Contoh Laporan NOD

SIC (EKO) 01.01.
21
∑ STAF PERAWAT/BIDAN YANG DINAS
Pagi Sore Malam

LT NAMA UNIT
EMERGENCY ROOM
EMERGENCY dr. Firdha, Ns. Ns. Kelvin, Zr. dr. Dwi, Ns.
ROOM Tomi, Zr. Nur Fitri Sanusi, Ns. Rizam
PONEK
GF TOTAL PASIEN EMG
Poli Obgyn
Poli Onkology
Poli Urology
Poli Ortho NS 1 : Ns IIN NS 1 :
Poli Internist
Poli Bedah Umum
Poli Bedah Plastik
Poli Bedah Degestif
Poli Bedah Vaskuler
Poli THT
Poli Gizi
Poli bedah saraf
Poli Neuro NS 2 : Ns Kiki NS 2 :
Dermis
Dental
Poli Endoscopy
Poli Fisioterapi
Poli Rehab Medik
Poli Nutrition
Poli Paru
Poli Anak NS 3 : NS 3 :
Poli Mata
Poli Psikiatri
Pain Clinic
MCU
POLI KEMOTERAPI
ODC
LT 3 TOTAL PASIEN OPD
IN PATIENT DP = Ns. salwa + DS = Ns. Devi + DM = Ns. indah+

DEPARTMENT Br. abdy Ns. silvi+ Ns.okta Br. yudi
LT 4
LT 4
IN PATIENT DEPARTME
DS = Ns. Wulan +
IN PATIENT DP = Ns. Tary + DM = Ns. Kristin
Ns. Ela (lembur) +
DEPARTMENT Ns. Ela + Ns. Santi + Ns. Tita
Ns. Santi (lembur)
LT 6
LT 6 Kemoterapi
OPERATING THEATER
OK
CRITICAL CARE
ICU
HCU
NICU
PICU
TOTAL Ps
CRITICAL
OBSTETRICS
VK
Nursery
HEARTOLOGY
Cathlab
Hybrid
OPD JANTUNG
LT 8
Dokter Jaga
Dokter Jaga IGD : siang : dr. Firdha
Dokter Jaga IPD : siang : dr
Dokter Jaga Critical : siang : dr Rizky
Total Pasien 24 jam : 64 Orang

KETERANGAN
TIPE PASIEN (Pasien baru Ranap/Pasien
perhatian/critical/Kemo/transfusi,
RINGAN SEDANG BERAT Pasien Risiko/Komplen, Pasien titipan,
TOTAL PASIEN
ODC, & Prosedur yang akan dilakukan)
EMERGENCY ROOM
PASIEN OBSERVASI :
1. An. Karan Alano /12th/ Dx. Nausea and

vomiting + Diarrhea / Keluhan : Bab cair
4x disertai muntah isi makanan lebih dari
3x paska mengkonsumsi makanan pedas,
badan lemas dan perut terasa melilit
Therapi IGD : infus RL 30 tpm
sanmol drip 800 mg IV
New diatab 1 tab tiap bab cair
cek lab darah dan feses => Konsul Dr.
Rizky Notario, Sp. OT(Rencan Rawat
Inap) Menunggu Hasil, Lab, PCR, dan R/
MRI
RAJAL :
1. Ny. Lusianingsih / 33th/ Dx. Dyspepsia
2. By. Benjamin Alois /10bln/ Dx. Fever 3.
By. Dia Kyna Alaska /1th 5bln/ Dx. Fever
4. Nn. Grace Shafadita /20th/ Dx. Ispa 5.
Ny. Iie Sri Rejeki /48th/ Dx. Ispa 6. Tn.
11 Rahmat /53th/ Dx. Dyspepsia 7. Ny. Funny
Natasya /40th/ Dx. Dyspepsia 8. An.
Muhammad Rivano /1th/ Dx. Febris 9. Ny.
Yulia Utami /42th/ Dx. Low back pain +
Dyspepsia
RANAP :
1. An. Azka Arbiansha /7th/ Dx. Dengue
Fever / Meirdhania Andina, dr. Sp.ADpjp /
Ruang 406
RUJUK :
APS :
D.O.A :
RAJAL :
RANAP :
1. Ny. Olga Dea Ramadhani /27th/ Dx.

Supervision of normal first + pregnancy
Urinary tract infection, Iron deficiency
anaemia dgn G1P0A0 hamil 39 minggu /
Dpjp. Nisa Fathoni, dr. Sp. OG, IBCLC /
4 Kel. Keluar flek coklat tadi pagi, dan lendir
merah tadi siang, ada mules 5 -10 menit
sekali / Rawat VK 2. Ny. Lydia Alissa /30/
Dx. Nause and Vomiting + Dyspepsia,
Supervision of normal pregnancy. G1P0A0
H 38minggu 3 hari, JPKTH / Dpjp. N.B.
Donny A.M, dr. Sp.OG / Ruang 401
PASIEN OBSERVASI :
1. Ny. Ananda /26th/ DPJP. dr.Nisa

Tathoni Sp.OG / G1P0A0 hamil 39 mgg
Inpartu kala 1 fase laten + JPKTH /
2. Ny. Lulu /26th/ G2P1A0 hamil 37 mgg
JPKTH / Dpjp. dr. Taufik /
G 13 Pasien
1.An. AZKA ARBIANSHA / Meirdhania
Andina, dr. Sp.A / Dengue fever
2.Ny. Dina / dr. Faris, Sp.JP / Post CAG
3.Ny. Isma / dr. Alvin Nursalim Sp.PD /
DHF
4.Ny. ROSSANA DAMARIS / Batara
Imanuel Sirait, dr. Sp.OG-KFER / post SC
5.Tn. Darry / dr. Alvin Nursalim Sp.PD /
DHF
6.Tn. Jaenal Arifin / dr. Alvin Nursalim
Sp.PD / Other gastroenteritis and colitis of
infectious
7.Ny. LYDIA ALISSA / N.B. Donny A.M,
dr. Sp.OG / Nausea and vomiting G1P0A0
H 38minggu
8.Tn. Bobby wiranata / Arif Rahman, dr.
Sp.S
1.An./ AZKA
syncopeARBIANSHA
+ collaps / Meirdhania
0
9.Ny.
Andina,Eladr./ dr. Sang,
Sp.A Sp.OGfever
/ Dengue / G2P1A0 UK
38 minggu
2.Ny. LYDIA ALISSA / N.B. Donny A.M,
10.Ny. Windha
dr. Sp.OG / dr. and
/ Nausea Alvin, Sp.PDG1P0A0
vomiting / DHF
11.Ny. Elok / dr. Amanda, Sp.PD / Acute
H 38minggu
PASIEN
Faringitis BARU : DAMARIS / Batara
3.Ny. ROSSANA
12.Ny.
Imanuel Sirait,Ndr.
Sarah / dr. Nisa, Sp.OG//post SC
Sp.OG-KFER
G1P0A0 UK 12 minggu, Fever
PASIEN
13.Ny. IsniOBSERVASI :
/ dr. Nisa, Sp.OG / G1P0A0
UK 18 minggu, Nausea & Vomitting
PASIEN DI VK :
1.Tn. Ir. Adrian / dr. Sunu, Sp.JP /

PASIEN RENCANA
Rencana 3DVT AblasiMASUK :
Aff Complex,
rencana masuk 03/01/2022
RENCANA TINDAKAN :
1.Ny. Elok / dr. Amanda, Sp.PD / Acute
Faringitis, rencana USG tgl 01/01/2022-->
FU jenis dan jam
2.Ny. Windha / dr. Alvin, Sp.PD / DHF/
rencana USG bed site jam 08.00
13 RENCANA PULANG :

Sp.S / syncope + collaps
PASEN PINDAH PICU
PASIEN PULANG :
1.Ny. Sri Wulandari / dr. Perwira
Widhianto Sp.B-KBD / Acute app,
Ovarian cystsAn
2.Ny. Nindya / dr. Alvin Nursalim Sp.PD /
DHF
3.Ny. Sarah P / dr. Vonty Sp.B / Acute app
dd/ ureterolithiasis
4.Ny. Liqa / dr. Fransisca Noela Sp.OG /
G2P1A0 UK 12mg, Other gastroenteritis
1.An. Muhammad
and colitis Fathan / Meirdhania
of infectious
Andina, dr. Sp.A/ DHF
2.An. M. Rasyif / Mira Febriani
Inkiriwang,dr. SpA/DHF
IN PATIENT DEPARTMENT 3.Ny. Fatima / Amanda Pitarini Utari,dr,
SpPD-KGEH/
PASIEN BARU Malignant
: neoplasm: Liver
cell carcinoma
4.An.
1.Ny. Aurora Mecca
Nur mentari / Mira
/ Sang Febriani
Arifianto,dr.
Inkiriwang,dr.
SpOG / G1POA0 SpA/ DHF
H-38 Minggu
5.Tn.
2.Ny. William Tanady /dr.
Melati / Haekal, Mira Yulianti,dr,
Sp.OG/ G3P2A0
SpPD-KP/Bacterial
UK 38 minggu
pneumonia,Myasthenia gravis
PASIEN OBSERVASI
6.Ny. Tessa / Batara Imanuel: Sirait, dr.
Sp.OG-KFER /Post SC P1A0
7.Ny. Ratih Tyas /Mira Yulianti,dr, SpPD-
KP /Malignant neoplasm: Bronchus or
lung, Pleural effusion
8.Ny. Nur mentari / Sang Arifianto,dr.
SpOG / Post SC P1A0
9.Ny. Riskha /Sang Arifianto,dr.
SpOG/G3P1A1 H-36 minggu
10.Ny. Zurma / Murdani Abdullah, Prof.
dr. SpPD-KGEH / Non-insulin-dependent
diabetes mellitus, Diare
14 pasien 11.Ny. Deby / Nisa Fathoni, dr. Sp. OG,
(13 di IBCLC / Post SC P1A0
Ranap, 1 di 12.An. Rayi gazza / Keumala Pringgardini,
VK) SpA/ DHF
13.Ny. Melati / Dr. Haekal / G2P1A0 H-38
minggu
PASIEN PINDAH
SpOG/G3P1A1 H-36PICU
minggu/ R/SC+eras
tanggal 2/1/2021 jam 11.00
1.Tn.
2.Ny. Efraim/
Melati / Alvin Nursalim,
Dr. Haekal dr. Sp.PD/
/ G2P1A0 H-38
RENCANA
DHF h-4R/SC
minggu/ TINDAKAN
+ Tubektomi tanggal
2.Tn. H.Tri
2/1/2021 jamFirdaus
09.00 / Faris Basalamah, dr.
SpJP (K)/ Post PCI 1 stenst (Pindahan
PASIEN
ICU)
1.Ny. OlgaDI/ VK
Nisa: Fathoni, Sp.OG/
3.Ny.
G1P0A0 Diegos
UK 39 / Nisa Fathoni,
minggu, dr. Sp.
rencana OG,
partus
IBCLC / post partum P1A0
PASIEN
1.Ny. PULANG
4.Ny. Tessa
Adiati // Batara Imanuel
Ario Soeryo, Sirait,
dr. SpJP dr.
(K)-
Sp.OG-KFER / Post SC
FIHA, FasCC / bacterial pneumoniaP1A0
2.Tn. William Tanady / Mira
RENCANA
Yulianti,dr, MASUK :
SpPD-KP/Bacterial
3.Ny. Zurma / Murdani Abdullah, Prof.
PASIEN RENCANA
dr. SpPD-KGEH PULANG :
/ Non-insulin-
dependent diabetes mellitus, Diare
Laporan Kegiatan Kamar Operasi
OPERATING THEATER 1. Tindakan sabtu, 01/01/22
- SC dr Batara a.n
-2.SC dr Nisatindakan
Rencana a.n Debby minggu, 02/01/22
1.
-- SC Tn.drWilly
Sang Purnama
a.n Nur Chandra /45th/
Dx.SCDissection
+ Tubectomy of dr Mentari
Haekal
aorta / a.n Suko
Dpjp. Mentari
4 -jam
SC09.00
dr Sang a.n Ela
Adiarto, dr. SpJP (K),FIHA,, FICA,
-FAsCC,
SC dr Sang
PhDa.n Riskha
/ Post jam 11.00
hemiarch &
1. By Ny Devi Maryani
ascending aortic replacement / ai st A, db.
Dx.Achondroplasia
pasien Ekstubasi jam / Usia
04.3022Wib
hr, Hari
CRITICAL CARE Rawat
(Subuh)ketgl
1831.12.21,
/ Dr Erick Gultom SpA ,
terpasang
1 Terpasang
arteriline diETT
radialukuran
kiri 3,5 kedalaman
8,5 cm tersambung Ventilator Mode
HFO dengan Setingan MAP 12, AMP
1 28,P-max 20 FREK 10, FIO2 40%
2 Pasien
1.Ny. Olga Dea / dr. Nisa, SpOG/
G1P0A0 hamil 39 mgg dengan PK I fase
PASIEN
1.
laten OBSERVASI
Ny. lidia
Melati /G1P0A0 : G3P2
hamil
/ dr. Haekal/ 38 mgg
A03
hari
hamil
‌ dengan
38-39 dispepsia
mgg dg /
bekas dr. Dony
sc/ Rencana
2.
SC+Ny.tubektomi
Olga dea jam / dr. 09.00
Nisa/ G1P0A0
RENCANA
1. Rishka
hamil 39 /
mgg TINDAKAN
dr. Sang/
dg
2. Ny.Rishka /dr. Sang/PK G2P1
I fase : laten
A0 hamil
G2P1A0 3. 36
Ny.
hamil
mgg/
Ananda
36 mgg CTG/ dr.
dg tiap 24 jam
Nisa/
gemelli/ G1P0A0
Rencanahamil SC jam 3911
2.
mggSarah
PK Ii /dr.Nisa/G1
fase laten hamil 32 mgg dgn
1 PONEK
febris obs : djj pershif, CTG/12
4. Ny. Lulu / G2P1A0 hamil 37jam mgg/ dr.
4 3.Ny.
Taufikisni / dr. Nisa/ G1P0 hamil 18
mgg / Djj/ shift
PASIEN OBSERVASI
4. Ny. Lydia / G1P0A0 hamil DI IPD38: mgg 3
4 hari dengan dyspepsia/ obs DJJ
PASIEN OBSERVASI :
1. By. Ny. Tessa / dr. Ali/NCB SMK usia
2 hari
PASIEN
2. By. Ny.PULANG
Rossana I / dr. Andina/ NKB
6 BMK usia 1 hari
3. By. Ny. Rossana II / dr. Andina/ NKB
PASIEN PINDAH NICU :
SMK usia 1 hari
4. By. Ny. Debby / dr. Andina/ NCB
HEARTOLOGY SMK usia 1 hari
5. By. Ny. Nur mentari / dr Andina/
NCB SMK usia 1 hari
6. By. Ny. Ela yanova / dr. Andina/ NCB
SMK usia 1 hari
Malam : dr Dwi
Malam : dr Nesya
Malam : dr Riri
SIC (AGUS) 01.01.21
∑ STAF PERAWAT/BIDAN
TIPE PASIEN
YANG DINAS
LT NAMA UNIT
Pagi Sore Malam RINGAN SEDANG BERAT
EMERGENCY ROOM
dr. Firdha, dr. Dwi, Ns.

EMERGENCY Ns. Kelvin,
Ns. Tomi, Sanusi, Ns.
ROOM Zr. Nur
Zr. Fitri
Rizam
GF
PONEK
TOTAL PASIEN EMG
Poli Obgyn
Poli Onkology NS 1 :
Ns NS 1 :
Poli Urology IIN
Poli Ortho
Poli Internist
Poli Bedah Umum
Poli Bedah Plastik
Poli Bedah Degestif NS 2 :
Poli Bedah Vaskuler Ns NS 2 :
Poli THT Kiki
Poli Gizi
Poli bedah saraf
Poli Neuro
Dermis
Dental
LT 3
Poli Endoscopy
Poli Fisioterapi
Poli Rehab Medik
Poli Nutrition
Poli Paru
Poli Mata
Poli Psikiatri
Pain Clinic
MCU
POLI KEMOTERAPI
ODC
TOTAL PASIEN OPD

DS = Ns.
DP = Ns.
LT 4 Devi + Ns. DM = Ns.
IN PATIENT salwa + Br.
silvi+ indah+ Br.
DEPARTMENT abdy
Ns.okta yudi
IN PATIENT DEPARTMENT
DP = Ns. DS = Ns.
Dini + Okta Avi + Ns. DM = Ns.
IN PATIENT
LT 6 DEPARTMENT
Tary + Ns. Wulan +
Ella Ns. Silvi
Kemoterapi
OPERATING THEATER
OK
CRITICAL CARE
ICU
HCU
NICU
PICU
TOTAL Ps
CRITICAL
OBSTETRICS
VK
Nursery
Nursery
HEARTOLOGY
Cathlab
Hybrid
LT 8
OPD JANTUNG
Dokter Jaga
Dokter Jaga IGD : siang : dr. Malam : dr
Dokter Jaga IPD : siang : dr NESYA Malam : DR NITA
Dokter Jaga Critical : siang : dr NILAM Malam : dr Riri

KETERANGAN
(Pasien baru Ranap/Pasien
TOTAL
perhatian/critical/Kemo/transfusi, Pasien
PASIEN
Risiko/Komplen, Pasien titipan, ODC, &
Prosedur yang akan dilakukan)
OM
PASIEN OBSERVASI :
RAJAL :
2.NY ANASTASYA FEBRIS
PULANG DENGAN RESEP
3.NY MIRA G3P2A0 36 MIN
GGU PULANG
4.NN RIZKY ABDOMIKNAL
PAIN PULANG DEN GAN
RESEP
5.NN ANNISA OPEN WORD
AFF HAKTING 4 JAHITAN
PULANG
6.NY MARIYA CHEST PAIN
PULANG
7.NY NAHLA FARIDA DHF DR
ALVIN RANAF DI 402
8.AN CHARLIS FEBRIS
PULANG
9.TN RIZKY DYPEPSIA
PULANG
10.TN HANDI DYPEPSIA
PULANG
14 14. NN DWI DYPEPSIA
PULNG
RANAP :1.NY AJENG DX LBP

PASIEN DR ARIF SPS
2. Ny. NAHLA FARIDA /
Alvin Nursalim, dr. Sp.PD /
Fever, Supervision of normal
pregnancy
RUJUK :
APS :
D.O.A :
RAJAL :
RANAP :
PASIEN OBSERVASI :
14 Pasien
0
1. Ny. NAHLA FARIDA / Alvin
Nursalim, dr. Sp.PD / Fever,
Supervision of normal pregnancy
PASIEN OBSERVASI :
1.An. AZKA ARBIANSHA /

Meirdhania Andina, dr. Sp.A /
Dengue fever
2.Ny. Dina / dr. Faris, Sp.JP / Post
CAG
3.Ny. Isma / dr. Alvin Nursalim
Sp.PD / DHF
Imanuel Sirait, dr. Sp.OG-KFER /
post SC
5. Ny. YULIA UTAMI / Rizky
Notario, dr, SpOT / Lumbar and other
intervertebral disc disorders with
radiculopathy
6.Tn. Jaenal Arifin / dr. Alvin
Nursalim Sp.PD / Other
gastroenteritis and colitis of infectious
7. Ny. AJENG NURTRI HIDAYATI /
Arief Rachman, dr. Sp.S / Low back
pain (Utama)
8.Tn. Bobby wiranata/ Arif Rahman,
dr. Sp.S / syncope + collaps
9.Ny. Ela / dr. Sang, Sp.OG / G2P1A0
UK 38 minggu
10.Ny. Windha / dr. Alvin, Sp.PD /
DHF
11.Ny. Elok / dr. Amanda, Sp.PD /
Acute Faringitis
12.Ny. Sarah N / dr. Nisa, Sp.OG /
13. Ny. LULU SAKINAH / Taufik
Jamaan, Dr.dr. Sp.OG / remature
rupture of membranes, unspecified /
post SC
PASIEN DI VK :
14
PASIEN RENCANA MASUK :
1.Tn. Ir. Adrian / dr. Sunu,

Sp.JP / Rencana 3DVT Ablasi Aff
Complex, rencana masuk
03/01/2022
RENCANA TINDAKAN :

Acute Faringitis, rencana USG
parotis dan usg abdomen tgl
03/01/2022--> jam masih di
followup.
RENCANA PULANG :
1.Ny. Isni / dr. Nisa, Sp.OG /

G1P0A0 UK 18 minggu, Nausea
& Vomitting
3. .Tn. Darry / dr. Alvin Nursalim
Sp.PD / DHF
PASEN APS :
1.Ny. LYDIA ALISSA / N.B.

Donny A.M, dr. Sp.OG / Nausea
and vomiting G1P0A0 H
38minggu
PASIEN PULANG :
1.Tn. Bobby wiranata / Arif
Rahman, dr. Sp.S / syncope +
collaps 2. Ny. Sarah N /
dr. Nisa, Sp.OG / G1P0A0 UK
12 minggu, Fever
MENT
1.Ny. Nur mentari / Sang

Arifianto,dr. SpOG / G1POA0 H-
38 Minggu
2.Ny. Melati / Haekal, dr. Sp.OG/
G3P2A0 UK 38 minggu
PASIEN OBSERVASI :
1.An. Muhammad Fathan /
Meirdhania Andina, dr. Sp.A/ DHF
2.An. M. Rasyif / Mira Febriani
4.Ny. Ratih Tyas /Mira Yulianti,dr,

SpPD-KP /Malignant neoplasm:
Bronchus or lung, Pleural effusion
5.Ny. Nur mentari / Sang
Arifianto,dr. SpOG / Post SC P1A0
7.Ny. Zurma / Murdani Abdullah,
Prof. dr. SpPD-KGEH / Non-insulin-
dependent diabetes mellitus, Diare
8.Ny. Deby / Nisa Fathoni, dr. Sp.
OG, IBCLC / Post SC P1A0
9.An. Rayi gazza / Keumala
Pringgardini, SpA/ DHF
10.Ny. Melati / Dr. Haekal / G2P1A0
H-38 minggu
PASIEN MENINGGAL
3.Ny. Fatima / Amanda Pitarini

Utari,dr, SpPD-KGEH/ Malignant
neoplasm: Liver cell carcinoma
RENCANA TINDAKAN
1.Ny. Endah Fatonah /Nisa

13 pasien Fathoni, dr. Sp. OG, IBCLC/G3P2
(13 di hamil 37 - 38 mgg/ Rencana
Ranap, 1 tindakan SC dg Ercs + IUD
di VK) tanggal 04/01/2022 jam 08.00 pagi
PASIEN DI VK :
1. Ny. Okta Mediutami
Putri/Fransisca Noela RMH, dr.
Sp.OG /G1P0A0 hamil 38 minggu 6
hari
2. Ny. Ananda Citra/ Nisa Fathoni, dr.
Sp. OG, IBCLC/G1P0A0 hamil 39
minggu 6 hari.
1.Ny. Olga / Nisa Fathoni, Sp.OG/
G1P0A0 UK 39 minggu, rencana
partus
PASIEN PULANG
1 Ny. Tessa / Batara Imanuel

Sirait, dr. Sp.OG-KFER / Post SC
P1A0
2. Tn. William Tanady/ Mira
Yulianti,dr, SpPD-KP/Bacterial
3. An. Aurora Mecca/ Mira
Febriani Inkiriwang,dr. SpA/ DHF
RENCANA MASUK :
1. Ny. Elga/ Dr. Fransisca

Noela RMH, SpOG/ rencana
SC besok tgl 04/02/2022 jam
19.00, masuk besok pagi
(kamar 618)
PASIEN RENCANA PULANG :
1.Ny. Zurma/ Murdani Abdullah,

Prof. dr. SpPD-KGEH / Non-
insulin-dependent diabetes
mellitus, Diare
TER
1. Tindakan sabtu, 02/01/221.Ny.
Olga Dea/ dr. Nisa, SpOG/ G1P0A0
hamil 39 mgg dengan PK I fase laten/
SC cito jam 11
2. Ny. Lulu sakinah/ G2P1A0 hamil
37 mgg dg PK I fase laten+ KPD/ dr.
4 Taufik, SpOG/ Sc cito jam 16.00
3. Ny. Ananda/ G1P0A0 hamil 39-40
mgg pro induksi/ dr. Nisa, SpOG
4. Ny. Okta mediutami/ G1P0A0
hamil 38-39 mgg/ dr. Noela, SpOG----
> partus jam 1.23, curet sisa placenta
di OK jam 04.30
1. Tn. Willy Purnama Chandra

1
/45th/ Dx. Dissection of aorta / Dpjp.
Suko Adiarto, dr. SpJP (K),FIHA,,
FICA, FAsCC, PhD / Post hemiarch
& ascending aortic replacement ai st
A, db. pasien Ekstubasi jam 04.30
Wib (Subuh) tgl 31.12.21, terpasang
arteriline di radial kiri
1. By Ny Devi Maryani /
1 Dx.Achondroplasia / Usia 22 hr, Hari
Rawat ke 18 / Dr Erick Gultom SpA ,
Terpasang ETT ukuran 3,5 kedalaman
28,P-max 20 FREK 10, FIO2 40%
BY.NY ROSSANA GEMELI 2

1 DX/hipoglikemi usia 2 hari dr
andina SPA terpasang infus
d10%6cc/jam
3 Pasien
PASIEN PONEX :
1. Ny. Lulu sakinah/ dr. Taufik,
SpOG/ G2P1A0 hamil 37 mgg
2. Ny. Ananda/ dr. Nisa, SpOG/
2 G1P0A0 hamil 39 mgg
RENCANA TINDAKAN
1‌ . Ny. Endah Fatonah/ G3P2A0

hamil 37-38 mgg/ SC + IUD
PASIEN OBSERVASI DI IPD :
PASIEN OBSERVASI :
12
1. By. Ny. Tessa / dr. Ali/NCB
SMK usia 2 hari/ pulang
2. By. Ny. Rossana I/ dr. Andina/
NKB BMK usia 2 hari
3. By. Ny. Rossana II/ dr. Andina/
NKB SMK usia 2 hari
4. By. Ny. Debby/ dr. Andina/
NCB SMK usia 2 hari
5. By. Ny. Nur mentari/ dr
Andina/ NCB SMK usia 2 hari
6. By. Ny. Ela yanova/ dr. Andina/
NCB SMK usia 2 hari
7. By. Ny. Melati/ dr. Mira/ NCB
SMK usia 1 hari
8. By. Ny. Olga/ dr. Mira/ NCB
SMK usia 1 hari
12 9. By. Ny. Rishka I/ dr. Mira/
NKB KMK usia 1 hari
10. By. Ny. Rishka II/ dr. Mira/
NKB KMK usia 1 hari
11. By. Lulu sakinah/ dr. Mira/
NCB SMK usia 1 hari
12. By. Ny. Okta / dr. Mira/ NCB
SMK usia 5 jam
PASIEN PULANG

SIC (EKO) 03.01.22, Senin
TIPE PASIEN
LT NAMA UNIT YANG DINAS
EMERGENCY ROOM
dr. audrey, dr.Fajar, Ns.

EMERGENCY Ns. Ardi, Zr.
Ns. Susi, Br. Kelvin, Zr.
ROOM Mohlis
Fitri
Nur
GF
GF
PONEK
TOTAL PASIEN EMG
Poli Obgyn
Ns NS 1 :
Poli Urology IIN
Poli Ortho
Poli Internist
Poli Bedah Umum
NS 2 :
Ns NS 2 :
Kiki
Poli Bedah Plastik
Poli THT Kiki
Poli Gizi
Poli bedah saraf
Poli Neuro
Dermis
LT 3 Dental
Poli Endoscopy
Poli Fisioterapi
Poli Rehab Medik
Poli Nutrition
Poli Paru
Poli Mata
Poli Psikiatri
Pain Clinic
MCU
POLI KEMOTERAPI
ODC
TOTAL PASIEN OPD

DP = Ns.
Nurul + Ns. DS = Ns. DM = Ns.
LT 4 IN PATIENT Salwa Dini + Wulan + Br.
DEPARTMENT MD = Br. Br.Taufik Rio + Ns.
Abdy Nadya
DP = Ns. DS = Ns. DM = Ns.
IN PATIENT Risha+ Ns. Avi + Ns.
LT 6 DEPARTMENT Citra Tary
Devi+ Ns.
Silvi
Kemoterapi
OPERATING THEATER
OK
CRITICAL CARE
ICU
HCU
NICU
PICU
TOTAL Ps
CRITICAL
OBSTETRICS
VK
Nursery
HEARTOLOGY
Cathlab
Hybrid
OPD JANTUNG
LT 8
LT 8
Dokter Jaga
Dokter Jaga IGD : siang : dr Audrey Malam : dr Fajar
Dokter Jaga IPD : siang : dr Neysa Malam : dr Megawati
Dokter Jaga Critical : siang : dr Dewi Malam : dr Rizky

TOTAL
PASIEN
Risiko/Komplen, Pasien titipan, ODC, & Prosedur
Y ROOM
PASIEN OBSERVASI :
RAJAL :
1. Ny. Evidesh Vannyta /29th/ Dx. Post
SC Hari ke 13 + Dyspepsia, Low back
pain
2. Tn. Riau Salim /25th/ Dx. Dhiare
3. Ny. Putri Afipah
/34th/ Dx. Ispa + Fever
4. Nn. Lulu
Pramahesti /25th/ Dx. Ispa
5. An. Jihan
Camilla /1th/ Dx. Dyspepsia + Fever
6. Ny. Kanti Mulyaningrum /35th/ Dx.

Ispa 7. Tn. Aldo Gibran /34th/ Dx. Ispa
8. Ny. Alfa Dea /27th/ Dx.
Fracture of tooth ( Rujuk konsul poli
gigi
drg. Bina Amanda Sp.KG )
9. Ny. Prima Virgina /44th/ Dx.
Dyspepsia 10. An. Alberich Hibari /
1th/ Dx. Vasomotor rhinitis
11. Ny. Cecilia
Rumondang /27th/ Dx. Dyspepsia, of
normal pregnancy
RANAP :
15 1. Ny. RA Natasha Farima /63th/ Dx. Ratih
Pahlesia, dr. Sp.P / Ruang 415
2. Tn. Aprizal Samelino /36th/ Dx.
Diarrhea / Dpjp. Alvin Nursalim, dr. Sp.PD /
Ruang 607 3. Tn.
Andi Sufriaa /28th/ Dx. Disruption of
operation wound, rehecting / Dpjp. Nisa
Fathoni, dr. Sp. OG, IBCLC
RUJUK :
APS :
1. Ny. Fatimah /34th/ Dx. Malignant
neoplasm of placenta / Dpjp. Nugroho
Kampono,Prof. dr. SpOG (K) Onk / Kel.
Pasien rencana kemo ke 3, Rencana kemo
total 12 kali setiap Senin dan Kamis. Pasien
mengeluh 1 hari sebelum kemo selalu
perdarahan, kurang lebih 3 kali ganti
pampers (Pasien menolak rawat inap dan
transfusi, Form Penolakan Tertanda
tangani)
D.O.A :
RAJAL :
1. Ny. Indah Dwi Chyntia /24th/ Dx.

Supervision of normal pregnancy, G1P0A0
H 38MINGGU 6 HARI JPKTH Instruksi
dr. Nisa Sp.OG:
- Pasien saat ini BLPL
- Pasien boleh PCR dulu di RSBS atau
diluar
2 - Hari rabu pasien kembali ke EMG
untuk rencana induksi (05/01/2022)
2. Ny. Novriena Rissanty /25th/ Dx. Mild
hyperemesis gravidarum, Supervision of
normal pregnancy + G1P0A0 H 15+5 mg
RANAP :
PASIEN OBSERVASI :
17 Pasien
44
5
1
3
19
2
8
5
7
10
3
1
2
38
3
153
Pasien
PASIEN BARU :
1.By.Belden Kautsarr/ Wulan Ayudyasari, dr.

Sp.B/ Post Redundant prepuce, phimosis and
paraphimosis
2.Ny. Ra Natasya/ Ratih Pahlesia, dr. Sp.P/
Hypertensive heart disease without (congestive)
heart failure
PASIEN OBSERVASI :
1.An. AZKA ARBIANSHA / Meirdhania
Andina, dr. Sp.A / Dengue fever
2. Ny. Isma / dr. Alvin Nursalim Sp.PD / DHF
3. Ny. ROSSANA DAMARIS / Batara Imanuel
Sirait, dr. Sp.OG-KFER / post SC (sedang
transfusi PRC)
4. Ny. YULIA UTAMI / Rizky Notario, dr,
SpOT / Lumbar and other intervertebral disc
disorders with radiculopathy
5. Ny. AJENG NURTRI HIDAYATI / Arief
Rachman, dr. Sp.S / Low back pain
6. Ny. Windha / dr. Alvin, Sp.PD / DHF
7. Ny. Elok / dr. Amanda, Sp.PD / Acute
Faringitis
8. Ny. Sarah N / dr. Nisa, Sp.OG / G1P0A0 UK
12 minggu, Fever
9. Ny. LULU SAKINAH / Taufik Jamaan, Dr.dr.
Sp.OG / remature rupture of membranes,
unspecified / post SC
10. Ny. NAHLA FARIDA / Alvin Nursalim, dr.
Sp.PD / Fever, Supervision of normal pregnancy
11. Tn. Ir Oei adrian / dr sunu / 3D vt ablasi
12. Ny.Regina / Syafrizal Abubakar, dr. Sp.BS/
Other benign neoplasms of connective and other
soft tissue
13. By.Belden Kautsarr/ Wulan Ayudyasari, dr.
Sp.B/ Redundant prepuce, phimosis and
paraphimosis
14. Ny. Ra Natasya/ Ratih Pahlesia, dr. Sp.P/
Hypertensive heart disease without (congestive)
13 Pasien, heart failure
1 di ICU
PASIEN PINDAH ICU :
1. Tn. Ir Oei adrian / dr sunu / Post 3D vt ablasi
RENCANA TINDAKAN :
1.Ny.Regina / Syafrizal Abubakar, dr. Sp.BS/ R/

tindakan reseksi kepala pukul 13.00
RENCANA PULANG :
Imanuel Sirait, dr. Sp.OG-KFER / post SC
2.Ny. Sarah N / dr. Nisa, Sp.OG / G1P0A0
UK 12 minggu, Fever
PASEN APS :
PASIEN PULANG :

Sp.S / syncope + collaps
2. Tn. Jaenal Arifin / dr. Alvin Nursalim
Sp.PD / Other gastroenteritis and colitis of
infectious
3. Ny. Ela / dr. Sang, Sp.OG / G2P1A0 UK
38 minggu
4. Ny. Dina / dr. Faris, Sp.JP / Post CAG
PARTMENT PASIEN BARU :
1. Tn. Arrizal Samelino / Diarrhea,

unspecified/ Alvin Nursalim, dr. Sp.PD
2. Ny. Andi Sufriana /Nisa Fathoni, dr. Sp.
OG, IBCLC/ Rehecting
3. An. Darren Giandra /Sara Ester, dr.
Sp.BP-RE/ post labioplasty bilateral
PASIEN OBSERVASI :
1. Olga dea ramadhani /Nisa Fathoni, dr. Sp.
OG, IBCL/ pos Sc G1P0A0
2. An. M. Rasyif / Mira Febriani Inkiriwang,dr.
SpA/DHF
3. Ny. Ananda Citra / Nisa Fathoni, dr. Sp. OG,
IBCLC/G1P0A0
4. Ny. Ratih Tyas /Mira Yulianti,dr, SpPD-
KP /Malignant neoplasm: Bronchus or lung,
Pleural effusion
5. Ny. Okta Mediutami Putri /Fransisca Noela
RMH, dr. Sp.OG /G1P0A0
6. Ny. Riskha /Sang Arifianto,dr.
7. An. Rayi gazza / Keumala Pringgardini, SpA/
DHF
8. Ny. Melati / Dr. Haekal / G2P1A0 H-38
minggu
9. An. Nada Labiba / Wulan Ayudyasari, dr.
Sp.B/Acute appendiciti
10. Ny. Endah Fatonah /Nisa Fathoni, dr. Sp.
OG, IBCLC/G3P2 hamil 37 - 38 mg
11. Tn. Arrizal Samelino / Diarrhea,
unspecified/ Alvin Nursalim, dr. Sp.PD
OG, IBCLC/ Rehecting post Sc tgl 14/12/21
13. An. Darren Giandra /Sara Ester, dr. Sp.BP-
RE/ post labioplasty bilateral
13 Ranap, PASIEN MENINGGAL

1 di ICU
RENCANA TINDAKAN

OG, IBCLC/ Rencana tindakan Rehecting
besok tanggal 04/ 01/2022 jam 08.00 Wib.
PASIEN PINDAH ICU :
1. Ny. Elga / Dr. Fransisca Noela RMH,

SpOG/ pos Sc G3P2 hamil 37-38 minggu
gemelli
PASIEN PULANG
1. Ny. Zurma / Murdani Abdullah, Prof. dr.
SpPD-KGEH / Non-insulin-dependent
diabetes mellitus.
2. An. Muhammad Fathan / Meirdhania
Andina, dr. Sp.A/ DHF
3. Ny. Nur mentari / Sang Arifianto,dr.
SpOG / Post SC P1A0
4. Ny. Deby / Nisa Fathoni, dr. Sp. OG,
IBCLC / Post SC P1A0
RENCANA MASUK :
1. Ny. Ratih Tyas /Mira Yulianti,dr, SpPD-

Pleural effusion
2. An. Darren Giandra /Sara Ester, dr.
Sp.BP-RE/ post labioplasty bilateral
THEATER

1. Tindakan senin, 03/01/22
- SC dr Nisa a.n Endah Fatonah
- SC dr Noela a.n Elga
5 - Labioplasty dr Sara a.n Darren
- Herniotomy + Sirkumsisi dr Wulan a.n
Belden
- Appenydictomy dr Wulan a.n Nada
2. Rencana selasa, 05/02/21

- Rehecting dr Nisa a.n ...
- Reseksi Sift Tissu Anoeb
CARE
1. Tn. Willy Purnama Chandra /45th/ Dx.
Dissection of aorta / Dpjp. Suko Adiarto, dr.
SpJP (K),FIHA,, FICA, FAsCC, PhD / Post
hemiarch & ascending aortic replacement ai st A,
2 db. pasien Ekstubasi jam 04.30 Wib (Subuh) tgl
31.12.21, terpasang arteriline di radial kiri
2. Tn. IR Oei
Andiran W /57th/ Dx. Atrial Fibrillation And
Flutter, Post Ablasi / Dpjp. Sunu Budhi Raharjo,
dr. SpJP (K), PhD
1. Ny. Elga Benedicta /38th/ Dx. Twin
1 Pregnancy, Post SC dan Tubectomy P4A0 /
Dpjp. Fransisca Noela RMH, dr. Sp.OG
1. By Ny Devi Maryani / Dx.Achondroplasia /

1 Usia 27 hr, Hari Rawat ke 23 / Dr Erick Gultom
SpA , Terpasang ETT ukuran 3,5 kedalaman 8,5
cm tersambung Ventilator Mode HFO dengan
Setingan MAP 12, AMP 28,P-max 20 FREK 10,
FIO2 40%
4 Pasien
PASIEN OBSERVASI :
1. Ny. Ananda / G1P0A0 hamil 39-40 mgg

pro induksi/ dr. Nisa, SpOG / lahir jam
1 15.53 WIB
RENCANA TINDAKAN :
PASIEN PONEK :
1. Ny. Indah Dwi / G1P0A0 H 38mg 6hari
ICA 6.2 / Pulang -> rencana datang Rabu
05/01/2022 bawa hasil PCR ke EMG untuk
rencana Induksi, datang CTG ceck lab
2
2. Ny.
Novriena Rissanty /25th/ Dx. Mild
hyperemesis gravidarum, Supervision of
normal pregnancy + G1P0A0 H 15+5 mggu
PASIEN OBSERVASI :
1. By. Ny. Rossana I / dr. Andina/ NKB
BMK usia 2 hari
2. By. Ny. Rossana II / dr. Andina/ NKB
SMK usia 2 hari
3. By. Ny. Melati / dr. Mira/ NCB SMK
usia 1 hari
4. By. Ny. Olga / dr. Mira/ NCB SMK usia
1 hari
5. By. Ny. Rishka I / dr. Mira/ NKB KMK
usia 1 hari
6. By. Ny. Rishka II / dr. Mira/ NKB KMK
usia 1 hari
7. By. Lulu sakinah / dr. Mira/ NCB SMK
usia 1 hari
8. By. Ny. Okta / dr. Mira/ NCB SMK usia
1 hari
9. By. Ny. Endah / dr. Tartila / NCB SMK
usia 1 hari
10. By. Ny. Ananda / dr. Tartila / NCB
SMK usia 15 jam
11. By. Ny. Elga 1 / dr. Tartila / NCB SMK
12 usia 15 jam
12. By. Ny. Elga 2 / dr. Tartila / NCB SMK
usia 15 jam
PASIEN PULANG
1. By. Ny. Debby / dr. Andina/ NCB SMK

usia 2 hari --> Pulang
2. By. Ny. Nur mentari / dr Andina/ NCB
SMK usia 2 hari --> pulang
3. By. Ny. Ela yanova / dr. Andina/ NCB
SMK usia 2 hari --> pulang
LOGY
Daily Census OPD cardiac 3 Januari 2022
Outpatient : 10
dr ario :
Dr dafsah :
dr denio : 2
dr faris : 1
dr DH :
dr DAW :
dr radityo : 2
10 Dr suko : 3
dr sunu : 1
dr Adi : 1
MCU : -
New patient: 2
Dr. Adi : 1 dari dr. Muliadi Wijaya Apotek Aries
Dr. Denio : 1 Pasien lama RSBS
Cancel : 5
Dr. Denio : 2
Dr. Faris : 1
De. Sunu : 2
Diagnostic & Info dokter* yang melakukan

ECHO : 2
Stress Echo :
USG Doppler : 1
Holter : 1
Ezypro :
ECG : 5
Treadmill : 1
CT Scan :
Pacemaker Programming : 1
Speckle :
TEE :
DSE :
ABI :
Advance Echo : 2
Handle echo :
ABPM :
Tilt Table Test :
Paket PJB :
Ganti verban minor : 2
Ganti verban sedang :
Ganti verban major :
Referral Brawijaya :
Refferal RS luar : dr. Muliadi Wijaya
Dokter tidak hadir : dr. Dafsah (sakit), dr. Dicky

Aligheri
dr Megawati
SIC (EKO) 04.01.22, Selasa
TIPE PASIEN
Pagi Sore Malam RINGAN SEDANG
EMERGENCY ROOM
dr. Audrey,
EMERGENCY dr. Dwi, Ns. Br. Mohlis,
NS. Ardi, Zr.
ROOM Susi, Tomi Zr. Fitri
Nur
GF
PONEK
TOTAL PASIEN EMG
Poli Obgyn
Ns NS 1 :
Poli Urology IIN
Poli Ortho
Poli Internist
NS 2 :
Ns NS 2 :
Kiki
Poli Bedah Umum
Poli Bedah Plastik
Poli THT Kiki
Poli Gizi
Poli bedah saraf
Poli Neuro
Dermis
Dental
LT 3 Poli Endoscopy
Poli Fisioterapi
Poli Rehab Medik
Poli Nutrition
Poli Paru
Poli Mata
Poli Psikiatri
Pain Clinic
MCU
POLI KEMOTERAPI
ODC
TOTAL PASIEN OPD

DP = Nurul, DS = Ns.
LT 4 Ns. Kristin, Dini, Ns. DM = Ns.
IN PATIENT
Br. Taufik, Santi, Ns. Salwa, Ns.
DEPARTMENT
Ns. Abdi Okta Rio
DP = Nurul, DS = Ns.
LT 4 Ns. Kristin, Dini, Ns. DM = Ns.
IN PATIENT
Br. Taufik, Santi, Ns. Salwa, Ns.
DEPARTMENT
Ns. Abdi Okta Rio
DP = Ns.
DS = Ns
Tita+ Ns. DM = Ns.
Risha +Ns.
IN PATIENT Citra + Br.
LT 6 DEPARTMENT Malik +Ns.
Avi + Ns. Devi+ Ns.
Tary Nadia
Melya
DP = Ns.
DS = Ns
Tita+ Ns. DM = Ns.
Risha +Ns.
IN PATIENT Citra + Br.
LT 6 DEPARTMENT Malik +Ns.
Avi + Ns. Devi+ Ns.
Tary Nadia
Melya
Kemoterapi
OPERATING THEATER
OK
CRITICAL CARE
Ns.
Ns. Gisma,
ICU Awaludin,
Ns. Rita
Ns. Winda
Ns. Ningsh
HCU
NICU
PICU
TOTAL Ps CRITICAL
OBSTETRICS
VK
Nursery Ns. Inggrid
HEARTOLOGY
Cathlab
Hybrid
LT 8
LT 8
OPD JANTUNG
Dokter Jaga
Dokter Jaga IGD : siang : dr Dwi Malam :
Dokter Jaga IPD : siang : dr Malam :
Dokter Jaga Critical : siang : dr Riri Malam :

TOTAL
BERAT PASIEN
ENCY ROOM
PASIEN OBSERVASI :
RAJAL :
1. Nn. Widya Natalie /22th/
Dx. Sincope + Myalgi
2. Nn. Elfitra Mercredi /35th/

Dx. Fever 3. Tn. Kami
Saragih /28th/ Dx. Dyspepsia
4. Tn. Hadi Assyarif /26th/
Dx. Migraine without aura
5.
Ny. Nabila Ramadila /28th/
Dx. Dyspepsia
6. Ny.
7 Ika Irene Riki /48th/ Dx. Ispa +
Myalgia
7. Nn. Syifa
Amalia /20th/ Dx. Dyspepsia
RANAP :
RUJUK :
APS :
D.O.A :
RAJAL :
RANAP :
PASIEN OBSERVASI :
7 Pasien
14
2
4
20
4
1
7
12
3
13
17
4
109
Pasien
PASIEN OBSERVASI :
1.Ny. Nahla Farida / Alvin
2.Ny. Lulu Sakinah / Taufik
rupture of membranes, unspecified /
post SC
3.Willy Purnama Chandra / Dicky
Aligheri, SpBTKV (K),dr, FIHA,
FICA / Post BENTAL, Dissection of
Aorta
4.An. Azka Arbiansha / Meirdhania
Andina, dr. Sp.A / DHF H-7
5.Ny. Ajeng Nurtri Hidayati / Arief
6.Ny. Yulia Utami / Rizky Notario,
dr, SpOT / Lumbar and other
radiculopathy
7.Ny. RA Natasya / Ratih Pahlesia,
dr. Sp.P/ Hypertensive heart disease
without (congestive) heart failure
8.Tn. Ir Oei Adrian / Sunu Budhi
Raharjo, dr. SpJP (K), PhD / Atrial
Fibrilasi + Flutter, Post tindakan 3D
ablasi
9.Ny.Regina / Syafrizal Abubakar, dr.
Sp.BS/ Post reseksi soft tissue tumor
PASIEN PINDAH ICU :
9 pasien RENCANA TINDAKAN :
RENCANA PULANG :
9 pasien

Raharjo, dr. SpJP (K), PhD /
Atrial Fibrilasi + Flutter, Post
tindakan 3D ablasi
2.Ny.Regina / Syafrizal
Abubakar, dr. Sp.BS/ Post reseksi
soft tissue tumor
PASEN APS :
PASIEN PULANG :
1.Ny. Isma / dr. Alvin Nursalim

Sp.PD / DHF
2.Ny. Rossana Damaris / Batara
Imanuel Sirait, dr. Sp.OG-KFER /
post SC (sedang transfusi PRC)
3.Ny. Windha / dr. Alvin, Sp.PD /
DHF
Acute Faringitis
5.Ny. Sarah N / dr. Nisa, Sp.OG /
6.By. Belden Kautsarr / Wulan
Ayudyasari, dr. Sp.B/ Redundant
prepuce, phimosis and
paraphimosis
DEPARTMENT
1. Tn. M. Yazim / Dicky
FICA / Atherosclerotic heart
disease
2. Ny. Dora / Sunu Budhi
Raharjo, dr. SpJP (K), PhD /
Ventricular premature
depolarization
PASIEN OBSERVASI :
1. An. M. Rasyif / Mira Febriani

2. Ny. Ananda Citra / Nisa Fathoni,
dr. Sp. OG, IBCLC/G1P0A0
3. Ny. Ratih Tyas /Mira Yulianti,dr,
4. Ny. Okta Mediutami Putri
/Fransisca Noela RMH, dr. Sp.OG
/G1P0A0
5. Ny. Riskha /Sang Arifianto,dr.
6. An. Rayi gazza / Keumala
Pringgardini, SpA/ DHF
7. An. Nada Labiba / Wulan
Ayudyasari, dr. Sp.B/Acute
appendiciti
8. Ny. Endah Fatonah /Nisa Fathoni,
dr. Sp. OG, IBCLC/G3P2 hamil 37 -
38 mg
9. Ny. Andi Sufriana /Nisa Fathoni,
dr. Sp. OG, IBCLC/ Rehecting post
Sc tgl 14/12/21
10. Ny. Dora / Sunu Budhi Raharjo,
dr. SpJP (K), PhD / Ventricular
premature depolarization
11. Tn. M. Yazim / Dicky Aligheri,
SpBTKV (K),dr, FIHA, FICA /
Atherosclerotic heart disease
12. Ny. Elga / Fransisca Noela RMH,
dr. Sp.OG / Supervision of high-risk
pregnancy
PASIEN MENINGGAL
RENCANA TINDAKAN
12 Pasien
12 Pasien 1. Tn. M. Yazim / Dicky
disease / Rencana tind CABG
urgen 5/1/22 jam 16.00
PASIEN PINDAH ICU :
PASIEN PULANG
1. An. Darren Giandra /Sara

Ester, dr. Sp.BP-RE/ post
labioplasty bilateral
2. Tn. Arrizal Samelino /
Diarrhea, unspecified/ Alvin
Nursalim, dr. Sp.PD
3. Olga dea ramadhani /Nisa
Fathoni, dr. Sp. OG, IBCL/ pos Sc
G1P0A0
4. Ny. Melati/ Dr. Haekal /
G2P1A0 H-38 minggu
RENCANA MASUK :

2. An. Nada Labiba / Wulan
appendiciti
3. Ny. Okta Mediutami Putri
/Fransisca Noela RMH, dr. Sp.OG
/G1P0A0
4. Ny. Endah Fatonah /Nisa
Fathoni, dr. Sp. OG, IBCLC/G3P2
hamil 37 - 38 mg
5. Ny. Ananda Citra / Nisa
Fathoni, dr. Sp. OG,
IBCLC/G1P0A0
6. Ny. Andi Sufriana /Nisa
Fathoni, dr. Sp. OG, IBCLC/
Rehecting post Sc tgl 14/12/21
NG THEATER

1. Tindakan selasa, 04/01/22
2 - Rehecting dr Nisa a.n Andi
- Reseksi dr Syafrizal a.n Regina
2. Rencan tindakan rabu, 05/01/22

- Dilatasi Kuretase dr Chamim a.n
Natalina jam 08.00
- SC dr Nisa a.n Siris jam 12.30
(Permintaan pasien dg women
team)
CAL CARE
0
Dx.Achondroplasia / Usia 28 hr, Hari
2 Terpasang ETT ukuran 3,5 kedalaman
28,P-max 20 FREK 10, FIO2 40%
2. By. Ny. Endah Fathona /
dr. Tartila / NCB SMK usia 2 hari-->
Pindah nicu Status HCU ( Titipan
Nursery dgn Biltot : 16,99), instruksi
dr Tartila, SpA(K) cek biltot dan tsh
neo setelah blt 1x24jam
0
2 Pasien
PASIEN OBSERVASI :
RENCANA TINDAKAN :
1. Ny. Indah Dwi / G1P0A0 H

38mg 6hari ICA 6.2 / Pulang ->
Rencana datang Rabu
0 05/01/2022 bawa hasil PCR ke
EMG untuk rencana Induksi,
datang CTG ceck lab
2. Ny. Siriz /dr.nisa,spog/G5P4A0
hamil 38 minggu 6 hari dengan
letak lintang. Rencana SC jam
12.30.
PASIEN PONEK :
PASIEN OBSERVASI :
1. By. Ny. Rishka I / dr. Mira/
NKB KMK usia 2 hari
2. By. Ny. Rishka II / dr. Mira/
NKB KMK usia 2 hari
3. By. Lulu sakinah / dr. Mira/
NCB SMK usia 2 hari
4. By. Ny. Okta / dr. Mira/ NCB
SMK usia 2 hari
6. By. Ny. Ananda / dr. Tartila /

NCB SMK usia 1 hari
7. By. Ny. Elga 1 / dr.Tartila /
NCB SMK usia 1 hari
8. By. Ny. Elga 2 / dr. Tartila /
NCB SMK usia 1 hari
8
PASIEN PULANG
1. By. Ny. Rossana I / dr. Andina/

NKB SMK usia 2 hari --> pulang
2. By. Ny. Rossana II / dr.
Andina/ NKB SMK usia 2 hari-->
pulang
3. By. Ny. Melati / dr. Mira/ NCB
SMK usia 2 hari--> pulang
4. By. Ny. Olga / dr. Mira/ NCB
SMK usia 2 hari--> pulang
1. By. Ny. Endah Fathona / dr.

Tartila / NCB SMK usia 2 hari-->
Pindah nicu ( Titipan Nursery
Dengan Status HCU)
TOLOGY
Cathlab-HOR Daily Utilization
Report*
04 Jan 22
CATHLAB
Schedule : -
Echo/TEE intra procedure : -
Non Schedule : -
Reschedule/ Cancel :
1. Faisal/CAG+PTCA/dr. Denio
HYBRID OR
Schedule :
1. Dora /ablasi 3D VT simple/dr.
Sunu/19.00
Echo/TEE intra procedure :
Non Schedule : -
Reschedule/ Cancel : -
Others : ny. Dora puncture jam 19.45

1
Problem : dr. Sunu selesai poli jam
19.00 baru tindakan pasien ablasi
disiapkan.
Overtime staf : -
Staff sakit : -
Staff cuti : -
Next Schedule
Wed, 05 Jan 22
1. M. Yazim Y /CABG/ dr. Dicky A /
16.00/ HOR / general anastesi
2 Conti /CAG+PTCA/dr. Denio
/16.00/Cathlab/ lokal anastesi
3. Chiu In /Ablasi Konven SVT /dr.
Sunu/19.00/lokal anestesi
Daily Census OPD cardiac 4
Januari 2022
Outpatient : 12
dr ario :
Dr dafsah :
dr denio : 4
dr faris : 1
dr DH : 2
dr DAW :
dr radityo :
Dr suko : 2
12 Pasien dr sunu : 3
dr Adi :
MCU : -
New patient: 6
Dr. Faris : 1 dari Dr.Chamim SpOG
Dr. Denio : 1 dari website
Dr sunu : 2 pasien lama HARKIT
Dr. Dicky hanafy:1 info dari teman
Dr suko2 : 1 dari Dr.Yohanes
Cancel : 4
Dr. Sunu : 2
Dr. Suko : 1
Dr Dicky Aligery: 1
Diagnostic & Info dokter* yang

melakukan
ECHO :
Stress Echo :
USG Doppler : 2
Holter :
Ezypro :
ECG : 13
Treadmill :
CT Scan :
Pacemaker Programming :
Speckle : TEE :
DSE :
ABI :
Advance Echo : 3
Handle echo :
ABPM :
Tilt Table Test :
Paket PJB :
Ganti verban minor :
Refferal RS luar : dr. Muliadi Wijaya
Dokter tidak hadir : dr. Dafsah (sakit),
dr Audrey
dr Mega
dr Nilam
SIC (CAROL) RABU,05.01.22.
TIPE PASIEN
EMERGENCY ROOM
Dr Fajar
Dr Fajar Dr Firdha
Dr Firdha
EMERGENCY ROOM Ns Susi
Ns Mohlis
Ns Tomi
Ns Sanusi Ns Ardhi
Ns Fitri
GF
PONEK
TOTAL PASIEN EMG
Poli Obgyn
Ns NS 1 :
Poli Urology IIN
Poli Ortho
Poli Internist
Poli Bedah Umum
Poli Bedah Plastik
Poli THT Kiki
Poli Gizi
Poli bedah saraf
Poli Neuro
Dermis
Dental
LT 3
Poli Endoscopy
Poli Fisioterapi
Poli Rehab Medik
Poli Nutrition
Poli Paru
Poli Mata
Poli Psikiatri
Pain Clinic
MCU
POLI KEMOTERAPI
ODC
TOTAL PASIEN OPD

Dr
Abdurahman Ns Kristin Dr Mega Ns
LT 4 IN PATIENT
DEPARTMENT
Ns Indah Ns Noela Salwa Ns 7
Ns ABdi Ns Okta Taufik
Ns Santi
Ns Ana Ns
IN PATIENT Yudi Ns Ns Citra Ns Avi
Ns Ana Ns
IN PATIENT Yudi Ns Ns Citra Ns Avi
LT 6 DEPARTMENT Melya Ns Ns Ela Ns Malik
9
Tita
Kemoterapi
OPERATING THEATER
Ns Sunandar
OK Ns Heryanti
CRITICAL CARE
Ns.
Ns. Gisma,
ICU Awaludin,
Ns. Rita
Ns. Winda
Ns. Ningsh
HCU
NICU
PICU
TOTAL Ps CRITICAL
OBSTETRICS
Bd Dewi Bd Dilla
VK Bd Tries
Bd Putri Bd Genda
Nursery Bd Nani
Nursery Bd Nani
HEARTOLOGY
Cathlab
Hybrid
OPD JANTUNG Ns Rini T
LT 8
Dokter Jaga
Dokter Jaga IGD : Pagi : dr Fajar Malam :
Dokter Jaga IPD : Pagi : dr Abdurahman Malam :
Dokter Jaga Critical : Pagi : dr Rizki Malam :

TOTAL
BERAT PASIEN
NCY ROOM
PASIEN OBSERVASI :
RAJAL :
1. Tn R Tarwan / 53 thn / Nyeri
perut kiri bawah menjalar sd
kelamin 2. An
Kendra winaya / 13 thn / Obsv
Febris H 2 3. Ny
Siti Aisyah / 65 thn / Batuk
batuk H2
4. Ny Maria Theresia /35 thn
/Mual muntah 2x
5. An Khalisa zafira / 8
thn /batuk batuk h1
6. Ny Soraya Oktaviani /
43 thn / Nyeri ulu hati sejak
siang SMRS
7. Ny Ratu Nesya / 31
thn / Nyeri ulu ati H1
8. An Mahabiru Khalifa /
3thn / Obsv Febris H1
9. An Katara Salsabila /
14 thn / Mual Muntah Sejak
malam SMRS
10. Ny Najmi Anisa /
12 12 24 thn / Mujal muntah
RANAP :
1. Ny Tiomindo / 75 thn / Melena

sejak 30 menit SMRS / Dr Amanda
Pitarini SpPD / Rawat 409
2. an
Clamira Shabira / Rujukan dari poli
Dr Anisa SpA / Obsv Febris H 3
( T 39.9 c ) / Rawat 607
RUJUK :
APS :
D.O.A :
RAJAL :
1. Ny Putri Sari Febiol / 28 thn /

lemas Mual muntah / Hamil
pertama G1 P0 A0 H 24 mg
2. Ny Halimah
abdullah / 33 thn / pro inj Venofer
2 amp
3 3 RANAP :
PASIEN OBSERVASI :
1. Ny Indah Dwi Chyntia / 24 thn /
G1 p0 a0 / h 39 MG / pRO
INDUKSI / Dr Nisa F SPOG /
Obsv VK
15
34
4
4
14
2
7
9
9
1
2
27
3
6
139
1.Ny. Hasdiyanty Anugrah Putri/ Nisa

Fathoni, dr. Sp. OG, IBCLC / Kuret /
ODC
2.Tn. Conti Chandra / Sunu Budhi
Raharjo, dr. SpJP (K), PhD / CAG +
PTCA 2 stent
3.Ny. Tiomindo Hutabarat / Amanda
Pitarini Utari,dr, SpPD-KGEH / Non-
insulin-dependent diabetes mellitus,
Haematemesis, Melaena
4. By. Kinanti Cahyaning Puteri /
Radityo Prakoso, dr. MD, FIHA,F /
Patent ductus arteriosus, Pro
Penutupan PDA dengan device
PASIEN OBSERVASI :
2.Tn. Conti Chandra / Sunu Budhi
Raharjo, dr. SpJP (K), PhD / CAG +
PTCA 2 stent
5.By. Kinanti Cahyaning Puteri /
6.Ny. Yulia Utami / Rizky Notario, dr,
SpOT / Lumbar and other
radiculopathy
7.Ny. RA Natasya/ Ratih Pahlesia, dr.
Sp.P/ Hypertensive heart disease
PASIEN PINDAH HCU

Aorta tgl 30 des 21
7
RENCANA TINDAKAN :
1. Ny Kinanti Cahyaning Puteri /

Penutupan PDA dengan device, R/ Pro
Penutupan PDA dengan device tanggal
6/1/2022 jam 19.00
Haematemesis, Melaena, R/ EGD
standby biopsi tanggal 6/1/2022 jam
07.00
RENCANA PULANG :

radiculopathy
PASEN APS :
PASIEN PULANG :
1.Ny. Nahla Farida / Alvin

2.Ny. Lulu Sakinah / Taufik
rupture of membranes,
unspecified / post SC
Raharjo, dr. SpJP (K), PhD / Atrial
Fibrilasi + Flutter, Post tindakan
3D ablasi
4.Ny.Regina / Syafrizal Abubakar,
dr. Sp.BS/ Post reseksi soft tissue
tumor
5.Hasdiyanty Anugrah Putri/ Nisa
Fathoni, dr. Sp. OG, IBCLC /
Kuret / ODC
DEPARTMENT
1. Tn M. Yazim / Dicky Aligheri,
2.An. CLEMIRA SHABIRA
RAMADHANI /Annisa Nur Aini,
dr. Sp.A (FT)/Dengue fever
[classical dengue]
3.Ny. Masrumi / Faris Basalamah,
dr. SpJP (K)/Bradycardia,
unspecified
4.Ny. INDAH DWI CHYNTIA
RISWANDI / Nisa Fathoni, dr. Sp.
OG, IBCLC/Labour and delivery
complicated by fetal stress
[distress]
5.Ny. CHIU IN /Sunu Budhi
Raharjo, dr. SpJP (K),
PhD/Supraventricular tachycardia
6.Ny. SIRIZ TENTANI/Nisa
PASIEN OBSERVASI :
1. An. M. Rasyif/ Mira Febriani
3. Ny. Ratih Tyas/Mira Yulianti,dr,
4. Tn. M. Yazim / Dicky Aligheri,
5. An. CLEMIRA SHABIRA
RAMADHANI /Annisa Nur Aini, dr.
Sp.A (FT)/Dengue fever [classical
dengue]
6.Ny. Masrumi / Faris Basalamah, dr.
SpJP (K)/Bradycardia, unspecified
7.Ny. INDAH DWI CHYNTIA
RISWANDI / Nisa Fathoni, dr. Sp.
OG, IBCLC/Labour and delivery
complicated by fetal stress [distress]
8. Ny. CHIU IN /Sunu Budhi Raharjo,
dr. SpJP (K), PhD/Supraventricular
tachycardia
9. Ny. SIRIZ TENTANI/Nisa Fathoni,
dr. Sp. OG, IBCLC/ Supervision of
normal pregnancy
PASIEN MENINGGAL
9
RENCANA TINDAKAN
1.Ny. Masrumi / Faris

Basalamah, dr. SpJP
(K)/Bradycardia,
unspecified/PPM Single
Chamber tgl 6/1/2021 Jam 12.00
PASIEN PINDAH ICU :
1. Tn Tn. M. Yazim / Dicky

disease
PASIEN PULANG
1.Ny. Elga / Fransisca Noela RMH,
dr. Sp.OG / Supervision of high-
risk pregnancy
2. An. Nada Labiba/ Wulan
appendiciti
3. Ny. Okta Mediutami
Putri/Fransisca Noela RMH, dr.
Sp.OG /G1P0A0
4. Ny. Ananda Citra/ Nisa Fathoni,
dr. Sp. OG, IBCLC/G1P0A0
5. Ny. Andi Sufriana /Nisa Fathoni,
dr. Sp. OG, IBCLC/ Rehecting post
Sc tgl 14/12/21
6. Ny. Dora / Sunu Budhi Raharjo,
dr. SpJP (K), PhD / Ventricular
premature depolarization
RENCANA RUJUK :
1.Ny. Ratih Tyas/Mira

Yulianti,dr, SpPD-KP /Malignant
neoplasm: Bronchus or lung,
Pleural effusion
1.Ny. Endah Fatonah /Nisa

Fathoni, dr. Sp. OG, IBCLC/G3P2
hamil 37 - 38 mg
G THEATER
1. SIRIZ TENTANI / BEDAH
OBGYN - Sectio Caesaria + Pasang
IUD / OK 1 jm 12.30 wib / Nisa
2. CONTI CHANDRA / BEDAH
HEARTOLOGY - CAG PTCA 2 Stent
/ OK Cathlab jam 12.38 wib / Sunu
Budhi Raharjo, dr. SpJP (K), PhD /
Denio A. Ridjab, dr. SpJP - FIHA
4 4 ( operator )
3. M YAZIM YAKUB
DR.SPOG / BEDAH HEARTOLOGY
- CABG / OK 3 jam 16.00 wib /
Dicky Aligheri, SpBTKV (K),dr,
FIHA, FICA
4.HASDIYANTY ANUGRAH PUTRI
/ BEDAH OBGYN - Dilatasi
Curretage / Ok 1 jm 21.00 wib / Nisa
RENCANA TINDAKAN ( 06.01.22 ) 1.

NICHOLAS JAMES LATIF / BEDAH
UROLOGY - Sirkumsisi + GA / OK 1 jam 14.00
wib / Vonty Elfrida, dr. SpB
2. PAULINA ISWANTI / unspecified
3 3 hydronephrosis / OK1 jam 16.10 wib / Sara
Ester, dr. Sp.BP-RE 3. DINA
ACYUNINDA / BEDAH OBGYN - Sectio
Caesaria / OK 1 jam 15.10 wib / Taufik Jamaan,
Dr.dr. Sp.OG
AL CARE
1. M YAZIM YAKUB DR.SPOG /

1 BEDAH HEARTOLOGY - CABG /
OK 3 jam 16.00 wib / Dicky Aligheri,
SpBTKV (K),dr, FIHA, FICA
1. By. Ny. Endah Fathona / dr. Tartila /
NCB SMK usia 2 hari--> Pindah nicu
Status HCU ( Titipan Nursery dgn
Biltot : 16,99. binstruksi dr Tartila,
SpA(K) cek biltot dan tsh neo setelah
blt 1x24jam tgl 05.01 15 mg/dl
2. By Ny
Okta mediutami / Neonatal Jaundice
3 Biltot 18 mg / dl / Mira Febriani
Inkiriwang,dr. SpA 3. Willy
Purnama Chandra / Dicky Aligheri,
SpBTKV (K),dr, FIHA, FICA / Post
BENTAL, Dissection of Aorta tgl 30
des 21 ( MAsuk HCU jam 01.30 wib )
1
28,P-max 20 FREK 10, FIO2 40%
0
5
PASIEN OBSERVASI :
1. Ny. Indah Dwi/dr.Nisa, Sp.
OG/G1P0A0 hamil 39 minggu 1
hari --> SC Cito jam 23.00
RENCANA TINDAKAN :
1
1. Ny. Dina Acyuninda / dr Taufik,
Sp.OG /G1P0A0 hamil 39-40
minggu dengan ICA sedikit
Rencana SC tgl 6/1/2022 jam 15.10
wib dr. Catur sudah terinfo (+)
PASIEN PONEK :
PASIEN OBSERVASI :
2
1. By. Ny. Siriz/dr.Nathalia,
SpA/NCB SMK usia 1 hari
2. By. Ny. Indah Dwi/dr.Nathalia,
2 SpA/ NCB SMK usia 7 jam
PASIEN PULANG
TOLOGY

Report*
05 Jan 22
CATHLAB
2 Schedule :
1. Conti chandra / cag ptca 1 stent +
IVUS / dr. Denio. 16.15-19.40
Team : jhoni, triyanto, aulia, akbar
2. Chiu in / conventional ablation / dr.
Sunu. 20.30. (23.00 masih proses)
Team : triyanto, jhoni, aulia, akbar
Non Schedule : -
HYBRID OR
Schedule :
1. Yaziim Yakub / CABG / dr. DAW /
16.30-21.30
Non Schedule : -
1
Others : -
Problem : -.
Overtime staf : 1 tim.
Staff sakit : -
Staff cuti : -
Next Schedule
Thurs, 6 Jan 22
1. Masrumi / ppm single / dr. Faris /
hybrid / jam 11
2. Kinanti cahyaning putri / ADO + TTE
intra prosedur / dr. Radityo / jam 19.00 /
Hybrid / General Anastesi / CSR YJI
Daily Census OPD cardiac 5 Januari

2022
Outpatient : 16
dr ario :
Dr dafsah :
dr denio : 3
dr faris : 3
16 16 dr DH :
dr DAW : 1
dr radityo :
Dr suko :
dr sunu : 6
dr Adi : 3
MCU : 1 (dr. Denio)
New patient: 7
Dr. Faris : 2 (1 dari dr. Rinny RS
Primaya Bekasi, 1 dari dr. Alvin
RSBS)
Dr. Denio : 2 (1 dari website, 1 pasien
lama di PIK)
Dr. Sunu : 3 (1 pasien lama dr. Dicky
Hanafy di RS Harkit, 1 dari website, 1
dari dr. Stephanie Salim, SpJP Kizuna
Clinic)
Cancel :
Dr. Ario : 1
melakukan
ECHO : 1
Stress Echo :
USG Doppler : 1
Holter :
Ezypro :
ECG : 11
Treadmill : 2
CT Scan :
Speckle :
TEE :
DSE :
ABI : 1
Advance Echo : 2
Handle echo :
ABPM :
Tilt Table Test :
Paket PJB :
Referral Brawijaya : dr. Alvin, SpPD

Refferal RS luar : dr. Rinny RS
Primaya Bekasi, dr. Stephanie Salim,
SpJP
dr Firdha
dr Mega + dr Rona
dr Dewi
SIC (CAROL) KAMIS,06.01.22.
TIPE PASIEN
YANG DINAS
LT NAMA UNIT
EMERGENCY ROOM
Dr Audrey
Dr Audrey Dr Dwi
EMERGENCY dr Dwi Ns
Ns Susi Ns Mohlis
ROOM Ns Kelvin
Rizam Ns
Ns Tomi
Sanusi
GF
Dr Audrey
Dr Audrey Dr Dwi
EMERGENCY dr Dwi Ns
Ns Susi Ns Mohlis
ROOM Rizam Ns
Ns Kelvin Ns Tomi
Sanusi
GF
PONEK
TOTAL PASIEN EMG
Poli Obgyn
Ns NS 1 :
Poli Urology IIN
Poli Ortho
Poli Internist
Poli Bedah Umum
Poli Bedah Plastik
Poli THT Kiki
Poli Gizi
LT 3
NS 2 :
Ns NS 2 :
Kiki
Poli bedah saraf

Poli Neuro
Dermis
Dental
LT 3
Poli Endoscopy
Poli Fisioterapi
Poli Rehab Medik
Poli Nutrition
Poli Paru
Poli Mata
Poli Psikiatri
Pain Clinic
MCU
POLI KEMOTERAPI
ODC
TOTAL PASIEN OPD

Dr Mega Ns
LT 4 Ns Indah Ns Dr Mega Ns
IN PATIENT Kristin Ns
DEPARTMENT
Abdi Ns
Santi Ns
Citra Ns 7
Wulan Taufik
Okta
Dr Mega Ns
LT 4 Ns Indah Ns Dr Mega Ns
IN PATIENT Kristin Ns
DEPARTMENT
Abdi Ns
Santi Ns
Citra Ns 7
Wulan Taufik
Okta
Ns Ana Ns Ns Risha
IN PATIENT Ns Dini
LT 6 DEPARTMENT
Tita Ns Ns yudi Ns
Ns Tari
11
Melya Ela
Ns Ana Ns Ns Risha
IN PATIENT Ns Dini
LT 6 DEPARTMENT
Tita Ns Ns yudi Ns
Ns Tari
11
Melya Ela
Kemoterapi
OPERATING THEATER
Ns Sunandar
OK Ns Heryanti 4
CRITICAL CARE
Ns. Ns Ani Ns Gisma

ICU Awaludin, Ns Esti p Ns Rita
HCU
Ns Esti Ns Ayu Ns Evi
NICU
PICU
TOTAL Ps CRITICAL
OBSTETRICS
Bd Viki Bd Tries Bd Anggi

VK Bd Ningsih Bd Putri Bd Genda
Bd Viki Bd Tries Bd Anggi
VK Bd Ningsih Bd Putri Bd Genda
Nursery Bd Nani 3
HEARTOLOGY
Cathlab Ns AKbar
LT 8
LT 8
Hybrid 3
Dokter Jaga
Dokter Jaga IGD : Pagi : dr Audrey Malam : dr Dwi
Dokter Jaga IPD : Pagi : dr Abdurrahman Malam : dr Mega
Dokter Jaga Critical : Pagi : dr Riri Malam : dr Nilam

KETERANGAN
TOTAL
PASIEN
OM
PASIEN OBSERVASI :
1. Ny Muzdalifah / 56 thn /
Nausea, vomiting
RAJAL :
1. NyFatimah /34 thn /Malignant
neoplasma of placenta / Pro Inf
Methotrexate / Prof NUgroho
Kampono ( Prof NK )
2. Ny Fita Anggraini/ 41 thn / Kel
dada berdebar debar
3. An Rasuna Bratandari/ 1 thn /
Diarhea 5x
4. Tn Andoko Gunawan / 38 thn /
Diarhea 2x
5. Tn Arief Budiman / 38 thn /ISPA
6. Tn
Adimas Aditya / 39 thn / Dypepsia
7. An
Bradley Prijadi / 2 thn / Obsv Febris
H3 8. Ny Hertria
/ 35 thn / Dyspesia 9. Nn Asla
sonia / 21 thn / Obsv Febris H2
RANAP :
1. An Ahmad Lukman / 12 thn
DHF / Rawat lt 4
2. Tn William Tanadi /40 thn /
Myastenia Gravis/ pro
Tracheostomi replacement / Dr
Mira SpPD / Rawat 617 3.
By Nakia Khinanti / 0 thn /
Neonatal jaundice / Rawat HCU
(titip NICU )
4. Ny Devi Ramesh / 70 thn /
Malignant / DC tidak keluar
urine( DC dipasang di RS Gading
Pluit oleh Dr Taufan SpU ) CT uro
dilakukan + / Dr Akbari SpU visite
- Spooling Catheter urine / Rawat
IPD 406 5. Tn
Oemar Noviardi / Obs Febris H1 /
Rawat IPD 407
RUJUK :
APS :
D.O.A :
RAJAL :
RANAP :
PASIEN OBSERVASI :
15
30
1
1
8
1
6
1
14
7
32
5
113
1.An. Lukman Utomo / Catur

Sapariyanto, dr. SpA / DHF H-5 NS 1
Positif
2.Ny. Devi Ramesh / Akbari Wahyudi
Kusumah, dr. Sp.U / Malignant
neoplasm of ovary, Retention of urine
3.Tn.Omar Noviardi / Alvin Nursalim,
dr. Sp.PD / Dyspepsia, Fever,
unspecified
PASIEN OBSERVASI :
Sapariyanto, dr. SpA / DHF H-5 NS 1
Positif
unspecified
6.By. Kinanti Cahyaning Puteri /
7.Ny. RA Natasya/ Ratih Pahlesia, dr.
Sp.P/ Hypertensive heart disease
PASIEN PINDAH HCU

Aorta
7 RENCANA TINDAKAN :
7
1. Tn Kinanti Cahyaning Puteri /

Penutupan PDA dengan device, R/ Pro
Penutupan PDA dengan device Hari
Sabtu, tanggal 8/1/2022 jam
12.00/13.00 -> FU untuk fix jamnya.
neoplasm of ovary, Retention of urine /
Rencana tindakan Pasang Dj stent
bilateral dan cystoscopi biopsi buli.
( sifatnya backup) -> blm ada waktu
dan tgl tindakan.
Rachman, dr. Sp.S / Low back pain/
Rencana tindakan PRO PELD & DRG
Ablation, Sabtu ini (08/01/22). SIO +,
Asuransi blm ACC, klo udah acc →
info dr. Syafrizal
RENCANA PULANG :
1.Ny. RA Natasya/ Ratih Pahlesia,

dr. Sp.P/ Hypertensive heart
disease without (congestive) heart
failure
PASEN APS :
PASIEN PULANG :
1. Tn Conti Chandra / Sunu Budhi

Raharjo, dr. SpJP (K), PhD / CAG
+ PTCA 2 stent
radiculopathy
3.Ny. Hasdiyanty Anugrah Putri/
Nisa Fathoni, dr. Sp. OG, IBCLC /
Kuret / ODC
MENT
1.Ny. Dina Acyuninda/ Taufik
Jamaan, Dr.dr. Sp.OG/ Post SC
P1A0
2.Tn. William Tanady/ Wisanti, dr.
Sp.THT-KL/ Myasthenia gravis
3.An.Kenrich Constantine/ Annisa
Nur Aini, dr. Sp.A (FT)/
Rhinobronkitis akut dd/ bacterial
Demam
Berdarah Dengue
4.Ny.Debby Fransiska Driyani/
Febriansyah Darus, dr. Sp.OG-
KFM/ G2P1A0,38 minggu
5.Ny. Almira Rahmadhani/ Nisa
G2P0A1 hamil 38-39 minggu a.i
CPD
PASIEN OBSERVASI :
10+1
(ICU)
1.Ny. Ratih Tyas/Mira Yulianti,dr,
2.An. Clemira Lemira Shabira/Annisa
Nur Aini, dr. Sp.A (FT)/ DHF H ke 4
3.Ny. Masrumi / Faris Basalamah, dr.
SpJP (K)/Bradycardia, unspecified
4.Ny. Indah Dwi Chyntia / Nisa
Fathoni, dr. Sp. OG, IBCLC/ Post SC
P1A0
5.Ny. Siriz TentaniI/Nisa Fathoni, dr.
Sp. OG, IBCLC/ Post Sc P5A0
6.Ny. Dina Acyuninda/ Taufik Jamaan,
Dr.dr. Sp.OG/ Post SC P1A0
8.An.Kenrich Constantine/ Annisa Nur
Aini, dr. Sp.A (FT)/ Rhinobronkitis
akut dd/ bacterial Demam
Berdarah Dengue
Febriansyah Darus, dr. Sp.OG-KFM/
G2P1A0,38 minggu
Fathoni, dr. Sp. OG, IBCLC/ G2P0A1
10+1 hamil 38-39 minggu a.i CPD
(ICU)
PASIEN MENINGGAL
RENCANA TINDAKAN
Febriansyah Darus, dr. Sp.OG-
KFM/ G2P1A0,38 minggu/
Rencana SC, tanggal 7/1/22, jam
12.30 Wib.
G2P0A1 hamil 38-39 minggu a.i
CPD/ Rencana tindakan SC +
Eracs, tanggal 7/1/22, Jam 09.00
Wib.
Sp.THT-KL/ Myasthenia gravis/
Renacana ganti kanul
Tracheostomy tanggal 7/1/22, Jam
15.00 Wib.
PASIEN PINDAH ICU :

1. Tn M.Yazim / Dicky Aligheri,
PASIEN PULANG
1.An. M. Rasyif/ Mira Febriani
RENCANA RUJUK :
1.Ny. Ratih Tyas/Mira Yulianti,dr,

Bronchus or lung, Pleural effusion (
Rencana rujuk RSCM KENCANA )-
ON PROSES
TER
1. Tn NICHOLAS JAMES LATIF /
BEDAH UROLOGY - Sirkumsisi +
GA / OK 1 jam 14.00 wib / Vonty
Elfrida, dr. SpB
2. PAULINA ISWANTI / unspecified
hydronephrosis / OK1 jam 16.10
wib / Sara Ester, dr. Sp.BP-RE
3.
4 DINA ACYUNINDA / BEDAH
OBGYN - Sectio Caesaria / OK 1 jam
15.10 wib / Taufik Jamaan, Dr.dr.
Sp.OG
4. WILLY PURNAMA CHANDRA
/ Dissection of aorta / OK Hybrid jam
21.00 wib / Dicky Aligheri, SpBTKV
(K),dr, FIHA, FICA
RENCANA TINDAKAN tgl 07.01.22 1.

DEBBY FRANSISKA DRIYANI / BEDAH
OBGYN - Sectio Caesaria / OK 1 jam 09.00 wib
/ Febriansyah Darus, dr. Sp.OG-KFM
2. ALMIRA
RAHMADHANI / Ok 1 jam 12.30 wib /
BEDAH OBGYN - Sectio Caesaria / Nisa
3. SRI DEWI LESTARI /
5 BEDAH OBGYN - Dilatasi Curretage / Ok 1
jam 13.30 wib / Nisa Fathoni, dr. Sp. OG,
IBCLC 4.
OCTIVIA RIAN FATMAWATI / BEDAH
UMUM - Eksisi Biopsi dengan anestesi umum /
Ok 1jam 16.30 wib / Wulan Ayudyasari, dr.
Sp.B 5. ENNY ANGGARAINI
S / BEDAH ONCOLOGY - Radical Mastectomy
/ OK 1 jam 20.00 wib / Bob Andinata, dr.
Sp.B(K)Onk
1. M YAZIM YAKUB DR.SPOG /

BEDAH HEARTOLOGY - CABG /
1
OK 3 jam 16.00 wib / Dicky Aligheri,
1. By. Ny Nakia Kinanthi / neonatal
jaundice / bltot: 16,31 mg/dl /
Keumala Pringgardini, SpA
2. By Ny Okta
mediutami / Neonatal Jaundice Biltot
18 mg / dl / Mira Febriani
Inkiriwang,dr. SpA 3. Willy
Purnama Chandra / Dicky Aligheri,
SpBTKV (K),dr, FIHA, FICA / Post
BENTAL, Dissection of Aorta tgl 30
des 21 ( MAsuk HCU jam 01.30 wib )
tgl 06.01.22 jam 20.00 tindakan reopen
Thoraks ec Tamponade. masuk iccu
jam 22.00 / on venti mode kontrol fio2
0.5 VT 500 f14 peep 5 / CVC di
subclavicula kiri, tepasang drain tup
no 28F di substernal dan 20F
intrapericard, undulasi WSD (+) /
3 perdarahan intra OK 500cc (clotting) /
loading koloid 500cc, kristaloid 500cc,
prc 1 bag, ffp 4 bag, tc 5 bag / Tersisa
1 darah pc.
TD 134/64 mmhg, HR 82x/mnt, RR
14, spo2 100% dgn nrm 12lpm
Sudah ekstubasi pkl 00.00
Kesadaran dpo
Terapi saat ini sesuai dr Anas, SpAn-

KAKV
RL 1000cc/24 jam
Cefuroxime 2x1,5gr
Tranexid 3x500mg
Morfin 10mcg/kgbb/jam
Dexmedetomidine 0.3mcg/kgbb/jam
Propofol bolus 20mg extra
28,P-max 20 FREK 10, FIO2 40%
0
5
PASIEN OBSERVASI :
RENCANA TINDAKAN :
2
1. Ny. Debby / dr Febriansyah /
G2P1A0 hamil 38 minggu dgn
BSC 1x Rencana SC tgl 7/1/2022
2
jam 09.00 wib dr Annisa sudah
terinfo (+) 2.
Ny. Almira / dr Nisa, Sp.OG
/G2P0A1 hamil 38-49 minggu
dengan CPD Rencana SC tgl
7/1/2022 jam 12.30 wib dr. Annisa
sudah terinfo (+)
PASIEN PONEK :
PASIEN OBSERVASI :
1. By. Ny. Siriz/dr.Nathalia,
SpA/NCB SMK usia 2 hari
2. By. Ny. Indah Dwi/dr.Nathalia,
SpA/ NCB SMK usia 1 hari
3 3. By. Ny. Dina/dr Catur,
SpA/NCB SMK usia 15 jam
PASIEN PULANG

Report*
06 Jan 22
CATHLAB
Schedule : -
Non Schedule : -
YBRID OR
Schedule :
1. Masrumi / ppm single / dr. Faris /
10.30-12.30
Team : Rinny, aulia, akbar, saiful
1. Willy / tee intra prosesur eksplorasi
tamponade.
Non Schedule :
1. Willy / eksplorasi tamponade / dr.
DAW / 19.30-22.30
3 Reschedule/ Cancel :
1. Kinanti cahyaning putri / ADO -
hybrid digunakan utk prosedur
emergency.
Others : -
Problem : -.
Overtime staf : 1 tim.
Staff sakit : -
Staff cuti : -
Next Schedule
Sat, 8 Jan 22
1. Kinanti cahyaning putri / ADO + TTE
intra prosedur / dr. Radityo / jam 19.00 /
Hybrid / General Anastesi / CSR YJI
15 Kunjungan pasien ke OPD CArdiac

SIC (EKO) JUM'AT,07.01.22.
TIPE PASIEN
YANG DINAS
LT NAMA UNIT
EMERGENCY ROOM
dr. Audrey, dr. Fajar,

EMERGENCY Ns. Sanusi,
Ns. Susi, Ns. Ns. Kelvin,
ROOM Fitri
Ns. Rizam
Br. Mohlis
GF
PONEK
TOTAL PASIEN EMG
Poli Obgyn
Ns NS 1 :
Poli Urology IIN
Poli Ortho
Poli Internist
Poli Bedah Umum
Poli Bedah Plastik
Poli THT Kiki
Poli Gizi
Poli bedah saraf
Poli Neuro
Dermis
LT 3 Dental
Poli Endoscopy
Poli Fisioterapi
LT 3
Poli Rehab Medik

Poli Nutrition
Poli Paru
Poli Mata
Poli Psikiatri
Pain Clinic
MCU
POLI KEMOTERAPI
ODC
TOTAL PASIEN OPD

DP =
Ns.Nurul + DS = Ns.
LT 4 Br. Abdi + Kristin + Ns. DM = Ns.
IN PATIENT
Ns. Wulan Silvi + Br. Citra + Ns.
DEPARTMENT Middle = Ns. Rio Okta
Indah
DP = Ns. DS = Ns
Ana + Ns. Tita + Br. DM = Ns.
IN PATIENT
LT 6 DEPARTMENT
Devi + Ns. Yudi + Ns. Dini + Ns.
Nadya Ella Risha
Risha
Kemoterapi
OPERATING THEATER
OK
CRITICAL CARE
Ns. Awal, Ns. Rita,

ICU Ns. Agus
Ns. Agus Gisma
HCU
NICU
PICU
TOTAL Ps CRITICAL
OBSTETRICS
Siang : bd. ‌Dines

‌ ines Pagi:
D
Viki , bd Malam : bd.
VK bd Ningsih
Putri Tries, bd
‌Dines
Dewi
VK bd Ningsih
Putri Tries, bd
‌Dines
Dewi
Nursery Eka
HEARTOLOGY
Cathlab
Hybrid
LT 8
Dokter Jaga
Dokter Jaga IGD : Pagi : dr Audrey Malam : dr Fajar
Dokter Jaga IPD : Pagi : dr Megawati Malam : dr Yunitha
Dokter Jaga Critical : Pagi : dr Riri Malam : dr Rizky

KETERANGAN
TOTAL PASIEN perhatian/critical/Kemo/transfusi, Pasien
Risiko/Komplen, Pasien titipan, ODC, & Prosedur yang
akan dilakukan)
NCY ROOM
PASIEN OBSERVASI :
RAJAL :
1. Tn. Nugroho Dandy /39th/ Dx. Fever
2. Ny. Dewi Melur Kampono /50th/ Dx.
Fibroadenosis of breast
3. Tn. Dani Kuswanto /50th/
Dx.Ispa 4. Ny. Fifi Sofia Aini /25th/
Dx. Supervision of normal pregnancy / konsul dr.
Nisa, Sp. OG
-instruksi infus venofer 2 amp dalam ns 100
maksimal 1 jam, jika mual ondancetron 8 mg
5. Tn. Muhammad Alvin /23th/ Dx. Ispa
6. Nn. Sarah Dinna /27th/ Dx. Dyspepsia
7. Ny. Halimah Abdullah /33th/ Dx. Supervision
of normal pregnancy / venofer 2 amp dalam NS
100, djj
8. Ny. Novita P Hutagalung /37th/ Dx. Malaise
and fatigue
9. Tn. Doan Ariyanto /38th/ Dx. Malaise and
fatigue
10. Ny. Maria Elizabeth /40th/ Dx. Gastro-
oesophageal reflux disease without oesophagitis
RANAP :
14
1. Ny. Nurbiati /56th/ Dx. Dyspepsia+ Fever
/ Dpjp. dr. Amanda Pitarini Utari, SpPD-
KGEH / Ruang 404
2. Tn. Zulfikar Arse /46th/ Dx. fever +
Nausea and vomiting / Dpjp. dr. Nenfiati,
SpPD-KEMD / Ruang 418 3.
Tn. Aldy Rama /47th/ Dx. Fever + Malaise
and fatigue / Dpjp. dr. Alvin Nursalim, Sp.PD
/ Ruang 405 4. Tn. Falak
Niaz /41th/ Dx. DHF / Dpjp. dr. Alvin
Nursalim, Sp.PD / Ruang 415 ( Pasien
Rujukan dri RSPI) 5. Nn.
Evita Christi /25th/ Dx. Fever / Dpjp. dr.
Amanda Pitarini Utari, SpPD-KGEH / Ruang
414
RUJUK :
APS :
D.O.A :
RAJAL :
RANAP :
1. Ny. Irodatul Khoiriya /26th/ Dx. / Dpjp.

dr. Nisa Fathoni, Sp. OG, IBCLC / Ruang
611(SC besok pagi tgl 08.01.22 jam 10.00,
Team OK Sdh terinfo Ns. Yanu)
2. Ny. Ayu
2 Wandira /32th/ Dx. Fetal death of
unspecified cause, G4p2A1 hml 16mggu /
Dpjp. dr. Ardiansjah Dara Sjahruddin, Sp.OG
/ Ruang 609 (Transfusi PRC 500 cc
secepatnya, harus selesai sebelum jam
07.00 karena rencana induksi dimulai jam
07.00)
PASIEN OBSERVASI :
17 Pasien
30
1
2
2
7
1
1
8
16
17
6
1
27
2
132
PASIEN BARU :
1.Ny. Muzdalipah / dr.Nenfiati Sp.PD-KEMD /

Diarrhea, Gastroenteritis and colitis of infectious
and unspecified origin
2.Ny. Enny Anggraini / dr. Bob Andinata Sp.B
(K) Onk / Post Radical Mastectomy + Axilla
Disection + Chemoport revisi aff + Reconstruction
Local Flap
3.Tn. Aldy / dr.Alvin Sp.PD / Fever H2
4.Ny. Evita / dr.Amanda Pitarini Sp.PD-KGEH /
Other specified fever
5.Tn. Falak / dr.Alvin Sp.PD / Dengue fever
[classical dengue]
6.Tn. Zulfikar / dr.Nenfiati Sp.PD-KEMD /
Gastroenteritis and colitis of unspecified origin
PASIEN OBSERVASI :
1.An. Lukman Utomo / Catur Sapariyanto, dr.
SpA / DHF H-5 NS 1 Positif
2.Ny. Ruth / dr.Chamim Sp.OG (K) Onk /
Malignant neoplasm of cervix uteri
3.Ny. Nurbaiti / dr. Amanda Pitarini Sp.PD-
KGEH / Fever, Dyspepsia
5.Ny. Devi Ramesh / Akbari Wahyudi Kusumah,
dr. Sp.U / Malignant neoplasm of ovary, Retention
of urine
6.Tn.Omar Noviardi / Alvin Nursalim, dr. Sp.PD
/ Dyspepsia, Fever, unspecified
7.Ny. Tiomindo Hutabarat / Amanda Pitarini
Utari,dr, SpPD-KGEH / Non-insulin-dependent
diabetes mellitus, Haematemesis, Melaena
9.By. Kinanti Cahyaning Puteri / Radityo
Prakoso, dr. MD, FIHA,F / Patent ductus
arteriosus, Pro Penutupan PDA dengan device
10.Ny. Enny Anggraini / dr. Bob Andinata Sp.B
(K) Onk / Post Radical Mastectomy + Axilla
Disection + Chemoport revisi aff + Reconstruction
Local Flap
14 pasien (13 [classical dengue]
diruangan, 1 13.Tn. Zulfikar / dr.Nenfiati Sp.PD-KEMD /
diruang ICU) Gastroenteritis and colitis of unspecified origin
PASIEN PINDAH ICU :

1.Willy Purnama Chandra / Dicky Aligheri,
SpBTKV (K),dr, FIHA, FICA / Post BENTAL,
Dissection of Aorta
RENCANA TINDAKAN :
1.By. Kinanti Cahyaning Puteri / Radityo
Prakoso, dr. MD, FIHA,F / Patent ductus
arteriosus, Pro Penutupan PDA dengan device, R/
Pro Penutupan PDA dengan device Hari Sabtu,
tanggal 8/1/2022 jam 12.00/13.00 -> FU untuk
fix jamnya.
of urine / Rencana tindakan dr.Chamim :
Laparatomi eksplorasi, dr. Perwira widi : LAR
+ adhesiolisis, kemungkinan sampai Stoma,
dr.Akbari : Pasang Dj stent bilateral dan
cystoscopi biopsi buli. ( sifatnya backup). Tgl
08/01/2022 jam 15.00 wib
3. Ny.Ruth / dr.Chamim Sp.OG (K) Onk /
Malignant neoplasm of cervix uteri / Rencana
tindakan Radical Hysterectomy + Diseksi
Kelenjar Getah Bening Pelvis 08/01/2022 jam
07:30.
RENCANA PULANG :
PASEN APS :
PASIEN PULANG :
1.Ny. RA Natasya / Ratih Pahlesia, dr. Sp.P/

Hypertensive heart disease without
(congestive) heart failure (Plg di dinas pagi)
Rachman, dr. Sp.S / Low back pain (Plg di
dinas malam)
DEPARTMENT PASIEN BARU :

1.Ny.Paulina Iswanti / dr.Sara Ester,Sp.BP-
RE/Lymphoedema, not elsewhere classified
2.Ny.Octivia Rian / dr. Wulan
Ayudyasari,Sp.B/ Benign lipomatous
neoplasm of other sites
3.Ny. AYU WANDIRA / dr. Ardiansjah
Dara Sjahruddin, Sp.OG / Fetal death of
unspecified cause
4.IRODATUL KHOIRIYAH / dr. Nisa
Fathoni,Sp. OG, IBCLC / G1P0A0 hamil 39
minggu dengan letak lintang
PASIEN OBSERVASI :
1.Ny. Ratih Tyas /Mira Yulianti,dr, SpPD-KP

/Malignant neoplasm: Bronchus or lung, Pleural
effusion
2.An. Clemira Lemira Shabira /Annisa Nur
Aini, dr. Sp.A (FT)/ DHF H ke 4
3.Ny. Indah Dwi Chyntia / Nisa Fathoni, dr. Sp.
OG, IBCLC/ Post SC P1A0
4.Ny. Dina Acyuninda / Taufik Jamaan, Dr.dr.
Sp.OG/ Post SC P1A0
5.Tn. William Tanady / Wisanti, dr. Sp.THT-
KL/ Myasthenia gravis
/ Annisa Nur Aini, dr. Sp.A (FT)/ Rhinobronkitis
akut ,Demam Berdarah Dengue
7.Ny.Debby Fransiska Driyani / Febriansyah
Darus, dr. Sp.OG-KFM/ Post SC P2A0
8.Ny. Almira Rahmadhani / Nisa Fathoni, dr.
Sp. OG, IBCLC/ Post SC P1A1 a.i CPD
9.Ny.Paulina Iswanti / dr.Sara
Ester,Sp.BP-RE/Lymphoedema, not elsewhere
classified
10.Ny.Octivia Rian / dr. Wulan Ayudyasari,Sp.B/
Benign lipomatous neoplasm of other sites
11.Ny. AYU WANDIRA / dr. Ardiansjah Dara
Sjahruddin, Sp.OG / Fetal death of unspecified
cause
12 Pasien 12.IRODATUL KHOIRIYAH / dr. Nisa
minggu dengan letak lintang
PASIEN MENINGGAL
RENCANA TINDAKAN
1.Ny.Paulina Iswanti / dr.Sara Ester,Sp.BP-
RE/Lymphoedema, not elsewhere classified /
Rencana Tindakan Liphatycovenular
Anastomosis tgl 08/01/2022 jam 10.00 wib
2.Ny. AYU WANDIRA / dr. Ardiansjah
Dara Sjahruddin, Sp.OG / Fetal death of
unspecified cause / Rencana tindakan
induksi besok 8/01/22 jam 07.00 WIB
3.IRODATUL KHOIRIYAH / dr. Nisa
minggu dengan letak lintang / Rencana
Tindakan SC tanggal 8/01/2022 jam 10.00
WIB
PASIEN PINDAH ICU :
PASIEN PULANG
1.Ny. Siriz TentaniI /Nisa Fathoni, dr. Sp.
OG, IBCLC/ Post Sc P5A0
2.Ny. Masrumi / Faris Basalamah, dr. SpJP
(K)/Bradycardia, unspecified
RENCANA RUJUK :
1.Ny. Ratih Tyas /Mira Yulianti,dr, SpPD-
Pleural effusion
G THEATER
1. Tindakan jumat, 07/01/22
- SC dr Febri a.n Debby
- SC dr Nisa a.n Almira
5 - Kuretase dr Nisa a.n Sri Dewi
- Eksisi Biopsi dr Wulan a.n Octivia
- Radical Mastectomy dr Bob a.n Enny
2. Rencana tindakan sabtu, 08/01/22

- Radical Histerectomy dr Chamim a.n Ruth
Pangabean jam 07.30
- LVA dr Sara a.n Paulina Iswanti Jam 09.30
- SC dr Nisa a.n Irodatul jam 10.00
- Laparotomy + DJ Stent dr Chamim + dr Akbari
+ dr Widi a.n Devi jam 15.00
AL CARE
1. Tn. Dr. M Yazim /67th/ Dx. Post CABG AI

3VD / Dpjp. dr. Denio, Sp.JP, dr. Dicky Sp.
BTKV, Pernafasan Spontan dg Nasal Canul 3
Lpm, Terpasang CVC 3Ldi Vena Sub clavia
sinistra, Sideport jugularis dexstra
2 2. Ny. Paulina Iswanti /51th/ Dx. Lymphoedema,
Post Lymphatic Venous Anastomosis (LVA) /
Dpjp. dr. Sara Ester Sp. BP-RE, Pasien masuk ke
ICU jam 20.30, K/u pasien sakit sedang, kes
Compos mentis GCS E4M6V5 Pernapasan
dengan nasal canul 4 lpmterpasang CVC 3
Lumen di vena subklavia sinistra, Terpasang
femoral vena besar di femoralis sinistra
1. Willy Purnama Chandra /45th/ Dicky
Aligheri, SpBTKV (K),dr, FIHA, FICA / Post
BENTAL, Dissection of Aorta tgl 30 des 21
( MAsuk HCU jam 01.30 wib ) tgl 06.01.22 jam
20.00 tindakan reopen Thoraks ec Tamponade.
masuk iccu jam 22.00, K/u pasien sakit sedang,
1 kes Compos mentis GCS E4M6V5Pernapasan
dengan nasal canul 3 lpmterpasang CVC 3
Lumen di vena subklavia sinistra, Terpasang
sideport di femoralis sinistra

Usia 31 hr, Hari Rawat ke 28 / Dr Erick Gultom
2 SpA , Terpasang ETT ukuran 3,5 kedalaman 8,5
FIO2 21%
4 Pasien
PASIEN OBSERVASI :
1. Ny Ayu / dr. Dara SpOG / G4P2A1 hamil
15 mgg dengan kematian mudigah pro
induksi (Di Ruang 609)
RENCANA TINDAKAN :
1 1. Ny Irodatul / dr. Nisa, SpOG / G1 hamil

37 mgg 5 hari dengan letak lintang sc jam
10.00 wib
2. Ny. Ayu / G4P2A1 h 15 mgg dengan
kematian mudigah rencana induksi jam 07.00
1
PASIEN PONEK :
1. Ny Irodatul / dr. Nisa, SpOG / G1 hamil
37 mgg 5 hari dengan kontraksi dan letak
lintang
2
2. Ny Ayu / dr. Dara SpOG / G4P2A1 hamil
15 mgg dengan kematian mudigah
PASIEN OBSERVASI :
1. By. Ny. Siriz /dr.Nathalia, SpA/NCB SMK
usia 2 hari / pulang
2. By. Ny. Indah Dwi /dr.Nathalia, SpA/
NCB SMK usia 2 hari / skrining pagi ini jam
06.00
3. By. Ny. Dina /dr Catur, SpA/ NCB SMK
usia 1 hari / skrining hari ini jam 16.00
4. By. Ny. Debby /dr annisa/NCB SMK usia
8 1 hari
5. By. Ny. Almira /dr.annisa/NCB SMK usia
17 jam
PASIEN PULANG
OLOGY
Daily Census opd cardiac 7/1/ 2021
Outpatient : 16
dr ario :
Dr dafsah :
dr denio : 10
dr faris :
dr DH : 2
dr DAW :
dr radityo :
16 Dr suko :
dr sunu :
dr Adi : 4
MCU :
New patient: 2
dr Denio : 1 pasien lama PIK
dr DH : 1 pasien lama di harkit
Cancel :
dr DH : 1 masih di luar kota
dr Denio : 2 1 reschedule tgl 7/2/2022 1 cancel
dr Adi : 1 reschedule tgl 10/1/22

ECHO :
Stress Echo :
USG Doppler : 1
Holter : 1
ECG : 7
Treadmill :
CT Scan
Speckle
TEE :
DSE :
ABI :
Tilt Table Test :
Advance Echo : 1
Handle Echo :
ABPM :
Ezypro :
Cardioversi :
Referral Brawijaya : -
Referral External : -
Info dokter tidak hadir : dr DAW tidak praktek
dr Yunitha
SIC (EKO) Sabtu,08.01.22
TIPE PASIEN
YANG DINAS
LT NAMA UNIT
EMERGENCY ROOM

EMERGENCY Ns. Rizam,
Ns. Fitri, Ns. Sanusi, Ns.
ROOM Rizam
Zr. Nur
Kelvin
GF
PONEK
TOTAL PASIEN EMG
Poli Obgyn
Ns NS 1 :
Poli Urology IIN
Poli Ortho
Poli Internist
Poli Bedah Umum
Poli Bedah Plastik
Poli THT Kiki
Poli Gizi
Poli bedah saraf
Poli Neuro
Dermis
LT 3 Dental
Poli Endoscopy
Poli Fisioterapi
Poli Rehab Medik
Poli Nutrition
Poli Paru
Poli Mata
Poli Psikiatri
Pain Clinic
MCU
POLI KEMOTERAPI
ODC
TOTAL PASIEN OPD
DP =
Ns.Nurul + DS = Ns. DM = Ns.
LT 4 Br. Abdi +
IN PATIENT indah + Ns. Christin+
Ns. Wulan
DEPARTMENT Middle = Br. Silvi Ns. Okta+ br
Rio taufik
DP = Ns. DS = Ns
Ana + Ns. Tita + DM = Ns.
IN PATIENT
LT 6 DEPARTMENT
Devi + Ns. Ns.Nadya + Risha +
Nella Ns. Ella Br.Yudi
Kemoterapi
OPERATING THEATER
OK
CRITICAL CARE
Ns. Awal, Ns. Awal, Ns. Elga,

ICU Ns. Any Ns. Agus Ningsih
HCU
Ns. Ayu,
Ns. Ayu,
NICU
PICU
TOTAL Ps CRITICAL
OBSTETRICS
‌Dines
‌ ines Pagi: Siang : bd.
D ‌Dines
bd Ningsih Malam : bd.
VK Bd Viki
Viki , bd Tries bd
ningsih putri
Nursery
HEARTOLOGY
Cathlab
Hybrid
LT 8
LT 8
Dokter Jaga
Dokter Jaga IGD : Pagi : dr Firdha Malam : dr Dwi
Dokter Jaga IPD : Pagi : dr Mega Malam : dr Nesya + dr. Rona
Dokter Jaga Critical : Pagi : dr Dewi Malam : dr Nilam

KETERANGAN
TOTAL PASIEN
perhatian/critical/Kemo/transfusi, Pasien Risiko/Komplen,
Pasien titipan, ODC, & Prosedur yang akan dilakukan)
ENCY ROOM
PASIEN OBSERVASI :
RAJAL :
1. Ny. Neneng Sri Nurhayati /43th/ Dx. Fever 2.
Ny. Adelia Mareta /34th/ Dx. Dysminorea 3.
Ny. Junaidi Afifa /30th/ Dx. Supervision of normal
pregnancy, G1P0A0 hamil 24 minggu 6 hari dg Iron
deficiency anaemia, / Infus Venofer 2 Ampul dalam
NS 100 cc Instruksi dr. Nisa Fathoni Sp. OG
4. Tn. R.P
Chairawan Padan /378th/ Dx. Mental and
behavioural disorders due to multiple drug use and use
of other psychoactive 5.
Tn. Erland Priyanugraha /26th/ Ispa
6. Ny. Ayu Putri R /26th/ Dx. spa
7. Nn. Nadia Mitrab O /32th/ Ispa
8.Ny. Aulia Elma A /26th/ Dx. Supervision
of normal pregnancy, G1P0A0 Hamil 10 minggu dg
Iron deficiency anaemia / instruksi dr. Alesia, SpOG
via buku kehamilan : infus venofer 3 ampul drip
dalam nacl 0,9% 100 ml
13 RANAP :
1. Tn. Tony Sudjiaryanto /62th/ Dx. Hiare /
Dpjp. Alvin Nursalim, dr. Sp.PD / Ruang 602
2. Tn. I Gede Ricky Rianto /27th/ Dx.
DHF / Dpjp. Alvin Nursalim, dr. Sp.PD / Ruang
603 3. Ny. Vinasari Muliana /40th/ Dx. Chest
Pain / Dpjp. Suko Adiarto, dr. SpJP (K),FIHA,,
FICA, FAsCC, PhD / Ruang 403
4. Ny. Yaasiina Hafidzah /25th/ Dx.
Myasthenia gravis / Dpjp. Zicky Yombana, dr.
Sp.S / Ruang 604
5. Ny. Suminem /58th/ Dx. DHF /
RUJUK :
APS :
D.O.A :
RAJAL :
RANAP :
1. Ny. Novianti Mandasari /30th/ Dx.
1 Supervision of normal pregnancy, G2P1A0
hamil. 39 minggu JPKTH dg Myalgia, other site
/ Dpjp. Nisa Fathoni, dr. Sp. OG, IBCLC /
Rawat VK
PASIEN OBSERVASI :
14 Pasien
34
5
4
7
4
8
18
22
2
7
13
82
7
9
225 Pasien
PASIEN BARU :
1. ny ida/dr.Amanda Pitarini Sp.PD-KGEH/dyspepsia

2. ny suminem/ Alvin Nursalim, dr. Sp.PD/ dhf h3
3. ny virnasari/ dr suko/ chest pain
PASIEN OBSERVASI :
1.An. Lukman Utomo / Catur Sapariyanto, dr. SpA /

DHF H-5 NS 1 Positif
2.Ny. Ruth / dr.Chamim Sp.OG (K) Onk / Malignant
neoplasm of cervix uteri
3.Ny. Nurbaiti / dr. Amanda Pitarini Sp.PD-KGEH /
Fever, Dyspepsia
5.Ny. Devi Ramesh / Akbari Wahyudi Kusumah, dr.
Sp.U / Malignant neoplasm of ovary, Retention of
urine
6.Tn.Omar Noviardi / Alvin Nursalim, dr. Sp.PD /
Dyspepsia, Fever, unspecified
7.Ny. Tiomindo Hutabarat / Amanda Pitarini Utari,dr,
SpPD-KGEH / Non-insulin-dependent diabetes
mellitus, Haematemesis, Melaena
Diarrhea, Gastroenteritis and colitis of infectious and
unspecified origin
9.Ny. Enny Anggraini / dr. Bob Andinata Sp.B (K)
Onk / Post Radical Mastectomy + Axilla Disection +
Chemoport revisi aff + Reconstruction Local Flap
[classical dengue]
13. ny ida/dr.Amanda Pitarini
Sp.PD-KGEH/dyspepsia
14. ny suminem/ Alvin Nursalim, dr. Sp.PD/ dhf h3
17 pasien (15
15. ny virnasari/ dr suko/ chest pain
diruangan 1
diruang ICU, 1
PICU)
PASIEN PINDAH ICU :
1.Willy Purnama Chandra / Dicky Aligheri, SpBTKV
(K),dr, FIHA, FICA / Post BENTAL, Dissection of
Aorta
2..By. Kinanti Cahyaning Puteri / Radityo Prakoso, dr.
MD, FIHA,F / Patent ductus arteriosus, Pro Penutupan
PDA dengan device
RENCANA TINDAKAN :
1 .Ny. Devi Ramesh / Akbari Wahyudi Kusumah, dr.

Sp.U / Malignant neoplasm of ovary, Retention of
urine / Rencana tindakan dr.Chamim : Laparatomi
eksplorasi, dr. Perwira widi : LAR + adhesiolisis,
kemungkinan sampai Stoma, dr.Akbari, Sembari
Menunggu Perbaikan K/U ( Karena Natrium Rendah
jdi hanya Tindakan yg lakukan di tgl 08.01.22 hanya
URS + Insersi DJ Stent Dulu, Info Pak Nandar )
RENCANA PULANG :
PASEN APS :
PASIEN PULANG :
1. ny ida/dr.Amanda Pitarini
T DEPARTMENT PASIEN BARU :
1.Tn. I Gede Ricky/ dr. Alvin Nursalim,

Sp.PD/DHF, Dispepsia
2.Tn.Tony Sudjiaryanto/ dr.Alvin
Nursalim,Sp.PD / GEA , DM ,Hipertensi
3.Ny.Yasiina Hafidzah/ dr.Zicky
Yombana,Sp.S / Myasthenia gravis
4.Ny.Novianti/ dr.Nisa Fathoni,Sp. OG, IBCLC /
G2P1A0 hamil 39 minggu
PASIEN OBSERVASI :
1.An. Clemira Lemira Shabira/Annisa Nur Aini, dr.
Sp.A (FT)/ DHF H ke 4
2.Ny. Dina Acyuninda/ Taufik Jamaan, Dr.dr. Sp.OG/
Post SC P1A0
3.Tn. William Tanady/ Wisanti, dr. Sp.THT-KL/
Myasthenia gravis
4.An.Kenrich Constantine/ Annisa Nur Aini, dr. Sp.A
(FT)/ Rhinobronkitis akut ,Demam Berdarah Dengue
5.Ny.Debby Fransiska Driyani/ Febriansyah Darus, dr.
Sp.OG-KFM/ Post SC P2A0
6.Ny. Almira Rahmadhani/ Nisa Fathoni, dr. Sp. OG,
IBCLC/ Post SC P1A1 a.i CPD
7.Ny.Octivia Rian/ dr. Wulan Ayudyasari,Sp.B/
8.IRODATUL KHOIRIYAH / dr. Nisa Fathoni,Sp.
OG, IBCLC / Poat SC P1A0
9.Tn. I Gede Ricky/ dr. Alvin Nursalim, Sp.PD/DHF,
Dispepsia
10.Tn.Tony Sudjiaryanto/ dr.Alvin Nursalim,Sp.PD /
GEA , DM ,Hipertensi
11.Ny.Yasiina Hafidzah/ dr.Zicky Yombana,Sp.S /
14 pasien(1 di VK, Myasthenia gravis
1 di HCU) 12.Ny.Novianti/ dr.Nisa Fathoni,Sp. OG, IBCLC /
PASIEN MENINGGAL
1.Ny. Ratih Tyas/Mira Yulianti,dr, SpPD-KP
/Malignant neoplasm: Bronchus or lung, Pleural
effusion
RENCANA TINDAKAN
1.Tn.Tony Sudjiaryanto/ dr.Alvin
Nursalim,Sp.PD / GEA , DM ,Hipertensi /
Rencana Tindakan USG bedside besok tgl 09-01-
2022 jam 08.00 wib
PASIEN PINDAH ICU :

1.Ny.Paulina Iswanti / dr.Sara
Ester,Sp.BP-RE/Lymphoedema, not elsewhere
classified
PASIEN PULANG
1.Ny. Indah Dwi Chyntia / Nisa Fathoni, dr. Sp.
OG, IBCLC/ Post SC P1A0
RENCANA RUJUK :
1.Ny. Dina Acyuninda/ Taufik Jamaan, Dr.dr.
Sp.OG/ Post SC P1A0 tunggu bayi
ING THEATER
1. Tindakan sabtu, 08/01/22
- Radical Histerectomy dr Chamim a.n Ruth
Pangabean jam 07.30
4 - LVA dr Sara a.n Paulina Iswanti Jam 09.30
- SC dr Nisa a.n Irodatul jam 10.00
- Laparotomy + DJ Stent dr Chamim + dr Akbari
+ dr Widi a.n Devi jam 15.00
2. Rencana tindakan minggu, 09/01/22
-
ICAL CARE
1. Tn. Dr. M Yazim /67th/ Dx. Post CABG AI 3VD /

Dpjp. dr. Denio, Sp.JP, dr. Dicky Sp. BTKV,
Pernafasan Spontan dg Nasal Canul 3 Lpm,
Terpasang CVC 3Ldi Vena Sub clavia sinistra,
Sideport jugularis dexstra
2 2. Ny. Paulina Iswanti /51th/ Dx. Lymphoedema,
Post Lymphatic Venous Anastomosis (LVA) / Dpjp.
dr. Sara Ester Sp. BP-RE, Pasien masuk ke ICU jam
20.30, K/u pasien sakit sedang, kes Compos mentis
GCS E4M6V5 Pernapasan dengan nasal canul 4
lpmterpasang CVC 3 Lumen di vena subklavia
sinistra, Terpasang femoral vena besar di
femoralis sinistra
1. Willy Purnama Chandra /45th/ Dicky Aligheri,
SpBTKV (K),dr, FIHA, FICA / Post BENTAL,
Dissection of Aorta tgl 30 des 21 ( MAsuk HCU jam
01.30 wib ) tgl 06.01.22 jam 20.00 tindakan reopen
Thoraks ec Tamponade. masuk iccu jam 22.00, K/u
1 pasien sakit sedang, kes Compos mentis GCS
E4M6V5Pernapasan dengan nasal canul 3
lpmterpasang CVC 3 Lumen di vena subklavia
sinistra, Terpasang sideport di femoralis sinistra
1. By Ny Devi Maryani / Dx.Achondroplasia / Usia
31 hr, Hari Rawat ke 28 / Dr Erick Gultom SpA ,
Terpasang ETT ukuran 3,5 kedalaman 8,5 cm
tersambung Ventilator Mode HFO dengan Setingan
2 MAP 10, AMP 30,P-max 20 FREK 10, FIO2 21%
(Pasien NICU)
2. By. Kenzie Zayn Mahardika /7hari/ Dx.
Hiperbillirubin 18 / Dpjp. Meirdhania Andina, dr.
Sp.A (Status pasien HCU, Titipan Nuersery dg
HIPERBIL)
1 1. An. Kinanti Cahyaning P /Usia 9 hri/ Dx.

Patent ductus arteriosus, Post ADO / Dpjp.
Radityo Prakoso, dr. MD, FIHA,FAPSIC,FAsCC
6 Pasien
PASIEN OBSERVASI :
1. Ny Ayu / dr. Dara SpOG / G4P2A1 hamil 15
mgg dengan kematian mudigah pro induksi
2. Ny. Novianti /dr.nisa,spog/G2P1 Hamil 39
2 mgg dgn inpartu
RENCANA TINDAKAN :
PASIEN PONEK :
1. Ny. Novianti /dr.nisa,spog/G2P1 Hamil 39
1 mgg /obs
PASIEN OBSERVASI :
1. By. Ny. Dina /dr Catur, SpA/ NCB SMK usia
1 hari / rencana pulang pagi
2. By. Ny. Debby /dr annisa/NCB SMK usia 2
hari rencana skrining jam 10.00 wib
3. By. Ny. Almira /dr.annisa/NCB SMK usia 2
hari rencana skring jam 14.00 wib
4 Pasien 4. By. Ny. Irodatul /dr.Natalie/NCB SMK usia
18 jam
PASIEN PULANG
1.By. Ny. Indah Dwi /dr.Nathalia, SpA/ NCB
SMK usia 2 hari / pulang
RTOLOGY
Outpatient : 13
dr ario : 7
Dr dafsah :
dr denio :
dr faris :
dr DH : 5
dr DAW :
dr radityo :
Dr suko : 1
13 Pasien dr sunu :
dr Adi :
MCU :
New patient: 4
Dr Ario : 1 dari kerabat, 2 dari website
Dr DH : 1 dari website
Cancel : 5
Dr Ario : 1 cancel akan infokan
Dr DH : 1 cancel Reshedule tgl 13/01/22
2 cancel akan infokan
1 reschedule tgl15/01/22
Dr Suko : 1 cancel akan infokan

ECHO :
Stress Echo : 3
USG Doppler : 3
Holter : 1
Ezypro :
ECG : 9
Treadmill :
CT Scan :
Speckle :
TEE :
DSE :
ABI :
Advance Echo : 4
Handle echo :
ABPM :
Tilt Table Test :
Paket PJB :
Refferal RS luar : -
Dokter tidak hadir : dr Sunu cuti

dr Dafsah sakit
dr Nesya + dr. Rona

TGL KAMAR/
No UNIT KELAS
IDENTITAS PASIEN KENDALA YANG DITEMUKAN
KEJADIAN
1. 08.01.22 NICU By. Kenzie Zayn Pasien naek ke NICU untuk di

Mahardika /7hari/ lakukan foto therapy / Sinar
Dx. Hiperbillirubin Tetapi tidak sesuai Alur dan
18 / Dpjp. Belum Swab Pcr untuk pasien
Meirdhania Andina, dan Blm swab Antigen untuk
dr. Sp.A keluarga pasien dan Keluarga
KETERANGAN
TINDAK LANJUT DATE
(Informasi yang di dapat dari Unit PIC
(ACTION PLAN) LINE
terkait)
SIC mendapatkan Lap. Dari perawat SIC melakukan Edukasi ke Keluarga
Nicu Zr. Esty da zr. Grace bahwa ada pasien serta menjelaskan bahwa
pasien dg Hiperbillirubin rencana Foto sebelum di lakukan Foto therapy harus
therapy tetapi blm di lakukan Swab PCR di lakukan PCR Swab untuk pasien dan
Antigen terlebih dahulu untuk keluaga
pasien, dan SIC mengarahkan keluarga
pasien Ke IGD serta mengkonfirmasi
unit unit terkait yaitu Polli, FL, serta
Nursery dan Meminta Kronologis
Kejadian
SIC (CAROL) Minggu,09.01.22
TIPE PASIEN
YANG DINAS
LT NAMA UNIT
EMERGENCY ROOM
Dr Fajar
Dr Fajar
EMERGENCY Dr Firdha Ns Sanusi
Ns Tomy
ROOM Ns Nur
Ns Mohlis Ns Fitri
Ns Zamzam
GF
PONEK
TOTAL PASIEN EMG
Poli Obgyn
Ns NS 1 :
Poli Urology IIN
Poli Ortho
Poli Internist
Poli Bedah Umum
Poli Bedah Plastik
Poli THT Kiki
Poli Gizi
Poli bedah saraf
Poli Neuro
Dermis
Dental
LT 3
Poli Endoscopy
Poli Fisioterapi
Poli Rehab Medik
Poli Nutrition
Poli Paru
Poli Mata
Poli Psikiatri
Pain Clinic
MCU
POLI KEMOTERAPI
ODC
TOTAL PASIEN OPD
Dr Yuanitha
LT 4 Dr Ludy Dr Yuanitha
IN PATIENT Ns Wulan
DEPARTMENT
Ns Salwa
Ns Silvi Ns
Ns Kristin 11
Ns Santi Ns Indah
Rio
Dr Yuanitha
LT 4 Dr Ludy Dr Yuanitha
IN PATIENT Ns Wulan
DEPARTMENT
Ns Salwa
Ns Silvi Ns
Ns Kristin 11
Ns Santi Ns Indah
Rio
Dr Megawati Dr Rona Ns Dr Rona Ns
IN PATIENT Ns Avi Ns Devi Ns
LT 6 DEPARTMENT Tari Ns Meliya Ns
Tita Ns 11
Nadya Ella Yudi
Kemoterapi
OPERATING THEATER
OK
Ns Sunandar
Ns Heryanti
CRITICAL CARE
ICU Ns Awaludin
HCU
Ns Esti
Ns Esti
NICU
PICU
TOTAL Ps CRITICAL
OBSTETRICS
Bd Ningsih Bd Ningsih Bd Putri

VK Bd Viki Bd Viki Bd Tries
Nursery
HEARTOLOGY
Cathlab
Hybrid
LT 8
Dokter Jaga
Dokter Jaga IGD : Pagi : dr Fajar Malam : dr Firdha
Dokter Jaga IPD : Pagi : dr Megawati + dr Ludi Malam : dr Yuanitha + dr Rona
Dokter Jaga Critical : Pagi : dr Riri Malam : dr Rizki

KETERANGAN
TOTAL
PASIEN
Risiko/Komplen, Pasien titipan, ODC,
& Prosedur yang akan dilakukan)
OM
PASIEN OBSERVASI :
RAJAL :
1. Ny Farah / 43 thn / Kel keluar
flek darah diluar siklus haid
2. Tn Iman Pribadi / 51 thn / Low
back Pain
3. Ny RR Retnastiti / 47 thn /
Acute Lymphadhenitis ( benjolan
dibawah telinga )
4. Tn Kamil Saragih / 28 thn /
ISPA 5. Tn Jadi raya / 42 thn /
Dyspepsia
6. An Kenzie Alkiano / 7 thn /
Dermatitis / Bercak merah di bibir
7. An Neisha Aurellia / 13 thn /
Obsv Febris H1
8. An Shakira Ameera / 14 thn /
Obsv Febris H 1
9. Ny Fitria / 43 thn / Obsv Febris
H1
13 RANAP :
1. Tn Nugroho / 39 thn / Obsv
Febris H1 / Dr Alvin SpPD /
Rawat IPD 401
2. Nn Monica Feby / 27 thn /
Sinusitis / Rawat IPD
3. An M Devantee / 12 thn /
Obsv Febris H 1 / Rawat IPd 607
RUJUK :
APS :
1. Nn Kheila / 26 thn / Obsv

Febris H1 / APS krn Tidak di
back up oleh Ass Sunlife Syariah
( ps baru pindah dari ass sunlife
biasa mejadi syariah
D.O.A :
RAJAL :
1. Ny Dian Indryani / 29 thn /

Nyeri perut bawah disertai ada
keluar stolsel / cek jalan lahir
dengan spekullum oleh Bd Putri
2 RANAP :
PASIEN OBSERVASI :
1. Ny Laristi / 25 thn / G1 P0 A0
H 38 mg / Keluar flek dari jalan
lahir sejak jam 11.00 wib
SMRS / Obsv VK
15
14
8
22
1. Tn Nugroho/dr. Alvin Nursalim

Sp. Pd/ Fever
PASIEN OBSERVASI :
1.Ny. Ruth / dr.Chamim Sp.OG (K)

Onk / Malignant neoplasm of cervix
uteri
2.Ny. Nurbaiti / dr. Amanda Pitarini
Sp.PD-KGEH / Fever, Dyspepsia
3.Tn. Aldy / dr.Alvin Sp.PD / Fever
H3
4.Ny. Devi Ramesh / Akbari
Wahyudi Kusumah, dr. Sp.U /
Malignant neoplasm of ovary,
Retention of urine
5.Tn.Omar Noviardi / Alvin
Nursalim, dr. Sp.PD / Dyspepsia,
Fever, unspecified
6.Ny. Enny Anggraini / dr. Bob
Andinata Sp.B (K) Onk / Post
Radical Mastectomy + Axilla
Disection + Chemoport revisi aff +
Reconstruction Local Flap
7.Ny. Evita / dr.Amanda Pitarini
Sp.PD-KGEH / Other specified
fever
8.Tn. Falak / dr.Alvin Sp.PD /
Dengue fever [classical dengue]
9.Ny. suminem/ Alvin Nursalim, dr.
Sp.PD/ dhf h3
10.Ny virnasari/ Suko Adiarto, dr.
SpJP (K),FIHA,, FICA, FAsCC,
PhD / chest pain
.
PASIEN PINDAH ICU :
11
Aorta
11
RENCANA TINDAKAN :
1.Ny. Devi Ramesh / Akbari

Wahyudi Kusumah, dr. Sp.U /
Malignant neoplasm of ovary,
Retention of urine / Rencana
tindakan dr.Chamim : Laparatomi
eksplorasi, dr. Perwira widi : LAR +
adhesiolisis, kemungkinan sampai
Stoma, dr.Akbari
RENCANA PULANG :
PASEN APS :
PASIEN PULANG :

Sapariyanto, dr. SpA / DHF H-5
NS 1 Positif
2.Ny. Tiomindo Hutabarat /
Amanda Pitarini Utari,dr, SpPD-
KGEH / Non-insulin-dependent
diabetes mellitus, Haematemesis,
Melaena
Ny. Muzdalipah / dr.Nenfiati
Sp.PD-KEMD / Diarrhea,
Gastroenteritis and colitis of
infectious and unspecified origin
3.Ny ida/dr.Amanda Pitarini
4.Tn. Zulfikar / dr.Nenfiati
Sp.PD-KEMD / Gastroenteritis
and colitis of unspecified origin
MENT
1. Tn I Gede Ricky/ dr. Alvin

Nursalim, Sp.PD/DHF,
Dispepsia
2.Tn.Tony Sudjiaryanto/ dr.
Alvin Nursalim,Sp.PD / GEA ,
DM ,Hipertensi
3.Ny. Yasiina Hafidzah/ dr.
Zicky Yombana,Sp.S /
Myasthenia gravis
4.Ny. Novianti/ dr. Nisa
Fathoni,Sp. OG, IBCLC /
5.Ny. Laristi/ dr. Nisa Fathoni,
Sp.OG / Supervision of normal
pregnancy
6.Ny. Monica/ dr. Mirta,
SpTHT / Chronic Sinusitis
7.Ny. Rumaisa/ dr. Caroline,
SpB / Ganglion
8.An. M. Devante R Abidin/ dr.
Diana, Sp.A / DHF H-4
PASIEN OBSERVASI :
1 Tn William Tanady/ Wisanti, dr.
2.Ny. Octivia Rian/ dr. Wulan
Ayudyasari,Sp.B/ Benign
lipomatous neoplasm of other sites
3.Ny. Irodatul / dr. Nisa Fathoni,Sp.
4.Tn. I Gede Ricky/ dr. Alvin
Nursalim, Sp.PD/DHF, Dispepsia
5.Tn.Tony Sudjiaryanto/ dr. Alvin
Nursalim,Sp.PD / GEA, DM,
Hipertensi
6.Ny. Yasiina Hafidzah/ dr. Zicky
7.Ny. Paulina Iswanti / dr.Sara
Ester, Sp.BP-RE/Lymphoedema, not
elsewhere classified
8.Ny. Monica/ dr. Mirta, SpTHT /
Chronic Sinusitis
9.Ny. Rumaisa/ dr. Caroline, SpB /
Ganglion
10.An. M. Devante R Abidin/ dr.
Diana, Sp.A / DHF H-4
RENCANA MASUK :
1.Ny. Rahmawati Putri/ dr. Sang,
SpOG / Rencana SC tgl 10/01/2022
11
RENCANA TINDAKAN
1. Tn I Gede Ricky/ dr. Alvin

Nursalim, Sp.PD/DHF,
Dispepsia, rencana USG bedside
10/01/2022 jam 13.00 WIB
2.Ny. Rumaisa/ dr. Caroline,
SpB / Ganglion, rencana eksisi
biopsi digital pedis 10/01/2022
jam 10.00 WIB
3.Ny. Monica/ dr. Mirta,
SpTHT / Chronic Sinusitis,
rencana FESS 10/01/2022 jam
18.30 WIB
PASIEN DI VK
1.Ny. Ayu / dr. Ardiansjah Dara
Sjahruddin, Sp.OG / Fetal death
of unspecified cause
pregnancy
PASIEN PULANG
1.An. Clemira Lemira

Shabira/Annisa Nur Aini, dr.
Sp.A (FT)/ DHF
2.Ny. Dina Acyuninda/ Taufik
Jamaan, Dr.dr. Sp.OG/ Post SC
P1A0
3.An.Kenrich Constantine/
Annisa Nur Aini, dr. Sp.A (FT)/
Rhinobronkitis akut ,Demam
Berdarah Dengue
Post SC P1A1 a.i CPD
5.Ny. Novianti/ dr.Nisa
Fathoni,Sp. OG, IBCLC /
RENCANA RUJUK :

Ester,Sp.BP-RE/Lymphoedema,
not elsewhere classified
TER
0
RENCANA TINDAKAN tgl 10.01.22
1.
RUMAISA RESTANI / BEDAH
UMUM - Eksisi + Biopsi / OK 1
jam 10.00 wib / Caroline Supit, dr.
SpB
2. IRODATUL KHOIRIYAH
WAAMALIAH / BEDAH OBGYN
- Sectio Caesaria / Ok 1 jam 13.30
wib / Nisa Fathoni, dr. Sp. OG,
4 IBCLC
3. MONICA FEBY TIARANI
/ BEDAH THT - Fess + Reduksi
Konka Bilateral / OK 1 jam 18.30
wib / Mirta Hediyati Reksodiputro,
Dr. dr. Sp.THT-KL(K)
4. XUE TIANDI / BEDAH THT -
Parotidektomi total / OK 2 jam
20.00 wib / Bob Andinata, dr.
Sp.B(K)Onk
1. Tn. Dr. M Yazim /67th/ Dx. Post

CABG AI 3VD / Dpjp. dr. Denio,
Sp.JP, dr. Dicky Sp. BTKV,
1 Pernafasan Spontan dg Nasal Canul
3 Lpm, Terpasang CVC 3Ldi Vena
Sub clavia sinistra, Sideport
jugularis dexstra
1. Willy Purnama Chandra /45th/

Dicky Aligheri, SpBTKV (K),dr,
FIHA, FICA / Post BENTAL,
Dissection of Aorta tgl 30 des 21
( Masuk HCU jam 01.30 wib ) tgl
06.01.22 jam 20.00 tindakan reopen
Thoraks ec Tamponade. masuk iccu
jam 22.00, K/u pasien sakit sedang,
1
kes Compos mentis GCS
E4M6V5Pernapasan dengan nasal
canul 3 lpmterpasang CVC 3 Lumen
di vena subklavia sinistra, Terpasang
sideport di femoralis sinistra
Dx.Achondroplasia / Usia 31 hr,
Hari Rawat ke 28 / Dr Erick Gultom
SpA , Terpasang ETT ukuran 3,5
kedalaman 8,5 cm tersambung
Ventilator Mode HFO dengan
2 Setingan MAP 10, AMP 30,P-max
20 FREK 10, FIO2 21% (Pasien
NICU)
2. By. Kenzie Zayn
Mahardika /7hari/ Dx.
Hiperbillirubin 18 / Dpjp.
Meirdhania Andina, dr. Sp.A
(Status pasien HCU, Titipan
Nuersery dg HIPERBIL)
PASIEN OBSERVASI :
1. Ny Ayu / dr. Dara SpOG /

G4P2A1 hamil 15 mgg dengan
kematian mudigah pro induksi
2. Ny. Novianti /dr.nisa,spog
G2P1 Hamil 39 mgg dgn inpartu
---> pulang jam 09.00
3. Ny. Laristi/ G1P0A0 hamil 38
3 mgg 2 hari dg inpartu/ dr. Nisa /
Partus jam 03.33 wib /Bayi lahir
perempuan dg BB 3185 gr
RENCANA TINDAKAN :
PASIEN PONEK :
1. Ny. Laristi / G1P0A0 hamil 38
mgg dg inpartu/ dr. Nisa
2. Ny. Dian/ G1P0A0 hamil 6
mgg / dr. Nisa

2 PASIEN OBSERVASI :
1. By Ny. Irodatu /dr.Natalie
/NCB SMK usia 1 hari
2. By. Ny. Laristi/ NCBSMK
usia 3 jam/ dr. Diana
PASIEN PULANG
1. By. Ny. Dina/dr Catur, SpA/

NCB SMK usia 2 hari / pulang
pagi
2. By. Ny. Debby/dr annisa/NCB
SMK usia 2 hari , pulang
3 By. Ny.
Almira/dr.annisa/NCB SMK usia
2 hari ---> pulang
dr Yuanitha + dr Rona
SIC (CAROL) Senin,10.01.22
TIPE PASIEN
YANG DINAS
LT NAMA UNIT
EMERGENCY ROOM
dr Audrey
dr Audrey dr Hanif
EMERGENCY dr Hanif
Ns Susi Ns Rizam
ROOM Ns Nur
Ns Mohlis
Ns Fitri
Ns Tomi
GF
PONEK
PONEK
TOTAL PASIEN EMG
Poli Obgyn
Ns NS 1 :
Poli Urology IIN
Poli Ortho
Poli Internist
Poli Bedah Umum
Poli Bedah Plastik
Poli THT Kiki
Poli Gizi
Poli bedah saraf
Poli Neuro
Dermis
Dental
LT 3
Poli Endoscopy
Poli Fisioterapi
Poli Rehab Medik
Poli Nutrition
Poli Paru
Poli Mata
Poli Psikiatri
Pain Clinic
MCU
POLI KEMOTERAPI
ODC
TOTAL PASIEN OPD

Ns Nurul Ns Ns Salwa
LT 4 IN PATIENT Citra Ns Rio Ns Wulan
DEPARTMENT Ns
Ns Abdi Ns
Ns Indah 10
Santi Santi
Ns Nurul Ns Ns Salwa
LT 4 IN PATIENT Citra Ns Rio Ns Wulan
DEPARTMENT Ns
Ns Abdi Ns
Ns Indah 10
Santi Santi
Ns Anatian Dr Megaati Dr
IN PATIENT Ns Dini Ns Devi Megawati
LT 6 DEPARTMENT Ns Melya Ns Avi Ns Ns Tita 16
Ns Tary Ela Ns Nadia
Ns Anatian Dr Megaati Dr
IN PATIENT Ns Dini Ns Devi Megawati
LT 6 DEPARTMENT Ns Melya Ns Avi Ns Ns Tita 16
Ns Tary Ela Ns Nadia
Kemoterapi
OPERATING THEATER
Ns Sunandar
OK Ns Heryanti
CRITICAL CARE
ICU Ns Awaludin Ns Agus
HCU
NICU
Ns Esti Ns Alvi
PICU
TOTAL Ps CRITICAL
OBSTETRICS
Bd Hilda Bd Dilla Bd Bd Viky
VK Bd Anggi Genda Bd Putri
Nursery Ns Nani
HEARTOLOGY
Cathlab Ns Akbar
Hybrid
LT 8
LT 8
Dokter Jaga
Dokter Jaga IGD : Pagi : dr Audrey Malam :
Dokter Jaga IPD : Pagi : dr Mega Malam :
Dokter Jaga Critical : Pagi : dr Mutiara Malam :

TIPE PASIEN
KETERANGAN
TOTAL
BERAT PASIEN
ENCY ROOM
PASIEN OBSERVASI :
RAJAL :
1. Ny Fatimah / 34 thn / Malignant
neoplasma / Pro inf methotrexat
2. Ny Devyanti diyani / 28 thn /
Dyspepsia
3. Tn Reinhard Jonathan / 21 thn / Obsv
Febris H 1
4. An Antalya Varisha / 0 thn / Obsv
Febris H1
5. Ny Leonita Setianing / 35 thn /
Kel Batuk sejak 3 hr SMRS
6. Tn Latif / 37 thn / Vomiting
7. An Nabil Ustman / 8 thn /
dyspepsia
8. An Putu Cheisa / 1 thn / Obsv Febris
10 10 H3
9. Tn Jorge Fransisco / 50 thn /
Haemorhoid and perianal venous
Thrombosus / Nyeri daerah anus sejak 3
hr SMRS
RANAP :
1. An Rafisqy zubair / 1 thn / obsv
Febris H / dr Nina SpA / Rawat IPD
6
RUJUK :
APS :
D.O.A :
RAJAL :
1. Ny Halimah Abdulah / 33 thn /
Anemia Zat Besi / pro inj Venofer 2
amp
RANAP :
3 3
1. Ny Dewi Humaira / 37 thn /G1 P0
3 3 A0 H 30 mg / Keluar air air dari
jalan lahir / Rawat obsv VK
2. Ny Rahmawati
Putri / 24 thn / G1 P0 A0 H 30 mg /
Pro SC / dr Sang SPOG / Rawat IPD
619
PASIEN OBSERVASI :
13
34
6
4
1
2
9
9
10
4
3
1
37
6
158
1.Tn Benyamin/ Suko Adiarto, dr. SpJP
(K),FIHA,, FICA, FAsCC, PhD/ Post
CAG + PTCA
2.Ny. Ika Wi / dr.Chamim Sp.OG (K)
Onk / Post Kemo Ke 2 Malignant
Neoplasm of Cervix uteri
3.Tn. M Yazim Yakub DR. SPOG/
dr.Dicky Aligery, SpBTKV (K) FIHA
FICA/ Post CABG, Post ICU
PASIEN OBSERVASI :
1.Ny. Ruth / dr.Chamim Sp.OG (K) Onk

/ Malignant neoplasm of cervix uteri
2. Tn. M Yazim Yakub DR. SPOG/
FICA/ Post CABG, Post ICU
4.Ny virnasari/ Suko Adiarto, dr. SpJP
(K),FIHA,, FICA, FAsCC, PhD / chest
pain
unspecified
6.Tn. Benyamin/ Suko Adiarto, dr. SpJP
(K),FIHA,, FICA, FAsCC, PhD/ Post
CAG + PTCA
7.Ny. suminem/ Alvin Nursalim, dr.
Sp.PD/ dhf h3
8.Tn. Falak / dr.Alvin Sp.PD / Dengue
fever [classical dengue]
9.Tn. Nugroho/dr. Alvin Nursalim Sp.
Pd/ Fever
10.Ny. Ika Wi / dr.Chamim Sp.OG (K)
Onk / Post Kemo Ke 2 Malignant
Neoplasm of Cervix uteri
PASIEN PINDAH ICU :
10
RENCANA TINDAKAN :
10

neoplasm of ovary, Retention of urine /
Rencana tindakan dr.Chamim :
Laparatomi eksplorasi, dr. Perwira widi :
LAR + adhesiolisis, kemungkinan
sampai Stoma Rabu / kamis (jadwal
belum fix, untuk jam belum tau)
RENCANA PULANG :
1.Ny. Ika Wi / dr.Chamim Sp.OG

(K) Onk / Post Kemo Ke 2
Malignant Neoplasm of Cervix uteri
PASEN APS :
PASIEN PULANG :
Aldy / dr.Alvin Sp.PD / Fever H3

(sudah close, pasien minta keluar
besok pagi)
2.Ny. Enny Anggraini / dr. Bob
Andinata Sp.B (K) Onk / Post
Radical Mastectomy + Axilla
Disection + Chemoport revisi aff +
Reconstruction Local Flap
3.Ny. Evita / dr.Amanda Pitarini
Sp.PD-KGEH / Other specified fever
4.Ny. Nurbaiti / dr. Amanda Pitarini
Sp.PD-KGEH / Fever, Dyspepsia
(sudah close, pasien minta keluar
besok pagi)
T DEPARTMENT
SpOG / G1P0A0 UK 39 minggu
2.An. Rafisqy/ dr. Nina, Sp.A /
Prolong Fever
3.Tn. Reinhard/ dr. Alvin, Sp.PD /
DHF
4.Ny. Novianti/ dr. Nisa, SpOH /
Post SC P2A0
5.Tn. Willy/ dr. Dicky Aligery,
Sp.JP / Post Tamvon Release
Bleeding
PASIEN OBSERVASI :
1. Tn William Tanady/ Wisanti, dr.

2.Ny. Octivia Rian/ dr. Wulan
Ayudyasari,Sp.B/ Benign lipomatous
neoplasm of other sites
4.Tn. Tony Sudjiaryanto/ dr. Alvin
Nursalim,Sp.PD / GEA, DM, Hipertensi
6.Ny. Monica/ dr. Mirta, SpTHT /
Chronic Sinusitis
7.An. M. Devante R Abidin/ dr. Diana,
Sp.A / DHF
8.Ny. Laristi/ dr. Nisa Fathoni, Sp.OG /
Post Partum
SpOG / G1P0A0 UK 39 minggu
10.An. Rafisqy/ dr. Nina, Sp.A / Prolong
Fever
11.Tn. Reinhard/ dr. Alvin, Sp.PD /
DHF
12.Ny. Novianti/ dr. Nisa, SpOH / Post
SC P2A0
13.Tn. Willy/ dr. Dicky Aligery, Sp.JP /
Post Tamvon Release Bleeding
RENCANA MASUK :
RENCANA TINDAKAN
13+ 3
(VK)
13+ 3 1.Ny. Yasiina Hafidzah/ dr. Zicky
(VK) Yombana,Sp.S / Myasthenia gravis,
rencana injeksi trigger point tgl
11/01/2022 KIE (+); rencana CT
Scan thoraks kontras tgl 12/01/2022
KIE (+)
2.Tn. Willy/ dr. Dicky Aligery,
Sp.JP / Post Tamvon Release
Bleeding, rencana rontgen thoraks
tgl 11/01/2022
SpOG / G1P0A0 UK 39 minggu,
rencana SC+ERACS+IUD tgl
11/01/2022 jam 09.00
PASIEN DI VK
1.Ny. Ayu / dr. Ardiansjah Dara

Sjahruddin, Sp.OG / Fetal death of
unspecified cause
2.Ny. Dewi Humarira / dr. Nisa,
pregnancy
3.Ny. Shaninca / dr. Nisa, Sp.OG /
PASIEN PULANG
1.Ny. Irodatul / dr. Nisa Fathoni,Sp.

Ester,Sp.BP-RE/Lymphoedema, not
elsewhere classified
3.Ny. Rumaisa/ dr. Caroline, SpB /
Ganglion
RENCANA RUJUK :

pregnancy
ING THEATER
1. RUMAISA RESTANI / BEDAH
UMUM - Eksisi + Biopsi / OK 1 jam
10.00 wib / Caroline Supit, dr. SpB
2.
IRODATUL KHOIRIYAH
WAAMALIAH / BEDAH OBGYN -
Sectio Caesaria / Ok 1 jam 13.30 wib /
Nisa Fathoni, dr. Sp. OG, IBCLC
4 3. MONICA
FEBY TIARANI / BEDAH THT - Fess
+ Reduksi Konka Bilateral / OK 1 jam
18.30 wib / Mirta Hediyati
Reksodiputro, Dr. dr. Sp.THT-KL(K)
4. XUE
TIANDI / BEDAH THT -
Parotidektomi total / OK 2 jam 20.00
wib / Bob Andinata, dr. Sp.B(K)Onk
RENCANA TINDAKAN : 11.01.22 1.

RAHMAWATI PUTRI COUSINS / BEDAH
1 OBGYN - Sectio Caesaria / OK 1 jam 09.00 wib /
Sang Arifianto,dr. SpOG
CAL CARE
1 8,5 cm tersambung Ventilator Mode
30,P-max 20 FREK 10, FIO2 21%
(Pasien NICU)
PASIEN OBSERVASI :
1. Ny Ayu / dr. Dara SpOG /
G4P2A1 hamil 15 mgg dengan
kematian mudigah pro induksi /
Lahir jam 01.55 wib
2. Ny. Novianti/dr.nisa,spog/G2P1
Hamil 39 mgg dgn inpartu ---> SC
cito jam 21.00
3. Ny. Dewi Humaira/ G1P0A0
hamil 39 mgg 4 hari dg inpartu/ dr.
Nisa
4. Ny. Shaninca/ G1P0A0 hamil 40
mgg 4 hari dg inpartu/ dr. Nisa
RENCANA TINDAKAN :
Tgl 11-1-2022 :
1. Ny. Rahmawati/ G1P0A0 hamil
38 mgg 4 hari dg PPT/ dr. sang/
SC+ ERASC jam 09.00
PASIEN PONEK :
1. Ny. Dewi humaira/ G1P0A0
hamil 39 mgg 4 hri/ dr. Nisa
PASIEN OBSERVASI :
1. By. Ny. Laristi/ NCBSMK usia 1
hr / dr. Diana
2. By Ny Novianti mandari / lahir
2 2 pkl 21.29 tgl 10.01.22 / BBl 3530
gr / usia 6 jam
PASIEN PULANG
RTOLOGY
Cathlab-HOR Daily Utilization Report*
10 Jan 22
CATHLAB
1 Schedule :
1 Benjamin S / cag ptca 2 stent + ivus /
dr. Suko / 18.30-22.00
Team : Saiful, triyanto, fefty
Non Schedule : -
HYBRID OR
Schedule : -
Non Schedule : -
Others : -
Problem : -
Overtime staf : -
Staff sakit : -
Staff cuti : -
Next Schedule
Outpatient : 15
dr ario :
Dr dafsah :
dr denio : 4
dr faris : 4
15 dr DH :
dr DAW : 3
dr radityo :
Dr suko : 2
dr sunu :
dr Adi : 2
New patient:
dr Denio 2 : 1 pasien dari dr Rajesh
Kalwani SpPD klinik sahara . 1 pasien
lama di PIK
dr Faris 1 : pasien dari dr Rahel di mitra

bekasi timur
dr DAW 1 : pasien dari kerabat
dr Suko 2 : 1 website . 1 dari kerabat
Cancel :
dr Faris 1 : no respon

melakukan
ECHO : 1
Stress Echo :
USG Doppler :
Holter : 1
ECG : 6
Treadmill : 1
CT Scan
Speckle
TEE :
DSE :
ABI : 1
Tilt Table Test :
Advance Echo : 3
Handle Echo :
ABPM : 1
Ezypro : 1
Cardioversi :
Referral External : dr Rajesh Kalwani
SpPD klinik sahara dan dr Rahel di mitra
bekasi timur
Info dokter tidak hadir : dr Radityo tidak

praktek dr Dafsah sakit
dr Hanif
dr Megawati
dr Nilam
SIC (EKO) Selasa,11.01.22
TIPE PASIEN
YANG DINAS
LT NAMA UNIT
EMERGENCY ROOM
dr. Firdha, dr. fajar, Ns.

Br. Sanusi,
EMERGENCY ROOM Ns. Susi, Ns. Ns. Tomi Rizam, Zr.
Ardi Nur
GF
PONEK
TOTAL PASIEN EMG
Poli Obgyn
Ns NS 1 :
Poli Urology IIN
Poli Ortho
Poli Internist
Poli Bedah Umum
Poli Bedah Plastik
Poli THT Kiki
Poli Gizi
Poli bedah saraf
Poli Neuro
Dermis
LT 3 Dental
Poli Endoscopy
Poli Fisioterapi
Poli Rehab Medik
Poli Nutrition
Poli Paru
Poli Mata
Poli Psikiatri
Pain Clinic
MCU
POLI KEMOTERAPI
ODC
TOTAL PASIEN OPD

DP = Ns. DS =
LT 4 Nurul + Ns. Ns.Salwa + DM = Ns.
IN PATIENT
Citra + Ns. Br. Abdy + Wulan + Br.
DEPARTMENT Rio Ns. Okta Taufik
DP = Ns. DS = Ns.
Anatian + Dini + Ns. DM = Ns.
IN PATIENT
LT 6 DEPARTMENT
Ns. Risha + Meliya + Ns. Devi + Ns.
Ns. Tary Ella Nadia
Kemoterapi
OPERATING THEATER
OK
CRITICAL CARE
ICU Ns. Gisma Ns. Winda Any
HCU
NICU
Esty Grace Alvi
PICU
TOTAL Ps CRITICAL
OBSTETRICS
‌Dines Pagi: D
‌ ines Siang : ‌Dines
bd. Dewi, bd. Dilla, Malam : bd.
VK bd. Tries bd. Genda Ningsih, bd.
Anggi
‌Dines Pagi: D
Anggi
Nursery Ns. Ika Ns. Nelly Ns. Inggrid
HEARTOLOGY
Cathlab
Hybrid
LT 8
Dokter Jaga
Dokter Jaga IGD : Pagi : dr Firdha Malam :
Dokter Jaga IPD : Pagi : dr Neysa Malam :
Dokter Jaga Critical : Pagi : dr Dewi Malam :

TIPE PASIEN KETERANGAN
BERAT Risiko/Komplen, Pasien titipan, ODC, & Prosedur yang
akan dilakukan)
MERGENCY ROOM
PASIEN OBSERVASI :
RAJAL :
1. An. Galvin Zachary /0th/ Dx. Fever
2. Ny. Merta Syifa / 38th/ Dx. Myalgia
3. Ny. Siti Nurhati /52th/ Dx. Diarrhea
4. An. Sean Shepherd /1th/ Dx. Fever +
Nausea and vomiting
5. Tn. Chandra Wira /26th/ Dx.
Superficial injury of lower leg
6. Ny. Liza Fildria /29th/ Dx.
Supervision of normal pregnancy, Iron deficiency
anaemia (Instruksi dr. Sang Sp.OG : Infus
Freinject 2 Ampul dalam NS 250 cc)
7. Ny. Annisa Biru /29th/ Dx. Ispa
8. Ny. Tazkya Putri /29th/ Dx. Fever
+ Diarrhea 9. Tn. Dwi Sugiyanto /31th/ Dx.
Dhiare
RANAP :
1. By. Ny. Windi Septiani /5hari/ Dx.
Hiperbillirubin 25,1 /Dpjp. Meirdhania
Andina, dr. Sp.A (Status HCU, Rawat
12 Nurseri R/ Blue Ligt)
2. Tn. Pikmi Putra Galih /48th/ Dx. Acute
transmural myocardial infarction of
unspecified site / Dpjp. Suko Adiarto, dr.
SpJP (K),FIHA,, FICA, FAsCC, PhD / Kel.
nyeri dada, mengaku sudah berulang 4x
seminggu terakhir ini / (Rawat, dan
Langsung Naik Ke Heartologi Untuk
Tindakan CAG + PCI ==> di Terima oleh
NS. Akbar)
3. An. Tengku Muhammad /2th/ Dx. Nausea
and vomiting / Dpjp. Nina Dwi Putri, dr. Sp.A
(K) / Ruang 611
RUJUK :
APS :
D.O.A :
RAJAL :
RANAP :
PASIEN OBSERVASI :
12 Pasien
16
6
1
4
9
1
3
1
5
8
7
8
10
28
6
113 Pasien
PASIEN BARU :
1.Ny. Soen / dr. Chamim Sp.OG (K) Onk/
Malignant Neoplasm of ovary
2.Ny. Ivana / dr. Mirta Hediyati Dr. Dr. Sp. THT-
KL (K)/ Hipertrophy of tonsils
PASIEN OBSERVASI :
1.Tn. M Yazim Yakub DR. SPOG/ dr.Dicky

Aligery, SpBTKV (K) FIHA FICA/ Post CABG,
Post ICU
2. Tn. Nugroho/dr. Alvin Nursalim Sp. Pd/ Fever
of urine
4.Ny virnasari/ Suko Adiarto, dr. SpJP (K),FIHA,,
FICA, FAsCC, PhD / chest pain
5.Tn.Omar Noviardi / Alvin Nursalim, dr. Sp.PD /
Dyspepsia, Fever, unspecified
[classical dengue]
PASIEN PINDAH ICU :
RENCANA TINDAKAN :

8 Pasien of urine / Rencana tindakan dr.Chamim :
+ adhesiolisis, kemungkinan sampai Stoma
Kamis 13/01/2022 Jam 15.00
KL (K)/ Hipertrophy of tonsils / Rencana
Tonsilektomy besok tgl 13/01/2022 Jam 13.00
Malignant Neoplasm of ovary. Rencana
pemasanhan Kemoport (belum terjadwal,
tunggu konsul dr. Dicky Aligery)
RENCANA PULANG :
1.Ny virnasari/ Suko Adiarto, dr. SpJP

(K),FIHA,, FICA, FAsCC, PhD / chest pain
PASEN APS :
PASIEN PULANG :
1.Tn. Benyamin/ Suko Adiarto, dr. SpJP

(K),FIHA,, FICA, FAsCC, PhD/ Post CAG +
PTCA
2.Ny. Ika Wi / dr.Chamim Sp.OG (K) Onk /
Post Kemo Ke 2 Malignant Neoplasm of
Cervix uteri
3.Ny. Ruth / dr.Chamim Sp.OG (K) Onk /
Malignant neoplasm of cervix uteri
4.Ny. suminem/ Alvin Nursalim, dr. Sp.PD/
dhf h3
TIENT DEPARTMENT PASIEN BARU :
1.Ny. Lia Amalia / Nisa Fathoni, dr. Sp. OG,

IBCLC / Supervision of normal pregnancy
2. Ny. Dewi Humaira / Nisa Fathoni, dr. Sp.
OG, IBCLC / Labour and delivery
complicated by fetal heart rate anomaly
3. An. Tengku Muhammad /2th/ Dx. Nausea
and vomiting / Dpjp. Nina Dwi Putri
PASIEN OBSERVASI :
1 .Ny. Octivia Rian/ dr. Wulan Ayudyasari,Sp.B/
3.Ny. Yasiina Hafidzah/ dr. Zicky Yombana,Sp.S /
Myasthenia gravis
4.Ny. Monica/ dr. Mirta, SpTHT / Chronic Sinusitis
5.An. M. Devante R Abidin/ dr. Diana, Sp.A / DHF
6.Ny. Laristi/ dr. Nisa Fathoni, Sp.OG / Post
Partum
7.Ny. Rahmawati Putri/ dr. Sang, SpOG / G1P0A0
UK 39 minggu
8.An. Rafisqy/ dr. Nina, Sp.A / Prolong Fever
9.Tn. Reinhard/ dr. Alvin, Sp.PD / DHF
10.Ny. Novianti/ dr. Nisa, SpOH / Post SC P2A0
11.Tn. Willy/ dr. Dicky Aligery, Sp.JP / Post
Tamvon Release Bleeding
12. Ny. Lia Amalia / Nisa Fathoni, dr. Sp. OG,
13. Ny. Dewi Humaira / Nisa Fathoni, dr. Sp. OG,
IBCLC / Labour and delivery complicated by fetal
heart rate anomaly 14.
An. Tengku Muhammad /2th/ Dx. Nausea and
vomiting / Dpjp. Nina Dwi Putri
15 Pasien
RENCANA MASUK :
RENCANA TINDAKAN

IBCLC / Supervision of normal pregnancy /
Rencana tind. SC tgl 12/1/2022 pkl 12.30
wib
2. Tn. Willy/ dr. Dicky Aligery, Sp.JP / Post
Tamvon Release Bleeding / Rencana tind.
ECHO tgl 12/01/2022
3. Ny. Yasiina Hafidzah / dr. Zicky
Yombana,Sp.S / Myasthenia gravis / Rencana
CT Thoraks dengan kontras tgl 12/01/22
pkl 08.00 wib
PASIEN DI VK
PASIEN PULANG
1.Tn. William Tanady/ Wisanti, dr. Sp.THT-
KL/ Myasthenia gravis
2. Tn. Tony Sudjiaryanto/ dr. Alvin
Nursalim,Sp.PD / GEA, DM, Hipertensi
3. Ny. Ayu / dr. Ardiansjah Dara Sjahruddin,
Sp.OG / Fetal death of unspecified cause
RENCANA RUJUK :

1. An. M. Devante R Abidin/ dr. Diana, Sp.A /
DHF
2. Ny. Monica/ dr. Mirta, SpTHT / Chronic
Sinusitis
ERATING THEATER
1. Tindakan senin, 11/01/22
1. SC dr Sang a.n Rahmawati
2 2. SC dr Nisa a.n Dewi Humaira
2. Rencana Tindakan Selasa, 12/01/22

1. Bedah Urologi - Aff Dj Stent + GA, dr. Endrika
Sp.U / a.n Harlina (Jam 10.00)
2. Bedah Obgyn - SC + Pasang IUD, dr. Nisa
Fathony Sp.OG / an. Lia Amalia Puspita (12.30)
3. Bedah THT - Ekstirpasi Tumor, dr. Mirta
Hediyati / an. Komang Srie (13.00)
4. Bedah THT - REduksi Konka / RDF, dr. Mirta
Hediyati / an. Ivana Yessica Setia (14.00)
CRITICAL CARE
0
0
1 SpA , Terpasang ETT ukuran 3,5 kedalaman 8,5 cm
MAP 10, AMP 30,P-max 20 FREK 10, FIO2 21%
(Pasien NICU)
0
1 Pasien
PASIEN OBSERVASI :
2 Pasien
1. Ny. Dewi Humaira/ G1P0A0 hamil 39 mgg
4 hari dg inpartu/ dr. Nisa--> sc cito jam 12.00
2. Ny. Shaninca/ G1P0A0 hamil 40 mgg 5 hari
dg inpartu/ dr. Nisa
2 Pasien
RENCANA TINDAKAN :
Tgl 12-01-2022 :
1. Ny. Lia amalia/G3P1A1 hamil 37-38
minggu dengan BSC 1x/dr. Nisa, spog-->
rencana SC jam 12.30
PASIEN PONEK :
PASIEN OBSERVASI :
1. By. Ny Laristi Tafdhila / dr. Diana / NCB
SMK 2 Hari
2 .By. Ny Novianti / dr. Keumala / NCB SMK
2 hari
3. By.Ny. rahmawati putri/ dr.Andhina/ NCB
SMK 1 hari
4 Pasien 4. By.Ny. Dewi Humaira/ dr.Andhina/ NCB
SMK 1 hari
PASIEN PULANG
PASIEN Status HCU :

Hiperbilirubin :
1 Pasien 1. By.Ny. Windi/dr.Andina/NCB SMK Usia
5 hari
HEARTOLOGY
Daily Census OPD cardiac 11Januari 2022
Outpatient : 10
dr ario :
Dr dafsah :
dr denio :
dr faris : 2
dr DH : 5
dr DAW :
dr radityo :
Dr suko : 3
10 Pasien dr sunu :
dr Adi :
MCU : -
New patient: 1
Dr. Dicky hanafy:1 info Dr Andre Faizal SpJP

Biotes
Cancel : 2
Dr. Faris : 1
Dr. Dicky Hanafy :1

ECHO :
Stress Echo :
USG Doppler : 1
Holter :
Ezypro :
ECG : 5
Treadmill : 1
CT Scan :
Speckle : TEE :
DSE :
ABI :
Advance Echo :
Handle echo :
ABPM :
Tilt Table Test : 1
Paket PJB :
Refferal RS luar : dr.Andre Faizal SpJP
Dokter tidak hadir : dr. Dafsah (sakit),

Dr.Dicky Aligery ( ada operasi di HARKIT)
dr Fajar
dr Rona
dr Riri
TGL
KAMAR/ KENDALA YANG
No KEJADIA UNIT KELAS
IDENTITAS PASIEN
DITEMUKAN
N
1. 11.01.22 Polli Ny. Lia Amalia Pasien Komplain Karena
/29th/ DPjp. dr. menunggu lama
Nisa Fhatony
KETERANGAN
TINDAK LANJUT DATE
(Informasi yang di dapat PIC
(ACTION PLAN) LINE
dari Unit terkait)
SIC mendapatkan Lap. Dari Fl SIC melakukan Edukasi kepada
Bahwa ada pasien Obgyn yg pasien, dan membantu untuk
akan Rananp dg Rencana menaikan pasien ke lantai 6, Sic
Tindakan Sc di tgl 12.01.22 Mengechek di tera untuk pasien
tetapi bingung karenatidak mmng sdh terjdwal SC di tgl
terinfokan sm sekli dan Tidak 12.01.22, Sic mengkonfirmasi
ada berkas yg lengkap Koor. Rajal dan Bid maya untuk
kejelasan pasien tersebut, dan
mmng bahwa Bid. maya lupa
mengoperkan pasien ke Unit unit
terkait, SIC sdh melaporkan ke
YANMED (Dr. Rain), Kronologs
kejadian sdh di krm via WA ke
dr.Rain
SIC (EKO) Selasa,11.01.22
TIPE PASIEN
YANG DINAS
LT NAMA UNIT
EMERGENCY ROOM
dr. Firdha, dr. fajar, Ns.

Br. Sanusi,
EMERGENCY ROOM Ns. Susi, Ns. Ns. Tomi Rizam, Zr.
Ardi Nur
GF
PONEK
PONEK
TOTAL PASIEN EMG
Poli Obgyn
Ns NS 1 :
Poli Urology IIN
Poli Ortho
Poli Internist
Poli Bedah Umum
Poli Bedah Plastik
Poli THT Kiki
Poli Gizi
Poli bedah saraf
Poli Neuro
Dermis
LT 3 Dental
Poli Endoscopy
Poli Fisioterapi
Poli Rehab Medik
Poli Nutrition
Poli Paru
Poli Mata
Poli Psikiatri
Pain Clinic
MCU
POLI KEMOTERAPI
ODC
TOTAL PASIEN OPD

DP = Ns. DS =
LT 4 Nurul + Ns. Ns.Salwa + DM = Ns.
IN PATIENT
Citra + Ns. Br. Abdy + Wulan + Br.
DEPARTMENT Rio Ns. Okta Taufik
DP = Ns.
Avi + Br. DS = Ns.
Yudi + Ns. Dini + Ns. DM = Ns.
IN PATIENT
LT 6 DEPARTMENT
Tary Risha + Ns. Devi + Ns.
Meliya Ella
Avi + Br. DS = Ns.
Yudi + Ns. Dini + Ns. DM = Ns.
IN PATIENT
LT 6 DEPARTMENT
Tary Risha + Ns. Devi + Ns.
Meliya Ella
Kemoterapi
OPERATING THEATER
OK
CRITICAL CARE
ICU Ns. Gisma Ns. Winda Any
HCU
NICU
Esty Grace Alvi
PICU
TOTAL Ps CRITICAL
OBSTETRICS
‌Dines Pagi: D
Anggi
Nursery Ns. Ika Ns. Nelly Ns. Inggrid
HEARTOLOGY
Cathlab
Hybrid
LT 8
Dokter Jaga
Dokter Jaga IPD : Pagi : dr Neysa Malam :
Dokter Jaga Critical : Pagi : dr mutiara Malam :

BERAT Risiko/Komplen, Pasien titipan, ODC, & Prosedur yang
akan dilakukan)
MERGENCY ROOM
PASIEN OBSERVASI :
RAJAL :
1. ny kharenai pb datang dengan keluhan batuk
pilek dan demam dx ISPA pulang dengan
resep
2. an quen up heakting pulang dengan resep
3. an.gavian pb dengan keluhan
batuk 3 hari an pilek tidakan di emg nebu
pulang dengan resep 5.tn
tomy sesek tiba tiba di pagi hari dan batuk
pulang dengan resep
6.tn tomy setiawan pb datang dengan
keluhan pegel pegel dan mimisan pagi tadi ,
pasien pulang dengan resep
7.ny ratih dx HEG pasein hamil 12
minngu dengan keluhan pusing , pasien pulang
dengan resep .
8.ny kinanty dx dispepsia pasien
pulamng dengan resep
11 9. ny kartika dx nyeri ulu hati
pasien pulang dengan resep
10. ny sri dengn x
abdominl pain pasien baru dengn keluhan nyeri
di daerah abdomn pasien riwayat kuretase
dengn dr nisa di hari jumat, pasien pulang
dengan resep 11.ny
rizky
RANAP :
1.an/antaliya pb datang rujukn dari rscm
orangtua pasien mengtakan 3 hari demam ,
pasien dr nina masuk ranap di 606
RUJUK :
APS :
D.O.A :
RAJAL :
RANAP :
PASIEN OBSERVASI :
12 Pasien
36
5
1
1
11
1
6
3
1
1
5
17
8
3
3
25
1
1
125 Pasien
PASIEN BARU :

KL (K)/ Hipertrophy of tonsils
PASIEN OBSERVASI :
1.Tn. Nugroho/dr. Alvin Nursalim Sp. Pd/ Obs
Febris H7
2.Ny. Soen Theresia / Chamim,DR. dr, SpOG (K)
Onk / Malignant Neoplasm of ovary
of urine
Sp.PD/DHF H8, Dispepsia
[classical dengue]
Aligery, SpBTKV (K) FIHA FICA/ Post CABG,
Post ICU
7.Ny. Fala Hindun Adinda / Bob Andinata, dr.
Sp.B(K)Onk / Ca Mammae dextra on chemotherpy
KE 6 dengan TCH 100/450/330
PASIEN PINDAH ICU :

Pindah ke ICU/HCU/PICU :
of urine
1.Tn. Pikni / Suko Adiarto, dr. SpJP
(K),FIHA,, FICA, FAsCC, PhD / Rencana
tindakan CAG 2Stent (401)
2.Tn. Replin / dr.Dicky Aligery, SpBTKV
7Pasien (K) FIHA FICA/ Rencana CABG Jumat
15/1/2022 jam…. (410)
RENCANA TINDAKAN :

of urine / Rencana tindakan dr.Chamim :
+ adhesiolisis, kemungkinan sampai Stoma
Kamis 13/01/2022 Jam 15.00
KL (K)/ Hipertrophy of tonsils / Rencana
Tonsilektomy besok tgl 13/01/2022 Jam 13.00
Malignant Neoplasm of ovary. Rencana
pemasanhan Kemoport (belum terjadwal,
tunggu konsul dr. Dicky Aligery)
RENCANA PULANG :
Rencana Pulang :
1.Ny. Fala Hindun Adinda / Bob Andinata, dr.
Sp.B(K)Onk / Ca Mammae dextra on
chemotherpy KE 6 dengan TCH 100/450/330
Aligery, SpBTKV (K) FIHA FICA/ Post
CABG, Post ICU
PASEN APS :
PASIEN PULANG :
1. An. Antalya / Nina Dwi Putri, dr. Sp.A (K) /

Fever, unspecified
PASIEN OBSERVASI :
1 .Ny. Octivia Rian/ dr. Wulan Ayudyasari,Sp.B/

2.Ny. Yasiina Hafidzah/ dr. Zicky Yombana,Sp.S /
Myasthenia gravis
3.Ny. Rahmawati Putri/ dr. Sang, SpOG / G1P0A0
UK 39 minggu
4.An. Rafisqy/ dr. Nina, Sp.A / Prolong Fever
6.Ny. Novianti/ dr. Nisa, SpOH / Post SC P2A0
9. Ny. Dewi Humaira / Nisa Fathoni, dr. Sp. OG,
IBCLC / Labour and delivery complicated by fetal
heart rate anomaly
10. An. Tengku / Nina Dwi Putri, dr. Sp.A (K) /
Nausea and vomiting
Fever, unspecified
12. Ny. Shaninca / dr. Nisa, Sp.OG / Supervision of
normal pregnancy
12 Pasien
RENCANA MASUK :
12 Pasien
RENCANA TINDAKAN
PASIEN DI VK
PASIEN PULANG
1. Ny. Monica/ dr. Mirta, SpTHT / Chronic

Sinusitis
2. An. M. Devante R Abidin/ dr. Diana, Sp.A /
DHF
3. Ny. Laristi/ dr. Nisa Fathoni, Sp.OG / Post
Partum
RENCANA RUJUK :

ERATING THEATER
CRITICAL CARE
1 1.tn pikmi dx I21.0 Acute transmural myocardial

infarction of anterior wall/ dr suko spjp
0
1 SpA , Terpasang ETT ukuran 3,5 kedalaman 8,5 cm
(Pasien NICU)
0 1
2 Pasien
PASIEN OBSERVASI :
RENCANA TINDAKAN :
PASIEN PONEK :
PASIEN OBSERVASI :
1 .By. Ny Novianti / dr. Keumala / NCB SMK
2 hari
2. By.Ny. rahmawati putri/ dr.Andhina/ NCB
SMK 2 hari
3. By.Ny. Dewi Humaira/ dr.Andhina/ NCB
SMK 2 hari
4. By.Ny. Lia amalia/dr. annisa/NCB SMK 1
hari
5. By.Ny. Shaninca Divana/dr. rifan/ NCB
SMK 1 hari
Hiperbilirubin :
8 Pasien 1. By.Ny. Windi/dr.Andina/NCB SMK Usia 5
hari
2. By. Ny Laristi Tafdhila / dr. Diana / NCB
SMK 2 Hari
3. By.Ny. Irodatul Khoiriyah.dr.nathali/NCB
SMK 5hari
PASIEN PULANG
PASIEN Status HCU :
HEARTOLOGY
dr audrey
dr Rona
dr Riri
SIC (CAROL) Kamis,13.01.22
TIPE PASIEN
YANG DINAS
LT NAMA UNIT
EMERGENCY ROOM
Dr Fajar
Dr Fajar Dr Hanif
EMERGENCY Dr hanif
ROOM
Ns Susi Ns
Ns Ardhi
Ns Mohlis 13
Sanusi Ns Tomy
Ns Kelvin
GF
PONEK 2
TOTAL PASIEN EMG
Poli Obgyn
Ns NS 1 :
Poli Urology IIN
Poli Ortho
Poli Internist
Poli Bedah Umum
Poli Bedah Plastik
Poli Bedah Degestif
Poli Bedah Vaskuler
NS 2 :
Ns NS 2 :
Poli THT Kiki
Poli Gizi
Poli bedah saraf
Poli Neuro
Dermis
LT 3 Dental
Poli Endoscopy
Poli Fisioterapi
Poli Rehab Medik
Poli Nutrition
Poli Paru
Poli Mata
Poli Psikiatri
Pain Clinic
MCU
POLI KEMOTERAPI
ODC
TOTAL PASIEN OPD

Dr Nesya Dr Ria
LT 4 D5 Ria Ns
IN PATIENT Ns Nurul Ns Citra
DEPARTMENT Ns Indah Ns Ns Rio Ns Kristin Ns 9
Santi Salwa
Okta
Dr Nesya Dr Ria
LT 4 D5 Ria Ns
IN PATIENT Ns Nurul Ns Citra
DEPARTMENT Ns Indah Ns Ns Rio Ns Kristin Ns 9
Santi Salwa
Okta
Dr Nesya Ns Dr Megawati Dr
IN PATIENT Ana Ns Ns Avi Megawati
LT 6 DEPARTMENT Yuli Ns Ns Risha Ns Dini
10
Yudi Ns Tari Ns Ella
Dr Nesya Ns Dr Megawati Dr
IN PATIENT Ana Ns Ns Avi Megawati
LT 6 DEPARTMENT Yuli Ns Ns Risha Ns Dini
10
Yudi Ns Tari Ns Ella
Kemoterapi
OPERATING THEATER
Ns Sunandar
OK Ns Heryanti
CRITICAL CARE
ICU Ns Awaludin Ns Gisma
HCU
NICU
Ns Esti Ns Grace
PICU
TOTAL Ps
CRITICAL
OBSTETRICS
Bd Tries Bd Dila
VK Bd Putri
Bd Dewi Bd Genda
Ns Nani
Nursery Ns Wiwi Ns Ika Ns Nelly
(MD)
HEARTOLOGY
Ns Akbar
Cathlab Ns Tryanto
Hybrid
OPD JANTUNG Ns Rini T 11
LT 8
LT 8
Dokter Jaga
Dokter Jaga IGD : Pagi : dr Fajar Malam : dr Hanif
Dokter Jaga IPD : Pagi : dr Nesya Malam : dr Megawati + dr Ria
Dokter Jaga Critical : Pagi : dr Rizki Malam : dr Nilam

KETERANGAN
TOTAL
PASIEN
yang akan dilakukan)
ROOM
PASIEN OBSERVASI :
1. An Raysharyki / 3 thn / Obsv Febris H /

Pro Rawat sedang menunggu PCR
RAJAL :
1. Ny Fatimah / 34 thn / Malignant Neoplasma
of placenta / Plan Chemo ke - 6 / pro inj
Methotrexate 2.
Ny Nadia Rhamadia / 26 thn / Injury of muscle
of tendon / Jatuh terpeleset ( Nyeri sendi kaki
kiri ) 3. Ny
Arinta Agustine / 38 thn / Dyspepsia 4. Ny
Putri Dwi Ilhami / 27 thn / Obsv Febris H2
5. Ny
Mardia / 39 thn / Dyspepsia 6. Ny
Deloni Anggraini / 35 thn / Malaise / Pro inj
Vitamin Cernevit
7. Tn Octovianus Ayub / 29 thn / ISPA 8.
Ny Irodatul / 26 thn / Surgical wound care post
SC tgl 8 jan 2022
9. Tn Airin Alisse / 36 thn /ISPA
13
RANAP :
1. Ny Rizki / 28 thn / ISPA / rawat IPD 402
2.
AN Chelsea / 6 thn / Thypopid / Dr Diana
SpA / Rawat IPD 615 3. Nn
Nurul Hildayani / 26 thn / Obsv Febris H7 /
Dr Alvin SpPD / Rawat IPD 409
4. Ny
Nurfiani / 40 thn / Nyeri kandung kemih
post op Histerektomi tgl 16 des 21/ rawat
IPD 402
RUJUK :
APS :
D.O.A :
RAJAL :
1. Ny Pisesa Wina/ 29 thn / G2 P1 A0 H
30 mg / Dr Nisa SPOG / Pro Inj Venofer 2
amp
RANAP :
1. Ny Adhella Regina / 32 thn / G2 P1 A0

H 39 mg / Bayi perempun BB 3355 gr,lahir
normal di EMG / Dr Verandi SPOG /
2 RAwat IPD 6 / DR Nisa, Dr Rani (Dr
Verandi SPOG COMPLAIN terkait sediaan
obat pharmacy yg tidak sesuai antara nama
merk dengan kandngan obat ( contoh :
Nitroferantin (AB ) - merk yg keluar
Levitra ( Verdenofil = obat
kuat ))
PASIEN OBSERVASI :
15
22
3
2
7
4
3
13
8
1
22
4
1
1
99
PASIEN BARU :
1.Nn. Faisya Akmal Nabila/Radi Muharris

Mulyana, dr. Sp.OT / Post Meniscus Repair
with arthroscopy + Anterior Cruciate Ligament
(Acl) Reconstruction
2.Tn. Pikmi Putra Galih / Suko Adiarto, dr.
ICU post Primary PCI 1 stent di LAD
3.Tn. Replin Maulana Nasution / Dicky
Aligheri, SpBTKV (K),dr, FIHA, FICA / Pro
CABG Ny. Rizky Ambarsari / Alvin Nursalim,
dr. Sp.PD / ISPA, Fever, unspecified
4.Nn. Nurul Hildayani / Alvin Nursalim, dr.
Sp.PD / Efusi pleura kanan ec susp pleuritis TB
5.Ny. Nurfiani / Veinardi Madjid,dr. Sp.OG /
Malignant neoplasm of cervix uteri, Retention
of urine, Acute cystitis
PASIEN OBSERVASI :
1. Tn Nugroho Dandy /Alvin Nursalim, dr.
Sp.PD / Dengue fever [classical dengue]
2.Ny. Rizky Ambarsari /Alvin Nursalim, dr.
Sp.PD/ISPA, Fever, unspecified
of urine, Acute cystitis
4.Tn. Pikmi Putra Galih / Suko Adiarto, dr.
5.Ny. Soen Theresia / Chamim,DR. dr, SpOG
(K) Onk / Malignant Neoplasm of ovary
6.Nn. Faisya Akmal Nabila / Radi Muharris
(Acl) Reconstruction
CABG
9.Tn. Falak / Alvin Nursalim, dr. Sp.PD /
PASIEN PINDAH ICU :

Kusumah, dr. Sp.U / Malignant neoplasm of
ovary, Retention of urine
1.Tn Bangun / Rencana Ligasi VE 14/1/22

jam ? / dr. Amanda / Rencana masuk
14/1/22 (Kamar 412)
2.An. Bayhaqi / Rencana Sirkumsisi
14/1/22 jam ? / Wulan Ayudyasari, dr.
Sp.B / Rencana masuk 14/1/22 (ODC
Kamar 410)
3.Nn. Ardelia / Rencana Odontectomy 4
gigi 14/1/22 jam ? / Ken Ayu Miranthy, drg
9 / Rencana masuk 14/1/22 (Kamar 414)
RENCANA TINDAKAN :
9
1. Tn Replin Maulana Nasution / Dicky

CABG Jumat 14/01/22 jam 16:00, Persiapan :
SIO (+), SIA (+), SIO ICU (+), Pemeriksaan
Rongten, Echo, Lab (+), SIO Transfusi (+),
Order Cross Match (+), OK (+), Cheklist Bedah
(+)
2.Ny. Rizky Ambarsari/Alvin Nursalim, dr.
Sp.PD/ISPA, Fever, unspecified / Pro USG
Bedsite Jumat 14/01/22 jam 12:00, Persiapan :
Puasa 6 jam, KIE (+)
(Acl) Reconstruction / Pro X-Ray Genu AP
Lateral Dextra Jumat 14/01/22 jam 09.00,
Persiapan : SIO (+), ACC(-), ORDER(+)
4.Ny. Soen Theresia / Chamim,DR. dr, SpOG
(K) Onk / Malignant Neoplasm of ovary / Pro
Kemoterapi Jumat 14/01/22 jam ?, Persiapan :
SIO (+), ACC(+), Tunggu Obat Kemo
of urine, Acute cystitis / Pro Torakosintesis SIO
(+)
RENCANA PULANG :
1. Tn Pikmi Putra Galih / Suko Adiarto, dr.

2.Tn. Nugroho Dandy /Alvin Nursalim, dr.
Sp.PD/ Dengue fever [classical dengue]
PASEN APS :
PASIEN PULANG :
I Gede Ricky / Alvin Nursalim, dr. Sp.PD /
DHF H8, Dispepsia
2.Tn. M Yazim Yakub DR. SPOG /
FICA / Post CABG, Post ICU
3.Ny. Fala Hindun Adinda / Bob Andinata,
dr. Sp.B(K)Onk / Ca Mammae dextra on
chemotherpy KE 6 dengan TCH
100/450/330
4.Ny. Ivana Yessica Setia Putri / Mirta
Hediyati Reksodiputro, Dr. Dr. Sp. THT-
KL(K) / Post Tonsilektomi Reduksi Konka
Inferior Bilateral
ARTMENT PASIEN BARU :
1. An. Chelsea/ dr. Diana, Sp.A/ Tifoid

fever
2. 1. Ny Adhella Regina / 32 thn / G2 P1
A0 H 39 mg / Bayi perempun BB 3355
gr,lahir normal di EMG / Dr Verandi
SPOG / RAwat IPD 6 / DR Nisa, Dr Rani
PASIEN OBSERVASI :

2. An. Chelsea/ dr. Diana, Sp.A/ tifoid fever
3. An. Rafisqy/ dr. Nina, Sp.A / Prolong Fever
4..Tn. Reinhard/ dr. Alvin, Sp.PD / DHF
IBCLC / post sc
6. An. Tengku / Nina Dwi Putri, dr. Sp.A (K) /
Nausea and vomiting
Fever, unspecified
8. Ny. Shaninca / dr. Nisa, Sp.OG / Supervision
of normal pregnancy
RENCANA MASUK :
10
10 1. An Alfonsus/ dr. Yonas, Sp.U/ Rencana
rekonstruksi penis/ masuk tanggal 14/01/22
2. Nn. Ketsa/ dr. Bob/ Rencana eksisi VAM/
Masuk tanggal 14/01/22
RENCANA TINDAKAN
PASIEN DI VK
PASIEN PULANG
1. Ny. Rahmawati/ dr. Sang, Sp.OG/ post

sc
2. Ny. Novianti/ dr. Nisa, Sp.OG/ post sc
3. Ny Dewi Humaira/ dr. Nisa, Sp.OG/ post
sc
4. Tn. Willy/ dr. Dicky Aligheri,
Sp.BTKV/ post tamvon release bleeding
RENCANA RUJUK :
1. Ny. Octivia/ dr. Wulan Sp.B/ post eksisi

biopsi
HEATER
1. DEVI RAMESH DADLANI / BEDAH

DIGESTIVE - Laparatomy Hartman Procedure
+ Colostomy / OK 1 jam 15.00 wib/ op Perwira
Widianto, dr. Sp.B-KBD, raw Chamim,DR. dr,
2 SpOG (K) Onk 2. FAISYA
AKMAL NABILA / BEDAH ORTHOPEDI -
Meniscus Repair With Arthroscopy / OK 1 jam
16.00 wib / Radi Muharris Mulyana, dr. Sp.OT
RENCANA TINDAKAN : TGL 14.01.22
1. BAIHAQI AFTARAZMI SIDQI / BEDAH
PEDIATRIC - Sirkumsisi OK 1 jam 16.30
wib / Wulan Ayudyasari, dr. Sp.B
2. ARDELIA NASYWA / BEDAH
MULUT - Odontectomy 4 Gigi / OK 1 jam
17.300 wib / Ken Ayu Miranthy, drg
4 3 Laki - Laki FAJAR AHMAD /
BEDAH UMUM - Eksisi + Biops / OK 1 jam
20.00 / Bob Andinata, dr. Sp.B(K)Onk
4. KEYSHA SELIA PUTERI
HARAHAP / BEDAH ONCOLOGY - FAM
Excision <3cm / OK 1 jam 21.00 wib / Bob
Andinata, dr. Sp.B(K)Onk
CARE
1. DEVI RAMESH DADLANI /Malignant
neoplasm of ovary, Essensial Hypertension / Dr
1 Vera Irawany, dr. Sp.An-KIC, Chamim,DR. dr,
SpOG (K) Onk , Alvin Nursalim, dr. Sp.PD ,
Perwira Widianto, dr. Sp.B-KBD , Endrika
Noviandrini, dr. Sp.U
0

1 SpA , Terpasang ETT ukuran 3,5 kedalaman
8,5 cm tersambung Ventilator Mode HFO
dengan Setingan MAP 10, AMP 30,P-max 20
FREK 10, FIO2 21% (Pasien NICU)
0
KETERANGAN : AC DI UNIT NICU ( 3 )
TURN OFF sejak jam 00.30 wib- Lapor
2 Pasien
maintenance Pak Jay - KOMPRESSOR
diperbaiki
PASIEN OBSERVASI :
PASIEN PONEK :
1. Ny. Irodatul/dr.nisa/P1A0 post sc hari
ke5
2. Ny Adhella / dr Nisa, dr Ranny /G3 P1
2
A1 H 39 mg 1 hr dengan inpartu kala 1 fase
aktif / Partus spontan jam 02. 38 di EMG
PASIEN OBSERVASI :
1. By.Ny. Lia amalia/dr. annisa/NCB SMK
2 hari
2. By.Ny. Shaninca Divana/dr. rifan/ NCB
SMK 2 hari 3.
3 By Ny Adhella Regina/ usia 3 jam / NCB
SMK
PASIEN PULANG
PASIEN Status HCU :
OGY
tgl 13.01.22
1 1. REPLIN MAULANA NASUTION / 46
thn / DrDicky Aligheri / CABG
Outpatient : 11
dr ario :
Dr dafsah :
dr denio :
dr faris : 3
dr DH : 3
dr DAW :
11 dr radityo : 2
Dr suko : 1
dr sunu :
dr Adi :
MCU :
New patient: 5
Dr. Faris : 3 (2 dari Angga Marketing, 1 dari dr.
Alvin, SpPD RSBS)
Dr. Radityo: 2 (1 dari dr. Erick, Sp. A., 1 pasien
lama dr. Radityo di RS Harkit)
Cancel : 3
Dr. Radityo : 2 (1 tunggu obat habis, 1 batal
regist hanya baca Holter)
Dr. Sunu : 1 (batal pasang Holter)
Dr. Dicky Hanafy : 2 (reschedule)
ECHO :
Stress Echo :
USG Doppler : 1
Holter :
Ezypro :
ECG : 7
Treadmill :
CT Scan :
Speckle :
TEE :
DSE :
ABI :
Advance Echo : 1
Handle echo :
ABPM :
Tilt Table Test :
Paket PJB :
Referral Brawijaya : dr. Alvin, dr. Erick

Dokter tidak hadir : Dr.Dafsah sakit
dr Megawati + dr Ria
SIC (CAROL) JUMA;AT 13.01.22
TIPE PASIEN
YANG DINAS
LT NAMA UNIT
EMERGENCY ROOM
Dr Dwi Dr
Dr Dwi Ns Dr Fajar
EMERGENCY Fajar Ns
Susi Ns Ns Ardhi
ROOM Rizam
Kelvin Ns
Ns Mohlis
Fitri
GF
PONEK
PONEK
TOTAL PASIEN EMG
Poli Obgyn
Ns NS 1 :
Poli Urology IIN
Poli Ortho
Poli Internist
Poli Bedah Umum
Poli Bedah Plastik
Poli THT Kiki
Poli Gizi
Poli bedah saraf
Poli Neuro
Dermis
Dental
LT 3
Poli Endoscopy
Poli Fisioterapi
Poli Rehab Medik
Poli Nutrition
Poli Paru
Poli Mata
Poli Psikiatri
Pain Clinic
MCU
POLI KEMOTERAPI
ODC
TOTAL PASIEN OPD

LT 4 Ns Nurul Ns Ns Indah
IN PATIENT NsDini Ns
DEPARTMENT
Wulan Ns NsSakti Ns
Tari 10
Silvi Okta
Ns Ana Ns Ns Avi Ns
IN PATIENT Ns Dini
LT 6 DEPARTMENT
Nadia Ns Yudi Ns
Ns Tari
11
Ela Risha
Kemoterapi
OPERATING THEATER
Ns Sunandar
OK Ns Heryanti 5
CRITICAL CARE
Ns Awaludin
ICU Ns Ani Ns Agus Ns Esti
HCU
NICU
Ns Lisa Ns Ayu Ns Esti
PICU
TOTAL Ps
CRITICAL
OBSTETRICS
Bd Putri Bd Genda
VK Bd Viky
Bd Ningsih Bd Tries
Ns Wiwi
Nursery Ns Inggrid Ns Nani Ns Ika
(MD)
HEARTOLOGY
Ns Akbar
Cathlab Ns Tryanto
Hybrid
LT 8 OPD JANTUNG Ns Rini T

LT 8
NOTED :
Dokter Jaga
Dokter Jaga IGD : Pagi : dr Dwi Malam : dr Fajar
Dokter Jaga IPD : Pagi : dr Mega Malam : dr Rona
Dokter Jaga Critical : Pagi : dr Rizki Malam : dr Riri

KETERANGAN
TOTAL
PASIEN
OOM
PASIEN OBSERVASI :
RAJAL :
1. Tn Dimas fauzi / 38 thn / ISPA
2. An KAnia nayaka / 2 thn / kel Anak
belum bisa berbicara
3. Tn Eddy Gerardus / 46 thn / Nyeri
bokong sd paha sejak pagi SMRS
4. Tn Faiq Bahwal / 45 thn / Abses
ditelapak kaki kanan H3
5. An Aidil / 1 thn / Obsv Febris H 1
RANAP :
1. An Raysharyki / 3 thn / obsv Febris
H2 / Rawat IPD 607 (*) 2.
7 Ny Dr Esti / 46 thn / Ambein + BAB
berdarah / Dr Widi SpB /Rawat IPD
416 3. Ny Jusni /
89 thn / LBP ec Jatuh dari kamar
mandi, nyeri pada daera dada,
pinggang kanan dan kiri / Dr Alvin
SpPD /rawat IPD 608
RUJUK :
APS :
D.O.A :
RAJAL :
1. Ny Karina / 27 thn / G2 P1 A0 H
24 mg / Nyeri perut sejak 1 hr SMRS
RANAP :
2
PASIEN OBSERVASI :
2
1. Ny Hina Watanabe / 26 thn /G1 P0

A0 H 37 mg / kel diare2x sejak 1 hr
SMRS
9
12
5
1
2
20
85
PASIEN BARU :
1.Ny. Ina Herawati / dr.Sara Ester Sp.BP-
RE / Benign lipomatous neoplasm
2.Tn. Bangun / dr.Amanda Pitarini Sp.PD-
KGEH / Internal haemorrhoids without
complication, Crohn disease of large
intestine
3.Nn. Ardelia / drg. Ken Ayu Miranthy /
Impacted teeth
4.Ny. Dr.Esti / Rofi Yuldi Saunar, dr.
Sp.B-KBD / hemoroid grade 3-4
PASIEN OBSERVASI :
1.Ny. Rizky Ambarsari /Alvin Nursalim,

dr. Sp.PD/ISPA, Fever, unspecified
2.Ny. Nurfiani / Veinardi Madjid,dr.
Sp.OG / Malignant neoplasm of cervix
uteri, Retention of urine, Acute cystitis
3.Ny. Soen Theresia / Chamim,DR. dr,
SpOG (K) Onk / Malignant Neoplasm of
ovary
4.Nn. Faisya Akmal Nabila / Radi
Muharris Mulyana, dr. Sp.OT / Post
Meniscus Repair with arthroscopy +
Anterior Cruciate Ligament (Acl)
Reconstruction
5.Nn. Nurul Hildayani / Alvin Nursalim,
dr. Sp.PD / Efusi pleura kanan ec susp
pleuritis TB
intestine
Impacted teeth
10 10.Ny. Dr.Esti / Rofi Yuldi Saunar, dr.
Sp.B-KBD / hemoroid grade 3-4
PASIEN PINDAH ICU :
1. Tn Replin Maulana Nasution / Dicky

Aligheri, SpBTKV (K),dr, FIHA, FICA /
Pro CABG
1.Ny. Dr.Esti / Rofi Yuldi Saunar, dr.
Sp.B-KBD / hemoroid grade 3-4 pro
hemorrhoidectomy 15/01/22 pukul 10:00
RE / Benign lipomatous neoplasm /
RENCANA TINDAKAN
rencana liposuction : dan tummy
abdomen
tuck tgl 15/01/2022 jam 09.00 wib
3.Tn.
RENCANABangunPULANG
/ dr.Amanda
: Pitarini Sp.PD-
complication,
1. Tn Falak / Crohn
Alvin disease of large
Nursalim, dr.
intestine / pro ligasi hemoroid 15/01/22
Sp.PD / Dengue fever [classical
pukul 06:00
dengue]
2.Nn. Ardelia / drg. Ken Ayu
Miranthy / Impacted teeth
3.Ny. Soen Theresia / Chamim,DR.
dr, SpOG (K) Onk / Malignant
Neoplasm of ovary
PASEN APS :
PASIEN PULANG :
1. Tn Nugroho Dandy /Alvin

Nursalim, dr. Sp.PD / Dengue fever
[classical dengue]
2.Tn. Pikmi Putra Galih / Suko
Adiarto, dr. SpJP (K),FIHA,, FICA,
FAsCC, PhD / Post ICU post Primary
PCI 1 stent di LAD
3.An. Baihaqi / dr.Wulan Sp.B / Post
Sirkumsisi.
RTMENT
1.An. Rausharyki Adeevaparisha/

Nina Dwi Putri, dr. Sp.A (K)/ GEA
2.Nn. Keysha Selia Puteri/Bob
Andinata, dr. Sp.B(K)Onk/
Fibroadenosis of breast
3.Ny. Jusni/ Alvin Nursalim, dr.
Sp.PD/ Malaise and fatigue
4.An. Alfonsus Noah/ Yonas Hutasoit,
dr. Sp.U/ Post sirkumsisi (ODC)
PASIEN OBSERVASI :

2.An. Chelsea/ dr. Diana, Sp.A/ tifoid
fever
3.An. Rafisqy/ Nina Dwi Putri, dr. Sp.A
(K) / Prolong Fever
H-6
5.An. Antalya / Nina Dwi Putri, dr. Sp.A
(K) / Fever, unspecified
6.Ny. Adhella/ Nisa Fathoni, dr. Sp. OG,
IBCLC/ Post SC P2A1
7.An. Rausharyki Adeevaparisha/ Nina
Dwi Putri, dr. Sp.A (K)/ GEA
8.Nn. Keysha Selia Puteri/Bob Andinata,
dr. Sp.B(K)Onk/ Fibroadenosis of breast
9.Ny. Jusni/ Alvin Nursalim, dr. Sp.PD/
Malaise and fatigue
dr. Sp.U/ Disorder of penis (ODC)
11
RENCANA MASUK :
1. Ny. Lim Bie Hwa/ dr. Suko/ Rencana
Tevar/ Masuk tanggal 15/1/22
RENCANA TINDAKAN
PASIEN DI VK
PASIEN PULANG

Post SC P1A0
2.Ny. Lia Amalia / Nisa Fathoni, dr.
Sp. OG, IBCLC / post sc
3.An. Tengku / Nina Dwi Putri, dr.
Sp.A (K) / Nausea and vomiting
RENCANA RUJUK :

1.Ny. Octivia/ dr. Wulan Sp.B/ post
eksisi biopsi
2.An. Rafisqy/ dr. Nina, Sp.A /
Prolong Fever
dr. Sp.U/ Post sirkumsisi (ODC)
EATER
1. BAIHAQI AFTARAZMI SIDQI /

BEDAH PEDIATRIC - Sirkumsisi OK 1
jam 16.30 wib / Wulan Ayudyasari, dr.
Sp.B
2. ARDELIA NASYWA /
BEDAH MULUT - Odontectomy 4 Gigi /
OK 1 jam 17.300 wib / Ken Ayu
Miranthy, drg
3 Laki - Laki
FAJAR AHMAD / BEDAH UMUM -
5 Eksisi + Biops / OK 1 jam 20.00 / Bob
4. KEYSHA SELIA PUTERI
HARAHAP / BEDAH ONCOLOGY -
FAM Excision <3cm / OK 1 jam 21.00
wib / Bob Andinata, dr. Sp.B(K)Onk
5. REPLIN MAULANA NASUTION/
BEDAH HEARTOLOGY - CABG / OK
HYBRID jam 16.00 wib / Dicky Aligheri,
RENCANA TINDAKAN : TGL 15.01.22 1.

DR. ESTI YUNIANINGSIH / BEDAH DIGESTIVE
1 - Hemoroidectomy (PPH / non PPH) / OK 1 jam
10.00 wib / Perwira Widianto, dr. Sp.B-KBD
RE
1. REPLIN MAULANA NASUTION /

46 thn / POST CABG 3 graft ec
Atherosclerotic cardiovascular disease,
Abnormal findings on diagnostic imaging
of heart and coronary circulation / Dicky
1 Aligheri, SpBTKV (K),dr, FIHA, FICA
terpasang ETT,
CVC, arteri line di radialis kiri, drain tube
di substernal dan intrapleural no 28
tersambung WSD, IABP di di femoral
kanan / Terintubasi connect Ventilator
0
1 Terpasang ETT ukuran 3,5 kedalaman 8,5
cm tersambung Ventilator Mode HFO
dengan Setingan MAP 10, AMP 30,P-max
20 FREK 10, FIO2 21% (Pasien NICU)
0
2
PASIEN OBSERVASI :
PASIEN PONEK :
1. Ny. Karina/dr Febriansyah,
Sp.OG/G2P1A0 hamil 28 minggu
JPKTH
PASIEN OBSERVASI :
1. ADHELLA REGIE MEZANTI By.
Ny. NCB SMK usia 1 hr
1
PASIEN PULANG
PASIEN Status HCU :
GY
tgl 14.01.22
1 1. REPLIN MAULANA
NASUTION / 46 thn / DrDicky Aligheri /
CABG
Kunjungan ps OPD Hearhtologi 16 orang

16 ps
RENCANA RUJUKAN pasien dari RS
BORROMEUS BANDUNG, PRO
TEVAR ec Hematoma Aorta Stannford,
HT
Posisi pasien saat ini, masih di RS
Borromeus Bandung
TGL KAMAR/ IDENTITAS KENDALA YANG
No UNIT KELAS
KEJADIAN PASIEN DITEMUKAN
1. 14.01.22 RAWAT INAP 404 Nurfiani WIFI SIGNAL
LT 4
2. 14.01.22 RAWAT INAP 602 ADHELLA REGIE DPJP SPOG datang

LT 6 MEZANTI setelah ps PArtus
Normal
KETERANGAN TINDAK LANJUT DATE
PIC
(Informasi yang di dapat dari Unit terkait) (ACTION PLAN) LINE
Sinyal di gedung bermasalah sama sekali gak bisa pakai Inform SARPRAS 15.01.22
data handphone pribadi, apakah tidak ada data penguat
signal..?
Saya melahirkan di IGD, Masuk IGD kurang lebih jam 15.01.22

02.00 wib dini hari, Karena Dr Nisa Fathoni SPOG
sedang cuti, akhirnya dialihkan ke dr Rani SPOG,yang
memungkinkan datang cepat untuk menangani saya.
Tapi anak sy keburu bersalindan dokternya datang ke RS
setelah saya selesai bersalin. Dan gak ada dokter anak
yang stand by. Seperti yang kita tahu, bayi yang baru
lahir, biasanya langsung dipegang oleh dr anak. Sebagai
masukan barangkali RS dipikirkan juga ke depan,
persiapan utk kasus kasus darurat seperti ini.
SIC (EKO) Sabtu 15.01.22
TIPE PASIEN
YANG DINAS
LT NAMA UNIT
EMERGENCY ROOM
dr. Audrey, dr. Firdha,

EMERGENCY Zr. Citra,
Ns. Sanusi, Ns. Kelvin,
ROOM NS.
Ns.
Ns. Ardi
GF
PONEK
TOTAL PASIEN EMG
Poli Obgyn
Ns NS 1 :
Poli Urology IIN
Poli Ortho
Poli Internist
Poli Bedah Umum
Poli Bedah Plastik
Poli Bedah Degestif
Poli Bedah Vaskuler
NS 2 :
Ns NS 2 :
Poli THT Kiki
Poli Gizi
Poli bedah saraf
Poli Neuro
Dermis
LT 3 Dental
Poli Endoscopy
Poli Fisioterapi
Poli Rehab Medik
Poli Nutrition
Poli Paru
Poli Mata
Poli Psikiatri
Pain Clinic
MCU
POLI KEMOTERAPI
ODC
TOTAL PASIEN OPD
DP = Ns. DS = Ns.
LT 4 DM = Ns.
IN PATIENT Nurul + Ns. Indah + Ns.
Citra + Ns.
DEPARTMENT Wulan + Ns. Okta
Silvi Abdy
Citra + Ns.
DEPARTMENT Wulan + Ns. Okta
Silvi Abdy
DP = Ns. DS = Ns.
Devi + Ns. Avi + Ns. DM = Ns.
IN PATIENT
LT 6 DEPARTMENT
Nadia + Ns. Tita+ Br. Risha + Ns.
Nela Yudi Tary
Kemoterapi
OPERATING THEATER
OK
CRITICAL CARE
ICU
HCU
NICU
PICU
TOTAL Ps
CRITICAL
OBSTETRICS
‌Dines
‌Dines
Dines Pagi: Siang : bd.
Malam : bd.
VK bd. Viki putri , bd.
genda , bd
dewi
Tries
Dinas
middle :
Ns. inggrid
‌Dines Pagi: ‌Dines
Dines siang
Nursery Ns. Nani
:Ns. Wiwi
Malam :
Ns. ika
‌Dines
Nursery Ns. Nani Malam :
Ns. ika
‌Dines
Malam :
Ns. ika
HEARTOLOGY
Cathlab
Hybrid
LT 8
OPD JANTUNG
Dokter Jaga
Dokter Jaga IGD : Pagi : dr Audrey Malam : dr Firdha
Dokter Jaga IPD : Pagi : dr Malam : dr Neysa
Dokter Jaga Critical : Pagi : dr Rizky Malam : dr Rizky

KETERANGAN
CY ROOM
PASIEN OBSERVASI :
RAJAL :
1. Galvin Zachary /3bln/ Dx. Imbalance of
constituents of food intake
2. Ny. Tifany Yfisan /26th/ Dx. Supervision of
normal pregnancy, G1 hamil 26 minggu /
venofer 2 ampul dalam ns 100 cc maksimal 1
jam DJJ instruksi dr. Nisa
3. An. Queena Aqila /8th/ Dx. Open wound of
lower leg
4. Tn. Pudio Harsono /52th/ Dx. Dyspepsia
5. Tn. Yusud Asmara /40th/ Dx. Cutaneous
abscess
6. Ny. Yosi Rara A /33th/ Dx. Varicella, Nausea
and vomiting 7. Nn.
Jeldita Pali /23th/ Dx. General medical
examination
8. Nn. Junaida Afifa /3oth/ Dx. Supervision of
normal pregnancy, G1P0A0 hamil 25 minggu
datang untuk / infus venofer 2 ampul dalam ns
100 cc DJJ / Instruksi dr. Nisa
9.Ny. Nisrina Kemal /27th/ Dx. Supervision of
normal pregnancy / infus VEnofer 2 Ampul
dalam Ns 100ml / Instruksi dr. Nisa
10. Ny.
15 Amanda /32th/ Dx. Dyspepsia 11. Ny.
Eka Trisnani /28th/ Dx. Dyspepsia 12. By.
Hazel Celia /9bln/ Dx. Nausea and vomiting +
Fever 13. An.
Mychalsa Auli /5th/ Dx. Ispa
RANAP :
1. Ny. Lim Be Hwa /78th/ Dx. Thoracic
aortic aneurysm, without mention of rupture
/ Dpjp. Suko Adiarto, dr. SpJP (K),FIHA,,
FICA, FAsCC, PhD / Ruang 612
2. Ny. Yosi Rara
APriliani /33th/ Dx. Varicella + Nausea and
vomiting / Dpjp. Alvin Nursalim, dr. Sp.PD
/ Ruang 412
RUJUK :
APS :
D.O.A :
RAJAL :
RANAP :
1. NY. Dina Komala s /25th/ Dx. Hadache +
1 Malaise & Fetigue + G1P0A0 hml 22
mggu / Dpjp. dr. dr. Alvin Sp.PD Raber
Dengan dr. Nisa Fathoni Sp.OG / Rawat
HCU
PASIEN OBSERVASI :
16 Pasien
41
1
3
11
3
11
2
7
13
7
10
1
66
8
7
1
192 Pasien
PASIEN BARU :
1.Tn.Jeffry / Alvin Nursalim, dr. Sp.PD /

dyspepsia syndrome dd IBD
2.Ny. Yosi / Alvin Nursalim, dr. Sp.PD /
Varicella, Nausea and Vomiting
PASIEN OBSERVASI :

Malignant neoplasm of cervix uteri, Retention of
urine, Acute cystitis
Mulyana, dr. Sp.OT / Post Meniscus Repair with
arthroscopy + Anterior Cruciate Ligament (Acl)
Reconstruction
5. Tn.Jeffry / Alvin Nursalim, dr. Sp.PD /
complication, Crohn disease of large intestine
7.Ny. Dr.Esti / Rofi Yuldi Saunar, dr. Sp.B-KBD
/ hemoroid grade 3-4
8.Ny. Ina Herawati / dr.Sara Ester Sp.BP-RE /
Benign lipomatous neoplasm
PASIEN PINDAH ICU :

1.Tn. Replin Maulana Nasution / Dicky Aligheri,
SpBTKV (K),dr, FIHA, FICA / Pro CABG
9 Pasien
RENCANA TINDAKAN :
RENCANA PULANG :
9 Pasien

with arthroscopy + Anterior Cruciate
Ligament (Acl) Reconstruction
intestine
3.Ny. Dr.Esti / Rofi Yuldi Saunar, dr. Sp.B-
KBD / hemoroid grade 3-4
PASEN APS :
PASIEN PULANG :

Impacted teeth
3.Ny. Soen Theresia / Chamim,DR. dr,
SpOG (K) Onk / Malignant Neoplasm of
ovary
4.Ny.Ine Agustine / Febriansyah Darus, dr.
Sp.OG-KFM / Fetal death of unspecified
cause (ODC)
1.Ny.Lim Bie Hwa / Suko Adiarto, dr. SpJP

(K),FIHA,, FICA, FAsCC, PhD / Thoracic
aortic aneurysm
PASIEN OBSERVASI :
(K),FIHA,, FICA, FAsCC, PhD / Thoracic aortic
aneurysm
3.An. Chelsea/ dr. Diana, Sp.A/ tifoid fever
4.Tn. Reinhard/ dr. Alvin, Sp.PD / DHF H-6
IBCLC/ Post SC P2A1
6.An. Rausharyki Adeevaparisha/ Nina Dwi
Putri, dr. Sp.A (K)/ GEA
7. Ny. Jusni/ Alvin Nursalim, dr. Sp.PD/ Malaise
and fatigue
8.An. Alfonsus Noah/ Yonas Hutasoit, dr. Sp.U/
Disorder of penis
RENCANA MASUK :
RENCANA
1.Ny. Jusni/TINDAKAN
Alvin Nursalim, dr. Sp.PD/
Malaise and fatigue / Rencana tindakan
USG Abdomen tgl 17/01/2022 jam 07.00
8 Pasien wib
aortic aneurysm / pro tindakan TEVAR
rencana senin pagi
PASIEN DI VK
PASIEN PULANG
1.An. Rafisqy/ Nina Dwi Putri, dr. Sp.A (K)

/ Prolong Fever
2.An. Antalya / Nina Dwi Putri, dr. Sp.A
(K) / Fever, unspecified
3.Nn. Keysha Selia Puteri/Bob Andinata, dr.
Sp.B(K)Onk/ Fibroadenosis of breast
RENCANA RUJUK :

2.An. Alfonsus Noah/ Yonas Hutasoit, dr.
Sp.U/ Disorder of penis
G THEATER
Tindakan Kamar Operasi
1. Sabtu, 15-01-22
- Hemoroid dg Stappler dr Widi a.n dr Esti
3 - Tummy Tuck & Liposuction Perut dr Sara a.n
Ina Herawati
- Kuretase dr Febri a.n Ine
AL CARE
1. REPLIN MAULANA NASUTION / 46 thn /

POST CABG 3 graft ec Atherosclerotic
cardiovascular disease, Abnormal findings on
1 diagnostic imaging of heart and coronary
circulation / Dicky Aligheri, SpBTKV (K),dr,
FIHA, FICA / terpasang ETT, CVC, arteri line di
radialis kiri, drain tube di substernal dan
intrapleural no 28 tersambung WSD, IABP di di
femoral kanan / Terintubasi connect Ventilator

FIO2 21% (Pasien NICU)
2 Pasien
PASIEN OBSERVASI :
RENCANA TINDAKAN :
PASIEN PONEK :
1. Ny karina/dr Febriansyah, Sp.
OG/G1P0A0 hamil 28 minggu dengan
2. Ny. Junaida/dr Nisa, Sp. OG/ G1P0A0
3
hamil 25 minggu
3. Ny. Dina/G1P0A0 hamil 22 minggu
PASIEN OBSERVASI :
1. By.Ny.Adhella/dr. Diana Sp.A/NCB
SMK Usia 2 hari
1
1
PASIEN PULANG
PASIEN Status HCU :
OLOGY
9
SIC (EKO) Minggu 16.01.22
TIPE PASIEN
YANG DINAS
LT NAMA UNIT
EMERGENCY ROOM
EMERGENCY ROOM
GF
PONEK
PONEK
TOTAL PASIEN EMG
Poli Obgyn
Ns NS 1 :
Poli Urology IIN
Poli Ortho
Poli Internist
Poli Bedah Umum
Poli Bedah Plastik
Poli THT Kiki
Poli Gizi
Poli bedah saraf
Poli Neuro
Dermis
LT 3 Dental
Poli Endoscopy
Poli Fisioterapi
Poli Rehab Medik
Poli Nutrition
Poli Paru
Poli Mata
Poli Psikiatri
Pain Clinic
MCU
POLI KEMOTERAPI
ODC
TOTAL PASIEN OPD

LT 4 IN PATIENT
DEPARTMENT

IN PATIENT Devi + Ns. Tita+ Ns.
LT 6 DEPARTMENT Nela Nadya
Risha + Ns.
Tary
Kemoterapi
OPERATING THEATER
OK
CRITICAL CARE
ICU
HCU
NICU
PICU
TOTAL Ps CRITICAL
OBSTETRICS
‌Dines
Siang : bd.
bd. Anggi, Malam : bd.
VK bd. Viki
Anggi , bd.
Putri, bd.
Ningsih
Tries
‌ ines Pagi:
D
Ns inggrid ‌Dines
‌Dines
Dinas Siang : Ns.
Nursery middle : b Wiwi
malam : Ns
. Nani
d nelly
HEARTOLOGY
Cathlab
Hybrid
LT 8
LT 8
OPD JANTUNG
Dokter Jaga
Dokter Jaga IGD : Pagi : dr Fajar Malam : dr Audrey
Dokter Jaga IPD : Pagi : dr Megawati Malam : dr Rona
Dokter Jaga Critical : Pagi : dr Malam : dr Nilam

KETERANGAN
TOTAL
PASIEN
Y ROOM
PASIEN OBSERVASI :
1. Tn. Charifadi Moch /61th/ Dx. Dyspnoe

/Kel. Sesak Nafar sdh 2 hari SMRS,
Rencana Rawat Dpjp. dr.Sutji Astuti Sp.P
Tinggal Munggu Hasil lab dan PCR Swab
RAJAL :
1. Tn. Fachri Tunggal /19th/ Dx. TFA
2. Tn. Diaz Adi indrawan /21th/ Dx. Routine
general health check-up (Ket Srt Sehat ) 3.
Ny. Novera Andayani /55th/ Dx. Dyspepsia 4.
Ny. Rezia Auliannisa /31th/ Dx. Dhiare 5.
Nn. Amiee Detria A /21th/ Dx. Fever 6.
Tn. Syahru Aryansyah /43th/ Dx. Hipertensi
7. Tn. Joshua /26th/ Dx. open Wound
RANAP :
11 1. An. Sherin Amanda /3th/ Dx. Diarrhea +
Nausea and vomiting / Dpjp. Mira Febriani
Inkiriwang,dr. SpA 2.
An. Muhammad Hanif /4th/ Dx.
Dyspepsia + Fever / Dpjp. Tartila, dr. Sp.A /
Ruang 601 3.
Nn. Vitri Hanariyanti /28th/ Dx.
Dyspepsia, hyperemesis gravidarum +
G1P0A0 hamil 8 minggu / Dpjp. Nisa
RUJUK :
APS :
D.O.A :
RAJAL :
RANAP :
PASIEN OBSERVASI :
11 Pasien
14 Pasien
PASIEN BARU :
PASIEN OBSERVASI :
3.Ny. Ina Herawati / dr.Sara Ester Sp.BP-RE /
Benign lipomatous neoplasm
PASIEN PINDAH ICU :

1.Tn. Replin Maulana Nasution / Dicky Aligheri,
SpBTKV (K),dr, FIHA, FICA / Pro CABG
RENCANA TINDAKAN :
dyspepsia syndrome dd IBD/ Rencana Echo dan
CT SCAN AORTA SIO (-)
2. Ny. Yosi / Alvin Nursalim, dr. Sp.PD /
Varicella, Nausea and Vomiting/ R/ USG
bedside besok tgl 17/01/22 jam 12.00
4 Pasien
RENCANA PULANG/ dr.Sara
1. Ny. Ina Herawati : Ester Sp.BP-
PASEN APS :
PASIEN PULANG :
1. Ny. Nurfiani / Veinardi Madjid,dr. Sp.OG

/ Malignant neoplasm of cervix uteri,
Retention of urine, Acute cystitis
2. Nn. Faisya Akmal Nabila / Radi Muharris
with arthroscopy + Anterior Cruciate
Ligament (Acl) Reconstruction
3. Nn. Nurul Hildayani / Alvin Nursalim,
dr. Sp.PD / Efusi pleura kanan ec susp
pleuritis TB
4. Tn. Bangun / dr.Amanda Pitarini Sp.PD-
intestine
5. Ny. Dr.Esti / Rofi Yuldi Saunar, dr. Sp.B-
KBD / hemoroid grade 3-4
1.An. Sherin Amanda/ Mira Febriani

Inkiriwang,dr. SpA/ GEA
2.An. Muhammad Hanif Faizan/ Tartila, dr.
Sp.A/ Acute amoebic dysentery
PASIEN OBSERVASI :

aneurysm
2.Tn. Reinhard/ dr. Alvin, Sp.PD / DHF H-8
3.An. Rausharyki Adeevaparisha/ Nina Dwi
Putri, dr. Sp.A (K)/ GEA
4.Ny. Jusni/ Alvin Nursalim, dr. Sp.PD/ Malaise
and fatigue
RENCANA PINDAH ICU :

6 Pasien Yombana,Sp.S / Myasthenia gravis
RENCANA TINDAKAN
aortic aneurysm / pro tindakan TEVAR,
Senin, 17/1/2022
PASIEN DI VK
PASIEN PULANG
1.An. Alfonsus Noah/ Yonas Hutasoit, dr.

Sp.U/ Disorder of penisca
IBCLC/ Post SC P2A1
RENCANA RUJUK :
HEATER
0
CARE
1. Nn. Yasina /24th/ Dx. Myasthenia Gravis /

Dpjp. dr. Zicky Sp. S / Terintubasi jam 02.00
Wib
2. REPLIN MAULANA NASUTION / 46 thn /
2
POST CABG 3 graft ec Atherosclerotic
cardiovascular disease, Abnormal findings on
diagnostic imaging of heart and coronary
circulation / Dicky Aligheri, SpBTKV (K),dr,
FIHA, FICA
1. Ny. Dina Komala sari /25th/ Dx. G1P0A0
1 Hamil 22 Minggu, dgn Syock Sepsis / Dpjp. dr.
Alvin dan dr Nisa Fhatoni Sp.OG

4 Pasien
PASIEN OBSERVASI :
PASIEN PONEK :
1. Ny. Dina/G1P0A0 hamil 22 minggu
1. Ny. Dina/ G1P0A0 hamil 22 mgg/
PASIEN OBSERVASI
HCU/ observasi DI HCU :
DJJ/jam
PASIEN OBSERVASI :
1. By.Ny.Adhella/dr. Diana Sp.A/NCB
SMK Usia 2 hari (Hiperbillirubin)
1
PASIEN PULANG
PASIEN Status HCU :
OGY
SIC (CAROL) Senin 17.01.22
TIPE PASIEN
YANG DINAS
LT NAMA UNIT
EMERGENCY ROOM
Dr Dwi Dr Dwi
Dr Fajar
EMERGENCY Ns Susi Dr Fajar
ROOM Ns Tomy Ns Rizam
Ns Sanusi 11
Ns Fitri
Ns Nur Ns Mohlis
GF
PONEK 1
TOTAL PASIEN EMG
Poli Obgyn
Ns NS 1 :
Poli Urology IIN
Poli Ortho
Poli Internist
Poli Bedah Umum
Poli Bedah Plastik
Poli THT Kiki
Poli Gizi
Poli bedah saraf
Poli Neuro
Dermis
Dental
Poli Endoscopy
Poli Fisioterapi
Poli Rehab Medik
LT 3
Poli Nutrition
Poli Paru
Poli Mata
Poli Psikiatri
Pain Clinic
MCU
POLI KEMOTERAPI
ODC
TOTAL PASIEN OPD
Dr Yuanitha
LT 4 Dr Mega Dr Yuanitha
IN PATIENT Ns Rio Ns
DEPARTMENT
Ns Wulan
Taufik Ns
Ns Salwa 6
Ns Nurul Ns Okta
Ella
Dr Yuanitha
LT 4 Dr Mega Dr Yuanitha
IN PATIENT Ns Rio Ns
DEPARTMENT
Ns Wulan
Taufik Ns
Ns Salwa 6
Ns Nurul Ns Okta
Ella
Dr
DR Yuanitha Yuanitha
Dr Dur
IN PATIENT Ns Tita Ns
LT 6 DEPARTMENT
Ns DIni
Okta Ns
Ns Indah 7
Ns Kristin Ns Silvi
Devi
Ns Yudi
Kemoterapi
OPERATING THEATER
OK
CRITICAL CARE
Dr Rizki Ns Agus Dr Dewi
ICU Ns Ns Esti p Ns Gisma
Awaludin Ns Rita Ns Elga
HCU
Ns Esti Ns Alvi Ns Ayu

NICU
PICU
TOTAL Ps CRITICAL
OBSTETRICS
Bd ANggi Bd Dewi
VK Bd Dilla
Bd Ningsih Bd Viky
Nursery Ns Nely Ns Inggrid Ns Nani

Nursery Ns Nely Ns Inggrid Ns Nani
HEARTOLOGY
Cathlab
Hybrid
LT 8
OPD JANTUNG
Dokter Jaga
Dokter Jaga IPD : Pagi : dr Mega + dr Dur Malam : dr Yuanitha
Dokter Jaga Critical : Pagi : dr Rizki Malam : dr Dewi

KETERANGAN
TOTAL
PASIEN
OOM
PASIEN OBSERVASI :
RAJAL :
1. Ny Sara Paradiska / 30 thn / Perawatan
luka Post op APP
2. Ny Fatimah / 34 thn /
Malignat Neoplasma / Pro Infus MTX dan
Calcium Folinate
3 Ny Sri Lestari / 34 thn
/Diare 2x 4. Nn Gabriella
Aveline / 27 thn / Pro Injeksi Vitamin - NB
5000 5. An Kayrana
Keenan / 3 thn / Obsv Febris H 3
6. Tn Mursidi /
38 thn / Kel Bahu kiri terasa sakit ec jatuh
saat main bola
RANAP :
1. Tn Charifadi Moch / 61 thn / Kel
Sesak Nafas / Rawatutk obsv di HCU
11 * 2. An
Clamira Arza / 2 thn / Obsv Febris H
3 / Rawat IPD 604 3. Ny
Noorjanah Malik / 77 thn / Diare 5x /
Rawat IPD 4 4. An Elan
Arana / 1 thn / Dr Anisa SpA / OBsv
Febris H4 / Rawat IPD 6
5 NyRisti
Pramita / 33 thn /Dyspepsia, Obsv
Febris H 1 / Rawat IPD 4
6. An Raysharyki / 3 thn /
Diare 2x ( Cair )
RUJUK :
APS :
D.O.A :
RAJAL :
1. NY okki PUSPITASARI / 26 THN /
G1 P0 A0 H 39 mg/ Dr Nisa Fathoni
SPOG
1
RANAP :
PASIEN OBSERVASI :
12
39
5
1
6
14
1
12
8
3
26
1
Schedule tindakan Endoskopi :
1. Tn. AMIRIL MUSLIMIN, 37th, diagnosa :

gerd, riwayat : dm, hipertensi.
rencana tindakan EGD + BIOPSI
Selasa, 18 Januari 2022, pkl 07.00, dokter
operator : dr amanda pitarini, SpPD-KGEH.
( Pasien ODC akan tiba brawijaya pkl 05.30)
133
PASIEN BARU :
1. Tn Sju Tong Kwang / Dicky Aligheri,

SpBTKV (K),dr, FIHA, FICA / Pro open
repair AAA
2.Tn. Iwan Sumadi / Dicky Armein
Hanafy, dr. SpJP - FIHA, FAsCC / Ablasi
konvensional Cavotricuspid Isthmus (CTI)
3.Ny. Noorjanah Malik Fadjar / Alvin
Nursalim, dr. Sp.PD / Diarrhea,
unspecified, Other and unspecified
abdominal pain, Malaise and fatigue, Non-
insulin-dependent diabetes mellitus 4.
yRisti Pramita / 33 thn /Dyspepsia, Obsv
Febris H 1 /
PASIEN OBSERVASI :

repair AAA
3.Tn. Jeffry / Alvin Nursalin, dr. Sp.PD /
4.Tn. Iwan Sumadi / Dicky Armein
Hanafy, dr. SpJP - FIHA, FAsCC / Ablasi
konvensional Cavotricuspid Isthmus (CTI)
abdominal pain, Malaise and fatigue, Non-
insulin-dependent diabetes mellitus
6
PASIEN PINDAH ICU :
1. Replin Maulana Nasution / Dicky

Aligheri, SpBTKV (K),dr, FIHA, FICA /
Pro CABG
6
1. Tn Charifadi Moch Anwar / Dicky

Armein Hanafy, dr. SpJP - FIHA,
FAsCC, Pindahan dari ICU
Kemungkinan pindah 18/01/22 (Kamar
407)
2.Tn. Amiril / Amanda Pitarini
Utari,dr, SpPD-KGEH / Rencana
Gastroscopy 18/01/22 jam 06.30
(Rencana masuk jam 05.00 pagi
18/01/22 Kamar 410 ) ODC
RENCANA TINDAKAN :

repair AAA Rabu 19/01/2022 Jam : 19.00
RENCANA PULANG :
1. Iwan Sumadi / Dicky Armein
Hanafy, dr. SpJP - FIHA, FAsCC /
Ablasi konvensional Cavotricuspid
Isthmus (CTI)
PASEN APS :
PASIEN PULANG :
1.Ny. Rizky Ambarsari /Alvin

Nursalim, dr. Sp.PD/ISPA, Fever,
unspecified
2.Ny. Ina Herawati / dr.Sara Ester
Sp.BP-RE / Benign lipomatous
neoplasm
3.Ny.Vitri / Nisa Fatoni, dr. Sp.OG /
G1P0A0 hamil 8 minggu, Dyspepsia
TMENT PASIEN BARU :

1.An. Clemira Arza Lavanya/ Tartila,
dr. Sp.A/ Dengue fever H-3 2. An
Raysharyki / 3 thn / Diare 2x ( Cair )
PASIEN OBSERVASI :
1.An. Clemira Arza Lavanya/ Tartila, dr.

Sp.A/ Dengue fever H-3
Malaise and fatigue
PASIEN OBSERVASI ICU :

7
1.Ny.Lim Bie Hwa / Suko Adiarto, dr.
SpJP (K),FIHA,, FICA, FAsCC, PhD /
Thoracic aortic aneurysm
RENCANA TINDAKAN
PASIEN DI VK
PASIEN PULANG
Reinhard/ dr. Alvin, Sp.PD / DHF H-8
RENCANA MASUK :
1.Ny. Patricia Gabriella/ Prof. dr.
Nugroho Kampono/ Rencana Sc tgl
19/01/2022, (Kamar 609)
ATER
0
RE
1. CHARIFADI M ANWAR /Post CAG ec
NSTEMI /Dicky Armein Hanafy, dr. SpJP
- FIHA, FAsCC
2. REPLIN MAULANA
NASUTION / 46 thn / POST CABG 3
graft ec Atherosclerotic cardiovascular
3 disease, Abnormal findings on diagnostic
imaging of heart and coronary circulation /
Dicky Aligheri, SpBTKV (K),dr, FIHA,
FICA
3. LIM BIE HWA / Post TEVAR /
Suko Adiarto, dr. SpJP (K),FIHA,, FICA,
FAsCC, PhD
1. Ny. Dina Komala sari /25th/ Dx.
G1P0A0 Hamil 22 Minggu, dgn Syock
1 Sepsis / Dpjp. dr. Alvin dan dr Nisa
Fhatoni Sp.OG ( DJJ per 6 jam )
1 Rawat ke 35 / Dr Erick Gultom SpA ,
Terpasang ETT ukuran 3,5 kedalaman 8,5
dengan Setingan MAP 10, AMP 30,P-max
20 FREK 10, FIO2 21% (Pasien NICU)
PASIEN OBSERVASI :
0
RENCANA TINDAKAN :
PASIEN PONEK :
1. Ny. Okky/dr. Nisa,spog/G1P0A0
hamil 39 minggu + 4 hari / evaluasi
CTG
PASIEN OBSERVASI DI HCU :
PASIEN OBSERVASI :
PASIEN PULANG
0
0
By Ny Adhella / dr. Diana Sp. A / NCB
SMK Usia 3 hari
PASIEN Status HCU :

1. Ny. Dina/G1P0A0 hamil 22
minggu/obs DJJ per 6 jam
Y
1 orang
1 orang
21 Orang
dr Yuanitha
SIC (CAROL) Selasa 18.01.22
TIPE PASIEN
YANG DINAS
LT NAMA UNIT
EMERGENCY ROOM
Dr Firdha
Dr Firdha Dr Hanif
EMERGENCY Dr Hanif
ROOM
Ns Susi Ns
Ns Mohlis
Ns Rizam 17
Nur Ns sanusi
Ns Tomi
GF
PONEK
TOTAL PASIEN EMG
Poli Obgyn
Ns NS 1 :
Poli Urology IIN
Poli Ortho
Poli Internist
Poli Bedah Umum
Poli Bedah Plastik
Poli Bedah Degestif
Poli Bedah Vaskuler NS 2 :
Ns NS 2 :
Poli THT Kiki
Poli Gizi
Poli bedah saraf
Poli Neuro ``
Dermis
LT 3
Dental
Poli Endoscopy
Poli Fisioterapi
Poli Rehab Medik
Poli Nutrition
Poli Paru
Poli Mata
Poli Psikiatri
Pain Clinic
MCU
POLI KEMOTERAPI
ODC
TOTAL PASIEN OPD
IN PATIENT Ns Citra Ns Ns Taufik Ns Salwa

DEPARTMENT 4 Malik Ns Ella Ns Okta 7
LT 4
LT 5
IN PATIENT Ns Citra Ns Ns Taufik Ns Salwa
DEPARTMENT 4 Malik Ns Ella Ns Okta 7
LT 4
LT 5
IN PATIENT
DEPARTMENT 5
Ns Santi Ns Tita Ns
Ns Anna Ns Rio Yudi
IN PATIENT Ns Dini Ns Christin Ns Aviani
LT 6 DEPARTMENT 6 Ns Melly Ns Devi Ns Nadia
8
Kemoterapi
OPERATING THEATER
Ns Sunandar
OK Ns Heryanti
CRITICAL CARE
Ns
ICU Awaludin
HCU
NICU
Ns Esti
PICU
TOTAL Ps CRITICAL
OBSTETRICS
Bd ANggi Bd Dewi
VK Bd Dilla
Bd Ningsih Bd Viky
Bd ANggi Bd Dewi
VK Bd Dilla
Bd Ningsih Bd Viky
Nursery Bd Nelly NsIka Ns Inggrid
HEARTOLOGY
Ns Akbar
Cathlab Ns Tryato
Hybrid
Ns Rini T
OPD JANTUNG
Ns Emma
19
LT 8
LT 8
Dokter Jaga
Dokter Jaga IPD : Pagi : dr Ludy Malam : dr Nesya

KETERANGAN
TOTAL
PASIEN
OOM
PASIEN OBSERVASI :
1. Tn Faiq Bawal / 46 / Control post

Insisi Abses tgl 15.01.22
2. Tn Muhammad Syaikh / 27 thn /
Konjungtivitis
3. Ny Yuli Aslihatun / 49 thn /
Vomitus 3x
4. Ny Gezira Nariska / Obsv Febris H
1
5. Charolina Septiana / 25 thn /
Dyspepsia 6.
An Queena Aqilla / 8 thn / perawatan
kuku jempol kaki kiri 7. Ny
Alika Nurul / 19 thn / Post KLL
terserempet mobil saat naik motor
8. Ny Vika
Vres Ceria / 32 thn / Dyspepsia
9. Nn
Muharam Dewi / 17 thn / KLL
terserempet mobil 10.
Ny Alyara Abiya / 26 thn / Vertigo
11. An
17 Mandhegani Arum / / Obsv Febris
H3 12. By Hadzka
Aladika / 0 thn / Obsv fever H 1
13. Ny Gladys
Benedicta / 30 thn / Obsv Febris H1
14. By Widuri / 0
thn / Obsv Febris H1
15. By Arkana / 1
thn / Obsv FebrisH1
RAJAL :
RANAP :
1. An Sarah Nicoline 1 thn / Obsv
Febris H 5 / Dr Ali SpA / Rawat IPD
610 2. Tn
Yohanes Julius / 21 thn / Obsv Febris
H 4 / Raweat IPD 416
RUJUK :
APS :
D.O.A :
RAJAL :
RANAP :
PASIEN OBSERVASI :
17
20
8
3
11
2
12
3
19
3
1
98
PASIEN BARU :
1.Ny. Risti Pramita / Alvin Nursalim, dr.

Sp.PD / Dyspepsia, Fever, unspecified
2.Tn. Charifadi Moch Anwar / Dicky
FAsCC / Post CAG
3.Tn. Yohanes Julius / Alvin Nursalim,
dr. Sp.PD / Dengue fever, Dyspepsia
4.Tn. Amiril / Amanda Pitarini Utari,dr,
SpPD-KGEH / Post EGD (ODC)
PASIEN OBSERVASI :

repair AAA
FAsCC / Post CAG
abdominal pain, Malaise and fatigue,
Non-insulin-dependent diabetes mellitus
7.Tn. Yohanes Julius / Alvin Nursalim,
dr. Sp.PD / Dengue fever, Dyspepsia
PASIEN PINDAH ICU :

7

7
1.Ny. Hesti / Bob Andinata, dr.

Sp.B(K)Onk / Pro Kemoterapi /
Rencana masuk pagi 19/01/22 (Kamar
409)
RENCANA TINDAKAN :

repair AAA Rabu 19/01/2022 Jam : 19.00
dyspepsia syndrome dd IBD / Pro EGD
Jumat 20/01/2022 Jam : pagi ? Lagi
konfirmasi
RENCANA PULANG :
1. Tn Charifadi Moch Anwar / Dicky
FAsCC / Post CAG
PASEN APS :
PASIEN PULANG :
1. Tn Iwan Sumadi / Dicky Armein

Hanafy, dr. SpJP - FIHA, FAsCC /
Ablasi konvensional Cavotricuspid
Isthmus (CTI)
2.Tn. Amiril / Amanda Pitarini
Utari,dr, SpPD-KGEH / Post EGD
(ODC)
Pasien Observasi :
1 1.Ny.Zahra/drg.Ken Ayu/Post
Odontectomy
Pasien Rencana Pulang
1.Ny.Zahra/drg.Ken Ayu/Post
Odontectomy
TMENT
1. An.Raysharyki/Nina Dwi Putri, dr.
Sp.A (K)/Viral and other specified
intestinal infections
PASIEN OBSERVASI :
1.An. Clemira Arza Lavanya/ Tartila, dr.

Malaise and fatigue
4.An. Muhammad Hanif Faizan/ Tartila,
dr. Sp.A/ Acute amoebic dysentery
5.An.Raysharyki/Nina Dwi Putri, dr. Sp.A
(K)/Viral and other specified intestinal
infections
6.Ny Dina Komalasari/dr Alvin Nursalim/
Sepsis (Pindahan dari ICU).
7.An. Elan/ dr Annisa Nur Aini/ Dengue
haemorrhagic fever (Utama)
19/01/2022 Jam 09.00 wib.
8
PASIEN OBSERVASI ICU :
RENCANA TINDAKAN

19/01/2022 Jam 09.00 wib.
PASIEN DI VK
PASIEN PULANG

RENCANA MASUK :

ATER
ZAHRA KARIMA / BEDAH MULUT -
1 Odontectomy 4 Gigi / OK 1 jam 15.00
wib / Ken Ayu Miranthy, drg

PATRICIA GABRIELA KAPARANG / BEDAH
OBGYN - Sectio Caesaria / OK 1 jam 09.00 wib /
Nugroho Kampono,Prof. dr. SpOG (K) Onk
2. MESTIKA
3 ANGGARINI / BEDAH OBGYN - Sectio
Caesaria / OK 3 jam 12.30 wib / Ardiansjah Dara
Sjahruddin, dr. Sp.OG 3. YENNI
SETIAWARDHANI / BEDAH ONCOLOGY -
Wide Excision For Malignant Tumor <5cm / OK 1
jam 20.00 wib / Bob Andinata, dr. Sp.B(K)Onk
RE
1. REPLIN MAULANA
NASUTION / 46 thn / POST CABG 3
graft ec Atherosclerotic cardiovascular
disease, Abnormal findings on diagnostic
2 imaging of heart and coronary
circulation / Dicky Aligheri, SpBTKV
(K),dr, FIHA, FICA
2. LIM BIE HWA /
Post TEVAR / Suko Adiarto, dr. SpJP
(K),FIHA,, FICA, FAsCC, PhD
0
1 Rawat ke 35 / Dr Erick Gultom SpA ,
Terpasang ETT ukuran 3,5 kedalaman 8,5
dengan Setingan MAP 10, AMP 30,P-
max 20 FREK 10, FIO2 21% (Pasien
NICU)
PASIEN OBSERVASI :
RENCANA TINDAKAN :
1. 609/Ny. Patricia/dr. Prof. NK, Sp.

Og/ G1 H37-38 minggu a/i PER/
rencana SC jam 09.00 / CTG (+)
2. Ny. Mestika Anggraini / dr. Dara,
Sp. Og / G2P1 H aterm BSC 1x /
rencana SC jam 12.30 -> os belum
datang
PASIEN PONEK :
NB : dr. Anak -> dr. Anisa Sp. A

NOTED sudah terinfo menggantikan dr.
Rifan Sp. A sedang cuti
1. 602 bed A/ Ny. Dina/dr.Alvin Sp.

PD + dr. Nisa Sp. Og/ G1P0A0 hamil
22 minggu/obs DJJ per shift
PASIEN OBSERVASI :
0
PASIEN PULANG
PASIEN Status HCU :
Y
2022
Outpatient : 19
dr ario :
Dr dafsah : 3
dr denio : 3
dr faris :
19 dr DH : 4
dr DAW :
dr radityo :
Dr suko : 3
dr sunu : 6
dr Adi :
MCU :
New patient: 5
Dr. Denio : 1 dari dr. Chamim, SpOG
Dr Sunu : 2 (1 dari dr. Bob, Sp Onk, 1
info dari teman)
Dr Dafsah : 1 (info dari kerabat)
Dr. Dicky Hanafy : 1 info dari teman
melakukan
ECHO :
Stress Echo :
USG Doppler :
Holter :
Ezypro :
ECG : 15
Treadmill : 1
CT Scan :
Speckle :
TEE :
DSE :
ABI :
Advance Echo : 4
Handle echo :
ABPM :
Tilt Table Test :
Paket PJB :
Referral Brawijaya : dr chamim, dr. Bob

Refferal RS luar :
Dokter tidak hadir : -

SIC (EKO) Rabu 19.01.22
TIPE PASIEN
YANG DINAS
LT NAMA UNIT
EMERGENCY ROOM
dr. Audrey. dr. Firdha,

EMERGENCY Zr. Nur, Ns.
Ns. Susi, Ns Ns. Mohlis,
ROOM Ardi
Tomi
Ns. Rizam
GF
PONEK
PONEK
TOTAL PASIEN EMG
Poli Obgyn
Ns NS 1 :
Poli Urology IIN
Poli Ortho
Poli Internist
Poli Bedah Umum
Poli Bedah Plastik
Poli THT Kiki
Poli Gizi
Poli bedah saraf
Poli Neuro
Dermis
LT 3 Dental
Poli Endoscopy
Poli Fisioterapi
Poli Rehab Medik
Poli Nutrition
Poli Paru
Poli Mata
Poli Psikiatri
Pain Clinic
MCU
POLI KEMOTERAPI
ODC
TOTAL PASIEN OPD
DS = Br.
DP = Ns. Taufik + Br. DM = Ns.
IN PATIENT Citra + Ns.
Abdi + Br. Wulan + Ns.
DEPARTMENT 4 Malik
Rio Ella
LT 4
LT 5
LT 5
DP = Ns. DM = Ns.
IN PATIENT DS = -
Ana Tita + Ns.
DEPARTMENT 5 Santy
DP =
DS = Ns. DM = Ns.
Ns.Dini +
IN PATIENT Kristine +
LT 6 DEPARTMENT 6
Ns. Risha
Ns. Silvi
Devi + Ns
+Ns. Melly Nadia
Kemoterapi
OPERATING THEATER
OK
CRITICAL CARE
Ns Ns.
Ns. Elga,
ICU Awaludin, Ningsih, Ns. Winda
Ns. Gisma Agus
HCU
NICU
Ns. Alfi
PICU
TOTAL Ps CRITICAL
OBSTETRICS
VK
VK
‌Dines Pagi:
Bd. Nely ‌Dines
‌Dines
Dinas Siang : Ns.
Nursery middle : Ika
Malam :
Ns. Inggrid
Ns. Wiwi
HEARTOLOGY
Cathlab
Hybrid
OPD JANTUNG
LT 8
Dokter Jaga
Dokter Jaga IPD : Pagi : dr Malam : dr Yunitha
Dokter Jaga Critical : Pagi : dr Dewi Malam : dr Rizky

KETERANGAN
CY ROOM
PASIEN OBSERVASI :
RAJAL :
1. An. M Raffa Tsaqif /12th/ Dx. Ispa
2. An. Karel Ezekiel /1th/ Dx. Fever
3. Ny. Poery Kusyani /46th/ Dx. Malaise and
fatigue
4. An. Regan Daneswara /12th/ Dx. Fever
5. Ny. Qistin Amiera /38th/ Dx. Asthma
6. Tn. Toni Ardiyanto /26th/ Dx. Myalgia,
ankle and foot
7. Yohana Kristiani /23th/ Dx. Nausea and
vomiting + Diarrhea
RANAP :
1. Ny. Adhella Regie /32th/ Dx. Post
Partum, Secondary hypertension / Dpjp.
Alvin Nursalim, dr. Sp.PD Raber Dr. Nisa
11 Fhatoni / Ruang 503 2.
Ny. Ajeng Tohasiana /32th/ Dx. Fever /
Dpjp. dr. Amanda Sp.PD 3.
Okky Puspitasari /26th/ Dx. G1P0A0 H 39
mgg 6 hari inpartu kala I fase ;aten Janin
tunggal hidup
RUJUK :
APS :
D.O.A :
1. Tn. Raden Dody Maladi /53th/ Dx.
D.O.A / Pasien datang ke EMG dgn keluhan
Tidak Sadarkan Diri => RJP + Ekg Asistol
RAJAL :
1. Ny. Adrien Dyamantha /33th/ Dx.
Nausea and vomitingh, G2P1A0 HAMIL 34
minggu 2 hari . JPKTH + Diarrhea / Kel.
1 Mules mules /
RANAP :
1
PASIEN OBSERVASI :
12 Pasien
31
5
2
16
8
8
8
4
1
28
117
EPARTMENT PASIEN BARU :
1. Ny. Hesti Rachmawati / dr. Bob Andinata/ Ca

Mamae Dextra (Kemo)
2. Ny. Yulia Prawidyastuti / dr. Bob Andinata /
Ca Mamae Dextra (Kemo)
PASIEN OBSERVASI :
unspecified abdominal pain, Malaise and fatigue,
Non-insulin-dependent diabetes mellitus
4.Tn. Yohanes Julius / Alvin Nursalim, dr.
Sp.PD / Dengue fever, Dyspepsia
Aligheri, SpBTKV (K), dr, FIHA, FICA
arherosclerotic deasease, Abnorman findings on
circulation
6.Ny. Then Suy Loy / Syafrizal Abubakar, dr.
Sp.PD
PASIEN PINDAH ICU :

1. Tn. Sju Tong Kwang / Dicky Aligheri,
SpBTKV (K),dr, FIHA, FICA / Pro open repair
AAA
9 pasien (1
ICU 8 PASIEN RENCANA MASUK :
RANAP)
RENCANA TINDAKAN :
dyspepsia syndrome dd IBD / Pro EGD Jumat
21/01/2022 Jam : 07.00
2. Tn. Replin Maulana Nasution / dr. Dicky
Aligheri, SpBTKV (K), FIHA, FICA
arherosclerotic deasease, Abnorman findings on
circulation / X-RAY
RENCANA PULANG :
1. Ny. Hesti Rachmawati / dr. Bob

Andinata/ Ca Mamae Dextra (Kemo)
2. Ny. Yulia Prawidyastuti / dr. Bob
Andinata / Ca Mamae Dextra (Kemo)
3. Ny. Yosi / Alvin Nursalim, dr. Sp.PD /
PASEN APS :
PASIEN PULANG :
Armein Hanafy, dr. SpJP - FIHA, FAsCC /
Post CAG
Nursalim, dr. Sp.PD / Diarrhea, unspecified,
Other and
1.Ny.Adhella /dr. Alvin Nursalim,

Sp.PD/Secondary Hypertension
2.Ny.Adrien /dr. Uf, Sp.OG/Nausea &
Vomitting, Supervision Normal Pragnancy,
Diarrhea
3.Ny.Ajeng /dr. Amanda,
Sp.PD-KGEH/Fever
4.Tn.Dharma /dr. Amanda,
Sp.PD-KGEH/Fever
PASIEN OBSERVASI :
1. Ny.Adhella /dr. Alvin Nursalim,

2. Ny.Adrien /dr. Uf, Sp.OG/Nausea &
3 Pasien Diarrhea
3. Ny.Ajeng /dr. Amanda, Sp.PD/Fever
4.Tn.Dharma /dr. Amanda,
Sp.PD-KGEH/Fever
PASIEN PINDAH ICU :

1.Ny.dr. Hafizah /dr.Chamim,
Sp.OG/Rencana Laparascopy tgl 21/01/2022
(Kamar 518)
RENCANA TINDAKAN
PASIEN PULANG :

1. Ny. Mestika / Ardiansjah Dara
Sjahruddin, dr. Sp.OG / Supervision of other
normal pregnancy
2. Ny. Chyntia / Ardiansjah Dara
normal pregnancy
PASIEN OBSERVASI :
1.An. Clemira Arza Lavanya/ Tartila, dr. Sp.A/

Dengue fever
2.An. Sarah / Ali Alhadar, dr. Sp.A (K) / Other
viral infections of unspecified site
3.Ny. Jusni/ Alvin Nursalim, dr. Sp.PD/ Malaise
and fatigue
(K)/Viral and other specified intestinal infections
6.Ny Dina Komalasari/dr Alvin Nursalim/ Sepsis
(Pindahan dari ICU).
7.An. Elan/ dr Annisa Nur Aini/ Dengue
8.Ny. Patricia Gabriella/ Prof. dr. Nugroho
Kampono/ Supervision of normal pregnancy
9. Ny. Mestika / Ardiansjah Dara Sjahruddin, dr.
Sp.OG / Supervision of other normal pregnancy
11 (Ranap 10, 10. Ny. Chyntia / Ardiansjah Dara Sjahruddin, dr.
ICU 1, 1 VK Sp.OG / Supervision of other normal pregnancy
PASIEN PINDA ICU :

aneurysm
RENCANA TINDAKAN
1. Ny. Chyntia / Ardiansjah Dara
normal pregnancy / Rencana tind SC tgl
20/01/22 pkl 09.00 wib
1.Ny.Okky
PASIEN DI /VKdr. Nisa sp. OG / Rencana
partus spontan
PASIEN PULANG
RENCANA MASUK :

1. Ny. Jusni/ Alvin Nursalim, dr. Sp.PD/
Malaise and fatigue
2. An. Elan/ dr Annisa Nur Aini/ Dengue
THEATER
Tindakan rabu, 19-01-22
1. PAtricia gabriaela /SC/ prof. dr.Nugroho
Kampono / 09.00 / OK 1
2. Mestika Anggraini /SC/ dr.
Ardiasyah dara/ 12.30 / Ok II
3. Neurolisis Ablasi dr
3 Syaf a.b Then Suy Loy
U/ rencana tindakan dr Bob d cancel karena
pasien sakit
Rencana tindakaan kamis, 20-01-22

1. SC dr Dara a.n jam 11.00
2. Eksisi Biopsi dr Vonty a.n Tjokro jam 14.00
L CARE
1. LIM BIE HWA / Post TEVAR / Suko

Adiarto, dr. SpJP (K),FIHA,, FICA, FAsCC, PhD
2.
Ny. Dewi Humaira /30th/ Dx. Post SC hari ke 8,
3 Eklamsia in the Puerperium / Dpjp. dr. Vera Sp.
AN + dr. Nisa Fathoni Sp.OG + dr. Alvin Sp. PD
+ dr. Zicky Sp. S 3. Ny. Sju
Thong Kwang /69yh/ Dx. Post Aorta Abdominal
Repair / Dpjp. dr. Daw, Sp. JP + dr. Dafsah, Sp.
JP

PASIEN OBSERVASI :
1 Pasien
1. Ny. Okky/ dr. Nisa,spog / G1P0A0 hamil
39 minggu 6 hari dengan inpartu
RENCANA TINDAKAN :
1 Pasien 1. Ny. Chyntia hayubi / G1P0A0 hamil 38
minggu 4 hari pro sc a.i LTP1x (APS)/ dr.
Dara,spog. Rencana SC jam 11.00 tgl
20.01.22
PASIEN PONEK :
1. Ny. Lutfia / dr. Tirsa, spo/ G1P0A0 hamil
26 minggu 5 hari
2. Ny. Adrien / dr. Uf bagazi,spog/ G2P1A0
hamil 34 minggu 2 hari dengan nausea
3 Pasien
vomiting
3. Ny. Okky / dr. Nisa,spog/ G1P0A0 hamil
39 minggu 6 hari dengan inpartu
1. 602 bed A/ Ny. Dina/dr.Alvin Sp. PD +

dr. Nisa Sp. Og/ G1P0A0 hamil 23
minggu/obs DJJ per 3 jam
2. Ny. Adrien/ dr. Uf bagazi,spog/ G2P1Ao
hamil 34 minggu 2 hari dengan nausea
vomiting. CTG per 12 jam.
PASIEN OBSERVASI :
1.By. Ny. Patricia Gabriela /dr. Annisa
Sp.A/NCB SMK usia 1 hari
2.By. Ny. Mestika Anggarini/ dr. Annisa
2 Pasien Sp.A/NCB SMK usia 1 hari
PASIEN PULANG
PASIEN Status HCU :
OLOGY
Outpatient : 18
dr ario :
Dr dafsah :
dr denio : 6
dr faris : 3
dr DH :
dr DAW :
dr radityo :
Dr suko : 2
dr sunu : 4
dr Adi : 3
18
MCU : -
New patient: 9
dr Adi 1: pasien lama di PIK
dr Faris 2 : 1 dr Bob 1 dari kerabat
dr Denio 2 : 1 PB dari kerabat pasien 1 dr
chamim spog
dr Sunu 2 :. 1dr Ritza spPD dr Adrianus kosasih
spjp
dr Suko 1 : dr Ike adriana spjp
Cancel : -

ECHO : 2
Stress Echo :
USG Doppler :
Holter :
ECG : 8
Treadmill : 1
CT Scan
Speckle
TEE :
DSE :
ABI :
Tilt Table Test :
Advance Echo : 2
Handle Echo :
ABPM :
Ezypro :
Cardioversi :
Referral Brawijaya : dr Chamim dr Bob
Referral External : dr Adrianus kosasih dr Ritza
SpPD RS budhi jaya , dr Ike Adriana spjp graha
kedoya
Info dokter tidak hadir : -
dr Yunitha
SIC (EKO) Kamis 20.01.22
TIPE PASIEN
YANG DINAS
LT NAMA UNIT
EMERGENCY ROOM
EMERGENCY
ROOM
GF
PONEK
TOTAL PASIEN EMG
Poli Obgyn
Ns NS 1 :
Poli Urology IIN
Poli Ortho
Poli Internist
Poli Bedah Umum
Poli Bedah Plastik
Poli THT Kiki
Poli Gizi
Poli bedah saraf
Poli Neuro
Dermis
LT 3 Dental
Poli Endoscopy
Poli Fisioterapi
Poli Rehab Medik
Poli Nutrition
Poli Paru
Poli Mata
Poli Psikiatri
Pain Clinic
MCU
POLI KEMOTERAPI
ODC
TOTAL PASIEN OPD
DP = Ns. DS = Br.
DM = Ns.
IN PATIENT Citra + Ns. Taufik + Br.
Wulan + Ns.
DEPARTMENT 4 Malik Abdi
Ella
LT 4
LT 5
LT 4
LT 5
DS = Ns
DP = Ns. Tary + DM = Ns.
IN PATIENT
Ana + Br.Malik Indah + Ns.
DEPARTMENT 5 ( PS ) Santy
Br.Malik
DP = DS = Ns. DM = Ns.
IN PATIENT Ns.Dini + Kristine +
LT 6 DEPARTMENT 6 Ns. Risha Ns. Silvi
Devi + Ns
Meliya
DP = DS = Ns. DM = Ns.
IN PATIENT Ns.Dini + Kristine +
LT 6 DEPARTMENT 6 Ns. Risha Ns. Silvi
Devi + Ns
Meliya
Kemoterapi
OPERATING THEATER
OK
CRITICAL CARE
ICU
HCU
NICU
lisa, alfi
PICU
TOTAL Ps CRITICAL
OBSTETRICS

‌Dines Pagi:
Tries, bd. Malam : bd.
VK bd. Dewi
Viki Dilla, bd.
‌Dines
Genda
‌Dines
Genda
‌Dines Pagi:
Ns. Nani
Siang : Ns.
Dinas Malam :
Nursery middle :
Ika
Bd. Nelly
‌Dines
Ns. Wiwi
‌Dines
HEARTOLOGY
Cathlab
Hybrid
OPD JANTUNG
LT 8
Dokter Jaga
Dokter Jaga IGD : Pagi : dr Dwi Malam : dr Audrey
Dokter Jaga IPD : Pagi : dr Nesya Malam : dr Rona
Dokter Jaga Critical : Pagi : dr Mutiara Malam : dr Riri

KETERANGAN
TOTAL
PASIEN
Y ROOM
PASIEN OBSERVASI :
1. Ny. Rossi Yulianti /48th/ Dx. CA Mamae

dekstra Stadium 4 meta hepar, paru, pleura,
multiple KGB /48th/ Kel. datang dengan
kesadaran somnolen. nafas cepat, dan nadi
sulit diraba, TD
50/30
Nadi sulit diraba
RR 38
akral dingin
Tampak luka di payudara kanan
tertutup verban
konsul dr. Vera, Sp. An, Acc Rawat ICU
tetapi pasien drop dan memburuk,
Intubasi & terpasang Ventilator,
Bradicardi==> Asistol==> RJP ==>
Meninggal J. 23.51 wib
RAJAL :
1. Ny. Fatimah /34th/ Dx. CA Placenta
8 2. An. Karel Ezekiel /1th/ Dx. Dengue Fever
3. Tn. Muhammad Fikri /35th/ Dx. Dyspepsia
4. Tn.
Nasrullah /58th/ Dx. Inguinal hernia
RANAP :
1. An. Jihane Aiza /7bln 30hri/ Dx.
Dengue fever / Dpjp. Annisa Nur Aini, dr.
Sp.A (FT) / Ruang 606 2.
An. Muhammad Ilham /10th/ Dx. Dengue
fever / Dpjp. Annisa Nur Aini, dr. Sp.A
(FT) / Ruang 418 3. An.
Kelana Islami Oesman /4th/ Dx. Dengue
fever / Dpjp. Annisa Nur Aini, dr. Sp.A
(FT)
RUJUK :
APS :
D.O.A :
RAJAL :
1. Ny. Natasyah Septiani /28th/ Dx.

G1P0A0 Hamil 23 minggu + ISK + Kista
ovarium kiri + Urinary tract infection
RANAP :
2
PASIEN OBSERVASI :
1. Ny. MIra Febrina /32th/ Dx. G3P2A0

Hamil 39 minggu dg gawat jalin + Bsc 1x /
Instruksi dokter Nisa Fhatoni Sc CITO.
10 Pasien
32 Shcedule tindakan endoskopi :
2 1. Tn. JEFFRY, 26th, diagnosa : gerd,

riwayat : dyspepsia, presence of prosthetic
3 heart valve.
12 Rencana tindakan EGD + BIOPSI
Jumat, 21 Januari 2022, pkl 07.00, dokter
operator : dr amanda pitarini, SpPD-
KGEH. ( Pasien RANAP kmr 411-1)
2
2
9
19
1
1
93
1.An. Muhammad Ilham / dr. Annisa,Sp.A /

Dengue fever
2.An. Kelana Islami Oesman /dr.
Annisa,Sp.A / Dengue fever
PASIEN OBSERVASI :
1.Ny. Risti Pramita / Alvin Nursalim, dr. Sp.PD

/ Dyspepsia, Fever, unspecified
2. Tn. Jeffry / Alvin Nursalin, dr. Sp.PD /
Aligheri, SpBTKV (K), dr, FIHA, FICA
arherosclerotic deasease, Abnorman findings
5. Ny. IR Kristin / Dicky Armein Hanafi, dr.
SpJP- FIHA, FAsCC / Atrial Septal Defect
PASIEN PINDAH ICU :

1. Tn. Sju Tong Kwang / Dicky Aligheri,
SpBTKV (K),dr, FIHA, FICA / Pro open repair
7
RENCANA TINDAKAN :
dyspepsia syndrome dd IBD / Pro EGD Jumat
21/01/2022 Jam : 07.00
RENCANA PULANG :
PASEN APS :
PASIEN PULANG :
2.Ny. Then Suy Loy/ Syafrizal Abubakar,
dr. Sp.PD
3.Ny. Hesti Rachmawati/ dr. Bob Andinata/
Ca Mamae Dextra (Kemo)
4. Ny. Yulia Prawidyastuti/ dr. Bob
Andinata / Ca Mamae Dextra (Kemo)
1.Ny. ANNISA NAHDAH

HIDAYATURRAHMAH / Nugroho
Kampono,Prof. dr. SpOG (K) Onk / Other
and unspecified ovarian cystsr
PASIEN OBSERVASI :
1.Ny.Adhella /dr. Alvin Nursalim,

2.Ny.Adrien /dr. Uf, Sp.OG/Nausea &
Diarrhea
3.Ny.Ajeng /dr. Amanda, Sp.PD-KGEH/
5 Fever
4.Tn.Dharma/dr. Amanda, Sp.PD-KGEH/
Fever
5. Ny. ANNISA NAHDAH
Kampono,Prof. dr. SpOG (K) Onk / Cysta
Ovarium
PASIEN PINDAH ICU :

1.Ny.dr. Hafizah /dr.Chamim, SpOG/
Rencana Laparascopy tgl 21/01/2022
(Kamar 518)
RENCANA TINDAKAN
Kampono,Prof. dr. SpOG (K) Onk / Cysta
Ovarium/ pro kistectomy besok 21/01/22
jam 13.00
PASIEN PULANG :

1. Ny.Adrien/dr. Uf, Sp.OG / Nausea &
Diarrhea
1. An. Jihane / Annisa Nur Aini, dr. Sp.A

(FT) / Dengue fever
2. Ny. Dewi / Nisa Fathoni, dr. Sp. OG,
IBCLC / Grand mal seizures, Eclampsia in
the puerperium
3. Ny. Okky / Nisa Fathoni, dr. Sp. OG,
PASIEN OBSERVASI :
1.An. Clemira Arza Lavanya/ Tartila, dr. Sp.A/

Dengue fever
(K)/Viral intestinal infections
4.Ny Dina Komalasari/dr Alvin Nursalim/ Sepsis
(Pindahan dari ICU).
5.Ny. Patricia Gabriella/ Prof. dr. Nugroho
6. Ny. Mestika / Ardiansjah Dara Sjahruddin,
dr. Sp.OG / Supervision of other normal
pregnancy
7. Ny. Chyntia / Ardiansjah Dara Sjahruddin, dr.
8. Ny. Dewi / Nisa Fathoni, dr. Sp. OG, IBCLC /
Grand mal seizures, unspecified (with or without
petit mal), Eclampsia in the puerperium
9. Ny. Okky / Nisa Fathoni, dr. Sp. OG, IBCLC /
10. An. Jihane / Annisa Nur Aini, dr. Sp.A (FT) /
Dengue fever
PASIEN PINDAH ICU :
10
10 aneurysm
RENCANA TINDAKAN

IBCLC / Grand mal seizures, unspecified
(with or without petit mal), Eclampsia in the
puerperium / Rencana tind. TCD/CD +
EMG + Usg bedside tgl 21/01/22 selesai
jumat'an
2. Ny Dina Komalasari/dr Alvin Nursalim/
Sepsis (Pindahan dari ICU) / Rencana tind
USG abdomen tgl 21/01/22 pkl 12.00 wib
PASIEN DI VK
PASIEN PULANG
1. An. Sarah / Ali Alhadar, dr. Sp.A (K) /

Other viral infections of unspecified site
2 .Ny. Jusni/ Alvin Nursalim, dr. Sp.PD/
Malaise and fatigue
3. An. Elan/ dr Annisa Nur Aini/ Dengue
haemorrhagic fever
RENCANA MASUK :
1. Ny. Santia / Dr. Noela sp.OG / rencana

tind SC masuk tgl 21/01/22 pkl 12.00 wib
1. Ny. Patricia Gabriella/ Prof. dr. Nugroho

2. An. Clemira Arza Lavanya/ Tartila, dr.
Sp.A/ Dengue fever
HEATER
Tindakan rabu, 20-01-22
1. CHINTYA HAYUBI /SC/ Ardiansjah Dara
Sjahruddin, dr. Sp.OG / OK I
2 2. TJOKRO GUNAWAN TJAHJONO / Eksisi
Biopsi dengan anestesi umum / Vonty Elfrida,
dr. SpB / OK II
Rencana tindakaan Jum,at, 21-01-22
1. ANNISA NAHDAH /Cystectomy/ Nugroho
Kampono,Prof. dr. SpOG (K) Onk / OK I J.
13.00
2. SHANTIA PARDILES /Sectio Caesaria/
Fransisca Noela RMH, dr. Sp.OG / OK II / J.
13.00
CARE
1. Ny. Sju Thong Kwang /69yh/ Dx. Post Aorta

Abdominal Repair / Dpjp. dr. Daw, Sp. JP + dr.
Dafsah, Sp. JP ==> Kamis 20.01.22 Post Re-
2 laparotomi thrombectomy / dr. DAW / 13.00-
17.30 (Hybrid)
2. LIM BIE HWA / Post TEVAR / Suko
Adiarto, dr. SpJP (K),FIHA,, FICA, FAsCC,
PhD
0

SpA , Terpasang ETT ukuran 3,5 kedalaman 8,5
2 cm tersambung Ventilator Mode HFO dengan
2. By. Ny. Chintya Hayubi /
Dx. Observasi Nafas / Dpjp. Eric Gultom, Bayi
di Nursery Saturasi Cendrung Rendah.
0
4 Pasien
PASIEN OBSERVASI :
1. Ny. Okky / dr. Nisa,spog/ G1P0A0 hamil
39 minggu 6 hari. Partus spontan dgn VE.
Pindah ranap jam 22.00
RENCANA TINDAKAN :
1
1. Ny. Shantia /dr. Noela, Spog/ G1P0A0
hamil 38 minggu pro SC a/i APS. Rencana
SC jam 13.10. Pasien belum datang.
PASIEN PONEK :
1. Ny. Natasyah/ dr. Nisa, spog/ G1P0A0

hamil 23 minggu 4 hari 2.
Ny. MIra Febrina /32th/ Dx. G3P2A0
Hamil 39 minggu dg gawat jalin + Bsc 1x /
jam 03.30 Wib dokter Nisa Fhatoni
2
instruksi ke GP IGD Persiapan Sc CITO
Scptnya, stelah hasil Antigen negatif lgsung
naik ke OK..Swab PCR tetap di lakukan,
jam 04.35 Wib pasien naik OK lantai 7
1. 602 bed A/ Ny. Dina /dr.Alvin Sp. PD +

dr. Nisa Sp. Og/ G1P0A0 hamil 23
minggu/obs DJJ per shift
2. Ny. Adrien / dr. Uf bagazi,spog/
G2P1A0 hamil 34 minggu 3 hari dengan
nausea vomiting. CTG per hari
PASIEN OBSERVASI :
1.By. Ny. Patricia Gabriela /dr. Annisa
2.By. Ny. Mestika Anggarini / dr. Annisa
3 3.By. Ny. Okky Puspitasari /dr. Keumala
Sp.A/12 jam
PASIEN PULANG
PASIEN Status HCU :
OGY
CATHLAB
Schedule : -
Non Schedule : -
HYBRID OR
Schedule : -
Non Schedule :
1. Sju tong kwang / re-laparotomi
thrombectomy / dr. DAW / 13.00-17.30
Tim : akbar, saiful, fefty, jhoni + ext tim
1. Ir kristina / PFO / dr. Dicky Hanafy. -- small
PFO, no need to closure.
1
Others : -
Problem : -
Overtime staf :
Staff sakit : -
Staff cuti : -
Next Schedule
Sat, 22 jan
1. Benny / cag ptca / dr. Denio / 08.00 / cathlab
Outpatient : 17
dr ario :
Dr dafsah : 4
dr denio :
dr faris : 3
dr DH : 5
dr DAW : 2
dr radityo :
Dr suko : 3
dr sunu :
dr Adi :
17
MCU :
New patient: 5
Dr. Faris : 1 dari dr. Siti RS Triadipa
Dr. Dicky Hanafy : 2 (1 dari website, 1 dari
saudara)
Dr.
Dr Dafsah : 2 (1 dari dr. Almara, 1 teman dr.
Dafsah)
Cancel:

ECHO :
Stress Echo :
USG Doppler :
Holter :
Ezypro :
ECG : 11
Treadmill :
CT Scan :
Speckle :
TEE :
DSE :
ABI :
Advance Echo : 2
Handle echo :
ABPM :
Tilt Table Test :
Paket PJB :
Cardioversi : 1
Refferal RS luar : dr. Almara, dr. Siti

SIC (CAROL) Jum;at 21.01.22
TIPE PASIEN
YANG DINAS
LT NAMA UNIT
EMERGENCY ROOM
Dr Dwi Dr Dwi Dr Dr Megawati

EMERGENCY Ns Susi Megawati Ns
ROOM Ns Sanusi Kelvin Ns
Ns Nur 12
Ns Fitri Ardi Ns Tomi
GF
PONEK
TOTAL PASIEN EMG
Poli Obgyn
Ns NS 1 :
Poli Urology IIN
Poli Ortho
Poli Internist
Poli Bedah Umum
Poli Bedah Plastik

Poli Bedah DegestifNS 2 :
Poli THT Kiki
Poli Gizi
Poli bedah saraf
Poli Neuro
Dermis
LT 3
Dental
Poli Endoscopy
Poli Fisioterapi
Poli Rehab Medik
Poli Nutrition
Poli Paru
Poli Mata
Poli Psikiatri
Pain Clinic
MCU
POLI KEMOTERAPI
ODC
TOTAL PASIEN OPD
IN PATIENT Ns Nurul Ns Ns Citra Ns Taufik

DEPARTMENT 4 Salwa Ns Abdi Ns Okta 9
IN PATIENT Ns Nurul Ns Ns Citra Ns Taufik
LT 4 LT
5
IN PATIENT Ns Ana Ns Tari Ns Indah
DEPARTMENT 5 Ns Yudi Ns Febrio Ns Malik 7
IN PATIENT Ns Dini Ns Ns Risha Ns Kristin

LT 6 DEPARTMENT 6 Alvi Ns Silvi Ns Meliya
10
IN PATIENT Ns Dini Ns Ns Risha Ns Kristin
LT 6 DEPARTMENT 6 Alvi Ns Silvi Ns Meliya
10
Kemoterapi
OPERATING THEATER
Ns Snandar
OK Ns Heryanti 3
4
CRITICAL CARE
ICU
HCU
NICU
PICU
TOTAL Ps
CRITICAL
OBSTETRICS
Bd Tries Bd Genda
VK Bd Dewi
Bd Vicky Bd Dilla
Ns Wiwi
Nursery Ns Nani Ns Ika Ns Nely 4
(MD)
Nursery Ns Nani Ns Ika Ns Nely 4
(MD)
HEARTOLOGY
Ns Akbar
Cathlab Ns Tryanto
Hybrid
LT 8
Ns Rini T
OPD JANTUNG
Ns Ema
17
LT 8
Dokter Jaga
Dokter Jaga IGD : Pagi : dr Dwi Malam : dr Megawati
Dokter Jaga IPD : Pagi : dr Mega Malam : dr Nesya + dr Ira
Dokter Jaga Critical : Pagi : dr Dewi Malam : dr Rizki

Total Pasien Meninggal 24 jam : 1 Orang
KETERANGAN
TOTAL
PASIEN
OOM
PASIEN OBSERVASI :
RAJAL :
1. Ny Meta Sundawan / 22 thn / Obsv
ebris H2 2.
Tn Lutfie Abdullah / Obsv Febris H1,
menggigil dan badan linu / MRI
Cervical non kontras + / PCR SWAB
POSITIF / Dr Nenfi SpPD / Dr
Zicky spS visite ( Kontak: FL, EMG
dan Radiologi ) 3.
Nn Vivin Oktaviani / 26 thn / Vertigo
4. Tn
Bongkot Septa / 36 thn / Tension
Type Headche 5. Tn
Faiq Bahwal / 45 thn / Perawatan luka
post insisi abses tgl 15.01.22
6. Ny Sri
Mulyani/ 29 thn / Obsv Febris H5
7. An
Mikael / 1 thn / Obsv Febris H1
RANAP :
1. Ny Daronah / Benign Paroximal
Vertigo / Rawat IPD 410
2. Tn Oesman
Widjaja / Dr Nenfi SpPD
12 Dyspepsia / Rawat IPD 411
3. Ny Nofrika
Sarah / 41 thn / Kel Nyeri
punggung kiri menjalr ke betis kir
sejak 1 hr SMRS
( LBP ) / Dr Zicky SpS /Rawat
IPD 410
4. Tn Farisan Adan / 35 hn / Obsv
Febris H 3 / Dr Nenfi SpPD /
Rawat IPD 507
RUJUK :
APS :
1. Tn Oey Oen Lie / 64 thn /

Fraktur lower of tibia / nyeri
tungkai bawah dikarenakan
terserempet dengan motor lain
saat sedang naik motor / menolak
di rawat dengan alasan hendak
dirawat di RSyang dekat rumah
D.O.A :
RAJAL :
RANAP :
PASIEN OBSERVASI :
12
32 Shcedule tindakan
1 endoskopi :
1
3 1. Tn. JEFFRY, 26th,
diagnosa : gerd, riwayat :
7
dyspepsia, presence of
prosthetic heart valve.
rencana tindakan EGD +
BIOPSI
Jumat, 21 Januari 2022, pkl
07.00, dokter operator : dr
3 amanda pitarini, SpPD-
KGEH. ( Pasien RANAP kmr
411-1)
7
9
3
5
3
30
3
112
TMENT
1.Ny. Daronah/ Indah Gianawati, dr.

Sp.PD/ Benign paroxysmal vertigo
2.Tn. Oesman/ Nenfiati, dr.SpPD-
KEMD/Non-insulin-dependent
diabetes mellitus
3.Ny. Novrika/Zicky Yombana, dr.
Sp.S/Lumbar and other intervertebral
disc disorders
4.Tn. Duddy/ Amanda Pitarini
Utari,dr, SpPD-KGEH/Internal
haemorrhoids
PASIEN OBSERVASI :
9
1.Ny. Risti Pramita / Alvin Nursalim,
unspecified
2. Ny. Daronah/ Indah Gianawati, dr.
3.Tn. Yohanes Julius / Alvin
Nursalim, dr. Sp.PD / Dengue fever,
Dyspepsia
4. An. Ilham / dr. Annisa,Sp.A /
5. An. Kelana /dr. Annisa,Sp.A /
6. Tn. Oesman/ Nenfiati, dr.SpPD-
diabetes mellitus
7. Ny. Enny/Bob Andinata, dr.
Sp.B(K)Onk/Malignant neoplasm of
breast
8. Ny. Novrika/Zicky Yombana, dr.
disc disorders
9. Tn. Duddy/ Amanda Pitarini
haemorrhoids
9 PASIEN PINDAH ICU :
RENCANA TINDAKAN :
1. Tn Duddy/ Amanda Pitarini

haemorrhoids/ Pro Ligasi
Colonoscopy jam 09.00 (22/01/2022)
1. Ny. Enny/Bob
RENCANA PULANGAndinata,
: dr.
Sp.B(K)Onk/Malignant neoplasm
of breast
PASEN APS :
PASIEN PULANG :
1. Tn Jeffry / Alvin Nursalin, dr.
Sp.PD / dyspepsia syndrome dd
IBD
unspecified abdominal pain,
Malaise and fatigue, Non-insulin-
dependent diabetes mellitus
2.Tn. Replin Maulana Nasution /
Dicky Aligheri, SpBTKV (K), dr,
FIHA, FICA arherosclerotic
deasease, Abnorman findings on
diagnostic imaging of heart and
coronary circulation
3 . Ny. IR Kristina/ Dicky Armein
Hanafi, dr. SpJP- FIHA, FAsCC /
Atrial Septal Defect
PARTMENT
1. Ny.dr. Hafizah/dr.Chamim,
SpOG/Rencana Laparascopy
2. Ny.Mela / dr.Chamim,
SpOG/Rencana Laparascopy HS, +
Kistektomi
3. Tn. FARISAN ADLAN
HAMIDI /Nenfiati, dr.SpPD-KEMD /
Dengue haemorrhagic fever
4. Tn. BENNY JOHANNES
HENDRY SALIM / Denio A. Ridjab,
dr. SpJP – FIHA / Atherosclerotic
heart disease
PASIEN OBSERVASI :
1.Ny.Ajeng/dr. Amanda, Sp.PD-
KGEH/Fever
2.Tn.Dharma/dr. Amanda, Sp.PD-
KGEH/Fever
HIDAYATURRAHMAH /
Nugroho Kampono,Prof. dr.
SpOG (K) Onk / Other and
unspecified ovarian cysts
SpOG/Rencana Laparascopy HS,
+ Kistektomi
HAMIDI /Nenfiati, dr.SpPD-
KEMD / Dengue haemorrhagic
fever
HENDRY SALIM / Denio A.
Ridjab, dr. SpJP – FIHA /
PASIEN PINDAH ICU :
7 PASIEN RENCANA MASUK :
RENCANA TINDAKAN
SpOG/Rencana Laparascopy tgl
22/01/2022 jam 7.00 (Kamar 518)
Kistektomi 22/01/2022 siang jam
12.00 (Kamar 503)
HENDRY SALIM / Denio A. Ridjab,
dr. SpJP – FIHA / Atherosclerotic
heart disease R/Tindakan Besok
CAG jam 8.00 22/01/2022
PASIEN PULANG :
1. Ny.Adrien/dr. Uf,
Sp.OG/Nausea & Vomitting,
Supervision Normal Pragnancy,
Diarrhea
2. Ny.Adhella/dr. Alvin Nursalim,
Sp.PD + dr Nisa Fatoni/
Secondary Hypertension
TMENT
1.Ny. Santia / Dr. Noela sp.OG

/Post SC
2.Ny. Mira Febrina/ dr. Nissa
Fathoni SpoG/ Post SC
3.Ny.Lim Bie Hwa / Suko
Adiarto, dr. SpJP (K),FIHA,,
FICA, FAsCC, PhD / Thoracic
aortic aneurysm
PASIEN OBSERVASI :
1.An. Muhammad Hanif Faizan/

Tartila, dr. Sp.A/ Acute amoebic
dysentery
2.An.Raysharyki/Nina Dwi Putri, dr.
Sp.A (K)/Viral and other specified
intestinal infections
3.Ny Dina Komalasari/dr Alvin
Nursalim/ Sepsis (Pindahan dari
ICU).
4.Ny. Dewi / Nisa Fathoni, dr. Sp.
OG, IBCLC / Grand mal seizures,
unspecified (with or without petit
mal), Eclampsia in the puerperium
5.An. Jihane / Annisa Nur Aini, dr.
Sp.A (FT) / Dengue fever [classical
dengue]
6.Ny. Santia / Dr. Noela sp.OG /Post
SC
SpJP (K),FIHA,, FICA, FAsCC,
PhD / Thoracic aortic aneurysm
10
PASIEN PINDAH ICU :
10
RENCANA TINDAKAN
PASIEN DI VK
PASIEN PULANG
1.An. Clemira Arza Lavanya/

Tartila, dr. Sp.A/ Dengue fever
Nugroho Kampono/ Supervision
of normal pregnancy
3.Ny. Mestika / Ardiansjah Dara
Sjahruddin, dr. Sp.OG /
Supervision of other normal
pregnancy
RENCANA MASUK :
1. Ny. Patricia Gabriella/ Prof. dr.

Nugroho Kampono/ Supervision
of normal pregnancy
2. An. Clemira Arza Lavanya/
Tartila, dr. Sp.A/ Dengue fever
ATER
1. MIRA FEBRINA / BEDAH
OBGYN - Sectio Caesaria / OK 1 jam
07.21 wib / Nisa Fathoni, dr. Sp. OG,
IBCLC
2. ANNISA NAHDAH
HIDAYATURRAHMAH / BEDAH
OBGYN - Cystectomy / OK 1 jam
3 09.00 wib /Nugroho Kampono,Prof.
dr. SpOG (K) Onk
3. SHANTIA PARDILES /
BEDAH OBGYN - Sectio Caesaria /
OK 1 jam 13.00 wib / Fransisca
Noela RMH, dr. Sp.OG
RENCANA TINDAKAN : 22.01.22

1. HAFIZA FATHAN / BEDAH
OBGYN - Laparoscopy Surgery
(Cystectomy, Adnectomy,
Salphingectomy) / OK 1jam 07.00
wib / Chamim,DR. dr, SpOG (K) Onk
2. FAJAR AHMAD / BEDAH
UMUM - Eksisi + Biopsi / OK 1 jam
09.00 wib / Bob Andinata, dr.
4 Sp.B(K)Onk
3. MELA SYINTIA / BEDAH
OBGYN - Hysterectomy Laparoscopy
/ OK 1 jam 12.00 wib / Chamim,DR.
dr, SpOG (K) Onk 4. NILA
RAHMAWATI / BEDAH OBGYN -
Sectio Caesaria / OK 1 jam 16.00
wib / N.B. Donny A.M, dr. Sp.OG
RE
1. Tn . Sju Thong Kwang /69 thn/

Dx. Post Aorta Abdominal Repair /
Dpjp. dr. Daw, Sp. JP + dr. Dafsah,
Sp. JP ==> Kamis 20.01.22 Post Re-
laparotomi thrombectomy / dr.
DAW / 13.00-17.30 (Hybrid)
pasien VT dengan nadi
cardioversi 3x, RJP 30 menit, no
respone. EKG flat. Ps Dinyatakan
meninggal + jam 21.00 wib oleh Dr
Riski didepan keluarga. Keluarga
menerima dengan sedih
Permasalahan : Tn Sju Tong
Kwang, meninggal jam 21.00
wib. Total biaya selama
+ perawatan Rp 390.
457.143 - Sudah deposit Rp 50
juta. Keluarga meminta
keringanan biaya dll -
akhirnya jam 03.00
menambah deposit sebesar Rp
280 juta ( Total Rp 330 juta )
kurang Rp 60.457.143.
Keluarga akan melunasinya
setelah mendapatkan
kepastian diskon dari harga
total perawatan, tindakan
operasi dll dari pihak
manajemen RS BRawijaya.
0
30,P-max 20 FREK 10, FIO2 21%
(Pasien NICU)
0
1
PASIEN OBSERVASI :
RENCANA TINDAKAN :
0
1. Ny. Nila / dr doni spog /
G2P1A0 hamil 38 minggu pro sc
a.i BSC 1X + APS
PASIEN PONEK :
1. 602 bed A/ Ny. Dina/dr.Alvin

Sp. PD + dr. Nisa Sp. Og/
G1P0A0 hamil 23 minggu/obs
DJJ per shift
1 2. Ny. Adrien/ dr. Uf bagazi,spog/
G2P1A0 hamil 34 minggu 3 hari
dengan nausea vomiting. CTG per
hari--> pulang
PASIEN OBSERVASI :
1.By.Chintya Hayubi/dr.Keumala
Sp.A/ NCB SMK usia 2 hari
2.By. Ny. Okky Puspitasari/dr.
Keumala Sp.A/NCB SMK usia 1
hari
3. By. Mira/ dr.Keumala Sp.A/
4 NCB SMK usia 1 hari
4. By.Ny.Shanita/ dr.Mira Sp.A/
NCB SMK usia 1 hari
4
PASIEN PULANG
NOTED
NY. Chintya Hayubi/dr. Keumala

Sp.A/NCB SMK usia 2hari--
>pindah ke NICU 20/01/2022 jam
20.00. -->21/01/2022 jam 09.40
Tiba di Nursery untuk Rooming In
dengan Ibu.
Y
CATHLAB
Schedule : -
Non Schedule : -
HYBRID OR
Schedule : -
Non Schedule :
Others : -
Problem : -
Overtime staf :
Staff sakit : -
Staff cuti : -
Next Schedule
Sat, 22 jan
1. Benny / cag ptca / dr. Denio / 08.00 /
cathlab
2022
Outpatient : 17
dr ario :
Dr dafsah :
dr denio :4
dr faris : 5
17 dr DH : 3
dr DAW :
dr radityo :
Dr suko :
dr sunu :
dr Adi : 5
MCU :
New patient: 6
Dr. Faris : 1 website, 1 dari keluarga
Dr. Dicky Hanafy : 1 dari keluarga, 1
dari website
Dr Adisaputra : 1 pasien dr. Adi di
PIK
Dr Denio : 1 dari dr. Anton Ojong
SpOK
Cancel: 5
melakukan
ECHO :
Stress Echo :
USG Doppler : 2
Holter :
Ezypro :
ECG :8
Treadmill : 1
CT Scan :
Speckle :
TEE :
DSE :
ABI :
Advance Echo : 1
Handle echo :
ABPM : 1
Tilt Table Test :
Paket PJB :
Cardioversi :
Refferal RS luar : dr. Anton Ojong
dr Megawati
dr Nesya + dr Ira
SIC (CAROL) Sabtu, 22.01.22
TIPE PASIEN
YANG DINAS
LT NAMA UNIT
EMERGENCY ROOM
Dr Dwi dr
Dr Dwi Ns
EMERGENCY Hanif Ns DrKelvin
Hanif Ns
ROOM
Susi Ns
Ardhi Ns
Ns 18
Fitri Nur
Sanusi
GF
GF
Bd Tries Bd Dilla
PONEK Bd Dewi
Bd Viky Bd Genda
5
TOTAL PASIEN EMG
Poli Obgyn
Ns NS 1 :
Poli Urology IIN
Poli Ortho
Poli Internist
Poli Bedah Umum
Poli Bedah Plastik
Ns NS 2 :
Kiki
NS 2 :
Poli THT Kiki
Poli Gizi
Poli bedah saraf
Poli Neuro
Dermis
LT 3 Dental
Poli Endoscopy
Poli Fisioterapi
Poli Rehab Medik
Poli Nutrition
Poli Paru
Poli Mata
Poli Psikiatri
Pain Clinic
MCU
POLI KEMOTERAPI
ODC
TOTAL PASIEN OPD
IN PATIENT Ns Nurul Ns Ns Citra Ns Taufk

IN PATIENT Ns Nurul Ns Ns Citra Ns Taufk
LT 4 LT 5
LT 4 LT 5
IN PATIENT Ns Ana Ns Tita Ns Ns Tari

DEPARTMENT 5 Ns Yudi Febrio Ns Malik 8
IN PATIENT Ns Dini Ns Risha Ns Kristin

LT 6 DEPARTMENT 6 Ns Indah Ns Nadia Ns Silvi
9
IN PATIENT Ns Dini Ns Risha Ns Kristin
LT 6 DEPARTMENT 6 Ns Indah Ns Nadia Ns Silvi
9
Kemoterapi
OPERATING THEATER
Ns Snandar
OK Ns Heryanti
CRITICAL CARE
ICU Ns Awaludin Ns Gisma Ns Esti P
HCU
NICU
Ns Esti Ns Ayu Ns Grace
PICU
TOTAL Ps CRITICAL
OBSTETRICS
Bd Tries Bd Dilla
VK Bd Dewi
Bd Viky Bd Genda
Ns Wiwi
Nursery Ns Nni Ns Ika Ns Nely
(MD)
HEARTOLOGY
Ns Akbar
Cathlab Ns Tryanto
Hybrid
Ns Rini T
OPD JANTUNG
Ns Ema
19
LT 8
LT 8
Dokter Jaga
Dokter Jaga IGD : Pagi : dr Dwi Malam : dr Hanif
Dokter Jaga IPD : Pagi : dr Yuanitha Malam : dr Mega + dr Tinda
Dokter Jaga Critical : Pagi : dr Riri Malam : dr Dewi

KETERANGAN
TOTAL
PASIEN
OM
PASIEN OBSERVASI :
1. Ny Chinthia Perdana / 27 thn

/ISPA, Epistaksis
2. By Ny Hertina / 0 thn / BAB
ada darah
RAJAL :
1. Tn Sabeth Uttara / 31 thn / Renal
Colik, LBP, Dyspepsia
2. An Rania Alisshandra / 11 thn /
Pro vaksin sinovac ke 2 / dr Nisa SpA
3. Ny Alfa Dea / 27 thn / Pro poli

bedah mulut ( Minta surat rujukan )
4. Ny Anie Christina / 31 thn / obsv
Febris H1
5. An Christine Hesly / Diare 9x
H1 6. An Keanu Adam / 7 thn /
ISPA 7. An Mikael hudaa / 2 thn /
Pain Unspesifik ec terjatuh dari tangga
8. Tn Faisal Bagus / 27 thn / Pro
Poli kulit ec kel gatal gatal di kedua
kaki 9. Ny M Khoirun najib / 26 thn /
Dyspepsia
10. Ny Ruth Lydia / 26 thn / Pro
konsul poli obgyn
11. Tn Nur saleh / 43 thn /Batuk
18 batuk sudah 10 hr
12. An Kyla Parisa / 5 thn / Obsv
Febris H 1
13. Nn Thalia Nauli 25 thn /
Perdarahan pasca coitus 5 jam SMRS
14.
Nn Frisilia Orien / 24 thn / Dyspepsia
RANAP :
1. Ny Lulu Jannah / 42 thn / Renal
Colik/ nyeri pinggang kiri H1
2. Ny Eni
Yulianti / 64 thn / Obsv Febris H 1
/ Dr Alvin SpPd / Rawat 617
RUJUK :
APS :
D.O.A :
RAJAL :
1. Ny Indri Ersela / 27 thn / H 31

mg / Supervision of normal
pregnancy / dr Nisa SPOG / Pro inj
Venofer (I) 2.
Ny Nafila / 28 thn / Supervision of
normal pregnancy /Keluar caira
kuning dari jalan lahir / dr Nisa
SPOG 3. Ny Febria
Ningsih /32 thn /Hamil 33 mg /Pro
inj Venofer ec Anemia
5
4. Ny Dhea Audrey /26
thn / Hamil 31 mg / pro inj
Venofer
RANAP :
1. Ny Arum mayangsari / 29 thn /

Supervision of normal pregnancy /
dr Nisa SPOG
PASIEN OBSERVASI :
23
34 Shcedule tindakan endoskopi :
1. Tn. DUDDY SUHADI, 46th,

8 diagnosa : hematochezia,
5 rencana tindakan LIGASI
4 HEMORROID
Sabtu, 22 Januari 2022, pkl
1
amanda pitarini, SpPD-KGEH. (
Pasien RANAP)
diagnosa : hematochezia,
rencana tindakan LIGASI
HEMORROID
Sabtu, 22 Januari 2022, pkl
amanda pitarini, SpPD-KGEH. (
Pasien RANAP)
4
4
7
19
10
11
3
70
5
7
196
MENT
1.Ny. Lulu IL Jannah/ Endrika

Noviandrini, dr. Sp.U/Unspecified
renal colic
PASIEN OBSERVASI :
8
1. Ny. Daronah/ Indah Gianawati, dr.
2. Tn. Yohanes Julius / Alvin
Nursalim, dr. Sp.PD / Dengue fever,
Dyspepsia
3. An. Ilham / dr. Annisa,Sp.A /
4. An. Kelana /dr. Annisa,Sp.A /
5. Tn. Oesman/ Nenfiati, dr.SpPD-
diabetes mellitus
6. Ny. Lulu IL Jannah/ Endrika
Noviandrini, dr. Sp.U/Unspecified
renal colic
7. Ny. Novrika/Zicky Yombana, dr.
disc disorders
8. Tn. Duddy/ Amanda Pitarini
haemorrhoids
8
PASIEN PINDAH ICU :
RENCANA TINDAKAN :
RENCANA PULANG :
1. Ny. Daronah/ Indah Gianawati,

dr. Sp.PD/ Benign paroxysmal
vertigo
PASEN APS :
PASIEN PULANG :
1.Ny. Risti Pramita / Alvin

Nursalim, dr. Sp.PD / Dyspepsia,
Fever, unspecified
PARTMENT
1. Ny. ENNY YULIATI S / Alvin
Nursalim, dr. Sp.PD / -Fever,
unspecified (Utama), NIDDM
PASIEN OBSERVASI :
KGEH/Fever
2.Tn.Dharma/dr. Amanda, Sp.PD-
KGEH/Fever
HIDAYATURRAHMAH /
Nugroho Kampono,Prof. dr. SpOG
(K) Onk / Other and unspecified
ovarian cysts
Kistektomi
HAMIDI /Nenfiati, dr.SpPD-
KEMD / Dengue haemorrhagic
fever
8. Ny. ENNY YULIATI S / Alvin
Nursalim, dr. Sp.PD / -Fever,
unspecified (Utama)
- R50.9 Fever, unspecified
(Utama)
- Non-insulin-dependent diabetes
mellitus (Tambahan)
- Vascular dementia (Tambahan)
- Essential (primary) hypertension
(Tambahan)
- Atrial fibrillation and flutter
(Tambahan)
- Cerebral infarction due to
thrombosis of cerebral
PASIEN PINDAH ICUarteries
:
8 RENCANA TINDAKAN
PASIEN PULANG :

HIDAYATURRAHMAH /
Nugroho Kampono,Prof. dr. SpOG
(K) Onk / Other and unspecified
ovarian cys
MENT
1.Ny. Arum Mayangsari/Nisa

Fathoni, dr. Sp. OG, IBCLC/ post
Sc G1P0A0 Hamil 38 mingg
2.Ny. Nila Rahmawati/ Nisa
Fathoni, dr. Sp. OG, IBCLC/ Post
Tindakan SC P2A0 Erasc G2P1
hamil 38 minggu
PASIEN OBSERVASI :
1. Ny. Arum Mayangsari/Nisa

Fathoni, dr. Sp. OG, IBCLC/ post Sc
G1P0A0 Hamil 38 mingg
2. Ny. Nila Rahmawati/ Nisa Fathoni,
dr. Sp. OG, IBCLC/ Post Tindakan SC
P2A0 Erasc G2P1 hamil 38 minggu
3. Ny. Dewi / Nisa Fathoni, dr. Sp.
OG, IBCLC / Grand mal seizures,
unspecified (with or without petit
mal), Eclampsia in the puerperium
4. An. Jihane / Annisa Nur Aini, dr.
dengue]
5. Ny.Lim Bie Hwa / Suko Adiarto, dr.
6. Chinta hayubi/ dr. Dara, Sp.OG
/Post SC P1AO + myomektomi
PASIEN PINDAH ICU :
9
RENCANA TINDAKAN
9
PASIEN DI VK
PASIEN PULANG
1. An. Muhammad Hanif Faizan/

Tartila, dr. Sp.A/ Acute amoebic
dysentery
2. An.Raysharyki/Nina Dwi Putri,
dr. Sp.A (K)/Viral and other
specified intestinal infections
3. Ny Dina Komalasari/dr Alvin
Nursalim/ Sepsis (Pindahan dari
ICU).
RENCANA MASUK :
1. Ny. Okky puspitasari/ Nisa

partus Hamil G1P0A0 hamil 40
minggu
2. Ny. Shantia / Dr. Noela
sp.OG /Post SC
3. Ny Mira Febrina/ Nisa Fathoni,
dr. Sp. OG, IBCLC/ post Sc P1A0
TER
1. HAFIZA FATHAN / BEDAH
OBGYN - Laparoscopy Surgery
(Cystectomy, Adnectomy,
Salphingectomy) / OK 1jam 07.00 wib
/ Chamim,DR. dr, SpOG (K) Onk
2. MELA
3 SYINTIA / BEDAH OBGYN -
Hysterectomy Laparoscopy / OK 1
jam 12.00 wib / Chamim,DR. dr,
SpOG (K) Onk 3. NILA
RAHMAWATI / BEDAH OBGYN -
Sectio Caesaria / OK 1 jam 16.00
wib / N.B. Donny A.M, dr. Sp.OG
1 8,5 cm tersambung Ventilator Mode
30,P-max 20 FREK 10, FIO2 21%
(Pasien NICU)
0
1
PASIEN OBSERVASI :
1. Ny arum/ dr nisa spog/ G1P0A0

hamil 38minggu inpartu --> SC
cito a.i kpd+aps
1
RENCANA TINDAKAN :
PASIEN PONEK :
1. Ny arum/ dr nisa spog/ G1P0A0
hamil 38minggu inpartu
2. Ny chyntia/ dr sang spog/
G1P0A0 hamil 34 minggu dengan
3 PCR positif --> Rujuk
3. Ny nafila/ dr nisa spog/ G1P0A0
hamil 38minggu+2 hari dengan
ISPA --> pulang
1. 602 bed A/ Ny. Dina/dr.Alvin

Sp. PD + dr. Nisa Sp. Og/ G1P0A0
hamil 23 minggu/obs DJJ per shift
--> pulang
PASIEN OBSERVASI :
1.By. Ny Chintya Hayubi
/dr.Keumala Sp.A/ NCB SMK usia
2 hari
2.By. Ny. Okky Puspitasari/dr.
Keumala Sp.A/NCB SMK usia 2
hari
3. By. Mira/ dr.Keumala Sp.A/
5 NCB SMK usia 1 hari
4. By.Ny.Shanita/ dr.Mira Sp.A/
NCB SMK usia 1 hari
5.By. Ny nila / dr. Nathalia
sp.A /NCB SMK usia 5 jam
PASIEN PULANG
NOTED
NY. Chintya Hayubi/dr. Keumala

Sp.A/NCB SMK usia 2hari--
>pindah ke NICU 20/01/2022 jam
20.00. -->21/01/2022 jam 09.40
Tiba di Nursery untuk Rooming In
dengan Ibu.
CATHLAB
Schedule : -
1 Non Schedule : -
1. Benny / cag ptca / dr. Denio /
08.00 / cathlab
HYBRID OR
Schedule : -
Non Schedule :
Others : -
Problem : -
Overtime staf :
Staff sakit : -
Staff cuti : -
Next Schedule :
Outpatient : 19
dr ario :
Dr dafsah : 2
dr denio :
dr faris :
19 dr DH : 4
dr DAW :
dr radityo :
Dr suko : 7
dr sunu : 6
dr Adi :
MCU : -
New patient: 10
dr Dafsah 2 : 1 dari teman. 1 website
dr Sunu 2 :. 1 pasien lama dr ario di
harkit 1 pasien lama dr sunu di harkit
dr Suko 4 : 1 PB dari dr Herman
medco energi 2 dari dr chamim 1 dari
dokter di JEC
dr DH 2 : 1 pasien lama dr Dian SpKJ
RSBS, 1 dari website
Cancel : 9
dr. Suko : 3
dr. Dicky Hanafy : 4
dr. Dafsah : 2

melakukan
ECHO :
Stress Echo :
USG Doppler :
Holter : 1
ECG : 15
Treadmill : 2
CT Scan
Speckle
TEE :
DSE :
ABI :
Tilt Table Test :
Advance Echo : 2
Handle Echo :
ABPM : 1
Ezypro :
Cardioversi :
Referral Brawijaya : dr Chamim , dr

Dian SpKJ
Referral External : dr Herman medco
energi dan dokter JEC
Info dokter tidak hadir : dr Ario sakit

dr Mega + dr Tinda
SIC (EKO) Minggu, 23.01.22
TIPE PASIEN
YANG DINAS
LT NAMA UNIT
EMERGENCY ROOM
dr. Audrey, dr. Dwi, Ns.

EMERGENCY Ns.Sanusi,
Br. Mohlis, Ardi, Ns.
ROOM Ns. Rizam
Zr. Fitri
Kelvin
GF
PONEK
GF
PONEK
TOTAL PASIEN EMG
Poli Obgyn
Ns NS 1 :
Poli Urology IIN
Poli Ortho
Poli Internist
Poli Bedah Umum
Poli Bedah Plastik
Poli THT Kiki
Poli Gizi
Poli bedah saraf
Poli Neuro
Dermis
LT 3 Dental
Poli Endoscopy
Poli Fisioterapi
Poli Rehab Medik
Poli Nutrition
Poli Paru
Poli Mata
Poli Psikiatri
Pain Clinic
MCU
POLI KEMOTERAPI
ODC
TOTAL PASIEN OPD
DS = Ns.
DP = Ns. Salwa
DM = Ns.
IN PATIENT Salwa + Ns. (Lembur) +
Citra + Br.
DEPARTMENT 4 Ella Ns. Ella
Abdi
(Lembur)
LT 4
LT 5 IN PATIENT DEPARTMENT
DP = Ns. DS = Ns.
DM = Ns.
IN PATIENT Tita + Ns. Tita + Br.
Tary + Br.
DEPARTMENT 5 Santi Yudi
Rio
DS = Ns.
DP = Ns. DM = Ns.
Avi + Ns.
IN PATIENT Devi + Ns.
LT 6 DEPARTMENT 6 Nadia
Nadia Rizha +
(Lembur) Ns. Silvi
DS = Ns.
DP = Ns. DM = Ns.
Avi + Ns.
IN PATIENT Devi + Ns.
LT 6 DEPARTMENT 6 Nadia
Nadia Rizha +
(Lembur) Ns. Silvi
Kemoterapi
OPERATING THEATER
OK
CRITICAL CARE
ICU
HCU
NICU
PICU
TOTAL Ps CRITICAL
OBSTETRICS

‌Dines Pagi:
Putri bd. Malam : bd.
VK bd. Ningsih,
Anggi Tries, bd.
‌Dines
Viki
‌ ines Pagi:
D
Ns.Inggrid ‌Dines
‌Dines
Dinas Siang : Ns.
Nursery middle : Ika
Malam :
Ns. Wiwi
Ns.Nani
HEARTOLOGY
Cathlab
Hybrid
LT 8
OPD JANTUNG
Dokter Jaga
Dokter Jaga IPD : Pagi : dr Nesya Malam : dr Yunitha
Dokter Jaga Critical : Pagi : dr Dewi Malam : dr Riri

KETERANGAN
TOTAL (Pasien baru Ranap/Pasien
PASIEN perhatian/critical/Kemo/transfusi, Pasien Risiko/Komplen,
NCY ROOM
PASIEN OBSERVASI :
RAJAL :
1. Azima Najwa /4th 7bln/ Dx. ISPA
2. Nn. Naila Innaya /17th/ Dx. Acute
nasopharyngitis
3. By. Oliver Mars /6bln 6hri/ Dx. Fever
4. Tn. Gusti Wibawa /43th/ Dx. Diarrhea
5. Tn. Daniel Eliezer /31th/ Dx. Fever
6. By. Alinka Gya Namira /5bln/ Dx. Fever
7. An. Omar Aulia /2th 6bln/ Dx. Cidera Kepala
Ringan
8. An. Anela Shafira /5th 7bln/ Dx. Open wound
9. Ny. Dewi Andriani /25th/ Dx. Epistaxis +
G1P0A0 Hamil 27 minggu
10. Ny. Sofie Maulani /26th/ Dx. Fever
11. By. Khalid Rafify /1th/ Dx. Sprain and strain of
14 wrist
12. An. Rashya Khalifi /6th/ Dx. Nausea and
vomiting / Dpjp. Annisa Nur Aini, dr. Sp.A (FT)
13. Tn. Febri Irawab /29th/ Dx. Fever
RANAP :
1. Tn. Nasrulla /58th/ Dx. Inguinal hernia /
Dpjp. Perwira Widianto, dr. Sp.B-KBD
RUJUK :
APS :
D.O.A :
RAJAL :
2
1. Ny. Keiva Ribby /25th/ Dx. G1P0A0 H 35
mgg 4 hari Janin tunggal hidup intrauterin / Kel.
keluar air air sejak tadi pagi, lendir darah tidak
ada, mules tidak ada => ku baik, kes cm DJJ :
148x/m HIS : belum ada CTG : reaktif kategori
1 VT : tdk dilakukan Lakmus tidak berubah
warna (Pulang & Resep +)
RANAP :
2 1. Ny. Mutia Ramadhani /26th/ Dx. G1P0A0
Hamil 39minggu + Kala 1 fase laten + JPKTH /
Dpjp. dr. Nisa Fathoni, dr. Sp. OG, IBCLC /
Kel. keluar lendir darah sejak pagi, semakin
banyak dimalam hari per vaginam disertai
mules teratur / Instruksi Dpjp. Observasi His
DJJ - CTG dan VT / 6 jam - Pantau
kemajuan persalinan => PCR Ngatif
Tranfser VK
PASIEN OBSERVASI :
16 Pasien
6
6 Pasien
1.Tn. Nasrullah/ Perwira Widianto, dr.

Sp.B-KBD/Inguinal hernia
PASIEN OBSERVASI :
1. Tn. Nasrullah/ Perwira Widianto, dr.
2. Ny. Lulu IL Jannah/ Endrika Noviandrini, dr.
Sp.U/Unspecified renal colic
3. Ny. Novrika/Zicky Yombana, dr. Sp.S/Lumbar
and other intervertebral disc disorders
4. Tn. Oesman/ Nenfiati, dr.SpPD-KEMD/Non-
5. Tn. Yohanes Julius / Alvin Nursalim, dr. Sp.PD /
Dengue fever, Dyspepsia
PASIEN PINDAH ICU :
RENCANA TINDAKAN :
1.Ny. Novrika/Zicky Yombana, dr. Sp.S/Lumbar and
other intervertebral disc disorders / Rencana tindakan
5 EMG tgl 24/01/2022 jam 10.00 wib, SIO (+) ACC
(+) -> Terinfo FL Ami.
RENCANA PULANG :
1.Ny. Lulu IL Jannah/ Endrika Noviandrini, dr.
Sp.U/Unspecified renal colic
Sp.S/Lumbar and other intervertebral disc
disorders
PASEN APS :
PASIEN PULANG :
1.Ny. Daronah/ Indah Gianawati, dr. Sp.PD/
Benign paroxysmal vertigo
2.An. Ilham / dr. Annisa,Sp.A / Dengue fever
3.An. Kelana /dr. Annisa,Sp.A / Dengue fever
4.Tn. Duddy/ Amanda Pitarini Utari,dr, SpPD-
KGEH/Internal haemorrhoids
PASIEN OBSERVASI :
1.Tn.Dharma/dr. Amanda, Sp.PD-KGEH/ DHF

H5
2.Ny.Mela / dr.Chamim, SpOG/Post
Laparascopy HS, + Kistektomi a/i adenomioma
4
3.Tn. Farisan Adlan Hamidi /Nenfiati, dr.SpPD-
KEMD / Dengue haemorrhagic fever
4.Ny. Enny Yuliati S / Alvin Nursalim, dr.
Sp.PD / Fever, DM, HT, AF, Celebral Infarction
PASIEN PINDAH ICU :

1.Tn. Zainal/ dr. Faris / Rencana CAG PTCA
simple 1 stand
RENCANA TINDAKAN
1.Ny. Enny Yuliati S / Alvin Nursalim, dr. Sp.PD /
Fever, DM, HT, AF, Celebral Infarction/ Rencana
USG bedside, tanggal 24/1/2022, Jam 13.00 dan
Rencana Echo
PASIEN PULANG :
1.Ny. Annisa Nahdah Hidayaturrahmah/
Nugroho Kampono,Prof. dr. SpOG (K) Onk /
Post Kistektomi
2.Ny.dr. Hafizah/dr.Chamim, SpOG/Post
Laparascopy
3.Ny.Ajeng/dr. Amanda, Sp.PD-KGEH/Fever
4.Tn. Benny Johannes Hendry Salim / Denio A.
Ridjab, dr. SpJP – FIHA / Post CAG dengan
PTCAD 2 stend
1. An.Rasyha Khalifi/Annisa Nur Aini, dr. Sp.A

(FT)/ nausea and fomiting
PASIEN OBSERVASI :
1. Ny. Arum Mayangsari/Nisa Fathoni, dr. Sp. OG,

IBCLC/ post Sc G1P0A0 Hamil 38 mingg
2. Ny. Nila Rahmawati/ N.B. Donny A.M, dr. Sp.OG
/ Post Tindakan SC P2A0 Erasc G2P1 hamil 38
minggu
4. An. Jihane / Annisa Nur Aini, dr. Sp.A (FT) /
5. Ny.Lim Bie Hwa / Suko Adiarto, dr. SpJP
aneurysm
6. An.Rasyha Khalifi/Annisa Nur Aini, dr. Sp.A
(FT)/ nausea and fomiting
PASIEN PINDAH ICU :
RENCANA TINDAKAN
6 PASIEN DI VK
PASIEN PULANG
6
1. Ny. Chinta hayubi/ dr. Dara, Sp.OG /Post SC

P1AO + myomektomi
2. Ny. Okky puspitasari/ Nisa Fathoni, dr. Sp.
OG, IBCLC/ post partus Hamil G1P0A0 hamil
40 mingg
3. Ny. Shantia / Dr. Noela sp.OG /Post SC
4. Ny Mira Febrina/ Nisa Fathoni, dr. Sp. OG,
IBCLC/ post Sc P1A0
RENCANA MASUK :

IBCLC / Grand mal seizures, unspecified (with
or without petit mal), Eclampsia in the
puerperiu
2. Ny. Nila Rahmawati/ N.B. Donny A.M, dr.
Sp.OG / Post Tindakan SC P2A0 Erasc G2P1
hamil 38 minggu
G THEATER
AL CARE
0
0
1. By Ny Devi Maryani / Dx.Achondroplasia / Usia
45 hr, Hari Rawat ke 42/ Dr Erick Gultom SpA ,
1 Terpasang ETT ukuran 3,5 kedalaman 8,5 cm
(Pasien NICU)
0
1 Pasien
PASIEN OBSERVASI :
1. Ny mutia /dr nisa spog / G1P0A0 hamil 39
minggu 1 hari. Inpartu
1
RENCANA TINDAKAN :
PASIEN PONEK :
1. Ny. Keiva Rubby / G1 H35mnggu / dr. Nisa
Sp. Og/ keluhan keluar air", pemberian Fenover,
Ctg Reactif, floor Albus (+), cek lakmus (-) ->
pulang
3 2. Ny. Dewi Andriani / G1 27mg / dr. Nisa Sp.
Og / -> pulang
3. Ny mutia /dr nisa spog / G1P0A0 hamil 39
minggu 1 hari. Inpartu
PASIEN OBSERVASI :
1.By. Ny. Nila Rahmawati/dr.Nathalia
Sp.A/NCB SMK usia 1 hari.
2. By.Ny. Arum mayangsari/dr.Nina Sp.A/NCB
2 SMK usia 1 hari.
PASIEN PULANG
NOTED
OLOGY
dr Yunitha
SIC (EKO) Senin, 24.01.22
TIPE PASIEN
YANG DINAS
LT NAMA UNIT
EMERGENCY ROOM
dr. Fajar,
EMERGENCY
Ns. Susi, Br.
ROOM Mohlis
GF
dr. Fajar,
EMERGENCY
Ns. Susi, Br.
ROOM Mohlis
GF
PONEK
TOTAL PASIEN EMG

Poli Obgyn
Ns NS 1 :
Poli Urology IIN
Poli Ortho
Poli Internist
Poli Bedah Umum
Poli Bedah Plastik
Poli THT Kiki
Poli Gizi
Poli bedah saraf
Poli Neuro
Dermis
LT 3 Dental
Poli Endoscopy
Poli Fisioterapi
Poli Rehab Medik
Poli Nutrition
Poli Paru
Poli Mata
Poli Psikiatri
Pain Clinic
MCU
POLI KEMOTERAPI
ODC
TOTAL PASIEN OPD
DP = Ns. DS = Ns.
DM = Br.
IN PATIENT Salwa + Ns. Wulan +
Abdi + Ns.
DEPARTMENT 4 Nurul Ns. Ella
Citra
Citra
LT 4
LT 5
DP = Ns. DS = Ns.
DM = Ns.
Anatian + Indah + Br.
Tita + Br.
Ns. Santi Yudi
Rio
IN PATIENT
DEPARTMENT 5
IN PATIENT Devi + Ns. Avi + Ns.
LT 6 DEPARTMENT 6 Dini Nadia
Risha +
Ns. Nela
Kemoterapi
OPERATING THEATER
OK
CRITICAL CARE
ICU
HCU
NICU
PICU
TOTAL Ps CRITICAL
OBSTETRICS
‌Dines
‌Dines
‌Dines Pagi: Siang :
Malam : bd.
VK bd ningsih bd.dilla bd.
Genda, bd
Anggi
putri
‌Dines Pagi: Siang : Ns. ‌Dines
Nursery Ns.Nani Inggrid Malam :
‌Dines Ns. Nelly
HEARTOLOGY
Cathlab
Hybrid
OPD JANTUNG
LT 8
Dokter Jaga
Dokter Jaga IGD : Pagi : dr dr. Fajar Malam : dr Audrey
Dokter Jaga IPD : Pagi : dr Malam : dr Megawati
Dokter Jaga Critical : Pagi : dr Mutiara Malam : dr Rizky

KETERANGAN
TOTAL
PASIEN
CY ROOM
PASIEN OBSERVASI :
RAJAL :
1. Tn. Donny David /29th/ Dx. Dyspepsia
2. An. Chatisya Mayzurra /10th/ Dx. Dyspepsia
3. Ny.
Rindayu Paramita / 25th/ Dx. Fever 4. Tn.
Miftahul Ulum /29th/ Dx. Tear of meniscus
5. Ny.
Fatimah /34th/ Dx. Ca placenta 6. Ny.
Novani Citra /40th/ Dx. Dyspepsia 7. An.
Avianti Zahira /2th 5bln/ Dx. Fevbris H ke 3
8. Ny.
Ayu Pawestri /40th/ Dx. vulnus ekskoriasi
multiple 9. Ny.
Yovita Putri /29th/ Dx. Dyspepsia 10. Tn.
Faiq Bahwal /45th/ Dx. Klavus
11. Ny. Shara Savilla /29th/ Dx. ISPA
12. Ny. Siti Rizki /34th/ Dx. Chek Up
13. Tn. M. Hisbullah /30th/ Dx. Dyspepsia
14. Nn. Keisya Nafaa /19th/ Dx. Dyspepsia
15. Tn. Dwiky /28th/ Dx. Fever
RANAP :
21
Tn. William Tanadi /41th/ Dx. Myasthenia
21 gravis / Dpjp. Zicky Yombana, dr. Sp.S
2. Ny. Hj Susilarti /76th/Dx. Stroke, not
specified as haemorrhage or infarction /
Dpjp. Aldy Novriansyah, dr. Sp.S
3. Ny. Sofie Maulani /26th/ Dx. Fever /
Dpjp. Alvin Nursalim, dr. Sp.PD
4. Nn. Cut Salsabillah /14th/ Dx. Dengue
Fever / Dpjp. Diana Mustika Chandra, dr.
Sp.A 5.
By. Freya Shakila /4bln/ Dx. Nausea and
vomiting + Fever / Dpjp. Diana Mustika
Chandra, dr. Sp.A
6. Tn. Azwir Markatin /83th/ Dx. diabetes
mellitus + Parkinson disease / Dpjp. Zicky
Yombana, dr. Sp.S
RUJUK :
APS :
D.O.A :
RAJAL :
RANAP :
1. Ny. Jocelinda Avelina /29th/ Dx.

G2P1A0 BSC 1x + Makrosomia + HDK dd
PEB + DMG / Dpjp. dr. Nisa Sp.OG /
Rawat VK.
PLANNING
ADVICE :
1 Instruksi dr. Nisa Sp.OG:
- Rencana SC nya dimajukan menjadi hari
ini
- Jika keluarga bersedia langsung PCR
untuk persiapan SC jam 18.00 hari ini
- Asisten SC dr. Sang Sp.OG
- Cek lab persiapan operasi.
PASIEN OBSERVASI :
22 Pasien
38
6
12
2
1
4
9
8
23
125 Pasien

1.Ny. Sofie / dr.Alvin Nursalim Sp.PD / Fever
2.Ny. Ari Fatmawati / dr.Bob Andinata Sp.B (K)
Onk / Malignant neoplasm of breast
3.Ny. Hj Sri / dr.Aldy Sp.S / Stroke, not
specified as haemorrhage or infarction, Essential
(primary) hypertension
4.Ny. Oemiati Wawo / dr.Dicky Hanafy Sp.JP -
FIHA, FAsCC / Sick sinus syndrome, Atrial
fibrillation and flutter
5.Tn. Azwir / dr.Zicky Yombana Sp.S / Non-
insulin-dependent diabetes mellitus, Parkinson
disease, Essential (primary) hypertension
PASIEN OBSERVASI :
1.Ny. Ari Fatmawati / dr.Bob Andinata Sp.B (K)

Onk / Malignant neoplasm of breast
2.Ny. Sofie / dr.Alvin Nursalim Sp.PD / Fever
unspecified
4.Tn. Oesman/ Nenfiati, dr.SpPD-KEMD/Non-

1.Tn. Nasrullah/ Perwira Widianto, dr. Sp.B-
KBD/Inguinal hernia
RENCANA TINDAKAN :
(primary) hypertension / Rencana Tindakan
TCD/CD dengan dr.Arief Rachman Sp.S Hari
selasa atau rabu -> FU jam. KIE (+)
fibrillation and flutter / Rencana Tindakan Pro
PPM Dual chamber Selasa 25/01/2022 jam
19.00. SIO (+)
RENCANA PULANG :
1.Tn. Oesman/ Nenfiati,

dr.SpPD-KEMD/Non-insulin-dependent
diabetes mellitus
PASEN APS :
PASIEN PULANG :
1.Ny. Lulu IL Jannah/ Endrika Noviandrini,

dr. Sp.U/Unspecified renal colic
Sp.S/Lumbar and other intervertebral disc
disorders
1.Tn. William / dr. Zicky, Sp.S / MG

2.An. Radeya / dr. Hamida, Sp.THT /
Mastoiditis
3.Tn. Zainal / dr. Faris, Sp.JP / Post CAG 2 stent
PASIEN OBSERVASI :
1.Tn. Dharma / dr. Amanda, Sp.PD-KGEH/
DHF H6
2.Ny. Mela / dr. Chamim, SpOG/ Post
Laparascopy HS, + Kistektomi a/i
adenomioma
3.Tn. Farisan Adlan Hamidi / dr. Nenfiati,
pPD-KEMD / DHF6
7
4.Ny. Enny Yuliati S / dr. Alvin Nursalim,
Sp.PD / DHF H5
Mastoiditis
7.Tn. Zainal / dr. Faris, Sp.JP / Post CAG 2
stent
PASIEN PINDAH ICU :
RENCANA TINDAKAN
Sp.PD / DHF H5, rencana TCD/CD jika
trombosit naik
Mastoiditis, rencana HRCT mastoid dengan
kontras tgl 25/01/2022 jam 08.00
PASIEN PULANG :
1.Ny. Jocelinda Avelina / Nisa Fathoni, dr.

Sp. OG, IBCLC / P2 Post SC ai BSC 1x
Makrosomia Inpartu
2.Ny. Mutia Ramadhani / Nisa Fathoni, dr.
Sp. OG, IBCLC /P1A0 Post partum
spontan 1 jam
3.An. Cut Salsabilla Hency / Diana Mustika
Chandra, dr. Sp.A /Dengue fever [classical
dengue]
PASIEN OBSERVASI :
1. Ny. Arum Mayangsari/Nisa Fathoni, dr. Sp.

OG, IBCLC/ post Sc G1P0A0 Hamil 38 mingg
2. Ny. Nila Rahmawati/ N.B. Donny A.M, dr.
Sp.OG / Post Tindakan SC P2A0 Erasc G2P1
hamil 38 minggu
4. Ny. Jocelinda Avelina / Nisa Fathoni, dr. Sp.
OG, IBCLC / P2 Post SC ai BSC 1x
Makrosomia Inpartu
5. Ny. Mutia Ramadhani / Nisa Fathoni, dr. Sp.
OG, IBCLC /P1A0 Post partum spontan 1 jam
6. An. Cut Salsabilla Hency / Diana Mustika
dengue]
PASIEN PINDAH ICU :

7
RENCANA TINDAKAN
PASIEN VK
1.Inesiantika Emma Sandhika P / Nisa
Fathoni, dr. Sp. OG, IBCLC / G1P0A0 H 38
mgg 6 hari inpartu kala I fase laten pro
induksi
PASIEN PULANG
1.Ny Mira Febrina/ Nisa Fathoni, dr. Sp.

OG, IBCLC/ post Sc P1A0
aortic aneurysm
3.An. Jihane / Annisa Nur Aini, dr. Sp.A
(FT) / Dengue fever (classical dengue)
4.An.Rasyha Khalifi/Annisa Nur Aini, dr.
Sp.A (FT)/ nausea and fomiting
RENCANA MASUK :

1.Ny. Dewi / Nisa Fathoni, dr. Sp. OG,
IBCLC / Grand mal seizures, unspecified
(with or without petit mal), Eclampsia in the
puerperiu
2.Ny. Nila Rahmawati/ N.B. Donny A.M,
dr. Sp.OG / Post Tindakan SC P2A0 Erasc
G2P1 hamil 38 minggu
THEATER
1. Tindakan senin, 24-01-22
- Laparoscopy Appendictomy + Herniotomy dr
2 Widi a.n Nasrullah
- SC dr Nisa a.n Jocelinda
2. Rencana tindakan selasa, 25-01-22

- SC dr Nisa jam 06.30 a.n
L CARE
1. Tn. Narsrullah /58th/ Dx. Acute
1 Appendicitis + Hernia nguinal / Post
Laparatomy, Apendektomy, Hernioraphy
0
1. 1. By Ny Devi Maryani /
Dx.Achondroplasia / Usia 45 hr, Hari Rawat ke
42/ Dr Erick Gultom SpA , Terpasang ETT
1 ukuran 3,5 kedalaman 8,5 cm tersambung
Ventilator Mode HFO dengan Setingan MAP 10,
AMP 30,P-max 20 FREK 10, FIO2 21% (Pasien
NICU)
0
2 Pasien
PASIEN OBSERVASI :
1.Ny mutia /dr nisa spog / G1P0A0 hamil

39 minggu 1 hari. Partus jam 19.30
2. Ny Ines / dr nisa SpOG. G1P0A0 hamil
2 39 minggu pro induksi. . Sc cito jam 6.30
RENCANA TINDAKAN :
PASIEN PONEK :
1. Ny jocelinda /G2P1A0 hamil 37 minggu
1 sc cito jam 20.00
PASIEN OBSERVASI :
1.By. Ny. Nila Rahmawati/dr.Nathalia
2. By.Ny. Arum mayangsari/dr.Nina
3.By.ny. Mutia
Ramadhani/dr.diana,Sp.A/NCB SMK usia 5
4 jam
4.By.ny jocelinda avelina/dr.diana,
Sp.A/NCB SMK usia 4 jam
PASIEN PULANG
NOTED
LOGY
CATHLAB
Schedule :
1. Zainal / cag / dr. Faris / 13.00-14.00
1 Team : jhoni, triyanto, akbar, aulia
Non Schedule : -
HYBRID OR
Schedule : -
Non Schedule : -
Others : -
Problem : -
Overtime staf :
Staff sakit : -
Staff cuti : -
Next Schedule
Tue, 25 jan
1. Oemiati / ppm 2 Chamber / dr. Dicky hanafy /
hybrid / 19.00 / konsul anestesi
Outpatient : 12
dr ario :
Dr dafsah :
dr denio :1
dr faris : 1
dr DH :
dr DAW : 1
dr radityo :
Dr suko : 1
12 dr sunu : 3
dr Adi : 5
MCU :
New patient: 4
Dr. Sunu : 2 dari website 1 dari teman
Dr Suko: 1 pasien dr. Adi di PIK
Cancel: 3

ECHO : 1
Stress Echo :
USG Doppler : 1
Holter :
Ezypro :
ECG :6
Treadmill :
CT Scan :
Speckle :
TEE :
DSE :
ABI :
Advance Echo :
Handle echo :
ABPM : 1
Tilt Table Test :
Paket PJB :
Cardioversi :
Refferal RS luar : dr. Adi
Dokter tidak hadir : dr. Radityo sakit
dr Megawati
SIC (CAROL) Selasa, 25.01.22
TIPE PASIEN
YANG DINAS
LT NAMA UNIT
EMERGENCY ROOM
Dr Fajar
Dr Fajar Dr Firdha
EMERGENCY Dr Firdha
Ns Susi Ns Sanusi
ROOM Ns Tomi
Ns Rizam
Ns Fitri
Ns Nur
GF
PONEK
TOTAL PASIEN EMG
Poli Obgyn
Ns NS 1 :
Poli Urology IIN
Poli Ortho
Poli Internist
Poli Bedah Umum
Poli Bedah Plastik
Poli THT Kiki
Poli Gizi
Poli bedah saraf
Poli Neuro
Dermis
LT 3 Dental
Poli Endoscopy
Poli Fisioterapi
Poli Rehab Medik
Poli Nutrition
Poli Paru
Poli Mata
Poli Psikiatri
Pain Clinic
MCU
POLI KEMOTERAPI
ODC
TOTAL PASIEN OPD
IN PATIENT Ns Taufk Ns Ns Wulan Ns Salwa

DEPARTMENT 4 Nurul Ns Ela Ns Okta 5
IN PATIENT Ns Taufk Ns Ns Wulan Ns Salwa
DEPARTMENT 4 Nurul Ns Ela Ns Okta 5
LT 4 LT
5
IN PATIENT Ns Anatian Ns Malik Ns Ns Tita Ns
DEPARTMENT 5 Ns Santi Indah Yudi 6
Dr
Ns Dini Ns Dr Yuanitha
IN PATIENT Yuanitha
LT 6 DEPARTMENT 6
Ade Ns Ns Devi
Ns Avi
10
Kristine Ns Nadia
Ns Nela
Kristine Ns Nadia
Ns Nela
Kemoterapi
OPERATING THEATER
Ns Sunandar
OK Ns Heryanti
CRITICAL CARE
Ns Ani
ICU Ns Awaludin
Ns Winda
HCU
Ns Esti Ns Ayu
NICU
PICU
TOTAL Ps
CRITICAL
OBSTETRICS
Bd Dilla Bd Bd Putri
VK Bd Ningsih
Anggi Bd Genda
Nursery Ns Nani Ns Inggrid Ns Nely

Nursery Ns Nani Ns Inggrid Ns Nely
HEARTOLOGY
Ns Akbar
Cathlab Ns Tryanto
Hybrid
Ns Rini T
OPD JANTUNG
Ns Emma
22
LT 8
Dokter Jaga
Dokter Jaga IPD : Pagi : dr Abdurahman Malam : dr Yuanitha
Dokter Jaga Critical : Pagi : dr Rizki Malam : dr Dewi

KETERANGAN
TOTAL
PASIEN
OM
PASIEN OBSERVASI :
1. Ny amanda / 32 thn / poisoning
by psychotroping
( Frixitas 50 butir + Riklona 20
butir ) / Dr Edi SpPD / Dr Agung
SpkJ
2. Linda Pratiwi / 30 thn / Obsv
Febris H2
RAJAL :
1. Ny Erni Noviani / 42 thn / Vertigo
2. Ny Nabila / 30 thn / Obsv Febris H1
3. Ny Setzy Tya / 41 thn / Fatique

4. Ny Nathsya / 24 thn / Dyspepsia
5. An Anela Shafira / 5 thn / Surgical
follow up / Kontrol luka jahitan
6. Ny Elfrida Sahita / 26 thn / Obsv
Febris H1
7. Nn feni Nadia / 22 thn / sakit
kepala H3, batuk batuk.
8. Ny Linda pratiwi / 30 thn / DObsv
Febris H 1
14
RANAP :
1. An Agmal Lathif Satria / 8 thn /
8 thn / Dengue Fever / Rawat IPD
614 2.
Ny Agnes Chyntia Dewi / 36 thn /
LBP / dr Radi SpOT / Rawat IPD
503 3. An Urai
M Al Haziq / 2 thn /Tidak mau
makan, dan perut terasa sakit sejak
hari minggu SMRS / Rawat IPD 6
RUJUK :
APS :
1. Tn Abdul Latief / 23 thn / Kel
dada berdebar debar sejak 1 jam
SMRS / saran rawat ps menolak
karna mau rawat di rumah saja
D.O.A :
RAJAL :
1. Ny Desy melysa /29 thn / G1 P0
A0 H 35 mg / Pro Inj Venofer 2
amp
1
RANAP :
PASIEN OBSERVASI :
15
12
3
2
9
2
2
7
4
6
12
2
29
8
110
TMENT
PASIEN OBSERVASI :
1.Ny. Sofie / dr.Alvin Nursalim

Sp.PD / Fever unspecified
2.Tn. Azwir / dr.Zicky Yombana Sp.S /
Non-insulin-dependent diabetes
mellitus, Parkinson disease, Essential
diabetes mellitus
4.Ny. Hj Sri / dr.Aldy Sp.S / Stroke,
not specified as haemorrhage or
infarction, Essential (primary)
hypertension
5.Ny. Oemiati Wawo / dr.Dicky
Hanafy Sp.JP - FIHA, FAsCC / Sick
sinus syndrome, Atrial fibrillation and
flutter
PASIEN PINDAH ICU :
1. Tn Nasrullah/ Perwira Widianto, dr.

1.An. Luky / dr. Caroline Supit,

Sp.B / Pro Sirkumsisi (Kamar
410/ODC Rencana masuk 26/01/22
jam 06.00)
RENCANA TINDAKAN :
5
5
1.An. Luky / dr. Caroline Supit, Sp.B /

Pro Sirkumsisi / R/ tindakan 26 Jan
2022 jam 9 pagi
2.Ny. Hj Sri / dr.Aldy Sp.S / Stroke,
not specified as haemorrhage or
infarction, Essential (primary)
hypertension / R/ ECHO 26 Jan 2022
jam ? (belum hub heartology)
sinus syndrome, Atrial fibrillation and
flutter / R/ cest x-ray 26 Jan 2022
RENCANA PULANG :
1.Ny. Ari Fatmawati / dr.Bob

Andinata Sp.B (K) Onk /
Malignant neoplasm of breast
2.Tn. Yohanes Julius / Alvin
Nursalim, dr. Sp.PD / Dengue
fever, Dyspepsia
PASEN APS :
PASIEN PULANG :
1. Tn Oesman/ Nenfiati, dr.SpPD-

diabetes mellitus
Hanafy Sp.JP - FIHA, FAsCC /
Sick sinus syndrome, Atrial
PARTMENT
1.Ny. Agnes / dr. Radi, SpOT / Low

Back Pain
PASIEN OBSERVASI :
1. Tn Dharma / dr. Amanda,
Sp.PD-KGEH/ DHF H7
2.Ny. Mela / dr. Chamim, SpOG/
Post Laparascopy HS, +
Kistektomi a/i adenomioma
3.Ny. Enny Yuliati S / dr. Alvin
Nursalim, Sp.PD / DHF H6
4.Tn. William / dr. Zicky, Sp.S /
MG
5.An. Radeya / dr. Hamida,
Sp.THT / Mastoiditis
RENCANA TINDAKAN

Nursalim, Sp.PD / DHF H6, rencana
TCD/CD jika trombosit naik
PASIEN PULANG :
1.Tn Farisan Adlan Hamidi / dr.
Nenfiati, pPD-KEMD / DHF6
2.Tn. Zainal / dr. Faris, Sp.JP / Post
CAG 2 stent

Post Laparascopy HS, +
Kistektomi a/i adenomioma
TMENT
1.Ny.Reni Julianie/dr
Chamim/Other benign neoplasms
of uterus
2.Ny.Putri Mayang/ dr
Chamim/Supervision of normal
pregnancy
3.An. Akmal/ dr Nathalia
Ningrum/Dengue Fever
4. An Urai M Al Haziq / 2 thn
/Tidak mau makan, dan perut
terasa sakit sejak hari minggu
SMRS
PASIEN OBSERVASI :
1. Ny. Arum Mayangsari/Nisa Fathoni,

dr. Sp. OG, IBCLC/ post Sc G1P0A0
Hamil 38 mingg
2. Ny. Jocelinda Avelina / Nisa
Fathoni, dr. Sp. OG, IBCLC / P2 Post
SC ai BSC 1x Makrosomia Inpartu
3. Ny. Mutia Ramadhani / Nisa
Fathoni, dr. Sp. OG, IBCLC /P1A0
Post partum spontan 1 jam
4. An. Cut Salsabilla Hency / Diana
Mustika Chandra, dr. Sp.A /Dengue
fever [classical dengue]- Pro PICU - ec
narrow pulse pressure and presyock
sign - menolak
5. An. Freya Shakila Saleh / Diana
Mustika Chandra, dr. Sp.A / Fever,
unspecified
6. Ny.Putri Mayang/ dr
pregnancy
7. Inesiantika/dr Nisa Fatoni/Delivery
by emergency caesarean section.
8. Ny.Reni Julianie/dr Chamim/Other
benign neoplasms of uterus
9. An. Akmal/dr Nathalia Ningrum/
10 Dengue fever classical dengue/
PASIEN PINDAH ICU :

RENCANA TINDAKAN
1.Ny.Putri Mayang/ dr
pregnancy, Rencana tindakan
SC+IUD jam 07.00 wib
2. Ny.Reni Julianie/dr
Chamim/Other benign neoplasms
of uterus, Rencana tindakan TLH
dan SOB, jam 11.00 wib
PASIEN VK
PASIEN PULANG
1.Ny. Arum Mayangsari/Nisa

Sc G1P0A0 Hamil 38 minggu.
RENCANA MASUK :
1.Ny. Nila Rahmawati/ N.B.

Donny A.M, dr. Sp.OG / Post
Tindakan SC P2A0 Erasc G2P1
hamil 38 minggu
2.Dewi Humairah/dr Nisa/
Eklamsi.
ATER
1. INESIANTIKA EMMA
SANDHIKA / BEDAH OBGYN -
1 Sectio Caesaria / OK 1 jam 06.30wib /
Nisa Fathoni, dr. Sp. OG, IBCLC

1. PUTRI MAYANG / BEDAH
IUD / OK 2 jam 07.00 wib /
Chamim,DR. dr, SpOG (K) Onk
2. LUKY / BEDAH UROLOGY -
Sirkumsisi + GA / OK 1 jam 09.00 wib
3 / Caroline Supit, dr. SpB
3. RENY JULIANIE
FATWANDARI /BEDAH OBGYN -
Laparascopy Total Histerectomy / OK
1 jam 11.00 wib /Chamim,DR. dr,
SpOG (K) Onk
1 1. Tn. Narsrullah /58th/ Dx. Acute

Appendicitis + Hernia nguinal / Post
Laparatomy, Apendektomy,
1. By Ny Arum Mayangsari /
Conjunctival haemorrhage / 0 thn / Dr
1 Nina SpA
0
0
PASIEN OBSERVASI :
RENCANA TINDAKAN :
1. Ny. Lamerasari /Prof.NK/

1 rencana Kuret tgl 26/01/2022 jam
09.00 wib
2. Ny. Putri Mayang/dr Chamim /
rencana SC tgl 26/01/2022 jam
07.00 wib
PASIEN PONEK :
1. Ny. Dessy/dr.Fransisca Noela,
Sp.OG/G1P0A0 hamil 35 minggu
1
JPKTH
PASIEN OBSERVASI :
3
1.By.ny. Mutia
Ramadhani/dr.diana,Sp.A/NCB
SMK usia 1 hari
3 3. By.Ny.Inesiantika/dr.Andina
Sp.A/NCB SMK usia 12 jam
PASIEN PULANG
BAYI HIPERBIL
1. By.Ny. Arum
mayangsari/dr.Nina Sp.A/NCB
1
SMK usia 2 hari.
Y
CATHLAB
Schedule :
Non Schedule : -
HYBRID OR
Schedule : -
Tue, 25 jan
1. Oemiati / ppm 2 Chamber / dr.
Dicky hanafy / hybrid / 19.00 /
Others : -
1 Problem : -
Overtime staf :
Staff sakit : -
Staff cuti : -
2022
Outpatient : 22
dr ario :
Dr dafsah : 5
dr denio : 8
dr faris : 3
22 dr DH : 5
dr DAW :
dr radityo :
Dr suko :
dr sunu : 1
dr Adi :
MCU :
New patient: 9
Dr. Denio : 3 dari website
Dr. Dicky Hanafy : 4 (2 dari Jenda
Marketing, 1 dari kerabat dr. Dicky, 1
dari dr. Sani)
Dr. Dafsah : 2 dari dr. Rendi RS Mitra
Kelapa Gading.
Cancel: 3
Dr. Faris : 1
Dr. Dicky Hanafy : 1
Dr. Denio : 1
melakukan
ECHO :
Stress Echo :
USG Doppler :
Holter : 1
Ezypro :
ECG : 14
Treadmill : 2
CT Scan :
Speckle :
TEE :
DSE : 1
ABI :
Advance Echo : 4
Handle echo :
ABPM :
Tilt Table Test :
Paket PJB :
Cardioversi :
Refferal RS luar : dr. Rendi RS Mitra
Kelapa Gading
Dokter tidak hadir : dr. Dicky Aligheri
dr Yuanitha
SIC (CAROL) Rabu, 26.01.22
TIPE PASIEN
YANG DINAS
LT NAMA UNIT
EMERGENCY ROOM
Dr Dwi
Dr Dwi Dr Fajar
EMERGENCY Dr Fajar
ROOM
NsKelvin
Ns Tomi
Ns Sanusi 11
Ns Rizam Ns Mohlis
Ns Nur
GF
Bd Dilla Bd Bd Ningsih Bd Putri

PONEK Tries Bd Anggi Bd Genda
2
Bd Dilla Bd Bd Ningsih Bd Putri
PONEK Tries Bd Anggi Bd Genda
2
TOTAL PASIEN EMG
Poli Obgyn
Ns NS 1 :
Poli Urology IIN
Poli Ortho
Poli Internist
Poli Bedah Umum
Poli Bedah Plastik
Poli THT Kiki
Poli Gizi
Poli bedah saraf
Poli Neuro
Dermis
LT 3 Dental
Poli Endoscopy
Poli Fisioterapi
Poli Rehab Medik
Poli Nutrition
Poli Paru
Poli Mata
Poli Psikiatri
Pain Clinic
MCU
POLI KEMOTERAPI
ODC
TOTAL PASIEN OPD
Dr Mega Dr Rona Dr Rona

IN PATIENT
DEPARTMENT 4
Ns Taufik Ns Wulan Ns Salwa 7
Ns Nurul Ns Ella Ns Okta
LT 4 LT
5
Dr Mega Ns Dr Rona Ns Dr Rona Ns
IN PATIENT
DEPARTMENT 5
Anatian Ns Indah Ns Santi Ns 7
Tari Malik Yudi
Dr Mega Ns Dr Rona Ns
Dr Rona
IN PATIENT Dini Ns
LT 6 DEPARTMENT 6 Ade Ns
Ns Devi Alvi Ns 10
Ns Silvi Nadya
Kristin
Kemoterapi
OPERATING THEATER
Ns Sunandar
OK Ns Heryanti
CRITICAL CARE
ICU Ns Awaludin Ns Rita
HCU
NICU
PICU Ns Esti Ns Ayu
TOTAL Ps CRITICAL
OBSTETRICS
Bd Dilla Bd Ningsih Bd Putri

VK Bd Tries Bd Anggi Bd Genda
Nursery Ns Nani Ns Inggrid Ns Nelly 4

HEARTOLOGY
Ns Akbar
Cathlab Ns Tryanto
Hybrid
Ns Rini T
OPD JANTUNG
Ns Emma
13
LT 8
Dokter Jaga
Dokter Jaga IPD : Pagi : dr Mega Malam : dr Rona

KETERANGAN
TOTAL
PASIEN
OM
PASIEN OBSERVASI :
RAJAL :
1. Nn Gantini Purnama / 22 thn / Obsv
Febris H 1
2. Tn Doni david / 28 thn /
Dyspepsia 3. Nn Alya Nasywa / 25
thn / Obsv Febris H 1 / PCR SWAB
POSITIF 4. Tn Kurni / 44 thn /
Obsv Febris H 1 / PCR SWAB
POSITIF 5. Ny
Elke Alexandrina / 48 thn / Control
kesehatan, karena suami positif Cov -
19 6. Tn
Aviandri / 37 thn/ batuk batuk sejak 10
hr SMRS 7. Nn
Stacia Viola / 31 thn / Vomiting 8.
Ny Lilis Fitriani / 29 thn / Dyspepsia
11
RANAP :
1. Ny Deswita Arieyanti / 42 thn /
Dyspepsia / Dr Amanda SpPD /
Rawat IPD 406
2. Ny Erni Noviani / 42 thn /
Headache H1 / Dr Zicky SpS /
Rawat IPD 414 3.
Tn Izzat Helmi Amier / 72 thn /
Fractur Intratrochanter sinistra pro
ORIF / Dr Radi SPOT / Rawat IPD
505
RUJUK :
APS :
D.O.A :
RAJAL :
2
1. Ny Lulu / 32 thn / G3 P1 A1 H 26
mg / Obsv Vomitus
RANAP :
PASIEN OBSERVASI :
2
1.Ny. Risa/ dr. Febry/ G1P0A0

hamil 39 mgg dengan inpartu +
HDK / Obsv VK ( TD 166 / 95
mmhg ) datang ke EMG jam 02.43
wib - obsv VK jam 05. 45 wib
13
25
6
1
3
11
3
1
1
9
13
9
2
16
1
3
2
107
TMENT
1.An. Luky / dr. Caroline Supit, Sp.B /

Pro Sirkumsisi / ODC
2.Tn. Nasrullah / Perwira Widianto, dr.
Sp.B-KBD/Acute appendicitis, Inguinal
hernia, Post Laparatomy
3.Tn. Deswita Arieyanti / Amanda
Pitarini Utari,dr, SpPD-KGEH /
abdominal pain, Diarrhea, unspecified
4.Ny. Erni Noviani / Zicky Yombana,
dr. Sp.S / Other peripheral vertigo
PASIEN OBSERVASI :
1. Tn Nasrullah / Perwira Widianto, dr.

2.Ny. Sofie / dr.Alvin Nursalim Sp.PD /
Fever unspecified
3.Tn. Deswita Arieyanti / Amanda
Pitarini Utari,dr, SpPD-KGEH /
abdominal pain, Diarrhea, unspecified
Non-insulin-dependent diabetes
mellitus, Parkinson disease, Essential
KEMD/Non-insulin-dependent diabetes
mellitus
specified as haemorrhage or infarction,
Essential (primary) hypertension
dr. Sp.S / Other peripheral vertigo
PASIEN PINDAH ICU :

RENCANA TINDAKAN :

dr. Sp.S / Other peripheral vertigo/
Rencana TCD-CD 27/01/22 sore sekitar
habis ashar, MRI cervical non contrast
ulang sekuen tambahan 27/01/22 jam
09.00
RENCANA PULANG :
1. Tn Oesman/ Nenfiati, dr.SpPD-

diabetes mellitus
2.Ny. Sofie / dr.Alvin Nursalim
Sp.PD / Fever unspecified
PASEN APS :
PASIEN PULANG :

sinus syndrome, Atrial fibrillation
and flutter
2.An. Luky / dr. Caroline Supit,
Sp.B / Post Sirkumsisi
PARTMENT
1. Tn.Izzat Helmi
Amier/dr.Rady.Sp.OT/Dislocation,
Fractur Intratrochanter Sinistra
( PRO ORIF ) / IPD 505
PASIEN OBSERVASI :
1.Tn Dharma / dr. Amanda, Sp.PD-
KGEH/ DHF H10
2.Ny.Amanada/
dr.Eddy.SpPD,Poisoning By
psychtropic drugs
Nursalim, Sp.PD / DHF H9
4.Tn. William / dr. Zicky, Sp.S /
MG
6..Ny. Agnes / dr. Radi, SpOT /
Low Back Pain
RENCANA TINDAKAN
PASIEN PULANG :
Post Laparascopy HS, + Kistektomi
a/i adenomioma
1.Ny.Amanada/
dr.Eddy.SpPD,Poisoning By
psychtropic drugs
TMENT
1.Ny. Lamelasari/ Prof NK/

Endometrial adenomatous
hyperplasia (post kuretase)
PASIEN OBSERVASI :
Endometrial adenomatous hyperplasia
(post kuretase)
2. Ny. Jocelinda Avelina / Nisa Fathoni,
dr. Sp. OG, IBCLC / P2 Post SC ai BSC
1x Makrosomia Inpartu
3. Ny. Mutia Ramadhani / Nisa Fathoni,
dr. Sp. OG, IBCLC /P1A0 Post partum
spontan 1 jam
unspecified
pregnancy
7. Inesiantika/dr Nisa Fatoni/Delivery
by emergency caesarean section.
9. An. Agmal/dr Nathalia Ningrum/
Dengue fever classical dengue/
10.An. Urai M Al
haziq/Intussusception/Mira Febriani
Inkiriwang,dr. SpA
PASIEN PINDAH ICU :
RENCANA TINDAKAN
10
1..An. Urai M Al
Inkiriwang,dr. SpA, Rencana Pro
laparotomi release invaginasi s/d
kemungkinan reseksi
anastomosis/stoma (Keluarga masih
berunding). F.U waktu jika keluarga
Acc tindakan operasi.
PASIEN VK
PASIEN PULANG
1. Ny. Arum Mayangsari/Nisa
Sc G1P0A0 Hamil 38 mingg
RENCANA MASUK :

Endometrial adenomatous
hyperplasia (post kuretase)
2. Ny. Jocelinda Avelina / Nisa
Fathoni, dr. Sp. OG, IBCLC / P2
Post SC ai BSC 1x
3. Inesiantika/dr Nisa
Fatoni/Delivery by emergency
caesarean section.
4. Ny. Mutia Ramadhani / Nisa
Fathoni, dr. Sp. OG, IBCLC /P1A0
Post partum spontan 1 jam
ATER
1. PUTRI MAYANG / BEDAH

IUD / OK 2 jam 07.00 wib /
2. LUKY / BEDAH UROLOGY -
Sirkumsisi + GA / OK 1 jam 09.00 wib /
3 Caroline Supit, dr. SpB
3. RENY JULIANIE
FATWANDARI /BEDAH OBGYN -
Laparascopy Total Histerectomy / OK 1
jam 11.00 wib /Chamim,DR. dr, SpOG
(K) Onk
1. KISNELY AYUNINGSIH / BEDAH

MULUT - Odontectomy 4 Gigi / Ok 1
1 jam 19.00 wib / Teuku Ahmad Arbi,
drg. SpBM
E
0
PASIEN OBSERVASI :
1. Lamerasari/ Pof NK/ Curetagge,
anastesi dr. Anas 2. Ny. Risa/
dr. Febry/ G1P0A0 hamil 39 mgg
dengan inpartu + HDK
1. Ny. Pramanti/ dr. Nisa/ G2P1A0

hamil 39 mgg 4 hari/ rencana
induksi
PASIEN PONEK :
1. Ny. Lulu/ dr. Nisa/ G3P1A1

hamil 26 mgg 4 hari
2. Ny. Risa/ dr. Febry/ G1P0A0
2
hamil 39 mgg dengan inpartu +
HDK
PASIEN OBSERVASI :
1.By.ny. Mutia
Ramadhani/dr.diana,Sp.A/NCB
SMK usia 2 hari
4 3. By.Ny.Inesiantika/dr.Andina
4. By.ny.putri mayang/dr.Rifan
Sp.A/ NCB SMK usia 15 jam
PASIEN PULANG
Y
CATHLAB
Schedule :
Non Schedule : -
HYBRID OR
Schedule : -
Others : -
Problem : -
Overtime staf :
Staff sakit : -
Staff cuti : -
Outpatient : 13
dr ario :
Dr dafsah : 1
dr denio : 3
dr faris :
13 dr DH :
dr DAW : 1
dr radityo :
Dr suko : 2
dr sunu : 2
dr Adi : 4
MCU : -
New patient: 2
dr Suko 1 : dari dr veinardi SpOG
dr adi 1 : dari teman
Cancel :
dr. Denio 1 : cancel
dr. Sunu 1 : reschedule februari 2022
melakukan
ECHO :
Stress Echo :
USG Doppler :
Holter :
ECG : 7
Treadmill :
CT Scan
Speckle
TEE :
DSE :
ABI :
Tilt Table Test :
Advance Echo :
Handle Echo :
ABPM :
Ezypro :
Cardioversi :
Referral Brawijaya : dr veinardi SpOG

Info dokter tidak hadir : dr Ario sakit

SIC (EKO) Kamis, 27.01.22
TIPE PASIEN
YANG DINAS
LT NAMA UNIT
EMERGENCY ROOM

EMERGENCY Ns. Tomi,
Ns. Susi, Ns. Rizam, Br.
ROOM Zr. Nur
Kelvin Mohlis
GF
PONEK
TOTAL PASIEN EMG
Poli Obgyn
Ns NS 1 :
Poli Urology IIN
Poli Ortho
Poli Internist
Poli Bedah Umum
Poli Bedah Plastik
Poli THT Kiki
Poli Gizi
Poli bedah saraf
Poli Neuro
Dermis
LT 3 Dental
Poli Endoscopy
Poli Fisioterapi
Poli Rehab Medik
Poli Nutrition
Poli Paru
Poli Mata
Poli Psikiatri
Pain Clinic
MCU
POLI KEMOTERAPI
ODC
TOTAL PASIEN OPD
DP = Ns. DS = Ns.
DM = Ns.
IN PATIENT Nurul + Br. Citra + Br.
Wulan + Zr.
DEPARTMENT 4 Abdi Taufik
Ella
LT 4
LT 5

IN PATIENT Anatian + Indah + Br. Santi + Br.
DEPARTMENT 5 Ns. Tari febrio Malik
hambali
DP = Ns.
DS = Ns. DM = Ns.
Dini + Ns.
LT 6 DEPARTMENT 6
Risha + Bd.
Ns. Silvi.
Devi + Ns.
Ade Nadia.
DP = Ns.
DS = Ns. DM = Ns.
Dini + Ns.
LT 6 DEPARTMENT 6
Risha + Bd.
Ns. Silvi.
Devi + Ns.
Ade Nadia.
Kemoterapi
OPERATING THEATER
OK
CRITICAL CARE
Ns Elga,
ICU Ns Awaludin
Agus
HCU
NICU
PICU Ns Esti Ns Grace
TOTAL Ps
CRITICAL
OBSTETRICS

‌Dines Pagi:
Tries, bd. Malam : bd.
VK bd. Viki
Dewi Dilla, bd.
‌Dines
Anggi
Nursery
Nursery
HEARTOLOGY
Cathlab
Hybrid
OPD JANTUNG
LT 8
LT 8
Dokter Jaga
Dokter Jaga IPD : Pagi : dr Malam : dr Megawati
Dokter Jaga Critical : Pagi : dr Malam : dr Nilam

KETERANGAN
TOTAL
PASIEN
CY ROOM
PASIEN OBSERVASI :
RAJAL :
1. Ny. Idrasti Kinswandari /52th/ Dx. Cat Bite
=> Tetagam , Antibiotik, Resep Pulang +
2. Ny.
Fatimah /34th/ Dx. Ca lacenta + Hydatidiform
mole 3. Ny.
Tsamara Hanifah /26th/ Dx. G1 hamil 28
minggu + 4 hari / Infus Venofer 2 ampul / 100
ml NacLdalam 1 jam 4.
Ny. Patricia Gabriela /29th/ Dx. Ganti Balutan
Post SC Hari ke 8 5. Nn.
Anisa Nahdah /21th/ Dx. kontrol luka post OP
kistaektomi hari ke 6 6. Ny.
Lumin Tuningtyas /53th/ Dx. Benjolan di
payudara kanan 7. Ny.
Yudita Budijanto /34th/ Dx. Fever 8. Ny.
Sintia Sukma Rachmat /39th/ Dx.Ispa 9. Ny.
Diffiyona Almas /22th/ Dx. Luka Lebam
Pangkal Paha + Dyspepsia
12 RANAP :
1. Tn. Martono /74th/ Dx. hypertension +
intracerebral haemorrhage / Dpjp. Michael
Norman Jusman, dr. Sp.BS / Rawat ICU
2. Ny. Yetty Rosalyna /48th/ Dx.
abdominal pain + Bacterial intestinal
infection (Terpasang Colostomi di
ambdomen Sblh Kanan Bawah) / Dpjp. dr.
Widi, SpB-KBD / Ruang 411
RUJUK :
APS :
1. Ny. Elysabeth Vivian /30th/ Dx.
Hypokalaemia + Palpitations + Syncope and
collapse / ( Alasan APS Karena Punya
Anak Kecil di Rumah )
D.O.A :
RAJAL :
RANAP :
1. Ny. Fania El Ridhasya /26th/ Dx.

G1P0A0 hamil 10 minggu + hyperemesis
2 gravidarum / Dpjp. Tirsa Verani Kembuan
Oroh, dr. SpOG / Ruang507
2. Tn. Asyraf Dhanada /27th/ Dx. Dengue
fever / Dpjp. Alvin Nursalim, dr. Sp.PD /
Ruang 511
PASIEN OBSERVASI :
14 Pasien
20
3
2
10
1
1
4
6
6
2
26
2
88
PASIEN OBSERVASI :
Pasien Observasi :
1.Nn. Kisnely/ Teuku Muhammad Arbi, drg.,
SpBM / Impacted teeth, Post Odontectomy
2.Tn. Nasrullah / Perwira Widianto, dr. Sp.B-
KBD/Acute appendicitis, Inguinal hernia, Post
Laparatomy
3.Tn. Deswita Arieyanti / Amanda Pitarini
Utari,dr, SpPD-KGEH / abdominal pain,
Diarrhea, unspecified
6.Ny. Erni Noviani / Zicky Yombana, dr. Sp.S /
Other peripheral vertigo
RENCANA TINDAKAN :
RENCANA PULANG :
1. Nn. Kisnely/ Teuku Muhammad Arbi,

drg., SpBM / Impacted teeth, Post
Odontectomy
2. Tn. Azwir / dr.Zicky Yombana Sp.S /
Non-insulin-dependent diabetes mellitus,
Parkinson disease, Essential (primary)
hypertension
PASEN APS :
PASIEN PULANG :
1.Tn. Oesman/ Nenfiati,
dr.SpPD-KEMD/Non-insulin-dependent
diabetes mellitus
1.Tn. ASYRAF DHANADA

PANGESTULLAH / Alvin Nursalim, dr.
Sp.PD/Dengue fever
2.Ny. FANIA EL RIDHASYA /Tirsa Verani
Kembuan Oroh, dr. SpOG/Supervision of
normal first pregnancy
3.Tn.Izzat Helmi
Amier/dr.Rady.Sp.OT/Dislocation, sprain and
strain of joint and
PASIEN OBSERVASI :

Sp.PD/Dengue fever
2.Ny. FANIA EL RIDHASYA /Tirsa
Verani Kembuan Oroh, dr.
SpOG/Supervision of normal first
pregnancy
3.Tn.Izzat Helmi
Amier/dr.Rady.Sp.OT/Dislocation, sprain
and strain of joint and
Mastoiditis
6..Ny. Agnes / dr. Radi, SpOT / Low Back
Pain

1.Tn. Anton/ dr. Dafsah Sp.Jp/
R/tindakan CT cardiac
RENCANA TINDAKAN
Mastoiditis/ R/tindakan insisi drainase Hari
Sabtu 29/1/2022
2.Tn.Izzat Helmi
strain of joint and/ R/tindakan hemiarthroplasty
+ implan hari senin, 31/01/2022
PASIEN PULANG :
Sp.PD / DHF H9
2.Tn. Dharma / dr. Amanda, Sp.PD-KGEH/
DHF H10
1. Ny. Risa / Febriansyah Darus, dr. Sp.OG-

KFM / Supervision of normal pregnancy,
Gestational + hypertension with significant
proteinuria
PASIEN OBSERVASI :

Chandra, dr. Sp.A /Dengue fever
2. An. Freya Shakila Saleh / Diana Mustika
Chandra, dr. Sp.A / Fever, unspecified
3. Ny.Putri Mayang/ dr Chamim/Supervision of
normal pregnancy
4. Ny.Reni Julianie/dr Chamim/Other benign
neoplasms of uterus
5. An. Agmal/dr Nathalia Ningrum/ Dengue
fever classical dengue
6.An. Urai M Al haziq/Intussusception/Mira
Febriani Inkiriwang,dr. SpA
Gestational [pregnancy-induced] hypertension
with significant proteinuria
PASIEN PINDAH ICU :
RENCANA TINDAKAN
8 (7 Ranap, 1
VK)
1 .An. Urai M Al
Inkiriwang,dr. SpA, Rencana Pro
laparotomi release invaginasi s/d
kemungkinan reseksi anastomosis/stoma
8 (7 Ranap, 1 (Keluarga masih berunding--> keputusan
VK) pkl 10.00 wib) F.U waktu jika keluarga Acc
tindakan operasi.
PASIEN VK
1. Ny. Pramanti Putri / dr. Nisa Fathoni,
Sp.OG / G2P1AO hamil 39minggu
PASIEN PULANG
1. Ny. Lamelasari/ Prof NK/ Endometrial

adenomatous hyperplasia (post kuretase)
2. Ny. Jocelinda Avelina / Nisa Fathoni, dr.
Sp. OG, IBCLC / P2 Post SC ai BSC 1x
Makrosomia Inpartu
3. Ny. Mutia Ramadhani / Nisa Fathoni, dr.
Sp. OG, IBCLC /P1A0 Post partum
spontan 1 jam
4. Inesiantika/dr Nisa Fatoni/Delivery by
emergency caesarean section.
RENCANA MASUK :

THEATER
1. Tindakan kamis, 27-01-22
- SC / dr Febriansyah Darus, Sp.OG-KFM
2 /J.10.00 / OK I
- Ondontectomy 4 Gigi / Drg. Teuku Ahmad,
Sp.BM /J. 06.30 / OK I
2. Rencana tindakan jum,at, 28-01-22
- SC / dr. Nisa Fathoni, Sp.OG /J. 12.30 / OK I
-
Sirkumsisi / dr. Wulan Ayudyasari, Sp.B /J.
17.00 / OK I
L CARE
1. Tn. Martono /74th/ Dx. intracerebral
1 haemorrhage + HT Emergency/ Dpjp. dr. Vera
Sp. An + dr. Zicky Sp. S + dr. Michael Norman
Jusman, Sp.BS
0
0
0
1 Pasien
PASIEN OBSERVASI :
1. Pramanti/ dr nisa/ G2P1A0 hamil 40
minggu inpartu
2. Ny Risa/ dr febri/ G1P0A0 hamil 39
minggu HDK --> SC CITO jam 10
3
RENCANA TINDAKAN :
1. Ny nafila/ dr nisa/ G2P0A1 hamil
39minggu pro SC + ERACS jam 12.30
PASIEN PONEK :
1. Ny. Pramanti/ dr. Nisa/ G2P1A0 hamil
40 minggu
PASIEN OBSERVASI :
1. By.ny. Putri mayang/dr.Rifan Sp.A/ NCB
SMK usia 1 hari
2. By.Ny Risa/dr.Ali,Sp.A/ NCB SMK Usia
13 Jam
PASIEN HIPERBILLIRUBIN :
1. By.Ny. Jocelinda avelina/dr.Diana Sp.A/
3 NCB SMK Usia 3 hari
PASIEN PULANG
3
1. By.Ny. Mutia ramadhani/dr.Diana,Sp.A/

NCB SMK Usia 2 hari.
2. By.Ny. Inesiantika emma shandika p/
dr.Andina,Sp.A/ NCB SMK Usia 2 hari.
OLOGY
Outpatient : 12
dr ario :
Dr dafsah : 3
dr denio :
dr faris : 1
dr DH : 3
dr DAW : 2
dr radityo : 2
12 Dr suko : 1
dr sunu :
dr Adi :
MCU : -
New patient: 3
dr Suko 1 : info dari saudara
Dr. Faris 1 : info dari teman
Dr. Dicky Hanafy 1 : info dari website
Cancel : 1
dr. Dicky Hanafy : 1 cancel

ECHO :
Stress Echo :
USG Doppler : 1
Holter :
ECG : 6
Treadmill :
CT Scan
Speckle
TEE :
DSE :
ABI :
Tilt Table Test :
Advance Echo : 3
Handle Echo :
ABPM :
Ezypro :
Cardioversi :
Info dokter tidak hadir : dr. Ario sakit
dr Megawati
SIC (EKO) Jum,at, 28.01.22
TIPE PASIEN
YANG DINAS
LT NAMA UNIT
EMERGENCY ROOM

EMERGENCY Ns. Ardi, Zr.
Ns. Susi, Ns. Ns. Rizam,
ROOM Kelvin
Fitri
Zr. Nur
GF
PONEK
TOTAL PASIEN EMG
Poli Obgyn
NS 1 :
Ns NS 1 :
IIN
Ns NS 1 :
Poli Urology IIN
Poli Ortho
Poli Internist
Poli Bedah Umum
Poli Bedah Plastik
Poli THT Kiki
Poli Gizi
Poli bedah saraf
Poli Neuro
Dermis
Dental
LT 3
Poli Endoscopy
Poli Fisioterapi
Poli Rehab Medik
Poli Nutrition
Poli Paru
Poli Mata
Poli Psikiatri
Pain Clinic
MCU
POLI KEMOTERAPI
ODC
TOTAL PASIEN OPD
DP = Ns. DS = Ns.
DM = Ns.
IN PATIENT Nurul + Br. Citra + Br.
Wulan + Zr.
DEPARTMENT 4 Taufik Abdi
Ella
LT 4
LT 5
LT 4
LT 5

IN PATIENT Anatian + tari + Br. indah + Br.
DEPARTMENT 5 Ns. Tita febrio Malik
hambali
DP = Ns.
DS = Ns. DM = Ns.
Dini + Ns.
LT 6 DEPARTMENT 6
Risha + Bd.
Ns. Meliya
Devi + Ns.
Ade Silvi
DP = Ns.
DS = Ns. DM = Ns.
Dini + Ns.
LT 6 DEPARTMENT 6
Risha + Bd.
Ns. Meliya
Devi + Ns.
Ade Silvi
Kemoterapi
OPERATING THEATER
OK
CRITICAL CARE
Ns Awaludin, Br. Gisma, Ns. Agus,
ICU Ns. Winda Ns. Any Ns. Ningsih
HCU
NICU
Ns. Evi,
PICU Ns Esti Ns. Grace
Ns. Alfi
TOTAL Ps CRITICAL
OBSTETRICS
‌Dines
‌Dines
‌Dines Pagi: Siang : bd.
Malam : bd.
VK bd. Putri Genda, bd.
Dewi, bd.
Tries
Viki
Dinas ‌Dines
‌Dines
pagi : Siang : Ns.
Nursery Bd.Nelly Nani
Malam :Ns
.Ika
HEARTOLOGY
Cathlab
Hybrid
OPD JANTUNG
LT 8
Dokter Jaga
Dokter Jaga IGD : Pagi : dr dr. Audrey Malam : dr Firdha
Dokter Jaga IPD : Pagi : dr Malam : dr Nesya
Dokter Jaga Critical : Pagi : dr Dewi Malam : dr Dewi

KETERANGAN
TOTAL
PASIEN
Y ROOM
PASIEN OBSERVASI :
RAJAL :
1. Ny. Laura Krisanti /25th/ Dx. Covid 19 2.
Ny. Yolin tri Wedari /29th/ Dx. Febris 3.
Ny. Hana Witsqa /30th/ Dx. Diarrhea +
haemorrhoids
4. Ny. Rivania Eda Anandiza /28th/ Dx. Febris
5. Tn. Yoga Satria /29th/ Dx. GEA
6. Tn. Sunarji /29th/ Dx. Takikardia
7. Ny. Ani Widiastuti /38th/ Dx. Dyspepsia
8. Ny. Dwi Hesti /47th/ Dx. Haid Tidak Teratur
9. An.
Saad Rashaad /3th/ Dx. Ispa 10.
An. Saladdin Rasyid /8th/ Dx. Ispa 11.
An. Aruna Nuala /5th 3bln/ Dx. Open Wound
12. Ny.
14 Vitri Hanariyanti /28th/ Dx. Constipasi
13. An. Aluna /4th/
Dx. Asthma
RANAP :
1. Tn. Faridz Miftah /36th/ Dx. Dengue
Fever / Dpjp. Alvin Nursalim, dr. Sp.PD /
Ruang 401
RUJUK :
APS :
D.O.A :
RAJAL :
RANAP :
PASIEN OBSERVASI :
14 Pasien
27
3
1
2
12
2
1
8
12
7
8
1
30
3
1
126 Pasien
1.Tn. Faridz Miftah / dr. Alvin, Sp.PD/ Dengue

fever [classical dengue, Fever, unspecified
PASIEN OBSERVASI :
KBD/Acute appendicitis, Inguinal hernia, Post
Laparatomy
4.Ny. Yetty Rosalina / Perwira Widianto, dr.
Sp.B-KBD/ abdominal pain
PASIEN PINDAH ICU :
RENCANA TINDAKAN :
4
RENCANA PULANG :
PASEN RUJUK :
1.Ny. Yetty Rosalina / Perwira Widianto,

dr. Sp.B-KBD/ abdominal pain
PASIEN PULANG :
1.Nn. Kisnely/ Teuku Muhammad Arbi,

drg., SpBM / Impacted teeth, Post
Odontectomy
2.Ny. Deswita Arieyanti / Amanda Pitarini
Utari,dr, SpPD-KGEH / abdominal pain,
Diarrhea, unspecified
3.Ny. Erni Noviani / Zicky Yombana, dr.
Sp.S / Other peripheral vertigo
Non-insulin-dependent diabetes mellitus,
Parkinson disease, Essential (primary)
hypertension
1.Tn. Anton/ dr. Dafsah Sp.Jp/ essential primary

hypertension
PASIEN OBSERVASI :
Sp.PD/Dengue fever
pregnancy
3.Tn.Izzat Helmi
7 Amier/dr.Rady.Sp.OT/Dislocation, sprain
and strain of joint and
Mastoiditis
6..Ny. Agnes / dr. Radi, SpOT / Low Back
Pain
7.Tn. Anton/ dr. Dafsah Sp.Jp/ essential
primary hypertension
PASIEN PINDAH ICU :
1.Ny . Norma / dr. Dicky hanafi Sp.JP/

R/tindakan 2D SVT ablasi/ besok pagi
29/01/2022 (516)
2.Tn. Chandra / dr. Amanda Sp.PD/
R/tindakan EGD + colonoscopy + biopsi,
Rencana masuk 01/02/2022 (518)
RENCANA TINDAKAN

Mastoiditis/ R/tindakan insisi drainase Hari
Sabtu 29/1/2022
2.Tn.Izzat Helmi
strain of joint and/ R/tindakan hemiarthroplasty
+ implan hari senin, 31/01/2022
PASIEN PULANG :

pregnancy
2.Ny. Agnes / dr. Radi, SpOT / Low Back
Pain
1. Ny. Nafila / Nisa Fathoni, dr. Sp. OG,

2. Ny. Ulva Yustina / Chamim,DR. dr,
SpOG (K) Onk / Endometriosis of uterus
3. Ny. Listyorini / Chamim,DR. dr, SpOG
(K) Onk / Endometriosis of uterus
PASIEN OBSERVASI :
10
dengue]
3. Ny.Reni Julianie/dr Chamim/Other benign
neoplasms of uterus
5. An. Urai M Al haziq/Intussusception/Mira
Febriani Inkiriwang,dr. SpA
Gestational [pregnancy-induced] hypertension
with significant proteinuria
7. Ny. Pramanti Putri / dr. Nisa Fathoni, Sp.OG /
Premature rupture of membranes, onset of labour
within 24 hours
8. Ny. Nafila / Nisa Fathoni, dr. Sp. OG,
9. Ny. Ulva Yustina / Chamim,DR. dr, SpOG
10. Ny. Listyorini / Chamim,DR. dr, SpOG (K)
Onk / Endometriosis of uterus
PASIEN PINDAH ICU :

10
RENCANA TINDAKAN
1 .Ny. Listyorini / Chamim,DR. dr, SpOG

(K) Onk / Endometriosis of uterus /
Rencana tind cystectomy laparoscopy tgl
29/1/22 jam 11.00
SpOG (K) Onk / Endometriosis of uterus /
Rencana Adesiolisis Kompleks
Hysterectomy Laparoscopy tgl 29/1/22 jam
07.00
PASIEN VK
PASIEN PULANG
Chamim/Supervision of normal pregnancy
RENCANA MASUK :

Mustika Chandra, dr. Sp.A /Dengue fever
[classical dengue]
Gestational [pregnancy-induced]
hypertension with significant proteinuria
THEATER
1. Tindakan Jum.at , 28-01-22
- SC / Ny. Nafila / dr Nisa Fathoni , Sp.OG
IBCLC /J.12.30 / OK I
- Sirkumsisi / An. Benedictus Giandra / dr.
Wulan Ayudyasari, Sp.B /J. 17.00 / OK I
4 - Laparatomi Release invaginasi /An.
Urai M Al Haziq /dr. Riana Pauline Tamba
Sp.B / OK I /J. 17.00
- SC / Ny. Pramanti putri /dr. dr
Nisa Fathoni , Sp.OG IBCLC /J. 20.27 / OK I
2. Rencana tindakan jum,at, 29-01-22 -

Insisi Drenase Abses / Radeya Arya / dr.
Hamida Hayati Sp.THT /J. 07.00 / OK I -
Laparascopy Total Histerectomy /Ulva
Yustina / dr. Chamim Sp.OG (K) ONK /J. 07.00
/ OK I -
Cystectomy Laparascopy /Listyorini Dian /
dr. dr. Chamim Sp.OG (K) ONK /J. 11.00 / OK I
-
Phaco Emulsoifikasi + IOL /Ny. Siti Anisah /
dr. Etty Budiasni Sp.M /J. 11.00 / OK II
- Phaco
Emulsoifikasi / dr. Etty Budiasni Sp.M /J. 11.30
/ OK II
CARE
1. Tn. Martono /74th/ Dx. intracerebral
1 haemorrhage + HT Emergency/ Dpjp. dr. Vera
Sp. An + dr. Zicky Sp. S + dr. Michael Norman
Jusman, Sp.BS
0
0
0
1 Pasien
PASIEN OBSERVASI :
1. Pramanti/ dr nisa/ G2P1A0 hamil 40
minggu inpartu --> sc CITO jam 21.00
1
RENCANA TINDAKAN :
PASIEN PONEK :
PASIEN OBSERVASI :
1. By.Ny Risa/dr.Ali,Sp.A/ NCB SMK Usia
1 hari.
2.By.Ny. Pramanti
putri/dr.annisa,Sp.A/NCB SMK Usia 3 jam
2
PASIEN PULANG
1. By.Ny.Jecolinda avelina/dr.Diana,Sp.A/
2. By.Ny. Putri mayang/ dr.Rifan
fauzie,Sp.A/ NCB SMK Usia 2 hari.
LOGY
Outpatient : 16
dr ario :
Dr dafsah :
dr denio : 4
dr faris : 2
dr DH : 2
dr DAW : 1
dr radityo :
16 Dr suko :
dr sunu :
dr Adi : 7
MCU : -
New patient: 3
dr Faris 2 : 1 dr chamim 1 website
dr Denio : 1 pasien lama di PIK
Cancel : 3
dr. Faris 1 : cancel
dr DH : 1 pasien sudah kontrol ke harkit
dr Denio : 1 reschedule bulan feb 2022

ECHO : 2
Stress Echo :
USG Doppler :
Holter :
ECG : 5
Treadmill : 1
CT Scan
Speckle
TEE :
DSE :
ABI :
Tilt Table Test : 1
Advance Echo : 2
Handle Echo :
ABPM :
Ezypro :
Cardioversi :
Referral Brawijaya : dr Chamim SpOG


SIC (CAROL) Sabtu, 29.01.22
TIPE PASIEN
YANG DINAS
LT NAMA UNIT
EMERGENCY ROOM
Dr Fajar
Dr Fajar Dr Audrey
EMERGENCY Dr Audrey
ROOM
Ns Susi
Ns Ardi
Ns Tomy 13
Ns Kelvin Ns Nur
Ns Putri
GF
PONEK 1
TOTAL PASIEN EMG
Poli Obgyn
Ns NS 1 :
Poli Urology IIN
Poli Ortho
Poli Internist
Poli Bedah Umum
Poli Bedah Plastik
Poli THT Kiki
Poli Gizi
Poli bedah saraf
Poli Neuro
Dermis
LT 3 Dental
Poli Endoscopy
Poli Fisioterapi
Poli Rehab Medik
Poli Nutrition
Poli Paru
Poli Mata
Poli Psikiatri
Pain Clinic
MCU
POLI KEMOTERAPI
ODC
TOTAL PASIEN OPD
Dr Mega Ns Dr Mega Ns
IN PATIENT Ns Nurul Ns
DEPARTMENT 4 taufik
Salwa Ns Citra Ns 7
Okta Abdi
LT 4
LT 5
Dr Ira Ns Dr Ira Ns
IN PATIENT Ns Anatian
DEPARTMENT 5 Ns Tita
Tari Ns Indah Ns 5
Yudi Rio
Dr Ira Dr Ira
IN PATIENT Ns Dini Dr Mega Dr Mega
LT 6 DEPARTMENT 6 Ns Avi Ns Risha Ns Kristin
5
Ns Nela Ns Silvi
Dr Ira Dr Ira
IN PATIENT Ns Dini Dr Mega Dr Mega
LT 6 DEPARTMENT 6 Ns Avi Ns Risha Ns Kristin
5
Ns Nela Ns Silvi
Kemoterapi
OPERATING THEATER
OK
7
CRITICAL CARE
Ns Awaludin, Br. Gisma, Ns. Agus,

ICU Ns. Winda Ns. Any Ns. Ningsih
HCU
Ns. Evi, Ns.
NICU Ns Esti Ns. Grace
Alfi
PICU
TOTAL Ps
CRITICAL
OBSTETRICS
Bd Putri Bd Genda Bd Dewi

VK Bd Genda Bd Putri Bd Viki
Nursery Bd Nelly Ns Nani Ns Ika 1
HEARTOLOGY
Ns Akbar
Cathlab Ns Tryanto
Hybrid
Ns Rini T
OPD JANTUNG
Ns Emma
17
LT 8
LT 8
Dokter Jaga
Dokter Jaga IGD : Pagi : dr Fajar Malam : dr Audrey
Dokter Jaga IPD : Pagi : dr Megawati Malam : dr Mega + dr Ira
KETERANGAN
TOTAL
PASIEN
OOM
PASIEN OBSERVASI :
RAJAL :
1. Ny Imaniar Fitria / G1 P0 A0 H 17 mg /
Ke Sesak nafas, batuk, pilek
2. An Muhammad Dean / 12 thn / open
wound ec terjatuh dekat selokan 2 hr SMRS
3. Ny Fitria Setyakirana / 43 thn / kel

Tangan kiri terjepit pintu
4. An Raneesha Fauzi / 1 thn / ISPA
5. Nn Chandra Purnama / 26 thn /
Dyspepsia
6 Nn Nabilah Ayu / 26 thn / Dyspepsia
7. Nn Putri Furqon / 27 thn / Nyeri menelan
sejak 1 hr SMRS 8.Ratna
Safira / 30 thn / Obsv Febris H1 9. Ny
Aliya Irsan Siregar / 25 thn / G1 P0 A0 /
Obsv Febris H 1 ( 39.7 c )
10. An Rafisqy Fauzi / 3 thn / ISPA
13
RANAP :
1. Syafiga Arinda / 19 thn / Obsv Febris
H14, batuk pilek / TUBEX + / Rawat
IPD 411 2. An
Sheza Nazifa / 1 thn / Dr Anisa SpA /
Bronchopneumonia / Rawat IPD 509
3. An Meutia Syifa
Kalis/ 2 thn / Inbalance of food,
Pneumonia / Dr Nina SpA / Rujukan
dari RSCM ( full bed ) /Rawat IPD 604
RUJUK :
APS :
D.O.A :
RAJAL :
1. NyDian Kristi / 36 thn / G3 P2 Ao /
Pro inj Venofer 2 amp
1 RANAP :
PASIEN OBSERVASI :
14
32
6
12
6
2
1
13
16
68
4
5
174
RTMENT PASIEN BARU :

1. Tn Yosea / Etty Budiasni, dr. Sp.M
/Cataract, Presence of intraocular lens
2.Nn. Syafiga /dr. Alvin, Sp.PD / Typoid
Fever
3.Ny. Alfiana / Nisa Fathoni, dr. Sp. OG,
IBCLC /Supervision of normal pregnancy
PASIEN OBSERVASI :
1. Tn Faridz Miftah / dr. Alvin, Sp.PD/

Dengue fever [classical dengue, Fever,
unspecified
2.Tn. Nasrullah / Perwira Widianto, dr.
3.Tn. Yosea / Etty Budiasni, dr. Sp.M
/Cataract, Presence of intraocular lens
4.Ny. Yetty Rosalina / Perwira Widianto,
dr. Sp.B-KBD/ abdominal pain
Fever
specified as haemorrhage or infarction,
7 IBCLC /Supervision of normal pregnancy
PASIEN PINDAH ICU :
RENCANA TINDAKAN :
RENCANA PULANG :
PASEN RENCANA RUJUK :
1.Ny. Yetty Rosalina / Perwira

Widianto, dr. Sp.B-KBD/ abdominal
pain -> R/ Rujuk ke RSCM --> sudah
menghubungi SPGDT RSCM Pusat dan
Kencana : jawaban masih penuh
PASIEN PULANG :

R/tindakan 2D SVT ablasi
2. An.SHEZA NAZIFA AZZAHRA /
Annisa Nur Aini, dr. Sp.A (FT) /
Bronchopneumonia, unspecified
PASIEN OBSERVASI :
1 Tn ASYRAF DHANADA
PANGESTULLAH / Alvin Nursalim,
dr. Sp.PD/Dengue fever
2. Tn.Izzat Helmi
sprain and strain of joint and
3. An. Radeya / dr. Hamida, Sp.THT /
Mastoiditis
4 .Ny . Norma / dr. Dicky hanafi Sp.JP/
R/tindakan 2D SVT ablasi
5. An.SHEZA NAZIFA AZZAHRA /
1. Tn. William / dr. Zicky, Sp.S /

Myasthenia gravis (Utama)
1. Tn Chandra / dr. Amanda Sp.PD/

R/tindakan EGD + colonoscopy +
biopsi, Rencana masuk 01/02/2022
(518)
RENCANA TINDAKAN
1.Tn.Izzat Helmi
Amier/dr.Rady.Sp.OT/Dislocation, sprain
and strain of joint and/ R/tindakan
hemiarthroplasty + implan hari senin,
31/01/2022
PASIEN PULANG :
1. Tn Anton/ dr. Dafsah Sp.Jp/ essential
primary hypertension
2. Ny. Agnes / dr. Radi, SpOT / Low
Back Pain
3. Ny. FANIA EL RIDHASYA /Tirsa
pregnancy

post tindakan 2D SVT ablasi
1. An. Meutia Syifa/ Nina Dwi Putri,

dr. Sp.A (K)/Pneumonia in viral
diseases classified elsewhere
PASIEN OBSERVASI :
1. An. Urai M Al
Inkiriwang,dr. SpA
Sp.OG / Premature rupture of membranes,
onset of labour within 24 hours
SpOG (K) Onk / Endometriosis of uterus
4. Ny. Listyorini / Chamim,DR. dr, SpOG
PASIEN PINDAH ICU :
RENCANA TINDAKAN
1. An. Davin Alief/ dr. Caroline supit,

SpB./ Ingrowing nail/ Rencana
tindakan debridement rozerplasty
dalam sedasi Jam 10.00 Wib.
PASIEN VK
PASIEN PULANG
5
5 1. An. Cut Salsabilla Hency / Diana
unspecified
4. An. Agmal/dr Nathalia Ningrum/
Dengue fever classical dengue
5. Ny. Risa / Febriansyah Darus, dr.
Sp.OG-KFM / Supervision of normal
pregnancy, Gestational [pregnancy-
induced] hypertension with significant
proteinur
6. Ny. Nafila / Nisa Fathoni, dr. Sp.
OG, IBCLC / Supervision of normal
pregnancy
RENCANA MASUK :
1. An. Davin Alief/ dr. Caroline supit,

SpB./ Ingrowing nail/ Masuk besok pagi
Tanggal 30/01/2022 , Rencana
tindakan debridement rozerplasty
dalam sedasi Jam 10.00 Wib.

Sp.OG / Premature rupture of
membranes, onset of labour within 24
hours.
EATER
4
1. Insisi Drenase Abses / Radeya Arya /
dr. Hamida Hayati Sp.THT /J. 07.00 / OK I
2. Laparascopy Total
Histerectomy /Ulva Yustina / dr. Chamim
Sp.OG (K) ONK /J. 07.00 / OK I
3. Cystectomy
Laparascopy /Listyorini Dian / dr. dr.
Chamim Sp.OG (K) ONK /J. 11.00 / OK I
4. Phaco Emulsoifikasi + IOL /Ny. Siti

7 Anisah / dr. Etty Budiasni Sp.M /J. 11.00 /
OK II
5. Phaco Emulsoifikasi / dr. Etty
Budiasni Sp.M /J. 11.30 / OK II
6. BEDAH M A T A - Phaco
Emulsoifikasi + IOL / Yosea Immanuel /
Etty Budiasni, dr. Sp.M,
7. BEDAH UMUM - Debridement
general anaesthesia / Muhamad Dean
Syarif / Caroline Supit, dr. SpB
ARE
1 1. Tn. Martono /74th/ Dx. intracerebral

haemorrhage + HT Emergency/ Dpjp. dr.
Vera Sp. An + dr. Zicky Sp. S + dr. Michael
Norman Jusman, Sp.BS
1 Myasthenia gravis (Utama)
0
0
PASIEN OBSERVASI :
1. Alfiana / dr. Nisa Sp. Og / G1P0A0

H 39 Mg 2 hari, inpartu Pro Induksi
1. Alfiana / dr. Nisa Sp. Og / G1P0A0

H 39 Mg 2 hari, inpartu Pro Induksi
PASIEN PONEK :
PASIEN OBSERVASI :
1.By.Ny. Pramanti
putri/dr.annisa,Sp.A/NCB SMK Usia 1
hari
1
PASIEN PULANG
1. By.Ny.Risa/dr.Ali,Sp.A/ NCB SMK
Usia 1 hari.
GY
Outpatient : 17
dr ario :
Dr dafsah : 5
dr denio :
dr faris :
17 dr DH : 3
dr DAW :
dr radityo :
Dr suko : 3
dr sunu : 6
dr Adi :
MCU : -
New patient:
Dr Suko 1 : PB dari teman
Dr Sunu 2 : 2 pasien lama harkit
Dr Dafsah 3 : 2 teman 1 dr amanda RSBS
Dr DH 1 : 1 dari sejawat
Cancel :
dr Dafsah 1 : no respon
dr Sunu 1 : cancel
Dr DH 4 : 3 reschedule pasien akan infokan
1 no respon
Dr Suko 1 : cancel

ECHO : 1
Stress Echo :
USG Doppler :
Holter :
ECG : 14
Treadmill : 3
CT Scan
Speckle
TEE :
DSE :
ABI :
Tilt Table Test : 1
Advance Echo : 3
Handle Echo :
ABPM :
Ezypro :
Cardioversi :
Referral Brawijaya : dr Amanda RSBS

Referral External :
dr Mega + dr Ira
SIC (CAROL) Minggu, 30.01.22
TIPE PASIEN
YANG DINAS
LT NAMA UNIT
EMERGENCY ROOM
Dr Dwi Dr
Dr Dwi Dr Fajar
EMERGENCY Fajar Ns
ROOM
Ns Sanusi
Ardhi Ns
Ns Kelvin 13
Ns Mohlis Ns Tomy
Fitri
GF
Dr Dwi Dr
Dr Dwi Dr Fajar
EMERGENCY Fajar Ns
ROOM
Ns Sanusi
Ardhi Ns
Ns Kelvin 13
Ns Mohlis Ns Tomy
Fitri
GF
PONEK
PONEK
TOTAL PASIEN EMG
Poli Obgyn
Ns NS 1 :
Poli Urology IIN
Poli Ortho
Poli Internist
Poli Bedah Umum
Poli Bedah Plastik
Poli THT Kiki
Poli Gizi
Poli bedah saraf
Poli Neuro
Dermis
LT 3 Dental
Poli Endoscopy
Poli Fisioterapi
Poli Rehab Medik
Poli Nutrition
Poli Paru
Poli Mata
Poli Psikiatri
Pain Clinic
MCU
POLI KEMOTERAPI
ODC
TOTAL PASIEN OPD
IN PATIENT Ns Taufik Ns Salwa Ns Citra
DEPARTMENT 4 Ns Okta Ns Okta Ns ABdi 6
LT 4 LT
5
LT 4 LT
5
IN PATIENT Ns Yudi Ns Tita Ns Ns Tary Ns

DEPARTMENT 5 Ns Santi Yudi Rio 3
IN PATIENT Ns Avi Ns Ns Risha Ns Kristin

LT 6 DEPARTMENT 6 Ade Ns Nella Ns Silvi
5
IN PATIENT Ns Avi Ns Ns Risha Ns Kristin
LT 6 DEPARTMENT 6 Ade Ns Nella Ns Silvi
5
Kemoterapi
OPERATING THEATER
Ns Sunandar
OK Ns Heryanti Ns Iqbal Ns Yanu 1
5
CRITICAL CARE
ICU
HCU
NICU
PICU
TOTAL Ps
CRITICAL
OBSTETRICS
Bd Putri Bd Genda Bd Dewi
VK Bd Genda Bd Putri Bd Viki
Nursery Bd Nelly Ns Nani Ns Ika 1
HEARTOLOGY
LT 8
Ns Akbar
Cathlab Ns Tryanto
LT 8 Hybrid
Ns Rini T
OPD JANTUNG
Ns Emma
Dokter Jaga
Dokter Jaga IPD : Pagi : dr Rona Malam : dr Nesya

KETERANGAN
TOTAL
PASIEN
OM
PASIEN OBSERVASI :
1. An Annisa Mussali / 3 thn /

Open Wound di dagu / Rencana
Heacting wound closer / Ok 1 jam
07.00 wib / book Ok Ns Iqbal ( ps
pulang- akan datang kembali tgl
31.01.22 jam 06.00 WIB )
2. Ny Dewi
Amalia / 38 thn / Kel sesak nafas
dan demam H1 Obsv Di EMG ,
datang jam 05.30 wib - sedang cek
LAB )
RAJAL :
1. Mohmmad Indra / 16 thn / Demam
> 3 hr, batuk pilek
2. An Izyan Alaric / 6 thn / Obsv
Febris H 3
3. Ny Elnifa / 56 thn / Nyeri lutut >
1 thn
4. Nn Alvi / 19 thn /
Conjungtivitis 5. An Anela Shafira
/ 5 thn / control luka post Heacting di
dagu 7 hr SMRS
6. Tn Muhammad
Mirza / 26 thn / ISPA, Headche / PCR
SWAB POSITIF
7. Tn Edo Neygro / 35 thn /
Unspecified renal colic
8. Ny Sinung Triwuland / 50 thn /
Contusion of thorak
9. Ny Sarah Sartika / 33 thn / Acute
Nasopharingitis ( Common Cold )
10. An Anissa Musali / 3 thn / Open
Wound di dagu
RANAP :
13
13 1. An Ezekiel Emmanuel / 3 thn /
Epilepsi ( kejang 1x sesaat di rs ) /
Dr Anisa SpA / Rawat 410 2.
Ny Hairiah Hm / 73 thn / Ps Tidak
sadarkan diri sejak jam 15.00 wib /
Ps APS dari RS Brawijaya
Antasari dan rujuk lepas ke RS
PON.Ps Berubah pikiran dan
datang ke RS Barawijaya Saharjo /
HCU / Dr Vera SpAN
RUJUK KE :
APS :
RUJUK DARI :
1. An Kimberly / 9 thn / EPILEPSI
/ Rencana masuk unit perawatan
Brawijaya Saharjo - dari
Brawijaya Antasari / dpjp Dr
Herbowo SpA / BATAL - HASIL
PCR swab POSITIF 2. By Ny
Retno Afrida / 1 hari / Dpjp dr Ari
SpA/ Rencana masuk unit NICU
Brawijaya saharjo, dgn Dpjp Dr
Erick SpA - dari Brawijaya Duren
Tiga / BATAL - Karena Tidak ada
alasan untuk merujuk bayi tsb
dikarenakan Dokter anak di Duren
tiga mampu merawat ps tsb serta
ps belum transportable GCS 5 / 7
RAJAL :
RANAP :
PASIEN OBSERVASI :
1
1
1. Ny Rachmasari / 29 thn / G1 P0
A0 H 38 mg 4 + / Kel Kontraksi
sejak jam 21.00 wib, keluar air
dari jalan lahir / Pembukaan 5 tipis
/ Obsv VK
14
11
5
1
17
MENT
1.An. Ezeziel Emmanuel / dr.Annisa

Sp.A / Febrile convulsions
PASIEN OBSERVASI :
1.Tn Faridz Miftah / dr. Alvin, Sp.PD/

unspecified
2.Tn. Nasrullah / Perwira Widianto,
dr. Sp.B-KBD/Acute appendicitis,
Inguinal hernia, Post Laparatomy
3.An. Ezeziel Emmanuel / dr.Annisa
Sp.A / Febrile convulsions
Widianto, dr. Sp.B-KBD/ abdominal
pain
5.Nn. Syafiga /dr. Alvin, Sp.PD /
Typoid Fever
6.Ny. Alfiana / Nisa Fathoni, dr. Sp.
OG, IBCLC /Supervision of normal
pregnancy
PASIEN PINDAH ICU :
1.Ny.Marlina Ika / dr.Bob

Andinata Sp.B (K) Onk / Rencana
KEMO hari senin 31/01/2022
2.An. Annisa Musali / dr.Sara
Ester Sp.BP-RE / Rencana Hecting
dagu
6
RENCANA TINDAKAN :
RENCANA PULANG :
1. Tn Nasrullah / Perwira
Widianto, dr. Sp.B-KBD/Acute
appendicitis, Inguinal hernia, Post
Laparatomy

Widianto, dr. Sp.B-KBD/
abdominal pain -> R/ Rujuk ke
RSCM --> sudah menghubungi
SPGDT RSCM Pusat dan Kencana
: jawaban masih penuh (UPDATE
31/1/22 jam 09.34, 19.13) >>>
saran rujuk lepas > pasein mau
diskusi dulu sama keluarga.
PASIEN PULANG :
1.Ny. Hj Sri / dr.Aldy Sp.S /

Stroke, not specified as
haemorrhage or infarction,
2.Tn. Yosea / Etty Budiasni, dr.
Sp.M /Cataract, Presence of
intraocular lens
PARTMENT
PASIEN OBSERVASI :
1.Tn.Izzat Helmi
sprain and strain of joint and
3.An.Sheza Nazifa Azzahra /
1. Tn Chandra / dr. Amanda

Sp.PD/ R/tindakan EGD +
colonoscopy + biopsi, Rencana
masuk 01/02/2022 (518)
RENCANA TINDAKAN
1.Tn.Izzat Helmi
sprain and strain of joint and/
R/tindakan hemiarthroplasty + implan
hari senin, 31/01/2022, Jam 18.00,
SIO (+)
PASIEN PULANG :
1. Tn Asyraf Dhanada
Pangestullah / Alvin Nursalim, dr.
Sp.PD/Dengue fever
2.Ny . Norma / dr. Dicky hanafi
Sp.JP/ Post tindakan 2D SVT
ablasi
MENT
1.Ny. Sri Sunarti/ Leiomyoma of

Uterus/ Veinardi Madjid,dr.
Sp.OG
2.An. Davin Alief Farrel/ In
growingnail/ Caroline Supit, dr.
SpB
PASIEN OBSERVASI :
1.An. Urai M Al
Inkiriwang,dr. Sp
2.An. Meutia Syifa/ Nina Dwi Putri,
dr. Sp.A (K)/Pneumonia in viral
diseases classified elsewhere
PASIEN PINDAH ICU :
RENCANA TINDAKAN
5
1.Ny. Sri Sunarti/ myoma of
Uterus/ Veinardi Madjid,dr.
Sp.OG/
- Rencana tindakan Histeroskopy
polimectomy tgl 31/1/22 jam
12.00 WIB.
5 2.An. Davin Alief Farrel/ In
growingnail/ Caroline Supit, dr.
SpB/ Rencana tindakan
debridement rozerplasty on sedasi.
Tanggal 31/01/2022 Jam 10.00
Wib.
PASIEN VK
PASIEN PULANG
1.Ny. Ulva/ dr. Chamim Sp.OG/

post laparascopy histerectomi
RENCANA MASUK :
1.Ny. Pramanti Putri / dr. Nisa

Fathoni, Sp.OG / Premature
rupture of membranes, onset of
labour within 24 hours.
TER
1. ALFIANA IKA PRASTANTI /
1 OK 2 ja 21.00 wib / Nisa Fathoni, dr.
Sp. OG, IBCLC
RENCANA TINDAKAN : Tgl 31.01.22

1. DAVIN ALIEF FARREL / BEDAH
UMUM - Debridement general anaesthesia
BEDAH UMUM - Rozerplasty / Ok 1 jam
10.00 wib / Caroline Supit, dr. SpB 2.
HUSIN SYARIF SHAHAB / OK Cathlab
jam 11.00 / wib BEDAH SARAF - PELD
+ DRG Ablation + Facet Ablation /
Syafrizal Abubakar, dr. Sp.BS
3. SRI
SUNARTI / BEDAH OBGYN -
5 Histeroskopi Poliipektomi / OK 1 jam
15.00 wib / Veinardi Madjid,dr. Sp.OG 4.
IZZAT HELMI AMIER / BEDAH
ORTHOPEDI - Hemiarthrosplasty / OK
1jam 18.00 wib / Radi Muharris Mulyana,
dr. Sp.OT 5.
ANNISA MUSALLI / BEDAH PLASTIK
- Jahitan Kulit dan Jahitan < 10 (jahit kulit
primer wajah oleh bedah plastik) / Ok 1
jam 23.29 wib / Sara Ester, dr. Sp.BP-RE
1. Tn. Martono /74th/ Dx.

intracerebral haemorrhage + HT
0 Emergency/ Dpjp. dr. Vera Sp. An +
dr. Zicky Sp. S + dr. Michael Norman
Jusman, Sp.BS
(SUDAH RUJUK KE RS
FATMAWATI )
Myasthenia gravis (Utama)
2. Ny Hairiah Hm / 73 thn / Ps Tidak
sadarkan diri sejak jam 15.00 wib / Ps
APS dari RS Brawijaya Antasari dan
2 rujuk lepas ke RS PON.Ps Berubah
pikiran dan datang ke RS Barawijaya
Saharjo / HCU / Dr Zicky SpS, Dr
Vera SpAN
1.By.Ny. Pramanti
1 putri/dr.annisa,Sp.A/NCB SMK Usia
2 hr / Sepsis, melena / Dr Erick SpA
PASIEN OBSERVASI :
1. Alfiana / dr. Nisa Sp. Og /
G1P0A0 H 39 Mg 2 hari, inpartu
Pro Induksi - SC CITO jam 21.00
wib 2.
Ny. Rachmasari Cahyaningdyah /
dr. Nisa.SpOg / G1P0A0 H38
minggu 4 hari, inpartu fase laten,
KPD 1 jam
2
RENCANA TINDAKAN :
1. Alfiana / dr. Nisa Sp. Og /

G1P0A0 H 39 Mg 2 hari, inpartu
Pro Induksi - SC CITO jam 21.00
wib
PASIEN PONEK :
1. Ny. Rachmasari Cahyaningdyah

/ dr. Nisa.SpOg / G1P0A0 H38
minggu 4 hari, inpartu fase laten,
KPD 1 jam
PASIEN OBSERVASI :
1. By. Ny. Alfiana ika Prastanti
/dr. Annisa sp.A /NCB SMK usia
9 jam
1
PASIEN PULANG
PASIEN DI NICU
1.By.Ny. Pramanti
putri/dr.annisa,Sp.A/NCB SMK
Usia 2 hr / Sepsis, melena / Dr
Erick SpA
Next Schedule : tgl 31.01.22
1. HUSIN SYARIF SHAHAB /
OK Cathlab jam 11.00 / BEDAH
SARAF PELD + DRG Ablation +
Facet Ablation / Syafrizal Abubakar,
dr. Sp.BS
TIPE PASIEN
YANG DINAS
LT NAMA UNIT
EMERGENCY ROOM

Ns. Susi, Br. Kelvin, Ns.
ROOM Mohlis
Ns. Rizam
Ardi
GF
PONEK
TOTAL PASIEN EMG
Poli Obgyn
Ns NS 1 :
Poli Urology IIN
Poli Ortho
Poli Internist
Poli Bedah Umum
Poli Bedah Plastik
Poli THT Kiki
Poli Gizi
Poli bedah saraf
Poli Neuro
Dermis
LT 3 Dental
Poli Endoscopy
Poli Fisioterapi
Poli Rehab Medik
Poli Nutrition
Poli Paru
Poli Mata
Poli Psikiatri
Pain Clinic
MCU
POLI KEMOTERAPI
ODC
TOTAL PASIEN OPD
DS = Ns.
DP = Ns. DM = Ns.
IN PATIENT Wulan + Ns.
Nurul + Ns. Salwa + Ns.
DEPARTMENT 4 Wulan Octa
Ella
LT 4
LT 5
LT 4
LT 5
DP = Ns. DS = Ns.
DM = Ns.
IN PATIENT Ana + Ns. Tita + Br.
Tary + Br.
DEPARTMENT 5 Santi Malik
Yudi
IN PATIENT Dini + Bd. Avi+ Ns.
LT 6 DEPARTMENT 6 ade Nella
Risha + Ns.
Nadia
Kemoterapi
OPERATING THEATER
OK
CRITICAL CARE
Gisma,
ICU Awaludin Elga, Rita
Winda
HCU
NICU
Esty Lisa Evi
PICU
TOTAL Ps CRITICAL
OBSTETRICS

Malam : bd.
bd. Dilla, Putri, bd.
VK bd. Anggi Genda
Ningsih, bd.
Tries
‌Dines ‌Dines
Malam : bd.
bd. Dilla, Putri, bd.
VK bd. Anggi Genda
Ningsih, bd.
Tries
‌Dines ‌Dines
Dinas
pagi : Ns. ‌Dines
‌Dines
Inggrid Siang : Ns.
Nursery Midlle : Nelly
Malam :Ns
. Nani
Wiwi
HEARTOLOGY
Cathlab
Hybrid
LT 8
OPD JANTUNG
Dokter Jaga
Dokter Jaga IGD : Pagi : dr dr. Firdha Malam : dr Dwi
Dokter Jaga IPD : Pagi : dr Malam : dr Mega
Dokter Jaga Critical : Pagi : dr dr. Rizky Malam : dr Dewi

KETERANGAN
TOTAL
PASIEN
akan dilakukan)
CY ROOM
PASIEN OBSERVASI :
RAJAL :
1.Ny. Sarah Sartika /33th/ Dx. Common Cold 2.
Ny. FAtimah /34th/ Dx. Ca. Plasenta +
Hydatidiform mole
3. Tn. Renzy Alitmarga /39th/ Dx. Coronavirus
infection 4.
Nn. Resha Aprilianti /25th/ Dx. Dyspepsia +
Dhiare
5. Nn. Ferlauna /27th/ Dx. Cedera superfisial kaki
bagian bawah 6.
Tn. Hendro Saputro /29th/ Dx. Fever 7.
An. Aruna Nuala G /5th/ Dx. Kontrol Post Hecting
Hri ke 3 8. Tn.
Kamil Saragih /28th/ Dx. Dyspepsia 9. Ny.
Keiva Ribby /25th/ Dx. G1P0A0 hamil 9 minggu 5
hari + hipoferitin + JPKTH / Menerima instruksi
dr, nisa fathoni, SpOG via buku kontrol tgl 17 jan
2022 untuk infus venofer 2 ampul dalam 100 ml
Nacl 0,9% 10. Nn. Rizqiana Rani /29th/ Dx.
Ispa + Dhiare 11. Tn. Albertho Joris /33th/ Dx.
tonsillitis Akut 12. Tn. Arya Danaswara /25th/ Dx.
17 Dhiare 13. Tn. Yudithia Sinatra /40th/ Dx.
Ispa + Fever 14. Nn. Nadya Belinda /29th/ Dx.
Nausea and vomiting + Dyspepsia
15. An. Keevano Deishan /1th 8bln/
Dx. Coronavirus infection
16. Nn Shiva Ramadhan /22th/ Dx. Alergy +
Dyspepsia
RANAP :
1. Ramada Sinaga /45th/ Dx. abdominal pain,
Fever, Diarrhea / Dpjp. Alvin Nursalim, dr.
Sp.PD / Ruang 402
RUJUK KE :
APS :
RUJUK DARI :
RAJAL :
RANAP :
0
PASIEN OBSERVASI :
16 Pasien
25
2
4
1
12
1
5
6
10
8
5
5
30
2
124

1.Ny. Ramada Sinaga/ dr. Alvin, Sp.PD/ fever,
diare, abdominal pain
2.Ny. Marlina Ika / dr. Bob Andinata, Sp. B (K)
Onk / CA Mamae / ODC
3.Ny. Ika Putri / Chamim, DR, dr, SpOG (K)
Onk / CA Utery
PASIEN OBSERVASI :

2.Ny. Ramada Sinaga/ dr. Alvin, Sp.PD/ fever,
3.An. Ezeziel Emmanuel / dr.Annisa Sp.A /
Febrile convulsions
4.Ny. Marlina Ika / dr. Bob Andinata, Sp. B (K)
Onk / CA Mamae
5.Nn. Syafiga /dr. Alvin, Sp.PD / Typoid Fever
Onk / CA Utery
PASIEN PINDAH ICU :
RENCANA PULANG :

2.Ny. Marlina Ika / dr. Bob Andinata, Sp. B
(K) Onk / CA Mamae / ODC
Onk / CA Utery
Febrile convulsions
PASIEN PULANG :
KBD/Acute appendicitis, Inguinal hernia,
Post Laparatomy
2.Ny. Yetty Rosalina / Perwira Widianto, dr.
Sp.B-KBD/ abdominal pain
PASIEN OBSERVASI :
1.An. Radeya Arya/ dr. Hamida, Sp.THT /
Mastoiditis and related conditions
2.An.Sheza Nazifa Azzahra / Annisa Nur
Aini, dr. Sp.A (FT) / Bronchopneumonia,
unspecified
1.Tn.Izzat Helmi Amier/dr.Rady.Sp.OT/

Fracture of femur
1.Tn. Chandra / dr. Amanda Sp.PD/

R/tindakan EGD + colonoscopy + biopsi,
Rencana masuk 01/02/2022 (518)
2.Tn. Husein Arif/ dr. Syafrizal / R/ tindakan
PELD , Rencana masuk 31/01/2022 (503)
RENCANA TINDAKAN
PASIEN PULANG :

1.Ny. Rachmasari Cahyaningdyah / dr. Nisa
Fathoni, Sp.OG / Post SC P1A0
2.Ny. Hina Watanabe / dr. Nisa Fathoni,
Sp.OG / G1P0A0 hamil 39 minggu 4 hari Pro
induksi
PASIEN OBSERVASI :
1.An. Urai M Al haziq/ dr. Riana, S.PBA /

Intussusception
2.Ny. Sri Sunarti / Veinardi Madjid,dr. Sp.OG /
post tindakan histereskopi polipektomi
4.Ny. Hina Watanabe / dr. Nisa Fathoni, Sp.OG /
G1P0A0 hamil 39 minggu 4 hari Pro induksi
PASIEN PINDAH ICU :
RENCANA TINDAKAN
4 PASIEN VK
Sp.OG / G1P0A0 hamil 39 minggu 4 hari Pro
induksi
PASIEN PULANG
1.Ny. Pramanti Putri / dr. Nisa Fathoni,

Sp.OG / Premature rupture of membranes,
onset of labour within 24 hours.
2.An. Davin Alief Farrel/ Caroline Supit, dr.
SpB / In growingnail
3.An. Meutia Syifa/ Nina Dwi Putri, dr. Sp.A
(K) / Pneumonia in viral diseases classified
elsewhere
RENCANA MASUK :

1.An. Urai M Al haziq/ dr. Riana, S.PBA/
Intussusception
THEATER
1. Tindakan Senin, 31-01-22
- SC / Ny. Rachmasari C / dr Nisa Fathoni , Sp.OG
IBCLC /J.06.55 / OK II
- Bedah Plastik (Open Wound of Other Parts Of
Heead) / Annisa Musalli / dr. Sara Ester Sp.BP-RE
/J. 07.30 / OK II -
Debridement + Rozerplasty /Davin Alief Farrel
/dr. Caroline Supit Sp.B / OK I /J. 10.00
6 - PELD + DRG
Ablasi + Facet Ablasi / Husin Syarif /dr. Syafrizal
Abubakar , Sp.BS /J. 11.00 / OK CATHLAB
- Histeroskopi
Polipektomi / Sri Sunarti /dr. Veinardi Madjid Sp.
OG / J. 15.00 / OK I - Hemiarthrospasty
/Tn. Izzat Helmi Amier / dr. Radi Muharris Sp. OT
/ J. 18.00 / OK I
2. Rencana tindakan Selasa, 01-02-22 -
L CARE
1. Tn. William Tanady /40th/ Dpjp. dr. Zicky,

Sp.S / Myasthenia gravis (Utama)
2. Ny Hairiah Hm /73 thn/ Dx.
3 Stroek / Dpjp. Dr Zicky SpS, Dr Vera SpAN
3. Tn. Izatt Helmi /72th/ Dx.
Heimiarthtroplasty Bipolar Long Stem /Dpjp. Dr.
Vera Sp. An, Dr. Radi Sp. OT, Dr. Amanda Sp.
PD, Dr. Faris Sp.JP
1. By.Ny. Pramanti putri /Usia 3hari/ Hari Rawat

1 Ke 2 / Dx. MELENA / Dpjp. dr. Annisa,Sp.A, Dr
Erick SpA
4 Pasien
PASIEN OBSERVASI :
1. Ny. RachmasariCahyaningdyah / dr. Nisa.
Sp. Og/ G1P0A0 H38 minggu 4 hari dengan
KPD--> SC cito jam 07.00
2. Ny. Hina watanabe/dr. Nisa, Sp.OG/
G1P0A0 hamil 39 minggu 4 hari pro induksi.
Partus spontan jam 00.54.
2
RENCANA TINDAKAN :
2
1. Ny. Dr. Fransisca/dr.nisa, spog/ G1P0A0

hamil 39 minggu pro induksi. Pasien rencana
datang jam 13.00
PASIEN PONEK :
PASIEN OBSERVASI :
1. By. Ny. Alfiana ika Prastanti /dr. Annisa
sp.A /NCB SMK usia 2 Hari
2. By. Ny Rachmasari / dr. Keumala, Sp.A /
3. By Ny Hina Watanabe / dr. Keumala, Sp.A
3 / NCB SMK Usia 5 jam
PASIEN PULANG
PASIEN DI NICU
OLOGY
11 Pasien
SIC (EKO) Selasa, 01.02.22
TIPE PASIEN
YANG DINAS
LT NAMA UNIT
EMERGENCY ROOM

NS. Rizam, Ns. Ardi, Zr.
ROOM Zr. Nur
Br. Mohlis
Fitri
GF
PONEK
PONEK
TOTAL PASIEN EMG
Poli Obgyn
Ns NS 1 :
Poli Urology IIN
Poli Ortho
Poli Internist
Poli Bedah Umum
Poli Bedah Plastik
Poli THT Kiki
Poli Gizi
Poli bedah saraf
Poli Neuro
Dermis
LT 3 Dental
Poli Endoscopy
Poli Fisioterapi
Poli Rehab Medik
Poli Nutrition
Poli Paru
Poli Mata
Poli Psikiatri
Pain Clinic
MCU
POLI KEMOTERAPI
ODC
TOTAL PASIEN OPD

DP = Br. DS = Ns. DM = Ns.

IN PATIENT Taufik Wulan Salwa + Ns.
DEPARTMENT 4
Ella
LT 5
LT 4
LT 5
DP = Ns. DS = Ns.
DM = Ns.
IN PATIENT Indah + Br. Indah + Br.
Tita + Br.
DEPARTMENT 5 Malik Malik
Yudi
DP = Ns. DS = DM = Ns.
IN PATIENT Avi+ Bd. Ns.Kristin+
LT 6 DEPARTMENT 6 ade Ns. Silvi
Risha + Ns.
Nella
Kemoterapi
OPERATING THEATER
Yohana,
OK Risyaf,
Herry
CRITICAL CARE
Elga,
Elga,
ICU Ningsih
Ningsih, Agus, Any
Agus Midle
HCU
NICU
Esty Lisa Evi
PICU
TOTAL Ps CRITICAL
OBSTETRICS
Dines pagi : D
‌ ines siang : ‌Dines
bd. Dewi, bd. Dilla, malam : bd.
VK bd. Viki bd. Anggi Putri, bd.
Genda
Dines pagi : D
‌ ines siang : ‌Dines
bd. Dewi, bd. Dilla, malam : bd.
VK bd. Viki bd. Anggi Putri, bd.
Genda
Dinas
pagi : Ns. ‌Dines
‌Dines
Inggrid Siang : Ns.
Nursery Midlle : Nelly
Malam :Ns
. Nani
Wiwi
HEARTOLOGY
Cathlab
Hybrid
LT 8
OPD JANTUNG
Dokter Jaga
Dokter Jaga IPD : Pagi : dr Rona Malam : dr Mutiara
Dokter Jaga Critical : Pagi : dr Nilam Malam : dr Rizky

KETERANGAN
TOTAL
PASIEN
akan dilakukan)
CY ROOM
PASIEN OBSERVASI :
RAJAL :
1. An. Andien Zulaika /3th 9bln/ Dx. Ispa 2.
An. Muhammad Rasya /13th/ Dx. Fever 3.
Ny. Ratna Hartani /40th/ Dx. Ispa 4.
Tn. Jayant Kumar /67th/ Dx. Diabetes Melitus 5.
Tn. Ghafiqi Kusuma /27th/ Dx. Fever 6.
Ny. Elsi Cucu W /39th/ Dx. Urticaria 7.
Ny. Suwarni /68th/ Dx. Dhiare 8.
By. Kinandra /6bln/ Dx. Dhiare 9.
Ny. Maria Francesca /30th/ Dx. Dhiare 10.
Ny. Atrasya Rahwita /27th/ Dx. Thipoid
12 RANAP :
1. Tn. Chandra Jaya /57th/ Dx. Melena /
Dpjp. Amanda Pitarini Utari,dr, SpPD-KGEH
/ Ruang 518 2. Tn.
Pui Johnny /39th/ Dx. Fatty Liver + Calculus
/39th/ Dpjp. Murdani Abdullah, Prof. dr.
SpPD-KGEH / Ruang 403
RUJUK KE :
APS :
RUJUK DARI :
RAJAL :
RANAP :
2
1. Ny. Dr. Fransiska /28th/ Dx.G1P0A0
hamil 40 minggu JPKTH pro Induksi / Dpjp.
Nisa Fathoni, dr. Sp. OG, IBCLC / Rawat VK
2 induksi dan observasi
2. Ny. Nining Kusuma /34th/
Dx. G2P1 hamil 37 minggu, Rencana Sc di tgl
02.02.22 / Dpjp. Ardiansjah Dara Sjahruddin,
dr. Sp.OG / Ruang 611
PASIEN OBSERVASI :
14 Pasien
1.Tn. Pui Johnny / Murdani Abdullah, Prof. dr.

SpPD-KGEH/Cholecystitis
PASIEN OBSERVASI :
fever
2.Ny. Ramada Sinaga / dr. Alvin, Sp.PD/ fever,
SpPD-KGEH / Cholecystitis
IBCLC /Post OP Sc
PASIEN PINDAH ICU :
RENCANA TINDAKAN :
4 RENCANA PULANG :

IBCLC /Post OP Sc
2.Tn. Faridz Miftah / dr. Alvin, Sp.PD/
Dengue fever
PASIEN PULANG :

Febris convulsi
2.Ny. Marlina Ika / dr. Bob Andinata, Sp. B
(K) Onk / CA Mamae
Fever
Onk / CA Utery
1.Tn. Chandra / dr. Amanda, Sp.PD / Melena
PASIEN OBSERVASI :
2.An. Sheza Nazifa Azzahra / dr. Annisa Nur
Aini, Sp.A (FT) / Bronchopneumonia
3.Tn. Chandra / dr. Amanda, Sp.PD / Melena
1.Tn. Izzat Helmi Amier / dr. Rady.Sp.OT /

Fracture of femur
2.Tn. William / dr. Zacky, Sp.S /
Myasthenia gravis
1.Tn. Husein Arif / dr. Syafrizal, Sp.S /

Rencana tindakan PELD, rencana masuk
31/01/2022 (Kamar 503)
2.Tn. Teguh / dr. Syafrizal, Sp.S / Rencana
tindakan PELD, rencana masuk 02/02/2022
(Kamar 511)
3.Ny. Desi / dr. Dicky Hanafy, Sp.JP /
Rencana tindakan 3DVT Ablasi, rencana
masuk 02/02/2022 (Kamar 507)
RENCANA TINDAKAN
1.Tn. Chandra / dr. Amanda, Sp.PD / Melena,
rencana tindakan Kolonoskopi tgl 02/02/2022 sore
--> FU jam
PASIEN PULANG :
1.dr. Fransiska / Nisa Fathoni, dr. Sp. OG,

IBCLC / G1P0A0, 40 minggu pro induksi
2.Ny. Nining Kusuma / dr. Ardiansjah
Dara,Sp.OG / G2P1AO, Hamil 38 Minggu
PASIEN OBSERVASI :
2.Ny. Hina Watanabe / dr. Nisa Fathoni, Sp.OG /
Post Partum P1A0
4.Ny. Nining Kusuma / dr. Ardiansjah Dara,Sp.OG
/ G2P1AO, Hamil 38 Minggu
PASIEN PINDAH ICU :
RENCANA TINDAKAN
Dara,Sp.OG / G2P1AO, Hamil 38 Minggu /
Rencana Tindakan SC tanggal 2/2/22 jam
10.00 WIB
4
PASIEN VK
PASIEN PULANG
1.An. Urai M Al haziq/ dr. Riana, S.PBA/

Intususepsi
2.Ny. Sri Sunarti / Veinardi Madjid,dr. Sp.OG
/ post tindakan histereskopi polipektomi
RENCANA MASUK :
1.Ny Aprilia Ekawati / dr. Febriansyah Darus /

G1POAO, Hamil 38 Minggu (Kamar 610)
2.Ny.Asih / dr.Fransisca Noela,Sp.OG /
(Kamar 601)
3.Ny.Siti Dina / dr.Tirsa,Sp.OG/ (Kamar 618)
THEATER
1. Tindakan Selasa, 01-02-22
- hemicraniectomy dekompresi / Ny. Hairiah HM /
1 dr Michael Norman Jusman, Sp.BS / J.19:16 / OK
I
2. Rencana tindakan Rabu, 02-02-22
- SC / ny. Nining Kesuma Jati / dr. Ardiansyah
Darah Sp.OG / J. 10.00 / Di OK I -
SC / ny. Siti Dina S / dr. Tirsa Verani Sp.OG / J.
12.00 / Di OK I -
SC / ny. Aprilia Ekawati / dr.Febriansyah Darus
Sp.OG / J. 13.30 / Di OK I -
6 SC + Tubektomy / ny. Asih Wijayanti / dr.
Fransisca Noela Sp.OG / J. 15.00 / Di OK I
- Sirkumsisi / An. Sadam Mikhail
A / dr. Wulan Ayudyasari Sp.B / J. 17.00 / Di OK I
- Pro Eksisi + Debridement /
ny. Nur Azis / dr. Bob Andinata Sp.B(K)Onk / J.
20.00 / Di OK I
L CARE
1. Tn. William Tanady /40th/ Dpjp. dr. Zicky,

Sp.S / Myasthenia gravis
2. Ny Hairiah Hm /73 thn/ Dx. Cerebral
oedema + Atrial fibrillation and flutter + troke, non
haemorrhage / Dpjp. dr. Alvin Sp.PD, dr. Michael
3 Sp.BS, dr. Vera Sp.AN KIC , dr. Zicky Sp.S (Post
Craniotomy)
3. Tn. Izatt Helmi /72th/ Dx.
Atherosclerotic heart disease + Stroke not
haemorrhage + Fracture of femur (Post
hemicraniectomy dekompresi) / Dpjp. Dr. Vera
Sp. An, Dr. Radi Sp. OT, Dr. Amanda Sp. PD, Dr.
Faris Sp.JP
1. By.Ny. Pramanti putri /Usia 4 hari/ Hari

1 Rawat Ke 3 / Dx. MELENA +Sepsis / Dpjp. dr.
Annisa,Sp.A, Dr Erick SpA
4 Pasien
PASIEN OBSERVASI :
1. Ny. Dr. Fransisca/dr.nisa, spog / G1P0A0
1 hamil 40 minggu pro induksi.
RENCANA TINDAKAN :
1. Ny. Nining kusuma jati/ dr. Dara,
spog/G2P1A0 hamil dgn BSC 1x. Rencana
SC jam 10.00
2. Ny. Siti dina shabrina/dr. Tirsa, spog/
G4P2A1 hamil 38 minggu 4 hari dengan BSC
2x. rencana sc jam 12.00
4
3. Ny. Aprilia ekawati/dr. Febriansyah, spog/
G1P0A0 hamil 38 minggu pro sc on request+
eracs. Rencana sc jam 13.30
4. Ny. Asih wijayanti/ dr. Noela,
spog/G4P2A1 hamil 38 minggu dengan
presbo. Rencana sc jam 15.00
PASIEN PONEK :
1. Ny. Dr. Fransisca/dr.nisa, spog/ G1P0A0
1 hamil 40 minggu pro induksi.
PASIEN OBSERVASI :
1. By. Ny. Alfiana ika Prastanti /dr. Annisa
sp.A /NCB SMK usia 2 Hari
2. By. Ny Rachmasari / dr. Keumala, Sp.A /
3. By Ny Hina Watanabe / dr. Keumala,
Sp.A / NCB SMK Usia 1 Hari
3
PASIEN PULANG
PASIEN DI NICU
OLOGY
Hari/Tanggal : Selasa, 01.02.22
NO UNIT RUANGAN/
KELAS/ BED
1 CRITICAL ICU
RUANGAN/
NO UNIT
KELAS/ BED
2 CRITICAL ICU
asa, 01.02.22
NAMA PASIEN/ UMUR/ DIAGNOSA
Ny. HAIRIAH HM AKIB /73th/ Dx. Cerebral

oedema + Atrial fibrillation + Stroke not haemorrhage
+ Bacterial pneumonia
NAMA PASIEN/ UMUR/ DIAGNOSA

Tn. IZZAT HELMI /72th/ Dx. Atherosclerotic heart
disease + Stroke not haemorrhage + Fracture of femur
(Post hemicraniectomy dekompresi)
DOKTER
dr. Michael Sp.BS + dr. Vera Sp.AN KIC +

dr. Zicky Sp.S + dr. Alvin Sp.PD
DOKTER
Dr. Radi Sp. OT, Dr. Vera Sp. An, Dr. Amanda
Sp. PD, Dr. Faris Sp.JP
KETERANGAN
Penurunan kesadaran sejak Selasa siang. kontak tidak baik, stupor.

makan dan minum terakhir 9.00. riwayat lixiana terakhir jam 7.00,
heparin terakhir jam 8.00
02.02.22 J.01:43 post operasi hemicraniectomy dekompresi
hemodinamik stabil
Pasien tiba dr OK post hemicraniectomy dekompresi., lama operasi

2 jam, perdarahan 1000 cc
TTV : Bb= 67, Tb = 165, BMI = 24.61, Td = 85 / 54, N = 140, RR = 24,
Temp = 38.1, E = 1, M = 5, V = afasia
PHYSICAL EXAMINATION :
Kesadaran dalam pengaruh obat, on vascon 0.03 mcg/kg/menit -->
BP 146/59 mmHg, HR 94-98x/ menit
on ventilator
ADVICE :
Transfusi 1 unit FFP dan 1 unit PRC
Cek lab postop (DPL, ur/cr, elektrolit, agd, GDS, laktat)
IVFD RL 500 cc/ 8 jam
Titrasi norepinefrin target MAP 60-100 mmHg
Analgetik sesuai TS ICU
KETERANGAN
20:51 pasien mengatakan perutnya masih begah, dan sedikit mual
Ku pasien tampak sakit sedang, sempat muntah tadi pagi, cair, bicara
agak pelo,Kes: CM GCS: 15 E4M6V5, terpasang 02 NK 5 lpm,
terpasang iv line tangan kanan dan kiri, terpasang drain femoralis
sinistra, produksi darah, terpasang DC, produksi urine ada, warna
kuning, 22:54 Nyeri saat kaki digerakkan
TTV :
Bb = 81, Tb = 179,
BMI = 25.28, Td Sistolik = 111, Diastolik = 83, RR = 18, PR = 71,
Temp = 36, E = 4, M = 6, V = 5 CM, GCS = 15, Pain Level = 2-3
PHYSICAL EXAMINATION :
intake : 1689 cc
urine : 350 cc
balans : (+) 1339 cc
diuresis: 0.35cc/kg/jam
OTHER :
MRI brain :
Lesi di white matter lobus fronto-temporo-parietal kanan;
sesuai dengan chronic cerebral infarction.
White matter ischemic foci pada cortical-subcortical lobus
oksipital kanan
Cerebral atrofi senilis disertai leukoaraiosis periventrikel
lateralis bilateral.
Cerebellum dan batang otak baik.
ADVICE :
dr. Vera Sp.An KIC
lapor pasien mulai oligouri
acc lasix drip
lapor hasil MRI brain
dr. Zicky Sp.S
lapor hasil MRI brain
advis: terapi lanjut
rencana edukasi ulang ke keluarga besok sore
KAMAR/ KENDALA YANG
IDENTITAS PASIEN
KELAS DITEMUKAN
Ny. HAIRIAH HM AKIB /73th/

Dx. Cerebral oedema + Atrial
dr. Grace Dan Team Ok
OK fibrillation + Stroke not
Komplain
haemorrhage + Bacterial
pneumonia
KETERANGAN
(Informasi yang di dapat dari Unit terkait)
Team ICU, dan Team OK melaporkan ke SIC bahwa BHP Untuk
tindakan dan BHP Anstesi belum juga di terima oleh Team OK, info yg
di dp bahwa Farmasi sdh terinfo dri pukul 17.00 wib 0leh p.nandar
(Koor OK), OT dan di Bantu Unit ICU (Ns. Agus) sdh mencoba berulang
kali untuk mnghub farmasi untuk segera di naikan, respon dri farmasi
BHP lgi di siapkan dan segera di naekan, Sic menghub farmasi 1x dri
ICu, dan yang ke 2 x dari OK karena smpai dgn pukul 19.20 blm juga
naik, kurang lebih pukul 19.25 baru BHP sampai di lantai 7 (Dam
Wter), Sic dan freelans Anstesi mengambil dan meberikan BHP ke
p.Risyaf ke dlm Ruang OK I
TINDAK LANJUT DATE
PIC
(ACTION PLAN) LINE
→ Sic Meminta kepada unit Farmasi menjelaskan kendala
dan maslah yg menghambat pengiriman BHP ke Ruang OK
dan meminta untuk di buat kan kronologis kejadian
→ Sic Sudah
melaporkan langsung komplainan OK, dan dr. Anstesi ke
Doc Rain dan Doc Putri G3pada saat itu
SIC (CAROL) RABU, 02.02.22
TIPE PASIEN
YANG DINAS
LT NAMA UNIT
EMERGENCY ROOM
Dr Dwi Dr
Dr Fajar Dr Dwi
EMERGENCY Fajar Ns
Ns Susi Ns Sanusi
ROOM Ns Nur
Mohlis Ns
Ns Fitri
Tomi
GF
Dr Dwi Dr
Dr Fajar Dr Dwi
EMERGENCY Fajar Ns
Ns Susi Ns Sanusi
ROOM Ns Nur
Mohlis Ns
Ns Fitri
Tomi
GF
PONEK
TOTAL PASIEN EMG
Poli Obgyn
Ns NS 1 :
Poli Urology IIN
Poli Ortho
Poli Internist
Poli Bedah Umum
Poli Bedah Plastik
Ns NS 2 :
Kiki
NS 2 :
Poli THT Kiki
Poli Gizi
Poli bedah saraf
Poli Neuro
Dermis
LT 3 Dental
Poli Endoscopy
Poli Fisioterapi
Poli Rehab Medik
Poli Nutrition
Poli Paru
Poli Mata
Poli Psikiatri
Pain Clinic
MCU
POLI KEMOTERAPI
ODC
TOTAL PASIEN OPD
Ns Citra
IN PATIENT Ns Nurul Ns Ns Wulan
DEPARTMENT 4 Taufik
Ns Abdi
Ns Ella 4
Ns Taufik
Ns Citra
IN PATIENT Ns Nurul Ns Ns Wulan
DEPARTMENT 4 Taufik
Ns Abdi
Ns Ella 4
Ns Taufik
LT 4 LT
5
IN PATIENT Ns Anatian Ns Indah Ns Tita Ns
DEPARTMENT 5 Ns Santi Ns Rio Malik 7
IN PATIENT Ns Dini Ns Kristin Ns Avi Ns

LT 6 DEPARTMENT 6 Ns Ade Ns Silvi Nella
9
KERUSAKAN
OPERATING THEATER
Ns Sunandar
OK Ns Heryanti
CRITICAL CARE
ICU Ns Awaludin Ns Agus
HCU
NICU
Ns Esti Ns Ayu
PICU
TOTAL Ps CRITICAL
OBSTETRICS
Bd Vicky Bd Dilla Bd Putri

VK Bd Dewi Bd ANggi Bd Gena
Nursery Ns Inggrid Ns Nelly NsIka

HEARTOLOGY
Cathlab
Hybrid
Ns Rini T
OPD JANTUNG Ns
Emma
LT 8
LT 8
Dokter Jaga
Dokter Jaga IPD : Pagi : dr Malam :
Dokter Jaga Critical : Pagi : dr Riri Malam :

TOTAL
BERAT PASIEN
RGENCY ROOM
PASIEN OBSERVASI :
1. An M Raffa Adi / 13 thn / ISPA

2. Ny Anggit
Pratiwi / 31 thn / ISPA
3. Tn Airlangga / 36 thn /
BAtuk Pilek H2
4. Ny Carolin Amelia / 38
thn / ISPA
5. Ny Monica / 38 thn / Batuk pilek ,
Demam H2
6. Tn Bryan Andika / 28 thn / Demam
dan Flu H 1 - PCR SWAB POSITIF
7. Nn Veronica Supriya / 30
thn / Vomiting
8. Ny Nila Rahmawati / 28 thn /
G1 P0 A0 / Post SC 11 hr SMRS / Pro
GV luka post op
9. An Raizan Al Fatih / 5 thn /
Robek di daerah kening ec terjatuh.
10. Sabrina
Aulia / 20 thn / Malaise / Post injeksi
vaksin ke 2 11.
Tn Bryan Yoga / 28 thn / Demam, Flu
H1 / PCR SWAB POSITIF
12. Ny Elba Anabela / 28 thn /
Batuk batuk H1
13. Tn haikal Kamil/ 30 thn /
Hipertermia H 1 / PCR SWAB POSITIF
14. Ny Nung Anggraeti / 63 thn /

Obsv Febris H1 / PCR SWAB POSITIF
RAJAL :
17 17
RANAP :
17 17
1. Ny Devi Ramesh / 70 thn /DpJp Dr

Chammim SPOG - riw Chemotherapi ec
Ca Ovarium / Rawat 604
2. Tn Yusuf
Asmara / 40 thn / Nyeri kepala H 1 / Dr
Arief SpS / Rawat IPD 412
3. An Keitaro Nakira /
3 thn / Obsv Febris H 3 / Dr Anisa SpA /
Rawat IPD 612
4. Tn Tjee Kiong Lin / 68 thn /
Peripheral Arteriovenous
Malformation / Rujukan dari RS Graha
Kedoya hari perawatan ke 5 / Kel Nyeri
pada ke dua kaki ( Kaki kiri terdapat luka
) / Pro Tindakan Arteriography Stand by
PTA direncanakan awal bila belum ada
perubahan tgl 03.02.22 jam 18.30 wib.
Hasil Lab +, ECHO +, Thorak foto +,
RUJUK KE :
APS :
PERALATAN :
Alat EKG Aset EMG ( kabel EKG belum
berfungsi dengan baik )
RAJAL :
1. Ny Gebrina rezki / G1 P0 A0 + Covid
19 (PCR SWAB POSITIF )
1 RANAP :
PASIEN OBSERVASI :
18
36 SShcedule tindakan endoskopi :

Shcedule tindakan endoskopi :
5
3 1. Tn. CHANDRA JAYA, 57th, diagnosa :
3 gastrointestinal haemorrhage, unspecified.
rencana tindakan EGD + KOLONOSKOPI
22 Rabu, 2 Februari 2022, pkl 16.00, dokter
operator : dr amanda pitarini, SpPD-KGEH. (
Pasien Ranap kmr 518)
Rencana :
Rencana :
5 Scedule tindakan endoskopi :
1. Tn. PUI JOHNNY, 39th, diagnosa :

calculus of gallbladder with other
8 cholecysistis, fatty liver not elsewhere
classified, cholecystitis.
11 rencana tindakan ERCP + pasang stentdokter
9 operator : prof. murdani (untuk tgl dan jam
akan di konfirmasi ulang )ni SpPD-KGEH dan dr.
amanda pitarini, SpPD-KGEH. ( Pasien ranap
kmr 403. Asuransi untuk tindakan masih on
1 proses)
tindakan endoskopi :
1 1. Tn. CHANDRA JAYA, 57th, diagnosa :

31 gastrointestinal haemorrhage,
unspecified.
1 rencana tindakan EGD +
5 KOLONOSKOPI
Rabu, 2 Februari 2022, pkl 16.00, dokter
operator : dr amanda pitarini, SpPD-
KGEH. ( Pasien Ranap kmr 518)
Rencana :
148
NT DEPARTMENT PASIEN BARU :
1. Nur Azis / Bob Andinata, dr. Sp. B (K)

Onk / Localizd Enlarged Lymph Nodes
PASIEN OBSERVASI :
1. Tn Pui Johnny / Murdani Abdullah, Prof.

dr. SpPD-KGEH/Cholecystitis
2.Tn. Nur Azis / Bob Andinata, dr. Sp. B (K)
3.Ny. Fala Hindun/ Bob Andinata, dr. Sp. B
(K) Onk / Maligna Neoplasma of Breast
(KEMO)
PASIEN PINDAH ICU :
RENCANA TINDAKAN :
4
1. Tn. Pui Johnny / Murdani Abdullah, Prof.
dr. SpPD-KGEH/Cholecystitis. Rencana
tindakan ERCP 03/02/2022 —> jam sedang
fu cathlab (menunggu jawaban pihak
4 Heartology, Prof murdani bisa di atas jam
18.00 wib, karna jadwal padat di RSCM)
RENCANA PULANG :
1. Tn Faridz Miftah / dr. Alvin, Sp.PD/

unspecified
2.Ny. Ramada Sinaga / dr. Alvin, Sp.PD/
fever, diare, abdominal pain
IBCLC /Supervision of normal
pregnancy
1.Ny. Fala Hindu/ Bob Andinata, dr. Sp.

B (K) Onk / Maligna Neoplasma of
Breast (KEMO)
PASIEN PULANG :
1. Tn Teguh / dr. Syafrizal, Sp.S / Post PELD

2.Tn. Eko / dr. Dicky Hanafy, Sp.JP / Post
CAG
3.Ny. Dessie / dr. Dicky Hanafy, Sp.JP / Post
3DVT Ablasi
4.Tn Izzat / dr. Radi, Sp.OT / Post
Hemiarthroplasty
5.Tn. Tjee Kioeng Lin / dr. Suko, Sp.JP /
Peripheral arteriovenous malformation
PASIEN OBSERVASI :
1.An. Radeya Arya/ dr. Hamida, Sp.THT
/ Mastoiditis and related conditions
2.Tn. Chandra / dr. Amanda, Sp.PD /
Melena
3.Tn. Teguh / dr. Syafrizal, Sp.S / Post
PELD
4.Tn. Eko / dr. Dicky Hanafy, Sp.JP /
Post CAG
5.Ny. Dessie / dr. Dicky Hanafy, Sp.JP /
Post 3DVT Ablasi
Hemiarthroplasty
1. Tn William / dr. Zacky, Sp.S / MG
1.Pasien MCU, rencana masuk tgl

03/03/22 (Kamar 515/517)
2.Tn. Baharudin / dr. Syafrizal, Sp.S /
Rencana Neuroablasi, masuk tgl
04/02/22 (Kamar 517)
RENCANA TINDAKAN
1. Tn Tjee Kioeng Lin / dr. Suko, Sp.JP /

Peripheral arteriovenous malformatio,
rencana tindakan ateriografi standby PTA
dengan kontras CO2 dan minimal kontras tgl
03/02/2022 pukul 18.30 WIB
PASIEN PULANG :
1.An. Sheza Nazifa Azzahra / dr. Annisa

Nur Aini, Sp.A (FT) /
Bronchopneumonia

1. Tn Chandra / dr. Amanda, Sp.PD /
Melena
2.Tn. Teguh / dr. Syafrizal, Sp.S / Post
PELD
3.Tn. Eko / dr. Dicky Hanafy, Sp.JP /
Post CAG
4.Ny. Dessie / dr. Dicky Hanafy, Sp.JP /
Post 3DVT Ablasi
1.Ny. Devi Ramesh/ Malignant neoplasm

of ovary,Urinary tract infection, site not
specified/dr Chamim.
2.Ny. Fifi Sovia Aini/ dr Nisa Fatoni/
Post SC
3.An. Keitaro Nakita/Dengue Hemoragic
Fever/ dr Annisa Nur aini
4.Ny. Siti Dina/ dr Tirsa/ Post SC
PASIEN OBSERVASI :

Sp.OG / Post Partum P1A0
IBCLC / Post SC
Dara,Sp.OG / Post SC
5.Ny. Devi Ramesh/ Malignant neoplasm of
ovary,Urinary tract infection, site not
specified/dr Chamim.
6.Ny. Fifi Sovia Aini/ dr Nisa Fatoni/ Post
SC
7.An. Keitaro Nakita/Dengue Hemoragic
Fever/ dr Annisa Nur aini
9 8.Ny. Siti Dina/ dr Tirsa/ Post SC
9.Ny Aprillia Ekawati/ dr Febriansyah
Darus/Post SC
PASIEN PINDAH ICU :
RENCANA TINDAKAN
PASIEN VK
PASIEN PULANG
RENCANA MASUK :
1.Ny. Rachmasari Cahyaningdyah / dr.

Nisa Fathoni, Sp.OG / Post SC P1A0
NOTED Kamar nmr 604 AC BOCOR

ATING THEATER
1. NINING KUSUMA JATI / BEDAH

OBGYN - Sectio Caesaria / OK 1 jam 10.00
wib / Ardiansjah Dara Sjahruddin, dr. Sp.OG
2.
SITI DINA SHABRINA / BEDAH OBGYN
- Sectio Caesaria / Ok 1 jam 12.00 wib /
Tirsa Verani Kembuan Oroh, dr. SpOG
3.
APRILIA EKAWATI JATININGRUM /
BEDAH OBGYN - Sectio Caesaria / Ok 1
jam 13.30 wib / Febriansyah Darus, dr.
Sp.OG-KFM
4. ASIH WIJAYANTI / BEDAH
OBGYN - SC + Tubectomy / OK 1 jam
8 8 15.00 wib / Fransisca Noela RMH, dr. Sp.OG
5. DR. FRANSISKA /
BEDAH OBGYN - Sectio Caesaria / Ok 1
jam 16.00 wib / Nisa Fathoni, dr. Sp. OG,
IBCLC 6. SADDAM
MIKHAIL ALDEN / BEDAH PEDIATRIC -
Sirkumsisi / Ok 1 jam 17.00 wb / Wulan
Ayudyasari, dr. Sp.B 7. NUR
AZIS / BEDAH ONCOLOGY - Pro Eksisi +
Debridement / Ok 1 jam 20.00 wib / Bob
8. FIFI SOFIA AINI / BEDAH OBGYN -
Sectio Caesaria / OK 1 jam 22.00 wib / Nisa
TICAL CARE
1. Tn. William Tanady /40th/ Dpjp. dr.
Zicky, Sp.S / Myasthenia gravis
2. Ny Hairiah Hm /73
thn/ Dx. Cerebral oedema + Atrial fibrillation
2 and flutter + troke, non haemorrhage / Dpjp.
dr. Alvin Sp.PD, dr. Michael Sp.BS, dr. Vera
Sp.AN KIC , dr. Zicky Sp.S (Post
Craniotomy)
PASIEN OBSERVASI :
1. dr Fransiska / dr. Nisa Sp. OG /
G1P0A0 H 40 minggu 1 hari, inpartu Pro
0
Induksi -> SC Cito jam 16.00
RENCANA TINDAKAN :
PASIEN PONEK :
PASIEN OBSERVASI :
1. By Ny Hina Watanabe / dr. Keumala,
Sp.A / NCB SMK Usia 2 hari
2. By. Ny Nining Kusumajati / dr.
Keumala, Sp.A / NCB SMK Usia 13
jam.
3. By.Ny.Siti
Dina/dr.Keumala,Sp.A/NCB SMK usia
11 jam
4.By.Ny. Aprilia
Ekawati/dr.Keumala,Sp.A/NCB SMK
Usia 9 jam
5.By.Ny.dr.Fransiska/dr.keumala,Sp.A/
NCB SMK Usia 8 jam
6.By.Ny.Fifi sofia
6 6 aini/dr.Keumala,Sp.A/NCB SMK Umur
2 jam.
1.By Ny Rachmasari / dr. Keumala, Sp.A
/ NCB SMK Usia 2 hari.
PASIEN PULANG
1. By Ny Alfiana ika Prastanti /dr.
Annisa sp.A /NCB SMK usia 2 Hari
PASIEN DI NICU
ARTOLOGY
Daily Census OPD cardiac 2 Februari 2022
Outpatient : 8
dr ario :
Dr dafsah :
dr denio : 2
dr faris :
8 8 dr DH :
dr DAW :
dr radityo :
Dr suko :
dr sunu : 2
dr Adi : 4
MCU :
New patient: 2
Dr. Sunu : 1 info dari keluarga
Dr Denio: 1 dari dr. Bob RSBS
Cancel: 1
Dr. Sunu : 1
ECHO :
Stress Echo :
USG Doppler :
Holter : 1
Ezypro :
ECG :5
Treadmill :
CT Scan :
Speckle :
TEE :
DSE :
ABI :
Advance Echo :
Handle echo :
ABPM :
Tilt Table Test :
Paket PJB :
Cardioversi :
Referral Brawijaya : dr. Bob, Sp.B Onk

Refferal RS luar :
Dokter tidak hadir :dr.Dicky Aligheri sakit
dr Dwi
dr Mega
dr Nilam
SIC (CAROL) KAMIS, 03.02.22
TIPE PASIEN
YANG DINAS
LT NAMA UNIT
EMERGENCY ROOM
Dr Fajar
Dr Fajar Dr Firdha
EMERGENCY Dr Firdha
Ns Susi Ns Sanusi
ROOM Ns Rizam
Ns Nur Ns
Ns Mohlis
Tomy
GF
PONEK
TOTAL PASIEN EMG
Poli Obgyn
Ns NS 1 :
Poli Urology IIN
Poli Ortho
Poli Internist
Poli Bedah Umum
Poli Bedah Plastik
Poli THT Kiki
Poli Gizi
Poli bedah saraf
Poli Neuro
Dermis
LT 3 Dental
Poli Endoscopy
Poli Fisioterapi
Poli Rehab Medik
Poli Nutrition
Poli Paru
Poli Mata
Poli Psikiatri
Pain Clinic
MCU
POLI KEMOTERAPI
ODC
TOTAL PASIEN OPD
Ns Citra
IN PATIENT Ns Nurul Ns Ns wulan
DEPARTMENT 4 Kim
Ns Taufik
Ns Okta 7
Ns Abdi
LT 4 LT 5
IN PATIENT Ns Anatian Ns Tary Ns Ns Indah

DEPARTMENT 5 Ns Santi Rio Ns Malik 4
IN PATIENT Ns Dini Ns Ns Kristin Ns Avi

LT 6 DEPARTMENT 6 Ade Ns Nadia Ns Silvi
10
IN PATIENT Ns Dini Ns Ns Kristin Ns Avi
LT 6 DEPARTMENT 6 Ade Ns Nadia Ns Silvi
10
KERUSAKAN
OPERATING THEATER
Ns Sunandar
OK Ns Heryanti
CRITICAL CARE
Ns Elga
ICU Ns Awaludin
Ns Esti p
HCU
Ns Esti Ns Ayu
NICU
PICU
TOTAL Ps
CRITICAL
OBSTETRICS
Bd Dilla Bd Putri
VK Bd Dewi
Bd Dewi Bd Genda
Nursery Ns Inggrid Ns Nelly Ns Ika 7
HEARTOLOGY
Ns Akbar
Cathlab Ns Tryanto
Hybrid
Ns Rini T
OPD JANTUNG Ns
Emma
LT 8
LT 8
Dokter Jaga
Dokter Jaga IPD : Pagi : dr Nesya Malam :
Dokter Jaga Critical : Pagi : dr Risky Malam :

TOTAL
BERAT PASIEN
GENCY ROOM
PASIEN OBSERVASI :
RAJAL :
1. Ny Nita Apryani / 34 thn / Fatique,
malaise ( Sudah cek PCR tgl 02.02.22
hasil negative )
2. Tn Kunto Harryo / 27 thn / ISPA,
obsv Febris H1
3. Ny Fatimah / 34 thn / Malignant
Neoplasma of plasenta / Pro
Chemotherapi ke 12
4. Tn Yazria Yazid / obsv febris
H1 / PCR POSITIF
5. Ny Ratih Ayuningtyas / 35
thn / Dermatitis
6. Ny Fenik Iradha / 28 thn /
Obsv Febris H1
7. An Kenan Malik / 4 thn / obsv
Febris H 1
8. Nn Zahwa nadira / 21 thn /
Dyspepsia
9. Nidya Odeta / 15 thn / Dyspepsia
10. Nn Dinie Koernia / 33 thn / obsv
Febris H1
16
RANAP :
1. An Alya Luthfia / Obsv Febris
H1/ Dr Anisa SpA /Cek Swab PCR
hasil negative / Rawat IPD 609
2. An
Malakai Ali / 6 thn / Urticaria / PCR
negative / Dr Anisa SpA / Rawat
IPD 416
3. An Ananda Putri / 14 thn
/ Supraventriculer Tachicardia / Dr
Faris Basalamah SpJP / Rawat IPD
514
RUJUK KE :
APS :
PERALATAN :
ALAT EKG ASSET IGD
( KABEL MASIH TROUBLE )
RAJAL :
1. Ny Cut Desy / 26 thn / G1 p0
A0 / Keluar flek dari jalan lahir
RANAP :
2
PASIEN OBSERVASI :
1. Ny Nesia Purwasuci / 35 thn / G2
P1 A0 / Mual muntah sebanyak 5x /
pemeriksaan DJJ +
18
37
1
11
1
8
3
6
24
1
106

1.Ny. Soen Theresia / dr. Chamim
SpOG (K) (Pro Kemo ke 2)
2.An. Malaika Ali/ dr. Annisa Sp.A (FT)
3.An. Jaima / dr. Dicky Armein Hanafi
Sp.JP FIHA FAsCC/ Post 2VT SVT
4.Tn. Syamsu / dr. Suko Adiarto Sp.JP
(K) FIHA,, FICA, FAsCC, PhD/
Atherosclerotic Heart Disease, post
tindakan CAG + PTCA simple 2 stents
PASIEN OBSERVASI :
1.Tn Pui Johnny / Murdani Abdullah,

Prof. dr. SpPD-KGEH/Cholecystitis
2.Tn. Nur Azis / Bob Andinata, dr. Sp. B
(K) Onk / Localizd Enlarged Lymph
Nodes
3. An. Jaima / dr. Dicky Armein Hanafi
Sp.JP FIHA FAsCC/ Post 2VT SVT
4. Tn. Yusuf Asmara/ dr. Arief Rachman
Sp.S
5. An. Malaika Ali/ dr. Annisa Sp.A
(FT)
6. Ny. Soen Theresia / dr. Chamim
SpOG (K) (Rencana Kemo ke 2)
PASIEN PINDAH ICU :

7
1. Tn Syamsu / dr. Suko Adiarto Sp.JP
(K) FIHA,, FICA, FAsCC, PhD/
Atherosclerotic Heart Disease, post
tindakan CAG + PTCA simple 2 stents
RENCANA TINDAKAN :
RENCANA PULANG :
1. Tn Nur Azis / Bob Andinata, dr.

Sp. B (K) Onk / Localizd Enlarged
Lymph Nodes
2.An. Jaima / dr. Dicky Armein
Hanafi Sp.JP FIHA FAsCC/ Post
2VT SVT
PASIEN PULANG :
1.Ny. Fala Hindun/ Bob Andinata,
dr. Sp. B (K) Onk / Maligna
Neoplasma of Breast (KEMO)
1. Nn. GABRIELA GAIZKA

KRISTIONO/ Caroline Supit, dr. SpB /
Benign neoplasm: Connective and other
soft tissue of trunk, unspecified 2. An.
ANANDA PUTRI / 14 thn /
Supraventricular Tachicardia / Dr Faris
Basalamah SpJP /
PASIEN OBSERVASI :
1.An. Radeya Arya/ dr. Hamida,

Sp.THT / Mastoiditis and related
conditions
Hemiarthroplasty / Sedang transfusi
darah PRC bag 2 ( HB terakhir tgl
01.02.22: 7.5 gr / dl ) Assuransi dg
CENTRAL ASIA RAYA
( overlimit )
3. Nn. GABRIELA GAIZKA
KRISTIONO/ Caroline Supit, dr.
SpB / Benign neoplasm: Connective
and other soft tissue of trunk,
unspecified
PASIEN PINDAH ICU :
1. Tn William / dr. Zacky, Sp.S / MG

2.Tn. Tjee Kioeng Lin / dr. Suko,
4 Sp.JP / Peripheral arteriovenous
malformation

1. Tn Baharudin / dr. Syafrizal,
Sp.S / Rencana Neuroablasi, masuk
tgl 04/02/22 (Kamar 517)
RENCANA TINDAKAN
1.Nn. GABRIELA GAIZKA
KRISTIONO/ Caroline Supit, dr. SpB /
Benign neoplasm: Connective and other
soft tissue of trunk, unspecified/
R/tindakan eksisi biopsi 04/02/2022 jam
10.00 wib
PASIEN PULANG :
1. Tn Chandra / dr. Amanda, Sp.PD /

Melena
2.Tn. Teguh / dr. Syafrizal, Sp.S /
Post PELD
3.Tn. Eko / dr. Dicky Hanafy,
Sp.JP / Post CAG
4.Ny. Dessie / dr. Dicky Hanafy,
Sp.JP / Post 3DVT Ablasi
NT DEPARTMENT
1. An. Alya Lutfia/Annisa Nur Aini,

dr. Sp.A (FT)/ Dengue fever H-2
2. An. Keitaro Nakira/Annisa Nur
Aini, dr. Sp.A/ Dengue fever H-5
3. Ny.Nesia Purwasuci/aufik
Jamaan, Dr.dr. Sp.OG/ mild HEG
PASIEN OBSERVASI :
10
1. An. Alya Lutfia/Annisa Nur Aini, dr.
Sp.A (FT)/ Dengue fever H-2
2. Ny. Hina Watanabe / dr. Nisa Fathoni,
3. Ny. dr. Fransiska / Nisa Fathoni, dr.
Sp. OG, IBCLC / Post SC
4. Ny. Nining Kusuma / dr. Ardiansjah
5. Ny. Devi Ramesh/ Malignant
neoplasm of ovary,Urinary tract
infection, site not specified/dr Chamim
SPOG.
6. Ny. Fifi Sovia Aini/ dr Nisa Fatoni/
Post SC
7. An. Keitaro Nakita/Dengue
Hemoragic Fever/ dr Annisa Nur ainiNy.
Siti Dina/ dr Tirsa/ Post SC
8. Ny Aprillia Ekawati/ dr Febriansyah
Darus/Post SC
10 9. An. Keitaro Nakira/Annisa Nur Aini,
dr. Sp.A/ Dengue fever H-5
10. Ny. Nesia Purwasuci/aufik Jamaan,
Dr.dr. Sp.OG/
PASIEN PINDAH ICU :
RENCANA TINDAKAN
PASIEN VK
PASIEN PULANG
RENCANA MASUK :
1. Ny. Rachmasari Cahyaningdyah /

dr. Nisa Fathoni, Sp.OG / Post SC
P1A0 (Tunggu bayi)
2. Ny. Hina Watanabe / dr. Nisa
Fathoni, Sp.OG / Post Partum P1A0
NOTED
TING THEATER
0 Tgl 03.02.22
RENCANA TINDAKAN : tgl 04.02.22
1. GABRIELA GAIZKA
KRISTIONO /BEDAH UMUM - Eksisi
Biopsi Dengan Anestesi Umum / OK 1
jam 10.00 wib / Caroline Supit, Dr. SpB
2. VACHRY HAMDREVA
PANE / BEDAH UROLOGY -
3 Sirkumsisi + GA / OK 1 jam 12.00 wib /
Vonty Elfrida, Dr. SpB
3. SADDAM
MIKHAIL ALDEN / BEDAH
PEDIATRIC - Sirkumsisi / OK 1 jam
17.00 wib / Wulan Ayudyasari, Dr. Sp.B
ICAL CARE
1. Tn. William Tanady /40th/ Dpjp. dr.
Zicky, Sp.S / Myasthenia gravis
2. Ny Hairiah Hm
/73 thn/ Dx. Cerebral oedema + Atrial
2 fibrillation and flutter + troke, non
haemorrhage / Dpjp. dr. Alvin Sp.PD, dr.
Michael Sp.BS, dr. Vera Sp.AN KIC , dr.
Zicky Sp.S (Post Craniotomy)
1. Tn Syamsu Afryansah / 52 thn /post

PCI 1 stand / Suko Adiarto, dr. SpJP
(K),FIHA,, FICA, FAsCC, PhD
2 2. .Tn. Tjee Kioeng Lin / dr. Suko,
Sp.JP / Peripheral arteriovenous
malformation / Post PTA
PASIEN OBSERVASI :
0
RENCANA TINDAKAN :
PASIEN PONEK :
1. Ny. Nesia/ G1P0A0 hamil 12

mgg/ dr. Taufik, SpOG
2. Ny. Fenik/ G1P0A0 hamil 28
3 mgg/ dr. Nisa, SpOG
3. Ny. Cut Desy/ G1P0A0 hamil 11
mgg/ dr. Noela, SpOG
PASIEN OBSERVASI :
1. By. Ny Nining Kusumajati / dr.
haru.
2. By.Ny.Siti
Dina/dr.Keumala,Sp.A/NCB SMK
usia 1hari
3.By.Ny. Aprilia
Ekawati/dr.Keumala,Sp.A/NCB
SMK Usia 1 hari
4.By.Ny.dr.Fransiska/
dr.keumala,Sp.A/NCB SMK Usia 1
hari
5.By.Ny.Fifi sofia
aini/dr.Keumala,Sp.A/NCB SMK
7 Umur 1hari
1.By. Ny Rachmasari / dr. Keumala,

Sp.A / NCB SMK Usia 2 hari.
2.By Ny Hina Watanabe / dr.
hari
PASIEN PULANG
PASIEN DI NICU
RTOLOGY
1. Tn Syamsu Afryansah / 52 thn /post
1 PCI 1 stand ec AHD / Suko Adiarto, dr.
SpJP (K),FIHA,, FICA, FAsCC, PhD
Daily Census OPD cardiac 3 Februari
2022
Outpatient : 11
dr ario :
Dr dafsah : 4
dr denio :
dr faris : 1
11 11 dr DH : 1
dr DAW :
dr radityo : 5
Dr suko :
dr sunu :
dr Adi :
MCU :
New patient:
Dr. Radityo 5 : 2 dari website, 1 pasien
lama dr. Radit di RS Harkit, 1 dari dr.
Noormanto JIH, 1 dari dr. Mahrus, SpA
RS Premier Surabaya
Dr. Dafsah 3 : 2 dari website, 1 info dari
keluarga
Dr. Faris 1 dari prof Nugroho RSBS
Cancel: 1
Dr. Dicky Hanafy : reschedule ke
10/2/22
melakukan
ECHO : 1
Stress Echo :
USG Doppler :
Holter :
Ezypro :
ECG : 8
Treadmill :
CT Scan :
Speckle :
TEE :
DSE :
ABI :
Advance Echo : 3
Handle echo :
ABPM :
Tilt Table Test :
Paket PJB :
Cardioversi :
Referral Brawijaya : Prof Nugroho

Refferal RS luar : dr. Noormanto JIC, dr.
Marhus, Sp.A RS Premier Surabaya
Dokter tidak hadir :dr. Dicky Aligheri

sakit, dr. Ario sakit
dr Firdha
dr Megawati
dr Dewi
SIC (EKO) Jum,at, 04.02.22
TIPE PASIEN
YANG DINAS
LT NAMA UNIT
EMERGENCY ROOM
dr. Audrey, dr. Dwi, Br.

EMERGENCY NS. Kelvin,
Ns. Susi, Ns. Mohlis, Ns.
ROOM Ardi
Ns. Tomi
Rizam
GF
PONEK
TOTAL PASIEN EMG
Poli Obgyn
Ns NS 1 :
Poli Urology IIN
Poli Ortho
Poli Internist
Poli Bedah Umum
Poli Bedah Plastik
Poli THT Kiki
Poli Gizi
Poli bedah saraf
Poli Neuro
Dermis
LT 3 Dental
Poli Endoscopy
Poli Fisioterapi
Poli Rehab Medik
Poli Nutrition
Poli Paru
Poli Mata
Poli Psikiatri
Pain Clinic
MCU
POLI KEMOTERAPI
ODC
TOTAL PASIEN OPD
DS = Ns.
DP = Ns. Salwa DM =
IN PATIENT Nurul + Ns.
(Lembur) + Ns.Citra +
DEPARTMENT 4 Salwa
Br. Taufik Br. Abdi
LT 4
LT 5
LT 4
LT 5
DP = Ns. DS = Ns.
DM = Ns.
IN PATIENT Anatian + tary + Br.
indah + Br.
DEPARTMENT 5 Ns. Santi Rio
yudi

IN PATIENT Dini+ Bd. Risha+ Ns.
DEPARTMENT 6 ade Nadia
Kristin +
Ns. Silvi
LT 6
DEPARTMENT 6 ade Nadia
Kristin +
Ns. Silvi
LT 6
Komplainan
KERUSAKAN
OPERATING THEATER
OK
CRITICAL CARE
ICU
HCU
NICU
PICU
TOTAL Ps CRITICAL
OBSTETRICS
‌Dines Siang : ‌Dines

‌Dines Pagi:
bd. Anggi & Malam : bd.
VK bd. Tries
bd dewi Dilla, bd.
Viki
Dinas pagi : D
‌ ines siang Dines
Nursery Ns.nani :Ns. Wiwi malam :
Ns .Nelly
HEARTOLOGY
Cathlab
Hybrid
OPD JANTUNG
LT 8
LT 8
Dokter Jaga
Dokter Jaga IPD : Pagi : dr Rona & Dur Malam : dr Neysa
Dokter Jaga Critical : Pagi : dr Riri Malam : dr Rizky

KETERANGAN
Y ROOM
PASIEN OBSERVASI :
RAJAL :
1. Ny. Bunga Mega /33th/ Dx. Covid 19
2. Tn. Winarno /58th/ Dx. Dhiare 3.
Ny. Dian Kristi /34th/ Dx. G3P2A0 H 32 mgg pro
Inf Venofer 4.
Ny. Afaf Khalaf /42th/ Dx. Abdominal Pain 5.
A. Kimiko /1th/ Dx. Fever
6. Nn. Nayla Danika /16th/ Dx. Covid 19
Terkonfirmasi 7.
Ny. Dwie Yanti /23th/ Dx. G3A2 hamil 28 minggu,
rencana infus venofer 8. An.
Kiana Alika /14th/ Dx. Febris 9. Ny.
Heidy Wijayanti /41th/ Dx. Covid 19 Terkonfirmasi
RANAP :
1. Ny. Cut Desi Murzalifah /26th/ Dx.
Spontaneous abortion: Incomplete, without
complication Hypovolaemic shock / Dpjp.
Fransisca Noela RMH, dr. Sp.OG 2.
Tn. DRS Mohammad Noor /64th/ Dx.
abdominal pain Atrial fibrillation and flutter /
Dpjp. Nenfiati, dr.SpPD-KEMD
11
RUJUK KE :
1. Tn. Charles Salmon /47th/ Dx. Coronavirus

infection + Angina pectoris / RUJUK KE RS
BRAWIJAYA SAWANGAN DEPOK
APS :
PERALATAN :
NOTE :
Ada Kesalahan Dalam Idendtifikasi Pasien
IGD a/n. Tn. Charles Salmon, Kesalahan
Pada Jenis Kelamain pasien di Sticker dan
Tera Menjadi Jenis Kelamin Perempuan,
Petugas FL : Novita mengkonfirmasi
Kelasahan Pada pengimputan Data pasien,
untuk pengimputan Identitas px sdh benar
berdasarkan KTP, Tetapi salah klick Saja
yg harusnya laki laki ke klick pd pilihan
Perempuan
RAJAL :
RANAP :
1 1. Ny. Kartika indah /31th/ Dx. Supervision
of normal pregnancy, Hamil 28 minggu
PASIEN OBSERVASI :
12 Pasien
26
2
14
1
2
9
6
24
1
95
1.Nn. Saffanah Azka / Sunu Budhi Raharjo, dr. SpJP

(K), PhD / Atrioventricular block, complete
2.Tn. DRS. Mohammad Noor / dr.Nenfianti Sp.PD-
KEMD / Dyspepsia syndrome + AF + HHD
PASIEN OBSERVASI :

2.Nn. Saffanah Azka / Sunu Budhi Raharjo, dr. SpJP
(K), PhD / Atrioventricular block, complete
3.Ny. Soen Theresia / dr. Chamim SpOG (K)
(Rencana Kemo ke 2)
4.Tn. DRS. Mohammad Noor / dr.Nenfianti Sp.PD-
KEMD / Dyspepsia syndrome + AF + HHD
PASIEN PINDAH ICU :
RENCANA TINDAKAN :
4
RENCANA PULANG :
PASIEN PULANG :
1.Tn. Nur Azis / Bob Andinata, dr. Sp. B (K)
2.An. Jaima / dr. Dicky Armein Hanafi Sp.JP
FIHA FAsCC/ Post 2VT SVT
3.An. Malaika Ali/ dr. Annisa Sp.A (FT)
4.Tn. Syamsu / dr. Suko Adiarto Sp.JP (K)
FIHA,, FICA, FAsCC, PhD/ Atherosclerotic
Heart Disease, post tindakan CAG + PTCA
simple 2 stents
5.Tn. Yusuf Asmara/ dr. Arief Rachman Sp.S
1. Tn. HERRY HARTO / Denio A. Ridjab, dr. SpJP

- FIHA / Atherosclerotic heart disease
2.Tn. BAHARUDDIN R / Syafrizal Abubakar, dr.
Sp.BS / Lumbar and other intervertebral disc
3. Ny. AGATHA CHRISTY FLORIS / Damar
Prasmusinto, dr,Med,Sp.OG (K) / Supervision of
normal pregnancy
PASIEN OBSERVASI :
Hemiarthroplasty
3. Nn. GABRIELA GAIZKA KRISTIONO/
Caroline Supit, dr. SpB / Benign neoplasm:
Connective and other soft tissue of trunk,
unspecified
4. Nn. ANANDA PUTRI SASKYA / Faris
Basalamah, dr. SpJP (K)/ Supraventricular
tachycardia
5. Tn. HERRY HARTO / Denio A. Ridjab, dr.
SpJP - FIHA / Atherosclerotic heart disease
6. Tn. Tjee Kioeng Lin / dr. Suko, Sp.JP /
7. Tn. BAHARUDDIN R / Syafrizal Abubakar,
dr. Sp.BS / Lumbar and other intervertebral disc
Prasmusinto, dr,Med,Sp.OG (K) / Supervision
of normal pregnancy
PASIEN PINDAH ICU :
1.Tn. William / dr. Zacky, Sp.S / MG

8
RENCANA TINDAKAN
1. Tn. HERRY HARTO / Denio A. Ridjab, dr. SpJP
- FIHA / Atherosclerotic heart disease / rencana
tindakan PCI, IVUS, Rota bila perlu besok 05/02 jam
09.00
Prasmusinto, dr,Med,Sp.OG (K) / Supervision of
normal pregnancy/ rencana SC tgl 5-2-2022 jam
10.00
PASIEN PULANG :
1. Tn. BAHARUDDIN R / Syafrizal
Abubakar, dr. Sp.BS / Lumbar and other
intervertebral disc disorders with radiculopathy
2. Nn. GABRIELA GAIZKA KRISTIONO/
Caroline Supit, dr. SpB / Benign neoplasm
1.Ny.Katrika indah/dr. Febriansyah Darus/

Supervision of normal pregnancy,
Incompetence of cervix uteri
2.Ny. Cut Desi Muzdalifah/Fransisca Noela
RMH, dr. Sp.OG/ Post Curetase
PASIEN OBSERVASI :
1.An. Alya Lutfia/Annisa Nur Aini, dr. Sp.A (FT)/

Dengue fever H-3
2.Ny. dr. Fransiska / Nisa Fathoni, dr. Sp. OG,
IBCLC / Post SC
3.Ny. Nining Kusuma / dr. Ardiansjah Dara,Sp.OG /
Post SC
ovary,Urinary tract infection, site not specified/dr
Chamim.
5.Ny. Fifi Sovia Aini/ dr Nisa Fatoni/ Post SC
6.An. Keitaro Nakita/Dengue Hemoragic Fever/ dr
Annisa Nur aini
8.An. Keitaro Nakira/Annisa Nur Aini, dr. Sp.A/
Dengue fever H-5
Supervision of normal pregnancy, Incompetence of
cervix uteri
10.Ny. Cut Desi Muzdalifah/Fransisca Noela RMH,
dr. Sp.OG/ Post Curetase
PASIEN PINDAH ICU :
RENCANA TINDAKAN
9
9 1.Ny.Katrika indah/dr. Febriansyah Darus/
Incompetence of cervix uteri/ Rencana tindakan
cerclage besok tgl 05/01/2022 pukul 13.00 wib.
PASIEN VK
PASIEN PULANG

Sp.OG / Post Partum P1A
3.Ny. Nesia Purwasuci/aufik Jamaan, Dr.dr.
Sp.OG/
RENCANA MASUK :
1.An. Keitaro Nakira/Annisa Nur Aini, dr.

3.Ny Aprillia Ekawati/ dr. Febriansyah Darus/
Post SC
4.Ny. dr. Fransiska / Nisa Fathoni, dr. Sp. OG,
IBCLC / Post SC
5.Ny.Siti Dina/Tirsa Verani Kembuan Oroh, dr.
SpOG/Post SC
Komplain untuk Ruang 604 dan 611 perihal

Suara Gaduh dri lantai & yg sedang ada
kegiatan untuk pemasangan Timbal => Sic
Sdh Berkoodinasi ke P. Ivan perihahal
tersebut, Dan lgsung meninjau Lokasi di OK
2 untuk Memastikan agar tdk ada kegiatan
lgi yg di lakukan
THEATER
1. Tindakan Jum,at, 04-02-22 -
Eksisi Biopsi / ny. Gabriela Gaizka / dr. Caroline
Supit Sp.B / J. 10.00 / Di OK I -
Sicumsisi / Vachry Hamdreva / dr. Vonti Elfrida
Sp.B / J. 12.00 / Di OK I
- Sircumsisi / Saddam Mikhail Alden / dr.
5 Wulan Ayudasari Sp.B / J. 17.00 / Di OK I
- Debridement Post PPm/ICD /
Saffanah Azka / dr. Sunu Budhi Raharjo Sp. JP / J.
19.41 / Di OK III
- Dilatasi Curettase / Cut Desi
Murzalifah / dr. Fransisca Noela RMH Sp.OG / J.
20.00 / Di OK I
1. Rencana Tindakan Sabtu, 05-02-22

- Sc / Ny. Agatha Christy Floris / dr Damar Pramusinto Sp.
OG, / J.10:06 / OK I -
Dilatasi Curettase / Ny. Devi Anggraeny / dr Chamim Sp.
OG (K) Onk , / J.11:00 / OK I
- Histirectomy Laparascopy / Ny. Siti Rahayu / dr
Chamim Sp. OG (K) Onk, / J.13:30 / OK II
- Dilatasi Curettase / Ny. Liza Martini
B / dr Chamim Sp. OG (K) Onk, / J.15:36 / OK II
CARE
1. Tn. William Tanady /40th/ Dpjp. dr. Zicky, Sp.S /
1 Myasthenia gravis
0
0
0
1 Pasien
PASIEN OBSERVASI :
RENCANA TINDAKAN :
PASIEN PONEK :
1. Ny. Cut / G1P0A0 hamil 11 mgg, Kematian

Mudigah/ dr. Noela, SpOG -> curetage jam
20.00 2.
2 Ny. Kartika/ G3P1A1 hamil 28 mgg, cervix
incompetence, plasenta previa with
haemorrhage/ dr. Febri, SpOG / DJJ per Shift /
rencana cerclage 05/02/2022

PASIEN OBSERVASI :
1. By. Ny Nining Kusumajati / dr. Keumala,
Sp.A / NCB SMK Usia 3 hari.
2. By.Ny.Siti Dina/dr.Keumala,Sp.A/NCB
SMK usia 3 hari
3 .By.Ny.dr.Fransiska/dr.keumala,Sp.A/NCB
SMK Usia 3 hari
4.By.Ny.Fifi sofia aini/dr.Keumala,Sp.A/NCB
SMK Umur 3 hari
1.By.Ny. Aprilia
4 Ekawati/dr.Keumala,Sp.A/NCB SMK Usia 3
hari
PASIEN PULANG
1.By. Ny Rachmasari / dr. Keumala, Sp.A /

2.By Ny Hina Watanabe / dr. Keumala, Sp.A /
NCB SMK Usia 3 hari
1.By. Ny Rachmasari / dr. Keumala, Sp.A /

2.By Ny Hina Watanabe / dr. Keumala, Sp.A /
NCB SMK Usia 3 hari
PASIEN DI NICU
LOGY
Outpatient : 13
dr ario :
Dr dafsah :
dr denio : 3
dr faris : 2
dr DH : 3
dr DAW :
dr radityo :
Dr suko :
dr sunu :
dr Adi : 5
13 Pasien
MCU :
New patient : 6
Dr. Denio 2 : 2 pasien lama dr Denio di PIK
Dr. Faris 2 : 1 dr Alvin 1 dari kerabat
Dr. Dicky Hanafy 2: 1 dari dr. Fahmi Hardini
Pertamina Hukum Mahakam. 1 pasien lama dr.
Dicky di RS Harkit
Cancel: 2
Dr. Denio : 2

ECHO :
Stress Echo :
USG Doppler :
Holter :
Ezypro :
ECG : 6
Treadmill :
CT Scan :
Speckle :
TEE :
DSE :
ABI :
Advance Echo : 2
Handle echo :
ABPM :
Tilt Table Test :
Paket PJB :
Cardioversi :
Referral Brawijaya : dr. Alvin

Refferal RS luar : dr. Fachmi Hardini Pertamina
Hulu Mahakam
Dokter tidak hadir :dr. Dicky Aligheri sakit

SIC (EKO) Sabtu, 05.02.22
TIPE PASIEN
YANG DINAS
LT NAMA UNIT
EMERGENCY ROOM
dr. Firdha,
EMERGENCY Ns. Susi, Zr. Ns. Kelvin,
Ns. Susi, Ns.
ROOM Tomi
Fitri Ns. Rizam
GF
PONEK
TOTAL PASIEN EMG
Poli Obgyn
Ns NS 1 :
Poli Urology IIN
Poli Ortho
Poli Internist
Poli Bedah Umum
Poli Bedah Plastik
Poli THT Kiki
Poli Gizi
Poli bedah saraf
Poli Neuro
Dermis
LT 3 Dental
Poli Endoscopy
7 Poli Fisioterapi
Poli Rehab Medik
Poli Nutrition
Poli Paru
Poli Mata
Poli Psikiatri
Pain Clinic
MCU
POLI KEMOTERAPI
ODC
TOTAL PASIEN OPD
DP = Br. DS = Ns.
DM =
IN PATIENT Taufik + Ns. Salwa +
Ns.Citra +
DEPARTMENT 4 Okta Ns.Ella
Br. Abdi
LT 4 LT
5
LT 4 LT
5 IN PATIENT DEPARTMENT
DP = Ns. DS = Ns.
DM = Ns.
IN PATIENT Anatian + Santi + Br.
Tary + Br.
DEPARTMENT 5 Ns. Santi Rio
Yudi

DEPARTMENT 6 ade Nella
Kristin +
LT 6 Ns. Nadya
Komplainan
KERUSAKAN
OPERATING THEATER
OK
CRITICAL CARE
Awal,
ICU Gisma
Any, Rita Winda Agus
HCU
NICU
PICU Esty Alfi, Evi Grace
TOTAL Ps CRITICAL
OBSTETRICS
‌Dines
‌ ines Pagi:
D ‌Dines
Siang : bd.
bd. Tries & Malam : bd.
VK Bd. Putri
Tries & Bd.
Ningsih &
Putri
bd. Dewi
Dinas
siang :Ns.
pagi : malam : Ns
Nursery Ns.Wiwi
Inggrid
.Nani
Dines
‌Dines
HEARTOLOGY
Cathlab
Hybrid
LT 8
OPD JANTUNG
Dokter Jaga
Dokter Jaga IGD : Pagi : dr Firdha Malam : dr Audrey
Dokter Jaga IPD : Pagi : dr Rona Malam : dr Megawati

KETERANGAN
TOTAL
PASIEN
Y ROOM
PASIEN OBSERVASI :
RAJAL :
1. Tn. H Salim /60th/ Dx. CHF, AF + Covid 19
Terconfirmasi
2. An. Raizan Alfath /5th/ Dx. kontrol luka
jahitan hari ke 3
3. Tn. Faisal Amri /32th/ Dx. Ispa
4. An. Aruna Nuala /5th/ Dx. Open Wound
5. Ny. Decia Widyasinta /29th/ Dx. Chronic
gingivitis
6. Ny. Alfa Dea Shabrina /27th/ Dx. Chronic
gingivitis
7. Tn. Dewan Toro /39th/ Dx. LBP
8. An. Mazaya Noorshandrina /15th/ Dx. Covid
19 Treconfirmasi, Anemia
9. Ny. Agnes Cynthia /36th/ Dx. Low back pain
, ontusion of lower back and pelvis
10. Tn. Agus Mala S /46th/ Dx. Fever
11. An. Muhammad Alfatih /1th/ Dx. Influenza
with other respiratory manifestations
12. Ny. Wine Adjie /67th/ Dx. Other anxietas
disorders
15 13. Nn. Putri Amanda /19th/ Dx. Dyspepsia
RANAP :
1. An. Zayden Rachfa /2th/ Dx. Viral
infection, Abnormal weight loss / Dpjp.
Nina Dwi Putri, dr. Sp.A (K) / Ruang 612
2. An. Muhammad Zhufar Alvaro /6th 9bln/
Dx. Nausea and vomiting, Fever / Dpjp.
Nina Dwi Putri, dr. Sp.A (K) / Ruang 614
RUJUK KE :
APS :
PERALATAN :
NOTE :
RAJAL :
RANAP :
PASIEN OBSERVASI :
15 Pasien
20
1
3
8
3
2
10
17
7
8
2
49
1
8
141

1.Nn. Saffanah Azka / Sunu Budhi Raharjo, dr.
SpJP (K), PhD / Atrioventricular block, complete
2.Tn. DRS. Mohammad Noor / dr.Nenfianti
Sp.PD-KEMD / Dyspepsia syndrome + AF +
HHD
PASIEN OBSERVASI :
1.Ny. Marcelline Siswadi / Dicky Aligeri

Sp.BTKV (K), dr. FIHA, FICA / Chronic
ischaemic heart disease, unspecified, Non-insulin-
3.Nn. Saffanah Azka / Sunu Budhi Raharjo, dr.
SpJP (K), PhD / Atrioventricular block, complete
4.Tn. DRS. Mohammad Noor / dr.Nenfianti
Sp.PD-KEMD / Dyspepsia syndrome + AF +
HHD
5.Tn. Agus Makarawo / Dicky Armein Hanafy,
dr. Sp.JP-FIHA, FAsCC / Post PCI LAD
PASIEN PINDAH ICU :
RENCANA TINDAKAN :
1.Ny. Marcelline Siswadi / Dicky Aligeri

Sp.BTKV (K), dr. FIHA, FICA / Chronic
ischaemic heart disease, unspecified, Non-insulin-
dependent diabetes mellitus / Rencana tindakan
Pro CABG senin 7/2/22 Jam 16:00 di OK Hybrid
RENCANA PULANG :

1.Tn. Agus Makarawo / Dicky Armein
Hanafy, dr. Sp.JP-FIHA, FAsCC / Post PCI
LAD
PASIEN PULANG :
1.Ny. Soen Theresia / dr. Chamim SpOG
(K) (Post Kemo ke 2)
2.Ny. Liza / dr.Chamim Sp.OG (K) Onk /
Post Kuretase
PASIEN OBSERVASI :

2.Tn Izzat Helmi/ dr. Radi, Sp.OT / Post
Hemiarthroplasty
3. Nn. Ananda Putri Saskya / Faris
Basalamah, dr. SpJP (K)/ Supraventricular
tachycardia
4. Tn. Herry Harto / Denio A. Ridjab, dr.
SpJP - FIHA / Atherosclerotic heart disease
5. Ny. Agatha Christy Floris / Damar
Prasmusinto, dr,Med,Sp.OG (K) / Post SC
P1A0
PASIEN PINDAH ICU :
RENCANA TINDAKAN
PASIEN PULANG :
1.Nn. Gabriela Gaizka Kristiono / Caroline

Supit, dr. SpB / Benign neoplasm:
Connective and other soft tissue of trunk,
unspecified
2.Tn. Baharuddin / Syafrizal Abubakar, dr.
Sp.BS / Lumbar and other intervertebral disc

1.An. Muhamad Zulfar Alvaro/ dr. Nina

Dwi Putri,Sp.A(K)/ DHF 2
PASIEN OBSERVASI :
1.An. Alya Lutfia/Annisa Nur Aini, dr. Sp.A
(FT)/ Dengue fever H-3
Chamim
Supervision of normal pregnancy, Incompetence
of cervix uteri
PASIEN PINDAH ICU :
RENCANA TINDAKAN
PASIEN VK
PASIEN PULANG
3
1.Ny. dr. Fransiska / Nisa Fathoni, dr. Sp.

OG, IBCLC / Post SC
4.An. Keitaro Nakira/Annisa Nur Aini, dr.
Incompetence of cervix uteri
7.Ny. Devi Anggriani/dr. Chamim SpoG/
Post Kuratase
RENCANA MASUK :
THEATER
1. Tindakan Sabtu, 05-02-22 -
Debridement Post PPm /ICD / Saffanah Azka /
dr. Sunu Budhi Raharjo Sp. JP / J. 08.00 / Di OK
HYBRID -
Cerclage / Ny. Kartika Indah Pratiwi / dr.
Febriansyah Darus Sp. OG-KFM / J.10.00 / OK I
- Sc / Ny. Agatha Christy Floris / dr Damar
Pramusinto Sp. OG, / J.10:05 / OK I
6 - Dilatasi Curettase / Ny. Devi
Anggraeny / dr Chamim Sp. OG (K) Onk , /
J.11:00 / OK I -
Histirectomy Laparascopy / Ny. Siti Rahayu / dr
Chamim Sp. OG (K) Onk, / J.13:30 / OK II
- Dilatasi Curettase /
Ny. Liza Martini B / dr Chamim Sp. OG (K)
Onk, / J.15:36 / OK II
-
L CARE
1 1. Tn. William Tanady /40th/ Dpjp. dr. Zicky,
0
0
0
1 Pasien
PASIEN OBSERVASI :
0
RENCANA TINDAKAN :
0
PASIEN PONEK :
0
1.1. Ny. Kartika/ G3P1A1 hamil 28 mgg,

cervix incompetence, plasenta previa with
haemorrhage/ dr. Febri, SpOG / Post
Cerclage / DJJ per Shift
PASIEN OBSERVASI :
1. By. Ny. Agatha/ dr.Nina Sp.A/ NCB SMK
usia 1 hari
1.By.Ny. Aprilia
Ekawati/dr.Keumala,Sp.A/NCB SMK Usia 3
hari
2. By.Ny. Fifi/ dr. keumala Sp.A/NCB SMK
Usia 3 hari
3
PASIEN PULANG
1. By.Ny.Nining/dr.Keumala Sp.A/ NCB

SMK usia 2 hari
2. By.Ny.fransiska/dr.Keumala Sp.A/NCB
SMK usia 2 hari
3. By.Ny.Siti Dina/dr.Keumala Sp.A/ NCB
SMK usia 2 hari
LOGY
21
dr Megawati
SIC (CAROL) MINGGU PAGI, 06.02.22
∑ STAF PERAWAT/BIDAN YANG
TIPE PASIEN
DINAS
LT NAMA UNIT Pagi 07.00 sd
19.00 wib
EMERGENCY ROOM
EMERGENCY
Ns Mohlis,
ROOM, Ns Nur
Dr Firdha
PONEK
GF
Dr Rahmat
RADIOLOGI Delly Mulyadi
SpRad
FRONT LINER (FL) Petugas :

Andra,Puput
TOTAL PASIEN EMG
Poli Obgyn NS 1 : Ns Siti H NS 1 : Ns

Dina H
Poli Internist
NS 2 : Ns Leni Dwi
LT 3 NS 2 :
Poli Pediatrik
PHARMACY OPD Indah Wahyu
TOTAL PASIEN OPD
LT 4 LT 5 IN PATIENT DEPARTMENT
LT 6
LT 4 LT 5
LT 6
LT4 :
Ns Wulan,Ns
Okta
IN PATIENT
LT5 :
DEPARTMENT Dr Megawati
Lt 4, 5, 6 Ns Tita,Ns Santi
Lt 6:
Ns
Avi,Ns Ade
AREA MP IGD/RAD
SOS Lt GF: Sutrisno
Riki
Petugas : Uti,
GIZI Tiara
Petugas :
LABORATORIUM Riska, Zefijka
Erika
PHARMACY (SB) Petugas :

Dina
Jumlah
DANDRU :
SECURITY, PARKIR, Petugas 12
Pak WIBI
orang
MASALAH
KERUSAKAN
OPERATING THEATER
OK
CRITICAL CARE
ICU Ns Gisma Dr Nilam
HCU
NICU Ns Esti Dr Nilam
PICU
MASALAH
OBSTETRICS
LT 7 Bd Putri
VK Bd Tries
Nursery Ns Wiwi
RUANG TUNGGU PS Terlihat 1 orang

CRITICAL Pagi jam 07 sd 10 Security Standby
HEARTOLOGY
Cathlab
Hybrid
LT 8
LT 8 OPD JANTUNG
AUDITORIUM
NOTED
LAPORAN SIC MINGGU PAGI, tgl 06.02.22
1. Total pasien dari jam 07 sd 19 00 wib: 42 orang

2. Kerusakan alat dari Nursery sudah dalam proses pengerjaan by Team
sarana prasarana RS - ter update oleh Koord
3. Complain dari pasien a.n Ny Devi Ramesh sudah dapat terselesaikan
4. Rencana Tindakan utk pasien masing masing lantai sudah terinfo
dengan baik antar staf unit yg bersangkutan
PE PASIEN
KETERANGAN
RGENCY ROOM
PASIEN OBSERVASI : 2
RAJAL : 5
RANAP : 0
jam 07 sd RUJUK : 0
jam 19.00 APS : 0
wib
PASIEN PONEK : 1
PASIEN TERKONFIRMASI Cov-19 : 0
TOTAL : 7
Dr Rahmad SpRad , Praktek jam 09.00 sd jam
12.00 wib
Petugas FL 2 orang, back up bersama ke OPD

8 Sunday clinik
10 KETERANGAN :
Pasien Lt 4 : 3 orang
1 Pasien Lt 6 : 6 o
20
ENT DEPARTMENT PASIEN BARU :
PASIEN OBSERVASI :
1. LT 5 : Tn Izzat / 72 thn / Post Herniaplasty / Hb
6,2 gr/dl - Transfusi 2 bag PRC 9 500 cc ) post
transfusi Hb 7.9 gr/dl. Terpasang Bedsite monitor /
Rencana Transfusi PRC 600 cc
PASIEN PINDAH ICU :
RENCANA TINDAKAN :
1. LT 4 : Ny Marceline Siswadi / 59 thn / CHD / Dr

Dicky Aligheri SpBTKV (K),dr, FIHA, FICA / Pro
CABG senin 07/02/22 senin, jam 16.00 wib di OK
Hybrid / Book ICU / Persiapan darah 1000 cc PRC,
1000 cc FFP, 5 TC ( all ON PROSES )
2. LT 4 : Nn Safanah azka / 19 thn / AV Block
/Post ASD closure, VSD closure dan PDA ligation
2003 / Post PPM DDDR ai SND dan AVND / Dr
Sunu SpJp (K) Terdapat rembesan darah (sedikit )
pada luka bekas Post op / Rencana GV by Dr Sunu
tgl 07.02.22 , senin
PASIEN ISTIMEWA :
1. LT 6 : Ny Devi Rames / Malignant neoplasm of

ovary,Urinary tract infection, site not specified/ Terpasang
Colostomy bag / dr Chamim SPOG
KETERANGAN : TOTAL PASIEN

Pasien Lt 4 : 3
orang Pasien Lt 5 :
2 orang Pasien
Lt 6 : 6 orang
MASALAH - DAPAT TERSELESAIKAN

1. Pasien lt 6 / Ibu Devi ramesh : Keluarga
( 2 orang ) hendak besuk / menjenguk dan
mendoakan pasien, SOP RS untuk terlebih
dahulu di lakukan pemeriksaan swab antigen,
keluarga meolak, awal memaksa hendak masuk
ke kamar ps, tapi setelah diberikan pengertian
keluarga tsb menerima dan menunda untuk
mengunjungi ps . Ibu Devi Ramesh sendiri,
sudah dinfokan bhwa ada rencana dikunjungi
oleh keluarga, ps maklum dan menerima aturan
dari RS, utk pengunjung dilakukan pemeriksaan
swab antigen.
Lt 3: Mara Lt 4 Lt 7: Syifa
: Irma Lt 5: Fastcontrol : Pujo
Nur Lt 6:
Lt 8 : Sigit
Hilda OT : Linda

Pasien lt 6 / Ibu
devi rames Complain terkait menu makanan yg ada
di meja pasien ( makanan masih utuh,belum disentuh
dan dimakan ) sudah diambil oleh petugas gizi.
Pasien mau supaya setiap makanan yg ada di meja,
jangan diambil sebelum ada izin untuk dambil,
dibersihkan atau dibawa oleh petugas gizi. ( Petugas
gizi sudah di infokan dan diedukasi, penyelesaiannya
makanan dikembalikan kembali dan keluarga
menerima )
1. Wibi, Herly , Ferly

2. Hamka, Afif , Feby
3. Indra, lesty, shifa
4. Gia, Novan, gading
ATING THEATER
TICAL CARE
1 1. Tn. William Tanady /40th/ Dpjp. dr. Zicky, Sp.S /

Myasthenia gravis
RENCANA TINDAKAN :
0
Pasien pak William / Dr Endang SpGizi /

0 direncanakan untuk diberikan DIPTIPEN 5 botol lagi
( karna sebelumnya pasien sdh pernah dapat) -
sedang pengajuan SIO ke ASURANSI
1 Pasien MASALAH
RENCANA TINDAKAN : 0
PASIEN PONEK : 1
1
PASIEN OBSERVASI :
usia 1 hari
2 1. By.Ny. Fifi Sofia aini/ dr. keumala

Sp.A/NCB SMK Usia 3 hari
ALAT RUSAK
1. Timbangan bayi ( Error )
2. Tempat memandikan bayi- bocor ( Team
Sarana Prasarana sudah terinfo-
3. Stop kontak tanam , posisi di lantai
Nursery
1. Ruangan bersih
2. AC dinyalakan dengan Temp suhu ruangan
( 25 sd 27 C )
3. TV dalam keadaan OFF

4. Penerangan Lampu terpantau tidak semua dinyalakan
ARTOLOGY
Supervisi Unit Cathlab keadaan kosong, tidak ada
aktifitas. alat alat tersusun rapi.
Supervisi Unit OPD Cardiac , terlihat ruangan
dibersihkan oleh SOS yg bertugas ( Bpk Sigit )
Keadaan ruangan Auditorium Rapi, sudah

dibersihkan oleh SOS, meja dan kursi tersusun baik
Sedang ada pengerjaan bangunan di lt 8, bagian luar.

dengan jumlah tukang pekerja sebanyak 3 orang. di
ltSedang
SIC (Agus) MINGGU PAGI, 06.02.22
TIPE PASIEN
DINAS
LT NAMA UNIT Pagi, malam
07.00 sd 07.00
wib
EMERGENCY ROOM
EMERGENCY
ROOM, Ns kelvin, Dr Fajar
PONEK
GF
Dr Rahmat
RADIOLOGI Delly Mulyadi
SpRad
FRONT LINER (FL) Petugas : 2 orang
TOTAL PASIEN EMG
Poli Obgyn NS 1 : Ns Siti H NS 1 : Ns

Dina H
Poli Internist
NS 2 : Ns Leni Dwi
NS 2 :
LT 3
Poli Pediatrik
PHARMACY OPD Indah Wahyu
TOTAL PASIEN OPD
LT 6
LT4 :
Ns taufik,Ns
IN PATIENT ela
Dr nesya Dr
DEPARTMENT LT5 : ria
Lt 4, 5, 6 Ns rio
Lt 6:
Ns risa,tarri
AREA MP IGD/RAD
SOS Lt GF: Sutrisno
Riki
Petugas : Uti,
GIZI Tiara
Petugas :
LABORATORIUM
krhisna ,adel
Petugas :
PHARMACY (SB)
asri
Jumlah
DANDRU :
SECURITY, PARKIR, Petugas 12
Pak WIBI
orang
MASALAH
KERUSAKAN
OPERATING THEATER
OK
CRITICAL CARE
ICU Ns winda Dr dewi
HCU
NICU Ns alfi Dr dewi
PICU
MASALAH
OBSTETRICS
LT 7
LT 7
Bd ning
VK Bd dewi
Nursery Ns nani
RUANG TUNGGU PS Terlihat 1 orang

CRITICAL Pagi jam 07 sd 07 Security Standby
HEARTOLOGY
Cathlab
Hybrid
LT 8 OPD JANTUNG
AUDITORIUM
NOTED
LAPORAN SIC MINGGU PAG malamI, tgl 06.02.22
1. Total pasien dari jam 07 sd 07 wib: 53 orang

2. Kerusakan alat dari Nursery sudah dalam proses pengerjaan by Team
sarana prasarana RS - ter update oleh Koord
3. Complain dari pasien a.n Ny Devi Ramesh sudah dapat terselesaikan
4. Rencana Tindakan utk pasien masing masing lantai sudah terinfo
dengan baik antar staf unit yg bersangkutan
PE PASIEN
KETERANGAN
RGENCY ROOM
RAJAL : 11
RANAP : 3
jam 07 sd RUJUK : 0
jam 07.00 APS : 0
wib
PASIEN PONEK : 1
TOTAL : 7
Dr Rahmad SpRad , Praktek jam 09.00 sd jam
12.00 wib
Petugas FL 2 orang,
17
10 KETERANGAN :
1 Pasien Lt 6 : 6 o
20
PASIEN OBSERVASI :
1. LT 5 : Tn Izzat / 72 thn / Post Herniaplasty / Hb
6,2 gr/dl - Transfusi 2 bag PRC 9 500 cc ) post
transfusi Hb 7.9 gr/dl. Terpasang Bedsite monitor /
Rencana Transfusi PRC 600 cc
PASIEN PINDAH ICU :
RENCANA TInDAKAN :

ovary,Urinary tract infection, site not specified/
Terpasang Colostomy bag / dr Chamim SPOG
tindakan kemoterapi besok tgl 7-2-22 2.
LT 4 : Ny Marceline Siswadi / 59 thn / CHD / Dr
Dicky Aligheri SpBTKV (K),dr, FIHA, FICA / Pro
CABG senin 07/02/22 senin, jam 16.00 wib di OK
Hybrid / Book ICU / Persiapan darah 1000 cc PRC,
1000 cc FFP, 5 TC ( all ON PROSES )
PASIEN ISTIMEWA :

ovary,Urinary tract infection, site not specified/ Terpasang
Colostomy bag / dr Chamim SPOG

Pasien Lt 4 : 3
orang Pasien Lt 5 :
3 orang Pasien
Lt 6 : 5 orang
1. Pasien lt 6 / Ibu Devi ramesh : Keluarga

( 2 orang ) hendak besuk / menjenguk dan
mendoakan pasien, SOP RS untuk terlebih
dahulu di lakukan pemeriksaan swab antigen,
keluarga meolak, awal memaksa hendak masuk
ke kamar ps, tapi setelah diberikan pengertian
keluarga tsb menerima dan menunda untuk
mengunjungi ps . Ibu Devi Ramesh sendiri,
sudah dinfokan bhwa ada rencana dikunjungi
oleh keluarga, ps maklum dan menerima aturan
dari RS, utk pengunjung dilakukan pemeriksaan
swab antigen.
Lt 3: Mara Lt 4 Lt 7: Syifa
: Irma Lt 5: Fastcontrol : Pujo
Nur Lt 6:
Lt 8 : Sigit
Hilda OT : Linda

Pasien lt 6 / Ibu
devi rames Complain terkait menu makanan yg ada
di meja pasien ( makanan masih utuh,belum disentuh
dan dimakan ) sudah diambil oleh petugas gizi.
Pasien mau supaya setiap makanan yg ada di meja,
jangan diambil sebelum ada izin untuk dambil,
dibersihkan atau dibawa oleh petugas gizi. ( Petugas
gizi sudah di infokan dan diedukasi, penyelesaiannya
makanan dikembalikan kembali dan keluarga
menerima )
1. Wibi, Herly , Ferly

2. Hamka, Afif , Feby
3. Indra, lesty, shifa
4. Gia, Novan, gading
ATING THEATER
1.Ny. Nida Hardianti/dr.Febrianyah
1 Darus,Sp.OG/Post Sc Cito
TICAL CARE
1 1. Tn. William Tanady /40th/ Dpjp. dr. Zicky, Sp.S /

Myasthenia gravis
RENCANA TINDAKAN :
0
Pasien pak William / Dr Endang SpGizi /

0 direncanakan untuk diberikan DIPTIPEN 5 botol lagi
( karna sebelumnya pasien sdh pernah dapat) -
sedang pengajuan SIO ke ASURANSI
1 Pasien MASALAH
RENCANA TINDAKAN : 0
PASIEN PONEK : 0
1
PASIEN OBSERVASI :
usia 1 hari 3. 2.by .Ny. Nida /dr andina
Sp.A/NCB SMK usia 1 hari 1
2
ALAT RUSAK
1. Timbangan bayi ( Error )
2. Tempat memandikan bayi- bocor ( Team
Sarana Prasarana sudah terinfo-
3. Stop kontak tanam , posisi di lantai
Nursery
1. Ruangan bersih
2. AC dinyalakan dengan Temp suhu ruangan
( 25 sd 27 C )
3. TV dalam keadaan OFF

4. Penerangan Lampu terpantau tidak semua dinyalakan
ARTOLOGY
Supervisi Unit Cathlab keadaan kosong, tidak ada
aktifitas. alat alat tersusun rapi.
Supervisi Unit OPD Cardiac , terlihat ruangan

dibersihkan oleh SOS yg bertugas ( Bpk Sigit )
Keadaan ruangan Auditorium Rapi, sudah

dibersihkan oleh SOS, meja dan kursi tersusun baik
Sedang ada pengerjaan bangunan di lt 8, bagian luar.

dengan jumlah tukang pekerja sebanyak 3 orang. di
ltSedang
SIC (CAROL) SENIN, 07.02.22
TIPE PASIEN
LT NAMA UNIT DINAS
EMERGENCY ROOM
EMERGENCY Dr Firdha Dr
Dr Firdha Dr Dwi Ns
Dwi Ns
ROOM, Ns Susi
Sanusi Ns
Nur Ns
PONEK Ns Kelvin Rizam
Fitri
GF
RADIOLOGI Ara
TOTAL PASIEN EMG
Poli Obgyn : 17 Poli anak : 35

Ns IIn THT : 4
Urology : 3
Poli Internist: 10 Poli Dental : 6
Rehab Medik :
Orthopedy : 2 4
LT 3 Poli Pediatrik Poli Mata : 3
Bedah
Onkology : 3 Fisotherapi : 7
digestive : 1
Dermis : 5
Neuro : 4 ODC : 1 MCU : 8
TOTAL PASIEN OPD
LT 4 LT IN PATIENT DEPARTMENT
5 LT
6
LT4 : LT4 :
LT4 :
Ns Ns
Ns
Salwa Ns Taufik Ns
Salwa Ns Tita
Rio Dr Rona
Malik LT5 : (P)
IN PATIENT LT5 :
LT5 :
DEPARTMENT
Ns Ns
Ns Dr
Lt 4, 5, 6 Lt 6: Megawati (M)
Lt 6: Lt 6:
Ns
Ns
Avi
Ns Silvi Karisha Ns
Ns Okta
Ns Ana Nela
SOS Petugas: Indra,

Trijaya, Arwan
Petugas : Fajar
GIZI (Cook)
Anti
Petugas :
LABORATORIUM
Marisa, adel
PHARMACY (SB)
Petugas :
Bulan, Heny
DANDRU : Jumlah
SECURITY,
Pak Adi Petugas 6
PARKIR,
Nugroho orang
MASALAH
KERUSAKAN
OPERATING THEATER
Ns Sunandar Ns
OK Heryanti
CRITICAL CARE
Dr Rizki Ns
Ns Dwi
ICU Ns Awaludin Gisma Ns
( HARKIT)
Rita
LT 7
HCU
NICU Ns Esti Ns Alvi

PICU
MASALAH
OBSTETRICS
Bd Viky Bd Bd Putri Bd
VK Bd Viky
Hilda Tries
Ns Wiwi
Nursery NsInggrid (M)
Ns Ika Ns Nani
Ns Wiwi
Nursery NsInggrid (M)
Ns Ika Ns Nani
RUANG TUNGGU
PS CRITICAL
HEARTOLOGY
Ns Akbar
Cathlab Ns Tryanto
Hybrid
LT 8
Ns Rini T
OPD JANTUNG
Ns Emma
AUDITORIUM
NOTED
TOTAL PASIEN : 161 Orang
PE PASIEN (Pasien baru Ranap/Pasien
TOTAL
PASIEN
GENCY ROOM
PASIEN OBSERVASI :
RAJAL : 13
RANAP : 4
RUJUK : 0
APS : 0
PASIEN PONEK :
TOTAL : 17
17
KETERANGAN :
Dokter Cuti/tidak prkatek :
dr. Nisa SpOG
Dr. Aidrus SpOG
Dr. Taufik SpOG
Dr. Mirta SpTHT
Dr. Lazuardy SpOG
Dr. Rifan SpA
Dr. Chairurizqi SpOGien Lt 4 : 3 orang
Pasien Lt 6 : 6
o
114
PASIEN OBSERVASI :
1. LT 4 : Tn Izzat / 72 thn / Post Herniaplasty /
HB 7,9 gr / dl ( 06.02.22 )
PASIEN PINDAH ICU :
1. LT 4 : Ny Marceline Siswadi / 59 thn / CHD
/ Dr Dicky Aligheri SpBTKV (K),dr, FIHA,
FICA / Pro CABG senin 07/02/22 senin, jam
16.00 wib di OK Hybrid / Book ICU / Persiapan
darah 1000 cc PRC, 1000 cc FFP, 5 TC
RENCANA TINDAKAN :
1. LT 6 : Ny Devi Rames / Malignant neoplasm

of ovary,Urinary tract infection, site not
specified/ Terpasang Colostomy bag / dr
Chamim SPOG Pro kemoterapi
2. LT 4 : Ny Marceline
Siswadi / 59 thn / CHD / Dr Dicky Aligheri
SpBTKV (K),dr, FIHA, FICA / Pro CABG senin
07/02/22 senin, jam 16.00 wib di OK Hybrid /
Book ICU / Persiapan darah 1000 cc PRC, 1000
cc FFP, 5 TC
PASIEN ISTIMEWA :

ovary,Urinary tract infection, site not specified/
Terpasang Colostomy bag / dr Chamim SPOG

Pasien Lt
4 : 6 orang + 1 ( ICU )
Pasien Lt 5 : 0
MASALAH
1. LT 6 : Ny Devi Rames / Malignant

neoplasm of ovary,Urinary tract infection,
site not specified/ Terpasang Colostomy bag
/ dr Chamim SPOG tindakan kemoterapi
( Deposit biaya Rp 30 juta )
1. Moh Ryanto ( RG1 ) EMG
2. Ari Setiawan ( Lobby )
3. Gading ( Lt 2 )
4. Iin Diare ( PKD )
5.Giantoro ( PKD )
ING THEATER
Tindakan Operasi : 3 Orang
1. BEDAH OBGYN - Ekspirtasi Kista Bartholine
Narkose / Fransisca Noela RMH, dr. Sp.OG 2.
BEDAH HEARTOLOGY - CABG / Dicky
3. BEDAH ONCOLOGY - FAM Excision <3cm /
Bob Andinata, dr. Sp.B(K)Onk
RENCANA TINDAKAN : Tgl 08.02022

1 1. BEDAH UROLOGY - Aff DJ Stent + GA / Dr
Endrika Noviandrini, dr. Sp.U
ICAL CARE

Myasthenia gravis 2.
2 Ny Marceline Siswadi / 59 thn / CHD / Dr Dicky
Aligheri SpBTKV (K),dr, FIHA / BEDAH
HEARTOLOGY - CABG / Dicky Aligheri,
1 Pasien
0 RENCANA TINDAKAN : 0
PASIEN PONEK :
PASIEN OBSERVASI :
2
1. By. Ny Nida Hardianti / dr. Andina, Sp.A
2 / NCB SMK Usia 1 Hari
1. By. Ny. Agatha/ dr.Nina Sp.A/ NCB

SMK usia 3 hr
RTOLOGY
1. BEDAH HEARTOLOGY - CABG / Dicky

Total Kunjungan Pasien : 13 orang

KETERANGAN : Dr Dicky
Aligheri ( Sakit )
SIC (EKO) Selasa, 08.02.22
TIPE PASIEN
YANG DINAS
LT NAMA UNIT
EMERGENCY ROOM
dr. Fajar, dr. Audrey,

EMERGENCY Br. Mohlis,
Ns. Susi, Zr. Ns. Sanusi,
ROOM Fitri
Zr. Fitri
Zr. Nur
GF
PONEK
TOTAL PASIEN EMG
Poli Obgyn
Ns NS 1 :
Poli Urology IIN
Poli Ortho
Poli Internist
Poli Bedah Umum
Poli Bedah Plastik
Poli THT Kiki
Poli Gizi
Poli bedah saraf
Poli Neuro
LT 3 Dermis
Dental
Poli Endoscopy
Poli Fisioterapi
Poli Psikiatri
Pain Klinick
Poli Rehab Medik
Poli Mata
Poli Nutrition
Poli Paru
ODC
MCU
TOTAL PASIEN OPD
DP = Ns. DS = Ns.
Citra + Ns. DM = Ns.
IN PATIENT Citra + Ns.
Malik + Ns. Salwa + Ns.
DEPARTMENT 4 Helen Abdy
Tita
LT 4
LT 5
LT 4
LT 5
IN PATIENT
DEPARTMENT 5
DM = Ns.
DP = Ns. DS = Ns. indah + Ns.
IN PATIENT kristin + Bd. aviani+ Ns.
DEPARTMENT 6 ade octa
santi
MD =
Br.yudi
LT 6
LT 6
KOMPLAIANAN
KERUSAKAN
OPERATING THEATER
OK
CRITICAL CARE
Awal,
ICU Gisma
Any, Rita Winda Agus
HCU
NICU
Esty Alfi, Evi Grace

PICU
TOTAL Ps CRITICAL
OBSTETRICS
‌Dines Pagi:
‌Dines
- ‌Dines
Siang : bd.
Dines Malam : bd.
VK Midle : bd.
Viki, bd
Putri, bd.
genda
Viki Tries
Dinas
siang :Ns.
pagi : malam : Ns
Nursery Ns.Wiwi
Inggrid
.Nani
Dines
‌Dines
Dinas
siang :Ns.
pagi : malam : Ns
Nursery Ns.Wiwi
Inggrid
.Nani
Dines
‌Dines
HEARTOLOGY
Cathlab
Hybrid
OPD JANTUNG
LT 8
LT 8
Dokter Jaga
Dokter Jaga IGD : Pagi : dr Malam : dr Rizky
Dokter Jaga IPD : Pagi : dr Mutiara Malam : dr Rona
Dokter Jaga Critical : Pagi : dr Fajar Malam : dr Audrey
1. Komplainan pasien a/n Ny. Agatha Christy Floris Perihal Visit dokter dan voucer serta permintaan Discount
2. Pasien Terkonfirmasi Covid 19 ada 2 pasien dari Unit EMG
3. Rencana Tindakan lantai 4 R/ MRI lumbal dan Cervical non kontras SIO (+) ACC (-), EMG lengan dan kaki kiri SIO (+) A
4. - Rencana Tindakan utk pasien masing masing lantai sudah terinfo dengan baik antar staf unit yg bersangkutan, untuk pe
Perihal Puasa dan Pencukuran
- Rencana Kemoterapi tgl 09/02/2022 a/n Ny. Devi Ramesh Info perawat Lantai 6 (sedang tunggu OBAT dari farmasi ), S
BHP nya sdh Siap, untuk Obat Tinggal Menunggu Staf Farmasi Yg akan melakukan pengoplosan Obat KEMO di Pagi In
KETERANGAN
TOTAL
PASIEN
akan dilakukan)
CY ROOM
PASIEN OBSERVASI :
RAJAL :
1. Tn. Asep Arie Taufiq /34th/ Dx. Fever (Hasil
Swab PCR Swab Cito Pasien Positif Covid 19) 2.
Ny. Reny Astumulatsih /40th/ Dx. Viral Infection
3. Nn.
Lisdawati /22th/ Dx. Other complications
following immunization
4. Ny. Shinta Imelda /53th/ Dx. Dyspepsia
Headache
5. Nn. Sika Ariani /26th/ Dx. Viral infection (Hasil
Swab PCR Swab Cito Pasien Positif Covid 19)
6. Ny. Nazhira
Janani /27th/ Dx. G1P0A0 Hml 28 mgg / Infus
Venofer 2 Amp dlm Ns100 ml 7. Nn. Jeanni
Indah 32th/ Dx. Dyspepsia 8. An. Gabe
Emmanuel / 6th/ Dx. Febris 9. Ny. Siti
Umairoh /42th/ Dx. Fever 10. Tn.
Agus Bambang /49th/ Dx. Dyspepsia
RANAP :
1. Nn. Nurul Fajria /37th/ Dx. Subserosal
leiomyoma of uterus / Dpjp. Veinardi
Madjid,dr. Sp.OG / Ruang 402
2. An. Shandaru Abbinata /1th/ Dx.
14 Gastroenteritis and colitis / Dpjp. Annisa Nur
Aini, dr. Sp.A (FT) / Ruang 601
3. Ny. Grace Desy /52th/ Dx. Lumbar and
other intervertebral disc disorders with
radiculopathy / Dpjp. Zicky Yombana, dr.
Sp.S / Ruang 403 4.
Nn Cindy Budie /40th/ Dx. Endometriosis of
uterus / Dpjp. Mohammad Haekal, dr.
Sp.OG, FICS / Ruang 610
RUJUK KE :
APS :
PASIEN TERKONFIRMASI COVID 19 :
Ada 2 Pasien Terkonfirmasih Covid 19

PERALATAN :
NOTE :
RAJAL :
RANAP :
1 1. Ny. Aviana Furi /26th/ Dx. G2P0A1

hamil 38+4 minggu / Dpjp. Nisa Fathoni,
dr. Sp. OG, IBCLC / Rawat VK
PASIEN OBSERVASI :
15 Pasien
20
2
3
13
1
3
1
10
5
1
10
3
2
29
1
117 Pasien
1.Ny. Grace Desy M Rumimpunu/Zicky Yombana,

dr. Sp.S/Lumbar and other intervertebral disc
disorders with radiculopathy, Cervicobrachial
syndrome, multiple sites, Pain in limb, multiple
sites
2.Ny. Hesti/Bob Andinata, dr.
Sp.B(K)Onk/Malignant neoplasm of breast, Ca.
Mammae Dextra Std IV
3.Ny. Yulia/Bob Andinata, dr. Sp.B(K)Onk/
Malignant neoplasm of breast, Pro transfusi PRC
pre Kemoterapi, Ca Mammae dextra st IIIB
PASIEN OBSERVASI :

Sp.B(K)Onk/Malignant neoplasm of breast, Ca.
Mammae Dextra Std IV
Malignant neoplasm of breast, Post transfusi PRC
pre Kemoterapi, Ca Mammae dextra st IIIB
3.Ny. DRA HJ. S Zainona/ Alvin Nursalim, dr. Sp.
PD/ GERD+HIPOKALEMI
4.Ny. Grace Desy M Rumimpunu/Zicky Yombana,
dr. Sp.S/Lumbar and other intervertebral disc
disorders with radiculopathy, Cervicobrachial
syndrome, multiple sites, Pain in limb, multiple
sites
5.Nn. Destyca Tamara/ Alvin Nursalim, dr. Sp.
PD/ Viral infection of unspecified site, Dyspepsia
Hemiarthroplasty
7.Tn. Muhammad Guntoro/ Alvin Nursalim, dr.
Sp. PD/ dhearea
8.Tn. Eddy Wiyono/ Denio A. Ridjab, dr. SpJP-
FIHA/ Atherosclorotic heart diseasse post CAG
9.Ny Indra Widyati/ Murdani Abdullah, Prof. Dr.
SpPD- KGEH
9
PASIEN PINDAH ICU :

RENCANA TINDAKAN :
1.Ny. Grace Desy M Rumimpunu / Zicky

Yombana, dr. Sp.S / Lumbar and other
intervertebral disc disorders with radiculopathy,
Cervicobrachial syndrome, multiple sites, Pain in
limb, multiple sites /R/ MRI lumbal dan Cervical
non kontras SIO (+) ACC (-), EMG lengan dan
kaki kiri SIO (+) ACC (-) tgl 9/2/22
RENCANA PULANG :

Sp.B(K)Onk/Malignant neoplasm of breast,
Ca. Mammae Dextra Std IV
2.Tn. Eddy Wiyono/ Denio A. Ridjab, dr.
SpJP- FIHA/ Atherosclorotic heart diseasse
post CAG
PASIEN PULANG :
1.Ny.Nurul/dr.Veinardy Sp.OG/Abdominal
Pain Unspecified and Other
2.Ny. Paulina Iswanti/dr. Endrica, Sp.U/Post
Aff Stent (ODC)
PASIEN OBSERVASI :
PASIEN PINDAH ICU :
RENCANA TINDAKAN
PASIEN PULANG :

1. Ny Rusmini Djajasepu/ Leymioma of

utereus/ Prof NK
2. Ny. Cindy Budie / Endometriosis of uterus /
dr. Haekal,Sp.OG
3. An. Shandaru A/ dr Annisa S.PA/
Gastroenteritis and colitis of unspecified
origin
4. Tn. William Tanady / Myasthenia gravis /
Zicky Yombana, dr. Sp.S
PASIEN OBSERVASI :
1. An. Muhamad Zulfar Alvaro/ dr. Nina Dwi

Putri,Sp.A(K)/ DHF
Chamim
3. An. Shandaru A/ dr Annisa S.PA/ Gastroenteritis
and colitis of unspecified origin
4.Tn. William Tanady / Myasthenia gravis / Zicky
Yombana, dr. Sp.S
5. Ny Rusmini Djajasepu/ Leymioma of utereus/
Prof NK
6. Ny. Cindy Budie / Endometriosis of uterus / dr.
Haekal,Sp.OG
PASIEN PINDAH ICU :
RENCANA TINDAKAN

7 utereus/ Prof NK / R/ Histerektomy tanggal
9/2/22 jam 09.00 wib
2. Ny. Devi Ramesh/ Dr.dr.Chamim, Sp.OG
(K) / Malignant neoplasm of ovary,Urinary
tract infection, site not specified/ Rencana
Kemoterapi tgl 09/02/2022 (sedang tunggu
OBAT dari farmasi )
PASIEN VK
1. Ny. AVIANA FURI ANNISA/ Nisa
Fathoni, dr. Sp. OG, IBCLC / Supervision of
normal pregnancy
pasien pindah ke PICU :
1. An. Josia Michael P. / Atrial premature
depolarization/ Sunu Budhi Raharjo, dr.
SpJP (K), PhD
PASIEN PULANG
1. Ny.agatha / dr damar / posT SC

2. An. Alya Lutfia/Annisa Nur Aini, dr. Sp.A
(FT)/ Dengue fever H-3
3. Ny. Nida Hardianti/dr.Febrianyah
Darus,Sp.OG/Post Sc Cito
4. Ny. S Meiryta / dr Fransisca Noela RMH,
dr. Sp.OG / Post Op Ekstirapasi Kista
Bartholin
RENCANA MASUK :
1. Ny. Agatha Christy Floris / Suami Pasien

Komplain Visit Dokter Damar Sp.OG di tgl
05/02/22 dan Permintaan Doscount. SIC dan
FL (Bu Tina) Melakukan penjelasan perihal
Discount yg menurut suami dia dan istri layak
untuk mendapatkan discoun, dgn Alsan
mendapatkan Voucer Discount sejumlah 2jta
dri antasi Beserta Cast Back, suami
menyesalkan kenpa tdk di berlakukan di
rs.brawijaya saharjo yg menurut beliau 1
Group, Sic sdh berkoordinasi lgsung kepda Bu
kothim dan sdh di jelaskn ke suami pasien.
untuk Voucer Suami meminta ada kebijakan
atau konfirmasi ulang ke pihak marketing
Brawijaya Antasari
THEATER
1. Tindakan Selasa, 08-02-22 -
Aff DJ Stent + GA / Paulina Iswanti / dr. Endriks
Noviandrini Sp. U / J. 10.00 / Di OK
2 - VT ABLATION / An.
Josia Michael / dr. Sunu Budhi Raharjo, Sp.JP
(K), PhD / J.19.00 / OK III
2. Rencana Tindakan Rabu, 09-02-22

- Abdominal Hysterectomy /Rusmini
Djajaseoutra / Prof. Dr. Nugroho Kompono, Sp.
OG (K) Onk / J. 09.00 OK I
- Lucian / Hysterectomy
Laparoscopy / Dr. Chamim Sp. OG (K) Onk / J.
11.00 OK I
L CARE
1 1. Ny Marceline Siswadi / 59 thn / Dx. POST CABG /

Dr Dicky Aligheri SpBTKV (K),dr, FIHA, Dr Dicky
Aligheri, SpBTKV (K),dr, FIHA, FICA
0
0
1 An. Josia Michael /3th/ Hari Rawat Ke 1

/Dx. Post OP ABLASI / Dpjp. dr. Sunu
Budhi Raharjo, Sp.JP (K), PhD
2 Pasien
PASIEN OBSERVASI :
1. Ny. Alviana/G2P1A0 hamil 38 mgg dg
1 Inpartu/ dr. Nisa
RENCANA TINDAKAN :
PASIEN PONEK :
1. Ny. Alviana/ G2P1A0 hamil 38 mgg/ dr.
1 Nisa
PASIEN OBSERVASI :
PASIEN PULANG
0
0
usia 3 hari
2. By. Ny Nida Hardianti / dr. Andina, Sp.A /
NCB SMK usia 2 hari
LOGY
Outpatient : 12
dr ario :
Dr dafsah : 2
dr denio : 3
dr faris : 1
dr DH : 5
dr DAW :
dr radityo :
12 Dr suko :
dr sunu : 1
dr Adi :
MCU : -
New patient: 4
Dr Dicky hanafi : PB dari keluarga
Dr sunu : PB dari Teman
Dr Dafsah 2 : PB dari keluarga
Cancel : 6
dr Dafsah : 1
Dr Denio : 1
Dr DICKY H : 1
Dr. Suko : 1
Dr Sunu :2

ECHO : 2
Stress Echo :
USG Doppler : 3
Holter : 1
ECG : 10
Treadmill : 1
CT Scan
Speckle
TEE :
DSE :
ABI :
Tilt Table Test :
Advance Echo :
Handle Echo :
ABPM :
Ezypro :
Cardioversi :
Referral Brawijaya : dr. Chamim SpOG RSBS

Referral External :
Info dokter tidak hadir : dr. Dicky Aligheri sakit
aan Discount
gan dan kaki kiri SIO (+) ACC (-) tgl 9/2/22
yg bersangkutan, untuk persiapannya SIC sdh memastikan ke perwat indah
ggu OBAT dari farmasi ), Sic Sdh KOnfirmasi ke farmasi (Upick) untuk
osan Obat KEMO di Pagi Ini
SIC (EKO) Rabu, 09.02.22
TIPE PASIEN
YANG DINAS
LT NAMA UNIT
EMERGENCY ROOM
dr. Dwi, Ns. dr. Firdha,

Ns. Kelvin,
EMERGENCY ROOM Susi, Ns.
Br. Mohlis
Ns. Sanusi,
Rizam Zr. Fitri
GF
PONEK
PONEK
TOTAL PASIEN EMG
Poli Obgyn
Ns NS 1 :
Poli Urology IIN
Poli Ortho
Poli Internist
Poli Bedah Umum
Poli Bedah Plastik
Poli THT Kiki
Poli Gizi
Poli bedah saraf
Poli Neuro
Dermis
Dental
Poli Endoscopy
Poli Kemotherapi
LT 3
Poli Fisioterapi
Poli Psikiatri
Pain Klinick
Poli Rehab Medik
Poli Mata
Poli Nutrition
Poli Paru
Poli Mata
Poli Psikiatri
Pain Clinic
MCU
ODC
TOTAL PASIEN OPD
DM = Ns.
DP = Br. DS = Ns.
Salwa + Ns.
IN PATIENT Malik + Ns. Citra + Br.
Tita
MD = Br.
Yudi
LT 4 LT
5
DM = Ns.
DP = Br. DS = Ns.
Salwa + Ns.
IN PATIENT Malik + Ns. Citra + Br. Tita
MD = Br.
Yudi
LT 4 LT
5
IN PATIENT
DEPARTMENT 5
DS = Ns.
DP = Ns. DM = Ns.
aviani
IN PATIENT Aviani+
( lembur)+ indah + Ns.
LT 6 DEPARTMENT 6 Ns.helen
Ns. octa sanTI
KOMPLAIANAN
KERUSAKAN
OPERATING THEATER
OK
CRITICAL CARE
ICU Awal, Agus Ning Helga, Any
HCU
NICU
Esty Grace Evi
PICU
TOTAL Ps CRITICAL
OBSTETRICS
‌Dines
‌Dines
Malam : bd.
VK bd. Genda Viki, bd
Putri, bd.
genda
Tries
Dinas D ‌ ines siang
Dines
pagi : B.d :Ns.
Nursery Nelly Inggrid
malam : Ns
.ika
HEARTOLOGY
Cathlab
LT 8
LT 8
Hybrid
OPD JANTUNG
Dokter Jaga
Dokter Jaga IGD : Pagi : dr Dwi Malam :
Pagi : dr Megawati &
Dokter Jaga IPD : Malam :
dr. Abdurahman
Dokter Jaga Critical : Pagi : dr Dwi Malam :

TIPE PASIEN
KETERANGAN
TOTAL
BERAT PASIEN
RGENCY ROOM
PASIEN OBSERVASI :
RAJAL :
1. An. Arbian /6bln/ Dx. Ispa (Covid 19
Terkonfirmasi) 2.
Tn. Chairul Amri /27th/ Dx. Febris H-2 (Covid
19 Terkonfirmasi)
3. Ny. Priza Pricyllia /35th/ Dx. G4P1A2 Hamil
32 minggu + dyspepsia syndrome ec susp
gastritis dd/ GERD + JPTKH + Dyspepsia ron
deficiency anaemia / infus venofer 2 ampul drip
dalam nacl 0,9% 100 ml habis dalam 1 jam
4. An. Wisly
Pratama /6th/ Dx. Ispa (Covid 19
Terkonfirmasi) 5.
Ny. Eny Anggraini /66th/ Dx. Ca Mamae 6.
Tn. Margono /69th/ Dx. Dhiare 7.
Ny. Naning Carningsih /76th/ Dx.
Haemarthrosis
8. An. Sulton Elbrama /9bln/ Dx. Anaemia,
9 Nausea and vomiting, Fever
9. Tn. Mohammad Ilham /30th/ Dx. Nausea
RANAP :
RUJUK KE :
APS :
PASIEN TERKONFIRMASI COVID 19

:
PERALATAN :
NOTE :
RAJAL :
2
1. Ny. Cecilia Rumondang /27th/ Dx. Mild
hyperemesis gravidarum + g1p0a0 hamil
35 minggu dengan hiperemesis JPKTH
RANAP :
2
1. Ny. Emelia Saberina /30th/ Dx.
G2P0A1 Hamil 38 minggu + Kala 1 fase
aktif + JPKTH / Dpjp. Nisa Fathoni, dr. Sp.
OG, IBCLC / Rawat VK
PASIEN OBSERVASI :
11 Pasien
24 Dokter Cuti/tidak prkatek :

dr. Zaki SpOT
Drg. Novan
1 Drg. Rininta
3 Dr. Widi SpB-KBD
Dr. Hamida SpTHT
11 Dr. Bob SpB Onk
1 Dr. Gatra SpOT
Dr. Rizky Notario SpOT
Dr. Winda SpA
Dr. Tenaga Isoman :

6 Siti
Resmita SpAOT
2
1
9
8
2
2
4
2
2
3
4
88
1.Ny. Wiwiek Handayani / Suko Adiarto, dr.

SpJP (K),FIHA, FICA, FAsCC, PhD/
Peripheral vascular disease, Non-insulin-
PASIEN OBSERVASI :

Malignant neoplasm of breast, Post transfusi
PRC pre Kemoterapi, Ca Mammae dextra st
IIIB
2.Ny. DRA HJ. S Zainona/ Alvin Nursalim, dr.
Sp. PD/ GERD+HIPOKALEMI
3.Ny. Grace Desy M Rumimpunu/Zicky
Yombana, dr. Sp.S/Lumbar and other
Cervicobrachial syndrome, multiple sites, Pain
in limb, multiple sites
4.Nn. Destyca Tamara/ Alvin Nursalim, dr. Sp.
PD/ Viral infection of unspecified site,
Dyspepsia
Hemiarthroplasty
6.Tn. Muhammad Guntoro/ Alvin Nursalim, dr.
Sp. PD/ dhearea
7.Ny. Wiwiek Handayani / Suko Adiarto, dr.
SpJP (K),FIHA, FICA, FAsCC, PhD/
Peripheral vascular disease, Non-insulin-
8.Ny Indra Widyati/ Murdani Abdullah, Prof.
Dr. SpPD- KGEH
PASIEN PINDAH ICU :

8
8
1.Ny. Miftahul Ulum / Radi Muharris

Mulyana, dr. Sp.OT / Rekonstruksi ACL
(Non FL) R/ masuk 10/02/22 (km. 401)
RENCANA TINDAKAN :
RENCANA PULANG :
1.Ny. Yulia/Bob Andinata, dr.

Sp.B(K)Onk/ Malignant neoplasm of
breast, Post transfusi PRC pre Kemoterapi,
Ca Mammae dextra st IIIB
2.Nn. Destyca Tamara/ Alvin Nursalim, dr.
Sp. PD/ Viral infection of unspecified site,
Dyspepsia
PASIEN PULANG :

Sp.B(K)Onk/Malignant neoplasm of breast,
Ca. Mammae Dextra Std IV
2.Tn. Eddy Wiyono/ Denio A. Ridjab, dr.
SpJP- FIHA/ Atherosclorotic heart diseasse
post CAG
PASIEN OBSERVASI :
PASIEN PINDAH ICU :
RENCANA TINDAKAN
PASIEN PULANG :

1. Ny. AVIANA FURI ANNISA/ Nisa

Fathoni, dr. Sp. OG, IBCLC / Supervision
of normal pregnancy
2. Ny.Siti umairoh / Amanda Pitarini
Utari,dr, SpPD-KGEH/ Dyspepsia,Nausea
and vomiting
3. Ny. Emelia Saberina / Nisa Fathoni, dr.
Sp. OG, IBCLC / Post partum P1A1+
PASIEN OBSERVASI :
1. An. Muhamad Zulfar Alvaro/ dr. Nina Dwi

Putri,Sp.A(K)/ DHF
ovary,Urinary tract infection, site not
specified/dr Chamim
3. An. Shandaru A/ dr Annisa S.PA/
4.Tn. William Tanady / Myasthenia gravis /
9
utereus/ Prof NK
6. Ny. Cindy Budie / Endometriosis of uterus /
dr. Haekal,Sp.OG
7. Ny. AVIANA FURI ANNISA/ Nisa Fathoni,
dr. Sp. OG, IBCLC / Supervision of normal
pregnancy
8. Ny.Siti umairoh / Amanda Pitarini Utari,dr,
SpPD-KGEH/ Dyspepsia,Nausea and vomiting
9. Ny. Emelia Saberina / Nisa Fathoni, dr. Sp.
OG, IBCLC / Post partum P1A1+
PASIEN PINDAH ICU :
RENCANA TINDAKAN
PASIEN VK
PASIEN PULANG
RENCANA MASUK :
ATING THEATER
1. Tindakan Rabu, 09-02-22
Abdominal Hysterectomy /Rusmini
Djajaseoutra / Prof. Dr. Nugroho Kompono, Sp.
OG (K) Onk / J. 09.00 OK I
2 - Lucian / Hysterectomy
Laparoscopy / Dr. Chamim Sp. OG (K) Onk / J.
11.00 OK I
2. Rencana Tindakan Rabu, 10-02-22

- Histerektomi Total, SOB + Cystotomy /Lia
Naskatiani / Veinardi Madjid, Sp. OG / J. 12.00
OK I -
Anterior Cruciate Ligament (ACL)
Reconstruction / Miftahul Ulum / Dr. Radi
Muharris Mulyana, Sp. OT / J. 16.00 OK I
ITICAL CARE
1. Ny Marceline Siswadi / 59 thn / Dx. POST
1 CABG / Dr Dicky Aligheri SpBTKV (K),dr,
FIHA, Dr Dicky Aligheri, SpBTKV (K),dr, FIHA,
FICA
0
0
1 Pasien
PASIEN OBSERVASI :
1. Ny. Alviana/G2P0A1 hamil 38 mgg/ dr.

Nisa/ partus spontan
2
2. Ny. Emelia saberina/G2P0A1 hamil 38
mgg/ dr. Nisa/ partus spontan jam 11.32
RENCANA TINDAKAN :
PASIEN PONEK :
1. Ny. Emelia/ G2P0A1 hamil 38 mgg/ dr.
Nisa
2. Ny. Cecilic rumondang/G1P0A0 hamil
35 mgg/ dr. Nisa, SpOG
PASIEN OBSERVASI :
1.By. ny . Aviana Furi / dr. Rifan fauzi sp.
A /NCB SMK usia 16 jam
2. By. Ny. Emelia Saberina /dr. Rifan fauzi
sp.A/ NCB SMK usia 12 jam
2
PASIEN PULANG
EARTOLOGY

9 Feb 22
CATHLAB
Schedule :
1 1. Wiwiek Handayani / PTA / dr. suko/ 18.30-
21.15
Team ; Saiful, jhoni, triyanto, aulia, tim anestesi
Non Schedule : -
HYBRID OR
Schedule : -
Non Schedule : -
Others : -
Problem : -
Overtime staf :Next Schedule
Thu, 10 Feb
1. Dr. Syafrizal / PELD / 17.00 / Cathlab
Sat, 12 Feb
1. Dr. Syafrizal / PELD / 13.00 / Cathlab -
Staff sakit : -
Staff cuti : -
Next Schedule
Thu, 10 Feb
Sat, 12 Feb
13
dr Firdha
dr Mutiara
dr Firdha
TIPE PASIEN
DINAS
LT NAMA UNIT
EMERGENCY ROOM
Dr Megawati Dr Megawati
EMERGENCY ROOM, Dr Dwi
Ns Kelvin Ns Ns Mohlis
PONEK Ns Susi
Rizam Ns Fitri
GF
RADIOLOGI Adi
FL Andra
TOTAL PASIEN EMG
Poli anak :
Poli Obgyn : 22
Ns IIn THT : 8 22
Urology :
Poli Internist: 5 Dental 6
Orthopedy : 2 Rehab Medik :
Poli Pediatrik Poli Mata : 2
Bedah
Onkology : Fisotherapi 8
digestive : 2
LT 3 Dermis : 1
Neuro : 5 ODC : MCU : 8

TOTAL PASIEN OPD
LT 6
L4
Ns Santi Lt 4 Lt 4
Ns Tari Ns Taufik Ns Citra
IN PATIENT
L6 Ns ABdi Ns Malik
DEPARTMENT
Lt 4, 5, 6 Ns Risha Lt 6 L6
Ns Ns Kristin Ns Ns Avi
Yudi Ns Yudi Ns Okta
Helen
SOS Petugas:
Petugas :
GIZI (Cook)
LABORATORIUM Petugas :
Petugas :
PHARMACY (SB)
PKD :
EMG :
DANDRU : Jumlah Petugas 1. Ilham
SECURITY, PARKIR, Ahmad
Pak 6 orang 2.
Jawadi
Husni
KERUSAKAN
OPERATING THEATER
Ns Sunandar Ns Ns Yanu Ns
OK Heryanti Heri
Ns Heni
CRITICAL CARE
Dr Rizki Dr Nilam
ICU Ns Awaludin Ns Ani
LT 7 HCU Ns Esti Ns Alvi

OBSTETRICS
Bd Ningsih Bd Viky Bd
VK Bd Dewi (M)
Bd Dewi Genda
Nursery Ns Nany Bd Nelly Ns Inggrid

RUANG TUNGGU PS
CRITICAL
HEARTOLOGY
Ns Akbar
Cathlab Ns Tryanto
NNs Syaiful
Hybrid
LT 8
Ns Rini T
OPD JANTUNG
Ns Emma
AUDITORIUM
NOTED
TIPE PASIEN
KETERANGAN
TOTAL
PASIEN
akan dilakukan)
ENCY ROOM
PASIEN OBSERVASI :
RAJAL : 8
RANAP : 4
RUJUK : 0
APS : 0
PASIEN PONEK :
TOTAL : 12
12
Bedah Dokter Cuti/tidak prkatek :

Umum : 2 dr. Radi SpOT
Dr. Eric SpA
Dr. Akbari SpU
Bedah PASIEN BATAL TINDAKAN :
Syaraf : 1 HASIL SWAB PCR POSITIF
1. dr. Mirta Hediyati. Sp.THT
00-27-45-89 RATNO ANGGAR KUSUMA male 29
tahun
dr.Mirta Hediyati , Sp.THT
Keluhan :
hidung tersumbat++. sakit kepala +. batuk -. pilek ++
diagnosa :
Utama : J31.0 Chronic rhinitis
Tambahan : J34.2 Deviated nasal septum
Tambahan : J34.3 Hypertrophy of nasal turbinates
Alergi : -
Renc. Ranap dengan tindakan Submukosa reseksi

septum (SMR) dan reduksi KI bilateral hari Jumat
11/02/2022 pkl 13.00 dengan asuransi
86
Lt 4 : 4 Lt 6 : 1
PASIEN OBSERVASI :
1. Lt 4 : Ny. MARCELLINE SISWAD/Dicky

Aligheri, SpBTKV (K),dr, FIHA, FICA/POST
CABG ( tgl 07.02.22 ) Atherosclerotic
cardiovascular disease
2. Lt 6 : Ny FLAVIA VONNY FRANSISCA /
dr. Ardiansjah Dara, Sp. OG /Premature
rupture of membranes, unspecified
PASIEN PINDAH ICU :

1. Lt 6 : Tn William Tanady / Myasthenia gravis /
RENCANA TINDAKAN :
1. Lt 6 : Ny. Cindy Budie / Endometriosis of

uterus / dr. Haekal,Sp.OG, Rencana tindakan
Laparoskopi Reseksi Adenomiosis + Miomektomi
dan Kistektomi tgl 11. 02.22 pkl 16:30WIB
PASIEN ISTIMEWA :

Pasien Lt 4 :
8 pasien Pasien Lt 5
: 0 Pasien Lt 6
: 8 Pasien
MASALAH
Agung
Vira, David
Marisa
Ardina,
Wulan
LOBBY : Lantai 2 :
Rigen R Dede D
ING THEATER
1. LIA NASKATIANI / BEDAH OBGYN -

Histerektomi Total, SOB + Cystotomy / OK 1 ja 12.00
wib / Veinardi Madjid,dr. Sp.OG 2.
2 MIFTAHUL ULUM / BEDAH ORTHOPEDI - Anterior
Cruciate Ligament (Acl) Reconstruction / OK 1 jam
16.00 wib / Radi Muharris Mulyana, dr. Sp.OT
RENCANA TINDAKAN Tgl 11.02.22 :

1. NAZMAH / BEDAH UROLOGY -
Aff DJ Stent + GA / OK 1 jam 10.00 wib / Endrika
2 Noviandrini, dr. Sp.U
2. Ny. CINDY BUDI / Endometriosis of
uterus / dr. Haekal,Sp.OG, Rencana tindakan
Laparoskopi Reseksi Adenomiosis/ jam 16.30 wib
ICAL CARE
1 Myasthenia gravis
0 RENCANA TINDAKAN : 0
PASIEN PONEK :
1 Ny. Flavia / dr. Dara, Sp. Og/ G1P0A0 H 22
1 minggu dengan KPSW
PASIEN OBSERVASI :
1. By ny . Aviana Furi / dr. Rifan fauzi sp.
A /NCB SMK usia 1 hari
2. By. Ny. Emelia Saberina /dr. Rifan fauzi
3 sp.A/ NCB SMK usia 1 hari
3
1. BY. IZZAM NUR AMIN/dr. keumala,

Sp.A/NCB SMK 11 HARI
RTOLOGY
111 1. Dr. Syafrizal / PELD / 17.00 / Cathlab
1
Next Schedule
Sat, 12 Feb
Daily Census OPD cardiac 10Februari 2022
Outpatient : 5
dr ario : 1
Dr dafsah : 2
dr denio :
5 5 dr faris :
dr DH : 1
dr DAW :
dr radityo :
Dr suko : 1
dr sunu :
dr Adi :
5
SIC (CAROL) Jumaat, 11.02.22
TIPE PASIEN
DINAS
LT NAMA UNIT
EMERGENCY ROOM
EMERGENCY Dr Dwi,
Dr Dwi Dr Fajar Ns
Dr Fajar
ROOM, Ns Susi
Ns Kelvin
Mohlis Ns
PONEK Ns Nur Rizam
GF
RADIOLOGI Delly
FL Andra + Rizki
TOTAL PASIEN EMG
Poli anak :
Poli Obgyn : 29
Ns IIn THT : 8 19
Urology :
Poli Internist: 12 Dental : 2
Orthopedy : 3 Rehab Medik : 2

LT 3
Poli Mata :
Poli Pediatrik 2
Bedah digestive Fisotherapi:
Onkology :
: 3
Dermis : 10
Neuro : ODC : 1 MCU :
LT 6
L4
Ns Santi Ns
Abdi Ns Lt 4 Lt 4
Helen Ns Yudi Ns Citra Pagi :
IN PATIENT Ns Tari Ns Malik Dr
DEPARTMENT Lt 6 L6 Megawati,
Lt 4, 5, 6 L6 Ns Ns Dr
Ns Risha Kristine Avni Abdrahman
Ns Ns Rio Ns Okta
yudi
SOS Petugas:
GIZI Petugas :
Petugas :
PHARMACY (SB)
DANDRU : Jumlah Petugas 6 EMG :

SECURITY, PARKIR,
Pak Rigen R orang Ahmad J
KERUSAKAN
OPERATING THEATER
Ns Sunandar
OK Ns Heryanti Ns Yanu Ns Heri
CRITICAL CARE
LT 7
Dr Dewi Dr Rizki
ICU Ns Awaludin Ns Ani
HCU Ns Esti Ns Ayu

OBSTETRICS
LT 7
Bd Ningsih Bd Bd Viky Bd
VK Bd Dewi (M)
Dewi Genda
RUANG TUNGGU PS
CRITICAL
HEARTOLOGY
Ns Akbar Ns
Cathlab Tryanto
NNs Syaiful
Hybrid
LT 8
Ns Rini T
OPD JANTUNG
Ns Emma
AUDITORIUM
NOTED
RGENCY ROOM
PASIEN OBSERVASI :
RAJAL : 10
RANAP : 2
RUJUK : 0
APS : 1
PASIEN PONEK :
TOTAL : 13

Umum : 4 Dr. Zaki SpOT
Dr. Bob SpB onk
Dr. Akbari SpU
Bedah Dr. Batara SpOG
Syaraf :
Dr. Rifan SpA
Dr. Nina SpA
Poli Neuro : TOTAL PASIEN OPD : 102
7
102
Lt 4 : 3 Lt 6 : 4
PASIEN OBSERVASI :
PASIEN PINDAH ICU :
1. Lt 6 : Tn William Tanady / Myasthenia

gravis / Zicky Yombana, dr. Sp.S
RENCANA TINDAKAN :
LANTAI 6 ( 6 pasien )
1.Ny Tria Azan Auliani/Supervision of
normal pregnancy (Utama)/ Nisa Fathoni, dr. Sp.
OG, IBCLC, Rencana Tindakan SC+ERAS
Tanggal 12 Februari jam 11.00 WIB.
2.Ny. Ani Widiastuti/ Cervical disc disorder
with radiculopathy (Utama), Lumbar and other
Gastro-oesophageal reflux disease without
oesophagitis (Utama) /Syafrizal Abubakar, dr.
Sp.BS, Rencana Tindakan PELD+DRG Tanggal
12 Februari jam 16.00 wib,
3.Ny Juliati/Malignant neoplasm: Endometrium
(Utama)/ M. Farid Aziz, Prof. DR. dr. SpOG (K)
Malam : Onk, Rencana tindakan Laparatomi Radikal Ca
Dr Tiara,
Dr Nesya
Endometrium+VC Tanggal 12 Februari jam
08.00 WIB.
4.Ny Mien Nio/Malignant neoplasm of ovary
(Utama) /Chamim,DR. dr, SpOG (K) Onk,
Rencana tindakan Laparatomy Histerektomy
tanggal 12 Februari jam 18.00 wib
5.Ny.Siti umairoh / Amanda Pitarini Utari,dr,
SpPD-KGEH/ Dyspepsia,Nausea and vomiting,
Rencana Tindakan EGD Tanggal 12 Februari
jam 10.00 wib
6. Flavia vonny Fransisca/ dr. Ardiansjah Dara,
Sp. OG /Premature rupture of membranes,
unspecified--> Rencana USG dengan dokter
Ardiansyah Dara hari sabtu/minggu sore
(Tanggal 12 Feb/Tanggal 13 Feb) dengan USG
Voluson (Sedang F.U Untuk alat USG nya).
PASIEN ISTIMEWA :

Pasien Lt
4 : 8 pasien ( 1 ICU )
Pasien Lt 5 : 0
Pasien Lt 6 : 7 Pasien
MASALAH
Ryvan Arwan
Sri Yudi
Krisna Rangga
Asri Wulan
PKD :
1. Husni LOBBY :
j 2. Ilham 1. Rigen R
3. Rizki
ATING THEATER
1. NAZMAH / BEDAH UROLOGY - Aff DJ Stent +

GA / OK 1 jam 10.00 wib / Endrika Noviandrini, dr.
Sp.U 2. CINDY
2 BUDIE MEILANI / BEDAH OBGYN - Histerektomi
Total, SOB + Cystotomy / OK 1 jam 16.30 wib /
Mohammad Haekal, dr. Sp.OG, FICS

1. KEIVA RIBBY ADAWIAH / BEDAH OBGYN
- Sectio Caesaria + Pasang IUD / OK 1 jam 07.00 wib
/ Nisa Fathoni, dr. Sp. OG, IBCLC 2. JULIATI /
BEDAH OBGYN - Laparatomi radikal kanker
endometrium + VC / OK 1 jam 08.00 wib / M. Farid
Aziz, Prof. DR. dr. SpOG (K) Onk
3. NY.SITI ANISAH /
BEDAH M A T A - Phaco Emulsoifikasi + IOL / OK
1 jam 14.00 wib / Etty Budiasni, dr. Sp.M
6 4. BOBY PUTRA NUR REZKI /
BEDAH UMUM - Eksisi Biopsi dengan anestesi
Lokal / OK 1 jAM 15.30 WIB / Vonty Elfrida, dr.
SpB 5. MIEN NIO / BEDAH OBGYN -
Laparatomy Histerectomy Radikal / ok JAM 18.00
WIB / Chamim,DR. dr, SpOG (K) Onk
6. Ny. Tria/dr Nisa / G2P1A0 hamil 38
minggu dengan BSC rencana SC tgl 12/2/2022 jam
11.00 wib
RITICAL CARE
1 Myasthenia gravis
PASIEN OBSERVASI : IPD
(1) Ny. Flavia / dr. Dara, Sp. Og/ G1P0A0
H 20 minggu dengan KPSW
RENCANA TINDAKAN :
(1) Ny. Tria/dr Nisa / G2P1A0 hamil 38
minggu dengan BSC rencana SC tgl 12/2/2022
jam 11.00 wib
PASIEN PONEK :
(1) Ny. Aninditha/dr Fransisca
Noela/G1P0A0 hamil 11-12 minggu dgn
Febris
PASIEN OBSERVASI :
1
1. BY. IZZAM NUR AMIN/dr. keumala,
Sp.A/NCB SMK 12 HARI
EARTOLOGY
Next Schedule
Sat, 12 Feb
Outpatient : 13
dr ario :
Dr dafsah :
dr denio : 5
dr faris : 2
5 dr DH : 4
dr DAW :
dr radityo :
Dr suko :
dr sunu :
dr Adi : 2
c
SIC (EKO) Sabtu, 12.02.22
TIPE PASIEN
YANG DINAS
LT NAMA UNIT
EMERGENCY ROOM

EMERGENCY Zr. Nur, Zr.
Ns. Susi, Ns. Dwi, Ns.
ROOM Fitri
Sanusi Rizam
GF
EMERGENCY Zr. Nur, Zr.
Ns. Susi, Ns. Dwi, Ns.
ROOM Sanusi
Fitri
Rizam
GF
PONEK
TOTAL PASIEN EMG
Poli Obgyn
Ns NS 1 :
Poli Urology IIN
Poli Ortho
Poli Internist
Poli Bedah Umum
Poli Bedah Plastik
Poli THT Kiki
Poli Gizi
Poli bedah saraf
NS 2 :
Ns NS 2 :
Kiki
Poli Neuro
Dermis
Dental
Poli Endoscopy
Poli Kemotherapi
LT 3
Poli Fisioterapi
Poli Psikiatri
Pain Klinick
Poli Rehab Medik
Poli Mata
Poli Nutrition
Poli Paru
Poli Mata
Poli Psikiatri
Pain Clinic
MCU
ODC
TOTAL PASIEN OPD
SOS Petugas Riki

(Malam) (IGD & SB)
GIZI Petugas Japar
(Malam) (Cook)
LABORATORIUM Petugas Rangga
(Malam)
FHARMACY Petugas Astri
(Malam)
SCURITY DANRU : Petugas Ryanto Ari Setiawan

Adi
(Malam) (RG1 & IGD) (Lobby)
Nugroho
DS = Br.
DP = Ns. DM = Ns.
Taufik + Br.
IN PATIENT Salwa + Br. Tary + Br.
Abdy + Ns.
DEPARTMENT 4 Taufik Malik
Helen
LT 4 Hambali
LT 5
IN PATIENT
DEPARTMENT 5
DS = Ns.
DP = Ns. DM = Ns.
Rizha +
IN PATIENT Indah + Ns
DEPARTMENT 6 Rio
Indah Kristin+ Ns
LT 6 (lembur) Yudi
KOMPLAIANAN
KERUSAKAN
OPERATING THEATER
OK
CRITICAL CARE
ICU
HCU
NICU
PICU
TOTAL Ps CRITICAL
OBSTETRICS
VK
Dinas pagi : D
Nursery Ns.Ika :Ns.Nani malam :
Bd.Nelly
Dinas pagi : D
Nursery Ns.Ika :Ns.Nani malam :
Bd.Nelly
HEARTOLOGY
Cathlab
Hybrid
LT 8
OPD JANTUNG
Dokter Jaga
Dokter Jaga IPD : Pagi : dr Rona & dr Mega Melisa Malam :
Dokter Jaga Critical : Pagi : dr Malam :
1. Komplainan : Tidak Ada

3. - Rencana Tindakan Sectio Caesaria / NADYA FEBRI ERIYANTI / Taufik Jamaan, Dr.dr. Sp.OG SIO (+) tgl 13/2/22, Ja
- Rencana USG dengan dokter Ardiansyah Dara hari minggu (Tanggal 13 Feb/Tanggal 13 Feb) dengan USG Voluson (
A/n Ny. Flavia vonny Fransisca/ dr. Ardiansjah Dara, Sp. OG dari Ruang Ranap Lantai 6
4. - Rencana Tindakan Sc Maupun USG utk pasien masing masing Unit Terkait sudah terinfo dengan baik antar staf unit y
5. - Pasien Rujuk a/n An. Nadief Abdillah /1th/ Dx. Fever (Covid 19 Terkonfirmasi) Rujuk Ke Brawijaya Sawangan Jam. 01
Ns. Rizam IGD dan Arfan (Driver Ambulan) Tiba Di sawangan jam. 03.00 tanpa ada Berjalan dengan Lancar Tanpa Ad
PE PASIEN KETERANGAN
TOTAL
BERAT PASIEN
GENCY ROOM
PASIEN OBSERVASI :
RAJAL :
1. Tn. Bernanda /34th/ Dx. Fever
2. Ny. Melisa Kusmarina /39th/ Dx. Covid 19
terkonfirmasi 3.
Ny. Yulianti Afifah /29th/ Dx. Dyspepsia 4.
Ny. Dian Kristi /34th/ Dx. G3P2A0 H 31
mgg 3 hari Pro infus Venofer ke 3 ( Inf.
Venofer 2 amp dalam 100 cc NaCl 0.9%) 5.
Nn. Jessica Clara /18th/ Dx. Fever (Covid 19
Terkonfirmasi) 6. Nn. Cory
Claudia /31th/ Dx. Dyspepsia 7. Tn. Joshua
Amadeo /25th/ Dx. Superficial injury of wrist
and hand 8. Nn. Sarah Lasroma
/28th/ Dx. Viral infection + Acute upper
respiratory infection
9. An. Nadief Abdillah /1th/ Dx.
Fever (Covid 19 Terkonfirmasi)
10. Nn. Affiyta Yunishafira /24th/ Dx.
Endometriosis Of Ovary
11. Ny. Hatoeti Retno /84th/ Dx. Urinary
Tract Calculus
12. Ny. Ririn Yulianti /28th/ Dx. Urinary
tract infectionDysmenorrhoea
13. Tn. Fedry Ginanjar /38th/ Dx. Dyspepsia
14. Ny.
Saknah /41th/ Dx. Other general
examinations
15. Tn. H. Achmad Salihi /70th/ Dx. Fever
16. Tn. F.x Suryo Patrianto /55th/ Dx. Alergy
17.
Nn. Omega Basana /25th/ Dx. Coronavirus
infection, Dyspepsia
19
RANAP :
19
1. Tn. Charles Salmon /47th/ Dx. Acute

transmural myocardial infarction (AMI) /
Dpjp. Faris Basalamah, dr. SpJP (K) /
Ruang 406 2.
An. Muahammad Rafi Atallah /7th/ Dx.
Localization-relatedsymptomatic
epilepsy and epileptic syndromes with
simple partial seizures / Dpjp. dr. tartila,
Sp.A
RUJUK :
1. An. Nadief Abdillah /1th/ Dx. Fever
(Covid 19 Terkonfirmasi) Rujuk Ke
Brawijaya Sawangan
APS :
PASIEN TERKONFIRMASI COVID

19 :
Ada 3 pasien Covid 19 Terkonfirmasi

PERALATAN :
NOTE :
RAJAL :
RANAP :
PASIEN OBSERVASI :
19 Pasien
Dr. Mira Yulianti, SpPD-KP

4 Dr. Dian Pitawati, SpKJ
2 Dr. Ibrahim Agung, SpKFR
dr. Yuri SpOg
9 Dr. Gatra SpOT
3
Tenaga Isoman :
Siti
Resmita
6
2
Tenaga Isoman :
Siti
Resmita
2
14
9
1
61
3
157
Rivan Indra Tidak Ada Kendala

(L.4,5,6) (L.7,8)
Arif Tidak ada masalah & Kendala
(Servies)
Aning Tidak ada maslah & Kendala
Heny Tidak ada masalah & Kendala
IIB Diare Giantoro

Aman, Tidak Ada Temuan Dan Kendala
(PKD) (PKD)
1.Tn. Charles Salmon Yarangga/ Faris

Basalamah, dr. SpJP (K)/ Acute transmural
myocardial infarction of unspecified site, ,
Angina pectoris
PASIEN OBSERVASI :
Dr. SpPD- KGEH
2.Tn. Muhammad Misbahul/Alvin Nursalim,
dr. Sp.PD/ Dengue fever [classical dengue
3.Tn. Poedjiharto Agus/ Zicky Yombana, dr.
Sp.S/ Myasthenia gravis
4.Ny. Marcellina Siswad/Dicky Aligheri,
SpBTKV (K),dr, FIHA,
FICA/Atherosclerotic cardiovascular disease,
so described
5.Tn. DRS. Aminuddin/Sunu Budhi Raharjo,
dr. SpJP (K), PhD/ Atrioventricular block,
complete
6.Ny. Audrey Anastasya /dr. Nenfiati
Sp.PD/Fever, unspecified
myocardial infarction of unspecified site,
Angina pectoris
PASIEN PINDAH ICU :

7
1.Tn. Jerry Riady/ dr. Mirta Hediyati, Sp.
THT/ Sleep apnoea/ Rencana masuk 13/
02/ 2022, Kamar (401)
RENCANA TINDAKAN :
RENCANA PULANG :

FICA/Atherosclerotic cardiovascular
disease, so described
PASIEN PULANG :
1.Tn. Miftahul Ulum / Radi Muharris
Mulyana, dr. Sp.OT / Post Rekonstruksi
ACL
2. Ny. Enny Anggraini/ Bob Andinata,
dr. Sp.B(K)Onk/Malignant neoplasm of
breast
PASIEN OBSERVASI :
PASIEN PINDAH ICU :
RENCANA TINDAKAN
PASIEN PULANG :
1. Nadya Febri/Taufik Jamaan, Dr.dr.

Sp.OG/ Rencana Sc tanggal 13/2/2022
pukul 09.00 WIB
2. An. Muahammad Rafi Atallah /7th/
Dx. Localization-relatedsymptomatic
epilepsy and epileptic syndromes with
simple partial seizures / Dpjp. dr. tartila,
Sp.A
PASIEN OBSERVASI :
1.1. Ny Tria Azan Auliani/Supervision of
normal pregnancy (Utama)/ Nisa Fathoni, dr.
Sp. OG, IBCLC
with radiculopathy (Utama), Lumbar and
other intervertebral disc disorders with
radiculopathy, Gastro-oesophageal reflux
disease without oesophagitis (Utama)
/Syafrizal Abubakar, dr. Sp.BS..
and vomiting
3. Flavia vonnyFransisca/ dr. Ardiansjah
Dara, Sp. OG /Premature rupture of
membranes, unspecified
4. Ny Mien Nio/Malignant neoplasm of
ovary (Utama) /Chamim,DR. dr, SpOG (K)
8 Onk
5. An. Muahammad Rafi Atallah /7th/ Dx.
Localization-relatedsymptomatic epilepsy
and epileptic syndromes with simple partial
seizures / Dpjp. dr. tartila, Sp.A
PASIEN PINDAH ICU :
RENCANA TINDAKAN
1. Flavia vonny Fransisca/ dr. Ardiansjah

membranes, unspecified--> Rencana
USG dengan dokter Ardiansyah Dara
hari minggu (Tanggal 13 Feb/Tanggal
13 Feb) dengan USG Voluson
2. Nadya Febri/Taufik Jamaan, Dr.dr.
Sp.OG/ Rencana Sc tanggal 13/2/2022
pukul 09.00 WIB
PASIEN VK
PASIEN PULANG
RENCANA MASUK :

1.Ny. Cindy Budie / Endometriosis of
uterus / dr. Haekal,Sp.OG
ING THEATER
1. Tindakan Sabtu, 12-02-22
1. Radical HT Prof Farid
2. SC dr Nisa
3. Phaco dr Etty
5 4. Radical HT dr Chamim
5. PELD + DRG Ablasi
dr Syaf
2. Rencana Tindakan Minggu, 13-02-22
- Sectio Caesaria / NADYA FEBRI
ERIYANTI / Taufik Jamaan, Dr.dr. Sp.OG /
J. 09.00 OK I
ICAL CARE
1. Tn. William Tanady /40th/ Dx.
Myasthenia gravis / Dpjp. dr. Zicky, Sp.S
2 2. Ny. Julianti /55th/ Dx.
Post OP Laparatomy Radikal / Dpjp. prof.
Farid, Sp.OG(k)Onk
2 Pasien
PASIEN OBSERVASI :
0
RENCANA TINDAKAN :
1. Ny. Nadya/ dr. Taufik, spog/G3P2A0

hamil 38-39 minggu dengan BSC 2x.
Rencana SC jam 09.00
PASIEN PONEK :

1. Ny. Flavia (602) / dr. Dara,
Sp.OG/G1P0A0 Hamil 20 minggu
dengan KPSW. DJJ/ shift
PASIEN OBSERVASI :
1.By. ny . Tria Azan Auliani / dr.
Nathalia sp. A /NCB SMK usia 1 hari
1
1
PASIEN PULANG
RTOLOGY
11
dr Dwi
dr Ira & dr. Megawati
dr Riri
r. Sp.OG SIO (+) tgl 13/2/22, Jam 09.00 Wib

13 Feb) dengan USG Voluson (hanya saja Info Perawat Kristine Untuk Jam belum Terinfo pasti).
info dengan baik antar staf unit yg bersangkutan, untuk persiapannya SIC sdh memastikan ke perwat
Ke Brawijaya Sawangan Jam. 01.30 wib dengan Ambulan Brawijaya Saharjo Team Team Pengantar
erjalan dengan Lancar Tanpa Ada Kendal, Dan Tiba Kembali di Brawijaya Saharjo 04.20 Wib
c
SIC (GISMA) Minggu, 13.02.22
YANG DINAS
TOTAL
LT NAMA UNIT PASIEN
Pagi Sore Malam RINGAN SEDANG BERAT Risiko/Komplen, Pasien titipan, ODC, & Prosedur
EMERGENCY ROOM
PASIEN OBSERVASI :
RAJAL :
1. Ny. Annisa Chika/27 th/Dx gastroenteritis
and colitis 2. Tn. Reno
Gandakusu/27 th/Dx gastroenteritis and
colitis 3. Ny. ianti
Indriani/34th/ Viral Infection, Susp
Coronavirus 4. Tn.
Bernanda/34 th/ Dx DHF H-4 5. Ny.
Sariah Carka/48 th/ Dx 6. Tn.
Dwi Surya 27 th/Dx Dyspepsia 7. Ny.
Nafilla Yuslam/35 th/ Dx Malaise and
fatigue, Dyspepsia dan Constipasi 8.
Rita Rahayu /44 th/ Viral Infection
Dr. Firda, Ahmad

EMERGENCY Dr. Fajar, RANAP :
ROOM
Muhlis, Sanusi, Nur
Kelvin 9
Ahmad sanusi astuti 1. Tn. Bernanda/34 th/ Dx DHF H-4 / dr.
Alvin Sp.Pd
GF RUJUK :
APS :

19 :
1. Nn. Omega Basana/ 25 th/Dx
Dyspepsia, Positif Coronavios
PERALATAN :
NOTE :
RAJAL :
RANAP :
PONEK
PASIEN OBSERVASI :
TOTAL PASIEN EMG 9 Pasien
Poli Obgyn 4 Dokter Cuti/tidak prkatek :

Cahya, Alin NS 1 : Dr. Mira Yulianti, SpPD-KP
Poli Urology Dr. Dian Pitawati, SpKJ
Poli Ortho Dr. Ibrahim Agung, SpKFR
dr. Yuri SpOg
Poli Internist
Dr. Gatra SpOT
Poli Bedah Umum
Poli Bedah Plastik
Tenaga Isoman :
Poli Bedah Degestif
NS 2 : Siti
Poli Bedah Vaskuler NS 2 : Resmita
Poli THT
Poli Gizi
Poli bedah saraf
Poli Neuro
Dermis
Dental
Poli Endoscopy
Poli Kemotherapi
LT 3 Poli Fisioterapi
Poli Psikiatri
Pain Klinick
Poli Rehab Medik
Poli Mata
Poli Nutrition
Poli Paru
NS 3 :
Poli Anak NS 3 : 16
Septi
Poli Mata
Poli Psikiatri
Pain Clinic
MCU
ODC
TOTAL PASIEN OPD 20
Sutrisno, Irma,
SOS Petugas Ahwan
Intan, Syifa Tidak Ada Kendala
Ahwan
(pagi, siang) (IGD & SB) (L.4,5,6) (L.7,8)
David, Fira,
GIZI Petugas Harigunawan Dafalfian Tidak ada masalah & Kendala
(Pagi, siang) (Cook) (Servies)
LABORATORIUM Petugas Ica Adel erika Tidak ada maslah & Kendala
(Pagi, siang)
Dina, alen,
Yeyen, Wulan,
FHARMACY Petugas Upi (Pagi)
upi Tidak ada masalah & Kendala
(sore)
(Pagi, siang)
SCURITY DANRU : Petugas Firli Hamka Novan Afif

Wibi (Pagi,siang) (RG1 & IGD) (Lobby) (PKD) (PKD)
IN PATIENT DEPARTMENT PASIEN BARU :
PASIEN OBSERVASI :
Dr. SpPD- KGEH
2.Tn. Muhammad Misbahul/Alvin Nursalim,
dr. Sp.PD/ Dengue fever [classical dengue
Sp.S/ Myasthenia gravis 4.Tn.
DRS. Aminuddin/Sunu Budhi Raharjo, dr.
SpJP (K), PhD/ Atrioventricular block,
complete
Angina pectoris
7. Tn. Bernanda/34 th/ Dx DHF H-4 / dr.
Alvin Sp.Pd
DP = Tita,
LT 4 DS = Tita,
IN PATIENT Salwa, Dr. PASIEN RENCANA MASUK :
Salwa 7
LT 5 DEPARTMENT 4 Mutiara DM =Tari,
Taufik 1.Tn. Jerry Riady/ dr. Mirta Hediyati, Sp.
THT/ Sleep apnoea/ Rencana masuk 13/
02/ 2022, Kamar (401)
RENCANA TINDAKAN :
1. Tn. Charles Salmon Yarangga/ Faris

Angina pectoris Rencana Tindakan CAG
stand by PCI 14.02.2022 jam ??
PASIEN PULANG :
PASIEN OBSERVASI :
PASIEN PINDAH ICU :

IN PATIENT
DEPARTMENT 5
RENCANA TINDAKAN
PASIEN PULANG :
PASIEN OBSERVASI :
and vomiting
Onk
6. An. Muahammad Rafi Atallah

/7th/ Dx. Localization-relatedsymptomatic
epilepsy and epileptic syndromes with simple
partial seizures / Dpjp. dr. tartila, Sp.A
7. Ny. Nadya Febri/ Dx Post SC/ Taufik

Jamaan, Dr.dr. Sp.OG
8. Ny. Julianti /55th/ Dx. Post OP

DP = Dr. Laparatomy Radikal / Dpjp. prof. Farid,
IN PATIENT DS =
DEPARTMENT 6
Mutiara,
Devi, Indah
DM = 10 Sp.OG(k)Onk
LT 6 Risha, Santi PASIEN PINDAH ICU :
RENCANA TINDAKAN
DP = Dr.
IN PATIENT DS =
DEPARTMENT 6
Mutiara,
Devi, Indah
DM = 10
LT 6 Risha, Santi
1. Ny. Chyntia Perdana Putri/ 27 th/dr.

Sang Sp.OG/Dx Placenta praevia
specified as without haemorrhage,
Oligohydramnios Rencana SC tanggal
14.02.2022 Jam 09.00 2.
Ny. Nazah Bawazier/37 th/Dr. Taufik
Jamaan Sp.OG/ Dx G2P1 hamil 38
minggu, air ketuban berkurang, kepala di
atas panggul, JPKTH Rencana SC
tanggal 14.02.2022 Jam 15.00
3. Ny. Sarah
Nadia/27 th/ Dx G1 hamil 37 mgg 6 hari,
JPKTH/ dr. Nisa Fatoni Sp. OG
Rencana SC tanggal 14.02.2022 Jam
11.00
PASIEN VK
PASIEN PULANG
1.Ny. Cindy Budie / Endometriosis of
uterus / dr. Haekal,Sp.OG
RENCANA MASUK :
1. Ny. Arimbi Lestari/ 33 th/ Dx G2 P1 hamil
38 mgg 1 hari, JPKTH
BSC 1x Air Ketuban Berkurang/ Dr. Nisa
Fatoni. Sp.OG Rencana SC tanggal
14.02.2022 Jam 10.00
KOMPLAIANAN
KERUSAKAN
OPERATING THEATER
Sectio Caesaria / NADYA FEBRI
OK Yanu, Heni 1 ERIYANTI / Taufik Jamaan, Dr.dr. Sp.OG /
J. 09.00 OK I
CRITICAL CARE
1. Tn. William Tanady /40th/ Dx.
dr. Nillam, Dr. Dewi,
ICU Nining
Haryani
Helga, Agus 1 Myasthenia gravis / Dpjp. dr. Zicky, Sp.S
HCU
NICU Alfi (Pagi),
PICU Grace
(Middle)
TOTAL Ps CRITICAL 1 Pasien
OBSTETRICS
PASIEN OBSERVASI :
RENCANA TINDAKAN :
Ningsih,
VK Genda, Viki Putri, Genda
Dewi 1. Ny. Flavia (602) / dr. Dara,
1 Sp.OG/G1P0A0 Hamil 20 minggu
dengan KPSW. DJJ/ shift
PASIEN PONEK :
PASIEN OBSERVASI :
1.By. ny . Tria Azan Auliani / dr.
Nathalia sp. A /NCB SMK usia 1 hari
2.By. Ny. Nadya/ Bayi lahir SC dari Ibu
G3P2A0 hamil 38-39 minggu SC a/i
Dines siang Dines BSC 2x , bayi lahir jam 09.39 wib
Dinas pagi :
Nursery Ika
: Nani malam : 2
Nely
PASIEN PULANG
HEARTOLOGY
Cathlab
Hybrid
LT 8
OPD JANTUNG 0
Dokter Jaga
Dokter Jaga IGD : Pagi : dr Firdha Malam : dr Fajar
Dokter Jaga IPD : Pagi : dr Mutiara Malam : dr Nesya
Dokter Jaga Critical : Pagi : dr Nilam Malam : dr Dewi

3. - 1. Ny. Chyntia Perdana Putri/ 27 th/dr. Sang Sp.OG/Dx Placenta praevia specified as without haemorrhage, Oligohydramnios Rencana SC tanggal 14.02.2022 Jam 09.00
2. Ny. Nazah Bawazier/37 th/Dr. Taufik Jamaan Sp.OG/ Dx G2P1 hamil 38 minggu, air ketuban berkurang, kepala di atas panggul, JPKTH Rencana SC tanggal 14.02.2022 Jam 15.00
4. -1. Ny. Arimbi Lestari/ 33 th/ Dx G2 P1 hamil 38 mgg 1 hari, JPKTH BSC 1x Air Ketuban Berkurang/ Dr. Nisa Fatoni. Sp.OG Rencana SC tanggal 14.02.2022 Jam 10.00
2. Ny. Sarah Nadia/27 th/ Dx G1 hamil 37 mgg 6 hari, JPKTH/ dr. Nisa Fatoni Sp. OG Rencana SC tanggal 14.02.2022 Jam 11.00
5. Ny. Flavia vonny Fransisca/ dr. Ardiansjah Dara, Sp. OG /Premature rupture of membranes, unspecified, Sedang proses induksi terminasi. sudah dijelaskan kondisi terburuk oleh dr. Dara bahwa baby kemungkinan kecil untuk selamat.
Keluarga minta di urus pemakaman baby oleh rumah sakit jika baby meninggal. Sudah kordinasi dengan dr. Rainy dan security untuk vendor pemakaman dan ambulance. saat ini masih menunggu baby lahir. Pasien saat ini berada di VK
6. Ny. Chyntia Perdana Putri/ 27 th/dr. Sang Sp.OG/Dx Placenta praevia specified as without haemorrhage, Oligohydramnios Pasien di VIP 607 tetapi status pasien kelas 1. Jika Kelas 1 kosong pasien bersedia di pindahkan ke Kelas 1.
SIC (EKO) Minggu Malam, 13.02.22
TIPE PASIEN
YANG DINAS
LT NAMA UNIT
EMERGENCY ROOM
Dr. Fajar,
dr. Firdha Ns. Ahmad Kelvin ,
EMERGENCY
Sanusi, Ns. Sanusi, Nur Yohana
ROOM Mohlis astuti (Perbantuan
team OK)
GF
PONEK
TOTAL PASIEN EMG
Poli Obgyn
Cahya, Alin NS 1 :
Poli Urology
Poli Ortho
Poli Internist
Poli Bedah Umum
Poli Bedah Plastik
Poli Bedah Degestif
NS 2 :
Poli THT
Poli Gizi
Poli bedah saraf
Poli Neuro
Dermis
Dental
Poli Endoscopy
Poli Kemotherapi
LT 3 Poli Fisioterapi
Poli Psikiatri
Pain Klinick
Poli Rehab Medik
Poli Mata
Poli Nutrition
Poli Paru
NS 3 :
Poli Anak NS 3 :
Septi
Poli Mata
Poli Psikiatri
Pain Clinic
MCU
ODC
TOTAL PASIEN OPD
SOS Petugas Rivan

(IGD &
(Malam)
SB)
GIZI Petugas Idris
(Malam) (Cook)
LABORATORIUM Petugas Aning
(Malam)
FHARMACY Petugas Henny
(Malam)
Ari
SCURITY DANRU : Petugas Ryanto
Setiawan
Adi (RG1 &
(Malam) (Lobby)
Nugroho IGD)
DP = Ns. DS = Ns.
DM = Ns.
IN PATIENT Salwa + Ns. Salwa + Ns.
LT 4 Tary + Br.
DEPARTMENT 4 Tita Tita
Taufik
LT 5
IN PATIENT
DEPARTMENT 5
IN PATIENT Risha + Ns Devi +
DEPARTMENT 6 Santi Indah
Kristin+ Ns
LT 6 Yudi
KOMPLAIANAN
KERUSAKAN
OPERATING THEATER
OK Yanu, Heni
CRITICAL CARE
dr. Nillam, Dr. Dewi,
ICU Nining
Haryani
Helga, Agus
HCU
NICU Alfi (Pagi),
PICU Grace
(Middle)
TOTAL Ps CRITICAL
OBSTETRICS
‌Dines
‌Dines
‌Dines
‌Dines Pagi: bd. Siang : bd.
Malam : bd.
VK Viki Viki , Bd.
Putri, bd.
Tries
Genda
Dines
Dinas pagi : D
‌ ines siang
malam :
Nursery Ns.inggrid :Ns.ika
Ns.Nani
HEARTOLOGY
Cathlab
Hybrid
LT 8
OPD JANTUNG
LT 8
Dokter Jaga
Pagi : dr
Dokter Jaga IPD : Malam :
Mutiara
Dokter Jaga Critical : Pagi : dr Nilam Malam :

2. Pasien Terkonfirmasi Covid 19 ada 1 pasien dari Unit IGD Isolasi, Rencana Mau di Rujuk tetapi Belum Ada RS yg bisa m
3. - 1. Ny. Chyntia Perdana Putri/ 27 th/dr. Sang Sp.OG/Dx Placenta praevia specified as without haemorrhage, Oligohydra
2. Ny. Nazah Bawazier/37 th/Dr. Taufik Jamaan Sp.OG/ Dx G2P1 hamil 38 minggu, air ketuban berkurang, kepala di ata
-3. Ny. Arimbi Lestari/ 33 th/ Dx G2 P1 hamil 38 mgg 1 hari, JPKTH BSC 1x Air Ketuban Berkurang/ Dr. Nisa Fatoni. Sp.
-4. Ny. Sarah Nadia/27 th/ Dx G1 hamil 37 mgg 6 hari, JPKTH/ dr. Nisa Fatoni Sp. OG Rencana SC tanggal 14.02.2022
4. Ny. Flavia vonny Fransisca/ dr. Ardiansjah Dara, Sp. OG /Premature rupture of membranes, unspecified, Sedang proses
Keluarga minta di urus pemakaman baby oleh rumah sakit jika baby meninggal. Sudah kordinasi dengan dr. Rainy dan sec
5. Ny. Chyntia Perdana Putri/ 27 th/dr. Sang Sp.OG/Dx Placenta praevia specified as without haemorrhage, Oligohydramn
6. Untuk Ny. Sarah SIC malam Mendapatkan info dri SIC pagi (Gisma) yg terinfo dri Lab Suami dri pasien Ny. Sarah Untuk
Sangat memahami Kondisi Yg terjadi saat itu dan memutuskan Pulang untuk Mencari Ganti Pendamping untuk Istrinya.
7. Staf OK (Zr. Yohana) Perbantuan stay EMG perawat IGD Hanya 1 org di karenakan 1 perawat Sakit dan 1 masih Isoma
TOTAL
BERAT PASIEN
ERGENCY ROOM
PASIEN OBSERVASI :
RAJAL :
1. Ny. Annisa Chika/27 th/Dx gastroenteritis
and colitis
2. Tn. Reno Gandakusu/27 th/Dx
gastroenteritis and colitis 3.
Ny. Fitratun Nida/24th/ Dx. G1P0A0 hamil 5
minggu 3 hari, Supervision of normal
pregnancy + Unspecified abortion 4.
Ny. Mianti Indriani/34th/ Viral Infection, Susp
Coronavirus
5. Ny. Sariah Carka/48 th/ Dx
6. Tn. Dwi Surya 27 th/Dx Dyspepsia
7. Ny. Nafilla Yuslam/35 th/ Dx
Malaise and fatigue, Dyspepsia dan Constipasi
8. Rita Rahayu /44 th/ Viral
Infection 9. Tn. Dharma Bhakti /71th/
Dx. Fever, Covid 19 Terkonfiemasi
10. Tn. Yapto Saputra /34th/ Dx.
Dyspepsia
RANAP :
1. Tn. Bernanda/34 th/ Dx DHF H-4 / Dpjp.
13 dr. Alvin, Sp.PD / Ruang 402 2. By.
Azakiel Kavindra /4hri/ Dx.
hiperbillirubinemia / Dpjp. Rifan Fauzie,
dr. Sp.A (K) / Rawat Ruang Nursery
3. Ny. Three Wolsef /46th/ Dx. Dyspepsia,
Symptoms and signs concerning food and
fluid intake / Ruang 414
RUJUK :
Tn. Dharma Bhakti /71th/ Dx. Fever,
Covid 19 Terkonfiemasi (Proses Rujuk)
APS :
PASIEN TERKONFIRMASI COVID 19

:
PERALATAN :
NOTE :
RAJAL :
RANAP :
PASIEN OBSERVASI :
13 Pasien
16
20 Pasien
Indra Chaerul Tidak Ada Kendala
(L.4,5,6) (L.7,8)
Nasya Tidak ada masalah & Kendala
(Servies &
Pramusaji)
Jesica Tidak ada maslah & Kendala
Surya Bulan Tidak ada masalah & Kendala
IIB Diare Giantoro

(PKD) (PKD)

myocardial infarction of unspecified site, ,
Angina pectoris
2.Tn. Bernanda/ Alvin Nursalim, dr. Sp. PD/
DHF H-4
3.Tn. Jerry Riady/ dr. Mirta Hediyati, Sp. THT/
Sleep apnoea
4.Ny. Three Wolse/ dr. Amanda Sp.PD-KGEH/
Dyspepsia, Symptoms and signs concerning
food and fluid intake
PASIEN OBSERVASI :
Dr. SpPD- KGEH
2.Tn. Muhammad Misbahul/Alvin Nursalim, dr.
Sp.PD/ Dengue fever [classical dengue
Sp.S/ Myasthenia gravis
4.Tn. DRS. Aminuddin/Sunu Budhi Raharjo, dr.
SpJP (K), PhD/ Atrioventricular block,
complete
Angina pectoris
7.Tn. Bernanda/ Alvin Nursalim, dr. Sp. PD/
DHF H-4
Sleep apnoea
9 9.Ny. Three Wolse/ dr. Amanda Sp.PD-KGEH/
Dyspepsia, Symptoms and signs concerning
RENCANA TINDAKAN :
Angina pectoris/ Rencana tindakan CAG-
PTCA, Senin, 14/ 02/22
Sleep apnoea/ Rencana tindakan OSA Surgery,
Senin, 14/02/22, Jam 13.00
1.Ny Indra Widyati/ Murdani Abdullah,

Prof. Dr. SpPD- KGEH
2.Tn. DRS. Aminuddin/Sunu Budhi
Raharjo, dr. SpJP (K), PhD/
Atrioventricular block, complete
PASIEN PULANG :
TIENT DEPARTMENT
PASIEN OBSERVASI :
PASIEN PINDAH ICU :
PASIEN PULANG :
1.Ny. Chyntia Perdana /dr. Sang ,Sp.OG/

Placenta praevia specified as without
haemorrhage
2.Ny.Julianti /dr, Farid ,Sp .OG/Malignant
neoplasm: Endometrium
3.Ny .Sarah Nadia /dr.Nisa
Fatoni,Sp.OG/Z34 Supervision of normal
pregnancy
4.Ny.Arimbi/dr.Nisa,Sp.OG/Z34
5.Ny.Naza Bawazier /dr,Taufik Jamaan,
Sp.OG/Z34 Supervision of normal
pregnancy
6 . An .Muhammad Rafi Athala /dr.Mira
Inkiriwang ,Sp.A
Pasien Pulang :
PASIEN OBSERVASI :
1.1. Ny Tria Azan Auliani/Supervision of
normal pregnancy (Utama)/ Nisa Fathoni, dr.
Sp. OG, IBCLC
with radiculopathy (Utama), Lumbar and other
Gastro-oesophageal reflux disease without
oesophagitis (Utama) /Syafrizal Abubakar, dr.
Sp.BS..
4. Flavia vonnyFransisca/ dr. Ardiansjah Dara,
Sp. OG /Premature rupture of membranes,
unspecified
5. Ny Mien Nio/Malignant neoplasm of ovary
(Utama) /Chamim,DR. dr, SpOG (K) Onk
6. Ny .Nadyab Febri/ Post SC/ dr.Taufik
Jamaan ,Sp .OG
12
PASIEN PINDAH ICU :
RENCANA TINDAKAN
1.Ny. Chyntia Perdana /dr. Sang ,Sp.OG/

haemorrhage,/Rencana tindakan SC ,Senin
14/02/2022 jam 09.00
2.Ny .Sarah Nadia /dr.Nisa
pregnancy,/Rencana Tindakan SC 14/02/22
jam11.00
3.Ny.Arimbi/dr.Nisa Fatoni,Sp.OG/Z34
Supervision of normal pregnancy/rencan
Tindakan SC 14/02/22 jam 10.00
4.Ny.Naza Bawazier /dr,Taufik Jamaan,
Sp.OG/Z34 Supervision of normal
pregnancy/rencana tindakan SC /14/02/22
PASIEN VK
PASIEN PULANG
RENCANA MASUK :
RATING THEATER
1. Tindakan Sabtu, 13-02-22
1. Sectio Caesaria / NADYA FEBRI
1 ERIYANTI / Taufik Jamaan, Dr.dr. Sp.OG / J.
09.00 OK I
2. Rencana Tindakan Senin, 14-02-22
1. SC / Ny. CHYNTIA PERDANA PUTRI / Sang

Arifianto,dr. SpOG / J. 09.00 / Ok I
2. SC / Ny. ARIMBI LESTARI / Nisa Fathoni, dr.
Sp. OG, IBCLC / J. 10.00 / OK I
3. SC / SARAH NADIA / Nisa Fathoni, dr. Sp. OG,
IBCLC / J. 11.00 / OK I
5 4. SC / NAZAH BAWAZIER / Taufik Jamaan,
Dr.dr. Sp.OG / J. 15.00 / OK I
5. OSA Surgery / Tn. Jerry / Mirta Hediyati
Reksodiputro, Dr. dr. Sp.THT-KL(K) / J. 13.00 / OK
I
CRITICAL CARE
1 1. Tn. William Tanady /40th/ Dx. Myasthenia

gravis / Dpjp. dr. Zicky, Sp.S
0
1 Pasien
PASIEN OBSERVASI :
1. Ny. Flavia (602) / dr. Dara,

Sp.OG/G1P0A0 Hamil 20 minggu dengan
1
terminasi kehamilan. Partus spontan 03.30.
RENCANA TINDAKAN :
1. Ny. Chyntia/dr. Sang, SpOG/ G1P0A0

hamil 37-38 minggu dengan plasenta
previa. TBJ: 3100 gram. Rencana SC jam
09.00
2. Ny. Arimbi/ dr. Nisa, SpOG/G2P1A0
hamil dengan BSC 1x. TBJ: 3256 gram.
Rencana SC jam 10.00
3. Ny. Sarah/dr. Nisa, SpOG/G1P0A0
hamil 38 minggu dengan letak lintang.
TBJ: 2992 gram. Rencana SC jam 11.00
4. Ny. Nazah/ dr. Taufik, SpOG/G2P1A0
hamil 39-40 minggu dengan air ketuban
berkurang + kepala belum masuk PAP.
TBJ : 3128 gram. Rencana SC jam 15.00
PASIEN PONEK :
PASIEN OBSERVASI :
1.By. ny . Tria Azan Auliani / dr. Nathalia
sp. A /NCB SMK usia 2 hari
2. By.ny.nadya/ dr.Mira Sp.A/ NCB SMK
usia 1 hari
3
By.Azakiel/ NCB SMK usia 4 hari/
dr.Rifan Fauzie Sp.A (k)
PASIEN PULANG
HEARTOLOGY
dr Fajar
dr Nesya
dr Dewi
Rujuk tetapi Belum Ada RS yg bisa menerima Rujukan, Baru ada jawabn pasti dari rs Hermina jatinegara j. 06.20 ACC Rujuk
as without haemorrhage, Oligohydramnios Rencana SC tanggal 14.02.2022 Jam 09.00
, air ketuban berkurang, kepala di atas panggul, JPKTH Rencana SC tanggal 14.02.2022 Jam 15.00
uban Berkurang/ Dr. Nisa Fatoni. Sp.OG Rencana SC tanggal 14.02.2022 Jam 10.00
OG Rencana SC tanggal 14.02.2022 Jam 11.00
mbranes, unspecified, Sedang proses induksi terminasi. sudah dijelaskan kondisi terburuk oleh dr. Dara bahwa baby kemungkinan kecil unt
h kordinasi dengan dr. Rainy dan security untuk vendor pemakaman dan ambulanc, Bayi sdh lahir Spontan pukul 03.30 wib.
without haemorrhage, Oligohydramnios Pasien di VIP 607 tetapi status pasien kelas 1. Jika Kelas 1 kosong pasien bersedia di pindahkan k
ab Suami dri pasien Ny. Sarah Untuk PCR nya POSITIF, Sic Melakukan Edukasi Kepada Suami pasien dan Cukup Kooperatif Suami mnge
ari Ganti Pendamping untuk Istrinya.
n 1 perawat Sakit dan 1 masih Isoman
a j. 06.20 ACC Rujuk
bahwa baby kemungkinan kecil untuk selamat.

an pukul 03.30 wib.
ng pasien bersedia di pindahkan ke Kelas 1.
dan Cukup Kooperatif Suami mngerti dan
SIC (CAROL) Senin, 14.02.22
TIPE PASIEN
DINAS
LT NAMA UNIT
EMERGENCY ROOM
Dr Dwi,
EMERGENCY Dr Dwi Dr Firdha Dr Firdha Ns
ROOM, Ns Susi Ns Rizam Sanusi Ns
PONEK Ns Mohlis Ns Nur
GF Mohlis
RADIOLOGI Hamida
FL Novi+ Sonya
TOTAL PASIEN EMG
Poli anak :
Poli Obgyn : 35
Ns IIn THT : 5 21
Urology : 4
Orthopedy : 4 Rehab Medik : 2

LT 3
Poli Pediatrik Poli Mata :1
Fisotherapi:6
Onkology : Bedah digestive :
Dermis : 4
Neuro : ODC : MCU :
LT 6
Lt 4
Ns Salwa
Ns Citra Lt 4 Lt 4
Ns Helen Ns Abdi Ns Taufik
Lt 6
DEPARTMENT Lt Nadya
Lt 4, 5, 6 Ns 6 Lt 6
Dini Ns Indah Ns Risha
Ns Avi Ns Okta Ns Devi
Ns
Santi
Lt 4
Ns Salwa
Ns Citra Lt 4 Lt 4
Ns Helen Ns Abdi Ns Taufik
Lt 6
DEPARTMENT Lt Nadya
Lt 4, 5, 6 Ns 6 Lt 6
Dini Ns Indah Ns Risha
Ns Avi Ns Okta Ns Devi
Ns
Santi
SOS Petugas:
GIZI Petugas :
Petugas :
PHARMACY (SB)
IT Petugas :
EMG :
SECURITY, DANDRU : Jumlah Petugas 6 Lantai 2 :
Hery
PARKIR, Pak Wibi orang Firlyano Pasande
TEKNISI Pak Jay
OPERATING THEATER
Ns Sunandar
OK Ns Heryanti
CRITICAL CARE
Dr Dewi
ICU Ns Awaludin
HCU Ns Esti
OBSTETRICS
LT 7
LT 7 VK Bd Vicky ( M)
Bd Vicky Bd Putri
Bd Tries Bd Genda
Nursery Ns Inggrid Ns Ika Ns Nani
RUANG TUNGGU PS
CRITICAL
HEARTOLOGY
Ns Akbar Ns
Cathlab Tryanto
NNs Syaiful
Hybrid
LT 8
Ns Rini T
OPD JANTUNG
Ns Emma
AUDITORIUM
NOTED
ERGENCY ROOM
RAJAL : 13
RANAP : 3
RUJUK : 0
APS :
PASIEN PONEK :
TOTAL : 17

Umum : 3 dr. M. Adya SpOg
Dr. Endrika SpU
Dr. Eddy SpPD
Bedah Dr. M. Norman SpBS
Syaraf :
Dr. Wulan SpB(A)
Drg. Astri
Dr. Rifan SpA
Poli Neuro:6
Poli Paru : 2
110
IENT DEPARTMENT PASIEN BARU :
Lt 4 : 3 Lt 6 : 2
PASIEN OBSERVASI :
1.( LT 4 ) Ny. Three Wolse/ dr. Amanda

Sp.PD-KGEH/ Dyspepsia, Symptoms and signs
concerning food and fluid intake - Tromb 10 rb
- Tranfusi TC ( 10 kantong )
PASIEN PINDAH ICU :

RENCANA TINDAKAN :
PASIEN ISTIMEWA :

Pasien
Lt 4 : 9 pasien
Pasien Lt 5 : 0
Pasien Lt 6 : 10 + ( 1 VK ) Pasien
MASALAH
Arwan + Indra +
Rivan Agung
Riska Zefika
Bulan Upi
ALL UNIT TERAMEDIK OFF SEJAK

Pak Jery JAM 00.25 wib sd jam 04.10 WIB. OFF
kembali jam 04.15 WIB sd 05.23 WIB
PKD :
1. Novan LOBBY :
sakti 2.IIB Diare Hamka
Listrik Unit Nursery OFF sejak jam 04.45

sd jam 05.00 wib
RATING THEATER
1. CHYNTIA PERDANA P / SC / ok 1 jam 09.00

wib / Dpjp Dr Sang SPOG
2. ARIMBI LESTARI / SC + PASANG IUD / Ok 1
jam 10.00 wib / Dpjp Nisa Fathoni SPOG 3.
SARAH NADIA / SC + Pasang IUD / OK 1 jam
5 11.00 wib / Dpjp Dr Nisa Fathoni SPOG 4.
JERRY RYADI / Ok 1 jam 13.00 wib / Dpjp Dr
Mirta SpTHT
5. NAZAH BAWAZIR / SC/ OK 1 jam 15.00
wib / Dpjp Dr Taufik Jamaan SPOG

RITICAL CARE
1 Myasthenia gravis
PASIEN OBSERVASI :
1. Ny. Siti nurazmi/ G3P2A0 hamil 37-38 mgg
dg inpartu/ dr. Noela, SpOG
1
PASIEN PONEK :
PASIEN OBSERVASI :
1. By.Ny.Nadya/ dr.Mira, Sp.A/ NCB SMK
usia 2 hari
2. By. Ny. Chyntia Perdana / dr. Diana,
Sp.A / NCB SMK Usia 17 jam
3. By. Ny Arimbi / dr. Diana, Sp.A / NCB
SMK Usia 15 Jam
4. By. Ny Sara / dr. Diana, Sp.A / NCB
SMK Usia 13 Jam
6
5. By Ny Nazah / dr. Diana, Sp.A / NCB
SMK Usia 10 Jam.
1. By.Azakiel/ NCB SMK usia 5 hari/
dr.Rifan Fauzie Sp.A (k)
PASIEN PULANG :
1. By. Ny. Tria Azan / dr. Nhatali, Sp.A / NCB
1 SMK 2 Hari
HEARTOLOGY
Outpatient : 9
dr ario :
Dr dafsah :
dr denio : 3
95 dr faris : 3
dr DH :
dr DAW :
dr radityo :
Dr suko :
dr sunu : 1
dr Adi : 2
SIC (CAROL) Senin, 15.02.22
TIPE PASIEN
YANG DINAS
LT NAMA UNIT
EMERGENCY ROOM
EMERGENCY
ROOM,
PONEK
GF
RADIOLOGI Arga
FL Novi+ Sonya
TOTAL PASIEN EMG
Poli anak :
Poli Obgyn : 18
Ns IIn THT : 2 17
Urology :
Rehab
Orthopedy : 2 Medik : 15
LT 3
Bedah Fisotherapi:
Onkology : digestive : 4
Dermis : 4 Psikiatri : 1
Neuro : ODC : MCU :
LT 5
LT 6
IPD LT 4
Ns IPD LT 4 IPD LT 4
Citra Ns Ns Abdi Ns Salwa
IN PATIENT
Ns Tita NsNeyla
DEPARTMENT Helen Ns IPD LT 6 IPD LT 6
Lt 4, 5, 6 Rio IPD Ns Indah Ns Risha
LT 6 Ns Ns Okta Ns Devi
Dini Ns
Avi Santi
(M)
SOS Petugas: Arwan, Rivan
GIZI Petugas :
LABORATORIUM Petugas : Riska
Petugas :
PHARMACY (SB) Dina
IT Petugas :
PKD :
DANDRU : Jumlah Lantai 2 : 1. Novan
EMG :
SECURITY, PARKIR Pak Petugas 6 Hery Firlyano
sakti
Wibi orang Pasande 2.Afif Haerudin
TEKNISI Pak Jay
OPERATING THEATER
Ns Sunandar
OK Ns
Heryanti
CRITICAL CARE
Dr Dewi
Dr Rizki
ICU Ns
Ns Elga
Awaludin
HCU / NICU Ns Esti Ns Alvi
OBSTETRICS
Bd Vicky
Bd Putri
VK Bd Anggi Bd
Bd Genda
Tries
LT 7
Nursery Ns Inggrid Ns Ika Ns Nani 5
RUANG TUNGGU PS
CRITICAL
HEARTOLOGY
Ns Akbar
Cathlab Ns Tryanto
NNs Syaiful
LT 8
Hybrid
Ns Rini T
OPD JANTUNG Ns
Emma
AUDITORIUM
NOTED
IPE PASIEN KETERANGAN
CY ROOM
RAJAL : 10
RANAP : 5
RUJUK : 0
APS : 0
PASIEN PONEK : 1
TOTAL : 15

Umum : Drg. Devy
Dr. Riana SpB
Dr. Gatra SpOT
Bedah
Syaraf :
Poli Neuro: 5
Poli Paru : 3
87
Lt 4 : 5 Lt 6 : 2
PASIEN OBSERVASI :
PASIEN PINDAH ICU :

1.Tn. Subagyo/dr.Alvin, Sp.PD/Melena
(Km.415)
2.Ny. Ratna/dr.Syafrizal/PELD DRG DIP
(Km.403)
RENCANA TINDAKAN :
1.LT 4 Ny. Hasanah/Malignant neoplasm:

Endometrium/Chamim,DR. dr, SpOG (K)
Onk/Pro Laparascopy Histerektomi Rabu,
16/02/2022 jam 07.00 WIB terinfo Ns. Nandar,
Order OK (+), SIA (+), SIO (+), ACC asuransi
(+)
2. LT 6 Ny. Atillah / Lazuardy Rachman,
dr. Sp.OG / Supervision of normal
pregnancy, Headache / Rencana TCD/CD +
trigger point tgl 16/2/22
PASIEN ISTIMEWA :

Pasien
Lt 4 : 11 Pasien
Pasien Lt 5 : 0
Total : 23 pasien
MASALAH
Indra, Agung
Adel
Upi
Pak Jery
LOBBY :
Hamka
G THEATER
1.SITI NURAZMAH MOHD AZMAN / BEDAH
1 OBGYN - Sectio Caesaria / OK 1 jam 14.00 wib /
Fransisca Noela RMH, dr. Sp.OG
RENCANA TINDAKAN : Tgl 16.02.22 1.
HASANAH / BEDAH OBGYN - Histerektomi Total,
1 SOB + Cystotomy / OK 1 jam 07.00 wib / dPjP
L CARE
1 Myasthenia gravis
PASIEN OBSERVASI :
1. Ny. Siti nurazmi/ G3P2A0 hamil 37-38
mgg / dr. Noela, SpOG/ SC jam 14.00
PASIEN PONEK :
1. Ny. Angelica Ghea/ G2P0A1 hamil 38-
39 mgg/ dr. Lazuardi, SpOG
PASIEN OBSERVASI :
1. By. Ny. Chyntia Perdana / dr. Diana,

Sp.A / NCB SMK Usia 1 hari
2. By. Ny Arimbi / dr. Diana, Sp.A / NCB
SMK Usia 1 hari
3. By. Ny Sara / dr. Diana, Sp.A / NCB
SMK Usia 1 hari
5
SMK Usia 1 hari
5. By. Ny Siti Nurazmah / dr. Andina,
Sp.A / NCB SMK 11 Jam
OLOGY
Next Schedule
1. Ratna / peld / dr. Syafrizal / 10.00
2. Tgl 16/02. Jam 16
Tn. Anton salamony (dr. Dafsah) CAG +
Standby pci + FFR/IVUS (acc asuransi)
3.Tgl 21/02 Jam 19
Ny Yosia (Dr Sunu) 3D VT Complex (Acc
asuransi)
4. Tgl 25/02. Tn Ardi Winarko (Dr DH)
Replacement CRTD (Acc Pribadi)
5. Tgl 26/02 Tn. Kenny (dr. DH) ekstraksi ICD
+ implantasi Micra AV (Dual Chamber)
6. Tn. Drs. M. Noor rahman (dr. DH) cath
standby PCI 2 stent simple, klg sdg berunding,
estimasi (+)
Outpatient : 19
dr ario :
Dr dafsah : 1
dr denio : 3
19 dr faris : 3
dr DH : 6
dr DAW :
dr radityo :
Dr suko : 1
dr sunu : 5
dr Adi :
SIC (EKO) Rabu, 16.02.22
TIPE PASIEN
YANG DINAS
LT NAMA UNIT
EMERGENCY ROOM
EMERGENCY dr. Fajar, Ns. Ns. Yuni, dr. Firdha,

ROOM Susi, Ns. Yuiar Ns. Rizam Br. Mohlis
GF
PONEK
PONEK
TOTAL PASIEN EMG
Poli Obgyn
Cahya, Alin NS 1 :
Poli Urology
Poli Ortho
Poli Internist
Poli Bedah Umum
Poli Bedah Plastik
Poli Bedah Degestif
NS 2 :
Poli THT
Poli Gizi
Poli bedah saraf
Poli Neuro
Dermis
Dental
LT 3 Poli Endoscopy
Poli Kemotherapi
Poli Fisioterapi
Poli Psikiatri
Pain Klinick
Poli Rehab Medik
Poli Mata
Poli Nutrition
Poli Paru
Poli Mata
Poli Psikiatri
Pain Clinic
MCU
ODC
TOTAL PASIEN OPD
Trijaya Arwan
SOS Petugas
(IGD &
(Malam)
SB)
(L.4,5,6)
Heru &
David
Petugas Arif
GIZI
(Malam) (Servies &
(Cook)
Pramusaji)
LABORATORIUM Petugas Rangga Icha
(Malam)
FHARMACY Petugas Wulan Dinas

(Malam)
Petugas
RADIOLOGI (Malam)
Arga
DANRU : Petugas Jawadi Rigen Husni
SCURITY (RG1 &
Rizky (Malam) IGD)
(Lobby) (PKD)
DS = Ns.
DP = Ns. Tary
LT 4 IN PATIENT + Br. Taufik +
Tita + Br. DM = Br.
LT 5 Rio + Ns. Abdy + Ns.
DEPARTMENT 4 Ns. Kiki
Helen + Ns Salwa
IN PATIENT
DEPARTMENT 5
DS = Ns.
DP = Ns. Dini
avi + Ns. DM = Ns.
IN PATIENT + Ns. kristin +
Okta + Ns. indah + Ns.
LT 6 DEPARTMENT 6 Ns. siti
egis santi
KOMPLAIANAN
KERUSAKAN
OPERATING THEATER
OK Yanu, Heni
CRITICAL CARE
dr. Dewi, Dr. Riri,
ICU Awal, Ning
Agus
Haryani
HCU
NICU
PICU Esty Ayu Grace
TOTAL Ps CRITICAL
OBSTETRICS
‌Dines Pagi: ‌Dines ‌Dines

Bd. Dilla Siang : bd. Malam : bd.
VK Ningsih , Tries, bd.
Bd. Dewi Anggi
Dinas pagi : Dines

‌Dines siang
Nursery Bd Nelly
:Ns.inggri
malam :
Ns.ika
HEARTOLOGY
Cathlab
Hybrid
LT 8
LT 8
OPD JANTUNG
Dokter Jaga
Pagi : dr mega melita
Dokter Jaga IPD : Malam : dr faisal & dr mutiara
& megawati
1. Komplainan : Tidak Ada Komplainan Saat dinas SIC Malam

2. Pasien Terkonfirmasi Covid 19 ada 1 pasien dari Unit IGD Isolasi, Rawat jalan untuk Isolasi mandiri
3. Lift A, B & C Macet dari Jam.19.45 Berkoordinasi dengan Mentenens dan Team Scurity Untuk memastikan Gangguan da
yag terjebak di dalam lift, untuk pengaliha Akses ke lantai dri GF ke Lantai Lainya mengunakan Lift D, Dan Kmbali Norma
4. Staf VK & ICU Perbantuan stay EMG perawat IGD Hanya 1 org di karenakan 4 Perawat masih Isoman
KETERANGAN
TOTAL
PASIEN
Y ROOM
PASIEN OBSERVASI :
RAJAL :
1. Tn. Mediyanto Rizki /27th/ Dx. Alergic
Rhinitis
2. An. Eiliyah Kalyavany /2th/ Dx. Contusion of
shoulder and upper arm
3. Tn. Uky Gunawan /39th/ Dx. Fever (Covid 19)
4. Nn.
Ghina Athyah Wahid /24th/ Dx. Dyspepsia
5. Ny. Adinda
Riani /38th/ Dx. Alergic Uticharia
6. An. Saladdin Rasyid
/8th/ Dx. Acute tonsillitis
7. Tn. Hendro Nababan /24th/ Dx.
First degree haemorrhoids
8. Ny. Esti Khoerunnisa /29th/ Dx.
Fever 9. Nn. Fitri Rizki Liani /30th/ Dx.
Dyspesia
9
RANAP :
RUJUK :
APS : Tidak Ada Pasien APS
Ada 1 PAsien IGD yg Terkonfirmasi

Covid 19
PERALATAN :
NOTE :
RAJAL :
RANAP :
PASIEN OBSERVASI :
9 Pasien

Dr. Nathalia SpA
Dr. Zaki SpOT
1 Dr. Herbowo SpA
1 Dr. Rigina SpKFR
Dr. Gatra SpOT
8 Dr. Winda SpA
2 Tenaga Isoman
Resmita
1
1
1
1
7
1
4
24
92 Pasien
Dwi Tidak Ada Kendala
(L.7,8)
Tidak ada masalah & Kendala
z
Tidak ada maslah & Kendala

Ilham
(PKD)
1.Tn. Susanto/46 thn/Caroline Supit, dr.

SpB/Cutaneous abscess, furuncle and carbuncle of
face, Pro insisi drainase debridement
2.Tn. Anton Salamony/Dafsah Arifa Juzar, dr.
SpJP (K) -FIHA, FasCC/Atherosclerotic
cardiovascular disease, so described,
Hypertension
3.Tn. Dwi Handoko/Caroline Supit, dr.
SpB/Orchitis, epididymitis and epididymo-
orchitis with abscess
PASIEN OBSERVASI :
1.Tn. Jerry Riady/Mirta Hediyati Reksodiputro,
Dr. dr. Sp.THT-KL(K)/ Sleep apnoea
3.Tn. Bernanda/ Alvin Nursalim, dr. Sp. PD/ DHF
H-9
4.Nn. Cornella Phebe Halim/Chamim,DR. dr,
SpOG (K) Onk/Endometriosis of ovary
5.Nn. Sarah Salsabilla/Alvin Nursalim, dr. Sp.PD/
Fever, unspecified,Nausea and vomiting, Obs
febris ec viral dd morbilli?
6.Tn. Anton Salamony/Dafsah Arifa Juzar, dr.
Hypertension
orchitis with abscess
8.Ny. Hasanah/Chamim,DR. dr, SpOG (K)
Onk/Malignant neoplasm: Endometrium/Ny.
9.Ny. Cahyaning/Abdominal Pain/Eddy
Supriadi,dr.SpPd
10.Ny. Three Wolse/ dr. Amanda Sp.PD-KGEH/
Dyspepsia, Symptoms and signs concerning food
and fluid intake
1.Tn. Subagyo/dr.Alvin, Sp.PD/Melena

(Km.415)
10 2.Ny. Ratna/dr.Syafrizal/PELD DRG DIP
(Km.403)
3.Tn. Mahfud/dr.Faris, Sp.JP/Pro Katerisasi
17/2/22jam 08.00(Km.418)
4.Tn. Abu Bakar/dr.Faris, Sp.JP/Pro
Katerisasi 17/2/22 malam (Km.417)
5.Tn. Teng Fekwa/dr.Denio, Sp.JP/Renc tind
jantung 17/2/22 masuk jam 09.00(Km.403A)
6.Untuk keluarga Tn.Teng/ (Km.403B)
RENCANA TINDAKAN :
orchitis with abscess/Pro insisi drainase
debridement 17/02/2022 jam 10 WIB, OK terinfo
Ns. Nandar (+), Order OK (+) SIO (+), SIA
pasien (+)
face, Pro insisi drainase debridement/Pro insisi
drainase debridement 17/02/2022 jam 11 WIB,
OK terinfo Ns. Nandar (+), Order OK (+) SIO (+)
SIA pasien (+) ACC Asuransi (+)

1.Tn. Jerry Riady/Mirta Hediyati
Reksodiputro, Dr. dr. Sp.THT-KL(K)/ Sleep
apnoea
PASIEN PULANG :
1.Tn. Raden Putut Ario Seto/Alvin Nursalim,

dr. Sp. PD/ DHF H7, Dyspepsia
2.Tn. Yugi Limantara /Alvin Nursalim, dr.
Sp. PD/ Dyspepsia+ Tension headeche
3.Tn. DRS. Aminuddin/Sunu Budhi Raharjo,
dr. SpJP (K), PhD/Obs nausea
Post CRTP pada HF TAVB
PASIEN OBSERVASI :
PASIEN PINDAH ICU :
RENCANA TINDAKAN
PASIEN PULANG :
1. An. Saladdin rasyid / dr. Rifan Fauzie,

Sp.A/ Acute tonsillitis due to other specified
organisms
PASIEN OBSERVASI :

2. Ny. Chyntia Perdana /dr. Sang ,Sp.OG/
haemorrhage
3. Ny.Julianti /dr, Farid ,Sp .OG/Malignant
neoplasm: Endometrium
4. Ny. Atillah / Lazuardy Rachman,dr. Sp.OG /
Supervision of normal pregnancy, Headache
5. Nn. Vania Sari / Nugroho Kampono,Prof. dr.
SpOG (K) Onk / Abnormal uterine and vaginal
bleeding, unspecified
6. Ny. Siti Nurazmah / Fransisca Noela RMH, dr.
7. An. Khayla / Ali Alhadar, dr. Sp.A (K) /
8. An. Aisha / Mira Febriani Inkiriwang,dr. SpA /
9. An. Saladdin rasyid / dr. Rifan Fauzie, Sp.A/
Acute tonsillitis due to other specified organisms
10. Tn . William / Zicky Yombana, dr. Sp.S /
Myasthenia gravis
11. Ny.Nazah Bawazier /dr,Taufik Jamaan,
Sp.OG/Z34 Supervision of normal pregnancy
11
PASIEN PINDAH ICU :
RENCANA TINDAKAN
PASIEN VK
PASIEN PULANG
Onk
2. Ny .Sarah Nadia /dr.Nisa
pregnancy
3. Ny.Arimbi/dr.Nisa,Sp.OG/Z34
RENCANA MASUK :

haemorrhage
2. Ny. Siti Nurazmah / Fransisca Noela
RMH, dr. Sp.OG / Supervision of other
normal pregnancy
3. Ny.Nazah Bawazier /dr,Taufik Jamaan,
Sp.OG/Z34 Supervision of normal pregnancy
HEATER
1. Tindakan Rqabu, 16-02-22
1. Histerektomi Total, SOB + Cystotomy /
HASANAH / Chamim,DR. dr, SpOG (K) Onk /
J. 07.00 OK I
2 2.Cystectomy Laparoscop y / CORNELLA
PHEBE HALIM / Chamim,DR. dr, SpOG (K)
Onk / J. 16.00 / OK I
2. Rencana Tindakan Kamis, 17-02-22
1. Sirkumsisi + GA / An. ROBERT CHARLES

WIGLEY / Yonas Hutasoit, dr. Sp.U / J. 08.00 /
Ok I
2. Debridement BEDAH PLASTIK - Insisi &
drainase abses / Tn. DWI HANDOKO /
3 Caroline Supit, dr. SpB / J. 10.00 / OK I
drainase abses / Tn. SUSANTO / Caroline Supit,
dr. SpB / J. 11.00 / OK I
CARE
0
0
0
0
0 Pasien
PASIEN OBSERVASI :
0
RENCANA TINDAKAN :
0
PASIEN PONEK :
0
PASIEN OBSERVASI :
1. By. Ny Siti Nurazmah / dr. Andina, Sp.A /
NCB SMK 1 hari
1. By. Ny. Chyntia Perdana / dr. Diana, Sp.A
4 / NCB SMK Usia 2 hari
2. By. Ny Sara / dr. Diana, Sp.A / NCB SMK
Usia 2 hari
SMK Usia 2 hari
PASIEN PULANG
OGY
16 Feb 22
CATHLAB
Schedule :
1. Anton Salamony / CAG PTCA Complex +
IVUS / dr. Dafsah / 17.00-19.45
Non Schedule : -
HYBRID OR
Schedule : -
Non Schedule : -
Others : -
Problem : -
Overtime staf : -
Staff sakit :
1. Saiful / + Covid Day 3
2. Triyanto / + Covid Day 3
Staff cuti : -
Next Schedule
1. 17 feb 22 : Mahfudzi / cag ptca ivus, ffr / dr.
Faris / 10.00 / cathlab
2. 18. Feb 22 : Teng Tek Hwa / cag ptca, ivus /
dr. Denio / 10.00 / cathlab
3. 19 feb 22 : Aboe Bakar / rdn / renal
denervasi / 14.00 / Hybrid
4. Tgl 21/02 Jam 19
1 Ny Yosia (Dr Sunu) 3D VT Complex (Acc
asuransi)
6. Tgl 26/02 Tn. Kenny (dr. DH) ekstraksi ICD
+ implantasi Micra AV (Dual Chamber)
7. Tn. Drs. M. Noor rahman (dr. DH) cath
standby PCI 2 stent simple, klg sdg berunding,
estimasi (+)
Outpatient : 15
dr ario : 1
Dr dafsah :
dr denio : 3
dr faris : 3
dr DH :
dr DAW :
dr radityo :
15 Dr suko :
dr sunu : 1
dr Adi : 7
MCU : -
New patient :
dr Denio 1 : pasien lama PIK
dr Adi 1 : pasien lama di PIK
Cancel:
dr Faris :
dr Denio : 1
dr Ario : 1

ECHO :
Stress Echo :
USG Doppler :
Holter :
Ezypro :
ECG : 6
Treadmill :
CT Scan :
Speckle :
TEE :
DSE :
ABI :
Advance Echo : 1
Handle echo :
ABPM :
Tilt Table Test :
Paket PJB :
Cardioversi : 1
dr faisal & dr mutiara
memastikan Gangguan dan memastikan tidak Ada Pasien ataupun Keluarga

Lift D, Dan Kmbali Normal di Jam 20.15 Wib untuk lift B & C, Untuk Lift A sdh kembali normal Terinfo di jam 05.49 wib
jam 05.49 wib
TIPE PASIEN
YANG DINAS
LT NAMA UNIT
EMERGENCY ROOM
dr. Megawati,
dr. Dwi, Ns. Ns. Sanusi,
EMERGENCY ROOM Susi, Zr. Nur Ns. Rizam
Br. Mohlis,
Ns. yuni
GF
PONEK
TOTAL PASIEN EMG

OPD
Poli Obgyn
Cahya, Alin NS 1 :
Poli Urology
Poli Ortho
Poli Internist
Poli Bedah Umum
Poli Bedah Plastik
Poli Bedah Degestif
NS 2 :
Poli THT
Poli Gizi
Poli bedah saraf
Poli Neuro
Dermis
Dental
LT 3
Poli Endoscopy
Poli Kemotherapi
Poli Fisioterapi
Poli Psikiatri
Pain Klinick
Poli Rehab Medik
Poli Mata
Poli Nutrition
Poli Paru
Poli Mata
Poli Psikiatri
Pain Clinic
MCU
ODC
TOTAL PASIEN OPD
Trijaya
SOS Petugas
(Malam) (IGD &
SB)
David
GIZI Petugas
(Malam)
(Cook)
LABORATORIUM Petugas Rangga

(Malam)
FHARMACY Petugas Wulan

(Malam)
Petugas
RADIOLOGI (Malam)
Sarah
DANRU : Petugas Jawadi Rigen
SCURITY (RG1 &
Rizky (Malam) IGD)
(Lobby)
DP = Ns.
DS = Ns. Tary
Anatian + Br. DM = Br.
IN PATIENT + Ns. Helen +
LT 4 DEPARTMENT 4
Taufik + Ns.
Ns. Novita
Abdy + Ns.
Ella + Ns. Kiki Tita + Br. Rio
DP = Ns.
DS = Ns. Tary
Anatian + Br. DM = Br.
IN PATIENT + Ns. Helen +
LT 4 DEPARTMENT 4
Taufik + Ns.
Ns. Novita
Abdy + Ns.
Ella + Ns. Kiki Tita + Br. Rio
IN PATIENT
LT 5 DEPARTMENT 5
LT 5 DEPARTMENT 5
DP = Ns. Dini DS = Ns. avi DM = Ns.

IN PATIENT + Ns. kristin + + Br.malik + indah + Ns.
DEPARTMENT 6 Ns. siti Ns. egis santi + Ns.
LT 6 Okta
DP = Ns. Dini DS = Ns. avi DM = Ns.
IN PATIENT + Ns. kristin + + Br.malik + indah + Ns.
DEPARTMENT 6 Ns. siti Ns. egis santi + Ns.
LT 6 Okta
KOMPLAIANAN
KERUSAKAN
OPERATING THEATER
Yohana
LT 7 OK
LT 7 OK
CRITICAL CARE
ICU Dr. Nilam,
Awal, Windsa Agus
HCU Haryani
LT 7 NICU
Esty Ayu Grace
PICU
TOTAL Ps CRITICAL
OBSTETRICS

‌ ines Siang :
D
Bd. Dilla Malam : bd.
VK bd.Dilla , bd
Tries, bd.
dewi
Anggi
LT 7
Dines malam
Dinas pagi :
: ika
nelly ‌Dines siang :
Nursery inggrid
Dines
middle :
wiwi
HEARTOLOGY
Cathlab
Hybrid
LT 8
LT 8
OPD JANTUNG
Dokter Jaga
Dokter Jaga IPD : Pagi : dr Malam :
1. Komplainan : Tidak Ada Komplainan Saat dinas SIC Malam.

2. Pasien Terkonfirmasi Covid 19 ada 2 pasien dari Unit IGD Isolasi, Pasien Memilih Rawat jalan dan Isolasi mandiri di rum
3. Di Ruang Nursery ada masalah pada kran tidak bisa untuk air panas, Info Mentenens mlm yg melakukan pengecekan ke
panas, untuk memastikan Apakah ada kerusakan lainya Mentenens meminta waktu untuk pengerjaan detail di pagi hari, un
hangat Menggunakan Termos Listrik milik Unit Gizi Untuk Sementara selama Hitter Dalam Perbaikan.
4. Untuk Pasien Nn. Sarah Dina Oktaviana // dr. Wisanti // Asuransi penolakan Karena masa tunggu // pasien terinfo dan
Terinfo Via, Perawat OK (Ns.Yohana) sdh Terinfo dan terjadwal di OK Tindakan di jam 17.00 Wib Sore ini)
4. Untuk Pasien Nn. Sarah Dina Oktaviana // dr. Wisanti // Asuransi penolakan Karena masa tunggu // pasien terinfo dan
Terinfo Via, Perawat OK (Ns.Yohana) sdh Terinfo dan terjadwal di OK Tindakan di jam 17.00 Wib Sore ini)
5. Pui johhny //R/ laparascopy cholesistrctomy Tgl 19.02.22 // dr. Perwira Widianto Sp.B-KBD //Asuransi prudential (ON R
memutuskan untuk Acc karena Tidak Ada Dokter yang jaga malam, Hingga Pagi Ini blm Acc Asuransi Untuk Renca
TIPE PASIEN
KETERANGAN
TOTAL (Pasien baru Ranap/Pasien perhatian/critical/Kemo/transfusi,
BERAT PASIEN Pasien Risiko/Komplen, Pasien titipan, ODC, & Prosedur
RGENCY ROOM
PASIEN OBSERVASI :
RAJAL :
1. Ny. Fatimah /34th/ Dx. Malignant neoplasm of
placenta
2. An. Grayson Abhdalla /7bln/ Dx. Fever (pagi)
3. Nn. Vickitra Aufananda /26th/ Dx. Fever
4. Ny. Meylianny /54th/ Dx. Crohn disease +
abdominal pain
5. Tn. Joseph Loui Spartz /79th/ Dx. Stroke not
haemorrhage
6. Ny. Yasmine M Bhalwan /35th/ Dx. Benign
paroxysmal vertigo
7. Tn. Resdian Wisudya /36th/ Dx. Fever (Covid 19
Terkonfirmasi)
8. Nn. Anisa Sabila /25th/ Dx. Fever + Dyspepsia
9. Ny. Yeni Susilawati /56th/ Dx. Dyspepsia
10. Tn. Agus Mulyadi /60th/ Dx. Dyspepsia
11. An. Grayson Abhdall 7bln/ Dx. Fever (Malam) /
Covid 19 Terkonfirmasi
12. Tn. Raehan Nico Fedrian /24th/ Dx. gastroenteritis
and colitis of infectious 13. Tn. Syahru
Aryansyah /43th/ Dx. Nausea and vomiting + Pure
14 hypercholesterolaemia
RANAP :
1. Nn. Shuffah Nopi H /33th/ Dx. Urinary tract
infection / Dpjp. dr.Alvin Nursalim, Sp.PD /
Ruang 407
RUJUK :
PERALATAN :
NOTE :
RAJAL :
RANAP :
1. Ny. Amiera Jamal /25th/ Dx. G1P0A0 Hamil
39 minggu + inpartu kala 1 fase laten + JPKTH
1 (mengeluh perut kenceng-kenceng seperti ingin
melahirkan yang dirasakan sejak jam 5 pagi hari
ini) / Dpjp. dr. Alesia Novita, SpOG (Observasi
VK Persiapan Partus Normal)
PASIEN OBSERVASI :
15 Pasien
OPD
Dr. Aldy SpS
Dr. Eric Gultom SpA
1 Dr. Fauziah SpTHT
2 Drg. Prita
5 Tenaga Sakit :
3 3 Orang
1
3
7
6
6
1
1
16
2
1
90 Pasien
Arwan Dwi
Tidak Ada Kendala
(L.4,5,6) (L.7,8)
Heru &
Arif
(Servies &
Pramusaji)
Icha Tidak ada maslah & Kendala
Rara Tidak ada masalah & Kendala

Husni Ilham
(PKD) (PKD)
ARTMENT
PASIEN BARU :
PASIEN OBSERVASI :
1.Nn. Cornella Phebe Halim/ DR. dr,Chamim, Sp.OG

(K) Onk/ Endometriosis of ovary
2.Tn. Dwi Handoko/ dr.Caroline Supit, SpB/ Orchitis,
epididymitis and epididymo-orchitis with abscess
3.Ny. Hasanah/ DR. dr,Chamim, SpOG (K) Onk/
Malignant neoplasm: Endometrium
4.Ny. Cahyaning/ dr. Eddy Supriadi, Sp.Pd/ Abdominal
Pain
5.Tn. Teng Tek Hwa /dr. Denio A. Ridjab, SpJP -
FIHA/CHF
6.Ny. Shuffah /dr. Alvin Nursalim, Sp.PD/ ISK
1.Tn. Subagyo /dr.Alvin, Sp.PD/ Melena

(Km.415)
2.Ny. Ratna /dr.Syafrizal/ PELD DRG DIP
(Km.403)
3.Tn. Abu Bakar /dr.Faris, Sp.JP/ Pro Katerisasi
18/2/22 malam (Km.417)
6
RENCANA TINDAKAN :
1.Tn. Teng Tek Hwa / dr. Denio A. Ridjab, SpJP -
FIHA / CHF, rencana tindakan CAG + PTCA 2 stent
simple + IVUS, tgl 18/02/22 jam 10.00 WIB
(Chatlab)
6

1.Ny. Hasanah / DR. dr.Chamim, Sp.OG (K)
Onk/Malignant neoplasm: Endometrium
PASIEN PULANG :
1.Tn. Jerry Riady /Dr.dr.Mirta Hediyati

Reksodiputro, Sp.THT-KL(K)/ Sleep apnoea
2.Tn. Susanto/46 thn /dr. Caroline Supit, SpB/
Cutaneous abscess, furuncle and carbuncle of
3.Tn. Bernanda/ dr. Alvin Nursalim, Sp.PD/ DHF
H-9
4.Nn. Sarah Salsabilla/ dr. Alvin Nursalim,
Sp.PD/ Fever, unspecified,Nausea and vomiting,
Obs febris ec viral dd morbilli
5.Tn. Anton Salamony /dr. Dafsah Arifa Juzar,
Hypertension
6.Ny. Three Wolse /dr. Amanda Sp.PD-KGEH/
Dyspepsia, Symptoms and signs concerning food
and fluid intake
7.Tn. Mahfudz /dr. Faris Basalamah,
Sp.JP/Angina Pectoris (Kamar 418) pulang jam
18.00 WIB tgl 17/02/22
PASIEN OBSERVASI :
PASIEN PINDAH ICU :
RENCANA TINDAKAN
PASIEN PULANG :
1. Ny. Anne Dasa Fitri / dr. Chamim Sp.OG /

Endometriosis of Uteri
2. An.Ahmad faruq / dr. Fauziah Fardizza,
Sp.THT/ Hypertrophy of tonsils with hypertrophy
of adenoids
3. Tn Josep Louis Spartz/ dr. Arief Rachman,
Sp.S / Stroke, not specified as haemorrhage or
infarction.
PASIEN OBSERVASI :
1. Ny.Siti umairoh / dr. Amanda Pitarini Utari, Sp.PD-

KGEH/ Dyspepsia,Nausea and vomiting
2. Ny. Atillah / dr. Lazuardy Rachman, Sp.OG /
Supervision of normal pregnancy, Headache
3. Nn. Vania Sari / Prof. dr. Nugroho Kampono, Sp.OG
(K) Onk / Abnormal uterine and vaginal bleeding,
unspecified
4. An. Khayla / dr. Ali Alhadar, Sp.A (K) / Dengue
fever
5. An. Aisha / dr. Mira Febriani Inkiriwang, Sp.A /
Dengue fever
6. An. Saladdin rasyid / dr. Rifan Fauzie, Sp.A/ Acute
tonsillitis due to other specified organisms
7. Tn. William / dr. Zicky Yombana, Sp.S /
Myasthenia gravis
9. An.Ahmad faruq / dr Fauziah Fardizza, Sp.THT/
Hypertrophy of tonsils with hypertrophy of adenoids
10. Tn Josep Louis Spartz/ dr. Arief Rachman, Sp.S /
Stroke, not haemorrhage or infarction.
10
PASIEN PINDAH ICU :
RENCANA TINDAKAN
10
1. An. Ahmad faruq /dr Fauziah Fardizza,

Sp.THT / Pro op rencana operasi pediatric OSA
surgery (tonsilektomi dan adenoidectomy dengan
endoskopi) Pagi ini 18/02/22 jam 07.00 pagi
2. Ny. Anne Dasa Fitri / dr.
Chamim Sp.OG / Endometriosis of Uteri / Pro
op Laparotomi Adhesiolisis Kompleks dan
Laparaskopi Reseksi Di Sabtu tgl 19/02/22 jam
07.00
PASIEN VK
PASIEN PULANG

haemorrhage
2. Ny.Julianti /dr, Farid ,Sp .OG/ Malignant
neoplasm : Endometrium
3. Ny. Siti Nurazmah / dr. Fransisca Noela RMH,
4. Ny.Nazah Bawazier /dr,Taufik Jamaan, Sp.OG/
RENCANA MASUK :
HEATER
1. Tindakan Kamis, 17-02-22
1. Sirkumsisi + GA / An. ROBERT CHARLES

WIGLEY / Chamim,DR. dr, SpOG (K) Onk, / J.
07.00 / Ok I
3 drainase abses / Tn. DWI HANDOKO / Dr.
Caroline Supit, Sp.B / J. 10.00 / OK I
drainase abses / Tn. SUSANTO / Dr. Caroline
Supit, Sp.B / J. 11.00 / OK I
2. Rencana Tindakan Jum'at, 18-02-22

1. BEDAH THT - Tonsilektomi dengan
adenoidektomi / An. AHMAD FARUQ / Dr.
Fauziah Fardizza, Sp.THT - KL (K) / J.07.00 /
2 OK I 2.
Tindakan Fess /Ny. Farah Dina / dr. Wisanti,
Sp.THT /Jam 17.00/ OK I
CARE
0
0
0
0
0 Pasien
ICS
PASIEN OBSERVASI :
1 1. Ny amiera jamal / dr Alecia novita SpOG.

G1P0A0 hamil 38-39 minggu inpartu kala 1,
Lahir Normal Jam 05.15 Wib
RENCANA TINDAKAN :
0
PASIEN PONEK :
1 1. Ny amiera jamal / dr alecia novita SpOG.
G1P0A0 hamil 38-39 minggu inpartu kala 1.
PASIEN OBSERVASI :
1. By Ny .Amiera jamal /dr.nathalia Sp.A /NCB
1 SMK usia 1 jam, Lahir jam 05.15 wib
0
PASIEN PULANG :
1. By. Ny Siti Nurazmah / dr. Andina, Sp.A /

NCB SMK 2 hari
2. By. Ny. Chyntia Perdana / dr. Diana, Sp.A /
4 NCB SMK Usia 3 hari
3. By. Ny Sara / dr. Diana, Sp.A / NCB SMK
Usia 3 hari
4. By Ny Nazah / dr. Diana, Sp.A / NCB SMK
Usia 3 hari
OGY
17 Feb 22
CATHLAB
Schedule :
1 1. Mahfudz / CAG / dr. Faris / 10.30-11.30
Non Schedule : -
HYBRID OR
Schedule : -
Non Schedule : -
Others : -
Problem : -
Overtime staf : -
Staff sakit :
Staff cuti : -
Next Schedule 1.
18. Feb 22 : Teng Tek Hwa / cag ptca, ivus / dr.
Denio / 10.00 / cathlab 2.
19 feb 22 : Aboe Bakar / rdn / renal denervasi /
14.00 / Hybrid
3. Tgl 21/02 Jam 19
Ny Yosia (Dr Sunu) 3D VT Complex (Acc asuransi)
5. Tgl 26/02 Tn. Kenny (dr. DH) ekstraksi ICD +
implantasi Micra AV (Dual Chamber)
6. Tn. Drs. M. Noor rahman (dr. DH) cath standby
PCI 2 stent simple, klg sdg berunding, estimasi (+)
Outpatient : 8
dr ario :
Dr dafsah : 1
dr denio :
dr faris : 4
dr DH : 3
dr DAW :
dr radityo :
Dr suko :
8 dr sunu :
dr Adi :
MCU : 1 comprehensiv
New patient :
dr DH : 3 dari kerabat
dr Faris 3 : 1 dr Chamim, 1 dari website, 1 dari
brawijaya mcu comprehensiv
Cancel:
dr Suko : 2
dr Dafsah : 1

ECHO : 1
Stress Echo :
USG Doppler : 3
Holter : 3
Ezypro :
ECG : 10
Treadmill :
CT Scan :
Speckle :
TEE :
DSE : 1
ABI : 1
Advance Echo : 3
Handle echo :
ABPM :
Tilt Table Test :
Paket PJB :
Cardioversi :
Referral Brawijaya : dr chamim

Dokter tidak hadir : dr DAW, dr Radityo
dr Megawati
dr Rona & dr Faisal
dr Nilam
dan Isolasi mandiri di rumah.

melakukan pengecekan kemungkinan ada konslet pada HITTER pada pompa pengatur
rjaan detail di pagi hari, untuk sementara apabila perawat membutuhkan Air panas /
ikan.
unggu // pasien terinfo dan Sudah setuju untuk Pembayaan Adm pribadi // untuk Estimasi Biaya Sudah
b Sore ini)
unggu // pasien terinfo dan Sudah setuju untuk Pembayaan Adm pribadi // untuk Estimasi Biaya Sudah
b Sore ini)
suransi prudential (ON REVIEW) / Sdh Di FU Berulang akan tetapi jawaban Asuransi Blm bs
c Asuransi Untuk Rencana Tindakan
SIC (CAROL) JUMAAT, 18.02.22
TIPE PASIEN
YANG DINAS
LT NAMA UNIT
EMERGENCY ROOM
EMERGENCY Dr Fajar Ns
Dr Dwi Ns Dr Fajar
ROOM, Susi Ns Sanusi
Nur Ns
PONEK Yuni
GF
RADIOLOGI Halima
FL Novi + Feby
TOTAL PASIEN EMG
Poli anak :
Poli Obgyn : 24
Ns IIn THT : 3 33
Urology :
Rehab
Orthopedy : 2 Medik : 2
LT 3
Bedah
Onkology : digestive :
Fisotherapi: 3
Neuro : ODC : MCU : 2
LT 5
LT 6
IPD LT 4
Dr Mutiara
IPD LT 4 Dr Mutiara
Ns Anatian Ns Tari Ns IPD LT 4
Ns Taufik Malik Ns Ns Tita
IN PATIENT
Nadya Ns Ns Rio
DEPARTMENT Ns Helen Novita IPD IPD LT 6
Lt 4, 5, 6 Ns Ella LT 6 Ns Ns Kristin
IPD LT 6 Risha Ns Ns Avi Ns
Ns Dini Yudhi Okta
Ns Adeselpi NsEgis
Ns Devi
SOS Petugas: Trijaya
GIZI Petugas : Vira
LABORATORIUM Petugas : Aning
PHARMACY (SB) Petugas : Rara

IT Petugas :
PKD :
DANDRU : Jumlah Lantai 2 : EMG : 1. Giantara
SECURITY, PARKIR Pak Petugas 6 1. Gading 1. M Ryanto 2. IIB Diare
Wibi orang 2. M Andeska
TEKNISI Pak Jay

OPERATING THEATER
Ns Sunandar
OK Ns Heryanti Ns Yohana
LT 7
CRITICAL CARE
Dr Riri Dr Rizki
ICU Ns Awaludin Ns Ning
HCU / NICU Ns Esti Ns Evi
OBSTETRICS
Bd Putri Bd Bd Dila Bd Bd Viky Bd

VK Genda (M) Genda Dewi
Ns Inggrid
Nursery Ns Nani (M)
Ns Nely NsWiwi
RUANG TUNGGU PS
CRITICAL
HEARTOLOGY
Ns Akbar
Cathlab Ns Tryanto
NNs Syaiful
Hybrid
LT 8
Ns Rini T
OPD JANTUNG
Ns Emma
AUDITORIUM
NOTED
IPE PASIEN
KETERANGAN
CY ROOM
RAJAL : 12
RANAP : 3
RUJUK : 0
APS : 3. ALASAN PS APS :
1. Ingin Menggunakan hak BPJS
2. Ingin dirawat di RS dekat
rumah 3 Ingin drawat di rumah
saja
PASIEN PONEK : 0
TOTAL : 18
Aman, tidak ada masalah

Umum : Dr. Zaki SpOT
Dr. Akbari SpU
Bedah
Syaraf :
Poli Neuro: 5
Poli Paru :
95
Lt 4 : 3 Lt 6 : 1
PASIEN OBSERVASI :
PASIEN PINDAH ICU :

1.Tn. Subagyo/dr.Alvin, Sp.PD/Melena (Km.415)

2.Ny. Ratna/dr.Syafrizal/PELD DRG DIP (Km.403)
3.Tn. Abu Bakar/dr.Faris, Sp.JP/Pro Katerisasi 17/2/22
malam (Km.417)
RENCANA TINDAKAN :
1. LT 6 Ny. Anne Dasa Fitri / dr. Chamim

Sp.OG / Endometriosis of Uteri /Pro op
Laparotomi Adhesiolisis Kompleks dan
Laparaskopi Reseksi DiE Sabtu tgl 19/02/22 jam
12.00 WIB
2. LT 4 Teng Tek Hwa/Denio A. Ridjab, dr.
SpJP - FIHA/CHF, rencana tindakan PCI
LAD, tgl 19/02/22 jam 09.00 WIB
PASIEN ISTIMEWA :

Pasien Lt
4 : 6 Pasien Pasien Lt
5 : 0 Pasien
Lt 6 : 9 Pasien Total
: 15 Pasien
MASALAH
Rivan + Indra Aman, tidak ada masalah
Putra Aman, tidak ada masalah
Elis Aman, tidak ada masalah
Nalendra Aman, tidak ada masalah

Pak Jery
LOBBY : Aman, PAtroli Satgas tidak ada masalah

1.Ari Setiawan
THEATER
1. AHMAD FARUQ/ BEDAH THT - Tonsilektomi

dengan adenoidektomi / OK 1 jam 07.00 wib / Fauziah
Fardizza, Dr. dr. Sp.THT - KL (K)
2 2. SARAH DINNA
OCTAVIANA / BEDAH THT - Antrotomi intranasal
(FESS) / ok 1 JAM 17.00 WIB / Wisanti, dr. Sp.THT-
KL

ANNE DASA FITRI / BEDAH DIGESTIVE - Laparotomi
Adhesiolisis Kompleks
BEDAH OBGYN - Laparaskopi Reseksi DiE / OK 1 jam
07.00 wib / Chamim,DR. dr, SpOG (K) Onk 2. PUI
JOHNNY / BEDAH DIGESTIVE - Cholecysistectomy
laparoskopic / OK 1 jam 10.00 wib /Perwira Widianto, dr.
4 Sp.B-KBD 3. ANNE DASA FITRI /
BEDAH DIGESTIVE - Laparotomi Adhesiolisis Kompleks
14.00 wib / Chamim,DR. dr, SpOG (K) Onk 4.
AHMAD FARUQ / BEDAH THT - Tonsilektomi dengan
adenoidektomi / OK 1 jam 14.00 wib / Fauziah Fardizza, Dr.
dr. Sp.THT - KL (K)
L CARE
0 Tidak ada pasien
0
PASIEN OBSERVASI :
1. Ny amiera jamal/ dr Alecia novita SpOG.
0 G1P0A0 hamil 38-39 minggu partus jam 5.15
WIB 18-02-2022
PASIEN PONEK :
PASIEN OBSERVASI :
1. By ny .almira jamal /dr.nathalia sp.A
/NCB SMK usia 17 jam
1
LOGY
18 Feb 22
CATHLAB
Schedule :
1 1. Teng Tek Hwa / CAG / dr. Denio / 11.15 -
12.30
Team ; Jhoni, Akbar, Fefty
Non Schedule : -
Next Schedule
1. 19. Feb 22 : Teng Tek Hwa / ptca, ivus / dr.
Denio / 09.00 / cathlab
2. 19 feb 22 : Aboe Bakar / rdn / renal denervasi /
14.00 / cathlab
3. Tgl 21/02 Jam 19
Ny Yosia (Dr Sunu) 3D VT Complex (Acc asuransi)
4. Tgl 22/02 Jam 13 : PELD dr. Syafrizal / cathlab
5. Tgl 22/02 Jam 16 : Neuro Ablasi dr. Syafrizal /
cathlab
7. Tgl 26/02 Tn. Kenny (dr. DH) ekstraksi ICD +
implantasi Micra AV (Dual Chamber)
8. Tn. Drs. M. Noor rahman (dr. DH) cath standby
PCI 2 stent simple, klg sdg berunding, estimasi (+)
Outpatient : 14
dr ario :
Dr dafsah :
dr denio : 3
dr faris : 3
119 dr DH : 5
dr DAW :
dr radityo :
Dr suko :
dr sunu :
dr Adi : 4
MCU : 1 comprehensiv

SIC (CAROL) SABTU, 19.02.22
TIPE PASIEN
DINAS
LT NAMA UNIT
EMERGENCY ROOM
EMERGENCY Dr Megawati Dr Megawati

Dr Dwi Ns Ns Tomi Ns Ns Nur Ns
ROOM, Susi Alfi Evi
PONEK ( NICU ) ( NICU )
GF
RADIOLOGI Halima
FL Novi + Feby
TOTAL PASIEN EMG
Poli anak :
Poli Obgyn : 28
Ns IIn THT : 10 43
Urology : 5
Rehab Medik :
Orthopedy : 5 Fisiotherapi : 1
9
LT 3
Bedah digestive
Onkology : :
Fisotherapi:
Dermis : 10 Psikiatri :
Neuro : ODC : MCU :
LT 5
LT 6
IPD LT 4
IPD LT 4
Ns Dr IPD LT 4 Dr IPD LT 4
Nurul Ns Ns Salwa Ns Ns Tari
Taufik Nadya Ns
Ns Malik Ns
IN PATIENT Novi IPD LT
Ns Riski Ela
DEPARTMENT 6
Lt 4, 5, 6 Ns Helen Ns Risha
IPD LT 6 Ns
IPD LT 6 Ns Adeselphi Avi
Ns Ana Ns Kristin
Ns Silvi Ns
Ns Yudi
Ns Devi Ns Agis
Ahid Ns
Siti
SOS Petugas: Trijaya
GIZI Petugas : Vira

Petugas :
PHARMACY (SB) Widya
IT Petugas :
PKD :
DANDRU : Lantai 2 : EMG :
Jumlah Petugas 1.Iib
SECURITY, PARKIR Pak Adie 1. Gading 1.M
6 orang Diare
Nugroho Andeska Ryanto
TEKNISI PAk Samsul

OPERATING THEATER
Ns Sunandar
CRITICAL CARE
Dr Dewi Ns
Dr Nilam Ns Agus
ICU Ns Awaludin Ns Rita
Ning Ns
Winda
LT 7
HCU / NICU Ns Esti Ns Alvi Ns Evi
OBSTETRICS
Bd Putri Bd Bd Dila Bd Bd Viky Bd

VK Genda (M) Genda Dewi
Ns Inggrid
Nursery Ns Nani (M)
Ns Nely NsWiwi
RUANG TUNGGU PS
CRITICAL
HEARTOLOGY
Ns Akbar
Cathlab Ns Tryanto
NNs Syaiful
Hybrid
LT 8
Ns Rini T
OPD JANTUNG
Ns Emma
AUDITORIUM
NOTED
akan dilakukan)
CY ROOM
RAJAL : 7
RANAP : 0
RUJUK : 0
PASIEN PONEK : 0
PASIEN TERKONFIRMASI Cov-19 :
TOTAL : 7
Bedah Umum : Dokter Cuti/tidak prkatek :

Dr. Sutji SpP
Dr. Nina SpA
Drg. Dona SpPros
Bedah Syaraf :
Poli Neuro:
Poli Paru :
139
Lt 4 : 1 Lt 6 : 0
PASIEN OBSERVASI :
1 Tn Aboe Bakar/ Faris Basalamah, dr. SpJP

(K) / hypertension, Hypertensive heart disease
without (congestive) heart failure, Atherosclerotic
heart disease / Post Tindakan CAG+PTCA 2stent
+RDN ( tgl 19.02.22 )
PASIEN PINDAH ICU / HCU

RENCANA TINDAKAN :
1.( Lt 6 ) Nn. Vania Sari / Nugroho

Kampono,Prof. dr. SpOG (K) Onk / Abnormal
uterine and vaginal bleeding, unspecified,
Rencana tindakan Laparaskopi Histerektomy senin,
tanggal 21 Februari 2022 jam 07.00 WIB
2. ( Lt 6 )Tn. William Tanady/dr Dziky
Zombana/ Rencana tindakan Ganti kanul
trakeostomy hari selasa 22 Februari 2022, jam dan
tempat menyusul.
PASIEN ISTIMEWA :

Pasien Lt 4 :
6 Pasien Pasien Lt 5 : 0
Pasien Lt 6 : 6
Pasien ( 1 di HCU )
Total : 12 Pasien
MASALAH
Rivan + Indra Aman, tidak ada masalah

Rangga Aman, tidak ada masalah
Nalendra Aman, tidak ada masalah

Pak Jery
LOBBY : 1.Ari Aman, PAtroli Satgas tidak ada masalah

Setiawan
Tgl 19.02.22 ALL LIFT, OUT OF ORDER

MASALAH Sejak jam 08.00 wib sd pagi ini Tgl 20.02.22
jam 05.30 wib ( ON/ OFF )
G THEATER
1. ANNE DASA FITRI / BEDAH DIGESTIVE -

Laparotomi Adhesiolisis Kompleks
07.00 wib / Chamim,DR. dr, SpOG (K) Onk 2.
PUI JOHNNY / BEDAH DIGESTIVE -
3 Cholecysistectomy laparoskopic / OK 1 jam 10.00
wib /Perwira Widianto, dr. Sp.B-KBD
3. AHMAD FARUQ / BEDAH THT - Tonsilektomi
dengan adenoidektomi / OK 1 jam 14.00 wib / Fauziah
Fardizza, Dr. dr. Sp.THT - KL (K)
RENCANA TINDAKAN :
L CARE
1. ANNE DASA FITRI / BEDAH DIGESTIVE -
1 Laparotomi Adhesiolisis Kompleks / Post Op
Laparaskopi Reseksi DiE / Dpjp Chamim,DR. dr, SpOG
(K) Onk
0
PASIEN OBSERVASI :
PASIEN PONEK :
1. Ny. Natasya/G1P0A0 H32mgg dgn
pematangan paru/dr nisa,spog
2 2. Ny. Lulu/G3P1A1 H31mgg dgn febris/ dr
nisa, spog
PASIEN OBSERVASI :
1
OLOGY
19 Feb 22
CATHLAB
Schedule :
1. Teng Tek Hwa / PTCA + IVUS / dr. Denio /
09.00 - 11.15
Team ; Jhoni, Akbar, Fefty, aulia
1 2. Aboe Bakar / RDN + CAG PTCA Complex +
IVUS / 14.00-17.30. Observasi di RR s/d 20.00
Team : Rinny, Jhoni, Akbar, Fefty, Aulia, dr. Anas,
risyaf (anestesi)
Non Schedule : -
Next Schedule
Mon, 21 feb
1. Ny. Zaidar / Neuro Ablasi / dr. Syafrizal / cathlab /
10.00 -- orang tua dr. Dicky Hanafy
Tue, 22 feb
1. PELD + Drg Abls / dr. syafrizal / Cathlab / 08.00
2. Drs. M noor Rahman / CAG PTCA / dr. dicky Hanafy
/ cathlab / 16.00
3. LAA Closure + TTE + CAG PTCA / dr. Sunu /
Hybrid / 18.30
Wed, 23 feb 22
1. 3D VT Ablation / dr. faris / 16.00 / Hybrid
Fri, 25 feb 22
1 Tn Ardi Winarko / Dr Dicky Hanafy / Replacement
CRTD / Hybrid
Sat, 26 feb 22
1. Tn. Kenny / dr. Dicky Hanafy / ekstraksi ICD +
implantasi Micra AV (Dual Chamber) / Hybrid
Outpatient : 21
dr ario : 1
Dr dafsah :
dr denio :
21 dr faris :
dr DH : 7
dr DAW :
dr radityo :
Dr suko : 6
dr sunu : 6
dr Adi :

Permasalahan selama 24 jam ( dari tgl 19.02.22 sd
tgl 20.02.22 ) LIFT ERROR ON / OFF
1
SIC (EKO) Minggu, 20.02.22
TIPE PASIEN
YANG DINAS
LT NAMA UNIT
EMERGENCY ROOM
dr. Firdha, Ns. Sanusi, dr. Fajar, Ns.

EMERGENCY ROOM Br. Mohlis, Ns. Tomi Rizam
GF
PONEK
TOTAL PASIEN EMG

OPD
Poli Obgyn
Cahya, Alin NS 1 :
NS 1 :
Cahya, Alin NS 1 :
Poli Urology
Poli Ortho
Poli Internist
Poli Bedah Umum
Poli Bedah Plastik
Poli Bedah Degestif
NS 2 :
Poli THT
Poli Gizi
Poli bedah saraf
Poli Neuro
Dermis
Dental
LT 3
Poli Endoscopy
Poli Kemotherapi
Poli Fisioterapi
Poli Psikiatri
Pain Klinick
Poli Rehab Medik
Poli Mata
Poli Nutrition
Poli Paru
Poli Mata
Poli Psikiatri
Pain Clinic
MCU
ODC
TOTAL PASIEN OPD
Trijaya
SOS Petugas
(Malam) (IGD, L.2
SB)
Putra
GIZI Petugas
(Malam) (Cook)
LABORATORIUM Petugas Riska

(Malam)
Petugas Henny,
FHARMACY
(Malam) Widya
Petugas
RADIOLOGI (Malam)
Ade
Hery
DANRU : Petugas Firliyano Hamka
Pasande
SCURITY
Wibi (Malam) (RG1 & IGD) (Lobby) (Lantai 2)
DP = Ns. DS = Ns.
DM = Ns. Tari
Wulan + Ns. Salwa + Ns.
IN PATIENT + Ns. EllaDM =
LT 4 DEPARTMENT 4
Helen + Br. Nadya + Br.
Ns. Tari + Ns.
Abdy Taufik
Ella
IN PATIENT
LT 5 DEPARTMENT 5
IN PATIENT
LT 5 DEPARTMENT 5
DS = Ns. DM = Ns.
DP = Ns.
Devi + Ns.
IN PATIENT Santi + Risha+ Ns.
Silvi +
DEPARTMENT 6 Ns.Ahid
Ns.Egis Yudi +
LT 6 Bd.Ade
KOMPLAIANAN
KERUSAKAN
OPERATING THEATER
Iqbal
LT 7 OK
CRITICAL CARE
ICU dr. Rizky,
Gisma, Rita Helga dr. Riri, Agus
HCU (Midle)
LT 7 NICU Grace,
Alfin Lisa Ayu
PICU (Midle)
TOTAL Ps CRITICAL
OBSTETRICS
Dines Pagi: ‌Dines Siang :

‌ ines Malam :
D
Bd. Putri, bd bd. Anggi , bd
VK Anggi Tries
bd. Dilla Bd.
Genda
LT 7
Dines Pagi: ‌Dines Siang :
‌ ines Malam :
D
Bd. Putri, bd bd. Anggi , bd
VK Anggi Tries
bd. Dilla Bd.
Genda
LT 7
Dinas pagi : D
‌ ines siang :
Dines malam :
Nursery Ns.Ika Ns.Nani
Bd.Nelly
HEARTOLOGY
Cathlab
Hybrid
LT 8 OPD JANTUNG
Dokter Jaga
Dokter Jaga IPD : Pagi : dr Rona Malam :
Dokter Jaga Critical : Pagi : dr Rizky Malam :

TOTAL (Pasien baru Ranap/Pasien perhatian/critical/Kemo/transfusi,
BERAT PASIEN Pasien Risiko/Komplen, Pasien titipan, ODC, & Prosedur
ERGENCY ROOM
PASIEN OBSERVASI :
RAJAL :
1. Ny. Rizky Ayu Mardhik /31th/ Dx. Migraine,
Dyspepsia
2. An. SavinoArfidiansyah /5th/ Dx. Fever
3. Nn. Umriyah /37th/ Dyspesia
4. Ny. Ina Oktaviasari /53th/ Dx. hypertension +
Asthma
5. Tn. Charles Salmon /47th/ Dx. Chest pain
6. An. Muhammad Badru /15th/ Dx. Febris Hri Ke I
RANAP :
1. Ny. Siti Khani Fatuzahro /32th/ Dx. Headache
7 + Dyspepsia + Nausea and vomiting / Dpjp. Dr.
Eddi Sp.PD / Ruang 401
RUJUK :
PERALATAN :
NOTE :
RAJAL :
RANAP :
1. Ny. Anggraini Widya /24th/ Dx. G1P0A0 hamil
1 38 minggu 2 hari JPKTH /Dpjp. Nisa Fathoni, dr.
Sp. OG, IBCLC (Observasi di VK 6 jam untuk
kemajuan persalian)
PASIEN OBSERVASI :
MG 8 Pasien
OPD
0
6
6 Pasien
Rivan
Indra
Tidak Ada Kendala
(L.4,5,6) (L.7,8)
Dafa
(Servies & Tidak ada masalah & Kendala
Pramusaji)

Novan Afif
Sakti Haerudin Aman, Tidak Ada Temuan Dan Kendala
(PKD Out) (PKD IN)
1. Ny. Siti Khani Fatuzahro /32th/ Dx. Headache +

Dyspepsia + Nausea and vomiting / Dpjp. Dr. Eddi
Sp.PD
PASIEN OBSERVASI :
1.Ny. Cahyaning/Eddy Supriadi,dr.SpPd/Abdominal
Pain
2. Tn. Teng Tek Hwa/Denio A. Ridjab, dr. SpJP -
FIHA/CHF
3. Tn. Aryo/Nenfiati, dr. Sp.PD/DHF H-4
4. Tn. Ahmad/Amanda, dr. Sp.PD/DHF
5. Ny. Siti Khani Fatuzahro, Dx. Headache +
Dyspepsia + Nausea and vomiting / Dpjp. Dr. Eddi
Sp.PD

1.Tn. Fajar/ Syafrizal, dr. Sp.BS/ PELD, kamar
(411)
2.Ny. Hj. Zaidar/ Syafrizal, dr. Sp.BS/ Neurologis
5 Ablasi, kamar (418)
RENCANA TINDAKAN :

1.Ny. Cahyaning/Eddy
Supriadi,dr.SpPd/Abdominal Pain
2. Tn. Teng Tek Hwa/Denio A. Ridjab, dr. SpJP -
FIHA/CHF
PASIEN PULANG :
1. Tn. Aboe Bakar/ Faris Basalamah, dr. SpJP (K)
/ hypertension, Hypertensive heart disease without
(congestive) heart failure, Atherosclerotic heart
disease
2. Ny. Shuffah/ dr. Alvin Nursalim, Sp.PD/ISK
PASIEN OBSERVASI :
PASIEN PINDAH ICU :

RENCANA TINDAKAN
PASIEN PULANG :
1.Ny.Anggraini / dr.Nisa fathoni,Sp.OG /

G1P0A0 H 38 mgg 2 hari
PASIEN OBSERVASI :
1. Ny.Siti umairoh / Amanda Pitarini Utari,dr, SpPD-

2. Nn. Vania Sari / Nugroho Kampono,Prof. dr. SpOG
unspecified.
Myasthenia gravis
4. Tn Josep Louis Spartz/ Arief Rachman, dr. Sp.S /
Stroke, not specified as haemorrhage or infarction.
5. Anne Dasa fitri / dr.Chamim ,Sp.OG/ Post tindakan
Laparatomi Salpingektomi Kistektomi (Post ICU)
6. Ny.Anggraini / dr.Nisa fathoni,Sp.OG / G1P0A0 H
38 mgg 2 hari
PASIEN PINDAH ICU :
RENCANA TINDAKAN
1.Nn. Vania Sari / Nugroho Kampono,Prof. dr.
SpOG (K) Onk / Abnormal uterine and vaginal
bleeding, unspecified, Rencana tindakan
Laparaskopi Histerektomy senin, tanggal 21
Februari 2022 jam 08.00 WIB
2.Tn. William Tanady/dr Dziky Zombana/
Rencana tindakan Ganti kanul trakeostomy hari
selasa 22 Februari 2022, jam dan tempat
menyusul.
6 3. Ny.Siti umairoh / Amanda Pitarini Utari,dr,
SpPD-KGEH/ Dyspepsia,Nausea and vomiting /
Rencana Tindakan Pungsi Lumbal dengan
dr.Arief, Sp.S Senin tgl 21/02/2022 diantara jam
12.00 - 15.00
PASIEN VK
1.Ny.Anggraini / dr.Nisa fathoni,Sp.OG /
G1P0A0 H 38 mgg 2 hari
PASIEN PULANG
1. Ny. Amiera Jamal/ Post partum spontan/ dr
Aleisa Novita, S.poG
RENCANA MASUK :
1.Ny.Rosi / dr.Nisa Fathoni,Sp.OG/ Rencana Tindakan

SC / booking kamar 605
2.Ny.Nidia/dr.Nisa Fathoni,Sp.OG/Rencana Tindakan
SC / booking kamar 606
3.Ny.Nazwa/Dr.Febriansyah,Sp.OG/Rencana Tindakan
SC/ booking kamar 607
4.Ny.Marini/dr.Nisa Ftahoni,Sp.OG/Rencana tindakan
SC/booking kamar 609
5.Ny.Desi Melisa/dr.Veinardi,Sp.OG/Rencana tindakan
SC/ booking kamar 618

1.Tn Josep Louis Spartz/ Arief Rachman, dr.
infarction.
THEATER
1. Tindakan Minggu, 20-02-22
0 -
2. Rencana Tindakan Senin, 21-02-22
1. Laparascopy Histerektomy / VANIA SARI
MUCHARDIE / Chamim,DR. dr, SpOG (K) Onk)
/ J. 07.00 / OkI 2.
2
Neurolis Ablasi + PRP / Ny. Zaidar / Dr.
Syafrizal, Sp.BS / J. 10.00
L CARE
0
0
0
0
0 Pasien
TRICS
PASIEN OBSERVASI :
1 1. Ny Anggraini Widiya/ dr Nisa/G1P0A0 hamil
38 minggu inpartu kala 1 Fase Laten
RENCANA TINDAKAN :
PASIEN PONEK :
1
1 1. Ny Anggraini Widiya/ dr Nisa/G1P0A0 hamil
38 minggu inpartu kala 1 Fase Laten
PASIEN OBSERVASI :
1 1. By. Azqila Ezra/ NCB SMK usia 6 hari/
dr.Diana Sp.A
PASIEN PULANG :
1 1. By.Ny. Amiera/NCB SMK usia 2 hari/
dr.Nathalia Sp.A
OLOGY
dr Fajar
dr Muti & dr. Faisal
dr Riri
TIPE PASIEN
DINAS
LT NAMA UNIT
Pagi Sore Malam RINGAN
EMERGENCY ROOM
dr. Firdha, Ns.

EMERGENCY dr. Dwi, Ns. Ns. Tomi, Ns.
Sanusi, Ns.
ROOM Ardi, Ns. Yuni Mohlis
Rizam
GF
PONEK
TOTAL PASIEN EMG

OPD
Poli Obgyn
Poli Onkology NS 1 : Cahya,
Alin NS 1 :
Poli Urology
Poli Ortho
Poli Internist
Poli Bedah Umum
Poli Bedah Plastik
Poli Bedah Degestif
NS 2 :
Poli THT
Poli Gizi
Poli bedah saraf
Poli Neuro
Dermis
Dental
LT 3
Poli Endoscopy
Poli Kemotherapi
Poli Fisioterapi
Poli Psikiatri
Pain Klinick
Poli Rehab Medik
Poli Mata
Poli Nutrition
Poli Paru
Poli Mata
Poli Psikiatri
Pain Clinic
MCU
ODC
TOTAL PASIEN OPD
SOS Petugas
(Malam)
GIZI Petugas
(Malam)
LABORATORIUM Petugas
(Malam)
FHARMACY Petugas
(Malam)
Petugas
RADIOLOGI (Malam)
DANRU : Petugas Firliyano Hamka

SCURITY
Wibi (Malam) (RG1 & IGD) (Lobby)
DP = Ns. DS = Ns. Salwa

DM = Ns.
IN PATIENT Wulan+ Ns + Br. Rio+ Br.
LT 4 DEPARTMENT 4 Novita Abdy+ Ns Riski
Nadya + Br
Taufik
DP = Ns. DS = Ns. Salwa
DM = Ns.
IN PATIENT Wulan+ Ns + Br. Rio+ Br.
LT 4 DEPARTMENT 4 Novita Abdy+ Ns Riski
Nadya + Br
Taufik
IN PATIENT
LT 5 DEPARTMENT 5
IN PATIENT
LT 5 DEPARTMENT 5
DP = Ns. Dini DS = Ns. Devi DM = Ns.

IN PATIENT + Ns. Indah + + Ns. Santi + Risha+ Bd.
DEPARTMENT 6 Ns. Siti Ns.Okta Ade + Ns.
LT 6 Silvi
DP = Ns. Dini DS = Ns. Devi DM = Ns.
IN PATIENT + Ns. Indah + + Ns. Santi + Risha+ Bd.
DEPARTMENT 6 Ns. Siti Ns.Okta Ade + Ns.
LT 6 Silvi
KOMPLAIANAN
KERUSAKAN
OPERATING THEATER
LT 7 OK
CRITICAL CARE
ICU
HCU
LT 7 NICU
PICU
TOTAL Ps
CRITICAL
OBSTETRICS
‌Dines Pagi:
‌Dines Siang :
Bd. Putri
bd. Anggi , bd Malam : bd.
VK Dines middle :
Tries Dilla Bd. Genda
bd tries
‌Dines
LT 7
Dinas pagi :
Ns.Ika
Middle :
Ns. Inggrid ‌Dines siang :
Dines malam :
‌Dines siang : Ns.Nani
Back Up : Ayu
Nursery Ns.Nani Dines malam :
, Rita
Dines ka' Ayu , Rita (
( NICU / ICU )
malam : ka' NICU / ICU )
Ayu , Rita
( NICU /
ICU )
HEARTOLOGY
Cathlab
Hybrid
LT 8
OPD JANTUNG
Dokter Jaga
Dokter Jaga IGD : Pagi : dr Dwi
Pagi : dr Nesya & dr. Nitha
Dokter Jaga IPD :
Dokter Jaga Critical : Pagi : dr Dewi

2. Pasien Terkonfirmasi Covid 19 ada 1 pasien dari Unit IGD Isolasi, Pasien di Rujuk Ke Brawijaya Sawangan Depok, deng
TIPE PASIEN
KETERANGAN
SEDANG BERAT PASIEN perhatian/critical/Kemo/transfusi, Pasien Risiko/Komplen,
EMERGENCY ROOM
PASIEN OBSERVASI :
RAJAL :
1. An. Evencio Athazaky /6bln/ Dx. Fever + Covid 19
Terkonfirmasi
2. Ny. Fatimah /34th/ Dx. Malignant neoplasm of
placenta
3. An. Ricardo Dimitri /8th/ Dx. ISPA
4. An. Richie Damian /5th/ Dx. ISPA
5. Nn. Esti Yuniarti /29th/ Dx. abdominal pain +
Dyspepsia + Nausea and vomiting
6. Nn. Prenda Wati /29th/ Dx. Dyspepsia
7. An. Nadhira Asy Syareefa /4th/ Dx. Superficial
injury of head
8. Ny. Grace Natasya /26th/ Dx. Acute peritonitis
9. Tn. Rezaril Frissandy /35th/ Dx. abdominal pain
10. Ny. Janufin Malahajat /58th/ Dx. Dyspepsia
RANAP :
1. Ny. DRA Yeni Nuryani /53th/ Dx. abdominal
pain + diabetes mellitus + hyponatraemia / Dpjp.
Amanda Pitarini Utari,dr, SpPD-KGEH / Ruang
401
12 2. Tn. Anton Partono /69th/ Dx. Atherosclerotic
heart disease + diabetes mellitus + Chronic
kidney disease / Dpjp. dr. Ario Soeryo, dr. SpJP
(K)-FIHA, FasCC / Ruang 412 (Rencana
tindakan hari Kamis untuk PTCA 2 stent
complex oleh dr. Dafsah, Sp.JP)
RUJUK :
- Rujuk Ke Brawijaya Hospital Depok a.n An.
Evencio Athazaky /6bln/ Dx. Fever + Covid 19
Terkonfirmasi

PERALATAN :
NOTE :
RAJAL :
RANAP :
1. Ny. Ramdlania /30th/ Dx. Maternal care for

1 intrauterine death dgn G2P1 hamil 24 minggu 5
hari janin tunggal IUFD BSC 1 x / Dpjp. dr. Nisa
Fathoni, Sp.OG (Rencana Terminasi di VK)
PASIEN OBSERVASI :
SIEN EMG 13 Pasien

OPD
Dr. Eric SpA
4 Dr. Aldy SpS
1
Tenaga Isoman
15
2
1
3
3
5
15
5
19
4
115
Arwan
Trijaya Indra
(IGD, L.2 Tidak Ada Kendala
SB)
(L.4,5,6) (L.7,8)
Putra Dafa
(Cook)
Pramusaji)
Rangga &
Echa
Henny &
Bulan
Delly Tidak ada masalah & Kendala

Hery
Novan Sakti Afif Haerudin
Pasande Aman, Tidak Ada Temuan Dan Kendala
(Lantai 2) (PKD Out) (PKD IN)
1.Ny. DRA Yeni Nuryani/ Amanda Pitarini Utari, dr,

SpPD-KGEH/ Abdominal pain
2.Tn. Fajar Aryanto/ Syahfrizal Abubakar, dr. Sp. BS/
Lumbar and other intervertebrtal
3.Ny. Andriani Mayanora/ N.B. Donny A.M, dr.
Sp.OG/ G2P0A1 H38-39mgg
4.Ny. DR H Zaidar Maharani Hanafy/ Syahfrizal
Abubakar, dr. Sp. BS/Lumbar and other intervertebrtal
5.Tn Anton/ Ario Soeryo, dr. SpJP (K)-FIHA, FasCC/
PASIEN OBSERVASI :
7
1. Tn. Aryo/Nenfiati, dr. Sp.PD/DHF H-4
2. Tn. Ahmad/Amanda, dr. Sp.PD/DHF
3. Ny. DRA Yeni Nuryani/ Amanda Pitarini Utari, dr,
SpPD-KGEH/ Abdominal pain
4. Tn. Fajar Aryanto/ Syahfrizal Abubakar, dr. Sp. BS/
Lumbar and other intervertebrtal
5. Ny. Andriani Mayanora/ N.B. Donny A.M, dr.
Sp.OG/ G2P0A1 H38-39mgg
6. Ny. DR H Zaidar Maharani Hanafy/ Syahfrizal
Abubakar, dr. Sp. BS/Lumbar and other intervertebrtal
7. Tn Anton/ Ario Soeryo, dr. SpJP (K)-FIHA,
7 FasCC/ Atherosclerotic heart disease
RENCANA TINDAKAN :
1.Tn. Ahmad/Amanda, dr. Sp.PD/DHF

2.Ny. DR H Zaidar Maharani Hanafy/ Syahfrizal
Abubakar, dr. Sp. BS/Lumbar and other
intervertebrtal
PASIEN PULANG :
1.Ny. Cahyaning/Eddy
Supriadi,dr.SpPD/Abdominal Pain
2. Tn. Teng Tek Hwa/Denio A. Ridjab, dr. SpJP
- FIHA/CHF
3. Ny. Siti Khani Fatuzahro/ Eddy Supriadi,
dr.SpPD/ Headache, Dyspepsia
PASIEN OBSERVASI :
PASIEN PINDAH ICU :
RENCANA TINDAKAN
PASIEN PULANG :
1.Ny.Dessy Mellysa/ Veinardi Madjid,dr.

Sp.OG/ G1 hamil 38-39 mgg
2.Ny. Nidia/dr.Nisa Fathoni,Sp.OG/ G1P0A0
hamil 38 minggu 1 hari.
3.Ny. Ramadlania/ dr.Nisa Fathoni,Sp.OG/
Maternal care for intrauterine death
4.Ny. Rosi / dr.Nisa Fathoni,Sp.OG/ G1P0A0 H
39 mgg
PASIEN OBSERVASI :
1. Ny. Siti umairoh / Amanda Pitarini Utari,dr, SpPD-

2. Nn.Vania Sari / Nugroho Kampono,Prof. dr. SpOG
unspecified.
Myasthenia gravis
4. Ny. Nidia/dr.Nisa Fathoni,Sp.OG/ G1P0A0 hamil
38 minggu 1 hari.
5. Ny. Anne Dasa fitri / dr.Chamim ,Sp.OG/ Post
tindakan Laparatomi Salpingektomi Kistektomi (Post
ICU)
6. Ny. Anggraini / dr.Nisa fathoni,Sp.OG / Post SC
P1A0
7. Ny.Dessy Mellysa/ dr. Veinardi Madjid,. Sp.OG/
G1 hamil 38-39 mgg
8. Ny. Ramadlania/ dr.Nisa Fathoni,Sp.OG/ Maternal
care for intrauterine death
PASIEN PINDAH ICU :
RENCANA TINDAKAN
9 (8 Ranap, 1
Di Vk)
1.Tn. William Tanady/dr Dziky Zombana/
Rencana tindakan Ganti kanul trakeostomy hari
selasa 22 Februari 2022, jam 13.00 diruang poli
endoscopy terinfo Ns. Devi.
2.Ny.Dessy Mellysa/ Veinardi Madjid,dr.
Sp.OG/ G1 hamil 38-39 mgg/ Rencana tindakan
SC besok tanggal 22/02/2022 jam 08.00 Wib.
9 (8 Ranap, 1 3.Ny. Nidia/dr.Nisa Fathoni,Sp.OG/ G1P0A0
Di Vk) hamil 38 minggu 1 hari./ rencana SC besok
tanggal 22/02/2022 jam 12.00 Wib.
PASIEN VK
1.Ny. Rosi / dr.Nisa Fathoni,Sp.OG/ G1P0A0 H
39 mgg
PASIEN PULANG
1. Tn Josep Louis Spartz/ Arief Rachman, dr.
infarction.
RENCANA MASUK :
1.Ny. Nazwa/Dr.Febriansyah,Sp.OG/Rencana
Tindakan SC/ booking kamar 607
2.Ny. Marini/dr.Nisa Fathoni,Sp.OG/Rencana
tindakan SC/booking kamar 609
3.Ny. Ati/ dr. Carolina sp. B/Rencana tindakan insisi
tanggal 22/02/2022/ Booking kamar 619
4.Ny. Desrianti/ /dr. Tirsa,Sp.OG/ rencana SC besok
22/02/2022/ booking kamar 602
5.Ny. Ayu Madinah/ dr.Nisa Fathoni,Sp.OG/ rencana
SC besok 22/02/2022/ booking kamar 614
6.Ny.Desrianti/ dr.Tirsa, Sp.OG/ Rencana SC tgl
22/02/22 booking kamar 602
7.Ny.Ayu Madinah/ dr.Nisa Fathoni,Sp.OG/ Rencana
SC tgl 22/02/22 booking kamar 615
PASIEN RENCANA RUJUK :
1.Ny. Siti umairoh / Amanda Pitarini Utari,dr,

Rencana Rujuk ke RSCM (keluarga pasien ingin
pakai BPJS saat ini sedang tunggu keputusan dari
dpjp)
RATING THEATER
1. Laparascopy Histerektomy / VANIA SARI
MUCHARDIE / Chamim,DR. dr, SpOG (K)
Onk) / J. 07.00 / Ok I 2.
2
ANGGRAINI WIDIYA ASTUTI / Nisa Fathoni,
dr. Sp. OG, IBCLC / J.18.30 OK I
2. Rencana Tindakan Selasa, 22-02-22

1. Sectio Caesaria /DESSY MELLYSA
CHRISTINA/ Veinardi Madjid,dr. Sp.OG / J.
07.00 OK I
2. Sectio Caesaria / ANDRIANI MAYANORA/
N.B. Donny A.M, dr. Sp.OG / J. 09.00 OK I
3.Incisi
drainage abses multiple/kompleks Sedang / ATTY
9 SUMIATY H / Caroline Supit, dr. SpB / J. 10.00
OK I
4. Sectio Caesaria / NIDIA KHAIRUNNISA/ Nisa
Fathoni, dr. Sp. OG, IBCLC / J. 12.00 OK I
5. Sectio
Caesaria / AYU MADINAH MUNAWAROH / OG,
IBCLC Nisa Fathoni, dr. Sp. OG, IBCLC / J.
13.00 OK I
6. Sectio Caesaria / MARINI TIRTA SARI/ Nisa
Fathoni, dr. Sp. OG, IBCLC / J. 14.00 OK I
7. Sectio
Caesaria / RIZKI RAMADHANI ZAMZAM/
Mohammad Haekal, dr. Sp.OG, FICS / J. 19.05 OK
I 8.
PLED + DRG /TN. FAJAR/ Dr. Syafrizal, Sp.BS
9. Sectio
Caesaria /DESTRIANTI / dr. Tirsa SP.OG
RITICAL CARE
0
0
0
0
0 Pasien
OBSTETRICS
PASIEN OBSERVASI :
3
1. Ny Anggraini Widiya/ dr Nisa/G1P0A0 hamil
38 minggu inpartu kala 1 FL --> SC cito jam
19.00
3 2. Ny. Rosi nazra/dr Nisa/G1P0A0 hamil 39
minggu JPKTH
3. Ny. Ramdlania/dr nisa/G2P1A0 hamil 24
minggu dengan IUFD
RENCANA TINDAKAN :
1. Ny. Dessy/dr Veinardi/G1P0A0 hamil 39

minggu +makrosomia rencana SC tgl 22/2/2022
jam 08.00 wib
2. Ny. Andriani/dr Donny/G2P0A1 hamil 39
minggu rencana SC tgl 22/2/2022 jam 09.00
3. Ny. Nidia/dr nisa/G1P0A0 hamil 38 minggu
rencana SC tgl 22/2/2022 jam 12.00
7
4. Ny. Ayu/dr nisa/G3P1A1 hamil 39 minggu
5. Ny. Marini/dr nisa/G1P0A0 hamil 39 minggu
6. Ny. Desrianty/dr tirsa/G3P2A0 hamil 38
7. Ny. Rizki/dr M Haekal/G3P2A0 hamil 37
PASIEN PONEK :
1 1. Ny. Ramdlania/dr nisa/G2P1A0 hamil 24
minggu dengan IUFD
PASIEN OBSERVASI :
1 1. By. Ny. Anggraeni / NCB SMK USIA 4
JAM / dr. Nathalia, Sp.A
PASIEN PULANG :
1. By. Azqila Ezra/ NCB SMK usia 7 hari/
dr.Diana Sp.A, Hasil Bilirubin : 8
HEARTOLOGY
21 Feb 22
CATHLAB
Schedule :
1. Zaidar / Neuro Ablasi / dr. Syafrizal / 10.00 -
1 13.w15
Team ; Fefty, catur, riadi
Non Schedule : -
HYBRID OR
Schedule : -
Non Schedule : -
Others : -
Problem : -
Overtime staf : 1 team
Staff sakit :
Staff cuti : -
Next Schedule
Tue, 22 feb
1. PELD + Drg Abls / dr. syafrizal / Cathlab / 08.00
2. Drs. M noor Rahman / CAG PTCA / dr. dicky
Hanafy / cathlab / 16.00
3. LAA Closure + TTE + CAG PTCA / dr. Sunu /
Hybrid / 18.30
Wed, 23 feb 22
Fri, 25 feb 22
1 Tn Ardi Winarko / Dr Dicky Hanafy /
Replacement CRTD / Hybrid
Sat, 26 feb 22
1. Tn. Kenny / dr. Dicky Hanafy /
ekstraksi ICD + implantasi Micra AV
(Dual Chamber) / Hybrid
Outpatient : 16
dr ario :
Dr dafsah : 1
dr denio : 3
dr faris : 2
dr DH : 1
dr DAW : 1
dr radityo :
Dr suko : 1
dr sunu : 1
17
dr Adi : 6
MCU : -
New patient : 4
dr Faris 1 : dari alodok
dr Dafsah 1 : pasien suami pasien lama dr dafsah
dr Sunu 1 : dr Hera SpJP RSUD Pasar Rebo
dr Denio 1 :
Cancel :
dr Faris : 1
dr adi : 1
dr Denio : 3

ECHO : 2
Stress Echo :
USG Doppler : 1
Holter :
Ezypro :
ECG : 7
Treadmill : 1
CT Scan :
Speckle :
TEE :
DSE :
ABI :
Advance Echo : 2
Handle echo :
ABPM :
Tilt Table Test :
Paket PJB :
Cardioversi :
Referral Brawijaya : dr Alvin

Refferal RS luar : dr Hera spjp RSUD Pasar
Rebo
Dokter tidak hadir : dr Radityo sakit
Malam : dr Firdha
Malam : dr Rona
Malam : dr Rizky
e Brawijaya Sawangan Depok, dengan Pendamping Ns.Tomi dengan Ambulance Brawijaya Saharjo
SIC (CAROL) Selasa, 22.02.22
TIPE PASIEN
DINAS
LT NAMA UNIT
EMERGENCY ROOM
EMERGENCY Dr Dwi Ns Dr Dwi Ns

Dr Audrey
ROOM, Ns Susi
Nur Ns Mohlis Ns
PONEK Tomi Sanusi
GF
RADIOLOGI Delly
FL Diba + Firdha
TOTAL PASIEN EMG
Poli anak :
Poli Obgyn : 6
Ns IIn THT : 1 21
Urology :
Rehab Medik :
Orthopedy : 1 Fisiotherapi :
11
LT 3
Poli Mata : 5
Poli Pediatrik
Bedah Fisotherapi:
Onkology : digestive : 1
Neuro : ODC : 1 MCU :
LT 6
IPD LT 4 Dr Mega M
IPD LT 4
Ns Salwa Dr Mega M
Ns Nurul Ns Rio IPD LT 4 Ns
Ns Ana Ns Abdi Ns Nadya
IN PATIENT
Riski Ns Taufik
DEPARTMENT Ns Wulan Ns IPD LT IPD LT 6
Lt 4, 5, 6 IPD LT 6 Ns Devi
6 Ns Dini Ns Kristin Ns Santi
Ns Siti Ns Okta Ns Silvi
Ns Indah Ns Ahid
Ns Egis
Arwan
SOS Petugas:
Indra
GIZI Petugas : Vira

Petugas :
PHARMACY (SB) Bulandari
IT Petugas :
PKD :
DANDRU : Jumlah EMG :
Lantai 2 : 1. Husni
SECURITY, PARKIR Pak Petugas 6 1
Rizki R orang 1. Dede Ahmad J
2. Ilham
TEKNISI PAk Samsul

OPERATING THEATER
Ns Sunandar
LT 7
CRITICAL CARE
Dr Ns Dr Rizki Dr Rizki Ns
ICU Awaludin Ns Winda Elga
HCU / NICU Ns Esti Ns Alfi
OBSTETRICS
Bd Dewi Bd Bd Tries Bd Viky Bd

VK Anggi Bd Aggi Nelly
MASALAH
Ns Nani
Nursery Ns Alvi
( NICU )
RUANG TUNGGU PS
CRITICAL
HEARTOLOGY
Ns Akbar
Cathlab Ns Tryanto
NNs Syaiful
Hybrid
LT 8
LT 8
Ns Rini T
OPD JANTUNG
Ns Emma
AUDITORIUM
NOTED
CY ROOM
PASIEN OBSERVASI :
RAJAL : 7
RANAP : 4
RUJUK : 0
PASIEN PONEK :
TOTAL : 11
Bedah Umum Dokter Cuti/tidak prkatek :

: Dr. Keumala SpA
Dr. Gatra SpOT
Dr. Akbari SpU
Bedah
Syaraf :
Poli Neuro: 5
Poli Paru : 3
77
Lt 4 : 4 Lt 6 : 11
PASIEN OBSERVASI :
1. Ny. Devi Ramesh/ Alvin Nursalim, dr. Sp.

PD/ Malignant neoplasm of ovary / HB 6,8
mg/dl / Tromb 21 rb / Transfusi PRC + TC
PASIEN PINDAH ICU / HCU

1. (lt 4)Tn Moestika Adjie / 74 thn / Post tindakan
CAG - PTCA ec AF / Dr Sunu Budhi SpJp
1.( Lt 6 ) Ny. Siti umairoh / Amanda Pitarini

Utari,dr, SpPD-KGEH/ Dyspepsia,Nausea and
vomiting / Rencana Rujuk ke RSCM (keluarga pasien
ingin pakai BPJS saat ini sedang tunggu keputusan dari
dpjp)
RENCANA TINDAKAN :
1. (LT 6 ) Ny. Lamelasari / Nugroho

Kampono,Prof. dr. SpOG (K) Onk / Malignant
neoplasm of uterus, part unspecified / Rencana
tind. laparotomi histerektomi ai ca endometrium
tgl 23/02/22 pkl 09.00 wib
2. ( Lt 6 ) Ny. Siti umairoh / Amanda Pitarini
Utari,dr, SpPD-KGEH/ Dyspepsia,Nausea and
vomiting / Rencana petscan ke MRCC Siloam
atau RS Gading Pluit tgl 23/02/22 (tempat sedang
menunggu keputusan keluarga)
PASIEN ISTIMEWA :
1. Ny. Devi Ramesh/ Alvin Nursalim, dr. Sp. PD/

Malignant neoplasm of ovary
PASEN DI VK :
1.Ny. Ramdlania / Nisa Fathoni, dr. Sp. OG,

IBCLC / G2P1A0 HAMIL 24 MINGGU 5
HARI DENGAN IUFD.
Pasien Lt 4
: 10 ( 1 HCU ) Pasien
Pasien Lt 5 : 0
Pasien Lt 6 : 16 ( 1 VK ) Pasien
Total : Pasien
MASALAH
Rivan
Agung Aman, tidak ada masalah

Rangga Aman, tidak ada masalah
Upi Nuraini Aman, tidak ada masalah

Pak Jery

1.Rigen R
THEATER
1. DESSY MELLYSA CHRISTINA / BEDAH

OBGYN - Sectio Caesaria / Veinardi Madjid,dr.
Sp.OG
2. ANDRIANI MAYANORA / BEDAH OBGYN
- Sectio Caesaria / N.B. Donny A.M, dr. Sp.OG 3
ATTY SUMIATY H / BEDAH PLASTIK - Incisi
drainage abses multiple/kompleks Sedang 1
BEDAH UMUM - Eksisi Biopsi dengan anestesi
umum / Caroline Supit, dr. SpB
4. NIDIA KHAIRUNNISA / BEDAH OBGYN -
Sectio Caesaria / Nisa Fathoni, dr. Sp. OG, IBCLC
8 5. AYU MADINAH MUNAWAROH / BEDAH
OBGYN - Sectio Caesaria / Nisa Fathoni, dr. Sp. OG,
IBCLC 6.
MARINI TIRTA SARI / BEDAH OBGYN - Sectio
Caesaria / Nisa Fathoni, dr. Sp. OG, IBCLC 7
DESRIANTI RIZKI UTAMI / BEDAH OBGYN -
Sectio Caesaria / Tirsa Verani Kembuan Oroh, dr.
SpOG 8.
RIZKI RAMADHANI ZAMZAM / BEDAH OBGYN
- Sectio Caesaria / Mohammad Haekal, dr. Sp.OG,
FICS

1. LAMELASAR / BEDAH OBGYN - Abdominal
Hysterectomy / Nugroho Kampono,Prof. dr. SpOG (K) Onk
2. CICIN
RURUH WINEDAR / BEDAH THT - Aurikuloplasti
3 rekonstruksi
BEDAH THT - Harvesting Konka / Mirta Hediyati
Reksodiputro, Dr. dr. Sp.THT-KL(K) 3.
FADHLY HAVIZ / BEDAH SARAF - Neurolysis Ablation /
Syafrizal Abubakar, dr. Sp.BS
L CARE
1 1. (lt 4)Tn Moestika Adjie / 74 thn / Post tindakan

CAG - PTCA ec AF / Dr Sunu Budhi SpJp
0
PASIEN OBSERVASI :
1. Ny. Rosi / dr. Nisa / G1 H 39 minggu pro
induksi -> Lahir jam 19.44 WIB
2. Ny. Ramdlania / dr. Nisa / G2P1 H 24 mg 6
2 hari IUFD, BSC 1 x -> lahir jam 00.10 -> curet
cito jam 02.00 WIB.
PASIEN PONEK :
By. Ny. Ramdlania G2P1A0 hamil 25 mgg

dengan iufd, bayi lahir tgl 23/02/2022 pukul
00.10 Wib. Bayi tidak bisa didaftarkan di
teramedik karna jam lahir tidak bisa di input
(00.01 sd 00.59)
PASIEN OBSERVASI :
8 bayi
1 bayi
LOGY
CATHLAB
Schedule :
1. Fajar / peld / dr. Syafrizal / 08.00-11.00
Team : fefty, catur, riadi
2. Drs Noor Rachman / cag ptca 2 stent / dr. dicky
21 hanafy / 16.00 - 17.30
Team ; akbar, jhoni, fefty, aulia
Non Schedule : -
HYBRID OR
Schedule :
1. Moestika Adjie / LAA closure + cag ptca
complex 2 stent + ivus / dr. Sunu (laa + cag)., Dr.
Dafsah (ptca + ivus) / 18.30- 01.00
Team : Jhoni, akbar, aulia, fefty
1. Moestika Adjie / TEE LAA closure / dr. Ario
Non Schedule : -
Next Schedule
Wed, 23 feb 22
Thu, 24 feb 22
1. Anton parnoto / cag ptca rota ivus / dr. Dafsah /
cathlab / 18.00
Fri, 25 feb 22
Sat, 26 feb 22
Outpatient : 19
dr ario :
Dr dafsah :
dr denio : 3
21 dr faris : 5
dr DH : 6
dr DAW :
dr radityo :
Dr suko : 1
dr sunu : 2
dr Adi :
SIC (CAROL) Rabu, 23.02.22
TIPE PASIEN
DINAS
LT NAMA UNIT
EMERGENCY ROOM
EMERGENCY Dr Fajar Dr
Dr Audrey Ns
Dr Fajar Audrey Ns
ROOM, Ns Susi Nur
Tomi
PONEK Ns Rizam
Ns
GF
RADIOLOGI Ibu Arga
FL Diba + Fridha
TOTAL PASIEN EMG
Poli anak :
Poli Obgyn : 27
Ns IIn THT : 7 16
Urology :
Orthopedy : 1 Fisiotherapi : Rehab Medik : 2

LT 3
Poli Mata : 6
Poli Pediatrik
Bedah Fisotherapi:
Onkology : 2 Gizi : 2 digestive : 7
Neuro : ODC : MCU :
LT 5
LT 6
IPD LT 4
Ns Dr Yuanita
Nurul, IPD LT 4
Ns Ana, Ns Dr Yuanitha
Ns Ela Abdi IPD LT 4
IPD LT 4
Ns Dr Yuanita
Nurul, IPD LT 4
Ns Ana, Ns Dr Yuanitha
Ns Ela Abdi IPD LT 4
Ns Ellen Ns Wulan Ns Salwa
IN PATIENT
Ns Tari Ns Rio
DEPARTMENT Ns Novita Ns Rizki IPD LT 6
Lt 4, 5, 6 IPD LT 6 IPD Ns Devi
Ns LT 6 Ns Santi
Dini Ns Indah Ns Helga (ICU )
Ns Avi Ns Okta
Ns Siti Ns Agis
Ns Ahid
SOS Petugas:
GIZI Petugas :
Petugas :
PHARMACY (SB)
IT Petugas :
DANDRU : Jumlah Petugas Lantai 2 : EMG :

SECURITY, PARKIR 1
Pak Rizki R 6 orang 1.Jawadi Jawadi
TEKNISI PAk Samsul
OPERATING THEATER
Ns Sunandar
CRITICAL CARE
Dr Nilam Ns
ICU Ns Awaludin
Elga
HCU / NICU Ns Esti Ns Alfi
OBSTETRICS
Bd Dilla Bd Vicky
VK Bd Tries
Bd Anggi Bd Dewi
LT 7
Ns Nani
Ns Wiwi
Nursery Ns Ika ( M)
Ns Ika Ns Alvi
( NICU )
RUANG TUNGGU PS
CRITICAL
HEARTOLOGY
Ns Akbar
Cathlab Ns Tryanto
NNs Syaiful
Hybrid
LT 8
Ns Rini T
OPD JANTUNG
Ns Emma
AUDITORIUM
NOTED
TIPE PASIEN
KETERANGAN
RGENCY ROOM
PASIEN OBSERVASI :
RAJAL : 7
RANAP : 5
RUJUK : 0
APS : 2 ( Ingin di rawat di rumah )
PASIEN PONEK : 1
PASIEN TERKONFIRMASI Cov-19 :
TOTAL : 14

Umum : Dr. Zaki SpOT
Bedah
Syaraf :
Poli Neuro:
6
Poli Paru :
120
Lt 4 : 8 Lt 6 : 1
PASIEN OBSERVASI :
PASIEN OBSERVASI VK :
1. Ny. Filda Amalia / Febriansyah Darus, dr.
Sp.OG-KFM / G2P0A1 hamil 39 minggu 2 hari
inpartu
RENCANA TINDAKAN :
1. (Lt 4 ) Tn Anton/ Ario Soeryo, dr. SpJP (K)-
FIHA, FasCC/ Atherosclerotic heart disease / R/
tindakan CAG PTCA 2 stent complex + IVUS
Kamis 24/02/2022 jam 17.00 oleh dr. Dafsah,
Sp. Jp, rencana sore, SIO (+) anastesi lokal
2.( Lt 4 ) Ny. Dila Merdia/Mirta Hediyati
Reksodiputro, Dr. dr. Sp.THT-KL(K)/Hipertrofi
of tonsil / R/ tindakan Tonsilektomi dan reduksi
konka bilateral Kamis 24/02/2022 jam 17.00 SIO
(+) ACC (+) 3.( Lt 6
) Ny. Siti umairoh / Amanda Pitarini Utari,dr,
Rencana petscan ke MRCC Siloam tgl 24/02/22
pkl 18.30 wib
PASIEN ISTIMEWA :
1. Ny. Devi Ramesh/ Alvin Nursalim, dr. Sp. PD/

Malignant neoplasm of ovary
PASEN
1.( Lt 4 RENCANA MASUK :
) Tn Fadli Hafiz/dr.Syafrizal, Sp.
Bs / Rencana neurolysis
KETERANGAN : TOTAL ablation
PASIEN(km 403)
Pasien Lt
4 : 16 Pasien
Lt 5 : 0
Pasien Lt 6 : 15 ( 1 di VK )
Total : Pasien
MASALAH
Arwan + Rivan +
Trijaya Agung Aman, tidak ada masalah
Vira Putra Aman, tidak ada masalah
Riska Rangga Aman, tidak ada masalah
Rara Upi Aman, tidak ada masalah

Pak Jery
PKD :
1.
Ilham
1.Dede
2. Husni
ATING THEATER
1. LAMELASAR / BEDAH OBGYN - Abdominal
Hysterectomy / Nugroho Kampono,Prof. dr. SpOG (K)
Onk
2. CICIN RURUH WINEDAR / BEDAH THT -
Aurikuloplasti rekonstruksi
BEDAH THT - Harvesting Konka / Mirta Hediyati
4 Reksodiputro, Dr. dr. Sp.THT-KL(K)
3. FADHLY HAVIZ / BEDAH SARAF - Neurolysis
Ablation / Syafrizal Abubakar, dr. Sp.BS
4.
NADHIRA TAHA TALIB / Bedah heartology - 3 D
ABLATION / Faris Basalamah, Dr SpJP
RENCANA TINDAKAN : 1.
BTARI EMBUN ANANDAYU / Bedah mata- Ekstirpasi
Tumor kelopak sederhana / Adhi Wicaksono, Dr SpM
3 2. DILA MEDIA RAMADHANI /
Bedah THT - Reduksi Konka / Mirta Hedyati, Dr Sp THT
3. ORISA PARAMIGA LADISTRA / Bedah Mulut
- Odontectomy 2 gigi / Teuku Ahmad , Drg. SpBM
ITICAL CARE
0
0
PASIEN OBSERVASI :
1. Ny. Filda/ dr. Febri / G2P0A1 H 39 minggu +
2 hari inpartu kala 1 fase laten
1
PASIEN PONEK :
1. Ny. Filda/ dr. Febri / G2P0A1 H 39
minggu + 2 hari inpartu kala 1 fase laten
PASIEN OBSERVASI :
1. By Ny .Anggraini /dr.nathalia sp.A /NCB
SMK usia 2 hari
2. By. Ny. Dessy Melly / dr. Ali, Sp. A /
NCB SMK USIA 1
3. By.Ny. Nidia / dr. Ali, Sp.A / NCB SMK
USIA 1 HARI.
4. By. Ny. Ayu Madinah / dr. Ali, Sp. A /
NCB SMK USIA 17 HARI.
5. By. Ny. Marini / dr. Ali, Sp. A / NCB
SMK Usia 1 Hari.
8 6. By. Ny. Desrianti / dr. Ali, Sp.A / NCB
SMK Usia 1 HARI.
7. By. Ny. Rizki / dr. Ali, Sp. A / NCB SMK
USIA 1 HARI
8. By. Ny. Rosi / dr. Ali, Sp. A / NCB SMK
USIA 1
EARTOLOGY
21
1. NADHIRA TAHA TALIB / Bedah heartology

- 3 D ABLATION / Faris Basalamah, Dr SpJP
Next Schedule
Thu, 24 feb 22
1. Anton parnoto / cag ptca rota ivus / dr. Dafsah /
cathlab / 18.00
Fri, 25 feb 22
Sat, 26 feb 22
Outpatient : 17
dr ario : 2
Dr dafsah :
dr denio : 6
2117 dr faris : 2
dr DH :
dr DAW :
dr radityo :
Dr suko : 1
dr sunu : 2
dr Adi : 4
TIPE PASIEN
YANG DINAS
LT NAMA UNIT
EMERGENCY ROOM
dr. Dwi, Ns. dr. Fajar, Ns.

Zr. Nur, Ns.
EMERGENCY ROOM Susi, Ns.
Yuniar
Sanusi, Ns.
Ardi Tomi
GF
PONEK
TOTAL PASIEN EMG

OPD
Poli Obgyn
Cahya, Alin NS 1 :
Poli Urology
Poli Ortho
Poli Internist
Poli Bedah Umum
Poli Bedah Plastik
Poli Bedah Degestif
NS 2 :
Poli THT
Poli Gizi
Poli bedah saraf
Poli Neuro
Dermis
Dental
LT 3
Poli Endoscopy
Poli Kemotherapi
Poli Fisioterapi
Poli Psikiatri
Pain Klinick
Poli Rehab Medik
Poli Mata
Poli Nutrition
Poli Paru
Poli Mata
Poli Psikiatri
Pain Clinic
MCU
ODC
TOTAL PASIEN OPD
Trijaya
SOS Petugas
(Malam) (IGD, L.2
SB)
japar
GIZI Petugas
(Malam) (Cook)
LABORATORIUM Petugas Rizka

(Malam)
FHARMACY Petugas Ara, Nurul

(Malam)
Petugas
RADIOLOGI (Malam)
DANRU : Petugas Gading Ary S M Riyanto
SCURITY Adui (RG1 &
(Malam) (Lobby) (Lantai 2)
Nugroho IGD)
DP = Sr. DS = Br.
Nurul + Ns. Abdy + Ns
Ella + Ns. Riski + Ny. DM = Ns.
IN PATIENT
LT 4 DEPARTMENT 4
Helen Tary Salwa + Ns.
(Middle : (Middle : Wulan
Novita) Novita)
IN PATIENT
LT 5 DEPARTMENT 5
DP =Ns. DS = Ns.
Dini + Ns. Indah + Ns. DM = Ns.
IN PATIENT
Rhisa + Ns. Avi + Ns.Siti Kristin +
DEPARTMENT 6 Ade + Ns. Egis
LT 6 Ns. Octa
KOMPLAIANAN
KERUSAKAN
OPERATING THEATER
Catur,
Risyaf
LT 7 OK
CRITICAL CARE
ICU Winda,
Awal + Ita Ningsih
Ningsih
LT 7
Winda,
Awal + Ita Ningsih
Ningsih
LT 7 HCU
NICU
Lisa
PICU
TOTAL Ps CRITICAL
OBSTETRICS
‌Dines Pagi: ‌Dines Siang : ‌Dines

Bd. Anggi, bd.dilla , Bd. Malam : bd.
VK Bd. Nelly Genda Tries, bd.
Dewi
LT 7
Dines
Dinas pagi : Dines
siang :
Nursery Ns. Ika
Ns.Wiwi
malam : Ns.
Inggrid
HEARTOLOGY
Cathlab
Hybrid
LT 8
OPD JANTUNG
LT 8
Dokter Jaga
Dokter Jaga IPD : Pagi : dr. Malam :

2. Pasien Terkonfirmasi Covid 19 ada 1 pasien usia 3 tahun dari Unit IGD Isolasi, Pasien di Rujuk Ke RSU BUNDA Menten
Ambulance Brawijaya Saharjo
TIPE PASIEN
KETERANGAN
BERAT PASIEN perhatian/critical/Kemo/transfusi, Pasien Risiko/Komplen,
ERGENCY ROOM
PASIEN OBSERVASI :
RAJAL :
1. Tn. Lucky Dzulkifli /39th/ Dx. ISPA
2. Ny. Siti Mariam /29th/ Dx. Iron deficiency
anaemia + G2P1 hamil 33 minggu 4 hari JPKTH
Janin cenderung besar / infus venofer 2 ampul drip
dalam nacl 0,9% 100 ml
3. Ny. Dewi Rahmawati /34th/ Dx. Iron deficiency
anaemia + G5P4 hamil 32 minggu 1hari JPKTH /
infus venofer 2 ampul drip dalam nacl 0,9% 100 ml
4. Tn. Aritya
Pradiza /34th/ Dx. ISPA 5. Ny. Siti
Anisah /30th/ Dx. G2P1A0 hamil 30 minggu +
anemia def zat besi / Infus venofer 2x2 amp selang
minimal selang waktu 24 jam dari dosis terakhir
6. Tn. Erry
Aditya /48th/ Dx. Dyspepsia 7. Ny. Cindi
Ranotra /33th/ Dx Iron deficiency anaemia + G1
hamil 29 minggu 6 hari JPKTH / infus venofer 2
ampul drip dalam nacl 0,9% 100 ml
8. Ny. Suci
Utami /31th/ Dx. Acute nasopharyngitis
9. Tn. Albertho M Joris
/33th/ Dx. Dhiarea 10. Ny. Bokirusun
Nofiana /44th/ Dx. Dyspepsia
14 RANAP :
1. Ny. Ina Oktaviasari /53th/ Dx. Pneumonia +
Asthma + hypertension / Dpjp. Mira
Yulianti,dr, SpPD-KP / Ruang 406
2. Tn. Farchan Fachrurrezy /26th/ Dx. Fever /
3. Ny. Ngiat Djiu /74th/ Dx. Disersi AORTA /
Dpjp. Dicky Aligheri, SpBTKV (K),dr, FIHA,
FICA (Rencan Tindakan BENTAL) Pasien
Rujukan Dri RS Graha Kedoya
RUJUK :
1. An. Jordan Arsenio /3th/ Dx. Febris H ke 1
(Covid 19 Terkonfirmasi) Rujuk Ke RSU
BUNDA Menteng
APS :

Ada 1 Pasien Terkonfirmasi Covid 19
PERALATAN :
NOTE :
RAJAL :
RANAP :
PASIEN OBSERVASI :
MG 14 Pasien
OPD
Dr. Catur SpA
2 Dr. Endrika
5 Dr. Rizky SpOT
Dr. Vonty SpB
4
Dr. Keumala SpA
2
Tenaga Isoman
2
2 Tenaga Sakit
2
1
7
2
9
2
4
2
26
3
1
2
109
Rivan Indra
Tidak Ada Kendala
(L.4,5,6) (L.7,8)
Nasya
Pramusaji)

Giantara Iib Diare
(PKD Out) (PKD IN)
1.Ny. Ina Oktaviasari / dr. Mira Sp. PD -KP / Asma

2.Ny. Soen / dr. Chamim SPOG (k) Onk/ Rencana
Kemo
3.Tn. Farchan / dr. Alvin Nursalim Sp.PD/
Dispepsia
4.NY. Oriza /dr. Teuku Ahmad Arbi, drg. SpBM/
Post Odontektomy (ODC)
PASIEN OBSERVASI :
1.Ny. DRA Yeni Nuryani/ Amanda Pitarini Utari,
dr, SpPD-KGEH/ Abdominal pain
2.Ny. Dila Merdia/Mirta Hediyati Reksodiputro, Dr.
dr. Sp.THT-KL(K)/Hipertrofi of tonsil
3.Ny. Julia Maya Betsy/dr. Alvin Nursalim, Sp.
PD/GEA
4.Tn. Moestika Adjie/ dr. Sunu Budhi, Sp. Jp/ Atrial
fibrilation
5.Tn. Aryo/Nenfiati, dr. Sp.PD/DHF H-9
6.Ny. Cicin Ruruh Winedar/Mirta Hediyati
Reksodiputro, Dr. dr. Sp.THT-KL(K)/Benign
neoplasm: Skin of ear and external auricular canal
7.An. Khayran Alarik Achmad/Rifan Fauzie, dr.
Sp.A (K)/Dengue fever [classical dengue]
8.An. Khayzar Arrashad Achmad/Rifan Fauzie, dr.
9.An. Kayla Zalikha Achmad/Rifan Fauzie, dr. Sp.A
(K)/Dengue fever [classical dengue]
10. NY. Orisa /dr. Teuku Ahmad Arbi, drg. SpBM/
Post Odontektomy (ODC)
11. Tn. Farchan / dr. Alvin Nursalim Sp.PD/
Dispepsia
12. Ny. Soen / dr. Chamim SPOG (k) Onk/ Rencana
Kemo
13. Ny. Ina Oktaviasari / dr. Mira Sp. PD -KP /
Asma
13 pasien
diranap, 1 di PASIEN RENCANA MASUK :
ICU 1.Tn. Fadli Hafiz/dr.Syafrizal, Sp. Bs/Rencana
neurolysis ablation (km 403)
RENCANA TINDAKAN :
PASIEN PINDAH ICU :

1.Tn. Anton/ Ario Soeryo, dr. SpJP (K)-FIHA,
FasCC/ Atherosclerotic heart disease

1.Ny. DRA Yeni Nuryani/ Amanda Pitarini
Utari, dr, SpPD-KGEH/ Abdominal pain

1.Ny. Cicin Ruruh Winedar/Mirta Hediyati
neoplasm: Skin of ear and external auricular
canal
2.NY. Oriza /dr. Teuku Ahmad Arbi, drg.
SpBM/ Post Odontektomy (ODC)
3.Ny. Julia Maya Betsy/dr. Alvin Nursalim, Sp.
PD/GEA
PASIEN PULANG :
1.Tn. Eddy/dr. Denio, Sp. JP/Chest pain,

unspecified
2.Ny. Fala Hindun/dr. Bob Andinata, Sp. B/Ca
Payudara
3.Ny. Devi Ramesh/ Alvin Nursalim, dr. Sp.
PD/ Malignant neoplasm of ovary
4.Ny. Nadira Taha Thalib/dr. Faris Basalamah,
Sp. JP/Ventricular premature depolarization
5.Ny. Sanya Astriani/ Alvin Nursalim, dr. Sp.
PD/ dyspepsia
6.Tn. Anggi/ dr Faris basalamah/ papilation
PASIEN OBSERVASI :
PASIEN PINDAH ICU :
RENCANA TINDAKAN
PASIEN PULANG :
PASIEN OBSERVASI :
1. Ny. Siti umairoh / Amanda Pitarini Utari,dr,
Myasthenia gravis
3. Ny. Desrianti / Tirsa Verani Kembuan Oroh, dr.
SpOG / Supervision of normal pregnancy
4. Ny. Rossi / Nisa Fathoni, dr. Sp. OG, IBCLC /
5. Ny. Ayu Madinah / Nisa Fathoni, dr. Sp. OG,
IBCLC / Maternal care for disproportion of mixed
6. Ny. Lamelasari / Nugroho Kampono,Prof. dr.
SpOG (K) Onk / Malignant neoplasm of uterus, part
7. An. Adilla / Annisa Nur Aini, dr. Sp.A (FT) /
Fever, unspecified
inpartu
PASIEN PINDAH ICU :
RENCANA TINDAKAN
PASIEN VK
inpartu
PASIEN PULANG
8 pasien (7 di
ranap, 1 di 1.Ny. Nidia/dr.Nisa Fathoni,Sp.OG/ G1P0A0
VK ) hamil 38 minggu 1 hari.
2.Ny.Dessy Mellysa/ dr. Veinardi Madjid,.
Sp.OG/ G1 hamil 38-39 mgg
3.Ny. Marini / Nisa Fathoni, dr. Sp. OG,
IBCLC / Maternal care for disproportion of
mixed maternal and fetal origin
4.Ny. Rizky Ramadhani / Mohammad Haekal,
dr. Sp.OG, FICS / Supervision of normal
pregnancy
5.An. Sultan Faisal / Zicky Yombana, dr.
Sp.S / Syncope and collapse
RENCANA MASUK :

1. Ny. Desrianti / Tirsa Verani Kembuan Oroh,
dr. SpOG / Supervision of normal pregnancy
mixed
3. Ny. Lamelasari / Nugroho Kampono,Prof. dr.
SpOG (K) Onk / Malignant neoplasm of uterus,
part
4. An. Adilla / Annisa Nur Aini, dr. Sp.A (FT) /
Fever, unspecified
5. Ny. Lai Fi Sia / Denio A. Ridjab, dr. SpJP -
FIHA / Myalgi
6. Ny. Rossi / Nisa Fathoni, dr. Sp. OG, IBCLC /
THEATER
1. Ekstirpasi Tumor Kelopak Sederhana /

BTARI EMBUN ANANDAYU /Adhi
Wicaksono, dr. Sp.M / OK I 2.
Reduksi konka + onsilektomi / DILA MEDIA
RAMADHANI /Mirta Hediyati Reksodiputro,
Dr. dr. Sp.THT-KL(K) / J. 17.00 OK I
4 3. Odontectomy 2 Gigi /
ORISA PARAMIGA LADISTRA / Teuku
Ahmad Arbi, drg. SpBM / J. 21.36 OK I
4. Sectio
Caesaria / FILDA AMALIA / Febriansyah
Darus, dr. Sp.OG-KFM / J. 22.37 OK I
2. Rencana Tindakan Jum'at, 25-02-22

1. Sirkumsisi /AHMAD ATAYA ANDI PUTRA/
Vonty Elfrida, dr. Sp.B / J.11.00 OK I
2. Sirkumsisi /
MUHAMMAD FATIH ANDI PUTRA/ Vonty
Elfrida, dr. Sp.B / J. 11.30 OK I
L CARE
1 1. Ny. Ngiat djiu /74th/ Dx. DiSesik Aorta / Dpjp.

Dicky Aligheri, SpBTKV (K),dr, FIHA, FICA
0
0
0
1 Pasien
RICS
PASIEN OBSERVASI :
1 1. Ny. Filda/ dr. Febri / G2P0A1 H 39 minggu
+ 3 hari --> sc cito jam 23.00
RENCANA TINDAKAN :
PASIEN PONEK :
PASIEN OBSERVASI :
1. By. Ny. DESRIANTI RIZKI UTAMI/NCB
SMK USIA/2 HARI/dr.Ali alhadar,Sp.A
2.By. Ny. ROSI NAZRA KAMILA/NCB SMK
USIA/2 HARI/dr.Ali alhadar,Sp.A
3 3. By. Ny. FILDA AMALIA/NCB SMK USIA
1 JAM/dr. Diana, Sp.A
1. By. Ny. Ayu madinah munawaroh/NCB
SMK USIA 2HARI/dr.Ali alhadar,Sp.A
2. By.FAIZ ZAKKYBALBEID/NCB SMK
USIA 11 HARI/dr. Diana, Sp.A
PASIEN PULANG :
LOGY
24 Feb 22
CATHLAB
Schedule :
1. Anton P / ptca complex 2 stent + rota ivus / dr.
1 Dafsah / 17.00-20.35
Team : saiful, jhoni, triyanto, fefty
Non Schedule : -
HYBRID OR
Schedule : -
Non Schedule : -
Others : -
Problem : -
Overtime staf :
Staff sakit : -
Staff cuti : -
Next Schedule
Fri, 25 feb 22
Replacement CRTD / Hybrid / 16.00
2. Tn.. / Dr. Sunu / Micra AV / Hybrid /
19.00
Outpatient : 17
dr ario : 2
Dr dafsah :
dr denio : 6
dr faris : 2
dr DH :
17
dr DAW :
dr radityo :
Dr suko : 1
dr sunu : 2
dr Adi : 4
MCU : -
New patient: 5
Dr. Denio 3 : 1 dari prof. Nugroho, dari dr. Alvin,
dr. Chamim
Dr. Ario 1 : info dari kerabat
Dr. Sunu 1 : dr. Amanda, SpPD
Cancel:
ECHO : 1
Stress Echo : 1
USG Doppler : 1
Holter :
Ezypro :
ECG : 9
Treadmill :
CT Scan :
Speckle :
TEE : 1
DSE :
ABI :
Advance Echo : 2
Handle echo :
ABPM :
Tilt Table Test :
Paket PJB :
Cardioversi :
Referral Brawijaya : dr. Alvin, prof. Nugroho,

dr. Chamim
Refferal RS luar :
Dokter tidak hadir :
dr Fajar
dr Nesya, dr. Megawati
dr Nilam
i Rujuk Ke RSU BUNDA Menteng, dengan Pendamping Ns.Sanusi dengan

SIC (EKO) Jum'at, 25.02.22
TIPE PASIEN
YANG DINAS
LT NAMA UNIT
EMERGENCY ROOM
dr. Audrey,
dr. Firdha,
EMERGENCY Ns. Susi, Zr. Ns. Ardi,
Zr. Nur, Ns.
ROOM Fitri, Ns. Rizam
Sanusi
Rizam
GF
PONEK
TOTAL PASIEN EMG

OPD
Poli Obgyn
Cahya, Alin NS 1 :
Poli Urology
Poli Ortho
Poli Internist
Poli Bedah Umum
Poli Bedah Plastik
Poli Bedah Degestif
NS 2 :
Poli THT
Poli Gizi
Poli bedah saraf
Poli Neuro
Dermis
Dental
LT 3
Poli Endoscopy
Poli Kemotherapi
Poli Fisioterapi
Poli Psikiatri
Pain Klinick
Poli Rehab Medik
Poli Mata
Poli Nutrition
Poli Paru
Poli Mata
Poli Psikiatri
Pain Clinic
MCU
ODC
TOTAL PASIEN OPD
Trijaya
SOS Petugas
(Malam) (IGD, L.2
SB)
japar
GIZI Petugas
(Malam) (Cook)
LABORATORIUM Petugas Rizka

(Malam)
FHARMACY Petugas Nurul

(Malam)
Petugas
RADIOLOGI (Malam)
Sarah

SCURITY
Adui (RG1 &
(Malam) (Lobby) (Lantai 2)
Nugroho IGD)
DS = Br.
DP = Sr.
Taufik + Ns.
Nurul + Ns. DM = Ns.
IN PATIENT Riski + Ns.
LT 4 DEPARTMENT 4
Ana + Ns.
Tary + Ns.
Wulan + Ns.
Novita + Ella
Helen
IN PATIENT
LT 5 DEPARTMENT 5
DS = Ns. DM = Ns.
DP =Ns.
Avi +
IN PATIENT Dini + Ns. Kristin +
Bd.Ade +
DEPARTMENT 6 Rhisa+ Ns.
Ns. Egis Ns. Octa +
LT 6 Ns. Indah
KOMPLAIANAN
KERUSAKAN
OPERATING THEATER
Yohana
LT 7 OK
CRITICAL CARE
ICU
Awal + Ita Helga Winda
LT 7 HCU
NICU
Evi Lisa
PICU
TOTAL Ps CRITICAL
OBSTETRICS

‌Dines
bd. Dewi Siang :
Malam : bd.
VK Middle : bd. bd.viki , bd.
Dilla, bd.
Viki Nelly
genda
LT 7
Dinas
Dines siang Dines
pagi : Ns.
Nursery Wiwi
: Ns.Wiwi malam :
Ns. Inggrid
HEARTOLOGY
Cathlab
Hybrid
LT 8
OPD JANTUNG
LT 8
Dokter Jaga
Dokter Jaga IGD : Pagi : dr dr. Audrey Malam :
Pagi : dr. Rona, dr.
Dokter Jaga IPD : Yunitha Malam :
Dokter Jaga Critical : Pagi : dr Riri Malam :

TOTAL
BERAT PASIEN
ERGENCY ROOM
PASIEN OBSERVASI :
RAJAL :
1. Tn. David Dahler /36th/ Dx. Fever + Myalgia
2. Ny. Yulinar /77th/ Dx. Urinary tract infection
3. Nn.
Bella Ariandini /24th/ Dx. Dyspepsia 4. An.
Jovanka Juliana /12th/ Dx. Coronavirus infection
5. Ny.
Sondang Yohanna /42th/ Dx. Coronavirus
infection
6. Ny. Nike Nur Rizkui /30th/ Dx. Varicella
7. Ny. Lora Mona /28th/ Dx. Other nail disorders
8. Ny. Afrin
Dwimeyriana /27th/ Dx. Dyspepsia 9. Nn. Risma
Gaatri /28th/ Dx. Dyspepsia 10. Ny.
Yulinar /77th/ Dx. Urinary tract infection (Dtng
ke IGD yg Ke 2 ) 11. Tn. Rizki
Mahadi /32th/ Dx. Dyspepsia 12. Ny.
Yunita Soediyono /46th/ Dx. Malayse
13
RANAP :
1. Ny. Nurdewan Siregar /85th/ Dx. Stroek /
Dpjp. dr. Arif, Sp.S / Ruang 409 (Penolakan
Rawat HCU) Status Pasien DNR untuk
Form Tertandatangani
RUJUK :
APS :
PERALATAN :
NOTE :
RAJAL :
1. Ny. Indah Dayanti /25th/ Dx. G4P2A1
hamil 39 minggu JPKTH, Riwayat -->
Spontan 2x, Mola 1x / (keluhan sudah
merasakan mules/kencang-kencang)
RANAP :
1. Ny. isda Putri /28th/ Dx. G2P1A0 H 37
2 Minggu 6 Hari, JPKTH Inpartu kala 1 fase
laten, Kel. keluhan kenceng - kenceng dari
kemarin , lebih intens sejak siang ini pukul
13:00 WIB / Dpjp. Febriansyah Darus, dr.
Sp.OG-KFM / (Per 6 jamObservasi His
DJJ - Pantau Kemajuan persalinan)
PASIEN OBSERVASI :
MG 15 Pasien
OPD
3 Dr. Zaki SpOT
Dr. Akbari SpU
1 Dr. Wisanti SpTHT
Dr. Zicky SpS
11
Tenaga Isoman
2
6
4
23
1
1
2
90
Rivan Indra
Tidak Ada Kendala
(L.4,5,6) (L.7,8)
Nasya

Pramusaji)
Zefika Tidak ada maslah & Kendala
Giantara Iib Diare

(PKD Out) (PKD IN)
1.Ny. Susama Djohan/ Prof. Nugroho Kampono

SpOG/ Rencana Kemo
2.Ny. Marlina / dr. Bob Andinata Sp.B (k)Onk /
Post Kemo
3.Ny. Teti Savitri/ dr. Chamim SPOG (k) Onk/
Endometriosis Of Uterus
4.Ny. Sarah Dinna / dr. Wisanti Sp.THT/ Chronic
PASIEN OBSERVASI :
1.Tn. Suhando Tjuntoro/ dr. Sunu Budhi, Sp. Jp/
Post Micra AV
2.Ny. Ina Oktaviasari / dr. Mira Sp. PD -KP /
Asma
Dispepsia
5.An. Khayzar Arrashad Achmad/Rifan Fauzie,
dr. Sp.A (K)/Dengue fever [classical dengue]
6.An. Kayla Zalikha Achmad/Rifan Fauzie, dr.
7.Ny. Soen / dr. Chamim SPOG (k) Onk/ Post
Kemo
8.Ny. Marlina / dr. Bob Andinata Sp.B (k)Onk /
Post Kemo
9.Ny. Susama Djohan/ Prof. Nugroho Kampono
SpOG/ Rencana Kemo
Endometriosis Of Uterus
11.Ny. Sarah Dinna / dr. Wisanti Sp.THT/
Chronic

1.Tn. Fadli Hafiz/dr.Syafrizal, Sp.
Bs/Rencana neurolysis ablation (km 403)
11 pasien
diranap, 1 di RENCANA TINDAKAN :
ICU
1.Ny. Sarah Dinna / dr. Wisanti Sp.THT/
Chronic. Rencana tindakan Antrotomi
Intranasal (FESS) besok 26/02/2022 Jam 17.00
Endometriosis Of Uterus. Rencana tindakan
Adhesiolysis Severe dan Hysterectomy
Laparascopy besok 26/02/2022 Jam 12.00
PASIEN PINDAH ICU :

1.Tn. Anton/ Ario Soeryo, dr. SpJP (K)-FIHA,
FasCC/ Atherosclerotic heart disease
PASIEN PULANG :
1.Tn. Moestika Adjie/ dr. Sunu Budhi, Sp.
Jp/ Atrial fibrilation
2.NY. Orisa /dr. Teuku Ahmad Arbi, drg.
SpBM/ Post Odontektomy (ODC)
Ny. Cicin Ruruh Winedar/Mirta Hediyati
neoplasm: Skin of ear and external auricular
canal
4.Ny. Dila Merdia/Mirta Hediyati
Reksodiputro, Dr. dr.
Sp.THT-KL(K)/Hipertrofi of tonsil
5.Ny. Julia Maya Betsy/dr. Alvin Nursalim,
Sp. PD/GEA
6.Ny. DRA Yeni Nuryani/ Amanda Pitarini
Utari, dr, SpPD-KGEH/ Abdominal pain
PASIEN OBSERVASI :
PASIEN PINDAH ICU :
RENCANA TINDAKAN
PASIEN PULANG :

1. An.GAVIN RAIHAN AIZADILA / Yonas
Hutasoit, dr. Sp.U / Urethral fistula
2. Tn. Ardi winarko / Dicky Armein Hanafy,
dr. SpJP - FIHA, FAsCC / Atrial fibrillation
and flutter
3. Ny. MISDA PUTRI / Febriansyah Darus,
dr. Sp.OG-KFM / Supervision of normal
pregnancy
PASIEN OBSERVASI :

Myasthenia gravis
mixed
inpartu
Hutasoit, dr. Sp.U / Urethral fistula
6. Tn. Ardi winarko / Dicky Armein Hanafy, dr.
SpJP - FIHA, FAsCC / Atrial fibrillation and
flutter
7. Ny. MISDA PUTRI / Febriansyah Darus, dr.
Sp.OG-KFM / Supervision of normal pregnancy
PASIEN PINDAH ICU :

7
RENCANA TINDAKAN
Hutasoit, dr. Sp.U / Urethral fistula / R/
UDT ( Undescended Testis)/Orkidopexi 26
February 2022 12:00
PASIEN VK
PASIEN PULANG
1. Ny. Desrianti / Tirsa Verani Kembuan
Oroh, dr. SpOG / Supervision of normal
pregnancy
2. Ny. Rossi / Nisa Fathoni, dr. Sp. OG,
3. Ny. Lamelasari / Nugroho Kampono,Prof.
dr. SpOG (K) Onk / Malignant neoplasm of
uterus,
4. An. Adilla / Annisa Nur Aini, dr. Sp.A
(FT) / Fever, unspecified
RENCANA MASUK :

1. Ny. Ayu Madinah / Nisa Fathoni, dr. Sp.
OG, IBCLC / Maternal care for disproportion
of mixed
THEATER
1. Tindakan Jum'at, 25-02-22
1. Sirkumsisi /AHMAD ATAYA ANDI
PUTRA/ Vonty Elfrida, dr. Sp.B / J.11.00
OK I
2
2. Sirkumsisi / MUHAMMAD
FATIH ANDI PUTRA/ Vonty Elfrida, dr.
Sp.B / J. 11.30 OK I

1.Repair Fistula Uretra /GAVIN RAIHAN
AIZADILA / Yonas Hutasoit, dr. Sp.U / J.12.00
OK I
2. Hysterectomy Laparoscopy / TETI
SAVITRI / Chamim,DR. dr, SpOG (K) Onk / J.
12.00 OK I I
3. Antrotomi intranasal (FESS) / SARAH
DINNA OCTAVIANA / Wisanti, dr. Sp.THT-
KL / J. 17.00 OK I
L CARE
1.Tn. Anton /69th/ Dpjp. Ario Soeryo, dr. SpJP
1 (K)-FIHA, FasCC/ Dx. CHF Low EF CAD 3
VD, Efusi Pleura, DM tipe 2, Akut On CKD,
Kista Ginjal Kanan (HBSAG +)
0
0
0
1 Pasien
RICS
PASIEN OBSERVASI :
1 1. Ny. Misda/ dr. Febri / G2P1A0 H 39

minggu --> lahir spontan jam 23.50
RENCANA TINDAKAN :
PASIEN PONEK :
1. Ny indah/ dr noela (cuti) --> dr haekal /
2 G4P2A1 hamil 39 minggu --> pulang
2. 1. Ny. Misda/ dr. Febri / G2P1A0 H 39
minggu
PASIEN OBSERVASI :
1. By. Ny. FILDA AMALIA/NCB SMK
USIA 1 hari/dr. Diana, Sp.A
2 2. By. Ny. MISDA PUTRI/NCB SMK USIA
1 Jam/dr. Mira, SpA
1. By. Ny. Ayu madinah munawaroh/NCB
SMK USIA 3 HARI/dr.Ali alhadar,Sp.A
2. By.FAIZ ZAKKYBALBEID/NCB SMK
2
USIA 12 HARI/dr. Diana, Sp.A
PASIEN PULANG :
LOGY
25 Feb 22
CATHLAB
Schedule :
1 1. Suhando / Micra AV / dr. Sunu / 18.30-21.00
Team : Jhoni, saiful, triyanto, aulia
Non Schedule : -
HYBRID OR
Schedule :
1. Ardi / replace crtd / dr. Dicky hanafy /
16.00-17.30
Team : Jhoni, saiful, fefty, aulia, triyanto
Non Schedule : -
1 Others : -
Problem : -
Overtime staf :
Staff sakit : -
Staff cuti : -
Next Schedule
-
Daily Census OPD cardiac 25 Februari
2022
Outpatient : 13
dr ario :
Dr dafsah :
dr denio : 5
dr faris :
dr DH : 2
dr DAW :
dr radityo :
Dr suko :
13 dr sunu :
dr Adi : 6
MCU : -
New patient: 5
Dr. Adi 1 : pasien dr. Adi di RS Mandaya
Dr. Denio 4 : 2 dr. Website, 1 dari
kerabat, 1 dr. Rony
Cancel: 2
Dr. Adi : 1
Dr. Denio : 1

ECHO :
Stress Echo :
USG Doppler : 2
Holter : 1
Ezypro :
ECG : 9
Treadmill : 1
CT Scan :
Speckle :
TEE :
DSE :
ABI : 1
Advance Echo : 2
Handle echo :
ABPM :
Tilt Table Test :
Paket PJB :
Cardioversi :
Referral Brawijaya : dr. Rony

Refferal RS luar :
Dokter tidak hadir :
dr Firdha
dr Mega
dr Dewi
SIC (CAROL) SABTU, 26.02.22
TIPE PASIEN
YANG DINAS
LT NAMA UNIT
EMERGENCY ROOM
EMERGENCY Dr Hanif Ns
Dr Audrey Dr Hanif Ns
ROOM, Ns Susi Rizam
Ardi Ns
PONEK Nur
GF
RADIOLOGI Ibu Arga
FL Novi Nur
TOTAL PASIEN EMG
Poli anak :
Poli Obgyn : 35
Ns IIn THT : 2 48
Urology : 2
Rehab Medik :
11
LT 3
Poli Mata : 6
Poli Pediatrik
Bedah Fisotherapi:
Onkology : Gizi : digestive : 3
5 LT 6
LT 4 LT
5 LT 6
IPD LT 4 Dr Rona
IPD LT 4
Dr Rona IPD
Ns Taufik
LT 4 Ns
Ns Nurul Ns Rio Ns
Tary Ns
IN PATIENT
Ns Ana Ns Risky Ela
DEPARTMENT
Lt 4, 5, 6 Nadia IPD LT 6
IPD LT 6
IPD LT 6 Ns Avi Ns Indah
Ns
Ns Silvi Ns Ade
Devi Ns Ns Avid
Santi
Indra
SOS Petugas:
Trijaya
GIZI Petugas : Vira

LABORATORIUM Petugas : Risa
Petugas :
PHARMACY (SB) Rara
IT Petugas :
PKD :
DANDRU : Jumlah Lantai 2 : EMG : 1.
SECURITY, PARKIR Pak Petugas 6 1. Heri 1. Novan 2.
Wibi orang Pasande Firliyano Hafif H
TEKNISI PAk Samsul

OPERATING THEATER
Ns Sunandar
CRITICAL CARE
Dr Nilam
ICU Ns Awaludin
Ns Esti P
LT 7
HCU / NICU Ns Esti Ns Evi
OBSTETRICS
Bd Viky Bd Bd Dilla Bd
VK Bd Viky
Nelly Genda
Nursery Ns Ika Ns Nani Ns Wiwi
RUANG TUNGGU PS
CRITICAL
HEARTOLOGY
Ns Akbar
Cathlab Ns Tryanto
NNs Syaiful
Hybrid
LT 8
Ns Rini T
OPD JANTUNG
Ns Emma
AUDITORIUM
NOTED
TIPE PASIEN
KETERANGAN
perhatian/critical/Kemo/transfusi, Pasien Risiko/Komplen,
NCY ROOM
PASIEN OBSERVASI :
RAJAL : 12
RANAP : 4
RUJUK : 0
APS :
PASIEN PONEK : 0
PASIEN TERKONFIRMASI COV - 19 : 1
TOTAL : 16

Umum : 2 Dr. Nyoto, SpPD
Dr. Indah Gianawati, SpPD
Dr. Fransisca Noela SpOG
Bedah Dr. Nina SpA
Syaraf :
Dr. Perwira SpB-KBD
Dr. Nenfiati SpPD
Dr. Syafrizal SpBS
Poli Neuro: 1 Dr. Vincent SpM
Dr. Etty SpM
Poli Paru : 1 Dr. Keumala SpA
Drg. Tri Julianti SpKGA
147
Lt 4 : 3 Lt 6 : 2
PASIEN OBSERVASI :
1. ( Lt 4 ) Tn. Suhando Tjuntoro/ dr. Sunu Budhi, Sp.
Jp/ Post Micra AV
2. ( Lt 4 ) 10.Tn. Galih Adityas Permana/
Alvin Nursalim, dr. SpPD/ Dengue Fever H-4
3. ( Lt 6 ) Tn . William /
Zicky Yombana, dr. Sp.S / Myasthenia gravis
4. ( Lt 6 ) Ny.
Syaqqila / Dengue Fever / Dr Mira SpA
PASIEN OBSERVASI VK :
RENCANA TINDAKAN :
1. ( Lt 4 ) Ny Isgiwati / Bacterial pneumonia / Dr

Alvin Nursalim / Suspek Cholelitiasis / Rencana
tindakan USG bedside by Dr Alvin SpPd / Tgl
27.02.22 2. ( Lt 4 ) Tn Galih
AAdytas Permana / Dengue Fever / Dr Alvin
Nursalim SpPD / Peningkatan liver Enzim / Rencana
USG bedside / Tgl 27.02.22 By Dr Alvin SpPD
PASIEN ISTIMEWA :
PASEN RENCANA MASUK :
1. Tn Fadli Hafiz/dr.Syafrizal, Sp. Bs/Rencana

neurolysis ablation (km 403)
KETERANGAN :
Pasien Lt 4 : 12 pasien
Pasien Lt 5 : 0
Pasien
Lt 6 : 7 pasien
Total : Pasien
MASALAH
Rivan Aman, tidak ada masalah

Riyan Aman, tidak ada masalah
Upi Aman, tidak ada masalah

Pak Jery

1.Hamka
G THEATER
1. TETI SAVITRI /BEDAH OBGYN - Adhesiolysis

Severe
BEDAH OBGYN - Hysterectomy Laparoscopy /
Chamim,DR. dr, SpOG (K) Onk 2.
GAVIN RAIHAN AIZADILA / BEDAH PEDIATRIC -
3 UDT ( Undescended Testis)/Orkidopexi
BEDAH UROLOGY - Repair Fistula Uretra / Yonas
Hutasoit, dr. Sp.U 3. SARAH
DINNA OCTAVIANA / BEDAH THT - Antrotomi
intranasal (FESS) / Wisanti, dr. Sp.THT-KL
RENCANA TINDAKAN :
AL CARE
0
0
PASIEN OBSERVASI :
0
PASIEN PONEK :
PASIEN OBSERVASI :
1. By. Ny. FILDA AMALIA/NCB SMK USIA 2
hari/dr. Diana, Sp.A
2. By. Ny. MISDA PUTRI/NCB SMK USIA 1
hari/dr. Mira, SpA

TOLOGY
21

Outpatient : 10
dr ario
Dr dafsah :
dr denio :
dr faris :
2117 dr DH : 7
dr DAW :
dr radityo :
Dr suko : 3
dr sunu :
dr Adi :
SIC (CAROL) MINGGU, 27.02.22
TIPE PASIEN
YANG DINAS
LT NAMA UNIT
EMERGENCY ROOM
EMERGENCY Dr Fajar Dr Fajar Dr Audrey

ROOM, Ns Sanusi Dr Audrey Ns Ardhi Ns
PONEK Ns Tomi Ns Kelvin Fitri
GF
RADIOLOGI Midah
FL Novi Firdha
TOTAL PASIEN EMG
Poli anak :
Poli Obgyn : 3
Ns IIn THT : 4
Urology :
Poli Internist: Dental :
Rehab
Fisiotherapi :
LT 3 Orthopedy : Medik :
Poli Pediatrik Poli Mata :
Bedah
Onkology : Gizi : digestive :
Fisotherapi:
Dermis : Psikiatri :
Neuro : ODC : MCU :
5 LT 6
LT 4 LT
5 LT 6
IPD LT 4
Dr Yuanita
Dr
Megawati
Ns IPD LT Dr Yuanita
Taufik Ns 4 Ns Dr Megawati
Nadia Salwa Ns IPD LT 4
IN PATIENT
Ns Novita Hellen Ns Ns Tary
DEPARTMENT
Rio Ns Abdi
Lt 4, 5, 6
IPD LT 6 IPD LT 6
Ns IPD LT 6 Ns Risha
Devi Ns Avi Ns Ade
Ns Silvi
Ns Santi Ns Ahid
NsEgis
Indra
SOS Petugas:
Trijaya
GIZI Petugas : Vira
LABORATORIUM Petugas : Risa
Petugas :
PHARMACY (SB) Rara
IT Petugas :
PKD :
DANDRU : Jumlah EMG : 1.
Lantai 2 :
SECURITY, PARKIR Pak Petugas 6 1. Novan 2.
Wibi orang 1. Hery P Firlyano Hafif H
TEKNISI PAk Samsul

OPERATING THEATER
Ns Sunandar
OK Ns
Heryanti
CRITICAL CARE
Dr Nilam
ICU / HCU Ns Awaludin
Ns Esti P
PICU / NICU Ns Esti Ns Evi
OBSTETRICS
Bd Viky Bd Ningsih
VK Bd Tries
Bd Nelly Bd Genda
LT 7
Nursery Ns Ika Ns Nani Ns Inggrid
RUANG TUNGGU PS
CRITICAL
HEARTOLOGY
Ns Akbar
Cathlab Ns Tryanto
Hybrid
LT 8
LT 8
Ns Rini T
OPD JANTUNG Ns
Emma
AUDITORIUM
NOTED
TIPE PASIEN
KETERANGAN
NCY ROOM
RAJAL : 12
RANAP : 6
RUJUK : 0
APS : 0
PASIEN PONEK :
1) Ny. Indah/ dr haekal/ G4P2A1 hamil
40 minggu inpartu kala 1 FL, JPKTH / artus
di EMG jam 04.37 wib
( Di tolong Oleh Dr Doni SPOG )
TOTAL : 18
Bedah
Umum :
Bedah
Syaraf :
Poli Neuro:
Poli Paru :
7
Lt 4 : 1 Lt 6 : 2
PASIEN OBSERVASI :
1. (Lt 6 )Ny.Yiyin / dr.Nisa Fathoni,Sp.OG /
2. ( Lt 6 ) Tn . William / Zicky Yombana, dr.
3. ( Lt 6 ) Ny. Indah/ dr haekal/ G4P2A1
hamil 40 minggu inpartu kala 1 FL, JPKTH
4. ( Lt 4 ) Tn. Arief Oesman/ Amanda
Pitarini, dr. SpPD/ DHF H-4
5. ( Lt 4 ) An. Khayran Alarik
Achmad/Rifan Fauzie, dr. Sp.A (K)/Dengue fever
H-6
PASIEN OBSERVASI PICU :

1.An. SYAQILLA ANZALA FADILLAH / Mira
Febriani Inkiriwang,dr. SpA / Dengue fever /
Masuk PICU jam 22.00 wib
RENCANA TINDAKAN :
PASIEN MENINGGAL :
1.( Lt 4 ) Ny. Nurdewan Siregar/ Arief, dr. SpS/
Stroke / + jam 22.11 wib
Pasien Lt 5 : 0
Total
: Pasien
MASALAH
Rivan Aman, tidak ada masalah
Riyan Aman, tidak ada masalah
Upi Aman, tidak ada masalah

Pak Jery
1.Hamka
G THEATER
RENCANA TINDAKAN :
AL CARE
0
1 1. By. Syaqqila / Dengue Fever / Dr Mira SpA
PASIEN OBSERVASI :
1. Ny. Yiyin/dr Nisa/ G4P2A1 hamil 39 minggu 4

hari inpartu kala 1 FL , JPKTH
2 2. Ny. Indah/ dr haekal/ G4P2A1 hamil 40
minggu inpartu kala 1 FL, JPKTH
PASIEN PONEK :
1. Ny. Yiyin/dr Nisa/ G4P2A1 hamil 39
minggu 4 hari inpartu kala 1 FL , JPKTH
2. Ny. Indah/ dr haekal/ G4P2A1 hamil 40
( Partus di EMG jam 04.37 wib )
PASIEN OBSERVASI :
1. By Ny. MISDA PUTRI/NCB SMK USIA 2
hari/dr. Mira, SpA
2 2. By Ny. Indah/ dr haekal/ G4P2A1 hamil 40
OLOGY
TIPE PASIEN
YANG DINAS
LT NAMA UNIT
EMERGENCY ROOM
dr. Fajar, dr. Hanif,

EMERGENCY Br. Mohlis,
Ns. Kelvin, Ns. Rizam,
ROOM Ns. Tomi
Ns. Yuni
Zr. Fitri
GF
PONEK
PONEK
TOTAL PASIEN EMG

OPD
Poli Obgyn
Cahya, Alin NS 1 :
Poli Urology
Poli Ortho
Poli Internist
Poli Bedah Umum
Poli Bedah Plastik
Poli Bedah Degestif
NS 2 :
Poli THT
Poli Gizi
Poli bedah saraf
Poli Neuro
Dermis
Dental
LT 3
Poli Endoscopy
Poli Kemotherapi
Poli Fisioterapi
Poli Psikiatri
Pain Klinick
Poli Rehab Medik
Poli Mata
Poli Nutrition
Poli Paru
Poli Mata
Poli Psikiatri
Pain Clinic
MCU
ODC
TOTAL PASIEN OPD
Trijaya
SOS Petugas
(Malam) (IGD, L.2
SB)
japar
GIZI Petugas
(Malam) (Cook)
LABORATORIUM Petugas Wahyu
(Malam)
FHARMACY Petugas Nurul

(Malam)
Petugas
RADIOLOGI (Malam)
Ade
DANRU : Petugas Jawadi Dede Rigen
SCURITY (RG1 &
Rizky (Malam) (Lobby) (Lantai 2)
IGD)
DP = Bd DS = Ns.
santi+ Ns Salwa + Ns DM =Br
IN PATIENT
LT 4 DEPARTMENT 4
Hellen+ Ns Rizki + Br. Taufik+ Ns
Novita Rio Nadya
IN PATIENT
LT 5 DEPARTMENT 5
DS = Ns.
DP =Ns. DM = Ns.
Avi + Ns.
DS = Ns.
DP =Ns. DM = Ns.
Avi + Ns.
IN PATIENT Devi+
siti+ Risha+ Ns.
DEPARTMENT 6 Ns.Egis
Ns.Okta
LT 6 Silvi
KOMPLAIANAN
KERUSAKAN
OPERATING THEATER
Catur
LT 7 OK
CRITICAL CARE
ICU
Helga Ita
LT 7
Helga Ita
HCU
NICU
LT 7 Esty Alfy Ayu
PICU
TOTAL Ps
CRITICAL
OBSTETRICS
‌Dines
‌Dines
‌Dines Pagi: Siang : Bd
Malam :
VK Bd. Tries Viki , Bd.
Bd. Anggi,
Dewi
Bd. Dilla
LT 7
Dinas
Dines siang Dines
pagi : Ns.
Nursery Ika
: Ns.Nani malam :
Ns. Inggrid
HEARTOLOGY
Cathlab
Hybrid
LT 8 OPD JANTUNG
Dokter Jaga
Dokter Jaga IPD : Pagi : dr. Neysa Malam :
Dokter Jaga Critical : Pagi : dr Malam :

2. Pasien Terkonfirmasi Covid 19 ada 1 pasien usia 4 tahun dari Unit IGD Isolasi, Keluarga Memilih Untuk ISOMAN
TOTAL
BERAT PASIEN
akan dilakukan)
ERGENCY ROOM
PASIEN OBSERVASI :
RAJAL :
1. Ny. Salami /75th/ Dx. Malaise
2. Nn. Resi /30th/ Dx. Post Covid
3. An. Gianara /3th/ Dx. Open Wound
4. Ny. Sita Hapsari /28th/ Dx. Abdominal Pain
5. By. Mafaza Aliyah /0th/ Dx. Fever
6. An. Maryama /4th/ Dx/ Fever H4
7. Tn. Edy Sulistyo /37th/ Dx. Dhiare
8. Ny. Isnaini Kharida /30th/ Dx. Candidiasis
9. An. Aldrin Khalif /4th/ Dx. Of Febris H2 (covid
19 terkonfirmasi) 10. Nn.
Bulan Ramadhan /25th/Dx. Dyspepsia 11. Ny.
Farida /26th/ Dx. Dyspepsia
RANAP :
1. Ny. Darda Nella /60th/ Dx. Stroek Non
Hemoragic / Dpjp. dr. Ziki, Sp.S
14 2. An. Abidzar Al Ghifa /1th/ Dx. MISC /
Dpjp. 3.
Tn. Azwir Markatin /84th/ Dx. Ht Urgency /
Dpjp. dr. Ziki, Sp. S
RUJUK :
APS :
1. An. Aldrin Khalif /4th/ Dx. Of Febris H2
rawat di rmh
1. An. Aldrin Khalif /4th/ Dx. Of Febris H2

(Covid 19 Terkonfirmasi)
PERALATAN :
NOTE :
RAJAL :
RANAP :
PASIEN OBSERVASI :
EMG 14 Pasien
OPD
Arwan Indra
Tidak Ada Kendala
(L.4,5,6) (L.7,8)
Heru
Pramusaji)
Rangga Tidak ada maslah & Kendala
Dina Tidak ada masalah & Kendala

Ilham Husni
(PKD Out) (PKD IN)
1.Tn. Azwir Markatin/ Zicky Yombana, dr. Sp. S/

HT urgency+ Dm
2.Ny. Darda Nella/ Zicky Yombana, dr. Sp. S/
Stroke Heamoragic
3.An. Abidzar Al Ghaifari/ Annisa, dr. Sp. A/
fever
4.Tn. KPH Sapardi/ Nefiati, dr. Sp. PD/ Diabetes
Mellitus non- insulin
5.Tn. Azwir Markatin/ Zicky Yombana, dr. Sp. S/
HT urgency+ Dm
PASIEN OBSERVASI :
1.Tn. Farchan / dr. Alvin Nursalim Sp.PD/ DHF

H-4
Sp.A (K)/Dengue fever H-6
3.Tn. Anton Partono/ Ario Soeryo, dr. SpJP (K)-
FIHA, FasCC/ Atherosclerotic heart disease
4.Tn. Galih Adityas Permana/ Alvin Nursalim, dr.
SpPD/ Dengue Fever H-4
5.Tn. Arief Oesman/ Amanda Pitarini, dr. SpPD/
DHF H-4
6.Nn. Kireina Laima/ Carolina Supit, dr. SpB/
Other and unspecified abdominal pain
7.Ny. Darda Nella/ Zicky Yombana, dr. Sp. S/
Stroke Heamoragic
8.An. Abidzar Al Ghaifari/ Annisa, dr. Sp. A/
fever
9.Tn. KPH Sapardi/ Nefiati, dr. Sp. PD/ Diabetes
10
Mellitus non- insulin
10.Tn. Azwir Markatin/ Zicky Yombana, dr. Sp.
S/ HT urgency+ Dm

1.Tn Hio Cio Sleng /dr mirta/ R/ tindakan
politektomi rekonstruksi konka bilateral
RENCANA TINDAKAN :
PASIEN PINDAH ICU :

1.Tn. Anton Partono/ Ario Soeryo, dr. SpJP
(K)-FIHA, FasCC/ Atherosclerotic heart
disease
PASIEN PULANG :
1.Ny. Teti Savitri/ dr. Chamim SPOG (k)

Onk/ Post Adhesiolysis Severe dan
Hysterectomy Laparoscopy
2.Ny. Isgiwati/ Alvin Nursalim, dr. SpPD/
Bacterial pneumonia, Unspecified
PASIEN OBSERVASI :
PASIEN PINDAH ICU :
RENCANA TINDAKAN
PASIEN PULANG :
PASIEN OBSERVASI :
2. Tn.William / Zicky Yombana, dr. Sp.S /
Myasthenia gravis
3. An.Gavin raihan aizadilla / Yonas Hutasoit, dr.
Sp.U / Urethral fistula
4. Ny.Yiyin / dr.Nisa Fathoni,Sp.OG / G4P2A1
hamil 38 minggu/ post partum
5. Ny.Indah Dayanti/ dr.Mohammad
haekal,Sp.OG/ Post Partum P3 1 jam
PASIEN PINDAH PICU :

1. An. Syaqilla Anzala Fadillah / Mira Febriani
Inkiriwang,dr. SpA / Dengue fever
6
RENCANA TINDAKAN
PASIEN VK
PASIEN PULANG
1. Ny. Misda Putri / Febriansyah Darus, dr.

Sp.OG-KFM / Supervision of normal
pregnancy
2. Ny. Putri Pratama / Taufik Jamaan, Dr.dr.
Sp.OG / G5P4A0 hamil usia 10 minggu
RENCANA MASUK :
THEATER
0
2. Rencana Tindakan Selasa 01-03-22

1.FESS / dr Mirtha / a.n Tn. Hio Sioeng / Jam
15.00
L CARE
0
0
0
1. An. Syaqilla Anzala Fadillah / Dx. DSS
Febris Hri ke 4, DHF Grade 3 dr. Tarlita
1 Sp.A
1 Pasien
TRICS
PASIEN OBSERVASI :
1 1) Ny. Yiyin/dr Nisa,spog/ G4P2A1 hamil 39

minggu 5 hari. Partus jam 16.05
RENCANA TINDAKAN :
PASIEN PONEK :
PASIEN OBSERVASI :
1.By.ny.indah dayanti darwis/NCB SMK
2 Usia 2 hari/dr.tartila
2. By.ny yiyin/ NCB SMK Usia 1hari/dr.
Keumala
PASIEN PULANG :
OLOGY
dr Hanif
dr Mega, dr. Faisal
dr Dewi
arga Memilih Untuk ISOMAN
SIC (DILLA) Selasa, 02.03.22
TIPE PASIEN
DINAS
LT NAMA UNIT
EMERGENCY ROOM
dr Dwi dr. Mega, Ns.

EMERGENCY
Ns. Susi, Zr. Ns. Ardi, Br. Mohlis Kelvin, Ns.
ROOM Nur Tomi
GF
PONEK
TOTAL PASIEN EMG

OPD
Poli Obgyn
Poli Onkology NS 1 : NS 1 :
Poli Urology
Poli Ortho
Poli Internist
Poli Bedah Umum
Poli Bedah Plastik
Poli Bedah Degestif
NS 2 :
Poli THT
Poli Gizi
Poli bedah saraf
Poli Neuro
Dermis
Dental
LT 3
Poli Endoscopy
Poli Kemotherapi
Poli Fisioterapi
Poli Psikiatri
Pain Klinick
Poli Rehab Medik
Poli Mata
Poli Nutrition
Poli Paru
Poli Mata
Poli Psikiatri
Pain Clinic
MCU
ODC
TOTAL PASIEN OPD

Tirjaya
SOS Petugas
(Malam) (IGD, L.2
SB)
Japar
GIZI Petugas
(Malam) (Cook)
LABORATORIUM Petugas Anin

(Malam)
FHARMACY Petugas Bulan

(Malam)
Petugas
RADIOLOGI (Malam)
Hamidah

SCURITY
(RG1 &
Rizky (Malam) (Lobby) (Lantai 2)
IGD)
IN PATIENT
LT 4 DEPARTMENT 4
IN PATIENT
LT 5 DEPARTMENT 5
DP
DS DM
Ns Dini, Ns
Ns Indah
IN PATIENT Afi, Ns Devi
Br Ahid
DEPARTMENT 6 Br Malik,
Ns Okta Ns Santi
LT 6 Ns Mutia Ns Siti
KOMPLAIANAN
KERUSAKAN
OPERATING THEATER
Ns Yanti Ns Heri
Ns Yohana
Ns Catur Ns Iqbal
LT 7 OK
CRITICAL CARE
ICU Ns Gisma,
Ns. Ning Ns Winda
HCU Ns Awal
NICU
LT 7 Ns. Esty N Ns Esti P
Ns Alfy
PICU Ns Epi Ns Lisa
TOTAL Ps
CRITICAL
OBSTETRICS
‌Dines
‌Dines Pagi: ‌ ines Siang : Bd.
D
Malam : Bd.
VK Bd. Genda Tries , Bd. Nelly
Viki, Bd.
Dewi
LT 7
Dinas
Dines siang : Ns Dines
pagi : Ns.
Nursery Wiwi
Ika malam : Ns.
Nani
HEARTOLOGY
Cathlab
Hybrid
OPD JANTUNG
LT 8
Dokter Jaga
Dokter Jaga IPD : Pagi : Malam :

2. Pasien Terkonfirmasi Covid 19 Tidak Ada
TIPE PASIEN
KETERANGAN
BERAT PASIEN perhatian/critical/Kemo/transfusi, Pasien Risiko/Komplen,
RGENCY ROOM
PASIEN OBSERVASI :
RAJAL :
1. An Talita/ 12th/ Fever
2. Tn Ferdinand/ 57th/ Malaise
3. An Gianara/ 3th/ kontrol luka
4. An Ergin/ 7 bln/ Fever
5. Ny Sharima/ 27th/ fever
6. Ny Teti/ 45th/ Dyspepsia
7. Ny Nanda/35th/ G1P0A0 hmil 27 minggu Hipoferitin
8. Ny Zulfah/ 37th/ Observ Nyeri
9. Ny Dina/ 38 th/ Pembersihan Jalan Nafas
10. Ny WaOde/ 27/ Dyspepsia
11. Tn Bokirusun/ 44th/ Dyspepsia
RANAP :
1. Tn Subarjo/ 92th/dr Alvin/ Dispepsia intake sulit
AKI dd akut on CKD dgn hiperkalemia
2. Ny Devi/ 70th/ dr Chamim/ Malignant Neoplasm ovary
19 ( kemoterapi)
3. Ny Cut Kemala/ 42th/ dr Taufik Jamaan/ Post Aff IUD
4. Ny Sharima/ 27th/ dr Alvin/ dengue Fever
5. By Quamila/ 1th/ dr Annisa/ dengue fever
6. Ny Rika/ 43 th/ dr ZickyMyalgia
7. Ny Farsia/ 29th/ dr Nisa/ G2P1A0 hamil 40 minggu
Inpartu
8. Reyner/ 31th/ dr Amanda/ Dyspepsia
RUJUK :
APS :
PERALATAN :
NOTE :
RAJAL :
RANAP :
1. Ny Farsiah/ dr Nisa SpOG / G2P1 hamil 40 minggu
1 inpartu
PASIEN OBSERVASI :
G 19 Pasien
OPD
34 Total Telekonsul =
2
3 dr Noela SpOG
2 dr Annisa SpA
dr Nathalia SpA
7 drg. Tri Yuliati
4 dr Melyarna SpGK
4
5
9
1
26
4
2
117
Arwan Rivan
Tidak Ada Kendala
(L.4,5,6) (L.7,8)
Nasya
Pramusaji)
Adel Tidak ada maslah & Kendala
Upi Tidak ada masalah & Kendala
Giantara Iib Diare

(PKD Out) (PKD IN)
PASIEN OBSERVASI :
RENCANA TINDAKAN :
PASIEN PINDAH ICU :
PASIEN PULANG :
PASIEN OBSERVASI :
PASIEN PINDAH ICU :
RENCANA TINDAKAN
PASIEN PULANG :

1. An. Quamila / Annisa Nur Aini, dr. Sp.A (FT) /

2. Ny. Cut Keumala / Taufik Jamaan, Dr.dr. Sp.OG /
Presence of (intrauterine) contraceptive device
PASIEN OBSERVASI :
1. Ny. Siti umairoh / Amanda Pitarini Utari,dr, SpPD-
2. Tn.William / Zicky Yombana, dr. Sp.S / Myasthenia
gravis
3. Ny. Siu Fung /Nugroho Kampono,Prof. dr. SpOG (K)
Onk /Leiomyoma of uterus
4. Ny. Agatha Anggita/ Sang Arifianto,dr. SpOG/ G1
Hamil 37 Minggu 4 Hari
5. An.Brielle Lydia/dr. Ali Al hadar Sp.A/ Fiver
8
RENCANA TINDAKAN
1. Ny. Agatha Anggita/ Sang Arifianto,dr. SpOG/ G1
Hamil 37 Minggu 4 Hari / Rencana tind SC tgl 3/3/22 pkl
15.00 wib
PASIEN VK
PASIEN PULANG
1. Tn. Azwir markatin/ dr. Zicky yombara, Sp.S/
Parkinson disease
2. Ny.Yiyin / dr.Nisa Fathoni,Sp.OG / G4P2A1 hamil 38
minggu/ post partum
RENCANA MASUK :

THEATER
1. TVH/ dr Chamim
2. Laparatomi + Hysterektomi/ Prof NK
3 3. Aff IUD / dr Taufik
2. Rencana Tindakan Selasa 03-03-22

1. Ny Cecilia/ dr Nisa SpOG/ G1P0A0 hamil 38 minggu
LTP 2x
2. Ny Ovira/ dr Nisa SpOG/ G4P2A1 hamil 38 minggu
BSC 2x
3. Ny Agatha/ dr Sang SpOG/ G1P0A0 hamil 38 minggu
Oligohidramnion
CARE
0
0
0
0
RICS
PASIEN OBSERVASI :
1. Ny Farsiah/ dr Nisa SpOG / G2P1 hamil 40 minggu
1 inpartu
RENCANA TINDAKAN :
1. Ny Cecilia/ dr Nisa SpOG/ G1P0A0 hamil 38 minggu
LTP 2x
2. Ny Ovira/ dr Nisa SpOG/ G4P2A1 hamil 38 minggu
3 BSC 2x
3. Ny Agatha/ dr Sang SpOG/ G1P0A0 hamil 38 minggu
Oligohidramnion
PASIEN PONEK :
1 1. Ny Farsiah/ dr NisaSpOG/ G2P1 hamil 40 minggu
inpartu
1
1. Ny Agatha/ dr sang/ G1P0A0 hamil 37 minggu
PASIEN OBSERVASI :
0
0
PASIEN PULANG :
1
1. By Yiyin/ NCB SMK/ dr Keumala SpA
LOGY
1 Mar 22
CATHLAB
Schedule : -
Non Schedule : -
HYBRID OR
Schedule : -
Non Schedule : -
Others : -
Problem : -
Overtime staf : -
Staff sakit : -
Staff cuti : -
Next Schedule
Sat, 5 Mar 22
1. Kenny / ekstraksi lead + Micra / dr. DH
2. CAG PTCA + IVUS / dr Dafsah/ cathlab/10.00
3. CAG PTCA + IVUS / dr Dafsah/ cathlab/ 12.00
Daily Census opd cardiac 2/3/22
Outpatient : 18
dr ario : 1
Dr dafsah : -
dr denio : 5
dr faris : 3
dr DH : 1
dr DAW : -
dr radityo : -
24 Dr suko : 1
dr sunu : 1
dr Adi : 6
MCU : -
New patient: 3
Dr Adi ( 1 dari mandaya, 1 dari website, 1 dari teman
dr adi)
Cancel :
dr Dafsah : -
Dr Denio : 1
Dr Faris : -
Dr Sunu : -

ECHO : -
Stress Echo : -
USG Doppler : -
Holter : -
ECG : 3
Treadmill : -
CT Scan : -
Pacemaker Programming : -
Speckle
TEE : 1
DSE : -
ABI : 1
Tilt Table Test : -
Advance Echo : -
Handle Echo : -
ABPM : -
Ganti verban minor : -
Ganti verban sedang : -
Ezypro : -
Cardioversi : -
dr Mega
dr Rona
dr Riri
SIC (DILLA) Selasa, 02.03.22
TIPE PASIEN TOTAL
LT NAMA UNIT YANG DINAS PASIEN
EMERGENCY ROOM
dr Dwi dr. Mega,

EMERGENCY Ns. Ardi,
ROOM
Ns. Susi, Zr.
Br. Mohlis
Ns. Kelvin, 21
Nur Ns. Tomi
GF
PONEK 1
TOTAL PASIEN EMG 121Pasien
OPD
Poli Obgyn 34
Poli Onkology NS 1 : 2
NS 1 :
Poli Urology 3
Poli Ortho 2
Poli Internist 7
Poli Bedah Umum 4
Poli Bedah Plastik
Poli Bedah Degestif
NS 2 :
Poli THT 3
Poli Gizi
Poli bedah saraf
Poli Neuro 4
Dermis 5
Dental 9
LT 3
Poli Endoscopy
Poli Kemotherapi
Poli Fisioterapi 7
Poli Psikiatri
Pain Klinick
Poli Rehab Medik 3
Poli Mata
Poli Nutrition
Poli Paru 1
Poli Anak NS 3 : NS 3 : 26
Poli Mata 4
Poli Psikiatri 2
Pain Clinic
MCU
ODC 1
TOTAL PASIEN OPD 117
Tirjaya Arwan Rivan

SOS Petugas
(IGD, L.2
(Malam)
SB)
(L.4,5,6) (L.7,8)
Japar Nasya
GIZI Petugas
(Malam) (Servies &
(Cook)
Pramusaji)
LABORATORIUM Petugas Anin Adel

(Malam)
FHARMACY Petugas Bulan Upi

(Malam)
Petugas
RADIOLOGI (Malam)
Hamidah
DANRU : Petugas Gading Ary S M Riyanto Giantara Iib Diare

SCURITY Adie A (RG1 &
(Malam) (Lobby) (Lantai 2) (PKD Out) (PKD IN)
Nugroho IGD)
DP
Ns. Citra,
DS
Ns. Nurul, DM
Ns. Tiwi, Br. 15 ( 1 di
IN PATIENT Ns. Ella, Ns. Br. Rio, Ns.
LT 4 DEPARTMENT 4 Novita, Ns.
Abdy, Ns.
Salwa, Ns. VK)
Tary, Ns.
Kiki, Ns. Egis
Helen
Nadia, Ns.
Indah
IN PATIENT
LT 5 DEPARTMENT 5
DP
DS DM
Ns Dini, Ns
Ns Indah
IN PATIENT Afi,
Br Ahid
Ns Devi 8
DEPARTMENT 6 Br Malik, Ns
Ns Okta Ns Santi
LT 6 Mutia Ns Siti
KOMPLAIANAN
KERUSAKAN
OPERATING THEATER
Ns Yanti Ns Heri
Ns Catur Ns Iqbal
Ns Yohana 3
LT 7 OK
CRITICAL CARE
ICU Ns Gisma, 0
Ns. Ning Ns Winda
HCU Ns Awal 0
NICU 0
LT 7 Ns. Esty N Ns Esti P
Ns Alfy
PICU Ns Epi Ns Lisa 0
TOTAL Ps
0
CRITICAL
OBSTETRICS
‌Dines Siang : ‌Dines

‌Dines Pagi:
Bd. Tries , Malam : Bd.
3
VK Bd. Genda
Bd. Nelly Viki, Bd.
Dewi
1
LT 7
Dinas pagi : Dines siang Dines

Nursery Ns. Wiwi : Ns Ika malam : Ns.
Nani
Dinas pagi : Dines siang Dines
Nursery Ns. Wiwi : Ns Ika malam : Ns.
Nani 0
HEARTOLOGY
Cathlab
Hybrid
LT 8
OPD JANTUNG 24
LT 8
Dokter Jaga
Dokter Jaga IGD : Pagi : dr Dwi Malam : dr Mega
Dokter Jaga IPD : Pagi : Malam : dr Rona
1. Komplainan : Tidak Ada Komplainan Saat dinas SIC

2. Pasien Terkonfirmasi Covid 19 Tidak Ada
PASIEN OBSERVASI :
1. An. Enzo/ 10th/ DHF
2. An Deyzia/ 8th/ observ febris
RAJAL :
1. An Talita/ 12th/ Fever
2. Tn Ferdinand/ 57th/ Malaise
3. An Gianara/ 3th/ kontrol luka
4. An Ergin/ 7 bln/ Fever
5. Ny Sharima/ 27th/ fever
6. Ny Teti/ 45th/ Dyspepsia
7. Ny Nanda/35th/ G1P0A0 hmil 27
minggu Hipoferitin
8. Ny Zulfah/ 37th/ Observ Nyeri
9. Ny Dina/ 38 th/ Pembersihan Jalan
Nafas
10. Ny WaOde/ 27/ Dyspepsia
11. Tn Bokirusun/ 44th/ Dyspepsia
12. Ny Soraya/ 42th/ Dyspepsia
RANAP :
1. Tn Subarjo/ 92th/dr Alvin/ Dispepsia
intake sulit
AKI dd akut on CKD dgn hiperkalemia
2. Ny Devi/ 70th/ dr Chamim/ Malignant
Neoplasm ovary ( kemoterapi)
3. Ny Cut Kemala/ 42th/ dr Taufik Jamaan/
Post Aff IUD
4. Ny Sharima/ 27th/ dr Alvin/ dengue
Fever
5. By Quamila/ 1th/ dr Annisa/ dengue
fever
6. Ny Rika/ 43 th/ dr ZickyMyalgia
7. Ny Farsia/ 29th/ dr Nisa/ G2P1A0 hamil
40 minggu Inpartu
8. Reyner/ 31th/ dr Amanda/ Dyspepsia
RUJUK :
APS :
PASIEN TERKONFIRMASI
COVID 19 :
PERALATAN :
NOTE :
RAJAL :
RANAP :
1. Ny Farsiah/ dr Nisa SpOG / G2P1 hamil
40 minggu inpartu
PASIEN OBSERVASI :
Total Telekonsul =
dr Noela SpOG
dr Annisa SpA
dr Nathalia SpA
drg. Tri Yuliati
dr Melyarna SpGK
Tidak Ada Kendala
Aman, Tidak Ada Temuan Dan

Kendala
1.Ny. Rika Widawati/Zicky Yombana, dr.

Sp.S/Benign paroxysmal vertigo, Myalgia,
shoulder region, Headache
2.Ny. Hesti Rachmawati/Bob Andinata, dr.
Sp.B(K)Onk/Malignant neoplasm of breast
3.Ny. Yulia Prawidyastuti//Bob Andinata,
breast
4.Ny. Reyner Adijaya Hartanto/Amanda
Pitarini Utari,dr, SpPD-KGEH/Crohn
disease, unspecified, Dyspepsia
5.Ny. Sharima Umaya/Alvin Nursalim, dr.
Sp.PD/Dengue fever
6.Ny. Farsia Ayu Liviani/Nisa Fathoni, dr.
Sp. OG, IBCLC/Supervision of normal
pregnancy
7.Tn. Subardjo/Alvin Nursalim, dr.
Sp.PD/Other symptoms and signs
concerning food and fluid intake (Utama)
8.Ny. Devi Ramesh/Chamim,DR. dr,
SpOG (K) Onk /Malignant neoplasm of
ovary
PASIEN OBSERVASI :
1.Ny. Marina Veronika/Amanda Pitarini,
dr. SpPD/Dengue fever
2.Ny. Ayu Tri Oktaviani/ Amanda Pitarini,
breast
6.Ny. Reyner Adijaya Hartanto/Amanda
Pitarini Utari,dr, SpPD-KGEH/Crohn
disease, unspecified, Dyspepsia
Sp.PD/Dengue fever
8.Nn. Savira Putri Ranasari/ Alvin
Nursalim, dr. SpPD/Dengue fever
9.Ny. Darda Nella/ Zicky Yombana, dr. Sp.
S/Stroke Heamoragic
10.Ny. Djuriah/ Chamim, dr. SpOG (K)
Onk/ Complete utervaginal prolapse
12.An. Abidzar Al Ghaifari/ Annisa, dr. Sp.
A/ fever
13.Tn. KPH Sapardi/ Nefiati, dr. Sp. PD/
Diabetes Mellitus non- insulin
concerning food and fluid intake (Utama)
15.Ny. Devi Ramesh/Chamim,DR. dr,
SpOG (K) Onk /Malignant neoplasm of
ovary
16.Tn. Arief Oesman/ Amanda Pitarini, dr.
SpPD/DHF H-4
RENCANA TINDAKAN :
concerning food and fluid intake
(Utama)/R USG Bedsite 03/03/22 jam
08.00
PASIEN PINDAH ICU :

breast
3.Tn. KPH Sapardi/ Nefiati, dr. Sp. PD/
Diabetes Mellitus non- insulin
PASIEN PULANG :

DHF
2.Tn. Galih Adityas Permana/ Alvin
Nursalim, dr. SpPD/ Dengue Fever
3.Nn. Kireina Laima/ Carolina Supit, dr.
SpB/ Other and unspecified abdominal pain
PASIEN OBSERVASI :
PASIEN PINDAH ICU :
RENCANA TINDAKAN
PASIEN PULANG :
1. An. Quamila / Annisa Nur Aini, dr.

dengue]
2. Ny. Cut Keumala / Taufik Jamaan,
Dr.dr. Sp.OG / Presence of (intrauterine)
contraceptive device
PASIEN OBSERVASI :
1. Ny. Siti umairoh / Amanda Pitarini
and vomiting
2. Tn.William / Zicky Yombana, dr. Sp.S /
Myasthenia gravis
3. Ny. Siu Fung /Nugroho Kampono,Prof.
dr. SpOG (K) Onk /Leiomyoma of uterus
4. Ny. Agatha Anggita/ Sang Arifianto,dr.
SpOG/ G1 Hamil 37 Minggu 4 Hari
5. An.Brielle Lydia/dr. Ali Al hadar Sp.A/
Fiver
6. An. Quamila / Annisa Nur Aini, dr.
dengue]
8. An. Syaqilla Anzala Fadillah / Mira
Febriani Inkiriwang,dr. SpA / Dengue fever
RENCANA TINDAKAN
SpOG/ G1 Hamil 37 Minggu 4 Hari /
Rencana tind SC tgl 3/3/22 pkl 15.00 wib
PASIEN VK
PASIEN PULANG
1. Tn. Azwir markatin/ dr. Zicky yombara,
Sp.S/ Parkinson disease
2. Ny.Yiyin / dr.Nisa Fathoni,Sp.OG /
G4P2A1 hamil 38 minggu/ post partum
RENCANA MASUK :

1. TVH/ dr Chamim
2. Laparatomi + Hysterektomi/ Prof NK
3. Aff IUD / dr Taufik
2. Rencana Tindakan Selasa

03-03-22
1. Ny Cecilia/ dr Nisa SpOG/ G1P0A0
hamil 38 minggu LTP 2x
2. Ny Ovira/ dr Nisa SpOG/ G4P2A1 hamil
38 minggu BSC 2x
3. Ny Agatha/ dr Sang SpOG/ G1P0A0
hamil 38 minggu Oligohidramnion
PASIEN OBSERVASI :
1. Ny Farsiah/ dr Nisa SpOG / G2P1 hamil
40 minggu inpartu
RENCANA TINDAKAN :
1. Ny Cecilia/ dr Nisa SpOG/ G1P0A0
hamil 38 minggu LTP 2x
2. Ny Ovira/ dr Nisa SpOG/ G4P2A1 hamil
38 minggu BSC 2x
3. Ny Agatha/ dr Sang SpOG/ G1P0A0
hamil 38 minggu Oligohidramnion
PASIEN PONEK :
1. Ny Farsiah/ dr NisaSpOG/ G2P1 hamil
40 minggu inpartu
1. Ny Agatha/ dr sang/ G1P0A0 hamil 37
minggu
PASIEN OBSERVASI :
PASIEN PULANG :
1. By Yiyin/ NCB SMK/ dr Keumala SpA

Report*
1 Mar 22
CATHLAB
Schedule : -
Non Schedule : -
HYBRID OR
Schedule : -
Non Schedule : -
Others : -
Problem : -
Overtime staf : -
Staff sakit : -
Staff cuti : -
Next Schedule
Sat, 5 Mar 22
1. Kenny / ekstraksi lead + Micra / dr.
DH
2. CAG PTCA + IVUS / dr Dafsah/
cathlab/10.00
cathlab/ 12.00
Outpatient : 18
dr ario : 1
Dr dafsah : -
dr denio : 5
dr faris : 3
dr DH : 1
dr DAW : -
dr radityo : -
Dr suko : 1
dr sunu : 1
dr Adi : 6
MCU : -
New patient: 3
Dr Adi ( 1 dari mandaya, 1 dari website,
1 dari teman dr adi)
Cancel :
dr Dafsah : -
Dr Denio : 1
Dr Faris : -
Dr Sunu : -

melakukan
ECHO : -
Stress Echo : -
USG Doppler : -
Holter : -
ECG : 3
Treadmill : -
CT Scan : -
Pacemaker Programming : -
Speckle
TEE : 1
DSE : -
ABI : 1
Tilt Table Test : -
Advance Echo : -
Handle Echo : -
ABPM : -
Ganti verban minor : -
Ganti verban sedang : -
Ezypro : -
Cardioversi : -

TIPE PASIEN
YANG DINAS
LT NAMA UNIT
EMERGENCY ROOM
EMERGENCY Dr Fajar Dr Firdha Dr Firdha

ROOM, Ns Susi Ns Ns Ardhi Ns Nur
PONEK Rizam Ns Rizam Ns Yani
GF
RADIOLOGI Hamida
FL Riski, Diba
TOTAL PASIEN EMG
Bedah
Poli Obgyn : Poli anak : Umum :
Ns IIn THT :
Urology :
Bedah
Syaraf :
Rehab
Fisiotherapi :
Poli Pediatrik Poli Mata : Poli Neuro:
Bedah
Fisotherapi: Poli Paru :
Neuro : ODC : MCU :
LT 5
LT 6
IPD LT 4
Dr Faisal Dr Faisal
LT 4
LT 5
LT 6
IPD LT 4
Dr Faisal Dr Faisal
IPD LT 4 IPD LT
Ns Ns Abdi 4
Citra Ns Ns Tary Ns Salwa
Ela Ns Ns Nadya Ns Rizki
IN PATIENT Novita Ns Ns Helen
DEPARTMENT Indah IPD
Lt 4, 5, 6 LT 6 Dr IPD LT 6
IPD LT 6 Mutiara Ns Dr Mutiara
Ns Indah Ns Ns Avi
Malik Ns NsSanti
Risha Ns Ashid Ns Okta
Adel Ns
Mutia
Agung Trijaya
SOS Petugas: Indra
Rivan
GIZI Petugas : Vira Putra
LABORATORIUM Petugas : Zefika Aning
Petugas :
PHARMACY (SB) Ashry Upi
IT Petugas : Pak Jery
PKD :
DANDRU : Jumlah EMG : 1.
SECURITY, Lantai 2 : LOBBY :
Pak Petugas 6 1. Giantara 2.
PARKIR 1. M Ryanto Iib Diare
1.Ari S
Adi Nugraha orang Gading
TEKNISI PAk Samsul
OPERATING THEATER
Ns Sunandar
OK Ns 4
Heryanti
CRITICAL CARE
Dr Dewi
Ns Elga
PICU / NICU Ns Esti Ns Alvi
OBSTETRICS
LT 7
Bd Ningsih Bd Tries Bd Dewi
VK Bd Genda Bd Nelly Bd viky 3
Nursery Ns Wiwi Ns Ika Ns Nani 6

Nursery Ns Wiwi Ns Ika Ns Nani 6
RUANG TUNGGU PS
CRITICAL
HEARTOLOGY
Ns Akbar
Cathlab Ns Tryanto
Hybrid
LT 8
Ns Rini T
OPD JANTUNG Ns
Emma
AUDITORIUM
NOTED
KETERANGAN
OM
RAJAL : 6
RANAP : 4
RUJUK : 0
APS : 0
TOTAL : 10
Pengerjaan perluasan ruang FL depan EMG sd jam

04.00 wib
MENT PASIEN BARU :
Lt 4 : 4 Lt 6 : 4
PASIEN OBSERVASI :
1. ( Lt 4 ) Ny. Devi Ramesh/Chamim,DR. dr,
SpOG (K) Onk /Malignant neoplasm of ovary
2. ( Lt 4 ) .An. Enzo Razka Kiandha/Mira
Febriani Inkiriwang,dr. SpA/Dengue fever
[classical dengue]
3. ( Lt 4 ) An. Deyzia Alisha Kiandha/Mira
Febriani Inkiriwang,dr. SpA/Fever, unspecified
4. ( Lt 6 ) Tn.William / Zicky Yombana, dr.
PASIEN OBSERVASI CRITICAL:
RENCANA TINDAKAN :
1.( Lt 4 ) Ny. Rika Widawati/Zicky Yombana, dr.

shoulder region, Headache/ R/TCD-CD 04/03/22
2.( Lt 4 ) Tn. Suheri Djusri /Zicky Yombana,
dr. Sp.S/Stroke, not specified as haemorrhage
or infarction, Angina pectoris/R/TCD-CD
04/03/22
PASIEN MENINGGAL :
KETERANGAN :
Pasien Lt 5 : 0
Total
: Pasien
MASALAH

Aman, PAtroli Satgas tidak ada masalah
TER
1. CECILIA RUMONDANG / BEDAH OBGYN

Sectio Caesaria / Nisa Fathoni, dr. Sp. OG, IBCLC 2.
NISRINA KEMALA DEWI / BEDAH OBGYN -
Sectio Caesaria / Nisa Fathoni, dr. Sp. OG, IBCLC
3. OVIRA
NURDINA / BEDAH OBGYN - Sectio Caesaria +
Pasang IUD / Nisa Fathoni, dr. Sp. OG, IBCLC
4. AGATHA
ANGGITA SINTYA DEVI / BEDAH OBGYN -
Sectio Caesaria /Sang Arifianto,dr. SpOG
RENCANA TINDAKAN : 1.
ALMAIR ALJABER PURNAMA MAFIRION / BEDAH
PEDIATRIC - Sirkumsisi / OK I jam 17.00 wib / Wulan
Ayudyasari, dr. Sp.B
PASIEN OBSERVASI :
1. Ny Farsia/ dr nisa/ G2P1A0 hamil 40 minggu

+ 5 hari/ Partus jam 05:34 wib
2. Ny Nisrina/ dr nisa/ G1P0A0 hamil 38 minggu
+ 6 hari maturasi grade 1 deselerasi/sc cito jam
13.00 wib
3. Ny Febria/ dr nisa/ G3P2A0 hamil 39 minggu
maturasi grade 1 gagal induksi partus tak maju sc
jam 21.00 wib
PASIEN PONEK :
PASIEN OBSERVASI :
1. By Ny .Farsia /dr. Mira Febriani sp.A /NLB
SMK usia 1 hari
2. By. Ny. Cecilia Rumondang / dr. Mira
Febriani sp.A / NCB SMK 18 JAM
3. By.Ny.Nisrina Kemala / dr. Mira Febriani sp.A
/ NCB SMK USIA 17 JAM.
4. By. Ny. Ovira Nurdina /dr. Mira Febriani sp.A
/ NCB SMK USIA 16 JAM.
5. By. Ny.Agatha Anggita/ dr. Mira Febriani
sp.A / NCB SMK USIA 15 JAM
6. By. Ny. Febria Ningsih /dr. Mira Febriani sp.A
/ NCB SMK Usia 10 JAM.
Y
SIC (EKO) Jum'at, 04.03.22
TIPE PASIEN
YANG DINAS
LT NAMA UNIT
EMERGENCY ROOM
dr. Yunitha, dr. Dwi, Ns.

EMERGENCY Ns. Rizam,
Ns. Sanusi, Yuni, Zr.
ROOM Ns. Susi
Zr. Fitri
Nur
GF
PONEK
TOTAL PASIEN EMG

OPD
Poli Obgyn
Cahya, Alin NS 1 :
Poli Urology
Poli Ortho
Poli Internist
Poli Bedah Umum
Poli Bedah Plastik
Poli Bedah Degestif
NS 2 :
Poli THT
Poli Gizi
Poli bedah saraf
Poli Neuro
Dermis
Dental
LT 3
Poli Endoscopy
Poli Kemotherapi
Poli Fisioterapi
Poli Psikiatri
Pain Klinick
Poli Rehab Medik
Poli Mata
Poli Nutrition
Poli Paru
Poli Mata
Poli Psikiatri
Pain Clinic
MCU
ODC
TOTAL PASIEN OPD

Trijaya Indra
SOS Petugas
(IGD, L.2
(Malam)
SB)
(L.4,5,6)
GIZI Petugas
(Malam) (Servies &
(Cook)
Pramusaji)
LABORATORIUM Petugas
(Malam)
FHARMACY Petugas
(Malam)
Petugas
RADIOLOGI (Malam)
DANRU : Petugas Firli Hamka M Hery Novan
SCURITY (RG1 &
Wibi (Malam) (Lobby) (Lantai 2) (PKD Out)
IGD)
DP = Ns. DS =
Ana, Br. Ns.Tiwi, Br.
DM = Ns.
Taufik, Ns. Abdy, Ns.
IN PATIENT Citra,
LT 4 DEPARTMENT 4
Ella, Ns. Tary, Ns.
Ns.Riski,
Novita, Ns. Nadya, Br.
Ns.Helen
Indah Rio
DP = Ns. DS =
Ana, Br. Ns.Tiwi, Br.
DM = Ns.
Taufik, Ns. Abdy, Ns.
IN PATIENT Citra,
LT 4 DEPARTMENT 4
Ella, Ns. Tary, Ns.
Ns.Riski,
Novita, Ns. Nadya, Br.
Ns.Helen
Indah Rio
IN PATIENT
LT 5 DEPARTMENT 5
DP = Ns DS = Ns. DM = Ns.
Dini+ Ns. Indah+ Bd.
IN PATIENT Aviani+
Risha+ Bd. Malik+
DEPARTMENT 6 Adeshelpi Ns.Ahid Ns. Yudi+
LT 6 Ns. Okta
KOMPLAIANAN
KERUSAKAN
OPERATING THEATER
Catur
LT 7 OK
CRITICAL CARE
ICU
Gisma
HCU
NICU
LT 7 Esty Lisa
PICU
TOTAL Ps
CRITICAL
OBSTETRICS
‌Dines
‌Dines
‌Dines Pagi: Siang : Bd.
Malam :
VK Bd. Putri Tries , Bd.
Bd. Anggi,
Ningsih
Bd. Genda
LT 7
Dinas
D
pagi : Ns.
Nursery Wiwi
:Ns. Nely malam :
Ns. Inggrid
Nursery Wiwi
Ns. Inggrid
HEARTOLOGY
Cathlab
Hybrid
LT 8
LT 8
OPD JANTUNG
Dokter Jaga
Dokter Jaga IGD : Pagi : dr Yunitha Malam : dr Dwi
Dokter Jaga IPD : Pagi : dr Malam : dr Nesya
Dokter Jaga Critical : Pagi : dr Dewi Malam : dr Rizky

2. Tidak Ada Pasien Terkonfirmasi Covid 19 Di EMG Dalam 1x24 Jam
KETERANGAN
TOTAL
PASIEN
akan dilakukan)
Y ROOM
PASIEN OBSERVASI :
RAJAL :
1. Ny. Nanik Aziddatus /24th/ Dx. G1 dengan
Biochemical Pregnancy
2. Ny. aning Candra /31th/ Dx. Commond Cold
3. An. Mukhammedali /2th/ Dx. Unspecified
injury of wrist and hand
4. Ny. Rochani /81th/ Dx. Dyspnoea
5. Ny. Dewi Rahmawati /34th/ Dx. Anemia
6. By. Sigma Karim Alfatih /11bln/ Dx. Febri H
Ke 2
7. Tn. Yoga Satria /29th/ Dx. Febris H ke 1
8. Tn. Lindra Sabana /34trh/ Dx. Fever
9. Ny. Pramanti Putri /34th/ Dx. Seborrhoeic
keratosis
10. Nn. Andini Putri /20th/ Dx. Fever
RANAP :
1. An. Vania Taresa /3th/ Dx. DHF / Dpjp.
Annisa Nur Aini, dr. Sp.A (FT) / Ruang 615
2. Nn. Sherina Aisya /22th/ Dx. DHF / Dpjp.
Alvin Nursalim, dr. Sp.PD
13 3. Tn. William Rihi Hina /33th/ Dx. Chest
Pain / Dpjp. Dr. Suko Sp,JP
RUJUK :
APS :
1. Ny. Rochani /81th/ Dx. Dyspnoea (Ingin

Berobat Jalan Karena masalah Biaya)
Form Terlampir dan Tertandantangani
Keluarga
2. Tn. Lindra Sabana /34trh/ Dx. Fever
(Pasien Ingin Di Rawat Di RS Lain)
PERALATAN :
NOTE :
RAJAL :
RANAP :
PASIEN OBSERVASI :
13 Pasien

dr. Noela SpOG
Dr. Rigina SpKFR
Dr. Michael SpBS
Dr. Hafiza SpKk
3
Dr. Wisanti SpTHT
3 Dr. Akbari SpU
Dr. Zaki SpOt
Dr. Nathalia SpA
Dr. Amanda SpPD-KGEH
Tenaga Isoman
1
8
17
6
29
103
Rivan
Tidak Ada Kendala
(L.7,8)

Afif
(PKD IN)
ENT PASIEN BARU :
1.Nn.Sherina / dr. Alvin Nursalim Sp.PD / Dengue

Fever
2.Tn.Taufan / dr. Dicky Aligeri Sp.BTKV (K),
FIHA, FICA / Mitral Valve Disease
3.Tn.Harlen / dr.Dafsah Sp.JP (K), FIHA, FasCC /
Atherosclerotic disease
PASIEN OBSERVASI :
1.Ny. Marina Veronika/Amanda Pitarini, dr.

SpPD/Dengue fever
2.Ny. Ayu Tri Oktaviani/ Amanda Pitarini, dr.
SpPD/Dengue fever
3.Nn.Sherina / dr. Alvin Nursalim Sp.PD / Dengue
Fever
4.An. Enzo Razka Kiandha/Mira Febriani
Inkiriwang,dr. SpA/Dengue fever [classical
dengue]
5.An. Deyzia Alisha Kiandha/Mira Febriani
Inkiriwang,dr. SpA/Fever, unspecified
6.Tn. Suheri Djusri /Zicky Yombana, dr.
Sp.S/Stroke, not specified as haemorrhage or
infarction, Angina pectoris
Sp.PD/Dengue fever
8.Nn. Savira Putri Ranasari/ Alvin Nursalim, dr.
SpPD/Dengue fever
9.Tn. Subardjo/Alvin Nursalim, dr. Sp.PD/Other
symptoms and signs concerning food and fluid
intake (Utama)
13
FIHA, FICA / Mitral Valve Disease / Rencana
Tindakan TEE Sabtu tgl 05/03/2022 jam 09.00
wib.
2.Tn.Harlen / dr.Dafsah Sp.JP (K), FIHA,
FasCC / Atherosclerotic disease / Rencana
tindakan CAG + PTCA 2 Stent complex +
IVUS tgl 05/03/2022 jam 10.00 wib.
PASIEN PINDAH ICU :

pregnancy
PASIEN PULANG :
1.Ny. Darda Nella/ Zicky Yombana, dr. Sp.

S/Stroke Heamoragic
2.Ny. Djuriah/ Chamim, dr. SpOG (K) Onk/
Complete utervaginal prolapse
3.Ny. Devi Ramesh/Chamim,DR. dr, SpOG
(K) Onk /Malignant neoplasm of ovary
ENT PASIEN BARU :
PASIEN OBSERVASI :
PASIEN PINDAH ICU :
RENCANA TINDAKAN
PASIEN PULANG :

ENT PASIEN BARU :
1.Vania Taresa Tarigan/dr Anissa/ DHF

2.Tn. Kenny Novandi/dr Dickey Armein
Hanafi/ Atrial fibrillation and flutter
3. Tn permana firdaus/ dr alvin/ dhf
PASIEN OBSERVASI :

SpPD-KGEH/ Dyspepsia,Nausea and vomiting.
2. Ny. Siu Fung /Nugroho Kampono,Prof. dr.
SpOG (K) Onk /Leiomyoma of uterus
3. Ny. Agatha Anggita/ Sang Arifianto,dr. SpOG/
G1 Hamil 37 Minggu 4 Hari
6. Ny. Cecilia / dr.Nisa Fathoni,Sp.OG / Post SC
7. Ny. Ovira / dr.Nisa Fathoni,Sp.OG / Post SC
8. Ny. Febrianingsih / dr.Nisa Fathoni,Sp.OG /
Post SC
9. Ny. Nisrina Kemala/ dr Nisa Fatoni,
Sp.OG/Post SC
12
RENCANA TINDAKAN
Hanafi/ Atrial fibrillation and flutter, rencana
Pro tindakan Ekstraksi ICD dan MICRA
besok tgl 5/3/2022 jam 08 pagi.
PASIEN VK
PASIEN PULANG
1.Tn.William / Zicky Yombana, dr. Sp.S /
Myasthenia gravis
RENCANA MASUK :

1. Ny. Siu Fung /Nugroho Kampono,Prof. dr.
SpOG (K) Onk /Leiomyoma of uterus
ER
1. Tindakan Jum'at, 04-03-22
1. Sirkumsisi /ALMAIR ALJABER
PURNAMA MAFIRION /7bln/ Wulan
1 Ayudyasari, dr. Sp.B / Jam. 17.00 Wib/ OK I
2. Rencana Tindakan Sabtu 05-03-22

1. Eksisi Fibroma/ Rekonstruksi Penis / RAKHA
MAHARDIKA N /9th/ Yonas Hutasoit, dr. Sp.U /
Jam. 08.00 Wib / OK I
0
0
0
0
0 Pasien
PASIEN OBSERVASI :
0
RENCANA TINDAKAN :
0
PASIEN PONEK :
0
PASIEN OBSERVASI :
1. By Ny .Farsia /dr. Mira Febriani sp.A
/NLB SMK usia 1 hari
2. By. Ny. Cecilia Rumondang / dr. Mira
Febriani sp.A / NCB SMK 1 hari
3. By.Ny.Nisrina Kemala / dr. Mira Febriani
sp.A / NCB SMK USIA 1 hari.
4. By. Ny. Ovira Nurdina /dr. Mira Febriani
6 sp.A / NCB SMK USIA 1 hari.
5. By. Ny.Agatha Anggita/ dr. Mira Febriani
sp.A / NCB SMK USIA 1 hari
6. By. Ny. Febria Ningsih /dr. Mira Febriani
sp.A / NCB SMK Usia 1 hari
0
PASIEN PULANG :

4 Mar 22
CATHLAB
Schedule : -
Non Schedule : -
HYBRID OR
Schedule : -
Non Schedule : -
Others : -
Problem : -
Overtime staf : -
Staff sakit : -
Staff cuti : -
Schedule
Sat, 5 Mar 22
1. Kenny / ekstraksi lead + Micra / dr.
DH
cathlab/10.00
cathlab/ 12.00
Outpatient : 14
dr ario :
Dr dafsah :
dr denio : 6
dr faris : 2
dr DH : 3
dr DAW :
14 dr radityo :
Dr suko :
dr sunu :
dr Adi : 3
MCU : -
New patient: 2
Dr. Denio 2 : 1 dari teman, 1 dari keluarga
Cancel :

ECHO :
Stress Echo :
USG Doppler :
Holter : 1
ECG : 10
Treadmill :
CT Scan
Speckle
TEE :
DSE :
ABI :
Tilt Table Test :
Advance Echo : 1
Handle Echo :
ABPM :
Ganti verban sedang : 1
Ezypro :
Cardioversi :
Referral External :

SIC (CAROL) MINGGU PAGI, 06.03.22
TIPE PASIEN
YANG DINAS
LT NAMA UNIT
EMERGENCY ROOM
EMERGENCY Dr Dwi Dr Dwi

ROOM, Ns Kelvin Ns Rizam
PONEK Ns Yuniar Ns Fitri
GF
RADIOLOGI Ibu Arga Ibu Arga
FL Diba, Feby
TOTAL PASIEN EMG
Poli Obgyn : Poli anak : Bedah

11 Ns IIn THT : 10 Umum :
Urology :
Bedah
Syaraf :
Rehab
LT 3 Orthopedy : Fisiotherapi : Medik :
Bedah
Fisotherapi: Poli Paru :
Neuro : ODC : MCU :
21
LT 5
LT 6
Dr Rona
IPD LT 4
Dr Rona
Ns IPD LT 4
Ns
IN PATIENT Salwa Ns
IPD LT 4
DEPARTMENT Rio Ns
IPD LT 6
Lt 4, 5, Egis
Ns Risha
6
Ns Silvi IPD LT 6
IPD LT 6 Ns Ade
Ns Devi
Ns Santi
Riki,
Irma, Neta,
SOS Petugas: Angga, Yatini, Intan
Winda
GIZI Petugas : Vira Ryan
LABORATORIU
M
Petugas : Elis, Aning Adela
PHARMACY Petugas : Ardina,

Upi
(SB) nurul
DANDRU : PKD :
Jumlah EMG : 1.
SECURITY, Lantai 2 : LOBBY :
Petugas 6 1. Giantara 2.
PARKIR Pak Adi 1. M Ryanto 1.Ari S
orang Gading Iib Diare
Nugraha
TEKNISI PAk Samsul
OPERATING THEATER
Ns Sunandar
OK Ns
Heryanti
CRITICAL CARE
Dr Dewi
Ns Elga 0
PICU / NICU Ns Esti Ns Alvi 0

OBSTETRICS
LT 7
VK
Nursery Ns Nani Ns Ika Ns Wiiwi 1
RUANG TUNGGU
PS CRITICAL
HEARTOLOGY
Ns Akbar
Cathlab Ns
Tryanto
Hybrid
LT 8
Ns Rini T
OPD
Ns
JANTUNG
AUDITORIU Emma
M
NOTED
KETERANGAN
OOM
RAJAL : 5
RANAP :
RUJUK : 0
APS : 0
TOTAL PASIEN :11
TMENT PASIEN BARU :
Lt 4 : 1 Lt 6 : 0
PASIEN OBSERVASI :
1. (Lt 6 ) An Aruna Laksmi / 2 thn / Crushing

injuri of skull / Dr Mira SpA / Konsul Dr Adi
SpM
2.( Lt 6 ) An Theresia / 3 thn / Dr Anisa SpA /
Ns 1 Positif
3.( Lt 6) Tn Kenny Novandi / 60 thn /
Dilated Cardiomyophati / Dr Dicky Hanafi SpJP
/ Pasien post tindakan Explantatsi ICD-CRTD
dan Implantasi Leadless PPM Micra AV 5/3/22
4. (
Lt 4 ) Tn. Willian Rihi Hina/33 thn /Suko
PhD / Post Obsv HCU

PASIEN MENINGGAL
RENCANA TINDAKAN :
1. ( Lt 4 ) Tn. Taufan Fanillus/26 tahun / Dicky

Aligheri, SpBTKV (K),dr, FIHA, FICA / R/
tindakan MVR Senin 07/03/2022 jam 16.00
ACC Asuransi (+) PBO (+)
2. ( Lt 4 ) Tn. Willian Rihi Hina/33 thn /Suko
PhD / Post Obsv HCU / CT angio koroner
07/02/22 jam11.00 SIO(+) ACC(+) > Info
Bena/Rizki
3. Tn. Masturoh/44thn / Alvin Nursalim,
dr. Sp.PD / USG bedside jam 8 pagi bsk tgl
07.03.32 / puasa 6 jam SIO(+) ACC(-) Puasa
jam 24.00 pasien terinfo (+) FU Assuransi
PASIEN RENCANA PULANG:
1. Ny Siti Umairoh / 42 thn / Dispepsia, vomitus

/ Dr Amamda SpPD, Dr Arif SpS /
KETERANGAN :
Pasien Lt 5 : 0
Total : Pasien
MASALAH
Tidak ada masalah
Tidak ada masalah
Tidak ada masalah
Tidak ada masalah

ATER
RE
PASIEN OBSERVASI :
PASIEN PONEK :
PASIEN OBSERVASI :
1. By. Ny. Cecilia rumondang /dr. Mira sp. A/
NCB SMK usia 3 hari
Tidak ada masalah
Y
SIC (DILLA) MINGGU MALAM 06.03.22

TIPE PASIEN
DINAS
LT NAMA UNIT
EMERGENCY ROOM
Dr Dwi Dr Dwi dr Firdha

EMERGENCY
Ns Kelvin Ns Rizam Ns Ardhi
ROOM Ns Yuniar Ns Fitri Ns Sanusi
GF
PONEK
TOTAL PASIEN EMG

OPD
Poli Obgyn
NS 1 :
Poli Urology
Poli Ortho
Poli Internist
Poli Bedah
Umum
Poli Bedah Plastik
Poli Bedah Degestif
Poli Bedah VaskulerNS 2 : NS 2 :
Poli THT
Poli Gizi
Poli bedah
saraf
Poli Neuro
Dermis
LT 3 Dental
Poli Endoscopy
Poli
Kemotherapi
Poli Fisioterapi
Poli Psikiatri
Pain Klinick
Poli Rehab Medik
Poli Mata
Poli Nutrition
Poli Paru
Poli Mata
Poli Psikiatri
Pain Clinic
MCU
ODC
TOTAL PASIEN OPD
Trijaya Indra
SOS Petugas
(IGD, L.2
(Malam)
SB)
(L.4,5,6)
Hari Heru
GIZI Petugas
(Malam) (Servies &
(Cook)
Pramusaji)
LABORATORI Petugas Krisna Rangga
UM (Malam)
FHARMACY Petugas Rara Narendra

(Malam)
Petugas
RADIOLOGI (Malam)
Arga
Rigen
DANRU : Petugas Ahmad Jawadi
Rivaldo
Dede Husni
SCURITY
Rizky (Malam) (RG1 & IGD) (Lobby) (Lantai 2) (PKD Out)
DP DS
DM
Ns. Salwa Ns. Abdi
IN PATIENT Ns.Tari, Ns.
LT 4 DEPARTMENT 4
Ns. Rio Ns. Taufik
Novita,
Ns. Egis Ns. Nadia
Ns. Ela
DP DS
DM
Ns. Salwa Ns. Abdi
IN PATIENT Ns.Tari, Ns.
LT 4 DEPARTMENT 4
Ns. Rio Ns. Taufik
Novita,
Ns. Egis Ns. Nadia
Ns. Ela
IN PATIENT
LT 5 DEPARTMENT
5
IN PATIENT Ns Devi, Ns Risa Ns Indah
DEPARTMENT Ns Santi, Ns Silvi Ns Malik
6 Ns Siti Ns Ade Ns Ahied
LT 6
KOMPLAIANAN
KERUSAKAN
OPERATING THEATER
Ns Heri Ns Heni Ns Iqbal

LT 7 OK
CRITICAL CARE
ICU
Ns Agus Ns Rita Ns Helga
HCU
LT 7
NICU
LT 7 Ns Ayu Ns Alfi Ns Grace
PICU
TOTAL Ps
CRITICAL
OBSTETRICS
‌Dines Pagi: Bd. ‌Dines Siang : Bd.

‌Dines Malam :
Anggi, Ningsih,
VK Bd Viki Bd. Nelly
Bd.Putri,
Bd. Tries
LT 7
Dinas pagi : Ns. ‌Dines siang :Ns.

Dines malam :
Nursery Nani Ika
Ns Wiwi
HEARTOLOGY
Cathlab
Hybrid
OPD
JANTUNG
LT 8
Dokter Jaga
Dokter Jaga IGD : Pagi : dr Dwi Malam : dr Firdha
Dokter Jaga IPD : Pagi : dr Rona Malam : dr Nesya
Dokter Jaga Critical : Pagi : dr Nilam Malam : dr Rizky
1. Komplainan : Tidak Ada Komplainan Saat dinas SIC Ma

KETERANGAN
ENCY ROOM
PASIEN OBSERVASI :
RAJAL :
1. Winner David/ 33th/ Fever
2. Mega Septiawati/ 32th/ Dyspepsia
3. Ana Septiana/ 27th/ Iron Defisiensi
4. Sri Arini/ 77th/ ISPA
5. Wannur AIda/ 35th/ Iron Defisiensi
6. Nyoman Riana/ 51th/ ISPA
7. Nadia/ 29th/ Iron Deficiency
8. Dwi Santi/ 40th/ Dyspepsia
9. Mohd Shamfirdaus/ 38th/ Dyspepsia
10.Yiesha/ 20th/ Dyspepsia
11. Cynthia Ayu/28th/ Dyspepsia
14 Pasien RANAP :
1. Marno/ 48th/ Injury of Achiles
2. Masturoh/ 44th/ Dyspepsia
3. Hariara Timothy/ 1th/ fever
RUJUK :
APS :

19 :
PERALATAN :
NOTE :
RAJAL :
RANAP :
PASIEN OBSERVASI :
14 Pasien
OPD
dr. Noela SpOG
Dr. Rigina SpKFR
Dr. Michael SpBS
Dr. Hafiza SpKk
Dr. Wisanti SpTHT
Dr. Akbari SpU
Dr. Zaki SpOt
Dr. Nathalia SpA
Dr. Amanda SpPD-KGEH
Tenaga Isoman
1
10
21
Rivan
Tidak Ada Kendala
(L.7,8)

Ilham
(PKD IN)
1.Tn. William Rihi Hina/ Suko Adiarto, dr.

SpJP (K),FIHA,, FICA, FAsCC, PhD/
Unstable angina
2.Ny. Masturoh/ dr. Alvin Nursalim, SpPD/
Dsypepsia
3.Tn. Marno/ dr. Radi, Sp.OT/ ruptur tendon
achilles sinistra
PASIEN OBSERVASI :
1.Ny. Marina Veronika/Amanda Pitarini, dr.

SpPD/Dengue fever
2.Nn.Sherina / dr. Alvin Nursalim Sp.PD /
Dengue Fever
dengue]
4.An. Deyzia Alisha Kiandha/Mira Febriani
Inkiriwang,dr. SpA/Fever, unspecified
5. Ny. Sharima Umaya/Alvin Nursalim, dr.
Sp.PD/Dengue fever
6. Tn. Reyner Adijaya/ Amanda Pitarini,
dr.SpPD/ Crohn disease, unspecified,
Dyspepsia
7. Tn.Taufan / dr. Dicky Aligeri Sp.BTKV
(K), FIHA, FICA / Mitral Valve Disease
8. Tn. William Rihi Hina/ Suko Adiarto, dr.
SpJP (K),FIHA,, FICA, FAsCC, PhD/
Unstable angina
9. Ny. Masturoh/ dr. Alvin Nursalim, SpPD/
Dsypepsia
10. An. Aruna/ Mira Febriani Inkiriwang,dr.
SpA/ Crushing injury of skull
11. Tn. Marno/ dr. Radi, Sp.OT/ ruptur
tendon achilles sinistra
11
11
RENCANA TINDAKAN :
1.Tn.Taufan / dr. Dicky Aligeri Sp.BTKV
(K), FIHA, FICA / Mitral Valve Disease /
Rencana Tindakan tindakan MVR Senin
07/03/2022 jam 16.00.
2.Ny. Masturoh/ dr. Alvin Nursalim, SpPD/
Dsypepsia/ Rencana USG Bedside, 7/03/
2022, jam 08.00
3.Tn. William/ Suko Adiarto, dr. SpJP
(K),FIHA,, FICA, FAsCC, PhD/ Rencana CT
angio koroner 07/02/22, jam 11.00
PASIEN PINDAH ICU :

1.Tn. Marno/ dr. Radi, Sp.OT/ ruptur tendon
achilles sinistra
dengue]
PASIEN PULANG :
1.Ny. Ayu Tri Oktaviani/ Amanda Pitarini,

2.Tn.Riza Permana / dr.Dafsah Sp.JP (K)-
FIHA, FasCC / Chronic Ischaemic Heart
disease
Sp.PD/Other symptoms and signs concerning
4.Tn.Harlen / dr.Dafsah Sp.JP (K), FIHA,
FasCC / Atherosclerotic disease
PARTMENT
PASIEN BARU :
PASIEN OBSERVASI :
PASIEN PINDAH ICU :
RENCANA TINDAKAN
PASIEN PULANG :
PARTMENT
PASIEN BARU :
1. An. Hariara / dr Mira SpA / DHF

PASIEN OBSERVASI :
1. Ny. Cecilia / dr.Nisa Fathoni,Sp.OG / Post
SC
2. Vania Taresa Tarigan/dr Anissa/ DHF
3. Tn. Kenny Novandi/dr Dickey / Atrial
4. Tn permana firdaus/ dr alvin/ dhf
5. An. Hariara / dr Mira SpA / DHF
RENCANA TINDAKAN
PASIEN VK
5
PASIEN PULANG
1. Ny. Siti umairoh / Amanda Pitarini
and vomiting.
SpOG/ G1 Hamil 37 Minggu 4 Hari
3. Ny. Ovira / dr.Nisa Fathoni,Sp.OG / Post

SC
4. Ny. Febrianingsih / dr.Nisa
Fathoni,Sp.OG / Post SC
5. Ny. Nisrina Kemala/ dr Nisa Fatoni,
Sp.OG/Post SC
Hanafi/ Atrial fibrillation and flutter
THEATER
Tindakan Minggu, 06-03-22
1. Ny Ratih/ dr Febriansyah SpOG/ Curetage
2 2. Tn Marno/ dr Radi SpOT/
Rencana Tindakan Senin, 07-03-22

1. Tn Taufan/ dr Dicky/ MRV
CARE
0
0
0
0
0 Pasien
RICS
PASIEN OBSERVASI :
1. Ny Ratih/ dr Febriansyah SpOG/ kematian
1 mudigah
RENCANA TINDAKAN :
0
PASIEN PONEK :
0
PASIEN OBSERVASI :
1 1. By Ny Cecilia/ dr Mira/ NCBSMK
0
PASIEN PULANG :
1. By Ny Nisrina/ dr Mira/ NCBSMK
2. By Ny Ovira/ dr Mira/ NCBSMK
4 3. By Ny Agatha/ dr Mira/ NCBSMK
4. By Ny Febria/ dr Mira/ NCBSMK
LOGY
4 Mar 22
CATHLAB
Schedule : -
Non Schedule : -
HYBRID OR
Schedule : -
Non Schedule : -
Others : -
Problem : -
Overtime staf : -
Staff sakit : -
Staff cuti : -
Schedule
Outpatient :
dr ario :
Dr dafsah :
dr denio :
dr faris :
dr DH :
dr DAW :
dr radityo :
Dr suko :
dr sunu :
dr Adi :
MCU : -
New patient:
Cancel :

ECHO :
Stress Echo :
USG Doppler :
Holter :
ECG :
Treadmill :
CT Scan
Speckle
TEE :
DSE :
ABI :
Tilt Table Test :
Advance Echo :
Handle Echo :
ABPM :
Ezypro :
Cardioversi :
Referral External :

SIC (CAROL) 07.03.22
TIPE PASIEN
YANG DINAS
LT NAMA UNIT
EMERGENCY ROOM
EMERGENCY Dr Fajar Ns Dr Fajar

Dr Yuanitha
ROOM, Ns Susi
Kelvin Ns Ns Rizam
PONEK Tomy Ns Fitri
GF
RADIOLOGI Bu Arga
Novi,
FL Faridha
TOTAL PASIEN EMG
Poli anak :
Poli Obgyn : 40
Ns IIn THT : 2 26
Urology : 1
Rehab
Medik : 5
LT 3
Poli Mata : 1
Poli Pediatrik
Bedah Fisotherapi:
Onkology : 2 Gizi : digestive : 8
LT 5
LT 6
LT 4
LT 5
LT 6
IPD LT 4
Ns Nurul Dr Faisal
Ns Salwa IPD LT 4 IPD LT 4
Ns Ziya Ns Taufik Ns Risha
IN PATIENT
Ns Rizki Ns Helen Ns Tari
DEPARTMENT
Lt 4, 5, 6 Ns Nadya Ns Abdi Ns Rio
Ns Indah Ns Egis
Trijaya,
SOS Petugas:
Khaerul
GIZI Petugas : Vira

Petugas :
PHARMACY (SB) Ardina
IT Petugas :
PKD :
DANDRU : Jumlah EMG : 1. Dede
SECURITY, Lantai 2 : 1.
Pak Petugas 6 D 2. Husni J
PARKIR 1. Efendi Ahmad J 2.
Rizki R orang Ilham A
TEKNISI PAk Samsul
OPERATING THEATER
Ns Sunandar
OK Ns Heryanti
CRITICAL CARE
Dr Riri
Ns Elga
Ns Esti
LT 7 Ns Grace
PICU / NICU Ns Esti Ns Alvi

OBSTETRICS
Bd Ning
VK Bd Vicky
Bd Putri
RUANG TUNGGU PS
CRITICAL
HEARTOLOGY
Ns Akbar
Cathlab Ns Tryanto
Hybrid
LT 8
LT 8
Ns Rini T
OPD JANTUNG
Ns Emma
AUDITORIUM
NOTED
TIPE PASIEN
KETERANGAN
CY ROOM
RAJAL : 7
RANAP : 0
RUJUK : 1 1.
Ny Natasya Chandra / H 34 mg / PCR
SWAB + / Dpjp Dr Nisa SPOG / Rujuk ke
RS HERMINA Jatinegara
APS : 1 1.
Tn Moh Sihabudin / 40 thn / PCR SWAB
+ / RS MAYAPADA Kuningan
TOTAL PASIEN : 9 Pasien
Persediaan Materai
Bedah Dokter Cuti/tidak prkatek

Umum : 1 Dr. Nathalia SpA
Dr. Aldy SpS
Dr. Akbari SpU
Bedah Dr. Ketut Ngurah SpAn-KIC
Syaraf : 2
Dr. Sara Ester SpBP
Dr. Aldy SpS
Dr. Vita Siphra SpDV
Poli Neuro: 8
Poli Paru : 4
133
Lt 4 : 2 Lt 6 : 0
PASIEN OBSERVASI :
1. ( Lt 6 ) An.HARIARA TIMOTHY
MANALU / Mira Febriani Inkiriwang,dr. SpA
/ Fever, unspecified
2. ( Lt 4 ) William Rihi Hina/ Suko Adiarto,
dr. SpJP (K),FIHA,, FICA, FAsCC, PhD/
Unstable angina

FIHA, FICA / Mitral Valve Disease
PASIEN MENINGGAL
RENCANA TINDAKAN :
PASIEN RENCANA PULANG:
1. ( Lt 4 ) Tn Fendi Kurniawan/ Prof. DR.

dr. H. Murdani Abdullah, FACG, Sp.PD,
KGEH, FINASIM 2.
( Lt 6 ) Ny.Indira / dr.Febriansya
Darus,Sp.OG/Rencana kuretase
2.( Lt 6 ) Ny.Selena / Prof.Nugroho
Kampono,Sp.OG (K)/Rencana tindakan
histerektomi
KETERANGAN :
Pasien Lt 5 : 0
Pasien Lt 6 : 1
pasien
Total : Pasien
MASALAH
Indra,
Agung Tidak ada masalah
Ryan Tidak ada masalah
Rangga Tidak ada masalah

Allen Tidak ada masalah
Pak Jery

1.Rigen R
G THEATER

1. INDRIA PERMATASARI / Bedah Obgyn : Dilatasi
Curretage / OK 1 jam 18.00 wib / Dpjp Febriansyah
Darus, Dr. SPOG
AL CARE

1 FIHA, FICA / Mitral Valve Disease / Post MVR
masuk ICU jam 22.00 wib / Jam 05.00 extube
PASIEN OBSERVASI :
PASIEN PONEK :
PASIEN OBSERVASI :
Tidak ada masalah
OLOGY

1 FIHA, FICA / Mitral Valve Disease
Next Schedule
Thu, 10 mar
1. Teguh rahmat / PELD / dr. Syafrizal / 10.00 /
cathlab
Fri, 11 mar
1. Masruwaida / CAG / dr. DH / cathlab / 16.00
Mon, 14 mar
1. Masruwaida / MVR / dr. DAW / Hybrid /
16.00
Tue, 15 Mar
1. R H Nurul Aeni / dr. Faris / replace ppm 2
chamber / Hybrid / 08.00
Outpatient : 15
dr ario :
Dr dafsah : 2
dr denio : 3
dr faris : 1
1 dr DH :
dr DAW :
dr radityo : 1
Dr suko : 2
dr sunu :
dr Adi : 6
SIC (CAROL) 09.03.22
TIPE PASIEN
DINAS
LT NAMA UNIT
EMERGENCY ROOM
EMERGENCY Dr Hanif
Dr Hanif Dr Dwi
Dr Dwi Ns
ROOM, Ns Yuniar
Yuniar Ns
Ns Kelvin
PONEK Ns Nur Ns Tomy
GF Nur
RADIOLOGI Hamida
FL Feby
TOTAL PASIEN EMG

Ns IIn THT :
Urology : 1
Orthopedy : 1 Rehab
Fisiotherapi :12
LT 3 Medik : 1
Bedah
Onkology : 2 Gizi : digestive :
Fisotherapi:
Neuro : 2 ODC : MCU :
TOTAL
5 LT 6
LT 4 LT
5 LT 6
IPD LT 4 Dr Mega
Dr Mega M
Ns Nurul IPD LT 4
M
Ns Nurlaela IPD LT 4
Ns Tiwi
Ns Nadya Ns Devi Ns
Ns Indah
IPD LT 6 Kiki Ns
IN PATIENT Ns Helen
Nadia IPD
DEPARTMENT Ns Ana IPD LT 6
LT 6 Ns
Lt 4, 5, 6 Ns Yudi Ns Avi Ns
Silvi Ns
Santi
Siti Ns
Ns Meutia
Ika
(MD)
( Nursery )
Arwan,
SOS Petugas:
Trijaya
GIZI Petugas : Vira
PHARMACY (SB) Petugas : Widya

IT Petugas :
Jumlah PKD :
SECURITY, DANDRU :
Petugas 6 Lantai 2 : EMG : 1.Giantara
PARKIR Pak 1. M Ryanto 1. Gading A 2. iib diare
orang
TEKNISI PAk Samsul

OPERATING THEATER
Ns Sunandar
OK Ns Heryanti
CRITICAL CARE
Dr Mutiara
Ns Agus

OBSTETRICS
LT 7 Bd Dilla Bd Bd Vicky
VK Bd Tries
Dewi Bd Genda

RUANG TUNGGU PS
CRITICAL
HEARTOLOGY
Ns Akbar
Cathlab Ns Tryanto
Hybrid
LT 8
Ns Rini T
OPD JANTUNG
Ns Emma
AUDITORIUM
NOTED
PE PASIEN KETERANGAN
Y ROOM
PASIEN OBSERVASI : -
RAJAL : 7
RANAP : 4
APS : 1
1. Ny Viona Dhita / 25 thn / G2 P0 A1 / H 28
mg / Pro Inj Venofer 2 amp
TOTAL PASIEN : 13
Bedah Umum : Dokter Cuti/tidak prkatek

2 Dr. Nathalia SpA
Dr. Zaki SpOT
Dr. Akbari SpU
Bedah Syaraf :
Dr. Rigina SpKFR
Dr. Eddy SpPD
Poli Neuro: Dr. Winda SpA
Poli Paru : 3
77 PASIEN
Lt 4 : 13 Lt 6 : 9
PASIEN OBSERVASI :
1.An. Hariara timothy manalu / Mira febriani
inkiriwang,dr. Spa / fever, unspecified
2.An. Annisa khayrani/Meirdhania andina, dr.
Sp.a/dhf- 4
3.An. Yodhanara/ Mira febriani inkiriwang,dr.
Spa/Fever, unspecified
4.An. Vieriwen/Rifan Fauzie, dr. Sp.A (K)/
Fever, unspecified
5.Ny. Anastasia/ Sang Arifianto,dr.
SpOG/Gastroenteritis and colitis of unspecified
origin
6.An. Danesh uzeir farabi/Mira febriani
inkiriwang,dr. Spa/Fever, unspecified
7. An. Humayra / Annisa Nur Aini, dr. Sp.A
(FT) / Dengue fever [classical dengue]
8. Ny. Telly / Taufik Jamaan, Dr.dr. Sp.OG /
9. An. Gibral / Keumala Pringgardini, SpA /
Malaise and fatigue
PASIEN MENINGGAL
RENCANA TINDAKAN :
1. Ny. Okty / dr. Nisa sp.OG / G1P0A0 Hamil

38-39 minggu rencana SC tgl 11/03/22 pkl
11.30(masuk ranap pkl 05.00 wib) 601
PASIEN RENCANA RUJUK:
1. Ny. Okty / dr. Nisa sp.OG / G1P0A0

Hamil 38-39 minggu rencana SC tgl
11/03/22 pkl 11.30(masuk ranap pkl 05.00
wib) 601
KETERANGAN :
Pasien Lt 4 : 10 pasien ( 9
ranap, 1 icu )
Pasien Lt 5 : 0
Pasien Lt 6
: 8 pasien
Total : 18 Pasien
KESIAPAN ALAT :
EKG Aset Rawat inap - Proses
perbaikan sd dimana
Rivan,Agung Tidak ada masalah
Zefika Tidak ada masalah
Nurul Tidak ada masalah

Pak Jery

1.Ari S
THEATER
RENCANA TINDAKAN : 11.03.22 1. Ny.

Octy Edriana/29 Thn/dr. Nisa . Sp. OG/G1P0A0 H 38-39
Mggu a/i CPD/ SC + Eracs/ Jam 11.30 WIB -> pasien
belum datang
2. Ny. Pisesa / 30th / dr. Nisa. Sp. OG/G2P1A0 H 38
Mggu BSC 1x/ SC + Eracs/ Jam 12.30 WIB-> pasien
belum datang.
CARE
0 meninggal : pasien atas nma ny dvi rames DNR di

nytakan meninggal jam 04.00 oleh dr nilam di
hadapan kelurga dan perawat kelurga menerima
PASIEN OBSERVASI :
PASIEN PONEK :
RENCANA TINDAKAN :
1. Ny. Octy Edriana/29 Thn/dr. Nisa .
Sp. OG/G1P0A0 H 38-39 Mggu a/i CPD/
SC + Eracs/ Jam 11.30 WIB -> pasien
belum datang
2. Ny. Pisesa / 30th / dr. Nisa. Sp.
OG/G2P1A0 H 38 Mggu BSC 1x/ SC +
Eracs/ Jam 12.30 WIB-> pasien belum
datang.
PASIEN OBSERVASI :
1
1
. By. Ny Telly/dr. Keumala/NCB SMK 17jam
Tidak ada masalah
LOGY
Next Schedule
Thu, 10 mar
1. Oder Mask / PTCA 2 Stent Complex+IVUS / dr. suko /
16.00 / cathlab
Fri, 11 mar
2. Soen Gan Bie / PELD / dr. Syafrizal / cathlab / 14.00
3. Ie Boen Hian / PELD / dr. Syafrizal / cathlab / 17.00
Saturday, 12 mar
1. Teguh Rahman / Neuro Ablasi / cathlab / 10.00
Mon, 14 mar
1. Masruwaida / MVR / dr. DAW / Hybrid / 16.00
Tue, 15 Mar
1. R H Nurul Aeni / dr. Faris / replace ppm 2 chamber /
Hybrid / 08.00
2. Hilman / PELD / dr. Syafrizal / Cathlab / 13.00
Outpatient :25
dr ario : 3
Dr dafsah :
dr denio : 6
dr faris : 3
1 dr DH :
dr DAW : 1
dr radityo :
Dr suko : 4
dr sunu : 2
dr Adi : 6
SIC (agus) 10.03.22
TIPE PASIEN
DINAS
LT NAMA UNIT
EMERGENCY ROOM
EMERGENCY Dr Hanif
Dr Hanif Dr Dwi
Dr Dwi Ns
ROOM, Ns Yuniar
Yuniar Ns
Ns Kelvin
GF Nur
RADIOLOGI Hamida
FL Feby
TOTAL PASIEN EMG

Ns IIn THT :
Urology : 1
Orthopedy : 1 Rehab
Fisiotherapi :12
LT 3 Medik : 1
Bedah
Fisotherapi:
Neuro : 2 ODC : MCU :
TOTAL
5 LT 6
LT 4 LT
5 LT 6
IPD LT 4 Dr Mega
Dr Mega M
Ns Nurul IPD LT 4
M
Ns Nurlaela IPD LT 4
Ns Tiwi
Ns Nadya Ns Devi Ns
Ns Indah
IPD LT 6 Kiki Ns
IN PATIENT Ns Helen
Nadia IPD
DEPARTMENT Ns Ana IPD LT 6
LT 6 Ns
Lt 4, 5, 6 Ns Yudi Ns Avi Ns
Silvi Ns
Santi
Siti Ns
Ns Meutia
Ika
(MD)
( Nursery )
Arwan,
SOS Petugas:
Trijaya
GIZI Petugas : Vira
PHARMACY (SB) Petugas : Widya

IT Petugas :
Jumlah PKD :
SECURITY, DANDRU :
Petugas 6 Lantai 2 : EMG : 1.Giantara
PARKIR Pak 1. M Ryanto 1. Gading A 2. iib diare
orang
TEKNISI PAk Samsul

OPERATING THEATER
Ns Sunandar
OK Ns Heryanti
CRITICAL CARE
Dr Mutiara
Ns Agus

OBSTETRICS
VK Bd Tries
Dewi Bd Genda
VK Bd Tries
Dewi Bd Genda
RUANG TUNGGU PS
CRITICAL
HEARTOLOGY
Ns Akbar
Cathlab Ns Tryanto
Hybrid
LT 8
LT 8
Ns Rini T
OPD JANTUNG
Ns Emma
AUDITORIUM
NOTED
CY ROOM
RAJAL : 7
RANAP : 4
APS : 1
1. Ny Viona Dhita / 25 thn / G2 P0 A1 / H 28
mg / Pro Inj Venofer 2 amp
TOTAL PASIEN : 13

2 Dr. Nathalia SpA
Dr. Zaki SpOT
Dr. Akbari SpU
Bedah Syaraf :
Dr. Rigina SpKFR
Dr. Eddy SpPD
Poli Neuro: Dr. Winda SpA
Poli Paru : 3
77 PASIEN
Lt 4 : 13 Lt 6 : 9
PASIEN OBSERVASI :
1.An. Hariara timothy manalu / Mira febriani
inkiriwang,dr. Spa / fever, unspecified
2.An. Annisa khayrani/Meirdhania andina, dr.
Sp.a/dhf- 4
3.An. Yodhanara/ Mira febriani inkiriwang,dr.
Spa/Fever, unspecified
4.An. Vieriwen/Rifan Fauzie, dr. Sp.A (K)/
Fever, unspecified
5.Ny. Anastasia/ Sang Arifianto,dr.
SpOG/Gastroenteritis and colitis of unspecified
origin
6.An. Danesh uzeir farabi/Mira febriani
inkiriwang,dr. Spa/Fever, unspecified
7. An. Humayra / Annisa Nur Aini, dr. Sp.A
(FT) / Dengue fever [classical dengue]
8. Ny. Telly / Taufik Jamaan, Dr.dr. Sp.OG /
9. An. Gibral / Keumala Pringgardini, SpA /
Malaise and fatigue
PASIEN MENINGGAL
RENCANA TINDAKAN :
1. Ny. Okty / dr. Nisa sp.OG / G1P0A0 Hamil

38-39 minggu rencana SC tgl 11/03/22 pkl
11.30(masuk ranap pkl 05.00 wib) 601
1. Ny. Okty / dr. Nisa sp.OG / G1P0A0

Hamil 38-39 minggu rencana SC tgl
11/03/22 pkl 11.30(masuk ranap pkl 05.00
wib) 601
KETERANGAN :
Pasien Lt 4 : 10 pasien ( 9
ranap, 1 icu )
Pasien Lt 5 : 0
Pasien Lt 6
: 8 pasien
Total : 18 Pasien
KESIAPAN ALAT :
EKG Aset Rawat inap - Proses
perbaikan sd dimana
Rivan,Agung Tidak ada masalah
Zefika Tidak ada masalah
Nurul Tidak ada masalah

Pak Jery

1.Ari S
THEATER
RENCANA TINDAKAN : 11.03.22 1. Ny.

Octy Edriana/29 Thn/dr. Nisa . Sp. OG/G1P0A0 H 38-39
Mggu a/i CPD/ SC + Eracs/ Jam 11.30 WIB -> pasien
belum datang
2. Ny. Pisesa / 30th / dr. Nisa. Sp. OG/G2P1A0 H 38
Mggu BSC 1x/ SC + Eracs/ Jam 12.30 WIB-> pasien
belum datang.
L CARE
0 meninggal : pasien atas nma ny dvi rames DNR di

nytakan meninggal jam 04.00 oleh dr nilam di
hadapan kelurga dan perawat kelurga menerima
PASIEN OBSERVASI :
PASIEN PONEK :
RENCANA TINDAKAN :
1. Ny. Octy Edriana/29 Thn/dr. Nisa .
Sp. OG/G1P0A0 H 38-39 Mggu a/i CPD/
SC + Eracs/ Jam 11.30 WIB -> pasien
belum datang
2. Ny. Pisesa / 30th / dr. Nisa. Sp.
OG/G2P1A0 H 38 Mggu BSC 1x/ SC +
Eracs/ Jam 12.30 WIB-> pasien belum
datang.
PASIEN OBSERVASI :
1
. By. Ny Telly/dr. Keumala/NCB SMK 17jam
Tidak ada masalah
OLOGY
1
Next Schedule
Thu, 10 mar
1. Oder Mask / PTCA 2 Stent Complex+IVUS / dr. suko /
16.00 / cathlab
Fri, 11 mar
2. Soen Gan Bie / PELD / dr. Syafrizal / cathlab / 14.00
3. Ie Boen Hian / PELD / dr. Syafrizal / cathlab / 17.00
Saturday, 12 mar
1. Teguh Rahman / Neuro Ablasi / cathlab / 10.00
Mon, 14 mar
1. Masruwaida / MVR / dr. DAW / Hybrid / 16.00
Tue, 15 Mar
1. R H Nurul Aeni / dr. Faris / replace ppm 2 chamber /
Hybrid / 08.00
2. Hilman / PELD / dr. Syafrizal / Cathlab / 13.00
Outpatient :25
dr ario : 3
Dr dafsah :
dr denio : 6
dr faris : 3
1 dr DH :
dr DAW : 1
dr radityo :
Dr suko : 4
dr sunu : 2
dr Adi : 6
SIC Nurul 11.03.22
TIPE PASIEN
DINAS
LT NAMA UNIT
EMERGENCY ROOM
EMERGENCY Dr Hanif
Dr Hanif Dr Dwi
Dr Dwi Ns
ROOM, Ns Yuniar
Yuniar Ns
Ns Kelvin
GF Nur
RADIOLOGI Hamida
FL Feby
TOTAL PASIEN EMG

Ns IIn THT : 7
Urology : 1
Rehab
Fisiotherapi :7
LT 3 Orthopedy : 1 Medik : 1
Bedah
Fisotherapi: 7
Neuro : 8 ODC : 1 MCU :
Telekonsul : 3
TOTAL
5 LT 6
LT 4 LT
5 LT 6
IPD LT 4
dr Abdur Ns
Citra Ns
Rio Ns Tiwi Dr Dur Ns Dr Audrey
Ns Ela Ns Tiwi Ns Ela
IN PATIENT Ns Salwa Ns
Ns Novi Ns
DEPARTMENT Novi Ns Indah Ns
Abdi Ns
Lt 4, 5, 6 Indah Ns Rizky Helen
Rizky
SOS Petugas: Kholik
GIZI Petugas : Ajeng

LABORATORIUM Petugas : Ika
PHARMACY (SB) Petugas : Kiki

IT Petugas :
PKD :
DANDRU : Jumlah
SECURITY,
Pak Petugas 6 Lantai 2 : EMG : 1.Apit
PARKIR 1. Heri 1. Firliano 2. Nova
Wibi orang
TEKNISI PAk Jay
OPERATING THEATER
Ns Sunandar
OK Ns Heryanti
CRITICAL CARE
ICU / HCU Winda Helga Helga
PICU / NICU Ns Ayu Ns Alfi Ns Grace

LT 7
OBSTETRICS
Bd Dilla Bd Bd Anggi
VK Hilda
Tries Bd Dewi
Nursery Ns Nelly Ns Wiwi Ns Inggrd

RUANG TUNGGU PS
CRITICAL
HEARTOLOGY
Ns Akbar
Cathlab Ns Tryanto
Hybrid
LT 8
AUDITORIUM
NOTED
OOM
RAJAL : 8
RANAP : 5
APS : 0
PASIEN TERKONFIRMASI COV -
19 : 2
PONEK : 1
Ny Mutiara G1P0A0 hamil 39 mg
TOTAL PASIEN : 14

1 Dr. Nathalia SpA
Dr. Zaki SpOT
Dr. Akbari SpU
Bedah Syaraf :
1
Poli Neuro:
Poli Paru : 0
105 PASIEN
Lt 4 : 7 Lt 6 : 7
PASIEN OBSERVASI :
Lantai 4 :
1. Tn Adinove /dr Deno SpJp/
CHF 2. Tn Taufan/ Dr Dcky/ Post
MVR
3. Ibu Putri/ dr Alvin/DHF
4. Ny Marisa/dr Febri/DHF 12 mg
Lantai 6
1. An Anisa/ dr Merdhania/DHF
hari ke4
2. An Yoodanara/dr
Mira/Fever 3. Anak Vieriwen/dr
Rivan/ Fever 4. Anak Danesh/ dr
Mira /Fever 5. anak Humaira/dr
Anisa/DHF 6. Azhar/dr
Rivan/RSP
PASIEN MENINGGAL
RENCANA TINDAKAN :
Pasien Lt 5 : 0
Pasien Lt 6
: 13 pasien
Total :
KESIAPAN ALAT :
EKG Aset Rawat
inap - Proses perbaikan sd dimana
Nidah Tidak ada masalah
Anti Tidak ada masalah

Icha Tidak ada masalah
Widya Tidak ada masalah

Pak Jery
LOBBY : Aman, PAtroli Satgas tidak ada

1.Hamka masalah
EATER
6
1. Ny. Faty/dr. Chamim
Sp.OG/Laparascopy/Tindakan Jam 06 .00
Pagi
2. Ny Nita / dr. Vernardi. Sp. OG/ SC +
Eracs/ Jam 10.00 WIB-
3. Tn
Pui Jony dr Widi / Laparscopy Cole/ Jam
11.00 4. Ny Citra/ dr Chamim/Laparascopy/
jam 14.00 5. Raka/ dr
Yonas/Rekonstruksi penis/jam 20.00
ARE
1
Tn Roy Raule/dr Faris Basalamah /Post
PCI/ selesai jam 19.30
PASIEN OBSERVASI :
PASIEN PONEK :
PASIEN OBSERVASI :
. By. Ny Telly/dr. Keumala/NCB
SMK 17jam 2. By Ny. Okti/ dr
Anisa/MCB 1 hari 3. Ny. Ny
Pisesa Wina dr Anisa/MCB SMK 1
3 hari
Tidak ada masalah
GY
Saturday, 12 mar
1. Teguh Rahman / Neuro Ablasi / cathlab /
10.00
Mon, 14 mar
1. Masruwaida / MVR / dr. DAW / Hybrid /
16.00
Tue, 15 Mar
1. R H Nurul Aeni / dr. Faris / replace ppm 2
chamber / Hybrid / 08.00
2. Hilman / PELD / dr. Syafrizal / Cathlab /
13.00
Outpatient :23
dr ario : 0
Dr dafsah :
dr denio : 9
dr faris : 3
1 dr DH : 4
dr DAW :
dr radityo :
Dr suko :
dr sunu :
dr Adi : 7
SIC agus 13.03.22
TIPE PASIEN
DINAS
LT NAMA UNIT
EMERGENCY ROOM
EMERGENCY Dr fajar
Dr fajar Ns
ROOM, kelvin ns tomi
Ns muhlis ns
PONEK rizam
GF
RADIOLOGI Bu Arga
FL puput, adra
TOTAL PASIEN EMG
Poli Obgyn : 8 Poli anak :

Ns IIn THT : 1
Urology :
Fisiotherapi :7 Rehab Medik :
LT 3 Orthopedy :
Poli Pediatrik 12 Poli Mata :
Bedah digestive
Onkology : Gizi : :
Fisotherapi:
Neuro : ODC : MCU :
Telekonsul :
TOTAL
LT 5
LT 6
IPD LT 4
Ns tiwi IPD LT 4
Ns nadia Dr nesya Ns
Ns Egis Tiwi Ns
IPD LT 6 Novita Ns
IN PATIENT
Rio IPD LT
DEPARTMENT Ns devi Ns 6 dr audrey
Lt 4, 5, 6 siti NsSlvi Ns Indah
Ns Ahid Ns
Malik
Indra,
SOS Petugas:
Khaerul

LABORATORIUM Petugas : Marisa
Petugas :
PHARMACY (SB) Yeyen
IT Petugas :
PKD :
DANDRU : EMG : 1.Apit
Jumlah Petugas Lantai 2 :
SECURITY, PARKIR Pak 1. 2. Nova
6 orang 1.
Wibi Firliano
TEKNISI SS
OPERATING THEATER
Ns Sunandar
OK Ns Heryanti Heri
CRITICAL CARE
ICU / HCU Ns Winda Ns ning
PICU / NICU Ns Evi Ns ayu

OBSTETRICS
Bd viki Bd Nely Bd
VK Bd Genda Tries
LT 7
Nursery Ns Nani Ns Ika
RUANG TUNGGU PS
CRITICAL
HEARTOLOGY
Cathlab
LT 8
Hybrid
LT 8
OPD JANTUNG
AUDITORIUM
NOTED
TIPE PASIEN
KETERANGAN
OOM
RAJAL : 6
RANAP : 2
APS :
PASIEN TERKONFIRMASI COV - 19 :
PONEK : 0
TOTAL PASIEN : 12
Bedah
Umum :
Bedah
Syaraf :
Poli Neuro:
Poli Paru : 0
20 Pasien
Lt 4 : 5 Lt 6 : 1
PASIEN OBSERVASI :
1. ( LT 6 ) Tn Mark Ashlin / 48 thn /
Angina Pectoris
1. (LT4 ) Ny. Citra/ Chamim, DR,/ dr,
SpOG (K) Onk/ Endometriosis of ovary /
HCU
2. (LT 6 ) An. Danesh uzeir
farabi/Mira febriani inkiriwang,dr.
Spa/Fever, unspecified / PICU
PASIEN MENINGGAL
RENCANA TINDAKAN :
1. ( Lt 4 ) Tn Alvin Pungki/ Mira

Yulianti,dr, SpPD-KP/ Malignant
neoplasm of bronchus and lung, Pleural
effusion in conditions classified
elsewhere Fever, unspecified/ Rencana
bronkoskopi+biopsi dan pungsi pleura
kiri
Kalau di saharjo bs mengadakan
bronkoskopi saya kerjakan di saharjo
(Tunggu ACC asuransi SIO (+) FL KIKI)
KETERANGAN :
Pasien
Lt 4 : 12 pasien
Pasien Lt
5 : 0
Total : 21Pasien
KELENGKAPAN SARANA PRASARANA :
1. Ketersediaan Oksigen portable di unit IPD 4,

5 dan 6 ( Standar masing masing unit 2 )belum
sesuai standar. Saat ini oksigen portable hanya
ada di lt 4 saja.
Irwan Tidak ada masalah

Adela Tidak ada masalah
Upi Tidak ada masalah

Pak Jery

1.Hamka
Pak Jati
EATER
RENCANA TINDAKAN : 13.03.22 :0

ARE
1. Citra Krisna / Bedah digestive Adesiolisis
1 komplek, Post tindakan laparoskopi
histerektomi / Chammim DR, Dr, SPOG (K)
Onk
1. An. Danesh uzeir farabi/Mira febriani
1 inkiriwang,dr. Spa/ DHF h4 / PICU
PASIEN OBSERVASI :
0
PASIEN PONEK :
PASIEN OBSERVASI :
1. By. Ny Telly/dr. Keumala/NCB SMK
USIA 2 hari
2. By. Ny. Octy Endriana/dr. Annisa,
Sp.A/NCB SMK USIA 1 hari
3. By. Ny. Pisesa Wina/dr. Annisa,
4.By.Ny. Nita Qonita/dr.Nina dwi
3 putri,Sp.A/NCB SMK Usia 12 jam
5.By.Ny. Mutiara ayu larasati/dr.nina dwi
putri,Sp.A/NCB SMK USIA
1 Jam
Tidak ada masalah
GY
1
1
SIC agus 13.03.22
TIPE PASIEN
DINAS
LT NAMA UNIT
EMERGENCY ROOM
EMERGENCY Dr fajar
Dr fajar Ns
ROOM, kelvin ns tomi
Ns muhlis ns
PONEK rizam
GF
RADIOLOGI Bu Arga
FL puput, adra
TOTAL PASIEN EMG
Poli Obgyn : 8 Poli anak :

Ns IIn THT : 1
Urology :
Fisiotherapi :7 Rehab Medik :
LT 3 Orthopedy :
Poli Pediatrik 12 Poli Mata :
Bedah digestive
Onkology : Gizi : :
Fisotherapi:
Neuro : ODC : MCU :
Telekonsul :
TOTAL
LT 5
LT 6
IPD LT 4
Ns tiwi IPD LT 4
Ns nadia Dr nesya Ns
Ns Egis Tiwi Ns
IPD LT 6 Novita Ns
IN PATIENT
Rio IPD LT
DEPARTMENT Ns devi Ns 6 dr audrey
Lt 4, 5, 6 siti NsSlvi Ns Indah
Ns Ahid Ns
Malik
Indra,
SOS Petugas:
Khaerul

Petugas :
PHARMACY (SB) Yeyen
IT Petugas :
PKD :
DANDRU : EMG : 1.Apit
Jumlah Petugas Lantai 2 :
SECURITY, PARKIR Pak 1. 2. Nova
6 orang 1.
Wibi Firliano
TEKNISI SS
OPERATING THEATER
Ns Sunandar
OK Ns Heryanti Heri
CRITICAL CARE
ICU / HCU Ns Winda Ns ning
PICU / NICU Ns Evi Ns ayu

OBSTETRICS
Bd viki Bd Nely Bd
VK Bd Genda Tries
LT 7
Nursery Ns Nani Ns Ika
RUANG TUNGGU PS
CRITICAL
HEARTOLOGY
Cathlab
LT 8
Hybrid
LT 8
OPD JANTUNG
AUDITORIUM
NOTED
TIPE PASIEN
KETERANGAN
OOM
RAJAL : 6
RANAP : 2
APS :
PASIEN TERKONFIRMASI COV - 19 :
PONEK : 0
TOTAL PASIEN : 12
Bedah
Umum :
Bedah
Syaraf :
Poli Neuro:
Poli Paru : 0
20 Pasien
Lt 4 : 5 Lt 6 : 1
PASIEN OBSERVASI :
1. ( LT 6 ) Tn Mark Ashlin / 48 thn /
Angina Pectoris
1. (LT4 ) Ny. Citra/ Chamim, DR,/ dr,
SpOG (K) Onk/ Endometriosis of ovary /
HCU
2. (LT 6 ) An. Danesh uzeir
farabi/Mira febriani inkiriwang,dr.
Spa/Fever, unspecified / PICU
PASIEN MENINGGAL
RENCANA TINDAKAN :
1. ( Lt 4 ) Tn Alvin Pungki/ Mira

Yulianti,dr, SpPD-KP/ Malignant
neoplasm of bronchus and lung, Pleural
effusion in conditions classified
elsewhere Fever, unspecified/ Rencana
bronkoskopi+biopsi dan pungsi pleura
kiri
Kalau di saharjo bs mengadakan
bronkoskopi saya kerjakan di saharjo
(Tunggu ACC asuransi SIO (+) FL KIKI)
KETERANGAN :
Pasien
Lt 4 : 12 pasien
Pasien Lt
5 : 0
Total : 21Pasien
1. Ketersediaan Oksigen portable di unit IPD 4,

5 dan 6 ( Standar masing masing unit 2 )belum
sesuai standar. Saat ini oksigen portable hanya
ada di lt 4 saja.
Irwan Tidak ada masalah

Adela Tidak ada masalah

Pak Jery

1.Hamka
Pak Jati
EATER
RENCANA TINDAKAN : 13.03.22 :0

ARE
1. Citra Krisna / Bedah digestive Adesiolisis
1 komplek, Post tindakan laparoskopi
histerektomi / Chammim DR, Dr, SPOG (K)
Onk
1 inkiriwang,dr. Spa/ DHF h4 / PICU
PASIEN OBSERVASI :
0
PASIEN PONEK :
PASIEN OBSERVASI :
1. By. Ny Telly/dr. Keumala/NCB SMK
USIA 2 hari
2. By. Ny. Octy Endriana/dr. Annisa,
3. By. Ny. Pisesa Wina/dr. Annisa,
4.By.Ny. Nita Qonita/dr.Nina dwi
3 putri,Sp.A/NCB SMK Usia 12 jam
5.By.Ny. Mutiara ayu larasati/dr.nina dwi
1 Jam
Tidak ada masalah
GY
1
1
SIC NURUL 13.03.22 DM
TIPE PASIEN
EMERGENCY ROOM
EMERGENCY Dr fajar
Dr fajar Ns dr.Frida
Ns
ROOM, kelvin ns
muhlis ns
Ns.Sanusi
PONEK tomi Ns.Ardy
rizam
GF
RADIOLOGI bu Arga
FL puput,adra Rizky,Raymond
TOTAL PASIEN EMG
Poli Obgyn : 5 Poli anak : Bedah Umum :

Ns IIn THT : 1
Urology :
Poli Internist: Dental : Bedah Syaraf :
Rehab
Fisiotherapi :
Poli Pediatrik 8 Poli Mata : Poli Neuro:
Bedah
Fisotherapi: Poli Paru : 0
Neuro : ODC : MCU :
Telekonsul :
TOTAL 13 Pasien
LT 5
LT
6
IPD LT 4
Ns tiwi
Ns nadia IPD LT 4
Ns Egis Dr nesya IPD LT 4
Midle: Ns Tary dr.Rhona
Indah Ns Novita Ns.Ella
IN PATIENT Ns Rio Ns.Helen
IPD LT 6
DEPARTMENT IPD LT 6 Ns.Rizky IPD
Lt 4, 5, 6 Ns devi dr audrey LT 6 Ns.Indah
Ns Santy
IPD LT 4
Ns tiwi
Ns nadia IPD LT 4
Ns Egis Dr nesya IPD LT 4
Midle: Ns Tary dr.Rhona
Indah Ns Novita Ns.Ella
IN PATIENT Ns Rio Ns.Helen
IPD LT 6
DEPARTMENT IPD LT 6 Ns.Rizky IPD
Lt 4, 5, 6 Ns devi dr audrey LT 6 Ns.Indah
Ns Santy Ns Rhisa Ns.Yudi
NsSlvi Ns Malik Ns.Ahid
Bid.Ade
Bid.Ade
Indra,
SOS Petugas: Irwan
Khaerul
GIZI Petugas : Ajeng Anti
LABORATORIUM Petugas : Marisa Adela
PHARMACY Petugas : Yeyen Upi

(SB)
PKD :
DANDRU : Jumlah EMG : 1.Apit
SECURITY, LOBBY :
PARKIR
Pak Petugas 6 Lantai 2 : 1. 1. 2. Nova
1.Hamka
Wibi orang Firliano
TEKNISI SS Pak Jati

OPERATING THEATER
Ns Sunandar
OK Ns hery 0
Heryanti
CRITICAL CARE
dr Riri Ns dr.Riri Ns dr.Nilam
ICU / HCU Winda ning Ns.Gisma 0
PICU / NICU Ns Evi Ns ayu Ns.Alfi 1
OBSTETRICS
LT 7
Bd viki Bd Nely Bid.Dilla

VK Bd Genda Bd Putri Bid.Tries 2
Nursery Ns Nani Ns Ika Ns.Wiwi 3
RUANG TUNGGU PS
CRITICAL
HEARTOLOGY
Cathlab
Hybrid 1
LT 8
LT 8
OPD JANTUNG 1
AUDITORIUM
NOTED
perhatian/critical/Kemo/tra
nsfusi, Pasien
Risiko/Komplen, Pasien
PASIEN
OBSERVASI : -
RAJAL : 11
RANAP : 6
APS : 0
PASIEN TERKONFIRMASI
COV - 19 : 0
PONEK : 2
TOTAL PASIEN :
19
Tidak ada masalah
Lt 4 : 4 Lt 6 : 2
PASIEN OBSERVASI
: Lantai 4:
1.Tn.Abdul Aziz/CAD
dr.Faris B,Sp.JP
2.Tn Roy /dr
Faris B Sp.JP
1. ( LT 6 ) Tn Mark
Ashlin / 48 thn / Angina
Pectoris
2.An.Ananda Putri/
dr.FarisB,Sp.JP/Suprav
entricular tachycardi
3.An.Annisa/dr.Andina/
DHF ke 4
4.An.Humayra/
dr.Annisa/dengue fever
5.An.Camilla/dr Sarah
6.An.Luddietsach/dr
Andina Sp.A/Dengue
Fever
PASIEN OBSERVASI
CRITICAL: LT.4
1.Ny.Citra/post
op Laparascopy/
dr.Chamim Sp.OG
2.Tn.Taufan /Post
MVR/dr.Dicky.A,Sp.B
TKV
PASIEN
MENINGGAL
RENCANA
TINDAKAN :
LANTAI:4
1.Ny.Wulan/dr Widi
Sp.B/Laparascopy
Appendictomy jam
05.00 (ass belum acc)
dari dr.widi untuk di
jadwalkan ulang
sampai ass acc (ass
FWD) OK sudah
terinfo dg Hery
2.Tn.Hioe
Sioeng Set/ dr.Mirta
Sp.THT/
Polypectomy
/jam.15.00
LANTAI:6
1.An.Camila Nazirah
dr.Sarah Ester Sp.BP
Debridement Luka
Bakar jam 07.00 (ass
belum acc)
2.An.Ananda Putri
dr.Faris B Sp.JP/
3D Ablasi hari Selasa
tgl 15/03/2022 u/jam
tgg penjadwalan
NOTE:. ( Lt 4 ) Tn
Alvin Pungki/ Mira
Yulianti,dr, SpPD-KP/
Malignant neoplasm of
bronchus and lung,
Pleural effusion in
conditions classified
elsewhere Fever,
unspecified/ Rencana
bronkoskopi+biopsi dan
pungsi pleura kiri
Kalau di saharjo bs
mengadakan
bronkoskopi saya
kerjakan di saharjo
(Tunggu ACC asuransi
SIO (+) FL KIKI)
PASIEN RENCANA
RUJUK:
PASEN RENCANA
MASUK :
1.Ny.Audrey/dr.Nisa
Rencana masuk hari
ini /619
KETERANGAN :
Pasien
Lt 4 : 16 pasien
Pasien Lt 5 : 0
Pasien Lt
6 : 11 pasien
Total
: 27Pasien
KELENGKAPAN SARANA
PRASARANA :
1. Ketersediaan Oksigen
portable di unit IPD 4, 5 dan
6 ( Standar masing masing
unit 2 )belum sesuai
standar. Saat Oksigen
portable ada di 4 dan 6
Tidak ada masalah
Tidak ada masalah
Tidak ada masalah
Tidak ada masalah
Aman, PAtroli Satgas

tidak ada masalah
RENCANA TINDAKAN :
14.03.22
1.Ny.Wulan/dr.Widi,Sp.Sp.
B/Laparascopy
Apendictomy jam.05.00
belum acc asuransi
2.Tn.Hioe Sioeng Set/ 79
th/dr.Mirta Sp.THT/
jam.15.00
3.An.Camila
Nazirah/dr.Sarah Ester
Debridement Luka bakar
jam.07.00(belum acc
asuransi)
4.By.Ny.Pisesa
Wina/dr.Riana/3 hr jam
16.30(ass acc)
5.Tn.Syahrul/dr bob jam
20.00
6.Ny.Dea/dr.Nisa.F
Sp.OG/jam.23.30
1. An. Danesh uzeir
farabi/Mira febriani
inkiriwang,dr. Spa/ DHF
h4 / PICU
PASIEN
OBSERVASI :Ny.Risca.
Anggraini/31
th/dr.Nisa.F,Sp.OG hml
39 mgg+6hr sedang
induksi
Ny.Selly/dr.Nisa.F
Sp.OG /R/induksi
PASIEN PONEK :
1.Ny.Selly/dr.Nisa.F
Sp.OG --R/Induksi
PASIEN OBSERVASI
:
1. By. Ny. Pisesa

Wina/dr. Annisa,
Sp.A/NCB SMK USIA
1 hari
2.By.Ny. Nita
Qonita/dr.Nina dwi
putri,Sp.A/NCB SMK
Usia 12 jam
3.By.Ny. Mutiara ayu
larasati/dr.nina dwi
putri,Sp.A/NCB SMK
USIA
1 Jam
PASIEN
HIPERBILLIRUBIN :
Tidak ada masalah

SIC NURUL 14.03.22 DM
TIPE PASIEN
LT NAMA UNIT DINAS
EMERGENCY ROOM
EMERGENCY Dr fajar Ns Dr fajar dr.Dwi

ROOM, Susi Ns Ns muhlis ns Ns.Sanusi
PONEK Nur rizam Ns.Yuniar
GF
RADIOLOGI Dedi
FL Novita Andra
TOTAL PASIEN EMG
Poli Obgyn : 40 Poli anak :25

Ns IIn THT : 5
Urology :
Fisiotherapi :
Rehab Medik :3
LT 3 Orthopedy : 4 5
Bedah
Fisotherapi:
Telekonsul :
TOTAL
LT 5
LT 6
IPD LT 4
Dr Mega
Ns Citra IPD LT 4
Ns SAlwa IPD LT 4 Dr dr.Faisal
Ns Nadia Mega Ns Abdi Ns.Tari
Lantai 5: Ns Indah Ns.Novita
DP:0 Ns Nadia Lantai :5
IN PATIENT Lantai 5: Ns.Indah
IPD LT 6
DEPARTMENT Ns.Rio IPD Ns.Malik
Lt 4, 5, 6 dr.Audrey LT 6 IPD LT 6
Ns Dini dr.Audrey dr.Megawati
Ns Santy Ns Silvi Ns.Devi
Ns Egis Ns Mutia Ns.Ahid
Indra,
SOS Petugas:
Khaerul
PHARMACY
(SB)
Petugas : Yeyen
IT Petugas :
DANDRU : PKD :
SECURITY, Jumlah Petugas Lantai 2 : 1. EMG : 1.Iip
Pak
PARKIR 6 orang Rianto 1. Gading 2. Rio
Adi
TEKNISI SS
OPERATING THEATER
Ns Sunandar
OK Ns hery
Heryanti
CRITICAL CARE
dr Riri Ns dr.Riri dr.Risky
ICU / HCU Awal Ns.Rita Ns.Aning
PICU / NICU Ns Hesti Ns ayu Ns.Grace
LT 7 OBSTETRICS
Bd Ningsih Bid.Putri
VK Bd Anggi
bid.Viki Bid.Tries
Nursery Ns Inggrid Ns Nani Ns.Nelly
RUANG TUNGGU
PS CRITICAL
HEARTOLOGY
Cathlab Ns.Akbar
Hybrid
LT 8
OPD
Ns.Rini
JANTUNG
AUDITORIUM
NOTED
TOTAL PASIEN : 196 pasien
TIPE PASIEN perhatian/critical/Kemo/transfusi,
Pasien Risiko/Komplen, Pasien
titipan, ODC, & Prosedur yang
OOM
RAJAL : 11
RANAP : 3
APS : 0
19 : 1
PONEK : 1
TOTAL PASIEN : 14
Tidak ada masalah
Bedah Umum : dr yang cuti:

2 1.dr.Nathalia Sp.A
Bedah Syaraf : 1
Poli Neuro:
Poli Paru : 0
128 Pasien
TMENT
Lt 4 : 2 Lt 5 : 2 Lt.6: 3
PASIEN OBSERVASI :
Lantai 4: 1.Tn.Abdul
Aziz/CAD dr.Faris B,Sp.JP
2.Tn Roy /dr Faris
B Sp.JP Lantai
5: 1.Ny.Soraya
/dr.Alvin.Sp.PD/Acute
Pancreatitis chole
2.Tn.Lucky/dr.Alvin.Sp.PD
Lantai 6 :
1.An.Humayra/
2.An.Luddietsach/dr
Andina Sp.A/Dengue Fever
3.An.Raindra/Rifan.F.Sp.A/
Dengue Fever
PASIEN OBSERVASI
CRITICAL: LT.4
1.Ny.Citra/post op
Laparascopy/
dr.Chamim Sp.OG
2.Tn.Taufan /Post
MVR/dr.Dicky.A,Sp.BTKV
PASIEN MENINGGAL
RENCANA TINDAKAN :
LANTAI:4
1.Tn.Abdul Aziz/dr.Faris.B
Sp.JP/CAG stby PCI
jam.08.00
2.Nn.Farah/dr.Carolina
Supit/Laparascopy App/jam
12.00
NOTE:. ( Lt 4 ) Tn Alvin
Pungki/ Mira Yulianti,dr,
SpPD-KP/ Malignant
neoplasm of bronchus and
lung, Pleural effusion in
conditions classified elsewhere
Fever, unspecified/ Rencana
bronkoskopi+biopsi dan pungsi
pleura kiri
Kalau di saharjo bs
mengadakan bronkoskopi saya
kerjakan di saharjo (Tunggu
ACC asuransi SIO (+) FL
KIKI)
PASIEN RENCANA
RUJUK:
PASEN RENCANA MASUK

:
KETERANGAN :
Pasien Lt
4 : 16 pasien
Pasien Lt 5 : 2
Total :
25 Pasien
EKG masih dalam perbaikan
trijaya Tidak ada masalah
nesya Tidak ada masalah
khrisna Tidak ada masalah
Pak Jery

1.Ari masalah
Pak Juki
ATER
0
1.Tn.Murtaza/dr
Wishanti/Tonsilectomy/
jam.15.00
2.Ny.Larasati/dr.Caroline/
debridement + eksisi drainase
jam.10.00
3.Ny.Farah/dr.Caroline/Lap
App/jam 12.00
4.Ny.Sherly/dr Nisa.F (dr.rani sp.og)
07.30 G3 P0 dg fetal distres
pembukaan 6-7cm PTM (CITO)
RE
0
1. An. Danesh uzeir farabi/Mira
febriani inkiriwang,dr. Spa/ DHF
1 h4 / PICU
PASIEN OBSERVASI :
Ny.Selly/dr.Nisa.F Sp.OG /R/Op
Cito dr.Rayni Sp.OG
1
PASIEN PONEK :
1.Ny.Ferawati/dr Rani Sp.OG

G1P0A0 hml dg abortus
PASIEN OBSERVASI :
1. By. Ny. Rizka/dr.Andina

Sp.A/ NCB SMK 1 hari
2.By.Ny. Dhea/dr.Andina
Sp.A/NCB SMK 6 jam
3 larasati/dr.nina dwi
1 Jam
PASIEN
HIPERBILLIRUBIN :
Tidak ada masalah

Y
0
1 0
total 24 pasien
dr.Dafsah:1
dr.Denio:6
dr.Faris:4
dr.Raditio:1
dr.Suko:2
dr.Sunu:3
1 Dr.Adi:7
MCU:0
Tindakan Diagnostic:
USG Doppler:2
EKG:10
Treadmil:2
Advance Echo:5
GV minor:2
SIC agus 15.03.22 DM
TIPE PASIEN
LT NAMA UNIT DINAS
EMERGENCY ROOM
EMERGENCY Dr fajar Ns Dr fajar dr.Dwi

ROOM, Susi Ns Ns muhlis ns Ns.Sanusi
PONEK Nur rizam Ns.Yuniar
GF
RADIOLOGI Dedi
FL Novita Andra
TOTAL PASIEN EMG
Poli Obgyn : 40 Poli anak :25

Ns IIn THT : 5
Urology :
Fisiotherapi :
Rehab Medik :3
LT 3 Orthopedy : 4 5
Bedah
Fisotherapi:
Telekonsul :
TOTAL
LT 5
LT 6
IPD LT 4
Dr Mega
Ns Citra IPD LT 4
Ns SAlwa IPD LT 4 Dr dr.Faisal
Ns Nadia Mega Ns Abdi Ns.Tari
Lantai 5: Ns Indah Ns.Novita
DP:0 Ns Nadia Lantai :5
IN PATIENT Lantai 5: Ns.rio
IPD LT 6
DEPARTMENT Ns.Rio IPD Ns.Malik
Lt 4, 5, 6 dr.Audrey LT 6 IPD LT 6
Ns Dini dr.Audrey dr.Megawati
Ns Santy Ns Silvi Ns.Devi
Ns Egis Ns Mutia Ns.Ahid
Indra,
SOS Petugas:
Khaerul
PHARMACY
(SB)
Petugas : Yeyen
IT Petugas :
DANDRU : PKD :
SECURITY, Jumlah Petugas Lantai 2 : 1. EMG : 1.Iip
Pak
PARKIR 5 orang Rianto 1. Gading 2. giantri
Adi
TEKNISI SS
OPERATING THEATER
Ns Sunandar
OK Ns hery
Heryanti
CRITICAL CARE
dr Riri Ns dr.Riri dr.Risky
ICU / HCU Awal Ns.Rita Ns.Aning
PICU / NICU Ns Hesti Ns ayu Ns.Grace
OBSTETRICS
Bd Ningsih Bid.Putri
VK Bd Anggi
bid.Viki Bid.Tries
LT 7
Nursery Ns Inggrid Ns Nani Ns.Nelly
RUANG TUNGGU
PS CRITICAL
HEARTOLOGY
Cathlab Ns.Akbar
Hybrid
LT 8
LT 8
OPD
Ns.Rini
JANTUNG
AUDITORIUM
NOTED
TOTAL PASIEN : 147 pasien
TIPE PASIEN perhatian/critical/Kemo/transfusi,
Pasien Risiko/Komplen, Pasien
titipan, ODC, & Prosedur yang
OOM
RAJAL : 8
RANAP : 1
APS : 0
19 : 2
PONEK : 1
TOTAL PASIEN : 9
Tidak ada masalah
Bedah Umum : dr yang cuti:

2 1.dr.Nathalia Sp.A
Bedah Syaraf : 1
Poli Neuro:
Poli Paru : 0
109Pasien
TMENT
Lt 4 : 2 Lt 5 : 2 Lt.6: 3
PASIEN OBSERVASI :
Lantai 4: 1.Tn.Abdul
Aziz/CAD dr.Faris B,Sp.JP
2.Tn Roy /dr Faris
B Sp.JP Lantai
5: 1.Ny.Soraya
/dr.Alvin.Sp.PD/Acute
Pancreatitis chole
2.Tn.Lucky/dr.Alvin.Sp.PD
Lantai 6 :
1.An.Humayra/
2.An.Luddietsach/dr
Andina Sp.A/Dengue Fever
3.An.Raindra/Rifan.F.Sp.A/
Dengue Fever
PASIEN OBSERVASI
CRITICAL: LT.4
1.Ny.Citra/post op
Laparascopy/
dr.Chamim Sp.OG
2.Tn.Taufan /Post
MVR/dr.Dicky.A,Sp.BTKV
PASIEN MENINGGAL
RENCANA TINDAKAN :
LANTAI:4 1.Tn.
Ronald Rendy/ Denio A
Ridjab, dr. SpJP - FIHA/
Chest pain, unspecified,
Palpitations/ Rencana CT
Cardiac 16/3/22
lantai5 : Ny.Nurul
Lutfiyah / dr.Syafrizal,
Sp.BS / Rencana Tindakan
Lumbal and other
intervetebral disc disoreders
with radiculopathy Rabu,
16/03/2022 pukul 08:00 WIB
-An. Vivian/ dr.Dicky
Hanafy.SpJP-FIHA, FAsCC/
Rencana Tindakan Ablasi 2D
SVT Kamis, 17 Maret 2022
Pukul 18:30 WIB
-Ny. Chesa Yenni Mahdaniar
/ Caroline Supit, dr. SpB
/Rencana Tindakan Insisi
Drainase dan Debridement
Rabu 16/03/2022 Pukul 10:00
WIB
NOTE:. ( Lt 4 ) Tn Alvin
Pungki/ Mira Yulianti,dr,
SpPD-KP/ Malignant
neoplasm of bronchus and
lung, Pleural effusion in
conditions classified elsewhere
Fever, unspecified/ Rencana
bronkoskopi+biopsi dan pungsi
pleura kiri
Kalau di saharjo bs
mengadakan bronkoskopi saya
kerjakan di saharjo (Tunggu
ACC asuransi SIO (+) FL
KIKI)
PASIEN RENCANA
RUJUK:
PASEN RENCANA MASUK

:
Pasien Lt
4 : 10 pasien
Pasien Lt 5 : 8
EKG masih dalam perbaikan
trijaya Tidak ada masalah
nesya Tidak ada masalah
khrisna Tidak ada masalah
Pak Jery

1.Ari masalah
Pak Juki
ATER
0
RENCANA TINDAKAN :
RE
0
PASIEN OBSERVASI :
0
PASIEN PONEK :
PASIEN OBSERVASI :
1. By. Ny. Rizka/dr.Andina

Sp.A/ NCB SMK 1 hari
2.By.Ny. Dhea/dr.Andina
Sp.A/NCB SMK 6 jam
4 larasati/dr.nina dwi
1 Jam
PASIEN
HIPERBILLIRUBIN :
Tidak ada masalah
1 0
total 24 pasien
dr.Dafsah:1
dr.Denio:6
dr.Faris:4
dr.Raditio:1
dr.Suko:2
dr.Sunu:3
1 Dr.Adi:7
MCU:0
Tindakan Diagnostic:
USG Doppler:2
EKG:10
Treadmil:2
Advance Echo:5
GV minor:2
SIC (CAROL) 16.003.22
TIPE PASIEN
YANG DINAS
LT NAMA UNIT
EMERGENCY ROOM
Dr Megawati
EMERGENCY Dr Dwi Dr Dwi
Ns
ROOM, Susi Ns
Ns Fitri Ns Kelvin
PONEK Ns Tomy Ns Rizam
Ardhi
GF
RADIOLOGI Hamida
FL Sonya Puput
TOTAL PASIEN EMG
Poli anak : Bedah

Poli Obgyn : 15 Umum : 3
Ns IIn THT : 6 25
Urology : 1
Bedah
Syaraf :
Rehab
Fisiotherapi :
LT 3 Orthopedy : 3 Medik : 2
Bedah Fisotherapi:
Onkology : 4 Gizi : digestive : 6
Poli Paru : 2
Dermis : 9 Mata: 2 Psikiatri : 5

Telekonsul : 4
TOTAL 112 Pasien
LT 5
LT 6
IPD LT 4
IPD LT 4
Ns Citra IPD LT 4
Ns Ella Dr Faisal
IPD LT 4
Ns Elen Ns Abdi
Dr Faisal
IPD Ns Nadya
Ns Salwa
LT 5 Ns IPD
Ns Indah
Heny Ns LT 5 Ns
IPD LT 5
IN PATIENT Tiwi Ns
Riski Ns Rio
DEPARTMENT Nadia Ns
Lt 4, 5, 6 IPD LT 6 Yudi IPD
Ns Siti
Ns Dini IPD LT 6
LT 6 Dr
Ns Egis Ns Silvi
Faisal
Ns Adelselpi
Ns Okta
Ns Mutia
Indra, trijaya
SOS Petugas:
Khaerul Agung
GIZI Petugas : Ajeng nesya
LABORATORIUM Petugas : Marisa khrisna
Petugas :
PHARMACY (SB) Yeyen Upi
DANDRU : Jumlah Lantai 2 : PKD :

1. Rianto EMG : 1.Aris LOBBY :
SECURITY, PARKIR Pak Petugas 5
Lantai 8 : 1. Firly 2. Afif 1 Hamka
Wibi orang
Hery
TEKNISI SS Pak Samsul
OPERATING THEATER
Ns Sunandar
OK Ns hery 6
Heryanti
LT 7
3
CRITICAL CARE
Dr Dewi Dr Nilam Dr Nilam
ICU / HCU Ns Awal Ns.Winda Ns.Ani 1
PICU / NICU Ns Esti Ns ayu Ns.Lisa 0

OBSTETRICS
Bd Anggi Bid.Genda
VK Bd Anggi
Bd Dilla Bid.Ning 0
Nursery Ns Inggrid Ns Nani Ns Ika 1

Nursery Ns Inggrid Ns Nani Ns Ika 1
RUANG TUNGGU PS
CRITICAL
HEARTOLOGY
Ns.Akbar
Cathlab Ns Tryanto
Ns NsAkb Ns Ns Ns
Hybrid 1
LT 8
LT 8
Ns.Rini T
OPD JANTUNG
Ns Ema
1
AUDITORIUM
NOTED
KETERANGAN
M
PASIEN OBSERVASI :
1. Nn Mutiara Martha / 44 thn /
AMI / Primary PCI CITO jam 02.45
wib / Dr Faris B SpJp
RAJAL : 4
RANAP : 3
APS : 0
PONEK : 0
TOTAL PASIEN : 7
Tidak ada masalah
ENT PASIEN BARU :
Lt 4 : 4
Lt 5 :
Lt 6 : 4
PASIEN MENINGGAL
PASIEN RUJUK
PASIEN ISTIMEWA
PASIEN RENCANA TINDAKAN:
1.( Lt 4 ) Tn Ronald Rendy/ Denio A

Ridjab, dr. SpJP - FIHA/ Chest pain,
unspecified, Palpitations/ rencana
tindakkan TEE SIO (+), ACC Assuransi
Generaly (+) Info FL Sonya / Jadwal
(Konfirm Heartologi )
2.( Lt 5 ) An. Vivian/
dr.Dicky Hanafy.SpJP-FIHA, FAsCC/
Rencana Tindakan Ablasi 2D SVT
Kamis, 17 Maret 2022 Pukul 18:30
WIB
3. ( Lt 6 ) Ny. Arfita Noor/ Sari
Febriana, dr.SpB/Nonpurulent mastitis
associated with childbirth. R/:
pro insisi drainase abses jam 07.00 tgl
17/03/2022
Pasien Lt 4 : 8
Pasien
Total :
23Pasien
EKG masih dalam proses perbaikan
Tidak ada masalah
Tidak ada masalah
Tidak ada masalah
Tidak ada masalah

R
1. ASLINA GINTING / BEDAH PLASTIK -

Eksisi HEMANGIOMA, flap Operasi Khusus I /
Chamim,DR. dr, SpOG (K) Onk 2. CHESA
YENNI MAHDANIAR S / BEDAH UMUM -
Debridement general anaesthesia
BEDAH UMUM - Insisi & Drainase Abses /
Caroline Supit, dr. SpB
3. NUR LUTHFIYAH QURROTU /BEDAH
SARAF - Neurolysis Ablation / Syafrizal
Abubakar, dr. Sp.BS
4. DHEA AUDREY / BEDAH OBGYN - Sectio
Caesaria + Pasang IUD / Nisa Fathoni, dr. Sp.
OG, IBCLC 5.
MUHAMMAD HILMAN BAGASKARA /
BEDAH SARAF - PELD + DRG Ablation +
Facet Ablation / Syafrizal Abubakar, dr. Sp.
6. Perempuan
EMY SUTARMIATI / BEDAH ONCOLOGY -
Wide Excision For Malignant Tumor <5cm /
Bob Andinata, dr. Sp.B(K)Onk

ARFITA NOOR AMALIA / BEDAH UMUM - Insisi
& Drainase Abses / Sari Febriana, dr. SpB
2. NAYYARA
SAFIA RACHMIAD / BEDAH UMUM -
Laparoscopy appendectomy / Caroline Supit, dr. SpB
3. ELDICK N. H / BEDAH
THT - Tonsilektomi dengan adenoidektomi / Mirta
Hediyati Reksodiputro, Dr. dr. Sp.THT-KL(K)
1. Nn Mutiara Martha / 44 thn / AMI / Primary

PCI CITO jam 02.45 wib / Dr Faris B SpJp /
Masuk HCU jam 04.00 wib
PASIEN OBSERVASI :
PASIEN PONEK :
PASIEN OBSERVASI :
1. By.ny.dhea audrey/dr.Andina Sp.A/ NCB

SMK usia 1 hari
Tidak ada masalah
Cathlab-HOR Daily Utilization Report

16 Mar 22
CATHLAB
Schedule :
1. Nur Lutfiyah / dr syafrizal/ neuro ablasi/
cath lab
2. Hilman / dr syafrizal / PELD / Cath Lab
Tgl 17 Maret 22
1. Nn Mutiara Martha / 44
thn / AMI / Primary PCI CITO jam 02.45
wib / Post Tindakan HCU masuk jam
04.00 wib
Next Schedule
Thues, 17 mar
1. Muhammad Jabir / dr. Radit / ADO / 16.30 /
Hybrid
2. Vivian / dr. dicky H / Ablasi SVT / 18.00 /
Hybrid
Frid, 18 mar
1. Mahalani / dr. Dicky H / Ablasi 3D VT
Complex / 18.00 / hybrid
2. Soen Gan Bie / PELD / dr. Syafrizal / 14.00 /
cathlab
3. Ie Boen Hian / PELD / dr. Syafrizal /17.00 /
cathlab
Sat, 19 mar
1. Yosia / dr. Sunu / Ablasi 3D VT / 08.00 /
hybrid
Mon, 21 Mar
1. An. Hanza Qonita ( 11 Thn ) / dr Radityo /
AMVO / Jam 19.00 / Hybrid
Tus, 22 Mar
1. R.H Nurul Aeni / dr Faris / Replace PPM 2
Chamber / jam 08.00 / Hybrid
2. Jie Ricky Firdaus / dr Sunu / ILR Reveal linq /
Jam 16.30 / Cath Lab
3. Ananda Putri / Dr Faris / Ablasi 3D VT
Complex / jam 18.30 / Hybrid
Wen, 23 Mar
1. Yudhy Tjendrawan / dr Faris / PTCA + IVUS Promo
/ jam 14.00 / Cath Lab /
Outpatient : 15
dr ario :
Dr dafsah :
dr denio : 3
dr faris : 4
dr DH :
dr DAW :
dr radityo :
Dr suko :
dr sunu : 1
dr Adi : 7
MCU : -
TIPE PASIEN
YANG DINAS
LT NAMA UNIT
EMERGENCY ROOM
Zr. Nur
dr. Firdha, dr. fajar, Br.
EMERGENCY (Midle), Zr.
Ns. Susi, Ns, Mohlis, Ns.
ROOM Tomi
Fitri, Ns.
Rizam
Sanusi
GF
PONEK
TOTAL PASIEN EMG
OPD
Poli Obgyn
Cahya, Alin NS 1 :
Poli Urology
Poli Ortho
Poli Internist
Poli Bedah Umum
Poli Bedah Plastik
Poli Bedah Degestif
NS 2 :
Poli THT
Poli Gizi
Poli bedah saraf
Poli Neuro
Dermis
Dental
LT 3
Poli Endoscopy
Poli Kemotherapi
Poli Fisioterapi
Poli Psikiatri
Pain Klinick
Poli Rehab Medik
Poli Mata
Poli Nutrition
Poli Paru
Poli Mata
Poli Psikiatri
Pain Clinic
MCU
ODC
TOTAL PASIEN OPD
Trijaya Rivan
SOS Petugas
(IGD, L.2
(Malam)
SB)
(L.4,5,6)
David Anti
GIZI Petugas
(Malam) (Servies &
(Cook)
Pramusaji)
LABORATORIUM Petugas Eulis Ani

(Malam)
FHARMACY Petugas Sarah Wulan

(Malam)
Petugas
RADIOLOGI (Malam)
Hamidah
DANRU : Petugas Firli Hamka M Hery Novan
SCURITY (RG1 &
Wibi (Malam) (Lobby) (Lantai 2) (PKD Out)
IGD)
DP = Ns.
DS = Ns.
Nurul, Ns. DM = Ns.
IN PATIENT Abdy, Ns.
LT 4 DEPARTMENT 4
Citra, Ns.
Helen
Salwa, Ns.
Helen Ziya
DP = Ns.
DS = Ns. DM = Br.
Indah
Indah + rizki yudi +
+rizki Ns.Siti
IN PATIENT
LT 5 DEPARTMENT 5

IN PATIENT Dini + Ns. Avi + Ns.
Silvi + Ns.
DEPARTMENT 6 ahid ahid
LT 6 Egis
KOMPLAIANAN
KERUSAKAN
OPERATING THEATER
LT 7 OK
CRITICAL CARE
ICU
Awal Agus
HCU
NICU
LT 7 Esty Alfi Ayu

PICU
TOTAL Ps
CRITICAL
OBSTETRICS
‌Dines
‌ ines Pagi:
D Dines
Siang : bd.
bd. Putri, bd. Malam : bd.
VK Dewi
Dilla, bd.
Anggi, bd.
Tries
Viki
LT 7
Dinas ‌Dines siang

Dines
pagi : :
Nursery Ns.wiwi Ns.inggrid
malam :
Ns. Ika
HEARTOLOGY
Cathlab
Hybrid
LT 8
LT 8
OPD JANTUNG
Dokter Jaga
Dokter Jaga IGD : Pagi : dr Firdha Malam : dr Fajar
Dokter Jaga IPD : Pagi : dr Rona Malam : dr Faisal & dr. Aswan
Dokter Jaga Critical : Pagi : dr Rizky Malam : dr Rizky

KETERANGAN
TOTAL
PASIEN
akan dilakukan)
Y ROOM
PASIEN OBSERVASI :
RAJAL :
1. An. Nania Stefany /7th/ Dx. Fever
2. Ny. Natalia Elsye /25th/ Dx. G1P0A0 hamil 12
minggu susp. Abortus Complete 3.
Ny. Eka Putri A /37th/ Dx. Superficial injury of
wrist and hand (Post KLL Hari ke 2) 4.
An. Ananda Putri /14th/ Dx. Supraventricular
tachycardia
5. Nn. Huriyah Aqilah /22th/ Dx. Gluteal
tendinitis
6. Ny. Pamela Ayu /27th/ Dx. Anemia
7. Ny. Margaretha Fitriani /28th/ Dx. Supervision
of normal pregnancy, G2P1A0 H 34 +6 JPKTH,
Instruksi dr. Dony Sp.OG :
- Inf. Venofer 2 amp dalam 100 cc NaCl 0.9%
8. An. Rachel Michell /4th/ Dx. Vomitus
9. Ny. Nova Aneke S /34th/ Dx. Allergic urticaria
RANAP :
1. Ny. DRA Wuryani /64th/ Dx. Unstable
angina / Dpjp. Faris Basalamah, dr. SpJP (K)
/ Ruang 411 2. Tn.
H. Agus Salim /63th/ Dx. diabetes mellitus +
Chronic obstructive pulmonary disease with
acute exacerbation + Hyperplasia of prostate /
Dpjp. Eric Daniel Tenda, dr, DIC, PhD,
13 SpPD, FINASIM / Ruang 507
3. Tn. Muhammad Abdul
/28th/ Dx. Other metabolic disorders +
Ventricular septal defect / Dpjp. Alvin
Nursalim, dr. Sp.PD / Ruang 605
4. An. Muhammad
Khalid /4th/ Dx. Acute upper respiratory
infection, Cough (Utama) + Nausea and
vomiting / Dpjp. Diana Mustika Chandra, dr.
Sp.A / Ruang 612
RUJUK :
APS : 1
1. Ny. Natalia Elsye /25th/ Dx. G1P0A0

hamil 12 minggu susp. Abortus Complete (
Alasan Ingin Menggunakan BPJS )
PERALATAN :
NOTE :
RAJAL :
RANAP :
PASIEN OBSERVASI :
13 pasien
14 Telekonsul = 1 Pasien
2 Dokter Cuti/tidak prkatek

1 dr. Nisa SpOG
Dr. Zaki SpOT
9
Dr. Yulindra SpM
2 Dr. Endrika SpU
Dr. Rio SpOT
Dr. Andry SpPD-KGEH
Dr. Harsha SpKK
4
4
3
9
1
3
11
3
1
71
Indra
Tidak Ada Kendala
(L.7,8)

Afif
(PKD IN)
TMENT PASIEN BARU :
1.Tn. Sutanto/Alvin Nursalim, dr.

SpPD/Dyspepsia, DM
2.Ny. Tiara Nurfatimah/Fransisca Noela RMH, dr.
Sp.OG/Labour and delivery complicated by fetal
stress [distress], SC CITO
3.Ny. DRA. Wuryani/Faris Basalamah, dr. SpJP
(K)/Unstable angina
4.Nn. Mutiara Martha/Faris Basalamah, dr. SpJP
(K)/Chest pain unspecified, Acute transmural
myocardial infarction of inferior wall, Obesity
5.Ny. Soen Theresia/dr.
Chamim,SpOG(K)Onk/Ca Ovarium
PASIEN OBSERVASI :
1.Tn. Windutama/Alvin Nursalim, dr.
SpPD/Medis: Low back pain, lumbosacral region
SpPD/Dyspepsia, DM
3.Ny. Lenny Kartikasari/Alvin Nursalim, dr.
SpPD/Dyspepsia, Haematemesis, Tension-type
headache, Myalgia, shoulder region
4.Ny. Tiara Nurfatimah/Fransisca Noela RMH, dr.
Sp.OG/Labour and delivery complicated by fetal
stress [distress], SC CITO
5.Tn. Pui jhonny/Perwira Widianto, dr. Sp.B-
KBD/Cholecystitis
6.Ny. DRA. Wuryani/Faris Basalamah, dr. SpJP
(K)/Unstable angina
7.Nn. Mutiara Martha/Faris Basalamah, dr. SpJP
(K)/Chest pain unspecified, Acute transmural
myocardial infarction of inferior wall, Obesity
8.Ny. Soen Theresia/dr.
Chamim,SpOG(K)Onk/Ca Ovarium
RENCANA TINDAKAN :
SpPD/Dyspepsia, DM/Rencana EGD
18/03/2022 Jam 15.30 WIB
2.Ny. DRA. Wuryani/Faris Basalamah, dr.
SpJP (K)/Unstable angina/Rencana CAG stby
PCI 18/03/2022 Jam 08.00 WIB
PASIEN PINDAH ICU :

1.Tn. Pui jhonny/Perwira Widianto, dr. Sp.B-
KBD/Cholecystitis
PASIEN PULANG :
1.Tn. M. Hilman Bagaskara/Syafrizal
Abubakar, dr. Sp.BS/Lumbar and other
radiculopathy
2.Nn. Farah Nursabrina/Carolina Supit, dr.
SpB/ Acute appendicitis
3.Ny. Marisa/dr. Febriansyah
D.SpOG(K)/G2P1A0 Hamil 12 minggu + obs
febris, susp HEG, dehidrasi ringan-sedang,
susp ISK + JIUTH
4.Tn. Ronald Rendy/Denio A Ridjab, dr.
SpJP - FIHA/Chest pain, unspecified,
Palpitations
5.Ny. Falah hindun/Bob Andinata, dr.
Sp.B(K)Onk/Post kemotherapy ke-9
TMENT PASIEN BARU :
1. Tn. H Agus salim /Eric Daniel Tenda, dr, DIC,

PhD, SpPD, FINASIM/ Respiratory
Sndrome ,PPOK dengan PH mild (Pulmonary
Hypertension),Hepatitis B
PASIEN OBSERVASI :
1. Ny. Soraya oktaviani / dr.Amanda Pitarini

Sp.PD/ cholelithiasis
2. Tn. Eduardus / dr. Alvin nursalim Sp.PD/
DHF
3. Ny. Chesa Yenni Mahdaniar / Caroline
Supit, dr. SpB /Cutaneous abscess
4. An. Vivian/ dr.Dicky Hanafy.SpJP-FIHA,
FAsCC/ Tachycardia
5
PASIEN PINDAH ICU :
RENCANA TINDAKAN
PASIEN PULANG :
1.Ny.Anggrety Trusye/ dr Denio SpJP-
FIHA/Dyspnea
2.Ny.Nurul Lutfiyah / dr.Syafrizal, Sp.BS /
Lumbal and other intervetebral disc
disoreders with radiculopathy
3.Tn. Luky juniansyah / dr. Alvin nursalim
Sp.PD/ Dyspepsia
TMENT PASIEN BARU :
1. Tn M. Abdullah/dr. Alvin Sp.PD/ Other

metabolic disorders
2. Muhammad Khalid/ Diana Mustika
Chandra, dr. Sp.A / Nausea and vomiting
PASIEN OBSERVASI :
1. Muhammad Khalid/ Diana Mustika Chandra,
dr. Sp.A / Nausea and vomiting
2. An. Luddiest / Meirdhania Andina, dr. Sp.A /
Dengue fever
3. Tn M. Abdullah/dr. Alvin Sp.PD/ Other
metabolic disorders
4. An. Raindra / Rifan Fauzie, dr. Sp.A (K) /
5. Ny. Syarifah Darmiyana/ Nenfiati, dr.SpPD-
KEMD / Non-insulin-dependent diabetes mellitus
+ Malaise and fatigue
6. An. Nayyara Safia /Caroline Supit, dr. SpB/
Other appendicitis
7. Ny. Arfita Noor / Sari Febriana, dr. SpB/

Nonpurulent mastitis associated with childbirth
7
1. By. Muhammad jabir /Radityo Prakoso, dr.
MD, FIHA,FAPSIC,FAsCC / Patent ductus
arteriosus
Pindah HCU
RENCANA TINDAKAN
PASIEN VK
PASIEN PULANG
inkiriwang,dr. Spa/Feve, unspecified
2. Ny. Dhea Audrey / Nisa Fathoni, dr. Sp.
OG, IBCLC / post sc + Erach+ Iud
RENCANA MASUK :
ATER
1. Ny. ARFITA NOOR AMALIA / BEDAH

UMUM - Insisi & Drainase Abses / Sari
Febriana, dr. SpB / J.07.00, OK I
2. NAYYARA SAFIA
RACHMIADI / BEDAH UMUM -
Laparoscopy appendectomy / Caroline Supit,
dr. SpB / J.10.00, OK I
3. ELDICK N. H / BEDAH THT -
Tonsilektomi dengan adenoidektomi / Mirta
Hediyati Reksodiputro, Dr. dr. Sp.THT-
KL(K) / J.16.00, OK I 4.
TIARA NURFATIMAH ZAKARIAH /
4 BEDAH OBGYN - Sectio Caesaria /
Fransisca Noela RMH, dr. Sp.OG / J.21.30,
OK I 5.
MUHAMMAD JABIR ZHAFRAN /
BEDAH HEARTOLOGY - ADO Ped/
Radityo Prakoso, dr. MD,
FIHA,FAPSIC,FAsCC / J.16.30, OK
HYBRID
6. MUTIARA
MARTHA LENA NAULI / BEDAH
HEARTOLOGY - PRIMARY PCI / Faris
Basalamah, dr. SpJP (K) / J.00.59, OK
CATHLAB
2. Rencana Tindakan Jum'at 18-03-22

1. POERWO MARTANTYO / BEDAH
UROLOGY - Tur Prostat / Buli-Buli / Akbari
Wahyudi Kusumah, dr. Sp.U / J.18.00, OK I
E
0
0
0
1. An. Muhammad Jabir Zhafran /2th,

1 10bln/ Hri Rawat Ke 1 / Dx. POST OP
ADO / Dpjp. Radityo Prakoso, dr. MD,
FIHA,FAPSIC,FAsCC
1 Pasien
PASIEN OBSERVASI :
1. Ny. Tiara/ dr. Noela, spog/ G1P0A0 hamil
1 39 minggu dengan KPD+ gawat janin. SC
Cito jam 21.30
RENCANA TINDAKAN :
PASIEN PONEK :
PASIEN OBSERVASI :
1 1. By. Ny Tiara nurfatimah /dr. Diana sp. A /
NCB SMK usia 11 jam
PASIEN PULANG :
1 1. By.Ny. dhea /NCB SMK usia 2 hari/
dr.andhina Sp.A
Y
Cathlab-HOR Daily Utilization Report
17 Mar 22
CATHLAB
Schedule :
1. Mutiara / Primary PCI / dr. Faris / 01.30-
04.30
Team : Akbar, jhoni, triyanto

Non Schedule : -
Yudhy Tjendrawan / dr faris/ PTCA + IVUS
promo
HYBRID OR
Schedule :
1. Muhammad Jabir / dr. Radit / ADO / 16.30 -
18.30
Team : saiful, jhoni, triyanto, fefty, aulia
2. Vivian / dr. dicky H / Ablasi SVT / 18.30-
22.30
Team : saiful, jhoni, triyanto, fefty, aulia
Echo/TEE intra procedure ;
1. Muhammad jabir / tee intra prosesur ADO
Non Schedule : -
Others : -
Problem : -
Overtime staf : -
Staff sakit : -
Staff cuti : -
Next Schedule
Frid, 18 mar
1. Wuryani / dr. Faris / CAG / 08.00 /
cathlab
2. Mahlani / dr. Dicky H / Ablasi 3D
VT Complex / 18.00 / hybrid
3. Soen Gan Bie / PELD / dr. Syafrizal /
14.00 / cathlab
4. Ie Boen Hian / PELD / dr.
Syafrizal /17.00 / cathlab
Sat, 19 mar
1. Yosia / dr. Sunu / Ablasi 3D VT /
10.00 / hybrid
Mon, 21 Mar
1. An. Hanza Qonita ( 11 Thn ) / dr
Radityo / AMVO / Jam 19.00 / Hybrid
Tus, 22 Mar
1. R.H Nurul Aeni / dr Faris / Replace
PPM 2 Chamber / jam 08.00 / Hybrid
2. Jie Ricky Firdaus / dr Sunu / ILR
Reveal linq / Jam 16.30 / Cath Lab
3. Ananda Putri / Dr Faris / Ablasi 3D
VT Complex / jam 18.30 / Hybrid
Outpatient : 14
dr ario : 4
Dr dafsah :
dr denio :
dr faris : 3
dr DH : 4
dr DAW :
dr radityo : 3
Dr suko :
dr sunu :
14
dr Adi :
MCU : -
New patient: 4
Dr. Dicky Hanafi 2 : 1 pasien lama di
harkit, 1 dari kerabat
Dr. Radityo 2 : 1 dari dr. Hendra
Simarmata SpJP RS Suci, 1 dari dr. Jamal
RS Mitra Keluarga bekasi
Cancel : 1
Dr. Dicky Hanafy : 1

ECHO : 1
Stress Echo : 1
USG Doppler :
Holter : 1
ECG : 6
Treadmill : 1
CT Scan
Speckle
TEE :
DSE : 1
ABI :
Tilt Table Test :
Advance Echo : 4
Handle Echo :
ABPM :
Ezypro :
Cardioversi :
ICD Programming : 1
Referral External : 2 (RS Suci, dan RS Mitra
Keluarga Bekasi)
Info dokter tidak hadir : dr. Dafsah (cuti)
dr Faisal & dr. Aswan

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SIC (EKO) 01.01.

Pagi Sore Malam

GF TOTAL PASIEN EMG

LT 3 TOTAL PASIEN OPD

IN PATIENT DP = Ns. salwa + DS = Ns. Devi + DM = Ns. indah+

Total Pasien 24 jam : 64 Orang

1. An. Karan Alano /12th/ Dx. Nausea and

1. Ny. Olga Dea Ramadhani /27th/ Dx.

1. Ny. Ananda /26th/ DPJP. dr.Nisa

1.Tn. Ir. Adrian / dr. Sunu, Sp.JP /

1.Tn. Bobby wiranata / Arif Rahman, dr.

dr. Firdha, dr. Dwi, Ns.

TOTAL PASIEN EMG

TOTAL PASIEN OPD

Total Pasien 24 jam : 63 Orang

RANAP :1.NY AJENG DX LBP

1.An. AZKA ARBIANSHA /

1.Tn. Ir. Adrian / dr. Sunu,

1.Ny. Elok / dr. Amanda, Sp.PD /

1.Ny. Isni / dr. Nisa, Sp.OG /

1.Ny. LYDIA ALISSA / N.B.

1.Ny. Nur mentari / Sang

4.Ny. Ratih Tyas /Mira Yulianti,dr,

3.Ny. Fatima / Amanda Pitarini

1.Ny. Endah Fatonah /Nisa

1 Ny. Tessa / Batara Imanuel

1. Ny. Elga/ Dr. Fransisca

1.Ny. Zurma/ Murdani Abdullah,

1. Tn. Willy Purnama Chandra

BY.NY ROSSANA GEMELI 2

1‌ . Ny. Endah Fatonah/ G3P2A0

PASIEN OBSERVASI DI IPD :

PASIEN PINDAH NICU :

dr. audrey, dr.Fajar, Ns.

TOTAL PASIEN EMG

TOTAL PASIEN OPD

Total Pasien 24 jam : 230 Orang

6. Ny. Kanti Mulyaningrum /35th/ Dx.

1. Ny. Indah Dwi Chyntia /24th/ Dx.

1.By.Belden Kautsarr/ Wulan Ayudyasari, dr.

PASIEN PINDAH ICU :

1. Tn. Ir Oei adrian / dr sunu / Post 3D vt ablasi

PASIEN RENCANA MASUK :

1.Ny.Regina / Syafrizal Abubakar, dr. Sp.BS/ R/

1.Tn. Bobby wiranata / Arif Rahman, dr.

PARTMENT PASIEN BARU :

1. Tn. Arrizal Samelino / Diarrhea,

13 Ranap, PASIEN MENINGGAL

1. Ny. Andi Sufriana /Nisa Fathoni, dr. Sp.

PASIEN PINDAH ICU :

1. Ny. Elga / Dr. Fransisca Noela RMH,

PASIEN RENCANA PULANG :

1. Ny. Ratih Tyas /Mira Yulianti,dr, SpPD-

Laporan Kegiatan Kamar Operasi

2. Rencana selasa, 05/02/21

1. By Ny Devi Maryani / Dx.Achondroplasia /

1. Ny. Ananda / G1P0A0 hamil 39-40 mgg

1. By. Ny. Debby / dr. Andina/ NCB SMK

PASIEN PINDAH NICU :

Diagnostic & Info dokter* yang melakukan

Dokter tidak hadir : dr. Dafsah (sakit), dr. Dicky

TOTAL PASIEN EMG