Lembar

LT005 01-06-50-41 L / 32 dr. Mienche Sp.
PD 05/01/2020 05/06/2020 6
III (522-A), ARIF PRATAMA
06 (521-A) PENYAKIT DALAM
ZZ088 01-06-50-42 P/0 dr. Hery Dharmawan, Sp. A 05/01/2020 05/02/2020 2

09 (201-O) BAYI NY BASE BANGKALA
ANAK
LT005 01-06-48-95 P / 28 dr. Johny Setio, Sp.OG 05/01/2020 05/02/2020 2
06 (599-O) RENITA
OBSTETRI DAN GINEKOLOGI
LT005 01-06-50-48 L / 20 dr. Putu Eka, Sp.PD 05/01/2020 05/05/2020 5

I (551-A), LUTFI AZHAR

06 (602E) KAMSATUN

06 (522-B) CASLADI
PENYAKIT DALAM
LT005 01-06-50-53 P / 49 dr. Putu Eka, Sp.PD 05/01/2020 05/02/2020 2
06 (522-E) RATI
PENYAKIT DALAM

04 (597-A) SITI MAESAROH
LT005 01-06-49-84 P / 25 dr. Ivan Rifai 05/02/2020 05/04/2020 3

I (551-A), MEI SITA LESTIYANING Sentosa,Sp.OG OBSTETRI DAN
05 (527-A) DYAH GINEKOLOGI

I (551-B), TRISWATI
04 (518) OBSTETRI DAN GINEKOLOGI

06 (606D) JUMIATI FITRIANI
ZZ088 01-06-50-63 P/0 dr. Hedy Vidiani, SpA 05/02/2020 05/04/2020 3

09 (201-P) BY NY MEI SITA
LESTIYANIN ANAK
ZZ088 01-06-50-64 L/0 dr. Hedy Vidiani, SpA 05/02/2020 05/04/2020 3

09 (201-A) BY NY TRISWATI
ANAK

I (551-C), SELVIANAH
LT006 01-06-50-65 P / 19 dr. Vidhia Umami. Sp.PD 05/02/2020 05/06/2020 5
06 (602A) LISTI MUAIMAH
PENYAKIT DALAM
I (597-B), RANTI MULYONO
ISOLASI (515-A), PENYAKIT DALAM
06 (522-C)
ZZ088 01-06-50-70 L/0 dr. Arief Gunadi, Sp. A 05/02/2020 05/04/2020 3

09 (201-B) BY NY JUMIATI FITRIANI
ANAK
ZZ088 01-06-50-72 P/0 dr. Arief Gunadi, Sp. A 05/02/2020 05/04/2020 3

09 (201-C) BY NY SELVIANAH
ANAK

III (522-D), WINDRY RIZKY PUTRI
06 (523-A) AMELIA OBSTETRI DAN GINEKOLOGI

I (597-B), VERAMITA
05 (502-B) OBSTETRI DAN GINEKOLOGI

09 (201-D) BY NY WINDRY RIZKY
PUTRI ANAK

RUANG BAYI BY NY VERAMITA
(201-E), ANAK
10 (PERI001-B)

06 (599-A) MONIKA KRISYULIANA
LT005 01-06-50-80 L / 27 dr. Vidhia Umami. Sp.PD 05/03/2020 05/06/2020 4

I (518), DANANG
I (597-D), PENYAKIT DALAM
05 (507-A)

I (597-C), MARYAMI
05 (505-B) PENYAKIT DALAM

I (551-B), WINDA LESTARI
LT005 01-06-50-86 P / 14 dr. Ivan Rifai 05/03/2020 05/05/2020 3
III (599-B), FITRI Sentosa,Sp.OG OBSTETRI DAN
06 (523-B) GINEKOLOGI

III (599-C), SITI JULAEHA
ISOLASI (515-B), OBSTETRI DAN GINEKOLOGI
08 (520)

RUANG BAYI BY NY SITI JULAEHA
(201-E), ANAK
10 (PERI001-C)
09 (201-F) CLAIRE KEZIA BUDIMAN
ANAK

09 (201-G) BY NY FITRI
ANAK
III (522-A), III HONG LIE ING
(523-D), PENYAKIT DALAM
06 (522-D)
III (522-B), WULAN DARI
06 (522-E) PENYAKIT DALAM

III (522-C), SHEREN BILLIAN
06 (522-A) GUNAWAN PENYAKIT DALAM
LT005 01-06-50-96 P/8 dr. Hedy Vidiani, SpA 05/03/2020 05/07/2020 5
III (526-A), NAZWA MAHARANI
06 (526-C) ANAK

06 (606A) NINING SETYOWATI

09 (201-E) BY NY NINING SETYOWATI
ANAK

III (553-A), SITI SUPRIYANTI
LT006 01-04-95-55 L / 68 dr. Budi Irawan, Sp.B-KBD 05/03/2020 05/07/2020 5

04 (605A) SUYOTO
BEDAH
LT005 01-06-50-99 P / 15 dr. Ivan Rifai 05/03/2020 05/06/2020 4
III (599-A), ICU PUTRI INDRIYANI Sentosa,Sp.OG OBSTETRI DAN
(ICU-A), HCU GINEKOLOGI
(HCU-A), HCU
(HCU-A), III
(599-C),
05 (528-B)

RUANG BAYI BY NY PUTRI INDRIYANI
(201-H), ANAK
10 (PERI001-A)

III (553-B), SUSANAH NINGSIH
06 (523-D) OBSTETRI DAN GINEKOLOGI
LT005 01-06-33-23 P / 27 dr. Budi Irawan, Sp.B-KBD 05/04/2020 05/05/2020 2

06 (521-E) DINTANG NAIDA SARI
BEDAH
LT005 01-06-50-21 L/4 dr. Arief Gunadi, Sp. A 05/04/2020 05/08/2020 5
III (526-B), AFNAN ALI RABBANI
06 (526-D) ANAK
I (597-A), RATNA LUTFIANA
05 (527-A) OBSTETRI DAN GINEKOLOGI

III (553-C), ROSMAWATI
ZZ088 01-06-51-17 L/0 dr. Hery Dharmawan, Sp. A 05/04/2020 05/06/2020 3

09 (201-H) BY NY SUSANAH NINGSIH
ANAK

04 (551-A) UMMU HABIBAH

09 (201-I) BY NY RATNA LUTFIANA
ANAK
LT005 01-06-22-92 P / 26 dr. Ivan Rifai 05/04/2020 05/06/2020 3

06 (523-C) CHIKA ANDIKA Sentosa,Sp.OG OBSTETRI DAN
GINEKOLOGI
LT005 01-06-51-21 P / 27 dr. Ivan Rifai 05/04/2020 05/05/2020 2

04 (551-J) IKA NURLELA Sentosa,Sp.OG OBSTETRI DAN
GINEKOLOGI

09 (201-J) BY NY ROSMAWATI
ANAK
LT005 01-06-51-16 L / 60 dr. Mienche Sp.PD 05/04/2020 05/07/2020 4
III (521-C), KAMARUDIN S.M
LT005 01-06-51-30 P / 33 dr. Andre, Sp.S 05/04/2020 05/07/2020 4

06 (522-B) APRIANA
SYARAF

VIP (501), VIP SUKMA BAYU NUGROHO
(619), ANAK
02 (519)
II (528-A), NURSIAH

03 (621) HAMIMAH

III (617-A), SUPARNO
06 (602A) PENYAKIT DALAM

09 (201-K) BY NY CHIKA ANDIKA
ANAK

I (551-B), SULISTYARINI

III (553-D), AYU MELYNA NUR SUSILO

III (553-E), SRI KATINI
LT005 00-00-84-46 L / 16 dr. Arief Gunadi, Sp. A 05/05/2020 05/10/2020 6

III (599-A), DANIEL
06 (526-A) ANAK

III (599-B), TIONG TJUN
06 (521-D) PENYAKIT DALAM

06 (522-C) LIN MOY
BEDAH
ZZ089 01-06-51-43 L / 37 dr. Budi Irawan, Sp.B-KBD 05/05/2020 05/06/2020 2

III (599-D), YATIMAN
07 (ICU-A) BEDAH
09 (201-L) BY NY AYU MELYNA NUR
SUSI ANAK
III (553-C), SITI NIRMA NISYAR
06 (526-B) BEDAH
09 (201-M) BY NY SULISTYARINI
ANAK

06 (599-E) SITI BARIAH

09 (201-A) BY NY SITI SUPRIYANTI
ANAK

III (599-F), FITRIA GUNARTI

III (553-F), PATONI

06 (599-G) ANDI SITI ARI FEBRIYANTI

06 (599-H) HERNI WIJAYANI

PERINATOLOGI BY NY FITRIA GUNARTI
(PERI001-D), ANAK
10 (PERI001-A)

06 (599-D) EFAH FAUZIAH

III (523-B), II SITI FADILA
(503-A), OBSTETRI DAN GINEKOLOGI
06 (523-A)

III (617-B), JUNDIAH BALQIS
09 (201-B) BY NY SITI FADILAH
ANAK

06 (522-D) AIGA SALIM
BEDAH
I (517), SUTINAH BIN MIRSAD
05 (603A) MALA KOMALASARI

III (599-I), RIBUT SEPTIANA BUDI
05 (527-A) ARTO OBSTETRI DAN GINEKOLOGI

III (599-J), SUNDARI

05 (507-B) ADAM SYAH DEWA
BEDAH
09 (201-C) BY NY EFAH FAOZIAH
ANAK

09 (201-N) BY NY MALA KOMALASARI
ANAK
LT005 01-06-51-90 P / 46 dr. Sofie Nurani, M.Biomed, 05/06/2020 05/07/2020 2

06 (599-K) NUR AZIZAH Sp.OG OBSTETRI DAN
GINEKOLOGI

09 (201-D) BY NY SUTINAH
ANAK

III (602B), HO ISA BELLA
06 (606B) OBSTETRI DAN GINEKOLOGI

06 (606A) SAFIRAH AZIZAH

09 (201-E) BY NY SAFIRAH AZIZAH
ANAK
LT005 01-05-35-68 P / 20 dr. Mienche Sp.PD 05/06/2020 05/08/2020 3

III (553-A), DEWI MUDIYATI

09 (201-F) BY NY RIBUT SEPTIANA
BUDI ANAK

10 (PERI001-C) BY NY ASTRINI FAJARWATI
ANAK
III (553-B), ERNI PUSPITASARI

III (599-B), WILLIAM RAFASYA
05 (505-B) PRATAMA ANAK
III (599-L), PRINGGO DWI PURJATI
05 (505-A) ANAK

06 (602D) TASLIM
PENYAKIT DALAM

III (599-G), HCU SITI KOIRIYAH
(HCU-A), OBSTETRI DAN GINEKOLOGI
06 (522-D)

09 (201-O) BY NY SUNDARI
ANAK
LT005 01-05-02-72 P/1 dr. Arief Gunadi, Sp. A 05/06/2020 05/08/2020 3

I (551-C), SHAQEENARAVA NASYWA
04 (501-A) HUMAIRA FARDANI ANAK

09 (201-P) BY NY HO ISA BELLA
ANAK

09 (201-G) BY NY SITI KOIRIYAH
ANAK

06 (606C) DINA WAHYUNI

III (521-C), TEGAR ADI NUGROHO

09 (201-Q) BY NY DINA WAHYUNI
ANAK
LT005 01-06-52-26 P / 26 dr. Ivan Rifai 05/07/2020 05/09/2020 3

III (599-G), RAGIL PUJI RAHAYU Sentosa,Sp.OG OBSTETRI DAN
08 (512-A) GINEKOLOGI

09 (201-R) BY NY RAGIL PUJI RAHAYU
ANAK
LT005 01-06-52-28 P / 38 dr. Andre, Sp.S 05/07/2020 05/08/2020 2

05 (525-A) MUSPIKHATUN
SYARAF
III (553-A), II GOUW NJO DJIH
(508-A), PENYAKIT DALAM
05 (603C)

I (551-A), SARYADI

06 (599-A) RISCA INDRIYANI Sp.OG OBSTETRI DAN
GINEKOLOGI

I (518), INEKE
04 (517) PENYAKIT DALAM

III (523-B), LINDA FITRIANAH Sp.OG OBSTETRI DAN
06 (606D) GINEKOLOGI

III (523-C), SUKIMAH

04 (551-B) UMMU HABIBAH

09 (201-E) BY NY LINDA FITRIANAH
ANAK

06 (553-A) ROHYATUN NUFUS

06 (523-C) TUTI ASIYAH

06 (523-B) AI SUHARYATI Sp.OG OBSTETRI DAN
GINEKOLOGI

06 (523-A) LIDIA EPRILIA Sp.OG OBSTETRI DAN
GINEKOLOGI

06 (553-B) IKA RINA
09 (201-H) BY NY UMMU HABIBAH
ANAK

09 (201-I) BY NY AI SUHARYATI
ANAK

I (518), FUAT HITOBUL IMAM
06 (617-A) EKA MARWANTI
PENYAKIT DALAM
LT005 01-06-48-99 P / 15 dr. Sendi Kurnia, Sp.B 05/08/2020 05/09/2020 2
06 (599-F) LUISAH GISKA MEILANI
BEDAH
06 (526-B) MUHAMMAD FORLAN
FAUZY ANAK
06 (606A) KASROYAH

06 (553-C) WIWIK EKA DEWI

09 (201-A) BY NY IKA RINA
ANAK

PERINATOLOGI BY NY KASROYAH I
(PERI001-D), ANAK
09 (201-A)

10 (PERI001-E) BY NY KASROYAH II
ANAK

RUANG BAYI BAYI NY BASE BANGKALA
(201-B), ANAK
10 (PERI001-B)

06 (599-B) EVA TRIANA

09 (201-B) BY NY TUTI AISYAH
ANAK

09 (201-F) BY NY WIWIK EKA DEWI
ANAK
04 (551-C) HJ HALIJAH
PENYAKIT DALAM
LT005 01-06-52-89 P / 24 dr. Ivan Rifai 05/08/2020 05/11/2020 4

III (553-D), CICIH MARSIDA Sentosa,Sp.OG OBSTETRI DAN

09 (201-J) BY NY EVA TRIANA
ANAK

06 (553-E) DWI UTAMI

I (597-A), ANIK DARYANTI

I (597-B), FITRI PUTRI

06 (606B) MERLIANA Sp.OG OBSTETRI DAN
GINEKOLOGI

06 (523-D) RINI KURNIA

09 (201-K) BY NY CICIH MARSIDI
ANAK

III (599-C), III FITA APRIYANA Sp.OG OBSTETRI DAN
(523-D), GINEKOLOGI
06 (523-C)

04 (551-D) ENDRAWATI
PENYAKIT DALAM
10 (PERI001-F) BY NY MEI SITA
LESTIYANIN ANAK

III (521-E), BY NY DWI UTAMI
09 (201-C) ANAK

09 (201-L) BY NY ANIK DARYANTI
ANAK
04 (501-A) ESTU ERIDYA ATMANTO
ANAK
09 (201-D) BY NY FITA APRIYANA
ANAK

09 (201-M) BY NY FITRI PUTRI
ANAK

III (599-A), LINDA WATI Sp.OG OBSTETRI DAN

III (599-D), III MIRANDA SAFIRA
(526-C), III (526- ANAK
C), III (526-C),
III (526-C), II
(527-A),
06 (526-C)

III (599-E), II MUSLIPAH
06 (522-C)

09 (201-N) BY NY MERLIANA
ANAK
LT005 01-06-53-33 P / 38 dr. Ivan Rifai 05/10/2020 05/12/2020 3

III (553-C), III SUHENI Sentosa,Sp.OG OBSTETRI DAN
(523-C), GINEKOLOGI
06 (523-A)
LT005 01-06-53-34 P / 29 dr. Ivan Rifai 05/10/2020 05/12/2020 3
I (597-C), NENG ILA Sentosa,Sp.OG OBSTETRI DAN

III (523-B), III PIPIH SOPIAH
(599-M), OBSTETRI DAN GINEKOLOGI
06 (523-D)
09 (201-O) BY NY SUHENI
ANAK
LT005 01-06-53-39 P / 41 dr. Ivan Rifai 05/10/2020 05/12/2020 3

II (502-A), NURHAYATI Sentosa,Sp.OG OBSTETRI DAN

II (502-B), ROKIYAH Sp.OG OBSTETRI DAN
RUANG BAYI BY NY NURHAYATI
(201-P), ANAK
10 (PERI001-C)

03 (621) NANI ENI ANDRIYANI
LT005 01-06-53-41 P / 25 dr. Ivan Rifai 05/10/2020 05/13/2020 4

III (599-B), RENI WAHYU NINGSIH Sentosa,Sp.OG OBSTETRI DAN
ISOLASI NON GINEKOLOGI
TEKANAN
NEGATIF
(512-A), ISOLASI
(512-A),
ISOLASI (515-B),
08 (512-A)

09 (201-Q) BY NY NENG ILA
ANAK

06 (606C) PENI

09 (201-P) BY NY PENI
ANAK

III (553-F), DEFI SAPUTRI

III (522-B), WINARTI
06 (606E) RENY FITRIA NINGSIH
LT005 01-06-29-06 P / 29 dr. Ivan Rifai 05/11/2020 05/13/2020 3

III (523-C), FATIMAH Sentosa,Sp.OG OBSTETRI DAN
LT005 01-03-82-49 L/4 dr. Budi Irawan, Sp.B-KBD 05/11/2020 05/12/2020 2

III (599-C), ANDIKA CAHYA HARIRI
06 (526-D) BEDAH
09 (201-R) BY NY ROKIAH
ANAK
III (553-A), ANAH OKTAVIANA Sp.OG OBSTETRI DAN
ISOLASI GINEKOLOGI
TEKANAN
NEGATIF (520-A),
ISOLASI (515-B),
ISOLASI (515-B),
08 (515-B)

09 (201-S) BY NY RENY FITRIA
NINGSIH ANAK
LT005 01-03-63-27 P / 17 dr. Hedy Vidiani, SpA 05/11/2020 05/13/2020 3

06 (526-A) DESTIANTI PUJI LESTARY
ANAK
III (522-D), FITRIANI
RUANG BAYI BY NY ANAH OKTAVIANA
(201-T), ANAK
10 (PERI001-B)

10 (PERI001-G) BY NY RENI WAHYU
NINGSIH ANAK

06 (617-A) ADI DARMADI
PENYAKIT DALAM
LT005 01-06-53-86 L / 50 dr. Susilo, Sp.N 05/11/2020 05/13/2020 3
04 (551-A) HARI MULYANTO
SYARAF

09 (201-U) BY NY FATIMAH
ANAK
LT005 01-06-53-98 L / 16 dr. Hedy Vidiani, SpA 05/11/2020 05/13/2020 3

III (599-D), YOGA FINANDA
06 (526-B) ANAK
III (521-C), IRSAD
RUANG BAYI BY NY PIPIH SOPIAH
(201-V), ANAK
10 (PERI001-K)

10 (PERI001-H) ELANA AIZA AZURA
ANAK
I (597-A), MAYASARI
ISOLASI OBSTETRI DAN GINEKOLOGI
TEKANAN
NEGATIF (515-A),
08 (515-A)
06 (606B) FITRI RAHAYU

III (522-E), III YOPI SANTOSO
(599-J), PENYAKIT DALAM
06 (521-C)
10 (PERI001-I) BY NY MAYASARI
ANAK

04 (597-D) RINI SUBEKTI

06 (606D) ADAH RAHMAWATI Sp.OG OBSTETRI DAN
GINEKOLOGI

08 (512-B) ROMLAH
PENYAKIT DALAM
LT005 01-06-54-38 L / 28 dr. Johny Setio, Sp.OG 05/12/2020 05/13/2020 2
06 (599-A) DEFNI YULIANTI
LT006 01-06-53-99 L / 26 dr. Martin Winardi, Sp.PD 05/12/2020 05/15/2020 4

06 (617-B) RICARDO
PENYAKIT DALAM
LT005 01-05-64-26 P / 31 dr. Martin Winardi, Sp.PD 05/12/2020 05/14/2020 3
III (553-A), MUNAYAH

I (551-B), YENI SUTANTI

RUANG BAYI BY NY FITRI RAHAYU
(201-V), ANAK
PERINATOLOGI
(PERI001-A),
09 (201-J)
09 (201-T) BY NY ADAH
ANAK
05 (603A) CARKEM
PENYAKIT DALAM
06 (606C) HASTUTI
04 (605A) ULFI NURJANAH

RUANG BAYI BY NY YENI SUTANTI
(201-W), ANAK
10 (PERI001-C)

09 (201-V) BY NY ULFI NURJANAH
ANAK

06 (602A) RAHMA DZAKIYA SAKHI
ANAK

06 (602B) SRI AZIZAH SIROJ
LT005 01-05-80-43 P / 35 dr. Ivan Rifai 05/13/2020 05/15/2020 3

II (525-B), II EVA HUDAIPAH Sentosa,Sp.OG OBSTETRI DAN
(505-B), GINEKOLOGI
05 (505-A)
06 (599-B) RAHMAWATI
BEDAH
III (523-A), II SITI KOMALA
(505-B), OBSTETRI DAN GINEKOLOGI
06 (523-A)
05 (603B) IKE TUJANAH
BEDAH
III (599-C), NUR ARIFAH
06 (522-E) BEDAH
06 (599-D) SUKIYAH

III (599-E), LINDAWATI Sp.OG OBSTETRI DAN

I (551-C), SURYANTO

III (599-F), SUSILA SHANTIKA P.W

I (551-F), KOMALA OKTAVIA
ISOLASI (515-A), MARSELA

09 (201-C) BY NY SITI KOMALA
ANAK

III (526-D), III SUPARDI
(521-D), III (599- PENYAKIT DALAM
D),
06 (521-D)

09 (201-D) BY NY EVA HUDAIPAH
ANAK

09 (201-E) BY NY SRI AZIZAH S
ANAK
III (599-G), SITI NUR KOMARIAH

09 (201-F) BY NY SUSILA SHANTIKA
ANAK

06 (608-A) NINA PUSPITA SARI
PENYAKIT DALAM
III (523-D), III KURNIYATI
06 (523-D)
LT005 01-06-54-96 L/6 dr. Hery Dharmawan, Sp. A 05/13/2020 05/18/2020 6

I (597-A), I (501- NAFIZ MIRZA
A), ANAK
02 (501)
III (599-H), MARIA YAKOBA KAPITAN
06 (523-C) OBSTETRI DAN GINEKOLOGI

II (507-A), I SURYATI
(517), OBSTETRI DAN GINEKOLOGI
05 (527-B)

III (553-E), TATA SUMINTA
LT005 01-06-54-97 L / 20 dr. Sendi Kurnia, Sp.B 05/14/2020 05/15/2020 2

II (552-A), MUHAMAD AZIS
05 (508-A) BEDAH
III (599-I), SIGIT RIYANTI
III (523-C), DINDA AMILIA
ISOLASI (512-B), OBSTETRI DAN GINEKOLOGI
08 (512-A)

09 (201-G) BY NY DINDA AMILIA I
ANAK

RUANG BAYI BY NY DINDA AMILIA II
(201-H), ANAK
10 (PERI001-C)
LT005 01-06-55-09 P / 14 dr. Hery Dharmawan, Sp. A 05/14/2020 05/17/2020 4

III (599-J), ZAHRA NAULA AEQILLAH
06 (526-A) ANAK

09 (201-K) BY NY MARIA YAKOBA
ANAK

III (526-B), IIS ISMAWATI

09 (201-L) BY NY MARIA YAKOBA II
ANAK

06 (599-K) HENNY SATRIO

III (599-L), ASDI

09 (201-I) BY NY IIS ISMAWATI
ANAK

I (551-A), KIKI FERNANDO

09 (201-E) BY NY SURYATI
ANAK
LT005 01-06-55-39 L / 10 dr. Hery Dharmawan, Sp. A 05/14/2020 05/17/2020 4

III (521-E), MUHAMMAD YUSUF
06 (526-B) SETIADI ANAK

09 (201-M) BY NY SIGIT RIYANTI
ANAK

06 (526-C) NINA HERLINA

II (505-B), FRANZESKA RANI
II (552-B), TATI Sp.OG OBSTETRI DAN

III (599-M), LALA

I (597-A), SUMAIROH

04 (597-B) LIM KRISTIN AGUSTINA

III (553-G), MUHAMMAD AQIF RAIHAN
06 (526-D) ANAK

06 (599-N) ROHMAH

06 (606A) REKA PATWARI

III (599-A), ANI MULYAWATI

III (599-L), III KHOLIFAH Sp.OG OBSTETRI DAN
(523-A), GINEKOLOGI
08 (512-B)
09 (201-A) BY NY TATI
ANAK

09 (201-B) BY NY FRANZESKA RANI
YULI ANAK

09 (201-H) BY NY LIM KRISTIN
ANAK
05 (525-B) IJUL FIKAR
PENYAKIT DALAM
06 (606A) YONAH

III (599-B), YULI RATNA SARI
LT005 01-02-86-95 P / 26 dr. Ivan Rifai 05/15/2020 05/16/2020 2

06 (599-C) NOVI FATAH HELENA Sentosa,Sp.OG OBSTETRI DAN
GINEKOLOGI
05 (552-A) SEPTIANI DWI CHANDRA

09 (201-C) BY NY YULI RATNA SARI
ANAK

RUANG BAYI BY NY KHOLIFAH
(201-J), ANAK
10 (PERI001-A)
09 (201-F) BY NY LALA
ANAK
LT005 01-06-55-57 P / 39 dr. Ivan Rifai 05/15/2020 05/17/2020 3

04 (551-A) LIZA FAUZIAH Sentosa,Sp.OG OBSTETRI DAN
GINEKOLOGI

09 (201-N) BY NY ANI MULYAWATI
ANAK

09 (201-O) BY NY YONAH
ANAK
I (551-B), JERY ELSA PUTRA
06 (606B) FARIDAH UMAMI

06 (521-C) AGUS SUGIARTO
PENYAKIT DALAM

III (521-A), MUHAMMAD LUTFI FAHMI
06 (521-D) BEDAH
II (507-A), SENDI SETIAWAN

05 (603A) CAHAYA STAR

06 (608-A) KRISTIANI
PENYAKIT DALAM
06 (608-B) CARKEM
PENYAKIT DALAM
10 (PERI001-D) BY NY IKA RINA
ANAK
06 (617-A) IRVAN SETIAWAN
PENYAKIT DALAM

ISOLASI (515-B), RAMLI
ISOLASI (512-A), BEDAH
08 (512-B)
LT005 01-04-99-81 P/1 dr. Hery Dharmawan, Sp. A 05/16/2020 05/18/2020 3

06 (526-C) FIRSA ASHA SABITHA
ANAK
I (597-A), RENDI WIGUNA
LT005 01-06-56-49 P / 15 dr. Hery Dharmawan, Sp. A 05/16/2020 05/20/2020 5

I (551-B), SALFARANI PUTRI
05 (505-B) ANAK

III (521-B), III MUHAMMAD ISKANDAR
(522-A), BEDAH
06 (521-A)
06 (522-A) DAREM
PENYAKIT DALAM
05 (603B) RANDY ANGGARA
PENYAKIT DALAM

04 (501-A) ITA FITRIANA

04 (601A) WARSIH
PENYAKIT DALAM
06 (599-A) INDA SETIANI
LT006 01-01-36-14 P / 65 dr. Hendradi Khumarga, 05/17/2020 05/18/2020 2

06 (602C) REGINA TJHI Sp.OT
BEDAH ORTHOPAEDI DAN
TRAUMATOL
III (599-B), III SITI SADIYAH
08 (520-A)

06 (599-D) ISLAMIA NADIAH
III (599-E), III LASMINI
(526-C), OBSTETRI DAN GINEKOLOGI
06 (523-A)

III (599-F), EKA SURYANI

09 (201-J) BY NY SITI SADIYAH
ANAK

III (602D), I ASNIAH BT ASRA Sp.OG OBSTETRI DAN
(601B), GINEKOLOGI
II (603C),
04 (601B)
III (599-G), NUR ANISAH

III (553-A), RAITI

RUANG BAYI BY NY ITA FITRIANA
(201-P), ANAK
10 (PERI001-H)

III (553-A), III SITI AMINAH
(522-B), III (523- PENYAKIT DALAM
C),
06 (522-A)

III (599-B), III SRI WATI Sp.OG OBSTETRI DAN
(523-B), GINEKOLOGI
06 (553-E)
III (522-A), WINARTI

06 (599-H) NUR ANNISA
BEDAH
III (521-B), IWAN SUGIANTO
06 (526-D) BEDAH
LT005 01-06-56-83 L / 35 dr. Johny Setio, Sp.OG 05/18/2020 05/21/2020 4
III (599-B), YANAH ANDRI

III (553-G), III MARIASIH GIRSANG
(522-E), BEDAH
06 (522-B)
09 (201-I) BY NY LASMINI
ANAK

09 (201-K) BY NY EKA SURYANI
ANAK

III (553-H), HALIMAH Sp.OG OBSTETRI DAN
06 (523-C) GINEKOLOGI

09 (201-L) BY NY NUR ANISAH
ANAK

I (517), AECI
I (551-B), OBSTETRI DAN GINEKOLOGI
04 (501-A)

II (527-A), CARKEM
RUANG BAYI BY NY SRI WATI
(201-M), ANAK
10 (PERI001-C)

06 (608-A) SUMINA
BEDAH
LT005 01-06-57-10 L/2 dr. Hedy Vidiani, SpA 05/18/2020 05/24/2020 7
III (526-B), III MUHAMAD ARKHAN
(553-C), PRATAMA ANAK
06 (526-D)

III (553-I), III JONO
(521-C), BEDAH
06 (521-B)

I (597-A), MAYRIANA LAORE Sp.OG OBSTETRI DAN
04 (517) GINEKOLOGI

RUANG BAYI BY NY ASNIAH
(201-H), ANAK
10 (PERI001-D)

10 (PERI001-B) BY NY ROKIAH
ANAK

06 (599-I) DIAN PRAWITASARI

09 (201-A) BY NY MAYRIANA
ANAK
LT005 01-01-21-48 P / 41 dr. Ivan Rifai 05/18/2020 05/19/2020 2
06 (599-J) ERLINA Sentosa,Sp.OG OBSTETRI DAN
GINEKOLOGI

III (522-C), PENNY
RUANG BAYI BY NY AECI
(201-B), ANAK
10 (PERI001-E)

III (553-A), III INDRI YANI
(602A), OBSTETRI DAN GINEKOLOGI
06 (606C)

III (523-A), III NANI ELGAYANI
06 (522-C)

I (551-A), NAFIZ MIRZA
05 (507-B) ANAK

II (502-A), HJ. KASTURI

III (606A), SUMINA
06 (608-B) BEDAH

09 (201-C) BY NY INDRI YANI
ANAK

06 (606B) MELIA NURJANAH
LT005 01-06-57-64 P / 25 dr. Ivan Rifai 05/19/2020 05/21/2020 3

06 (553-B) TERA ANJELA Sentosa,Sp.OG OBSTETRI DAN
GINEKOLOGI

06 (553-C) BELLA PRISCILLA Sp.OG OBSTETRI DAN
GINEKOLOGI

06 (599-C) ROHENAH

I (597-A), LILI MAESAROH
09 (201-O) BY NY MELIA NURJANAH
ANAK

09 (201-D) BY NY YANAH ANDRI
ANAK
LT005 01-06-57-69 P / 18 dr. Sendi Kurnia, Sp.B 05/19/2020 05/22/2020 4

III (521-C), III VERONICA
(521-E), III (522- BEDAH
C),
06 (522-D)
06 (606A) SUSIYANTI
PENYAKIT DALAM

09 (201-G) BY NY TERA ANJELA
ANAK

III (553-F), NUR ALIANAH

06 (599-J) ALFIN JANNATIN

09 (201-F) BY NY NUR ALIANAH
ANAK

III (599-D), III SUHEMAN
(521-D), BEDAH
04 (517)
LT005 01-06-57-99 L / 12 dr. Hery Dharmawan, Sp. A 05/19/2020 05/22/2020 4

I (551-C), FAJAR SURYAWANSYAH
05 (507-A) ANAK

06 (606C) AYU RAHAYU

I (597-B), AYU UNDARDI

06 (599-K) SUCI MARGAWATI

09 (201-B) BY NY AYU RAHAYU
ANAK
05 (505-A) FITARNIAT NDURU
ANAK
III (599-L), FEBRIAN FALENTINO
06 (526-C) GULTOM ANAK

08 (515-B) ANIS ROSITA
PENYAKIT DALAM
LT006 01-06-58-25 P / 38 dr. Ivan Rifai 05/20/2020 05/20/2020 1
06 (606D) SRI HANDAYANI Sentosa,Sp.OG OBSTETRI DAN
GINEKOLOGI
LT005 01-06-58-26 P / 35 dr. Ivan Rifai 05/20/2020 05/23/2020 4

III (599-L), SITI SAMSIYAH Sentosa,Sp.OG OBSTETRI DAN

06 (599-E) RIKA FEBRIYOLA
ANAK
05 (603A) RANI SASLITA

09 (201-E) BY NY AYU UNDARDI
ANAK

09 (201-H) BY NY SUCI MARGAWATI
ANAK

III (553-D), NOVITA WELING Sp.OG OBSTETRI DAN

09 (201-J) BY NY LILI MAESAROH
ANAK

III (521-C), II SUKARNI SAPITRI
06 (523-D)

06 (602A) ARSAKA LUTFI PIRENDRA
ANAK
09 (201-M) BY NY RANI SASLITA
ANAK
III (521-A), ARMANSYAH
06 (526-C) ANAK
09 (201-P) BY NY NOVITA WELING S
ANAK
LT006 01-05-52-45 P / 25 dr. Ivan Rifai 05/20/2020 05/22/2020 3

06 (606E) ROHAYATI Sentosa,Sp.OG OBSTETRI DAN
GINEKOLOGI

09 (201-Q) BY NY SITI SAMSIYAH
ANAK
LT006 01-06-58-60 L / 81 dr. Susilo, Sp.N 05/20/2020 05/22/2020 3

06 (602D) SANG
SYARAF
III (553-G), HERAWATI

06 (599-F) SALMAH WATI

III (553-J), UMINAH
LT005 01-06-58-62 P / 38 dr. Ivan Rifai 05/20/2020 05/21/2020 2

06 (553-E) SRI SULASTRI Sentosa,Sp.OG OBSTETRI DAN
GINEKOLOGI

I (501-A), PUTRI ANANDA

06 (553-K) RESMADYA PUTRI

06 (606A) RIYAN SUSI

09 (201-R) BY NY ROHAYATI
ANAK

III (599-G), RIYAN SUSI

III (599-M), ZAENAL ARIFIN
06 (521-C) PENYAKIT DALAM
III (599-N), LILY
09 (201-S) BY NY RIYAN SUSI
ANAK
09 (201-T) BY NY SUKARNI
ANAK

09 (201-U) BY NY PUTRI ANANDA
ANAK

03 (621) DJAP SU FUN SANTI

09 (201-A) BY NY RESMADYA PUTRI
ANAK

RUANG BAYI BY NY DJAP SU FON SANTI
(201-B), ANAK
10 (PERI001-C)
08 (512-A) SITI ANISA
ANAK

III (553-A), ITA FATMASARI

III (599-I), YUSUP BUDIYANTO

06 (522-E) DIAH TRI UTARININGSIH

06 (523-A) RATNAWATI

III (523-B), RIKA RIYANTI

III (523-C), SUCI MEILIANA Sp.OG OBSTETRI DAN

III (523-D), YANTI WAHYUNI

II (502-A), ELNINO MUBARAK
05 (503-B) ANAK
LT005 01-05-89-40 P/4 dr. Hedy Vidiani, SpA 05/22/2020 6
III (599-J), ARUNA SACHI KAYANA
06 (526-A) ANAK
III (521-B), MUHAMMAD DAVID ISMAIL

III (553-J), KAMSIYATUN
09 (201-C) BY NY ITA PATMASARI
ANAK

09 (201-F) BY NY RATNA WATI
ANAK

10 (PERI001-F) BY NY SUCI MEILIANA
ANAK

06 (606F) FATRASA CHAIRONA

06 (553-D) EDDY ANDRIYADHI
PENYAKIT DALAM
09 (201-I) BY NY DIAH TRI
UTARININGSIH ANAK

09 (201-D) BY NY RIKA RIYANTI
ANAK

09 (201-G) BY NY YANTI WAHYUNI
ANAK

III (553-H), YOSUA IMANUELL
06 (526-B) ANAK
10 (PERI001-G) BY NY LIM KRISTIN
ANAK

I (551-A), RIZKY AFFANDI

II (510-B), SITI ASMAH

06 (599-A) MUTIA NISA ALFATEHAH Sp.OG OBSTETRI DAN
GINEKOLOGI
09 (201-A) BY NY SITI ASMAH
ANAK
LT005 01-02-70-36 P/3 dr. Hedy Vidiani, SpA 05/23/2020 5
III (553-J), CHARISSA KATHLEEN
05 (505-B) ANAK

04 (501-A) UNUN KHUSNUL KHOTIMA

III (523-B), WAHYUNI

09 (201-E) BY NY UNUN KHUSNUL
ANAK

III (523-C), SRI NURHAYATI MUSTIKA

09 (201-H) BY NY SRI NURHAYATI
MUSTIKA ANAK

09 (201-J) BY NY WAHYUNI
ANAK

06 (602A) MARTIN ARDIONO
ANAK
LT005 01-06-42-33 P / 45 dr. Andre, Sp.S 05/24/2020 05/25/2020 2
06 (522-A) SUJATMI
SYARAF

II (527-B), MEGAWATI

III (523-A), MARIANIE GUNAWAN
06 (523-C) OBSTETRI DAN GINEKOLOGI

09 (201-K) BY NY MEGAWATI
ANAK
ZZ086 01-06-59-67 L/0 dr. Hedy Vidiani, SpA 05/24/2020 4

RUANG BAYI BY NY MARIANIE
(201-L), GUNAWAN ANAK
10 (PERI001-B)
02 (619) MEILI HUINI
09 (201-M) BY NY MEILINI HUINI
ANAK
LT005 01-02-53-30 L/2 dr. Arief Gunadi, Sp. A 05/25/2020 3
III (526-B), II GHAILAN SHAKEIL
(510-A), II (510- FATURAHMAN ANAK
B),
05 (510-B)
LT005 01-06-57-98 P / 35 dr. Johny Setio, Sp.OG 05/25/2020 3
II (502-A), IIN PARLINA
LT006 01-06-59-79 P / 23 dr. Vidhia Umami. Sp.PD 05/25/2020 3

06 (602E) IIS
PENYAKIT DALAM
LT005 01-01-24-87 P / 56 dr. Susilo, Sp.N 05/25/2020 3
III (553-A), HARNENGSIH
08 (512-B) SYARAF

04 (501-A) WIWI RUSMINI Sp.OG OBSTETRI DAN
GINEKOLOGI
LT005 00-00-41-92 P / 77 dr. Martin Winardi, Sp.PD 05/26/2020 2

I (551-A), ELIANA GUNAWAN
LT005 01-06-59-84 P / 14 dr. Arief Gunadi, Sp. A 05/26/2020 2
06 (553-B) RIFA NAILA SILMI
ANAK

06 (599-A) RATNA SARI JUWITA

06 (553-D) SRI NURHAYATI
LT005 01-06-57-78 L / 51 dr. Mienche Sp.PD 05/26/2020 2

III (521-B), SIDAMULYA
ZZ088 01-06-59-99 P/0 dr. Hedy Vidiani, SpA 05/26/2020 2

09 (201-B) BY NY SRI NURHAYATI
ANAK
LT006 01-06-59-91 L / 48 dr. Budi Irawan, Sp.B-KBD 05/26/2020 2
03 (621) AMAD
BEDAH
06 (523-A) YULIANA MUET
ZZ086 01-06-60-00 L/0 dr. Hedy Vidiani, SpA 05/26/2020 2

RUANG BAYI BY NY RATNA SARI JUWITA
(201-C), ANAK
10 (PERI001-C)

04 (501-A) PRIHATINA WIJAYANTI

06 (523-B) VIVI DESTIA SEPTI
LT005 01-03-41-03 P / 27 dr. Mienche Sp.PD 05/26/2020 2
06 (523-D) TRI WINDAHTARI
PENYAKIT DALAM
III (526-B), MARITA
ZZ088 01-06-60-10 P/0 dr. Arief Gunadi, Sp. A 05/26/2020 2

09 (201-D) BY NY IIN PARLINA
ANAK
LT005 01-06-27-71 L / 64 dr. Sendi Kurnia, Sp.B 05/26/2020 2
III (521-A), TOMMY LIMANJAYA LIM
06 (521-E) BEDAH
06 (526-B) NURAINI
ZZ088 01-06-60-13 P/0 dr. Arief Gunadi, Sp. A 05/26/2020 2

09 (201-I) BY NY MARITA
ANAK
06 (526-C) RUKINI

II (525-A), II TJO EDDY BUDIMAN
(525-B), BEDAH
05 (527-A)
LT005 01-06-59-59 L/1 dr. Hedy Vidiani, SpA 05/26/2020 2

06 (526-D) MARTIN ARDIONO
ANAK
ZZ089 01-06-60-17 L / 57 dr. Susilo, Sp.N 05/26/2020 2
III (521-C), JUJUK BODIYO
07 (ICU-A) SYARAF
LT005 01-06-59-71 L / 49 dr. Martin Winardi, Sp.PD 05/26/2020 2

III (521-D), ATOK VIRMANTO
ZZ088 01-06-60-21 L/0 dr. Arief Gunadi, Sp. A 05/26/2020 2
09 (201-F) BY NY NURAINI
ANAK
LT005 01-06-60-04 P / 13 dr. Arief Gunadi, Sp. A 05/26/2020 2
06 (523-C) FITRIA OCTAVIANI
ANAK

06 (599-B) NURUL AINI WIDYASTUTI
ZZ088 01-06-60-24 L/0 dr. Arief Gunadi, Sp. A 05/26/2020 2

09 (201-G) BY NY PRIHATINA
WIJAYANTI ANAK
08 (515-A) KIM SAN
BEDAH
06 (599-C) SAHRONAH
LT005 01-01-78-67 P / 39 dr. Martin Winardi, Sp.PD 05/27/2020 1

05 (552-A) ATIKA MURNI
PENYAKIT DALAM
Acute hep. B without
delta-agent&wit
hout hepc coma (B16.9,
037, LAMA)
Gestat.
[preg.-ind.]hypert
without sig.proteinuria
(O13, 237.9, LAMA)
demam/Fever,
unspecified -
Hyperpyrexia
NOS-Pyrexia NOS
(R50.9, 268, LAMA)
Single spontaneous
delivery
(O80, 243, LAMA)
Diabetes Melitus tidak

tergantung insulin
(E11,
104.1, LAMA)
Maternal care for
disproportion,
unspecified (O33.9,
239.9, LAMA)
Single delivery by
caesarean section (O82,
242.9, LAMA)
Single delivery by
242.9, LAMA)
Placenta praevia (O44,

238.0, LAMA), Delivery
by emergency
caesarean section
(O82.1, 242.9, LAMA),
Single live birth
(Z37.0, 298, LAMA)
Other neonatal
aspiration syndromes
(P24.8, 249, LAMA)
Other neonatal
(P24.8, 249, LAMA)
Single delivery by
242.9, LAMA)
DHF / DBD
(A91, 032.1, LAMA)
Congenital pneumonia
(P23, 249, LAMA)
Fetus and newborn

affected by caesarean
delivery (P03.4, 245,
LAMA)
Other neonatal
(P24.8, 249, LAMA)
Single delivery by
242.9, LAMA)
Single delivery by
242.9, LAMA)
Other neonatal
(P24.8, 249, LAMA)
Fetus and newborn

LAMA)
Anaemia comp.
preg.,childbirth
& the puerperium
(O99.0, 244, LAMA)
Paralytic ileus
(K56.0, 190, LAMA)

tergantung insulin
(E11,
104.1, LAMA)
Gestat.
[preg.-ind.]hypert
(O13, 237.9, LAMA)
Severe
pre-eclampsia (O14.1,
by emergency
caesarean section
(O82.1, 242.9, LAMA),
Single live birth (Z37.0,
298, LAMA), Anaemia
comp. preg.,childbirth
& the puerperium
(O99.0, 244, LAMA)
Anaemia comp.
preg.,childbirth
& the puerperium
(O99.0, 244, LAMA)
Fetus and newborn

LAMA)
Fetus and newborn
LAMA)
DHF / DBD
(A91, 032.1, LAMA)
Ge/Diare (A09.9,
005, LAMA)
Single spontaneous
delivery
(O80, 243, LAMA)
Fetus and newborn

LAMA)
Mild hyperemesis
gravidarum (O21.0,
242.9, LAMA)
Connective & other

soft tissue of head,
face&neck (D21.0,
096.6, LAMA)
Prolonged first stage
(of labour) (O63.0,
242.9, LAMA)
Fetus and newborn

LAMA)
Gestat.
[preg.-ind.]hypert
(O13, 237.9, LAMA)
Other benign neoplasms

of skin (d23, 090,
LAMA)
Dengue fever [classical
dengue] (A90, 032.0,
LAMA)
Delivery by caesarean
section, unspecified
(O82.9, 242.9, LAMA)
(O82.9, 242.9, LAMA)
Fetus and newborn

LAMA)
Fetus and newborn

LAMA)
(O82.9, 242.9, LAMA)
Blighted ovum and

nonhydatidiform
mole (O02.0,
236.9, LAMA)
Fetus and newborn
LAMA)
tergantung insulin
(E11,
104.1, LAMA)
Stroke, not specified as
haemorrhage or
infarction (I64, 155,
LAMA)
Ge/Diare (A09.9,
005, LAMA)
Gestat.
[preg.-ind.]hypert
(O13, 237.9, LAMA)
Unspecified abortion
[See above for
subdivisions] (O06,
236.9, LAMA)
Follow-up exam.after
radiothera.for other
conditi. (Z09.1,
290.9, LAMA)
Fetus and newborn

LAMA)
Fetus and newborn

LAMA)
Maternal care for
disproportion,
unspecified (O33.9,
239.9, LAMA)
Gestat.
[preg.-ind.]hypert
(O13, 237.9, LAMA)
Hypokalaemia
(E87.6, 111, LAMA)
Larynx - Epiglottis
(suprahyoid portion)
(D14.1, 096.4, LAMA)

tergantung insulin
(E11,
104.1, BARU)
Liver, unspecified
(C22.9, 063, LAMA)
Fetus and newborn

LAMA)
Acute appendicitis
(K35, 186, LAMA)
Fetus and newborn

LAMA)
Anaemia comp.
preg.,childbirth
& the puerperium
(O99.0, 244, LAMA)
Fetus and newborn

LAMA)
Mild hyperemesis
gravidarum (O21.0,
242.9, LAMA)

tergantung insulin
(E11,
104.1, LAMA)
[See above for
subdivisions] (O06,
236.9, LAMA)
Other anaemias
(D64, 098, LAMA)
Fetus and newborn

LAMA)
Single delivery by
242.9, LAMA)
Postpartum care and

examination
(Z39, 296, LAMA), Fetus
and newborn affected
by caesarean delivery
(P03.4, 245, LAMA)
DHF / DBD
(A91, 032.1, LAMA)
Fetus and newborn

LAMA)
Abdominal and pelvic
pain
(R10, 267, LAMA)
Single delivery by
242.9, LAMA)
Single delivery by
242.9, LAMA)
Single delivery by
242.9, LAMA)
Single delivery by
242.9, LAMA)
Lymph nodes (D36.0,

096.6, LAMA)
Fetus and newborn

LAMA)
Fetus and newborn
LAMA)
Mild hyperemesis
gravidarum (O21.0,
242.9, LAMA)
Fetus and newborn

LAMA)
Single delivery by
242.9, LAMA)
Mild hyperemesis
gravidarum (O21.0,
242.9, LAMA),
Fetus and newborn
affected by
caesarean delivery
(P03.4, 245, LAMA)
Fetus and newborn

LAMA)
Nausea and vomiting
(R11, 270.9, LAMA)
Fetus and newborn

LAMA)
Neonatal jaundice from
other specified causes
(P59.8,
253.9, LAMA)
DHF / DBD
(A91, 032.1, LAMA)
Nausea and vomiting

(R11, 270.9, LAMA)
DHF / DBD
(A91, 032.1, LAMA)
Congestive heart failure-

Congestive heart
disease (I50.0, 151,
LAMA)
Single delivery by
242.9, LAMA)
Fetus and newborn

LAMA)
demam/Fever,
unspecified -
Hyperpyrexia
NOS-Pyrexia NOS
(R50.9, 268, LAMA)
Fetus and newborn
LAMA)
Other neonatal
(P24.8, 249, LAMA)
Single delivery by
242.9, LAMA)
DHF / DBD
(A91, 032.1, LAMA)
Fetus and newborn

LAMA)
Single delivery by
242.9, LAMA)
Fetus and newborn

LAMA)
Vertigo
NOS-Dizziness
&
giddiness-Light-head
edness (R42, 270.9,
LAMA)
Congestive heart
LAMA)
Maternal care for
intrauterine death
(O36.4, 239.9, LAMA)
Typhoid fever - Infection

due to Salmonella typhi
(A01.0, 002, LAMA)
Anaemia, unspecified
(D64.9, 098, LAMA),
Dyspepsia - Indigestion
(K30, 189.9, LAMA)
Maternal care for

disproportion,
unspecified (O33.9,
239.9, LAMA)
Fetus and newborn

LAMA)
Gestat.
[preg.-ind.]hypert
(O13, 237.9, LAMA)
Anaemia comp.
preg.,childbirth
& the puerperium
(O99.0, 244, LAMA)
M.care for disp.due to

deform.of mat.pelvic
bones (O33.0, 239.9,
LAMA)
Maternal care for

intrauterine death
(O36.4, 239.9, LAMA)
Anaemia comp.
preg.,childbirth
& the puerperium
(O99.0, 244, LAMA)
Fetus and newborn
LAMA)
Fetus and newborn
LAMA)
(K30, 189.9, LAMA)

dengue] (A90, 032.0,
LAMA)
Maternal care for

disproportion,
unspecified (O33.9,
239.9, LAMA)
Fetus and newborn

LAMA)
Fetus and newborn
LAMA)
Fetus and newborn

LAMA)
Physiological jaundice
(intense) (prolonged)
NOS (P59.9, 253.9,
LAMA)
Other
mater.dis.class.but
comp.preg.,childbirt h
(O99, 244, LAMA)
Fetus and newborn

LAMA)
Fetus and newborn
LAMA)
Stroke, not specified as
haemorrhage or
infarction (I64, 155,
LAMA)
Anaemia comp.
preg.,childbirth
& the puerperium
(O99.0, 244, LAMA)
Fetus and newborn

LAMA)
(of labour) (O63.0,
242.9, LAMA)
Gestat.
[preg.-ind.]hypert
(O13, 237.9, LAMA)
Gestat.
[preg.-ind.]hypert
(O13, 237.9, LAMA)
Gestat.
[preg.-ind.]hypert
(O13, 237.9, LAMA)
(D64.9, 098, LAMA)
Fetus and newborn

LAMA)
Anaemia comp.
preg.,childbirth
& the puerperium
(O99.0, 244, LAMA)
(K30, 189.9, LAMA)
Fetus and newborn

LAMA)
Fetus and newborn
LAMA)
Fetus and newborn

LAMA)
Febrile convulsions
(R56.0, 270.3, LAMA)
Fetus and newborn

LAMA)
Fetus and newborn
LAMA)
Hyperemesis gravidarum
with metabolic
disturbance (O21.1,
242.9, LAMA)
DHF / DBD
(A91, 032.1, LAMA)
demam/Fever,
unspecified -
Hyperpyrexia
NOS-Pyrexia NOS
(R50.9, 268, LAMA)
Fetus and newborn
LAMA)

(of labour) (O63.0,
242.9, LAMA)
Prem.rupt.of
membranes,onset of
lab.after 24 hours
(O42.1, 239.2, LAMA)
Prolonged second stage

(of labour) (O63.1,
242.9, LAMA)
Fetus and newborn

LAMA)
(of labour) (O63.0,
242.9, LAMA)
Gestat.
[preg.-ind.]hypert
(O13, 237.9, LAMA)
Fetus and newborn
LAMA)
Other and unspecified

ovarian cysts
(N83.2, 229, LAMA)

(of labour) (O63.0,
242.9, LAMA)
Fetus and newborn

LAMA)
(of labour) (O63.0,
242.9, LAMA)
Fetus and newborn

LAMA)
Hepatitis virus akut
lainnya
(B17, , LAMA)

(of labour) (O63.0,
242.9, LAMA)
(O82.9, 242.9, LAMA)
Lymph nodes (D36.0,

096.6, LAMA)
Fetus and newborn

LAMA)
Fetus and newborn
LAMA)
Neonatal aspiration
syndrome, unspecified
(P24.9, 249, LAMA)
Other neonatal
(P24.8, 249, LAMA)
DHF / DBD
(A91, 032.1, LAMA)

tergantung insulin
(E11,
104.1, LAMA)
Fetus and newborn
LAMA)
DHF / DBD
(A91, 032.1, LAMA)
Constipation (K59.0,
192.9, LAMA)
Hypoglycaemia,
unspecified
(E16.2, 111, LAMA)
DHF / DBD
(a91, 032.1, LAMA)
Premature rupture of
membranes
(O42, 239.2, LAMA)
Prolonged second stage
(of labour) (O63.1,
242.9, LAMA)
(K30, 189.9, LAMA)
Transient tachypnoea of
newborn
(P22.1, 249, LAMA)
Supervision of normal
pregnancy, unspecified
(Z34.9, 294.0, LAMA)
DHF / DBD
(a91, 032.1, LAMA)
Gastrooesophageal
reflux dis. without
oesophagitis (K21.9,
185.9, LAMA)
Severe
237.0, LAMA)
Fetus and newborn

LAMA)
Chronic renal failure

(N18, 214.9, LAMA)
Prem.rupt.of
membran,onset of
lab.within 24 hours
(O42.0, 239.2, LAMA)
Fetus and newborn

LAMA)
demam/Fever,
unspecified -
Hyperpyrexia
NOS-Pyrexia NOS
(R50.9, 268, LAMA)
membranes
(O42, 239.2, LAMA)
membranes
(O42, 239.2, LAMA)
Neoplasma jinak
payudara
(D24, 091, LAMA)
Other diseases of anus

and rectum (k62, 192.9,
LAMA)
Acute appendicitis
(K35, 186, LAMA)
Blighted ovum and

nonhydatidiform
mole (O02.0,
236.9, LAMA)
Anaemia comp.
preg.,childbirth
& the puerperium
(O99.0, 244, LAMA)
DHF / DBD
(A91, 032.1, LAMA)
DHF / DBD
(A91, 032.1, LAMA)
Fetus and newborn

LAMA)
Abdominal and pelvic
pain
(R10, 267, LAMA)
Fetus and newborn

LAMA)
Anaemia comp.
preg.,childbirth
& the puerperium
(O99.0, 244, LAMA)
Fetus and newborn

LAMA)
Ge/Diare (A09.9,
005, LAMA)
DHF / DBD
(A91, 032.1, LAMA)
Single delivery by
242.9, LAMA)
Single delivery by
242.9, LAMA)
DHF / DBD
(A91, 032.1, LAMA)
Other headache
syndromes
(G44, 125, LAMA)
Single delivery by
242.9, LAMA)
Single delivery by
242.9, LAMA)
Other neonatal
(P24.8, 249, LAMA)
Other neonatal
(P24.8, 249, LAMA)
DHF / DBD
(a91, 032.1, LAMA)
Neonatal aspiration
(P24.9, 249, LAMA)
Single delivery by
242.9, LAMA)
Other neonatal
(P24.8, 249, LAMA)

tergantung insulin
(E11,
104.1, LAMA)
Other neonatal
(P24.8, 249, LAMA)
Atherosclerotic
cardiovascular diseas,so
describ. (I25.0, 148,
LAMA)
Other neonatal
(P24.8, 249, LAMA)

(a01.0, 002, LAMA)
Single delivery by
caesarean section (o82,
242.9, LAMA)
Single delivery by
242.9, LAMA)
Single delivery by
242.9, LAMA)
Single delivery by
242.9, LAMA)
DHF / DBD
(a91, 032.1, LAMA)
Anaemia comp.
preg.,childbirth
& the puerperium
(O99.0, 244, LAMA)
Single delivery by
242.9, LAMA)
Fetus and newborn

LAMA)
Other neonatal
(p24.8, 249, LAMA)
(Z34.9, 294.0, LAMA)
Single delivery by
242.9, LAMA)
(Z34.9, 294.0, LAMA)
Other neonatal
(p24.8, 249, LAMA)
Respiratory distress
syndrome of newborn
(P22.0, 249, LAMA)
Fetus and newborn

LAMA)
(z34.9, 294.0, LAMA)
Fetus and newborn

LAMA)
Gastritis, unspecified
(k29.7, 185.9, LAMA)
(D64.9, 098, LAMA)

tergantung insulin
(E11,
104.1, LAMA)
Acute appendicitis
(K35, 186, LAMA)
(D64.9, 098, LAMA)
Gestat.
[preg.-ind.]hypert
(O13, 237.9, LAMA)
Physiological jaundice
NOS (P59.9, 253.9,
LAMA)
HIV disease resulting in
infec.&parasitic
diseases (B20, 039,
LAMA)
Ge/Diare (A09.9,
005, LAMA)
DHF / DBD
(A91, 032.1, LAMA)
DHF / DBD
(A91, 032.1, LAMA)
Unspecified renal colic

(N23, 215, LAMA)
(K30, 189.9, LAMA)
demam/Fever,
unspecified -
Hyperpyrexia
NOS-Pyrexia NOS
(R50.9, 268, LAMA)
Anaemia comp.
preg.,childbirth
& the puerperium
(O99.0, 244, LAMA)
DHF / DBD
(A91, 032.1, LAMA)
[See above for
subdivisions] (O06,
236.9, LAMA)
membranes
(O42, 239.2, LAMA)
[See above for
subdivisions] (O06,
236.9, LAMA)
(O82.9, 242.9, LAMA)
Delivery by elective
caesarean section
(O82.0, 242.9, LAMA)
Fetus and newborn

LAMA)
Single delivery by
242.9, LAMA)
(O82.9, 242.9, LAMA)
Tuberculosis of lung,
bacteri.& his.
examination not
done (A16.1, 007.1,
LAMA)
Fetus and newborn
LAMA)

tergantung insulin
(E11,
104.1, BARU)
Oligohydramnios
(O41.0, 239.9, LAMA)
Lymph nodes (D36.0,

096.6, LAMA)
Lymph nodes (D36.0,

096.6, LAMA)
Connective & other

face&neck (D21.0,
096.6, LAMA)
Fetus and newborn
LAMA)
Fetus and newborn
LAMA)
Maternal care for breech
presentation (O32.1,
239.9, LAMA)
Fetus and newborn

LAMA)
(O82.9, 242.9, LAMA)
Fetus and newborn

LAMA)
Hypovolaemic shock
(R57.1, 270.9, LAMA)
Inguinal hernia
(K40, 187, LAMA)
membranes
(O42, 239.2, LAMA)
Fetus and newborn

LAMA)
Neonatal jaundice
associated with preterm
delivery (P59.0, 253.9,
LAMA)
Fetus and newborn

LAMA)
Blighted ovum and
nonhydatidiform
mole (O02.0,
236.9, LAMA)
Fetus and newborn

LAMA)
membranes
(O42, 239.2, LAMA)
demam/Fever,
unspecified -
Hyperpyrexia
NOS-Pyrexia NOS
(R50.9, 268, LAMA)
tergantung insulin
(E11,
104.1, BARU)
Anal abscess - Perianal

abscess (K61.0, 192.9,
LAMA)
Fetus and newborn

LAMA)
Anaemia comp.
preg.,childbirth
& the puerperium
(O99.0, 244, LAMA)
Maternal care for

disproportion,
unspecified (O33.9,
239.9, LAMA)
Gestat.
[preg.-ind.]hypert with
sig. proteinuria (O14,
237.0, LAMA)
Fetus and newborn
LAMA)
Fetus and newborn
LAMA)
Acute appendicitis
(K35, 186, LAMA)

(A01.0, 002, LAMA)
Fetus and newborn

LAMA)
M.care for disp.due to
bones (O33.0, 239.9,
LAMA)
Fetus and newborn

LAMA)
Ispa/Acute upper
respiratory infection,
unspecified (J06.9,
167, LAMA)
membranes
(O42, 239.2, LAMA)
(O82.9, 242.9, LAMA)
(O82.9, 242.9, LAMA)
DHF / DBD
(A91, 032.1, LAMA)
Ge/Diare (A09.9,
005, LAMA)
membranes
(O42, 239.2, LAMA)
membranes
(O42, 239.2, LAMA)
Fetus and newborn

LAMA)
Fetus and newborn
LAMA)
(O82.9, 242.9, LAMA)
Fetus and newborn

LAMA)
Pre-eclampsia,
unspecified (O14.9,
237.0, LAMA)
Other
symptoms&sign s
involv.the
digestive ........ (R19,
270.9, LAMA)
Fetus and newborn
LAMA)
Anaemia comp.
preg.,childbirth
& the puerperium
(O99.0, 244, LAMA)
Fetus and newborn

LAMA)
Cerebral infarction
(I63, 154, LAMA)
Chronic renal failure,

unspecified
(N18.9, 214.9, BARU)
Ectopic pregnancy
(O00, 236.0, LAMA)

Congestive heart
BARU)
Anaemia comp.
preg.,childbirth
& the puerperium
(O99.0, 244, LAMA)
membranes
(O42, 239.2, LAMA)
membranes
(O42, 239.2, LAMA)

(of labour) (O63.0,
242.9, LAMA)
Fetus and newborn

LAMA)
Ge/Diare (A09.9,
005, LAMA)
dengue] (A90, 032.0,
LAMA)
Fetus and newborn

LAMA)
Fetus and newborn
LAMA)
(of labour) (O63.0,
242.9, LAMA)
Fetus and newborn

LAMA)
Fetus and newborn

LAMA)
Maternal care for
intrauterine death
(O36.4, 239.9, LAMA)
M.care for dispr.due to

unusually large fetus
(O33.5,
239.9, LAMA)
Urinary tract infection,
site not specified
(N39.0, 217, LAMA)
membranes
(O42, 239.2, LAMA)
Pre-eclampsia,
unspecified (O14.9,
237.0, LAMA)
Foreign body in
respiratory tract,part
unspecified (T17.9,
282.9, LAMA)
(K30, 189.9, LAMA)
Fetus and newborn

LAMA)
Other neonatal
(P24.8, 249, LAMA)
Other neonatal
(P24.8, 249, LAMA)
(Z34.9, 294.0, LAMA)
Fetus and newborn

LAMA)
Fetus and newborn
LAMA)
Fetus and newborn

LAMA)
Viral infection,
unspecified
(B34.9, 041, LAMA)
Neonatal jaundice
delivery (P59.0, 253.9,
LAMA)
Gestat.
[preg.-ind.]hypert
(O13, 237.9, LAMA)
Gestat.
[preg.-ind.]hypert
(O13, 237.9, LAMA)
Fetus and newborn

LAMA)
Anaemia comp.
preg.,childbirth
& the puerperium
(O99.0, 244, LAMA)
Fetus and newborn

LAMA)
Fetus and newborn
LAMA)
Vertigo
NOS-Dizziness
&
edness (R42, 270.9,
LAMA)
Maternal care for
disproportion,
unspecified (O33.9,
239.9, LAMA)
Gestat.
[preg.-ind.]hypert
(O13, 237.9, LAMA)
No Tgl Jenis No Reg No RM Nama JK/ Umur
Tgl Keluar Ruang Rawat
Kunjungan Kunj. Kelas
1 05/01/2020 Baru RI20200501-0001 01-06-50-41 L / 32 05/06/2020 LT005

ARIF PRATAMA III (522-A),
06 (521-A)
2 05/01/2020 Baru RI20200501-0002 01-06-50-42 P/0 05/02/2020 ZZ088

BAYI NY BASE BANGKALA 09 (201-O)
3 05/01/2020 Baru RI20200501-0003 01-06-48-95 P / 28 05/02/2020 LT005

RENITA 06 (599-O)
4 05/01/2020 Baru RI20200501-0004 01-06-50-48 L / 20 05/05/2020 LT005

LUTFI AZHAR I (551-A),
04 (501-A)
5 05/01/2020 Baru RI20200501-0005 01-05-49-71 P / 25 05/02/2020 LT006

KAMSATUN 06 (602E)
6 05/01/2020 Baru RI20200501-0006 01-06-50-49 L / 56 05/02/2020 LT005

CASLADI 06 (522-B)
7 05/01/2020 Baru RI20200501-0007 01-06-50-53 P / 49 05/02/2020 LT005

RATI 06 (522-E)
8 05/02/2020 Baru RI20200502-0001 01-06-50-44 P / 42 05/03/2020 LT005

SITI MAESAROH 04 (597-A)
9 05/02/2020 Baru RI20200502-0002 01-06-49-84 P / 25 05/04/2020 LT005

MEI SITA LESTIYANING I (551-A),
DYAH 05 (527-A)

10 05/02/2020 Baru RI20200502-0003 01-06-50-57 P / 39 05/04/2020 LT005

TRISWATI I (551-B),
04 (518)
11 05/02/2020 Baru RI20200502-0004 01-06-50-58 P / 27 05/04/2020 LT006

JUMIATI FITRIANI 06 (606D)
12 05/02/2020 Baru RI20200502-0005 01-06-50-63 P/0 05/04/2020 ZZ088

BY NY MEI SITA 09 (201-P)
LESTIYANIN
13 05/02/2020 Baru RI20200502-0007 01-06-50-64 L/0 05/04/2020 ZZ088

BY NY TRISWATI 09 (201-A)
14 05/02/2020 Baru RI20200502-0008 01-06-50-68 P / 19 05/04/2020 LT005
SELVIANAH I (551-C),
04 (517)
15 05/02/2020 Baru RI20200502-0009 01-06-50-65 P / 19 05/06/2020 LT006

LISTI MUAIMAH 06 (602A)
16 05/02/2020 Baru RI20200502-0010 01-03-89-38 P / 55 05/08/2020 LT005

RANTI MULYONO I (597-B),
ISOLASI (515-A),
06 (522-C)
17 05/02/2020 Baru RI20200502-0011 01-06-50-70 L/0 05/04/2020 ZZ088

BY NY JUMIATI FITRIANI 09 (201-B)

18 05/02/2020 Baru RI20200502-0012 01-06-50-72 P/0 05/04/2020 ZZ088

BY NY SELVIANAH 09 (201-C)
19 05/02/2020 Baru RI20200502-0013 01-06-50-73 P / 24 05/04/2020 LT005

WINDRY RIZKY PUTRI III (522-D),
AMELIA 06 (523-A)
20 05/02/2020 Lama RI20200502-0014 01-02-13-18 P / 21 05/04/2020 LT005

VERAMITA I (597-B),
05 (502-B)
21 05/02/2020 Baru RI20200502-0015 01-06-50-74 P/0 05/04/2020 ZZ088

BY NY WINDRY RIZKY 09 (201-D)
PUTRI
22 05/02/2020 Baru RI20200502-0016 01-06-50-78 L/0 05/06/2020 ZZ086

BY NY VERAMITA RUANG BAYI
(201-E),
10 (PERI001-B)
23 05/02/2020 Baru RI20200502-0017 01-06-50-79 P / 22 05/03/2020 LT005

MONIKA KRISYULIANA 06 (599-A)
24 05/03/2020 Baru RI20200503-0001 01-06-50-80 L / 27 05/06/2020 LT005

DANANG I (518),
I (597-D),
05 (507-A)
25 05/03/2020 Baru RI20200503-0002 01-06-50-82 P / 53 05/06/2020 LT005

MARYAMI I (597-C),
05 (505-B)
26 05/03/2020 Baru RI20200503-0003 01-06-50-85 P / 28 05/05/2020 LT005

WINDA LESTARI I (551-B),
05 (527-B)
27 05/03/2020 Baru RI20200503-0004 01-06-50-86 P / 14 05/05/2020 LT005

FITRI III (599-B),
06 (523-B)
28 05/03/2020 Baru RI20200503-0005 01-06-50-87 P / 29 05/05/2020 LT005

SITI JULAEHA III (599-C),
ISOLASI (515-B),
08 (520)
29 05/03/2020 Baru RI20200503-0006 01-06-50-89 L/0 05/05/2020 ZZ086

BY NY SITI JULAEHA RUANG BAYI
(201-E),
10 (PERI001-C)
30 05/03/2020 Baru RI20200503-0007 01-06-50-90 P/0 05/05/2020 ZZ088
CLAIRE KEZIA BUDIMAN 09 (201-F)
31 05/03/2020 Baru RI20200503-0008 01-06-50-91 L/0 05/05/2020 ZZ088

BY NY FITRI 09 (201-G)
32 05/03/2020 Baru RI20200503-0009 01-06-50-92 P / 62 05/05/2020 LT005

HONG LIE ING III (522-A), III
(523-D),
06 (522-D)
33 05/03/2020 Baru RI20200503-0010 01-06-50-95 P / 21 05/06/2020 LT005

WULAN DARI III (522-B),
06 (522-E)

34 05/03/2020 Lama RI20200503-0011 01-03-78-21 P / 23 05/14/2020 LT005

SHEREN BILLIAN III (522-C),
GUNAWAN 06 (522-A)
35 05/03/2020 Baru RI20200503-0012 01-06-50-96 P/8 05/07/2020 LT005
NAZWA MAHARANI III (526-A),
06 (526-C)
36 05/03/2020 Baru RI20200503-0013 01-06-45-81 P / 40 05/04/2020 LT006

NINING SETYOWATI 06 (606A)
37 05/03/2020 Baru RI20200503-0014 01-06-50-98 L/0 05/04/2020 ZZ088

BY NY NINING SETYOWATI 09 (201-E)
38 05/03/2020 Baru RI20200503-0015 01-06-47-55 P / 27 05/07/2020 LT005

SITI SUPRIYANTI III (553-A),
08 (520)
39 05/03/2020 Baru RI20200503-0016 01-04-95-55 L / 68 05/07/2020 LT006
SUYOTO 04 (605A)
40 05/03/2020 Baru RI20200503-0017 01-06-50-99 P / 15 05/06/2020 LT005

PUTRI INDRIYANI III (599-A), ICU
(ICU-A), HCU
(HCU-A), HCU
(HCU-A), III
(599-C),
05 (528-B)
41 05/03/2020 Baru RI20200504-0001 01-06-51-02 P/0 05/05/2020 ZZ086

BY NY PUTRI INDRIYANI RUANG BAYI
(201-H),
10 (PERI001-A)

42 05/04/2020 Baru RI20200504-0002 01-06-51-03 P / 31 05/06/2020 LT005

SUSANAH NINGSIH III (553-B),
06 (523-D)
43 05/04/2020 Baru RI20200504-0003 01-06-33-23 P / 27 05/05/2020 LT005

DINTANG NAIDA SARI 06 (521-E)
44 05/04/2020 Baru RI20200504-0004 01-06-50-21 L/4 05/08/2020 LT005

AFNAN ALI RABBANI III (526-B),
06 (526-D)
45 05/04/2020 Lama RI20200504-0005 01-02-16-04 P / 27 05/06/2020 LT005

RATNA LUTFIANA I (597-A),
05 (527-A)
46 05/04/2020 Lama RI20200504-0006 01-04-29-32 P / 22 05/06/2020 LT005

ROSMAWATI III (553-C),
06 (523-A)
47 05/04/2020 Baru RI20200504-0007 01-06-51-17 L/0 05/06/2020 ZZ088

BY NY SUSANAH NINGSIH 09 (201-H)
48 05/04/2020 Baru RI20200504-0008 01-06-51-26 P / 26 05/06/2020 LT005

UMMU HABIBAH 04 (551-A)
49 05/04/2020 Baru RI20200504-0009 01-06-51-29 L/0 05/06/2020 ZZ088

BY NY RATNA LUTFIANA 09 (201-I)
50 05/04/2020 Baru RI20200504-0010 01-06-22-92 P / 26 05/06/2020 LT005

CHIKA ANDIKA 06 (523-C)
51 05/04/2020 Baru RI20200504-0011 01-06-51-21 P / 27 05/05/2020 LT005

IKA NURLELA 04 (551-J)
52 05/04/2020 Baru RI20200504-0012 01-06-51-32 L/0 05/06/2020 ZZ088

BY NY ROSMAWATI 09 (201-J)
53 05/04/2020 Baru RI20200504-0013 01-06-51-16 L / 60 05/07/2020 LT005

KAMARUDIN S.M III (521-C),
06 (521-E)
54 05/04/2020 Baru RI20200504-0014 01-06-51-30 P / 33 05/07/2020 LT005

APRIANA 06 (522-B)
55 05/04/2020 Baru RI20200504-0015 01-06-51-27 L/4 05/07/2020 LT005

SUKMA BAYU NUGROHO VIP (501), VIP
(619),
02 (519)
56 05/04/2020 Lama RI20200504-0016 01-06-46-37 P / 40 05/06/2020 LT005
NURSIAH II (528-A),
05 (527-B)
57 05/04/2020 Baru RI20200504-0017 01-06-51-36 P / 24 05/06/2020 LT006

HAMIMAH 03 (621)
58 05/04/2020 Baru RI20200504-0018 01-06-51-37 L / 52 05/09/2020 LT006

SUPARNO III (617-A),
06 (602A)
59 05/04/2020 Baru RI20200505-0001 01-06-51-38 P/0 05/06/2020 ZZ088

BY NY CHIKA ANDIKA 09 (201-K)

60 05/05/2020 Baru RI20200505-0002 01-05-13-19 P / 29 05/07/2020 LT005

SULISTYARINI I (551-B),
05 (502-A)
61 05/05/2020 Baru RI20200505-0003 01-06-51-39 P / 28 05/07/2020 LT005

AYU MELYNA NUR SUSILO III (553-D),
05 (528-A)
62 05/05/2020 Baru RI20200505-0004 01-06-51-40 P / 38 05/06/2020 LT005

SRI KATINI III (553-E),
05 (502-B)
63 05/05/2020 Lama RI20200505-0005 00-00-84-46 L / 16 05/10/2020 LT005

DANIEL III (599-A),
06 (526-A)
64 05/05/2020 Lama RI20200505-0006 01-05-63-39 L / 69 05/08/2020 LT005
TIONG TJUN III (599-B),
06 (521-D)
65 05/05/2020 Baru RI20200505-0007 01-03-59-21 P / 70 05/06/2020 LT005

LIN MOY 06 (522-C)
66 05/05/2020 Baru RI20200505-0008 01-06-51-43 L / 37 05/06/2020 ZZ089

YATIMAN III (599-D),
07 (ICU-A)
67 05/05/2020 Baru RI20200505-0009 01-06-51-53 L/0 05/07/2020 ZZ088
BY NY AYU MELYNA NUR 09 (201-L)
SUSI
68 05/05/2020 Baru RI20200505-0010 01-06-51-50 P / 14 05/08/2020 LT005

SITI NIRMA NISYAR III (553-C),
06 (526-B)
69 05/05/2020 Baru RI20200505-0011 01-06-51-58 L/0 05/07/2020 ZZ088
BY NY SULISTYARINI 09 (201-M)

70 05/05/2020 Lama RI20200505-0012 01-06-16-43 P / 41 05/08/2020 LT005

SITI BARIAH 06 (599-E)
71 05/05/2020 Baru RI20200505-0013 01-06-51-67 P/0 05/07/2020 ZZ088

BY NY SITI SUPRIYANTI 09 (201-A)
72 05/05/2020 Baru RI20200505-0014 01-06-51-69 P / 34 05/07/2020 LT005

FITRIA GUNARTI III (599-F),
06 (523-B)
73 05/05/2020 Baru RI20200505-0015 01-06-51-64 L / 58 05/08/2020 LT005

PATONI III (553-F),
06 (521-B)
74 05/05/2020 Lama RI20200505-0016 01-03-99-68 P / 25 05/06/2020 LT005

ANDI SITI ARI FEBRIYANTI 06 (599-G)
75 05/05/2020 Baru RI20200505-0017 01-06-51-72 P / 25 05/06/2020 LT005

HERNI WIJAYANI 06 (599-H)
76 05/05/2020 Baru RI20200505-0018 01-06-51-76 P/0 05/11/2020 ZZ086

BY NY FITRIA GUNARTI PERINATOLOGI
(PERI001-D),
10 (PERI001-A)
77 05/05/2020 Baru RI20200505-0019 01-06-51-82 P / 40 05/08/2020 LT005

EFAH FAUZIAH 06 (599-D)
78 05/05/2020 Baru RI20200505-0020 01-06-51-83 P / 24 05/07/2020 LT005
SITI FADILA III (523-B), II
(503-A),
06 (523-A)

79 05/05/2020 Baru RI20200505-0021 01-06-51-84 P / 26 05/08/2020 LT005

JUNDIAH BALQIS III (617-B),
08 (515-A)
80 05/05/2020 Baru RI20200505-0022 01-06-51-85 P/0 05/07/2020 ZZ088
BY NY SITI FADILAH 09 (201-B)
81 05/06/2020 Lama RI20200506-0001 01-03-71-26 P / 24 05/08/2020 LT005

AIGA SALIM 06 (522-D)
82 05/06/2020 Baru RI20200506-0002 01-06-47-58 P / 41 05/08/2020 LT005

SUTINAH BIN MIRSAD I (517),
05 (527-B)
83 05/06/2020 Lama RI20200506-0003 01-04-30-98 P / 23 05/08/2020 LT006

MALA KOMALASARI 05 (603A)
84 05/06/2020 Baru RI20200506-0004 01-06-51-88 P / 24 05/08/2020 LT005

RIBUT SEPTIANA BUDI III (599-I),
ARTO 05 (527-A)
85 05/06/2020 Lama RI20200506-0005 01-03-54-39 P / 37 05/08/2020 LT005

SUNDARI III (599-J),
06 (523-D)
86 05/06/2020 Baru RI20200506-0006 01-06-51-51 L / 19 05/07/2020 LT005

ADAM SYAH DEWA 05 (507-B)
87 05/06/2020 Baru RI20200506-0007 01-06-51-92 P/0 05/08/2020 ZZ088

BY NY EFAH FAOZIAH 09 (201-C)
88 05/06/2020 Baru RI20200506-0008 01-06-51-93 L/0 05/08/2020 ZZ088

BY NY MALA KOMALASARI 09 (201-N)

89 05/06/2020 Baru RI20200506-0009 01-06-51-90 P / 46 05/07/2020 LT005

NUR AZIZAH 06 (599-K)
90 05/06/2020 Baru RI20200506-0010 01-06-51-96 L/0 05/08/2020 ZZ088

BY NY SUTINAH 09 (201-D)
91 05/06/2020 Baru RI20200506-0011 01-05-17-93 P / 32 05/08/2020 LT006

HO ISA BELLA III (602B),
06 (606B)
92 05/06/2020 Baru RI20200506-0012 01-06-52-00 P / 17 05/07/2020 LT006
SAFIRAH AZIZAH 06 (606A)
93 05/06/2020 Baru RI20200506-0013 01-06-52-02 P/0 05/07/2020 ZZ088

BY NY SAFIRAH AZIZAH 09 (201-E)
94 05/06/2020 Lama RI20200506-0014 01-05-35-68 P / 20 05/08/2020 LT005

DEWI MUDIYATI III (553-A),
05 (507-A)
95 05/06/2020 Baru RI20200506-0015 01-06-52-05 L/0 05/08/2020 ZZ088

BY NY RIBUT SEPTIANA 09 (201-F)
BUDI
96 05/06/2020 Lama RI20200506-0016 01-06-49-75 P/0 05/09/2020 ZZ086

BY NY ASTRINI FAJARWATI 10 (PERI001-C)
97 05/06/2020 Baru RI20200506-0017 01-06-52-01 P / 22 05/08/2020 LT005

ERNI PUSPITASARI III (553-B),
06 (522-E)

98 05/06/2020 Lama RI20200506-0018 01-04-14-63 L/1 05/08/2020 LT005

WILLIAM RAFASYA III (599-B),
PRATAMA 05 (505-B)
99 05/06/2020 Baru RI20200506-0019 01-06-52-03 L/9 05/08/2020 LT005
PRINGGO DWI PURJATI III (599-L),
05 (505-A)
100 05/06/2020 Baru RI20200506-0020 01-06-52-07 L / 58 05/08/2020 LT006

TASLIM 06 (602D)
101 05/06/2020 Baru RI20200506-0021 01-05-57-74 P / 39 05/09/2020 LT005

SITI KOIRIYAH III (599-G), HCU
(HCU-A),
06 (522-D)
102 05/06/2020 Baru RI20200506-0022 01-06-52-18 L/0 05/08/2020 ZZ088

BY NY SUNDARI 09 (201-O)
103 05/06/2020 Lama RI20200506-0023 01-05-02-72 P/1 05/08/2020 LT005

SHAQEENARAVA NASYWA I (551-C),
HUMAIRA FARDANI 04 (501-A)
104 05/06/2020 Baru RI20200506-0024 01-06-52-19 L/0 05/08/2020 ZZ088

BY NY HO ISA BELLA 09 (201-P)
105 05/06/2020 Baru RI20200506-0025 01-06-52-21 P/0 05/09/2020 ZZ088

BY NY SITI KOIRIYAH 09 (201-G)
106 05/06/2020 Lama RI20200506-0026 01-03-01-82 P / 28 05/08/2020 LT006
DINA WAHYUNI 06 (606C)
107 05/07/2020 Baru RI20200507-0001 01-06-52-22 L / 18 05/12/2020 LT005

TEGAR ADI NUGROHO III (521-C),
06 (521-A)

108 05/07/2020 Baru RI20200507-0002 01-06-52-24 P/0 05/08/2020 ZZ088

BY NY DINA WAHYUNI 09 (201-Q)
109 05/07/2020 Baru RI20200507-0003 01-06-52-26 P / 26 05/09/2020 LT005

RAGIL PUJI RAHAYU III (599-G),
08 (512-A)
110 05/07/2020 Baru RI20200507-0004 01-06-52-29 P/0 05/09/2020 ZZ088

BY NY RAGIL PUJI RAHAYU 09 (201-R)
111 05/07/2020 Baru RI20200507-0005 01-06-52-28 P / 38 05/08/2020 LT005

MUSPIKHATUN 05 (525-A)
112 05/07/2020 Baru RI20200507-0006 01-06-52-34 L / 58 05/11/2020 LT006

GOUW NJO DJIH III (553-A), II
(508-A),
05 (603C)
113 05/07/2020 Baru RI20200507-0007 01-06-52-37 L / 48 05/11/2020 LT005

SARYADI I (551-A),
05 (508-B)
114 05/07/2020 Baru RI20200507-0008 01-06-52-38 P / 25 05/08/2020 LT005

RISCA INDRIYANI 06 (599-A)
115 05/07/2020 Baru RI20200507-0009 01-06-52-41 P / 23 05/12/2020 LT005

INEKE I (518),
04 (517)
116 05/07/2020 Baru RI20200507-0010 01-06-52-44 P / 26 05/09/2020 LT006

LINDA FITRIANAH III (523-B),
06 (606D)

117 05/07/2020 Baru RI20200507-0011 01-06-52-43 P / 75 05/10/2020 LT005

SUKIMAH III (523-C),
06 (522-B)
118 05/08/2020 Lama RI20200508-0001 01-06-51-26 P / 26 05/10/2020 LT005

UMMU HABIBAH 04 (551-B)
119 05/08/2020 Baru RI20200508-0002 01-06-52-45 P/0 05/09/2020 ZZ088
BY NY LINDA FITRIANAH 09 (201-E)
120 05/08/2020 Baru RI20200508-0003 01-06-51-71 P / 24 05/10/2020 LT005

ROHYATUN NUFUS 06 (553-A)
121 05/08/2020 Baru RI20200508-0004 01-06-52-50 P / 34 05/10/2020 LT005

TUTI ASIYAH 06 (523-C)
122 05/08/2020 Baru RI20200508-0005 01-06-52-52 P / 40 05/10/2020 LT005

AI SUHARYATI 06 (523-B)
123 05/08/2020 Baru RI20200508-0006 01-06-52-51 P / 19 05/09/2020 LT005

LIDIA EPRILIA 06 (523-A)
124 05/08/2020 Baru RI20200508-0007 01-06-52-56 P / 23 05/10/2020 LT005

IKA RINA 06 (553-B)

125 05/08/2020 Baru RI20200508-0008 01-06-52-64 L/0 05/10/2020 ZZ088

BY NY UMMU HABIBAH 09 (201-H)
126 05/08/2020 Baru RI20200508-0009 01-06-52-65 L/0 05/10/2020 ZZ088

BY NY AI SUHARYATI 09 (201-I)
127 05/08/2020 Baru RI20200508-0010 01-06-52-61 L / 30 05/11/2020 LT005

FUAT HITOBUL IMAM I (518),
05 (508-A)
128 05/08/2020 Baru RI20200508-0011 01-06-52-58 P / 37 05/10/2020 LT006
EKA MARWANTI 06 (617-A)
129 05/08/2020 Baru RI20200508-0012 01-06-48-99 P / 15 05/09/2020 LT005

LUISAH GISKA MEILANI 06 (599-F)
130 05/08/2020 Baru RI20200508-0013 01-06-52-59 L/3 05/11/2020 LT005

MUHAMMAD FORLAN 06 (526-B)
FAUZY
131 05/08/2020 Baru RI20200508-0014 01-06-52-67 P / 37 05/13/2020 LT006
KASROYAH 06 (606A)
132 05/08/2020 Baru RI20200508-0015 01-06-52-70 P / 30 05/10/2020 LT005

WIWIK EKA DEWI 06 (553-C)
133 05/08/2020 Baru RI20200508-0016 01-06-52-71 P/0 05/10/2020 ZZ088
BY NY IKA RINA 09 (201-A)
134 05/08/2020 Baru RI20200508-0017 01-06-52-77 L/0 05/13/2020 ZZ088

BY NY KASROYAH I PERINATOLOGI
(PERI001-D),
09 (201-A)

135 05/08/2020 Baru RI20200508-0018 01-06-52-78 P/0 05/13/2020 ZZ086

BY NY KASROYAH II 10 (PERI001-E)
136 05/08/2020 Lama RI20200508-0019 01-06-50-42 P/0 05/10/2020 ZZ086

BAYI NY BASE BANGKALA RUANG BAYI
(201-B),
10 (PERI001-B)
137 05/08/2020 Baru RI20200508-0020 01-06-52-83 P / 23 05/10/2020 LT005

EVA TRIANA 06 (599-B)
138 05/08/2020 Baru RI20200508-0021 01-06-52-84 L/0 05/10/2020 ZZ088

BY NY TUTI AISYAH 09 (201-B)
139 05/08/2020 Baru RI20200508-0023 01-06-52-87 L/0 05/10/2020 ZZ088

BY NY WIWIK EKA DEWI 09 (201-F)
140 05/08/2020 Lama RI20200508-0024 01-01-76-27 P / 87 05/10/2020 LT005

HJ HALIJAH 04 (551-C)
141 05/08/2020 Baru RI20200508-0025 01-06-52-89 P / 24 05/11/2020 LT005

CICIH MARSIDA III (553-D),
05 (528-A)
142 05/08/2020 Baru RI20200508-0026 01-06-52-86 L/0 05/10/2020 ZZ088

BY NY EVA TRIANA 09 (201-J)
143 05/09/2020 Baru RI20200509-0001 01-06-52-93 P / 23 05/11/2020 LT005

DWI UTAMI 06 (553-E)

144 05/09/2020 Lama RI20200509-0002 01-01-58-79 P / 29 05/11/2020 LT005

ANIK DARYANTI I (597-A),
04 (518)
145 05/09/2020 Lama RI20200509-0003 01-02-03-03 P / 27 05/11/2020 LT005
FITRI PUTRI I (597-B),
05 (525-A)
146 05/09/2020 Baru RI20200509-0004 01-06-52-63 P / 26 05/11/2020 LT006

MERLIANA 06 (606B)
147 05/09/2020 Baru RI20200509-0005 01-02-76-72 P / 38 05/10/2020 LT005

RINI KURNIA 06 (523-D)
148 05/09/2020 Baru RI20200509-0006 01-06-53-04 P/0 05/11/2020 ZZ088

BY NY CICIH MARSIDI 09 (201-K)
149 05/09/2020 Baru RI20200509-0007 01-06-53-06 P / 27 05/14/2020 LT005

FITA APRIYANA III (599-C), III
(523-D),
06 (523-C)
150 05/09/2020 Baru RI20200509-0008 01-06-53-01 P / 43 05/11/2020 LT005

ENDRAWATI 04 (551-D)
151 05/09/2020 Lama RI20200509-0009 01-06-50-63 P/0 05/12/2020 ZZ086

BY NY MEI SITA 10 (PERI001-F)
LESTIYANIN
152 05/09/2020 Baru RI20200509-0010 01-06-53-09 P/0 05/11/2020 ZZ088

BY NY DWI UTAMI III (521-E),
09 (201-C)

153 05/09/2020 Baru RI20200509-0011 01-06-53-14 P/0 05/11/2020 ZZ088

BY NY ANIK DARYANTI 09 (201-L)
154 05/09/2020 Lama RI20200509-0012 01-03-76-61 L/1 05/13/2020 LT005

ESTU ERIDYA ATMANTO 04 (501-A)
155 05/09/2020 Baru RI20200509-0013 01-06-53-16 P/0 05/11/2020 ZZ088

BY NY FITA APRIYANA 09 (201-D)
156 05/09/2020 Baru RI20200509-0014 01-06-53-17 P/0 05/11/2020 ZZ088

BY NY FITRI PUTRI 09 (201-M)
157 05/09/2020 Lama RI20200509-0015 01-03-74-81 P / 33 05/13/2020 LT005

LINDA WATI III (599-A),
05 (507-B)
158 05/09/2020 Baru RI20200509-0016 01-06-53-24 P/8 05/14/2020 LT005
MIRANDA SAFIRA III (599-D), III
(526-C), III (526-
C), III (526-C),
III (526-C), II
(527-A),
06 (526-C)
159 05/10/2020 Baru RI20200510-0002 01-06-53-29 P / 25 05/15/2020 LT005

MUSLIPAH III (599-E), II
(505-A),
06 (522-C)
160 05/10/2020 Baru RI20200510-0003 01-06-53-31 L/0 05/11/2020 ZZ088

BY NY MERLIANA 09 (201-N)

161 05/10/2020 Baru RI20200510-0004 01-06-53-33 P / 38 05/12/2020 LT005

SUHENI III (553-C), III
(523-C),
06 (523-A)
162 05/10/2020 Baru RI20200510-0005 01-06-53-34 P / 29 05/12/2020 LT005
NENG ILA I (597-C),
05 (503-B)
163 05/10/2020 Baru RI20200510-0006 01-06-53-35 P / 35 05/13/2020 LT005

PIPIH SOPIAH III (523-B), III
(599-M),
06 (523-D)
164 05/10/2020 Baru RI20200510-0007 01-06-53-38 P/0 05/12/2020 ZZ088
BY NY SUHENI 09 (201-O)
165 05/10/2020 Baru RI20200510-0008 01-06-53-39 P / 41 05/12/2020 LT005

NURHAYATI II (502-A),
05 (507-A)
166 05/10/2020 Baru RI20200510-0009 01-05-31-92 P / 32 05/13/2020 LT005

ROKIYAH II (502-B),
05 (505-B)
167 05/10/2020 Baru RI20200510-0010 01-06-53-40 L/0 05/13/2020 ZZ086

BY NY NURHAYATI RUANG BAYI
(201-P),
10 (PERI001-C)
168 05/10/2020 Baru RI20200510-0011 01-06-52-15 P / 33 05/12/2020 LT006

NANI ENI ANDRIYANI 03 (621)
169 05/10/2020 Baru RI20200510-0012 01-06-53-41 P / 25 05/13/2020 LT005

RENI WAHYU NINGSIH III (599-B),
ISOLASI NON
TEKANAN
NEGATIF
(512-A), ISOLASI
(512-A),
ISOLASI (515-B),
08 (512-A)
170 05/10/2020 Baru RI20200510-0013 01-06-53-42 P/0 05/12/2020 ZZ088

BY NY NENG ILA 09 (201-Q)
171 05/11/2020 Baru RI20200511-0001 01-06-53-45 P / 34 05/12/2020 LT006

PENI 06 (606C)
172 05/11/2020 Baru RI20200511-0002 01-06-53-46 L/0 05/12/2020 ZZ088

BY NY PENI 09 (201-P)
173 05/11/2020 Lama RI20200511-0003 01-01-47-68 P / 27 05/16/2020 LT005

DEFI SAPUTRI III (553-F),
06 (522-D)
174 05/11/2020 Lama RI20200511-0005 01-01-33-88 P / 33 05/12/2020 LT005

WINARTI III (522-B),
06 (522-E)
175 05/11/2020 Baru RI20200511-0006 01-06-51-65 P / 24 05/12/2020 LT006
RENY FITRIA NINGSIH 06 (606E)
176 05/11/2020 Baru RI20200511-0007 01-06-29-06 P / 29 05/13/2020 LT005

FATIMAH III (523-C),
06 (523-B)

177 05/11/2020 Lama RI20200511-0008 01-03-82-49 L/4 05/12/2020 LT005

ANDIKA CAHYA HARIRI III (599-C),
06 (526-D)
178 05/11/2020 Baru RI20200511-0010 01-06-53-73 P/0 05/13/2020 ZZ088
BY NY ROKIAH 09 (201-R)
179 05/11/2020 Baru RI20200511-0011 01-05-67-44 P / 34 05/13/2020 LT005

ANAH OKTAVIANA III (553-A),
ISOLASI
TEKANAN
NEGATIF (520-A),
ISOLASI (515-B),
ISOLASI (515-B),
08 (515-B)
180 05/11/2020 Baru RI20200511-0012 01-06-53-78 P/0 05/12/2020 ZZ088
BY NY RENY FITRIA 09 (201-S)
NINGSIH
181 05/11/2020 Baru RI20200511-0013 01-03-63-27 P / 17 05/13/2020 LT005

DESTIANTI PUJI LESTARY 06 (526-A)
182 05/11/2020 Baru RI20200511-0015 01-06-53-79 P / 36 05/14/2020 LT005

FITRIANI III (522-D),
06 (522-B)
183 05/11/2020 Baru RI20200511-0016 01-06-53-96 P/0 05/16/2020 ZZ086
BY NY ANAH OKTAVIANA RUANG BAYI
(201-T),
10 (PERI001-B)
184 05/11/2020 Baru RI20200511-0017 01-06-53-97 L/0 05/16/2020 ZZ086

BY NY RENI WAHYU 10 (PERI001-G)
NINGSIH

185 05/11/2020 Baru RI20200511-0018 01-06-53-83 L / 21 05/14/2020 LT006

ADI DARMADI 06 (617-A)
186 05/11/2020 Baru RI20200511-0019 01-06-53-86 L / 50 05/13/2020 LT005

HARI MULYANTO 04 (551-A)
187 05/11/2020 Baru RI20200511-0020 01-06-54-00 L/0 05/13/2020 ZZ088

BY NY FATIMAH 09 (201-U)
188 05/11/2020 Baru RI20200511-0021 01-06-53-98 L / 16 05/13/2020 LT005

YOGA FINANDA III (599-D),
06 (526-B)
189 05/11/2020 Baru RI20200511-0022 01-06-53-91 L / 55 05/13/2020 LT005
IRSAD III (521-C),
06 (521-D)
190 05/11/2020 Baru RI20200511-0024 01-06-54-14 P/0 05/18/2020 ZZ086

BY NY PIPIH SOPIAH RUANG BAYI
(201-V),
10 (PERI001-K)
191 05/11/2020 Baru RI20200511-0025 01-06-54-10 P/0 05/14/2020 ZZ086

ELANA AIZA AZURA 10 (PERI001-H)
192 05/11/2020 Baru RI20200511-0026 01-03-43-33 P / 30 05/14/2020 LT005

MAYASARI I (597-A),
ISOLASI
TEKANAN
NEGATIF (515-A),
08 (515-A)
193 05/12/2020 Baru RI20200512-0001 01-06-54-16 P / 20 05/15/2020 LT006

FITRI RAHAYU 06 (606B)
194 05/12/2020 Baru RI20200512-0002 01-06-54-18 L / 37 05/13/2020 LT005

YOPI SANTOSO III (522-E), III
(599-J),
06 (521-C)
195 05/12/2020 Baru RI20200512-0003 01-06-54-20 P/0 05/14/2020 ZZ086
BY NY MAYASARI 10 (PERI001-I)
196 05/12/2020 Baru RI20200512-0004 01-06-53-20 P / 39 05/13/2020 LT005

RINI SUBEKTI 04 (597-D)
197 05/12/2020 Baru RI20200512-0005 01-06-53-66 P / 35 05/13/2020 LT006

ADAH RAHMAWATI 06 (606D)
198 05/12/2020 Baru RI20200512-0006 01-02-11-20 P / 72 05/14/2020 LT005

ROMLAH 08 (512-B)
199 05/12/2020 Baru RI20200512-0007 01-06-54-38 L / 28 05/13/2020 LT005

DEFNI YULIANTI 06 (599-A)
200 05/12/2020 Baru RI20200512-0008 01-06-53-99 L / 26 05/15/2020 LT006

RICARDO 06 (617-B)
201 05/12/2020 Baru RI20200512-0009 01-05-64-26 P / 31 05/14/2020 LT005

MUNAYAH III (553-A),
05 (527-B)
202 05/12/2020 Baru RI20200512-0010 01-04-68-21 P / 31 05/14/2020 LT005

YENI SUTANTI I (551-B),
04 (551-B)

203 05/12/2020 Baru RI20200512-0011 01-06-54-44 L/0 05/15/2020 ZZ088

BY NY FITRI RAHAYU RUANG BAYI
(201-V),
PERINATOLOGI
(PERI001-A),
09 (201-J)
204 05/12/2020 Baru RI20200512-0012 01-06-54-45 P/0 05/13/2020 ZZ088
BY NY ADAH 09 (201-T)
205 05/12/2020 Baru RI20200512-0013 01-03-76-30 P / 64 05/13/2020 LT006

CARKEM 05 (603A)
206 05/12/2020 Baru RI20200512-0014 01-06-54-50 P / 41 05/12/2020 LT006

HASTUTI 06 (606C)
207 05/12/2020 Baru RI20200512-0015 01-06-54-51 P / 26 05/13/2020 LT006
ULFI NURJANAH 04 (605A)
208 05/12/2020 Baru RI20200512-0016 01-06-54-52 L/0 05/14/2020 ZZ086

BY NY YENI SUTANTI RUANG BAYI
(201-W),
10 (PERI001-C)
209 05/12/2020 Baru RI20200512-0017 01-06-54-55 L/0 05/13/2020 ZZ088

BY NY ULFI NURJANAH 09 (201-V)
210 05/12/2020 Baru RI20200513-0001 01-06-54-56 P/6 05/16/2020 LT006

RAHMA DZAKIYA SAKHI 06 (602A)
211 05/13/2020 Baru RI20200513-0002 01-06-54-59 P / 26 05/15/2020 LT006

SRI AZIZAH SIROJ 06 (602B)

212 05/13/2020 Baru RI20200513-0003 01-05-80-43 P / 35 05/15/2020 LT005

EVA HUDAIPAH II (525-B), II
(505-B),
05 (505-A)
213 05/13/2020 Baru RI20200513-0004 01-06-54-31 P / 29 05/14/2020 LT005
RAHMAWATI 06 (599-B)
214 05/13/2020 Baru RI20200513-0005 01-05-13-56 P / 21 05/15/2020 LT005

SITI KOMALA III (523-A), II
(505-B),
06 (523-A)
215 05/13/2020 Baru RI20200513-0006 01-06-53-67 P / 28 05/15/2020 LT006
IKE TUJANAH 05 (603B)
216 05/13/2020 Baru RI20200513-0007 01-06-53-77 P / 25 05/16/2020 LT005

NUR ARIFAH III (599-C),
06 (522-E)
217 05/13/2020 Baru RI20200513-0008 01-06-52-04 P / 40 05/14/2020 LT005
SUKIYAH 06 (599-D)
218 05/13/2020 Baru RI20200513-0009 01-05-70-11 P / 45 05/15/2020 LT005

LINDAWATI III (599-E),
08 (520-A)
219 05/13/2020 Baru RI20200513-0010 01-06-54-65 L / 27 05/16/2020 LT005

SURYANTO I (551-C),
04 (517)
220 05/13/2020 Baru RI20200513-0011 01-06-53-81 P / 32 05/15/2020 LT005

SUSILA SHANTIKA P.W III (599-F),
06 (523-B)
221 05/13/2020 Baru RI20200513-0013 01-06-54-82 P / 29 05/15/2020 LT005
KOMALA OKTAVIA I (551-F),
05 (505-B)

222 05/13/2020 Baru RI20200513-0014 01-06-54-78 P / 23 05/15/2020 LT005

MARSELA ISOLASI (515-A),
04 (518)
223 05/13/2020 Baru RI20200513-0015 01-06-54-88 L/0 05/15/2020 ZZ088

BY NY SITI KOMALA 09 (201-C)
224 05/13/2020 Baru RI20200513-0016 01-06-48-72 L / 61 05/16/2020 LT005

SUPARDI III (526-D), III
(521-D), III (599-
D),
06 (521-D)
225 05/13/2020 Baru RI20200513-0017 01-06-54-91 L/0 05/15/2020 ZZ088
BY NY EVA HUDAIPAH 09 (201-D)
226 05/13/2020 Baru RI20200513-0018 01-06-54-92 P/0 05/14/2020 ZZ088

BY NY SRI AZIZAH S 09 (201-E)
227 05/13/2020 Baru RI20200513-0019 01-05-88-94 P / 33 05/14/2020 LT005

SITI NUR KOMARIAH III (599-G),
06 (523-D)
228 05/13/2020 Baru RI20200513-0020 01-06-54-93 L/0 05/15/2020 ZZ088

BY NY SUSILA SHANTIKA 09 (201-F)
229 05/13/2020 Baru RI20200513-0021 01-06-54-95 P / 24 05/15/2020 LT006

NINA PUSPITA SARI 06 (608-A)
230 05/13/2020 Lama RI20200513-0022 01-01-05-17 P / 27 05/15/2020 LT005

KURNIYATI III (523-D), III
(526-A),
06 (523-D)

231 05/13/2020 Baru RI20200513-0023 01-06-54-96 L/6 05/18/2020 LT005

NAFIZ MIRZA I (597-A), I (501-
A),
02 (501)
232 05/13/2020 Baru RI20200513-0024 01-06-54-98 P / 28 05/16/2020 LT005
MARIA YAKOBA KAPITAN III (599-H),
06 (523-C)
233 05/13/2020 Baru RI20200513-0025 01-02-63-94 P / 33 05/16/2020 LT005

SURYATI II (507-A), I
(517),
05 (527-B)
234 05/14/2020 Baru RI20200514-0001 01-06-55-03 L / 45 05/15/2020 LT005
TATA SUMINTA III (553-E),
06 (521-A)
235 05/14/2020 Baru RI20200514-0002 01-06-54-97 L / 20 05/15/2020 LT005
MUHAMAD AZIS II (552-A),
05 (508-A)
236 05/14/2020 Baru RI20200514-0003 01-06-54-06 P / 37 05/16/2020 LT005
SIGIT RIYANTI III (599-I),
05 (527-A)
237 05/14/2020 Baru RI20200514-0004 01-06-55-06 P / 22 05/16/2020 LT005

DINDA AMILIA III (523-C),
ISOLASI (512-B),
08 (512-A)
238 05/14/2020 Baru RI20200514-0005 01-06-55-25 P/0 05/16/2020 ZZ088

BY NY DINDA AMILIA I 09 (201-G)
239 05/14/2020 Baru RI20200514-0006 01-06-55-26 P/0 05/16/2020 ZZ086

BY NY DINDA AMILIA II RUANG BAYI
(201-H),
10 (PERI001-C)
240 05/14/2020 Baru RI20200514-0007 01-06-55-09 P / 14 05/17/2020 LT005

ZAHRA NAULA AEQILLAH III (599-J),
06 (526-A)

241 05/14/2020 Baru RI20200514-0008 01-06-55-28 P/0 05/16/2020 ZZ088

BY NY MARIA YAKOBA 09 (201-K)
242 05/14/2020 Baru RI20200514-0009 01-06-33-90 P / 28 05/16/2020 LT005

IIS ISMAWATI III (526-B),
08 (515-A)
243 05/14/2020 Baru RI20200514-0010 01-06-55-31 L/0 05/16/2020 ZZ088

BY NY MARIA YAKOBA II 09 (201-L)
244 05/14/2020 Baru RI20200514-0011 01-06-55-14 P / 42 05/14/2020 LT005

HENNY SATRIO 06 (599-K)
245 05/14/2020 Baru RI20200514-0012 01-06-44-46 L / 47 05/18/2020 LT005

ASDI III (599-L),
06 (521-E)
246 05/14/2020 Baru RI20200514-0013 01-06-55-37 P/0 05/16/2020 ZZ088

BY NY IIS ISMAWATI 09 (201-I)
247 05/14/2020 Baru RI20200514-0014 01-06-55-33 L / 29 05/17/2020 LT005

KIKI FERNANDO I (551-A),
05 (503-A)
248 05/14/2020 Baru RI20200514-0015 01-06-55-42 P/0 05/16/2020 ZZ088

BY NY SURYATI 09 (201-E)
249 05/14/2020 Baru RI20200514-0016 01-06-55-39 L / 10 05/17/2020 LT005
MUHAMMAD YUSUF III (521-E),
SETIADI 06 (526-B)
250 05/14/2020 Baru RI20200514-0017 01-06-55-55 P/0 05/16/2020 ZZ088

BY NY SIGIT RIYANTI 09 (201-M)

251 05/14/2020 Baru RI20200514-0018 01-01-62-13 P / 31 05/15/2020 LT005

NINA HERLINA 06 (526-C)
252 05/14/2020 Baru RI20200514-0019 01-05-96-66 P / 33 05/17/2020 LT005

FRANZESKA RANI II (505-B),
05 (502-B)
253 05/14/2020 Lama RI20200514-0020 01-02-25-78 P / 42 05/17/2020 LT005

TATI II (552-B),
05 (507-B)
254 05/14/2020 Baru RI20200514-0021 01-05-49-16 P / 29 05/16/2020 LT005

LALA III (599-M),
06 (523-B)
255 05/14/2020 Baru RI20200514-0022 01-05-37-37 P / 28 05/15/2020 LT005

SUMAIROH I (597-A),
05 (525-A)
256 05/14/2020 Baru RI20200514-0023 01-06-52-80 P / 36 05/16/2020 LT005

LIM KRISTIN AGUSTINA 04 (597-B)
257 05/14/2020 Baru RI20200514-0024 01-06-55-67 L/4 05/17/2020 LT005

MUHAMMAD AQIF RAIHAN III (553-G),
06 (526-D)
258 05/14/2020 Baru RI20200514-0025 01-06-12-39 P / 38 05/15/2020 LT005
ROHMAH 06 (599-N)
259 05/15/2020 Baru RI20200515-0001 01-06-19-22 P / 23 05/15/2020 LT006

REKA PATWARI 06 (606A)
260 05/15/2020 Baru RI20200515-0002 01-06-55-21 P / 23 05/17/2020 LT005

ANI MULYAWATI III (599-A),
06 (523-D)

261 05/15/2020 Baru RI20200515-0003 01-06-55-70 P / 37 05/17/2020 LT005

KHOLIFAH III (599-L), III
(523-A),
08 (512-B)
262 05/15/2020 Baru RI20200515-0004 01-06-55-74 P/0 05/17/2020 ZZ088
BY NY TATI 09 (201-A)
263 05/15/2020 Baru RI20200515-0005 01-06-55-78 L/0 05/17/2020 ZZ088
BY NY FRANZESKA RANI 09 (201-B)
YULI
264 05/15/2020 Baru RI20200515-0006 01-06-55-79 L/0 05/16/2020 ZZ088

BY NY LIM KRISTIN 09 (201-H)
265 05/15/2020 Baru RI20200515-0007 01-06-55-77 L / 29 05/18/2020 LT005

IJUL FIKAR 05 (525-B)
266 05/15/2020 Baru RI20200515-0008 01-06-55-80 P / 37 05/16/2020 LT006

YONAH 06 (606A)
267 05/15/2020 Baru RI20200515-0009 01-06-55-83 P / 34 05/17/2020 LT005

YULI RATNA SARI III (599-B),
08 (520-A)
268 05/15/2020 Lama RI20200515-0010 01-02-86-95 P / 26 05/16/2020 LT005

NOVI FATAH HELENA 06 (599-C)
269 05/15/2020 Baru RI20200515-0011 01-06-55-85 P / 16 05/15/2020 LT005

SEPTIANI DWI CHANDRA 05 (552-A)
270 05/15/2020 Baru RI20200515-0012 01-06-55-90 P/0 05/17/2020 ZZ088

BY NY YULI RATNA SARI 09 (201-C)

271 05/15/2020 Baru RI20200515-0013 01-06-55-91 L/0 05/25/2020 ZZ086

BY NY KHOLIFAH RUANG BAYI
(201-J),
10 (PERI001-A)
272 05/15/2020 Baru RI20200515-0014 01-06-55-97 P/0 05/16/2020 ZZ088
BY NY LALA 09 (201-F)
273 05/15/2020 Baru RI20200515-0015 01-06-55-57 P / 39 05/17/2020 LT005

LIZA FAUZIAH 04 (551-A)
274 05/15/2020 Baru RI20200515-0016 01-06-56-00 L/0 05/17/2020 ZZ088

BY NY ANI MULYAWATI 09 (201-N)
275 05/15/2020 Baru RI20200515-0017 01-06-56-04 P/0 05/16/2020 ZZ088

BY NY YONAH 09 (201-O)
276 05/15/2020 Baru RI20200515-0018 01-06-55-82 L / 42 05/17/2020 LT005

JERY ELSA PUTRA I (551-B),
05 (503-B)
277 05/15/2020 Baru RI20200515-0019 01-06-56-07 P / 44 05/16/2020 LT006
FARIDAH UMAMI 06 (606B)
278 05/15/2020 Baru RI20200515-0020 01-06-56-08 L / 43 05/18/2020 LT005
AGUS SUGIARTO 06 (521-C)
279 05/16/2020 Baru RI20200516-0001 01-06-56-10 L / 18 05/19/2020 LT005

MUHAMMAD LUTFI FAHMI III (521-A),
06 (521-D)
280 05/16/2020 Baru RI20200516-0002 01-06-55-36 P / 18 05/19/2020 LT005
SENDI SETIAWAN II (507-A),
04 (518)

281 05/16/2020 Lama RI20200516-0003 01-06-36-88 P / 26 05/17/2020 LT006

CAHAYA STAR 05 (603A)
282 05/16/2020 Baru RI20200516-0004 01-06-55-92 P / 45 05/18/2020 LT006

KRISTIANI 06 (608-A)
283 05/16/2020 Lama RI20200516-0005 01-03-76-30 P / 64 05/18/2020 LT006

CARKEM 06 (608-B)
284 05/16/2020 Lama RI20200516-0006 01-06-52-71 P/0 05/18/2020 ZZ086

BY NY IKA RINA 10 (PERI001-D)
285 05/16/2020 Baru RI20200516-0008 01-06-56-39 L / 26 05/19/2020 LT006

IRVAN SETIAWAN 06 (617-A)
286 05/16/2020 Baru RI20200516-0009 01-06-56-30 L / 54 05/20/2020 LT005

RAMLI ISOLASI (515-B),
ISOLASI (512-A),
08 (512-B)
287 05/16/2020 Lama RI20200516-0010 01-04-99-81 P/1 05/18/2020 LT005

FIRSA ASHA SABITHA 06 (526-C)
288 05/16/2020 Baru RI20200516-0012 01-06-56-47 L / 22 05/18/2020 LT005

RENDI WIGUNA I (597-A),
04 (517)
289 05/16/2020 Baru RI20200516-0013 01-06-56-49 P / 15 05/20/2020 LT005

SALFARANI PUTRI I (551-B),
05 (505-B)

290 05/17/2020 Baru RI20200517-0001 01-06-56-55 L / 27 05/19/2020 LT005

MUHAMMAD ISKANDAR III (521-B), III
(522-A),
06 (521-A)
291 05/17/2020 Baru RI20200517-0002 01-06-56-56 P / 62 05/17/2020 LT005
DAREM 06 (522-A)
292 05/17/2020 Baru RI20200517-0003 01-06-56-58 L / 31 05/18/2020 LT006

RANDY ANGGARA 05 (603B)
293 05/17/2020 Baru RI20200517-0004 01-06-50-54 P / 24 05/19/2020 LT005

ITA FITRIANA 04 (501-A)
294 05/17/2020 Baru RI20200517-0005 01-06-56-65 P / 48 05/19/2020 LT006

WARSIH 04 (601A)
295 05/17/2020 Baru RI20200517-0006 01-06-56-66 P / 22 05/18/2020 LT005

INDA SETIANI 06 (599-A)
296 05/17/2020 Baru RI20200517-0007 01-01-36-14 P / 65 05/18/2020 LT006

REGINA TJHI 06 (602C)
297 05/17/2020 Baru RI20200517-0008 01-06-56-69 P / 33 05/19/2020 LT005

SITI SADIYAH III (599-B), III
(523-A),
08 (520-A)
298 05/17/2020 Baru RI20200517-0009 01-06-56-71 P / 30 05/18/2020 LT005

ISLAMIA NADIAH 06 (599-D)

299 05/17/2020 Baru RI20200517-0011 01-06-55-24 P / 29 05/20/2020 LT005

LASMINI III (599-E), III
(526-C),
06 (523-A)
300 05/17/2020 Lama RI20200517-0012 00-00-57-43 P / 29 05/20/2020 LT005

EKA SURYANI III (599-F),
06 (523-B)
301 05/17/2020 Baru RI20200517-0013 01-06-56-76 P/0 05/19/2020 ZZ088

BY NY SITI SADIYAH 09 (201-J)
302 05/17/2020 Baru RI20200517-0014 01-05-59-09 P / 34 05/20/2020 LT006

ASNIAH BT ASRA III (602D), I
(601B),
II (603C),
04 (601B)
303 05/17/2020 Baru RI20200517-0015 01-06-55-41 P / 31 05/20/2020 LT005
NUR ANISAH III (599-G),
06 (523-D)
304 05/17/2020 Baru RI20200517-0016 01-01-24-05 P / 79 05/25/2020 LT005
RAITI III (553-A),
08 (515-A)
305 05/17/2020 Baru RI20200517-0017 01-06-56-78 P/0 05/21/2020 ZZ086

BY NY ITA FITRIANA RUANG BAYI
(201-P),
10 (PERI001-H)
306 05/17/2020 Baru RI20200517-0018 01-02-85-86 P / 57 05/19/2020 LT005

SITI AMINAH III (553-A), III
(522-B), III (523-
C),
06 (522-A)

307 05/18/2020 Baru RI20200518-0001 01-06-51-89 P / 38 05/20/2020 LT005

SRI WATI III (599-B), III
(523-B),
06 (553-E)
308 05/18/2020 Lama RI20200518-0002 01-01-33-88 P / 33 05/19/2020 LT005
WINARTI III (522-A),
06 (522-D)
309 05/18/2020 Baru RI20200518-0003 01-06-55-71 P / 19 05/19/2020 LT005

NUR ANNISA 06 (599-H)
310 05/18/2020 Baru RI20200518-0004 01-04-56-14 L / 27 05/19/2020 LT005

IWAN SUGIANTO III (521-B),
06 (526-D)
311 05/18/2020 Baru RI20200518-0005 01-06-56-83 L / 35 05/21/2020 LT005
YANAH ANDRI III (599-B),
08 (520-B)
312 05/18/2020 Baru RI20200518-0008 01-06-54-40 P / 28 05/21/2020 LT005

MARIASIH GIRSANG III (553-G), III
(522-E),
06 (522-B)
313 05/18/2020 Baru RI20200518-0009 01-06-56-95 L/0 05/20/2020 ZZ088

BY NY LASMINI 09 (201-I)
314 05/18/2020 Baru RI20200518-0010 01-06-56-98 L/0 05/20/2020 ZZ088

BY NY EKA SURYANI 09 (201-K)
315 05/18/2020 Baru RI20200518-0011 01-06-57-04 P / 24 05/20/2020 LT005

HALIMAH III (553-H),
06 (523-C)
316 05/18/2020 Baru RI20200518-0012 01-06-57-11 L/0 05/20/2020 ZZ088

BY NY NUR ANISAH 09 (201-L)

317 05/18/2020 Baru RI20200518-0013 01-06-57-13 P / 36 05/20/2020 LT005
AECI I (517),
I (551-B),
04 (501-A)
318 05/18/2020 Lama RI20200518-0014 01-03-76-30 P / 64 05/20/2020 LT005

CARKEM II (527-A),
05 (527-B)
319 05/18/2020 Baru RI20200518-0015 01-06-57-25 P/0 05/20/2020 ZZ086
BY NY SRI WATI RUANG BAYI
(201-M),
10 (PERI001-C)
320 05/18/2020 Baru RI20200518-0016 01-06-55-18 P / 32 05/18/2020 LT006

SUMINA 06 (608-A)
321 05/18/2020 Baru RI20200518-0017 01-06-57-10 L/2 05/24/2020 LT005

MUHAMAD ARKHAN III (526-B), III
PRATAMA (553-C),
06 (526-D)
322 05/18/2020 Baru RI20200518-0018 01-06-57-06 L / 74 05/20/2020 LT005

JONO III (553-I), III
(521-C),
06 (521-B)
323 05/18/2020 Baru RI20200518-0019 01-06-57-09 P / 29 05/20/2020 LT005

MAYRIANA LAORE I (597-A),
04 (517)
324 05/18/2020 Baru RI20200518-0020 01-06-57-34 L/0 05/22/2020 ZZ086

BY NY ASNIAH RUANG BAYI
(201-H),
10 (PERI001-D)
325 05/18/2020 Lama RI20200518-0021 01-06-53-73 P/0 05/22/2020 ZZ086

BY NY ROKIAH 10 (PERI001-B)

326 05/18/2020 Lama RI20200518-0022 01-02-46-19 P / 37 05/18/2020 LT005

DIAN PRAWITASARI 06 (599-I)
327 05/18/2020 Baru RI20200518-0023 01-06-57-47 L/0 05/20/2020 ZZ088

BY NY MAYRIANA 09 (201-A)
328 05/18/2020 Baru RI20200518-0024 01-01-21-48 P / 41 05/19/2020 LT005

ERLINA 06 (599-J)
329 05/18/2020 Baru RI20200518-0025 01-06-57-41 P / 67 05/20/2020 LT005

PENNY III (522-C),
06 (522-E)
330 05/18/2020 Baru RI20200518-0026 01-06-57-51 P/0 05/22/2020 ZZ086

BY NY AECI RUANG BAYI
(201-B),
10 (PERI001-E)
331 05/18/2020 Baru RI20200518-0027 01-06-57-53 P / 22 05/19/2020 LT006
INDRI YANI III (553-A), III
(602A),
06 (606C)
332 05/18/2020 Baru RI20200518-0029 01-06-57-57 P / 28 05/21/2020 LT005

NANI ELGAYANI III (523-A), III
(553-A),
06 (522-C)
333 05/18/2020 Lama RI20200519-0001 01-06-54-96 L/6 05/22/2020 LT005

NAFIZ MIRZA I (551-A),
05 (507-B)
334 05/19/2020 Baru RI20200519-0002 01-05-35-04 P / 60 05/21/2020 LT005

HJ. KASTURI II (502-A),
05 (508-B)

335 05/19/2020 Lama RI20200519-0003 01-06-55-18 P / 32 05/20/2020 LT006

SUMINA III (606A),
06 (608-B)
336 05/19/2020 Baru RI20200519-0004 01-06-57-62 P/0 05/19/2020 ZZ088

BY NY INDRI YANI 09 (201-C)
337 05/19/2020 Baru RI20200519-0005 01-06-57-63 P / 25 05/21/2020 LT006

MELIA NURJANAH 06 (606B)
338 05/19/2020 Baru RI20200519-0006 01-06-57-64 P / 25 05/21/2020 LT005

TERA ANJELA 06 (553-B)
339 05/19/2020 Baru RI20200519-0007 01-06-53-55 P / 24 05/20/2020 LT005

BELLA PRISCILLA 06 (553-C)
340 05/19/2020 Baru RI20200519-0008 01-06-56-94 P / 37 05/20/2020 LT005

ROHENAH 06 (599-C)
341 05/19/2020 Baru RI20200519-0009 01-06-54-34 P / 37 05/22/2020 LT005

LILI MAESAROH I (597-A),
05 (503-A)
342 05/19/2020 Baru RI20200519-0010 01-06-57-81 P/0 05/21/2020 ZZ088

BY NY MELIA NURJANAH 09 (201-O)
343 05/19/2020 Baru RI20200519-0011 01-06-57-84 P/0 05/21/2020 ZZ088

BY NY YANAH ANDRI 09 (201-D)
344 05/19/2020 Baru RI20200519-0012 01-06-57-69 P / 18 05/22/2020 LT005

VERONICA III (521-C), III
(521-E), III (522-
C),
06 (522-D)
345 05/19/2020 Baru RI20200519-0014 01-06-57-86 P / 25 05/20/2020 LT006
SUSIYANTI 06 (606A)
346 05/19/2020 Baru RI20200519-0015 01-06-58-00 P/0 05/21/2020 ZZ088

BY NY TERA ANJELA 09 (201-G)
347 05/19/2020 Baru RI20200519-0016 01-06-58-01 P / 40 05/21/2020 LT005

NUR ALIANAH III (553-F),
08 (520-A)
348 05/19/2020 Baru RI20200519-0017 01-06-58-12 P / 28 05/21/2020 LT005

ALFIN JANNATIN 06 (599-J)
349 05/19/2020 Baru RI20200519-0018 01-06-58-13 P/0 05/21/2020 ZZ088

BY NY NUR ALIANAH 09 (201-F)
350 05/19/2020 Baru RI20200519-0019 01-06-58-09 L / 37 05/23/2020 LT005

SUHEMAN III (599-D), III
(521-D),
04 (517)
351 05/19/2020 Baru RI20200519-0020 01-06-57-99 L / 12 05/22/2020 LT005

FAJAR SURYAWANSYAH I (551-C),
05 (507-A)
352 05/19/2020 Baru RI20200519-0021 01-06-58-16 P / 20 05/20/2020 LT006

AYU RAHAYU 06 (606C)

353 05/19/2020 Lama RI20200519-0022 01-03-85-97 P / 36 05/22/2020 LT005

AYU UNDARDI I (597-B),
05 (503-B)
354 05/19/2020 Baru RI20200519-0023 01-06-19-65 P / 30 05/22/2020 LT005

SUCI MARGAWATI 06 (599-K)
355 05/19/2020 Baru RI20200519-0024 01-06-58-21 L/0 05/20/2020 ZZ088

BY NY AYU RAHAYU 09 (201-B)
356 05/19/2020 Baru RI20200519-0025 01-06-58-19 P / 18 05/22/2020 LT005

FITARNIAT NDURU 05 (505-A)
357 05/19/2020 Baru RI20200519-0026 01-06-58-20 L/8 05/21/2020 LT005
FEBRIAN FALENTINO III (599-L),
GULTOM 06 (526-C)
358 05/20/2020 Baru RI20200520-0001 01-06-12-60 P / 25 05/20/2020 LT005
ANIS ROSITA 08 (515-B)
359 05/20/2020 Baru RI20200520-0002 01-06-58-25 P / 38 05/20/2020 LT006

SRI HANDAYANI 06 (606D)
360 05/20/2020 Baru RI20200520-0003 01-06-58-26 P / 35 05/23/2020 LT005

SITI SAMSIYAH III (599-L),
08 (512-B)
361 05/20/2020 Baru RI20200520-0004 01-06-58-23 P / 11 05/21/2020 LT005

RIKA FEBRIYOLA 06 (599-E)
362 05/20/2020 Baru RI20200520-0005 01-05-43-02 P / 33 05/22/2020 LT006

RANI SASLITA 05 (603A)

363 05/20/2020 Baru RI20200520-0007 01-06-58-39 L/0 05/22/2020 ZZ088

BY NY AYU UNDARDI 09 (201-E)
364 05/20/2020 Baru RI20200520-0008 01-06-58-44 P/0 05/22/2020 ZZ088

BY NY SUCI MARGAWATI 09 (201-H)
365 05/20/2020 Baru RI20200520-0009 01-02-64-88 P / 30 05/22/2020 LT005

NOVITA WELING III (553-D),
08 (512-A)
366 05/20/2020 Baru RI20200520-0010 01-06-58-50 L/0 05/22/2020 ZZ088

BY NY LILI MAESAROH 09 (201-J)
367 05/20/2020 Baru RI20200520-0011 01-06-58-52 P / 27 05/23/2020 LT005

SUKARNI SAPITRI III (521-C), II
(525-A),
06 (523-D)
368 05/20/2020 Baru RI20200520-0012 01-06-58-45 L/1 05/20/2020 LT006

ARSAKA LUTFI PIRENDRA 06 (602A)
369 05/20/2020 Baru RI20200520-0013 01-06-58-55 P/0 05/22/2020 ZZ088

BY NY RANI SASLITA 09 (201-M)
370 05/20/2020 Baru RI20200520-0014 01-06-58-61 L/4 05/24/2020 LT005

ARMANSYAH III (521-A),
06 (526-C)
371 05/20/2020 Baru RI20200520-0015 01-06-58-64 P/0 05/22/2020 ZZ088
BY NY NOVITA WELING S 09 (201-P)

372 05/20/2020 Baru RI20200520-0016 01-05-52-45 P / 25 05/22/2020 LT006

ROHAYATI 06 (606E)
373 05/20/2020 Baru RI20200520-0017 01-06-58-65 L/0 05/23/2020 ZZ088

BY NY SITI SAMSIYAH 09 (201-Q)
374 05/20/2020 Baru RI20200520-0018 01-06-58-60 L / 81 05/22/2020 LT006

SANG 06 (602D)
375 05/20/2020 Lama RI20200520-0019 01-03-56-43 P / 36 05/23/2020 LT005

HERAWATI III (553-G),
06 (522-A)
376 05/20/2020 Baru RI20200520-0020 01-06-58-69 P / 27 05/22/2020 LT005

SALMAH WATI 06 (599-F)
377 05/20/2020 Lama RI20200520-0021 01-02-35-77 P / 61 05/23/2020 LT005

UMINAH III (553-J),
05 (510-A)
378 05/20/2020 Baru RI20200520-0022 01-06-58-62 P / 38 05/21/2020 LT005

SRI SULASTRI 06 (553-E)
379 05/20/2020 Baru RI20200520-0023 01-05-10-63 P / 29 05/22/2020 LT005

PUTRI ANANDA I (501-A),
04 (518)
380 05/20/2020 Baru RI20200520-0024 01-06-51-11 P / 18 05/22/2020 LT005

RESMADYA PUTRI 06 (553-K)

381 05/20/2020 Baru RI20200520-0025 01-06-58-71 P / 29 05/20/2020 LT006

RIYAN SUSI 06 (606A)
382 05/20/2020 Baru RI20200520-0026 01-06-58-74 P/0 05/22/2020 ZZ088

BY NY ROHAYATI 09 (201-R)
383 05/20/2020 Lama RI20200520-0027 01-06-58-71 P / 29 05/22/2020 LT005

RIYAN SUSI III (599-G),
08 (520-A)
384 05/20/2020 Baru RI20200520-0028 01-06-58-73 L / 46 05/23/2020 LT005
ZAENAL ARIFIN III (599-M),
06 (521-C)
385 05/20/2020 Lama RI20200520-0029 01-02-38-86 P / 31 05/24/2020 LT005
LILY III (599-N),
05 (502-B)
386 05/20/2020 Baru RI20200520-0030 01-06-58-76 L/0 05/22/2020 ZZ088

BY NY RIYAN SUSI 09 (201-S)
387 05/20/2020 Baru RI20200520-0031 01-06-58-77 L/0 05/22/2020 ZZ088

BY NY SUKARNI 09 (201-T)
388 05/21/2020 Baru RI20200521-0001 01-06-58-78 L/0 05/22/2020 ZZ088

BY NY PUTRI ANANDA 09 (201-U)
389 05/21/2020 Baru RI20200521-0002 01-02-80-14 P / 36 05/22/2020 LT006

DJAP SU FUN SANTI 03 (621)
390 05/21/2020 Baru RI20200521-0003 01-06-58-81 P/0 05/22/2020 ZZ088

BY NY RESMADYA PUTRI 09 (201-A)

391 05/21/2020 Baru RI20200521-0004 01-06-58-83 P/0 05/23/2020 ZZ086

BY NY DJAP SU FON SANTI RUANG BAYI
(201-B),
10 (PERI001-C)
392 05/21/2020 Baru RI20200521-0005 01-06-58-70 P / 17 05/22/2020 LT005
SITI ANISA 08 (512-A)
393 05/21/2020 Baru RI20200521-0006 01-06-58-86 P / 28 05/24/2020 LT005

ITA FATMASARI III (553-A),
05 (527-A)
394 05/21/2020 Baru RI20200521-0007 01-06-58-87 L / 66 05/23/2020 LT005

YUSUP BUDIYANTO III (599-I),
06 (521-A)
395 05/21/2020 Baru RI20200521-0008 01-06-58-89 P / 25 05/24/2020 LT005

DIAH TRI UTARININGSIH 06 (522-E)
396 05/21/2020 Baru RI20200521-0010 01-06-58-93 P / 31 05/24/2020 LT005

RATNAWATI 06 (523-A)
397 05/21/2020 Baru RI20200521-0011 01-05-74-94 P / 25 05/24/2020 LT005

RIKA RIYANTI III (523-B),
08 (520-B)
398 05/21/2020 Baru RI20200522-0001 01-06-58-94 P / 23 05/24/2020 LT005

SUCI MEILIANA III (523-C),
08 (512-A)
399 05/21/2020 Lama RI20200522-0002 01-03-36-44 P / 43 05/24/2020 LT005
YANTI WAHYUNI III (523-D),
08 (520-A)
400 05/22/2020 Lama RI20200522-0003 01-03-69-53 L/1 05/23/2020 LT005

ELNINO MUBARAK II (502-A),
05 (503-B)

401 05/22/2020 Lama RI20200522-0004 01-05-89-40 P/4 LT005

ARUNA SACHI KAYANA III (599-J),
06 (526-A)
402 05/22/2020 Baru RI20200522-0005 01-06-58-96 L / 22 05/24/2020 LT005
MUHAMMAD DAVID ISMAIL III (521-B),
06 (521-D)
403 05/22/2020 Baru RI20200522-0006 01-06-59-05 P / 66 05/23/2020 LT005

KAMSIYATUN III (553-J),
06 (522-C)
404 05/22/2020 Baru RI20200522-0007 01-06-59-12 P/0 05/23/2020 ZZ088
BY NY ITA PATMASARI 09 (201-C)
405 05/22/2020 Baru RI20200522-0008 01-06-59-16 P/0 05/24/2020 ZZ088

BY NY RATNA WATI 09 (201-F)
406 05/22/2020 Baru RI20200522-0009 01-06-59-19 L/0 05/24/2020 ZZ086

BY NY SUCI MEILIANA 10 (PERI001-F)
407 05/22/2020 Baru RI20200522-0010 01-06-58-92 P / 28 05/23/2020 LT006

FATRASA CHAIRONA 06 (606F)
408 05/22/2020 Baru RI20200522-0011 01-06-59-15 L / 57 05/23/2020 LT005

EDDY ANDRIYADHI 06 (553-D)
409 05/22/2020 Baru RI20200522-0012 01-06-59-20 L/0 05/23/2020 ZZ088

BY NY DIAH TRI 09 (201-I)
UTARININGSIH
410 05/22/2020 Baru RI20200522-0013 01-06-59-21 P/0 05/23/2020 ZZ088

BY NY RIKA RIYANTI 09 (201-D)

411 05/22/2020 Baru RI20200522-0014 01-06-59-23 L/0 05/23/2020 ZZ088

BY NY YANTI WAHYUNI 09 (201-G)
412 05/22/2020 Baru RI20200522-0016 01-06-59-27 L/5 05/24/2020 LT005

YOSUA IMANUELL III (553-H),
06 (526-B)
413 05/22/2020 Lama RI20200522-0017 01-06-55-79 L/0 05/24/2020 ZZ086
BY NY LIM KRISTIN 10 (PERI001-G)
414 05/22/2020 Baru RI20200522-0018 01-06-59-31 L / 29 05/26/2020 LT005

RIZKY AFFANDI I (551-A),
04 (518)
415 05/22/2020 Baru RI20200522-0019 01-06-10-86 P / 32 05/25/2020 LT005

SITI ASMAH II (510-B),
05 (503-B)
416 05/23/2020 Lama RI20200523-0001 01-05-15-29 P / 21 05/24/2020 LT005

MUTIA NISA ALFATEHAH 06 (599-A)
417 05/23/2020 Baru RI20200523-0002 01-06-59-40 P/0 05/25/2020 ZZ088

BY NY SITI ASMAH 09 (201-A)
418 05/23/2020 Baru RI20200523-0003 01-02-70-36 P/3 LT005

CHARISSA KATHLEEN III (553-J),
05 (505-B)
419 05/23/2020 Baru RI20200523-0005 01-04-17-64 P / 30 05/25/2020 LT005

UNUN KHUSNUL KHOTIMA 04 (501-A)
420 05/23/2020 Baru RI20200523-0006 01-06-59-46 P / 34 05/25/2020 LT005

WAHYUNI III (523-B),
05 (509-B)

421 05/23/2020 Baru RI20200523-0007 01-06-59-47 P/0 05/25/2020 ZZ088

BY NY UNUN KHUSNUL 09 (201-E)
422 05/23/2020 Baru RI20200523-0008 01-06-59-48 P / 31 05/25/2020 LT005

SRI NURHAYATI MUSTIKA III (523-C),
04 (517)
423 05/23/2020 Baru RI20200523-0009 01-06-59-52 L/0 05/25/2020 ZZ088

BY NY SRI NURHAYATI 09 (201-H)
MUSTIKA
424 05/23/2020 Baru RI20200523-0010 01-06-59-54 P/0 05/25/2020 ZZ088

BY NY WAHYUNI 09 (201-J)
425 05/24/2020 Baru RI20200524-0001 01-06-59-59 L/1 05/26/2020 LT006

MARTIN ARDIONO 06 (602A)
426 05/24/2020 Baru RI20200524-0003 01-06-42-33 P / 45 05/25/2020 LT005

SUJATMI 06 (522-A)
427 05/24/2020 Baru RI20200524-0004 01-06-59-60 P / 35 05/25/2020 LT005
MEGAWATI II (527-B),
05 (503-A)
428 05/24/2020 Baru RI20200524-0005 01-06-59-63 P / 34 05/26/2020 LT005

MARIANIE GUNAWAN III (523-A),
06 (523-C)
429 05/24/2020 Baru RI20200524-0006 01-06-59-65 L/0 05/25/2020 ZZ088

BY NY MEGAWATI 09 (201-K)

430 05/24/2020 Baru RI20200524-0007 01-06-59-67 L/0 ZZ086

BY NY MARIANIE RUANG BAYI
GUNAWAN (201-L),
10 (PERI001-B)
431 05/24/2020 Lama RI20200524-0008 01-06-59-28 P / 27 05/25/2020 LT006
MEILI HUINI 02 (619)
432 05/24/2020 Baru RI20200524-0009 01-06-59-68 L/0 05/25/2020 ZZ088

BY NY MEILINI HUINI 09 (201-M)
433 05/25/2020 Lama RI20200525-0001 01-02-53-30 L/2 LT005

GHAILAN SHAKEIL III (526-B), II
FATURAHMAN (510-A), II (510-
B),
05 (510-B)
434 05/25/2020 Baru RI20200525-0002 01-06-57-98 P / 35 LT005
IIN PARLINA II (502-A),
08 (520-A)
435 05/25/2020 Baru RI20200525-0003 01-06-59-79 P / 23 LT006

IIS 06 (602E)
436 05/25/2020 Lama RI20200525-0004 01-01-24-87 P / 56 LT005

HARNENGSIH III (553-A),
08 (512-B)
437 05/25/2020 Lama RI20200525-0005 01-03-92-06 P / 37 05/26/2020 LT005

WIWI RUSMINI 04 (501-A)
438 05/26/2020 Baru RI20200526-0001 00-00-41-92 P / 77 LT005

ELIANA GUNAWAN I (551-A),
05 (525-A)
439 05/26/2020 Baru RI20200526-0002 01-06-59-84 P / 14 LT005

RIFA NAILA SILMI 06 (553-B)

440 05/26/2020 Lama RI20200526-0003 01-01-77-62 P / 34 LT005

RATNA SARI JUWITA 06 (599-A)
441 05/26/2020 Lama RI20200526-0004 01-04-01-85 P / 30 LT005
SRI NURHAYATI 06 (553-D)
442 05/26/2020 Baru RI20200526-0005 01-06-57-78 L / 51 LT005

SIDAMULYA III (521-B),
06 (521-D)
443 05/26/2020 Baru RI20200526-0006 01-06-59-99 P/0 ZZ088

BY NY SRI NURHAYATI 09 (201-B)
444 05/26/2020 Baru RI20200526-0007 01-06-59-91 L / 48 LT006

AMAD 03 (621)
445 05/26/2020 Baru RI20200526-0008 01-06-57-14 P / 30 LT005

YULIANA MUET 06 (523-A)
446 05/26/2020 Baru RI20200526-0009 01-06-60-00 L/0 ZZ086

BY NY RATNA SARI JUWITA RUANG BAYI
(201-C),
10 (PERI001-C)
447 05/26/2020 Baru RI20200526-0010 01-06-07-51 P / 29 LT005

PRIHATINA WIJAYANTI 04 (501-A)
448 05/26/2020 Baru RI20200526-0011 01-06-60-03 P / 22 LT005

VIVI DESTIA SEPTI 06 (523-B)
449 05/26/2020 Lama RI20200526-0012 01-03-41-03 P / 27 LT005

TRI WINDAHTARI 06 (523-D)
450 05/26/2020 Baru RI20200526-0013 01-06-60-09 P / 32 LT006

MARITA III (526-B),
06 (608-A)

451 05/26/2020 Baru RI20200526-0014 01-06-60-10 P/0 ZZ088

BY NY IIN PARLINA 09 (201-D)
452 05/26/2020 Baru RI20200526-0015 01-06-27-71 L / 64 LT005

TOMMY LIMANJAYA LIM III (521-A),
06 (521-E)
453 05/26/2020 Lama RI20200526-0016 01-06-30-94 P / 33 LT005
NURAINI 06 (526-B)
454 05/26/2020 Baru RI20200526-0017 01-06-60-13 P/0 ZZ088

BY NY MARITA 09 (201-I)
455 05/26/2020 Baru RI20200526-0018 01-06-60-15 P / 36 05/27/2020 LT005

RUKINI 06 (526-C)
456 05/26/2020 Baru RI20200526-0019 01-06-60-07 L / 37 LT005

TJO EDDY BUDIMAN II (525-A), II
(525-B),
05 (527-A)
457 05/26/2020 Lama RI20200526-0020 01-06-59-59 L/1 LT005

MARTIN ARDIONO 06 (526-D)
458 05/26/2020 Baru RI20200526-0021 01-06-60-17 L / 57 ZZ089
JUJUK BODIYO III (521-C),
07 (ICU-A)
459 05/26/2020 Baru RI20200526-0022 01-06-59-71 L / 49 LT005
ATOK VIRMANTO III (521-D),
06 (521-C)
460 05/26/2020 Baru RI20200526-0023 01-06-60-21 L/0 ZZ088
BY NY NURAINI 09 (201-F)
461 05/26/2020 Baru RI20200526-0024 01-06-60-04 P / 13 LT005

FITRIA OCTAVIANI 06 (523-C)

462 05/26/2020 Baru RI20200526-0025 01-06-60-23 P / 25 LT005

NURUL AINI WIDYASTUTI 06 (599-B)
463 05/26/2020 Baru RI20200526-0027 01-06-60-24 L/0 ZZ088

BY NY PRIHATINA 09 (201-G)
WIJAYANTI
464 05/26/2020 Baru RI20200526-0028 01-06-59-83 L / 52 LT005
KIM SAN 08 (515-A)
465 05/27/2020 Baru RI20200527-0001 01-06-44-34 P / 27 LT005

SAHRONAH 06 (599-C)
466 05/27/2020 Lama RI20200527-0002 01-01-78-67 P / 39 LT005

ATIKA MURNI 05 (552-A)
Dokter Hari Penjamin Keadaan Keluar Diagnosa
SMF Rawat
dr. Mienche Sp.PD 6 BPJS KESEHATAN DIIZINKAN PULANG Acute hep. B without
delta-agent&wit
PENYAKIT DALAM hout hepc coma (B16.9,
037, LAMA)
dr. Hery Dharmawan, Sp. A 2 BPJS KESEHATAN DIIZINKAN PULANG
ANAK
dr. Johny Setio, Sp.OG 2 BPJS KESEHATAN DIIZINKAN PULANG Gestat.
[preg.-ind.]hypert
OBSTETRI DAN GINEKOLOGI without sig.proteinuria
(O13, 237.9, LAMA)
dr. Putu Eka, Sp.PD 5 BPJS KESEHATAN DIIZINKAN PULANG demam/Fever,

unspecified -
PENYAKIT DALAM Hyperpyrexia
NOS-Pyrexia NOS
(R50.9, 268, LAMA)
dr. Johny Setio, Sp.OG 2 PRIBADI DIIZINKAN PULANG Single spontaneous
delivery
OBSTETRI DAN GINEKOLOGI (O80, 243, LAMA)
dr. Putu Eka, Sp.PD 2 BPJS KESEHATAN BELUM SEMBUH
PENYAKIT DALAM
dr. Putu Eka, Sp.PD 2 BPJS KESEHATAN BELUM SEMBUH Diabetes Melitus tidak
tergantung insulin
PENYAKIT DALAM (E11,
104.1, LAMA)
dr. Johny Setio, Sp.OG 2 BPJS KESEHATAN DIIZINKAN PULANG Maternal care for
disproportion,
OBSTETRI DAN GINEKOLOGI unspecified (O33.9,
239.9, LAMA)
dr. Ivan Rifai 3 BPJS KESEHATAN DIIZINKAN PULANG Single delivery by

Sentosa,Sp.OG OBSTETRI DAN caesarean section (O82,
GINEKOLOGI 242.9, LAMA)

SMF Rawat
dr. Johny Setio, Sp.OG 3 BPJS KESEHATAN DIIZINKAN PULANG Single delivery by
OBSTETRI DAN GINEKOLOGI 242.9, LAMA)
dr. Johny Setio, Sp.OG 3 PRIBADI DIIZINKAN PULANG Placenta praevia (O44,
OBSTETRI DAN GINEKOLOGI by emergency
caesarean section
(O82.1, 242.9, LAMA),
Single live birth
(Z37.0, 298, LAMA)
dr. Hedy Vidiani, SpA 3 BPJS KESEHATAN DIIZINKAN PULANG Other neonatal
ANAK (P24.8, 249, LAMA)
ANAK (P24.8, 249, LAMA)
dr. Vidhia Umami. Sp.PD 5 PRIBADI DIIZINKAN PULANG DHF / DBD

(A91, 032.1, LAMA)
PENYAKIT DALAM
dr. Vidhia Umami. Sp.PD 7 BPJS KESEHATAN DIIZINKAN PULANG Congenital pneumonia
(P23, 249, LAMA)
PENYAKIT DALAM
dr. Arief Gunadi, Sp. A 3 PRIBADI DIIZINKAN PULANG Fetus and newborn
ANAK delivery (P03.4, 245,
LAMA)

SMF Rawat
dr. Arief Gunadi, Sp. A 3 BPJS KESEHATAN DIIZINKAN PULANG Other neonatal
ANAK (P24.8, 249, LAMA)
ANAK (P24.8, 249, LAMA)
dr. Hedy Vidiani, SpA 5 BPJS KESEHATAN DIIZINKAN PULANG Fetus and newborn
LAMA)
dr. Johny Setio, Sp.OG 2 BPJS KESEHATAN DIIZINKAN PULANG Anaemia comp.
preg.,childbirth
OBSTETRI DAN GINEKOLOGI & the puerperium
(O99.0, 244, LAMA)
dr. Vidhia Umami. Sp.PD 4 BPJS KESEHATAN DIIZINKAN PULANG Paralytic ileus
(K56.0, 190, LAMA)
PENYAKIT DALAM
dr. Vidhia Umami. Sp.PD 4 BPJS KESEHATAN DIIZINKAN PULANG Diabetes Melitus tidak
tergantung insulin
104.1, LAMA)
[preg.-ind.]hypert
(O13, 237.9, LAMA)
SMF Rawat
dr. Ivan Rifai 3 BPJS KESEHATAN DIIZINKAN PULANG Severe

Sentosa,Sp.OG OBSTETRI DAN pre-eclampsia (O14.1,
GINEKOLOGI 237.0, LAMA), Delivery
by emergency
caesarean section
(O82.1, 242.9, LAMA),
Single live birth (Z37.0,
298, LAMA), Anaemia
comp. preg.,childbirth
& the puerperium
(O99.0, 244, LAMA)
preg.,childbirth
(O99.0, 244, LAMA)
LAMA)
LAMA)
dr. Hedy Vidiani, SpA 3 BPJS KESEHATAN DIIZINKAN PULANG
ANAK
dr. Vidhia Umami. Sp.PD 3 BPJS KESEHATAN DIIZINKAN PULANG
PENYAKIT DALAM
dr. Vidhia Umami. Sp.PD 4 BPJS KESEHATAN DIIZINKAN PULANG DHF / DBD
(A91, 032.1, LAMA)
PENYAKIT DALAM

SMF Rawat
PENYAKIT DALAM
dr. Hedy Vidiani, SpA 5 BPJS KESEHATAN DIIZINKAN PULANG Ge/Diare (A09.9,
005, LAMA)
ANAK
dr. Johny Setio, Sp.OG 2 PRIBADI DIIZINKAN PULANG Single spontaneous

delivery
OBSTETRI DAN GINEKOLOGI (O80, 243, LAMA)
LAMA)
dr. Johny Setio, Sp.OG 5 BPJS KESEHATAN DIIZINKAN PULANG Mild hyperemesis
gravidarum (O21.0,
dr. Budi Irawan, Sp.B-KBD 5 PRIBADI DIIZINKAN PULANG Connective & other
BEDAH face&neck (D21.0,
096.6, LAMA)
dr. Ivan Rifai 4 BPJS KESEHATAN DIIZINKAN PULANG Prolonged first stage
Sentosa,Sp.OG OBSTETRI DAN (of labour) (O63.0,
dr. Arief Gunadi, Sp. A 3 BPJS KESEHATAN DIIZINKAN PULANG Fetus and newborn
LAMA)

SMF Rawat

[preg.-ind.]hypert
(O13, 237.9, LAMA)
dr. Budi Irawan, Sp.B-KBD 2 BPJS KESEHATAN DIIZINKAN PULANG Other benign neoplasms
of skin (d23, 090,
BEDAH LAMA)
dr. Arief Gunadi, Sp. A 5 BPJS KESEHATAN DIIZINKAN PULANG Dengue fever [classical
dengue] (A90, 032.0,
ANAK LAMA)
dr. Johny Setio, Sp.OG 3 BPJS KESEHATAN DIIZINKAN PULANG Delivery by caesarean
OBSTETRI DAN GINEKOLOGI (O82.9, 242.9, LAMA)
dr. Hery Dharmawan, Sp. A 3 BPJS KESEHATAN DIIZINKAN PULANG Fetus and newborn
LAMA)
dr. Johny Setio, Sp.OG 3 BPJS KESEHATAN DIIZINKAN PULANG
LAMA)
dr. Ivan Rifai 3 BPJS KESEHATAN DIIZINKAN PULANG Delivery by caesarean
Sentosa,Sp.OG OBSTETRI DAN section, unspecified
GINEKOLOGI (O82.9, 242.9, LAMA)
SMF Rawat
dr. Ivan Rifai 2 BPJS KESEHATAN DIIZINKAN PULANG Blighted ovum and
Sentosa,Sp.OG OBSTETRI DAN nonhydatidiform
GINEKOLOGI mole (O02.0,
236.9, LAMA)
LAMA)
dr. Mienche Sp.PD 4 BPJS KESEHATAN DIIZINKAN PULANG Diabetes Melitus tidak
tergantung insulin
104.1, LAMA)
dr. Andre, Sp.S 4 BPJS KESEHATAN DIIZINKAN PULANG Stroke, not specified as
haemorrhage or
SYARAF infarction (I64, 155,
LAMA)
dr. Arief Gunadi, Sp. A 4 BPJS KESEHATAN DIIZINKAN PULANG Ge/Diare (A09.9,
005, LAMA)
ANAK

[preg.-ind.]hypert
(O13, 237.9, LAMA)
dr. Johny Setio, Sp.OG 3 PRIBADI DIIZINKAN PULANG Unspecified abortion

[See above for
OBSTETRI DAN GINEKOLOGI subdivisions] (O06,
236.9, LAMA)
dr. Vidhia Umami. Sp.PD 6 PRIBADI DIIZINKAN PULANG Follow-up exam.after
radiothera.for other
PENYAKIT DALAM conditi. (Z09.1,
290.9, LAMA)
LAMA)

SMF Rawat
dr. Johny Setio, Sp.OG 3 BPJS KESEHATAN DIIZINKAN PULANG Fetus and newborn
OBSTETRI DAN GINEKOLOGI delivery (P03.4, 245,
LAMA)
disproportion,
239.9, LAMA)

[preg.-ind.]hypert
(O13, 237.9, LAMA)
dr. Arief Gunadi, Sp. A 6 BPJS KESEHATAN DIIZINKAN PULANG Hypokalaemia

(E87.6, 111, LAMA)
ANAK
dr. Vidhia Umami. Sp.PD 4 BPJS KESEHATAN DIIZINKAN PULANG Larynx - Epiglottis
(suprahyoid portion)
PENYAKIT DALAM (D14.1, 096.4, LAMA)
dr. Budi Irawan, Sp.B-KBD 2 BPJS KESEHATAN DIIZINKAN PULANG Diabetes Melitus tidak
tergantung insulin
BEDAH (E11,
104.1, BARU)
dr. Budi Irawan, Sp.B-KBD 2 BPJS KESEHATAN MENINGGAL < 48 JAM Liver, unspecified
(C22.9, 063, LAMA)
BEDAH
LAMA)
dr. Budi Irawan, Sp.B-KBD 4 BPJS KESEHATAN DIIZINKAN PULANG Acute appendicitis
(K35, 186, LAMA)
BEDAH
LAMA)
SMF Rawat
preg.,childbirth
(O99.0, 244, LAMA)
LAMA)
dr. Johny Setio, Sp.OG 3 BPJS KESEHATAN DIIZINKAN PULANG Mild hyperemesis
gravidarum (O21.0,
tergantung insulin
104.1, LAMA)
dr. Johny Setio, Sp.OG 2 BPJS KESEHATAN DIIZINKAN PULANG Unspecified abortion
[See above for
236.9, LAMA)
dr. Johny Setio, Sp.OG 2 BPJS KESEHATAN DIIZINKAN PULANG Other anaemias
(D64, 098, LAMA)
LAMA)
dr. Johny Setio, Sp.OG 3 BPJS KESEHATAN DIIZINKAN PULANG Postpartum care and
examination
OBSTETRI DAN GINEKOLOGI (Z39, 296, LAMA), Fetus
and newborn affected
by caesarean delivery
(P03.4, 245, LAMA)

SMF Rawat
dr. Vidhia Umami. Sp.PD 4 PRIBADI DIIZINKAN PULANG DHF / DBD

(A91, 032.1, LAMA)
PENYAKIT DALAM
LAMA)
dr. Budi Irawan, Sp.B-KBD 3 BPJS KESEHATAN DIIZINKAN PULANG Abdominal and pelvic
pain
BEDAH (R10, 267, LAMA)
dr. Johny Setio, Sp.OG 3 PRIBADI DIIZINKAN PULANG Single delivery by

dr. Budi Irawan, Sp.B-KBD 2 BPJS KESEHATAN DIIZINKAN PULANG Lymph nodes (D36.0,
096.6, LAMA)
BEDAH
LAMA)
LAMA)

SMF Rawat
dr. Sofie Nurani, M.Biomed, 2 BPJS KESEHATAN DIIZINKAN PULANG Mild hyperemesis
Sp.OG OBSTETRI DAN gravidarum (O21.0,
LAMA)
dr. Johny Setio, Sp.OG 2 PRIBADI DIIZINKAN PULANG Mild hyperemesis
gravidarum (O21.0,
OBSTETRI DAN GINEKOLOGI 242.9, LAMA),
Fetus and newborn
affected by
caesarean delivery
(P03.4, 245, LAMA)
LAMA)
dr. Mienche Sp.PD 3 BPJS KESEHATAN DIIZINKAN PULANG Nausea and vomiting
(R11, 270.9, LAMA)
PENYAKIT DALAM
LAMA)
dr. Hedy Vidiani, SpA 4 BPJS KESEHATAN DIIZINKAN PULANG Neonatal jaundice from
other specified causes
ANAK (P59.8,
253.9, LAMA)
dr. Mienche Sp.PD 3 BPJS KESEHATAN DIIZINKAN PULANG DHF / DBD
(A91, 032.1, LAMA)
PENYAKIT DALAM

SMF Rawat
dr. Arief Gunadi, Sp. A 3 BPJS KESEHATAN DIIZINKAN PULANG Nausea and vomiting
(R11, 270.9, LAMA)
ANAK
dr. Arief Gunadi, Sp. A 3 BPJS KESEHATAN DIIZINKAN PULANG DHF / DBD
(A91, 032.1, LAMA)
ANAK
dr. Mienche Sp.PD 3 PRIBADI DIIZINKAN PULANG Congestive heart failure-

Congestive heart
PENYAKIT DALAM disease (I50.0, 151,
LAMA)
LAMA)
dr. Arief Gunadi, Sp. A 3 BPJS KESEHATAN DIIZINKAN PULANG demam/Fever,
unspecified -
ANAK Hyperpyrexia
NOS-Pyrexia NOS
(R50.9, 268, LAMA)
LAMA)
ANAK (P24.8, 249, LAMA)

(A91, 032.1, LAMA)
PENYAKIT DALAM

SMF Rawat
LAMA)
dr. Ivan Rifai 3 BPJS KESEHATAN DIIZINKAN PULANG Single delivery by
Sentosa,Sp.OG OBSTETRI DAN caesarean section (O82,
LAMA)
dr. Andre, Sp.S 2 BPJS KESEHATAN DIIZINKAN PULANG Vertigo
NOS-Dizziness
SYARAF &
edness (R42, 270.9,
LAMA)
dr. Mienche Sp.PD 5 PRIBADI DIIZINKAN PULANG
PENYAKIT DALAM
dr. Mienche Sp.PD 5 BPJS KESEHATAN DIIZINKAN PULANG Congestive heart failure-
Congestive heart
LAMA)
dr. Sofie Nurani, M.Biomed, 2 BPJS KESEHATAN DIIZINKAN PULANG Maternal care for
Sp.OG OBSTETRI DAN intrauterine death
dr. Mienche Sp.PD 6 BPJS KESEHATAN DIIZINKAN PULANG Typhoid fever - Infection
PENYAKIT DALAM (A01.0, 002, LAMA)
dr. Sofie Nurani, M.Biomed, 3 PRIBADI DIIZINKAN PULANG

Sp.OG OBSTETRI DAN
GINEKOLOGI

SMF Rawat
dr. Mienche Sp.PD 4 BPJS KESEHATAN DIIZINKAN PULANG Anaemia, unspecified

(D64.9, 098, LAMA),
PENYAKIT DALAM Dyspepsia - Indigestion
(K30, 189.9, LAMA)
disproportion,
239.9, LAMA)
LAMA)
[preg.-ind.]hypert
(O13, 237.9, LAMA)
preg.,childbirth
(O99.0, 244, LAMA)
dr. Sofie Nurani, M.Biomed, 3 BPJS KESEHATAN DIIZINKAN PULANG M.care for disp.due to
Sp.OG OBSTETRI DAN deform.of mat.pelvic
GINEKOLOGI bones (O33.0, 239.9,
LAMA)
dr. Sofie Nurani, M.Biomed, 2 BPJS KESEHATAN DIIZINKAN PULANG Maternal care for
Sp.OG OBSTETRI DAN intrauterine death
preg.,childbirth
(O99.0, 244, LAMA)

SMF Rawat
LAMA)
LAMA)
dr. Vidhia Umami. Sp.PD 4 BPJS KESEHATAN BELUM SEMBUH
PENYAKIT DALAM
dr. Putu Eka, Sp.PD 3 PRIBADI DIIZINKAN PULANG Dyspepsia - Indigestion
(K30, 189.9, LAMA)
PENYAKIT DALAM
dr. Sendi Kurnia, Sp.B 2 BPJS KESEHATAN DIIZINKAN PULANG
BEDAH
dr. Arief Gunadi, Sp. A 4 BPJS KESEHATAN DIIZINKAN PULANG Dengue fever [classical
dengue] (A90, 032.0,
ANAK LAMA)
dr. Johny Setio, Sp.OG 6 PRIBADI DIIZINKAN PULANG
disproportion,
239.9, LAMA)
LAMA)
LAMA)

SMF Rawat
LAMA)
dr. Arief Gunadi, Sp. A 3 BPJS KESEHATAN DIIZINKAN PULANG Physiological jaundice
ANAK NOS (P59.9, 253.9,
LAMA)
dr. Johny Setio, Sp.OG 3 BPJS KESEHATAN DIIZINKAN PULANG Other

mater.dis.class.but
OBSTETRI DAN GINEKOLOGI comp.preg.,childbirt h
(O99, 244, LAMA)
LAMA)
LAMA)
dr. Putu Eka, Sp.PD 3 BPJS KESEHATAN DIIZINKAN PULANG Stroke, not specified as
haemorrhage or
PENYAKIT DALAM infarction (I64, 155,
LAMA)
dr. Ivan Rifai 4 BPJS KESEHATAN DIIZINKAN PULANG Anaemia comp.
Sentosa,Sp.OG OBSTETRI DAN preg.,childbirth
GINEKOLOGI & the puerperium
(O99.0, 244, LAMA)
LAMA)
dr. Johny Setio, Sp.OG 3 BPJS KESEHATAN DIIZINKAN PULANG Prolonged first stage
(of labour) (O63.0,

SMF Rawat

[preg.-ind.]hypert
(O13, 237.9, LAMA)
[preg.-ind.]hypert
(O13, 237.9, LAMA)
dr. Sofie Nurani, M.Biomed, 3 PRIBADI DIIZINKAN PULANG Gestat.

Sp.OG OBSTETRI DAN [preg.-ind.]hypert
GINEKOLOGI without sig.proteinuria
(O13, 237.9, LAMA)
dr. Johny Setio, Sp.OG 2 BPJS KESEHATAN DIIZINKAN PULANG Anaemia, unspecified
(D64.9, 098, LAMA)
LAMA)
dr. Sofie Nurani, M.Biomed, 6 BPJS KESEHATAN BELUM SEMBUH Anaemia comp.
Sp.OG OBSTETRI DAN preg.,childbirth
(O99.0, 244, LAMA)
dr. Putu Eka, Sp.PD 3 BPJS KESEHATAN DIIZINKAN PULANG Dyspepsia - Indigestion
(K30, 189.9, LAMA)
PENYAKIT DALAM
LAMA)
LAMA)

SMF Rawat
LAMA)
dr. Arief Gunadi, Sp. A 5 BPJS KESEHATAN DIIZINKAN PULANG Febrile convulsions
(R56.0, 270.3, LAMA)
ANAK
LAMA)
LAMA)
dr. Sofie Nurani, M.Biomed, 5 BPJS KESEHATAN DIIZINKAN PULANG Hyperemesis gravidarum
Sp.OG OBSTETRI DAN with metabolic
GINEKOLOGI disturbance (O21.1,
242.9, LAMA)
(A91, 032.1, LAMA)
ANAK
dr. Mienche Sp.PD 6 BPJS KESEHATAN DIIZINKAN PULANG demam/Fever,

unspecified -
NOS-Pyrexia NOS
(R50.9, 268, LAMA)
dr. Hedy Vidiani, SpA 2 PRIBADI DIIZINKAN PULANG Fetus and newborn
LAMA)

SMF Rawat
dr. Ivan Rifai 3 BPJS KESEHATAN DIIZINKAN PULANG Prem.rupt.of

Sentosa,Sp.OG OBSTETRI DAN membranes,onset of
GINEKOLOGI lab.after 24 hours
(O42.1, 239.2, LAMA)
dr. Johny Setio, Sp.OG 4 BPJS KESEHATAN DIIZINKAN PULANG Prolonged second stage
(of labour) (O63.1,
LAMA)
dr. Sofie Nurani, M.Biomed, 4 BPJS KESEHATAN DIIZINKAN PULANG Gestat.

Sp.OG OBSTETRI DAN [preg.-ind.]hypert
GINEKOLOGI without sig.proteinuria
(O13, 237.9, LAMA)
LAMA)
dr. Johny Setio, Sp.OG 3 PRIBADI DIIZINKAN PULANG Other and unspecified
ovarian cysts
OBSTETRI DAN GINEKOLOGI (N83.2, 229, LAMA)
SMF Rawat
LAMA)
dr. Johny Setio, Sp.OG 2 PRIBADI DIIZINKAN PULANG Prolonged first stage
(of labour) (O63.0,
LAMA)
dr. Mienche Sp.PD 6 BPJS KESEHATAN DIIZINKAN PULANG Hepatitis virus akut
lainnya
PENYAKIT DALAM (B17, , LAMA)
PENYAKIT DALAM
(of labour) (O63.0,
dr. Ivan Rifai 3 BPJS KESEHATAN DIIZINKAN PULANG Delivery by caesarean

Sentosa,Sp.OG OBSTETRI DAN section, unspecified

SMF Rawat
096.6, LAMA)
BEDAH
LAMA)
dr. Sofie Nurani, M.Biomed, 3 BPJS KESEHATAN DIIZINKAN PULANG
Sp.OG OBSTETRI DAN
GINEKOLOGI
LAMA)
ANAK
PENYAKIT DALAM
dr. Hery Dharmawan, Sp. A 6 BPJS KESEHATAN DIIZINKAN PULANG Neonatal aspiration
ANAK (P24.9, 249, LAMA)
dr. Hery Dharmawan, Sp. A 6 BPJS KESEHATAN DIIZINKAN PULANG Other neonatal
ANAK (P24.8, 249, LAMA)

SMF Rawat
dr. Mienche Sp.PD 4 PRIBADI DIIZINKAN PULANG DHF / DBD

(A91, 032.1, LAMA)
PENYAKIT DALAM
dr. Susilo, Sp.N 3 BPJS KESEHATAN DIIZINKAN PULANG Diabetes Melitus tidak
tergantung insulin
SYARAF (E11,
104.1, LAMA)
LAMA)
dr. Hedy Vidiani, SpA 3 BPJS KESEHATAN DIIZINKAN PULANG DHF / DBD
(A91, 032.1, LAMA)
ANAK
dr. Vidhia Umami. Sp.PD 3 BPJS KESEHATAN DIIZINKAN PULANG Constipation (K59.0,
192.9, LAMA)
PENYAKIT DALAM
dr. Arief Gunadi, Sp. A 8 BPJS KESEHATAN DIIZINKAN PULANG Hypoglycaemia,

unspecified
ANAK (E16.2, 111, LAMA)
(a91, 032.1, LAMA)
ANAK
dr. Johny Setio, Sp.OG 4 BPJS KESEHATAN DIIZINKAN PULANG Premature rupture of
membranes
OBSTETRI DAN GINEKOLOGI (O42, 239.2, LAMA)
dr. Johny Setio, Sp.OG 4 PRIBADI DIIZINKAN PULANG Prolonged second stage
(of labour) (O63.1,
SMF Rawat
dr. Vidhia Umami. Sp.PD 2 BPJS KESEHATAN DIIZINKAN PULANG Dyspepsia - Indigestion
(K30, 189.9, LAMA)
PENYAKIT DALAM
dr. Hery Dharmawan, Sp. A 3 BPJS KESEHATAN DIIZINKAN PULANG Transient tachypnoea of
newborn
ANAK (P22.1, 249, LAMA)
dr. Sofie Nurani, M.Biomed, 2 PRIBADI DIIZINKAN PULANG Supervision of normal

Sp.OG OBSTETRI DAN pregnancy, unspecified
GINEKOLOGI (Z34.9, 294.0, LAMA)
dr. Vidhia Umami. Sp.PD 3 BPJS KESEHATAN BELUM SEMBUH
PENYAKIT DALAM
dr. Martin Winardi, Sp.PD 4 PRIBADI DIIZINKAN PULANG DHF / DBD

(a91, 032.1, LAMA)
PENYAKIT DALAM
dr. Martin Winardi, Sp.PD 3 BPJS KESEHATAN DIIZINKAN PULANG Gastrooesophageal
reflux dis. without
PENYAKIT DALAM oesophagitis (K21.9,
185.9, LAMA)
dr. Johny Setio, Sp.OG 3 BPJS KESEHATAN DIIZINKAN PULANG Severe

SMF Rawat
dr. Hery Dharmawan, Sp. A 4 PRIBADI DIIZINKAN PULANG Fetus and newborn
LAMA)
dr. Hery Dharmawan, Sp. A 2 PRIBADI DIIZINKAN PULANG
ANAK
dr. Martin Winardi, Sp.PD 2 PRIBADI DIIZINKAN PULANG Chronic renal failure
(N18, 214.9, LAMA)
PENYAKIT DALAM
dr. Johny Setio, Sp.OG 1 PRIBADI DIIZINKAN PULANG

dr. Johny Setio, Sp.OG 2 PRIBADI DIIZINKAN PULANG Prem.rupt.of
membran,onset of
OBSTETRI DAN GINEKOLOGI lab.within 24 hours
(O42.0, 239.2, LAMA)
ANAK
LAMA)
dr. Arief Gunadi, Sp. A 5 PRIBADI DIIZINKAN PULANG demam/Fever,
unspecified -
ANAK Hyperpyrexia
NOS-Pyrexia NOS
(R50.9, 268, LAMA)
dr. Johny Setio, Sp.OG 3 PRIBADI DIIZINKAN PULANG Premature rupture of
membranes

SMF Rawat
dr. Ivan Rifai 3 BPJS KESEHATAN DIIZINKAN PULANG Premature rupture of

Sentosa,Sp.OG OBSTETRI DAN membranes
GINEKOLOGI (O42, 239.2, LAMA)
dr. Budi Irawan, Sp.B-KBD 2 BPJS KESEHATAN DIIZINKAN PULANG Neoplasma jinak
payudara
BEDAH (D24, 091, LAMA)
dr. Budi Irawan, Sp.B-KBD 3 PRIBADI DIIZINKAN PULANG Other diseases of anus
and rectum (k62, 192.9,
BEDAH LAMA)
dr. Budi Irawan, Sp.B-KBD 4 BPJS KESEHATAN DIIZINKAN PULANG Acute appendicitis
(K35, 186, LAMA)
BEDAH
dr. Johny Setio, Sp.OG 2 BPJS KESEHATAN DIIZINKAN PULANG Blighted ovum and
nonhydatidiform
OBSTETRI DAN GINEKOLOGI mole (O02.0,
236.9, LAMA)
dr. Sofie Nurani, M.Biomed, 3 BPJS KESEHATAN DIIZINKAN PULANG Anaemia comp.
Sp.OG OBSTETRI DAN preg.,childbirth
(O99.0, 244, LAMA)

(A91, 032.1, LAMA)
PENYAKIT DALAM


SMF Rawat

(A91, 032.1, LAMA)
PENYAKIT DALAM
LAMA)
dr. Mienche Sp.PD 4 BPJS KESEHATAN DIIZINKAN PULANG Abdominal and pelvic
pain
PENYAKIT DALAM (R10, 267, LAMA)
LAMA)
ANAK
preg.,childbirth
(O99.0, 244, LAMA)
LAMA)
dr. Mienche Sp.PD 3 PRIBADI DIIZINKAN PULANG Ge/Diare (A09.9,
005, LAMA)
PENYAKIT DALAM

SMF Rawat
dr. Hery Dharmawan, Sp. A 6 BPJS KESEHATAN DIIZINKAN PULANG DHF / DBD
(A91, 032.1, LAMA)
ANAK
(A91, 032.1, LAMA)
PENYAKIT DALAM
dr. Sendi Kurnia, Sp.B 2 BPJS KETENAGAKERJAANDIIZINKAN PULANG Other headache
syndromes
BEDAH (G44, 125, LAMA)
ANAK (P24.8, 249, LAMA)
ANAK (P24.8, 249, LAMA)
(a91, 032.1, LAMA)
ANAK

SMF Rawat
dr. Hedy Vidiani, SpA 3 BPJS KESEHATAN DIIZINKAN PULANG Neonatal aspiration
ANAK (P24.9, 249, LAMA)
ANAK (P24.8, 249, LAMA)
tergantung insulin
104.1, LAMA)
ANAK (P24.8, 249, LAMA)
dr. Mienche Sp.PD 4 BPJS KESEHATAN DIIZINKAN PULANG Atherosclerotic

cardiovascular diseas,so
PENYAKIT DALAM describ. (I25.0, 148,
LAMA)
ANAK (P24.8, 249, LAMA)
dr. Hery Dharmawan, Sp. A 4 BPJS KESEHATAN DIIZINKAN PULANG Typhoid fever - Infection
ANAK (a01.0, 002, LAMA)
ANAK

SMF Rawat
dr. Sofie Nurani, M.Biomed, 4 BPJS KESEHATAN DIIZINKAN PULANG Single delivery by
Sp.OG OBSTETRI DAN caesarean section (o82,
(a91, 032.1, LAMA)
ANAK
dr. Johny Setio, Sp.OG 1 PRIBADI BELUM SEMBUH Anaemia comp.

preg.,childbirth
(O99.0, 244, LAMA)

SMF Rawat
dr. Sofie Nurani, M.Biomed, 3 BPJS KESEHATAN DIIZINKAN PULANG Single delivery by
Sp.OG OBSTETRI DAN caesarean section (o82,
LAMA)
ANAK (p24.8, 249, LAMA)
ANAK
PENYAKIT DALAM
dr. Johny Setio, Sp.OG 2 PRIBADI DIIZINKAN PULANG Supervision of normal
OBSTETRI DAN GINEKOLOGI (Z34.9, 294.0, LAMA)
dr. Ivan Rifai 2 BPJS KESEHATAN DIIZINKAN PULANG Supervision of normal

Sentosa,Sp.OG OBSTETRI DAN pregnancy, unspecified
GINEKOLOGI (Z34.9, 294.0, LAMA)
ANAK (p24.8, 249, LAMA)

SMF Rawat
dr. Hery Dharmawan, Sp. A 11 BPJS KESEHATAN DIIZINKAN PULANG Respiratory distress
syndrome of newborn
ANAK (P22.0, 249, LAMA)
LAMA)
dr. Ivan Rifai 3 BPJS KESEHATAN DIIZINKAN PULANG Supervision of normal
Sentosa,Sp.OG OBSTETRI DAN pregnancy, unspecified
GINEKOLOGI (z34.9, 294.0, LAMA)
LAMA)
ANAK
dr. Putu Eka, Sp.PD 3 BPJS KESEHATAN DIIZINKAN PULANG Gastritis, unspecified
(k29.7, 185.9, LAMA)
PENYAKIT DALAM
dr. Johny Setio, Sp.OG 2 PRIBADI DIIZINKAN PULANG Anaemia, unspecified
(D64.9, 098, LAMA)
dr. Putu Eka, Sp.PD 4 BPJS KESEHATAN DIIZINKAN PULANG Diabetes Melitus tidak
tergantung insulin
104.1, LAMA)
dr. Sendi Kurnia, Sp.B 4 BPJS KESEHATAN DIIZINKAN PULANG Acute appendicitis
(K35, 186, LAMA)
BEDAH
dr. Putu Eka, Sp.PD 4 BPJS KESEHATAN DIIZINKAN PULANG Anaemia, unspecified
(D64.9, 098, LAMA)
PENYAKIT DALAM

SMF Rawat
dr. Johny Setio, Sp.OG 2 PRIBADI DIIZINKAN PULANG Gestat.

[preg.-ind.]hypert
(O13, 237.9, LAMA)
dr. Martin Winardi, Sp.PD 3 PRIBADI DIIZINKAN PULANG
PENYAKIT DALAM
dr. Martin Winardi, Sp.PD 3 PRIBADI DIIZINKAN PULANG
PENYAKIT DALAM
dr. Hedy Vidiani, SpA 3 BPJS KESEHATAN DIIZINKAN PULANG Physiological jaundice
ANAK NOS (P59.9, 253.9,
LAMA)
dr. Putu Eka, Sp.PD 4 PRIBADI DIIZINKAN PULANG HIV disease resulting in
infec.&parasitic
PENYAKIT DALAM diseases (B20, 039,
LAMA)
BEDAH
dr. Hery Dharmawan, Sp. A 3 BPJS KESEHATAN DIIZINKAN PULANG Ge/Diare (A09.9,
005, LAMA)
ANAK
dr. Putu Eka, Sp.PD 3 BPJS KESEHATAN DIIZINKAN PULANG DHF / DBD
(A91, 032.1, LAMA)
PENYAKIT DALAM
(A91, 032.1, LAMA)
ANAK

SMF Rawat
dr. Sendi Kurnia, Sp.B 3 BPJS KESEHATAN DIIZINKAN PULANG Unspecified renal colic
(N23, 215, LAMA)
BEDAH
dr. Putu Eka, Sp.PD 1 BPJS KESEHATAN TIDAK SEMBUH Dyspepsia - Indigestion
(K30, 189.9, LAMA)
PENYAKIT DALAM
dr. Putu Eka, Sp.PD 2 ASURANSI FWD DIIZINKAN PULANG demam/Fever,
unspecified -
NOS-Pyrexia NOS
(R50.9, 268, LAMA)
preg.,childbirth
(O99.0, 244, LAMA)
dr. Putu Eka, Sp.PD 3 PRIBADI DIIZINKAN PULANG DHF / DBD

(A91, 032.1, LAMA)
PENYAKIT DALAM
[See above for
236.9, LAMA)
dr. Hendradi Khumarga, 2 PRIBADI DIIZINKAN PULANG
Sp.OT
BEDAH ORTHOPAEDI DAN
TRAUMATOL
membranes
[See above for
236.9, LAMA)

SMF Rawat
dr. Johny Setio, Sp.OG 4 BPJS KESEHATAN DIIZINKAN PULANG Delivery by elective
caesarean section
LAMA)
dr. Sofie Nurani, M.Biomed, 4 PRIBADI DIIZINKAN PULANG Single delivery by
Sp.OG OBSTETRI DAN caesarean section (O82,
dr. Putu Eka, Sp.PD 9 BPJS KESEHATAN DIIZINKAN PULANG Tuberculosis of lung,
bacteri.& his.
PENYAKIT DALAM examination not
done (A16.1, 007.1,
LAMA)
LAMA)
dr. Putu Eka, Sp.PD 3 BPJS KESEHATAN DIIZINKAN PULANG Diabetes Melitus tidak
tergantung insulin
104.1, BARU)

SMF Rawat
dr. Sofie Nurani, M.Biomed, 3 BPJS KESEHATAN DIIZINKAN PULANG Oligohydramnios

Sp.OG OBSTETRI DAN (O41.0, 239.9, LAMA)
GINEKOLOGI
PENYAKIT DALAM
096.6, LAMA)
BEDAH
096.6, LAMA)
BEDAH
dr. Budi Irawan, Sp.B-KBD 4 BPJS KESEHATAN DIIZINKAN PULANG Connective & other
BEDAH face&neck (D21.0,
096.6, LAMA)
LAMA)
LAMA)
dr. Sofie Nurani, M.Biomed, 3 BPJS KESEHATAN DIIZINKAN PULANG Maternal care for breech
Sp.OG OBSTETRI DAN presentation (O32.1,
LAMA)
SMF Rawat
dr. Martin Winardi, Sp.PD 3 BPJS KESEHATAN MENINGGAL < 48 JAM
PENYAKIT DALAM
LAMA)
dr. Budi Irawan, Sp.B-KBD 1 PRIBADI DIIZINKAN PULANG
BEDAH
dr. Hedy Vidiani, SpA 7 BPJS KESEHATAN DIIZINKAN PULANG Hypovolaemic shock
(R57.1, 270.9, LAMA)
ANAK
dr. Budi Irawan, Sp.B-KBD 3 BPJS KESEHATAN DIIZINKAN PULANG Inguinal hernia
(K40, 187, LAMA)
BEDAH
dr. Sofie Nurani, M.Biomed, 3 BPJS KESEHATAN DIIZINKAN PULANG Premature rupture of
Sp.OG OBSTETRI DAN membranes
LAMA)
dr. Hedy Vidiani, SpA 5 BPJS KESEHATAN DIIZINKAN PULANG Neonatal jaundice
ANAK delivery (P59.0, 253.9,
LAMA)

SMF Rawat
dr. Johny Setio, Sp.OG 1 RUMAH SAKIT DUTA INDAH

BELUM SEMBUH
LAMA)
dr. Ivan Rifai 2 BPJS KESEHATAN DIIZINKAN PULANG Blighted ovum and
Sentosa,Sp.OG OBSTETRI DAN nonhydatidiform
GINEKOLOGI mole (O02.0,
236.9, LAMA)
dr. Mienche Sp.PD 3 BPJS KESEHATAN DIIZINKAN PULANG
PENYAKIT DALAM
LAMA)
membranes
PENYAKIT DALAM
dr. Hery Dharmawan, Sp. A 5 BPJS KESEHATAN DIIZINKAN PULANG demam/Fever,

unspecified -
ANAK Hyperpyrexia
NOS-Pyrexia NOS
(R50.9, 268, LAMA)
dr. Vidhia Umami. Sp.PD 3 BPJS KESEHATAN DIIZINKAN PULANG Diabetes Melitus tidak
tergantung insulin
104.1, BARU)

SMF Rawat
dr. Budi Irawan, Sp.B-KBD 2 PRIBADI DIIZINKAN PULANG Anal abscess - Perianal
abscess (K61.0, 192.9,
BEDAH LAMA)
LAMA)
dr. Johny Setio, Sp.OG 3 PRIBADI DIIZINKAN PULANG Anaemia comp.
preg.,childbirth
(O99.0, 244, LAMA)
dr. Ivan Rifai 3 BPJS KESEHATAN DIIZINKAN PULANG Maternal care for
Sentosa,Sp.OG OBSTETRI DAN disproportion,
GINEKOLOGI unspecified (O33.9,
239.9, LAMA)

Sp.OG OBSTETRI DAN
GINEKOLOGI

[preg.-ind.]hypert with
OBSTETRI DAN GINEKOLOGI sig. proteinuria (O14,
237.0, LAMA)
LAMA)
LAMA)
SMF Rawat
dr. Sendi Kurnia, Sp.B 4 BPJS KESEHATAN DIIZINKAN PULANG Acute appendicitis
(K35, 186, LAMA)
BEDAH
dr. Martin Winardi, Sp.PD 2 PRIBADI DIIZINKAN PULANG Typhoid fever - Infection
PENYAKIT DALAM (A01.0, 002, LAMA)
LAMA)
dr. Johny Setio, Sp.OG 3 BPJS KESEHATAN DIIZINKAN PULANG M.care for disp.due to
OBSTETRI DAN GINEKOLOGI bones (O33.0, 239.9,
LAMA)
LAMA)
BEDAH
dr. Hery Dharmawan, Sp. A 4 BPJS KESEHATAN DIIZINKAN PULANG Ispa/Acute upper
respiratory infection,
ANAK unspecified (J06.9,
167, LAMA)
membranes

SMF Rawat
dr. Arief Gunadi, Sp. A 2 PRIBADI DIIZINKAN PULANG
ANAK
dr. Hedy Vidiani, SpA 4 BPJS KESEHATAN DIIZINKAN PULANG DHF / DBD
(A91, 032.1, LAMA)
ANAK
dr. Hedy Vidiani, SpA 3 BPJS KESEHATAN DIIZINKAN PULANG Ge/Diare (A09.9,
005, LAMA)
ANAK
dr. Martin Winardi, Sp.PD 1 BPJS KESEHATAN DIIZINKAN PULANG
PENYAKIT DALAM
dr. Ivan Rifai 1 PRIBADI DIIZINKAN PULANG
Sentosa,Sp.OG OBSTETRI DAN
GINEKOLOGI
dr. Ivan Rifai 4 BPJS KESEHATAN DIIZINKAN PULANG Premature rupture of

Sentosa,Sp.OG OBSTETRI DAN membranes
ANAK
membranes

SMF Rawat
LAMA)
LAMA)
dr. Sofie Nurani, M.Biomed, 3 BPJS KESEHATAN DIIZINKAN PULANG Delivery by caesarean
Sp.OG OBSTETRI DAN section, unspecified
LAMA)
dr. Johny Setio, Sp.OG 4 BPJS KESEHATAN DIIZINKAN PULANG Pre-eclampsia,
unspecified (O14.9,
dr. Hedy Vidiani, SpA 1 PRIBADI DIIZINKAN PULANG
ANAK
ANAK
dr. Hedy Vidiani, SpA 5 BPJS KESEHATAN DIIZINKAN PULANG Other
symptoms&sign s
ANAK involv.the
digestive ........ (R19,
270.9, LAMA)
LAMA)

SMF Rawat
dr. Ivan Rifai 3 PRIBADI DIIZINKAN PULANG Anaemia comp.

(O99.0, 244, LAMA)
LAMA)
dr. Susilo, Sp.N 3 PRIBADI DIIZINKAN PULANG Cerebral infarction
(I63, 154, LAMA)
SYARAF
dr. Vidhia Umami. Sp.PD 4 BPJS KESEHATAN DIIZINKAN PULANG Chronic renal failure,
unspecified
PENYAKIT DALAM (N18.9, 214.9, BARU)
dr. Johny Setio, Sp.OG 3 BPJS KESEHATAN DIIZINKAN PULANG Ectopic pregnancy
(O00, 236.0, LAMA)
dr. Vidhia Umami. Sp.PD 4 BPJS KESEHATAN DIIZINKAN PULANG Congestive heart failure-
Congestive heart
BARU)
dr. Ivan Rifai 2 BPJS KESEHATAN DIIZINKAN PULANG Anaemia comp.
(O99.0, 244, LAMA)
membranes
membranes

SMF Rawat
(of labour) (O63.0,
LAMA)

dr. Mienche Sp.PD 4 BPJS KESEHATAN DIIZINKAN PULANG Ge/Diare (A09.9,
005, LAMA)
PENYAKIT DALAM
dr. Putu Eka, Sp.PD 5 BPJS KESEHATAN DIIZINKAN PULANG Dengue fever [classical
dengue] (A90, 032.0,
PENYAKIT DALAM LAMA)
ANAK
LAMA)
LAMA)
(of labour) (O63.0,
LAMA)

SMF Rawat
LAMA)
dr. Hedy Vidiani, SpA 2 BPJS KESEHATAN DIIZINKAN PULANG Maternal care for
intrauterine death
ANAK (O36.4, 239.9, LAMA)
dr. Johny Setio, Sp.OG 4 BPJS KESEHATAN DIIZINKAN PULANG M.care for dispr.due to
unusually large fetus
OBSTETRI DAN GINEKOLOGI (O33.5,
239.9, LAMA)
dr. Mienche Sp.PD 3 BPJS KESEHATAN DIIZINKAN PULANG Urinary tract infection,
site not specified
PENYAKIT DALAM (N39.0, 217, LAMA)
membranes

Sp.OG OBSTETRI DAN
GINEKOLOGI
dr. Johny Setio, Sp.OG 4 BPJS KESEHATAN DIIZINKAN PULANG Pre-eclampsia,
unspecified (O14.9,
dr. Hedy Vidiani, SpA 2 BPJS KESEHATAN DIIZINKAN PULANG Foreign body in
respiratory tract,part
ANAK unspecified (T17.9,
282.9, LAMA)

SMF Rawat
dr. Hedy Vidiani, SpA 6 BPJS KESEHATAN
ANAK
dr. Mienche Sp.PD 3 BPJS KESEHATAN DIIZINKAN PULANG
PENYAKIT DALAM
dr. Putu Eka, Sp.PD 2 BPJS KESEHATAN DIIZINKAN PULANG Dyspepsia - Indigestion
(K30, 189.9, LAMA)
PENYAKIT DALAM
LAMA)
ANAK (P24.8, 249, LAMA)
ANAK (P24.8, 249, LAMA)
dr. Johny Setio, Sp.OG 2 PRIBADI DIIZINKAN PULANG Supervision of normal

OBSTETRI DAN GINEKOLOGI (Z34.9, 294.0, LAMA)
dr. Putu Eka, Sp.PD 2 BPJS KESEHATAN DIIZINKAN PULANG
PENYAKIT DALAM
LAMA)
LAMA)

SMF Rawat
LAMA)
dr. Arief Gunadi, Sp. A 3 BPJS KESEHATAN DIIZINKAN PULANG Viral infection,
unspecified
ANAK (B34.9, 041, LAMA)
dr. Arief Gunadi, Sp. A 3 BPJS KESEHATAN DIIZINKAN PULANG Neonatal jaundice
ANAK delivery (P59.0, 253.9,
LAMA)
dr. Putu Eka, Sp.PD 5 BPJS KESEHATAN DIIZINKAN PULANG
PENYAKIT DALAM

[preg.-ind.]hypert
(O13, 237.9, LAMA)

Sp.OG OBSTETRI DAN
GINEKOLOGI
ANAK
ANAK

[preg.-ind.]hypert
(O13, 237.9, LAMA)

SMF Rawat
LAMA)
preg.,childbirth
(O99.0, 244, LAMA)
LAMA)
LAMA)
ANAK
dr. Andre, Sp.S 2 BPJS KESEHATAN DIIZINKAN PULANG Vertigo
NOS-Dizziness
SYARAF &
edness (R42, 270.9,
LAMA)
disproportion,
239.9, LAMA)
ANAK

SMF Rawat
ANAK
dr. Johny Setio, Sp.OG 2 PRIBADI DIIZINKAN PULANG Gestat.

[preg.-ind.]hypert
(O13, 237.9, LAMA)
ANAK
dr. Arief Gunadi, Sp. A 3 BPJS KESEHATAN
ANAK
dr. Johny Setio, Sp.OG 3 BPJS KESEHATAN
dr. Vidhia Umami. Sp.PD 3 PRIBADI
PENYAKIT DALAM
dr. Susilo, Sp.N 3 BPJS KESEHATAN
SYARAF

Sp.OG OBSTETRI DAN
GINEKOLOGI
dr. Martin Winardi, Sp.PD 2 BPJS KESEHATAN
PENYAKIT DALAM
ANAK

SMF Rawat

dr. Mienche Sp.PD 2 BPJS KESEHATAN
PENYAKIT DALAM
ANAK
dr. Budi Irawan, Sp.B-KBD 2 ASURANSI SYNTECH MITRA INTEGRASI
BEDAH
ANAK
dr. Mienche Sp.PD 2 BPJS KESEHATAN
PENYAKIT DALAM
dr. Johny Setio, Sp.OG 2 PRIBADI

SMF Rawat
ANAK
dr. Sendi Kurnia, Sp.B 2 BPJS KESEHATAN
BEDAH
dr. Arief Gunadi, Sp. A 2 PRIBADI
ANAK
BEDAH
ANAK
dr. Susilo, Sp.N 2 BPJS KESEHATAN
SYARAF
PENYAKIT DALAM
ANAK
ANAK

SMF Rawat
ANAK
BEDAH
PENYAKIT DALAM

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LT005 01-06-50-41 L / 32 dr. Mienche Sp.

ZZ088 01-06-50-42 P/0 dr. Hery Dharmawan, Sp. A 05/01/2020 05/02/2020 2

LT005 01-06-50-48 L / 20 dr. Putu Eka, Sp.PD 05/01/2020 05/05/2020 5

LT006 01-05-49-71 P / 25 dr. Johny Setio, Sp.OG 05/01/2020 05/02/2020 2

LT005 01-06-50-49 L / 56 dr. Putu Eka, Sp.PD 05/01/2020 05/02/2020 2

LT005 01-06-50-44 P / 42 dr. Johny Setio, Sp.OG 05/02/2020 05/03/2020 2

LT005 01-06-49-84 P / 25 dr. Ivan Rifai 05/02/2020 05/04/2020 3

LT005 01-06-50-57 P / 39 dr. Johny Setio, Sp.OG 05/02/2020 05/04/2020 3

LT006 01-06-50-58 P / 27 dr. Johny Setio, Sp.OG 05/02/2020 05/04/2020 3

ZZ088 01-06-50-63 P/0 dr. Hedy Vidiani, SpA 05/02/2020 05/04/2020 3

ZZ088 01-06-50-64 L/0 dr. Hedy Vidiani, SpA 05/02/2020 05/04/2020 3

LT005 01-06-50-68 P / 19 dr. Johny Setio, Sp.OG 05/02/2020 05/04/2020 3

ZZ088 01-06-50-70 L/0 dr. Arief Gunadi, Sp. A 05/02/2020 05/04/2020 3

ZZ088 01-06-50-72 P/0 dr. Arief Gunadi, Sp. A 05/02/2020 05/04/2020 3

LT005 01-06-50-73 P / 24 dr. Johny Setio, Sp.OG 05/02/2020 05/04/2020 3

LT005 01-02-13-18 P / 21 dr. Johny Setio, Sp.OG 05/02/2020 05/04/2020 3

ZZ088 01-06-50-74 P/0 dr. Arief Gunadi, Sp. A 05/02/2020 05/04/2020 3

ZZ086 01-06-50-78 L/0 dr. Hedy Vidiani, SpA 05/02/2020 05/06/2020 5

LT005 01-06-50-79 P / 22 dr. Johny Setio, Sp.OG 05/02/2020 05/03/2020 2

LT005 01-06-50-80 L / 27 dr. Vidhia Umami. Sp.PD 05/03/2020 05/06/2020 4

LT005 01-06-50-82 P / 53 dr. Vidhia Umami. Sp.PD 05/03/2020 05/06/2020 4

LT005 01-06-50-85 P / 28 dr. Johny Setio, Sp.OG 05/03/2020 05/05/2020 3

LT005 01-06-50-87 P / 29 dr. Johny Setio, Sp.OG 05/03/2020 05/05/2020 3

ZZ086 01-06-50-89 L/0 dr. Hedy Vidiani, SpA 05/03/2020 05/05/2020 3

ZZ088 01-06-50-91 L/0 dr. Hedy Vidiani, SpA 05/03/2020 05/05/2020 3

LT005 01-03-78-21 P / 23 dr. Vidhia Umami. Sp.PD 05/03/2020 05/14/2020 12

LT006 01-06-45-81 P / 40 dr. Johny Setio, Sp.OG 05/03/2020 05/04/2020 2

ZZ088 01-06-50-98 L/0 dr. Arief Gunadi, Sp. A 05/03/2020 05/04/2020 2

LT005 01-06-47-55 P / 27 dr. Johny Setio, Sp.OG 05/03/2020 05/07/2020 5

LT006 01-04-95-55 L / 68 dr. Budi Irawan, Sp.B-KBD 05/03/2020 05/07/2020 5

ZZ086 01-06-51-02 P/0 dr. Arief Gunadi, Sp. A 05/03/2020 05/05/2020 3

LT005 01-06-51-03 P / 31 dr. Johny Setio, Sp.OG 05/04/2020 05/06/2020 3

LT005 01-06-33-23 P / 27 dr. Budi Irawan, Sp.B-KBD 05/04/2020 05/05/2020 2

LT005 01-04-29-32 P / 22 dr. Johny Setio, Sp.OG 05/04/2020 05/06/2020 3

ZZ088 01-06-51-17 L/0 dr. Hery Dharmawan, Sp. A 05/04/2020 05/06/2020 3

LT005 01-06-51-26 P / 26 dr. Johny Setio, Sp.OG 05/04/2020 05/06/2020 3

ZZ088 01-06-51-29 L/0 dr. Hery Dharmawan, Sp. A 05/04/2020 05/06/2020 3

LT005 01-06-22-92 P / 26 dr. Ivan Rifai 05/04/2020 05/06/2020 3

LT005 01-06-51-21 P / 27 dr. Ivan Rifai 05/04/2020 05/05/2020 2

ZZ088 01-06-51-32 L/0 dr. Arief Gunadi, Sp. A 05/04/2020 05/06/2020 3

LT005 01-06-51-30 P / 33 dr. Andre, Sp.S 05/04/2020 05/07/2020 4

LT005 01-06-51-27 L/4 dr. Arief Gunadi, Sp. A 05/04/2020 05/07/2020 4

LT006 01-06-51-36 P / 24 dr. Johny Setio, Sp.OG 05/04/2020 05/06/2020 3

LT006 01-06-51-37 L / 52 dr. Vidhia Umami. Sp.PD 05/04/2020 05/09/2020 6

ZZ088 01-06-51-38 P/0 dr. Hery Dharmawan, Sp. A 05/04/2020 05/06/2020 3

LT005 01-05-13-19 P / 29 dr. Johny Setio, Sp.OG 05/05/2020 05/07/2020 3

LT005 01-06-51-39 P / 28 dr. Johny Setio, Sp.OG 05/05/2020 05/07/2020 3

LT005 01-06-51-40 P / 38 dr. Johny Setio, Sp.OG 05/05/2020 05/06/2020 2

LT005 00-00-84-46 L / 16 dr. Arief Gunadi, Sp. A 05/05/2020 05/10/2020 6

LT005 01-05-63-39 L / 69 dr. Vidhia Umami. Sp.PD 05/05/2020 05/08/2020 4

LT005 01-03-59-21 P / 70 dr. Budi Irawan, Sp.B-KBD 05/05/2020 05/06/2020 2

ZZ089 01-06-51-43 L / 37 dr. Budi Irawan, Sp.B-KBD 05/05/2020 05/06/2020 2

LT005 01-06-16-43 P / 41 dr. Johny Setio, Sp.OG 05/05/2020 05/08/2020 4

ZZ088 01-06-51-67 P/0 dr. Arief Gunadi, Sp. A 05/05/2020 05/07/2020 3

LT005 01-06-51-69 P / 34 dr. Johny Setio, Sp.OG 05/05/2020 05/07/2020 3

LT005 01-06-51-64 L / 58 dr. Mienche Sp.PD 05/05/2020 05/08/2020 4

LT005 01-03-99-68 P / 25 dr. Johny Setio, Sp.OG 05/05/2020 05/06/2020 2

LT005 01-06-51-72 P / 25 dr. Johny Setio, Sp.OG 05/05/2020 05/06/2020 2

ZZ086 01-06-51-76 P/0 dr. Hery Dharmawan, Sp. A 05/05/2020 05/11/2020 7

LT005 01-06-51-82 P / 40 dr. Johny Setio, Sp.OG 05/05/2020 05/08/2020 4

LT005 01-06-51-83 P / 24 dr. Johny Setio, Sp.OG 05/05/2020 05/07/2020 3

LT005 01-06-51-84 P / 26 dr. Vidhia Umami. Sp.PD 05/05/2020 05/08/2020 4

LT005 01-03-71-26 P / 24 dr. Budi Irawan, Sp.B-KBD 05/06/2020 05/08/2020 3