Excel

<h2>DATA DIAGNOSIS PASIEN PUSKESMAS</h2>
Periode : 01-02-2019 s/d 28-02-2019<br>

<table class='grid' border='1'>
<tr>
<th>Kode Penyakit</th>
<th>Nama Diagnosis</th>
<th>ICDX</th>
<th>No.<br>Registrasi</th>
<th>No.Index</th>
<th>Tanggal</th>
<th>Nama</th>
<th>NamaKK</th>
<th>Pekerjaan</th>
<th>Alamat</th>
<th>Dusun</th>
<th>Desa</th>
<th>Tempat Periksa</th>
<th>Petugas Medis</th>
<th>Perawat Bidan</th>
<th>JK</th>
<th>Kelompok<br>Umur</th>
<th>Pengirim</th>
<th>Kunjungan</th>
<th>Jenis<br>Pasien</th>
<th>Tindak<br>Lanjut</th>
<th>Hari</th>
<th>Bulan</th>
<th>Tahun</th>
<th>Unit</th>
<th>Poli Rujuk</th>
<th>Rumah Sakit</th>
<th>Wilayah</th>
<th>Kartu Sehat</th>
<th>NIK</th>
<th>Systole</th>
<th>Diastole</th>
</tr><tr><td align='right'>J11.8</td><td>Influenza with
other manifestations, virus not identified</td><td></td><td
align='right'>287798</td><td align='right'>55010027</td><td>01-02-2019</td><td>AJI
PRASETIO</td><td>PANAN 0501 P 05</td><td>PELAJAR/MAHASISWA</td><td>GIRIBELAH
RT02 RW07</td><td>GIRIBELAH</td><td>JATIREJO</td><td>INDUK</td><td>dr. BUDI
ASHARI</td><td>SUWARTO,S.Kep.Nes</td><td>L</td><td>10-14 Thn.</td><td>Datang
Sendiri</td><td>Lama</td><td>BPJS PBI</td><td>Rajal</td><td
align='right'>25</td><td align='right'>6</td><td align='right'>12</td><td>BP.
Umum</td><td></td><td></td><td>Dalam
Wilayah</td><td>'0000563855703</td><td>'3312022108620001</td><td>110</td><td>80</td
></tr><tr><td align='right'>J11.8</td><td>Influenza with other manifestations,
virus not identified</td><td></td><td align='right'>287831</td><td
align='right'>56060114</td><td>01-02-2019</td><td>ARFA TIZA DARA
JELITA</td><td>HERMAWAN 0606 H 05</td><td>PELAJAR/MAHASISWA</td><td>GOBOH RT02
RW06</td><td></td><td>GIRITONTRO</td><td>INDUK</td><td>dr. BUDI
ASHARI</td><td>SUWARTO,S.Kep.Nes</td><td>P</td><td>5-9 Thn.</td><td>Datang
Sendiri</td><td>Lama</td><td>UMUM WONOGIRI</td><td>Rajal</td><td
Wilayah</td><td>'</td><td>'3312024411100001</td><td>120</td><td>80</td></tr><tr><td
align='right'>J11.8</td><td>Influenza with other manifestations, virus not
identified</td><td></td><td align='right'>287809</td><td
align='right'>56020244</td><td>01-02-2019</td><td>ARIFA</td><td>MARIMIN 0602 M
01</td><td>BELUM/TIDAK BEKERJA</td><td>GIRITONTRO KIDUL RT04
RW03</td><td>GIRITONTRO KIDUL</td><td>GIRITONTRO</td><td>INDUK</td><td>dr. BUDI
Sendiri</td><td>Lama</td><td>Umum</td><td>Rajal</td><td align='right'>21</td><td
align='right'>7</td><td align='right'>5</td><td>BP.
Wilayah</td><td>'</td><td>'</td><td>110</td><td>80</td></tr><tr><td
align='right'>56010227</td><td>01-02-2019</td><td>ARIS SURYANI</td><td>SUGIYANTO
06 01 S 17</td><td>MENGURUS RUMAH TANGGA</td><td>GIRITONTRO LOR RT01 RW
01</td><td>GIRITONTRO LOR</td><td>GIRITONTRO</td><td>INDUK</td><td>dr. BUDI
align='right'>H82</td><td>Vertiginous syndromes in diseases classified
elsewhere</td><td></td><td align='right'>289275</td><td
align='right'>52077015</td><td>01-02-
2019</td><td>BANU</td><td>HARNO</td><td>PETANI/PEKEBUN</td><td>SUMBERJO</td><td>SUM
BERJO</td><td>TLOGOSARI</td><td>PUSTU TLOGOSARI</td><td>SULARNO,S.Kep.Ns</td><td> -
</td><td>L</td><td>10-14 Thn.</td><td>Datang Sendiri</td><td>Lama</td><td>UMUM
WONOGIRI</td><td>Rajal</td><td align='right'>15</td><td align='right'>2</td><td
align='right'>11</td><td>BP. Umum</td><td></td><td></td><td>Dalam
align='right'>M13.9</td><td>Arthritis, unspecified</td><td></td><td
align='right'>289277</td><td align='right'>52077002</td><td>01-02-
2019</td><td>BOINEM</td><td>PONIJAN</td><td>PETANI/PEKEBUN</td><td>SUMBERJO</td><td
>SUMBERJO</td><td>TLOGOSARI</td><td>PUSTU
TLOGOSARI</td><td>SULARNO,S.Kep.Ns</td><td> - </td><td>P</td><td>60-69
Thn.</td><td>Datang Sendiri</td><td>Lama</td><td>BPJS PBI</td><td>Rajal</td><td
align='right'>57150074</td><td>01-02-2019</td><td>CRISTIYAN ALAN
SAPUTRA</td><td>SUGIYARNO 0715 S 16</td><td>PELAJAR/MAHASISWA</td><td>SAWIT KIDUL
RT02 RW14</td><td>SAWIT KIDUL</td><td>PUCANGANOM</td><td>INDUK</td><td>dr. BUDI
Sendiri</td><td>Baru</td><td>BPJS PBI</td><td>Rajal</td><td
></tr><tr><td align='right'>H58.8</td><td>Other specified disorders of eye and
adnexa in diseases classified elsewhere</td><td></td><td
2019</td><td>DASRI</td><td>DASRI 06 01 D 01</td><td>PEDAGANG</td><td>GIRITONTRO
LOR RT 02 RW 02</td><td>GIRITONTRO LOR</td><td>GIRITONTRO</td><td>INDUK</td><td>dr.
BUDI ASHARI</td><td>SUWARTO,S.Kep.Nes</td><td>L</td><td>55-59 Thn.</td><td>Datang
Sendiri</td><td>Lama</td><td>BPJS NON PBI</td><td>Rujuk</td><td
align='right'>57030267</td><td>01-02-2019</td><td>DEWI PUJIANTI</td><td>MISNO 07
03 M 18</td><td>KARYAWAN SWASTA</td><td>KUWANG RT 02 RW
06</td><td>KUWANG</td><td>PUCANGANOM</td><td>INDUK</td><td>dr. BUDI
align='right'>N34.3</td><td>Urethral syndrome, unspecified</td><td></td><td
align='right'>287813</td><td align='right'>56020204</td><td>01-02-2019</td><td>DWI
SASONGKO</td><td>DWI SASONGKO 0602 D 01</td><td>KARYAWAN SWASTA</td><td>GIRITONTRO
KIDUL RT02 RW03</td><td>GIRITONTRO
KIDUL</td><td>GIRITONTRO</td><td>INDUK</td><td>dr. BUDI
Sendiri</td><td>Baru</td><td>BPJS NON PBI</td><td>Rujuk</td><td
align='right'>57040063</td><td>01-02-2019</td><td>ECA</td><td>SARDI 0704 S
33</td><td></td><td>MANDEYAN</td><td>MANDEYAN</td><td>PUCANGANOM</td><td>INDUK</td>
<td>dr. BUDI ASHARI</td><td>SUWARTO,S.Kep.Nes</td><td>P</td><td>5-9
Thn.</td><td>Datang Sendiri</td><td>Lama</td><td>Umum</td><td>Rajal</td><td
align='right'>53025056</td><td>01-02-2019</td><td>ELVIRA MARRIANA
P</td><td>SUMARNO</td><td>BELUM/TIDAK
BEKERJA</td><td>SAMBIREJO</td><td>SAMBIREJO</td><td>TLOGOHARJO</td><td>PKD
TLOGOHARJO</td><td>SRI SUPATMI</td><td> - </td><td>P</td><td>1-4
Thn.</td><td>Datang Sendiri</td><td>Lama</td><td>UMUM
></tr><tr><td align='right'>N60.9</td><td>Benign mammary dysplasia,
unspecified</td><td></td><td align='right'>287828</td><td
align='right'>56100342</td><td>01-02-2019</td><td>ENDANG PRASTUTI</td><td>SLAMET
WIDODO 0610 S 58</td><td>PEDAGANG</td><td>TANGGUNG
04/05</td><td>TANGGUNG</td><td>GIRITONTRO</td><td>INDUK</td><td>dr. BUDI
></tr><tr><td align='right'>D69.0</td><td>Allergic purpura</td><td></td><td
2019</td><td>EXEL</td><td>BUDI SANTOSO 0703 B 07</td><td>BELUM/TIDAK
BEKERJA</td><td>KUWANG RT 04 RW
ASHARI</td><td>RISTINA Amd Keb</td><td>L</td><td>1-4 Thn.</td><td>Datang
align='right'>20</td><td align='right'>9</td><td
align='right'>4</td><td>KIA</td><td></td><td></td><td>Dalam
align='right'>57050205</td><td>01-02-2019</td><td>FANI AQILA
SALSABILA</td><td>LUKMAN EFFENDI 0705 L 01</td><td></td><td>SUKOROYOM
KULON</td><td></td><td>PUCANGANOM</td><td>INDUK</td><td>dr. BUDI
ASHARI</td><td>RISTINA Amd Keb</td><td>P</td><td>1-4 Thn.</td><td>Datang
Sendiri</td><td>Lama</td><td>BPJS NON PBI</td><td>Rajal</td><td
Wilayah</td><td>'0001834631537</td><td>'3312026609140001</td><td>80</td><td>50</td>
</tr><tr><td align='right'>K00.6</td><td>Disturbances in tooth
eruption</td><td></td><td align='right'>287819</td><td
align='right'>57060113</td><td>01-02-2019</td><td>FIRDAUSA AKBAR</td><td>EKO
TAMTOMO 0706 E 01</td><td>BELUM/TIDAK
BEKERJA</td><td>TAMBAHSARI</td><td>TAMBAHSARI</td><td>PUCANGANOM</td><td>INDUK</td>
<td>drg.DANAR WULANDARI</td><td>RIZKI ANISSA, AM.Kg</td><td>L</td><td>5-9
align='right'>7</td><td>BP. Gigi</td><td></td><td></td><td>Dalam
align='right'>0208</td><td>01-02-
2019</td><td>IHSAN</td><td></td><td>PELAJAR/MAHASISWA</td><td>TLOGOSARI</td><td>TLO
GOSARI</td><td>TLOGOSARI</td><td>PUSTU TLOGOSARI</td><td>SULARNO,S.Kep.Ns</td><td>
- </td><td>L</td><td>5-9 Thn.</td><td>Datang Sendiri</td><td>Baru</td><td>UMUM
align='right'>K40.9</td><td>Unilateral or unspecified inguinal hernia, without
obstruction or gangrene</td><td></td><td align='right'>287821</td><td
align='right'>56060139</td><td>01-02-2019</td><td>ISTIYARSO</td><td>ISTIYARSO
0606 I 01</td><td>WIRASWASTA</td><td>GOBOH RT 03 RW
06</td><td>GOBOH</td><td>GIRITONTRO</td><td>INDUK</td><td>dr. BUDI
Sendiri</td><td>Lama</td><td>BPJS PBI</td><td>Rajal</td><td align='right'></td><td
></tr><tr><td align='right'>K29.7</td><td>Gastritis, unspecified</td><td></td><td
2019</td><td>KARMI</td><td></td><td>PETANI/PEKEBUN</td><td>TLOGOSARI</td><td>TLOGOS
ARI</td><td>TLOGOSARI</td><td>PUSTU TLOGOSARI</td><td>SULARNO,S.Kep.Ns</td><td> -
</td><td>P</td><td>55-59 Thn.</td><td>Datang Sendiri</td><td>Lama</td><td>BPJS
PBI</td><td>Rajal</td><td align='right'>19</td><td align='right'>11</td><td
Wilayah</td><td>'0000565127785</td><td>'</td><td>130</td><td>80</td></tr><tr><td
align='right'>S81</td><td>Open wound of lower leg</td><td></td><td
2019</td><td>KARNO</td><td>KARNO 06 08 K
10</td><td>PETANI/PEKEBUN</td><td>DUNGKLEPU WETAN RT 01 RW 04</td><td>DUNG KLEPU
WETAN</td><td>GIRITONTRO</td><td>INDUK</td><td>dr. BUDI
Wilayah</td><td>'0002469479231</td><td>'3312022211590001</td><td>160</td><td>100</t
d></tr><tr><td align='right'>R51</td><td>Headache</td><td></td><td
2019</td><td>KASANAH</td><td></td><td>MENGURUS RUMAH
TANGGA</td><td>NGELO</td><td>NGELO</td><td>TLOGOSARI</td><td>PUSTU
align='right'>K05.3</td><td>Chronic periodontitis</td><td></td><td
2019</td><td>KATIJO</td><td>KATIJO 01 01 K 05</td><td>PETANI/PEKEBUN</td><td>PELET
RT01RW 02</td><td>PELET</td><td>NGARGOHARJO</td><td>INDUK</td><td>dr. BUDI
Sendiri</td><td>Lama</td><td>BPJS PBI</td><td>internal rujukan</td><td
Gigi</td><td></td><td></td><td>Dalam
2019</td><td>KATIJO</td><td>KATIJO 01 01 K 05</td><td>PETANI/PEKEBUN</td><td>PELET
RT01RW 02</td><td>PELET</td><td>NGARGOHARJO</td><td>INDUK</td><td>dr. BUDI
align='right'>I11.9</td><td>Hypertensive heart disease without (congestive) heart
failure</td><td></td><td align='right'>287812</td><td
align='right'>57020049</td><td>01-02-2019</td><td>KATINAH</td><td>SAIMIN 0702 S
15</td><td>PETANI/PEKEBUN</td><td>SUKOROYOM WETAN</td><td>SUKOROYOM
WETAN</td><td>PUCANGANOM</td><td>INDUK</td><td>dr. BUDI
d></tr><tr><td align='right'>M13.9</td><td>Arthritis, unspecified</td><td></td><td
2019</td><td>KATINAH</td><td>KATINAH</td><td>PETANI/PEKEBUN</td><td>GLAGAH</td><td>
GLAGAH</td><td>TLOGOSARI</td><td>PUSTU TLOGOSARI</td><td>SULARNO,S.Kep.Ns</td><td>
- </td><td>P</td><td>>70 Thn.</td><td>Datang Sendiri</td><td>Lama</td><td>BPJS
Wilayah</td><td>'0000564946716</td><td>'3312025708510001</td><td>1</td><td>1</td></
tr><tr><td align='right'>M13.9</td><td>Arthritis, unspecified</td><td></td><td
2019</td><td>KATINEM</td><td>NYOTO</td><td>PETANI/PEKEBUN</td><td>GLAGAH</td><td>GL
AGAH</td><td>TLOGOSARI</td><td>PUSTU TLOGOSARI</td><td>SULARNO,S.Kep.Ns</td><td> -
</td><td>P</td><td>55-59 Thn.</td><td>Datang Sendiri</td><td>Lama</td><td>UMUM
align='right'>K29.7</td><td>Gastritis, unspecified</td><td></td><td
align='right'>55010112</td><td>01-02-2019</td><td>KATMI</td><td>SAMIDI DARYONO
0501 S 43</td><td>MENGURUS RUMAH TANGGA</td><td>GIRIBELAH RT04
RW05</td><td>GIRIBELAH</td><td>JATIREJO</td><td>INDUK</td><td>dr. BUDI
d></tr><tr><td align='right'>R51</td><td>Headache</td><td></td><td
align='right'>289243</td><td align='right'>52057079</td><td>01-02-2019</td><td>M
RISKI</td><td></td><td>PETANI/PEKEBUN</td><td>GLAGAH</td><td>GLAGAH</td><td>TLOGOSA
RI</td><td>PUSTU TLOGOSARI</td><td>SULARNO,S.Kep.Ns</td><td> -
</td><td>L</td><td>20-44 Thn.</td><td>Datang
Sendiri</td><td>Baru</td><td>Umum</td><td>Rajal</td><td align='right'>25</td><td
RISKI</td><td></td><td>PETANI/PEKEBUN</td><td>GLAGAH</td><td>GLAGAH</td><td>TLOGOSA
RI</td><td>PUSTU TLOGOSARI</td><td>SULARNO,S.Kep.Ns</td><td> -
</td><td>L</td><td>20-44 Thn.</td><td>Datang
align='right'>J45.9</td><td>Asthma, unspecified</td><td></td><td
2019</td><td>MIJEM</td><td>RAHMANTO</td><td>PETANI/PEKEBUN</td><td>TLOGO</td><td>TL
OGO</td><td>TLOGOHARJO</td><td>PKD TLOGOHARJO</td><td>SRI
SUPATMI</td><td> - </td><td>P</td><td>45-54 Thn.</td><td>Datang
align='right'>53015101</td><td>01-02-
2019</td><td>MINTOREJO</td><td>MINTOREJO</td><td>PETANI/PEKEBUN</td><td>TLOGO</td><
td>TLOGO</td><td>TLOGOHARJO</td><td>PKD TLOGOHARJO</td><td>SRI SUPATMI</td><td> -
</td><td>L</td><td>55-59 Thn.</td><td>Datang Sendiri</td><td>Lama</td><td>BPJS
></tr><tr><td align='right'>I10</td><td>Essential (primary)
hypertension</td><td></td><td align='right'>289280</td><td
align='right'>53015101</td><td>01-02-
2019</td><td>MINTOREJO</td><td>MINTOREJO</td><td>PETANI/PEKEBUN</td><td>TLOGO</td><
td>TLOGO</td><td>TLOGOHARJO</td><td>PKD TLOGOHARJO</td><td>SRI SUPATMI</td><td> -
></tr><tr><td align='right'>M13.9</td><td>Arthritis, unspecified</td><td></td><td
2019</td><td>MISNEM</td><td>TUKINO</td><td>PETANI/PEKEBUN</td><td>SALAM</td><td>SAL
AM</td><td>TLOGOSARI</td><td>PUSTU TLOGOSARI</td><td>SULARNO,S.Kep.Ns</td><td> -
tr><tr><td align='right'>J11.8</td><td>Influenza with other manifestations, virus
not identified</td><td></td><td align='right'>287810</td><td
align='right'>57020154</td><td>01-02-2019</td><td>MUHAMMAD BAYU DWI
NUGROHO</td><td>RIYANTO 07 02 R 02</td><td>PELAJAR/MAHASISWA</td><td>SUKOROYOM
WETAN</td><td>SUKOROYOM WETAN</td><td>PUCANGANOM</td><td>INDUK</td><td>dr. BUDI
></tr><tr><td align='right'>F20.6</td><td>Simple schizophrenia</td><td></td><td
2019</td><td>MULYANI</td><td>SIHONO 0211 S 17</td><td>LAINNYA</td><td>TAMBAK RT01
RW02</td><td>TAMBAK</td><td>TLOGOSARI</td><td>INDUK</td><td>dr. BUDI
></tr><tr><td align='right'>I11.9</td><td>Hypertensive heart disease without
(congestive) heart failure</td><td></td><td align='right'>287808</td><td
align='right'>57030228</td><td>01-02-2019</td><td>NARSI</td><td>SUNARSI 07 03 S
30</td><td>PETANI/PEKEBUN</td><td>KUWANG RT 03 RW
Sendiri</td><td>Lama</td><td>BPJS PBI</td><td>Rujuk</td><td
d></tr><tr><td align='right'>J11.8</td><td>Influenza with other manifestations,
align='right'>54070016</td><td>01-02-2019</td><td>NELA A Y</td><td>SANTOSO 0407 S
10</td><td>MENGURUS RUMAH TANGGA</td><td>NGALURAN RT01
RW05</td><td>NGALURAN</td><td>BAYEMHARJO</td><td>INDUK</td><td>dr. BUDI
></tr><tr><td align='right'>M06.9</td><td>Rheumatoid arthritis,
align='right'>52115010</td><td>01-02-
2019</td><td>PARNI</td><td>TUSNI</td><td>PETANI/PEKEBUN</td><td>TAMBAK</td><td>TAMB
AK</td><td>TLOGOSARI</td><td>PKD TLOGOSARI</td><td>RETNO AMBARWATI AMD KEB</td><td>
- </td><td>P</td><td>60-69 Thn.</td><td>Datang Sendiri</td><td>Lama</td><td>UMUM
align='right'>57050099</td><td>01-02-2019</td><td>PARTIYEM</td><td>PARTIYEM 07 05
P 01</td><td>PETANI/PEKEBUN</td><td>SUKOROYOM KULON RT03 RW03</td><td>SUKOROYOM
KULON</td><td>PUCANGANOM</td><td>INDUK</td><td>dr. BUDI
d></tr><tr><td align='right'>M13.9</td><td>Arthritis, unspecified</td><td></td><td
2019</td><td>PONEM</td><td>PONEM</td><td>PETANI/PEKEBUN</td><td>PORO</td><td>PORO</
td><td>TLOGOSARI</td><td>PUSTU TLOGOSARI</td><td>SULARNO,S.Kep.Ns</td><td> -
</td><td>P</td><td>>70 Thn.</td><td>Datang Sendiri</td><td>Lama</td><td>BPJS NON
></tr><tr><td align='right'>K29.6</td><td>Other gastritis</td><td></td><td
2019</td><td>PONIYAH</td><td>KARJO 0402 K
02</td><td>PETANI/PEKEBUN</td><td>NGUNDUK RT01
RW06</td><td>NGUNDUK</td><td>BAYEMHARJO</td><td>INDUK</td><td>dr. BUDI
Sendiri</td><td>Baru</td><td>BPJS NON PBI</td><td>Rajal</td><td
d></tr><tr><td align='right'>I11.9</td><td>Hypertensive heart disease without
align='right'>54020028</td><td>01-02-2019</td><td>PONIYAH</td><td>KARJO 0402 K
d></tr><tr><td align='right'>K02.1</td><td>Caries of dentine</td><td></td><td
2019</td><td>PURWANTI</td><td>YUDIANTO</td><td>PETANI/PEKEBUN</td><td>TLOGOSARI</td
><td>TLOGOSARI</td><td>TLOGOSARI</td><td>PUSTU
align='right'>57090119</td><td>01-02-2019</td><td>REBIYEM</td><td>REBIYEM 07 09 R
02</td><td>PETANI/PEKEBUN</td><td>PUCANGANOM LOR</td><td>PUCANGANOM
LOR</td><td>PUCANGANOM</td><td>INDUK</td><td>dr. BUDI
ASHARI</td><td>SUWARTO,S.Kep.Nes</td><td>P</td><td>>70 Thn.</td><td>Datang
d></tr><tr><td align='right'>K12.1</td><td>Other forms of
stomatitis</td><td></td><td align='right'>289241</td><td
align='right'>0213</td><td>01-02-2019</td><td>RENAN</td><td></td><td>BELUM/TIDAK
BEKERJA</td><td>KERJO</td><td>KERJO</td><td>TLOGOSARI</td><td>PUSTU
TLOGOSARI</td><td>SULARNO,S.Kep.Ns</td><td> - </td><td>L</td><td>1-4
align='right'>M43.6</td><td>Torticollis</td><td></td><td
2019</td><td>SAMINAH</td><td>SUTARNO</td><td>PETANI/PEKEBUN</td><td>SUMBERJO</td><t
d>SUMBERJO</td><td>TLOGOSARI</td><td>PUSTU
Thn.</td><td>Datang Sendiri</td><td>Lama</td><td>BPJS NON PBI</td><td>Rajal</td><td
2019</td><td>SARMINI</td><td>SARMINI</td><td>PETANI/PEKEBUN</td><td>TLOGOSARI</td><
td>TLOGOSARI</td><td>TLOGOSARI</td><td>PUSTU
></tr><tr><td align='right'>E11.9</td><td>Non-insulin-dependent diabetes mellitus
without complications</td><td></td><td align='right'>287802</td><td
align='right'>55070015</td><td>01-02-2019</td><td>SARNI</td><td>TUKINO 0507 T
01</td><td>PETANI/PEKEBUN</td><td>NGELOSARI RT 01 RW
03</td><td>NGELOSARI</td><td>JATIREJO</td><td>INDUK</td><td>dr. BUDI
align='right'>53015080</td><td>01-02-
2019</td><td>SARNI</td><td>PAWIROREJO</td><td>PETANI/PEKEBUN</td><td>TLOGO</td><td>
TLOGO</td><td>TLOGOHARJO</td><td>PKD TLOGOHARJO</td><td>SRI SUPATMI</td><td> -
align='right'>54065103</td><td>01-02-2019</td><td>SARWADI</td><td>SARWADI 04 06 S
05</td><td>PETANI/PEKEBUN</td><td>BAYEM RT 02 RW
01</td><td>BAYEM</td><td>BAYEMHARJO</td><td>INDUK</td><td>dr. BUDI
></tr><tr><td align='right'>K02.1</td><td>Caries of dentine</td><td></td><td
2019</td><td>SEPTYAN TRI HANDIKA</td><td></td><td>BELUM/TIDAK
BEKERJA</td><td>SALAM</td><td>SALAM</td><td>TLOGOSARI</td><td>PUSTU
tr><tr><td align='right'>G43.9</td><td>Migraine, unspecified</td><td></td><td
align='right'>289276</td><td align='right'>52027039</td><td>01-02-2019</td><td>SITI
HARYANI</td><td></td><td>MENGURUS RUMAH
TANGGA</td><td>MANTANG</td><td>MANTHANG</td><td>TLOGOSARI</td><td>PUSTU
Thn.</td><td>Datang Sendiri</td><td>Baru</td><td>UMUM
align='right'>Z30.8</td><td>Other contraceptive management</td><td></td><td
align='right'>287824</td><td align='right'>57060138</td><td>01-02-2019</td><td>SRI
HANDAYANI</td><td>AGUS RIKY 07 06 A 02</td><td>MENGURUS RUMAH
TANGGA</td><td>TAMBAHSARI RT 02 RW
07</td><td>TAMBAHSARI</td><td>PUCANGANOM</td><td>INDUK</td><td>dr. BUDI
align='right'>57020153</td><td>01-02-2019</td><td>SRI SULASMI</td><td>RIYANTO 07
02 R 02</td><td>PETANI/PEKEBUN</td><td>SUKOROYOM WETAN RT03 RW04</td><td>SUKOROYOM
align='right'>51080039</td><td>01-02-2019</td><td>SUDADI</td><td>SUDADI 0108 S
06</td><td>PETANI/PEKEBUN</td><td>NGADIREJO RT02
RW04</td><td>NGADIREJO</td><td>NGARGOHARJO</td><td>INDUK</td><td>dr. BUDI
align='right'>56050071</td><td>01-02-2019</td><td>SUKATMI</td><td>SUKATMI 0605 S
29</td><td>PETANI/PEKEBUN</td><td>NGUJUNG RT04
d></tr><tr><td align='right'>K29.7</td><td>Gastritis, unspecified</td><td></td><td
2019</td><td>SUKINAH</td><td></td><td>PETANI/PEKEBUN</td><td>TLOGOSARI</td><td>TLOG
OSARI</td><td>TLOGOSARI</td><td>PUSTU TLOGOSARI</td><td>SULARNO,S.Kep.Ns</td><td> -
align='right'>R05</td><td>Cough</td><td></td><td align='right'>289231</td><td
align='right'>52037012</td><td>01-02-
2019</td><td>SULASTRI</td><td>TRIONO</td><td>PETANI/PEKEBUN</td><td>SALAM</td><td>T
LOGOSARI</td><td>TLOGOSARI</td><td>PUSTU
</tr><tr><td align='right'>M13.9</td><td>Arthritis, unspecified</td><td></td><td
2019</td><td>SUPARSO</td><td></td><td>PETANI/PEKEBUN</td><td>GLAGAH</td><td>GLAGAH<
/td><td>TLOGOSARI</td><td>PUSTU TLOGOSARI</td><td>SULARNO,S.Kep.Ns</td><td> -
2019</td><td>SURATI</td><td></td><td>PETANI/PEKEBUN</td><td>MANTANG</td><td>MANTHAN
G</td><td>TLOGOSARI</td><td>PUSTU TLOGOSARI</td><td>SULARNO,S.Kep.Ns</td><td> -
align='right'>289240</td><td
align='right'>52037014</td><td>01-02-
2019</td><td>SUTARNI</td><td></td><td>PETANI/PEKEBUN</td><td>SALAM</td><td>SALAM</t
d><td>TLOGOSARI</td><td>PUSTU TLOGOSARI</td><td>SULARNO,S.Kep.Ns</td><td> -
tr><tr><td align='right'>K08.3</td><td>Retained dental root</td><td></td><td
2019</td><td>SUYATNI</td><td>MUSTAQIM 0714 M
02</td><td>PETANI/PEKEBUN</td><td>PENDEM RT02
RW15</td><td>PENDEM</td><td>PUCANGANOM</td><td>INDUK</td><td>drg.DANAR
WULANDARI</td><td>RIZKI ANISSA, AM.Kg</td><td>P</td><td>20-44 Thn.</td><td>Datang
></tr><tr><td align='right'>K29.5</td><td>Chronic gastritis,
align='right'>56010413</td><td>01-02-2019</td><td>TASNIM AHYA NADLIRAH</td><td>FUAD
HELMI 0601 F 01</td><td>PELAJAR/MAHASISWA</td><td>GIRITONTRO LOR RT 02
RW01</td><td>GIRITONTRO LOR</td><td>GIRITONTRO</td><td>INDUK</td><td>dr. BUDI
></tr><tr><td align='right'>M54.5</td><td>Low back pain</td><td></td><td
2019</td><td>TUKIMIN
KARTONO</td><td>TUKIMIN</td><td>PETANI/PEKEBUN</td><td>TLOGOSARI</td><td>TLOGOSARI<
</td><td>L</td><td>>70 Thn.</td><td>Datang Sendiri</td><td>Lama</td><td>BPJS
2019</td><td>TUKIYEM</td><td></td><td>PETANI/PEKEBUN</td><td>TLOGOSARI</td><td>TLOG
OSARI</td><td>TLOGOSARI</td><td>PUSTU TLOGOSARI</td><td>SULARNO,S.Kep.Ns</td><td> -
</td><td>P</td><td>>70 Thn.</td><td>Datang Sendiri</td><td>Lama</td><td>BPJS
2019</td><td>TUNIYEM</td><td>TUKIJO 06 02 T
11</td><td>PETANI/PEKEBUN</td><td>GIRITONTRO KIDUL</td><td>GIRITONTRO
2019</td><td>WAHYUNI</td><td>PURWANTO</td><td>PETANI/PEKEBUN</td><td>NGELO</td><td>
NGELO</td><td>TLOGOSARI</td><td>PUSTU TLOGOSARI</td><td>SULARNO,S.Kep.Ns</td><td> -
</td><td>P</td><td>20-44 Thn.</td><td>Datang Sendiri</td><td>Lama</td><td>BPJS NON
2019</td><td>WARSINI</td><td>WARDI</td><td>PETANI/PEKEBUN</td><td>TLOGOSARI</td><td
>TLOGOSARI</td><td>TLOGOSARI</td><td>PUSTU
</tr><tr><td align='right'>K01.1</td><td>Impacted teeth</td><td></td><td
2019</td><td>WAWAN PASTYO</td><td>WAWAN PASTYO 0502 W 04</td><td>KARYAWAN
SWASTA</td><td>GIRIROTO RT01
RW06</td><td>GIRIROTO</td><td>JATIREJO</td><td>INDUK</td><td>drg.DANAR
WULANDARI</td><td>RIZKI ANISSA, AM.Kg</td><td>L</td><td>20-44 Thn.</td><td>Datang
</tr><tr><td align='right'>J11.8</td><td>Influenza with other manifestations, virus
align='right'>57030324</td><td>01-02-2019</td><td>ZICCO RENDY PRADANA</td><td>ZICCO
RENDY PRADANA</td><td>KARYAWAN SWASTA</td><td>KUWANG RT03
RW06</td><td>KUWANG</td><td>PUCANGANOM</td><td>INDUK</td><td>dr. BUDI
align='right'>14</td><td align='right'></td><td align='right'>33</td><td>BP.
></tr><tr><td align='right'>H67</td><td>Otitis media in diseases classified
align='right'>57020173</td><td>02-02-2019</td><td>AJI SEPTIANSAH</td><td>SUNARNO
07 02 S 31</td><td>PELAJAR/MAHASISWA</td><td>SUKOROYOM WETAN RT01
RW04</td><td>SUKOROYOM WETAN</td><td>PUCANGANOM</td><td>INDUK</td><td>dr. BUDI
></tr><tr><td align='right'>J45.9</td><td>Asthma, unspecified</td><td></td><td
align='right'>287866</td><td align='right'>56040010</td><td>02-02-2019</td><td>ARIF
SAPUTRA</td><td>TRI RUSMANTO 06 04 T 02</td><td>PELAJAR/MAHASISWA</td><td>KETONGGO
RT 01 RW 07</td><td>KETONGGO</td><td>GIRITONTRO</td><td>INDUK</td><td>dr. BUDI
></tr><tr><td align='right'>K12.1</td><td>Other forms of
align='right'>58080336</td><td>02-02-2019</td><td>DEA ANASTSYA</td><td>TARYANTO
0808 T </td><td>BELUM/TIDAK
BEKERJA</td><td>PULOSARI</td><td></td><td>PRACIMANTORO</td><td>INDUK</td><td>dr.
BUDI ASHARI</td><td>SRI MURWATININGSIH</td><td>P</td><td>1-4 Thn.</td><td>Datang
align='right'>4</td><td>KIA</td><td></td><td></td><td>Luar
align='right'>N89.8</td><td>Other specified noninflammatory disorders of
vagina</td><td></td><td align='right'>287842</td><td
align='right'>53065025</td><td>02-02-2019</td><td>DEWI
MURNI</td><td>MARYONO</td><td>BURUH HARIAN
LEPAS</td><td>KLEPU</td><td>KLEPU</td><td>TLOGOHARJO</td><td>INDUK</td><td>dr. BUDI
ASHARI</td><td>SRI MURWATININGSIH</td><td>P</td><td>20-44 Thn.</td><td>Datang
Sendiri</td><td>Lama</td><td>BPJS PBI</td><td>Rajal</td><td align='right'>1</td><td
align='right'>J45</td><td>Asthma</td><td></td><td align='right'>287858</td><td
align='right'>57070077</td><td>02-02-2019</td><td>DIMIN</td><td>DIMIN 07 07 D
03</td><td>PETANI/PEKEBUN</td><td>BANJAR RT03
RW05</td><td>BANJAR</td><td>PUCANGANOM</td><td>INDUK</td><td>dr. BUDI
Sendiri</td><td>Lama</td><td>JAMKESDA</td><td>Rajal</td><td
Wilayah</td><td>'3312020903510001</td><td>'3312020903510001</td><td>120</td><td>80<
/td></tr><tr><td align='right'>J11.8</td><td>Influenza with other manifestations,
align='right'>52105191</td><td>02-02-2019</td><td>EKA
APRILIA</td><td>MASUDI</td><td>PELAJAR/MAHASISWA</td><td>PORO</td><td>PORO</td><td>
TLOGOSARI</td><td>PKD
TLOGOSARI</td><td>RETNO AMBARWATI AMD KEB</td><td> - </td><td>P</td><td>10-14
align='right'>57160016</td><td>02-02-2019</td><td>FAULANA ARIFIN</td><td>WAKIJA 07
16 W 03</td><td></td><td>SAWIT LOR RT01 RW 13</td><td>SAWIT
align='right'>E11.6</td><td>Non-insulin-dependent diabetes mellitus with other
specified complications</td><td></td><td align='right'>287838</td><td
align='right'>57050353</td><td>02-02-2019</td><td>HARYANTO</td><td>HARYANTO 0705 H
08</td><td>WIRASWASTA</td><td>SUKOROYOM KULON RT01 RW03</td><td>SUKOROYOM
d></tr><tr><td align='right'>I50.9</td><td>Heart failure,
align='right'>55110057</td><td>02-02-2019</td><td>KASIDI</td><td>KASIDI 05 11 K
04</td><td>PETANI/PEKEBUN</td><td>BUWENG RT01
RW05</td><td></td><td>JATIREJO</td><td>INDUK</td><td>dr. BUDI
align='right'>57070113</td><td>02-02-2019</td><td>KASIRAH</td><td>KASIRAH 07 07 K
align='right'>55050086</td><td>02-02-2019</td><td>LATIFAH NUR AFIFAH</td><td>SURADI
0505 S 24</td><td>BELUM/TIDAK
BEKERJA</td><td>PUNUNG</td><td></td><td>JATIREJO</td><td>INDUK</td><td>dr. BUDI
Sendiri</td><td>Lama</td><td>JAMKESDA</td><td>Rajal</td><td align='right'>5</td><td
align='right'>9</td><td align='right'>1</td><td>KIA</td><td></td><td></td><td>Dalam
Wilayah</td><td>'3312026804170001</td><td>'3312026804170001</td><td>70</td><td>60</
td></tr><tr><td align='right'>N34.1</td><td>Nonspecific urethritis</td><td></td><td
2019</td><td>MAMIK MILANINGSIH</td><td>WIDI LISTIONO 0601 W 03</td><td>MENGURUS
RUMAH TANGGA</td><td>GIRITONTRO LOR RT01 RW02</td><td>GIRITONTRO
LOR</td><td>GIRITONTRO</td><td>INDUK</td><td>dr. BUDI
align='right'>K29.5</td><td>Chronic gastritis, unspecified</td><td></td><td
2019</td><td>MARIDI</td><td>JOWO/MARIDI 0602 J
03</td><td>PEDAGANG</td><td>GIRITONTRO KIDUL RT02 RW03</td><td>GIRITONTRO
2019</td><td>MARSINI SUKIYEM</td><td>WARDI 04 08 W
02</td><td>WIRASWASTA</td><td>NGANTAP RT03
RW05</td><td>NGANTAP</td><td>BAYEMHARJO</td><td>INDUK</td><td>dr. BUDI
Sendiri</td><td>Lama</td><td>JAMKESDA</td><td>Rujuk</td><td align='right'>9</td><td
align='right'>4</td><td align='right'>36</td><td>BP. Umum</td><td>Poli
Dalam</td><td>RSUD DR. SOEDIRAN MS WONOGIRI</td><td>Dalam
align='right'>57090110</td><td>02-02-2019</td><td>MAY LUTFI AULIA
ROHMAH</td><td>SRI DARYANTO 0709 S 04</td><td></td><td>PUCANGANOM LOR RT02
RW09</td><td>PUCANGANOM LOR</td><td>PUCANGANOM</td><td>INDUK</td><td>dr. BUDI
align='right'>56050082</td><td>02-02-2019</td><td>MELODY FANELLO EIEVEL
LISGITA</td><td>SULISTYO 0605 S 39</td><td>PELAJAR/MAHASISWA</td><td>NGUJUNG RT03
RW08</td><td>NGUJUNG</td><td>GIRITONTRO</td><td>INDUK</td><td>dr. BUDI
align='right'></td><td align='right'>10</td><td>BP.
align='right'>56030128</td><td>02-02-2019</td><td>MISDI</td><td>MISDI 06 03 M
03</td><td>PETANI/PEKEBUN</td><td>GEBLUG RT 04 RW
07</td><td>GEBLUG</td><td>GIRITONTRO</td><td>INDUK</td><td>dr. BUDI
align='right'>56050048</td><td>02-02-2019</td><td>MUGIYATI</td><td>SULISTYO 06 05
S 39</td><td>MENGURUS RUMAH TANGGA</td><td>NGUJUNG RT 03 RW
08</td><td>NGUJUNG</td><td>GIRITONTRO</td><td>INDUK</td><td>dr. BUDI
align='right'>57095014</td><td>02-02-2019</td><td>MUHAMAD RUSDI</td><td>SRI
DARYANTO 57 09 S 04</td><td></td><td>PUCANGANOM LOR</td><td>PUCANGANOM
align='right'>57050313</td><td>02-02-2019</td><td>NANA ANIS
SETYOWATI</td><td>SOLIKIN 07 05 S 26</td><td>KARYAWAN SWASTA</td><td>SUKOROYOM
KULON RT02 RW03</td><td>SUKOROYOM
KULON</td><td>PUCANGANOM</td><td>INDUK</td><td>dr. BUDI ASHARI</td><td>SRI
MURWATININGSIH</td><td>P</td><td>20-44 Thn.</td><td>Datang
align='right'>A09</td><td>Diarrhoea
and gastroenteritis of presumed infectious origin</td><td></td><td
2019</td><td>NANIK</td><td>SARTO 07 13 S 32</td><td>PETANI/PEKEBUN</td><td>KEPUH
RT02 RW12</td><td>KEPUH</td><td>PUCANGANOM</td><td>INDUK</td><td>dr. BUDI
/td></tr><tr><td align='right'>I11.9</td><td>Hypertensive heart disease without
align='right'>56065002</td><td>02-02-2019</td><td>NGATIYEM</td><td>SUTIYO 06 06 S
04</td><td>PETANI/PEKEBUN</td><td>GOBOH RT 03 RW
d></tr><tr><td align='right'>K00.6</td><td>Disturbances in tooth
align='right'>56010128</td><td>02-02-2019</td><td>REAL HAMMI
YAHYA</td><td>RETOL</td><td></td><td>GIRITONTRO LOR</td><td>GIRITONTRO
LOR</td><td>GIRITONTRO</td><td>INDUK</td><td>drg.DANAR WULANDARI</td><td>RIZKI
ANISSA, AM.Kg</td><td>P</td><td>5-9 Thn.</td><td>Datang
align='right'>56090005</td><td>02-02-2019</td><td>REBO HARJONO</td><td>REBO HARJONO
06 09 R 05</td><td>PETANI/PEKEBUN</td><td>DUNGKLEPU KULON</td><td>DUNG KLEPU
KULON</td><td>GIRITONTRO</td><td>INDUK</td><td>dr. BUDI
align='right'>287833</td><td align='right'>56090005</td><td>02-02-2019</td><td>REBO
HARJONO</td><td>REBO HARJONO 06 09 R 05</td><td>PETANI/PEKEBUN</td><td>DUNGKLEPU
KULON</td><td>DUNG KLEPU KULON</td><td>GIRITONTRO</td><td>INDUK</td><td>dr. BUDI
align='right'>56060074</td><td>02-02-2019</td><td>RIFKI</td><td>SANTOSO 06 06 S
24</td><td>BELUM/TIDAK
BEKERJA</td><td>GOBOH</td><td>GOBOH</td><td>GIRITONTRO</td><td>INDUK</td><td>dr.
align='right'>57040011</td><td>02-02-2019</td><td>SAMIYEM</td><td>SUKIRNO 07 04 S
06</td><td>PETANI/PEKEBUN</td><td>MANDEYAN RT03
RW01</td><td>MANDEYAN</td><td>PUCANGANOM</td><td>INDUK</td><td>dr. BUDI
d></tr><tr><td align='right'>M79.16</td><td>Myalgia, lower leg</td><td></td><td
2019</td><td>SARSI</td><td>WARJI 04 07 W
03</td><td>PELAJAR/MAHASISWA</td><td>NGALURAN RT01 RW
5</td><td>NGALURAN</td><td>BAYEMHARJO</td><td>INDUK</td><td>dr. BUDI
></tr><tr><td align='right'>Z34.8</td><td>Supervision of other normal
pregnancy</td><td></td><td align='right'>287850</td><td
align='right'>56100390</td><td>02-02-2019</td><td>SUKATMI</td><td>MARIDI 06 10 M
14</td><td>MENGURUS RUMAH TANGGA</td><td>TANGGUNG RT01
RW05</td><td>TANGGUNG</td><td>GIRITONTRO</td><td>INDUK</td><td>dr. BUDI
align='right'>K05.1</td><td>Chronic gingivitis</td><td></td><td
2019</td><td>SULARDI</td><td>SUYLARDI 06 05 S
21</td><td>PELAJAR/MAHASISWA</td><td>NGUJUNG RT 04 RW
08</td><td>NGUJUNG</td><td>GIRITONTRO</td><td>INDUK</td><td>drg.DANAR
align='right'>56035036</td><td>02-02-2019</td><td>SULARSI</td><td>MISDI 0603 M
03</td><td>PETANI/PEKEBUN</td><td>GEBLUG RT03
RW07</td><td>GEBLUG</td><td>GIRITONTRO</td><td>INDUK</td><td>dr. BUDI
></tr><tr><td align='right'>N18.9</td><td>Chronic renal failure,
align='right'>55020002</td><td>02-02-2019</td><td>SULARTO</td><td>SULARTO 05 02 S
09</td><td>PENSIUNAN</td><td>GIRIROTO RT01 RW
06</td><td>GIRIROTO</td><td>JATIREJO</td><td>INDUK</td><td>dr. BUDI
align='right'>54080079</td><td>02-02-2019</td><td>SUNARTI</td><td>SURATMAN 04 08 S
18</td><td>PELAJAR/MAHASISWA</td><td>NGANTAP RT02 RW
05,BAYEMHARJO</td><td>NGANTAP</td><td>BAYEMHARJO</td><td>INDUK</td><td>dr. BUDI
></tr><tr><td align='right'>O03.9</td><td>Spontaneous abortion, complete or
unspecified, without complication</td><td></td><td align='right'>287848</td><td
align='right'>57120121</td><td>02-02-2019</td><td>SUPINAH</td><td>WARSIMAN 0712 W
04</td><td>PETANI/PEKEBUN</td><td>NGAK INGUK RT01 RW16</td><td>INGAK -
INGUK</td><td>PUCANGANOM</td><td>INDUK</td><td>dr. BUDI ASHARI</td><td>SRI
Sendiri</td><td>Lama</td><td>UMUM WONOGIRI</td><td>Rujuk</td><td
align='right'>42</td><td>KIA</td><td>Poli Kandungan</td><td>RSUD DR. SOEDIRAN MS
WONOGIRI</td><td>Dalam
2019</td><td>SUPRIADI</td><td>SUPRIADI 07 07 S 37</td><td>KARYAWAN
SWASTA</td><td>BANJAR RT0 3RW
05</td><td>BANJAR</td><td>PUCANGANOM</td><td>INDUK</td><td>dr. BUDI
align='right'>56070078</td><td>02-02-2019</td><td>SURATI</td><td>SUKIYO 0607 S
11</td><td>PETANI/PEKEBUN</td><td>DUNG KANCIL RT01 RW09</td><td>DUNG
KANCIL</td><td>GIRITONTRO</td><td>INDUK</td><td>dr. BUDI
></tr><tr><td align='right'>S51</td><td>Open wound of forearm</td><td></td><td
2019</td><td>SURYANTO</td><td>SURYANTO 06 02 S
06</td><td>PEDAGANG</td><td>GIRITONTRO KIDUL</td><td>GIRITONTRO
align='right'>55100026</td><td>02-02-2019</td><td>SUTANTI</td><td>NURYADI 0510 N
01</td><td>PEDAGANG</td><td>SENGON</td><td>SENGON</td><td>JATIREJO</td><td>INDUK</t
d><td>dr. BUDI ASHARI</td><td>SRI MURWATININGSIH</td><td>P</td><td>20-44
</tr><tr><td align='right'>M79.05</td><td>Rheumatism, unspecified, pelvic region
and thigh</td><td></td><td align='right'>287861</td><td
align='right'>57160035</td><td>02-02-2019</td><td>SUTARMI</td><td>WAGIMAN 0716 W
02</td><td>PETANI/PEKEBUN</td><td>SAWIT LOR</td><td>SAWIT
align='right'>59090485</td><td>02-02-2019</td><td>SUTI</td><td>SUTI 09 09 S
24</td><td>PENSIUNAN</td><td>NAWANGAN RT 02 RW
07</td><td></td><td>GIRIWOYO</td><td>INDUK</td><td>dr. BUDI
Umum</td><td></td><td></td><td>Luar
align='right'>57080059</td><td>02-02-2019</td><td>TIRTONO</td><td>TIRTONO 07 08 T
11</td><td>PETANI/PEKEBUN</td><td>PUCANGANOM KIDUL</td><td>PUCANGANOM
KIDUL</td><td>PUCANGANOM</td><td>INDUK</td><td>dr. BUDI
ASHARI</td><td>SUWARTO,S.Kep.Nes</td><td>L</td><td>>70 Thn.</td><td>Datang
align='right'>55110111</td><td>02-02-2019</td><td>TOKARMO</td><td>TOKARMO 0511 T
RW05</td><td>BUWENG</td><td>JATIREJO</td><td>INDUK</td><td>dr. BUDI
</tr><tr><td align='right'>K29</td><td>Gastritis and duodenitis</td><td></td><td
2019</td><td>TOKARMO</td><td>TOKARMO 0511 T
</tr><tr><td align='right'>F20.6</td><td>Simple schizophrenia</td><td></td><td
align='right'>287851</td><td align='right'>57040045</td><td>02-02-2019</td><td>TRI
WAHYUNINGSIH</td><td>SUKIRNO 07 04 S
06</td><td>PETANI/PEKEBUN</td><td>MANDEYAN</td><td></td><td>PUCANGANOM</td><td>INDU
K</td><td>dr. BUDI ASHARI</td><td>SUWARTO,S.Kep.Nes</td><td>P</td><td>20-44
Thn.</td><td>Datang Sendiri</td><td>Lama</td><td>BPJS PBI</td><td>Rujuk</td><td
align='right'>56020553</td><td>02-02-2019</td><td>TUKILAH</td><td>TUKILAH 5602 T
16</td><td>PETANI/PEKEBUN</td><td>GIRITONTRO KIDUL 02/03</td><td>GIRITONTRO
></tr><tr><td align='right'>J45</td><td>Asthma</td><td></td><td
2019</td><td>WAGINAH</td><td>SOMO 0 7 14 S
RW15</td><td>PENDEM</td><td>PUCANGANOM</td><td>INDUK</td><td>dr. BUDI
align='right'>56045013</td><td>02-02-2019</td><td>WASUR RAHMAH</td><td>TRI RUSMANTO
06 04 T 02</td><td>PELAJAR/MAHASISWA</td><td>KETONGGO RT01 RW
07</td><td>KETONGGO</td><td>GIRITONTRO</td><td>INDUK</td><td>dr. BUDI
></tr><tr><td align='right'>L24.9</td><td>Irritant contact dermatitis, unspecified
cause</td><td></td><td align='right'>287940</td><td
align='right'>57010164</td><td>04-02-2019</td><td>ADLI AHSANUL HAKIM</td><td>ALI
ABAS 07 01 A </td><td>BELUM/TIDAK
BEKERJA</td><td>GROGOL</td><td>GROGOL</td><td>PUCANGANOM</td><td>INDUK</td><td>dr.
BUDI ASHARI</td><td>UMI NUR ISNIATI</td><td>L</td><td>1-4 Thn.</td><td>Datang
align='right'>57050158</td><td>04-02-2019</td><td>ALFIAH</td><td>ALFIAH 07 05 A
02</td><td>PETANI/PEKEBUN</td><td>SUKOROYOM KULON RT 01 RW 03</td><td>SUKOROYOM
ASHARI</td><td>SUGIYONO,S.Kep.Ns</td><td>P</td><td>55-59 Thn.</td><td>Datang
/td></tr><tr><td align='right'>L20.9</td><td>Atopic dermatitis,
align='right'>54060040</td><td>04-02-2019</td><td>ANISA NS</td><td>SARWADI 0406 S
05</td><td>PELAJAR/MAHASISWA</td><td>BAYEM RT02
RW01</td><td>BAYEM</td><td>BAYEMHARJO</td><td>INDUK</td><td>dr. BUDI
Sendiri</td><td>Lama</td><td>BPJS
align='right'>57010247</td><td>04-02-2019</td><td>ANITASYA PUTRI
NAJWA</td><td>SATINO 07 01 S 15</td><td>BELUM/TIDAK BEKERJA</td><td>GROGOLRT 02 RW
02</td><td>GROGOL</td><td>PUCANGANOM</td><td>INDUK</td><td>dr. BUDI
ASHARI</td><td>UMI NUR ISNIATI</td><td>P</td><td>1-4 Thn.</td><td>Datang
align='right'>B00.9</td><td>Herpesviral infection, unspecified</td><td></td><td
2019</td><td>ANJANI AZAHRA</td><td>SULARTO 0306 S 11</td><td>BELUM/TIDAK
BEKERJA</td><td>KLEPU,TLOGOHARJO</td><td>KLEPU</td><td>TLOGOHARJO</td><td>INDUK</td
><td>dr. BUDI ASHARI</td><td>SUGIYONO,S.Kep.Ns</td><td>P</td><td>5-9
align='right'>56010227</td><td>04-02-2019</td><td>ARIS SURYANI</td><td>SUGIYANTO
06 01 S 17</td><td>MENGURUS RUMAH TANGGA</td><td>GIRITONTRO LOR RT01 RW
align='right'>56030105</td><td>04-02-2019</td><td>ARYO PUTRA PRATAMA</td><td>TARIP
0603 T 05</td><td>BELUM/TIDAK BEKERJA</td><td>GEBLUG RT.04
RW.07</td><td>GEDANGAN</td><td>GIRITONTRO</td><td>INDUK</td><td>dr. BUDI
ASHARI</td><td>SUGIYONO,S.Kep.Ns</td><td>L</td><td>5-9 Thn.</td><td>Datang
align='right'>K00.6</td><td>Disturbances in tooth eruption</td><td></td><td
2019</td><td>ASNAN
MAULANA</td><td>TAMPAN</td><td>PELAJAR/MAHASISWA</td><td>PUCANGANOM
KIDUL</td><td>PUCANGANOM KIDUL</td><td>PUCANGANOM</td><td>INDUK</td><td>drg.DANAR
Sendiri</td><td>Lama</td><td>Umum</td><td>internal rujukan</td><td
align='right'>D36.9</td><td>Benign neoplasm of unspecified site</td><td></td><td
2019</td><td>ASNAN
MAULANA</td><td>TAMPAN</td><td>PELAJAR/MAHASISWA</td><td>PUCANGANOM
KIDUL</td><td>PUCANGANOM KIDUL</td><td>PUCANGANOM</td><td>INDUK</td><td>dr. BUDI
align='right'>E11.9</td><td>Non-insulin-dependent diabetes mellitus without
complications</td><td></td><td align='right'>287879</td><td
align='right'>57040001</td><td>04-02-2019</td><td>BOINEM</td><td>SARINO 0704 S
23</td><td>PETANI/PEKEBUN</td><td>MANDEYAN</td><td>MANDEYAN</td><td>PUCANGANOM</td>
<td>INDUK</td><td>dr. BUDI ASHARI</td><td>SUGIYONO,S.Kep.Ns</td><td>P</td><td>55-59
Thn.</td><td>Datang Sendiri</td><td>Lama</td><td>BPJS NON PBI</td><td>Rujuk</td><td
align='right'>57130007</td><td>04-02-2019</td><td>CHACHA</td><td>SUNARYO 0713 S
23</td><td>PELAJAR/MAHASISWA</td><td>KEPUH
RT.01/12</td><td>KEPUH</td><td>PUCANGANOM</td><td>INDUK</td><td>dr. BUDI
/td></tr><tr><td align='right'>R05</td><td>Cough</td><td></td><td
2019</td><td>DANIS ENGGAR PRASETYAPUTRI</td><td></td><td>BELUM/TIDAK
BEKERJA</td><td>SUMBERJO</td><td>SUMBERJO</td><td>TLOGOSARI</td><td>PUSTU
></tr><tr><td align='right'>K04.7</td><td>Periapical abscess without
sinus</td><td></td><td align='right'>287936</td><td
align='right'>59091188</td><td>04-02-2019</td><td>DAVIN DWI ABDULAH</td><td>ABDUL
MAJID 0909 A 04</td><td>BELUM/TIDAK BEKERJA</td><td>NGUDAL RT01
RW08</td><td></td><td>GIRIWOYO</td><td>INDUK</td><td>drg.DANAR
Gigi</td><td></td><td></td><td>Luar
align='right'>K05.2</td><td>Acute periodontitis</td><td></td><td
align='right'>287930</td><td align='right'>52110046</td><td>04-02-2019</td><td>DENI
SAPUTRA </td><td>DENI SAPUTRA 0211 D 04</td><td>KARYAWAN SWASTA</td><td>TAMBAK
RT01 RW02</td><td>TAMBAK</td><td>TLOGOSARI</td><td>INDUK</td><td>drg.DANAR
tr><tr><td align='right'>K04.7</td><td>Periapical abscess without
align='right'>52110046</td><td>04-02-2019</td><td>DENI SAPUTRA </td><td>DENI
SAPUTRA 0211 D 04</td><td>KARYAWAN SWASTA</td><td>TAMBAK RT01
RW02</td><td>TAMBAK</td><td>TLOGOSARI</td><td>INDUK</td><td>drg.DANAR
tr><tr><td align='right'>N90.3</td><td>Dysplasia of vulva,
align='right'>53065025</td><td>04-02-2019</td><td>DEWI MURNI</td><td>MARYONO 0306
M 01</td><td>BURUH HARIAN LEPAS</td><td>KLEPU RT01
RW04</td><td>KLEPU</td><td>TLOGOHARJO</td><td>INDUK</td><td>dr. BUDI
align='right'>288741</td><td align='right'>54065125</td><td>04-02-2019</td><td>DIAN
TRIYANTO</td><td>SUGENG</td><td>PETANI/PEKEBUN</td><td>BAYEM</td><td>BAYEM</td><td>
BAYEMHARJO</td><td>PUSTU BAYEMHARJO</td><td>RISTINA Amd Keb</td><td> -
align='right'>287923</td><td align='right'>51045013</td><td>04-02-2019</td><td>ENI
PURWANTI</td><td>SARWONO 01 04 S 03</td><td>MENGURUS RUMAH TANGGA</td><td>KLEPU RT
04 RW 06</td><td>KLEPU</td><td>NGARGOHARJO</td><td>INDUK</td><td>dr. BUDI
></tr><tr><td align='right'>K00.6</td><td>Disturbances in tooth
align='right'>53080018</td><td>04-02-2019</td><td>EVANSYAH AJI
FALENTINO</td><td>AGUS PURWADI 0308 A 01</td><td>BELUM/TIDAK
BEKERJA</td><td>GINADE KULON</td><td>GINADE
KULON</td><td>TLOGOHARJO</td><td>INDUK</td><td>drg.DANAR WULANDARI</td><td>RIZKI
ANISSA, AM.Kg</td><td>L</td><td>5-9 Thn.</td><td>Datang
align='right'>56020491</td><td>04-02-2019</td><td>EVIENZA QIESHA
AZZAAHRA</td><td>CAHYO 0602 C 03</td><td>BELUM/TIDAK BEKERJA</td><td>GIRITONTRO
KIDUL</td><td>GIRITONTRO</td><td>INDUK</td><td>dr. BUDI ASHARI</td><td>UMI NUR
ISNIATI</td><td>P</td><td>1-4 Thn.</td><td>Datang
2019</td><td>FAISA NINGTYAS</td><td>WATONO /TRIYATNO 06 05 W
01</td><td>PELAJAR/MAHASISWA</td><td>NGUJUNG, RT 03, RW
08</td><td>NGUJUNG</td><td>GIRITONTRO</td><td>INDUK</td><td>drg.DANAR
align='right'>K29.6</td><td>Other gastritis</td><td></td><td
2019</td><td>FIBIA CINTIA RAHMA</td><td>SRIYANTO 0607 S
02</td><td>PELAJAR/MAHASISWA</td><td>DUNGKANCIL RT01 RW09</td><td>DUNG
align='right'>287934</td><td align='right'>57070166</td><td>04-02-2019</td><td>IKA
KURNIA SARI</td><td>SUGENG 0707 S 08</td><td>BURUH HARIAN
LEPAS</td><td>BANJAR</td><td>BANJAR</td><td>PUCANGANOM</td><td>INDUK</td><td>dr.
BUDI ASHARI</td><td>SUGIYONO,S.Kep.Ns</td><td>P</td><td>20-44 Thn.</td><td>Datang
align='right'>H58.8</td><td>Other specified disorders of eye and adnexa in diseases
classified elsewhere</td><td></td><td align='right'>287898</td><td
align='right'>52130071</td><td>04-02-2019</td><td>JAMI</td><td>MISRI 0213 M
04</td><td>PETANI/PEKEBUN</td><td>KERJO RT03 RW
03</td><td>KERJO</td><td>TLOGOSARI</td><td>INDUK</td><td>dr. BUDI
Sendiri</td><td>Baru</td><td>BPJS PBI</td><td>Rujuk</td><td align='right'>3</td><td
align='right'>57050120</td><td>04-02-2019</td><td>JAMIATUN</td><td>SAMIYO 0705 S
22</td><td>PETANI/PEKEBUN</td><td>SUKOROYOM KULON RT01 RW03</td><td>SUKOROYOM
/td></tr><tr><td align='right'>Z35</td><td>Supervision of high-risk
align='right'>57030211</td><td>04-02-2019</td><td>KARMI</td><td>KATIMIN 0703 K
2019</td><td>KARNI</td><td>SAINO</td><td>PETANI/PEKEBUN</td><td>PORO</td><td>PORO</
td><td>TLOGOSARI</td><td>PKD TLOGOSARI</td><td>RETNO AMBARWATI AMD KEB</td><td> -
></tr><tr><td align='right'>A09</td><td>Diarrhoea and gastroenteritis of presumed
infectious origin</td><td></td><td align='right'>287907</td><td
align='right'>51020104</td><td>04-02-2019</td><td>KARTOMO</td><td>KARTOMO 0103 K
06</td><td>PETANI/PEKEBUN</td><td>NGRINGIN RT01
RW01</td><td>NGRINGIN</td><td>NGARGOHARJO</td><td>INDUK</td><td>dr. BUDI
ASHARI</td><td>SUGIYONO,S.Kep.Ns</td><td>L</td><td>>70 Thn.</td><td>Datang
align='right'>51115043</td><td>04-02-
2019</td><td>KASNI</td><td>SUNARDI</td><td>PETANI/PEKEBUN</td><td>BLEBER</td><td>BL
EBER</td><td>NGARGOHARJO</td><td>PKD NGARGOHARJO</td><td>HENI WIDIYASTUTI</td><td>
- </td><td>P</td><td>20-44 Thn.</td><td>Datang
align='right'>54065022</td><td>04-02-
2019</td><td>KATNI</td><td>KATINO</td><td>PETANI/PEKEBUN</td><td>BAYEM</td><td>BAYE
M</td><td>BAYEMHARJO</td><td>PUSTU BAYEMHARJO</td><td>RISTINA Amd Keb</td><td> -
align='right'>A75</td><td>Typhus fever</td><td></td><td
2019</td><td>LIYENSI ENDAH PERMATASARI</td><td>SUTIMAN/SUWARTI 06 09 S
05</td><td>PELAJAR/MAHASISWA</td><td>DUNGKLEPU KULON RT04 RW 04</td><td>DUNG KLEPU
KULON</td><td>GIRITONTRO</td><td>INDUK</td><td>dr. BUDI
</tr><tr><td align='right'>J45.9</td><td>Asthma, unspecified</td><td></td><td
2019</td><td>MALOYO</td><td>MALOYO</td><td>PETANI/PEKEBUN</td><td>JAJAR</td><td>JAJ
AR</td><td>TLOGOHARJO</td><td>PKD TLOGOHARJO</td><td>SRI SUPATMI</td><td> -
align='right'>53025069</td><td>04-02-
2019</td><td>MARGONO</td><td>MARGONO</td><td>PETANI/PEKEBUN</td><td>SAMBIREJO</td><
td>SAMBIREJO</td><td>TLOGOHARJO</td><td>PKD TLOGOHARJO</td><td>SRI SUPATMI</td><td>
- </td><td>L</td><td>60-69 Thn.</td><td>Datang Sendiri</td><td>Lama</td><td>BPJS
NON PBI</td><td>Rajal</td><td align='right'>24</td><td align='right'>3</td><td
></tr><tr><td align='right'>L24</td><td>Irritant contact
dermatitis</td><td></td><td
2019</td><td>MARSIH</td><td>TUGINO</td><td>PELAJAR/MAHASISWA</td><td>KERJO RT03
RW03,TLOGOSARI</td><td>KERJO</td><td>TLOGOSARI</td><td>INDUK</td><td>dr. BUDI
align='right'>57070056</td><td>04-02-2019</td><td>MARSIYEM</td><td>MARSIYEM 07 07
M 10 </td><td>PETANI/PEKEBUN</td><td>BANJAR RT 02 RW
ASHARI</td><td>SUGIYONO,S.Kep.Ns</td><td>P</td><td>>70 Thn.</td><td>Datang
align='right'>56070134</td><td>04-02-2019</td><td>MARTO YOSO</td><td>MARTO YOSO
0607 M 06</td><td>PETANI/PEKEBUN</td><td>DUNGKANCIL RT01 RW09</td><td>DUNG
align='right'>54065108</td><td>04-02-
2019</td><td>MARWOKO</td><td>DARNO</td><td>PELAJAR/MAHASISWA</td><td>BAYEM</td><td>
BAYEM</td><td>BAYEMHARJO</td><td>PUSTU BAYEMHARJO</td><td>RISTINA Amd Keb</td><td>
></tr><tr><td align='right'>N34.1</td><td>Nonspecific urethritis</td><td></td><td
align='right'>287882</td><td align='right'>56050027</td><td>04-02-2019</td><td>MEGA
OKTAVIA KARNAS</td><td>KARYATI 06 05 K 04</td><td>MENGURUS RUMAH
TANGGA</td><td>NGUJUNG RT02
></tr><tr><td align='right'>Z34.0</td><td>Supervision of normal first
align='right'>57130049</td><td>04-02-2019</td><td>MEIDA NIA GIMAWAN
SARI</td><td>SUGIMAN 0713 S
25</td><td>PEDAGANG</td><td>KEPUH</td><td>KEPUH</td><td>PUCANGANOM</td><td>INDUK</t
d><td>dr. BUDI ASHARI</td><td>UMI NUR ISNIATI</td><td>P</td><td>20-44
Thn.</td><td>Datang Sendiri</td><td>Lama</td><td>JAMKESDA</td><td>Rajal</td><td
align='right'>53025021</td><td>04-02-
2019</td><td>MELANI</td><td>KATNO</td><td>PELAJAR/MAHASISWA</td><td>SAMBIREJO</td><
td>SAMBIREJO</td><td>TLOGOHARJO</td><td>PKD TLOGOHARJO</td><td>SRI SUPATMI</td><td>
- </td><td>P</td><td>5-9 Thn.</td><td>Datang Sendiri</td><td>Lama</td><td>BPJS
align='right'>54110041</td><td>04-02-2019</td><td>MISNO</td><td>MISNO 0411 M
03</td><td>PETANI/PEKEBUN</td><td>GUWO RT03
RW06</td><td>GUWO</td><td>BAYEMHARJO</td><td>INDUK</td><td>dr. BUDI
2019</td><td>MUGIYONO</td><td>MUGIYONO 0602 M
09</td><td>PETANI/PEKEBUN</td><td>GIRITONTRO KIDUL RT05 RW03</td><td>GIRITONTRO
align='right'>59091329</td><td>04-02-2019</td><td>MUHAMAD AMIRUL ADLI</td><td>AFIF
FIANTO 0909 A 06</td><td>BELUM/TIDAK BEKERJA</td><td>NGUDAL RT02
align='right'>R50.9</td><td>Fever, unspecified</td><td></td><td
2019</td><td>MUHAMAD SUBKHI</td><td>WIYONO</td><td></td><td>JATI RT 03 RW
03</td><td>JATI</td><td>JATIREJO</td><td>INDUK</td><td>dr. BUDI ASHARI</td><td>UMI
NUR ISNIATI</td><td>P</td><td>1-4 Thn.</td><td>Datang
td></tr><tr><td align='right'>L20</td><td>Atopic dermatitis</td><td></td><td
2019</td><td>MUHAMMAD EVAN RUSNADI</td><td>SUTRISNO 0702 S 04</td><td>PERANGKAT
DESA</td><td>SUKOROYOM WETAN</td><td>SUKOROYOM
align='right'>58081366</td><td>04-02-2019</td><td>MUHAMMAD KHOIRUN
NIZAM</td><td>ROSIYEM 0808 R 05</td><td>BELUM/TIDAK BEKERJA</td><td>PULOSARI RT02
RW07</td><td></td><td>PRACIMANTORO</td><td>INDUK</td><td>drg.DANAR
align='right'>54065133</td><td>04-02-2019</td><td>MUTIARA
AGUSTIN</td><td>SUPARMAN</td><td>PELAJAR/MAHASISWA</td><td>BAYEM</td><td>BAYEM</td>
<td>BAYEMHARJO</td><td>PUSTU BAYEMHARJO</td><td>RISTINA Amd Keb</td><td> -
align='right'>56060013</td><td>04-02-2019</td><td>NADIYAH NUR
CAHYANI</td><td>SARNEN 06 06 S 05</td><td>PELAJAR/MAHASISWA</td><td>GOBOH RT03
RW 06</td><td>GOBOH</td><td>GIRITONTRO</td><td>INDUK</td><td>dr. BUDI
></tr><tr><td align='right'>Z34</td><td>Supervision of normal
align='right'>57070272</td><td>04-02-2019</td><td>NENI
ROMANIKA</td><td>SUPRIYANTO 0707 S 45</td><td>MENGURUS RUMAH
TANGGA</td><td>BANJAR RT03
></tr><tr><td align='right'>J44.9</td><td>Chronic obstructive pulmonary disease,
align='right'>56100361</td><td>04-02-2019</td><td>NGATINO</td><td>NGATINO 0610 N
04</td><td>WIRASWASTA</td><td>TANGGUNG RT02
Sendiri</td><td>Lama</td><td>BPJS PBI</td><td>Rujuk</td><td align='right'>3</td><td
></tr><tr><td align='right'>L20.9</td><td>Atopic dermatitis,
align='right'>57010260</td><td>04-02-2019</td><td>NUR AYIYAH</td><td>WARINO 0701 W
04</td><td>KARYAWAN
SWASTA</td><td>GROGOL</td><td>GROGOL</td><td>PUCANGANOM</td><td>INDUK</td><td>dr.
></tr><tr><td align='right'>D53.9</td><td>Nutritional anaemia,
align='right'>54010076</td><td>04-02-2019</td><td>PAINO</td><td>PAINO 0401
P02</td><td>PETANI/PEKEBUN</td><td>BELEH RT02
RW04</td><td>BELEH</td><td>BAYEMHARJO</td><td>INDUK</td><td>dr. BUDI
align='right'>56010084</td><td>04-02-2019</td><td>PARINEM</td><td>PARINEM 0601 P
06</td><td>MENGURUS RUMAH TANGGA</td><td>GIRITONTRO LOR RT01
d></tr><tr><td align='right'>H82</td><td>Vertiginous syndromes in diseases
align='right'>51057007</td><td>04-02-
2019</td><td>PONEM</td><td>SARTU</td><td>PETANI/PEKEBUN</td><td>GENTUNG</td><td>GEN
TUNG</td><td>NGARGOHARJO</td><td>PKD NGARGOHARJO</td><td>HENI WIDIYASTUTI</td><td>
2019</td><td>PONIYEM</td><td>PONIYEM 07 07 P
04</td><td>PETANI/PEKEBUN</td><td>BANJAR 03
d></tr><tr><td align='right'>D53.9</td><td>Nutritional anaemia,
align='right'>51090010</td><td>04-02-2019</td><td>PONO</td><td>PONO 01 09 P
02</td><td>PETANI/PEKEBUN</td><td>PULUNG RT04
RW04</td><td>PULUNG</td><td>NGARGOHARJO</td><td>INDUK</td><td>dr. BUDI
align='right'>289251</td><td align='right'>52127038</td><td>04-02-2019</td><td>PUJI
LESTARI</td><td></td><td>MENGURUS RUMAH
Thn.</td><td>Datang Sendiri</td><td>Baru</td><td>Umum</td><td>Rajal</td><td
2019</td><td>PURWANTI</td><td>PURWANTI</td><td>PETANI/PEKEBUN</td><td>GEDANGAN</td>
<td>GEDANGAN</td><td>NGARGOHARJO</td><td>PKD NGARGOHARJO</td><td>HENI
WIDIYASTUTI</td><td> - </td><td>P</td><td>20-44 Thn.</td><td>Datang
Sendiri</td><td>Baru</td><td>BPJS PBI</td><td>Rajal</td><td align='right'>4</td><td
</tr><tr><td align='right'>Z34.0</td><td>Supervision of normal first
align='right'>52110045</td><td>04-02-2019</td><td>RANI NURANI</td><td>DENI SAPUTRA
0211 D 04</td><td>MENGURUS RUMAH TANGGA</td><td>TAMBAK RT01
Sendiri</td><td>Baru</td><td>UMUM WONOGIRI</td><td>Rajal</td><td
align='right'>58080369</td><td>04-02-2019</td><td>RENDI</td><td>SAMIDI 0808 S
34</td><td>PELAJAR/MAHASISWA</td><td>JIMBAR</td><td></td><td>PRACIMANTORO</td><td>I
NDUK</td><td>dr. BUDI ASHARI</td><td>SUGIYONO,S.Kep.Ns</td><td>L</td><td>10-14
align='right'>56035029</td><td>04-02-2019</td><td>REVASYA</td><td>SUYADI 0603 S
08</td><td>PELAJAR/MAHASISWA</td><td>GEBLUG RT04
align='right'>51030058</td><td>04-02-2019</td><td>RINI ASTUTI</td><td>DIDIK
KURNIAWAN 0103 D 01</td><td>MENGURUS RUMAH TANGGA</td><td>PRINGKUKU
</td><td>PRINGKUKU</td><td>NGARGOHARJO</td><td>INDUK</td><td>dr. BUDI
align='right'>57050146</td><td>04-02-2019</td><td>SADIYEM</td><td>MULYADI 0705 M
04</td><td>PETANI/PEKEBUN</td><td>SUKOROYOM KULON</td><td>SUKOROYOM
Wilayah</td><td>'</td><td>'3312026008450002</td><td>160</td><td>100</td></tr><tr><t
d align='right'>J11.8</td><td>Influenza with other manifestations, virus not
align='right'>55080048</td><td>04-02-2019</td><td>SAFA</td><td>MARGONO 05 08 M
04</td><td>PELAJAR/MAHASISWA</td><td>NGORODOWO
RT04 RW03</td><td>NGORODOWO</td><td>JATIREJO</td><td>INDUK</td><td>dr. BUDI
align='right'>55110007</td><td>04-02-2019</td><td>SAMIYEM</td><td>KATIYEM 05 11 K
03</td><td>PETANI/PEKEBUN</td><td>BUWENG RT 01 RW
05</td><td>BUWENG</td><td>JATIREJO</td><td>INDUK</td><td>dr. BUDI
align='right'>52087055</td><td>04-02-2019</td><td>SAMIYEM</td><td>KARYO
S</td><td>PETANI/PEKEBUN</td><td>TLOGOSARI</td><td>TLOGOSARI</td><td>TLOGOSARI</td>
<td>PUSTU TLOGOSARI</td><td>SULARNO,S.Kep.Ns</td><td> - </td><td>P</td><td>60-69
align='right'>54065084</td><td>04-02-
2019</td><td>SARINAH</td><td>SUGING</td><td>PETANI/PEKEBUN</td><td>BAYEM</td><td>BA
YEM</td><td>BAYEMHARJO</td><td>PUSTU BAYEMHARJO</td><td>RISTINA Amd Keb</td><td> -
></tr><tr><td align='right'>K05.3</td><td>Chronic periodontitis</td><td></td><td
2019</td><td>SARWATI</td><td>MARLAN 0406 M
02</td><td>PETANI/PEKEBUN</td><td>BAYEM RT01
RW01</td><td>BAYEM</td><td>BAYEMHARJO</td><td>INDUK</td><td>drg.DANAR
></tr><tr><td align='right'>M79.1</td><td>Myalgia</td><td></td><td
2019</td><td>SISWOYO</td><td>SISWOYO 0411 S
align='right'>Z34.8</td><td>Supervision of other normal pregnancy</td><td></td><td
FATIMAH</td><td>ALIF SAPARTO 0208 A 02</td><td>PETANI/PEKEBUN</td><td>TLOGOSARI
RT01 RW05</td><td>TLOGOSARI</td><td>TLOGOSARI</td><td>INDUK</td><td>dr. BUDI
align='right'>I10</td><td>Essential (primary) hypertension</td><td></td><td
2019</td><td>SOGINI</td><td>WAKINO</td><td>PETANI/PEKEBUN</td><td>BAYEM</td><td>BAY
EM</td><td>BAYEMHARJO</td><td>PUSTU BAYEMHARJO</td><td>RISTINA Amd Keb</td><td> -
/td></tr><tr><td align='right'>Z30.4</td><td>Surveillance of contraceptive
drugs</td><td></td><td align='right'>289286</td><td
align='right'>53085007</td><td>04-02-2019</td><td>SRI
SETIYATMI</td><td>KARBI</td><td>PETANI/PEKEBUN</td><td>GINADE KULON</td><td>GINADE
KULON</td><td>TLOGOHARJO</td><td>PKD TLOGOHARJO</td><td>SRI SUPATMI</td><td> -
2019</td><td>SRIYANI</td><td>SULINO 07 11 S 14</td><td>PETANI/PEKEBUN</td><td>PLOSO
RT02 RW 11</td><td>PLOSO</td><td>PUCANGANOM</td><td>INDUK</td><td>dr. BUDI
2019</td><td>SUKINAH</td><td></td><td>PETANI/PEKEBUN</td><td>NGELO</td><td>NGELO</t
</td><td>P</td><td>>70 Thn.</td><td>Datang Sendiri</td><td>Lama</td><td>UMUM
align='right'>57170005</td><td>04-02-2019</td><td>SULAMI</td><td>KARJO 0717 K
01</td><td>PETANI/PEKEBUN</td><td>WATES</td><td>WATES</td><td>PUCANGANOM</td><td>IN
DUK</td><td>dr. BUDI ASHARI</td><td>SUGIYONO,S.Kep.Ns</td><td>P</td><td>45-54
2019</td><td>SUMARNI</td><td>MALOYO</td><td>PETANI/PEKEBUN</td><td>JAJAR</td><td>JA
JAR</td><td>TLOGOHARJO</td><td>PKD TLOGOHARJO</td><td>SRI SUPATMI</td><td> -
2019</td><td>SUMINI</td><td>SULARDI</td><td>PETANI/PEKEBUN</td><td>GEDANGAN</td><td
>GEDANGAN</td><td>NGARGOHARJO</td><td>PKD NGARGOHARJO</td><td>HENI
WIDIYASTUTI</td><td> - </td><td>L</td><td>45-54 Thn.</td><td>Datang
align='right'>L24.9</td><td>Irritant contact dermatitis, unspecified
align='right'>52067007</td><td>04-02-
2019</td><td>SUNARSI</td><td></td><td>PETANI/PEKEBUN</td><td>SUMBERJO</td><td>BERGU
NG</td><td>TLOGOSARI</td><td>PUSTU TLOGOSARI</td><td>SULARNO,S.Kep.Ns</td><td> -
</td><td>P</td><td>20-44 Thn.</td><td>Datang Sendiri</td><td>Baru</td><td>BPJS
align='right'>J11.8</td><td>Influenza
with other manifestations, virus not identified</td><td></td><td
2019</td><td>SUNARTI</td><td>SUHARDI 0606 S
09</td><td>PETANI/PEKEBUN</td><td>GOBOH</td><td>GOBOH</td><td>GIRITONTRO</td><td>IN
align='right'>Z35</td><td>Supervision of high-risk pregnancy</td><td></td><td
2019</td><td>SUNARTI</td><td>SOKIRAN 03 06 S 04</td><td>MENGURUS RUMAH
TANGGA</td><td>KLEPU RT01
</tr><tr><td align='right'>K29.5</td><td>Chronic gastritis,
align='right'>55040011</td><td>04-02-2019</td><td>SUPARMI</td><td>SUTARNO 0504 S
07</td><td>PETANI/PEKEBUN</td><td>KANIGORO RT02
RW01</td><td>KANIGORO</td><td>JATIREJO</td><td>INDUK</td><td>dr. BUDI
d></tr><tr><td align='right'>I10</td><td>Essential (primary)
align='right'>52077033</td><td>04-02-
2019</td><td>SURATI</td><td></td><td>PETANI/PEKEBUN</td><td>SUMBERJO</td><td>SUMBER
JO</td><td>TLOGOSARI</td><td>PUSTU TLOGOSARI</td><td>SULARNO,S.Kep.Ns</td><td> -
align='right'>57100164</td><td>04-02-2019</td><td>SURATNO</td><td>SURATNO 07 10 S
27</td><td>PETANI/PEKEBUN</td><td>JEPURUN</td><td>JEPURUN</td><td>PUCANGANOM</td><t
d>INDUK</td><td>dr. BUDI ASHARI</td><td>SUGIYONO,S.Kep.Ns</td><td>L</td><td>45-54
align='right'>I27.9</td><td>Pulmonary heart disease, unspecified</td><td></td><td
2019</td><td>SURATO</td><td>SURATO 07 02 S
2019</td><td>SURIP</td><td></td><td>PETANI/PEKEBUN</td><td>TLOGOSARI</td><td>TLOGOS
ARI</td><td>TLOGOSARI</td><td>PUSTU TLOGOSARI</td><td>SULARNO,S.Kep.Ns</td><td> -
align='right'>A01.0</td><td>Typhoid fever</td><td></td><td
2019</td><td>SUTARMI</td><td>TUGINO 07 05 T 06</td><td>PEGAWAI NEGERI
SIPIL</td><td>SUKOROYOM KULON RT 02 RW 03</td><td>SUKOROYOM
></tr><tr><td align='right'>R05</td><td>Cough</td><td></td><td
2019</td><td>SUTINI</td><td>BEJO</td><td>PETANI/PEKEBUN</td><td>WATES</td><td>WATES
</td><td>BAYEMHARJO</td><td>PUSTU BAYEMHARJO</td><td>RISTINA Amd Keb</td><td> -
</td><td>P</td><td>55-59 Thn.</td><td>Datang Sendiri</td><td>Baru</td><td>UMUM
2019</td><td>SUWARDI</td><td>SUWARDI 0601 S
04</td><td>PETANI/PEKEBUN</td><td>GIRITONTRO LOR RT O1 RW O2</td><td>GIRITONTRO
2019</td><td>SUYANI</td><td></td><td>PETANI/PEKEBUN</td><td>GLAGAH</td><td>GLAGAH</
2019</td><td>SUYATNO</td><td>SUYATNO</td><td>PETANI/PEKEBUN</td><td>NGRINGIN</td><t
d>NGRINGIN</td><td>NGARGOHARJO</td><td>PKD NGARGOHARJO</td><td>HENI
WIDIYASTUTI</td><td> - </td><td>L</td><td>60-69 Thn.</td><td>Datang
align='right'>51135007</td><td>04-02-
2019</td><td>SUYEKTI</td><td>ARI</td><td>PETANI/PEKEBUN</td><td>GEDANGAN</td><td>GE
DANGAN</td><td>NGARGOHARJO</td><td>PKD NGARGOHARJO</td><td>HENI
tr><tr><td align='right'>H58.8</td><td>Other specified disorders of eye and adnexa
in diseases classified elsewhere</td><td></td><td align='right'>287945</td><td
align='right'>53030086</td><td>04-02-2019</td><td>TEGUH</td><td>TEGUH 03 03 T
04</td><td>PETANI/PEKEBUN</td><td>JAJR RT 04 RW
02</td><td></td><td>TLOGOHARJO</td><td>INDUK</td><td>dr. BUDI
Sendiri</td><td>Lama</td><td>JAMKESDA</td><td>Rujuk</td><td
Umum</td><td>Poli Mata</td><td>RSUD DR. SOEDIRAN MS WONOGIRI</td><td>Dalam
align='right'>56100095</td><td>04-02-2019</td><td>TIARA</td><td>NASRUN 0610 N
01</td><td>PELAJAR/MAHASISWA</td><td>TANGGUNG RT02
align='right'>51115016</td><td>04-02-
2019</td><td>TUKIJEM</td><td>SULARNO</td><td>PETANI/PEKEBUN</td><td>BLEBER</td><td>
BLEBER</td><td>NGARGOHARJO</td><td>PKD
NGARGOHARJO</td><td>HENI WIDIYASTUTI</td><td> - </td><td>P</td><td>45-54
2019</td><td>TUMI</td><td></td><td>PETANI/PEKEBUN</td><td>NGELO</td><td>NGELO</td><
td>TLOGOSARI</td><td>PUSTU TLOGOSARI</td><td>SULARNO,S.Kep.Ns</td><td> -
2019</td><td>TUMIYEM</td><td></td><td>PETANI/PEKEBUN</td><td>NGELO</td><td>NGELO</t
align='right'>56060133</td><td>04-02-2019</td><td>WAHYU EDI EXSANTO</td><td>DWI
SANYOTO/SUTARYO 0606 D 03</td><td>KARYAWAN SWASTA</td><td>GOBOH RT03 RW
align='right'>M06.9</td><td>Rheumatoid arthritis, unspecified</td><td></td><td
2019</td><td>WAHYU
SAYEKTI</td><td>SUPARMIN</td><td>PETANI/PEKEBUN</td><td>BAYEM</td><td>BAYEM</td><td
>BAYEMHARJO</td><td>PUSTU BAYEMHARJO</td><td>RISTINA Amd Keb</td><td> -
align='right'>57095012</td><td>04-02-2019</td><td>WARSI</td><td>SURAHMAN 07 09 S
05</td><td>PETANI/PEKEBUN</td><td>PUCANGANOM LOR 02/09</td><td>PUCANGANOM
></tr><tr><td align='right'>K01.1</td><td>Impacted teeth</td><td></td><td
2019</td><td>WAWAN PRASETYO</td><td>WAWAN PRASTYO 0502 W 04</td><td>KARYAWAN
SWASTA</td><td>GIRIROTO RT01
align='right'>287899</td><td align='right'>56080322</td><td>04-02-2019</td><td>YANA
FITRIANA</td><td>EDI SURYANTO 0608 E
03</td><td>PELAJAR/MAHASISWA</td><td>DUNGKLEPU WETAN RT01 RW04</td><td>DUNG KLEPU
WETAN</td><td>GIRITONTRO</td><td>INDUK</td><td>drg.DANAR WULANDARI</td><td>RIZKI
align='right'>S81.0</td><td>Open wound of knee</td><td></td><td
2019</td><td>ZUKA</td><td>WALUYO 06 02 W
01</td><td>PELAJAR/MAHASISWA</td><td>GIRITONTRO KIDUL RT 04 RW 3</td><td>GIRITONTRO
align='right'>53085047</td><td>06-02-
2019</td><td>AFIF</td><td>SULARTO</td><td>BELUM/TIDAK BEKERJA</td><td>GINADE
KULON</td><td>GINADE KULON</td><td>TLOGOHARJO</td><td>PKD TLOGOHARJO</td><td>SRI
SUPATMI</td><td> - </td><td>L</td><td>5-9 Thn.</td><td>Datang
2019</td><td>ALDHYNO MUCHTY PRASETYA</td><td>SARINO 04 06 S 14</td><td>BELUM/TIDAK
BEKERJA</td><td>BAYEM RT02
tr><tr><td align='right'>K00.6</td><td>Disturbances in tooth
align='right'>51020062</td><td>06-02-2019</td><td>ALDIRA PRAMESTI</td><td>SARNO
0102 S 18</td><td>PELAJAR/MAHASISWA</td><td>NGRINGIN RT02
RW01</td><td>NGRINGIN</td><td>NGARGOHARJO</td><td>INDUK</td><td>drg.DANAR
</tr><tr><td align='right'>K29.6</td><td>Other gastritis</td><td></td><td
2019</td><td>ALVIS VITO HERMAWAN</td><td></td><td>BELUM/TIDAK
BEKERJA</td><td>KLEPU</td><td>KLEPU</td><td>NGARGOHARJO</td><td>PUSTU
NGARGOHARJO</td><td>SUSI HERAWATI, AMK</td><td> - </td><td>L</td><td>1-4
2019</td><td>ARDELIA</td><td>ALFALIAN 0605 A
03</td><td>PELAJAR/MAHASISWA</td><td>NGUJUNG RT03
RW08</td><td>NGUJUNG</td><td>GIRITONTRO</td><td>INDUK</td><td>drg.DANAR
2019</td><td>ARDYANSYAH ADHY PRASETYO</td><td>WASINO 0705 W
002</td><td></td><td>SUKOROYOM KULON</td><td>SUKOROYOM
align='right'>287969</td><td align='right'>55030045</td><td>06-02-2019</td><td>ARIP
ARIWIBOWO</td><td>SULARTO 05 03 S 10</td><td>BELUM/TIDAK
BEKERJA</td><td>SONGGODULANG RT 01 RW
01</td><td></td><td>JATIREJO</td><td>INDUK</td><td>dr. BUDI
></tr><tr><td align='right'>K29.1</td><td>Other acute gastritis</td><td></td><td
2019</td><td>BERLIAN KUSUMA</td><td>HARIYANTO 07 05 H
08</td><td>PELAJAR/MAHASISWA</td><td>SUKOROYM KULON</td><td>SUKOROYOM
></tr><tr><td align='right'>J02.9</td><td>Acute pharyngitis,
align='right'>54080024</td><td>06-02-2019</td><td>BONDAN HERIANTO</td><td>JUMADI
0408 J 01</td><td>PELAJAR/MAHASISWA</td><td>NGANTAP RT02
RW05</td><td>NGANTAP</td><td>BAYEMHARJO</td><td>INDUK</td><td>dr. ZAENAL ARIFIN
HP</td><td>SUWARTO,S.Kep.Nes</td><td>L</td><td>15-19 Thn.</td><td>Datang
align='right'>R52.9</td><td>Pain, unspecified</td><td></td><td
2019</td><td>DALTINI</td><td>TUGIMIN 0107 T 05</td><td>MENGURUS RUMAH
TANGGA</td><td>NGASEM RT02
RW04</td><td>NGASEM</td><td>NGARGOHARJO</td><td>INDUK</td><td>dr. BUDI
align='right'>287965</td><td align='right'>58080336</td><td>06-02-2019</td><td>DEA
ANASTSYA</td><td>TARYANTO 08 08 T 01</td><td>BELUM/TIDAK
BEKERJA</td><td>PULOSARI</td><td></td><td>PRACIMANTORO</td><td>INDUK</td><td>dr.
BUDI ASHARI</td><td>SUHARNI</td><td>P</td><td>1-4 Thn.</td><td>Datang
2019</td><td>DESTRIA KAILA FARANISSA</td><td>EDI SUMARNO 0502 E
02</td><td>PELAJAR/MAHASISWA</td><td>GIRIROTO RT02
2019</td><td>ELFIA AYU SAPUTRI</td><td>ANDI HARIYANTO 0512 A
01</td><td>PELAJAR/MAHASISWA</td><td>NGASEM</td><td>NGASEM</td><td>JATIREJO</td><td
>INDUK</td><td>drg.DANAR WULANDARI</td><td>RIZKI ANISSA, AM.Kg</td><td>P</td><td>5-
9 Thn.</td><td>Datang Sendiri</td><td>Lama</td><td>JAMKESDA</td><td>Rajal</td><td
td></tr><tr><td align='right'>I11.0</td><td>Hypertensive heart disease with
align='right'>57110028</td><td>06-02-2019</td><td>HADI UTOMO</td><td>HADI UTOMO 07
11 H 01</td><td>PETANI/PEKEBUN</td><td>PLOSO RT 01 RW
11</td><td>PLOSO</td><td>PUCANGANOM</td><td>INDUK</td><td>dr. BUDI
Sendiri</td><td>Lama</td><td>BPJS PBI</td><td>Rujuk</td><td align='right'></td><td
align='right'>57080212</td><td>06-02-2019</td><td>HARIYADI</td><td>SAYADI 07 08 S
23</td><td>KARYAWAN SWASTA</td><td>PUCANGANOM KIDUL</td><td>PUCANGANOM
align='right'>58081368</td><td>06-02-2019</td><td>IBNU NUR TRI
ANTO</td><td>KRISTIANTO 0808 K 13</td><td>BELUM/TIDAK
BEKERJA</td><td>MOJO,SUCI</td><td></td><td>PRACIMANTORO</td><td>INDUK</td><td>dr.
BUDI ASHARI</td><td>HENI WIDIYASTUTI</td><td>L</td><td>1-4 Thn.</td><td>Datang
align='right'>9</td><td align='right'>2</td><td>KIA</td><td></td><td></td><td>Luar
align='right'>Z02.8</td><td>Other examinations for administrative
purposes</td><td></td><td align='right'>287973</td><td
align='right'>52050038</td><td>06-02-2019</td><td>INDRALIYA
SEPTIYANI</td><td>WAHYUDI 02 05 W 01</td><td>BELUM/TIDAK BEKERJA</td><td>GLAGAH RT
03 RW 06</td><td></td><td>TLOGOSARI</td><td>INDUK</td><td>dr. BUDI
ASHARI</td><td>HENI WIDIYASTUTI</td><td>P</td><td>15-19 Thn.</td><td>Datang
align='right'>Z02</td><td>Examination and encounter for administrative
align='right'>56030085</td><td>06-02-2019</td><td>IPUNG BIMA PUTRA</td><td>REBO
MARJONO 0603 R 01</td><td>PETANI/PEKEBUN</td><td>GEBLUG, RT 04, RW
07</td><td></td><td>GIRITONTRO</td><td>INDUK</td><td>dr. ZAENAL ARIFIN
align='right'>O48</td><td>Prolonged pregnancy</td><td></td><td
2019</td><td>ISLAH MUKTI</td><td>SULIMIN 56 08 S 13</td><td>PERANGKAT
DESA</td><td>DUMGKLEPU WETAN</td><td></td><td>GIRITONTRO</td><td>INDUK</td><td>dr.
BUDI ASHARI</td><td>HENI WIDIYASTUTI</td><td>P</td><td>20-44 Thn.</td><td>Datang
align='right'>54065116</td><td>06-02-
2019</td><td>JUMIYEM</td><td>TUKIMIN</td><td>PETANI/PEKEBUN</td><td>BAYEM</td><td>B
AYEM</td><td>BAYEMHARJO</td><td>PUSTU BAYEMHARJO</td><td>RISTINA Amd Keb</td><td> -
2019</td><td>JURIYANI</td><td>SUKIMIN</td><td>PETANI/PEKEBUN</td><td>BAYEM</td><td>
2019</td><td>KADINO</td><td>KADINO</td><td>PETANI/PEKEBUN</td><td>BAYEM</td><td>BAY
virus
align='right'>58080310</td><td>06-02-2019</td><td>KALIS</td><td>KRISTIANTO 0808 K
BEKERJA</td><td>MOJO,SUCI</td><td></td><td>PRACIMANTORO</td><td>INDUK</td><td>dr.
BUDI ASHARI</td><td>HENI WIDIYASTUTI</td><td>L</td><td>1-4 Thn.</td><td>Datang
align='right'>J02.9</td><td>Acute pharyngitis, unspecified</td><td></td><td
2019</td><td>KALIYEM</td><td>MUSIMAN</td><td>PETANI/PEKEBUN</td><td>GEDANGAN</td><t
d>GEDANGAN</td><td>NGARGOHARJO</td><td>PUSTU NGARGOHARJO</td><td>SUSI HERAWATI,
AMK</td><td> - </td><td>P</td><td>>70 Thn.</td><td>Datang
2019</td><td>KALIYEM</td><td>MUSIMAN</td><td>PETANI/PEKEBUN</td><td>GEDANGAN</td><t
d>GEDANGAN</td><td>NGARGOHARJO</td><td>PUSTU NGARGOHARJO</td><td>SUSI HERAWATI,
2019</td><td>KAMIYEM</td><td>WARTONO 07 07 W
RW05</td><td></td><td>PUCANGANOM</td><td>INDUK</td><td>dr. BUDI
align='right'>51027003</td><td>06-02-
2019</td><td>KANEM</td><td>PARMAN</td><td>PETANI/PEKEBUN</td><td>NGRINGIN</td><td>N
GRINGIN</td><td>NGARGOHARJO</td><td>PUSTU NGARGOHARJO</td><td>SUSI HERAWATI,
></tr><tr><td align='right'>M13</td><td>Other arthritis</td><td></td><td
2019</td><td>KARTI</td><td>SUKINO 0702 S
22</td><td>PETANI/PEKEBUN</td><td>SUKOROYOM KULON</td><td>SUKOROYOM
WETAN</td><td>PUCANGANOM</td><td>INDUK</td><td>dr. ZAENAL ARIFIN
/td></tr><tr><td align='right'>M13.9</td><td>Arthritis,
align='right'>51047027</td><td>06-02-
2019</td><td>KASMI</td><td>WARINO</td><td>PETANI/PEKEBUN</td><td>KLEPU</td><td>KLEP
U</td><td>NGARGOHARJO</td><td>PUSTU NGARGOHARJO</td><td>SUSI HERAWATI, AMK</td><td>
</tr><tr><td align='right'>I10</td><td>Essential (primary)
align='right'>57040168</td><td>06-02-2019</td><td>KATIJEM</td><td>SUROYO 0704 S
<td>INDUK</td><td>dr. ZAENAL ARIFIN
HP</td><td>SUWARTO,S.Kep.Nes</td><td>P</td><td>60-69 Thn.</td><td>Datang
Wilayah</td><td>'0000565808005</td><td>'33120241250001</td><td>150</td><td>90</td><
/tr><tr><td align='right'>M06.9</td><td>Rheumatoid arthritis,
align='right'>51047012</td><td>06-02-
2019</td><td>KATINAH</td><td>KATINAH</td><td>PETANI/PEKEBUN</td><td>KLEPU</td><td>K
LEPU</td><td>NGARGOHARJO</td><td>PUSTU NGARGOHARJO</td><td>SUSI HERAWATI,
AMK</td><td> - </td><td>P</td><td>60-69 Thn.</td><td>Datang
align='right'>51047012</td><td>06-02-
2019</td><td>KATINAH</td><td>KATINAH</td><td>PETANI/PEKEBUN</td><td>KLEPU</td><td>K
LEPU</td><td>NGARGOHARJO</td><td>PUSTU NGARGOHARJO</td><td>SUSI HERAWATI,
align='right'>52057011</td><td>06-02-
2019</td><td>KATINO</td><td>KATINO</td><td>PETANI/PEKEBUN</td><td>TLOGO</td><td>TLO
GO</td><td>TLOGOHARJO</td><td>PKD TLOGOHARJO</td><td>SRI SUPATMI</td><td> -
align='right'>53020098</td><td>06-02-2019</td><td>KATMI</td><td>JUMADI 0302 J
03</td><td>PETANI/PEKEBUN</td><td>SAMBIREJO RT03
RW01</td><td>SAMBIREJO</td><td>TLOGOHARJO</td><td>INDUK</td><td>dr. ZAENAL ARIFIN
/td></tr><tr><td align='right'>K29.7</td><td>Gastritis,
align='right'>52027002</td><td>06-02-
2019</td><td>KIRMAN</td><td>KIRMAN</td><td>PETANI/PEKEBUN</td><td>MANTANG</td><td>M
ANTHANG</td><td>TLOGOSARI</td><td>PUSTU TLOGOSARI</td><td>SULARNO,S.Kep.Ns</td><td>
- </td><td>L</td><td>>70 Thn.</td><td>Datang Sendiri</td><td>Lama</td><td>BPJS
></tr><tr><td align='right'>L24.8</td><td>Irritant contact dermatitis due to other
agents</td><td></td><td align='right'>288216</td><td
align='right'>51027060</td><td>06-02-
2019</td><td>KIYEM</td><td></td><td>PETANI/PEKEBUN</td><td>NGRINGIN</td><td>NGRINGI
N</td><td>NGARGOHARJO</td><td>PUSTU NGARGOHARJO</td><td>SUSI HERAWATI, AMK</td><td>
- </td><td>P</td><td>>70 Thn.</td><td>Datang Sendiri</td><td>Lama</td><td>BPJS NON
align='right'>51027060</td><td>06-02-
2019</td><td>KIYEM</td><td></td><td>PETANI/PEKEBUN</td><td>NGRINGIN</td><td>NGRINGI
- </td><td>P</td><td>>70 Thn.</td><td>Datang Sendiri</td><td>Lama</td><td>BPJS NON
align='right'>56060039</td><td>06-02-2019</td><td>KUSTANTI</td><td>SETYO SAMSURI 06
06 S 12</td><td>PELAJAR/MAHASISWA</td><td>GOBOH RT 01 RW
></tr><tr><td align='right'>G43.9</td><td>Migraine, unspecified</td><td></td><td
2019</td><td>LESTARI</td><td>SLAMET WIYONO 02 14 S
05</td><td>PEDAGANG</td><td>GUPAKAAN RT02 RW
03</td><td>GUPAKAN</td><td>TLOGOSARI</td><td>INDUK</td><td>dr. BUDI
align='right'>57050123</td><td>06-02-2019</td><td>M. ZIDAN ALFATH</td><td>MUHAMMAD
SYARIF USMAN 0705 M 11</td><td>PELAJAR/MAHASISWA</td><td>SUKOROYOM KULON RT01
RW03</td><td>SUKOROYOM KULON</td><td>PUCANGANOM</td><td>INDUK</td><td>dr. BUDI
Sendiri</td><td>Lama</td><td>UMUM WONOGIRI</td><td>internal rujukan</td><td
align='right'>287961</td><td align='right'>57050123</td><td>06-02-2019</td><td>M.
ZIDAN ALFATH</td><td>MUHAMMAD SYARIF USMAN 0705 M
11</td><td>PELAJAR/MAHASISWA</td><td>SUKOROYOM KULON RT01 RW03</td><td>SUKOROYOM
KULON</td><td>PUCANGANOM</td><td>INDUK</td><td>drg.DANAR WULANDARI</td><td>RIZKI
align='right'>H25.9</td><td>Senile cataract, unspecified</td><td></td><td
2019</td><td>MARTO YOSO</td><td>MARTO YOSO 0607 M
06</td><td>PETANI/PEKEBUN</td><td>DUNGKANCIL RT01 RW09</td><td>DUNG
align='right'>57030064</td><td>06-02-2019</td><td>MIFTAH SYAHUDA</td><td>DENAN 07
03 D 04</td><td>BELUM/TIDAK
BEKERJA</td><td>KUWANG</td><td>KUWANG</td><td>PUCANGANOM</td><td>INDUK</td><td>drg.
DANAR WULANDARI</td><td>RIZKI ANISSA, AM.Kg</td><td>P</td><td>5-9
align='right'>L24.8</td><td>Irritant contact dermatitis due to other
align='right'>51137004</td><td>06-02-2019</td><td>NANDA ADITYA
SAPUTRA</td><td></td><td>PELAJAR/MAHASISWA</td><td>GEDANGAN</td><td>GEDANGAN</td><t
d>NGARGOHARJO</td><td>PUSTU NGARGOHARJO</td><td>SUSI HERAWATI, AMK</td><td> -
</tr><tr><td align='right'>R05</td><td>Cough</td><td></td><td
2019</td><td>PAIJAN</td><td>PAIJAN</td><td>PETANI/PEKEBUN</td><td>MANTANG</td><td>M
ANTHANG</td><td>TLOGOSARI</td><td>PUSTU TLOGOSARI</td><td>SULARNO,S.Kep.Ns</td><td>
></tr><tr><td align='right'>R51</td><td>Headache</td><td></td><td
2019</td><td>PAIJEM</td><td>SUYANTO</td><td>PETANI/PEKEBUN</td><td>BAYEM</td><td>BA
></tr><tr><td align='right'>K29</td><td>Gastritis and duodenitis</td><td></td><td
2019</td><td>PAINAH</td><td>PAINAH 07 04 P
></tr><tr><td align='right'>H27.0</td><td>Aphakia</td><td></td><td
2019</td><td>PARINEM</td><td>SUTARMAN 07 12 S
25</td><td>PETANI/PEKEBUN</td><td>NGAK INGUK RT01RW16</td><td>INGAK -
INGUK</td><td>PUCANGANOM</td><td>INDUK</td><td>dr. ZAENAL ARIFIN
HP</td><td>SUWARTO,S.Kep.Nes</td><td>P</td><td>>70 Thn.</td><td>Datang
align='right'>57010118</td><td>06-02-2019</td><td>PUJIYONO</td><td>PUJIYONO 0701
P 03</td><td>PETANI/PEKEBUN</td><td>GROGOL RT 03 RW
2019</td><td>RIDHO ARDIANTO</td><td>SUPRIYANTO 0601 S
15</td><td>PELAJAR/MAHASISWA</td><td>GIRITONTRO LOR RT 01 RW 02</td><td>GIRITONTRO
align='right'>Z02</td><td>Examination and encounter for administrative
align='right'>59091194</td><td>06-02-2019</td><td>RINTO HASMORO</td><td>RINTO
HASMORO 0909 R 04</td><td>KARYAWAN BUMD</td><td>SEJATI RT01
RW07</td><td></td><td>GIRIWOYO</td><td>INDUK</td><td>dr. ZAENAL ARIFIN
align='right'>Z00.0</td><td>General medical examination</td><td></td><td
2019</td><td>ROHADI</td><td>WAHYUDI/AHMADI 0205 W 01</td><td>BURUH HARIAN
LEPAS</td><td>SUKOREJO RT31 RW13,KLATEN</td><td></td><td>JAWA
TENGAH</td><td>INDUK</td><td>dr. BUDI
2019</td><td>RUSILAH</td><td>SOGIMIN 02 08 S
31</td><td>PETANI/PEKEBUN</td><td>TLOGOSARI 01
RW05</td><td>TLOGOSARI</td><td>TLOGOSARI</td><td>INDUK</td><td>dr. BUDI
></tr><tr><td align='right'>K08.3</td><td>Retained dental root</td><td></td><td
2019</td><td>SADINO MOH CIPTOWIYONO</td><td>SADINO 03 02 S
28</td><td>PENSIUNAN</td><td>SAMBIREJO RT04 RT
01</td><td>SAMBIREJO</td><td>TLOGOHARJO</td><td>INDUK</td><td>drg.DANAR
WULANDARI</td><td>RIZKI ANISSA, AM.Kg</td><td>L</td><td>>70 Thn.</td><td>Datang
2019</td><td>SAIKEM</td><td></td><td>PETANI/PEKEBUN</td><td>SOKO</td><td>SOKO</td><
2019</td><td>SAIMIN</td><td>SAIMIN 01 10 S 13</td><td>PETANI/PEKEBUN</td><td>BALONG
RT 06 RW 01</td><td></td><td>NGARGOHARJO</td><td>INDUK</td><td>drg.DANAR
/td></tr><tr><td align='right'>R51</td><td>Headache</td><td></td><td
2019</td><td>SAMINAH</td><td>KADINO</td><td>PETANI/PEKEBUN</td><td>BAYEM</td><td>BA
align='right'>51027014</td><td>06-02-
2019</td><td>SARIYEM</td><td>KADIMAN</td><td>PETANI/PEKEBUN</td><td>NGRINGIN</td><t
d>NGRINGIN</td><td>NGARGOHARJO</td><td>PUSTU NGARGOHARJO</td><td>SUSI HERAWATI,
align='right'>51027014</td><td>06-02-
2019</td><td>SARIYEM</td><td>KADIMAN</td><td>PETANI/PEKEBUN</td><td>NGRINGIN</td><t
align='right'>51047066</td><td>06-02-
2019</td><td>SARMINI</td><td></td><td>PETANI/PEKEBUN</td><td>KLEPU</td><td>KLEPU</t
d><td>NGARGOHARJO</td><td>PUSTU NGARGOHARJO</td><td>SUSI HERAWATI, AMK</td><td> -
></tr><tr><td align='right'>K81</td><td>Cholecystitis</td><td></td><td
2019</td><td>SATINI</td><td>TAMINO 0309 T 01</td><td>PENSIUNAN</td><td>KRANGGAN
RT02 RW04</td><td>KRANGGAN</td><td>TLOGOHARJO</td><td>INDUK</td><td>dr. ZAENAL
ARIFIN HP</td><td>SUWARTO,S.Kep.Nes</td><td>P</td><td>55-59 Thn.</td><td>Datang
></tr><tr><td align='right'>G44.2</td><td>Tension-type headache</td><td></td><td
2019</td><td>SENEN HADI
MULYONO</td><td></td><td>PETANI/PEKEBUN</td><td>PELET</td><td>PELET</td><td>NGARGOH
ARJO</td><td>PUSTU NGARGOHARJO</td><td>SUSI HERAWATI, AMK</td><td> -
2019</td><td>SLAMET</td><td>SLAMET</td><td>PETANI/PEKEBUN</td><td>TLOGO</td><td>TLO
2019</td><td>SOMAN</td><td></td><td>PETANI/PEKEBUN</td><td>NGRINGIN</td><td>NGRINGI
- </td><td>L</td><td>60-69 Thn.</td><td>Datang Sendiri</td><td>Lama</td><td>UMUM
align='right'>J18.9</td><td>Pneumonia, unspecified</td><td></td><td
HARTININGSIH</td><td>SUHARDI 07 07 S 02</td><td>BURUH HARIAN
LEPAS</td><td>BANJAR RT 01 RW
PURWANTINI</td><td>LUWARNO</td><td>PETANI/PEKEBUN</td><td>GENTUNG</td><td>GENTUNG</
td><td>NGARGOHARJO</td><td>PUSTU NGARGOHARJO</td><td>SUSI HERAWATI, AMK</td><td> -
align='right'>57030336</td><td>06-02-2019</td><td>SRI RAHAYU</td><td>BOYADI 07 03
B 05</td><td>PELAJAR/MAHASISWA</td><td>KUWANG
RT02/06</td><td>KUWANG</td><td>PUCANGANOM</td><td>INDUK</td><td>dr. ZAENAL ARIFIN
</tr><tr><td align='right'>S01.7</td><td>Multiple open wounds of
head</td><td></td><td align='right'>287962</td><td
align='right'>54080029</td><td>06-02-2019</td><td>SRI REJEKI</td><td>MISMAN 04 0 8
M 02</td><td>PELAJAR/MAHASISWA</td><td>NGANTAP RT03
</tr><tr><td align='right'>I11.0</td><td>Hypertensive heart disease with
align='right'>57090246</td><td>06-02-2019</td><td>SRI SAYEKTI</td><td>GUNADI 07 09
G 01</td><td>PETANI/PEKEBUN</td><td>PUCANGANOM LOR RT 01RW 09</td><td>PUCANGANOM
Wilayah</td><td>'3312024509630004</td><td>'3312024509630004</td><td>170</td><td>100
</td></tr><tr><td align='right'>J45.9</td><td>Asthma, unspecified</td><td></td><td
2019</td><td>SRIYANI</td><td>MISNO</td><td>PETANI/PEKEBUN</td><td>KLEPU</td><td>KLE
PU</td><td>NGARGOHARJO</td><td>PUSTU NGARGOHARJO</td><td>SUSI HERAWATI,
align='right'>56020472</td><td>06-02-2019</td><td>SUBAGYO</td><td>SUBAGYO 0602 S
align='right'>J30</td><td>Vasomotor and allergic rhinitis</td><td></td><td
2019</td><td>SUJIRAH</td><td>GIMAN 06 05 G
2019</td><td>SUKARMI</td><td>SUKARMI</td><td>PENSIUNAN</td><td>GENTUNG</td><td>GENT
UNG</td><td>NGARGOHARJO</td><td>PUSTU NGARGOHARJO</td><td>SUSI HERAWATI,
align='right'>51025003</td><td>06-02-
2019</td><td>SUKATNI</td><td>SARIMIN</td><td>PETANI/PEKEBUN</td><td>NGRINGIN</td><t
/td></tr><tr><td align='right'>I10</td><td>Essential (primary)
align='right'>51037024</td><td>06-02-
2019</td><td>SUKINAH</td><td>PARDI</td><td>PETANI/PEKEBUN</td><td>PRINGKUKU</td><td
>PRINGKUKU</td><td>NGARGOHARJO</td><td>PUSTU NGARGOHARJO</td><td>SUSI HERAWATI,
align='right'>51037024</td><td>06-02-
/td></tr><tr><td align='right'>K29.6</td><td>Other gastritis</td><td></td><td
2019</td><td>SUKINI</td><td>LANTIP</td><td>PETANI/PEKEBUN</td><td>NGRINGIN</td><td>
NGRINGIN</td><td>NGARGOHARJO</td><td>PUSTU NGARGOHARJO</td><td>SUSI HERAWATI,
dermatitis</td><td></td><td align='right'>287953</td><td
align='right'>56010158</td><td>06-02-2019</td><td>SUKIRMO</td><td>SUKIRMO 0601 S
22</td><td>PETANI/PEKEBUN</td><td>GIRITONTRO LOR RT01 RW01</td><td>GIRITONTRO
2019</td><td>SULARNI</td><td>TUKINO</td><td>PETANI/PEKEBUN</td><td>GIRIROTO</td><td
>GIRIROTO</td><td>JATIREJO</td><td>PKD JATIREJO</td><td>SUHARNI</td><td> -
2019</td><td>SULASTRI</td><td>TRIONO</td><td>PETANI/PEKEBUN</td><td>SALAM</td><td>T
2019</td><td>SULASTRI</td><td>KASIMUN</td><td>PETANI/PEKEBUN</td><td>GINADE
></tr><tr><td align='right'>H11.0</td><td>Pterygium</td><td></td><td
2019</td><td>SUMINI</td><td>SUMARNO 0308 S 10</td><td>KARYAWAN
SWASTA</td><td>GINADE KULON RT02 RW03</td><td>GINADE
KULON</td><td>TLOGOHARJO</td><td>INDUK</td><td>dr. ZAENAL ARIFIN
align='right'>51057012</td><td>06-02-
2019</td><td>SUNARTI</td><td>PAIJAN</td><td>PETANI/PEKEBUN</td><td>GENTUNG</td><td>
GENTUNG</td><td>NGARGOHARJO</td><td>PUSTU NGARGOHARJO</td><td>SUSI HERAWATI,
2019</td><td>SUNARWI</td><td>SUJARTO</td><td>PETANI/PEKEBUN</td><td>SUMBERJO</td><t
align='right'>J02.9</td><td>Acute pharyngitis, unspecified</td><td></td><td
2019</td><td>SUPARTIN</td><td>EDI SUMARNO 0502 E
02</td><td>PETANI/PEKEBUN</td><td>GIRIROTO RT02
RW06,JATIREJO</td><td>GIRIROTO</td><td>JATIREJO</td><td>INDUK</td><td>dr. ZAENAL
ARIFIN HP</td><td>SUWARTO,S.Kep.Nes</td><td>P</td><td>20-44 Thn.</td><td>Datang
2019</td><td>SUPIAH</td><td></td><td>PETANI/PEKEBUN</td><td>BLEBER</td><td>BLEBER</
2019</td><td>SURATMI</td><td>KARMIN 0704 K
<td>INDUK</td><td>dr. ZAENAL ARIFIN
2019</td><td>SUWARTI</td><td>WAKIDI</td><td>PETANI/PEKEBUN</td><td>PRINGKUKU</td><t
d>PRINGKUKU</td><td>NGARGOHARJO</td><td>PUSTU NGARGOHARJO</td><td>SUSI HERAWATI,
align='right'>51037027</td><td>06-02-
align='right'>11110215</td><td>06-02-
2019</td><td>SUWARTI</td><td></td><td>PETANI/PEKEBUN</td><td>GEDOMPOL</td><td></td>
<td>JAWA TIMUR</td><td>PUSTU TLOGOSARI</td><td>SULARNO,S.Kep.Ns</td><td> -
</td><td>P</td><td>45-54 Thn.</td><td>Datang
align='right'>Z30.4</td><td>Surveillance of contraceptive drugs</td><td></td><td
2019</td><td>SUWARTI</td><td>SUTRISNO</td><td>PETANI/PEKEBUN</td><td>GINADE
align='right'>57035004</td><td>06-02-2019</td><td>TANAYA VIDYA
MAHARANI</td><td>KETUT SETIAWAN 07 03 K 14</td><td>BELUM/TIDAK
align='right'>57020085</td><td>06-02-2019</td><td>TRIYANTO</td><td>SUKINO 0702 T
22</td><td>LAINNYA</td><td>SUKOROYOM KULON</td><td>SUKOROYOM
WETAN</td><td>PUCANGANOM</td><td>INDUK</td><td>dr. ZAENAL ARIFIN
/td></tr><tr><td align='right'>K29.1</td><td>Other acute gastritis</td><td></td><td
2019</td><td>TUGINAH</td><td>TUGINAH 06 01 T
02</td><td>PETANI/PEKEBUN</td><td>GIRITONTRO LOR RT01 RW 02</td><td>GIRITONTRO
></tr><tr><td align='right'>R53</td><td>Malaise and fatigue</td><td></td><td
2019</td><td>TUKINI</td><td>TUKINI</td><td>PETANI/PEKEBUN</td><td>KRANGGAN</td><td>
KRANGGAN</td><td>TLOGOHARJO</td><td>PUSTU BAYEMHARJO</td><td>RISTINA Amd
Keb</td><td> - </td><td>P</td><td>>70 Thn.</td><td>Datang
align='right'>I50.0</td><td>Congestive heart failure</td><td></td><td
2019</td><td>TUMINEM</td><td>SUWARDI 0105 S
10</td><td>PETANI/PEKEBUN</td><td>GENTUNG RT 02 RW
03</td><td>GENTUNG</td><td>NGARGOHARJO</td><td>INDUK</td><td>dr. BUDI
2019</td><td>UMIYATUN</td><td>UMIYATUN 07 05
U1</td><td>PELAJAR/MAHASISWA</td><td>SIKOROYOM KULON RRT 03 RW 03</td><td>SUKOROYOM
></tr><tr><td align='right'>G43.8</td><td>Other migraine</td><td></td><td
2019</td><td>WIDODO</td><td>WIDODO 0709 W 07</td><td>WIRASWASTA</td><td>PUCANGANOM
LOR RT02 RW09</td><td>PUCANGANOM LOR</td><td>PUCANGANOM</td><td>INDUK</td><td>dr.
d></tr><tr><td align='right'>K29.6</td><td>Other gastritis</td><td></td><td
2019</td><td>WIJI</td><td></td><td>PETANI/PEKEBUN</td><td>NGRINGIN</td><td>NGRINGIN
</td><td>NGARGOHARJO</td><td>PUSTU
NGARGOHARJO</td><td>SUSI HERAWATI, AMK</td><td> - </td><td>P</td><td>60-69
></tr><tr><td align='right'>I11.0</td><td>Hypertensive heart disease with
align='right'>56100079</td><td>06-02-2019</td><td>WONGSO PADMO
SISWANTO</td><td>WONGSO PADMO SISWANTO 0610 W
11</td><td>PENSIUNAN</td><td>TANGGUNG</td><td></td><td>GIRITONTRO</td><td>INDUK</td
><td>dr. BUDI ASHARI</td><td>SUWARTO,S.Kep.Nes</td><td>L</td><td>>70
></tr><tr><td align='right'>Z00.8</td><td>Other general
examinations</td><td></td><td align='right'>288018</td><td
align='right'>15151370</td><td>07-02-2019</td><td>ALI
MUSTOFA</td><td>JAINO/SOETIRTO </td><td>KARYAWAN SWASTA</td><td>BEKASI RT02
RW01</td><td></td><td>JAKARTA</td><td>INDUK</td><td>dr. BUDI
2019</td><td>ANING PULUNGSARI</td><td>PEPRI 05 04 P
02</td><td>PETANI/PEKEBUN</td><td>KANIGORO RT02
ASHARI</td><td>RETNO AMBARWATI AMD KEB</td><td>P</td><td>20-44 Thn.</td><td>Datang
</tr><tr><td align='right'>M79.1</td><td>Myalgia</td><td></td><td
2019</td><td>ANISA WAHYU</td><td>DIMIN 0214 D
01</td><td>PELAJAR/MAHASISWA</td><td>GUPAKAN RT02
RW03</td><td>GUPAKAN</td><td>TLOGOSARI</td><td>INDUK</td><td>dr. BUDI
></tr><tr><td align='right'>A15.6</td><td>Tuberculous pleurisy, confirmed
bacteriologically and histologically</td><td></td><td align='right'>288059</td><td
align='right'>53020096</td><td>07-02-2019</td><td>ANISA YULIANA</td><td>SUNARSIH
0302 S 36</td><td>KARYAWAN SWASTA</td><td>SAMBIREJO RT03
RW01</td><td>SAMBIREJO</td><td>TLOGOHARJO</td><td>INDUK</td><td>dr. BUDI
align='right'>57150072</td><td>07-02-2019</td><td>ARVINO NAZRI
RASHAD</td><td>SURONO 0715 S 22</td><td>BELUM/TIDAK BEKERJA</td><td>SAWIT KIDUL
RT 01RW14</td><td>SAWIT KIDUL</td><td>PUCANGANOM</td><td>INDUK</td><td>dr. BUDI
ASHARI</td><td>RETNO AMBARWATI AMD KEB</td><td>L</td><td>1-4 Thn.</td><td>Datang
td></tr><tr><td align='right'>D36.9</td><td>Benign neoplasm of unspecified
site</td><td></td><td align='right'>288025</td><td
align='right'>56010076</td><td>07-02-2019</td><td>CAESAR FADLI
MARDIANTO</td><td>SUTINO 0601 S 53</td><td>PERANGKAT DESA</td><td>GIRITONTRO
LOR</td><td>GIRITONTRO LOR</td><td>GIRITONTRO</td><td>INDUK</td><td>dr. BUDI
></tr><tr><td align='right'>K04.1</td><td>Necrosis of pulp</td><td></td><td
2019</td><td>CAHYA ANJANI</td><td>YUDI 0909 Y
03</td><td>PELAJAR/MAHASISWA</td><td>SELOREJO RT01
2019</td><td>CIPTA
DOPINKA</td><td>PAIJAN</td><td>PELAJAR/MAHASISWA</td><td>SOKO</td><td>SOKO</td><td>
TLOGOSARI</td><td>PUSTU TLOGOSARI</td><td>SULARNO,S.Kep.Ns</td><td> -
></tr><tr><td align='right'>R50.9</td><td>Fever, unspecified</td><td></td><td
2019</td><td>FABRIAN PUTANTO</td><td>TEGUH 1010 T 02</td><td>BELUM/TIDAK
BEKERJA</td><td>PARANGGUPITO</td><td></td><td>PARANGGUPITO</td><td>INDUK</td><td>dr
. BUDI ASHARI</td><td>RETNO AMBARWATI AMD KEB</td><td>L</td><td>1-4
align='right'>288055</td><td align='right'>51070058</td><td>07-02-2019</td><td>FAIS
DELTA FACHRUROZI</td><td>IWAN NURFIANTO</td><td>PELAJAR/MAHASISWA</td><td>NGASEM
RT02 RW04</td><td>NGASEM</td><td>NGARGOHARJO</td><td>INDUK</td><td>drg.DANAR
</tr><tr><td align='right'>S99</td><td>Other and unspecified injuries of ankle and
foot</td><td></td><td align='right'>288035</td><td
align='right'>10101372</td><td>07-02-2019</td><td>FAIZ ALEXI
PRATAMA</td><td>GIYARNO 1010 G 02</td><td>BELUM/TIDAK
BEKERJA</td><td>BLIMBING</td><td></td><td>PARANGGUPITO</td><td>INDUK</td><td>dr.
BUDI ASHARI</td><td>RETNO AMBARWATI AMD KEB</td><td>P</td><td>1-4
align='right'>56010020</td><td>07-02-2019</td><td>FHYANDRA ALIF
RAMADHAN</td><td>KARTINI 06 01 K 01</td><td>PETANI/PEKEBUN</td><td>GIRITONTRO
align='right'>51070056</td><td>07-02-2019</td><td>FILMA ALIYA
CANDRAWATI</td><td>HENI SETIAWAN 0107 H 01</td><td>BELUM/TIDAK
BEKERJA</td><td>NGASEM RT02
RW04</td><td>NGASEM</td><td>NGARGOHARJO</td><td>INDUK</td><td>drg.DANAR
2019</td><td>HERNI</td><td>BUDIANTO 1010 B 03</td><td>MENGURUS RUMAH
TANGGA</td><td>BLIMBING</td><td></td><td>PARANGGUPITO</td><td>INDUK</td><td>drg.DAN
AR
align='right'>11110217</td><td>07-02-
2019</td><td>INTAN</td><td></td><td>PELAJAR/MAHASISWA</td><td>PUDAK</td><td></td><t
d>JAWA TIMUR</td><td>PUSTU TLOGOSARI</td><td>SULARNO,S.Kep.Ns</td><td> -
2019</td><td>ISNADI</td><td></td><td>PETANI/PEKEBUN</td><td>GLAGAH</td><td>GLAGAH</
align='right'>57050120</td><td>07-02-2019</td><td>JAMIATUN</td><td>SAMIYO 0705 S
ASHARI</td><td>SULARNO,S.Kep.Ns</td><td>P</td><td>55-59 Thn.</td><td>Datang
align='right'>55070032</td><td>07-02-2019</td><td>JULIO AFANDY RIZKY
ANUGRAH</td><td>ANDRI SUSANTO</td><td>BELUM/TIDAK
BEKERJA</td><td>NGELOSARI</td><td>NGELOSARI</td><td>JATIREJO</td><td>PKD
JATIREJO</td><td>SUHARNI</td><td> - </td><td>L</td><td>5-9 Thn.</td><td>Datang
align='right'>L20.9</td><td>Atopic dermatitis, unspecified</td><td></td><td
2019</td><td>KALIMAN</td><td>KALIMAN</td><td>PETANI/PEKEBUN</td><td>PORO</td><td>PO
RO</td><td>TLOGOSARI</td><td>PKD TLOGOSARI</td><td>RETNO AMBARWATI AMD KEB</td><td>
- </td><td>L</td><td>>70 Thn.</td><td>Datang Sendiri</td><td>Baru</td><td>BPJS
></tr><tr><td align='right'>I11</td><td>Hypertensive heart disease</td><td></td><td
2019</td><td>KARTINEM</td><td>MULYONO 0713 M
02</td><td>PETANI/PEKEBUN</td><td>KEPUH RT02
RW12</td><td>KEPUH</td><td>PUCANGANOM</td><td>INDUK</td><td>dr. BUDI
2019</td><td>KARTINI</td><td>KARTINI 06 01 K
align='right'>57080063</td><td>07-02-2019</td><td>KASIH</td><td>TUGIMIN 0708 T
></tr><tr><td align='right'>N34.3</td><td>Urethral syndrome,
align='right'>58081256</td><td>07-02-2019</td><td>KASMADI</td><td>KASMADI 0808 K
18</td><td>PENSIUNAN</td><td>BELIK RT03
RW12</td><td></td><td>PRACIMANTORO</td><td>INDUK</td><td>dr. BUDI
2019</td><td>KASTINI</td><td>WARDI</td><td>PETANI/PEKEBUN</td><td>NGASEM</td><td>NG
ASEM</td><td>JATIREJO</td><td>PKD JATIREJO</td><td>SUHARNI</td><td> -
2019</td><td>KATIMAN</td><td>KATIMAN</td><td>PETANI/PEKEBUN</td><td>GENTUNG</td><td
>GENTUNG</td><td>NGARGOHARJO</td><td>PUSTU NGARGOHARJO</td><td>SUSI HERAWATI,
AMK</td><td> - </td><td>L</td><td>60-69 Thn.</td><td>Datang
2019</td><td>KATINEM</td><td>KATINEM</td><td>PETANI/PEKEBUN</td><td>GIRIROTO</td><t
d>GIRIROTO</td><td>JATIREJO</td><td>PKD JATIREJO</td><td>SUHARNI</td><td> -
align='right'>56020365</td><td>07-02-2019</td><td>KATMI</td><td>SOMO 06 02 S
36</td><td>PETANI/PEKEBUN</td><td>GIRITONTRO KIDUL RT 01 RW 03</td><td>GIRITONTRO
ASHARI</td><td>SULARNO,S.Kep.Ns</td><td>P</td><td>60-69 Thn.</td><td>Datang
align='right'>53050077</td><td>07-02-2019</td><td>KRISTIANTO</td><td>KRISTIANTO
0305 K 03</td><td>KARYAWAN SWASTA</td><td>PLARENG RT03
RW05</td><td>PLARENG</td><td>TLOGOHARJO</td><td>INDUK</td><td>dr. BUDI
ASHARI</td><td>SULARNO,S.Kep.Ns</td><td>L</td><td>20-44 Thn.</td><td>Datang
2019</td><td>LASTRI</td><td>GIARSO</td><td>PETANI/PEKEBUN</td><td>BAYEM</td><td>BAY
/td></tr><tr><td
align='right'>F20</td><td>Schizophrenia</td><td></td><td
align='right'>288040</td><td align='right'>57020081</td><td>07-02-2019</td><td>LENI
WULANSARI</td><td>SUNARDI 0702 S 28</td><td>MENGURUS RUMAH
TANGGA</td><td>SUKOROYOM WETAN</td><td>SUKOROYOM
align='right'>57010086</td><td>07-02-2019</td><td>MAHESA RIDHO AL HABIB</td><td>EKO
PURWANTO 0701 E 01</td><td>PELAJAR/MAHASISWA</td><td>GROGOL RT01
RW02</td><td>GROGOL</td><td>PUCANGANOM</td><td>INDUK</td><td>dr. BUDI
align='right'>53040060</td><td>07-02-2019</td><td>MALIKA NINDYA INDAH
KIRANA</td><td>SLAMET PURWOKO 0304 S 10</td><td>BELUM/TIDAK
BEKERJA</td><td>PUREMBE RT01
RW02</td><td>PUREMBE</td><td>TLOGOHARJO</td><td>INDUK</td><td>dr. BUDI
ASHARI</td><td>RETNO AMBARWATI AMD KEB</td><td>P</td><td><1 Thn.</td><td>Datang
align='right'>57010188</td><td>07-02-2019</td><td>MARSUDI ANAS
MUJAHID</td><td>MARSUDI 0701 M 01</td><td>PETANI/PEKEBUN</td><td>GROGOL
RT03RW02</td><td>GROGOL</td><td>PUCANGANOM</td><td>INDUK</td><td>dr. BUDI
2019</td><td>MELODI GASTAN KIANA </td><td> SULISTYO 0605 S 39</td><td>BELUM/TIDAK
BEKERJA</td><td>NGUJUNG</td><td>NGUJUNG</td><td>GIRITONTRO</td><td>INDUK</td><td>dr
. BUDI ASHARI</td><td>RETNO AMBARWATI AMD KEB</td><td>P</td><td><1
align='right'></td><td align='right'>3</td><td
align='right'></td><td>KIA</td><td></td><td></td><td>Dalam
align='right'>56050082</td><td>07-02-2019</td><td>MELODY FANELLO EIEVEL
LISGITA</td><td>SULISTYO 0605 S 39</td><td>PELAJAR/MAHASISWA</td><td>NGUJUNG RT03
2019</td><td>MISMAN</td><td>MISMAN</td><td>PETANI/PEKEBUN</td><td>BAYEM</td><td>BAY
</td><td>L</td><td>60-69 Thn.</td><td>Datang Sendiri</td><td>Baru</td><td>UMUM
align='right'>288006</td><td align='right'>57110230</td><td>07-02-2019</td><td>MITA
SRI RAHAYU</td><td>ANTON 0711 A 04</td><td>MENGURUS RUMAH TANGGA</td><td>PLOSO
RT02 RW11</td><td>PLOSO</td><td>PUCANGANOM</td><td>INDUK</td><td>dr. BUDI
align='right'>57040307</td><td>07-02-2019</td><td>NADIA RATNA EKA
PUTRI</td><td>SRIYANTO 0704 S
24</td><td>PELAJAR/MAHASISWA</td><td>MANDEYAN</td><td>MANDEYAN</td><td>PUCANGANOM</
td><td>INDUK</td><td>dr. BUDI
align='right'>55035002</td><td>07-02-2019</td><td>NANI
S</td><td>SULARNO</td><td>PETANI/PEKEBUN</td><td>SONGGODULANG</td><td>SONGGODULANG<
/td><td>JATIREJO</td><td>PKD JATIREJO</td><td>SUHARNI</td><td> -
align='right'>J11</td><td>Influenza, virus not identified</td><td></td><td
2019</td><td>PONIYEM</td><td>TUKIYO 02 02 T
07</td><td>PETANI/PEKEBUN</td><td>MANTHANG RT02
RW07</td><td>MANTHANG</td><td>TLOGOSARI</td><td>INDUK</td><td>dr. BUDI
RAHAYU</td><td>MISWANTO 0601 M 10</td><td>MENGURUS RUMAH TANGGA</td><td>GIRITONTRO
LOR</td><td></td><td>GIRITONTRO</td><td>INDUK</td><td>dr. BUDI ASHARI</td><td>RETNO
AMBARWATI AMD KEB</td><td>P</td><td>20-44 Thn.</td><td>Datang
align='right'>57030163</td><td>07-02-2019</td><td>RAFAEL</td><td>JEMAKUN 07 03 J
01</td><td>BELUM/TIDAK BEKERJA</td><td>KUWANG RT 01 RW
align='right'>55050096</td><td>07-02-2019</td><td>RAKA AJI
PANGESTU</td><td>SUGIYANTO 05 05 S 09</td><td>KARYAWAN SWASTA</td><td>PUNUNG RT02
RW 02</td><td>PUNUNG</td><td>JATIREJO</td><td>INDUK</td><td>dr. BUDI
align='right'>57110111</td><td>07-02-2019</td><td>RETNO WULANDARI</td><td>FITRIANTO
07 11 F 01</td><td>MENGURUS RUMAH TANGGA</td><td>PLOSO RT01
RW11</td><td>PLOSO</td><td>PUCANGANOM</td><td>INDUK</td><td>dr. BUDI
align='right'>K04.1</td><td>Necrosis of pulp</td><td></td><td
align='right'>288023</td><td align='right'>51030008</td><td>07-02-2019</td><td>REVI
MINOKASARI</td><td>SUNARTO 0103 S 03</td><td>MENGURUS RUMAH
TANGGA</td><td>PRINGKUKU RT 02 RW
02</td><td>PRINGKUKU</td><td>NGARGOHARJO</td><td>INDUK</td><td>drg.DANAR
</tr><tr><td align='right'>K03.6</td><td>Deposits [accretions] on
teeth</td><td></td><td align='right'>288023</td><td
align='right'>51030008</td><td>07-02-2019</td><td>REVI MINOKASARI</td><td>SUNARTO
0103 S 03</td><td>MENGURUS RUMAH TANGGA</td><td>PRINGKUKU RT 02 RW
</tr><tr><td align='right'>Z34.8</td><td>Supervision of other normal
align='right'>57050139</td><td>07-02-2019</td><td>RINI WIDI ASTUTI</td><td>SUGIYONO
0705 S 02</td><td>MENGURUS RUMAH TANGGA</td><td>SUKOROYOM KULON</td><td>SUKOROYOM
KULON</td><td>PUCANGANOM</td><td>INDUK</td><td>dr. BUDI ASHARI</td><td>RETNO
AMBARWATI AMD KEB</td><td>P</td><td>20-44 Thn.</td><td>Datang
2019</td><td>RIVALDI</td><td>SUTIMIN</td><td>PELAJAR/MAHASISWA</td><td>NGELO</td><t
d>NGELO</td><td>TLOGOSARI</td><td>PUSTU TLOGOSARI</td><td>SULARNO,S.Kep.Ns</td><td>
align='right'>52130055</td><td>07-02-2019</td><td>RIYANI</td><td>SARMO 0213 S
10</td><td>KARYAWAN SWASTA</td><td>KERJO RT03
RW03</td><td>KERJO</td><td>TLOGOSARI</td><td>INDUK</td><td>dr. BUDI
align='right'>M79.1</td><td>Myalgia</td><td></td><td align='right'>288196</td><td
align='right'>55025064</td><td>07-02-2019</td><td>RUTH SUWARNI</td><td>MARLINA
SUKIMIN</td><td>PETANI/PEKEBUN</td><td>GIRIROTO</td><td>GIRIROTO</td><td>JATIREJO</
td><td>PKD JATIREJO</td><td>SUHARNI</td><td> - </td><td>P</td><td>60-69
align='right'>K04.7</td><td>Periapical abscess without sinus</td><td></td><td
2019</td><td>SADIMIN</td><td>SADIMIN 0405 S 06</td><td>PENSIUNAN</td><td>DOLOGAN
RT01 RW02</td><td>DOLOGAN</td><td>BAYEMHARJO</td><td>INDUK</td><td>drg.DANAR
align='right'>11110230</td><td>07-02-
2019</td><td>SAKIJEM</td><td></td><td>PETANI/PEKEBUN</td><td>PUDAK</td><td></td><td
>JAWA TIMUR</td><td>PUSTU TLOGOSARI</td><td>SULARNO,S.Kep.Ns</td><td> -
2019</td><td>SAMINEM</td><td>SAMINEM</td><td>PETANI/PEKEBUN</td><td>PRINGKUKU</td><
td>PRINGKUKU</td><td>NGARGOHARJO</td><td>PUSTU NGARGOHARJO</td><td>SUSI HERAWATI,
d align='right'>R05</td><td>Cough</td><td></td><td align='right'>288230</td><td
align='right'>51037040</td><td>07-02-
d align='right'>R05</td><td>Cough</td><td></td><td align='right'>288231</td><td
align='right'>51037040</td><td>07-02-
d align='right'>I10</td><td>Essential (primary) hypertension</td><td></td><td
d align='right'>I10</td><td>Essential (primary) hypertension</td><td></td><td
2019</td><td>SANIJEM</td><td></td><td>MENGURUS RUMAH
TLOGOSARI</td><td>SULARNO,S.Kep.Ns</td><td> - </td><td>P</td><td>>70
2019</td><td>SARMI</td><td>SAGIMIN</td><td>PETANI/PEKEBUN</td><td>NGRINGIN</td><td>
NGRINGIN</td><td>NGARGOHARJO</td><td>PUSTU NGARGOHARJO</td><td>SUSI HERAWATI,
2019</td><td>SARYANTI</td><td></td><td>PETANI/PEKEBUN</td><td>SUMBERJO</td><td>SUMB
ERJO</td><td>TLOGOSARI</td><td>PUSTU TLOGOSARI</td><td>SULARNO,S.Kep.Ns</td><td> -
align='right'>D50.9</td><td>Iron deficiency anaemia, unspecified</td><td></td><td
2019</td><td>SEPTIN KINASIH</td><td></td><td>MENGURUS RUMAH
TANGGA</td><td>NGRINGIN</td><td>NGRINGIN</td><td>NGARGOHARJO</td><td>PUSTU
align='right'>57130022</td><td>07-02-2019</td><td>SISILIA ANGGI
KUSUMAWATI</td><td>SUNARNO0713 S
17</td><td></td><td>KEPUH</td><td>KEPUH</td><td>PUCANGANOM</td><td>INDUK</td><td>dr
g.DANAR WULANDARI</td><td>RIZKI ANISSA, AM.Kg</td><td>P</td><td>5-9
align='right'>57140107</td><td>07-02-2019</td><td>SISWANTO</td><td>SISWANTO 0714
S 26</td><td>PETANI/PEKEBUN</td><td>PENDEM RT02
Sendiri</td><td>Baru</td><td>JAMKESDA</td><td>Rajal</td><td
align='right'>56100028</td><td>07-02-2019</td><td>SITI MUZAYANAH</td><td>SUPARMIN
06 10 S 36</td><td>MENGURUS RUMAH TANGGA</td><td>TANGGUNG RT 04 RW
05</td><td>TANGGUNG</td><td>GIRITONTRO</td><td>INDUK</td><td>dr. BUDI
2019</td><td>SIYEM</td><td>SIYEM</td><td>PETANI/PEKEBUN</td><td>GIRIROTO</td><td>GI
RIROTO</td><td>JATIREJO</td><td>PKD JATIREJO</td><td>SUHARNI</td><td> -
align='right'>56020381</td><td>07-02-2019</td><td>SOMO WIREJO</td><td>SOMO WIREJO
0602 S 36</td><td>PETANI/PEKEBUN</td><td>GIRITONTRO KIDUL</td><td>GIRITONTRO
align='right'>13131369</td><td>07-02-2019</td><td>SRI LESTARI</td><td>AGUS SETIAWAN
1313 A 04</td><td>MENGURUS RUMAH TANGGA</td><td>GUNUNG CILIK RT02
RW08</td><td></td><td>WONOGIRI</td><td>INDUK</td><td>dr. BUDI
2019</td><td>SUGIYEM</td><td>IRFAN SUHARTOYO 06 01 I 02</td><td>MENGURUS RUMAH
TANGGA</td><td>GIRITONTRO LOR RT2 RW02</td><td>GIRITONTRO
2019</td><td>SUKARTI</td><td>SUTARJO 06 03 S
RW07</td><td>GEBLUG</td><td>GIRITONTRO</td><td>INDUK</td><td>drg.DANAR
2019</td><td>SUKATMI</td><td>SUKATMI</td><td>PETANI/PEKEBUN</td><td>GENTUNG</td><td
2019</td><td>SULARNI</td><td>TUKINO</td><td>PETANI/PEKEBUN</td><td>GIRIROTO</td><td
></tr><tr><td align='right'>M79.04</td><td>Rheumatism, unspecified,
hand</td><td></td><td align='right'>288022</td><td
align='right'>57070283</td><td>07-02-2019</td><td>SUMARSO</td><td>SUMARSO 0707
S03</td><td>PETANI/PEKEBUN</td><td>BANJAR RT01
></tr><tr><td align='right'>H82</td><td>Vertiginous syndromes in diseases
align='right'>51037067</td><td>07-02-
2019</td><td>SUMINEM</td><td></td><td>PETANI/PEKEBUN</td><td>PRINGKUKU</td><td>PRIN
GKUKU</td><td>NGARGOHARJO</td><td>PUSTU NGARGOHARJO</td><td>SUSI HERAWATI,
align='right'>57145012</td><td>07-02-2019</td><td>SUNARMI</td><td>MUSTAQIM 0714
M03</td><td>PETANI/PEKEBUN</td><td>PENDEM RT01
></tr><tr><td align='right'>Z02.8</td><td>Other examinations for administrative
align='right'>57060139</td><td>07-02-2019</td><td>SUPADMI</td><td>JAINO 0706 J
03</td><td>MENGURUS RUMAH TANGGA</td><td>TAMBAHSARI RT02
RW07</td><td>TAMBAHSARI</td><td>PUCANGANOM</td><td>INDUK</td><td>dr. BUDI
align='right'>55110112</td><td>07-02-2019</td><td>SURIP</td><td>PAIMAN 0511 P
align='right'>54015023</td><td>07-02-
2019</td><td>SUTANTI</td><td>LEHAN</td><td>PETANI/PEKEBUN</td><td>BELEH</td><td>BEL
EH</td><td>BAYEMHARJO</td><td>PUSTU BAYEMHARJO</td><td>RISTINA Amd Keb</td><td> -
2019</td><td>SUTANTI</td><td>LEHAN</td><td>PETANI/PEKEBUN</td><td>BELEH</td><td>BEL
EH</td><td>BAYEMHARJO</td><td>PUSTU BAYEMHARJO</td><td>RISTINA Amd Keb</td><td> -
align='right'>L20.8</td><td>Other atopic dermatitis</td><td></td><td
2019</td><td>SUTI</td><td>SUTI 09 09 S 24</td><td>PENSIUNAN</td><td>NAWANGAN RT 02
RW 07</td><td></td><td>GIRIWOYO</td><td>INDUK</td><td>dr. BUDI
align='right'></td><td align='right'>9</td><td align='right'>64</td><td>BP.
align='right'>54025005</td><td>07-02-
2019</td><td>SUWARNI</td><td>SUWARNI</td><td>PETANI/PEKEBUN</td><td>NGUNDUK</td><td
>NGUNDUK</td><td>BAYEMHARJO</td><td>PUSTU BAYEMHARJO</td><td>RISTINA Amd
Keb</td><td> - </td><td>P</td><td>20-44 Thn.</td><td>Datang
></tr><tr><td align='right'>Z30.4</td><td>Surveillance of contraceptive
align='right'>55025070</td><td>07-02-
2019</td><td>SUYANTI</td><td>WIYAHTO</td><td>PETANI/PEKEBUN</td><td>GIRIROTO</td><t
align='right'>A15</td><td>Respiratory tuberculosis, bacteriologically and
histologically confirmed</td><td></td><td align='right'>288058</td><td
align='right'>55050110</td><td>07-02-2019</td><td>SUYANTO</td><td>SUYANTO 05 05 S
21</td><td>PETANI/PEKEBUN</td><td>PUNUNG RT 02 RW
02</td><td>PUNUNG</td><td>JATIREJO</td><td>INDUK</td><td>dr. BUDI
align='right'>52105005</td><td>07-02-
2019</td><td>SUYATMI</td><td>SUPRIYONO</td><td>PETANI/PEKEBUN</td><td>PORO</td><td>
PORO</td><td>TLOGOSARI</td><td>PKD TLOGOSARI</td><td>RETNO AMBARWATI AMD
KEB</td><td> - </td><td>P</td><td>20-44 Thn.</td><td>Datang
align='right'>56100092</td><td>07-02-2019</td><td>TASYA</td><td>NASRUN 0610 N
01</td><td>PELAJAR/MAHASISWA</td><td>TANGGUNG</td><td>TANGGUNG</td><td>GIRITONTRO</
td><td>INDUK</td><td>dr. BUDI ASHARI</td><td>SUGIYONO,S.Kep.Ns</td><td>P</td><td>5-
9 Thn.</td><td>Datang Sendiri</td><td>Lama</td><td>Umum</td><td>Rajal</td><td
2019</td><td>TINEM</td><td>SONOKARIYO</td><td>PETANI/PEKEBUN</td><td>NGUNDUK</td><t
d>NGUNDUK</td><td>BAYEMHARJO</td><td>PUSTU BAYEMHARJO</td><td>RISTINA Amd
></tr><tr><td align='right'>M06.8</td><td>Other specified rheumatoid
arthritis</td><td></td><td align='right'>288229</td><td
align='right'>51057021</td><td>07-02-
2019</td><td>TINI</td><td>TINI</td><td>PENSIUNAN</td><td>GENTUNG</td><td>GENTUNG</t
2019</td><td>TINI</td><td>TINI</td><td>PENSIUNAN</td><td>GENTUNG</td><td>GENTUNG</t
align='right'>G44.2</td><td>Tension-type headache</td><td></td><td
2019</td><td>TUKIJEM</td><td>PAIMAN</td><td></td><td>NGRINGIN</td><td>NGRINGIN</td>
<td>NGARGOHARJO</td><td>PUSTU NGARGOHARJO</td><td>SUSI HERAWATI, AMK</td><td> -
2019</td><td>TUKINEM</td><td>KATU</td><td>PETANI/PEKEBUN</td><td>SOKO</td><td>SOKO<
align='right'>51080013</td><td>07-02-2019</td><td>TUKIYAH</td><td>WALUYO 0108 W
04</td><td>PETANI/PEKEBUN</td><td>NGADIREJO
RT.03/04</td><td>NGADIREJO</td><td>NGARGOHARJO</td><td>INDUK</td><td>dr. BUDI
td></tr><tr><td align='right'>K29.7</td><td>Gastritis, unspecified</td><td></td><td
2019</td><td>TUKIYEM</td><td>SUTARNO</td><td>PETANI/PEKEBUN</td><td>GIRIROTO</td><t
2019</td><td>TUKIYEM</td><td>GIMUN</td><td>PETANI/PEKEBUN</td><td>PORO</td><td>PORO
</td><td>TLOGOSARI</td><td>PKD TLOGOSARI</td><td>RETNO AMBARWATI AMD KEB</td><td> -
PBI</td><td>Rajal</td><td
align='right'>11110194</td><td>07-02-
2019</td><td>TUMINEM</td><td></td><td>PETANI/PEKEBUN</td><td>PUDAK</td><td></td><td
align='right'>57050019</td><td>07-02-2019</td><td>WAHYU EMY NINGSIH</td><td>DIAN
WINARTO 0705 D 01</td><td>PETANI/PEKEBUN</td><td>SUKOROYOM
KULON</td><td>SUKOROYOM KULON</td><td>PUCANGANOM</td><td>INDUK</td><td>dr. BUDI
align='right'>57010277</td><td>07-02-2019</td><td>WAHYU RISTI</td><td>RISTIYANTO
0701 R 03</td><td>PELAJAR/MAHASISWA</td><td>GROGOL
</td><td>GROGOL</td><td>PUCANGANOM</td><td>INDUK</td><td>dr. BUDI
2019</td><td>WAHYUNI</td><td>MUHANSORI 07 04 M 07</td><td>MENGURUS RUMAH
TANGGA</td><td>MANDEYAN RT 02 RW
01</td><td>MANDEYAN</td><td>PUCANGANOM</td><td>INDUK</td><td>dr. BUDI
2019</td><td>WALTINI</td><td>YATNO 06 01 Y 01</td><td>MENGURUS RUMAH
cause</td><td></td><td align='right'>288754</td><td align='right'>0309</td><td>07-
02-
2019</td><td>WARSINI</td><td>WARINO</td><td>PETANI/PEKEBUN</td><td>KRANGGAN</td><td
>KRANGGAN</td><td>TLOGOHARJO</td><td>PUSTU BAYEMHARJO</td><td>RISTINA Amd
align='right'>57020033</td><td>07-02-2019</td><td>WIRATI</td><td>SUNARDI 0702 S
align='right'>K08.3</td><td>Retained dental root</td><td></td><td
align='right'>288034</td><td align='right'>58080156</td><td>07-02-2019</td><td>YENI
MARTUTI</td><td>HARMOKO 0808 H
03</td><td>PEDAGANG</td><td>PARANGGUPITO</td><td></td><td>PARANGGUPITO</td><td>INDU
K</td><td>drg.DANAR WULANDARI</td><td>RIZKI ANISSA, AM.Kg</td><td>P</td><td>20-44
align='right'>31</td><td>BP. Gigi</td><td></td><td></td><td>Luar
align='right'>C50.9</td><td>Malignant neoplasm of breast,
align='right'>55020079</td><td>08-02-2019</td><td>AYU FATMA SARI</td><td>RIBUT
WAHYUDI 0502 R 01</td><td>PETANI/PEKEBUN</td><td>GIRIROTO RT02
RW06</td><td>GIRIROTO</td><td>JATIREJO</td><td>INDUK</td><td>dr. BUDI
drugs</td><td></td><td align='right'>288201</td><td align='right'>0502</td><td>08-
02-2019</td><td>AYUK</td><td>RIBUT</td><td>MENGURUS RUMAH
TANGGA</td><td>GIRIROTO</td><td>GIRIROTO</td><td>JATIREJO</td><td>PKD
JATIREJO</td><td>SUHARNI</td><td> - </td><td>P</td><td>20-44 Thn.</td><td>Datang
align='right'>57020174</td><td>08-02-2019</td><td>BOIMIN</td><td>BOIMIN 07 02 B
03</td><td>PETANI/PEKEBUN</td><td>SUKOROYOM WETAN RT01 RW04</td><td>SUKOROYOM
d></tr><tr><td align='right'>D69.0</td><td>Allergic purpura</td><td></td><td
2019</td><td>EXEL</td><td>BUDI SANTOSO 0703 B 07</td><td>BELUM/TIDAK
align='right'>4</td><td>KIA</td><td>Poli Anak</td><td>RSUD DR. SOEDIRAN MS
2019</td><td>HASTUTIK</td><td>MISMIN</td><td>PETANI/PEKEBUN</td><td>GIRIROTO</td><t
></tr><tr><td align='right'>J11.0</td><td>Influenza with pneumonia, virus not
align='right'>57100172</td><td>08-02-2019</td><td>HIMAWAN TRI CAHYONO</td><td>SRI
LESTARI 0710 S 28</td><td>PELAJAR/MAHASISWA</td><td>JEPURUN RT02
RW10</td><td>JEPURUN</td><td>PUCANGANOM</td><td>INDUK</td><td>dr. BUDI
align='right'>56020237</td><td>08-02-2019</td><td>KAMINI</td><td>UMAR NAYIRI 06 02
U 01</td><td>MENGURUS RUMAH TANGGA</td><td>GIRITONTRO KIDUL RT05
align='right'>57170044</td><td>08-02-2019</td><td>KARTI</td><td>KARTI 0717 K
07</td><td>PETANI/PEKEBUN</td><td>WATES RT01
RW17</td><td>WATES</td><td>PUCANGANOM</td><td>INDUK</td><td>dr. BUDI
align='right'>55030044</td><td>08-02-2019</td><td>KARYO SUWARTO</td><td>KARYO
SUWARTO 05 03 K 05</td><td>BELUM/TIDAK BEKERJA</td><td>SONGGODULANG RT 01 RW
align='right'>57060076</td><td>08-02-2019</td><td>KASIRAN</td><td>KASIRAN 0706 K
03</td><td>PENSIUNAN</td><td>TAMBAHSARI</td><td>TAMBAHSARI</td><td>PUCANGANOM</td><
td>INDUK</td><td>dr. BUDI ASHARI</td><td>SUGIYONO,S.Kep.Ns</td><td>L</td><td>>70
d></tr><tr><td align='right'>M19.95</td><td>Arthrosis, unspecified, pelvic and
thigh</td><td></td><td align='right'>288060</td><td
align='right'>57020249</td><td>08-02-2019</td><td>KASNO</td><td>KASNO 07 02 K
06</td><td>PETANI/PEKEBUN</td><td>SUKOROYOM WETAN RT 02 RW 04</td><td>SUKOROYOM
align='right'>57070193</td><td>08-02-2019</td><td>KHOIRUNISA PUTRI A</td><td>SUGENG
07 07 S 08</td><td>BELUM/TIDAK BEKERJA</td><td>BANJAR RT03
align='right'>57020017</td><td>08-02-2019</td><td>MARINAH</td><td>BOIMIN 0702 B
align='right'>52145059</td><td>08-02-2019</td><td>MUHAMAD RIZAL
ARIANTO</td><td>YAHMIN</td><td>PELAJAR/MAHASISWA</td><td>GUPAKAN</td><td>GUPAKAN</t
d><td>TLOGOSARI</td><td>PKD TLOGOSARI</td><td>RETNO AMBARWATI AMD KEB</td><td> -
</td><td>L</td><td>10-14 Thn.</td><td>Datang Sendiri</td><td>Lama</td><td>BPJS NON
align='right'>56080147</td><td>08-02-2019</td><td>NUR AINI</td><td>ROHMAD LUBIS
0608 R 04</td><td></td><td>DUNGKLEPU WETAN</td><td>DUNG KLEPU
WETAN</td><td>GIRITONTRO</td><td>INDUK</td><td>dr. BUDI ASHARI</td><td>RISTINA Amd
Keb</td><td>P</td><td>1-4 Thn.</td><td>Datang Sendiri</td><td>Lama</td><td>UMUM
align='right'>56020047</td><td>08-02-2019</td><td>PARTINA SAYEKTI</td><td>SARNO
0602 S 16</td><td>MENGURUS RUMAH TANGGA</td><td>GIRITONTRO
KIDUL</td><td>GIRITONTRO KIDUL</td><td>GIRITONTRO</td><td>INDUK</td><td>dr. BUDI
></tr><tr><td align='right'>Z35</td><td>Supervision of high-risk
align='right'>57050267</td><td>08-02-2019</td><td>RUSNAENI</td><td>IMAM SAFINGI
0705 I 03</td><td>BURUH HARIAN LEPAS</td><td>SUKOROYOM
></tr><tr><td align='right'>I20.9</td><td>Angina pectoris,
align='right'>54050004</td><td>08-02-2019</td><td>SAMINO, </td><td>SAMINO, 04 05
S 04</td><td>PENSIUNAN</td><td>DOLOGAN RRT 01 RW
02</td><td>DOLOGAN</td><td>BAYEMHARJO</td><td>INDUK</td><td>dr. BUDI
</tr><tr><td align='right'>I11.9</td><td>Hypertensive heart disease without
align='right'>54070025</td><td>08-02-2019</td><td>SATIYEM</td><td>SATIYEM 0407 S
11</td><td>PETANI/PEKEBUN</td><td>NGALURAN RT 01 RW
d align='right'>F20.6</td><td>Simple schizophrenia</td><td></td><td
2019</td><td>SEPI</td><td>SEPI 0311 S 13</td><td>PETANI/PEKEBUN</td><td>GINADE
ETAN RT03 RW03</td><td>GINADE ETAN</td><td>TLOGOHARJO</td><td>INDUK</td><td>dr.
align='right'>56060035</td><td>08-02-2019</td><td>SHINTA KUSUMA PUTRI
SAMSURI</td><td>SETYO SAMSURI 06 06 S 12</td><td>PELAJAR/MAHASISWA</td><td>GOBOH
RT 01 RW 06</td><td>GOBOH</td><td>GIRITONTRO</td><td>INDUK</td><td>dr. BUDI
align='right'>56070048</td><td>08-02-2019</td><td>SIGIT</td><td>NANANG 0607 N
01</td><td>PELAJAR/MAHASISWA</td><td>DUNGKANCIL</td><td>DUNG
/td></tr><tr><td align='right'>L25.9</td><td>Unspecified contact dermatitis,
unspecified cause</td><td></td><td align='right'>288079</td><td
align='right'>56060126</td><td>08-02-2019</td><td>SRI SULASTRI</td><td>SRI SULASTRI
0606 S 30</td><td>PETANI/PEKEBUN</td><td>GOBOH RT02
RW06</td><td>GOBOH</td><td>GIRITONTRO</td><td>INDUK</td><td>dr. BUDI
align='right'>51055003</td><td>08-02-2019</td><td>SUKATMI</td><td>SUKATMI 5105 S
03</td><td>PETANI/PEKEBUN</td><td>GENTUNG RT 02 RW
03</td><td>GENTUNG</td><td>NGARGOHARJO</td><td>INDUK</td><td>dr. BUDI
align='right'>51120075</td><td>08-02-2019</td><td>SUPARTI</td><td>SUPRAPTO 0112 S
05</td><td>PETANI/PEKEBUN</td><td>SELUR RT03
RW05</td><td>SELUR</td><td>NGARGOHARJO</td><td>INDUK</td><td>dr. BUDI
align='right'>56010170</td><td>08-02-2019</td><td>SURIP</td><td>SAMTO 0601 S
align='right'>55025038</td><td>08-02-
2019</td><td>SURYANI</td><td>JOKO</td><td>PETANI/PEKEBUN</td><td>GIRIROTO</td><td>G
IRIROTO</td><td>JATIREJO</td><td>PKD JATIREJO</td><td>SUHARNI</td><td> -
align='right'>53030026</td><td>08-02-2019</td><td>SUTARDI</td><td>SUTARDI 03 03 S
11</td><td>WIRASWASTA</td><td>JAJAR RT 05 RW
02</td><td>JAJAR</td><td>TLOGOHARJO</td><td>INDUK</td><td>dr. BUDI
align='right'>53030001</td><td>08-02-2019</td><td>SUTINEM</td><td>SARNEN 0303 S
06</td><td>PETANI/PEKEBUN</td><td>JAJAR</td><td>JAJAR</td><td>TLOGOHARJO</td><td>IN
DUK</td><td>dr. BUDI ASHARI</td><td>SUGIYONO,S.Kep.Ns</td><td>P</td><td>>70
d></tr><tr><td align='right'>J45</td><td>Asthma</td><td></td><td
align='right'>57090171</td><td>08-02-2019</td><td>SUYATI</td><td>SUYATI 0709 S
43</td><td>PETANI/PEKEBUN</td><td>PUCANGANOM LOR RT02
align='right'>53080014</td><td>08-02-2019</td><td>TUGINO</td><td>TUGINO 03 08 T
01</td><td>PETANI/PEKEBUN</td><td>GINADE KULON RT 01 RW 03</td><td>GINADE
KULON</td><td>TLOGOHARJO</td><td>INDUK</td><td>dr. BUDI
2019</td><td>TUKIYO</td><td>TUKIYO</td><td>PETANI/PEKEBUN</td><td>GIRIROTO</td><td>
GIRIROTO</td><td>JATIREJO</td><td>PKD JATIREJO</td><td>SUHARNI</td><td> -
align='right'>F20.6</td><td>Simple schizophrenia</td><td></td><td
2019</td><td>TUMINI</td><td>WARSO 0302 W
02</td><td>PETANI/PEKEBUN</td><td>SAMBIREJO</td><td>SAMBIREJO</td><td>TLOGOHARJO</t
d><td>INDUK</td><td>dr. BUDI ASHARI</td><td>SUGIYONO,S.Kep.Ns</td><td>P</td><td>45-
54 Thn.</td><td>Datang Sendiri</td><td>Lama</td><td>BPJS PBI</td><td>Rajal</td><td
align='right'>57170045</td><td>09-02-2019</td><td>AIUNURSILA
ERLANDINI</td><td>MUSTAQIM 0717 M 04</td><td>PELAJAR/MAHASISWA</td><td>WATES RT01
></tr><tr><td align='right'>B00</td><td>Herpesviral [herpes simplex]
infections</td><td></td><td align='right'>288110</td><td
align='right'>57030252</td><td>09-02-2019</td><td>ALINA SALSABILA</td><td>UMAR
0703 U 02</td><td>BELUM/TIDAK
BEKERJA</td><td>KUWANG</td><td>KUWANG</td><td>PUCANGANOM</td><td>INDUK</td><td>dr.
BUDI ASHARI</td><td>SRI SUPATMI</td><td>P</td><td>1-4 Thn.</td><td>Datang
2019</td><td>BENING</td><td>TIKTO</td><td>BELUM/TIDAK
BEKERJA</td><td>TAMBAK</td><td>TAMBAK</td><td>TLOGOSARI</td><td>PKD
align='right'>K37</td><td>Unspecified appendicitis</td><td></td><td
2019</td><td>DAUNI</td><td>SUTIMAN 0610 S
34</td><td>PETANI/PEKEBUN</td><td>TANGGUNG RT01
RW05,GIRITONTRO</td><td>TANGGUNG</td><td>GIRITONTRO</td><td>INDUK</td><td>dr. BUDI
></tr><tr><td align='right'>I50.9</td><td>Heart failure,
align='right'>56025017</td><td>09-02-2019</td><td>DIKEM</td><td>KIMIN 0602 K
align='right'>57120061</td><td>09-02-2019</td><td>DIVA ALFATUNISA</td><td>AGUS
PARMANTO 0712 A 02</td><td>BELUM/TIDAK BEKERJA</td><td>INGAK INGUK</td><td>INGAK
- INGUK</td><td>PUCANGANOM</td><td>INDUK</td><td>dr. BUDI ASHARI</td><td>SRI
align='right'>288098</td><td align='right'>56100309</td><td>09-02-2019</td><td>EKO
SRI WIBOWO</td><td>EKO SRI WIBOWO 0610 E 01</td><td>PEGAWAI NEGERI
SIPIL</td><td>TANGGUNG 04
></tr><tr><td align='right'>Z35.1</td><td>Supervision of pregnancy with history of
abortive outcome</td><td></td><td align='right'>288089</td><td
align='right'>55060103</td><td>09-02-2019</td><td>FEBRI EKA YULIANTI</td><td>PARMO
0506 P 07</td><td>MENGURUS RUMAH TANGGA</td><td>JATI RT03
RW03</td><td>JATI</td><td>JATIREJO</td><td>INDUK</td><td>dr. BUDI
></tr><tr><td align='right'>Z39.2</td><td>Routine postpartum follow-
up</td><td></td><td align='right'>288112</td><td align='right'>53030062</td><td>09-
02-2019</td><td>IDA PRASETYA</td><td>PURWADI 03 03 P 06</td><td>KARYAWAN
SWASTA</td><td>JAJAR RT04
RW02</td><td>JAJAR</td><td>TLOGOHARJO</td><td>INDUK</td><td>dr. BUDI
align='right'>55090001</td><td>09-02-2019</td><td>KALISTA</td><td>EKO RUDIYANTO
0509 E
02</td><td></td><td>MULWOSARI</td><td>MULWOSARI</td><td>JATIREJO</td><td>INDUK</td>
<td>dr. BUDI ASHARI</td><td>SUGIYONO,S.Kep.Ns</td><td>P</td><td>5-9
align='right'>57030199</td><td>09-02-2019</td><td>MA'RUF ABIDA</td><td>NGATMAN
0703 N 02</td><td>BELUM/TIDAK BEKERJA</td><td>KUWANG RT01
ASHARI</td><td>SRI MURWATININGSIH</td><td>L</td><td>1-4 Thn.</td><td>Datang
align='right'>E05.9</td><td>Thyrotoxicosis, unspecified</td><td></td><td
2019</td><td>MISRI</td><td>MISRI 0208 M
05</td><td>PETANI/PEKEBUN</td><td>TLOGOSARI</td><td>TLOGOSARI</td><td>TLOGOSARI</td
><td>INDUK</td><td>dr. BUDI ASHARI</td><td>SUGIYONO,S.Kep.Ns</td><td>L</td><td>60-
69 Thn.</td><td>Datang Sendiri</td><td>Lama</td><td>BPJS PBI</td><td>Rujuk</td><td
align='right'>57130040</td><td>09-02-2019</td><td>PARNI</td><td>SULIHNO 0713 S
align='right'>56020333</td><td>09-02-2019</td><td>RATNA NURAINI</td><td>KATWADI
0602 K 19</td><td>BELUM/TIDAK BEKERJA</td><td>GIRITONTRO KIDUL</td><td>GIRITONTRO
KIDUL</td><td>GIRITONTRO</td><td>INDUK</td><td>dr. BUDI ASHARI</td><td>SRI
align='right'>M79.10</td><td>Myalgia, multiple sites</td><td></td><td
2019</td><td>RIBUT SRI WAHYUNI</td><td>SUHERMAN 0707 S
align='right'>56010049</td><td>09-02-2019</td><td>RIDHO ARDIANTO</td><td>SUPRIYANTO
0601 S 15</td><td>PELAJAR/MAHASISWA</td><td>GIRITONTRO LOR RT 01 RW
02</td><td>GIRITONTRO LOR</td><td>GIRITONTRO</td><td>INDUK</td><td>drg.DANAR
align='right'>57090188</td><td>09-02-2019</td><td>RIZKI A P</td><td>SURADI 07 09 S
19</td><td>PELAJAR/MAHASISWA</td><td>PUCANGANOM LOR RT03 RW09</td><td>PUCANGANOM
align='right'>53050010</td><td>09-02-2019</td><td>SADIYEM</td><td>KARMAN 0305 K
01</td><td>PETANI/PEKEBUN</td><td>PLARENG
RT03 RW04</td><td>PLARENG</td><td>TLOGOHARJO</td><td>INDUK</td><td>dr. BUDI
align='right'>56020512</td><td>09-02-2019</td><td>SARMI</td><td>MISNO 0602 M
22</td><td>PETANI/PEKEBUN</td><td>GIRITONTRO KIDUL RT02/03</td><td>GIRITONTRO
align='right'>288094</td><td align='right'>56080323</td><td>09-02-2019</td><td>SIFA
FAUZIAH</td><td>SEDIYANTO 0608 S 33</td><td>BELUM/TIDAK BEKERJA</td><td>DUNGKLEPU
WETAN</td><td>DUNG KLEPU WETAN</td><td>GIRITONTRO</td><td>INDUK</td><td>drg.DANAR
align='right'>56080016</td><td>09-02-2019</td><td>SUKATMIN</td><td>SUKATMIN 06 08 S
></tr><tr><td align='right'>H60.9</td><td>Otitis externa,
align='right'>56050172</td><td>09-02-2019</td><td>SULARDI</td><td>SUYLARDI 06 05 S
21</td><td>PETANI/PEKEBUN</td><td>NGUJUNG RT 04 RW
align='right'>57050013</td><td>09-02-2019</td><td>SUMARNI</td><td>SUMADI 07 05 S
07</td><td>MENGURUS RUMAH TANGGA</td><td>SUKOROYOM KULON RT 02 RW
03</td><td>SUKOROYOM KULON</td><td>PUCANGANOM</td><td>INDUK</td><td>dr. BUDI
align='right'>57050067</td><td>09-02-2019</td><td>TRI WINARTI</td><td> SUMADI/AHMAD
SATINI 07 05 S 07</td><td>PELAJAR/MAHASISWA</td><td>SUKOROYOM KULON RT 02 RW
03</td><td>SUKOROYOM KULON</td><td>PUCANGANOM</td><td>INDUK</td><td>dr. BUDI
align='right'>57130004</td><td>09-02-2019</td><td>WASINI</td><td>KATIMAN 0713 K
2019</td><td>WASIYEM</td><td>GITO</td><td>PETANI/PEKEBUN</td><td>TAMBAK</td><td>TAM
BAK</td><td>TLOGOSARI</td><td>PKD TLOGOSARI</td><td>RETNO AMBARWATI AMD
align='right'>56100024</td><td>09-02-2019</td><td>WIJI SUNARSI</td><td>EKO SRI
WIBOWO 06 01 E 01</td><td>PEGAWAI NEGERI SIPIL</td><td>TANGGUNG RT 04 RW
align='right'>57120088</td><td>11-02-2019</td><td>ADAM VAISAL</td><td>SIGIT 07 12
S 15</td><td>BELUM/TIDAK BEKERJA</td><td>NGAK INGUK RT 01 RW 16</td><td>INGAK -
INGUK</td><td>PUCANGANOM</td><td>INDUK</td><td>dr. BUDI ASHARI</td><td>UMI NUR
ISNIATI</td><td>L</td><td>1-4 Thn.</td><td>Datang
td></tr><tr><td align='right'>C48.8</td><td>Malignant neoplasm overlapping
retroperitoneum and peritoneum sites</td><td></td><td align='right'>288166</td><td
align='right'>56040142</td><td>11-02-2019</td><td>ADVIS SAFA
ARBIANSYAH</td><td>TULUS 0604 T 06</td><td>KARYAWAN SWASTA</td><td>KETONGGO RT02
RW07</td><td>KETONGGO</td><td>GIRITONTRO</td><td>INDUK</td><td>dr. BUDI
Sendiri</td><td>Baru</td><td>UMUM WONOGIRI</td><td>Rujuk</td><td
Umum</td><td>Poli Bedah</td><td>RS PKU MUHAMMADIYAH SURAKARTA</td><td>Dalam
align='right'>Z00.6</td><td>Examination for normal comparison and control in
clinical research programme</td><td></td><td align='right'>288129</td><td
align='right'>57140108</td><td>11-02-2019</td><td>AGUNG SUSILO</td><td>AGUNG SUSILO
0714 A 01</td><td>KARYAWAN SWASTA</td><td>PENDEM RT01
align='right'>288126</td><td align='right'>53080070</td><td>11-02-2019</td><td>ALYA
KAYSHA ZAAFARANI</td><td>SUHONO 03 08 S 11</td><td>BELUM/TIDAK
BEKERJA</td><td>GIBNADE KULON RT 01 RW 03</td><td>GINADE
align='right'>53080070</td><td>11-02-2019</td><td>ALYA KAYSHA
ZAAFARANI</td><td>SUHONO 03 08 S 11</td><td>BELUM/TIDAK BEKERJA</td><td>GIBNADE
KULON RT 01 RW 03</td><td>GINADE KULON</td><td>TLOGOHARJO</td><td>INDUK</td><td>dr.
align='right'>56010428</td><td>11-02-2019</td><td>AMIRA HASNA
SABILA</td><td>SULARTO 06 01 S 01</td><td>BELUM/TIDAK BEKERJA</td><td>GIRITONTRO
align='right'>288504</td><td align='right'>55025053</td><td>11-02-2019</td><td>ANI
WIDIYASTUTI</td><td>GITO</td><td>PETANI/PEKEBUN</td><td>GIRIROTO</td><td>GIRIROTO</
td><td>JATIREJO</td><td>PKD JATIREJO</td><td>SUHARNI</td><td> -
></tr><tr><td align='right'>B01.9</td><td>Varicella without
complication</td><td></td><td align='right'>288501</td><td
align='right'>55040008</td><td>11-02-2019</td><td>ANING
PULUNGSARI</td><td>PEPRI</td><td>PETANI/PEKEBUN</td><td>KANIGORO</td><td>KANIGORO</
td><td>JATIREJO</td><td>PKD JATIREJO</td><td>SUHARNI</td><td> -
2019</td><td>AQILA AYATUL HUSNA</td><td>PARWANTO 0303 P 05</td><td>BELUM/TIDAK
BEKERJA</td><td>JAJAR RT04
RW02</td><td>JAJAR</td><td>TLOGOHARJO</td><td>INDUK</td><td>drg.DANAR
2019</td><td>ARKAN SAID RAMADHAN</td><td>MARGO BUDI HATNO 0405 M
04</td><td>BELUM/TIDAK BEKERJA</td><td>DOLOGAN RT01
RW02</td><td>DOLOGAN</td><td>BAYEMHARJO</td><td>INDUK</td><td>drg.DANAR
align='right'>288115</td><td align='right'>55030045</td><td>11-02-2019</td><td>ASEP
ARIWIBOWO</td><td>SULARTO 0503 S 10</td><td>BELUM/TIDAK
BEKERJA</td><td>SONGGODULANG RT 01 RW
01</td><td>SONGGODULANG</td><td>JATIREJO</td><td>INDUK</td><td>dr. BUDI
></tr><tr><td align='right'>Z23.2</td><td>Need for immunization against
tuberculosis [BCG]</td><td></td><td align='right'>288526</td><td
align='right'>57010279</td><td>11-02-2019</td><td>ASSIFA PUTU AURA
ZASKIA</td><td>ANJAR ARDIYANTO</td><td>BELUM/TIDAK
BEKERJA</td><td>GROGOL</td><td>GROGOL</td><td>PUCANGANOM</td><td>INDUK</td><td>RETN
O AMBARWATI AMD KEB</td><td> - </td><td>P</td><td>8-30 hari</td><td>Datang
Sendiri</td><td>Baru</td><td>Imunisasi</td><td>Rajal</td><td
align='right'>Z23.2</td><td>Need for immunization against tuberculosis
[BCG]</td><td></td><td align='right'>288260</td><td
align='right'>57010279</td><td>11-02-2019</td><td>ASSYIFA PUTRI AURA
ZASKIA</td><td>WARINO/FAJAR ARDIYANTO</td><td>BELUM/TIDAK
hari</td><td>Datang Sendiri</td><td>Baru</td><td>Imunisasi</td><td>Rajal</td><td
align='right'>0</td><td>Imunisasi</td><td></td><td></td><td>Dalam
align='right'>Z24.0</td><td>Need for immunization against
poliomyelitis</td><td></td><td align='right'>288260</td><td
align='right'>57010279</td><td>11-02-2019</td><td>ASSYIFA PUTRI AURA
ZASKIA</td><td>WARINO/FAJAR ARDIYANTO</td><td>BELUM/TIDAK
align='right'>D17.0</td><td>Benign lipomatous neoplasm of skin and subcutaneous
tissue of head, face and neck</td><td></td><td align='right'>288150</td><td
align='right'>56080123</td><td>11-02-2019</td><td>ATIKA JANI
ARANIFA</td><td>SUGIRAN 0608 S 04</td><td>BELUM/TIDAK BEKERJA</td><td>DUNGKLEPU
WETAN</td><td>DUNG KLEPU WETAN</td><td>GIRITONTRO</td><td>INDUK</td><td>dr. BUDI
align='right'></td><td align='right'>1</td><td>KIA</td><td></td><td></td><td>Dalam
align='right'>56080001</td><td>11-02-2019</td><td>AZAH RANIFAH</td><td>SUGIRAN 06
08 S 04</td><td>PELAJAR/MAHASISWA</td><td>DUNGKLEPU WETAN</td><td>DUNG KLEPU
align='right'>57010278</td><td>11-02-2019</td><td>AZAM
MAULANA</td><td>SUTARTO</td><td>BELUM/TIDAK BEKERJA</td><td>GROGOL RT02
ASHARI</td><td>RETNO AMBARWATI AMD KEB</td><td>L</td><td>0-7 hari</td><td>Datang
MAULANA</td><td>SUTARTO</td><td>BELUM/TIDAK BEKERJA</td><td>GROGOL RT02
MAULANA</td><td>SUTARTO</td><td>BELUM/TIDAK
BEKERJA</td><td>GROGOL</td><td>GROGOL</td><td>PUCANGANOM</td><td>INDUK</td><td>RETN
O AMBARWATI AMD KEB</td><td> - </td><td>L</td><td>0-7 hari</td><td>Datang
align='right'>53010087</td><td>11-02-2019</td><td>AZKIA AURELLIA
WALISTA</td><td>PURWADI</td><td>BELUM/TIDAK BEKERJA</td><td>TLOGO RT02
RW01</td><td>TLOGO</td><td>TLOGOHARJO</td><td>INDUK</td><td>dr. BUDI
align='right'>Z24.0</td><td>Need
for immunization against poliomyelitis</td><td></td><td
2019</td><td>AZKIA AURELLIA WALISTA</td><td>PURWADI</td><td>BELUM/TIDAK
BEKERJA</td><td>TLOGO RT02
align='right'>53010087</td><td>11-02-2019</td><td>AZKIA AURELLIA
WALISTA</td><td>PURWADI</td><td>BELUM/TIDAK
BEKERJA</td><td>TLOGO</td><td>TLOGO</td><td>TLOGOHARJO</td><td>INDUK</td><td>RETNO
AMBARWATI AMD KEB</td><td> - </td><td>P</td><td>8-30 hari</td><td>Datang
align='right'>57050360</td><td>11-02-2019</td><td>BERLIAN KUSUMA</td><td>HARIYANTO
07 05 H 08</td><td>PELAJAR/MAHASISWA</td><td>SUKOROYM KULON</td><td>SUKOROYOM
></tr><tr><td align='right'>C61</td><td>Malignant neoplasm of
prostate</td><td></td><td align='right'>288144</td><td
align='right'>52010106</td><td>11-02-2019</td><td>BOGIMIN</td><td>BOGIMIN 0201 B
02</td><td>PETANI/PEKEBUN</td><td>GEMBUK RT02
RW07</td><td>GEMBUK</td><td>TLOGOSARI</td><td>INDUK</td><td>dr. BUDI
align='right'>52077002</td><td>11-02-
2019</td><td>BOINEM</td><td>PONIJAN</td><td>PETANI/PEKEBUN</td><td>SUMBERJO</td><td
>SUMBERJO</td><td>TLOGOSARI</td><td>PUSTU
align='right'>51130059</td><td>11-02-2019</td><td>BUDI HANDOYO</td><td>BUDI HANDOYO
0113 B 01</td><td>SOPIR</td><td>GEDANGAN RT01
RW05</td><td>GEDANGAN</td><td>NGARGOHARJO</td><td>INDUK</td><td>dr. BUDI
align='right'>56070079</td><td>11-02-2019</td><td>DASRINAH</td><td>KATIMIN 0607 K
></tr><tr><td align='right'>Z00.6</td><td>Examination for normal comparison and
control in clinical research programme</td><td></td><td
KARTIKA SARI</td><td>AGUNG SUSILO 0714 A 01</td><td>MENGURUS RUMAH
TANGGA</td><td>PENDEM RT 01 RW
15</td><td>PENDEM</td><td>PUCANGANOM</td><td>INDUK</td><td>dr. BUDI
2019</td><td>DZAKY ANWAR FAIQ</td><td>SUGENG 01 03 S 04</td><td>BELUM/TIDAK
BEKERJA</td><td>PRINGKUKU RT 02 RW
2019</td><td>DZAKY ANWAR FAIQ</td><td>SUGENG 01 03 S 04</td><td>BELUM/TIDAK
BEKERJA</td><td>PRINGKUKU RT 02 RW
align='right'>52077018</td><td>11-02-2019</td><td>EDI PRIHANI</td><td>HERI
SUWANDI</td><td>PETANI/PEKEBUN</td><td>SUMBERJO</td><td>SUMBERJO</td><td>TLOGOSARI<
/td><td>PUSTU TLOGOSARI</td><td>SULARNO,S.Kep.Ns</td><td> - </td><td>P</td><td>55-
align='right'>56010469</td><td>11-02-2019</td><td>ENDANG NUR CAHYANI</td><td>ABDUL
FATAH 06 01 A 05</td><td>PEGAWAI NEGERI SIPIL</td><td>GIRITONTRO
align='right'>288506</td><td align='right'>0503</td><td>11-02-2019</td><td>FITRI
HARYATI</td><td>SUMADI</td><td>MENGURUS RUMAH
TANGGA</td><td>SONGGODULANG</td><td>SONGGODULANG</td><td>JATIREJO</td><td>PKD
align='right'>56050218</td><td>11-02-2019</td><td>GALIH
SAPUTRA</td><td>WAHYU/SLAMET</td><td>BELUM/TIDAK
align='right'>56050218</td><td>11-02-2019</td><td>GALIH
SAPUTRA</td><td>WAHYU/SLAMET</td><td>BELUM/TIDAK
[BCG]</td><td></td><td
2019</td><td>GALIH SAPUTRA</td><td>WAHYU</td><td>BELUM/TIDAK
BEKERJA</td><td>NGUJUNG</td><td>NGUJUNG</td><td>GIRITONTRO</td><td>INDUK</td><td>RE
TNO AMBARWATI AMD KEB</td><td> - </td><td>L</td><td>8-30 hari</td><td>Datang
align='right'>57050303</td><td>11-02-2019</td><td>GALUH KIRANA</td><td>AGUS 0705
A 14</td><td>PELAJAR/MAHASISWA</td><td> SUKOROYOM KULON RT01 RW03</td><td>SUKOROYOM
align='right'>56050217</td><td>11-02-2019</td><td>GALUH
SAPUTRI</td><td>WAHYU/SLAMET</td><td>BELUM/TIDAK
. BUDI ASHARI</td><td>RETNO AMBARWATI AMD KEB</td><td>P</td><td>8-30
SAPUTRI</td><td>WAHYU/SLAMET</td><td>BELUM/TIDAK
SAPUTRI</td><td>WAHYU</td><td>BELUM/TIDAK
BEKERJA</td><td>NGUJUNG</td><td>NGUJUNG</td><td>GIRITONTRO</td><td>INDUK</td><td>RE
TNO AMBARWATI AMD KEB</td><td> - </td><td>P</td><td>8-30 hari</td><td>Datang
align='right'>M79.0</td><td>Rheumatism, unspecified</td><td></td><td
align='right'>288124</td><td align='right'>57090141</td><td>11-02-2019</td><td>HADI
WIYONO</td><td>HADI WIYONO 0709 H 01</td><td>PETANI/PEKEBUN</td><td>PUCANGANOM LOR
RT02 RW09</td><td>PUCANGANOM LOR</td><td>PUCANGANOM</td><td>INDUK</td><td>dr. BUDI
></tr><tr><td align='right'>Z41.3</td><td>Ear piercing</td><td></td><td
2019</td><td>HANINDITAN TSABITA KHAMA</td><td>YUDI SETYAWAN 0705 Y
01</td><td>BELUM/TIDAK BEKERJA</td><td>SUKOROYOM KULON</td><td>SUKOROYOM
KULON</td><td>PUCANGANOM</td><td>INDUK</td><td>dr. BUDI ASHARI</td><td>UMI NUR
ISNIATI</td><td>P</td><td><1 Thn.</td><td>Datang Sendiri</td><td>Lama</td><td>UMUM
WONOGIRI</td><td>Rajal</td><td align='right'></td><td align='right'>1</td><td
align='right'>I50.9</td><td>Heart failure, unspecified</td><td></td><td
2019</td><td>HARDANI</td><td>PAIDI 04 06 P 06</td><td>PETANI/PEKEBUN</td><td>BAYEM
RT 1 RW 01</td><td>BAYEM</td><td>BAYEMHARJO</td><td>INDUK</td><td>dr. BUDI
align='right'>56065025</td><td>11-02-2019</td><td>ISMINI</td><td>SUGIYARNO 0606 S
25</td><td>PETANI/PEKEBUN</td><td>GOBOH</td><td>GOBOH</td><td>GIRITONTRO</td><td>IN
</tr><tr><td align='right'>M13.9</td><td>Arthritis, unspecified</td><td></td><td
2019</td><td>JIKEM</td><td>JIKEM</td><td>PETANI/PEKEBUN</td><td>PELET</td><td>PELET
</td><td>NGARGOHARJO</td><td>PUSTU NGARGOHARJO</td><td>SUSI HERAWATI, AMK</td><td>
align='right'>56020219</td><td>11-02-2019</td><td>KANAYA NAURA
QALISIYA</td><td>M.NUR HUDA</td><td>BELUM/TIDAK
align='right'>56020219</td><td>11-02-2019</td><td>KANAYA NAURA
QALISIYA</td><td>M.NUR HUDA</td><td>BELUM/TIDAK
align='right'>56020219</td><td>11-02-2019</td><td>KANAYA NAURA QALISIYA</td><td>M
NUR HUDA</td><td>BELUM/TIDAK BEKERJA</td><td>GIRITONTRO KIDUL</td><td>GIRITONTRO
KIDUL</td><td>GIRITONTRO</td><td>INDUK</td><td>RETNO AMBARWATI AMD KEB</td><td> -
</td><td>P</td><td>8-30 hari</td><td>Datang
2019</td><td>KARYO SUMANTO</td><td>KARYO
SUMANTO</td><td>PETANI/PEKEBUN</td><td>TLOGOSARI</td><td>TLOGOSARI</td><td>TLOGOSAR
I</td><td>PUSTU TLOGOSARI</td><td>SULARNO,S.Kep.Ns</td><td> -
</td><td>L</td><td>>70 Thn.</td><td>Datang Sendiri</td><td>Lama</td><td>BPJS NON
2019</td><td>KATIJEM</td><td></td><td>PETANI/PEKEBUN</td><td>BLEBER</td><td>BLEBER<
/td><td>NGARGOHARJO</td><td>PUSTU NGARGOHARJO</td><td>SUSI HERAWATI, AMK</td><td> -
2019</td><td>KATIJEM</td><td></td><td>PETANI/PEKEBUN</td><td>BLEBER</td><td>BLEBER<
align='right'>57090075</td><td>11-02-2019</td><td>KATIKEM</td><td>HADI WIYONO 0709
H 01</td><td>PETANI/PEKEBUN</td><td>PUCANGANOM LOR RT 02 RW 09</td><td>PUCANGANOM
2019</td><td>KINEM</td><td>PARMAN</td><td>PETANI/PEKEBUN</td><td>NGRINGIN</td><td>N
GRINGIN</td><td>NGARGOHARJO</td><td>PUSTU NGARGOHARJO</td><td>SUSI HERAWATI,
align='right'>53110013</td><td>11-02-2019</td><td>LESTARI PUJI
ASTUTI</td><td>TRIYANTO 0311 T 03</td><td>PETANI/PEKEBUN</td><td>GINADE WETAN RT03
RW03,TLOGOHARJO</td><td>GINADE ETAN</td><td>TLOGOHARJO</td><td>INDUK</td><td>dr.
align='right'>14141377</td><td>11-02-2019</td><td>LUTFI KHASANAH</td><td>JAMIN
1414 J 01</td><td>PELAJAR/MAHASISWA</td><td>SUKOHARJO</td><td></td><td>JAWA
TENGAH</td><td>INDUK</td><td>dr. BUDI
2019</td><td>MANIYEM</td><td>KATIJO</td><td>PETANI/PEKEBUN</td><td>PELET</td><td>PE
LET</td><td>NGARGOHARJO</td><td>PUSTU NGARGOHARJO</td><td>SUSI HERAWATI,
2019</td><td>MANREJO</td><td>MANREJO</td><td>PETANI/PEKEBUN</td><td>NGELO</td><td>N
GELO</td><td>TLOGOSARI</td><td>PUSTU TLOGOSARI</td><td>SULARNO,S.Kep.Ns</td><td> -
></tr><tr><td align='right'>J11</td><td>Influenza, virus not
align='right'>57010188</td><td>11-02-2019</td><td>MARSUDI ANAS
MUJAHID</td><td>MARSUDI 0701 M 01</td><td>PETANI/PEKEBUN</td><td>GROGOL
RT03RW02</td><td>GROGOL</td><td>PUCANGANOM</td><td>INDUK</td><td>dr. BUDI
align='right'>53020101</td><td>11-02-2019</td><td>MARTONO SUGINO</td><td>MARTONO
SUGINO 0302 M 06</td><td>PETANI/PEKEBUN</td><td>SAMBIREJO RT04
Sendiri</td><td>Baru</td><td>JAMKESDA</td><td>Rujuk</td><td
Umum</td><td>Poli Dalam</td><td>RSUD DR. SOEDIRAN MS WONOGIRI</td><td>Dalam
></tr><tr><td align='right'>I50</td><td>Heart failure</td><td></td><td
align='right'>288140</td><td align='right'>57030208</td><td>11-02-2019</td><td>MUJI
SRI WAHYUNI</td><td>WARSITO 0703 W
02</td><td>PETANI/PEKEBUN</td><td>KUWANG</td><td>KUWANG</td><td>PUCANGANOM</td><td>
INDUK</td><td>dr. BUDI ASHARI</td><td>SUGIYONO,S.Kep.Ns</td><td>P</td><td>20-44
></tr><tr><td align='right'>F20</td><td>Schizophrenia</td><td></td><td
2019</td><td>MULYANI</td><td>SIHONO 0211 S 17</td><td>LAINNYA</td><td>TAMBAK RT01
align='right'>57120115</td><td>11-02-2019</td><td>NAJWA ADELIA
SAPUTRI</td><td>SIGIT 0712 S 15</td><td>BELUM/TIDAK BEKERJA</td><td>NGAK
INGUK</td><td>INGAK - INGUK</td><td>PUCANGANOM</td><td>INDUK</td><td>dr. BUDI
td></tr><tr><td align='right'>K00.6</td><td>Disturbances in tooth
align='right'>56010101</td><td>11-02-2019</td><td>NAJWA CANTIKA AURELLY
SANTOSO</td><td>RIYADI SANTOSO 0601 R 03</td><td>PENSIUNAN</td><td>GIRITONTRO
LOR</td><td>GIRITONTRO LOR</td><td>GIRITONTRO</td><td>INDUK</td><td>drg.DANAR
</tr><tr><td align='right'>K05.0</td><td>Acute gingivitis</td><td></td><td
2019</td><td>NAJWA CANTIKA AURELLY SANTOSO</td><td>RIYADI SANTOSO 0601 R
03</td><td>PENSIUNAN</td><td>GIRITONTRO LOR</td><td>GIRITONTRO
</tr><tr><td align='right'>Z23.2</td><td>Need for immunization against tuberculosis
align='right'>57120180</td><td>11-02-2019</td><td>NESSYA AURELIA
GUNAWAN</td><td>SONI GUNAWAN</td><td>BELUM/TIDAK BEKERJA</td><td>NGAK INGUK RT02
RW16</td><td>INGAK - INGUK</td><td>PUCANGANOM</td><td>INDUK</td><td>dr. BUDI
ASHARI</td><td>RETNO AMBARWATI AMD KEB</td><td>P</td><td>8-30
GUNAWAN</td><td>SONI GUNAWAN</td><td>BELUM/TIDAK BEKERJA</td><td>NGAK INGUK RT02
ASHARI</td><td>RETNO AMBARWATI AMD KEB</td><td>P</td><td>8-30 hari</td><td>Datang
GUNAWAN</td><td>SANI GUNAWAN</td><td>BELUM/TIDAK BEKERJA</td><td>NGAK
INGUK</td><td>INGAK - INGUK</td><td>PUCANGANOM</td><td>INDUK</td><td>RETNO
align='right'>Z02.8</td><td>Other examinations for administrative
align='right'>57030300</td><td>11-02-2019</td><td>NOFENTI DIYAN
MANGGARANI</td><td>MESRAN 07 03 M
04</td><td>LAINNYA</td><td>KUWANG</td><td>KUWANG</td><td>PUCANGANOM</td><td>INDUK</
td><td>dr. BUDI ASHARI</td><td>UMI NUR ISNIATI</td><td>P</td><td>20-44
2019</td><td>PAINEM</td><td></td><td>PETANI/PEKEBUN</td><td>GEDANGAN</td><td>GEDANG
AN</td><td>NGARGOHARJO</td><td>PUSTU NGARGOHARJO</td><td>SUSI HERAWATI,
2019</td><td>PAINO</td><td></td><td>PETANI/PEKEBUN</td><td>SUMBERJO</td><td>BERGUNG
</td><td>TLOGOSARI</td><td>PUSTU TLOGOSARI</td><td>SULARNO,S.Kep.Ns</td><td> -
</td><td>L</td><td>60-69 Thn.</td><td>Datang Sendiri</td><td>Baru</td><td>UMUM
2019</td><td>PAIYEM</td><td></td><td>PETANI/PEKEBUN</td><td>PRINGKUKU</td><td>PRING
KUKU</td><td>NGARGOHARJO</td><td>PUSTU NGARGOHARJO</td><td>SUSI HERAWATI,
align='right'>57140109</td><td>11-02-2019</td><td>PARMI</td><td>SISWADI 0714 S
Umum</td><td></td><td></td><td>Dalam Wilayah</td><td>'
3312025607600002</td><td>'3312025607600002</td><td>150</td><td>90</td></tr><tr><td
align='right'>R51</td><td>Headache</td><td></td><td align='right'>288251</td><td
align='right'>51057007</td><td>11-02-
2019</td><td>PONEM</td><td>SARTU</td><td>PETANI/PEKEBUN</td><td>GENTUNG</td><td>GEN
TUNG</td><td>NGARGOHARJO</td><td>PKD NGARGOHARJO</td><td>HENI WIDIYASTUTI</td><td>
2019</td><td>PONIJEM</td><td>TUKIJAN</td><td>PETANI/PEKEBUN</td><td>GENTUNG</td><td
>GENTUNG</td><td>NGARGOHARJO</td><td>PKD NGARGOHARJO</td><td>HENI
></tr><tr><td align='right'>J45.8</td><td>Mixed asthma</td><td></td><td
2019</td><td>PONIKEM</td><td></td><td>PETANI/PEKEBUN</td><td>NGRINGIN</td><td>NGRIN
GIN</td><td>NGARGOHARJO</td><td>PUSTU NGARGOHARJO</td><td>SUSI HERAWATI,
align='right'>57070199</td><td>11-02-2019</td><td>PONIYEM</td><td>PONIYEM 07 07 P
d></tr><tr><td align='right'>Z34.8</td><td>Supervision of other normal
align='right'>55100030</td><td>11-02-2019</td><td>PUJI
ASTUTI</td><td>SARJONO</td><td>PETANI/PEKEBUN</td><td>SENGON
RT02/04</td><td>SENGON</td><td>JATIREJO</td><td>PKD
align='right'>56020676</td><td>11-02-2019</td><td>RENANDO GHAISAN
USTADI</td><td>DANIK USTADI</td><td>BELUM/TIDAK BEKERJA</td><td>GIRITONTRO KIDUL
RT04 RW03</td><td>GIRITONTRO KIDUL</td><td>GIRITONTRO</td><td>INDUK</td><td>dr.
BUDI ASHARI</td><td>RETNO AMBARWATI AMD KEB</td><td>L</td><td><1
Thn.</td><td>Datang Sendiri</td><td>Baru</td><td>Imunisasi</td><td>Rajal</td><td
USTADI</td><td>DANIK USTADI</td><td>BELUM/TIDAK BEKERJA</td><td>GIRITONTRO KIDUL
RT04 RW03</td><td>GIRITONTRO KIDUL</td><td>GIRITONTRO</td><td>INDUK</td><td>dr.
Thn.</td><td>Datang Sendiri</td><td>Baru</td><td>Imunisasi</td><td>Rajal</td><td
USTADI</td><td>DANIK USTADI</td><td>BELUM/TIDAK BEKERJA</td><td>GIRITONTRO
KIDUL</td><td>GIRITONTRO KIDUL</td><td>GIRITONTRO</td><td>INDUK</td><td>RETNO
AMBARWATI AMD KEB</td><td> - </td><td>L</td><td><1 Thn.</td><td>Datang
align='right'>Z34.8</td><td>Supervision
of other normal pregnancy</td><td></td><td align='right'>288508</td><td
align='right'>55050012</td><td>11-02-2019</td><td>RETNO
KURNIAWATI</td><td>SEPIWIYANTO</td><td>PETANI/PEKEBUN</td><td>PUNUNG</td><td>PUNUNG
</td><td>JATIREJO</td><td>PKD JATIREJO</td><td>SUHARNI</td><td> -
align='right'>55080045</td><td>11-02-2019</td><td>ROFI EKO</td><td>SUTRISNO 0508 S
19</td><td>SOPIR</td><td>NGORODOWO</td><td>NGORODOWO</td><td>JATIREJO</td><td>INDUK
</td><td>dr. BUDI ASHARI</td><td>SUGIYONO,S.Kep.Ns</td><td>L</td><td>20-44
align='right'>57060064</td><td>11-02-2019</td><td>ROKHANI</td><td>ROKHANI 0706 R
01</td><td>PETANI/PEKEBUN</td><td>TAMBAHSARI</td><td>TAMBAHSARI</td><td>PUCANGANOM<
/td><td>INDUK</td><td>dr. BUDI
align='right'>10101375</td><td>11-02-2019</td><td>SADEWA DWI
PRATIKTA</td><td>SUWARMAN 1010 S
40</td><td>PELAJAR/MAHASISWA</td><td>GODANGHARJO,PARANGGUPITO</td><td></td><td>PARA
NGGUPITO</td><td>INDUK</td><td>drg.DANAR WULANDARI</td><td>RIZKI ANISSA,
AM.Kg</td><td>L</td><td>5-9 Thn.</td><td>Datang
RT01 RW02</td><td>DOLOGAN</td><td>BAYEMHARJO</td><td>INDUK</td><td>drg.DANAR
align='right'>54050038</td><td>11-02-2019</td><td>SADIMIN</td><td>SADIMIN 0405 S
06</td><td>PENSIUNAN</td><td>DOLOGAN RT01
RW02</td><td>DOLOGAN</td><td>BAYEMHARJO</td><td>INDUK</td><td>drg.DANAR
align='right'>51117021</td><td>11-02-
2019</td><td>SAGINEM</td><td></td><td>PETANI/PEKEBUN</td><td>BLEBER</td><td>BLEBER<
align='right'>52077003</td><td>11-02-
2019</td><td>SAMINAH</td><td>SUTARNO</td><td>PETANI/PEKEBUN</td><td>SUMBERJO</td><t
align='right'>51110008</td><td>11-02-2019</td><td>SAMINEM</td><td>SUMADI 01 11 S
02</td><td>PETANI/PEKEBUN</td><td>BLEBER RT 02 RW 06
NGARGOHARJO</td><td>BLEBER</td><td>NGARGOHARJO</td><td>INDUK</td><td>dr. BUDI
></tr><tr><td align='right'>M79.0</td><td>Rheumatism, unspecified</td><td></td><td
2019</td><td>SAMIYEM</td><td>KATIYEM 05 11 K
2019</td><td>SAMIYEM</td><td>SUMARNO</td><td>PETANI/PEKEBUN</td><td>SUMBERJO</td><t
2019</td><td>SANIJEM</td><td></td><td>MENGURUS RUMAH
TLOGOSARI</td><td>SULARNO,S.Kep.Ns</td><td> - </td><td>P</td><td>>70
align='right'>56060143</td><td>11-02-2019</td><td>SANINDIYA KINAN
AZAHRA</td><td>SUGENG RIYADI</td><td>BELUM/TIDAK
BEKERJA</td><td>GOBOH</td><td>GOBOH</td><td>GIRITONTRO</td><td>INDUK</td><td>RETNO
2019</td><td>SARMIN</td><td></td><td>PETANI/PEKEBUN</td><td>NGELO</td><td>NGELO</td
><td>TLOGOSARI</td><td>PUSTU TLOGOSARI</td><td>SULARNO,S.Kep.Ns</td><td>
- </td><td>L</td><td>55-59 Thn.</td><td>Datang Sendiri</td><td>Baru</td><td>BPJS
2019</td><td>SARSI</td><td>WARJI 04 07 W
03</td><td>PELAJAR/MAHASISWA</td><td>NGALURAN RT01 RW
align='right'>52077054</td><td>11-02-
2019</td><td>SARTANTI</td><td></td><td>PETANI/PEKEBUN</td><td>SUMBERJO</td><td>SUMB
ERJO</td><td>TLOGOSARI</td><td>PUSTU TLOGOSARI</td><td>SULARNO,S.Kep.Ns</td><td> -
2019</td><td>SARTINI</td><td>TEMIN</td><td>PETANI/PEKEBUN</td><td>PRINGKUKU</td><td
align='right'>56080324</td><td>11-02-2019</td><td>SARYONO</td><td>SARYONO 0608 S
align='right'>A09</td><td>Diarrhoea and gastroenteritis of presumed infectious
origin</td><td></td><td align='right'>288161</td><td
align='right'>56010236</td><td>11-02-2019</td><td>SELVIA ANGGRAHENI</td><td>HERI
PURWANTO 0601 H 07</td><td>MENGURUS RUMAH TANGGA</td><td>GIRITONTRO LOR RT03
align='right'>288157</td><td align='right'>59090983</td><td>11-02-2019</td><td>SERY
SERRA</td><td>SUMARDI 0909 S 20</td><td>PELAJAR/MAHASISWA</td><td>NGUDAL
03/08</td><td></td><td>GIRIWOYO</td><td>INDUK</td><td>drg.DANAR
Sendiri</td><td>Lama</td><td>UMUM WONOGIRI</td><td></td><td align='right'>5</td><td
align='right'>56080171</td><td>11-02-2019</td><td>SITI NUR RASYIDAH</td><td>SUPARMO
0608 S 40</td><td>MENGURUS RUMAH TANGGA</td><td>DUNGKLEPU ETAN</td><td>DUNG KLEPU
d></tr><tr><td align='right'>E11.6</td><td>Non-insulin-dependent diabetes mellitus
with other specified complications</td><td></td><td align='right'>288167</td><td
align='right'>56070121</td><td>11-02-2019</td><td>SITI NURUL AINI</td><td>WALUYO
0606 W 02</td><td>PEGAWAI NEGERI SIPIL</td><td>DUNGKANCIL</td><td>DUNG
2019</td><td>SOGINI</td><td>WAKINO</td><td>PETANI/PEKEBUN</td><td>BAYEM</td><td>BAY
</td></tr><tr><td align='right'>I10</td><td>Essential (primary)
align='right'>54075009</td><td>11-02-
2019</td><td>SOGIYEM</td><td>NGATIMAN</td><td>PETANI/PEKEBUN</td><td>NGALURAN</td><
td>NGALURAN</td><td>BAYEMHARJO</td><td>PUSTU BAYEMHARJO</td><td>RISTINA Amd
align='right'>288153</td><td align='right'>56010073</td><td>11-02-2019</td><td>SONI
SETYAWAN</td><td>ERFAN 0601 E 02</td><td>WIRASWASTA</td><td>GIRITONTRO LOR RT02
></tr><tr><td align='right'>M79.0</td><td>Rheumatism, unspecified</td><td></td><td
PURWANTI</td><td>SULARDI 0610 S 06</td><td>MENGURUS RUMAH TANGGA</td><td>TANGGUNG
RT02 RW05</td><td>TANGGUNG</td><td>GIRITONTRO</td><td>INDUK</td><td>dr. BUDI
SURATMI</td><td>WAKIDI</td><td>PETANI/PEKEBUN</td><td>GIRIROTO</td><td>GIRIROTO</td
><td>JATIREJO</td><td>PKD JATIREJO</td><td>SUHARNI</td><td> -
></tr><tr><td align='right'>K05.2</td><td>Acute periodontitis</td><td></td><td
2019</td><td>SUGENG</td><td>SUGENG 0103 S 04</td><td>LAINNYA</td><td>PRINGKUKU
RT02 RW02</td><td>PRINGKUKU</td><td>NGARGOHARJO</td><td>INDUK</td><td>drg.DANAR
align='right'>52077006</td><td>11-02-
2019</td><td>SUGINEM</td><td></td><td>PETANI/PEKEBUN</td><td>SUMBERJO</td><td>SUMBE
RJO</td><td>TLOGOSARI</td><td>PUSTU TLOGOSARI</td><td>SULARNO,S.Kep.Ns</td><td> -
WONOGIRI</td><td>Rajal</td><td
align='right'>K29.9</td><td>Gastroduodenitis, unspecified</td><td></td><td
2019</td><td>SUKADI</td><td>SUKADI 07 13 S
align='right'>51037024</td><td>11-02-
align='right'>51037024</td><td>11-02-
align='right'>51037026</td><td>11-02-
2019</td><td>SUKINI</td><td>KASMO</td><td>PETANI/PEKEBUN</td><td>PRINGKUKU</td><td>
PRINGKUKU</td><td>NGARGOHARJO</td><td>PUSTU NGARGOHARJO</td><td>SUSI HERAWATI,
align='right'>52100056</td><td>11-02-2019</td><td>SUKINO</td><td>SUKINO 0210 S
15</td><td>PETANI/PEKEBUN</td><td>PORO RT01
RW01</td><td>PORO</td><td>TLOGOSARI</td><td>INDUK</td><td>dr. BUDI
align='right'>51057024</td><td>11-02-
2019</td><td>SUMARNI</td><td>SUYANTO</td><td>PETANI/PEKEBUN</td><td>GENTUNG</td><td
>GENTUNG</td><td>NGARGOHARJO</td><td>PKD NGARGOHARJO</td><td>HENI
/td></tr><tr><td align='right'>Z30.4</td><td>Surveillance of contraceptive
align='right'>55025110</td><td>11-02-
2019</td><td>SUMARNI</td><td>JUMATDI</td><td>PETANI/PEKEBUN</td><td>GIRIROTO</td><t
tr><tr><td align='right'>Z00.8</td><td>Other general examinations</td><td></td><td
2019</td><td>SUNARTO</td><td>SUNARTO 1010 S
38</td><td>PETANI/PEKEBUN</td><td>GENDAYAAN RT03
RW01</td><td></td><td>PARANGGUPITO</td><td>INDUK</td><td>dr. BUDI
align='right'>55100022</td><td>11-02-
2019</td><td>SUPADMINI</td><td>WAKIDI</td><td>PETANI/PEKEBUN</td><td>SENGON</td><td
>SENGON</td><td>JATIREJO</td><td>PKD JATIREJO</td><td>SUHARNI</td><td> -
align='right'>52047001</td><td>11-02-
2019</td><td>SUPARMI</td><td>SUWITO</td><td>PETANI/PEKEBUN</td><td>SOKO</td><td>SOK
O</td><td>TLOGOSARI</td><td>PUSTU TLOGOSARI</td><td>SULARNO,S.Kep.Ns</td><td> -
2019</td><td>SUPARSI</td><td>JIMIN</td><td>PETANI/PEKEBUN</td><td>SUMBERJO</td><td>
SUMBERJO</td><td>TLOGOSARI</td><td>PUSTU
align='right'>51117037</td><td>11-02-
2019</td><td>SUPRAPTI</td><td>ARYADI</td><td>PETANI/PEKEBUN</td><td>MULWOSARI</td><
td>MULWOSARI</td><td>JATIREJO</td><td>PKD JATIREJO</td><td>SUHARNI</td><td> -
align='right'>56010200</td><td>11-02-2019</td><td>SURANI</td><td>SAHUDI 0601 S
07</td><td>PETANI/PEKEBUN</td><td>GIRITONTRO LOR RT03
forearm</td><td></td><td align='right'>288152</td><td
align='right'>55095003</td><td>11-02-2019</td><td>SURANI</td><td>SUKINO 0509 S
13</td><td>BURUH HARIAN LEPAS</td><td>MULWOSARI RT01
RW04</td><td>MULWOSARI</td><td>JATIREJO</td><td>INDUK</td><td>dr. BUDI
</tr><tr><td align='right'>M79.02</td><td>Rheumatism, unspecified, upper
arm</td><td></td><td align='right'>288152</td><td
align='right'>55095003</td><td>11-02-2019</td><td>SURANI</td><td>SUKINO 0509 S
13</td><td>BURUH HARIAN LEPAS</td><td>MULWOSARI RT01
RW04</td><td>MULWOSARI</td><td>JATIREJO</td><td>INDUK</td><td>dr. BUDI
align='right'>57070284</td><td>11-02-2019</td><td>SURESNO</td><td>DIMIN 0707 D
03</td><td>KARYAWAN SWASTA</td><td>BANJAR RT03
Sendiri</td><td>Baru</td><td>JAMKESDA</td><td>Rajal</td><td align='right'>6</td><td
/td></tr><tr><td align='right'>J45</td><td>Asthma</td><td></td><td
2019</td><td>SURESNO</td><td>DIMIN 0707 D 03</td><td>KARYAWAN
SWASTA</td><td>BANJAR RT03
align='right'>55020065</td><td>11-02-
2019</td><td>SUTIYEM</td><td>JUMIKO</td><td>PETANI/PEKEBUN</td><td>GIRIROTO</td><td
align='right'>N34.1</td><td>Nonspecific urethritis</td><td></td><td
2019</td><td>SUTRISNO</td><td>SUTRISNO 07 05 S
32</td><td>PETANI/PEKEBUN</td><td>SUKOROYOM KULON RT 02 RW 03</td><td>SUKOROYOM
align='right'>52105005</td><td>11-02-
2019</td><td>SUYATMI</td><td>SUPRIYONO</td><td>PETANI/PEKEBUN</td><td>PORO</td><td>
></tr><tr><td align='right'>L20.8</td><td>Other atopic dermatitis</td><td></td><td
2019</td><td>TEGAR PRIYO PUTRO</td><td>IDA LAILA 07 09 I
01</td><td>PELAJAR/MAHASISWA</td><td>PUCANGANOM LOR</td><td>PUCANGANOM
align='right'>56080096</td><td>11-02-2019</td><td>TIFA AYU NIANTIKA</td><td>SUPANTO
0608 S 08</td><td>PELAJAR/MAHASISWA</td><td>DUNGKLEPU WETAN RT 02 RW
04</td><td>DUNG KLEPU WETAN</td><td>GIRITONTRO</td><td>INDUK</td><td>dr. BUDI
align='right'>57130098</td><td>11-02-2019</td><td>TRI ASTUTI</td><td>SUGIMAN 0713 S
/td></tr><tr><td align='right'>M79.10</td><td>Myalgia, multiple
sites</td><td></td><td align='right'>288165</td><td
align='right'>53010026</td><td>11-02-2019</td><td>TRI WIDIANTO</td><td>TRI WIDIANTO
0301 T
03</td><td>PETANI/PEKEBUN</td><td>TLOGO</td><td>TLOGO</td><td>TLOGOHARJO</td><td>IN
DUK</td><td>dr. BUDI ASHARI</td><td>SUGIYONO,S.Kep.Ns</td><td>L</td><td>20-44
align='right'>J44</td><td>Other chronic obstructive pulmonary
disease</td><td></td><td align='right'>288171</td><td
align='right'>55020096</td><td>11-02-2019</td><td>TUKIJAN
ATMOSARJONO</td><td>TUKIJAN ATMOSARJONO 0502 T
05</td><td>PETANI/PEKEBUN</td><td>GIRIROTO RT01
align='right'>51027086</td><td>11-02-2019</td><td>TUKIJO MARTOREJO</td><td>TUKIJO
MARTOREJO</td><td>PETANI/PEKEBUN</td><td>NGRINGIN</td><td>NGRINGIN</td><td>NGARGOHA
RJO</td><td>PUSTU NGARGOHARJO</td><td>SUSI HERAWATI, AMK</td><td> -
2019</td><td>TUKINAH</td><td>SARTU</td><td>PETANI/PEKEBUN</td><td>GENTUNG</td><td>G
ENTUNG</td><td>NGARGOHARJO</td><td>PKD NGARGOHARJO</td><td>HENI
></tr><tr><td align='right'>W57</td><td>Bitten or stung by nonvenomous insect and
other nonvenomous arthropods</td><td></td><td align='right'>288178</td><td
align='right'>56050037</td><td>11-02-2019</td><td>TUKINEM</td><td>SAKIDI 0605 S
RW8</td><td>NGUJUNG</td><td>GIRITONTRO</td><td>INDUK</td><td>dr.
align='right'>52145001</td><td>11-02-
2019</td><td>TUKIRAH</td><td>TUKIRAH</td><td>PETANI/PEKEBUN</td><td>GUPAKAN</td><td
>GUPAKAN</td><td>TLOGOSARI</td><td>PKD TLOGOSARI</td><td>RETNO AMBARWATI AMD
align='right'>52105047</td><td>11-02-
2019</td><td>TUKIYEM</td><td>GIMUN</td><td>PETANI/PEKEBUN</td><td>PORO</td><td>PORO
></tr><tr><td align='right'>E05.8</td><td>Other thyrotoxicosis</td><td></td><td
2019</td><td>TUMINI</td><td>KARDI 07 01 K 03</td><td>MENGURUS RUMAH
TANGGA</td><td>GROGOL RT 03 RW
align='right'>56020459</td><td>11-02-2019</td><td>ULFIZIAH YUMA
ESTIWAYANTI</td><td>AGUS BUDI S </td><td>BELUM/TIDAK BEKERJA</td><td>GIRITONTRO
KIDUL</td><td>GIRITONTRO</td><td>INDUK</td><td>dr. BUDI ASHARI</td><td>RETNO
AMBARWATI AMD KEB</td><td>P</td><td>8-30 hari</td><td>Datang
align='right'>56020459</td><td>11-02-2019</td><td>ULFIZIAH YUMA
ESTIWAYANTI</td><td>AGUS BUDI S </td><td>BELUM/TIDAK BEKERJA</td><td>GIRITONTRO
KIDUL</td><td>GIRITONTRO</td><td>INDUK</td><td>dr. BUDI ASHARI</td><td>RETNO
AMBARWATI AMD KEB</td><td>P</td><td>8-30 hari</td><td>Datang
align='right'>56020459</td><td>11-02-2019</td><td>ULTIZIAH YUMA
ESTIWAYANTY</td><td>AGUS BUDI S</td><td>BELUM/TIDAK BEKERJA</td><td>GIRITONTRO
KIDUL</td><td>GIRITONTRO KIDUL</td><td>GIRITONTRO</td><td>INDUK</td><td>RETNO
2019</td><td>WAGINARSIH</td><td>SULARNA</td><td>PETANI/PEKEBUN</td><td>KANIGORO
RT02 RW01</td><td>KANIGORO</td><td>JATIREJO</td><td>PKD
2019</td><td>WAHYU ANIKATAMA
</td><td>MESRAN</td><td>WIRASWASTA</td><td>SIDOHARJO</td><td></td><td>WONOGIRI</td>
<td>INDUK</td><td>dr. BUDI ASHARI</td><td>SUGIYONO,S.Kep.Ns</td><td>L</td><td>20-44
align='right'>57140110</td><td>11-02-2019</td><td>WATIK</td><td>SURONO 0714 S
2019</td><td>WIDATI</td><td>KASNO</td><td>PETANI/PEKEBUN</td><td>PULUNG</td><td>PUL
align='right'>51097015</td><td>11-02-
2019</td><td>WIDATI</td><td>KASNO</td><td>PETANI/PEKEBUN</td><td>PULUNG</td><td>PUL
align='right'>52080122</td><td>11-02-2019</td><td>WINDI ASTUTI</td><td>SUPRIYANTO
0208 S
34</td><td>PELAJAR/MAHASISWA</td><td>TLOGOSARI</td><td>TLOGOSARI</td><td>TLOGOSARI<
align='right'>16</td><td>UGD</td><td></td><td></td><td>Dalam
align='right'>I63</td><td>Cerebral infarction</td><td></td><td
align='right'>288117</td><td align='right'>57020211</td><td>11-02-2019</td><td>WITO
KASINO</td><td>WITO KASINO 07 02 W 06</td><td>PETANI/PEKEBUN</td><td>SUKOROYOM
WETAN RT03 RW04</td><td>SUKOROYOM
></tr><tr><td align='right'>H66.0</td><td>Acute suppurative otitis
media</td><td></td><td align='right'>288121</td><td
align='right'>57080226</td><td>11-02-2019</td><td>ZAKKY DINUL KHOLIS</td><td>SAYADI
0708 S 23</td><td>PELAJAR/MAHASISWA</td><td>PUCANGANOM KIDULRT01
RW08</td><td>PUCANGANOM KIDUL</td><td>PUCANGANOM</td><td>INDUK</td><td>dr. BUDI
align='right'>56050015</td><td>12-02-2019</td><td>AGISHA</td><td>ANANG 06 05 A
g.DANAR WULANDARI</td><td>RIZKI ANISSA, AM.Kg</td><td>L</td><td>5-9
align='right'>Z00.8</td><td>Other general examinations</td><td></td><td
2019</td><td>AHMAD SOBARI</td><td>AHMAD SOBARI 0702 A
01</td><td>PEDAGANG</td><td>SUKOROYOM WETAN</td><td>SUKOROYOM
align='right'>N60.2</td><td>Fibroadenosis of breast</td><td></td><td
2019</td><td>ANDITA</td><td>JOKO PURNOMO 0104 J 01</td><td>LAINNYA</td><td>KLEPU
RT03 RW05,NGARGOHARJO</td><td>KLEPU</td><td>NGARGOHARJO</td><td>INDUK</td><td>dr.
BUDI ASHARI</td><td>SRI SUPATMI</td><td>P</td><td>20-44 Thn.</td><td>Datang
/td></tr><tr><td align='right'>Z00.6</td><td>Examination for normal comparison and
align='right'>288328</td><td align='right'>51050048</td><td>12-02-2019</td><td>ARI
FITRIYANI</td><td>TULUS SETYONO 0105 T 02</td><td>MENGURUS RUMAH
TANGGA</td><td>GENTUNG RT02
RW03</td><td>GENTUNG</td><td>NGARGOHARJO</td><td>INDUK</td><td>dr. BUDI
align='right'>56045067</td><td>12-02-2019</td><td>ASMIAH REGA</td><td>TRI RUSMANTO
06 04 T 02</td><td>PETANI/PEKEBUN</td><td>KETONGGO RT02
d align='right'>Z00.6</td><td>Examination for normal comparison and control in
align='right'>57080057</td><td>12-02-2019</td><td>ASTERALDA ZOVACH
LOVEA</td><td>SUTARDI 0708 S 26</td><td>PELAJAR/MAHASISWA</td><td>PUCANGANOM
align='right'>288515</td><td align='right'>55020079</td><td>12-02-2019</td><td>AYU
FATMASARI</td><td>RIBUT WAHYUDI</td><td>PETANI/PEKEBUN</td><td>GIRIROTO,
JATIREJO</td><td>GIRIROTO</td><td>JATIREJO</td><td>PKD
align='right'>54065160</td><td>12-02-2019</td><td>AYUNINGDYA AILA
VARISHA</td><td>EDI</td><td>BELUM/TIDAK
BEKERJA</td><td>BAYEM</td><td>BAYEM</td><td>BAYEMHARJO</td><td>PUSTU
BAYEMHARJO</td><td>RISTINA Amd Keb</td><td> - </td><td>P</td><td>1-4
align='right'>57090252</td><td>12-02-2019</td><td>AZAM ROFA MAULUL
IZZA</td><td>AHMAD ROFIQ 0709 A 10</td><td>PELAJAR/MAHASISWA</td><td>PUCANGANOM
RT02 RW09</td><td>PUCANGANOM LOR</td><td>PUCANGANOM</td><td>INDUK</td><td>dr. BUDI
2019</td><td>BALYA FAQIH</td><td>DEVI SETYAWAN 0705 D
03</td><td></td><td>SUKOROYOM KULON</td><td>SUKOROYOM
KULON</td><td>PUCANGANOM</td><td>INDUK</td><td>drg.DANAR WULANDARI</td><td>RIZKI
align='right'>N39.9</td><td>Disorder of urinary system,
align='right'>52115067</td><td>12-02-
2019</td><td>BOINEM</td><td>KARIMAN</td><td>PETANI/PEKEBUN</td><td>TAMBAK</td><td>T
AMBAK</td><td>TLOGOSARI</td><td>PKD TLOGOSARI</td><td>RETNO AMBARWATI AMD
align='right'>288287</td><td align='right'>56020575</td><td>12-02-2019</td><td>BOWO
PRASETYO</td><td>BOWO PRASETYO 06 02 B 01</td><td>PEGAWAI NEGERI
SIPIL</td><td>GIRITONTRO KIDUL RT02 RW03</td><td>GIRITONTRO
></tr><tr><td align='right'>Z34.0</td><td>Supervision of normal first
align='right'>15151378</td><td>12-02-2019</td><td>CUCUN TAHLINA</td><td>ANIK
SYAHANIK</td><td>MENGURUS RUMAH TANGGA</td><td>PANDEGLANG RT01
RW03</td><td></td><td>JAKARTA</td><td>INDUK</td><td>dr. BUDI ASHARI</td><td>SRI
SUPATMI</td><td>P</td><td>20-44 Thn.</td><td>Datang
align='right'>289216</td><td align='right'>51145059</td><td>12-02-2019</td><td>DEWI
RATNASARI</td><td>DIDIK MULYANTO</td><td>MENGURUS RUMAH
TANGGA</td><td>TLOGOMATI</td><td>TLOGOMATI</td><td>NGARGOHARJO</td><td>PKD
NGARGOHARJO</td><td>HENI WIDIYASTUTI</td><td> - </td><td>P</td><td>20-44
2019</td><td>DIANA LUPITASARI</td><td>TULUS BASUKI 07 03 T 06</td><td>KARYAWAN
SWASTA</td><td>KUWANG</td><td>KUWANG</td><td>PUCANGANOM</td><td>INDUK</td><td>drg.D
ANAR WULANDARI</td><td>RIZKI ANISSA, AM.Kg</td><td>P</td><td>15-19
align='right'>53050018</td><td>12-02-2019</td><td>DINA SARTINI RIA
PUTRININGSIH</td><td>SLAMET RIYADI 03 05 S 06</td><td>KARYAWAN
SWASTA</td><td>PLARENG RT 02 RW
05</td><td>PLARENG</td><td>TLOGOHARJO</td><td>INDUK</td><td>dr. BUDI
ASHARI</td><td>SRI SUPATMI</td><td>P</td><td>15-19 Thn.</td><td>Datang
/td></tr><tr><td align='right'>K00.6</td><td>Disturbances in tooth
align='right'>53020097</td><td>12-02-2019</td><td>EKA FARISA
FEBRIANTI</td><td>SUWADI 0302 S 37</td><td>BELUM/TIDAK BEKERJA</td><td>SAMBIREJO
RT03 RW01</td><td>SAMBIREJO</td><td>TLOGOHARJO</td><td>INDUK</td><td>drg.DANAR
align='right'>57110030</td><td>12-02-2019</td><td>ERIKA</td><td>MARYANTO 07 11 M
05</td><td>PELAJAR/MAHASISWA</td><td>PLOSO RT 01 RW
align='right'>52105087</td><td>12-02-
2019</td><td>ERWIN</td><td>SUPARLAN</td><td>PELAJAR/MAHASISWA</td><td>PORO</td><td>
KEB</td><td> - </td><td>L</td><td>10-14 Thn.</td><td>Datang
align='right'>57080105</td><td>12-02-2019</td><td>FATCHUR</td><td>UTUL ILMA 0708
U 01</td><td>PERANGKAT DESA</td><td>PUCANGANOM KIDUL</td><td>PUCANGANOM
align='right'>S60.1</td><td>Contusion of finger(s) with damage to
nail</td><td></td><td align='right'>288304</td><td
align='right'>57030154</td><td>12-02-2019</td><td>FIRDIANSAH</td><td>PRIHANTO 0703
P 08</td><td>BELUM/TIDAK
align='right'>N21.9</td><td>Calculus of lower urinary tract,
align='right'>57040096</td><td>12-02-2019</td><td>HARDIMAN</td><td>HARDIMAN 0704 H
03</td><td>SOPIR</td><td>MANDEYAN RT04
2019</td><td>HARTINI</td><td>SUGIYANTO</td><td>PETANI/PEKEBUN</td><td>GIRIROTO</td>
<td>GIRIROTO</td><td>JATIREJO</td><td>PKD JATIREJO</td><td>SUHARNI</td><td> -
2019</td><td>HARYANTO</td><td>HARYANTO 07 04 H
04</td><td>WIRASWASTA</td><td>MANDEYAN</td><td>MANDEYAN</td><td>PUCANGANOM</td><td>
INDUK</td><td>dr. BUDI ASHARI</td><td>SUWARTO,S.Kep.Nes</td><td>L</td><td>60-69
align='right'>57030254</td><td>12-02-2019</td><td>ISTIDIYAH
PRAMESTI</td><td>ISMANTO 0703 I 01</td><td>PELAJAR/MAHASISWA</td><td>KUWANG RT02
align='right'>51095023</td><td>12-02-2019</td><td>ISYA RAMADHAN
HARYANTO</td><td>ANGKRI HARYANTO</td><td>BELUM/TIDAK
BEKERJA</td><td>PULUNG</td><td>PULUNG</td><td>NGARGOHARJO</td><td>PKD
NGARGOHARJO</td><td>HENI WIDIYASTUTI</td><td> - </td><td>L</td><td>5-9
align='right'>54065027</td><td>12-02-
2019</td><td>KATINO</td><td>KATINO</td><td>PETANI/PEKEBUN</td><td>BAYEM</td><td>BAY
/td></tr><tr><td align='right'>L20.9</td><td>Atopic dermatitis,
align='right'>52105193</td><td>12-02-
2019</td><td>KATIRAN</td><td>KATIRAN</td><td>PETANI/PEKEBUN</td><td>PORO</td><td>PO
2019</td><td>LILIS SULISTYANINGSIH</td><td>WIDODO 01 13 W 02</td><td>MENGURUS
RUMAH TANGGA</td><td>GEDANGAN RT 01 RW
05</td><td>GEDANGAN</td><td>NGARGOHARJO</td><td>INDUK</td><td>dr. BUDI
align='right'>57100111</td><td>12-02-2019</td><td>MARIYEM</td><td>KARENDI 0710 K
10</td><td>PETANI/PEKEBUN</td><td>JEPURUN RT 01 RW
10</td><td>JEPURUN</td><td>PUCANGANOM</td><td>INDUK</td><td>dr. BUDI
></tr><tr><td align='right'>S01.8</td><td>Open wound of other parts of
head</td><td></td><td align='right'>288298</td><td
align='right'>56100082</td><td>12-02-2019</td><td>MINEM</td><td>WASINO 06 10 W
align='right'>13130454</td><td>12-02-2019</td><td>MISDI</td><td>MISDI 1313 M
01</td><td>PETANI/PEKEBUN</td><td>MOJOPURO,EROMOKO</td><td></td><td>WONOGIRI</td><t
d>INDUK</td><td>dr. BUDI ASHARI</td><td>SUWARTO,S.Kep.Nes</td><td>L</td><td>>70
align='right'>52087065</td><td>12-02-
2019</td><td>MISNEM</td><td>TUKIJEM</td><td>PETANI/PEKEBUN</td><td>TLOGOSARI</td><t
d>TLOGOSARI</td><td>TLOGOSARI</td><td>PUSTU
align='right'>54060047</td><td>12-02-2019</td><td>NITA HARYATI</td><td>MARLAN
0406 M 02</td><td>KARYAWAN SWASTA</td><td>BAYEM RT01
align='right'>56040027</td><td>12-02-2019</td><td>NOVIYAN ALDI
SAPUTRA</td><td>SUKADI 0604 S 15</td><td>PELAJAR/MAHASISWA</td><td>KETONGGO
RT02 RW07</td><td></td><td>GIRITONTRO</td><td>INDUK</td><td>dr. BUDI
align='right'>289319</td><td align='right'>0207</td><td>12-02-2019</td><td>NUR
WIDIARTI</td><td></td><td>PETANI/PEKEBUN</td><td>SUMBERJO</td><td>SUMBERJO</td><td>
TLOGOSARI</td><td>PUSTU TLOGOSARI</td><td>SULARNO,S.Kep.Ns</td><td> -
align='right'>55010313</td><td>12-02-2019</td><td>PARINAH</td><td>KASNO 0501 K
10</td><td>PETANI/PEKEBUN</td><td>GIRIBELAH RT02
align='right'>56020406</td><td>12-02-2019</td><td>PARTIYEM</td><td>WARINO 0602 W
02</td><td>PENSIUNAN</td><td>GIRITONTRO KIDUL RT01 RW03</td><td>GIRITONTRO
align='right'>51020048</td><td>12-02-2019</td><td>PONIYEM</td><td>WIDODO 0102 W
06</td><td>PETANI/PEKEBUN</td><td>NGRINGINRT03/01</td><td>NGRINGIN</td><td>NGARGOHA
RJO</td><td>INDUK</td><td>drg.DANAR WULANDARI</td><td>RIZKI ANISSA,
AM.Kg</td><td>P</td><td>45-54 Thn.</td><td>Datang Sendiri</td><td>Lama</td><td>BPJS
d></tr><tr><td align='right'>Z00.6</td><td>Examination for normal comparison and
2019</td><td>PRIYA SETIAWAN</td><td>SUKRI 0501 S
48</td><td>PETANI/PEKEBUN</td><td>GIRIBELAH
01/07</td><td>GIRIBELAH</td><td>JATIREJO</td><td>INDUK</td><td>dr. BUDI
RAHAYU</td><td>KATIJO 0501 K 04</td><td>PETANI/PEKEBUN</td><td>GIRIBELAH RT02
align='right'>56040095</td><td>12-02-2019</td><td>REYSHA KHARISMA
PUTRI</td><td>HARMADI 0604 H 03</td><td>PELAJAR/MAHASISWA</td><td>KETONGGO RT02
RW07</td><td>KETONGGO</td><td>GIRITONTRO</td><td>INDUK</td><td>drg.DANAR
align='right'>54065130</td><td>12-02-2019</td><td>RIZKY DWI
YULIANTO</td><td>SUPARMAN</td><td>BELUM/TIDAK
BAYEMHARJO</td><td>RISTINA Amd Keb</td><td> - </td><td>L</td><td>1-4
</tr><tr><td align='right'>Z00.6</td><td>Examination for normal comparison and
2019</td><td>SAMINO</td><td>SAMINO 0211 S 04</td><td>KARYAWAN
SWASTA</td><td>TAMBAK</td><td>TAMBAK</td><td>TLOGOSARI</td><td>INDUK</td><td>dr.
></tr><tr><td align='right'>Z34</td><td>Supervision of normal
align='right'>57030007</td><td>12-02-2019</td><td>SAMSIYAH</td><td>PRIHANTO 0703 P
06</td><td></td><td>PUCANGANOM</td><td>INDUK</td><td>dr. BUDI ASHARI</td><td>SRI
2019</td><td>SARWINI</td><td>BOWO P 06 02 B 01</td><td>PEGAWAI NEGERI
SIPIL</td><td>GIRITONTRO KIDUL RT02 RW03</td><td>GIRITONTRO
align='right'>56100190</td><td>12-02-2019</td><td>SHANUM</td><td>SULARDI 0610 S
06</td><td>BELUM/TIDAK BEKERJA</td><td>TANGGUNG RT02
td></tr><tr><td align='right'>Z34.8</td><td>Supervision of other normal
align='right'>51095022</td><td>12-02-2019</td><td>SITI AISYAH</td><td>MARSUDI
W</td><td>PETANI/PEKEBUN</td><td>PULUNG</td><td>PULUNG</td><td>NGARGOHARJO</td><td>
PKD NGARGOHARJO</td><td>HENI WIDIYASTUTI</td><td> - </td><td>P</td><td>20-44
2019</td><td>SOKINAH</td><td></td><td>PETANI/PEKEBUN</td><td>BERGUNG</td><td>BERGUN
G</td><td>TLOGOSARI</td><td>PUSTU TLOGOSARI</td><td>SULARNO,S.Kep.Ns</td><td> -
align='right'>M79.70</td><td>Fibromyalgia, multiple sites</td><td></td><td
SULASTI</td><td>ANANG BUDI PURNOMO 0605 A 07</td><td>PETANI/PEKEBUN</td><td>NGUJUNG
RT01 RW08</td><td>NGUJUNG</td><td>GIRITONTRO</td><td>INDUK</td><td>dr. BUDI
SUPARMI YULIANA</td><td>SULARNO 0208 S
17</td><td>PEDAGANG</td><td>TLOGOSARI</td><td>TLOGOSARI</td><td>TLOGOSARI</td><td>I
NDUK</td><td>dr. BUDI ASHARI</td><td>SUWARTO,S.Kep.Nes</td><td>P</td><td>45-54
SUTENI</td><td>HERIYONO 0404H03</td><td>PETANI/PEKEBUN</td><td>BAYEM RT01
2019</td><td>SUGIMIN</td><td>SUGIMIN 0107 S 07</td><td>WIRASWASTA</td><td>NGASEM
RT02 RW03</td><td>NGASEM</td><td>NGARGOHARJO</td><td>INDUK</td><td>dr. BUDI
align='right'>52130072</td><td>12-02-2019</td><td>SUHARNO</td><td>SUHARNO 0213 S
01</td><td>KARYAWAN SWASTA</td><td>KERJO RT03
RW03</td><td>KERJO</td><td>TLOGOSARI</td><td>INDUK</td><td>dr. BUDI
2019</td><td>SUKARNI</td><td>BAYU BUDI UTOMO 0601 B 01</td><td>MENGURUS RUMAH
LOR</td><td>GIRITONTRO</td><td>INDUK</td><td>dr. BUDI ASHARI</td><td>SRI
/tr><tr><td align='right'>J11.8</td><td>Influenza with other manifestations, virus
align='right'>56010027</td><td>12-02-2019</td><td>SUKARNI</td><td>BAYU BUDI UTOMO
0601 B 01</td><td>MENGURUS RUMAH TANGGA</td><td>GIRITONTRO LOR RT03
/tr><tr><td align='right'>M79.1</td><td>Myalgia</td><td></td><td
2019</td><td>SUKATI</td><td>ALI JAFAR 0302 A 04</td><td>MENGURUS RUMAH
TANGGA</td><td>SAMBIREJO RT04
align='right'>52020039</td><td>12-02-2019</td><td>SUKINEM</td><td>PAIJAN 0202 P
04</td><td>PETANI/PEKEBUN</td><td>MANTANG
01/07</td><td>MANTHANG</td><td>TLOGOSARI</td><td>INDUK</td><td>dr. BUDI
2019</td><td>SULARDI PARTOREJO</td><td>SULARDI
PARTOREJO</td><td>PETANI/PEKEBUN</td><td>KLEPU</td><td>KLEPU</td><td>NGARGOHARJO</t
d><td>PKD NGARGOHARJO</td><td>HENI WIDIYASTUTI</td><td> - </td><td>L</td><td>>70
align='right'>52080062</td><td>12-02-2019</td><td>SULARNO</td><td>SULARNO 0208
S17</td><td>PEGAWAI NEGERI SIPIL</td><td>TLOGOSARI RT01
></tr><tr><td align='right'>S89.9</td><td>Unspecified injury of lower
leg</td><td></td><td align='right'>288268</td><td
align='right'>57050132</td><td>12-02-2019</td><td>SULIMAH</td><td>MAKNO 0705 M
align='right'>52105041</td><td>12-02-
2019</td><td>SUMARSIH</td><td>PARLAN</td><td>PETANI/PEKEBUN</td><td>PORO</td><td>PO
></tr><tr><td align='right'>M79.01</td><td>Rheumatism, unspecified, shoulder
region</td><td></td><td align='right'>288290</td><td
align='right'>57040276</td><td>12-02-2019</td><td>SUMIYEM</td><td>SIRIN 0704 S
align='right'>52127009</td><td>12-02-
2019</td><td>SUMIYEM</td><td>SATIMIN</td><td>PETANI/PEKEBUN</td><td>NGELO</td><td>N
GELO</td><td>TLOGOSARI</td><td>PUSTU TLOGOSARI</td><td>SULARNO,S.Kep.Ns</td><td> -
align='right'>55020018</td><td>12-02-2019</td><td>SUNARWI</td><td>SARMO 0502 S
08</td><td>PEGAWAI NEGERI SIPIL</td><td>GIRIROTO RT01
RW06</td><td>GIRIROTO</td><td>JATIREJO</td><td>INDUK</td><td>dr. BUDI
align='right'>53050027</td><td>12-02-2019</td><td>SUPAMI</td><td>SUPRIYADI 0305 S
05</td><td>MENGURUS RUMAH TANGGA</td><td>PLARENG RT03
RW05,TLOGOHARJO</td><td>PLARENG</td><td>TLOGOHARJO</td><td>INDUK</td><td>dr. BUDI
2019</td><td>SUPARSI</td><td>DWI SANYOTO/06/06/D/03</td><td>BURUH HARIAN
LEPAS</td><td>GOBOH</td><td>GOBOH</td><td>GIRITONTRO</td><td>INDUK</td><td>dr. BUDI
align='right'>55095013</td><td>12-02-2019</td><td>SUPARTIN</td><td>WARTO
SANTOSO</td><td>PETANI/PEKEBUN</td><td>MULWOSARI</td><td>MULWOSARI</td><td>JATIREJO
</td><td>PKD JATIREJO</td><td>SUHARNI</td><td> - </td><td>P</td><td>45-54
2019</td><td>SUPRANTINI</td><td>TRIYONO</td><td>PETANI/PEKEBUN</td><td>PUNUNG</td><
td>PUNUNG</td><td>JATIREJO</td><td>PKD JATIREJO</td><td>SUHARNI</td><td> -
2019</td><td>SURAMI</td><td></td><td>PETANI/PEKEBUN</td><td>TLOGOSARI</td><td>TLOGO
SARI</td><td>TLOGOSARI</td><td>PUSTU TLOGOSARI</td><td>SULARNO,S.Kep.Ns</td><td> -
2019</td><td>SURATI</td><td>SUROTO 07 16 S 11</td><td>PETANI/PEKEBUN</td><td>SAWIT
LOR RT03 RW13</td><td>SAWIT LOR</td><td>PUCANGANOM</td><td>INDUK</td><td>dr. BUDI
2019</td><td>SUROTO</td><td>SUROTO 0103 S
07</td><td>PETANI/PEKEBUN</td><td>PRINGKUKU</td><td>PRINGKUKU</td><td>NGARGOHARJO</
align='right'>54020004</td><td>12-02-2019</td><td>SUTARTI</td><td>SUTARTI 0402 S
align='right'>52020049</td><td>12-02-2019</td><td>SUTIKNO</td><td>SUTIKNO 0202 S
01</td><td>PERANGKAT DESA</td><td>MANTANG RT 01 RW
07</td><td>MANTHANG</td><td>TLOGOSARI</td><td>INDUK</td><td>dr. BUDI
align='right'>51075017</td><td>12-02-
2019</td><td>SUTINAH</td><td>SUTINAH</td><td>PETANI/PEKEBUN</td><td>NGASEM</td><td>
NGASEM</td><td>NGARGOHARJO</td><td>PKD NGARGOHARJO</td><td>HENI
2019</td><td>SUTINI</td><td>SULARNO 0602 S
58</td><td>PENSIUNAN</td><td>GIRITONTRO KIDUL RT05 RW03</td><td>GIRITONTRO
2019</td><td>SUWANTO</td><td>SUWANTO 0203 S 04</td><td>KARYAWAN
SWASTA</td><td>SALAM RT01
RW06</td><td>SALAM</td><td>TLOGOSARI</td><td>INDUK</td><td>dr. BUDI
align='right'>56030125</td><td>12-02-2019</td><td>SUWARNO</td><td>SUWARNO 0603 S
31</td><td>WIRASWASTA</td><td>GEBLUG RT03
></tr><tr><td align='right'>J11</td><td>Influenza, virus not
align='right'>55010332</td><td>12-02-2019</td><td>TARMI</td><td>PARIYO 0501 P
2019</td><td>TASNIM AHYA NADLIRAH</td><td>FUAD HELMI 0601 F
01</td><td>PELAJAR/MAHASISWA</td><td>GIRITONTRO LOR RT 02 RW01</td><td>GIRITONTRO
2019</td><td>TOKARMO</td><td>TOKARMO 0511 T
align='right'>57040245</td><td>12-02-2019</td><td>TRIANI</td><td>TRIANI 0704 T
07</td><td>LAINNYA</td><td>MANDEYAN RT01
2019</td><td>TRIANI</td><td>TRIANI 0704 T 07</td><td>LAINNYA</td><td>MANDEYAN
RT01 RW01</td><td>MANDEYAN</td><td>PUCANGANOM</td><td>INDUK</td><td>dr. BUDI
align='right'>56010005</td><td>12-02-2019</td><td>TUGINAH</td><td>TUGINAH 06 01 T
2019</td><td>TUMINI</td><td>ANGKRI
HARYANTO</td><td>PETANI/PEKEBUN</td><td>PULUNG</td><td>PULUNG</td><td>NGARGOHARJO</
td><td>PKD NGARGOHARJO</td><td>HENI WIDIYASTUTI</td><td> - </td><td>P</td><td>20-44
2019</td><td>TUNIYATI</td><td>SUTARNO</td><td>PETANI/PEKEBUN</td><td>GIRIROTO</td><
td>GIRIROTO</td><td>JATIREJO</td><td>PKD JATIREJO</td><td>SUHARNI</td><td> -
align='right'>56020090</td><td>12-02-2019</td><td>TUNIYEM</td><td>TUKIJO 06 02 T
d></tr><tr><td align='right'>Z00.8</td><td>Other general
align='right'>51030072</td><td>12-02-2019</td><td>WAHYU TRIANTO</td><td>WAHYU
TRIANTO 0103 W 03</td><td>KARYAWAN SWASTA</td><td>PRINGKUKU RT02
RW02</td><td>PRINGKUKU</td><td>NGARGOHARJO</td><td>INDUK</td><td>dr. BUDI
Sendiri</td><td>Baru</td><td>BPJS
align='right'>51040005</td><td>12-02-2019</td><td>WAKIYEM</td><td>JOKO PURNOMO 01
04 J
01</td><td>PETANI/PEKEBUN</td><td>KLEPU</td><td>KLEPU</td><td>NGARGOHARJO</td><td>I
NDUK</td><td>dr. BUDI ASHARI</td><td>SUWARTO,S.Kep.Nes</td><td>P</td><td>45-54
align='right'>52140045</td><td>12-02-2019</td><td>WARIMIN</td><td>WARIMIN 0214 W
01</td><td>PERANGKAT DESA</td><td>GUPAKAN RT02
align='right'>54020029</td><td>12-02-2019</td><td>WARSONO</td><td>WARSONO 0402 W
01</td><td>KARYAWAN SWASTA</td><td>NGUNDUK RT 01
2019</td><td>WIDYANINGSIH</td><td>SUKINI 0511 S 18</td><td>LAINNYA</td><td>BUWENG
RT02 RW05</td><td>BUWENG</td><td>JATIREJO</td><td>INDUK</td><td>dr. BUDI
align='right'>J11</td><td>Influenza, virus not identified</td><td></td><td
2019</td><td>WINDA SETYORINI</td><td>BUDI AGUNG NUGROHO 0712 B 01</td><td>MENGURUS
RUMAH TANGGA</td><td>INGAKINGUK RT 01 RW 16</td><td>INGAK -
INGUK</td><td>PUCANGANOM</td><td>INDUK</td><td>dr. BUDI
align='right'>L20.8</td><td>Other atopic dermatitis</td><td></td><td
2019</td><td>YOHANA KRISTIYANTI</td><td>DWI SANYOTO 0606 D 03</td><td>KARYAWAN
SWASTA</td><td>GOBOH RT03
align='right'>57010146</td><td>12-02-2019</td><td>ZAIMAH</td><td>ZAIMAH 0701 Z
01</td><td>PETANI/PEKEBUN</td><td>GROGOL</td><td>GROGOL</td><td>PUCANGANOM</td><td>
INDUK</td><td>dr. BUDI ASHARI</td><td>SUWARTO,S.Kep.Nes</td><td>P</td><td>45-54
2019</td><td>ZAIMAH</td><td>ZAIMAH 0701 Z
INDUK</td><td>dr. BUDI ASHARI</td><td>SUWARTO,S.Kep.Nes</td><td>P</td><td>45-54
align='right'>54020017</td><td>12-02-2019</td><td>ZELVIA MAILANI</td><td>MIRANTO
0402 M 01</td><td>PETANI/PEKEBUN</td><td>NGUNDUK 01
align='right'>56050220</td><td>13-02-2019</td><td>ADE IWAN BINTORO</td><td>SURAHMIN
0605 S 12</td><td>WIRASWASTA</td><td>NGUJUNG RT01
align='right'>52087111</td><td>13-02-
2019</td><td>ADILA</td><td>YUDI</td><td>PELAJAR/MAHASISWA</td><td>TLOGOSARI</td><td
align='right'>K03.6</td><td>Deposits [accretions] on teeth</td><td></td><td
2019</td><td>AGUNG SEDAYU</td><td>SARTO 0702 S 03</td><td>BELUM/TIDAK
BEKERJA</td><td>SUKOROYOM WETAN</td><td>SUKOROYOM
WETAN</td><td>PUCANGANOM</td><td>INDUK</td><td>drg.DANAR WULANDARI</td><td>RIZKI
></tr><tr><td align='right'>K05.1</td><td>Chronic gingivitis</td><td></td><td
align='right'>288363</td><td align='right'>52100057</td><td>13-02-2019</td><td>AGUS
SUSANTO</td><td>GITO 0210 G 01</td><td>KARYAWAN SWASTA</td><td>PORO RT01
RW01</td><td>PORO</td><td>TLOGOSARI</td><td>INDUK</td><td>dr. BUDI
align='right'>56050180</td><td>13-02-2019</td><td>ALFALIAN ADITYA
HASTUNGKORO</td><td>ALFALIAN ADITYA HASTUNGKORO 0605
A 03</td><td>PETANI/PEKEBUN</td><td>NGUJUNG
03/08</td><td>NGUJUNG</td><td>GIRITONTRO</td><td>INDUK</td><td>dr. BUDI
align='right'>S51</td><td>Open wound of forearm</td><td></td><td
2019</td><td>ANDIRA</td><td>AGUS P 0608 A 01</td><td>PERANGKAT
DESA</td><td>DUNGKLEPU WETAN</td><td>DUNG KLEPU
align='right'>55050111</td><td>13-02-2019</td><td>ANDRI WIJAYANTO</td><td>SUKADI
0505 S 07</td><td>KARYAWAN SWASTA</td><td>PUNUNG RT02
align='right'>55110002</td><td>13-02-2019</td><td>ASRI ASMARANINGRUM</td><td>WIYONO
0511 W 06</td><td>KARYAWAN HONORER</td><td>BUWENG RT01
align='right'>288369</td><td align='right'>57100173</td><td>13-02-2019</td><td>BAYU
AJI SULISTYO</td><td>SURATMAN 0710 S 05</td><td>PELAJAR/MAHASISWA</td><td>JEPURUN
RT02 RW10</td><td>JEPURUN</td><td>PUCANGANOM</td><td>INDUK</td><td>dr. BUDI
2019</td><td>DIMIN</td><td>DIMIN 07 07 D 03</td><td>PETANI/PEKEBUN</td><td>BANJAR
RT03 RW05</td><td>BANJAR</td><td>PUCANGANOM</td><td>INDUK</td><td>dr. BUDI
align='right'>55040094</td><td>13-02-2019</td><td>DINI SEPTYA
RAMADHANI</td><td>SATIMAN 05 04 S 18</td><td>PELAJAR/MAHASISWA</td><td>KANIGORO RT
02 RW 01</td><td>KANIGORO</td><td>JATIREJO</td><td>INDUK</td><td>dr. BUDI
/tr><tr><td align='right'>Z00.6</td><td>Examination for normal comparison and
align='right'>288404</td><td align='right'>54110086</td><td>13-02-2019</td><td>DODY
SETIAWAN</td><td>DODY SETIAWAN 0411 D 01</td><td>PETANI/PEKEBUN</td><td>GUWO
RT03 RW06</td><td>GUWO</td><td>BAYEMHARJO</td><td>INDUK</td><td>dr. BUDI
align='right'>10100643</td><td>13-02-2019</td><td>DONAL AGUS
PRADACA</td><td>SUHARTO/
SENO</td><td>PEDAGANG</td><td>PARANGGUPITO</td><td></td><td>PARANGGUPITO</td><td>IN
DUK</td><td>dr. BUDI ASHARI</td><td>SUGIYONO,S.Kep.Ns</td><td>L</td><td>20-44
align='right'>28</td><td>BP. Umum</td><td></td><td></td><td>Luar
align='right'>55065004</td><td>13-02-2019</td><td>DWI UTAMI</td><td>SAMINO 0506 S
15</td><td>MENGURUS RUMAH
TANGGA</td><td>JATI</td><td>JATI</td><td>JATIREJO</td><td>INDUK</td><td>dr. BUDI
align='right'>288381</td><td align='right'>57020362</td><td>13-02-2019</td><td>EDI
TOPO ASHARI </td><td>EDI TOPO ASHARI 0702 E 01</td><td>PERANGKAT
DESA</td><td>SUKOROYOM WETAN RT02 RW04</td><td>SUKOROYOM
align='right'>288356</td><td align='right'>57020097</td><td>13-02-2019</td><td>ERI
PAMUNGKAS</td><td>SARTO 0702 S 03</td><td>PETANI/PEKEBUN</td><td>SUKOROYOM
WTN</td><td>SUKOROYOM WETAN</td><td>PUCANGANOM</td><td>INDUK</td><td>dr. BUDI
2019</td><td>ERIKA ADI PANDU AJI</td><td>SULARTO 06 05 S
02</td><td>LAINNYA</td><td>NGUJUNG RT 02 RW
align='right'>55120014</td><td>13-02-2019</td><td>ERWAN SUSENO</td><td>SUROTO
0512 S
04</td><td>PEDAGANG</td><td>NGASEM</td><td>NGASEM</td><td>JATIREJO</td><td>INDUK</t
d><td>dr. BUDI ASHARI</td><td>SUGIYONO,S.Kep.Ns</td><td>L</td><td>20-44
align='right'>57050022</td><td>13-02-2019</td><td>FANDY HIDAYAT</td><td>BASUNI
ROHMAD 0705 B 01</td><td>PELAJAR/MAHASISWA</td><td>SUKOROYOM
align='right'>53015085</td><td>13-02-2019</td><td>FHARISCA PUTRA
ANGGORO</td><td>ARIF</td><td>PELAJAR/MAHASISWA</td><td>TLOGO</td><td>TLOGO</td><td>
TLOGOHARJO</td><td>PKD TLOGOHARJO</td><td>SRI SUPATMI</td><td> -
tr><tr><td align='right'>J45.9</td><td>Asthma, unspecified</td><td></td><td
2019</td><td>FHARISCA PUTRA
ANGGORO</td><td>ARIF</td><td>PELAJAR/MAHASISWA</td><td>TLOGO</td><td>TLOGO</td><td>
TLOGOHARJO</td><td>PKD TLOGOHARJO</td><td>SRI SUPATMI</td><td> -
tr><tr><td align='right'>L24.9</td><td>Irritant contact dermatitis, unspecified
align='right'>54065149</td><td>13-02-2019</td><td>FIQKRI ADITYA
S</td><td>PAIJAN</td><td>PELAJAR/MAHASISWA</td><td>BAYEM</td><td>BAYEM</td><td>BAYE
MHARJO</td><td>PUSTU BAYEMHARJO</td><td>RISTINA Amd Keb</td><td> -
td></tr><tr><td align='right'>I10</td><td>Essential (primary)
align='right'>54035004</td><td>13-02-
2019</td><td>GINAH</td><td>WARTO</td><td>PETANI/PEKEBUN</td><td>KLAPEYAN</td><td>KL
AMPEYAN</td><td>BAYEMHARJO</td><td>PUSTU BAYEMHARJO</td><td>RISTINA Amd
d align='right'>I11.9</td><td>Hypertensive heart disease without (congestive) heart
align='right'>10101379</td><td>13-02-2019</td><td>GIYARTO</td><td>GIYARTO 1010 G
04</td><td>PETANI/PEKEBUN</td><td>SAMBIHARJO</td><td></td><td>PARANGGUPITO</td><td>
INDUK</td><td>dr. BUDI ASHARI</td><td>SUGIYONO,S.Kep.Ns</td><td>L</td><td>60-69
align='right'>56010320</td><td>13-02-2019</td><td>HERI PURWANTO</td><td>HERI
PURWANTO 0601 H 07</td><td>PEDAGANG</td><td>GIRITONTRO LOR RT03
align='right'>57120109</td><td>13-02-2019</td><td>IKA NURMIYANINGSIH</td><td>AGUS
PARMANTO 0712 A 02</td><td>BURUH HARIAN LEPAS</td><td>INGAK INGUK</td><td>INGAK -
align='right'>K41.9</td><td>Unilateral or unspecified femoral hernia, without
obstruction or gangrene</td><td></td><td align='right'>288379</td><td
align='right'>56060139</td><td>13-02-2019</td><td>ISTIYARSO</td><td>ISTIYARSO
0606 I 01</td><td>WIRASWASTA</td><td>GOBOH RT 03 RW
2019</td><td>JUMADI</td><td>JUMADI 0603 J 03</td><td>PETANI/PEKEBUN</td><td>GEBLUG
RT04 RW07</td><td>GEBLUG</td><td>GIRITONTRO</td><td>INDUK</td><td>dr. BUDI
align='right'>56080004</td><td>13-02-2019</td><td>JUMINEM</td><td>SAMIJO 06 08 S
18</td><td>PETANI/PEKEBUN</td><td>DUNGKLEPU WETAN RT 02 RW04</td><td>DUNG KLEPU
align='right'>51137009</td><td>13-02-
2019</td><td>KADIYEM</td><td></td><td>PETANI/PEKEBUN</td><td>GEDANGAN</td><td>GEDAN
GAN</td><td>NGARGOHARJO</td><td>PUSTU NGARGOHARJO</td><td>SUSI HERAWATI,
2019</td><td>KANIYEM</td><td></td><td>PETANI/PEKEBUN</td><td>BLEBER</td><td>BLEBER<
align='right'>57020035</td><td>13-02-2019</td><td>KARMI</td><td>BOWO 07 02 B
align='right'>53015083</td><td>13-02-
2019</td><td>KARMI</td><td>TUKINO</td><td>PETANI/PEKEBUN</td><td>TLOGO</td><td>TLOG
O</td><td>TLOGOHARJO</td><td>PKD TLOGOHARJO</td><td>SRI SUPATMI</td><td> -
align='right'>53015083</td><td>13-02-
2019</td><td>KARMI</td><td>TUKINO</td><td>PETANI/PEKEBUN</td><td>TLOGO</td><td>TLOG
O</td><td>TLOGOHARJO</td><td>PKD TLOGOHARJO</td><td>SRI SUPATMI</td><td> -
d></tr><tr><td align='right'>J11</td><td>Influenza, virus not
align='right'>56080278</td><td>13-02-2019</td><td>KARNO</td><td>KARNO 06 08 K
align='right'>53065043</td><td>13-02-
2019</td><td>KARTI</td><td>PARDI</td><td>PETANI/PEKEBUN</td><td>KLEPU</td><td>KLEPU
</td><td>TLOGOHARJO</td><td>PKD TLOGOHARJO</td><td>SRI SUPATMI</td><td> -
2019</td><td>KATINEM</td><td>KATIJO</td><td>PETANI/PEKEBUN</td><td>GENTUNG</td><td>
align='right'>51050007</td><td>13-02-
2019</td><td>KATINEM</td><td>KATIJO</td><td>PETANI/PEKEBUN</td><td>GENTUNG</td><td>
align='right'>53015027</td><td>13-02-
2019</td><td>KATINO</td><td>KATINO</td><td>PETANI/PEKEBUN</td><td>TLOGO</td><td>TLO
align='right'>11110214</td><td>13-02-
2019</td><td>KUSWANTI</td><td></td><td>PETANI/PEKEBUN</td><td>KALAK</td><td></td><t
d>JAWA TIMUR</td><td>PUSTU TLOGOSARI</td><td>SULARNO,S.Kep.Ns</td><td> -
align='right'>51040016</td><td>13-02-
2019</td><td>KUYEM</td><td>SUTARMO</td><td>PETANI/PEKEBUN</td><td>KLEPU</td><td>KLE
align='right'>51050043</td><td>13-02-2019</td><td>LETHISYA ZEZE
ANINDYA</td><td>SAMINO 05060 S 15</td><td>BELUM/TIDAK BEKERJA</td><td>GENTUNG
</td><td>GENTUNG</td><td>NGARGOHARJO</td><td>INDUK</td><td>dr. BUDI
align='right'>51037083</td><td>13-02-2019</td><td>LISA
WULANDARI</td><td></td><td>MENGURUS RUMAH
TANGGA</td><td>PRINGKUKU</td><td>PRINGKUKU</td><td>NGARGOHARJO</td><td>PUSTU
Thn.</td><td>Datang Sendiri</td><td>Baru</td><td>BPJS PBI</td><td>Rajal</td><td
align='right'>51030061</td><td>13-02-2019</td><td>MALICA
ADILA</td><td>WAKIDI</td><td>PELAJAR/MAHASISWA</td><td>PRINGKUKU</td><td>PRINGKUKU<
2019</td><td>MARDIHANTO</td><td>TAMINO 03 09 T
01</td><td>PETANI/PEKEBUN</td><td>KRANGGAN RT02
RW04</td><td>KRANGGAN</td><td>TLOGOHARJO</td><td>INDUK</td><td>dr. BUDI
align='right'>54050025</td><td>13-02-2019</td><td>MARGO BUDIHATNO</td><td>MARGO
BUDIHATNO 0405 M 04</td><td>KARYAWAN SWASTA</td><td>DOLOGAN RT01
RW02</td><td>DOLOGAN</td><td>BAYEMHARJO</td><td>INDUK</td><td>dr. BUDI
/td></tr><tr><td align='right'>K38.9</td><td>Disease of appendix,
align='right'>57070146</td><td>13-02-2019</td><td>MARTINI</td><td>SUPRAPTO 0707 S
align='right'>57030064</td><td>13-02-2019</td><td>MIFTAH SYAHUDA</td><td>DENAN 07
03 D 04</td><td>BELUM/TIDAK
BEKERJA</td><td>KUWANG</td><td>KUWANG</td><td>PUCANGANOM</td><td>INDUK</td><td>drg.
DANAR WULANDARI</td><td>RIZKI ANISSA, AM.Kg</td><td>P</td><td>5-9
WONOGIRI</td><td>Rajal</td><td align='right'>4</td><td align='right'></td><td
2019</td><td>MINEM</td><td>PAIJAN</td><td>PETANI/PEKEBUN</td><td>BAYEM</td><td>BAYE
align='right'>54065007</td><td>13-02-
2019</td><td>MINEM</td><td>PAIJAN</td><td>PETANI/PEKEBUN</td><td>BAYEM</td><td>BAYE
align='right'>52057060</td><td>13-02-
2019</td><td>MIYEM</td><td></td><td>PETANI/PEKEBUN</td><td>GLAGAH</td><td>GLAGAH</t
></tr><tr><td align='right'>N91.2</td><td>Amenorrhoea, unspecified</td><td></td><td
2019</td><td>MUSTIKASARI</td><td>DWI HANDOKO 0404 D 01</td><td>KARYAWAN
SWASTA</td><td>NGELO RT02
RW02</td><td>NGELO</td><td>BAYEMHARJO</td><td>INDUK</td><td>dr. BUDI
ASHARI</td><td>SUHARNI</td><td>P</td><td>20-44 Thn.</td><td>Datang
2019</td><td>MUTIARA</td><td>SUPARMAN 0406
S04</td><td>PELAJAR/MAHASISWA</td><td>BAYEM RT02
</tr><tr><td align='right'>R05</td><td>Cough</td><td></td><td
2019</td><td>NATIFA ISNA HASIMAH</td><td>DWI HARTANTO 06 03 D
01</td><td>BELUM/TIDAK BEKERJA</td><td>GEBLUG RT04
2019</td><td>NAYLA OKTAVIAN SARI</td><td>MUSTAQIM 0714 M 02</td><td>BELUM/TIDAK
BEKERJA</td><td>PENDEM RT01
RW15</td><td>PENDEM</td><td>PUCANGANOM</td><td>INDUK</td><td>drg.DANAR
</tr><tr><td align='right'>G44.2</td><td>Tension-type headache</td><td></td><td
2019</td><td>NGATMI</td><td></td><td>PETANI/PEKEBUN</td><td>NGRINGIN</td><td>NGRING
IN</td><td>NGARGOHARJO</td><td>PUSTU NGARGOHARJO</td><td>SUSI HERAWATI,
align='right'>51027080</td><td>13-02-
2019</td><td>NGATMI</td><td></td><td>PETANI/PEKEBUN</td><td>NGRINGIN</td><td>NGRING
IN</td><td>NGARGOHARJO</td><td>PUSTU NGARGOHARJO</td><td>SUSI HERAWATI,
align='right'>55040093</td><td>13-02-2019</td><td>NINA SURYANISIH</td><td>SATIMAN
05 04 S 18</td><td>MENGURUS RUMAH TANGGA</td><td>KANIGORO RT 02 RW
01</td><td>KANIGORO</td><td>JATIREJO</td><td>INDUK</td><td>dr. BUDI
align='right'>288351</td><td align='right'>56070127</td><td>13-02-2019</td><td>NOVA
ALDINO</td><td>WIDODO 0607 W 01</td><td>BELUM/TIDAK
BEKERJA</td><td>DUNGKANCIL</td><td>DUNG
KANCIL</td><td>GIRITONTRO</td><td>INDUK</td><td>dr. BUDI ASHARI</td><td>HENI
WIDIYASTUTI</td><td>L</td><td>1-4 Thn.</td><td>Datang
td></tr><tr><td align='right'>J11.8</td><td>Influenza with other manifestations,
align='right'>57130135</td><td>13-02-2019</td><td>PAIJEM</td><td>SUMARDI 0713
S30</td><td>MENGURUS RUMAH TANGGA</td><td>KEPUH RT 02 RW
12</td><td>KEPUH</td><td>PUCANGANOM</td><td>INDUK</td><td>dr. BUDI
></tr><tr><td align='right'>S01.9</td><td>Open wound of head, part
align='right'>57040010</td><td>13-02-
2019</td><td>PAIKEM</td><td>PURNOMO</td><td>PETANI/PEKEBUN</td><td>MANDEYAN</td><td
>MANDEYAN</td><td>PUCANGANOM</td><td>INDUK</td><td>dr. BUDI
align='right'>54110026</td><td>13-02-2019</td><td>PAINEM</td><td>SUROREJO 0411 S
25</td><td>PETANI/PEKEBUN</td><td>GUWO</td><td>GUWO</td><td>BAYEMHARJO</td><td>INDU
K</td><td>dr. BUDI ASHARI</td><td>SUGIYONO,S.Kep.Ns</td><td>P</td><td>>70
align='right'>54035003</td><td>13-02-
2019</td><td>PARIYEM</td><td>NGATMAN</td><td>PETANI/PEKEBUN</td><td>KLAMPEYAN</td><
td>KLAMPEYAN</td><td>BAYEMHARJO</td><td>PUSTU BAYEMHARJO</td><td>RISTINA Amd
align='right'>56020047</td><td>13-02-2019</td><td>PARTINA SAYEKTI</td><td>SARNO
0602 S 16</td><td>MENGURUS RUMAH TANGGA</td><td>GIRITONTRO
KIDUL</td><td>GIRITONTRO
2019</td><td>PARTINI</td><td>JUMADI 0603 J
align='right'>52087145</td><td>13-02-
2019</td><td>PONIYEM</td><td>BOLO</td><td>PETANI/PEKEBUN</td><td>TLOGOSARI</td><td>
TLOGOSARI</td><td>TLOGOSARI</td><td>PUSTU
2019</td><td>PURWANTI</td><td>YUDIANTO</td><td>PETANI/PEKEBUN</td><td>TLOGOSARI</td
><td>TLOGOSARI</td><td>TLOGOSARI</td><td>PUSTU
align='right'>55080101</td><td>13-02-2019</td><td>RIAN ROMADHON</td><td>NGADIYO
0508 N 01</td><td>KARYAWAN SWASTA</td><td>NGORODOWO RT04
RW03</td><td>NGORODOWO</td><td>JATIREJO</td><td>INDUK</td><td>dr. BUDI
align='right'>288368</td><td align='right'>57100063</td><td>13-02-2019</td><td>RINA
WIJAYANTI</td><td>AHMAD HARI PURWOKO 0710 A 03</td><td>BURUH HARIAN
LEPAS</td><td>JEPURUN</td><td>JEPURUN</td><td>PUCANGANOM</td><td>INDUK</td><td>dr.
align='right'>51137010</td><td>13-02-
2019</td><td>RUKINEM</td><td></td><td>PETANI/PEKEBUN</td><td>GEDANGAN</td><td>GEDAN
d></tr><tr><td align='right'>L24.8</td><td>Irritant contact dermatitis due to other
align='right'>51137010</td><td>13-02-
2019</td><td>SALINO</td><td>SALINO</td><td>PETANI/PEKEBUN</td><td>KLEPU</td><td>KLE
AMK</td><td> - </td><td>L</td><td>45-54 Thn.</td><td>Datang
align='right'>56080082</td><td>13-02-2019</td><td>SAMIJO</td><td>SAMIJO 06 08 S
align='right'>57100171</td><td>13-02-2019</td><td>SARNI</td><td>WIJIONO 0710 W
align='right'>51035001</td><td>13-02-
align='right'>51035001</td><td>13-02-
></tr><tr><td align='right'>I84.9</td><td>Unspecified haemorrhoids without
align='right'>57090253</td><td>13-02-2019</td><td>SARTUMI</td><td>SUGENG 0709 S
44</td><td>PETANI/PEKEBUN</td><td>PUCANGANOM LOR RT02 RW09</td><td>PUCANGANOM
Sendiri</td><td>Baru</td><td>JAMKESDA</td><td>Rujuk</td><td
align='right'>52037036</td><td>13-02-2019</td><td>SEPTYAN TRI
HANDIKA</td><td></td><td>BELUM/TIDAK
BEKERJA</td><td>SALAM</td><td>SALAM</td><td>TLOGOSARI</td><td>PUSTU
2019</td><td>SETIATI</td><td>SAINO</td><td>PETANI/PEKEBUN</td><td>TLOGOSARI</td><td
TLOGOSARI</td><td>SULARNO,S.Kep.Ns</td><td>
- </td><td>P</td><td>45-54 Thn.</td><td>Datang
Sendiri</td><td>Lama</td><td></td><td>Rajal</td><td align='right'>24</td><td
align='right'>56080323</td><td>13-02-2019</td><td>SIFA FAUZIAH</td><td>SEDIYANTO
0608 S 33</td><td>BELUM/TIDAK BEKERJA</td><td>DUNGKLEPU WETAN</td><td>DUNG KLEPU
WETAN</td><td>GIRITONTRO</td><td>INDUK</td><td>drg.DANAR WULANDARI</td><td>RIZKI
align='right'>B26</td><td>Mumps</td><td></td><td align='right'>288410</td><td
align='right'>56010208</td><td>13-02-2019</td><td>SITI AZIAH
SARIYANTI</td><td>SUMARNO 0601 S 03</td><td>PELAJAR/MAHASISWA</td><td>GIRITONTRO
align='right'>52077029</td><td>13-02-
2019</td><td>SITUN</td><td></td><td>PETANI/PEKEBUN</td><td>SUMBERJO</td><td>SUMBERJ
2019</td><td>SOMAN</td><td></td><td>PETANI/PEKEBUN</td><td>NGRINGIN</td><td>NGRINGI
- </td><td>L</td><td>60-69 Thn.</td><td>Datang Sendiri</td><td>Lama</td><td>UMUM
MARYATI</td><td>SUPRIYADI 0608 S 25</td><td>PETANI/PEKEBUN</td><td>DUNGKLEPU WETAN
RT02 RW04</td><td>DUNG KLEPU WETAN</td><td>GIRITONTRO</td><td>INDUK</td><td>dr.
BUDI ASHARI</td><td>SUHARNI</td><td>P</td><td>20-44 Thn.</td><td>Datang
></tr><tr><td align='right'>K05.2</td><td>Acute periodontitis</td><td></td><td
UTAMI</td><td>WIYANTO 0706 W 01</td><td>BURUH HARIAN
LEPAS</td><td>TAMBAHSARI</td><td>TAMBAHSARI</td><td>PUCANGANOM</td><td>INDUK</td><t
d>drg.DANAR WULANDARI</td><td>RIZKI ANISSA, AM.Kg</td><td>P</td><td>20-44
WONOGIRI</td><td>Rajal</td><td align='right'></td><td align='right'>5</td><td
W</td><td>SARYONO 0407 S 09</td><td>PETANI/PEKEBUN</td><td>NGALURAN RT01
2019</td><td>SUGENG</td><td>SUPARNO 02 06 S
01</td><td>PETANI/PEKEBUN</td><td>BERGUNG RT01
RW04</td><td>BERGUNG</td><td>TLOGOSARI</td><td>INDUK</td><td>dr. BUDI
align='right'>56010131</td><td>13-02-2019</td><td>SUGIARTI</td><td>SUWARDI 06 01
S 04</td><td>PETANI/PEKEBUN</td><td>GIRITONTRO LOR RT01 RW2</td><td>GIRITONTRO
2019</td><td>SUGIYARMI</td><td></td><td>PETANI/PEKEBUN</td><td>SALAM</td><td>SALAM<
align='right'>52037043</td><td>13-02-
2019</td><td>SUGIYARMI</td><td></td><td>PETANI/PEKEBUN</td><td>SALAM</td><td>SALAM<
align='right'>L24.8</td><td>Irritant contact dermatitis due to other
align='right'>51115002</td><td>13-02-
2019</td><td>SUGIYEM</td><td>SUGIYEM</td><td>PETANI/PEKEBUN</td><td>BLEBER</td><td>
BLEBER</td><td>NGARGOHARJO</td><td>PUSTU NGARGOHARJO</td><td>SUSI HERAWATI,
align='right'>51115002</td><td>13-02-
2019</td><td>SUGIYEM</td><td>SUGIYEM</td><td>PETANI/PEKEBUN</td><td>BLEBER</td><td>
BLEBER</td><td>NGARGOHARJO</td><td>PUSTU NGARGOHARJO</td><td>SUSI HERAWATI,
2019</td><td>SUKARTI</td><td>AGUS SARYONO 5702 A 03</td><td>KARYAWAN
HONORER</td><td>SUKOROYOM WETAN</td><td>SUKOROYOM
2019</td><td>SUKINI</td><td>KATMIN 03 07 K 02</td><td>PETANI/PEKEBUN</td><td>PAGER
GUNUNG RT04 RW05</td><td>PAGER GUNUNG</td><td>TLOGOHARJO</td><td>INDUK</td><td>dr.
></tr><tr><td
align='right'>54065161</td><td>13-02-
2019</td><td>SUKIYEM</td><td></td><td>PETANI/PEKEBUN</td><td>BAYEM</td><td>BAYEM</t
d><td>BAYEMHARJO</td><td>PUSTU BAYEMHARJO</td><td>RISTINA Amd Keb</td><td> -
</td><td>P</td><td>>70 Thn.</td><td>Datang Sendiri</td><td>Baru</td><td>BPJS
align='right'>57060025</td><td>13-02-2019</td><td>SULASMI</td><td>SULASMI 0706 S
07</td><td>PETANI/PEKEBUN</td><td>TAMBAKSARI</td><td>TAMBAHSARI</td><td>PUCANGANOM<
2019</td><td>SUMARMI</td><td></td><td>PETANI/PEKEBUN</td><td>SUMBERJO</td><td>SUMBE
RJO</td><td>TLOGOSARI</td><td>PUSTU TLOGOSARI</td><td>SULARNO,S.Kep.Ns</td><td> -
</td><td>P</td><td>45-54 Thn.</td><td>Datang Sendiri</td><td>Baru</td><td>UMUM
align='right'>K05.2</td><td>Acute periodontitis</td><td></td><td
2019</td><td>SUMARNI</td><td>SUKIJO</td><td>PETANI/PEKEBUN</td><td>TLOGO</td><td>TL
OGO</td><td>TLOGOHARJO</td><td>PKD TLOGOHARJO</td><td>SRI SUPATMI</td><td> -
align='right'>57040087</td><td>13-02-2019</td><td>SUMARTO</td><td>SUMARTO 0704 S
04</td><td>PENSIUNAN</td><td>MANDEYAN</td><td>MANDEYAN</td><td>PUCANGANOM</td><td>I
NDUK</td><td>dr. BUDI ASHARI</td><td>SUGIYONO,S.Kep.Ns</td><td>L</td><td>>70
2019</td><td>SUMINI</td><td></td><td>PETANI/PEKEBUN</td><td>GEDANGAN</td><td>GEDANG
AN</td><td>NGARGOHARJO</td><td>PUSTU NGARGOHARJO</td><td>SUSI HERAWATI,
2019</td><td>SUPANTO</td><td>SUPANTO 0210 S 04</td><td>PERANGKAT
DESA</td><td>PORO</td><td>PORO</td><td>TLOGOSARI</td><td>INDUK</td><td>dr. BUDI
align='right'>M79.15</td><td>Myalgia, pelvic and thigh</td><td></td><td
2019</td><td>SUPARNO</td><td>SUPARNO 02 06 S 01
</td><td>PETANI/PEKEBUN</td><td>BERGUNG</td><td>BERGUNG</td><td>TLOGOSARI</td><td>I
NDUK</td><td>dr. BUDI ASHARI</td><td>SUGIYONO,S.Kep.Ns</td><td>L</td><td>60-69
2019</td><td>SURATI</td><td>SUJARWO 0207 S
03</td><td>PETANI/PEKEBUN</td><td>SUMBERJO RT02
RW04</td><td>SUMBERJO</td><td>TLOGOSARI</td><td>INDUK</td><td>dr. BUDI
align='right'>54110042</td><td>13-02-2019</td><td>SUROREJO</td><td>SUROREJO 0411
S
25</td><td>PETANI/PEKEBUN</td><td>GUWO</td><td>GUWO</td><td>BAYEMHARJO</td><td>INDU
K</td><td>dr. BUDI ASHARI</td><td>SUGIYONO,S.Kep.Ns</td><td>L</td><td>>70
d></tr><tr><td align='right'>J45</td><td>Asthma</td><td></td><td
align='right'>54025005</td><td>13-02-
align='right'>54025005</td><td>13-02-
</tr><tr><td align='right'>M06.9</td><td>Rheumatoid arthritis,
align='right'>54065081</td><td>13-02-
2019</td><td>SUYANI</td><td>SARYANTO</td><td>MENGURUS RUMAH
TANGGA</td><td>BAYEM</td><td>BAYEM</td><td>BAYEMHARJO</td><td>PUSTU
align='right'>55060039</td><td>13-02-2019</td><td>SUYATI</td><td>SUTARNO 0506 S
06</td><td>PETANI/PEKEBUN</td><td>JATI RT02
RW03</td><td>JATI</td><td>JATIREJO</td><td>INDUK</td><td>dr.
2019</td><td>SYAFA</td><td>SUHARTO/07/12/S/18</td><td></td><td>NGAK
NGUK</td><td>INGAK - INGUK</td><td>PUCANGANOM</td><td>INDUK</td><td>drg.DANAR
align='right'>55050028</td><td>13-02-2019</td><td>THOHA AL IKSAN</td><td>TRIYONO
0505 T 04</td><td>BELUM/TIDAK BEKERJA</td><td>PUNUNG RT01 RW
ASHARI</td><td>SUHARNI</td><td>L</td><td>1-4 Thn.</td><td>Datang
2019</td><td>TRINI</td><td>TUKIMIN 0702 T
WETAN</td><td>PUCANGANOM</td><td>INDUK</td><td>dr. BUDI ASHARI</td><td>HENI
WIDIYASTUTI</td><td>P</td><td>20-44 Thn.</td><td>Datang
align='right'>52115036</td><td>13-02-
2019</td><td>TUINEM</td><td>TUINEM</td><td>PETANI/PEKEBUN</td><td>TAMBAK</td><td>TA
MBAK</td><td>TLOGOSARI</td><td>PKD TLOGOSARI</td><td>RETNO AMBARWATI AMD
KEB</td><td> - </td><td>P</td><td>>70 Thn.</td><td>Datang
2019</td><td>TUINEM</td><td>TUINEM</td><td>PETANI/PEKEBUN</td><td>TAMBAK</td><td>TA
KEB</td><td> - </td><td>P</td><td>>70 Thn.</td><td>Datang
2019</td><td>TUKIJEM</td><td>PARTO</td><td>PETANI/PEKEBUN</td><td>PRINGKUKU</td><td
align='right'>51055035</td><td>13-02-
2019</td><td>TUKINO</td><td>TUKINO</td><td>PETANI/PEKEBUN</td><td>GENTUNG</td><td>G
ENTUNG</td><td>NGARGOHARJO</td><td>PUSTU NGARGOHARJO</td><td>SUSI HERAWATI,
AMK</td><td> - </td><td>L</td><td>>70 Thn.</td><td>Datang
2019</td><td>TULADI</td><td>TULADI 0111 T 01</td><td>KARYAWAN
HONORER</td><td>BLEBER RT02
RW06</td><td>BLEBER</td><td>NGARGOHARJO</td><td>INDUK</td><td>dr. BUDI
align='right'>54050029</td><td>13-02-2019</td><td>WAHYU HIDAYATULLAH</td><td>WAHYU
HIDAYATULLAH 0405 W
02</td><td>PETANI/PEKEBUN</td><td>DOLOGAN</td><td>DOLOGAN</td><td>BAYEMHARJO</td><t
d>INDUK</td><td>dr. BUDI ASHARI</td><td>SUGIYONO,S.Kep.Ns</td><td>L</td><td>20-44
2019</td><td>WAHYU SUTRISNI</td><td>SOGIMIN 0102 S 04</td><td>MENGURUS RUMAH
TANGGA</td><td>NGRINGIN RT02
align='right'>56040128</td><td>13-02-2019</td><td>WAHYU WIDODO</td><td>WAHYU WIDODO
0604 W 01</td><td>KARYAWAN
SWASTA</td><td>KETONGGO</td><td></td><td>GIRITONTRO</td><td>INDUK</td><td>dr. BUDI
2019</td><td>WASINI</td><td>KATIMAN 0713 K 02</td><td>PETANI/PEKEBUN</td><td>KEPUH
></tr><tr><td align='right'>Z30.8</td><td>Other contraceptive
management</td><td></td><td align='right'>288375</td><td
align='right'>51020105</td><td>13-02-2019</td><td>WINDI ARTI YOHANA</td><td>TAUFIQ
WIDIASMOKO 0102 T 05</td><td>KARYAWAN SWASTA</td><td>NGRINGIN RT01
align='right'>55110026</td><td>13-02-2019</td><td>WIYONO</td><td>WIYONO 0511 W
06</td><td>KARYAWAN
SWASTA</td><td>BUWENG</td><td>BUWENG</td><td>JATIREJO</td><td>INDUK</td><td>dr.
BUDI ASHARI</td><td>SUGIYONO,S.Kep.Ns</td><td>L</td><td>20-44 Thn.</td><td>Datang
align='right'>56065024</td><td>13-02-2019</td><td>YUGO LARE
VITIANTO</td><td>HARMANTO 0604 H
04</td><td>PELAJAR/MAHASISWA</td><td>GOBOH</td><td>GOBOH</td><td>GIRITONTRO</td><td
>INDUK</td><td>dr. BUDI ASHARI</td><td>SUGIYONO,S.Kep.Ns</td><td>P</td><td>5-9
align='right'>57070020</td><td>13-02-2019</td><td>ZAKI ALFARIZI</td><td>SUGENG
PRIYANTO 0707 S 08</td><td>BELUM/TIDAK BEKERJA</td><td>BANJAR RT0 3RW
05</td><td>BANJAR</td><td>PUCANGANOM</td><td>INDUK</td><td>drg.DANAR
align='right'>288421</td><td align='right'>56010063</td><td>14-02-2019</td><td>
JUMIYEM</td><td>SURIP JUMIYEM 0601 S 48</td><td>PETANI/PEKEBUN</td><td>GIRITONTRO
LOR RT01 RW02</td><td>GIRITONTRO LOR</td><td>GIRITONTRO</td><td>INDUK</td><td>dr.
align='right'>57130123</td><td>14-02-2019</td><td>ADRIAN RAFAEL
PRATAMA</td><td>SOGIMAN / BAYU PRASETYO 0713 S 26</td><td>BELUM/TIDAK
BEKERJA</td><td>KEPUH RT01
ASHARI</td><td>SRI MURWATININGSIH</td><td>L</td><td><1 Thn.</td><td>Datang
align='right'>57050194</td><td>14-02-2019</td><td>AHMAD HAFID
MASRUKHAN</td><td>AMIR CHALIMI 0705 A 08</td><td>KARYAWAN HONORER</td><td>SUKOROYOM
Sendiri</td><td>Lama</td><td>UMUM WONOGIRI</td><td></td><td align='right'>5</td><td
align='right'>B37</td><td>Candidiasis</td><td></td><td align='right'>288466</td><td
align='right'>56050194</td><td>14-02-2019</td><td>ALMAHIRA RINA
RAFIFA</td><td>PRESLAN 06 05 P 02</td><td></td><td>NGUJUNG RT 01 RW
08</td><td></td><td>GIRITONTRO</td><td>INDUK</td><td>dr. BUDI ASHARI</td><td>SRI
align='right'></td><td align='right'>4</td><td>KIA</td><td></td><td></td><td>Dalam
align='right'>288462</td><td align='right'>56050088</td><td>14-02-2019</td><td>ARIF
WIDIYANTO</td><td>ARIF WIDIYANTO 0605 A 01</td><td>KARYAWAN
HONORER</td><td>NGUJUNG</td><td>NGUJUNG</td><td>GIRITONTRO</td><td>INDUK</td><td>dr
. BUDI ASHARI</td><td>SUGIYONO,S.Kep.Ns</td><td>L</td><td>20-44 Thn.</td><td>Datang
align='right'>11111380</td><td>14-02-2019</td><td>ARIP
WICAKSONO</td><td>KURYANTO/KARJO</td><td>KARYAWAN
SWASTA</td><td>MALANG</td><td></td><td>JAWA TIMUR</td><td>INDUK</td><td>dr. BUDI
align='right'>53010086</td><td>14-02-2019</td><td>ARISTA ADINDA
ZAHRANI</td><td>POIMIN / WARSINO 0301 P 07</td><td>BELUM/TIDAK
ASHARI</td><td>SRI MURWATININGSIH</td><td>P</td><td><1 Thn.</td><td>Datang
align='right'>54090061</td><td>14-02-2019</td><td>ARJUNA CAISAR</td><td>TOPIK 0409
T 01</td><td>BELUM/TIDAK BEKERJA</td><td>WATES RT02
RW06</td><td>WATES</td><td>BAYEMHARJO</td><td>INDUK</td><td>dr. BUDI
ASHARI</td><td>SRI MURWATININGSIH</td><td>L</td><td>1-4 Thn.</td><td>Datang
2019</td><td>CHELSEA ERLY ANJANI</td><td>SUNARTO 0707 S 49</td><td>BELUM/TIDAK
BEKERJA</td><td>BANJAR RT03
RW05</td><td>BANJAR</td><td>PUCANGANOM</td><td>INDUK</td><td>drg.DANAR
align='right'>53040057</td><td>14-02-2019</td><td>DEWI LESTARI</td><td>TAUFIK SETYO
HADI 0304 T 01</td><td>KARYAWAN SWASTA</td><td>PUREMBE RT01
RW02</td><td>PUREMBE</td><td>TLOGOHARJO</td><td>INDUK</td><td>dr. BUDI
align='right'>288444</td><td align='right'>52070028</td><td>14-02-2019</td><td>DIAN
ANGGRAHENI PUTRI</td><td>PARMIN 02 07 P 02</td><td>KARYAWAN
SWASTA</td><td>SUMBEREJO RT02
td></tr><tr><td align='right'>R05</td><td>Cough</td><td></td><td
2019</td><td>ERLANGGA</td><td>MUJIYANTO</td><td>BELUM/TIDAK
BEKERJA</td><td>GEMBUK</td><td>GEMBUK</td><td>TLOGOSARI</td><td>PUSTU
2019</td><td>ERLYTA ASYIFA MEY SALSABILA</td><td>BAMBANG 0409 B
01</td><td>BELUM/TIDAK BEKERJA</td><td>WATES RT02
align='right'>288457</td><td align='right'>57100160</td><td>14-02-2019</td><td>EXEL
VIRENDRA PUTRA R </td><td>AHMAD HARI PURWOKO 0710 A 03</td><td>BELUM/TIDAK
BEKERJA</td><td>JEPURUN RT 02 RW
10</td><td>JEPURUN</td><td>PUCANGANOM</td><td>INDUK</td><td>drg.DANAR
tr><tr><td align='right'>R05</td><td>Cough</td><td></td><td
2019</td><td>FAISAL</td><td>JUMALI 0610 J
02</td><td></td><td>TANGGUNG</td><td></td><td>GIRITONTRO</td><td>INDUK</td><td>dr.
BUDI ASHARI</td><td>SRI MURWATININGSIH</td><td>L</td><td>1-4 Thn.</td><td>Datang
align='right'>56010040</td><td>14-02-2019</td><td>FANIA JAUDAH ANA
KAMILA</td><td>ADI MULYADI 0601 A 01</td><td></td><td>GIRITONTRO
2019</td><td>FATHIR MUSTOFA</td><td>TUGIYO 06 10 T
align='right'>57080068</td><td>14-02-2019</td><td>GUNAWAN</td><td>WAKIMIN 0708 W
03</td><td>PEDAGANG</td><td>PUCANG ANOM KIDUL</td><td>PUCANGANOM
align='right'>288456</td><td align='right'>57060129</td><td>14-02-2019</td><td>IBNU
TRI HANANTO</td><td>IBNU TRI HANANTO 0706 I 01</td><td>KARYAWAN
HONORER</td><td>TAMBAHSARI RT02
align='right'>52077055</td><td>14-02-2019</td><td>IHSAN TIRTAN
M</td><td></td><td>PELAJAR/MAHASISWA</td><td>SUMBERJO</td><td>SUMBERJO</td><td>TLOG
OSARI</td><td>PUSTU TLOGOSARI</td><td>SULARNO,S.Kep.Ns</td><td> -
align='right'>G46.8</td><td>Other vascular syndromes of brain in cerebrovascular
diseases</td><td></td><td align='right'>288431</td><td
align='right'>57040248</td><td>14-02-2019</td><td>JUDI</td><td>JUDI 0704 J
2019</td><td>KADINAH</td><td>KADINAH</td><td>PETANI/PEKEBUN</td><td>KLAMPEYAN</td><
td>KLAMPEYAN</td><td>BAYEMHARJO</td><td>PUSTU BAYEMHARJO</td><td>RISTINA Amd
></tr><tr><td align='right'>L29.9</td><td>Pruritus, unspecified</td><td></td><td
2019</td><td>KASTINI</td><td>WARDI</td><td>PETANI/PEKEBUN</td><td>NGASEM</td><td>NG
ASEM</td><td>JATIREJO</td><td>PKD JATIREJO</td><td>SUHARNI</td><td> -
align='right'>52105193</td><td>14-02-
2019</td><td>KATIRAN</td><td>KATIRAN</td><td>PETANI/PEKEBUN</td><td>PORO</td><td>PO
align='right'>54035014</td><td>14-02-
2019</td><td>KATMI</td><td>PAIJEM</td><td>PETANI/PEKEBUN</td><td>KLAMPEYAN</td><td>
KLAMPEYAN</td><td>BAYEMHARJO</td><td>PUSTU BAYEMHARJO</td><td>RISTINA Amd
align='right'>57150075</td><td>14-02-2019</td><td>KHOIRUL DIAH
PRATIWI</td><td>KARJO 0715 K 04</td><td>KARYAWAN SWASTA</td><td>SAWIT KIDUL RT01
RW14</td><td>SAWIT KIDUL</td><td>PUCANGANOM</td><td>INDUK</td><td>dr. BUDI
align='right'>53015037</td><td>14-02-2019</td><td>KIYEM</td><td>POIMIN 0301 P
07</td><td>PETANI/PEKEBUN</td><td>TLOGO RT02
RW01</td><td></td><td>TLOGOHARJO</td><td>INDUK</td><td>dr. BUDI
></tr><tr><td
align='right'>57050228</td><td>14-02-2019</td><td>M. ROFIQ NUR
ALFAN</td><td>SOLAUDIN 0705 S 27</td><td>PETANI/PEKEBUN</td><td>SUKOROYOM KULON RT
02 RW 03</td><td>SUKOROYOM KULON</td><td>PUCANGANOM</td><td>INDUK</td><td>dr. BUDI
align='right'>56080172</td><td>14-02-2019</td><td>M.WAHID</td><td>RAHMAD LUBIS
0608 R 04</td><td>PELAJAR/MAHASISWA</td><td>DUNGKLEPU ETAN</td><td>DUNG KLEPU
align='right'>55010303</td><td>14-02-2019</td><td>MUHAMAD BUSCHAERY
AMIN</td><td>MARYATIN 0501 M 10</td><td>KARYAWAN SWASTA</td><td>GIRIBELAH RT02
align='right'>51020040</td><td>14-02-2019</td><td>NACHELIA DESI
FAJARANI</td><td>SEDIYANTO 0102 S
14</td><td>PEDAGANG</td><td>NGRINGIN</td><td>NGRINGIN</td><td>NGARGOHARJO</td><td>I
NDUK</td><td>dr. BUDI ASHARI</td><td>SUGIYONO,S.Kep.Ns</td><td>P</td><td>20-44
align='right'>57030140</td><td>14-02-2019</td><td>NAT CHUA AULIYA AISYAH
PUTRI</td><td>SULISTIAWAN</td><td>BELUM/TIDAK BEKERJA</td><td>KUWANG RT 03 RW
06</td><td></td><td>PUCANGANOM</td><td>INDUK</td><td>dr. BUDI
2019</td><td>OKTAVIA EMI KUSUMANINGSIH</td><td>WARDI
P</td><td>PETANI/PEKEBUN</td><td>NGASEM</td><td>NGASEM</td><td>JATIREJO</td><td>PKD
align='right'>56010084</td><td>14-02-2019</td><td>PARINEM</td><td>PARINEM 0601 P
06</td><td>MENGURUS RUMAH TANGGA</td><td>GIRITONTRO LOR RT01
2019</td><td>PRAPTI</td><td>AGUS
HARTANTO</td><td>PETANI/PEKEBUN</td><td>GLAGAH</td><td>GLAGAH</td><td>TLOGOSARI</td
><td>PUSTU TLOGOSARI</td><td>SULARNO,S.Kep.Ns</td><td> - </td><td>P</td><td>20-44
align='right'>55030029</td><td>14-02-2019</td><td>RAKIYEM</td><td>RAKIYEM 0503 R
02</td><td>PETANI/PEKEBUN</td><td>SONGGODULANG RT01
RW01</td><td>SONGGODULANG</td><td>JATIREJO</td><td>INDUK</td><td>dr. BUDI
align='right'>288417</td><td align='right'>57100166</td><td>14-02-2019</td><td>RIAN
SETIAWAN</td><td>MARJAN 0710 M 07</td><td>KARYAWAN SWASTA</td><td>JEPURUN RT 03
RW 10</td><td>JEPURUN</td><td>PUCANGANOM</td><td>INDUK</td><td>dr. BUDI
align='right'>N92.6</td><td>Irregular menstruation, unspecified</td><td></td><td
align='right'>288451</td><td align='right'>54065011</td><td>14-02-2019</td><td>RINI
SETYOWATI</td><td>EKO HARYANTO 0406 E 01</td><td>MENGURUS RUMAH
TANGGA</td><td>BAYEMHARJO</td><td>BAYEM</td><td>BAYEMHARJO</td><td>INDUK</td><td>dr
. BUDI ASHARI</td><td>RISTINA Amd Keb</td><td>P</td><td>20-44 Thn.</td><td>Datang
/td></tr><tr><td align='right'>F20</td><td>Schizophrenia</td><td></td><td
2019</td><td>RIYADI</td><td>SUKIRNO 02 05 S
06</td><td>PETANI/PEKEBUN</td><td>GLAGAH RT03
RW06</td><td>GLAGAH</td><td>TLOGOSARI</td><td>INDUK</td><td>dr. BUDI
2019</td><td>RUKON</td><td>RUKON</td><td>PETANI/PEKEBUN</td><td>TAMBAK</td><td>TAMB
align='right'>54080121</td><td>14-02-2019</td><td>RUSIMIN</td><td>RUSIMIN 0408 R
01</td><td>WIRASWASTA</td><td>NGANTAP RT03
d></tr><tr><td align='right'>K05.3</td><td>Chronic periodontitis</td><td></td><td
RT01 RW02</td><td>DOLOGAN</td><td>BAYEMHARJO</td><td>INDUK</td><td>dr. BUDI
></tr><tr><td
align='right'>51110008</td><td>14-02-2019</td><td>SAMINEM</td><td>SUMADI 01 11 S
02</td><td>PETANI/PEKEBUN</td><td>BLEBER RT 02 RW 06
NGARGOHARJO</td><td>BLEBER</td><td>NGARGOHARJO</td><td>INDUK</td><td>dr. BUDI
align='right'>54070006</td><td>14-02-2019</td><td>SARDJONO</td><td>SARDJONO 0407
S 04</td><td>PENSIUNAN</td><td>NGALURAN RT01
align='right'>54070010</td><td>14-02-2019</td><td>SARSI</td><td>WARJI 04 07 W
03</td><td>PETANI/PEKEBUN</td><td>NGALURAN RT01 RW
align='right'>56010236</td><td>14-02-2019</td><td>SELVIA ANGGRAHENI</td><td>HERI
PURWANTO 0601 H 07</td><td>MENGURUS RUMAH TANGGA</td><td>GIRITONTRO LOR RT03
align='right'>56050145</td><td>14-02-2019</td><td>SETYANINGSIH</td><td>PRISLAN 06
05 P02</td><td>MENGURUS RUMAH TANGGA</td><td>NGUJUNG
RT.01/08</td><td>NGUJUNG</td><td>GIRITONTRO</td><td>INDUK</td><td>dr. BUDI
align='right'>53100046</td><td>14-02-2019</td><td>SHOLIHIN</td><td>SHOLIHIN 0310
S 09</td><td>WIRASWASTA</td><td>KELOR RT01
RW04</td><td>KELOR</td><td>TLOGOHARJO</td><td>INDUK</td><td>dr. BUDI
HARTANTI BADRIYAH</td><td>FUAD HELMI EFFENDI 06 01 F 01</td><td>MENGURUS RUMAH
TANGGA</td><td>GIRITONTRO LOR RT 02 RW01</td><td>GIRITONTRO
align='right'>52027039</td><td>14-02-2019</td><td>SITI
HARYANI</td><td></td><td>MENGURUS RUMAH
TANGGA</td><td>MANTANG</td><td>MANTHANG</td><td>TLOGOSARI</td><td>PUSTU
2019</td><td>SOFIANI</td><td>RADIYO 0214 R 01</td><td>MENGURUS RUMAH
TANGGA</td><td>GUPAKAN RT03 RW02</td><td>GUPAKAN</td><td>TLOGOSARI</td><td>PKD
align='right'>52105095</td><td>14-02-
2019</td><td>SOKINAH</td><td>MARSO</td><td>PETANI/PEKEBUN</td><td>PORO</td><td>PORO
></tr><tr><td align='right'>A15</td><td>Respiratory tuberculosis, bacteriologically
and histologically confirmed</td><td></td><td align='right'>288464</td><td
align='right'>56020584</td><td>14-02-2019</td><td>SUGITO</td><td>SUGITO 0602 S
10</td><td>PETANI/PEKEBUN</td><td>GIRITONTRO KDUL 05/03I</td><td>GIRITONTRO
align='right'>51120077</td><td>14-02-2019</td><td>SUHARDI</td><td>GEMAN 0112 G
02</td><td>KARYAWAN
SWASTA</td><td>SELUR</td><td>SELUR</td><td>NGARGOHARJO</td><td>INDUK</td><td>dr.
align='right'>51080040</td><td>14-02-2019</td><td>SULISTIYONO</td><td>SULISTIYONO
0108 S 08</td><td>KARYAWAN SWASTA</td><td>NGADIREJO RT03
RW04</td><td>NGADIREJO</td><td>NGARGOHARJO</td><td>INDUK</td><td>dr. BUDI
2019</td><td>SUPATMI</td><td>RUSGIYANTO 04 04 R
01</td><td>PETANI/PEKEBUN</td><td>NGELO RT02
RW02</td><td>NGELO</td><td>BAYEMHARJO</td><td>INDUK</td><td>dr. BUDI
2019</td><td>SUPRIHATIN</td><td>SUGITO 06 02 S 08 </td><td>BURUH HARIAN
LEPAS</td><td>GIRITONTRO KIDUL</td><td>GIRITONTRO
align='right'>51050020</td><td>14-02-2019</td><td>SUTARNO</td><td>SUTARNO 0105 S
11</td><td>KARYAWAN SWASTA</td><td>GENTUNG RT02
align='right'>57070040</td><td>14-02-2019</td><td>SUTRISNO</td><td>SUTRISNO 0707 S
10</td><td>PENSIUNAN</td><td>BANJAR</td><td>BANJAR</td><td>PUCANGANOM</td><td>INDUK
</td><td>dr. BUDI ASHARI</td><td>SUGIYONO,S.Kep.Ns</td><td>L</td><td>60-69
></tr><tr><td align='right'>H66.4</td><td>Suppurative otitis media,
align='right'>54100047</td><td>14-02-2019</td><td>SUYATMI</td><td>SUPARMAN 0410 S
08</td><td>MENGURUS RUMAH TANGGA</td><td>GUNUNG BROMO </td><td>GUNUNG
BROMO</td><td>BAYEMHARJO</td><td>INDUK</td><td>dr. BUDI
align='right'>57120151</td><td>14-02-2019</td><td>TAUFIK LOGMAN
MAULANA</td><td>RA'IL 0712 R 01</td><td>PETANI/PEKEBUN</td><td>INGAK INGUK RT02
2019</td><td>TAUFIQ GHOZALI</td><td>ARDANI </td><td>PEDAGANG</td><td>SUKOROYOM
align='right'>J44.9</td><td>Chronic obstructive pulmonary disease,
align='right'>53030088</td><td>14-02-2019</td><td>TIKROMO</td><td>TIKROMO 0303 T
09</td><td>PETANI/PEKEBUN</td><td>JAJAR RT03
align='right'>54025006</td><td>14-02-
2019</td><td>TINEM</td><td>SONOKARIYO</td><td>PETANI/PEKEBUN</td><td>NGUNDUK</td><t
d>NGUNDUK</td><td>BAYEMHARJO</td><td>PUSTU BAYEMHARJO</td><td>RISTINA Amd
HARTANTO</td><td>PARTIYEM</td><td>LAINNYA</td><td>SUKOROYOM KULON</td><td>SUKOROYOM
align='right'>53030011</td><td>14-02-2019</td><td>TRIANA WIDIHASTUTI</td><td>NANANG
S 0303 N 01</td><td>KARYAWAN SWASTA</td><td>JAJAR RT04
align='right'>53090024</td><td>14-02-2019</td><td>TRIYONO</td><td>SADINO 0309 S
03</td><td>LAINNYA</td><td>KRANGGAN RT02
RW04</td><td>KRANGGAN</td><td>TLOGOHARJO</td><td>INDUK</td><td>dr. BUDI
align='right'>57050180</td><td>14-02-2019</td><td>TUGINO</td><td>TUGINO 07 05 T
04</td><td>PEDAGANG</td><td>SUKOROYOM KULON</td><td>SUKOROYOM
></tr><tr><td align='right'>N34.3</td><td>Urethral syndrome,
align='right'>51010079</td><td>14-02-2019</td><td>TYAS RETNANINGSIH
KUSNIATI</td><td>UNTORO HERU SAPUTRO 0101 U 01</td><td>MENGURUS RUMAH
TANGGA</td><td>PELET</td><td>PELET</td><td>NGARGOHARJO</td><td>INDUK</td><td>dr.
2019</td><td>WAGINO</td><td>WAGINO</td><td>PETANI/PEKEBUN</td><td>KRANGGAN</td><td>
KRANGGAN</td><td>TLOGOHARJO</td><td>PUSTU BAYEMHARJO</td><td>RISTINA Amd
Keb</td><td> - </td><td>L</td><td>>70 Thn.</td><td>Datang
align='right'>56060133</td><td>14-02-2019</td><td>WAHYU
EDI EXSANTO</td><td>DWI SANYOTO/SUTARYO 0606 D 03</td><td>KARYAWAN
SWASTA</td><td>GOBOH RT03 RW
2019</td><td>WAHYUDI</td><td>WAHYUDI 0706 W
03</td><td>WIRASWASTA</td><td>TAMBAHSARI RT01
Sendiri</td><td>Lama</td><td>Umum</td><td>Rajal</td><td align='right'></td><td
align='right'>T42.7</td><td>Poisoning by antiepileptic and sedative-hypnotic drugs,
align='right'>57030116</td><td>14-02-2019</td><td>WASIS AMANAH</td><td>MISDI 0703
M
09</td><td>PELAJAR/MAHASISWA</td><td>KUWANG</td><td>KUWANG</td><td>PUCANGANOM</td><
td>INDUK</td><td>dr. BUDI ASHARI</td><td>SUGIYONO,S.Kep.Ns</td><td>L</td><td>10-14
></tr><tr><td align='right'>S81</td><td>Open wound of lower leg</td><td></td><td
align='right'>288483</td><td align='right'>57010280</td><td>15-02-2019</td><td>ALI
ABAS</td><td>ALI ABAS 0701 A 01</td><td>KARYAWAN SWASTA</td><td>GROGOL RT01
align='right'>55070059</td><td>15-02-2019</td><td>ALVINO PANDU
SETIAWAN</td><td>SUYATNO 05 07 S 04</td><td>BELUM/TIDAK BEKERJA</td><td>NGELOSARI
RT 01 RW 03</td><td>NGELOSARI</td><td>JATIREJO</td><td>INDUK</td><td>dr. BUDI
ASHARI</td><td>SUGIYONO,S.Kep.Ns</td><td>L</td><td><1 Thn.</td><td>Datang
align='right'>4</td><td align='right'></td><td>BP.
align='right'>53085061</td><td>15-02-2019</td><td>ANINDYA
SALMA</td><td>PRIYADI</td><td>BELUM/TIDAK BEKERJA</td><td>GINADE
align='right'>56100381</td><td>15-02-2019</td><td>ARKA NIZARUL
MAULANA</td><td>MARIDI 06 10 M
14</td><td>PELAJAR/MAHASISWA</td><td>TANGGUNG</td><td>TANGGUNG</td><td>GIRITONTRO</
td><td>INDUK</td><td>dr. BUDI ASHARI</td><td>SUGIYONO,S.Kep.Ns</td><td>L</td><td>5-
9 Thn.</td><td>Datang Sendiri</td><td>Lama</td><td>UMUM
align='right'>56080225</td><td>15-02-2019</td><td>ASSA NUR ASSYIFA</td><td>BASUKI
0608 B 01</td><td>PELAJAR/MAHASISWA</td><td>DUNGKLEPU WETAN</td><td>DUNG KLEPU
align='right'>289034</td><td align='right'>52105032</td><td>15-02-2019</td><td>ATIK
SURYANINGSIH</td><td>SUWANTO</td><td>PETANI/PEKEBUN</td><td>PORO</td><td>PORO</td><
td>TLOGOSARI</td><td>PKD TLOGOSARI</td><td>RETNO AMBARWATI AMD KEB</td><td> -
align='right'>57020363</td><td>15-02-2019</td><td>DIAN SURYANTO</td><td>SUWARNO
0702 S 59</td><td>KARYAWAN SWASTA</td><td>SUKOROYOM WETAN RT03
RW04</td><td>SUKOROYOM WETAN</td><td>PUCANGANOM</td><td>INDUK</td><td>dr. BUDI
align='right'>56010036</td><td>15-02-
2019</td><td>FERNANDO</td><td>WISNU</td><td>PERANGKAT DESA</td><td>GIRITONTRO
align='right'>56020677</td><td>15-02-2019</td><td>GINO</td><td>GINO 06 02 G
02</td><td>PEGAWAI NEGERI SIPIL</td><td>GIRITONTRO RT 02 RW
03</td><td></td><td>GIRITONTRO</td><td>INDUK</td><td>dr. BUDI
align='right'>288494</td><td align='right'>57020181</td><td>15-02-2019</td><td>IDA
KRIDARYANTI</td><td>RUDI ISTANTO 07 02 R
01</td><td>PELAJAR/MAHASISWA</td><td>SUKOROYOM WETAN RT04 RW04</td><td>SUKOROYOM
/td></tr><tr><td align='right'>M19.96</td><td>Arthrosis, unspecified, lower
leg</td><td></td><td align='right'>288481</td><td
align='right'>53065034</td><td>15-02-2019</td><td>KATINEM</td><td>KATINO 0306 K
01</td><td>PETANI/PEKEBUN</td><td>KLEPU RT01
2019</td><td>LILIS PURWANINGSIH</td><td>KETUT SETIAWAN 07 03 K
06</td><td>KUWANG</td><td>PUCANGANOM</td><td>INDUK</td><td>drg.DANAR
></tr><tr><td align='right'>M79.16</td><td>Myalgia, lower leg</td><td></td><td
align='right'>288498</td><td align='right'>54010037</td><td>15-02-2019</td><td>M.
IQBAL ARTA ZANUAR</td><td>MISNO 04 01 M
01</td><td>PELAJAR/MAHASISWA</td><td>BELEH RT 01 RW
04</td><td>BELEH</td><td>BAYEMHARJO</td><td>INDUK</td><td>dr. BUDI
></tr><tr><td align='right'>M79.15</td><td>Myalgia, pelvic and
align='right'>54110062</td><td>15-02-2019</td><td>MARYANTI</td><td>SARWONO 0411 S
19</td><td>BURUH HARIAN LEPAS</td><td>GUWO RT03
align='right'>56100229</td><td>15-02-2019</td><td>MISRAN</td><td>MISRAN 0610 M
align='right'>51060009</td><td>15-02-2019</td><td>PANIYEM</td><td>SARPAN 01 06 S
02</td><td>PETANI/PEKEBUN</td><td>NGLARANGAN RT04
RW03</td><td>NGLARANGAN</td><td>NGARGOHARJO</td><td>INDUK</td><td>dr. BUDI
Sendiri</td><td>Lama</td><td>JAMKESDA</td><td>Rujuk</td><td align='right'>5</td><td
align='right'>53055047</td><td>15-02-
2019</td><td>PARMI</td><td>PARMI</td><td>PETANI/PEKEBUN</td><td>PLARENG</td><td>PLA
RENG</td><td>TLOGOHARJO</td><td>PKD TLOGOHARJO</td><td>SRI SUPATMI</td><td> -
align='right'>52105052</td><td>15-02-
2019</td><td>POIMAN</td><td>POIMAN</td><td>PETANI/PEKEBUN</td><td>PORO</td><td>PORO
2019</td><td>RENITA WULANDARI</td><td>TUMIRAN 03 08 T 05</td><td>MENGURUS RUMAH
TANGGA</td><td>GINADE KULON RT 01 RW 03</td><td>GINADE
align='right'>51087010</td><td>15-02-2019</td><td>SARINEM</td><td>SUKIDI 01 08 S
02</td><td>PETANI/PEKEBUN</td><td>NGADIREJO RT03 RW
04</td><td>NGADIREJO</td><td>NGARGOHARJO</td><td>INDUK</td><td>dr. BUDI
align='right'>57010004</td><td>15-02-2019</td><td>SATINO</td><td>SATINO 07 01 S
15</td><td>PETANI/PEKEBUN</td><td>GROGOL RT 02 RW
align='right'>54015010</td><td>15-02-2019</td><td>SRI RAHAYU</td><td>MISNO 04 01 M
01</td><td>PETANI/PEKEBUN</td><td>BELEH RT 01 RW
04</td><td>BELEH</td><td>BAYEMHARJO</td><td>INDUK</td><td>dr. BUDI
tr><tr><td align='right'>R05</td><td>Cough</td><td></td><td
RETNO HERI WAHYUNI</td><td>AGUS</td><td>PERANGKAT
DESA</td><td>TLOGOSARI</td><td>TLOGOSARI</td><td>TLOGOSARI</td><td>PUSTU
align='right'>56060075</td><td>15-02-2019</td><td>SUHARDI</td><td>SUHARDI 06 06 S
09</td><td>PELAJAR/MAHASISWA</td><td>GOBOH RT 01 RW
2019</td><td>SUKATMI</td><td>PAINO 06 05 P
03</td><td>PELAJAR/MAHASISWA</td><td>NGUJUNG RT 03 RW
align='right'>56100390</td><td>15-02-2019</td><td>SUKATMI</td><td>MARIDI 06 10 M
14</td><td>MENGURUS RUMAH TANGGA</td><td>TANGGUNG RT01
align='right'>M79.05</td><td>Rheumatism, unspecified, pelvic region and
align='right'>55010319</td><td>15-02-2019</td><td>SURATMI</td><td>WARSONO 05 01 W
11</td><td>KARYAWAN SWASTA</td><td>GIRIBELAH RT01
></tr><tr><td align='right'>J11.8</td><td>Influenza
with other manifestations, virus not identified</td><td></td><td
2019</td><td>TUMINI</td><td>SUYATNO 05 07 S
04</td><td>PETANI/PEKEBUN</td><td>NGELOSARI RT01
RW03</td><td>NGELOSARI</td><td>JATIREJO</td><td>INDUK</td><td>dr. BUDI
</tr><tr><td align='right'>H82</td><td>Vertiginous syndromes in diseases classified
align='right'>52077014</td><td>15-02-
2019</td><td>TUMIRAH</td><td>SUKIMIN</td><td>PETANI/PEKEBUN</td><td>SUMBERJO</td><t
align='right'>O14.9</td><td>Pre-eclampsia, unspecified</td><td></td><td
2019</td><td>WAHYUNI</td><td>MUHANSORI 07 04 M 07</td><td>MENGURUS RUMAH
TANGGA</td><td>MANDEYAN RT 02 RW
2019</td><td>WAHYUNI</td><td>PURWANTO</td><td>PERANGKAT
DESA</td><td>NGELO</td><td>NGELO</td><td>TLOGOSARI</td><td>PUSTU
tr><tr><td align='right'>K05.2</td><td>Acute periodontitis</td><td></td><td
2019</td><td>WASIYEM</td><td>GITO</td><td>PETANI/PEKEBUN</td><td>TAMBAK</td><td>TAM
BAK</td><td>TLOGOSARI</td><td>PKD TLOGOSARI</td><td>RETNO AMBARWATI AMD
align='right'>51130052</td><td>15-02-2019</td><td>YANTO</td><td>YANTO 0113 Y
01</td><td>PETANI/PEKEBUN</td><td>GEDANGAN RT01
RW05</td><td>GEDANGAN</td><td>NGARGOHARJO</td><td>PUSTU
></tr><tr><td align='right'>S26.9</td><td>Injury of heart,
align='right'>51130049</td><td>16-02-2019</td><td> ANGGORO UTOMO</td><td>SUPRIYANTO
01 13 S 01</td><td>BELUM/TIDAK BEKERJA</td><td>GEDANGAN RT01
align='right'>54070031</td><td>16-02-2019</td><td>AHMAD RIZAL
FATONI</td><td>SARYONO 0407 S 09</td><td>PELAJAR/MAHASISWA</td><td>NGALURAN RT01
></tr><tr><td align='right'>S52.8</td><td>Fracture of other parts of
forearm</td><td></td><td align='right'>288582</td><td
align='right'>56100072</td><td>16-02-2019</td><td>ASIH SETIYOWATI</td><td>WASIS
0610 W 15</td><td>MENGURUS RUMAH TANGGA</td><td>TANGGUNG RT03
chemical products</td><td></td><td align='right'>288559</td><td
align='right'>15151381</td><td>16-02-2019</td><td>AULIA FAUZIAH</td><td>SUMARNO
1515 S 08</td><td>BELUM/TIDAK
BEKERJA</td><td>JAKARTA</td><td></td><td>JAKARTA</td><td>INDUK</td><td>dr. BUDI
align='right'>57120089</td><td>16-02-2019</td><td>BIMO MAYSAKHI</td><td>IRFAN 0712
I 02</td><td></td><td>INGAK INGUK</td><td>INGAK -
align='right'>55100024</td><td>16-02-2019</td><td>BRYGITA AURA
PUTRIANI</td><td>PONIJAN 05 10 P 01</td><td>BELUM/TIDAK BEKERJA</td><td>SENGON
RT02 RW04</td><td>SENGON</td><td>JATIREJO</td><td>INDUK</td><td>dr. BUDI
td></tr><tr><td align='right'>I11.9</td><td>Hypertensive heart disease without
align='right'>55040088</td><td>16-02-2019</td><td>DARIYEM</td><td>DUL KASPAN 05 04
D 02</td><td>MENGURUS RUMAH
TANGGA</td><td>KANIGORO</td><td>KANIGORO</td><td>JATIREJO</td><td>INDUK</td><td>dr.
BUDI ASHARI</td><td>SUGIYONO,S.Kep.Ns</td><td>P</td><td>>70 Thn.</td><td>Datang
align='right'>51090037</td><td>16-02-2019</td><td>DWI SUTRISNO</td><td>DWI SUTRISNO
0109 D 01</td><td>PETANI/PEKEBUN</td><td>PULUNG RT.04 /
04</td><td>PULUNG</td><td>NGARGOHARJO</td><td>INDUK</td><td>dr. BUDI
></tr><tr><td align='right'>I21.9</td><td>Acute myocardial infarction,
align='right'>51090037</td><td>16-02-2019</td><td>DWI SUTRISNO</td><td>DWI SUTRISNO
0109 D 01</td><td>PETANI/PEKEBUN</td><td>PULUNG RT.04 /
04</td><td>PULUNG</td><td>NGARGOHARJO</td><td>INDUK</td><td>dr. BUDI
align='right'>53050090</td><td>16-02-2019</td><td>FADILAHSYUKUR
ROCHMAN</td><td>SEDIYANTO 0305 S 01</td><td>PELAJAR/MAHASISWA</td><td>PLARENG
RT02 RW05</td><td>PLARENG</td><td>TLOGOHARJO</td><td>INDUK</td><td>dr. BUDI
align='right'>56100378</td><td>16-02-2019</td><td>FAHDIL AQIDUN
HAKIM</td><td>JUMALI 0610 J 02</td><td>BELUM/TIDAK BEKERJA</td><td>TANGGUNG RT02
ASHARI</td><td>SRI MURWATININGSIH</td><td>L</td><td><1 Thn.</td><td>Datang
align='right'>53020039</td><td>16-02-2019</td><td>HAFIDZ RAFFIE RABANI DALIFU
</td><td>SARINO / M FANDI 0302 S
09</td><td></td><td>SAMBIREJO</td><td>SAMBIREJO</td><td>TLOGOHARJO</td><td>INDUK</t
d><td>dr. BUDI ASHARI</td><td>SRI MURWATININGSIH</td><td>L</td><td>1-4
align='right'>57100174</td><td>16-02-2019</td><td>KARENDI</td><td>KARENDI 0710 K
10</td><td>PETANI/PEKEBUN</td><td>JEPURUN RT01
align='right'>56020445</td><td>16-02-2019</td><td>KARTUN</td><td>KARTUN 06 02 K
></tr><tr><td align='right'>I21.1</td><td>Acute transmural myocardial infarction of
inferior wall</td><td></td><td align='right'>288558</td><td
align='right'>52020069</td><td>16-02-
2019</td><td>KATIYEM</td><td>SUKIJAN</td><td>PETANI/PEKEBUN</td><td>MANTHANG RT01
align='right'>53050077</td><td>16-02-2019</td><td>KRISTIANTO</td><td>KRISTIANTO
0305 K 03</td><td>KARYAWAN SWASTA</td><td>PLARENG RT03
align='right'>57100111</td><td>16-02-2019</td><td>MARIYEM</td><td>KARENDI 0710 K
align='right'>13130454</td><td>16-02-2019</td><td>MISDI</td><td>MISDI 1313 M
01</td><td>PETANI/PEKEBUN</td><td>MOJOPURO,EROMOKO</td><td></td><td>WONOGIRI</td><t
d>INDUK</td><td>dr. BUDI ASHARI</td><td>SUGIYONO,S.Kep.Ns</td><td>L</td><td>>70
align='right'>56010250</td><td>16-02-2019</td><td>NASRUL</td><td>ADI 0601 A
01</td><td>PELAJAR/MAHASISWA</td><td>GIRITONTRO LOR RT03 RW01</td><td>GIRITONTRO
align='right'>57050064</td><td>16-02-2019</td><td>NOVA ROMADHON</td><td>SARJONO
0705 S 12</td><td>PELAJAR/MAHASISWA</td><td>SUKOROYOM KULON</td><td>SUKOROYOM
align='right'>56050133</td><td>16-02-2019</td><td>NOVEBRIAN YOHANA
ARIF</td><td>ARIF WIDIYANTO 0605 A 01</td><td>BELUM/TIDAK
. BUDI ASHARI</td><td>SRI MURWATININGSIH</td><td>L</td><td>1-4 Thn.</td><td>Datang
align='right'>55070034</td><td>16-02-2019</td><td>PAINEM</td><td>SUYAYNO 0507 S
align='right'>55070034</td><td>16-02-2019</td><td>PAINEM</td><td>SUYAYNO 0507 S
align='right'>57125025</td><td>16-02-2019</td><td>PARMI</td><td>RAIL 07 12 R
01</td><td>PETANI/PEKEBUN</td><td>INGAK INGUK RT 02 RW 16</td><td>INGAK -
2019</td><td>PARNI</td><td>TUSNI</td><td>PETANI/PEKEBUN</td><td>TAMBAK</td><td>TAMB
- </td><td>P</td><td>60-69 Thn.</td><td>Datang Sendiri</td><td>Lama</td><td>UMUM
2019</td><td>RHEKHAN FIRDAUS</td><td>SUHADI 0709 S
align='right'>S01.7</td><td>Multiple open wounds of head</td><td></td><td
align='right'>288583</td><td align='right'> 57050364</td><td>16-02-2019</td><td>S
HUTOMO</td><td>S HUTOMO</td><td>LAINNYA</td><td>SUKOROYOM KULON</td><td>SUKOROYOM
2019</td><td>SIGIT PURNOMO</td><td>MISDI 07 02 M 10</td><td>KARYAWAN
SWASTA</td><td>SUKOROYOM WETAN RT 02 RW
d align='right'>Z00.8</td><td>Other general examinations</td><td></td><td
2019</td><td>SIROTUR ROSIDIN</td><td>SURATNO 0709 S 21</td><td>PERANGKAT
DESA</td><td>PUCANG ANOM LOR</td><td>PUCANGANOM
W</td><td>SARYONO 0407 S 09</td><td>PETANI/PEKEBUN</td><td>NGALURAN RT01
align='right'>25</td><td align='right'></td><td
></tr><tr><td align='right'>J11.1</td><td>Influenza with other respiratory
manifestations, virus not identified</td><td></td><td align='right'>288546</td><td
align='right'>56070016</td><td>16-02-2019</td><td>SUGINO</td><td>SUGINO 0607 S
01</td><td>PETANI/PEKEBUN</td><td>DUNGKANCIL</td><td>DUNG
</tr><tr><td align='right'>M79.04</td><td>Rheumatism, unspecified,
align='right'>55010333</td><td>16-02-2019</td><td>SURIP</td><td>SAMADI 0501 S
align='right'>55010333</td><td>16-02-2019</td><td>SURIP</td><td>SAMADI 0501 S
align='right'>S01.7</td><td>Multiple open wounds of head</td><td></td><td
2019</td><td>SUWARDI</td><td>SUWARDI 06 06 S
02</td><td>PETANI/PEKEBUN</td><td>GOBOH RT 02
></tr><tr><td align='right'>N18.9</td><td>Chronic renal failure,
align='right'>51130061</td><td>16-02-2019</td><td>SUWARTO</td><td>SUWARTO 0113 S
12</td><td>WIRASWASTA</td><td>GEDANGAN RT01
align='right'>56010096</td><td>16-02-2019</td><td>TRI RINI KRISTIANTI</td><td>SOLEH
PADMADI 06 01 S 23</td><td>MENGURUS RUMAH TANGGA</td><td>GIRITONTRO LOR 01/01
</td><td>GIRITONTRO LOR</td><td>GIRITONTRO</td><td>INDUK</td><td>dr. BUDI
></tr><tr><td align='right'>C61</td><td>Malignant neoplasm of
prostate</td><td></td><td align='right'>288575</td><td
align='right'>51020102</td><td>16-02-2019</td><td>TUKINO</td><td>TUKINO 0102 T
06</td><td>PENSIUNAN</td><td>NGRINGIN RT02
align='right'>57090029</td><td>16-02-2019</td><td>UMI</td><td>SARGINO 07 09 S
></tr><tr><td align='right'>A15.4</td><td>Tuberculosis of intrathoracic lymph
nodes, confirmed bacteriologically and histologically</td><td></td><td
2019</td><td>UMI</td><td>SARGINO 07 09 S
align='right'>56010125</td><td>16-02-2019</td><td>WAGINEM</td><td>SEMANGUN 06 01 S
27</td><td>PETANI/PEKEBUN</td><td>GIRITONTRO LOR 02 RW 032</td><td>GIRITONTRO
2019</td><td>WAGINEM</td><td>SEMANGUN 06 01 S
27</td><td>PETANI/PEKEBUN</td><td>GIRITONTRO LOR 02 RW 032</td><td>GIRITONTRO
align='right'>51020023</td><td>16-02-2019</td><td>WAHYU SUTRISNI</td><td>SOGIMIN
0102 S 04</td><td>MENGURUS RUMAH TANGGA</td><td>NGRINGIN RT02
align='right'>F20</td><td>Schizophrenia</td><td></td><td
2019</td><td>WIWIN</td><td>MESMIN 07 01 M
11</td><td>PETANI/PEKEBUN</td><td>GROGOL RT03
2019</td><td>YASMIN</td><td>SURYANTO 0702 S
01</td><td>PELAJAR/MAHASISWA</td><td>SUKOROYOM WETAN RT02 RW04</td><td>SUKOROYOM
align='right'>56010063</td><td>18-02-2019</td><td> JUMIYEM</td><td>SURIP JUMIYEM
0601 S 48</td><td>PETANI/PEKEBUN</td><td>GIRITONTRO LOR RT01
2019</td><td>ADINA RANI FAHMAWATI</td><td>JOKO SUSILO 0706 J 01</td><td>KARYAWAN
SWASTA</td><td>TAMBAKSARI</td><td>TAMBAHSARI</td><td>PUCANGANOM</td><td>INDUK</td><
td>dr. BUDI ASHARI</td><td>SUGIYONO,S.Kep.Ns</td><td>P</td><td>20-44
align='right'>K03</td><td>Other diseases of hard tissues of teeth</td><td></td><td
align='right'>51030018</td><td>18-02-2019</td><td>AGUSTA RAHMA
PRADINA</td><td>LUGINO</td><td>LAINNYA</td><td>PRINGKUKU</td><td>PRINGKUKU</td><td>
NGARGOHARJO</td><td>INDUK</td><td>dr. BUDI ASHARI</td><td>UMI NUR
ISNIATI</td><td>L</td><td>15-19 Thn.</td><td>Datang
2019</td><td>AJENG FAUSIYAH HERLINA </td><td>SUYANTO 0402 S
09</td><td>PELAJAR/MAHASISWA</td><td>NGUNDUK RT01
align='right'>55090064</td><td>18-02-2019</td><td>AKHTAR NAWAIT ABDUL
ROHMAN</td><td>ARSI SETIANTO 05 09 A 02</td><td>BELUM/TIDAK
BEKERJA</td><td>MULWOSARI RT 04 RW
02</td><td>MULWOSARI</td><td>JATIREJO</td><td>INDUK</td><td>dr. BUDI
/td></tr><tr><td align='right'>K04.7</td><td>Periapical abscess without
align='right'>56010044</td><td>18-02-2019</td><td>ALEA</td><td>HARSANTO 0601 H
04</td><td>PELAJAR/MAHASISWA</td><td>GIRITONTRO LOR RT01 RW02</td><td>GIRITONTRO
ABAS</td><td>ALI ABAS 0701 A 01</td><td>KARYAWAN SWASTA</td><td>GROGOL RT01
align='right'>B37</td><td>Candidiasis</td><td></td><td align='right'>288645</td><td
BUDI ASHARI</td><td>UMI NUR ISNIATI</td><td>P</td><td>1-4
2019</td><td>ALVAN ALVINO VENDYA PUTRA</td><td>YATNO 06 01 Y
01</td><td>PELAJAR/MAHASISWA</td><td>GIRITONTRO LOR RT 02 RW
02</td><td></td><td>PUCANGANOM</td><td>INDUK</td><td>drg.DANAR
</tr><tr><td align='right'>Q40.1</td><td>Congenital hiatus hernia</td><td></td><td
2019</td><td>ALVIN DERREN RADITYA</td><td>PRIYONO 0102 P 01</td><td>BELUM/TIDAK
BEKERJA</td><td>NGRINGIN RT02
ASHARI</td><td>UMI NUR ISNIATI</td><td>L</td><td>1-4 Thn.</td><td>Datang
/tr><tr><td align='right'>J11.8</td><td>Influenza with other manifestations, virus
align='right'>57050080</td><td>18-02-2019</td><td>AMELIA ALIFAH</td><td>SUMADI
align='right'>57090151</td><td>18-02-2019</td><td>ANDRI SETIAWAN</td><td>MISIYEM
0709 M 08</td><td>PETANI/PEKEBUN</td><td>PUCANGANOM LOR</td><td>PUCANGANOM
align='right'>54110029</td><td>18-02-2019</td><td>ANITA WATI</td><td>DODI SETIAWAN
0411 D 01</td><td>MENGURUS RUMAH TANGGA</td><td>GUWO RT03
align='right'>56020299</td><td>18-02-2019</td><td>ARDIANI RAVEENI</td><td>ARIF
HANTORO 0602 A 09</td><td>PERANGKAT DESA</td><td>GIRITONTRO
></tr><tr><td align='right'>S52.80</td><td>Fracture of other parts of forearm ,
closed</td><td></td><td align='right'>288584</td><td
align='right'>56100072</td><td>18-02-2019</td><td>ASIH SETIYOWATI</td><td>WASIS
0610 W 15</td><td>MENGURUS RUMAH TANGGA</td><td>TANGGUNG RT03
2019</td><td>AYUNINGDYA AILA VARISHA</td><td>EDI</td><td>BELUM/TIDAK
align='right'>57070140</td><td>18-02-2019</td><td>BOWO ARIYANTO</td><td>BOWO
ARIYANTO 0706 B 03</td><td>WIRASWASTA</td><td>TAMBAHSARI RT01
align='right'>56020223</td><td>18-02-2019</td><td>DAL SOSIALIS
SETYOWATI</td><td>SUWANDI 06 02 S 19</td><td>MENGURUS RUMAH
TANGGA</td><td>GIRITONTRO KIDUL</td><td>GIRITONTRO
align='right'>57150017</td><td>18-02-2019</td><td>DANIEL ABE
SANJAYA</td><td>VERONIKA MULYANI 07 15 V
01</td><td>PELAJAR/MAHASISWA</td><td>SAWIT KIDUL RT 01 RW 14</td><td>SAWIT
align='right'>56020010</td><td>18-02-2019</td><td>DIAJENG KEMALA</td><td>KATIMIN
0602 K 09</td><td>PELAJAR/MAHASISWA</td><td>GIRITONTRO KIDUL</td><td>GIRITONTRO
align='right'>288630</td><td align='right'>57030231</td><td>18-02-2019</td><td>DIKI
SUDARMANTO</td><td>DIKI SUDARMANTO 0703 D 03</td><td>KARYAWAN
SWASTA</td><td>KUWANG</td><td>KUWANG</td><td>PUCANGANOM</td><td>INDUK</td><td>dr.
align='right'>57040009</td><td>18-02-2019</td><td>ERNA WIDYARINI</td><td>WIYANTO
0704 W 01</td><td>MENGURUS RUMAH TANGGA</td><td>MANDEYAN RT04
2019</td><td>FITRI IRAWATI</td><td>BUDI HARTANTO 05 01 B 01</td><td>MENGURUS
RUMAH TANGGA</td><td>GIRIBELAH RT03
2019</td><td>FITRI VANDU WINATA</td><td>AHMAD YASIN 0207 A 02</td><td>MENGURUS
RUMAH TANGGA</td><td>SUMBEREJO RT02
align='right'>L24.5</td><td>Irritant contact dermatitis due to other chemical
products</td><td></td><td align='right'>288586</td><td
align='right'>54070087</td><td>18-02-2019</td><td>I PUTU AYU ALVERNIA
WULANDARI</td><td>WIDYASTUTI 0407 W 06</td><td>PELAJAR/MAHASISWA</td><td>NGALURAN
RT01 RW05</td><td>NGALURAN</td><td>BAYEMHARJO</td><td>INDUK</td><td>dr. BUDI
/td></tr><tr><td align='right'>Z00.8</td><td>Other general
align='right'>56080252</td><td>18-02-2019</td><td>IPIK SUWANTI</td><td>SARYONO
0608 S 47</td><td>MENGURUS RUMAH TANGGA</td><td>DUNGKLEPU WETAN RT01
RW04</td><td>DUNG KLEPU WETAN</td><td>GIRITONTRO</td><td>INDUK</td><td>dr. BUDI
align='right'>52077010</td><td>18-02-
2019</td><td>JIKEM</td><td></td><td>PETANI/PEKEBUN</td><td>SUMBERJO</td><td>SUMBERJ
align='right'>54065047</td><td>18-02-
2019</td><td>KARIMIN</td><td>TUGIYEM 0717 T
align='right'>56100003</td><td>18-02-2019</td><td>KARNI</td><td>KARNI 06 10 K
03</td><td>PETANI/PEKEBUN</td><td>TANGGUNG RT 01 RW
align='right'>56020445</td><td>18-02-2019</td><td>KARTUN</td><td>KARTUN 06 02 K
align='right'>52057013</td><td>18-02-
align='right'>56010244</td><td>18-02-2019</td><td>KAYLA NADHIRA ALMIRA</td><td>BAYU
0601 B 01</td><td>BELUM/TIDAK BEKERJA</td><td>GIRITONTRO LOR RT03
align='right'>57030106</td><td>18-02-2019</td><td>KEVIN ASKHA</td><td>ARGA /DASUKI
0703 A 01</td><td>BELUM/TIDAK BEKERJA</td><td>KUWANG RT 03 RW
align='right'>54055020</td><td>18-02-2019</td><td>MARGO BUDIHATNO</td><td>MARGO
BUDIHATNO</td><td>PETANI/PEKEBUN</td><td>DOLOGAN</td><td>DOLOGAN</td><td>BAYEMHARJO
</td><td>PUSTU BAYEMHARJO</td><td>RISTINA Amd Keb</td><td> - </td><td>L</td><td>20-
align='right'>56080008</td><td>18-02-2019</td><td>MARIYEM</td><td>MULYADI 06 08 M
16</td><td>PETANI/PEKEBUN</td><td>DUNGKLEPU WETAN RT01 RW04</td><td>DUNG KLEPU
align='right'>53025024</td><td>18-02-2019</td><td>MARYANTI</td><td>SRIYONO /
MARYANTI 03 02 S 06</td><td>BURUH HARIAN LEPAS</td><td>SAMBIREJO RT 04 RW
01</td><td></td><td>TLOGOHARJO</td><td>INDUK</td><td>dr. BUDI
</tr><tr><td
2019</td><td>MARYATI</td><td>KASNO 07 02 K
WETAN</td><td>PUCANGANOM</td><td>INDUK</td><td>dr. BUDI ASHARI</td><td>UMI NUR
align='right'>56100200</td><td>18-02-2019</td><td>MAYA CHOIRUNISA</td><td>SUYATNO
0610 S 09</td><td>PELAJAR/MAHASISWA</td><td>TANGGUNG RT03
align='right'>56020041</td><td>18-02-2019</td><td>MOKARYO</td><td>MOKARYO 06 01 M
></tr><tr><td align='right'>K29.9</td><td>Gastroduodenitis,
align='right'>57050004</td><td>18-02-2019</td><td>MUGIYEM</td><td>SUKIMAN 07 05 S
01</td><td>MENGURUS RUMAH TANGGA</td><td>SUKOROYOM KULON</td><td>SUKOROYOM
d></tr><tr><td align='right'>K29.5</td><td>Chronic gastritis,
align='right'>56020521</td><td>18-02-2019</td><td>MUGIYONO</td><td>MUGIYONO 0602 M
></tr><tr><td align='right'>H65.9</td><td>Nonsuppurative otitis media,
align='right'>57030158</td><td>18-02-2019</td><td>MUHAMMAD FADIEL
BUDIATMA</td><td>BUDI SETIONO 0703 B 01</td><td>PELAJAR/MAHASISWA</td><td>KUWANG
RT01 RW06</td><td>KUWANG</td><td>PUCANGANOM</td><td>INDUK</td><td>dr. BUDI
align='right'>57120145</td><td>18-02-2019</td><td>MUSTOFA MUHAMMAD
ILMI</td><td>GINEN 07 12 G 02</td><td>BELUM/TIDAK BEKERJA</td><td>NGAK-INGUK RT02
RW 16</td><td>INGAK - INGUK</td><td>PUCANGANOM</td><td>INDUK</td><td>dr. BUDI
align='right'>54110060</td><td>18-02-2019</td><td>NABILA MAHARANI</td><td>ARI
INDRAWANTO 04 11 A 01</td><td>BELUM/TIDAK BEKERJA</td><td>GUWO RT03
/td></tr><tr><td align='right'>M79.05</td><td>Rheumatism, unspecified, pelvic
region and thigh</td><td></td><td align='right'>288607</td><td
align='right'>57020074</td><td>18-02-2019</td><td>NARTI</td><td>SARTO 0702 S
align='right'>57070272</td><td>18-02-2019</td><td>NENI ROMANIKA</td><td>SUPRIYANTO
0707 S 45</td><td>MENGURUS RUMAH TANGGA</td><td>BANJAR RT03
2019</td><td>NOVIANTI</td><td>SARWADI</td><td>PETANI/PEKEBUN</td><td>PELET</td><td>
PELET</td><td>NGARGOHARJO</td><td>PUSTU NGARGOHARJO</td><td>SUSI HERAWATI,
></tr><tr><td align='right'>K29.9</td><td>Gastroduodenitis,
align='right'>57040114</td><td>18-02-2019</td><td>PAINAH</td><td>PAINAH 07 04 P
align='right'>57120016</td><td>18-02-2019</td><td>PARYANTI</td><td>GINEN 07 12 G
02</td><td>PETANI/PEKEBUN</td><td>INGAK INGUK RT02 RW 16</td><td>INGAK -
INGUK</td><td>PUCANGANOM</td><td>INDUK</td><td>dr. BUDI ASHARI</td><td>UMI NUR
chemical products</td><td></td><td align='right'>288633</td><td
align='right'>56010488</td><td>18-02-2019</td><td>PUGUH DARMANU</td><td>PUGUH
DARMANU 0601 P 08</td><td>WIRASWASTA</td><td>GIRITONTRO LOR RT02
align='right'>O30.0</td><td>Twin pregnancy</td><td></td><td
2019</td><td>RETNO KURNIAWATI</td><td>SEPDWIYANTO 05 05 S 20</td><td>MENGURUS
RUMAH TANGGA</td><td>PUNUNG RT01
RW02</td><td>PUNUNG</td><td>JATIREJO</td><td>INDUK</td><td>dr. BUDI
Sendiri</td><td>Lama</td><td>BPJS
</tr><tr><td align='right'>S52.80</td><td>Fracture of other parts of forearm ,
Umum</td><td>Poli Ortopedi</td><td>RSUD DR. SOEDIRAN MS WONOGIRI</td><td>Dalam
align='right'>C50.9</td><td>Malignant neoplasm of breast,
align='right'>57130054</td><td>18-02-2019</td><td>RINEM</td><td>BOIMIN 07 13 B
03</td><td>PETANI/PEKEBUN</td><td>KEPUH RT 02 RW
align='right'>51137010</td><td>18-02-
align='right'>57090059</td><td>18-02-2019</td><td>RUKIYEM</td><td>MARIYO 0709 M
10</td><td>PETANI/PEKEBUN</td><td>PUCANGANOM LOR</td><td>PUCANGANOM
align='right'>55010103</td><td>18-02-2019</td><td>SAIDS AGIL
MUNAWAR</td><td>SALOSAK 0501 S 51</td><td>PELAJAR/MAHASISWA</td><td>GIRIBELAH
align='right'>52047030</td><td>18-02-
2019</td><td>SAIKEM</td><td></td><td>PETANI/PEKEBUN</td><td>SOKO</td><td>SOKO</td><
align='right'>52110003</td><td>18-02-
2019</td><td>SAMINO</td><td>SAMINO</td><td>PETANI/PEKEBUN</td><td>TAMBAK</td><td>TA
MBAK</td><td>TLOGOSARI</td><td>PUSTU TLOGOSARI</td><td>SULARNO,S.Kep.Ns</td><td> -
align='right'>51057018</td><td>18-02-
2019</td><td>SARIYEM</td><td>SARIYEM</td><td>PETANI/PEKEBUN</td><td>GENTUNG</td><td
2019</td><td>SARIYEM</td><td>SARIYEM</td><td>PETANI/PEKEBUN</td><td>GENTUNG</td><td
2019</td><td>SATINEM</td><td></td><td>PETANI/PEKEBUN</td><td>NGRINGIN</td><td>NGRIN
align='right'>56020234</td><td>18-02-2019</td><td>SENEN</td><td>MOKARYO 06 02 M
></tr><tr><td align='right'>Z39.2</td><td>Routine postpartum follow-
up</td><td></td><td align='right'>288640</td><td align='right'>57010031</td><td>18-
02-2019</td><td>SITI NUR HASANAH</td><td>SUTARTO 07 01 S 08</td><td>KARYAWAN
SWASTA</td><td>GROGOL RT02
align='right'>54065162</td><td>18-02-2019</td><td>SONIYEM</td><td>TOTO
P</td><td>PETANI/PEKEBUN</td><td>BAYEM</td><td>BAYEM</td><td>BAYEMHARJO</td><td>PUS
TU BAYEMHARJO</td><td>RISTINA Amd Keb</td><td> - </td><td>P</td><td>>70
Thn.</td><td>Datang Sendiri</td><td>Baru</td><td>BPJS PBI</td><td>Rajal</td><td
align='right'>56020356</td><td>18-02-2019</td><td>SRI RAHAYU</td><td>MISMAN 0602 M
16</td><td>BURUH HARIAN LEPAS</td><td>GIRITONTRO KIDUL</td><td>GIRITONTRO
UPAMI</td><td></td><td>PETANI/PEKEBUN</td><td>GEDANGAN</td><td>GEDANGAN</td><td>NGA
RGOHARJO</td><td>PUSTU NGARGOHARJO</td><td>SUSI HERAWATI, AMK</td><td> -
2019</td><td>SUGITO</td><td>SUGITO</td><td>PETANI/PEKEBUN</td><td>TAMBAK</td><td>TA
KEB</td><td> - </td><td>L</td><td>45-54 Thn.</td><td>Datang
2019</td><td>SUHARNI</td><td>SAHYONO</td><td>PETANI/PEKEBUN</td><td>NGUNDUK</td><td
align='right'>Z35</td><td>Supervision of high-risk pregnancy</td><td></td><td
2019</td><td>SUKARNI</td><td>BAYU BUDI UTOMO 0601 B 01</td><td>MENGURUS RUMAH
LOR</td><td>GIRITONTRO</td><td>INDUK</td><td>dr. BUDI ASHARI</td><td>UMI NUR
</tr><tr><td align='right'>S81</td><td>Open wound of lower leg</td><td></td><td
2019</td><td>SUKATMI</td><td>PAINO 06 05 P
d></tr><tr><td align='right'>K04.5</td><td>Chronic apical
periodontitis</td><td></td><td align='right'>288613</td><td
align='right'>55010219</td><td>18-02-2019</td><td>SUKATNI</td><td>SUKIRNO 0501 S
04</td><td>PETANI/PEKEBUN</td><td>GIRIBELAH RT
2019</td><td>SULARTO</td><td>SULARTO</td><td>PETANI/PEKEBUN</td><td>TLOGOSARI</td><
td>TLOGOSARI</td><td>TLOGOSARI</td><td>PUSTU
align='right'>51030073</td><td>18-02-2019</td><td>SULISTIAWAN</td><td>LUGINO/SARMAN
0103 L01</td><td>KARYAWAN SWASTA</td><td>PRINGKUKU
</td><td>PRINGKUKU</td><td>NGARGOHARJO</td><td>INDUK</td><td>dr. BUDI
align='right'>56055141</td><td>18-02-2019</td><td>SUMARNO</td><td>SUMARNO 0605 S
align='right'>54080134</td><td>18-02-2019</td><td>SUPRIYADI</td><td>SUPRIYADI 0408
S 21</td><td>KARYAWAN SWASTA</td><td>NGANTAP RT03
align='right'>53030026</td><td>18-02-2019</td><td>SUTARDI</td><td>SUTARDI 03 03 S
11</td><td>WIRASWASTA</td><td>JAJAR RT 05 RW
2019</td><td>SUTINEM</td><td>SARNEN 0303 S
06</td><td>PETANI/PEKEBUN</td><td>JAJAR</td><td>JAJAR</td><td>TLOGOHARJO</td><td>IN
DUK</td><td>dr. BUDI ASHARI</td><td>SUGIYONO,S.Kep.Ns</td><td>P</td><td>>70
align='right'>56100310</td><td>18-02-2019</td><td>SUTINO</td><td>SUTINO 0610 S
15</td><td>PETANI/PEKEBUN</td><td>TANGGUNG</td><td>TANGGUNG</td><td>GIRITONTRO</td>
align='right'>56020355</td><td>18-02-2019</td><td>SUWANDI</td><td>SUWANDI 06 02 S
19</td><td>PENSIUNAN</td><td>GIRITONTRO KIDUL RT 01 RW 03</td><td>GIRITONTRO
></tr><tr><td
align='right'>L20</td><td>Atopic dermatitis</td><td></td><td
2019</td><td>TINI</td><td>SUTIMIN 0703 S 14</td><td>PETANI/PEKEBUN</td><td>KUWANG
RT03 RW06</td><td>KUWANG</td><td>PUCANGANOM</td><td>INDUK</td><td>dr. BUDI
2019</td><td>TUGINAH</td><td>TUGINAH 06 01 T
align='right'>56080233</td><td>18-02-2019</td><td>TUKIRAN ATMO
WIRANTO</td><td>TUKIRAN ATMO WIRANTO 0608 T 06</td><td>PEDAGANG</td><td>DUNGKLEPU
WETAN RT01 RW04</td><td>DUNG KLEPU
align='right'>52127015</td><td>18-02-
2019</td><td>TUMI</td><td></td><td>PETANI/PEKEBUN</td><td>NGELO</td><td>NGELO</td><
align='right'>J45</td><td>Asthma</td><td></td><td align='right'>288627</td><td
align='right'>57140094</td><td>18-02-2019</td><td>WAGINAH</td><td>SOMO 0 7 14 S
2019</td><td>WAGINAH</td><td>SOMO 0 7 14 S
align='right'>54065054</td><td>18-02-
2019</td><td>WAGIYEM</td><td>WAGIYEM</td><td>PETANI/PEKEBUN</td><td>BAYEM</td><td>B
AYEM</td><td>BAYEMHARJO</td><td>PUSTU BAYEMHARJO</td><td>RISTINA Amd Keb</td><td> -
align='right'>52057059</td><td>18-02-2019</td><td>WENI</td><td></td><td>PERANGKAT
DESA</td><td>GLAGAH</td><td>GLAGAH</td><td>TLOGOSARI</td><td>PUSTU
</tr><tr><td align='right'>L55.9</td><td>Sunburn, unspecified</td><td></td><td
2019</td><td>WENING</td><td>SURYONO 0411 S
/td></tr><tr><td align='right'>Z00.8</td><td>Other general
align='right'>56050221</td><td>18-02-2019</td><td>WIJI HASTANTI</td><td>SULARTO
0605 S 02</td><td>KARYAWAN SWASTA</td><td>NGUJUNG RT03
2019</td><td>ZAERONI AJI DIANTOKO</td><td>HERI 0703 H
01</td><td>WIRASWASTA</td><td>KUWANG RT02
align='right'>56010114</td><td>18-02-2019</td><td>ZAKIYA INEZ
KEYRILLA</td><td>MESGI 06 01 M 01</td><td>PELAJAR/MAHASISWA</td><td>GIRITONTRO
2019</td><td>AHMAD YASIN</td><td>AHMAD YASIN 0207 A 02</td><td>KARYAWAN
SWASTA</td><td>SUMBEREJO RT02
align='right'>57050360</td><td>19-02-2019</td><td>BERLIAN KUSUMA</td><td>HARIYANTO
07 05 H 08</td><td>PELAJAR/MAHASISWA</td><td>SUKOROYM KULON</td><td>SUKOROYOM
align='right'>288673</td><td align='right'>53010039</td><td>19-02-2019</td><td>CAKA
PD</td><td>MOREJO 0301 M 10</td><td>PELAJAR/MAHASISWA</td><td>TLOGO RT01
2019</td><td>CHRISTINA
SRI PURWANTI</td><td>FR. SULARSO 07 10 F
align='right'>57050365</td><td>19-02-2019</td><td>CITA PURNAMA SARI</td><td>SURANTO
0705 S 21</td><td>MENGURUS RUMAH TANGGA</td><td>SUKOROYOM KULON RT01
></tr><tr><td align='right'>Z01.7</td><td>Laboratory examination</td><td></td><td
align='right'>288812</td><td align='right'>0104</td><td>19-02-2019</td><td>ENDANG
SUSILOWATI</td><td>KARTOREJO</td><td>PETANI/PEKEBUN</td><td>KLEPU</td><td>KLEPU</td
><td>NGARGOHARJO</td><td>PUSKESLING NGARGOHARJO</td><td>dr. ZAENAL ARIFIN
HP</td><td>SUSI HERAWATI, AMK</td><td>P</td><td>20-44 Thn.</td><td>Datang
align='right'>R11</td><td>Nausea and vomiting</td><td></td><td
2019</td><td>ERLYTA ASYIFA MEY SALSABILA</td><td>BAMBANG 0409 B
01</td><td>BELUM/TIDAK BEKERJA</td><td>WATES RT02
align='right'>54090028</td><td>19-02-2019</td><td>ETIK</td><td>SUTRISNO 0409 S
04</td><td>BURUH HARIAN LEPAS</td><td>WATES RT01
align='right'>57100160</td><td>19-02-2019</td><td>EXEL VIRENDRA PUTRA R
</td><td>AHMAD HARI PURWOKO 0710 A 03</td><td>BELUM/TIDAK BEKERJA</td><td>JEPURUN
RT 02 RW 10</td><td>JEPURUN</td><td>PUCANGANOM</td><td>INDUK</td><td>drg.DANAR
tr><tr><td align='right'>A01.0</td><td>Typhoid fever</td><td></td><td
2019</td><td>FAJAR ALFIAN</td><td>SISWANTO 06 10 S
05</td><td>PELAJAR/MAHASISWA</td><td>TANGGUNG RT 03 RW
align='right'>54070045</td><td>19-02-2019</td><td>HANDIKA ADI
PRATAMA</td><td>SURIPTO 0407 S 06</td><td>BELUM/TIDAK
BEKERJA</td><td>NGALURAN</td><td>NGALURAN</td><td>BAYEMHARJO</td><td>INDUK</td><td>
dr. BUDI ASHARI</td><td>SUGIYONO,S.Kep.Ns</td><td>P</td><td>5-9 Thn.</td><td>Datang
align='right'>57050353</td><td>19-02-2019</td><td>HARYANTO</td><td>HARYANTO 0705 H
08</td><td>WIRASWASTA</td><td>SUKOROYOM KULON RT01 RW03</td><td>SUKOROYOM
align='right'>56100415</td><td>19-02-2019</td><td>HESTI
PARAMITARADYASTUTI</td><td>BUDIYONO 0610 B 04</td><td>WIRASWASTA</td><td>TANGGUNG
RT03 RW05</td><td>TANGGUNG</td><td>GIRITONTRO</td><td>INDUK</td><td>dr. BUDI
d></tr><tr><td align='right'>M79.0</td><td>Rheumatism, unspecified</td><td></td><td
2019</td><td>JAMIYEM</td><td>SUKIMIN 0109 S
13</td><td>PETANI/PEKEBUN</td><td>PULUNG RT04
RW04</td><td>PULUNG</td><td>NGARGOHARJO</td><td>INDUK</td><td>dr. BUDI
2019</td><td>JIKEM</td><td>JIKEM</td><td>PETANI/PEKEBUN</td><td>PELET</td><td>PELET
</td><td>NGARGOHARJO</td><td>PUSKESLING NGARGOHARJO</td><td>SUSI HERAWATI,
AMK</td><td>HENI WIDIYASTUTI</td><td>P</td><td>>70 Thn.</td><td>Datang
2019</td><td>JINEM</td><td>WARIDI</td><td>PETANI/PEKEBUN</td><td>NGADIREJO RT03
RW04</td><td>NGADIREJO</td><td>NGARGOHARJO</td><td>PUSKESLING
NGARGOHARJO</td><td>dr. ZAENAL ARIFIN HP</td><td>SUSI HERAWATI,
AMK</td><td>P</td><td>45-54 Thn.</td><td>Datang Sendiri</td><td>Lama</td><td>BPJS
2019</td><td>JUMI</td><td>WAKIMAN</td><td>PETANI/PEKEBUN</td><td>GENTUNG</td><td>GE
NTUNG</td><td>NGARGOHARJO</td><td>PUSKESLING NGARGOHARJO</td><td>dr. ZAENAL ARIFIN
align='right'>51047024</td><td>19-02-
2019</td><td>KALIYEM</td><td>TUGIMIN</td><td>PETANI/PEKEBUN</td><td>KLEPU</td><td>K
LEPU</td><td>NGARGOHARJO</td><td>PUSKESLING NGARGOHARJO</td><td>dr. ZAENAL ARIFIN
align='right'>57080227</td><td>19-02-2019</td><td>KARTIN</td><td>KARTIN
0708 K 10</td><td>PETANI/PEKEBUN</td><td>PUCANGANOM KIDUL RT01
align='right'>57080227</td><td>19-02-2019</td><td>KARTIN</td><td>KARTIN 0708 K
10</td><td>PETANI/PEKEBUN</td><td>PUCANGANOM KIDUL RT01 RW08</td><td>PUCANGANOM
/td></tr><tr><td align='right'>N39.9</td><td>Disorder of urinary system,
align='right'>51057029</td><td>19-02-2019</td><td>KARYATI
R</td><td>SUPRAPTO</td><td>PETANI/PEKEBUN</td><td>GENTUNG</td><td>GENTUNG</td><td>N
GARGOHARJO</td><td>PUSKESLING NGARGOHARJO</td><td>dr. ZAENAL ARIFIN HP</td><td>SUSI
HERAWATI, AMK</td><td>P</td><td>45-54 Thn.</td><td>Datang
2019</td><td>KASMI</td><td></td><td>PETANI/PEKEBUN</td><td>PELET</td><td>PELET</td>
<td>NGARGOHARJO</td><td>PUSKESLING NGARGOHARJO</td><td>SUSI HERAWATI,
AMK</td><td>HENI WIDIYASTUTI</td><td>P</td><td>60-69 Thn.</td><td>Datang
align='right'>51115042</td><td>19-02-
2019</td><td>KATIJEM</td><td>PARNO</td><td>PETANI/PEKEBUN</td><td>BLEBER</td><td>BL
EBER</td><td>NGARGOHARJO</td><td>PUSKESLING NGARGOHARJO</td><td>dr. ZAENAL ARIFIN
2019</td><td>KATIJO</td><td>KATIJO</td><td>PETANI/PEKEBUN</td><td>PELET</td><td>PEL
ET</td><td>NGARGOHARJO</td><td>PUSKESLING NGARGOHARJO</td><td>SUSI HERAWATI,
AMK</td><td>HENI WIDIYASTUTI</td><td>L</td><td>60-69 Thn.</td><td>Datang
align='right'>I11</td><td>Hypertensive heart disease</td><td></td><td
2019</td><td>KATIYEM</td><td>KATIMIN 0601 K
align='right'>56010182</td><td>19-02-2019</td><td>KUSMIYATI</td><td>ESA 0601 E
03</td><td>PEDAGANG</td><td>GIRITONTRO LOR RT03 RW02</td><td>GIRITONTRO
2019</td><td>LANDEP</td><td>KATIM</td><td>PETANI/PEKEBUN</td><td>PELET</td><td>PELE
T</td><td>NGARGOHARJO</td><td>PUSKESLING NGARGOHARJO</td><td>SUSI HERAWATI,
2019</td><td>LILIK ZUBAIDAH</td><td>SISWANTO 0610 S 05</td><td>MENGURUS RUMAH
TANGGA</td><td>TANGGUNG RT03
></tr><tr><td align='right'>I21.2</td><td>Acute transmural myocardial infarction of
other sites</td><td></td><td align='right'>288659</td><td
align='right'>56010129</td><td>19-02-2019</td><td>MAMI</td><td>WIDODO 06 01 W
19</td><td>MENGURUS RUMAH TANGGA</td><td>GIRITONTRO LOR RT 01 RW
align='right'>51017037</td><td>19-02-
2019</td><td>MANIYEM</td><td>KATIJO</td><td>PETANI/PEKEBUN</td><td>PELET</td><td>PE
LET</td><td>NGARGOHARJO</td><td>PUSKESLING NGARGOHARJO</td><td>SUSI HERAWATI,
align='right'>56025006</td><td>19-02-2019</td><td>MARINAH</td><td>MARINAH 06 02 M
23</td><td>MENGURUS RUMAH TANGGA</td><td>GIRITONTRO KIDUL RT01
2019</td><td>MINATUN</td><td>SRIYONO</td><td>PETANI/PEKEBUN</td><td>PRINGKUKU</td><
td>PRINGKUKU</td><td>NGARGOHARJO</td><td>PUSKESLING NGARGOHARJO</td><td>dr. ZAENAL
ARIFIN HP</td><td>SUSI HERAWATI, AMK</td><td>P</td><td>20-44 Thn.</td><td>Datang
align='right'>57080201</td><td>19-02-2019</td><td>MUHAMAD FIKHI
FEBRIANTO</td><td>AHMADI 07 08 A 01</td><td>KARYAWAN SWASTA</td><td>PUCANGANOM RT
01 RW 08</td><td>PUCANGANOM KIDUL</td><td>PUCANGANOM</td><td>INDUK</td><td>dr. BUDI
2019</td><td>MUJIONO</td><td>MUJIONO
07 03 M 14</td><td>PETANI/PEKEBUN</td><td>KUWANG RT 03 RW
06</td><td>KUWANG</td><td>PUCANGANOM</td><td>INDUK</td><td>drg.DANAR
2019</td><td>NAJWA</td><td>YULIANTO 01 01 Y
03</td><td></td><td>PELET</td><td>PELET</td><td>NGARGOHARJO</td><td>INDUK</td><td>d
r. BUDI ASHARI</td><td>SRI SUPATMI</td><td>P</td><td>1-4 Thn.</td><td>Datang
2019</td><td>NOVIYANTI
AZIS</td><td>SARWADI</td><td>PETANI/PEKEBUN</td><td>PELET</td><td>PELET</td><td>NGA
RGOHARJO</td><td>PUSKESLING NGARGOHARJO</td><td>dr. ZAENAL ARIFIN HP</td><td>SUSI
HERAWATI, AMK</td><td>P</td><td>20-44 Thn.</td><td>Datang
align='right'>51057045</td><td>19-02-
2019</td><td>PONIJEM</td><td>TUKIJAN</td><td>PETANI/PEKEBUN</td><td>GENTUNG</td><td
>GENTUNG</td><td>NGARGOHARJO</td><td>PUSKESLING NGARGOHARJO</td><td>dr. ZAENAL
2019</td><td>PONIYEM</td><td>WIDODO 0102 W
RJO</td><td>INDUK</td><td>drg.DANAR WULANDARI</td><td>RIZKI ANISSA,
AM.Kg</td><td>P</td><td>45-54 Thn.</td><td>Datang Sendiri</td><td>Lama</td><td>BPJS
PBI</td><td>internal rujukan</td><td align='right'>28</td><td
></tr><tr><td align='right'>I11</td><td>Hypertensive heart disease</td><td></td><td
2019</td><td>PONIYEM</td><td>WIDODO 0102 W
RJO</td><td>INDUK</td><td>dr. BUDI
2019</td><td>RADJIMAN</td><td></td><td>PENSIUNAN</td><td>PELET</td><td>PELET</td><t
d>NGARGOHARJO</td><td>PUSKESLING NGARGOHARJO</td><td>SUSI HERAWATI,
align='right'>51017012</td><td>19-02-
2019</td><td>RADJIMAN</td><td></td><td>PENSIUNAN</td><td>PELET</td><td>PELET</td><t
d>NGARGOHARJO</td><td>PUSKESLING NGARGOHARJO</td><td>SUSI HERAWATI,
></tr><tr><td align='right'>H65.2</td><td>Chronic serous otitis
align='right'>57070286</td><td>19-02-2019</td><td>RYAN DWISETYO
NUGROHO</td><td>RYAN DWISETYO NUGROHO 0707 R 02</td><td>WIRASWASTA</td><td>BANJAR
2019</td><td>SAFARI</td><td>SAFARI</td><td>PETANI/PEKEBUN</td><td>GENTUNG</td><td>G
ENTUNG</td><td>NGARGOHARJO</td><td>PUSKESLING NGARGOHARJO</td><td>dr. ZAENAL ARIFIN
HP</td><td>SUSI HERAWATI, AMK</td><td>L</td><td>60-69 Thn.</td><td>Datang
2019</td><td>SAIKEM</td><td>WAGIMAN</td><td>PETANI/PEKEBUN</td><td>PELET</td><td>PE
2019</td><td>SAINEM</td><td>SAINEM</td><td>PETANI/PEKEBUN</td><td>PELET</td><td>PEL
2019</td><td>SAINEM</td><td>SAINEM</td><td>PETANI/PEKEBUN</td><td>PELET</td><td>PEL
align='right'>51057032</td><td>19-02-
2019</td><td>SAJINEM</td><td></td><td>PETANI/PEKEBUN</td><td>GENTUNG</td><td>GENTUN
G</td><td>NGARGOHARJO</td><td>PUSKESLING NGARGOHARJO</td><td>dr. ZAENAL ARIFIN
HP</td><td>SUSI HERAWATI, AMK</td><td>P</td><td>>70 Thn.</td><td>Datang
align='right'>51017033</td><td>19-02-2019</td><td>SENEN HADI
MULYONO</td><td></td><td>PETANI/PEKEBUN</td><td>PELET</td><td>PELET</td><td>NGARGOH
ARJO</td><td>PUSKESLING NGARGOHARJO</td><td>SUSI HERAWATI, AMK</td><td>HENI
WIDIYASTUTI</td><td>L</td><td>60-69 Thn.</td><td>Datang
2019</td><td>SOGINAH</td><td>TUGIMIN</td><td>PETANI/PEKEBUN</td><td>PELET</td><td>P
ELET</td><td>NGARGOHARJO</td><td>PUSKESLING NGARGOHARJO</td><td>SUSI HERAWATI,
2019</td><td>SOGINEM</td><td>SOGINEM 0203 S
12</td><td>PETANI/PEKEBUN</td><td>SALAM RT 01 RW
06,TLOGOSARI</td><td>SALAM</td><td>TLOGOSARI</td><td>INDUK</td><td>drg.DANAR
WULANDARI</td><td>RIZKI ANISSA, AM.Kg</td><td>P</td><td>>70 Thn.</td><td>Datang
2019</td><td>SOGINEM</td><td>KATMIN</td><td>PETANI/PEKEBUN</td><td>NGADIREJO</td><t
d>NGADIREJO</td><td>NGARGOHARJO</td><td>PUSKESLING NGARGOHARJO</td><td>dr. ZAENAL
ARIFIN HP</td><td>SUSI HERAWATI, AMK</td><td>P</td><td>>70 Thn.</td><td>Datang
align='right'>51017050</td><td>19-02-
2019</td><td>SUKATMI</td><td>WAKINO</td><td>PETANI/PEKEBUN</td><td>PELET</td><td>PE
2019</td><td>SUKINI</td><td>KASMO</td><td>PETANI/PEKEBUN</td><td>PRINGKUKU</td><td>
PRINGKUKU</td><td>NGARGOHARJO</td><td>PUSKESLING NGARGOHARJO</td><td>dr. ZAENAL
></tr><tr><td align='right'>H66.9</td><td>Otitis media,
align='right'>54090092</td><td>19-02-2019</td><td>SULASTRI</td><td>DENI KRISTIANTO
0409 D 01</td><td>MENGURUS RUMAH TANGGA</td><td>WATES RT02
2019</td><td>SUMARNI</td><td>KATMIN</td><td>PETANI/PEKEBUN</td><td>NGADIREJO</td><t
align='right'>57020131</td><td>19-02-2019</td><td>SUPADMI</td><td>MUHADI 0702 M
/td></tr><tr><td align='right'>S61.8</td><td>Open wound of other parts of wrist and
align='right'>51040062</td><td>19-02-2019</td><td>SUPARMIN</td><td>SUPARMIN 0104 S
RW03</td><td>KLEPU</td><td>NGARGOHARJO</td><td>INDUK</td><td>dr. BUDI
2019</td><td>SUPIYAH</td><td>WARSINO</td><td>PETANI/PEKEBUN</td><td>BLEBER</td><td>
BLEBER</td><td>NGARGOHARJO</td><td>PUSKESLING NGARGOHARJO</td><td>dr. ZAENAL ARIFIN
2019</td><td>SURATMAN</td><td>SURATMAN 0710 S
05</td><td>PENSIUNAN</td><td>JEPURUN RT.02
align='right'>51017024</td><td>19-02-
2019</td><td>SURIP</td><td>KATINO</td><td>PETANI/PEKEBUN</td><td>PELET</td><td>PELE
T</td><td>NGARGOHARJO</td><td>PUSKESLING NGARGOHARJO</td><td>SUSI HERAWATI,
2019</td><td>SUTANTINI</td><td>MISNO</td><td>PEGAWAI NEGERI
SIPIL</td><td>PRINGKUKU</td><td>PRINGKUKU</td><td>NGARGOHARJO</td><td>PUSKESLING
NGARGOHARJO</td><td>dr. ZAENAL ARIFIN HP</td><td>SUSI HERAWATI,
AMK</td><td>L</td><td>55-59 Thn.</td><td>Datang Sendiri</td><td>Lama</td><td>BPJS
></tr><tr><td align='right'>Z01.7</td><td>Laboratory examination</td><td></td><td
2019</td><td>SUTARMINI</td><td>SUMADI</td><td>PETANI/PEKEBUN</td><td>BALONG</td><td
>BALONG</td><td>NGARGOHARJO</td><td>PUSKESLING NGARGOHARJO</td><td>dr. ZAENAL
2019</td><td>SUYATI</td><td>SARYONO</td><td>PETANI/PEKEBUN</td><td>PELET</td><td>PE
2019</td><td>SUYATI</td><td>SOGIMAN</td><td>PETANI/PEKEBUN</td><td>NGADIREJO</td><t
align='right'>54075002</td><td>19-02-
2019</td><td>TARNI</td><td>WIDODO</td><td>PETANI/PEKEBUN</td><td>NGALURAN</td><td>N
GALURAN</td><td>BAYEMHARJO</td><td>PUSTU BAYEMHARJO</td><td>RISTINA Amd
align='right'>54075002</td><td>19-02-
2019</td><td>TARNI</td><td>WIDODO</td><td>PETANI/PEKEBUN</td><td>NGALURAN</td><td>N
GALURAN</td><td>BAYEMHARJO</td><td>PUSTU BAYEMHARJO</td><td>RISTINA Amd
align='right'>0101</td><td>19-02-2019</td><td>THERESIA
SULASTRI</td><td>GUNADI</td><td>PETANI/PEKEBUN</td><td>PELET</td><td>PELET</td><td>
NGARGOHARJO</td><td>PUSKESLING NGARGOHARJO</td><td>dr. ZAENAL ARIFIN
align='right'>52145052</td><td>19-02-
2019</td><td>TIWIANI</td><td>YAHMIN</td><td>PETANI/PEKEBUN</td><td>GUPAKAN</td><td>
GUPAKAN</td><td>TLOGOSARI</td><td>PKD TLOGOSARI</td><td>RETNO AMBARWATI AMD
ASTUTI</td><td>SUGIMAN 0713 S 25</td><td>PETANI/PEKEBUN</td><td>KEPUH RT01
RW12</td><td>KEPUH</td><td>PUCANGANOM</td><td>INDUK</td><td>drg.DANAR
Gigi</td><td>Poli Gigi</td><td>RSUD DR. SOEDIRAN MS WONOGIRI</td><td>Dalam
/td></tr><tr><td align='right'>Z00.6</td><td>Examination for normal comparison and
2019</td><td>TRIYANTI</td><td>SUNARNO / PRAYITNO 0704 S 43</td><td>MENGURUS
RUMAH TANGGA</td><td>MANDEYAN RT01
2019</td><td>TUGIMIN</td><td>TUGIMIN</td><td>PETANI/PEKEBUN</td><td>PELET</td><td>P
2019</td><td>TUGIMIN</td><td>TUGIMIN</td><td>PETANI/PEKEBUN</td><td>PELET</td><td>P
2019</td><td>TUGINEM</td><td>TUGINEM</td><td>PETANI/PEKEBUN</td><td>PELET</td><td>P
></tr><tr><td align='right'>I84.9</td><td>Unspecified haemorrhoids without
align='right'>51017002</td><td>19-02-
2019</td><td>TUKEM</td><td>RAJIMAN</td><td>PETANI/PEKEBUN</td><td>PELET</td><td>PEL
align='right'>51055035</td><td>19-02-
2019</td><td>TUKINO</td><td>TUKINO</td><td>PETANI/PEKEBUN</td><td>GENTUNG</td><td>G
ENTUNG</td><td>NGARGOHARJO</td><td>PUSKESLING NGARGOHARJO</td><td>dr. ZAENAL ARIFIN
HP</td><td>SUSI HERAWATI, AMK</td><td>L</td><td>>70 Thn.</td><td>Datang
2019</td><td>TUMINEM</td><td>TUMINEM</td><td>PETANI/PEKEBUN</td><td>PELET</td><td>P
align='right'>51010024</td><td>19-02-2019</td><td>UNTORO HERU
SAPUTRA</td><td>UNTORO HERU SAPUTRA 01 01 U 01</td><td>KARYAWAN
SWASTA</td><td>PELET, RT 01 RW
02</td><td></td><td>NGARGOHARJO</td><td>INDUK</td><td>dr. BUDI
2019</td><td>WAGI</td><td>WAGI0708 W 08</td><td>PETANI/PEKEBUN</td><td>PUCANGANOM
align='right'>54035016</td><td>19-02-
2019</td><td>WAGIYEM</td><td>PAIJO</td><td>PETANI/PEKEBUN</td><td>KLAMPEYAN</td><td
>KLAMPEYAN</td><td>BAYEMHARJO</td><td>PUSTU BAYEMHARJO</td><td>RISTINA Amd
align='right'>54065057</td><td>19-02-2019</td><td>WAHYU
SAYEKTI</td><td>SUPARMIN</td><td>PETANI/PEKEBUN</td><td>BAYEM</td><td>BAYEM</td><td
>BAYEMHARJO</td><td>PUSTU BAYEMHARJO</td><td>RISTINA Amd Keb</td><td> -
2019</td><td>WARINEM</td><td>SURADI</td><td>PETANI/PEKEBUN</td><td>NGADIREJO</td><t
align='right'>51017006</td><td>19-02-
2019</td><td>WARTI</td><td>WIRATNO</td><td>PETANI/PEKEBUN</td><td>PELET</td><td>PEL
2019</td><td>WINARNI</td><td>SUHAMTO 0703 S
21</td><td>PETANI/PEKEBUN</td><td>KUWANG RT03
align='right'>57120108</td><td>20-02-2019</td><td>ADITYA</td><td>SARJONO 0712 S
09</td><td></td><td>NGAK INGUK</td><td>INGAK -
align='right'>57130094</td><td>20-02-2019</td><td>AKHSITA HIMMATANA</td><td>TUGUR
ANJAR SETIAWAN 07 13 T 01</td><td></td><td>KEPUH RRT 3RW 13 P
.ANOM</td><td></td><td>PUCANGANOM</td><td>INDUK</td><td>dr. BUDI
align='right'>57130094</td><td>20-02-2019</td><td>AKHSITA HIMMATANA</td><td>TUGUR
ANJAR SETIAWAN 07 13 T 01</td><td></td><td>KEPUH RRT 3RW 13 P
.ANOM</td><td>KEPUH</td><td>PUCANGANOM</td><td>INDUK</td><td>dr. BUDI
align='right'>52145066</td><td>20-02-2019</td><td>ANISA WAHYU</td><td>DIMIN 0214
D 01</td><td>PELAJAR/MAHASISWA</td><td>GUPAKAN RT02
2019</td><td>ANISA WAHYU</td><td>DIMIN 0214 D
01</td><td>PELAJAR/MAHASISWA</td><td>GUPAKAN RT02
align='right'>56020036</td><td>20-02-2019</td><td>ANJELICA</td><td>ADI KRISTIANTO
0602 A 04</td><td>BELUM/TIDAK BEKERJA</td><td>GIRITONTRO KIDUL</td><td>GIRITONTRO
align='right'>57070032</td><td>20-02-2019</td><td>ENDANG PURNOMOWATI</td><td>ENDANG
PURNOMOWATI 07 07 E 02</td><td>PEGAWAI NEGERI SIPIL</td><td>BANJAR RT01
align='right'>55050057</td><td>20-02-2019</td><td>FAJRINA ZAHWA NURILIA
PUTRI</td><td>ARYANTO 0505 A 01</td><td>BELUM/TIDAK
BEKERJA</td><td>PUNUNG</td><td>PUNUNG</td><td>JATIREJO</td><td>INDUK</td><td>drg.DA
NAR WULANDARI</td><td>RIZKI ANISSA, AM.Kg</td><td>P</td><td>5-9 Thn.</td><td>Datang
align='right'>56020322</td><td>20-02-2019</td><td>HAFIZAH
DESTIANI</td><td>HERU S 06 02 H 07</td><td>PELAJAR/MAHASISWA</td><td>GIRITONTRO
2019</td><td>KARNI</td><td>SAINO</td><td>PETANI/PEKEBUN</td><td>PORO</td><td>PORO</
td><td>TLOGOSARI</td><td>PKD TLOGOSARI</td><td>RETNO AMBARWATI AMD KEB</td><td> -
align='right'>54080117</td><td>20-02-2019</td><td>KARTI</td><td>MISMAN 04 08 M
02</td><td>PETANI/PEKEBUN</td><td>NGANTAP RT 03 RW
05</td><td>NGANTAP</td><td>BAYEMHARJO</td><td>INDUK</td><td>dr. BUDI
align='right'>57080124</td><td>20-02-2019</td><td>KASIYO</td><td>KASIYO 0708 K
04</td><td>PELAJAR/MAHASISWA</td><td>PUCANGANOM KIDUL</td><td>PUCANGANOM
align='right'>52057011</td><td>20-02-
tr><tr><td align='right'>K29.6</td><td>Other gastritis</td><td></td><td
2019</td><td>KATMINI</td><td>SUWARNO 0601 S 24</td><td>BURUH HARIAN
LEPAS</td><td>GIRITONTRO LOR</td><td>GIRITONTRO
align='right'>56070065</td><td>20-02-2019</td><td>LUTFIAH</td><td>HERU
LUTFI</td><td>PELAJAR/MAHASISWA</td><td>DUNGKANCIL</td><td>DUNG
KANCIL</td><td>GIRITONTRO</td><td>INDUK</td><td>drg.DANAR WULANDARI</td><td>RIZKI
td></tr><tr><td align='right'>F20</td><td>Schizophrenia</td><td></td><td
2019</td><td>MARYANTI</td><td>MISDI 07 02 M 10</td><td>LAINNYA</td><td>SUKOROYOM
WETAN RT 02 RW 04</td><td>SUKOROYOM
align='right'>57050071</td><td>20-02-2019</td><td>MELINDA FAUZIAH
AMELIA</td><td>SUKIDI 07 05 S 11</td><td>PELAJAR/MAHASISWA</td><td>SUKOROYOM KULON
RT 03 RW 3</td><td>SUKOROYOM KULON</td><td>PUCANGANOM</td><td>INDUK</td><td>dr.
/td></tr><tr><td align='right'>L02.9</td><td>Cutaneous abscess, furuncle and
carbuncle, unspecified</td><td></td><td align='right'>288734</td><td
align='right'>57120178</td><td>20-02-2019</td><td>MULYONO</td><td>MULYONO 0712 M
07</td><td>PETANI/PEKEBUN</td><td>NGAKINGUK RT 02 RW 16</td><td>INGAK -
2019</td><td>NGAISATUN</td><td>PUGUH 0601 P 08</td><td>BURUH HARIAN
LEPAS</td><td>GIRITONTRO LOR</td><td>GIRITONTRO
align='right'>56010334</td><td>20-02-2019</td><td>NGAISATUN</td><td>PUGUH 0601 P
08</td><td>BURUH HARIAN LEPAS</td><td>GIRITONTRO LOR</td><td>GIRITONTRO
WIYANTO</td><td>NUR WIYANTO 0501 N 07</td><td>KARYAWAN SWASTA</td><td>GIRIBELAH
align='right'>54020028</td><td>20-02-2019</td><td>PONIYAH</td><td>KARJO 0402 K
d></tr><tr><td align='right'>Z34.8</td><td>Supervision of other normal
align='right'>55100030</td><td>20-02-2019</td><td>PUJI ASTUTI</td><td>SARJONO 05 10
S 06</td><td>BURUH HARIAN LEPAS</td><td>SENGON
RT02/04</td><td>SENGON</td><td>JATIREJO</td><td>INDUK</td><td>dr. BUDI
></tr><tr><td align='right'>Z23.5</td><td>Need for immunization against tetanus
alone</td><td></td><td align='right'>288708</td><td
align='right'>55100030</td><td>20-02-2019</td><td>PUJI ASTUTI</td><td>SARJONO 05
10 S 06</td><td>BURUH HARIAN LEPAS</td><td>SENGON
RT02/04</td><td>SENGON</td><td>JATIREJO</td><td>INDUK</td><td>dr. BUDI
align='right'>52110045</td><td>20-02-2019</td><td>RANI NURANI</td><td>DENI SAPUTRA
0211 D 04</td><td>MENGURUS RUMAH TANGGA</td><td>TAMBAK RT01
align='right'>57130100</td><td>20-02-2019</td><td>ROSMAWATI</td><td>SRIYONO 0713 S
14</td><td>PERANGKAT DESA</td><td>KEPUH RT03
align='right'>53050010</td><td>20-02-2019</td><td>SADIYEM</td><td>KARMAN 0305 K
01</td><td>PETANI/PEKEBUN</td><td>PLARENG RT03
align='right'>52087055</td><td>20-02-2019</td><td>SAMIYEM</td><td>KARYO
S</td><td>PETANI/PEKEBUN</td><td>TLOGOSARI</td><td>TLOGOSARI</td><td>TLOGOSARI</td>
<td>PUSTU TLOGOSARI</td><td>SULARNO,S.Kep.Ns</td><td> - </td><td>P</td><td>60-69
2019</td><td>SOGIMAN</td><td>SOGIMAN</td><td>PETANI/PEKEBUN</td><td>PORO</td><td>PO
2019</td><td>SRINI</td><td>LETOMO</td><td>PETANI/PEKEBUN</td><td>PORO</td><td>PORO<
/td><td>TLOGOSARI</td><td>PKD TLOGOSARI</td><td>RETNO AMBARWATI AMD KEB</td><td> -
align='right'>55050037</td><td>20-02-2019</td><td>SUGINEM</td><td>KATIMAN 05 05 K
01</td><td>PETANI/PEKEBUN</td><td>PUNUNGRT 01 RW
</td></tr><tr><td align='right'>K09.9</td><td>Cyst of oral region,
align='right'>55010219</td><td>20-02-2019</td><td>SUKATNI</td><td>SUKIRNO 0501 S
04</td><td>PETANI/PEKEBUN</td><td>GIRIBELAH RT
align='right'>55010334</td><td>20-02-2019</td><td>SUKIYEM</td><td>SUKIYEM 0501 S
ASHARI</td><td>SUHARNI</td><td>P</td><td>>70 Thn.</td><td>Datang
align='right'>55050050</td><td>20-02-2019</td><td>SUMARNI</td><td>SUMARNI 0505 S
15</td><td>PETANI/PEKEBUN</td><td>PUNUNG</td><td>PUNUNG</td><td>JATIREJO</td><td>IN
align='right'>57050030</td><td>20-02-2019</td><td>SUNARMI</td><td>SUTRISNO 0705 S
2019</td><td>SUPRANTINI</td><td>TRIYONO 05 05 T
04</td><td>PETANI/PEKEBUN</td><td>PUNUNG RT01
RW02</td><td>PUNUNG</td><td>JATIREJO</td><td>INDUK</td><td>dr. BUDI
></tr><tr><td align='right'>I50.0</td><td>Congestive heart failure</td><td></td><td
2019</td><td>SUTATMAN</td><td>SUTATMAN 0602 S
17</td><td>PENSIUNAN</td><td>GIRITONTRO KIDULRT 02 RW 3</td><td>GIRITONTRO
align='right'>57050108</td><td>20-02-2019</td><td>SUTRISNO</td><td>SUTRISNO 07 05
S 32</td><td>PETANI/PEKEBUN</td><td>SUKOROYOM KULON RT 02 RW 03</td><td>SUKOROYOM
align='right'>56070143</td><td>20-02-2019</td><td>TAMIYEM</td><td>KASIMIN
06 07 K 16</td><td>PETANI/PEKEBUN</td><td>DUNGKANCIL RT 02 RW 09</td><td>DUNG
></tr><tr><td align='right'>S01.3</td><td>Open wound of ear</td><td></td><td
2019</td><td>TARJAN</td><td>TARJAN 0709 T
align='right'>53100031</td><td>20-02-2019</td><td>TEGUH WIYONO</td><td>TEGUH WIYONO
0310 T 01</td><td>PERANGKAT DESA</td><td>KELOR RT01
RW04</td><td>KELOR</td><td>TLOGOHARJO</td><td>INDUK</td><td>dr. BUDI
align='right'>52105133</td><td>20-02-
2019</td><td>TUKINAH</td><td>WAKIMIN</td><td>PETANI/PEKEBUN</td><td>PORO</td><td>PO
align='right'>11110194</td><td>20-02-
2019</td><td>TUMINEM</td><td></td><td>PETANI/PEKEBUN</td><td>PUDAK</td><td></td><td
align='right'>M79.04</td><td>Rheumatism, unspecified, hand</td><td></td><td
2019</td><td>TUMIYEM</td><td>PAIRAN 0702 P 09</td><td>MENGURUS RUMAH
TANGGA</td><td>SUKOROYOM WETAN RT04 RW04</td><td>SUKOROYOM
/td></tr><tr><td align='right'>R05</td><td>Cough</td><td></td><td
2019</td><td>WARINEM</td><td></td><td>PETANI/PEKEBUN</td><td>NGELO</td><td>NGELO</t
tr><tr><td align='right'>I11.9</td><td>Hypertensive heart disease without
align='right'>54020029</td><td>20-02-2019</td><td>WARSONO</td><td>WARSONO 0402 W
01</td><td>KARYAWAN SWASTA</td><td>NGUNDUK RT 01
></tr><tr><td align='right'>L55.9</td><td>Sunburn, unspecified</td><td></td><td
2019</td><td>WENING</td><td>SURYONO 0411 S
/td></tr><tr><td align='right'>N34.3</td><td>Urethral syndrome,
align='right'>56020168</td><td>20-02-2019</td><td>WIYATI</td><td>TULADI 0602 T
d></tr><tr><td align='right'>J44.9</td><td>Chronic obstructive pulmonary disease,
align='right'>53065044</td><td>20-02-2019</td><td>YATMI</td><td>YATMI 03 06 Y
2019</td><td>YULIANA</td><td>PAIRAN 0702 P 09</td><td>BELUM/TIDAK
BEKERJA</td><td>SUKOROYOM WETAN RT04 RW04</td><td>SUKOROYOM
></tr><tr><td align='right'>Z24.6</td><td>Need for immunization against viral
hepatitis</td><td></td><td align='right'>288889</td><td
align='right'>55110109</td><td>21-02-2019</td><td>ABDILLAH ASHRAF
PRATAMA</td><td>SARYOKO</td><td>BELUM/TIDAK
BEKERJA</td><td>BUWENG</td><td></td><td>JATIREJO</td><td>INDUK</td><td>dr. BUDI
ASHARI</td><td>RISTINA Amd Keb</td><td>L</td><td><1 Thn.</td><td>Datang
Sendiri</td><td>Lama</td><td>Imunisasi</td><td>Rajal</td><td align='right'></td><td
align='right'></td><td>Imunisasi</td><td></td><td></td><td>Dalam
align='right'>Z27.3</td><td>Need for immunization against diphtheria-tetanus-
pertussis with poliomyelitis [DTP + polio]</td><td></td><td
2019</td><td>ABDILLAH ASHRAF PRATAMA</td><td>SARYOKO</td><td>BELUM/TIDAK
align='right'>Z24.6</td><td>Need for immunization against viral
align='right'>56020661</td><td>21-02-2019</td><td>ABDUL HAFIZ
MUZAKKI</td><td>AZIZ</td><td>BELUM/TIDAK BEKERJA</td><td>GIRITONTRO
KIDUL</td><td></td><td>GIRITONTRO</td><td>INDUK</td><td>dr.
BUDI ASHARI</td><td>RISTINA Amd Keb</td><td>L</td><td><1 Thn.</td><td>Datang
align='right'>56020661</td><td>21-02-2019</td><td>ABDUL HAFIZ
MUZAKKI</td><td>AZIZ</td><td>BELUM/TIDAK BEKERJA</td><td>GIRITONTRO
KIDUL</td><td></td><td>GIRITONTRO</td><td>INDUK</td><td>dr. BUDI
2019</td><td>ABDUL HAFIZ MUZAKKI</td><td>AZIZ</td><td>BELUM/TIDAK
BEKERJA</td><td>GIRITONTRO
KIDUL</td><td></td><td>GIRITONTRO</td><td>INDUK</td><td>dr. BUDI
align='right'>53060051</td><td>21-02-2019</td><td>ADINDA AYU
PRATIWI</td><td>SUTARNO</td><td>BELUM/TIDAK
BEKERJA</td><td>KLEPU,TLOGOHARJO</td><td></td><td>TLOGOHARJO</td><td>INDUK</td><td>
dr. BUDI ASHARI</td><td>HENI WIDIYASTUTI</td><td>P</td><td><1 Thn.</td><td>Datang
2019</td><td>ADINDA AYU PRATIWI</td><td>SUTARNO</td><td>BELUM/TIDAK
BEKERJA</td><td>KLEPU,TLOGOHARJO</td><td></td><td>TLOGOHARJO</td><td>INDUK</td><td>
dr. BUDI ASHARI</td><td>HENI WIDIYASTUTI</td><td>P</td><td><1 Thn.</td><td>Datang
align='right'>Z24.4</td><td>Need for immunization against measles
align='right'>57050259</td><td>21-02-2019</td><td>ADITYA</td><td>WIYONO/LILIK JOKO
P 0705 W 01</td><td>BELUM/TIDAK BEKERJA</td><td>SUKOROYOM
Sendiri</td><td>Lama</td><td>Imunisasi</td><td>Rajal</td><td
align='right'>Z24.5</td><td>Need for immunization against rubella
align='right'>56050199</td><td>21-02-2019</td><td>AHLE SYABANI
PUJIANDRA</td><td>WARDOYO</td><td>BELUM/TIDAK
BEKERJA</td><td>NGUJUNG</td><td></td><td>GIRITONTRO</td><td>INDUK</td><td>dr. BUDI
align='right'>56070157</td><td>21-02-2019</td><td>AHMAD
FAQIH</td><td>WALUYO/RIZKY</td><td>BELUM/TIDAK
BEKERJA</td><td>DUNGKANCIL</td><td></td><td>GIRITONTRO</td><td>INDUK</td><td>dr.
align='right'>53110031</td><td>21-02-2019</td><td>AHMAD ZAIDAN
FAUZI</td><td>YANTO</td><td>BELUM/TIDAK BEKERJA</td><td>GINADE
WETAN</td><td></td><td>TLOGOHARJO</td><td>INDUK</td><td>dr. BUDI
2019</td><td>AJENG FAUSIYAH HERLINA </td><td>SUYANTO 04 02 S
09</td><td>PELAJAR/MAHASISWA</td><td>NGUNDUK RT01
/td></tr><tr><td align='right'>Z24.6</td><td>Need for immunization against viral
align='right'>55060107</td><td>21-02-2019</td><td>AKIO AL
AYYUBI</td><td>TUGIRAN</td><td>BELUM/TIDAK BEKERJA</td><td>JATI
</td><td></td><td>JATIREJO</td><td>INDUK</td><td>dr. BUDI ASHARI</td><td>RISTINA
Amd Keb</td><td>L</td><td><1 Thn.</td><td>Datang
align='right'>288918</td><td align='right'>55060107</td><td>21-02-2019</td><td>AKIO
AL AYYUBI</td><td>TUGIRAN</td><td>BELUM/TIDAK BEKERJA</td><td>JATI
</td><td></td><td>JATIREJO</td><td>INDUK</td><td>dr. BUDI ASHARI</td><td>RISTINA
Amd Keb</td><td>L</td><td><1 Thn.</td><td>Datang
align='right'>57010243</td><td>21-02-2019</td><td>ALESIA KAYLA PUTRI
A</td><td>NGATIMAN /DONI W 07 01 N 02</td><td>BELUM/TIDAK
BEKERJA</td><td>GROGOL</td><td></td><td>PUCANGANOM</td><td>INDUK</td><td>dr. BUDI
align='right'>56020453</td><td>21-02-2019</td><td>ALFREZI CAHYA
SASONGKO</td><td>DWI SASONGKO 06 02 D 01</td><td></td><td>GIRITONTRO KIDUL RT 02
RW 03</td><td>GIRITONTRO KIDUL</td><td>GIRITONTRO</td><td>INDUK</td><td>dr. BUDI
ABAS</td><td>ALI ABAS 07 01 A 01</td><td>KARYAWAN SWASTA</td><td>GROGOL RT01
align='right'>57050300</td><td>21-02-2019</td><td>ALISHA TSABITA
KANAYA</td><td>TEGUH P 0705 T 05</td><td>BELUM/TIDAK BEKERJA</td><td>SUKOROYOM
align='right'>54010077</td><td>21-02-2019</td><td>ALMAHESA</td><td>DWI NUR
W.</td><td>BELUM/TIDAK
BEKERJA</td><td>BELEH</td><td></td><td>BAYEMHARJO</td><td>INDUK</td><td>dr. BUDI
2019</td><td>ALVAN ALVINO VENDYA PUTRA</td><td>YATNO 06 01 Y
01</td><td>PELAJAR/MAHASISWA</td><td>GIRITONTRO LOR RT 02 RW
02</td><td></td><td>GIRITONTRO</td><td>INDUK</td><td>drg.DANAR
</tr><tr><td align='right'>Z24.6</td><td>Need for immunization against viral
align='right'>56020671</td><td>21-02-2019</td><td>ANAYA ELSYIFA LAILI</td><td>AGUS
BUDI SANTOSO 0602 A 20</td><td>BELUM/TIDAK BEKERJA</td><td>GIRITONTRO KIDUL RT04
align='right'>54080091</td><td>21-02-2019</td><td>ANDARA PARAMESWARI</td><td>DWI
ATMADI 0408 D 01</td><td>BELUM/TIDAK BEKERJA</td><td>NGANTAP RT02
</tr><tr><td align='right'>Z24.0</td><td>Need for immunization against
align='right'>56100406</td><td>21-02-2019</td><td>ANINDIRA KOMALA
M</td><td>ISMANTO</td><td>BELUM/TIDAK
BEKERJA</td><td>TANGGUNG</td><td></td><td>GIRITONTRO</td><td>INDUK</td><td>dr. BUDI
ASHARI</td><td>UMI NUR ISNIATI</td><td>L</td><td><1 Thn.</td><td>Datang
align='right'>56100406</td><td>21-02-2019</td><td>ANINDIRA KOMALA
M</td><td>ISMANTO</td><td>BELUM/TIDAK
2019</td><td>ANINDIRA KOMALA M</td><td>ISMANTO</td><td>BELUM/TIDAK
align='right'>53010086</td><td>21-02-2019</td><td>ARISTA ADINDA
ZAHRANI</td><td>POIMIN / WARSINO 0301 P 07</td><td>BELUM/TIDAK
ASHARI</td><td>RISTINA Amd Keb</td><td>P</td><td><1 Thn.</td><td>Datang
2019</td><td>ARISTA ADINDA ZAHRANI</td><td>POIMIN / WARSINO 0301 P
07</td><td>BELUM/TIDAK BEKERJA</td><td>TLOGO RT02
align='right'>54090061</td><td>21-02-2019</td><td>ARJUNA CAISAR</td><td>TOPIK 0409
T 01</td><td>BELUM/TIDAK BEKERJA</td><td>WATES RT02
RW06</td><td></td><td>BAYEMHARJO</td><td>INDUK</td><td>dr. BUDI
align='right'>288858</td><td align='right'>58081317</td><td>21-02-2019</td><td>ARUM
SAFIRA</td><td>SULISNO 08 08 S 51</td><td>PELAJAR/MAHASISWA</td><td>PLOSO RT04
align='right'>L23</td><td>Allergic contact dermatitis</td><td></td><td
2019</td><td>ASAUQI USNAH</td><td>SLAMET 0705 S 37</td><td>BELUM/TIDAK
BEKERJA</td><td>SUKOROYOM KULON RT01 RW03</td><td>SUKOROYOM
KULON</td><td>PUCANGANOM</td><td>INDUK</td><td>dr. BUDI ASHARI</td><td>HENI
align='right'>55090083</td><td>21-02-2019</td><td>ATAYA FILZA
EILIA</td><td>SUNARNO/RAHMAD</td><td>BELUM/TIDAK BEKERJA</td><td>MULWOSARI RT01
RW04</td><td></td><td>JATIREJO</td><td>INDUK</td><td>dr. BUDI ASHARI</td><td>SRI
SUPATMI</td><td>P</td><td><1 Thn.</td><td>Datang
2019</td><td>ATAYA FILZA EILIA</td><td>SUNARNO/RAHMAD</td><td>BELUM/TIDAK
BEKERJA</td><td>MULWOSARI RT01
align='right'>51050039</td><td>21-02-2019</td><td>AULIAN BAZHIRA
FATANNA</td><td>WIDODO 0105 W 01</td><td>BELUM/TIDAK BEKERJA</td><td>GENTUNG RT02
RW03</td><td></td><td>NGARGOHARJO</td><td>INDUK</td><td>dr. BUDI ASHARI</td><td>SRI
align='right'>55010314</td><td>21-02-2019</td><td>AVIKA
VAMESSA</td><td>SURONO</td><td>BELUM/TIDAK
BEKERJA</td><td>GIRIBELAH</td><td></td><td>JATIREJO</td><td>INDUK</td><td>dr. BUDI
ASHARI</td><td>HENI WIDIYASTUTI</td><td>P</td><td><1 Thn.</td><td>Datang
align='right'>57100165</td><td>21-02-2019</td><td>AZAHWA AQILA
ANGGRAINI</td><td>DIYONO</td><td>BELUM/TIDAK
BEKERJA</td><td>JEPURUN</td><td></td><td>PUCANGANOM</td><td>INDUK</td><td>dr. BUDI
2019</td><td>AZAHWA AQILA ANGGRAINI</td><td>DIYONO</td><td>BELUM/TIDAK
BEKERJA</td><td>JEPURUN</td><td></td><td>PUCANGANOM</td><td>INDUK</td><td>dr. BUDI
align='right'>56070159</td><td>21-02-
2019</td><td>AZKA</td><td>SUNOTO</td><td>BELUM/TIDAK BEKERJA</td><td>DUNG
KANCIL</td><td></td><td>GIRITONTRO</td><td>INDUK</td><td>dr. BUDI
align='right'>51120062</td><td>21-02-2019</td><td>AZKA RIFQI
RAMADHAN</td><td>SARWANTO</td><td>BELUM/TIDAK
BEKERJA</td><td>SELUR</td><td></td><td>NGARGOHARJO</td><td>INDUK</td><td>dr. BUDI
align='right'>K12.1</td><td>Other forms of stomatitis</td><td></td><td
2019</td><td>AZKIA AYUNINA RAMADHANI</td><td>SEDIYANTO/KHAIRULLOH 06 08 S
33</td><td>BELUM/TIDAK BEKERJA</td><td>DUNG KLEPU
WETAN</td><td></td><td>GIRITONTRO</td><td>INDUK</td><td>dr. BUDI
align='right'>8</td><td align='right'></td><td>KIA</td><td></td><td></td><td>Dalam
align='right'>56010482</td><td>21-02-2019</td><td>AZRIL RAFIQ
SYAHPUTRA</td><td>WINARNO</td><td>BELUM/TIDAK BEKERJA</td><td>GIRITONTRO
LOR</td><td></td><td>GIRITONTRO</td><td>INDUK</td><td>dr. BUDI ASHARI</td><td>SRI
SUPATMI</td><td>L</td><td><1 Thn.</td><td>Datang
2019</td><td>AZRIL RAFIQ SYAHPUTRA</td><td>WINARNO</td><td>BELUM/TIDAK
BEKERJA</td><td>GIRITONTRO
LOR</td><td></td><td>GIRITONTRO</td><td>INDUK</td><td>dr. BUDI ASHARI</td><td>SRI
align='right'>51010137</td><td>21-02-2019</td><td>BAGUS BANGKIT
WISAKA</td><td>KASMIN / ANGGA 0101 K 03</td><td>BELUM/TIDAK BEKERJA</td><td>PELET
RT01 RW02</td><td></td><td>NGARGOHARJO</td><td>INDUK</td><td>dr. BUDI
align='right'>51010042</td><td>21-02-2019</td><td>BANIYAH</td><td>TRIYANTO 01 01
T 08</td><td>PETANI/PEKEBUN</td><td>PELET RT01 TW
01</td><td>PELET</td><td>NGARGOHARJO</td><td>INDUK</td><td>dr. BUDI
></tr><tr><td align='right'>Z24.5</td><td>Need for immunization against rubella
align='right'>53010058</td><td>21-02-2019</td><td>BILQIS SIQIA A</td><td>RIKI
AFANDI 03 01 R 01</td><td>BELUM/TIDAK BEKERJA</td><td>TLOGO
RT02RW01,TLOGOHARJO</td><td></td><td>TLOGOHARJO</td><td>INDUK</td><td>dr. BUDI
td></tr><tr><td align='right'>Z24.6</td><td>Need for immunization against viral
align='right'>56040111</td><td>21-02-2019</td><td>CANTIKA PUTRI
ANUGRAH</td><td>RUSMAN 06 04 R 01</td><td>BELUM/TIDAK BEKERJA</td><td>KETONGGO
RT02 RW07</td><td></td><td>GIRITONTRO</td><td>INDUK</td><td>dr. BUDI
2019</td><td>CARRISA ULFA NADHIFA</td><td>WIYONO</td><td>BELUM/TIDAK
BEKERJA</td><td>GOBOH</td><td></td><td>GIRITONTRO</td><td>INDUK</td><td>dr. BUDI
align='right'>56060142</td><td>21-02-2019</td><td>CARRISA ULFA
NADHIFA</td><td>WIYONO</td><td>BELUM/TIDAK
align='right'>53115041</td><td>21-02-2019</td><td>CHINDY AURELIA P</td><td>EDI
SIHWANTO</td><td>BELUM/TIDAK BEKERJA</td><td>GINADE
WETAN</td><td></td><td>TLOGOHARJO</td><td>INDUK</td><td>dr. BUDI
align='right'></td><td
align='right'>57020199</td><td>21-02-2019</td><td>DENTA ALFARIZI
ARIANSYAH</td><td>RIYANTO 07 02 R 02</td><td>PERANGKAT
DESA</td><td>SUKOROYOM WETAN RT 03 RW 04</td><td>SUKOROYOM
></tr><tr><td align='right'>Z27.3</td><td>Need for immunization against diphtheria-
tetanus-pertussis with poliomyelitis [DTP + polio]</td><td></td><td
2019</td><td>DEVANI WAHYU ISMIYANTI</td><td>YULIANTO</td><td></td><td>PELET,
NGARGOHARJO</td><td></td><td>NGARGOHARJO</td><td>INDUK</td><td>dr. BUDI
align='right'>51010117</td><td>21-02-2019</td><td>DEVANI WAHYU
ISMIYANTI</td><td>YULIANTO</td><td></td><td>PELET,
NGARGOHARJO</td><td></td><td>NGARGOHARJO</td><td>INDUK</td><td>dr. BUDI
align='right'>57020349</td><td>21-02-
2019</td><td>DINARA</td><td>BUDIYANTO</td><td>BELUM/TIDAK BEKERJA</td><td>SUKOROYOM
ETAN</td><td></td><td>PUCANGANOM</td><td>INDUK</td><td>dr. BUDI
ASHARI</td><td>RETNO AMBARWATI AMD KEB</td><td>L</td><td><1 Thn.</td><td>Datang
align='right'>57020349</td><td>21-02-
2019</td><td>DIYAH SHOLLIFITRIANI</td><td>BARNO 07 10 B 02</td><td>KARYAWAN
SWASTA</td><td>JEPURUN RT02
RW10</td><td></td><td>PUCANGANOM</td><td>INDUK</td><td>dr. BUDI ASHARI</td><td>UMI
align='right'>56060137</td><td>21-02-2019</td><td>DYCKO FALAH
IBRAHIM</td><td>YOKO</td><td>BELUM/TIDAK
align='right'>56060137</td><td>21-02-2019</td><td>DYCKO FALAH
IBRAHIM</td><td>YOKO</td><td>BELUM/TIDAK
2019</td><td>DYCKO FALAH IBRAHIM</td><td>YOKO</td><td>BELUM/TIDAK
2019</td><td>ELISA NOVITA SARI</td><td>SUNARLI 05 06 S 20</td><td>BELUM/TIDAK
BEKERJA</td><td>JATI RT02
></tr><tr><td align='right'>Z24.5</td><td>Need for immunization against rubella
align='right'>52010096</td><td>21-02-2019</td><td>ENGGAL IHSAN ARGA
SIREGAR</td><td> SOKIMIN /SUMADI 02 01 S 06</td><td>BELUM/TIDAK
BEKERJA</td><td>GEMBUK RT 02 RW
07</td><td></td><td>TLOGOSARI</td><td>INDUK</td><td>dr. BUDI ASHARI</td><td>HENI
WIDIYASTUTI</td><td>L</td><td><1 Thn.</td><td>Datang
2019</td><td>FADHIL SYABANI</td><td>MIYANTO</td><td>BELUM/TIDAK
BEKERJA</td><td>DUNGKLEPU
align='right'>56080318</td><td>21-02-2019</td><td>FADHIL
SYABANI</td><td>MIYANTO</td><td>BELUM/TIDAK BEKERJA</td><td>DUNGKLEPU
align='right'>B00.1</td><td>Herpesviral vesicular dermatitis</td><td></td><td
2019</td><td>FAJRIESTA DECHA SETIYAWAN</td><td>MUKLIS 07 09 M
11</td><td>PELAJAR/MAHASISWA</td><td>PUCANGANOM LOR RT 02 RW 09</td><td>PUCANGANOM
align='right'>55030037</td><td>21-02-2019</td><td>FITRI AL HAYATI</td><td>SUTARNO
05 03 S 04</td><td>KARYAWAN SWASTA</td><td>SONGGODULANG RT01
RW01</td><td>SONGGODULANG</td><td>JATIREJO</td><td>INDUK</td><td>dr. BUDI
ASHARI</td><td>UMI
align='right'>52030032</td><td>21-02-2019</td><td>GEBYNA NUHA
ARDIANA</td><td>SUTARSO</td><td>BELUM/TIDAK
BEKERJA</td><td>SALAM</td><td></td><td>TLOGOSARI</td><td>INDUK</td><td>dr. BUDI
2019</td><td>GEBYNA NUHA ARDIANA</td><td>SUTARSO</td><td>BELUM/TIDAK
align='right'>52030032</td><td>21-02-2019</td><td>GEBYNA NUHA
ARDIANA</td><td>SUTARSO</td><td>BELUM/TIDAK
align='right'>57040237</td><td>21-02-2019</td><td>GIBRAN WIDIANTO</td><td>SRIYANTO
0704 S
02</td><td></td><td>MANDEYAN</td><td></td><td>PUCANGANOM</td><td>INDUK</td><td>dr.
BUDI ASHARI</td><td>RETNO AMBARWATI AMD KEB</td><td>L</td><td>1-4
Thn.</td><td>Datang Sendiri</td><td>Lama</td><td>Imunisasi</td><td>Rajal</td><td
align='right'>288862</td><td align='right'>56020484</td><td>21-02-2019</td><td>HADI
SUMARTO SEMIN</td><td>HADI SUMARTO SEMIN 06 02 H
33</td><td>PETANI/PEKEBUN</td><td>GIRITONTRO KIDUL RT04
></tr><tr><td align='right'>Z27.3</td><td>Need for immunization against diphtheria-
2019</td><td>HAFIDZAH</td><td>ERWIN</td><td>BELUM/TIDAK
ASHARI</td><td>HENI WIDIYASTUTI</td><td>L</td><td><1 Thn.</td><td>Datang
align='right'>56050214</td><td>21-02-
2019</td><td>HAFIDZAH</td><td>ERWIN</td><td>BELUM/TIDAK
align='right'>57050361</td><td>21-02-2019</td><td>HANINDITAN TSABITA
KHAMA</td><td>YUDI SETYAWAN 0705 Y 01</td><td>BELUM/TIDAK
BEKERJA</td><td>SUKOROYOM
2019</td><td>HANINDITAN TSABITA KHAMA</td><td>YUDI SETYAWAN 0705 Y
01</td><td>BELUM/TIDAK BEKERJA</td><td>SUKOROYOM
align='right'>56060141</td><td>21-02-2019</td><td>HERFIZA GEVA WIDAYANA
Q</td><td>HERMAWAN</td><td>BELUM/TIDAK
2019</td><td>HERFIZA GEVA WIDAYANA Q</td><td>HERMAWAN</td><td>BELUM/TIDAK
align='right'>58081000</td><td>21-02-2019</td><td>IDA WURYANTI SRI
SULASMI</td><td>AGUS SUMARNO 08 08 A 01</td><td>PEGAWAI NEGERI
SIPIL</td><td>BEDUNGAN,TUBOKARTO RT 02
align='right'>52030025</td><td>21-02-2019</td><td>JOVANI MILA
INDAH</td><td>TUKIMAN</td><td>BELUM/TIDAK
BEKERJA</td><td>SALAM,TLOGOSARI</td><td></td><td>TLOGOSARI</td><td>INDUK</td><td>dr
. BUDI ASHARI</td><td>SRI SUPATMI</td><td>P</td><td>1-4 Thn.</td><td>Datang
align='right'>57060135</td><td>21-02-2019</td><td>KEENANDRA ASKARA
M</td><td>MIHARYANTO</td><td>BELUM/TIDAK
BEKERJA</td><td>TAMBAHSARI</td><td></td><td>PUCANGANOM</td><td>INDUK</td><td>dr.
BUDI ASHARI</td><td>UMI NUR ISNIATI</td><td>L</td><td><1 Thn.</td><td>Datang
align='right'>57060135</td><td>21-02-2019</td><td>KEENANDRA ASKARA
M</td><td>MIHARYANTO</td><td>BELUM/TIDAK
2019</td><td>KEENANDRA ASKARA M</td><td>MIHARYANTO</td><td>BELUM/TIDAK
align='right'>51030059</td><td>21-02-2019</td><td>KYEMAS
YULIAN</td><td>SUROTO</td><td>BELUM/TIDAK
BEKERJA</td><td>PRINGKUKU</td><td></td><td>NGARGOHARJO</td><td>INDUK</td><td>dr.
BUDI ASHARI</td><td>RISTINA Amd Keb</td><td>L</td><td>1-4 Thn.</td><td>Datang
align='right'>56060106</td><td>21-02-2019</td><td>LAIRE QURENAY
AVIANTI</td><td>HARMANTO 0606 H 04</td><td>BELUM/TIDAK BEKERJA</td><td>GOBOH RT03
align='right'>54060101</td><td>21-02-2019</td><td>LINTANG
CHRISTIANANAABABIL</td><td>SUKRISTIYANTO</td><td>BELUM/TIDAK
BEKERJA</td><td>BAYEM</td><td></td><td>BAYEMHARJO</td><td>INDUK</td><td>dr. BUDI
2019</td><td>LINTANG CHRISTIANANAABABIL</td><td>SUKRISTIYANTO</td><td>BELUM/TIDAK
align='right'>54060101</td><td>21-02-2019</td><td>LINTANG
CHRISTIANANAABABIL</td><td>SUKRISTIYANTO</td><td>BELUM/TIDAK
align='right'>57040184</td><td>21-02-2019</td><td>LISTIANA ARI
SUBEKTI</td><td>EDWIN 07 04 E
<td>INDUK</td><td>dr. BUDI ASHARI</td><td>SUGIYONO,S.Kep.Ns</td><td>P</td><td>20-44
></tr><tr><td align='right'>K03.2</td><td>Erosion of teeth</td><td></td><td
2019</td><td>LUSMIATI DWI MARYANTI</td><td>MARIYO 06 02 M 17</td><td>MENGURUS RUMAH
TANGGA</td><td>GIRITONTRO KIDUL RT 01 RW
</tr><tr><td align='right'>K05.1</td><td>Chronic gingivitis</td><td></td><td
2019</td><td>LUSMIATI DWI MARYANTI</td><td>MARIYO 06 02 M 17</td><td>MENGURUS RUMAH
TANGGA</td><td>GIRITONTRO KIDUL RT 01 RW
</tr><tr><td align='right'>Z24.0</td><td>Need for immunization against
align='right'>55030040</td><td>21-02-2019</td><td>M RIZA D SALAM</td><td>BADRUS
SALAM</td><td>BELUM/TIDAK
BEKERJA</td><td>SONGGODULANG</td><td></td><td>JATIREJO</td><td>INDUK</td><td>dr.
align='right'>55030040</td><td>21-02-2019</td><td>M RIZA D SALAM</td><td>BADRUS
SALAM</td><td>BELUM/TIDAK
RIZA D SALAM</td><td>BADRUS SALAM</td><td>BELUM/TIDAK
align='right'>57050228</td><td>21-02-2019</td><td>M. ROFIQ NUR
ALFAN</td><td>SOLAUDIN 07 05 S 27</td><td>PETANI/PEKEBUN</td><td>SUKOROYOM KULON
RT 02 RW 03</td><td>SUKOROYOM KULON</td><td>PUCANGANOM</td><td>INDUK</td><td>dr.
align='right'>55060111</td><td>21-02-2019</td><td>M.MARVEL
FADILAH</td><td>SULIYANTO</td><td>BELUM/TIDAK
BEKERJA</td><td>JATI</td><td></td><td>JATIREJO</td><td>INDUK</td><td>dr. BUDI
2019</td><td>M.MARVEL FADILAH</td><td>SULIYANTO</td><td>BELUM/TIDAK
BEKERJA</td><td>JATI</td><td></td><td>JATIREJO</td><td>INDUK</td><td>dr. BUDI
align='right'>53110049</td><td>21-02-2019</td><td>MAHYRA
MAGHFIROTUNNISA</td><td>TRIYANTO 03 11 T 02</td><td>BELUM/TIDAK
BEKERJA</td><td>GINADE WETAN </td><td></td><td>TLOGOHARJO</td><td>INDUK</td><td>dr.
BUDI ASHARI</td><td>HENI WIDIYASTUTI</td><td>P</td><td>1-4 Thn.</td><td>Datang
align='right'>54065046</td><td>21-02-2019</td><td>MELI</td><td>MARLAN 06406 M
02</td><td></td><td>BAYEM RT 01 RW
/td></tr><tr><td align='right'>Z24.0</td><td>Need for immunization against
align='right'>56050211</td><td>21-02-2019</td><td>MELODI GASTAN KIANA </td><td>
SULISTYO 0605 S 39</td><td>BELUM/TIDAK
align='right'>56050211</td><td>21-02-2019</td><td>MELODI GASTAN KIANA </td><td>
SULISTYO 0605 S 39</td><td>BELUM/TIDAK
</tr><tr><td align='right'>Z27.3</td><td>Need for immunization against diphtheria-
2019</td><td>MELODI GASTAN KIANA </td><td> SULISTYO 0605 S 39</td><td>BELUM/TIDAK
</tr><tr><td align='right'>I63.9</td><td>Cerebral infarction,
align='right'>56080141</td><td>21-02-2019</td><td>MISMIN SISWANTO</td><td>SISWANTO
0608 S 38</td><td>PELAJAR/MAHASISWA</td><td>DUNGKLEPU WETAN</td><td>DUNG KLEPU
align='right'>55040109</td><td>21-02-2019</td><td>MORGAN ARDHANA
PUTRA</td><td>SARINGAT 0504 S 20</td><td>BELUM/TIDAK BEKERJA</td><td>KANIGORO
RT02 RW01</td><td></td><td>JATIREJO</td><td>INDUK</td><td>dr. BUDI
ASHARI</td><td>SRI SUPATMI</td><td>L</td><td><1 Thn.</td><td>Datang
2019</td><td>MORGAN ARDHANA PUTRA</td><td>SARINGAT 0504 S 20</td><td>BELUM/TIDAK
BEKERJA</td><td>KANIGORO RT02
align='right'>53050080</td><td>21-02-2019</td><td>MUHAMMAD DZAKI
FATURROCHMAN</td><td>SEDIANTO</td><td>BELUM/TIDAK
BEKERJA</td><td>PLARENG</td><td></td><td>TLOGOHARJO</td><td>INDUK</td><td>dr. BUDI
2019</td><td>MUHAMMAD DZAKI FATURROCHMAN</td><td>SEDIANTO</td><td>BELUM/TIDAK
BEKERJA</td><td>PLARENG</td><td></td><td>TLOGOHARJO</td><td>INDUK</td><td>dr. BUDI
align='right'>51030070</td><td>21-02-2019</td><td>MUHAMMAD ILHAM</td><td>HERI
SETIAWAN 0103 H 01</td><td>BELUM/TIDAK
BUDI ASHARI</td><td>RISTINA Amd Keb</td><td>P</td><td><1 Thn.</td><td>Datang
2019</td><td>MUHAMMAD ILHAM</td><td>HERI SETIAWAN 0103 H 01</td><td>BELUM/TIDAK
align='right'>53110026</td><td>21-02-2019</td><td>MUHITA SURYA
ELFIRA</td><td>WAKIMIN</td><td>BELUM/TIDAK BEKERJA</td><td>GINADE
WETAN</td><td></td><td>TLOGOHARJO</td><td>INDUK</td><td>dr. BUDI ASHARI</td><td>UMI
align='right'>F20.6</td><td>Simple schizophrenia</td><td></td><td
2019</td><td>MULYANI</td><td>SIHONO 02 11 S 17</td><td>LAINNYA</td><td>TAMBAK
RT01 RW02</td><td>TAMBAK</td><td>TLOGOSARI</td><td>INDUK</td><td>dr. BUDI
align='right'>52110044</td><td>21-02-2019</td><td>MUTIA
ALKAYRA</td><td>SLAMET</td><td>BELUM/TIDAK
BEKERJA</td><td>TAMBAK</td><td></td><td>TLOGOSARI</td><td>INDUK</td><td>dr. BUDI
2019</td><td>MUTIA ALKAYRA</td><td>SLAMET</td><td>BELUM/TIDAK
BEKERJA</td><td>TAMBAK</td><td></td><td>TLOGOSARI</td><td>INDUK</td><td>dr. BUDI
align='right'>53040044</td><td>21-02-2019</td><td>NAIRA AZIZAH
AFATUNISSA</td><td>YUSRON 0304 Y 01</td><td>BELUM/TIDAK BEKERJA</td><td>PUREMBE
TLOGOHARJO</td><td></td><td>TLOGOHARJO</td><td>INDUK</td><td>dr. BUDI
align='right'>55060112</td><td>21-02-2019</td><td>NANAIK UMAYAH</td><td>HARYANTO 05
06 H 02</td><td>MENGURUS RUMAH TANGGA</td><td>JATI RT 03 RW
align='right'>57050354</td><td>21-02-2019</td><td>NATAFISA DESMALIA
SALSABILA</td><td>KADIMIN / SUKMA </td><td>BELUM/TIDAK BEKERJA</td><td>SUKOROYO
KULON RT 02 RW 03</td><td></td><td>PUCANGANOM</td><td>INDUK</td><td>dr. BUDI
2019</td><td>NATAFISA DESMALIA SALSABILA</td><td>KADIMIN / SUKMA
</td><td>BELUM/TIDAK BEKERJA</td><td>SUKOROYO KULON RT 02 RW
align='right'>56030115</td><td>21-02-2019</td><td>NATASHA AYUNINGTIAS</td><td>YUSUF
0603 Y 01</td><td>BELUM/TIDAK BEKERJA</td><td>GEBLUG RT03
align='right'>57050355</td><td>21-02-2019</td><td>NAVIA LISTYANI</td><td>ANDRI
SULISTIAWAN</td><td>BELUM/TIDAK BEKERJA</td><td>SUKOROYOM KULO RT 01 RW
2019</td><td>NAVIA LISTYANI</td><td>ANDRI SULISTIAWAN</td><td>BELUM/TIDAK
BEKERJA</td><td>SUKOROYOM KULO RT 01 RW
align='right'>57030435</td><td>21-02-2019</td><td>NAYLA AL MAHIRA
HARTONO</td><td>KALIK/HARTONO 0703 K 07</td><td>BELUM/TIDAK BEKERJA</td><td>KUWANG
RT03 RW06</td><td></td><td>PUCANGANOM</td><td>INDUK</td><td>dr. BUDI
ASHARI</td><td>UMI NUR ISNIATI</td><td>P</td><td><1 Thn.</td><td>Datang
2019</td><td>NAYLA AL MAHIRA HARTONO</td><td>KALIK/HARTONO 0703 K
07</td><td>BELUM/TIDAK BEKERJA</td><td>KUWANG RT03
RW06</td><td></td><td>PUCANGANOM</td><td>INDUK</td><td>dr. BUDI ASHARI</td><td>UMI
NUR ISNIATI</td><td>P</td><td><1 Thn.</td><td>Datang
align='right'>59091318</td><td>21-02-2019</td><td>NIDA DANIATI
RISNANDAR</td><td>UJU WARJU RISNANDAR 09 09 U
01</td><td>PELAJAR/MAHASISWA</td><td>NAWANGAN,GIRIWOYO</td><td></td><td>GIRIWOYO</t
align='right'>15</td><td>BP. Umum</td><td></td><td></td><td>Luar
2019</td><td>NYOTO</td><td>NYOTO</td><td>PETANI/PEKEBUN</td><td>GLAGAH</td><td>GLAG
AH</td><td>TLOGOSARI</td><td>PUSTU TLOGOSARI</td><td>SULARNO,S.Kep.Ns</td><td> -
align='right'>57050366</td><td>21-02-2019</td><td>OKTAVIA TRI
WIDIASARI</td><td>WASIATUN 0705 W 05</td><td>PELAJAR/MAHASISWA</td><td>SUKOROYOM
KULON RT02 RW05</td><td>SUKOROYOM
align='right'>56100407</td><td>21-02-2019</td><td>PANJALU ARSYASHAKA</td><td>PRIYA
SETIAWAN</td><td>BELUM/TIDAK
2019</td><td>PANJALU ARSYASHAKA</td><td>PRIYA SETIAWAN</td><td>BELUM/TIDAK
2019</td><td>PARSINEM</td><td>TUKIJAN 0712 T
01</td><td>PETANI/PEKEBUN</td><td>INGAK INGUK 02/16</td><td>INGAK -
align='right'>56050174</td><td>21-02-2019</td><td>PINARING KUSUMO BEKTI</td><td>ERI
KUSUMO BEKTI 0605 E
01</td><td></td><td>NGUJUNG</td><td></td><td>GIRITONTRO</td><td>INDUK</td><td>dr.
BUDI ASHARI</td><td>SRI SUPATMI</td><td>L</td><td>1-4 Thn.</td><td>Datang
align='right'>15151316</td><td>21-02-2019</td><td>PUTRI MEIRA ARI SANDI</td><td>ARI
SANDI 15 15 A
01</td><td>PELAJAR/MAHASISWA</td><td>DEPOK,JAKARTA</td><td></td><td>JAKARTA</td><td
>INDUK</td><td>dr. BUDI ASHARI</td><td>SUGIYONO,S.Kep.Ns</td><td>P</td><td>15-19
2019</td><td>RAISAH MUFIDAH</td><td>IMAM FAQIH 08 08 I 04</td><td>KARYAWAN
SWASTA</td><td>JOHO RT 01 RW
01</td><td></td><td>PRACIMANTORO</td><td>INDUK</td><td>dr. BUDI
align='right'>56060105</td><td>21-02-2019</td><td>REGA AGUSTA
F</td><td>SURATMO</td><td></td><td>GOBOH</td><td></td><td>GIRITONTRO</td><td>INDUK<
/td><td>dr. BUDI ASHARI</td><td>UMI NUR ISNIATI</td><td>P</td><td>1-4
align='right'>55040108</td><td>21-02-2019</td><td>REVAN
ADIKA</td><td>SULARNO</td><td>BELUM/TIDAK
BEKERJA</td><td>KANIGORO</td><td></td><td>JATIREJO</td><td>INDUK</td><td>dr. BUDI
2019</td><td>REVAN ADIKA</td><td>SULARNO</td><td>BELUM/TIDAK
BEKERJA</td><td>KANIGORO</td><td></td><td>JATIREJO</td><td>INDUK</td><td>dr. BUDI
align='right'>54065011</td><td>21-02-2019</td><td>RINI SETYOWATI</td><td>EKO
HARYANTO 04 06 E 01</td><td>MENGURUS RUMAH TANGGA</td><td>BAYEMHARJO RT 01 RW
/td></tr><tr><td align='right'>L23</td><td>Allergic contact
align='right'>54110128</td><td>21-02-2019</td><td>RISTI OKATAVIASARI</td><td>RUDI
HARTONO 04 11 R 03</td><td>BELUM/TIDAK BEKERJA</td><td>GUWO RT03
2019</td><td>RISTI OKATAVIASARI</td><td>RUDI HARTONO 04 11 R
03</td><td>BELUM/TIDAK BEKERJA</td><td>GUWO RT03
align='right'>55110113</td><td>21-02-2019</td><td>RONI
SETYAWAN</td><td>SAMINO</td><td>BELUM/TIDAK
ASHARI</td><td>HENI WIDIYASTUTI</td><td>L</td><td>8-30 hari</td><td>Datang
align='right'>55110113</td><td>21-02-2019</td><td>RONI
SETYAWAN</td><td>SAMINO</td><td>BELUM/TIDAK
ASHARI</td><td>HENI WIDIYASTUTI</td><td>L</td><td>8-30 hari</td><td>Datang
align='right'>52050037</td><td>21-02-2019</td><td>SABIAN AZMI
ARDIANO</td><td>SULARDI</td><td>BELUM/TIDAK
BEKERJA</td><td>GLAGAH</td><td></td><td>TLOGOSARI</td><td>INDUK</td><td>dr. BUDI
align='right'>Z27.3</td><td>Need
for immunization against diphtheria-tetanus-pertussis with poliomyelitis [DTP +
polio]</td><td></td><td align='right'>288929</td><td
align='right'>52050037</td><td>21-02-2019</td><td>SABIAN AZMI
ARDIANO</td><td>SULARDI</td><td>BELUM/TIDAK
BEKERJA</td><td>GLAGAH</td><td></td><td>TLOGOSARI</td><td>INDUK</td><td>dr. BUDI
align='right'>57050289</td><td>21-02-2019</td><td>SAFFIYA ADHRA
SYAHRIAL</td><td>ARI ZAHRIAL</td><td>BELUM/TIDAK BEKERJA</td><td>SUKOROYOM
align='right'>55110095</td><td>21-02-2019</td><td>SATYA MAY PUTRA
LIYANNO</td><td>HERDIYANTO 0511 H 02</td><td>BELUM/TIDAK
align='right'>57080219</td><td>21-02-2019</td><td>SIFANI ALISIA
SALSABILA</td><td>PONIJAN 0708 P 02</td><td>BELUM/TIDAK
BEKERJA</td><td>PUCANGANOM KIDUL RT01
2019</td><td>SIFANI ALISIA SALSABILA</td><td>PONIJAN 0708 P
02</td><td>BELUM/TIDAK BEKERJA</td><td>PUCANGANOM KIDUL RT01
align='right'>58081384</td><td>21-02-2019</td><td>SINDY ASTIKA SARI</td><td>SARMO
08 08 S 56</td><td>PELAJAR/MAHASISWA</td><td>GALO RT 01 RW 08
PRACIMANTORO</td><td></td><td>PRACIMANTORO</td><td>INDUK</td><td>dr. BUDI
align='right'>51010159</td><td>21-02-2019</td><td>SOFIA
AZAHRA</td><td>TRIYANTO</td><td>BELUM/TIDAK
BEKERJA</td><td>PELET</td><td></td><td>NGARGOHARJO</td><td>INDUK</td><td>dr. BUDI
2019</td><td>SOFIA AZAHRA</td><td>TRIYANTO</td><td>BELUM/TIDAK
BEKERJA</td><td>PELET</td><td></td><td>NGARGOHARJO</td><td>INDUK</td><td>dr. BUDI
align='right'>N34.1</td><td>Nonspecific urethritis</td><td></td><td
2019</td><td>SUKADI</td><td>SUKADI 05 03 S
09</td><td>PETANI/PEKEBUN</td><td>SONGGODULANG RT 01 RW
2019</td><td>SUPARMI</td><td>SUPARMI</td><td>PETANI/PEKEBUN</td><td>GLAGAH</td><td>
align='right'>52057029</td><td>21-02-
2019</td><td>SUPARMI</td><td>SUPARMI</td><td>PETANI/PEKEBUN</td><td>GLAGAH</td><td>
align='right'>56100075</td><td>21-02-2019</td><td>SUWASTI</td><td>HARYANTO 06 10
H 01</td><td>PETANI/PEKEBUN</td><td>TANGGUNG RT 04 RW
></tr><tr><td align='right'>A15.5</td><td>Tuberculosis of larynx, trachea and
bronchus, confirmed bacteriologically and histologically</td><td></td><td
2019</td><td>SUYANTO</td><td>SUYANTO 05 05 S
21</td><td>PETANI/PEKEBUN</td><td>PUNUNG RT 02 RW
></tr><tr><td align='right'>N34.2</td><td>Other urethritis</td><td></td><td
2019</td><td>SUYOTO</td><td>SUYOTO 01 02 S
12</td><td>PETANI/PEKEBUN</td><td>NGRINGIN RT02
align='right'>56080253</td><td>21-02-2019</td><td>TRIYONO,SE</td><td>TRIYONO,SE 06
08 T 05</td><td>PEDAGANG</td><td>DUNGKLEPU WETAN RT02/04</td><td>DUNG KLEPU
></tr><tr><td align='right'>M79.15</td><td>Myalgia,
pelvic and thigh</td><td></td><td align='right'>288855</td><td
align='right'>56010402</td><td>21-02-2019</td><td>TUMINAH</td><td>SARIJAN 06 01
2019</td><td>TUMINO</td><td>TUMINO 03 01 T 01</td><td>PEGAWAI NEGERI
SIPIL</td><td>TLOGOHARJO RT 01 RW
01</td><td>TLOGO</td><td>TLOGOHARJO</td><td>INDUK</td><td>dr. BUDI
align='right'>58081385</td><td>21-02-2019</td><td>TUSIMIN</td><td>TUSIMIN
KUSRAHARJO 08 08 T 07</td><td>PETANI/PEKEBUN</td><td>DUNGTEMU RT 02 RW
align='right'>56010433</td><td>21-02-2019</td><td>VENYA DWI PUSPITASARI</td><td>DWI
PURNOMO 0601 D 03</td><td>BELUM/TIDAK BEKERJA</td><td>GIRITONTRO LOR,
GIRITONTRO</td><td></td><td>GIRITONTRO</td><td>INDUK</td><td>dr. BUDI
align='right'>Z35.8</td><td>Supervision of other high-risk
pregnancies</td><td></td><td align='right'>288850</td><td
align='right'>57040284</td><td>21-02-2019</td><td>WAHYUNI</td><td>MUHANSORI 07 04 M
07</td><td>MENGURUS RUMAH TANGGA</td><td>MANDEYAN RT 02 RW
align='right'>58081383</td><td>21-02-2019</td><td>WAHYUNINGSIH</td><td>SUTIKNO
PRIHATIN 08 08 55</td><td>PELAJAR/MAHASISWA</td><td>MIRI RT03 RW
align='right'>55100048</td><td>21-02-2019</td><td>WAKIDI</td><td>WAKIDI 05 10 W
02</td><td>PETANI/PEKEBUN</td><td>SENGON RT02
RW04</td><td>SENGON</td><td>JATIREJO</td><td>INDUK</td><td>dr. BUDI
Umum</td><td>Poli Dalam</td><td>RS MAGUAN HUSADA</td><td>Dalam
></tr><tr><td align='right'>S60.7</td><td>Multiple superficial injuries of wrist
and hand</td><td></td><td align='right'>288911</td><td
align='right'>57030237</td><td>21-02-2019</td><td>WESTRI NUR UTAMI</td><td>SARIMAN
07 03 S 27</td><td>MENGURUS RUMAH TANGGA</td><td>KUWANG RT02
RW06</td><td></td><td>PUCANGANOM</td><td>INDUK</td><td>dr. BUDI ASHARI</td><td>HENI
></tr><tr><td align='right'>Z24.4</td><td>Need for immunization against measles
align='right'>51030030</td><td>21-02-2019</td><td>YUNITA NUR VITASARI</td><td>HERI
SETYAWAN</td><td></td><td>PRINGKUKU</td><td></td><td>NGARGOHARJO</td><td>INDUK</td>
<td>dr. BUDI ASHARI</td><td>RISTINA Amd Keb</td><td>P</td><td>1-4
align='right'>13090025</td><td>22-02-2019</td><td>AGENG DWI CANDRA
PERMANA</td><td>RUDIANTO</td><td>BELUM/TIDAK
BEKERJA</td><td>KRANGGAN</td><td>KRANGGAN</td><td>TLOGOHARJO</td><td>INDUK</td><td>
dr. BUDI ASHARI</td><td>RISTINA Amd Keb</td><td>L</td><td><1 Thn.</td><td>Datang
2019</td><td>AGENG DWI CANDRA PERMANA</td><td>RUDIANTO</td><td>BELUM/TIDAK
BEKERJA</td><td>KRANGGAN</td><td>KRANGGAN</td><td>TLOGOHARJO</td><td>INDUK</td><td>
align='right'>H01.9</td><td>Inflammation of eyelid, unspecified</td><td></td><td
2019</td><td>ARDIAN DHANI PRATAMA</td><td>SUNARDI 0101 S 09</td><td>BELUM/TIDAK
BEKERJA</td><td>PELET RT01
RW02</td><td>PELET</td><td>NGARGOHARJO</td><td>INDUK</td><td>dr. BUDI
align='right'>288975</td><td align='right'>53010039</td><td>22-02-2019</td><td>CAKA
PD</td><td>MOREJO 0301 M 10</td><td>PELAJAR/MAHASISWA</td><td>TLOGO RT01
align='right'>288956</td><td align='right'>53040028</td><td>22-02-2019</td><td>DEDI
PRASETYO</td><td>SRIYANTO 0304 S 02</td><td>LAINNYA</td><td>PUREMBE
RT.02/02</td><td>PUREMBE</td><td>TLOGOHARJO</td><td>INDUK</td><td>dr. BUDI
align='right'>57050140</td><td>22-02-2019</td><td>DIAH ARYANI</td><td>WASINO
0705 W 02</td><td>PEDAGANG</td><td>SUKOROYOM KULON</td><td>SUKOROYOM
></tr><tr><td
align='right'>57030443</td><td>22-02-2019</td><td>FERI BP</td><td>WAGIMIN 0703 W
05</td><td>PELAJAR/MAHASISWA</td><td>KUWANG RT03
2019</td><td>JAYENG</td><td>BADRI 07 13 B 02</td><td></td><td>KEPUH RT 01 RW
12</td><td>KEPUH</td><td>PUCANGANOM</td><td>INDUK</td><td>drg.DANAR
align='right'>56030001</td><td>22-02-2019</td><td>KATMIN</td><td>KATMIN 0603 K
05</td><td>PETANI/PEKEBUN</td><td>GEBLUG</td><td>GEBLUG</td><td>GIRITONTRO</td><td>
INDUK</td><td>dr. BUDI ASHARI</td><td>SUGIYONO,S.Kep.Ns</td><td>L</td><td>60-69
></tr><tr><td align='right'>J44.9</td><td>Chronic obstructive pulmonary disease,
align='right'>54010027</td><td>22-02-2019</td><td>KIYEM</td><td>KIYEM 0401 K
02</td><td>PETANI/PEKEBUN</td><td>BELEH RT02
RW04</td><td>BELEH</td><td>BAYEMHARJO</td><td>INDUK</td><td>dr. BUDI
></tr><tr><td align='right'>J41.1</td><td>Mucopurulent chronic
bronchitis</td><td></td><td align='right'>288951</td><td
align='right'>52145020</td><td>22-02-2019</td><td>MUHAMAD DWI A</td><td>SUTRISNO
0214 S 14</td><td>PELAJAR/MAHASISWA</td><td>GUPAKAN RT02
RW03</td><td>GUPAKAN</td><td>TLOGOSARI</td><td>INDUK</td><td>dr. ZAENAL ARIFIN
HP</td><td>SUGIYONO,S.Kep.Ns</td><td>L</td><td>10-14 Thn.</td><td>Datang
</tr><tr><td align='right'>E11.6</td><td>Non-insulin-dependent diabetes mellitus
align='right'>56100078</td><td>22-02-2019</td><td>MUJI RAHAYU</td><td>SAMADI 0610
S 12</td><td>MENGURUS RUMAH TANGGA</td><td>TANGGUNG RT 04 RW
></tr><tr><td align='right'>K08.1</td><td>Loss of teeth due to accident, extraction
or local periodontal disease</td><td></td><td align='right'>288982</td><td
align='right'>56100188</td><td>22-02-2019</td><td>NITA JULIATI</td><td>CUSWINDYA
TIYANARTA 06 10 C 01</td><td>MENGURUS RUMAH TANGGA</td><td>TANGGUNG RT02
RW05</td><td>TANGGUNG</td><td>GIRITONTRO</td><td>INDUK</td><td>drg.DANAR
2019</td><td>RUBIYATI</td><td>SUPRIYANTO 0101 S
13</td><td>PELAJAR/MAHASISWA</td><td>PELET</td><td></td><td>NGARGOHARJO</td><td>IND
UK</td><td>dr. BUDI ASHARI</td><td>SUGIYONO,S.Kep.Ns</td><td>P</td><td>20-44
align='right'>56080236</td><td>22-02-2019</td><td>SADIMAN CIPTO
WINOTO</td><td>SADIMAN CIPTO WINOTO 0608 S
></tr><tr><td align='right'>E56.9</td><td>Vitamin deficiency,
align='right'>56100041</td><td>22-02-2019</td><td>SAMADI</td><td>SAMADI 06 10 S
12</td><td>PEGAWAI NEGERI SIPIL</td><td>TANGGUNG RT04
2019</td><td>SAMADI</td><td>SAMADI 06 10 S 12</td><td>PEGAWAI NEGERI
SIPIL</td><td>TANGGUNG RT04
2019</td><td>SAMINEM</td><td>SAYUTI 0709 S
14</td><td>PETANI/PEKEBUN</td><td>PUCANGANOM LOR RT03 RW 09</td><td>PUCANGANOM
LOR</td><td>PUCANGANOM</td><td>INDUK</td><td>drg.DANAR WULANDARI</td><td>RIZKI
align='right'>57090227</td><td>22-02-2019</td><td>SAMINEM</td><td>SAYUTI 0709 S
align='right'>K29.1</td><td>Other acute gastritis</td><td></td><td
2019</td><td>SAMINI</td><td>SUGITO 06 02 S 72</td><td>MENGURUS RUMAH
TANGGA</td><td>GIRITONTRO KIDUL RT03 RW03</td><td>GIRITONTRO
align='right'>57130136</td><td>22-02-2019</td><td>SARBINAH</td><td>SARBINAH 0713 S
</td></tr><tr><td align='right'>I52.8</td><td>Other heart disorders in other
diseases classified elsewhere</td><td></td><td align='right'>288974</td><td
align='right'>56100028</td><td>22-02-2019</td><td>SITI MUZAYANAH</td><td>SUPARMIN
06 10 S 36</td><td>MENGURUS RUMAH TANGGA</td><td>TANGGUNG RT 04 RW
align='right'>56010332</td><td>22-02-2019</td><td>SRENGENGE</td><td>WAHYU NUGROHO
06 01 W 06</td><td>PELAJAR/MAHASISWA</td><td>GIRITONTRO LOR RT02
align='right'>L24</td><td>Irritant contact dermatitis</td><td></td><td
2019</td><td>SUGIARTI</td><td>SUWARDI 06 01 S
align='right'>56010131</td><td>22-02-2019</td><td>SUGIARTI</td><td>SUWARDI 06 01
align='right'>53040027</td><td>22-02-2019</td><td>SUGIYARTI</td><td>CIPTO SUMARSO
0304 C 01</td><td>PETANI/PEKEBUN</td><td>PUREMBE RT02
RW02;TLOGOHARJO</td><td>PUREMBE</td><td>TLOGOHARJO</td><td>INDUK</td><td>dr. BUDI
2019</td><td>SUKATMI</td><td>PAINO 0605 P
2019</td><td>SULIYANTO</td><td>SULIYANTO 06 01 S
11</td><td>WIRASWASTA</td><td>GIRITONTRO LOR RT02 RW01</td><td>GIRITONTRO
</tr><tr><td align='right'>H58.8</td><td>Other specified disorders of eye and
2019</td><td>SUMINI</td><td>SUMARNO 03 03 S 07</td><td>MENGURUS RUMAH
TANGGA</td><td>JAJAR RT 05 RW
align='right'>53040056</td><td>22-02-2019</td><td>SUPRAPTI</td><td>SRIYANTO 0304 S
02</td><td>PETANI/PEKEBUN</td><td>PUREMBE RT 02 RW
02</td><td>PUREMBE</td><td>TLOGOHARJO</td><td>INDUK</td><td>dr. BUDI
align='right'>57130039</td><td>22-02-2019</td><td>SUSANA WARINEM</td><td>H.B.MISDI
0713 H 04</td><td>PETANI/PEKEBUN</td><td>KEPUH RT03
align='right'>56100310</td><td>22-02-2019</td><td>SUTINO</td><td>SUTINO 0610 S
15</td><td>PETANI/PEKEBUN</td><td>TANGGUNG</td><td>TANGGUNG</td><td>GIRITONTRO</td>
></tr><tr><td align='right'>J45.8</td><td>Mixed asthma</td><td></td><td
align='right'>57010112</td><td>22-02-2019</td><td>WAHYU WIDIASTUTI</td><td>RATMO
0701 R 01</td><td></td><td>GROGOL RT 02 RW
align='right'>57050357</td><td>22-02-2019</td><td>WANTO</td><td>WANTO 0705 W
04</td><td>PEGAWAI
NEGERI SIPIL</td><td>SUKOROYOM KULON RT 03 RW 3</td><td>SUKOROYOM
></tr><tr><td align='right'>H65.9</td><td>Nonsuppurative otitis media,
align='right'>57115003</td><td>22-02-2019</td><td>WARSI</td><td>YOSO SUKATNO 0711
Y 01</td><td>PETANI/PEKEBUN</td><td>PLOSO RT 02 RW
2019</td><td>YUSUF SABARNO</td><td>TUGIRAN 0202 T
05</td><td>PELAJAR/MAHASISWA</td><td>MANTHANG RT01
/td></tr><tr><td align='right'>A02.9</td><td>Salmonella infection,
></tr><tr><td align='right'>Z24.4</td><td>Need for immunization against measles
align='right'>56030118</td><td>23-02-2019</td><td>ADILA NISYA
PUTRI</td><td>WAGINO/RAGIL WAHYU 0603 0603 W 03</td><td>BELUM/TIDAK
BEKERJA</td><td>GEBLUG</td><td>GEBLUG</td><td>GIRITONTRO</td><td>INDUK</td><td>dr.
align='right'>51050058</td><td>23-02-2019</td><td>ALEXA WAHYU
MARGARETA</td><td>WAHYUDI 0105 W 02</td><td>BELUM/TIDAK BEKERJA</td><td>GENTUNG
RT02 RW03</td><td>GENTUNG</td><td>NGARGOHARJO</td><td>INDUK</td><td>dr. BUDI
ASHARI</td><td>SRI MURWATININGSIH</td><td>P</td><td><1 Thn.</td><td>Datang
align='right'>56100234</td><td>23-02-2019</td><td>ALFI ARROHMAH</td><td>SUPARMIN
0610 S 36</td><td>PETANI/PEKEBUN</td><td>TANGGUNG RT 04 RW
</tr><tr><td align='right'>Z24.4</td><td>Need for immunization against measles
align='right'>53010063</td><td>23-02-2019</td><td>ALTHAF NABIL
MUBAROK</td><td>AGUNG JATI/SUKIJO</td><td>MENGURUS RUMAH
TANGGA</td><td>TLOGO</td><td>TLOGO</td><td>TLOGOHARJO</td><td>INDUK</td><td>dr.
align='right'>55070059</td><td>23-02-
2019</td><td>ALVINO</td><td>SUYATNO</td><td>BELUM/TIDAK
BEKERJA</td><td>NGELOSARI</td><td>NGELOSARI</td><td>JATIREJO</td><td>INDUK</td><td>
2019</td><td>ALVINO</td><td>SUYATNO</td><td>BELUM/TIDAK
BEKERJA</td><td>NGELOSARI</td><td>NGELOSARI</td><td>JATIREJO</td><td>INDUK</td><td>
align='right'>51060022</td><td>23-02-2019</td><td>ALYA ZAHRA AZIZA</td><td>AULID
UMAR ASMI</td><td>BELUM/TIDAK
BEKERJA</td><td>NGLARANGAN</td><td>NGLARANGAN</td><td>NGARGOHARJO</td><td>INDUK</td
><td>dr. BUDI ASHARI</td><td>RISTINA Amd Keb</td><td>P</td><td>8-30
align='right'>51060022</td><td>23-02-2019</td><td>ALYA ZAHRA AZIZA</td><td>AULID
UMAR ASMI</td><td>BELUM/TIDAK
BEKERJA</td><td>NGLARANGAN</td><td>NGLARANGAN</td><td>NGARGOHARJO</td><td>INDUK</td
><td>dr. BUDI ASHARI</td><td>RISTINA Amd Keb</td><td>P</td><td>8-30
align='right'>51057016</td><td>23-02-2019</td><td>ANJELINA WAHYU
AGUSTIN</td><td>WAHYUDI 0105 W
02</td><td></td><td>GENTUNG</td><td></td><td>NGARGOHARJO</td><td>INDUK</td><td>dr.
BUDI ASHARI</td><td>SRI MURWATININGSIH</td><td>P</td><td>1-4 Thn.</td><td>Datang
align='right'>57050290</td><td>23-02-2019</td><td>ARSHYLA MAHARDIKA
PUTRI</td><td>FEBINA FERON MARGA BUDI</td><td>BELUM/TIDAK BEKERJA</td><td>SUKOROYOM
align='right'>51110042</td><td>23-02-2019</td><td>AZIZAH NATALIA N</td><td>AGUS P
</td><td>BELUM/TIDAK
BEKERJA</td><td>BLEBER</td><td>BLEBER</td><td>NGARGOHARJO</td><td>INDUK</td><td>dr.
2019</td><td>AZIZAH NATALIA N</td><td>AGUS P </td><td>BELUM/TIDAK
BEKERJA</td><td>BLEBER</td><td>BLEBER</td><td>NGARGOHARJO</td><td>INDUK</td><td>dr.
align='right'>S52.80</td><td>Fracture of other parts of forearm ,
align='right'>52080124</td><td>23-02-2019</td><td>BELLA S</td><td>SUTASNO 0208 S
35</td><td>PELAJAR/MAHASISWA</td><td>TLOGOSARI RT01
Sendiri</td><td>Baru</td><td>BPJS PBI</td><td>Rujuk</td><td
align='right'>55100050</td><td>23-02-2019</td><td>BRLYAN PRADIPTA AL
FATIH</td><td>WITRIATNO</td><td>BELUM/TIDAK BEKERJA</td><td>SENGON
</td><td>SENGON</td><td>JATIREJO</td><td>INDUK</td><td>dr. BUDI
2019</td><td>BRLYAN PRADIPTA AL FATIH</td><td>WITRIATNO</td><td>BELUM/TIDAK
BEKERJA</td><td>SENGON </td><td>SENGON</td><td>JATIREJO</td><td>INDUK</td><td>dr.
align='right'>57040054</td><td>23-02-2019</td><td>DAFIN
SETHIYANTO</td><td>SUGIYANTO 0704 S
30</td><td>PELAJAR/MAHASISWA</td><td>MANDEYAN</td><td>MANDEYAN</td><td>PUCANGANOM</
td><td>INDUK</td><td>dr. ZAENAL ARIFIN
HP</td><td>SUGIYONO,S.Kep.Ns</td><td>L</td><td>5-9 Thn.</td><td>Datang
align='right'>55060104</td><td>23-02-2019</td><td>ELFATHAN NURGHIFARI
RAFASYA</td><td>DWI NURWIYANTO</td><td>BELUM/TIDAK
BEKERJA</td><td>JATI</td><td>JATI</td><td>JATIREJO</td><td>INDUK</td><td>dr. BUDI
align='right'>55060104</td><td>23-02-2019</td><td>ELFATHAN NURGHIFARI
RAFASYA</td><td>DWI NURWIYANTO</td><td>BELUM/TIDAK
2019</td><td>ELFATHAN NURGHIFARI RAFASYA</td><td>DWI NURWIYANTO</td><td>BELUM/TIDAK
align='right'>57080223</td><td>23-02-2019</td><td>FAISAL ARDI ARZAIN</td><td>SUYONO
0708 S 09</td><td>PELAJAR/MAHASISWA</td><td>PUCANGANOM KIDUL RT01
align='right'>57090257</td><td>23-02-2019</td><td>FEBIANDRA SAKTI
ASA</td><td>GUNAWAN</td><td>BELUM/TIDAK BEKERJA</td><td>PUCANGANOM
2019</td><td>FEBIANDRA SAKTI ASA</td><td>GUNAWAN</td><td>BELUM/TIDAK
BEKERJA</td><td>PUCANGANOM KIDUL</td><td>PUCANGANOM
KIDUL</td><td>PUCANGANOM</td><td>INDUK</td><td>dr. BUDI ASHARI</td><td>RISTINA Amd
Keb</td><td>L</td><td><1 Thn.</td><td>Datang
align='right'>55110114</td><td>23-02-2019</td><td>FELYSIA INEZ
GIANINA</td><td>SUTRISNO </td><td>BELUM/TIDAK BEKERJA</td><td>BUWENG
</td><td>BUWENG</td><td>JATIREJO</td><td>INDUK</td><td>dr. BUDI
ASHARI</td><td>RISTINA Amd Keb</td><td>P</td><td>8-30 hari</td><td>Datang
align='right'>55110114</td><td>23-02-2019</td><td>FELYSIA INEZ
GIANINA</td><td>SUTRISNO </td><td>BELUM/TIDAK BEKERJA</td><td>BUWENG
</td><td>BUWENG</td><td>JATIREJO</td><td>INDUK</td><td>dr. BUDI
ASHARI</td><td>RISTINA Amd Keb</td><td>P</td><td>8-30 hari</td><td>Datang
align='right'>56020636</td><td>23-02-2019</td><td>GUFTRY NUR RAMADHAN</td><td>AGUS
KRISTIANTO</td><td>BELUM/TIDAK BEKERJA</td><td>GIRITONTRO KIDUL</td><td>GIRITONTRO
KIDUL</td><td>GIRITONTRO</td><td>INDUK</td><td>dr. BUDI ASHARI</td><td>RISTINA Amd
Keb</td><td>L</td><td><1 Thn.</td><td>Datang
align='right'>O75.7</td><td>Vaginal delivery following previous caesarean
section</td><td></td><td align='right'>288986</td><td
align='right'>55090040</td><td>23-02-2019</td><td>HARTATIK</td><td>PARINO 05 09 P
02</td><td>MENGURUS RUMAH TANGGA</td><td>MULWOSARI
01/04,JATIREJO</td><td>MULWOSARI</td><td>JATIREJO</td><td>INDUK</td><td>dr. BUDI
align='right'>56010679</td><td>23-02-2019</td><td>JOVANDRA RAFIF
RAHANDIKA</td><td>DHIKA PURNA MANGGALA</td><td>BELUM/TIDAK
BEKERJA</td><td>GIRITONTRO LOR RT02 RW02</td><td>GIRITONTRO
LOR</td><td>GIRITONTRO</td><td>INDUK</td><td>dr. BUDI ASHARI</td><td>RISTINA Amd
Keb</td><td>L</td><td>8-30 hari</td><td>Datang
align='right'>56010679</td><td>23-02-2019</td><td>JOVANDRA RAFIF
RAHANDIKA</td><td>DHIKA PURNA MANGGALA</td><td>BELUM/TIDAK
BEKERJA</td><td>GIRITONTRO LOR RT02 RW02</td><td>GIRITONTRO
LOR</td><td>GIRITONTRO</td><td>INDUK</td><td>dr. BUDI ASHARI</td><td>RISTINA Amd
align='right'>M25.05</td><td>Haemarthrosis, pelvic and thigh</td><td></td><td
2019</td><td>KASNO</td><td>KASNO 07 02 K
align='right'>52110047</td><td>23-02-2019</td><td>KIRANA R
P</td><td>SUMARJI</td><td>BELUM/TIDAK
BEKERJA</td><td>TAMBAK</td><td>TAMBAK</td><td>TLOGOSARI</td><td>INDUK</td><td>dr.
BUDI ASHARI</td><td>RISTINA Amd Keb</td><td>P</td><td>1-4 Thn.</td><td>Datang
align='right'>55090084</td><td>23-02-2019</td><td>LUBNA NUR ATALA M</td><td>DENI P
</td><td>MENGURUS RUMAH
TANGGA</td><td>GIRIROTO</td><td>GIRIROTO</td><td>JATIREJO</td><td>INDUK</td><td>dr.
2019</td><td>LUBNA NUR ATALA M</td><td>DENI P </td><td>MENGURUS RUMAH
TANGGA</td><td>GIRIROTO</td><td>GIRIROTO</td><td>JATIREJO</td><td>INDUK</td><td>dr.
align='right'>57030301</td><td>23-02-2019</td><td>MAMI</td><td>MARWAN 0703 M
05</td><td>PETANI/PEKEBUN</td><td>KUWANG RT04
align='right'>K35</td><td>Acute appendicitis</td><td></td><td
2019</td><td>MARTINI</td><td>SUPRAPTO 0707 S
align='right'>57110230</td><td>23-02-2019</td><td>MITA SRI RAHAYU</td><td>ANTON
0711 A 04</td><td>MENGURUS RUMAH TANGGA</td><td>PLOSO RT02
align='right'>52080123</td><td>23-02-2019</td><td>MUHAMMAD
AZKA</td><td>NUROHIMAH</td><td>BELUM/TIDAK
BEKERJA</td><td>TLOGOSARI</td><td>TLOGOSARI</td><td>TLOGOSARI</td><td>INDUK</td><td
>dr. BUDI ASHARI</td><td>RISTINA Amd Keb</td><td>L</td><td>1-4 Thn.</td><td>Datang
align='right'>53030090</td><td>23-02-2019</td><td>MUHAMMAD WAHYU ZALVA
PRADINATA</td><td>KRIBIANTORO</td><td>BELUM/TIDAK
BEKERJA</td><td>JAJAR</td><td>JAJAR</td><td>TLOGOHARJO</td><td>INDUK</td><td>dr.
BUDI ASHARI</td><td>RISTINA Amd Keb</td><td>L</td><td>8-30 hari</td><td>Datang
align='right'>53030090</td><td>23-02-2019</td><td>MUHAMMAD WAHYU ZALVA
PRADINATA</td><td>KRIBIANTORO</td><td>BELUM/TIDAK
BEKERJA</td><td>JAJAR</td><td>JAJAR</td><td>TLOGOHARJO</td><td>INDUK</td><td>dr.
BUDI ASHARI</td><td>RISTINA Amd Keb</td><td>L</td><td>8-30 hari</td><td>Datang
align='right'>56020672</td><td>23-02-2019</td><td>NAURA PUTRI
RAHMADITA</td><td>KUNCORO ADI</td><td>BELUM/TIDAK BEKERJA</td><td>GIRITONTRO
2019</td><td>NAURA PUTRI RAHMADITA</td><td>KUNCORO ADI</td><td>BELUM/TIDAK
BEKERJA</td><td>GIRITONTRO KIDUL</td><td>GIRITONTRO
KIDUL</td><td>GIRITONTRO</td><td>INDUK</td><td>dr. BUDI ASHARI</td><td>RISTINA Amd
Keb</td><td>P</td><td><1 Thn.</td><td>Datang
align='right'>57050138</td><td>23-02-2019</td><td>NURUN NA'IMAH</td><td>ISKANDAR
0705 I 010</td><td>KARYAWAN SWASTA</td><td>SUKOROYOM KULON</td><td>SUKOROYOM
align='right'>57050138</td><td>23-02-2019</td><td>NURUN NA'IMAH</td><td>ISKANDAR
0705 I 010</td><td>KARYAWAN SWASTA</td><td>SUKOROYOM KULON</td><td>SUKOROYOM
KULON</td><td>PUCANGANOM</td><td>INDUK</td><td>dr.
align='right'>53010083</td><td>23-02-2019</td><td>RAHMAT SURYA
PRATAMA</td><td>MULYADI</td><td>MENGURUS RUMAH
2019</td><td>RAHMAT SURYA PRATAMA</td><td>MULYADI</td><td>MENGURUS RUMAH
align='right'>54060071</td><td>23-02-2019</td><td>RIZKY DWI
YULIANTO</td><td>SUPARMAN 0406 S 04</td><td>BELUM/TIDAK
BEKERJA</td><td>BAYEMHARJO RT02
align='right'>54090062</td><td>23-02-2019</td><td>RYO BAGUS
ANDRIANSYAH</td><td>SUBANDI 0409 S 01</td><td>BELUM/TIDAK
BEKERJA</td><td>WATES</td><td>WATES</td><td>BAYEMHARJO</td><td>INDUK</td><td>dr.
BUDI ASHARI</td><td>RISTINA Amd Keb</td><td>L</td><td>1-4 Thn.</td><td>Datang
align='right'>56010019</td><td>23-02-2019</td><td>SARIJAN</td><td>SARIJAN 5601 S
align='right'>53080090</td><td>23-02-2019</td><td>SIGNI
TIAN</td><td>KRISTIANTO</td><td>BELUM/TIDAK BEKERJA</td><td>GINADE
KULON</td><td>GINADE KULON</td><td>TLOGOHARJO</td><td>INDUK</td><td>dr. BUDI
align='right'>53080090</td><td>23-02-2019</td><td>SIGNI
TIAN</td><td>KRISTIANTO</td><td>BELUM/TIDAK BEKERJA</td><td>GINADE
KULON</td><td>GINADE KULON</td><td>TLOGOHARJO</td><td>INDUK</td><td>dr. BUDI
align='right'>51050040</td><td>23-02-2019</td><td>SRI PURWANINGSIH </td><td>WAYUDI
0106 W 02</td><td>BURUH HARIAN LEPAS</td><td>GENTUNG RT02
align='right'>57140076</td><td>23-02-2019</td><td>SUTINI</td><td>TUGINO AL SURIP
0714 T 09</td><td>PETANI/PEKEBUN</td><td>PENDEM RT01
align='right'>56050032</td><td>23-02-2019</td><td>YASID DWI HARTOYO</td><td>HARTOYO
0605 H
01</td><td>PEDAGANG</td><td>NGUJUNG</td><td>NGUJUNG</td><td>GIRITONTRO</td><td>INDU
K</td><td>dr. BUDI ASHARI</td><td>SUGIYONO,S.Kep.Ns</td><td>L</td><td>45-54
align='right'>57090256</td><td>23-02-2019</td><td>ZIAN CANDRA MUSTOFA</td><td>M.
MUSTOFA </td><td>BELUM/TIDAK BEKERJA</td><td>PUCANGANOM LOR</td><td>PUCANGANOM
LOR</td><td>PUCANGANOM</td><td>INDUK</td><td>dr. BUDI ASHARI</td><td>RISTINA Amd
align='right'>57090256</td><td>23-02-2019</td><td>ZIAN CANDRA MUSTOFA</td><td>M.
MUSTOFA </td><td>BELUM/TIDAK BEKERJA</td><td>PUCANGANOM LOR</td><td>PUCANGANOM
LOR</td><td>PUCANGANOM</td><td>INDUK</td><td>dr. BUDI ASHARI</td><td>RISTINA Amd
align='right'>57020142</td><td>25-02-2019</td><td>AGUNG SEDAYU</td><td>SARTO 0702
S 03</td><td>BELUM/TIDAK BEKERJA</td><td>SUKOROYOM
WETAN</td><td></td><td>PUCANGANOM</td><td>INDUK</td><td>dr. BUDI
</tr><tr><td align='right'>K05.3</td><td>Chronic periodontitis</td><td></td><td
WETAN</td><td></td><td>PUCANGANOM</td><td>INDUK</td><td>drg.DANAR
2019</td><td>ALFIZA TATA SETYANA</td><td>TUHINO 1010 T 03</td><td></td><td>SUMUR
RT04 RW01,GENDAYAAN</td><td></td><td>PARANGGUPITO</td><td>INDUK</td><td>drg.DANAR
ABAS</td><td>ALI ABAS 07 01 A 01</td><td>KARYAWAN SWASTA</td><td>GROGOL RT01
align='right'>55040112</td><td>25-02-2019</td><td>ALVIAN RAMADHANI</td><td>EDI
GURITNO</td><td>BELUM/TIDAK
BEKERJA</td><td>KANIGORO</td><td>KANIGORO</td><td>JATIREJO</td><td>INDUK</td><td>dr
. BUDI ASHARI</td><td>RISTINA Amd Keb</td><td>L</td><td><1 Thn.</td><td>Datang
Sendiri</td><td>Baru</td><td>Imunisasi</td><td>Rajal</td><td align='right'></td><td
2019</td><td>ALVIAN RAMADHANI</td><td>EDI GURITNO</td><td>BELUM/TIDAK
BEKERJA</td><td>KANIGORO</td><td>KANIGORO</td><td>JATIREJO</td><td>INDUK</td><td>dr
. BUDI ASHARI</td><td>RISTINA Amd Keb</td><td>L</td><td><1 Thn.</td><td>Datang
Sendiri</td><td>Baru</td><td>Imunisasi</td><td>Rajal</td><td align='right'></td><td
2019</td><td>ANASTASYA
</td><td>SUTARTO</td><td>PELAJAR/MAHASISWA</td><td>TAMBAHSARI RT01
RW07</td><td>TAMBAHSARI</td><td>PUCANGANOM</td><td>INDUK</td><td>drg.DANAR
align='right'>51040026</td><td>25-02-2019</td><td>ANDITA</td><td>JOKO PURNOMO 0104
J 01</td><td>LAINNYA</td><td>KLEPU RT03
RW05,NGARGOHARJO</td><td>KLEPU</td><td>NGARGOHARJO</td><td>INDUK</td><td>dr. BUDI
/td></tr><tr><td align='right'>L29.9</td><td>Pruritus, unspecified</td><td></td><td
align='right'>289205</td><td align='right'>55020076</td><td>25-02-2019</td><td>ANIK
SRI HARTANTI</td><td>EPNU UTOMO</td><td>PETANI/PEKEBUN</td><td>GIRIROTO RT 01
RW01,JATIREJO</td><td>GIRIROTO</td><td>JATIREJO</td><td>PKD
align='right'>56010267</td><td>25-02-2019</td><td>ANITA AISYALAMAH</td><td>ASHARI
0601 A 02</td><td>PERANGKAT DESA</td><td>GIRITONTRO LOR</td><td>GIRITONTRO
align='right'>57010149</td><td>25-02-2019</td><td>ARGA PERMANA</td><td>SULARNO
0701 S
07</td><td></td><td>GROGOL</td><td>GROGOL</td><td>PUCANGANOM</td><td>INDUK</td><td>
dr. BUDI ASHARI</td><td>UMI NUR ISNIATI</td><td>L</td><td>1-4 Thn.</td><td>Datang
align='right'>53020074</td><td>25-02-2019</td><td>ARSYAD MAUZA
RIZBULLAH</td><td>DWI HASTONO</td><td>BELUM/TIDAK
BEKERJA</td><td>SUMBEREJO</td><td></td><td>TLOGOSARI</td><td>INDUK</td><td>dr. BUDI
align='right'>56030128</td><td>25-02-2019</td><td>ARUM DWI WARDANI</td><td>SRI
MARYANTO 0603 S 24</td><td>PELAJAR/MAHASISWA</td><td>GEBLUG RT03
align='right'>54065160</td><td>25-02-2019</td><td>AYUNINGDYA AILA
VARISHA</td><td>EDI </td><td>BELUM/TIDAK
align='right'>57080245</td><td>25-02-2019</td><td>AZZAM AMAR FADHIL</td><td>SUYONO
0708 S 09</td><td>PELAJAR/MAHASISWA</td><td>PUCANGANOM KIDUL RT01
align='right'>I50.0</td><td>Congestive heart failure</td><td></td><td
2019</td><td>BUDIYANTO</td><td>KATIJAN 0308 K
02</td><td>WIRASWASTA</td><td>GINADE KULON RT01 RW03</td><td>GINADE
align='right'>57160093</td><td>25-02-2019</td><td>CINDI NUR AINI</td><td>SUROTO
0716 S 11</td><td>PELAJAR/MAHASISWA</td><td>SAWIT LOR RT03 RW13</td><td>SAWIT
2019</td><td>DHANU RAMADHAN</td><td>WIDODO 07 02 W
09</td><td>PELAJAR/MAHASISWA</td><td>SUKOROYOM WETAN</td><td>SUKOROYOM
ASHARI</td><td>SUGIYONO,S.Kep.Ns</td><td>L</td><td>15-19
2019</td><td>DHANU
SILVIANTO</td><td></td><td>PELAJAR/MAHASISWA</td><td>KLEPU</td><td>KLEPU</td><td>TL
OGOSARI</td><td>PUSTU TLOGOSARI</td><td>SULARNO,S.Kep.Ns</td><td> -
</td><td>L</td><td>10-14 Thn.</td><td>Datang Sendiri</td><td>Baru</td><td>BPJS NON
></tr><tr><td align='right'>M79.01</td><td>Rheumatism, unspecified, shoulder
region</td><td></td><td align='right'>289093</td><td
align='right'>56010004</td><td>25-02-2019</td><td>DWI ARWOTO</td><td>DWI ARWOTO
0601 D 02</td><td>WIRASWASTA</td><td>GIRITONTRO LOR RT 02 RW01</td><td>GIRITONTRO
ARWOTO</td><td>DWI ARWOTO 0601 D 02</td><td>WIRASWASTA</td><td>GIRITONTRO LOR RT
02 RW01</td><td>GIRITONTRO LOR</td><td>GIRITONTRO</td><td>INDUK</td><td>dr. BUDI
ROHANI</td><td>SULARSO</td><td>PETANI/PEKEBUN</td><td>SALAM</td><td>SALAM</td><td>T
LOGOSARI</td><td>PUSTU TLOGOSARI</td><td>SULARNO,S.Kep.Ns</td><td> -
align='right'>53025023</td><td>25-02-2019</td><td>DWI
SURYANI</td><td>NARTO</td><td>MENGURUS RUMAH
TANGGA</td><td>SAMBIREJO</td><td>SAMBIREJO</td><td>TLOGOHARJO</td><td>PKD
TLOGOHARJO</td><td>SRI SUPATMI</td><td> - </td><td>P</td><td>20-44
align='right'>56030013</td><td>25-02-2019</td><td>DWITA AULIA
KENNY</td><td>SULIYONO 0603 S 25</td><td>PELAJAR/MAHASISWA</td><td>GEBLUG RT03
align='right'>54065157</td><td>25-02-2019</td><td>EDI HARTONO</td><td>EDI
HARTONO</td><td>PETANI/PEKEBUN</td><td>BAYEM</td><td>BAYEM</td><td>BAYEMHARJO</td><
td>PUSTU BAYEMHARJO</td><td>RISTINA Amd Keb</td><td> - </td><td>L</td><td>45-54
align='right'>M41</td><td>Scoliosis</td><td></td><td align='right'>289109</td><td
align='right'>57110033</td><td>25-02-2019</td><td>EKA ROOSA SEPTIANI</td><td>SARONO
0711 S 02</td><td>PELAJAR/MAHASISWA</td><td>PLOSO RT01
align='right'>57010161</td><td>25-02-2019</td><td>FATAN AL MAISAN</td><td>HARYANTO
0701 H 03</td><td>BELUM/TIDAK BEKERJA</td><td>GROGOL RT01 RW
RW5</td><td>TANGGUNG</td><td>GIRITONTRO</td><td>INDUK</td><td>drg.DANAR
WULANDARI</td><td>SUGIYONO,S.Kep.Ns</td><td>L</td><td>5-9 Thn.</td><td>Datang
align='right'>57030265</td><td>25-02-2019</td><td>FELIVIA AZIWA BILQIS
P</td><td>SISWANTO 0703 S 40</td><td>BELUM/TIDAK BEKERJA</td><td>KUWANG RT02
2019</td><td>FIRDAUSA AKBAR</td><td>EKO TAMTOMO 0706 E 01</td><td>BELUM/TIDAK
BEKERJA</td><td>TAMBAHSARI</td><td>TAMBAHSARI</td><td>PUCANGANOM</td><td>INDUK</td>
<td>drg.DANAR WULANDARI</td><td>RIZKI ANISSA, AM.Kg</td><td>L</td><td>5-9
WONOGIRI</td><td>Rajal</td><td align='right'>19</td><td align='right'></td><td
2019</td><td>GIYATMI</td><td>DONI</td><td>PETANI/PEKEBUN</td><td>PULUNG</td><td>PUL
></tr><tr><td align='right'>E05.9</td><td>Thyrotoxicosis,
align='right'>56100178</td><td>25-02-2019</td><td>HERNI SRI
HARMINI</td><td>SUPRIYANTO 0610 S 03</td><td>MENGURUS RUMAH
TANGGA</td><td>TANGGUNG</td><td>TANGGUNG</td><td>GIRITONTRO</td><td>INDUK</td><td>d
r. BUDI ASHARI</td><td>SUGIYONO,S.Kep.Ns</td><td>P</td><td>20-44
align='right'>57020135</td><td>25-02-2019</td><td>IKA WAHYU NITA</td><td>SUKINO
td></tr><tr><td align='right'>Z00.6</td><td>Examination for normal comparison and
2019</td><td>IRSANTI</td><td>BOWO SANTOSO 0808 B 06</td><td>KARYAWAN
SWASTA</td><td>SEDAYU RT01
2019</td><td>KASIYEM</td><td></td><td>PETANI/PEKEBUN</td><td>JATI</td><td>JATI</td>
<td>JATIREJO</td><td>PKD JATIREJO</td><td>SUHARNI</td><td> - </td><td>P</td><td>60-
2019</td><td>KASMI</td><td>SAJIMAN</td><td>PETANI/PEKEBUN</td><td>KLEPU</td><td>KLE
align='right'>56080122</td><td>25-02-2019</td><td>KATIJAH</td><td>SISWANTO 06 08 S
38</td><td>PETANI/PEKEBUN</td><td>DUNGKLEPU WETAN RT01 RW 04</td><td>DUNG KLEPU
2019</td><td>KATIYEM</td><td>DARMO</td><td>PETANI/PEKEBUN</td><td>SALAM</td><td>SAL
AM</td><td>TLOGOSARI</td><td>PUSTU TLOGOSARI</td><td>SULARNO,S.Kep.Ns</td><td> -
d align='right'>Z24.4</td><td>Need for immunization against measles
align='right'>55020087</td><td>25-02-2019</td><td>KEVIN</td><td>SURONO 0502 S
BEKERJA</td><td>GIRIROTO</td><td>GIRIROTO</td><td>JATIREJO</td><td>INDUK</td><td>dr
. BUDI ASHARI</td><td>RISTINA Amd Keb</td><td>L</td><td>1-4 Thn.</td><td>Datang
align='right'>54065163</td><td>25-02-2019</td><td>KRISTIYANI</td><td>EDI
HARTONO</td><td>MENGURUS RUMAH
TANGGA</td><td>BAYEM</td><td>BAYEM</td><td>BAYEMHARJO</td><td>PUSTU
2019</td><td>LINDA FATMAWATI</td><td>JUMIN 0715 J 01</td><td>LAINNYA</td><td>SAWIT
KIDUL RT02 RW14</td><td>PUCANGANOM
KIDUL</td><td>PUCANGANOM</td><td>INDUK</td><td>dr. BUDI ASHARI</td><td>UMI NUR
</tr><tr><td align='right'>H58.8</td><td>Other specified disorders of eye and
2019</td><td>MARISIH</td><td>MARISIH 0602 M
align='right'>56080008</td><td>25-02-2019</td><td>MARIYEM</td><td>MULYADI 06 08 M
2019</td><td>MIJEM</td><td>RAHMANTO</td><td>PETANI/PEKEBUN</td><td>TLOGO</td><td>TL
OGO</td><td>TLOGOHARJO</td><td>PKD TLOGOHARJO</td><td>SRI SUPATMI</td><td> -
2019</td><td>MISNI</td><td>MISNI</td><td>PETANI/PEKEBUN</td><td>KLEPU</td><td>KLEPU
</td><td>NGARGOHARJO</td><td>PUSTU NGARGOHARJO</td><td>SUSI HERAWATI, AMK</td><td>
2019</td><td>MISNO</td><td>MISNO</td><td>PETANI/PEKEBUN</td><td>BAYEM</td><td>BAYEM
</td><td>BAYEMHARJO</td><td>PUSTU BAYEMHARJO</td><td>RISTINA Amd Keb</td><td> -
align='right'>51037019</td><td>25-02-
2019</td><td>MUJIYEM</td><td>RAJIMIN</td><td>PETANI/PEKEBUN</td><td>PRINGKUKU</td><
d></tr><tr><td align='right'>N34.3</td><td>Urethral
syndrome, unspecified</td><td></td><td align='right'>289080</td><td
align='right'>54080062</td><td>25-02-2019</td><td>MULYADI</td><td>MULYADI 04 08 M
03</td><td>PEGAWAI NEGERI SIPIL</td><td>NGANTAP RT02
2019</td><td>NGATIYEM</td><td>SOGIMAN</td><td>PETANI/PEKEBUN</td><td>NGRINGIN</td><
td>NGRINGIN</td><td>NGARGOHARJO</td><td>PUSTU NGARGOHARJO</td><td>SUSI HERAWATI,
align='right'>51027006</td><td>25-02-
2019</td><td>NGATIYEM</td><td>SOGIMAN</td><td>PETANI/PEKEBUN</td><td>NGRINGIN</td><
td>NGRINGIN</td><td>NGARGOHARJO</td><td>PUSTU NGARGOHARJO</td><td>SUSI HERAWATI,
align='right'>57030419</td><td>25-02-2019</td><td>NUR FAIZAH MUFIDAH</td><td>PAIMAN
0703 P 14</td><td>KARYAWAN SWASTA</td><td>KUWANG RT03
align='right'>C96.2</td><td>Malignant mast cell tumour</td><td></td><td
2019</td><td>NURANI UTAMI</td><td>HERIYANTO 07 05 H 01</td><td>BURUH HARIAN
LEPAS</td><td>SUKOROYM KULON RT01 RW03</td><td>SUKOROYOM
2019</td><td>PAIMIN</td><td>PAIMIN</td><td>PETANI/PEKEBUN</td><td>SOKO</td><td>SOKO
</td><td>TLOGOSARI</td><td>PUSTU TLOGOSARI</td><td>SULARNO,S.Kep.Ns</td><td> -
align='right'>57040114</td><td>25-02-2019</td><td>PAINAH</td><td>PAINAH 07 04 P
align='right'>57020141</td><td>25-02-2019</td><td>PAIYEM</td><td>PAIDI 07 02 P
Sendiri</td><td>Lama</td><td>JAMKESDA</td><td>Rujuk</td><td align='right'></td><td
align='right'>57125025</td><td>25-02-2019</td><td>PARMI</td><td>RAIL 07 12 R
01</td><td>PETANI/PEKEBUN</td><td>INGAK INGUK RT 02 RW 16</td><td>INGAK -
d></tr><tr><td align='right'>S51</td><td>Open wound of forearm</td><td></td><td
2019</td><td>PARMIN</td><td>SUPARMIN 0104 S
RW02</td><td>KLEPU</td><td>NGARGOHARJO</td><td>INDUK</td><td>drg.DANAR
WULANDARI</td><td>SUGIYONO,S.Kep.Ns</td><td>L</td><td>60-69 Thn.</td><td>Datang
></tr><tr><td align='right'>L29.9</td><td>Pruritus, unspecified</td><td></td><td
ASTUTI</td><td>SARJONO</td><td>PETANI/PEKEBUN</td><td>SENGON
RT02/04</td><td>SENGON</td><td>JATIREJO</td><td>PKD
2019</td><td>PUSPITA AYUNINGTYAS</td><td>MUJI
WAHYONO</td><td>PELAJAR/MAHASISWA</td><td>SOKO</td><td>SOKO</td><td>TLOGOSARI</td><
td>PUSTU TLOGOSARI</td><td>SULARNO,S.Kep.Ns</td><td> - </td><td>P</td><td>15-19
align='right'>57080192</td><td>25-02-2019</td><td>RAKIJO</td><td>RAKIJO 0708 R
05</td><td>PETANI/PEKEBUN</td><td>PUCANGANOM KIDUL RT02 RW08</td><td>PUCANGANOM
align='right'>53025046</td><td>25-02-
2019</td><td>REZA</td><td>NARKO</td><td>BELUM/TIDAK
BEKERJA</td><td>SAMBIREJO</td><td>SAMBIREJO</td><td>TLOGOHARJO</td><td>PKD
TLOGOHARJO</td><td>SRI SUPATMI</td><td> - </td><td>L</td><td>5-9
align='right'>S80.9</td><td>Superficial injury of lower leg,
align='right'>55040078</td><td>25-02-2019</td><td>RUSMIATI </td><td>SUPARSO 0504 S
16</td><td>MENGURUS RUMAH TANGGA</td><td>KANIGORO RT02
></tr><tr><td align='right'>M13.9</td><td>Arthritis,
align='right'>51017041</td><td>25-02-
2019</td><td>SAINEM</td><td></td><td>PETANI/PEKEBUN</td><td>PELET</td><td>PELET</td
><td>NGARGOHARJO</td><td>PUSTU NGARGOHARJO</td><td>SUSI HERAWATI, AMK</td><td> -
align='right'>51017041</td><td>25-02-
2019</td><td>SAINEM</td><td></td><td>PETANI/PEKEBUN</td><td>PELET</td><td>PELET</td
><td>NGARGOHARJO</td><td>PUSTU NGARGOHARJO</td><td>SUSI HERAWATI, AMK</td><td> -
2019</td><td>SAINO</td><td>SAINO</td><td>PETANI/PEKEBUN</td><td>TLOGOSARI</td><td>T
align='right'>52087025</td><td>25-02-
2019</td><td>SAINO</td><td>SAINO</td><td>PETANI/PEKEBUN</td><td>TLOGOSARI</td><td>T
2019</td><td>SAKIYO</td><td>SAKIYO</td><td>PETANI/PEKEBUN</td><td>GIRIROTO</td><td>
GIRIROTO</td><td>JATIREJO</td><td>PKD JATIREJO</td><td>SUHARNI</td><td> -
></tr><tr><td align='right'>I63.9</td><td>Cerebral infarction,
align='right'>57080048</td><td>25-02-2019</td><td>SAMIJEM</td><td>TUGIYO 0708 T
align='right'>52110003</td><td>25-02-
2019</td><td>SAMINO</td><td>SAMINO</td><td>PERANGKAT
DESA</td><td>TAMBAK</td><td>TAMBAK</td><td>TLOGOSARI</td><td>PUSTU
2019</td><td>SAMPENI</td><td>SUWARNO 07 09 S
LOR</td><td>PUCANGANOM</td><td>INDUK</td><td>drg.DANAR WULANDARI</td><td>RIZKI
align='right'>57060072</td><td>25-02-2019</td><td>SATUTI</td><td>SUTARTO 0706 S
09</td><td>PENSIUNAN</td><td>TAMBASARI
</td><td>TAMBAHSARI</td><td>PUCANGANOM</td><td>INDUK</td><td>dr. BUDI
2019</td><td>SOKIDI</td><td>SOKIDI</td><td>PETANI/PEKEBUN</td><td>GLAGAH</td><td>GL
align='right'>50120294</td><td>25-02-2019</td><td>SRI BROTO R</td><td>SRI BROTO R
1212 S
01</td><td>PEDAGANG</td><td>PIYUNGAN</td><td></td><td>DIY</td><td>INDUK</td><td>dr.
align='right'>57050256</td><td>25-02-2019</td><td>SUGINEM</td><td>SUKIRMAN 0705 S
09</td><td>PETANI/PEKEBUN</td><td>SUKOROYOM KULON RT03/03</td><td>SUKOROYOM
2019</td><td>SUKATNI</td><td>SARIMIN</td><td>PETANI/PEKEBUN</td><td>NGRINGIN</td><t
align='right'>57050150</td><td>25-02-
2019</td><td>SUKIRMAN</td><td>SUKIRMAN</td><td>PELAJAR/MAHASISWA</td><td>SUKOROYOM
align='right'>52140021</td><td>25-02-2019</td><td>SUKIYAH</td><td>SUYANI0214 S
01</td><td>BURUH HARIAN
LEPAS</td><td>GUPAKAN</td><td>GUPAKAN</td><td>TLOGOSARI</td><td>INDUK</td><td>dr.
Sendiri</td><td>Lama</td><td>Lain-lain</td><td>Rajal</td><td
align='right'>N99.8</td><td>Other postprocedural disorders of genitourinary
system</td><td></td><td align='right'>289074</td><td
align='right'>56045072</td><td>25-02-2019</td><td>SULARMI</td><td>DARMIN 0604 D
02</td><td>PELAJAR/MAHASISWA</td><td>KETONGGO</td><td>KETONGGO</td><td>GIRITONTRO</
2019</td><td>SUMI</td><td>SUTAR</td><td>PETANI/PEKEBUN</td><td>KRANGGAN</td><td>KRA
NGGAN</td><td>TLOGOHARJO</td><td>PUSTU BAYEMHARJO</td><td>RISTINA Amd Keb</td><td>
- </td><td>P</td><td>>70 Thn.</td><td>Datang Sendiri</td><td>Lama</td><td>UMUM
2019</td><td>SUNARTI</td><td>SOKIRAN 03 06 S 04</td><td>MENGURUS RUMAH
TANGGA</td><td>KLEPU RT01
></tr><tr><td align='right'>M05</td><td>Seropositive rheumatoid
arthritis</td><td></td><td align='right'>289096</td><td
align='right'>56100055</td><td>25-02-2019</td><td>SUPRIYANTO</td><td>SUPRIYANTO
0610 S 03</td><td>TENTARA NASIONAL
INDONESIA</td><td>TANGGUNG</td><td></td><td>GIRITONTRO</td><td>INDUK</td><td>dr.
></tr><tr><td align='right'>I51.9</td><td>Heart disease,
align='right'>54050037</td><td>25-02-2019</td><td>SURAHMIN </td><td>SURAHMIN 0405
S 09</td><td>PETANI/PEKEBUN</td><td>DOLOGAN RT 01 RW
02</td><td>DOLOGAN</td><td>BAYEMHARJO</td><td>INDUK</td><td>dr. BUDI
align='right'>57160041</td><td>25-02-2019</td><td>SURATI</td><td>SUROTO 07 16 S
11</td><td>PETANI/PEKEBUN</td><td>SAWIT LOR RT03 RW13</td><td>SAWIT
LOR</td><td>PUCANGANOM</td><td>INDUK</td><td>dr. BUDI ASHARI</td><td>UMI NUR
</tr><tr><td align='right'>R51</td><td>Headache</td><td></td><td
2019</td><td>SURIPNI</td><td>SURIPNI</td><td>PELAJAR/MAHASISWA</td><td>JATI</td><td
>JATI</td><td>JATIREJO</td><td>PKD JATIREJO</td><td>SUHARNI</td><td> -
2019</td><td>SURIPNI</td><td>SURIPNI</td><td>PELAJAR/MAHASISWA</td><td>JATI</td><td
>JATI</td><td>JATIREJO</td><td>PKD JATIREJO</td><td>SUHARNI</td><td> -
2019</td><td>SURYANI</td><td>JOKO</td><td>PETANI/PEKEBUN</td><td>GIRIROTO</td><td>G
IRIROTO</td><td>JATIREJO</td><td>PKD JATIREJO</td><td>SUHARNI</td><td> -
2019</td><td>SUTIYEM</td><td></td><td>PETANI/PEKEBUN</td><td>SALAM</td><td>SALAM</t
2019</td><td>SUTRISNI</td><td>MUJI
WAHYONO</td><td>PETANI/PEKEBUN</td><td>SOKO</td><td>SOKO</td><td>TLOGOSARI</td><td>
PUSTU TLOGOSARI</td><td>SULARNO,S.Kep.Ns</td><td> - </td><td>P</td><td>20-44
align='right'>51037075</td><td>25-02-
2019</td><td>SUTRIYATMI</td><td>WARSINO</td><td>MENGURUS RUMAH
align='right'>51037075</td><td>25-02-
2019</td><td>SUTRIYATMI</td><td>WARSINO</td><td>MENGURUS RUMAH
/td></tr><tr><td align='right'>K02.1</td><td>Caries of dentine</td><td></td><td
align='right'>57030042</td><td>25-02-2019</td><td>SUYANTI</td><td>MARDI
0703 M
20</td><td>PELAJAR/MAHASISWA</td><td>KUWANG</td><td>KUWANG</td><td>PUCANGANOM</td><
td>INDUK</td><td>dr. BUDI ASHARI</td><td>SUGIYONO,S.Kep.Ns</td><td>P</td><td>20-44
align='right'>56070147</td><td>25-02-2019</td><td>SUYATMAN</td><td>SUYATMAN 06 07 S
2019</td><td>TINI</td><td>TINI</td><td>PETANI/PEKEBUN</td><td>GENTUNG</td><td>GENTU
NG</td><td>NGARGOHARJO</td><td>PUSTU NGARGOHARJO</td><td>SUSI HERAWATI,
align='right'>55025040</td><td>25-02-
align='right'>56020642</td><td>25-02-2019</td><td>TULATMI</td><td>WARSINO 0602 W
07</td><td>WIRASWASTA</td><td>GIRITONTRO KIDUL RT 02 RW 03</td><td>GIRITONTRO
align='right'>56010111</td><td>25-02-2019</td><td>TUYEM</td><td>TUYEM 0601 T
04</td><td>PETANI/PEKEBUN</td><td>GIRITONTRO LOR</td><td>GIRITONTRO
align='right'>54065005</td><td>25-02-2019</td><td>UNTUNG BAYU
AJI</td><td></td><td>PELAJAR/MAHASISWA</td><td>BAYEM</td><td>BAYEM</td><td>BAYEMHAR
JO</td><td>PUSTU BAYEMHARJO</td><td>RISTINA Amd Keb</td><td> -
align='right'>57160013</td><td>25-02-2019</td><td>WAGIMAN</td><td>WAGIMAN 0716 W
02</td><td>PETANI/PEKEBUN</td><td>SAWIT LOR RT01 RW13</td><td>SAWIT
align='right'>56080041</td><td>25-02-2019</td><td>WAGINI</td><td>JUWANDI 0608 J
01</td><td>BURUH HARIAN LEPAS</td><td>DUNGKLEPU WETAN</td><td>DUNG KLEPU
2019</td><td>WAKIJEM</td><td>PARMIN 0701 P
INDUK</td><td>dr. BUDI ASHARI</td><td>SUGIYONO,S.Kep.Ns</td><td>P</td><td>45-54
align='right'>56035055</td><td>25-02-2019</td><td>WARNI</td><td>SRI
HARMADI</td><td>MENGURUS RUMAH
TANGGA</td><td>GEBLUG</td><td>GEBLUG</td><td>GIRITONTRO</td><td>INDUK</td><td>dr.
align='right'>54055021</td><td>25-02-
2019</td><td>WARNO</td><td>WARNO</td><td>PETANI/PEKEBUN</td><td>DOLOGAN</td><td>DOL
OGAN</td><td>BAYEMHARJO</td><td>PUSTU BAYEMHARJO</td><td>RISTINA Amd Keb</td><td> -
</td><td>L</td><td>45-54 Thn.</td><td>Datang Sendiri</td><td>Baru</td><td>BPJS
align='right'>57030444</td><td>25-02-2019</td><td>WATIK</td><td>SLAMET SANTOSO 0703
S 44</td><td>PETANI/PEKEBUN</td><td>KUWANG RT02
WETAN</td><td></td><td>PUCANGANOM</td><td>INDUK</td><td>drg.DANAR
</tr><tr><td align='right'>K05.1</td><td>Chronic gingivitis</td><td></td><td
2019</td><td>ALDIRA PRAMESTI</td><td>SARNO 0102 S
18</td><td>PELAJAR/MAHASISWA</td><td>NGRINGIN RT02
</tr><tr><td align='right'>H60.9</td><td>Otitis externa,
align='right'>57050074</td><td>26-02-2019</td><td>ALIKA</td><td>SURATNO 07 05 S
31</td><td>PELAJAR/MAHASISWA</td><td>SUKOROYOM KULON</td><td>SUKOROYOM
/td></tr><tr><td align='right'>K00.6</td><td>Disturbances in tooth
align='right'>53080070</td><td>26-02-2019</td><td>ALYA KAYSHA
ZAAFARANI</td><td>SUHONO 03 08 S 11</td><td>BELUM/TIDAK BEKERJA</td><td>GIBNADE
KULON RT 01 RW 03</td><td>GINADE
align='right'>C50</td><td>Malignant neoplasm of breast</td><td></td><td
2019</td><td>ANDITA</td><td>JOKO PURNOMO 0104 J 01</td><td>LAINNYA</td><td>KLEPU
RT03 RW05,NGARGOHARJO</td><td>KLEPU</td><td>NGARGOHARJO</td><td>INDUK</td><td>dr.
align='right'>57020151</td><td>26-02-2019</td><td>ARIF RAHMAN
NURDIANSYAH</td><td>RIYANTO 07 02 R 02</td><td>BELUM/TIDAK
BEKERJA</td><td>SUKOROYOM WETAN RT03 RW04</td><td>SUKOROYOM
align='right'>57050189</td><td>26-02-2019</td><td>AZIZAH ZASKIA</td><td>MARYOTO
0705 M 02</td><td>PELAJAR/MAHASISWA</td><td>SUKOROYOM KULON RT01
align='right'>B08.4</td><td>Enteroviral vesicular stomatitis with
exanthem</td><td></td><td align='right'>289143</td><td
align='right'>57130042</td><td>26-02-2019</td><td>CHIKO ARYA
ARSYAFATH</td><td>SUNARYO 0713 S 23</td><td>BELUM/TIDAK BEKERJA</td><td>KEPUH
ASHARI</td><td>SRI SUPATMI</td><td>L</td><td>1-4 Thn.</td><td>Datang
td></tr><tr><td align='right'>J45</td><td>Asthma</td><td></td><td
2019</td><td>DIMIN</td><td>DIMIN 07 07 D 03</td><td>PETANI/PEKEBUN</td><td>BANJAR
/td></tr><tr><td align='right'>Z34.8</td><td>Supervision of other normal
align='right'>53050018</td><td>26-02-2019</td><td>DINA SARTINI RIA
PUTRININGSIH</td><td>SLAMET RIYADI 03 05 S 06</td><td>KARYAWAN
SWASTA</td><td>PLARENG RT 02 RW
align='right'>57040250</td><td>26-02-2019</td><td>ELISA FEBRIANI</td><td>SUGINO
0704 S 10</td><td>PERANGKAT DESA</td><td>MANDEYAN RT02
></tr><tr><td align='right'>R50</td><td>Fever of other and unknown
origin</td><td></td><td align='right'>289141</td><td
align='right'>56100182</td><td>26-02-2019</td><td>FAISAL</td><td>JUMALI 0610 J
02</td><td></td><td>TANGGUNG</td><td>TANGGUNG</td><td>GIRITONTRO</td><td>INDUK</td>
<td>dr. BUDI ASHARI</td><td>SRI SUPATMI</td><td>L</td><td>1-4 Thn.</td><td>Datang
2019</td><td>FAJRINA ZAHWA NURILIA PUTRI</td><td>ARYANTO 0505 A
2019</td><td>FAJRINA ZAHWA NURILIA PUTRI</td><td>ARYANTO 0505 A
align='right'>51017018</td><td>26-02-2019</td><td>HENI </td><td>SUPARSO 0101 S
11</td><td>MENGURUS RUMAH TANGGA</td><td>PELET RT01
2019</td><td>HULIYAH YANI</td><td>WINARDI 0704 W 03</td><td>MENGURUS RUMAH
TANGGA</td><td>MANDEYAN RT02
></tr><tr><td align='right'>H60.8</td><td>Other otitis
externa</td><td></td><td align='right'>289155</td><td
align='right'>56010057</td><td>26-02-2019</td><td>KIARA RIZQITA
NABILLA</td><td>TUKIMAN 0601 T 05</td><td>PELAJAR/MAHASISWA</td><td>GIRITONTRO
align='right'>289113</td><td align='right'>57020081</td><td>26-02-2019</td><td>LENI
WULANSARI</td><td>SUNARDI 0702 S 28</td><td>MENGURUS RUMAH
TANGGA</td><td>SUKOROYOM WETAN</td><td>SUKOROYOM
align='right'>57125006</td><td>26-02-2019</td><td>LIYEP</td><td>MULYONO 0712 M
07</td><td>PETANI/PEKEBUN</td><td>NGAK NGUK RT02
2019</td><td>MARSINI</td><td>DUKUT 06 05 D
></tr><tr><td align='right'>M19.99</td><td>Arthrosis, unspecified, unspecified
site</td><td></td><td align='right'>289128</td><td
align='right'>56100148</td><td>26-02-2019</td><td>NGATIYEM</td><td>TUMIN 06 10 T
ROCHMAN</td><td>HASAN 0102 H 02</td><td>KARYAWAN SWASTA</td><td>NGRINGIN RT01
td></tr><tr><td align='right'>Z34.8</td><td>Supervision of other normal
align='right'>51010103</td><td>26-02-2019</td><td>ODILIA NUHANA DEWI
</td><td>SUPARSO 0101 S 11</td><td>PETANI/PEKEBUN</td><td>PELET RT01
align='right'>51010043</td><td>26-02-2019</td><td>ROJATUN HANDAYANI</td><td>AGUS
TERIYANTO 01 01 A 03</td><td>PEGAWAI NEGERI SIPIL</td><td>PELET RT01
></tr><tr><td align='right'>S61.8</td><td>Open wound of other parts of wrist and
align='right'>55060113</td><td>26-02-2019</td><td>SARMONO</td><td>SARMONO 0506 S
25</td><td>WIRASWASTA</td><td>JATI RT 03
2019</td><td>SARNO</td><td>SARNO 0102 S
18</td><td>PETANI/PEKEBUN</td><td>NGRINGIN</td><td></td><td>NGARGOHARJO</td><td>IND
UK</td><td>dr. BUDI ASHARI</td><td>SUGIYONO,S.Kep.Ns</td><td>L</td><td>45-54
></tr><tr><td align='right'>S51</td><td>Open wound of forearm</td><td></td><td
2019</td><td>SARTI</td><td>SARTI 0410 S 21</td><td>PETANI/PEKEBUN</td><td>GUNUNG
BROMO RT02 RW07</td><td>GUNUNG BROMO</td><td>BAYEMHARJO</td><td>INDUK</td><td>dr.
align='right'>56020310</td><td>26-02-2019</td><td>SARWINI</td><td>BOWO P 06 02 B
01</td><td>PEGAWAI NEGERI SIPIL</td><td>GIRITONTRO KIDUL RT02
></tr><tr><td align='right'>A01.4</td><td>Paratyphoid fever,
align='right'>51050021</td><td>26-02-2019</td><td>SATRIA AJI</td><td>SUPRAPTO 0105
S 08</td><td>KARYAWAN SWASTA</td><td>GENTUNG RT02
/td></tr><tr><td align='right'>F20.6</td><td>Simple schizophrenia</td><td></td><td
2019</td><td>SEPI</td><td>SEPI 0311 S 13</td><td>PETANI/PEKEBUN</td><td>GINADE
ETAN RT03 RW03</td><td>GINADE ETAN</td><td>TLOGOHARJO</td><td>INDUK</td><td>dr.
align='right'>56010218</td><td>26-02-2019</td><td>SITI HAYATI</td><td>SUNARDI 06 01
S 34</td><td>PEGAWAI NEGERI SIPIL</td><td>GIRITONTRO LOR RT01
RW01</td><td>GIRITONTRO LOR</td><td>GIRITONTRO</td><td>INDUK</td><td>drg.DANAR
</tr><tr><td
align='right'>57060032</td><td>26-02-2019</td><td>SITI NUR HAYATI</td><td>IBUN
0706 I 01</td><td>MENGURUS RUMAH
TANGGA</td><td>TAMBAKSARI</td><td>TAMBAHSARI</td><td>PUCANGANOM</td><td>INDUK</td><
td>dr. BUDI ASHARI</td><td>SUGIYONO,S.Kep.Ns</td><td>P</td><td>20-44
align='right'>57090246</td><td>26-02-2019</td><td>SRI SAYEKTI</td><td>GUNADI 07 09
G 01</td><td>PETANI/PEKEBUN</td><td>PUCANGANOM LOR RT 01RW 09</td><td>PUCANGANOM
</td></tr><tr><td align='right'>L20.9</td><td>Atopic dermatitis,
align='right'>56040023</td><td>26-02-2019</td><td>SUGER SUTRISNO</td><td>SUGER
SUTRISNO 06 04 S 02</td><td>PETANI/PEKEBUN</td><td>KETONGGO RTN 02 RW
07</td><td>KETONGGO</td><td>GIRITONTRO</td><td>INDUK</td><td>dr. BUDI
></tr><tr><td align='right'>J01.9</td><td>Acute sinusitis,
align='right'>56010046</td><td>26-02-2019</td><td>SUGIYEM</td><td>IRFAN SUHARTOYO
06 01 I 02</td><td>MENGURUS RUMAH TANGGA</td><td>GIRITONTRO LOR RT2
align='right'>51047017</td><td>26-02-
2019</td><td>SUKIJEM</td><td>KADI</td><td>PETANI/PEKEBUN</td><td>KLEPU</td><td>KLEP
U</td><td>NGARGOHARJO</td><td>PKD NGARGOHARJO</td><td>HENI WIDIYASTUTI</td><td> -
2019</td><td>SUTINAH</td><td>SUGER 0604 S
02</td><td>PETANI/PEKEBUN</td><td>KETONGGO RT02
></tr><tr><td align='right'>C50.9</td><td>Malignant neoplasm of breast,
align='right'>51010003</td><td>26-02-2019</td><td>TUGINEM</td><td>SOGIMIN 0101 S
09</td><td>PETANI/PEKEBUN</td><td>PELET</td><td>PELET</td><td>NGARGOHARJO</td><td>I
NDUK</td><td>dr. BUDI ASHARI</td><td>SUGIYONO,S.Kep.Ns</td><td>P</td><td>60-69
2019</td><td>TUMINI</td><td>WARSO 0302 W
02</td><td>PETANI/PEKEBUN</td><td>SAMBIREJO</td><td>SAMBIREJO</td><td>TLOGOHARJO</t
align='right'>56020601</td><td>26-02-2019</td><td>UMAR NAYIRI</td><td>UMAR NAYIRI
0602 U 01</td><td>PEGAWAI NEGERI SIPIL</td><td>GIRITONTRO KIDUL RT04
align='right'>53010040</td><td>26-02-2019</td><td>VANIA ZASKIA AZAHRA</td><td>TRI
WIDIYANTO</td><td>BELUM/TIDAK
BEKERJA</td><td>TLOGO</td><td></td><td>TLOGOHARJO</td><td>INDUK</td><td>drg.DANAR
2019</td><td>WIWIT PRIHATIN</td><td>SUPRIADI 07 07 S 37</td><td>MENGURUS RUMAH
TANGGA</td><td>BANJAR RT 03 RW
></tr><tr><td align='right'>S90</td><td>Superficial injury of ankle and
foot</td><td></td><td align='right'>289135</td><td
align='right'>56020311</td><td>26-02-2019</td><td>YESI CATUR P</td><td>GANA 06 02 G
01</td><td>PEGAWAI NEGERI SIPIL</td><td>GIRITONTRO KIDOL</td><td>GIRITONTRO
align='right'>57090258</td><td>26-02-2019</td><td>YETI</td><td>HARNO 0709 H
02</td><td>MENGURUS RUMAH TANGGA</td><td>PUCANGANOM LOR RT01
RW09</td><td>PUCANGANOM LOR</td><td>PUCANGANOM</td><td>INDUK</td><td>drg.DANAR
align='right'>L20</td><td>Atopic dermatitis</td><td></td><td
align='right'>289152</td><td align='right'>57090256</td><td>26-02-2019</td><td>ZIAN
CANDRA MUSTOFA</td><td>YATNO / M. MUSTOFA 0709 Y 01</td><td>BELUM/TIDAK
BEKERJA</td><td>PUCANGANOM LOR</td><td>PUCANGANOM
LOR</td><td>PUCANGANOM</td><td>INDUK</td><td>dr. BUDI ASHARI</td><td>SRI
SUPATMI</td><td>L</td><td>8-30 hari</td><td>Datang
2019</td><td>ADITYA</td><td>WIYONO/LILIK JOKO P 0705 W 01</td><td>BELUM/TIDAK
2019</td><td>AHMAD FAJRIN DIMAS SATRIA</td><td>SUTOPO 0706 S
02</td><td>BELUM/TIDAK BEKERJA</td><td>TAMBAHSARI RT02
td></tr><tr><td align='right'>R50.9</td><td>Fever, unspecified</td><td></td><td
2019</td><td>ATIKA JANI ARANIFA</td><td>SUGIRAN 0608 S 04</td><td>BELUM/TIDAK
BEKERJA</td><td>DUNGKLEPU WETAN</td><td>DUNG KLEPU
align='right'>56010076</td><td>27-02-2019</td><td>CAESAR FADLI
MARDIANTO</td><td>SUTINO 0601 S 53</td><td>PERANGKAT DESA</td><td>GIRITONTRO
align='right'>56070079</td><td>27-02-2019</td><td>DASRINAH</td><td>KATIMIN 0607 K
align='right'>56020273</td><td>27-02-2019</td><td>DIAN PRATIWI</td><td>MISMAN 0602
M 16</td><td>PELAJAR/MAHASISWA</td><td>GIRITONTRO KIDUL</td><td>GIRITONTRO
2019</td><td>ENDANG BUDI NUR SETIANINGSIH</td><td>SUTINO 06 01 S
53</td><td>MENGURUS RUMAH TANGGA</td><td>GIRITONTRO LOR RT.03
RW.01</td><td>GIRITONTRO LOR</td><td>GIRITONTRO</td><td>INDUK</td><td>drg.DANAR
align='right'>58080188</td><td>27-02-2019</td><td>FAUZAL USNA</td><td>MUSLIM 0808
M
13</td><td>PELAJAR/MAHASISWA</td><td>PULOSARI</td><td></td><td>PRACIMANTORO</td><td
>INDUK</td><td>drg.DANAR WULANDARI</td><td>RIZKI ANISSA, AM.Kg</td><td>P</td><td>5-
9 Thn.</td><td>Datang Sendiri</td><td>Lama</td><td>Umum</td><td>Rajal</td><td
align='right'>56020378</td><td>27-02-2019</td><td>FITRIANI</td><td>HERU SULISTYO
0602 H 07</td><td>BURUH HARIAN LEPAS</td><td>GIRITONTRO KIDUL</td><td>GIRITONTRO
2019</td><td>GINO</td><td>GINO 06 02 G 02</td><td>PEGAWAI NEGERI
SIPIL</td><td>GIRITONTRO RT 02 RW 03</td><td>GIRITONTRO
align='right'>54070089</td><td>27-02-2019</td><td>ILHAM D P</td><td>SURANTO 0409 S
02</td><td>PELAJAR/MAHASISWA</td><td>NGALURAN RT01
></tr><tr><td align='right'>I50</td><td>Heart failure</td><td></td><td
2019</td><td>KARENDI</td><td>KARENDI 0710 K
align='right'>57020351</td><td>27-02-2019</td><td>KARSI</td><td>SUWARNO 0702 S
align='right'>57135006</td><td>27-02-2019</td><td>KARTINEM</td><td>MULYONO 0713 M
align='right'>55080041</td><td>27-02-2019</td><td>KASIYEM</td><td>KASIYEM 05 08 K
01</td><td>PELAJAR/MAHASISWA</td><td>NGORODOWO RT 04 RW
03</td><td>NGORODOWO</td><td>JATIREJO</td><td>INDUK</td><td>dr. BUDI
d></tr><tr><td align='right'>H58.8</td><td>Other specified disorders of eye and
2019</td><td>KASMI</td><td>TEGUH 06 03 T 03</td><td>PETANI/PEKEBUN</td><td>GEBLUG
RT04 RW07</td><td>GEBLUG</td><td>GIRITONTRO</td><td>INDUK</td><td>dr. BUDI
2019</td><td>MUHAMMAD AL FARIZI</td><td>ALI 0714 A 03</td><td>BELUM/TIDAK
BEKERJA</td><td>PENDEM RT02
td></tr><tr><td align='right'>N60.2</td><td>Fibroadenosis of
breast</td><td></td><td align='right'>289192</td><td
align='right'>56030127</td><td>27-02-2019</td><td>NARISEM</td><td>WARSINO 0603 W
02</td><td>MENGURUS RUMAH TANGGA</td><td>GEBLUG
RT</td><td>GEBLUG</td><td>GIRITONTRO</td><td>INDUK</td><td>dr. BUDI
align='right'>44</td><td>KIA</td><td>Poli Bedah</td><td>RSUD DR. SOEDIRAN MS
align='right'>S51.9</td><td>Open wound of forearm, part
align='right'>51040062</td><td>27-02-2019</td><td>PARMIN</td><td>SUPARMIN 0104 S
RW02</td><td>KLEPU</td><td>NGARGOHARJO</td><td>INDUK</td><td>dr. BUDI
2019</td><td>RENANDO GHAISAN USTADI</td><td>DANIK USTADI 0610 D
02</td><td>BELUM/TIDAK BEKERJA</td><td>GIRITONTRO KIDUL</td><td>GIRITONTRO
ASHARI</td><td>SUHARNI</td><td>L</td><td><1 Thn.</td><td>Datang
align='right'>53050091</td><td>27-02-2019</td><td>RIKI HARDI IRAWAN</td><td>SUHARDI
0305 S 13</td><td>PETANI/PEKEBUN</td><td>PLARENG RT03
></tr><tr><td align='right'>A01.4</td><td>Paratyphoid fever,
align='right'>57090188</td><td>27-02-2019</td><td>RIZKI A P</td><td>SURADI 07 09 S
</tr><tr><td align='right'>I11.9</td><td>Hypertensive heart disease without
align='right'>57080048</td><td>27-02-2019</td><td>SAMIJEM</td><td>TUGIYO 0708 T
d></tr><tr><td align='right'>H65.0</td><td>Acute serous otitis
align='right'>56020681</td><td>27-02-2019</td><td>SANKARTO</td><td>SANKARTO /
SURATMAN 0602 S 20</td><td>PEDAGANG</td><td>GIRITONTRO KIDUL</td><td>GIRITONTRO
align='right'>54060075</td><td>27-02-2019</td><td>SATIMAN</td><td>SATIMAN 04 06 S
03</td><td>PETANI/PEKEBUN</td><td>BAYEMHARJO RT02
align='right'>53060053</td><td>27-02-2019</td><td>SUNARTI</td><td>SOKIRAN 03 06 S
04</td><td>MENGURUS RUMAH TANGGA</td><td>KLEPU RT01
align='right'>52095020</td><td>27-02-2019</td><td>SUPARMI</td><td>SUGIMIN 0209 S
RW03</td><td>KLEPU</td><td>TLOGOSARI</td><td>INDUK</td><td>dr. BUDI
align='right'>54060055</td><td>27-02-2019</td><td>SUTARNO </td><td>SUTARNO 04 06
S 08</td><td>PENSIUNAN</td><td>BAYEM RT02
RW01,BAYEMHARJO</td><td>BAYEM</td><td>BAYEMHARJO</td><td>INDUK</td><td>dr. BUDI
align='right'>52080070</td><td>27-02-2019</td><td>SYIFA MEHRUNISA</td><td>SUMARDI
NATA 0208 S 19</td><td>PELAJAR/MAHASISWA</td><td>TLOGOSARI
</td><td>TLOGOSARI</td><td>TLOGOSARI</td><td>INDUK</td><td>drg.DANAR
Sendiri</td><td>Baru</td><td>BPJS
tr><tr><td align='right'>I11.9</td><td>Hypertensive heart disease without
align='right'>57040141</td><td>27-02-2019</td><td>TUKIYEM</td><td>PARTO SUWITO
0704 P
<td>INDUK</td><td>dr. BUDI ASHARI</td><td>SUGIYONO,S.Kep.Ns</td><td>P</td><td>>70
d></tr><tr><td align='right'>N92.6</td><td>Irregular menstruation,
align='right'>57070230</td><td>27-02-2019</td><td>TUMINI</td><td>TUMINI 07 07 T
align='right'>H60.9</td><td>Otitis externa, unspecified</td><td></td><td
2019</td><td>WALUYO</td><td>WALUYO 0713 W 06</td><td>PETANI/PEKEBUN</td><td>KEPUH
align='right'>56010260</td><td>27-02-2019</td><td>WARSIMIN</td><td>WARSIMIN 0601
W 08</td><td>PEGAWAI NEGERI SIPIL</td><td>GIRITONTRO LOR</td><td>GIRITONTRO
2019</td><td>WARTONO</td><td>SOKIDI 0211 S 18</td><td>LAINNYA</td><td>TAMBAK RT01
2019</td><td>WIDATMI</td><td>HALDOKO 0704 H 06</td><td>MENGURUS RUMAH
TANGGA</td><td>MANDEYAN RT01
align='right'>57090258</td><td>27-02-2019</td><td>YETI</td><td>HARNO 0709 H
02</td><td>MENGURUS RUMAH TANGGA</td><td>PUCANGANOM LOR RT01
RW09</td><td>PUCANGANOM LOR</td><td>PUCANGANOM</td><td>INDUK</td><td>dr. BUDI
Umum</td><td>Poli Gigi</td><td>RSUD DR. SOEDIRAN MS WONOGIRI</td><td>Dalam
align='right'>L02.8</td><td>Cutaneous abscess, furuncle and carbuncle of other
sites</td><td></td><td align='right'>289189</td><td
align='right'>56100194</td><td>27-02-2019</td><td>ZAFINA</td><td>NGATMAN 0610 N
2019</td><td>ZULFA UZI AQUARIZTA</td><td>KASINO 0709 K
03</td><td>LAINNYA</td><td>PUCANGANOM LOR 03/09</td><td>PUCANGANOM
align='right'>Z23.0</td><td>Need for immunization against cholera
align='right'>57090131</td><td>27-02-2019</td><td>ZULFA UZI
AQUARIZTA</td><td>KASINO 0709 K 03</td><td>LAINNYA</td><td>PUCANGANOM LOR
03/09</td><td>PUCANGANOM LOR</td><td>PUCANGANOM</td><td>INDUK</td><td>dr. BUDI
2019</td><td>ADIBA SYIFA RAMADHANI</td><td>WAGIMAN 05 01 W
04</td><td>BELUM/TIDAK BEKERJA</td><td>GIRIBELAH RT 03
</tr><tr><td align='right'>A15.5</td><td>Tuberculosis of larynx, trachea and
bronchus, confirmed bacteriologically and histologically</td><td></td><td
2019</td><td>AHYAN ARDHYAN</td><td>SURAHMAN 07 09 S 05</td><td>KARYAWAN
SWASTA</td><td>PUCANGANOM LOR 02/09</td><td>PUCANGANOM
align='right'>58080691</td><td>28-02-2019</td><td>CHELSEA HERA
INKABELA</td><td>BEJO 0808 B
01</td><td>PELAJAR/MAHASISWA</td><td>NOJO,GAMBIRMANIS,PRACIMANTORO</td><td></td><td
>PRACIMANTORO</td><td>INDUK</td><td>drg.DANAR WULANDARI</td><td>RIZKI ANISSA,
AM.Kg</td><td>P</td><td>10-14 Thn.</td><td>Datang
align='right'>B26.9</td><td>Mumps without complication</td><td></td><td
2019</td><td>CLAURANISA ZULFA ASIFA RAMADANI</td><td>SUDARMAN ROHANI 0705 S
BEKERJA</td><td>SUKOROYOM KULON RT03 RW03</td><td>SUKOROYOM
LESTARI</td><td>DWI LESTARI 0710 D 04</td><td>WIRASWASTA</td><td>JEPURUN RT01
align='right'>56090119</td><td>28-02-2019</td><td>ERIK PRASETIYO</td><td>ERIK
PRASETIYO 0609 E 02</td><td>KARYAWAN SWASTA</td><td>DUNGKLEPU KULON RT04
RW04</td><td>DUNG KLEPU KULON</td><td>GIRITONTRO</td><td>INDUK</td><td>dr. BUDI
></tr><tr><td align='right'>S81.0</td><td>Open wound of knee</td><td></td><td
align='right'>57130035</td><td>28-02-2019</td><td>KATIMAN</td><td>KATIMAN 07 13 K
align='right'>289344</td><td align='right'>57010220</td><td>28-02-2019</td><td>MUH.
ZAKI</td><td>PUJIONO 07 01 P 03</td><td>BELUM/TIDAK BEKERJA</td><td>GROGOL
RT.03/02</td><td>GROGOL</td><td>PUCANGANOM</td><td>INDUK</td><td>dr. BUDI
ASHARI</td><td>RETNO AMBARWATI AMD KEB</td><td>L</td><td>1-4 Thn.</td><td>Datang
align='right'>H25.9</td><td>Senile cataract, unspecified</td><td></td><td
align='right'>289358</td><td align='right'>57030208</td><td>28-02-2019</td><td>MUJI
SRI WAHYUNI</td><td>WARSITO 0703 W 02</td><td>PETANI/PEKEBUN</td><td>KUWANG RT02
></tr><tr><td align='right'>Z96.1</td><td>Presence of intraocular
lens</td><td></td><td align='right'>289371</td><td
align='right'>57030424</td><td>28-02-2019</td><td>MUKINI</td><td>PAIJO 07 03 P
></tr><tr><td align='right'>H25.9</td><td>Senile cataract,
align='right'>57070199</td><td>28-02-2019</td><td>PONIYEM</td><td>PONIYEM 07 07 P
align='right'>57130095</td><td>28-02-2019</td><td>RETNO NINGSIH</td><td>RETNO
NINGSIH 07 13 R 03</td><td>MENGURUS RUMAH TANGGA</td><td>KEPUH RT02
</tr><tr><td align='right'>K29.5</td><td>Chronic gastritis,
align='right'>57090227</td><td>28-02-2019</td><td>SAMINEM</td><td>SAYUTI 0709 S
2019</td><td>SAMINO, DRS</td><td>SAMINO, DRS 05 02 S
02</td><td>PENSIUNAN</td><td>GIRIROTO</td><td>GIRIROTO</td><td>JATIREJO</td><td>IND
UK</td><td>dr. BUDI ASHARI</td><td>SUGIYONO,S.Kep.Ns</td><td>L</td><td>>70
></tr><tr><td align='right'>S60.2</td><td>Contusion of other parts of wrist and
align='right'>54100073</td><td>28-02-2019</td><td>SARTI</td><td>SARTI 0410 S
21</td><td>PETANI/PEKEBUN</td><td>GUNUNG BROMO RT02 RW07</td><td>GUNUNG
BROMO</td><td>BAYEMHARJO</td><td>INDUK</td><td>dr. BUDI
align='right'>56080050</td><td>28-02-2019</td><td>SRI HANDAYANI</td><td>SUYITNO
0608 S 26</td><td>PETANI/PEKEBUN</td><td>DUNGKLEPU WETAN RT02 RW04</td><td>DUNG
KLEPU WETAN</td><td>GIRITONTRO</td><td>INDUK</td><td>dr. BUDI
></tr><tr><td align='right'>L24.5</td><td>Irritant contact dermatitis
due to other chemical products</td><td></td><td align='right'>289346</td><td
align='right'>57120074</td><td>28-02-2019</td><td>SRI HARTATIK</td><td>DWI SUYANTO
0712 D 04</td><td>MENGURUS RUMAH TANGGA</td><td>INGAK
INGUK</td><td></td><td>PUCANGANOM</td><td>INDUK</td><td>dr. BUDI
HARTATIK</td><td>DWI SUYANTO 0712 D 04</td><td>MENGURUS RUMAH TANGGA</td><td>INGAK
INGUK</td><td></td><td>PUCANGANOM</td><td>INDUK</td><td>dr. BUDI
LESTARI</td><td>MUSMAN 0712 M 02</td><td>BURUH HARIAN LEPAS</td><td>INGAK
INGUK</td><td>INGAK - INGUK</td><td>PUCANGANOM</td><td>INDUK</td><td>dr. BUDI
align='right'>56050130</td><td>28-02-2019</td><td>SRI LESTARI</td><td>SRI MARYANTO
0605 S 27</td><td>MENGURUS RUMAH TANGGA</td><td>NGUJUNG RT04
></tr><tr><td align='right'>A15</td><td>Respiratory tuberculosis, bacteriologically
and histologically confirmed</td><td></td><td align='right'>289369</td><td
align='right'>56020584</td><td>28-02-2019</td><td>SUGITO</td><td>SUGITO 0602 S
10</td><td>PETANI/PEKEBUN</td><td>GIRITONTRO KDUL 05/03I</td><td>GIRITONTRO
align='right'>55070056</td><td>28-02-2019</td><td>SUKATNO</td><td>SUKATNO 05 07 S
align='right'>53050023</td><td>28-02-2019</td><td>SUKIJO</td><td>SUKIJO 03 05 S
08</td><td>PETANI/PEKEBUN</td><td>PLARENG RT 03 RW
align='right'>56020009</td><td>28-02-2019</td><td>SUKIMAN</td><td>SUKIMAN 0602 S
56</td><td>PEDAGANG</td><td>GIRITONTRO KIDUL</td><td>GIRITONTRO
align='right'>52010006</td><td>28-02-2019</td><td>SULARMI</td><td>WAKINO 02 01 W
02</td><td>PETANI/PEKEBUN</td><td>GEMBUK RT 02 RW
07</td><td>GEMBUK</td><td>TLOGOSARI</td><td>INDUK</td><td>dr. BUDI
></tr><tr><td align='right'>K02.0</td><td>Caries limited to enamel</td><td></td><td
2019</td><td>SULIYANTO</td><td>SULIYANTO 06 01 S
11</td><td>WIRASWASTA</td><td>GIRITONTRO LOR RT02 RW01</td><td>GIRITONTRO
</tr><tr><td align='right'>N18.9</td><td>Chronic renal failure,
align='right'>57030232</td><td>28-02-2019</td><td>SUNADI</td><td>SUNADI 0 7 03 S
align='right'>57090259</td><td>28-02-2019</td><td>SUPARNEM</td><td>SUPARNEM 0709 S
align='right'>K29.4</td><td>Chronic atrophic gastritis</td><td></td><td
2019</td><td>SUPINI</td><td>SUKIJAN 0310 S
08</td><td>PETANI/PEKEBUN</td><td>KELOR
01/04</td><td>KELOR</td><td>TLOGOHARJO</td><td>INDUK</td><td>dr. BUDI
2019</td><td>SUPRIHATIN</td><td>SUGITO 06 02 S 08 </td><td>BURUH HARIAN
LEPAS</td><td>GIRITONTRO KIDUL</td><td>GIRITONTRO
align='right'>53050092</td><td>28-02-2019</td><td>TUMPON</td><td>HARTO 0305 H
02</td><td>PETANI/PEKEBUN</td><td>PLARENG RT03
Sendiri</td><td>Baru</td><td>BPJS PBI</td><td>Rujuk</td><td
d></tr><tr><td
2019</td><td>WARSI</td><td>SURAHMAN 07 09 S
05</td><td>PETANI/PEKEBUN</td><td>PUCANGANOM LOR 02/09</td><td>PUCANGANOM
></tr><tr><td align='right'>G20</td><td>Parkinson's disease</td><td></td><td
2019</td><td>WIDATIN</td><td>BASUNI 0703 B 08</td><td>MENGURUS RUMAH
TANGGA</td><td>KUWANG RT03
></tr><tr><td align='right'>K29.3</td><td>Chronic superficial
gastritis</td><td></td><td align='right'>289350</td><td
align='right'>56100144</td><td>28-02-2019</td><td>YATI SUHAETI</td><td>WAKIMIN 06
10 W 05</td><td>MENGURUS RUMAH
TANGGA</td><td>TANGGUNG</td><td>TANGGUNG</td><td>GIRITONTRO</td><td>INDUK</td><td>d
r. BUDI ASHARI</td><td>SUGIYONO,S.Kep.Ns</td><td>P</td><td>45-54
></tr></table>

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<h2>DATA DIAGNOSIS PASIEN PUSKESMAS</h2>

Periode : 01-02-2019 s/d 28-02-2019<br>

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