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

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

NO TANGGAL NO KUNJUNGAN NO KARTU
1 30-04-2018 170406010418Y000448 0000122654801
2 30-04-2018 170406010418Y000450 0000122756714
3 30-04-2018 170406010418Y000462 0000148656216
4 30-04-2018 170406010418Y000457 0000158013213
5 30-04-2018 170406010418Y000452 0000889706283
6 30-04-2018 170406010418Y000469 0000889798577
7 30-04-2018 170406010418Y000465 0000889907534
8 30-04-2018 170406010418Y000464 0000889930056
9 30-04-2018 170406010418Y000449 0000889971309
10 30-04-2018 170406010418Y000467 0000890013352
11 30-04-2018 170406010418Y000511 0000890017211
12 30-04-2018 170406010418Y000460 0000890452405
13 30-04-2018 170406010418Y000463 0000890739033
14 30-04-2018 170406010418Y000466 0000890749574
15 30-04-2018 170406010418Y000458 0000890786946
16 30-04-2018 170406010418Y000451 0000976815178
17 30-04-2018 170406010418Y000461 0001078578224
18 30-04-2018 170406010418Y000454 0001267645329
19 30-04-2018 170406010418Y000453 0001325524151
20 30-04-2018 170406010418Y000468 0002084192313
21 30-04-2018 170406010418Y000459 0002252866072
22 30-04-2018 170406010418Y000456 0002279875746

NAMA PESERTA SE JENIS PESERTA DIAGNOSA
X
ERNAWATI P PENERIMA PENSIUN PNS Heart failure, unspecified
ARKANI L PENERIMA PENSIUN PNS Parkinson's disease
LAILA RAHMI, A.MA P PNS DAERAH Contraceptive management,

unspecified
M. SALEH MARAN, DRS L PENERIMA PENSIUN PNS Heart failure
RISNAWATI P PBI (APBN) Twin pregnancy
KARMIYANTI P PBI (APBN) Contraceptive management,

unspecified
NOOR AIDA P PBI (APBN) Antenatal screening, unspecified
MULIATI P PBI (APBN) Contraceptive management,

unspecified
BARKATI SIMBARA L PBI (APBN) Dyspepsia
HELDAWATI P PBI (APBN) Antenatal screening, unspecified
AMAH P PBI (APBN) Contraceptive management
DESY NOVITA P PBI (APBN) Pulp degeneration
HAMIDAH P PBI (APBN) Contraceptive management,

unspecified
RAUDAH P PBI (APBN) Antenatal screening, unspecified
SITI AISYAH P PBI (APBN) Cough
MUHAMMAD NOOR SYABANI L PNS PUSAT Acute lymphoblastic leukaemia
SHOFIA NOOR AFIFAH P PNS DAERAH Necrosis of pulp
M. IRFAN MAULANA L PEKERJA MANDIRI Thalassaemia
NAYLA SYABILA AZAHRA P PEGAWAI SWASTA Allergic contact dermatitis
SUPARMI P PEGAWAI SWASTA Contraceptive management,

unspecified
NURUL PURNAMA SARI P PEKERJA MANDIRI Diseases of pulp and periapical
tissues
RASYIDAH P PEKERJA MANDIRI Essential (primary) hypertension
DIRUJUK
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23 30-04-2018 170406010418Y000455 0002420982358
24 28-04-2018 170406010418Y000497 0000122654801
25 28-04-2018 170406010418Y000498 0000122713345
26 28-04-2018 170406010418Y000499 0000122717766
27 28-04-2018 170406010418Y000500 0000122718791
28 28-04-2018 170406010418Y000501 0000122718824
29 28-04-2018 170406010418Y000502 0000122718971
30 28-04-2018 170406010418Y000503 0000122718993
31 28-04-2018 170406010418Y000504 0000122719037
32 28-04-2018 170406010418Y000505 0000122719195
33 28-04-2018 170406010418Y000506 0000122719206
34 28-04-2018 170406010418Y000507 0000122719432
35 28-04-2018 170406010418Y000440 0000122726979
36 28-04-2018 170406010418Y000429 0000122819692
37 28-04-2018 170406010418Y000435 0000123189243
38 28-04-2018 170406010418Y000438 0000124080805
39 28-04-2018 170406010418Y000432 0000158013213
40 28-04-2018 170406010418Y000508 0000167797361
41 28-04-2018 170406010418Y000442 0000889905205
42 28-04-2018 170406010418Y000443 0000890348747
43 28-04-2018 170406010418Y000444 0000890503378

ISLAHIAH P PEKERJA MANDIRI Cough
ERNAWATI P PENERIMA PENSIUN PNS Examination of blood pressure
ANNA BUDIARTI P PNS DAERAH Examination of blood pressure
ADTRI KORNIATI P PNS DAERAH Examination of blood pressure
DENI ELFENI P PNS DAERAH Examination of blood pressure
DEWI ESTIKA SARI P PNS DAERAH Examination of blood pressure
FARIDAWATY P PNS DAERAH Examination of blood pressure
BURHANUDDIN L PNS DAERAH Examination of blood pressure
MAHDIATUL WAHDAH P PNS DAERAH Examination of blood pressure
MAULANA IBRAHIM L PNS DAERAH Examination of blood pressure
NOOR ASLIANI P PNS DAERAH Examination of blood pressure
SESSI TRI AYU REVILLA P PNS DAERAH Examination of blood pressure
AH.BIDJIRMI AM L PENERIMA PENSIUN PNS Allergic contact dermatitis
SITI RUSINAH P PNS DAERAH Disorder of refraction, unspecified
MISRAN L PNS DAERAH Non-insulin-dependent diabetes

mellitus without
RABIATUL MAJDIAH P PENERIMA PENSIUN PNS Hyperlipidaemia, unspecified
M. SALEH MARAN, DRS L PENERIMA PENSIUN PNS Periapical abscess without sinus
RENI, AM.KEB P PNS DAERAH Examination of blood pressure
FARIDAH P PBI (APBN) Asthma
AMIYA P PBI (APBN) Acute upper respiratory infection,

unspecified
PATIMAH P PBI (APBN) Suppurative and unspecified otitis
media
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44 28-04-2018 170406010418Y000446 0000890555253
45 28-04-2018 170406010418Y000437 0001266035848
46 28-04-2018 170406010418Y000428 0001381991128
47 28-04-2018 170406010418Y000436 0001441794846
48 28-04-2018 170406010418Y000430 0001660140303
49 28-04-2018 170406010418Y000431 0001801331807
50 28-04-2018 170406010418Y000509 0002207775701
51 28-04-2018 170406010418Y000434 0002250656627
52 28-04-2018 170406010418Y000439 0002308001635
53 28-04-2018 170406010418Y000433 0002436711524
54 28-04-2018 170406010418Y000445 0002445543696
55 27-04-2018 170406010418Y000471 0000122621141
56 27-04-2018 170406010418Y000425 0000122719162
57 27-04-2018 170406010418Y000477 0000122843171
58 27-04-2018 170406010418Y000427 0000123815182
59 27-04-2018 170406010418Y000472 0000204782804
60 27-04-2018 170406010418Y000470 0000889697632
61 27-04-2018 170406010418Y000474 0000890632528
62 27-04-2018 170406010418Y000476 0000890685123
63 27-04-2018 170406010418Y000475 0000890888488
64 27-04-2018 170406010418Y000473 0001275340601
65 27-04-2018 170406010418Y000426 0001974870775

SUTIMAH P PBI (APBN) Contraceptive management,
unspecified
MASTAYAH P PEKERJA MANDIRI Dyspepsia
ABDUL HADI L PEKERJA MANDIRI Low back pain
ANNI NURHIDAYAH P PEKERJA MANDIRI Essential (primary) hypertension
AINA AZKIA P PEGAWAI SWASTA Disorders of tooth development

and eruption
SITI AISYAH P PEKERJA MANDIRI Caries of dentine
DINA MARIANI P PEGAWAI SWASTA Examination of blood pressure
YULIANTO PONGTULURAN L PEGAWAI SWASTA Acute pharyngitis
muhammad ghani rais L PEKERJA MANDIRI Pneumonia due to other infectious

organisms, not
KIRAN L PEKERJA MANDIRI Acute upper respiratory infection,

unspecified
MASLIAH P PEKERJA MANDIRI Cough
KAMARUDDIN L PNS DAERAH Heart failure, unspecified
RUSLIASARI P PNS PUSAT Gonarthrosis, unspecified
ZAINUDDIN L PNS DAERAH Necrosis of pulp
NOPARISA P PENERIMA PENSIUN PNS Insulin-dependent diabetes

mellitus with
SITI PATIMAH P PENERIMA PENSIUN PNS Myalgia
FADRIAN NOOR L PBI (APBN) Acute nasopharyngitis [common

cold]
NORHASANAH P PBI (APBN) Acute upper respiratory infection,
unspecified
IDA P PBI (APBN) Necrosis of pulp
ICA PUTRI KIRANA P PBI (APBN) Fever of other and unknown origin
HUSAINI L PEKERJA MANDIRI Heart failure, unspecified
NASRULLAH L PBI (APBN) Undifferentiated schizophrenia

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66 27-04-2018 170406010418Y000447 0002231648234
67 26-04-2018 170406010418Y000418 0000117635602
68 26-04-2018 170406010418Y000408 0000123093011
69 26-04-2018 170406010418Y000417 0000123583307
70 26-04-2018 170406010418Y000421 0000123583307
71 26-04-2018 170406010418Y000406 0000124507877
72 26-04-2018 170406010418Y000423 0000889697338
73 26-04-2018 170406010418Y000405 0000889950172
74 26-04-2018 170406010418Y000424 0000890454587
75 26-04-2018 170406010418Y000416 0000890773154
76 26-04-2018 170406010418Y000409 0000890843826
77 26-04-2018 170406010418Y000420 0000978029818
78 26-04-2018 170406010418Y000413 0001302082593
79 26-04-2018 170406010418Y000411 0001442907821
80 26-04-2018 170406010418Y000410 0001634570829
81 26-04-2018 170406010418Y000415 0001810491085
82 26-04-2018 170406010418Y000419 0001847931783
83 26-04-2018 170406010418Y000412 0001880785214
84 26-04-2018 170406010418Y000422 0002204133423
85 26-04-2018 170406010418Y000407 0002220897115
86 26-04-2018 170406010418Y000414 0002253471063
87 25-04-2018 170406010418Y000390 0000122805314
88 25-04-2018 170406010418Y000395 0000889823586

NURJANAH P PEGAWAI SWASTA Acute upper respiratory infection,
unspecified
HERY SUSANTO L PNS DAERAH Caries of dentine
RAHMAYANTI P PNS DAERAH Disorder of refraction, unspecified
RITTA CHAIRIAH P PENERIMA PENSIUN PNS Diseases of pulp and periapical

tissues
RITTA CHAIRIAH P PENERIMA PENSIUN PNS Gout
SITI AISYAH P PENERIMA PENSIUN PNS Non-insulin-dependent diabetes

mellitus with
HALIMATUS SADIAH P PBI (APBN) Contraceptive management,

unspecified
M. MAULANA L PBI (APBN) Hyperparathyroidism, unspecified
PITRIYAH P PBI (APBN) Antenatal screening, unspecified
SALIMAH P PBI (APBN) Caries of dentine
KHAIRUDIN L PBI (APBN) Gout
RUSMIATI P PENERIMA PENSIUN PNS Essential (primary) hypertension
ACHMAD EFFENDI L PEKERJA MANDIRI Acute bronchiolitis
HUSAINI L PEKERJA MANDIRI Heart failure, unspecified
PURNAMA P PEGAWAI SWASTA Myalgia
MURSILAH P PEKERJA MANDIRI Gout
AGUS SOEHARIYANTO L PEGAWAI SWASTA Gingivitis and periodontal diseases
budi hartono L PNS DAERAH Cough
ITA P PEGAWAI PEMERINTAH NON Contraceptive management,

PNS unspecified
JHONI ABDURAHMAN ABDILLAH L PEKERJA MANDIRI End-stage renal disease
NORLATIFAH P PEKERJA MANDIRI Allergic contact dermatitis
AGUS PRIBADI L PNS DAERAH Unspecified renal colic
FATMAWATI P PBI (APBN) Dyspepsia

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89 25-04-2018 170406010418Y000394 0000889835477
90 25-04-2018 170406010418Y000396 0000890202284
91 25-04-2018 170406010418Y000400 0000890525992
92 25-04-2018 170406010418Y000401 0000890836435
93 25-04-2018 170406010418Y000391 0000891218417
94 25-04-2018 170406010418Y000510 0000891241018
95 25-04-2018 170406010418Y000404 0000891582489
96 25-04-2018 170406010418Y000402 0001460055453
97 25-04-2018 170406010418Y000398 0001889939654
98 25-04-2018 170406010418Y000403 0002043596608
99 25-04-2018 170406010418Y000399 0002206784924
100 25-04-2018 170406010418Y000397 0002309476781
101 25-04-2018 170406010418Y000392 0002314068906
102 25-04-2018 170406010418Y000393 0002327068135
103 24-04-2018 170406010418Y000368 0000122620127
104 24-04-2018 170406010418Y000371 0000124080805
105 24-04-2018 170406010418Y000328 0000200681943
106 24-04-2018 170406010418Y000329 0000889798577
107 24-04-2018 170406010418Y000373 0000889798577
108 24-04-2018 170406010418Y000372 0000889957427
109 24-04-2018 170406010418Y000370 0000890467964
110 24-04-2018 170406010418Y000369 0000890681038
111 24-04-2018 170406010418Y000366 0000890791885

RASIAH P PBI (APBN) Dyspepsia
NOOR SYARIFAH P PBI (APBN) Dyspepsia
SAPNAH P PBI (APBN) Spondylolisthesis
RUSMAWATI P PBI (APBN) Allergic contact dermatitis
TABRI L PBI (APBN) Spondylolysis
MUNAWARAH P PBI (APBN) Contraceptive management,

unspecified
M. LUTHFI L PBI (APBN) Acute apical periodontitis of pulpal
origin
RUSMILAWATI P PEGAWAI SWASTA Essential (primary) hypertension
M. ROMAWIE L PEKERJA MANDIRI Essential (primary) hypertension
MARTINI P PBI (APBD) Necrosis of pulp
RIKA P PEKERJA MANDIRI Diarrhoea and gastroenteritis of

presumed infectious origin
HASBIANNOR L PEKERJA MANDIRI Dyspepsia
ARBAYAH P PEKERJA MANDIRI Acute haemorrhagic gastritis
TADJUDIN NOOR L PEKERJA MANDIRI Allergic contact dermatitis
HARTINAH P PNS DAERAH Gastritis, unspecified
RABIATUL MAJDIAH P PENERIMA PENSIUN PNS Tuberculosis of lung, confirmed by

unspecified
SITI MARYAM, JD P PENERIMA PENSIUN TNI Primary gonarthrosis, bilateral
KARMIYANTI P PBI (APBN) Allergic contact dermatitis
KARMIYANTI P PBI (APBN) Contraceptive management,

unspecified
SITI RABIAH P PBI (APBN) Gastritis, unspecified
MURHAN BASERI L PBI (APBN) Asthma
BAHJAH P PBI (APBN) Essential (primary) hypertension
JANNATUL RAHMI P PBI (APBN) Cough

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112 24-04-2018 170406010418Y000326 0000890872716
113 24-04-2018 170406010418Y000367 0000891583244
114 24-04-2018 170406010418Y000365 0001266035848
115 24-04-2018 170406010418Y000325 0001424633861
116 24-04-2018 170406010418Y000330 0001426235523
117 24-04-2018 170406010418Y000331 0001902576161
118 24-04-2018 170406010418Y000327 0002308001635
119 23-04-2018 170406010418Y000324 0000122707045
120 23-04-2018 170406010418Y000359 0000122733303
121 23-04-2018 170406010418Y000364 0000148656216
122 23-04-2018 170406010418Y000318 0000202391043
123 23-04-2018 170406010418Y000317 0000889854445
124 23-04-2018 170406010418Y000311 0000890203083
125 23-04-2018 170406010418Y000312 0000890340614
126 23-04-2018 170406010418Y000363 0000891661871
127 23-04-2018 170406010418Y000320 0001173437447
128 23-04-2018 170406010418Y000361 0001267501601
129 23-04-2018 170406010418Y000321 0001302082593
130 23-04-2018 170406010418Y000310 0001302083278
131 23-04-2018 170406010418Y000314 0001316879897
132 23-04-2018 170406010418Y000309 0001389842087
133 23-04-2018 170406010418Y000313 0001425352072
134 23-04-2018 170406010418Y000308 0001481549793

NOORJANAH P PBI (APBN) End-stage renal disease
ASPURI L PBI (APBN) Cough
MASTAYAH P PEKERJA MANDIRI Dyspepsia
husnah P PEKERJA MANDIRI Heart failure, unspecified
arbiansyah L PEKERJA MANDIRI Diseases of pulp and periapical

tissues
RINI ANDRIATI P PEKERJA MANDIRI Pulpitis
muhammad ghani rais L PEKERJA MANDIRI Ventricular septal defect
ROHANI P PENERIMA PENSIUN TNI Asthma
H. IBERAHIM TUKACIL L PENERIMA PENSIUN PNS Heart failure, unspecified
LAILA RAHMI, A.MA P PNS DAERAH Contraceptive management,

unspecified
KARMAH P PNS DAERAH Essential (primary) hypertension
AHMAD YANI L PBI (APBN) Diseases of pulp and periapical

tissues
gazali RAHMAN L PBI (APBN) Undifferentiated schizophrenia
redho setiawan L PBI (APBN) Undifferentiated schizophrenia
MASRAH P PBI (APBN) Contraceptive management,

unspecified
ADHA AZ ZAHRA P PEGAWAI SWASTA Dyspepsia
ASRANI L PEKERJA MANDIRI Gastritis, unspecified
ACHMAD EFFENDI L PEKERJA MANDIRI Other chronic obstructive

pulmonary disease
NURLIANA P PEKERJA MANDIRI Non-insulin-dependent diabetes
mellitus with
KAMSIAH P PEKERJA MANDIRI Heart failure, unspecified
MARTA P PEKERJA MANDIRI Disorder of refraction, unspecified
SYUKRAN L PEKERJA MANDIRI Other chronic obstructive

pulmonary disease
RAZAKIAH P PEKERJA MANDIRI Primary gonarthrosis, bilateral
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135 23-04-2018 170406010418Y000315 0001821515725
136 23-04-2018 170406010418Y000322 0001833652293
137 23-04-2018 170406010418Y000323 0001833652394
138 23-04-2018 170406010418Y000319 0001904156392
139 23-04-2018 170406010418Y000307 0002208762955
140 23-04-2018 170406010418Y000316 0002252866072
141 23-04-2018 170406010418Y000360 0002286853053
142 23-04-2018 170406010418Y000362 0002442650466
143 21-04-2018 170406010418Y000303 0000122622085
144 21-04-2018 170406010418Y000374 0000122654801
145 21-04-2018 170406010418Y000375 0000122713907
146 21-04-2018 170406010418Y000376 0000122717766
147 21-04-2018 170406010418Y000377 0000122718791
148 21-04-2018 170406010418Y000378 0000122718971
149 21-04-2018 170406010418Y000379 0000122719026
150 21-04-2018 170406010418Y000380 0000122719037
151 21-04-2018 170406010418Y000381 0000122719151
152 21-04-2018 170406010418Y000382 0000122719195
153 21-04-2018 170406010418Y000299 0000122719206
154 21-04-2018 170406010418Y000383 0000122719432
155 21-04-2018 170406010418Y000384 0000122719509
156 21-04-2018 170406010418Y000304 0000122725899

FARIDAH P PEKERJA MANDIRI Essential (primary) hypertension
M. AINI L PEKERJA MANDIRI Allergic contact dermatitis
ARSIAH P PEKERJA MANDIRI Dyspepsia
SALMAN L PEKERJA MANDIRI Heart failure, unspecified
MUHAMMAD YANI L PEKERJA MANDIRI Non-insulin-dependent diabetes

mellitus with peripheral circulatory
NURUL PURNAMA SARI P PEKERJA MANDIRI Necrosis of pulp
FATHAN GHAZI RAIHAN L PNS DAERAH Fever, unspecified
AMINAH P PEKERJA MANDIRI Antenatal screening, unspecified
MUHAMMAD TAAT NOOR L PNS DAERAH Congestive heart failure
NURIL ARIFAH P PNS DAERAH Examination of blood pressure
H SAIBATUL HAMDI L PNS DAERAH Examination of blood pressure
JOHNY RAMOON L PNS PUSAT Examination of blood pressure
NOOR ASLIANI P PNS DAERAH Polyneuropathy, unspecified
SUNARNI P PNS DAERAH Examination of blood pressure
ABDUL HADI, BBA. L PENERIMA PENSIUN PNS Stroke, not specified as

haemorrhage or infarction
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157 21-04-2018 170406010418Y000347 0000123209379
158 21-04-2018 170406010418Y000301 0000123583307
159 21-04-2018 170406010418Y000345 0000136245993
160 21-04-2018 170406010418Y000305 0000158013213
161 21-04-2018 170406010418Y000385 0000167797361
162 21-04-2018 170406010418Y000351 0000889705326
163 21-04-2018 170406010418Y000350 0000889705934
164 21-04-2018 170406010418Y000346 0000889764671
165 21-04-2018 170406010418Y000300 0000889764759
166 21-04-2018 170406010418Y000344 0000889926276
167 21-04-2018 170406010418Y000306 0000889948372
168 21-04-2018 170406010418Y000358 0000890043671
169 21-04-2018 170406010418Y000354 0000890503378
170 21-04-2018 170406010418Y000357 0000890533091
171 21-04-2018 170406010418Y000352 0000890555253
172 21-04-2018 170406010418Y000348 0001260954505
173 21-04-2018 170406010418Y000349 0001320164785
174 21-04-2018 170406010418Y000356 0001796551615
175 21-04-2018 170406010418Y000302 0002041697171
176 21-04-2018 170406010418Y000355 0002043596608
177 21-04-2018 170406010418Y000386 0002207775701

ANITA P PENERIMA PENSIUN PNS Non-insulin-dependent diabetes
mellitus without
RITTA CHAIRIAH P PENERIMA PENSIUN PNS Other postsurgical states
ABD FATAH SAFRONI L PEGAWAI SWASTA Hypotension, unspecified
M. SALEH MARAN, DRS L PENERIMA PENSIUN PNS Periapical abscess without sinus
RENI, AM.KEB P PNS DAERAH Examination of blood pressure
TUHLUS L PBI (APBN) Gastritis, unspecified
INA P PBI (APBN) Dyspepsia
MURSIDAH P PBI (APBN) Myalgia
ahmad saidi L PBI (APBN) Undifferentiated schizophrenia
ERNA P PBI (APBN) Tuberculosis of lung, confirmed by

unspecified
M. NAUPAL L PBI (APBN) Disturbances in tooth eruption
ASNIAH P PBI (APBN) Contraceptive management,

unspecified
PATIMAH P PBI (APBN) Suppurative and unspecified otitis
media
ARBAYAH P PBI (APBN) Contraceptive management,
unspecified
SUTIMAH P PBI (APBN) Allergic contact dermatitis
TABERANI L PEKERJA MANDIRI Non-insulin-dependent diabetes

mellitus without
MARIANI P PNS DAERAH Hypotension, unspecified
SITI AMINAH P PEKERJA MANDIRI Necrosis of pulp
MUSLIM L PEKERJA MANDIRI Tuberculosis of lung, confirmed by

unspecified
MARTINI P PBI (APBD) Necrosis of pulp

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178 21-04-2018 170406010418Y000353 0002436711669
179 20-04-2018 170406010418Y000294 0000122808969
180 20-04-2018 170406010418Y000292 0000124003618
181 20-04-2018 170406010418Y000296 0000890630695
182 20-04-2018 170406010418Y000297 0000890674277
183 20-04-2018 170406010418Y000343 0001065415601
184 20-04-2018 170406010418Y000293 0001271659454
185 20-04-2018 170406010418Y000298 0001441794846
186 20-04-2018 170406010418Y000291 0001793642095
187 20-04-2018 170406010418Y000295 0002445543696
188 19-04-2018 170406010418Y000284 0000122756591
189 19-04-2018 170406010418Y000289 0000122819657
190 19-04-2018 170406010418Y000496 0000122843171
191 19-04-2018 170406010418Y000279 0000123313206
192 19-04-2018 170406010418Y000286 0000123421228
193 19-04-2018 170406010418Y000290 0000889305963
194 19-04-2018 170406010418Y000342 0000889471293
195 19-04-2018 170406010418Y000340 0000889981389
196 19-04-2018 170406010418Y000341 0000890067633
197 19-04-2018 170406010418Y000281 0000890212026
198 19-04-2018 170406010418Y000280 0000890356476

SANIAH P PEKERJA MANDIRI Tuberculosis of lung, confirmed by
unspecified
SUHARI L PNS DAERAH Cough
MUNIROH P PENERIMA PENSIUN PNS Non-insulin-dependent diabetes

mellitus with
MISLIWATI P PBI (APBN) Essential (primary) hypertension
SARINAH P PBI (APBN) Dyspepsia
NOR JANAH P PBI (APBN) Antenatal screening, unspecified
ASFIANOOR BAHRAN L PEKERJA MANDIRI Chest pain, unspecified
KASPIAH P PENERIMA PENSIUN PNS Sciatica, multiple sites
MASLIAH P PEKERJA MANDIRI Pneumothorax
ABDUL HADI L PENERIMA PENSIUN PNS Rheumatism, unspecified, multiple

sites
MASRANI L PNS DAERAH Essential (primary) hypertension
ZAINUDDIN L PNS DAERAH Caries of dentine
A ATHAILAH L PNS PUSAT Follow-up examination after

surgery for other
ACHMAD NOOR L PENERIMA PENSIUN PNS Allergic rhinitis due to pollen
MAULIDANI L PBI (APBN) Diseases of pulp and periapical

tissues
ARBAYAH P PBI (APBN) Antenatal screening, unspecified
JARIAH P PBI (APBN) Contraceptive management,

unspecified
MARIANI P PBI (APBN) Antenatal screening, unspecified
SYARIFUDINOOR L PBI (APBN) Headache
SRI RAHAYU P PBI (APBN) Fracture of forearm

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199 19-04-2018 170406010418Y000283 0000890466219
200 19-04-2018 170406010418Y000285 0000890764659
201 19-04-2018 170406010418Y000339 0001271659735
202 19-04-2018 170406010418Y000288 0001460055453
203 19-04-2018 170406010418Y000495 0001460057297
204 19-04-2018 170406010418Y000494 0001852185093
205 19-04-2018 170406010418Y000282 0002229564835
206 19-04-2018 170406010418Y000287 0002420982303
207 18-04-2018 170406010418Y000275 0000122757276
208 18-04-2018 170406010418Y000272 0000123114969
209 18-04-2018 170406010418Y000277 0000889376703
210 18-04-2018 170406010418Y000271 0000890555253
211 18-04-2018 170406010418Y000335 0000890678632
212 18-04-2018 170406010418Y000333 0000890710312
213 18-04-2018 170406010418Y000336 0000890811977
214 18-04-2018 170406010418Y000269 0000975900565
215 18-04-2018 170406010418Y000268 0001306752142
216 18-04-2018 170406010418Y000278 0001307796309
217 18-04-2018 170406010418Y000276 0001380784746
218 18-04-2018 170406010418Y000337 0001442206901
219 18-04-2018 170406010418Y000334 0001810491085

LAMBERI L PBI (APBN) Atherosclerotic heart disease
MISRAN L PBI (APBN) Motorcycle rider injured in collision

with pedestrian or animal,
passenger, nontraffic accident
RAHMAWATI P PEKERJA MANDIRI Contraceptive management,

unspecified
RUSMILAWATI P PEGAWAI SWASTA Essential (primary) hypertension
M. RIYADH AZHAR L PEGAWAI SWASTA Calculus of gallbladder with other

cholecystitis
YUSRIANSYAH L PEKERJA MANDIRI Acute periodontitis
YUSRAN L PEKERJA MANDIRI Hyperplasia of prostate
SURIANSYAH L PEKERJA MANDIRI Essential (primary) hypertension
HJ. MURNI P PENERIMA PENSIUN PNS Essential (primary) hypertension
AINI P PNS DAERAH Allergic contact dermatitis
hj jawita P PBI (APBN) End-stage renal disease
SUTIMAH P PBI (APBN) Allergic contact dermatitis
WIWI ARIYANI P PBI (APBN) Essential (primary) hypertension
SITI AISYAH P PBI (APBN) Essential (primary) hypertension
MISBATUN NI'MAH P PBI (APBN) Gastritis, unspecified
FATHUL JANNAH P PENERIMA PENSIUN TNI Moderate depressive episode
MAHRITA P PEKERJA MANDIRI Sequelae of cerebral infarction
ARBAYAH P PEKERJA MANDIRI Insulin-dependent diabetes

mellitus with
RAWANSYAH L PEKERJA MANDIRI Hyperplasia of prostate
RISMA SUSANTI P PEKERJA MANDIRI Contraceptive management,

unspecified
MURSILAH P PEKERJA MANDIRI Stomatitis and related lesions
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220 18-04-2018 170406010418Y000273 0001825643171
221 18-04-2018 170406010418Y000338 0001870716442
222 18-04-2018 170406010418Y000270 0001930384686
223 18-04-2018 170406010418Y000492 0002043596608
224 18-04-2018 170406010418Y000332 0002263889193
225 18-04-2018 170406010418Y000274 0002263889711
226 18-04-2018 170406010418Y000493 0002441771368
227 17-04-2018 170406010418Y000223 0000121375045
228 17-04-2018 170406010418Y000222 0000121375056
229 17-04-2018 170406010418Y000230 0000122620127
230 17-04-2018 170406010418Y000490 0000167075875
231 17-04-2018 170406010418Y000228 0000889759631
232 17-04-2018 170406010418Y000229 0000890820944
233 17-04-2018 170406010418Y000212 0000890834578
234 17-04-2018 170406010418Y000217 0000890887825
235 17-04-2018 170406010418Y000219 0000976814976
236 17-04-2018 170406010418Y000218 0000976815178
237 17-04-2018 170406010418Y000231 0001065414284
238 17-04-2018 170406010418Y000227 0001065417333
239 17-04-2018 170406010418Y000489 0001173437425
240 17-04-2018 170406010418Y000224 0001302082593
241 17-04-2018 170406010418Y000214 0001318164388

MUCHRI DAHLAN L PEKERJA MANDIRI Presence of intraocular lens
MARDANITA SARI P PEKERJA MANDIRI Contraceptive management,

unspecified
EDY RAHMADI L PEGAWAI SWASTA Motorcycle rider injured in collision
with pedestrian or
MARTINI P PBI (APBD) Pulpitis
SITI SALAMAH P PEKERJA MANDIRI Pruritus
MUHAMMAD FIRMANSYAH L PEKERJA MANDIRI Malignant neoplasm of brain,

unspecified
ABDULLAH SANI L PEKERJA MANDIRI Acute periodontitis
ERNAWATY KUSTIAH, SH. P PENERIMA PENSIUN PNS Essential (primary) hypertension
TOTO SUMEKTO L PENERIMA PENSIUN PNS Heart failure, unspecified
HARTINAH P PNS DAERAH Essential (primary) hypertension
JUHAN HADI KRISWANTO, ST L PNS DAERAH Chronic periodontitis
JASMANI L PBI (APBN) Cough
MAHRIANI P PBI (APBN) Essential (primary) hypertension
ILMI L PBI (APBN) Chronic myeloid leukaemia
RIDUAN L PBI (APBN) Hearing loss, unspecified
AHMAD DHIYAI SYABANI L PNS PUSAT Thalassaemia, unspecified
MUHAMMAD NOOR SYABANI L PNS PUSAT Acute lymphoblastic leukaemia
LATIFAH P PBI (APBN) Essential (primary) hypertension
SITI RAHMAH P PBI (APBN) Allergic contact dermatitis
HIKMAH P PEGAWAI SWASTA Necrosis of pulp
ACHMAD EFFENDI L PEKERJA MANDIRI Other chronic obstructive

pulmonary disease
TANKASIANI L PEKERJA MANDIRI Non-insulin-dependent diabetes
mellitus with
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242 17-04-2018 170406010418Y000225 0001376122037
243 17-04-2018 170406010418Y000226 0001425352072
244 17-04-2018 170406010418Y000491 0001426235523
245 17-04-2018 170406010418Y000488 0001484006861
246 17-04-2018 170406010418Y000221 0001821515725
247 17-04-2018 170406010418Y000216 0002043596608
248 17-04-2018 170406010418Y000220 0002124150851
249 17-04-2018 170406010418Y000215 0002277325754
250 17-04-2018 170406010418Y000213 0002322240895
251 16-04-2018 170406010418Y000191 0000122728915
252 16-04-2018 170406010418Y000193 0000158671361
253 16-04-2018 170406010418Y000207 0000889917669
254 16-04-2018 170406010418Y000208 0000890212026
255 16-04-2018 170406010418Y000210 0000890420049
256 16-04-2018 170406010418Y000202 0000890656042
257 16-04-2018 170406010418Y000487 0000890685123
258 16-04-2018 170406010418Y000201 0000890786946
259 16-04-2018 170406010418Y000204 0000891518962
260 16-04-2018 170406010418Y000200 0000891539008
261 16-04-2018 170406010418Y000206 0000891583244
262 16-04-2018 170406010418Y000199 0000978029818
263 16-04-2018 170406010418Y000198 0001262525938

HABIB ABDUL ADHIM L PEGAWAI SWASTA Acute suppurative otitis media
SYUKRAN L PEKERJA MANDIRI Other chronic obstructive

pulmonary disease
arbiansyah L PEKERJA MANDIRI Pulpitis
NOOR JUBAIDAH A.A P PEKERJA MANDIRI Necrosis of pulp
FARIDAH P PEKERJA MANDIRI Essential (primary) hypertension
MARTINI P PBI (APBD) Epilepsy
SITI MAIMUNAH P PBI (APBN) Dyspepsia
HADERI L PEKERJA MANDIRI Other specified anaemias
ABDUL GANI L PEKERJA MANDIRI Senile cataract, unspecified
ASUN B L PENERIMA PENSIUN PNS Other specified disorders of

muscle, lower leg
NORHAYATI P PNS PUSAT Heart failure, unspecified
GALUH P PBI (APBN) Dyspepsia
SYARIFUDINOOR L PBI (APBN) Dyspepsia
RUSIADI L PBI (APBN) Allergic contact dermatitis
MASRANI L PBI (APBN) Influenza with pneumonia,

influenza virus identified
IDA P PBI (APBN) Loss of teeth due to accident,

extraction or
M. TAUFIQ RAHMAN L PBI (APBN) Acute pharyngitis
AINI L PBI (APBN) Other benign neoplasm of skin of

ear and external
ASPURI L PBI (APBN) Influenza with pneumonia,

influenza virus identified
RUSMIATI P PENERIMA PENSIUN PNS Essential (primary) hypertension
RACHMAD HIDAYAT L PEKERJA MANDIRI Fracture of upper end of radius,

closed
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264 16-04-2018 170406010418Y000209 0001271566315
265 16-04-2018 170406010418Y000205 0001286578293
266 16-04-2018 170406010418Y000203 0001286581386
267 16-04-2018 170406010418Y000196 0001291826709
268 16-04-2018 170406010418Y000190 0001481549793
269 16-04-2018 170406010418Y000486 0001791971043
270 16-04-2018 170406010418Y000485 0001796551615
271 16-04-2018 170406010418Y000211 0002124150851
272 16-04-2018 170406010418Y000195 0002213331581
273 16-04-2018 170406010418Y000194 0002229571541
274 16-04-2018 170406010418Y000192 0002309476781
275 16-04-2018 170406010418Y000197 0002320909738
276 13-04-2018 170406010418Y000252 0000122654801
277 13-04-2018 170406010418Y000253 0000122695571
278 13-04-2018 170406010418Y000183 0000122707135
279 13-04-2018 170406010418Y000254 0000122713345
280 13-04-2018 170406010418Y000255 0000122717766
281 13-04-2018 170406010418Y000256 0000122718791
282 13-04-2018 170406010418Y000257 0000122718971
283 13-04-2018 170406010418Y000258 0000122718982
284 13-04-2018 170406010418Y000259 0000122718993
285 13-04-2018 170406010418Y000260 0000122719026

NURUL JANNAH P PEKERJA MANDIRI Headache
MAHFUD L PNS DAERAH Heart failure, unspecified
SITI MARIYAM L PNS DAERAH Headache
AHMAD ZAKI ILMI L PEKERJA MANDIRI Undifferentiated schizophrenia
RAZAKIAH P PEKERJA MANDIRI Insulin-dependent diabetes

mellitus with peripheral circulatory
yulia karina rakhman P PEKERJA MANDIRI Disturbances in tooth eruption
SITI AMINAH P PEKERJA MANDIRI Necrosis of pulp
SITI MAIMUNAH P PBI (APBN) Myalgia
JAHRATUN SIFA P PEKERJA MANDIRI Delayed milestone
SITI SARAH P PEKERJA MANDIRI Stroke, not specified as

HASBIANNOR L PEKERJA MANDIRI Stroke, not specified as
RUSDI L PEKERJA MANDIRI Hyperplasia of prostate
ERNI RAHMI P PNS DAERAH Examination of blood pressure
SITI FATIMAH P PENERIMA PENSIUN TNI Stroke, not specified as

FAULIAH P PNS DAERAH Examination of blood pressure

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286 13-04-2018 170406010418Y000261 0000122719037
287 13-04-2018 170406010418Y000262 0000122719195
288 13-04-2018 170406010418Y000263 0000122719206
289 13-04-2018 170406010418Y000264 0000122719432
290 13-04-2018 170406010418Y000265 0000122719509
291 13-04-2018 170406010418Y000181 0000123302812
292 13-04-2018 170406010418Y000185 0000123612535
293 13-04-2018 170406010418Y000484 0000163775867
294 13-04-2018 170406010418Y000187 0000889763624
295 13-04-2018 170406010418Y000182 0000890678709
296 13-04-2018 170406010418Y000180 0000890787159
297 13-04-2018 170406010418Y000179 0001424666294
298 13-04-2018 170406010418Y000186 0001425352072
299 13-04-2018 170406010418Y000188 0001425352858
300 13-04-2018 170406010418Y000266 0001441794846
301 13-04-2018 170406010418Y000189 0001460053989
302 13-04-2018 170406010418Y000267 0002207775701
303 13-04-2018 170406010418Y000184 0002436711669
304 12-04-2018 170406010418Y000174 0000122605626
305 12-04-2018 170406010418Y000177 0000122605637
306 12-04-2018 170406010418Y000175 0000122653631
307 12-04-2018 170406010418Y000236 0000122843171

SUBONO L PENERIMA PENSIUN PNS Heart failure, unspecified
KAMARIAH, HJ P PENERIMA PENSIUN PNS Spondylolysis
EDISON SITORUS L PNS PUSAT Caries of dentine
SETIA BUDI L PBI (APBN) Heart failure, unspecified
NOOR MULYANI P PBI (APBN) Cough
RAMLI L PBI (APBN) Essential (primary) hypertension
FAJRI NANDA L PEKERJA MANDIRI Spondylolysis
SYUKRAN L PEKERJA MANDIRI Cough
SITI AISYAH P PEKERJA MANDIRI Cough
ANNI NURHIDAYAH P PEKERJA MANDIRI Examination of blood pressure
M. SUBLI MAKSUM L PEGAWAI SWASTA Essential (primary) hypertension
SANIAH P PEKERJA MANDIRI Tuberculosis of lung, confirmed by

culture only
MUHAIMIN L PENERIMA PENSIUN PNS Parkinson's disease
HJ. SYUFIAH UHIN P PENERIMA PENSIUN PNS Non-insulin-dependent diabetes

mellitus with
SANIAH H KACIL P PNS PUSAT Allergic contact dermatitis
ZAINUDDIN L PNS DAERAH Diseases of pulp and periapical

tissues
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308 12-04-2018 170406010418Y000166 0000123313689
309 12-04-2018 170406010418Y000483 0000890340423
310 12-04-2018 170406010418Y000169 0000890512367
311 12-04-2018 170406010418Y000164 0000890561733
312 12-04-2018 170406010418Y000170 0000890679058
313 12-04-2018 170406010418Y000176 0001065501459
314 12-04-2018 170406010418Y000173 0001078411318
315 12-04-2018 170406010418Y000168 0001094262467
316 12-04-2018 170406010418Y000167 0001267501601
317 12-04-2018 170406010418Y000171 0001478814906
318 12-04-2018 170406010418Y000165 0001825643171
319 12-04-2018 170406010418Y000172 0001877935768
320 12-04-2018 170406010418Y000178 0002074966233
321 12-04-2018 170406010418Y000234 0002204133423
322 12-04-2018 170406010418Y000235 0002315556729
323 11-04-2018 170406010418Y000149 0000122598483
324 11-04-2018 170406010418Y000148 0000122706988
325 11-04-2018 170406010418Y000154 0000122757052
326 11-04-2018 170406010118Y000404 0000122805617
327 11-04-2018 170406010418Y000482 0000122843171
328 11-04-2018 170406010418Y000156 0000122976088

ABDULLAHKARIM L PNS PUSAT Non-insulin-dependent diabetes
mellitus with
SITI FATIMAH P PBI (APBN) Caries of dentine
ALA L PBI (APBN) Cough
SURIADI L PBI (APBN) Dyspepsia
ACHMAD RAMADHAN L PBI (APBN) Cough
NAPIYAH L PBI (APBN) Senile cataract, unspecified
RUSTINI P PNS PUSAT Sequelae of cerebrovascular

disease
M. WAHYUDIN .HN L PENERIMA PENSIUN POLRI Non-insulin-dependent diabetes
mellitus with
ASRANI L PEKERJA MANDIRI Dyspepsia
PANDI ARIADI L PEKERJA MANDIRI Heart failure, unspecified
MUCHRI DAHLAN L PEKERJA MANDIRI Essential (primary) hypertension
norsabah P PEKERJA MANDIRI Cutaneous abscess, furuncle and

carbuncle
MARNITI L KEPOLISIAN RI Examination of blood pressure
ITA P PEGAWAI PEMERINTAH NON Necrosis of pulp

PNS
MUHAMMAD FADEL YUSRAN L PEKERJA MANDIRI Other and unspecified diseases of
pulp and
NOOR HASANAH P PENERIMA PENSIUN PNS Chronic kidney disease
KASPUL ANWAR, H L PENERIMA PENSIUN TNI Disorder of refraction, unspecified
ABDUL HADI L PENERIMA PENSIUN PNS Surgical follow-up care,

unspecified
SAHIB IBERAHIM L PNS DAERAH Essential (primary) hypertension
ZAINUDDIN L PNS DAERAH Caries of dentine
HAMDAH P PNS DAERAH Leiomyoma of uterus, unspecified

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329 11-04-2018 170406010418Y000158 0000123189243
330 11-04-2018 170406010218Y000160 0000123287253
331 11-04-2018 170406010418Y000163 0000196393419
332 11-04-2018 170406010418Y000160 0000889479854
333 11-04-2018 170406010418Y000161 0000889947977
334 11-04-2018 170406010418Y000152 0000890342302
335 11-04-2018 170406010418Y000151 0000975900565
336 11-04-2018 170406010418Y000153 0001065417333
337 11-04-2018 170406010418Y000159 0001442536211
338 11-04-2018 170406010418Y000155 0001548389698
339 11-04-2018 170406010418Y000481 0001548389709
340 11-04-2018 170406010418Y000150 0001790572871
341 11-04-2018 170406010418Y000162 0001821515725
342 11-04-2018 170406010418Y000157 0001857673214
343 10-04-2018 170406010418Y000144 0000122707001
344 10-04-2018 170406010418Y000136 0000122736183
345 10-04-2018 170406010418Y000139 0000122810556
346 10-04-2018 170406010418Y000138 0000123114969
347 10-04-2018 170406010418Y000137 0000123115105
348 10-04-2018 170406010418Y000133 0000123209379
349 10-04-2018 170406010418Y000479 0000123329542
350 10-04-2018 170406010418Y000134 0000123612535

mellitus with
MUDERAN L PENERIMA PENSIUN PNS Heart failure
JACKY MANIHIN L PENERIMA PENSIUN POLRI Cervicalgia
AMINAH P PBI (APBN) Acute vaginitis
NAPSIAH P PBI (APBN) Dyspepsia
WAHYU ADHITYA L PBI (APBN) Acute pharyngitis
FATHUL JANNAH P PENERIMA PENSIUN TNI Insulin-dependent diabetes

mellitus with
SITI RAHMAH P PBI (APBN) Allergic contact dermatitis
HAURA ELYSA GUNTUR P PEKERJA MANDIRI Allergic contact dermatitis
MIRDA BANJARIAH P PEGAWAI SWASTA Non-insulin-dependent diabetes

mellitus with
INTAN CAMELIA SARI P PEGAWAI SWASTA Caries of dentine
ROHANI P PEKERJA MANDIRI Secondary hypertension
FARIDAH P PEKERJA MANDIRI Idiopathic gout
alya sairina P PEKERJA MANDIRI Epilepsy, unspecified
SITI FARIDAH, HJ P PENERIMA PENSIUN TNI Primary gonarthrosis, bilateral
HASYIM AMID L PENERIMA PENSIUN PNS Acute pharyngitis, unspecified
MURWATI P PNS DAERAH Dyspepsia
AINI P PNS DAERAH Varicella [chickenpox]
BURHANUDDIN, H, B.SC L PENERIMA PENSIUN PNS Presence of intraocular lens
ANITA P PENERIMA PENSIUN PNS Insulin-dependent diabetes

mellitus without
CHAIRUL ANWAR L PNS DAERAH Chronic periodontitis
KAMARIAH, HJ P PENERIMA PENSIUN PNS Hypertensive heart disease without

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351 10-04-2018 170406010418Y000132 0000196393419
352 10-04-2018 170406010418Y000141 0000890539097
353 10-04-2018 170406010418Y000140 0000890729717
354 10-04-2018 170406010418Y000143 0000891177164
355 10-04-2018 170406010418Y000142 0000891580421
356 10-04-2018 170406010418Y000147 0001261691144
357 10-04-2018 170406010418Y000129 0001266035253
358 10-04-2018 170406010418Y000130 0001266035848
359 10-04-2018 170406010418Y000146 0001271659454
360 10-04-2018 170406010418Y000480 0001279185816
361 10-04-2018 170406010418Y000128 0001302569829
362 10-04-2018 170406010418Y000131 0001381991128
363 10-04-2018 170406010418Y000478 0001484006861
364 10-04-2018 170406010418Y000135 0002211778811
365 10-04-2018 170406010418Y000145 0002235454154
366 09-04-2018 170406010418Y000122 0000122653631
367 09-04-2018 170406010418Y000127 0000122756725
368 09-04-2018 170406010418Y000107 0000122824495
369 09-04-2018 170406010418Y000103 0000123029032
370 09-04-2018 170406010418Y000115 0000123807036

JACKY MANIHIN L PENERIMA PENSIUN POLRI Hyperplasia of prostate
SAHWATI P PBI (APBN) Allergic contact dermatitis
NOOR AIN P PBI (APBN) Motorcycle rider injured in collision

with pedestrian or
YULIANA P PBI (APBN) Acute haemorrhagic gastritis
HELDA P PBI (APBN) Examination of blood pressure
JURAHMAH P PENERIMA PENSIUN PNS Influenza, virus not identified
AHMAD MUHAMMAD MARZUKI L PEKERJA MANDIRI Rheumatoid nodule, multiple sites
MASTAYAH P PEKERJA MANDIRI Non-insulin-dependent diabetes

mellitus with
ASFIANOOR BAHRAN L PEKERJA MANDIRI Dyspepsia
FAHREZY ADITYA PUTRA L PEKERJA MANDIRI Disturbances in tooth eruption
MANSYAH L PEKERJA MANDIRI Sequelae of cerebral infarction
ABDUL HADI L PEKERJA MANDIRI Low back pain
NOOR JUBAIDAH A.A P PEKERJA MANDIRI Caries of dentine
SITI AISYAH P PEKERJA MANDIRI Acute pharyngitis, unspecified
BARKIAH P PNS DAERAH Essential (primary) hypertension
SANIAH H KACIL P PNS PUSAT Allergic contact dermatitis
AS'ARI ISFANI L PENERIMA PENSIUN PNS Insulin-dependent diabetes

mellitus without
YUDA SYAIFUDDIN L PEKERJA MANDIRI Other specified mental disorders

due to brain damage and
dysfunction
AHMADI L PNS DAERAH End-stage renal disease
NORMI ULFAH P PENERIMA PENSIUN PNS Cough

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371 09-04-2018 170406010418Y000121 0000124564544
372 09-04-2018 170406010418Y000108 0000889477964
373 09-04-2018 170406010418Y000114 0000889721201
374 09-04-2018 170406010418Y000105 0000889951116
375 09-04-2018 170406010418Y000112 0000889988657
376 09-04-2018 170406010418Y000117 0000890467964
377 09-04-2018 170406010418Y000118 0000890513302
378 09-04-2018 170406010418Y000110 0000890561733
379 09-04-2018 170406010318Y000061 0000890681038
380 09-04-2018 170406010418Y000116 0000891539008
381 09-04-2018 170406010418Y000123 0000891540786
382 09-04-2018 170406010418Y000124 0001264056265
383 09-04-2018 170406010418Y000125 0001271566315
384 09-04-2018 170406010418Y000119 0001465179546
385 09-04-2018 170406010418Y000120 0001627257521
386 09-04-2018 170406010418Y000111 0001664277287
387 09-04-2018 170406010418Y000104 0001791037012
388 09-04-2018 170406010418Y000106 0001863928528
389 09-04-2018 170406010218Y000115 0001974854092
390 09-04-2018 170406010418Y000109 0002256219628
391 09-04-2018 170406010418Y000113 0002315556246

ABDUL GAFAR L PENERIMA PENSIUN POLRI Spondylolysis
RUBIAH P PBI (APBN) Diseases of pulp and periapical

tissues
MAULIDA P PBI (APBN) Gastritis and duodenitis
SITI AISYAH P PBI (APBN) Thyrotoxicosis [hyperthyroidism]
SALAPUDIN L PBI (APBN) Allergic contact dermatitis
MURHAN BASERI L PBI (APBN) Cough
AMAT YANI L PBI (APBN) Undifferentiated schizophrenia
SURIADI L PBI (APBN) Non-insulin-dependent diabetes

mellitus with
BAHJAH P PBI (APBN) Essential (primary) hypertension
AINI L PBI (APBN) Other benign neoplasm of skin of

ear and external
YANTO L PBI (APBN) Gastritis and duodenitis
NORAIDA P PEKERJA MANDIRI Heart failure, unspecified
NURUL JANNAH P PEKERJA MANDIRI Low back pain
JURAH P PEKERJA MANDIRI Gastritis and duodenitis
MUHAMMAD MAULANA RIFQI L PEKERJA MANDIRI Acute upper respiratory infections

of multiple and
HASANAH P PEGAWAI SWASTA Cough
TImAH P PEKERJA MANDIRI Calculus of kidney
MARIFATULLAH AWALUDDIN L PEGAWAI SWASTA Systemic lupus erythematosus,
ASPANDI L PBI (APBN) Non-insulin-dependent diabetes

mellitus without
BAHARUDIN L PEKERJA MANDIRI Spondylolisthesis
JUMRIAH P PEKERJA MANDIRI Allergic contact dermatitis

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392 09-04-2018 170406010418Y000126 0002438267005
393 07-04-2018 170406010418Y000237 0000122654801
394 07-04-2018 170406010418Y000094 0000122660032
395 07-04-2018 170406010418Y000238 0000122695571
396 07-04-2018 170406010418Y000239 0000122713345
397 07-04-2018 170406010418Y000240 0000122717766
398 07-04-2018 170406010418Y000250 0000122718982
399 07-04-2018 170406010418Y000241 0000122718993
400 07-04-2018 170406010418Y000242 0000122719026
401 07-04-2018 170406010418Y000243 0000122719037
402 07-04-2018 170406010418Y000244 0000122719195
403 07-04-2018 170406010418Y000245 0000122719206
404 07-04-2018 170406010418Y000246 0000122719432
405 07-04-2018 170406010418Y000247 0000122719509
406 07-04-2018 170406010418Y000091 0000122757636
407 07-04-2018 170406010418Y000093 0000123093268
408 07-04-2018 170406010418Y000092 0000123318865
409 07-04-2018 170406010418Y000102 0000889905205
410 07-04-2018 170406010418Y000099 0000890786946
411 07-04-2018 170406010418Y000100 0000890791738
412 07-04-2018 170406010418Y000090 0001266035848

FITRIA P PEKERJA MANDIRI Periapical abscess without sinus
NUNUK YULIASTUTI P PNS DAERAH Other disorders of eye and adnexa
ERNI RAHMI P PNS DAERAH Examination of blood pressure
FAULIAH P PNS DAERAH Examination of blood pressure
IMAS P PENERIMA PENSIUN PNS Follow-up examination after

surgery for other
RUDY ANWARI L PNS DAERAH Acute hepatitis B
MUHAMMAD MUKRI, H L PNS PUSAT Hyperplasia of prostate
FARIDAH P PBI (APBN) Tuberculosis of lung, confirmed by

unspecified
SITI AISYAH P PBI (APBN) Spondylolysis
SALAMIAH P PBI (APBN) Examination of blood pressure
MASTAYAH P PEKERJA MANDIRI Cough

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413 07-04-2018 170406010418Y000101 0001279182374
414 07-04-2018 170406010418Y000248 0001441794846
415 07-04-2018 170406010418Y000096 0001455741314
416 07-04-2018 170406010418Y000249 0001873511245
417 07-04-2018 170406010418Y000098 0002124150535
418 07-04-2018 170406010418Y000251 0002207775701
419 07-04-2018 170406010418Y000095 0002220897115
420 07-04-2018 170406010418Y000097 0002290778302
421 06-04-2018 170406010418Y000083 0000122653631
422 06-04-2018 170406010418Y000081 0000122688617
423 06-04-2018 170406010418Y000084 0000890043535
424 06-04-2018 170406010418Y000088 0000890678709
425 06-04-2018 170406010418Y000087 0001079882201
426 06-04-2018 170406010418Y000085 0001266044051
427 06-04-2018 170406010418Y000086 0001271659454
428 06-04-2018 170406010418Y000082 0001302083278
429 06-04-2018 170406010418Y000080 0001328026138
430 06-04-2018 170406010418Y000089 0001433414924
431 06-04-2018 170406010418Y000233 0002438267005
432 05-04-2018 170406010418Y000075 0000122660032
433 05-04-2018 170406010418Y000066 0000122706988
434 05-04-2018 170406010418Y000069 0000122738387

AHMAD SYAIPUDIN L PEKERJA MANDIRI Disorder of urinary system,
unspecified
ANNI NURHIDAYAH P PEKERJA MANDIRI Examination of blood pressure
FAKHRUROZI L PEKERJA MANDIRI Disorder of refraction, unspecified
MASTANIAH P PEKERJA MANDIRI Examination of blood pressure
FAHRIYAH P PBI (APBN) Acute haemorrhagic gastritis
JHONI ABDURAHMAN ABDILLAH L PEKERJA MANDIRI Chronic kidney disease
SELAMAT L PEKERJA MANDIRI Influenza, virus not identified
SANIAH H KACIL P PNS PUSAT Senile cataract, unspecified
JUNAIDI, DRS L PNS PUSAT Mixed anxiety and depressive

disorder
TAUFIK AKHMAD L PBI (APBN) Atherosclerotic cardiovascular
disease, so
NOOR MULYANI P PBI (APBN) Cough
MIRA JELITA P PNS DAERAH Cutaneous abscess, furuncle and

carbuncle
RAHMANI L PBI (APBD) Heart failure, unspecified
ASFIANOOR BAHRAN L PEKERJA MANDIRI Dyspepsia
NURLIANA P PEKERJA MANDIRI Senile cataract, unspecified
SALAMAH P PEKERJA MANDIRI Undifferentiated schizophrenia
SABARIAH P PEKERJA MANDIRI Spondylolysis
FITRIA P PEKERJA MANDIRI Disturbances in tooth eruption
NUNUK YULIASTUTI P PNS DAERAH Essential (primary) hypertension
KASPUL ANWAR, H L PENERIMA PENSIUN TNI Hyperplasia of prostate
M.ABERANI. L PENERIMA PENSIUN PNS Secondary hypertension,

unspecified
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435 05-04-2018 170406010418Y000068 0000122824855
436 05-04-2018 170406010418Y000065 0000889956854
437 05-04-2018 170406010418Y000073 0000890637142
438 05-04-2018 170406010418Y000074 0000890820944
439 05-04-2018 170406010418Y000072 0000890836435
440 05-04-2018 170406010418Y000079 0001267733373
441 05-04-2018 170406010418Y000067 0001809273262
442 05-04-2018 170406010418Y000071 0002209303541
443 05-04-2018 170406010418Y000070 0002262697762
444 05-04-2018 170406010418Y000078 0002277325754
445 05-04-2018 170406010418Y000077 0002277325833
446 05-04-2018 170406010418Y000076 0002424466754
447 04-04-2018 170406010418Y000063 0000122608732
448 04-04-2018 170406010418Y000052 0000122733303
449 04-04-2018 170406010418Y000061 0000158671361
450 04-04-2018 170406010418Y000054 0000889477964
451 04-04-2018 170406010418Y000053 0000889777067
452 04-04-2018 170406010418Y000062 0000889798994
453 04-04-2018 170406010418Y000060 0000890656042
454 04-04-2018 170406010418Y000059 0000890656661
455 04-04-2018 170406010418Y000513 0000890728839
456 04-04-2018 170406010418Y000051 0000890764659
457 04-04-2018 170406010418Y000058 0001065415779

NOORLENA P PNS DAERAH Mixed anxiety and depressive
disorder
BAHRUL BASRI L PBI (APBN) Hyperplasia of prostate
WIDIAWATI MASLOMAN P PBI (APBN) Pterygium
MAHRIANI P PBI (APBN) Essential (primary) hypertension
RUSMAWATI P PBI (APBN) Essential (primary) hypertension
ERNAYATI P PEKERJA MANDIRI Essential (primary) hypertension
iwan sulaiman L PEGAWAI PEMERINTAH NON Acute viral hepatitis, unspecified

PNS
ZAKARIYA S L PEKERJA MANDIRI Fever, unspecified
ANANG SHALAHUDDIN NOOR L PEKERJA MANDIRI Motorcycle rider injured in collision

with pedestrian or
HADERI L PEKERJA MANDIRI Dyspepsia
MUTMAINAH P PEKERJA MANDIRI Essential (primary) hypertension
MIFTAHUL QARI'AH P PEGAWAI PEMERINTAH NON Dyspepsia

PNS
MUHAMMAD JAMAHSYARI L PNS PUSAT Predominantly allergic asthma
H. IBERAHIM TUKACIL L PENERIMA PENSIUN PNS Cough
NORHAYATI P PNS PUSAT Hyperlipidaemia, unspecified
RUBIAH P PBI (APBN) Asthma, unspecified
HELMAN MAHMUDI L PBI (APBN) Typhoid fever
abdul rahim L PBI (APBN) Other and unspecified convulsions
MASRANI L PBI (APBN) Essential (primary) hypertension
IDA RAHMAWATI P PBI (APBN) Dyspepsia
NORIDAH P PBI (APBN) Contraceptive management,

unspecified
MISRAN L PBI (APBN) Ganglion
SITI HALIDAH P PBI (APBN) Cough

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458 04-04-2018 170406010418Y000064 0001260954505
459 04-04-2018 170406010418Y000056 0001262525938
460 04-04-2018 170406010418Y000050 0001279182374
461 04-04-2018 170406010418Y000057 0001306752142
462 04-04-2018 170406010418Y000049 0001481294035
463 04-04-2018 170406010418Y000055 0001483848887
464 03-04-2018 170406010418Y000035 0000122707135
465 03-04-2018 170406010418Y000037 0000122805314
466 03-04-2018 170406010418Y000036 0000123313206
467 03-04-2018 170406010418Y000030 0000123329542
468 03-04-2018 170406010418Y000389 0000123329542
469 03-04-2018 170406010418Y000041 0000890561733
470 03-04-2018 170406010418Y000038 0000890674277
471 03-04-2018 170406010418Y000046 0000890729717
472 03-04-2018 170406010418Y000042 0000890789139
473 03-04-2018 170406010418Y000043 0000890843826
474 03-04-2018 170406010418Y000048 0000891218417
475 03-04-2018 170406010418Y000031 0001267501601
476 03-04-2018 170406010418Y000029 0001269910967
477 03-04-2018 170406010418Y000028 0001303166687

TABERANI L PEKERJA MANDIRI Non-insulin-dependent diabetes
mellitus with
RACHMAD HIDAYAT L PEKERJA MANDIRI Fracture of upper end of radius,

closed
AHMAD SYAIPUDIN L PEKERJA MANDIRI Epilepsy
MAHRITA P PEKERJA MANDIRI Sequelae of cerebral infarction
supiyah P PEKERJA MANDIRI Carcinoma in situ of breast,

unspecified
jumaiah P PEKERJA MANDIRI Dyspepsia
SITI FATIMAH P PENERIMA PENSIUN TNI Conjunctivitis
AGUS PRIBADI L PNS DAERAH Chronic periodontitis
A ATHAILAH L PNS PUSAT Benign lipomatous neoplasm of

skin and subcutaneous tissue of
other and unspecified sites
CHAIRUL ANWAR L PNS DAERAH Panic disorder [episodic

paroxysmal anxiety]
CHAIRUL ANWAR L PNS DAERAH Acute periodontitis
SURIADI L PBI (APBN) Dyspepsia
SARINAH P PBI (APBN) Dyspepsia
NOOR AIN P PBI (APBN) Motorcycle rider injured in collision

with pedestrian or
MUHAMMAD HAMDI .HB L PBI (APBN) Essential (primary) hypertension
KHAIRUDIN L PBI (APBN) Tuberculosis of lung, confirmed by

unspecified
TABRI L PBI (APBN) Essential (primary) hypertension
ASRANI L PEKERJA MANDIRI Atherosclerotic cardiovascular

disease, so
ENDANG JUMIATI P PEGAWAI SWASTA Hypertensive heart disease
SYAEPULLAH L PEKERJA MANDIRI Epilepsy

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478 03-04-2018 170406010418Y000034 0001313876002
479 03-04-2018 170406010418Y000033 0001484006861
480 03-04-2018 170406010418Y000032 0001790572871
481 03-04-2018 170406010418Y000040 0001810491085
482 03-04-2018 170406010418Y000039 0001858815112
483 03-04-2018 170406010418Y000044 0001967109647
484 03-04-2018 170406010418Y000232 0001967109647
485 03-04-2018 170406010418Y000045 0002219622827
486 03-04-2018 170406010418Y000047 0002235454154
487 03-04-2018 170406010418Y000512 0002304843478
488 02-04-2018 170406010418Y000019 0000122660032
489 02-04-2018 170406010418Y000020 0000122707034
490 02-04-2018 170406010418Y000011 0000122707045
491 02-04-2018 170406010418Y000018 0000122757985
492 02-04-2018 170406010418Y000003 0000123115105
493 02-04-2018 170406010418Y000026 0000123189243
494 02-04-2018 170406010418Y000024 0000889783165
495 02-04-2018 170406010418Y000001 0000889829098
496 02-04-2018 170406010418Y000002 0000889830786
497 02-04-2018 170406010418Y000007 0000890630695
498 02-04-2018 170406010418Y000022 0000890780196

MUKHTAR L PEKERJA MANDIRI Hyperplasia of prostate
NOOR JUBAIDAH A.A P PEKERJA MANDIRI Acute nasopharyngitis [common

cold]
ROHANI P PEKERJA MANDIRI Essential (primary) hypertension
MURSILAH P PEKERJA MANDIRI Gout
MARIAH P PEKERJA MANDIRI Diarrhoea and gastroenteritis of

presumed infectious origin
DWI RIDHA YULIANTI P PEGAWAI SWASTA Dyspepsia
DWI RIDHA YULIANTI P PEGAWAI SWASTA Contraceptive management,

unspecified
SURIANSYAH L PEKERJA MANDIRI Heart failure, unspecified
BARKIAH P PNS DAERAH Essential (primary) hypertension
DEWI KARMILAWATI P PEKERJA MANDIRI Contraceptive management,

unspecified
NUNUK YULIASTUTI P PNS DAERAH Conjunctivitis
M. MAKI L PENERIMA PENSIUN TNI Insulin-dependent diabetes

mellitus without
ROHANI P PENERIMA PENSIUN TNI Cough
SANUSI TUGANAL,H L PENERIMA PENSIUN PNS Essential (primary) hypertension
BURHANUDDIN, H, B.SC L PENERIMA PENSIUN PNS Essential (primary) hypertension

mellitus with
M. RIZKI ABDUL AKBAR L PBI (APBN) Dyspepsia
ARSUNI L PBI (APBN) Hyperparathyroidism, unspecified
RISKA AMALIA PUTRI P PBI (APBN) Fracture of upper end of tibia,

closed
MISLIWATI P PBI (APBN) Essential (primary) hypertension
ANANG SAHRI L PBI (APBN) Dyspepsia

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499 02-04-2018 170406010418Y000012 0000890786946
500 02-04-2018 170406010418Y000027 0000890835862
501 02-04-2018 170406010418Y000017 0000890852995
502 02-04-2018 170406010418Y000008 0000890854716
503 02-04-2018 170406010418Y000014 0000891056237
504 02-04-2018 170406010418Y000016 0000891058779
505 02-04-2018 170406010418Y000009 0001441794846
506 02-04-2018 170406010418Y000387 0001460057297
507 02-04-2018 170406010418Y000006 0001790572871
508 02-04-2018 170406010418Y000005 0001833652394
509 02-04-2018 170406010418Y000388 0001852185093
510 02-04-2018 170406010418Y000021 0001877935768
511 02-04-2018 170406010418Y000015 0002079582581
512 02-04-2018 170406010418Y000004 0002213331581
513 02-04-2018 170406010418Y000025 0002216875296
514 02-04-2018 170406010418Y000023 0002220754948
515 02-04-2018 170406010418Y000010 0002262697762
516 02-04-2018 170406010418Y000013 0002420982303

M YUSUP L PBI (APBN) Asthma, unspecified
RAHIMAH P PBI (APBN) Dyspepsia
AKHMAD NASRULLAH L PBI (APBN) Thalassaemia, unspecified
JUMILAH P PBI (APBN) Disorder of refraction, unspecified
NADIA AMALIA P PBI (APBN) Otitis media, unspecified
M. RIYADH AZHAR L PEGAWAI SWASTA Calculus of gallbladder with other

cholecystitis
ROHANI P PEKERJA MANDIRI Examination of blood pressure
ARSIAH P PEKERJA MANDIRI Essential (primary) hypertension
YUSRIANSYAH L PEKERJA MANDIRI Acute periodontitis
norsabah P PEKERJA MANDIRI Cutaneous abscess, furuncle and

carbuncle
NURHIDAYAH P PEKERJA MANDIRI Carcinoma in situ of breast,
unspecified
JAHRATUN SIFA P PEKERJA MANDIRI Down's syndrome, unspecified
KALAMI L PEKERJA MANDIRI Dyspepsia
AUFA RIZAL RASYAD L PENERIMA PENSIUN PNS Acute upper respiratory infection,
unspecified
ANANG SHALAHUDDIN NOOR L PEKERJA MANDIRI Motorcycle rider injured in collision
with pedestrian or
SURIANSYAH L PEKERJA MANDIRI Cough

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

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

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Kantor Cabang : BANJARMASIN - 1701

FKTP : KERTAK HANYAR - 17040601

1 30-04-2018 170406010418Y000448 0000122654801

2 30-04-2018 170406010418Y000450 0000122756714

3 30-04-2018 170406010418Y000462 0000148656216

4 30-04-2018 170406010418Y000457 0000158013213

5 30-04-2018 170406010418Y000452 0000889706283

6 30-04-2018 170406010418Y000469 0000889798577

7 30-04-2018 170406010418Y000465 0000889907534

8 30-04-2018 170406010418Y000464 0000889930056

9 30-04-2018 170406010418Y000449 0000889971309

10 30-04-2018 170406010418Y000467 0000890013352

11 30-04-2018 170406010418Y000511 0000890017211

12 30-04-2018 170406010418Y000460 0000890452405

13 30-04-2018 170406010418Y000463 0000890739033

14 30-04-2018 170406010418Y000466 0000890749574

15 30-04-2018 170406010418Y000458 0000890786946

16 30-04-2018 170406010418Y000451 0000976815178

17 30-04-2018 170406010418Y000461 0001078578224

18 30-04-2018 170406010418Y000454 0001267645329

19 30-04-2018 170406010418Y000453 0001325524151

20 30-04-2018 170406010418Y000468 0002084192313

21 30-04-2018 170406010418Y000459 0002252866072

22 30-04-2018 170406010418Y000456 0002279875746

ARKANI L PENERIMA PENSIUN PNS Parkinson's disease

LAILA RAHMI, A.MA P PNS DAERAH Contraceptive management,

RISNAWATI P PBI (APBN) Twin pregnancy

KARMIYANTI P PBI (APBN) Contraceptive management,

MULIATI P PBI (APBN) Contraceptive management,

HELDAWATI P PBI (APBN) Antenatal screening, unspecified

AMAH P PBI (APBN) Contraceptive management

DESY NOVITA P PBI (APBN) Pulp degeneration

HAMIDAH P PBI (APBN) Contraceptive management,

SITI AISYAH P PBI (APBN) Cough

MUHAMMAD NOOR SYABANI L PNS PUSAT Acute lymphoblastic leukaemia

SHOFIA NOOR AFIFAH P PNS DAERAH Necrosis of pulp

M. IRFAN MAULANA L PEKERJA MANDIRI Thalassaemia

NAYLA SYABILA AZAHRA P PEGAWAI SWASTA Allergic contact dermatitis

SUPARMI P PEGAWAI SWASTA Contraceptive management,

24 28-04-2018 170406010418Y000497 0000122654801

25 28-04-2018 170406010418Y000498 0000122713345

26 28-04-2018 170406010418Y000499 0000122717766

27 28-04-2018 170406010418Y000500 0000122718791

28 28-04-2018 170406010418Y000501 0000122718824

29 28-04-2018 170406010418Y000502 0000122718971

30 28-04-2018 170406010418Y000503 0000122718993

31 28-04-2018 170406010418Y000504 0000122719037

32 28-04-2018 170406010418Y000505 0000122719195

33 28-04-2018 170406010418Y000506 0000122719206

34 28-04-2018 170406010418Y000507 0000122719432

35 28-04-2018 170406010418Y000440 0000122726979

36 28-04-2018 170406010418Y000429 0000122819692

37 28-04-2018 170406010418Y000435 0000123189243

38 28-04-2018 170406010418Y000438 0000124080805

39 28-04-2018 170406010418Y000432 0000158013213

40 28-04-2018 170406010418Y000508 0000167797361

41 28-04-2018 170406010418Y000442 0000889905205

42 28-04-2018 170406010418Y000443 0000890348747

43 28-04-2018 170406010418Y000444 0000890503378

ERNAWATI P PENERIMA PENSIUN PNS Examination of blood pressure

ANNA BUDIARTI P PNS DAERAH Examination of blood pressure

ADTRI KORNIATI P PNS DAERAH Examination of blood pressure

DENI ELFENI P PNS DAERAH Examination of blood pressure