DENKESYAH 05.04.04.

SURABAYA
FKTP KLINIK DKT 02 SIDOARJO

TANGGAL NAMA
1/9/2018 RASAD

1/9/2018 SUBAKIR
1/9/2018 SOLIKAH
1/9/2018 TOTOK SOEDJIHARIJANTO
1/9/2018 DWI FITRIYAH SARI
1/9/2018 RAHMAT NUR ARDIANATA
1/9/2018 YOHANNES NICODEMUS ISWORO
1/9/2018 FAHRINA HARTATIK
1/9/2018 byandra uri joanika verena
1/9/2018 M KUSAERI
3/9/2018 DWI LESTARI
3/9/2018 ARIF BIDAYAD
3/9/2018 TRIANA FEBRIANTI

3/9/2018 SUSANTO
3/9/2018 RENY OKTAVIA DIAN EKA POLWITA
3/9/2018 shinta bintang alsyla salsabilla
3/9/2018 LAILIS FAIZAH JAMIL
3/9/2018 KHOIRI
3/9/2018 SITI MAISYAROH
3/9/2018 kristina setyawati
3/9/2018 AQILA PUTRI MAULANA AKHMAD
3/9/2018 ZHAFRAN MAULANA ADIATMODJO
4/9/2018 CHAIRINA WIRNA
4/9/2018 SULISTIONO
4/9/2018 INDAH IRAWATI
4/9/2018 HJ. FARIDATUN NUR ABIBA
4/9/2018 R.ANDY WIDARYANTO
4/9/2018 FANNIA NAZUAR
4/9/2018 NURRY FATMAWATI
4/9/2018 SUHARTINI
4/9/2018 Dwi Sushanti Permata Hati
4/9/2018 SITI SUDARWANTI
5/9/2018 YAYUK YULIANI
5/9/2018 SURIPTO
5/9/2018 IKA RATNAWATI

5/9/2018 MUHAMMAD SUNNI

5/9/2018 HENY LINAWATI
5/9/2018 ENUNG TRIYANI A W
5/9/2018 SAIDAH YUSROFANI
5/9/2018 ITA ROSITA
5/9/2018 RATNA DWI INDRAWAN
 5/9/2018 EDY SANTOSO
5/9/2018 ninik ariyaningsih
5/9/2018 RAJUN
6/9/2018 SUSWANTONO
6/9/2018 MOCHAMMAD RAYHAN PUTRA BHASKARA
6/9/2018 AYU BHUANA SAKTI febri andriyanti
6/9/2018 WILLA YULIASTUTIK, S.S
6/9/2018 SITI TARWIYAH
6/9/2018 agus marsono
6/9/2018 ELLY MAHTURO
6/9/2018 SAHRUL ULUL ILMAN
6/9/2018 ERIC KUSUMA WARDANI
8/9/2018 RACHMAD BASUKI
8/9/2018 AHMAD ZAKI JAINURI
8/9/2018 MUNTIANAH
10/9/2018 DEFI PURNAWATI, S.PD
10/9/2018 DJOEHARIJAH
10/9/2018 YAMAN SUPA'AT
10/9/2018 PAITEN
10/9/2018 JEFRI HERMAWAN
10/9/2018 AULIA SARAH DINI
10/9/2018 ROCHIKO INTAN SARI
12/9/2018 MOCHAMAD YUSUF SUHADA
12/9/2018 COMMY PUSPITA RINI

12/9/2018 MEI ALIF TA'MARTHA TILAROSA

12/9/2018 asmana
12/9/2018 RAHMAT RAFIF
13-09-2018 SATU'IN
13-09-2018 IMAM SyAFI'I
13-09-2018 SUGENG PRIYANTO
13-09-2018 TITIN NURMASRUROH
13-09-2018 ANDIKA FERID PRADANA
13-09-2018 SUKAREN
13-09-2018 MOHAMMED JABER MALEEQ EL ZAROH
14-09-2018 DWI INDARKASIONO
14-09-2018 SUWARNO
14-09-2018 FATIMAH SYAHIUKI AZZAHRA
14-09-2018 LINA KRISTINI
15-09-2018 NURSIONO
15-09-2018 ELvA ARWANTO
15-09-2018 MUSTALIA
15-09-2018 KUNANDAYANI, SE
15-09-2018 MUT MAINAH
17-09-2018 WIDADA
17-09-2018 UMI CHASANAH
17-09-2018 MOCH NICO PRATAMA
17-09-2018 AGUS PURNOMO, S.E
17-09-2018 MOH SYAMSUL HUDHA
17-09-2018 RATNA WILIS
18-09-2018 HARYA NIKEN WIDOWATI
18-09-2018 MUHAMMAD ROFIQIN NUGROHO
18-09-2018 WINARMI
18-09-2018 NUR SALAM HIDAYAT
18-09-2018 RAHAR TRIANINGSIH
18-09-2018 EKA WAHYU NINGSIH
19-09-2018 SISWONO
19-09-2018 UMBARIYANTI
19-09-2018 MITA ROKH NURMANINGSIH
19-09-2018 KATHARINA TASSYA ARIRATNA PUTRI
19-09-2018 moh rizki salilama
19-09-2018 NASYWA ADZKIA RAHNA AZ-ZAHRA
20-09-2018 ZEN DINI PRATIWI
20-09-2018 SITI INDRAWATI NINGSIIH
20-09-2018 HERMIN ISDARTI
20-09-2018 EVI SURYA ANGGRAYNI
20-09-2018 KHALILAH TSABITAH AS-SYIFAH PUTRI HAMZAH
20-09-2018 AZIZY FACHRYZA ROBBANI
20-09-2018 DIANA HARINI
20-09-2018 NOVITA RATNASARI
20-09-2018 BAROWI S.PD
21-09-2018 DAHLIA SARI
21-09-2018 TARBIN
24-09-2018 AINUR ROFIQ
24-09-2018 TEGUH SETYO WANTO
24-09-2018 DASTAM
24-09-2018 TRIYADI
24-09-2018 T. HASONANGAN SIMBOLON
24-09-2018 DANI SURYA WIRATNO
24-09-2018 TIO TJIOE O
24-09-2018 wiwik pitriyah
24-09-2018 SUPARTI
25-09-2018 ERNA DWI WIJAYANTI
25-09-2018 DWI ELISTYOWATI NINGSIH
25-09-2018 EKO MURDJITO
25-09-2018 YULI DWI DAMAYANTI
25-09-2018 BELVINA TIARA IRWANTO
26-09-2018 SUJIMAN
26-09-2018 SUPARNO
26-09-2018 NATAShA FARIHA
26-09-2018 SUBIYANTO
26-09-2018 NURIYAH
26-09-2018 ITTA CATRIANA SEDIANTO,SH
27-09-2018 SUKARLAN
27-09-2018 NANANG AGUS ERYYANTO
27-09-2018 SUSANTO
27-09-2018 KRISNAWATI
27-09-2018 RAHAR TRIANINGSIH
27-09-2018 PRATIKA YUNI FITRIA
27-09-2018 TARBIN
27-09-2018 ACHMAD MIRZA EL-AZZAM
27-09-2018 WULAN PRATIWI
28-09-2018 RINI SETIOWATI
29-09-2018 HANIF RIZKY RAMADHAN
29-09-2018 LISA HERI
29-09-2018 AULIA T
29-09-2018 MUSTALIA
29-09-2018 Amalia Nur Ramadhani
29-09-2018 META CHARISA
29-09-2018 Patria Nada Ritma Andita
29-09-2018 SUGENG SIDI SAPUTRO
29-09-2018 SUTJI RAHAYU
BULAN SEPTEMBER 2018

NO BPJS
1104585568

1104715901
1484022688

1542020771
1670240766
1702442867

1703365108
1876819735
1879717296
2237633166
1102341249
1104537936
1109574617
1123907264
1265419089
1380003704
1381165424
1429894787
1464330058
2055964138

2292284441
2292285082
159016149
1104205364
1107305278
1109456256
1150153953

1205356228
1383455417
1428930797
1645511308
1666924132
1103578514
1104398976

1104552775
1105635969
1107373037
1130103606
1275633663
1306881088
1320318325
1438382823
1810530922
2197273342
1105141421

1108066678
1292112527
1103816676
1261569295
1380001443
1472926825
1832545168
2241693044
1104710668
1389255535
1865631306
1109483381

1277529153
1315062808
1457493142

1535278274
1629108944
2200300637
1105406144
1108138544
1270188336
1437159396
2319607236
1102533355
1103837984
1105116884
1106647929
1108380969
1812502855
2480531951
1104552876
1104865424
1327819757
1787951665
1102778504
1105757278

1266712143
1312187073
1813522544
1104696527
1107369999
1109457426

1312185767
1438300552

1448898074
1102274921
1104545114
1107660971
1109396799
1326852009
1896856569
98412153
1301687469
1302336382
1543092423
1894706403
1895530419
100542317
1152051423
1162260268
1264769199
1282325848
1293620501
1540394054

2035051929
2241692368
1104260973

2424143621
1101665766
1102500977

1103837815
1104549895
1105167317
1543863317

1724315005
1870446227
2213564736
1086029638
1842610498
1844486482

2060117368
2254216498
1104004517

1105343651
1482476602
2062620718
2251794723

2264657905
1103615234
1105229698

1123907264
1196117043
1326852009
2275078285
2424143621

2453683206
2454467229
1106429782
1081226733
1134928541
1202602994
1266712143

1285574837
1291703106
1766096763
1842610307
2210474395
 DIAGNOSA
Secondary hypertension
Calcaneal spur, multiple sites
Secondary hypertension
Chronic ulcer of skin, not elsewhere classified
Haemorrhoids in pregnancy
Pleural effusion in conditions classified elsewhere
Other acute osteomyelitis, multiple sites
Acute laryngitis and tracheitis
Lipomatosis, not elsewhere classified
Acute periodontitis
Schizophrenia
Non-insulin-dependent diabetes mellitus with unspecified complications
Premature rupture of membranes, unspecified
Non-insulin-dependent diabetes mellitus with unspecified complications
Vaginal delivery following previous caesarean section
Disorder of refraction, unspecified
Excessive and frequent menstruation with irregular cycle
Chronic renal failure, unspecified
Supervision of high-risk pregnancy
Supervision of high-risk pregnancy
Acute bronchitis, unspecified

Acute bronchitis, unspecified

Chronic renal failure, unspecified
Necrosis of pulp
Other benign neoplasms of uterus
Pterygium
Melaena
Impacted teeth
Maternal care for malpresentation of fetus, unspecified
Secondary hypertension
Supervision of high-risk pregnancy
Supervision of high-risk pregnancy
Cervical disc disorder, unspecified
Non-insulin-dependent diabetes mellitus with multiple complications
Acute maxillary sinusitis
Acute myocardial infarction, unspecified
Non-insulin-dependent diabetes mellitus without complications
Pterygium
Cardiac arrhythmia, unspecified

Malformation of placenta
Oesophagitis
Disorder of refraction, unspecified
Impacted teeth
Other corneal scars and opacities
Necrosis of pulp
Nonsuppurative otitis media, unspecified
Acute bronchitis
Amenorrhoea, unspecified
Unspecified haemorrhoids without complication
Secondary hypertension
Allergic contact dermatitis, unspecified cause
Acute conjunctivitis, unspecified
Necrosis of pulp
Secondary hypertension
Acute sinusitis, unspecified
Insulin-dependent diabetes mellitus with unspecifi, Secondary hypertension
Supervision of high-risk pregnanc
Non-insulin-dependent diabetes mellitus with unspecified complications
Gastritis, unspecified
Non-insulin-dependent diabetes mellitus with unspecified complications
Disorder of refraction, unspecified
Necrosis of pulp
Malformation of placenta
Non-insulin-dependent diabetes mellitus with unspecified complications
Primary respiratory tuberculosis, confirmed bacteriologically and histologically
Impacted teeth
Non-insulin-dependent diabetes mellitus with multi, Secondary hypertension
Bronchopneumonia, unspecified
Osseous stenosis of neural canal
Non-insulin-dependent diabetes mellitus without complications
Foreign body on external eye, part unspecified
Secondary hypertension
Acute tonsillitis
Carcinoma in situ of rectum
Neonatal jaundice due to excessive haemolysis, uns
Secondary hypertension, unspecified
Myalgia, multiple sites
Predominantly allergic asthma
Necrosis of pulp
Non-insulin-dependent diabetes mellitus with multiple complications
Secondary hypertension
Benign lipomatous neoplasm
Amenorrhoea, unspecified
Cardiomegaly
Secondary hypertension
Other specified abnormal uterine and vaginal bleeding
Impacted teeth
Disorder of refraction, unspecified
Insulin-dependent diabetes mellitus with unspecified complication
Cystic fibrosis
Disorder of refraction, unspecified
njury of muscle(s) and tendon(s) of anterior muscle group at lower leg leve
Disorder of refraction, unspecified
Disorder of refraction, unspecified
Dyspepsia
Acute appendicitis with peritoneal abscess
Secondary hypertension
Human immunodeficiency virus [HIV] disease resulting in infectious and parasitic diseases
Haemorrhoids in pregnancy
Disorder of refraction, unspecified
Necrosis of pulp
Superficial injuries involving other combinations of body region
Primary oligomenorrhoea
Vaginal delivery following previous caesarean section
Complications and ill-defined descriptions of heart disease
Unspecified appendicitis
Primary respiratory tuberculosis, confirmed bacteriologically and histologically
Unspecified haematuria
Vomiting of pregnancy, unspecified
Amenorrhoea, unspecified
Disorder of refraction, unspecified
Syringomyelia and syringobulbia
Nonorganic insomnia
Gastritis, unspecified
Non-insulin-dependent diabetes mellitus with unspecified complications
Lipomatosis, not elsewhere classified
Other and unspecified right bundle-branch block
Gangrene, not elsewhere classified
Acute appendicitis, unspecified
Acute hepatitis B
Other cardiac arrhythmias
Non-insulin-dependent diabetes mellitus with unspecified complications
Amenorrhoea, unspecified
Non-insulin-dependent diabetes mellitus with multiple complications
Secondary hypertension
Other cardiac arrhythmias
Other intracranial injuries
Acute nephritic syndrome, diffuse membranous glomerulonephritis
Calculus of kidney
Necrosis of pulp
Acute hepatitis B
Secondary hypertension, unspecified
Necrosis of pulp
Calculus of kidney
Vertigo of central origin
Primary arthrosis of other joints, multiple sites
Hypertensive heart and renal disease, unspecified
Presence of intraocular lens
Supervision of high-risk pregnancy, unspecified
Non-Hodgkin's lymphoma, unspecified type
Necrosis of pulp
Amenorrhoea, unspecified
Respiratory tuberculosis, bacteriologically and h
Chronic tonsillitis
Chronic gastritis, unspecified
Allergic contact dermatitis, unspecified cause
Benign lipomatous neoplasm of intra-abdominal organs
Impacted teeth
Supervision of high-risk pregnancy
Amenorrhoea, unspecified
Chronic gastritis, unspecified
Supervision of high-risk pregnancy
 RUJUKAN
RUMKITBAN SIDOARJO
RSI Siti Hajar
RSI Siti Hajar
RSI Siti Hajar
RUMKITBAN SIDOARJO
RSI Siti Hajar
RSUD SIDOARJO
RS MITRA KELUARGA WARU
RUMKITBAN SIDOARJO
RSUD SIDOARJO
RSUD SIDOARJO
RUMKITBAN SIDOARJO
RUMKITBAN SIDOARJO
RUMKITBAN SIDOARJO
RUMKITBAN SIDOARJO
RS MATA FATMA SIDOARJO
RUMKITBAN SIDOARJO
RSAL DR.RAMELAN SURABAYA
RUMKITBAN SIDOARJO
RSI Siti Hajar
RSI Siti Hajar
RSI Siti Hajar
RS BHAYANGKARA SURABAYA
RUMKITBAN SIDOARJO
RS Bhayangkara Pusdik Porong
RS MATA FATMA SIDOARJO
RSUD SIDOARJO
RSUD SIDOARJO
RSI Siti Hajar
RUMKITBAN SIDOARJO
RS. ANWAR MEDIKA
RSUD SIDOARJO
RSUD SIDOARJO
RUMKITBAN SIDOARJO
RSI Siti Hajar
RS AISYIYAH SITI FATIMAH
RUMKITBAN SIDOARJO
RSI Siti Hajar
RSI Siti Hajar
RUMKITBAN SIDOARJO
RSUD SIDOARJO
RSI Siti Hajar
RSUD SIDOARJO
RS MATA FATMA SIDOARJO
RUMKITBAN SIDOARJO
RSI Siti Hajar
RSI Siti Hajar
RUMKITBAN SIDOARJO
RUMKITBAN SIDOARJO
RS AISYIYAH SITI FATIMAH
RSI Siti Hajar
RSI Siti Hajar
RUMKITBAN SIDOARJO
RSI Siti Hajar
RSI Siti Hajar
RSUD SIDOARJO
RUMKITBAN SIDOARJO
RUMKITBAN SIDOARJO
RSUD SIDOARJO
RUMKITBAN SIDOARJO
RSI Siti Hajar
RSUD SIDOARJO
RUMKITBAN SIDOARJO
RUMKITBAN SIDOARJO
RSI Siti Hajar
RSUD SIDOARJO
RUMKITBAN SIDOARJO
RSI Siti Hajar
RSUD SIDOARJO
RSI Siti Hajar
RSI Siti Hajar
RSUD SIDOARJO
RSI Siti Hajar
RSUD DR SOETOMO SURABAYA
RSI Siti Hajar
RUMKITBAN SIDOARJO
RSI Siti Hajar
RSUD DR SOETOMO SURABAYA
RUMKITBAN SIDOARJO
RUMKITBAN SIDOARJO
RUMKITBAN SIDOARJO
RSI Siti Hajar
RUMKITBAN SIDOARJO
RUMKITBAN SIDOARJO
RUMKITBAN SIDOARJO
RUMKITBAN SIDOARJO
RSUD SIDOARJO
RSI Siti Hajar
RUMKITBAN SIDOARJO
RS Bhayangkara Pusdik Porong
RSI Siti Hajar
RSAL DR.RAMELAN SURABAYA
RSUD SIDOARJO
RSI Siti Hajar
RUMKITBAN SIDOARJO
RSUD SIDOARJO
RUMKITBAN SIDOARJO
RSAL DR.RAMELAN SURABAYA
RUMKITBAN SIDOARJO
RSI Siti Hajar
RUMKITBAN SIDOARJO
RS MITRA KELUARGA WARU
RUMKITBAN SIDOARJO
RUMKITBAN SIDOARJO
RSUD SIDOARJO
RUMKITBAN SIDOARJO
RSI Siti Hajar
RUMKITBAN SIDOARJO
RUMKITBAN SIDOARJO
RSI Siti Hajar
RSI Siti Hajar
RSUD SIDOARJO
RSUD SIDOARJO
RUMKITBAN SIDOARJO
RUMKITBAN SIDOARJO
RUMKITBAN SIDOARJO
RSI Siti Hajar
RUMKITBAN SIDOARJO
RUMKITBAN SIDOARJO
RUMKITBAN SIDOARJO
RSUD SIDOARJO
RUMKITBAN SIDOARJO
RUMKITBAN SIDOARJO
RUMKITBAN SIDOARJO
RUMKITBAN SIDOARJO
RUMKITBAN SIDOARJO
RUMKITBAN SIDOARJO
RUMKITBAN SIDOARJO
RSI Siti Hajar
RSI Siti Hajar
RSU JASEM
RUMKITBAN SIDOARJO
RUMKITBAN SIDOARJO
RSUD SIDOARJO
RUMKITBAN SIDOARJO
RS Bhayangkara Pusdik Porong
RSI Siti Hajar
RS MATA FATMA SIDOARJO
RUMKITBAN SIDOARJO
RUMKITBAN SIDOARJO
RSI Siti Hajar
RUMKITBAN SIDOARJO
RS Bhayangkara Pusdik Porong
RS MITRA KELUARGA WARU
RUMKITBAN SIDOARJO
RSI Siti Hajar
RSI Siti Hajar
RUMKITBAN SIDOARJO
RSUD SIDOARJO
RSU JASEM
RUMKITBAN SIDOARJO
RUMKITBAN SIDOARJO
DENKESYAH 05.04.04.SURABAYA
FKTP KLINIK DKT 02 SIDOARJO BULAN OKTOBER 2018

TANGGAL NAMA NO BPJS

1/10/2018 KUSTAM 1082178022
1/10/2018 MAIYUL AIDAYATI 1082178077
1/10/2018 LASMONO WARDOJO 1095348396

1/10/2018 ISMINI 1098346667

1/10/2018 RIZKY AMALIA PUTRA UTAMA 1103551558

1/10/2018 INSRI MAHANANI 1105956167

1/10/2018 RINA CRISNINA MAHARANI 1150699825

1/10/2018 CHRISTIANTO HADI POERWO SUBAGJO 1339245999
1/10/2018 FERISQO TRI JAYA AZHAR 1424946104
1/10/2018 TEGUH PRIBADI,SE 1537940799
1/10/2018 NUR CHASANAH 2209090511
1/10/2018 TITIK SUPENI 2230844231
1/10/2018 anindita arsyfa ariyanti 2441470162
2/10/2018 ALHAMDU SAMAD 1103161138
2/10/2018 KASMONO 1104346271
2/10/2018 BERLIANA FEBRIANTI 1106402962
2/10/2018 MOCH. AGUS EFENDI 1226622486
2/10/2018 SITI FATIMAH 1305214661
2/10/2018 sugeng widjaja 1325914031
2/10/2018 TOTOK SOEDJIHARIJANTO 1542020771
2/10/2018 LILIES GARTIKA 1798884922
2/10/2018 DEWINTA ELMA ROSSANTY 1901550486

2/10/2018 KIRANIA SHIREEN RAFANDA 2492142311

2/10/2018 mochamad azam azwar anas 2492146708
3/10/2018 DJAMIL WIBISONO 98077588
3/10/2018 DR, AGUSTIN KUSUMA Dewi 1109608839
3/10/2018 ENUNG TRIYANI A W 1130103606

3/10/2018 INDAH TRI WAHYUNI 1285384926

3/10/2018 ANIK SUHARTINI 1383061847
3/10/2018 SITI SYAMSIYAH 1456277477

3/10/2018 MUHAMMAD SARONI 1843597552

3/10/2018 JUS MUSTARI 2209531588
4/10/2018 NARYO 1104865503
4/10/2018 ZAINAL MUSTAQIM 1108485009
4/10/2018 FANNIA NAZUAR 1205356228
4/10/2018 MOCH. KODIM 1469781933
4/10/2018 ETIK DJUWITA 1844277636
5/10/2018 BAMBANG SUBROTO 1105096318
5/10/2018 SHINTA SURAYA 1109574573
5/10/2018 NIKEN APRILIA ESPERANCE 1302949664
6/10/2018 ASRI YULIANTY 127236014
6/10/2018 JOKO APRIANTO 1226656326
8/10/2018 DJUWARTATIK 98447758
8/10/2018 DASTAM 1103837815
8/10/2018 M. MUKHID 1103883085
8/10/2018 SAKUR 1104278084
8/10/2018 NINIK SULISTYANI 1105879588
8/10/2018 YULES MARKUS AYUB BOKAU 1303165023
8/10/2018 Heny Dwi Wahyuni 1308268124
8/10/2018 NUR HIDAYATI 1433846981
8/10/2018 SRININGSIH 1437961274
8/10/2018 PUK'ATI 1479957761
8/10/2018 AI HALIAH 1726714541
8/10/2018 EKO SUSENO 2263869009
9/10/2018 SURATIMAH 29322652
9/10/2018 FELICIANUS HENDRAWAN 1105913957
9/10/2018 TITIN FRIDA IRAWATI 1106453823
9/10/2018 ROFIQ MUHAMSAH 1226560522
9/10/2018 JOKO APRIANTO 1226656326
9/10/2018 ANIK ISANDAYANI 1795509911
9/10/2018 DHANANJAYA RAJENDRA PUTRA HAMZAH 1890003532
9/10/2018 DIAH PUSPA RETI 2226701733
9/10/2018 NIEKE MULYO SEJATI 2248757256
9/10/2018 JOVAN AL VARO SAPARIYANTO 2472451931
10/10/2018 MISWADI 1105500813

10/10/2018 CHOIDAROH 1106087499

10/10/2018 Diah Nur hasanah 1309193019
10/10/2018 KHOIRI 1429894787
10/10/2018 LINDA YULIANA LUMANGKUN 1721774621
10/10/2018 NAFISHA AURELLIA 1899786993
10/10/2018 FARIDATUL ILMI 2478890733
11/10/2018 SRI WAHYUNINGSIH 206276332
11/10/2018 MUSRINI 1086029616
11/10/2018 TITIN NURMASRUROH 1106647929
11/10/2018 RUMIATI 1106791209

11/10/2018 I GUSTI AYU CINDY AGUSTIRA PURPITA S 1109731162

11/10/2018 Murdianingsih 1301864602
11/10/2018 FITRIANINGSIH 1308343882
11/10/2018 LULUK FARIDA 1313382418
11/10/2018 NANIK WULANDARI 2488474383
12/10/2018 ASNUNAH 1105919122
12/10/2018 ENY AMBARWATI 1106788779
12/10/2018 ANIK HANDAYANI 1109732804
12/10/2018 TITIN ASFIATI 1110413935
12/10/2018 HENY DWI AMBIKA SARI 1301887203
12/10/2018 AZHALEA ULLY MONICA 1426156187
12/10/2018 ch wasiah 1871219518

12/10/2018 LILIK ANGGRAINI 1838824683

13-10-2018 MULYADI 1102681247
13-10-2018 MUHAMMAD AKMAL ARSALAN 1108135451
13-10-2018 NURUL MAR ATI 1279381421
13-10-2018 ASMIYATI 1292665972
13-10-2018 ERNI SUSWATI 1299380049
13-10-2018 laily hidayati, se 2036349606
13-10-2018 imam subari 2076826487
15-10-2018 CHOLI'AH 98371405
15-10-2018 AGUS PUJIONO 1102347527
15-10-2018 ALHAMDU SAMAD 1103161138
15-10-2018 SUJUD 1104306388
15-10-2018 SUMARNO 1256704503
15-10-2018 SIDIQ DWI PAMUNGKAS 1307271431

15-10-2018 MUHAMMAD ARYA ADITYA PRATAMA 1312390732

15-10-2018 IKA NOVITASARI K, SE 1327883229
15-10-2018 PUSPITA TIRTANINGRUM 1437191278
15-10-2018 shofie aulia izzatunnisa 1860117849
15-10-2018 RR ENDANG SOEPRIYANTINI 1875363434
15-10-2018 dwi mira yudi setiyawati 2036980732
15-10-2018 SITI MARIYAM 2275896431
16-10-2018 HJ UMI ISRORI HINDUN 97891907
16-10-2018 EVARIYANTO 1104813369
16-10-2018 DAVA ZAIN FIRMANSYAH 1108485022
16-10-2018 MANAN 1702404099
16-10-2018 KARTIKA DWI RAHAYU 1785537393
16-10-2018 wahyu fajar atthariq 2094157978
16-10-2018 sheni a.h.d. juhandi 2451201592
16-10-2018 FANEZA BRILLIANTARI 2378150278
17-10-2018 AGUS PURWANTO 1105469403
17-10-2018 RIA MUTIARANI 1390595264

18-10-2018 yandika sandah 2041188401

18-10-2018 ALI IMRON 2033084441
18-10-2018 sumiyati 1869760697

18-10-2018 EMI RYANTI OKTAVIA 1381192648

18-10-2018 BAMBANG SUTOPO 1455001132

18-10-2018 LENI NUR IFFADA 1475971209
19-10-2018 SUYANTI 1317669996
19-10-2018 alistiana 1428194665
19-10-2018 Kirana Naema Ardian 2318566983
20-10-2018 BAMBANG SURYONO 1103615335
20-10-2018 BAYU AFRIYANTO 1162260281

20-10-2018 Lilis Tri Soesanti Ningsih 1205321692

20-10-2018 KUNANDAYANI, SE 1312187073
20-10-2018 ACHMAD 1441495899
20-10-2018 NELA ERNAWATI 2275490406
22-10-2018 QURROTA A'YUN 98283565
22-10-2018 SUDIONO, A.MD.KEP. 1104306412
22-10-2018 WININGSIH 1106296582
22-10-2018 AULIA T 1202602994
22-10-2018 LINA WAHYU NUR RACHMAWATI 1270592572
22-10-2018 ENDIK 1301428967
22-10-2018 SUKIYAR 1836553915
22-10-2018 muhammad nadhif amrulloh 2039679944
22-10-2018 FITRI MARTASARI 2196021385

23-10-2018 MOCHAMAD ABDI FAJARIYANTO 1108401311

23-10-2018 GIRI TRI ANGGA SASONGKO 1272867028

23-10-2018 ARDIANA 1327876108

23-10-2018 SUPIYEM 1839849557
23-10-2018 ACHMAD MISBAHUL KHOIR 1868557904
23-10-2018 suyati 2055759816
23-10-2018 SUDARMIATI 2449507667
24-10-2018 ASTRI PEBRIANI, amd. keb. 1300067245
24-10-2018 RAHMADHAN TEGAR PRAKASA 1327883567
25-10-2018 ZAINAL MUSTAQIM 1108485009
25-10-2018 ADI SUCIPTO 1105229586
25-10-2018 NURUL ILMIATUS SHOLIKHA 1293622053
25-10-2018 LULUK WAHYUNI 1832160971
25-10-2018 ARIEF SISWANTO 1838823186
26-10-2018 DIAN SASMITA 1100931219
26-10-2018 ARIEF CAHYO WIDODO 1103511701
26-10-2018 HAERUDDIN 1105282102
26-10-2018 KOUMI 1105853332

26-10-2018 INDAH IRAWATI 1107305278

26-10-2018 AMINAH 1107623147

26-10-2018 MOKHAMAD AMIRUDIN 1140384868

26-10-2018 ALILIA YENIDA SARI 1270201162

26-10-2018 KRISTINA BUDIARTY 1302803223
26-10-2018 MASRIFATUS SHOLIKHAH, ST. 1722533365
26-10-2018 AHMAD RYAN RAMDAN 1806521466
26-10-2018 CARRYTY JULIA PUTRI DJATMIKO 2057850843
27-10-2018 NURIJATI 1785733637
27-10-2018 nanik herawati 1849397499
27-10-2018 ANDREAS SUGIO 2060630054
27-10-2018 SUSMINI SILLIA 2090007494
29-10-2018 SUKARLI 1105183765
29-10-2018 HENI WIDAYANTI 1106254877
29-10-2018 SITI FATIMAH 1205278424
29-10-2018 NIKKO SANJAYA 2071724602
29-10-2018 PURYADI 2073778244
29-10-2018 NINIK MULYANI 2091095998
29-10-2018 GIAT 2289386057
30-10-2018 dierja janu narendra 2091095998
30-10-2018 WAWAN TRIONO 1105774402
30-10-2018 RINI WAHYUNI 1107908166
30-10-2018 FASHA RIZKY MAULANA 1428857166
30-10-2018 SITI MAISYAROH 1464330058
30-10-2018 IS KUSTIANINGSIH 1817591308
30-10-2018 DHANANJAYA RAJENDRA PUTRA HAMZAH 1890003532
30-10-2018 SUNIMAH 2376068545
31-10-2018 TOHIRIN 1105140701
31-10-2018 IRIANI 1109200544

31-10-2018 CHOIRIYATI 1339668819

31-10-2018 NAZWA AISYAH RAYA ROFIQOH 1847554817
31-10-2018 NASYWA ADZKIA RAHNA AZ-ZAHRA 1895530419
 DIAGNOSA
Insulin-dependent diabetes mellitus with unspecified complications
Non-insulin-dependent diabetes mellitus with unspecified complications
Insulin-dependent diabetes mellitus with multiple complications
Non-insulin-dependent diabetes mellitus with unspecified complications
Cellulitis, unspecified
Non-insulin-dependent diabetes mellitus without complications
Malformation of placenta
Alcoholic gastritis
Acute bronchitis
Non-insulin-dependent diabetes mellitus with multiple complications
Arthrosis, unspecified
Burn of unspecified body region, unspecified degree
Delayed milestone
Acute cholecystitis
Non-insulin-dependent diabetes mellitus with multiple complications
Benign mammary dysplasia, unspecified
Benign neoplasm of unspecified site
Necrosis of pulp
Primary respiratory tuberculosis, confirmed bacteriologically and histologically
Allergic contact dermatitis due to food in contact with skin
Secondary hypertension, unspecified
Lipomatosis, not elsewhere classified

Benign mammary dysplasia, unspecified

Neonatal jaundice, unspecified
Other specified chronic obstructive pulmonary disease
Vaginal delivery following previous caesarean section
Pterygium
Amenorrhoea, unspecified
Non-insulin-dependent diabetes mellitus with unspecified complications
Senile cataract, unspecified
Predominantly allergic asthma
Non-insulin-dependent diabetes mellitus with multiple complications
Secondary hypertension, unspecified
Non-insulin-dependent diabetes mellitus with unspecified complications
Hypertensive heart and renal disease, unspecified
Acute myocardial infarction, unspecified
Non-insulin-dependent diabetes mellitus with multiple complications
Traumatic cerebral oedema, with open intracranial wound
Malformation of placenta
Maternal care for malpresentation of fetus, unspecified
Necrosis of pulp
Impacted teeth
Non-insulin-dependent diabetes mellitus with unspecified complications
Benign lipomatous neoplasm of skin and subcutaneous tissue of head, face and neck
Necrosis of pulp
Hypertensive heart and renal disease, unspecified
Necrosis of pulp
Conjunctivitis
Fracture of shaft of radius, closed
Gastritis, unspecified
Amenorrhoea, unspecified
Secondary hypertension, unspecified
Postcoital and contact bleeding
Disorder of refraction, unspecified
Melanocytic naevi, unspecified
Other benign neoplasm of connective and other soft tissue, unspecified
Acute hepatitis B
Non-insulin-dependent diabetes mellitus with multiple complications
Chronic ischaemic heart disease
Secondary hypertension, unspecified
Disorder of penis, unspecified
Necrosis of pulp
Fatty (change of) liver, not elsewhere classified
Diarrhoea and gastroenteritis of presumed infectious origin
Secondary hypertension
Secondary hypertension
Disorder of refraction, unspecified
Chronic kidney disease
Hordeolum and chalazion
Developmental disorder of speech and language, unspecified
Malformation of placenta
Non-insulin-dependent diabetes mellitus with unspecified complications
Non-insulin-dependent diabetes mellitus with unspecified complications
Chronic kidney disease
Supervision of high-risk pregnancy
Gastro-oesophageal reflux disease
Impacted teeth
Fracture of tooth, open
Necrosis of pulp
Maternal care for transverse and oblique lie
Nontoxic single thyroid nodule
Necrosis of pulp
Secondary hypertension, unspecified
Hepatomegaly, not elsewhere classified
Necrosis of pulp
Vomiting of pregnancy, unspecified
Degenerative disease of nervous system, unspecified
Disorder of refraction, unspecified
Non-insulin-dependent diabetes mellitus with unspecified complications
Acute tonsillitis

Nonorganic insomnia
Insulin-dependent diabetes mellitus with unspecified complications
Necrosis of pulp
Insulin-dependent diabetes mellitus with unspecified complications
Stroke, not specified as haemorrhage or infarction
Necrosis of pulp
Respiratory tuberculosis unspecified, confirmed bacteriologically and histologically
Benign lipomatous neoplasm of skin and subcutaneous tissue of other and unspecified sites
Secondary hypertension

Other rheumatic heart diseases

Disorder of urinary system, unspecified
Acute tonsillitis
Necrosis of pulp
Lipomatosis, not elsewhere classified
Allergic contact dermatitis, unspecified cause
Secondary hypertension
Vomiting of pregnancy, unspecified
Thyrotoxicosis, unspecified
Calculus of ureter
Chronic serous otitis media
Paraplegia and tetraplegia
Lipomatosis, not elsewhere classified
Acute tonsillitis, unspecified
Epilepsy, unspecified
Acute bronchitis, unspecified
Amenorrhoea, unspecified
Diabetic cataract
Insulin-dependent diabetes mellitus with unspecified complications
Impacted teeth
Non-insulin-dependent diabetes mellitus with multiple complications
Benign lipomatous neoplasm
Amenorrhoea, unspecified
Secondary hypertension, unspecified
Necrosis of pulp
Non-insulin-dependent diabetes mellitus with unspecified complications
Other benign neoplasm of uterus, unspecified
Allergic contact dermatitis due to cosmetics
Benign neoplasm of prostate
External haemorrhoids with other complications
Disorder of refraction, unspecified
Disorder of refraction, unspecified
Hypertensive heart and renal disease, unspecified
Disorder of refraction, unspecified
Vomiting of pregnancy, unspecified
Acute gingivitis
Arthrosis, unspecified, multiple sites
Oedema, not elsewhere classified
Necrosis of pulp
Necrosis of pulp
Muscular dystrophy
Epilepsy, unspecified
Amenorrhoea, unspecified
Ganglion
Fracture of clavicle, closed
Malformation of placenta
Senile cataract, unspecified
Non-insulin-dependent diabetes mellitus
Non-insulin-dependent diabetes mellitus with multiple complications
Disorder of refraction, unspecified
Malformation of placenta
Melanocytic naevi of ear and external auricular canal
Cataract, unspecified
Chronic renal failure, unspecified
Other urethritis
Non-insulin-dependent diabetes mellitus with multiple complications
Disorder of refraction, unspecified
Excessive and frequent menstruation with regular cycle
Fever, unspecified
Necrosis of pulp
Calculus of kidney
Allergic contact dermatitis, unspecified cause
Carpal tunnel syndrome
Necrosis of pulp
Necrosis of pulp
Disorder of refraction, unspecified
Necrosis of pulp
Acute tonsillitis, unspecified
Tinea nigra
Disorder of refraction, unspecified
Nontoxic goitre, unspecified
Necrosis of pulp
Low back pain, multiple sites
Calculus of kidney
Necrosis of pulp
Non-insulin-dependent diabetes mellitus with unspecified complications
Fracture of clavicle, closed
Stroke, not specified as haemorrhage or infarction
Disorder of refraction, unspecified
Secondary hypertension
Fever, unspecified
Necrosis of pulp
Epidemic vertigo
Unspecified haematuria
Necrosis of pulp
Secondary hypertension, unspecified
Allergy, unspecified
Non-insulin-dependent diabetes mellitus with multiple complications
Secondary hypertension
Secondary hypertension
Blighted ovum and nonhydatidiform mole

Foreign body in nasal sinus

Other allergic rhinitis
 RUJUKAN
RSU JASEM
RSU JASEM
RUMKITBAN SIDOARJO
RUMKITBAN SIDOARJO
RUMKITBAN SIDOARJO
RUMKITBAN SIDOARJO
RUMKITBAN SIDOARJO
RUMKITBAN SIDOARJO
RUMKITBAN SIDOARJO
RUMKITBAN SIDOARJO
RSUD SIDOARJO
RSUD SIDOARJO
RSI Siti Hajar
RUMKITBAN SIDOARJO
RUMKITBAN SIDOARJO
RUMKITBAN SIDOARJO
Rumkitalmar Ewa Pangalila
RUMKITBAN SIDOARJO
RSUD SIDOARJO
RSI Siti Hajar
RUMKITBAN SIDOARJO
RUMKITBAN SIDOARJO
RUMKITBAN SIDOARJO
RUMKITBAN SIDOARJO
RSUD SIDOARJO
RUMKITBAN SIDOARJO
RS MATA FATMA SIDOARJO
RUMKITBAN SIDOARJO
RUMKITBAN SIDOARJO
RS MATA FATMA SIDOARJO
RUMKITBAN SIDOARJO
RUMKITBAN SIDOARJO
RUMKITBAN SIDOARJO
RUMKITBAN SIDOARJO
RSUD SIDOARJO
RSUD SIDOARJO
RUMKITBAN SIDOARJO
RSUD SIDOARJO
RUMKITBAN SIDOARJO
RUMKITBAN SIDOARJO
RSI Siti Hajar
RSUD SIDOARJO
RUMKITBAN SIDOARJO
RUMKITBAN SIDOARJO
RUMKITBAN SIDOARJO
RSUD SIDOARJO
RUMKITBAN SIDOARJO
RS Bhayangkara Pusdik Porong : :
RSUD SIDOARJO
RUMKITBAN SIDOARJO
RSU JASEM
RUMKITBAN SIDOARJO
RUMKITBAN SIDOARJO
RS Bhayangkara Pusdik Porong
RSI Siti Hajar
RUMKITBAN SIDOARJO
RUMKITBAN SIDOARJO
RUMKITBAN SIDOARJO
RS RAHMAN RAHIM
RUMKITBAN SIDOARJO
RUMKITBAN SIDOARJO
RUMKITBAN SIDOARJO
RUMKITBAN SIDOARJO
RUMKITBAN SIDOARJO
RUMKITBAN SIDOARJO
RUMKITBAN SIDOARJO
RS Bhayangkara Pusdik Porong
RSAL DR.RAMELAN SURABAYA
RS MATA FATMA SIDOARJO
RUMKITBAN SIDOARJO
RUMKITBAN SIDOARJO
RUMKITBAN SIDOARJO
RUMKITBAN SIDOARJO
RSUD SIDOARJO
RUMKITBAN SIDOARJO
RUMKITBAN SIDOARJO
RSUD SIDOARJO
RUMKITBAN SIDOARJO
RUMKITBAN SIDOARJO
RS RAHMAN RAHIM
RUMKITBAN SIDOARJO
RUMKITBAN SIDOARJO
RSU JASEM
RSU JASEM
RUMKITBAN SIDOARJO
RUMKITBAN SIDOARJO
RSI Siti Hajar
RSI Siti Hajar
RUMKITBAN SIDOARJO
RUMKITBAN SIDOARJO
RUMKITBAN SIDOARJO
RSUD SIDOARJO
RSI Siti Hajar
RSI Siti Hajar
RSI Siti Hajar
RUMKITBAN SIDOARJO
RSI Siti Hajar
RUMKITBAN SIDOARJO
RUMKITBAN SIDOARJO
RUMKITBAN SIDOARJO
RSUD SIDOARJO
Rumkitalmar Ewa Pangalila
RUMKITBAN SIDOARJO
RUMKITBAN SIDOARJO
RUMKITBAN SIDOARJO
Rumkital Dr. Oepomo
RUMKITBAN SIDOARJO
RSUD SIDOARJO
RSUD SIDOARJO
RSI Siti Hajar
RS RAHMAN RAHIM
RUMKITBAN SIDOARJO
RUMKITBAN SIDOARJO
RSI Siti Hajar
RUMKITBAN SIDOARJO
RUMKITBAN SIDOARJO
Rumkital Dr. Oepomo
RUMKITBAN SIDOARJO
RUMKITBAN SIDOARJO
RUMKITBAN SIDOARJO
RUMKITBAN SIDOARJO
RUMKITBAN SIDOARJO
RUMKITBAN SIDOARJO
RUMKITBAN SIDOARJO
RSU JASEM
RUMKITBAN SIDOARJO
RUMKITBAN SIDOARJO
RSUD SIDOARJO
RSUD SIDOARJO
RSI Siti Hajar
RSI Siti Hajar
RSUD SIDOARJO
RSUD SIDOARJO
RSU JASEM
RUMKITBAN SIDOARJO
RUMKITBAN SIDOARJO
RSUD SIDOARJO
RUMKITBAN SIDOARJO
RUMKITBAN SIDOARJO
RSI Siti Hajar
RSUD SIDOARJO
RUMKITBAN SIDOARJO
RSU JASEM
RSUD SIDOARJO
RUMKITBAN SIDOARJO
Rumkital dr.opoemo
RUMKITBAN SIDOARJO
RUMKITBAN SIDOARJO
RSI Siti Hajar
RUMKITBAN SIDOARJO
RUMKITBAN SIDOARJO
RS MATA FATMA SIDOARJO
RSUD SIDOARJO
RUMKITBAN SIDOARJO
RUMKITBAN SIDOARJO
RSI Siti Hajar
RUMKITBAN SIDOARJO
RUMKITBAN SIDOARJO
RUMKITBAN SIDOARJO
RUMKITBAN SIDOARJO
RSI Siti Hajar
RSUD SIDOARJO
RUMKITBAN SIDOARJO
RUMKITBAN SIDOARJO
RSI Siti Hajar
RUMKITBAN SIDOARJO
RSUD SIDOARJO
RSI Siti Hajar
RSI Siti Hajar
RSUD SIDOARJO
RUMKITBAN SIDOARJO
RSUD SIDOARJO
RSI Siti Hajar
RUMKITBAN SIDOARJO
RSUD SIDOARJO
RSI Siti Hajar
RS RAHMAN RAHIM
RSI Siti Hajar
RUMKITBAN SIDOARJO
RUMKITBAN SIDOARJO
RUMKITBAN SIDOARJO
RSI Siti Hajar
RSUD SIDOARJO
RUMKITBAN SIDOARJO
RUMKITBAN SIDOARJO
RUMKITBAN SIDOARJO
RS RAHMAN RAHIM
RUMKITBAN SIDOARJO
RUMKITBAN SIDOARJO
RSU JASEM
RSUD SIDOARJO
RUMKITBAN SIDOARJO
DENKESYAH 05.04.04.SURABAYA
FKTP KLINIK DKT 02 SIDOARJO
BULAN NOVEMBER 2018
TANGGAL NAMA NO BPJS
1/11/2018 KHOIRUM MAS'ULAH, S.PD.I 203201201
1/11/2018 IWAN SURYAWAN 1104044771
2/11/2018 IMAM MALIKI 1103828365
2/11/2018 ANISA RACHMAWATI 1318530846
2/11/2018 anissah setianingrum 1875895637
2/11/2018 MUHAMMAD RAFIF ANDRIANSYAH 1895592767
2/11/2018 YULI DWI DAMAYANTI 2060117368

2/11/2018 SIAMI 2211197804

3/11/2018 MUH MIFTAH KHOIRONI 1105853354
3/11/2018 KA NOVITASARI K, SE 1327883229
3/11/2018 ELLY MAHTURO 1472926825
3/11/2018 IBNU MAULANA YUDISTIRA S. 1540394076
3/11/2018 MUHAMMAD HAFI NUUR AKHADIST 1836554567
5/11/2018 ALHAMDU SAMAD 1103161138
5/11/2018 SUTRISNO HADI 1103382887
5/11/2018 SUDOMO 1105486132
5/11/2018 JANUAR ARGARANA 1105527194
5/11/2018 NURUL MAR ATI 1279381421

5/11/2018 DICKY ADIPUTRA BAGUS PRIAMBODO 1309942293

5/11/2018 AGUS PRIJANTO 1817232884
5/11/2018 MOCH. FADEL LUKMAN HAKIM 2042656874
5/11/2018 PRATIKA YUNI FITRIA 2275078285
6/11/2018 SITI KAULATIN 1106876722

6/11/2018 MUTIARA JAYA 1106904958

6/11/2018 DEFI PURNAWATI, S.PD 1109483381

6/11/2018 JAYA HARTONO 1295672387

6/11/2018 ARIEF EFFENDY RIFAI 1871036346

7/11/2018 PATIMAH 1836547187
7/11/2018 MUHAMMAD DHINA NUR PRATAMA 2041205782
7/11/2018 HINDUN PURBAWATI 2280375854
7/11/2018 MAULANA RIFKI RAMADHAN 2447708422
7/11/2018 NAINA NUR SALSABILA 2481484498

8/11/2018 YAMAN SUPA'AT 1315062808

8/11/2018 ALWI HASAN 2264308604

8/11/2018 PUTRI NISFI ILMAYA 2495783463
9/11/2018 ULUMIYAH 1105870757
9/11/2018 BIBAWATI 1285574275
9/11/2018 MITA ROKH NURMANINGSIH 1302336382
9/11/2018 SUTANTO PRAJOGO 1382205712
9/11/2018 SUDARMIN 2065670796
9/11/2018 FRIDA AMELIA 2469311122
10/11/2018 MAIYUL AIDAYATI 1082178077
10/11/2018 AGUS PURWANTO 1105469403
10/11/2018 KHIDAYATUL FARDIANA 1540137115
10/11/2018 SAUDIN 1619042591
10/11/2018 SITI FATIMAH 1808736772
10/11/2018 FANEZA BRILLIANTARI 2378150278
10/11/2018 SUTJI RAHAYU 2210474395
12/11/2018 MUHLISIN 1101546832
12/11/2018 KUSNOTO 1101930794
12/11/2018 OBIN LATIF 1102110017
12/11/2018 LIES DIANA KARTINI 1109789032
12/11/2018 HARTUTIK 1126017404
12/11/2018 AZHALEA ULLY MONICA 1426156187
12/11/2018 ABD RACHIM 1437158542

12/11/2018 SITI FATIMAH 1808736772

12/11/2018 byandra uri joanika verena 1879717296
12/11/2018 ARETA DAFFARA PRAMESWARI 2060117752
12/11/2018 NATASYA ZAHRA ZAHIRA 2263869843

13-11-2018 LUSIA SUPIT 1109442069

13-11-2018 VENY SUCI APRILIA 1227412157
13-11-2018 AULIA ALAM AZMANU 1270201511
13-11-2018 AZIZY FACHRYZA ROBBANI 1293620501
13-11-2018 MUKHAMMAD SAIIN 1785533815
13-11-2018 JIHAN TALITA AMIRA 1877734541
13-11-2018 CARRYTY JULIA PUTRI DJATMIKO 2057850843
14-11-2018 TOPAN BUDIONO 1102110434
14-11-2018 SUGENG ASRI WULANDARI 1180967567
14-11-2018 lipurhati 1807321072
14-11-2018 DODY DWI ERIYANTO 1879136706
14-11-2018 ALDI ALFIANSYAH 2485078727
15-11-2018 PURNOMO 1313255902

15-11-2018 ALINTIA NURDIKASARI 1832540714

15-11-2018 olivia anadita trihapsari 2221432108
16-11-2018 NASYWA NATHANIA SALSABINA 1313076633

16-11-2018 NUR ASLUCHAH 2241692807

17-11-2018 ALBET SURBAKTI 1105116603
17-11-2018 ELOK HIDAYATI 1108378168
17-11-2018 CHURIN AIN AZMI 1239542403
17-11-2018 UMIATIN 1268693998
17-11-2018 SUNARSIH 1305810167
17-11-2018 TINI SUPUTRO 1317277732
17-11-2018 MUKELAR 1865628101

17-11-2018 TITIK SUPENI 2230844231

19-11-2018 SATU'IN 1102533355
19-11-2018 INDANA MUTIARA PERMATASARI 1106911067
19-11-2018 ZUHRIATUL MADINA 1284739885
19-11-2018 TRI HARYANTO 1302219549
19-11-2018 ACHMAD FIRDAUS WIRAJAYA 1303071243

19-11-2018 ARDIANA 1327876108

19-11-2018 FERICHA 1327898531
19-11-2018 SUYATI SE 2053086805

19-11-2018 m. almeer izhar mauza 2312108403

21-11-2018 MISLAN 1104770698
21-11-2018 SAIFUL ALFAN 1104853724
21-11-2018 ARDIKA INDA ROCHANI 1105873108
21-11-2018 SUYANTI 1317669996
21-11-2018 HENDRIKA SATRIA rizqi 1449718571
21-11-2018 ERLINA DWI KUSPUJIYANTHI 1539345903
21-11-2018 SUKI ANNA MULJAWATI 1542739353
21-11-2018 WISNU HADI S 1718866686
21-11-2018 MUNIROH 1860135344
21-11-2018 MUHAMMAD ATHARRAZKA RAMAZAN 2258380124

21-11-2018 syifa nur azzahra kurniawan 2427769855

22-11-2018 SUKIRMANTO 1104696347
22-11-2018 TRI WULANNINGSIH 1106453777
22-11-2018 EKA WIJIARTI 1109573774
22-11-2018 LILIK INDRAWATI 1129930727
22-11-2018 NUR HIDAYATI 1322109145
23-11-2018 AGUS PURNOMO, S.E 1312185767
23-11-2018 SUNARKO 1384827423

23-11-2018 MOH SYAMSUL HUDHA 1438300552

23-11-2018 NUNIK YULIATININGTYAS 1702442518

23-11-2018 DWI BUDIATI 1718050847

23-11-2018 ra ismi tjahjawati 1959623122
23-11-2018 SUUDIYAH HASANAH. 2275663904
24-11-2018 ACHMAD FAUZY 1961004835
24-11-2018 NIEKE MULYO SEJATI 2248757256
26-11-2018 WIJIONO 1104398998
26-11-2018 SUYONO 1104935668

26-11-2018 KASIH PUTRI AYU 1108013951

26-11-2018 Sherly Maail 1323083608
26-11-2018 EKA NINA MUJIASTUTIK 1327856488
26-11-2018 Emi Purharini 1327885378
26-11-2018 SUJONO 1796729973
27-11-2018 YULIANTO 1102602756
27-11-2018 WAWAN TRIONO 1105774402

27-11-2018 SUPARMAN 1702442529

27-11-2018 LILIES GARTIKA 1798884922
27-11-2018 SUPIYEM 1839849557

28-11-2018 TOPAN BUDIONO 1102110434

28-11-2018 ZUBAIDAH HALIMAH 1338246066
29-11-2018 RACHMAD BASUKI 1104710668
29-11-2018 SITI TARWIYAH 1261569295
29-11-2018 ELLY MAHTURO 1472926825
29-11-2018 NURHANDINI WERDIHAYATI,SE 1887983493
30-11-2018 LUKWAN WAHYUDI 1104696617
30-11-2018 YOHANNES NICODEMUS ISWORO 1703365108
30-11-2018 anik sumariyati 1786389693

30-11-2018 MARIAH INDRAWATI 1792751051

30-11-2018 RUKAYAH 1817233288
30-11-2018 NURHANDINI WERDIHAYATI,SE 1887983493
 DIAGNOSA
Delivery by caesarean section, unspecified
Non-insulin-dependent diabetes mellitus with unspecified complications
Angina pectoris, unspecified
Allergic contact dermatitis, unspecified cause
Amenorrhoea, unspecified
Dissociative motor disorders
Chronic gastritis, unspecified
Secondary hypertension
Disorder of refraction, unspecified
Secondary hypertension, unspecified
Secondary hypertension, unspecified

Suppurative and unspecified otitis media

Necrosis of pulp
Benign lipomatous neoplasm of skin and subcutaneous tissue of head, face and neck
Low back pain, multiple sites
Hypokalaemia
Impacted teeth
Arthrosis, unspecified, multiple sites
Cutaneous abscess, furuncle and carbuncle, unspecified
Secondary hypertension, unspecified
Residual schizophrenia
Disorder of refraction, unspecified
Non-insulin-dependent diabetes mellitus with multiple complications
Necrosis of pulp
Delivery by caesarean section, unspecified
Fracture of fibula alone, closed

Stroke, not specified as haemorrhage or infarction

Hypertensive heart disease with (congestive) heart failure
Necrosis of pulp
Leiomyoma of uterus
Atopic dermatitis, unspecified
Bronchopneumonia, unspecifie
Non-insulin-dependent diabetes mellitus with unspecified complications
Neuromuscular scoliosis
Haemorrhoids in pregnancy
Non-insulin-dependent diabetes mellitus with unspecified complications
Dyspepsia
Haemorrhoids in pregnancy
Arthritis, unspecified
Chronic renal failure, unspecified
Haemorrhoids in pregnancy
Necrosis of pulp
Non-insulin-dependent diabetes mellitus with multiple complications
Acute viral hepatitis, unspecified
Hypoplasia of testis and scrotum
Chronic ischaemic heart disease, unspecified
Impacted teeth

Supervision of high-risk pregnancy, unspecified

Fracture of shaft of radius, closed
Necrosis of pulp
Rheumatic heart disease, unspecified
Carpal tunnel syndrome
Secondary hypertension

Disorders of calcium metabolism

Secondary hypertension, unspecified
Lumbago with sciatica, site unspecified
Acute tonsillitis, unspecified
Conjunctivitis, unspecified
Necrosis of pulp
Lipomatosis, not elsewhere classified
Prolonged pregnancy
Ingrowing nail
Corns and callosities
Calculus of kidney
Nonspecific lymphadenitis, unspecified
Haemorrhoids in pregnancy
Osteophyte, unspecified site
Chest pain, unspecified
Oligomenorrhoea, unspecified
Allergic contact dermatitis
Fever, unspecified
Inflammatory spondylopathy, unspecified
Maternal care for disproportion, unspecified
Acute bronchitis, unspecified
Benign lipomatous neoplasm of skin and subcutaneous tissue of other and unspecified sites

Carpal tunnel syndrome

Other hearing loss
Necrosis of pulp
Melanoma in situ of eyelid, including canthus
Secondary hypertension, unspecified

Acute appendicitis, unspecified

Carpal tunnel syndrome
Other specified anaemias
Insulin-dependent diabetes mellitus with unspecified complications
Lumbar and other intervertebral disc disorders with myelopathy
Organic amnesic syndrome, not induced by alcohol and other psychoactive substances
Necrosis of pulp
Insulin-dependent diabetes mellitus with unspecified complications
Fever, unspecified
Delivery by caesarean section, unspecified
Necrosis of pulp
Irregular menstruation, unspecified
Fever, unspecified
Non-insulin-dependent diabetes mellitus with multiple complications
Other specified disorders of muscle, forearm
Allergic contact dermatitis
Stroke, not specified as haemorrhage or infarction
Predominantly allergic asthma
Amenorrhoea, unspecified
Disorder of refraction, unspecified
Benign lipomatous neoplasm of other sites
Necrosis of pulp
Allergic contact dermatitis
Allergic contact dermatitis
Necrosis of pulp
Dementia in Alzheimer's disease, unspecified
Impacted teeth

Missed abortion
Excessive, frequent and irregular menstruation
Neurotic disorder, unspecified
Disorder of refraction, unspecified

Hyperplasia of prostate
Predominantly allergic asthma
Haemorrhage in early pregnancy, unspecified
Neurotic disorder, unspecified
Pterygium
Predominantly allergic asthma
Necrosis of pulp
Vertigo of central origin
Other specified intervertebral disc displacement
Cerebral palsy
Necrosis of pulp
Acute bronchitis, unspecified
Amenorrhoea, unspecified
Secondary hypertension
Allergic contact dermatitis
Pterygium
Other rheumatoid arthritis
Disorder of refraction, unspecified
Non-insulin-dependent diabetes mellitus with unspecified complications
Other and unspecified right bundle-branch block
Other hereditary haemolytic anaemias
Hypertensive heart and renal disease, unspecified
Rheumatic heart disease, unspecified
Hypertensive heart and renal disease, unspecified
Unspecified mycosis
Secondary hypertension
Osteomyelitis, unspecified, multiple sites
Non-insulin-dependent diabetes mellitus with unspecified complications
Disorder of refraction, unspecified
Disorder of refraction, unspecified

Alopecia (capitis) totalis

 RUJUKAN
RUMKITBAN SIDOARJO
RUMKITBAN SIDOARJO
RSI Siti Hajar
RSI SITI HAJAR
Rumkitl dr.opeomo
RUMKITBAN SIDOARJO
RUMKITBAN SIDOARJO
RUMKITBAN SIDOARJO
RSI Siti Hajar
RUMKITBAN SIDOARJO
RUMKITBAN SIDOARJO
RSUD SIDOARJO
RUMKITBAN SIDOARJO
RUMKITBAN SIDOARJO
RSUD SIDOARJO
RUMKITBAN SIDOARJO
RSUD SIDOARJO
RSUD SIDOARJO
RUMKITBAN SIDOARJO
RUMKITBAN SIDOARJO
RSUD SIDOARJO
RSUD SIDOARJO
RUMKITBAN SIDOARJO
RUMKITBAN SIDOARJO
RUMKITBAN SIDOARJO
RUMKITBAN SIDOARJO
RSUD SIDOARJO
RSI Siti Hajar
RUMKITBAN SIDOARJO
RSI Siti Hajar
RUMKITBAN SIDOARJO
RUMKITBAN SIDOARJO
RUMKITBAN SIDOARJO
RSUD SIDOARJO
RUMKITBAN SIDOARJO
RUMKITBAN SIDOARJO
RUMKITBAN SIDOARJO
RUMKITBAN SIDOARJO
RSI Siti Hajar
RSUD SIDOARJO
RUMKITBAN SIDOARJO
RUMKITBAN SIDOARJO
RUMKITBAN SIDOARJO
RSI Siti Hajar
RSI Siti Hajar
RSUD SIDOARJO
RSUD SIDOARJO
RUMKITBAN SIDOARJO
RSUD SIDOARJO
RUMKITBAN SIDOARJO
RSUD SIDOARJO
RSI Siti Hajar
RSI Siti Hajar
RUMKITBAN SIDOARJO
RUMKITBAN SIDOARJO
RSUD SIDOARJO
RSUD SIDOARJO
RSI Siti Hajar
RUMKITBAN SIDOARJO
RUMKITBAN SIDOARJO
RUMKITBAN SIDOARJO
RUMKITBAN SIDOARJO
RUMKITBAN SIDOARJO
RSI Siti Hajar
RUMKITBAN SIDOARJO
RUMKITBAN SIDOARJO
RSUD SIDOARJO
RSI Siti Hajar
RUMKITBAN SIDOARJO
RSI Siti Hajar
RUMKITBAN SIDOARJO
RSUD SIDOARJO
RUMKITBAN SIDOARJO
RUMKITBAN SIDOARJO
RUMKITBAN SIDOARJO
RSI Siti Hajar

RUMKITBAN SIDOARJO
RUMKITBAN SIDOARJO
RSI Siti Hajar
RUMKITBAN SIDOARJO
RSI Siti Hajar
RSI Siti Hajar
RSUD SIDOARJO
RSUD SIDOARJO
RSI Siti Hajar
RUMKITBAN SIDOARJO
RUMKITBAN SIDOARJO
RUMKITBAN SIDOARJO
RUMKITBAN SIDOARJO
RUMKITBAN SIDOARJO
RUMKITBAN SIDOARJO
RUMKITBAN SIDOARJO
RUMKITBAN SIDOARJO
RUMKITBAN SIDOARJO
RSI Siti Hajar
RSI Siti Hajar
RSI Siti Hajar
RUMKITBAN SIDOARJO
RUMKITBAN SIDOARJO
RSI Siti Hajar
RUMKITBAN SIDOARJO
RUMKITBAN SIDOARJO
RSI Siti Hajar
RSI Siti Hajar
RUMKITBAN SIDOARJO
RSAL DR.RAMELAN SURABAYA
RSUD SIDOARJO
RSU JASEM
RUMKITBAN SIDOARJO
RSI Siti Hajar
RSI Siti Hajar
RSI Siti Hajar
RSUD SIDOARJO
RSU JASEM
RSI Siti Hajar
RSI Siti Hajar
RSI Siti Hajar
RS RAHMA RAHIM
RSUD SIDOARJO
RSAL DR.RAMELAN SURABAYA
RUMKITBAN SIDOARJO
RUMKITBAN SIDOARJO
RSUD SIDOARJO
RUMKITBAN SIDOARJO
RUMKITBAN SIDOARJO
RSI Siti Hajar
RSUD SIDOARJO
RSUD SIDOARJO
RSUD SIDOARJO
RUMKITBAN SIDOARJO
RSUD SIDOARJO
RSI Siti Hajar
RSI Siti Hajar
RSI Siti Hajar
RSI Siti Hajar
RSI Siti Hajar
RUMKITBAN SIDOARJO
RSUD SIDOARJO
RUMKITBAN SIDOARJO
RSI Siti Hajar
RSI Siti Hajar
RSI Siti Hajar
DENKESYAH 05.04.04.SURABAYA
FKTP KLINIK DKT 02 SIDOARJO
BULAN NOVEMBER 2018
TANGGAL NAMA NO BPJS
1/12/2018 ANANG ANGGA PRADANA 729423843
1/12/2018 TEGUH SETYO WANTO 1102500977
1/12/2018 SUBAKIR 1104715901
1/12/2018 OKTY PUJI PURWANI 1107908425
1/12/2018 MUKELAR 1865628101
1/12/2018 hj. nurdjannah, ba 2036348965
1/12/2018 ATIK IRMAWATI 2285812236
3/12/2018 DWI LESTARI 1102341249
3/12/2018 BAMBANG SUBROTO 1105096318
3/12/2018 DRA. YULIANTI 1301334502
3/12/2018 LILIS 1337554754
3/12/2018 DESSI LISTIANAH,S.SI 1373985279
3/12/2018 SRI WIDARTI 1828333596
3/12/2018 AWWALIA IZZAH KARIMAH 1836581523
3/12/2018 AHMAD ZAAHIDAN ABQARY 1836581657
3/12/2018 hannah ramadhanni 1885825945
3/12/2018 SUPARTI 2213564736
3/12/2018 athar yasa' hutagalung 2611078582
4/12/2018 HERU WANTORO 1102146175
4/12/2018 LILIN INDAH DAMAYANTI 1270975588
4/12/2018 RUMIYATI 1286459987
4/12/2018 SAUDIN 1619042591
4/12/2018 SITI HAWACHIBUL LAILI 2612764214
5/12/2018 HENY DIANE YUSNITA 148425928
5/12/2018 R. ARIES DIANY KARTA KUSUMA 1389617087
5/12/2018 ARKANANTA GANTARA AJI 1658735403
6/12/2018 BUDI SETIAWAN 1102478005
6/12/2018 SISMUDJIONO 1104204846
6/12/2018 INDAH IRAWATI 1107305278
6/12/2018 DIAH WAHYUNINGTYAS 1107467537
6/12/2018 SUKARMI 1135478406
6/12/2018 HARI TRI SISWOYO 1453055938
6/12/2018 SOLIKAH 1484022688
6/12/2018 PRIBADI 1813522331
6/12/2018 ACHMAD MISBAHUL KHOIR 1868557904
7/12/2018 YAYUK YULIANI 1103578514
7/12/2018 Munifah 1105965088
7/12/2018 TRI WAHYUNINGSIH 1107467774
7/12/2018 NIKEN APRILIA ESPERANCE 1302949664
7/12/2018 MUHAMMAD ATHAR ABRISYAMSHAKTI 1459600648
8/12/2018 AYU BHUANA SAKTI febri andriyanti 1292112527
8/12/2018 SUNARSIH 1305810167
8/12/2018 YESSIE AFRIANA WULANDARI 1421031993
8/12/2018 SUTRISNO 1539458245
8/12/2018 ANGGRAENI OCTAVIANA SETYOWATI 1630157545
8/12/2018 MUNTIANAH 1865631306
8/12/2018 SUSI YULIYANTI 1881349209
8/12/2018 JUMIATI 2263685872
8/12/2018 heni purwihati 2048282054
10/12/2018 NANI SUHARTINI, SPD 98284781
10/12/2018 ARISKA CHERIA TWINS OLLIVERA 1106767631
10/12/2018 ASMANA 1437159396
10/12/2018 SUKAREN 1812502855
10/12/2018 ULUL NISWATIN 2068074336
10/12/2018 DJONSON SUTRISNO 2071179876
10/12/2018 DENIK AMBARWATI 2161038172
10/12/2018 UMI HANIFAH 2219637993
10/12/2018 MUHAMMAD ZAYYAN NABHANI AL KHOIR 2255057111
10/12/2018 ADITA PUTRI FERDIANZAH 2477995424
11/12/2018 H. ISKANDAR, M.SC 173871483
11/12/2018 ACH. FIRDAUS 775835763
11/12/2018 YARHADI 1103480897
11/12/2018 KUSTIANININGSIH 1792982226
11/12/2018 W. BAMBANG SRIYANTO 2090007325
11/12/2018 MUHAMMAD ATHARRAZKA RAMAZAN 2258380124
11/12/2018 asya devian albizar arnimerstya 2621594992
12/12/2018 MOCHAMAD YUSUF SUHADA 1105406144
12/12/2018 AFKAR ANNIBROS MUHAMMAD 1106806331
12/12/2018 MENIK PRIMA OKTAVIANTI 1106985947
12/12/2018 ERLITA MELINDA 1475481791
12/12/2018 UMINATUS ATRIKA 1832545574
12/12/2018 TINI SUPIYANTI SE 2068555961
12/12/2018 PUTRI AULIA LORENSYAH 2277588609
13-12-2018 SITI FATIMAH 1109073014
13-12-2018 AGOES SOERJANTO 1790277939
13-12-2018 RAJUN 2197273342
13-12-2018 PRATIKA YUNI FITRIA 2275078285
14-12-2018 NURSIONO 1102778504
14-12-2018 SUKARLI 1105183765
14-12-2018 NOVI ENDANG KURNIAWATI 1109392514
14-12-2018 SUSANTO 1123907264
14-12-2018 SHOLIHUL UMAM 2497309479
15-12-2018 SURATIMAH 29322652
17-12-2018 HERU WANTORO 1102110017
17-12-2018 MULYADI 1102681247
17-12-2018 YAYUK YULIANI 1103578514
17-12-2018 WAHYU ALFINDAH QUR'AINI 1106803225
17-12-2018 SUGIYATI 1106872064
17-12-2018 ALWINAH 1267622919
17-12-2018 MOHAmmAD HAIKAL ANDHIKA P 1272702519
17-12-2018 ACHMAD 1441495899
17-12-2018 SUDARMAJI 1445246559
17-12-2018 KRISNA MUHAMMAD SLAMET 1845411221
17-12-2018 AQILA PUTRI MAULANA AKHMAD 2292284441
18-12-2018 SUWARDI 1102070305
18-12-2018 HENY LINAWATI 1107373037
18-12-2018 YAYUK ELY AGUSTIN 1108752794
18-12-2018 ARI ROSTIANTI 1474697981
18-12-2018 ARIEKA WERAWATI 1722702069
18-12-2018 ATIK IRMAWATI 2285812236
18-12-2018 SRI HANDAYANI 2482778428
19-12-2018 DAHLIA SARI 1104260973
19-12-2018 SRI WIJAYA NINGSIH 1313385456
19-12-2018 MOH SYAMSUL HUDHA 1438300552
19-12-2018 wiwik pitriyah 1870446227
19-12-2018 KRIS STYORINI 2257371246
19-12-2018 azka putra rahadian 2617527813
20-12-2018 MOH AMNIL MANASIH 1106296604
20-12-2018 ANIK ISANDAYANI 1795509911
20-12-2018 muhammad arfan putra hendriyanto 2428320835
21-12-2018 SUKARLAN 1103615234
21-12-2018 NURUL HADI 1103817475
21-12-2018 BUDIE YULISTIANI 1321980164
22-12-2018 TIKA MAULIDAH KURNIAWATI 1105960173
22-12-2018 DIDIN PUSPITA 721943471
22-12-2018 RAHAR TRIANINGSIH 1326852009
22-12-2018 TERZA AFLIKA HAPPY 1636906342
22-12-2018 ERNA yudiawati 2202961342
26-12-2018 WIDADA 1104696527
26-12-2018 SHANDY WIRAYUDHA ADHITYA PUTRA 1107925356
26-12-2018 TRIANA FEBRIANTI 1109574617
26-12-2018 HERMIN ISDARTI 1162260268
26-12-2018 ALI ROSIDI 1390132383
26-12-2018 MOCHAMAD TATANG 1464330047
26-12-2018 MOCHAMAD JUFRI 1721401255
26-12-2018 zahrani qurrota a'yun 1881066486
26-12-2018 VIRGINA SUCI GRACIA 2322533362
27-12-2018 ANA FAUZIJAH 1109199497
27-12-2018 UMBARIYANTI 1301687469
28-12-2018 ARIF BIDAYAD 1104537936
28-12-2018 ELvA ARWANTO 1105757278
28-12-2018 AULIA T 1202602994
28-12-2018 GIRI TRI ANGGA SASONGKO 1272867028
28-12-2018 ERNI WINARTI 1314702549
28-12-2018 YURI HARDINI 1389255388
28-12-2018 iMRO'ATUL HASANAH 1538577459
28-12-2018 MUHAMMAD BISMA HAFIZH MAULANA 1733096182
28-12-2018 MUHAMMAD RAFIF ANDRIANSYAH 1895592767
29-12-2018 SUTRISNO 1109541802
29-12-2018 RR ENDANG SOEPRIYANTINI 1875363434
29-12-2018 suyati 2055759816
31-12-2018 PURBATIN TITIS KUSTIYAR 1102177348
31-12-2018 IMAM SyAFI'I 1103837984
31-12-2018 SUHARDI 1105583646
31-12-2018 ninik ariyaningsih 1810530922
31-12-2018 SUPIYEM 1839849557
31-12-2018 vara ayutania putri 2200975356
31-12-2018 NUR CHASANAH 2209090511
31-12-2018 SLAMET SOEPODO 2264303711
31-12-2018 SITI KHOTIJAH 2264306894
VEMBER 2018
DIAGNOSA
Unilateral or unspecified inguinal hernia, without obstruction or gangrene
Non-insulin-dependent diabetes mellitus with multiple complications
Injury of plantar artery of foot

Hypertensive heart disease without (congestive) heart failure

Stroke, not specified as haemorrhage or infarction
Insulin-dependent diabetes mellitus with multiple complications
Amenorrhoea, unspecified
Schizophrenia, unspecified
Impacted teeth
Lipomatosis, not elsewhere classified
Necrosis of pulp
Malformation of placenta
Cardiac arrhythmia, unspecified
Acute bronchitis, unspecified
Acute bronchitis, unspecified
Other specified disorders of external ear
Insulin-dependent diabetes mellitus with multiple complications
Acute bronchitis
Impacted teeth

Vomiting of pregnancy, unspecified

Conjunctivitis, unspecified
Varicose veins of other sites
Impacted teeth
Chronic gastritis, unspecified
Old myocardial infarction
Mumps without complication
Acute conjunctivitis, unspecified
Secondary hypertension, unspecified
Leiomyoma of uterus
Amenorrhoea, unspecified
Other disorders of refraction
Suppurative and unspecified otitis media
Non-insulin-dependent diabetes mellitus without complications
Secondary hypertension, unspecified
Acute suppurative otitis media
Cervical disc disorders
Non-insulin-dependent diabetes mellitus with unspecified complications
Anal abscess
Hypertonic, incoordinate, and prolonged uterine contractions
Typhoid and paratyphoid fevers
Respiratory tuberculosis unspecified, confirmed bacteriologically and histologically
Acute appendicitis, unspecified
Malformation of placenta
Acute conjunctivitis, unspecified
Vaginal delivery following previous caesarean section
Non-insulin-dependent diabetes mellitus with unspecified complications
Disorder of refraction, unspecified

Other specified anaemias

Non-insulin-dependent diabetes mellitus with unspecified complications
Non-insulin-dependent diabetes mellitus with unspecified complications

Dyspepsia
Non-insulin-dependent diabetes mellitus with unspecified complications
Carcinoma in situ of rectum
Amenorrhoea, unspecified
Paralytic syndrome, unspecified
Necrosis of pulp

Labour and delivery complicated by umbilical cord complications

Diarrhoea and gastroenteritis of presumed infectious origin
Fever, unspecified
Non-insulin-dependent diabetes mellitus with unspecified complications
Inguinal hernia
Disorder of kidney and ureter, unspecified
Vitreous haemorrhage
Disorder of prostate, unspecified
Diarrhoea and gastroenteritis of presumed infectious origin
Scrotal varices
Non-insulin-dependent diabetes mellitus with unspecified complications
Benign neoplasm of pelvic bones, sacrum and coccyx
Acute suppurative otitis media
Malformation of placenta
Secondary hypertension, unspecified
Chronic maxillary sinusitis
Ganglion
Necrosis of pulp
Disorder of refraction, unspecified
Keratitis, unspecified
Retained portions of placenta and membranes, without haemorrhage
Non-insulin-dependent diabetes mellitus with unspecified complications
Other peripheral vertigo

Vaginal delivery following previous caesarean section

Non-insulin-dependent diabetes mellitus with unspecified complications
Varicose veins of other specified sites
Other diseases of gallbladder
Hypertensive heart disease without (congestive) heart failure

Non-insulin-dependent diabetes mellitus with unspecified complications

Necrosis of pulp
Malignant melanoma of skin, unspecified
Acute serous otitis media
Benign neoplasm of vagina
Allergic contact dermatitis
Non-insulin-dependent diabetes mellitus with multiple complications
Non-insulin-dependent diabetes mellitus with multiple complications
Disorder of refraction, unspecified
Typhus fever
Otitis media in bacterial diseases classified elsewhere
Non-insulin-dependent diabetes mellitus with multiple complications
Otalgia
Diabetic retinopathy
Benign lipomatous neoplasm of skin and subcutaneous tissue of other and unspecified sites
Acute sinusitis
Disorder of refraction, unspecified
Gastro-oesophageal reflux disease
Necrosis of pulp

Insulin-dependent diabetes mellitus with unspecified complications

Excessive and frequent menstruation with irregular cycle
Necrosis of pulp
Atrial septal defect
External haemorrhoids with other complications
Secondary hypertension, unspecified
Predominantly allergic asthma
Chronic kidney disease
Non-insulin-dependent diabetes mellitus with multiple complications
Disorder of refraction, unspecified
Haemorrhage in early pregnancy, unspecified
Malformation of placenta
Non-insulin-dependent diabetes mellitus with multiple complications
Necrosis of pulp
Cataract, unspecified
Secondary hypertension
Necrosis of pulp
Prolonged pregnancy
Atherosclerotic heart disease
Hypertensive heart and renal disease, unspecified
Necrosis of pulp
Other specified disorders of parathyroid gland
Necrosis of pulp
Corns and callosities
Carcinoma in situ of bladder
Human immunodeficiency virus [HIV] disease resulting in infectious and parasitic diseases
Non-insulin-dependent diabetes mellitus with multiple complications
Non-insulin-dependent diabetes mellitus with multiple complications
Allergic contact dermatitis

Acute thyroiditis
Chronic gastritis, unspecified
Acute myocardial infarction, unspecified
Gastritis, unspecified
Fever, unspecified
Acute suppurative otitis media
Acute sinusitis
Low back pain, site unspecified
Diabetic retinopathy
Unspecified diabetes mellitus
Unspecified diabetes mellitus
Tachycardia, unspecified
Necrosis of pulp
Unspecified diabetes mellitus
Sequelae of stroke, not specified as haemorrhage or infarction

Osteoporosis of disuse
Non-insulin-dependent diabetes mellitus

Unspecified appendicitis
 RUJUKAN
RSI Siti Hajar
RUMKITBAN SIDOARJO
RSI Siti Hajar
RSUD SIDOARJO
RSUD SIDOARJO
RSI Siti Hajar
RUMKITBAN SIDOARJO
RSAL DR.RAMELAN SURABAYA
RSUD SIDOARJO
RUMKITBAN SIDOARJO
RUMKITBAN SIDOARJO
RS RAHMAN RAHIM
RSI Siti Hajar
RS RAHMAN RAHIM
RS RAHMAN RAHIM
RSI Siti Hajar
RUMKITBAN SIDOARJO
RUMKITBAN SIDOARJO
RSUD SIDOARJO
RUMKITBAN SIDOARJO
RSI Siti Hajar
RSI Siti Hajar
RSUD SIDOARJO
RUMKITBAN SIDOARJO
RUMKITBAN SIDOARJO
RSI Siti Hajar
RSI Siti Hajar
RUMKITBAN SIDOARJO
RSU JASEM
RUMKITBAN SIDOARJO
RSI Siti Hajar
RUMKITBAN SIDOARJO
RUMKITBAN SIDOARJO
RUMKITBAN SIDOARJO
RUMKITBAN SIDOARJO
RSUD SIDOARJO
RUMKITBAN SIDOARJO
RUMKITBAN SIDOARJO
RUMKITBAN SIDOARJO
RUMKITBAN SIDOARJO
RSI Siti Hajar
RSI Siti Hajar
RUMKITBAN SIDOARJO
RSI Siti Hajar
RSU JASEM
RSUD SIDOARJO
RSI Siti Hajar
RSI Siti Hajar
RUMKITBAN SIDOARJO
RUMKITBAN SIDOARJO
RUMKITBAN SIDOARJO
RUMKITBAN SIDOARJO
RSUD DR SOETOMO SURABAYA
RUMKITBAN SIDOARJO
RUMKITBAN SIDOARJO
RSI Siti Hajar
RUMKITBAN SIDOARJO
RUMKITBAN SIDOARJO
RUMKITBAN SIDOARJO
RUMKITBAN SIDOARJO
RUMKITBAN SIDOARJO
RSUD SIDOARJO
RSI Siti Hajar
RSUD SIDOARJO
RUMKITBAN SIDOARJO
RUMKITBAN SIDOARJO
RUMKITBAN SIDOARJO
RSUD SIDOARJO
RSAD BRAWIJAYA SURABAYA
RUMKITBAN SIDOARJO
RUMKITBAN SIDOARJO
RUMKITBAN SIDOARJO
RUMKITBAN SIDOARJO
RUMKITBAN SIDOARJO
RSI Siti Hajar
RUMKITBAN SIDOARJO
RSU JASEM
RUMKITBAN SIDOARJO
RSI Siti Hajar
RUMKITBAN SIDOARJO
RUMKITBAN SIDOARJO
RUMKITBAN SIDOARJO
RSUD SIDOARJO
RSUD SIDOARJO
RUMKITBAN SIDOARJO
RUMKITBAN SIDOARJO
RSI Siti Hajar
RUMKITBAN SIDOARJO
RUMKITBAN SIDOARJO
RSI Siti Hajar
RUMKITBAN SIDOARJO
RUMKITBAN SIDOARJO
RSI Siti Hajar
RUMKITBAN SIDOARJO
RSUD SIDOARJO
RUMKITBAN SIDOARJO
RUMKITBAN SIDOARJO
RSUD SIDOARJO
RUMKITBAN SIDOARJO
RUMKITBAN SIDOARJO
RSI Siti Hajar
RSAL DR.RAMELAN SURABAYA
RUMKITBAN SIDOARJO
RUMKITBAN SIDOARJO
RSU JASEM
RUMKITBAN SIDOARJO
RUMKITBAN SIDOARJO
RUMKITBAN SIDOARJO
RUMKITBAN SIDOARJO
RUMKITBAN SIDOARJO
RSUD SIDOARJO
RSUD SIDOARJO
RSUD SIDOARJO
RUMKITBAN SIDOARJO
RS RAHMAN RAHIM
RUMKITBAN SIDOARJO
RSI Siti Hajar
RSUD SIDOARJO
RUMKITBAN SIDOARJO
RUMKITBAN SIDOARJO
RUMKITBAN SIDOARJO
RSUD SIDOARJO
RUMKITBAN SIDOARJO
RUMKITBAN SIDOARJO
RUMKITBAN SIDOARJO
RSUD SIDOARJO
RUMKITBAN SIDOARJO
RSI Siti Hajar
RSAL DR.RAMELAN SURABAYA
RUMKITBAN SIDOARJO
RUMKITBAN SIDOARJO
RSI Siti Hajar
RSUD SIDOARJO
RUMKITBAN SIDOARJO
RSI Siti Hajar
RUMKITBAN SIDOARJO
RS RAHMAN RAHIM
RUMKITBAN SIDOARJO
RSAL DR.RAMELAN SURABAYA
RSI Siti Hajar
RSI Siti Hajar
RUMKITBAN SIDOARJO
RUMKITBAN SIDOARJO
RS RAHMAN RAHIM
RUMKITBAN SIDOARJO
RUMKITBAN SIDOARJO
RSUD SIDOARJO
RSU JASEM
RSUD SIDOARJO
RUMKITBAN SIDOARJO
DENKESYAH 05.04.04 SURABAYA
FKTP KLINIK DKT 02 SIDOARJO
LAPORAN RUJUKAN BULAN JANUARI 2018
TANGGAL NAMA PASIEN NO BPJS
1/2/2018 RASAT 1104585568
LIS MUFARIKIYAH 1109731059
ASTRI KHUSNUL KHOTIMAH 1110496307
AULIA RAHMA 1227187978
KHIDAYATUL FARDIANA 1540137115
ELTRYS LIMIARTINI 1542020782
NAURA ALMAZENA SALSABILA 1799631426
ARIEF EFFENDY RIFAI 1871036346
ALI IMRON 2033084441
aisila mikhayla hani 2064858682
KRIS STYORINI 2257371246
ATIK IRMAWATI 2285812236
NOER HANIFAH MAHARANI , S.PI 2309645463
FIKRI SAKA ARDANI 2309646238
1/3/2018 AINUL YACHIN 112010578
NIKE DWI PUTRI SAMIAN 277622695
BAMBANG SUBROTO 1105096318
ULUMIYAH 1105870757
sugeng widjaja 1325914031
BINTI MASRUROH 1729905715
SITI FATIMAH 1808736772
SITI MARIYAM 2275896431
1/4/2018 NOVI AISHA 173902094
ADI SUCIPTO 1105229586
ELvA ARWANTO 1105757278
YULI ASTUTIK 1109395901
ANNIZARUL TRI DHAIFULLAH 1300245603
ZUBAIDAH HALIMAH 1338246066
ch wasiah 1871219518
JUS MUSTARI 2209531588
PUTRA ALTAF AL-AZZAM 2325489017
1/5/2018 SITI ENDANG PUJI RAHAYU 1107395662
ELLY MAHTURO 1472926825
NAURA ALMAZENA SALSABILA 1799631426
SYAH AKMAL ROMADHON 1868520519
PARLAN PERMANA 2058846535
SUPAAT 2205985318
1/6/2018 ENY MASLICHAH 1196306122
1/8/2018 NANTO 1101903164
MOCHAMAD YUSUF SUHADA 1105406144
LILIK MUFLIHAINY 1106221724
 DR, AGUSTIN KUSUMA Dewi 1109608839
8/ YULIA FIKRI 1428841506
MOCH. KODIM 1469781933
SUMEWIGATI 1469781966
KHOIRUL ANWAR, S.PD. 1728680466
SITI FATIMAH 1808736772
putri utami nusantara 1900205133
AGUNG SETYAWATI 2052264137
NOVANI AKHADIYAH 2081111589
1/9/2018 PURBATIN TITIS KUSTIYAR 1102177348
ANIK HANDAYANI 1109732804
ITA MAHARANI 1227336221
TUTY RAHMAWATI 1459458426
YOHANNES NICODEMUS ISWORO 1703365108
ADHISTIE MYRIA 1791853042
mohammed jusuf milan el zaroh 2035560249
MOCH YUDA SYAIFUDIN 2296746685
1/10/2018 LYNDA SUSANTI 1102236208
COMMY PUSPITA RINI 1108138544
TITIN ASFIATI 1110413935
ASMIYATI 1292665972
WIDIYAWATI 1295675188
ELSA SELVIRA 1457026626
anik sumariyati 1786389693
LINGGA HUDA NURANDIKA 1828135451
ANTONIUS SANTOSO 1899512649
EMA ANDRIYANAH 1959549592
ABIZARD RENDRA RAMADHAN 2238917556
MUHAMMAD FAREL SETYAWAN 2243531046
1/11/2018 SUKANDAR 1101588322
ARIF BIDAYAD 1104537936
NURIKA SRI LESTARI 1227009082
MUHAMMAD IQROM WIRATAMA 1302309775
A.M.WIDYARTANTO 1706698225
GOFAR CAHYO 1722704894
m riadhlun ni'am 1810531541
1/12/2018 HARTUTIK 1126017404
YOHANNES NICODEMUS ISWORO 1703365108
ANY WIARTI 1815055108
JOELOEYS ACHMADY 1817275217
RIBUT SRI MULYA ASTUTI 1843597631
RAHMAT FIRDAUS 1843597642
IR. H. MOCH. ZAENURI ARIFIN, MT. 1885299671
MUSTAFAH 1967606842
SITI MARIYAM 2275896431
 1/13/2018 M. YUNUS MANULLANG 1103999005
ULUMIYAH 1105870757
MAFTUHATUL MAHMUDAH 1105960162
TRIASTUTI Andaningsih 1108393492
SUPIYEM 1839849557
Suprapti 2137567498
WAGIMIN 2197470317
1/15/2018 LUSIANA TAHALELE 1102431532
SATU'IN 1102533355
IMAM MALIKI 1103828365
KASMONO 1104346271
SUKIRMANTO 1104696347
SAIFUL ALFAN 1104853724
Munifah 1105965088
DICKY SATRIA ANUGRAH 1106128078
ANIK JULIASTUTI 1106170683
IVANA SUPIT 1109442058
ANIK HANDAYANI 1109732804
DEALOVA 1188737065
ENDANG PUSPITO SARI 1279558451
RIA ARIYATI WULANJANI 1293643001
YAMAN SUPA'AT 1315062808
Sherly Maail 1323083608
sugeng widjaja 1325914031
IMAM WAHYUDI 1540137104
SUSILOWATI 1702875565
ANIK ISANDAYANI 1795509911
LILIES GARTIKA 1798884922
m riadhlun ni'am 1810531541
ANY WIARTI 1815055108
SUPIYEM 1839849557
SHELLY CASTELIA HUTOMO 1899514034
M. JAMALUDIN 1962539098
SITI LINDIAWAti 1968339521
NURUL HIDAYATI 2070863515
W. BAMBANG SRIYANTO 2090007325
AKHMAD FADKURZAINI WAGIZAMZIAR 2197470745
SRI SURYANI 2205122308
NIEKE MULYO SEJATI 2248757256
SLAMET SOEPODO 2264303711
SITI KHOTIJAH 2264306894
10/16/2018 DJUWARTATIK 98447758
ADI SUCIPTO 1105229586
SRI WAHYUNI 1108197145
HJ. FARIDATUN NUR ABIBA 1109456256
 NUR SULISTIANI 1388240853
RIZAKY ACHMAD RAhNA AL FATIH 1868457802
NASYWA ADZKIA RAHNA AZ-ZAHRA 1895530419
1/17/2018 NOVI AISHA 173902094
SUKARLAN 1103615234
DAHLIA SARI 1104260973
BAMBANG SUTOPO 1455001132
LESTARININGSIH 1704129366
EKO MURDJITO 1844486482
m. irfan junaidi 1887034487
1/18/2018 SITI FADLIYAH 1106681512
UMIATIN 1268693998
AHMAD BIO REFLY 1482700511
SILVI ANGRAYANI 1817826287
OEI YULI PUSPITASARI 1892536986
SETYOWATI 1962539526
SUSMINI SILLIA 2090007494
1/19/2018 KADARSIH 1336827273
ILMI FATMAWATI 1824995474
ABIZARD RENDRA RAMADHAN 2238917556
1/20/2018 SUKIRMANTO 1104696347
SANTI 1327883534
ALYA PUTRI WINDARTO 1456328564
muhammad nadhif amrulloh 2039679944
TITAN YUSUF PRATAMA 2063658868
NOER HANIFAH MAHARANI , S.PI 2309645463
OLANMUKTI ARUMSARI 2318298827
AGUSTIN IMANINGTYAS 2325816898
1/22/2019 KUSTAM 1082178022
MAIYUL AIDAYATI 1082178077
DWI LESTARI 1102341249
MUHAMMAD SUNI 1105635969
ZAINAL MUSTAQIM 1108485009
SUSANTO 1123907264
KRISNAWATI 1196117043
SARIFAH 1243784114
RIZKY DIO FERNANDO 1308343555
ISMIATUN 1309940381
LUPPY DWI WAHYU VERDINAYANTI 1535063938
ANDIK SUPRAYOGIK 1868457622
ACHMAD MISBAHUL KHOIR 1868557904
MUHAMMAD ANSHORI ASY SYATHIBI 1880804193
1/23/2018
DIAGNOSA
Hypertensive heart and renal disease
Other disorders of urinary system
Corns and callosities
Chronic serous otitis media, Acute
Amenorrhoea, unspecified
Fracture of fibula alone , open
Benign lipomatous neoplasm
Hemiplegia, unspecified
Hyperplasia of prostate, Secondary hypertension
Vomiting following gastrointestinal surgery
Malformation of placenta
Suppurative otitis media, unspecified
Allergic contact dermatitis due to metal
Vomiting following gastrointestinal surgery
Necrosis of pulp
Premature rupture of membranes, onset of labour wi
Cerebral oedem
Non-insulin-dependent diabetes mellitus with multi
Glaucoma, unspecified
Typhoid and paratyphoid fevers
Lumbago with sciatica, Radial styloid tenosynovitis [de Quervain]
Thyrotoxicosis, unspecified, Other and unspecified right bundle-branch block
Eclampsia in pregnancy
Hypertensive renal disease with renal failure
Insulin-dependent diabetes mellitus with unspecifi, Secondary hypertension
Glaucoma, unspecified
Corns and callosities
Hereditary haemolytic anaemia, unspecified
Other spondylosis with myelopathy, lumbar region
Non-insulin-dependent diabetes mellitus with multi, Secondary hypertension
Other specified kernicterus
Acute appendicitis, unspecified
Chronic ischaemic heart disease
Acute lymphadenitis, unspecified
Disorder of refraction, unspecified
Fracture of tooth, open
Gangrene, not elsewhere classified, Secondary hypertension, unspecified, Non
Malformation of placenta
Ganglion
Non-insulin-dependent diabetes mellitus with multi
Non-insulin-dependent diabetes mellitus with multi, Myalgia
 Amenorrhoea, unspecified
Necrosis of pulp
Acute myocardial infarction, unspecified, Pleural effusion, not elsewhere classified, Hypertensive he
Supervision of high-risk pregnancy, unspecified
Diabetic retinopathy
Hypertensive heart and renal disease, unspecified, Chronic ischaemic heart disease
Excessive and frequent menstruation with regular c
Necrosis of pulp
Disorder of refraction, unspecified
Insulin-dependent diabetes mellitus with multiple
Secondary hypertension, unspecified
Amenorrhoea, unspecified
Other benign neoplasms of uterus
Other acute osteomyelitis, multiple sites
Acute conjunctivitis, unspecified
Fever, unspecified, Irritable bowel syndrome with diarrhoea
Fracture of tooth, open
Dyspnoea
Vertigo of central origin
Non-insulin-dependent diabetes mellitus with unspe, Essential (primary) hypertension
Mitral stenosis with insufficiency, Atrial fibrillation and flutte
Melanocytic naevi, unspecified
Necrosis of pulp
Non-insulin-dependent diabetes mellitus with multi
Allergic contact dermatitis
Cataract, unspecified
Prolonged pregnancy
Cleft palate
Diarrhoea and gastroenteritis of presumed infectio
Calculus of kidney
Acute suppurative otitis media
Disorder of refraction, unspecified, Acute upper respiratory infection, unspecified
Congenital absence and aplasia of penis
Stroke, not specified as haemorrhage or infarction
Angina pectoris, unspecified
Paratyphoid fever, unspecified
Fracture of other carpal bone(s) , closed, Secondary hypertensio
Other acute osteomyelitis, multiple sites
Leiomyoma of uterus, unspecified
Non-insulin-dependent diabetes mellitus with unspe, Secondary hypertension
Other anxiety disorders
Impetiginization of other dermatoses
Hypertensive heart and renal disease, unspecified, Secondary hypertension
Disorder of refraction, unspecified
Thyrotoxicosis, unspecified, Other and unspecified right bundle-branch block
Impacted teeth
Spondylolisthesis, Fracture of lumbar vertebra
Follow-up examination after other treatment for ot, Lipomatosis, not elsewhere classified
Hypertensive heart and renal disease, unspecified
Insulin-dependent diabetes mellitus with unspecifi
Suppurative and unspecified otitis media
Respiratory tuberculosis unspecified, confirmed ba
Umbilical hernia
Calculus of gallbladder with other cholecystitis
Secondary hypertension, unspecified
Non-insulin-dependent diabetes mellitus with multi
Other and unspecified disorders of circulatory sys
Necrosis of pulp
Non-insulin-dependent diabetes mellitus with multi
Necrosis of pulp
Psoriasis, unspecified
Eclampsia in pregnancy
Fracture of shaft of tibia , open, Stiffness of joint, not elsewhere classified, ank
Allergic contact dermatitis, unspecified cause, Acute tonsillitis
Systemic lupus erythematosus, unspecified
Malformation of placenta
Primary open-angle glaucoma, Diarrhoea and gastroenteritis of presumed infectio
Malformation of placenta
Hyperplasia of prostate
Necrosis of pulp
Disorder of refraction, unspecified
Secondary hypertension, unspecified
Non-insulin-dependent diabetes mellitus with multi
Acute bronchitis, unspecified
Low back pain, multiple sites
Primary respiratory tuberculosis, confirmed bacter
Cataract, unspecified, Gastritis, unspecified
Disorder of refraction, unspecified
Primary oligomenorrhoea
Excessive and frequent menstruation with irregular
Benign neoplasm of prostate
Fracture of shaft of ulna, closed
Calculus of kidney
Fracture of fibula alone, closed
Non-insulin-dependent diabetes mellitus with unspe, Arthrosis, unspecified
Calculus of kidney
Hypertensive renal disease with renal failure
Presence of other cardiac and vascular implants an
Vomiting of pregnancy, unspecified
Pterygium
Disorder of refraction, unspecified
Fever, unspecified, Vomiting following gastrointestinal surgery
Fever, unspecified, Vomiting following gastrointestinal surgery
External haemorrhoids with other complications
Calculus of kidney
Acute paralytic poliomyelitis, other and unspecifi
Secondary hypertension, unspecified
Disorder of refraction, unspecified
Secondary hypertension, unspecified
Necrosis of pulp
Calculus of kidney
Secondary hypertension, Non-insulindependent diabetes mellitus with multi
Fever, unspecified
Vomiting of pregnancy
Disorder of refraction, unspecified
Chronic serous otitis media
Low back pain, site unspecified
Low back pain, site unspecified
Haemorrhage in early pregnancy, unspecified
Cardiovascular devices associated with adverse inc
Other and unspecified disorders of circulatory sy
Necrosis of pulp
Acute lymphadenitis of face, head and neck
Epilepsy, unspecified, Influenza with other respiratory manifestations, i
Anxiety disorder, unspecified
Supervision of high-risk pregnancy, unspecified
Puerperal sepsis
Benign neoplasm of breas
Non-insulin-dependent diabetes mellitus with unspe
Non-insulin-dependent diabetes mellitus with multi, Secondary hypertension
Fracture of shaft of tibia, closed
Acute myocardial infarction, unspecified
Non-insulin-dependent diabetes mellitus with multi, Secondary hypertension,
Non-insulin-dependent diabetes mellitus with multi, Secondary hypertension, unspecified
Hypertensive heart and renal disease
Trigger finger, site unspecified
Attention to colostomy
Diarrhoea and gastroenteritis of presumed infectio
Premature separation of placenta, unspecified
Fracture of shaft of tibia, closed
Non-insulin-dependent diabetes mellitus with unspe, Secondary hypertension
Diarrhoea and gastroenteritis of presumed infectio
NAMA RS
RUMKITBAN SIDOARJO
RUMKITBAN SIDOARJO
RUMKITBAN SIDOARJO
RSI Siti Hajar
RUMKITBAN SIDOARJO
RUMKITBAN SIDOARJO
RUMKITBAN SIDOARJO
RSUD SIDOARJO
RUMKITBAN SIDOARJO
RUMKITBAN SIDOARJO
RUMKITBAN SIDOARJO
RSUD SIDOARJO
RSI Siti Hajar
RSI Siti Hajar
RUMKITBAN SIDOARJO
RUMKITBAN SIDOARJO
RSUD SIDOARJO
RSUD SIDOARJO
RSUD SIDOARJO
RUMKITBAN SIDOARJO
RSUD SIDOARJO
RSUD SIDOARJO
RSI Siti Hajar
RSUD SIDOARJO
RUMKITBAN SIDOARJO
RS MATA FATMA SIDOARJO
RUMKITBAN SIDOARJO
RSI Siti Hajar
RSUD SIDOARJO
RUMKITBAN SIDOARJO
RUMKITBAN SIDOARJO
RS AISYIYAH SITI FATIMAH
RSI Siti Hajar
RSUD SIDOARJO
RSI Siti Hajar
RUMKITBAN SIDOARJO
RSUD SIDOARJO
RUMKITBAN SIDOARJO
RUMKITBAN SIDOARJO
RUMKITBAN SIDOARJO
RUMKITBAN SIDOARJO
RUMKITBAN SIDOARJO
RUMKITBAN SIDOARJO
RSUD SIDOARJO
RSUD SIDOARJO
RSUD SIDOARJO
RSUD SIDOARJO
RSI Siti Hajar
RUMKITBAN SIDOARJO
RSI Siti Hajar
RSI Siti Hajar
RUMKITBAN SIDOARJO
RUMKITBAN SIDOARJO
RSUD SIDOARJO
RSUD SIDOARJO
RSI Siti Hajar
RSI Siti Hajar
RSI Siti Hajar
RUMKITBAN SIDOARJO
RUMKITBAN SIDOARJO
RUMKITBAN SIDOARJO
RSUD SIDOARJO
RSI Siti Hajar
RUMKITBAN SIDOARJO
RUMKITBAN SIDOARJO
RSI Siti Hajar
RS MATA FATMA SIDOARJO
RUMKITBAN SIDOARJO
RSI Siti Hajar
RSI Siti Hajar
RSI Siti Hajar
RSI Siti Hajar
RSI Siti Hajar
RUMKITBAN SIDOARJO
RUMKITBAN SIDOARJO
RSI Siti Hajar
RSI Siti Hajar
RSI Siti Hajar
RSUD SIDOARJO
RUMKITBAN SIDOARJO
RUMKITBAN SIDOARJO
RSI Siti Hajar
RSI Siti Hajar
RUMKITBAN SIDOARJO
RSI Siti Hajar
RSUD SIDOARJO
RSUD SIDOARJO
RSUD SIDOARJO
RSI Siti Hajar
RSI Siti Hajar
RSUD SIDOARJO
RSI Siti Hajar
RSI Siti Hajar
RUMKITBAN SIDOARJO
RSUD SIDOARJO
RSI Siti Hajar
RSI Siti Hajar
RUMKITBAN SIDOARJO
RUMKITBAN SIDOARJO
RUMKITBAN SIDOARJO
RUMKITBAN SIDOARJO
RSI Siti Hajar
RUMKITBAN SIDOARJO
RSUD SIDOARJO
RSI Siti Hajar
RSUD SIDOARJO
RSUD SIDOARJO
RSUD SIDOARJO
RUMKITBAN SIDOARJO
RSUD SIDOARJO
RUMKITBAN SIDOARJO
RSI Siti Hajar
RUMKITBAN SIDOARJO
RUMKITBAN SIDOARJO
RSUD SIDOARJO
RUMKITBAN SIDOARJO
RSUD SIDOARJO
RS MATA FATMA SIDOARJO
RSI Siti Hajar
RSI Siti Hajar
RUMKITBAN SIDOARJO
RSUD SIDOARJO
RSI Siti Hajar
RSI Siti Hajar
RSUD SIDOARJO
RSUD SIDOARJO
RSUD SIDOARJO
RUMKITBAN SIDOARJO
RSUD SIDOARJO
RUMKITBAN SIDOARJO
RS MATA FATMA SIDOARJO
RSI Siti Hajar
RUMKITBAN SIDOARJO
RUMKITBAN SIDOARJO
RUMKITBAN SIDOARJO
RSUD SIDOARJO
RUMKITBAN SIDOARJO
RSI Siti Hajar
RSI Siti Hajar
RUMKITBAN SIDOARJO
RUMKITBAN SIDOARJO
RSUD SIDOARJO
RUMKITBAN SIDOARJO
RUMKITBAN SIDOARJO
RSI Siti Hajar
RSUD SIDOARJO
RSI Siti Hajar
RSUD SIDOARJO
RSUD SIDOARJO
RSI Siti Hajar
RS SITI KHODIJAH
RSI Siti Hajar
RUMKITBAN SIDOARJO
RSUD SIDOARJO
RSUD SIDOARJO
RSUD SIDOARJO
RUMKITBAN SIDOARJO
RSI Siti Hajar
RSI Siti Hajar
RSI Siti Hajar
RSI Siti Hajar
RSUD SIDOARJO
RS AISYIYAH SITI FATIMAH
RUMKITBAN SIDOARJO
RUMKITBAN SIDOARJO
RSI Siti Hajar
RSI Siti Hajar
RUMKITBAN SIDOARJO
RUMKITBAN SIDOARJO
RUMKITBAN SIDOARJO
RSUD SIDOARJO
RUMKITBAN SIDOARJO
RSUD SIDOARJO
DENKESYAH 05.04.04 SURABAYA
FKTP KLINIK DKT 02 SIDOARJO
LAPORAN RUJUKAN BULAN FEBRUARI 2018
TANGGAL NAMA PASIEN NO BPJS
2/1/2018 ITA ROSITA 1306881088
TRIANIWATIK AS 1838189856
2/2/2018 CHAIRINA WIRNA 159016149
LUSIANA TAHALELE 1102431532
SUTRISNO HADI 1103382887
YAYUK YULIANI 1103578514
ANIK HANDAYANI 1109732804
ELLY MAHTURO 1472926825
ch wasiah 1871219518
anissah setianingrum 1875895637
MUHAMMAD RAFIF ANDRIANSYA 1895592767
hj. nurdjannah, ba 2036348965
laily hidayati, se 2036349606
GALIH DEANDRA AGUNG PRAWI 2086870724
2/3/2018
DIAGNOSA
Amenorrhoea, unspecified
Necrosis of pulp
Other chronic renal failure
Cystic fibrosis
Lumbago with sciatica
Cervical root disorders, not elsewhere classified, Carpal tunnel syndrome
Fracture of shaft of tibia, Stiffness of joint, not elsewhere classified
secondary hypertension, unspecified
Non-insulin-dependent diabetes mellitus with multi
Non-insulin-dependent diabetes mellitus with unspe
Dissociative motor disorders
Non-insulin-dependent diabetes mellitus with multi, Calculus of kidney
Non-insulin-dependent diabetes mellitus with multi
Nausea and vomiting
RUMAH SAKIT
RUMKITBAN SIDOARJO
RUMKITBAN SIDOARJO
RSUD SIDOARJO
RUMKITBAN SIDOARJO
RSUD SIDOARJO
RSUD SIDOARJO
RSUD SIDOARJO
RUMKITBAN SIDOARJO
RUMKITBAN SIDOARJO
RUMKITBAN SIDOARJO
RSI Siti Hajar
RSI Siti Hajar
RSI Siti Hajar
RUMKITBAN SIDOARJO
DENKESYAH 05.04.04 SURABAYA
FKTP KLINIK DKT 02 SIDOARJO
LAPORAN RUJUKAN BULAN MARET 2018
TANGGAL NAMA PASIEN NO BPJS
3/1/2018 DENNY FIRMANSYAH 1102349114
LULUK EKA ENDRAWATI 1327657105
ANIK SUHARTINI 1383061847
SATIMIN 1383061689
HARI SUTANTO 1449720011
NUR KHOLIFAH 1454180962
imam subari 2076826487
nur fadhilah 2076826869
BILQIS RAMADHANI AL-GOZALI 2259725128
3/2/2018 DENNY FIRMANSYAH 1102349114
IMROATUS SOLIHAH 1107983957
MOH SYAMSUL HUDHA 1438300552
NANIA AYU LESTARI 1462197374
NURDIYANTO 1475971075
ST QOMARIAH 1733624447
EKO MURDJITO 1844486482
SIAMI 2211197804
SAMORA REBECCA HALIM 2304778882
aqila bilvania meynanda 2217122043
3/3/2018
DIAGNOSA
Other urethritis
Disorder of refraction, unspecified
Non-insulin-dependent diabetes mellitus with multi
Otitis externa, unspecified
Dizziness and giddiness
Excessive and frequent menstruation with regular c
Stroke, not specified as haemorrhage or infarction
Inflammatory polyneuropathy, unspecified
Gastro-oesophageal reflux disease without oesophag
Other and unspecified hydronephrosis
Disorder of refraction, unspecified
Insulin-dependent diabetes mellitus with unspecifi, Secondary hypertension
Paratyphoid fever, unspecified
Arthrosis, unspecified
Disorder of refraction, unspecified, Hyperuricaemia without signs of inflammatory
Disorder of refraction, unspecified
Secondary hypertension, unspecified, Hypertensive heart and renal disease, unspecified
Diarrhoea and gastroenteritis of presumed infectio
Typhoid and paratyphoid fevers
RUMAH SAKIT
RSI Siti Hajar
RSUD SIDOARJO
RUMKITBAN SIDOARJO
RSI Siti Hajar
RUMKITBAN SIDOARJO
RUMKITBAN SIDOARJO
RSI Siti Hajar
RSI Siti Hajar
RSI Siti Hajar
RSUD SIDOARJO
RS MATA FATMA SIDOARJO
RUMKITBAN SIDOARJO
RUMKITBAN SIDOARJO
RUMKITBAN SIDOARJO
RSI Siti Hajar
RSI Siti Hajar
RUMKITBAN SIDOARJO
RSI Siti Hajar
RUMKITBAN SIDOARJO
DENKESYAH 05.04.04 SURABAYA
FKTP KLINIK DKT 02 SIDOARJO
LAPORAN RUJUKAN BULAN APRIL 2018
TANGGAL NAMA PASIEN NO BPJS DIAGNOSA RUMAH SAKIT
2/14/2018SRIE WULAN AGUSTYNA 0000102634525 Malformation of placenta RUMKITBAN SIDOARJO
DESAK PUTU DEWI KUSUMA WATI 0001109574099 Gastritis, unspecifiedRUMKITBAN SIDOARJO
GIOVANNI WIDYATMOKO 0001180199799 Necrosis of pulp RUMKITBAN SIDOARJO
LAFASYA PUTRIE HAGASTA 0001306882203 Disorder of arteries and arter
RSUD SIDOARJO
RIRIN JUNI LIANTI 0001313222422 Necrosis of pulp Tahun Utama/ Tangg
RUMKITBAN SIDOARJO
YASINTA DEWI ANGRAENI 0001313222769 Necrosis of pulp RUMKITBAN SIDOARJO
YUYUN ANA'S 0001327863666 Necrosis of pulp RUMKITBAN SIDOARJO
TUTY RAHMAWATI 0001459458426 Other benign neoplasm of uterus, RSUD SIDOARJO
SUS HARTuTIK 0001537940801 Arthrosis, unspecified, Acute nasophary
RSUD SIDOARJO