DAFTAR KUNJUNGAN HARIAN

PUSKESMAS REJOMULYO
Tanggal : 01-11-2021 s/d 30-11-2021

No. Tgl Kunjungan Nama Pasien Tanggal Lahir Umur

Jenis Kelamin Alamat No KTP Jenis Pembayaran
Kunjungan Anamnesa

13 01-11-2021 DJUMINEM 01-07-1950 71 th P REJOMULYO 14/03 352000000022 BPJS PBI Baru pusing bliyur, badan lemes 3 hari
20 01-11-2021 JUMIRAH 22-06-1972 49 th P RT 14 RW 4 3520126206720001 BPJS PBI Lamapusing bliyur, gatal di bawah ketiak
34 01-11-2021 ARDHIANSYAH DWI SAPUTRO 04-01-2002 19 th L REJOMULYO 4/1 352012040120001 BPJS PBI Baru pandangan mata kabur, kemeng
42 02-11-2021 SLAMET RIYADI 27-06-1967 54 th L 15/04 3520122706670001 BPJS
RUJUKAN
PBI Lama
KE RUMAH SAKIT DR. EFRAM HARSANA POLI BEDAH
207 09-11-2021 SUYADI 12-02-1953 68 th L JONGGRANG 2/1 3520121202530004 BPJS PBI
RUJUKAN
Lama
KE POLI MATA RUMAH SAKIT GRIYA HUSADA
324 15-11-2021 PARNI 01-07-1956 65 th P BLARAN 11/03 3520124107560059 BPJS PBI
TELINGA
Baru
KANAN DAN KIRI PENDENGARAN BERKURANG
338 16-11-2021 HUSSANA SALSABILA 16-07-2005 16 th P BANGUNASRI 3/1 3520125607050001 BPJS NON PBI ASKES
Baru penglihatan mata kabur
391 18-11-2021 PUTUT AHMAD NUGROHO 04-02-2010 11 th L REJOMULYO TR 09 RW 02 3520120402100001 BPJS PBI Lama TELINGA KANA NYERI ADA PUS
445 20-11-2021 DEWI RAHMAWATI 24-04-2004 17 th P BLARAN 05/01 3520126404040001 BPJS PBI Baru
MATA SEBELAH KANAN KADANG NYERI
506 24-11-2021 YOVAN ELCHAPITANO JHUNIOR 03-05-2008 13 th L REJOMULYO 13/02 3520120305080001BPJS NON PBI MANDIRI
Lama
TELINGA KANAN KIRI MBRUBUIG 4 HARI
527 25-11-2021 RASIYEM 01-04-1945 76 th P BAYEM TAMAN 01/01 3520154104450019 BPJS PBI Baru
PENGLIHATAN KABUR SUDAH 2 MINGGU
601 29-11-2021 MURSINI 06-05-1974 47 th P REJOMULYO 4/1 3520124605740001 BPJS
MATA
PBIKEMERAHAN,
Lama MINTA RUJUKAN KE POLI MATA RSI MADIUN
642 30-11-2021 RENDI BAGUS PAMUNGKAS 27-09-2017 4 th L PURWODADI 11/2 3520122709170002BERBAYAR (Rp 10.000,-)
PANAS
BaruMULAI KMRN,MUAL MUNTAH 1X,KEMBUNG
 Diagnosa

[H81.1/B] Benign paroxysmal vertigo

[H81.1/B] Benign paroxysmal vertigo, [M79.0/L] Rheumatism, unspecified
[H54.2/B] Low vision, both eyes
[H74.9/L] Disorder of middle ear and mastoid, unspecified
[H36.0/B] Diabetic retinopathy
[H61.2/B] Serumen Prop
[H54.2/B] Low vision, both eyes
[H66/B] Infeksi Telinga Tengah, [J06.9/L] Acute upper respiratory infection, unspecified
[H15.9/B] Disorder of sclera, unspecified
[H67/B] Otitis media in diseases classified elsewhere
[H54/B] Kebutaan Dan Penglihatan Kurang
[H54.5/B] Low vision, one eye
[R11/B] Mual Dan Muntah
 Klinik Umum UGD
Klinik
Lk Pr Total Lk Pr Total
UMUM / SWADAYA 1 0 1 2 1 3
SKTM 0 0 0 0 0 0
BPJS PBI 139 183 322 2 5 7
BPJS NON PBI MANDIRI 18 45 63 1 0 1
BPJS NON PBI ASKES 15 38 53 0 2 2
JAMKESDA 0 0 0 0 0 0
UKS 0 0 0 0 0 0
FDC 0 0 0 0 0 0
MDT 0 0 0 0 0 0
POSYANDU 0 0 0 0 0 0
GRATIS LAINNYA 8 6 14 0 0 0
BERBAYAR (Rp 10.000,-) 36 55 91 0 0 0
BERBAYAR (Rp 20.000,-) 0 0 0 2 0 2
 Klinik Gigi KIA Poli KB Klinik Anak
Lk Pr Total Lk Pr Total Lk Pr Total Lk
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
1 11 12 3 30 33 0 0 0 0
0 1 1 1 7 8 0 0 0 0
1 2 3 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 1 1 0 0 0 0
1 5 6 3 13 16 0 0 0 0
0 0 0 0 0 0 0 0 0 0
Klinik Anak Pojok Gizi Klinik Sanitasi Rawat Inap
Pr Total Lk Pr Total Lk Pr Total Lk Pr
0 0 0 0 0 0 0 0 1 1
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 1
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
Rawat Inap Klinik Lansia Poli IVA Poli IMS & VCT
Total Lk Pr Total Lk Pr Total Lk Pr Total
2 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
1 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
 Poli DDTK
Lk Pr Total
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0