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DINAS KESEHATAN KAB. KUANTAN SINGINGI DINAS KESEHATAN KAB.
KUANTAN SINGINGI
UPTD KESEHATAN PUSKESMAS BENAI UPTD KESEHATAN PUSKESMAS BENAI

JLN. AGUSSALIM KEC. BENAI KODEPOS 29566 JLN. AGUSSALIM KEC. BENAI KODEPOS 29566
E-mail : pkmbenai@gmail.com E-mail : pkmbenai@gmail.com
drg. YULIA NENGSIH drg. YULIA NENGSIH

SIP : 109/DPMPTSP-PNP/1.02.01.02.1/2021 SIP : 109/DPMPTSP-PNP/1.02.01.02.1/2021
Tgl Resep :................................... No RM : 00 Tgl Resep :................................... No RM : 00
R/ R/
BPJS UMUM
Pro/Umur/JK :....................................................... ( L / P ) Pro/Umur/JK :....................................................... ( L / P )

BB/TB :.................................. Dokter Pemeriksa BB/TB :.................................. Dokter Pemeriksa
Diagnosa :.................................. Diagnosa :..................................
No HP :.................................. No HP :..................................
Alamat :.................................. drg. Yulia Nengsih Alamat :.................................. drg. Yulia Nengsih
DINAS KESEHATAN KAB. KUANTAN SINGINGI DINAS KESEHATAN KAB. KUANTAN SINGINGI

drg. YULIA NENGSIH drg. YULIA NENGSIH

SIP : 109/DPMPTSP-PNP/1.02.01.02.1/2021 SIP : 109/DPMPTSP-PNP/1.02.01.02.1/2021
R/ R/
BPJS UMUM

No HP :.................................. No HP :..................................
Alamat :.................................. drg. Yulia Nengsih Alamat :.................................. drg. Yulia Nengsih

drg. TETRA DONA ASMIRA drg. TETRA DONA ASMIRA

SIP : 156 / DPMPTSP-PNP / 1.02.01.02.1 / 2020 SIP : 156 / DPMPTSP-PNP / 1.02.01.02.1 / 2020
R/ R/
BPJS UMUM

No HP :.................................. No HP :..................................
Alamat :.................................. drg. Tetra Dona Asmira Alamat :.................................. drg. Tetra Dona Asmira

drg. TETRA DONA ASMIRA drg. TETRA DONA ASMIRA

SIP : 156 / DPMPTSP-PNP / 1.02.01.02.1 / 2020 SIP : 156 / DPMPTSP-PNP / 1.02.01.02.1 / 2020
R/ R/
BPJS UMUM

No HP :.................................. No HP :..................................
Alamat :.................................. drg. Tetra Dona Asmira Alamat :.................................. drg. Tetra Dona Asmira
JL. AGUSSALIM KEC. BENAI KODEPOS 29566 JL. AGUSSALIM KEC. BENAI KODEPOS 29566
dr.H. ARMEN SUHERI, M.Kes dr.H. ARMEN SUHERI, M.Kes

SIP : 45/DPMPTSP-PTSP/1.02.01.01.2/2022 SIP : 45/DPMPTSP-PTSP/1.02.01.01.2/2022
R/ R/
BPJS BPJS

No HP :.................................. No HP :..................................
Alamat :.................................. dr.H. Armen Suheri, M.Kes Alamat :.................................. dr.H. Armen Suheri, M.Kes

SIP : 45/DPMPTSP-PTSP/1.02.01.01.2/2022 SIP : 45/DPMPTSP-PTSP/1.02.01.01.2/2022
R/ R/
BPJS BPJS
No HP :.................................. No HP :..................................

SIP : 440/KS-SDKK/XI/2017/112 SIP : 440/KS-SDKK/XI/2017/112
R/ R/
UMUM UMUM

No HP :.................................. No HP :..................................

SIP : 440/KS-SDKK/XI/2017/112 SIP : 440/KS-SDKK/XI/2017/112
R/ R/
UMUM UMUM

No HP :.................................. No HP :..................................

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DINAS KESEHATAN KAB. KUANTAN SINGINGI DINAS KESEHATAN KAB.

UPTD KESEHATAN PUSKESMAS BENAI UPTD KESEHATAN PUSKESMAS BENAI

E-mail : pkmbenai@gmail.com E-mail : pkmbenai@gmail.com

drg. YULIA NENGSIH drg. YULIA NENGSIH

Pro/Umur/JK :....................................................... ( L / P ) Pro/Umur/JK :....................................................... ( L / P )

UPTD KESEHATAN PUSKESMAS BENAI UPTD KESEHATAN PUSKESMAS BENAI

E-mail : pkmbenai@gmail.com E-mail : pkmbenai@gmail.com

drg. YULIA NENGSIH drg. YULIA NENGSIH

Pro/Umur/JK :....................................................... ( L / P ) Pro/Umur/JK :....................................................... ( L / P )

UPTD KESEHATAN PUSKESMAS BENAI UPTD KESEHATAN PUSKESMAS BENAI

E-mail : pkmbenai@gmail.com E-mail : pkmbenai@gmail.com

drg. TETRA DONA ASMIRA drg. TETRA DONA ASMIRA

Pro/Umur/JK :....................................................... ( L / P ) Pro/Umur/JK :....................................................... ( L / P )

UPTD KESEHATAN PUSKESMAS BENAI UPTD KESEHATAN PUSKESMAS BENAI

E-mail : pkmbenai@gmail.com E-mail : pkmbenai@gmail.com

drg. TETRA DONA ASMIRA drg. TETRA DONA ASMIRA

Pro/Umur/JK :....................................................... ( L / P ) Pro/Umur/JK :....................................................... ( L / P )

dr.H. ARMEN SUHERI, M.Kes dr.H. ARMEN SUHERI, M.Kes

Pro/Umur/JK :....................................................... ( L / P ) Pro/Umur/JK :....................................................... ( L / P )

dr.H. ARMEN SUHERI, M.Kes dr.H. ARMEN SUHERI, M.Kes

dr.H. ARMEN SUHERI, M.Kes dr.H. ARMEN SUHERI, M.Kes

Pro/Umur/JK :....................................................... ( L / P ) Pro/Umur/JK :....................................................... ( L / P )

dr.H. ARMEN SUHERI, M.Kes dr.H. ARMEN SUHERI, M.Kes

Pro/Umur/JK :....................................................... ( L / P ) Pro/Umur/JK :....................................................... ( L / P )

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