SAKIT

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DAFTAR KUNJUNGAN PESERTA SAKIT

Kantor Cabang : PASURUAN - 1309

FKTP : Kejayan - 13261301

NO TANGGAL NO KUNJUNGAN NO KARTU NAMA PESERTA SEX JENIS PESERTA DIAGNOSA STATUS PRB PROLANIS
PULANG

1 31-10-2019 132613011019Y001866 0000112538586 HASANAH P PNS DAERAH Other diseases of hard Berobat Jalan
tissues of teeth
2 31-10-2019 132613011019Y001854 0000112592171 SITI HIDAYATI P PNS DAERAH Pneumonia due to other Rujuk Vertikal
infectious organisms, not
elsewhere classified
3 31-10-2019 132613011019Y001883 0000112593418 MUKHAMAD MULKHAN L PNS DAERAH Allergic contact dermatitis Berobat Jalan
PRIMADANA
4 31-10-2019 132613011019Y001869 0000112726618 SUPRIYATI P PNS DAERAH Low vision, both eyes Rujuk Vertikal

5 31-10-2019 132613011019Y001853 0000714784252 AHMAD FERDI HANDOKO L PBI (APBN) Influenza, virus not Berobat Jalan
identified
6 31-10-2019 132613011019Y001880 0000715133485 AHKAQUL KARIMAH P PBI (APBN) Other headache Berobat Jalan
syndromes
7 31-10-2019 132613011019Y001871 0000715196913 SATUHA P PBI (APBN) Supervision of high-risk Berobat Jalan
pregnancy
8 31-10-2019 132613011019Y001905 0000715270184 HOLID L PBI (APBN) Migraine Berobat Jalan

9 31-10-2019 132613011019Y001881 0000715340687 JUREYA P PBI (APBN) Other specified Berobat Jalan
counselling
10 31-10-2019 132613011019Y001858 0000715367845 HOLIQ L PBI (APBN) Other disorders of muscle Berobat Jalan

11 31-10-2019 132613011019Y001859 0000715382638 MUANAH P PBI (APBN) Other disorders of muscle Berobat Jalan

12 31-10-2019 132613011019Y001860 0000715391291 SUMANA P PBI (APBN) Other disorders of muscle Berobat Jalan

13 31-10-2019 132613011019Y001861 0000715409853 SALAM L PBI (APBN) Other headache Berobat Jalan
syndromes
14 31-10-2019 132613011019Y001862 0000715409998 HOFSAH P PBI (APBN) Other headache Berobat Jalan
syndromes
15 31-10-2019 132613011019Y001906 0000715426975 JUM'ATI P PBI (APBN) Gastritis and duodenitis Berobat Jalan

16 31-10-2019 132613011019Y001884 0000715427212 M.JUNAEDI L PBI (APBN) Other headache Berobat Jalan
syndromes
17 31-10-2019 132613011019Y001902 0000715543356 MOCH.SUEB L PBI (APBN) Bursopathy, unspecified Berobat Jalan

18 31-10-2019 132613011019Y001903 0000715549061 MUKHLIS L PBI (APBN) Gastritis and duodenitis Berobat Jalan

19 31-10-2019 132613011019Y001904 0000715557969 MUNATI B.HAJIN P PBI (APBN) Bursopathy, unspecified Berobat Jalan

20 31-10-2019 132613011019Y001888 0000715817755 SAIDAH P PBI (APBN) Other headache Berobat Jalan
syndromes
DAFTAR KUNJUNGAN PESERTA SAKIT

Kantor Cabang : PASURUAN - 1309

FKTP : Kejayan - 13261301

21 31-10-2019 132613011019Y001863 0000715844878 AHMADI L PBI (APBN) Respiratory tuberculosis, Rujuk Vertikal
bacteriologically and
histologically confirmed
22 31-10-2019 132613011019Y001889 0000715852269 JAMILA P PBI (APBN) Cough Berobat Jalan

23 31-10-2019 132613011019Y001879 0000715865387 DJAMILAH P PBI (APBN) Other disorders of muscle Berobat Jalan

24 31-10-2019 132613011019Y001894 0000715924596 ABDUR ROHIM L PBI (APBN) Fever of other and Berobat Jalan
unknown origin
25 31-10-2019 132613011019Y001907 0000715927059 JENATIN P PBI (APBN) Fever of other and Berobat Jalan
unknown origin
26 31-10-2019 132613011019Y001873 0000715936184 SUNAYA P PBI (APBN) Gastritis and duodenitis Berobat Jalan

27 31-10-2019 132613011019Y001897 0000715939648 HOLIL L PBI (APBN) Other headache Berobat Jalan
syndromes
28 31-10-2019 132613011019Y001896 0000715940008 FATHUR ROZI L PBI (APBN) Gastritis and duodenitis Berobat Jalan

29 31-10-2019 132613011019Y001895 0000715951877 AROFAH P PBI (APBN) Nausea and vomiting Berobat Jalan

30 31-10-2019 132613011019Y001877 0000716010491 JUMA`ATI P PBI (APBN) Gastritis and duodenitis Berobat Jalan

31 31-10-2019 132613011019Y001867 0000716013832 HORIDAH P PBI (APBN) Gingivitis and periodontal Berobat Jalan
diseases
32 31-10-2019 132613011019Y001887 0000716029334 URIPAH P PBI (APBN) Migraine Berobat Jalan

33 31-10-2019 132613011019Y001875 0000717454124 ANIK ATUL MAULIA P PBI (APBN) Allergic contact dermatitis Berobat Jalan

34 31-10-2019 132613011019Y001851 0001042695213 NURIL NAFISAH P PBI (APBN) Other headache Berobat Jalan
syndromes
35 31-10-2019 132613011019Y001890 0001042711233 SUPANJI L PBI (APBN) Migraine Berobat Jalan

36 31-10-2019 132613011019Y001891 0001042712829 BADRUL HUDA L PBI (APBN) Dental caries Berobat Jalan

37 31-10-2019 132613011019Y001868 0001042713347 MUJAYANAH P PBI (APBN) Benign neoplasm of breast Rujuk Vertikal

38 31-10-2019 132613011019Y001886 0001042714146 TOWILA P PBI (APBN) Other headache Berobat Jalan
syndromes
39 31-10-2019 132613011019Y001849 0001274626708 SHINTA NURIYAH P PNS DAERAH Other headache Berobat Jalan
syndromes
40 31-10-2019 132613011019Y001870 0001296021238 FARIANI P PRAJURIT AD Gingivitis and periodontal Berobat Jalan
diseases
41 31-10-2019 132613011019Y001872 0001540796106 MARIA ULFA P PEKERJA MANDIRI Anaemia complicating Berobat Jalan
pregnancy, childbirth and
the puerperium
42 31-10-2019 132613011019Y001876 0001820956318 MUHAMMAD TAUFIQ HIDAYAT L PEGAWAI SWASTA Allergic contact dermatitis Berobat Jalan
DAFTAR KUNJUNGAN PESERTA SAKIT

Kantor Cabang : PASURUAN - 1309

FKTP : Kejayan - 13261301

43 31-10-2019 132613011019Y001885 0002001958716 KHOLILA P PBI (APBN) Other headache Berobat Jalan
syndromes
44 31-10-2019 132613011019Y001852 0002280825347 YULI RAHMAWATI P PEGAWAI SWASTA Gastritis and duodenitis Berobat Jalan

45 31-10-2019 132613011019Y001850 0002470907654 SHILA FINA MAFAZA P PEKERJA MANDIRI Diarrhoea and Berobat Jalan
gastroenteritis of
presumed infectious origin

46 31-10-2019 132613011019Y001874 0002486804501 MUHAMAD ARIK SUBHAN L PEKERJA MANDIRI Acute upper respiratory Berobat Jalan
ZAMZAMI infections of multiple and
unspecified sites
47 31-10-2019 132613011019Y001882 0002486804771 RAYI ARIQA FATINA P PEKERJA MANDIRI Influenza, virus not Berobat Jalan
identified
48 31-10-2019 132613011019Y001878 0002628985329 ZUMROTUS SOLIHATIN P PBI (APBN) Fever of other and Berobat Jalan
unknown origin
49 31-10-2019 132613011019Y001864 0002776155478 NAILY INAYAH P PEKERJA MANDIRI Blindness, both eyes Rujuk Vertikal

50 30-10-2019 132613011019Y001833 0000112590077 KHOIRUN NIKMAH P PNS DAERAH Other specified Berobat Jalan
counselling
51 30-10-2019 132613011019Y001798 0000714338649 SUNAN L PBI (APBN) Other disorders of muscle Berobat Jalan

52 30-10-2019 132613011019Y001778 0000714732311 KASIATUN P PBI (APBN) Allergic contact dermatitis Berobat Jalan

53 30-10-2019 132613011019Y001831 0000714937871 SAODA P PBI (APBN) Other disorders of muscle Berobat Jalan

54 30-10-2019 132613011019Y001782 0000715121289 M. AGUNG CHUSAENI L PBI (APBN) Other headache Berobat Jalan
syndromes
55 30-10-2019 132613011019Y001775 0000715186629 SAMSUL ARIFIN L PBI (APBN) Other viral infections Berobat Jalan
characterized by skin and
mucous membrane
lesions, not elsewhere
classified
56 30-10-2019 132613011019Y001829 0000715235488 KODIR L PBI (APBN) Other headache Berobat Jalan
syndromes
57 30-10-2019 132613011019Y001865 0000715306274 FAUZI L PBI (APBN) Acute upper respiratory Berobat Jalan
infections of multiple and
unspecified sites
58 30-10-2019 132613011019Y001857 0000715315746 HOPSAH P PBI (APBN) Other headache Berobat Jalan
syndromes
59 30-10-2019 132613011019Y001824 0000715438236 JUHRIYAH P PBI (APBN) Myalgia Berobat Jalan

60 30-10-2019 132613011019Y001823 0000715438484 ALAIKO ASRORI L PBI (APBN) Other local infections of Berobat Jalan
skin and subcutaneous
tissue
DAFTAR KUNJUNGAN PESERTA SAKIT

Kantor Cabang : PASURUAN - 1309

FKTP : Kejayan - 13261301

61 30-10-2019 132613011019Y001796 0000715466777 SYAMSUL ARIFIN L PBI (APBN) Other disorders of muscle Berobat Jalan

62 30-10-2019 132613011019Y001776 0000715615029 H.SAMI`AN L PBI (APBN) Heart failure Rujuk Vertikal

63 30-10-2019 132613011019Y001781 0000715751482 SAPIUDIN L PBI (APBN) Other headache Berobat Jalan
syndromes
64 30-10-2019 132613011019Y001803 0000715789653 CHALIMAH P PBI (APBN) Other disorders of muscle Berobat Jalan

65 30-10-2019 132613011019Y001898 0000715819893 HOLIPA P PBI (APBN) Acute upper respiratory Berobat Jalan
infections of multiple and
unspecified sites
66 30-10-2019 132613011019Y001841 0000715846263 SUPAIDAH P PBI (APBN) Other headache Berobat Jalan
syndromes
67 30-10-2019 132613011019Y001825 0000715859392 MUNIPAH P PBI (APBN) Respiratory tuberculosis, Berobat Jalan
bacteriologically and
histologically confirmed
68 30-10-2019 132613011019Y001842 0000715863971 IMRON L PBI (APBN) Diarrhoea and Berobat Jalan
gastroenteritis of
presumed infectious origin

69 30-10-2019 132613011019Y001847 0000715885749 MUNASIH L PBI (APBN) Migraine Berobat Jalan

70 30-10-2019 132613011019Y001840 0000715907338 SITI AFIA P PBI (APBN) Gastritis and duodenitis Berobat Jalan

71 30-10-2019 132613011019Y001786 0000715908767 SOFEYAH P PBI (APBN) Other disorders of muscle Berobat Jalan

72 30-10-2019 132613011019Y001774 0000715914077 SAIDAH P PBI (APBN) Chronic sinusitis, Rujuk Vertikal
unspecified
73 30-10-2019 132613011019Y001846 0000715923775 SATUHA P PBI (APBN) Other headache Berobat Jalan
syndromes
74 30-10-2019 132613011019Y001844 0000715933001 SAMSURI L PBI (APBN) Diarrhoea and Berobat Jalan
gastroenteritis of
presumed infectious origin

75 30-10-2019 132613011019Y001795 0000715978888 HANIPAH P PBI (APBN) Gingivitis and periodontal Berobat Jalan
diseases
76 30-10-2019 132613011019Y001843 0000715984817 JAMILA P PBI (APBN) Other local infections of Berobat Jalan
skin and subcutaneous
tissue
77 30-10-2019 132613011019Y001848 0000715995461 SAIHU L PBI (APBN) Dental caries Berobat Jalan

78 30-10-2019 132613011019Y001845 0000716044691 SITI PUTRI ASIA P PBI (APBN) Cough Berobat Jalan
DAFTAR KUNJUNGAN PESERTA SAKIT

Kantor Cabang : PASURUAN - 1309

FKTP : Kejayan - 13261301

79 30-10-2019 132613011019Y001783 0000716057414 SUMARMI P PBI (APBN) Other viral infections Berobat Jalan
characterized by skin and
mucous membrane
lesions, not elsewhere
classified
80 30-10-2019 132613011019Y001785 0000716087891 JAMILAH L PBI (APBN) Malaise and fatigue Berobat Jalan

81 30-10-2019 132613011019Y001839 0000716117736 HASENNAH P PBI (APBN) Nausea and vomiting Berobat Jalan

82 30-10-2019 132613011019Y001828 0000716395421 MUHAMMAD FIKRI FIRDAUS L PBI (APBN) Acute nasopharyngitis Berobat Jalan
[common cold]
83 30-10-2019 132613011019Y001780 0001042693907 SAIDAH P PBI (APBN) Other headache Berobat Jalan
syndromes
84 30-10-2019 132613011019Y001779 0001042697384 ABD.ROHIM L PBI (APBN) Allergic contact dermatitis Berobat Jalan

85 30-10-2019 132613011019Y001821 0001042718477 KASIYANAH P PBI (APBN) Essential (primary) Berobat Jalan
hypertension
86 30-10-2019 132613011019Y001808 0001042719816 SRI RAHAYU P PBI (APBN) Other disorders of muscle Berobat Jalan

87 30-10-2019 132613011019Y001817 0001324075419 M.KHUSAIRI L PEKERJA MANDIRI Diarrhoea and Berobat Jalan
gastroenteritis of
presumed infectious origin

88 30-10-2019 132613011019Y001822 0001702852323 RUDI IRWANTO L PEGAWAI SWASTA Acute nasopharyngitis Berobat Jalan
[common cold]
89 30-10-2019 132613011019Y001784 0002067101267 NOVIA FAHMA FADHILA P PRAJURIT AD Low vision, both eyes Rujuk Vertikal

90 30-10-2019 132613011019Y001805 0002161101971 UMI KHOLIFAH P PBI (APBD) Other headache Berobat Jalan
syndromes
91 30-10-2019 132613011019Y001777 0002247357453 LAILATUL MUKARROMAH P PEKERJA MANDIRI Influenza, virus not Berobat Jalan
identified
92 30-10-2019 132613011019Y001832 0002475076004 MUKHAMAD ANDRIAN L PEGAWAI SWASTA Respiratory tuberculosis, Berobat Jalan
SABILILLA bacteriologically and
histologically confirmed
93 30-10-2019 132613011019Y001830 0002617718141 M. KHOLILI L PEKERJA MANDIRI Leprosy [Hansen disease] Berobat Jalan

94 30-10-2019 132613011019Y001794 0002636013701 NOR AZIJII P PBI (APBN) Dental caries Berobat Jalan

95 30-10-2019 132613011019Y001819 0002749486746 BAYI NYONYA HILYATUL L PBI (APBN) Need for other Berobat Jalan
UNSIYAH prophylactic measures
96 30-10-2019 132613011019Y001810 0002773160098 SUYASTI P PEKERJA MANDIRI Fever of other and Berobat Jalan
unknown origin
97 30-10-2019 132613011019Y001818 0002881579487 ZAINUL FALAQ L PEKERJA MANDIRI Respiratory tuberculosis, Berobat Jalan
bacteriologically and
histologically confirmed
DAFTAR KUNJUNGAN PESERTA SAKIT

Kantor Cabang : PASURUAN - 1309

FKTP : Kejayan - 13261301

98 30-10-2019 132613011019Y001838 0002896474318 ALVINO DAFFA MUWAFFIQ L PBI (APBN) Pneumonia, unspecified Berobat Jalan

99 30-10-2019 132613011019Y001816 0002899347208 IRFAN AFFANDI L PEKERJA MANDIRI Acute nephritic syndrome, Rujuk Vertikal
unspecified
100 29-10-2019 132613011019Y001899 0000714281872 SULIS SUSILOWATI P PBI (APBN) Acute upper respiratory Berobat Jalan
infections of multiple and
unspecified sites
101 29-10-2019 132613011019Y001789 0000714347897 ABD. ROHMAN L PBI (APBN) Other disorders of muscle Berobat Jalan

102 29-10-2019 132613011019Y001790 0000714347943 SUTIHAT P PBI (APBN) Other disorders of muscle Berobat Jalan

103 29-10-2019 132613011019Y001791 0000714349427 SAMSUL ARIFIN L PBI (APBN) Dental caries Berobat Jalan

104 29-10-2019 132613011019Y001793 0000714356234 MARSITI P PBI (APBN) Other disorders of muscle Berobat Jalan

105 29-10-2019 132613011019Y001728 0000714697525 RISKY MAULIDYA P PBI (APBN) Cluster headache Berobat Jalan
syndrome
106 29-10-2019 132613011019Y001750 0000714754686 AMENA P PBI (APBN) Heart failure Berobat Jalan

107 29-10-2019 132613011019Y001856 0000715287183 MINARSI P PBI (APBN) Gastritis and duodenitis Berobat Jalan

108 29-10-2019 132613011019Y001855 0000715289714 UBAIDILLAH L PBI (APBN) Other headache Berobat Jalan
syndromes
109 29-10-2019 132613011019Y001799 0000715302933 SULAIMANA P PBI (APBN) Acute upper respiratory Berobat Jalan
infections of multiple and
unspecified sites
110 29-10-2019 132613011019Y001741 0000715336975 ANDIHASBULLOH L PBI (APBN) Respiratory tuberculosis, Berobat Jalan
bacteriologically and
histologically confirmed
111 29-10-2019 132613011019Y001725 0000715446022 SUDARWATI P PBI (APBN) Influenza, virus not Berobat Jalan
identified
112 29-10-2019 132613011019Y001797 0000715449363 ISMATUL IZZAH P PBI (APBN) Other headache Berobat Jalan
syndromes
113 29-10-2019 132613011019Y001724 0000715476497 SITI MUNAWARO P PBI (APBN) Allergic contact dermatitis Berobat Jalan

114 29-10-2019 132613011019Y001723 0000715778447 DEWI RIZKIYAH P PBI (APBN) Other headache Berobat Jalan
syndromes
115 29-10-2019 132613011019Y001738 0000715795749 NIZAR L PBI (APBN) Observation for suspected Berobat Jalan
tuberculosis
116 29-10-2019 132613011019Y001749 0000715805875 LAILATUL KHOMISA P PBI (APBN) Varicella [chickenpox] Berobat Jalan

117 29-10-2019 132613011019Y001730 0000715822187 CHOTIMAH P PBI (APBN) Erosion and ectropion of Rujuk Vertikal
cervix uteri
118 29-10-2019 132613011019Y001800 0000715852721 TONIYAH P PBI (APBN) Other disorders of muscle Berobat Jalan
DAFTAR KUNJUNGAN PESERTA SAKIT

Kantor Cabang : PASURUAN - 1309

FKTP : Kejayan - 13261301

119 29-10-2019 132613011019Y001912 0000715854148 DEWI FATIMA P PBI (APBN) Gingivitis and periodontal Berobat Jalan
diseases
120 29-10-2019 132613011019Y001900 0000715876751 SULIHANA P PBI (APBN) Fever of other and Berobat Jalan
unknown origin
121 29-10-2019 132613011019Y001809 0000715880193 AISAH P PBI (APBN) Other headache Berobat Jalan
syndromes
122 29-10-2019 132613011019Y001901 0000715898417 MUHAMMAD MASRUHIN L PBI (APBN) Fever of other and Berobat Jalan
unknown origin
123 29-10-2019 132613011019Y001815 0000715965658 FATHULLOH L PBI (APBN) Diarrhoea and Berobat Jalan
gastroenteritis of
presumed infectious origin

124 29-10-2019 132613011019Y001806 0000715970417 SHOLIHIN L PBI (APBN) Migraine Berobat Jalan

125 29-10-2019 132613011019Y001746 0000715985649 RATNA P PBI (APBN) Gastritis and duodenitis Berobat Jalan

126 29-10-2019 132613011019Y001811 0000716017116 SITI AMINAH P PBI (APBN) Cough Berobat Jalan

127 29-10-2019 132613011019Y001807 0000716027567 ARI HAFIS SOLIHA P PBI (APBN) Acute upper respiratory Berobat Jalan
infections of multiple and
unspecified sites
128 29-10-2019 132613011019Y001733 0000716062397 UMYATI P PBI (APBN) Other disorders of muscle Berobat Jalan

129 29-10-2019 132613011019Y001813 0000716360984 M. IQBALU SAID L PBI (APBN) Acute upper respiratory Berobat Jalan
infections of multiple and
unspecified sites
130 29-10-2019 132613011019Y001814 0000716408188 ABDULLOH L PBI (APBN) Fever of other and Berobat Jalan
unknown origin
131 29-10-2019 132613011019Y001801 0000717369355 LAILATUR ROCHMAH P PBI (APBN) Fever of other and Berobat Jalan
unknown origin
132 29-10-2019 132613011019Y001752 0000717554327 CHUSNIYAH P PBI (APBN) Essential (primary) Berobat Jalan
hypertension
133 29-10-2019 132613011019Y001753 0001042696585 ROBI ATUN P PBI (APBN) Myalgia Berobat Jalan

134 29-10-2019 132613011019Y001748 0001042702547 USWATUL HASANAH P PBI (APBN) Acute nasopharyngitis Berobat Jalan
[common cold]
135 29-10-2019 132613011019Y001802 0001042712627 NUR HASAN L PBI (APBN) Dental caries Berobat Jalan

136 29-10-2019 132613011019Y001729 0001043033455 NAILILATUL FARKHAH P PBI (APBN) Calculus of kidney and Rujuk Vertikal
ureter
137 29-10-2019 132613011019Y001732 0001313840226 SAIFULLOH L PEKERJA MANDIRI Other disorders of Rujuk Vertikal
conjunctiva
DAFTAR KUNJUNGAN PESERTA SAKIT

Kantor Cabang : PASURUAN - 1309

FKTP : Kejayan - 13261301

138 29-10-2019 132613011019Y001751 0001544482719 CLARET A DARREL ELMIRA P PEGAWAI SWASTA Cystitis Berobat Jalan
BUNJAMIN
139 29-10-2019 132613011019Y001745 0001704585442 LILIK SUPAIDAH P PBI (APBD) Acute nasopharyngitis Berobat Jalan
[common cold]
140 29-10-2019 132613011019Y001744 0001804474258 KUN KINARTI P PEKERJA MANDIRI Other local infections of Berobat Jalan
skin and subcutaneous
tissue
141 29-10-2019 132613011019Y001743 0001874393302 SHODIKIN L PEGAWAI SWASTA Gastritis and duodenitis Berobat Jalan

142 29-10-2019 132613011019Y001727 0001879522108 M RAFI SYAIKA PUTRA L PEGAWAI SWASTA Allergic contact dermatitis Berobat Jalan

143 29-10-2019 132613011019Y001739 0002001952181 MARTINI P PBI (APBN) Acute nasopharyngitis Berobat Jalan
[common cold]
144 29-10-2019 132613011019Y001742 0002204105073 BAIHAKI L PEGAWAI SWASTA Influenza, virus not Berobat Jalan
identified
145 29-10-2019 132613011019Y001726 0002237937614 IWAN SUBANDI L PEKERJA MANDIRI Gastritis and duodenitis Berobat Jalan

146 29-10-2019 132613011019Y001737 0002286873652 YULI SUSANTI P PEKERJA MANDIRI Human immunodeficiency Rujuk Vertikal
virus [HIV] disease
resulting in infectious and
parasitic diseases

147 29-10-2019 132613011019Y001740 0002301126557 SIIN L PBI (APBD) Schizophrenia Berobat Jalan

148 29-10-2019 132613011019Y001736 0002307642434 MUKHAMAD ABDAN NAFIK L PEKERJA MANDIRI Human immunodeficiency Rujuk Vertikal
virus [HIV] disease
resulting in infectious and
parasitic diseases

149 29-10-2019 132613011019Y001734 0002427495344 CHOLIL L PEKERJA MANDIRI Cholelithiasis Rujuk Vertikal

150 29-10-2019 132613011019Y001731 0002459244093 SRIATUN P PEKERJA MANDIRI Acute myocardial Rujuk Vertikal
infarction
151 29-10-2019 132613011019Y001804 0002597423117 SOLIHATUN NISA P PBI (APBN) Fever of other and Berobat Jalan
unknown origin
152 29-10-2019 132613011019Y001812 0002604989529 SUMARMI P PBI (APBN) Other headache Berobat Jalan
syndromes
153 29-10-2019 132613011019Y001747 0002753508071 SOELISTYOWATI P PEKERJA MANDIRI Other disorders of muscle Berobat Jalan Hipertensi

154 29-10-2019 132613011019Y001754 0002765719675 M.IQBAL MAULANA L PEGAWAI SWASTA Acute upper respiratory Berobat Jalan
infections of multiple and
unspecified sites
DAFTAR KUNJUNGAN PESERTA SAKIT

Kantor Cabang : PASURUAN - 1309

FKTP : Kejayan - 13261301

155 29-10-2019 132613011019Y001735 0002893961755 SOLIHATI P PBI (APBD) Human immunodeficiency Rujuk Vertikal
virus [HIV] disease
resulting in infectious and
parasitic diseases

156 28-10-2019 132613011019Y001713 0000097180031 NURUL HAYATI P PENERIMA PENSIUN Non-insulin-dependent Berobat Jalan
PNS diabetes mellitus
157 28-10-2019 132613011019Y001716 0000112988463 ALIF INDRALISTYARINI P PNS DAERAH Other specified Berobat Jalan
counselling
158 28-10-2019 132613011019Y001893 0000714282118 ROBIATUN P PBI (APBN) Other headache Berobat Jalan
syndromes
159 28-10-2019 132613011019Y001675 0000714397961 SUEB EFENDI L PBI (APBN) Acute upper respiratory Berobat Jalan
infections of multiple and
unspecified sites
160 28-10-2019 132613011019Y001676 0000714404586 FAUZAN L PBI (APBN) Other disorders of muscle Berobat Jalan

161 28-10-2019 132613011019Y001678 0000714405363 ZAINAB P PBI (APBN) Other disorders of muscle Berobat Jalan

162 28-10-2019 132613011019Y001705 0000714455662 NABILA P PBI (APBN) Other headache Berobat Jalan
syndromes
163 28-10-2019 132613011019Y001710 0000714593193 RAFIQA FARAH FAUZET P PBI (APBN) Conjunctivitis Berobat Jalan

164 28-10-2019 132613011019Y001692 0000714680728 SITI SOLEHA P PBI (APBN) Other headache Berobat Jalan
syndromes
165 28-10-2019 132613011019Y001686 0000714710362 LILIK MAS`UDAH P PBI (APBN) Gastritis and duodenitis Berobat Jalan

166 28-10-2019 132613011019Y001758 0000714731613 HOLIFAH P PBI (APBN) Fever of other and Berobat Jalan
unknown origin
167 28-10-2019 132613011019Y001701 0000715095505 DASIA P PBI (APBN) Other disorders of muscle Berobat Jalan

168 28-10-2019 132613011019Y001707 0000715109916 M. YAJID AL BUS TOMI L PBI (APBN) Dysphagia Berobat Jalan

169 28-10-2019 132613011019Y001695 0000715193998 M KELVIN MAULANA L PBI (APBN) Fever of other and Berobat Jalan
unknown origin
170 28-10-2019 132613011019Y001837 0000715207678 RIFKI L PBI (APBN) Acute upper respiratory Berobat Jalan
infections of multiple and
unspecified sites
171 28-10-2019 132613011019Y001694 0000715256447 FATIMA P PBI (APBN) Diarrhoea and Berobat Jalan
gastroenteritis of
presumed infectious origin

172 28-10-2019 132613011019Y001659 0000715299524 HUSAINI L PBI (APBN) Facial nerve disorders Rujuk Vertikal

173 28-10-2019 132613011019Y001711 0000715326805 MUCHAMAD SAIFUDIN L PBI (APBN) Amoebiasis Berobat Jalan
DAFTAR KUNJUNGAN PESERTA SAKIT

Kantor Cabang : PASURUAN - 1309

FKTP : Kejayan - 13261301

174 28-10-2019 132613011019Y001691 0000715386227 WILDANUM P PBI (APBN) Conjunctivitis Berobat Jalan

175 28-10-2019 132613011019Y001757 0000715414138 ILMATUL HIKMAH P PBI (APBN) Fever of other and Berobat Jalan
unknown origin
176 28-10-2019 132613011019Y001709 0000715418199 RASID P. ROFIK L PBI (APBN) Other disorders of muscle Berobat Jalan

177 28-10-2019 132613011019Y001685 0000715433769 TRI SETYO BUDIANTO L PBI (APBN) Other headache Berobat Jalan
syndromes
178 28-10-2019 132613011019Y001679 0000715470221 M. SAMALI L PBI (APBN) Calculus of kidney and Rujuk Vertikal
ureter
179 28-10-2019 132613011019Y001697 0000715479603 JAELANI L PBI (APBN) Other disorders of muscle Berobat Jalan

180 28-10-2019 132613011019Y001696 0000715538878 B. JUPRI L PBI (APBN) Other headache Berobat Jalan
syndromes
181 28-10-2019 132613011019Y001911 0000715763586 SAPARI L PBI (APBN) Fever of other and Berobat Jalan
unknown origin
182 28-10-2019 132613011019Y001714 0000715769212 HUSNUL CHOTIMAH P PBI (APBN) Other specified Berobat Jalan
counselling
183 28-10-2019 132613011019Y001909 0000715797178 SANATI P PBI (APBN) Gingivitis and periodontal Berobat Jalan
diseases
184 28-10-2019 132613011019Y001760 0000715875715 UMI KULSUM P PBI (APBN) Gastritis and duodenitis Berobat Jalan

185 28-10-2019 132613011019Y001908 0000715901692 HOLILI L PBI (APBN) Fever of other and Berobat Jalan
unknown origin
186 28-10-2019 132613011019Y001763 0000715924798 NURUL HABIBAH P PBI (APBN) Fever of other and Berobat Jalan
unknown origin
187 28-10-2019 132613011019Y001766 0000715929221 RIYAMA P PBI (APBN) Migraine Berobat Jalan

188 28-10-2019 132613011019Y001765 0000715954083 SAERI L PBI (APBN) Other local infections of Berobat Jalan
skin and subcutaneous
tissue
189 28-10-2019 132613011019Y001910 0000715959279 ASMAYU P PBI (APBN) Gastritis and duodenitis Berobat Jalan

190 28-10-2019 132613011019Y001767 0000715967111 NANANG BUDI SETYAWAN L PBI (APBN) Other headache Berobat Jalan
syndromes
191 28-10-2019 132613011019Y001769 0000715978214 SUDIRMAN L PBI (APBN) Migraine Berobat Jalan

192 28-10-2019 132613011019Y001770 0000715978394 MULYATI P PBI (APBN) Cough Berobat Jalan

193 28-10-2019 132613011019Y001759 0000715984435 M MARUF L PBI (APBN) Diarrhoea and Berobat Jalan
gastroenteritis of
presumed infectious origin
DAFTAR KUNJUNGAN PESERTA SAKIT

Kantor Cabang : PASURUAN - 1309

FKTP : Kejayan - 13261301

194 28-10-2019 132613011019Y001715 0000716013832 HORIDAH P PBI (APBN) Other specified Berobat Jalan
counselling
195 28-10-2019 132613011019Y001768 0000716365203 SAMIATUN P PBI (APBN) Nausea and vomiting Berobat Jalan

196 28-10-2019 132613011019Y001682 0001042694616 SITI NAFISA P PBI (APBN) Anaemia complicating Rujuk Vertikal
pregnancy, childbirth and
the puerperium
197 28-10-2019 132613011019Y001703 0001042713988 HANIFAH P PBI (APBN) Other disorders of muscle Berobat Jalan

198 28-10-2019 132613011019Y001684 0001042718444 DWI INDAH RATNANI P PBI (APBN) Supervision of high-risk Berobat Jalan
pregnancy
199 28-10-2019 132613011019Y001704 0001042719917 MUKHAMMAD FATHUR ROZI L PBI (APBN) Acute upper respiratory Berobat Jalan
infections of multiple and
unspecified sites
200 28-10-2019 132613011019Y001681 0001078245314 CAHYO HADI RUMADHON L PENERIMA PENSIUN TNI Other surgical follow-up Rujuk Vertikal
care
201 28-10-2019 132613011019Y001762 0001704290578 SUGIANTO L PEGAWAI SWASTA Migraine Berobat Jalan

202 28-10-2019 132613011019Y001708 0002001952034 MOKH AINUL YAKIN L PBI (APBN) Other dermatitis Berobat Jalan

203 28-10-2019 132613011019Y001702 0002217290657 SRI WAHYUNINGSIH P PEGAWAI PEMERINTAH Other headache Berobat Jalan
DENGAN PERJANJIAN syndromes
KERJA
204 28-10-2019 132613011019Y001712 0002303816084 DJUWARIYAH P PEKERJA MANDIRI Respiratory tuberculosis, Berobat Jalan
bacteriologically and
histologically confirmed
205 28-10-2019 132613011019Y001689 0002447310789 RODIYAH P PEGAWAI PEMERINTAH Influenza, virus not Berobat Jalan
DENGAN PERJANJIAN identified
KERJA
206 28-10-2019 132613011019Y001660 0002459244093 SRIATUN P PEKERJA MANDIRI Stroke, not specified as Rujuk Vertikal
haemorrhage or infarction
207 28-10-2019 132613011019Y001706 0002487871596 ENDRO ARIFIN L PBI (APBD) Gastritis and duodenitis Berobat Jalan

208 28-10-2019 132613011019Y001657 0002487871833 SITI AISYAH P PBI (APBD) Epilepsy Rujuk Vertikal

209 28-10-2019 132613011019Y001699 0002584395549 SYELA RIZKIYAH P PBI (APBN) Typhoid and paratyphoid Berobat Jalan
fevers
210 28-10-2019 132613011019Y001764 0002585261114 JUWARIYAH P PBI (APBN) Other local infections of Berobat Jalan
skin and subcutaneous
tissue
211 28-10-2019 132613011019Y001761 0002594533678 IDA SAKYANTI P PBI (APBN) Acute upper respiratory Berobat Jalan
infections of multiple and
unspecified sites
DAFTAR KUNJUNGAN PESERTA SAKIT

Kantor Cabang : PASURUAN - 1309

FKTP : Kejayan - 13261301

212 28-10-2019 132613011019Y001680 0002595628451 ABU HASIM L PBI (APBN) Benign neoplasm of Rujuk Vertikal
urinary organs
213 28-10-2019 132613011019Y001688 0002598402813 ISLAHUDDIN L PBI (APBN) Other headache Berobat Jalan
syndromes
214 28-10-2019 132613011019Y001690 0002759657736 RUMILA P PEKERJA MANDIRI Allergic contact dermatitis Berobat Jalan

215 28-10-2019 132613011019Y001683 0002885018657 LULUK FARIDAH P PBI (APBD) Supervision of normal Berobat Jalan
pregnancy
216 26-10-2019 132613011019Y001605 0000112592878 SUHADI, S.PD L PNS DAERAH Cholelithiasis Rujuk Vertikal

217 26-10-2019 132613011019Y001566 0000112702432 UMAR FARUQ L PNS DAERAH Other headache Berobat Jalan
syndromes
218 26-10-2019 132613011019Y001668 0000714394732 MISNAYANTO L PBI (APBN) Dental caries Berobat Jalan

219 26-10-2019 132613011019Y001673 0000714395316 SITI SUBAIDAH P PBI (APBN) Influenza, virus not Berobat Jalan
identified
220 26-10-2019 132613011019Y001663 0000714430912 SIATI P PBI (APBN) Other disorders of muscle Berobat Jalan

221 26-10-2019 132613011019Y001665 0000714431057 SAIFUL ARIEF ARDIANTO L PBI (APBN) Other headache Berobat Jalan
syndromes
222 26-10-2019 132613011019Y001756 0000714731005 ABD. KARIM L PBI (APBN) Gastritis and duodenitis Berobat Jalan

223 26-10-2019 132613011019Y001669 0000714754686 AMENA P PBI (APBN) Gastritis and duodenitis Berobat Jalan

224 26-10-2019 132613011019Y001820 0000714937487 M.TOHER ABIDIN L PBI (APBN) Other dermatitis Berobat Jalan

225 26-10-2019 132613011019Y001611 0000714938095 RODEYAH P PBI (APBN) Other headache Berobat Jalan
syndromes
226 26-10-2019 132613011019Y001826 0000714938837 TOSIN L PBI (APBN) Influenza, virus not Berobat Jalan
identified
227 26-10-2019 132613011019Y001827 0000714940413 A`ISA P PBI (APBN) Bursopathy, unspecified Berobat Jalan

228 26-10-2019 132613011019Y001661 0000715130695 SYAMSUDIN L PBI (APBN) Other disorders of muscle Berobat Jalan

229 26-10-2019 132613011019Y001655 0000715148278 DANIA P PBI (APBN) Gastritis and duodenitis Berobat Jalan

230 26-10-2019 132613011019Y001755 0000715187441 SRI WIJAYATI P PBI (APBN) Other headache Berobat Jalan
syndromes
231 26-10-2019 132613011019Y001617 0000715268125 ALIMAN L PBI (APBN) Acute upper respiratory Berobat Jalan
infections of multiple and
unspecified sites
232 26-10-2019 132613011019Y001620 0000715299052 SUKHUFAN L PBI (APBN) Other headache Berobat Jalan
syndromes
233 26-10-2019 132613011019Y001622 0000715299175 SUNARTI P PBI (APBN) Other disorders of muscle Berobat Jalan
DAFTAR KUNJUNGAN PESERTA SAKIT

Kantor Cabang : PASURUAN - 1309

FKTP : Kejayan - 13261301

234 26-10-2019 132613011019Y001574 0000715416322 JUMADI L PBI (APBN) Other disorders of muscle Berobat Jalan

235 26-10-2019 132613011019Y001604 0000715492124 SAODAH P PBI (APBN) Other surgical follow-up Rujuk Vertikal
care
236 26-10-2019 132613011019Y001672 0000715600168 SOLEHUDIN L PBI (APBN) Leprosy [Hansen disease] Berobat Jalan

237 26-10-2019 132613011019Y001667 0000715678198 CHAJALI L PBI (APBN) Acute upper respiratory Berobat Jalan
infections of multiple and
unspecified sites
238 26-10-2019 132613011019Y001573 0000715776017 KAMELIAH L PBI (APBN) Other headache Berobat Jalan
syndromes
239 26-10-2019 132613011019Y001836 0000715822187 CHOTIMAH P PBI (APBN) Gingivitis and periodontal Berobat Jalan
diseases
240 26-10-2019 132613011019Y001646 0000715845069 M. ROHMATULLOH L PBI (APBN) Fever of other and Berobat Jalan
unknown origin
241 26-10-2019 132613011019Y001616 0000715848311 KHOTIMAH P PBI (APBN) Diarrhoea and Berobat Jalan
gastroenteritis of
presumed infectious origin

242 26-10-2019 132613011019Y001645 0000715854857 MUNA P PBI (APBN) Acute upper respiratory Berobat Jalan
infections of multiple and
unspecified sites
243 26-10-2019 132613011019Y001670 0000715897045 SAIDA P PBI (APBN) Gastritis and duodenitis Berobat Jalan

244 26-10-2019 132613011019Y001653 0000716022009 HUSNA P PBI (APBN) Other headache Berobat Jalan
syndromes
245 26-10-2019 132613011019Y001664 0000716038773 MUJANI L PBI (APBN) Myalgia Berobat Jalan

246 26-10-2019 132613011019Y001562 0000716097969 ROHMA L PBI (APBN) Other disorders of muscle Berobat Jalan

247 26-10-2019 132613011019Y001652 0000716364955 ARI L PBI (APBN) Diarrhoea and Berobat Jalan
gastroenteritis of
presumed infectious origin

248 26-10-2019 132613011019Y001658 0000716494263 MAHRUSIN L PBI (APBN) Other disorders of muscle Berobat Jalan

249 26-10-2019 132613011019Y001666 0000716720556 SUYATI P PBI (APBN) Other headache Berobat Jalan
syndromes
250 26-10-2019 132613011019Y001662 0001042695426 HUDAIFAH P PBI (APBN) Non-insulin-dependent Berobat Jalan
diabetes mellitus
251 26-10-2019 132613011019Y001651 0001042701827 ABDUR ROHMAN L PBI (APBN) Acute upper respiratory Berobat Jalan
infections of multiple and
unspecified sites
DAFTAR KUNJUNGAN PESERTA SAKIT

Kantor Cabang : PASURUAN - 1309

FKTP : Kejayan - 13261301

252 26-10-2019 132613011019Y001612 0001042707622 MUSO L PBI (APBN) Gingivitis and periodontal Berobat Jalan
diseases
253 26-10-2019 132613011019Y001674 0001042709905 KHORIDATUL BAHIYA P PBI (APBN) Respiratory tuberculosis, Berobat Jalan
bacteriologically and
histologically confirmed
254 26-10-2019 132613011019Y001644 0001042711885 DEWI/B. SAMOTI P PBI (APBN) Gastritis and duodenitis Berobat Jalan

255 26-10-2019 132613011019Y001677 0001042716688 ADI ANOM HIKMATUL L PBI (APBN) Other specified Berobat Jalan
MUKMININ counselling
256 26-10-2019 132613011019Y001671 0001080518242 M.ANDHIKA YUDA L PNS DAERAH Respiratory tuberculosis, Berobat Jalan
ARDIANSYAH bacteriologically and
histologically confirmed
257 26-10-2019 132613011019Y001567 0001600223679 EKO SARIFUDIN L PEGAWAI SWASTA Gastritis and duodenitis Berobat Jalan

258 26-10-2019 132613011019Y001654 0001704586149 SAROHA P PBI (APBD) Myalgia Berobat Jalan Diabetes
Mellitus
Hipertensi
259 26-10-2019 132613011019Y001569 0001814637328 HM NURUL AMIN L PEKERJA MANDIRI Other rheumatoid arthritis Berobat Jalan

260 26-10-2019 132613011019Y001571 0001814639793 SITI KAROMATUL AZIZAH P PEKERJA MANDIRI Influenza, virus not Berobat Jalan
identified
261 26-10-2019 132613011019Y001608 0001970976925 KHOIRIN NAFAHATILLAH P PEGAWAI PEMERINTAH Acute upper respiratory Berobat Jalan
DENGAN PERJANJIAN infections of multiple and
KERJA unspecified sites
262 26-10-2019 132613011019Y001792 0002121301394 SUMIYATI P PBI (APBN) Fever of other and Berobat Jalan
unknown origin
263 26-10-2019 132613011019Y001656 0002273472674 TANISHA FIRYAL HASTI P PEKERJA MANDIRI Influenza, virus not Berobat Jalan
LUBENA identified
264 26-10-2019 132613011019Y001834 0002494457144 MUHAMAD NURUL L PEGAWAI SWASTA Acute upper respiratory Berobat Jalan
infections of multiple and
unspecified sites
265 26-10-2019 132613011019Y001835 0002584116551 MICHAILA HIDAYAH P PBI (APBN) Fever of other and Berobat Jalan
unknown origin
266 26-10-2019 132613011019Y001892 0002755351203 SUNARSIH P PBI (APBD) Fever of other and Berobat Jalan
unknown origin
267 25-10-2019 132613011019Y001455 0000112589335 DJUWARI L PNS DAERAH Stroke, not specified as Rujuk Vertikal
haemorrhage or infarction
268 25-10-2019 132613011019Y001513 0000112748646 LULUK PURWANTI P PENERIMA PENSIUN Non-insulin-dependent Berobat Jalan
PNS diabetes mellitus
269 25-10-2019 132613011019Y001510 0000112965063 MURYANI P PNS DAERAH Other dermatitis Berobat Jalan
DAFTAR KUNJUNGAN PESERTA SAKIT

Kantor Cabang : PASURUAN - 1309

FKTP : Kejayan - 13261301

270 25-10-2019 132613011019Y001771 0000714829601 HOIRIYA P PBI (APBN) Acute upper respiratory Berobat Jalan
infections of multiple and
unspecified sites
271 25-10-2019 132613011019Y001772 0000714838408 SODIK L PBI (APBN) Nausea and vomiting Berobat Jalan

272 25-10-2019 132613011019Y001773 0000714895356 SULTON EFENDI L PBI (APBN) Fever of other and Berobat Jalan
unknown origin
273 25-10-2019 132613011019Y001445 0000714940031 SITI RUKAYAH P PBI (APBN) Benign neoplasm of breast Rujuk Vertikal

274 25-10-2019 132613011019Y001499 0000714945824 AFIFAH P PBI (APBN) Gingivitis and periodontal Berobat Jalan
diseases
275 25-10-2019 132613011019Y001447 0000715094471 M.RIDWAN L PBI (APBN) Dysphagia Berobat Jalan

276 25-10-2019 132613011019Y001553 0000715110603 SUHADAK L PBI (APBN) Gastritis and duodenitis Berobat Jalan

277 25-10-2019 132613011019Y001512 0000715154387 SILFI NUR DIANA P PBI (APBN) Fever of other and Berobat Jalan
unknown origin
278 25-10-2019 132613011019Y001558 0000715160531 YULIATI P PBI (APBN) Other rheumatoid arthritis Berobat Jalan

279 25-10-2019 132613011019Y001486 0000715272186 AMINAH P PBI (APBN) Other disorders of muscle Berobat Jalan

280 25-10-2019 132613011019Y001516 0000715296824 SAMIAN L PBI (APBN) Essential (primary) Berobat Jalan
hypertension
281 25-10-2019 132613011019Y001511 0000715723413 MISTINA P PBI (APBN) Essential (primary) Berobat Jalan
hypertension
282 25-10-2019 132613011019Y001449 0000715737745 GHOJALI L PBI (APBN) Hypertensive heart Rujuk Vertikal
disease
283 25-10-2019 132613011019Y001556 0000715756138 NISAUL KHOIRIYAH P PBI (APBN) Other headache Berobat Jalan
syndromes
284 25-10-2019 132613011019Y001484 0000715782431 ARIKA FAUZIA P PBI (APBN) Acute upper respiratory Berobat Jalan
infections of multiple and
unspecified sites
285 25-10-2019 132613011019Y001481 0000715840424 HAMBALI L PBI (APBN) Allergic contact dermatitis Berobat Jalan

286 25-10-2019 132613011019Y001452 0000715880586 M.YUSUF L PBI (APBN) Other chronic obstructive Rujuk Vertikal
pulmonary disease
287 25-10-2019 132613011019Y001788 0000715900781 HANIFAH P PBI (APBN) Fever of other and Berobat Jalan
unknown origin
288 25-10-2019 132613011019Y001522 0000715955668 NUR AINI P PBI (APBN) Other specified Berobat Jalan
counselling
289 25-10-2019 132613011019Y001619 0000716023282 MESRI P PBI (APBN) Other headache Berobat Jalan
syndromes
DAFTAR KUNJUNGAN PESERTA SAKIT

Kantor Cabang : PASURUAN - 1309

FKTP : Kejayan - 13261301

290 25-10-2019 132613011019Y001448 0000716040674 M. ZAKI FIKRI L PBI (APBN) Symptoms and signs Berobat Jalan
concerning food and fluid
intake
291 25-10-2019 132613011019Y001450 0000716118017 RUKAYAH P PBI (APBN) Other disorders of muscle Berobat Jalan

292 25-10-2019 132613011019Y001504 0000716885919 RUBAINA P PBI (APBN) Leprosy [Hansen disease] Berobat Jalan

293 25-10-2019 132613011019Y001561 0001042698249 HUSNIK MUBAROK L PBI (APBN) Diarrhoea and Berobat Jalan
gastroenteritis of
presumed infectious origin

294 25-10-2019 132613011019Y001614 0001042710399 AHMADUN L PBI (APBN) Diarrhoea and Berobat Jalan
gastroenteritis of
presumed infectious origin

295 25-10-2019 132613011019Y001615 0001042710412 ELSA KAMELIA P PBI (APBN) Acute upper respiratory Berobat Jalan
infections of multiple and
unspecified sites
296 25-10-2019 132613011019Y001613 0001042712752 ABD. HALIM L PBI (APBN) Migraine Berobat Jalan

297 25-10-2019 132613011019Y001521 0001042713617 JUMAANA P PBI (APBN) Non-insulin-dependent Berobat Jalan
diabetes mellitus
298 25-10-2019 132613011019Y001451 0001042713718 HENDRO PURNOMO L PBI (APBN) Acute upper respiratory Berobat Jalan
infections of multiple and
unspecified sites
299 25-10-2019 132613011019Y001446 0001042717274 SUBIARI L PBI (APBN) Heart failure Rujuk Vertikal

300 25-10-2019 132613011019Y001483 0001042719243 VALENTINA IRMAWATI P PBI (APBN) Influenza, virus not Berobat Jalan
identified
301 25-10-2019 132613011019Y001508 0001133454745 UNTUNG L PEGAWAI SWASTA Myalgia Berobat Jalan

302 25-10-2019 132613011019Y001509 0001182458586 MUHAMAD ALFAN HAKIM L PEGAWAI SWASTA Gastritis and duodenitis Berobat Jalan

303 25-10-2019 132613011019Y001621 0001196653443 IDA FITRIA P PEGAWAI SWASTA Gastritis and duodenitis Berobat Jalan

304 25-10-2019 132613011019Y001505 0001227154285 NAFISSA NURUL FADHILLAH P PRAJURIT AL Scabies Berobat Jalan

305 25-10-2019 132613011019Y001453 0001227154296 ODE EVI YULIANTI P PNS DAERAH Other specified Berobat Jalan
counselling
306 25-10-2019 132613011019Y001560 0001831996361 TRI WULANDARI P PENERIMA PENSIUN TNI Gastritis and duodenitis Berobat Jalan

307 25-10-2019 132613011019Y001609 0001879888151 QUEEN AQILLAH ZAYYAN P PRAJURIT AL Acute upper respiratory Berobat Jalan
NURKHOFIFAH infections of multiple and
unspecified sites
308 25-10-2019 132613011019Y001490 0002001951786 MOKHAMMAD SUFYAN L PBI (APBN) Gingivitis and periodontal Berobat Jalan
HIDAYATULLAH diseases
DAFTAR KUNJUNGAN PESERTA SAKIT

Kantor Cabang : PASURUAN - 1309

FKTP : Kejayan - 13261301

309 25-10-2019 132613011019Y001480 0002161102263 KHUSIYAH P PBI (APBD) Other headache Berobat Jalan
syndromes
310 25-10-2019 132613011019Y001523 0002204601467 MOH. ZAMAH SYARI L PEGAWAI SWASTA Other specified Berobat Jalan
counselling
311 25-10-2019 132613011019Y001517 0002248084506 AHMAD YAZID L PEGAWAI SWASTA Fever of other and Berobat Jalan
unknown origin
312 25-10-2019 132613011019Y001610 0002265260433 KHOIROTUL MUHIBBAH P PEGAWAI SWASTA Supervision of normal Berobat Jalan
pregnancy
313 25-10-2019 132613011019Y001618 0002289555538 MUHAMMAD ZEFRYZAL L PEKERJA MANDIRI Cough Berobat Jalan

314 25-10-2019 132613011019Y001520 0002298529888 M.AKBAR MAULANA HASBY L PEKERJA MANDIRI Typhoid and paratyphoid Berobat Jalan
fevers
315 25-10-2019 132613011019Y001507 0002298531159 M. ASRAF ZAIRUL UBAID L PBI (APBD) Respiratory tuberculosis, Berobat Jalan
bacteriologically and
histologically confirmed
316 25-10-2019 132613011019Y001518 0002582720054 CAHYO AGUNG SRIJATI L PBI (APBN) Gastritis and duodenitis Berobat Jalan

317 25-10-2019 132613011019Y001519 0002584395549 SYELA RIZKIYAH P PBI (APBN) Typhoid and paratyphoid Berobat Jalan
fevers
318 25-10-2019 132613011019Y001787 0002585998271 NAZIL GHUFRON L PBI (APBN) Fever of other and Berobat Jalan
unknown origin
319 25-10-2019 132613011019Y001515 0002628985329 ZUMROTUS SOLIHATIN P PBI (APBN) Influenza, virus not Berobat Jalan
identified
320 25-10-2019 132613011019Y001456 0002768811017 RISKA DIANASARI P PEKERJA MANDIRI Gestational Rujuk Vertikal
[pregnancy-induced]
hypertension without
significant proteinuria
321 25-10-2019 132613011019Y001514 0002773160098 SUYASTI P PEKERJA MANDIRI Essential (primary) Berobat Jalan
hypertension
322 24-10-2019 132613011019Y001398 0000112595714 QURROTA AYUN P PEKERJA MANDIRI Fever of other and Berobat Jalan
unknown origin
323 24-10-2019 132613011019Y001494 0000112901679 ROEKIJANAH P PENERIMA PENSIUN Essential (primary) Berobat Jalan Diabetes
PNS hypertension Mellitus
324 24-10-2019 132613011019Y001479 0000112988463 ALIF INDRALISTYARINI P PNS DAERAH Respiratory tuberculosis, Berobat Jalan
bacteriologically and
histologically confirmed
325 24-10-2019 132613011019Y001541 0000195274438 APRILLIA ELOK P PNS DAERAH Other headache Berobat Jalan
PURWONINGTIAS syndromes
326 24-10-2019 132613011019Y001542 0000714818632 SYAIFUL ANWAR L PBI (APBN) Gastritis and duodenitis Berobat Jalan

327 24-10-2019 132613011019Y001495 0000714940795 ZAINAL ABIDIN L PBI (APBN) Fever of other and Berobat Jalan
unknown origin
DAFTAR KUNJUNGAN PESERTA SAKIT

Kantor Cabang : PASURUAN - 1309

FKTP : Kejayan - 13261301

328 24-10-2019 132613011019Y001414 0000715094087 HOTIJAH P PBI (APBN) Medical observation and Berobat Jalan
evaluation for suspected
diseases and conditions
329 24-10-2019 132613011019Y001473 0000715101693 RIAMAH P PBI (APBN) Non-insulin-dependent Berobat Jalan
diabetes mellitus
330 24-10-2019 132613011019Y001477 0000715165029 LAIMIN L PBI (APBN) Non-insulin-dependent Berobat Jalan
diabetes mellitus
331 24-10-2019 132613011019Y001466 0000715299524 HUSAINI L PBI (APBN) Other specified Berobat Jalan
counselling
332 24-10-2019 132613011019Y001399 0000715314879 SULASTRI P PBI (APBN) Other disorders of muscle Berobat Jalan

333 24-10-2019 132613011019Y001410 0000715325826 SALIHA P PBI (APBN) Other headache Berobat Jalan
syndromes
334 24-10-2019 132613011019Y001411 0000715328583 HUMAIYA P PBI (APBN) Other disorders of muscle Berobat Jalan

335 24-10-2019 132613011019Y001412 0000715330697 SAMIATI P PBI (APBN) Acute upper respiratory Berobat Jalan
infections of multiple and
unspecified sites
336 24-10-2019 132613011019Y001545 0000715382346 NADIYA NUR AZIZAH P PBI (APBN) Allergic contact dermatitis Berobat Jalan

337 24-10-2019 132613011019Y001467 0000715407489 HALIMATUSADIYAH P PBI (APBN) Non-insulin-dependent Berobat Jalan
diabetes mellitus
338 24-10-2019 132613011019Y001549 0000715467339 NASOR L PBI (APBN) Other headache Berobat Jalan
syndromes
339 24-10-2019 132613011019Y001524 0000715595984 SAIDA P PBI (APBN) Other headache Berobat Jalan
syndromes
340 24-10-2019 132613011019Y001478 0000715648825 MACHMUDAH P PBI (APBN) Non-insulin-dependent Berobat Jalan
diabetes mellitus
341 24-10-2019 132613011019Y001471 0000715670155 ATIM SUAIDAH P PBI (APBN) Essential (primary) Berobat Jalan
hypertension
342 24-10-2019 132613011019Y001543 0000715736485 M. AINUL YAQIN L PBI (APBN) Fever of other and Berobat Jalan
unknown origin
343 24-10-2019 132613011019Y001401 0000715783307 SUPARTO L PBI (APBN) Other headache Berobat Jalan
syndromes
344 24-10-2019 132613011019Y001526 0000715834912 MUHAMAD IKSAN L PBI (APBN) Migraine Berobat Jalan

345 24-10-2019 132613011019Y001402 0000715863576 PARTINI P PBI (APBN) Other headache Berobat Jalan
syndromes
346 24-10-2019 132613011019Y001525 0000715885997 SIRAT L PBI (APBN) Dental caries Berobat Jalan

347 24-10-2019 132613011019Y001468 0000715924833 ROIFAH P PBI (APBN) Other disorders of muscle Berobat Jalan
DAFTAR KUNJUNGAN PESERTA SAKIT

Kantor Cabang : PASURUAN - 1309

FKTP : Kejayan - 13261301

348 24-10-2019 132613011019Y001493 0000715974456 MOH.MAHIN L PBI (APBN) Other disorders of muscle Berobat Jalan

349 24-10-2019 132613011019Y001529 0000715976087 M. BADRUSSOLEH L PBI (APBN) Cough Berobat Jalan

350 24-10-2019 132613011019Y001469 0000716062061 SUHAINA P PBI (APBN) Other specified Berobat Jalan
counselling
351 24-10-2019 132613011019Y001419 0000716091917 RORIYAH P PBI (APBN) Malaise and fatigue Berobat Jalan

352 24-10-2019 132613011019Y001422 0000716113888 M. DHIKA AGUSTIAN L PBI (APBN) Symptoms and signs Berobat Jalan
ALAMSYAH concerning food and fluid
intake
353 24-10-2019 132613011019Y001497 0000716735777 ROSYIDI L PBI (APBN) Nasal polyp, unspecified Berobat Jalan

354 24-10-2019 132613011019Y001544 0001042697542 SRI WAHYUNI P PBI (APBN) Influenza, virus not Berobat Jalan
identified
355 24-10-2019 132613011019Y001386 0001042700343 SRI NINGSIH P PBI (APBN) Typhoid and paratyphoid Berobat Jalan
fevers
356 24-10-2019 132613011019Y001532 0001042702918 SA`ID L PBI (APBN) Diarrhoea and Berobat Jalan
gastroenteritis of
presumed infectious origin

357 24-10-2019 132613011019Y001475 0001042702953 MALIKHA P PBI (APBN) Typhoid and paratyphoid Berobat Jalan
fevers
358 24-10-2019 132613011019Y001527 0001042711672 LUTFIYAH P PBI (APBN) Nausea and vomiting Berobat Jalan

359 24-10-2019 132613011019Y001528 0001042711694 SANTI RAHAYU P PBI (APBN) Acute upper respiratory Berobat Jalan
infections of multiple and
unspecified sites
360 24-10-2019 132613011019Y001470 0001042712932 MASRUROH P PBI (APBN) Other specified Berobat Jalan
counselling
361 24-10-2019 132613011019Y001417 0001042713775 M. SUKRON L PBI (APBN) Dysphagia Berobat Jalan

362 24-10-2019 132613011019Y001546 0001194513963 MUHAMMAD MUNIF NAZRIEL L PEGAWAI SWASTA Fever of other and Berobat Jalan
ANAM unknown origin
363 24-10-2019 132613011019Y001530 0001402354866 RUSDIANA P PEGAWAI SWASTA Other local infections of Berobat Jalan
skin and subcutaneous
tissue
364 24-10-2019 132613011019Y001472 0001540008281 MUSTOFA L PEGAWAI SWASTA Acute nasopharyngitis Berobat Jalan
[common cold]
365 24-10-2019 132613011019Y001500 0002091451509 M.SODIKIN L PEKERJA MANDIRI Other specified Berobat Jalan
counselling
366 24-10-2019 132613011019Y001464 0002301174819 SUGENG L PBI (APBD) Schizophrenia Berobat Jalan
DAFTAR KUNJUNGAN PESERTA SAKIT

Kantor Cabang : PASURUAN - 1309

FKTP : Kejayan - 13261301

367 24-10-2019 132613011019Y001498 0002301175078 LULUK ILJANNAH P PBI (APBD) Other specified Berobat Jalan
counselling
368 24-10-2019 132613011019Y001496 0002419933274 YUNI HIMAWATI P PEKERJA MANDIRI Acute nasopharyngitis Berobat Jalan
[common cold]
369 24-10-2019 132613011019Y001501 0002449664818 MUJIATI P PEGAWAI SWASTA Other specified Berobat Jalan
counselling
370 24-10-2019 132613011019Y001531 0002467043638 SAMPURNO L PEKERJA MANDIRI Migraine Berobat Jalan

371 24-10-2019 132613011019Y001465 0002616975832 SOFIYAH P PEKERJA MANDIRI Non-insulin-dependent Berobat Jalan
diabetes mellitus
372 24-10-2019 132613011019Y001474 0002637447197 SUGIONO L PBI (APBN) Respiratory tuberculosis, Berobat Jalan
bacteriologically and
histologically confirmed
373 24-10-2019 132613011019Y001476 0002767373313 CHOLIPAH P PEKERJA MANDIRI Other disorders of muscle Berobat Jalan

374 23-10-2019 132613011019Y001293 0000112589379 DWI ASTUTI P PNS DAERAH Gingivitis and periodontal Berobat Jalan
diseases
375 23-10-2019 132613011019Y001397 0000112590077 KHOIRUN NIKMAH P PNS DAERAH Otitis externa Berobat Jalan

376 23-10-2019 132613011019Y001292 0000112829894 SOETRISNO HADI L PENERIMA PENSIUN TNI Stroke, not specified as Rujuk Vertikal
haemorrhage or infarction
377 23-10-2019 132613011019Y001291 0000112829905 NGATIAYAH P PENERIMA PENSIUN TNI Dorsalgia Rujuk Vertikal

378 23-10-2019 132613011019Y001503 0000112965063 MURYANI P PNS DAERAH Essential (primary) Berobat Jalan
hypertension
379 23-10-2019 132613011019Y001502 0000714209409 TASMI P PBI (APBN) Essential (primary) Berobat Jalan
hypertension
380 23-10-2019 132613011019Y001575 0000714433961 FAQEH L PBI (APBN) Other disorders of muscle Berobat Jalan

381 23-10-2019 132613011019Y001492 0000714939647 MUCH. AS`AT L PBI (APBN) Other headache Berobat Jalan
syndromes
382 23-10-2019 132613011019Y001390 0000715081342 YANTO L PBI (APBN) Other disorders of muscle Berobat Jalan

383 23-10-2019 132613011019Y001277 0000715132539 KOMARIA P PBI (APBN) Other headache Berobat Jalan
syndromes
384 23-10-2019 132613011019Y001310 0000715143374 SOMANA P PBI (APBN) Heart failure Rujuk Vertikal

385 23-10-2019 132613011019Y001294 0000715165773 YAHDI L PBI (APBN) Gingivitis and periodontal Berobat Jalan
diseases
386 23-10-2019 132613011019Y001393 0000715188644 FUAD HASYIM AS`ARI L PBI (APBN) Schizophrenia Berobat Jalan
DAFTAR KUNJUNGAN PESERTA SAKIT

Kantor Cabang : PASURUAN - 1309

FKTP : Kejayan - 13261301

387 23-10-2019 132613011019Y001415 0000715240383 NISWATUN NABILAH P PBI (APBN) Acute upper respiratory Berobat Jalan
infections of multiple and
unspecified sites
388 23-10-2019 132613011019Y001597 0000715248461 RIA AISYAH MUNIR P PBI (APBN) Other headache Berobat Jalan
syndromes
389 23-10-2019 132613011019Y001326 0000715263388 EDY SANTOSO L PBI (APBN) Other headache Berobat Jalan
syndromes
390 23-10-2019 132613011019Y001598 0000715266314 KHOSIAH P PBI (APBN) Other headache Berobat Jalan
syndromes
391 23-10-2019 132613011019Y001403 0000715269554 ALIYATUL ROHMAH P PBI (APBN) Other disorders of muscle Berobat Jalan

392 23-10-2019 132613011019Y001413 0000715271488 M. SALIM L PBI (APBN) Cough Berobat Jalan

393 23-10-2019 132613011019Y001404 0000715276967 SITI MARIA ULFA P PBI (APBN) Fever of other and Berobat Jalan
unknown origin
394 23-10-2019 132613011019Y001327 0000715287082 M NURAINI L PBI (APBN) Influenza, virus not Berobat Jalan
identified
395 23-10-2019 132613011019Y001295 0000715296824 SAMIAN L PBI (APBN) Malignant neoplasm of Rujuk Vertikal
nasopharynx, unspecified
396 23-10-2019 132613011019Y001600 0000715455461 ASMAWI L PBI (APBN) Other disorders of muscle Berobat Jalan

397 23-10-2019 132613011019Y001599 0000715458723 HOLIK L PBI (APBN) Other disorders of muscle Berobat Jalan

398 23-10-2019 132613011019Y001601 0000715468364 SHOLEH L PBI (APBN) Dental caries Berobat Jalan

399 23-10-2019 132613011019Y001405 0000715600552 JUPRIYANTO L PBI (APBN) Dental caries Berobat Jalan

400 23-10-2019 132613011019Y001392 0000715678198 CHAJALI L PBI (APBN) Acute upper respiratory Berobat Jalan
infections of multiple and
unspecified sites
401 23-10-2019 132613011019Y001280 0000715752674 KASIATI P PEGAWAI SWASTA Influenza, virus not Berobat Jalan
identified
402 23-10-2019 132613011019Y001391 0000715841741 UMI KULSUM P PBI (APBN) Myalgia Berobat Jalan Diabetes
Mellitus
403 23-10-2019 132613011019Y001394 0000715844878 AHMADI L PBI (APBN) Observation for suspected Berobat Jalan
tuberculosis
404 23-10-2019 132613011019Y001302 0000715845069 M. ROHMATULLOH L PBI (APBN) Pulpitis Berobat Jalan

405 23-10-2019 132613011019Y001331 0000715865703 FAURIYAH P PBI (APBN) Acute upper respiratory Berobat Jalan Diabetes
infections of multiple and Mellitus
unspecified sites
DAFTAR KUNJUNGAN PESERTA SAKIT

Kantor Cabang : PASURUAN - 1309

FKTP : Kejayan - 13261301

406 23-10-2019 132613011019Y001407 0000715910488 SAMSURI L PBI (APBN) Diarrhoea and Berobat Jalan
gastroenteritis of
presumed infectious origin

407 23-10-2019 132613011019Y001381 0000715921795 SYIFA`ATUL HUSNIAH P PBI (APBN) Gastritis and duodenitis Berobat Jalan

408 23-10-2019 132613011019Y001379 0000715924798 NURUL HABIBAH P PBI (APBN) Diarrhoea and Berobat Jalan
gastroenteritis of
presumed infectious origin

409 23-10-2019 132613011019Y001416 0000715956096 NAPIA P PBI (APBN) Gastritis and duodenitis Berobat Jalan

410 23-10-2019 132613011019Y001400 0000715972689 WIRO`I L PBI (APBN) Other disorders of muscle Berobat Jalan

411 23-10-2019 132613011019Y001418 0000716012111 M FARID ALWAN L PBI (APBN) Fever of other and Berobat Jalan
unknown origin
412 23-10-2019 132613011019Y001421 0000716020121 SITI WAHYUNI P PBI (APBN) Acute upper respiratory Berobat Jalan
infections of multiple and
unspecified sites
413 23-10-2019 132613011019Y001406 0000716046063 HASANA . P PBI (APBN) Other headache Berobat Jalan
syndromes
414 23-10-2019 132613011019Y001408 0000716046759 IRSADURROFIQ L PBI (APBN) Migraine Berobat Jalan

415 23-10-2019 132613011019Y001409 0000716065457 MUDRIKAH P PBI (APBN) Cough Berobat Jalan

416 23-10-2019 132613011019Y001603 0000716498717 NURALIM L PBI (APBN) Other headache Berobat Jalan
syndromes
417 23-10-2019 132613011019Y001276 0001042697171 NIKMATUL ISLAMIYA P PBI (APBN) Gastritis and duodenitis Berobat Jalan

418 23-10-2019 132613011019Y001278 0001042697182 AHMAD BAJURI L PBI (APBN) Allergic contact dermatitis Berobat Jalan

419 23-10-2019 132613011019Y001281 0001042698003 LILIK HIDAYATI P PBI (APBN) Gastritis and duodenitis Berobat Jalan

420 23-10-2019 132613011019Y001289 0001042705607 SOFEYAH P PBI (APBN) Chronic ischaemic heart Rujuk Vertikal
disease
421 23-10-2019 132613011019Y001305 0001042716431 RISKIANAH P PBI (APBN) Dental caries Berobat Jalan

422 23-10-2019 132613011019Y001330 0001042719434 ACHMAD L PBI (APBN) Acute upper respiratory Berobat Jalan
infections of multiple and
unspecified sites
423 23-10-2019 132613011019Y001378 0001181390275 ROHJANATIN P PEGAWAI SWASTA Essential (primary) Berobat Jalan
hypertension
424 23-10-2019 132613011019Y001317 0001452584294 HOTIJAH P PBI (APBD) Other specified diabetes Rujuk Vertikal Diabetes
mellitus with unspecified Mellitus
complications
DAFTAR KUNJUNGAN PESERTA SAKIT

Kantor Cabang : PASURUAN - 1309

FKTP : Kejayan - 13261301

425 23-10-2019 132613011019Y001313 0001612203895 LUKI HARIADI L PEGAWAI SWASTA Gingivitis and periodontal Berobat Jalan
diseases
426 23-10-2019 132613011019Y001395 0001706181671 UYUN NUR ROHMAH P PEGAWAI SWASTA Other local infections of Berobat Jalan
skin and subcutaneous
tissue
427 23-10-2019 132613011019Y001506 0002001951358 RISKY YATUL OMANIA P PBI (APBN) Other headache Berobat Jalan
syndromes
428 23-10-2019 132613011019Y001388 0002198175322 AHMAD NANDANA GITRIF L PEKERJA MANDIRI Acute nasopharyngitis Berobat Jalan
WIDIARTAMA [common cold]
429 23-10-2019 132613011019Y001328 0002221628229 SUBANDI L PEKERJA MANDIRI Other disorders of muscle Berobat Jalan

430 23-10-2019 132613011019Y001463 0002247356957 SHOMADI KR L PEKERJA MANDIRI Non-insulin-dependent Berobat Jalan
diabetes mellitus
431 23-10-2019 132613011019Y001329 0002263905584 LULUK SUDI LESTARI P PEKERJA MANDIRI Other headache Berobat Jalan
syndromes
432 23-10-2019 132613011019Y001311 0002461364548 KHOIROTUN NISAK P PEKERJA MANDIRI Gingivitis and periodontal Berobat Jalan
diseases
433 23-10-2019 132613011019Y001279 0002478544299 DEVAN DWI PRAYOGHA L PEKERJA MANDIRI Fever of other and Berobat Jalan
unknown origin
434 23-10-2019 132613011019Y001396 0002518745578 SRI WINDARTATIK P PEKERJA MANDIRI Gastritis and duodenitis Berobat Jalan

435 23-10-2019 132613011019Y001420 0002604761436 SAMSUL ARIFIN L PBI (APBN) Diarrhoea and Berobat Jalan
gastroenteritis of
presumed infectious origin

436 23-10-2019 132613011019Y001307 0002620188314 H. ABDUL ROHMAN L PEKERJA MANDIRI Hypertensive heart Rujuk Vertikal
disease
437 23-10-2019 132613011019Y001296 0002633188331 LATIFAH SARI P PBI (APBN) Gingivitis and periodontal Berobat Jalan
diseases
438 23-10-2019 132613011019Y001389 0002896474318 ALVINO DAFFA MUWAFFIQ L PBI (APBN) Other specified Berobat Jalan
counselling
439 22-10-2019 132613011019Y001349 0000103345593 HAMDANI L PENERIMA PENSIUN Acute pharyngitis Berobat Jalan
PNS
440 22-10-2019 132613011019Y001457 0000200109791 LAILIL RAHMA P PNS DAERAH Other disorders of muscle Berobat Jalan

441 22-10-2019 132613011019Y001576 0000714791979 MUSRIPAH P PBI (APBN) Bursopathy, unspecified Berobat Jalan

442 22-10-2019 132613011019Y001722 0000714812681 DEWI P PBI (APBN) Gastritis and duodenitis Berobat Jalan

443 22-10-2019 132613011019Y001443 0000714934787 M. RASUMO L PBI (APBN) Other disorders of muscle Berobat Jalan

444 22-10-2019 132613011019Y001693 0000714942718 NASRIFAH P PBI (APBN) Other headache Berobat Jalan
syndromes
DAFTAR KUNJUNGAN PESERTA SAKIT

Kantor Cabang : PASURUAN - 1309

FKTP : Kejayan - 13261301

445 22-10-2019 132613011019Y001377 0000715087192 NURUL HIDAYATI P PBI (APBN) Other headache Berobat Jalan
syndromes
446 22-10-2019 132613011019Y001155 0000715105642 MAULIDIA P PBI (APBN) Other headache Berobat Jalan
syndromes
447 22-10-2019 132613011019Y001368 0000715166627 M. SOHADI L PBI (APBN) Gastritis and duodenitis Berobat Jalan

448 22-10-2019 132613011019Y001339 0000715239167 KHOLIFAH P PBI (APBN) Other headache Berobat Jalan
syndromes
449 22-10-2019 132613011019Y001222 0000715259237 MOKH IKBAL FAHMI L PBI (APBN) Allergic contact dermatitis Berobat Jalan

450 22-10-2019 132613011019Y001233 0000715260172 ASPI'A L PBI (APBN) Other disorders of muscle Berobat Jalan

451 22-10-2019 132613011019Y001346 0000715306836 JUHRIYA P PBI (APBN) Essential (primary) Berobat Jalan
hypertension
452 22-10-2019 132613011019Y001555 0000715330271 UYUNUR ROHMAH P PBI (APBN) Bursopathy, unspecified Berobat Jalan

453 22-10-2019 132613011019Y001223 0000715406106 SRI WAHYUNI P PBI (APBN) Influenza, virus not Berobat Jalan
identified
454 22-10-2019 132613011019Y001373 0000715413969 ISMAIL L PBI (APBN) Other specified Berobat Jalan
counselling
455 22-10-2019 132613011019Y001354 0000715417075 TASRIFAH P PBI (APBN) Essential (primary) Berobat Jalan
hypertension
456 22-10-2019 132613011019Y001462 0000715423386 ROMELAH P PBI (APBN) Non-insulin-dependent Berobat Jalan
diabetes mellitus
457 22-10-2019 132613011019Y001340 0000715549915 KHOLILA P PBI (APBN) Cough Berobat Jalan

458 22-10-2019 132613011019Y001698 0000715654113 SALIMA P PBI (APBN) Acute upper respiratory Berobat Jalan
infections of multiple and
unspecified sites
459 22-10-2019 132613011019Y001355 0000715732907 ABD ROHIM L PBI (APBN) Essential (primary) Berobat Jalan
hypertension
460 22-10-2019 132613011019Y001459 0000715746903 TUSA AMALIA P PBI (APBN) Other local infections of Berobat Jalan
skin and subcutaneous
tissue
461 22-10-2019 132613011019Y001700 0000715810779 AISA P PBI (APBN) Other headache Berobat Jalan
syndromes
462 22-10-2019 132613011019Y001607 0000715851966 ROHIMA P PBI (APBN) Bursopathy, unspecified Berobat Jalan

463 22-10-2019 132613011019Y001332 0000715876784 M. ZAINUDDIN L PBI (APBN) Acute upper respiratory Berobat Jalan
infections of multiple and
unspecified sites
464 22-10-2019 132613011019Y001334 0000715891882 MUNIB L PBI (APBN) Migraine Berobat Jalan
DAFTAR KUNJUNGAN PESERTA SAKIT

Kantor Cabang : PASURUAN - 1309

FKTP : Kejayan - 13261301

465 22-10-2019 132613011019Y001333 0000715896448 FATHUL IBAD L PBI (APBN) Fever of other and Berobat Jalan
unknown origin
466 22-10-2019 132613011019Y001444 0000715899789 SATUMAN L PBI (APBN) Fever of other and Berobat Jalan
unknown origin
467 22-10-2019 132613011019Y001342 0000715914617 M.FAUZI L PBI (APBN) Cough Berobat Jalan

468 22-10-2019 132613011019Y001335 0000715921007 FITRIAH NINGSIH P PBI (APBN) Cough Berobat Jalan

469 22-10-2019 132613011019Y001336 0000715976796 AHMAD L PBI (APBN) Other local infections of Berobat Jalan
skin and subcutaneous
tissue
470 22-10-2019 132613011019Y001338 0000716011479 KHOLIL L PBI (APBN) Gastritis and duodenitis Berobat Jalan

471 22-10-2019 132613011019Y001461 0000716077923 MAHMUDA L PBI (APBN) Non-insulin-dependent Berobat Jalan
diabetes mellitus
472 22-10-2019 132613011019Y001687 0000716079543 AMINAH P PBI (APBN) Other disorders of teeth Berobat Jalan
and supporting structures
473 22-10-2019 132613011019Y001359 0000716114338 M HOIRI L PBI (APBN) Observation for suspected Berobat Jalan
tuberculosis
474 22-10-2019 132613011019Y001382 0000716123632 MOHAMMAD KHAMZAH L PBI (APBN) Other viral infections Berobat Jalan
characterized by skin and
mucous membrane
lesions, not elsewhere
classified
475 22-10-2019 132613011019Y001383 0000716126152 ISLIN P PBI (APBN) Adverse effects in the Berobat Jalan
therapeutic use of oral
contraceptives
476 22-10-2019 132613011019Y001650 0000716322216 SUUDI L PBI (APBN) Fever of other and Berobat Jalan
unknown origin
477 22-10-2019 132613011019Y001581 0000716423163 SATIKA P PBI (APBN) Bursopathy, unspecified Berobat Jalan

478 22-10-2019 132613011019Y001606 0000716455967 HOIRIYAH P PBI (APBN) Bursopathy, unspecified Berobat Jalan

479 22-10-2019 132613011019Y001361 0000717554327 CHUSNIYAH P PBI (APBN) Essential (primary) Berobat Jalan
hypertension
480 22-10-2019 132613011019Y001154 0001042694572 TAJUL MUSLIMIN L PBI (APBN) Nausea and vomiting Berobat Jalan

481 22-10-2019 132613011019Y001385 0001042713292 SUMIATI P PBI (APBN) Other contraceptive Berobat Jalan
management
482 22-10-2019 132613011019Y001356 0001042716058 SOFIYAH P PBI (APBN) Other headache Berobat Jalan
syndromes
483 22-10-2019 132613011019Y001218 0001042719658 HUMAIYAH P PBI (APBN) Other disorders of muscle Berobat Jalan
DAFTAR KUNJUNGAN PESERTA SAKIT

Kantor Cabang : PASURUAN - 1309

FKTP : Kejayan - 13261301

484 22-10-2019 132613011019Y001219 0001042719985 MUKHAMMAD FERI MAULANA L PBI (APBN) Acute upper respiratory Berobat Jalan
infections of multiple and
unspecified sites
485 22-10-2019 132613011019Y001353 0001226975995 ALDILLAH AKBAR L PRAJURIT AL Influenza, virus not Berobat Jalan
identified
486 22-10-2019 132613011019Y001192 0001254342014 NUR ISNAINI P PEGAWAI SWASTA Supervision of normal Berobat Jalan
pregnancy
487 22-10-2019 132613011019Y001358 0001321623461 SAMSUL ARIS L PEGAWAI SWASTA Other headache Berobat Jalan
syndromes
488 22-10-2019 132613011019Y001341 0001701734196 NURUL HIDAYATI P PEGAWAI SWASTA Nausea and vomiting Berobat Jalan

489 22-10-2019 132613011019Y001348 0001704585644 ABDULLOH L PBI (APBD) Unspecified transport Berobat Jalan
accident
490 22-10-2019 132613011019Y001458 0001704586026 MUJAMMAH P PBI (APBD) Other headache Berobat Jalan
syndromes
491 22-10-2019 132613011019Y001460 0001775842378 SITI ASIYAH P PEGAWAI SWASTA Non-insulin-dependent Berobat Jalan
diabetes mellitus
492 22-10-2019 132613011019Y001172 0001820957343 LENY DAMAYANTI P PEGAWAI SWASTA Supervision of high-risk Rujuk Vertikal
pregnancy
493 22-10-2019 132613011019Y001169 0001960697428 YASKUR L PEKERJA MANDIRI Heart failure Rujuk Vertikal

494 22-10-2019 132613011019Y001374 0002001952563 RODEYAH P PBI (APBN) Other specified Berobat Jalan
counselling
495 22-10-2019 132613011019Y001337 0002075989105 MUHAMMAD ALFATIH L PEGAWAI SWASTA Fever of other and Berobat Jalan
unknown origin
496 22-10-2019 132613011019Y001168 0002203422715 SITI NUR ASIYAH P PEKERJA MANDIRI Other chest pain Rujuk Vertikal

497 22-10-2019 132613011019Y001152 0002252630474 ABD. MUGNI L PBI (APBD) Other rheumatoid arthritis Berobat Jalan

498 22-10-2019 132613011019Y001196 0002427656253 MUHAMMAD ALIF ALFIAN L PBI (APBN) Acute upper respiratory Berobat Jalan
infections of multiple and
unspecified sites
499 22-10-2019 132613011019Y001365 0002464059227 MUKHAMAD ALIF MAIMUN L PEKERJA MANDIRI Diarrhoea and Berobat Jalan
gastroenteritis of
presumed infectious origin

500 22-10-2019 132613011019Y001370 0002489464765 HARIRO P PEKERJA MANDIRI Essential (primary) Berobat Jalan
hypertension
501 22-10-2019 132613011019Y001352 0002597335424 MUSTOFA L PBI (APBN) Other dermatitis Berobat Jalan

502 22-10-2019 132613011019Y001175 0002609368659 ISMAIL L PBI (APBN) Hepatic fibrosis Rujuk Vertikal
DAFTAR KUNJUNGAN PESERTA SAKIT

Kantor Cabang : PASURUAN - 1309

FKTP : Kejayan - 13261301

503 22-10-2019 132613011019Y001174 0002622124541 HASIM L PEKERJA MANDIRI Urinary calculus, Rujuk Vertikal
unspecified
504 22-10-2019 132613011019Y001153 0002631387475 MUDAWAMAH P PBI (APBN) Other headache Berobat Jalan
syndromes
505 22-10-2019 132613011019Y001367 0002639694058 NURIL ILMIAH RIZKI P PBI (APBN) Gastritis and duodenitis Berobat Jalan
HIDAYULAH
506 22-10-2019 132613011019Y001178 0002767373313 CHOLIPAH P PEKERJA MANDIRI Other erythema multiforme Rujuk Vertikal

507 22-10-2019 132613011019Y001170 0002896238237 YULI KUSUMANENGSIH P PEKERJA MANDIRI Bronchopneumonia, Rujuk Vertikal
unspecified
508 21-10-2019 132613011019Y001092 0000114436168 YASHINTA MEITIARA LARASATI P PEKERJA MANDIRI Supervision of high-risk Rujuk Vertikal
pregnancy
509 21-10-2019 132613011019Y001649 0000714277326 HAMSIN L PBI (APBN) Gingivitis and periodontal Berobat Jalan
diseases
510 21-10-2019 132613011019Y001537 0000714414418 JUMROTI P PBI (APBN) Other disorders of muscle Berobat Jalan

511 21-10-2019 132613011019Y001538 0000714414611 ASPIA P PBI (APBN) Other headache Berobat Jalan
syndromes
512 21-10-2019 132613011019Y001321 0000714754686 AMENA P PBI (APBN) Heart failure Berobat Jalan

513 21-10-2019 132613011019Y001319 0000714783284 SULISTYOWATI P PBI (APBN) Other headache Berobat Jalan
syndromes
514 21-10-2019 132613011019Y001721 0000714813838 SAMSUDIN L PBI (APBN) Other headache Berobat Jalan
syndromes
515 21-10-2019 132613011019Y001372 0000714928544 JAZULI L PBI (APBN) Gastritis and duodenitis Berobat Jalan

516 21-10-2019 132613011019Y001095 0000714944327 SITI FAIDAH P PBI (APBN) Diarrhoea and Berobat Jalan
gastroenteritis of
presumed infectious origin

517 21-10-2019 132613011019Y001098 0000714955476 M RISQI L PBI (APBN) Other headache Berobat Jalan
syndromes
518 21-10-2019 132613011019Y001491 0000714963587 RUBAI`AH P PBI (APBN) Gingivitis and periodontal Berobat Jalan
diseases
519 21-10-2019 132613011019Y001366 0000715089295 AMINAH P PBI (APBN) Other disorders of muscle Berobat Jalan

520 21-10-2019 132613011019Y001369 0000715090252 SUDARI L PBI (APBN) Other headache Berobat Jalan
syndromes
521 21-10-2019 132613011019Y001323 0000715141787 MUZAKI L PBI (APBN) Other specified Berobat Jalan
counselling
522 21-10-2019 132613011019Y001067 0000715166627 M. SOHADI L PBI (APBN) Allergic contact dermatitis Berobat Jalan
DAFTAR KUNJUNGAN PESERTA SAKIT

Kantor Cabang : PASURUAN - 1309

FKTP : Kejayan - 13261301

523 21-10-2019 132613011019Y001540 0000715255536 HAMID L PBI (APBN) Other disorders of muscle Berobat Jalan

524 21-10-2019 132613011019Y001539 0000715256998 ASFIYAH P PBI (APBN) Other disorders of muscle Berobat Jalan

525 21-10-2019 132613011019Y001069 0000715382403 FARHAN HIDAYAT L PBI (APBN) Diarrhoea and Berobat Jalan
gastroenteritis of
presumed infectious origin

526 21-10-2019 132613011019Y001582 0000715431339 ABD.CHOLIK L PBI (APBN) Other specified Berobat Jalan
counselling
527 21-10-2019 132613011019Y001070 0000715432072 MUSRIFAH P PBI (APBN) Acute myocardial Rujuk Vertikal
infarction
528 21-10-2019 132613011019Y001214 0000715587557 ROMLAH P PBI (APBN) Non-insulin-dependent Berobat Jalan
diabetes mellitus
529 21-10-2019 132613011019Y001384 0000715637384 ROHIMA P PBI (APBN) Other headache Berobat Jalan
syndromes
530 21-10-2019 132613011019Y001718 0000715655068 SULASTRI P PBI (APBN) Acute pharyngitis Berobat Jalan

531 21-10-2019 132613011019Y001113 0000715674194 NURWATI P PBI (APBN) Other surgical follow-up Rujuk Vertikal
care
532 21-10-2019 132613011019Y001068 0000715731232 ANIK NURAINI P PBI (APBN) Influenza, virus not Berobat Jalan
identified
533 21-10-2019 132613011019Y001101 0000715745902 M. SULTON MAULANA L PBI (APBN) Stomatitis and related Berobat Jalan
lesions
534 21-10-2019 132613011019Y001103 0000715761606 NIKMATUL HASANAH P PBI (APBN) Acute upper respiratory Berobat Jalan
infections of multiple and
unspecified sites
535 21-10-2019 132613011019Y001265 0000715806202 NUR ROHMAN L PBI (APBN) Dental caries Berobat Jalan

536 21-10-2019 132613011019Y001441 0000715855746 DEWI MAISAROH P PBI (APBN) Other disorders of muscle Berobat Jalan

537 21-10-2019 132613011019Y001440 0000715877381 SARO P PBI (APBN) Other headache Berobat Jalan
syndromes
538 21-10-2019 132613011019Y001439 0000715884693 SUMIATI P PBI (APBN) Fever of other and Berobat Jalan
unknown origin
539 21-10-2019 132613011019Y001273 0000715886076 NAFISAH P PBI (APBN) Other local infections of Berobat Jalan
skin and subcutaneous
tissue
540 21-10-2019 132613011019Y001267 0000715906214 SIFAK NUR ROHMAN L PBI (APBN) Other headache Berobat Jalan
syndromes
541 21-10-2019 132613011019Y001269 0000715929412 SAPI'I L PBI (APBN) Migraine Berobat Jalan
DAFTAR KUNJUNGAN PESERTA SAKIT

Kantor Cabang : PASURUAN - 1309

FKTP : Kejayan - 13261301

542 21-10-2019 132613011019Y001648 0000715941584 SAUDA P PBI (APBN) Fever of other and Berobat Jalan
unknown origin
543 21-10-2019 132613011019Y001371 0000715967177 ABD.SOMAT L PBI (APBN) Other viral infections Berobat Jalan
characterized by skin and
mucous membrane
lesions, not elsewhere
classified
544 21-10-2019 132613011019Y001647 0000715967493 HUMAIYAH P PBI (APBN) Other disorders of muscle Berobat Jalan

545 21-10-2019 132613011019Y001442 0000715975334 NURUL HIDAYAH P PBI (APBN) Other headache Berobat Jalan
syndromes
546 21-10-2019 132613011019Y001270 0000715979248 NURAFIDA P PBI (APBN) Gastritis and duodenitis Berobat Jalan

547 21-10-2019 132613011019Y001275 0000715990386 SAODAH P PBI (APBN) Other headache Berobat Jalan
syndromes
548 21-10-2019 132613011019Y001271 0000715993604 CHASANI L PBI (APBN) Migraine Berobat Jalan

549 21-10-2019 132613011019Y001272 0000715994212 HOMSI P PBI (APBN) Fever of other and Berobat Jalan
unknown origin
550 21-10-2019 132613011019Y001274 0000715996359 SUHAN L PBI (APBN) Dental caries Berobat Jalan

551 21-10-2019 132613011019Y001266 0000716035004 SAPRAWI L PBI (APBN) Cough Berobat Jalan

552 21-10-2019 132613011019Y001287 0000716121011 SOFIAH P PBI (APBN) Conjunctivitis Berobat Jalan

553 21-10-2019 132613011019Y001320 0000716133958 SUGIANTO L PBI (APBN) Myalgia Berobat Jalan

554 21-10-2019 132613011019Y001380 0000716276619 SAPI AH P PBI (APBN) Other headache Berobat Jalan
syndromes
555 21-10-2019 132613011019Y001387 0000716402531 FATHULLOH L PBI (APBN) Bursopathy, unspecified Berobat Jalan

556 21-10-2019 132613011019Y001299 0000716415568 HOTIJAH P PBI (APBN) Other disorders of muscle Berobat Jalan

557 21-10-2019 132613011019Y001312 0000716417133 LULUK KARIMAH P PBI (APBN) Acute upper respiratory Berobat Jalan
infections of multiple and
unspecified sites
558 21-10-2019 132613011019Y001315 0000717669145 NISWATIN KHASANAH P PBI (APBN) Gingivitis and periodontal Berobat Jalan
diseases
559 21-10-2019 132613011019Y001720 0001042685021 MUSLIMAH P PBI (APBN) Gastritis and duodenitis Berobat Jalan

560 21-10-2019 132613011019Y001717 0001042685043 SAUDAH P PBI (APBN) Other headache Berobat Jalan
syndromes
561 21-10-2019 132613011019Y001719 0001042686224 AHMAD FAUZI L PBI (APBN) Urticaria Berobat Jalan

562 21-10-2019 132613011019Y001301 0001042686336 B. MUSLIHA P PBI (APBN) Essential (primary) Berobat Jalan
hypertension
DAFTAR KUNJUNGAN PESERTA SAKIT

Kantor Cabang : PASURUAN - 1309

FKTP : Kejayan - 13261301

563 21-10-2019 132613011019Y001066 0001042696585 ROBI ATUN P PBI (APBN) Other headache Berobat Jalan
syndromes
564 21-10-2019 132613011019Y001583 0001042702953 MALIKHA P PBI (APBN) Other specified Berobat Jalan
counselling
565 21-10-2019 132613011019Y001376 0001042713189 ANSORI . L PBI (APBN) Malaise and fatigue Berobat Jalan

566 21-10-2019 132613011019Y001375 0001042713393 RUPIAH P PBI (APBN) Other disorders of muscle Berobat Jalan

567 21-10-2019 132613011019Y001107 0001042719333 HENI ANISAH P PBI (APBN) Fever of other and Berobat Jalan
unknown origin
568 21-10-2019 132613011019Y001109 0001042719344 MUHAMMAD REYHAN L PBI (APBN) Acute upper respiratory Berobat Jalan
FITANZILIL FURQON infections of multiple and
unspecified sites
569 21-10-2019 132613011019Y001115 0001042719693 SUTRISMIATIK P PBI (APBN) Other headache Berobat Jalan
syndromes
570 21-10-2019 132613011019Y001112 0001042720119 SOLICHATI P PBI (APBN) Other disorders of muscle Berobat Jalan

571 21-10-2019 132613011019Y001072 0001043033433 ILYAS L PBI (APBN) Hyperplasia of prostate Rujuk Vertikal

572 21-10-2019 132613011019Y001300 0001043033444 SAIDA P PBI (APBN) Observation for suspected Berobat Jalan
tuberculosis
573 21-10-2019 132613011019Y001215 0001308927598 IMAM ARIF RUDIANTO L PEGAWAI SWASTA Non-insulin-dependent Berobat Jalan
diabetes mellitus
574 21-10-2019 132613011019Y001303 0001704586217 SOLIKHATI P PBI (APBD) Influenza, virus not Berobat Jalan
identified
575 21-10-2019 132613011019Y001076 0001820956318 MUHAMMAD TAUFIQ HIDAYAT L PEGAWAI SWASTA Gastro-oesophageal reflux Rujuk Vertikal
disease
576 21-10-2019 132613011019Y001304 0002001951764 MOKHAMMAD IKROM L PBI (APBN) Typhoid and paratyphoid Berobat Jalan
fevers
577 21-10-2019 132613011019Y001325 0002001952563 RODEYAH P PBI (APBN) Other specified Berobat Jalan
counselling
578 21-10-2019 132613011019Y001318 0002001958795 SITI RUKOYAH P PBI (APBN) Gingivitis and periodontal Berobat Jalan
diseases
579 21-10-2019 132613011019Y001309 0002161097425 MUSTAIN L PBI (APBD) Observation for suspected Berobat Jalan
tuberculosis
580 21-10-2019 132613011019Y001306 0002161100531 SUNIA P PBI (APBD) Acute upper respiratory Berobat Jalan
infections of multiple and
unspecified sites
581 21-10-2019 132613011019Y001322 0002217291208 MUKHAMAD AREZA RIZKI L PEGAWAI PEMERINTAH Impacted cerumen Berobat Jalan
DENGAN PERJANJIAN
KERJA
DAFTAR KUNJUNGAN PESERTA SAKIT

Kantor Cabang : PASURUAN - 1309

FKTP : Kejayan - 13261301

582 21-10-2019 132613011019Y001584 0002236920952 LATIFATUL BARIROH P PEGAWAI SWASTA Other specified Berobat Jalan
counselling
583 21-10-2019 132613011019Y001065 0002237938468 CANTICA SANDI AULIA L PEKERJA MANDIRI Fever of other and Berobat Jalan
unknown origin
584 21-10-2019 132613011019Y001308 0002289694724 BASOR WAHID L PEKERJA MANDIRI Myalgia Berobat Jalan

585 21-10-2019 132613011019Y001111 0002308587996 KARTOMO L PEKERJA MANDIRI Other surgical follow-up Rujuk Vertikal
care
586 21-10-2019 132613011019Y001080 0002470167156 MOH. LUKMAN CH L PEKERJA MANDIRI Glaucoma Rujuk Vertikal

587 21-10-2019 132613011019Y001324 0002475076004 MUKHAMAD ANDRIAN L PEGAWAI SWASTA Other specified Berobat Jalan
SABILILLA counselling
588 21-10-2019 132613011019Y001071 0002494558326 SITI ROHMA P PNS DAERAH Calculus of kidney and Rujuk Vertikal
ureter
589 21-10-2019 132613011019Y001314 0002499822191 ZAINUDDIN L PEKERJA MANDIRI Respiratory tuberculosis, Berobat Jalan
bacteriologically and
histologically confirmed
590 21-10-2019 132613011019Y001316 0002584395549 SYELA RIZKIYAH P PBI (APBN) Acute upper respiratory Berobat Jalan
infections of multiple and
unspecified sites
591 21-10-2019 132613011019Y001124 0002747417433 MIRZA ARDIL WAFA L PBI (APBN) Acute nasopharyngitis Berobat Jalan
[common cold]
592 21-10-2019 132613011019Y001123 0002885018657 LULUK FARIDAH P PBI (APBD) Supervision of normal Berobat Jalan
pregnancy
593 19-10-2019 132613011019Y001242 0000103345593 HAMDANI L PENERIMA PENSIUN Acute upper respiratory Berobat Jalan
PNS infections of multiple and
unspecified sites
594 19-10-2019 132613011019Y000981 0000112867086 IRIYANTO.SH L PNS DAERAH Calculus of kidney and Rujuk Vertikal
ureter
595 19-10-2019 132613011019Y001256 0000713604328 KHOLIFAH P PBI (APBN) Essential (primary) Berobat Jalan
hypertension
596 19-10-2019 132613011019Y000952 0000714701709 JAMILAH P PBI (APBN) Other rheumatoid arthritis Berobat Jalan

597 19-10-2019 132613011019Y000945 0000714810341 QUNITATUL KHOIRO L PBI (APBN) Other headache Berobat Jalan
syndromes
598 19-10-2019 132613011019Y001489 0000714950469 ALFIYAH P PBI (APBN) Fever of other and Berobat Jalan
unknown origin
599 19-10-2019 132613011019Y000990 0000715226196 BAWON MULIYANI P PBI (APBN) Other specified Berobat Jalan
counselling
600 19-10-2019 132613011019Y001535 0000715259158 MUHALI L PBI (APBN) Other disorders of muscle Berobat Jalan
DAFTAR KUNJUNGAN PESERTA SAKIT

Kantor Cabang : PASURUAN - 1309

FKTP : Kejayan - 13261301

601 19-10-2019 132613011019Y001536 0000715284088 M.JUHARI L PBI (APBN) Other headache Berobat Jalan
syndromes
602 19-10-2019 132613011019Y000965 0000715411192 BADREYAH P PBI (APBN) Other disorders of muscle Berobat Jalan

603 19-10-2019 132613011019Y001247 0000715435492 RAGIL FAJAR PANGESTU L PBI (APBN) Other local infections of Berobat Jalan
skin and subcutaneous
tissue
604 19-10-2019 132613011019Y001212 0000715459342 JULAIHA P PBI (APBN) Non-insulin-dependent Berobat Jalan
diabetes mellitus
605 19-10-2019 132613011019Y001241 0000715484867 ENIK NUR HAYATI P PBI (APBN) Insulin-dependent Berobat Jalan
diabetes mellitus
606 19-10-2019 132613011019Y000954 0000715491472 HOLIPAH P PBI (APBN) Schizophrenia Rujuk Vertikal

607 19-10-2019 132613011019Y001043 0000715604139 DALAIL L PBI (APBN) Fever of other and Berobat Jalan
unknown origin
608 19-10-2019 132613011019Y001213 0000715632254 SUMIATI P PBI (APBN) Non-insulin-dependent Berobat Jalan
diabetes mellitus
609 19-10-2019 132613011019Y000947 0000715759301 BASTIYA P PBI (APBN) Other rheumatoid arthritis Berobat Jalan

610 19-10-2019 132613011019Y000950 0000715760785 JUMAIYA P PBI (APBN) Other rheumatoid arthritis Berobat Jalan

611 19-10-2019 132613011019Y000967 0000715780945 ABD.QODIR L PBI (APBN) Other dermatitis Berobat Jalan

612 19-10-2019 132613011019Y001282 0000715845238 LULUK ANDRAENI P PBI (APBN) Other specified Berobat Jalan
counselling
613 19-10-2019 132613011019Y001064 0000715901275 HALIMIN L PBI (APBN) Other headache Berobat Jalan
syndromes
614 19-10-2019 132613011019Y001046 0000715901692 HOLILI L PBI (APBN) Gingivitis and periodontal Berobat Jalan
diseases
615 19-10-2019 132613011019Y001243 0000715924798 NURUL HABIBAH P PBI (APBN) Acute upper respiratory Berobat Jalan
infections of multiple and
unspecified sites
616 19-10-2019 132613011019Y001082 0000715925439 ZAINURI L PBI (APBN) Cough Berobat Jalan

617 19-10-2019 132613011019Y001041 0000715940278 JUMA'ATIN P PBI (APBN) Other headache Berobat Jalan
syndromes
618 19-10-2019 132613011019Y001044 0000715954961 MALI L PBI (APBN) Stomatitis and related Berobat Jalan
lesions
619 19-10-2019 132613011019Y001040 0000715963983 SAFIYULLOH L PBI (APBN) Fever of other and Berobat Jalan
unknown origin
620 19-10-2019 132613011019Y001039 0000715964938 PIANA P PBI (APBN) Other headache Berobat Jalan
syndromes
DAFTAR KUNJUNGAN PESERTA SAKIT

Kantor Cabang : PASURUAN - 1309

FKTP : Kejayan - 13261301

621 19-10-2019 132613011019Y001042 0000715965006 M. SUADI L PBI (APBN) Other headache Berobat Jalan
syndromes
622 19-10-2019 132613011019Y001081 0000715969124 KHOTIJAH P PBI (APBN) Acute upper respiratory Berobat Jalan
infections of multiple and
unspecified sites
623 19-10-2019 132613011019Y001363 0000716034598 SITI HAMIDAH P PBI (APBN) Other contraceptive Berobat Jalan
management
624 19-10-2019 132613011019Y001362 0000716047839 ALFIYAH P PBI (APBN) Medical observation and Berobat Jalan
evaluation for suspected
diseases and conditions
625 19-10-2019 132613011019Y001364 0000716122067 RIFAT FUANDI L PBI (APBN) Medical observation and Berobat Jalan
evaluation for suspected
diseases and conditions
626 19-10-2019 132613011019Y001253 0001042681195 SEDEK L PBI (APBN) Influenza, virus not Berobat Jalan
identified
627 19-10-2019 132613011019Y000949 0001042694493 M. ARDIAN JANUAR L PBI (APBN) Influenza, virus not Berobat Jalan
identified
628 19-10-2019 132613011019Y001045 0001042699893 WASIA P PBI (APBN) Gastritis and duodenitis Berobat Jalan

629 19-10-2019 132613011019Y001590 0001042699904 FITRIYA DAMAYANTI P PBI (APBN) Fever of other and Berobat Jalan
unknown origin
630 19-10-2019 132613011019Y001083 0001042703098 LULUK P PBI (APBN) Gastritis and duodenitis Berobat Jalan

631 19-10-2019 132613011019Y001063 0001042710017 ALVI MIRZA SALSABILA P PBI (APBN) Acute upper respiratory Berobat Jalan
infections of multiple and
unspecified sites
632 19-10-2019 132613011019Y001062 0001042710557 IRMAWATI P PBI (APBN) Fever of other and Berobat Jalan
unknown origin
633 19-10-2019 132613011019Y000966 0001042719254 KARIM L PBI (APBN) Other headache Berobat Jalan
syndromes
634 19-10-2019 132613011019Y001283 0001080518242 M.ANDHIKA YUDA L PNS DAERAH Other specified Berobat Jalan
ARDIANSYAH counselling
635 19-10-2019 132613011019Y001261 0001189473592 ARIANTI P PEGAWAI SWASTA Influenza, virus not Berobat Jalan
identified
636 19-10-2019 132613011019Y001259 0001292669144 HILALIYAH P PEKERJA MANDIRI Fever of other and Berobat Jalan
unknown origin
637 19-10-2019 132613011019Y001244 0001479302537 ROBIATUL ADAWIYAH P PEGAWAI SWASTA Acute upper respiratory Berobat Jalan
infections of multiple and
unspecified sites
638 19-10-2019 132613011019Y001245 0001887586413 HUSNUL KHOTIMAH P PNS DAERAH Influenza, virus not Berobat Jalan
identified
DAFTAR KUNJUNGAN PESERTA SAKIT

Kantor Cabang : PASURUAN - 1309

FKTP : Kejayan - 13261301

639 19-10-2019 132613011019Y001246 0001887586986 HABILA PURNAMA PUTRI L PNS DAERAH Acute nasopharyngitis Berobat Jalan
[common cold]
640 19-10-2019 132613011019Y000955 0002001951821 FATMAWATI P PBI (APBN) Supervision of high-risk Rujuk Vertikal
pregnancy
641 19-10-2019 132613011019Y001254 0002161097425 MUSTAIN L PBI (APBD) Influenza, virus not Berobat Jalan
identified
642 19-10-2019 132613011019Y001284 0002217291208 MUKHAMAD AREZA RIZKI L PEGAWAI PEMERINTAH Other specified Berobat Jalan
DENGAN PERJANJIAN counselling
KERJA
643 19-10-2019 132613011019Y000968 0002246429002 TRI WULANDARI P PEGAWAI SWASTA Acute upper respiratory Berobat Jalan
infections of multiple and
unspecified sites
644 19-10-2019 132613011019Y000988 0002271202211 ACH CHASBY WA KAFA L PEGAWAI SWASTA Acute upper respiratory Berobat Jalan
ROCHMATULLOH infections of multiple and
unspecified sites
645 19-10-2019 132613011019Y000992 0002301136637 ADAM FARUQ SAUQILLAH L PBI (APBN) Other dermatitis Berobat Jalan

646 19-10-2019 132613011019Y001285 0002303816084 DJUWARIYAH P PEKERJA MANDIRI Other specified Berobat Jalan
counselling
647 19-10-2019 132613011019Y000951 0002478544053 M.PANDU KURNIA RAMADHAN L PEKERJA MANDIRI Fever of other and Berobat Jalan
unknown origin
648 19-10-2019 132613011019Y000956 0002584116551 MICHAILA HIDAYAH P PBI (APBN) Paratyphoid fever, Rujuk Vertikal
unspecified
649 19-10-2019 132613011019Y001257 0002584595463 ROBIATUL MUTAMIMAH P PBI (APBN) Other disorders of muscle Berobat Jalan

650 19-10-2019 132613011019Y000958 0002891921591 IKA NURAINI SAFITRI P PBI (APBD) Benign neoplasm of breast Rujuk Vertikal

651 18-10-2019 132613011019P001592 0000062050961 NGAPINI P PNS DAERAH Essential (primary) Berobat Jalan Hipertensi
hypertension
652 18-10-2019 132613011019Y001211 0000097180031 NURUL HAYATI P PENERIMA PENSIUN Non-insulin-dependent Berobat Jalan
PNS diabetes mellitus
653 18-10-2019 132613011019P001631 0000112592046 SUBIYANTO L PENERIMA PENSIUN Essential (primary) Berobat Jalan Hipertensi
PNS hypertension
654 18-10-2019 132613011019P001423 0000112592564 SRI WIDAJATI P PENERIMA PENSIUN Non-insulin-dependent Berobat Jalan Diabetes
PNS diabetes mellitus Mellitus
655 18-10-2019 132613011019P001589 0000112592744 sudjak al sudjak harianto L PNS DAERAH Essential (primary) Berobat Jalan Hipertensi
hypertension
656 18-10-2019 132613011019Y000914 0000112640758 SITI PONINTEN P PNS DAERAH Gastritis and duodenitis Berobat Jalan

657 18-10-2019 132613011019P001593 0000112706471 M.ANAS L PENERIMA PENSIUN Essential (primary) Berobat Jalan Hipertensi
PNS hypertension
DAFTAR KUNJUNGAN PESERTA SAKIT

Kantor Cabang : PASURUAN - 1309

FKTP : Kejayan - 13261301

658 18-10-2019 132613011019P001594 0000112706482 PUDJIATI P PENERIMA PENSIUN Essential (primary) Berobat Jalan Hipertensi
PNS hypertension
659 18-10-2019 132613011019P001588 0000112735203 SRI MARTARIANI P PNS DAERAH Essential (primary) Berobat Jalan Hipertensi
hypertension
660 18-10-2019 132613011019Y001018 0000112767467 SLAMET PRIYANTO L PNS DAERAH Dental caries Berobat Jalan

661 18-10-2019 132613011019P001632 0000112779459 YAYUK INDRA ISWATI P PENERIMA PENSIUN Essential (primary) Berobat Jalan Hipertensi
PNS hypertension
662 18-10-2019 132613011019P001635 0000112796109 SRI RAHAYU P PNS DAERAH Essential (primary) Berobat Jalan Hipertensi
hypertension
663 18-10-2019 132613011019P001437 0000112853259 MOH. ARIYONO L PNS DAERAH Non-insulin-dependent Berobat Jalan Diabetes
diabetes mellitus Mellitus
664 18-10-2019 132613011019P001637 0000112853294 H.MUKHAMAD BUSRO L PNS DAERAH Essential (primary) Berobat Jalan Hipertensi
hypertension
665 18-10-2019 132613011019P001596 0000112853384 NURHAYATI P PNS DAERAH Essential (primary) Berobat Jalan Hipertensi
hypertension
666 18-10-2019 132613011019P001636 0000112853654 SURATNA P PNS DAERAH Essential (primary) Berobat Jalan Hipertensi
hypertension
667 18-10-2019 132613011019P001595 0000112867694 RINA ANJARWATI P PNS DAERAH Essential (primary) Berobat Jalan Hipertensi
hypertension
668 18-10-2019 132613011019P001625 0000112868414 YUNI ASTUTI P PNS DAERAH Essential (primary) Berobat Jalan Hipertensi
hypertension
669 18-10-2019 132613011019P001434 0000112868425 MOCH. RIFAI L PNS DAERAH Non-insulin-dependent Berobat Jalan Diabetes
diabetes mellitus Mellitus
670 18-10-2019 132613011019P001591 0000112902366 SAMSUDI L PENERIMA PENSIUN Essential (primary) Berobat Jalan Hipertensi
PNS hypertension
671 18-10-2019 132613011019P001424 0000112902996 SUBANDI L PENERIMA PENSIUN Non-insulin-dependent Berobat Jalan Diabetes
PNS diabetes mellitus Mellitus
672 18-10-2019 132613011019P001426 0000112903525 WAHYUDI L PENERIMA PENSIUN Non-insulin-dependent Berobat Jalan Diabetes
PNS diabetes mellitus Mellitus
Hipertensi
673 18-10-2019 132613011019P001436 0000112949684 AMIN L PENERIMA PENSIUN Non-insulin-dependent Berobat Jalan Diabetes
PNS diabetes mellitus Mellitus
Hipertensi
674 18-10-2019 132613011019P001638 0000112949684 AMIN L PENERIMA PENSIUN Essential (primary) Berobat Jalan Diabetes
PNS hypertension Mellitus
Hipertensi
675 18-10-2019 132613011019Y000927 0000112988463 ALIF INDRALISTYARINI P PNS DAERAH Insulin-dependent Rujuk Vertikal
diabetes mellitus with
unspecified complications
DAFTAR KUNJUNGAN PESERTA SAKIT

Kantor Cabang : PASURUAN - 1309

FKTP : Kejayan - 13261301

676 18-10-2019 132613011019P001435 0000112999926 MURSINEM P PNS DAERAH Non-insulin-dependent Berobat Jalan Diabetes
diabetes mellitus Mellitus
677 18-10-2019 132613011019Y000939 0000113239552 BAYU SAJIDAN L PENERIMA PENSIUN Acute upper respiratory Berobat Jalan
PNS infections of multiple and
unspecified sites
678 18-10-2019 132613011019P001630 0000147881272 AKHMAD RIFA'I L PNS DAERAH Essential (primary) Berobat Jalan Hipertensi
hypertension
679 18-10-2019 132613011019P001430 0000156767409 MOCH FADHOLI L PENERIMA PENSIUN Non-insulin-dependent Berobat Jalan Diabetes
PNS diabetes mellitus Mellitus
680 18-10-2019 132613011019P001427 0000168038684 JUBAEDAH P PNS DAERAH Non-insulin-dependent Berobat Jalan Diabetes
diabetes mellitus Mellitus
Hipertensi
681 18-10-2019 132613011019P001425 0000170087837 DJUWARIYAH P PENERIMA PENSIUN Non-insulin-dependent Berobat Jalan Diabetes
PNS diabetes mellitus Mellitus
682 18-10-2019 132613011019P001639 0000170088491 WIJI ROH UTAMI P PENERIMA PENSIUN Essential (primary) Berobat Jalan
PNS hypertension
683 18-10-2019 132613011019P001432 0000170094341 TAYUMI P PNS DAERAH Non-insulin-dependent Berobat Jalan Diabetes
diabetes mellitus Mellitus
684 18-10-2019 132613011019P001431 0000205896036 MOCHAMAD SYAFI'I L PENERIMA PENSIUN TNI Non-insulin-dependent Berobat Jalan Diabetes
diabetes mellitus Mellitus
685 18-10-2019 132613011019P001629 0000205896148 SRI SUKAYATI P PENERIMA PENSIUN TNI Essential (primary) Berobat Jalan Hipertensi
hypertension
686 18-10-2019 132613011019Y001036 0000714249821 HUMAIYA P PBI (APBN) Conjunctivitis Berobat Jalan

687 18-10-2019 132613011019Y001031 0000714252284 CAHYONO IKHWANU MUSLIMIN L PBI (APBN) Other headache Berobat Jalan
syndromes
688 18-10-2019 132613011019Y000913 0000714763179 ATIKA SHOLICHAH P PBI (APBN) Other headache Berobat Jalan
syndromes
689 18-10-2019 132613011019Y000908 0000714789088 SANE'AH P PBI (APBN) Other specified diabetes Rujuk Vertikal
mellitus with unspecified
complications
690 18-10-2019 132613011019Y001093 0000714942404 MUHAMAD HASANI L PBI (APBN) Other headache Berobat Jalan
syndromes
691 18-10-2019 132613011019Y001488 0000714948276 NUR AINI P PBI (APBN) Fever of other and Berobat Jalan
unknown origin
692 18-10-2019 132613011019Y001487 0000714951595 MUZDALIFA P PBI (APBN) Gastritis and duodenitis Berobat Jalan

693 18-10-2019 132613011019Y001350 0000715086123 SATINI P PBI (APBN) Malaise and fatigue Berobat Jalan

694 18-10-2019 132613011019Y001351 0000715086358 MOCH. SYAHRUDDIN L PBI (APBN) Symptoms and signs Berobat Jalan
concerning food and fluid
intake
DAFTAR KUNJUNGAN PESERTA SAKIT

Kantor Cabang : PASURUAN - 1309

FKTP : Kejayan - 13261301

695 18-10-2019 132613011019Y001239 0000715094864 SAIFUL L PBI (APBN) Other specified Berobat Jalan
counselling
696 18-10-2019 132613011019Y001228 0000715160147 AISAH P PBI (APBN) Other headache Berobat Jalan
syndromes
697 18-10-2019 132613011019Y000943 0000715165694 ANSORI L PBI (APBN) Necrosis of pulp Berobat Jalan

698 18-10-2019 132613011019Y001226 0000715165762 LEGIANI P PBI (APBN) Myalgia Berobat Jalan

699 18-10-2019 132613011019P001627 0000715247684 ARIYA P PBI (APBN) Essential (primary) Berobat Jalan Diabetes
hypertension Mellitus
700 18-10-2019 132613011019Y001533 0000715290096 ISMAIL L PBI (APBN) Other disorders of muscle Berobat Jalan

701 18-10-2019 132613011019Y001534 0000715290197 MUSIAH P PBI (APBN) Other disorders of muscle Berobat Jalan

702 18-10-2019 132613011019Y000938 0000715297195 LASIANAH P PBI (APBN) Other headache Berobat Jalan
syndromes
703 18-10-2019 132613011019Y000898 0000715432994 JUMROTIN NAJIYA P PBI (APBN) Other disorders of muscle Berobat Jalan

704 18-10-2019 132613011019Y001224 0000715479603 JAELANI L PBI (APBN) Myalgia Berobat Jalan

705 18-10-2019 132613011019Y001210 0000715769212 HUSNUL CHOTIMAH P PBI (APBN) Non-insulin-dependent Berobat Jalan
diabetes mellitus
706 18-10-2019 132613011019Y001035 0000715785579 NISWATI P PBI (APBN) Other headache Berobat Jalan
syndromes
707 18-10-2019 132613011019Y001236 0000715785906 ROBI`AH P PBI (APBN) Diarrhoea and Berobat Jalan
gastroenteritis of
presumed infectious origin

708 18-10-2019 132613011019Y001032 0000715853608 SITI ROHMA P PBI (APBN) Acute upper respiratory Berobat Jalan
infections of multiple and
unspecified sites
709 18-10-2019 132613011019Y000941 0000715858042 UYUN CHOTIMAH P PBI (APBN) Other headache Berobat Jalan
syndromes
710 18-10-2019 132613011019Y000940 0000715859684 M.FAUZI ALI L PEGAWAI SWASTA Allergic contact dermatitis Berobat Jalan

711 18-10-2019 132613011019Y001034 0000715876143 HIKMATUR ROHIMAH P PBI (APBN) Other headache Berobat Jalan
syndromes
712 18-10-2019 132613011019Y001033 0000715876751 SULIHANA P PBI (APBN) Fever of other and Berobat Jalan
unknown origin
713 18-10-2019 132613011019Y001025 0000715921108 SALAMAN L PBI (APBN) Dental caries Berobat Jalan

714 18-10-2019 132613011019Y001038 0000715939547 MUSTOFA L PBI (APBN) Other disorders of muscle Berobat Jalan

715 18-10-2019 132613011019Y001565 0000715951451 RUDI SUKARTONO L PBI (APBN) Fever of other and Berobat Jalan
unknown origin
DAFTAR KUNJUNGAN PESERTA SAKIT

Kantor Cabang : PASURUAN - 1309

FKTP : Kejayan - 13261301

716 18-10-2019 132613011019Y001037 0000715963061 SUBADAR L PBI (APBN) Gastritis and duodenitis Berobat Jalan

717 18-10-2019 132613011019Y001023 0000715995911 SANATIN P PBI (APBN) Diarrhoea and Berobat Jalan
gastroenteritis of
presumed infectious origin

718 18-10-2019 132613011019Y001360 0000716076797 LAILATUL MUBAROKAH P PBI (APBN) Acute upper respiratory Berobat Jalan
infections of multiple and
unspecified sites
719 18-10-2019 132613011019Y001015 0000716104517 M. SUEB L PBI (APBN) Cough Berobat Jalan

720 18-10-2019 132613011019Y001017 0000716133958 SUGIANTO L PBI (APBN) Other local infections of Berobat Jalan
skin and subcutaneous
tissue
721 18-10-2019 132613011019Y001229 0000716425751 SITI ASIYAH P PBI (APBN) Myalgia Berobat Jalan

722 18-10-2019 132613011019Y001024 0000716459938 SYAFII L PBI (APBN) Cough Berobat Jalan

723 18-10-2019 132613011019Y000935 0001042700343 SRI NINGSIH P PBI (APBN) Supervision of normal Berobat Jalan
pregnancy
724 18-10-2019 132613011019Y000932 0001042702918 SA`ID L PBI (APBN) Insulin-dependent Rujuk Vertikal
diabetes mellitus with
multiple complications
725 18-10-2019 132613011019Y001357 0001042714361 HOLIFA P PBI (APBN) Dysphagia Berobat Jalan

726 18-10-2019 132613011019Y000937 0001042718938 LAILA NUR CHABIBA P PBI (APBN) Influenza, virus not Berobat Jalan
identified
727 18-10-2019 132613011019Y001129 0001042719298 MASLUKHA. P PBI (APBN) Other disorders of muscle Berobat Jalan

728 18-10-2019 132613011019P001624 0001080666685 SOEPARTI P PENERIMA PENSIUN TNI Essential (primary) Berobat Jalan Hipertensi
hypertension
729 18-10-2019 132613011019Y001240 0001147553245 ROKHIM L PEGAWAI SWASTA Other specified Berobat Jalan
counselling
730 18-10-2019 132613011019P001429 0001320065223 SOFEYAH P PNS DAERAH Non-insulin-dependent Berobat Jalan Diabetes
diabetes mellitus Mellitus
731 18-10-2019 132613011019P001642 0001406734683 WARTIYAH P PEKERJA MANDIRI Essential (primary) Berobat Jalan Hipertensi
hypertension
732 18-10-2019 132613011019Y000931 0001426830704 wiwik widayati P PEKERJA MANDIRI Ankylosing spondylitis, Rujuk Vertikal Hipertensi
multiple sites in spine
733 18-10-2019 132613011019Y001232 0001452490773 SITI FATIMAH P PEGAWAI SWASTA Acute upper respiratory Berobat Jalan
infections of multiple and
unspecified sites
DAFTAR KUNJUNGAN PESERTA SAKIT

Kantor Cabang : PASURUAN - 1309

FKTP : Kejayan - 13261301

734 18-10-2019 132613011019Y001235 0001452491605 ALFIN MASYKUR L PEGAWAI SWASTA Acute upper respiratory Berobat Jalan
infections of multiple and
unspecified sites
735 18-10-2019 132613011019P001438 0001452584294 HOTIJAH P PBI (APBD) Non-insulin-dependent Berobat Jalan Diabetes
diabetes mellitus Mellitus
736 18-10-2019 132613011019P001428 0001704586149 SAROHA P PBI (APBD) Non-insulin-dependent Berobat Jalan Diabetes
diabetes mellitus Mellitus
Hipertensi
737 18-10-2019 132613011019P001433 0001799393861 RODEYYAH P PEGAWAI SWASTA Non-insulin-dependent Berobat Jalan Diabetes
diabetes mellitus Mellitus
738 18-10-2019 132613011019Y001128 0001870647963 MUKHAMAD ABDUL QODIR L PEKERJA MANDIRI Other disorders of muscle Berobat Jalan

739 18-10-2019 132613011019Y000912 0001882398824 SANATI P PEKERJA MANDIRI Influenza, virus not Berobat Jalan
identified
740 18-10-2019 132613011019P001641 0001890059499 MUSLIMAH P PEKERJA MANDIRI Essential (primary) Berobat Jalan Hipertensi
hypertension
741 18-10-2019 132613011019P001626 0001905677897 HJ NURHAYATI P PEKERJA MANDIRI Essential (primary) Berobat Jalan Hipertensi
hypertension
742 18-10-2019 132613011019P001628 0002001951268 ROFI`AH P PBI (APBN) Essential (primary) Berobat Jalan
hypertension
743 18-10-2019 132613011019P001643 0002001951292 SUHARTI P PBI (APBN) Essential (primary) Berobat Jalan Diabetes
hypertension Mellitus
744 18-10-2019 132613011019Y001127 0002001951303 SUMARDI L PBI (APBN) Essential (primary) Berobat Jalan
hypertension
745 18-10-2019 132613011019Y001580 0002001951764 MOKHAMMAD IKROM L PBI (APBN) Other specified Berobat Jalan
counselling
746 18-10-2019 132613011019Y000918 0002001951821 FATMAWATI P PBI (APBN) Supervision of high-risk Berobat Jalan
pregnancy
747 18-10-2019 132613011019P001602 0002067650122 SUMILA P PEKERJA MANDIRI Essential (primary) Berobat Jalan Hipertensi
hypertension
748 18-10-2019 132613011019P001633 0002087573938 solikha P PEKERJA MANDIRI Essential (primary) Berobat Jalan Hipertensi
hypertension
749 18-10-2019 132613011019Y000936 0002087573938 solikha P PEKERJA MANDIRI Other specified Berobat Jalan Hipertensi
counselling
750 18-10-2019 132613011019P001634 0002211220023 SARIYYA P PEKERJA MANDIRI Essential (primary) Berobat Jalan Hipertensi
hypertension
751 18-10-2019 132613011019Y000928 0002227696828 SATRYA MAHADIRA ADI L PEGAWAI SWASTA Glaucoma Rujuk Vertikal
RANGGA
DAFTAR KUNJUNGAN PESERTA SAKIT

Kantor Cabang : PASURUAN - 1309

FKTP : Kejayan - 13261301

752 18-10-2019 132613011019Y001238 0002262498423 NAFISAH P PEGAWAI SWASTA Acute upper respiratory Berobat Jalan
infections of multiple and
unspecified sites
753 18-10-2019 132613011019Y000911 0002284874897 M.ANSORI L PEKERJA MANDIRI Other rheumatoid arthritis Berobat Jalan

754 18-10-2019 132613011019P001623 0002288662018 SITI ROKAYAH P PEKERJA MANDIRI Essential (primary) Berobat Jalan Hipertensi
hypertension
755 18-10-2019 132613011019Y001230 0002301126557 SIIN L PBI (APBD) Schizophrenia Berobat Jalan

756 18-10-2019 132613011019Y001231 0002307985031 MURTOFIAH P PEKERJA MANDIRI Essential (primary) Berobat Jalan
hypertension
757 18-10-2019 132613011019Y000926 0002356917996 IIN ROSYIDA P PEGAWAI SWASTA Other surgical follow-up Rujuk Vertikal
care
758 18-10-2019 132613011019Y001234 0002461563742 SITI NURLAELI P PBI (APBD) Gastritis and duodenitis Berobat Jalan

759 18-10-2019 132613011019Y001227 0002583083384 NAPISAH P PBI (APBN) Essential (primary) Berobat Jalan
hypertension
760 18-10-2019 132613011019Y001225 0002590577054 WALDJANNAH P PBI (APBN) Non-insulin-dependent Berobat Jalan
diabetes mellitus
761 18-10-2019 132613011019Y001237 0002606074942 MUFATUN NI'MAH P PBI (APBN) Gastritis and duodenitis Berobat Jalan

762 18-10-2019 132613011019P001640 0002753508071 SOELISTYOWATI P PEKERJA MANDIRI Essential (primary) Berobat Jalan Hipertensi
hypertension
763 17-10-2019 132613011019Y001106 0000112590077 KHOIRUN NIKMAH P PNS DAERAH Other specified Berobat Jalan
counselling
764 17-10-2019 132613011019Y001208 0000112590189 ISMUAT L PNS DAERAH Non-insulin-dependent Berobat Jalan
diabetes mellitus
765 17-10-2019 132613011019Y001087 0000112592171 SITI HIDAYATI P PNS DAERAH Observation for suspected Berobat Jalan
tuberculosis
766 17-10-2019 132613011019Y001216 0000714275987 TOHA L PBI (APBN) Gingivitis and periodontal Berobat Jalan
diseases
767 17-10-2019 132613011019Y000904 0000714679986 MUSAFAK L PBI (APBN) Other rheumatoid arthritis Berobat Jalan

768 17-10-2019 132613011019Y001482 0000714736697 UYUNURROHMAH P PBI (APBN) Gastritis and duodenitis Berobat Jalan

769 17-10-2019 132613011019Y001343 0000715078168 JUMALI L PBI (APBN) Other viral infections Berobat Jalan
characterized by skin and
mucous membrane
lesions, not elsewhere
classified
770 17-10-2019 132613011019Y001344 0000715097913 SITI FATIMAH P PBI (APBN) Malaise and fatigue Berobat Jalan

771 17-10-2019 132613011019Y000903 0000715126803 RIO FEBRIAN SAPUTRA L PBI (APBN) Allergic contact dermatitis Berobat Jalan
DAFTAR KUNJUNGAN PESERTA SAKIT

Kantor Cabang : PASURUAN - 1309

FKTP : Kejayan - 13261301

772 17-10-2019 132613011019Y001579 0000715133979 SOLEHUDIN L PBI (APBN) Other specified Berobat Jalan
counselling
773 17-10-2019 132613011019Y000905 0000715142812 KHUSNA P PBI (APBN) Influenza, virus not Berobat Jalan
identified
774 17-10-2019 132613011019Y000907 0000715172477 UMAMA P PBI (APBN) Other headache Berobat Jalan
syndromes
775 17-10-2019 132613011019Y000906 0000715264604 MISRANI L PBI (APBN) Other rheumatoid arthritis Berobat Jalan

776 17-10-2019 132613011019Y001105 0000715271488 M. SALIM L PBI (APBN) Other specified Berobat Jalan
counselling
777 17-10-2019 132613011019Y000899 0000715327457 MUYASAROH P PBI (APBN) Other headache Berobat Jalan
syndromes
778 17-10-2019 132613011019Y000900 0000715327795 HERIY KURNIAWAN L PBI (APBN) Fever of other and Berobat Jalan
unknown origin
779 17-10-2019 132613011019Y001102 0000715417075 TASRIFAH P PBI (APBN) Other disorders of muscle Berobat Jalan

780 17-10-2019 132613011019Y000902 0000715454324 LULUK KUSUMIATI P PBI (APBN) Other headache Berobat Jalan
syndromes
781 17-10-2019 132613011019Y000860 0000715491472 HOLIPAH P PBI (APBN) Other surgical follow-up Rujuk Vertikal
care
782 17-10-2019 132613011019Y001084 0000715610068 MUHAMMAD L PBI (APBN) Acute upper respiratory Berobat Jalan
infections of multiple and
unspecified sites
783 17-10-2019 132613011019Y001485 0000715636326 SA`DYAH P PBI (APBN) Other headache Berobat Jalan
syndromes
784 17-10-2019 132613011019Y001209 0000715670155 ATIM SUAIDAH P PBI (APBN) Non-insulin-dependent Berobat Jalan
diabetes mellitus
785 17-10-2019 132613011019Y000934 0000715674914 HOTIM P PBI (APBN) Other specified Berobat Jalan
counselling
786 17-10-2019 132613011019Y000859 0000715680011 SUTIK P PBI (APBN) Stroke, not specified as Rujuk Vertikal
haemorrhage or infarction
787 17-10-2019 132613011019Y000881 0000715789269 KAFI L PBI (APBN) Other disorders of muscle Berobat Jalan

788 17-10-2019 132613011019Y000917 0000715865635 HANIFAH P PBI (APBN) Cough Berobat Jalan

789 17-10-2019 132613011019Y001220 0000715878562 SULIKHATI P PBI (APBN) Other headache Berobat Jalan
syndromes
790 17-10-2019 132613011019Y001217 0000715881093 MULIHA P PBI (APBN) Fever of other and Berobat Jalan
unknown origin
791 17-10-2019 132613011019Y000923 0000715922548 MUHAMMAD NAJIBULLOH L PBI (APBN) Fever of other and Berobat Jalan
unknown origin
DAFTAR KUNJUNGAN PESERTA SAKIT

Kantor Cabang : PASURUAN - 1309

FKTP : Kejayan - 13261301

792 17-10-2019 132613011019Y000920 0000715961575 HUSNUL MUBAROK L PBI (APBN) Acute upper respiratory Berobat Jalan
infections of multiple and
unspecified sites
793 17-10-2019 132613011019Y001347 0000715973613 HANNAH P PBI (APBN) Other disorders of muscle Berobat Jalan

794 17-10-2019 132613011019Y000922 0000715975042 M. HOIRUD L PBI (APBN) Other headache Berobat Jalan
syndromes
795 17-10-2019 132613011019Y001345 0000716007532 MUARIP L PBI (APBN) Other disorders of muscle Berobat Jalan

796 17-10-2019 132613011019Y001088 0000716019759 KHOIRUL L PBI (APBN) Allergic contact dermatitis Berobat Jalan

797 17-10-2019 132613011019Y001089 0000716020121 SITI WAHYUNI P PBI (APBN) Allergic contact dermatitis Berobat Jalan

798 17-10-2019 132613011019Y000925 0000716020435 SUBANDRIYO L PBI (APBN) Migraine Berobat Jalan

799 17-10-2019 132613011019Y000915 0000716020571 SAHRONI L PBI (APBN) Other local infections of Berobat Jalan
skin and subcutaneous
tissue
800 17-10-2019 132613011019Y000919 0000716093155 ABDUL SOMAD L PBI (APBN) Dental caries Berobat Jalan

801 17-10-2019 132613011019Y000916 0000716093357 JAMAAH P PBI (APBN) Nausea and vomiting Berobat Jalan

802 17-10-2019 132613011019Y001094 0000716831201 M.SURURI L PEKERJA MANDIRI Other symptoms and signs Berobat Jalan
involving the circulatory
and respiratory systems

803 17-10-2019 132613011019Y001097 0001042697676 MISTIN P PBI (APBN) Acute upper respiratory Berobat Jalan
infections of multiple and
unspecified sites
804 17-10-2019 132613011019Y000921 0001042701254 BAGUS PERMADI L PBI (APBN) Acute upper respiratory Berobat Jalan
infections of multiple and
unspecified sites
805 17-10-2019 132613011019Y000858 0001042704483 HASANAH P PBI (APBN) Malignant neoplasm of Rujuk Vertikal
cervix uteri, unspecified
806 17-10-2019 132613011019Y001104 0001042709905 KHORIDATUL BAHIYA P PBI (APBN) Other specified Berobat Jalan
counselling
807 17-10-2019 132613011019Y001120 0001042718894 ANGGUN TRI SAFIRA NINGRUM P PBI (APBN) Acute nasopharyngitis Berobat Jalan
[common cold]
808 17-10-2019 132613011019Y000882 0001042719039 JOKO UNTUNG L PBI (APBN) Other headache Berobat Jalan
syndromes
809 17-10-2019 132613011019Y001221 0001133087826 SUKRON L PEGAWAI SWASTA Other headache Berobat Jalan
syndromes
810 17-10-2019 132613011019Y000861 0001177107478 ABDUL WAHAB L PEGAWAI SWASTA Foreign body in ear Rujuk Vertikal
DAFTAR KUNJUNGAN PESERTA SAKIT

Kantor Cabang : PASURUAN - 1309

FKTP : Kejayan - 13261301

811 17-10-2019 132613011019Y001100 0001701734196 NURUL HIDAYATI P PEGAWAI SWASTA Other specified Berobat Jalan
counselling
812 17-10-2019 132613011019Y001121 0002001951325 MUCHAMAD ZAIDAR L PBI (APBN) Other local infections of Berobat Jalan
skin and subcutaneous
tissue
813 17-10-2019 132613011019Y000864 0002161100575 HOTIJAH P PBI (APBD) Other disorders of muscle Berobat Jalan

814 17-10-2019 132613011019Y000901 0002201725798 HUMAIDAH P PEKERJA MANDIRI Other headache Berobat Jalan
syndromes
815 17-10-2019 132613011019Y001091 0002204712764 M. DIMAS AGUNG SAPUTRO L PEGAWAI SWASTA Acute nasopharyngitis Berobat Jalan
[common cold]
816 17-10-2019 132613011019Y000933 0002244013132 KEISHA ANINDITA ZAHRA P PEKERJA MANDIRI Acute upper respiratory Berobat Jalan
infections of multiple and
unspecified sites
817 17-10-2019 132613011019Y001086 0002584116551 MICHAILA HIDAYAH P PBI (APBN) Typhoid and paratyphoid Berobat Jalan
fevers
818 17-10-2019 132613011019Y001096 0002601964934 LAILATUN NURIA P PBI (APBN) Amoebiasis Berobat Jalan

819 17-10-2019 132613011019Y000924 0002608257947 AZIZAH P PBI (APBN) Fever of other and Berobat Jalan
unknown origin
820 17-10-2019 132613011019Y000863 0002628833185 IZZA AFKARINA P PBI (APBN) Stomatitis and related Berobat Jalan
lesions
821 17-10-2019 132613011019Y001090 0002767373313 CHOLIPAH P PEKERJA MANDIRI Non-insulin-dependent Berobat Jalan
diabetes mellitus
822 17-10-2019 132613011019Y000862 0002884805098 BAYI NYONYA INTAN PUSPITA P PEGAWAI SWASTA Malignant neoplasm of Rujuk Vertikal
SARI external upper lip
823 17-10-2019 132613011019Y001099 0002891833929 FATMIATI P PBI (APBD) Other disorders of muscle Berobat Jalan

824 16-10-2019 132613011019Y001073 0000112592621 SUCI MARGININGSIH P PNS DAERAH Essential (primary) Berobat Jalan
hypertension
825 16-10-2019 132613011019Y001578 0000112829894 SOETRISNO HADI L PENERIMA PENSIUN TNI Non-insulin-dependent Berobat Jalan
diabetes mellitus
826 16-10-2019 132613011019Y000832 0000112829905 NGATIAYAH P PENERIMA PENSIUN TNI Panniculitis affecting Rujuk Vertikal
regions of neck and back,
thoracolumbar region

827 16-10-2019 132613011019Y000842 0000149518732 YAHYA ZAKARIA MUDASSIR, L PNS DAERAH Insulin-dependent Rujuk Vertikal
SPD diabetes mellitus
828 16-10-2019 132613011019Y000834 0000164313527 INDI WAHBIYAH MAULAYA P PNS DAERAH Visual impairment Rujuk Vertikal
including blindness
(binocular or monocular)
DAFTAR KUNJUNGAN PESERTA SAKIT

Kantor Cabang : PASURUAN - 1309

FKTP : Kejayan - 13261301

829 16-10-2019 132613011019Y001181 0000714414925 SELAMET L PBI (APBN) Other headache Berobat Jalan
syndromes
830 16-10-2019 132613011019Y001171 0000714426333 SUHAIRI L PBI (APBN) Other disorders of muscle Berobat Jalan

831 16-10-2019 132613011019Y001173 0000714427751 NURUL ANWAR L PBI (APBN) Other headache Berobat Jalan
syndromes
832 16-10-2019 132613011019Y000854 0000714675824 RITA HARIATI P PBI (APBN) Allergic contact dermatitis Berobat Jalan

833 16-10-2019 132613011019Y000855 0000714697479 SITI MUSFIROH P PBI (APBN) Other rheumatoid arthritis Berobat Jalan

834 16-10-2019 132613011019Y000980 0000714754686 AMENA P PBI (APBN) Gastritis and duodenitis Berobat Jalan

835 16-10-2019 132613011019Y000857 0000714799697 RUSMIATI P PBI (APBN) Influenza, virus not Berobat Jalan
identified
836 16-10-2019 132613011019Y000840 0000714944362 MUHAMAD JULFIKAR ALDI L PBI (APBN) Fever of other and Berobat Jalan
SEPTIAWAN unknown origin
837 16-10-2019 132613011019Y001252 0000714967132 SU'UDAH P PBI (APBN) Fever of other and Berobat Jalan
unknown origin
838 16-10-2019 132613011019Y001251 0000714976086 KHOLIFAH P PBI (APBN) Other headache Berobat Jalan
syndromes
839 16-10-2019 132613011019Y001206 0000715101693 RIAMAH P PBI (APBN) Non-insulin-dependent Berobat Jalan
diabetes mellitus
840 16-10-2019 132613011019Y000856 0000715118984 DUMAIYAH P PBI (APBN) Other headache Berobat Jalan
syndromes
841 16-10-2019 132613011019Y000833 0000715127984 MILA SILFIA P PBI (APBN) Threatened abortion Rujuk Vertikal

842 16-10-2019 132613011019Y000853 0000715198533 NURIFAH P PBI (APBN) Other headache Berobat Jalan
syndromes
843 16-10-2019 132613011019Y000835 0000715226196 BAWON MULIYANI P PBI (APBN) Other surgical follow-up Rujuk Vertikal
care
844 16-10-2019 132613011019Y000892 0000715236851 MISNATI P PBI (APBN) Gastritis and duodenitis Berobat Jalan

845 16-10-2019 132613011019Y000979 0000715259711 SOMAD L PBI (APBN) Haemorrhoids Berobat Jalan

846 16-10-2019 132613011019Y000845 0000715280905 DEWI CHALIMAH P PBI (APBN) Other disorders of muscle Berobat Jalan

847 16-10-2019 132613011019Y001176 0000715294361 SAINI L PBI (APBN) Other disorders of muscle Berobat Jalan

848 16-10-2019 132613011019Y001177 0000715294585 SARIYAH P PBI (APBN) Other disorders of muscle Berobat Jalan

849 16-10-2019 132613011019Y000984 0000715301583 MOCHAMAD NARIP L PBI (APBN) Acute upper respiratory Berobat Jalan
infections of multiple and
unspecified sites
850 16-10-2019 132613011019Y000994 0000715312664 JURI L PBI (APBN) Pneumonia due to Berobat Jalan
Haemophilus influenzae
DAFTAR KUNJUNGAN PESERTA SAKIT

Kantor Cabang : PASURUAN - 1309

FKTP : Kejayan - 13261301

851 16-10-2019 132613011019Y000830 0000715339833 SOFIYAH P PBI (APBN) Benign neoplasm of breast Rujuk Vertikal

852 16-10-2019 132613011019Y001061 0000715383382 ACHMAD SANULAM L PBI (APBN) Other headache Berobat Jalan
syndromes
853 16-10-2019 132613011019Y001203 0000715423386 ROMELAH P PBI (APBN) Non-insulin-dependent Berobat Jalan
diabetes mellitus
854 16-10-2019 132613011019Y000839 0000715430373 ALI MUSTOFA L PBI (APBN) Other headache Berobat Jalan
syndromes
855 16-10-2019 132613011019Y001077 0000715443524 MUSDALIPA P PBI (APBN) Conjunctivitis Berobat Jalan

856 16-10-2019 132613011019Y001204 0000715582383 SIYAMAH P PBI (APBN) Non-insulin-dependent Berobat Jalan
diabetes mellitus
857 16-10-2019 132613011019Y000989 0000715723413 MISTINA P PBI (APBN) Myalgia Berobat Jalan

858 16-10-2019 132613011019Y000996 0000715761505 MAIMUNAH P PBI (APBN) Influenza, virus not Berobat Jalan
identified
859 16-10-2019 132613011019Y000850 0000715780427 UMIATI P PBI (APBN) Other disorders of muscle Berobat Jalan

860 16-10-2019 132613011019Y000884 0000715815145 HULIDA P PBI (APBN) Gastritis and duodenitis Berobat Jalan

861 16-10-2019 132613011019Y000844 0000715830939 LUTFI FAKHRUDIN L PBI (APBN) Other headache Berobat Jalan
syndromes
862 16-10-2019 132613011019Y001205 0000715877831 NAWIYA P PBI (APBN) Non-insulin-dependent Berobat Jalan
diabetes mellitus
863 16-10-2019 132613011019Y000895 0000715895908 SAPIUDIN L PBI (APBN) Fever of other and Berobat Jalan
unknown origin
864 16-10-2019 132613011019Y000896 0000715909522 M.RIF`AN L PBI (APBN) Other local infections of Berobat Jalan
skin and subcutaneous
tissue
865 16-10-2019 132613011019Y000893 0000715920221 LENI HESTIANI P PBI (APBN) Fever of other and Berobat Jalan
unknown origin
866 16-10-2019 132613011019Y000831 0000715937095 RUSDITIYANINGSIH P PBI (APBN) Epilepsy Rujuk Vertikal

867 16-10-2019 132613011019Y000887 0000715970237 M. SUBADAR L PBI (APBN) Migraine Berobat Jalan

868 16-10-2019 132613011019Y000886 0000715971385 M. ATIM L PBI (APBN) Dental caries Berobat Jalan

869 16-10-2019 132613011019Y000998 0000715974985 KHADIRO P PBI (APBN) Acute upper respiratory Berobat Jalan
infections of multiple and
unspecified sites
870 16-10-2019 132613011019Y000982 0000716007205 LAILA DEWI DEWANI P PBI (APBN) Acute upper respiratory Berobat Jalan
infections of multiple and
unspecified sites
DAFTAR KUNJUNGAN PESERTA SAKIT

Kantor Cabang : PASURUAN - 1309

FKTP : Kejayan - 13261301

871 16-10-2019 132613011019Y001286 0000716024169 APIYAH. P PBI (APBN) Malaise and fatigue Berobat Jalan

872 16-10-2019 132613011019Y000985 0000716038773 MUJANI L PBI (APBN) Myalgia Berobat Jalan

873 16-10-2019 132613011019Y000894 0000716360624 KHOLILATUL INAYAH P PBI (APBN) Acute upper respiratory Berobat Jalan
infections of multiple and
unspecified sites
874 16-10-2019 132613011019Y000983 0000718544463 M. NIZAR AZIZ L PBI (APBN) Acute nasopharyngitis Berobat Jalan
[common cold]
875 16-10-2019 132613011019Y000993 0001042681195 SEDEK L PBI (APBN) Observation for suspected Berobat Jalan
tuberculosis
876 16-10-2019 132613011019Y000991 0001042697237 ERVANIA P PBI (APBN) Gastritis and duodenitis Berobat Jalan

877 16-10-2019 132613011019Y001207 0001042697799 YASIK L PBI (APBN) Non-insulin-dependent Berobat Jalan
diabetes mellitus
878 16-10-2019 132613011019Y000897 0001042702738 LILIK VIDIAWATI P PBI (APBN) Diarrhoea and Berobat Jalan
gastroenteritis of
presumed infectious origin

879 16-10-2019 132613011019Y001079 0001042704617 NUR KHOLIS L PEGAWAI SWASTA Other specified Berobat Jalan
counselling
880 16-10-2019 132613011019Y000841 0001042706687 SOHIBURROH L PBI (APBN) Other headache Berobat Jalan
syndromes
881 16-10-2019 132613011019Y000883 0001042712256 M.SAIHU L PBI (APBN) Migraine Berobat Jalan

882 16-10-2019 132613011019Y000885 0001042712932 MASRUROH P PBI (APBN) Other headache Berobat Jalan
syndromes
883 16-10-2019 132613011019Y001288 0001042713371 LEGIATI P PBI (APBN) Contraceptive Berobat Jalan
management
884 16-10-2019 132613011019Y001290 0001042714135 NAJWA ADELIA MAGFIROH P PBI (APBN) Acute upper respiratory Berobat Jalan
infections of multiple and
unspecified sites
885 16-10-2019 132613011019Y000846 0001042719208 DIANELLA KARTIKA P PBI (APBN) Allergic contact dermatitis Berobat Jalan

886 16-10-2019 132613011019Y000942 0001042719715 FIKI NUGRAHA KRISWANTO L PBI (APBN) Allergic contact dermatitis Berobat Jalan

887 16-10-2019 132613011019Y000843 0001042720075 MISKI AGUS HARIANTO L PBI (APBN) Acute upper respiratory Berobat Jalan
infections of multiple and
unspecified sites
888 16-10-2019 132613011019Y000987 0001452649689 SLAMET WAHYUDI L PEGAWAI SWASTA Other dermatitis Berobat Jalan

889 16-10-2019 132613011019Y000836 0001861710928 PUTRI RISKIAH P PEKERJA MANDIRI Special epileptic Rujuk Vertikal
syndromes
DAFTAR KUNJUNGAN PESERTA SAKIT

Kantor Cabang : PASURUAN - 1309

FKTP : Kejayan - 13261301

890 16-10-2019 132613011019Y000997 0002001952056 MOCHAMAD AZKAL AZKIYAK L PBI (APBN) Acute nasopharyngitis Berobat Jalan
[common cold]
891 16-10-2019 132613011019Y000849 0002278233876 PUTRI RAHAYU P PEKERJA MANDIRI Influenza, virus not Berobat Jalan
identified
892 16-10-2019 132613011019Y000986 0002289695049 MAHMIYA P PEKERJA MANDIRI Disorders of lipoprotein Berobat Jalan
metabolism and other
lipidaemias
893 16-10-2019 132613011019Y001074 0002461562717 SOCHEH L PBI (APBD) Myalgia Berobat Jalan

894 16-10-2019 132613011019Y000852 0002490624808 RIFQIYANTO L PEKERJA MANDIRI Gastritis and duodenitis Berobat Jalan

895 16-10-2019 132613011019Y000851 0002490625023 KHANSA RIFQITA ASZARRAH P PEKERJA MANDIRI Fever of other and Berobat Jalan
unknown origin
896 16-10-2019 132613011019Y001078 0002498461255 HENDRIK SAPUTRO L PEKERJA MANDIRI Other headache Berobat Jalan
syndromes
897 16-10-2019 132613011019Y000847 0002585484527 SITI KHASANAH P PBI (APBN) Other headache Berobat Jalan
syndromes
898 16-10-2019 132613011019Y000930 0002621557631 ADINDA P PEGAWAI SWASTA Need for immunization Berobat Jalan
against single bacterial
diseases
899 16-10-2019 132613011019Y000995 0002633234938 M. ALIMUN L PBI (APBN) Gastritis and duodenitis Berobat Jalan

900 16-10-2019 132613011019Y000848 0002744228586 MUSIKAN L PEKERJA MANDIRI Malignant neoplasm of Rujuk Vertikal
mouth, unspecified
901 16-10-2019 132613011019Y001075 0002748551973 WIWIK SUDARTI P PBI (APBD) Myalgia Berobat Jalan

902 16-10-2019 132613011019Y000909 0002753801886 NURIN NAHDIYAH P PEKERJA MANDIRI Supervision of high-risk Berobat Jalan
pregnancy
903 16-10-2019 132613011019Y000910 0002757534276 YASMIN KAYLILA P PBI (APBD) Need for immunization Berobat Jalan
against combinations of
infectious diseases
904 16-10-2019 132613011019Y000978 0002881579487 ZAINUL FALAQ L PEKERJA MANDIRI Respiratory tuberculosis, Berobat Jalan
bacteriologically and
histologically confirmed
905 16-10-2019 132613011019Y000929 0002889603933 BAYI NYONYA LULUK KARIMAH P PBI (APBN) Need for immunization Berobat Jalan
against single bacterial
diseases
906 15-10-2019 132613011019Y001202 0000112592226 LILIK KHUSNUL KH. P PNS DAERAH Non-insulin-dependent Berobat Jalan
diabetes mellitus
907 15-10-2019 132613011019Y001117 0000112689088 SAIHUL L PNS DAERAH Fever of other and Berobat Jalan
unknown origin
908 15-10-2019 132613011019Y001159 0000113014675 MUSAROKHAH P PNS DAERAH Stomatitis and related Berobat Jalan
lesions
DAFTAR KUNJUNGAN PESERTA SAKIT

Kantor Cabang : PASURUAN - 1309

FKTP : Kejayan - 13261301

909 15-10-2019 132613011019Y000797 0000199348784 ZIDANE RAUFARREL ABRARY L PNS DAERAH Influenza, virus not Berobat Jalan
identified
910 15-10-2019 132613011019Y001157 0000204535653 SA'DIYAH P PNS DAERAH Non-insulin-dependent Berobat Jalan
diabetes mellitus
911 15-10-2019 132613011019Y001146 0000714445738 SAMSIYAMI P PBI (APBN) Other disorders of muscle Berobat Jalan

912 15-10-2019 132613011019Y001144 0000714447325 SUUDI L PBI (APBN) Other headache Berobat Jalan
syndromes
913 15-10-2019 132613011019Y001145 0000714447819 ANISAH P PBI (APBN) Other disorders of muscle Berobat Jalan

914 15-10-2019 132613011019Y001118 0000714615118 HUSNI L PBI (APBN) Observation for suspected Berobat Jalan
tuberculosis
915 15-10-2019 132613011019Y000780 0000714793645 NAUMI P PBI (APBN) Other rheumatoid arthritis Berobat Jalan

916 15-10-2019 132613011019Y001250 0000714969819 CHOIRUL L PBI (APBN) Gastritis and duodenitis Berobat Jalan

917 15-10-2019 132613011019Y001248 0000714976389 IHYA ULUMUDDIN L PBI (APBN) Fever of other and Berobat Jalan
unknown origin
918 15-10-2019 132613011019Y001249 0000714985211 RIYADUSSOLIHIN L PBI (APBN) Acute nasopharyngitis Berobat Jalan
[common cold]
919 15-10-2019 132613011019Y000787 0000715138615 ILVI NUR DIANA P PBI (APBN) Other headache Berobat Jalan
syndromes
920 15-10-2019 132613011019Y000781 0000715147975 MUSTOFAH L PBI (APBN) Other headache Berobat Jalan
syndromes
921 15-10-2019 132613011019Y000785 0000715165694 ANSORI L PBI (APBN) Gastritis and duodenitis Berobat Jalan

922 15-10-2019 132613011019Y000805 0000715267394 MUKHAMAD USMAN ALI L PBI (APBN) Other headache Berobat Jalan
syndromes
923 15-10-2019 132613011019Y000804 0000715268125 ALIMAN L PBI (APBN) Other disorders of muscle Berobat Jalan

924 15-10-2019 132613011019Y000807 0000715287925 SA`DIYAH P PBI (APBN) Other disorders of muscle Berobat Jalan

925 15-10-2019 132613011019Y000806 0000715299377 CHAYANAH P PBI (APBN) Other disorders of muscle Berobat Jalan

926 15-10-2019 132613011019Y000794 0000715314971 UROTUL UYUN L PBI (APBN) Threatened abortion Berobat Jalan

927 15-10-2019 132613011019Y001116 0000715417626 SUILA P PBI (APBN) Gastritis and duodenitis Berobat Jalan

928 15-10-2019 132613011019Y001262 0000715441511 LUKMAN L PBI (APBN) Dysphagia Berobat Jalan

929 15-10-2019 132613011019Y001263 0000715478984 FATKHUR L PBI (APBN) Other headache Berobat Jalan
syndromes
930 15-10-2019 132613011019Y000810 0000715540364 JAINUL L PBI (APBN) Gastritis and duodenitis Berobat Jalan

931 15-10-2019 132613011019Y000789 0000715565272 NUR HASAN L PBI (APBN) Gingivitis and periodontal Berobat Jalan
diseases
DAFTAR KUNJUNGAN PESERTA SAKIT

Kantor Cabang : PASURUAN - 1309

FKTP : Kejayan - 13261301

932 15-10-2019 132613011019Y001160 0000715587759 M. RIZQI KURNIAWAN L PBI (APBN) Diarrhoea and Berobat Jalan
gastroenteritis of
presumed infectious origin

933 15-10-2019 132613011019Y001264 0000715623671 M. SAMSUDIN L PBI (APBN) Medical observation and Berobat Jalan
evaluation for suspected
diseases and conditions
934 15-10-2019 132613011019Y001054 0000715650952 SITI RAHAYU P PBI (APBN) Gastritis and duodenitis Berobat Jalan

935 15-10-2019 132613011019Y001055 0000715656609 MUSLIMIN L PBI (APBN) Diarrhoea and Berobat Jalan
gastroenteritis of
presumed infectious origin

936 15-10-2019 132613011019Y000792 0000715732907 ABD ROHIM L PBI (APBN) Stroke, not specified as Rujuk Vertikal
haemorrhage or infarction
937 15-10-2019 132613011019Y001150 0000715756285 IRFAN L PBI (APBN) Other dermatitis Berobat Jalan

938 15-10-2019 132613011019Y000791 0000715762225 M FARHAN AULIYAK L PBI (APBN) Disorders of tooth Berobat Jalan
development and eruption
939 15-10-2019 132613011019Y001148 0000715790092 MUHAIMIN P PBI (APBN) Acute nasopharyngitis Berobat Jalan
[common cold]
940 15-10-2019 132613011019Y000786 0000715806944 DEWI HUSNA P PBI (APBN) Influenza, virus not Berobat Jalan
identified
941 15-10-2019 132613011019Y001130 0000715819206 KASIYATI P PBI (APBN) Essential (primary) Berobat Jalan
hypertension
942 15-10-2019 132613011019Y000866 0000715842641 SAWALI L PBI (APBN) Dental caries Berobat Jalan

943 15-10-2019 132613011019Y000865 0000715842707 MARDEYA P PBI (APBN) Diarrhoea and Berobat Jalan
gastroenteritis of
presumed infectious origin

944 15-10-2019 132613011019Y000872 0000715874444 ASPINAH P PBI (APBN) Other headache Berobat Jalan
syndromes
945 15-10-2019 132613011019Y001149 0000715916182 HALILAH P PBI (APBN) Other dermatitis Berobat Jalan

946 15-10-2019 132613011019Y000811 0000715943193 MASUD L PBI (APBN) Other headache Berobat Jalan
syndromes
947 15-10-2019 132613011019Y001268 0000715957288 SITI RUKOYAH P PBI (APBN) Other contraceptive Berobat Jalan
management
948 15-10-2019 132613011019Y001122 0000715965941 FAIZIN L PBI (APBN) Fever of other and Berobat Jalan
unknown origin
949 15-10-2019 132613011019Y001147 0000716020468 SOFWATIL MILA P PBI (APBN) Other superficial mycoses Berobat Jalan
DAFTAR KUNJUNGAN PESERTA SAKIT

Kantor Cabang : PASURUAN - 1309

FKTP : Kejayan - 13261301

950 15-10-2019 132613011019Y001166 0000716044509 M FARHAN L PBI (APBN) Schizophrenia Berobat Jalan

951 15-10-2019 132613011019Y001058 0000716254817 TAMA`I L PBI (APBN) Gingivitis and periodontal Berobat Jalan
diseases
952 15-10-2019 132613011019Y001056 0000716281604 SITI HOTIJAH P PBI (APBN) Influenza, virus not Berobat Jalan
identified
953 15-10-2019 132613011019Y000890 0000716420248 MARHAMAH P PBI (APBN) Gastritis and duodenitis Berobat Jalan

954 15-10-2019 132613011019Y001156 0000716448249 KHOTIJAH P PBI (APBN) Other specified Berobat Jalan
counselling
955 15-10-2019 132613011019Y000889 0000716460682 FATIMAH P PBI (APBN) Other headache Berobat Jalan
syndromes
956 15-10-2019 132613011019Y000790 0000716732368 MASRURO P PBI (APBN) Dental caries Berobat Jalan

957 15-10-2019 132613011019Y000888 0000716828163 M.JAKFAR SODIK L PBI (APBN) Acute upper respiratory Berobat Jalan
infections of multiple and
unspecified sites
958 15-10-2019 132613011019Y000798 0001042679529 MASRURO P PBI (APBN) Supervision of high-risk Berobat Jalan
pregnancy
959 15-10-2019 132613011019Y000784 0001042695911 SOLIHATI P PBI (APBN) Allergic contact dermatitis Berobat Jalan

960 15-10-2019 132613011019Y000891 0001042703302 JUMA`ATI P PBI (APBN) Nausea and vomiting Berobat Jalan

961 15-10-2019 132613011019Y001161 0001042704617 NUR KHOLIS L PEGAWAI SWASTA Observation for suspected Berobat Jalan
tuberculosis
962 15-10-2019 132613011019Y000808 0001042707802 SAMI P PBI (APBN) Other headache Berobat Jalan
syndromes
963 15-10-2019 132613011019Y000867 0001042711705 BADRUL MUNIR L PBI (APBN) Migraine Berobat Jalan

964 15-10-2019 132613011019Y001164 0001042712627 NUR HASAN L PBI (APBN) Suppurative and Berobat Jalan
unspecified otitis media
965 15-10-2019 132613011019Y000873 0001042712943 NURUL HIDAYATI P PBI (APBN) Nausea and vomiting Berobat Jalan

966 15-10-2019 132613011019Y001158 0001042713933 ASMAUN L PBI (APBN) Other symptoms and signs Berobat Jalan
involving the circulatory
and respiratory systems

967 15-10-2019 132613011019Y000796 0001042719219 BUARI L PBI (APBN) Other headache Berobat Jalan
syndromes
968 15-10-2019 132613011019Y001163 0001268344271 HUSWATUL HASANAH P PEGAWAI SWASTA Acute nasopharyngitis Berobat Jalan
[common cold]
969 15-10-2019 132613011019Y001125 0001324075419 M.KHUSAIRI L PEKERJA MANDIRI Gastritis and duodenitis Berobat Jalan
DAFTAR KUNJUNGAN PESERTA SAKIT

Kantor Cabang : PASURUAN - 1309

FKTP : Kejayan - 13261301

970 15-10-2019 132613011019Y001201 0001704586149 SAROHA P PBI (APBD) Non-insulin-dependent Berobat Jalan Diabetes
diabetes mellitus Mellitus
Hipertensi
971 15-10-2019 132613011019Y001165 0001820768005 HJ. SITI FATIMAH P PEKERJA MANDIRI Essential (primary) Berobat Jalan
hypertension
972 15-10-2019 132613011019Y001151 0002001951347 FATIMAH P PBI (APBN) Other disorders of muscle Berobat Jalan

973 15-10-2019 132613011019Y001119 0002001951358 RISKY YATUL OMANIA P PBI (APBN) Influenza, virus not Berobat Jalan
identified
974 15-10-2019 132613011019Y000771 0002001958839 DINA MARIYANTI P PBI (APBN) Allergic contact dermatitis Berobat Jalan

975 15-10-2019 132613011019Y001162 0002203422715 SITI NUR ASIYAH P PEKERJA MANDIRI Gastritis and duodenitis Berobat Jalan

976 15-10-2019 132613011019Y000795 0002211119638 MUHAMMAD FADIL L PBI (APBN) Influenza, virus not Berobat Jalan
identified
977 15-10-2019 132613011019Y001126 0002298529438 SITI MA'RIFA P PEKERJA MANDIRI Acute nasopharyngitis Berobat Jalan
[common cold]
978 15-10-2019 132613011019Y001167 0002298531159 M. ASRAF ZAIRUL UBAID L PBI (APBD) Other specified Berobat Jalan
counselling
979 15-10-2019 132613011019Y001057 0002477620451 HANAPI L PBI (APBD) Migraine Berobat Jalan

980 15-10-2019 132613011019Y000809 0002611518816 BAHRUL WIDAD L PBI (APBN) Conjunctivitis Berobat Jalan

981 15-10-2019 132613011019Y000793 0002615287252 M. ALFANDI GIOVAN PUTRA L PEKERJA MANDIRI Acute upper respiratory Berobat Jalan
infections of multiple and
unspecified sites
982 15-10-2019 132613011019Y000788 0002768848661 SEPTIANI SISKA ARIYANTI P PBI (APBD) Stroke, not specified as Rujuk Vertikal
haemorrhage or infarction
983 14-10-2019 132613011019Y000706 0000112589109 CHUSNIYAH FATATIK P PNS DAERAH Gingivitis and periodontal Berobat Jalan
diseases
984 14-10-2019 132613011019Y000727 0000112592327 SRI ANUDJU P PENERIMA PENSIUN Stroke, not specified as Rujuk Vertikal Hipertensi
PNS haemorrhage or infarction
985 14-10-2019 132613011019Y000879 0000112592788 SUGIANTO L PNS DAERAH Essential (primary) Berobat Jalan
hypertension
986 14-10-2019 132613011019Y000708 0000112593352 SUSILAH P PNS DAERAH Insulin-dependent Rujuk Vertikal
diabetes mellitus
987 14-10-2019 132613011019Y000974 0000112988463 ALIF INDRALISTYARINI P PNS DAERAH Other specified Berobat Jalan
counselling
988 14-10-2019 132613011019Y000960 0000714783284 SULISTYOWATI P PBI (APBN) Myalgia Berobat Jalan

989 14-10-2019 132613011019Y001059 0000714813838 SAMSUDIN L PBI (APBN) Other headache Berobat Jalan
syndromes
DAFTAR KUNJUNGAN PESERTA SAKIT

Kantor Cabang : PASURUAN - 1309

FKTP : Kejayan - 13261301

990 14-10-2019 132613011019Y001255 0000715086044 HADIYANTO L PBI (APBN) Malaise and fatigue Berobat Jalan

991 14-10-2019 132613011019Y000740 0000715109861 YULIANAH P PBI (APBN) Supervision of normal Berobat Jalan
pregnancy
992 14-10-2019 132613011019Y000741 0000715127984 MILA SILFIA P PBI (APBN) Supervision of normal Berobat Jalan
pregnancy
993 14-10-2019 132613011019Y000970 0000715133463 SITI CHOLIFAH P PBI (APBN) Gastritis and duodenitis Berobat Jalan

994 14-10-2019 132613011019Y000971 0000715133597 HADI SITIAWAN L PBI (APBN) Other disorders of muscle Berobat Jalan

995 14-10-2019 132613011019Y000738 0000715175111 SITI CHUMAIROH P PBI (APBN) Other contraceptive Berobat Jalan
management
996 14-10-2019 132613011019Y000818 0000715248808 ANANG ANDI KARISMA L PBI (APBN) Acute upper respiratory Berobat Jalan
infections of multiple and
unspecified sites
997 14-10-2019 132613011019Y000957 0000715263614 DIANA DEWI AMALIA P PBI (APBN) Other specified Berobat Jalan
counselling
998 14-10-2019 132613011019Y000769 0000715263873 SITI HAMIDAH P PBI (APBN) Allergic contact dermatitis Berobat Jalan

999 14-10-2019 132613011019Y001139 0000715276304 M.NADIR L PBI (APBN) Other disorders of muscle Berobat Jalan

1000 14-10-2019 132613011019Y001140 0000715277373 HASANAH P PBI (APBN) Other disorders of muscle Berobat Jalan

1001 14-10-2019 132613011019Y001137 0000715296374 SUPARDI L PBI (APBN) Other disorders of muscle Berobat Jalan

1002 14-10-2019 132613011019Y001138 0000715297048 HUZAIMAH P PBI (APBN) Other disorders of muscle Berobat Jalan

1003 14-10-2019 132613011019Y000962 0000715301583 MOCHAMAD NARIP L PBI (APBN) Influenza, virus not Berobat Jalan
identified
1004 14-10-2019 132613011019Y000770 0000715328695 SAFI`AH P PBI (APBN) Other disorders of muscle Berobat Jalan

1005 14-10-2019 132613011019Y000977 0000715336569 HOTIMAH P PBI (APBN) Other specified Berobat Jalan
counselling
1006 14-10-2019 132613011019Y000729 0000715351915 ROFIKOH P PBI (APBN) Glaucoma Rujuk Vertikal

1007 14-10-2019 132613011019Y001141 0000715361152 ZUHADIS SOLIHIN L PBI (APBN) Acute upper respiratory Berobat Jalan
infections of multiple and
unspecified sites
1008 14-10-2019 132613011019Y000773 0000715384359 SITI SIFAK'IYAH P PBI (APBN) Gastritis and duodenitis Berobat Jalan

1009 14-10-2019 132613011019Y000775 0000715387443 USWATUL HASANAH P PBI (APBN) Gastritis and duodenitis Berobat Jalan

1010 14-10-2019 132613011019Y001142 0000715408154 KARSAN L PBI (APBN) Other disorders of muscle Berobat Jalan

1011 14-10-2019 132613011019Y000871 0000715423386 ROMELAH P PBI (APBN) Gastritis and duodenitis Berobat Jalan
DAFTAR KUNJUNGAN PESERTA SAKIT

Kantor Cabang : PASURUAN - 1309

FKTP : Kejayan - 13261301

1012 14-10-2019 132613011019Y000878 0000715459342 JULAIHA P PBI (APBN) Diarrhoea and Berobat Jalan
gastroenteritis of
presumed infectious origin

1013 14-10-2019 132613011019Y000969 0000715484867 ENIK NUR HAYATI P PBI (APBN) Non-insulin-dependent Berobat Jalan
diabetes mellitus
1014 14-10-2019 132613011019Y001060 0000715592136 RUMYATI P PBI (APBN) Other arthritis Berobat Jalan

1015 14-10-2019 132613011019Y001143 0000715639342 RUKYATI P PBI (APBN) Other disorders of muscle Berobat Jalan

1016 14-10-2019 132613011019Y001260 0000715642042 SUPAEDA P PBI (APBN) Other headache Berobat Jalan
syndromes
1017 14-10-2019 132613011019Y000743 0000715701205 ULFIYAH P PBI (APBN) Supervision of normal Berobat Jalan
pregnancy
1018 14-10-2019 132613011019Y001577 0000715701205 ULFIYAH P PBI (APBN) Supervision of normal Berobat Jalan
pregnancy
1019 14-10-2019 132613011019Y001050 0000715723097 SANALI L PBI (APBN) Other dermatitis Berobat Jalan

1020 14-10-2019 132613011019Y000874 0000715761742 ISPANDI L PBI (APBN) Other dermatitis Berobat Jalan

1021 14-10-2019 132613011019Y000766 0000715784411 SODIQ L PBI (APBN) Other headache Berobat Jalan
syndromes
1022 14-10-2019 132613011019Y000715 0000715807732 IZZA AFKARINA P PBI (APBN) Other surgical follow-up Rujuk Vertikal
care
1023 14-10-2019 132613011019Y000768 0000715819206 KASIYATI P PBI (APBN) Other headache Berobat Jalan
syndromes
1024 14-10-2019 132613011019Y000761 0000715846184 ISMATUL CHOTIMAH P PBI (APBN) Acute upper respiratory Berobat Jalan
infections of multiple and
unspecified sites
1025 14-10-2019 132613011019Y000800 0000715857671 ALIFAH P PBI (APBN) Other disorders of muscle Berobat Jalan

1026 14-10-2019 132613011019Y000799 0000715860033 M.FATCHUR RONI L PBI (APBN) Acute upper respiratory Berobat Jalan
infections of multiple and
unspecified sites
1027 14-10-2019 132613011019Y000802 0000715860865 NUR FAIDAH P PBI (APBN) Influenza, virus not Berobat Jalan
identified
1028 14-10-2019 132613011019Y000801 0000715862171 NUR FARIDAH P PBI (APBN) Gastritis and duodenitis Berobat Jalan

1029 14-10-2019 132613011019Y000812 0000715926879 NOR SAIDAH P PBI (APBN) Diarrhoea and Berobat Jalan
gastroenteritis of
presumed infectious origin

1030 14-10-2019 132613011019Y000814 0000715938906 SUPARMAN L PBI (APBN) Dental caries Berobat Jalan
DAFTAR KUNJUNGAN PESERTA SAKIT

Kantor Cabang : PASURUAN - 1309

FKTP : Kejayan - 13261301

1031 14-10-2019 132613011019Y000815 0000715961823 DICKY ROFIQULLOH L PBI (APBN) Fever of other and Berobat Jalan
unknown origin
1032 14-10-2019 132613011019Y000819 0000715997608 MAIMUNAH P PBI (APBN) Other headache Berobat Jalan
syndromes
1033 14-10-2019 132613011019Y000875 0000716077607 ISMIATUL FADILAH P PBI (APBN) Other local infections of Berobat Jalan
skin and subcutaneous
tissue
1034 14-10-2019 132613011019Y001258 0000716090771 ASEP L PBI (APBN) Other disorders of muscle Berobat Jalan

1035 14-10-2019 132613011019Y000816 0000716155806 SON HAJI L PBI (APBN) Gastritis and duodenitis Berobat Jalan

1036 14-10-2019 132613011019Y001048 0000716257934 BAWON P PBI (APBN) Other headache Berobat Jalan
syndromes
1037 14-10-2019 132613011019Y001053 0000716299683 DIMYATI L PBI (APBN) Other dermatitis Berobat Jalan

1038 14-10-2019 132613011019Y001051 0000716344479 NURHASAN L PBI (APBN) Gastritis and duodenitis Berobat Jalan

1039 14-10-2019 132613011019Y001052 0000716359329 P. BUANI L PBI (APBN) Conjunctivitis Berobat Jalan

1040 14-10-2019 132613011019Y001049 0000716360275 BAKRI L PBI (APBN) Other disorders of muscle Berobat Jalan

1041 14-10-2019 132613011019Y000973 0000716370737 MOH. KHOFAR L PBI (APBN) Respiratory tuberculosis, Berobat Jalan
bacteriologically and
histologically confirmed
1042 14-10-2019 132613011019Y001047 0000716382257 SENIOWATI P PBI (APBN) Other disorders of muscle Berobat Jalan

1043 14-10-2019 132613011019Y000762 0000716834902 MUFIDA L PBI (APBN) Other headache Berobat Jalan
syndromes
1044 14-10-2019 132613011019Y000772 0001042694381 DEWI SRIATI P PBI (APBN) Other headache Berobat Jalan
syndromes
1045 14-10-2019 132613011019Y000817 0001042701952 SULIHA P PBI (APBN) Migraine Berobat Jalan

1046 14-10-2019 132613011019Y000820 0001042702953 MALIKHA P PBI (APBN) Other local infections of Berobat Jalan
skin and subcutaneous
tissue
1047 14-10-2019 132613011019Y000813 0001042712638 KHOIRIYAH P PBI (APBN) Cough Berobat Jalan

1048 14-10-2019 132613011019Y000803 0001042719906 UMI KULSUM P PBI (APBN) Other disorders of muscle Berobat Jalan

1049 14-10-2019 132613011019Y000869 0001043031104 CHUSNUL CHOTIMAH P PBI (APBN) Other dermatitis Berobat Jalan

1050 14-10-2019 132613011019Y000719 0001227032976 SITI SUKRIYAH P PEGAWAI PEMERINTAH Heart failure Rujuk Vertikal
DENGAN PERJANJIAN
KERJA
1051 14-10-2019 132613011019Y000778 0001311145211 MUKHAMMAD ZUHAIR AL L PNS DAERAH Gastritis and duodenitis Berobat Jalan
IRSYAD
DAFTAR KUNJUNGAN PESERTA SAKIT

Kantor Cabang : PASURUAN - 1309

FKTP : Kejayan - 13261301

1052 14-10-2019 132613011019Y000880 0001371679683 RUDIMAN L PEGAWAI SWASTA Diarrhoea and Berobat Jalan
gastroenteritis of
presumed infectious origin

1053 14-10-2019 132613011019Y000953 0001600379133 MISNADI L PEGAWAI SWASTA Non-insulin-dependent Berobat Jalan
diabetes mellitus
1054 14-10-2019 132613011019Y000976 0001600379144 ROCHMAH P PEGAWAI SWASTA Other specified Berobat Jalan
counselling
1055 14-10-2019 132613011019Y000948 0001704585723 CHAYUMI P PBI (APBD) Non-insulin-dependent Berobat Jalan
diabetes mellitus
1056 14-10-2019 132613011019Y000975 0001704585789 DHOFIR L PBI (APBD) Other specified Berobat Jalan
counselling
1057 14-10-2019 132613011019Y000972 0001795302101 NURUL YAQIN L PEGAWAI SWASTA Respiratory tuberculosis, Berobat Jalan
bacteriologically and
histologically confirmed
1058 14-10-2019 132613011019Y000868 0001880073494 M. DIRGANTARA BRILLIANT L PNS DAERAH Bronchitis, not specified as Berobat Jalan
PUTRA HAMZAH acute or chronic
1059 14-10-2019 132613011019Y000726 0002001959008 ALWAN FEBRUARI L PBI (APBN) Dislocation, sprain and Rujuk Vertikal
strain of joints and
ligaments of elbow
1060 14-10-2019 132613011019Y000876 0002143635309 SRI REJEKI P PEKERJA MANDIRI Myalgia Berobat Jalan

1061 14-10-2019 132613011019Y000877 0002161101868 SONHAJI AKHMAD L PBI (APBD) Influenza, virus not Berobat Jalan
identified
1062 14-10-2019 132613011019Y000821 0002204248059 CHANDRA AGUS BACHTIAR L PEGAWAI SWASTA Fever of other and Berobat Jalan
unknown origin
1063 14-10-2019 132613011019Y000944 0002252324755 RADITYA NAUVAL RAMDHANI L PEGAWAI SWASTA Amoebiasis Berobat Jalan

1064 14-10-2019 132613011019Y000774 0002277921161 HIMMATUL KARIMAH P PEGAWAI SWASTA Allergic contact dermatitis Berobat Jalan

1065 14-10-2019 132613011019Y000731 0002312756651 ISMI HIDAMATUL IZZAH P PBI (APBD) Gingivitis and periodontal Berobat Jalan
diseases
1066 14-10-2019 132613011019Y000709 0002463641346 MAIMUNAH P PEKERJA MANDIRI Heart failure Rujuk Vertikal

1067 14-10-2019 132613011019Y000717 0002478895964 FREYA AIDA RISQI RAHMAWATI P PEKERJA MANDIRI Respiratory tuberculosis, Rujuk Vertikal
bacteriologically and
histologically confirmed
1068 14-10-2019 132613011019Y000946 0002489464765 HARIRO P PEKERJA MANDIRI Essential (primary) Berobat Jalan
hypertension
1069 14-10-2019 132613011019Y000959 0002584116551 MICHAILA HIDAYAH P PBI (APBN) Other specified Berobat Jalan
counselling
1070 14-10-2019 132613011019Y000870 0002590577054 WALDJANNAH P PBI (APBN) Non-insulin-dependent Berobat Jalan
diabetes mellitus
DAFTAR KUNJUNGAN PESERTA SAKIT

Kantor Cabang : PASURUAN - 1309

FKTP : Kejayan - 13261301

1071 14-10-2019 132613011019Y000964 0002606330799 MUHAMMAD ALAIK FARHAN L PBI (APBN) Acute nasopharyngitis Berobat Jalan
ABADAN [common cold]
1072 14-10-2019 132613011019Y000963 0002616975832 SOFIYAH P PEKERJA MANDIRI Non-insulin-dependent Berobat Jalan
diabetes mellitus
1073 14-10-2019 132613011019Y000730 0002621772663 DINA ZAINUN P PEGAWAI SWASTA Dental caries Berobat Jalan

1074 14-10-2019 132613011019Y000961 0002638402479 RIFA KUMALASARI P PBI (APBN) Gastritis and duodenitis Berobat Jalan

1075 14-10-2019 132613011019Y000736 0002885018657 LULUK FARIDAH P PBI (APBD) Supervision of normal Berobat Jalan
pregnancy
1076 12-10-2019 132613011019Y000588 0000112597154 MUJASIR(PST) L PNS DAERAH Essential (primary) Berobat Jalan
hypertension
1077 12-10-2019 132613011019Y000558 0000112858839 SOEMARLAN L PNS DAERAH Stroke, not specified as Rujuk Vertikal
haemorrhage or infarction
1078 12-10-2019 132613011019Y000757 0000112965063 MURYANI P PNS DAERAH Other headache Berobat Jalan
syndromes
1079 12-10-2019 132613011019Y000563 0000112975301 RUSWINARNI P PENERIMA PENSIUN Other conduction Rujuk Vertikal
PNS disorders
1080 12-10-2019 132613011019Y000549 0000714723851 DIKRON L PBI (APBN) Diarrhoea and Berobat Jalan
gastroenteritis of
presumed infectious origin

1081 12-10-2019 132613011019Y000732 0000714754686 AMENA P PBI (APBN) Gastritis and duodenitis Berobat Jalan

1082 12-10-2019 132613011019Y000739 0000714800114 UMI KULSUM P PBI (APBN) Non-insulin-dependent Berobat Jalan
diabetes mellitus
1083 12-10-2019 132613011019Y000547 0000715193447 SANTI RAHAYU P PBI (APBN) Allergic contact dermatitis Berobat Jalan

1084 12-10-2019 132613011019Y000760 0000715270768 MALIKHA P PBI (APBN) Other headache Berobat Jalan
syndromes
1085 12-10-2019 132613011019Y000759 0000715275527 ILYAS L PBI (APBN) Allergic contact dermatitis Berobat Jalan

1086 12-10-2019 132613011019Y000546 0000715287892 HUDORI L PBI (APBN) Gastritis and duodenitis Berobat Jalan

1087 12-10-2019 132613011019Y000758 0000715300637 SURIFAH P PBI (APBN) Other disorders of muscle Berobat Jalan

1088 12-10-2019 132613011019Y000585 0000715311821 NURIL HIKMAH P PBI (APBN) Supervision of normal Berobat Jalan
pregnancy
1089 12-10-2019 132613011019Y000749 0000715336975 ANDIHASBULLOH L PBI (APBN) Other specified Berobat Jalan
counselling
1090 12-10-2019 132613011019Y000756 0000715367092 HABIBULLOH L PBI (APBN) Other specified Berobat Jalan
counselling
1091 12-10-2019 132613011019Y001110 0000715470636 M.HOLIL L PBI (APBN) Other disorders of muscle Berobat Jalan
DAFTAR KUNJUNGAN PESERTA SAKIT

Kantor Cabang : PASURUAN - 1309

FKTP : Kejayan - 13261301

1092 12-10-2019 132613011019Y001108 0000715471288 M.TOYIB L PBI (APBN) Acute upper respiratory Berobat Jalan
infections of multiple and
unspecified sites
1093 12-10-2019 132613011019Y000734 0000715568253 SAHID KRISNA L PBI (APBN) Other disorders of muscle Berobat Jalan

1094 12-10-2019 132613011019Y001131 0000715649062 IHSANUDDIN L PBI (APBN) Dental caries Berobat Jalan

1095 12-10-2019 132613011019Y001132 0000715649725 MAISAROH P PBI (APBN) Other headache Berobat Jalan
syndromes
1096 12-10-2019 132613011019Y000640 0000715680213 ALIMA P PBI (APBN) Other headache Berobat Jalan
syndromes
1097 12-10-2019 132613011019Y000642 0000715686434 NURSALIM L PBI (APBN) Diarrhoea and Berobat Jalan
gastroenteritis of
presumed infectious origin

1098 12-10-2019 132613011019Y000584 0000715687986 KHOLIFAH P PBI (APBN) Insulin-dependent Rujuk Vertikal
diabetes mellitus
1099 12-10-2019 132613011019Y000543 0000715688807 LAILATUR RIZQIYAH P PBI (APBN) Other headache Berobat Jalan
syndromes
1100 12-10-2019 132613011019Y000747 0000715742976 EDI LISTIONO L PBI (APBN) Gastritis and duodenitis Berobat Jalan

1101 12-10-2019 132613011019Y000586 0000715760324 SITI KARLINAH P PBI (APBN) Supervision of normal Berobat Jalan
pregnancy
1102 12-10-2019 132613011019Y000548 0000715795749 NIZAR L PBI (APBN) Influenza, virus not Berobat Jalan
identified
1103 12-10-2019 132613011019Y000728 0000715827341 RIDWAN L PBI (APBN) Fever of other and Berobat Jalan
unknown origin
1104 12-10-2019 132613011019Y000699 0000715897168 MUNIP L PBI (APBN) Migraine Berobat Jalan

1105 12-10-2019 132613011019Y000748 0000715929581 TOSIN L PBI (APBN) Leprosy [Hansen disease] Berobat Jalan

1106 12-10-2019 132613011019Y000698 0000716023833 IDA SA`DIYAH P PBI (APBN) Other local infections of Berobat Jalan
skin and subcutaneous
tissue
1107 12-10-2019 132613011019Y000697 0000716044509 M FARHAN L PBI (APBN) Diarrhoea and Berobat Jalan
gastroenteritis of
presumed infectious origin

1108 12-10-2019 132613011019Y001114 0000716098419 MISNATI P PBI (APBN) Other viral infections Berobat Jalan
characterized by skin and
mucous membrane
lesions, not elsewhere
classified
1109 12-10-2019 132613011019Y000644 0000716280445 NAWAWI L PBI (APBN) Other dermatitis Berobat Jalan
DAFTAR KUNJUNGAN PESERTA SAKIT

Kantor Cabang : PASURUAN - 1309

FKTP : Kejayan - 13261301

1110 12-10-2019 132613011019Y000643 0000716283189 MUSLIHA P PBI (APBN) Diarrhoea and Berobat Jalan
gastroenteritis of
presumed infectious origin

1111 12-10-2019 132613011019Y000645 0000716338181 SOLIHIN L PBI (APBN) Acute upper respiratory Berobat Jalan
infections of multiple and
unspecified sites
1112 12-10-2019 132613011019Y000561 0000716370737 MOH. KHOFAR L PBI (APBN) Respiratory tuberculosis, Rujuk Vertikal
bacteriologically and
histologically confirmed
1113 12-10-2019 132613011019Y000641 0000716402428 HUNAINA P PBI (APBN) Acute upper respiratory Berobat Jalan
infections of multiple and
unspecified sites
1114 12-10-2019 132613011019Y001134 0000716704839 ARUFA P PBI (APBN) Other disorders of muscle Berobat Jalan

1115 12-10-2019 132613011019Y001133 0000716705212 SUAIDAH P PBI (APBN) Other disorders of muscle Berobat Jalan

1116 12-10-2019 132613011019Y001135 0000716707822 LUKMAN HADI L PBI (APBN) Influenza, virus not Berobat Jalan
identified
1117 12-10-2019 132613011019Y001136 0000716743607 NUR GHOZALI L PBI (APBN) Other disorders of muscle Berobat Jalan

1118 12-10-2019 132613011019Y000745 0000716831201 M.SURURI L PEKERJA MANDIRI Other symptoms and signs Berobat Jalan
involving the circulatory
and respiratory systems

1119 12-10-2019 132613011019Y000744 0000717554327 CHUSNIYAH P PBI (APBN) Essential (primary) Berobat Jalan
hypertension
1120 12-10-2019 132613011019Y000754 0000717669145 NISWATIN KHASANAH P PBI (APBN) Other disorders of muscle Berobat Jalan

1121 12-10-2019 132613011019Y000701 0000718150443 SHOLIKHATI P PBI (APBN) Diarrhoea and Berobat Jalan
gastroenteritis of
presumed infectious origin

1122 12-10-2019 132613011019Y001030 0001042699127 MAS RUIN L PBI (APBN) Other headache Berobat Jalan
syndromes
1123 12-10-2019 132613011019Y000696 0001042701669 MAISAROH P PBI (APBN) Cough Berobat Jalan

1124 12-10-2019 132613011019Y000737 0001042712627 NUR HASAN L PBI (APBN) Acute nasopharyngitis Berobat Jalan
[common cold]
1125 12-10-2019 132613011019Y000700 0001042712818 HUSNIA P PBI (APBN) Acute upper respiratory Berobat Jalan
infections of multiple and
unspecified sites
1126 12-10-2019 132613011019Y000750 0001042715316 SRI WIJAYANTI P PBI (APBN) Other specified Berobat Jalan
counselling
DAFTAR KUNJUNGAN PESERTA SAKIT

Kantor Cabang : PASURUAN - 1309

FKTP : Kejayan - 13261301

1127 12-10-2019 132613011019Y000755 0001042717735 DEWI SUSANTI P PBI (APBN) Other specified Berobat Jalan
counselling
1128 12-10-2019 132613011019Y000733 0001042718062 KHUSWATUL KHASANAH P PBI (APBN) Myalgia Berobat Jalan

1129 12-10-2019 132613011019Y000591 0001704585789 DHOFIR L PBI (APBD) Essential (primary) Berobat Jalan
hypertension
1130 12-10-2019 132613011019Y000557 0001870647963 MUKHAMAD ABDUL QODIR L PEKERJA MANDIRI Peritonitis Rujuk Vertikal

1131 12-10-2019 132613011019Y000542 0001969890748 FITROTIN NIKMAH P PEGAWAI SWASTA Other headache Berobat Jalan
syndromes
1132 12-10-2019 132613011019Y000752 0002001951279 ULFA NAFIDATUL YAHANA P PBI (APBN) Other local infections of Berobat Jalan
skin and subcutaneous
tissue
1133 12-10-2019 132613011019Y000705 0002001952348 SALWA NADHIRAH AQILAH P PBI (APBN) Disorders of tooth Berobat Jalan
development and eruption
1134 12-10-2019 132613011019Y000592 0002161102162 SRI WIJAYATI P PBI (APBD) Other local infections of Berobat Jalan
skin and subcutaneous
tissue
1135 12-10-2019 132613011019Y000590 0002161102184 MUCH. ANGGA FIRMANSYAH L PBI (APBD) Other headache Berobat Jalan
syndromes
1136 12-10-2019 132613011019Y000751 0002204616216 ROMLI L PEGAWAI SWASTA Influenza, virus not Berobat Jalan
identified
1137 12-10-2019 132613011019Y000560 0002218897304 MUHAMMAD RAIHAN L PEGAWAI SWASTA Microcephaly Rujuk Vertikal
RAMADHAN
1138 12-10-2019 132613011019Y000589 0002221628229 SUBANDI L PEKERJA MANDIRI Other disorders of muscle Berobat Jalan

1139 12-10-2019 132613011019Y000554 0002260688703 CHISBULLAH FAQIH L PEKERJA MANDIRI Paraplegia and tetraplegia Rujuk Vertikal

1140 12-10-2019 132613011019Y000742 0002263905584 LULUK SUDI LESTARI P PEKERJA MANDIRI Meningococcal arthritis Berobat Jalan

1141 12-10-2019 132613011019Y000570 0002278274422 NABILLA WAHYU AGUSTIN P PEKERJA MANDIRI Tuberculosis of other Rujuk Vertikal
organs
1142 12-10-2019 132613011019Y000753 0002464059508 MUKHAMMAD CHANIF L PEKERJA MANDIRI Fever of other and Berobat Jalan
MACHMUD ZEN unknown origin
1143 12-10-2019 132613011019Y000746 0002584116551 MICHAILA HIDAYAH P PBI (APBN) Typhoid and paratyphoid Berobat Jalan
fevers
1144 12-10-2019 132613011019Y000735 0002749486746 BAYI NYONYA HILYATUL L PBI (APBN) Acute nasopharyngitis Berobat Jalan
UNSIYAH [common cold]
1145 12-10-2019 132613011019Y000587 0002768811017 RISKA DIANASARI P PEKERJA MANDIRI Supervision of normal Berobat Jalan
pregnancy
1146 11-10-2019 132613011019Y000491 0000112687514 YAHYA ABDULLAH L PNS DAERAH Other rheumatoid arthritis Berobat Jalan
DAFTAR KUNJUNGAN PESERTA SAKIT

Kantor Cabang : PASURUAN - 1309

FKTP : Kejayan - 13261301

1147 11-10-2019 132613011019Y000499 0000112988215 IMAM SUPRIYADI L PNS DAERAH Unspecified transport Rujuk Vertikal
accident
1148 11-10-2019 132613011019Y000498 0000113224689 HAYUMI P PNS DAERAH Pterygium Rujuk Vertikal

1149 11-10-2019 132613011019Y000713 0000383000848 ETY IRAWATI P PBI (APBN) Other local infections of Berobat Jalan
skin and subcutaneous
tissue
1150 11-10-2019 132613011019Y001199 0000713590075 SARIMAN L PBI (APBN) Non-insulin-dependent Berobat Jalan
diabetes mellitus
1151 11-10-2019 132613011019Y000494 0000714696838 SLAMET WAHYUDI L PBI (APBN) Gastritis and duodenitis Berobat Jalan

1152 11-10-2019 132613011019Y000493 0000714769841 RIF`AN L PBI (APBN) Other headache Berobat Jalan
syndromes
1153 11-10-2019 132613011019Y000492 0000715161148 SUMIATI P PBI (APBN) Other rheumatoid arthritis Berobat Jalan

1154 11-10-2019 132613011019Y000509 0000715196913 SATUHA P PBI (APBN) Supervision of high-risk Berobat Jalan
pregnancy
1155 11-10-2019 132613011019Y001020 0000715204539 SHOLICHATI P PBI (APBN) Malaise and fatigue Berobat Jalan

1156 11-10-2019 132613011019Y000540 0000715239011 ABD.FAKEH L PBI (APBN) Other local infections of Berobat Jalan
skin and subcutaneous
tissue
1157 11-10-2019 132613011019Y000541 0000715256943 SOFEYA P PBI (APBN) Cough Berobat Jalan

1158 11-10-2019 132613011019Y000528 0000715272737 MASDUKI L PBI (APBN) Fever of other and Berobat Jalan
unknown origin
1159 11-10-2019 132613011019Y000526 0000715283493 HOBIR L PBI (APBN) Allergic contact dermatitis Berobat Jalan

1160 11-10-2019 132613011019Y000639 0000715474563 AISA P PBI (APBN) Gastritis and duodenitis Berobat Jalan

1161 11-10-2019 132613011019Y001019 0000715490019 RIYANTO L PBI (APBN) Acute upper respiratory Berobat Jalan
infections of multiple and
unspecified sites
1162 11-10-2019 132613011019Y000500 0000715492124 SAODAH P PBI (APBN) Follow-up examination Rujuk Vertikal
after other treatment for
other conditions
1163 11-10-2019 132613011019Y000519 0000715539881 SAROHA P PBI (APBN) Acute upper respiratory Berobat Jalan
infections of multiple and
unspecified sites
1164 11-10-2019 132613011019Y001021 0000715621645 RUHAYATIN P PBI (APBN) Other headache Berobat Jalan
syndromes
1165 11-10-2019 132613011019Y001198 0000715632254 SUMIATI P PBI (APBN) Non-insulin-dependent Berobat Jalan
diabetes mellitus
1166 11-10-2019 132613011019Y001022 0000715633446 SAMU`I L PBI (APBN) Dysphagia Berobat Jalan
DAFTAR KUNJUNGAN PESERTA SAKIT

Kantor Cabang : PASURUAN - 1309

FKTP : Kejayan - 13261301

1167 11-10-2019 132613011019Y000710 0000715678198 CHAJALI L PBI (APBN) Influenza, virus not Berobat Jalan
identified
1168 11-10-2019 132613011019Y000711 0000715678547 SAYENAH P PBI (APBN) Other dermatitis Berobat Jalan

1169 11-10-2019 132613011019Y000635 0000715712308 JAMIAH P PBI (APBN) Other disorders of muscle Berobat Jalan

1170 11-10-2019 132613011019Y000527 0000715741479 NADIFAH P PBI (APBN) Other headache Berobat Jalan
syndromes
1171 11-10-2019 132613011019Y000637 0000715759874 SAIHU L PBI (APBN) Fever of other and Berobat Jalan
unknown origin
1172 11-10-2019 132613011019Y001564 0000715795749 NIZAR L PBI (APBN) Other specified Berobat Jalan
counselling
1173 11-10-2019 132613011019Y000513 0000715827857 DEWI P PBI (APBN) Supervision of normal Berobat Jalan
pregnancy
1174 11-10-2019 132613011019Y000497 0000715845238 LULUK ANDRAENI P PBI (APBN) Other surgical follow-up Rujuk Vertikal
care
1175 11-10-2019 132613011019Y000723 0000715865387 DJAMILAH P PBI (APBN) Non-insulin-dependent Berobat Jalan
diabetes mellitus
1176 11-10-2019 132613011019Y001026 0000715933293 SULASTRI P PBI (APBN) Fever of other and Berobat Jalan
unknown origin
1177 11-10-2019 132613011019Y001029 0000715934496 JAKPAR SODIQ L PBI (APBN) Other headache Berobat Jalan
syndromes
1178 11-10-2019 132613011019Y001027 0000715957029 SAHARI L PBI (APBN) Allergic contact dermatitis Berobat Jalan

1179 11-10-2019 132613011019Y001028 0000715957255 MIATI P PBI (APBN) Acute upper respiratory Berobat Jalan
infections of multiple and
unspecified sites
1180 11-10-2019 132613011019Y000539 0000716031077 SAADAH P PBI (APBN) Other headache Berobat Jalan
syndromes
1181 11-10-2019 132613011019Y000607 0000716035454 SUPARTO L PBI (APBN) Migraine Berobat Jalan

1182 11-10-2019 132613011019Y000636 0000716285305 ROHMA P PBI (APBN) Other headache Berobat Jalan
syndromes
1183 11-10-2019 132613011019Y000725 0000716370737 MOH. KHOFAR L PBI (APBN) Other specified Berobat Jalan
counselling
1184 11-10-2019 132613011019Y000638 0000716404408 ASIYAH P PBI (APBN) Migraine Berobat Jalan

1185 11-10-2019 132613011019Y000716 0000716425751 SITI ASIYAH P PBI (APBN) Other specified Berobat Jalan
counselling
1186 11-10-2019 132613011019Y000507 0001042685122 SITI AISAH P PBI (APBN) Anaemia complicating Berobat Jalan
pregnancy, childbirth and
the puerperium
DAFTAR KUNJUNGAN PESERTA SAKIT

Kantor Cabang : PASURUAN - 1309

FKTP : Kejayan - 13261301

1187 11-10-2019 132613011019Y000606 0001042712335 ACHMAD IRFAN L PBI (APBN) Diarrhoea and Berobat Jalan
gastroenteritis of
presumed infectious origin

1188 11-10-2019 132613011019Y000605 0001042712403 KHOLIL L PBI (APBN) Dental caries Berobat Jalan

1189 11-10-2019 132613011019Y000718 0001042716317 M. SAFRIZAL FAHMI L PBI (APBN) Other dermatitis Berobat Jalan

1190 11-10-2019 132613011019Y000490 0001043033433 ILYAS L PBI (APBN) Gastritis and duodenitis Berobat Jalan

1191 11-10-2019 132613011019Y001568 0001318481493 RINA PUSPITA P PEKERJA MANDIRI Other specified Berobat Jalan
counselling
1192 11-10-2019 132613011019Y001200 0001452447099 KHOLIFAH P PEKERJA MANDIRI Non-insulin-dependent Berobat Jalan
diabetes mellitus
1193 11-10-2019 132613011019Y000724 0001704583901 SITI ZAINAB P PBI (APBD) Other specified Berobat Jalan
counselling
1194 11-10-2019 132613011019Y000529 0002001958795 SITI RUKOYAH P PBI (APBN) Other disorders of muscle Berobat Jalan

1195 11-10-2019 132613011019Y000511 0002265260433 KHOIROTUL MUHIBBAH P PEGAWAI SWASTA Supervision of normal Berobat Jalan
pregnancy
1196 11-10-2019 132613011019Y000707 0002278233292 MURNI P PEKERJA MANDIRI Influenza due to other Berobat Jalan
identified influenza virus
1197 11-10-2019 132613011019Y001563 0002307985031 MURTOFIAH P PEKERJA MANDIRI Essential (primary) Berobat Jalan
hypertension
1198 11-10-2019 132613011019Y000514 0002312756651 ISMI HIDAMATUL IZZAH P PBI (APBD) Gingivitis and periodontal Berobat Jalan
diseases
1199 11-10-2019 132613011019Y000504 0002323094984 ALDIANTO WAHYU RAMADHAN L PEGAWAI SWASTA Acute upper respiratory Berobat Jalan
infections of multiple and
unspecified sites
1200 11-10-2019 132613011019Y000505 0002417894381 KYRA RAMADHANI P PBI (APBD) Influenza, virus not Berobat Jalan
identified
1201 11-10-2019 132613011019Y000496 0002435371918 SITI ROMLA P PEKERJA MANDIRI Chronic sinusitis Rujuk Vertikal

1202 11-10-2019 132613011019Y000722 0002461364548 KHOIROTUN NISAK P PEKERJA MANDIRI Diarrhoea and Berobat Jalan
gastroenteritis of
presumed infectious origin

1203 11-10-2019 132613011019Y000520 0002470141675 SUPANDI L PEKERJA MANDIRI Other headache Berobat Jalan
syndromes
1204 11-10-2019 132613011019Y000721 0002605251543 MUZAYYAN BIAUFARIS SYAN L PBI (APBN) Other specified Berobat Jalan
counselling
1205 11-10-2019 132613011019Y000503 0002613332215 MUSLIHA P PEKERJA MANDIRI Necrosis of pulp Berobat Jalan
DAFTAR KUNJUNGAN PESERTA SAKIT

Kantor Cabang : PASURUAN - 1309

FKTP : Kejayan - 13261301

1206 11-10-2019 132613011019Y000518 0002617796081 HAMIYATUL UMMAH P PBI (APBD) Other headache Berobat Jalan
syndromes
1207 11-10-2019 132613011019Y000512 0002621772663 DINA ZAINUN P PEGAWAI SWASTA Gingivitis and periodontal Berobat Jalan
diseases
1208 11-10-2019 132613011019Y001570 0002639669253 NAIMAH P PBI (APBN) Other specified Berobat Jalan
counselling
1209 11-10-2019 132613011019Y000704 0002640010972 SULIHATI P PBI (APBN) Gingivitis and periodontal Berobat Jalan
diseases
1210 11-10-2019 132613011019Y000510 0002755384389 SITI LAILATUS NUR SHOLIHA P PBI (APBD) Postpartum care and Berobat Jalan
examination
1211 11-10-2019 132613011019Y000506 0002757534276 YASMIN KAYLILA P PBI (APBD) Influenza, virus not Berobat Jalan
identified
1212 11-10-2019 132613011019Y001572 0002767373313 CHOLIPAH P PEKERJA MANDIRI Non-insulin-dependent Berobat Jalan
diabetes mellitus
1213 11-10-2019 132613011019Y000495 0002894081106 SOLEHUDDIN L PEKERJA MANDIRI Ascites Rujuk Vertikal

1214 10-10-2019 132613011019Y000577 0000112538586 HASANAH P PNS DAERAH Acute upper respiratory Berobat Jalan
infections of multiple and
unspecified sites
1215 10-10-2019 132613011019Y000593 0000112589087 CHOLIL L PNS DAERAH Other headache Berobat Jalan
syndromes
1216 10-10-2019 132613011019Y000470 0000112591214 AMRINA ROSADA P PNS DAERAH Systemic lupus Rujuk Vertikal
erythematosus
1217 10-10-2019 132613011019Y000524 0000112591225 NANIK HENDRIATI P PNS DAERAH Acute upper respiratory Berobat Jalan
infections of multiple and
unspecified sites
1218 10-10-2019 132613011019Y000630 0000112966828 SAROPA P PNS DAERAH Gastritis and duodenitis Berobat Jalan

1219 10-10-2019 132613011019Y000467 0000714397961 SUEB EFENDI L PBI (APBN) Epilepsy Rujuk Vertikal

1220 10-10-2019 132613011019Y000461 0000714700844 USWATUN HASANAH P PBI (APBN) Other headache Berobat Jalan
syndromes
1221 10-10-2019 132613011019Y000463 0000715083017 KHOLILAH P PBI (APBN) Stroke, not specified as Rujuk Vertikal
haemorrhage or infarction
1222 10-10-2019 132613011019Y001016 0000715192479 RIFATUL JANAH P PBI (APBN) Dysphagia Berobat Jalan

1223 10-10-2019 132613011019Y000472 0000715196913 SATUHA P PBI (APBN) Supervision of normal Berobat Jalan
pregnancy
1224 10-10-2019 132613011019Y000562 0000715263614 DIANA DEWI AMALIA P PBI (APBN) Fever of other and Berobat Jalan
unknown origin
1225 10-10-2019 132613011019Y000556 0000715282132 SURATIN P PBI (APBN) Essential (primary) Berobat Jalan
hypertension
DAFTAR KUNJUNGAN PESERTA SAKIT

Kantor Cabang : PASURUAN - 1309

FKTP : Kejayan - 13261301

1226 10-10-2019 132613011019Y000767 0000715328965 ALFIAH P PBI (APBN) Other dermatitis Berobat Jalan

1227 10-10-2019 132613011019Y000516 0000715339495 HOTIJA P PBI (APBN) Other headache Berobat Jalan
syndromes
1228 10-10-2019 132613011019Y001085 0000715388736 HOFUR L PBI (APBN) Other disorders of muscle Berobat Jalan

1229 10-10-2019 132613011019Y000579 0000715407489 HALIMATUSADIYAH P PBI (APBN) Myalgia Berobat Jalan

1230 10-10-2019 132613011019Y000465 0000715434164 YAYUK IRAWAN P PBI (APBN) Allergic contact dermatitis Berobat Jalan

1231 10-10-2019 132613011019Y000555 0000715479603 JAELANI L PBI (APBN) Other disorders of muscle Berobat Jalan

1232 10-10-2019 132613011019Y000632 0000715662292 MUHANI L PBI (APBN) Influenza, virus not Berobat Jalan
identified
1233 10-10-2019 132613011019Y000559 0000715691946 MUHAJR L PBI (APBN) Essential (primary) Berobat Jalan
hypertension
1234 10-10-2019 132613011019Y000633 0000715723841 NAFISAH P PBI (APBN) Gastritis and duodenitis Berobat Jalan

1235 10-10-2019 132613011019Y000523 0000715742548 PANUT P PBI (APBN) Other disorders of muscle Berobat Jalan Diabetes
Mellitus
1236 10-10-2019 132613011019Y000462 0000715742662 HUSEN L PBI (APBN) Gastritis and duodenitis Berobat Jalan

1237 10-10-2019 132613011019Y000469 0000715760324 SITI KARLINAH P PBI (APBN) Maternal care for known or Rujuk Vertikal
suspected malpresentation
of fetus
1238 10-10-2019 132613011019Y000583 0000715761505 MAIMUNAH P PBI (APBN) Other specified Berobat Jalan
counselling
1239 10-10-2019 132613011019Y000569 0000715830827 QORROTUL A'YUN P PBI (APBN) Cough Berobat Jalan

1240 10-10-2019 132613011019Y000564 0000715846228 LIYASIN L PBI (APBN) Sequelae of malnutrition Berobat Jalan
and other nutritional
deficiencies
1241 10-10-2019 132613011019Y000565 0000715846702 SANAI P PBI (APBN) Essential (primary) Berobat Jalan
hypertension
1242 10-10-2019 132613011019Y000576 0000715859392 MUNIPAH P PBI (APBN) Respiratory tuberculosis, Berobat Jalan
bacteriologically and
histologically confirmed
1243 10-10-2019 132613011019Y000568 0000715873937 MARYATIK P PBI (APBN) Gastritis and duodenitis Berobat Jalan

1244 10-10-2019 132613011019Y001587 0000715912986 MALIK L PBI (APBN) Fever of other and Berobat Jalan
unknown origin
1245 10-10-2019 132613011019Y000838 0000715922335 HALIM L PBI (APBN) Acute upper respiratory Berobat Jalan
infections of multiple and
unspecified sites
DAFTAR KUNJUNGAN PESERTA SAKIT

Kantor Cabang : PASURUAN - 1309

FKTP : Kejayan - 13261301

1246 10-10-2019 132613011019Y001585 0000715922627 SITI FATIMAH. P PBI (APBN) Fever of other and Berobat Jalan
unknown origin
1247 10-10-2019 132613011019Y001586 0000715922818 NUR HASAN L PBI (APBN) Fever of other and Berobat Jalan
unknown origin
1248 10-10-2019 132613011019Y000837 0000715923459 WASIAH P PBI (APBN) Fever of other and Berobat Jalan
unknown origin
1249 10-10-2019 132613011019Y000535 0000715935407 SALIYAH P PBI (APBN) Other headache Berobat Jalan
syndromes
1250 10-10-2019 132613011019Y000566 0000715948571 LILIS ERNAWATI P PEGAWAI SWASTA Typhoid and paratyphoid Berobat Jalan
fevers
1251 10-10-2019 132613011019Y000822 0000715971701 FAIRUS TIHARO L PBI (APBN) Acute upper respiratory Berobat Jalan
infections of multiple and
unspecified sites
1252 10-10-2019 132613011019Y000536 0000715979801 HUDA L PBI (APBN) Acute upper respiratory Berobat Jalan
infections of multiple and
unspecified sites
1253 10-10-2019 132613011019Y000571 0000716146751 MUHIMATUL F P PBI (APBN) Diarrhoea and Berobat Jalan
gastroenteritis of
presumed infectious origin

1254 10-10-2019 132613011019Y000629 0000716327021 MARSINI P PBI (APBN) Other local infections of Berobat Jalan
skin and subcutaneous
tissue
1255 10-10-2019 132613011019Y000628 0000716351062 ROHIM P PBI (APBN) Other disorders of muscle Berobat Jalan

1256 10-10-2019 132613011019Y000572 0000716370737 MOH. KHOFAR L PBI (APBN) Respiratory tuberculosis, Berobat Jalan
bacteriologically and
histologically confirmed
1257 10-10-2019 132613011019Y000634 0000716404184 BUSAR L PBI (APBN) Acute upper respiratory Berobat Jalan
infections of multiple and
unspecified sites
1258 10-10-2019 132613011019Y000631 0000716557566 MUHTAR L PBI (APBN) Conjunctivitis Berobat Jalan

1259 10-10-2019 132613011019Y000474 0000716812896 AISA P PBI (APBN) Other contraceptive Berobat Jalan
management
1260 10-10-2019 132613011019Y000466 0001042697957 JAURI L PBI (APBN) Diarrhoea and Berobat Jalan
gastroenteritis of
presumed infectious origin

1261 10-10-2019 132613011019Y000538 0001042701592 M.SYUKRON BASOR L PBI (APBN) Cough Berobat Jalan
DAFTAR KUNJUNGAN PESERTA SAKIT

Kantor Cabang : PASURUAN - 1309

FKTP : Kejayan - 13261301

1262 10-10-2019 132613011019Y000537 0001042702244 SITI DEWI KARADINDA N.D.A P PBI (APBN) Other local infections of Berobat Jalan
skin and subcutaneous
tissue
1263 10-10-2019 132613011019Y000567 0001042711795 TOHIR L PBI (APBN) Other local infections of Berobat Jalan
skin and subcutaneous
tissue
1264 10-10-2019 132613011019Y001013 0001042714326 JUMADI L PBI (APBN) Other disorders of muscle Berobat Jalan

1265 10-10-2019 132613011019Y001014 0001042714337 HUNAINAH P PBI (APBN) Other headache Berobat Jalan
syndromes
1266 10-10-2019 132613011019Y000575 0001042716317 M. SAFRIZAL FAHMI L PBI (APBN) Unspecified transport Berobat Jalan
accident
1267 10-10-2019 132613011019Y000574 0001042716385 HAMIDAH P PBI (APBN) Essential (primary) Berobat Jalan
hypertension
1268 10-10-2019 132613011019Y000473 0001042719963 NASUHA P PBI (APBN) Other contraceptive Berobat Jalan
management
1269 10-10-2019 132613011019Y000573 0001146226612 YUSUF L PEGAWAI SWASTA Other headache Berobat Jalan
syndromes
1270 10-10-2019 132613011019Y000522 0001704585971 MAHMUDAH P PBI (APBD) Allergic contact dermatitis Berobat Jalan

1271 10-10-2019 132613011019Y001012 0001802966589 CHADIJAH P PBI (APBD) Malaise and fatigue Berobat Jalan

1272 10-10-2019 132613011019Y000468 0001821461477 SYAMSUL ARIFIN L PBI (APBD) Cytomegaloviral disease, Rujuk Vertikal
unspecified
1273 10-10-2019 132613011019Y000580 0001870647963 MUKHAMAD ABDUL QODIR L PEKERJA MANDIRI Other specified Berobat Jalan
counselling
1274 10-10-2019 132613011019Y000521 0001968885922 MOCH. KASAN L PEKERJA MANDIRI Other headache Berobat Jalan
syndromes
1275 10-10-2019 132613011019Y000581 0002001952563 RODEYAH P PBI (APBN) Other specified Berobat Jalan
counselling
1276 10-10-2019 132613011019Y000525 0002161102061 ABIYA MARWAH SALSABILLA P PBI (APBD) Acute upper respiratory Berobat Jalan
infections of multiple and
unspecified sites
1277 10-10-2019 132613011019Y000475 0002265260433 KHOIROTUL MUHIBBAH P PEGAWAI SWASTA Other specified Berobat Jalan
counselling
1278 10-10-2019 132613011019Y000578 0002303816084 DJUWARIYAH P PEKERJA MANDIRI Other specified Berobat Jalan
counselling
1279 10-10-2019 132613011019Y000464 0002440644862 BIRZATUL HANIK L PBI (APBD) Other headache Berobat Jalan
syndromes
1280 10-10-2019 132613011019Y000517 0002487987821 MESNATI P PEKERJA MANDIRI Stomatitis and related Berobat Jalan
lesions
DAFTAR KUNJUNGAN PESERTA SAKIT

Kantor Cabang : PASURUAN - 1309

FKTP : Kejayan - 13261301

1281 10-10-2019 132613011019Y000582 0002584116551 MICHAILA HIDAYAH P PBI (APBN) Typhoid and paratyphoid Berobat Jalan
fevers
1282 09-10-2019 132613011019Y000437 0000112592676 ENDANG RUSMIATI P PNS DAERAH Other headache Berobat Jalan
syndromes
1283 09-10-2019 132613011019Y000439 0000112748332 KRISMA YOGA SATRIA L PNS DAERAH Epilepsy Berobat Jalan

1284 09-10-2019 132613011019Y000443 0000112853136 KULFARIYAH P PNS DAERAH Other symptoms and signs Berobat Jalan
involving the circulatory
and respiratory systems

1285 09-10-2019 132613011019Y000411 0000149518732 YAHYA ZAKARIA MUDASSIR, L PNS DAERAH Insulin-dependent Berobat Jalan
SPD diabetes mellitus
1286 09-10-2019 132613011019Y000828 0000714281872 SULIS SUSILOWATI P PBI (APBN) Acute upper respiratory Berobat Jalan
infections of multiple and
unspecified sites
1287 09-10-2019 132613011019Y000695 0000714599043 JAMILAH P PBI (APBN) Gastritis and duodenitis Berobat Jalan

1288 09-10-2019 132613011019Y000478 0000714751558 NUR KAMILA P PBI (APBN) Fever of other and Berobat Jalan
unknown origin
1289 09-10-2019 132613011019Y000458 0000714797122 NURUL HUDA L PBI (APBN) Influenza, virus not Berobat Jalan
identified
1290 09-10-2019 132613011019Y000459 0000714804399 ULUMI P PBI (APBN) Allergic contact dermatitis Berobat Jalan

1291 09-10-2019 132613011019Y000445 0000715097913 SITI FATIMAH P PBI (APBN) Other rheumatoid arthritis Berobat Jalan

1292 09-10-2019 132613011019Y000446 0000715098341 AGUS SUPRIYADI L PEGAWAI SWASTA Acute upper respiratory Berobat Jalan
infections of multiple and
unspecified sites
1293 09-10-2019 132613011019Y000460 0000715110772 DULLAH L PBI (APBN) Gastritis and duodenitis Berobat Jalan

1294 09-10-2019 132613011019Y000428 0000715113685 MUNAWAROH P PBI (APBN) Supervision of normal Berobat Jalan
pregnancy
1295 09-10-2019 132613011019Y000457 0000715123372 MUNASRI P PBI (APBN) Other headache Berobat Jalan
syndromes
1296 09-10-2019 132613011019Y000455 0000715155478 TOLIB L PBI (APBN) Other rheumatoid arthritis Berobat Jalan

1297 09-10-2019 132613011019Y000456 0000715165301 ATIM L PBI (APBN) Gastritis and duodenitis Berobat Jalan

1298 09-10-2019 132613011019Y000417 0000715182816 SANIYAH P PBI (APBN) Stroke, not specified as Rujuk Vertikal
haemorrhage or infarction
1299 09-10-2019 132613011019Y000441 0000715298758 SUPIAH P PBI (APBN) Other disorders of muscle Berobat Jalan

1300 09-10-2019 132613011019Y000453 0000715333239 UMYANA P PBI (APBN) Essential (primary) Berobat Jalan
hypertension
DAFTAR KUNJUNGAN PESERTA SAKIT

Kantor Cabang : PASURUAN - 1309

FKTP : Kejayan - 13261301

1301 09-10-2019 132613011019Y000438 0000715334152 NAWAWI P PBI (APBN) Schizophrenia Berobat Jalan

1302 09-10-2019 132613011019Y000763 0000715394114 SITI FATIMAH P PBI (APBN) Other disorders of muscle Berobat Jalan

1303 09-10-2019 132613011019Y000765 0000715403496 M SYARONI L PBI (APBN) Dental caries Berobat Jalan

1304 09-10-2019 132613011019Y000477 0000715420359 NAILIL ROHMAH P PBI (APBN) Acute nasopharyngitis Berobat Jalan
[common cold]
1305 09-10-2019 132613011019Y000436 0000715424589 SUMIATI P PBI (APBN) Other dermatitis Berobat Jalan

1306 09-10-2019 132613011019Y000764 0000715432149 M.MUNIR L PBI (APBN) Other headache Berobat Jalan
syndromes
1307 09-10-2019 132613011019Y000476 0000715443153 ACHMAD DOFIR L PBI (APBN) Gingivitis and periodontal Berobat Jalan
diseases
1308 09-10-2019 132613011019Y000694 0000715452941 AMIMAH P PBI (APBN) Other headache Berobat Jalan
syndromes
1309 09-10-2019 132613011019Y000483 0000715599639 SOLIHA P PBI (APBN) Cough Berobat Jalan

1310 09-10-2019 132613011019Y000444 0000715652436 JUHRIYAH P PBI (APBN) Other headache Berobat Jalan
syndromes
1311 09-10-2019 132613011019Y000627 0000715656609 MUSLIMIN L PBI (APBN) Fever of other and Berobat Jalan
unknown origin
1312 09-10-2019 132613011019Y000409 0000715674194 NURWATI P PBI (APBN) Other surgical follow-up Rujuk Vertikal
care
1313 09-10-2019 132613011019Y000508 0000715677647 MASHURI L PBI (APBN) Bursopathy, unspecified Berobat Jalan

1314 09-10-2019 132613011019Y000410 0000715691946 MUHAJR L PBI (APBN) Low vision, both eyes Rujuk Vertikal

1315 09-10-2019 132613011019Y000449 0000715743281 ULIVAH P PBI (APBN) Other disorders of muscle Berobat Jalan

1316 09-10-2019 132613011019Y000440 0000715773879 ABD GHONI L PBI (APBN) Essential (primary) Berobat Jalan
hypertension
1317 09-10-2019 132613011019Y000433 0000715814111 TUMINI P PBI (APBN) Gastritis and duodenitis Berobat Jalan

1318 09-10-2019 132613011019Y000827 0000715825326 FITRIA P PBI (APBN) Acute upper respiratory Berobat Jalan
infections of multiple and
unspecified sites
1319 09-10-2019 132613011019Y000534 0000715902445 MUHDOR L PBI (APBN) Dental caries Berobat Jalan

1320 09-10-2019 132613011019Y000447 0000715904357 SITI MUTI' AH P PBI (APBN) Other headache Berobat Jalan
syndromes
1321 09-10-2019 132613011019Y000482 0000715905077 HOSIAH P PBI (APBN) Other headache Berobat Jalan
syndromes
DAFTAR KUNJUNGAN PESERTA SAKIT

Kantor Cabang : PASURUAN - 1309

FKTP : Kejayan - 13261301

1322 09-10-2019 132613011019Y000533 0000715934147 AMINAH P PBI (APBN) Diarrhoea and Berobat Jalan
gastroenteritis of
presumed infectious origin

1323 09-10-2019 132613011019Y000826 0000715943193 MASUD L PBI (APBN) Fever of other and Berobat Jalan
unknown origin
1324 09-10-2019 132613011019Y001009 0000715951372 AKHMAD AHARI L PBI (APBN) Other disorders of muscle Berobat Jalan

1325 09-10-2019 132613011019Y000532 0000715957817 ALFIN ADNAN FAKEH L PBI (APBN) Acute upper respiratory Berobat Jalan
infections of multiple and
unspecified sites
1326 09-10-2019 132613011019Y001011 0000716012616 RONI SUGIONO L PBI (APBN) Other headache Berobat Jalan
syndromes
1327 09-10-2019 132613011019Y001010 0000716013854 MOHAMMAD EKO L PBI (APBN) Dysphagia Berobat Jalan

1328 09-10-2019 132613011019Y000502 0000716291482 BAHRUL ULUM L PBI (APBN) Gastritis and duodenitis Berobat Jalan

1329 09-10-2019 132613011019Y000501 0000716292088 MUSTOPA L PBI (APBN) Other dermatitis Berobat Jalan

1330 09-10-2019 132613011019Y000412 0000716370737 MOH. KHOFAR L PBI (APBN) Respiratory tuberculosis, Rujuk Vertikal
bacteriologically and
histologically confirmed
1331 09-10-2019 132613011019Y000626 0000716562011 ABDULLAH L PBI (APBN) Gingivitis and periodontal Berobat Jalan
diseases
1332 09-10-2019 132613011019Y000624 0000716576771 SA'I L PBI (APBN) Conjunctivitis Berobat Jalan

1333 09-10-2019 132613011019Y000623 0000716581361 MUHDOR ADINATA L PBI (APBN) Other disorders of muscle Berobat Jalan

1334 09-10-2019 132613011019Y000625 0000716596334 SITI HOTIJA P PBI (APBN) Allergic contact dermatitis Berobat Jalan

1335 09-10-2019 132613011019Y000454 0000716804954 SUKUR L PBI (APBN) Other headache Berobat Jalan
syndromes
1336 09-10-2019 132613011019Y001195 0001042697799 YASIK L PBI (APBN) Non-insulin-dependent Berobat Jalan
diabetes mellitus
1337 09-10-2019 132613011019Y000427 0001042697889 ABD.ROCHIM L PBI (APBN) Gingivitis and periodontal Berobat Jalan
diseases
1338 09-10-2019 132613011019Y000515 0001042707712 FATIMAH P PBI (APBN) Diarrhoea and Berobat Jalan
gastroenteritis of
presumed infectious origin

1339 09-10-2019 132613011019Y000435 0001704586206 SOLIKHATIN P PBI (APBD) Acute upper respiratory Berobat Jalan
infections of multiple and
unspecified sites
1340 09-10-2019 132613011019Y000434 0001740814143 KUN RIYANTI P PEGAWAI SWASTA Other headache Berobat Jalan
syndromes
DAFTAR KUNJUNGAN PESERTA SAKIT

Kantor Cabang : PASURUAN - 1309

FKTP : Kejayan - 13261301

1341 09-10-2019 132613011019Y000408 0001775842378 SITI ASIYAH P PEGAWAI SWASTA Malignant neoplasm of Rujuk Vertikal
breast
1342 09-10-2019 132613011019Y000442 0001820956318 MUHAMMAD TAUFIQ HIDAYAT L PEGAWAI SWASTA Gastritis and duodenitis Berobat Jalan

1343 09-10-2019 132613011019Y000829 0001861858247 NURHAYATI PRIHATI P PEGAWAI SWASTA Allergic contact dermatitis Berobat Jalan
NINGTYAS
1344 09-10-2019 132613011019Y000430 0001968887046 CHOLIFAH P PEKERJA MANDIRI Acute upper respiratory Berobat Jalan
infections of multiple and
unspecified sites
1345 09-10-2019 132613011019Y000432 0002001958661 JULAEKHA P PBI (APBN) Other headache Berobat Jalan
syndromes
1346 09-10-2019 132613011019Y001194 0002039202459 RASWATI P PEKERJA MANDIRI Non-insulin-dependent Berobat Jalan
diabetes mellitus
1347 09-10-2019 132613011019Y000530 0002136707177 KHURIN AINUR ROHMA P PEGAWAI SWASTA Gastritis and duodenitis Berobat Jalan

1348 09-10-2019 132613011019Y000485 0002155163782 MOKHAMAD AMINUDIN L PEGAWAI SWASTA Fever of other and Berobat Jalan
unknown origin
1349 09-10-2019 132613011019Y000484 0002204754366 SITI AMINAH P PEGAWAI SWASTA Acute upper respiratory Berobat Jalan
infections of multiple and
unspecified sites
1350 09-10-2019 132613011019Y001197 0002247356957 SHOMADI KR L PEKERJA MANDIRI Non-insulin-dependent Berobat Jalan
diabetes mellitus
1351 09-10-2019 132613011019Y000531 0002295198336 FATIMATU ZAHRO P PEGAWAI SWASTA Migraine Berobat Jalan

1352 09-10-2019 132613011019Y000448 0002475076004 MUKHAMAD ANDRIAN L PEGAWAI SWASTA Respiratory tuberculosis, Berobat Jalan
SABILILLA bacteriologically and
histologically confirmed
1353 09-10-2019 132613011019Y000451 0002594533678 IDA SAKYANTI P PBI (APBN) Other superficial mycoses Berobat Jalan

1354 09-10-2019 132613011019Y000452 0002626318798 ABD.ROCHMAN L PBI (APBD) Other specified Berobat Jalan
counselling
1355 09-10-2019 132613011019Y001193 0002745272834 SITI FATIMAH P PEKERJA MANDIRI Non-insulin-dependent Berobat Jalan
diabetes mellitus
1356 09-10-2019 132613011019Y000431 0002885018578 ROFIATUL ADAWIYAH P PBI (APBD) Supervision of high-risk Berobat Jalan
pregnancy
1357 08-10-2019 132613011019Y000407 0000097180031 NURUL HAYATI P PENERIMA PENSIUN Non-insulin-dependent Berobat Jalan
PNS diabetes mellitus
1358 08-10-2019 132613011019Y000398 0000112592226 LILIK KHUSNUL KH. P PNS DAERAH Essential (primary) Berobat Jalan
hypertension
1359 08-10-2019 132613011019Y000336 0000714680976 M. TORIQ L PBI (APBN) Influenza, virus not Berobat Jalan
identified
DAFTAR KUNJUNGAN PESERTA SAKIT

Kantor Cabang : PASURUAN - 1309

FKTP : Kejayan - 13261301

1360 08-10-2019 132613011019Y000406 0000714715018 ABD. ROSID L PBI (APBN) Non-insulin-dependent Berobat Jalan
diabetes mellitus
1361 08-10-2019 132613011019Y000392 0000714754686 AMENA P PBI (APBN) Complications and Berobat Jalan
ill-defined descriptions of
heart disease
1362 08-10-2019 132613011019Y000471 0000714940299 HASANAH P PBI (APBN) Fever of other and Berobat Jalan
unknown origin
1363 08-10-2019 132613011019Y000384 0000714958672 MANISA P PBI (APBN) Stomatitis and related Berobat Jalan
lesions
1364 08-10-2019 132613011019Y000342 0000715105697 SAFAK`UDIN L PBI (APBN) Other rheumatoid arthritis Berobat Jalan

1365 08-10-2019 132613011019Y000387 0000715127984 MILA SILFIA P PBI (APBN) Supervision of normal Berobat Jalan
pregnancy
1366 08-10-2019 132613011019Y000343 0000715142766 HOLILI L PBI (APBN) Other headache Berobat Jalan
syndromes
1367 08-10-2019 132613011019Y000421 0000715166627 M. SOHADI L PBI (APBN) Typhoid and paratyphoid Berobat Jalan
fevers
1368 08-10-2019 132613011019Y000388 0000715228863 M. JAMMIL L PBI (APBN) Fever of other and Berobat Jalan
unknown origin
1369 08-10-2019 132613011019Y000712 0000715266134 MOH. BAGUS AMINULLO L PBI (APBN) Acute upper respiratory Berobat Jalan
infections of multiple and
unspecified sites
1370 08-10-2019 132613011019Y000352 0000715267607 TIARA P PBI (APBN) Other headache Berobat Jalan
syndromes
1371 08-10-2019 132613011019Y000479 0000715269756 HOTIJAH P PBI (APBN) Diarrhoea and Berobat Jalan
gastroenteritis of
presumed infectious origin

1372 08-10-2019 132613011019Y000340 0000715415433 SUMARTO L PBI (APBN) Other rheumatoid arthritis Berobat Jalan

1373 08-10-2019 132613011019Y000396 0000715423612 SITI HURMATI P PBI (APBN) Supervision of high-risk Berobat Jalan
pregnancy
1374 08-10-2019 132613011019Y000349 0000715434579 MOCHAMAD ALI L PBI (APBN) Other headache Berobat Jalan
syndromes
1375 08-10-2019 132613011019Y000714 0000715471852 SALIMIN L PBI (APBN) Other disorders of muscle Berobat Jalan

1376 08-10-2019 132613011019Y000720 0000715472302 SITI CHOTIDJAH P PBI (APBN) Other disorders of muscle Berobat Jalan

1377 08-10-2019 132613011019Y000386 0000715525198 ISTINA L PBI (APBN) Other disorders of muscle Berobat Jalan

1378 08-10-2019 132613011019Y001005 0000715626977 SITI RAHAYU P PBI (APBN) Symptoms and signs Berobat Jalan
concerning food and fluid
intake
DAFTAR KUNJUNGAN PESERTA SAKIT

Kantor Cabang : PASURUAN - 1309

FKTP : Kejayan - 13261301

1379 08-10-2019 132613011019Y001007 0000715647936 SAROHAH P PBI (APBN) Other disorders of muscle Berobat Jalan

1380 08-10-2019 132613011019Y001006 0000715648555 SAMSUL ARIFIN L PBI (APBN) Other headache Berobat Jalan
syndromes
1381 08-10-2019 132613011019Y000350 0000715739736 SITI CHOTIJAH P PBI (APBN) Other disorders of muscle Berobat Jalan Diabetes
Mellitus
1382 08-10-2019 132613011019Y000337 0000715752314 MOKH.KOMARUDIN L PBI (APBN) Gastritis and duodenitis Berobat Jalan

1383 08-10-2019 132613011019Y000423 0000715897225 MARJUKI L PBI (APBN) Migraine Berobat Jalan

1384 08-10-2019 132613011019Y001008 0000715906899 SUKARNO L PBI (APBN) Malaise and fatigue Berobat Jalan

1385 08-10-2019 132613011019Y000783 0000715932156 MUNIR L PBI (APBN) Gingivitis and periodontal Berobat Jalan
diseases
1386 08-10-2019 132613011019Y000823 0000715932303 SATINA P PBI (APBN) Acute upper respiratory Berobat Jalan
infections of multiple and
unspecified sites
1387 08-10-2019 132613011019Y000824 0000715932415 SATUPA P PBI (APBN) Other disorders of muscle Berobat Jalan

1388 08-10-2019 132613011019Y000825 0000715932876 SAMSUL ARIFIN L PBI (APBN) Acute upper respiratory Berobat Jalan
infections of multiple and
unspecified sites
1389 08-10-2019 132613011019Y000782 0000715954713 USWATUN HASANAH P PBI (APBN) Acute upper respiratory Berobat Jalan
infections of multiple and
unspecified sites
1390 08-10-2019 132613011019Y000394 0000716005427 BAYU BASORUDIN L PBI (APBN) Fever of other and Berobat Jalan
unknown origin
1391 08-10-2019 132613011019Y000424 0000716084256 MUIN L PBI (APBN) Other local infections of Berobat Jalan
skin and subcutaneous
tissue
1392 08-10-2019 132613011019Y000450 0000716335907 DINAL ISLAMI P PBI (APBN) Fever of other and Berobat Jalan
unknown origin
1393 08-10-2019 132613011019Y000486 0000716336414 DINIL QOIYIMAH P PBI (APBN) Eating disorders Berobat Jalan

1394 08-10-2019 132613011019Y000622 0000716360275 BAKRI L PBI (APBN) Diarrhoea and Berobat Jalan
gastroenteritis of
presumed infectious origin

1395 08-10-2019 132613011019Y000621 0000716382257 SENIOWATI P PBI (APBN) Gastritis and duodenitis Berobat Jalan

1396 08-10-2019 132613011019Y000355 0000716394677 SOPIA P PBI (APBN) Heart failure Rujuk Vertikal

1397 08-10-2019 132613011019Y000480 0000716405411 SULIANI P PBI (APBN) Gastritis and duodenitis Berobat Jalan

1398 08-10-2019 132613011019Y000400 0001042703515 MADELAN L PBI (APBN) Other disorders of muscle Berobat Jalan
DAFTAR KUNJUNGAN PESERTA SAKIT

Kantor Cabang : PASURUAN - 1309

FKTP : Kejayan - 13261301

1399 08-10-2019 132613011019Y000390 0001042706619 SAYATI P PBI (APBN) Diarrhoea and Berobat Jalan
gastroenteritis of
presumed infectious origin

1400 08-10-2019 132613011019Y000425 0001042710219 AYAH P PBI (APBN) Other headache Berobat Jalan
syndromes
1401 08-10-2019 132613011019Y000426 0001042712414 NURUL H P PBI (APBN) Nausea and vomiting Berobat Jalan

1402 08-10-2019 132613011019Y000420 0001042715204 ROKHMATUL AIDAH P PBI (APBN) Other dermatitis Berobat Jalan

1403 08-10-2019 132613011019Y000415 0001042715452 SUPARNI P PBI (APBN) Acute nasopharyngitis Berobat Jalan
[common cold]
1404 08-10-2019 132613011019Y000389 0001042719243 VALENTINA IRMAWATI P PBI (APBN) Supervision of normal Berobat Jalan
pregnancy
1405 08-10-2019 132613011019Y000353 0001042719366 SALAMAH P PBI (APBN) Other headache Berobat Jalan Diabetes
syndromes Mellitus
1406 08-10-2019 132613011019Y000422 0001042737107 MARIA RUSPITA MARGARETA P PBI (APBN) Other specified Berobat Jalan
counselling
1407 08-10-2019 132613011019Y000397 0001043033444 SAIDA P PBI (APBN) Other specified Berobat Jalan
counselling
1408 08-10-2019 132613011019Y000359 0001043033455 NAILILATUL FARKHAH P PBI (APBN) Visual impairment Rujuk Vertikal
including blindness
(binocular or monocular)
1409 08-10-2019 132613011019Y000383 0001197502413 IKA OKTAVIA RATHIH P PEGAWAI SWASTA Supervision of high-risk Berobat Jalan
pregnancy
1410 08-10-2019 132613011019Y000399 0001226976006 NAYLA FADILLAH FITRI P PRAJURIT AL Acute upper respiratory Berobat Jalan
infections of multiple and
unspecified sites
1411 08-10-2019 132613011019Y000481 0001321623461 SAMSUL ARIS L PEGAWAI SWASTA Other local infections of Berobat Jalan
skin and subcutaneous
tissue
1412 08-10-2019 132613011019Y000393 0001433123166 MAIMUNA P PEKERJA MANDIRI Non-insulin-dependent Berobat Jalan
diabetes mellitus
1413 08-10-2019 132613011019Y000391 0001821649588 MOHAMMAD ALBI LUTFI AL L PEGAWAI SWASTA Fever of other and Berobat Jalan
GHIFARI unknown origin
1414 08-10-2019 132613011019Y000414 0002001951268 ROFI`AH P PBI (APBN) Essential (primary) Berobat Jalan Hipertensi
hypertension
1415 08-10-2019 132613011019Y000413 0002001951279 ULFA NAFIDATUL YAHANA P PBI (APBN) Other local infections of Berobat Jalan
skin and subcutaneous
tissue
1416 08-10-2019 132613011019Y000429 0002001952809 FATLUCHA P PBI (APBN) Other disorders of muscle Berobat Jalan
DAFTAR KUNJUNGAN PESERTA SAKIT

Kantor Cabang : PASURUAN - 1309

FKTP : Kejayan - 13261301

1417 08-10-2019 132613011019Y000419 0002278233292 MURNI P PEKERJA MANDIRI Myalgia Berobat Jalan

1418 08-10-2019 132613011019Y000371 0002470907654 SHILA FINA MAFAZA P PEKERJA MANDIRI Disorders of tooth Berobat Jalan
development and eruption
1419 08-10-2019 132613011019Y000416 0002590576817 M.AMIRUDIN L PBI (APBN) Other local infections of Berobat Jalan
skin and subcutaneous
tissue
1420 08-10-2019 132613011019Y000401 0002595056409 M WAHYU FIRMANSYAH L PBI (APBN) Other local infections of Berobat Jalan
skin and subcutaneous
tissue
1421 08-10-2019 132613011019Y000395 0002629092418 WISNU SARIFUDDIN L PBI (APBN) Acute nasopharyngitis Berobat Jalan
[common cold]
1422 08-10-2019 132613011019Y000418 0002749486746 BAYI NYONYA HILYATUL L PBI (APBN) Other specified Berobat Jalan
UNSIYAH counselling
1423 08-10-2019 132613011019Y000385 0002771776765 NURUL HOLILA P PBI (APBD) Supervision of high-risk Berobat Jalan
pregnancy
1424 08-10-2019 132613011019Y000351 0002889153988 HAMID L PEKERJA MANDIRI Stroke, not specified as Rujuk Vertikal
haemorrhage or infarction
1425 07-10-2019 132613011019Y000283 0000112590213 JUNURIYATI P PNS DAERAH Calculus of kidney and Rujuk Vertikal
ureter
1426 07-10-2019 132613011019Y000310 0000112900645 PAMOEDJI L PENERIMA PENSIUN Other disorders of muscle Berobat Jalan
PNS
1427 07-10-2019 132613011019Y000285 0000714395316 SITI SUBAIDAH P PBI (APBN) Supervision of normal Berobat Jalan
pregnancy
1428 07-10-2019 132613011019Y000322 0000714435647 AHMAD L PBI (APBN) Other headache Berobat Jalan
syndromes
1429 07-10-2019 132613011019Y000324 0000714441071 M. HAMBALI L PBI (APBN) Dental caries Berobat Jalan

1430 07-10-2019 132613011019Y000691 0000714615546 RODIYA P PBI (APBN) Other headache Berobat Jalan
syndromes
1431 07-10-2019 132613011019Y000313 0000714739544 NURUL P PBI (APBN) Fever of other and Berobat Jalan
unknown origin
1432 07-10-2019 132613011019Y000307 0000714756745 MUNAWAROH P PBI (APBN) Other disorders of muscle Berobat Jalan

1433 07-10-2019 132613011019Y000270 0000714789191 KHOJIN L PBI (APBN) Allergic contact dermatitis Berobat Jalan

1434 07-10-2019 132613011019Y000331 0000714808721 MUJIB L PBI (APBN) Other headache Berobat Jalan
syndromes
1435 07-10-2019 132613011019Y000311 0000714937577 B. ASTIMA P PBI (APBN) Stomatitis and related Berobat Jalan
lesions
1436 07-10-2019 132613011019Y000308 0000714938185 FIRFAN S. L PBI (APBN) Gastritis and duodenitis Berobat Jalan
DAFTAR KUNJUNGAN PESERTA SAKIT

Kantor Cabang : PASURUAN - 1309

FKTP : Kejayan - 13261301

1437 07-10-2019 132613011019Y000312 0000714941741 M. NUROHMAN L PBI (APBN) Other headache Berobat Jalan
syndromes
1438 07-10-2019 132613011019Y000279 0000715129389 MUANA P PBI (APBN) Ganglion Rujuk Vertikal

1439 07-10-2019 132613011019Y000288 0000715132236 SITI ASIA P PBI (APBN) Supervision of normal Berobat Jalan
pregnancy
1440 07-10-2019 132613011019Y000268 0000715152892 M. MUNIR AR L PBI (APBN) Other rheumatoid arthritis Berobat Jalan

1441 07-10-2019 132613011019Y000295 0000715258258 SYAFII L PBI (APBN) Other functional intestinal Berobat Jalan
disorders
1442 07-10-2019 132613011019Y000369 0000715265379 ARI DWI SANTOSO L PBI (APBN) Other headache Berobat Jalan
syndromes
1443 07-10-2019 132613011019Y000332 0000715274965 NAIMAH P PBI (APBN) Allergic contact dermatitis Berobat Jalan

1444 07-10-2019 132613011019Y000323 0000715306678 M. NUR FAIZIN L PBI (APBN) Fever of other and Berobat Jalan
unknown origin
1445 07-10-2019 132613011019Y000316 0000715326322 SAINI L PBI (APBN) Other headache Berobat Jalan
syndromes
1446 07-10-2019 132613011019Y001001 0000715412305 RIDUWAN L PBI (APBN) Malaise and fatigue Berobat Jalan

1447 07-10-2019 132613011019Y000315 0000715415984 SOLEHATI P PBI (APBN) Gastritis and duodenitis Berobat Jalan

1448 07-10-2019 132613011019Y000347 0000715417626 SUILA P PBI (APBN) Bronchitis, not specified as Berobat Jalan
acute or chronic
1449 07-10-2019 132613011019Y000327 0000715430801 SO`IDAH P PBI (APBN) Other disorders of muscle Berobat Jalan

1450 07-10-2019 132613011019Y000338 0000715435424 JUARIYAH P PBI (APBN) Fever of other and Berobat Jalan
unknown origin
1451 07-10-2019 132613011019Y000334 0000715451084 ACHMAD YASIN L PBI (APBN) Other headache Berobat Jalan
syndromes
1452 07-10-2019 132613011019Y001002 0000715464843 AMELIA PUTRI P PBI (APBN) Dysphagia Berobat Jalan

1453 07-10-2019 132613011019Y001003 0000715476306 NURYAHYA L PBI (APBN) Acute upper respiratory Berobat Jalan
infections of multiple and
unspecified sites
1454 07-10-2019 132613011019Y000300 0000715484867 ENIK NUR HAYATI P PBI (APBN) Essential (primary) Berobat Jalan
hypertension
1455 07-10-2019 132613011019Y000348 0000715506164 AMINAH P PBI (APBN) Essential (primary) Berobat Jalan
hypertension
1456 07-10-2019 132613011019Y000289 0000715564495 HALIMA P PBI (APBN) Supervision of normal Berobat Jalan
pregnancy
1457 07-10-2019 132613011019Y000693 0000715583924 TAMIMAH P PBI (APBN) Other headache Berobat Jalan
syndromes
DAFTAR KUNJUNGAN PESERTA SAKIT

Kantor Cabang : PASURUAN - 1309

FKTP : Kejayan - 13261301

1458 07-10-2019 132613011019Y001004 0000715606929 M ALFANDI L PBI (APBN) Medical observation and Berobat Jalan
evaluation for suspected
diseases and conditions
1459 07-10-2019 132613011019Y000703 0000715621689 KASIYATI P PBI (APBN) Bursopathy, unspecified Berobat Jalan

1460 07-10-2019 132613011019Y000702 0000715637439 SATUWI L PBI (APBN) Acute upper respiratory Berobat Jalan
infections of multiple and
unspecified sites
1461 07-10-2019 132613011019Y000358 0000715648825 MACHMUDAH P PBI (APBN) Essential (primary) Berobat Jalan
hypertension
1462 07-10-2019 132613011019Y000665 0000715691248 M. SYAFI'I L PBI (APBN) Influenza, virus not Berobat Jalan
identified
1463 07-10-2019 132613011019Y000661 0000715698358 ROMLI L PBI (APBN) Other headache Berobat Jalan
syndromes
1464 07-10-2019 132613011019Y000284 0000715751605 HARIYANTO L PBI (APBN) Stroke, not specified as Rujuk Vertikal
haemorrhage or infarction
1465 07-10-2019 132613011019Y000364 0000715761742 ISPANDI L PBI (APBN) Other local infections of Berobat Jalan
skin and subcutaneous
tissue
1466 07-10-2019 132613011019Y000363 0000715762225 M FARHAN AULIYAK L PBI (APBN) Influenza, virus not Berobat Jalan
identified
1467 07-10-2019 132613011019Y000344 0000715766916 SITI AMINA P PBI (APBN) Other headache Berobat Jalan
syndromes
1468 07-10-2019 132613011019Y000329 0000715769583 MUJIATI P PBI (APBN) Other disorders of muscle Berobat Jalan

1469 07-10-2019 132613011019Y000666 0000715775635 HATIMA P PBI (APBN) Gingivitis and periodontal Berobat Jalan
diseases
1470 07-10-2019 132613011019Y000376 0000715855656 M. AS`ARI L PBI (APBN) Migraine Berobat Jalan

1471 07-10-2019 132613011019Y000377 0000715856613 MOCH. BAITUR RIZQI . L PBI (APBN) Cough Berobat Jalan

1472 07-10-2019 132613011019Y000341 0000715869011 M. ANUN NA'IM L PBI (APBN) Gastritis and duodenitis Berobat Jalan

1473 07-10-2019 132613011019Y000617 0000715900511 JUHRIYAH P PBI (APBN) Other headache Berobat Jalan
syndromes
1474 07-10-2019 132613011019Y000777 0000715930918 AWI L PBI (APBN) Other headache Berobat Jalan
syndromes
1475 07-10-2019 132613011019Y000382 0000715953824 ARUMI P PBI (APBN) Other headache Berobat Jalan
syndromes
1476 07-10-2019 132613011019Y000379 0000715953868 ABD.HAMID L PBI (APBN) Cough Berobat Jalan

1477 07-10-2019 132613011019Y000779 0000715954263 SOHIB L PBI (APBN) Gingivitis and periodontal Berobat Jalan
diseases
DAFTAR KUNJUNGAN PESERTA SAKIT

Kantor Cabang : PASURUAN - 1309

FKTP : Kejayan - 13261301

1478 07-10-2019 132613011019Y000776 0000715976864 SAKRODI L PBI (APBN) Other disorders of muscle Berobat Jalan

1479 07-10-2019 132613011019Y000280 0000715993751 HAIRUMI P PBI (APBN) Other specified diabetes Rujuk Vertikal
mellitus with unspecified
complications
1480 07-10-2019 132613011019Y000380 0000715997024 HUSNUL YAKIN L PBI (APBN) Diarrhoea and Berobat Jalan
gastroenteritis of
presumed infectious origin

1481 07-10-2019 132613011019Y000354 0000716020571 SAHRONI L PBI (APBN) Necrosis of pulp Berobat Jalan

1482 07-10-2019 132613011019Y000374 0000716109344 AHMAD FAISOL. MZ L PBI (APBN) Fever of other and Berobat Jalan
unknown origin
1483 07-10-2019 132613011019Y000664 0000716346775 JUMARI. L PBI (APBN) Other inflammation of Berobat Jalan
eyelid
1484 07-10-2019 132613011019Y000404 0000716350015 SAUNA P PBI (APBN) Other headache Berobat Jalan
syndromes
1485 07-10-2019 132613011019Y000660 0000716380863 MASRUROH P PBI (APBN) Other disorders of muscle Berobat Jalan

1486 07-10-2019 132613011019Y000663 0000716564092 SUPADI L PBI (APBN) Acute upper respiratory Berobat Jalan
infections of multiple and
unspecified sites
1487 07-10-2019 132613011019Y000692 0001042683434 ROBIK P PBI (APBN) Gastritis and duodenitis Berobat Jalan

1488 07-10-2019 132613011019Y000281 0001042685245 SARIPA P PBI (APBN) Iodine-deficiency-related Rujuk Vertikal
thyroid disorders and allied
conditions
1489 07-10-2019 132613011019Y000690 0001042685954 SITI HANIK P PBI (APBN) Acute upper respiratory Berobat Jalan
infections of multiple and
unspecified sites
1490 07-10-2019 132613011019Y000298 0001042694008 SALAMAH P PBI (APBN) Non-insulin-dependent Berobat Jalan
diabetes mellitus
1491 07-10-2019 132613011019Y000330 0001042695268 SUPARDI L PBI (APBN) Other diseases of intestine Berobat Jalan

1492 07-10-2019 132613011019Y000361 0001042698868 MOCHAMMAD IZZUDDIN L PBI (APBN) Typhoid and paratyphoid Berobat Jalan
fevers
1493 07-10-2019 132613011019Y000362 0001042703559 SOLEHUDIN L PBI (APBN) Influenza, virus not Berobat Jalan
identified
1494 07-10-2019 132613011019Y000339 0001042709905 KHORIDATUL BAHIYA P PBI (APBN) Allergic contact dermatitis Berobat Jalan

1495 07-10-2019 132613011019Y000378 0001042712201 MUSTA ALIMAH P PBI (APBN) Diarrhoea and Berobat Jalan
gastroenteritis of
presumed infectious origin
DAFTAR KUNJUNGAN PESERTA SAKIT

Kantor Cabang : PASURUAN - 1309

FKTP : Kejayan - 13261301

1496 07-10-2019 132613011019Y000375 0001042713011 MARYATI P PBI (APBN) Dental caries Berobat Jalan

1497 07-10-2019 132613011019Y000282 0001042716881 SITI MARYAM P PBI (APBN) Insulin-dependent Rujuk Vertikal Diabetes
diabetes mellitus Mellitus
1498 07-10-2019 132613011019Y000370 0001042717274 SUBIARI L PBI (APBN) Other specified Berobat Jalan
counselling
1499 07-10-2019 132613011019Y000299 0001270140118 TITIK SUSIATI P PEKERJA MANDIRI Myalgia Berobat Jalan

1500 07-10-2019 132613011019Y000346 0001426830704 wiwik widayati P PEKERJA MANDIRI Essential (primary) Berobat Jalan Hipertensi
hypertension
1501 07-10-2019 132613011019Y000326 0001775842378 SITI ASIYAH P PEGAWAI SWASTA Myalgia Berobat Jalan

1502 07-10-2019 132613011019Y000333 0001795302101 NURUL YAQIN L PEGAWAI SWASTA Respiratory tuberculosis, Berobat Jalan
bacteriologically and
histologically confirmed
1503 07-10-2019 132613011019Y000335 0001832802028 MAISAROH P PEGAWAI SWASTA Other specified Berobat Jalan
counselling
1504 07-10-2019 132613011019Y000296 0001882398824 SANATI P PEKERJA MANDIRI Gastritis and duodenitis Berobat Jalan

1505 07-10-2019 132613011019Y000276 0002001950054 NASIPA P PBI (APBN) Stricture and atresia of Rujuk Vertikal
vagina
1506 07-10-2019 132613011019Y000304 0002001952034 MOKH AINUL YAKIN L PBI (APBN) Fever of other and Berobat Jalan
unknown origin
1507 07-10-2019 132613011019Y000302 0002001952113 ANISAH P PBI (APBN) Influenza, virus not Berobat Jalan
identified
1508 07-10-2019 132613011019P000305 0002001958716 KHOLILA P PBI (APBN) Single spontaneous Lain-lain
delivery
1509 07-10-2019 132613011019Y000356 0002080704306 CHUMAIDAH P PEKERJA MANDIRI Necrosis of pulp Berobat Jalan

1510 07-10-2019 132613011019Y000309 0002161101971 UMI KHOLIFAH P PBI (APBD) Essential (primary) Berobat Jalan
hypertension
1511 07-10-2019 132613011019Y000381 0002204247789 NUR HALIMAH P PEGAWAI SWASTA Nausea and vomiting Berobat Jalan

1512 07-10-2019 132613011019Y000662 0002215638775 SOLEH L PBI (APBD) Other dermatitis Berobat Jalan

1513 07-10-2019 132613011019Y000293 0002236216138 DWI MARTAN L PEGAWAI SWASTA Acute upper respiratory Berobat Jalan
infections of multiple and
unspecified sites
1514 07-10-2019 132613011019Y000357 0002267085598 ANIK SUBAKTI P PBI (APBD) Gastritis and duodenitis Berobat Jalan

1515 07-10-2019 132613011019Y000278 0002289694724 BASOR WAHID L PEKERJA MANDIRI Ganglion Rujuk Vertikal

1516 07-10-2019 132613011019Y000345 0002301126557 SIIN L PBI (APBD) Schizophrenia Berobat Jalan
DAFTAR KUNJUNGAN PESERTA SAKIT

Kantor Cabang : PASURUAN - 1309

FKTP : Kejayan - 13261301

1517 07-10-2019 132613011019Y000287 0002463905711 KUNI ZAKIYAH P PEGAWAI SWASTA Supervision of normal Berobat Jalan
pregnancy
1518 07-10-2019 132613011019Y000366 0002478543895 LINDA EFIN ROMADONI P PEKERJA MANDIRI Gastric ulcer Berobat Jalan

1519 07-10-2019 132613011019Y000328 0002494457144 MUHAMAD NURUL L PEGAWAI SWASTA Other diseases of intestine Berobat Jalan

1520 07-10-2019 132613011019Y000367 0002583628356 ZUBAIDAH P PBI (APBN) Other dermatitis Berobat Jalan

1521 07-10-2019 132613011019Y000277 0002585261755 NOER IZZABELLAH P PBI (APBN) Gingivitis and periodontal Berobat Jalan
diseases
1522 07-10-2019 132613011019Y000368 0002603976974 AHMAD FAUZAN L PBI (APBN) Otitis externa Berobat Jalan

1523 07-10-2019 132613011019Y000360 0002631193929 ZAINUL ARIFIN L PBI (APBN) Acute nasopharyngitis Berobat Jalan
[common cold]
1524 07-10-2019 132613011019Y000294 0002639669253 NAIMAH P PBI (APBN) Other contraceptive Berobat Jalan
management
1525 07-10-2019 132613011019Y000286 0002749741266 TITAVIANA PRAVNA SARI P PEGAWAI SWASTA Supervision of normal Berobat Jalan
pregnancy
1526 07-10-2019 132613011019Y000365 0002759657736 RUMILA P PEKERJA MANDIRI Gastritis and duodenitis Berobat Jalan

1527 07-10-2019 132613011019Y000290 0002885018657 LULUK FARIDAH P PBI (APBD) Supervision of normal Berobat Jalan
pregnancy
1528 05-10-2019 132613011019Y001559 0000040466013 AWAN AGIONO L PNS PUSAT Other specified Berobat Jalan
counselling
1529 05-10-2019 132613011019Y000269 0000112988463 ALIF INDRALISTYARINI P PNS DAERAH Other specified Berobat Jalan
counselling
1530 05-10-2019 132613011019Y000241 0000713604328 KHOLIFAH P PBI (APBN) Essential (primary) Berobat Jalan
hypertension
1531 05-10-2019 132613011019Y000321 0000714431935 MISBAHUL MUNIR L PBI (APBN) Acute upper respiratory Berobat Jalan
infections of multiple and
unspecified sites
1532 05-10-2019 132613011019Y000236 0000714448089 MAMLU'ATUR ROHMA P PBI (APBN) Other specified Berobat Jalan
counselling
1533 05-10-2019 132613011019Y000688 0000714617144 ROSIDA P PBI (APBN) Gingivitis and periodontal Berobat Jalan
diseases
1534 05-10-2019 132613011019Y000297 0000714732287 MURNIATI P PBI (APBN) Fever of other and Berobat Jalan
unknown origin
1535 05-10-2019 132613011019Y000303 0000714739612 M IKROM L PBI (APBN) Diarrhoea and Berobat Jalan
gastroenteritis of
presumed infectious origin

1536 05-10-2019 132613011019Y000301 0000714758433 M. FATHUR ROZI L PBI (APBN) Gastritis and duodenitis Berobat Jalan
DAFTAR KUNJUNGAN PESERTA SAKIT

Kantor Cabang : PASURUAN - 1309

FKTP : Kejayan - 13261301

1537 05-10-2019 132613011019Y000686 0000714790012 SUBAIDAH P PBI (APBN) Influenza, virus not Berobat Jalan
identified
1538 05-10-2019 132613011019Y000602 0000715078844 SUPAIDAH P PBI (APBN) Acute upper respiratory Berobat Jalan
infections of multiple and
unspecified sites
1539 05-10-2019 132613011019Y000242 0000715116644 NUR WAKHIDA ARIANI P PBI (APBN) Other local infections of Berobat Jalan
skin and subcutaneous
tissue
1540 05-10-2019 132613011019Y000222 0000715130199 LULUK SUJIATI P PBI (APBN) Influenza, virus not Berobat Jalan
identified
1541 05-10-2019 132613011019Y000655 0000715133171 HAMIDAH P PBI (APBN) Diarrhoea and Berobat Jalan
gastroenteritis of
presumed infectious origin

1542 05-10-2019 132613011019Y000252 0000715254265 MOCHAMAD ALI L PBI (APBN) Other disorders of muscle Berobat Jalan

1543 05-10-2019 132613011019Y000253 0000715255187 MOCHAMAD NURHASAN L PBI (APBN) Allergic contact dermatitis Berobat Jalan

1544 05-10-2019 132613011019Y000223 0000715261814 AHMAD ALAWI L PBI (APBN) Gastritis and duodenitis Berobat Jalan

1545 05-10-2019 132613011019Y000251 0000715289804 KHODIJAH BARROH P PBI (APBN) Other headache Berobat Jalan
syndromes
1546 05-10-2019 132613011019Y000243 0000715304564 CHOIRIYAH P PBI (APBN) Influenza, virus not Berobat Jalan
identified
1547 05-10-2019 132613011019Y000248 0000715329538 MUFIDA P PBI (APBN) Other headache Berobat Jalan
syndromes
1548 05-10-2019 132613011019Y000317 0000715387847 ROHILAH P PBI (APBN) Fever of other and Berobat Jalan
unknown origin
1549 05-10-2019 132613011019Y001000 0000715406422 HASANAH P PBI (APBN) Other disorders of muscle Berobat Jalan

1550 05-10-2019 132613011019Y000603 0000715419461 MOH. SOLEH L PBI (APBN) Other headache Berobat Jalan
syndromes
1551 05-10-2019 132613011019Y000604 0000715419775 MUHAMAD FAHRUR ROZI L PBI (APBN) Symptoms and signs Berobat Jalan
concerning food and fluid
intake
1552 05-10-2019 132613011019Y000249 0000715424027 SOLIHIN L PBI (APBN) Influenza, virus not Berobat Jalan
identified
1553 05-10-2019 132613011019Y000687 0000715429372 SAUDAH P PBI (APBN) Gastritis and duodenitis Berobat Jalan

1554 05-10-2019 132613011019Y000318 0000715436919 SOFWAN L PBI (APBN) Other disorders of muscle Berobat Jalan

1555 05-10-2019 132613011019Y000264 0000715444165 AISAH P PBI (APBN) Necrosis of pulp Berobat Jalan

1556 05-10-2019 132613011019Y000657 0000715455347 SAHRIYA P PBI (APBN) Other disorders of muscle Berobat Jalan
DAFTAR KUNJUNGAN PESERTA SAKIT

Kantor Cabang : PASURUAN - 1309

FKTP : Kejayan - 13261301

1557 05-10-2019 132613011019Y000319 0000715455461 ASMAWI L PBI (APBN) Other disorders of muscle Berobat Jalan

1558 05-10-2019 132613011019Y000320 0000715455775 SURATNI P PBI (APBN) Other disorders of muscle Berobat Jalan

1559 05-10-2019 132613011019Y000659 0000715473022 NAIMA P PBI (APBN) Diarrhoea and Berobat Jalan
gastroenteritis of
presumed infectious origin

1560 05-10-2019 132613011019Y000999 0000715473202 RASAD L PBI (APBN) Malaise and fatigue Berobat Jalan

1561 05-10-2019 132613011019Y000656 0000715670155 ATIM SUAIDAH P PBI (APBN) Gingivitis and periodontal Berobat Jalan
diseases
1562 05-10-2019 132613011019Y000266 0000715732907 ABD ROHIM L PBI (APBN) Influenza due to other Berobat Jalan
identified influenza virus
1563 05-10-2019 132613011019Y000218 0000715813119 USWATUN HASANAH P PBI (APBN) Other headache Berobat Jalan
syndromes
1564 05-10-2019 132613011019Y000235 0000715942686 DAWILAH P PBI (APBN) Cholelithiasis Rujuk Vertikal

1565 05-10-2019 132613011019Y000265 0000715944688 SITI NUR HALIMAH P PBI (APBN) Acute upper respiratory Berobat Jalan
infections of multiple and
unspecified sites
1566 05-10-2019 132613011019Y000273 0000715964613 LUTFIA P PBI (APBN) Other headache Berobat Jalan
syndromes
1567 05-10-2019 132613011019Y000247 0000716038773 MUJANI L PBI (APBN) Essential (primary) Berobat Jalan
hypertension
1568 05-10-2019 132613011019Y000372 0000716058854 SULIANA P PBI (APBN) Radicular cyst Berobat Jalan

1569 05-10-2019 132613011019Y000257 0000716137288 DAERI L PBI (APBN) Dental caries Berobat Jalan

1570 05-10-2019 132613011019Y000658 0000716276259 SAHUD L PBI (APBN) Other headache Berobat Jalan
syndromes
1571 05-10-2019 132613011019Y000325 0000716359599 AYU LESTARI P PBI (APBN) Fever of other and Berobat Jalan
unknown origin
1572 05-10-2019 132613011019Y000402 0000716420992 SUBALI L PBI (APBN) Acute upper respiratory Berobat Jalan
infections of multiple and
unspecified sites
1573 05-10-2019 132613011019Y000689 0001042686235 ALFIAH P PBI (APBN) Migraine Berobat Jalan

1574 05-10-2019 132613011019Y000220 0001042694403 MIANAH P PBI (APBN) Other rheumatoid arthritis Berobat Jalan

1575 05-10-2019 132613011019Y000373 0001042697935 AISAH P PBI (APBN) Gingivitis and periodontal Berobat Jalan
diseases
1576 05-10-2019 132613011019Y000274 0001042702446 UMI FATHONAH P PBI (APBN) Nausea and vomiting Berobat Jalan

1577 05-10-2019 132613011019Y000272 0001042702492 IHYAK L PBI (APBN) Migraine Berobat Jalan
DAFTAR KUNJUNGAN PESERTA SAKIT

Kantor Cabang : PASURUAN - 1309

FKTP : Kejayan - 13261301

1578 05-10-2019 132613011019Y000250 0001042707464 SOHIB L PBI (APBN) Acute upper respiratory Berobat Jalan
infections of multiple and
unspecified sites
1579 05-10-2019 132613011019Y000258 0001042710423 MOCH.HUSNAN L PBI (APBN) Diarrhoea and Berobat Jalan
gastroenteritis of
presumed infectious origin

1580 05-10-2019 132613011019Y000259 0001042711986 ROSIDA HANIM P PBI (APBN) Gastritis and duodenitis Berobat Jalan

1581 05-10-2019 132613011019Y001191 0001042717792 RUQOYAH P PBI (APBN) Non-insulin-dependent Berobat Jalan
diabetes mellitus
1582 05-10-2019 132613011019Y000245 0001080518242 M.ANDHIKA YUDA L PNS DAERAH Other dermatitis Berobat Jalan
ARDIANSYAH
1583 05-10-2019 132613011019Y000263 0001124974912 LIYANATUL ADAM MASMITA P PEGAWAI SWASTA Gingivitis and periodontal Berobat Jalan
diseases
1584 05-10-2019 132613011019Y000267 0001227154296 ODE EVI YULIANTI P PNS DAERAH Other headache Berobat Jalan
syndromes
1585 05-10-2019 132613011019Y000244 0001439839056 MUHAMMAD RIDHOLLOH L PEGAWAI SWASTA Fever of other and Berobat Jalan
unknown origin
1586 05-10-2019 132613011019Y000221 0001542030153 ALMAIRA DARYN NAIFAH P PEGAWAI SWASTA Gastritis and duodenitis Berobat Jalan

1587 05-10-2019 132613011019Y000238 0001879888151 QUEEN AQILLAH ZAYYAN P PRAJURIT AL Diarrhoea and Berobat Jalan
NURKHOFIFAH gastroenteritis of
presumed infectious origin

1588 05-10-2019 132613011019Y000234 0001879996781 SULASTRI P PEKERJA MANDIRI Calculus of kidney and Rujuk Vertikal
ureter
1589 05-10-2019 132613011019Y000239 0002001950054 NASIPA P PBI (APBN) Acute upper respiratory Berobat Jalan
infections of multiple and
unspecified sites
1590 05-10-2019 132613011019Y000685 0002001959561 NUR SALIM L PBI (APBN) Acute upper respiratory Berobat Jalan
infections of multiple and
unspecified sites
1591 05-10-2019 132613011019Y000271 0002298531159 M. ASRAF ZAIRUL UBAID L PBI (APBD) Other specified Berobat Jalan
counselling
1592 05-10-2019 132613011019Y000240 0002300585422 HAMIDA P PBI (APBD) Myalgia Berobat Jalan

1593 05-10-2019 132613011019Y000219 0002629408296 MUHAMMAD ZAIDAN NAWAWI L PBI (APBN) Fever of other and Berobat Jalan
unknown origin
1594 05-10-2019 132613011019Y000275 0002639669253 NAIMAH P PBI (APBN) Other specified Berobat Jalan
counselling
DAFTAR KUNJUNGAN PESERTA SAKIT

Kantor Cabang : PASURUAN - 1309

FKTP : Kejayan - 13261301

1595 05-10-2019 132613011019Y000246 0002680904777 JAMAALI L PBI (APBD) Other local infections of Berobat Jalan
skin and subcutaneous
tissue
1596 05-10-2019 132613011019Y000237 0002758190872 DISTYA NAYASAKHI P PNS DAERAH Acute upper respiratory Berobat Jalan
WICAKSONO infections of multiple and
unspecified sites
1597 05-10-2019 132613011019Y000233 0002883960606 PRAPTI EKA LESTARI P PEKERJA MANDIRI Viral hepatitis complicating Rujuk Vertikal
pregnancy, childbirth and
the puerperium

1598 04-10-2019 132613011019Y000552 0000714250361 HOIRON L PBI (APBN) Allergic contact dermatitis Berobat Jalan

1599 04-10-2019 132613011019Y000553 0000714250552 HOIRUL ANAM L PBI (APBN) Acute upper respiratory Berobat Jalan
infections of multiple and
unspecified sites
1600 04-10-2019 132613011019Y000551 0000714270104 MOHARI L PBI (APBN) Other disorders of muscle Berobat Jalan

1601 04-10-2019 132613011019Y000550 0000714270701 JUARIYA P PBI (APBN) Fever of other and Berobat Jalan
unknown origin
1602 04-10-2019 132613011019Y000227 0000714951729 YANA P PBI (APBN) Other disorders of muscle Berobat Jalan

1603 04-10-2019 132613011019Y000228 0000715087192 NURUL HIDAYATI P PBI (APBN) Acute upper respiratory Berobat Jalan
infections of multiple and
unspecified sites
1604 04-10-2019 132613011019Y000231 0000715129389 MUANA P PBI (APBN) Other specified Berobat Jalan
counselling
1605 04-10-2019 132613011019Y000179 0000715143374 SOMANA P PBI (APBN) Pneumonia due to other Rujuk Vertikal
specified infectious
organisms
1606 04-10-2019 132613011019Y000150 0000715155153 SUILMIAH P PBI (APBN) Gastritis and duodenitis Berobat Jalan

1607 04-10-2019 132613011019Y000202 0000715192075 SUWITA P PBI (APBN) Other disorders of muscle Berobat Jalan

1608 04-10-2019 132613011019Y000684 0000715216948 SAIFUL RIZKI ADITIA L PBI (APBN) Fever of other and Berobat Jalan
RHOMADON unknown origin
1609 04-10-2019 132613011019Y000683 0000715249697 HUNAINAH P PBI (APBN) Influenza, virus not Berobat Jalan
identified
1610 04-10-2019 132613011019Y000190 0000715256616 NURYATI P PBI (APBN) Other disorders of muscle Berobat Jalan

1611 04-10-2019 132613011019Y000189 0000715256818 MOCH.DULAJI L PBI (APBN) Other headache Berobat Jalan
syndromes
1612 04-10-2019 132613011019Y000148 0000715401729 M. JUPRI L PBI (APBN) Other headache Berobat Jalan
syndromes
DAFTAR KUNJUNGAN PESERTA SAKIT

Kantor Cabang : PASURUAN - 1309

FKTP : Kejayan - 13261301

1613 04-10-2019 132613011019Y000191 0000715419483 KHAYUMI P PBI (APBN) Other headache Berobat Jalan
syndromes
1614 04-10-2019 132613011019Y000600 0000715508976 MUHAMMAD SUHAEMI L PBI (APBN) Other viral infections Berobat Jalan
characterized by skin and
mucous membrane
lesions, not elsewhere
classified
1615 04-10-2019 132613011019Y000178 0000715652559 NURSATIK P PBI (APBN) Medical observation and Berobat Jalan
evaluation for suspected
diseases and conditions
1616 04-10-2019 132613011019Y000653 0000715670493 AHMAD L PBI (APBN) Other disorders of muscle Berobat Jalan

1617 04-10-2019 132613011019Y000654 0000715679291 NAWAWI P PBI (APBN) Other headache Berobat Jalan
syndromes
1618 04-10-2019 132613011019Y000652 0000715692688 KASIAMI P PBI (APBN) Gastritis and duodenitis Berobat Jalan

1619 04-10-2019 132613011019Y000152 0000715758726 ROBIATUL UMMA P PBI (APBN) Influenza, virus not Berobat Jalan
identified
1620 04-10-2019 132613011019Y000192 0000715823144 SAMU`IN L PBI (APBN) Other disorders of muscle Berobat Jalan

1621 04-10-2019 132613011019Y000171 0000715865703 FAURIYAH P PBI (APBN) Hypertensive heart Rujuk Vertikal Diabetes
disease Mellitus
1622 04-10-2019 132613011019Y001557 0000715869011 M. ANUN NA'IM L PBI (APBN) Other specified Berobat Jalan
counselling
1623 04-10-2019 132613011019Y000256 0000715875884 SUAH AL AMENAH P PBI (APBN) Gastritis and duodenitis Berobat Jalan

1624 04-10-2019 132613011019Y000261 0000715888754 EMIL AKRIMA P PBI (APBN) Fever of other and Berobat Jalan
unknown origin
1625 04-10-2019 132613011019Y000180 0000715924798 NURUL HABIBAH P PBI (APBN) Dental caries Berobat Jalan

1626 04-10-2019 132613011019Y000601 0000715940932 M FARIS ROMDANI L PBI (APBN) Acute upper respiratory Berobat Jalan
infections of multiple and
unspecified sites
1627 04-10-2019 132613011019Y000254 0000715970755 SUMIK P PBI (APBN) Nausea and vomiting Berobat Jalan

1628 04-10-2019 132613011019Y000260 0000716009411 SOLIKHIN L PBI (APBN) Other local infections of Berobat Jalan
skin and subcutaneous
tissue
1629 04-10-2019 132613011019Y000262 0000716051698 SARIAMI P PBI (APBN) Migraine Berobat Jalan

1630 04-10-2019 132613011019Y000173 0000716417188 SULIATI P PBI (APBN) Gingivitis and periodontal Berobat Jalan
diseases
1631 04-10-2019 132613011019Y000314 0000716428181 MUHAMMAD YUSUF DANIAL P PBI (APBN) Fever of other and Berobat Jalan
unknown origin
DAFTAR KUNJUNGAN PESERTA SAKIT

Kantor Cabang : PASURUAN - 1309

FKTP : Kejayan - 13261301

1632 04-10-2019 132613011019Y000207 0000716499764 BACKDIA MUNAWAROH P PBI (APBN) Fever of other and Berobat Jalan
unknown origin
1633 04-10-2019 132613011019Y000208 0000716500271 ABD. ROHMAN L PBI (APBN) Acute upper respiratory Berobat Jalan
infections of multiple and
unspecified sites
1634 04-10-2019 132613011019Y000306 0000716515738 ROBI P PBI (APBN) Fever of other and Berobat Jalan
unknown origin
1635 04-10-2019 132613011019Y000229 0001042685245 SARIPA P PBI (APBN) Other local infections of Berobat Jalan
skin and subcutaneous
tissue
1636 04-10-2019 132613011019Y000149 0001042694616 SITI NAFISA P PBI (APBN) Allergic contact dermatitis Berobat Jalan

1637 04-10-2019 132613011019Y000151 0001042697676 MISTIN P PBI (APBN) Other rheumatoid arthritis Berobat Jalan

1638 04-10-2019 132613011019Y000153 0001042697733 SITI AISAH P PBI (APBN) Gastritis and duodenitis Berobat Jalan

1639 04-10-2019 132613011019Y000224 0001042707295 WAWAN L PBI (APBN) Fever of other and Berobat Jalan
unknown origin
1640 04-10-2019 132613011019Y000230 0001542280375 SAHRUL RACHMAT DANI L PEKERJA MANDIRI Other dermatitis Berobat Jalan

1641 04-10-2019 132613011019Y000193 0001704586015 MUIN JUNAIDI L PBI (APBD) Other disorders of muscle Berobat Jalan

1642 04-10-2019 132613011019Y000682 0002001959706 M WILDAN PRATAMA L PBI (APBN) Diarrhoea and Berobat Jalan
gastroenteritis of
presumed infectious origin

1643 04-10-2019 132613011019Y001190 0002121301798 SAROFA P PBI (APBN) Non-insulin-dependent Berobat Jalan
diabetes mellitus
1644 04-10-2019 132613011019Y000155 0002205974485 SITI BADRIYAH P PEKERJA MANDIRI Other cataract Rujuk Vertikal

1645 04-10-2019 132613011019Y000232 0002214176758 MUHAMMAD FATHUL L PEGAWAI SWASTA Other specified Berobat Jalan
AGNANUDIN counselling
1646 04-10-2019 132613011019Y000225 0002446347014 DENI PANCANDARI P PEKERJA MANDIRI Acute nasopharyngitis Berobat Jalan
[common cold]
1647 04-10-2019 132613011019Y000201 0002582211238 ZAKIYATUL HUMAIROH P PBI (APBN) Fever of other and Berobat Jalan
unknown origin
1648 04-10-2019 132613011019Y000255 0002594942875 INRAWATI P PBI (APBN) Other headache Berobat Jalan
syndromes
1649 04-10-2019 132613011019Y000174 0002609476301 HURROTUL UYUN P PBI (APBN) Gingivitis and periodontal Berobat Jalan
diseases
1650 04-10-2019 132613011019Y000165 0002612585654 DOMIIYAH P PEKERJA MANDIRI Malignant neoplasm of Rujuk Vertikal
cervix uteri
DAFTAR KUNJUNGAN PESERTA SAKIT

Kantor Cabang : PASURUAN - 1309

FKTP : Kejayan - 13261301

1651 04-10-2019 132613011019Y000226 0002631387475 MUDAWAMAH P PBI (APBN) Influenza, virus not Berobat Jalan
identified
1652 04-10-2019 132613011019Y000176 0002744187592 UMI KULSUM P PEKERJA MANDIRI Heart failure Rujuk Vertikal

1653 04-10-2019 132613011019Y000177 0002755384389 SITI LAILATUS NUR SHOLIHA P PBI (APBD) Single spontaneous Berobat Jalan
delivery
1654 04-10-2019 132613011019Y000167 0002890330132 KHOLIFATUS SA'DEYAH P PEKERJA MANDIRI Other surgical follow-up Rujuk Vertikal
care
1655 03-10-2019 132613011019Y000091 0000112555091 YULIS WILUJENG P PNS DAERAH Anxiety disorder, Rujuk Vertikal
unspecified
1656 03-10-2019 132613011019Y000159 0000112901848 SUPIYAH P PENERIMA PENSIUN Other dermatitis Berobat Jalan
PNS
1657 03-10-2019 132613011019Y000678 0000713594608 NIKMAH P PBI (APBN) Diarrhoea and Berobat Jalan
gastroenteritis of
presumed infectious origin

1658 03-10-2019 132613011019Y000213 0000714431147 M. TAUFIQ L PBI (APBN) Acute upper respiratory Berobat Jalan
infections of multiple and
unspecified sites
1659 03-10-2019 132613011019Y000080 0000714727405 FARIDA P PBI (APBN) Other rheumatoid arthritis Berobat Jalan

1660 03-10-2019 132613011019Y000594 0000715087923 SYAFIUDIN L PBI (APBN) Dysphagia Berobat Jalan

1661 03-10-2019 132613011019Y001554 0000715114506 MAISAROH P PBI (APBN) Non-insulin-dependent Berobat Jalan
diabetes mellitus
1662 03-10-2019 132613011019Y000646 0000715195383 CHOLILI L PBI (APBN) Other disorders of muscle Berobat Jalan

1663 03-10-2019 132613011019Y001551 0000715206846 HUSNIYAH P PBI (APBN) Other specified Berobat Jalan
counselling
1664 03-10-2019 132613011019Y000204 0000715240844 DALIPAH P PBI (APBN) Nausea and vomiting Berobat Jalan

1665 03-10-2019 132613011019Y000077 0000715241081 UMI KULSUM P PBI (APBN) Gastritis and duodenitis Berobat Jalan

1666 03-10-2019 132613011019Y000111 0000715258394 NUR AINI P PBI (APBN) Supervision of normal Berobat Jalan
pregnancy
1667 03-10-2019 132613011019Y000131 0000715300277 RUPI`I L PBI (APBN) Other headache Berobat Jalan
syndromes
1668 03-10-2019 132613011019Y000132 0000715300637 SURIFAH P PBI (APBN) Other disorders of muscle Berobat Jalan

1669 03-10-2019 132613011019Y000156 0000715306836 JUHRIYA P PBI (APBN) Essential (primary) Berobat Jalan
hypertension
1670 03-10-2019 132613011019Y000106 0000715339203 SUWARNO L PBI (APBN) Other headache Berobat Jalan
syndromes
DAFTAR KUNJUNGAN PESERTA SAKIT

Kantor Cabang : PASURUAN - 1309

FKTP : Kejayan - 13261301

1671 03-10-2019 132613011019Y000595 0000715423184 M FATHUR ROHMAN L PBI (APBN) Acute upper respiratory Berobat Jalan
infections of multiple and
unspecified sites
1672 03-10-2019 132613011019Y000145 0000715424589 SUMIATI P PBI (APBN) Necrosis of pulp Berobat Jalan

1673 03-10-2019 132613011019Y000596 0000715425175 UMIYATI P PBI (APBN) Malaise and fatigue Berobat Jalan

1674 03-10-2019 132613011019Y000597 0000715425287 ERNAWATI P PBI (APBN) Other headache Berobat Jalan
syndromes
1675 03-10-2019 132613011019Y000092 0000715431082 LIA HABIBATUR NING KHUS P PBI (APBN) Visual impairment Rujuk Vertikal
including blindness
(binocular or monocular)
1676 03-10-2019 132613011019Y000197 0000715439441 SUPIATUN P PBI (APBN) Essential (primary) Berobat Jalan
hypertension
1677 03-10-2019 132613011019Y000157 0000715439766 LAILATUL KOMARIAH P PBI (APBN) Influenza, virus not Berobat Jalan
identified
1678 03-10-2019 132613011019Y000217 0000715448777 NURYATI P PBI (APBN) Other disorders of muscle Berobat Jalan

1679 03-10-2019 132613011019Y000093 0000715451038 HAMIDAH P PBI (APBN) Other surgical follow-up Rujuk Vertikal
care
1680 03-10-2019 132613011019Y000133 0000715452592 SLAMET L PBI (APBN) Other disorders of muscle Berobat Jalan

1681 03-10-2019 132613011019Y000182 0000715478837 FITRIYAH P PBI (APBN) Other disorders of muscle Berobat Jalan

1682 03-10-2019 132613011019Y000146 0000715489132 APIPA P PBI (APBN) Caries of dentine Berobat Jalan

1683 03-10-2019 132613011019Y001552 0000715489266 MUHAMAD SAIFUL ROHMAN L PBI (APBN) Other specified Berobat Jalan
counselling
1684 03-10-2019 132613011019Y000599 0000715502294 ASMAUN L PBI (APBN) Other disorders of muscle Berobat Jalan

1685 03-10-2019 132613011019Y000598 0000715502351 MUIN P PBI (APBN) Malaise and fatigue Berobat Jalan

1686 03-10-2019 132613011019Y000113 0000715544201 SAMADUN L PBI (APBN) Other disorders of muscle Berobat Jalan

1687 03-10-2019 132613011019Y000214 0000715641129 KASIANI P PBI (APBN) Other headache Berobat Jalan
syndromes
1688 03-10-2019 132613011019Y000215 0000715641873 M.FAUZI L PBI (APBN) Other disorders of muscle Berobat Jalan

1689 03-10-2019 132613011019Y000216 0000715647655 SUHUD L PBI (APBN) Other headache Berobat Jalan
syndromes
1690 03-10-2019 132613011019Y000198 0000715675781 SULHAN L PBI (APBN) Other headache Berobat Jalan
syndromes
1691 03-10-2019 132613011019Y000649 0000715687266 LAILATUL FITRIYAH P PBI (APBN) Gastritis and duodenitis Berobat Jalan

1692 03-10-2019 132613011019Y000078 0000715747746 ASKAR / H. ABD. KARIM L PBI (APBN) Other rheumatoid arthritis Berobat Jalan
DAFTAR KUNJUNGAN PESERTA SAKIT

Kantor Cabang : PASURUAN - 1309

FKTP : Kejayan - 13261301

1693 03-10-2019 132613011019Y000164 0000715845238 LULUK ANDRAENI P PBI (APBN) Respiratory tuberculosis, Berobat Jalan
bacteriologically and
histologically confirmed
1694 03-10-2019 132613011019Y000545 0000715881464 HOTIMAH P PBI (APBN) Acute upper respiratory Berobat Jalan
infections of multiple and
unspecified sites
1695 03-10-2019 132613011019Y000544 0000715881802 NURUL HUDA L PBI (APBN) Other headache Berobat Jalan
syndromes
1696 03-10-2019 132613011019Y000403 0000715964534 SUUDI SALIM L PBI (APBN) Diarrhoea and Berobat Jalan
gastroenteritis of
presumed infectious origin

1697 03-10-2019 132613011019Y000188 0000715970665 HUSEN L PBI (APBN) Migraine Berobat Jalan

1698 03-10-2019 132613011019Y000205 0000715999612 SOLIKHA P PBI (APBN) Other local infections of Berobat Jalan
skin and subcutaneous
tissue
1699 03-10-2019 132613011019Y000185 0000716006812 MISLAN L PBI (APBN) Other local infections of Berobat Jalan
skin and subcutaneous
tissue
1700 03-10-2019 132613011019Y000206 0000716021504 DIMAS ALFIANSYAH P PBI (APBN) Acute upper respiratory Berobat Jalan
infections of multiple and
unspecified sites
1701 03-10-2019 132613011019Y000144 0000716058854 SULIANA P PBI (APBN) Necrosis of pulp Berobat Jalan

1702 03-10-2019 132613011019Y000186 0000716088082 NOFITA SARI P PBI (APBN) Acute upper respiratory Berobat Jalan
infections of multiple and
unspecified sites
1703 03-10-2019 132613011019Y000118 0000716334186 SOLIHATI P PBI (APBN) Supervision of high-risk Berobat Jalan
pregnancy
1704 03-10-2019 132613011019Y000083 0000716370737 MOH. KHOFAR L PBI (APBN) Hearing loss, unspecified Rujuk Vertikal

1705 03-10-2019 132613011019Y000620 0000716379221 YAYUK P PBI (APBN) Diarrhoea and Berobat Jalan
gastroenteritis of
presumed infectious origin

1706 03-10-2019 132613011019Y000184 0000716439666 RUMINI P PBI (APBN) Bursopathy, unspecified Berobat Jalan

1707 03-10-2019 132613011019Y000200 0000716475374 DIO REFANDY L PBI (APBN) Fever of other and Berobat Jalan
unknown origin
1708 03-10-2019 132613011019Y000181 0000716483766 KHOTIJAH P PBI (APBN) Conjunctivitis Berobat Jalan

1709 03-10-2019 132613011019Y000648 0000716534008 SOFIYAH P PBI (APBN) Acute upper respiratory Berobat Jalan
infections of multiple and
unspecified sites
DAFTAR KUNJUNGAN PESERTA SAKIT

Kantor Cabang : PASURUAN - 1309

FKTP : Kejayan - 13261301

1710 03-10-2019 132613011019Y000651 0000716578053 BUSRO P PBI (APBN) Influenza, virus not Berobat Jalan
identified
1711 03-10-2019 132613011019Y000650 0000716585444 SAPIYAN P PBI (APBN) Acute upper respiratory Berobat Jalan
infections of multiple and
unspecified sites
1712 03-10-2019 132613011019Y000203 0000716830503 SAIDA P PBI (APBN) Other headache Berobat Jalan
syndromes
1713 03-10-2019 132613011019Y000162 0000716885919 RUBAINA P PBI (APBN) Leprosy [Hansen disease] Berobat Jalan

1714 03-10-2019 132613011019Y000679 0000717785414 SITI FATIMAH P PBI (APBN) Other headache Berobat Jalan
syndromes
1715 03-10-2019 132613011019Y000681 0001042685954 SITI HANIK P PBI (APBN) Gastritis and duodenitis Berobat Jalan

1716 03-10-2019 132613011019Y000199 0001042696484 SITI JAZILAH P PBI (APBN) Other headache Berobat Jalan
syndromes
1717 03-10-2019 132613011019Y001550 0001042702018 SUMAIYAH P PBI (APBN) Other specified Berobat Jalan
counselling
1718 03-10-2019 132613011019Y000187 0001042711457 SALAM L PBI (APBN) Dental caries Berobat Jalan

1719 03-10-2019 132613011019Y000116 0001195692208 SITI MAISAROH P PEGAWAI SWASTA Supervision of normal Berobat Jalan
pregnancy
1720 03-10-2019 132613011019Y000183 0001704583901 SITI ZAINAB P PBI (APBD) Respiratory tuberculosis, Berobat Jalan
bacteriologically and
histologically confirmed
1721 03-10-2019 132613011019Y000194 0001704586173 SIONO L PBI (APBD) Essential (primary) Berobat Jalan
hypertension
1722 03-10-2019 132613011019Y000079 0001796025429 RAFA AL- GHAZALY FAJRIAN L PEKERJA MANDIRI Fever of other and Berobat Jalan
unknown origin
1723 03-10-2019 132613011019Y000196 0001843346586 ABD. MUGHNI L PEKERJA MANDIRI Essential (primary) Berobat Jalan
hypertension
1724 03-10-2019 132613011019Y000195 0002327482337 SANUSI L PEKERJA MANDIRI Essential (primary) Berobat Jalan
hypertension
1725 03-10-2019 132613011019Y000115 0002441589388 NAWIRO P PEKERJA MANDIRI Supervision of normal Berobat Jalan
pregnancy
1726 03-10-2019 132613011019Y000084 0002450399782 MANSUR L PEKERJA MANDIRI Heart failure Rujuk Vertikal

1727 03-10-2019 132613011019Y000117 0002468953899 NINDI ANIVIYA SAFITRI L PEGAWAI SWASTA Supervision of normal Berobat Jalan
pregnancy
1728 03-10-2019 132613011019Y000647 0002584766654 TOMIMAH P PBI (APBN) Acute upper respiratory Berobat Jalan
infections of multiple and
unspecified sites
1729 03-10-2019 132613011019Y000680 0002585998146 M.SODIKIN L PBI (APBN) Other dermatitis Berobat Jalan
DAFTAR KUNJUNGAN PESERTA SAKIT

Kantor Cabang : PASURUAN - 1309

FKTP : Kejayan - 13261301

1730 03-10-2019 132613011019Y001189 0002590577054 WALDJANNAH P PBI (APBN) Non-insulin-dependent Berobat Jalan
diabetes mellitus
1731 03-10-2019 132613011019Y000081 0002604989125 SAADAH P PBI (APBN) Other rheumatoid arthritis Berobat Jalan

1732 03-10-2019 132613011019Y000166 0002767373313 CHOLIPAH P PEKERJA MANDIRI Non-insulin-dependent Berobat Jalan
diabetes mellitus
1733 02-10-2019 132613011019Y001185 0000112590189 ISMUAT L PNS DAERAH Non-insulin-dependent Berobat Jalan
diabetes mellitus
1734 02-10-2019 132613011019Y000130 0000112702421 MAIMUNATUN NAFISAH P PNS DAERAH Allergic contact dermatitis Berobat Jalan

1735 02-10-2019 132613011019Y000143 0000113229303 CATUR SULISTYO BUDI L PNS DAERAH Migraine Berobat Jalan

1736 02-10-2019 132613011019Y000141 0000113229314 EFIE NORYANI P PNS DAERAH Other headache Berobat Jalan
syndromes
1737 02-10-2019 132613011019Y000489 0000714254859 MOH. NASERI L PBI (APBN) Gingivitis and periodontal Berobat Jalan
diseases
1738 02-10-2019 132613011019Y000405 0000714257021 SUNARSIH P PBI (APBN) Other headache Berobat Jalan
syndromes
1739 02-10-2019 132613011019Y000487 0000714264772 MUHID L PBI (APBN) Other disorders of muscle Berobat Jalan

1740 02-10-2019 132613011019Y000209 0000714436132 SYARIF HIDAYATULAH L PBI (APBN) Other headache Berobat Jalan
syndromes
1741 02-10-2019 132613011019Y000044 0000714448089 MAMLU'ATUR ROHMA P PBI (APBN) Benign neoplasm of breast Rujuk Vertikal

1742 02-10-2019 132613011019Y000676 0000714823615 ROMLA P PBI (APBN) Gastritis and duodenitis Berobat Jalan

1743 02-10-2019 132613011019Y000674 0000714854452 AISA P PBI (APBN) Gastritis and duodenitis Berobat Jalan

1744 02-10-2019 132613011019P000291 0000715130199 LULUK SUJIATI P PBI (APBN) Supervision of normal Berobat Jalan
pregnancy
1745 02-10-2019 132613011019Y001187 0000715138121 SITI FADILAH P PBI (APBN) Non-insulin-dependent Berobat Jalan
diabetes mellitus
1746 02-10-2019 132613011019Y000076 0000715140549 DEWI ISNANIA P PBI (APBN) Allergic contact dermatitis Berobat Jalan

1747 02-10-2019 132613011019Y000065 0000715153149 LUTFI L PBI (APBN) Fever of other and Berobat Jalan
unknown origin
1748 02-10-2019 132613011019Y000064 0000715198241 FARIDAH P PBI (APBN) Acute nasopharyngitis Berobat Jalan
[common cold]
1749 02-10-2019 132613011019Y001548 0000715206846 HUSNIYAH P PBI (APBN) Other specified Berobat Jalan
counselling
1750 02-10-2019 132613011019Y000124 0000715208782 HAMBYAH L PBI (APBN) Varicella [chickenpox] Berobat Jalan

1751 02-10-2019 132613011019Y000677 0000715213629 MUDAWAMA P PBI (APBN) Gastritis and duodenitis Berobat Jalan
DAFTAR KUNJUNGAN PESERTA SAKIT

Kantor Cabang : PASURUAN - 1309

FKTP : Kejayan - 13261301

1752 02-10-2019 132613011019Y000057 0000715231945 MUNANDAR L PBI (APBN) Other headache Berobat Jalan
syndromes
1753 02-10-2019 132613011019Y000128 0000715253523 UMI KULSUM P PBI (APBN) Respiratory tuberculosis, Berobat Jalan
bacteriologically and
histologically confirmed
1754 02-10-2019 132613011019Y000122 0000715277171 HANIPA P PBI (APBN) Other dermatitis Berobat Jalan

1755 02-10-2019 132613011019Y000055 0000715292572 NINIL MARIA ULFA P PEGAWAI SWASTA Fever of other and Berobat Jalan
unknown origin
1756 02-10-2019 132613011019Y000058 0000715315713 NANANG MAKRUP P PBI (APBN) Gastritis and duodenitis Berobat Jalan

1757 02-10-2019 132613011019Y000062 0000715331643 MATENI P PBI (APBN) Other headache Berobat Jalan
syndromes
1758 02-10-2019 132613011019Y000210 0000715333149 KASRI P PBI (APBN) Other disorders of muscle Berobat Jalan

1759 02-10-2019 132613011019Y000127 0000715336975 ANDIHASBULLOH L PBI (APBN) Respiratory tuberculosis, Berobat Jalan
bacteriologically and
histologically confirmed
1760 02-10-2019 132613011019Y000211 0000715337594 MELINDA DEVI NADA SANTI P PBI (APBN) Dental caries Berobat Jalan

1761 02-10-2019 132613011019Y000212 0000715391234 AMINULLOH L PBI (APBN) Other headache Berobat Jalan
syndromes
1762 02-10-2019 132613011019Y000051 0000715431339 ABD.CHOLIK L PBI (APBN) Other disorders of muscle Berobat Jalan

1763 02-10-2019 132613011019Y000052 0000715432072 MUSRIFAH P PBI (APBN) Other headache Berobat Jalan
syndromes
1764 02-10-2019 132613011019Y000170 0000715614129 ROMLAH P PBI (APBN) Malaise and fatigue Berobat Jalan

1765 02-10-2019 132613011019Y000169 0000715614186 PUTRI YULIANA P PBI (APBN) Acute upper respiratory Berobat Jalan
infections of multiple and
unspecified sites
1766 02-10-2019 132613011019Y000616 0000715648241 HAMZAH L PBI (APBN) Other dermatitis Berobat Jalan

1767 02-10-2019 132613011019Y000107 0000715648487 MUTIMMAH P PBI (APBN) Anaemia complicating Berobat Jalan
pregnancy, childbirth and
the puerperium
1768 02-10-2019 132613011019Y000671 0000715653022 NAFISA P PBI (APBN) Other disorders of muscle Berobat Jalan

1769 02-10-2019 132613011019Y000102 0000715678198 CHAJALI L PBI (APBN) Unspecified viral infection Berobat Jalan
characterized by skin and
mucous membrane lesions

1770 02-10-2019 132613011019Y000108 0000715678547 SAYENAH P PBI (APBN) Other dermatitis Berobat Jalan

1771 02-10-2019 132613011019Y000618 0000715681719 SUPAIDI L PBI (APBN) Other headache Berobat Jalan
syndromes
DAFTAR KUNJUNGAN PESERTA SAKIT

Kantor Cabang : PASURUAN - 1309

FKTP : Kejayan - 13261301

1772 02-10-2019 132613011019Y000614 0000715696299 ROMLAH P PBI (APBN) Conjunctivitis Berobat Jalan

1773 02-10-2019 132613011019Y000075 0000715733223 JAZILA P PBI (APBN) Influenza, virus not Berobat Jalan
identified
1774 02-10-2019 132613011019Y000048 0000715762776 MARDJI L PBI (APBN) Essential (primary) Berobat Jalan
hypertension
1775 02-10-2019 132613011019Y000042 0000715770843 SALAMA P PBI (APBN) Insulin-dependent Rujuk Vertikal Diabetes
diabetes mellitus Mellitus
1776 02-10-2019 132613011019Y000056 0000715771506 M.TEGUH FERDIANSYAH L PBI (APBN) Acute upper respiratory Berobat Jalan
infections of multiple and
unspecified sites
1777 02-10-2019 132613011019Y000615 0000715771809 ARMAD SAPARIDIN L PBI (APBN) Other disorders of muscle Berobat Jalan

1778 02-10-2019 132613011019Y000488 0000715797663 SHOLIHAH P PBI (APBN) Fever of other and Berobat Jalan
unknown origin
1779 02-10-2019 132613011019Y000114 0000715834967 CHOSI`A P PBI (APBN) Myalgia Berobat Jalan

1780 02-10-2019 132613011019Y000112 0000715835608 M. TAUFIK KUROHMAN L PBI (APBN) Fever of other and Berobat Jalan
unknown origin
1781 02-10-2019 132613011019Y000071 0000715877763 JAKFAR L PBI (APBN) Respiratory tuberculosis, Berobat Jalan
bacteriologically and
histologically confirmed
1782 02-10-2019 132613011019Y000137 0000715916801 M. SUFYAN L PBI (APBN) Migraine Berobat Jalan

1783 02-10-2019 132613011019Y000139 0000715926846 ALI MUNTOHA L PBI (APBN) Fever of other and Berobat Jalan
unknown origin
1784 02-10-2019 132613011019Y000135 0000715965096 MOH. ZAINAL ABIDIN L PBI (APBN) Acute upper respiratory Berobat Jalan
infections of multiple and
unspecified sites
1785 02-10-2019 132613011019Y000109 0000715978888 HANIPAH P PBI (APBN) Gastritis and duodenitis Berobat Jalan

1786 02-10-2019 132613011019Y000125 0000716005427 BAYU BASORUDIN L PBI (APBN) Fever of other and Berobat Jalan
unknown origin
1787 02-10-2019 132613011019Y000136 0000716031448 M. NASOR L PBI (APBN) Gastritis and duodenitis Berobat Jalan

1788 02-10-2019 132613011019Y001188 0000716035127 SRI HANDAYANI P PBI (APBN) Non-insulin-dependent Berobat Jalan
diabetes mellitus
1789 02-10-2019 132613011019Y001186 0000716133958 SUGIANTO L PBI (APBN) Non-insulin-dependent Berobat Jalan
diabetes mellitus
1790 02-10-2019 132613011019Y000103 0000716415568 HOTIJAH P PBI (APBN) Other disorders of muscle Berobat Jalan

1791 02-10-2019 132613011019Y000172 0000716456529 ROHMATULLAH L PBI (APBN) Fever of other and Berobat Jalan
unknown origin
DAFTAR KUNJUNGAN PESERTA SAKIT

Kantor Cabang : PASURUAN - 1309

FKTP : Kejayan - 13261301

1792 02-10-2019 132613011019Y000175 0000716490933 MAHMUDA P PBI (APBN) Acute upper respiratory Berobat Jalan
infections of multiple and
unspecified sites
1793 02-10-2019 132613011019Y000121 0000717554327 CHUSNIYAH P PBI (APBN) Essential (primary) Berobat Jalan
hypertension
1794 02-10-2019 132613011019Y000104 0001042694008 SALAMAH P PBI (APBN) Non-insulin-dependent Berobat Jalan
diabetes mellitus
1795 02-10-2019 132613011019Y000043 0001042697935 AISAH P PBI (APBN) Gingivitis and periodontal Berobat Jalan
diseases
1796 02-10-2019 132613011019Y000060 0001042706608 SAUDA P PBI (APBN) Other headache Berobat Jalan
syndromes
1797 02-10-2019 132613011019Y000134 0001042711762 HALIMA P PBI (APBN) Cough Berobat Jalan

1798 02-10-2019 132613011019Y000138 0001042712392 M.MUZAKI L PBI (APBN) Fever of other and Berobat Jalan
unknown origin
1799 02-10-2019 132613011019Y000168 0001042714708 RAMINA P PBI (APBN) Malaise and fatigue Berobat Jalan

1800 02-10-2019 132613011019Y000053 0001042720143 WARIYAN L PBI (APBN) Other headache Berobat Jalan
syndromes
1801 02-10-2019 132613011019Y000140 0001162674494 NAILUL MUROM P PEGAWAI SWASTA Diarrhoea and Berobat Jalan
gastroenteritis of
presumed infectious origin

1802 02-10-2019 132613011019Y000126 0001183256346 WIDI SISWANTORO L PEGAWAI SWASTA Other specified Berobat Jalan
counselling
1803 02-10-2019 132613011019Y001547 0001270140118 TITIK SUSIATI P PEKERJA MANDIRI Other specified Berobat Jalan
counselling
1804 02-10-2019 132613011019Y000073 0001543027059 JAMHARI L PEGAWAI SWASTA Other rheumatoid arthritis Berobat Jalan

1805 02-10-2019 132613011019Y000049 0001775709505 IMRON SANTOSO L PEGAWAI SWASTA Other headache Berobat Jalan
syndromes
1806 02-10-2019 132613011019Y000050 0001775709516 NUNUK HENDRANINGTYAS P PEGAWAI SWASTA Influenza, virus not Berobat Jalan
identified
1807 02-10-2019 132613011019Y000045 0001861710928 PUTRI RISKIAH P PEKERJA MANDIRI Epilepsy Rujuk Vertikal

1808 02-10-2019 132613011019Y000120 0002091451509 M.SODIKIN L PEKERJA MANDIRI Other disorders of muscle Berobat Jalan

1809 02-10-2019 132613011019Y000119 0002091452455 SITI AMINAH P PEKERJA MANDIRI Other headache Berobat Jalan
syndromes
1810 02-10-2019 132613011019Y000613 0002161098112 M. SAIFUDDIN L PBI (APBD) Other dermatitis Berobat Jalan

1811 02-10-2019 132613011019P000292 0002201725798 HUMAIDAH P PEKERJA MANDIRI Supervision of normal Berobat Jalan
pregnancy
DAFTAR KUNJUNGAN PESERTA SAKIT

Kantor Cabang : PASURUAN - 1309

FKTP : Kejayan - 13261301

1812 02-10-2019 132613011019Y000123 0002303816084 DJUWARIYAH P PEKERJA MANDIRI Respiratory tuberculosis, Berobat Jalan
bacteriologically and
histologically confirmed
1813 02-10-2019 132613011019Y000612 0002318823505 H. ROHMAT L PBI (APBD) Influenza, virus not Berobat Jalan
identified
1814 02-10-2019 132613011019Y000147 0002470907654 SHILA FINA MAFAZA P PEKERJA MANDIRI Disorders of tooth Berobat Jalan
development and eruption
1815 02-10-2019 132613011019Y000142 0002476029734 ABD. ROCHIM L PBI (APBD) Dental caries Berobat Jalan

1816 02-10-2019 132613011019Y000673 0002606617798 SUHAEMI L PBI (APBN) Gastritis and duodenitis Berobat Jalan

1817 02-10-2019 132613011019Y000675 0002608257914 ROFIAH P PBI (APBN) Acute gingivitis Berobat Jalan

1818 02-10-2019 132613011019Y000105 0002621064778 SANIYATI P PBI (APBD) Conjunctivitis Berobat Jalan

1819 02-10-2019 132613011019Y000129 0002639694058 NURIL ILMIAH RIZKI P PBI (APBN) Gastritis and duodenitis Berobat Jalan
HIDAYULAH
1820 02-10-2019 132613011019Y001184 0002745272834 SITI FATIMAH P PEKERJA MANDIRI Non-insulin-dependent Berobat Jalan
diabetes mellitus
1821 02-10-2019 132613011019Y000672 0002767021874 BAYI NYONYA ROIL P PBI (APBN) Diarrhoea and Berobat Jalan
gastroenteritis of
presumed infectious origin

1822 02-10-2019 132613011019Y000074 0002768615627 AURELY KHANZA SHAKIRA P PEKERJA MANDIRI Fever of other and Berobat Jalan
unknown origin
1823 02-10-2019 132613011019Y000072 0002768848661 SEPTIANI SISKA ARIYANTI P PBI (APBD) Gastritis and duodenitis Berobat Jalan

1824 02-10-2019 132613011019Y000619 0002808507958 SOPIA P PBI (APBN) Other headache Berobat Jalan
syndromes
1825 02-10-2019 132613011019Y000101 0002881579487 ZAINUL FALAQ L PEKERJA MANDIRI Respiratory tuberculosis, Berobat Jalan
bacteriologically and
histologically confirmed
1826 02-10-2019 132613011019Y000110 0002888511917 BAYI NYONYA NEVI SUCI L PEKERJA MANDIRI Need for immunization Berobat Jalan
ANGGRAENI against single bacterial
diseases
1827 01-10-2019 132613011019Y000611 0000099744129 EKO KURNIADI L PNS PUSAT Conjunctivitis Berobat Jalan

1828 01-10-2019 132613011019Y000100 0000112702757 BAHARUDDIN L PNS DAERAH Other specified Berobat Jalan
counselling
1829 01-10-2019 132613011019Y000013 0000112737868 MUHAMMAD RAFI AL AZMI L PNS DAERAH Acute upper respiratory Berobat Jalan
infections of multiple and
unspecified sites
1830 01-10-2019 132613011019Y000024 0000714338649 SUNAN L PBI (APBN) Other disorders of muscle Berobat Jalan
DAFTAR KUNJUNGAN PESERTA SAKIT

Kantor Cabang : PASURUAN - 1309

FKTP : Kejayan - 13261301

1831 01-10-2019 132613011019Y000040 0000714808383 LULUK MASLUKHA P PBI (APBN) Allergic contact dermatitis Berobat Jalan

1832 01-10-2019 132613011019Y000015 0000714941482 MUHANA P PBI (APBN) Other disorders of muscle Berobat Jalan

1833 01-10-2019 132613011019Y000016 0000714961102 SODIK L PBI (APBN) Other headache Berobat Jalan
syndromes
1834 01-10-2019 132613011019Y000061 0000715176358 SAFIYA P PBI (APBN) Other headache Berobat Jalan
syndromes
1835 01-10-2019 132613011019Y000063 0000715184403 HOLIFAH P PBI (APBN) Fever of other and Berobat Jalan
unknown origin
1836 01-10-2019 132613011019Y000008 0000715226501 ISTIYA P PBI (APBN) Dental caries Berobat Jalan

1837 01-10-2019 132613011019Y000669 0000715248865 HORIZA P PBI (APBN) Acute upper respiratory Berobat Jalan
infections of multiple and
unspecified sites
1838 01-10-2019 132613011019Y000021 0000715258394 NUR AINI P PBI (APBN) Supervision of normal Berobat Jalan
pregnancy
1839 01-10-2019 132613011019Y000070 0000715301278 TOWILAH P PBI (APBN) Other headache Berobat Jalan
syndromes
1840 01-10-2019 132613011019Y000069 0000715316286 MUHAMAD L PBI (APBN) Dental caries Berobat Jalan

1841 01-10-2019 132613011019Y000026 0000715367845 HOLIQ L PBI (APBN) Other disorders of muscle Berobat Jalan

1842 01-10-2019 132613011019Y000027 0000715382638 MUANAH P PBI (APBN) Other disorders of muscle Berobat Jalan

1843 01-10-2019 132613011019Y000028 0000715391291 SUMANA P PBI (APBN) Other headache Berobat Jalan
syndromes
1844 01-10-2019 132613011019Y000029 0000715409853 SALAM L PBI (APBN) Other disorders of muscle Berobat Jalan

1845 01-10-2019 132613011019Y000025 0000715425107 DASUM L PBI (APBN) Acute upper respiratory Berobat Jalan
infections of multiple and
unspecified sites
1846 01-10-2019 132613011019Y000059 0000715430272 M. ISMAIL L PBI (APBN) Other disorders of muscle Berobat Jalan

1847 01-10-2019 132613011019Y001183 0000715435198 SULIMAH . P PBI (APBN) Non-insulin-dependent Berobat Jalan
diabetes mellitus
1848 01-10-2019 132613011019Y000011 0000715439812 UMI KUSWATI P PBI (APBN) Other headache Berobat Jalan
syndromes
1849 01-10-2019 132613011019P001179 0000715440352 MUSRIFA P PBI (APBN) Non-insulin-dependent Berobat Jalan
diabetes mellitus
1850 01-10-2019 132613011019P001180 0000715440352 MUSRIFA P PBI (APBN) Non-insulin-dependent Berobat Jalan
diabetes mellitus
1851 01-10-2019 132613011019Y000154 0000715466913 MUHAFIROH P PBI (APBN) Malaise and fatigue Berobat Jalan
DAFTAR KUNJUNGAN PESERTA SAKIT

Kantor Cabang : PASURUAN - 1309

FKTP : Kejayan - 13261301

1852 01-10-2019 132613011019Y000163 0000715510462 SITI MUNAWAROH P PBI (APBN) Other headache Berobat Jalan
syndromes
1853 01-10-2019 132613011019Y000608 0000715721782 LATIFA P PBI (APBN) Fever of other and Berobat Jalan
unknown origin
1854 01-10-2019 132613011019Y000609 0000715777492 ROSIDI L PBI (APBN) Gastritis and duodenitis Berobat Jalan

1855 01-10-2019 132613011019Y000014 0000715860505 SITI FATIMAH P PBI (APBN) Stomatitis and related Berobat Jalan
lesions
1856 01-10-2019 132613011019Y000033 0000715864781 SIFAUL ROHMAH P PBI (APBN) Fever of other and Berobat Jalan
unknown origin
1857 01-10-2019 132613011019Y000095 0000715876301 MUCHAMAD ROMLI L PBI (APBN) Other headache Berobat Jalan
syndromes
1858 01-10-2019 132613011019Y000161 0000715876391 M.SUEB L PBI (APBN) Other disorders of muscle Berobat Jalan

1859 01-10-2019 132613011019Y000096 0000715876402 SULAINA P PBI (APBN) Other disorders of muscle Berobat Jalan

1860 01-10-2019 132613011019Y000032 0000715901714 ABD. KARIM AS. L PBI (APBN) Other local infections of Berobat Jalan
skin and subcutaneous
tissue
1861 01-10-2019 132613011019Y000068 0000715921716 NOVI NUR'AINI P PBI (APBN) Nausea and vomiting Berobat Jalan

1862 01-10-2019 132613011019Y000009 0000715924798 NURUL HABIBAH P PBI (APBN) Dental caries Berobat Jalan

1863 01-10-2019 132613011019Y000066 0000715940447 ROHMA P PBI (APBN) Other headache Berobat Jalan
syndromes
1864 01-10-2019 132613011019Y000046 0000715950066 NAIMA P PBI (APBN) Diarrhoea and Berobat Jalan
gastroenteritis of
presumed infectious origin

1865 01-10-2019 132613011019Y000067 0000715999768 SITI KHOIRIYAH P PBI (APBN) Gastritis and duodenitis Berobat Jalan

1866 01-10-2019 132613011019Y000047 0000716015621 M. ANDRIYAN IVANI L PBI (APBN) Acute upper respiratory Berobat Jalan
infections of multiple and
unspecified sites
1867 01-10-2019 132613011019Y000034 0000716058911 SUHAIMI L PBI (APBN) Diarrhoea and Berobat Jalan
gastroenteritis of
presumed infectious origin

1868 01-10-2019 132613011019Y000030 0000716082838 ABD RASAD L PBI (APBN) Migraine Berobat Jalan

1869 01-10-2019 132613011019Y000007 0000716124857 NURUL KHASANAH P PBI (APBN) Threatened abortion Rujuk Vertikal

1870 01-10-2019 132613011019Y000031 0000716142857 MOHAMMAD YUNUS L PBI (APBN) Dental caries Berobat Jalan

1871 01-10-2019 132613011019Y000085 0000716365045 MUTI`AH P PBI (APBN) Other dermatitis Berobat Jalan
DAFTAR KUNJUNGAN PESERTA SAKIT

Kantor Cabang : PASURUAN - 1309

FKTP : Kejayan - 13261301

1872 01-10-2019 132613011019Y000610 0000716564564 TAUFIQUR ROHMAN L PBI (APBN) Gingivitis and periodontal Berobat Jalan
diseases
1873 01-10-2019 132613011019Y000670 0001042685818 ARSIH P PBI (APBN) Influenza, virus not Berobat Jalan
identified
1874 01-10-2019 132613011019Y000036 0001042698262 MISBAH AINURIYAN L PBI (APBN) Other headache Berobat Jalan
syndromes
1875 01-10-2019 132613011019Y000019 0001042699904 FITRIYA DAMAYANTI P PBI (APBN) Supervision of high-risk Berobat Jalan
pregnancy
1876 01-10-2019 132613011019Y000003 0001042704483 HASANAH P PBI (APBN) Leiomyoma of uterus Berobat Jalan

1877 01-10-2019 132613011019Y000035 0001042711266 M SUKI L PBI (APBN) Other headache Berobat Jalan
syndromes
1878 01-10-2019 132613011019Y000054 0001042711312 SUAIDA P PBI (APBN) Influenza, virus not Berobat Jalan
identified
1879 01-10-2019 132613011019Y000158 0001042713314 ARDIAH P PBI (APBN) Other disorders of muscle Berobat Jalan

1880 01-10-2019 132613011019Y000160 0001042713325 SARIYATI P PBI (APBN) Malaise and fatigue Berobat Jalan

1881 01-10-2019 132613011019Y000088 0001042713808 NUR HASAN L PBI (APBN) Other disorders of urinary Berobat Jalan
system
1882 01-10-2019 132613011019Y001182 0001042713819 SOFIYAH P PBI (APBN) Non-insulin-dependent Berobat Jalan
diabetes mellitus
1883 01-10-2019 132613011019Y000086 0001042717331 RIYAN MUJIANTO L PBI (APBN) Gastritis and duodenitis Berobat Jalan

1884 01-10-2019 132613011019Y000087 0001042737107 MARIA RUSPITA MARGARETA P PBI (APBN) Other specified Berobat Jalan
counselling
1885 01-10-2019 132613011019Y000094 0001183256346 WIDI SISWANTORO L PEGAWAI SWASTA Other specified Berobat Jalan
counselling
1886 01-10-2019 132613011019Y000006 0001292669144 HILALIYAH P PEKERJA MANDIRI Carcinoma in situ of cervix Rujuk Vertikal
uteri
1887 01-10-2019 132613011019Y000667 0001704581087 RIRIN P PBI (APBD) Diarrhoea and Berobat Jalan
gastroenteritis of
presumed infectious origin

1888 01-10-2019 132613011019Y000004 0001704584979 SHOLEH L PBI (APBD) Other cataract Rujuk Vertikal

1889 01-10-2019 132613011019Y000037 0001795890971 RITA MAULIDIAH P PEKERJA MANDIRI Other rheumatoid arthritis Berobat Jalan

1890 01-10-2019 132613011019Y000022 0001820957343 LENY DAMAYANTI P PEGAWAI SWASTA Supervision of high-risk Berobat Jalan
pregnancy
1891 01-10-2019 132613011019Y000098 0001834306435 NURUL HIDAYATI WAKHIDAH P PNS DAERAH Acute nasopharyngitis Berobat Jalan
[common cold]
DAFTAR KUNJUNGAN PESERTA SAKIT

Kantor Cabang : PASURUAN - 1309

FKTP : Kejayan - 13261301

1892 01-10-2019 132613011019Y000099 0001834309517 MUHAMMAD ALVIN NURUDDIN L PNS DAERAH Influenza due to other Berobat Jalan
identified influenza virus
1893 01-10-2019 132613011019Y000012 0001904437855 YASMI NINGSIH P PEGAWAI SWASTA Fever of other and Berobat Jalan
unknown origin
1894 01-10-2019 132613011019Y000005 0001965671256 AMALIA NIRMALA SALSABILA L PEKERJA MANDIRI Other surgical follow-up Rujuk Vertikal
care
1895 01-10-2019 132613011019Y000089 0001969890129 MUKHAMAD LUTFI ULUM L PEGAWAI SWASTA Other disorders of muscle Berobat Jalan

1896 01-10-2019 132613011019Y000020 0002001950335 AZIZAH P PBI (APBN) Supervision of normal Berobat Jalan
pregnancy
1897 01-10-2019 132613011019Y000097 0002001952563 RODEYAH P PBI (APBN) Respiratory tuberculosis, Berobat Jalan
bacteriologically and
histologically confirmed
1898 01-10-2019 132613011019Y000082 0002039202459 RASWATI P PEKERJA MANDIRI Other local infections of Berobat Jalan
skin and subcutaneous
tissue
1899 01-10-2019 132613011019Y000041 0002121301809 MUHAMMAD TOMI L PBI (APBN) Influenza, virus not Berobat Jalan
identified
1900 01-10-2019 132613011019Y000018 0002161100665 ALFIATUS ZAHIRA P PBI (APBD) Diarrhoea and Berobat Jalan
gastroenteritis of
presumed infectious origin

1901 01-10-2019 132613011019Y000010 0002214176095 AFIANA SOHIDA P PEGAWAI SWASTA Dental caries Berobat Jalan

1902 01-10-2019 132613011019Y000090 0002214176758 MUHAMMAD FATHUL L PEGAWAI SWASTA Fever of other and Berobat Jalan
AGNANUDIN unknown origin
1903 01-10-2019 132613011019Y000038 0002241204682 LISWATUL KHOIROH P PEKERJA MANDIRI Gastritis and duodenitis Berobat Jalan

1904 01-10-2019 132613011019Y000023 0002414928699 ALFATIHFEBRIZIO L PBI (APBD) Other dermatitis Berobat Jalan

1905 01-10-2019 132613011019Y001298 0002461562717 SOCHEH L PBI (APBD) Other specified Berobat Jalan
counselling
1906 01-10-2019 132613011019Y000001 0002469232451 AISAH P PEKERJA MANDIRI Acute viral hepatitis, Rujuk Vertikal
unspecified
1907 01-10-2019 132613011019Y000002 0002470141765 FATIMA P PEKERJA MANDIRI Acute and unspecified Rujuk Vertikal
inflammation of lacrimal
passages
1908 01-10-2019 132613011019Y000039 0002616975652 MOCH. MUNIF L PEKERJA MANDIRI Other headache Berobat Jalan
syndromes
1909 01-10-2019 132613011019Y001297 0002884962238 SITI HUMAIDAH P PBI (APBD) Acute nasopharyngitis Berobat Jalan
[common cold]
1910 01-10-2019 132613011019Y000017 0002884962328 M.SAIKHON L PBI (APBD) Embedded and impacted Berobat Jalan
teeth
DAFTAR KUNJUNGAN PESERTA SAKIT

Kantor Cabang : PASURUAN - 1309

FKTP : Kejayan - 13261301

1911 01-10-2019 132613011019Y000668 0002885018578 ROFIATUL ADAWIYAH P PBI (APBD) Other dermatitis Berobat Jalan

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