REGISTER PELAYANAN DIABETES MELITUS SESUAI STANDART DI PUSKESMAS KEBAMAN

NO NAMA PENDERITA NIK UMUR JENIS KELAMIN ALAMAT KET * JANUARI FEBRUARI MARET APRIL MEI JUNI JULI AGUSTUS SEPTEMBER OKTOBER NOVEMBER DESEMBER

1MASRIBUT 3510084409580001 61P KEBAMAN 2/2 1 2/P

2

no. hp : 3

2HARTINI 3510085011600009 59P SUKOMUKTI 2/2 1 2/P 4/P

2
3
4

1
3SUBIYATI 351008431730001 46P KRAJAN 1/6 2/P 15/P
2

no. hp : 3
4 RUJUK

4NUR FAIZIN 3510082909590007 60L SUMBERJO 5/1 1 2/P

2

no. hp : 3

4
RUJUK

5HALIMAH 3510087006580053 61P KALIGORO 2/4 1

3/P 14/P 1/P 2/P
2

4
RUJUK
1
6KUSWATI 3510086808850007 33P KEBAMAN 1/4 3/P 21/P 19/P
2

7TUGIYAH 3510087007640002 56P SUKOPURO WETAN 1/3 1 3/P 17/P

2
3
4

8SUCIPTO 3510080909590002 60L KEBAMAN 3/3 1

3/P 18/P 28/P
2
3
4

9SUJIATI 3510084507520001 67P BLANGKON 2/2 1 3/P 20/P 1/P

2
3
4
10WARSINI 3510084107560002 63P SUKOPURO 3/1 1 3/P 18/P
2
3
4
11NGAINAH 3510084506500006 69P SUKOREJO 3/3 1 4/P 8/P 21/P 11/P 4/P 22/P
2 140 172 110 116 162
3 XXX XXX XXX XXX
4 METFO METFO METFO METFO METFO METFO
12MURYANI 3510087012610001 58P SUKOPURO WETAN 2/2 1 6/P
2
no. hp : 3
4 RUJUK
13SITI MARIYATUN 3510086503710008 48P SUOREJO 4/3 1 6/P 6/P 18/P 3/P 10/P
2
3
4
14SITI ROKANIYAH 3510085211640005 44P SRONO 2/2 1 6/P 15/P 11/P 18/P
2
3
4
15SUHARTONO 3510081504520001 67P SUKOMUKTI 3/1 1 6/P 11/P 31/P
2
3
4
16EKSAN SUSANTO 3510081407530001 66L KALIGORO 3/2 1 6/P 16/P
2
3
4
17IMRO'AH 351008211740004 45P SRONO 1/1 1 6/P 7/P 2/P 16/P
2
3
4
18MUSA ARIANTO 3510082607600002 59P SRONO 2/1 1 6/P 23/P 14/P
2
3
4
19ARIEF DARMAWAN 351008113810007 38P KALIGORO 5/1 1 7/P
2
3
4 RUJUK
20SLAMET 3510081509500006 69L SUMBERWANGI 2/19 1 7/P
2
3
4 RUJUK
21KOMARI 351008050723282 55L KARANGLO1/1 1 7/P 5/P 10/P
2
3
4
22HERMININGSIH 730684601610007 59P KRAJAN 3/6 1 8/P
BAGOREJO 2
3
4 RUJUK
23TITI KUSDIARTI 3510084812470000 72P SRONO 2/4 1 8/P 5/P 4/P
2
3
4
24ABDUL KARIM 3510082610500002 69L KRAJAN 3/5 1 8/P 3/P 18/P
2
3
4
25ABDUL HAQQI 3510050110280003 61L TEGALPARE 1/2 1 8/P
2
3
4
26SITI FATIMAH 3510065111620003 57P KRAJAN 2/2 1 8/P 17/P 2/P 16/P
2
3
4
27NURHADI 3510082811680001 51L KRAJAN 5/3 1 9/P 3/P
2
3
4
28SANDONO 3510051307640006 55L KUMENDUNG 2/5 1 9/P
2
3
4 RUJUL
29MURTININGSIH 3510086009600002 59P KEBAMAN 4/4 1 9/P
2
3
4 RUJUK
30SITI JAJILAH 3510085407590001 60P SUKOPURO WETAN 1/3 1 10/P 27/P 10/P
2
3
4
31TEMU 3510085303560002 63P SRONO 1/13 1 10/P 8/P
2
3
4
32SITI MASNAH 3510085509650006 54P SRONO 1/9 1 10/P 10/P 25/P
2
 3
4
33DJAHRONI 3510085012460002 73P KARANGLO 2/2 1 11/P 8/P
2
3
4 RUJUK
34BINTI ISTI'AMAH 3510084203780005 41P KEBAMAN 1/2 1 11/P
2
3
4
35NAWAWI 3510082408640002 55L SUKOLILO 2/2 1 11/P 30/P
2
3
4
36SUHARIYADI 3510053112500001 69L MANGUNREJO 4/3 1 13/P 27/P 11/P 25/P 10/P
2
no. hp : 3
4
37SOLEHATI 3510085906580001 61P KRAJAN 1/2 1 13/P
2
3
4
38HARTATIK 351008450764007 55P KRAJAN 5/4 1 13/P
2
3
4 RUJUK
39SITI ASIYAH 3510084402520001 67P KRAJAN 4/4 1 14/P
2
3
4
40ASWIYAH 70P SUKOLILO 2/4 1 14/P 2/P
2
3
4
41AMENAH 69P SUKOLILO 1/4 1 14/P 17/P 2/P
2
3
4
42SRIWATI 3510087006550015 64P SUKOPURO 1/1 1 14/P
2
3
4
43SA'ADAH 3510085006670004 52P SRONO 1/2 1 14/P
2
3
4
SITI ROKAYAH 3510085211640005 56P SRONO 1/2 1 15/P 11/P 17/P 20/P
2 426 254 295 104
3 XXX VII XXX
4 GLIBEN GLIBEN GLIBEN RUJUK
44SUMIYATI 3510084609590002 60P SUKOREJO 2/3 1 15/P 28/P
2
3
4
45SUTIYEM 3510085308750006 48P SUKOLILO 3/3 1 15/P 20/P 8/P 21/P 17/P
2
3
4
46SULASMI 3510087006680006 51P KRAJAN 1/6 1 15/P 12/P 21/P
2
3
4
47HJ. JUMIYAH 3510085306590001 60P KARANGLO 1/5 1 15/P
2
3
4
48MARSITI 3510085409710001 48P BLANGKON 3/1 1 16/P 17/P 4/P
2
3
4
49ACHMADI 3510080810580001 61L SRONO 1/1 1 17/P 5/P 4/P
2
3
4
50MESNATI 3510085509770002 42P SUKOPURO 1/2 1 17/P
2
3
4
51SLAMET PONIRIN 3510081210650012 54L SUKOPRO 1/2 1 17/P
2
3
4
52HUDRIYAH 3510084401690003 51P PARIREJO 2/2 1 18/P 1/P 6/P 2/P
PARIJATAH KULON 2
3
4
53SUTRI HANDAYANI 3510085201710001 49P SUKOMUKTI 1/3 18/P 14/P 9/P 22/P
398 453 304 262
XXX XXX XV XV
GLIME,METFO GLIB,METFO GLIBEN GLIBEN
54YOS SUDARSO 3510080704540002 65L SRONO 1/2 1 18/P 29-Jan
2
3
4
55HUSNUL CHOTIMAH 3510084408680001 51P SRONO 1/9 1 18/P 18/P 16/P
2
3
4
56HENI DWI ASTUTI 3510085407780004 41P SUKOREJO 1/3 1 18/P
2
3
4
57PAENAH 3510087006550084 64P KRAJAN 2/1 1 20/P 20/P
2
3
4
58SUKATI 3510085205500009 69P BLANGKON 3/1 1 20/P
2
3
4
59SUNANIK 3510085005670005 52p sukolilo 1/2 1 20/P 28/P 7/P 4/P 17/P
2
3
4
60SUMEKAR 35100847 2750004 52P KARANGLO 2/4 1 21/P 6/P 17/P 22/P 9/P
2
3
4
61SUHADI 3510081709620001 57L KRAJAN 6/1 1 21/P
2
3
4
62WINARNI 3510084206560005 53P KRAJAN 4/1 1 21/P
2
3
4
63KHOFSOH 3510084111520003 67P SRONO 2/8 1 22/P
2
3
4
64SUSIYATI 3510065501570001 63P SEMPU 3/2 1 23/P
2
3
4
65KUSNAN 3510080504640005 55L KARANGLO 1/5 1 23/P 9/P
2
3
4
66WIWIN LESTARI 3510085002740005 45P SUKOLILO 5/1 1 24/P 14/P
2
 3
4
67YAMINEM 3510084103600009 59P SUKOREJO 3/3 1 27/P
2
3
4
68HOIRIYAH 3510084511630004 56P SUKOREJO 1/3 1 27/P
2
3
4
69SRI RAHAYU 3510085007620006 57P KRAJAN 3/5 1 27/P 13/P 2/P
2
3
4
70NUR KOLIS 3510081605690005 50L KRAJAN 1/4 1 27/P
2
3
4
71SUGIARTI 3510084808680007 51P KEBAMAN 1/2 1 27/P 24/P 9/P
2
3
4
72MURTINI 3510085203650015 54P SUKOPURO 3/2 1 27/P
2
3
4
73SUMARDJI 3510082503470002 72L SUKOREJO 4/1 1 28/P
2
3
4
74PAINI 351008410261005 58P KALIGORO 2/4 1 28/P 12/P
2
3
4
75LASMIRAH 3510084804580005 61P SUKOLILO 4/2 1 28/P
2
3
4
76MUJIHARTO 3510080507550002 64L SRONO 2/9 1 28/P
2
3
4
77SUMINI 3510084105600007 59P SUKOPURO 2/2 1 28/P
2
3
4
78MISIYATI 3510085101580004 62P KRAJAN 2/4 1 28/P 12/P 3/P 17/P
2
3
4
79SUPARMAN 3510081005410002 78L KRAJAN 5/4 1 29/P 8/P 19/P 7/P
2
3
4
80EDI RIYATNO 3510080210660002 53L SUKOLIO 5/3 1 29/P
2
3
4
81SUNA'IYAH 3510085708600002 59P SUKOLILO 2/3 1 29/P 13/P 29/P 16/P
2
3
4 RUJUK
82SUMARNO 3510082006670002 52L KRAJAN 4/3 1 29/P
2
3
4
83ISMIRAH 3510087010440003 75P SUKOREJO 2/1 1 29/P
2
3
4
 84SUNAIYAH 351008570860002 60P SUKOLILO 2/3 1 29/P 13/P 29/P 16/P 30/P 14/P 23/P
2 261 265 382 356
3 XV XV XV XV XV XV XV
4 GLIME GLIME GLIME GLIME GLIME GLIME GLIBEN, METFO
85SUPIYANI 3510084505680004 51P SRONO 1/2 1 29/P 7/P
2
3
4
86FAHRUR ROJI 3510081207750006 44L SUKOPURO WETAN 2/2 1 30/P
2
3
4
87LUKMANUL HAKIM 3510081710620003 57L SRONO 1/6 1 30/P 7/P 24/P
2
3
4
88KATINI 3510085802700002 49P SUKOREJO 4/3 1 30/P 4/P
2
3
4
89SUWANDI 3510080308500001 69L SUKOPURO WETAN 1/3 1 31/P
2
3
4
90MISIYAH 3510084903580005 61P SUKOPURO WETAN 1/3 1 31/P 10/P 24/P
2
3
4
91SUNARMI 3510086912510001 68P SRONO 2/10 1 1/P 7/P
2
3
4
92HASANAH 3510084910610004 58P KRAJAN 5/5 1 1/P 10/P 25/P
2 320 194 110
3 XV XV XX
4 GLIB,METF GLIB,METF GLIB
93RUBINI 3510084609760004 43P KALIGORO 5/1 1 1/P
2
3
4
94PONIYAH 3510084404620001 57P KRAJAN 6/3 1 3/P
2
3
4
95KHAIRIYAH 3510085604550003 64P SRONO 1/2 1 3/P
2
3
4 RUJUK
96IMAM MASTURI 3510082410530001 66L SRONO 1/12 1 3/P 26/P
2
3
4
97SRI ENDAH Z 3510066705730003 46P SEMPU 2/2 1 3/P
2
3
4 RUJUK
98MUT MA'INAH 3510084304570002 62P SUKOREJO 2/1 1 3/P
2
3
4
99SITI MAESAROH 3510084909610001 58P SUKOREJO 2/1 1 3/P
2
3
4
100HARY SULISTYOWATI 3510084506530001 66P KRAJAN 3/4 1 3/P
2
3
4
101USMAN RANU 3510081003500007 69P SUKOLILO 1/4 1 3/P 11/P
2
 3
4
102SUDARTO 3510081204520001 67L KARANGLO 1/2 1 3/P 3/P
2
3
4
103KATIYEM 3510084507580003 61P KRAJAN 3/4 1 3/P 22/P
2
3
4
104SAMINI 3510085207640002 55P SRONO 1/1 1 5/P
2
3
4
105MOH. SHOLEH 3510081306600001 59L SRONO 1/2 1 5/P
2
3
4
106ABDUL MUHID 3510080712540002 65L SRONO 1/4 1 5/P 20/P 9/P
2
3
4
107MOH. HARUN 3510080410630002 56L SRONO 2/10 1 5/P 10/P 24/P
2
3
4
108PONIYATI 3510084503680001 51P SRONO 2/8 1 5/P
2
3
4
109DEWI MUNIROH 3510085711750001 44P SUKOPURO 3/3 1 6/P 29/P
2
3
4 RUJUK
110TITIK SASMI R 3510084505600003 59P SRONO 1/1 1 5/P
2
3
4
111SITI NURIYAH 3510125206700006 49P KEBAMAN 1/4 1 7/P
2
3
4
112WAGIRAH 3510084501630005 57P KARANGLO 2/4 1 7/P
2
3
4
113SUPRAPTO 35100807056560004 63L SUKOLILO 1/2 1 7/P 19/P
2
3
4
114LAMINI 3510085205710001 48P KARANGLO 3/2 1 8/P
2
3
4
115BAMBANG WALUYO 3510081109550004 64L KOMIS WETAN 1/7 1 10/P 2/P
WONOSOBO 2
3
4
116NAWAWI 3510082408640002 55L SUKOLILO 2/2 1 10/P 5/P
2
3
4
117SIRUP 3510085212690008 50P BONGKORAN 4/2 1 10/P
PARIJATAH WETAN 2
3
4
118SARIATI 3510085303540004 65P KRAJAN 3/1 1 10/P 19/P
2
3
4
119SUKIRAH 3510084611560003 63P SUWALUH 3/1 1 10/P
SUMBERSARI 2
3
4
120WAHID 3510061502520002 67L SEMPU 1/3 1 11/P
2
3
4
121SITI AMINAH 3510084504650006 54P SUKOREJO 2/1 1 12/P 26/P
2
3
4
122MIANA 3510085110660005 53P KARANGLO 2/2 1 12/P
2
3
4
123MUAWANAH 3510084708550009 64P KARANGLO 2/2 1 12/P
2
3
4
124SAMSUL HADI 3510080102560001 64L SUKOREJO 1/2 1 12/P 28/P
2 135 130
3 XV XV
4 GLIM GLIM
125PAINEM 3510085206550014 61P KARANGLO 3/1 1 12/P
2
3
4
126NASEHAH 60P KALIGORO 2/2 1 12/P
2
3
4
127SUJONO 3510080111530002 66L KRAJAN 2/1 1 13/P
2
3
4
128KOMSATUN 3510085408590001 60P KRAJAN 2/3 1 14/P
BAGOREJO 2
3
4
129SUYONO 3510080808540003 65L KRAJAN 4/5 1 17/P
2
3
4
130WIDARTI 3510085502630001 57P SUKOPURO 3/3 1 17/P
2
3
4
131AMAN SANTOSO 3510080808650004 54L KOMIS KULON 1 17/P 26/P
2
3
4
132SUMARYATI 3510086102630001 56P SUKOPURO 24/1 1 18/P
2
3
4
133RAHNITA 351008571076007 43P SUKOPURO 2/1 1 18/P
2
3
4
134VIVI NURHIDAYAH 3510085106770001 42P SUKOPURO 3/3 1 18/P
2
3
4
135ISTIKLAH 3510084707590002 60P SUKOPURO 3/3 1 19/P 7/P
2
3
4
136SURATMAN 3510080405400002 79L KRAJAN 6/5 1 19/P
2
 3
4
137SITI SUPIATI 3510085511750004 44P KALIGORO 2/3 1 19/P
2
3
4
138ADI SUCIPTO 3510081509580001 61L KRAJAN 4/4 1 20/P
2
3
4
139SIAMAH 3510084408580004 61P SUKOMUKTI 4/3 1 20/P 19/P
2
3
4
140AHMADUN 3510080612600007 59L SUKOMUKTI 2/1 1 21/P
2
3
4
141PAISAH 3510085205580005 61P SRONO 1/6 1 26/P
2
3
4
142TITIK ENDANG S 3510086111590003 60P KEPNDUNGAN 3/1 1 26/P
2
3
4 RUJUK
143MURTINI 3510085203650015 54P SUKOPURO 3/2 1 28/P
2
3
4
144MUSRIBUT 3510084409580001 61P KEBAMAN 2/2 1 29/P
2
3
4
145SUNARTI 3510084401570005 63P SUKOLILO 2/3 1 29/P
2
3
4
ISNAYAH 3510086702500001 88P KARANGLO 1/1 1 2/P
2
3
4
MISKAN 3510081104640001 55L SRONO 2/8 1 3/P 14/P
2
3
4
RUMIYATI 60P SRONO 3/4 1 3/P 17/P
2
3 X X
4
SRIANAH 3510084107730044 44P KALIGORO 1/1 1 3/P
2
3
4
BUAMI 3510084909600002 59P SUKOREJO 3/2 1 5/P
2
3
4
M. MUDJIB MA'SHUM 3510081203610003 58L SUKOMUKTI 3/3 1 5/P 11/P
2
3
4
MULYANI 3510086005570001 62P KRAJAN 1/5 1 6/P
2
3
4
SUTARMAN 3510080806560003, 63L KEBAMAN 2/3 1 9/P
2
3
4
UNTUNG JULASMAN 3510081708600005 59L SUKOREJO 1/1 1 19/P
2
3
4
IMAM GOZALI 3510080606410002 78L SRONO 1/2 1 19/P
2
3
4
RUSMIYATI 3510084101590004 61P SUKOLILO 2/4 1 24/P 23/P
2 527 328
3 XIV XIV
4 GLIM,METF GLIM,METF
ASTININGSIH 3510084805600002 60P KEBAMAN 3/3 1 23/P
2 312
3 XV
4 GLIBEN
AGUS PURNOMO 3510082507670002 53L SUKOMUKTI 3/1 1 13/P 22/P
2 323
no. hp : 3 X XX
4 GLIBEN GLIBEN
KET * TEMPAT LAYANAN **
TANGGAL KUNJUNGAN/ TEMPAT LAYANAN** P : PUSKESMAS
GDA KS : RUMAH SAKIT
JUMLAH OBAT YANG DIBERIKAN KL : KLINIK
JENIS OBAT YANG DIBERIKAN PTP : DOKTER PRATAMA
NO NAMA PENDERITA NIK UMUR
1HALIMAH 3510087006580053 61
2NGAINAH 3510084506500006 69
3SITI MARIYATUN 3510086503710008 48
4EKSAN SUSANTO 3510081407530001 66
5ARIEF DARMAWAN 351008113810007 38
6NAWAWI 3510082408640002 55
7ASWIYAH 70
8AMENAH 69
9SUMIYATI 3510084609590002 60
10SUTIYEM 3510085308750006 48
11HENI DWI ASTUTI 3510085407780004 41
12SUNANIK 3510085005670005 52
13WIWIN LESTARI 3510085002740005 45
14YAMINEM 3510084103600009 59
15HOIRIYAH 3510084511630004 56
16SUMARDJI 3510082503470002 72
17PAINI 351008410261005 58
18LASMIRAH 3510084804580005 61
19EDI RIYATNO 3510080210660002 53
20SUNA'IYAH 3510085708600002 59
21ISMIRAH 3510087010440003 75
22SUNAIYAH 351008570860002 60
23KATINI 3510085802700002 49
24RUBINI 3510084609760004 43
25MUT MA'INAH 3510084304570002 62
26SITI MAESAROH 3510084909610001 58
27USMAN RANU 3510081003500007 69
28SUPRAPTO 35100807056560004 63
29NAWAWI 3510082408640002 55
30SITI AMINAH 3510084504650006 54
31SAMSUL HADI 3510080102560001 64
32NASEHAH 60
33SITI SUPIATI 3510085511750004 44
34SUNARTI 3510084401570005 63
35SRIANAH 3510084107730044 44
36BUAMI 3510084909600002 59
37UNTUNG JULASMAN 3510081708600005 59
38RUSMIYATI 3510084101590004 61
JENIS KELAMIN ALAMAT KET * JANUARI FEBRUARI
P KALIGORO 2/4 1 3/P 14/P 1/P
P SUKOREJO 3/3 1 4/P 8/P 21/P
P SUOREJO 4/3 1 6/P 6/P 18/P
L KALIGORO 3/2 1 6/P 16/P
P KALIGORO 5/1 1 7/P
L SUKOLILO 2/2 1 11/P 30/P
P SUKOLILO 2/4 1 14/P
P SUKOLILO 1/4 1 14/P 17/P
P SUKOREJO 2/3 1 15/P 28/P
P SUKOLILO 3/3 1 15/P 20/P 8/P 21/P
P SUKOREJO 1/3 1 18/P
p sukolilo 1/2 1 20/P 28/P 7/P
P SUKOLILO 5/1 1 24/P
P SUKOREJO 3/3 1 27/P
P SUKOREJO 1/3 1 27/P
L SUKOREJO 4/1 1 28/P
P KALIGORO 2/4 1 28/P 12/P
P SUKOLILO 4/2 1 28/P
L SUKOLIO 5/3 1 29/P
P SUKOLILO 2/3 1 29/P 13/P 29/P
P SUKOREJO 2/1 1 29/P
P SUKOLILO 2/3 1 29/P 13/P 29/P
P SUKOREJO 4/3 1 30/P
P KALIGORO 5/1 1 1/P
P SUKOREJO 2/1 1 3/P
P SUKOREJO 2/1 1 3/P
P SUKOLILO 1/4 1 3/P
L SUKOLILO 1/2 1 7/P 19/P
L SUKOLILO 2/2 1 10/P
P SUKOREJO 2/1 1 12/P 26/P
L SUKOREJO 1/2 1 12/P
P KALIGORO 2/2 1 12/P
P KALIGORO 2/3 1 19/P
P SUKOLILO 2/3 1 29/P
P KALIGORO 1/1 1
P SUKOREJO 3/2 1
L SUKOREJO 1/1 1
P SUKOLILO 2/4 1
EBRUARI MARET APRIL MEI
2/P
11/P 4/P 22/P
3/P 10/P

2/P
2/P

17/P

4/P 17/P
14/P

16/P

16/P 30/P 14/P 23/P

4/P

11/P

5/P

28/P

3/P
5/P
19/P
24/P 23/P
JUNI JULI AGUSTUS SEPTEMBER
SEPTEMBER OKTOBER NOVEMBER DESEMBER
ESEMBER