KLINIK MEDISTIRA

Izin No: 445.5/IOK/00022/DPMPTSP /2017

2
Jl. R aya Cicadas, Kp. Pabuaran, RT.001 R W. 009
Desa Cicadas, K ecam atan Gunung Putri, Kabupaten Bogor
Telp./ Fax (021) 8670130 / (021) 8675832
E m a i l : k l i n i k _ m e d i s ti r a 2 @ y a h o o . c o . i d

LAPORAN BULANAN PELAYANAN KLINIS

LAYANAN : PENDAFTARAN
BULAN : JANUARI 2022

UMUR JAMINAN KUNJUNGAN JENIS PELAYANAN

TANGGAL BPJS JML JML
0-7 Hari 8-28 Hari 29 Hari-1 Th 1-4 5-9 10-14 15-19 20-44 45-54 55-59 60-69 >= 70 UMUM BPJS INHEALTH ASURANSI PERUSAHAAN MCU SKD LAMA BARU UMUM KIA & KB GIGI
TK
01.01.22 0 0 8 15 6 7 2 58 13 1 4 1 8 106 0 0 0 0 0 1 76 39 115 104 11 0 115
02.01.22 0 0 10 10 12 8 6 66 16 4 4 0 22 110 0 0 0 1 0 3 92 44 136 126 10 0 136
03.01.22 0 1 3 10 16 10 12 97 20 4 6 0 22 148 0 1 4 0 0 4 121 59 179 155 18 6 179
04.01.22 0 0 4 15 8 10 5 57 17 3 1 1 14 104 0 0 0 1 0 2 92 29 121 106 10 5 121
05.01.22 0 0 4 8 11 8 8 64 12 1 3 0 10 106 0 0 2 1 0 0 85 34 119 104 15 0 119
06.01.22 0 0 12 9 6 10 3 58 14 4 7 2 15 110 0 0 0 0 0 0 90 35 125 101 17 7 125
07.01.22 0 0 5 11 6 7 5 51 9 4 4 1 9 91 0 0 1 0 1 1 71 32 103 80 15 8 103
08.01.22 0 1 9 14 20 11 4 76 19 8 2 1 14 146 0 1 2 0 0 2 113 52 165 144 13 8 165
09.01.22 0 1 9 14 15 7 4 60 17 5 3 0 11 121 0 0 1 0 0 2 102 33 135 115 20 0 135
10.01.22 0 0 7 12 15 8 8 72 26 2 4 1 15 139 0 0 0 0 1 0 123 32 155 136 12 7 155
11.01.22 0 0 3 5 7 4 8 52 10 3 2 0 11 81 0 0 0 2 0 0 70 24 94 80 8 6 94
12.01.22 0 0 4 11 13 7 5 68 12 2 8 1 15 107 0 2 0 1 2 4 88 43 131 119 9 3 131
13.01.22 2 0 15 11 21 8 13 82 21 1 6 2 20 155 0 2 1 1 0 3 135 47 182 152 25 5 182
14.01.22 0 0 4 14 17 7 10 66 14 1 2 4 15 121 0 0 1 0 0 2 92 47 139 120 11 8 139
15.01.22 0 0 6 7 11 8 5 72 16 2 6 0 10 121 0 0 1 0 0 1 97 36 133 112 15 6 133
16.01.22 0 0 3 14 16 8 5 76 14 4 6 1 20 122 0 0 0 0 0 5 97 50 147 134 13 0 147
17.01.22 0 0 5 12 13 7 7 78 12 1 1 0 13 120 0 0 2 1 0 0 100 36 136 124 6 6 136
18.01.22 0 0 4 14 8 9 15 61 16 2 5 0 11 121 0 0 1 0 1 0 101 33 134 123 6 5 134
19.01.22 0 1 4 5 21 10 10 89 18 1 3 1 16 142 0 0 1 1 0 3 122 41 163 141 17 5 163
20.01.22 0 0 17 12 8 9 10 81 12 5 4 0 15 139 1 0 2 0 0 1 119 39 158 132 21 5 158
21.01.22 0 0 4 14 20 8 10 74 14 4 3 1 13 134 0 1 1 1 0 2 108 44 152 131 12 9 152
22.01.22 0 0 5 8 21 8 6 82 9 3 4 2 15 126 0 0 1 1 0 5 106 42 148 122 18 8 148
23.01.22 0 2 4 12 24 11 6 70 23 3 3 2 11 143 0 0 2 1 1 2 116 44 160 147 13 0 160
24.01.22 0 0 7 6 18 4 11 89 25 6 3 0 9 158 1 0 0 1 0 0 130 39 169 152 9 8 169
25.01.22 0 0 7 14 19 11 7 91 23 5 6 1 16 165 0 0 1 2 0 0 140 44 184 164 16 4 184
26.01.22 0 0 6 6 13 16 7 107 17 1 1 0 12 145 1 0 2 0 10 4 116 58 174 156 11 7 174
27.01.22 0 0 15 9 17 6 8 82 14 6 5 1 11 138 1 1 1 0 10 0 119 43 163 146 12 5 163
28.01.22 0 0 10 4 10 9 7 69 22 3 3 0 12 109 0 0 1 1 10 4 95 42 137 125 8 4 137
29.01.22 0 0 3 9 19 6 7 82 22 4 1 1 18 124 0 3 0 1 8 0 106 48 154 144 10 0 154
30.01.22 0 0 5 14 11 9 5 64 21 3 3 1 18 118 0 0 0 0 0 0 93 43 136 126 10 0 136
31.01.22 0 0 6 9 13 7 10 89 21 4 4 1 13 148 0 1 0 1 0 1 134 30 164 146 13 5 164
JUMLAH 2 6 208 328 435 258 229 2283 519 100 117 26 434 3918 4 12 28 18 44 52 3249 1262 4511 3967 404 140 4511

Mengetahui Bogor,31 JANUARI 2022

Penanggung Jawab Klinik Medistira 2 Penanggung Jawab

Siswarti Adnan Yuyun Ambarwati

Penanggung Jawab UKP

Wahyu Candra Andri Putranto

 KLINIK MEDISTIRA
Iz in No: 445.5/IOK /00022/DPMPTSP/2 017
2
Jl. Raya Cicadas, Kp. Pa bua ran, RT.001 RW. 009
Desa Cicadas, K ecamatan Gunung Putri, Kabupaten Bo gor
Telp ./ Fax (021) 867 0130 / (021) 8675 832
E m a i l : k l i n i k _ m e d i s ti r a 2 @ y a h o o . c o . i d

LAPORAN BULANAN PELAYANAN KLINIS

LAYANAN : PENDAFTARAN
BULAN : FEBRUARI 2022
UMUR JAMINAN KUNJUNGAN
TANGGAL JML
0-7 Hari 8-28 Hari 29 Hari-1 Th 1-4 5-9 10-14 15-19 20-44 45-54 55-59 60-69 >= 70 UMUM BPJS BPJSTK INHEALTH ASURANSI PERUSAHAAN MCU SKD LAMA BARU
01/02/2022 0 0 5 4 13 4 7 54 21 5 3 0 15 100 0 0 1 0 0 0 80 36 116
02/02/2022 0 0 4 7 14 7 9 86 20 5 5 0 12 140 0 1 0 2 0 2 113 42 157
03/02/2022 0 0 4 4 15 8 8 110 21 4 3 3 17 160 0 0 2 1 0 0 129 51 180
04/02/2022 0 0 5 5 10 7 8 57 13 1 3 1 10 95 0 0 2 3 0 0 79 31 110
05/02/2022 0 0 5 11 16 13 7 99 28 2 4 1 15 167 0 1 0 3 0 0 135 51 186
06/02/2022 0 0 10 14 14 5 13 85 25 6 8 0 18 161 0 0 0 1 0 0 133 47 180
07/02/2022 0 0 1 9 14 7 16 106 32 2 13 3 18 180 0 0 1 2 1 1 141 60 203
08/02/2022 0 0 3 5 13 8 11 91 16 2 2 0 17 130 0 1 0 2 0 1 107 43 151
09/02/2022 0 0 4 9 19 8 10 94 25 6 7 0 11 163 1 1 0 4 1 1 143 37 182
10/02/2022 0 0 6 11 15 7 18 114 25 4 6 1 15 187 1 1 1 1 0 1 164 42 207
11/02/2022 0 0 2 10 15 7 10 102 30 7 8 2 12 174 2 1 1 2 0 1 162 30 193
12/02/2022 0 0 2 7 12 8 9 76 23 4 9 3 10 140 0 1 1 1 0 0 116 37 153
13/02/2022 0 1 3 5 11 10 6 89 20 1 4 1 14 127 1 1 3 0 0 5 116 30 151
14/02/2022 0 0 6 7 12 11 18 121 31 11 13 4 19 212 0 1 2 0 0 0 178 56 234
15/02/2022 0 0 6 5 17 16 10 119 20 5 7 1 14 189 0 0 1 0 1 1 165 39 206
16/02/2022 0 0 1 7 15 9 6 112 14 2 16 0 17 161 0 2 0 0 2 0 145 35 182
17/02/2022 0 0 6 11 12 8 8 98 26 3 0 0 9 159 0 1 0 1 0 2 133 37 172
18/02/2022 0 0 4 10 13 6 14 92 30 7 6 1 16 161 0 0 2 3 0 1 146 36 183
19/02/2022 0 0 2 15 22 7 7 71 22 2 6 1 15 138 0 1 0 1 0 0 120 35 155
20/02/2022 0 0 4 11 14 11 10 79 25 3 6 0 9 149 0 2 1 1 0 1 131 31 163
21/02/2022 0 0 2 6 11 10 13 110 21 7 7 2 12 177 0 0 0 0 0 0 154 35 189
22/02/2022 0 0 10 16 16 5 9 105 22 4 10 0 25 166 0 2 1 1 2 0 148 47 197
23/02/2022 0 0 1 11 22 7 10 84 32 4 3 1 15 156 0 1 0 0 1 2 139 33 175
24/02/2022 0 0 26 8 18 7 8 88 18 1 3 0 17 157 0 0 1 1 0 1 136 40 177
25/02/2022 0 0 2 8 16 2 9 65 19 4 5 0 13 114 0 2 1 0 0 0 105 25 130
26/02/2022 0 1 7 8 9 7 11 71 11 2 5 3 14 115 0 2 0 1 0 3 98 34 135
27/02/2022 0 0 7 9 4 4 2 51 10 1 3 0 6 83 0 1 0 1 0 0 73 18 91
28/02/2022 0 0 4 2 20 6 4 47 13 4 1 2 8 90 0 3 0 1 0 1 75 27 103
JUMLAH 0 2 142 235 402 215 271 2476 613 109 166 30 393 4151 5 26 21 33 8 24 3564 1065 4661

Mengetahui
Penanggung Jawab Klinik Medistira 2

Siswarti Adnan

Penanggung Jawab UKP

Wahyu Candra Andri Putranto

 KLINIK MEDISTIRA
Iz in No: 445. 5/ IOK /00022 / DPMPTSP /2017
2
Jl. Ray a C icadas , Kp . P abuaran, RT.0 01 RW. 009
Desa Ci cadas , K ecamatan Gunung Putr i , K abupaten Bogor
Telp. / F ax ( 021) 8670130 / ( 021) 8675832
E m a i l : k l i n i k _ m e d i s ti r a 2 @ y a h o o . c o . i d

LAPORAN BULANAN PELAYANAN KLINIS

LAYANAN : PENDAFTARAN
BULAN : MARET 2022

UMUR JAMINAN KUNJUNGAN JENIS PELAYANAN

TANGGAL JML JML
0-7 Hari 8-28 Hari 29 Hari-1 Th 1-4 5-9 10-14 15-19 20-44 45-54 55-59 60-69 >= 70 UMUM BPJS BPJSTK INHEALTH ASURANSI PERUSAHAAN MCU SKD LAMA BARU UMUM KIA & KB GIGI
01.03.22 0 0 2 5 8 8 5 95 15 4 6 1 20 101 0 0 4 0 1 0 108 41 126 103 15 8 126
02.03.22 0 1 6 9 14 2 5 79 13 1 7 1 9 116 0 1 1 0 1 0 110 28 128 118 4 6 128
03.03.22 0 1 30 7 12 6 3 69 13 1 3 0 16 129 0 0 0 0 0 0 159 31 145 100 38 7 145
04.03.22 0 0 1 6 7 3 10 60 14 4 0 0 14 86 0 0 0 1 0 3 89 30 104 91 8 5 104
05.03.22 0 0 4 5 14 1 7 60 11 2 1 2 14 88 0 0 3 1 0 1 99 28 107 87 13 7 107
06.03.22 0 0 3 4 7 3 5 60 16 1 2 0 8 91 0 0 0 1 0 1 106 17 101 79 22 0 101
07.03.22 0 0 3 9 9 4 6 71 18 2 3 2 14 112 0 0 0 0 1 0 109 33 127 107 15 5 127
08.03.22 0 0 7 3 7 5 4 48 15 3 3 0 7 82 0 0 2 3 1 0 78 31 95 82 6 7 95
09.03.22 0 0 5 5 8 7 4 81 16 3 4 2 13 113 0 0 1 0 2 2 122 44 131 96 27 8 131
10.03.22 0 0 24 10 8 3 1 56 13 1 4 1 16 100 1 0 0 0 0 4 127 36 121 79 35 7 121
11.03.22 0 0 2 5 10 3 5 53 5 1 2 0 10 71 0 0 0 0 0 5 67 14 86 69 13 4 86
12.03.22 0 0 4 6 17 5 8 33 10 1 5 0 10 75 1 0 2 0 0 1 66 23 89 67 17 5 89
13.03.22 0 0 8 7 7 6 4 38 13 3 4 1 8 80 1 0 0 1 0 1 71 20 91 73 18 0 91
14.03.22 0 0 2 6 12 5 9 54 21 2 4 1 4 107 0 0 0 0 0 5 90 26 116 90 22 4 116
15.03.22 0 0 4 8 16 7 6 52 12 1 3 1 6 100 1 0 2 1 0 1 93 18 111 85 19 7 111
16.03.22 0 0 2 9 8 3 6 51 9 1 6 1 5 85 0 1 2 1 0 1 81 14 95 73 14 8 95
17.03.22 0 0 2 3 13 7 3 59 15 0 1 0 12 86 1 0 2 2 0 0 74 29 103 89 11 3 103
18.03.22 0 0 6 10 4 8 3 47 11 0 1 2 4 87 0 0 0 0 0 1 73 19 92 80 5 7 92
19.03.22 0 0 8 15 15 6 2 33 13 2 2 1 8 88 0 0 1 0 0 0 80 17 97 69 21 7 97
20.03.22 0 0 5 9 10 9 2 50 13 0 1 1 16 83 0 0 0 0 0 1 81 19 100 83 17 0 100
21.03.22 0 0 4 4 13 7 7 66 11 4 6 2 20 103 0 0 0 1 0 0 96 28 124 106 16 2 124
22.03.22 0 1 7 10 15 8 7 67 16 1 4 1 14 121 1 0 0 0 0 1 99 38 137 115 15 7 137
23.03.22 0 0 2 3 23 7 7 57 23 5 2 0 6 117 3 2 1 0 0 0 107 22 129 98 22 9 129
24.03.22 0 1 27 6 12 2 4 62 19 2 3 0 12 123 1 0 0 0 1 1 113 25 138 99 34 5 138
25.03.22 0 0 4 12 13 7 9 47 8 3 3 2 8 94 1 1 0 2 0 2 82 26 108 94 8 6 108
26.03.22 0 0 1 10 9 4 4 52 16 3 1 0 14 83 0 0 0 2 0 1 72 28 100 88 4 8 100
27.03.22 0 0 5 8 21 14 8 79 6 1 5 1 11 116 0 1 1 0 0 2 103 28 131 114 17 0 131
28.03.22 0 0 8 6 7 9 5 95 22 3 5 2 15 118 0 1 1 2 0 2 109 30 139 116 15 8 139
29.03.22 0 1 7 13 10 8 4 96 14 3 4 0 6 127 0 0 1 0 0 1 108 27 135 110 16 9 135
30.03.22 0 0 4 4 13 3 8 76 8 0 9 1 8 99 1 0 2 0 0 3 85 28 113 92 13 8 113
31.03.22 0 0 5 5 13 3 3 71 12 5 3 2 9 97 0 0 0 0 1 1 78 30 108 94 14 0 108
JUMLAH 0 5 202 222 355 173 164 1792 421 63 107 28 337 3078 12 7 26 18 8 41 2935 828 3527 2846 514 167 3527

Mengetahui Bogor,31 MARET 2022

Penanggung Jawab Klinik Medistira 2 Penanggung Jawab
Penanggung Jawab

Siswarti Adnan Yuyun Ambarwati

Wahyu Candra Andri Putranto
 KLINIK MEDISTIRA 2 Izin No: 445.5/IOK/00022/DPMPTSP/2017
Jl. Raya Cicadas, Kp. Pabuaran, RT.001 RW. 009
Desa Cicadas, Kecamatan Gunung Putri, Kabupaten Bogor
Telp./ Fax (021) 8670130 / (021) 8675832
E m a i l : k l i n i k _ m e d i s ti r a 2 @ y a h o o . c o . i d

LAPORAN BULANAN PELAYANAN KLINIS

LAYANAN : PENDAFTARAN
BULAN : APRIL 2022

UMUR JAMINAN KUNJUNGAN JENIS PELAYANAN

TANGGAL JML KIA & GIGI LAB RO MCUSKD JML
0-7 Hari 8-28 Hari 29 Hari-1 Th 1-4 5-9 10-14 15-19 20-44 45-54 55-59 60-69 >= 70 UMUM BPJS BPJSTK INHEALTH ASURANSI PT LAMA BARU UMUM
KB
01.04.22 0 0 9 3 10 4 7 80 17 6 5 0 27 111 0 0 1 2 111 30 141 105 15 0 8 13 0 0 141
02.04.22 0 0 4 9 11 11 8 65 19 2 2 0 9 121 1 0 0 0 99 32 131 104 18 7 0 0 0 2 131
03.04.22 0 0 5 8 14 2 4 44 9 1 3 0 19 70 0 0 0 1 72 18 90 69 13 0 0 7 0 1 90
04.04.22 0 0 4 8 11 5 16 85 9 7 3 1 20 123 0 1 2 3 98 51 149 119 10 2 5 7 0 6 149
05.04.22 0 0 2 7 10 6 11 49 13 4 2 0 11 92 0 1 0 0 86 18 104 85 5 4 6 3 0 1 104
06.04.22 1 0 0 8 11 7 13 73 18 4 5 0 21 116 1 0 2 0 117 23 140 98 17 10 11 3 0 1 140
07.04.22 0 0 38 12 19 7 6 50 14 1 3 0 14 133 0 0 1 2 120 30 150 105 32 5 4 3 0 1 150
08.04.22 0 0 5 10 15 7 11 58 17 1 2 2 19 104 3 1 0 1 102 26 128 91 12 9 7 8 0 1 128
09.04.22 0 0 8 16 9 2 1 51 11 3 2 0 6 95 1 0 0 1 83 20 103 81 12 8 0 2 0 0 103
10.04.22 0 0 9 11 12 8 2 69 8 0 4 1 12 112 0 0 0 0 98 26 124 105 14 0 0 3 0 2 124
11.04.22 0 0 1 5 11 6 8 77 15 0 5 0 13 114 1 0 0 0 99 29 128 88 17 6 9 6 1 1 128
12.04.22 0 1 3 9 8 7 16 59 11 1 3 0 8 109 0 0 0 1 95 23 118 86 10 5 11 6 0 0 118
13.04.22 0 0 2 10 16 5 8 62 7 3 6 2 15 102 1 2 1 0 93 28 121 95 9 7 5 4 1 0 121
14.04.22 0 0 21 13 8 3 8 66 14 3 3 2 7 133 0 1 0 0 111 30 141 93 30 6 5 5 1 1 141
15.04.22 0 0 6 5 9 3 6 54 8 5 5 0 13 86 0 0 0 2 80 21 101 80 15 0 0 4 0 2 101
16.04.22 0 0 6 11 25 2 1 43 10 4 7 2 11 99 0 0 1 0 84 27 111 85 11 9 0 6 0 0 111
17.04.22 0 0 4 14 19 5 5 46 12 3 4 0 7 105 0 0 0 0 89 23 112 98 9 0 0 3 0 2 112
18.04.22 0 0 3 3 11 5 7 57 10 1 2 0 14 83 0 0 1 1 71 28 99 76 13 2 3 4 0 1 99
19.04.22 0 0 2 7 8 4 9 68 8 5 3 0 10 104 0 0 0 0 95 19 114 91 12 4 3 4 0 0 114
20.04.22 0 0 6 6 10 4 8 126 13 4 3 0 61 117 0 0 2 0 108 72 180 99 14 7 52 8 0 0 180
21.04.22 0 0 24 10 18 4 6 70 21 1 1 0 15 138 1 0 0 1 125 30 155 110 25 3 9 6 1 1 155
22.04.22 0 0 2 10 5 3 12 45 8 3 2 2 8 83 0 0 1 0 78 14 92 70 9 5 0 7 0 1 92
23.04.22 1 0 2 5 13 5 15 68 12 1 5 0 12 115 0 0 0 0 105 22 127 71 15 5 0 36 0 0 127
24.04.22 0 0 6 5 17 9 5 59 15 6 2 1 8 114 1 0 1 1 108 17 125 113 11 0 0 1 0 0 125
25.04.22 0 0 2 9 6 6 11 50 13 4 2 0 15 85 1 0 0 2 80 23 103 87 7 4 0 5 0 0 103
26.04.22 0 0 0 8 12 6 14 49 14 4 8 2 11 105 1 0 0 0 93 24 117 96 11 1 7 2 0 0 117
27.04.22 0 0 9 7 11 4 18 58 13 0 6 0 17 107 2 0 0 0 102 24 126 88 20 4 3 11 0 0 126
28.04.22 0 0 13 9 14 4 7 42 19 2 2 0 13 97 1 0 0 1 90 22 112 84 21 3 0 4 0 0 112
29.04.22 0 0 3 7 8 10 12 44 7 5 4 0 13 85 0 1 1 0 83 17 100 72 16 5 7 0 0 0 100
30.04.22 0 0 2 5 5 4 4 23 7 2 0 0 5 46 0 0 0 1 44 8 52 45 7 0 0 0 0 0 52
JUMLAH 2 1 201 250 356 158 259 1790 372 86 104 15 434 3104 15 7 14 20 2819 775 3594 2689 430 121 155 171 4 24 3594

Mengetahui Bogor,30 APRIL 2022

Penanggung Jawab Klinik Medistira 2 Penanggung Jawab

Siswarti Adnan Yuyun Ambarwati

Penanggung Jawab UKP

Wahyu Candra Andri Putranto

 KLINIK MEDISTIRA
Iz in N o: 44 5. 5/ IOK / 00 0 2 2/ D PM P TSP /2 0 1 7
2
Jl. Ra y a Cica da s , K p . P a bu a ran , RT. 001 R W. 0 0 9
D es a Cicad a s , K eca m ata n G u n ung P utr i, K ab u pa te n Bo g or
Telp . / F a x (0 2 1) 8 6 70 1 30 / ( 02 1 ) 8 67 58 3 2
E m a i l : k l i n i k _ m e d i s ti r a 2 @ y a h o o . c o . i d

LAPORAN BULANAN PELAYANAN KLINIS

LAYANAN : PENDAFTARAN
BULAN : MEI 2022

UMUR JAMINAN KUNJUNGAN JENIS PELAYANAN

TANGGAL JML KIA & JML
0-7 Hari 8-28 Hari 29 Hari-1 Th 1-4 5-9 10-14 15-19 20-44 45-54 55-59 60-69 >= 70 UMUM BPJS BPJSTK INHEALTH ASURANSI PT LAMA BARU UMUM GIGI LAB RO MCU SKD
KB
01.05.22
02.05.22
03.05.22 LIBUR HARI RAYA IDUL FITRI
04.05.22
05.05.22
06.05.22 0 0 5 6 10 11 4 79 25 1 4 0 22 122 0 0 0 1 107 38 145 108 21 0 9 5 0 2 145
07.05.22 0 0 8 8 11 9 2 63 12 2 3 1 22 96 0 0 1 0 92 27 119 88 22 0 6 1 0 2 119
08.05.22 0 0 6 9 9 5 14 48 10 0 5 0 15 90 0 1 0 0 85 21 106 74 15 0 11 2 0 4 106
09.05.22 0 0 6 5 7 7 11 70 20 4 3 3 27 106 1 1 0 1 106 30 136 91 18 6 7 10 0 4 136
10.05.22 0 0 11 15 17 8 10 114 25 3 4 0 31 172 0 3 0 1 169 38 207 165 18 6 2 7 0 9 207
11.05.22 0 0 7 8 12 11 4 88 24 4 3 2 30 123 3 3 1 3 127 36 163 121 18 7 0 12 2 3 163
12.05.22 1 0 38 11 11 7 3 108 16 3 6 2 41 163 0 0 2 0 147 59 206 144 41 5 0 11 1 4 206
13.05.22 0 0 10 17 9 6 4 81 27 1 3 0 20 137 1 0 0 0 115 43 158 126 18 6 0 7 0 1 158
14.05.22 0 1 8 10 12 11 7 55 18 4 7 0 15 118 0 0 0 0 105 28 133 110 13 7 0 3 0 0 133
15.05.22 0 0 3 5 8 6 6 61 14 2 3 0 18 90 0 0 0 0 83 25 108 86 19 0 0 3 0 0 108
16.05.22 0 0 11 12 7 7 4 68 15 4 1 1 21 106 0 0 0 3 104 26 130 110 13 0 0 4 0 3 130
17.05.22 0 0 2 3 18 4 20 92 23 8 10 4 22 162 0 0 0 0 141 43 184 132 24 6 13 3 0 6 184
18.05.22 0 0 2 16 11 7 16 105 33 5 3 1 46 152 1 0 0 0 145 54 199 127 19 7 16 19 11 0 199
19.05.22 0 0 21 12 20 14 12 73 20 3 6 0 26 150 0 4 1 0 137 44 181 124 32 11 7 7 0 0 181
20.05.22 0 0 5 18 16 5 10 60 13 1 2 0 14 115 1 0 0 0 98 32 130 106 7 5 3 7 1 1 130
21.05.22 0 0 5 7 18 6 2 75 28 4 5 2 13 137 1 0 1 0 119 33 152 119 22 6 0 4 0 1 152
22.05.22 0 0 6 9 20 4 6 63 7 1 6 0 12 102 1 2 1 4 94 28 122 105 14 0 0 3 0 0 122
23.05.22 0 0 5 9 11 8 16 99 27 2 3 4 18 163 1 0 2 0 142 42 184 140 25 6 8 4 0 1 184
24.05.22 0 0 8 8 21 15 19 85 23 5 2 1 27 158 1 0 0 1 139 48 187 142 16 6 10 10 1 2 187
25.05.22 0 0 1 9 15 11 16 74 14 4 2 1 17 122 1 0 0 7 112 35 147 108 16 6 10 6 1 0 147
26.05.22 0 1 38 13 16 5 6 70 19 0 1 0 25 142 0 0 1 1 128 41 169 116 47 0 0 5 0 1 169
27.05.22 0 0 4 11 9 5 5 88 12 5 6 2 23 123 0 0 0 1 111 36 147 118 9 5 7 6 0 2 147
28.05.22 0 0 2 11 12 7 4 75 15 4 7 0 15 118 1 1 2 0 113 24 137 105 18 8 0 4 0 2 137
29.05.22 0 0 7 9 19 8 10 80 18 1 5 0 24 131 0 1 1 0 124 33 157 136 12 0 0 0 2 7 157
30.05.22 0 0 5 13 14 5 17 78 22 8 4 1 25 139 1 0 1 1 121 46 167 132 8 7 14 6 0 0 167
31.05.22 0 0 5 11 8 7 8 73 13 4 4 2 11 121 1 0 0 2 111 24 135 113 4 7 11 0 0 0 135
JUMLAH 1 2 229 265 341 199 236 2025 493 83 108 27 580 3358 15 16 14 26 3075 934 4009 3046 489 117 134 149 19 55 4009
 Mengetahui Bogor,31 MEI 2022
Penanggung Jawab Klinik Medistira 2 Penanggung Jawab
Penanggung Jawab

Siswarti Adnan Yuyun Ambarwati

Wahyu Candra Andri Putranto
 KLINIK MEDISTIRAIzin No: 445.5/IOK /00022/DPMPTSP/2017
2
Jl. Raya Cicadas, Kp. Pab uaran, RT.001 RW. 009
Desa Cicadas, Kecamatan Gunung Putri, K abupaten B ogor
Telp./ Fax (021) 8670130 / ( 021) 8675832
E m a i l : k l i n i k _ m e d i s ti r a 2 @ y a h o o . c o . i d

LAPORAN BULANAN PELAYANAN KLINIS

LAYANAN : PENDAFTARAN
BULAN : JUNI 2022

UMUR JAMINAN KUNJUNGAN JENIS PELAYANAN

TANGGAL JML KIA & JML
0-7 Hari 8-28 Hari 29 Hari-1 Th 1-4 5-9 10-14 15-19 20-44 45-54 55-59 60-69 >= 70 UMUM BPJS BPJSTK INHEALTH ASURANSI PT LAMA BARU UMUM KB GIGI LAB RO MCU SKD
01.06.22 0 0 8 12 17 6 26 82 18 4 1 2 36 138 1 0 1 0 132 44 176 149 10 0 5 5 0 7 176
02.06.22 0 0 19 8 9 4 17 54 14 1 1 0 25 99 1 0 2 0 102 25 127 79 25 6 7 5 0 5 127
03.06.22 0 0 6 15 14 7 22 69 11 4 8 2 32 123 1 0 0 2 130 28 158 130 12 0 7 8 0 1 158
04.06.22 0 0 5 10 11 6 8 65 19 2 5 1 18 112 0 0 2 0 108 24 132 106 14 6 0 5 0 1 132
05.06.22 0 0 2 6 9 7 6 63 10 1 1 1 15 88 0 0 0 3 84 22 106 92 13 0 0 1 0 0 106
06.06.22 0 0 5 6 11 5 15 92 9 4 8 0 22 129 1 3 0 0 115 40 155 114 18 6 9 6 1 1 155
07.06.22 0 0 2 13 23 7 17 94 13 2 4 2 20 148 4 0 1 4 127 50 177 137 19 7 9 5 0 0 177
08.06.22 0 0 7 5 10 10 11 67 12 2 4 1 10 119 0 0 0 0 115 14 129 110 13 0 4 1 0 1 129
09.06.22 0 1 16 4 17 10 16 73 12 2 2 3 22 132 2 0 0 0 126 30 156 116 20 9 8 3 0 0 156
10.06.22 0 0 3 11 19 14 10 84 22 4 6 1 23 147 1 1 1 1 144 30 174 136 16 7 9 6 0 0 174
11.06.22 0 1 3 6 20 8 6 58 15 2 5 2 12 112 1 0 0 1 103 23 126 95 20 8 0 3 0 0 126
12.06.22 0 0 6 5 11 8 11 62 16 0 2 0 18 99 1 1 0 2 97 24 121 95 22 0 0 4 0 0 121
13.06.22 0 0 4 12 14 8 18 98 19 4 1 0 29 146 2 0 0 1 129 49 178 141 13 6 5 10 1 2 178
14.06.22
15.06.22 LIBUR
16.06.22 0 0 31 16 22 10 18 102 20 4 10 3 32 203 0 0 0 1 195 41 236 177 44 6 0 8 1 0 236
17.06.22 0 0 8 4 22 6 15 79 20 1 8 0 26 136 0 0 0 1 133 30 163 120 18 7 9 5 2 2 163
18.06.22 0 0 9 7 19 10 11 81 21 4 7 2 22 148 1 0 0 0 140 31 171 138 21 7 0 3 0 2 171
19.06.22 0 1 3 14 24 9 8 72 15 3 3 3 18 134 0 3 0 0 115 40 155 132 21 0 0 0 0 2 155
20.06.22 0 0 5 10 16 8 10 114 22 3 3 2 21 169 0 0 1 2 160 33 193 145 20 7 7 13 1 0 193
21.06.22 0 0 6 10 23 8 17 83 27 4 2 0 20 158 0 1 0 1 138 42 180 145 10 6 10 9 0 0 180
22.06.22 0 0 3 9 10 9 19 83 22 3 7 1 25 139 0 1 0 1 135 31 166 120 14 8 12 12 0 0 166
23.06.22 0 0 15 13 20 8 11 67 15 4 4 2 21 135 0 0 0 3 132 27 159 120 19 4 5 9 1 1 159
24.06.22 0 0 4 11 15 12 8 69 20 1 4 0 14 128 0 0 1 1 106 38 144 112 10 11 7 4 0 0 144
25.06.22 0 0 10 11 11 11 15 77 19 4 5 0 15 146 0 1 1 0 137 26 163 132 13 9 6 1 0 2 163
26.06.22 0 0 10 13 28 6 13 60 17 2 4 2 14 139 0 1 0 1 127 28 155 136 16 0 0 1 1 1 155
27.06.22 0 1 4 13 20 7 10 81 19 3 3 3 21 139 0 1 3 0 120 44 164 132 13 8 0 11 0 0 164
28.06.22 0 0 3 7 15 6 11 65 16 4 3 1 24 104 0 2 0 1 98 33 131 109 8 8 2 2 0 2 131
29.06.22 0 0 8 10 25 6 14 91 16 3 6 3 28 152 1 1 0 0 144 38 182 143 13 9 10 4 0 3 182
30.06.22 0 1 31 10 16 8 14 90 13 4 3 0 39 146 1 0 2 2 156 34 190 131 41 8 0 7 0 3 190
JUMLAH 0 5 236 271 471 224 377 2175 472 79 120 37 622 3768 18 16 15 28 3548 919 4467 3492 496 153 131 151 8 36 4467

Mengetahui Bogor,30 JUNI 2022

Penanggung Jawab Klinik Medistira 2 Penanggung Jawab

Siswarti Adnan Yuyun Ambarwati

Penanggung Jawab UKP

Wahyu Candra Andri Putranto

 KLINIK MEDISTIR
I z in N o : 4 4 5 . 5 / I O K / 0 0 0 2 2 / D P M P T S P / 2 0 1 7
J l . R a y a C i c a d a s , K p . P a b u a r a n , R T . 0 0 1 R W .
D e s a C i c a d a s , K e c a m a t a n G u n u n g P u t r i , K a b u p a t e
T e l p . / F a x ( 0 2 1 ) 8 6 7 0 1 3 0 / ( 0 2 1 ) 8 6 7 5 8 3 2
E m a i l : k l i n i k _ m e d i s ti r a 2 @ y a h o o . c o . i d

LAPORAN BULANAN PELAYANAN KLINIS

LAYANAN : PENDAFTARAN
BULAN : JULI 2022

UMUR JAMINAN KUNJUNGAN

TANGGAL
0-7 Hari 8-28 Hari 29 Hari-1 Th 1-4 5-9 10-14 15-19 20-44 45-54 55-59 60-69 >= 70 UMUM BPJS BPJSTK INHEALTH ASURANSI PT LAMA
01.07.22 0 0 4 10 20 5 20 84 20 4 6 3 24 152 0 0 0 0 139
02.07.22 0 0 1 9 15 11 12 73 20 2 7 0 17 128 1 0 2 2 115
03.07.22 0 0 13 8 13 6 5 79 15 3 7 0 20 126 1 0 1 1 104
04.07.22 0 0 7 12 10 9 42 99 11 4 6 1 14 184 0 0 2 1 167
05.07.22 0 0 8 13 18 9 37 92 17 1 5 0 21 177 0 0 2 0 156
06.07.22 0 0 3 5 13 4 26 72 12 1 2 1 12 127 0 0 0 0 120
07.07.22 0 0 28 12 21 7 21 100 14 1 5 1 37 169 0 1 1 2 165
08.07.22 0 0 4 8 10 5 32 93 9 0 9 1 29 141 1 0 0 0 136
09.07.22 0 0 7 7 14 7 14 79 21 0 5 2 24 131 0 0 0 1 123
10.07.22 0 0 2 7 5 4 9 35 4 0 2 0 13 54 0 0 1 0 58
11.07.22 0 0 9 8 17 10 27 157 18 1 3 0 45 203 1 0 1 0 205
12.07.22 0 0 5 13 18 9 24 98 16 2 5 1 31 159 1 0 0 0 142
13.07.22 0 0 6 5 15 11 32 115 15 1 4 1 30 172 0 1 1 1 150
14.07.22 0 0 28 14 16 11 23 106 27 1 6 3 41 190 1 1 1 1 176
15.07.22 0 0 6 7 12 6 14 77 15 4 2 3 16 127 0 1 1 1 117
16.07.22 0 0 6 9 21 3 23 76 14 1 5 0 17 138 1 0 0 2 126
17.07.22 0 0 6 12 20 9 12 61 17 4 2 0 18 123 0 1 1 0 107
18.07.22 0 0 9 10 18 11 33 109 29 5 4 1 24 203 0 0 1 1 186
19.07.22 0 0 4 8 13 8 37 99 16 4 5 1 28 164 1 0 0 2 145
20.07.22 0 0 8 15 13 10 26 99 11 3 9 2 20 173 1 2 0 0 146
21.07.22 0 0 18 10 12 9 36 79 15 4 3 1 26 157 0 0 3 1 147
22.07.22 0 0 2 7 12 9 33 79 10 4 7 4 9 158 0 0 0 0 120
23.07.22 0 0 3 12 16 9 15 81 23 4 7 1 15 152 0 2 1 1 125
24.07.22 0 0 8 15 14 10 17 84 8 0 3 0 16 142 0 0 0 1 120
25.07.22 0 0 4 7 17 12 45 133 18 3 3 1 38 203 0 0 2 0 172
26.07.22 0 0 5 15 21 6 23 72 18 7 5 2 23 151 0 0 0 0 125
27.07.22 0 0 9 12 22 16 27 82 28 2 5 2 22 181 0 0 0 2 167
28.07.22 0 0 36 9 12 4 39 92 11 3 3 2 26 183 1 0 0 1 160
29.07.22 0 0 3 9 5 16 35 80 28 0 6 0 25 156 0 0 1 0 125
30.07.22 0 0 4 10 25 9 14 62 21 0 4 1 13 137 0 0 0 0 118
31.07.22 0 0 4 26 20 18 23 77 9 3 3 0 27 153 0 1 1 1 133
JUMLAH 0 0 260 324 478 273 776 2724 510 72 148 35 721 4814 10 10 23 22 4295

Mengetahui
Penanggung Jawab Klinik Medistira 2

Siswarti Adnan
Penanggung Jawab UKP

Wahyu Candra Andri Putranto

 STIRA
P M P T SP / 2 0 1 7
2
R T . 0 0 1 R W . 0 0 9
t r i , K a b u p a t e n B o g o r
0 2 1 ) 8 6 7 5 8 3 2
a h o o . c o . i d

KUNJUNGAN JENIS PELAYANAN

JML KIA & JML
BARU UMUM GIGI LAB RO MCU SKD
KB
37 176 136 14 7 7 11 0 1 176
35 150 136 7 0 0 6 0 1 150
45 149 129 20 0 0 0 0 0 149
34 201 187 10 0 4 0 0 0 201
44 200 164 12 11 10 3 0 0 200
19 139 120 11 5 0 3 0 0 139
45 210 148 36 6 6 8 3 3 210
35 171 134 20 3 5 8 0 1 171
33 156 130 23 0 0 2 0 1 156
10 68 60 5 0 0 0 0 3 68
45 250 201 17 7 7 12 1 5 250
49 191 152 16 8 8 6 0 1 191
55 205 165 17 7 10 6 0 0 205
59 235 186 32 5 5 3 0 4 235
29 146 115 13 7 5 4 0 2 146
32 158 129 21 6 0 0 0 2 158
36 143 134 7 0 0 0 0 2 143
43 229 184 23 7 10 4 0 1 229
50 195 160 8 8 9 6 0 4 195
50 196 170 13 3 7 2 0 1 196
40 187 146 21 7 5 6 1 1 187
47 167 139 16 6 4 2 0 0 167
46 171 145 15 8 0 3 0 0 171
39 159 136 20 0 0 2 0 1 159
71 243 182 19 6 12 23 0 1 243
49 174 149 6 6 9 2 0 2 174
38 205 176 14 7 0 6 0 2 205
51 211 148 40 4 9 9 0 1 211
57 182 156 2 7 12 5 0 0 182
32 150 138 10 0 0 0 0 2 150
50 183 154 19 0 0 6 0 4 183
1305 5600 4609 507 141 144 148 5 46 5600

Bogor,31 JULI 2022

Penanggung Jawab

Yuyun Ambarwati
 KLINIK MEDISTIRA Izin No: 445.5/IOK/00022/DPMPTSP/2017
Jl. Raya Cicadas, Kp. Pa buaran, RT.001 RW. 009
Desa Cicadas, Kecamatan Gunung Putri , Kabupaten B
Telp./ Fax (021) 8670130 / (021) 8675832
E m a i l : k l i n i k _ m e d i s ti r a 2 @ y a h o o . c o . i d

LAPORAN BULANAN PELAYANAN KLINIS

LAYANAN : PENDAFTARAN
BULAN : AGUSTUS 2022

UMUR JAMINAN KUNJUNGAN

TANGGAL
0-7 Hari 8-28 Hari29 Hari-1 Th 1-4 5-9 10-14 15-19 20-44 45-54 55-59 60-69 >= 70 UMUM BPJS BPJSTK INHEALTH ASURANSI PT LAMA BARU
01.08.22 0 0 3 10 22 9 19 136 31 2 3 3 25 210 0 1 0 2 189 49
02.08.22 0 0 6 15 26 11 21 101 24 3 3 1 14 190 1 4 1 1 170 41
03.08.22 0 0 7 17 18 6 15 99 26 3 6 1 17 177 1 1 0 2 163 35
04.08.22 1 0 23 11 26 10 4 91 32 3 3 1 28 174 1 2 0 0 151 54
05.08.22 0 0 2 8 21 6 10 101 22 8 4 1 18 163 1 0 0 1 149 34
06.08.22 0 0 5 17 17 16 8 84 13 2 6 0 16 149 1 0 2 0 127 41
07.08.22 0 0 9 18 12 11 8 71 12 2 4 0 17 127 0 1 1 1 117 30
08.08.22 0 0 11 15 16 15 11 115 30 4 5 3 21 199 2 1 1 1 188 37
09.08.22 0 0 2 11 21 11 17 133 34 3 3 1 24 208 0 0 2 2 188 48
10.08.22 0 0 8 14 17 15 14 113 27 1 1 5 25 188 1 0 0 1 163 52
11.08.22 0 0 15 13 15 15 10 107 25 8 3 1 28 183 0 0 0 1 168 44
12.08.22 0 0 1 12 18 10 13 95 13 3 2 2 18 150 0 0 0 1 137 32
13.08.22 0 0 7 12 24 16 17 107 21 3 4 0 26 182 0 2 1 0 167 44
14.08.22 0 0 5 11 18 11 13 91 16 2 7 0 21 150 0 1 0 2 136 38
15.08.22 0 0 7 10 24 13 27 128 31 2 8 1 29 220 1 1 0 0 199 52
16.08.22 0 0 4 12 16 14 16 100 28 3 2 0 22 172 0 0 1 0 150 45
17.08.22 0 0 8 9 17 11 11 73 16 2 3 0 8 141 0 0 0 1 120 30
18.08.22 0 1 26 11 25 10 21 131 13 1 5 0 22 218 1 1 1 1 183 61
19.08.22 0 0 7 7 18 8 18 113 30 5 5 2 15 195 1 0 1 1 166 47
20.08.22 0 0 7 10 23 17 19 106 24 0 2 1 11 195 1 0 1 1 163 46
21.08.22 0 0 3 14 21 15 15 86 13 1 2 0 20 147 2 0 0 1 124 46
22.08.22 0 0 5 16 25 16 17 129 25 1 3 2 24 211 1 2 1 0 181 58
23.08.22 0 1 7 13 17 17 25 132 20 7 4 1 11 231 1 0 1 0 195 49
24.08.22 0 0 11 7 21 21 24 128 22 4 6 2 13 228 1 1 1 2 194 52
25.08.22 0 0 21 11 22 12 25 118 19 2 1 2 23 208 0 1 0 1 184 49
26.08.22 0 0 5 12 17 12 15 106 19 5 2 4 19 175 1 2 0 0 151 46
27.08.22 0 0 8 11 20 11 25 108 13 0 4 3 14 184 0 0 3 2 158 45
28.08.22 0 0 11 14 27 14 10 80 12 5 5 0 22 152 1 1 2 0 140 38
29.08.22 0 0 9 6 24 19 36 115 35 2 5 2 11 239 1 1 0 1 200 53
30.08.22 0 0 5 9 16 10 35 137 31 3 5 2 23 226 1 1 0 2 190 63
31.08.22 0 0 12 11 19 14 31 110 13 2 8 0 17 199 2 1 0 1 166 54
JUMLAH 1 2 260 367 623 396 550 3344 690 92 124 41 602 5791 23 25 20 29 5077 1413

Mengetahui
Penanggung Jawab Klinik Medistira 2
Penanggung Jawab UKP

Siswarti Adnan
Wahyu Candra Andri Putranto
TIRA
SP/2017
2
01 RW. 009
abupaten Bogor
8675832
o.co.i d

JENIS PELAYANAN
JML JML
UMUM KIA & GIGI LAB RO MCU SKD
KB
238 216 5 0 9 4 0 4 238
211 177 14 8 8 3 1 0 211
198 166 13 5 11 3 0 0 198
205 161 25 7 4 7 0 1 205
183 149 11 7 12 2 0 2 183
168 147 18 0 0 3 0 0 168
147 132 12 0 0 0 0 3 147
225 196 12 6 6 2 0 3 225
236 202 13 3 10 6 1 1 236
215 177 15 7 13 3 0 0 215
212 166 29 8 8 1 0 0 212
169 139 12 7 7 4 0 0 169
211 171 15 9 8 3 4 1 211
174 155 15 0 0 2 0 2 174
251 213 16 6 8 7 0 1 251
195 174 7 6 0 6 0 2 195
150 137 13 0 0 0 0 0 150
244 189 41 0 7 7 0 0 244
213 169 21 11 10 2 0 0 213
 209 184 11 8 0 4 0 2 209
170 152 11 0 0 5 1 1 170
239 207 18 4 0 6 2 2 239
244 198 16 8 17 4 1 0 244
246 216 5 10 11 3 0 1 246
233 185 31 6 8 1 0 2 233
197 164 12 9 10 2 0 0 197
203 175 16 7 0 4 0 1 203
178 157 17 0 0 3 0 1 178
253 231 9 6 5 2 0 0 253
253 212 18 8 9 5 0 1 253
220 169 12 7 15 6 10 1 220
6490 5486 483 163 196 110 20 32 6490

Bogor,31 AGUSTUS 2022

Penanggung Jawab

Yuyun Ambarwati
 KLIN
J l .
D e s a C i c

LAP

UMUR
TANGGAL 8-28 29 Hari-
0-7 Hari 1-4 5-9 10-14 15-19 20-44 45-54 55-59 60-69 >= 70
Hari 1 Th
01.09.22
02.09.22
03.09.22
04.09.22
05.09.22
06.09.22
07.09.22
08.09.22
09.09.22
10.09.22
11.09.22
12.09.22
13.09.22
14.09.22
15.09.22
16.09.22
17.09.22
18.09.22
19.09.22
20.09.22
21.09.22
22.09.22
23.09.22
24.09.22
25.09.22
26.09.22
27.09.22
28.09.22
29.09.22
30.09.22
JUMLAH 0 0 0 0 0 0 0 0 0 0 0 0

Mengetahui
Penanggung Jawab Klinik Medistira 2
Penanggung
Siswarti Adnan
Wahyu Candra
LINIK MEDISTIR
I z i n N o : 4 4 5 . 5 / I O K / 0 0 0 2 2 / D P M P T S P / 2 0 1 7
J l . R a y a C i c a d a s , K p . P a b u a r a n , R T . 0 0 1 R W . 0
D e s a C i c a d a s , K e c a m a t a n G u n u n g P u t r i , K a b u p a t e n
T e l p . / F a x ( 0 2 1 ) 8 6 7 0 1 3 0 / ( 0 2 1 ) 8 6 7 5 8 3 2
E m a i l : k l i n i k _ m e d i s ti r a 2 @ y a h o o . c o . i d

LAPORAN BULANAN PELAYANAN KLINIS

LAYANAN : PENDAFTARAN
BULAN : SEPTEMBER 2022

JAMINAN KUNJUNGAN
JML UMUM BPJS BPJSTK INHEALTH ASURANSI PT MCU SKD LAMA BARU JML
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

Penanggung Jawab UKP

Wahyu Candra Andri Putranto
STIRA
P T S P / 2 0 1 7
2
. 0 0 1 R W . 0 0 9
K a b u p a t e n B o g o r
) 8 6 7 5 8 3 2
o o . c o . i d

JENIS PELAYANAN
JML KIA & JML
UMUM GIGI LAB RO MCU SKD
KB
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

Bogor,30 SEPTEMBER 2022

Penanggung Jawab
Yuyun Ambarwati
 KLI
D e s a

UMUR
TANGGAL 8-28 29 Hari- 1-4
0-7 Hari 5-9 10-14 15-19 20-44 45-54 55-59 60-69
Hari 1 Th
01.10.22
02.10.22
03.10.22
04.10.22
05.10.22
06.10.22
07.10.22
08.10.22
09.10.22
10.10.22
11.10.22
12.10.22
13.10.22
14.10.22
15.10.22
16.10.22
17.10.22
18.10.22
19.10.22
20.10.22
21.10.22
22.10.22
23.10.22
24.10.22
25.10.22
26.10.22
27.10.22
28.10.22
29.10.22
30.10.22
31.10.22
JUMLAH 0 0 0 0 0 0 0 0 0 0 0

Mengetahui
Penanggung Jawab Klinik Medistira 2
Penan

Siswarti Adnan
Wahyu Ca
KLINIK MEDIST
I z i n N o : 4 4 5 . 5 / I O K / 0 0 0 2 2 / D P M P T
J l . R a y a C i c a d a s , K p . P a b u a r a n , R T . 0
D e s a C i c a d a s , K e c a m a t a n G u n u n g P u t r i , K
T e l p . / F a x ( 0 2 1 ) 8 6 7 0 1 3 0 / ( 0 2 1 ) 8
E m a i l : k l i n i k _ m e d i s ti r a 2 @ y a h o o

LAPORAN BULANAN PELAYANAN KLINIS

LAYANAN : PENDAFTARAN
BULAN : SEPTEMBER 2022

JAMINAN KUNJUNGAN
>= 70 JML UMUM BPJS BPJSTK INHEALTH ASURANSI PT MCU SKD LAMA BARU
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
 Penanggung Jawab UKP

Wahyu Candra Andri Putranto

DISTIRA
2 / D P M P T S P / 2 0 1 7
2
r a n , R T . 0 0 1 R W . 0 0 9
g P u t r i , K a b u p a t e n B o g o r
0 / ( 0 2 1 ) 8 6 7 5 8 3 2
a 2 @ y a h o o . c o . i d

JENIS PELAYANAN
JML JML
JML UMUM KIA & KB GIGI LAB RO MCU SKD
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

Bogor,30 SEPTEMBER 2022

Penanggung Jawab

Yuyun Ambarwati
 KLINIK MEDISTIRA 2
Izin No: 445.5/IOK/00022/DPMPTSP/2017
Jl. Raya Cicadas, Kp. Pabuaran, RT.001 RW. 009
Desa Cicadas, Kecamatan Gunung Putri, Kabupaten Bogor
Telp./ Fax (021) 8670130 / (021) 8675832
E m a i l : k l i n i k _ m e d i s ti r a 2 @ y a h o o . c o . i d

LAPORAN BULANAN PELAYANAN KLINIS

LAYANAN : PENDAFTARAN
BULAN : NOVEMBER 2021

UMUR JAMINAN
TANGGAL JML
0-7 Hari 8-28 Hari 29 Hari-1 Th 1-4 5-9 10-14 15-19 20-44 45-54 55-59 60-69 >= 70 UMUM BPJS BPJSTK Inhealt Asuransi Perusahaan
01/11/2022 0 0 6 6 9 8 5 65 11 2 3 2 13 103 0 1 0 0 117
02/11/2022 0 0 7 6 11 3 6 71 21 5 1 0 16 113 2 0 0 0 131
03/11/2022 0 0 4 7 13 6 6 73 18 2 3 1 9 123 1 0 0 0 133
04/11/2022 0 0 26 7 17 4 3 61 14 5 1 2 18 117 2 2 1 0 140
05/11/2022 0 0 3 7 14 7 6 68 13 5 5 1 16 106 1 1 3 2 129
06/11/2022 0 1 3 10 16 1 5 55 13 2 4 2 8 101 1 0 2 0 112
07/11/2022 0 1 3 4 18 4 2 39 3 3 2 0 12 66 1 0 0 0 79
08/11/2022 0 0 7 11 14 6 9 99 21 4 4 1 11 160 2 2 0 1 176
09/11/2022 0 2 2 1 14 7 5 67 17 1 5 1 17 105 0 0 0 0 122
10/11/2022 0 0 3 5 12 8 6 64 14 2 3 1 16 102 0 0 0 0 118
11/11/2022 0 0 14 3 11 5 6 65 19 3 4 1 21 107 0 0 1 2 131
12/11/2022 0 0 3 7 11 6 8 55 10 3 2 3 15 91 1 0 1 0 108
13/11/2022 0 0 9 10 12 8 5 70 13 3 2 1 9 123 0 1 0 0 133
14/11/2022 2 0 4 12 13 5 5 43 9 0 1 0 12 82 0 0 0 0 94
15/11/2022 0 0 4 6 21 7 8 95 28 2 5 2 13 162 1 0 1 1 178
16/11/2022 1 0 5 12 17 3 7 91 18 4 4 1 13 148 0 2 0 0 163
17/11/2022 0 0 4 13 17 9 5 68 14 1 4 1 16 118 0 0 1 1 136
18/11/2022 0 0 22 12 16 4 5 62 10 4 4 0 10 127 0 1 1 0 139
19/11/2022 0 0 5 6 15 3 6 54 15 4 5 1 12 101 0 0 0 1 114
20/11/2022 0 0 4 12 17 2 7 66 18 3 4 1 3 128 0 2 1 0 134
21/11/2022 0 0 5 8 25 10 14 61 13 3 7 0 13 131 0 0 2 0 146
22/11/2022 0 0 9 11 19 7 11 82 32 4 3 0 15 154 1 2 6 0 178
23/11/2022 0 0 6 8 20 13 5 71 24 2 5 1 14 140 0 0 0 1 155
24/11/2022 0 0 6 12 16 6 10 59 19 4 4 0 7 120 2 2 4 1 136
25/11/2022 0 0 7 9 13 8 9 70 14 0 8 1 11 124 1 1 0 2 139
26/11/2022 0 0 4 5 12 3 3 34 7 3 2 1 4 69 1 0 0 0 74
27/11/2022 0 0 3 12 16 5 5 56 13 2 6 1 10 106 1 0 1 1 119
28/11/2022 0 0 3 12 19 9 10 60 19 7 4 1 8 133 1 1 1 0 144
29/11/2022 0 0 6 13 14 4 7 82 27 3 5 0 13 145 1 0 0 2 161
30/11/2022 0 0 9 11 7 5 11 87 17 5 4 0 19 135 1 0 1 0 156
JUMLAH 3 4 196 258 449 176 200 1993 484 91 114 27 374 3540 21 18 27 15 3995

Mengetahui Bogor, 30 November 2021

Kepala Klinik Medistira 2 Penanggung Jawab

Siswarti Adnan Yuyun Ambarwati

 KLINIK MEDISTIRA 2
Izin No: 445.5/IOK/00022/DPMPTSP/2017
Jl. Raya Cicadas, Kp. Pabuaran, RT.001 RW. 009
Desa Cicadas, Kecamatan Gunung Putri, Kabupaten Bogor
Telp./ Fax (021) 8670130 / (021) 8675832
E m a i l : k l i n i k _ m e d i s ti r a 2 @ y a h o o . c o . i d

LAPORAN BULANAN PELAYANAN KLINIS

LAYANAN : PENDAFTARAN
BULAN : DESEMBER 2021

UMUR
TANGGAL 29 Hari-1
0-7 Hari 8-28 Hari 1-4 5-9 10-14 15-19 20-44 45-54 55-59 60-69 >= 70
Th
01/12/2021 0 0 6 9 18 6 8 66 14 3 5 1
02/12/2021 0 0 1 15 17 8 5 66 26 0 2 2
03/12/2021 0 0 5 9 10 3 4 58 19 4 2 3
04/12/2021 0 0 3 8 21 10 3 72 21 1 4 1
05/12/2021 0 0 4 19 18 5 8 73 18 3 1 2
06/12/2021 0 0 10 5 14 4 8 92 19 2 3 0
07/12/2021 0 0 1 4 12 6 6 86 16 4 1 0
08/12/2021 0 0 6 13 26 7 5 79 18 6 4 1
09/12/2021 0 0 20 11 21 8 10 55 17 3 5 1
10/12/2021 0 1 8 5 22 5 4 70 13 2 7 1
11/12/2021 0 0 4 7 14 6 4 62 18 2 4 0
12/12/2021 0 0 8 13 15 5 9 72 14 3 2 1
13/12/2021 0 0 7 9 18 2 10 87 24 2 3 1
14/12/2021 0 0 8 14 12 7 5 82 21 4 4 2
15/12/2021 0 0 4 10 20 7 8 72 14 2 5 1
16/12/2021 0 0 5 10 15 5 7 66 10 3 6 0
17/12/2021 0 0 6 7 10 6 4 67 11 2 3 0
18/12/2021 0 0 10 14 24 3 7 60 9 3 2 2
19/12/2021 0 0 4 17 18 8 6 90 10 1 1 1
20/12/2021 0 0 3 11 19 6 4 82 14 4 2 0
21/12/2021 0 1 10 16 17 11 8 85 19 5 7 0
22/12/2021 0 0 9 16 18 4 5 74 12 5 3 0
23/12/2021 0 0 21 15 16 6 6 58 10 4 6 1
24/12/2021 0 0 7 13 8 9 14 54 19 4 5 1
25/12/2021 0 0 6 20 11 13 3 55 16 2 2 3
26/12/2021 0 0 7 24 19 12 5 80 13 1 4 0
27/12/2021 0 0 8 10 22 7 12 87 16 4 8 1
28/12/2021 0 1 6 12 15 9 10 68 21 6 2 0
29/12/2021 0 0 3 19 11 6 9 66 12 3 7 0
30/12/2021 0 0 13 7 13 6 6 60 12 2 1 2
31/12/2021 0 0 8 9 6 6 5 62 9 4 9 0
JUMLAH 0 3 221 371 500 206 208 2206 485 94 120 28

Mengetahui
Kepala Klinik Medistira 2

Siswarti Adnan
A 2
ogor

JAMINAN
JML
UMUM BPJS BPJSTK Inhealt Asuransi Perusahaa
n
14 119 1 0 0 2 272
9 131 1 0 1 0 284
8 107 0 0 2 0 234
12 131 0 0 0 1 288
21 129 0 0 1 0 302
13 138 1 2 2 1 314
18 117 0 0 1 0 272
12 150 0 0 3 0 330
25 123 1 1 0 1 302
13 124 1 0 0 0 276
15 104 0 1 1 0 242
15 124 0 2 1 0 284
20 140 0 1 2 0 326
16 142 0 0 0 1 318
17 124 0 1 1 0 286
17 109 0 0 1 0 254
5 109 0 0 1 1 232
10 124 0 0 0 0 268
14 140 0 1 0 1 312
11 133 0 0 1 0 290
17 158 1 2 0 1 358
16 128 0 0 1 1 292
14 126 0 0 1 2 286
12 120 1 0 0 1 268
11 120 0 0 0 0 262
11 152 0 0 2 0 330
19 152 1 1 0 2 350
17 131 0 0 1 1 300
17 116 1 1 0 1 272
12 106 0 1 1 2 244
15 103 0 0 0 0 236
446 3930 9 14 24 19 4442
Bogor,31 Desember 2021
Penanggung Jawab

Yuyun Ambarwati
 KLINIK MEDI Izin No: 445.5/IOK/00022/D
Jl. Raya Cicadas, Kp. Pabuaran
Desa Cicadas, Kecamatan Gunung Pu
Telp./ Fax (021) 8670130 / (
E m a i l : k l i n i k _ m e d i s ti r a 2 @

REKAPAN LAPORAN BULANAN PELAYANAN KLINIS

LAYANAN : PENDAFTARAN
TAHUN 2022
JAMINAN
NO BULAN JML
UMUM BPJS BPJSTK INHEALTH PERUSAHAAN ASURANSI
1 JANUARI 592 3918 4 12 28 18 4511
2 FEBRUARI 568 4151 5 26 21 33 4804
3 MARET 557 3078 12 7 26 18 3698
4 APRIL 434 3104 15 7 14 20 3594
5 MEI 580 3358 15 16 14 26 4009
6 JUNI 622 3768 18 16 15 28 4467
7 JULI 721 4814 10 10 23 22 5600
8 AGUSTUS 602 5791 23 25 20 29 6490
9 SEPTEMBER 0
10 OKTOBER 0
11 NOVEMBER 0
12 DESEMBER 0
JUMLAH 4676 31982 102 119 161 194 37173
MEDISTIRA 2
5.5/IOK/00022/DPMPTSP/2017
s, Kp. Pabuaran, RT.001 RW. 009
matan Gunung Putri, Kabupaten Bogor
021) 8670130 / (021) 8675832
n i k _ m e d i s ti r a 2 @ y a h o o . c o . i d

LAYANAN KLINIS
ARAN

POLI
JML
UMUM KIA & KB GIGI LAB RO MCU SKD
3967 404 140 62 44 52 4669
4092 451 118 143 8 24 4836
2846 514 167 171 8 41 3747
2689 430 121 155 171 4 24 3594
3046 489 117 134 149 19 55 4009
3492 496 153 131 151 8 36 4467
4609 507 141 144 148 5 46 5600
5486 483 163 196 110 20 32 6490
0
0
0
0
30227 3774 1120 760 ### 116 310 37412