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  • Register Rujukan Eksternal: Unit: Poli Umum Bulan: JANUARI 2021

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    LuLu Ika Rizkika
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    1. The document is a register of external referrals from the general polyclinic unit for the month of January 2021 containing patients' names, ID numbers, age, gender, place of residence, insurance number, diagnosis, referred hospital, referral department, and BPJS referral number. 2. It includes 22 patient referrals from January 20th to January 29th 2021 to RSUD Asy-Syifa' hospital in various departments such as internal medicine, pediatrics, surgery, psychiatry, and orthopedics. 3. The most common reasons for referral include follow-up examinations after previous treatment, prescriptions for ongoing conditions like hypertension, diabetes, and respiratory diseases.

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    REGISTER RUJUKAN EKSTERNAL

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    1. The document is a register of external referrals from the general polyclinic unit for the month of January 2021 containing patients' names, ID numbers, age, gender, place of residence, insurance number, diagnosis, referred hospital, referral department, and BPJS referral number. 2. It includes 22 patient referrals from January 20th to January 29th 2021 to RSUD Asy-Syifa' hospital in various departments such as internal medicine, pediatrics, surgery, psychiatry, and orthopedics. 3. The most common reasons for referral include follow-up examinations after previous treatment, prescriptions for ongoing conditions like hypertension, diabetes, and respiratory diseases.

    Copyright:

    © All Rights Reserved
    Download as XLSX, PDF, TXT or read online from Scribd
    Flag for inappropriate content
    Download as xlsx, pdf, or txt
    15 views5 pages

    Register Rujukan Eksternal: Unit: Poli Umum Bulan: JANUARI 2021

    Uploaded by

    LuLu Ika Rizkika
    1. The document is a register of external referrals from the general polyclinic unit for the month of January 2021 containing patients' names, ID numbers, age, gender, place of residence, insurance number, diagnosis, referred hospital, referral department, and BPJS referral number. 2. It includes 22 patient referrals from January 20th to January 29th 2021 to RSUD Asy-Syifa' hospital in various departments such as internal medicine, pediatrics, surgery, psychiatry, and orthopedics. 3. The most common reasons for referral include follow-up examinations after previous treatment, prescriptions for ongoing conditions like hypertension, diabetes, and respiratory diseases.

    Copyright:

    © All Rights Reserved
    Download as XLSX, PDF, TXT or read online from Scribd
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    of 5

    REGISTER RUJUKAN EKSTERNAL

    UNIT : POLI UMUM


    BULAN : JANUARI 2021

    Jenis
    No. Tanggal Nama Pasien NIK Umur Kelamin Kelurahan No. Asuransi Diagnosa RS Tujuan Rujukan Poli Tujuan Rujukan No. Rujukan BPJS

    - Follow-up examination after other treatment for other


    SAPUGARA conditions (Z09.8) - Acute tubulo-interstitial nephritis
    1 29-01-2021 JIMMI JULIYAN 5207050905000001 20 Thn 8Laki-laki BREE 845015332 (N10) - Cystitis (N30) RSUD ASY-SYIFA' BEDAH 230902030121Y000831
    BANGKAT - Follow-up examination after treatment of fracture
    2 29-01-2021 SAHEMA 5207054505750003 45 Thn 8Perempuan MONTEH 1058202549 (Z09.4) RSUD Sumbawa ORTHOPEDI 230902030121Y000808

    3 29-01-2021 SALMAN ALFARISI 5207051709140001 6 Thn 4 Laki-laki TEPAS SEPAKAT 1581232948 - Epilepsy (G40) RSUD ASY-SYIFA' ANAK 230902030121Y000798

    - Follow-up examination after other treatment for other


    conditions (Z09.8) - Non-insulin-dependent diabetes
    mellitus (E11) - Disorders of lipoprotein metabolism and
    BANGKAT other lipidaemias (E78) - Essential (primary)
    4 28-01-2021 HASANAH 5207054107670005 53 Thn 6Perempuan MONTEH 2109748634 hypertension (I10) RSUD ASY-SYIFA' PENYAKIT DALAM 230902030121Y000767
    ARISKA INDAH PUJI AYU - Issue of repeat prescription (Z76.0) - Asthma,
    5 27-01-2021 LESTARI 5207015201940001 27 Thn 0Perempuan TEPAS SEPAKAT 2032140789 unspecified (J45.9) RSUD ASY-SYIFA' PENYAKIT DALAM 230902030121Y000732
    - Cellulitis, unspecified (L03.9) - Fibromyalgia, other site
    6 27-01-2021 JIBRIANTO 5207052311760002 44 Thn 2Laki-laki TEPAS 1581041856 (M79.78) RSUD ASY-SYIFA' PENYAKIT DALAM 230902030121Y000731
    7 27-01-2021 JON HENDI TUSWADI 5207052106870001 33 Thn 7Laki-laki DESA BERU 2051483679 - Anxiety disorder, unspecified (F41.9) RSUD ASY-SYIFA' JIWA 230902030121Y000721
    - Cerebral infarction, unspecified (I63.9) - Essential
    8 26-01-2021 RUSDAN 5207051611720001 48 Thn 2Laki-laki TEPAS 1293534628 (primary) hypertension (I10) RS H. L. MANAMBAISARAF 230902030121Y000671

    SAPUGARA - Atherosclerotic cardiovascular disease, so described


    9 26-01-2021 INDU UNGANG 5207055407650001 55 Thn 6Perempuan BREE 2061045461 (I25.0) - Essential (primary) hypertension (I10) RSUD ASY-SYIFA' PENYAKIT DALAM 230902030121Y000670
    SAPUGARA
    10 26-01-2021 ALVIANSYAH 5207050407110002 9 Thn 6 Laki-laki BREE 1581107589 - Nontoxic goitre, unspecified (E04.9) RSUD ASY-SYIFA' ANAK 230902030121Y000669

    - Follow-up examination after other treatment for other


    11 25-01-2021 MAEZUN 5207055412680002 52 Thn 1Perempuan DESA BERU 146760715 conditions (Z09.8) - Low back pain (M54.5) RS H. L. MANAMBAISARAF 230902030121Y000663
    - Unspecified renal colic (N23) - Calculus of kidney and
    12 25-01-2021 DIANA 5207054810730001 47 Thn 3Perempuan DESA BERU 146482132 ureter (N20) RSUD ASY-SYIFA' BEDAH 230902030121Y000637

    - Other and unspecified abdominal pain (R10.4) - Chronic


    13 25-01-2021 RAIN HERFANDI 5207051209800001 40 Thn 4Laki-laki TEPAS SEPAKAT 1581166372 hepatitis, not elsewhere classified (K73) RSUD ASY-SYIFA' PENYAKIT DALAM 230902030121Y000618

    - Issue of repeat prescription (Z76.0) - Disorders of


    lipoprotein metabolism and other lipidaemias (E78) -
    SAPUGARA Myalgia (M79.1) - Non-insulin-dependent diabetes
    14 25-01-2021 PANCAWATI 5207054411740002 46 Thn 2Perempuan BREE 1581107185 mellitus with ophthalmic complications (E11.3) RSUD ASY-SYIFA' PENYAKIT DALAM 230902030121Y000614
    SAPUGARA - Chronic kidney disease (N18) - Insulin-dependent
    15 25-01-2021 SAMSIA 5207056010680002 52 Thn 3Perempuan BREE 2933598903 diabetes mellitus (E10) RSUD ASY-SYIFA' PENYAKIT DALAM 230902030121Y000613
    EVAN ANUGRAH
    16 23-01-2021 PRATAMA 5207051302130001 7 Thn 11Laki-laki DESA BERU 2663709074 - Epilepsy (G40) RSUD ASY-SYIFA' PENYAKIT DALAM 230902030121Y000601
    - Follow-up examination after treatment for conditions
    other than malignant neoplasms (Z09) - Asthma,
    17 22-01-2021 YULIANI 5207056704790002 41 Thn 8Perempuan SEMINAR SALIT 846164766 unspecified (J45.9) RSUD ASY-SYIFA' PENYAKIT DALAM 230902030121Y000570
    SAPUGARA - Atrial fibrillation and flutter (I48) - Other and
    18 22-01-2021 SOLIHAT 3202454512750001 45 Thn 1Perempuan BREE 2661272458 unspecified right bundle-branch block (I45.1) RSUD ASY-SYIFA' PENYAKIT DALAM 230902030121Y000568

    - Non-insulin-dependent diabetes mellitus with


    neurological complications (E11.4) - Non-insulin-
    dependent diabetes mellitus (E11) - Disorders of
    19 22-01-2021 ALIA BT.M.ALI 5207056008760001 44 Thn 5Perempuan TEPAS 1058201684 lipoprotein metabolism and other lipidaemias (E78) RSUD ASY-SYIFA' PENYAKIT DALAM 230902030121Y000558

    - Chronic kidney disease (N18) - Essential (primary)


    hypertension (I10) - Heart failure (I50) - Atherosclerotic
    20 21-01-2021 JUMAIAH 5207055207670002 53 Thn 6Perempuan DESA BERU 846056406 cardiovascular disease, so described (I25.0) RSUD ASY-SYIFA' PENYAKIT DALAM 230902030121Y000517
    SAPUGARA - Other benign neoplasm of connective and other soft
    21 20-01-2021 SITI MARIAM 5207055503830001 37 Thn 1Perempuan BREE 846751307 tissue of abdomen (D21.4) RSUD ASY-SYIFA' BEDAH 230902030121Y000509
    - Follow-up examination after other treatment for other
    SAPUGARA conditions (Z09.8) - Acute tubulo-interstitial nephritis
    22 20-01-2021 JIMMI JULIYAN 5207050905000001 20 Thn 8Laki-laki BREE 845015332 (N10) - Cystitis (N30) RSUD ASY-SYIFA' BEDAH 230902030121Y000507
    - Irritable bowel syndrome (K58) - Other and unspecified
    abdominal pain (R10.4) - Non-insulin-dependent
    23 20-01-2021 RAHMA 5207056805670001 53 Thn 7Perempuan DESA BERU 146765766 diabetes mellitus (E11) RSUD ASY-SYIFA' PENYAKIT DALAM 230902030121Y000505

    - Follow-up examination after treatment for conditions


    other than malignant neoplasms (Z09) - Non-insulin-
    dependent diabetes mellitus (E11) - Essential (primary)
    24 20-01-2021 NURAINI 5207054406690002 51 Thn 7Perempuan RARAK RONGIS 845719615 hypertension (I10) RSUD ASY-SYIFA' PENYAKIT DALAM 230902030121Y000500

    - Follow-up examination after treatment for conditions


    other than malignant neoplasms (Z09) - Non-insulin-
    dependent diabetes mellitus (E11) - Disorders of
    lipoprotein metabolism and other lipidaemias (E78) -
    25 20-01-2021 AGUSTINA 5207057112700014 50 Thn 0Perempuan TEPAS 2205433372 Essential (primary) hypertension (I10) RSUD ASY-SYIFA' PENYAKIT DALAM 230902030121Y000490

    - Follow-up examination after other treatment for other


    conditions (Z09.8) - Essential (primary) hypertension
    26 20-01-2021 HJ.SENDAWAN 5207055307650001 55 Thn 6Perempuan SEMINAR SALIT 1452353905 (I10) - Hypertensive heart disease (I11) RSUD ASY-SYIFA' PENYAKIT DALAM 230902030121Y000489

    27 20-01-2021 MANAWIYAH 5207056509620001 58 Thn 2Perempuan SEMINAR SALIT 2506387173 - Non-Hodgkin's lymphoma, unspecified type (C85.9) RSUD ASY-SYIFA' BEDAH 230902030121Y000488
    - Follow-up examination after other treatment for other
    conditions (Z09.8) - Other orthopaedic follow-up care
    28 19-01-2021 DESI SAGITA 5207054212980001 23 Thn 1Perempuan TEPAS SEPAKAT 1889264608 (Z47) RSUD ASY-SYIFA' BEDAH 230902030121Y000457

    - Follow-up examination after treatment for conditions


    other than malignant neoplasms (Z09) - Other chronic
    SAPUGARA obstructive pulmonary disease (J44) - Essential (primary)
    29 18-01-2021 ADAIYAH 5207057012840002 56 Thn 0Perempuan BREE 846509218 hypertension (I10) RSUD ASY-SYIFA' PENYAKIT DALAM 230902030121Y000408
    30 18-01-2021 SARDI 5207050101760001 45 Thn 0Laki-laki RARAK RONGIS 846495235 - Calculus of kidney and ureter (N20) RSUD ASY-SYIFA' BEDAH 230902030121Y000407

    - Follow-up examination after other treatment for other


    SAPUGARA conditions (Z09.8) - Non-insulin-dependent diabetes
    31 18-01-2021 SUMARNI 5207054407650001 55 Thn 6Perempuan BREE 1581106375 mellitus (E11) - Essential (primary) hypertension (I10) RSUD ASY-SYIFA' PENYAKIT DALAM 230902030121Y000405
    BANGKAT - Follow-up examination after treatment of fracture
    32 15-01-2021 SAHEMA 5207054505750003 45 Thn 8Perempuan MONTEH 1058202549 (Z09.4) RSUD Sumbawa ORTHOPEDI 230902030121Y000362
    - Issue of repeat prescription (Z76.0) - Non-insulin-
    SAPUGARA dependent diabetes mellitus (E11) - Cerebral infarction
    33 15-01-2021 ZAINUDDIN 5207051611630001 57 Thn 1Laki-laki BREE 2245595815 (I63) RSUD ASY-SYIFA' PENYAKIT DALAM 230902030121Y000344

    - Issue of repeat prescription (Z76.0) - Insulin-dependent


    diabetes mellitus (E10) - Disorders of lipoprotein
    metabolism and other lipidaemias (E78) -
    SAPUGARA Hyperuricaemia without signs of inflammatory arthritis
    34 15-01-2021 HADIJA 5207055503650001 55 Thn 1Perempuan BREE 2245596219 and tophaceous disease (E79.0) RSUD ASY-SYIFA' PENYAKIT DALAM 230902030121Y000343
    - Follow-up examination after other treatment for other
    conditions (Z09.8) - Asthma (J45) - Seropositive
    35 15-01-2021 HAFSAH 5204105209620002 58 Thn 4Perempuan DESA BERU 2108148489 rheumatoid arthritis (M05) RSUD ASY-SYIFA' PENYAKIT DALAM 230902030121Y000342
    EVAN ANUGRAH
    36 15-01-2021 PRATAMA 5207051302130001 7 Thn 11Laki-laki DESA BERU 2663709074 - Epilepsy (G40) RSUD ASY-SYIFA' ANAK 230902030121Y000340

    - Follow-up examination after other treatment for other


    37 14-01-2021 ZAENAL ABIDIN 20 Thn 4Laki-laki SEMINAR SALIT 1583986307 conditions (Z09.8) - Other headache syndromes (G44) RSUD ASY-SYIFA' PENYAKIT DALAM 230902030121Y000328

    SAPUGARA - Irritable bowel syndrome without diarrhoea (K58.9) -


    38 14-01-2021 KAMALUDDIN 5207051512870001 33 Thn 1Laki-laki BREE 1581168868 Gastro-oesophageal reflux disease (K21) RSUD ASY-SYIFA' PENYAKIT DALAM 230902030121Y000327
    - Follow-up examination after other treatment for other
    BANGKAT conditions (Z09.8) - Essential (primary) hypertension
    39 14-01-2021 HUSNUL HOTIMAH 5207057112670006 53 Thn 0Perempuan MONTEH 2108489635 (I10) RSUD ASY-SYIFA' PENYAKIT DALAM 230902030121Y000317

    - Issue of repeat prescription (Z76.0) - Insulin-dependent


    diabetes mellitus (E10) - Disorders of lipoprotein
    40 13-01-2021 AHMAD MAHDAR 5207050410700001 50 Thn 3Laki-laki LAMUNTET 2620244125 metabolism and other lipidaemias (E78) RSUD ASY-SYIFA' PENYAKIT DALAM 230902030121Y000297
    - Other chronic obstructive pulmonary disease (J44) -
    41 13-01-2021 ISMAIL KASIM 5207053112620009 58 Thn 0Laki-laki DESA BERU 1579901837 Headache (R51) RSUD ASY-SYIFA' PENYAKIT DALAM 230902030121Y000289
    42 13-01-2021 A RAHMAN 5207053112630007 57 Thn 0Laki-laki TEPAS 1386906333 - Paranoid schizophrenia (F20.0) RSUD ASY-SYIFA' JIWA 230902030121Y000285
    43 13-01-2021 JON HENDI TUSWADI 5207052106870001 33 Thn 6Laki-laki DESA BERU 2051483679 - Anxiety disorder, unspecified (F41.9) RSUD ASY-SYIFA' JIWA 230902030121Y000284
    - Non-insulin-dependent diabetes mellitus with
    neurological complications (E11.4) - Essential (primary)
    44 12-01-2021 LILI AGUSNAWATI 5207054808720001 48 Thn 5Perempuan DESA BERU 2111696201 hypertension (I10) RSUD ASY-SYIFA' PENYAKIT DALAM 230902030121Y000267

    - Issue of repeat prescription (Z76.0) - Non-insulin-


    dependent diabetes mellitus (E11) - Disorders of
    45 12-01-2021 USMAN,S.PT 36 Thn 8Laki-laki LAMUNTET 173080765 lipoprotein metabolism and other lipidaemias (E78) RSUD ASY-SYIFA' PENYAKIT DALAM 230902030121Y000251
    46 11-01-2021 JUMAIYAH 5204055212820005 38 Thn 0Perempuan SEMINAR SALIT 1581045704 - Mucocele of salivary gland (K11.6) RSUD ASY-SYIFA' BEDAH
    SAPUGARA
    47 11-01-2021 NURPAWAN 5207055007730002 47 Thn 6Perempuan BREE 846497643 - Benign neoplasm of meninges, unspecified (D32.9) RSUD ASY-SYIFA' BEDAH 230902030121Y000221
    - Issue of repeat prescription (Z76.0) - Non-insulin-
    BANGKAT dependent diabetes mellitus (E11) - Essential (primary)
    48 11-01-2021 NURKEMAH 5207056207710001 49 Thn 5Perempuan MONTEH 845723169 hypertension (I10) RSUD ASY-SYIFA' PENYAKIT DALAM 230902030121Y000216
    BANGKAT
    49 11-01-2021 HASRINI 5207057003890001 31 Thn 9Perempuan MONTEH 2060466849 - Paranoid schizophrenia (F20.0) RSUD ASY-SYIFA' JIWA 230902030121Y000215

    50 11-01-2021 TEA ARISTI PUTRI 5207056412150001 5 Thn 0 Perempuan TEPAS SEPAKAT 2662932069 - Epilepsy (G40) RSUD ASY-SYIFA' ANAK 230902030121Y000213
    51 11-01-2021 SUSI SUSANTI 5207055404890005 31 Thn 8Perempuan TEPAS 2506384585 - Paranoid schizophrenia (F20.0) RSUD ASY-SYIFA' JIWA 230902030121Y000212
    - Follow-up examination after other treatment for other
    conditions (Z09.8) - Insulin-dependent diabetes mellitus
    (E10) - Disorders of lipoprotein metabolism and other
    lipidaemias (E78) - Disorders of purine and pyrimidine
    52 08-01-2021 AHMAD MAHDAR 5207050410700001 50 Thn 3Laki-laki LAMUNTET 2620244125 metabolism (E79) RSUD ASY-SYIFA' PENYAKIT DALAM 230902030121Y000174

    - Issue of repeat prescription (Z76.0) - Non-insulin-


    dependent diabetes mellitus (E11) - Disorders of
    lipoprotein metabolism and other lipidaemias (E78) -
    Disorders of purine and pyrimidine metabolism (E79) -
    53 08-01-2021 FATIMAH 5207055609650001 55 Thn 3Perempuan TEPAS SEPAKAT 1581168104 Essential (primary) hypertension (I10) RSUD ASY-SYIFA' PENYAKIT DALAM 230902030121Y000165

    - Issue of repeat prescription (Z76.0) - Essential (primary)


    SAPUGARA hypertension (I10) - Disorders of lipoprotein metabolism
    54 08-01-2021 BINRI 5207054906670002 53 Thn 7Perempuan BREE 845176599 and other lipidaemias (E78) RSUD ASY-SYIFA' PENYAKIT DALAM 230902030121Y000163

    55 07-01-2021 SAMSIAH 5207054402710001 49 Thn 1Perempuan TEPAS SEPAKAT 1581168341 - Malignant neoplasm of breast, unspecified (C50.9) RSUD ASY-SYIFA' BEDAH 230902030121Y000146
    SAPUGARA - Dislocation, sprain and strain of joints and ligaments of
    56 07-01-2021 ABIDA DANIYAH 5207065601150001 5 Thn 11Perempuan BREE 1901535557 elbow (S53) RSUD ASY-SYIFA' BEDAH 230902030121Y000138
    SAPUGARA - Issue of repeat prescription (Z76.0) - Insulin-dependent
    57 07-01-2021 SITI NUR 5207055012620001 58 Thn 0Perempuan BREE 2662755851 diabetes mellitus (E10) RSUD ASY-SYIFA' PENYAKIT DALAM 230902030121Y000131
    SAPUGARA - Orchitis, epididymitis and epididymo-orchitis without
    58 06-01-2021 SYAMSUL HADI 5207052507830001 37 Thn 5Laki-laki BREE 146517985 abscess (N45.9) RSUD ASY-SYIFA' BEDAH 230902030121Y000114
    - Congestive heart failure (I50.0) - Atrial fibrillation and
    SAPUGARA flutter (I48) - Other and unspecified right bundle-branch
    59 06-01-2021 SOLIHAT 3202454512750001 45 Thn 1Perempuan BREE 2661272458 block (I45.1) RSUD ASY-SYIFA' PENYAKIT DALAM 230902030121Y000109
    60 05-01-2021 HABIBA 5207054504700001 58 Thn 9Perempuan TEPAS 2749015844 - Urinary calculus, unspecified (N20.9) RSUD ASY-SYIFA' BEDAH 230902030121Y000078

    - Non-insulin-dependent diabetes mellitus with other


    specified complications (E11.6) - Insulin-dependent
    diabetes mellitus (E10) - Disorders of lipoprotein
    HADIJAH BT. SAPUGARA metabolism and other lipidaemias (E78) - Essential
    61 05-01-2021 FATAHOLLAH 5207055412690001 51 Thn 0Perempuan BREE 2588226041 (primary) hypertension (I10) RSUD ASY-SYIFA' PENYAKIT DALAM 230902030121Y000072
    62 05-01-2021 SYAFARUDDIN 5207052404640001 56 Thn 9Laki-laki DESA BERU 846078647 - Ulcerative colitis, unspecified (K51.9) RSUD ASY-SYIFA' PENYAKIT DALAM 230902030121Y000068
    63 05-01-2021 SUEF SAID SALMEN 5207051905810001 39 Thn 7Laki-laki DESA BERU 1581043443 - Epilepsy (G40) RSUD ASY-SYIFA' PENYAKIT DALAM 230902030121Y000066

    - Other chronic obstructive pulmonary disease (J44) -


    SAPUGARA Essential (primary) hypertension (I10) - Disorders of
    64 04-01-2021 ADAIYAH 5207057012840002 56 Thn 0Perempuan BREE 846509218 lipoprotein metabolism and other lipidaemias (E78) RSUD ASY-SYIFA' PENYAKIT DALAM 230902030121Y000061
    - Congestive heart failure (I50.0) - Essential (primary)
    hypertension (I10) - Chronic kidney disease (N18) -
    65 04-01-2021 SUDIRMAN 5207051708790004 50 Thn 4Laki-laki SEMINAR SALIT 1254575619 Cerebral infarction (I63) RSUD ASY-SYIFA' PENYAKIT DALAM 230902030121Y000056
    66 04-01-2021 HABIBA 5207054504700001 58 Thn 8Perempuan TEPAS 2749015844 - Urinary calculus, unspecified (N20.9) RSUD ASY-SYIFA' PENYAKIT DALAM 230902030121Y000039

    - Non-insulin-dependent diabetes mellitus with


    neurological complications (E11.4) - Insulin-dependent
    diabetes mellitus (E10) - Anxiety disorder, unspecified
    SAPUGARA (F41.9) - Lumbago with sciatica (M54.4) - Chronic kidney
    67 04-01-2021 SAMSIA 5207056010680002 52 Thn 2Perempuan BREE 2933598903 disease (N18) RSUD ASY-SYIFA' PENYAKIT DALAM 230902030121Y000024
    - Non-insulin-dependent diabetes mellitus with
    neurological complications (E11.4) - Non-insulin-
    SAPUGARA dependent diabetes mellitus (E11) - Disorders of
    68 04-01-2021 PANCAWATI 5207054411740002 46 Thn 2Perempuan BREE 1581107185 lipoprotein metabolism and other lipidaemias (E78) RSUD ASY-SYIFA' PENYAKIT DALAM 230902030121Y000022

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