DAFTAR KUNJUNGAN PESERTA SAKIT

Kantor Cabang : SUKABUMI - 1005

FKTP : POLIKLINIK BRIMOB CIPANAS - 0119B030

TANGGAL TANGGAL JENIS STATUS

NO NO KUNJUNGAN NO KARTU NAMA PESERTA JENIS PESERTA DIAGNOSA PRB PROLANIS
PELAYANAN ENTRI KELAMIN PULANG

0119B0300222P00 24-02-2022 24-02-2022 Essential (primary)

1 0001093248876 TATAN RUSWANDI L - Berobat Jalan
0081 00:00 14:23 hypertension
0119B0300222P00 24-02-2022 24-02-2022
2 0001109332642 ETIKA LARASATI P - Other vitamin deficiencies Berobat Jalan
0079 00:00 14:22
Acute upper respiratory
0119B0300222P00 24-02-2022 24-02-2022
3 0001293037896 IRA HENDAYANTI P - infections of multiple and Berobat Jalan
0076 00:00 14:20
unspecified sites
0119B0300222P00 24-02-2022 24-02-2022 Acute pharyngitis,
4 0001298219679 DESI HANDRIANI P - Berobat Jalan
0082 00:00 14:24 unspecified
0119B0300222P00 24-02-2022 24-02-2022
5 0001320688282 NUR SAFII L - Pulpitis Berobat Jalan
0084 00:00 14:24
Acute upper respiratory
0119B0300222P00 24-02-2022 24-02-2022
6 0001328376036 GIO TRIGATRA MAOLANA L - infections of multiple and Berobat Jalan
0080 00:00 14:22
unspecified sites
0119B0300222P00 24-02-2022 24-02-2022 WAHID ANWAR
7 0001873157051 L - Dental caries, unspecified Berobat Jalan
0083 00:00 14:24 PRAYITNO
0119B0300222P00 24-02-2022 24-02-2022
8 0002434340902 UTARI PERMATASARI P - Gastritis and duodenitis Berobat Jalan
0077 00:00 14:21
0119B0300222P00 24-02-2022 24-02-2022 EL BHARA RAHSYA Fever of other and
9 0002502546142 L - Berobat Jalan
0078 00:00 14:21 IRBAN unknown origin
0119B0300222P00 24-02-2022 24-02-2022
10 0002698495727 ROSE HANDAYANI P - Myalgia Berobat Jalan
0075 00:00 14:19
0119B0300222P00 23-02-2022 23-02-2022 Gastroenteritis and colitis
11 0001674931184 TUTI MELAWATI P - Berobat Jalan
0073 00:00 13:40 of unspecified origin
Acute upper respiratory
0119B0300222P00 23-02-2022 23-02-2022
12 0002290612746 AGUS HERI SETIAWAN L - infections of multiple and Berobat Jalan
0074 00:00 13:41
unspecified sites
0119B0300222P00 22-02-2022 22-02-2022 Malignant neoplasm of
13 0002876308885 EDI SUBAEDI L - Rujuk Vertikal
0072 00:00 11:19 colon
Acute upper respiratory
0119B0300222P00 21-02-2022 21-02-2022
14 0001293137515 IPIT SETIAWATI P - infections of multiple and Berobat Jalan
0071 00:00 09:55
unspecified sites
0119B0300222P00 21-02-2022 21-02-2022 Acute upper respiratory
15 0001666176412 WINA SRI RAHAYU P - Berobat Jalan
0069 00:00 09:48 infection, unspecified
Acute upper respiratory
0119B0300222P00 21-02-2022 21-02-2022
16 0002774636572 SHANUM PUTRI ISMAIL P - infections of multiple and Berobat Jalan
0070 00:00 09:49
unspecified sites
 DAFTAR KUNJUNGAN PESERTA SAKIT

Kantor Cabang : SUKABUMI - 1005

FKTP : POLIKLINIK BRIMOB CIPANAS - 0119B030

0119B0300222P00 18-02-2022 18-02-2022 DHAVINA MAULIDYA Diseases of pulp and

17 0001293208795 P - Rujuk Vertikal
0065 00:00 08:24 KADARISMAN periapical tissues

Conjunctivitis in infectious
0119B0300222P00 18-02-2022 18-02-2022 LAYSHA MAULIDYA
18 0001293209076 P - and parasitic diseases Rujuk Vertikal
0066 00:00 08:26 KADARISMAN
classified elsewhere

Respiratory tuberculosis,
0119B0300222P00 18-02-2022 18-02-2022
19 0002923835523 KHAFI ZIDAN KHRISNA L - bacteriologically and Rujuk Vertikal
0067 00:00 11:04
histologically confirmed
Developmental disorder of
0119B0300222P00 18-02-2022 18-02-2022
20 0003061089134 YUSUF HABIBIE ABQARY L - speech and language, Rujuk Vertikal
0068 00:00 13:47
unspecified
0119B0300222P00 17-02-2022 17-02-2022
21 0000408369936 MULYANA L - Myalgia Berobat Jalan
0060 00:00 12:52
Acute upper respiratory
0119B0300222P00 17-02-2022 17-02-2022
22 0001093009959 M ROHMAN YAYAT L - infections of multiple and Berobat Jalan
0063 00:00 12:53
unspecified sites
Acute upper respiratory
0119B0300222P00 17-02-2022 17-02-2022
23 0001096429792 MUH ARIEF L - infections of multiple and Berobat Jalan
0061 00:00 12:52
unspecified sites
0119B0300222P00 17-02-2022 17-02-2022
24 0001299432846 II IRBAN L - Other vitamin deficiencies Berobat Jalan
0064 00:00 12:56
0119B0300222P00 17-02-2022 17-02-2022
25 0001873727289 DERI RAHMAN L - Gastritis and duodenitis Berobat Jalan
0062 00:00 12:52
0119B0300222P00 15-02-2022 15-02-2022
26 0000163007425 SAMUEL KRISTIANTO G L - Gout Berobat Jalan
0059 00:00 14:15
0119B0300222P00 15-02-2022 15-02-2022 Fever of other and
27 0001095383845 INDOE KARYONO L - Berobat Jalan
0050 00:00 13:58 unknown origin
0119B0300222P00 15-02-2022 15-02-2022 Essential (primary)
28 0001095623932 ZAJI PRANOTO L - Berobat Jalan
0051 00:00 13:59 hypertension
0119B0300222P00 15-02-2022 15-02-2022 Fever of other and
29 0001293091626 RISMA NURMEILANI P - Berobat Jalan
0055 00:00 14:09 unknown origin
0119B0300222P00 15-02-2022 15-02-2022 DENY WAHYU Essential (primary)
30 0001300122101 L - Berobat Jalan
0057 00:00 14:10 PRIHAMBODO hypertension
0119B0300222P00 15-02-2022 15-02-2022
31 0001379260124 FERRY HANDRIAN L - Other vitamin deficiencies Berobat Jalan
0058 00:00 14:11
Acute upper respiratory
0119B0300222P00 15-02-2022 15-02-2022 MUHAMAD ARDIAN
32 0002290613049 L - infections of multiple and Berobat Jalan
0049 00:00 13:56 FEBRIANSYAH
unspecified sites
0119B0300222P00 15-02-2022 15-02-2022
33 0002323500489 SASIA DWI MARINA P - Other dermatitis Berobat Jalan
0052 00:00 14:01
 DAFTAR KUNJUNGAN PESERTA SAKIT

Kantor Cabang : SUKABUMI - 1005

FKTP : POLIKLINIK BRIMOB CIPANAS - 0119B030

0119B0300222P00 15-02-2022 15-02-2022

34 0002397365537 CECEP MULYAMIN L - Haemorrhoids Berobat Jalan
0053 00:00 14:04
Acute upper respiratory
0119B0300222P00 15-02-2022 15-02-2022
35 0002431971988 YULI AGUSTIN P - infections of multiple and Berobat Jalan
0056 00:00 14:10
unspecified sites
Respiratory tuberculosis,
0119B0300222P00 15-02-2022 15-02-2022
36 0002923834612 KHAFA ZIDAN KHRISNA L - bacteriologically and Berobat Jalan
0054 00:00 14:06
histologically confirmed
0119B0300222P00 10-02-2022
37 02-10-2022 0001300146592 EKA HADI SETYAWAN L - Other vitamin deficiencies Berobat Jalan
0041 09:32
FIKRI MUHAMMAD Acute upper respiratory
0119B0300222P00 10-02-2022
38 02-10-2022 0001320124792 SHAHIZINDA L - infections of multiple and Berobat Jalan
0040 09:31
FADHLURROHMAN unspecified sites
Other specified disorders
0119B0300222P00 10-02-2022
39 02-10-2022 0001328633133 MELINDA FEBRIANTI P - of gingiva and edentulous Berobat Jalan
0044 09:35
alveolar ridge
0119B0300222P00 10-02-2022
40 02-10-2022 0001465030776 TAUFIQ GUNADI L - Dental caries, unspecified Berobat Jalan
0043 09:35
0119B0300222P00 10-02-2022 RONALDO ALBERTO Fever of other and
41 02-10-2022 0001473942363 L - Berobat Jalan
0042 09:33 VALENTINO LOKOLLO unknown origin
Acute upper respiratory
0119B0300222P00 10-02-2022
42 02-10-2022 0001873906402 JIMSON L - infections of multiple and Berobat Jalan
0039 09:30
unspecified sites
0119B0300222P00 10-02-2022
43 02-10-2022 0002446269715 RENDI NASRULLAH L - Myalgia Berobat Jalan
0046 09:38
0119B0300222P00 10-02-2022
44 02-10-2022 0002452708596 NANAN NURAENI P - Other dermatitis Berobat Jalan
0045 09:36
Respiratory tuberculosis,
0119B0300222P00 10-02-2022
45 02-10-2022 0002923834612 KHAFA ZIDAN KHRISNA L - bacteriologically and Rujuk Vertikal
0047 11:10
histologically confirmed
Respiratory tuberculosis,
0119B0300222P00 10-02-2022
46 02-10-2022 0002923835523 KHAFI ZIDAN KHRISNA L - bacteriologically and Rujuk Vertikal
0048 11:11
histologically confirmed
0119B0300222P00 09-02-2022 Supervision of normal
47 02-09-2022 0000032407176 DEVI EKA LESTARI P - Rujuk Vertikal
0037 09:46 pregnancy
0119B0300222P00 09-02-2022
48 02-09-2022 0003101669436 ravabia khansa maritsa P - Dermatitis, unspecified Rujuk Vertikal
0038 10:37
0119B0300222P00 08-02-2022
49 02-08-2022 0001300117498 SEPTIADY SIMANJUNTAK L - Fever, unspecified Berobat Jalan
0035 13:32
 DAFTAR KUNJUNGAN PESERTA SAKIT

Kantor Cabang : SUKABUMI - 1005

FKTP : POLIKLINIK BRIMOB CIPANAS - 0119B030

Acute upper respiratory

0119B0300222P00 08-02-2022 ANGGER YUGO
50 02-08-2022 0001300197025 L - infections of multiple and Berobat Jalan
0036 13:33 PRASTIKO
unspecified sites
Respiratory tuberculosis,
0119B0300222P00 08-02-2022
51 02-08-2022 0001873205234 KHRIS ANTORO PUTRA L - bacteriologically and Rujuk Vertikal
0031 07:39
histologically confirmed
Respiratory tuberculosis,
0119B0300222P00 08-02-2022 KIRANA PUTRI
52 02-08-2022 0002304836357 P - bacteriologically and Rujuk Vertikal
0030 07:36 RAHMADIANI
histologically confirmed
Acute upper respiratory
0119B0300222P00 08-02-2022
53 02-08-2022 0002431971988 YULI AGUSTIN P - infections of multiple and Berobat Jalan
0034 13:31
unspecified sites
Acute upper respiratory
0119B0300222P00 08-02-2022
54 02-08-2022 0002754970615 IKA PUTRI DAMAYANTI P - infections of multiple and Berobat Jalan
0033 13:31
unspecified sites
Respiratory tuberculosis,
0119B0300222P00 08-02-2022
55 02-08-2022 0002923835523 KHAFI ZIDAN KHRISNA L - bacteriologically and Rujuk Vertikal
0032 08:40
histologically confirmed
0119B0300222P00 07-02-2022
56 02-07-2022 0000406899235 M PAIZAN L - Other dermatitis Berobat Jalan
0028 14:15
0119B0300222P00 07-02-2022
57 02-07-2022 0001095617428 BINTANG L - Other vitamin deficiencies Berobat Jalan
0021 14:08
Acute upper respiratory
0119B0300222P00 07-02-2022
58 02-07-2022 0001109588499 ARISTA DWI RAHAYU P - infections of multiple and Berobat Jalan
0026 14:12
unspecified sites
0119B0300222P00 07-02-2022 Fever of other and
59 02-07-2022 0001286983541 SEPTIA RIZKI MUHAROM L - Berobat Jalan
0022 14:08 unknown origin
Other specified disorders
0119B0300222P00 07-02-2022 NUR FARANDY
60 02-07-2022 0001299002523 L - of gingiva and edentulous Berobat Jalan
0024 14:09 FERDIANSAH
alveolar ridge
0119B0300222P00 07-02-2022
61 02-07-2022 0001299366279 FERI AGUS SUWARNO L - Other vitamin deficiencies Berobat Jalan
0025 14:10
Acute upper respiratory
0119B0300222P00 07-02-2022
62 02-07-2022 0001300171443 AGUS NUR HADI L - infections of multiple and Berobat Jalan
0020 14:07
unspecified sites
0119B0300222P00 07-02-2022 THEO PRAKUSYA BELLA
63 02-07-2022 0002280806414 L - Other vitamin deficiencies Berobat Jalan
0023 14:08 S
Acute upper respiratory
0119B0300222P00 07-02-2022
64 02-07-2022 0002290612746 AGUS HERI SETIAWAN L - infections of multiple and Berobat Jalan
0027 14:13
unspecified sites
0119B0300222P00 07-02-2022
65 02-07-2022 0002449228072 PERA RISMAYA P - Scoliosis, unspecified Rujuk Vertikal
0029 14:17
 DAFTAR KUNJUNGAN PESERTA SAKIT

Kantor Cabang : SUKABUMI - 1005

FKTP : POLIKLINIK BRIMOB CIPANAS - 0119B030

0119B0300222P00 05-02-2022
66 02-05-2022 0002449228072 PERA RISMAYA P - Scoliosis, unspecified Rujuk Vertikal
0019 09:34
0119B0300222P00 04-02-2022 Essential (primary)
67 02-04-2022 0001093248876 TATAN RUSWANDI L - Berobat Jalan
0015 13:34 hypertension
0119B0300222P00 04-02-2022
68 02-04-2022 0001096429792 MUH ARIEF L - Low back pain Berobat Jalan
0016 13:37
0119B0300222P00 04-02-2022 BAGUS BRIANANTA HADI Fever of other and
69 02-04-2022 0001299529844 L - Berobat Jalan
0018 14:02 MUSTOFA unknown origin
0119B0300222P00 04-02-2022
70 02-04-2022 0001379557135 OKE JUMIANDINI P - Gout Berobat Jalan
0014 13:32
Acute upper respiratory
0119B0300222P00 04-02-2022
71 02-04-2022 0002186518656 ACEP AHMAD L - infections of multiple and Berobat Jalan
0013 13:31
unspecified sites
0119B0300222P00 04-02-2022 Fever of other and
72 02-04-2022 0002754970615 IKA PUTRI DAMAYANTI P - Berobat Jalan
0017 13:49 unknown origin
0119B0300222P00 03-02-2022 FRANSIKUS MAH
73 02-03-2022 0001293136492 L - Dermatitis, unspecified Berobat Jalan
0007 08:45 SILABAN
FIKRI MUHAMMAD
0119B0300222P00 03-02-2022
74 02-03-2022 0001320124792 SHAHIZINDA L - Other vitamin deficiencies Berobat Jalan
0006 08:42
FADHLURROHMAN
0119B0300222P00 03-02-2022 Allergic rhinitis,
75 02-03-2022 0001328376036 GIO TRIGATRA MAOLANA L - Berobat Jalan
0009 08:48 unspecified
0119B0300222P00 03-02-2022
76 02-03-2022 0001379557135 OKE JUMIANDINI P - Nasal polyp, unspecified Berobat Jalan
0010 08:51
0119B0300222P00 03-02-2022
77 02-03-2022 0001440271012 fadhal najmudin L - Acute tonsillitis Berobat Jalan
0011 08:55
0119B0300222P00 03-02-2022 PELANGI NADA PUTERI
78 02-03-2022 0002048671541 P - Hordeolum and chalazion Berobat Jalan
0008 08:46 AS
0119B0300222P00 03-02-2022 Benign lipomatous
79 02-03-2022 0002923834612 KHAFA ZIDAN KHRISNA L - Rujuk Vertikal
0012 09:24 neoplasm, unspecified
Acute upper respiratory
0119B0300222P00 02-02-2022
80 02-02-2022 0000457485614 JAJANG SUMARNA L - infections of multiple and Berobat Jalan
0003 13:26
unspecified sites
0119B0300222P00 02-02-2022
81 02-02-2022 0001093009959 M ROHMAN YAYAT L - Other vitamin deficiencies Berobat Jalan
0002 13:25
Acute upper respiratory
0119B0300222P00 02-02-2022
82 02-02-2022 0001094566432 HENDRI SUTISNA L - infections of multiple and Berobat Jalan
0004 13:27
unspecified sites
 DAFTAR KUNJUNGAN PESERTA SAKIT

Kantor Cabang : SUKABUMI - 1005

FKTP : POLIKLINIK BRIMOB CIPANAS - 0119B030

Diarrhoea and
0119B0300222P00 02-02-2022
83 02-02-2022 0001300102536 DANANG SUMANTRI L - gastroenteritis of Berobat Jalan
0001 13:24
presumed infectious origin

0119B0300222P00 02-02-2022 Fever of other and

84 02-02-2022 0001379260124 FERRY HANDRIAN L - Berobat Jalan
0005 13:42 unknown origin