI (APBN) Cough
RUSMIATI P PENERIMA PENSIUN PNS Pure hypercholesterolaemia

Sembuh
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128 25-08-2018 170406010818Y000360 0001078411318
129 25-08-2018 170406010818Y000453 0001278170245
130 25-08-2018 170406010818Y000467 0001298136914
131 25-08-2018 170406010818Y000348 0001307796309
132 25-08-2018 170406010818Y000468 0001441794846
133 25-08-2018 170406010818Y000349 0001657157692
134 25-08-2018 170406010818Y000355 0001796551615
135 25-08-2018 170406010818Y000469 0002207775701
136 25-08-2018 170406010818Y000354 0002216666801
137 25-08-2018 170406010818Y000358 0002265929111
138 25-08-2018 170406010818Y000351 0002471802816
139 24-08-2018 170406010818Y000341 0000122606526
140 24-08-2018 170406010818Y000332 0000122707045
141 24-08-2018 170406010818Y000337 0000123209379
142 24-08-2018 170406010818Y000346 0000123736792
143 24-08-2018 170406010818Y000470 0000200778669
144 24-08-2018 170406010818Y000344 0000889424414
145 24-08-2018 170406010818Y000343 0000889980928
146 24-08-2018 170406010818Y000342 0000890199988
147 24-08-2018 170406010818Y000338 0000890683503

RUSTINI P PNS PUSAT Essential (primary) hypertension
MARDIANA P PEKERJA MANDIRI Contraceptive management,

unspecified
MAHWATI P PEKERJA MANDIRI Examination of blood pressure
ARBAYAH P PEKERJA MANDIRI Non-insulin-dependent diabetes

mellitus without
ANNI NURHIDAYAH P PEKERJA MANDIRI Examination of blood pressure
IWAN JAYA SAPUTERA L PEKERJA MANDIRI Essential (primary) hypertension
SITI AMINAH P PEKERJA MANDIRI Pulpitis
DINA MARIANI P PEGAWAI SWASTA Examination of blood pressure
ATAYA DWI RAFKA L PEGAWAI SWASTA Dyspepsia
NURSIAH P PEKERJA MANDIRI Tuberculosis of lung, confirmed by

sputum microscopy with or without
ERY SASONGKO L PEKERJA MANDIRI Tuberculous pleurisy, confirmed

bacteriologically and histologically
ZULPAEDHA P PNS DAERAH Essential (primary) hypertension
ROHANI P PENERIMA PENSIUN TNI Malaise and fatigue
ANITA P PENERIMA PENSIUN PNS Spondylolysis
RIDUANSYAHRANI L PNS DAERAH Necrosis of pulp
NORLIANI P PEKERJA MANDIRI Antenatal screening, unspecified
SAWIYAH P PBI (APBN) Acute upper respiratory infection,

unspecified
MUBARAK L PBI (APBN) Other disorders of urinary system
RAHMAT ARIANSYAH L PBI (APBN) Cutaneous abscess, furuncle and

carbuncle
LAILA HIDAYATI P PBI (APBN) Essential (primary) hypertension
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148 24-08-2018 170406010818P000524 0000890749574
149 24-08-2018 170406010818Y000471 0000891668665
150 24-08-2018 170406010818Y000336 0001380784746
151 24-08-2018 170406010818Y000335 0001422558099
152 24-08-2018 170406010818Y000334 0001790572871
153 24-08-2018 170406010818Y000340 0001794111851
154 24-08-2018 170406010818Y000333 0001857673214
155 24-08-2018 170406010818Y000339 0001868734877
156 24-08-2018 170406010818Y000347 0002206172799
157 24-08-2018 170406010818Y000345 0002251470666
158 23-08-2018 170406010818Y000322 0000123093707
159 23-08-2018 170406010818Y000319 0000123287253
160 23-08-2018 170406010818Y000318 0000123582879
161 23-08-2018 170406010818Y000328 0000158013213
162 23-08-2018 170406010818Y000325 0000889950172
163 23-08-2018 170406010818Y000472 0000889992764
164 23-08-2018 170406010818Y000327 0000890042231
165 23-08-2018 170406010818Y000324 0001319216321
166 23-08-2018 170406010818Y000323 0001847115505
167 23-08-2018 170406010818Y000317 0002071972978
168 23-08-2018 170406010818Y000326 0002216666801
169 23-08-2018 170406010818Y000320 0002270213717
170 23-08-2018 170406010818Y000316 0002456749102

RAUDAH P PBI (APBN) Complications of anaesthesia
during the
MUJAIMAH P PBI (APBN) Antenatal screening, unspecified
RAWANSYAH L PEKERJA MANDIRI Spondylolysis
NOFA SEPITRI P PEKERJA MANDIRI Other disorders of gingiva and

edentulous alveolar
ROHANI P PEKERJA MANDIRI Other secondary hypertension
NOOR AIDA P PEKERJA MANDIRI Dyspepsia
alya sairina P PEKERJA MANDIRI Epilepsy
KASINAH P PEKERJA MANDIRI Acute upper respiratory infection,

unspecified
SULLIYANTI P PEKERJA MANDIRI Necrosis of pulp
FARHAN KHAZIN L PNS PUSAT Pulpitis
SITI HADIJAH P PNS DAERAH Intracerebral haemorrhage,

unspecified
MUDERAN L PENERIMA PENSIUN PNS Heart failure, unspecified
ARMAT BASRI L PENERIMA PENSIUN PNS Essential (primary) hypertension
M. SALEH MARAN, DRS L PENERIMA PENSIUN PNS Pulpitis
M. MAULANA L PBI (APBN) Fever of other and unknown origin
WAHIDAH P PBI (APBN) Antenatal screening, unspecified
KHAIRIADI L PBI (APBN) Conjunctivitis
SITI MARIAM P PEKERJA MANDIRI Conjunctivitis
HADRI L PNS DAERAH Conjunctivitis
ASMAH P PEKERJA MANDIRI Other disorders of eye and adnexa
ATAYA DWI RAFKA L PEGAWAI SWASTA Malaise and fatigue
AHNAF SYAIRAZI L PBI (APBN) Cough
SITI AISYAH P PEKERJA MANDIRI Severe pre-eclampsia

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171 23-08-2018 170406010818Y000321 0002483888815
172 21-08-2018 170406010818Y000305 0000122719522
173 21-08-2018 170406010818Y000307 0000163507184
174 21-08-2018 170406010818Y000475 0000889697338
175 21-08-2018 170406010818Y000304 0000889764759
176 21-08-2018 170406010818Y000311 0000890683503
177 21-08-2018 170406010818Y000312 0000890843826
178 21-08-2018 170406010818Y000477 0000894751784
179 21-08-2018 170406010818Y000314 0001320164785
180 21-08-2018 170406010818Y000310 0001551459712
181 21-08-2018 170406010818Y000315 0001859978619
182 21-08-2018 170406010818Y000309 0002047441623
183 21-08-2018 170406010818Y000313 0002065412452
184 21-08-2018 170406010818Y000476 0002084192313
185 21-08-2018 170406010818Y000308 0002206172799
186 21-08-2018 170406010818Y000473 0002216666801
187 21-08-2018 170406010818Y000306 0002229564835
188 20-08-2018 170406010818Y000295 0000122605626
189 20-08-2018 170406010818Y000294 0000122605637
190 20-08-2018 170406010818Y000296 0000123322184
191 20-08-2018 170406010818Y000292 0000123347103

ZAHIRA NUR AZIZAH P PNS DAERAH Chronic tonsillitis
SURBINI L PENERIMA PENSIUN PNS Insulin-dependent diabetes

mellitus without
RUSDIANA. HJ P PENERIMA PENSIUN PNS Calcific tendinitis
HALIMATUS SADIAH P PBI (APBN) Contraceptive management,

unspecified
ahmad saidi L PBI (APBN) Undifferentiated schizophrenia
LAILA HIDAYATI P PBI (APBN) Essential (primary) hypertension
KHAIRUDIN L PBI (APBN) Non-insulin-dependent diabetes

mellitus
NOORLIANA SANTI P PBI (APBN) Contraceptive management,
unspecified
MARIANI P PNS DAERAH Haemorrhoids
SYARWANI ABDAN L PEGAWAI SWASTA Cough
NORHAYATI P PEKERJA MANDIRI Tuberculosis of lung, confirmed by

unspecified
HANUUN P PEKERJA MANDIRI Acute pharyngitis
PANG SING KOK L PEKERJA MANDIRI Haemorrhoids
SUPARMI P PEGAWAI SWASTA Contraceptive management,

unspecified
SULLIYANTI P PEKERJA MANDIRI Periapical abscess with sinus
ATAYA DWI RAFKA L PEGAWAI SWASTA Fever of other and unknown origin
MUHAIMIN L PENERIMA PENSIUN PNS Parkinson's disease
HJ. SYUFIAH UHIN P PENERIMA PENSIUN PNS Insulin-dependent diabetes

mellitus without
IFAH AMINAH P PNS PUSAT Dyspepsia
HERYADI, DRS L PNS PUSAT Non-insulin-dependent diabetes

mellitus without
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192 20-08-2018 170406010818Y000289 0000124003618
193 20-08-2018 170406010818Y000297 0000889478335
194 20-08-2018 170406010818Y000303 0000889671857
195 20-08-2018 170406010818Y000299 0000889671903
196 20-08-2018 170406010818Y000478 0000889976237
197 20-08-2018 170406010818Y000483 0000890038899
198 20-08-2018 170406010818Y000300 0000890236337
199 20-08-2018 170406010818Y000474 0000890310778
200 20-08-2018 170406010818Y000481 0000890539097
201 20-08-2018 170406010818Y000482 0000890678632
202 20-08-2018 170406010818Y000298 0000890762264
203 20-08-2018 170406010818Y000302 0000890786946
204 20-08-2018 170406010818Y000480 0000890826568
205 20-08-2018 170406010818Y000521 0000891524902
206 20-08-2018 170406010818Y000291 0001425352072
207 20-08-2018 170406010818Y000479 0001791969311
208 20-08-2018 170406010818Y000290 0002083725639
209 20-08-2018 170406010818Y000301 0002265929111
210 20-08-2018 170406010818Y000293 0002478726437
211 18-08-2018 170406010818Y000489 0000122654801
212 18-08-2018 170406010818Y000491 0000122695571
213 18-08-2018 170406010818Y000490 0000122717766

MUNIROH P PENERIMA PENSIUN PNS Allergic contact dermatitis
DELLA MARENDA P PBI (APBN) Pulpitis
RUSMINA P PBI (APBN) Dyspepsia
YULIA RUSMITA P PBI (APBN) Caries of dentine
NOOR HASANAH P PBI (APBN) Contraceptive management,

unspecified
FATMAWATI P PBI (APBN) Contraceptive management,
unspecified
ATIKAH P PBI (APBN) Rheumatism, unspecified
RUSMIATI P PBI (APBN) Contraceptive management,

unspecified
SAHWATI P PBI (APBN) Contraceptive management,
unspecified
WIWI ARIYANI P PBI (APBN) Contraceptive management,
unspecified
SITI AISYAH P PBI (APBN) Necrosis of pulp
SITI AISYAH P PBI (APBN) Gout
RINI RIANI P PBI (APBN) Antenatal screening, unspecified
TUFIKURRAHMAN P PBI (APBN) Contraceptive management,

unspecified
SYUKRAN L PEKERJA MANDIRI Asthma
isrina P PEKERJA MANDIRI Antenatal screening, unspecified
ABD. HALIM L PEKERJA MANDIRI Acute pharyngitis
NURSIAH P PEKERJA MANDIRI Tuberculosis of lung, confirmed by

unspecified
MASITAH P PEKERJA MANDIRI Hypertensive heart disease
ADTRI KORNIATI P PNS DAERAH Examination of blood pressure

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214 18-08-2018 170406010818Y000492 0000122718791
215 18-08-2018 170406010818Y000493 0000122718824
216 18-08-2018 170406010818Y000494 0000122718971
217 18-08-2018 170406010818Y000495 0000122718982
218 18-08-2018 170406010818Y000496 0000122718993
219 18-08-2018 170406010818Y000497 0000122719026
220 18-08-2018 170406010818Y000498 0000122719037
221 18-08-2018 170406010818Y000499 0000122719195
222 18-08-2018 170406010818Y000431 0000122719206
223 18-08-2018 170406010818Y000500 0000122719432
224 18-08-2018 170406010818Y000501 0000122719509
225 18-08-2018 170406010818Y000284 0000123115061
226 18-08-2018 170406010818Y000288 0000123205544
227 18-08-2018 170406010818Y000488 0000123347103
228 18-08-2018 170406010818Y000287 0000123587021
229 18-08-2018 170406010818Y000286 0000162190945
230 18-08-2018 170406010818Y000502 0000204782804
231 18-08-2018 170406010818Y000365 0000889725971
232 18-08-2018 170406010818Y000487 0000890561733
233 18-08-2018 170406010818Y000330 0000890772941
234 18-08-2018 170406010818Y000484 0000890843826

DEWI ESTIKA SARI P PNS DAERAH Examination of blood pressure
SESSI TRI AYU REVILLA P PNS DAERAH Examination of blood pressure
SUNARNI P PNS DAERAH Examination of blood pressure
ARBANI L PNS DAERAH Non-insulin-dependent diabetes

mellitus without
RUKIAH. P PNS DAERAH Myalgia
HERYADI, DRS L PNS PUSAT Non-insulin-dependent diabetes

mellitus
ITA AS P PENERIMA PENSIUN PNS Tuberculosis of lung, confirmed by
unspecified
ABU BAKAR SIDIK L PENERIMA PENSIUN PNS Cough
SALASIAH P PBI (APBN) Gout
SURIADI L PBI (APBN) Dyspepsia
JURMIYAH P PBI (APBN) Gastritis, unspecified
KHAIRUDIN L PBI (APBN) Gout

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235 18-08-2018 170406010818Y000285 0001065414284
236 18-08-2018 170406010818Y000331 0001065414317
237 18-08-2018 170406010818Y000503 0001298136914
238 18-08-2018 170406010818Y000504 0001441794846
239 18-08-2018 170406010818Y000486 0001827796612
240 18-08-2018 170406010818Y000485 0001827797466
241 18-08-2018 170406010818Y000329 0002213305784
242 16-08-2018 170406010818Y000276 0000122707179
243 16-08-2018 170406010818Y000269 0000122719162
244 16-08-2018 170406010818Y000273 0000158013213
245 16-08-2018 170406010818Y000277 0000163775867
246 16-08-2018 170406010818Y000275 0000202900915
247 16-08-2018 170406010818Y000280 0000890785405
248 16-08-2018 170406010818Y000271 0000891208394
249 16-08-2018 170406010818Y000281 0001433339752
250 16-08-2018 170406010818Y000282 0001437168126
251 16-08-2018 170406010818Y000272 0001816967057
252 16-08-2018 170406010818Y000274 0001868734877
253 16-08-2018 170406010818Y000278 0002293560178
254 16-08-2018 170406010818Y000279 0002293560538

LATIFAH P PBI (APBN) Essential (primary) hypertension
AHMAD NAZORI L PBI (APBN) Allergic contact dermatitis
SUCI NURHIDAYATI P PEGAWAI SWASTA Allergic contact dermatitis,

unspecified cause
MUHAMMAD NABIL L PEGAWAI SWASTA Fever of other and unknown origin
MUHAMMAD NAUFAL AL-FARHAN L PEGAWAI SWASTA Fever, unspecified
SAPERAH P PENERIMA PENSIUN TNI Influenza with other respiratory

manifestations, influenza virus
identified
RUSLIASARI P PNS PUSAT Gonarthrosis, unspecified
M. SALEH MARAN, DRS L PENERIMA PENSIUN PNS Pulpitis
EDISON SITORUS L PNS PUSAT Dyspepsia
SUKARSIH P PENERIMA PENSIUN PNS Acute pharyngitis, unspecified
LIDYA WARDANI P PBI (APBN) Antenatal screening, unspecified
ROHANA P PBI (APBN) Dyspepsia
RUSDIANA HANDAYANI P PEKERJA MANDIRI Antenatal screening, unspecified
HERLINA HARTATI P PEKERJA MANDIRI Antenatal screening, unspecified
ARIE ANDRIANTO L PEGAWAI SWASTA Necrosis of pulp
KASINAH P PEKERJA MANDIRI Influenza with other

manifestations, influenza
IRHAN, H L PEKERJA MANDIRI Essential (primary) hypertension
NORHAYATI, HJ P PEKERJA MANDIRI Non-insulin-dependent diabetes

mellitus
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255 16-08-2018 170406010818Y000270 0002322240895
256 16-08-2018 170406010818Y000283 0002431209993
257 15-08-2018 170406010818Y000247 0000122330698
258 15-08-2018 170406010818Y000240 0000122654801
259 15-08-2018 170406010818Y000241 0000122813313
260 15-08-2018 170406010818Y000260 0000122819703
261 15-08-2018 170406010818Y000257 0000123736792
262 15-08-2018 170406010818Y000259 0000123844768
263 15-08-2018 170406010818Y000248 0000202899407
264 15-08-2018 170406010818Y000245 0000889926276
265 15-08-2018 170406010818Y000251 0000889946976
266 15-08-2018 170406010818Y000253 0000889947977
267 15-08-2018 170406010818Y000250 0000889948372
268 15-08-2018 170406010818Y000252 0000890001145
269 15-08-2018 170406010818Y000256 0000890202284
270 15-08-2018 170406010818Y000255 0000890836435
271 15-08-2018 170406010818Y000261 0000890844592
272 15-08-2018 170406010818Y000264 0001065414756
273 15-08-2018 170406010818Y000246 0001065414947
274 15-08-2018 170406010818Y000258 0001065417333
275 15-08-2018 170406010818Y000243 0001422284488
276 15-08-2018 170406010818Y000244 0001483387525

ABDUL GANI L PEKERJA MANDIRI Follow-up examination after
surgery for other
SITI RAHMAH P PEKERJA MANDIRI Contraceptive management,

unspecified
HASANAH P PNS PUSAT Headache
ERNAWATI P PENERIMA PENSIUN PNS Heart failure, unspecified
M.ASYARI L PNS DAERAH Unspecified dementia
SURIADI L PNS DAERAH Acute bronchiolitis
RIDUANSYAHRANI L PNS DAERAH Pulpitis
MAWARDAH P PENERIMA PENSIUN PNS Cutaneous abscess, furuncle and

carbuncle
SITI BARKIS P PENERIMA PENSIUN PNS Essential (primary) hypertension
ERNA P PBI (APBN) Cough
YATI P PBI (APBN) Acute upper respiratory infection,

unspecified
NAPSIAH P PBI (APBN) Dyspepsia
M. NAUPAL L PBI (APBN) Acute upper respiratory infections

of multiple and
ARIPA ZAHRA P PBI (APBN) Allergic contact dermatitis
NOOR SYARIFAH P PBI (APBN) Acute upper respiratory infections

of multiple and
RUSMAWATI P PBI (APBN) Allergic contact dermatitis
NORSEHAN P PBI (APBN) Dyspepsia
ARBAINAH P PBI (APBN) Residual foreign body in soft

tissue, ankle and foot
MASARAH P PBI (APBN) Cough
SITI RAHMAH P PBI (APBN) Acute upper respiratory infections

of multiple and
yusmi ariany P PEKERJA MANDIRI Disorder of refraction, unspecified
GT. NAURA SALSABILA P PEKERJA MANDIRI Disorder of refraction, unspecified

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277 15-08-2018 170406010818Y000268 0001786622196
278 15-08-2018 170406010818Y000242 0001802951313
279 15-08-2018 170406010818Y000254 0001823098781
280 15-08-2018 170406010818P000523 0001865551937
281 15-08-2018 170406010818Y000249 0002471803885
282 14-08-2018 170406010818Y000226 0000122719162
283 14-08-2018 170406010818Y000237 0000122813313
284 14-08-2018 170406010818Y000238 0000123205533
285 14-08-2018 170406010818Y000231 0000124497325
286 14-08-2018 170406010818Y000239 0000166492383
287 14-08-2018 170406010818Y000265 0000201646451
288 14-08-2018 170406010818Y000228 0000889798994
289 14-08-2018 170406010818Y000266 0000890017211
290 14-08-2018 170406010818Y000225 0000890781287
291 14-08-2018 170406010818Y000236 0000890843826
292 14-08-2018 170406010818Y000234 0000978029818
293 14-08-2018 170406010818Y000232 0001266035848
294 14-08-2018 170406010818Y000227 0001278170245
295 14-08-2018 170406010818Y000262 0001385980176
296 14-08-2018 170406010818Y000263 0001898501613

SRI YULIANTI P PEKERJA MANDIRI Contraceptive management,
unspecified
FITRIANA P PEGAWAI SWASTA Benign neoplasm of breast
ARBAYAH, HJ P PEKERJA MANDIRI Essential (primary) hypertension
dewi arfina P PEKERJA MANDIRI Complications of anaesthesia

during the
BAYI NY LIDIA WATI L PBI (APBN) Conjunctivitis
RUSLIASARI P PNS PUSAT Gonarthrosis, unspecified
M.ASYARI L PNS DAERAH Essential (primary) hypertension
RASIDI L PNS DAERAH Essential (primary) hypertension
SRF.RODIYAH, SP P PNS DAERAH Allergic contact dermatitis due to

metals
AISYAH P PENERIMA PENSIUN TNI Dyspepsia
MUHAMMAD ZEFRY AKBAR L PNS DAERAH Other and unspecified diseases of

pulp and
abdul rahim L PBI (APBN) Tuberculosis of lung, confirmed by

unspecified
AMAH P PBI (APBN) Contraceptive management,

unspecified
HAFIZ ANSYARI L PBI (APBN) Cough
KHAIRUDIN L PBI (APBN) Headache
RUSMIATI P PENERIMA PENSIUN PNS Hyperlipidaemia, unspecified
MASTAYAH P PEKERJA MANDIRI Acute haemorrhagic gastritis
MARDIANA P PEKERJA MANDIRI Headache
RUSMAH P PEKERJA MANDIRI Other and unspecified diseases of

pulp and
MUHAMMAD IHSAN L PNS DAERAH Other and unspecified diseases of

pulp and
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297 14-08-2018 170406010818Y000230 0002071972978
298 14-08-2018 170406010818Y000235 0002093457723
299 14-08-2018 170406010818Y000229 0002240179222
300 14-08-2018 170406010818Y000267 0002456799377
301 14-08-2018 170406010818Y000233 0002469003581
302 13-08-2018 170406010818Y000185 0000123209379
303 13-08-2018 170406010818Y000184 0000123555058
304 13-08-2018 170406010818Y000189 0000124507877
305 13-08-2018 170406010818Y000194 0000195495761
306 13-08-2018 170406010818Y000190 0000211436987
307 13-08-2018 170406010818Y000183 0000889763624
308 13-08-2018 170406010818Y000205 0000889907534
309 13-08-2018 170406010818Y000192 0000889927885
310 13-08-2018 170406010818Y000204 0000890038899
311 13-08-2018 170406010818Y000202 0000890070715
312 13-08-2018 170406010818Y000186 0000890073944
313 13-08-2018 170406010818Y000201 0000890074754
314 13-08-2018 170406010818Y000187 0000890216109
315 13-08-2018 170406010818Y000191 0000890450109
316 13-08-2018 170406010818Y000195 0000890811977
317 13-08-2018 170406010818Y000193 0000891183892

ASMAH P PEKERJA MANDIRI Conjunctivitis
HARI LISWATI P PEKERJA MANDIRI Non-insulin-dependent diabetes

mellitus without
PANDI L PEKERJA MANDIRI Calculus in bladder
NOOR HASANAH P PEKERJA MANDIRI Antenatal screening, unspecified
MAHDINI L PEKERJA MANDIRI Essential (primary) hypertension
ANITA P PENERIMA PENSIUN PNS Gout
RUSLIANI, hj P PENERIMA PENSIUN PNS Low back pain
SITI AISYAH P PENERIMA PENSIUN PNS Non-insulin-dependent diabetes

mellitus with
RAHIMAH P PENERIMA PENSIUN PNS Hyperlipidaemia, unspecified
AHMAD MUHYIDDIN L PNS DAERAH Influenza due to other identified

influenza virus
SETIA BUDI L PBI (APBN) Stroke, not specified as
NOOR AIDA P PBI (APBN) Contraceptive management,
unspecified
HAMIDAH P PBI (APBN) Obstructed labour due to other
malposition and
FATMAWATI P PBI (APBN) Antenatal screening, unspecified
ITI WAHIDAH P PBI (APBN) Antenatal screening, unspecified
IDHAM L PBI (APBN) Conjunctivitis
BAHRAH P PBI (APBN) Contraceptive management,

unspecified
SYAIPULLAH L PBI (APBN) Influenza, virus not identified
NOOR EFFENDI L PBI (APBN) Periapical abscess without sinus
MISBATUN NI'MAH P PBI (APBN) Spondylolysis
MUHAMMAD ABDURRAHIM L PBI (APBN) Stomatitis and related lesions

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318 13-08-2018 170406010818Y000188 0000891219633
319 13-08-2018 170406010818Y000182 0001303166687
320 13-08-2018 170406010818Y000200 0001441794194
321 13-08-2018 170406010818Y000199 0001483848887
322 13-08-2018 170406010818Y000206 0001791969311
323 13-08-2018 170406010818Y000198 0001791970097
324 13-08-2018 170406010818Y000203 0001801331807
325 13-08-2018 170406010818Y000197 0001810491085
326 13-08-2018 170406010818Y000181 0001868734877
327 13-08-2018 170406010818Y000196 0002065412452
328 11-08-2018 170406010818Y000207 0000122654801
329 11-08-2018 170406010818Y000208 0000122695571
330 11-08-2018 170406010818Y000209 0000122717766
331 11-08-2018 170406010818Y000210 0000122718791
332 11-08-2018 170406010818Y000211 0000122718971
333 11-08-2018 170406010818Y000212 0000122718982
334 11-08-2018 170406010818Y000213 0000122718993
335 11-08-2018 170406010818Y000214 0000122719026
336 11-08-2018 170406010818Y000215 0000122719037
337 11-08-2018 170406010818Y000216 0000122719151
338 11-08-2018 170406010818Y000217 0000122719195

BAHRUDIN L PBI (APBN) Tuberculosis of lung, confirmed by
sputum microscopy with or without
SYAEPULLAH L PEKERJA MANDIRI Epilepsy
ISKANDAR L PEKERJA MANDIRI Hyperlipidaemia, unspecified
jumaiah P PEKERJA MANDIRI Conjunctivitis
isrina P PEKERJA MANDIRI Antenatal screening, unspecified
rahma agustina P PEKERJA MANDIRI Headache
SITI AISYAH P PEKERJA MANDIRI Antenatal screening, unspecified
MURSILAH P PEKERJA MANDIRI Spondylolysis
KASINAH P PEKERJA MANDIRI Disorder of refraction, unspecified
PANG SING KOK L PEKERJA MANDIRI Constipation

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Berobat Jalan
Berobat Jalan
Berobat Jalan
Berobat Jalan
Berobat Jalan
Rujuk Lanjut
Berobat Jalan
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Sembuh
339 11-08-2018 170406010818Y000218 0000122719206
340 11-08-2018 170406010818Y000219 0000122719432
341 11-08-2018 170406010818Y000220 0000122719509
342 11-08-2018 170406010818Y000179 0000123421228
343 11-08-2018 170406010818Y000170 0000123562001
344 11-08-2018 170406010818Y000172 0000123587021
345 11-08-2018 170406010818Y000221 0000204782804
346 11-08-2018 170406010818Y000171 0000889926276
347 11-08-2018 170406010818Y000180 0000890665367
348 11-08-2018 170406010818Y000178 0000890811977
349 11-08-2018 170406010818Y000222 0001298136914
350 11-08-2018 170406010818Y000177 0001425352072
351 11-08-2018 170406010818Y000223 0001441794846
352 11-08-2018 170406010818Y000174 0001827797466
353 11-08-2018 170406010818Y000175 0001883400502
354 11-08-2018 170406010818Y000176 0001907099032
355 11-08-2018 170406010818Y000224 0002207775701
356 11-08-2018 170406010818Y000173 0002431209712
357 10-08-2018 170406010818Y000155 0000122756714
358 10-08-2018 170406010818Y000160 0000123578526
359 10-08-2018 170406010818Y000157 0000123578537

SESSI TRI AYU REVILLA P PNS DAERAH Examination of blood pressure
ACHMAD NOOR L PENERIMA PENSIUN PNS Allergic contact dermatitis
SUNI DIRIS L PENERIMA PENSIUN PNS Disorder of refraction, unspecified
ITA AS P PENERIMA PENSIUN PNS Acute haemorrhagic gastritis
ERNA P PBI (APBN) Tuberculosis of lung, confirmed by

unspecified
ARBAIN L PBI (APBN) Acute haemorrhagic gastritis
MISBATUN NI'MAH P PBI (APBN) Spondylolysis
SYUKRAN L PEKERJA MANDIRI Headache
MUHAMMAD NABIL L PEGAWAI SWASTA Corns and callosities
ROHANI P PEKERJA MANDIRI Dyspepsia
SUSAN RITA IRENE TORE P PEKERJA MANDIRI Essential (primary) hypertension
RAHMANI L PEKERJA MANDIRI Stroke, not specified as

ARKANI L PENERIMA PENSIUN PNS Parkinson's disease
SITI AZIZAH P PENERIMA PENSIUN PNS Myalgia
WAHIDIN L PENERIMA PENSIUN PNS Non-insulin-dependent diabetes

mellitus without
Sembuh
Sembuh
Sembuh
Berobat Jalan
Rujuk Lanjut
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Sembuh
Rujuk Lanjut
Berobat Jalan
Berobat Jalan
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Rujuk Lanjut
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Berobat Jalan
360 10-08-2018 170406010818Y000163 0000158013213
361 10-08-2018 170406010818Y000168 0000889702828
362 10-08-2018 170406010818Y000159 0000889957045
363 10-08-2018 170406010818Y000167 0000890053525
364 10-08-2018 170406010818Y000156 0000890465016
365 10-08-2018 170406010818Y000161 0000890630695
366 10-08-2018 170406010818Y000158 0000890656042
367 10-08-2018 170406010818Y000165 0000891603437
368 10-08-2018 170406010818Y000169 0001271659735
369 10-08-2018 170406010818Y000162 0001460053989
370 10-08-2018 170406010818Y000154 0001481549793
371 10-08-2018 170406010818Y000166 0002251470666
372 10-08-2018 170406010818Y000164 0002438267624
373 09-08-2018 170406010818Y000144 0000123302812
374 09-08-2018 170406010818Y000141 0000123359861
375 09-08-2018 170406010818Y000149 0000889819762
376 09-08-2018 170406010818Y000147 0000889979534
377 09-08-2018 170406010818Y000150 0000889992718
378 09-08-2018 170406010818Y000143 0000890340614
379 09-08-2018 170406010818Y000146 0000890681038

M. SALEH MARAN, DRS L PENERIMA PENSIUN PNS Essential (primary) hypertension
MIDAWATI P PBI (APBN) Contraceptive management,

unspecified
LAMISAH P PBI (APBN) Cough
MARIANA P PBI (APBN) Contraceptive management,

unspecified
RUSMINAH P PBI (APBN) Essential (primary) hypertension
MISLIWATI P PBI (APBN) Hemiplegia
MASRANI L PBI (APBN) Acute upper respiratory infection,

unspecified
MURSIDI L PBI (APBN) Chronic periodontitis
RAHMAWATI P PEKERJA MANDIRI Contraceptive management,

unspecified
M. SUBLI MAKSUM L PEGAWAI SWASTA Essential (primary) hypertension
RAZAKIAH P PEKERJA MANDIRI Insulin-dependent diabetes

mellitus with peripheral circulatory
FARHAN KHAZIN L PNS PUSAT Necrosis of pulp
RAISA ASPIAN P PEKERJA MANDIRI Acute upper respiratory infections

of multiple and
SUBONO L PENERIMA PENSIUN PNS Heart failure, unspecified
RUSLI L PENERIMA PENSIUN PNS Non-insulin-dependent diabetes

mellitus with
SARBANI L PBI (APBN) Gout
M. SUPIAN SAURI L PBI (APBN) Hypotension, unspecified
NASRI L PBI (APBN) Other and unspecified diseases of

pulp and
redho setiawan L PBI (APBN) Schizoaffective disorder, manic

type
BAHJAH P PBI (APBN) Essential (primary) hypertension
Berobat Jalan
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Berobat Jalan
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Rujuk Lanjut
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Berobat Jalan
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380 09-08-2018 170406010818Y000148 0000890786946
381 09-08-2018 170406010818Y000152 0000891629739
382 09-08-2018 170406010818Y000153 0001173437425
383 09-08-2018 170406010818Y000151 0001286581386
384 09-08-2018 170406010818Y000140 0001295326405
385 09-08-2018 170406010818Y000139 0001295327013
386 09-08-2018 170406010818Y000142 0001302083278
387 09-08-2018 170406010818Y000145 0002297436118
388 08-08-2018 170406010818Y000128 0000122330698
389 08-08-2018 170406010818Y000130 0000122654801
390 08-08-2018 170406010818Y000126 0000122813313
391 08-08-2018 170406010818Y000132 0000123366071
392 08-08-2018 170406010818Y000122 0000889926276
393 08-08-2018 170406010818Y000136 0000889956854
394 08-08-2018 170406010818Y000124 0000890236337
395 08-08-2018 170406010818Y000138 0000977274977
396 08-08-2018 170406010818Y000135 0001065415779
397 08-08-2018 170406010818Y000137 0001065793634
398 08-08-2018 170406010818Y000123 0001279227227
399 08-08-2018 170406010818Y000133 0001284111044

SITI AISYAH P PBI (APBN) Essential (primary) hypertension
ASLAMIAH P PBI (APBN) Antenatal screening, unspecified
HIKMAH P PEGAWAI SWASTA Contraceptive management,

unspecified
SITI MARIYAM L PNS DAERAH Other and unspecified diseases of
pulp and
SYARKAWI L PEKERJA MANDIRI Hyperplasia of prostate
ARSIAH P PEKERJA MANDIRI Senile cataract, unspecified
NURLIANA P PEKERJA MANDIRI Non-insulin-dependent diabetes

mellitus with
ainah L PEKERJA MANDIRI Hyperlipidaemia, unspecified
HASANAH P PNS PUSAT Essential (primary) hypertension
ERNAWATI P PENERIMA PENSIUN PNS Allergic contact dermatitis
M.ASYARI L PNS DAERAH Essential (primary) hypertension
HASAN BASRI L PNS PUSAT Other and unspecified

hydronephrosis
ERNA P PBI (APBN) Cough
BAHRUL BASRI L PBI (APBN) Essential (primary) hypertension
ATIKAH P PBI (APBN) Acute upper respiratory infection,

unspecified
DADANG SEPTIYANGGA L PNS DAERAH Acute upper respiratory infections
of multiple and
SITI HALIDAH P PBI (APBN) Essential (primary) hypertension
ISLAMIWATI P PBI (APBN) Allergic contact dermatitis
EVA YUSANTI P PEGAWAI SWASTA Headache
FARIDA IRIANA P PEKERJA MANDIRI Non-insulin-dependent diabetes

mellitus with
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400 08-08-2018 170406010818Y000131 0001380923177
401 08-08-2018 170406010818Y000129 0001810491085
402 08-08-2018 170406010818Y000121 0001859978619
403 08-08-2018 170406010818Y000127 0001902576161
404 08-08-2018 170406010818Y000120 0002083725639
405 08-08-2018 170406010818Y000134 0002093722571
406 08-08-2018 170406010818Y000125 0002291496816
407 07-08-2018 170406010818Y000104 0000122608732
408 07-08-2018 170406010818Y000096 0000122824495
409 07-08-2018 170406010818Y000101 0000123347103
410 07-08-2018 170406010818Y000094 0000123359861
411 07-08-2018 170406010818Y000099 0000890665367
412 07-08-2018 170406010818Y000109 0001278170245
413 07-08-2018 170406010818Y000103 0001284111044
414 07-08-2018 170406010818Y000105 0001286578293
415 07-08-2018 170406010818Y000100 0001306752142
416 07-08-2018 170406010818Y000107 0001317889247
417 07-08-2018 170406010818Y000097 0001425352072
418 07-08-2018 170406010818Y000106 0001451368113
419 07-08-2018 170406010818Y000098 0001451642679
420 07-08-2018 170406010818Y000108 0001481294035

RAHMAWATY P PEKERJA MANDIRI Other benign neoplasm of skin of
scalp and neck
MURSILAH P PEKERJA MANDIRI Gout
NORHAYATI P PEKERJA MANDIRI Other benign neoplasm of skin of

scalp and neck
RINI ANDRIATI P PEKERJA MANDIRI Dyspepsia
ABD. HALIM L PEKERJA MANDIRI Essential (primary) hypertension
WARDANIAH P PEKERJA MANDIRI Acute haemorrhagic gastritis
MOLIYONO L PEKERJA MANDIRI Acute upper respiratory infection,

unspecified
MUHAMMAD JAMAHSYARI L PNS PUSAT Asthma
YUDA SYAIFUDDIN L PEKERJA MANDIRI Other specified mental disorders

due to brain damage and
dysfunction
HERYADI, DRS L PNS PUSAT Disorder of refraction, unspecified
RUSLI L PENERIMA PENSIUN PNS Non-insulin-dependent diabetes

mellitus with
ARBAIN L PBI (APBN) Dyspepsia
MARDIANA P PEKERJA MANDIRI Impacted cerumen
FARIDA IRIANA P PEKERJA MANDIRI Disorder of refraction, unspecified
MAHFUD L PNS DAERAH Atherosclerotic heart disease
MAHRITA P PEKERJA MANDIRI Non-insulin-dependent diabetes

RADIAH P PEKERJA MANDIRI Heart failure, unspecified
SYUKRAN L PEKERJA MANDIRI Cough
DJANTRAK L PEKERJA MANDIRI Heart failure, unspecified
A. ARBANI L PEKERJA MANDIRI Impacted cerumen
supiyah P PEKERJA MANDIRI Carcinoma in situ of breast,

unspecified
Rujuk Lanjut
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421 07-08-2018 170406010818Y000118 0001547172988
422 07-08-2018 170406010818Y000119 0001816967057
423 07-08-2018 170406010818Y000117 0001898501613
424 07-08-2018 170406010818Y000095 0002064469386
425 07-08-2018 170406010818Y000102 0002454246718
426 06-08-2018 170406010818Y000082 0000123209379
427 06-08-2018 170406010818Y000113 0000123587021
428 06-08-2018 170406010818Y000112 0000195495761
429 06-08-2018 170406010818Y000093 0000889774042
430 06-08-2018 170406010818Y000115 0000890450335
431 06-08-2018 170406010818Y000088 0000890843826
432 06-08-2018 170406010818Y000083 0000891511446
433 06-08-2018 170406010818Y000110 0001065414947
434 06-08-2018 170406010818Y000084 0001266035848
435 06-08-2018 170406010818Y000087 0001266036219
436 06-08-2018 170406010818Y000089 0001439724183
437 06-08-2018 170406010818Y000114 0001441794194
438 06-08-2018 170406010818Y000080 0001441794846
439 06-08-2018 170406010818Y000079 0001449942322
440 06-08-2018 170406010818Y000116 0001801331807

YUDA DWI ARIANTO L PEGAWAI SWASTA Other and unspecified diseases of
pulp and
ARIE ANDRIANTO L PEGAWAI SWASTA Dental caries
MUHAMMAD IHSAN L PNS DAERAH Other and unspecified diseases of

pulp and
SARKIAH P PEKERJA MANDIRI Other postsurgical states
HAIRIAH P PEGAWAI SWASTA Non-insulin-dependent diabetes

ANITA P PENERIMA PENSIUN PNS Insulin-dependent diabetes

mellitus without
ITA AS P PENERIMA PENSIUN PNS Dyspepsia
RAHIMAH P PENERIMA PENSIUN PNS Hyperlipidaemia, unspecified
MUHAMMAD IMAM RAMADHANI L PBI (APBN) Diseases of pulp and periapical

tissues
SARI DEWI RAHMA YANI P PBI (APBN) Contraceptive management,
unspecified
mellitus without
RUSPUDIANSYAH L PBI (APBN) Stroke, not specified as

MASARAH P PBI (APBN) Cough
MASTAYAH P PEKERJA MANDIRI Non-insulin-dependent diabetes

mellitus with
MURNIATI SARI P PEKERJA MANDIRI Otitis externa
AINA NUR HELMINA L PEGAWAI SWASTA Cough
ISKANDAR L PEKERJA MANDIRI Essential (primary) hypertension
ANNI NURHIDAYAH P PEKERJA MANDIRI Rheumatism, unspecified
MULYADI L PEKERJA MANDIRI Disorder of refraction, unspecified
SITI AISYAH P PEKERJA MANDIRI Contraceptive management,

unspecified
Berobat Jalan
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Berobat Jalan
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Berobat Jalan
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441 06-08-2018 170406010818Y000086 0002201165987
442 06-08-2018 170406010818Y000090 0002216666801
443 06-08-2018 170406010818Y000092 0002252866072
444 06-08-2018 170406010818Y000081 0002431209712
445 06-08-2018 170406010818Y000091 0002456954627
446 06-08-2018 170406010818Y000085 0002464618612
447 06-08-2018 170406010818Y000111 0002469003581
448 04-08-2018 170406010818Y000047 0000122606188
449 04-08-2018 170406010818Y000060 0000122654801
450 04-08-2018 170406010818Y000061 0000122695571
451 04-08-2018 170406010818Y000062 0000122717766
452 04-08-2018 170406010818Y000063 0000122718791
453 04-08-2018 170406010818Y000064 0000122718824
454 04-08-2018 170406010818Y000065 0000122718971
455 04-08-2018 170406010818Y000066 0000122718982
456 04-08-2018 170406010818Y000067 0000122718993
457 04-08-2018 170406010818Y000068 0000122719026
458 04-08-2018 170406010818Y000070 0000122719037
459 04-08-2018 170406010818Y000069 0000122719094
460 04-08-2018 170406010818Y000071 0000122719151
461 04-08-2018 170406010818Y000072 0000122719206

MAIMUNAH P PBI (APBD) Hyperlipidaemia, unspecified
ATAYA DWI RAFKA L PEGAWAI SWASTA Acute nasopharyngitis [common

cold]
NURUL PURNAMA SARI P PEKERJA MANDIRI Necrosis of pulp
RAHMANI L PEKERJA MANDIRI Hypertensive heart disease
BY.NY.MARDANITA SARI L PEKERJA MANDIRI Cough
NUR RISKI P PEKERJA MANDIRI Hydrocephalus, unspecified
MAHDINI L PEKERJA MANDIRI Non-insulin-dependent diabetes

mellitus without
BARKIAH P PNS DAERAH Tuberculosis of lung, confirmed by

unspecified
DEWI ESTIKA SARI P PNS DAERAH Examination of blood pressure
HERTATI P PNS DAERAH Examination of blood pressure

Berobat Jalan
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Rujuk Lanjut
Berobat Jalan
Berobat Jalan
Sembuh
Sembuh
Sembuh
Sembuh
Sembuh
Sembuh
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Sembuh
Sembuh
Sembuh
Sembuh
Sembuh
Sembuh
462 04-08-2018 170406010818Y000073 0000122719509
463 04-08-2018 170406010818Y000048 0000122757276
464 04-08-2018 170406010818Y000074 0000204782804
465 04-08-2018 170406010818Y000055 0000889784976
466 04-08-2018 170406010818Y000052 0000889799218
467 04-08-2018 170406010818Y000059 0000889926276
468 04-08-2018 170406010818Y000053 0000890665367
469 04-08-2018 170406010818Y000054 0000890823778
470 04-08-2018 170406010818Y000051 0001261691144
471 04-08-2018 170406010818Y000075 0001266035848
472 04-08-2018 170406010818Y000050 0001267501601
473 04-08-2018 170406010818Y000057 0001278170245
474 04-08-2018 170406010818Y000076 0001298136914
475 04-08-2018 170406010818Y000046 0001316879897
476 04-08-2018 170406010818Y000077 0001441794846
477 04-08-2018 170406010818Y000058 0002053007019
478 04-08-2018 170406010818Y000049 0002201165987
479 04-08-2018 170406010818Y000078 0002207775701
480 04-08-2018 170406010818Y000056 0002308025171
481 03-08-2018 170406010818Y000020 0000122654801

HJ. MURNI P PENERIMA PENSIUN PNS Non-insulin-dependent diabetes

mellitus without
SALAMIAH P PBI (APBN) Dyspepsia
SUGENG L PBI (APBN) Acute pharyngitis, unspecified
ERNA P PBI (APBN) Tuberculosis of lung, confirmed by

unspecified
ARBAIN L PBI (APBN) Gastritis, unspecified
MUSA L PBI (APBN) Acute upper respiratory infection,

unspecified
JURAHMAH P PENERIMA PENSIUN PNS Myalgia
MASTAYAH P PEKERJA MANDIRI Examination of blood pressure
ASRANI L PEKERJA MANDIRI Atherosclerotic cardiovascular

disease, so
MARDIANA P PEKERJA MANDIRI Impacted cerumen
KAMSIAH P PEKERJA MANDIRI Heart failure, unspecified
BAHRAN L PEKERJA MANDIRI Tuberculosis of lung, confirmed by

unspecified
MAIMUNAH P PBI (APBD) Essential (primary) hypertension
THAIBAH P PEKERJA MANDIRI Fever of other and unknown origin
ERNAWATI P PENERIMA PENSIUN PNS Necrosis of pulp

Sembuh
Berobat Jalan
Sembuh
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482 03-08-2018 170406010818Y000044 0000122718791
483 03-08-2018 170406010818Y000018 0000123612535
484 03-08-2018 170406010818Y000041 0000123793918
485 03-08-2018 170406010818Y000039 0001266035848
486 03-08-2018 170406010818Y000019 0001266036219
487 03-08-2018 170406010818Y000042 0001299209455
488 03-08-2018 170406010818Y000045 0001442203918
489 03-08-2018 170406010818Y000021 0001796551615
490 03-08-2018 170406010818Y000043 0002204292003
491 03-08-2018 170406010818Y000022 0002251470666
492 03-08-2018 170406010818Y000040 0002297436118
493 02-08-2018 170406010818Y000010 0000123161793
494 02-08-2018 170406010818Y000012 0000123667637
495 02-08-2018 170406010818Y000017 0000890784584
496 02-08-2018 170406010818Y000036 0000890791738
497 02-08-2018 170406010818Y000007 0001265576771
498 02-08-2018 170406010818Y000037 0001267645329
499 02-08-2018 170406010818Y000011 0001279227227
500 02-08-2018 170406010818Y000035 0001291826709
501 02-08-2018 170406010818Y000016 0001302082593
502 02-08-2018 170406010818Y000014 0001302083278
503 02-08-2018 170406010818Y000033 0001449943121

DENI ELFENI P PNS DAERAH Hyperlipidaemia, unspecified
KAMARIAH, HJ P PENERIMA PENSIUN PNS Hypertensive heart disease
LIZA YUSNITA P PNS DAERAH Cough
MASTAYAH P PEKERJA MANDIRI Cough
MURNIATI SARI P PEKERJA MANDIRI Other otitis externa
NOR KAMALIA P PEKERJA MANDIRI Acute pharyngitis
YUNIDA ASTUTI P PEKERJA MANDIRI Antenatal screening, unspecified
SITI AMINAH P PEKERJA MANDIRI Caries of dentine
ANIDA YUSPA P PEGAWAI PEMERINTAH Dyspepsia

DENGAN PERJANJIAN
FARHAN KHAZIN L PNS PUSAT Pulpitis
ainah L PEKERJA MANDIRI Myalgia
ELYA WAHYUNI P PNS DAERAH Influenza due to other identified

influenza virus
RISWAN IRIYANDY L PNS DAERAH Disorder of refraction, unspecified
MOH ALDY L PBI (APBN) Necrosis of pulp
SALAMIAH P PBI (APBN) Malaise and fatigue
MASJA P PEKERJA MANDIRI Senile cataract, unspecified
M. IRFAN MAULANA L PEKERJA MANDIRI Thalassaemia
EVA YUSANTI P PEGAWAI SWASTA Influenza due to other identified

influenza virus
AHMAD ZAKI ILMI L PEKERJA MANDIRI Residual schizophrenia
ACHMAD EFFENDI L PEKERJA MANDIRI Other arthritis
NURLIANA P PEKERJA MANDIRI Non-insulin-dependent diabetes

mellitus with
SANIAH P PEKERJA MANDIRI Antenatal screening, unspecified

Berobat Jalan
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504 02-08-2018 170406010818Y000008 0001452452185
505 02-08-2018 170406010818Y000009 0001785680741
506 02-08-2018 170406010818Y000015 0001827797466
507 02-08-2018 170406010818Y000034 0001899369404
508 02-08-2018 170406010818Y000038 0002229564835
509 02-08-2018 170406010818Y000013 0002291525008
510 01-08-2018 170406010818Y000001 0000122688617
511 01-08-2018 170406010818Y000031 0000123056392
512 01-08-2018 170406010818Y000002 0000123093268
513 01-08-2018 170406010818Y000026 0000195495761
514 01-08-2018 170406010818Y000027 0000889790826
515 01-08-2018 170406010818Y000023 0000890005836
516 01-08-2018 170406010818Y000025 0000890665367
517 01-08-2018 170406010818Y000005 0000890734329
518 01-08-2018 170406010818Y000028 0000890843826
519 01-08-2018 170406010818Y000024 0000890884877
520 01-08-2018 170406010818Y000030 0001065415779
521 01-08-2018 170406010818Y000029 0001065415781
522 01-08-2018 170406010818Y000003 0001078411318
523 01-08-2018 170406010818Y000004 0001318164388
524 01-08-2018 170406010818Y000006 0001816967057

AHMAD FADILLAH L PEKERJA MANDIRI Unspecified organic or
symptomatic mental
MARIANAH P PEKERJA MANDIRI Other nonorganic sleep disorders
MUHAMMAD NABIL L PEGAWAI SWASTA Corns and callosities
IFFA KHALISA BALQIS P PNS PUSAT Other and unspecified diseases of

pulp and
putri humaira P PBI (APBN) Cough
JUNAIDI, DRS L PNS PUSAT Mixed anxiety and depressive

disorder
ABDUL HAMID L PNS PUSAT Acute pharyngitis
RUDY ANWARI L PNS DAERAH Chronic viral hepatitis B without

delta-agent
RAHIMAH P PENERIMA PENSIUN PNS Essential (primary) hypertension
MUHAMMAD HENDRI SAPUTRA L PBI (APBN) Acute pharyngitis
ALAN L PBI (APBN) Non-insulin-dependent diabetes

mellitus with
ARBAIN L PBI (APBN) Asthma
MUHAMMAD ARIF L PBI (APBN) Gingivitis and periodontal diseases

mellitus without
PITRIA WATI P PBI (APBN) Gastritis, unspecified
SITI HALIDAH P PBI (APBN) Influenza due to other identified

influenza virus
NOR HELDAYANI P PBI (APBN) Otitis media, unspecified
RUSTINI P PNS PUSAT Sequelae of cerebrovascular

disease
TANKASIANI L PEKERJA MANDIRI Senile cataract, unspecified
ARIE ANDRIANTO L PEGAWAI SWASTA Necrosis of pulp

Rujuk Lanjut
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Rujuk Lanjut
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525 01-08-2018 170406010818Y000032 0001839006876
ANIDA P PEKERJA MANDIRI Contraceptive management,
unspecified
Berobat Jalan

Kantor Cabang: BANJARMASIN - 1701 FKTP: Kertak Hanyar - 17040601

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Kantor Cabang : BANJARMASIN - 1701

FKTP : KERTAK HANYAR - 17040601

1 31-08-2018 170406010818Y000511 0000889469684

2 31-08-2018 170406010818Y000519 0000889779047

3 31-08-2018 170406010818Y000518 0000890212026

4 31-08-2018 170406010818Y000517 0000890836435

5 31-08-2018 170406010818Y000510 0000890886341

6 31-08-2018 170406010818Y000514 0001302569829

7 31-08-2018 170406010818Y000506 0001460053989

8 31-08-2018 170406010818Y000507 0001460055453

9 31-08-2018 170406010818Y000512 0001660140292

10 31-08-2018 170406010818Y000516 0001833652293

11 31-08-2018 170406010818Y000509 0001833652394

12 31-08-2018 170406010818Y000508 0002229571269

13 31-08-2018 170406010818Y000505 0002229571541

14 31-08-2018 170406010818Y000520 0002251470666

15 31-08-2018 170406010818Y000513 0002286718806

16 31-08-2018 170406010818Y000515 0002482520681

17 30-08-2018 170406010818Y000432 0000122733303

18 30-08-2018 170406010818Y000437 0000889697338

19 30-08-2018 170406010818Y000438 0000889764671

20 30-08-2018 170406010818Y000441 0000890038899

21 30-08-2018 170406010818Y000433 0000890043535

NUR FAIJAH P PBI (APBN) Acute upper respiratory infection,

RUSMAWATI P PBI (APBN) Conjunctivitis

LAILA P PBI (APBN) Hordeolum and chalazion

MANSYAH L PEKERJA MANDIRI Cough

M. SUBLI MAKSUM L PEGAWAI SWASTA Urinary tract infection, site not

RIDAYATI P PEGAWAI SWASTA Varicella [chickenpox]

M. AINI L PEKERJA MANDIRI Gastritis, unspecified

ARSIAH P PEKERJA MANDIRI Foreign body in ear

DANIANSYAH L PEKERJA MANDIRI Dyspepsia

SITI SARAH P PEKERJA MANDIRI Stroke, not specified as

FEBRIYANDI L PEGAWAI SWASTA Retained (old) foreign body

BAYI NY RUSNANI L PBI (APBN) Other low birth weight

H. IBERAHIM TUKACIL L PENERIMA PENSIUN PNS Atherosclerotic cardiovascular

HALIMATUS SADIAH P PBI (APBN) Acute periodontitis

MURSIDAH P PBI (APBN) Cutaneous abscess, furuncle and

23 30-08-2018 170406010818Y000439 0000890888488

24 30-08-2018 170406010818P000525 0000895294956

25 30-08-2018 170406010818P000522 0001266036219

26 30-08-2018 170406010818Y000435 0001441794846

27 30-08-2018 170406010818Y000436 0001796551615

28 30-08-2018 170406010818Y000434 0002216875634

29 30-08-2018 170406010818Y000446 0002304843478

30 29-08-2018 170406010818Y000424 0000122330698

31 29-08-2018 170406010818Y000421 0000122714864

32 29-08-2018 170406010818Y000429 0000122719026

33 29-08-2018 170406010818Y000425 0000122756591

34 29-08-2018 170406010818Y000426 0000122824855

35 29-08-2018 170406010818Y000414 0000123209379

36 29-08-2018 170406010818Y000410 0000123313689

37 29-08-2018 170406010818Y000416 0000889455251

38 29-08-2018 170406010818Y000418 0000889979725

39 29-08-2018 170406010818Y000409 0000890043535

40 29-08-2018 170406010818Y000420 0000890236337

41 29-08-2018 170406010818Y000430 0000890450561

ICA PUTRI KIRANA P PBI (APBN) Cough

DEWI LESTARI P PBI (APBN) Antenatal screening

MURNIATI SARI P PEKERJA MANDIRI Complications of anaesthesia

ANNI NURHIDAYAH P PEKERJA MANDIRI Essential (primary) hypertension

SITI AMINAH P PEKERJA MANDIRI Necrosis of pulp

LIANI P PEKERJA MANDIRI Acute pharyngitis