LAPORAN RUJUKAN

TANGGAL NO NAMA NO BPJS

1/8/2019 1 CATUR BUDI ASIH 0000594674526

2 NALA FARIDATUL AKHLAK 0000593874101

3 SARMIJAN 0000593903935
4 KARTINI 0000582739143
5 WIDIYASARI 0001529092484
6 MUSIRI 0000594762039
7 KASMIN 0000593717894
8 KUNDARI PS 0000593985396
9 BAROKAH 0000594057521
10 SIMPEN 0000593746312
11 SRI SUMIYATI 0001025923151
12 JOKO MUKARNO 0000594493716
13 SUMIRAH 0001025917558
14 UMI MUSYAROFAH 0002497565081
2/8/2019 15 MASINI 0001025924804
16 DJARI 0000594340942
17 MUHAMMAD KHANAFI 0000594134829
18 NUR FAIZAH 0000593888163

19 RIFATUN YULIANTI 0002448536466

20 PUPUT WINDASARI 0000595032546
10/8/2019 21 RUBISAH 0000593422075
22 SUHARNO 0001084897844
23 MOH. RAMELAN 0001025941274
24 UMI NUR SHOLEKAH 0000576738652
25 SUWARDI 0000594738382
26 ROBET NURDIANSYAH 0000594325348
27 SUHARDI 0000593699602
28 ABU BADRI 0000594309407

NO TANGGAL NO BPJS NAMA

29 16-08-2019 0002476482276 KHOIRUL ANAS
30 16-08-2019 0001611520986 CHOIRIA DWI ANNISA
31 16-08-2019 0001449544869 NGATMINAH
32 16-08-2019 0001085038863 JASEMI
33 16-08-2019 000594169885 MULYATI
34 16-08-2019 0002438395031 SITI ASTUTI
35 16-08-2019 1025957845 TUMINI
36 16-08-2019 2344234961 SUTAJI
37 16-08-2019 593780861 HANIYATU ROVITA
38 16-08-2019 594366928 RUKATI
 16-08-2019 594916132 MASRUIN
39
40 21-08-2019 0001278677305 RUDI HARTONO
41 21-08-2019 00000594903813 INSAROH
42 21-08-2019 0000593437544 RUBIYANTI
43 21-08-2019 0000593438139 dinda sanita lestari
44 21-08-2019 0002694264827 SURATI MIATI
45 21-08-2019 0002123572443 siti mustaghfiroh
46 21-08-2019 0001966197071 ANOM SUROTO
47 21-08-2019 0000593971413 MARIANTO
48
49 26-08-2019 0002581371393 KHANIF SYAIFULLAH
50 26-08-2019 00000593974416 KASTURI
51 26-08-2019 00000594291407 NGADIMAN
52
53
54
55
AN RUJUKAN BULAN AGUSTUS
DIAGNOSA POLI RUJUKAN
Benign neoplasm of other anBEDAH

Epilepsy ANAK

Other disorders of middle ea THT-KL

Non-insulin-dependent diabet PENYAKIT DALAM
Maternal care for disproport OBGYN
Follow-up examination after PENYAKIT DALAM
Low back pain SARAF
Follow-up examination after BEDAH
Dorsalgia, unspecified SARAF
Dorsalgia, unspecified SARAF
Chronic tubotympanic suppur THT-KL
Cerebral infarction, unspecif SARAF
Myopia MATA
Dermatopolymyositis, unspec KULIT KELAMIN
Chronic obstructive pulmona PENYAKIT DALAM
Congestive heart failure PENYAKIT DALAM
Tuberculous peripheral lym BEDAH
Cerebral infarction, unspecif SARAF
Supervision of high-risk
pregnancy, unspecified OBGYN
Supervision of high-risk pre OBGYN
Non-insulin-dependent diabet DALAM
Schizophrenia (F20 JIWA
Multiple fractures of ribs, cl ORTHOPEDI
Supervision of high-risk pre OBSGYN
Disorders of accommodationMATA
Foreign body in ear THT-KL
Schizophrenia, unspecified JIWA
Stroke, not specified as haemorrSARAF

JENIS KELAMIN JENIS BPJS

L PBI (APBD)
P PBI (APBD)
P PEKERJA MANDIRI
P PBI (APBN)
P PBI (APBN)
P PEKERJA MANDIRI
P PBI (APBN)
L PBI (APBD)
P PBI (APBN)
P PBI (APBN)
P PBI (APBN)

L GIGI
P SARAF
P SARAF
P MATA
P DALAM
p obgyn
L HEMODIALISA
L DALAM

L GIGI
L BEDAH
L SARAF
 RUMAH SAKIT RUJUKAN
RSI SUNAN KUDUS

RSI SUNAN KUDUS

RSI SUNAN KUDUS

RSU KUMALA SIWI MIJEN
RS PKU MUHAMMADIYAH MAYONG
RSI SUNAN KUDUS
RSU KUMALA SIWI MIJEN
RS PKU MUHAMMADIYAH MAYONG
RSU KUMALA SIWI MIJEN
RSU KUMALA SIWI MIJEN
RSI SUNAN KUDUS
RS PKU MUHAMMADIYAH MAYONG
RSU KUMALA SIWI MIJEN
RSI SUNAN KUDUS
RS PKU MUHAMMADIYAH MAYONG
RS PKU MUHAMMADIYAH MAYONG
RSI SUNAN KUDUS
RS PKU MUHAMMADIYAH MAYONG

RSI SUNAN KUDUS

RS PKU MUHAMMADIYAH MAYONG

DIAGNOSA
Schizophrenia, unspecified
Infantile cerebral palsy, unspecified
Female genital prolapse
Senile cataract, unspecified
Gonarthrosis [arthrosis of knee]
Infantile, juvenile and presenile cataract
Spondylolysis
Congestive heart failure
Fracture of forearm
Congestive heart failure
Non-insulin-dependent diabetes mellitus with neurological complications

K 05.2 ( ACUT PERIODENTITIS )

G 56.0 ( CARPAL TUNEL SYNDROME )
M 54.5 ( Low Back Paint )
H52.2( GG REFRAKSI )
E 11.1 ( Non Insulin DM With Ketoacidosis )
z 35.5 ( AB dengan Hepatitis B )
N 18.4 ( ckd STG 4 )
HEART DISEASE ( I51.9)

S02.5
T 30.7
I64
 LAPORAN RUJUKAN BULAN SEPTEMBER TAHUN 2019

TANGGAL NO NAMA NO BPJS DIAGNOSA

4/9/2019 1 ZAENAL ABIDIN 1277441594 SCIZOPHRENIA
2 FENTI SILVIA 593538445 EPILEPSI
3 TRUBUS 593546894 OTHER CATARAC
4 ADAM BAHARUDIN 582756761 BENIGN OF TONSILI
5 NURUL KHOIRIYAH 1294001741 LOW VISION

5/9/2019 1 NASOKA 594545185 Nasal polyp

2 RUSMIYATI 1025954741 HIV
3 MUSLIMIN 1025941691 schizophrenia
4 FAFA ILFI SAIROH 1084806415 HRP
5 EVI ANIS SYAROFAH 2581164966 Diabetes
6 SUKOYO 1278664481 schizophrenia
7 SRINAH 1793396867 Low back pain
8 NOVI WILANDARI 594073596 lymphatic

11/9/2019 1 ngatemi 594642238 gonarthrosis,unpe

2 yusuf fathul 2581371371 k05.2
3 Noor azis 2581371358 urolithiasis N20
4 nawwaf khoirul shobi 2088972268 nephrotic syndrom
5 karni 1025924668 E 11.8
6 TITIN HENDRAWATI 593629176 G44 cluster heard
7 runi 1025923149 I 24.9
8 bunaim 2424107013 DM complikasi
9 natasya erlangga 2011797044 A16
10 parinah 1025927008 I 64
11 RUSMADI 1025950577 O10 Hipertensi comp
12 SUTIAH 1700076148 M 17

12/9/2019 1 YUNIATI AYUNINGSIH 594216786 Schizophrenia

2 AHMAD ROZIKIN 1025958205 Epilepsy
3 MUKHAYATUN 1084824641 CHF
4 EVI ANIS SYAROFAH 2581164966 high-risk pregnancy
5 CAHYONO 1278574301 Schizophrenia

16/9/2019 1 NGASRIPAH 1025921248 ASTHMA

18/9/2019 1 SUMARNI 1025924321 FR ULNA

2 SUKIR 2306292456 LBP
3 HARTINI 1025920269 DM E11
4 RUKISAH 1025928674 Z09.8
 5 subur 593584211 acute miokard infracti
6 NOR SAHID 594674166 D10
7 SUNARDI 594236711 N 18.9
8 SITI FATIMAH 1025918763 Z09.8

19/9/2019 1 nur sahid 2739790394 Schizophrenia

2 MUHAMMAD KODIR 594072898 Chalazion
3 ADIP TAUFIQUR ROZI 594470272 A16
4 ATIK NAJIHATI 2883627887 Z35.9
5 HENI DWI INDRIYANTI 594888232 Schizophrenia

25/9/2019 1 SURIPAH 593838808 M 51.2

2 BASORI 594226495 F 20
3 MUHAMMAD FAISAL LABIB 1969472046 F 20
4 TAMAJI 2074393754 Z96.1
5 ROMADON 1084634774 E11

28/9/2019 1 DINA ISTIYANA 593528826 (M41.9)

2 KHOLIFATUN MAR'FUAH 1025918234 N23
3 BARINI 582782512 (I50.0)
4 M. RADITYA ALVINO .P 2626618285 R62
5 ABDUL KHORIB 595438075 (H40.9)
6 TEMU 594071864 (M54.5)

30/9/2019 1 MIFTAKHUL AJIB 1729190744 (I50.0)

2 FATKHIYATUL IANAH 2774117452 O48
3 WARSINAH 2465863626 B90.9
4 AHMAD ARFIAN RIZKI N 2677740748 H16
5 SULATRI 593953558 S52.6
6 NAWAWI 2573825545 H40.0
7 LUFIANA ULFA 595439662 O20.0
8 YAYU TRININGSIH 536248945 B20
 POLI RUJUKAN RUMAH SAKIT RUJUKAN
JIWA PKU M MAYONG
ANAK PKU MAYONG
MATA PKU MAYONG
THT RSI KUDUS
MATA RSI KUDUS

THT-KL RS PKU M MAYONG

PENYAKIT DALAM RSU RA KARTINI JEPARA
JIWA RS PKU M MAYONG
OBGYN RS PKU M MAYONG
PENYAKIT DALAM RSU KUMALA SIWI MIJEN
JIWA RS PKU MAYONG
SARAF RSU KUMALA SIWI MIJEN
BEDAH RS PKU M MAYONG

saraf kumala siwi

gigi RSI Kudus
urologi RSI Kudus
anak RSI Kudus
poli dalam kumala siwi
saraf kumala siwi
dalam kumala siwi
dalam pku M mayong
anak rpku m mayong
saraf kumala siwi
dalam kumala siwi
SARAF kumala siwi

JIWA RS PKU M MAYONG

SARAF RS PKU M MAYONG
DALAM RS PKU M MAYONG
OBGYN RSU KUMALA SIWI
JIWA RS PKU M MAYONG

PARU RS PKU M MAYONG

ORTHOPEDI RSI KUDUS

SARAF RSI KUDUS
DALAM PKU MAYONG
DALAM KUMALA SIWI
jantung rsi KUDUS
BEDAH RSI KUDUS
HEMODIALISA RS KUMALA SIWI
DALAM RS KUMALA SIWI

JIWA PKU MAYONG

MATA PKU MAYONG
PARU RSI SUNAN KUDUS
OBGYN RSI SUNAN KUDUS
JIWA RSI SUNAN KUDUS

SARAF RS PKU M MAYONG

JIWA RS PKU M MAYONG
JIWA RSI KUDUS
MATA RS PKU M MAYONG
DALAM RS KUMALA SIWI

SARAF RSU KUMALA SIWI

UROLOGI RSI SUNAN KUDUS
PENYAKIT DALAM RSI SUNAN KUDUS
ANAK RS PKU M MAYONG
MATA RSI SUNAN KUDUS
SARAF RSU KUMALA SIWI

PENYAKIT DALAM RS PKU MAYONG

OBGYN RSI SUNAN KUDUS
PARU RSI SUNAN KUDUS
MATA RSI SUNAN KUDUS
ORTHOPEDI RSI SUNAN KUDUS
MATA RSI SUNAN KUDUS
OBGYN RSI SUNAN KUDUS
PENYAKIT DALAM RSU RA KARTINI JEPARA
 LAPORAN RUJUKAN BULAN OKTO

TANGGAL NO NAMA NO BPJS

2/10/2019 1 AHMAD SAFI'I 594467111
2 SUJONO 593855662
3 NUR ALIMAH 594221782
4 SUDARTO 93836092
5 ACHYA UDDIN 2677739995
6 SITI MUZAYANAH 1025940003
7 SAADATUL MUNA 1084973679
8 SITI ZULAIKAH 1025946202
9 DANU ANUGRAH 2351162913
10 USWATUN HASANAH 593749877

3/10/2019 1 WARSINAH 2465863626

2 SUNIPAH 1025933692
3 SURYANTO 1611515867
4 ALI MUSTAFI\\\\'IN 593602648
5 M. PAIMAN 582754544
6 SURATNO 594080109
7 ZUBAIDAH 1025896858
8 RUSMADI 1025950577
9 LISTIYANI 2621105087
10 JUMIATI 1309811376

4/10/2019 1 SA'DIYAH 1084852348

2 SUWARYO 593582804
3 KHOIRUN NIKMAH 1025959994
4 NOR KHOLIS 594340964
5 KARSINAH 594971818
6 ZALF CHRISYA 594059354
7 SUPIJAH 593507575
8 FIRDAUSI SOIMAH 2071407846
9 NIKE MELINDA 2677740085
10 BAROKAH 594057521
11 ABDUL AZIS 594082899
12 BUKHORI 594148713
13 HATEMI 1025929157
14 SUMARTO 2088811506

15 AQILA LAILATUL AS-SIFFA 2272237413

9/10/2019 1 SRI ERI MURNIASIH 1025956765

2 FERI PRASETYO 1533759456
 3 ABDUL GANI LUBIS 1278670285
4 SUMIYATI 1025920765
5 SUMI 594593493
6 SARIBIN 593990662

10/10/2019 1 SARDI 594080818

2 SUMARNO 582739064
3 ENDANG SIDOLASTUTI 2573854929
4 SRI WAHYUNINGSIH 594875507
5 PIPIT FEBRIANI 593773064
6 WARSINI 1025931993

14-10-2019 1 SUJONO 593855662

2 SANTI NUR SAFITRI 588552041
3 SUMADI 594569575
4 NUR JANAH 1025951951
5 SUWIJI 593951117
6 RUKAYAH 1479753213
7 SUKAMAH 1025922587
8 SUPAR SHODIQ 595460957

16/10/2019 1 RUMINI 592597168

2 AKHMAD SHOKEH 593626814
3 NOR ARIF 2463612805
4 SUPIYAH 1298726087
5 nada ismatullah 1306284287

17/10/2019 1 SUBHAN 593674615

21/10/2019 SITI MARHAMAH 0000592575952

RUDI HARTONO 0001278677305
SUKAMAH 0001533760165
SUMINTRI 0002014316818
CHOIRUL ANWAR 0000594653556
MUSLIMIN 0001698362065
MASKIN 0000593722315
M ULUL AZMI 0002573848089
KUSNIN 0000593112036
DEWI AMALIA RUSYDA 0001873512303
NAILA TRI SEPTIN 0002573845839
JAYANAH 0001025921349
MUKARI 0000594098526
23/10/2019 1 HATEMI 1025929157
2 TAMSURI 2292491169
3 MULYONO 1025943489
4 MASLIKAN 594943468
5 NGASEMAN 593460505
6 SITI KHODIJAH 593838112
7 AHMAD ZUMAR 593964202
8 MARWATI 1025930845
9 SURATI MIATI 2694264827

TGL NAMA NO BPJS

24/10/19 ILYA MUNAWAROH 594113411

25/10 FAINZAH 0002169422291 Schizophrenia, unspecified (F20.9)

28/10/201 MUHAMMAD FAISHAL LABIB 0001969472046 Sacroiliitis, not elsewhere classified (M46.1) :
SAMIAN 0000593681499 Senile cataract, unspecified (H25.9)
AFDHOLI 0001025973685 Chronic kidney disease, stage 5 (N18.5)
SUNARTI 0001084944341 Fracture of neck of femur (S72.0)
RUSMI 0000593672602 Senile cataract, unspecified (H25.9) :
MASRIAH 0001326443286 Respiratory tuberculosis, not confirmed bacteriologically or histologically (
SUTRIYANTO 0002775850018 Non-insulin-dependent diabetes mellitus with other specified complica
HANDOKO 0001697001737 Schizophrenia (F20) :
MUKANAN 0000593906747 Bacterial meningoencephalitis and meningomyelitis, not elsewhere classi
BAEDLOWI 0000594216437 Perforation of tympanic membrane (H72)
SEKAR 0002471543471 Congestive heart failure (I50.0)

30/10/2019 1 MUNJAROAH 2889040511

2 SUHENDRI 1697751033
3 JA'FAR 2316469375
4 SUTRIMAH 594083507
5 SUKATI 591963366
6 SULASTRI 594996412
7 ANA FATHIYYATUR ROHMAH 595207247
8 JAMARI 1025918256
9 WARDOYO 2711156231
10 BAMBANG HERMANTO 1025932768
11 DWI ISMAWATI 2890783552
12 VANESA DWI ARIYANI 2677737791

31/10/2019 1 nanik fandayani 1025957992

2 KASMIN 593717894
3 MASLIHAN 594055923
4 LONGGAR EDY PURYANTO 593346688
 5 SUMIYATI 1025959116
6
7
8
9
10
 LAPORAN RUJUKAN BULAN OKTOBER 2019

DIAGNOSA POLI RUJUKAN

SCIZOFRENIA JIWA
HEMATOMESI DALAM
D01.2 BEDAH
CALCULUS KIDNEY UROLOGI
H25.0 MATA
GLUCOM MATA
F 20.9 JIWA
I63.9 SARAF
J44 THT
(T31.3) BEDAH

(I50.0) JANTUNG
M19 SARAF
F20 JIWA
F20 JIWA
F20 JIWA
E11.7 PENYAKIT DALAM
Z35.9 OBGYN
(K40.9) BEDAH
(H43.1) MATA
(I25.9) PENYAKIT DALAM

(Z35.9) OBGYN
(E11.8) PENYAKIT DALAM
(O32.9) OBGYN
(J44.9) PARU
(N20.1) UROLOGI
(D21.2) BEDAH
(A16.4) PARU
(Z09.8) OBGYN
l43.9 KULIT KELAMIN
I50.0 PENYAKIT DALAM
f20 JIWA
F20 JIWA
I63 SARAF
H40.9 MATA

H10.0 THT-KL

COLILITHIASIS DALAM
F41 JIWA
F20.9 JIWA
F20.9 JIWA
I 51.7 DALAM
F20.9 JIWA

(I64) SARAF
(I69.3) SARAF
(S42.3) ORTHOPEDI
(O33.9) OBGYN
(O20.0) OBGYN
(Z09.8) PENYAKIT DALAM

(Z08.9) PENYAKIT DALAM

(N93.9) : OBGYN
H66.1 THT-KL
(N18) Hemodialisa
(I50.9) JANTUNG DAN PEMBULUH DARAH
(I50.0) PENYAKIT DALAM
(E10.6) PENYAKIT DALAM
(I50.0) PENYAKIT DALAM

H28 MATA
B 17 DALAM
G 40.9 SARAF
M51.2 SARAF
f 80.9 anak

(I50.0) PENYAKIT DALAM

MATA RSI SUNAN KUDUS

Glaucoma (H40)
Melanocytic (D22.9) : BEDAH :
Non-insulin (E11.8) PENYAKIT DALAM
Cardiomegaly (I51.7) PENYAKIT DALAM
Schizophrenia (F20) : JIWA
Peptic ulcer, site unspecified (K27) : PENYAKIT DALAM
Chronic ischaemic heart disease (I25) PENYAKIT DALAM
Undifferentiated schizophrenia (F20.3) JIWA :
Spastic hemiplegia (G81.1) SARAF
Severe depressive episode with psychotic symptoms (FJIWA
Adjustment disorders (F43.2) JIWA
Congestive heart failure (I50.0) PENYAKIT DALAM
Unspecified dementia (F03 JIWA
 R31 UROLOGI
(I50.0) PENYAKIT DALAM
(K01.1) GIGI
(Z09.8) PENYAKIT DALAM
(J44.9) PENYAKIT DALAM
D25.9 OBSGYN
H66.2 THT-KL
I50.0 PENYAKIT DALAM
(E11.1) PENYAKIT DALAM

DIAGNOSA POLI RUJUKAN

O36.4 OBGYN

pecified (F20.9) JIWA RS PKU MUHAMMADIYAH MAYONG

Sacroiliitis, not elsewhere classified (M46.1) : SARAF RS PKU MUHAMMADIYAH MAYONG

pecified (H25.9) MATA RS PKU MUHAMMADIYAH MAYONG
ase, stage 5 (N18.5) Hemodialisa RSI SUNAN KUDUS
femur (S72.0) SARAF RSU KUMALA SIWI MIJEN
ecified (H25.9) : MATA RS PKU MUHAMMADIYAH MAYONG
ulosis, not confirmed bacteriologically or histologically (A16) PENYAKIT DALAM RSU KUMALA SIWI MIJEN :
pendent diabetes mellitus with other specified complications (E11. PENYAKIT DALAM RSI SUNAN KUDUS
JIWA RS PKU MUHAMMADIYAH MAYONG
oencephalitis and meningomyelitis, not elsewhere classified (G04.2 SARAF RS PKU MUHAMMADIYAH MAYONG :
mpanic membrane (H72) THT-KL RSI SUNAN KUDUS
PENYAKIT DALAM RSU KUMALA SIWI MIJEN

(I64) SARAF
(F20) JIWA
(E10.4) PENYAKIT DALAM
(G81) SARAF
(I50.0) PENYAKIT DALAM
(M54.3) SARAF
(N60.2) BEDAH
(E11.8) PENYAKIT DALAM
(N20.1) UROLOGI
(H25) MATA
(O48) OBGYN
(H16.0) MATA

f20 jiwa
M54.5 SARAF
M54.56 DALAM
M17 SARAF
I69.3 SARAF
 RUMAH SAKIT RUJUKAN
PKU MAYONG
KUMALA SIWI
RSI KUDUS
RSI KUDUS
RSI KUDUS
RSI KUDUS
RSI KUDUS
RS KUMALASIWI
RS PKU MAYONG
RS PKU MAYONG

RSI SUNAN KUDUS

RS PKU MAYONG
RS PKU MAYONG
RS PKU MAYONG
RS PKU MAYONG
RS PKU MAYONG
RSU KUMALA SIWI
RSU KUMALA SIWI
RSU KUMALA SIWI
RSU KUMALA SIWI

RSU KUMALA SIWI

RSU KUMALA SIWI
RSI SUNAN KUDUS
RSI SUNAN KUDUS
RSI SUNAN KUDUS
RS PKU MAYONG
RSI SUNAN KUDUS
RS PKU MAYONG
RSU RA KARTINI JEPARA
RSU KUMALA SIWI
RS PKU MAYONG
RS PKU MAYONG
RSU KUMALA SIWI
RSU KUMALA SIWI

RS PKU MAYONG

RSI KUDUS
PKU MAYONG
PKU MAYONG
PKU MAYONG
KUMALA SIWI
PKU MAYONG

RS PKU MAYONG
RSU KUMALA SIWI
RSI SUNAN KUDUS
RSU KUMALA SIWI
RSU KUMALA SIWI
RSU KUMALA SIWI

RSU KUMALA SIWI MIJEN

RSI SUNAN KUDUS
RSI SUNAN KUDUS :
RSI SUNAN KUDUS
RSI SUNAN KUDUS
RS PKU MUHAMMADIYAH MAYONG
RSI SUNAN KUDUS
RS PKU MUHAMMADIYAH MAYONG

RS KUMALA SIWI
RSI KUDUS
PKU MAYONG
kumala siwi
rsi kudus

RS PKU MAYONG

RS PKU MUHAMMADIYAH MAYONG

RSU KUMALA SIWI MIJEN :
RSU KUMALA SIWI MIJEN
RS PKU MUHAMMADIYAH MAYONG
RS PKU MUHAMMADIYAH MAYONG
RS PKU MUHAMMADIYAH MAYONG
RS PKU MUHAMMADIYAH MAYONG
RS PKU MUHAMMADIYAH MAYONG :
RS PKU MUHAMMADIYAH MAYONG
RSI SUNAN KUDUS
RS PKU MUHAMMADIYAH MAYONG
RS PKU MUHAMMADIYAH MAYONG
 RSI SUNAN KUDUS
PKU MUHAMMADIYAH MAYONG
RSI SUNAN KUDUS
RSU KUMALA SIWI MIJEN
PKU MUHAMMADIYAH MAYONG
RSI SUNAN KUDUS
RSI SUNAN KUDUS
RSU KUMALA SIWI MIJEN
PKU MUHAMMADIYAH MAYONG

RUMAH SAKIT RUJUKAN

RSI KUDUS

H MAYONG

SIWI MIJEN :

H MAYONG :

SIWI MIJEN

RS PKU MUHAMMADIYAH
RS PKU MUHAMMADIYAH
RSI SUNAN KUDUS
RSU KUMALA SIWI
RS PKU MUHAMMADIYAH
RS PKU MUHAMMADIYAH
RS PKU MUHAMMADIYAH
RSU KUMALA SIWI
RSI SUNAN KUDUS
RS PKU MUHAMMADIYAH
RSI SUNAN KUDUS
RSU KUMALA SIWI

rs pku m ayong
RS KUMALA SIWI
PKU MAYONG
RSI KUDUS
RS KUMALA SIWI
 LAPORAN RUJUKAN BULAN NOVEMBER TAHUN 2019

TANGGAL NO NAMA NO BPJS

1/11/2019 WAHYU NUGROHO 0000594908728 Depressive episode, unspecified

(F32.9
MUKHLISIN 0000594557965 Other specified diseases of hard tissues
of teeth (K03.8)
YUSSYA AMINUDIN 0000593372777 Schizophrenia (F20)

SAREH 0002677732683 Disorder of refraction, unspecified (H52.7)

MAHMUDAH 0000594071019 Senile cataract (H25) :

MAFTUKHAH 0000591766424 Congestive heart failure (I50.0) :

MASRUIN 0000594916132 Insulin-dependent diabetes mellitus with

multiple complications (E10.7)
HATEMI 0001025929157 Cholelithiasis (K80) :

INTI'AH 0002265651876 Tuberculosis of lung, bacteriologically and

histologically negative (A16.0)
SUGIYANTO 0000592899592 Peptic ulcer, site unspecified (K27)

4-11=19 SUWARSI 0001902338572 Cerebral infarction, unspecified (I63.9)

SHOLIKAH 0000593565467 Supervision of high-risk pregnancy,

unspecified (Z35.9)
SARDI 0000594080818 Other surgical follow-up care (Z48)

YURIYAH 0000598112943 Malignant neoplasm of connective and soft

tissue, unspecified (C49.9)
WAWAN HIDAYAT 0002314286019 Constipation (K59.0)

MUHAMMAD APRIYANTO 0000594371542 Cholelithiasis (K80) :

SUHADI 0000593745399 Respiratory tuberculosis, not confirmed

bacteriologically or histologically (A16)
 DANANG AMANNUDIN 0001025925625 Schizophrenia (F20)

RIZQY AHMAD FAHREZA 0000093669017 Follow-up examination after

other treatment for other conditions (Z09.8)

6/11/2019 1 REBISAH 594343989

2 MIFTAKHUL QOMARIYAH 593666864

3 SURASDI 2774715759

4 MUKHAMAD SHOLIKHUL BASORI 2901314823

5 MAROAH 1025935727

6 MUHAMMAD REYNAL PUTRA PERDANA 1906693402

7 USWATUN YUSRO 594326305

8 FIFI DWI SUKMA ANGGRAINI 594369358

9 FISNU FATHUL MAULA 594641924

10 KARSANAH 2212734609

11 KARTINI 582739143

7/11/2019 1 idhotus syarifah 594607026

2 WIDA KUMALA 1277448996

3 MASINI 10255924804

4 RUMISIH 593876294

5 HARIYANTO 593876845
 6 SULKIN 593876024

7 SAWIR 2581744138

8 SITI ZARIAH 594019697

9 MASINI 1025924804

10 ROHMIATI 2521558822

8/11/2019 1 SRI SUNDARI 1025919437

2 REBAN 2738523486

3 SUWITO 593856145

4 MASTOHA 593863209

5 SRI MULYATI 1444354301

13/11/19 1 WAHYU INDRA PRATAMA 2614075705

2 SRI MASNI 593668517

3 ETIK AMRIYANA 593008132

4 MUNAWIROH 595073529

5 HENY LESTARI 594467043

6 KARSIH 593881997

7 SUTAMAN 593881435

8 TURIYAH 593627848
 9 BUDIYONO 594441382

10 SUMARMI 2262369881

11 SITI FADILAH 594292983

14/11/19 1 ROHYATI 1025966294

2 SUDIYANAH 2747462613

3 ZAFRULLAH 93669671

4 SRI RAHAYU 93666655

5 SUDIYONO 1445215331

6 MASRUIN 594916132

16/11/19 1 SITI MARTUNIK 1084762451

2 choiria dwi annisa 1611520986

3 SUTAJI 2344234961

4 MUHAMMAD HASIM SAFAAT 595004376

5 SITI MUAYANAH 1084752505

6 ABDUL MANAF 595597994

7 RUDI HARTONO 1278677305

8 ALI AHMADI 593874426

9 KHOIRUL ANAS 2476482276

18/11/2019 1 SITI AMANAH 2467592673

2 SUNARDI 594236711

3 SUHARSONO 594350199

4 SITI RAKINAH 593857001

5 KHOIRUZZAD 594471295

6 SHOLIKATUN 593590656

7 SUTIAH 1700076148

8 MUSTAMARO 2900521596

9 DWI JULIYANTI 594568181

10 JURIYAH 594914354

20/11/19 1 RAHAYU 2345597605

2 RUKANAH 1025958846

3 KASMUDI 2573857203

4 ENDANG SUSILOWATI 2573854929

21/11/19 1
MUHTAR KUNDHORI 1025959983
2
WAHYUDI 1025957057
22/11/19 1 ALI THO'AM 593976249

2 2283315917

AHMAD KHAFINDHI
3 KARTINI 582739143

25/11/19 1 SUMARNI 1025924321

2
SUTIKHAT 594084734
3 MASTOHA 593863209

4 AHMAD KUSNAN
595001812
5 YOHANA RUKATI 93656182

6 SULISTYAWATI
593873976
7 NALA FARIDATUL
593874101
8 LUSIANA
2128367439
9 ALFIYAH
593494661
10 ZAENAB 0002616260062 

29/11/2019
1 MULYATI 0000594169885 Gonarthrosis [arthrosis of knee] (M17)
KUSTAMI 0002744920642 Congestive heart failure (I50.0)
RIQI HARIYADI 0000594745323 Blindness, both eyes (H54.0)
FARIZA KHOIRUN NIDA 0002497565373 Trichomoniasis (A59) :

2/12/2019 1 ELLY LIANA SARI 1084116339

2 ARIS IDAWATI 2581799624
3 MASTUTIK 593609185
4 DEWI SAMARAH 1277437948
5 SUSANA 595425159
6 ALI RIDHO 2573848473
7 SARMINAH 594254608
8 SRINAH 1793396867
 9 AMBAR ZULAEKO 2312652879
10 SITI ZAULAIKHAH 1025946202

9/12/2019 1 SITI PUJIATI 594582849

2 SILAH 2449831285

11/12/2019 1 zamah 594689613

2 Runni 1025923149
3 SULASTRI 594978941
5 ahmad rifai 593625677
6 ZAENAL ARIFIN 593704293
7 PASRIAH 594082067

17/12/19 1 ABDUL FALAH 2573858608

2 SRINAH 593791086
3 ROMADHON 1084634774
4 by ny. Istirofiyah 2909905457
5 KARSI 534668125
6 NING ULUL AZMI 1611516824

23/12/19 1 SUMARINI 1025924321

2 NOVI WILANDARI 594073596
3 SUBUR 593584211
4 MARIA ULFA 93598143
5 M ZAMAH A 93168088
6 NGASRIPAH 1025921248
7 ABDUL KHAMID 593873447
8 AMELIA WIDIA R 1025931295
9 MASRIAH 1326443286
10 RATEMI 1025917457

27/12/19 1 INTI'AH 2265651876

2 SITI ROKHANAH 1271137983
3 MUHAMMAD SHOLIKHIN 594338343
4 NUR ALIMAH 594221782
5 DINA ISTIYANA 593528826
6 ETIK SUSILOWATI 1025919573
7 SUBADI 1025917694
8 ELIN HANDAYANI 2581348138
9 DARSI 593329162
10 ROMADONA 594645783
11 JIHAN SANDO ANGGRAINY 594649473
 2/1/2020 1 IMAROTUL ALIYAH 1025947236
2 ABDUL KHORIB 595438075
3 LIANA SAFITRI 593974888
4 SRI ERI MURNIASIH 1025956765
5 JUMIATI 1309811376
6 SULIMAH 593036651
7 TUMINAH 594895713
8 MACHRONI, B.SC 2909810452

9/1/2020 1 NILA AFRILIANI 1025948351

2 SUMARMI 2262369881
3 WARSINAH 2465863626
4 NURUL AZIZAH 202207184
5 RUMINAH 2756314473

16/1/2020 1 ASMINAH 594442631

17/1/2020 1 RUMINI 592597168

CREISTAVIA FIORENZA FREDELLA 0000195548578 Nasal polyp, unspecified (J33.9)
SUWARYO 0000593582804 Non-insulin-dependent diabetes mellitus with unspecified complic
JUPRI 0000594088119 Alzheimer's disease, unspecified (G30.9)
ARIS MULYANI 0000593579518 Respiratory tuberculosis, not confirmed bacteriologically or histologically (
AKHMAD SHOKHEH 0000593626814 Acute delta-(super)infection of hepatitis B carrier (B17.0)

23/1/2020 1 SUHARTINI 592862883

2 BASIR 594084699
3 SHOLIKATI 594635073
4 RUKIJAH 593555051
5 MUHAMMAD FUAT ZAENURI 594560103
6 SARDI 1842989951
7 BAYI NYONYA RATIH SYAFA'ATUS S. 2771394456

24/1/2020 RIRIN ALFAH 0001699527071 Inflammatory liver disease, unspecified (K75.9) :

BASORI
0000594194387
Schizophrenia, unspecified (F20.9)
BAROKAH 0000594057521 Dorsalgia, unspecified (M54.9)
SUWARNI 0002246329664 Zoster with other nervous system involvement (B02.2)
DIAH LISWANINGSIH 0000593613696 Supervision of high-risk pregnancy, unspecified (Z35.9)
SUDIRIN ABDUL ROHMAN 0000595071854 Paranoid schizophrenia (F20.0)
SUMIYATI 0001025959116 Sequelae of cerebral infarction (I69.3)

29/1/2020 1 FIRKHATUS SHOLIKHAH 2915484399

2 ISTIKHAROH 594076421
3 SUHADI SUDI 594468145
 4 SABARI 594653343
5 MARWATI 1025930845
6 ROFIATUN 1025947372
7 ZAENAL ABIDIN 1277441594
8 ALKHALIFI CANDRA KUSUMA 1649146768

30/1/2020 1 ZUBAIDI 594275196

2 KASMIN 593717894
3 MUHAMMAD NOVAL SYARIFUDDIN 2775225791
4 AHMADI 2376928754

31/1/2020 1 SUHADI 593745399

2 SAWIR 2581744138
3 SANDI EVA YANT 594977951
4 SILFIYANI 1908418105
5 SRI MASNI 593668517
6 SRI MASNI 593668517
7 KARSIH 593881997
8 SUHARTI 2169422447
9 ROKHAYATI 593079873
10 LOSO 594403481
11 ROHMAH 594639854
12 SAWIR 2581744138
13 SUKARTI 593873515
14 ROKHAYATI 593079873
15 RADI 595339615

8/2/2020 1 AHMAD YAKARIM 1085088464

2 JAMI'AH 594323289
3 MASKANAH 594557199
4 BAROKAH 594057521
5 TURIYAH 593627848
6 SUHARDI 593699602
7 SUMARSIH 594338883
8 MUKHAMAD SHOLIKHUL BASORI 2901314823
9 SUBADI 1025917694

13/2/2020 1 CICIK HANDAYANI 594633576

2 RUBIYANTI 593437544
3 SULDI 593605809
4 SUWITO 593856145

14/2/2020 1 ROHYATI 1025966294

2 NGADIMAN 593869948
 SULASTRI 0000594878332 Cerebral infarction, unspecified (I63.9), Essential (primary) hypertension (I10)
KARTINI 0000582739143 Non-insulin-dependent diabetes mellitus with multiple complications (E11.7)
SUTAJI 0002344234961 Congestive heart failure (I50.0)
SULKHANI 0000594258906 Low vision, both eyes (H54.2)
CHOIRIA DWI ANNISA 0001611520986 Infantile cerebral palsy, unspecified (G80.9)
JIWA RS PKU MUHAMMADIYAH MAYONG
JAMIATUL KHUSNA 0001529108785 Schizophrenia, unspecified (F20.9)
SUNARWI 0000594190056 Acute hepatitis B without delta-agent and without hepatic coma (B16.9)
SUWARDI 0002573821271 Dissociative convulsions (F44.5)
SULASMI 0000594902193 Heart failure (I50)

20/2/2020 1 MOH. SHOLIHUL GHULAM 1692958162

21/2/2020 1 SUGIYANTO 0000592899592 Gastro-oesophageal reflux disease with oesophagitis (K21.0)

2 MUHAMMAD SAPUAN 0000593031701 B20
3 MARIANA 0000593328688 Thyrotoxicosis [hyperthyroidism] (E05)
4 SUTAMAN 0000593881435 Chronic obstructive pulmonary disease, unspecified (J44.9)
5 SUNARTO 0000593964999 Other chronic obstructive pulmonary disease (J44)
6 RIQI HARIYADI 0000594745323 Corneal scars and opacities (H17)
7 SITI MUAYANAH 0001084752505 Paranoid schizophrenia (F20.0)
8 MUSTOFA 0002913341927 Ascites (R18)
9
10

26/2/2020 1 Respiratory tuberculosis, not confirmed bacteriologically or histologically (A16)

2 MUNTAMAH 0000594788782 Supervision of high-risk pregnancy, unspecified (Z35.9)
3 SUJANARKO 0000593560462 Non-insulin-dependent diabetes mellitus with unspecified complications (E1
4 MUHAMMAD REYNAL PUTRA PERDANA 0001906693402 Keratoconjunctivitis (H16.2)

27/2/2020 1 MURYANAH 2700804251

2 BAYI NYONYA YAYU TRININGSIH 2896577752
3 SULIPUR 593447073
4 SUTOPO 1025953839
5 BASORI 594226495
6 SUNARTI 593823069
7 UMI MUSYAROFAH 2497565081
8 RUKANAH 1025958846
9 ENDANG SIDOLASTUTI 2573854929

28/2/2020 SITI KHOTIJAH 0000592857191 Other specified retinal disorders (H35.8), Essential (primary) hypertension
FATIMAH AZ ZAHRA 0002778390033 Respiratory tuberculosis, not confirmed bacteriologically or histologi
MAFTUKHAH 0000591766424 Heart failure (I50)

5/3/2020 1 SUMAJI 593071119

 2 ISTIANAH 594434687
3 SUJANARKO 593560462
4 ASIKAH 593825005
5 ABDUL MAJID 594543442
6 NURYATI 593541663
7 SAPURAH 1025921531

9/3/2020 1 ABDUL BASYIR 0000594540123 Sequelae of cerebral infarction (I69.3)

2 SUDARMI 0001084673204 Non-insulin-dependent diabetes mellitus with unspecified complications (E11.8
3 MUALIFAH 0002677733818 Trigger finger (M65.3)
4 KHALIMI 0000594737526 Thyrotoxicosis with toxic multinodular goitre (E05.2), Unspecified chronic bronc
5 SULASTRI 0000595109654 Polyarthritis, unspecified (M13.0)
6 KHAMID 0001025933758 Unilateral or unspecified inguinal hernia, without obstruction or gangrene (K40.9
7 KUMAIDI 0000594138025 Low back pain (M54.5)
8 RATEMI 0001025917457 Other specified surgical follow-up care (Z48.8), Aphakia (H27.0)
9 CAHYONO 0001278574301 Schizophrenia, unspecified (F20.9)
10 SULASMI 0002573838933 Other and unspecified abdominal pain (R10.4), Anaemia, unspecified (D64.9)
11 INNAYATI 0000591936513 Other and unspecified abdominal pain (R10.4)

12/3/2020 1 RUNI 1025923149

2 RUMILAH 594219925
3 SUKARDI 2581351839
4 FERI PRASETIYO 1533759456
5 MUJI SELAMET 594365859
6 ZAENAB 2616260062
7 DEWI SAMARAH 1277437948
8 ALFIYAH 593494661
9 JUMI'ATI 2799847102

13/3/2020 SAODAH 0000594629785 Presence of intraocular lens (Z96.1)

SUTIAH 0001700076148 Gonarthrosis, unspecified (M17.9), Non-insulin-dependent diabetes mellitus with
RIRIN ALFAH 0001699527071 Acute hepatitis B (B16)
NGATMINAH 0001449544869 Female genital prolapse, unspecified (N81.9)
ABDUL RAHMAT SYAFE'I 0002169422504 Epilepsy (G40)
SUSANTI 0001025929168 Carpal tunnel syndrome (G56.0)
SUPIJAH 0000593507575 Tuberculous pleurisy, without mention of bacteriological or histological confirma
NGATEMI 0000593675537 Maternal care for disproportion due to generally contracted pelvis (O33.1) :
KURIN 0002351165319 Chronic kidney disease, stage 5 (N18.5)

14/3/2020 1 ABDUL WAKID 593890233

2 MARWATI 1025960679
3 MUKAHONO 594117246
4 MAT KUAT 592591263
5 YUNIATI AYUNINGSIH 594216786
6 SYEH ERVINA 594543598
19/3/2020 1 JUMI\\\\'AH 594321208
2 KARTIPAH 1025918267
3 ISTI ADAH 1025959836
4 SURINAH 1025927019
5 KURIN 2351165319
6 SUMARNI 1025924321
7 SUDIYONO 594463285
8 NENENG WIJAYANTI 594463656
9 NAILA AYU AGUSTINA 594464016
10 ZAMAH 594689613
11 SITI NARTI 594066238
12 ZAROFAH 2573824454
13 SUNIAH 1025948845
14 ZUMENI 594374196

26/3/2020 1 SUBUR 593584211

2 ALMIYATI 593707836

27/3/2020 NOVI WILANDARI 0000594073596 Tuberculosis of lung, bacteriologically and histologically negative (A16.0
AHMAD MAKSUM 0000594336633 Fracture of tooth (S02.5)
ENY SUKHLIS 0001803205653 Non-insulin-dependent diabetes mellitus with multiple complications (E11.7
NING ULUL AZMI 0001611516824 Schizophrenia, unspecified (F20.9)
SUMIRAH 0000593005083 Non-insulin-dependent diabetes mellitus with multiple complications (E11.7)
31/3/2020 FARIZA KHOIRUN NIDA 0002497565373

UMI MUSYAROFAH 0002497565081

KHUSNI BAHTIAR 0001084577613
ZIDAN BAROQ AHMAD 0000594616781
MUNTIAH WAHYUNINGSIH 0000594586934
DARSI 0000593329162

JASEMI 0001085038863
SRI HARTATIK 0000595162473
AMELIA WIDIA RAMADHANI 0001025931295

ABDUL BASIR 0000594689905

RUDI HARTONO 0001278677305

2/4/2020 1 MARTONO 2581371472

2 NUR ALIMAH 594221782
3 AUFA RAFIQI ALAMSYAH 593583131
4 KUNDERIN 2169422471
 5 MOH.RIDLO 593845896
6 ISTIFAIYAH 2677742897
7 MUHAMMAD SHOFA 'AZMI 2226864082
8 MUHAMMAD SUYUTI H 1482864287
9 LISTIYANI 2621105087
10 AMINAH 2032523313

3/4/2020 1 KUSTAMI 2744920642

2 KARSIH 0000593881997 Loss of teeth due to accident, extraction or local periodontal disease (K08.1)
3 NAFSUL MUTHMAINNAH 0001025948654 Threatened abortion (O20.0)
4 SULASTRI 0000594996412 Presence of intraocular lens (Z96.1) :
5 ANA MAULIDAH 0002677737295 Prolonged pregnancy (O48)
6 SUPIYAH 0001298726087 Chronic superficial gastritis (K29.3)
7 S,MUDLOFAR 0001611515384 Schizophrenia (F20)
8 SUNARDI 0000594236711 Insulin-dependent diabetes mellitus with peripheral circulatory complications (E
9 YESSI YUSTAFIDA 0000593797061 Supervision of pregnancy with history of insufficient antenatal care (Z35
10 NALA FARIDATUL AKHLAK 0000593874101 Epilepsy (G40)
11 MUHAMMAD MA\\\\'MUN 0000593993496 Hydronephrosis with renal and ureteral calculous obstruction
KUNDERIN 0002169422471 Non-insulin-dependent diabetes mellitus with multiple complications (E11.7)

7/4/2020 HERI PRAYOGO 0002069578146 Schizophrenia, unspecified (F20.9)

MUNASIR 0000593794912 Calculus of kidney (N20.0)
SUBEKAN 0002677742109 Other chronic obstructive pulmonary disease (J44)
SITI AMINAH 0001839895029 Female infertility, unspecified (N97.9)

SRIYONO 0000593480957

SITI RIFATI 0000592647873

KHOLIFATUN MA\\\\'RUFAH 0001025918234

ZURIYAH 0000593852488
SITI MUZAYANAH 0001025940003

9/4/2020 EKO RAHMAWATI 0000593590004

11/4/2020 KAISAH 0000594566583

ABDUL KHORIB 0000595438075

SARDI 0000594268852

SULIMAH 0000593036651
 SITI RUKMINI 0001529308102

WAHYUNI 0001025960319

MUH NUR AZIS 0000593815318

SRIYATUN 0002693217093

MUSLIM FIKRI 0001025943388

FIRKHATUS SHOLIKAH 0000594366423

SUMARTI 0001025961423
UMI KHOLIPAH 0002885832472

13/4/2020 AHMAD FAEDHONI 0001277442426

WIDA KUMALA 0001277448996
BROTO SENO 0002250307719

16/4/2020 ABDUL GANI LUBIS 0001278670285

MUHAMMAD SANTOSO 0002315421922

ARIS MULYANI 0000593579518

AMIR 0002908481411

BADELI 0001025931352
SUMARNO 0000582739064

KASYONO 0001084347832

RUMISIH 0000592691095

17/4/20 WARSINAH 0002465863626 :

MARIYATI 0000593708106 Non-insulin-dependent diabetes mellitus with multiple complications (E11.7)
SABAR 0000593521918 Senile cataract, morgagnian type (H25.2)
ETIK SUSILOWATI 0001025919573 Schizophrenia (F20)
JURATMIN 0000594672816 Keloid scar (L91.0)
SITI ALIYAH 0000595632532 Maternal care for other malpresentation of fetus (O32.8)
SRI ERI MURNIASIH 0001025956765 Cholelithiasis (K80)
MUNAJAD 0000593757911 Gangrene, not elsewhere classified (R02)
KARTINI 0000582739143 Other disorders of refraction (H52.6)
 SUPIYAH 0001298726087 Spondylosis (M47)
AHMAD ROZIKIN 0001025958205 Epilepsy, unspecified (G40.9)
MASTOHA 0000593863209
SUWITONO 0000593787497
SUNARDI 0000594236711

20/4/20 SALI 2573817399

NAILA TRI SEPTIN 2573845839
A KALSUN 2314281418
akhmad shokeh 593626814
Sulami 2677734099
RIZQI WIDIASTUTI 594238509
mujiarti 593661857
Sunarti 1084944341
JOKO MUKARNO 594493716
SUMIYATI 1025959116
SA'ADATUL MUNAWAROH 1084973679
ELSI 594647559
SUMARNI 594487798
MUHAMMAD SUYUTI H 1482864287
21/4/2020 TRI AGUS LISTYANI 0000093618101
RIF\\\\'ATUN 0001025926661

SUWATI 0000594440785
ABDUL MANAF 0000595597994

22/4/2020 SUADI 0001278558775

DEVI NATALIA 0000594159276

SUGIATI 0000592814801

NGATMI 0000593865639
NOR ARIF 0002463612805

JUMIATI 0001309811376
MARIYATI 0001025947416

24/4/20 SUCIPTO 0000594105849 Congestive heart failure (I50.0) :

SULASTRI 0000594978941 Calculus of kidney (N20.0) :
SRI UTAMI 0002435451535 Other and unspecified injuries of head (S09)
SITI UMANAH 0000593923702 Antepartum haemorrhage, unspecified (O46.9) :

27/4/2020 RUBIAH 0001025938359

 SRI MULYATI 0001025968566
BUKHORI 0000594148713
ANIS FITRIYA 0000593675987
NGATEMI M 0000594642238

KARSI 0000594077152
SURYA AJI WIJAYA 0001611517781
SAWIR 0002581744138
DENI SETIAWAN 0001693496351
2/5/2020 NOOR AZIZ 0002581371358
MUCHAYATUN 0000593090458

NUR WAKID 0002167397875

SITI SATIMAH 0000593689105
KASMIN 0000593717894

SUGIHARTO 0001455451108

RASIMIN 0000594809414
WAHYU NUGROHO 0000594908728

HJ. KUSMIATI 0002074394092

KUSMANTO 1025925186
BUADI 0002036114436

4/5/2020 SAMPRI 0000593901911

SUWIJI 0000593951117
KHOIRUZZAD 0000594471295

SUWARYO 0000593582804
RUKATI 0000594366928
NANIK DWIYANTI 0000593457309
DANANG AMANNUDIN 0001025925625
YUSSYA AMINUDIN 0000593372777
SUHARDI 0000593699602

SUKARTI 0000593873515
MIFTAKHUL QOMARIYAH 0000593666864
TURIYAH 0000593627848
RIRIN ALFAH 0001699527071
EKO RAHMAWATI 0000593590004

8\5\2020 HATEMI : 1025929157

SRI MASNI 0000593668517,
 SUWARTI 0000582747592 Congestive heart failure (I50.0)

11/5/2020 ABDUL JALIL 0000594083035

SHOLIKATUN 0000593590656
MURDIONO 0001960744296
KARSANAH 0002212734609
CAHYONO 0001278574301
SOPIYAH 0001284558063
CHOIRUL ANWAR 0000594653556
ULIN NI\\\\'AM 0000593531201
RUTINAH 0000593662419

SRI SUNDARI 0001025919437

MASINI 0002799847001
DIAGNOSA POLI RUJUKAN

JIWA RS PKU MUHAMMADIYAH MAYONG

GIGI RSI SUNAN KUDU

JIWA RS PKU MUHAMMADIYAH MAYONG

MATA RSI SUNAN KUDUS :

MATA RSI SUNAN KUDUS

PENYAKIT DALAM RSU KUMALA SIWI MIJEN

PENYAKIT DALAM RS PKU MUHAMMADIYAH

MAYONG
PENYAKIT DALAM RS PKU MUHAMMADIYAH
MAYONG
PENYAKIT DALAM RSI SUNAN KUDUS

PENYAKIT DALAM RS PKU MUHAMMADIYAH

MAYONG

SARAF RS PKU MUHAMMADIYAH MAYONG

OBGYN RSI SUNAN KUDUS

BEDAH RS PKU MUHAMMADIYAH MAYONG

BEDAH RSU KUMALA SIWI MIJEN

ANAK RS PKU MUHAMMADIYAH MAYONG

PENYAKIT DALAM RS PKU MUHAMMADIYAH

MAYONG
PARU RS PKU MUHAMMADIYAH MAYONG :
 JIWA RS PKU MUHAMMADIYAH MAYONG

ORTHOPEDI RSI SUNAN KUDUS

(Z09.8) PENYAKIT DALAM

(F20.5) JIWA

(I25) PENYAKIT DALAM

(F20.0) JIWA

(Z09.8) PENYAKIT DALAM

(H16.2) MATA

(O32.9) OBGYN

(S05.9) MATA

(G40) SARAF

(M53.1) SARAF

(E11.7) PENYAKIT DALAM

k 35 bedah

O02.0 OBGYN

J44.9 DALAM

(J44.9) PARU

(F20) JIWA
(F20) JIWA

(A88.1) SARAF

(E11.8) PENYAKIT DALAM

(J44.9) PENYAKIT DALAM

(I63.9) SARAF

Follow-up (Z09.8) SARAF

Thrombocytopenia, unspecified (D69.6)

Senile cataract, unspecified (H25.9) MATA

Benign neoplasm of meninges, unspecified (D32.9) THT-KL

Non-insulin-depende (E11.6) PENYAKIT DALAM

N20.0 UROLOGI

I64 SARAF

Z09.8 OBGYN

A18.2 DALAM

A19.9 PARU

I64 SARAF

A19.9 PARU

M51.9 SARAF
F20.0 JIWA

K71.9 DALAM

H52.6 MATA

Schizophrenia, unspecified (F20.9) JIWA

Nasal polyp (J33) THT-KL

Low vision, one eye (H54.5) MATA

Low vision, one eye (H54.5) MATA

Fracture of rib, closed (S22.30) BEDAH

E 11.4 SARAF

F 20 JIWA

g80.9 anak

I50.9 JANTUNG

K 03.8 GIGI

F20.0 JIWA

N30 UROLOGI

F20.9 JIWA

M50.9 SARAF

F20.9 JIWA
A16 PARU

N18 HEMODIALISA

K35 BEDAH

N13.0 PENYAKIT DALAM

F20.9 JIWA

G44.0 SARAF

Z09 MATA

Z47.8 ORTHOPEDI

Z35.9 OBSGYN

J44 PENYAKIT DALAM

Z35.9 OBGYN

K27 DALAM

E11.8 DALAM

CATARACT MATA

(M51.2) SARAF

(M07.5) KULIT KELAMIN

J32.9 THT

BEDAH
Benign neoplasm of middle ear, nasal cavity and accessory
sinuses
MATA
Other disorders of refraction

E05 PENYAKIT DALAM

K74.6 PENYAKIT DALAM

N18.9 HEMODIALISA

G62.9 SARAF

G56.9 SARAF

Z48.0 OBSGYN

G40 ANAK

J37.1 THT

F20.3 JIWA

F20.3 JIWA

SARAF RSI SUNAN KUDUS

PENYAKIT DALAM RSU KUMALA SIWI MIJEN
MATA RSU KUMALA SIWI MIJEN
OBGYN RSU KUMALA SIWI MIJEN

F20.9 JIWA
Z35.9 OBSGYN
H30 MATA
F20.9 JIWA
C56 OBSGYN
S39.9 BEDAH
I63.9 SARAF
M54.5 SARAF
R07.1 PENYAKIT DALAM
Z09.9 REHAB MEDIK

O02.1 OBSGYN
GLAUCOMA MATA

senile catarac mata

I24 Dalam
R19 BEDAH
542 ortopedi
F20 JIWA
E12.4 Dalam

C 09 THT
C53.9 OBGYN
E12 DALAM
d 28.1 anak
J44 DALAM
F20.9 JIWA

S52.2 ORTOPHEDI
A18.8 PARU
I21 JANTUNG PEMBULUH DARAH
H40 MATA
H52.7 MATA
Z82.5 PARU
I84.8 BEDAH
E04.8 BEDAH
A16 PENYAKIT DALAM
E11.2 PENYAKIT DALAM

(N60.2) BEDAH
(I50.0) JANTUNG DAN PEMBULUH DARAH
(E11.7) PENYAKIT DALAM
(C20) PENYAKIT DALAM
(M41.9) SARAF
(F20) JIWA
(K25) PENYAKIT DALAM
(Z35.9) OBGYN
M54.4) SARAF :
(H48) MATA
(H48) MATA
 (O46.9) OBGYN
(H40.9) MATA
(Z35.9) OBGYN
(K80) PENYAKIT DALAM
(I25.9) PENYAKIT DALAM
(E11.7) PENYAKIT DALAM
(F23.0) JIWA
(I21.0) JANTUNG DAN PEMBULUH DARAH

(O20.0) OBGYN
(H27) MATA
(I50.0) JANTUNG DAN PEMBULUH DARAH
(H66.3) THT-KL
(I11) PENYAKIT DALAM

B20 PENYAKIT DALAM

Senile cataract, unspecified (H25.9) MATA

THT-KL RSI SUNAN KUDUS
PENYAKIT DALAM RSU KUMALA SIWI MIJEN :
SARAF RSI SUNAN KUDUS PARU RSI SUNAN KUDUS
ogically or histologically (A16)
rrier (B17.0) PENYAKIT DALAM RSI SUNAN KUDUS

(O98.1) OBGYN
(I60) SARAF
(O41.0) OBGYN
(J32.9) THT-KL
(T12) ORTHOPEDI
(E11.7) BEDAH
(S05) MATA

PENYAKIT DALAM RSI SUNAN KUDUS

JIWA RS PKU MUHAMMADIYAH MAYONG

SARAF RSU KUMALA SIWI MIJEN
SARAF RS PKU MUHAMMADIYAH MAYONG
fied (Z35.9) OBGYN RSI SUNAN KUDUS
IWA RS PKU MUHAMMADIYAH MAYONG
SARAF RSU KUMALA SIWI MIJEN

I11.9 ,E78.5 ,E11.9 PENYAKIT DALAM

(Z09.8) UROLOGI
(H26.2) MATA
(Z48.8) MATA
(I50.0) PENYAKIT DALAM
(I21) JANTUNG DAN PEMBULUH DARAH
(F20.9) JIWA
(H66.3) THT-KL

(K40.9) BEDAH
(M54.5) SARAF
(J35.3) THT-KL
(S62) ORTHOPEDI

(J44.0) PARU
(A88.1) SARAF
(F20) JIWA
(E04) BEDAH
(Z09.8) SARAF
(Z08.9) SARAF
(H54.2) MATA
(F20) JIWA
(H54.2) MATA
(I50.0) (I63.9) PENYAKIT DALAM
(Z09.8) MATA
(G52.9) SARAF
(E10.7) PENYAKIT DALAM
(H54.2 MATA
(N40) UROLOGI

(F20) JIWA
(F20.9) JIWA
(N18) PENYAKIT DALAM
(I50.0) PENYAKIT DALAM
(M51.9) SARAF
(F20.9) JIWA
(J44.1) PARU
(F20) JIWA
(K28) PENYAKIT DALAM

(E11.8) PENYAKIT DALAM

(M17.5) SARAF
(N20) UROLOGI
(H25.9) MATA

Schizophrenia (F20) JIWA

Cataract, unspecified (H26.9) MATA
ary) hypertension (I10)
omplications (E11.7)
atic coma (B16.9)
SARAF RSU KUMALA SIWI MIJEN
PENYAKIT DALAM RSU KUMALA SIWI MIJEN
JANTUNG DAN PEMBULUH DARAH RSU RA KARTINI JEPARA
MATA RS PKU MUHAMMADIYAH MAYONG
ANAK RS PKU MUHAMMADIYAH MAYONG
SYAHUDI 0001084798438 Schizophrenia (F20)
JIWA RSU RA KARTINI JEPARA
PENYAKIT DALAM RSU KUMALA SIWI MIJEN
SARAF RS PKU MUHAMMADIYAH MAYONG
PENYAKIT DALAM RS PKU MUHAMMADIYAH MAYONG

(H52.7) MATA

PENYAKIT DALAM RS PKU MUHAMMADIYAH MAYONG : :

B20 RSU RA KARTINI JEPARA
PENYAKIT DALAM RSI SUNAN KUDUS
PARU RS PKU MUHAMMADIYAH MAYONG
PARU RS PKU MUHAMMADIYAH MAYONG
MATA RSU KUMALA SIWI MIJEN
JIWA RS PKU MUHAMMADIYAH MAYONG :
PENYAKIT DALAM RSI SUNAN KUDUS :

PARU RS PKU MUHAMMADIYAH MAYONG

OBGYN RSI SUNAN KUDUS :
ecified complications (E11.8) PENYAKIT DALAM RSI SUNAN KUDUS
MATA RSI SUNAN KUDUS

B20 PENYAKIT DALAM

B20 PENYAKIT DALAM
(N18) PENYAKIT DALAM
(E11.7) PENYAKIT DALAM
(F20.9) JIWA
(M17.9) SARAF
(N93.9) OBGYN
(K27) PENYAKIT DALAM
(H25.9) MATA

(primary) hypertension (I10) MATA RSU KUMALA SIWI MIJEN

teriologically or histologically (A16) ANAK RSI SUNAN KUDUS
PENYAKIT DALAM RSU KUMALA SIWI MIJEN :

(F20) JIWA
 (O48) OBGYN
(N40) BEDAH
(O03.4) OBGYN
(B17.9) PENYAKIT DALAM
(K80) PENYAKIT DALAM
(F01.8) JIWA

SARAF RS PKU MUHAMMADIYAH MAYONG

fied complications (E11.8), Abdominal and pelvic pain (R10 PENYAKIT DALAM RS PKU MUHAMMADIYAH MAYONG
ORTHOPEDI RSI SUNAN KUDUS
nspecified chronic bronchitis (J42) PENYAKIT DALAM RSI SUNAN KUDUS
SARAF RSI SUNAN KUDUS
uction or gangrene (K40.9), Essential (primary) hypertension (I10) BEDAH RSI SUNAN KUDUS :
SARAF RS PKU MUHAMMADIYAH MAYONG
MATA RSI SUNAN KUDUS
JIWA RS PKU MUHAMMADIYAH MAYONG
a, unspecified (D64.9) PENYAKIT DALAM RSU KUMALA SIWI MIJEN
PENYAKIT DALAM RSU KUMALA SIWI MIJEN

(I24.9) PENYAKIT DALAM

(M51.1) SARAF
(I82) PENYAKIT DALAM
(F20) JIWA
(I69.4) SARAF
(F20) JIWA
(F20) JIWA
(F20.3) JIWA
(L80) KULIT KELAMIN

RSU KUMALA SIWI MIJEN

nt diabetes mellitus with other specified complications (E11.6) SARAF RSU KUMALA SIWI MIJEN
PENYAKIT DALAM RSI SUNAN KUDUS
OBGYN RSU RA KARTINI JEPARA
ANAK RSI SUNAN KUDUS
SARAF RSU KUMALA SIWI MIJEN
l or histological confirmation (A16.5) PARU RSI SUNAN KUDUS
acted pelvis (O33.1) : OBGYN RS PKU MUHAMMADIYAH MAYONG
PENYAKIT DALAM RSI SUNAN KUDUS :

(F20.9) JIWA
(M54.5) SARAF
(K40.9) BEDAH
(K40.9) BEDAH
(F20.9) JIWA
(N93.9) OBGYN
 (N18) PENYAKIT DALAM
(E11.7) PENYAKIT DALAM
(E11.8) PENYAKIT DALAM
(F20) JIWA
(N13.2) UROLOGI
(E04.9) PENYAKIT DALAM
B20 MATAHARI
B20 MATAHARI
B20 MATAHARI
(H26.9) MATA
(F25) JIWA
(D61.8) PENYAKIT DALAM
(N92.4) OBGYN
(G20) SARAF

(I25) JANTUNG DAN PEMBULUH DARAH

(O32.9) OBGYN

ologically negative (A16.0) PARU RS PKU MUHAMMADIYAH MAYONG

GIGI RSU KUMALA SIWI MIJEN
ple complications (E11.7 PENYAKIT DALAM RSI SUNAN KUDUS
JIWA RS PKU MUHAMMADIYAH MAYONG
complications (E11.7) PENYAKIT DALAM RS PKU MUHAMMADIYAH MAYONG
Nephrotic syndrome, unspecified (N04.9) PENYAKIT DALAM
Abnormal uterine and vaginal bleeding, unspecified
(N93.9) OBGYN
Schizophrenia (F20) JIWA
Nephrotic syndrome, unspecified (N04.9) ANAK
Other mixed anxiety disorders (F41.3) JIWA
Low back pain (M54.5) SARAF

Presence of intraocular lens (Z96.1), Follow-up

examination after unspecified treatment for other
conditions (Z09.9) MATA
Oligohydramnios (O41.0) OBGYN
Other specified nontoxic goitre (E04.8) ANAK

Hypertensive heart disease without (congestive) heart

failure (I11.9), Chest pain, unspecified (R07.4) PENYAKIT DALAM
Schizophrenia, unspecified JIWA

Heart failure (I50) JANTUNG DAN PEMBULUH DARAH

(C20) PENYAKIT DALAM
(J98.0) ANAK
(I11) PENYAKIT DALAM
 l (S62) ORTHOPEDI
(I25), JANTUNG DAN PEMBULUH DARAH
(L23) KULIT KELAMIN
(C61) BEDAH
(H43.1) MATA
(K65.0) BEDAH

Congestive heart failure (I50.0) PENYAKIT DALAM

ntal disease (K08.1) GIGI RS PKU MUHAMMADIYAH MAYONG
OBGYN RSI SUNAN KUDUS :
MATA RSU KUMALA SIWI MIJEN
OBGYN RSI SUNAN KUDUS
PENYAKIT DALAM RSU KUMALA SIWI MIJEN :
JIWA RS PKU MUHAMMADIYAH MAYONG
culatory complications (E10.5) BEDAH RSU KUMALA SIWI MIJEN
cient antenatal care (Z35.3) OBGYN RSU KUMALA SIWI MIJEN
ANAK RSI SUNAN KUDUS
ral calculous obstruction (N13.2) UROLOGI RSI SUNAN KUDUS
e complications (E11.7) BEDAH RS PKU MUHAMMADIYAH MAYONG

JIWA RS PKU MUHAMMADIYAH MAYONG

UROLOGI RSI SUNAN KUDUS
PENYAKIT DALAM RS PKU MUHAMMADIYAH MAYONG
OBGYN RSI SUNAN KUDUS
Cellulitis, unspecified (L03.9) BEDAH
Chronic obstructive pulmonary disease, unspecified
(J44.9) PARU
Calculus of kidney (N20.0) UROLOGI
Non-insulin-dependent diabetes mellitus with
unspecified complications (E11.8) PENYAKIT DALAM
Glaucoma (H40) MATA

Supervision of high-risk pregnancy, unspecified (Z35.9) OBGYN

Non-insulin-dependent diabetes mellitus with multiple

complications (E11.7) PENYAKIT DALAM
Glaucoma, unspecified (H40.9) MATA
Respiratory tuberculosis, not confirmed bacteriologically
or histologically (A16) PENYAKIT DALAM
Non-insulin-dependent diabetes mellitus with multiple
complications (E11.7) PENYAKIT DALAM
 Gestational [pregnancy-induced] hypertension without
significant proteinuria (O13), Non-insulin-dependent
diabetes mellitus with unspecified complications OBGYN

Diabetes mellitus arising in pregnancy (O24.4) OBGYN

Follow-up examination after treatment of fracture
(Z09.4) ORTHOPEDI
Chronic renal failure, unspecified (N18.9) PENYAKIT DALAM

Stroke, not specified as haemorrhage or infarction (I64) SARAF

Non-insulin-dependent diabetes mellitus with

unspecified complications (E11.8), Essential (primary)
hypertension (I10) PENYAKIT DALAM
Chronic renal failure, unspecified (N18.9) PENYAKIT DALAM
Prolonged pregnancy (O48) OBGYN

Schizophrenia (F20) JIWA

Schizophrenia (F20) JIWA
Congestive heart failure (I50.0) JANTUNG DAN PEMBULUH DARAH

Schizophrenia, unspecified (F20.9) JIWA

Fasciculation (R25.3) PENYAKIT DALAM
Respiratory tuberculosis, not confirmed bacteriologically
or histologically (A16) PARU
Follow-up examination after surgery for other
conditions (Z09.0) BEDAH

Chronic obstructive pulmonary disease, unspecified

(J44.9), Non-insulin-dependent diabetes mellitus with
multiple complications PENYAKIT DALAM
Sequelae of cerebral infarction (I69.3) SARAF
Chronic obstructive pulmonary disease, unspecified
(J44.9) PARU

Stroke, not specified as haemorrhage or infarction (I64) SARAF

Congestive heart failure (I50.0) JANTUNG DAN PEMBULUH DARAH

e complications (E11.7) PENYAKIT DALAM RS PKU MUHAMMADIYAH MAYONG
MATA RSU KUMALA SIWI MIJEN
JIWA RS PKU MUHAMMADIYAH MAYONG
KULIT KELAMIN RSI SUNAN KUDUS
OBGYN RSI SUNAN KUDUS
PENYAKIT DALAM RSI SUNAN KUDUS
BEDAH RSI SUNAN KUDUS
MATA RSU KUMALA SIWI MIJEN
 SARAF RSU KUMALA SIWI MIJEN
SARAF RS PKU MUHAMMADIYAH MAYONG
Congestive heart failure (I50.0) JANTUNG DAN PEMBULUH DARAH
Acute hepatitis B (B16) PENYAKIT DALAM
Chronic renal failure, unspecified (N18.9) Hemodialisa

Non-insulin-dependent diabetes mellitus with multiple coPENYAKIT DALAM

Adjustment disorders (F43.2) JIWA
Congestive heart failure (I50.0) JANTUNG DAN PEMBULUH DARAH
acute hepatitis ( B 16 ) Poli dalam
Atrial Embolis and trombosiis ( I 74 ) Poli Bedah
High Risk pregnency Poli Obgyn
low vision eye ( H 54 ) Poli Mata
Gonarthrosisi (M 17) Poli saraf
STROKE (I 64 ) POLI SARAF
STROKE (I 64 ) Poli saraf
F20 POLI JIWA
Z 35.9 POLI KANDUMGAN
M 54.5 POLI SARAF
I 11.0 POLI DALAM
Polyneuropathy, unspecified (G62.9) SARAF
Twin pregnancy (O30.0) OBGYN
Severe depressive episode with psychotic symptoms
(F32.3) JIWA
Cystitis (N30) UROLOGI

Bipolar affective disorder, currently in remission (F31.7) JIWA

Schizophrenia, unspecified (F20.9) JIWA
Non-insulin-dependent diabetes mellitus with multiple
complications (E11.7) PENYAKIT DALAM
Respiratory tuberculosis, not confirmed bacteriologically
or histologically (A16) PENYAKIT DALAM
Epilepsy, unspecified (G40.9) SARAF
Non-insulin-dependent diabetes mellitus with multiple
complications (E11.7) PENYAKIT DALAM
Prolonged pregnancy (O48) OBGYN

PENYAKIT DALAM RS PKU MUHAMMADIYAH MAYONG

UROLOGI RSI SUNAN KUDUS
SARAF RSI SUNAN KUDUS
OBGYN RSI SUNAN KUDUS

Hypertensive heart disease (I11) PENYAKIT DALAM

Threatened abortion (O20.0) OBGYN
Schizophrenia (F20) JIWA
Prolonged pregnancy (O48) OBGYN
Senile cataract, unspecified (H25.9) MATA

Stroke, not specified as haemorrhage or infarction (I64) SARAF

Undifferentiated schizophrenia (F20.3) JIWA
Cervicobrachial syndrome (M53.1) SARAF
Fracture of shaft of ulna (S52.2) ORTHOPEDI
Community Acquired Pneumonia (J18.90) PARU
Cystitis (N30) UROLOGI
Follow-up examination after surgery for other
conditions (Z09.0) BEDAH
Other acute viral hepatitis (B17) PENYAKIT DALAM
Low back pain (M54.5) SARAF
Heart failure (I50), Non-insulin-dependent diabetes
mellitus (E11), Essential (primary) PENYAKIT DALAM
Chronic obstructive pulmonary disease with acute
exacerbation, unspecified (J44.1) PARU
Depressive episode, unspecified (F32.9) JIWA
Non-insulin-dependent diabetes mellitus with multiple
complications (E11.7) PENYAKIT DALAM
Paraplegia, unspecified (G82.2) SARAF
Inguinal hernia (K40) BEDAH

Low vision, both eyes (H54.2) MATA

Heart failure (I50) JANTUNG DAN PEMBULUH DARAH
Schizophrenia, unspecified (F20.9) JIWA
Non-insulin-dependent diabetes mellitus with
unspecified complications (E11.8) PENYAKIT DALAM
Heart failure (I50) PENYAKIT DALAM
Calculus of kidney with calculus of ureter (N20.2) PENYAKIT DALAM
Schizophrenia (F20) JIWA
Schizophrenia (F20) JIWA
Schizophrenia (F20) JIWA
Non-insulin-dependent diabetes mellitus with multiple
complications (E11.7) PENYAKIT DALAM
Residual schizophrenia (F20.5) JIWA
Intervertebral disc disorder, unspecified (M51.9) SARAF
Acute hepatitis B (B16) OBGYN
Prolonged pregnancy (O48) OBGYN

Follow-up examination after other treatment for other coSARAF

Stroke not specified as haemorrhage or infarction (I64) SARAF
 PENYAKIT DALAM RSU KUMALA SIWI MIJEN

Schizophrenia, unspecified (F20.9) JIWA

Cluster headache syndrome (G44.0) SARAF
Other chronic pancreatitis (K86.1) PENYAKIT DALAM
Cervicobrachial syndrome (M53.1) SARAF
Schizophrenia, unspecified (F20.9) JIWA
Hypertensive heart disease (I11) PENYAKIT DALAM
Schizophrenia (F20) JIWA
Residual schizophrenia (F20.5) JIWA
Malignant neoplasm of breast, unspecified (C50.9) BEDAH

Stroke, not specified as haemorrhage or infarction (I64) SARAF

Chronic obstructive pulmonary disease with acute lower
respiratory infection (J44.0) PENYAKIT DALAM
RUMAH SAKIT RUJUKAN
RS PKU MUHAMMADIYAH

RS PKU MUHAMMADIYAH

RSU KUMALA SIWI

RSU RA KARTINI

RSU KUMALA SIWI

RSI SUNAN KUDUS

RSI SUNAN KUDUS

RSI SUNAN KUDUS

RS PKU MUHAMMADIYAH

RS PKU MUHAMMADIYAH

RSU KUMALA SIWI

rsi kudus

RSI KUDUS

PKUM MAYONG

RS PKU MUHAMMADIYAH

RS PKU MUHAMMADIYAH
RS PKU MUHAMMADIYAH

RSI SUNAN KUDUS

RSU KUMALA SIWI MIJEN

RS PKU MUHAMMADIYAH

RSI SUNAN KUDUS

RSU KUMALA SIWI MIJEN

RSI SUNAN KUDUS

RSI SUNAN KUDUS

RSU KUMALA SIWI MIJEN

RSU KUMALA SIWI MIJEN

RSI KUDUS

KUMALA SIWI

KUMALA SIWI

PKU MAYONG

PKU MAYONG

PKU MAYONG

PKU MAYONG

RSI KUDUS
PKU MAYONG

RSI KUDUS

RSI KUDUS

RS PKU MUHAMMADIYAH MAYONG

RSI SUNAN KUDUS

RSI SUNAN KUDUS

RSI SUNAN KUDUS

RSI SUNAN KUDUS

RS PKU MUHAMMADIYAH MAYONG

PKU MUHAMMADIYAH MAYONG

pku muhammadiyah mayong

RSU JEPARA

pku muhammadiyah mayong

PKu muhammadiyah mayong

RSI KUDUS

pku muhammadiyah mayong

Pku muhammadiyah mayong

pku muhammadiyah mayong

PKU MUHAMMADIYAH MAYON

RS KUMALA SIWI MIJEN

RS PKU MUHAMMADIYAH MAYONG

RS PKU MUHAMMADIYAH MAYONG

RS PKU MUHAMMADIYAH MAYONG

RS PKU MUHAMMADIYAH MAYONG

RS KUMALA SIWI MIJEN

RSI SUNAN KUDUS

RSI SUNAN KUDUS

RS KUMALA SIWI MIJEN

RS KUMALASIWI

RS KUMALASIWI

RS KUMALASIWI

RSI KUDUS

RS PKU MUHAMMADIYAH MAYONG

RS PKU MUHAMMADIYAH MAYONG

RSI SUNAN KUDUS

RS PKU MUYHAMMADIYAH MAYONG

RS KUMALA SIWI

RSI SUNAN KUDUS

RS KUMALA SIWI

RS KUMALA SIWI

RS PKU MUHAMMADIYAH MAYONG

RS PKU MUHAMMADIYAH MAYONG

RSI SUNAN KUDUS

RSI SUNAN KUDUS

RS PKU MUHAMMADIYAH MAYONG

RS PKU MUHAMMADIYAH MAYONG

RS PKU MUHAMMADIYAH MAYONG

RS PKU MAYONG
RSI SUNAN KUDUS
RSI SUNAN KUDUS
RS PKU MAYONG
RSI SUNAN KUDUS
RS PKU MAYONG
RSI SUNAN KUDUS
RS KUMALA SIWI
RSI SUNAN KUDUS
RS KUMALA SIWI

RSI SUNAN KUDUS

RSI SUNAN KUDUS

RS PKU Mayong
RS Kumala Siwi
RSI KUDUS
rsi KUDUS
RS PKU Mayong
RS PKU Mayong

RS KUMALA SIWI
RS KUMALA SIWI
RS KUMALA SIWI
RSI KUDUS
PKUM MAYONG
PKUM MAYONG

RSI SUNAN KUDUS

RS PKU MAYONG
RSI SUNAN KUDUS
RS PKU MAYONG
RS PKU MAYONG
RS PKU MAYONG
RSI SUNAN KUDUS
RS PKU MAYONG
RS KUMALA SIWI
RSI SUNAN KUDUS

RSI SUNAN KUDUS

RSI SUNAN KUDUS
RS PKU MUHAMMADIYAH MAYONG
RSI SUNAN KUDUS
RSU KUMALA SIWI MIJEN
RS PKU MUHAMMADIYAH MAYONG
RSU KUMALA SIWI MIJEN
RSI SUNAN KUDUS
RS PKU MUHAMMADIYAH MAYONG
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RSI SUNAN KUDUS
RSU KUMALA SIWI MIJEN
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RSI SUNAN KUDUS
RSI SUNAN KUDUS
RS PKU MUHAMMADIYAH MAYONG
RS PKU MUHAMMADIYAH MAYONG
RSI SUNAN KUDUS
RSI SUNAN KUDUS

RSI SUNAN KUDUS

RSI SUNAN KUDUS
RSI SUNAN KUDUS
RS PKU MUHAMMADIYAH MAYONG
RS PKU MUHAMMADIYAH MAYONG

RSU RA KARTINI JEPARA

RSU KUMALA SIWI MIJEN

RSU RA KARTINI JEPARA

RS PKU MUHAMMADIYAH MAYONG
RS PKU MUHAMMADIYAH MAYONG
RSI SUNAN KUDUS
RSI SUNAN KUDUS
RSI SUNAN KUDUS
RSI SUNAN KUDUS

RS PKU MUHAMMADIYAH MAYONG

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RSI SUNAN KUDUS
RSI SUNAN KUDUS
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RS PKU MUHAMMADIYAH MAYONG
RS PKU MUHAMMADIYAH MAYONG

RS PKU MUHAMMADIYAH MAYONG

RSU KUMALA SIWI MIJEN
RSI SUNAN KUDUS
RSI SUNAN KUDUS

RS PKU MUHAMMADIYAH MAYONG : :

RSI SUNAN KUDUS
RS PKU MUHAMMADIYAH MAYONG
RS PKU MUHAMMADIYAH MAYONG : :
RSU KUMALA SIWI MIJEN
RSU KUMALA SIWI MIJEN : :
RS PKU MUHAMMADIYAH MAYONG
RS PKU MUHAMMADIYAH MAYONG : :
RS PKU MUHAMMADIYAH MAYONG
RSI SUNAN KUDUS
RSU KUMALA SIWI MIJEN : :
RSI SUNAN KUDUS
RS PKU MUHAMMADIYAH MAYONG : :
RS PKU MUHAMMADIYAH MAYONG
RSI SUNAN KUDUS

RS PKU MUHAMMADIYAH MAYONG

RS PKU MUHAMMADIYAH MAYONG
RSI SUNAN KUDUS
RSU KUMALA SIWI MIJEN
RSI SUNAN KUDUS
RS PKU MUHAMMADIYAH MAYONG
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RSU RA KARTINI JEPARA
RSI SUNAN KUDUS

RSI SUNAN KUDUS

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RSI SUNAN KUDUS
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RS PKU MUHAMMADIYAH MAYONG

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AH MAYONG

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RS PKU MUHAMMADIYAH MAYONG
RS PKU MUHAMMADIYAH MAYONG
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RS PKU MUHAMMADIYAH MAYONG
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RSI SUNAN KUDUS

RS PKU MUHAMMADIYAH MAYONG

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RSI SUNAN KUDUS
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RS PKU MUHAMMADIYAH MAYONG
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RSI SUNAN KUDUS

AH MAYONG

RSU KUMALA SIWI MIJEN

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RS PKU MUHAMMADIYAH MAYONG
RS PKU MUHAMMADIYAH MAYONG
RSI SUNAN KUDUS
RS PKU MUHAMMADIYAH MAYONG
RS PKU MUHAMMADIYAH MAYONG
RS PKU MUHAMMADIYAH MAYONG
RSI SUNAN KUDUS

RSU RA KARTINI JEPARA

RS PKU MUHAMMADIYAH MAYONG
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RS PKU MUHAMMADIYAH MAYONG
RSU KUMALA SIWI MIJEN
 RS PKU MUHAMMADIYAH MAYONG
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RS PKU MUHAMMADIYAH MAYONG
RS PKU MUHAMMADIYAH MAYONG
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RSI SUNAN KUDUS
RSU RA KARTINI JEPARA
RSU RA KARTINI JEPARA
RSU RA KARTINI JEPARA
RS PKU MUHAMMADIYAH MAYONG
RS PKU MUHAMMADIYAH MAYONG
RSI SUNAN KUDUS
RSI SUNAN KUDUS
RSU KUMALA SIWI MIJEN

RSI SUNAN KUDUS

RSU KUMALA SIWI MIJEN

AH MAYONG
RS PKU MUHAMMADIYAH MAYONG

RSU KUMALA SIWI MIJEN

RS PKU MUHAMMADIYAH MAYONG
RSU KUMALA SIWI MIJEN
RS PKU MUHAMMADIYAH MAYONG
RS PKU MUHAMMADIYAH MAYONG

RSU KUMALA SIWI MIJEN

RSI SUNAN KUDUS
RSU RA KARTINI JEPARA

RS PKU MUHAMMADIYAH MAYONG

RS PKU MUHAMMADIYAH MAYONG

RSI SUNAN KUDUS

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RS PKU MUHAMMADIYAH MAYONG

RSI SUNAN KUDUS

RSU KUMALA SIWI MIJEN

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RS PKU MUHAMMADIYAH MAYONG

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RSI SUNAN KUDUS
RSI SUNAN KUDUS

RS PKU MUHAMMADIYAH MAYONG

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RS PKU MUHAMMADIYAH MAYONG

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RSI SUNAN KUDUS

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RSU KUMALA SIWI MIJEN
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RS PKU MUHAMMADIYAH MAYONG

RSI SUNAN KUDUS
RSI SUNAN KUDUS
RSI Sunan Kudus
RS Kumala Siwi
RS PKU MUHAMMADIYAH MAYONG
RS PKU MUHAMMADIYAH MAYONG
RS Kumala Siwi
RS PKU MUHAMMADIYAH MAYONG
RS Kumala Siwi
RS PKU MUHAMMADIYAH MAYONG
RS PKU MUHAMMADIYAH MAYONG
RS PKU MUHAMMADIYAH MAYONG
RS PKU MUHAMMADIYAH MAYONG
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RS PKU MUHAMMADIYAH MAYONG

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RS PKU MUHAMMADIYAH MAYONG
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RSI SUNAN KUDUS
RSI SUNAN KUDUS
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RS PKU MUHAMMADIYAH MAYONG

RS PKU MUHAMMADIYAH MAYONG
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RS PKU MUHAMMADIYAH MAYONG

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RS PKU MUHAMMADIYAH MAYONG

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RS PKU MUHAMMADIYAH MAYONG
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RS PKU MUHAMMADIYAH MAYONG
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RS PKU MUHAMMADIYAH MAYONG

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RS PKU MUHAMMADIYAH MAYONG
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RS PKU MUHAMMADIYAH MAYONG

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