Rekap September, Sakit

DAFTAR KUNJUNGAN PESERTA SAKIT
Kantor Cabang : PASURUAN - 1309
FKTP : Wonorejo - 13261401

NO TANGGAL NO KUNJUNGAN NO KARTU NAMA PESERTA SEX JENIS PESERTA DIAGNOSA STATUS PRB PROLANIS
PULANG
1 30-09-2019 132614010919Y001636 0000112642457 MOH. NASIR AMRULLOH L PEGAWAI SWASTA Impacted cerumen Rujuk Vertikal
2 30-09-2019 132614010919Y001635 0000112670436 EVA ROSITA P PEGAWAI SWASTA Impacted cerumen Rujuk Vertikal
3 30-09-2019 132614010919Y001593 0000166594533 NINIK FAIZAH P PNS DAERAH Haemorrhoids Berobat Jalan
4 30-09-2019 132614010919Y001605 0000714828172 AHMAD L PBI (APBN) Other disorders of muscle Berobat Jalan
5 30-09-2019 132614010919Y001630 0000715031572 NASTITI P PBI (APBN) Urticaria Berobat Jalan
6 30-09-2019 132614010919Y001602 0000715038996 WASIATUL IQBAL L PBI (APBN) Acute pharyngitis Berobat Jalan
7 30-09-2019 132614010919Y001606 0000715250169 SAIFUL ROHMAN L PBI (APBN) Asthma Berobat Jalan
8 30-09-2019 132614010919Y001633 0000715484889 FAUZAN L PBI (APBN) Stroke, not specified as Rujuk Vertikal
haemorrhage or infarction
9 30-09-2019 132614010919Y001619 0000715597571 ASMINAH P PBI (APBN) Hyperlipidaemia, Berobat Jalan
unspecified
10 30-09-2019 132614010919Y001621 0000715620857 NURUL HARIANTI P PBI (APBN) Essential (primary) Berobat Jalan
hypertension
11 30-09-2019 132614010919Y001622 0000715620969 CHOLILI L PBI (APBN) Diseases of pulp and Berobat Jalan
periapical tissues
12 30-09-2019 132614010919Y001623 0000715621162 UMI SARO P PBI (APBN) Allergic contact dermatitis Berobat Jalan
13 30-09-2019 132614010919Y001624 0000715621443 MUHAMMAD JAMIK L PBI (APBN) Essential (primary) Berobat Jalan
hypertension
14 30-09-2019 132614010919Y001625 0000715621511 MAKIATUS SHOLIHA P PBI (APBN) Pneumonia due to other Berobat Jalan
infectious organisms, not
elsewhere classified
15 30-09-2019 132614010919Y001601 0000715677412 ANISAH P PBI (APBN) Acute pharyngitis Berobat Jalan
16 30-09-2019 132614010919Y001616 0000715844586 SITI P PBI (APBN) Mumps Berobat Jalan
17 30-09-2019 132614010919Y001631 0000715980914 SUBADAR L PBI (APBN) Non-insulin-dependent Berobat Jalan
diabetes mellitus
18 30-09-2019 132614010919P001640 0000715981667 HOSIÀH P PBI (APBN) Other contraceptive Berobat Jalan
management
19 30-09-2019 132614010919Y001598 0000716049652 HOLIMAH P PBI (APBN) Chronic kidney disease, Rujuk Vertikal
stage 5
20 30-09-2019 132614010919Y001629 0000716096891 AHMAD QUSJAERI L PBI (APBN) Caught, crushed, jammed Berobat Jalan
or pinched in or between
objects causing accidental
injury

21 132614010919Y001612 0000716161342 M.JUNAEDI L PBI (APBN) Atherosclerotic heart Rujuk Vertikal
30-09-2019
disease
22 30-09-2019 132614010919Y001638 0000716191762 ANGGUN APRILIAWATI P PBI (APBN) Acute upper respiratory Berobat Jalan
infections of multiple and
unspecified sites
23 30-09-2019 132614010919Y001643 0000716220055 MASRUR HIDAYATULLOH L PBI (APBN) Scabies Berobat Jalan
24 30-09-2019 132614010919Y001595 0000716274437 MUSRIAH BT MARKATAM P PBI (APBN) Acute upper respiratory Berobat Jalan
MANSUR infections of multiple and

unspecified sites
25 30-09-2019 132614010919Y001632 0000716303351 NAWAWI L PBI (APBN) Essential (primary) Berobat Jalan
hypertension
26 30-09-2019 132614010919Y001648 0000716304734 SUPINTIN P PBI (APBN) Other rheumatoid arthritis Berobat Jalan
27 30-09-2019 132614010919Y001647 0000716323757 ERIANA P PBI (APBN) Acute upper respiratory Berobat Jalan

unspecified sites
28 30-09-2019 132614010919Y001620 0000716432343 KHUSNIA P PBI (APBN) Non-insulin-dependent Berobat Jalan
diabetes mellitus
29 30-09-2019 132614010919Y001603 0000716437124 ANANDA ALIYA P PBI (APBN) Gastric ulcer Berobat Jalan
30 30-09-2019 132614010919Y001645 0000716476206 MOHAMMAD RIKI L PBI (APBN) Gingivitis and periodontal Berobat Jalan
HIDAYATULLOH diseases
31 30-09-2019 132614010919Y001600 0000716517134 HOIROH P PBI (APBN) Malignant neoplasm of Rujuk Vertikal
breast
32 30-09-2019 132614010919Y001599 0000716613164 LAILATUL BADRIYAH P PBI (APBN) Scabies Berobat Jalan
33 30-09-2019 132614010919Y001639 0000716878034 AHMAD ROZI ALI L PBI (APBN) Haemorrhoids Berobat Jalan
34 30-09-2019 132614010919Y001615 0000716899689 BADRIYAH P PBI (APBN) Pain in throat and chest Rujuk Vertikal
35 30-09-2019 132614010919Y001608 0000717136953 CHOLIFAH P PBI (APBN) Excessive, frequent and Rujuk Vertikal
irregular menstruation
36 30-09-2019 132614010919Y001627 0000717365676 ABDUL HALIM L PBI (APBN) Respiratory tuberculosis, Berobat Jalan
bacteriologically and
histologically confirmed
37 30-09-2019 132614010919P001642 0000788873016 AISYAH FARA K P PBI (APBN) Ventricular fibrillation and Berobat Jalan
flutter
38 30-09-2019 132614010919Y001618 0001042725767 SULAMI P PBI (APBN) Non-insulin-dependent Berobat Jalan
diabetes mellitus
39 30-09-2019 132614010919Y001634 0001042728658 HUSNIATUL MAULIDAH P PBI (APBN) Dysmenorrhoea, Berobat Jalan
unspecified

40 132614010919Y001597 0001042730471 CHUSNUL HOTIMAH P PBI (APBN) Examination and Berobat Jalan
30-09-2019
encounter for
administrative purposes
41 30-09-2019 132614010919Y001613 0001042734339 NOR HALIMAH P PBI (APBN) Parkinson's disease Rujuk Vertikal
42 30-09-2019 132614010919Y001628 0001042739616 ANA YULIAWATI P PBI (APBN) Respiratory tuberculosis, Berobat Jalan
43 30-09-2019 132614010919Y001644 0001042753893 ARIS EFENDI L PBI (APBN) Gingivitis and periodontal Berobat Jalan
diseases
44 30-09-2019 132614010919Y001611 0001042754229 M.BAHRUDDIN L PBI (APBN) Acute upper respiratory Berobat Jalan
unspecified sites
45 30-09-2019 132614010919Y001626 0001314426543 SATOYA P PEKERJA MANDIRI Respiratory tuberculosis, Berobat Jalan
46 30-09-2019 132614010919Y001594 0001543341104 SUWAR KOMARI L PEGAWAI BUMN Essential (primary) Berobat Jalan
hypertension
47 30-09-2019 132614010919Y001641 0001700857236 AHMAD FAIZIN L PEGAWAI SWASTA Typhoid and paratyphoid Berobat Jalan
fevers
48 30-09-2019 132614010919Y001637 0002086584917 MUHAMMAD RAIHAN L PEGAWAI SWASTA Impacted cerumen Rujuk Vertikal
ATHAILLAH
49 30-09-2019 132614010919Y001610 0002250391623 HJ.HANNAH AFAF P PBI (APBD) Intracranial injury, Rujuk Vertikal
unspecified
50 30-09-2019 132614010919Y001592 0002436534999 MURDIANTO L PEKERJA MANDIRI Nasal polyp, unspecified Rujuk Vertikal
51 30-09-2019 132614010919Y001596 0002436535361 ARINA NIQYAL KHURRIYAH P PEKERJA MANDIRI Acute pharyngitis Berobat Jalan
52 30-09-2019 132614010919Y001614 0002455127201 SOCHIP L PEKERJA MANDIRI Essential (primary) Berobat Jalan
hypertension
53 30-09-2019 132614010919Y001609 0002491664501 SYIFAU'L HASANAH P PBI (APBD) Supervision of normal Berobat Jalan
pregnancy
54 30-09-2019 132614010919Y001617 0002584258705 ALZIAF DAMANG SYAH P PBI (APBN) Gastric ulcer Berobat Jalan
55 30-09-2019 132614010919Y001646 0002604216802 FERY IBRAHIM L PBI (APBN) Disorders of tooth Berobat Jalan
development and eruption

56 30-09-2019 132614010919Y001607 0002604761291 JAYADI L PBI (APBN) Influenza, virus not Berobat Jalan
identified
57 30-09-2019 132614010919Y001604 0002887905464 KHOIRON L PEKERJA MANDIRI Respiratory tuberculosis, Berobat Jalan

58 132614010919Y001591 0002888078657 NURUL HIKMATUT TOYIBA P PEKERJA MANDIRI Acute hepatitis B without Rujuk Vertikal
30-09-2019
delta-agent and without
hepatic coma
59 28-09-2019 132614010919Y001579 0000112670414 MULYONO L PENERIMA PENSIUN Hebephrenic Berobat Jalan
PNS schizophrenia
60 28-09-2019 132614010919Y001565 0000112754171 ADING BACHTIAR L PNS DAERAH Neuropathic arthropathy Rujuk Vertikal
61 28-09-2019 132614010919Y001520 0000715191794 WAHYU ROCHMAWATI P PBI (APBN) Thyrotoxicosis with toxic Rujuk Vertikal
single thyroid nodule

62 28-09-2019 132614010919Y001567 0000715298602 NUR HIKMATUS SOLIHA P PBI (APBN) Other contraceptive Berobat Jalan
management
63 28-09-2019 132614010919Y001585 0000715500369 SUNARSIH P PBI (APBN) Acute upper respiratory Berobat Jalan
unspecified sites
64 28-09-2019 132614010919Y001586 0000715613477 WIWIK Z P PBI (APBN) Pneumonia due to other Berobat Jalan
65 28-09-2019 132614010919Y001587 0000715613804 SAI P PBI (APBN) Diseases of pulp and Berobat Jalan
periapical tissues
66 28-09-2019 132614010919Y001588 0000715614467 LULUK HANIFAH P PBI (APBN) Allergic contact dermatitis Berobat Jalan
67 28-09-2019 132614010919Y001589 0000715615571 BAGIMAH L PBI (APBN) Allergic contact dermatitis Berobat Jalan
68 28-09-2019 132614010919Y001590 0000715615929 HALIMATUS SAKDEYAH P PBI (APBN) Other headache Berobat Jalan
syndromes
69 28-09-2019 132614010919P001540 0000715772237 ARWIYAH P PBI (APBN) Other contraceptive Berobat Jalan
management
70 28-09-2019 132614010919P001553 0000715865242 ANISA P PBI (APBN) Contraceptive Berobat Jalan
management
71 28-09-2019 132614010919Y001552 0000715877368 TORIMAH P PBI (APBN) Essential (primary) Berobat Jalan
hypertension
72 28-09-2019 132614010919Y001518 0000715916654 SOLIHAH P PBI (APBN) Benign neoplasm of breast Rujuk Vertikal
73 28-09-2019 132614010919Y001529 0000715959281 MUJIB L PBI (APBN) Chronic viral hepatitis C Berobat Jalan
74 28-09-2019 132614010919Y001574 0000716039188 SITI AISAH P PBI (APBN) Schizophrenia Berobat Jalan
75 28-09-2019 132614010919Y001527 0000716048469 ATI KAMILATU DIANA P PBI (APBN) Disorders of tooth Berobat Jalan

76 28-09-2019 132614010919Y001525 0000716063398 KASIATI P PBI (APBN) Non-insulin-dependent Berobat Jalan
diabetes mellitus
77 28-09-2019 132614010919Y001535 0000716079363 SULASTRI P PBI (APBN) Other headache Berobat Jalan
syndromes

78 132614010919Y001581 0000716218435 ZAENAL ABIDIN L PBI (APBN) Caught, crushed, jammed Berobat Jalan
28-09-2019
injury
79 28-09-2019 132614010919Y001584 0000716224307 TENTREM P PBI (APBN) Other rheumatoid arthritis Berobat Jalan
80 28-09-2019 132614010919Y001580 0000716226377 MAHFUD L PBI (APBN) Caught, crushed, jammed Berobat Jalan
injury
81 28-09-2019 132614010919Y001536 0000716253377 WASILAH P PBI (APBN) Other disorders of muscle Berobat Jalan
82 28-09-2019 132614010919Y001517 0000716272593 ENI SUROYAH P PBI (APBN) Gastric ulcer Berobat Jalan
83 28-09-2019 132614010919Y001545 0000716358745 ZULFAH P PBI (APBN) Diseases of pulp and Berobat Jalan
periapical tissues
84 28-09-2019 132614010919Y001541 0000716466543 ANI P PBI (APBN) Fever of other and Berobat Jalan
unknown origin
85 28-09-2019 132614010919Y001521 0000716948651 WIJI PURWATIN P PBI (APBN) Non-insulin-dependent Rujuk Vertikal
diabetes mellitus with
peripheral circulatory
complications
86 28-09-2019 132614010919Y001528 0000717146469 INDAH WULAN NINGSIH P PBI (APBN) Cystitis Berobat Jalan
87 28-09-2019 132614010919Y001560 0001042727815 WIWIK MAULIDIA P PBI (APBN) Haemorrhoids Rujuk Vertikal
88 28-09-2019 132614010919Y001533 0001042737985 SAMAI L PBI (APBN) Acute pharyngitis Berobat Jalan
89 28-09-2019 132614010919Y001530 0001042739616 ANA YULIAWATI P PBI (APBN) Respiratory tuberculosis, Berobat Jalan
90 28-09-2019 132614010919Y001547 0001042753173 SITI MARIAM P PBI (APBN) Other disorders of muscle Berobat Jalan
91 28-09-2019 132614010919Y001526 0001126010305 SUJAK ARIF L PEGAWAI SWASTA Other headache Berobat Jalan
syndromes
92 28-09-2019 132614010919Y001531 0001314426543 SATOYA P PEKERJA MANDIRI Altered pattern of family Rujuk Vertikal
relationships in childhood
93 28-09-2019 132614010919Y001569 0001541382401 IMAM GOZALI L PEKERJA MANDIRI Acute upper respiratory Berobat Jalan
unspecified sites
94 28-09-2019 132614010919Y001557 0001543341148 AHMAD JOUSHAN CARNAVY L PEGAWAI BUMN Pneumonia due to other Berobat Jalan
95 28-09-2019 132614010919Y001524 0001787205701 DAVIN HARNY ANGGRAWIKSA L PNS DAERAH Urticaria Berobat Jalan

96 132614010919Y001522 0001918391578 DIAN APRILIA P PBI (APBN) Gastric ulcer Berobat Jalan
28-09-2019
97 28-09-2019 132614010919Y001519 0002032902617 LAILATUL KIFTIYAH P PEKERJA MANDIRI Acute nasopharyngitis Berobat Jalan
[common cold]
98 28-09-2019 132614010919Y001570 0002064248469 ANINDITA KEISHA ZAHRA P PEKERJA MANDIRI Impetigo Berobat Jalan
99 28-09-2019 132614010919Y001523 0002069557896 KHOIRIYAH P PEKERJA MANDIRI Pregnancy-related Rujuk Vertikal
condition, unspecified
100 28-09-2019 132614010919Y001559 0002243378395 ASSYFA PUTRI APRILIA P PEGAWAI SWASTA Acute upper respiratory Berobat Jalan
unspecified sites
101 28-09-2019 132614010919Y001532 0002253111862 MERVIN LOUISA P PNS DAERAH Disorders of tooth Berobat Jalan
102 28-09-2019 132614010919Y001546 0002254925474 HAFIZH MAULANA MAHARDIKA L PBI (APBN) Impetigo Berobat Jalan
103 28-09-2019 132614010919Y001537 0002301272008 H. ALI RIDHO L PEKERJA MANDIRI Senile cataract Rujuk Vertikal
104 28-09-2019 132614010919Y001516 0002422240727 KRISFANDI L PEKERJA MANDIRI Hebephrenic Rujuk Vertikal
schizophrenia
105 28-09-2019 132614010919Y001577 0002455647197 IRA KHUSNUL KHOTIMAH P PBI (APBD) Typhoid and paratyphoid Berobat Jalan
fevers
106 28-09-2019 132614010919Y001543 0002465134391 FAHRUN NISAK P PEKERJA MANDIRI Gingivitis and periodontal Berobat Jalan
diseases
107 28-09-2019 132614010919Y001538 0002630887569 NAULA SYARIFAH P PBI (APBN) Typhoid and paratyphoid Rujuk Vertikal
fevers
108 28-09-2019 132614010919Y001550 0002635837108 MASYHURI L PBI (APBN) Respiratory tuberculosis, Berobat Jalan
109 28-09-2019 132614010919Y001551 0002761586728 NURITA P PBI (APBD) Supervision of normal Rujuk Vertikal
pregnancy
110 28-09-2019 132614010919Y001578 0002883699909 SUWAIBATUL ISLAMIYAH P PEKERJA MANDIRI Single delivery by Rujuk Vertikal
caesarean section
111 28-09-2019 132614010919Y001548 0002884769335 M. BAYU ASYROFI L PBI (APBD) Polydactyly, unspecified Rujuk Vertikal
112 28-09-2019 132614010919Y001554 0002891965555 BAYI NYONYA SUWAIBATUL P PEKERJA MANDIRI Other specified Berobat Jalan
ISLAMIYAH counselling
113 27-09-2019 132614010919Y001477 0000112670032 KHALIMATUL WIDDAT P PNS DAERAH Gastro-oesophageal reflux Berobat Jalan
disease
114 27-09-2019 132614010919Y001491 0000112947478 MATOHA L PENERIMA PENSIUN Essential (primary) Berobat Jalan
PNS hypertension
115 27-09-2019 132614010919Y001483 0000112948187 SITI RUKKAYYAH JD.HADJIN P PENERIMA PENSIUN Heart failure Rujuk Vertikal
PNS

116 132614010919Y001488 0000714534535 LULUK HUMAIDAH P PBI (APBN) Other headache Berobat Jalan
27-09-2019
syndromes
117 27-09-2019 132614010919Y001457 0000714675699 TOSIM L PBI (APBN) Respiratory tuberculosis, Berobat Jalan
118 27-09-2019 132614010919Y001444 0000715167167 MARSIYATI P PBI (APBN) Insulin-dependent Rujuk Vertikal
diabetes mellitus
119 27-09-2019 132614010919Y001459 0000715287069 ABDUL MUHID L PBI (APBN) Other arthrosis Rujuk Vertikal
120 27-09-2019 132614010919Y001467 0000715287745 FATMAWATI P PBI (APBN) Scabies Berobat Jalan
121 27-09-2019 132614010919Y001458 0000715449734 TAHE L PBI (APBN) Hebephrenic Rujuk Vertikal
schizophrenia
122 27-09-2019 132614010919Y001583 0000715482483 USWATUN HASANAH P PBI (APBN) Acute upper respiratory Berobat Jalan
unspecified sites
123 27-09-2019 132614010919Y001479 0000715484182 ZAINAL ABIDIN L PBI (APBN) Acute upper respiratory Berobat Jalan
unspecified sites
124 27-09-2019 132614010919Y001476 0000715512802 ROMLAH P PBI (APBN) Essential (primary) Berobat Jalan
hypertension
125 27-09-2019 132614010919Y001478 0000715513498 M.SOMAT L PBI (APBN) Acute upper respiratory Berobat Jalan
unspecified sites
126 27-09-2019 132614010919Y001451 0000715525907 MUCHAMMAD L PBI (APBN) Essential (primary) Berobat Jalan
hypertension
127 27-09-2019 132614010919Y001484 0000715573967 PAIMAN L PBI (APBN) Asthma Rujuk Vertikal
128 27-09-2019 132614010919Y001456 0000715606852 SAMOJI L PBI (APBN) Senile cataract Rujuk Vertikal
129 27-09-2019 132614010919Y001513 0000715609541 SILVIN P PBI (APBN) Gastric ulcer Berobat Jalan
130 27-09-2019 132614010919Y001514 0000715609798 MAHRUS L PBI (APBN) Gastric ulcer Berobat Jalan
131 27-09-2019 132614010919Y001515 0000715609934 NUR CHALIMAH P PBI (APBN) Gastric ulcer Berobat Jalan
132 27-09-2019 132614010919Y001455 0000715617066 M.HUDA L PBI (APBN) Disorders of refraction and Rujuk Vertikal
accommodation
133 27-09-2019 132614010919Y001463 0000715763294 UMI LAILI P PBI (APBN) Bronchitis, not specified as Rujuk Vertikal
acute or chronic
134 27-09-2019 132614010919Y001454 0000715918937 NAJIB DENI L PBI (APBN) Impetigo Berobat Jalan
135 27-09-2019 132614010919Y001472 0000716186193 YULIANA DEWI P PBI (APBN) Acute upper respiratory Berobat Jalan

unspecified sites

136 132614010919Y001449 0000716237638 MARIA ULFA P PBI (APBN) Other contraceptive Berobat Jalan
27-09-2019
management
137 27-09-2019 132614010919Y001490 0000716242566 MASTUROH P PBI (APBN) Conjunctivitis Rujuk Vertikal
138 27-09-2019 132614010919Y001469 0000716276711 FIRMANSYAH L PBI (APBN) Diseases of pulp and Berobat Jalan
periapical tissues
139 27-09-2019 132614010919P001466 0000716318414 NIKMATUS SOLIHAH P PBI (APBN) Spontaneous vertex Sembuh
delivery
140 27-09-2019 132614010919Y001482 0000716324051 ARI WAHYUNINGSIH P PBI (APBN) Urticaria Berobat Jalan
141 27-09-2019 132614010919Y001470 0000716355314 M QODAR L PBI (APBN) Gingivitis and periodontal Berobat Jalan
diseases
142 27-09-2019 132614010919Y001445 0000716358161 WAHYUNI P PBI (APBN) Other contraceptive Berobat Jalan
management
143 27-09-2019 132614010919Y001480 0000716362266 MUHLIS L PBI (APBN) Typhoid and paratyphoid Berobat Jalan
fevers
144 27-09-2019 132614010919Y001461 0000716389334 MUNAWARO P PBI (APBN) Other contraceptive Berobat Jalan
management
145 27-09-2019 132614010919Y001447 0000716449318 SANIPA P PBI (APBN) Essential (primary) Berobat Jalan
hypertension
146 27-09-2019 132614010919Y001452 0000716518765 ACH.HANAFI L PBI (APBN) Acute upper respiratory Berobat Jalan
unspecified sites
147 27-09-2019 132614010919Y001489 0000716815787 RIDUWAN L PBI (APBN) Respiratory tuberculosis, Berobat Jalan
148 27-09-2019 132614010919Y001582 0000716840166 SATUAN P PBI (APBN) Other rheumatoid arthritis Berobat Jalan
149 27-09-2019 132614010919Y001481 0000717063085 MUJAYANA P PBI (APBN) Senile cataract Rujuk Vertikal
150 27-09-2019 132614010919Y001465 0001042732304 KARWATI P PBI (APBN) Gastric ulcer Berobat Jalan
151 27-09-2019 132614010919Y001468 0001127266986 ROSIDAH P PEGAWAI SWASTA Disorders of initiating and Berobat Jalan
maintaining sleep
[insomnias]
152 27-09-2019 132614010919Y001446 0001383492148 HJ.ZUHROH P PEKERJA MANDIRI Dislocation, sprain and Rujuk Vertikal
strain of joint and
ligaments of hip
153 27-09-2019 132614010919Y001450 0001539879221 ANINDYA RASYA NUR AZIZAH P PEKERJA MANDIRI Suppurative and Berobat Jalan
unspecified otitis media
154 27-09-2019 132614010919Y001473 0001838664832 NURUL AINI P PEKERJA MANDIRI Typhoid and paratyphoid Berobat Jalan
fevers

155 27-09-2019 132614010919Y001448 0001849893941 MOHAMAD AFIF FULLOH L PBI (APBD) Hebephrenic Rujuk Vertikal
schizophrenia
156 27-09-2019 132614010919Y001464 0001889872569 ACHMAD ALI L PEKERJA MANDIRI Caught, crushed, jammed Berobat Jalan
injury
157 27-09-2019 132614010919Y001462 0002284918233 TUMINAH P PBI (APBD) Zoster [herpes zoster] Berobat Jalan
158 27-09-2019 132614010919Y001471 0002453573259 MUHAMMAD RAFI AL IMRON L PEKERJA MANDIRI Gastric ulcer Berobat Jalan
159 27-09-2019 132614010919Y001487 0002477662626 TOSIN L PBI (APBD) Gastric ulcer Berobat Jalan
160 27-09-2019 132614010919Y001485 0002477663144 JUWARIYAH P PBI (APBD) Essential (primary) Berobat Jalan
hypertension
161 27-09-2019 132614010919Y001460 0002585784317 A AINUL YAKIN L PBI (APBN) Scabies Berobat Jalan
162 27-09-2019 132614010919Y001453 0002887905464 KHOIRON L PEKERJA MANDIRI Other specified Berobat Jalan
counselling
163 26-09-2019 132614010919Y001475 0000112670515 MUYONO, SPD L PNS DAERAH Insulin-dependent Rujuk Vertikal Diabetes
diabetes mellitus Mellitus
164 26-09-2019 132614010919Y001423 0000112670818 ASIYAH P PNS DAERAH Acute upper respiratory Berobat Jalan
unspecified sites
165 26-09-2019 132614010919Y001393 0000112947287 SRI ASTUTI P PENERIMA PENSIUN Gastritis and duodenitis Berobat Jalan
PNS
166 26-09-2019 132614010919Y001403 0000113227795 PATRIA IRBAWATI P PNS DAERAH Anxiety disorder, Rujuk Vertikal
unspecified
167 26-09-2019 132614010919Y001400 0000714563908 SAROHA P PBI (APBN) Cystitis Berobat Jalan
168 26-09-2019 132614010919Y001416 0000714564933 NIKMATUS SHOLIHAH P PBI (APBN) Supervision of normal Berobat Jalan
pregnancy
169 26-09-2019 132614010919Y001381 0000715201582 CHOIRIYAH P PBI (APBN) Cutaneous abscess, Berobat Jalan
furuncle and carbuncle
170 26-09-2019 132614010919Y001651 0000715212641 SITI SUMAMI P PBI (APBN) Supervision of normal Berobat Jalan
pregnancy
171 26-09-2019 132614010919Y001392 0000715359958 MARYAMAH P PBI (APBN) Acute upper respiratory Berobat Jalan
unspecified sites
172 26-09-2019 132614010919Y001496 0000715492179 MUSLIMIN L PBI (APBN) Allergic contact dermatitis Berobat Jalan
173 26-09-2019 132614010919Y001405 0000715510517 ABD.KHOLIQ L PBI (APBN) Acute upper respiratory Berobat Jalan

unspecified sites

174 132614010919Y001387 0000715551737 RUPIANI P PBI (APBN) Acute upper respiratory Berobat Jalan
26-09-2019
unspecified sites
175 26-09-2019 132614010919Y001382 0000715580289 MAILA FUTUHATIL ILAYAH P PBI (APBN) Cutaneous abscess, Berobat Jalan
176 26-09-2019 132614010919P001394 0000715588885 HUSNUL CHOTIMAH P PBI (APBN) Delivery by elective Rujuk Vertikal
caesarean section
177 26-09-2019 132614010919Y001379 0000715596142 MUKODDAM L PBI (APBN) Acute pharyngitis Berobat Jalan
178 26-09-2019 132614010919Y001429 0000715597806 SINTA NURIYAH P PBI (APBN) Pneumonia due to other Berobat Jalan

179 26-09-2019 132614010919Y001430 0000715598357 SOLIHIN L PBI (APBN) Diseases of pulp and Berobat Jalan
periapical tissues
180 26-09-2019 132614010919Y001431 0000715598605 RUPIAH P PBI (APBN) Diseases of pulp and Berobat Jalan
periapical tissues
181 26-09-2019 132614010919Y001432 0000715599595 HAFIFAH P PBI (APBN) Gout Berobat Jalan
182 26-09-2019 132614010919Y001380 0000715604782 YULIA ISMI P PBI (APBN) Acute upper respiratory Berobat Jalan

unspecified sites
183 26-09-2019 132614010919Y001421 0000715610384 KUNI TAQIYAH P PBI (APBN) Varicella [chickenpox] Berobat Jalan
184 26-09-2019 132614010919Y001399 0000715734955 SITI ROMZAH P PBI (APBN) Gingivitis and periodontal Berobat Jalan
diseases
185 26-09-2019 132614010919Y001425 0000715747318 AHMAD HADI USMAN L PBI (APBN) Caught, crushed, jammed Berobat Jalan
injury
186 26-09-2019 132614010919Y001389 0000715763294 UMI LAILI P PBI (APBN) Acute upper respiratory Berobat Jalan
unspecified sites
187 26-09-2019 132614010919Y001492 0000715908341 SUPNARI P PBI (APBN) Non-insulin-dependent Rujuk Vertikal
complications
188 26-09-2019 132614010919Y001424 0000716080397 EDI MASYHURI L PBI (APBN) Caught, crushed, jammed Berobat Jalan
injury
189 26-09-2019 132614010919Y001414 0000716155288 PUTRI ANIKE P PBI (APBN) Conjunctivitis Berobat Jalan
190 26-09-2019 132614010919Y001388 0000716164727 AINUL ABIDIN L PBI (APBN) Other specified Berobat Jalan
counselling

191 132614010919Y001433 0000716185359 KAMARIA P PBI (APBN) Essential (primary) Berobat Jalan
26-09-2019
hypertension
192 26-09-2019 132614010919Y001404 0000716249834 NINDY SRI AYUNI P PBI (APBN) Gastric ulcer Berobat Jalan
193 26-09-2019 132614010919Y001410 0000716271557 MOCH.SUBHAN L PBI (APBN) Other orthopaedic Rujuk Vertikal
follow-up care
194 26-09-2019 132614010919Y001409 0000716286868 NUR KHASANAH P PBI (APBN) Non-insulin-dependent Berobat Jalan Diabetes
195 26-09-2019 132614010919Y001408 0000716315139 CHUSNIYAH P PBI (APBN) Non-insulin-dependent Berobat Jalan Diabetes
196 26-09-2019 132614010919Y001420 0000716321474 AMINATU ZUHRO P PBI (APBN) Acute upper respiratory Berobat Jalan
unspecified sites
197 26-09-2019 132614010919Y001427 0000716323004 FIFIANATUL ZUHRO P PBI (APBN) Diseases of pulp and Berobat Jalan
periapical tissues
198 26-09-2019 132614010919Y001417 0000716358745 ZULFAH P PBI (APBN) Diseases of pulp and Berobat Jalan
periapical tissues
199 26-09-2019 132614010919Y001390 0000716391865 KARIM HOJI L PBI (APBN) Respiratory tuberculosis, Berobat Jalan
200 26-09-2019 132614010919P001385 0000716467893 DOPIR L PBI (APBN) Hebephrenic Rujuk Vertikal
schizophrenia
201 26-09-2019 132614010919Y001391 0000716469107 MOHAMMAD ROSYDI L PBI (APBN) Other and unspecified Berobat Jalan
gastroenteritis and colitis
of infectious origin
202 26-09-2019 132614010919Y001418 0000716567275 FATMAWATI P PBI (APBN) Supervision of normal Berobat Jalan
pregnancy
203 26-09-2019 132614010919Y001411 0000716570853 MUHAMAD ZULFIKRI ADAM L PBI (APBN) Acute upper respiratory Berobat Jalan
unspecified sites
204 26-09-2019 132614010919Y001383 0000716648275 SYARIFATUL JANNAH P PBI (APBN) Amoebiasis Berobat Jalan
205 26-09-2019 132614010919P001384 0000716831853 MUSLIHA P PBI (APBN) Benign lipomatous Rujuk Vertikal
neoplasm of skin and

subcutaneous tissue of
trunk
206 26-09-2019 132614010919Y001406 0000716838759 SUTIANINGSIH P PBI (APBN) Non-insulin-dependent Rujuk Vertikal
complications
207 26-09-2019 132614010919Y001413 0000717450265 LISWATI P PBI (APBN) Non-insulin-dependent Berobat Jalan
diabetes mellitus

208 132614010919Y001402 0000717450265 LISWATI P PBI (APBN) Gingivitis and periodontal Berobat Jalan
26-09-2019
diseases
209 26-09-2019 132614010919Y001428 0001042738424 DEWI NOFITA P PBI (APBN) Diseases of pulp and Berobat Jalan
periapical tissues
210 26-09-2019 132614010919Y001395 0001042739109 SALAMAH L PBI (APBN) Hyperlipidaemia, Berobat Jalan
unspecified
211 26-09-2019 132614010919Y001386 0001162545401 SAPTO FATONAH P PEGAWAI SWASTA Acute upper respiratory Berobat Jalan
unspecified sites
212 26-09-2019 132614010919Y001398 0001541286516 M SOLEH L PEGAWAI SWASTA Diarrhoea and Berobat Jalan
gastroenteritis of
presumed infectious origin
213 26-09-2019 132614010919P001397 0001542988877 SITI FADILATUL NIKMAH P PEGAWAI SWASTA Benign neoplasm of ovary Rujuk Vertikal
214 26-09-2019 132614010919Y001650 0001828898302 ABDUR ROHMAN L PEGAWAI SWASTA Acute upper respiratory Berobat Jalan

unspecified sites
215 26-09-2019 132614010919Y001419 0002200784523 SAMIATI P PEKERJA MANDIRI Contraceptive Berobat Jalan
management
216 26-09-2019 132614010919Y001412 0002200785579 DINI WULAN DARI P PEKERJA MANDIRI Disorders of tooth Berobat Jalan
217 26-09-2019 132614010919Y001407 0002285932825 MISIAH P PEKERJA MANDIRI Unspecified organic or Berobat Jalan
symptomatic mental
disorder
218 26-09-2019 132614010919Y001415 0002589912999 KHOIRUL BARIAH P PBI (APBN) Diseases of pulp and Berobat Jalan
periapical tissues
219 26-09-2019 132614010919Y001426 0002597477207 SUNARTI P PBI (APBN) Caught, crushed, jammed Berobat Jalan
injury
220 26-09-2019 132614010919P001401 0002742327887 H.AHMAD L PEKERJA MANDIRI Hyperplasia of prostate Rujuk Vertikal
221 26-09-2019 132614010919Y001396 0002766512463 NASIPAH P PEKERJA MANDIRI Non-insulin-dependent Berobat Jalan
diabetes mellitus
222 25-09-2019 132614010919Y001303 0000113018398 GATOT SUYUDI L PNS DAERAH Essential (primary) Berobat Jalan
hypertension
223 25-09-2019 132614010919Y001316 0000148580019 JAZULI, S.KOM L PNS DAERAH Typhoid and paratyphoid Berobat Jalan
fevers
224 25-09-2019 132614010919Y001342 0000160400812 YULIA KUSWORINI P PNS DAERAH Heart failure Berobat Jalan
225 25-09-2019 132614010919P001373 0000168026771 FRANSISCA P PNS DAERAH Supervision of normal Rujuk Vertikal
pregnancy

226 132614010919Y001331 0000714607604 JAMILAH P PBI (APBN) Cystitis Berobat Jalan
25-09-2019
227 25-09-2019 132614010919Y001300 0000715203191 NURUL QOMARIYAH P PBI (APBN) Hyperlipidaemia, Berobat Jalan
unspecified
228 25-09-2019 132614010919P001295 0000715250237 SAFUAH P PBI (APBN) Gastritis and duodenitis Rujuk Vertikal
229 25-09-2019 132614010919Y001366 0000715251251 M. SOFIYULLOH L PBI (APBN) Gingivitis and periodontal Berobat Jalan
diseases
230 25-09-2019 132614010919Y001442 0000715291222 WIDARIYA P PBI (APBN) Contraceptive Berobat Jalan
management
231 25-09-2019 132614010919Y001362 0000715301065 NURUL AINI P PBI (APBN) Supervision of normal Berobat Jalan
pregnancy
232 25-09-2019 132614010919Y001435 0000715331992 SITI RIANI P PBI (APBN) Contraceptive Berobat Jalan
management
233 25-09-2019 132614010919Y001319 0000715337728 KHASANAH P PBI (APBN) Essential (primary) Berobat Jalan
hypertension
234 25-09-2019 132614010919Y001375 0000715368644 ROICHA P PBI (APBN) Essential (primary) Berobat Jalan
hypertension
235 25-09-2019 132614010919Y001370 0000715435457 SITI ROHMA P PBI (APBN) Gingivitis and periodontal Berobat Jalan
diseases
236 25-09-2019 132614010919Y001376 0000715589886 RUSTI P PBI (APBN) Essential (primary) Berobat Jalan
hypertension
237 25-09-2019 132614010919Y001377 0000715590044 SUDAR L PBI (APBN) Allergic contact dermatitis Berobat Jalan
238 25-09-2019 132614010919Y001378 0000715590202 SUMIATI P PBI (APBN) Pneumonia due to other Berobat Jalan

239 25-09-2019 132614010919Y001436 0000715708809 SITI WIWIN FATIMAH P PBI (APBN) Contraceptive Berobat Jalan
management
240 25-09-2019 132614010919Y001499 0000715796728 KHOTIMATUL KHUSNA P PBI (APBN) Supervision of normal Berobat Jalan
pregnancy
241 25-09-2019 132614010919Y001310 0000715899161 PONITI P PBI (APBN) Essential (primary) Berobat Jalan
hypertension
242 25-09-2019 132614010919Y001498 0000715937916 RODI`YA P PBI (APBN) Supervision of normal Berobat Jalan
pregnancy
243 25-09-2019 132614010919P001298 0000715944295 M.RIZAL L PBI (APBN) Fracture of lower end of Rujuk Vertikal
radius
244 25-09-2019 132614010919Y001294 0000715962431 IRSAD L PBI (APBN) Acute upper respiratory Berobat Jalan
unspecified sites

245 132614010919Y001352 0000715965118 USMAIDAH P PBI (APBN) Supervision of normal Berobat Jalan
25-09-2019
pregnancy
246 25-09-2019 132614010919Y001292 0000715991411 MASKUR ALI L PBI (APBN) Cutaneous abscess, Berobat Jalan
247 25-09-2019 132614010919Y001350 0000715991466 NUR HAYATI P PBI (APBN) Supervision of normal Berobat Jalan
pregnancy
248 25-09-2019 132614010919Y001339 0000716052273 BUDI WAHYUWONO L PBI (APBN) Hyperlipidaemia, Berobat Jalan
unspecified
249 25-09-2019 132614010919Y001441 0000716273572 SITI ROSADAH P PBI (APBN) Contraceptive Berobat Jalan
management
250 25-09-2019 132614010919Y001321 0000716277238 MUALAFA P PBI (APBN) Other superficial mycoses Berobat Jalan
251 25-09-2019 132614010919Y001313 0000716288962 YASIRO P PBI (APBN) Non-insulin-dependent Berobat Jalan
diabetes mellitus
252 25-09-2019 132614010919Y001354 0000716300829 NOVI TRI LILIVIANI L PBI (APBN) Supervision of normal Berobat Jalan
pregnancy
253 25-09-2019 132614010919Y001369 0000716317558 RUHANAH P PBI (APBN) Other specified Berobat Jalan
counselling
254 25-09-2019 132614010919Y001434 0000716331295 SUTRIYAH P PBI (APBN) Contraceptive Berobat Jalan
management
255 25-09-2019 132614010919Y001437 0000716334309 NURYATI P PBI (APBN) Contraceptive Berobat Jalan
management
256 25-09-2019 132614010919Y001361 0000716386836 LAILATUL HOZILAH P PBI (APBN) Supervision of normal Berobat Jalan
pregnancy
257 25-09-2019 132614010919Y001297 0000716469219 SITI SHOFIYAH P PBI (APBN) Acute upper respiratory Berobat Jalan
unspecified sites
258 25-09-2019 132614010919Y001296 0000716470334 ZAINAL ABIDIN L PBI (APBN) Acute upper respiratory Berobat Jalan
unspecified sites
259 25-09-2019 132614010919Y001371 0000716511813 HAPIPAH P PBI (APBN) Dental caries Berobat Jalan
260 25-09-2019 132614010919Y001290 0000716521735 SUNARSIH P PBI (APBN) Essential (primary) Berobat Jalan
hypertension
261 25-09-2019 132614010919Y001322 0000716550412 ACHMAD HIDAYAT L PBI (APBN) Other acute viral hepatitis Berobat Jalan
262 25-09-2019 132614010919Y001309 0000716680989 SOFIYATUL HIKMA P PBI (APBN) Typhoid and paratyphoid Berobat Jalan
fevers
263 25-09-2019 132614010919Y001333 0000716838265 NUR KHOLIS SASMITO L PBI (APBN) Impacted cerumen Berobat Jalan
264 25-09-2019 132614010919Y001372 0000716838759 SUTIANINGSIH P PBI (APBN) Non-insulin-dependent Berobat Jalan
diabetes mellitus

265 132614010919Y001315 0000716838783 M. SUDIRMAN L PBI (APBN) Gastric ulcer Berobat Jalan
25-09-2019
266 25-09-2019 132614010919Y001314 0000716856423 SITI EVI P PBI (APBN) Gastric ulcer Berobat Jalan
267 25-09-2019 132614010919P001304 0000716938918 SANTI SEPTIANDARI P PBI (APBN) Threatened abortion Rujuk Vertikal
268 25-09-2019 132614010919Y001355 0000716981139 RISALATUL BADRIYAH P PBI (APBN) Supervision of normal Berobat Jalan
pregnancy
269 25-09-2019 132614010919Y001291 0000717107782 SITI ROHMAH P PBI (APBN) Examination and Berobat Jalan
encounter for
270 25-09-2019 132614010919P001311 0001042722549 MATASIN L PBI (APBN) Chronic obstructive Rujuk Vertikal
pulmonary disease,
unspecified
271 25-09-2019 132614010919Y001649 0001042722685 SAROPA P PBI (APBN) Other disorders of muscle Berobat Jalan
272 25-09-2019 132614010919Y001293 0001042729839 CHUSNATUL LAILI P PBI (APBN) Diarrhoea and Berobat Jalan
gastroenteritis of
273 25-09-2019 132614010919Y001440 0001042733316 SULIMAH P PBI (APBN) Contraceptive Berobat Jalan
management
274 25-09-2019 132614010919Y001439 0001042736084 SAIKHU L PBI (APBN) Contraceptive Berobat Jalan
management
275 25-09-2019 132614010919Y001438 0001042736095 NUR AINI P PBI (APBN) Contraceptive Berobat Jalan
management
276 25-09-2019 132614010919Y001374 0001042736681 ASIMAH P PBI (APBN) Other rheumatoid arthritis Berobat Jalan
277 25-09-2019 132614010919Y001341 0001042739616 ANA YULIAWATI P PBI (APBN) Other specified Berobat Jalan
counselling
278 25-09-2019 132614010919Y001349 0001124973865 DWI YESSI HERLINASARI P PEGAWAI SWASTA Supervision of normal Berobat Jalan
pregnancy
279 25-09-2019 132614010919Y001332 0001127266997 AMINAH P PEGAWAI SWASTA Acute upper respiratory Berobat Jalan
unspecified sites
280 25-09-2019 132614010919P001305 0001290531734 NUR INAYAH P PEKERJA MANDIRI Senile cataract Rujuk Vertikal
281 25-09-2019 132614010919P001306 0001295812541 MOCH. DJUWADI L PEKERJA MANDIRI Other cardiac arrhythmias Rujuk Vertikal
283 25-09-2019 132614010919Y001360 0001450067949 MALIATUS SAADAH P PEKERJA MANDIRI Supervision of normal Berobat Jalan
pregnancy

284 132614010919Y001539 0001451295854 DWI HANDAYANI P PEGAWAI SWASTA Acute pharyngitis Berobat Jalan
25-09-2019
285 25-09-2019 132614010919Y001364 0001539111881 SAMSUL ISLAM L PBI (APBD) Diseases of pulp and Berobat Jalan
periapical tissues
286 25-09-2019 132614010919Y001289 0001706730838 RIVKA OKTAFIANA P PBI (APBD) Acute upper respiratory Berobat Jalan
unspecified sites
287 25-09-2019 132614010919Y001299 0001706823641 SUPANDI L PBI (APBD) Calculus of kidney Rujuk Vertikal
288 25-09-2019 132614010919Y001353 0001900607556 FATMAWATI P PEGAWAI SWASTA Supervision of normal Berobat Jalan
pregnancy
289 25-09-2019 132614010919Y001312 0001969695235 MARIA ULFA P PEKERJA MANDIRI Non-insulin-dependent Berobat Jalan
diabetes mellitus
290 25-09-2019 132614010919Y001365 0002121284621 MARIATUL KIFTIYAH P PBI (APBN) Diseases of pulp and Berobat Jalan
periapical tissues
291 25-09-2019 132614010919Y001443 0002200012299 PRATIWI P PEKERJA MANDIRI Contraceptive Berobat Jalan
management
292 25-09-2019 132614010919Y001318 0002423572604 RODIYAH P PBI (APBD) Hyperlipidaemia, Berobat Jalan
unspecified
293 25-09-2019 132614010919Y001317 0002450517399 MOKHAMMAD UBAIDILLA L PEGAWAI SWASTA Influenza, virus not Berobat Jalan
identified
294 25-09-2019 132614010919Y001325 0002455647197 IRA KHUSNUL KHOTIMAH P PBI (APBD) Acute upper respiratory Berobat Jalan
unspecified sites
295 25-09-2019 132614010919Y001344 0002626163155 CHUSNUL MUTAMAROH P PEKERJA MANDIRI Hyperlipidaemia, Berobat Jalan
unspecified
296 25-09-2019 132614010919Y001368 0002632159539 JAMILA P PBI (APBN) Diseases of pulp and Berobat Jalan
periapical tissues
297 25-09-2019 132614010919Y001367 0002636774199 SITI JUWARIYA P PBI (APBN) Disorders of tooth Berobat Jalan
298 25-09-2019 132614010919P001287 0002637930543 HANIFAH P PBI (APBN) Leiomyoma of uterus, Rujuk Vertikal
unspecified
299 25-09-2019 132614010919P001288 0002771143334 NURUL KHOTIJAH P PBI (APBD) Delivery by elective Rujuk Vertikal
caesarean section
300 25-09-2019 132614010919Y001302 0002773912138 BUSTAN L PEKERJA MANDIRI Essential (primary) Berobat Jalan
hypertension
301 25-09-2019 132614010919Y001347 0002779497865 HUSNUL HOTIMAH P PBI (APBD) Supervision of normal Berobat Jalan
pregnancy
302 25-09-2019 132614010919P001307 0002808567202 EVI RIZKIYAH P PBI (APBN) Other cardiac arrhythmias Rujuk Vertikal

303 132614010919Y001308 0002887905464 KHOIRON L PEKERJA MANDIRI Tuberculosis of intestines, Berobat Jalan
25-09-2019
peritoneum and
mesenteric glands
304 25-09-2019 132614010919P001301 0002889146711 FATIMATUS ZAHRA P PEKERJA MANDIRI Nonspecific lymphadenitis, Rujuk Vertikal
unspecified
305 24-09-2019 132614010919P001211 0000112846972 AMAR L PENERIMA PENSIUN TNI Hyperplasia of prostate Rujuk Vertikal
306 24-09-2019 132614010919P001244 0000162299496 ACHJANI P PENERIMA PENSIUN TNI Disorders of refraction and Rujuk Vertikal
accommodation
307 24-09-2019 132614010919P001502 0000715209232 SILFIYATUL MUDLIFAH P PBI (APBN) Other contraceptive Berobat Jalan
management
308 24-09-2019 132614010919Y001286 0000715391414 NUR AINI P PBI (APBN) Gingivitis and periodontal Berobat Jalan
diseases
309 24-09-2019 132614010919Y001194 0000715481673 NASIPA P PBI (APBN) Essential (primary) Berobat Jalan
hypertension
310 24-09-2019 132614010919Y001285 0000715564001 MISBAHUL MUNIR L PBI (APBN) Other headache Berobat Jalan
syndromes
311 24-09-2019 132614010919Y001280 0000715579075 ABD.ROSID L PBI (APBN) Gout Berobat Jalan
312 24-09-2019 132614010919Y001281 0000715579211 SUWARNI P PBI (APBN) Diseases of pulp and Berobat Jalan
periapical tissues
313 24-09-2019 132614010919Y001282 0000715579492 MOHAMMAD KHOIRON L PBI (APBN) Essential (primary) Berobat Jalan
hypertension
314 24-09-2019 132614010919Y001283 0000715580291 NURIS SAÀDAH P PBI (APBN) Essential (primary) Berobat Jalan
hypertension
315 24-09-2019 132614010919Y001284 0000715580741 TOSIN L PBI (APBN) Acute nasopharyngitis Berobat Jalan
[common cold]
316 24-09-2019 132614010919P001190 0000715686952 JUARIYAH P PBI (APBN) Other acute viral hepatitis Rujuk Vertikal
317 24-09-2019 132614010919Y001231 0000715734955 SITI ROMZAH P PBI (APBN) Gingivitis and periodontal Berobat Jalan
diseases
318 24-09-2019 132614010919P001186 0000715908341 SUPNARI P PBI (APBN) Non-insulin-dependent Rujuk Vertikal
complications
319 24-09-2019 132614010919Y001220 0000715915225 SITI NADIATUS SAÌF P PBI (APBN) Gastric ulcer Berobat Jalan
320 24-09-2019 132614010919Y001262 0000715926464 M.YUSUF L PBI (APBN) Typhoid and paratyphoid Berobat Jalan
fevers

321 132614010919Y001243 0000715931515 NURUL BADRIYAH P PBI (APBN) Acute upper respiratory Berobat Jalan
24-09-2019
unspecified sites
322 24-09-2019 132614010919Y001212 0000715992748 BADRUS SOLEH L PBI (APBN) Other disorders of muscle Berobat Jalan
323 24-09-2019 132614010919Y001207 0000716025262 HANIFAH P PBI (APBN) Gastric ulcer Berobat Jalan
324 24-09-2019 132614010919P001195 0000716052993 KHOIRIYATUL IKRIMAH P PBI (APBN) Haemorrhoids Rujuk Vertikal
325 24-09-2019 132614010919P001192 0000716088802 SUSI SUSANTI P PBI (APBN) Myopia Rujuk Vertikal
326 24-09-2019 132614010919Y001256 0000716111853 DINA SAFITRI PUTRI P PBI (APBN) Gastric ulcer Berobat Jalan
327 24-09-2019 132614010919Y001252 0000716220797 WISNU RAMDHAN L PBI (APBN) Examination and Berobat Jalan
encounter for
328 24-09-2019 132614010919Y001272 0000716277238 MUALAFA P PBI (APBN) Other specified Berobat Jalan
counselling
329 24-09-2019 132614010919Y001233 0000716278612 SITI AISYAH P PBI (APBN) Gastric ulcer Berobat Jalan
330 24-09-2019 132614010919P001263 0000716303204 KHOIRI L PBI (APBN) Gastric ulcer, chronic Rujuk Vertikal
without haemorrhage or
perforation
331 24-09-2019 132614010919Y001363 0000716330856 ABDUL HADI L PBI (APBN) Essential (primary) Berobat Jalan
hypertension
332 24-09-2019 132614010919P001196 0000716339676 IMRAL USMAN ALI L PBI (APBN) Foreign body on external Rujuk Vertikal
eye
333 24-09-2019 132614010919Y001205 0000716355595 IN DAH SAROH P PBI (APBN) Essential (primary) Berobat Jalan
hypertension
334 24-09-2019 132614010919Y001245 0000716361287 SITI MUKARROMA P PBI (APBN) Impetigo Berobat Jalan
335 24-09-2019 132614010919Y001237 0000716386836 LAILATUL HOZILAH P PBI (APBN) Diseases of pulp and Berobat Jalan
periapical tissues
336 24-09-2019 132614010919Y001218 0000716390458 NUR QOMARIYA P PBI (APBN) Gingivitis and periodontal Berobat Jalan
diseases
337 24-09-2019 132614010919Y001225 0000716391606 MAHMUDI HIDAYAT L PBI (APBN) Disorders of tooth Berobat Jalan
338 24-09-2019 132614010919Y001187 0000716460039 ZAINIA P PBI (APBN) Acute upper respiratory Berobat Jalan
unspecified sites
339 24-09-2019 132614010919P001236 0000716464236 SAHRI L PBI (APBN) Inguinal hernia Rujuk Vertikal
340 24-09-2019 132614010919Y001359 0000716498379 SAUDAH P PBI (APBN) Other disorders of muscle Berobat Jalan

341 24-09-2019 132614010919P001503 0000716630321 HOIRIYAH P PBI (APBN) Other contraceptive Berobat Jalan
management
342 24-09-2019 132614010919P001230 0000716774938 NUR AZIZAH P PEGAWAI SWASTA Multiple dislocations of Rujuk Vertikal
fingers
343 24-09-2019 132614010919Y001250 0000716878034 AHMAD ROZI ALI L PBI (APBN) Haemorrhoids Berobat Jalan
344 24-09-2019 132614010919Y001356 0001042721019 MALUMA P PBI (APBN) Essential (primary) Berobat Jalan Diabetes
hypertension Mellitus
345 24-09-2019 132614010919Y001242 0001042727782 ARBIATI P PBI (APBN) Other disorders of muscle Berobat Jalan
346 24-09-2019 132614010919Y001191 0001042730133 FATIMATUS ZAHRO P PBI (APBN) Non-insulin-dependent Berobat Jalan
diabetes mellitus
347 24-09-2019 132614010919Y001210 0001042740167 ROSITA P PBI (APBN) Gastric ulcer Berobat Jalan
348 24-09-2019 132614010919P001500 0001042742608 DEWI FATIMAH P PBI (APBN) Other contraceptive Berobat Jalan
management
349 24-09-2019 132614010919P001501 0001042752677 RATIH PURWATI P PBI (APBN) Other contraceptive Berobat Jalan
management
350 24-09-2019 132614010919Y001246 0001277994137 ENDANG WIDYASTUTIK P PEKERJA MANDIRI Essential (primary) Berobat Jalan
hypertension
351 24-09-2019 132614010919Y001208 0001283745341 SUMINARTI P PEKERJA MANDIRI Non-insulin-dependent Berobat Jalan
diabetes mellitus
352 24-09-2019 132614010919Y001188 0001314426543 SATOYA P PEKERJA MANDIRI Other specified Berobat Jalan
counselling
353 24-09-2019 132614010919Y001214 0001323468742 UMI HIDAYATI P PEKERJA MANDIRI Asthma Berobat Jalan
354 24-09-2019 132614010919Y001198 0001537342929 MUHAMMAD ZAIDAN ALI L PEGAWAI SWASTA Typhoid and paratyphoid Berobat Jalan
fevers
355 24-09-2019 132614010919Y001254 0001540879997 ALFANDI AKHMAD NOVIANTO L PEKERJA MANDIRI Examination and Berobat Jalan
encounter for
356 24-09-2019 132614010919P001206 0001706730265 ABD.KARIM L PBI (APBD) Pterygium Rujuk Vertikal
357 24-09-2019 132614010919Y001189 0002059944805 CHASBIYAL CHAVIDH L PEKERJA MANDIRI Acute upper respiratory Berobat Jalan

unspecified sites
358 24-09-2019 132614010919Y001257 0002072336286 MUHAMMAD JAKFAR, SE L PEKERJA MANDIRI Other disorders of muscle Berobat Jalan
359 24-09-2019 132614010919Y001258 0002156417021 NASIYAH P PBI (APBD) Headache Berobat Jalan
360 24-09-2019 132614010919Y001357 0002157648142 AMEL NABILA P PBI (APBD) Influenza, virus not Berobat Jalan
identified

361 24-09-2019 132614010919Y001215 0002204828954 ISHMATUL MAULA P PEKERJA MANDIRI Gingivitis and periodontal Berobat Jalan
diseases
362 24-09-2019 132614010919Y001219 0002434611317 RISMAN L PEKERJA MANDIRI Gingivitis and periodontal Berobat Jalan
diseases
363 24-09-2019 132614010919Y001235 0002497177269 SIFAUL FUADAH P PEKERJA MANDIRI Gingivitis and periodontal Berobat Jalan
diseases
364 24-09-2019 132614010919Y001204 0002582402084 JAMALUDDIN L PBI (APBN) Impetigo Berobat Jalan
365 24-09-2019 132614010919P001232 0002584259166 ABD WAHID L PBI (APBN) Other acute viral hepatitis Rujuk Vertikal
366 24-09-2019 132614010919Y001216 0002619932826 MUKTIANI P PEKERJA MANDIRI Non-insulin-dependent Berobat Jalan
diabetes mellitus
367 24-09-2019 132614010919Y001358 0002633974457 MALIK ABDUL AZIZ L PBI (APBN) Typhoid and paratyphoid Berobat Jalan
fevers
368 24-09-2019 132614010919Y001249 0002635321735 MOCH. ANDIK FIRMANSYAH L PBI (APBN) Other specified Berobat Jalan
counselling
369 24-09-2019 132614010919Y001227 0002638644456 M NASRULLOH BAZIL AMIN L PBI (APBN) Disorders of tooth Berobat Jalan
370 24-09-2019 132614010919Y001259 0002768500067 RUHILA P PEKERJA MANDIRI Hyperlipidaemia, Berobat Jalan
unspecified
371 24-09-2019 132614010919P001199 0002880277029 AKHMAD RYAN WAHYUDI L PEKERJA MANDIRI Suppurative and Rujuk Vertikal
372 24-09-2019 132614010919P001247 0002881239535 RISDATIN NISAK P PEKERJA MANDIRI Tuberculosis of nervous Rujuk Vertikal
system
373 23-09-2019 132614010919Y001163 0000112751594 SUPRAPTO L PNS DAERAH Heart failure Rujuk Vertikal
374 23-09-2019 132614010919Y001274 0000112763439 NING TUFA P PNS PUSAT Caught, crushed, jammed Berobat Jalan
injury
375 23-09-2019 132614010919Y001176 0000112847321 IMIATI MOKODOMPIT P PENERIMA PENSIUN TNI Presbyopia Rujuk Vertikal Diabetes
Mellitus
376 23-09-2019 132614010919Y001200 0000714535784 M.KAMIL L PBI (APBN) Hebephrenic Berobat Jalan
schizophrenia
377 23-09-2019 132614010919Y001261 0000714558699 WARDATUN NAFISAH P PBI (APBN) Gastric ulcer Berobat Jalan
378 23-09-2019 132614010919Y001221 0000714776578 MOANI P PBI (APBN) Other disorders of muscle Berobat Jalan
379 23-09-2019 132614010919Y001343 0000715207296 BUHAWI L PBI (APBN) Essential (primary) Berobat Jalan
hypertension
380 23-09-2019 132614010919Y001238 0000715232665 GUFRON L PBI (APBN) Respiratory tuberculosis, Berobat Jalan

381 132614010919Y001184 0000715321607 NUR AISAH P PBI (APBN) Contraceptive Berobat Jalan
23-09-2019
management
382 23-09-2019 132614010919Y001337 0000715411563 ELLY RAHMAWATI P PBI (APBN) Asthma Berobat Jalan
383 23-09-2019 132614010919Y001213 0000715424005 RUMIATI P PBI (APBN) Hyperlipidaemia, Berobat Jalan
unspecified
384 23-09-2019 132614010919Y001268 0000715467666 SALIK P PBI (APBN) Non-insulin-dependent Berobat Jalan
diabetes mellitus
385 23-09-2019 132614010919Y001175 0000715471031 MARIYAM P PBI (APBN) Gingivitis and periodontal Berobat Jalan
diseases
386 23-09-2019 132614010919Y001336 0000715525907 MUCHAMMAD L PBI (APBN) Asthma Berobat Jalan
387 23-09-2019 132614010919Y001165 0000715571504 MAISURO P PBI (APBN) Gout Berobat Jalan
388 23-09-2019 132614010919Y001167 0000715571572 MULKILLAH P PBI (APBN) Gastric ulcer Berobat Jalan
389 23-09-2019 132614010919Y001168 0000715571965 UMYANAH P PBI (APBN) Allergic contact dermatitis Berobat Jalan
390 23-09-2019 132614010919Y001169 0000715572011 SAHRILLAH L PBI (APBN) Allergic contact dermatitis Berobat Jalan
391 23-09-2019 132614010919Y001170 0000715572088 SUBADAR L PBI (APBN) Allergic contact dermatitis Berobat Jalan
392 23-09-2019 132614010919Y001251 0000715622319 JUARTO L PBI (APBN) Hebephrenic Berobat Jalan
schizophrenia
393 23-09-2019 132614010919Y001270 0000715747318 AHMAD HADI USMAN L PBI (APBN) Caught, crushed, jammed Berobat Jalan
injury
394 23-09-2019 132614010919Y001222 0000715776759 MUSLIH L PBI (APBN) Other specified Berobat Jalan
counselling
395 23-09-2019 132614010919Y001217 0000715777784 MUHAMMAD L PBI (APBN) Acute upper respiratory Berobat Jalan
unspecified sites
396 23-09-2019 132614010919Y001348 0000715802703 SITI MASRUROH P PBI (APBN) Diseases of pulp and Berobat Jalan
periapical tissues
397 23-09-2019 132614010919Y001159 0000715892692 HAMIDAH P PBI (APBN) Other maternal diseases Berobat Jalan
classifiable elsewhere but
complicating pregnancy,
childbirth and the
puerperium
398 23-09-2019 132614010919Y001279 0000715899161 PONITI P PBI (APBN) Caught, crushed, jammed Berobat Jalan
injury
399 23-09-2019 132614010919Y001223 0000715946231 LAZIM KHOIRON MUZACKY L PBI (APBN) Gastritis and duodenitis Berobat Jalan

400 132614010919P001161 0000715959281 MUJIB L PBI (APBN) Chronic viral hepatitis C Rujuk Vertikal
23-09-2019
401 23-09-2019 132614010919Y001172 0000716049652 HOLIMAH P PBI (APBN) Non-insulin-dependent Rujuk Vertikal
diabetes mellitus
402 23-09-2019 132614010919Y001273 0000716080397 EDI MASYHURI L PBI (APBN) Caught, crushed, jammed Berobat Jalan
injury
403 23-09-2019 132614010919Y001269 0000716138548 MUHAMMAD UBAIDILLAH L PBI (APBN) Allergic contact dermatitis Berobat Jalan
404 23-09-2019 132614010919P001549 0000716257822 HUDROTUN NASIHA P PBI (APBN) Other contraceptive Berobat Jalan
management
405 23-09-2019 132614010919Y001174 0000716269566 KHOIRUN NISAK P PBI (APBN) Gingivitis and periodontal Berobat Jalan
diseases
406 23-09-2019 132614010919Y001265 0000716274437 MUSRIAH BT MARKATAM P PBI (APBN) Essential (primary) Berobat Jalan
MANSUR hypertension
407 23-09-2019 132614010919Y001160 0000716280895 AHMADSOLI L PBI (APBN) Cutaneous abscess, Berobat Jalan
408 23-09-2019 132614010919Y001180 0000716282706 M.ALIMUDIN L PBI (APBN) Gastric ulcer Berobat Jalan
409 23-09-2019 132614010919Y001275 0000716303351 NAWAWI L PBI (APBN) Caught, crushed, jammed Berobat Jalan
injury
410 23-09-2019 132614010919Y001162 0000716375384 SUKAESI P PBI (APBN) Essential (primary) Berobat Jalan
hypertension
411 23-09-2019 132614010919Y001266 0000716436898 M.WAHYUDI L PBI (APBN) Diarrhoea and Berobat Jalan
gastroenteritis of
412 23-09-2019 132614010919Y001271 0000716469219 SITI SHOFIYAH P PBI (APBN) Non-insulin-dependent Berobat Jalan
diabetes mellitus
413 23-09-2019 132614010919P001504 0000716511519 NURHASANAH P PBI (APBN) Other contraceptive Berobat Jalan
management
414 23-09-2019 132614010919Y001182 0000716513016 SUWARNI P PBI (APBN) Contraceptive Berobat Jalan
management
415 23-09-2019 132614010919Y001181 0000716533007 NUR`FIAH P PBI (APBN) Acute pharyngitis Berobat Jalan
416 23-09-2019 132614010919Y001346 0000716540433 HALIMA P PBI (APBN) Other contraceptive Berobat Jalan
management
417 23-09-2019 132614010919P001422 0000716540433 HALIMA P PBI (APBN) Other contraceptive Berobat Jalan
management

418 132614010919Y001240 0000716627485 SUMIATI P PBI (APBN) Non-insulin-dependent Berobat Jalan
23-09-2019
diabetes mellitus
419 23-09-2019 132614010919Y001209 0000716694096 KHUSULA P PBI (APBN) Respiratory tuberculosis, Berobat Jalan
420 23-09-2019 132614010919Y001202 0000716776119 SITI QOMARIYAH P PBI (APBN) Gastric ulcer Berobat Jalan
421 23-09-2019 132614010919Y001264 0000716864883 SAMAÀNI P PBI (APBN) Respiratory tuberculosis, Berobat Jalan
422 23-09-2019 132614010919Y001173 0000716917408 SHOLIHAN L PBI (APBN) Other disorders of muscle Berobat Jalan
423 23-09-2019 132614010919Y001224 0001042729795 CHOLILI L PBI (APBN) Gastritis and duodenitis Berobat Jalan
424 23-09-2019 132614010919Y001183 0001042733878 RUSLIN P PBI (APBN) Contraceptive Berobat Jalan
management
425 23-09-2019 132614010919Y001185 0001042734251 KHOTIMAH. P PBI (APBN) Contraceptive Berobat Jalan
management
426 23-09-2019 132614010919Y001267 0001042735588 LULUK KURNIAWATI P PBI (APBN) Gastric ulcer Berobat Jalan
427 23-09-2019 132614010919Y001278 0001042737344 ATIM TIMBUL L PBI (APBN) Caught, crushed, jammed Berobat Jalan
injury
428 23-09-2019 132614010919Y001158 0001042742024 NASARI P PBI (APBN) Cutaneous abscess, Berobat Jalan
429 23-09-2019 132614010919Y001248 0001268026997 IRAWAN SOEDJATMIKO L PEKERJA MANDIRI Acute upper respiratory Berobat Jalan
WIDODO infections of multiple and
unspecified sites
430 23-09-2019 132614010919Y001260 0001304983563 M.SOVWAN NUR EVENDI L PEGAWAI SWASTA Acute upper respiratory Berobat Jalan
unspecified sites
431 23-09-2019 132614010919Y001171 0001322625701 RAJA YANRIKAL AKBAR L PNS DAERAH Disorders of refraction and Rujuk Vertikal
accommodation
432 23-09-2019 132614010919Y001179 0001543341644 SITI KHURIYAH MAULIDA P PEGAWAI SWASTA Gingivitis and periodontal Berobat Jalan
diseases
433 23-09-2019 132614010919Y001277 0001850083637 IRCHAM ATOK'ILLAH L PNS DAERAH Caught, crushed, jammed Berobat Jalan
injury
434 23-09-2019 132614010919Y001226 0002087995601 GHOZALI L PEKERJA MANDIRI Diarrhoea and Berobat Jalan
gastroenteritis of

435 132614010919Y001178 0002239981749 AQILA KHANZA AZ ZAHRA P PEKERJA MANDIRI Gingivitis and periodontal Berobat Jalan
23-09-2019
diseases
436 23-09-2019 132614010919Y001201 0002280783251 DEVANI ABDILLAH L PEGAWAI SWASTA Caught, crushed, jammed Berobat Jalan
injury
437 23-09-2019 132614010919Y001340 0002294271224 DAIMATUL HUSNA P PEKERJA MANDIRI Other specified Berobat Jalan
counselling
438 23-09-2019 132614010919Y001253 0002478892667 FITRIYA P PEKERJA MANDIRI Respiratory tuberculosis, Berobat Jalan
439 23-09-2019 132614010919Y001255 0002493846134 JUMALI L PBI (APBD) Respiratory tuberculosis, Berobat Jalan
440 23-09-2019 132614010919Y001351 0002583245766 UMI KULSUM P PBI (APBN) Diseases of pulp and Berobat Jalan
periapical tissues
441 23-09-2019 132614010919Y001276 0002597477207 SUNARTI P PBI (APBN) Other surgical follow-up Berobat Jalan
care
442 23-09-2019 132614010919Y001177 0002604216802 FERY IBRAHIM L PBI (APBN) Disorders of tooth Berobat Jalan
443 23-09-2019 132614010919P001542 0002608192991 SHOFIYAH P PBI (APBN) Other contraceptive Berobat Jalan
management
444 23-09-2019 132614010919Y001345 0002608192991 SHOFIYAH P PBI (APBN) Other contraceptive Berobat Jalan
management
445 23-09-2019 132614010919Y001239 0002609455814 IS WAHYUDI L PBI (APBN) Scabies Berobat Jalan
446 23-09-2019 132614010919P001505 0002635321994 KHOLIFAH P PBI (APBN) Other contraceptive Berobat Jalan
management
447 23-09-2019 132614010919Y001164 0002808549639 MARIYAM P PBI (APBN) Umbilical hernia Rujuk Vertikal
448 23-09-2019 132614010919Y001166 0002888861826 SUDARSONO L PEKERJA MANDIRI Gastric ulcer Berobat Jalan
449 22-09-2019 132614010919Y001157 0000716919333 AINIYATUL YAQIN P PBI (APBN) Other maternal diseases Berobat Jalan

childbirth and the
puerperium
450 22-09-2019 132614010919Y001155 0000716920198 NITAJUL ROHMA P PBI (APBN) Gastric ulcer Berobat Jalan
451 22-09-2019 132614010919Y001156 0000716920874 SUBRO L PBI (APBN) Typhoid and paratyphoid Berobat Jalan
fevers
452 21-09-2019 132614010919Y001099 0000112670414 MULYONO L PENERIMA PENSIUN Schizophrenia Berobat Jalan
PNS

453 21-09-2019 132614010919Y001085 0000112671865 SUMARIAH P PNS DAERAH Examination and Berobat Jalan
encounter for
454 21-09-2019 132614010919Y001088 0000112847321 IMIATI MOKODOMPIT P PENERIMA PENSIUN TNI Gingivitis and periodontal Berobat Jalan Diabetes
diseases Mellitus
455 21-09-2019 132614010919Y001074 0000113019693 SRI AGUSTINI P PNS DAERAH Acute upper respiratory Berobat Jalan
unspecified sites
456 21-09-2019 132614010919Y001084 0000714563908 SAROHA P PBI (APBN) Cystitis Berobat Jalan
457 21-09-2019 132614010919Y001329 0000714784522 ASPIYA P PBI (APBN) Other contraceptive Berobat Jalan
management
458 21-09-2019 132614010919P001544 0000714784522 ASPIYA P PBI (APBN) Other contraceptive Berobat Jalan
management
459 21-09-2019 132614010919Y001090 0000715321934 BUNATI P PBI (APBN) Examination and Berobat Jalan
encounter for
460 21-09-2019 132614010919Y001110 0000715412013 SUWARNI P PBI (APBN) Conjunctivitis Berobat Jalan
461 21-09-2019 132614010919Y001107 0000715564102 MUSTADA P PBI (APBN) Gastric ulcer Berobat Jalan
462 21-09-2019 132614010919Y001108 0000715564574 MUHAMMAD NAFIUDIN L PBI (APBN) Gout Berobat Jalan
463 21-09-2019 132614010919Y001109 0000715564822 MAULIDAH BADRIYAH P PBI (APBN) Acute nasopharyngitis Berobat Jalan
[common cold]
464 21-09-2019 132614010919Y001083 0000715565529 SATIA P PBI (APBN) Acute upper respiratory Berobat Jalan
unspecified sites
465 21-09-2019 132614010919Y001086 0000715572742 MUHAMMAD HAPIT USMAN L PBI (APBN) Respiratory tuberculosis, Berobat Jalan
466 21-09-2019 132614010919Y001095 0000715626314 IMAMI P PBI (APBN) Respiratory tuberculosis, Rujuk Vertikal
not confirmed
bacteriologically or
histologically
467 21-09-2019 132614010919Y001334 0000715779538 FITRIYAH P PBI (APBN) Supervision of normal Berobat Jalan
pregnancy
468 21-09-2019 132614010919Y001081 0000715849953 BIDAYATIN P PBI (APBN) Non-insulin-dependent Berobat Jalan
diabetes mellitus
469 21-09-2019 132614010919Y001076 0000715888517 TINARA P PBI (APBN) Heart failure Rujuk Vertikal
470 21-09-2019 132614010919Y001094 0000716039188 SITI AISAH P PBI (APBN) Schizophrenia Berobat Jalan
471 21-09-2019 132614010919Y001326 0000716052554 NASIHIN L PBI (APBN) Other disorders of muscle Berobat Jalan

472 132614010919Y001324 0000716053138 ABD. KARIM AL FAHMI L PBI (APBN) Cutaneous abscess, Berobat Jalan
21-09-2019
473 21-09-2019 132614010919Y001323 0000716083762 SUSIYATI P PBI (APBN) Acute upper respiratory Berobat Jalan
unspecified sites
474 21-09-2019 132614010919Y001077 0000716187069 SITI ASIA P PBI (APBN) Gingivitis and periodontal Berobat Jalan
diseases
475 21-09-2019 132614010919Y001328 0000716257822 HUDROTUN NASIHA P PBI (APBN) Other contraceptive Berobat Jalan
management
476 21-09-2019 132614010919Y001153 0000716260059 NAFIÀH. P PBI (APBN) Contraceptive Berobat Jalan
management
477 21-09-2019 132614010919Y001116 0000716270905 MUTIMA P PBI (APBN) Acute upper respiratory Berobat Jalan
unspecified sites
478 21-09-2019 132614010919Y001154 0000716273572 SITI ROSADAH P PBI (APBN) Contraceptive Berobat Jalan
management
479 21-09-2019 132614010919Y001101 0000716338607 SUKRI L PBI (APBN) Fracture of lower leg, Rujuk Vertikal
including ankle
480 21-09-2019 132614010919Y001096 0000716355786 RAHMANIA SYAFIRA PUTRI P PBI (APBN) Caught, crushed, jammed Berobat Jalan
injury
481 21-09-2019 132614010919Y001335 0000716399627 M. ROHIM L PBI (APBN) Diseases of pulp and Berobat Jalan
periapical tissues
482 21-09-2019 132614010919Y001078 0000716434468 MALIK L PBI (APBN) Idiopathic Rujuk Vertikal
thrombocytopenic purpura
484 21-09-2019 132614010919P001509 0000716511442 SUPIÀTI P PBI (APBN) Other contraceptive Berobat Jalan
management
485 21-09-2019 132614010919Y001330 0000716587716 HASANA P PBI (APBN) Other contraceptive Berobat Jalan
management
486 21-09-2019 132614010919Y001073 0001042729007 JULAIHA P PBI (APBN) Cyst of Bartholin's gland Rujuk Vertikal
487 21-09-2019 132614010919Y001080 0001042732203 SUMAIDA P PBI (APBN) Non-insulin-dependent Berobat Jalan
diabetes mellitus
488 21-09-2019 132614010919Y001151 0001042736321 JUWAIRIYAH P PBI (APBN) Contraceptive Berobat Jalan
management
489 21-09-2019 132614010919Y001117 0001042737039 KHUMAIYAH P PBI (APBN) Acute upper respiratory Berobat Jalan
unspecified sites

490 132614010919Y001105 0001042738413 MUSRIFAH P PBI (APBN) Other disorders of muscle Berobat Jalan
21-09-2019
491 21-09-2019 132614010919Y001089 0001042739616 ANA YULIAWATI P PBI (APBN) Acute upper respiratory Berobat Jalan

unspecified sites
492 21-09-2019 132614010919Y001106 0001042748188 IMRON ROSYADI L PBI (APBN) Respiratory tuberculosis, Berobat Jalan
493 21-09-2019 132614010919Y001075 0001042754635 BELLA RIZQIYAH P PBI (APBN) Acute nasopharyngitis Berobat Jalan
[common cold]
495 21-09-2019 132614010919Y001152 0001398277721 SA'IDAH P PEGAWAI SWASTA Contraceptive Berobat Jalan
management
496 21-09-2019 132614010919P001507 0001704324385 IKA NURDIANI P PEGAWAI SWASTA Other contraceptive Berobat Jalan
management
497 21-09-2019 132614010919Y001093 0001793129038 RIZIQ GARIS BAWONO L PEKERJA MANDIRI Suppurative and Berobat Jalan
498 21-09-2019 132614010919Y001098 0001823341994 KHULIATI P PNS DAERAH Gingivitis and periodontal Berobat Jalan
diseases
499 21-09-2019 132614010919Y001097 0001889874022 MILATUZ ZAKIYAH P PEKERJA MANDIRI Other headache Berobat Jalan
syndromes
500 21-09-2019 132614010919Y001091 0002239480596 SUSI INDIATI P PEKERJA MANDIRI Typhoid and paratyphoid Berobat Jalan
fevers
501 21-09-2019 132614010919Y001327 0002326849108 M ADAM MAULANA L PBI (APBN) Cutaneous abscess, Berobat Jalan
502 21-09-2019 132614010919Y001103 0002455127201 SOCHIP L PEKERJA MANDIRI Stroke, not specified as Berobat Jalan
503 21-09-2019 132614010919Y001104 0002460338313 AHMAD TAUFIK L PEKERJA MANDIRI Allergic contact dermatitis Berobat Jalan
504 21-09-2019 132614010919Y001338 0002499729726 DULASIM L PBI (APBD) Essential (primary) Berobat Jalan
hypertension
505 21-09-2019 132614010919P001508 0002501347689 ROMLAH P PBI (APBD) Other contraceptive Berobat Jalan
management
506 21-09-2019 132614010919Y001100 0002517820795 SITI KHOIRIYAH P PBI (APBD) Caught, crushed, jammed Berobat Jalan
injury
507 21-09-2019 132614010919Y001072 0002583142367 HAMIDAH P PBI (APBN) Dental caries Berobat Jalan

508 21-09-2019 132614010919Y001102 0002609445947 ANDINI RAHMANIA P PBI (APBN) Caught, crushed, jammed Berobat Jalan
injury
509 21-09-2019 132614010919Y001082 0002741410067 ADELIA RISMA KHISELA L PEKERJA MANDIRI Disorders of tooth Berobat Jalan
510 21-09-2019 132614010919Y001087 0002885568423 MUHAMMAD TEGUH SANTUSO L PEKERJA MANDIRI Special screening Rujuk Vertikal
examination for other
diseases and disorders
511 21-09-2019 132614010919Y001071 0002889146711 FATIMATUS ZAHRA P PEKERJA MANDIRI Nonspecific lymphadenitis, Rujuk Vertikal
unspecified
512 20-09-2019 132614010919Y001042 0000112669672 EKO SUKOWATI P PNS DAERAH Examination and Berobat Jalan
encounter for
513 20-09-2019 132614010919Y001115 0000112847321 IMIATI MOKODOMPIT P PENERIMA PENSIUN TNI Impetigo Berobat Jalan Diabetes
Mellitus
514 20-09-2019 132614010919Y001029 0000112947074 IIN ROCHAENAH P PENERIMA PENSIUN Senile cataract Rujuk Vertikal
PNS
515 20-09-2019 132614010919Y001114 0000170085791 MURTINAH P PENERIMA PENSIUN Impetigo Berobat Jalan Diabetes
PNS Mellitus
516 20-09-2019 132614010919Y001015 0000714826359 DJUWARIYAH P PBI (APBN) Insulin-dependent Rujuk Vertikal
diabetes mellitus
517 20-09-2019 132614010919Y001064 0000715178845 SUGIATI P PBI (APBN) Gastric ulcer Berobat Jalan
518 20-09-2019 132614010919Y001034 0000715201582 CHOIRIYAH P PBI (APBN) Essential (primary) Berobat Jalan
hypertension
519 20-09-2019 132614010919Y001145 0000715329279 SHOLIHATI P PBI (APBN) Contraceptive Berobat Jalan
management
520 20-09-2019 132614010919Y001028 0000715349338 SUPATMI P PBI (APBN) Acute pharyngitis Berobat Jalan
521 20-09-2019 132614010919Y001038 0000715545933 DUWI AYU RAHMAWATI P PBI (APBN) Disorders of refraction and Rujuk Vertikal
accommodation
522 20-09-2019 132614010919Y001066 0000715553594 M. KHOJIN L PBI (APBN) Gout Berobat Jalan
523 20-09-2019 132614010919Y001067 0000715554674 SITI FAIDAH P PBI (APBN) Diseases of pulp and Berobat Jalan
periapical tissues
524 20-09-2019 132614010919Y001068 0000715554775 WAFIQ AZIZAH P PBI (APBN) Allergic contact dermatitis Berobat Jalan
525 20-09-2019 132614010919Y001069 0000715555539 FATIMATUZ ZAHRO P PBI (APBN) Allergic contact dermatitis Berobat Jalan
526 20-09-2019 132614010919Y001070 0000715555596 SURANTAN L PBI (APBN) Gastric ulcer Berobat Jalan

527 132614010919Y001053 0000715578636 SUTIK P PBI (APBN) Caught, crushed, jammed Berobat Jalan
20-09-2019
injury
528 20-09-2019 132614010919Y001009 0000715602251 AZIZAH P PBI (APBN) Other headache Berobat Jalan
syndromes
529 20-09-2019 132614010919Y001013 0000715638115 M ROSUL L PBI (APBN) Disorders of tooth Berobat Jalan
530 20-09-2019 132614010919Y001011 0000715639781 LILIS NURHALIMAH P PBI (APBN) Disorders of refraction and Rujuk Vertikal
accommodation
531 20-09-2019 132614010919Y001047 0000715735146 HOIRUL ANWAR L PEGAWAI SWASTA Other headache Berobat Jalan
syndromes
532 20-09-2019 132614010919Y001039 0000715749906 HARISIN L PBI (APBN) Respiratory tuberculosis, Berobat Jalan
533 20-09-2019 132614010919Y001026 0000716001928 M TOHA L PBI (APBN) Other disorders of lens Rujuk Vertikal
534 20-09-2019 132614010919Y001008 0000716044961 JAMIATUN NIKMAH P PBI (APBN) Other maternal diseases Berobat Jalan

childbirth and the
puerperium
535 20-09-2019 132614010919Y001021 0000716078305 FITRIYAH P PBI (APBN) Gastric ulcer Berobat Jalan
536 20-09-2019 132614010919Y001035 0000716086776 MUSTARAM L PBI (APBN) Gastritis, unspecified Rujuk Vertikal
537 20-09-2019 132614010919Y001036 0000716123733 PONEDI L PBI (APBN) Heart failure Rujuk Vertikal
538 20-09-2019 132614010919Y001032 0000716138245 SUTIHAT P PBI (APBN) Acute nasopharyngitis Berobat Jalan
[common cold]
539 20-09-2019 132614010919Y001493 0000716157696 SUKESI P PBI (APBN) Gastric ulcer Berobat Jalan
540 20-09-2019 132614010919Y001023 0000716179577 LULUK KARTINI P PBI (APBN) Essential (primary) Berobat Jalan
hypertension
541 20-09-2019 132614010919Y001148 0000716197961 SITI ROFIAH P PBI (APBN) Contraceptive Berobat Jalan
management
542 20-09-2019 132614010919Y001025 0000716251588 SASI P PBI (APBN) Acute pharyngitis Berobat Jalan
follow-up care
544 20-09-2019 132614010919Y001112 0000716272097 MUDRIKAH L PBI (APBN) Impetigo Berobat Jalan
545 20-09-2019 132614010919Y001048 0000716276711 FIRMANSYAH L PBI (APBN) Disorders of tooth Berobat Jalan


546 132614010919Y001113 0000716306949 KASIH P PBI (APBN) Cutaneous abscess, Berobat Jalan
20-09-2019
547 20-09-2019 132614010919Y001150 0000716308626 JAMILAH P PBI (APBN) Contraceptive Berobat Jalan
management
548 20-09-2019 132614010919Y001012 0000716314127 MOCH. SYA'RONI L PBI (APBN) Stroke, not specified as Rujuk Vertikal
549 20-09-2019 132614010919Y001149 0000716323454 LULUK ISTIQOMAH P PBI (APBN) Contraceptive Berobat Jalan
management
550 20-09-2019 132614010919Y001019 0000716324207 KALIMAH P PBI (APBN) Gastric ulcer Berobat Jalan
551 20-09-2019 132614010919Y001037 0000716326637 NURUL P PBI (APBN) Non-insulin-dependent Berobat Jalan
diabetes mellitus
552 20-09-2019 132614010919Y001049 0000716345166 HUFRON L PBI (APBN) Acute upper respiratory Berobat Jalan
unspecified sites
553 20-09-2019 132614010919Y001147 0000716359814 ULFA IRANIYAH P PBI (APBN) Contraceptive Berobat Jalan
management
554 20-09-2019 132614010919Y001022 0000716383438 M.LUKMAN HAKIM L PBI (APBN) Paranoid schizophrenia Rujuk Vertikal
555 20-09-2019 132614010919Y001016 0000716388513 SALAMA P PBI (APBN) Other headache Berobat Jalan
syndromes
556 20-09-2019 132614010919Y001041 0000716452953 SAMIATUN P PBI (APBN) Non-insulin-dependent Berobat Jalan
diabetes mellitus
557 20-09-2019 132614010919Y001063 0000716496197 KAMILUDIN L PBI (APBN) Acute pharyngitis Berobat Jalan
558 20-09-2019 132614010919Y001495 0000716781611 HOFIDA P PBI (APBN) Other headache Berobat Jalan
syndromes
559 20-09-2019 132614010919Y001494 0000716827307 SAADAH P PBI (APBN) Gingivitis and periodontal Berobat Jalan
diseases
560 20-09-2019 132614010919Y001146 0001042734069 SITI WAFRO P PBI (APBN) Contraceptive Berobat Jalan
management
561 20-09-2019 132614010919Y001030 0001042735588 LULUK KURNIAWATI P PBI (APBN) Examination and Berobat Jalan
encounter for
562 20-09-2019 132614010919Y001143 0001042736095 NUR AINI P PBI (APBN) Contraceptive Berobat Jalan
management
563 20-09-2019 132614010919Y001111 0001042737412 BUDI RAHAYU P PBI (APBN) Impetigo Berobat Jalan
564 20-09-2019 132614010919Y001040 0001042738885 AMALA P PBI (APBN) Essential (primary) Berobat Jalan
hypertension

565 132614010919Y001014 0001042742237 BESRI L PBI (APBN) Acute upper respiratory Berobat Jalan
20-09-2019
unspecified sites
567 20-09-2019 132614010919Y001046 0001538833533 RUDIANTO HADI PRASETYO L PEGAWAI SWASTA Impetigo Berobat Jalan
568 20-09-2019 132614010919Y001065 0001539111892 ANIS MUNADZIFAH P PBI (APBD) Essential (primary) Berobat Jalan
hypertension
569 20-09-2019 132614010919Y001024 0001600037177 CHOIRON L PEGAWAI SWASTA Stroke, not specified as Rujuk Vertikal
570 20-09-2019 132614010919Y001044 0001828997673 NUR HALIMAH P PEGAWAI SWASTA Examination and Berobat Jalan
encounter for
571 20-09-2019 132614010919Y001031 0001918391826 LAILATUL QOMARIYAH P PBI (APBN) Varicella [chickenpox] Berobat Jalan
572 20-09-2019 132614010919Y001052 0002163915202 HABIBATUS SOLIKHA P PEGAWAI SWASTA Typhoid and paratyphoid Berobat Jalan
fevers
573 20-09-2019 132614010919Y001045 0002195812607 M.URIP L PEKERJA MANDIRI Impetigo Berobat Jalan
574 20-09-2019 132614010919Y001050 0002203675514 MUHAMAD NURFARISKI AL L PEGAWAI SWASTA Impetigo Berobat Jalan
MAHBUBI
575 20-09-2019 132614010919Y001043 0002214070299 SUMARNIASIH P PEKERJA MANDIRI Typhoid and paratyphoid Berobat Jalan
fevers
576 20-09-2019 132614010919Y001018 0002299135342 KHUSNUL KHOTIMAH P PEKERJA MANDIRI Examination and Berobat Jalan
encounter for
577 20-09-2019 132614010919Y001027 0002609445925 ALMUWIDATAINI P PBI (APBN) Essential (primary) Berobat Jalan
hypertension
578 20-09-2019 132614010919Y001017 0002623611251 SIAMA P PBI (APBD) Essential (primary) Berobat Jalan
hypertension
579 20-09-2019 132614010919Y001144 0002753370729 ROHMAH P PBI (APBD) Contraceptive Berobat Jalan
management
580 19-09-2019 132614010919Y000956 0000112670649 NINIK ADI HARIAMI P PNS DAERAH Caught, crushed, jammed Berobat Jalan
injury
581 19-09-2019 132614010919P000976 0000112948648 ROCHAYATUN P PENERIMA PENSIUN Essential (primary) Berobat Jalan
PNS hypertension

582 132614010919Y000926 0000113018398 GATOT SUYUDI L PNS DAERAH Diarrhoea and Berobat Jalan
19-09-2019
gastroenteritis of
583 19-09-2019 132614010919Y000952 0000714495824 UMROH P PBI (APBN) Supervision of normal Berobat Jalan
pregnancy
584 19-09-2019 132614010919Y000935 0000715306689 URIFAH P PBI (APBN) Gastritis and duodenitis Berobat Jalan
585 19-09-2019 132614010919Y000938 0000715466643 FADLULLOH L PBI (APBN) Typhoid and paratyphoid Berobat Jalan
fevers
586 19-09-2019 132614010919Y000995 0000715469343 WAGIMAH P PBI (APBN) Other rheumatoid arthritis Berobat Jalan
587 19-09-2019 132614010919Y000936 0000715475889 SODIK L PBI (APBN) Acute upper respiratory Berobat Jalan

unspecified sites
588 19-09-2019 132614010919Y000948 0000715528271 NUR HAMIDATUL HASANAH P PBI (APBN) Supervision of normal Berobat Jalan
pregnancy
589 19-09-2019 132614010919Y001005 0000715547553 FATHURRONI L PBI (APBN) Allergic contact dermatitis Berobat Jalan
590 19-09-2019 132614010919Y001006 0000715547845 ADENAN L PBI (APBN) Allergic contact dermatitis Berobat Jalan
591 19-09-2019 132614010919Y001007 0000715547902 ASMI P PBI (APBN) Gout Berobat Jalan
592 19-09-2019 132614010919Y000916 0000715622556 KHOLIP P PBI (APBN) Keratitis Rujuk Vertikal
593 19-09-2019 132614010919Y000942 0000715753012 SAMIATIN P PBI (APBN) Essential (primary) Berobat Jalan
hypertension
594 19-09-2019 132614010919Y000954 0000715881677 RUM MARIANA P PBI (APBN) Other disorders of muscle Berobat Jalan
595 19-09-2019 132614010919Y000909 0000715887731 MESNADI L PBI (APBN) Cutaneous abscess, Berobat Jalan

596 19-09-2019 132614010919Y000911 0000715968628 M. IMRON ROSYADI L PBI (APBN) Other rheumatoid arthritis Berobat Jalan
597 19-09-2019 132614010919Y000934 0000716006979 WARINI P PBI (APBN) Acute upper respiratory Berobat Jalan

unspecified sites
598 19-09-2019 132614010919Y000924 0000716047064 SITI FATIMAH P PBI (APBN) Other headache Berobat Jalan
syndromes
599 19-09-2019 132614010919Y000915 0000716047874 SULAIMIN L PBI (APBN) Periapical abscess with Rujuk Vertikal
sinus
600 19-09-2019 132614010919Y000953 0000716095135 MISNATI P PBI (APBN) Diseases of pulp and Berobat Jalan
periapical tissues
601 19-09-2019 132614010919Y000912 0000716097262 SANTIYAM P PBI (APBN) Other headache Berobat Jalan
syndromes

602 132614010919Y000937 0000716111335 FITRIYAH P PBI (APBN) Other specified Berobat Jalan
19-09-2019
counselling
603 19-09-2019 132614010919Y000920 0000716185359 KAMARIA P PBI (APBN) Senile cataract Berobat Jalan
604 19-09-2019 132614010919Y000939 0000716262568 MUSLIMIN L PBI (APBN) Other superficial mycoses Berobat Jalan
605 19-09-2019 132614010919P001511 0000716265268 SUNARSIH P PBI (APBN) Other contraceptive Berobat Jalan
management
606 19-09-2019 132614010919Y000922 0000716271557 MOCH.SUBHAN L PBI (APBN) Follow-up care involving Berobat Jalan
removal of fracture plate
and other internal fixation
device
607 19-09-2019 132614010919Y000946 0000716304339 SUHRO P PBI (APBN) Supervision of normal Berobat Jalan
pregnancy
608 19-09-2019 132614010919Y000994 0000716324938 M. AMAN ABADI L PBI (APBN) Other rheumatoid arthritis Berobat Jalan
609 19-09-2019 132614010919Y001140 0000716325546 MUSNATIN P PBI (APBN) Contraceptive Berobat Jalan
management
610 19-09-2019 132614010919Y000929 0000716367971 M. NOVEL ALVIANSYAH L PBI (APBN) Varicella [chickenpox] Berobat Jalan
611 19-09-2019 132614010919Y001141 0000716513016 SUWARNI P PBI (APBN) Contraceptive Berobat Jalan
management
612 19-09-2019 132614010919Y001129 0000716620961 TUNAWAR L PBI (APBN) Contraceptive Berobat Jalan
management
613 19-09-2019 132614010919Y001131 0000716626563 SUILAH P PBI (APBN) Contraceptive Berobat Jalan
management
614 19-09-2019 132614010919Y001130 0000716626989 DEWI AISAH P PBI (APBN) Contraceptive Berobat Jalan
management
615 19-09-2019 132614010919Y001128 0000716798654 HALIMAH P PBI (APBN) Contraceptive Berobat Jalan
management
616 19-09-2019 132614010919Y000951 0000716835701 DESI LIA KHUSNAH P PBI (APBN) Supervision of normal Berobat Jalan
pregnancy
617 19-09-2019 132614010919Y000932 0000716917408 SHOLIHAN L PBI (APBN) Gingivitis and periodontal Berobat Jalan
diseases
618 19-09-2019 132614010919Y000914 0001042723866 SUADAH P PBI (APBN) Uterovaginal prolapse, Rujuk Vertikal
unspecified
619 19-09-2019 132614010919Y000925 0001042730122 ABD.MUÌN L PBI (APBN) Acute upper respiratory Berobat Jalan
unspecified sites
620 19-09-2019 132614010919Y001135 0001042733316 SULIMAH P PBI (APBN) Contraceptive Berobat Jalan
management

621 132614010919Y001142 0001042734025 WIWIN HIDAYATI P PBI (APBN) Contraceptive Berobat Jalan
19-09-2019
management
622 19-09-2019 132614010919Y001137 0001042734249 ROSYID. L PBI (APBN) Contraceptive Berobat Jalan
management
623 19-09-2019 132614010919Y001132 0001042734982 SITI YANTI P PBI (APBN) Contraceptive Berobat Jalan
management
624 19-09-2019 132614010919Y001138 0001042735184 ZUHRO P PBI (APBN) Contraceptive Berobat Jalan
management
625 19-09-2019 132614010919Y001134 0001042736117 HOSIÌN L PBI (APBN) Contraceptive Berobat Jalan
management
626 19-09-2019 132614010919Y001133 0001042736128 MARDIYAH P PBI (APBN) Contraceptive Berobat Jalan
management
627 19-09-2019 132614010919Y001136 0001042741967 HUSNUL KHOTIMAH P PBI (APBN) Contraceptive Berobat Jalan
management
628 19-09-2019 132614010919Y000923 0001042744858 AMINATUS ZUHRIYAH P PBI (APBN) Senile cataract Rujuk Vertikal
629 19-09-2019 132614010919Y000950 0001042752249 SYAMI ROFAS L PBI (APBN) Supervision of normal Berobat Jalan
pregnancy
630 19-09-2019 132614010919Y000910 0001162605925 MUJIATI P PEGAWAI SWASTA Acute upper respiratory Berobat Jalan
unspecified sites
631 19-09-2019 132614010919Y000933 0001162665123 NAILIS SAADAH P PEGAWAI SWASTA Respiratory tuberculosis, Berobat Jalan
632 19-09-2019 132614010919Y000944 0001291961204 MUKHAMAD LAVIKAL AZIZ L PEKERJA MANDIRI Presence of intraocular Rujuk Vertikal
lens
633 19-09-2019 132614010919Y000913 0001314426543 SATOYA P PEKERJA MANDIRI Non-insulin-dependent Rujuk Vertikal
diabetes mellitus
634 19-09-2019 132614010919Y000940 0001434175097 SAYUTI P PEKERJA MANDIRI Haemorrhoids Berobat Jalan
635 19-09-2019 132614010919Y001139 0001450050254 UMI HANIK P PNS DAERAH Contraceptive Berobat Jalan
management
injury
637 19-09-2019 132614010919Y000941 0001862157137 BAHROWI L PEKERJA MANDIRI Other schizoaffective Rujuk Vertikal
disorders
638 19-09-2019 132614010919Y000921 0001905537216 ANDRIANSYAH L PNS DAERAH Acute lymphoblastic Rujuk Vertikal
leukaemia

639 132614010919Y000908 0002081292917 KHOIRUN NISAK P PEGAWAI SWASTA Gingivitis and periodontal Berobat Jalan
19-09-2019
diseases
640 19-09-2019 132614010919Y000930 0002205597374 YASIN L PEKERJA MANDIRI Gingivitis and periodontal Berobat Jalan
diseases
641 19-09-2019 132614010919Y000945 0002238862803 ULUL AZMI P PEKERJA MANDIRI Supervision of normal Berobat Jalan
pregnancy
642 19-09-2019 132614010919Y000919 0002295072538 SUASTIK L PEKERJA MANDIRI Insulin-dependent Rujuk Vertikal
diabetes mellitus
643 19-09-2019 132614010919Y000918 0002477468709 DJUWARIYAH P PEKERJA MANDIRI Chronic kidney disease, Rujuk Vertikal
stage 5
644 19-09-2019 132614010919Y000927 0002497177269 SIFAUL FUADAH P PEKERJA MANDIRI Gingivitis and periodontal Berobat Jalan
diseases
645 19-09-2019 132614010919Y000949 0002589913034 NI'MATUS S P PBI (APBN) Supervision of normal Berobat Jalan
pregnancy
646 19-09-2019 132614010919Y000955 0002597477207 SUNARTI P PBI (APBN) Caught, crushed, jammed Berobat Jalan
injury
647 19-09-2019 132614010919Y000917 0002598013989 ACHMAD HAMDANI L PBI (APBN) Disorders of tooth Berobat Jalan
648 19-09-2019 132614010919Y000943 0002622567047 AHMAD MARZUQI FIRDAUS L PEKERJA MANDIRI Acute upper respiratory Berobat Jalan
unspecified sites
649 19-09-2019 132614010919Y000947 0002631193209 M ALFARIZI L PBI (APBN) Scabies Berobat Jalan
650 19-09-2019 132614010919Y000931 0002808554578 BU MARYAM P PBI (APBN) Senile cataract Rujuk Vertikal
651 19-09-2019 132614010919Y000928 0002880277029 AKHMAD RYAN WAHYUDI L PEKERJA MANDIRI Suppurative and Rujuk Vertikal

652 18-09-2019 132614010919Y000880 0000112669964 MASÀDA P PNS DAERAH Other arthrosis Rujuk Vertikal
653 18-09-2019 132614010919Y000897 0000112735484 SUGIATI P PNS DAERAH Acute nasopharyngitis Berobat Jalan
[common cold]
654 18-09-2019 132614010919Y000851 0000112947074 IIN ROCHAENAH P PENERIMA PENSIUN Senile cataract Rujuk Vertikal
PNS
655 18-09-2019 132614010919Y000893 0000677627289 YULIANA DWI PUSPITASARI P PBI (APBN) Supervision of normal Berobat Jalan
pregnancy
pregnancy
657 18-09-2019 132614010919Y000898 0000715208646 SITI URIFATUL HASANAH P PBI (APBN) Supervision of normal Berobat Jalan
pregnancy

658 132614010919Y000881 0000715269418 MAIMUNA P PBI (APBN) Supervision of normal Berobat Jalan
18-09-2019
pregnancy
659 18-09-2019 132614010919Y001120 0000715301223 SUHAMA P PBI (APBN) Contraceptive Berobat Jalan
management
660 18-09-2019 132614010919Y000876 0000715306184 RISTA ARINI P PBI (APBN) Examination and Berobat Jalan
encounter for
661 18-09-2019 132614010919Y001124 0000715357899 MUSRIP L PBI (APBN) Contraceptive Berobat Jalan
management
662 18-09-2019 132614010919Y000847 0000715420462 SUPRIATIN L PBI (APBN) Unspecified abortion, Rujuk Vertikal
complete or unspecified,
without complication
663 18-09-2019 132614010919Y000859 0000715522432 IZATUL MUNAWAROH P PBI (APBN) Supervision of normal Rujuk Vertikal
pregnancy
664 18-09-2019 132614010919Y000905 0000715541635 ROMLAH BASORI ALWI P PBI (APBN) Pneumonia due to other Berobat Jalan
665 18-09-2019 132614010919Y000906 0000715541995 JAMILATUL MUKARROMAH P PBI (APBN) Diseases of pulp and Berobat Jalan
periapical tissues
666 18-09-2019 132614010919Y000907 0000715542131 PAINAH P PBI (APBN) Allergic contact dermatitis Berobat Jalan
667 18-09-2019 132614010919Y000849 0000715604646 MULYONO L PBI (APBN) Non-insulin-dependent Rujuk Vertikal
diabetes mellitus
668 18-09-2019 132614010919Y000883 0000715622556 KHOLIP P PBI (APBN) Other specified Berobat Jalan
counselling
669 18-09-2019 132614010919Y000879 0000715672168 SILFI NOFIYANI P PBI (APBN) Supervision of normal Berobat Jalan
pregnancy
670 18-09-2019 132614010919Y000901 0000715725404 NASRIAH P PBI (APBN) Acute pharyngitis Berobat Jalan
671 18-09-2019 132614010919Y000871 0000715804255 JAMILA P PBI (APBN) Acute upper respiratory Berobat Jalan

unspecified sites
672 18-09-2019 132614010919Y000867 0000715815134 ZULAEHA P PBI (APBN) Supervision of normal Berobat Jalan
pregnancy
673 18-09-2019 132614010919Y000889 0000715844586 SITI P PBI (APBN) Gastric ulcer Berobat Jalan
674 18-09-2019 132614010919Y000844 0000715850831 WAGE L PBI (APBN) Other headache Berobat Jalan
syndromes
675 18-09-2019 132614010919Y000866 0000715874578 AMINAH P PBI (APBN) Typhoid and paratyphoid Berobat Jalan
fevers
676 18-09-2019 132614010919Y000882 0000715911816 VIVI FUADI P PBI (APBN) Disorders of refraction and Rujuk Vertikal
accommodation

677 132614010919Y000892 0000715912222 ROMELAH P PBI (APBN) Essential (primary) Berobat Jalan
18-09-2019
hypertension
678 18-09-2019 132614010919Y000890 0000715926464 M.YUSUF L PBI (APBN) Tension-type headache Rujuk Vertikal
679 18-09-2019 132614010919Y000853 0000715965309 WASIS L PBI (APBN) Other benign neoplasms Rujuk Vertikal
of connective and other

soft tissue
680 18-09-2019 132614010919Y001121 0000715997856 MUSAROFA P PBI (APBN) Contraceptive Berobat Jalan
management
681 18-09-2019 132614010919Y000891 0000716024733 HIKMATUL ISLAMIYAH P PBI (APBN) Supervision of normal Berobat Jalan
pregnancy
682 18-09-2019 132614010919Y000856 0000716049652 HOLIMAH P PBI (APBN) Chronic kidney disease, Rujuk Vertikal
stage 5
683 18-09-2019 132614010919Y000877 0000716154322 KHALIMAH P PBI (APBN) Cholelithiasis Rujuk Vertikal
684 18-09-2019 132614010919Y001125 0000716282932 LAILAS ZAHRO P PBI (APBN) Contraceptive Berobat Jalan
management
685 18-09-2019 132614010919Y001126 0000716283055 SOLICHAN P PBI (APBN) Contraceptive Berobat Jalan
management
686 18-09-2019 132614010919Y000904 0000716304734 SUPINTIN P PBI (APBN) Gastric ulcer Berobat Jalan
687 18-09-2019 132614010919Y000903 0000716305645 SUMIATI P PBI (APBN) Acute upper respiratory Berobat Jalan

unspecified sites
688 18-09-2019 132614010919Y000902 0000716308255 ANUK P PBI (APBN) Acute upper respiratory Berobat Jalan
unspecified sites
689 18-09-2019 132614010919Y000845 0000716316388 NOVI P PBI (APBN) Acute pharyngitis Berobat Jalan
690 18-09-2019 132614010919Y001127 0000716376453 SITI RUKOIYAH P PBI (APBN) Contraceptive Berobat Jalan
management
691 18-09-2019 132614010919Y000896 0000716466227 LUTFIAH P PBI (APBN) Supervision of normal Berobat Jalan
pregnancy
692 18-09-2019 132614010919Y000861 0000716497165 FATIMA P PBI (APBN) Supervision of normal Berobat Jalan
pregnancy
693 18-09-2019 132614010919Y000899 0000716525965 SITI MARIYAM P PBI (APBN) Gastric ulcer Berobat Jalan
694 18-09-2019 132614010919Y000888 0000716975537 LASTRI P PBI (APBN) Allergic contact dermatitis Berobat Jalan
695 18-09-2019 132614010919Y000887 0001042734339 NOR HALIMAH P PBI (APBN) Essential (primary) Berobat Jalan
hypertension
696 18-09-2019 132614010919Y001123 0001042736321 JUWAIRIYAH P PBI (APBN) Contraceptive Berobat Jalan
management

697 132614010919Y000875 0001042742698 FADILA P PBI (APBN) Allergic contact dermatitis Berobat Jalan
18-09-2019
698 18-09-2019 132614010919Y000874 0001042744858 AMINATUS ZUHRIYAH P PBI (APBN) Senile cataract Berobat Jalan
699 18-09-2019 132614010919Y000868 0001042748188 IMRON ROSYADI L PBI (APBN) Insulin-dependent Rujuk Vertikal
diabetes mellitus
700 18-09-2019 132614010919Y000884 0001130278105 SUGIYANTO L PEGAWAI SWASTA Acute upper respiratory Berobat Jalan
unspecified sites
701 18-09-2019 132614010919Y000860 0001314426543 SATOYA P PEKERJA MANDIRI Respiratory tuberculosis, Rujuk Vertikal
702 18-09-2019 132614010919Y000878 0001538984687 ABDUL ROHMAN P PEGAWAI SWASTA Typhoid and paratyphoid Berobat Jalan
fevers
703 18-09-2019 132614010919Y000857 0001539873415 SUSANTOKO L PEGAWAI SWASTA Other specified Berobat Jalan
counselling
704 18-09-2019 132614010919Y000864 0001826497787 NUR LAILY ISROIYAH P PEGAWAI SWASTA Supervision of normal Berobat Jalan
pregnancy
705 18-09-2019 132614010919Y000848 0001826501534 ANISA RAMADHANI P PEGAWAI SWASTA Disorders of tooth Berobat Jalan
706 18-09-2019 132614010919Y000850 0001826502996 RIZQA ALIYAH L PEGAWAI SWASTA Gingivitis and periodontal Berobat Jalan
diseases
707 18-09-2019 132614010919Y000854 0001851090063 TIMBUL EFENDY L PEGAWAI SWASTA Insulin-dependent Rujuk Vertikal
diabetes mellitus
708 18-09-2019 132614010919Y001119 0002065582001 HASANAH P PEKERJA MANDIRI Contraceptive Berobat Jalan
management
709 18-09-2019 132614010919Y000852 0002121284621 MARIATUL KIFTIYAH P PBI (APBN) Diseases of pulp and Berobat Jalan
periapical tissues
710 18-09-2019 132614010919Y000895 0002281954206 MUSYAROFAH P PBI (APBD) Non-insulin-dependent Berobat Jalan
diabetes mellitus
711 18-09-2019 132614010919Y000862 0002477969954 SUMIATI P PBI (APBD) Keratitis Berobat Jalan
712 18-09-2019 132614010919Y000858 0002477971359 SARONI L PBI (APBD) Acute upper respiratory Berobat Jalan

unspecified sites
714 18-09-2019 132614010919Y001122 0002599115793 SITI FADILLAH P PBI (APBN) Contraceptive Berobat Jalan
management
715 18-09-2019 132614010919Y001118 0002608454439 RIRIS HANDAYANI P PBI (APBN) Contraceptive Berobat Jalan
management

716 18-09-2019 132614010919Y000869 0002808557289 NADIFAH P PBI (APBN) Supervision of normal Berobat Jalan
pregnancy
717 18-09-2019 132614010919Y000846 0002891551353 MARTIK P VETERAN Senile cataract Rujuk Vertikal
718 17-09-2019 132614010919Y000830 0000112669964 MASÀDA P PNS DAERAH Cardiomegaly Rujuk Vertikal
719 17-09-2019 132614010919Y000797 0000112733054 ENDAH WULANDARI P PNS DAERAH Other cardiac arrhythmias Berobat Jalan
720 17-09-2019 132614010919Y000790 0000113227795 PATRIA IRBAWATI P PNS DAERAH Asthma Berobat Jalan
721 17-09-2019 132614010919Y000779 0000714766522 ADAM IDRUS L PBI (APBN) Chronic conjunctivitis Rujuk Vertikal
722 17-09-2019 132614010919Y001004 0000714819982 RODIYAH P PBI (APBN) Contraceptive Berobat Jalan Diabetes
management Mellitus
723 17-09-2019 132614010919Y000833 0000714959201 NURUL CHOLIFAH P PBI (APBN) Gastric ulcer Berobat Jalan
724 17-09-2019 132614010919Y000834 0000715035071 NURJANNAH P PBI (APBN) Gastric ulcer Berobat Jalan
725 17-09-2019 132614010919Y000773 0000715250237 SAFUAH P PBI (APBN) Gastric ulcer Berobat Jalan
726 17-09-2019 132614010919Y000788 0000715440115 DULLAH L PBI (APBN) Other headache Berobat Jalan
syndromes
727 17-09-2019 132614010919Y000809 0000715490662 GUNARSO L PBI (APBN) Other rheumatoid arthritis Berobat Jalan
728 17-09-2019 132614010919Y000810 0000715492078 SUMIANAH P PBI (APBN) Acute upper respiratory Berobat Jalan

unspecified sites
729 17-09-2019 132614010919Y000838 0000715527887 KARTONO L PBI (APBN) Gastritis and duodenitis Berobat Jalan
730 17-09-2019 132614010919Y000808 0000715532229 USWATUN HASANAH P PBI (APBN) Pneumonia due to other Berobat Jalan

731 17-09-2019 132614010919Y000812 0000715532938 AMINULLOH L PBI (APBN) Gout Berobat Jalan
732 17-09-2019 132614010919Y000814 0000715533388 NURHAMIDAH P PBI (APBN) Diseases of pulp and Berobat Jalan
periapical tissues
733 17-09-2019 132614010919Y000818 0000715533759 SUKRON L PBI (APBN) Diseases of pulp and Berobat Jalan
periapical tissues
734 17-09-2019 132614010919Y000822 0000715533783 HALIMAH P PBI (APBN) Essential (primary) Berobat Jalan
hypertension
735 17-09-2019 132614010919Y000840 0000715540983 FARIDA P PBI (APBN) Amoebiasis Berobat Jalan
736 17-09-2019 132614010919Y000843 0000715547586 SALAMAH P PBI (APBN) Other rheumatoid arthritis Berobat Jalan
737 17-09-2019 132614010919Y000815 0000715559624 IRA ISMAWATI P PBI (APBN) Examination and Berobat Jalan
encounter for

738 132614010919Y000841 0000715560939 ABD. HAFID L PBI (APBN) Gastric ulcer Berobat Jalan
17-09-2019
739 17-09-2019 132614010919Y000839 0000715571021 M.BUDI L PBI (APBN) Acute pharyngitis Berobat Jalan
740 17-09-2019 132614010919Y000842 0000715574496 M. YASIN L PBI (APBN) Cutaneous abscess, Berobat Jalan

741 17-09-2019 132614010919Y000816 0000715597806 SINTA NURIYAH P PBI (APBN) Epilepsy Rujuk Vertikal
742 17-09-2019 132614010919Y000782 0000715681798 NIKMATUL ULFA P PBI (APBN) Acute upper respiratory Berobat Jalan

unspecified sites
743 17-09-2019 132614010919Y000835 0000715724998 SUMILA P PBI (APBN) Acute upper respiratory Berobat Jalan
unspecified sites
744 17-09-2019 132614010919Y000827 0000715766523 SAÌDAH P PBI (APBN) Conjunctivitis Berobat Jalan
745 17-09-2019 132614010919Y000799 0000715849018 RUPIÀ P PBI (APBN) Essential (primary) Berobat Jalan
hypertension
746 17-09-2019 132614010919Y000792 0000715849299 SUPINTIN P PBI (APBN) Diseases of pulp and Berobat Jalan
periapical tissues
747 17-09-2019 132614010919Y000776 0000715895357 TALITA SALSABILA P PBI (APBN) Gastric ulcer, acute with Berobat Jalan
haemorrhage
748 17-09-2019 132614010919Y000791 0000715963544 MUJAYANA P PBI (APBN) Other specified Berobat Jalan
counselling
749 17-09-2019 132614010919Y000774 0000716043115 SATUMI P PEGAWAI PEMERINTAH Non-insulin-dependent Berobat Jalan
DENGAN PERJANJIAN diabetes mellitus
KERJA
750 17-09-2019 132614010919Y001003 0000716071555 MOCH.TOIF L PBI (APBN) Contraceptive Berobat Jalan
management
751 17-09-2019 132614010919Y000872 0000716084425 HANIA P PBI (APBN) Acute pharyngitis Berobat Jalan
752 17-09-2019 132614010919P001510 0000716092964 LILA ANGGREANI P PBI (APBN) Other contraceptive Berobat Jalan
management
753 17-09-2019 132614010919Y000772 0000716168125 ZUHROTUL QAMARIA P PBI (APBN) Acute pharyngitis Berobat Jalan
754 17-09-2019 132614010919Y000795 0000716177788 EKA TEGUH WICAKSONO L PBI (APBN) Acute upper respiratory Berobat Jalan

unspecified sites
755 17-09-2019 132614010919Y000807 0000716207343 RUBAKYAH P PBI (APBN) Acute upper respiratory Berobat Jalan
unspecified sites
756 17-09-2019 132614010919Y000806 0000716286194 SAROFA P PBI (APBN) Other headache Berobat Jalan
syndromes

757 132614010919Y000775 0000716310404 MAHMUDA P PBI (APBN) Gingivitis and periodontal Berobat Jalan
17-09-2019
diseases
758 17-09-2019 132614010919Y000805 0000716350026 MUHAMMAD SOFIYULLOH L PBI (APBN) Foreign body in Rujuk Vertikal
oesophagus
759 17-09-2019 132614010919Y000783 0000716391865 KARIM HOJI L PBI (APBN) Respiratory tuberculosis, Rujuk Vertikal
not confirmed
histologically
760 17-09-2019 132614010919Y000836 0000716463573 NURUL UMROTIN P PBI (APBN) Gastric ulcer Berobat Jalan
761 17-09-2019 132614010919Y000787 0000716464001 FATIMA P PBI (APBN) Acute upper respiratory Berobat Jalan

unspecified sites
762 17-09-2019 132614010919P001506 0000716489853 MUHIMATUL ULYA P PBI (APBN) Other contraceptive Berobat Jalan
management
763 17-09-2019 132614010919Y000796 0000716828859 JAENAB P PBI (APBN) Insulin-dependent Rujuk Vertikal
diabetes mellitus
764 17-09-2019 132614010919Y000803 0000716994123 AMINAH P PBI (APBN) Severe depressive Rujuk Vertikal
episode with psychotic
symptoms
765 17-09-2019 132614010919Y000778 0000717384813 SADIKYAH P PBI (APBN) Non-insulin-dependent Berobat Jalan
diabetes mellitus
766 17-09-2019 132614010919Y000831 0001042724755 MAISA P PBI (APBN) Typhoid and paratyphoid Berobat Jalan
fevers
767 17-09-2019 132614010919Y000784 0001042735195 MUHAMMAD KHOIRON L PBI (APBN) Scabies Berobat Jalan
WAHYUDI
768 17-09-2019 132614010919Y000813 0001042736758 SARIYO L PBI (APBN) Other rheumatoid arthritis Berobat Jalan
769 17-09-2019 132614010919Y000789 0001042750833 PATONA P PBI (APBN) Non-insulin-dependent Berobat Jalan
diabetes mellitus
770 17-09-2019 132614010919Y000817 0001198084307 HAMIDAH P PEGAWAI SWASTA Gingivitis and periodontal Berobat Jalan
diseases
771 17-09-2019 132614010919Y000820 0001539111892 ANIS MUNADZIFAH P PBI (APBD) Diseases of pulp and Berobat Jalan
periapical tissues
772 17-09-2019 132614010919Y000811 0001825797969 SITI AMANIA P PNS PUSAT Gestational Rujuk Vertikal
[pregnancy-induced]
hypertension with
773 17-09-2019 132614010919Y000801 0002214070299 SUMARNIASIH P PEKERJA MANDIRI Typhoid and paratyphoid Berobat Jalan
fevers
774 17-09-2019 132614010919Y000798 0002214072696 M. ARIF AL AMIN L PEKERJA MANDIRI Epilepsy, unspecified Rujuk Vertikal

775 132614010919Y000785 0002217776916 SUGENG MULYADI L PEGAWAI PEMERINTAH Typhoid and paratyphoid Berobat Jalan
17-09-2019
DENGAN PERJANJIAN fevers
KERJA
776 17-09-2019 132614010919Y000777 0002224366176 ENDAH SULISTYORINI P PEKERJA MANDIRI Low back pain Rujuk Vertikal
777 17-09-2019 132614010919Y000771 0002260705465 FATIMAH P PEKERJA MANDIRI Tuberculous peripheral Rujuk Vertikal
lymphadenopathy
778 17-09-2019 132614010919Y000770 0002260706804 ZAINUL ARIFIN L PEKERJA MANDIRI Unspecified human Rujuk Vertikal
immunodeficiency virus
[HIV] disease
779 17-09-2019 132614010919Y000794 0002444368397 FAIZATUL A`YUNI P PEKERJA MANDIRI Other mental retardation Rujuk Vertikal
780 17-09-2019 132614010919Y000780 0002465132938 MOH. NAFISIL FIKRI L PEKERJA MANDIRI Other disorders of muscle Berobat Jalan
781 17-09-2019 132614010919Y000786 0002465134391 FAHRUN NISAK P PEKERJA MANDIRI Gingivitis and periodontal Berobat Jalan
diseases
782 17-09-2019 132614010919Y000824 0002484887422 muhammad hasim L PEKERJA MANDIRI Chronic kidney disease Rujuk Vertikal
783 17-09-2019 132614010919Y000825 0002484887861 HUSNUL LAILA P PEKERJA MANDIRI Acute upper respiratory Berobat Jalan

unspecified sites
784 17-09-2019 132614010919Y000837 0002499729726 DULASIM L PBI (APBD) Other disorders of muscle Berobat Jalan
785 17-09-2019 132614010919Y000832 0002593505305 SUNDARI P PBI (APBN) Other contraceptive Berobat Jalan
management
786 17-09-2019 132614010919Y001002 0002595840478 LULUK FAIDAH P PBI (APBN) Contraceptive Berobat Jalan
management
787 17-09-2019 132614010919Y000804 0002600235156 MUHAMMAD RAFA ILZAMI L PBI (APBN) Acute upper respiratory Berobat Jalan
unspecified sites
788 17-09-2019 132614010919Y000802 0002602551598 WARAS P PBI (APBN) Other rheumatoid arthritis Berobat Jalan
789 17-09-2019 132614010919Y000781 0002609445925 ALMUWIDATAINI P PBI (APBN) Essential (primary) Berobat Jalan
hypertension
790 17-09-2019 132614010919Y000793 0002753370911 NAILI HIMMATUL ULYA P PBI (APBD) Acute upper respiratory Berobat Jalan
unspecified sites
791 17-09-2019 132614010919Y000800 0002766715604 RINA P PEKERJA MANDIRI Contraceptive Berobat Jalan
management
792 16-09-2019 132614010919Y000732 0000112947906 SUNDARI P PENERIMA PENSIUN Cardiomegaly Rujuk Vertikal
PNS
793 16-09-2019 132614010919Y000826 0000714770752 ZUBAUDAH P PBI (APBN) Cystitis Berobat Jalan
794 16-09-2019 132614010919Y000718 0000714786895 NURUL HUDA L PBI (APBN) Allergic contact dermatitis Berobat Jalan

795 132614010919Y000701 0000715249574 PAIMAN L PBI (APBN) Essential (primary) Berobat Jalan
16-09-2019
hypertension
796 16-09-2019 132614010919Y000726 0000715430496 SARI P PBI (APBN) Non-insulin-dependent Berobat Jalan
diabetes mellitus
797 16-09-2019 132614010919Y000739 0000715466643 FADLULLOH L PBI (APBN) Acute nasopharyngitis Berobat Jalan
[common cold]
798 16-09-2019 132614010919Y001000 0000715475136 ILMIATI P PBI (APBN) Contraceptive Berobat Jalan
management
799 16-09-2019 132614010919Y000748 0000715492585 SLAMET HARIYADI L PBI (APBN) Gingivitis and periodontal Berobat Jalan
diseases
800 16-09-2019 132614010919Y000829 0000715512802 ROMLAH P PBI (APBN) Essential (primary) Berobat Jalan
hypertension
801 16-09-2019 132614010919Y000757 0000715524377 AHMAD SYARIF L PBI (APBN) Diseases of pulp and Berobat Jalan
periapical tissues
802 16-09-2019 132614010919Y000758 0000715524704 YULIATI P PBI (APBN) Essential (primary) Berobat Jalan
hypertension
803 16-09-2019 132614010919Y000760 0000715525299 RIZKI MAULIDINA P PBI (APBN) Pneumonia due to other Berobat Jalan
804 16-09-2019 132614010919Y000761 0000715525907 MUCHAMMAD L PBI (APBN) Gout Berobat Jalan
805 16-09-2019 132614010919Y000762 0000715526627 HAYANAH P PBI (APBN) Gout Berobat Jalan
806 16-09-2019 132614010919Y000766 0000715527797 SITI FATIMAH P PBI (APBN) Other headache Berobat Jalan
syndromes
807 16-09-2019 132614010919Y000768 0000715528697 FAISOL MALIK L PBI (APBN) Cutaneous abscess, Berobat Jalan
808 16-09-2019 132614010919Y000767 0000715557104 KHOIRIYA P PBI (APBN) Gingivitis and periodontal Berobat Jalan
diseases
809 16-09-2019 132614010919Y000765 0000715564258 HATNAWI L PBI (APBN) Other rheumatoid arthritis Berobat Jalan
810 16-09-2019 132614010919Y000764 0000715567487 IKBAL L PBI (APBN) Acute pharyngitis Berobat Jalan
811 16-09-2019 132614010919Y000769 0000715569006 NURUL YAQIN L PBI (APBN) Acute upper respiratory Berobat Jalan

unspecified sites
812 16-09-2019 132614010919Y000819 0000715571526 NURUL HAYATI P PBI (APBN) Non-insulin-dependent Berobat Jalan
diabetes mellitus
813 16-09-2019 132614010919Y000745 0000715572595 ABD.MUHID L PBI (APBN) Acute upper respiratory Berobat Jalan
unspecified sites

814 132614010919Y000722 0000715575341 ILMIYAH P PBI (APBN) Other specified disorders Rujuk Vertikal
16-09-2019
of eyelid
815 16-09-2019 132614010919Y000727 0000715602971 SAIDAH P PBI (APBN) Gastritis and duodenitis Berobat Jalan
816 16-09-2019 132614010919Y000736 0000715613095 LULUK FARIDA P PBI (APBN) Essential (primary) Berobat Jalan
hypertension
817 16-09-2019 132614010919Y000719 0000715615132 AZIS L PBI (APBN) Other disorders of muscle Berobat Jalan
818 16-09-2019 132614010919Y000741 0000715638249 CHOIRUL UMAH L PBI (APBN) Gastric ulcer Berobat Jalan
819 16-09-2019 132614010919Y000999 0000715774588 MUHAMMAD MUSTAIN L PBI (APBN) Contraceptive Berobat Jalan
management
820 16-09-2019 132614010919Y000744 0000715844283 SUÌ L PBI (APBN) Other benign neoplasms Berobat Jalan
of connective and other
soft tissue
821 16-09-2019 132614010919Y000708 0000715863947 YATUN P PBI (APBN) Malignant neoplasm of Rujuk Vertikal
breast
822 16-09-2019 132614010919Y000720 0000715904572 NUR HOLIS L PBI (APBN) Hypertensive renal Rujuk Vertikal
disease
823 16-09-2019 132614010919Y000713 0000715926464 M.YUSUF L PBI (APBN) Glaucoma suspect Rujuk Vertikal
824 16-09-2019 132614010919Y000763 0000715927408 SITI NUR HOLISON P PBI (APBN) Gingivitis and periodontal Berobat Jalan
diseases
825 16-09-2019 132614010919Y000738 0000715963544 MUJAYANA P PBI (APBN) Other specified Berobat Jalan
counselling
826 16-09-2019 132614010919Y000721 0000715970327 MALIK ABD AZIZ L PBI (APBN) Typhoid and paratyphoid Berobat Jalan
fevers
827 16-09-2019 132614010919Y000715 0000715997856 MUSAROFA P PBI (APBN) Heart failure Rujuk Vertikal
828 16-09-2019 132614010919Y000700 0000716008779 MUNIR L PBI (APBN) Gastric ulcer Berobat Jalan
diabetes mellitus
830 16-09-2019 132614010919Y000737 0000716096283 HOIRON L PBI (APBN) Haemorrhoids Berobat Jalan
831 16-09-2019 132614010919Y000723 0000716242252 SIOFIN SAFITRI P PBI (APBN) Urticaria Berobat Jalan
832 16-09-2019 132614010919Y001001 0000716275146 SOFIYAH P PBI (APBN) Contraceptive Berobat Jalan
management
injury

834 132614010919Y000714 0000716337718 ARIL RAMADANI L PBI (APBN) Acute upper respiratory Berobat Jalan
16-09-2019
unspecified sites
835 16-09-2019 132614010919Y000993 0000716342466 HOTIM P PBI (APBN) Other headache Berobat Jalan
syndromes
836 16-09-2019 132614010919Y000724 0000716355336 MARHUMA P PBI (APBN) Non-insulin-dependent Berobat Jalan
diabetes mellitus
837 16-09-2019 132614010919Y000734 0000716361557 RUMIYAH P PBI (APBN) Non-insulin-dependent Berobat Jalan
diabetes mellitus
838 16-09-2019 132614010919Y000702 0000716391865 KARIM HOJI L PBI (APBN) Acute upper respiratory Berobat Jalan
unspecified sites
839 16-09-2019 132614010919Y000707 0000716486556 SAKDEYA P PBI (APBN) Respiratory tuberculosis, Berobat Jalan
840 16-09-2019 132614010919Y000717 0000716511519 NURHASANAH P PBI (APBN) Other disorders of gingiva Rujuk Vertikal
and edentulous alveolar
ridge
841 16-09-2019 132614010919Y000821 0000716526663 SAROFAH P PBI (APBN) Other contraceptive Berobat Jalan
management
842 16-09-2019 132614010919P001558 0000716526663 SAROFAH P PBI (APBN) Other contraceptive Berobat Jalan
management
843 16-09-2019 132614010919Y000697 0000716795482 SUMADI L PBI (APBN) Primary arthrosis of other Rujuk Vertikal
joints
844 16-09-2019 132614010919Y000709 0000716864883 SAMAÀNI P PBI (APBN) Senile cataract Berobat Jalan
845 16-09-2019 132614010919Y000759 0000716919254 HALIMATUL QODRIYAH P PBI (APBN) Other rheumatoid arthritis Berobat Jalan
846 16-09-2019 132614010919Y000747 0000717033734 SIFDAUL ZANNAH P PBI (APBN) Acute hepatitis B Rujuk Vertikal
847 16-09-2019 132614010919Y000712 0001042728175 PATIMAH P PBI (APBN) Acute upper respiratory Berobat Jalan

unspecified sites
848 16-09-2019 132614010919Y000706 0001042728647 SUMINAH P PBI (APBN) Non-insulin-dependent Rujuk Vertikal
diabetes mellitus
849 16-09-2019 132614010919Y000996 0001042735926 SAFUATI P PBI (APBN) General counselling and Berobat Jalan
advice on contraception
850 16-09-2019 132614010919Y000699 0001042736556 ABDUL HADI L PBI (APBN) Essential (primary) Berobat Jalan
hypertension
851 16-09-2019 132614010919Y000703 0001042736567 SUMARMI P PBI (APBN) Non-insulin-dependent Berobat Jalan
diabetes mellitus

852 132614010919Y000742 0001042737715 MUHAMMAD IRFAN L PBI (APBN) Examination and Berobat Jalan
16-09-2019
encounter for
853 16-09-2019 132614010919Y000997 0001042749281 ISMIA P PBI (APBN) Contraceptive Berobat Jalan
management
854 16-09-2019 132614010919Y000710 0001268026997 IRAWAN SOEDJATMIKO L PEKERJA MANDIRI Acute upper respiratory Berobat Jalan
WIDODO infections of multiple and
unspecified sites
855 16-09-2019 132614010919Y000705 0001539879221 ANINDYA RASYA NUR AZIZAH P PEKERJA MANDIRI Acute upper respiratory Berobat Jalan
unspecified sites
856 16-09-2019 132614010919Y000698 0001599916882 NUR HALIMAH P PEGAWAI SWASTA Pterygium Rujuk Vertikal
857 16-09-2019 132614010919Y000828 0001706729949 SITI AMINATUS ZAHRO P PBI (APBD) Acute upper respiratory Berobat Jalan

unspecified sites
858 16-09-2019 132614010919Y000733 0001706730322 LAILATUL FITRIYAH P PBI (APBD) Other headache Berobat Jalan
syndromes
859 16-09-2019 132614010919Y000728 0002075091434 SUILA P PEKERJA MANDIRI Insulin-dependent Rujuk Vertikal
diabetes mellitus
860 16-09-2019 132614010919Y000696 0002301273685 WARDATUN NAFISAH P PEKERJA MANDIRI Delivery by elective Rujuk Vertikal
caesarean section
861 16-09-2019 132614010919Y000716 0002378034663 FADILAH P PEKERJA MANDIRI Non-insulin-dependent Berobat Jalan
diabetes mellitus
862 16-09-2019 132614010919Y000746 0002519387559 SAKUR L PEKERJA MANDIRI Non-insulin-dependent Berobat Jalan
diabetes mellitus
863 16-09-2019 132614010919Y000704 0002582776809 SITI MAISAROH P PBI (APBN) Other specified Berobat Jalan
counselling
864 16-09-2019 132614010919Y000823 0002593505305 SUNDARI P PBI (APBN) Acute upper respiratory Berobat Jalan
unspecified sites
865 16-09-2019 132614010919Y000731 0002594674304 AINUN NI'AM L PBI (APBN) Other specified Berobat Jalan
counselling
866 16-09-2019 132614010919Y000998 0002599115771 SAROFAH P PBI (APBN) Contraceptive Berobat Jalan
management
867 16-09-2019 132614010919Y000711 0002639487363 JUARIYAH P PBI (APBN) Hyperlipidaemia, Berobat Jalan
unspecified
868 16-09-2019 132614010919Y000729 0002681969769 SITI ROHANI P PEGAWAI SWASTA Non-insulin-dependent Berobat Jalan
diabetes mellitus

869 132614010919Y000735 0002764684596 ALIFAH P PEKERJA MANDIRI Acute upper respiratory Berobat Jalan
16-09-2019
unspecified sites
870 16-09-2019 132614010919Y000730 0002773749093 MUSRIFAH P PEKERJA MANDIRI Heart failure Rujuk Vertikal
871 16-09-2019 132614010919Y000740 0002779124512 MUKSIN L PEKERJA MANDIRI Gastro-oesophageal reflux Rujuk Vertikal
disease without
oesophagitis
872 15-09-2019 132614010919Y000693 0000715559207 YUSRO P PBI (APBN) Acute upper respiratory Berobat Jalan
unspecified sites
873 15-09-2019 132614010919Y000695 0000715562594 KARSIANI P PBI (APBN) Insulin-dependent Berobat Jalan
diabetes mellitus
874 15-09-2019 132614010919Y000694 0000715563099 HILAL L PBI (APBN) Essential (primary) Berobat Jalan
hypertension
875 15-09-2019 132614010919Y000691 0000715563652 MARYAM P PBI (APBN) Gastric ulcer Berobat Jalan
876 15-09-2019 132614010919Y000692 0000715565046 UMMAIYA P PBI (APBN) Acute upper respiratory Berobat Jalan

unspecified sites
877 15-09-2019 132614010919Y000690 0000715609023 SULIS P PBI (APBN) Amoebiasis Berobat Jalan
878 14-09-2019 132614010919Y000660 0000112671865 SUMARIAH P PNS DAERAH Essential (primary) Rujuk Vertikal
hypertension
879 14-09-2019 132614010919Y000665 0000112717809 KRISTA SUSRINI. S.PD P PNS DAERAH Examination and Berobat Jalan
encounter for
880 14-09-2019 132614010919Y000669 0000112791249 HASAN BASORI L PENERIMA PENSIUN Non-insulin-dependent Berobat Jalan
PNS diabetes mellitus
881 14-09-2019 132614010919Y000662 0000200324362 IDHAM CHOLIL L PNS DAERAH Atherosclerotic heart Rujuk Vertikal
disease
882 14-09-2019 132614010919Y000753 0000714482717 ROSIDAH P PBI (APBN) Acute upper respiratory Berobat Jalan
unspecified sites
883 14-09-2019 132614010919Y000667 0000714631072 HANIFAH P PBI (APBN) Respiratory tuberculosis, Berobat Jalan
884 14-09-2019 132614010919Y000675 0000715448665 JUMRIYA P PBI (APBN) Other specified Berobat Jalan
counselling
885 14-09-2019 132614010919Y000654 0000715624817 ASWATUN P PBI (APBN) Allergic contact dermatitis Berobat Jalan

886 132614010919Y000671 0000715681798 NIKMATUL ULFA P PBI (APBN) Acute upper respiratory Berobat Jalan
14-09-2019
unspecified sites
887 14-09-2019 132614010919Y000673 0000715723402 ABD. ROHMAN P PBI (APBN) Other headache Berobat Jalan
syndromes
888 14-09-2019 132614010919Y000756 0000715730602 TUHAMI P PBI (APBN) Conjunctivitis Berobat Jalan
889 14-09-2019 132614010919Y000658 0000715835079 NUR AZIZAH P PBI (APBN) Acute upper respiratory Berobat Jalan

unspecified sites
890 14-09-2019 132614010919Y000648 0000716030831 SUTINI P PBI (APBN) Gingivitis and periodontal Berobat Jalan
diseases
891 14-09-2019 132614010919Y000656 0000716032855 SUHUDIL KHOIRI L PBI (APBN) Gastric ulcer Berobat Jalan
892 14-09-2019 132614010919Y000657 0000716042632 SUMIATI P PBI (APBN) Other arthritis Rujuk Vertikal
893 14-09-2019 132614010919Y000685 0000716062724 HUSNA P PBI (APBN) Allergic contact dermatitis Berobat Jalan
894 14-09-2019 132614010919Y000686 0000716063207 SITI LIYANA P PBI (APBN) Essential (primary) Berobat Jalan
hypertension
895 14-09-2019 132614010919Y000687 0000716063848 KARDOYO L PBI (APBN) Diseases of pulp and Berobat Jalan
periapical tissues
896 14-09-2019 132614010919Y000688 0000716064142 SUADAH P PBI (APBN) Acute nasopharyngitis Berobat Jalan
[common cold]
897 14-09-2019 132614010919Y000689 0000716064715 HOLILAH P PBI (APBN) Acute nasopharyngitis Berobat Jalan
[common cold]
898 14-09-2019 132614010919Y000652 0000716100827 PARIS P PBI (APBN) Acute upper respiratory Berobat Jalan
unspecified sites
899 14-09-2019 132614010919Y000752 0000716144049 SRIAMAH P PBI (APBN) Other headache Berobat Jalan
syndromes
900 14-09-2019 132614010919Y000646 0000716259328 RIYANTO L PBI (APBN) Depressive episode Rujuk Vertikal
901 14-09-2019 132614010919Y000655 0000716269926 SALAMAH P PBI (APBN) Essential (primary) Berobat Jalan
hypertension
902 14-09-2019 132614010919Y000670 0000716355595 IN DAH SAROH P PBI (APBN) Essential (primary) Berobat Jalan
hypertension
903 14-09-2019 132614010919Y000664 0000716423872 THOIFUR ROCHMAN L PBI (APBN) Typhoid and paratyphoid Berobat Jalan
fevers
905 14-09-2019 132614010919Y000754 0000716499224 NAWAMA P PBI (APBN) Cutaneous abscess, Berobat Jalan

906 132614010919P001555 0000716587716 HASANA P PBI (APBN) Other contraceptive Berobat Jalan
14-09-2019
management
907 14-09-2019 132614010919Y000650 0000716877257 MISBAHUL ARIF L PBI (APBN) Lepromatous leprosy Rujuk Vertikal
908 14-09-2019 132614010919Y000683 0000716938367 SINTA ROSMAWATI P PBI (APBN) Gastric ulcer Berobat Jalan
909 14-09-2019 132614010919P001561 0001042723337 MAIMUNAH P PBI (APBN) Other contraceptive Berobat Jalan
management
910 14-09-2019 132614010919Y000755 0001042723337 MAIMUNAH P PBI (APBN) Other contraceptive Berobat Jalan
management
911 14-09-2019 132614010919Y000649 0001042735331 ROMLAH P PBI (APBN) Non-insulin-dependent Berobat Jalan
diabetes mellitus
912 14-09-2019 132614010919Y000684 0001042736624 ASIYAH P PBI (APBN) Acute upper respiratory Berobat Jalan
unspecified sites
913 14-09-2019 132614010919Y000682 0001042736703 M.SYA`RONI L PBI (APBN) Other rheumatoid arthritis Berobat Jalan
914 14-09-2019 132614010919Y000677 0001042748651 HERLINA SUSANTI P PBI (APBN) Gingivitis and periodontal Berobat Jalan
diseases
915 14-09-2019 132614010919Y000666 0001042749911 EDI SANTOSO L PBI (APBN) Schizophrenia Berobat Jalan
916 14-09-2019 132614010919Y000661 0001042752857 ATIM YATI L PBI (APBN) Hebephrenic Rujuk Vertikal
schizophrenia
917 14-09-2019 132614010919Y000679 0001539873404 HARIYANTO L PEKERJA MANDIRI Non-insulin-dependent Berobat Jalan
diabetes mellitus
diseases
919 14-09-2019 132614010919Y000647 0001828629404 YUYUD AFANDI L PEKERJA MANDIRI Acute pharyngitis Berobat Jalan
injury
921 14-09-2019 132614010919Y000680 0002092759323 SUSANTI HARTATIK P PEKERJA MANDIRI Hyperlipidaemia, Berobat Jalan
unspecified
922 14-09-2019 132614010919Y000653 0002243378395 ASSYFA PUTRI APRILIA P PEGAWAI SWASTA Special screening Rujuk Vertikal
examination for certain
developmental disorders in
childhood
923 14-09-2019 132614010919Y000676 0002434612421 SINDI AWALIA RAMADANI P PEKERJA MANDIRI Epilepsy Rujuk Vertikal
924 14-09-2019 132614010919Y000651 0002592230398 M HAPIL L PBI (APBN) Sequelae of respiratory Berobat Jalan
and unspecified
tuberculosis

925 132614010919Y000678 0002592615789 SITI FATIMATUZ ZAHRO P PBI (APBN) Naevus, non-neoplastic Rujuk Vertikal
14-09-2019
926 14-09-2019 132614010919Y000674 0002606323667 KHOIROTUN NISA P PBI (APBN) Scabies Berobat Jalan
927 14-09-2019 132614010919Y000668 0002608076709 FINA KAMILA P PBI (APBN) Fibroadenosis of breast Rujuk Vertikal
928 14-09-2019 132614010919Y000663 0002766168549 SUMARJI L PEKERJA MANDIRI Injury of muscle and Rujuk Vertikal
tendon at ankle and foot

level
929 13-09-2019 132614010919Y000626 0000112671966 SUNARMI NINGSIH P PNS DAERAH Thyrotoxicosis, Rujuk Vertikal
unspecified
930 13-09-2019 132614010919Y000621 0000112948391 SOERAJI L PENERIMA PENSIUN Essential (primary) Berobat Jalan
PNS hypertension
931 13-09-2019 132614010919Y000750 0000714523498 FATONA P PBI (APBN) Acute upper respiratory Berobat Jalan
unspecified sites
932 13-09-2019 132614010919Y000751 0000714530283 MISBAHUL L PBI (APBN) Cutaneous abscess, Berobat Jalan
933 13-09-2019 132614010919Y000612 0000714556844 SA'ADATUN NAFIDAH P PBI (APBN) Acute upper respiratory Berobat Jalan
unspecified sites
934 13-09-2019 132614010919Y000614 0000715467666 SALIK P PBI (APBN) Non-insulin-dependent Berobat Jalan
diabetes mellitus
935 13-09-2019 132614010919Y000625 0000715618282 FADILAH P PBI (APBN) Pain in throat and chest Rujuk Vertikal
936 13-09-2019 132614010919Y000606 0000715713491 NURHAYATI P PBI (APBN) Amoebiasis Berobat Jalan
937 13-09-2019 132614010919Y000623 0000715992838 SAIHUL L PBI (APBN) Bronchitis, not specified as Berobat Jalan
acute or chronic
938 13-09-2019 132614010919Y000630 0000716032023 ABD. WACHID L PBI (APBN) Other disorders of muscle Berobat Jalan
939 13-09-2019 132614010919Y000635 0000716053871 ROMELAH P PBI (APBN) Allergic contact dermatitis Berobat Jalan
940 13-09-2019 132614010919Y000636 0000716054624 QURROTUL A'YUNINA P PBI (APBN) Diseases of pulp and Berobat Jalan
periapical tissues
941 13-09-2019 132614010919Y000637 0000716054714 HAMSIYA P PBI (APBN) Gout Berobat Jalan
942 13-09-2019 132614010919Y000638 0000716054861 WASILAHTUS SAÀDAH L PBI (APBN) Gout Berobat Jalan
943 13-09-2019 132614010919P001534 0000716076167 ELY LISMIYAH P PBI (APBN) Other contraceptive Berobat Jalan
management
944 13-09-2019 132614010919Y000629 0000716138065 KASIADI L PBI (APBN) Conjunctivitis Berobat Jalan
945 13-09-2019 132614010919Y000605 0000716186834 SAIDATUL FITRIYAH P PBI (APBN) Gingivitis and periodontal Berobat Jalan
diseases

946 132614010919Y000609 0000716218143 SITI AISA P PBI (APBN) Cutaneous abscess, Berobat Jalan
13-09-2019
947 13-09-2019 132614010919Y000628 0000716269566 KHOIRUN NISAK P PBI (APBN) Diseases of pulp and Berobat Jalan
periapical tissues
948 13-09-2019 132614010919Y000640 0000716302023 ALFIA P PBI (APBN) Impetigo Berobat Jalan
949 13-09-2019 132614010919Y000617 0000716390807 FATHUR ROZI L PBI (APBN) Scabies Berobat Jalan
950 13-09-2019 132614010919Y000608 0000716719173 ROFII L PBI (APBN) Other headache Berobat Jalan
syndromes
951 13-09-2019 132614010919Y000618 0000716769448 TIAMAH P PBI (APBN) Respiratory tuberculosis, Berobat Jalan
952 13-09-2019 132614010919Y000639 0000716855905 ARBAÀTIN P PBI (APBN) Essential (primary) Berobat Jalan
hypertension
953 13-09-2019 132614010919Y000615 0001042735149 FAHRUR ROZI L PBI (APBN) Hebephrenic Rujuk Vertikal
schizophrenia
954 13-09-2019 132614010919Y000607 0001042742024 NASARI P PBI (APBN) Essential (primary) Berobat Jalan
hypertension
955 13-09-2019 132614010919Y000616 0001326786625 SAMSUL WAHYUDI P PEGAWAI SWASTA Diarrhoea and Berobat Jalan
gastroenteritis of
956 13-09-2019 132614010919Y000634 0001440495898 H.ABDUL HADI L PEKERJA MANDIRI Asthma Rujuk Vertikal
957 13-09-2019 132614010919Y000624 0001836481015 MUHAMMAD ARIF WAFANI L PEGAWAI SWASTA Impetigo Rujuk Vertikal
958 13-09-2019 132614010919Y000611 0001849893941 MOHAMAD AFIF FULLOH L PBI (APBD) Hebephrenic Rujuk Vertikal
schizophrenia
959 13-09-2019 132614010919Y000627 0002082895165 M.YASRIL AMAR BATISTUTA L PNS PUSAT Scabies Berobat Jalan
960 13-09-2019 132614010919Y000620 0002161803339 MAULIDATUL ULFA P PBI (APBD) Cystitis Berobat Jalan
961 13-09-2019 132614010919Y000613 0002271890619 CHAIRUL WAHYONO L PEKERJA MANDIRI Disorders of refraction and Rujuk Vertikal
accommodation
962 13-09-2019 132614010919Y000622 0002458745357 SUGIONO L PEKERJA MANDIRI Non-insulin-dependent Berobat Jalan
diabetes mellitus
963 13-09-2019 132614010919Y000619 0002462250284 M. FAIZAR RIZKI RAMADHAN L PEGAWAI SWASTA Typhoid and paratyphoid Berobat Jalan
fevers
964 13-09-2019 132614010919P001512 0002595151348 MUAFIYAH P PBI (APBN) Other contraceptive Berobat Jalan
management
965 13-09-2019 132614010919Y000633 0002608076114 ANISA KANAYA BILQIS P PBI (APBN) Disorders of tooth Berobat Jalan

966 132614010919Y000749 0002637761196 NADIFA P PBI (APBN) Acute pharyngitis Berobat Jalan
13-09-2019
967 13-09-2019 132614010919Y000631 0002638724804 MAULIDIA P PBI (APBN) Allergic contact dermatitis Berobat Jalan
968 13-09-2019 132614010919Y000610 0002754685822 M. ARIYA MAULANA AHMAD L PBI (APBN) Other specified congenital Rujuk Vertikal
malformations
969 13-09-2019 132614010919Y000632 0002883841852 HASIATI P PEKERJA MANDIRI Insulin-dependent Rujuk Vertikal
diabetes mellitus
970 12-09-2019 132614010919Y000565 0000112669738 F.KALIMAH P PENERIMA PENSIUN Acute upper respiratory Berobat Jalan
PNS infections of multiple and
unspecified sites
971 12-09-2019 132614010919Y000561 0000112712163 ABDUL SOMAD L PNS DAERAH Examination and Berobat Jalan
encounter for
972 12-09-2019 132614010919Y000544 0000113227795 PATRIA IRBAWATI P PNS DAERAH Acute upper respiratory Berobat Jalan
unspecified sites
973 12-09-2019 132614010919Y000535 0000209591043 SITI MUDAWAMAH P PENERIMA PENSIUN TNI Chronic atrophic gastritis Rujuk Vertikal
974 12-09-2019 132614010919Y000560 0000679909149 NUR IMAMAH P PBI (APBN) Acute hepatitis B Rujuk Vertikal
975 12-09-2019 132614010919Y000575 0000714564044 ROBIATUL ADAWIYAH P PBI (APBN) Examination and Berobat Jalan
encounter for
976 12-09-2019 132614010919Y000546 0000714954284 ABD.HALIM P PBI (APBN) Acute nasopharyngitis Berobat Jalan
[common cold]
977 12-09-2019 132614010919Y000555 0000715308344 NURIYATUL MAULIDIYA P PBI (APBN) Gastric ulcer Berobat Jalan
978 12-09-2019 132614010919Y000559 0000715369105 WARSIATI P PBI (APBN) Lepromatous leprosy Berobat Jalan
979 12-09-2019 132614010919Y000568 0000715399075 SUPIATUN P PBI (APBN) Impetigo Berobat Jalan
980 12-09-2019 132614010919Y000600 0000715407772 SITI NUR FAUTIK P PBI (APBN) Other headache Berobat Jalan
syndromes
981 12-09-2019 132614010919Y000602 0000715427379 SANUSI L PBI (APBN) Other rheumatoid arthritis Berobat Jalan
982 12-09-2019 132614010919Y000585 0000715506761 NASMIYAH P PBI (APBN) Gastric ulcer Berobat Jalan
983 12-09-2019 132614010919Y000543 0000715508267 WAKIP L PBI (APBN) Other specified Berobat Jalan
counselling
984 12-09-2019 132614010919Y000539 0000715558983 AKHIYAT L PBI (APBN) Headache Berobat Jalan
985 12-09-2019 132614010919Y000603 0000715560669 UMI KULSUM P PBI (APBN) Acute pharyngitis Berobat Jalan
986 12-09-2019 132614010919Y000532 0000715575341 ILMIYAH P PBI (APBN) Other specified Berobat Jalan
counselling

987 132614010919Y000540 0000715583518 KAMALIA P PBI (APBN) Respiratory tuberculosis, Berobat Jalan
12-09-2019
not confirmed
histologically
988 12-09-2019 132614010919Y000530 0000715784804 NISAUL KARIMAH P PBI (APBN) Influenza, virus not Berobat Jalan
identified
989 12-09-2019 132614010919Y000564 0000715799913 PUTRI NATALIA P PBI (APBN) Disorders of tooth Berobat Jalan
990 12-09-2019 132614010919Y000550 0000715946286 IDA P PBI (APBN) Other superficial mycoses Berobat Jalan
991 12-09-2019 132614010919Y000549 0000715946591 WASI'A P PBI (APBN) Respiratory tuberculosis, Rujuk Vertikal
992 12-09-2019 132614010919Y000601 0000715991049 IRFAN L PBI (APBN) Acute pharyngitis Berobat Jalan
993 12-09-2019 132614010919Y000596 0000716042834 HOTIM P PBI (APBN) Gout Berobat Jalan
994 12-09-2019 132614010919Y000597 0000716042924 ABD. JALIL L PBI (APBN) Gout Berobat Jalan
995 12-09-2019 132614010919Y000598 0000716042981 LAILATUL QOMARIYAH P PBI (APBN) Other headache Berobat Jalan
syndromes
996 12-09-2019 132614010919Y000599 0000716043971 SITI HANIFAH P PBI (APBN) Diseases of pulp and Berobat Jalan
periapical tissues
997 12-09-2019 132614010919Y000586 0000716059585 SALMA P PBI (APBN) Acute upper respiratory Berobat Jalan
unspecified sites
998 12-09-2019 132614010919Y000587 0000716083762 SUSIYATI P PBI (APBN) Other headache Berobat Jalan
syndromes
999 12-09-2019 132614010919Y000583 0000716083907 ABDUL HALIM L PBI (APBN) Other headache Berobat Jalan
syndromes
1000 12-09-2019 132614010919Y000576 0000716132518 USWATUN HASANAH P PBI (APBN) Supervision of normal Berobat Jalan
pregnancy
1001 12-09-2019 132614010919Y000570 0000716161757 WAHYU HIDAYAT P PBI (APBN) Acute upper respiratory Berobat Jalan
unspecified sites
1002 12-09-2019 132614010919Y000548 0000716216488 MESRAN L PBI (APBN) Asthma Berobat Jalan
injury
1004 12-09-2019 132614010919Y000582 0000716313982 LAILIYAH P PBI (APBN) Supervision of normal Berobat Jalan
pregnancy

1005 12-09-2019 132614010919Y000572 0000716415118 ZAINAL ARIF L PBI (APBN) Respiratory tuberculosis, Berobat Jalan
1006 12-09-2019 132614010919Y000588 0000716428967 SITI SOFIYAH P PBI (APBN) Acute upper respiratory Berobat Jalan
unspecified sites
1007 12-09-2019 132614010919Y000580 0000716462155 ASIPRO WANTO L PBI (APBN) Respiratory tuberculosis, Berobat Jalan
1008 12-09-2019 132614010919Y000533 0000716463099 EFI MAUFIRO P PBI (APBN) Acute nasopharyngitis Berobat Jalan
[common cold]
1009 12-09-2019 132614010919Y000581 0000716474079 JUWARIYAH P PBI (APBN) Supervision of normal Berobat Jalan
pregnancy
1010 12-09-2019 132614010919Y000556 0000716656432 DIDIK ANSORI L PBI (APBN) Epilepsy Rujuk Vertikal
1011 12-09-2019 132614010919Y000563 0000716790688 FATCHUR ROZI L PBI (APBN) Essential (primary) Berobat Jalan
hypertension
1012 12-09-2019 132614010919Y000574 0000716828343 IDA FITRIAH P PBI (APBN) Supervision of normal Berobat Jalan
pregnancy
1013 12-09-2019 132614010919Y000569 0000716888283 AISAH P PBI (APBN) Supervision of normal Berobat Jalan
pregnancy
1014 12-09-2019 132614010919Y000562 0000717450265 LISWATI P PBI (APBN) Diseases of pulp and Rujuk Vertikal
periapical tissues
1015 12-09-2019 132614010919Y000547 0000763117738 ICA PARAMITA P PBI (APBN) Delivery by elective Rujuk Vertikal
caesarean section
1016 12-09-2019 132614010919Y000584 0001042721019 MALUMA P PBI (APBN) Essential (primary) Berobat Jalan Diabetes
hypertension Mellitus
1017 12-09-2019 132614010919Y000573 0001042730965 NAIFAH P PBI (APBN) Supervision of normal Berobat Jalan
pregnancy
1018 12-09-2019 132614010919Y000558 0001042744252 ATIM L PBI (APBN) Epistaxis Berobat Jalan
1019 12-09-2019 132614010919Y000531 0001042755322 ISMAEL L PBI (APBN) Acute upper respiratory Berobat Jalan

unspecified sites
1020 12-09-2019 132614010919Y000552 0001042755333 FAIZAH P PBI (APBN) Supervision of normal Berobat Jalan
pregnancy
1021 12-09-2019 132614010919Y000567 0001042799297 MOCH.HUJAIMI L PBI (APBN) Acute nasopharyngitis Berobat Jalan
[common cold]
1022 12-09-2019 132614010919Y000554 0001269444317 SULIANA P PEGAWAI BUMD Acute upper respiratory Berobat Jalan
unspecified sites

1023 132614010919Y000557 0001269444813 DEVI MAULIDIYAH P PEGAWAI BUMD Conjunctivitis Berobat Jalan
12-09-2019
1024 12-09-2019 132614010919Y000538 0001313383814 HASIN L PEGAWAI SWASTA Insulin-dependent Rujuk Vertikal
diabetes mellitus
1025 12-09-2019 132614010919Y000553 0001451547753 ROBIATUL ADAWIYAH P PEGAWAI SWASTA Single delivery by Rujuk Vertikal
caesarean section
1026 12-09-2019 132614010919Y000545 0001536291426 SAIFUL ALI L PEGAWAI SWASTA Acute upper respiratory Berobat Jalan
unspecified sites
1027 12-09-2019 132614010919Y001062 0001541382412 MUAWANAH P PEKERJA MANDIRI Supervision of normal Berobat Jalan
pregnancy
1028 12-09-2019 132614010919Y000571 0001706730399 ALI SUWONDO L PBI (APBD) Essential (primary) Berobat Jalan
hypertension
1029 12-09-2019 132614010919Y000578 0001871326528 EVI NUR AFIA P PEKERJA MANDIRI Supervision of normal Berobat Jalan
pregnancy
1030 12-09-2019 132614010919Y000551 0001900304965 PUTRI AQILATUS SAHILAH P PNS DAERAH Examination and Berobat Jalan
encounter for
1031 12-09-2019 132614010919Y000536 0002224366176 ENDAH SULISTYORINI P PEKERJA MANDIRI Other disorders of muscle Berobat Jalan
1032 12-09-2019 132614010919Y000534 0002436534999 MURDIANTO L PEKERJA MANDIRI Bronchitis, not specified as Rujuk Vertikal
acute or chronic
1033 12-09-2019 132614010919Y000542 0002458745548 ZUBAIDAH P PEKERJA MANDIRI Non-insulin-dependent Berobat Jalan
diabetes mellitus
1034 12-09-2019 132614010919Y000579 0002594807616 NISROTIN P PBI (APBN) Supervision of normal Berobat Jalan
pregnancy
1035 12-09-2019 132614010919Y000577 0002628985421 KHOIRUN NISAK DIANA PUTRI P PBI (APBN) Acute upper respiratory Berobat Jalan
unspecified sites
1036 12-09-2019 132614010919Y000541 0002640278452 M SYUKRON L PBI (APBN) Diseases of pulp and Berobat Jalan
periapical tissues
1037 12-09-2019 132614010919Y000537 0002755383063 FATHIMATUZ ZAHROH P PBI (APBD) Threatened abortion Rujuk Vertikal
1038 12-09-2019 132614010919Y000566 0002808576156 MAULIDIYA P PBI (APBN) Supervision of normal Berobat Jalan
pregnancy
PNS
1040 11-09-2019 132614010919Y000473 0000112743483 EDY PRIYANTO L PNS DAERAH Dental caries Berobat Jalan
1041 11-09-2019 132614010919Y000467 0000112784343 WIJAYA SUGIANTO L PNS DAERAH Acute pharyngitis Berobat Jalan
1042 11-09-2019 132614010919Y000463 0000112947287 SRI ASTUTI P PENERIMA PENSIUN Non-insulin-dependent Berobat Jalan


1043 132614010919Y000474 0000112948007 SRI WAHYURINI P PENERIMA PENSIUN Senile cataract Rujuk Vertikal
11-09-2019
PNS
1044 11-09-2019 132614010919Y000494 0000714494035 ACH.ABD.ROHIM L PBI (APBN) Gastric ulcer Berobat Jalan
1045 11-09-2019 132614010919P001474 0000714857905 SITI AMINAH P PBI (APBN) Other contraceptive Berobat Jalan
management
1046 11-09-2019 132614010919Y000464 0000715031201 AMINULLAH L PBI (APBN) Hebephrenic Rujuk Vertikal
schizophrenia
1047 11-09-2019 132614010919Y000493 0000715210716 TUTIK ZUBAIDAH P PBI (APBN) Supervision of normal Berobat Jalan
pregnancy
1048 11-09-2019 132614010919Y000462 0000715553008 WARDATUN NAFISA P PBI (APBN) Diarrhoea and Berobat Jalan
gastroenteritis of
1049 11-09-2019 132614010919Y000486 0000715556867 MIFTAHUL JANNAH P PBI (APBN) Other contraceptive Berobat Jalan
management
1050 11-09-2019 132614010919P000512 0000715579209 SIYAMA P PBI (APBN) Other contraceptive Berobat Jalan
management
1051 11-09-2019 132614010919Y000455 0000715753012 SAMIATIN P PBI (APBN) Essential (primary) Berobat Jalan
hypertension
1052 11-09-2019 132614010919Y000452 0000715763294 UMI LAILI P PBI (APBN) Acute upper respiratory Berobat Jalan
unspecified sites
1053 11-09-2019 132614010919Y000487 0000715772035 LISAUDA P PBI (APBN) Acute upper respiratory Berobat Jalan
unspecified sites
1054 11-09-2019 132614010919Y000500 0000715796728 KHOTIMATUL KHUSNA P PBI (APBN) Supervision of normal Berobat Jalan
pregnancy
1055 11-09-2019 132614010919Y000496 0000715815134 ZULAEHA P PBI (APBN) Supervision of normal Berobat Jalan
pregnancy
1056 11-09-2019 132614010919Y000444 0000715909329 MUHDOR L PBI (APBN) Other headache Berobat Jalan
syndromes
1057 11-09-2019 132614010919Y000488 0000715937916 RODI`YA P PBI (APBN) Supervision of normal Berobat Jalan
pregnancy
1058 11-09-2019 132614010919Y000528 0000715979845 LILIK MAULIDIA P PBI (APBN) Supervision of normal Berobat Jalan
pregnancy
1059 11-09-2019 132614010919Y000469 0000716032023 ABD. WACHID L PBI (APBN) Other disorders of muscle Berobat Jalan
1060 11-09-2019 132614010919Y000501 0000716037377 SAROPAH P PBI (APBN) Diseases of pulp and Berobat Jalan
periapical tissues

1061 11-09-2019 132614010919Y000502 0000716037513 FANLA P PBI (APBN) Diseases of pulp and Berobat Jalan
periapical tissues
1062 11-09-2019 132614010919Y000503 0000716037581 WARIS WIDIYANTO L PBI (APBN) Acute nasopharyngitis Berobat Jalan
[common cold]
1063 11-09-2019 132614010919Y000504 0000716037669 SUPIATUN P PBI (APBN) Gastric ulcer Berobat Jalan
1064 11-09-2019 132614010919Y000505 0000716037939 RISMA YURINA P PBI (APBN) Allergic contact dermatitis Berobat Jalan
1065 11-09-2019 132614010919Y000458 0000716095113 HUDZAIFATUL AISYAH P PBI (APBN) Acute nasopharyngitis Berobat Jalan
[common cold]
1066 11-09-2019 132614010919Y000485 0000716095135 MISNATI P PBI (APBN) Gastric ulcer Berobat Jalan
1067 11-09-2019 132614010919Y000457 0000716134151 MARTONO L PBI (APBN) Bronchitis, not specified as Berobat Jalan
acute or chronic
1068 11-09-2019 132614010919Y000484 0000716165875 MUTIÀTUL MUT TIMMAH P PBI (APBN) Delivery by elective Rujuk Vertikal
caesarean section
1069 11-09-2019 132614010919Y000483 0000716173018 HAMIDA P PBI (APBN) Other specified Berobat Jalan
counselling
1070 11-09-2019 132614010919Y000450 0000716178328 NUR FAIZAH P PBI (APBN) Acute upper respiratory Berobat Jalan
unspecified sites
1071 11-09-2019 132614010919Y000477 0000716221822 INDRIANI SAMUDRA P PBI (APBN) Other disorders of muscle Berobat Jalan
1072 11-09-2019 132614010919Y000645 0000716274865 SUNARSIH P PBI (APBN) Allergic contact dermatitis Berobat Jalan
1073 11-09-2019 132614010919Y000470 0000716317536 MUTAMMIMAH P PBI (APBN) Other disorders of muscle Berobat Jalan
1074 11-09-2019 132614010919Y000481 0000716444199 FITRIYA P PBI (APBN) Supervision of normal Berobat Jalan
pregnancy
1075 11-09-2019 132614010919Y000527 0000716452997 DESY RATNASARI P PBI (APBN) Acute upper respiratory Berobat Jalan
unspecified sites
1076 11-09-2019 132614010919Y000523 0000716467487 CHOTIMAH. P PBI (APBN) Other rheumatoid arthritis Berobat Jalan
1077 11-09-2019 132614010919Y000497 0000716506211 SAPIATUN P PBI (APBN) Other headache Berobat Jalan
syndromes
1078 11-09-2019 132614010919Y000490 0000716519068 MANSUR L PBI (APBN) Cystitis Berobat Jalan
1079 11-09-2019 132614010919Y000446 0000716521735 SUNARSIH P PBI (APBN) Other inflammation of Berobat Jalan
eyelid
1080 11-09-2019 132614010919Y000525 0000716523401 AISA P PBI (APBN) Seronegative rheumatoid Berobat Jalan
arthritis
1081 11-09-2019 132614010919Y000491 0000716557937 MAIMUNA P PBI (APBN) Conjunctivitis Berobat Jalan Diabetes
Mellitus

1082 132614010919Y000489 0000716808532 IKRIMA P PBI (APBN) Supervision of normal Berobat Jalan
11-09-2019
pregnancy
1083 11-09-2019 132614010919Y000453 0001042730122 ABD.MUÌN L PBI (APBN) Acute upper respiratory Berobat Jalan
unspecified sites
1084 11-09-2019 132614010919Y000495 0001042730368 FATHUR ROZAK L PBI (APBN) Conjunctivitis Berobat Jalan
HIDAYATULLOH
1085 11-09-2019 132614010919Y000522 0001042734058 KASIAMI P PBI (APBN) Essential (primary) Berobat Jalan
hypertension
1086 11-09-2019 132614010919Y000492 0001042734868 INDRA KURNIATI P PBI (APBN) Other contraceptive Berobat Jalan
management
1087 11-09-2019 132614010919Y000526 0001042735509 TAMIMA P PBI (APBN) Other headache Berobat Jalan
syndromes
1088 11-09-2019 132614010919Y000524 0001042735869 ALFIYA P PBI (APBN) Other headache Berobat Jalan
syndromes
1089 11-09-2019 132614010919Y000465 0001042736049 SUPIANAH P PBI (APBN) Non-insulin-dependent Berobat Jalan
diabetes mellitus
1090 11-09-2019 132614010919Y000482 0001042738301 SUPIAH P PBI (APBN) Non-insulin-dependent Berobat Jalan
diabetes mellitus
1091 11-09-2019 132614010919Y000461 0001042750451 NUR YASIN L PBI (APBN) Essential (primary) Berobat Jalan
hypertension
1092 11-09-2019 132614010919P001497 0001162807492 SAUDAH P PEGAWAI SWASTA Other contraceptive Berobat Jalan
management
1093 11-09-2019 132614010919Y000498 0001162807492 SAUDAH P PEGAWAI SWASTA Other contraceptive Berobat Jalan
management
1094 11-09-2019 132614010919Y000476 0001388644626 AMINAH P PBI (APBD) Other disorders of muscle Berobat Jalan
1095 11-09-2019 132614010919Y000466 0001442380509 ZAINUL L PEKERJA MANDIRI Haemorrhoids Berobat Jalan
1096 11-09-2019 132614010919Y000454 0001536283484 HUSEN L PEGAWAI SWASTA Gingivitis and periodontal Berobat Jalan
diseases
1097 11-09-2019 132614010919Y000456 0001539879219 SOPHIE AURELIA FIRDAUSI P PEKERJA MANDIRI Diseases of pulp and Berobat Jalan
periapical tissues
1098 11-09-2019 132614010919Y000448 0001828898302 ABDUR ROHMAN L PEGAWAI SWASTA Gastric ulcer Berobat Jalan
1099 11-09-2019 132614010919Y000478 0001969695235 MARIA ULFA P PEKERJA MANDIRI Non-insulin-dependent Berobat Jalan
diabetes mellitus
1100 11-09-2019 132614010919Y000445 0002228768289 KASIYATI P PEGAWAI SWASTA Disorders of refraction and Rujuk Vertikal
accommodation
1101 11-09-2019 132614010919Y000447 0002238862803 ULUL AZMI P PEKERJA MANDIRI Placenta praevia Rujuk Vertikal

1102 132614010919Y000449 0002473751981 ROBIJANTO L PEKERJA MANDIRI Stroke, not specified as Rujuk Vertikal
11-09-2019
1103 11-09-2019 132614010919Y000459 0002486049243 NUR HASAN L PBI (APBD) Disorders of refraction and Rujuk Vertikal
accommodation
1104 11-09-2019 132614010919Y000460 0002486049693 PONIAH P PBI (APBD) Insulin-dependent Rujuk Vertikal
diabetes mellitus
1105 11-09-2019 132614010919Y000451 0002490265179 SALAMI P PBI (APBD) Diarrhoea and Berobat Jalan
gastroenteritis of
1106 11-09-2019 132614010919Y000472 0002501187232 KHOZINUDDIN L PEKERJA MANDIRI Non-insulin-dependent Rujuk Vertikal

other specified
complications
1107 11-09-2019 132614010919Y000479 0002501187805 YULIANA P PEKERJA MANDIRI Non-insulin-dependent Berobat Jalan
diabetes mellitus
1108 11-09-2019 132614010919Y000468 0002634738546 DELA P PBI (APBN) Acute upper respiratory Berobat Jalan
unspecified sites
1109 11-09-2019 132614010919Y000471 0002779124512 MUKSIN L PEKERJA MANDIRI Vertigo of central origin Rujuk Vertikal
1110 11-09-2019 132614010919Y000475 0002779125006 MUSJAROFAH P PEKERJA MANDIRI Non-insulin-dependent Berobat Jalan
diabetes mellitus
1111 10-09-2019 132614010919Y000409 0000113008498 BAMBANG YULIANTO L PNS DAERAH Non-insulin-dependent Rujuk Vertikal
diabetes mellitus
1112 10-09-2019 132614010919Y000434 0000714484078 AMANAH P PBI (APBN) Other contraceptive Berobat Jalan
management
1113 10-09-2019 132614010919Y000410 0000714561884 ANIS TAMARA P PBI (APBN) Respiratory tuberculosis, Berobat Jalan
1114 10-09-2019 132614010919Y000439 0000715524118 HALIMATUS SAKDIYA P PBI (APBN) Other headache Berobat Jalan
syndromes
1115 10-09-2019 132614010919Y000440 0000715524401 AHMAD FUÀDI L PBI (APBN) Allergic contact dermatitis Berobat Jalan
1116 10-09-2019 132614010919Y000441 0000715524513 LAILATUL MUNAWAROH P PBI (APBN) Gout Berobat Jalan
1117 10-09-2019 132614010919Y000442 0000715525312 BAMBANG SUTEJO L PEGAWAI SWASTA Gout Berobat Jalan
1118 10-09-2019 132614010919Y000443 0000715525367 JUMROTIN P PEGAWAI SWASTA Gout Berobat Jalan
1119 10-09-2019 132614010919Y000424 0000715546618 ISNANI P PBI (APBN) Other contraceptive Berobat Jalan
management

1120 132614010919P000516 0000715556867 MIFTAHUL JANNAH P PBI (APBN) Other contraceptive Berobat Jalan
10-09-2019
management
1121 10-09-2019 132614010919Y000408 0000715581303 SOLEH AWIR L PBI (APBN) Acute upper respiratory Berobat Jalan
unspecified sites
1122 10-09-2019 132614010919P000508 0000715588828 DARIATI P PBI (APBN) Other contraceptive Berobat Jalan
management
1123 10-09-2019 132614010919Y000396 0000715622319 JUARTO L PBI (APBN) Hebephrenic Berobat Jalan
schizophrenia
1124 10-09-2019 132614010919Y000401 0000715667962 SIANA P PBI (APBN) Gout, unspecified Berobat Jalan
1125 10-09-2019 132614010919P000510 0000715676297 LULUK HALIMA P PBI (APBN) Other contraceptive Berobat Jalan
management
1126 10-09-2019 132614010919Y000423 0000715860461 SITI NAFISAH P PBI (APBN) Other specified Berobat Jalan
counselling
1127 10-09-2019 132614010919Y000407 0000715896358 WARSI P PBI (APBN) Glaucoma Rujuk Vertikal
1128 10-09-2019 132614010919Y000425 0000715911816 VIVI FUADI P PBI (APBN) Other specified Berobat Jalan
counselling
1129 10-09-2019 132614010919Y000419 0000715931515 NURUL BADRIYAH P PBI (APBN) Other specified Berobat Jalan
counselling
1130 10-09-2019 132614010919Y000411 0000716085202 SUTATIK P PBI (APBN) Other disorders of muscle Berobat Jalan
1131 10-09-2019 132614010919Y000418 0000716116037 MUHAMMAD SAHUL L PBI (APBN) Lepromatous leprosy Berobat Jalan
follow-up care
injury
1134 10-09-2019 132614010919P000400 0000716319268 M. JAWAHIR L PBI (APBN) Unilateral or unspecified Berobat Jalan
inguinal hernia, with
obstruction, without
gangrene
1135 10-09-2019 132614010919Y000416 0000716386443 MOH.AFIÙDDIN L PBI (APBN) Diarrhoea and Berobat Jalan
gastroenteritis of
1136 10-09-2019 132614010919Y000404 0000716447889 SAÀDAH P PBI (APBN) Gingivitis and periodontal Berobat Jalan
diseases
1137 10-09-2019 132614010919Y000412 0000716469219 SITI SHOFIYAH P PBI (APBN) Non-insulin-dependent Berobat Jalan
diabetes mellitus

1138 132614010919Y000436 0000716504758 YAYUK ENDANG SUAIDAH P PBI (APBN) Essential (primary) Berobat Jalan
10-09-2019
hypertension
1139 10-09-2019 132614010919Y000433 0000716505074 PUPUT NISWATUL KAROMAH P PBI (APBN) Gastric ulcer Berobat Jalan
1140 10-09-2019 132614010919Y000435 0000716528215 MUHAMMAD ILHAM ADI L PBI (APBN) Acute upper respiratory Berobat Jalan
SAPUTRA infections of multiple and

unspecified sites
1141 10-09-2019 132614010919Y000437 0000716575432 ACHMAD RIZKY RAMDHANY L PBI (APBN) Typhoid and paratyphoid Berobat Jalan
fevers
1142 10-09-2019 132614010919Y000438 0001042722358 SITI SOHIFAH P PBI (APBN) Other contraceptive Berobat Jalan
management
1143 10-09-2019 132614010919Y000414 0001042739763 TUTIK P PBI (APBN) Other disorders of muscle Berobat Jalan
1144 10-09-2019 132614010919Y000432 0001042753893 ARIS EFENDI L PBI (APBN) Deposits [accretions] on Berobat Jalan
teeth
1145 10-09-2019 132614010919Y000417 0001280571761 SUUDI L PEKERJA MANDIRI Other specified Berobat Jalan
counselling
1146 10-09-2019 132614010919Y000420 0001304983563 M.SOVWAN NUR EVENDI L PEGAWAI SWASTA Acute upper respiratory Berobat Jalan
unspecified sites
1147 10-09-2019 132614010919Y000415 0001323468742 UMI HIDAYATI P PEKERJA MANDIRI Essential (primary) Berobat Jalan
hypertension
1148 10-09-2019 132614010919Y000402 0001539111892 ANIS MUNADZIFAH P PBI (APBD) Diseases of pulp and Berobat Jalan
periapical tissues
1149 10-09-2019 132614010919Y000421 0001706729949 SITI AMINATUS ZAHRO P PBI (APBD) Other contraceptive Berobat Jalan
management
1150 10-09-2019 132614010919Y000397 0001809964574 SHOBIH RAMADHANI L PEKERJA MANDIRI Epilepsy Rujuk Vertikal
1151 10-09-2019 132614010919Y000427 0002072336668 NURUL ISWATUL MUARIFAH, P PEKERJA MANDIRI Gingivitis and periodontal Berobat Jalan
SPD diseases
1152 10-09-2019 132614010919Y000399 0002156126736 MUKHAMMAD FERI AFANDI L PEGAWAI SWASTA Acute upper respiratory Berobat Jalan
unspecified sites
1153 10-09-2019 132614010919Y000429 0002205597374 YASIN L PEKERJA MANDIRI Essential (primary) Berobat Jalan
hypertension
1154 10-09-2019 132614010919Y000405 0002455127201 SOCHIP L PEKERJA MANDIRI Stroke, not specified as Berobat Jalan
1155 10-09-2019 132614010919P000509 0002460338469 ERNI P PEKERJA MANDIRI Other contraceptive Berobat Jalan
management
1156 10-09-2019 132614010919Y000406 0002590660631 M SYAIFULLAH L PBI (APBN) Fever, unspecified Rujuk Vertikal

1157 132614010919Y000403 0002596716189 S KHULIYAH P PBI (APBN) Acute upper respiratory Berobat Jalan
10-09-2019
unspecified sites
1158 10-09-2019 132614010919Y000422 0002635989377 ACHMAD AFANDI L PBI (APBN) Diarrhoea and Berobat Jalan
gastroenteritis of
1159 10-09-2019 132614010919Y000413 0002738796862 TUMINI P PEKERJA MANDIRI Lepromatous leprosy Berobat Jalan
1160 10-09-2019 132614010919Y000395 0002754685822 M. ARIYA MAULANA AHMAD L PBI (APBN) Other specified congenital Rujuk Vertikal
malformations
1161 09-09-2019 132614010919Y000342 0000112948391 SOERAJI L PENERIMA PENSIUN Essential (primary) Berobat Jalan
PNS hypertension
1162 09-09-2019 132614010919Y000333 0000112956333 ABU HARTO L PENERIMA PENSIUN Essential (primary) Berobat Jalan
PNS hypertension
1163 09-09-2019 132614010919Y000344 0000112964141 MOCH YASIN L PNS DAERAH Non-insulin-dependent Berobat Jalan
diabetes mellitus
1164 09-09-2019 132614010919Y000365 0000714653346 ROMELAH P PBI (APBN) Cystitis Berobat Jalan
1165 09-09-2019 132614010919Y000376 0000714992141 MISNATI P PBI (APBN) Acute upper respiratory Berobat Jalan

unspecified sites
1166 09-09-2019 132614010919P001566 0000715194718 ROHIMAH P PBI (APBN) Other contraceptive Berobat Jalan
management
1167 09-09-2019 132614010919Y000380 0000715194718 ROHIMAH P PBI (APBN) Other contraceptive Berobat Jalan
management
1168 09-09-2019 132614010919P000513 0000715229313 HALIMATUS SADIKYA P PBI (APBN) Other contraceptive Berobat Jalan
management
1169 09-09-2019 132614010919Y000339 0000715270522 UMYANA P PBI (APBN) Allergic contact dermatitis Berobat Jalan
1170 09-09-2019 132614010919Y000340 0000715272726 KURNIAWATI P PBI (APBN) Disorders of refraction and Rujuk Vertikal
accommodation
1171 09-09-2019 132614010919Y000359 0000715281535 SUKARIYAH. P PBI (APBN) Other contraceptive Berobat Jalan
management
1172 09-09-2019 132614010919Y000350 0000715413971 MAULIDIYAH AKHYUNI P PBI (APBN) Examination and Berobat Jalan
encounter for
1173 09-09-2019 132614010919Y000383 0000715429899 ASMANI P PBI (APBN) Gingivitis and periodontal Berobat Jalan
diseases
1174 09-09-2019 132614010919Y000352 0000715448665 JUMRIYA P PBI (APBN) Respiratory tuberculosis, Berobat Jalan
not confirmed
histologically

1175 132614010919Y000382 0000715453479 ROIHATUL JANNAH P PBI (APBN) Gastritis and duodenitis Berobat Jalan
09-09-2019
1176 09-09-2019 132614010919Y000379 0000715481166 HARJITO L PBI (APBN) Other surgical follow-up Berobat Jalan
care
1177 09-09-2019 132614010919Y000388 0000715516615 SRI MURTI P PBI (APBN) Essential (primary) Berobat Jalan
hypertension
1178 09-09-2019 132614010919Y000394 0000715545933 DUWI AYU RAHMAWATI P PBI (APBN) Other maternal diseases Berobat Jalan
childbirth and the
puerperium
1179 09-09-2019 132614010919Y000341 0000715565924 MUHAYANAH P PBI (APBN) Essential (primary) Berobat Jalan
hypertension
1180 09-09-2019 132614010919Y000360 0000715572742 MUHAMMAD HAPIT USMAN L PBI (APBN) Respiratory tuberculosis, Berobat Jalan
not confirmed
histologically
1181 09-09-2019 132614010919Y000391 0000715632221 SUPARTO L PBI (APBN) Gastric ulcer Berobat Jalan
1182 09-09-2019 132614010919Y000364 0000715730703 SAHRUJI L PBI (APBN) Senile cataract Rujuk Vertikal
1183 09-09-2019 132614010919Y000357 0000715759143 SAYUTIK P PBI (APBN) Other contraceptive Berobat Jalan
management
1184 09-09-2019 132614010919Y000348 0000715759738 IRHAM JAYA KUSUMA L PBI (APBN) Suppurative and Berobat Jalan
1185 09-09-2019 132614010919Y000356 0000715887731 MESNADI L PBI (APBN) Gastric ulcer Berobat Jalan
1186 09-09-2019 132614010919Y000361 0000715893625 UMILA P PBI (APBN) Other acute ischaemic Berobat Jalan
heart diseases
1187 09-09-2019 132614010919Y000338 0000716063062 M RIZK RAMADANA L PBI (APBN) Scabies Berobat Jalan
1188 09-09-2019 132614010919Y000328 0000716079363 SULASTRI P PBI (APBN) Cutaneous abscess, Rujuk Vertikal

1189 09-09-2019 132614010919Y000371 0000716082704 LAILATUL FITRIYA P PBI (APBN) Acute upper respiratory Berobat Jalan
unspecified sites
1190 09-09-2019 132614010919Y000332 0000716093561 NURUZ ZAKIYA P PBI (APBN) Acute appendicitis Rujuk Vertikal
1191 09-09-2019 132614010919Y000368 0000716139011 KOSEM L PBI (APBN) Haemorrhoids Berobat Jalan
1192 09-09-2019 132614010919Y000392 0000716177463 JUHROTUL PUJIANTI P PBI (APBN) Acute upper respiratory Berobat Jalan

unspecified sites
1193 09-09-2019 132614010919Y000326 0000716274011 M HARI L PBI (APBN) Other acute viral hepatitis Rujuk Vertikal

1194 132614010919Y000343 0000716274437 MUSRIAH BT MARKATAM P PBI (APBN) Essential (primary) Berobat Jalan
09-09-2019
MANSUR hypertension
1195 09-09-2019 132614010919Y000327 0000716390807 FATHUR ROZI L PBI (APBN) Cutaneous abscess, Berobat Jalan
1196 09-09-2019 132614010919Y000393 0000716542626 ELIA NURDIANA P PBI (APBN) Acute upper respiratory Berobat Jalan
unspecified sites
1197 09-09-2019 132614010919Y000354 0000716567512 SRI SUTAMI P PBI (APBN) Acute renal failure Rujuk Vertikal
1198 09-09-2019 132614010919P001564 0000716609068 HUMAIYAH P PBI (APBN) Other contraceptive Berobat Jalan
management
1199 09-09-2019 132614010919Y000381 0000716609068 HUMAIYAH P PBI (APBN) Other contraceptive Berobat Jalan
management
1200 09-09-2019 132614010919Y000334 0000716615469 RACHMA ALIYAH P PBI (APBN) Disorders of refraction and Rujuk Vertikal
accommodation
1201 09-09-2019 132614010919Y000590 0000716664328 NUR AINI P PBI (APBN) Supervision of normal Berobat Jalan
pregnancy
1202 09-09-2019 132614010919Y000358 0000716669864 IKA NURMALA P PBI (APBN) Diarrhoea and Berobat Jalan
gastroenteritis of
1203 09-09-2019 132614010919Y000384 0000716694129 M.NURUL YAKIN L PBI (APBN) Pneumonia due to other Berobat Jalan

1204 09-09-2019 132614010919Y000385 0000716694546 IDIL FITRO L PBI (APBN) Pneumonia due to other Berobat Jalan
1205 09-09-2019 132614010919Y000386 0000716695738 NUR AINI P PBI (APBN) Gastric ulcer Berobat Jalan
1206 09-09-2019 132614010919Y000387 0000716695885 ABDUR ROHMAN L PBI (APBN) Gastric ulcer Berobat Jalan
1207 09-09-2019 132614010919Y000389 0000716837207 SULTON L PBI (APBN) Acute upper respiratory Berobat Jalan

unspecified sites
1208 09-09-2019 132614010919Y000390 0000716848896 LENI P PBI (APBN) Other headache Berobat Jalan
syndromes
1209 09-09-2019 132614010919Y000331 0000716920918 SANDRA LESTIYA P PBI (APBN) Acute upper respiratory Berobat Jalan
unspecified sites
1210 09-09-2019 132614010919P000517 0000717084808 SITI LUTFIYAH P PBI (APBN) Dengue fever [classical Berobat Jalan
dengue]
1211 09-09-2019 132614010919Y000337 0000717164324 SITI MAISYAROH P PBI (APBN) Other iron deficiency Berobat Jalan
anaemias

1212 132614010919Y000351 0001042722876 M.HASIM L PBI (APBN) Pterygium Rujuk Vertikal
09-09-2019
1213 09-09-2019 132614010919P000514 0001042734868 INDRA KURNIATI P PBI (APBN) Other contraceptive Berobat Jalan
management
1214 09-09-2019 132614010919Y000345 0001042748188 IMRON ROSYADI L PBI (APBN) Non-insulin-dependent Berobat Jalan
diabetes mellitus
1215 09-09-2019 132614010919Y000335 0001124996016 HERMINI RIFTANTI P PEGAWAI SWASTA Other polyneuropathies Berobat Jalan
1216 09-09-2019 132614010919Y000369 0001191142563 WARASTUTIK P PEGAWAI SWASTA Conjunctivitis Berobat Jalan
1217 09-09-2019 132614010919Y000346 0001427802974 SITI AISAH P PEKERJA MANDIRI Chronic obstructive Rujuk Vertikal
pulmonary disease with

acute exacerbation,
unspecified
1218 09-09-2019 132614010919Y000336 0001442135531 WAHYU FITRIA ASTUTIK P PEKERJA MANDIRI Acute upper respiratory Berobat Jalan
unspecified sites
1219 09-09-2019 132614010919Y000374 0001706823729 ALLIF ABRAR AMRULLOH L PBI (APBD) Acute upper respiratory Berobat Jalan
unspecified sites
1220 09-09-2019 132614010919Y000349 0002204828954 ISHMATUL MAULA P PEKERJA MANDIRI Diseases of pulp and Berobat Jalan
periapical tissues
1221 09-09-2019 132614010919Y000375 0002211652574 MUHAMMAD IZZAL MAHBUBI L PEGAWAI SWASTA Stomatitis and related Berobat Jalan
lesions
1222 09-09-2019 132614010919Y000363 0002217362545 ARJO TRISNO L PEGAWAI PEMERINTAH Cutaneous abscess, Berobat Jalan
DENGAN PERJANJIAN furuncle and carbuncle
KERJA
1223 09-09-2019 132614010919Y000353 0002242547932 HALEK SUGANDI L PEKERJA MANDIRI Gingivitis and periodontal Berobat Jalan
diseases
1224 09-09-2019 132614010919Y000519 0002294271224 DAIMATUL HUSNA P PEKERJA MANDIRI Acute upper respiratory Berobat Jalan
unspecified sites
1225 09-09-2019 132614010919Y000520 0002294272078 IFATUL MARDIYAH P PEKERJA MANDIRI Acute upper respiratory Berobat Jalan
unspecified sites
1226 09-09-2019 132614010919Y000370 0002299135342 KHUSNUL KHOTIMAH P PEKERJA MANDIRI Unspecified condition Rujuk Vertikal
associated with female
genital organs and
menstrual cycle
1227 09-09-2019 132614010919Y000373 0002301273685 WARDATUN NAFISAH P PEKERJA MANDIRI Other specified Berobat Jalan
counselling

1228 132614010919Y000372 0002447371102 M. LUTFI L PBI (APBN) Diarrhoea and Berobat Jalan
09-09-2019
gastroenteritis of
1229 09-09-2019 132614010919Y000366 0002462361963 MOCHAMMAD RIZQI RAMADANI L PBI (APBN) Acute upper respiratory Berobat Jalan

unspecified sites
1230 09-09-2019 132614010919Y000367 0002472707643 MOCH. HASBULLOH HABIBI L PEKERJA MANDIRI Acute upper respiratory Berobat Jalan
unspecified sites
1231 09-09-2019 132614010919Y000378 0002499729726 DULASIM L PBI (APBD) Other disorders of muscle Berobat Jalan
1232 09-09-2019 132614010919Y000595 0002606916306 USTHUM AL ARIF BILLAH L PBI (APBN) Acute pharyngitis Berobat Jalan
1233 09-09-2019 132614010919Y000521 0002607726352 MUHAMMAD MURSYIDUL L PBI (APBN) Acute upper respiratory Berobat Jalan
UMAM infections of multiple and

unspecified sites
1234 09-09-2019 132614010919Y000377 0002608193698 MIFTAHUR ROHMAH P PBI (APBN) Diseases of pulp and Berobat Jalan
periapical tissues
1235 09-09-2019 132614010919Y000362 0002616873851 M. KHOLILULLOH L PBI (APBN) Need for immunization Berobat Jalan
against combinations of
infectious diseases
1236 09-09-2019 132614010919Y000329 0002623611251 SIAMA P PBI (APBD) Essential (primary) Berobat Jalan
hypertension
1237 09-09-2019 132614010919Y000347 0002629743164 AKHMAD KARIYONO L PBI (APBN) Typhoid and paratyphoid Berobat Jalan
fevers
1238 09-09-2019 132614010919Y000355 0002761582138 WARDAH P PBI (APBD) Suppurative and Berobat Jalan
1239 09-09-2019 132614010919Y000518 0002766077842 IKA NURJANAH P PBI (APBD) Supervision of high-risk Berobat Jalan
pregnancy
1240 09-09-2019 132614010919Y000330 0002885247505 SUTIK P PEKERJA MANDIRI Impetigo Berobat Jalan
1241 08-09-2019 132614010919P001563 0000714484078 AMANAH P PBI (APBN) Other contraceptive Berobat Jalan
management
1242 08-09-2019 132614010919P000507 0000716246054 SALHA L PBI (APBN) Other contraceptive Berobat Jalan
management
1243 08-09-2019 132614010919P000511 0001042743014 HAFIYAH P PBI (APBN) Other contraceptive Berobat Jalan
management
1244 07-09-2019 132614010919P000970 0000100027629 SULISTIYANI P PENERIMA PENSIUN Essential (primary) Berobat Jalan
PNS hypertension
1245 07-09-2019 132614010919Y000300 0000112669918 JARWO L PNS DAERAH Cardiomegaly Rujuk Vertikal

1246 07-09-2019 132614010919P000982 0000112670155 MASYHURI L PENERIMA PENSIUN Essential (primary) Berobat Jalan
PNS hypertension
1247 07-09-2019 132614010919Y000301 0000112671865 SUMARIAH P PNS DAERAH Heart failure Rujuk Vertikal
1248 07-09-2019 132614010919P000991 0000112948659 SUKANTI P PENERIMA PENSIUN Essential (primary) Berobat Jalan Diabetes
PNS hypertension Mellitus

1249 07-09-2019 132614010919P000965 0000170084722 SUMIN P PENERIMA PENSIUN Essential (primary) Berobat Jalan
PNS hypertension
1250 07-09-2019 132614010919Y000306 0000714507557 M.MAHFUD L PBI (APBN) Cutaneous abscess, Berobat Jalan
1251 07-09-2019 132614010919Y000289 0000715242767 MUHDOR L PBI (APBN) Typhoid and paratyphoid Berobat Jalan
fevers
1252 07-09-2019 132614010919Y000288 0000715397883 BADRIYAH P PBI (APBN) Asthma Berobat Jalan
1253 07-09-2019 132614010919Y000272 0000715398254 KAMARIA P PBI (APBN) Essential (primary) Berobat Jalan
hypertension
1254 07-09-2019 132614010919Y000305 0000715400458 MUFIDA P PBI (APBN) Cutaneous abscess, Berobat Jalan
1255 07-09-2019 132614010919Y000290 0000715579209 SIYAMA P PBI (APBN) Acute upper respiratory Berobat Jalan
unspecified sites
1256 07-09-2019 132614010919Y000279 0000715597198 M HABIBUR ROHMAN L PBI (APBN) Typhoid and paratyphoid Berobat Jalan
fevers
1257 07-09-2019 132614010919Y000277 0000715622319 JUARTO L PBI (APBN) Hebephrenic Rujuk Vertikal
schizophrenia
1258 07-09-2019 132614010919Y000291 0000715623805 HASIN L PBI (APBN) Stroke, not specified as Rujuk Vertikal
1259 07-09-2019 132614010919Y000296 0000715720061 MUSTIAH P PBI (APBN) Other maternal diseases Berobat Jalan
childbirth and the
puerperium
1260 07-09-2019 132614010919Y000317 0000715738847 SITI MAISA P PBI (APBN) Cutaneous abscess, Berobat Jalan
1261 07-09-2019 132614010919Y000284 0000715836846 INDRI NAZILATUL MUBAROKAH P PBI (APBN) Gingivitis and periodontal Berobat Jalan
diseases
1262 07-09-2019 132614010919Y000271 0000715842999 YENI SETIYA NINGSIH P PBI (APBN) Respiratory tuberculosis, Berobat Jalan
1263 07-09-2019 132614010919Y000304 0000715995797 YESIRO P PBI (APBN) Typhoid and paratyphoid Berobat Jalan
fevers

1264 132614010919Y000280 0000716082704 LAILATUL FITRIYA P PBI (APBN) Other specified Berobat Jalan
07-09-2019
counselling
1265 07-09-2019 132614010919Y000278 0000716094898 KASIYANI P PBI (APBN) Diarrhoea and Berobat Jalan
gastroenteritis of
1266 07-09-2019 132614010919Y000299 0000716128986 SAPI'A P PBI (APBN) Lepromatous leprosy Berobat Jalan
1267 07-09-2019 132614010919Y000303 0000716462155 ASIPRO WANTO L PBI (APBN) Respiratory tuberculosis, Rujuk Vertikal
1268 07-09-2019 132614010919Y000276 0000716566274 HALIMATUS SA`DIYAH P PBI (APBN) Gingivitis and periodontal Berobat Jalan
diseases
1269 07-09-2019 132614010919Y000320 0000716684321 SULASTRI P PBI (APBN) Gout Berobat Jalan
1270 07-09-2019 132614010919Y000321 0000716684624 WARDATUL MUNAWARO P PBI (APBN) Diseases of pulp and Berobat Jalan
periapical tissues
1271 07-09-2019 132614010919Y000322 0000716684747 SAKIF P PBI (APBN) Gastric ulcer Berobat Jalan
1272 07-09-2019 132614010919Y000323 0000716685221 ASEP L PBI (APBN) Allergic contact dermatitis Berobat Jalan
1273 07-09-2019 132614010919Y000324 0000716685625 DARMIATI P PBI (APBN) Allergic contact dermatitis Berobat Jalan
1274 07-09-2019 132614010919Y000292 0000716774938 NUR AZIZAH P PEGAWAI SWASTA Multiple dislocations of Rujuk Vertikal
fingers
1275 07-09-2019 132614010919Y000287 0000716845509 SARIFA P PBI (APBN) Acute upper respiratory Berobat Jalan
unspecified sites
1276 07-09-2019 132614010919Y000286 0000716937412 HASAN WAHYUDI L PBI (APBN) Other rheumatoid arthritis Berobat Jalan
1277 07-09-2019 132614010919Y000307 0001042720356 MIATON P PBI (APBN) Essential (primary) Berobat Jalan
hypertension
1278 07-09-2019 132614010919Y000297 0001042739122 IMRON L PBI (APBN) Disorders of refraction and Rujuk Vertikal
accommodation
1279 07-09-2019 132614010919Y000298 0001042739133 CHURIYAH P PBI (APBN) Disorders of refraction and Rujuk Vertikal
accommodation
1280 07-09-2019 132614010919Y000313 0001042740911 HOLIPAH P PBI (APBN) Acute pharyngitis Berobat Jalan
1281 07-09-2019 132614010919Y000315 0001042741967 HUSNUL KHOTIMAH P PBI (APBN) Cutaneous abscess, Berobat Jalan

1282 07-09-2019 132614010919Y000295 0001042750923 HALIMAH P PBI (APBN) Other contraceptive Berobat Jalan
management
1283 07-09-2019 132614010919Y000294 0001124971479 LAILA AFISA P PEGAWAI SWASTA Supervision of normal Berobat Jalan
pregnancy

1284 132614010919Y000282 0001126010305 SUJAK ARIF L PEGAWAI SWASTA Essential (primary) Berobat Jalan
07-09-2019
hypertension
1285 07-09-2019 132614010919Y000293 0001436221743 SITI P PEKERJA MANDIRI Insulin-dependent Rujuk Vertikal
diabetes mellitus
1286 07-09-2019 132614010919Y000273 0002281999882 MOHAMMAD MUNIB L PEKERJA MANDIRI Pain in throat and chest Rujuk Vertikal
1287 07-09-2019 132614010919Y000270 0002282001129 ASMIATIN P PEKERJA MANDIRI Keloid scar Rujuk Vertikal
1288 07-09-2019 132614010919Y000269 0002327096024 NAZRIL ILHAM L PEKERJA MANDIRI Epilepsy Rujuk Vertikal
1289 07-09-2019 132614010919Y000302 0002476400321 SUWAIBAH P PEGAWAI SWASTA Hyperlipidaemia, Berobat Jalan
unspecified
1291 07-09-2019 132614010919Y000275 0002602482287 JAZILATUL MUFIDAH P PBI (APBN) Acute nasopharyngitis Berobat Jalan
[common cold]
1292 07-09-2019 132614010919Y000281 0002602556662 TURINA P PBI (APBN) Acute nasopharyngitis Berobat Jalan
[common cold]
1293 06-09-2019 132614010919P001568 0000714857905 SITI AMINAH P PBI (APBN) Other contraceptive Berobat Jalan
management
1294 06-09-2019 132614010919Y000642 0000715007035 RUMIA`TI P PBI (APBN) Essential (primary) Berobat Jalan
hypertension
1295 06-09-2019 132614010919Y000593 0000715062712 JUMA'ANA P PBI (APBN) Influenza, virus not Berobat Jalan
identified
1296 06-09-2019 132614010919Y000247 0000715408187 M SELAMET L PBI (APBN) Typhoid and paratyphoid Berobat Jalan
fevers
1297 06-09-2019 132614010919Y000246 0000715411181 YULIATIN. P PBI (APBN) Other disorders of muscle Berobat Jalan
1298 06-09-2019 132614010919Y000594 0000715470489 SALMA P PBI (APBN) Diarrhoea and Berobat Jalan
gastroenteritis of
1299 06-09-2019 132614010919Y000274 0000715775398 SUMIATI P PBI (APBN) Other rheumatoid arthritis Berobat Jalan
1300 06-09-2019 132614010919Y000244 0000715822029 NADIFA P PBI (APBN) Bronchitis, not specified as Rujuk Vertikal
acute or chronic
1301 06-09-2019 132614010919Y000260 0000715836969 SAMSUL HADI L PBI (APBN) Acute upper respiratory Berobat Jalan
unspecified sites
1302 06-09-2019 132614010919Y000261 0000715837331 NUR HIDAYATI P PBI (APBN) Myositis Berobat Jalan

1303 132614010919Y000314 0000715949313 SADI`YAH P PBI (APBN) Acute upper respiratory Berobat Jalan
06-09-2019
unspecified sites
1304 06-09-2019 132614010919Y000641 0000716079363 SULASTRI P PBI (APBN) Cutaneous abscess, Berobat Jalan
1305 06-09-2019 132614010919Y000251 0000716100434 M.YUNUS SYAM L PBI (APBN) Conjunctivitis Berobat Jalan
1306 06-09-2019 132614010919Y000252 0000716100682 SULIHA P PBI (APBN) Gastric ulcer Berobat Jalan
1307 06-09-2019 132614010919Y000253 0000716118423 ROMELA P PBI (APBN) Pterygium Rujuk Vertikal
1308 06-09-2019 132614010919Y000643 0000716140528 HAMIDAH P PBI (APBN) Essential (primary) Berobat Jalan
hypertension
1309 06-09-2019 132614010919Y000263 0000716211033 SITI FARIDAH P PBI (APBN) Contraceptive Berobat Jalan
management
1310 06-09-2019 132614010919Y000259 0000716280636 NUR FADILAH P PBI (APBN) Gastric ulcer Berobat Jalan
1311 06-09-2019 132614010919Y000262 0000716364562 YASAK L PBI (APBN) Other specified Berobat Jalan
counselling
1312 06-09-2019 132614010919Y000248 0000716416727 DAMANA P PBI (APBN) Respiratory tuberculosis, Berobat Jalan
not confirmed
histologically
1313 06-09-2019 132614010919Y000255 0000716447889 SAÀDAH P PBI (APBN) Gingivitis and periodontal Berobat Jalan
diseases
1314 06-09-2019 132614010919Y000241 0000716450681 MOCH. DIMAS ANDRA L PBI (APBN) Disorders of tooth Berobat Jalan
SAPUTRA development and eruption
1315 06-09-2019 132614010919Y000245 0000716452953 SAMIATUN P PBI (APBN) Gastric ulcer Berobat Jalan
1316 06-09-2019 132614010919Y000257 0000716479277 SULAIHA P PBI (APBN) Other contraceptive Berobat Jalan
management
1317 06-09-2019 132614010919Y000240 0000716500574 RUHAMA P PBI (APBN) Hebephrenic Rujuk Vertikal
schizophrenia
1318 06-09-2019 132614010919Y000264 0000716675692 SABIDIN L PBI (APBN) Essential (primary) Berobat Jalan
hypertension
1319 06-09-2019 132614010919Y000265 0000716676017 MUJENI P PBI (APBN) Gastric ulcer Berobat Jalan
1320 06-09-2019 132614010919Y000266 0000716677154 ABD. HOLIQ L PBI (APBN) Allergic contact dermatitis Berobat Jalan
1321 06-09-2019 132614010919Y000267 0000716677198 SATUMI P PBI (APBN) Acute nasopharyngitis Berobat Jalan
[common cold]
1322 06-09-2019 132614010919Y000268 0000716678627 ATIKA P PBI (APBN) Diseases of pulp and Berobat Jalan
periapical tissues

1323 132614010919Y000644 0000716813976 MUSOFA P PBI (APBN) Other headache Berobat Jalan
06-09-2019
syndromes
1324 06-09-2019 132614010919Y000237 0000716838759 SUTIANINGSIH P PBI (APBN) Non-insulin-dependent Rujuk Vertikal
diabetes mellitus
1325 06-09-2019 132614010919Y000254 0001042740911 HOLIPAH P PBI (APBN) Gastro-oesophageal reflux Rujuk Vertikal
disease
1326 06-09-2019 132614010919Y000250 0001130216466 ANIK WIJAYANTI P PEGAWAI SWASTA Diseases of pulp and Berobat Jalan
periapical tissues
1327 06-09-2019 132614010919Y000238 0001189664357 LILIS TRISNAWATI P PEKERJA MANDIRI Cerebrovascular disease, Rujuk Vertikal
unspecified
1328 06-09-2019 132614010919Y000242 0001380121007 SULKHAN AFANDI L PEGAWAI SWASTA Acute pharyngitis Berobat Jalan
1329 06-09-2019 132614010919Y000256 0001440498701 FINA SOFWAH P PEKERJA MANDIRI Gingivitis and periodontal Berobat Jalan
diseases
diseases
1331 06-09-2019 132614010919Y000243 0002444323048 UMI MARIA ULFA P PEKERJA MANDIRI Acute upper respiratory Berobat Jalan
unspecified sites
1332 06-09-2019 132614010919P000515 0002583628334 ULFIATI P PBI (APBN) Other contraceptive Berobat Jalan
management
1333 06-09-2019 132614010919Y000258 0002608193687 SOPIYAH P PBI (APBN) Non-insulin-dependent Berobat Jalan
diabetes mellitus
pregnancy
1335 06-09-2019 132614010919Y000318 0002779374396 MAHFUD L PBI (APBD) Diseases of pulp and Berobat Jalan
periapical tissues
1336 06-09-2019 132614010919Y000319 0002779374418 MOCHAMAD ARIFIN L PBI (APBD) Diseases of pulp and Berobat Jalan
periapical tissues
1337 06-09-2019 132614010919Y000316 0002779374429 FITRIATUR RIZKYAH P PBI (APBD) Diseases of pulp and Berobat Jalan
periapical tissues
1338 06-09-2019 132614010919Y000239 0002808546603 WIANI P PBI (APBN) Cerebral infarction, Rujuk Vertikal
unspecified
1339 05-09-2019 132614010919Y000211 0000112671641 SUJIATI P PNS DAERAH Low back pain Rujuk Vertikal
1340 05-09-2019 132614010919Y000201 0000112948953 SUWIRTO L PENERIMA PENSIUN Acute upper respiratory Berobat Jalan
PNS infections of multiple and

unspecified sites
1341 05-09-2019 132614010919Y000200 0000113019693 SRI AGUSTINI P PNS DAERAH Acute upper respiratory Berobat Jalan
unspecified sites

1342 132614010919Y000199 0000714607604 JAMILAH P PBI (APBN) Acute upper respiratory Berobat Jalan
05-09-2019
unspecified sites
1343 05-09-2019 132614010919Y000214 0000714631072 HANIFAH P PBI (APBN) Respiratory tuberculosis, Berobat Jalan
1344 05-09-2019 132614010919Y000309 0000714770752 ZUBAUDAH P PBI (APBN) Typhoid and paratyphoid Berobat Jalan
fevers
1345 05-09-2019 132614010919Y000592 0000715058177 SAÀDA P PBI (APBN) Gastric ulcer Berobat Jalan
1346 05-09-2019 132614010919Y000179 0000715089699 LUKMAN HAKIM L PBI (APBN) Heart failure Rujuk Vertikal
1347 05-09-2019 132614010919Y000217 0000715175886 HABIBA P PBI (APBN) Anaemia, unspecified Rujuk Vertikal
1348 05-09-2019 132614010919Y000310 0000715200658 ARIS NUR FAHMI L PBI (APBN) Acute pharyngitis Berobat Jalan
1349 05-09-2019 132614010919Y001060 0000715254175 DOLARI L PBI (APBN) Other disorders of muscle Berobat Jalan
1350 05-09-2019 132614010919Y001059 0000715254579 SUMINAH P PBI (APBN) Other disorders of muscle Berobat Jalan
1351 05-09-2019 132614010919Y000181 0000715260082 LILIK ISWATI P PBI (APBN) Supervision of normal Rujuk Vertikal
pregnancy
1352 05-09-2019 132614010919Y001056 0000715475428 SAYYI L PBI (APBN) Essential (primary) Berobat Jalan
hypertension
1353 05-09-2019 132614010919Y000224 0000715480593 SITI HALIMAH P PBI (APBN) Other rheumatoid arthritis Berobat Jalan
1354 05-09-2019 132614010919Y000225 0000715500279 ARTINA P PBI (APBN) Other rheumatoid arthritis Berobat Jalan
1355 05-09-2019 132614010919Y000204 0000715581303 SOLEH AWIR L PBI (APBN) Other specified Berobat Jalan
counselling
1356 05-09-2019 132614010919Y000184 0000715604646 MULYONO L PBI (APBN) Non-insulin-dependent Berobat Jalan
diabetes mellitus
1357 05-09-2019 132614010919Y000210 0000715616188 HONA P PBI (APBN) Gingivitis and periodontal Berobat Jalan
diseases
1358 05-09-2019 132614010919Y000189 0000715754801 TASLIMA P PBI (APBN) Supervision of normal Berobat Jalan
pregnancy
1359 05-09-2019 132614010919P000506 0000715765713 PUNIRA P PBI (APBN) Other contraceptive Berobat Jalan
management
1360 05-09-2019 132614010919Y000215 0000715822029 NADIFA P PBI (APBN) Other specified Berobat Jalan
counselling
1361 05-09-2019 132614010919Y000190 0000715846623 SUMARNI P PBI (APBN) Supervision of normal Berobat Jalan
pregnancy
1362 05-09-2019 132614010919Y001058 0000715861078 DAWAMAH P PBI (APBN) Other disorders of muscle Berobat Jalan

1363 132614010919Y001055 0000715868019 MUSRIFA P PBI (APBN) Other disorders of muscle Berobat Jalan
05-09-2019
1364 05-09-2019 132614010919Y000308 0000716044059 MUHAMMAD FAHMI GUNAWAN L PBI (APBN) Cutaneous abscess, Berobat Jalan

1365 05-09-2019 132614010919Y000220 0000716049652 HOLIMAH P PBI (APBN) Caught, crushed, jammed Berobat Jalan
injury
1366 05-09-2019 132614010919Y000191 0000716073928 NAFSATUL FITRIYAH P PBI (APBN) Supervision of normal Berobat Jalan
pregnancy
1367 05-09-2019 132614010919Y000312 0000716083762 SUSIYATI P PBI (APBN) Gastric ulcer Berobat Jalan
1368 05-09-2019 132614010919Y000311 0000716083907 ABDUL HALIM L PBI (APBN) Gastric ulcer Berobat Jalan
1369 05-09-2019 132614010919Y000195 0000716143601 NURIL LAILATUL ILVIAH P PBI (APBN) Cyst of Bartholin's gland Rujuk Vertikal
1370 05-09-2019 132614010919Y001054 0000716154322 KHALIMAH P PBI (APBN) Gastric ulcer Berobat Jalan
1371 05-09-2019 132614010919Y000206 0000716154401 SITI ALMANIA P PBI (APBN) Supervision of normal Berobat Jalan
pregnancy
1372 05-09-2019 132614010919Y000197 0000716209626 ATIM P PBI (APBN) Non-insulin-dependent Berobat Jalan
diabetes mellitus
1373 05-09-2019 132614010919Y000198 0000716216488 MESRAN L PBI (APBN) Acute upper respiratory Berobat Jalan
unspecified sites
1374 05-09-2019 132614010919Y001057 0000716289614 SULISTIANI P PBI (APBN) Other disorders of muscle Berobat Jalan
1375 05-09-2019 132614010919Y000177 0000716298232 JAMILA P PBI (APBN) Acute hepatitis B with Rujuk Vertikal
delta-agent (coinfection)
with hepatic coma
1376 05-09-2019 132614010919Y000205 0000716303351 NAWAWI L PBI (APBN) Other surgical follow-up Berobat Jalan
care
1377 05-09-2019 132614010919Y000232 0000716316491 ARMI P PBI (APBN) Supervision of high-risk Berobat Jalan
pregnancy
1378 05-09-2019 132614010919Y000591 0000716429114 MUHAMMAD IKBAL SOFI L PBI (APBN) Suppurative and Berobat Jalan
1379 05-09-2019 132614010919Y000216 0000716566274 HALIMATUS SA`DIYAH P PBI (APBN) Gingivitis and periodontal Berobat Jalan
diseases
1380 05-09-2019 132614010919Y000194 0000716627485 SUMIATI P PBI (APBN) Non-insulin-dependent Berobat Jalan
diabetes mellitus
1381 05-09-2019 132614010919Y000175 0000716648499 MUSOFFA P PBI (APBN) Other contraceptive Berobat Jalan
management

1382 132614010919Y000235 0000716667039 SOFEYAH P PBI (APBN) Diseases of pulp and Berobat Jalan
05-09-2019
periapical tissues
1383 05-09-2019 132614010919Y000236 0000716667366 JUARIYAH P PBI (APBN) Allergic contact dermatitis Berobat Jalan
1384 05-09-2019 132614010919Y000174 0000716734348 ABDILAH JAELANI L PBI (APBN) Gingivitis and periodontal Berobat Jalan
diseases
1385 05-09-2019 132614010919Y000219 0000716838759 SUTIANINGSIH P PBI (APBN) Insulin-dependent Berobat Jalan
diabetes mellitus
1386 05-09-2019 132614010919Y000176 0000716864883 SAMAÀNI P PBI (APBN) Respiratory tuberculosis, Berobat Jalan
1387 05-09-2019 132614010919Y000223 0000716951327 SUPENI P PBI (APBN) Acute upper respiratory Berobat Jalan
unspecified sites
1388 05-09-2019 132614010919Y000203 0000717068474 M.TAUFIK L PBI (APBN) Essential (primary) Berobat Jalan
hypertension
1389 05-09-2019 132614010919Y000183 0000717384813 SADIKYAH P PBI (APBN) Non-insulin-dependent Berobat Jalan
diabetes mellitus
1390 05-09-2019 132614010919Y000192 0000717567625 NAFI'AH P PBI (APBN) Supervision of normal Berobat Jalan
pregnancy
1391 05-09-2019 132614010919Y000208 0000728279199 SUNARWATI P PEGAWAI SWASTA Examination and Berobat Jalan
encounter for
1392 05-09-2019 132614010919Y000182 0001042720997 MUHAMMAD ILHAMUL FAIZIN L PBI (APBN) Disorders of tooth Berobat Jalan
1393 05-09-2019 132614010919Y000196 0001042730807 KHOLIL L PBI (APBN) Other specified Berobat Jalan
counselling
1394 05-09-2019 132614010919Y001061 0001042754163 FADILAH P PBI (APBN) Insulin-dependent Berobat Jalan
diabetes mellitus
1395 05-09-2019 132614010919Y000213 0001042755333 FAIZAH P PBI (APBN) Supervision of normal Berobat Jalan
pregnancy
1396 05-09-2019 132614010919Y000185 0001535845094 ZAFIFATUL ABID P PEGAWAI SWASTA Supervision of normal Berobat Jalan
pregnancy
1397 05-09-2019 132614010919Y000212 0001539111892 ANIS MUNADZIFAH P PBI (APBD) Gingivitis and periodontal Berobat Jalan
diseases
1398 05-09-2019 132614010919Y000207 0001539873404 HARIYANTO L PEKERJA MANDIRI Non-insulin-dependent Berobat Jalan
diabetes mellitus
1399 05-09-2019 132614010919Y000202 0001851840369 HUMIYAH P PEKERJA MANDIRI Non-insulin-dependent Berobat Jalan
diabetes mellitus

1400 132614010919Y000178 0001889140983 RUWAIDATUL ISMAWATI P PEGAWAI SWASTA Supervision of normal Berobat Jalan
05-09-2019
pregnancy
1401 05-09-2019 132614010919Y000193 0001889149026 AHMAD HOLIL L PEGAWAI SWASTA Acute upper respiratory Berobat Jalan
unspecified sites
1402 05-09-2019 132614010919Y000234 0002061675055 MASRURO P PBI (APBD) Supervision of high-risk Berobat Jalan
pregnancy
1403 05-09-2019 132614010919Y000173 0002498635978 H. SUWANDI L PEKERJA MANDIRI Senile cataract Rujuk Vertikal
1404 05-09-2019 132614010919Y000180 0002584259166 ABD WAHID L PBI (APBN) Other acute viral hepatitis Berobat Jalan
1405 05-09-2019 132614010919Y000187 0002593002442 M RIZKI ADITIYA L PBI (APBN) Conjunctivitis Berobat Jalan
1406 05-09-2019 132614010919Y000188 0002636774199 SITI JUWARIYA P PBI (APBN) Disorders of tooth Berobat Jalan

1407 05-09-2019 132614010919Y000233 0002757838544 IRMA HASANAH P PEKERJA MANDIRI Supervision of high-risk Berobat Jalan
pregnancy
1408 05-09-2019 132614010919Y000218 0002883664247 MUCH. FAUZAN L PEKERJA MANDIRI Caught, crushed, jammed Berobat Jalan
injury
1409 05-09-2019 132614010919Y000186 0002883699909 SUWAIBATUL ISLAMIYAH P PEKERJA MANDIRI Supervision of normal Berobat Jalan
pregnancy
1410 04-09-2019 132614010919Y000123 0000112737396 BAMBANG SUDJATMIKO L PENERIMA PENSIUN Insulin-dependent Rujuk Vertikal
1411 04-09-2019 132614010919Y000146 0000112775354 ABOE NASER MAZIED L PENERIMA PENSIUN Diseases of pulp and Berobat Jalan
PNS periapical tissues
1412 04-09-2019 132614010919Y000142 0000714786153 FAUZAN KARIMAH P PBI (APBN) Pneumonia, organism Rujuk Vertikal
unspecified
pregnancy
1414 04-09-2019 132614010919Y000139 0000715269047 M.SELAMET L PBI (APBN) Other disorders of muscle Berobat Jalan
1415 04-09-2019 132614010919Y000167 0000715354661 SANIJA P PBI (APBN) Acute upper respiratory Berobat Jalan

unspecified sites
1416 04-09-2019 132614010919Y000163 0000715417896 HUDAYATI P PBI (APBN) Diarrhoea and Berobat Jalan
gastroenteritis of
1417 04-09-2019 132614010919Y000164 0000715429776 SIFAK L PBI (APBN) Influenza, virus not Berobat Jalan
identified

1418 132614010919Y000160 0000715448665 JUMRIYA P PBI (APBN) Diseases of pulp and Berobat Jalan
04-09-2019
periapical tissues
1419 04-09-2019 132614010919Y000127 0000715657364 NUR AFITA P PBI (APBN) Supervision of normal Berobat Jalan
pregnancy
1420 04-09-2019 132614010919Y000129 0000715810173 SUMIK P PBI (APBN) Other disorders of muscle Berobat Jalan
1421 04-09-2019 132614010919Y000130 0000715811747 SAIFI L PBI (APBN) Impetigo Berobat Jalan
1422 04-09-2019 132614010919Y000140 0000715822029 NADIFA P PBI (APBN) Asthma Berobat Jalan
1423 04-09-2019 132614010919Y000153 0000715945972 RIRIN P PBI (APBN) Cutaneous abscess, Berobat Jalan

1424 04-09-2019 132614010919Y000138 0000715948233 SITI KARIMATUL A`YUNI P PBI (APBN) Gastric ulcer Berobat Jalan
1425 04-09-2019 132614010919Y000162 0000715972061 MASLUHA P PBI (APBN) Acute pharyngitis Berobat Jalan
1426 04-09-2019 132614010919Y000231 0000715973073 SUNARSI P PBI (APBN) Essential (primary) Berobat Jalan
hypertension
1427 04-09-2019 132614010919Y000145 0000716039447 SOLEHUDDIN L PBI (APBN) Diseases of pulp and Berobat Jalan
periapical tissues
coma
1429 04-09-2019 132614010919Y000158 0000716094382 MURLIA P PBI (APBN) Essential (primary) Berobat Jalan
hypertension
1430 04-09-2019 132614010919Y000132 0000716138245 SUTIHAT P PBI (APBN) Bronchitis, not specified as Berobat Jalan
acute or chronic
1431 04-09-2019 132614010919Y000165 0000716293719 SUMAKYA P PBI (APBN) Essential (primary) Berobat Jalan
hypertension
1432 04-09-2019 132614010919Y000604 0000716312891 CHOMSATUN P PBI (APBN) Other headache Berobat Jalan
syndromes
1433 04-09-2019 132614010919Y000131 0000716326637 NURUL P PBI (APBN) Non-insulin-dependent Berobat Jalan
diabetes mellitus
1434 04-09-2019 132614010919Y000147 0000716379974 A.SUMAJI L PBI (APBN) Gingivitis and periodontal Berobat Jalan
diseases
1435 04-09-2019 132614010919Y000154 0000716403159 ROHIMAH P PBI (APBN) Other disorders of muscle Berobat Jalan
1436 04-09-2019 132614010919Y000126 0000716443694 AMINAH P PBI (APBN) Pterygium Rujuk Vertikal
1437 04-09-2019 132614010919Y000133 0000716462155 ASIPRO WANTO L PBI (APBN) Tuberculosis of lung, Berobat Jalan
histologically negative

1438 132614010919Y000431 0000716513387 JUMAÌYA P PBI (APBN) Essential (primary) Berobat Jalan
04-09-2019
hypertension
1439 04-09-2019 132614010919Y000430 0000716595895 SUKARTI P PBI (APBN) Diseases of pulp and Berobat Jalan
periapical tissues
1440 04-09-2019 132614010919Y000168 0000716655587 SODIKIN ASADI L PBI (APBN) Gastric ulcer Berobat Jalan
1441 04-09-2019 132614010919Y000169 0000716655868 SITI HANIFAH P PBI (APBN) Other headache Berobat Jalan
syndromes
1442 04-09-2019 132614010919Y000170 0000716656397 RIZKA SIDKI L PBI (APBN) Other headache Berobat Jalan
syndromes
1443 04-09-2019 132614010919Y000171 0000716656544 MAULANA FAHMI SIKDI P PBI (APBN) Allergic contact dermatitis Berobat Jalan
1444 04-09-2019 132614010919Y000172 0000716656612 MISTAR L PBI (APBN) Allergic contact dermatitis Berobat Jalan
1445 04-09-2019 132614010919Y000135 0000716726171 SAIHU L PBI (APBN) Other disorders of muscle Berobat Jalan
1446 04-09-2019 132614010919Y000166 0000716874052 SULASRI P PBI (APBN) Essential (primary) Berobat Jalan
hypertension
1447 04-09-2019 132614010919Y000428 0001042720986 ITA YULIANAH P PBI (APBN) Diseases of pulp and Berobat Jalan
periapical tissues
1448 04-09-2019 132614010919Y000152 0001042732348 LUKFIYATUL P PBI (APBN) Acute pharyngitis Berobat Jalan
1449 04-09-2019 132614010919Y000229 0001042733913 NIKMA YOCHAH P PBI (APBN) Supervision of normal Berobat Jalan
pregnancy
1450 04-09-2019 132614010919Y000125 0001200274435 MUHAMMAD YARDAN L PNS DAERAH Acute nasopharyngitis Berobat Jalan
ALREYHAN [common cold]
1451 04-09-2019 132614010919Y000136 0001299392357 MUHAMAD GILANG L PNS DAERAH Gingivitis and periodontal Berobat Jalan
PERMANA.P diseases
1452 04-09-2019 132614010919Y000230 0001436742909 MILATUL QOYIMAH P PEGAWAI SWASTA Supervision of high-risk Berobat Jalan
pregnancy
1453 04-09-2019 132614010919Y000529 0002161805534 NURSAIDAH P PBI (APBD) Supervision of normal Berobat Jalan
pregnancy
1454 04-09-2019 132614010919Y000141 0002379356493 ROFIÌ L PEKERJA MANDIRI Chronic kidney disease Rujuk Vertikal
1455 04-09-2019 132614010919Y000134 0002583142367 HAMIDAH P PBI (APBN) Dental caries Berobat Jalan
1456 04-09-2019 132614010919Y000124 0002629743164 AKHMAD KARIYONO L PBI (APBN) Acute upper respiratory Berobat Jalan

unspecified sites
1457 04-09-2019 132614010919Y000137 0002773912307 KHULASHOTUNNISA' P PEKERJA MANDIRI Gingivitis and periodontal Berobat Jalan
diseases
PNS

1459 132614010919Y000085 0000170085666 DJUMIATI P PENERIMA PENSIUN Essential (primary) Rujuk Vertikal
03-09-2019
PNS hypertension
1460 03-09-2019 132614010919Y000143 0000714523511 KHUSNUL KHOTIMAH P PBI (APBN) Supervision of normal Berobat Jalan
pregnancy
1461 03-09-2019 132614010919Y000082 0000714601181 IIL P PBI (APBN) Acute upper respiratory Berobat Jalan
unspecified sites
1462 03-09-2019 132614010919Y000102 0000714975851 NURUL ILYAH P PBI (APBN) Other specified Berobat Jalan
counselling
1463 03-09-2019 132614010919Y000084 0000715031572 NASTITI P PBI (APBN) Urticaria Berobat Jalan
1464 03-09-2019 132614010919Y000103 0000715089699 LUKMAN HAKIM L PBI (APBN) Heart failure Rujuk Vertikal
1465 03-09-2019 132614010919Y000151 0000715247829 SALMA P PBI (APBN) Essential (primary) Berobat Jalan
hypertension
1466 03-09-2019 132614010919Y000076 0000715251519 MUHLIS L PBI (APBN) Gastric ulcer Berobat Jalan
1467 03-09-2019 132614010919Y000092 0000715420091 HOTIMAH P PBI (APBN) Cystitis Berobat Jalan
1468 03-09-2019 132614010919P001572 0000715448665 JUMRIYA P PBI (APBN) Other contraceptive Berobat Jalan
management
1469 03-09-2019 132614010919Y000075 0000715615132 AZIS L PBI (APBN) Pterygium Rujuk Vertikal
1470 03-09-2019 132614010919Y000107 0000716079363 SULASTRI P PBI (APBN) Cutaneous abscess, Berobat Jalan

1471 03-09-2019 132614010919Y000104 0000716107724 MARNILEM P PBI (APBN) Non-insulin-dependent Berobat Jalan
diabetes mellitus
1472 03-09-2019 132614010919Y000111 0000716109221 YUNI SAFITRI P PBI (APBN) Other specified Berobat Jalan
counselling
1473 03-09-2019 132614010919Y000109 0000716116037 MUHAMMAD SAHUL L PBI (APBN) Lepromatous leprosy Berobat Jalan
1474 03-09-2019 132614010919Y000077 0000716134151 MARTONO L PBI (APBN) Chronic obstructive Berobat Jalan
pulmonary disease with

acute exacerbation,
unspecified
1475 03-09-2019 132614010919Y000086 0000716254918 HOLIFA P PBI (APBN) Acute nasopharyngitis Berobat Jalan
[common cold]
1476 03-09-2019 132614010919Y000105 0000716269566 KHOIRUN NISAK P PBI (APBN) Diseases of pulp and Berobat Jalan
periapical tissues
1477 03-09-2019 132614010919Y000113 0000716303351 NAWAWI L PBI (APBN) Occupant of railway train Berobat Jalan
or railway vehicle injured
in transport accident
1478 03-09-2019 132614010919Y000097 0000716361287 SITI MUKARROMA P PBI (APBN) Impetigo Berobat Jalan

1479 132614010919P001575 0000716464001 FATIMA P PBI (APBN) Other contraceptive Berobat Jalan
03-09-2019
management
1480 03-09-2019 132614010919Y000148 0000716464001 FATIMA P PBI (APBN) Other specified Berobat Jalan
counselling
1481 03-09-2019 132614010919Y000116 0000716473618 ARINIL HAK L PBI (APBN) Occupant of railway train Berobat Jalan
or railway vehicle injured
in transport accident
1482 03-09-2019 132614010919Y000079 0000716492349 JUWARIYAH P PBI (APBN) Typhoid and paratyphoid Berobat Jalan
fevers
1483 03-09-2019 132614010919P001571 0000716595895 SUKARTI P PBI (APBN) Other contraceptive Berobat Jalan
management
1484 03-09-2019 132614010919Y000118 0000716648152 B. AMINAH P PBI (APBN) Gout Berobat Jalan
1485 03-09-2019 132614010919Y000119 0000716648185 SAKIR L PBI (APBN) Gout Berobat Jalan
1486 03-09-2019 132614010919Y000120 0000716648264 JUNDA P PBI (APBN) Essential (primary) Berobat Jalan
hypertension
1487 03-09-2019 132614010919Y000121 0000716648861 IZZA WARDATUL MUTFIA P PBI (APBN) Acute nasopharyngitis Berobat Jalan
[common cold]
1488 03-09-2019 132614010919Y000122 0000716649412 AHMAD FUADI L PBI (APBN) Pneumonia due to other Berobat Jalan
1489 03-09-2019 132614010919Y000098 0000716769448 TIAMAH P PBI (APBN) Respiratory tuberculosis, Berobat Jalan
1490 03-09-2019 132614010919Y000091 0000716838759 SUTIANINGSIH P PBI (APBN) Insulin-dependent Rujuk Vertikal
diabetes mellitus
1491 03-09-2019 132614010919Y000074 0000716840335 SARONI L PBI (APBN) Other headache Berobat Jalan
syndromes
1492 03-09-2019 132614010919Y000073 0000716848042 MANIA P PBI (APBN) Impetigo Berobat Jalan
1493 03-09-2019 132614010919Y000078 0000716949088 SUPRIYANTO L PBI (APBN) Essential (primary) Berobat Jalan
hypertension
1494 03-09-2019 132614010919Y000110 0000717352176 WENI DIAN NITA P PBI (APBN) Other contraceptive Berobat Jalan
management
1495 03-09-2019 132614010919P001562 0001042722358 SITI SOHIFAH P PBI (APBN) Other contraceptive Berobat Jalan
management
1496 03-09-2019 132614010919Y000149 0001042724013 FUATI P PBI (APBN) Other disorders of muscle Berobat Jalan
1497 03-09-2019 132614010919Y000089 0001042742913 SYAFI'I L PBI (APBN) Other disorders of muscle Berobat Jalan
1498 03-09-2019 132614010919Y000088 0001042742924 SURYAH P PBI (APBN) Non-insulin-dependent Berobat Jalan
diabetes mellitus

1499 132614010919Y000081 0001042754635 BELLA RIZQIYAH P PBI (APBN) Gingivitis and periodontal Berobat Jalan
03-09-2019
diseases
1500 03-09-2019 132614010919Y000144 0001042754714 KHOTIJAH P PBI (APBN) Supervision of normal Berobat Jalan
pregnancy
1501 03-09-2019 132614010919Y000095 0001130216466 ANIK WIJAYANTI P PEGAWAI SWASTA Diseases of pulp and Berobat Jalan
periapical tissues
1502 03-09-2019 132614010919Y000115 0001162665123 NAILIS SAADAH P PEGAWAI SWASTA Paraplegia and tetraplegia Rujuk Vertikal
1503 03-09-2019 132614010919Y000094 0001283745341 SUMINARTI P PEKERJA MANDIRI Non-insulin-dependent Berobat Jalan
diabetes mellitus
1504 03-09-2019 132614010919Y000114 0001539111892 ANIS MUNADZIFAH P PBI (APBD) Deposits [accretions] on Berobat Jalan
teeth
1505 03-09-2019 132614010919Y000106 0001706821176 IFA UYUN NUROSYIDAH P PBI (APBD) Typhoid and paratyphoid Berobat Jalan
fevers
1506 03-09-2019 132614010919Y000100 0001849893941 MOHAMAD AFIF FULLOH L PBI (APBD) Schizophrenia Berobat Jalan
1507 03-09-2019 132614010919Y000096 0002082894186 NURUL KASIFAH P PNS PUSAT Other disorders of muscle Berobat Jalan
1508 03-09-2019 132614010919Y000093 0002082895165 M.YASRIL AMAR BATISTUTA L PNS PUSAT Stomatitis and related Berobat Jalan
lesions
1509 03-09-2019 132614010919Y000090 0002159785102 ANDIK L PEGAWAI SWASTA Inguinal hernia Rujuk Vertikal
1510 03-09-2019 132614010919Y000083 0002239480596 SUSI INDIATI P PEKERJA MANDIRI Essential (primary) Berobat Jalan
hypertension
1511 03-09-2019 132614010919Y000080 0002251203805 SUNARIYAH P PEKERJA MANDIRI Non-insulin-dependent Berobat Jalan
diabetes mellitus
1512 03-09-2019 132614010919Y000099 0002485108168 DAMIN L PEKERJA MANDIRI Stroke, not specified as Rujuk Vertikal
1513 03-09-2019 132614010919Y000087 0002498635978 H. SUWANDI L PEKERJA MANDIRI Non-insulin-dependent Berobat Jalan
diabetes mellitus
1514 03-09-2019 132614010919Y000150 0002583245766 UMI KULSUM P PBI (APBN) Diseases of pulp and Berobat Jalan
periapical tissues
1515 03-09-2019 132614010919P001556 0002593505305 SUNDARI P PBI (APBN) Other contraceptive Berobat Jalan
management
1516 03-09-2019 132614010919Y000117 0002624727778 SAHARI L PEKERJA MANDIRI Inguinal hernia Rujuk Vertikal
1517 03-09-2019 132614010919Y000112 0002635836952 USMAN ALI L PBI (APBN) Generalized skin eruption Rujuk Vertikal
due to drugs and

medicaments
1518 03-09-2019 132614010919Y000101 0002761587595 MUHAMMAD BAHRUDDIN L PBI (APBD) Acute upper respiratory Berobat Jalan
unspecified sites

1519 132614010919Y000003 0000112619946 ACHMAD YASIN L PNS DAERAH Calculus of kidney and Rujuk Vertikal
02-09-2019
ureter
1520 02-09-2019 132614010919Y000052 0000112662876 IMAM SUJAI L PNS DAERAH Acute upper respiratory Berobat Jalan
unspecified sites
1521 02-09-2019 132614010919Y000045 0000112669424 ANTONO S.PD L PNS DAERAH Insulin-dependent Rujuk Vertikal
diabetes mellitus
1522 02-09-2019 132614010919Y000046 0000112669435 ZUBAIDAH P PNS DAERAH Juvenile rheumatoid Rujuk Vertikal
arthritis
1523 02-09-2019 132614010919Y000011 0000112670144 MARSILAH P PENERIMA PENSIUN Essential (primary) Berobat Jalan
PNS hypertension
1524 02-09-2019 132614010919Y000209 0000714509537 FATIMA P PBI (APBN) Diseases of pulp and Berobat Jalan
periapical tissues
1525 02-09-2019 132614010919Y000040 0000714552647 ZUBAIDAH P PBI (APBN) Gastric ulcer Berobat Jalan
1526 02-09-2019 132614010919Y000015 0000714561884 ANIS TAMARA P PBI (APBN) Acute upper respiratory Berobat Jalan

unspecified sites
1527 02-09-2019 132614010919Y000029 0000714566542 HUSNUL HOTIMA P PBI (APBN) Cutaneous abscess, Berobat Jalan
1528 02-09-2019 132614010919Y000033 0000714611992 ABD. GHOFUR L PBI (APBN) Calculus in bladder Rujuk Vertikal
1529 02-09-2019 132614010919Y000067 0000714857905 SITI AMINAH P PBI (APBN) Essential (primary) Berobat Jalan
hypertension
1530 02-09-2019 132614010919Y000042 0000715185977 SUSANTI P PBI (APBN) Acute pharyngitis Berobat Jalan
1531 02-09-2019 132614010919Y000064 0000715200647 HUSNUL HOTIMAH P PBI (APBN) Burn and corrosion, body Berobat Jalan
region unspecified
1532 02-09-2019 132614010919Y000066 0000715201648 M. CANDRA ADITIYA SAPUTRA L PBI (APBN) Gastric ulcer Berobat Jalan
1533 02-09-2019 132614010919Y000050 0000715324893 SOLIHA P PBI (APBN) Gastric ulcer Berobat Jalan
1534 02-09-2019 132614010919Y000222 0000715452873 ROHMA P PBI (APBN) Other headache Berobat Jalan
syndromes
1535 02-09-2019 132614010919Y000044 0000715486904 MARYAM P PBI (APBN) Acute upper respiratory Berobat Jalan
unspecified sites
1536 02-09-2019 132614010919Y000026 0000715572167 NURUN NADIA P PBI (APBN) Pain in throat and chest Rujuk Vertikal
1537 02-09-2019 132614010919Y000053 0000715572742 MUHAMMAD HAPIT USMAN L PBI (APBN) Acute pharyngitis Berobat Jalan
1538 02-09-2019 132614010919Y000036 0000715579852 ABD ROZI L PBI (APBN) Hebephrenic Rujuk Vertikal
schizophrenia

1539 132614010919Y000221 0000715591135 RUMIYATI P PBI (APBN) Other rheumatoid arthritis Berobat Jalan
02-09-2019
1540 02-09-2019 132614010919Y000060 0000715772035 LISAUDA P PBI (APBN) Acute pharyngitis Berobat Jalan
1541 02-09-2019 132614010919P001576 0000715772035 LISAUDA P PBI (APBN) Other contraceptive Berobat Jalan
management
1542 02-09-2019 132614010919Y000058 0000715780675 USWATUN HASANAH P PBI (APBN) Cutaneous abscess, Berobat Jalan
1543 02-09-2019 132614010919Y000004 0000715800407 NURIVA P PBI (APBN) Embedded and impacted Rujuk Vertikal
teeth
1544 02-09-2019 132614010919Y000013 0000715871981 ACHMAD FAUZI L PBI (APBN) Examination and Berobat Jalan
encounter for
1545 02-09-2019 132614010919Y000020 0000715962172 TUPA P PBI (APBN) Insulin-dependent Rujuk Vertikal
diabetes mellitus
1546 02-09-2019 132614010919Y000001 0000716083108 SAMI P PBI (APBN) Non-insulin-dependent Rujuk Vertikal
diabetes mellitus
1547 02-09-2019 132614010919Y000156 0000716084076 MARSAIT L PBI (APBN) Conjunctivitis Berobat Jalan
1548 02-09-2019 132614010919Y000038 0000716110571 SUTIKAMIN P PBI (APBN) Non-insulin-dependent Berobat Jalan
diabetes mellitus
1549 02-09-2019 132614010919Y000155 0000716122214 MISBAR L PBI (APBN) Influenza, virus not Berobat Jalan
identified
1550 02-09-2019 132614010919Y000014 0000716152241 SUMA P PBI (APBN) Senile cataract Rujuk Vertikal
1551 02-09-2019 132614010919Y000041 0000716153365 NUR AZIZAH P PBI (APBN) Gastric ulcer Berobat Jalan
1552 02-09-2019 132614010919Y000061 0000716190704 MIFTAHUL ULUM L PBI (APBN) Caught, crushed, jammed Berobat Jalan
injury
1553 02-09-2019 132614010919Y000159 0000716230989 SOBIRIN L PBI (APBN) Other headache Berobat Jalan
syndromes
1554 02-09-2019 132614010919Y000002 0000716274011 M HARI L PBI (APBN) Haematemesis Rujuk Vertikal
1555 02-09-2019 132614010919Y000031 0000716292731 HASBULLAH L PBI (APBN) Essential (primary) Berobat Jalan
hypertension
1556 02-09-2019 132614010919Y000028 0000716309493 SULAIMAN L PBI (APBN) Examination and Berobat Jalan
encounter for
1557 02-09-2019 132614010919Y000047 0000716388928 NIKMATUL ROHMAH P PBI (APBN) Other disorders of muscle Berobat Jalan
1558 02-09-2019 132614010919Y000227 0000716402632 SITI FATONAH P PBI (APBN) Supervision of high-risk Berobat Jalan
pregnancy

1559 132614010919Y000161 0000716418044 DIYANA P PBI (APBN) Impetigo Berobat Jalan
02-09-2019
1560 02-09-2019 132614010919Y000063 0000716539138 NURUL QOMARIAH P PBI (APBN) Other surgical follow-up Berobat Jalan
care
1561 02-09-2019 132614010919Y000057 0000716549174 KAMSIRIN L PBI (APBN) Caught, crushed, jammed Berobat Jalan
injury
1562 02-09-2019 132614010919Y000021 0000716599967 AHMAD SIFAUDIN L PBI (APBN) Acute upper respiratory Berobat Jalan
unspecified sites
1563 02-09-2019 132614010919Y000068 0000716638015 SITI KHOIRIYATUL KHASANAH P PBI (APBN) Diseases of pulp and Berobat Jalan
periapical tissues
1564 02-09-2019 132614010919Y000069 0000716638577 ACHMAD AL DAIROBI L PBI (APBN) Other headache Berobat Jalan
syndromes
1565 02-09-2019 132614010919Y000070 0000716639051 NURUS SHOBA L PBI (APBN) Diseases of pulp and Berobat Jalan
periapical tissues
1566 02-09-2019 132614010919Y000071 0000716640388 MUNASIP L PBI (APBN) Allergic contact dermatitis Berobat Jalan
1567 02-09-2019 132614010919Y000072 0000716640759 UMI HANIK P PBI (APBN) Gastric ulcer Berobat Jalan
1568 02-09-2019 132614010919Y000007 0000716730131 AMINAH P PBI (APBN) Pterygium Rujuk Vertikal
1569 02-09-2019 132614010919Y000065 0000716808532 IKRIMA P PBI (APBN) Supervision of normal Berobat Jalan
pregnancy
1570 02-09-2019 132614010919Y000012 0000716886933 NAWARI P PBI (APBN) Fever of other and Berobat Jalan
unknown origin
1571 02-09-2019 132614010919Y000035 0000716906711 KAFINA P PBI (APBN) Other contraceptive Berobat Jalan
management
1572 02-09-2019 132614010919Y000043 0000716910434 ENIK P PBI (APBN) Other headache Berobat Jalan
syndromes
1573 02-09-2019 132614010919Y000037 0000716910513 ROSI WULANDARI P PBI (APBN) Acute upper respiratory Berobat Jalan
unspecified sites
1574 02-09-2019 132614010919Y000051 0000717365676 ABDUL HALIM L PBI (APBN) Respiratory tuberculosis, Berobat Jalan
1575 02-09-2019 132614010919Y000018 0001042738975 ABDUL ROCHMAN L PBI (APBN) Non-insulin-dependent Rujuk Vertikal
diabetes mellitus
1576 02-09-2019 132614010919Y000034 0001042751711 AGUS BUDIANTO L PEGAWAI SWASTA Diarrhoea and Berobat Jalan
gastroenteritis of

1577 132614010919Y000030 0001042754163 FADILAH P PBI (APBN) Non-insulin-dependent Berobat Jalan
02-09-2019
diabetes mellitus
1578 02-09-2019 132614010919Y000055 0001198084307 HAMIDAH P PEGAWAI SWASTA Gingivitis and periodontal Berobat Jalan
diseases
1579 02-09-2019 132614010919Y000056 0001198084318 SYIRFIRATIH P PEGAWAI SWASTA Disorders of tooth Berobat Jalan
1580 02-09-2019 132614010919Y000017 0001427802974 SITI AISAH P PEKERJA MANDIRI Superficial injury of thorax Rujuk Vertikal
1581 02-09-2019 132614010919Y000024 0001442380105 SULIMA P PEKERJA MANDIRI Senile cataract Rujuk Vertikal
1582 02-09-2019 132614010919Y000032 0001538809334 MASEHUDIN L PEGAWAI SWASTA Acute upper respiratory Berobat Jalan

unspecified sites
1583 02-09-2019 132614010919Y000009 0001600037177 CHOIRON L PEGAWAI SWASTA Stroke, not specified as Rujuk Vertikal
1584 02-09-2019 132614010919Y000025 0001828221377 MUHAMMAD SODIKIN L PEGAWAI SWASTA Haemorrhoids Rujuk Vertikal
1585 02-09-2019 132614010919Y000016 0002087995601 GHOZALI L PEKERJA MANDIRI Hyperlipidaemia, Berobat Jalan
unspecified
1586 02-09-2019 132614010919Y000005 0002087996466 KHOTAMAH P PEKERJA MANDIRI Bipolar affective disorder, Rujuk Vertikal
current episode mild or
moderate depression
1587 02-09-2019 132614010919Y000054 0002204619388 MUSTOFA L PEGAWAI SWASTA Headache Berobat Jalan
1588 02-09-2019 132614010919Y000019 0002204828954 ISHMATUL MAULA P PEKERJA MANDIRI Gingivitis and periodontal Berobat Jalan
diseases
1589 02-09-2019 132614010919Y000027 0002251292679 MUHAMMAD ALWI FATHIR L PEGAWAI SWASTA Epilepsy Rujuk Vertikal
PURNOMO
1590 02-09-2019 132614010919Y000059 0002272694073 HASIM ASARI L PEKERJA MANDIRI Gingivitis and periodontal Berobat Jalan
diseases
1591 02-09-2019 132614010919Y000049 0002287344622 NURYATIN P PBI (APBD) Suppurative and Berobat Jalan
1592 02-09-2019 132614010919Y000023 0002427419081 AKBAR PLAJATI L PEKERJA MANDIRI Atrial septal defect Rujuk Vertikal
1593 02-09-2019 132614010919Y000048 0002455648031 NADIYATUL JANNAH P PBI (APBD) Acute upper respiratory Berobat Jalan

unspecified sites
1594 02-09-2019 132614010919Y000022 0002485612888 NETIK P PBI (APBD) Supervision of normal Rujuk Vertikal
pregnancy
1595 02-09-2019 132614010919Y000062 0002499729726 DULASIM L PBI (APBD) Non-insulin-dependent Berobat Jalan
diabetes mellitus
1596 02-09-2019 132614010919Y000039 0002582973123 SABRINA NUR AZIZAH P PBI (APBN) Suppurative and Berobat Jalan

1597 132614010919Y000010 0002616092346 MANISAH P PEKERJA MANDIRI Fracture of lumbar spine Rujuk Vertikal
02-09-2019
and pelvis
1598 02-09-2019 132614010919Y000008 0002624727778 SAHARI L PEKERJA MANDIRI Inguinal hernia Rujuk Vertikal
1599 02-09-2019 132614010919Y000228 0002753225842 FATIMATUS ZAHRO P PEGAWAI SWASTA Supervision of normal Berobat Jalan
pregnancy
pregnancy
1601 02-09-2019 132614010919Y000006 0002886522996 BAYI NYONYA RODEKYAH L PBI (APBN) Singleton, born in hospital Rujuk Vertikal
1602 01-09-2019 132614010919P001573 0000715780675 USWATUN HASANAH P PBI (APBN) Other contraceptive Berobat Jalan
management

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DAFTAR KUNJUNGAN PESERTA SAKIT

Kantor Cabang : PASURUAN - 1309

FKTP : Wonorejo - 13261401

5 30-09-2019 132614010919Y001630 0000715031572 NASTITI P PBI (APBN) Urticaria Berobat Jalan

17 30-09-2019 132614010919Y001631 0000715980914 SUBADAR L PBI (APBN) Non-insulin-dependent Berobat Jalan

FKTP : Wonorejo - 13261401

MANSUR infections of multiple and

infections of multiple and

FKTP : Wonorejo - 13261401

development and eruption

FKTP : Wonorejo - 13261401

single thyroid nodule

development and eruption

FKTP : Wonorejo - 13261401

FKTP : Wonorejo - 13261401

FKTP : Wonorejo - 13261401

infections of multiple and

FKTP : Wonorejo - 13261401

FKTP : Wonorejo - 13261401

infections of multiple and

FKTP : Wonorejo - 13261401

infectious organisms, not

infections of multiple and

FKTP : Wonorejo - 13261401

neoplasm of skin and

FKTP : Wonorejo - 13261401

infections of multiple and

FKTP : Wonorejo - 13261401

infectious organisms, not

FKTP : Wonorejo - 13261401

FKTP : Wonorejo - 13261401

FKTP : Wonorejo - 13261401

FKTP : Wonorejo - 13261401

FKTP : Wonorejo - 13261401

FKTP : Wonorejo - 13261401

infections of multiple and

FKTP : Wonorejo - 13261401

FKTP : Wonorejo - 13261401

FKTP : Wonorejo - 13261401

FKTP : Wonorejo - 13261401

FKTP : Wonorejo - 13261401

classifiable elsewhere but

FKTP : Wonorejo - 13261401

FKTP : Wonorejo - 13261401

FKTP : Wonorejo - 13261401

infections of multiple and

FKTP : Wonorejo - 13261401

FKTP : Wonorejo - 13261401

classifiable elsewhere but

development and eruption

FKTP : Wonorejo - 13261401

FKTP : Wonorejo - 13261401

FKTP : Wonorejo - 13261401

infections of multiple and

furuncle and carbuncle

infections of multiple and

FKTP : Wonorejo - 13261401

FKTP : Wonorejo - 13261401

FKTP : Wonorejo - 13261401

unspecified otitis media

FKTP : Wonorejo - 13261401

infections of multiple and

FKTP : Wonorejo - 13261401

of connective and other