PELAYANAN RUJUKAN

DAFTAR NAMA PENYAKIT DI PUSKESMAS YANG DIRUJUK KE FASKES LANJUTAN

KODE
NO PENYAKIT PENYAKIT LAKI-LAKI PEREMPUAN JUMLAH
1 Fetal Blood Loss From Fasa Praevila P 500 0 1 1
2 Mental Disorder F 99 5 1 6
3 Atrophy of Prostate N 422 1 0 1
4 Heart Disease I 159 3 1 4
5 Tuberculosis Pheriperal Lymphodenopaty A 182 1 1 2
6 Gastritis K 29 2 2 4
7 Unspecified Viral Hepatitis w/o coma B 199 0 1 1
8 Dyspepsia K 309 0 2 2
9 Carsinoma in situ skin of other part of face D 043 0 1 1
10 Other injuries of eye and orbit S 058 1 0 1
11 Schizophrenia F 209 0 1 1
12 Appendicitis K 389 0 1 1
13 Senile ctaract H 259 0 2 2
14 Otitis Media in other disease clasified else H 678 2 1 3
15 Carsinoma in situ of breast D 059 0 3 3
16 Hypermetropia H 520 4 1 5
17 Presbiopi H 524 6 11 17
18 Idiopatic Gout, hand M 1004 1 0 1
19 Atheroscleratic Heart Disease I 251 0 4 4
20 Cluster Headache System 0 2 2
21 Attopic Dermatitis L 209 2 1 3
22 Tuberculosis of Lung A 153 3 3 6
23 NIDDM E 119 5 7 12
24 Migrain G 439 1 1 2
25 Chronic Ischemic Heart Disease I 259 0 1 1
26 Unspec Genitoury Tract Infection J 0239 0 1 1
27 Pleural Condition J 949 1 0 1
28 Men &Behav Dismul/psychoact Drug Depp F 192 1 0 1
29 Inflamatory Disease of Cervix Uteri N 72 0 1 1
30 Submucous Leiomyoma of Uterus D 250 0 1 1
31 Coronary Artery Aneurism I 254 0 1 1
32 Other Seborrhoeic Dermatitis L 218 1 0 1
33 Chonic Ginggivitis K 051 1 0 1
34 Paralitic Ileus K 560 0 1 1
35 Hypertension I 109 7 5 12
36 Hypertensive Heart Disease w/ Heart Failure I 110 6 4 10
37 Tinea Pedis B 153 1 0 1
38 Dengue Haemorragic Fever A 91 0 1 1
39 Sub acute and chronic vaginitis N 760 0 1 1
40 Myopia H 521 0 6 6
41 Chronic Renal Failure N 189 5 3 8
42 Acute Upper Respiratory Infection J 069 1 0 1
43 Disorder of Urinary System N 399 1 0 1
44 Malignant Neoplasma sub Mandibular Gland C 080 1 0 1
45 Hypertension Renal Dis w/ Renal Failure I 120 2 1 3
46 Dental Caries K 029 1 0 1
47 Tuberculosis of other spec organ A 188 1 0 1
48 Headache R 51 0 1 1
49 LBP M 545 2 1 3
50 Exam and obs following other accident Z 043 1 0 1
51 Disturbances in tooth formation K 004 1 0 1
52 Pleural Efusion J 90 1 0 1
53 Senile nuclear Cataract H 251 0 5 5
54 Acute Miliary Tuberculosis A 192 2 0 2
55 Asthma J 4599 1 0 1
56 Otitis media In bacterial disease H 620 1 0 1
KODE
NO PENYAKIT PENYAKIT LAKI-LAKI PEREMPUAN JUMLAH
57 Allergic Contact Dermatitis L 239 0 1 1
58 Common Cold J 00 0 1 1
59 Parkinson's Disease G 20 0 1 1
60 Stroke not spec haemorragic or not I 64 3 1 4
61 Chronic nephritic syndrom N 038 1 0 1
62 Conginetal bowing of tibia and fibula Q 684 1 0 1
63 Leiomyoma of Uterus D 529 0 1 1
64 PPOK J 449 1 2 3
65 Post Menopause Osteoporosis w/ Pat Fracture N 800 0 1 1
66 Other Spec Disease of Spinal Cord G 598 0 1 1
67 Inflamatory Disease of Prostate N 491 2 0 2
68 Osteoporosis of Disease w/ Pathological N 802 0 1 1
69 Benigma Neoplasma Colon D126 0 1 1
70 Whooping cough due to Bordetella pertusis H 370 1 0 1
71 Congenital Diafragmatic Hernia Q 790 1 0 1
72 Cardiomyophaty Unspec I 429 1 0 1
73 Hypotension I 959 1 0 1
74 Traumatic Arthopaty M 125 0 1 1
75 Excesive&Frequent Menstruation w/ reg cycle N 920 0 1 1
Total 88 95 183

Pematangsiantar, 3 Maret 2014

Kepala Puskesmas Pembuat Laporan

Kota Pematangsiantar

(Drg. Artha D M Bako) (Rimbun Sitindaon, S.Si)

NIP. 19700411 200604 2 003 NIP. 19740602 199503 2 001
 PELAYANAN RUJUKAN
DAFTAR NAMA PENYAKIT DI PUSKESMAS YANG DIRUJUK KE FASKES LANJUTAN

KODE
NO PENYAKIT PENYAKIT LAKI-LAKI PEREMPUAN JUMLAH
1 Schizophrenia F 209 1 0 1
2 Mental Disorder F 99 6 1 7
3 Atrophy of Prostate N 422 4 0 4
4 Heart Disease I 159 13 13 26
5 Tuberculosis Pheriperal Lymphodenopaty A 182 1 1 2
6 Gastritis K 29 0 7 7
7 Unspecified Viral Hepatitis w/o coma B 199 1 0 1
8 Dyspepsia K 309 0 1 1
9 Carsinoma in situ skin of other part of face D 043 0 1 1
10 Appendicitis K 389 0 1 1
11 Senile ctaract H 259 0 1 1
12 Otitis Media in other disease clasified else H 678 0 1 1
13 Carsinoma in situ of breast D 059 0 2 2
14 Hypermetropia H 520 4 9 13
15 Presbiopi H 524 6 10 16
16 Idiopatic Gout, hand M 1004 1 2 3
17 Cluster Headache System G440 1 4 5
18 Attopic Dermatitis L 209 0 1 1
19 Pulmonary Micobacterium Infection A310 4 3 7
20 NIDDM E 119 3 7 10
21 Migrain G 439 0 1 1
22 Unspec Genitoury Tract Infection J 0239 2 0 2
23 Inflamatory Disease of Cervix Uteri N 72 0 1 1
24 Other Seborrhoeic Dermatitis L 218 0 1 1
25 Chonic Ginggivitis K 051 1 0 1
26 Hypertension I 109 4 3 7
27 Tinea Pedis B 153 1 0 1
28 Dengue Haemorragic Fever A 91 0 1 1
29 Sub acute and chronic vaginitis N 760 0 1 1
30 Myopia H 521 4 8 12
31 Chronic Renal Failure N 189 2 0 2
32 Acute Upper Respiratory Infection J 069 1 0 1
33 Malignant Neoplasma sub Mandibular Gland C 080 1 0 1
34 Dental Caries K 029 1 0 1
35 Headache R 51 0 4 4
36 LBP M 545 1 6 7
37 Exam and obs following other accident Z 043 1 0 1
38 Senile nuclear Cataract H 251 0 1 1
39 Asthma J 4599 2 1 3
40 Otitis media In bacterial disease H 620 0 1 1
41 Allergic Contact Dermatitis L239 2 0 2
42 Common Cold J00 1 1 2
43 Diarhoea and gastroenteritis A09 1 0 1
44 Cough R05 4 0 4
45 Bronchitis J209 2 0 2
46 Stroke not spec haemorragic or not I64 3 0 3
Total 79 95 174
Pematangsiantar, 1 April 2014

Kepala Puskesmas Pembuat Laporan

Kota Pematangsiantar

(Drg. Artha D M Bako) (Rimbun Sitindaon, S.Si)

NIP. 19700411 200604 2 003 NIP. 19740602 199503 2 001
 PELAYANAN RUJUKAN
DAFTAR NAMA PENYAKIT DI PUSKESMAS YANG DIRUJUK KE FASKES LANJUTAN

KODE
NO PENYAKIT PENYAKIT LAKI-LAKI PEREMPUAN JUMLAH
1 Mental Disorder F 99 4 2 6
2 Atrophy of Prostate N 422 3 0 3
3 Senile cataract H 259 0 1 1
4 Heart Disease I 159 10 15 25
5 Pulmonary Micobacterium Infection A310 3 3 6
6 Unspecified Viral Hepatitis w/o coma B199 1 0 1
7 Appendicitis K37 1 0 1
8 Schizophrenia F 209 1 0 1
9 Carsinoma in situ of breast D 059 0 2 2
10 Hypermetropia H 520 1 2 3
11 Presbiopi H 524 4 9 13
12 Chronic Renal Failure N 189 5 2 7
13 Pleural Condition J949 0 1 1
14 Myopia H 521 7 6 13
15 Stroke not spec haemorragic or not I64 4 0 4
16 Cardio megali I517 3 1 4
17 Bronchitis J209 1 0 1
18 Chronic Obstructive Pulmonary Disease J 440 0 0 0
19 Otitis media H 669 3 0 3
20 Cough R05 1 1 2
21 Urinary Tract Infection N390 0 3 3
22 IDDM E108 1 1 2
23 NIDDM E 119 2 7 9
24 Asthma J 459 2 0 2
25 Headache R 51 0 3 3
26 Allergic Contact Dermatitis L239 0 2 2
27 Acute Upper Respiratory Infection J069 1 2 3
28 LBP M 545 1 4 5
29 Gastritis K 29 0 1 1
30 Idiopatic Gout M 100 1 3 4
31 Myalgia M791 1 1 2
32 Hypertension I 109 4 5 9
33 Common Cold J00 1 0 1
34 Calculus of kidney N200 2 0 2
35 Childhood Autism F840 1 0 1
36 Loss of Teeth, accidental extraction of local K081 2 0 2
37 Malignant neoplasma cervic uteri NOS C539 0 1 1
38 Psoriasis L409 0 1 1
39 Acute Haemorragic Gastritis K290 1 1 2
40 Parkinson G20 0 2 2
41 Viral Warts B07 1 0 1
42 Thyroiditis E069 0 1 1
43 Peptic Ulcers K274 0 1 1
44 Unsp Abdominal Hernia w/o obstr or gangren K469 1 1 2
45 Other Single Delivery by Caesarean Setcion O828 0 1 1
46 Mathernal Care for Other Abn pelvic organ O349 0 1 1
47 Benign Neoplasm of Colon D126 1 0 1
48 Vitiligo L80 0 1 1
49 Angina Pectoris I209 1 0 1
50 Leiomyoma of Uterus D259 0 1 1
51 Whooping cough due to Bordetella pertusis H 370 1 0 1
 KODE
NO PENYAKIT PENYAKIT LAKI-LAKI PEREMPUAN JUMLAH
52 Ulcer of Lower Limbs L97 1 0 1
53 Benign Neoplasm of Middle Ear and Sinuses D140 0 1 1
54 Herpes Viral Infection B009 1 1 2
55 Carsinoma in situ other parts of Respy Sistem D024 1 0 1
56 Malignant neoplsm of Uterus C55 0 2 2
57 Localized Swelling, mass and lump R229 1 0 1
58 Erotion of teeth K032 1 0 1
59 Cellulities and An=bscess of mouth K122 0 1 1
60 Delivery by emergency caesarean section O821 0 1 1
61 Benign Neoplasm of Colon, unsp D126 0 2 2
62 Subacute and Chronic Vaginitis N761 0 1 1
63 Typus fever A752 1 0 1
64 Coronary Artery aneurysm I254 1 1 2
65 Bell's Palsy G510 0 1 1
66 Impected Cerumen H612 0 2 2
Total 84 102 186

Pematangsiantar, 2 Juni 2014

Kepala Puskesmas Pembuat Laporan

Kota Pematangsiantar

(Drg. Artha D M Bako) (Rimbun Sitindaon, S.Si)

NIP. 19700411 200604 2 003 NIP. 19740602 199503 2 001
 PELAYANAN RUJUKAN
DAFTAR NAMA PENYAKIT DI PUSKESMAS YANG DIRUJUK KE FASKES LANJUTAN

KODE
NO PENYAKIT PENYAKIT LAKI-LAKI PEREMPUAN JUMLAH
1 Mental Disorder F99 2 1 3
2 Diarhoeae and gastroenteritis A09 0 1 1
3 Senile cataract H259 0 1 1
4 Heart Disease I159 14 6 20
5 Pulmonary Micobacterium Infection A310 3 3 6
6 Injury of thoracic tracea S275 1 0 1
7 Appendicitis K37 1 0 1
8 Schizophrenia F209 3 1 4
9 Carsinoma in situ of breast D059 0 1 1
10 Hypermetropia H520 4 6 10
11 Presbiopi H524 3 13 16
12 Chronic Renal Failure N189 4 1 5
13 Pleural Condition J949 1 0 1
14 Myopia H521 3 8 11
15 Exam and obs following work accident Z042 1 0 1
16 Cardio megali I517 3 1 4
17 Bronchitis J209 1 0 1
18 Chronic Obstructive Pulmonary Disease J440 1 0 1
19 Otitis media H669 2 0 2
20 Cough R05 4 1 5
21 Urinary Tract Infection N390 2 1 3
22 IDDM E108 1 0 1
23 NIDDM E 119 5 3 8
24 Asthma J 459 0 1 1
25 Headache R 51 0 4 4
26 Allergic Contact Dermatitis L239 2 1 3
27 Acute Upper Respiratory Infection J069 2 4 6
28 LBP M545 0 5 5
29 Gastritis K29 3 2 5
30 Idiopatic Gout M100 2 6 8
31 Myalgia M791 1 2 3
32 Hypertension I109 3 7 10
33 Common Cold J00 1 0 1
34 Unsp Haemorrhoids w/o complication I849 2 0 2
35 Necrosis of Pulp K041 1 0 1
36 Keloid scar L910 0 1 1
37 Localized Swelling, mass and lump R229 3 1 4
38 Psoriasis L409 0 1 1
39 Other Chronic Sinuisitis J328 1 1 2
40 Other spec inflamation of eyelid H018 1 0 1
41 GERD w/o oesophagitis K219 1 0 1
42 Malaise and Fatique R53 0 1 1
43 Other tick-borne viral enchepalitis A848 1 1 2
44 Leiomyoma of Uterus D259 0 1 1
45 Crushing injury of ankle S970 1 1 2
46 Primary generalized (osteo) arthrisis M150 0 1 1
47 Abnormal uterine and vaginal bleeding N939 0 1 1
48 Vitiligo L80 0 1 1
49 Osteophorosis of dissuse w/ pato fracture M802 1 0 1
50 Ostheophyte, pelvic/thigh M2575 1 1 2
 KODE
NO PENYAKIT PENYAKIT LAKI-LAKI PEREMPUAN JUMLAH
51 Subacute and Chronic Vaginitis N761 0 1 1
52 Bell's Palsy G510 0 1 1
53 Carsinoma in situ prostate D075 1 0 1
54 Hiperlipidemia E785 0 1 1
55 Carsinoma in situ other parts of Respy Sistem D024 1 0 1
56 Malignant neoplsm of Uterus C55 0 1 1
57 Erythema multiforme, unspec L519 1 1 2
58 Erotion of teeth K032 1 0 1
59 Gest (pregnancy) hypertens w/o protenuria O13 0 1 1
60 Abses of mediastinum J853 0 1 1
61 Drugabuse counselling and survellance Z715 1 0 1
Total 91 99 190

Pematangsiantar, 1 Juli 2014

Kepala Puskesmas Pembuat Laporan

Kota Pematangsiantar

(Drg. Artha D M Bako) (Rimbun Sitindaon, S.Si)

NIP. 19700411 200604 2 003 NIP. 19740602 199503 2 001
 PELAYANAN RUJUKAN
DAFTAR NAMA PENYAKIT DI PUSKESMAS YANG DIRUJUK KE FASKES LANJUTAN

KODE
NO PENYAKIT PENYAKIT LAKI-LAKI PEREMPUAN JUMLAH
1 Mental Disorder F99 4 0 4
2 Chronic Renal Failure J440 3 3 6
3 Senile cataract H259 0 3 3
4 Heart Disease I159 11 12 23
5 Pulmonary Micobacterium Infection A310 9 3 12
6 Athropy of Prostate N422 4 0 4
7 Appendicitis K37 1 0 1
8 Schizophrenia F209 1 1 2
9 Carsinoma in situ of breast D059 0 1 1
10 Hypermetropia H520 3 4 7
11 Presbiopi H524 4 13 17
12 Benign neoplasma, parotid gland D110 0 1 1
13 Pleural Condition J949 1 0 1
14 Myopia H521 3 8 11
15 Exam and obs following work accident Z042 1 0 1
16 Abnormality of Red Blood Cells R71 1 0 1
17 Bronchitis J209 1 0 1
18 Chronic Obstructive Pulmonary Disease J440 1 0 1
19 Otitis media H669 1 0 1
20 Cough R05 0 1 1
21 Urinary Tract Infection N390 0 2 2
22 IDDM E108 1 1 2
23 NIDDM E 119 4 6 10
24 Asthma J 459 1 1 2
25 Non Spec Lympadenitis I889 0 1 1
26 Allergic Contact Dermatitis L239 3 3 6
27 Acute Upper Respiratory Infection J069 0 1 1
28 Stroke I64 2 1 3
29 Gastritis K29 0 2 2
30 Idiopatic Gout M100 3 2 5
31 Myalgia M791 0 2 2
32 Hypertension I109 4 5 9
33 Common Cold J00 1 1 2
34 LBP M545 2 1 3
35 Dyspepsia K30 1 0 1
36 Atopic Dermatitis L209 0 2 2
37 Benign neoplasma transverse colon D126 0 1 1
38 Irregular Menstruation N926 0 1 1
39 Other Chronic Sinuisitis J328 1 0 1
40 Bell's Palsy G510 0 1 1
41 Odontoclasia K024 1 0 1
42 Osteophorosis of dissuse w/ pato fracture M802 1 1 2
43 Other tick-borne viral enchepalitis A848 0 1 1
44 Leiomyoma of Uterus D259 0 2 2
45 Anaemia D649 0 1 1
46 Spondilolysis N430 0 1 1
47 Post Menopausel Osteoporosis N800 0 1 1
48 Parkinson Disease L80 2 0 2
49 Viral Intestinal Infection A848 1 0 1
50 Calculus of Gallblader w/Acute Cholecystitis K800 1 0 1
51 Impected Cerumen H612 1 1 2
52 Viral Warts B07 0 1 1
53 Erotion and Ectropion of Cervic Uteri N86 0 1 1
 KODE
NO PENYAKIT PENYAKIT LAKI-LAKI PEREMPUAN JUMLAH
54 Reactive Attachment Disorder of Childhood F941 0 1 1
55 Carsinoma in situ of prostate R71 1 0 1
Total 80 95 175

Pematangsiantar, 25 Juli 2014

Kepala Puskesmas Pembuat Laporan

Kota Pematangsiantar

(Drg. Artha D M Bako) (Rimbun Sitindaon, S.Si)

NIP. 19700411 200604 2 003 NIP. 19740602 199503 2 001
 PELAYANAN RUJUKAN
DAFTAR NAMA PENYAKIT DI PUSKESMAS YANG DIRUJUK KE FASKES LANJUTAN

KODE
NO PENYAKIT PENYAKIT LAKI-LAKI PEREMPUAN JUMLAH
1 Mental Disorder F99 3 0 3
2 Chronic Renal Failure J440 3 3 6
3 Senile cataract H259 1 0 1
4 Heart Disease I159 14 11 25
5 Pulmonary Micobacterium Infection A310 17 6 23
6 Athropy of Prostate N422 1 0 1
7 Appendicitis K37 0 1 1
8 Schizophrenia F209 3 2 5
9 Carsinoma in situ of breast D059 0 3 3
10 Hypermetropia H520 1 0 1
11 Presbiopi H524 7 17 24
12 Benign neoplasma, parotid gland D110 0 1 1
13 Vertigo of Central origin H814 1 1 2
14 Myopia H521 9 7 16
15 Exam and obs following work accident Z042 1 0 1
16 Tubal Pregnancy O001 0 1 1
17 Bronchitis J209 3 3 6
18 Chronic Obstructive Pulmonary Disease J440 1 3 4
19 Otitis media H669 1 1 2
20 Cough R05 1 1 2
21 Urinary Tract Infection N390 2 0 2
22 IDDM E108 0 6 6
23 NIDDM E 119 7 7 14
24 Asthma J 459 1 1 2
25 Post Traumatic Arthrosis of other join M191 0 1 1
26 Allergic Contact Dermatitis L239 2 2 4
27 Acute Upper Respiratory Infection J069 1 1 2
28 Stroke I64 2 3 5
29 Gastritis K29 4 9 13
30 Idiopatic Gout M100 3 2 5
31 Myalgia M791 0 2 2
32 Hypertension I109 7 8 15
33 Common Cold J00 1 1 2
34 LBP M545 2 2 4
35 Dyspepsia K30 1 0 1
36 Atopic Dermatitis L209 0 2 2
37 Benign neoplasma transverse colon D126 0 1 1
38 Benign Neoplasma Lip D100 0 1 1
39 Other Chronic Sinuisitis J328 1 1 2
40 Bell's Palsy G510 0 1 1
41 Benign Limpomatous Neoplsm Skin D173 1 0 1
42 Osteophorosis of dissuse w/ pato fracture M802 1 1 2
43 Other tick-borne viral enchepalitis A848 1 7 8
44 Leiomyoma of Uterus D259 0 2 2
45 Fracture of Upper and of Humerus S422 0 1 1
46 Allergic Rhinitis N430 0 1 1
47 Post Menopausel Osteoporosis N800 0 1 1
48 Parkinson Disease L80 2 0 2
49 Viral Intestinal Infection A848 1 0 1
50 Calculus of Gallblader w/Acute Cholecystitis K800 1 0 1
51 Other Spondilosis N478 1 2 3
52 Placenta Previa D440 0 1 1
53 Odontoclasia K024 1 0 1
 KODE
NO PENYAKIT PENYAKIT LAKI-LAKI PEREMPUAN JUMLAH
54 Post Menopausel Osteoporosis N800 0 1 1
55 Salmonella Infection A029 0 1 1
56 Acute Thyroiditis E060 1 0 1
57 Other Birth Injury P128 0 1 1
58 Conditions Originating in The Perinatal Period P969 0 1 1
59 Supervision of elderly Primigranda Z355 0 1 1
Total 110 130 240

Pematangsiantar, 1 September 2014

Kepala Puskesmas Pembuat Laporan

Kota Pematangsiantar

(Drg. Artha D M Bako) (Rimbun Sitindaon, S.Si)

NIP. 19700411 200604 2 003 NIP. 19740602 199503 2 001
 PELAYANAN RUJUKAN
DAFTAR NAMA PENYAKIT DI PUSKESMAS YANG DIRUJUK KE FASKES LANJUTAN

KODE
NO PENYAKIT PENYAKIT LAKI-LAKI PEREMPUAN JUMLAH
1 Mental Disorder F99 2 1 3
2 Athropy of Prostate N422 5 0 5
3 Heart Disease I159 13 8 21
4 Schizophrenia F209 3 1 4
5 Pulmonary Micobacterium Infection A310 7 9 16
6 Carcinoma in situ of breast D059 0 3 3
7 Hypermetropia H520 3 0 3
8 Presbiopi H524 8 10 18
9 Chronic Renal Failure J440 4 3 7
10 Pleural conditions J949 1 1 2
11 Myopia H521 3 3 6
12 Stroke I64 2 0 2
13 Conjungtivitis H109 1 0 1
14 Leiomyoma of Uterus D259 0 1 1
15 Post Menopausel Osteoporosis N800 0 1 1
16 Cardio Megali I517 2 2 4
17 Bronchitis J209 1 0 1
18 Chronic Obstructive Pulmonary Disease J440 2 0 2
19 Otitis media H669 5 0 5
20 Cough R05 2 0 2
21 Urinary Tract Infection N390 1 0 1
22 IDDM E108 0 1 1
23 NIDDM E 119 3 3 6
24 Asthma J 459 2 2 4
25 Allergic Contact Dermatitis L239 0 1 1
26 Dyspepsia K30 0 2 2
27 LBP M545 1 1 2
28 Gastritis K29 0 3 3
29 Idiopatic Gout M100 2 3 5
30 Myalgia M791 0 1 1
31 Hypertension I109 5 7 12
32 Common Cold J00 1 1 2
33 Acute Upper Respiratory Infection J069 1 3 4
34 Carsinoma in situ of Colon A395 1 0 1
35 Fracture of Upper and of Humerus S422 1 0 1
36 Abnormal uterine and vaginal bleeding N939 0 1 1
37 Cluster Headache System G440 0 1 1
38 Status migronomus G432 1 0 1
39 Maternal care for abnormalities O348 0 1 1
40 Renal Colic N23 1 0 1
41 Viral Warts E039 0 2 2
42 Benign Limpomatous Neoplsm Skin D173 1 0 1
43 Impected Cerumen P721 0 1 1
44 Thyroiditis E069 0 1 1
45 Lipid Storage Disorder E756 1 0 1
46 Benign Neoplasma of Breast D24 1 0 1
47 Odontoclasia K024 0 1 1
48 Pain Localized to other of lower abdomen R103 1 0 1
49 Allergic Rhinitis N430 1 0 1
 KODE
NO PENYAKIT PENYAKIT LAKI-LAKI PEREMPUAN JUMLAH
50 Other Spondilosis N478 1 1 2
51 Parkinson Disease L80 0 1 1
52 Acute Thyroiditis E060 0 1 1
53 Low weight gain in pregnancy O261 0 1 1
54 Pulpitis K040 0 1 1
55 Late vomiting of pregnancy O212 0 1 1
56 Malignant Neoplasm of Uterus C55 0 1 1
57 Typoid Fever A010 1 0 1
58 Osteo Arthritis M150 0 1 1
59 Hypothyroidsm H814 0 1 1
Total 91 88 179

Pematangsiantar, 2 Januari 2015

Kepala Puskesmas Pembuat Laporan

Kota Pematangsiantar

(Drg. Artha D M Bako) (Rimbun Sitindaon, S.Si)

NIP. 19700411 200604 2 003 NIP. 19740602 199503 2 001
 PELAYANAN RUJUKAN
DAFTAR NAMA PENYAKIT DI PUSKESMAS YANG DIRUJUK KE FASKES LANJUTAN

KODE
NO PENYAKIT PENYAKIT LAKI-LAKI PEREMPUAN JUMLAH
1 Mental Disorder F99 1 0 1
2 Athropy of Prostate N422 2 0 2
3 Heart Disease I159 26 16 42
4 Schizophrenia F209 5 0 5
5 Pulmonary Micobacterium Infection A310 3 8 11
6 Appendicitis K37 0 1 1
7 Carcinoma in situ of breast D059 0 1 1
8 Hypermetropia H520 2 0 2
9 Presbiopi H524 9 26 35
10 Chronic Renal Failure J440 4 4 8
11 Pleural conditions J949 1 0 1
12 Myopia H521 3 7 10
13 Stroke I64 0 1 1
14 Conjungtivitis H109 0 2 2
15 Leiomyoma of Uterus D259 0 2 2
16 Examination & Observasi Follow Accident N800 3 1 4
17 Necrosis of Pulp K041 1 0 1
18 Cardio Megali I517 2 3 5
19 Bronchitis J209 2 1 3
20 Chronic Obstructive Pulmonary Disease Z402 1 1 2
21 Tinea Cruris B356 0 2 2
22 Otitis media H669 6 2 8
23 Cough R05 3 4 7
24 Urinary Tract Infection N390 1 1 2
25 IDDM E108 0 0 0
26 NIDDM E 119 6 2 8
27 Asthma J 459 1 0 1
28 Headache R51 1 2 3
29 Allergic Contact Dermatitis L239 2 6 8
30 Dyspepsia K30 1 3 4
31 LBP M545 1 2 3
32 Gastritis K29 2 4 6
33 Idiopatic Gout M100 1 3 4
34 Myalgia M791 2 3 5
35 Hypertension I109 5 8 13
36 Common Cold J00 3 1 4
37 Acute Upper Respiratory Infection J069 1 0 1
38 Acquired Keratosis Follicularis L110 0 1 1
39 Benign Neoplasma Parotid Gland D110 0 1 1
40 Benign Neoplasma of Breast D24 0 2 2
41 Disorder of Thyroid E079 0 2 2
42 Epilepsy G409 2 1 3
43 Acute Abdomen R100 2 1 3
44 Acute Limphadenitis L049 1 0 1
45 Impected Cerumen H612 0 2 2
46 Pulpitis K040 1 0 1
47 Other Spec Symtoms sign involv musc sys R298 0 1 1
48 Calculus of Kidney with calculus of ureter N202 0 1 1
49 Congenital Diafragmatic Hernia Q790 1 0 1
50 Lipid Storage Disorder E756 1 0 1
 KODE
NO PENYAKIT PENYAKIT LAKI-LAKI PEREMPUAN JUMLAH
51 Unspec Haemorrhoid w/o comp I848 0 1 1
52 Myocardial Degeneration I515 0 1 1
53 Thyroiditis E069 1 0 1
54 Mononeuropathy G589 1 0 1
55 Other Spondilosis N478 1 0 1
56 Unspec Viral Hepatitis w/o coma B199 0 1 1
57 Superficial Injury of Nose S003 0 1 1
58 Acute Sinusitis J019 0 1 1
59 Childhood Autism F840 1 0 1
60 Dislocation of Finger S631 0 1 1
61 Parkinson Dissease G20 0 1 1
62 Vertigo of Central origin H814 1 2 3
63 Carsinoma in situ of Colon D10 1 0 1
64 Angina Pectoris I209 2 0 2
65 Thypoid Fever A010 1 0 1
66 Chlecystitis unspec K819 1 0 1
Total 119 138 257

Pematangsiantar, 2 Januari 2015

Kepala Puskesmas Pembuat Laporan

Kota Pematangsiantar

(Drg. Artha D M Bako) (Rimbun Sitindaon, S.Si)

NIP. 19700411 200604 2 003 NIP. 19740602 199503 2 001
 PELAYANAN RUJUKAN
DAFTAR NAMA PENYAKIT DI PUSKESMAS YANG DIRUJUK KE FASKES LANJUTAN

KODE
NO PENYAKIT PENYAKIT LAKI-LAKI
27 Ispa J069 0
28 Hypertensi I109 3
3 Idiopatic gout M100 2
4 Gastrits k297 0
5 LBP M545 0
6 Allergic Contact Dermatitis C239 1
7 Asthma J459 1
8 Non-insulin dipend DM E119 6
9 Insulin Depend DM E108 1
10 Urinary Tract Infection N390 1
11 Otitis media H669 1
12 PPOK J440 2
13 Cardio Megali I517 0
14 Post-Meriopausal osteoporosis M8109 1
15 Examination & Observasi Follow Accident Z402 2
16 Stroke I64 1
17 Myopia H521 1
18 Cronic Ronal Falture N18a 2
19 Presbiopia H524 7
20 Carsinoma in situ of breast D059 0
21 Schrooptenia F209 4
22 Pulmonary Mycobacterion Infection A310 13
23 Heart Disease I519 10
24 Senile Cataract H259 2
25 Athropy of prostate N422 3
26 Mental disorder F99 3
27 Neuropathic orthropathy M146 0
28 Benign Neoplasma Parotid Gland D110 1
29 Constipation K590 0
30 Plaanta previa speapied as withoat haemorrhage O440 1
31 Unspecipied haematuria R31 0
32 Dangue haemorhagic fever A91 1
33 Disease of spleen , unsspecipied D739 1
34 Impected Cerumen H612 0
35 encephanlitis, myelitis and encephalomyelitis anspecified G04a 1
36 Parkinson Dissease G20 0
37 Carsinoma in situ retun D012 0
38 Disease of bronchus , not elsewhere classfied J980 1
39 Fracture of bone in neoplatic disease ankle / foot M9077 0
40 Epilepsi unspecipied G409 1
41 Erosive (osteo) arthrosis M154 1
42 Prymary generalized (osteo) arthrosis M150 1
43 Pterigium H10 1
44 toxic lever disease with fibrosis and cirohosis of liver K717 1
45 Acute peritonitis K650 1
46 Other and unspecified ovarian cysts N832 0
47 Leiomyoma of ateros, unspecified D259 0
48 Cholecystitis , unspecified K819 0
49 Hyperlipidemic E785 1
50 Benign neoplasma , other and unspecified parts of smalt intestal D133 1
ES LANJUTAN

PEREMPUAN JUMLAH
1 1
1 4
0 2
1 1
1 1
2 3
0 1
4 10
4 5
0 1
2 3
0 2
4 4
4 5
1 3
0 1
9 10
5 7
14 21
1 1
2 6
4 17
17 27
0 2
0 3
0 3
1 1
0 1
1 1
1 2
1 1
1 2
0 1
1 1
1 2
1 1
1 1
1 2
1 1
0 1
1 2
1 2
1 2
0 1
1 2
1 1
1 1
1 1
0 1
0 1
 PELAYANAN RUJUKAN
DAFTAR NAMA PENYAKIT DI PUSKESMAS YANG DIRUJUK KE FASKES LANJUTAN

KODE
NO PENYAKIT PENYAKIT LAKI-LAKI PEREMPUAN JUMLAH
1 Ispa J069 0 1 1
2 Hypertensi I109 3 1 4
3 Idiopatic gout M100 2 0 2
4 Gastrits k297 0 1 1
5 LBP M545 0 1 1
6 Allergic Contact Dermatitis C239 1 2 3
7 Asthma J459 1 0 1
8 Non-insulin dipend DM E119 6 4 10
9 Insulin Depend DM E108 1 4 5
10 Urinary Tract Infection N390 1 0 1
11 Otitis media H669 1 3 4
12 PPOK J440 2 0 2
13 Cardio Megali I517 0 4 4
14 Post-Meriopausal osteoporosis M8109 1 4 5
15 Examination & Observasi Follow Accident Z402 2 1 3
16 Stroke I64 1 0 1
17 Myopia H521 1 9 10
18 Cronic Ronal Falture N18a 2 5 7
19 Presbiopia H524 7 14 21
20 Carsinoma in situ of breast D059 0 1 1
21 Schrooptenia F209 4 2 6
22 Pulmonary Mycobacterion Infection A310 13 4 17
23 Heart Disease I519 10 17 27
24 Senile Cataract H259 2 0 2
25 Athropy of prostate N422 3 0 3
26 Mental disorder F99 3 0 3
27 Neuropathic orthropathy M146 0 1 1
28 Benign Neoplasma Parotid Gland D110 1 0 1
29 Constipation K590 0 1 1
30 Plaanta previa speapied as withoat haemorrh O440 1 1 2
31 Unspecipied haematuria R31 0 1 1
32 Dangue haemorhagic fever A91 1 1 2
33 Disease of spleen , unsspecipied D739 1 0 1
34 Impected Cerumen H612 0 1 1
35 encephanlitis, myelitis and encephalomyelitis G04a 1 1 2
36 Parkinson Dissease G20 0 1 1
37 Carsinoma in situ retun D012 0 1 1
38 Disease of bronchus , not elsewhere classfied J980 1 1 2
39 Fracture of bone in neoplatic disease ankle / M9077 0 1 1
40 Epilepsi unspecipied G409 1 1 2
 KODE
NO PENYAKIT PENYAKIT LAKI-LAKI PEREMPUAN JUMLAH
41 Erosive (osteo) arthrosis M154 1 1 2
42 Prymary generalized (osteo) arthrosis M150 1 1 2
43 Pterigium H10 1 1 2
44 toxic lever disease with fibrosis and cirohosis o K717 1 0 1
45 Acute peritonitis K650 1 1 2
46 Other and unspecified ovarian cysts N832 0 0 0
47 Leiomyoma of ateros, unspecified D259 0 1 1
48 Cholecystitis , unspecified K819 0 1 1
49 Hyperlipidemic E785 1 0 1
50 Benign neoplasma , other and unspecified part D133 1 0 1
Total 126 114 240

Pematangsiantar, 4 Mei 2015

Kepala Puskesmas Pembuat Laporan

Kota Pematangsiantar

(Drg. Artha D M Bako) (Rimbun Sitindaon, S.Si)

NIP. 19700411 200604 2 003 NIP. 19740602 199503 2 001
 PELAYANAN RUJUKAN
DAFTAR NAMA PENYAKIT DI PUSKESMAS YANG DIRUJUK KE FASKES LANJUTAN

KODE
NO PENYAKIT PENYAKIT LAKI-LAKI PEREMPUAN JUMLAH
1 Hypertensi I109 2 1 3
2 Idiopatic gout M100 0 3 3
4 LBP M545 4 4 8
5 Dyspepsia K30 1 3 4
6 Allergic Contact Dermatitis C239 1 0 1
8 Non-insulin dipend DM E119 0 4 4
9 Insulin Depend DM E108 0 1 1
10 Urinary Tract Infection N390 3 1 4
11 Chronic Gingivitis K051 1 0 1
12 Otitis media H669 1 0 1
13 PPOK J440 2 0 2
15 Cardio Megali I517 3 1 4
16 Post-Menopausal osteoporosis M8109 1 1 2
17 Examination & Obsevasi following accident Z042 2 0 2
20 Myopia H521 1 5 6
22 Cronic Renal Failure N189 2 5 7
23 Presbiopy H524 2 6 8
27 Schizoperenia F209 7 1 8
28 Pulomonary Mycrobacterian Infection A310 9 2 11
29 Heart Disease I519 19 14 33
30 Senili Catarac H259 2 6 8
31 Athropy of Prostate N422 5 0 5
32 Mental Disoderl F99 1 1 2
33 Vertigo H814 1 2 3
34 Lumb and oth intrvertbrl disch disorder worth M511 0 1 1
36 Irregular Menstruation N926 0 1 1
37 Other Haemorrhage in early pregnancy O208 0 2 2
38 Leimyoma of uterus D259 0 1 1
39 Constipasi R100 1 0 1
40 Lipomatosis E882 0 1 1
41 SLE M329 0 1 1
42 Typoid fever A010 2 1 3
43 Transitory Neonatal P721 0 1 1
44 Mastoiditis H709 0 1 1
45 Calculus Of Kidney N200 1 0 1
46 Allergic Rhinitis J304 1 2 3
47 Acute abdomen R100 0 1 1
48 Intra cerebral haemorrhage I612 1 0 1
49 Epilepsi G409 1 0 1
50 Abnormal uterino and vaginal bleedry unspeci N939 0 2 2
51 Guvenile arthits in psoriasis hand M0904 0 1 1
52 Cholecystitis 2 0 2
53 Calculus Of Kidney N200 2 1 3
54 Unspec haemorrhage L849 0 1 1
55 Eclampsia of pregnancy O150 0 1 1
56 Localized Sweling, mass & lumb, head R220 0 2 2
 KODE
NO PENYAKIT PENYAKIT LAKI-LAKI PEREMPUAN JUMLAH
57 Benign Neoplasma of rectum D128 1 0 1
58 Tinia Ungulum B351 0 1 1
59 Spondylositosis M431 1 1 2
60 Nasal polip J339 1 0 1
61 Acute Cholecystitis K810 0 1 1
62 Bell's Palsy 1 1 2
63 Parkinson dissease G20 0 1 1
Total 85 87 172

Pematangsiantar,3 Agustus 2015

Kepala Puskesmas Pembuat Laporan

Kota Pematangsiantar

(Drg. Artha D M Bako) (Rimbun Sitindaon, S.Si)

NIP. 19700411 200604 2 003 NIP. 19740602 199503 2 001
 PELAYANAN RUJUKAN
DAFTAR NAMA PENYAKIT DI PUSKESMAS YANG DIRUJUK KE FASKES LANJUTAN

KODE
NO PENYAKIT PENYAKIT LAKI-LAKI PEREMPUAN JUMLAH
1 Hypertensi I109 2 1 3
2 Idiopatic gout M100 1 0 1
4 LBP M545 1 8 9
5 Gastritis K30 1 1 2
6 Allergic Contact Dermatitis K297 1 2 3
8 Non-insulin dipend DM E119 1 0 1
9 Insulin Depend DM E108 1 1 2
10 Urinary Tract Infection N390 0 0 0
11 Chronic Gingivitis K051 0 0 0
12 Otitis media H669 2 4 6
13 PPOK J440 3 0 3
15 Cardio Megali I517 5 3 8
16 Post-Menopausal osteoporosis M8109 0 3 3
17 Examination & Obsevasi following accident Z042 1 0 1
18 Stroke I64 1 2 3
20 Myopia H521 6 7 13
22 Cronic Renal Failure N189 3 4 7
23 Presbiopy H524 2 6 8
24 Schizoperenia F209 6 2 8
25 Appendicitis K37 1 0 1
28 Pulomonary Mycrobacterian Infection A310 8 3 11
29 Heart Disease I519 16 15 31
30 Senili Catarac H259 7 6 13
31 Athropy of Prostate N422 3 0 3
32 Hypothyroidsm E039 0 1 1
33 Glaucoma H405 10 16 26
34 Benign Neoplasma of breast D24 0 2 2
36 Parkinson G20 1 2 3
37 Atherosclerosis I700 0 1 1
38 Benignm lipomatous neoplsm of skin D170 1 3 4
39 Lumb and oth in invert M511 1 0 1
40 Diabetic cataract H280 1 0 1
41 Ivander Mesach heart O348 1 0 1
42 Umbilical hernia with obstruction K420 0 1 1
43 Benignm neoplsm of vertebra D166 1 0 1
44 Epilepsi G409 2 1 3
45 Calculus Of Kidney N200 1 0 1
46 Allergic Rhinitis J304 1 2 3
47 Acute abdomen R100 1 0 1
48 Odontoclasia K024 0 2 2
49 Peptic ulcer acute K279 0 1 1
50 Carsinoma in situ bronchus and lung D022 1 1 2
51 Guvenile arthits in psoriasis hand M0904 0 1 1
52 Disorder of ear H939 0 1 1
53 Maternal care of abnormalities of pelvic O348 0 1 1
54 Unspec haemorrhage L849 0 1 1
 KODE
NO PENYAKIT PENYAKIT LAKI-LAKI PEREMPUAN JUMLAH
55 Eclampsia of pregnancy O150 0 1 1
56 Bronchial R220 1 1 2
57 Benign Neoplasma of rectum D128 1 0 1
58 Asthma in exerbation J4590 2 0 2
59 Spondylositosis M431 0 2 2
60 Venous Complication of pregnancy O228 0 1 1
61 Vitiligo L86 0 1 1
62 Osteophorosis M8017 0 1 1
63 Temporomandibular joint mandibular dis K076 1 0 1
Total 99 112 211

Pematangsiantar,2 September 2015

Kepala Puskesmas Pembuat Laporan

Kota Pematangsiantar

(Drg. Artha D M Bako) (Rimbun Sitindaon, S.Si)

NIP. 19700411 200604 2 003 NIP. 19740602 199503 2 001
 PELAYANAN RUJUKAN
DAFTAR NAMA PENYAKIT DI PUSKESMAS YANG DIRUJUK KE FASKES LANJUTAN

KODE
NO PENYAKIT PENYAKIT LAKI-LAKI PEREMPUAN JUMLAH
1 Hypertensi I109 1 0 1
2 Idiopatic gout M100 0 1 1
3 LBP M545 0 2 2
5 Allergic Contact Dermatitis K297 1 1 2
7 Insulin Depend DM E108 0 1 1
10 Otitis media H669 3 2 5
11 PPOK J440 2 1 3
12 Cardio Megali I517 3 5 8
13 Post-Menopausal osteoporosis M8109 3 4 7
14 Examination & Obsevasi following accident Z042 1 0 1
15 Leiomyoma of uterus O259 0 1 1
16 Glaucoma H405 9 14 23
17 Myopia H521 2 3 5
18 Cronic Renal Failure N189 3 2 5
19 Presbiopy H524 7 8 15
20 Schizoperenia F209 9 2 11
22 Pulomonary Mycrobacterian Infection A310 9 1 10
23 Heart Disease I519 22 15 37
24 Senili Catarac H259 5 14 19
25 Athropy of Prostate N422 3 0 3
26 Mental Disorder F99 1 1 2
27 Carsinoma in situ of breast D059 0 2 2
28 Other obstectric injury of pelvic organ O715 0 1 1
29 Peptic ulcer acute K279 0 1 1
30 Diabetic Retinophaty H360 1 1 2
31 Spondylositosis M431 1 2 3
32 Unsp Abdominal hernia K469 1 0 1
33 Carsinoma in situ of bronchus and lung D022 2 0 2
34 Lumb and oth intervertebral disorders M511 0 1 1
35 Acute cholechystitis K810 1 2 3
36 Adult osteochondrosis of spine M421 0 1 1
37 Epilepsi G409 2 0 2
38 Calculus Of Kidney N200 0 2 2
39 Allergic Rhinitis J304 0 1 1
40 Systemic Lupus Erythematosis M329 0 2 2
41 Odontoclasia K024 0 2 2
42 Peptic ulcer acute K279 0 1 1
43 Unspec haemorrhoids with complication I848 0 2 2
44 Psoriasis L409 1 1 2
45 Disorder of ear H939 0 1 1
46 Maternal care of abnormalities of pelvic O348 0 2 2
47 Mononeurophaty G589 0 2 2
48 Eclampsia of pregnancy O150 0 1 1
49 Bronchial R220 1 1 2
50 Benign Neoplasma of rectum D128 1 0 1
51 Thyroiditis E069 0 2 2
52 Benign Lipomatosus neoplsm of other site D177 0 1 1
53 Parkinson dissease G20 0 1 1
54 Infection of kidney in pregnancy O230 0 1 1
55 Other supervficial injuries of eyelid S011 0 1 1
56 Benign neoplasm uterus D269 0 1 1
Total 95 114 209

Pematangsiantar,1 Oktober 2015

Kepala Puskesmas Pembuat Laporan
Kota Pematangsiantar

(Drg. Artha D M Bako) (Rimbun Sitindaon, S.Si)

NIP. 19700411 200604 2 003 NIP. 19740602 199503 2 001
 PELAYANAN RUJUKAN
DAFTAR NAMA PENYAKIT DI PUSKESMAS YANG DIRUJUK KE FASKES LANJUTAN

KODE
NO PENYAKIT PENYAKIT LAKI-LAKI PEREMPUAN JUMLAH
1 Hypertensi I109 4 1 5
2 Gastritis K297 0 1 1
3 Idiopatic Gout M100 1 2 3
4 LBP M545 1 3 4
5 Allergic Contact Dermatitis L239 1 0 1
6 Non-insulin dipend DM E119 1 0 1
7 Insulin Depend DM E108 0 2 2
8 Otitis media H669 0 1 1
9 PPOK J440 8 0 8
10 Cardio Megali I517 4 6 10
11 Post-Menopausal osteoporosis M8109 0 4 4
12 Carcinoma in situ of bronchus and lung D022 0 1 1
13 Spondylositosis M431 2 3 5
14 Odontoclasia K024 0 3 3
15 Lumb and oth intervertebral disorders M511 2 1 3
16 Acute cholechystitis K810 2 3 5
17 Fracture of fibula S8240 0 1 1
18 Carsinoma in situ of breast D059 0 2 2
19 Schizoperenia F209 10 2 12
20 Pulomonary Mycrobacterian Infection A310 8 3 11
21 Heart Disease I519 17 6 23
22 Senili Catarac H259 7 8 15
23 Athropy of Prostate N422 3 0 3
24 Acute Thyroiditis E060 0 2 2
25 Fracture of lower and femur S7241 1 0 1
26 Mononeurophaty G589 0 1 1
27 Myopia H521 7 6 13
28 Cronic Renal Failure N189 4 2 6
29 Presbiopy H524 11 16 27
30 Unspec haemorrhoids with complication I848 0 1 1
32 Epilepsi G409 2 2 4
33 Acute abdomen R100 0 1 1
34 Diabetic Retinophaty H360 1 1 2
35 Mastoiditis H709 1 1 2
36 Retrogade Amnesia R412 1 0 1
37 Primary generalized atrosis M150 1 0 1
38 Fracture of other finger S626 1 0 1
39 Examination & Obsevasi following accident Z042 0 1 1
40 Glaucoma H405 8 11 19
41 Stroke I64 4 1 5
42 Brucellosis due to brucella abortus A231 0 2 2
43 Chronic sphenoidal sinuisitis J323 1 1 2
44 Calculus of Kidney N200 0 1 1
45 Patological dislocation of joint N2437 1 0 1
46 Maternal care of abnormalities of pelvic O348 0 2 2
48 Intra cerebral haemorragic I619 1 0 1
49 Ataxic cerebral palsy G804 0 1 1
50 Scrotal varises I861 1 0 1
51 Corpus luteum cyst N831 0 1 1
52 Parkinson dissease G20 3 5 8
53 Benign neoplasm of breast D24 0 2 2
54 Abdominal hernia K450 6 0 6
Total 126 114 240
 Pematangsiantar, 2 Agustus 2016

Kepala Puskesmas Pembuat Laporan

Kota Pematangsiantar

(Drg. Artha D M Bako) (Ida kartiana saragih)

NIP. 19700411 200604 2 003 NIP. 197009051995032003