REKAPAN KLAIM ANC,INPARTU,PNC

NO TGL NO JAMKESMAS NO KTP NAMA / KK UMUR

Desember 11
INC
1/12/2011 3604194101730010 Juleha/Saripudin 38
5/12/2011 360419540182081 Rina R/Mumu M 29
10/12/2011 1025956293 Mulyati/Jaeni 37
10/12/2011 1026075284 Septi/Saudi 32
11/12/2011 1026000933 Ovi Nopianti/Suhendi 21
13-12-11 360419500482001 Jumenti/Endung P 36
13-12-11 1025961838 Asminah/Subari 31
14-12-11 1026074981 Unengsih/Mulyadi 17
15-12-11 1025922047 Mustiaroh/Gahtiar 28
15-12-11 1025921338 Herti/Salam 29
20-12-11 3604195002720390 Hasanah/Oji S 39
22-12-11 3604194202930000 Yanti/Yunus 18
25-12-11 360419480488001 Ela Rohila/Kaslan 23
26-12-11 360419590976001 Jumi/Uding 34
27-12-11 360419430980001 Atik D/Cecep 31
28-12-11 3604194306820000 Umayah/Agus 27
28-12-11 1026527321 Aspiah/Parta 39
30-12-11 360419430390005 Susi/Robana 21
30-12-11 360419411184002 RUminah/Ruslan 27
31-12-11 3604194612750710 Anih/Udin 36
3604194404900140 Iis/Rahmat 21
RUJUKAN
19-12-11 360419440686004 Idoh M/ Ahmad 25

ANC
15-12-11 360419520877001 Adijah/Ujer 34
14-12-11 3604196612760120 Sadiyah/Dori 35
14-12-11 360419440379004 Sanah/Sueb 32
14-12-11 360419461168001 Darwanah/Eli 43
15-12-11 360419510586001 Maesitoh/Firmansyah 25
15-12-11 360419410183100 Mumun/Asep 28
15-12-11 3604194812740100 Cicih/Enjay 37
10/12/2011 1030561784 Ina/Tibri 30
10/12/2011 360419551270001 Marsiti/Ahyani 41
13-12-11 1026018685 Euros/Rosid 20
6/12/2011 3604195906910360 Masruroh/A. Fauj 20
19-12-11 10260744553 Miryati/Emi 43
 6/12/2011 1026093418 Lisnawati/Kustomo 21
13-12-11 36041054119541100000 Farida/Suparol 17
27-12-11 1026020226 Paozah/Faturohman 19
8/12/2011 3604235306870000 Sa'adah/Ali 35
5/12/2011 3604194507810390 Suherni/Siwad 32
15-12-11 36041948710322 Enok/Ahmad 41
15-12-11 3604194508840200 Utami/Iman 28
15-12-11 36041930391001 Aliyah/M. Asli 20
15-12-11 3604196801930000 Ita R/Madaris 27
17-12-11 3604194509840000 Juleha/Dadang 27
17-12-11 3604195202810270 Idah M/Masrudi 30
17-12-11 3604194506680640 Asnayah/Nuryani 42
3604195505900001 Isnawati/Rudi 21
3604195103820001 Emah/Samhudi 29
3604194101810708 Amah/Lomri 30
3604196201820001 Nurlela/Suhada 29
3604196905770495 Bahiyah/Jejen 34
3604215206870056 Santiah/Fahyudin 24
Suhaeti/Suparman 40
Halimah/Asep 27
PNC Nurayani/Rusli 23
3604195101720291 Kusniati/Jakri 39
21-12-11 1025951231 Iti/Sanuhri 37
19-12-11 360419460490002 Dian N/Juli 21
21-12-11 360419500272039 Hasanah/Oji S 30
9/12/2011 360419560286002 Siti Munjiah/Malawi 25
27-12-11 3604195906910360 Masruroh A/A. Fauzi 21
30-12-11 360419550489003 Masitoh/Abedi 23
21-12-11 3604194101850460 Uti Sulastri/Sumadi 26
30-12-11 3604194510780130 Santi/Marsudi 33
26-12-11 3604337006870560 Jumronah/Muklis 24
3/12/2011 3604195008910500 Siti Nuraini/Zaenul 21
22-12-11 10306557914 Warsih/Edi 29
22-12-11 360419420293003 Yanti/Yunus 18
102593968 Rumi/Abu 25
360419671089003 Nunung/Supandi 22
3604194305830001 Anti M/Iding 27
3604195110780266 Siti Mariam/A Sapei 33
3604195208880001 Marnah/Suroso 19
3604194107750025 Jaojah/Amami 36
3604192610070001 Tuti S/Nuryamin 24
3604194112850229 Nurheti/Wahyudin 28
3604195504890003 Masitoh/Abedi 23
3604194510780131 Santi/Marsudi 33
3604195007870005 Lilis S/Dudin 25
3604194112850229 Nurheti/Wahyu 29
APAN KLAIM ANC,INPARTU,PNC DAN RUJUKAN PUSKESMAS PETIR

JENIS PERSALINAN ANC PNC

ALAMAT
N P K1 K2 K3 K4 KF 1 KF II KF III

Mk.Baru 1 0 0 0 1 1 1 0
Tambiluk 1 0 0 0 1 1 1 0
Mk.Baru 1 0 0 0 0 1 1 0
Tambiluk 1 0 0 0 0 1 1 0
Petir 1 0 0 0 1 1 1 0
Tambiluk 1 0 0 1 0 1 1 0
Mk.Baru 1 0 0 0 0 1 1 0
Tambiluk 1 0 0 1 0 1 1 0
Kd. Genep 1 0 0 0 1 1 1 0
Kd. Genep 1 0 0 0 1 1 1 0
Sd. Sari 1 0 0 1 0 1 1 0
Kd. Genep 1 0 0 1 0 1 1 0
Petir 1 0 0 1 0 1 0 0
Pd. Suka 1 0 0 1 0 1 0 0
Mk.Baru 1 1 0 0 0 1 0 0
Sd. Sari 1 0 0 1 0 1 0 0
Cikeusal 1 0 0 1 0 1 0 0
Tambiluk 1 0 0 0 0 1 0 0
Kd. Genep 1 0 0 0 1 1 0 0
Sd. Sari 1 0 1 0 0 1 0 0
Tambiluk 1 0 0 0 1 1 0 0

Sd. Sari 1

0 0 0 0 1 0 0
Kp. Baru 0 1 0 0 0 0 0 0
Kp. Baru 0 1 0 0 0 0 0 0
Kp. Baru 0 1 0 0 0 0 0 0
Kp. Baru 0 0 1 0 0 0 0 0
Kp. Baru 0 0 1 0 0 0 0 0
Kp. Baru 0 0 0 1 0 0 0 0
Kp. Baru 0 0 0 1 0 0 0 0
Petir 1 0 0 0 0 0 0
Petir 1 0 0 0 0 0 0
Sanding 1 0 0 0 0 0 0
Sd. Sari 0 1 0 0 0 0 0
Tambiluk 1 0 0 0 0 0 0
 Tambiluk 0 0 1 0 0 0 0
Ngr. Pdng 0 1 0 0 0 0 0
Sanding 1 0 0 0 0 0 0
Cikeusal 1 0 0 0 0 0 0
Ngr. Pdng 1 0 0 0 0 0 0
Cirangkong 0 1 0 0 0 0 0
Cirangkong 1 0 0 0 0 0 0
Cirangkong 0 1 0 0 0 0 0
Cirangkong 0 0 1 0 0 0 0
Cirangkong 0 0 1 0 0 0 0
Cirangkong 0 0 1 0 0 0 0
Cirangkong 0 1 0 0 0 0 0
Pd. Suka 0 1 0 0 0 0 0
Pd. Suka 0 1 0 0 0 0 0
Pd. Suka 0 1 0 0 0 0 0
Pd. Suka 0 1 0 0 0 0 0
Pd. Suka 0 1 0 0 0 0 0
Pd.Suka 0 1 0 0 0 0 0
petir 0 0 1 0 0 0 0
Petir 0 0 1 0 0 0 0
Mk.baru 0 1 0 0 0 0 0
Pd. Suka 0 1 0 0 0 0 0
Kp. Baru 0 0 0 0 1 1 0
Kp. Baru 0 0 0 0 1 1 0
Sd. Sari 0 0 0 0 1 1 0
Sd. Sari 0 0 0 0 1 1 0
Sd. Sari 0 0 0 0 1 0 0
Sd. Sari 0 0 0 0 0 0 1
Sd. Sari 0 0 0 0 0 0 1
Sd. Sari 0 0 0 0 0 0 1
Sd. Sari 0 0 0 0 0 0 1
Kd. Genep 0 0 0 0 1 1 0
Kd. Genep 0 0 0 0 1 1 0
Kd. Genep 0 0 0 0 1 1 0
Kp.baru 0 0 0 0 0 0 1
Sd. Sari 0 0 0 0 0 0 1
Kd.gnp 0 0 0 0 0 0 1
Crk 0 0 0 0 0 0 1
Petir 0 0 0 0 0 0 1
S.Jaya 0 0 0 0 0 1 1
CRD 0 0 0 0 0 1 1
Pd. Suka 0 0 0 0 0 1 1
Sd.Sari 0 0 0 0 0 0 1
Sd.Sari 0 0 0 0 0 0 1
Pd.Suka 0 0 0 0 0 0 1
Pd.Suka 0 0 0 0 0 0 1

16 5 12 16 16 8 30 22 16
KB RUJUKAN BD. PENOLONG KET

Bd. Fifih
Bd. Kurniasih
Bd. Fifih
Bd. Geuis
Bd. Desi
Bd. Rohmayati
Bd. Fifih
Bd. Geuis
Bd. Okvi
Bd. Okvi
Bd. Lilis
Bd. Susi
Bd. Rani
bd. Yayah
Bd. Nur
Bd. Nur
Bd. Nur
Bd. Nur
Bd. Geuis
Bd. Desi
Bd. Geuis

1 Bd. Nur

Bd. Geuis
Bd. Lilis
Bd. Lilis
Bd. Lilis
Bd. Lilis
Bd. Lilis
Bd. Lilis
Bd. Lilis
Bd. Eva
Bd. Eva
Bd. Eva
Bd. Eva
Bd. Eva
 Bd. Eva
Bd. Eva
Bd. Eva
Bd. Eva
Bd. Eva
Bd. Puspita
Bd. Puspita
Bd. Puspita
Bd. Puspita
Bd. Puspita
Bd. Puspita
Bd. Puspita
Bd. Desi
Bd. Desi
Bd. Desi
Bd. Desi
Bd. Desi
Bd. Desi
Bd. Desi
Bd. Desi
Bd. Puspita
Bd. Desi
Bd. Lilis
Bd. Lilis
Bd. Titin
Bd. Titin
Bd. Titin
Bd. Titin
Bd. Titin
Bd. Titin
Bd. Titin
Bd. Okvi
Bd. Okvi
Bd. Okvi
Bd. Desi
Bd. Desi
Bd. Desi
Bd. Desi
Bd. Desi
Bd. Desi
Bd. Desi
Bd. Desi
Bd. Desi
Bd. Desi
Bd. Desi
Bd. Desi
 KB DESEMBER 2011

NO TANGGAL JPS JAMPERSAL

1 1/12/2011 1026067959
2 3/12/2011 1026073978
3 3/12/2011 1026021194
4 3/12/2011 1030561874
5 3/12/2011 1025932702
6 5/12/2011 1026007031
7 5/12/2011 1025996758
8 5/12/2011 1026077051
9 5/12/2011 3604194107840010
10 6/12/2011 1030496376
11 6/12/2011 1025928742
12 6/12/2011 3604194473002
13 6/12/2011 1025981709
14 6/12/2011 1025910224
15 6/12/2011 1025953637
16 7/12/2011 1026015041
17 7/12/2011 1026062605
18 8/12/2011 1026065711
19 8/12/2011 1026069311
20 8/12/2011 1030559275
21 8/12/2011 1026014477
22 8/12/2011 1025927616
23 8/12/2011 1025999245
24 8/12/2011 3604196004780050
25 12/12/2011 1025997546
26 12/12/2011 1025913339
7 12/12/2011 1025910639
28 13-12-11 1026018775
29 13-12-11 1026086477
30 13-12-11 1025967418
31 13-12-11 1026067307
32 13-12-11 1025993169
33 14-12-11 1026064653
34 15-12-11 1026011654
35 15-12-11 1025959487
36 15-12-11 1026021734
37 17-12-11 1026074981
38 17-12-11 360419610186001
39 17-12-11 1026072933
40 19-12-11 10300492383
41 20-12-11 1025998536
42 20-12-11 1026068308
43 23-12-11 1026062897
44 23-12-11 1026064653
45 23-12-11 1026062515
46 23-12-11 1026020226
47 23-12-11 1025927357
48 23-12-11 1025931947
49 23-12-11 1026068455
50 23-12-11 1026004904
51 24-12-11 360419511273003
52 24-12-11 3604195401820080
53 28-12-11 1025963504
54 28-12-11 1025998874
55 30-12-11 1025952355
56 31-12-11 1026017379
JUMLAH
 NAMA/KK UMUR ALAMAT JENIS ALKON BD.PELAKSANA
Ipah/Sukri 30 Sd. Sari Suntik Bd. Rohmayati
Sapiah/Dulhak 25 Tambiluk Suntik Bd. Rohmayati
Halimah/Sukani 36 Sanding Suntik Bd. Rohmayati
Rosilah/Tajudin 21 Sanding Suntik Bd. Rohmayati
Sutohat/Muslih 26 Kd. Genep Suntik Bd. Rohmayati
Ubaedah/Nasim 38 Sanding Suntik Bd. Rohmayati
Kartini/Herman 22 Petir Suntik Bd. Rohmayati
Linda w/Saidi 24 Tambiluk Suntik Bd. Rohmayati
Satimah/Herman 30 Ngr. Padang Suntik Bd. Rohmayati
Saidah/Tatang 42 Kd. Genep Suntik Bd. Rohmayati
Endang/Karsiman 24 Kd. Genep Suntik Bd. Rohmayati
Adah Istiadah/Rapi 22 Mk. Baru aff. Implant Bd. Rohmayati
Rani/Kardi 30 Ngr. Padang Suntik Bd. Rohmayati
Anisah/Taru 25 Cireundeu Suntik Bd. Rohmayati
Murtapiah/Jayadi 43 Mk. Baru Suntik Bd. Rohmayati
Tinah/Jumati 41 Sanding Suntik Bd. Rohmayati
Nining N/Bedi 24 Sd. Sari Suntik Bd. Rohmayati
Halimah/Roni 21 Sd. Sari Suntik Bd. Rohmayati
Rohinah/Doni 31 Tambiluk Suntik Bd. Rohmayati
Mintasari/Ralian 19 Kd. Genep Suntik Bd. Rohmayati
Sarmah/Jaman 32 Sanding Suntik Bd. Rohmayati
Patimah/Juhdi 32 Kd. Genep Suntik Bd. Rohmayati
Epon/Duryani 22 Petir Suntik Bd. Rohmayati
Uun Usnariyah/Supana 27 Tambiluk IUD Bd. Rohmayati
St. Komariah/uned 32 Petir Suntik Bd. Rohmayati
St. Heni/Saepi 27 Cireundeu Suntik Bd. Rohmayati
Edah/Emul 36 Cireundeu Suntik Bd. Rohmayati
Sarnikah/Sakmin 23 Sanding Suntik Bd. Rohmayati
Iin/Rayani 39 Tambiluk Suntik Bd. Rohmayati
Supriyah/Mayuni 30 Mk. Baru Suntik Bd. Rohmayati
Numi/Saleh 30 Sd. Sari Suntik Bd. Rohmayati
Sarti/Suhendra 44 Petir Suntik Bd. Rohmayati
Een Heriah/Udin 41 Sd. Sari Suntik Bd. Rohmayati
Aliyah/Dedi 30 Sanding Suntik Bd. Rohmayati
Sutiah/Mingga 35 Mk. Baru Suntik Bd. Rohmayati
Mulyati/Sujana 32 Sanding Suntik Bd. Rohmayati
Unengsih/Sanudin 27 Tambiluk Suntik Bd. Rohmayati
St. Suherni/Yuyung 32 Kd. Genep Suntik Bd. Rohmayati
Umheti/Babang 19 Tambiluk Suntik Bd. Rohmayati
Lasmi/A. Satibi 38 Kd. Genep Suntik Bd. Rohmayati
Rasna/Kamarudin 37 Petir Suntik Bd. Rohmayati
 Aminah/Supriyadi 31 Sd. Sari Suntik Bd. Rohmayati
Iti Asnati/Udi 40 Sd. Sari Suntik Bd. Rohmayati
Een Heriah/Udin 41 Sd. Sari Implant Bd. Rohmayati
Lena/Tuni 33 Sd. Sari Implant Bd. Rohmayati
Paozah/Husen 23 Sanding Implant Bd. Rohmayati
Anah/Roni 25 Kd. Genep Implant Bd. Rohmayati
Een/Udin 37 Kd. Genep Implant Bd. Rohmayati
St. Rominah/Asep 39 Sd. Sari Implant Bd. Rohmayati
Supriatin/dede 21 Petir Implant Bd. Rohmayati
Supinah/Mudi 35 Tambiluk Implant Bd. Rohmayati
Rina/Asep 29 Tambiluk Implant Bd. Rohmayati
Rumi/Usup 22 Mk. Baru Suntik Bd. Rohmayati
Ikoh/Ade 47 Petir Implant Bd. Rohmayati
Sarmanah/Hendrik 42 Mk. Baru Suntik Bd. Rohmayati
Uni/Ahmad 37 Sanding Suntik Bd. Rohmayati
JUMLAH
 TARIF TOTAL
Rp 10,000 Rp 10,000
Rp 10,000 Rp 10,000
Rp 10,000 Rp 10,000
Rp 10,000 Rp 10,000
Rp 10,000 Rp 10,000
Rp 10,000 Rp 10,000
Rp 10,000 Rp 10,000
Rp 10,000 Rp 10,000
Rp 10,000 Rp 10,000
Rp 10,000 Rp 10,000
Rp 10,000 Rp 10,000
Rp 50,000 Rp 50,000
Rp 10,000 Rp 10,000
Rp 10,000 Rp 10,000
Rp 10,000 Rp 10,000
Rp 10,000 Rp 10,000
Rp 10,000 Rp 10,000
Rp 10,000 Rp 10,000
Rp 10,000 Rp 10,000
Rp 10,000 Rp 10,000
Rp 10,000 Rp 10,000
Rp 10,000 Rp 10,000
Rp 10,000 Rp 10,000
Rp 25,000 Rp 25,000
Rp 10,000 Rp 10,000
Rp 10,000 Rp 10,000
Rp 10,000 Rp 10,000
Rp 10,000 Rp 10,000
Rp 10,000 Rp 10,000
Rp 10,000 Rp 10,000
Rp 10,000 Rp 10,000
Rp 10,000 Rp 10,000
Rp 10,000 Rp 10,000
Rp 10,000 Rp 10,000
Rp 10,000 Rp 10,000
Rp 10,000 Rp 10,000
Rp 10,000 Rp 10,000
Rp 10,000 Rp 10,000
Rp 10,000 Rp 10,000
Rp 10,000 Rp 10,000
Rp 10,000 Rp 10,000
Rp 10,000 Rp 10,000
Rp 10,000 Rp 10,000
Rp 50,000 Rp 50,000
Rp 50,000 Rp 50,000
Rp 50,000 Rp 50,000
Rp 50,000 Rp 50,000
Rp 50,000 Rp 50,000
Rp 50,000 Rp 50,000
Rp 50,000 Rp 50,000
Rp 50,000 Rp 50,000
Rp 50,000 Rp 50,000
Rp 10,000 Rp 10,000
Rp 50,000 Rp 50,000
Rp 10,000 Rp 10,000
Rp 10,000 Rp 10,000
Rp 1,015,000 Rp 1,015,000