DATA PASIEN DR. ERVINA NINGSIH, Sp.

OG
TGL : 18 APRIL 2022/SENIN
NO. NAMA NOKA NIK NO TLP NO MR STATUS NO RUJUKAN NAMA FASKES KETERANGAN
1 Atik Yulianingsih 0001258473058 3172026507800004 085779685194 56740 PASIEN LAMA 090504070422P000013 Kel,kebun bawang III POLI BERBEDA
2
3
4
5
6
7
8
9
10
 DATA PASIEN DR. KENZOLA SP.JP
TGL : 18 APRIL 2022/SENIN
NO. NAMA NOKA NIK NO TLP NO MR STATUS NO RUJUKAN NAMA FASKES KETERANGAN
1 Suminah 1767199498 3172045210570000 895391085295 80709 PASIEN LAMA 090504120322Y000067 Kelurahan warakas 0116R0280422K001472
2 HANURAWATI 377909324 3172034603670000 81211607295 95267 PASIEN LAMA 090505070122P000611 PUSKESMAS RBU II 0116R0280422K001473
3 SUGONDO 1136938713 3172022803610000 81299145380 11355 PASIEN LAMA 011681800222P000483 KLINIK SANTO YOSEF 0116R0280422K001474
4 Aminah 1224775203 3172025207550000 895337990776 95369 PASIEN LAMA 09050407022P000006 kel kebon bawang 111 0116R0280422K001475
5 Musliman 12256240004 3172021603650000 89525364658 73812 PASIEN LAMA 090504000322Y001761 KEC. TANJUNG PRIOK POLI BERBEDA , Z01.8
6 Sario hamidi 1745258949 3172022010640000 85692291879 55383 PASIEN LAMA 090504040322Y000225 Sungai bambu 0116R0280422K001477
7 Adem 1315421921 3172027012580040 +62 812-1167-6855 90548 PASIEN LAMA 090504040222Y000241 Sungai Bambu POLI BERBEDA , Z01.8
8 Samsudin 1315421379 3172021105480000 +62 812-1167-6855 38164 PASIEN LAMA 090504040222Y000242 Sungai Bambu POLI BERBEDA , I10
9 waspan 1225862998 3172021809760000 85839355817 28609 PASIEN LAMA 09050412022Y000653 puskesmas warakas 0116R0280422K001510
10 Dasimi 46243945 3.1720202015E+016 85775404269 79569 PASIEN LAMA 090504070422P000456 Kel kebon bawang III RUJUKAN BARU
11 HJ YESSY 1225342348 3172025807600000 81287401439 52973 PASIEN LAMA 090504050222Y001139 Kel. Kebon bawang I POLI BERBEDA
12 H.ERIZAL MUJALIS 1436898374 3172022708520000 87881954781 91889 PASIEN LAMA 090504050322Y000201 Kel. Kebon bawang I POLI BERBEDA
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
32
33
34
35
36
37
38
39
40
 DATA PASIEN DR. NUGRAHENI IRDA SP.PD
TGL : 18 APRIL 2022/SENIN
NO. NAMA NOKA NIK NO TLP NO MR STATUS NO RUJUKAN NAMA FASKES KETERANGAN
1 Theresia G. 122521178 3172027006520000.00 81280869965 68881 PASIEN LAMA 090504000322Y001014 Rs.Puri Medika 0116R0280422K001479
2 Yani 1260177715 317203000000000000000.00 81398537266 74030 PASIEN LAMA 090504040222Y000144 KEL. SUNGAI BAMBU 0116R0280422K001480
Kristina +62 812-8733-
3 Simanihuruk 1223622733 3172025103610000.00 9993 68921 PASIEN LAMA 090504120122Y000909 Rs. Puri Medika POLI BERBEDA , E11
4 Sutrisno anwar 1807298471 3172020603620010.00 81293921697 68972 PASIEN LAMA 090504050322Y000006 Puskesmas kebon bawang 0116R0280422K001481
5 Hj.zainab 46266614 317203000000000000000.00 85779775238 81210 PASIEN LAMA 090504000222Y000553 Kec.tg.priok 0116R0280422K001482
6 Sanusi redi f 1126548775 3172021008670010.00 89601973063 61572 PASIEN LAMA 09054040322Y001168 Sungai bambu 0116R0280422K001483
7 Suratno 1229146874 3172023012500000.00 87889380508 45988 PASIEN LAMA 090504120122Y000909 Kel Warakas 0116R0280422K001484
8 Siti Hodijah 1304762927 3172024705700000.00 89659414992 56083 PASIEN LAMA 090504040422Y000214 Puskesmas sungai bambu POLI BERBEDA , Z01.8
Ismail
9 Ambomasse 1320465879 3172022702700000.00 81382449140 38515 PASIEN LAMA 090504060322y000299 Kebon bawang 2 0116R0280422K001485
PULANG RI
10 Kurniyah 1474802627 3209304608700000.00 895359518687 PASIEN LAMA 090504130422Y000001 KEL. PAPANGGO 0116R0280422K001491

11 Rahmat Wildani 1135202848 3171032305750000.00 83818139293 96075 PASIEN LAMA 0116U1530322P001095 Klinik P Sisma Medikal Sunter 0116R0280422K001508
12 Astuti 1269901091 3172026308560000.00 81322255506 58335 PASIEN LAMA 0116U1650222P000085 Klinik Oilia I Swasembada POLI BERBEDA. I10

13 Djarot Rukiyanto 1128593632 3172020502580000.00 81280631624 69781 PASIEN LAMA 090504060222Y000189 Kebon bawang II 0116R0280422K001511
14 Chandra Ludy 1224616792 3172030103680000.00 83807524630 93271 PASIEN LAMA 090505010422P000252 Puskesmas Gang 28 POLI BERBEDA

England
15 Yonnetty Sahea 1457002078 3172024401620000.00 81315977275 66622 PASIEN LAMA 090504060422Y000346 Kel. Kebon bawang 2 RUJUKAN BARU
16 Yayat rudiyat 1638535241 3172020908760010.00 81297971908 96073 PASIEN LAMA 090504040322Y000503 Kel sungai bambu POLI BERBEDA E11
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
32
33
34
35
 DATA PASIEN DR. LUTFI SP, PD
TGL : 18 APRIL 2022/SENIN
NO NAMA NOKA NIK NO TLP NO MR STATUS NO RUJUKAN NAMA FASKES KETERANGAN
1 DARWISA 1292998511 3172026105540000.00 82311448443 63226 PASIEN LAMA 090504080222P001012 Puskesmas Tg Priok. 0116R0280422K001492
2 LAHIDA. 1225805679 3172021701480000.00 82311448443 34635 PASIEN LAMA 090504080222P001107 Puskesmas Tg Priok. POLI BERBEDA , Z01.8
3 ZAINAL ABIDIN 1871082483 3172021909610000.00 6408613 / 085714777775 PASIEN LAMA 0116U1530322P000175 KLINIK P. SISMA MEDIKAL 0116R0280422K001493
4 Moh.reffis hs 1464197624 3172022805600000.00 8881650986 71198 PASIEN LAMA 090504080222p000973 Tg.priok POLI BERBEDA , Z01.8
5 Binti Masruroh 1225485033 3172025506720000.00 214303403 46544 PASIEN LAMA 090504070422P000321 Rs Puri Medika RUJUKAN BARU

6 Rehulina Br Tarigan 1224134908 3172027107590000.00 0812-1352-7525 76362 PASIEN LAMA 090504120322P001214 Puskesmas Warakas POLI BERBEDA , Z01.8
7 Supriyatin 377468774 3172024212670000.00 85810495464 87789 PASIEN LAMA 090504000122Y004825 Kel. Tanjung Priok 0116R0280422K001495
8 JAWAWI 39987099 3172020405570000.00 81293562353 84306 PASIEN LAMA 84306 Kecamatan Tanjung Priok POLI BERBEDA , I10
9 Apipah 377956978 3172026112530000.00 85894765736 88696 PASIEN LAMA 090504000322Y001020 Kecamatan Tg Priok 0116R0280422K001497
H. Andy Zaenal
10 Abidin 1296440752 3172031010480000.00 81213174594 62652 PASIEN LAMA 0116U1620222P001696 Klinik P. Sisma Medika 0116R0280422K001498
HJ. Andi
11 Halimatulsadiah 1296441077 317203000000000000000.00 81213174594 62651 PASIEN LAMA 0116U1620322P000085 Klinik P. Sisma Medika 0116R0280422K001499
12 Yuni Syafruddin 2331491501 3172022906650000.00 81387062586 72686 PASIEN LAMA 090504000322Y003295 Tanjung Priok POLI BERBEDA , Z01.8
13 Sutini 1602467346 3171034605410000.00 89510284779 59272 PASIEN LAMA 090504040322y000067 Kel.sungai bambu (09050404) 0116R0280422K001500

14 Roy fredick tolosang 1338573431 3216060806620020.00 81289497588 67489 PASIEN LAMA 0116U0090322P000512 Klinik indosehat 2003 warakas 0116R0280422K001502
15 Sri Sumarni 1301240351 3172024606560000.00 81905673015 85155 PASIEN LAMA 090504000322y003549 Kelurahan Papanggo 0116R0280422K001503
16 M. Muchtar 1223648943 3172022811550000.00 87887964981 86545 PASIEN LAMA 0116U1650322P001607 Klinik Wahana Sejahteta II 0116R0280422K001504
17 SULI 1277444259 3172020506570000.00 0819-0398-5405 68548 PASIEN LAMA 090504080222P000574 Puskesmas Tg Priok 0116R0280422K001505
18 SAMUEL SONNY 2510465973 317202040010560000.00 81289829227 9825 PASIEN LAMA 090504040322Y000007 Kel.Sungai Bambu POLI BERBEDA, Z01
Puskesmas Kelurahan
19 HAYATI 1373365506 3172024311690000.00 81573168499 27356 PASIEN LAMA 090504130222Y000930 Papanggo POLI BERBEDA, Z01
20 m usman 377047034 3172020404550000.00 81287974319 83975 PASIEN LAMA 090504000422y001636 tanjung priuk POLI BERBEDA, Z01
21 Aas waspiyah 1850804223 3173025209740000.00 0857-1018-1784 71902 PASIEN LAMA 090504020322Y000125 Puskesmas sunter jaya 2 0116R0280422K001507
22 Esih suka esih 1806766626 3172025505590000.00 81311552403 65420 PASIEN LAMA 090504120122Y001380 Puskesmas Kel warakas POLI BERBEDA
23 Suwarti 1745260694 3172027110600000.00 81381227876 79616 PASIEN LAMA 090504040222Y000092 Puskesmas Sungai Bambu POLI BERBEDA, Z01
24 SUMARTIMAN 1613420987 3172020606510000.00 85330576458 7004 PASIEN LAMA 090504070422P000490 Puskesmas kebon bawang 3 RUJUKAN BARU
25 juhariyah 1225541349 3172025212520000.00 81211018538 66113 PASIEN LAMA 090504120222Y000127 puskesmas warakas 0116R0280422K001524
Puskesmas Kelurahan sungai
26 Bahjah 46242731 3172026111520000.00 82213209111 78847 PASIEN LAMA 090504040322Y001008 bambu 0116R0280422K001528
27
28
29
30
31
32
33
34
35
 DATA PASIEN DR. BOBBY SP,P
TGL : 18 APRIL 2022/SENIN
NO NAMA NOKA NIK NO TLP NO MR STATUS NO RUJUKAN NAMA FASKES

1 purwanti 1225792585 3172024606690010.00 81218562661 5 PASIEN LAMA 68956 Puri medika

+62 812-1854-
2 Dariyah 1404304571 3172027112800010.00 1543 95833 PASIEN LAMA 090504120322P000129 Warakas

3 HANIATUN HASANAH 998863378 317202000000000000000.00 81903558978 68746 PASIEN LAMA 090504050322Y000915 KEL. KEBON BAWANG 1

4 Carolien wihelmina 2331041411 3172024905510000.00 81389468660 89105 PASIEN LAMA 090504000422Y000401 Kecamatan tanjung priok

5 Kasminah Ada 3172024506600000.00 89611336523 53055 PASIEN LAMA 090504040422y000286 Puskesmas sungai bambu

6 SELVY FARIDA 2059973043 3172024112670000.00 8551137974 96483 PASIEN BARU 0 KEC. TANJUNG PRIOK

7 Bunga 46243192 3172027112470020.00 85823145516 32204 PASIEN LAMA 090504050322Y001214 Puskesmas Kebon Bawang 1
Mochamad Topan
8 Pamungkas 1371315227 3302120105990000.00 82134261331 94551 PASIEN LAMA 090504060422Y000344 Kel. Kebon Bawang II

9 Mamah maryamah 1079988017 3172026512580010.00 89643805772 34714 PASIEN LAMA 090504020222y000115 Sunter jaya 2

10 Salmin 1771648356 317202000000000000000.00 89637269067 91882 PASIEN LAMA 09050409022Y000354 Puskesmas tanjung priok

11 Tokiran 377428724 3172022611530000.00 85282925533 53015 PASIEN LAMA 090504120322P001664 puskesmas keluarahan warakas

12 TARWADI 376747301 3172020703780010.00 85771449421 90170 PASIEN LAMA 090504050122Y000987 Puskesmas Kel. Kebon Bawang I
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
KETERANGAN

0116R0280422K001463

0116R0280422K001464

POLI BERBEDA, Z01

0116R0280422K001466

0116R0280422K001467

0116R0280422K001468

0116R0280422K001469

RUJUKAN BARU

POLI BERBEDA, Z01

0116R0280422K001518

0116R0280422K001520
0116R0280422K0015
27
 DATA PASIEN DR. IVANA SP ,A
TGL : 18 APRIL 2022/SENIN
NO NAMA NOKA NIK NO TLP NO MR STATUS NO RUJUKAN NAMA FASKES
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
KETERANGAN
 DATA PASIEN DR. FIKI SP,B
TGL : 18 APRIL 2022/SENIN
NO NAMA NOKA NIK NO TLP NO MR STATUS NO RUJUKAN NAMA FASKES KETERANGAN

1 Fijliey natalia sajesty 1224718086 3172025312970000.00 81384141711 54192 PASIEN LAMA 090504000322Y003775 Puskesmas tanjung priok POLI BERBEDA, Z01

2 Muhammad Hafiz 1226269844 317202000000000000000.00 81381453061 PASIEN LAMA 0116U1650322P001509 Wahana II 0116R0280422K001512
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
 DATA PASIEN DR. INDAWATI SP,P
TGL : 18 APRIL 2022/SENIN
NO. NAMA NOKA NIK NO TLP NO MR STATUS NO RUJUKAN NAMA FASKES KETERANGAN
1 Erwin Setiawan 376898725 3172022709870000 82213425201 42295 PASIEN LAMA 090504050122Y00128727 Kel. Kebun bawang I 0116R0280422K001486
2 SLAMET 0001224559552 3172020105510004 0216512784 84932 PASIEN LAMA 09050413022Y000231 KEL PAPANGGO I POLI BERBEDA
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
 DATA PASIEN DR.HANNA SP,N
TGL : 18 APRIL 2022/SENIN
NO. NAMA NOKA NIK NO TLP NO MR STATUS NO RUJUKAN NAMA FASKES KETERANGAN

1 Yoses kalengkongan 376500082 3172020506600000.00 82210720765 83621 PASIEN LAMA 090504050222Y001305 Puskesmas kebun bawang 0116R0280422K001470
Klinik wahana sejahtera
2 ROSARIA 2264711747 3175076712871000.00 81319519825 94455 PASIEN LAMA 0116u1650422p000004 ll(0116u165) POLI BERBEDA , I67

3 Benijanta Elia TjuTjuElia 1406737056 3172022301630000.00 89518554244 89233 PASIEN LAMA 090504050222y000154 Kebon bawang 1 0116R0280422K001471

4 Ramlah mail 1462774702 3172025506490000.00 89622171943 57896 PASIEN LAMA 0116U1650322P000218 klinik wahana II POLI BERBEDA, E11

5 Peringetten tarigan 45971616 3172025608460000.00 8128750183 33328 PASIEN LAMA 090504050333Y001127 Kel.kebon bawang POLI BERBEDA,I10

6 Firdaus anwar 1294246956 3171010909680000.00 8589635915 33507 PASIEN LAMA 33507 090504070322P000944 0116R0280422K001476

7 Mausuludin 1727155271 3216070204720010.00 85647874723 95466 PASIEN LAMA 090504040222Y000615 Puskesmas sungai bambu POLI BERBEDA,Z01.8

8 Amin triyono 1457798308 317202000000000000000.00 81284005212 96163 PASIEN LAMA 0116U0060422P000015 Klinik Oilia 0116R0280422K001478
Klinik Santo Yosef
9 Sutirah BA 1478832456 3172026704510000.00 81288343569 41890 PASIEN LAMA 011681800422P000294 (01168180) RUJUKAN BARU
Muhammad Achirullah
10 Amin 1630414506 31720226068900000.00 83873007975 96473 PASIEN LAMA 0116U1650422P000148 Klinik wahana Sejahtera II 0116R0280422K001509
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
 DATA PASIEN DR. ELITA SP,U
TGL :18 APRIL 2022/SENIN
NO. NAMA NOKA NIK NO TLP NO MR STATUS NO RUJUKAN NAMA FASKES KETERANGAN
Klinik indosehat 2003
1 Frederik souhoka 2044026663 3172021410590000.00 82288682630.00 78996 PASIEN LAMA 0116u0090122p000909 warakas POLI BERBEDA, Z01.8

Puskesamas kecamatab
2 KARTINI 1323319779 3172024404650000.00 895341220102.00 PASIEN LAMA 090504000422Y001844 tajung priok RUJUKAN BARU

3 Maryono 1322727704 3172021503590000.00 85774587927.00 60018 PASIEN BARU 090504120122P001384 Puskemas gg13 POLI BERBEDA , N40

4 Suganda 1738861582 3172022110510000.00 85697733145.00 47200 PASIEN LAMA 090504070122P000356 Kebon Bawang lll 0116R0280422K001523
Klinik indosehat 2003
5 Dahniar 2061735107 3172046806740010.00 81291420208.00 PASIEN BARU 0116U0090422P000234 warakas RUJUKAN BARU
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
 DATA PASIEN DR. JOVIEL SP ,KFR
TGL : 18 APRIL 2022/SENIN
NO NAMA NOKA NIK NO TLP NO MR STATUS NO RUJUKAN NAMA FASKES KETERANGAN

1 Febriyan Yohanes MK 2223881324 3172021702910000.00 81383841747 89396 PASIEN LAMA 090504060222Y000181 Kel. Kebon bawang 2 POLI BERBEDA, M54.5
Klinik wahana
2 Nur dewi astini 1209140256 3171034810780000.00 89510284779 53743 PASIEN LAMA 0116u1650322p000638 2(0116u165 POLI BERBEDA, Z01
Puskesmas sungai
3 Suwarno 1225233033 3172020706620000.00 85714153432 90919 PASIEN LAMA 090504040222Y000180 Bambu POLI BERBEDA M54.5

4 Tri Endah Wahyuningsih 1224158657 3172026102920000.00 87883806176 88478 PASIEN LAMA 090504120222Y000730 Puskesmas Warakas POLI BERBEDA
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
 DATA PASIEN DR. ARDHESTIRO SP,JP
TGL : 18 APRIL 2022/SENIN
NO NAMA NOKA NIK NO TLP NO MR STATUS NO RUJUKAN NAMA FASKES
1 Amat nawawi 1464207175 3172021101620000.00 81282197380 71197 PASIEN LAMA 090504120322y000431 Kel.warakas
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
 KETERANGAN
0116R0280422K001465
 DATA PASIEN DR. SEBASTIAN SP,OT
TGL : 18 APRIL 2022/SENIN
NO. NAMA NOKA NIK NO TLP NO MR STATUS NO RUJUKAN NAMA FASKES KETERANGAN

1
Archie timothy 1229138212 3172022301080000.00 81284275624 24252 PASIEN LAMA 0116B1800322P000134 Klinik St.yusuf (0116B180) 0116R0280422K001487

2 Maylie Ribka Sahea 1225705454 3172027005600000.00 85215826420 88261 PASIEN LAMA 090504070122P001182 Puskesmas Keb Bawang 3 0116R0280422K001488
3 Nico Yandra 1137930208 3172021904780000.00 81280813838 94789 PASIEN LAMA 090504070322P000839 Kebon Bawang III 0116R0280422K001489
Puskesmas rawabadak
4
Umi 159374496 3172035902430000.00 81297869443 93163 PASIEN LAMA 011600160322p001351
selatan
0116R0280422K001490

5
Andut Farida 1224134065 3172035102540000.00 81387874477 68318 PASIEN LAMA 0116U1700322P001391 Klinik Syifa Medical Center POLI BERBEDA. Z01.8

6
Sutini 1602467346 3171034605410000.00 89510284779 59272 PASIEN LAMA 090504040322y000067 Kel.sungau bambu (09050404) POLI BERBEDA.M19

7 Ernasari 1225856698 317202000000000000000.00 85894862920 93424 PASIEN LAMA 09050404122y00033 Puskesmas sungai bambu RUJUKAN BARU
Puskesmas Kec. Tanjung
8
Khumairo mah 2075139099 3172024402970000.00 8996074214 71201 PASIEN LAMA 090504000222Y000889
Priok
0116R0280422K001494

9 Darma Wintara 94613 3172021901540000.00 81347463434 PASIEN LAMA 090504040422Y000228 Sungai bambu 0116R0280422K001496
10 Eliah BT Memed 1840851707 3172024407630000.00 85894533454 86273 PASIEN LAMA 090504040322Y000478 Kel. Sungai bambu 0116R0280422K001501
11 HARTATI 3002283911 327504000000000000000.00 81398514028 67332 PASIEN LAMA 09050412022Y000825 KEL. WARAKAS POLI BERBEDA. M19
12 Gatot Suyobo 1223663602 3172022309590000.00 81324685934 40059 PASIEN LAMA 090504130422Y000009 Kel. Papanggo II POLI BERBEDA, M19
13 Nurhaina 45954865 3172025707470000.00 81220137566 95847 PASIEN LAMA 090504120222P001438 Puskesmas warakas 0116R0280422K001506
14 Sumiati 3.10001E+12 3172026510570000.00 85694455186 43106 PASIEN LAMA 090504130322Y000700 Papanggo II POLI BERBEDA. H81.1

15 HANIFAH BIN RIMAN 1223644004 3172026010600010.00 87879508349 67482 PASIEN LAMA 090504120222Y000585 KEL.WARAKAS 0116R0280422K001522

16
DAMIYEM SRI UTAMI 163613182 3172025904490000.00 85775986649 85617 PASIEN LAMA 090504040322Y000230 Puskesmas Sungai Bambu 0116R0280422K001526

17
ACIH 122370558 3172024912700000.00 81291007786 69478 PASIEN LAMA 0116B2050422P000105 Siloam Clinic Center RUJUKAN BARU

18 Tjhie tje sian 1272631645 3172026901580000.00 87889146999 52448 PASIEN LAMA 090504040222y000640 Puskesmas Tg Priok 0116R0280422K001529
19 Roskini 1223723531 3172025004610010.00 895327426564 95938 PASIEN LAMA 090504050122Y000791 Pkl kebon bawang 1 0116R0280422K001530
20
21
22
23
24
25
26
27
28
29
30
31
32
33
34
35
 DATA PASIEN DR. YOSEPH AP.M
TGL : 18 APRIL 2022/SENIN
NO. NAMA NOKA NIK NO TLP NO MR STATUS NO RUJUKAN NAMA FASKES KETERANGAN
1 agastia barunaswara 0001644946593 3272012508680001 081387595516 93943 PASIEN LAMA 0116B1800122P000450 klinik santo yosef POLI BERBEDA, Z01
2 Suparno 0001224752084 3172031309600002 08892154599 81785 090505000322Y000004 Puskesmas kecamatan koja POLI BERBEDA, I25
3
4
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6
7
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9
10