NO RM NAMA PASIEN ALAMAT/IDENTITAS UMUR TANGGAL MASUK

001/20 Naila P Tulungagung 5/1 16 01/01/2022

002/10 Fatina Karanggandu 4/2 5 03/01/2022
003/45 Saini Tasikmadu 37/6 70 03/01/2022
004/20 Sutikno Prigi 21/5 46 03/01/2022
005/20 Asmungi Karanggandu 6/2 54 03/01/2022
006/10 Afifah Prigi 31/7 5 03/01/2022
007/35 Mujirah Margomulyo 2/3 70 04/01/2022
008/55 Supini Tasikmadu 26/4 82 04/01/2022
009/35 Mujianto Tasikmadu 7/1 65 05/01/2022
010/10 Ahmad Tasikmadu 6/1 11.5 05/01/2022
011/10 Arga Margomulyo 3/3 12 05/01/2022
012/20 Disah Tasikmadu 29/5 54 05/01/2022
013/10 Salwa Tasikmadu 30/5 11 06/01/2022
014/45 Sakinah Tasikmadu 36/6 71 06/01/2022
015/20 Edi Suranto Lampung 24 06/01/2022
016/46 Sri Wulansari Tasikmadu 26/4 46 07/01/2022
017/45 Asiyah Karanggandu 6/2 69 07/01/2022
018/20 Jefri Tasikmadu 18/3 25 07/01/2022
019/20 Eni Prigi 48/10 39 07/01/2022
020/35 Manis Sawahan 12/4 66 08/01/2022
021/20 Antik Sawahan 12/4 19 08/01/2022
022/20 Akia Tasikmadu 37/6 17 09/01/2022
023/20 Ulfiati Tasikmadu 7/1 29 10/01/2022
024/20 Suji Prigi 41/9 40 10/01/2022
025/45 Sudarmi Margomulyo 20/1 72 10/01/2022
026/35 Kamsriati Margomulyo 28/05 50 10/01/2022
027/20 Dyah Ayu Prigi 12/3 23 10/01/2022
028/20 Vega Sawahan 4/2 20 10/01/2022
029/20 Muhlazim Karanggandu 29/9 27 11/01/2022
030/10 Giring Tasikmadu 131/5 12 11/01/2022
031/20 Hafid Margomulyo 12/1 55 11/01/2022
032/20 Muntiah Tasikmadu 3/1 48 11/01/2022
033/20 Siti Sofia Tasikmadu 17/3 16 11/01/2022
034/10 Musa Prigi 16/4 7 11/01/2022
035/20 M. Zanefar Karanggandu 21/7 20 11/01/2022
036/20 Suranianto Margomulyo 16/6 55 11/01/2022
037/10 M. Dafa Tasikmadu 13/2 11 12/01/2022
038/10 Iqbal Prigi 41/9 10 12/01/2022
039/20 Qurotun Prigi 20/4 31 13/01/2022
040/10 Zamrotul Karanggandu 5/2 6 14/01/2022
041/35 Sholihatin Tasikmadu 23/4 60 14/01/2022
042/13 Adila Prigi 12/3 23 bulan 14/01/2022
043/10 Gresia Karanggandu 4/2 6 15/01/2022
044/20 Kolisiyah Prigi 9/2 46 16/01/2022
045/35 Kidam Karanggandu 7/3 59 17/01/2022
046/10 Handini Margomulyo 2/3 4 18/01/2022
047/10 Ninayatul Margomulyo 3/3 14 18/01/2022
048/10 Sifa Prigi 7/2 11 19/01/2022
049/20 Yeyen Margomulyo 21/1 24 19/01/2022
050/35 Mulyani Margomulyo 4/3 60 19/01/2022
051/20 Uul Tasikmadu 17/6 30 19/01/2022
052/55 Sutarji Tasikmadu 27/4 53 19/01/2022
053/20 Krisna Margomulyo 10/2 21 20/01/2022
054/35 Samijan Margomulyo 2/3 71 21/01/2022
055/20 Sudarmono Karanggandu 3/8 41 21/01/2022
056/45 Tini Prigi 11/3 70 21/01/2022
057/45 Hendrik Tamanan 3/2 Kediri 27 23/01/2022
058/13 Gita Prigi 23/5 6 bulan 24/01/2022
059/20 Violita Slawe 8/3 29 25/01/2022
060/20 Farid Karanggandu 18/6 26 25/01/2022
061/20 Mulyono Prigi 27/6 58 26/01/2022
062/20 Volita Slawe 8/3 29 26/01/2022
063/10 Alvino Sawahan 2/1 8 26/01/2022
064/20 Nita Kampak 12/4 22 27/01/2022
065/35 Yustin Karanggandu 18/6 50 28/01/2022
066/10 M. Zaki Karanggandu 15/14 6 29/01/2022
067/10 M. Abidzan Margomulyo 10/2 5,5 30/01/2022
068/35 Mutiah Tasikmadu 37/6 65 30/01/2022
069/20 Candra Bolorejo Kauman Tulung 24 30/01/2022
070/55 Sawinem Prigi 48/10 90 30/01/2022
071/90 Muji Prigi 48/10 90 30/01/2022
072/20 Supiyah Karanggandu 18/6 54 30/01/2022
073/20 Novi Tasikmadu 15/2 23 01/02/2022
074/10 Rafel Karanggandu 8/3 13 01/02/2022
075/35 Miskun Karanggandu 19/6 62 02/02/2022
076/10 Satriya Karanggandu 2/7 8 02/02/2022
077/20 Yogis Tasikmadu 15/2 26 03/02/2022
078/35 Supardi Karanggandu 20/7 79 03/02/2022
079/10 Rafika Tasikmadu 6/1 10 04/02/2022
080/20 Linartiwi Bolon 3/1 Jateng 43 05/02/2022
081/35 Giran Prigi 34/7 67 06/02/2022
082/45 Rigan Karanggandu 10/3 74 06/02/2022
083/35 Sukari Tasikmadu 8/2 61 07/02/2022
084/20 Jumar Tasikmadu 15/2 46 07/02/2022
085/13 Cecio Karanggandu 1/1 14 bulan 08/02/2022
086/20 Olivia Karanggandu 9/3 16 08/02/2022
087/20 Akmal Karanggandu 10/3 22 09/02/2022
088/20 Rega Karanggandu 17/6 21 09/02/2022
089/35 Sukini Karanggandu 1/1 71 09/02/2022
090/13 Lisa Karanggandu 21/7 3 bulan 09/02/2022
091/35 Mursini Prigi 50/10 52 10/02/2022
092/20 Rio Tasikmadu 35/6 23 10/02/2022
093/20 Feri S Sawahan 12/4 30 11/02/2022
094/20 Dika Gares 10/3 19 11/02/2022
095/45 Sukirah Prigi 37/8 77 11/02/2022
096/20 Redy Prigi 39/8 18 11/02/2022
097/20 Elsi Karanggandu 7/3 16 12/02/2022
098/14 Miftakhul Tasikmadu 3/1 18 bulan 13/02/2022
099/10 Fiko Malang 12 13/02/2022
100/45 Mukiran Tasikmadu 23/4 87 13/02/2022
101/20 Agus S Margomulyo 2/3 30 14/02/2022
102/20 Jaelani Prigi 40/8 40 15/02/2022
103/13 Devi A Karanggandu 14/5 2,5 15/02/2022
104/10 Naomi Tasikmadu 25/4 10 15/02/2022
105/20 Ririn Karanggandu 4/2 32 16/02/2022
106/45 Marjikun Prigi 16/4 60 16/02/2022
107/10 Meysha Tasikmadu 24/4 13 16/02/2022
108/20 Lingky K Karanggandu 13/4 18 16/02/2022
109/20 Rita Margomulyo 7/4 21 16/02/2022
110/13 Harwati Margomulyo 12/3 1 16/02/2022
111/35 Jirah Tasikmadu 9/2 55 17/02/2022
112/11 Reza Prigi 21/5 4 17/02/2022
113/10 Zico R Prigi 14/3 9 17/02/2022
114/20 Aqlina Karanggandu 6/2 19 16/02/2022
115/20 Kuroji Prigi 18/2 45 19/02/2022
116/20 Alvino Sawahan 5/2 17 19/02/2022
117/10 Ameera Tasikmadu 24/4 4 20/02/2022
118/20 Mustakin Margomulyo 8/5 37 21/02/2022
119/35 Kusni Tasikmadu 34/6 65 23/02/2022
120/45 Suraji Margomulyo 16/6 66 25/02/2022
121/35 Jakir Prigi 47/10 51 26/02/2022
122/20 Niken Prigi 11/3 25 26/02/2022
123/20 Mia Karanggandu 8/3 49 27/02/2022
124/14 Abid Tasikmadu 4/1 1.4 28/02/2022
125/35 Supiyah Tasikmadu 8/1 56 28/02/2022
126/10 M. Fadhil Dukuh 17/5 11 01/03/2022
127/14 Kenzio Tasikmadu 3/1 1.3 01/03/2022
128/45 Musinem Karanggandu 20/7 60 01/03/2022
129/20 Eko M. Tasikmadu 13/2 33 02/03/2022
130/20 Rina Prigi 31/7 28 03/03/2022
131/20 Sri Wahyuni Karanggandu 6/2 38 03/03/2022
132/20 Lis Winasih Sawahan 2/1 43 04/03/2022
13320 Vega Prigi 14/3 18 04/03/2022
134/20 Winarsih Tasikmadu 12/2 46 08/03/2022
13520 Andri S. Sawahan 6/2 25 10/03/2022
136/70 Mirat Tasikmadu 10/2 98 12/03/2022
137/10 Allega D Tasikmadu 5/1 10 15/03/2022
138/45 Suminah Tasikmadu 1/1 47 15/03/2022
139/50 Pairah Margomulyo 18/7 84 14/03/2022
140/20 Englo Tasikmadu 29/5 20 3/18/2022
141/10 Artis Indana Margomulyo 19/7 10 20/03/2022
142/20 Norma Tasikmadu 6/1 21 24/03/2022
143/45 Musini Tasikmadu 37/6 61 24/03/2022
144/20 Rike Karanggandu 1/1 23 25/03/2022
145/20 Suparmi Prigi 47/10 40 26/03/2022
146/45 Agus S Tasikmadu 23/5 51 26/03/2022
147/20 Lutfiana Tasikmadu 27/4 22 28/03/2022
148/20 Leni Tasikmadu 20/3 20 30/03/2022
149/45 Muhsin Prigi 35/7 53 31/03/2022
150/10 Nanza Tasikmadu 5/1 9 01/04/2022
151/10 Rehan Karanggandu 1/1 8 03/04/2022
152/10 Naila Prigi 26/6 5 04/04/2022
153/20 Dedi Karanggandu 28/9 25 05/04/2022
154/35 Santoso Margomulyo 15/6 52 08/04/2022
155/20 Endang Prigi 10/2 47 08/04/2022
156/35 Sani Prigi 36/8 66 10/04/2022
157/20 Suprianik Prigi 15/3 43 13/04/2022
158/45 Suyoto Tales 1/1 58 13/04/2022
159/20 Helmida Tasikmadu 34/6 19 15/04/2022
160/20 Zaskia A. Margomulyo 4/3 22 16/04/2022
161/20 Iqbal Prigi 46/9 17 17/04/2022
162/35 Rokiyah Margomulyo 4/3 65 18/04/2022
163/35 Painah Sawahan 10/4 58 18/04/2022
164/35 Abdul Somad Margomulyo 2/3 56 19/04/2022
165/20 Alex Dukuh 15/4 21 20/04/2022
166/35 Siswanto Prigi 29/6 60 20/04/2022
167/10 Dian Tasikmadu 27/6 9 21/04/2022
168/10 Melky Tasikmadu 26/5 6 26/04/2022
169/10 Keysana Tasikmadu 1/1 5 26/04/2022
170/14 M. Rayan Prigi 15/3 2 29/04/2022
171/45 Sukri Margomulyo 1/6 72 30/04/2022
172/20 Dandi Prigi 41/9 19 01/05/2022
173/45 Sukiran Tasikmadu 27/4 80 03/05/2022
174/45 Tini Karanggandu 1/1 74 04/05/2022
175/20 Khorul Margomulyo 10/2 49 05/05/2022
176/20 Panikem Karanggandu 22/8 50 05/05/2022
177/35 Subandi Tasikmadu 28/5 65 09/05/2022
178/35 Samelan Prigi 11/3 63 09/05/2022
179/10 Naira Tasikmadu 8/2 3 10/05/2022
180/20 Nur S. Karanggandu 7/3 20 11/05/2022
181/20 Diah Karanggandu 22/8 20 12/05/2022
182/20 Dewi Tasikmadu 1/1 25 12/05/2022
183/35 Sumini Tasikmadu 12/2 60 13/05/2022
184/35 Sumijan Karanggandu 26/7 76 14/05/2022
185/35 Toinem Margomulyo 18/7 75 15/05/2022
186/14 Delvin Karanggandu 14/6 2.5 16/05/2022
187/35 Mujilah Tasikmadu 8/2 52 16/05/2022
188/20 Suryana Tasikmadu 35/6 42 16/05/2022
189/45 Suparti Tasikmadu 35/6 75 17/05/2022
190/35 Wairan Sawahan 10/4 65 17/05/2022
191/20 Ismadi Tasikmadu 14/2 47 18/05/2022
192/20 Sri Puji Karanggandu 19/6 28 19/05/2022
193/35 Sapar Tasikmadu 34/6 50 20/05/2022
194/35 Muyatim Karanggandu 29/9 71 21/05/2022
195/35 Sumini Tasikmadu 12/2 66 22/05/2022
196/14 Narendra Tasikmadu 12/2 23 bl 22/05/2022
197/20 Elsa Putri Tasikmadu 2/1 22 23/05/2022
198/20 Melisa Tasikmadu 2/1 17 24/05/2022
199/20 Revan Tasikmadu 23/4 14 24/05/2022
200/14 M. Kiano Karanggandu 19/6 3 bl 25/05/2022
201/10 Gita Tasikmadu 29/3 3 25/05/2022
202/35 Suwadi Margomulyo 17/6 60 25/05/2022
203/20 Santoso Prigi 9/2 35 26/05/2022
204/20 Yunia Margomulyo 2/3 25 26/05/2022
205/45 Somijem Karanggandu 26/7 77 27/05/2022
206/35 Supardi Margomulyo 16/6 54 28/05/2022
207/13 Silvia Prigi 34/7 22 bl 29/05/2022
208/35 Mino Tasikmadu 1/1 68 30/05/2022
209/10 Atsa Tasikmadu 32/5 14 31/05/2022
210/10 Aldi Karanggandu 11/6 7 01/06/2022
211/10 Dilsat Tasikmadu 11/2 3 02/06/2022
212/20 Heri P. Karanggandu 1/1 34 02/06/2022
213/20 Nova Karanggandu 9/3 21 03/06/2022
214/20 Ninik Prigi 36/7 37 04/06/2022
215/20 Nurlaila Tasikmadu 6/1 35 06/06/2022
216/35 Musilah Tasikmadu 16/3 57 08/06/2022
217/20 Betris Karanggandu 8/3 22 08/06/2022
218/20 Linda Sawahan 7/3 23 09/06/2022
219/14 Kaka Tasikmadu 20/3 10 bl 09/06/2022
220/35 Bustain Arifin Prigi 39/8 63 10/06/2022
221/10 Daehan Tasikmadu 12/2 9 11/06/2022
222/20 Nyamiran Karanggandu 9/3 49 11/06/2022
223/35 Sutilah Prigi 8/2 60 12/06/2022
224/35 Jarno Prigi 26/6 59 12/06/2022
225/20 Arip S. Tasikmadu 354/6 57 12/06/2022
226/20 Laila Tasikmadu 16/3 25 12/06/2022
227/35 Robingatun Tasikmadu 6/1 58 13/06/2022
228/35 Suwarti Tasikmadu 26/4 69 14/06/2022
229/45 Musani Karanggadu15/5 77 15/06/2022
230/45 Yamah Prigi 38/8 75 16/06/2022
231/10 Keysi Karanggandu 15/5 7 17/06/2022
232/20 Asriatin Lamongan 13/3 45 18/06/2022
233/20 Arjuna M. Sawo Ponorogo 21 18/06/2022
234/20 Happy Karanggandu 3/1 17 19/06/2022
235/20 Zainal Margomulyo 4/3 39 19/06/2022
236/35 Suwito Karanggandu 22/8 60 20/06/2022
237/10 Nathalia Karanggandu 10/3 13 20/06/2022
238/35 Yunus Prigi 14/3 71 21/06/2022
239/20 Adib Tasikmadu 21/3 37 21/06/2022
240/10 Safa Prigi 46/6 9 22/06/2022
241/14 Arizam Tasikmadu 10/2 20 BLN 22/06/2022
242/35 Warsi Karanggandu 16/5 70 23/06/2022
243/10 Zahra Lkaranggandu 29/9 9.5 26/06/2022
244/10 Nuril Margomulyo 3/3 13 26/06/2022
245/35 Tarmuji Watulimo 5/2 65 27/06/2022
246/20 Riska Tasikmadu 12/2 16 28/06/2022
247/20 Reni Tasikmadu 7/1 36 28/06/2022
248/35 Paniyem Karanggandu 23/8 62 29/06/2022
249/35 Imam Margomulyo 21/1 60 29/06/2022
250/10 Abelia Tasikmadu 12/2 10 30/06/2022
251/14 Mahesa Karanggnadu 12/4 2.5 01/07/2022
252/20 Sadianto Sawahan 9/3 57 02/07/2022
253/20 Juwari Tasikmadu 8/2 54 02/07/2022
254/35 Mariyem Karanggandu 17/6 63 03/07/2022
255/10 Cahayu Karanggnandu 12/4 3 03/07/2022
256/10 Fatar Karanggandu 27/4 4 03/07/2022
257/20 Jaino Karanggandu 25/6 49 04/07/2022
258/20 Elsen Tasikmadu 3/1 15 05/07/2022
259/10 Firsa Prigi 15/3 9 05/07/2022
260/10 Keke tasikmadu 7/1 11 06/07/2022
261/20 Siti M. Tasikmadu 4/1 41 08/07/2022
262/35 Badri Sawahan 2/1 75 08/07/2022
263/20 Maratus Karanggandu2/1 18 09/07/2022
264/35 Sopiah Karanggandu 11/4 60 09/07/2022
265/20 Srinah Margomulyo 17/6 52 10/07/2022
266/20 Sinta Karanggandu 17/6 23 11/07/2022
267/10 Arkan Karanggandu 10/3 11 12/07/2022
268/20 Elsen tasikmadu 3/1 15 12/07/2022
269/20 Jito Tasikmadu 26/4 50 13/07/2022
270/20 Eni A. Tasikmadu 8/2 50 14/07/2022
271/35 Tumirem Tasikmadu 15/2 60 15/07/2022
272/20 Musrini Prigi 50/10 53 17/07/2022
273/20 Suminto Margomulyo 3/3 36 18/07/2022
274/20 Supatmi Prigi 2/1 50 18/07/2022
275/20 Najib M. Margomulyo 7/4 38 19/07/2022
276/35 Mukani Bendungan 9/3 64 19/07/2022
277/20 Lailatul Tasikmadu 3/6 23 20/07/2022
278/20 Dimas Margomulyo 3/3 21 21/07/2022
279/20 Risqi Karanggandu 21/7 20 22/07/2022
280/20 Findiani Prigi 7/2 24 23/07/2022
281/20 Surtinem Prigi 9/2 44 24/07/2022
282/10 Zakaria Margomulyo 8/5 4 25/07/2022
283/35 Mubin Karanggandu 4/2 45 26/07/2022
284/20 Agna Tasikmadu 25/4 7 27/07/2022
285/20 Yesi Tasikmadu 24/4 42 28/07/2022
286/14 Kenzio Tasikmadu 3/1 18 BLN 29/07/2022
287/20 Gemi Tasikmadu 3/1 56 30/07/2022
288/20 Muginanto Sawahan 5/2 41 02/08/2022
289/35 Sumarji Tasikmadu 20/4 61 02/08/2022
290/20 Senesa Margomulyo 12/1 16 03/08/2022
291/55 Marsum Prigi 24/5 81 05/08/2022
292/10 Ahmad Tasikmadu 7/2 13 06/08/2022
293/20 Visia Prigi 31/7 27 07/08/2022
294/20 Asiami Karanggandu 18/6 30 09/08/2022
295/13 Asyifa Tasikmadu 31/7 2 09/08/2022
296/45 Muslih Margomulyo 2/3 68 10/08/2022
297/20 Nining Prigi 39/8 33 10/08/2022
298/20 Dewi Prigi 368/10 17 11/08/2022
299/20 Sriyanto Karanggandu 8/3 40 12/08/2022
300/10 Azila Prigi 45/9 6 13/08/2022
301/20 Robi Prigi 4/2 18 14/08/2022
302/20 Laila Margomulyo 17/6 32 15/08/2022
303/20 Jefri Bantengan 1/1 20 16/08/2022
304/20 Komari Tasikmadu 28/5 55 17/08/2022
305/10 Adibah Karanggandu 16/5 6 17/08/2022
306/35 Sumarlan Karanggandu 2/1 50 18/08/2022
307/20 Fika N. Tasikmadu 13/2 15 19/08/2022
308/20 Vera Tasikmadu 7/1 21 20/08/2022
309/20 Safi Prigi 28/6 26 21/08/2022
310/35 Paidi Karanggandu 20/7 70 21/08/2022
311/20 Arida Prigi 34/7 52 23/08/2022
312/10 Shevana Prigi 15/3 3.7 24/08/2022
313/10 M. Alfin Tasikmadu 31/5 4 25/08/2022
314/20 Shelvianti Tasikmadu 31/5 18 26/08/2022
315/20 Azka Tasikmadu 12/2 20 28/08/2022
316/10 Wildan Tasikmadu 1/1 12 29/08/2022
317/20 Ahmad Slawe 6/2 39 30/08/2022
318/10 Faneza Tasikmadu 19/3 8 31/08/2022
319/20 Nurosid Karanggandu 25/8 44 01/09/2022
320/20 Fromus Prigi 7/2 19 02/09/2022
321/10 Wabil Margomulyo 3/3 4.5 02/09/2022
322/10 Radi S Prigi 13/3 12 03/09/2022
323/20 Ines Nggandong 10/3 23 03/09/2022
324/20 Bela A. Sawahan 14/5 18 04/09/2022
325/20 Yuda Margomulyo 8/5 26 05/09/2022
326/20 Riyanto Karanggandu 10/3 34 06/09/2022
327/20 Susiatin Margomulyo 21/1 42 07/09/2022
328/20 Bayu Margomulyo 1/2 30 08/09/2022
329/20 Maya Diana Margomulyo 8/5 32 09/09/2022
330/20 Arik Sulandari Tasikmadu 7/1 52 09/09/2022
331/20 Rizky Tasikmadu 9/1 26 10/09/2022
332/20 Ficko Prigi 48/10 18 10/09/2022
333/20 Sutarmi Karanggandu 25/8 49 11/09/2022
334/35 Pujiaatun Prigi 8/2 62 11/09/2022
335/10 Kristian Prigi 89/2 9 12/09/2022
336/20 Migel Prigi 29/6 17 13/09/2022
337/20 Ike I. Karanggandu 1/1 17 13/09/2022
338/20 Fiki Prigi 45/9 34 14/09/2022
339/20 Budi Karanggandu 2/1 35 14/09/2022
340/10 Rizki Karanggandu 22/8 8 15/09/2022
341/20 Zuhudi Prigi 40/8 54 16/09/2022
342/20 Putra Karanggandu 17/6 18 16/09/2022
343/20 Evelin Margomulyo 8/5 15 16/09/2022
344/10 Fauzan Tasikmadu 7/1 10 17/09/2022
345/20 Widodo Margomulyo 2/3 42 18/09/2022
346/35 Bitun Prigi 18/1 69 18/09/2022
347/35 Sugeng Margomulyo 4/1 66 9/19/2022
348/20 Bekti Margomulyo 22/2 42 9/19/2022
349/10 Lionel Tasikmadu 1/1 4 9/20/2022
350/14 M.Arifin Tasikmadu 3/1 2 9/21/2022
351/20 Mega Margomulyo 10/1 29 9/22/2022
352/10 Haidar Prigi 52/10 7 9/23/2022
353/10 Fathina Karanggandu 4/2 5.5 9/25/2022
354/10 Afia Tasikmadu 25/4 8.5 27/09/2022
355/13 Arista Prigi 23/5 2.5 28/09/2022
356/20 Bagus Prigi 11/3 22 29/09/2022
357/45 Pailah Tasikmadu 36/6 75 30/09/2022
358/20 Yogi Sawahan 10/4 22 01/10/2022
359/13 Ning I. Karanggandu 5/2 2 02/10/2022
360/35 Kasjiman Karanggandu 28/9 66 03/10/2022
361/20 Wari Sawahan 13/5 56 04/10/2022
362/35 Youmi Tasikmadu 21/3 65 05/10/2022
363/35 Arik Tasikmadu 7/1 52 06/10/2022
364/35 Mukin Prigi 45/9 59 07/10/2022
365/10 Shafi Karanggandu 3/1 12 08/10/2022
366/20 Kanti Tasikmadu 24/4 35 09/10/2022
367/20 Heriyanto Margomulyo 18/7 36 11/10/2022
368/20 Selor Prigi 50/10 45 12/10/2022
369/20 Muyatin Prigi 21/5 59 12/10/2022
370/35 Agus S Sawahan 4/2 69 13/10/2022
371/35 Nur K. Margomulyo 7/4 51 14/10/2022
372/20 Yunita Prigi 48/10 31 15/10/2022
373/20 Samsul Hadi Karanggandu 12/4 39 16/10/2022
374/45 Wagiran Prigi 14/3 70 17/10/2022
375/20 Ricki Margomulyo 9/5 20 17/10/2022
376/20 Lina Suruh 35/9 30 18/10/2022
377/20 Roy Nur Prigi 36/7 22 19/10/2022
378/35 Erlangga Tasikmadu 2/1 65 20/10/2022
379/10 Fito Prigi 43/9 6 20/10/2022
380/20 Rifa Karanggandu 10/3 29 21/10/2022
381/20 Bella Prigi 9/2 18 22/10/2022
382/20 Nuril Tasikmadu 15/3 26 23/10/2022
383/20 Neni Tasikmadu 25/6 35 24/10/2022
384/20 Alfi Karanggandu 10/2 18 25/10/2022
385/20 Ilfan Tasikmadu 16/3 16 25/10/2022
386/20 Yuni Ngunggahan 1/1 49 25/10/2022
387/20 Agus Tasikmadu 13/2 45 26/10/2022
388/35 Tholib Dukuh 19/5 65 26/10/2022
389/10 Narendra Gador 5/1 6 27/10/2022
390/20 Fuad Sawahan 1/1 16 28/10/2022
391/10 Nabil Margomulyo 3/3 4.5 29/10/2022
392/35 Joni Margomulyo 7/4 60 29/10/2022
393/14 Jonathan Karanggandu 29/9 1.5 29/10/2022
394/10 Rahel Tasikmadu 31/5 13 30/10/2022
395/20 Rifka Surondakan 3/2 29 30/10/2022
396/10 Aldi Karanggandu 2/1 8 11/1/2022
397/20 Purwati Sawahan 4/3 40 11/1/2022
398/20 Lukman Sawahan 3/1 21 11/1/2022
399/20 Sholikah Margomulyo 16/6 40 11/1/2022
400/55 Ponirah Prigi 25/ 96 11/2/2022
401/20 Alfi Karanggandu 16/5 21 11/2/2022
402/10 Melki Tasikmadu 26/4 7 11/2/2022
403/10 Izzam Tasikmadu 24/5 9 11/3/2022
404/20 Riayatul Karanggandu 4/2 20 11/4/2022
405/13 Akeila Sawahan 13/5 1 11/4/2022
406/35 Sarni Karanggandu 21/7 57 11/4/2022
407/20 Sri Utami Tasikmadu 1/1 48 11/4/2022
408/20 Kholifah Prigi 32/7 35 11/5/2022
409/11 Bagus Karanggandu 1/1 3.5 11/5/2022
410/35 Suyanto Prigi 47/10 55 11/6/2022
411/20 Eni Sawahan 8/3 36 11/6/2022
412/35 Mujadi Prigi 35/7 75 11/6/2022
413/35 Musrini Tasikmadu 15/2 62 11/7/2022
414/20 Felix F Margomulyo 2/3 24 11/7/2022
415/20 Laili Tasikmadu 28/5 24 11/8/2022
416/50 Musinem Prigi 31/07 81 11/9/2022
417/10 Chelsea Sawahan 5/2 8 11/9/2022
418/20 Suyanto Karanggandu 12/4 43 11/10/2022
419/14 Narendra Tasikmadu 12/2 2 11/10/2022
420/20 Antonio Tasikmadu 5/2 17 11/10/2022
421/10 Arlen Tasikmadu 15/2 10 11/10/2022
422/20 Dewi Tasikmadu 25/5 29 11/11/2022
423/35 Suhartini Tasikmadu 35/6 46 11/11/2022
424/20 Umi K. Prigi 43/9 46 11/11/2022
425/35 Bahrodin Prigi 43/9 54 11/12/2022
426/20 Edi Karanggandu 10/3 40 11/12/2022
427/20 Mela Prigi 43/9 18 11/13/2022
428/20 Sunardi Tasikmadu 36/6 50 11/13/2022
429/10 Lina Sawahan 7/3 11 11/13/2022
430/10 Andra Tasikmadu 25/4 14 11/13/2022
431/10 Yovi Karanggandu 2/1 4 11/14/2022
432/35 Tawinem Prigi 9/2 61 11/14/2022
433/20 Amin Tasikmadu 12/2 39 11/14/2022
434/20 Maryatin Tasikmadu 2/7 45 11/14/2022
435/20 Nanang Margomulyo 18/7 29 11/15/2022
436/35 Muyatin Prigi 21/5 59 11/15/2022
437/35 Wasiah Prigi 9/2 50 11/15/2022
438/11 Wabil Margomulyo 3/3 4.5 11/16/2022
439/20 Suranianto Margomulyo 16/6 55 11/17/2022
440/45 Musiyah Margomulyo 18/7 74 11/17/2022
441/20 Linda Prigi 13/3 21 11/17/2022
442/20 Galuh Prigi 47/10 40 11/18/2022
443/70 Aris Tasikmadu 25/4 39 11/19/2022
444/20 Sudarno Tasikmadu 4/1 45 11/19/2022
445/20 Solikin Prigi 24/5 47 11/20/2022
446/20 Etik Margomulyo 12/1 29 11/21/2022
447/20 Sunarsih Karanggandu 26/7 57 11/21/2022
448/20 Fahrurozi Karanggandu 10/3 28 11/21/2022
449/10 Faiza Prigi 40/8 8 11/21/2022
450/13 Nensi Tasikmadu 35/6 1 11/22/2022
451/20 Sri Utami Tasikmadu 1/1 49 11/22/2022
452/35 Samsuri Karanggandu 16/5 69 11/23/2022
453/10 Hizam Tasikmadu 37/6 4.5 11/24/2022
454/20 Eko Karanggandu 16/5 37 11/24/2022
455/20 Suyanto Prigi 47/10 55 11/25/2022
456/20 Wahyu Prigi 40/8 20 11/25/2022
457/20 Rika Tasikmadu 18/3 31 11/26/2022
458/20 Geri Tasikmadu 4/1 19 11/26/2022
459/20 Dwi Waluyo Tasikmadu 24/4 33 11/27/2022
460/20 Halimatus Tasikmadu 19/3 42 11/28/2022
461/35 Mutoyo Prigi 26/6 69 11/28/2022
462/45 Tuminah Tasikmadu 1/1 80 11/29/2022
463/35 Sulbiyah Tasikmadu 18/3 55 11/29/2022
464/20 Winarti Prigi 33/7 45 11/30/2022
465/20 Diyah Margomulyo 5/4 24 11/30/2022
466/20 Pipit Karanggandu 18/6 29 12/1/2022
467/20 Asroni Margomulyo 3/5 53 12/2/2022
468/10 Kenzo Karanggandu 3/1 12 12/2/2022
469/13 Mikayla Tasikmadu 24/4 9bln 12/3/2022
470/35 Srinah Margomulyo 17/6 52 12/3/2022
471/20 Andri Tasikmadu 18/3 37 12/4/2022
472/20 Febriani Tasikmadu 16/3 27 12/5/2022
473/20 Rizqi Karanggandu 3/1 23 12/5/2022
474/35 Sri Utami Tasikmadu 1/1 49 12/7/2022
475/20 Suminto Prigi 24/5 52 12/8/2022
476/35 Durohman Tasikmadu 25/4 54 12/10/2022
477/13 Marisa Prigi 31/07 2 12/11/2022
478/20 Efri Margomulyo 17/6 31 12/12/2022
479/20 Via Fitri Karanggandu 14/5 23 12/13/2022
480/35 Atim Tasikmadu 11/2 60 12/13/2022
481/20 Monika Tasikmadu 33/6 21 12/14/2022
482/35 Musani Karanggandu 15/5 60 12/17/2022
483/14 Alzio Slawe 7/2 1.5 12/18/2022
484/10 Yuan Prigi 1/1 4 12/19/2022
485/10 Zahira Tasikmadu 2/1 8.5 12/19/2022
486/45 Painem Prigi 48/10 85 12/20/2022
487/20 Bambang Sidoarjo 13/2 41 12/20/2022
488/10 Rizky Palembang 9 12/21/2022
489/20 Selor Prigi 46 12/21/2022
490/14 Khenzio Prigi 12/3 2 12/22/2022
491/35 Tukiyar Margomulyo 3/3 62 12/22/2022
492/35 Sumanto Sawahan 12/4 60 12/23/2022
493/20 Agus Tasikmadu 13/2 47 12/23/2022
494/11 Raditya Margomulyo 14/1 3 12/24/2022
495/20 Suparman Tasikmadu 27/4 63 12/24/2022
496/35 Kasri Tasikmadu 12/2 75 12/25/2022
497/35 Sukaji Tasikmadu 28/5 65 12/26/2022
498/35 Musikah Tasikmadu 4/1 59 12/26/2022
499/35 Musirah Karanggandu 29/9 60 12/27/2022
500/20 Syabila Margomulyo 12/1 18 12/28/2022
501/20 Adya Tasikmadu 3/1 28 12/29/2022
502/20 Laminto Karanggandu 13/4 41 12/29/2022
 LAMA PENGISIAN REKAM MEDIS RUJUKAN /
PERAWATAN PEMULANGAN
SOAP OBSERVASI ASKEP GIZI RESUME
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1
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2 √ √ √ √ √ √ P
2 √ √ √ √ √ √ P
3 √ √ √ √ √ √ P
3 √ √ √ √ √ √ P
3 √ √ √ √ √ √ P
4 √ √ √ √ √ √ P
2 √ √ √ √ √ √ P
2 √ √ √ √ √ √ P
2 √ √ √ √ √ √ P
3 √ √ √ √ √ √ P
2 √ √ √ √ √ √ P
4 √ √ √ √ √ √ P
2 √ √ √ √ √ √ P
2 √ √ √ √ √ √ P
2 √ √ √ √ √ √ P
1 √ √ √ √ √ √ P
3 √ √ √ √ √ √ P
3 √ √ √ √ √ √ P
2 √ √ √ √ √ √ R
1 √ √ √ √ √ √ P
3 √ √ √ √ √ √ P
3 √ √ √ √ √ √ P
3 √ √ √ √ √ √ P
1 √ √ √ √ √ √ P
3 √ √ √ √ √ √ P
3 √ √ √ √ √ √ P
4 √ √ √ √ √ √ P
1 √ √ √ √ √ √ P
1 √ √ √ √ √ √ P
4 √ √ √ √ √ √ P
3 √ √ √ √ √ √ P
3 √ √ √ √ √ √ P
4 √ √ √ √ √ √ P
1 √ √ √ √ √ √ R
2 √ √ √ √ √ √ P
3 √ √ √ √ √ √ P
1 √ √ √ √ √ √ P
2 √ √ √ √ √ √ P
2 √ √ √ √ √ √ P
3 √ √ √ √ √ √ P
4 √ √ √ √ √ √ P
3 √ √ √ √ √ √ P
1 √ √ √ √ √ √ P
3 √ √ √ √ √ √ P
2 √ √ √ √ √ √ P
2 √ √ √ √ √ √ P
2 √ √ √ √ √ √ P
4 √ √ √ √ √ √ P
1 √ √ √ √ √ √ R
2 √ √ √ √ √ √ P
3 √ √ √ √ √ √ P
2 √ √ √ √ √ √ P
2 √ √ √ √ √ √ P
1 √ √ √ √ √ √ P
2 √ √ √ √ √ √ P
4 √ √ √ √ √ √ PP
3 √ √ √ √ √ √ P
5 √ √ √ √ √ √ P
3 √ √ √ √ √ √ P
3 √ √ √ √ √ √ P
3 √ √ √ √ √ √ P
3 √ √ √ √ √ √ P
2 √ √ √ √ √ √ P
3 √ √ √ √ √ √ P
4 √ √ √ √ √ √ P
2 √ √ √ √ √ √ PP
1 √ √ √ √ √ √ P
3 √ √ √ √ √ √ P
3 √ √ √ √ √ √ P
5 √ √ √ √ √ √ P
3 √ √ √ √ √ √ P
3 √ √ √ √ √ √ P
3 √ √ √ √ √ √ P
3 √ √ √ √ √ √ P
1 √ √ √ √ √ √ PP
3 √ √ √ √ √ √ P
3 √ √ √ √ √ √ P
3 √ √ √ √ √ √ P
5 √ √ √ √ √ √ PP
2 √ √ √ √ √ √ PP
1 √ √ √ √ √ √ R
4 √ √ √ √ √ √ P
3 √ √ √ √ √ √ R
4 √ √ √ √ √ √ PP
3 √ √ √ √ √ √ PP
2 √ √ √ √ √ √ P
2 √ √ √ √ √ √ P
3 √ √ √ √ √ √ P
3 √ √ √ √ √ √ P
3 √ √ √ √ √ √ P
3 √ √ √ √ √ √ P
1 √ √ √ √ √ √ R
5 √ √ √ √ √ √ P
2 √ √ √ √ √ √ P
2 √ √ √ √ √ √ PP
4 √ √ √ √ √ √ P
4 √ √ √ √ √ √ P
1 √ √ √ √ √ √ R
2 √ √ √ √ √ √ P
4 √ √ √ √ √ √ P
3 √ √ √ √ √ √ PP
1 √ √ √ √ √ √ R
1 √ √ √ √ √ √ P
4 √ √ √ √ √ √ P
2 √ √ √ √ √ √ P
1 √ √ √ √ √ √ P
3 √ √ √ √ √ √ P
3 √ √ √ √ √ √ P
1 √ √ √ √ √ √ PP
3 √ √ √ √ √ √ P
3 √ √ √ √ √ √ P
3 √ √ √ √ √ √ P
1 √ √ √ √ √ √ PP
1 √ √ √ √ √ √ PP
3 √ √ √ √ √ √ P
2 √ √ √ √ √ √ PP
2 √ √ √ √ √ √ P
3 √ √ √ √ √ √ P
2 √ √ √ √ √ √ P
2 √ √ √ √ √ √ P
3 √ √ √ √ √ √ P
4 √ √ √ √ √ √ P
1 √ √ √ √ √ √ P
2 √ √ √ √ √ √ P
1 √ √ √ √ √ √ PP
3 √ √ √ √ √ √ P
3 √ √ √ √ √ √ P
2 √ √ √ √ √ √ P
2 √ √ √ √ √ √ P
3 √ √ √ √ √ √ P
1 √ √ √ √ √ √ R
2 √ √ √ √ √ √ P
4 √ √ √ √ √ √ P
2 √ √ √ √ √ √ P
1 √ √ √ √ √ √ PP
3 √ √ √ √ √ √ P
1 √ √ √ √ √ √ R
2 √ √ √ √ √ √ P
2 √ √ √ √ √ √ P
3 √ √ √ √ √ √ P
4 √ √ √ √ √ √ P
1 √ √ √ √ √ √ PP
3 √ √ √ √ √ √ P
3 √ √ √ √ √ √ P
3 √ √ √ √ √ √ P
3 √ √ √ √ √ √ PP
4 √ √ √ √ √ √ P
3 √ √ √ √ √ √ PP
2 √ √ √ √ √ √ P
1 √ √ √ √ √ √ P
1 √ √ √ √ √ √ P
2 √ √ √ √ √ √ PP
2 √ √ √ √ √ √ P
1 √ √ √ √ √ √ PP
2 √ √ √ √ √ √ PP
4 √ √ √ √ √ √ P
2 √ √ √ √ √ √ P
3 √ √ √ √ √ √ P
3 √ √ √ √ √ √ P
1 √ √ √ √ √ √ PP
1 √ √ √ √ √ √ P
NAMA DAN TTD MEDIS/
PARAMEDIS

20
10
45
20
20
10
35
55
35
10
10
 ALAMAT/IDENTITAS
NO RM NAMA PASIEN UMUR
TANGGAL MASUK
001/35 Paikem Tasikmadu 2/1 80 1/1/2022
002/45 Pailah Margomulyo 21/1 78 1/1/2022
003/35 Aripin Tasikmadu 24/4 68 1/2/2022
004/20 Nelsen Tasikmadu 26/4 16 1/2/2022
005/20 Suratin Tasikmadu 30/5 51 1/3/2022
006/20 Surati Prigi 45/9 41 1/4/2022
007/20 Ayob Tasikmadu 3/1 19 1/4/2022
008/35 Gemi Tasikmadu 1/1 73 1/6/2022
009/45 Imam Rosjidin Tasikmadu 3/1 72 1/6/2022
010/35 Nurjahmi Tasikmadu 3/1 60 1/7/2022
011/20 Mazhidan Hope Tasikmadu 31/5 21 1/8/2022
012/45 Suciati Tasikmadu 2/1 79 1/8/2022
013/35 Supiyah Keboireng 9/2 Bandung 70 1/9/2022
014/35 Suti Tasikmadu 17/3 64 1/9/2022
015/20 Mujayat Bendorejo 20/10 50 1/10/2022
016/20 Aris K Karanggandu 37 1/10/2022
017/35 Sudarmani Tasikmadu 1/1 57 1/10/2022
018/20 Sutrini Tasikmadu 7/3 52 1/10/2022
019/20 Paijan Sawahan 8/3 69 1/12/2022
020/20 Cindy Virdiana Margomulyo 14/1 22 1/12/2022
021/20 Diky S Tasikmadu 29/5 23 1/14/2022
022/35 Tegen Tasikmadu 35/6 67 1/15/2022
023/45 Rukini Sawahan 4/2 77 1/15/2022
024/20 Suminto Prigi 12/3 55 1/15/2022
025/13 Neyla Agatha Tasikmadu 3/1 2.1 1/16/2022
026/20 Palal Tasikmadu 10/2 56 1/17/2022
027/20 Ridwan Margomulyo 14/1 51 1/18/2022
028/14 An. Fathoni Tasikmadu 36/6 2.5 1/19/2022
029/20 Tupani Tasikmadu 33/6 57 1/19/2022
030/35 Tegen Tasikmadu 35/6 67 1/20/2022
031/10 An. Cintia Ayu Karanggandu 5/2 10 1/21/2022
032/45 Paijah Sawahan 3/1 76 1/21/2022
033/10 An. Aura Angesti Tasikmadu 32/5 4 1/22/2022
034/20 Inadah Prigi 5/1 50 1/22/2022
035/20 Yunifer Tasikmadu 22/4 26 1/23/2022
036/45 Kamsiyah Prigi 15/3 71 1/24/2022
037/14 Piki Candra Karanggandu 22/8 2.6 1/24/2022
038/10 An. Shafa Karanggandu 3/1 11 1/27/2022
039/10 An. M. Ardi Margomulyo 21/1 8 1/28/2022
040/20 Triono Gemaharjo 15/6 33 1/28/2022
041/20 Wahyu Budianto Prigi 13/3 22 1/29/2022
042/35 Musri Margomulyo 13/1 69 1/30/2022
043/45 Sudarman Tasikmadu 1/1 58 1/30/2022
044/35 Bibit Margomulyo 3/3 61 1/30/2022
045/20 Wasis Prigi 25/5 52 1/30/2022
046/35 Wakijo Margomulyo 9/5 68 1/30/2022
047/20 Nanik Prigi 43/9 33 2/2/2022
048/45 Tawinem Prigi 40/8 74 2/2/2022
049/20 Maryatin Karanggandu 2/1 51 2/2/2022
050/35 Supanan Margomulyo 13/1 78 2/3/2022
051/11 An. M. Arkana Karanggandu 21/7 4 2/3/2022
052/45 Sumini Prigi 40/8 71 2/3/2022
053/20 Galang Prigi 21/5 17 2/5/2022
054/20 Handis Tasikmadu 28/5 20 2/7/2022
055/20 Kanthi A. Prigi 40/8 31 2/9/2022
056/20 Linda Ayu Tasikmadu 13/2 19 2/9/2022
057/45 Pairun Tasikmadu 26/4 85 2/10/2022
058/45 Tukijah Margomulyo 8/7 67 2/14/2022
059/20 Pariyatno Wedoro, Sidorejo 49 2/14/2022
060/20 Dadut Sawahan 1/1 40 2/14/2022
061/12 Hellen Fitria Sawahan 15/5 18 2/15/2022
062/45 Mukinah Tasikmadu 1/1 57 2/15/2022
063/45 Kasiman Margomulyo 11/2 79 2/16/2022
064/35 Paikem Talun Kulon 3/2 Bandung 65 2/16/2022
065/20 Lilik Tasikmadu 13/2 22 2/18/2022
066/35 Ikhsanudin Gemaharjo 5/4 42 2/20/2022
067/45 Lamijo Prigi 1/1 67 2/20/2022
068/35 Katminah Prigi 32/7 58 2/20/2022
069/35 Paijan Sawahan 8/3 69 2/21/2022
070/20 Rohmat Tasikmadu 18/4 18 2/23/2022
071/20 David Margomulyo 12/1 20 2/24/2022
072/20 Rohim Tasikmadu 18/4 18 2/24/2022
073/35 Daminem Karanggandu 16/5 66 2/24/2022
074/20 Candra Tasikmadu 25/4 19 2/25/2022
075/13 Asyifa Margomulyo 17/6 2.5 2/26/2022
076/45 Triono Prigi 40/8 32 2/26/2022
077/35 Inggrid Elok Tasikmadu 11/2 85 2/27/2022
078/35 Sadinem Tasikmadu 7/1 86 2/28/2022
079/10 Misha Prii 24/5 4 3/2/2022
080/10 Febrilian Margomulyo 15/6 9 3/3/2022
081/20 Latief S. Watulimo 16/6 43 3/4/2022
082/20 Ardinda Sawahan 1/1 19 3/5/2022
083/35 Nurdianto Tasikmadu 24/4 51 3/5/2022
084/45 Pairah Margomulyo 2/8 71 3/6/2022
085/45 Misno Karanggandu 9/3 53 3/7/2022
086/35 Muginarti Prigi 28/8 71 3/8/2022
087/14 Arzhad Margomulyo 2/3 2.5 3/10/2022
088/20 Triwahyuni Karanggandu 14/5 42 3/11/2022
089/10 Irsyad Sawahan 4/7 7 3/11/2022
090/35 Yatmini Gresik 65 3/13/2022
091/35 Sriani Prigi 7/2 56 3/15/2022
092/35 Aripin Tasikmadu 24/4 68 3/18/2022
093/45 Tojo Prigi 3/1 72 3/19/2022
094/20 Ita Krisnawati Prigi 16/4 34 3/21/2022
095/45 Prayitno Sawahan 1/1 68 3/21/2022
096/11 Aysel Prigi 12/3 6 3/22/2022
097/10 Nina Margomulyo 10/2 3 3/23/2022
098/35 Sinem Prigi 34/7 76 3/24/2022
099/20 Anggun Tulungagung 26 3/25/2022
100/45 Sukidi Prigi 40/8 79 3/27/2022
101/45 Mairan Karanggandu 28/9 70 3/27/2022
102/20 Suyatmi Tasikmadu 20/3 52 3/28/2022
103/20 Sulani Tasikmadu 36/6 50 3/28/2022
104/20 Winarsih Tasikmadu 42 3/31/2022
105/20 Widayati Tasikmadu 35/6 42 4/1/2022
106/14 M. Arsa Tasikmadu 4/1 1 4/2/2022
107/35 Siti Insiyah Prigi 24/5 58 4/3/2022
108/35 Maesaroh Prigi 33/7 59 4/4/2022
109/35 Bibit Margomulyo 3/3 60 4/4/2022
110/10 Dimas Prigi 46/9 12 4/5/2022
111/20 Nisful Lailatin Prigi 24/5 43 4/6/2022
112/20 Desi Karanggandu 1/1 19 4/9/2022
113/20 Wanda Prigi 45/9 18 4/10/2022
114/45 Kasirin Prigi 47/10 80 4/10/2022
115/35 Djumirah Prigi 17/4 70 4/16/2022
116/20 Panah Maggomulyo 17/6 49 4/17/2022
117/20 Yunik Tasikmadu 22/4 32 4/17/2022
118/20 Ani Handriyani Sawahan 15/5 36 4/17/2022
119/45 Bibit Margomulyo 3/3 60 4/18/2022
120/10 Ahmad G Tasikmadu 34/6 13 4/18/2022
121/14 Muh. Arsha Tasikmadu 4/1 1 4/19/2022
122/20 Mayhar Ansana 3/6 Kalsel 23 4/20/2022
123/10 Ardi N Margomulyo 21/1 8 4/20/2022
124/45 Atim Margomulyo 1/1 76 4/20/2022
125/20 Muhawan Margomulyo 8/5 52 4/21/2022
126/35 Sukatoyo Karanggandu 19/6 60 4/22/2022
127/20 Septi Yuliana Margomulyo 13/1 26 4/26/2022
128/45 Misran Tasikmadu 7/3 80 4/28/2022
129/35 Widji Karanggandu 28/9 64 4/28/2022
130/35 Maman Karanggandu 28/9 70 4/29/2022
131/20 Temu W Margomulyo 20/1 44 4/30/2022
132/35 Yahmi Tasikmadu 26/4 63 5/1/2022
133/35 Girun Prigi 2/1 78 5/3/2022
134/20 Solani Tasikmadu 36/6 45 5/4/2022
135/20 Endang Prigi 1/1 34 5/5/2022
136/20 Waode K Tasikmadu 24/4 22 5/6/2022
137/20 Ardinda Sawahan 1/1 19 5/7/2022
138/35 Ahmad Mas'an Prigi 19/4 61 5/12/2022
139/20 Ismi Tasikmadu 23/4 21 5/12/2022
140/20 Muhsin Prigi 35/7 55 5/13/2022
141/20 Dedi Tasikmadu 24 5/14/2022
142/35 Sriani Prigi 7/2 56 5/14/2022
143/35 Martiyah Margomulyo 17/6 70 5/17/2022
144/35 Suparti Tasikmadu 4/1 75 5/17/2022
145/45 Bibit Margomulyo 3/3 60 5/17/2022
146/45 Mukadi Prigi 8/3 80 5/18/2022
147/35 Tukiyem Tasikmadu 4/18 60 5/19/2022
148/45 Sutiyah Margomulyo 22/2 86 5/19/2022
149/35 Suparji Prigi 12/3 67 5/20/2022
150/35 Saripah Margomulyo 18/7 77 5/20/2022
151/35 Suparti Tasikmadu 22/4 65 5/20/2022
152/20 Nur Rohim Karanggandu 10/3 40 5/20/2022
153/35 Nanang L Tasikmadu 37/6 64 5/22/2022
154/20 Erik Herinawati Prigi 46/9 36 5/22/2022
155/14 M. Athaya R Tasikmadu 33/6 2.5 5/22/2022
156/35 Istini Tasikmadu 3/1 67 5/22/2022
157/20 Hana Margomulyo 21/5 21 5/25/2022
158/20 Erna Irianti Karanggandu 29/9 31 5/26/2022
159/20 Vernina Prigi 6/2 21 5/28/2022
160/35 Srikah Papar 5/2 Kediri 62 5/29/2022
161/35 Mukiman Margomulyo 18/7 64 5/29/2022
162/20 Rokim Sawahan 4/2 45 5/30/2022
163/35 Istini Tasikmadu 3/1 67 5/30/2022
164/35 Markinah Prigi 29/6 63 5/30/2022
165/20 Sulani Tasikmaddu 36/6 50 5/31/2022
166/35 Mathani Tasikmadu 13/2 73 5/31/2022
167/20 Winarti Karanggandu 29/9 40 5/31/2022
168/45 Sadinem Tasikmadu 7/1 80 6/1/2022
169/35 Istini Tasikmadu 3/1 61 6/3/2022
170/20 Romy Rahcmad Kendari 28 6/3/2022
171/35 Samini Tasikmadu 6/1 63 6/4/2022
172/35 Ladinem Tasikmadu 24/4 58 6/5/2022
173/35 Musani Tasikmadu 4/1 73 6/5/2022
174/10 An. Arka Tasikmadu 32/5 12 6/6/2022
175/35 Murtini Margomulyo 1/2 54 6/4/2022
176/35 Ahmad Mas'an Prigi 19/4 60 6/5/2022
177/20 Ningsih Tasikmadu 7/1 39 6/6/2022
178/13 An. Kayana Sukun, Malang 2 6/7/2022
179/20 Mega Margomulyo 15/6 33 6/7/2022
180/20 Fanessa Prigi 38/8 23 6/8/2022
181/10 An. Arga Tasikmadu 32/5 11 6/8/2022
182/20 Abdul Dwi S Tasikmadu 34/6 18 6/9/2022
183/35 Sumilah Tasikmadu 25/6 63 6/9/2022
184/10 An. Aura Tasikmadu 32/5 5 6/9/2022
185/20 Supriyanto Karanggandu 9/3 49 6/10/2022
186/10 An. Bagus Tasikmadu 7/1 12 6/11/2022
187/20 Pantiah Prigi 4/1 45 6/11/2022
188/35 Paini Prigi 23/5 58 6/14/2022
189/20 Mashada Tasikmadu 4/1 42 6/14/2022
190/14 Arshad Ainur R Margomulyo 2/3 2.5 6/14/2022
191/35 Supiyah Margomulyo 7/4 71 6/15/2022
192/20 Supriyanto Karanggandu 22/8 32 6/17/2022
193/20 Marisih Margomulyo 2/3 26 6/17/2022
194/20 Selin Tasikmadu 32/5 24 6/17/2022
195/20 Muntoyah Prigi 3/1 50 6/17/2022
196/20 Fitriana Prigi 50/10 26 6/19/2022
197/20 Slamet Rianto Prigi 16/4 51 6/20/2022
198/35 Sulkan Prigi 12/3 64 6/20/2022
199/20 Thrie Putri Kota Bitung, Sulut 21 6/20/2022
200/20 Nelvin Tasikmadu 12/2 22 6/21/2022
201/20 Suparno Tasikmadu 16/3 50 6/21/2022
202/35 Suji Margomulyo 12/1 64 6/21/2022
203/20 M. Bayu Tasikmadu 6/1 19 6/21/2022
204/20 Kabul Tasikmadu 25/4 53 6/22/2022
205/35 Lkasri Tasikmadu 12/1 74 6/22/2022
206/35 Sugianto Tasikmadu 36/6 61 6/23/2022
207/20 Mulik Karanggandu 6/2 32 6/23/2022
208/45 Slamet Riyanto Prigi 16/4 51 6/24/2022
209/14 An. Arshad Ainur Margomulyo 2/3 2.5 6/26/2022
210/20 Suparti Karanggandu 16/5 42 6/26/2022
211/35 Yamini Karanggandu 5/2 52 6/26/2022
212/10 Aminah Asmi Karanggandu 16/5 12 6/27/2022
213/35 Musahir Margomulyo 17/6 62 6/28/2022
214/20 Tatik Karanggandu 4/2 48 6/28/2022
215/35 Mirah Tasikmadu 37/6 63 6/28/2022
216/35 Kawit Karanggandu 29/9 54 6/28/2022
217/35 Sugianto Prigi 31/7 55 6/29/2022
218/20 Sriatun Tasikmau 30/5 55 6/29/2022
219/20 Ribut Sawahan 4/2 44 6/30/2022
220/10 Eustacia Tasikmau 25/4 8 7/1/2022
221/20 Katamsi Prigi 47/10 53 7/1/2022
222/35 Muslimin Margomulyo 14/1 64 7/1/2022
223/20 Pujud Tasikmadu 17/3 46 7/1/2022
224/35 Pujianto Karanggandu 22/8 65 7/2/2022
225/35 Kususiyah Prigi 23/5 59 7/2/2022
226/20 Marisih Margomulyo 2/3 26 7/2/2022
227/35 Lilik Sunarti Tasikmadu 3/1 54 7/4/2022
228/72 Karinah Tasikmadu 30/1 72 7/4/2022
229/35 Hari Sutikno Sawahan 4/2 49 7/4/2022
230/35 Pairan Prigi 14/3 65 7/5/2022
231/35 Pendek Margomulyo 8/5 74 7/5/2022
232/35 Siti Koiriyah Gampingrejo 2/1 70 7/5/2022
233/35 Wakijo Margomulyo 9/1 68 7/6/2022
234/20 Dina Nuril Aini Karanggandu 4/2 16 7/6/2022
235/35 Sukatmi Tasikmadu 7/1 58 7/7/2022
236/20 Ani Lestari Gemaharjo 10/5 24 7/7/2022
237/20 Erik Herinawati Prigi 46/9 35 7/7/2022
238/20 Sumini Tasikmau 26/4 49 7/7/2022
239/20 Wagino Margomulyo 8/5 59 7/8/2022
240/35 Musahir Margomulyo 17/6 62 7/8/2022
241/20 Eko S. Sawahan 2/1 57 7/9/2022
242/55 Jari Prigi 22/5 90 7/10/2022
243/35 Suwanto Karanggandu 22/8 64 7/10/2022
244/20 Muhamin Margomulyo 11/2 43 7/10/2022
245/14 Muh Arsha Tasikmadu 4/1 1.5 7/11/2022
246/10 Ahmad Zico Prigi 29/5 11 7/11/2022
247/35 Saodah Sawahan 1/1 57 7/12/2022
248/10 Zahira Margomulyo 2/1 7 7/13/2022
249/10 Melinda Tasikmadu 11/3 3.5 7/13/2022
250/35 Rusdi Margomulyo 64 7/15/2022
251/10 Afan Karanggandu 22/8 11 7/15/2022
252/20 Sutrisno Prigi 48/10 56 7/16/2022
253/20 Imam K. Tasikmadu 18/3 67 7/17/2022
254/20 Nofia Tasikmadu 25/4 23 7/17/2022
255/35 Sukilah Margomulyo 4/4 65 7/17/2022
256/20 Albar Tasikmadu 20/3 28 7/18/2022
257/20 Imam Tasikmadu 12/2 49 7/19/2022
258/35 Suyatmi Tasikmadu 20/3 55 7/20/2022
259/35 Paini Prigi 11/3 58 7/21/2022
260/12 Pangky Tasikmadu 27/4 18 7/22/2022
261/35 Mitun Tasikmadu 265/4 54 7/23/2022
262/20 Yunarti Margomulyo 12/1 44 7/24/2022
263/45 Nyanirah Tasikmadu 29/5 82 7/25/2022
264/45 Paijah Sawahan 3/1 77 7/28/2022
265/35 Sumiati Margomulyo 12/1 64 7/29/2022
266/20 Rongatin Karanggandu 24/8 52 7/30/2022
267/20 Sunarsih Sawahan 13/5 43 8/1/2022
268/35 Tumbu Prigi 14/3 68 8/2/2022
269/35 Sarbini Prigi 43/9 63 8/3/2022
270/35 Kadar Sawahan 10/4 67 8/3/2022
271/35 Karsini Prigi 12/3 51 8/6/2022
272/20 Erfa Hengki Sawahan 7/3 22 8/7/2022
273/35 Kasti Tasikmadu 12/2 74 8/8/2022
274/20 Budi Winarto Prigi 40/8 41 8/9/2022
275/20 Dona Riyan Sawahan 14/5 28 8/10/2022
276/35 Laminem Karanggandu 5/2 70 8/11/2022
277/35 Sriani Prigi 7/2 57 8/12/2022
278/35 Lami Margomulyo 2/3 66 8/12/2022
279/14 Ahmad G Tasikmadu 34/6 14 8/13/2022
280/35 Mirah Tasikmadu 37/6 64 8/14/2022
281/14 Aurora Prigi 31/7 14 bl 8/15/2022
282/20 Rindy Tasikmadu 22/4 30 8/16/2022
283/20 Sayuti Margomulyo 2/3 48 8/17/2022
284/35 Mukinah Tasikmadu 21/3 71 8/17/2022
285/35 Suminah Prigi 38/8 60 8/19/2022
286/11 M. Faisal Karanggandu 21/3 6 8/20/2022
287/35 Miatin Tasikmadu 24/4 71 8/21/2022
288/20 Uminarti Tasikmadu 14/2 41 8/21/2022
289/14 Emir Prigi 38/8 2.5 8/22/2022
290/45 Imam Sodikin Tasikmadu 10/2 60 8/23/2022
291/35 Mainem Karanggandu 20/7 77 8/24/2022
292/20 Nelvin Intan Prigi 45/9 23 8/24/2022
293/35 Fatonah Prigi 44/9 50 8/25/2022
294/10 Putri Eka Tasikmadu 31/5 11 8/25/2022
295/35 Rokim Sawahan 4/2 45 8/27/2022
296/35 Mirah Tasikmadu 37/6 63 8/28/2022
297/10 Yulia Zahra Tasikmadu 5/1 10 8/29/2022
298/10 Gressia Naura Prigi 44/9 6 8/30/2022
299/35 Katminah Karanggandu 14/5 74 8/31/2022
300/20 Watirah Prigi 16/4 55 8/31/2022
301/20 Ananda Prigi 25/5 22 9/1/2022
302/35 Modo Tasikmadu 12/2 56 9/1/2022
303/20 Yuli Utami Prigi 15/3 44 9/2/2022
304/35 Sholikan Tasikmadu 31/5 51 9/3/2022
305/35 Slamet Riyadi Prigi 15/4 51 9/4/2022
306/35 Kasri Tasikmadu 12/2 75 9/5/2022
307/10 Ahmad Zico Prigi 29/5 11 9/5/2022
308/35 Mukani Tasikmadu 31/6 74 9/5/2022
309/35 Slamet Tasikmadu 6/1 63 9/6/2022
310/35 Atim Margomulyo 17/6 62 9/6/2022
311/20 Intan Ummu Kranggandu 1/7 18 9/7/2022
312/35 Musahir Margomulyo 17/6 63 9/7/2022
313/20 Musiana P Margomulyo 1/2 16 9/9/2022
314/45 Sumirah Prigi 38/8 60 9/10/2022
315/20 Lisa Dwi Tasikmadu37/6 42 9/11/2022
316/35 Suparti Tasikmadu 22/4 66 9/11/2022
317/20 Anggi Margomulyo 22/6 26 9/13/2022
318/20 Wirantika Tasikmadu 1/1 26 9/14/2022
319/20 Indah Tasikmadu 1/1 36 9/15/2022
320/45 Sulkan Prigi 12/3 64 9/17/2022
321/35 Sriatun Tasikmadu 30/5 55 9/18/2022
322/20 Fikri Sawahan 10/4 21 9/19/2022
323/10 Vasiela Prigi 45/9 14 9/20/2022
324/14 Haidar Raffan Margomulyo 14/1 2.5 9/23/2022
325/35 Yasir Prigi 39/8 59 9/24/2022
326/35 Joko T Prigi 52/10 51 9/24/2022
327/20 M. Zaki Karanggandu 11/4 28 9/25/2022
328/35 Muhadi Sawahan 2/1 65 9/25/2022
329/10 Rendra Margomulto 5/4 11 9/26/2022
330/10 Lutfi Margomulyo 7/4 6 9/27/2022
331/10 M. Hafizh Tasikmadu 18/3 9 9/28/2022
332/45 Mujilah Sawahan 1/1 61 9/28/2022
333/35 Sumarti Sawahan 4/3 59 9/30/2022
334/10 Anindita Margomulyo 6/4 7 9/30/2022
335/10 Dina Nuril Aini Sawahan 2/5 10 10/1/2022
336/10 Shafa Karanggandu 3/1 12 10/2/2022
337/20 Juwartini Karanggandu 6/2 53 10/3/2022
338/35 Supardi Prigi 1/1 49 10/4/2022
339/10 Rizhaka Tasikmadu 23/4 3 10/4/2022
340/35 Tukiran Prigi 25/5 72 10/5/2022
341/35 Supadmi Prigi 50/10 54 10/5/2022
342/20 Hesti Eka Karanggandu 20/7 25 10/6/2022
343/45 Suciati Tasikmadu 2/1 80 10/6/2022
344/35 Ngaini Prigi 40/8 62 10/7/2022
345/20 Yuniar Prigi 47/10 29 10/7/2022
346/11 Dilan Margomulyo 7/4 3.5 10/8/2022
347/20 Dwi Hadi Taskmadu 5/1 45 10/9/2022
348/45 Tuminem Tasikmadu 15/2 59 10/9/2022
349/35 Jauri Prigi 45/9 56 10/10/2022
350/45 Sukarmin Slawe 7/2 48 10/10/2022
351/35 Saidi Margomulyo 16/6 57 10/11/2022
352/20 Yogi Sawahan 10/4 22 10/12/2022
353/35 Tukijan Prigi 1/1 87 10/13/2022
354/45 Lasmini Prigi 44/10 58 10/15/2022
355/45 Suji Margomulyo 12/1 64 10/16/2022
356/20 Inadah Prigi 5/1 52 10/17/2022
357/35 Kadar Sawahan 10/4 67 10/17/2022
358/20 M. Rofik Tasikmadu 14/2 26 10/17/2022
359/35 Tukiran Prigi 25/2 72 10/18/2022
360/20 Siti Munawaroh Tasikmadu 24/4 42 10/19/2022
361/45 Rusminah Prigi 28/4 88 10/20/2022
362/20 Subandi Tasikmadu 13/2 53 10/21/2022
363/35 Tarmuji Margomulyo 13/1 53 10/21/2022
364/20 Sri Retnowati Tasikmadu 14/2 38 10/23/2022
365/45 Menik Prigi 26/6 74 10/23/2022
366/20 Paini Prigi 23/5 58 10/24/2022
367/11 Arya Karanggandu 29/9 4 10/24/2022
368/20 Estu Wulan Margomulyo 7/4 30 10/24/2022
369/35 Jumarin Prigi 42/9 73 10/25/2022
370/10 Adelia C. Sawahan 13/5 5 10/27/2022
371/20 Jumani Ringin Kembar 16/4 58 10/27/2022
372/11 Adzriel Tasikmadu 7/1 3.5 10/28/2022
373/20 Fitriani Tasikmadu 18/1 32 10/29/2022
374/14 M. Arsha Tasikmadu 4/1 19 BLN 10/30/2022
375/20 Sukani Margomulyo 7/4 51 10/31/2022
376/20 Dartik Karanggandu 6/2 47 11/1/2022
377/20 Fatonah Prigi 44/9 50 11/2/2022
378/20 Sringatin Margomulyo 14/1 58 11/3/2022
379/20 Thalita S Tamanan 1/1 Trenggalek 15 11/4/2022
380/20 Meylinda Prigi 47/10 22 11/5/2022
381/35 Rusdi Prigi 11/3 64 11/5/2022
382/45 Kadir Margomulyo 12/1 72 11/5/2022
383/35 Kabul Tasikmadu 25/4 54 11/6/2022
384/11 Arfendra Tasikmadu 35/6 8 11/7/2022
385/35 Suwoyo Karanggandu 2/1 64 11/7/2022
386/35 Marjuki Tasikmadu 36/6 46 11/8/2022
387/35 Tini Tasikmadu 24/4 54 11/8/2022
388/20 M. Alfitra Margomulyo 17/6 23 11/9/2022
389/10 Ahmad Zaenul Tasikmadu 6/1 12 11/9/2022
390/45 Kadino Margomulyo 11/2 87 11/10/2022
391/35 Mukandam Margomulyo 3/3 61 11/10/2022
392/20 Sukidi Prigi 18/4 45 11/11/2022
393/35 Sriani Margomulyo 3/3 58 11/11/2022
394/35 Tawab Prigi 9/2 70 11/12/2022
395/35 Untung Haryono Tasikmadu 7/1 60 11/13/2022
396/35 Jauri Margomulyo 1/2 63 11/14/2022
397/20 Andika Prigi 8/2 26 11/14/2022
398/20 Sitra TASIKMADU 33/6 27 11/15/2022
399/35 Toiran Sawahan 4/2 66 11/15/2022
400/20 Agus Suprianto Sawahan 11/4 38 11/15/2022
401/20 Erna Karanggandu 3/1 33 11/16/2022
402/10 Prasta Prigi 2/1 14 11/17/2022
403/35 Sutrisno Prigi 48/10 57 11/17/2022
404/35 Yuli Prigi 1/1 50 11/17/2022
405/35 Tinem Karanggandu 12/4 67 11/18/2022
406/20 Beni Timahan 5/2 61 11/19/2022
407/35 Sringatin Margomulyo 6/4 48 11/20/2022
408/35 Yamirah Prigi 15/3 70 11/20/2022
409/35 Sadinem Tasikmadu 7/1 61 11/21/2022
410/45 Mujani Karanggandu 19/6 81 11/21/2022
411/35 Sebin Tasikmadu 1/1 76 11/23/2022
412/11 Arjuna Sebo 12/3 5 11/24/2022
413/20 Umi Tri Margomulyo 19/7 21 11/26/2022
414/14 Zeyzio M. Prigi 1/1 20bln 11/27/2022
415/35 Tukiran Prigi 25/5 72 11/27/2022
416/20 Ahmad Rifai Tasikmadu 18/3 25 11/29/2022
417/35 Mujiat Sawahan 13/5 57 11/29/2022
418/20 Dikri Prigi 31/7 26 11/29/2022
419/35 Samini Karanggandu 25/8 62 11/29/2022
420/35 Nurdianto Tasikmadu 24/4 51 11/30/2022
421/11 M. Athaya TASIKMADU 33/6 3 11/30/2022
422/20 Inka Tasikmadu 11/2 22 12/1/2022
423/20 Defi Karanggandu 18/6 31 12/1/2022
424/35 Sukatmi Tasikmadu 7/1 68 12/2/2022
425/11 An. Dylan Margomulyo 7/4 6 12/2/2022
426/35 Istikomah Tasikmadu 8/2 49 12/3/2022
427/35 Juprianto Prigi 17/4 43 12/3/2022
428/35 Rantinem Tasikmadu 7/1 57 12/5/2022
429/35 Alimin Margomulyo 8/5 55 12/5/2022
430/10 Sakha Prigi 45/9 5 12/6/2022
431/20 Arina Tasikmadu 21/3 24 12/7/2022
432/20 Nova Ardiansyah Prigi 36/7 26 12/8/2022
433/35 Suparno Tasikmadu 14/2 64 12/9/2022
434/35 Sudarmi Margomulyo 20/1 71 12/9/2022
435/35 Herlita Tasikmadu 19/3 18 12/10/2022
436/35 Lamiyo Karanggandu 11/4 60 12/10/2022
437/20 Tiatun Karanggandu 1/1 44 12/11/2022
438/35 Kamilah Tasikmadu 18/3 64 12/11/2022
439/35 Komarudin Prigi 24/5 61 12/12/2022
440/35 Sumarti Maggomulyo 3/3 68 12/13/2022
441/20 Imam R Sawahan 3/1 24 12/13/2022
442/35 Senin Tasikmadu 3/1 65 12/14/2022
443/35 Juwartini Karanggandu 6/2 53 12/14/2022
444/35 Sumiati Karanggandu 7/3 56 12/16/2022
445/45 Sri Mukti Tasikmadu 8/2 50 12/17/2022
446/45 Tini Prigi 11/3 81 12/17/2022
447/35 Baidek Tasikmadu 9/3 69 12/18/2022
448/21 Jerry Angga Tasikmadu 24/4 21 12/18/2022
449/35 Maryani Tasikmadu 14/2 57 12/19/2022
450/20 Shela Novi Tasikmadu 35/6 20 12/20/2022
451/14 M. Febriansyah Sawahan 13/5 1.5 12/20/2022
452/35 Puspita Sukarsih Margomulyo 19/7 58 12/21/2022
453/35 Dono Karanggandu 1/1 53 12/21/2022
454/35 Mulyani Sawahan 10/4 58 12/22/2022
455/45 Pailah Margomulyo 8/5 57 12/22/2022
456/11 Febrilian Margomulyo 15/6 9 12/23/2022
457/20 Fatonah Prigi 44/9 50 12/27/2022
458/45 Paijah Sawahan 3/1 77 12/25/2022
459/35 Iskanto Margomulyo 16/6 68 12/25/2022
460/27 Yevi Astrid Prigi 44/9 27 12/28/2022
461/55 Mairan Karanggandu 16/5 90 12/29/2022
462/35 Jahlan Prigi 19/4 69 12/29/2022
 LAMA PENGISIAN REKAM MEDIS
PERAWATAN SOAP OBSERVASI ASKEP GIZI
1 √ √ √ √ √
2 √ √ √ √ √
3 √ √ √ √ √
2 √ √ √ √ √
3 √ √ √ √ √
2 √ √ √ √ √
1 √ √ √ √ √
2 √ √ √ √ √
2 √ √ √ √ √
1 √ √ √ √ √
1 √ √ √ √ √
5 √ √ √ √ √
2 √ √ √ √ √
3 √ √ √ √ √
1 √ √ √ √ √
3 √ √ √ √ √
1 √ √ √ √ √
2 √ √ √ √ √
2 √ √ √ √ √
2 √ √ √ √ √
1 √ √ √ √ √
1 √ √ √ √ √
1 √ √ √ √ √
2 √ √ √ √ √
1 √ √ √ √ √
2 √ √ √ √ √
2 √ √ √ √ √
2 √ √ √ √ √
2 √ √ √ √ √
2 √ √ √ √ √
2 √ √ √ √ √
2 √ √ √ √ √
3 √ √ √ √ √
1 √ √ √ √ √
2 √ √ √ √ √
4 √ √ √ √ √
1 √ √ √ √ √
1 √ √ √ √ √
2 √ √ √ √ √
1 √ √ √ √ √
2 √ √ √ √ √
1 √ √ √ √ √
2 √ √ √ √ √
1 √ √ √ √ √
3 √ √ √ √ √
3 √ √ √ √ √
3 √ √ √ √ √
1 √ √ √ √ √
2 √ √ √ √ √
2 √ √ √ √ √
2 √ √ √ √ √
2 √ √ √ √ √
2 √ √ √ √ √
2 √ √ √ √ √
2 √ √ √ √ √
2 √ √ √ √ √
2 √ √ √ √ √
2 √ √ √ √ √
1 √ √ √ √ √
2 √ √ √ √ √
1 √ √ √ √ √
1 √ √ √ √ √
2 √ √ √ √ √
2 √ √ √ √ √
3 √ √ √ √ √
1 √ √ √ √ √
2 √ √ √ √ √
2 √ √ √ √ √
2 √ √ √ √ √
3 √ √ √ √ √
2 √ √ √ √ √
2 √ √ √ √ √
2 √ √ √ √ √
1 √ √ √ √ √
1 √ √ √ √ √
1 √ √ √ √ √
2 √ √ √ √ √
2 √ √ √ √ √
2 √ √ √ √ √
3 √ √ √ √ √
1 √ √ √ √ √
1 √ √ √ √ √
1 √ √ √ √ √
3 √ √ √ √ √
1 √ √ √ √ √
2 √ √ √ √ √
1 √ √ √ √ √
2 √ √ √ √ √
1 √ √ √ √ √
3 √ √ √ √ √
3 √ √ √ √ √
1 √ √ √ √ √
1 √ √ √ √ √
1 √ √ √ √ √
1 √ √ √ √ √
4 √ √ √ √ √
1 √ √ √ √ √
1 √ √ √ √ √
3 √ √ √ √ √
1 √ √ √ √ √
1 √ √ √ √ √
3 √ √ √ √ √
2 √ √ √ √ √
1 √ √ √ √ √
2 √ √ √ √ √
1 √ √ √ √ √
1 √ √ √ √ √
1 √ √ √ √ √
1 √ √ √ √ √
3 √ √ √ √ √
2 √ √ √ √ √
4 √ √ √ √ √
2 √ √ √ √ √
2 √ √ √ √ √
4 √ √ √ √ √
3 √ √ √ √ √
1 √ √ √ √ √
1 √ √ √ √ √
1 √ √ √ √ √
2 √ √ √ √ √
3 √ √ √ √ √
1 √ √ √ √ √
2 √ √ √ √ √
2 √ √ √ √ √
1 √ √ √ √ √
2 √ √ √ √ √
1 √ √ √ √ √
1 √ √ √ √ √
2 √ √ √ √ √
2 √ √ √ √ √
2 √ √ √ √ √
3 √ √ √ √ √
2 √ √ √ √ √
3 √ √ √ √ √
2 √ √ √ √ √
1 √ √ √ √ √
1 √ √ √ √ √
1 √ √ √ √ √
3 √ √ √ √ √
1 √ √ √ √ √
2 √ √ √ √ √
2 √ √ √ √ √
 3 √ √ √ √ √
3 √ √ √ √ √
2 √ √ √ √ √
2 √ √ √ √ √
2 √ √ √ √ √
2 √ √ √ √ √
1 √ √ √ √ √
2 √ √ √ √ √
2 √ √ √ √ √
1 √ √ √ √ √
2 √ √ √ √ √
3 √ √ √ √ √
2 √ √ √ √ √
3 √ √ √ √ √
1 √ √ √ √ √
1 √ √ √ √ √
3 √ √ √ √ √
2 √ √ √ √ √
4 √ √ √ √ √
3 √ √ √ √ √
2 √ √ √ √ √
2 √ √ √ √ √
1 √ √ √ √ √
2 √ √ √ √ √
2 √ √ √ √ √
5 √ √ √ √ √
1 √ √ √ √ √
2 √ √ √ √ √
1 √ √ √ √ √
2 √ √ √ √ √
1 √ √ √ √ √
1 √ √ √ √ √
2 √ √ √ √ √
1 √ √ √ √ √
2 √ √ √ √ √
3 √ √ √ √ √
3 √ √ √ √ √
33 √ √ √ √ √
2 √ √ √ √ √
4 √ √ √ √ √
2 √ √ √ √ √
3 √ √ √ √ √
2 √ √ √ √ √
2 √ √ √ √ √
2 √ √ √ √ √
1 √ √ √ √ √
2 √ √ √ √ √
2 √ √ √ √ √
 2 √ √ √ √ √
2 √ √ √ √ √
1 √ √ √ √ √
1 √ √ √ √ √
1 √ √ √ √ √
1 √ √ √ √ √
2 √ √ √ √ √
2 √ √ √ √ √
2 √ √ √ √ √
3 √ √ √ √ √
3 √ √ √ √ √
2 √ √ √ √ √
3 √ √ √ √ √
2 √ √ √ √ √
2 √ √ √ √ √
2 √ √ √ √ √
3 √ √ √ √ √
5 √ √ √ √ √
2 √ √ √ √ √
3 √ √ √ √ √
4 √ √ √ √ √
2 √ √ √ √ √
1 √ √ √ √ √
2 √ √ √ √ √
1 √ √ √ √ √
4 √ √ √ √ √
5 √ √ √ √ √
2 √ √ √ √ √
1 √ √ √ √ √
1 √ √ √ √ √
2 √ √ √ √ √
1 √ √ √ √ √
3 √ √ √ √ √
1 √ √ √ √ √
2 √ √ √ √ √
2 √ √ √ √ √
2 √ √ √ √ √
4 √ √ √ √ √
1 √ √ √ √ √
1 √ √ √ √ √
1 √ √ √ √ √
12 √ √ √ √ √
3 √ √ √ √ √
2 √ √ √ √ √
1 √ √ √ √ √
4 √ √ √ √ √
1 √ √ √ √ √
3 √ √ √ √ √
2 √ √ √ √ √
1 √ √ √ √ √
1 √ √ √ √ √
2 √ √ √ √ √
3 √ √ √ √ √
3 √ √ √ √ √
2 √ √ √ √ √
3 √ √ √ √ √
3 √ √ √ √ √
2 √ √ √ √ √
2 √ √ √ √ √
1 √ √ √ √ √
2 √ √ √ √ √
2 √ √ √ √ √
1 √ √ √ √ √
1 √ √ √ √ √
2 √ √ √ √ √
2 √ √ √ √ √
2 √ √ √ √ √
2 √ √ √ √ √
2 √ √ √ √ √
2 √ √ √ √ √
2 √ √ √ √ √
3 √ √ √ √ √
4 √ √ √ √ √
4 √ √ √ √ √
2 √ √ √ √ √
1 √ √ √ √ √
3 √ √ √ √ √
2 √ √ √ √ √
3 √ √ √ √ √
1 √ √ √ √ √
1 √ √ √ √ √
4 √ √ √ √ √
2 √ √ √ √ √
4 √ √ √ √ √
2 √ √ √ √ √
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 RUJUKAN /
NAMA DAN TTD MEDIS/ PARAMEDIS
RESUME PEMULANGAN
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