Laporan Harian Diagnosa 02062018-092238

Laporan Diagnosa Pasien Harian
Puskesmas : SUMBERGEMPOL
Tanggal : 01-05-2018 s.d 31-05-2018
Tanggal
No Nama Pasien L/P CM Lama
Kunjungan
1 2018-05-02 SUWITO L 14660A
2 2018-05-02 khoirun nikmah P 1481e
3 2018-05-02 siti fatimah P 5885b
4 2018-05-02 SUTIYAH P 15628B
5 2018-05-02 SULIMAH P 1434B
6 2018-05-02 SUMARTI P 3100A
7 2018-05-02 suyono L 13831a
8 2018-05-02 radtya L 10508i
9 2018-05-02 DENI SUSILOWATI P 2558D
10 2018-05-02 SRIANI P 2608A
11 2018-05-02 DUROTUL MAHMUDAH P 13313E
12 2018-05-02 MUSTI P 175B
13 2018-05-02 KASIYAH P 1274B
14 2018-05-02 YULIANI P 21054B
15 2018-05-02 SRINI P 3580B
16 2018-05-02 DEVITA AZAHRA INDRIAWAN P 8459G
17 2018-05-02 NAURA P 9434c
18 2018-05-02 m faizzul L 9145c
19 2018-05-02 revan aditia L 14883f
20 2018-05-02 AHMAD MURTADLO L 663e
21 2018-05-02 choirunnisa P 3701d
22 2018-05-02 IIS KUNTI ISMIAH P 15310b
23 2018-05-02 siti latifah P 4188b
24 2018-05-02 SUMARNO KAKASONO L 1061a
25 2018-05-02 FATAHILLAH L 13456D
26 2018-05-02 SUTOMO L 1019a
27 2018-05-02 KRISTANTI P 13033c
28 2018-05-02 fadhillah inas P 9954
29 2018-05-02 HABIBAH P 14277b
30 2018-05-02 ike widiyanti P 11327b
31 2018-05-02 bibit P 9098b
32 2018-05-02 PUSPA RAHMAWATI P 1712d
33 2018-05-02 SUSI NOFITASARI P 15958e
34 2018-05-02 ina masrurin P 3126b
35 2018-05-02 ISMI LAILATUL BADRIYAH P 24061c
36 2018-05-02 IMRO'ATUL AZIZAH P 8983c
37 2018-05-02 SITI FATIMAH P 14527c
38 2018-05-02 YENI ZUBAIDAH P 1301c
39 2018-05-03 LILIK SUDARTI P 2484B
40 2018-05-03 MISTIANI P 14880B
41 2018-05-03 BANGUN AJAR SASMITANINGTYAS P 3471B
42 2018-05-03 SUCIPTO DANU SUPROJO L 2362A
43 2018-05-03 bibit P 14290b
44 2018-05-03 eni P 7274a
45 2018-05-03 wiji P 676b
46 2018-05-03 yuyun hidayatul P 3870d
47 2018-05-03 SITI UMI ROMLAH P 9494A
48 2018-05-03 YATINI P 4380h
49 2018-05-03 MUHAMMAD BASYARUDDIN L 21347a
50 2018-05-03 SUSI HARIYANTI NURROHMAH P 5292c
51 2018-05-03 ENDAH WINARMI P 9536b
52 2018-05-03 lukman hakim L 1235a
53 2018-05-04 YENI YULAIKAH P 1323C
54 2018-05-04 LAILY MEI YUNI L 3993B
55 2018-05-04 SUNARMI P 14855F
56 2018-05-04 nurul hidayah P 4148b
57 2018-05-04 apriliana P 2421e
58 2018-05-04 robi'in P 16134a
59 2018-05-04 tamanto L 4348a
60 2018-05-04 SUDJAK L 15835a
61 2018-05-04 SRINGATIN P 13035d
62 2018-05-05 siti yulaikah P 2787b
63 2018-05-05 SULIKAH P 787B
64 2018-05-05 ISMIATI P 4518B
65 2018-05-05 M. SULTON BAHRUL L 21195A
66 2018-05-05 SITI MAESAROH P 8360B
67 2018-05-05 nanda maria P 2085b
68 2018-05-05 SARTINI P 1209b
69 2018-05-05 jamin L 9733a
70 2018-05-05 fuat miftah budi L 4465a
71 2018-05-05 ali makhfud L 15289
72 2018-05-05 katimin L 5785a
73 2018-05-05 MUFATIROH P 641b
74 2018-05-05 SLAMET L 3554a
75 2018-05-07 siti suliyah P 14707b
76 2018-05-07 SITI KHOLIFAH P 7062B
77 2018-05-07 WIJI UTAMI P 10999B
78 2018-05-07 ATMINAH P 175M
79 2018-05-07 WATINI P 7362B
80 2018-05-07 KATINAH P 5208B
81 2018-05-07 windi susanti P 21181b
82 2018-05-07 endang rahayu P 4429e
83 2018-05-07 ISTI SAYEKTININGSIH L 1534B
84 2018-05-07 RETNONING HITAQILLA P 15007D
85 2018-05-07 wakini P 9028a
86 2018-05-07 fahreza aldiansyah L 11400c
87 2018-05-07 martun P 15916a
88 2018-05-07 ENI MUSTAKIM L 15835j
89 2018-05-07 SAWOTO L 16162a
90 2018-05-07 SIGIT PRANOTO L 664a
91 2018-05-07 ahmad fahrudin L 14847a
92 2018-05-08 SUPRIYADI L 777A
93 2018-05-08 ISTATIAH P 1562C
94 2018-05-08 SRIANING P 22310B
95 2018-05-08 khususiyah P 14842b
96 2018-05-08 sumarji L 20298a
97 2018-05-08 DJUPRI L 3650a
98 2018-05-09 BASUKI L 2668A
99 2018-05-09 BAKRI L 697A
100 2018-05-09 galih kurniawan L 4157c
101 2018-05-09 HENI INDRI ASTUTI P 15799B
102 2018-05-09 MITUN P 20021E
103 2018-05-09 KARINI P 13283B
104 2018-05-09 sudaryono L 3362a
105 2018-05-09 MUKIDJAH P 13843b
106 2018-05-09 BADJURI L 9026a
107 2018-05-11 MUSTAKIM L 9843A
108 2018-05-11 SAMINAH P 2684h
109 2018-05-11 SUKARNO L 15628A
110 2018-05-11 SRI SURYANTINI P 1043B
111 2018-05-11 muarofah P 3249e
112 2018-05-11 gunawan L 5761a
113 2018-05-11 mochamad imam hanapi L 1684d
114 2018-05-11 SRIASIH P 77B
115 2018-05-11 sutrisno L 13692a
116 2018-05-11 YUYUN WAHYUNI P 2371c
117 2018-05-11 winarsih P 8162c
118 2018-05-12 siti amanah P 24151b
119 2018-05-12 JAMIATI P 2866B
120 2018-05-12 toisah P 15111b
121 2018-05-12 SUPARTI P 9798B
122 2018-05-12 kaseni L 347a
123 2018-05-12 MUSRINGAH P 14940B
124 2018-05-12 widya P 9315c
125 2018-05-12 fara P 8162i
126 2018-05-12 sri hidayati P 16049b
127 2018-05-12 ahmad zaki L 8015h
128 2018-05-12 ali mahsun L 10175a
129 2018-05-12 PHACHARAPORN KHONGMAN P 9372b
130 2018-05-12 SAMINI P 5734b
131 2018-05-12 EKA FITRIANI P 2471c
132 2018-05-12 AURELIA VERA WARDANI P 2171c
133 2018-05-12 MUKHAMAD MINAN NUR ROKHIM L 14842d
134 2018-05-12 BASKORO ANANDA NUR AHMAD KARTIAS L 13211c
135 2018-05-12 alfi audina P 9517d
136 2018-05-14 SRINGATUN P 3207H
137 2018-05-14 BINTI NASIKAH P 4522B
138 2018-05-14 yatemi P 4140a
139 2018-05-14 WIDJI UTAMI P 893B
140 2018-05-14 FITRI RAYA P 9830D
141 2018-05-14 WINIH SUSANTI P 15515B
142 2018-05-14 SUTIANI P 3554B
143 2018-05-14 SUPRIANTI P 10228A
144 2018-05-14 ABD. KAMID L 3534A
145 2018-05-14 FARREL ASKA SAPUTRA L 1701H
146 2018-05-14 SIYO L 380A
147 2018-05-14 JANAH P 1701B
148 2018-05-14 MUNAYAH P 4668E
149 2018-05-14 rahayu astutik P 2322b
150 2018-05-14 siti aminah P 1092b
151 2018-05-14 rizka wulandari P 3554c
152 2018-05-14 MUHAMAD ALFANDI DIO SAPUTRA L 3941d
153 2018-05-14 RAHMAT ARJUNTINO ARTA SAPUTRA L 787h
154 2018-05-14 ABSHARI NURIA RAHMATIANI P 8815f
155 2018-05-14 SRI RAHAYU P 9007b
156 2018-05-15 FRISKA DIAH P 1531C
157 2018-05-15 masdikoh P 10961b
158 2018-05-15 IMAM ROPINGI L 2093A
159 2018-05-15 HANIK CHOLIBATUN P 15099B
160 2018-05-15 TATIK SETYO UTAMI P 1640b
161 2018-05-15 SITI KHOMARIYATI P 9220E
162 2018-05-15 kUSNAN L 15574K
163 2018-05-15 JUMITUN P 4352E
164 2018-05-15 ISTIFADAH P 7080B
165 2018-05-15 SUPARTIN P 4214B
166 2018-05-15 IMAM SIDIK L 1640a
167 2018-05-15 sumiati P 661b
168 2018-05-15 erna dwi lestari P 133d
169 2018-05-15 MURTI P 2278b
170 2018-05-15 PRASTIKA ARIFENI P 7533c
171 2018-05-15 SUENTINI P 1962b
172 2018-05-15 RENI SILVIANA P 3607e
173 2018-05-15 hikmatul wafiroh P 3727
174 2018-05-16 SAHRONI L 7186G
175 2018-05-16 MUJI SLAMET L 22670E`
176 2018-05-16 ASLIFAH P 624B
177 2018-05-16 MURTINAH P 14899B
178 2018-05-16 ENDANG PRASETYONINGSIH P 10508D
179 2018-05-16 hari sri peni P 3391b
180 2018-05-16 SITI ASIYAH P 1145B
181 2018-05-16 SITI MASRUROH P 1230B
182 2018-05-16 DIAH SUSANTI P 13272C
183 2018-05-16 suliyah P 4336b
184 2018-05-16 anik mikdah P 4431b
185 2018-05-16 musiyah P 1410b
186 2018-05-16 EVA RATNAWATI P 4658B
187 2018-05-17 mardiyah P 14711b
188 2018-05-17 ATNON BAKTIAR L 7681D
189 2018-05-17 WIJI P 2804A
190 2018-05-17 MISTI ANJAR P 15883B
191 2018-05-17 nuraja laela P 14934f
192 2018-05-17 M. WILDAN ALIF IRDIANSAH L 14934C
193 2018-05-17 supiyah P 618b
194 2018-05-17 sheka panji L 1534d
195 2018-05-17 mariyatun P 7252b
196 2018-05-18 SITI HALIMAH P 3885B
197 2018-05-18 mujiono L 9314a
198 2018-05-18 weni sukmayanti P 1338b
199 2018-05-18 INSIYAH P 9567B
200 2018-05-18 MUJIATIN UMITASARI P 22555g
201 2018-05-18 HIDAYATUL MUBTADIIN P 4321b
202 2018-05-19 RETNO ROEBIASTOETI P 359B
203 2018-05-19 murti P 4397b
204 2018-05-19 sugianto L 7209a
205 2018-05-19 RISKA HERMANTO L 3929d
206 2018-05-19 ISMANGIL L 9117a
207 2018-05-21 ulfa nurlaili P 01338d
208 2018-05-21 abdul kamit L 08403i
209 2018-05-21 KUMINI P 22396A
210 2018-05-21 SHAFIA ADHELYA AZZAHRA P 13815F
211 2018-05-21 WAMA TUTIK P 10764B
212 2018-05-21 SALAMAH P 2925B
213 2018-05-21 KEPRI KRISNAWATI P 4337C
214 2018-05-21 yadhan rakha fawwazi L 14110d
215 2018-05-21 ananda mega agustina P 14879e
216 2018-05-21 tatik P 24178g
217 2018-05-21 chika amelya P 24178h
218 2018-05-21 endang sri utami P 5002n
219 2018-05-21 SUYATIN P 4470g
220 2018-05-21 YUSIANI P 4470b
221 2018-05-21 ahmad ardana dwi L 9563d
222 2018-05-21 RIZQI ROCHMATUL JANNAH P 22123c
223 2018-05-21 PAITO L 08a
224 2018-05-21 nuril istikomah P 3862
225 2018-05-21 MOHAMAD SAIFUL AMRI L 24203c
226 2018-05-21 KHUSNUL KHOTIMAH P 2248b
227 2018-05-22 JOKO SANTOSO L 5447E
228 2018-05-22 SUMARNINGSIH P 9002B
229 2018-05-22 ISROFAH P 7364B
230 2018-05-22 YOYOK NURCAHYANTO L 1246g
231 2018-05-22 MARTUBI L 14241A
232 2018-05-22 PRIYAN HARDIYANTO L 880c
233 2018-05-22 SUTIYAH P 1428a
234 2018-05-22 SRINAH P 1765b
235 2018-05-22 TUTIK P 742g
236 2018-05-22 SUNYONO L 21276a
237 2018-05-22 SUNARYO L 9435a
238 2018-05-22 UMINASIKAH P 78
239 2018-05-22 hanif khasbulloh L 4630
240 2018-05-22 ENIK WAHYUNI P 1129b
241 2018-05-22 TRI WULANDARI P 13627b
242 2018-05-23 EKO WAHONO L 13950A
243 2018-05-23 erni wulandari P 9092e
244 2018-05-23 andi rahmansyah L 14987a
245 2018-05-23 LILIK PURNAWATI P 3776b
246 2018-05-23 stiti rodliyah P 433b
247 2018-05-23 ghea ayu P 3271d
248 2018-05-23 suradi L 14861a
249 2018-05-23 MUHAMMAD LUQMAN SYARIFUDIN L 13035c
250 2018-05-23 MUHAMMAD AFRUL LATIF L 2388c
251 2018-05-23 YENNY AGUSTIN NINGDYAS P 543d
252 2018-05-24 mustika putri nursafira P 01905c
253 2018-05-24 elza tazkia P 5750E
254 2018-05-24 sulistya ratnadewi P 1562d
255 2018-05-24 siti kalimah P 3980b
256 2018-05-24 ZAHIRA AINUN VRIZKA P 8256D
257 2018-05-24 bakin L 5732a
258 2018-05-24 ALSYIFA ABEL ANANDAYU P 8256C
259 2018-05-24 M. AMIRUR ROSYIDIN L 21109E
260 2018-05-24 NUR HABIBAH P 15792B
261 2018-05-24 sri mulawati P 1905b
262 2018-05-24 ZAINUR ROHMAH P 1074D
263 2018-05-24 muhimatus solichah P 7709b
264 2018-05-24 WIJIATI P 11358C
265 2018-05-24 GEMPITA NURIL HERASTYA P 1562O
266 2018-05-24 chelsea az zahra P 10178d
267 2018-05-24 elma fitriani P 15593c
268 2018-05-24 umi hanif lailatul wahidah P 4699
269 2018-05-24 SIYAM P 1505b
270 2018-05-24 ISMIAH P 501b
271 2018-05-25 SLAMET BASUKI L 1852A
272 2018-05-25 binti asiah P 2906b
273 2018-05-25 SUNARTI P 895B
274 2018-05-25 azzaki L 1005h
275 2018-05-25 sinto L 105j
276 2018-05-25 SITI SAROPAH P 10655b
277 2018-05-25 AMIN L 10655a
278 2018-05-25 SUTIKAH P 18034b
279 2018-05-25 NUR AZIZAH NIDA L 4699
280 2018-05-26 M. WAHUDI L 2338C
281 2018-05-26 mukin P 00347b
282 2018-05-26 yatini P 5761b
283 2018-05-26 DJARWANI P 13347A
284 2018-05-26 latifaturrobaniyah P 347c
285 2018-05-26 KAMILA MARDIYA P 1076e
286 2018-05-26 SULIKAH P 2855b
287 2018-05-26 SUWUN P 1362b
288 2018-05-26 agus hariyadi L 14200a
289 2018-05-26 SARNO L 13300a
290 2018-05-30 SITI HASANAH P 9220B
291 2018-05-30 GALIH L 2322D
292 2018-05-30 YENSI AISYA FARADILLA P 22373C
293 2018-05-30 SITI MARSIYAH P 16111B
294 2018-05-30 m rafi L 4265f
295 2018-05-30 SITI NUROHMAH P 5951B
296 2018-05-30 SITI MUFAIDAH P 2632B
297 2018-05-30 umi hidayatul P 6167u
298 2018-05-30 ADIP SUSANTO L 3421c
299 2018-05-30 SOLIKATIN P 4115b
300 2018-05-30 EVI TRIANA P 2700b
301 2018-05-31 WASI L 1768A
302 2018-05-31 siti munawaroh P 14252d
303 2018-05-31 TU'INI P 9346B
304 2018-05-31 hidayatul P 9336c
305 2018-05-31 SURIP P 22674B
306 2018-05-31 suyono L 2138a
307 2018-05-31 m dimas L 10098g
308 2018-05-31 munayah P 4668e
309 2018-05-31 SUTOMO L 1019a
310 2018-05-31 RICHA MALIKA P 11025d
311 2018-05-31 SUMIASIH P 4634b
312 2018-05-31 BINTI ROSIDAH P 15007b
nosa Pasien Harian
Usia Diagnosa Jenis Kasus

66 Th 8 Bln Infeksi saluran pernapasan akut atas (ISPA), tidak spesifik; Allergic Baru
34 Th 7 Bln Demam Tifoid Baru
59 Th 1 Bln Infeksi saluran pernapasan akut atas (ISPA), tidak spesifik Baru
45 Th 7 Bln Gastritis, tidak spesifik Baru
50 Th 10 Bln Allergic contact dermatitis; Hipertensi primer/essensial; Gastritis, ti Baru
58 Th 10 Bln Hipertensi primer/essensial Baru
3 Th 10 Bln Other vomiting complicating pregnancy Baru
24 Th 6 Bln Necrosis of pulp Baru
49 Th 5 Bln Myalgia Baru
30 Th 5 Bln Abdominal pregnancy Baru
55 Th 10 Bln Asma, tidak spesifik; Infeksi saluran pernapasan akut atas (ISPA), tidBaru
45 Th 11 Bln Infeksi saluran pernapasan akut atas (ISPA), tidak spesifik; Asma, tidBaru
6 Th 6 Bln Disturbances in tooth eruption Baru
12 Th 7 Bln Gangguan telinga lainnya tidak spesifik Baru
10 Th 5 Bln Pulpitis Baru
25 Th 0 Bln Retained dental root Baru
10 Th 4 Bln Diarrhoea and gastroenteritis of presumed infectious origin; Infeksi Baru
33 Th 6 Bln Abdominal pregnancy Lama
58 Th 8 Bln Hipertensi primer/essensial; Myalgia Baru
9 Th 7 Bln Infeksi saluran pernapasan akut atas (ISPA), tidak spesifik Lama
28 Th 6 Bln Allergic contact dermatitis Baru
20 Th 0 Bln Diarrhoea and gastroenteritis of presumed infectious origin Baru
66 Th 5 Bln Hearing loss, unspecified Baru
14 Th 6 Bln Demam yang tidak diketahui sebabnya Baru
18 Th 3 Bln Abscess, furuncle and carbuncle of nose Baru
27 Th 8 Bln Otitis externa Baru
50 Th 8 Bln Dispepsia; Myalgia; Infeksi saluran pernapasan akut atas (ISPA), tidaBaru
71 Th 0 Bln Infeksi saluran pernapasan akut atas (ISPA), tidak spesifik; DispepsiaBaru
59 Th 11 Bln Myalgia; Conjunctivitis Baru
48 Th 0 Bln Urinary tract infection, site not specified Baru
35 Th 1 Bln Other and unspecified water transport accidents; Personal history Baru
30 Th 5 Bln Dispepsia Baru
19 Th 11 Bln Other and unspecified water transport accidents Baru
34 Th 2 Bln Skizofrenia, tidak spesifik Baru
46 Th 9 Bln Atopic dermatitis Baru
58 Th 6 Bln Myalgia; Infeksi saluran pernapasan akut atas (ISPA), tidak spesifik; Baru
40 Th 11 Bln Faringitis akut, tidak spesifik Baru
48 Th 6 Bln Epidemic vertigo Baru
51 Th 6 Bln Baru
55 Th 2 Bln Hipertensi primer/essensial; Dispepsia Baru
56 Th 3 Bln Infeksi saluran pernapasan akut atas (ISPA), tidak spesifik; Myalgia Baru
43 Th 7 Bln Conjunctivitis Baru
55 Th 4 Bln Myalgia; Infeksi saluran pernapasan akut atas (ISPA), tidak spesifik Baru
51 Th 7 Bln Haemorrhoids Baru
64 Th 6 Bln Myalgia; Hipertensi primer/essensial Baru
63 Th 11 Bln Non-insulin-dependent diabetes mellitus Baru
59 Th 10 Bln Myalgia; Infeksi saluran pernapasan akut atas (ISPA), tidak spesifik; Baru
45 Th 11 Bln Sariawan / Recurrent oral aphthae; Gastritis, tidak spesifik Baru
51 Th 11 Bln Asma, tidak spesifik Baru
80 Th 0 Bln Other hearing loss Baru
67 Th 8 Bln Non-insulin-dependent diabetes mellitus; Myalgia Baru
66 Th 6 Bln Myalgia; Allergic contact dermatitis Baru
48 Th 2 Bln Urinary tract infection, site not specified Baru
23 Th 9 Bln Sakit kepala Baru
38 Th 9 Bln Keputihan / Candidiasis of vulva and vagina (N77.1*); Infeksi saluranBaru
54 Th 9 Bln Artritis lainnya Baru
3 Th 10 Bln Sariawan / Recurrent oral aphthae Baru
51 Th 11 Bln Chronic gingivitis Baru
37 Th 3 Bln Infeksi saluran pernapasan akut atas (ISPA), tidak spesifik; DispepsiaBaru
63 Th 11 Bln Myalgia; Hipertensi primer/essensial Baru
70 Th 5 Bln Atopic dermatitis, unspecified Baru
42 Th 4 Bln Atopic dermatitis; Infeksi saluran pernapasan akut atas (ISPA), tidak Baru
48 Th 9 Bln Dispepsia; Hipertensi primer/essensial; Gastritis, tidak spesifik Baru
37 Th 11 Bln Hordeolum and chalazion Baru
44 Th 0 Bln Myalgia; Sakit kepala Baru
71 Th 11 Bln Allergic contact dermatitis; Myalgia Baru
58 Th 0 Bln Caisson disease [decompression sickness] Baru
37 Th 7 Bln Infeksi saluran pernapasan akut atas (ISPA), tidak spesifik; Herpes s Baru
32 Th 9 Bln Acute sinusitis Baru
26 Th 10 Bln Epilepsi, tidak spesifik Baru
41 Th 7 Bln Disorder of urinary system, unspecified; Urinary tract infection, siteBaru
9 Bln 3Hr Infeksi saluran pernapasan akut atas (ISPA), tidak spesifik Baru
66 Th 8 Bln Sakit kepala; Asma, tidak spesifik; Myalgia Baru
42 Th 8 Bln Respiratory tuberculosis unspecified, confirmed bacteriologi Baru
78 Th 0 Bln Respiratory tuberculosis unspecified, confirmed bacteriologi Baru
15 Th 4 Bln Demam Tifoid; Gastritis, tidak spesifik Baru
5 Th 2 Bln Diarrhoea and gastroenteritis of presumed infectious origin; Infeksi Baru
3 Th 11 Bln Sariawan / Recurrent oral aphthae; Infeksi saluran pernapasan akut Baru
a
26 Th 7 Bln Personal history of contraception Baru
51 Th 11 Bln Acute periodontitis Baru
62 Th 9 Bln Caisson disease [decompression sickness] Baru
2 Th 5 Bln Abses, Furunkel, Karbunkel Kutan Baru
47 Th 2 Bln Myalgia; Allergic contact dermatitis, unspecified cause Baru
55 Th 2 Bln Gastro-oesophageal reflux disease without oesophagitis Baru
21 Th 11 Bln Epilepsi, tidak spesifik Baru
61 Th 10 Bln Hipertensi primer/essensial; Infeksi saluran pernapasan akut atas (ISBaru
6 Th 7 Bln Gangguan telinga lainnya tidak spesifik Baru
18 Th 11 Bln Faringitis akut, tidak spesifik Baru
43 Th 6 Bln Herpes zoster Baru
Status
Cara Bayar Dokter Desa
Keluar/Rujukan
TUNAI DILAYANI VEMI MUJIATI WONOREJO
TUNAI DILAYANI VEMI MUJIATI JABALSARI
GRATIS DILAYANI VEMI MUJIATI JABALSARI
GRATIS DILAYANI VEMI MUJIATI JUNJUNG
GRATIS DILAYANI VEMI MUJIATI SUMBERDADI
GRATIS DILAYANI VEMI MUJIATI PLOSOKANDANG
GRATIS DILAYANI VEMI MUJIATI BENDILJATI KULON
GRATIS DILAYANI WINARTI BENDILJATI KULON
PBI DILAYANI SUMBERDADI
GRATIS DILAYANI VEMI MUJIATI SAMBIROBYONG
NON PBI DILAYANI VEMI MUJIATI SAMBIROBYONG
TUNAI DILAYANI NUR ALIYAH SUMBERDADI
GRATIS DILAYANI NUR ALIYAH WONOREJO
NON PBI DILAYANI PLOSOKANDANG
GRATIS DILAYANI WINARTI BENDILJATI WETAN
GRATIS DILAYANI SYAMRATUL LATIFAH TAMBAKREJO
GRATIS DILAYANI VEMI MUJIATI TANJUNGSARI
GRATIS DILAYANI VEMI MUJIATI PULOTONDO
TUNAI DILAYANI WINARTI TEPAS
TUNAI DILAYANI WINARTI JUNJUNG
TUNAI DILAYANI SITI MUYASAROH WONOREJO
TUNAI DILAYANI WINARTI JUNJUNG
TUNAI DILAYANI WINARTI PODOREJO
GRATIS DILAYANI VEMI MUJIATI TUNGGULSARI
TUNAI DILAYANI WINARTI PODOREJO
GRATIS DILAYANI VEMI MUJIATI DOROAMPEL
TUNAI DILAYANI VEMI MUJIATI JUNJUNG
GRATIS DILAYANI VEMI MUJIATI BENDILJATI WETAN
TUNAI DILAYANI VEMI MUJIATI SUMBERDADI
GRATIS DILAYANI VEMI MUJIATI WONOREJO
TUNAI DILAYANI VEMI MUJIATI NGANTRU
TUNAI DILAYANI VEMI MUJIATI DOROAMPEL
GRATIS DILAYANI VEMI MUJIATI KROMASAN
TUNAI DILAYANI VEMI MUJIATI PLOSOKANDANG
GRATIS DILAYANI VEMI MUJIATI BALESONO
PBI DILAYANI JABALSARI
TUNAI DILAYANI VEMI MUJIATI SAMBIROBYONG
PBI DILAYANI SUMBERDADI
TUNAI DILAYANI VEMI MUJIATI BENDILJATI KULON
GRATIS DILAYANI NUR ALIYAH JABALSARI
TUNAI DILAYANI NUR ALIYAH BENDILJATI KULON
GRATIS DILAYANI VEMI MUJIATI BUKUR
GRATIS DILAYANI NUR ALIYAH JABALSARI
TUNAI DILAYANI VEMI MUJIATI BENDILJATI WETAN
TUNAI DILAYANI SRIYANTO DOROAMPEL
TUNAI DILAYANI SYAMRATUL LATIFAH JABALSARI
GRATIS DILAYANI SRIYANTO WONOREJO
GRATIS DILAYANI VEMI MUJIATI PURWOREJO
TUNAI DILAYANI VEMI MUJIATI KROMASAN
GRATIS DILAYANI BUKUR
GRATIS DILAYANI SITI MUYASAROH BENDILJATI WETAN
TUNAI DILAYANI SITI MUYASAROH JABALSARI
GRATIS DILAYANI SITI MUYASAROH JABALSARI
GRATIS DILAYANI SITI MUYASAROH SAMBIROBYONG
GRATIS DILAYANI NUR ALIYAH BUKUR
GRATIS DILAYANI NUR ALIYAH
GRATIS DILAYANI SITI MUYASAROH WONOREJO
GRATIS DILAYANI SITI MUYASAROH SUMBERDADI
GRATIS DILAYANI VEMI MUJIATI LODERESAN
GRATIS DILAYANI SITI MUYASAROH BUKUR
GRATIS DILAYANI SITI MUYASAROH SAMBIROBYONG
TUNAI DILAYANI VEMI MUJIATI LODERESAN
GRATIS DILAYANI VEMI MUJIATI KROMASAN
GRATIS DILAYANI VEMI MUJIATI SAMBIJAJAR
GRATIS DILAYANI SYAMRATUL LATIFAH BENDILJATI KULON
GRATIS DILAYANI VEMI MUJIATI WATES
TUNAI DILAYANI VEMI MUJIATI SOBONTORO
TUNAI DILAYANI SITI MUYASAROH JABALSARI
GRATIS DILAYANI SITI MUYASAROH BENDILJATI KULON
GRATIS DILAYANI VEMI MUJIATI TUNGGULSARI
GRATIS DILAYANI VEMI MUJIATI TALES
GRATIS DILAYANI SRIYANTO SUMBERDADI
TUNAI DILAYANI VEMI MUJIATI TURUS
GRATIS DILAYANI VEMI MUJIATI PONCOL
TUNAI DILAYANI SITI MUYASAROH PLOSOKANDANG
GRATIS DILAYANI SITI MUYASAROH PURWOREJO
GRATIS DILAYANI SITI MUYASAROH JUNJUNG
GRATIS DILAYANI SYAMRATUL LATIFAH BUKUR
GRATIS DILAYANI VEMI MUJIATI PODOREJO
GRATIS 0 SITI MUYASAROH SUMBERDADI
GRATIS DILAYANI NUR ALIYAH BUKUR
GRATIS DILAYANI NUR ALIYAH WONOREJO
GRATIS DILAYANI NUR ALIYAH SAMBIROBYONG
GRATIS DILAYANI SITI MUYASAROH BENDILJATI WETAN
TUNAI DILAYANI SYAMRATUL LATIFAH SAMBIROBYONG
GRATIS DILAYANI SRIYANTO KROMASAN
GRATIS DILAYANI SRIYANTO KROMASAN
GRATIS DILAYANI SRIYANTO SAMBIJAJAR
TUNAI DILAYANI SRIYANTO PLOSOKANDANG
GRATIS DILAYANI VEMI MUJIATI LODERESAN
TUNAI DILAYANI SITI MUYASAROH PLOSOKANDANG
GRATIS DILAYANI VEMI MUJIATI KALIDAWIR
GRATIS DILAYANI VEMI MUJIATI PULOTONDO
TUNAI DILAYANI VEMI MUJIATI LODERESAN
GRATIS DILAYANI VEMI MUJIATI NGRANTI
Tanggal : 01-05-2018 s.d 31-05-2018
No Tanggal Nama Pasien L/P CM Lama Usia

Kunjungan
1 2018-05-15 RENI SILVIANA P 3607e 15 Th 11 Bln
2 2018-05-24 mustika putri nursafira P 01905c 15 Th 4 Bln
3 2018-05-11 mochamad imam hanapi L 1684d 17 Th 0 Bln
4 2018-05-15 FRISKA DIAH P 1531C 17 Th 11 Bln
5 2018-05-15 erna dwi lestari P 133d 17 Th 4 Bln
6 2018-05-22 UMINASIKAH P 78 17 Th 5 Bln
7 2018-05-21 MOHAMAD SAIFUL AMRI L 24203c 18 Th 0 Bln

9 2018-05-30 umi hidayatul P 6167u 18 Th 11 Bln
10 2018-05-02 IMRO'ATUL AZIZAH P 8983c 18 Th 3 Bln
11 2018-05-12 alfi audina P 9517d 18 Th 9 Bln
12 2018-05-05 ali makhfud L 15289 19 Th 1 Bln
13 2018-05-21 RIZQI ROCHMATUL JANNAH P 22123c 19 Th 1 Bln

14 2018-05-12 MUKHAMAD MINAN NUR ROKHIM L 14842d 19 Th 10 Bln
15 2018-05-03 lukman hakim L 1235a 19 Th 11 Bln
20 2018-05-25 NUR AZIZAH NIDA L 4699 19 Th 7 Bln
22 2018-05-26 latifaturrobaniyah P 347c 19 Th 7 Bln

23 2018-05-02 fadhillah inas P 9954 20 Th 0 Bln
24 2018-05-22 hanif khasbulloh L 4630 20 Th 0 Bln

26 2018-05-04 apriliana P 2421e 20 Th 1 Bln
27 2018-05-24 umi hanif lailatul wahidah P 4699 20 Th 11 Bln
28 2018-05-05 nanda maria P 2085b 20 Th 6 Bln
29 2018-05-15 hikmatul wafiroh P 3727 20 Th 8 Bln
30 2018-05-22 TRI WULANDARI P 13627b 20 Th 8 Bln
31 2018-05-21 nuril istikomah P 3862 20 Th 9 Bln
33 2018-05-16 DIAH SUSANTI P 13272C 21 Th 0 Bln
34 2018-05-26 M. WAHUDI L 2338C 21 Th 11 Bln
35 2018-05-14 rizka wulandari P 3554c 21 Th 2 Bln
36 2018-05-23 MUHAMMAD AFRUL LATIF L 2388c 21 Th 2 Bln
37 2018-05-23 erni wulandari P 9092e 21 Th 4 Bln
38 2018-05-23 YENNY AGUSTIN NINGDYAS P 543d 22 Th 9 Bln
39 2018-05-22 YOYOK NURCAHYANTO L 1246g 23 Th 0 Bln
40 2018-05-17 sheka panji L 1534d 23 Th 1 Bln
41 2018-05-02 SITI FATIMAH P 14527c 23 Th 5 Bln
42 2018-05-11 YUYUN WAHYUNI P 2371c 23 Th 9 Bln
43 2018-05-03 yuyun hidayatul P 3870d 24 Th 10 Bln
44 2018-05-02 ISMI LAILATUL BADRIYAH P 24061c 24 Th 3 Bln
45 2018-05-31 hidayatul P 9336c 24 Th 5 Bln
Page 22 of 65
Tanggal : 01-05-2018 s.d 31-05-2018

Kunjungan
46 2018-05-02 DENI SUSILOWATI P 2558D 24 Th 6 Bln
47 2018-05-24 sulistya ratnadewi P 1562d 24 Th 8 Bln
48 2018-05-02 AHMAD MURTADLO L 663e 25 Th 0 Bln
49 2018-05-15 PRASTIKA ARIFENI P 7533c 25 Th 1 Bln
50 2018-05-19 RISKA HERMANTO L 3929d 25 Th 3 Bln
51 2018-05-17 ATNON BAKTIAR L 7681D 26 Th 10 Bln
52 2018-05-22 TUTIK P 742g 26 Th 2 Bln
53 2018-05-24 muhimatus solichah P 7709b 26 Th 7 Bln
54 2018-05-22 PRIYAN HARDIYANTO L 880c 26 Th 9 Bln
55 2018-05-07 endang rahayu P 4429e 27 Th 0 Bln
56 2018-05-02 ina masrurin P 3126b 27 Th 3 Bln
57 2018-05-02 YENI ZUBAIDAH P 1301c 27 Th 8 Bln
58 2018-05-21 KHUSNUL KHOTIMAH P 2248b 28 Th 0 Bln
59 2018-05-02 SUSI NOFITASARI P 15958e 28 Th 1 Bln
60 2018-05-23 LILIK PURNAWATI P 3776b 28 Th 10 Bln
61 2018-05-02 KRISTANTI P 13033c 28 Th 6 Bln
62 2018-05-17 nuraja laela P 14934f 28 Th 7 Bln
63 2018-05-21 tatik P 24178g 28 Th 9 Bln
64 2018-05-21 KEPRI KRISNAWATI P 4337C 29 Th 1 Bln
65 2018-05-02 HABIBAH P 14277b 29 Th 7 Bln
66 2018-05-30 ADIP SUSANTO L 3421c 30 Th 11 Bln
67 2018-05-02 DUROTUL MAHMUDAH P 13313E 30 Th 5 Bln
68 2018-05-03 ENDAH WINARMI P 9536b 30 Th 5 Bln
69 2018-05-22 JOKO SANTOSO L 5447E 30 Th 5 Bln
70 2018-05-22 ENIK WAHYUNI P 1129b 30 Th 7 Bln
71 2018-05-26 agus hariyadi L 14200a 30 Th 9 Bln
72 2018-05-30 EVI TRIANA P 2700b 30 Th 9 Bln
73 2018-05-07 ahmad fahrudin L 14847a 31 Th 10 Bln
74 2018-05-07 SIGIT PRANOTO L 664a 31 Th 7 Bln
75 2018-05-18 weni sukmayanti P 1338b 32 Th 2 Bln
76 2018-05-02 ike widiyanti P 11327b 32 Th 8 Bln
77 2018-05-05 fuat miftah budi L 4465a 32 Th 9 Bln
78 2018-05-16 EVA RATNAWATI P 4658B 32 Th 9 Bln
79 2018-05-12 ali mahsun L 10175a 33 Th 0 Bln
80 2018-05-23 stiti rodliyah P 433b 33 Th 0 Bln
81 2018-05-02 IIS KUNTI ISMIAH P 15310b 33 Th 6 Bln
82 2018-05-21 YUSIANI P 4470b 33 Th 6 Bln
83 2018-05-04 YENI YULAIKAH P 1323C 34 Th 2 Bln
85 2018-05-02 khoirun nikmah P 1481e 34 Th 7 Bln
87 2018-05-07 windi susanti P 21181b 34 Th 8 Bln
Page 23 of 65
Tanggal : 01-05-2018 s.d 31-05-2018

Kunjungan
88 2018-05-03 SUSI HARIYANTI NURROHMAH P 5292c 35 Th 1 Bln
89 2018-05-07 ENI MUSTAKIM L 15835j 35 Th 1 Bln

90 2018-05-14 WINIH SUSANTI P 15515B 35 Th 1 Bln
91 2018-05-30 SOLIKATIN P 4115b 35 Th 3 Bln
92 2018-05-16 MUJI SLAMET L 22670E` 35 Th 9 Bln
93 2018-05-04 nurul hidayah P 4148b 36 Th 0 Bln
94 2018-05-14 SRI RAHAYU P 9007b 36 Th 4 Bln

95 2018-05-11 winarsih P 8162c 36 Th 9 Bln
96 2018-05-25 SUTIKAH P 18034b 36 Th 9 Bln
97 2018-05-11 muarofah P 3249e 37 Th 11 Bln
98 2018-05-15 HANIK CHOLIBATUN P 15099B 37 Th 11 Bln
99 2018-05-07 SITI KHOLIFAH P 7062B 37 Th 2 Bln
101 2018-05-14 BINTI NASIKAH P 4522B 37 Th 3 Bln
102 2018-05-24 NUR HABIBAH P 15792B 37 Th 4 Bln

103 2018-05-19 murti P 4397b 37 Th 6 Bln
104 2018-05-16 ENDANG PRASETYONINGSIH P 10508D 37 Th 7 Bln
105 2018-05-16 anik mikdah P 4431b 37 Th 7 Bln
106 2018-05-05 M. SULTON BAHRUL L 21195A 37 Th 8 Bln

107 2018-05-21 endang sri utami P 5002n 38 Th 1 Bln
108 2018-05-12 siti amanah P 24151b 38 Th 9 Bln
109 2018-05-04 SUNARMI P 14855F 39 Th 1 Bln

110 2018-05-15 ISTIFADAH P 7080B 40 Th 0 Bln
111 2018-05-03 MUHAMMAD BASYARUDDIN L 21347a 40 Th 1 Bln
112 2018-05-03 BANGUN AJAR SASMITANINGTYAS P 3471B 40 Th 10 Bln
113 2018-05-05 siti yulaikah P 2787b 40 Th 11 Bln
114 2018-05-30 SITI MUFAIDAH P 2632B 40 Th 5 Bln
115 2018-05-18 MUJIATIN UMITASARI P 22555g 40 Th 7 Bln
116 2018-05-23 EKO WAHONO L 13950A 41 Th 1 Bln
117 2018-05-25 binti asiah P 2906b 41 Th 1 Bln
118 2018-05-31 suyono L 2138a 41 Th 1 Bln
119 2018-05-02 YULIANI P 21054B 41 Th 11 Bln
120 2018-05-21 SALAMAH P 2925B 41 Th 2 Bln
121 2018-05-19 ISMANGIL L 9117a 41 Th 7 Bln
122 2018-05-03 MISTIANI P 14880B 41 Th 8 Bln
Page 24 of 65
Tanggal : 01-05-2018 s.d 31-05-2018

Kunjungan
123 2018-05-14 rahayu astutik P 2322b 42 Th 4 Bln
126 2018-05-16 ASLIFAH P 624B 42 Th 5 Bln

128 2018-05-31 BINTI ROSIDAH P 15007b 42 Th 7 Bln
130 2018-05-23 andi rahmansyah L 14987a 42 Th 8 Bln
133 2018-05-19 sugianto L 7209a 43 Th 4 Bln

135 2018-05-31 SURIP P 22674B 43 Th 6 Bln
136 2018-05-07 ATMINAH P 175M 43 Th 7 Bln
137 2018-05-31 SUMIASIH P 4634b 43 Th 8 Bln
138 2018-05-15 SITI KHOMARIYATI P 9220E 44 Th 0 Bln
139 2018-05-17 MISTI ANJAR P 15883B 44 Th 0 Bln
141 2018-05-18 HIDAYATUL MUBTADIIN P 4321b 44 Th 0 Bln
142 2018-05-09 HENI INDRI ASTUTI P 15799B 44 Th 1 Bln
143 2018-05-11 sutrisno L 13692a 44 Th 10 Bln
144 2018-05-12 MUSRINGAH P 14940B 44 Th 10 Bln
146 2018-05-08 sumarji L 20298a 44 Th 4 Bln
147 2018-05-11 SUKARNO L 15628A 44 Th 7 Bln
148 2018-05-02 SRINI P 3580B 45 Th 11 Bln
149 2018-05-08 SRIANING P 22310B 45 Th 11 Bln

150 2018-05-02 siti latifah P 4188b 45 Th 4 Bln
151 2018-05-02 SUTIYAH P 15628B 45 Th 7 Bln
155 2018-05-16 hari sri peni P 3391b 46 Th 0 Bln
156 2018-05-11 SRI SURYANTINI P 1043B 46 Th 1 Bln
157 2018-05-12 sri hidayati P 16049b 46 Th 11 Bln
158 2018-05-15 sumiati P 661b 46 Th 7 Bln
159 2018-05-04 tamanto L 4348a 46 Th 9 Bln
160 2018-05-31 TU'INI P 9346B 46 Th 9 Bln
161 2018-05-14 SUTIANI P 3554B 47 Th 0 Bln
162 2018-05-02 suyono L 13831a 47 Th 11 Bln
163 2018-05-25 SITI SAROPAH P 10655b 47 Th 2 Bln
164 2018-05-26 SULIKAH P 2855b 47 Th 5 Bln
165 2018-05-03 eni P 7274a 48 Th 0 Bln
166 2018-05-22 SUNARYO L 9435a 48 Th 10 Bln
167 2018-05-22 SUMARNINGSIH P 9002B 48 Th 11 Bln
168 2018-05-09 sudaryono L 3362a 48 Th 2 Bln
169 2018-05-15 SUENTINI P 1962b 48 Th 3 Bln
170 2018-05-05 katimin L 5785a 48 Th 4 Bln
171 2018-05-18 INSIYAH P 9567B 48 Th 4 Bln
172 2018-05-22 ISROFAH P 7364B 48 Th 4 Bln
Page 25 of 65
Tanggal : 01-05-2018 s.d 31-05-2018

Kunjungan
173 2018-05-15 IMAM SIDIK L 1640a 48 Th 5 Bln
174 2018-05-17 mariyatun P 7252b 48 Th 5 Bln
175 2018-05-05 SULIKAH P 787B 48 Th 6 Bln
176 2018-05-15 IMAM ROPINGI L 2093A 48 Th 9 Bln
177 2018-05-26 yatini P 5761b 48 Th 9 Bln

178 2018-05-04 LAILY MEI YUNI L 3993B 49 Th 0 Bln
179 2018-05-05 SITI MAESAROH P 8360B 49 Th 11 Bln
180 2018-05-30 SITI NUROHMAH P 5951B 49 Th 11 Bln
181 2018-05-24 siti kalimah P 3980b 49 Th 2 Bln
182 2018-05-24 sri mulawati P 1905b 49 Th 2 Bln
183 2018-05-02 SRIANI P 2608A 49 Th 5 Bln
184 2018-05-22 MARTUBI L 14241A 49 Th 5 Bln
185 2018-05-15 masdikoh P 10961b 49 Th 9 Bln
186 2018-05-11 SRIASIH P 77B 50 Th 0 Bln

187 2018-05-24 WIJIATI P 11358C 50 Th 0 Bln
188 2018-05-02 SULIMAH P 1434B 50 Th 10 Bln
189 2018-05-25 sinto L 105j 50 Th 11 Bln

190 2018-05-30 SITI MARSIYAH P 16111B 50 Th 2 Bln
191 2018-05-03 LILIK SUDARTI P 2484B 50 Th 8 Bln
193 2018-05-04 SRINGATIN P 13035d 50 Th 8 Bln

194 2018-05-22 SUNYONO L 21276a 50 Th 8 Bln
195 2018-05-18 mujiono L 9314a 50 Th 9 Bln
196 2018-05-14 SIYO L 380A 51 Th 10 Bln
197 2018-05-08 khususiyah P 14842b 51 Th 11 Bln
198 2018-05-12 SAMINI P 5734b 51 Th 11 Bln
199 2018-05-24 SIYAM P 1505b 51 Th 11 Bln
200 2018-05-31 siti munawaroh P 14252d 51 Th 2 Bln
201 2018-05-05 SLAMET L 3554a 51 Th 3 Bln
202 2018-05-05 ISMIATI P 4518B 51 Th 6 Bln

203 2018-05-07 ISTI SAYEKTININGSIH L 1534B 51 Th 7 Bln
204 2018-05-09 BASUKI L 2668A 51 Th 8 Bln
205 2018-05-24 ISMIAH P 501b 52 Th 1 Bln
206 2018-05-07 siti suliyah P 14707b 52 Th 11 Bln
208 2018-05-12 toisah P 15111b 52 Th 11 Bln
209 2018-05-16 MURTINAH P 14899B 52 Th 11 Bln
211 2018-05-16 SITI MASRUROH P 1230B 52 Th 2 Bln
Page 26 of 65
Tanggal : 01-05-2018 s.d 31-05-2018

Kunjungan
212 2018-05-24 elma fitriani P 15593c 52 Th 4 Bln
213 2018-05-11 gunawan L 5761a 52 Th 5 Bln
216 2018-05-25 SLAMET BASUKI L 1852A 52 Th 7 Bln
218 2018-05-12 JAMIATI P 2866B 53 Th 0 Bln
219 2018-05-14 siti aminah P 1092b 53 Th 1 Bln
220 2018-05-11 MUSTAKIM L 9843A 53 Th 7 Bln
222 2018-05-14 JANAH P 1701B 54 Th 11 Bln
223 2018-05-15 SUPARTIN P 4214B 54 Th 11 Bln
224 2018-05-17 mardiyah P 14711b 54 Th 11 Bln
225 2018-05-18 SITI HALIMAH P 3885B 54 Th 11 Bln
226 2018-05-16 SITI ASIYAH P 1145B 54 Th 2 Bln
227 2018-05-09 MUKIDJAH P 13843b 54 Th 4 Bln
228 2018-05-12 SUPARTI P 9798B 54 Th 9 Bln

229 2018-05-02 KASIYAH P 1274B 55 Th 10 Bln
230 2018-05-17 supiyah P 618b 55 Th 11 Bln

231 2018-05-05 SARTINI P 1209b 55 Th 2 Bln
232 2018-05-25 AMIN L 10655a 55 Th 2 Bln
233 2018-05-07 KATINAH P 5208B 55 Th 4 Bln
234 2018-05-21 WAMA TUTIK P 10764B 55 Th 9 Bln

235 2018-05-21 SUYATIN P 4470g 56 Th 11 Bln
236 2018-05-26 mukin P 00347b 56 Th 11 Bln
237 2018-05-26 SARNO L 13300a 56 Th 2 Bln
238 2018-05-07 WIJI UTAMI P 10999B 56 Th 3 Bln
239 2018-05-03 SITI UMI ROMLAH P 9494A 56 Th 5 Bln

240 2018-05-14 WIDJI UTAMI P 893B 57 Th 0 Bln
241 2018-05-19 RETNO ROEBIASTOETI P 359B 57 Th 1 Bln
242 2018-05-07 wakini P 9028a 57 Th 11 Bln
243 2018-05-22 SRINAH P 1765b 57 Th 6 Bln
244 2018-05-16 suliyah P 4336b 58 Th 0 Bln
245 2018-05-02 SUMARTI P 3100A 58 Th 10 Bln
246 2018-05-04 robi'in P 16134a 58 Th 5 Bln
248 2018-05-03 wiji P 676b 58 Th 6 Bln
250 2018-05-04 SUDJAK L 15835a 58 Th 6 Bln
251 2018-05-02 SUMARNO KAKASONO L 1061a 58 Th 8 Bln

252 2018-05-02 siti fatimah P 5885b 59 Th 1 Bln
Page 27 of 65
Tanggal : 01-05-2018 s.d 31-05-2018

Kunjungan
254 2018-05-08 ISTATIAH P 1562C 59 Th 10 Bln
255 2018-05-15 TATIK SETYO UTAMI P 1640b 59 Th 10 Bln

257 2018-05-03 bibit P 14290b 59 Th 11 Bln
260 2018-05-07 SAWOTO L 16162a 59 Th 11 Bln
261 2018-05-09 KARINI P 13283B 59 Th 11 Bln
263 2018-05-26 DJARWANI P 13347A 61 Th 10 Bln
264 2018-05-26 SUWUN P 1362b 61 Th 11 Bln

267 2018-05-15 kUSNAN L 15574K 62 Th 0 Bln
268 2018-05-17 WIJI P 2804A 62 Th 1 Bln
269 2018-05-03 YATINI P 4380h 62 Th 9 Bln
270 2018-05-25 SUNARTI P 895B 62 Th 9 Bln
271 2018-05-08 SUPRIYADI L 777A 63 Th 11 Bln
272 2018-05-14 SUPRIANTI P 10228A 63 Th 11 Bln
273 2018-05-12 kaseni L 347a 64 Th 10 Bln
275 2018-05-31 WASI L 1768A 64 Th 11 Bln
276 2018-05-14 SRINGATUN P 3207H 64 Th 2 Bln
277 2018-05-07 martun P 15916a 64 Th 6 Bln
278 2018-05-21 abdul kamit L 08403i 65 Th 10 Bln
279 2018-05-21 KUMINI P 22396A 65 Th 4 Bln
280 2018-05-11 SAMINAH P 2684h 66 Th 4 Bln
281 2018-05-02 bibit P 9098b 66 Th 5 Bln
282 2018-05-09 MITUN P 20021E 66 Th 6 Bln
283 2018-05-02 SUWITO L 14660A 66 Th 8 Bln
284 2018-05-22 SUTIYAH P 1428a 66 Th 8 Bln

286 2018-05-09 BADJURI L 9026a 66 Th 9 Bln
287 2018-05-14 MUNAYAH P 4668E 67 Th 11 Bln
288 2018-05-15 MURTI P 2278b 67 Th 11 Bln
289 2018-05-31 munayah P 4668e 67 Th 11 Bln
290 2018-05-15 JUMITUN P 4352E 67 Th 7 Bln
293 2018-05-09 BAKRI L 697A 67 Th 8 Bln
295 2018-05-05 MUFATIROH P 641b 68 Th 3 Bln
296 2018-05-14 ABD. KAMID L 3534A 70 Th 5 Bln
297 2018-05-03 SUCIPTO DANU SUPROJO L 2362A 71 Th 0 Bln
298 2018-05-16 SAHRONI L 7186G 71 Th 11 Bln

299 2018-05-14 yatemi P 4140a 72 Th 9 Bln
300 2018-05-07 WATINI P 7362B 73 Th 11 Bln
Page 28 of 65
Tanggal : 01-05-2018 s.d 31-05-2018

Kunjungan
301 2018-05-30 SITI HASANAH P 9220B 73 Th 7 Bln
302 2018-05-02 MUSTI P 175B 74 Th 11 Bln
303 2018-05-21 PAITO L 08a 75 Th 7 Bln
304 2018-05-23 suradi L 14861a 78 Th 0 Bln
305 2018-05-24 bakin L 5732a 79 Th 10 Bln

306 2018-05-02 SUTOMO L 1019a 79 Th 4 Bln
308 2018-05-31 SUTOMO L 1019a 79 Th 4 Bln
309 2018-05-08 DJUPRI L 3650a 80 Th 0 Bln
311 2018-05-05 jamin L 9733a 80 Th 11 Bln
312 2018-05-16 musiyah P 1410b 84 Th 11 Bln
Page 29 of 65
Diagnosa Desa
Abscess, furuncle and carbuncle of nose WONOREJO

Demam Tifoid; Gastritis, tidak spesifik BENDILJATI KULON
Allergic contact dermatitis JABALSARI
Demam Tifoid LODERESAN
Infeksi saluran pernapasan akut atas (ISPA), tidak spesifik PLOSOKANDANG
Diarrhoea and gastroenteritis of presumed infectious origin WONOREJO
Demam Tifoid JABALSARI

Faringitis akut, tidak spesifik KALIDAWIR
Abscess, furuncle and carbuncle of nose TUNGGULSARI
Dispepsia WONOREJO
Infeksi saluran pernapasan akut atas (ISPA), tidak spesifik JUNJUNG
Allergic contact dermatitis SUMBERDADI

Other and unspecified water transport accidents NGANTRU
Diarrhoea and gastroenteritis of presumed infectious origin PLOSOKANDANG
Dispepsia JABALSARI
Diarrhoea and gastroenteritis of presumed infectious origin JUNJUNG

Allergic contact dermatitis KROMASAN
Demam Tifoid JUNJUNG
Demam Tifoid SAMBIROBYONG
Atopic dermatitis PLOSOKANDANG
Myalgia SAMBIJAJAR
Demam Tifoid PLOSOKANDANG
Allergic contact dermatitis DOROAMPEL
Epilepsi, tidak spesifik SUMBERDADI
Infeksi saluran pernapasan akut atas (ISPA), tidak spesifik WONOREJO
Infeksi saluran pernapasan akut atas (ISPA), tidak spesifik SUMBERDADI
Abdominal pregnancy WONOREJO
Demam Tifoid SUMBERDADI
Hearing loss, unspecified SUMBERDADI
Abdominal pregnancy PODOREJO
Sakit kepala DOROAMPEL
Infeksi saluran pernapasan akut atas (ISPA), tidak spesifik BENDILJATI KULON
Abdominal pregnancy PODOREJO
Page 30 of 65
Diagnosa Desa
Necrosis of pulp SUMBERDADI

Infeksi saluran pernapasan akut atas (ISPA), tidak spesifik BUKUR
Retained dental root PLOSOKANDANG
Conjunctivitis SAMBIROBYONG
Infeksi saluran pernapasan akut atas (ISPA), tidak spesifik SAMBIJAJAR
Epilepsi, tidak spesifik SUMBERDADI
Personal history of contraception SUMBERDADI
Other and unspecified water transport accidents WONOREJO
Skizofrenia, tidak spesifik JABALSARI
Abdominal pregnancy JUNJUNG
Otitis externa DOROAMPEL
Demam Tifoid PLOSOKANDANG
Abdominal pregnancy WONOREJO
Abdominal pregnancy SUMBERDADI
Allergic contact dermatitis PULOTONDO
Demam Tifoid BUKUR
Hearing loss, unspecified SUMBERDADI
Abdominal pregnancy TEPAS
Myalgia JABALSARI
Abdominal pregnancy JABALSARI
Dispepsia SAMBIROBYONG
Demam Tifoid BENDILJATI KULON
Abdominal pregnancy BENDILJATI KULON
Infeksi saluran pernapasan akut atas (ISPA), tidak spesifik BENDILJATI WETAN
Necrosis of pulp JABALSARI
Allergic contact dermatitis SAMBIROBYONG
Abdominal pregnancy JUNJUNG
Hearing loss, unspecified DOROAMPEL
Acute sinusitis DOROAMPEL
Abdominal pregnancy BENDILJATI WETAN
Gastritis, tidak spesifik TUNGGULSARI
Skizofrenia, tidak spesifik DOROAMPEL
Necrosis of pulp JABALSARI
Page 31 of 65
Diagnosa Desa
Other and unspecified water transport accidents; Personal history SAMBIROBYONG

of contraception
Other and unspecified water transport accidents JABALSARI
Gastritis, tidak spesifik PULOTONDO
Skizofrenia, tidak spesifik SAMBIROBYONG
Diarrhoea and gastroenteritis of presumed infectious origin SUMBERDADI
Hipertensi primer/essensial BENDILJATI KULON

Infeksi saluran pernapasan akut atas (ISPA), tidak spesifik JABALSARI
Non-insulin-dependent diabetes mellitus SAMBIJAJAR
Hordeolum and chalazion BENDILJATI KULON
Infeksi saluran pernapasan akut atas (ISPA), tidak spesifik; BENDILJATI KULON
Dispepsia
Hipertensi primer/essensial DOROAMPEL
Infeksi saluran pernapasan akut atas (ISPA), tidak spesifik; Herpes JABALSARI
simplex genitalis
Abscess, furuncle and carbuncle of nose JABALSARI
Infeksi saluran pernapasan akut atas (ISPA), tidak spesifik SAMBIROBYONG
Keputihan / Candidiasis of vulva and vagina (N77.1*); Infeksi SAMBIROBYONG
saluran pernapasan akut atas (ISPA), tidak spesifik; Gastritis, tidak
spesifik; Personal history of contraception

Atopic dermatitis WONOREJO
Infeksi saluran pernapasan akut atas (ISPA), tidak spesifik BENDILJATI WETAN
Faringitis akut, tidak spesifik SUMBERDADI
Gastritis, tidak spesifik SAMBIROBYONG
Myalgia PONCOL
Myalgia JABALSARI
Gastritis, tidak spesifik JABALSARI
Myalgia JABALSARI
Disorder of urinary system, unspecified; Urinary tract infection, JABALSARI
site not specified
Page 32 of 65
Diagnosa Desa
Atopic dermatitis; Infeksi saluran pernapasan akut atas (ISPA), PLOSOKANDANG

tidak spesifik
Infeksi saluran pernapasan akut atas (ISPA), tidak spesifik SAMBIJAJAR
Myalgia BENDILJATI KULON
Respiratory tuberculosis unspecified, confirmed bacteriologi SUMBERDADI
Gastritis, tidak spesifik BENDILJATI KULON

Herpes zoster SAMBIROBYONG
Conjunctivitis SAMBIROBYONG
Hearing loss, unspecified SAMBIROBYONG
Myalgia; Sakit kepala SUMBERDADI
Demam Tifoid WONOREJO
Gastritis, tidak spesifik WATES
Allergic contact dermatitis WONOREJO
Dispepsia JABALSARI
Infeksi saluran pernapasan akut atas (ISPA), tidak spesifik; Asma, JUNJUNG
tidak spesifik
Sariawan / Recurrent oral aphthae; Gastritis, tidak spesifik SAMBIROBYONG
Myalgia JUNJUNG
Gastritis, tidak spesifik JUNJUNG
Myalgia SAMBIROBYONG
Gastritis, tidak spesifik SUMBERDADI
Atopic dermatitis PLOSOKANDANG
Demam Tifoid LODERESAN
Myalgia WONOREJO
Myalgia; Allergic contact dermatitis, unspecified cause KROMASAN
Asma, tidak spesifik SUMBERDADI
Urinary tract infection, site not specified SUMBERDADI
Allergic contact dermatitis TURUS
Hipertensi primer/essensial PLOSOKANDANG
Urinary tract infection, site not specified PURWOREJO
Allergic contact dermatitis KROMASAN
Other and unspecified water transport accidents JUNJUNG
Page 33 of 65
Diagnosa Desa

Myalgia SUMBERDADI
Epidemic vertigo JABALSARI
Dispepsia; Hipertensi primer/essensial; Gastritis, tidak spesifik PLOSOKANDANG
Hipertensi primer/essensial WONOREJO
Asma, tidak spesifik SAMBIROBYONG
Myalgia PODOREJO
Demam Tifoid BENDILJATI KULON
Myalgia SUMBERDADI
Sakit kepala WONOREJO
Infeksi saluran pernapasan akut atas (ISPA), tidak spesifik; Myalgia BENDILJATI KULON

Non-insulin-dependent diabetes mellitus JABALSARI
Allergic contact dermatitis; Hipertensi primer/essensial; Gastritis, SUMBERDADI
tidak spesifik
Other and unspecified water transport accidents SAMBIROBYONG
Dispepsia; Myalgia; Infeksi saluran pernapasan akut atas (ISPA), JUNJUNG
tidak spesifik
Infeksi saluran pernapasan akut atas (ISPA), tidak spesifik BALESONO
Myalgia JABALSARI
Allergic contact dermatitis WONOREJO
Asma, tidak spesifik JABALSARI
Chronic gingivitis BUKUR
Acute periodontitis SAMBIROBYONG
JABALSARI
Haemorrhoids SUMBERDADI
Myalgia DOROAMPEL
Atopic dermatitis JABALSARI
Myalgia SUMBERDADI
Myalgia BUKUR
Myalgia WONOREJO
Page 34 of 65
Diagnosa Desa
Necrosis of pulp WONOREJO

Gastritis, tidak spesifik SAMBIROBYONG
Dispepsia SUMBERDADI
Infeksi saluran pernapasan akut atas (ISPA), tidak spesifik KROMASAN
Atopic dermatitis LODERESAN
Other and unspecified water transport accidents PLOSOKANDANG
Sariawan / Recurrent oral aphthae BENDILJATI KULON
Myalgia SUMBERDADI
Artritis lainnya SUMBERDADI

Asma, tidak spesifik; Infeksi saluran pernapasan akut atas (ISPA), JUNJUNG
tidak spesifik
Hipertensi primer/essensial; Dispepsia SUMBERDADI
Gastro-oesophageal reflux disease without oesophagitis KROMASAN
Myalgia; Infeksi saluran pernapasan akut atas (ISPA), tidak spesifik SAMBIROBYONG
Myalgia PLOSOKANDANG
Dispepsia JABALSARI
Myalgia WONOREJO
Infeksi saluran pernapasan akut atas (ISPA), tidak spesifik; Myalgia BENDILJATI KULON

Myalgia BENDILJATI WETAN
Allergic contact dermatitis SOBONTORO
Myalgia BUKUR
Caisson disease [decompression sickness] SUMBERDADI
Hipertensi primer/essensial PLOSOKANDANG
Demam Tifoid DOROAMPEL
Myalgia WONOREJO
Myalgia; Infeksi saluran pernapasan akut atas (ISPA), tidak spesifik; JABALSARI
Hipertensi primer/essensial
Hipertensi primer/essensial; Myalgia TAMBAKREJO
Page 35 of 65
Diagnosa Desa
Myalgia; Infeksi saluran pernapasan akut atas (ISPA), tidak spesifik; JUNJUNG
Hipertensi primer/essensial
Myalgia; Conjunctivitis SUMBERDADI
Myalgia BUKUR
Hipertensi primer/essensial JABALSARI
Hipertensi primer/essensial; Infeksi saluran pernapasan akut atas PLOSOKANDANG
(ISPA), tidak spesifik
Infeksi saluran pernapasan akut atas (ISPA), tidak spesifik LODERESAN
Caisson disease [decompression sickness] SUMBERDADI
Non-insulin-dependent diabetes mellitus PLOSOKANDANG
Myalgia; Hipertensi primer/essensial BENDILJATI KULON
Myalgia JABALSARI
Dispepsia BENDILJATI KULON
Myalgia JUNJUNG
Myalgia; Hipertensi primer/essensial JABALSARI
Non-insulin-dependent diabetes mellitus SAMBIROBYONG
Hearing loss, unspecified JUNJUNG
Myalgia; Allergic contact dermatitis WONOREJO
Infeksi saluran pernapasan akut atas (ISPA), tidak spesifik; Allergic WONOREJO
contact dermatitis
Sakit kepala; Asma, tidak spesifik; Myalgia PLOSOKANDANG
Myalgia PLOSOKANDANG
Sakit kepala PLOSOKANDANG
Myalgia JABALSARI
Non-insulin-dependent diabetes mellitus; Myalgia JABALSARI
Myalgia BENDILJATI WETAN
Atopic dermatitis, unspecified BENDILJATI KULON
Infeksi saluran pernapasan akut atas (ISPA), tidak spesifik; SUMBERDADI
Dispepsia
Allergic contact dermatitis; Myalgia JABALSARI
Infeksi saluran pernapasan akut atas (ISPA), tidak spesifik; Myalgia SUMBERDADI
Hipertensi primer/essensial; Myalgia BENDILJATI KULON
Page 36 of 65
Diagnosa Desa
Myalgia SUMBERDADI
Hipertensi primer/essensial SAMBIROBYONG
Myalgia TALES
Respiratory tuberculosis unspecified, confirmed bacteriologi WONOREJO
Infeksi saluran pernapasan akut atas (ISPA), tidak spesifik TANJUNGSARI
Myalgia NGRANTI
Other hearing loss JABALSARI
Hipertensi primer/essensial; Myalgia PLOSOKANDANG
Page 37 of 65
Tanggal : 01-05-2018 s.d 31-05-2018

Kunjungan
55 2018-05-07 endang rahayu P 4429e 27 Th 0 Bln
62 2018-05-17 nuraja laela P 14934f 28 Th 7 Bln
69 2018-05-22 JOKO SANTOSO L 5447E 30 Th 5 Bln
83 2018-05-04 YENI YULAIKAH P 1323C 34 Th 2 Bln
92 2018-05-16 MUJI SLAMET L 22670E` 35 Th 9 Bln
109 2018-05-04 SUNARMI P 14855F 39 Th 1 Bln
190 2018-05-30 SITI MARSIYAH P 16111B 50 Th 2 Bln
220 2018-05-11 MUSTAKIM L 9843A 53 Th 7 Bln
Page 38 of 65
Diagnosa Desa

Skizofrenia, tidak spesifik SAMBIROBYONG
Page 39 of 65
PCARE BULAN MEI 2018
No TANGGAL No. KARTU NAMA PESERTA SEX JENIS PESERTA
1 5/31/2018 118201915 SUKARJI L PNS PUSAT
2 5/31/2018 667107999 DJANI L PBI (APBN)
3 5/31/2018 667312402 IMAM GOZALI L PBI (APBN)
4 5/31/2018 667593202 WAGINAH P PBI (APBN)
5 5/31/2018 667696803 NASIKIN L PBI (APBN)
6 5/31/2018 667728167 LAMIDJAN L PBI (APBN)
7 5/31/2018 667844921 KUSNAN L PBI (APBN)
8 5/31/2018 667845178 SRINGATUN P PBI (APBN)
9 5/31/2018 667920385 MURYATI P PBI (APBN)
10 5/31/2018 668099092 ARIS TIANI P PBI (APBN)
11 5/31/2018 668235879 SUYITNO L PBI (APBN)
12 5/31/2018 668312019 MURDIM L PBI (APBN)
13 5/31/2018 1037183861 INDARTIK P PBI (APBN)
14 5/31/2018 1037186886 SEMI P PBI (APBN)

15 5/31/2018 1261417814 SITI NURASIYAH P PEKERJA MANDIRI
16 5/31/2018 1264132089 NURUL KOTIMAH P PEKERJA MANDIRI
17 5/31/2018 1290777153 TIKAH P PEKERJA MANDIRI
18 5/31/2018 1380428673 SARMINI P PEKERJA MANDIRI
19 5/31/2018 2053551971 MISTAR L PEGAWAI SWASTA

20 5/31/2018 2155186719 POPO HARJUMIRAN L PEKERJA MANDIRI
21 5/31/2018 2155186721 SUJIWIYATI P PEKERJA MANDIRI
22 5/31/2018 2260305382 MUHAMMAD MUSLIH KODIN L PEKERJA MANDIRI
23 5/31/2018 2447975441 SUTIYAH P PEKERJA MANDIRI
24 5/31/2018 2455932161 MIRAH P PEKERJA MANDIRI
25 5/30/2018 205842475 ERNA YULI RAHMAWATI P PEGAWAI SWASTA
26 5/30/2018 666968084 SUPARMI P PBI (APBN)
27 5/30/2018 667279833 MARSAM L PBI (APBN)
28 5/30/2018 667340504 JARNO L PBI (APBN)
29 5/30/2018 667388351 MARIYAM P PBI (APBN)
30 5/30/2018 667534274 AGUS PUTRA EMAS A.S. L PBI (APBN)
31 5/30/2018 667658621 SAMINI P PBI (APBN)
32 5/30/2018 667674167 BONARI L PBI (APBN)
33 5/30/2018 667725592 MUSRIKAH P PBI (APBN)
34 5/30/2018 668064273 MAHSUSROTIN P PBI (APBN)
35 5/30/2018 668216081 DWI UNTARI P PBI (APBN)
36 5/30/2018 1037186919 WINARSIH P PBI (APBN)
37 5/30/2018 1037187202 RIONO L PBI (APBN)
38 5/30/2018 1261699211 ENNY P PEKERJA MANDIRI
39 5/30/2018 1438609781 BINTI MU'AWANAH P PEKERJA MANDIRI
40 5/30/2018 1701798862 RENI ANJANI P PBI (APBD)
41 5/30/2018 1817955123 SUBHAN BAHRUL ULUM L PEKERJA MANDIRI

42 5/30/2018 1829220884 KOLIPAH P PEKERJA MANDIRI
Page 40 of 65
43 5/30/2018 2307601383 MUNTIYAH P PEKERJA MANDIRI
44 5/30/2018 2435545866 ALIPAH P PEKERJA MANDIRI

45 5/30/2018 2458811327 SITI MAESAROH P PEKERJA MANDIRI
46 5/28/2018 667094984 SON HAJI L PBI (APBN)
47 5/28/2018 667134742 NONIK INTAN SARI P PBI (APBN)
48 5/28/2018 667284311 SOLEMAN L PBI (APBN)
49 5/28/2018 667421976 SITI ROKAYAH P PBI (APBN)
50 5/28/2018 667443712 KATIRAH P PBI (APBN)
51 5/28/2018 667539584 SITI MAHMUDAH P PBI (APBN)
52 5/28/2018 667736919 SURYANI L PBI (APBN)
53 5/28/2018 667864225 ROHMAT L PBI (APBN)
54 5/28/2018 667907256 LINA SOFIANA SAFITRI P PBI (APBN)
55 5/28/2018 667931422 SUHARI P PBI (APBN)
56 5/28/2018 668007988 MARWIYAH P PBI (APBN)
57 5/28/2018 668078673 ALDHA YULI HARIYATI SAPUTRI P PBI (APBN)
58 5/28/2018 668148412 MUJIATIN P PBI (APBN)
60 5/28/2018 668751175 BINTI WAHYUNI P PBI (APBN)
61 5/28/2018 1037176907 NURSIYAH P PBI (APBN)
62 5/28/2018 1037181453 MUNTIANAH P PBI (APBN)

63 5/28/2018 1037225103 HERISETIAWAN L PBI (APBN)
64 5/28/2018 1245545932 SULISTIA RATNA DEWI P PEGAWAI SWASTA
65 5/28/2018 1271540788 KIYAR L PEKERJA MANDIRI
66 5/28/2018 1705038524 SUPIAH P PBI (APBD)
67 5/28/2018 1875577814 PAMUDJI L PEKERJA MANDIRI

69 5/28/2018 2259358108 MUKIDI L PEKERJA MANDIRI
70 5/28/2018 2259359111 KATIMAH P PEKERJA MANDIRI
71 5/28/2018 2259820157 SRIYANTI P PEKERJA MANDIRI
72 5/26/2018 667230287 JUNARTI P PBI (APBN)
73 5/26/2018 667254745 DWI PRAMILA OCTAFIANA P PBI (APBN)
74 5/26/2018 667696105 RUBINI L PBI (APBN)
75 5/26/2018 667696239 MASTUR L PBI (APBN)
76 5/26/2018 667725592 MUSRIKAH P PBI (APBN)
77 5/26/2018 667828023 SUSIATI P PBI (APBN)
78 5/26/2018 668103006 SUGIANTO L PBI (APBN)
79 5/26/2018 668137792 ALFIYAH P PBI (APBN)
80 5/26/2018 1037179934 MUNTINAH P PBI (APBN)
81 5/26/2018 1037183545 MURTINI P PBI (APBN)
82 5/26/2018 1703608187 SETIONO L PBI (APBD)
83 5/26/2018 1871718996 LEGIATI P PEKERJA MANDIRI
84 5/26/2018 1971205007 RENI LINA RAHAYU P PEKERJA MANDIRI
85 5/26/2018 2088522022 KASMAH P PEKERJA MANDIRI
Page 41 of 65
86 5/25/2018 667269088 AMIN P PBI (APBN)
87 5/25/2018 667284333 PORNOMO L PBI (APBN)
88 5/25/2018 667324247 TITIK PURWANINGSIH P PBI (APBN)
90 5/25/2018 667638652 MARTIN P PBI (APBN)
91 5/25/2018 667810765 UMINI P PBI (APBN)
92 5/25/2018 667947183 MUYATI P PBI (APBN)
93 5/25/2018 1037187178 WAHYU SUWITO L PBI (APBN)
94 5/25/2018 1271540788 KIYAR L PEKERJA MANDIRI
95 5/25/2018 1315908009 UMIATI P PEKERJA MANDIRI
96 5/25/2018 1447926208 KATIN P PEKERJA MANDIRI
97 5/25/2018 1701780783 SALEH L PBI (APBD)
98 5/25/2018 2443279252 BAYI NY RISKA DIANA I P PBI (APBN)
99 5/24/2018 107042016 MUARIS L PENERIMA PENSIUN PNS
100 5/24/2018 667240301 ROHMAN L PBI (APBN)
101 5/24/2018 667312402 IMAM GOZALI L PBI (APBN)
102 5/24/2018 667312762 YATMININGSIH P PBI (APBN)
103 5/24/2018 667397777 KASIYAN L PBI (APBN)
104 5/24/2018 667846157 SUKADI L PBI (APBN)

105 5/24/2018 668312019 MURDIM L PBI (APBN)
106 5/24/2018 2072561207 SURATMI P PEKERJA MANDIRI
107 5/24/2018 2223359357 SAINI L PEKERJA MANDIRI
108 5/24/2018 2245818947 SASMITO L PEKERJA MANDIRI
109 5/24/2018 2424708235 YAMAT L PEKERJA MANDIRI
110 5/24/2018 2424708628 LAMIRAH P PEKERJA MANDIRI
112 5/23/2018 666812676 RODIYAH P PBI (APBN)

113 5/23/2018 667327487 AHMAD SIPON L PBI (APBN)
114 5/23/2018 667917696 SRI WAHYUNI P PBI (APBN)
115 5/23/2018 668016213 RINA SAPUTRI P PBI (APBN)
116 5/23/2018 1037176863 SUPINI P PBI (APBN)
117 5/23/2018 1037180417 SITI AMINAH P PBI (APBN)
118 5/23/2018 1037181688 SIIN P PBI (APBN)
119 5/23/2018 1282267012 SITI MUZAYAROH P PEKERJA MANDIRI
120 5/23/2018 1390113977 AZAFIRA AULIA FITRIANI P PEKERJA MANDIRI
121 5/23/2018 1462234555 BADJURI L PEKERJA MANDIRI

122 5/23/2018 1808672591 DESI PURWATI L PEKERJA MANDIRI
123 5/23/2018 2212988027 PATMININGSIH P PEKERJA MANDIRI
125 5/23/2018 2427161477 YUNITA P PEKERJA MANDIRI
126 5/22/2018 108595945 SUTINI L PENERIMA PENSIUN PNS
127 5/22/2018 667094984 SON HAJI L PBI (APBN)
Page 42 of 65
128 5/22/2018 667130376 PAITUN P PBI (APBN)
129 5/22/2018 667177525 MARINI P PBI (APBN)
130 5/22/2018 667340109 ELLA KHUSNUL FATIMAH P PBI (APBN)
131 5/22/2018 667633059 ALI MUKSIN L PBI (APBN)

133 5/22/2018 667991147 WIJI P PBI (APBN)
134 5/22/2018 668004028 TUMINAH P PBI (APBN)
135 5/22/2018 668052911 MARI PUJIATI P PBI (APBN)
136 5/22/2018 668244633 SUPINAH P PBI (APBN)
138 5/22/2018 1261678331 FIRDAUS ZUBAIDI P PEKERJA MANDIRI
139 5/22/2018 1705047693 MARIYATIN P PBI (APBD)
140 5/22/2018 1884521981 SITI ALFIAH P PEKERJA MANDIRI
141 5/22/2018 2261193276 SUNGKONO L PEKERJA MANDIRI
142 5/22/2018 2308265155 ENDANAH P PEKERJA MANDIRI
143 5/22/2018 2444056874 SUKAMTO L PEKERJA MANDIRI
144 5/22/2018 2445622457 SUPANDI L PEKERJA MANDIRI
145 5/21/2018 666068679 NUR AINI P PBI (APBN)
146 5/21/2018 667100619 JILIN P PBI (APBN)
147 5/21/2018 667462792 SUPRIHATIN P PBI (APBN)
148 5/21/2018 667563917 RINA MALIKA P PBI (APBN)
149 5/21/2018 667658621 SAMINI P PBI (APBN)
150 5/21/2018 667863303 MUNTINI P PBI (APBN)
151 5/21/2018 667883147 ISTI KURIAH P PBI (APBN)
152 5/21/2018 667884339 DWI SITI MASLIKAH P PBI (APBN)
153 5/21/2018 667905243 KHAFIT BADRUS ZAMAN L PBI (APBN)
154 5/21/2018 667947126 MARJATIN P PBI (APBN)
155 5/21/2018 668024864 SUKIRNO L PBI (APBN)

156 5/21/2018 668312019 MURDIM L PBI (APBN)
158 5/21/2018 1037187202 RIONO L PBI (APBN)
159 5/21/2018 1275511724 RIAN SAPUTRA L PEKERJA MANDIRI
160 5/21/2018 1701780928 KATUMI P PBI (APBD)
162 5/21/2018 1705038524 SUPIAH P PBI (APBD)
163 5/21/2018 1705046466 SUWARTI P PBI (APBD)
164 5/21/2018 2062382714 MUHAMMAD ZAENURI L PEKERJA MANDIRI
165 5/21/2018 2062491142 MUHAMMAD FAREL NUR FAIZIN L PEKERJA MANDIRI
167 5/21/2018 2298354399 HERI SAYUTI L PEKERJA MANDIRI
168 5/21/2018 2303842116 SITI JUARIAH P PEKERJA MANDIRI
169 5/21/2018 2421286683 MAISAH P PEKERJA MANDIRI
170 5/19/2018 666037844 MUHROJI L PBI (APBN)
Page 43 of 65
171 5/19/2018 667133818 SEPTI AMALINA P PBI (APBN)
173 5/19/2018 667262316 SITI ROMLAH P PBI (APBN)

176 5/19/2018 667639179 ISMIATI P PBI (APBN)
177 5/19/2018 667742591 YATUN P PBI (APBN)
178 5/19/2018 667744086 MUT NAIMAH P PBI (APBN)
179 5/19/2018 667864225 ROHMAT L PBI (APBN)
180 5/19/2018 667931308 SUDARMAJI L PBI (APBN)
181 5/19/2018 667986063 SARTINI P PBI (APBN)
182 5/19/2018 668966668 SITI ROSIDAH P PBI (APBN)
183 5/19/2018 1422582052 TOTOK WAHYUDI L PEKERJA MANDIRI
184 5/19/2018 1705045353 RULI SUSIATIN P PBI (APBD)
185 5/19/2018 1861054222 AGUNG CAHYANI L PEKERJA MANDIRI
188 5/18/2018 107447308 SITI SAMSIYAH P PNS DAERAH
189 5/18/2018 344340167 HARTATI P PBI (APBN)
190 5/18/2018 667075162 JARNO L PBI (APBN)
192 5/18/2018 667644704 SUNARTIN P PBI (APBN)
193 5/18/2018 667674167 BONARI L PBI (APBN)
194 5/18/2018 667808177 MUKRIP L PBI (APBN)
196 5/18/2018 668252891 HERWANTO L PBI (APBN)
197 5/18/2018 668338075 YASIN MUSTOFA L PBI (APBN)
198 5/18/2018 1037183861 INDARTIK P PBI (APBN)

199 5/18/2018 2037715795 ERNA P PEKERJA MANDIRI
201 5/17/2018 667251325 SAHRONI L PBI (APBN)
202 5/17/2018 667259706 MUJI P PBI (APBN)
203 5/17/2018 667266467 VERI EFENDI L PBI (APBN)

205 5/17/2018 667658621 SAMINI P PBI (APBN)
206 5/17/2018 667772965 MUJIATEN P PBI (APBN)
208 5/17/2018 667865981 SAMITOEN P PBI (APBN)
209 5/17/2018 668180564 RONA ELVA AZIZAH P PBI (APBN)
210 5/17/2018 1037180834 DJUMIRAH P PBI (APBN)
211 5/17/2018 1304339185 BIBIT P PEKERJA MANDIRI
212 5/17/2018 1423008538 AHMADAH P PEKERJA MANDIRI
Page 44 of 65
213 5/17/2018 1866914998 SAROFAH P PEKERJA MANDIRI
214 5/16/2018 667222852 KATOYAH P PBI (APBN)
215 5/16/2018 667444691 SRI UTAMI P PBI (APBN)
216 5/16/2018 667638652 MARTIN P PBI (APBN)
217 5/16/2018 667923671 NATUN P PBI (APBN)
218 5/16/2018 667965014 MARIYATIN P PBI (APBN)
220 5/16/2018 668312019 MURDIM L PBI (APBN)
221 5/16/2018 668609627 SIRUS P PBI (APBN)
222 5/16/2018 668954711 LILIS HERAWATI P PBI (APBN)
223 5/16/2018 1271625941 SULISTRIANI P PEKERJA MANDIRI
224 5/16/2018 1420987869 RISKA NOVITA SARI P PEKERJA MANDIRI
225 5/16/2018 1479805435 SUNDARI P PEKERJA MANDIRI
226 5/16/2018 1854695182 KASMINI P PNS DAERAH
227 5/16/2018 1860205252 UMI SAROPAH P PEKERJA MANDIRI

228 5/16/2018 2036741141 YENI DWI WULANDARI L PEKERJA MANDIRI
229 5/16/2018 2075120853 SUPARTI P PEKERJA MANDIRI
230 5/16/2018 2435545866 ALIPAH P PEKERJA MANDIRI

231 5/16/2018 2453726654 NURHAYATI P PEKERJA MANDIRI
232 5/15/2018 667171192 USWATUL HASANAH P PBI (APBN)
233 5/15/2018 667187065 RUKAYAH P PBI (APBN)
235 5/15/2018 667428041 SITI ROSIDAH P PBI (APBN)
236 5/15/2018 667447828 MUCHTADI L PBI (APBN)
238 5/15/2018 667957296 MOH. YUSUF PUTRA INDRAYATI L PBI (APBN)

239 5/15/2018 668060763 UMILATIFAH P PBI (APBN)
240 5/15/2018 668641869 TITIK NASROTIN P PBI (APBN)
241 5/15/2018 668669962 SATIR L PBI (APBN)
243 5/15/2018 668969908 YASIN L PBI (APBN)
244 5/15/2018 1264310346 MIRATUN P PEKERJA MANDIRI
245 5/15/2018 1279880111 JARIYATUN P PEKERJA MANDIRI
246 5/15/2018 1705038524 SUPIAH P PBI (APBD)
247 5/15/2018 1884521981 SITI ALFIAH P PEKERJA MANDIRI
248 5/15/2018 2091626559 ABDUL MANAP L PEKERJA MANDIRI
249 5/15/2018 2139699453 FANNY RAHMA SARI P PEGAWAI SWASTA

250 5/14/2018 107042016 MUARIS L PENERIMA PENSIUN PNS
251 5/14/2018 667240301 ROHMAN L PBI (APBN)
252 5/14/2018 667269088 AMIN P PBI (APBN)
253 5/14/2018 667342833 IQBAL FAHRI ZAMZAMI L PBI (APBN)
254 5/14/2018 667363386 MIJEM P PBI (APBN)
Page 45 of 65
256 5/14/2018 667440573 ASPIYAH P PBI (APBN)
257 5/14/2018 667654086 SUNU FINARDI L PBI (APBN)
258 5/14/2018 667696105 RUBINI L PBI (APBN)
259 5/14/2018 667696239 MASTUR L PBI (APBN)
260 5/14/2018 667831151 MASYEM L PBI (APBN)
262 5/14/2018 667877635 SUKARNI L PBI (APBN)
263 5/14/2018 668064892 TUKIJO L PBI (APBN)
264 5/14/2018 668066501 SRI ASIH WIGATI P PBI (APBN)
265 5/14/2018 668092476 NURUN ASOMAH P PBI (APBN)
266 5/14/2018 668219872 SITI AISYAH P PBI (APBN)
267 5/14/2018 668289936 SUTOMO L PBI (APBN)
268 5/14/2018 668321414 BIBIT SUPARMAN L PBI (APBN)
269 5/14/2018 1262464154 MURLAN L PEKERJA MANDIRI
270 5/14/2018 1283769437 ZAM ZAINI, H. L PEKERJA MANDIRI
271 5/14/2018 1284929392 ISTIANAH P PEKERJA MANDIRI
272 5/14/2018 1446176395 FUTIHAH P PEKERJA MANDIRI

274 5/14/2018 2035233641 MARYATIN P PEKERJA MANDIRI
275 5/14/2018 2080730485 SUTEJO L PEKERJA MANDIRI
278 5/14/2018 2440701696 MUHAMMAD DHANIS RAFARDHAN L PBI (APBN)
280 5/12/2018 666686439 SURIPTO L PBI (APBN)

281 5/12/2018 666798006 KARIYANAH P PBI (APBN)
282 5/12/2018 667091248 KASIYANI L PBI (APBN)
283 5/12/2018 667124954 KAWIT P PBI (APBN)
286 5/12/2018 667742591 YATUN P PBI (APBN)
287 5/12/2018 667744086 MUT NAIMAH P PBI (APBN)
288 5/12/2018 667880098 TUMINEM P PBI (APBN)
289 5/12/2018 668601652 SUMILAH P PBI (APBN)
290 5/12/2018 668692269 JUWANAH P PBI (APBN)
291 5/12/2018 1037176863 SUPINI P PBI (APBN)
294 5/12/2018 1866914998 SAROFAH P PEKERJA MANDIRI
296 5/12/2018 1874219286 MASROMI P PEKERJA MANDIRI
297 5/12/2018 1900558247 JUMINAH L PEKERJA MANDIRI
Page 46 of 65
299 5/12/2018 2438684324 TANIMAN L PEKERJA MANDIRI
300 5/12/2018 2438687327 SAIFUL HUDA L PEKERJA MANDIRI

301 5/11/2018 107390981 SUNARMI P PENERIMA PENSIUN PNS
302 5/11/2018 667068693 HIMARODIN L PBI (APBN)
303 5/11/2018 667201961 MIRATUN P PBI (APBN)
304 5/11/2018 667269088 AMIN P PBI (APBN)
305 5/11/2018 667273151 RUMINI P PBI (APBN)
306 5/11/2018 667423361 MITUN P PBI (APBN)
308 5/11/2018 667635783 SURATIN P PBI (APBN)
309 5/11/2018 667772965 MUJIATEN P PBI (APBN)
310 5/11/2018 667853493 SITIN P PBI (APBN)
311 5/11/2018 667864225 ROHMAT L PBI (APBN)
312 5/11/2018 668312019 MURDIM L PBI (APBN)
313 5/11/2018 668355131 ISROTIN P PBI (APBN)
314 5/11/2018 668581738 WATINI P PBI (APBN)
315 5/11/2018 1037185424 NOVI FITRIA RATNASARI P PBI (APBN)
316 5/11/2018 1083004975 YULI EKA TRISNAWATI P PBI (APBN)
317 5/11/2018 1283476083 MARIYATUN P PENERIMA PENSIUN TNI

318 5/11/2018 1286476749 KAMSIYAH P PEKERJA MANDIRI
319 5/11/2018 1432853335 WIJI MUTMAINAH P PEKERJA MANDIRI
320 5/11/2018 1705038524 SUPIAH P PBI (APBD)
321 5/11/2018 1799371293 ROHNAINI P PEKERJA MANDIRI

322 5/11/2018 2284346079 SUNAR L PEKERJA MANDIRI
323 5/11/2018 2311150318 MUNAWAROH P PEKERJA MANDIRI
325 5/9/2018 667645312 TINI P PBI (APBN)
326 5/9/2018 667646662 NOFI PURNATA SARI P PBI (APBN)
327 5/9/2018 667658621 SAMINI P PBI (APBN)
329 5/9/2018 1037178731 IMAM AFANDI L PBI (APBN)
330 5/9/2018 1265778977 BASAR L PEKERJA MANDIRI
331 5/9/2018 1705047186 MUHAMMAD MAJID MA'RUF L PBI (APBD)
334 5/8/2018 106971827 IMAM BASUNI L PNS DAERAH
335 5/8/2018 667170505 SUMILAH P PBI (APBN)

336 5/8/2018 667177525 MARINI P PBI (APBN)
337 5/8/2018 667810765 UMINI P PBI (APBN)
Page 47 of 65
338 5/8/2018 667991147 WIJI P PBI (APBN)
339 5/8/2018 668970077 SITI MASRURIN P PBI (APBN)
341 5/8/2018 1104296635 IMAM SUPARDI L PENERIMA PENSIUN TNI
342 5/8/2018 1446257507 MARKUP L PEKERJA MANDIRI
344 5/8/2018 2091626559 ABDUL MANAP L PEKERJA MANDIRI
345 5/8/2018 2291766928 SITI CHULSUMIATI P PEKERJA MANDIRI

346 5/8/2018 2327914236 KOTIYAH P PEKERJA MANDIRI
347 5/7/2018 666004375 MOHTOWIL L PBI (APBN)
348 5/7/2018 666682143 SITI LATIFAH P PBI (APBN)
349 5/7/2018 666685271 SITI MASITAH P PBI (APBN)
350 5/7/2018 666795159 AGUS DARMAWAN L PBI (APBN)
351 5/7/2018 667122726 YENI HARNANI P PBI (APBN)
353 5/7/2018 667248028 SULIMAH P PBI (APBN)
354 5/7/2018 667259706 MUJI P PBI (APBN)
355 5/7/2018 667279833 MARSAM L PBI (APBN)

356 5/7/2018 667313278 WIJI P PBI (APBN)
357 5/7/2018 667314753 DWIKI KURNIAWAN L PBI (APBN)
358 5/7/2018 667347581 MISDIANTORO L PBI (APBN)
359 5/7/2018 667363386 MIJEM P PBI (APBN)
361 5/7/2018 667487902 KARTIAH P PBI (APBN)
362 5/7/2018 667666236 KATOYAH P PBI (APBN)
363 5/7/2018 667681694 SUGENG L PBI (APBN)
364 5/7/2018 667898122 KASIYATI P PBI (APBN)
365 5/7/2018 668114774 WINDY SULISTYO PUTRI P PBI (APBN)
366 5/7/2018 668150144 SATUN P PBI (APBN)
367 5/7/2018 668346862 WIJI P PBI (APBN)
368 5/7/2018 668692269 JUWANAH P PBI (APBN)
369 5/7/2018 1037180834 DJUMIRAH P PBI (APBN)
370 5/7/2018 1037181396 ROWI ATROJAM L PBI (APBN)
371 5/7/2018 1037181407 MUSRIANIK P PBI (APBN)
372 5/7/2018 1283476083 MARIYATUN P PENERIMA PENSIUN TNI
373 5/7/2018 1380429887 SRINGATIN P PEKERJA MANDIRI
374 5/7/2018 1861054222 AGUNG CAHYANI L PEKERJA MANDIRI

376 5/7/2018 2245818947 SASMITO L PEKERJA MANDIRI

379 5/5/2018 344340167 HARTATI P PBI (APBN)
Page 48 of 65
380 5/5/2018 667171372 MUHAMMAD ZAENUDIN L PBI (APBN)
382 5/5/2018 667302197 MOHAMAD HASIM L PBI (APBN)
383 5/5/2018 667343272 WELAS P PBI (APBN)
384 5/5/2018 667658621 SAMINI P PBI (APBN)
385 5/5/2018 667742591 YATUN P PBI (APBN)
386 5/5/2018 667806737 SUTIYAH P PBI (APBN)
387 5/5/2018 667817392 SURIP P PBI (APBN)
390 5/5/2018 667986063 SARTINI P PBI (APBN)

392 5/5/2018 1037186886 SEMI P PBI (APBN)
393 5/5/2018 1269226811 MOH MAKRUF L PEKERJA MANDIRI
394 5/5/2018 1275408549 SITI NURHAYATI P PEKERJA MANDIRI
395 5/5/2018 1701780513 SUMIATUN P PBI (APBD)
396 5/5/2018 1705041167 SURATIN P PBI (APBD)
397 5/5/2018 1811239154 SULISTYORINI P PBI (APBD)
398 5/5/2018 1885926385 KHOIRUN NISAK P PEKERJA MANDIRI
399 5/5/2018 2196060153 TOINI P PBI (APBD)
400 5/5/2018 2311150318 MUNAWAROH P PEKERJA MANDIRI

401 5/5/2018 2323284614 KAYATI P PEKERJA MANDIRI
402 5/4/2018 107447308 SITI SAMSIYAH P PNS DAERAH
403 5/4/2018 108592626 TIMAH P PENERIMA PENSIUN PNS
404 5/4/2018 667092813 SULANI L PBI (APBN)
405 5/4/2018 667143562 SUNGEP L PBI (APBN)
406 5/4/2018 667340638 SIYAR L PBI (APBN)
407 5/4/2018 667368966 PRAYITNO L PBI (APBN)

409 5/4/2018 667877488 HARIMI P PBI (APBN)
411 5/4/2018 668155702 DIKKY WAHYUDI L PBI (APBN)
413 5/4/2018 1037179574 KHOIRUN NI'MAH P PBI (APBN)
414 5/4/2018 1128760176 JUWARI L PEGAWAI BUMN
415 5/4/2018 1190263555 YATIAH P PEGAWAI BUMN
416 5/4/2018 1390111154 SITI MUJAYAMAH P PEKERJA MANDIRI
417 5/4/2018 1422583705 SISWANTI P PEKERJA MANDIRI
418 5/4/2018 1422584616 FEVILICIA CAHYA OKTAFIANI P PEKERJA MANDIRI
419 5/4/2018 1422821305 HABIB ROYAN ALKAUTSAR L PEKERJA MANDIRI
421 5/4/2018 1539034953 RENGGO ANDRIONO L PEGAWAI SWASTA
Page 49 of 65
422 5/4/2018 1701780772 DASAR L PBI (APBD)
423 5/4/2018 1705038524 SUPIAH P PBI (APBD)
424 5/4/2018 1705046714 KASERI L PBI (APBD)

425 5/4/2018 2195326269 CITRANING WAHYU P PEKERJA MANDIRI
426 5/3/2018 667165083 MOHAMMAD TIO RYVAN L PBI (APBN)
427 5/3/2018 667186514 RASEMI P PBI (APBN)
428 5/3/2018 667226114 SUDARMI P PBI (APBN)
429 5/3/2018 667240301 ROHMAN L PBI (APBN)
430 5/3/2018 667563816 KASINI P PBI (APBN)
431 5/3/2018 667820643 SUPINI P PBI (APBN)
432 5/3/2018 667849285 SLAMET L PBI (APBN)
433 5/3/2018 667864225 ROHMAT L PBI (APBN)
434 5/3/2018 668001385 MUJIATI P PBI (APBN)
435 5/3/2018 668078098 SUTRISNO L PBI (APBN)
436 5/3/2018 668112131 MINAN L PBI (APBN)
438 5/3/2018 1037178011 SURTIANI P PBI (APBN)
439 5/3/2018 1288242303 SUPANI L PEKERJA MANDIRI
440 5/3/2018 1833011965 LAYLATUL FITRI L PNS DAERAH
441 5/3/2018 1874218149 SLAMET L PEKERJA MANDIRI
442 5/3/2018 2075120853 SUPARTI P PEKERJA MANDIRI
443 5/3/2018 2442626752 SRINGATIN P PEKERJA MANDIRI
444 5/2/2018 107344978 MARLIYAH P PENERIMA PENSIUN PNS

445 5/2/2018 667125178 AMIN P PBI (APBN)
447 5/2/2018 667368009 MARSIYAM P PBI (APBN)
448 5/2/2018 667447828 MUCHTADI L PBI (APBN)
449 5/2/2018 667639956 JOKO FITRIANTODWI NUGROHO L PBI (APBN)
450 5/2/2018 667645672 SINDY ZAHRO P P PBI (APBN)
451 5/2/2018 667810765 UMINI P PBI (APBN)
452 5/2/2018 667860333 SRINGATIN P PBI (APBN)
454 5/2/2018 668020691 NINIK SETIANINGSIH P PBI (APBN)
455 5/2/2018 668024864 SUKIRNO L PBI (APBN)
456 5/2/2018 668059964 TASMIRAH P PBI (APBN)
457 5/2/2018 668154879 DENI SUSILOWATI P PBI (APBN)
459 5/2/2018 1037181407 MUSRIANIK P PBI (APBN)
460 5/2/2018 1037183534 DJULI L PBI (APBN)
461 5/2/2018 1271853268 ALBERNO ZEVARES NATHA PRAWIRA L TNI ANGKATAN DARAT
462 5/2/2018 1380428673 SARMINI P PEKERJA MANDIRI
463 5/2/2018 1804894176 KASIYAN L PEKERJA MANDIRI
Page 50 of 65
464 5/2/2018 1846939601 SITI KHABIBAH, HJ P PEKERJA MANDIRI
465 5/2/2018 1966618539 KORIJAH P PEKERJA MANDIRI
466 5/2/2018 2195162921 AHMAD MURTADLO L PEGAWAI PEMERINTAH NON PNS

467 5/2/2018 2205519862 ENY SUSIANAH P PEKERJA MANDIRI
469 5/2/2018 2443581189 DANANG PRASTIYO L PEKERJA MANDIRI
Page 51 of 65
DIAGNOSA DI RUJUK
Acute myocardial infarction YA
Retention of urine YA
Myalgia TIDAK
Myalgia TIDAK
Low back pain, multiple sites YA
Schizophrenia, unspecified TIDAK
Myalgia TIDAK
Asthma, unspecified TIDAK
Urinary tract infection, site not specified TIDAK
Myalgia TIDAK
Allergic contact dermatitis TIDAK
Acute upper respiratory infection, unspecified TIDAK
Human immunodeficiency virus [HIV] disease resulting in infectious YA
and parasitic diseases
Dyspepsia TIDAK
Epilepsy TIDAK
Epilepsy, unspecified YA
Non-insulin-dependent diabetes mellitus without complications YA
Chronic ischaemic heart disease, unspecified YA

Essential (primary) hypertension TIDAK
Dyspepsia YA
Myalgia TIDAK
Stroke, not specified as haemorrhage or infarction YA
Dyspepsia YA
Low back pain, multiple sites YA
Benign intracranial hypertension YA
Chronic obstructive pulmonary disease, unspecified YA
Myalgia TIDAK
Soft tissue disorder, unspecified TIDAK
Dyspepsia YA
Myalgia TIDAK
Typhoid and paratyphoid fevers TIDAK
Epilepsy, unspecified TIDAK
Unstable angina YA
Gastritis, unspecified TIDAK
Localization-related (focal) (partial) idiopathic epilepsy and epileptic YA
syndromes with seizures of localized onset
Dyspepsia TIDAK
Page 52 of 65
DIAGNOSA DI RUJUK
Iodine-deficiency-related thyroid disorders and allied conditions YA

Low back pain YA
Dislocation of jaw YA
Myalgia TIDAK
Myalgia TIDAK
Myalgia TIDAK
Disorders of refraction and accommodation YA
Hypertensive heart disease YA
Dyspepsia TIDAK
Conjunctivitis TIDAK
Insulin-dependent diabetes mellitus with multiple complications YA
Carcinoma in situ of cervix, unspecified YA

Myalgia TIDAK
Non-insulin-dependent diabetes mellitus with multiple complications TIDAK
Myalgia TIDAK
Headache TIDAK
Schizophrenia, unspecified
Myalgia TIDAK
Zoster [herpes zoster] TIDAK
Myalgia TIDAK
Dyspepsia TIDAK
Myalgia TIDAK
Chronic renal failure, unspecified YA
Page 53 of 65
DIAGNOSA DI RUJUK
Schizophrenia TIDAK
Dyspepsia TIDAK
Myalgia TIDAK
Atopic dermatitis, unspecified YA
Asthma TIDAK
Benign lipomatous neoplasm, unspecified YA
Cataract, unspecified YA
Other peripheral vertigo YA
Dyspepsia YA
Mild and moderate birth asphyxia YA
Myalgia TIDAK
Non-insulin-dependent diabetes mellitus without complications TIDAK
Non-insulin-dependent diabetes mellitus with multiple complications YA

Follow-up care involving plastic surgery YA
Haemorrhoids YA
Myalgia TIDAK
Abdominal pregnancy TIDAK

Myalgia TIDAK
Myalgia TIDAK
Anaemia, unspecified TIDAK
Hypertensive heart disease without (congestive) heart failure YA
Localization-related (focal) (partial) idiopathic epilepsy and epileptic YA
syndromes with seizures of localized onset
Cataract, unspecified YA
Myalgia TIDAK
Myalgia TIDAK
Myalgia TIDAK
Page 54 of 65
DIAGNOSA DI RUJUK
Myalgia TIDAK
Supervision of high-risk pregnancy, unspecified YA

Myalgia TIDAK
Headache TIDAK
Epilepsy TIDAK
Zoster [herpes zoster] TIDAK
Irregular menstruation, unspecified YA
Myalgia TIDAK
Neuralgia and neuritis, unspecified YA
Chronic renal failure, unspecified YA
Asthma, unspecified YA
Myalgia TIDAK
Myalgia TIDAK
Toxoplasmosis, unspecified YA
Myalgia TIDAK

Spondylolysis, lumbosacral region YA
Atopic dermatitis TIDAK
Malignant neoplasm of lower-inner quadrant of breast YA
Other autoimmune haemolytic anaemias YA
Disorder of refraction, unspecified YA
Myalgia TIDAK
Page 55 of 65
DIAGNOSA DI RUJUK
Ectopic pregnancy, unspecified YA
Myalgia TIDAK
Respiratory tuberculosis, bacteriologically and histologically TIDAK
confirmed
Diarrhoea and gastroenteritis of presumed infectious origin TIDAK
Myalgia TIDAK
Myalgia TIDAK
Other and unspecified water transport accidents TIDAK
Other specified anxiety disorders YA
Ascites YA
Myalgia TIDAK
Myalgia TIDAK
Myalgia TIDAK
Unspecified diabetes mellitus without complications YA
Schizophrenia TIDAK
Unilateral or unspecified femoral hernia, without obstruction or YA
gangrene

Myalgia TIDAK
Myalgia TIDAK
Hordeolum and chalazion YA
Insulin-dependent diabetes mellitus with other specified YA
complications
Page 56 of 65
DIAGNOSA DI RUJUK
Myalgia TIDAK
Myalgia TIDAK
Myalgia TIDAK
Myalgia TIDAK
Myalgia TIDAK
Myalgia TIDAK
Myalgia TIDAK
Myalgia TIDAK
Non-insulin-dependent diabetes mellitus with multiple complications TIDAK
Myalgia TIDAK
Myalgia TIDAK
Prolonged pregnancy YA
Recurrent dislocation and subluxation of joint, forearm YA

Necrosis of pulp YA
Myalgia TIDAK
Myalgia TIDAK
Personal history of other physical trauma YA
Essential (primary) hypertension YA

Myalgia TIDAK
Page 57 of 65
DIAGNOSA DI RUJUK
Myalgia TIDAK
Acute nasopharyngitis [common cold] TIDAK
Diseases of pulp and periapical tissues YA
Myalgia TIDAK
General counselling and advice on contraception TIDAK
Acute myocardial infarction, unspecified YA
Non-insulin-dependent diabetes mellitus YA
Chronic ulcer of skin, not elsewhere classified YA
Other headache syndromes YA

Myalgia TIDAK
Pneumonia, unspecified YA
Myalgia TIDAK
Other intracerebral haemorrhage YA
Person consulting on behalf of another person TIDAK
Heart failure TIDAK

Hearing loss, unspecified TIDAK
Myalgia TIDAK
Myalgia TIDAK
Dyspepsia TIDAK
Epilepsy TIDAK
Other and unspecified ovarian cysts YA
Melaena YA
Myalgia TIDAK
Page 58 of 65
DIAGNOSA DI RUJUK
Myalgia TIDAK
Follow-up examination after other treatment for other conditions YA
Dyspepsia YA
Myalgia TIDAK
Headache TIDAK
Other and unspecified abdominal pain YA
Myalgia TIDAK
Myalgia TIDAK
Myalgia TIDAK
Myalgia TIDAK
Viral hepatitis complicating pregnancy, childbirth and the puerperium YA
Personal history of complications of pregnancy, childbirth and the YA

puerperium
Myalgia TIDAK
Other sepsis YA
Myalgia TIDAK
Myalgia TIDAK
Congestive heart failure YA
Myalgia TIDAK
Myalgia TIDAK
Myalgia TIDAK
Myalgia TIDAK
Loss of teeth due to accident, extraction or local periodontal disease YA

Page 59 of 65
DIAGNOSA DI RUJUK
Myalgia TIDAK
Essential (primary) hypertension YA
Malignant neoplasm of posterior wall of nasopharynx YA

Myalgia TIDAK
Haemorrhoids TIDAK
Stomatitis and related lesions TIDAK
Disorder of urinary system, unspecified TIDAK

Myalgia TIDAK
Myalgia TIDAK
Myalgia TIDAK
Myalgia YA
Headache TIDAK
Dyspepsia YA
Myalgia TIDAK
Myalgia TIDAK
Anaemia complicating pregnancy, childbirth and the puerperium YA
Chronic kidney disease, stage 5 YA

Myalgia TIDAK
Myalgia TIDAK
Fracture of clavicle YA
Page 60 of 65
DIAGNOSA DI RUJUK
Epilepsy YA
Myalgia TIDAK
Myalgia TIDAK
Myalgia TIDAK

Dyspepsia TIDAK
Myalgia TIDAK
Haemorrhoids YA
Complicated cataract YA
Paranoid schizophrenia YA

Stiffness of joint, not elsewhere classified, multiple sites YA
Acute nonspecific idiopathic pericarditis YA
End-stage renal disease YA

Epidemic vertigo TIDAK
Myalgia TIDAK
Haemorrhoids TIDAK
Vertigo of central origin YA
Nummular dermatitis YA
Unspecified renal failure YA
Predominantly allergic asthma YA
Predominantly allergic asthma YA
Status asthmaticus YA
Myalgia TIDAK
Page 61 of 65
DIAGNOSA DI RUJUK
Disorder of refraction, unspecified YA

End-stage renal disease YA
Necrosis of pulp YA
Calculus of kidney YA
Myalgia TIDAK
Low back pain, lumbosacral region YA
Myalgia TIDAK
Other disorders of nose and nasal sinuses TIDAK
Abnormal uterine and vaginal bleeding, unspecified YA

Myalgia TIDAK
Other and unspecified water transport accidents TIDAK
Other acute conjunctivitis YA
Myalgia TIDAK
Necrosis of pulp TIDAK
Myalgia TIDAK
Myalgia TIDAK
Vertigo of central origin YA
Talipes equinovarus YA
Page 62 of 65
DIAGNOSA DI RUJUK
Retained dental root TIDAK

Other disorders of nose and nasal sinuses TIDAK
Dyspepsia TIDAK
Scrotal varices YA
Page 63 of 65
48 5/28/2018 667284311 SOLEMAN L PBI (APBN)
63 5/28/2018 1037225103 HERISETIAWAN L PBI (APBN)
75 5/26/2018 667696239 MASTUR L PBI (APBN)
100 5/24/2018 667240301 ROHMAN L PBI (APBN)
159 5/21/2018 1275511724 RIAN SAPUTRA L PEKERJA MANDIRI
251 5/14/2018 667240301 ROHMAN L PBI (APBN)
259 5/14/2018 667696239 MASTUR L PBI (APBN)
313 5/11/2018 668355131 ISROTIN P PBI (APBN)
367 5/7/2018 668346862 WIJI P PBI (APBN)
382 5/5/2018 667302197 MOHAMAD HASIM L PBI (APBN)
396 5/5/2018 1705041167 SURATIN P PBI (APBD)
405 5/4/2018 667143562 SUNGEP L PBI (APBN)
429 5/3/2018 667240301 ROHMAN L PBI (APBN)
Page 64 of 65
DIAGNOSA DI RUJUK
Schizophrenia, unspecified
Schizophrenia TIDAK
Schizophrenia TIDAK
Page 65 of 65

Laporan Harian Diagnosa 02062018-092238

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Laporan Harian Diagnosa 02062018-092238

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Laporan Harian Diagnosa 02062018-092238

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Laporan Diagnosa Pasien Harian

Usia Diagnosa Jenis Kasus

No Tanggal Nama Pasien L/P CM Lama Usia

7 2018-05-21 MOHAMAD SAIFUL AMRI L 24203c 18 Th 0 Bln

13 2018-05-21 RIZQI ROCHMATUL JANNAH P 22123c 19 Th 1 Bln

22 2018-05-26 latifaturrobaniyah P 347c 19 Th 7 Bln

24 2018-05-22 hanif khasbulloh L 4630 20 Th 0 Bln

No Tanggal Nama Pasien L/P CM Lama Usia

No Tanggal Nama Pasien L/P CM Lama Usia

89 2018-05-07 ENI MUSTAKIM L 15835j 35 Th 1 Bln

94 2018-05-14 SRI RAHAYU P 9007b 36 Th 4 Bln

102 2018-05-24 NUR HABIBAH P 15792B 37 Th 4 Bln

106 2018-05-05 M. SULTON BAHRUL L 21195A 37 Th 8 Bln

109 2018-05-04 SUNARMI P 14855F 39 Th 1 Bln

122 2018-05-03 MISTIANI P 14880B 41 Th 8 Bln

No Tanggal Nama Pasien L/P CM Lama Usia

126 2018-05-16 ASLIFAH P 624B 42 Th 5 Bln

133 2018-05-19 sugianto L 7209a 43 Th 4 Bln

149 2018-05-08 SRIANING P 22310B 45 Th 11 Bln

No Tanggal Nama Pasien L/P CM Lama Usia

177 2018-05-26 yatini P 5761b 48 Th 9 Bln

186 2018-05-11 SRIASIH P 77B 50 Th 0 Bln

189 2018-05-25 sinto L 105j 50 Th 11 Bln

193 2018-05-04 SRINGATIN P 13035d 50 Th 8 Bln

202 2018-05-05 ISMIATI P 4518B 51 Th 6 Bln

No Tanggal Nama Pasien L/P CM Lama Usia

228 2018-05-12 SUPARTI P 9798B 54 Th 9 Bln

230 2018-05-17 supiyah P 618b 55 Th 11 Bln

234 2018-05-21 WAMA TUTIK P 10764B 55 Th 9 Bln

239 2018-05-03 SITI UMI ROMLAH P 9494A 56 Th 5 Bln

251 2018-05-02 SUMARNO KAKASONO L 1061a 58 Th 8 Bln

No Tanggal Nama Pasien L/P CM Lama Usia

255 2018-05-15 TATIK SETYO UTAMI P 1640b 59 Th 10 Bln

264 2018-05-26 SUWUN P 1362b 61 Th 11 Bln

284 2018-05-22 SUTIYAH P 1428a 66 Th 8 Bln

298 2018-05-16 SAHRONI L 7186G 71 Th 11 Bln

300 2018-05-07 WATINI P 7362B 73 Th 11 Bln

No Tanggal Nama Pasien L/P CM Lama Usia

305 2018-05-24 bakin L 5732a 79 Th 10 Bln

Abscess, furuncle and carbuncle of nose WONOREJO

Demam Tifoid JABALSARI

Allergic contact dermatitis SUMBERDADI

Infeksi saluran pernapasan akut atas (ISPA), tidak spesifik PLOSOKANDANG

Necrosis of pulp SUMBERDADI

Other and unspecified water transport accidents; Personal history SAMBIROBYONG

Hipertensi primer/essensial BENDILJATI KULON

Skizofrenia, tidak spesifik DOROAMPEL

Atopic dermatitis; Infeksi saluran pernapasan akut atas (ISPA), PLOSOKANDANG

Gastritis, tidak spesifik BENDILJATI KULON

Asma, tidak spesifik SUMBERDADI

Demam Tifoid SUMBERDADI

Necrosis of pulp WONOREJO

Artritis lainnya SUMBERDADI

Myalgia BENDILJATI KULON

Hipertensi primer/essensial; Myalgia BENDILJATI KULON

No Tanggal Nama Pasien L/P CM Lama Usia

Skizofrenia, tidak spesifik JABALSARI

13 5/31/2018 1037183861 INDARTIK P PBI (APBN)

14 5/31/2018 1037186886 SEMI P PBI (APBN)