Poliklinik Depan Belakang Januari 2022

LAPORAN POLIKLINIK JANT
Dr. ADI BESTARA, Sp.JP FI

BULAN JANUARI 2022
N0 RM NAMA TANGGAL CARA KET

BAYAR RJ RI
1 37177 TUMINI 1/4/2022 BPJS RJ
2 39775 SUTOMO 1/4/2022 BPJS RJ
3 44193 SAINO 1/4/2022 BPJS RJ
4 45166 KARJI 1/4/2022 BPJS RJ
5 37359 ASRININGSIH 1/4/2022 BPJS RJ
6 41135 BUDI PRAJITNO 1/4/2022 BPJS RJ
7 50280 NIRMALA 1/4/2022 BPJS RJ
8 52511 MARNO 1/4/2022 BPJS RJ
9 44462 M.YONO 1/4/2022 BPJS RJ
10 52496 SUKIYEM 1/4/2022 BPJS RJ
11 40248 SIGIT WIDODO 1/4/2022 BPJS RJ
12 52515 ANAFATUN 1/4/2022 BPJS RJ
13 48781 MARYATI 1/4/2022 BPJS RJ
14 42829 SUNANI 1/4/2022 BPJS RJ
15 37666 SULARMAN 1/4/2022 BPJS RJ
16 53213 KARSI 1/4/2022 BPJS RJ
17 37014 SARTINI 1/4/2022 BPJS RJ
18 38456 SRI NARYATI 1/4/2022 BPJS RJ
19 51297 JAMINEM 1/4/2022 BPJS RJ
20 45624 SUWARDI 1/4/2022 BPJS RJ
21 47629 ARYA PUTRA 1/4/2022 BPJS RJ
22 35677 E.W HANDAYANI 1/4/2022 BPJS RJ
23 48779 MADIANTA 1/4/2022 BPJS RJ
24 46592 SUNARSI 1/4/2022 BPJS RJ
25 39443 SRI LESTARI 1/4/2022 BPJS RJ
26 46154 SUMINI 1/4/2022 BPJS RJ
27 50420 KARSINEM 1/4/2022 BPJS RJ
28 38377 SADINEM 1/4/2022 BPJS RJ
29 38898 TUMIJEM 1/4/2022 BPJS RJ
30 37609 TIMIN 1/4/2022 BPJS RJ
61 37755 SRI RUNTINI 1/7/2022 BPJS RJ

62 33711 DWI HARYANTO 1/7/2022 BPJS RJ
63 38011 SISWANTO 1/7/2022 BPJS RJ
64 42822 YULI ARIYANTO 1/7/2022 BPJS RJ
65 53712 KATINEM 1/7/2022 BPJS RJ
66 53642 WARNO SUWITO 1/7/2022 BPJS RJ
67 40311 MARSONO 1/7/2022 BPJS RJ
68 53713 EMI SUNDARI 1/7/2022 BPJS RJ
69 38519 KENTUT SUPARYO 1/8/2022 BPJS RJ
70 46252 SUKARMIN 1/8/2022 BPJS RJ
71 39332 SRI REJEKI 1/8/2022 BPJS RJ
72 45714 SUTARTO 1/8/2022 BPJS RJ
73 43462 SUNARYO 1/8/2022 BPJS RJ
74 50468 KARSI 1/8/2022 BPJS RJ
75 39417 KUSTINING 1/8/2022 BPJS RJ
76 37694 KATINI 1/8/2022 BPJS RJ
77 37374 SAMINEM 1/8/2022 BPJS RJ
78 51793 RIZKY PUJI 1/8/2022 BPJS RJ
79 37779 SRI UMI 1/8/2022 BPJS RJ
81 53763 NUR SAHID 1/8/2022 BPJS RJ
82 37131 WARMAN 1/8/2022 BPJS RJ
83 37668 KADIMIN 1/8/2022 BPJS RJ
84 46705 SIGIT RIYANTO 1/8/2022 BPJS RJ
85 43576 KARSIMAN EDI 1/8/2022 BPJS RJ
86 37121 SAIMIN 1/8/2022 BPJS RJ
87 38767 SITI KHOTIJAH 1/8/2022 BPJS RJ
88 51466 WARIMIN 1/8/2022 BPJS RJ
89 37256 MURTIWININGSIH 1/8/2022 BPJS RJ
90 44573 SETYO RUSDITO 1/8/2022 BPJS RJ
91 49458 TAWIYEM 1/8/2022 BPJS RJ
92 46301 MARMI 1/8/2022 BPJS RJ
93 43118 SUKIYATI 1/8/2022 BPJS RJ
94 51695 NERMIN 1/8/2022 BPJS RJ
95 48561 TAWIJO 1/8/2022 BPJS RJ
131 47758 SUNARDI 1/11/2022 BPJS RJ

132 38770 SUKIMAN 1/11/2022 BPJS RJ
133 48721 ENI SULISTYOWATI 1/11/2022 BPJS RJ
134 46050 RUDHI SULISTYO 1/11/2022 BPJS RJ
135 52504 SUHARDIYANTO 1/11/2022 BPJS RJ
136 37009 SUDARSI 1/11/2022 BPJS RJ
137 44348 TUMINI 1/11/2022 BPJS RJ
138 53576 SARYATMI 1/11/2022 BPJS RJ
139 41606 SULARTI 1/11/2022 BPJS RJ
140 53849 WINI 1/11/2022 BPJS RJ
141 43821 AGUS SUSANTO 1/11/2022 BPJS RJ
142 51228 ERNI KUSUMA 1/11/2022 BPJS RJ
143 46379 RIYAWAN 1/11/2022 BPJS RJ
144 42299 KUSWANTO 1/11/2022 BPJS RJ
145 40133 KASIYEM 1/11/2022 BPJS RJ
146 49539 KARTINEM 1/11/2022 BPJS RJ
147 44211 YANI 1/11/2022 BPJS RJ
148 36910 SUNARTO 1/11/2022 BPJS RJ
149 45491 SUHADI 1/11/2022 BPJS RJ
150 48929 KERRY SUNARTO 1/11/2022 BPJS RJ
151 38391 DWI PUTRA 1/11/2022 BPJS RJ
152 369575 ANDRI D 1/14/2022 BPJS RJ
153 37671 NANIK SULISTYA 1/14/2022 BPJS RJ
154 52898 WARSIH 1/14/2022 BPJS RJ
155 45186 WAHYU BUDIYANTO 1/14/2022 BPJS RJ
156 49886 WAGINO 1/14/2022 BPJS RJ
157 52551 SUYADI 1/14/2022 BPJS RJ
158 36911 HARI SISWANTO 1/14/2022 BPJS RJ
159 52514 PAIMIN 1/14/2022 BPJS RJ
160 38916 WARTI 1/14/2022 BPJS RJ
161 39418 HARMINI 1/14/2022 BPJS RJ
162 49887 SUGIHARTO 1/14/2022 BPJS RJ
163 38973 JAMINO 1/14/2022 BPJS RJ
164 44574 SETIYANTO 1/14/2022 BPJS RJ
165 54036 MARIA ASSUMPTA 1/14/2022 BPJS RJ
201 53713 EMI SUNDARI 1/15/2022 BPJS RJ

202 46148 SOGIYAH 1/15/2022 BPJS RJ
203 36848 SANU REJO 1/15/2022 BPJS RJ
204 42541 PUJI ASTUTI 1/15/2022 BPJS RJ
205 39388 SUHARNO 1/15/2022 BPJS RJ
206 35375 RIYANTO 1/15/2022 BPJS RJ
207 38042 SUTIKEM 1/15/2022 BPJS RJ
208 54423 SUNAR 1/4/2022 BPJS RJ
209 53600 TUKINI 1/4/2022 BPJS RJ
210 52830 TUMI 1/15/2022 BPJS RJ
211 38897 SITI MARYATI 1/15/2022 BPJS RJ
212 50288 SOEDARSONO 1/15/2022 BPJS RJ
213 45115 SUTI 1/15/2022 BPJS RJ
214 38585 PUJI RAHAYU 1/15/2022 BPJS RJ
215 45077 OKTAVIANUS 1/15/2022 BPJS RJ
216 40037 DANUNG SUKINI 1/15/2022 BPJS RJ
217 34890 SURATMIN 1/15/2022 BPJS RJ
218 49174 TRI HARSINI 1/15/2022 BPJS RJ
219 54092 JUARSIH 1/15/2022 BPJS RJ
220 37919 SARINEM 1/15/2022 BPJS RJ
221 39805 EMA WAHYUNINGSIH 1/15/2022 BPJS RJ
222 54079 SUYATI 1/15/2022 BPJS RJ
223 54093 SRI WINARNI 1/15/2022 BPJS RJ
224 54105 GIYARKI 1/15/2022 BPJS RJ
225 52075 JAELANI 1/18/2022 BPJS RJ
226 38517 SADIKEM 1/18/2022 BPJS RJ
227 51985 SUPARMI 1/18/2022 BPJS RJ
228 52705 SUPARMO 1/18/2022 BPJS RJ
229 45509 CITROWIYONO 1/18/2022 BPJS RJ
230 41714 SEMI 1/18/2022 BPJS RJ
231 49171 TARNO 1/18/2022 BPJS RJ
232 53612 SAKINEM 1/18/2022 BPJS RJ
233 54204 LARMAN 1/18/2022 BPJS RJ
234 51986 SUHARNI 1/18/2022 BPJS RJ
235 50683 TINI 1/18/2022 BPJS RJ
271 37186 AMRIH SULASNO 1/21/2022 BPJS RJ
272 37492 TUMINAH 1/21/2022 BPJS RJ
273 37111 HERI KUSNADI 1/21/2022 BPJS RJ
274 44964 SRIYANTO 1/21/2022 BPJS RJ
275 37162 SUMIYEM 1/21/2022 BPJS RJ
276 54336 KARTO WIYONO 1/21/2022 BPJS RJ
277 54337 DIDIK SUTRISNO 1/21/2022 BPJS RJ
278 36912 SUMARNI 1/22/2022 BPJS RJ
279 38990 M.HASANUDIN 1/22/2022 BPJS RJ
280 49843 BOINEM 1/22/2022 BPJS RJ
281 52748 MUJIONO 1/22/2022 BPJS RJ
282 49827 PADMINI 1/22/2022 BPJS RJ
283 38402 BEJO 1/22/2022 BPJS RJ
284 51019 MINAH 1/22/2022 BPJS RJ
285 45513 KARNAN KARTOYO 1/22/2022 BPJS RJ
286 45311 SUNARTO 1/22/2022 BPJS RJ
287 52962 SRI NYARWITRI 1/22/2022 BPJS RJ
288 51015 KAMIRAH 1/22/2022 BPJS RJ
289 37760 TRI SETIYARTINI 1/22/2022 BPJS RJ
290 50681 HARIYANTI 1/22/2022 BPJS RJ
291 37388 SRI MUNJUNG 1/22/2022 BPJS RJ
292 43048 KARNI 1/22/2022 BPJS RJ
293 46607 AHMADI 1/22/2022 BPJS RJ
294 50882 MARNI 1/22/2022 BPJS RJ
295 38536 SUPARNO 1/22/2022 BPJS RJ
296 41151 ANASTASIA 1/22/2022 BPJS RJ
297 41507 MARNI 1/22/2022 BPJS RJ
298 51916 WARSIYEM 1/22/2022 BPJS RJ
299 38096 SUPARMI 1/22/2022 BPJS RJ
300 44589 SRIYANTO 1/22/2022 BPJS RJ
301 50679 NUNING 1/22/2022 BPJS RJ
302 50697 SENO 1/22/2022 BPJS RJ
303 53567 DIYEM 1/22/2022 BPJS RJ
304 37914 MULYONO 1/22/2022 BPJS RJ
305 37609 TIMIN 1/22/2022 BPJS RJ
341 49179 SRI SUGIYARTI 1/25/2022 BPJS RJ

342 49376 HERU SULISTYO 1/25/2022 BPJS RJ
343 51100 WAHYU ENDARSAH 1/25/2022 BPJS RJ
344 37238 YATI 1/25/2022 BPJS RJ
345 40326 YAHMI 1/25/2022 BPJS RJ
346 51108 SUTARMI 1/25/2022 BPJS RJ
347 40036 SULIYEM 1/25/2022 BPJS RJ
348 49460 WARIJEM 1/25/2022 BPJS RJ
349 39773 EMANUEL EKO 1/25/2022 BPJS RJ
350 43009 HASWANTO 1/25/2022 BPJS RJ
351 50883 SURATMI 1/25/2022 BPJS RJ
352 47823 PANIKEM 1/25/2022 BPJS RJ
353 51394 AGUSTINUS 1/25/2022 BPJS RJ
354 46725 YATMIN 1/25/2022 BPJS RJ
355 49093 KASINEM 1/25/2022 BPJS RJ
356 54068 WARSO WIYONO 1/25/2022 BPJS RJ
357 42931 TUKIMIN 1/28/2022 BPJS RJ
358 38247 TUGINEM 1/28/2022 BPJS RJ
359 49442 SOEJADI 1/28/2022 BPJS RJ
360 43179 SUPARNO 1/28/2022 BPJS RJ
361 37125 SRI AGUS 1/28/2022 BPJS RJ
362 37126 SUMIWI 1/28/2022 BPJS RJ
363 51267 NUR DWI ASA 1/28/2022 BPJS RJ
364 41546 MULYADI 1/28/2022 BPJS RJ
365 36706 LASIJO 1/28/2022 BPJS RJ
366 42438 IIS SURYANI 1/28/2022 BPJS RJ
367 51837 SUWARTO 1/28/2022 BPJS RJ
368 37120 MARSIH 1/28/2022 BPJS RJ
369 44054 TENAN MARYANTEX 1/28/2022 BPJS RJ
370 37241 SUNARNI 1/28/2022 BPJS RJ
371 44717 HARI WIYONO 1/28/2022 BPJS RJ
372 39167 MURDIYANTO 1/28/2022 BPJS RJ
373 52278 TIMIN 1/28/2022 BPJS RJ
374 49330 SOEJATMO 1/28/2022 BPJS RJ
375 54771 SANIYEM 1/28/2022 BPJS RI

BAYAR RJ RI
1 46690 KADIRAN 1/7/2022 UMUM RJ
2 37608 SUMARSO 1/8/2022 UMUM RJ
3 53765 LANTIP SUSILO 1/8/2022 UMUM RJ
4 44589 SRIYANTO 1/8/2022 UMUM RJ
5 43589 LANGGENG 1/11/2022 UMUM RJ
6 49872 SUMARIYAH 1/14/2022 UMUM RJ
7 52075 JAELANI 1/4/2022 UMUM RJ
8 53567 DIYEM 1/4/2022 UMUM RJ
9 44589 SRIYANTO 1/15/2022 UMUM RJ
10 45403 WALTINI 1/15/2022 UMUM RJ
11 54217 BADRUS 1/18/2022 UMUM RJ
12 39157 SUMIJATI 1/21/2022 UMUM RJ
13 53755 SUKIYEM 1/21/2022 UMUM RJ
14 54562 SUPATMI 1/25/2022 UMUM RJ
15 54768 TOTO LAKSONO 1/28/2022 UMUM RJ
16 54791 KATINO 1/28/2022 UMUM RJ
17 32106 TUKIYO KARSO 1/29/2022 UMUM RJ
18 54811 SAGIYEM 1/29/2022 UMUM RJ
19 54217 BADRUS AGUNG 1/29/2022 UMUM RJ
AN POLIKLINIK JANTUNG
DI BESTARA, Sp.JP FIHA
ULAN JANUARI 2022

BAYAR RJ RI
31 49510 HINDUN 1/4/2022 BPJS RJ
32 38613 KASIO 1/4/2022 BPJS RJ
33 42847 EDY PURNOMO 1/4/2022 BPJS RJ
34 52178 SARIYEM 1/4/2022 BPJS RJ
35 50282 HARSANTO 1/7/2022 BPJS RJ
36 38455 ANDRIAS 1/7/2022 BPJS RJ
37 37462 SOEJADI 1/7/2022 BPJS RJ
38 37522 KASTO 1/7/2022 BPJS RJ
39 40236 SARMI 1/7/2022 BPJS RJ
40 41499 ANTONIUS PURWANI 1/7/2022 BPJS RJ
41 38310 SLAMET ARYANTO 1/7/2022 BPJS RJ
42 42902 HENRI YATNO 1/7/2022 BPJS RJ
43 38577 SUMARJO DIMIN 1/7/2022 BPJS RJ
44 43035 SOETIMAN 1/7/2022 BPJS RJ
45 42904 SALIYO SOLEH 1/7/2022 BPJS RJ
46 41153 MARIDI HADI 1/7/2022 BPJS RJ
47 42809 SUJARINI 1/7/2022 BPJS RJ
48 53714 WAGINO 1/7/2022 BPJS RJ
49 39150 PURWANDARI 1/7/2022 BPJS RJ
50 41059 H.FUAD 1/7/2022 BPJS RJ
51 44056 ANY JURNIANAWATI 1/7/2022 BPJS RJ
52 36264 MARJUKI 1/7/2022 BPJS RJ
53 38201 SUFIAH 1/7/2022 BPJS RJ
54 37757 SUTARMI 1/7/2022 BPJS RJ
55 38350 PARMAN 1/7/2022 BPJS RJ
56 36608 BANJAR 1/7/2022 BPJS RJ
57 52495 SRI WANTO 1/7/2022 BPJS RJ
58 49745 ABDUL FATAH 1/7/2022 BPJS RJ
59 49645 MUKIJEM 1/7/2022 BPJS RJ
60 52506 SUPARMAN 1/7/2022 BPJS RJ
96 41460 ANDARWATI 1/8/2022 BPJS RJ

97 51342 WARINEM 1/8/2022 BPJS RJ
98 53542 PARIYEM 1/8/2022 BPJS RJ
99 53744 KARTONO SIMIN 1/8/2022 BPJS RJ
100 53745 ISTANTI 1/8/2022 BPJS RJ
101 37653 SETIYARTO 1/8/2022 BPJS RJ
102 44375 ESTI RAHAYU 1/8/2022 BPJS RJ
103 47496 PURBANINGRUM 1/8/2022 BPJS RJ
104 50168 SUGITO 1/8/2022 BPJS RJ
105 38832 NANIK YULIATI 1/8/2022 BPJS RJ
106 36367 TUMINEM 1/8/2022 BPJS RJ
107 53762 SLAMET DWI 1/8/2022 BPJS RJ
108 53747 PUAN LASTONO 1/8/2022 BPJS RJ
109 53748 KARDI 1/8/2022 BPJS RJ
110 53755 SUKIMIN 1/8/2022 BPJS RJ
111 33497 GIYONO 1/8/2022 BPJS RJ
112 53749 PARTI 1/8/2022 BPJS RJ
113 40077 WARSI 1/8/2022 BPJS RJ
114 38120 BAMBANG SUTEJO 1/8/2022 BPJS RJ
115 53750 TRIYANTO 1/8/2022 BPJS RJ
116 53743 SUTARNI 1/8/2022 BPJS RJ
117 53727 MUGIYEM 1/8/2022 BPJS RJ
118 53746 PAIMAN 1/8/2022 BPJS RJ
119 38653 SULARNO 1/11/2022 BPJS RJ
120 37181 PANIKEM 1/11/2022 BPJS RJ
121 39835 SATMOKO 1/11/2022 BPJS RJ
122 50433 WAHYUNI 1/11/2022 BPJS RJ
123 52706 SRI SUNARNI 1/11/2022 BPJS RJ
124 43047 MURTINI 1/11/2022 BPJS RJ
125 46243 KISNARDI 1/11/2022 BPJS RJ
126 48850 BADRI 1/11/2022 BPJS RJ
127 38041 DIDIK WIDIYANTO 1/11/2022 BPJS RJ
128 50451 SUGIYATMI 1/11/2022 BPJS RJ
129 36203 CANDRA SUSANTO 1/11/2022 BPJS RJ
130 45984 RAYEM 1/11/2022 BPJS RJ
166 36511 DIJASANTO 1/14/2022 BPJS RJ

167 49255 SUGINO 1/14/2022 BPJS RJ
168 42711 YOHANES WAHONO 1/14/2022 BPJS RJ
169 42219 SITI MURSIDATIN 1/14/2022 BPJS RJ
170 50250 WIDIYATMI 1/14/2022 BPJS RJ
171 51953 SADINI 1/14/2022 BPJS RJ
172 49501 HASAN KASINO 1/14/2022 BPJS RJ
173 44833 TITIK WIDIATI 1/14/2022 BPJS RJ
174 49449 PARTONO 1/14/2022 BPJS RJ
175 49830 TUGIYEM 1/14/2022 BPJS RJ
176 53999 LEGANI 1/14/2022 BPJS RJ
177 51569 AMANDA AKSAL 1/14/2022 BPJS RJ
178 54046 FX.RIBUDIADI 1/14/2022 BPJS RJ
179 52139 NURLELY 1/14/2022 BPJS RJ
180 39449 SUTARNI 1/14/2022 BPJS RJ
181 54069 HERI BROTO 1/14/2022 BPJS RJ
182 54054 SUKEMI 1/14/2022 BPJS RJ
183 42133 SAKIMIN 1/15/2022 BPJS RJ
184 37491 WARIYEM 1/15/2022 BPJS RJ
185 38111 BUDI ASTUTI 1/15/2022 BPJS RJ
186 51576 SRIYANTI 1/15/2022 BPJS RJ
187 51640 SURATMI 1/15/2022 BPJS RJ
188 39617 PARYOTO 1/15/2022 BPJS RJ
189 49654 KATIJEM 1/15/2022 BPJS RJ
190 49544 EVI WIDODO 1/15/2022 BPJS RJ
191 38315 SUKINO 1/15/2022 BPJS RJ
192 37908 SUHARTO 1/15/2022 BPJS RJ
193 37665 SURATNO 1/15/2022 BPJS RJ
194 50467 SUYANTI 1/15/2022 BPJS RJ
195 40201 SUMINI 1/15/2022 BPJS RJ
196 52747 DEWI MEGA 1/15/2022 BPJS RJ
197 37719 RIYAN SETYAWAN 1/15/2022 BPJS RJ
198 42441 TASLIMAH 1/15/2022 BPJS RJ
199 50648 SARNO 1/15/2022 BPJS RJ
200 40732 HARYANTO 1/15/2022 BPJS RJ
236 38141 SRININGSIH 1/18/2022 BPJS RJ

237 39576 SUKIYO 1/18/2022 BPJS RJ
238 41237 SRI SUPADMINI 1/18/2022 BPJS RJ
239 52948 WINARNI 1/18/2022 BPJS RJ
240 50661 TRISNO MARTOYO 1/18/2022 BPJS RJ
241 40323 KROMO WIYONO 1/18/2022 BPJS RJ
242 44197 SUYANTO 1/18/2022 BPJS RJ
243 54198 SUNARNO 1/18/2022 BPJS RJ
244 50552 SARTONO 1/18/2022 BPJS RJ
245 37279 TEGUH 1/18/2022 BPJS RJ
246 35742 WAGIMAN 1/18/2022 BPJS RJ
247 51125 TITI MURDIATMINI 1/18/2022 BPJS RJ
248 46398 ATMO SUPARTO 1/18/2022 BPJS RJ
249 49837 SUTRISNI 1/18/2022 BPJS RJ
250 39613 SUTINI 1/18/2022 BPJS RJ
251 54199 SUTIYARMI 1/18/2022 BPJS RJ
252 52924 NGATINO 1/18/2022 BPJS RJ
253 36136 SRI SUWARNI 1/18/2022 BPJS RJ
254 51151 YATMI 1/18/2022 BPJS RJ
255 51017 SURAMI 1/21/2022 BPJS RJ
256 48005 SUKARMAN 1/21/2022 BPJS RJ
257 50048 PURWANTO 1/21/2022 BPJS RJ
258 11548 NGAISAH 1/21/2022 BPJS RJ
259 37780 SUTIMAN 1/21/2022 BPJS RJ
260 45403 WALTINI 1/21/2022 BPJS RJ
261 39982 KENT SIDHARTA 1/21/2022 BPJS RJ
262 50937 PENI PRASTIWI 1/21/2022 BPJS RJ
263 41696 INDRIASARI 1/21/2022 BPJS RJ
264 41024 BAMBANG HADI 1/21/2022 BPJS RJ
265 51952 ERISA PERMATA 1/21/2022 BPJS RJ
266 37076 SUPRAPTI 1/21/2022 BPJS RJ
267 48953 JOKO WAHONO 1/21/2022 BPJS RJ
268 52984 WAHYUNINGSIH 1/21/2022 BPJS RJ
269 37186 AMRIH SULASNO 1/21/2022 BPJS RJ
270 54050 SAKIYEM 1/21/2022 BPJS RJ
306 50275 MARIYAM 1/22/2022 BPJS RJ
307 51869 AGUS TRIYANTO 1/22/2022 BPJS RJ
308 39042 SUTIMAN 1/22/2022 BPJS RJ
309 51035 KUSTAR 1/22/2022 BPJS RJ
310 52170 SLAMET SUPRAPTO 1/22/2022 BPJS RJ
311 37567 TUMINI 1/22/2022 BPJS RJ
312 53112 LASIYEM 1/22/2022 BPJS RJ
313 53661 PUJIATI 1/22/2022 BPJS RJ
314 38139 GATOT PAINO 1/22/2022 BPJS RJ
315 38776 SATIMIN HENDRO 1/22/2022 BPJS RJ
316 37060 TARSI 1/22/2022 BPJS RJ
317 37913 DARYONO 1/22/2022 BPJS RJ
318 52961 TUMINI 1/22/2022 BPJS RJ
319 46266 TARWI SOLEHA 1/22/2022 BPJS RJ
320 43936 TRI WINARKO 1/22/2022 BPJS RJ
321 53658 AGUS PURWANTO 1/22/2022 BPJS RJ
322 46496 KIKI SRI WAHNO 1/22/2022 BPJS RJ
323 52726 SUGIYARTI 1/22/2022 BPJS RJ
324 54078 MARKUS BUDI 1/22/2022 BPJS RJ
325 36735 LILIK TRIYANI 1/25/2022 BPJS RJ
326 51797 NURI WINARNI 1/25/2022 BPJS RJ
327 49362 THERESIA TRIANTI 1/25/2022 BPJS RJ
328 39712 SUTIMIN 1/25/2022 BPJS RJ
329 43359 SUYEM 1/25/2022 BPJS RJ
330 52169 SULARNI 1/25/2022 BPJS RJ
331 51016 KARTINI 1/25/2022 BPJS RJ
332 54070 DARIYEM 1/25/2022 BPJS RJ
333 36349 PONIYEM 1/25/2022 BPJS RJ
334 47782 LASNO 1/25/2022 BPJS RJ
335 39208 SUPRIYO 1/25/2022 BPJS RJ
336 51091 HERI SETYAWAN 1/25/2022 BPJS RJ
337 50426 NURHADI UTOMO 1/25/2022 BPJS RJ
338 49899 MONIASIH 1/25/2022 BPJS RJ
339 42833 SRI PURWANI 1/25/2022 BPJS RJ
340 35953 ELLYZABETH 1/25/2022 BPJS RJ
376 51955 KATARINA 1/29/2022 BPJS RJ

377 43444 TUKIMIN 1/29/2022 BPJS RJ
378 40015 SARIYANTI 1/29/2022 BPJS RJ
379 51332 SUNARNI 1/29/2022 BPJS RJ
380 36550 SUKASMINI 1/29/2022 BPJS RJ
381 39199 AGUS SETYO 1/29/2022 BPJS RJ
382 36815 RINI 1/29/2022 BPJS RJ
383 49372 SUKATNO 1/29/2022 BPJS RJ
384 33497 GIYONO 1/29/2022 BPJS RJ
385 38582 ATIK WINARTI 1/29/2022 BPJS RJ
386 38663 ENIK INDRASTUTIK 1/29/2022 BPJS RJ
387 44583 SATIYEM 1/29/2022 BPJS RJ
388 49374 SUYANTI 1/29/2022 BPJS RJ
389 38117 KASI 1/29/2022 BPJS RJ
390 46905 TRI MULATININGSIH 1/29/2022 BPJS RJ
391 52368 SUMARSO 1/29/2022 BPJS RJ
392 46388 SAKIMIN 1/29/2022 BPJS RJ
393 50274 SUGIYATMO 1/29/2022 BPJS RJ
394 37715 MARTI 1/29/2022 BPJS RJ
395 37762 SUMINI 1/29/2022 BPJS RJ
396 39420 SUGIYARNO 1/29/2022 BPJS RJ
397 53447 RIS SETYANA 1/29/2022 BPJS RJ
398 35244 PAIMAN 1/29/2022 BPJS RJ
399 44214 WARDIYATI 1/29/2022 BPJS RJ
400 49896 WARINEM 1/29/2022 BPJS RJ
401 38394 GIYARTO 1/29/2022 BPJS RJ
402 38390 TITIK TRI 1/29/2022 BPJS RJ
403 37994 SARJONO 1/29/2022 BPJS RJ
404 42118 SRIYATUN 1/29/2022 BPJS RJ
405 38393 SRI HASTUTI 1/29/2022 BPJS RJ
406 51092 KATINI 1/29/2022 BPJS RJ
407 41725 SETO 1/29/2022 BPJS RJ
408 36249 BUDI SUHARSO 1/29/2022 BPJS RJ
409 39005 LIAS YUARINI 1/29/2022 BPJS RJ
410 35608 RUSMINI 1/29/2022 BPJS RJ
411 50913 SURIPTI 1/29/2022 BPJS RJ

412 51146 NURUL AZIZAH 1/29/2022 BPJS RJ
413 52302 TITIK ANJARSARI 1/29/2022 BPJS RJ
414 38893 NANIK SRI 1/29/2022 BPJS RJ
415 41152 DJOEMAN 1/29/2022 BPJS RJ
416 36763 BOINEM 1/29/2022 BPJS RJ
417 39875 TRI HANDAYANI 1/29/2022 BPJS RJ
418 37231 SUNARSO 1/29/2022 BPJS RJ
419 54756 MAIRDIANTO 1/29/2022 BPJS RJ
420 38385 SRI MULYATI 1/29/2022 BPJS RJ
PASIEN BPJS : 420

BPJS RAJAL : 419
BPJS RANAP :1
PASIEN UMUM : 19
UMUM RAJAL : 19
UMUM RANAP :-
TOTAL PASIEN : 439

LAPORAN POLIKLINIK JANT
Dr. FIRDA JAYA, Sp.JP FIH
BULAN JANUARI 2022

BAYAR RJ RI
1 47167 SAMINI 1/3/2022 BPJS RJ
2 50223 SUPARDI 1/3/2022 BPJS RJ
3 39621 KATIYEM 1/3/2022 BPJS RJ
5 52208 SUYONO 1/3/2022 BPJS RJ
6 48816 SRI WIDAYATSIH 1/3/2022 BPJS RJ
7 49429 WASINI 1/3/2022 BPJS RJ
8 49028 SUPARNI 1/3/2022 BPJS RJ
9 53521 TUKINO 1/3/2022 BPJS RJ
10 53287 PIPIT SUGIYANTI 1/3/2022 BPJS RJ
11 53283 RIYANTINI 1/3/2022 BPJS RJ
12 41825 KARTI 1/3/2022 BPJS RJ
13 49304 SURATMAN 1/3/2022 BPJS RJ
14 37421 ICHSANUDIN 1/3/2022 BPJS RJ
15 45257 SUNARSI 1/3/2022 BPJS RJ
16 52247 LASMO 1/3/2022 BPJS RJ
17 46745 SRI PURWANI 1/3/2022 BPJS RJ
18 49004 NGATIMIN 1/3/2022 BPJS RJ
19 50028 SURATO 1/3/2022 BPJS RJ
20 43989 SUPRIHATI 1/3/2022 BPJS RJ
21 50989 MANI 1/3/2022 BPJS RJ
22 51989 PONIMIN 1/3/2022 BPJS RJ
23 52027 PARDIYANTO 1/3/2022 BPJS RJ
24 37011 SUMARYATI 1/3/2022 BPJS RJ
25 52671 KARSO REJO 1/3/2022 BPJS RJ
26 49276 TRI LASMINI 1/3/2022 BPJS RJ
27 40713 WAGIYO 1/3/2022 BPJS RJ
28 44983 HARIYADI 1/3/2022 BPJS RJ
29 40503 PARINO ATMO 1/3/2022 BPJS RJ
30 41548 AGUS PURWANTO 1/3/2022 BPJS RJ
61 49869 SANTOYO 1/6/2022 BPJS RJ

62 46838 JAKIYEM 1/6/2022 BPJS RJ
63 44991 ARI HERMAWANTO 1/6/2022 BPJS RJ
64 53413 BEGOG 1/6/2022 BPJS RJ
65 51291 MARGARETA 1/6/2022 BPJS RJ
66 50809 KARTOYO 1/6/2022 BPJS RJ
67 47143 WARSINI 1/6/2022 BPJS RJ
68 41881 SURATNO 1/6/2022 BPJS RJ
69 48165 SULARDI 1/6/2022 BPJS RJ
70 52591 SARIJEM 1/6/2022 BPJS RJ
71 42475 SUPARMI 1/6/2022 BPJS RJ
72 53682 SIMIN ADMO 1/6/2022 BPJS RJ
73 52156 WALUYO 1/6/2022 BPJS RJ
74 53684 RASITA NUR 1/6/2022 BPJS RJ
75 52126 WINIH 1/6/2022 BPJS RJ
76 53305 TIYEM 1/6/2022 BPJS RJ
77 48832 SUGIMIN 1/6/2022 BPJS RJ
78 47328 SARMUJI 1/6/2022 BPJS RJ
79 53664 SARIYEM 1/6/2022 BPJS RJ
80 53666 TUGIYEM 1/6/2022 BPJS RJ
81 53665 RENI ANGGRAINI 1/6/2022 BPJS RJ
82 42820 SUGIYATTO 1/6/2022 BPJS RJ
83 47577 WURYANTI 1/10/2022 BPJS RJ
84 50332 SAMAN 1/10/2022 BPJS RJ
85 50422 DWI BUDI 1/10/2022 BPJS RJ
86 49161 SUMARYANTO 1/10/2022 BPJS RJ
87 53585 SUNARTI 1/10/2022 BPJS RJ
88 46049 DWI SURYANI 1/10/2022 BPJS RJ
89 45463 AMSYA AULIA 1/10/2022 BPJS RJ
90 53806 WARSITI 1/10/2022 BPJS RJ
91 53425 PURWANTINI 1/10/2022 BPJS RJ
92 50371 SURATMI 1/10/2022 BPJS RJ
93 50322 SUGIYONO 1/10/2022 BPJS RJ
94 53371 TAMINEM 1/10/2022 BPJS RJ
95 45676 SLAMET NARTO 1/10/2022 BPJS RJ
131 49719 TRIYATMI 1/13/2022 BPJS RJ

132 50766 PARDI SUPARTO 1/13/2022 BPJS RJ
133 53297 SUGINO 1/13/2022 BPJS RJ
134 42103 SUGIYARTI 1/13/2022 BPJS RJ
135 53663 EKO PURWANTO 1/13/2022 BPJS RJ
136 42207 WITOMANTRI 1/13/2022 BPJS RJ
137 51444 SITI MULYANI 1/13/2022 BPJS RJ
138 49048 SOENARTO 1/13/2022 BPJS RJ
139 47087 TRI HARTUTI 1/13/2022 BPJS RJ
140 42209 TUGIMIN 1/13/2022 BPJS RJ
141 49697 MULYONO 1/13/2022 BPJS RJ
142 48437 WASKITO 1/13/2022 BPJS RJ
143 53401 PARNO YITNO 1/13/2022 BPJS RJ
144 40757 WARIYEM 1/13/2022 BPJS RJ
145 43922 WAWI ASIH 1/13/2022 BPJS RJ
146 50772 SUTEJO 1/13/2022 BPJS RJ
147 35401 SUYONO 1/13/2022 BPJS RJ
148 53990 SUPARNO 1/13/2022 BPJS RJ
149 51429 WARIMIN 1/13/2022 BPJS RJ
150 53623 MARSONO 1/13/2022 BPJS RJ
151 41173 MARNI 1/13/2022 BPJS RJ
152 49406 MARFUAH 1/13/2022 BPJS RJ
153 46339 SUMARNI 1/13/2022 BPJS RJ
154 50369 SANI 1/13/2022 BPJS RJ
155 53182 KHADELA F 1/13/2022 BPJS RJ
156 51867 PUJI HASTUTI 1/13/2022 BPJS RJ
157 30389 SUWANTINI 1/13/2022 BPJS RJ
158 49810 SUKINI 1/13/2022 BPJS RJ
159 53996 PAINEM 1/13/2022 BPJS RJ
160 49729 PARTIYEM 1/13/2022 BPJS RJ
161 46869 SRIYONO 1/13/2022 BPJS RJ
162 49282 PUJIATI 1/13/2022 BPJS RJ
163 52793 LOWUNG 1/13/2022 BPJS RJ
164 53682 SIMIN ADMO 1/13/2022 BPJS RJ
165 53417 SULAMI 1/13/2022 BPJS RJ
201 54257 PURWANTO 1/19/2022 BPJS RJ

202 53627 SUCIPTO 1/19/2022 BPJS RJ
203 54238 SRI WAHYUNI 1/19/2022 BPJS RJ
204 53616 SUHARTO 1/19/2022 BPJS RJ
205 43534 SARIDI 1/19/2022 BPJS RJ
206 44418 SITI SURYANI 1/19/2022 BPJS RJ
207 39557 WITO BEJO 1/19/2022 BPJS RJ
208 37034 KONEM 1/19/2022 BPJS RJ
209 53898 SURAT 1/19/2022 BPJS RJ
210 51377 SUGIYARTO 1/19/2022 BPJS RJ
211 50519 SITI 1/19/2022 BPJS RJ
212 52494 SRI ASTUTI 1/19/2022 BPJS RJ
213 45146 RUSDIANA 1/19/2022 BPJS RJ
214 52889 SITI AMANAH 1/19/2022 BPJS RJ
215 52399 SARTO 1/19/2022 BPJS RJ
216 41821 HARTATI 1/19/2022 BPJS RJ
217 50512 JOKO PURWANTO 1/19/2022 BPJS RJ
218 46530 HERU ISTIANTO 1/19/2022 BPJS RJ
219 52632 SUTINAH 1/19/2022 BPJS RJ
220 52871 WIDODO 1/19/2022 BPJS RJ
221 52888 KARMI 1/19/2022 BPJS RJ
222 48348 SUPARNI 1/20/2022 BPJS RJ
223 53618 PARIYEM 1/20/2022 BPJS RJ
224 52450 WIJIANTI 1/20/2022 BPJS RJ
225 44396 PANTES WINARNI 1/20/2022 BPJS RJ
226 46150 JOKO BUDIARSO 1/20/2022 BPJS RJ
227 47973 SUPARTI 1/20/2022 BPJS RJ
228 33984 SUGIR ALOYSIUS 1/20/2022 BPJS RJ
229 48014 KARNO 1/20/2022 BPJS RJ
230 42820 SUGIYATO 1/20/2022 BPJS RJ
231 41109 ROSALIA ENI 1/20/2022 BPJS RJ
232 36720 SUPRIYATNI 1/20/2022 BPJS RJ
233 54282 WARDI 1/20/2022 BPJS RJ
234 54281 UDI SUSILO 1/20/2022 BPJS RJ
235 52758 AGUS SANTOSO 1/20/2022 BPJS RJ
271 54489 HERU CAHYONO 1/24/2022 BPJS RJ
272 47970 SUMIYATI 1/26/2022 BPJS RJ
273 36958 NARNI 1/26/2022 BPJS RJ
274 53159 RUKIMIN 1/26/2022 BPJS RJ
275 48903 SUMARNI 1/26/2022 BPJS RJ
276 49819 TRISTUTIK 1/26/2022 BPJS RJ
277 52140 DARIYATUN 1/26/2022 BPJS RJ
278 52894 WADIMIN 1/26/2022 BPJS RJ
279 36123 KIRNO 1/26/2022 BPJS RJ
280 54693 SISWO MUJIONO 1/26/2022 BPJS RJ
281 37361 SARTI 1/26/2022 BPJS RJ
282 52881 SUTI 1/26/2022 BPJS RJ
283 54695 WARTINI 1/26/2022 BPJS RJ
284 54694 KARYONO 1/26/2022 BPJS RJ
285 50589 PAINEM 3/26/2027 BPJS RJ
286 53417 SULAMI 1/27/2022 BPJS RJ
287 49075 ASIH WULANDARI 1/27/2022 BPJS RJ
288 49250 TUGIMAN 1/27/2022 BPJS RJ
289 46452 ENDANG S 1/27/2022 BPJS RJ
290 47207 PARMIN 1/27/2022 BPJS RJ
291 47993 SUKATMI 1/27/2022 BPJS RJ
292 48282 SUPARNO 1/27/2022 BPJS RJ
293 49371 KASIKEM 1/27/2022 BPJS RJ
294 38825 SUGI 1/27/2022 BPJS RJ
295 41819 MUSLIM 1/27/2022 BPJS RJ
296 53043 YOSEPIN HERI 1/27/2022 BPJS RJ
297 50140 SARNI 1/27/2022 BPJS RJ
298 39399 TUMIRAN 1/27/2022 BPJS RJ
299 48230 SASTROWIYONO 1/27/2022 BPJS RJ
300 45499 SUPARNO 1/27/2022 BPJS RJ
301 51424 TUKIJEM 1/27/2022 BPJS RJ
302 43855 SUYADI 1/27/2022 BPJS RJ
303 50859 PARTO 1/27/2022 BPJS RJ
304 51867 PUJI ASTUTI 1/27/2022 BPJS RJ
305 54717 SRI MULYONO 1/27/2022 BPJS RJ
341 42654 NGAPINI 1/31/2022 BPJS RJ

342 47045 WIYADI 1/31/2022 BPJS RJ
343 47261 MISMANTO 1/31/2022 BPJS RJ
344 52437 SARMI 1/31/2022 BPJS RJ
345 46041 SADIYEM 1/31/2022 BPJS RJ
346 47052 SUYATI 1/31/2022 BPJS RJ
347 51933 SULARNO 1/31/2022 BPJS RJ
348 44668 SUKATINI 1/31/2022 BPJS RJ
349 52849 KASINI 1/31/2022 BPJS RJ
350 43306 SULARMI 1/31/2022 BPJS RJ
351 54483 TARNO 1/31/2022 BPJS RJ
PASIEN BPJS : 351
BPJS RAJAL : 350
BPJS RANAP :1
PASIEN UMUM : 19
UMUM RAJAL : 19
UMUM RANAP :-
TOTAL PASIEN : 370

AN POLIKLINIK JANTUNG
FIRDA JAYA, Sp.JP FIHA
ULAN JANUARI 2022

BAYAR RJ RI
31 43915 TUGIYEM 1/5/2022 BPJS RJ
32 53624 SUKATMI 1/5/2022 BPJS RJ
33 42256 SRI SUNENSI 1/5/2022 BPJS RJ
34 42879 SARTINAH 1/5/2022 BPJS RJ
35 43196 KASIYEM 1/5/2022 BPJS RJ
36 39469 NURHAYATI 1/5/2022 BPJS RJ
37 53617 TITIK PRIHATIN 1/5/2022 BPJS RJ
38 53623 MARSONO 1/5/2022 BPJS RJ
39 53625 ISNAN ALI 1/5/2022 BPJS RJ
40 53622 SUGIYEM 1/5/2022 BPJS RJ
41 53618 PARIYEM 1/5/2022 BPJS RJ
42 52494 SRI ASTUTI 1/5/2022 BPJS RJ
43 53620 SUMIDI 1/5/2022 BPJS RJ
44 46308 MAMAN DURAHMAN 1/5/2022 BPJS RJ
45 35566 SUKINEM 1/5/2022 BPJS RJ
46 41723 LAMAN 1/5/2022 BPJS RJ
47 35849 DJOKO SUDARMONO 1/5/2022 BPJS RJ
48 53626 SARDJANTO 1/5/2022 BPJS RJ
49 53627 SUCIPTO 1/5/2022 BPJS RJ
50 47031 PARMO SUWITO 1/5/2022 BPJS RJ
51 44464 SARIDI 1/5/2022 BPJS RJ
52 53621 UNGGUL JOKO 1/5/2022 BPJS RJ
53 44167 NGADI 1/6/2022 BPJS RJ
54 50333 TUKINO 1/6/2022 BPJS RJ
55 41881 SURATMO 1/6/2022 BPJS RJ
56 53297 SUGINO 1/6/2022 BPJS RJ
57 38842 S.WAN KAMARI 1/6/2022 BPJS RJ
58 54401 SULARDI 1/6/2022 BPJS RJ
59 50456 HADI PURNOMO 1/6/2022 BPJS RJ
60 47411 SUHARTONO 1/6/2022 BPJS RJ
96 41951 SUPI HARTANTO 1/10/2022 BPJS RJ

97 46718 BAMBANG K 1/10/2022 BPJS RJ
98 39615 NGATINEM 1/10/2022 BPJS RJ
99 47006 ROSYID WIBUDI 1/10/2022 BPJS RJ
100 49592 MARMADI 1/10/2022 BPJS RJ
101 43509 DIDIK PURWANTO 1/10/2022 BPJS RJ
102 36866 SUNARMI 1/10/2022 BPJS RJ
103 53303 SUMIYEM 1/12/2022 BPJS RJ
104 53617 TITIK PRIHATIN 1/12/2022 BPJS RJ
105 46901 SUBANDIYAH 1/12/2022 BPJS RJ
106 41723 LAMAN 1/12/2022 BPJS RJ
107 47657 KRISTINA 1/12/2022 BPJS RJ
108 53298 HALIMI SASMITA 1/12/2022 BPJS RJ
109 42540 SUGIYONO 1/12/2022 BPJS RJ
110 53620 SUMIDI 1/12/2022 BPJS RJ
111 47743 NUR SARI ASTUTI 1/12/2022 BPJS RJ
112 48689 RUBEN 1/12/2022 BPJS RJ
113 50253 SUPRIYONO 1/12/2022 BPJS RJ
114 48453 KARIYEM 1/12/2022 BPJS RJ
115 51849 SRI NURHAYATI 1/12/2022 BPJS RJ
116 53888 SRI SUPARTININGSIH 1/12/2022 BPJS RJ
117 48603 SOETARNI 1/12/2022 BPJS RJ
118 40470 TOTOK SRI 1/12/2022 BPJS RJ
119 51393 AGUS GURIDNO 1/12/2022 BPJS RJ
120 52692 SRI MULYATI 1/12/2022 BPJS RJ
121 40703 SIHWADI 1/12/2022 BPJS RJ
122 53886 SUROTO 1/12/2022 BPJS RJ
123 37624 SUWARTI 1/12/2022 BPJS RJ
124 53797 NARTO WIYONO 1/12/2022 BPJS RJ
125 50218 SRI MULYANI 1/12/2022 BPJS RJ
126 51852 KATIMIN 1/12/2022 BPJS RJ
127 53890 SOBARI 1/12/2022 BPJS RJ
128 40689 SUKARTI 1/12/2022 BPJS RJ
129 49410 WAHYU W 1/12/2022 BPJS RJ
130 40539 WAKIDI 1/13/2022 BPJS RJ
166 43962 PURNOMO 1/17/2022 BPJS RJ

167 52858 SUKINI 1/17/2022 BPJS RJ
168 54149 SUYATO 1/17/2022 BPJS RJ
169 54150 SARNO 1/17/2022 BPJS RJ
170 47377 DEWI SRI 1/17/2022 BPJS RJ
171 51258 SAMINO 1/17/2022 BPJS RJ
172 51886 SUWARTINI 1/17/2022 BPJS RJ
173 48773 MURLAN 1/17/2022 BPJS RJ
174 46554 UMAMI 1/17/2022 BPJS RJ
175 52424 YUSTINUS 1/17/2022 BPJS RJ
176 37336 SAMI 1/17/2022 BPJS RJ
177 50518 SULARNO 1/17/2022 BPJS RJ
178 32770 KASIMAN 1/17/2022 BPJS RJ
179 52341 YATINO 1/17/2022 BPJS RJ
180 45465 ETIK NINGSIH 1/17/2022 BPJS RJ
181 46825 NGATMIN 1/17/2022 BPJS RJ
182 54168 FRISDA DERRY 1/17/2022 BPJS RJ
183 36357 SUYITNO 1/17/2022 BPJS RJ
185 44274 SLAMET 1/17/2022 BPJS RJ
186 47913 KARYANTI 1/17/2022 BPJS RJ
187 44507 RAKINO 1/17/2022 BPJS RJ
188 52672 SUKAMTO 1/17/2022 BPJS RJ
189 52152 ENDANG SALUPI 1/17/2022 BPJS RJ
190 47417 SOMI DARYANTI 1/17/2022 BPJS RJ
191 54148 MINEM 1/17/2022 BPJS RJ
192 44517 SUGINEM 1/17/2022 BPJS RJ
193 50514 SUPRIYATIN 1/17/2022 BPJS RJ
194 52681 MAINEM 1/17/2022 BPJS RJ
195 52027 PARDIYANTO 1/17/2022 BPJS RJ
196 41824 MARTINI 1/19/2022 BPJS RJ
197 54255 PUJI SESANTI 1/19/2022 BPJS RJ
198 50253 SUPRIYONO 1/19/2022 BPJS RJ
199 54240 DEKA SETYAKA 1/19/2022 BPJS RJ
200 54243 SUKATMI 1/19/2022 BPJS RJ
236 37019 SUWARDI TIGOR 1/20/2022 BPJS RJ

237 50776 HERWANSAH 1/20/2022 BPJS RJ
238 43357 SUTARYO 1/20/2022 BPJS RJ
239 53393 LAMIYEM 1/20/2022 BPJS RJ
240 50743 TUKIYO 1/20/2022 BPJS RJ
241 54280 SISKA SAPUTRI 1/20/2022 BPJS RJ
242 47223 RAHAYU 1/20/2022 BPJS RJ
243 53044 TRI YATNO 1/24/2022 BPJS RJ
244 46687 SUMINI 1/24/2022 BPJS RJ
245 51040 DJOKO SUDONO 1/24/2022 BPJS RJ
246 48134 SRI RAHAYU 1/24/2022 BPJS RJ
247 50832 LARMINI 1/24/2022 BPJS RJ
248 48600 HATMUNINGSIH 1/24/2022 BPJS RJ
249 36755 PARTI 1/24/2022 BPJS RJ
250 47454 NGATINI 1/24/2022 BPJS RJ
251 47052 SUYATI 1/24/2022 BPJS RJ
252 47201 TUGINEM 1/24/2022 BPJS RJ
253 47910 DARMANTO 1/24/2022 BPJS RJ
254 36200 SARONO 1/24/2022 BPJS RJ
255 42969 RESTIK SURYANI 1/24/2022 BPJS RJ
256 44286 ARIS SETYAWAN 1/24/2022 BPJS RJ
257 54484 HANDOYO SENO 1/24/2022 BPJS RJ
258 39468 HARMAWAN 1/24/2022 BPJS RJ
259 54485 NARTO 1/24/2022 BPJS RJ
260 54479 WARSINI 1/24/2022 BPJS RJ
261 43168 GIYONO 1/24/2022 BPJS RJ
262 50317 MARMI 1/24/2022 BPJS RJ
263 54148 MINEM 1/24/2022 BPJS RJ
264 50822 KATINEM 1/24/2022 BPJS RJ
265 52845 WINARNI 1/24/2022 BPJS RJ
266 35452 SUWARMI 1/24/2022 BPJS RJ
267 54168 FARISA DERRY 1/24/2022 BPJS RJ
268 43364 PUJO SANTOSO 1/24/2022 BPJS RJ
269 54483 TARNO 1/24/2022 BPJS RJ
270 49411 TRI LESTARI 1/24/2022 BPJS RJ
306 51557 SULARNI 1/27/2022 BPJS RJ
307 54718 SUWARSI 1/27/2022 BPJS RJ
308 43194 SUTARNI 1/27/2022 BPJS RJ
309 54739 NURHAYATI 1/27/2022 BPJS RJ
310 54731 NGATIDJEM 1/27/2022 BPJS RJ
311 36670 WAKIMAN 1/27/2022 BPJS RJ
312 40383 WAHONO 1/27/2022 BPJS RJ
313 48205 SIDO PRAPTO 1/27/2022 BPJS RJ
314 54715 SRIHARDONO 1/27/2022 BPJS RJ
315 54732 SUWARMI 1/27/2022 BPJS RJ
316 39380 SUDARNO 1/31/2022 BPJS RJ
317 47689 RISDIYANTO 1/31/2022 BPJS RJ
318 49974 SIMAN 1/31/2022 BPJS RI
319 50146 AGUS SUYATNO 1/31/2022 BPJS RJ
320 54858 TUNEM 1/31/2022 BPJS RJ
321 48688 KARMANTO 1/31/2022 BPJS RJ
322 53162 MARYATI 1/31/2022 BPJS RJ
323 53412 SUMARMI 1/31/2022 BPJS RJ
324 47768 SUKADI 1/31/2022 BPJS RJ
326 41012 SUPARMI 1/31/2022 BPJS RJ
327 54859 SULARNI 1/31/2022 BPJS RJ
328 54860 EKO RIWAYATMO 1/31/2022 BPJS RJ
329 46022 WIDODO 1/31/2022 BPJS RJ
330 53162 MARYATI 1/31/2022 BPJS RJ
331 48688 KARMANTO 1/31/2022 BPJS RJ
332 54858 TUNEM 1/31/2022 BPJS RJ
333 47689 RISDIYANTO 1/31/2022 BPJS RJ
334 54861 BAMBANG 1/31/2022 BPJS RJ
335 45169 SUNARNO 1/31/2022 BPJS RJ
336 52862 HENI PURWANINGSIH 1/31/2022 BPJS RJ
337 54883 JARWADI 1/31/2022 BPJS RJ
338 52127 LASINEM 1/31/2022 BPJS RJ
339 54857 SUYATO 1/31/2022 BPJS RJ
340 50181 SITI KUSTIYAH 1/31/2022 BPJS RJ

BAYAR RJ RI
1 53285 WARNI 1/3/2022 UMUM RJ
2 53616 SUHARTO 1/5/2022 UMUM RJ
3 53638 IPIAWATI 1/5/2022 UMUM RJ
4 53594 SUMIYARSIH 1/5/2022 UMUM RJ
5 48543 TRIONO 1/5/2022 UMUM RJ
6 53639 KRIS SUKAMTO 1/5/2022 UMUM RJ
7 53883 KAMI 1/12/2022 UMUM RJ
8 48060 SUWANDI 1/12/2022 UMUM RJ
9 53383 KHASANI 1/13/2022 UMUM RJ
10 33984 SUGIR ALOYSIUS 1/13/2022 UMUM RJ
11 43535 PARIYO 1/20/2022 UMUM RJ
12 52426 PAIKEM 1/20/2022 UMUM RJ
13 54301 TARNI 1/20/2022 UMUM RJ
14 39981 SURATMI 1/20/2022 UMUM RJ
15 54173 SIMAN 1/24/2022 UMUM RJ
16 52851 KATIYEM 1/26/2022 UMUM RJ
17 51049 SUPARTI 1/26/2022 UMUM RJ
18 44668 SUTINEM 1/31/2022 UMUM RJ
19 54861 BAMBANG 1/31/2022 UMUM RJ
LAPORAN POLIKLINIK SYARA
Dr. MISNAHATI,Sp.S
BULAN JANUARI 2022

BAYAR RJ RI
1 53163 SUYANTI 1/4/2022 BPJS RJ
2 53085 KAMIYEM 1/4/2022 BPJS RJ
3 48417 SARMO 1/4/2022 BPJS RJ
4 52914 ANNISA 1/4/2022 BPJS RJ
5 52814 HENDRI S 1/4/2022 BPJS RJ
6 50660 SUMIYATI 1/4/2022 BPJS RJ
7 52071 SUKATMI 1/4/2022 BPJS RJ
8 41854 SITI DJUNAIDAH 1/4/2022 BPJS RJ
9 53254 SAKINI 1/4/2022 BPJS RJ
10 48259 KASIMIN 1/4/2022 BPJS RJ
11 522510 SULARNI 1/4/2022 BPJS RJ
13 37507 SOEKAMTI 1/4/2022 BPJS RJ
14 50838 SUGIYANTI 1/4/2022 BPJS RJ
15 36853 GINO 1/4/2022 BPJS RJ
16 53561 KASIMIN 1/4/2022 BPJS RJ
18 53560 RANTI 1/4/2022 BPJS RI
19 49915 SUKARTI 1/4/2022 BPJS RJ
20 50733 WARDI 1/6/2022 BPJS RJ
21 52251 SRI SAYEKTI 1/6/2022 BPJS RJ
22 50617 SULARMI 1/6/2022 BPJS
23 40054 DARYATMI 1/6/2022 BPJS RJ
24 52443 SATIMIN 1/6/2022 BPJS RJ
25 51436 NIHAYAH 1/6/2022 BPJS RJ
26 52242 SULARNO 1/6/2022 BPJS RJ
27 37514 SUMIYEM 1/6/2022 BPJS RJ
28 48211 SUTARTI 1/6/2022 BPJS RJ
29 54405 SUPARNI 1/6/2022 BPJS RJ
61 38737 KUSTINI 1/11/2022 BPJS RJ

62 53842 TUKIYEM 1/11/2022 BPJS RJ
63 53843 JIKEM 1/11/2022 BPJS RI
64 522510 SULARNI 1/11/2022 BPJS RJ
65 46865 MARSI 1/13/2022 BPJS RJ
66 48856 TUGI 1/13/2022 BPJS RJ
67 40743 SUYATMI 1/13/2022 BPJS RJ
68 50403 PARNI 1/13/2022 BPJS RJ
69 53692 DIAH MARITI 1/13/2022 BPJS RJ
70 45205 SRI WINARNA 1/13/2022 BPJS RJ
71 43124 SULARNO 1/13/2022 BPJS RJ
72 54022 SUMINI 1/13/2022 BPJS RJ
73 43321 SUPARNO 1/13/2022 BPJS RJ
74 44208 HARTINI 1/13/2022 BPJS RJ
75 49113 WARTI 1/13/2022 BPJS RJ
76 52616 SUWARSI 1/13/2022 BPJS RJ
77 49390 MARTI 1/13/2022 BPJS RJ
78 50352 SRI SARTINI 1/13/2022 BPJS RJ
79 53560 RANTI 1/13/2022 BPJS RJ
80 37374 SAMINEM 1/13/2022 BPJS RJ
81 38349 ARI SRIJONO 1/13/2022 BPJS RJ
82 44531 SARNI 1/13/2022 BPJS RJ
83 40755 SUKENI 1/13/2022 BPJS RJ
84 49013 SIGIT HARTONO 1/13/2022 BPJS RJ
85 54008 LASI 1/13/2022 BPJS RJ
86 40355 MUKMINAH 1/13/2022 BPJS RJ
87 54013 SINTIA WATI 1/13/2022 BPJS RJ
88 46513 SUKATI 1/13/2022 BPJS RJ
89 52289 LASIMAN 1/13/2022 BPJS RJ
90 54015 WARIYEM 1/13/2022 BPJS RJ
91 54010 SUHARTINI 1/13/2022 BPJS RJ
92 50660 SUMIYATI 1/18/2022 BPJS RJ
93 48259 KASIMIN 1/18/2022 BPJS RJ
94 53842 TUKIYEM 1/18/2022 BPJS RJ
95 53841 YUSTINA B 1/18/2022 BPJS RJ
131 54405 SUPARNI 1/20/2022 BPJS RJ

132 51031 ISMI 1/20/2022 BPJS RJ
133 46616 SUYATMI 1/20/2022 BPJS RI
134 54423 SUNAR 1/25/2022 BPJS RJ
135 54064 KARTI ASTUTI 1/25/2022 BPJS RJ
136 46636 PARSI 1/25/2022 BPJS RJ
137 47070 SRI SUPARMI 1/25/2022 BPJS RJ
138 48628 MARUTO 1/25/2022 BPJS RJ
139 49857 KURNIANTO 1/25/2022 BPJS RJ
140 50188 SUPARMAN 1/25/2022 BPJS RJ
141 54668 MARNI 1/25/2022 BPJS RJ
142 49445 SRI SUYANTI 1/25/2022 BPJS RJ
143 49444 SUNARDI 1/25/2022 BPJS RJ
144 52511 MARNO 1/25/2022 BPJS RJ
145 51939 SUNDARI 1/25/2022 BPJS RJ
146 43932 SURANTO 1/25/2022 BPJS RJ
147 53163 SUYANTI 1/25/2022 BPJS RJ
148 50617 SULARMI 1/25/2022 BPJS RJ
149 44293 ENY WIDIASTUTI 1/25/2022 BPJS RJ
150 47323 RAHAYU 1/25/2022 BPJS RJ
151 52256 SLAMET 1/25/2022 BPJS RJ
152 43349 KUS BINMANTO 1/25/2022 BPJS RJ
153 53254 SAKINI 1/25/2022 BPJS RJ
154 46853 SOEDARTI 1/25/2022 BPJS RJ
155 38047 SARNO 1/25/2022 BPJS RJ
156 44208 HARTINI 1/25/2022 BPJS RJ
157 51984 MUKIMAN 1/25/2022 BPJS RJ
158 50838 SUGIYANTI 1/25/2022 BPJS RJ
159 54661 WASIKEM 1/25/2022 BPJS RJ
160 54545 PURWANTO 1/25/2022 BPJS RJ
161 54667 HARYANTO 1/25/2022 BPJS RJ
162 54572 SULINO 1/25/2022 BPJS RJ
163 54547 SITI YUHANI 1/25/2022 BPJS RJ
164 40539 WAKIDI 1/27/2022 BPJS RJ
165 53752 SUPARMI 1/27/2022 BPJS RI
PASIEN BPJS : 186

BPJS RAJAL : 182
BPJS RANAP :4
PASIEN UMUM :8
UMUM RAJAL :8
UMUM RANAP :-
PASIEN JASA RAHARJA RAJAL :2
TOTAL PASIEN : 196

POLIKLINIK SYARAF
MISNAHATI,Sp.S
AN JANUARI 2022

BAYAR RJ RI
31 40313 NGATEMI 1/6/2022 BPJS RJ
32 51646 INAWATI 1/6/2022 BPJS RJ
33 44209 SUKATNO 1/6/2022 BPJS RJ
34 33674 ROESTIYANTI 1/6/2022 BPJS RJ
35 39580 NGATINEM 1/6/2022 BPJS RJ
36 37673 SUWARTI 1/6/2022 BPJS RJ
37 51059 WIDODO 1/6/2022 BPJS RJ
38 45700 MAYA UNTARI 1/6/2022 BPJS RJ
39 53692 DIAH MARITI 1/6/2022 BPJS RJ
40 39663 MAHARANI 1/6/2022 BPJS RJ
41 42248 EKA WIDYANTI 1/6/2022 BPJS RJ
42 50470 JOKO SUPRAPTO 1/6/2022 BPJS RJ
43 51031 ISMI 1/6/2022 BPJS RJ
44 47424 MULAT YUDO 1/11/2022 BPJS RJ
45 52610 PARDIONO 1/11/2022 BPJS RJ
46 53561 KASIMIN 1/11/2022 BPJS RJ
47 53163 SUYANTI 1/11/2022 BPJS RJ
49 50393 WARDANI 1/11/2022 BPJS RJ
50 38303 SUMARDI ATMO 1/11/2022 BPJS RJ
51 38261 SEMAN MANTO 1/11/2022 BPJS RJ
53 53254 SAKINI 1/11/2022 BPJS RJ
54 50611 PURWANI PUJI 1/11/2022 BPJS RJ
55 52511 MARNO 1/11/2022 BPJS RJ
56 47323 RAHAYU 1/11/2022 BPJS RJ
57 40308 YOHANES SUPARTO 1/11/2022 BPJS RJ
58 52256 SLAMET 1/11/2022 BPJS RJ
59 53481 SANTOSO 1/11/2022 BPJS RJ
60 53841 YUSTINA B 1/11/2022 BPJS RJ
96 54192 SUKARNO 1/18/2022 BPJS RJ

97 52914 ANNISA MUSLIHATI 1/18/2022 BPJS RJ
99 49915 SUKARTI 1/18/2022 BPJS RJ
100 52814 HENDRI SRI 1/18/2022 BPJS RJ
101 53481 SANTOSO 1/18/2022 BPJS RJ
102 52071 SUKATMI 1/18/2022 BPJS RJ
103 48628 MARUTO SUYATMIN 1/18/2022 BPJS RJ
104 37514 SUMIYEM 1/20/2022 BPJS RJ
105 39169 ALI SUBKHAN 1/20/2022 BPJS RJ
106 52242 SULARNO 1/20/2022 BPJS RJ
107 54008 LASI 1/20/2022 BPJS RJ
108 41836 RIYANTO 1/20/2022 BPJS RJ
109 51060 SRI WALUYANINGSIH 1/20/2022 BPJS RJ
110 51436 NIHAYAH 1/20/2022 BPJS RJ
111 44209 SUKATNO 1/20/2022 BPJS RJ
112 53843 JIKEM 1/20/2022 BPJS RJ
113 41950 SUMARNI 1/20/2022 BPJS RJ
114 54022 SUMINI 1/20/2022 BPJS RJ
116 54010 SUHARTINI 1/20/2022 BPJS RJ
117 53560 RANTI 1/20/2022 BPJS RJ
118 45205 SRI WINARNA 1/20/2022 BPJS RJ
119 54299 FERAWATI 1/20/2022 BPJS RJ
120 43850 SOEPOYO 1/20/2022 BPJS RJ
121 50733 WARDI 1/20/2022 BPJS RJ
123 50867 SLAMET 1/20/2022 BPJS RJ
124 52443 SATIMAN 1/20/2022 BPJS RJ
125 33674 ROESTIYANTI 1/20/2022 BPJS RJ
126 54015 WARIYEM 1/20/2022 BPJS RJ
127 54013 SINTIA WATI 1/20/2022 BPJS RJ
128 39580 NGATINEM 1/20/2022 BPJS RJ
129 53608 PUJIATI 1/20/2022 BPJS RJ
130 38778 SUJIANI 1/20/2022 BPJS RJ
166 49592 MARMADI 1/27/2022 BPJS RJ

167 37019 SUWARDI TIGOR 1/27/2022 BPJS RJ
168 48856 TUGI 1/27/2022 BPJS RJ
169 52242 SULARNO 1/27/2022 BPJS RJ
170 41836 RIYANTO 1/27/2022 BPJS RJ
171 51060 SRI WALUYANINGSIH 1/27/2022 BPJS RJ
172 53843 JIKEM 1/27/2022 BPJS RJ
173 41950 SUMARNI 1/27/2022 BPJS RJ
175 53608 PUJIATI 1/27/2022 BPJS RJ
176 54299 FERAWATI 1/27/2022 BPJS RJ
177 52616 SUWARSI 1/27/2022 BPJS RJ
178 51085 LARTI 1/27/2022 BPJS RJ
179 49013 SIGIT HARTONO 1/27/2022 BPJS RJ
180 522510 SULARNI 1/27/2022 BPJS RJ
182 52961 TUMINI 1/27/2022 BPJS RJ
183 49390 MARTI 1/27/2022 BPJS RJ
184 46869 SRIYONO 1/27/2022 BPJS RJ
185 50403 PARNI 1/27/2022 BPJS RJ
186 46513 SUKATI 1/27/2022 BPJS RJ

BAYAR RJ RI
1 52487 SADINO MARTONO 1/4/2022 JR RJ
2 52487 SADINO MARTONO 1/11/2022 JR RJ

BAYAR RJ RI
1 49260 LAMBANG PURNOMO 1/6/2022 UMUM RJ
2 52668 SUPARMI 1/6/2022 UMUM RJ
3 46627 MARMI 1/6/2022 UMUM RJ
4 39169 ALI SUBKHAN 1/13/2022 UMUM RJ
5 54283 PARTINI 1/20/2022 UMUM RJ
6 49260 LAMBANG 1/20/2022 UMUM RJ
7 54571 NINO SEBASTIAN 1/25/2022 UMUM RJ
8 52289 LASIMAN 1/27/2022 UMUM RJ
LAPORAN RAWAT JALAN SPESIALIS ORTOPEDI
Drg. HIKMAH FAJAROSITA
BULAN JANUARI 2022
TANGG CARA KET

NO RM NAMA
AL BAYAR RJ RI
1 20580 ALIF BAD27/1/2022 UMUM RJ
2 54727 KARIJO 27/1/2022 UMUM RJ
TOTAL PASIEN = 2
UMUM RAJAL = 2
UMUM RANAP = -
LAPORAN RAWAT JALAN SPESIALIS ORTOPEDI
Dr.TWODY YUDIMAN, Sp.OT
BULAN JANUARI 2022
TANGG CARA KET

NO RM NAMA NO RM
AL BAYAR RJ RI
1 52456 MIRA 3/1/2022 BPJS RJ 1 51464
2 49412 RINEM 3/1/2022 BPJS RJ 2 53260
3 51286 INDIAH 3/1/2022 BPJS RJ 3 51858
4 51723 VERONIK 3/1/2022 BPJS RJ 4 52155
5 49546 SUNARTI 3/1/2022 BPJS RJ 5 53588
6 53197 WIDODO 3/1/2022 BPJS RJ 6 53565
7 37022 SUKAMTI 3/1/2022 BPJS RJ 7 53592
8 53434 TEGAR 3/1/2022 BPJS RJ 8 31405
9 52934 SUSILOW 3/1/2022 BPJS RJ 9 52412
10 49276 FAIDA 3/1/2022 BPJS RJ 10 52653
11 51510 SUWARN 3/1/2022 BPJS RJ 11 20236
12 41568 TRI HAN 3/1/2022 BPJS RJ 12 49381
13 49746 HERMAW 3/1/2022 BPJS RJ 13 50239
14 50926 SUMARN 3/1/2022 BPJS RJ 14 52685
15 52554 KASINO 3/1/2022 BPJS RJ 15 52629
16 53021 SANTI 3/1/2022 BPJS RJ 16 51084
17 51836 MUH. RIS 3/1/2022 BPJS RJ 17 53676
18 53541 DWIYAT 3/1/2022 BPJS RI 18 52481
19 52797 SUNARWI3/1/2022 BPJS RJ 19 53408
20 40689 PARAMIT 4/1/2022 BPJS RI 20 53153
21 48809 WANDI 4/1/2022 BPJS RJ 21 53732
22 40691 MULYANI4/1/2022 BPJS RJ 22 52872
23 53261 WIJI 4/1/2022 BPJS RJ 23 43180
24 52531 HESTI 4/1/2022 BPJS RJ 24 53595
25 42758 DIFA 4/1/2022 BPJS RI 25 53771
26 53308 FAJAR 4/1/2022 BPJS RJ 26 53374
27 35572 ERNI 4/1/2022 BPJS RJ 27 52434
28 52598 SUTIYATI4/1/2022 BPJS RJ 28 49070
29 42405 SULARNO4/1/2022 BPJS RJ 29 24909
30 41432 SUGIYAT 4/1/2022 BPJS RJ 30 52393
31 53047 SAMURI 4/1/2022 BPJS RJ 31 51356
32 51574 NANANG 4/1/2022 BPJS RI 32 53345
33 52594 SARTINI 4/1/2022 BPJS RJ 33 52817
34 51397 LASMI 4/1/2022 BPJS RJ 34 53856
35 50040 SRI WAH 4/1/2022 BPJS RJ 35 27280
36 52831 SUTARDI 4/1/2022 BPJS RJ 36 53260
37 53008 INDAH 4/1/2022 BPJS RJ 37 27284
38 52372 RIYANTI 4/1/2022 BPJS RJ 38 31406
39 50179 SUMIYEM4/1/2022 BPJS RJ 39 51858
40 50180 MUKTAM 4/1/2022 BPJS RJ 40 53924
41 50285 WARIJAN 4/1/2022 BPJS RJ 41 52686
42 49927 YATMI 4/1/2022 BPJS RJ 42 53596
43 42211 BENI 4/1/2022 BPJS RJ 43 53598
44 53426 ANANDA 4/1/2022 BPJS RJ 44 20326
45 53579 SUYATMI 4/1/2022 BPJS RJ 45 50388
46 52736 SUDIMAN4/1/2022 BPJS RJ 46 52947
47 36720 SUPRIYAT4/1/2022 BPJS RJ 47 54019
48 50219 INDRIYA 4/1/2022 BPJS RJ 48 53195
49 43530 RAYANA 4/1/2022 BPJS RJ 49 52905
50 53562 SUMIYAT 4/1/2022 BPJS RJ 50 10246
51 53033 TRI MAST4/1/2022 BPJS RJ 51 53732
52 52519 SUMIYEM4/1/2022 BPJS RJ 52 53408
53 52508 WURINI 4/1/2022 BPJS RJ 53 53770
54 37301 SUPARNI 4/1/2022 BPJS RJ 54 39555
55 51074 SUGINO 4/1/2022 BPJS RJ 55 35326
56 53588 PUPUT 4/1/2022 BPJS RJ 56 51689
57 52532 SANTI 4/1/2022 BPJS RJ 57 53781
58 53207 KHAIRUL 4/1/2022 BPJS RJ 58 52946
59 53645 GIYEM 5/1/2022 BPJS RI 59 39161
60 39143 HAKIM 5/1/2022 BPJS RJ 60 52414
61 52619 RIMBANI 5/1/2022 BPJS RJ 61 53593
62 49880 PAITEM 5/1/2022 BPJS RJ 62 54403
63 53084 WIJIANTO5/1/2022 BPJS RJ 63 54223
64 52523 KASMIN 5/1/2022 BPJS RJ 64 45268
65 53072 MAULAN 5/1/2022 BPJS RJ 65 53563
66 520001 DWI IND 5/1/2022 BPJS RJ 66 51689
67 52580 PAIDI 5/1/2022 BPJS RJ 67 53836
68 53613 SARTIYA 5/1/2022 BPJS RJ 68 54247
69 53010 ANANDA 5/1/2022 BPJS RJ 69 54244
70 49590 SUNIYEM 5/1/2022 BPJS RJ 70 53598
71 52573 TUYEM 5/1/2022 BPJS RJ 71 54091
72 50505 MUH. RAS5/1/2022 BPJS RJ 72 53598
73 52838 NARYATI 5/1/2022 BPJS RJ 73 50340
74 38065 UMI 5/1/2022 BPJS RJ 74 54316
75 52335 SUYATMI 5/1/2022 BPJS RJ 75 51465
76 53615 YATI 5/1/2022 BPJS RI 76 53911
77 52252 MARIDI 6/1/2022 BPJS RJ 77 52626
78 53669 SITI 6/1/2022 BPJS RJ 78 28822
79 53369 SUHARDI 6/1/2022 BPJS RJ 79 50790
80 40625 SUTARNI 6/1/2022 BPJS RJ 80 54375
81 52613 NOVAL 6/1/2022 BPJS RJ 81 54035
82 51309 SATRIA 6/1/2022 BPJS RI 82 53770
83 40495 QUMAIRA6/1/2022 BPJS RJ 83 53781
84 53363 SUGENG 6/1/2022 BPJS RJ 84 54520
85 52123 GATOT 6/1/2022 BPJS RJ 85 54348
86 53169 KATIEM 6/1/2022 BPJS RJ 86 54515
87 52118 MARIA 6/1/2022 BPJS RJ 87 54510
88 36153 PARTI 6/1/2022 BPJS RJ 88 27518
89 53347 JUWARIA 6/1/2022 BPJS RJ 89 27284
90 40290 AISYAH 6/1/2022 BPJS RI 90 27284
91 47699 PARIYEM 6/1/2022 BPJS RJ 91 54555
92 50260 GIYARTO 6/1/2022 BPJS RJ 92 54565
93 36630 ERNI 6/1/2022 BPJS RJ 93 50636
94 46341 WINARNI 6/1/2022 BPJS RJ 94 54327
95 43351 PARJAN 6/1/2022 BPJS RJ 95 40495
96 51029 SUTINI 6/1/2022 BPJS RJ 96 53260
97 47191 SRI WAH 6/1/2022 BPJS RJ 97 50802
98 51094 SUPRAPT 6/1/2022 BPJS RJ 98 54238
99 46616 SUTIYEM 6/1/2022 BPJS RJ 99 52473
100 36511 DIJASAN 6/1/2022 BPJS RJ 100 54230
101 50637 TRI MURN6/1/2022 BPJS RJ 101 53915
102 53667 SUGENG 6/1/2022 BPJS RJ 102 54748
103 53105 SURATMI 6/1/2022 BPJS RJ 103 54073
104 53079 FAJAR 6/1/2022 BPJS RJ 104 51602
105 53077 SAKINEM 6/1/2022 BPJS RJ 105 52905
106 53688 KARMI 6/1/2022 BPJS RJ 106 10246
107 51095 ROSYID 7/1/2022 BPJS RJ 107 54318
108 52481 ALDI 7/1/2022 BPJS RJ 108 54785
109 51125 TITI 7/1/2022 BPJS RJ 109 54285
110 50351 SRI IRIA 7/1/2022 BPJS RJ 110 54292
111 54470 TRIYANT 7/1/2022 BPJS RJ 111 54305
112 53337 MARYON 7/1/2022 BPJS RJ 112 54341
113 47775 SUKATNO7/1/2022 BPJS RJ 113 54466
114 40780 MARDIMI 7/1/2022 BPJS RJ 114 35326
115 39770 SILFESTE 7/1/2022 BPJS RJ 115 54326
116 42892 YUSUF 7/1/2022 BPJS RJ 116 54035
117 48725 KASTIYA 7/1/2022 BPJS RJ 117 54384
118 52483 MARWAN7/1/2022 BPJS RJ 118 39161
119 42219 SITI 7/1/2022 BPJS RJ 119 54862
120 38989 SUMARMI7/1/2022 BPJS RJ 120 53593
121 38835 SRI MULY7/1/2022 BPJS RJ
122 52664 KENDRA 7/1/2022 BPJS RJ
123 48812 SRI ATUN 7/1/2022 BPJS RJ
124 52686 DHARMA 7/1/2022 BPJS RJ
125 52818 SUMARY 7/1/2022 BPJS RJ
126 52995 ZIDAN 7/1/2022 BPJS RJ
127 50689 NASIRUN 7/1/2022 BPJS RJ
128 37795 MIKEM 7/1/2022 BPJS RJ
129 53668 CICIK 7/1/2022 BPJS RJ
NO RM
NO RM
130 44827 MULYO 7/1/2022 BPJS RJ
131 53432 SURATMI 8/1/2022 BPJS RJ 1 52487
132 54408 WARDI 8/1/2022 BPJS RJ 2 45149
133 41467 YOSI 8/1/2022 BPJS RJ 3 53333
134 52340 SARMI 8/1/2022 BPJS RJ 4 46146
135 54414 RISKI 8/1/2022 BPJS RJ 5 50363
136 35326 SUNARTO8/1/2022 BPJS RJ 6 49600
137 52257 PAIMAN 8/1/2022 BPJS RI 7 52672
138 35142 KARTI 8/1/2022 BPJS RJ 8 44653
139 52981 DEWI 8/1/2022 BPJS RJ 9 42472
140 45691 SULARTI 8/1/2022 BPJS RJ 10 52282
141 50951 PONO 8/1/2022 BPJS RJ 11 48873
142 46909 KARDIMA8/1/2022 BPJS RJ 12 48763
143 36013 KARIJEM 8/1/2022 BPJS RJ 13 52754
144 50065 NOVEL 8/1/2022 BPJS RJ 14 51554
145 50830 SUWARN 8/1/2022 BPJS RJ 15 51885
146 46181 SUNARTI 8/1/2022 BPJS RJ 16 53006
147 53752 SUPARMI 8/1/2022 BPJS RJ 17 51551
148 39303 WAGIMIN8/1/2022 BPJS RJ 18 48811
149 41582 SRI SUND 8/1/2022 BPJS RJ 19 52488
150 49621 GALIP 8/1/2022 BPJS RJ 20 53653
151 53012 SUTINEM 8/1/2022 BPJS RJ 21 44653
152 53339 SURAJA 8/1/2022 BPJS RJ 22 52282
153 53772 CHINTYA 8/1/2022 BPJS RJ 23 51544
154 46000 NASIB 8/1/2022 BPJS RJ 24 50363
155 39367 SEMANTO10/1/2022 BPJS RJ 25 53608
156 44396 PANTES 10/1/2022 BPJS RJ 26 53551
157 36917 SUMARMI10/1/2022 BPJS RJ 27 53653
158 51270 ANI 10/1/2022 BPJS RJ 28 44653
159 53478 YONKY 10/1/2022 BPJS RJ 29 49253
160 53498 SRIYONO10/1/2022 BPJS RJ 30 54023
161 53831 MAIYUNA10/1/2022 BPJS RJ 31 53006
162 50105 SARI 10/1/2022 BPJS RJ 32 53304
163 53437 KHOIRUL10/1/2022 BPJS RJ 33 49465
164 53800 SARIKEM10/1/2022 BPJS RI 34 54227
165 49879 NANIK 10/1/2022 BPJS RJ 35 54273
166 46575 KARNOM10/1/2022 BPJS RJ 36 36085
167 40632 WASTINI 10/1/2022 BPJS RI 37 54146
168 51496 RONI 10/1/2022 BPJS RJ 38 54254
169 52456 MYRA 10/1/2022 BPJS RJ 39 51574
170 53795 SRI HARJ 10/1/2022 BPJS RJ 40 48554
171 44726 SULARDI 10/1/2022 BPJS RJ
172 35676 AGUS 10/1/2022 BPJS RJ
173 40320 SUMARMI10/1/2022 BPJS RJ
174 53218 YOHANES10/1/2022 BPJS RJ
175 42167 TADICHA10/1/2022 BPJS RJ
176 52710 NGADINE11/1/2022 BPJS RJ
177 52547 UBAIDIL 11/1/2022 BPJS RJ
178 50942 SUNARTI 11/1/2022 BPJS RJ
179 51353 HENING 11/1/2022 BPJS RJ TOTAL PASIEN = 710
180 51350 SUKASTIN11/1/2022 BPJS RJ TOTAL PASIEN BPJS = 550
181 53426 ANANDA 11/1/2022 BPJS RJ BPJS RAJAL = 509
182 48219 KHADAFI11/1/2022 BPJS RJ BPJS RANAP = 41
183 50448 SATINAH11/1/2022 BPJS RJ TOTAL PASIEN UMUM = 120
184 53082 EKO 11/1/2022 BPJS RJ UMUM RAJAL = 116
185 23993 KUSTINI 11/1/2022 BPJS RJ UMUM RANAP = 4
186 45986 WARJO 11/1/2022 BPJS RJ TOTAL PASIEN JASARAHARJA =
187 51667 NATHAN 11/1/2022 BPJS RJ JASARAHARJA RAJAL = 36
188 46296 SUTARTI 11/1/2022 BPJS RJ JASARAHARJA RANAP= 4
189 51885 ILHAM 11/1/2022 BPJS RJ
190 49408 MEISENL 11/1/2022 BPJS RI
191 44570 TUMI 11/1/2022 BPJS RJ
192 52496 SUKIYEM11/1/2022 BPJS RJ
193 52751 SUKINAH11/1/2022 BPJS RJ
194 53321 MULYANI11/1/2022 BPJS RJ
195 52604 AMAT 11/1/2022 BPJS RJ
196 53006 SULASMI11/1/2022 BPJS RJ
197 53844 FAJAR 11/1/2022 BPJS RJ
198 37034 KONEM 11/1/2022 BPJS RJ
199 50225 SRI UTAM11/1/2022 BPJS RJ
200 53318 SUMARNI11/1/2022 BPJS RJ
201 52736 SUDIMAN11/1/2022 BPJS RJ
202 57220 SURATMI11/1/2022 BPJS RJ
203 53197 WIDODO 11/1/2022 BPJS RJ
204 34934 SRI PUR 11/1/2022 BPJS RJ
205 53540 WARIJEM11/1/2022 BPJS RJ
206 53322 SUTIJO 11/1/2022 BPJS RJ
207 53848 JUANITA 11/1/2022 BPJS RJ
208 53858 EKA NOV11/1/2022 BPJS RJ
209 53308 FAJAR 11/1/2022 BPJS RJ
210 53870 DEWI 11/1/2022 BPJS RJ
211 53930 IBRAHIM 12/1/2022 BPJS RJ
212 51830 GIJANTO 12/1/2022 BPJS RJ
213 52203 DJUMINE12/1/2022 BPJS RJ
214 53366 JOKO 12/1/2022 BPJS RJ
215 53545 SURATIN 12/1/2022 BPJS RJ
216 40683 PARAMIT12/1/2022 BPJS RJ
217 53895 DARYON 12/1/2022 BPJS RJ
218 53894 SRI SUNA12/1/2022 BPJS RJ
219 53541 DWIYAT 12/1/2022 BPJS RJ
220 53926 BAGUS 12/1/2022 BPJS RI
221 48811 INTAN 12/1/2022 BPJS RJ
222 42114 SADIKIN 12/1/2022 BPJS RJ
223 42758 DIVA 12/1/2022 BPJS RJ
224 49872 SUMARIY12/1/2022 BPJS RJ
225 51225 SRI DJAR 12/1/2022 BPJS RJ
226 53368 SAMINO 12/1/2022 BPJS RJ
227 37438 MUH. FAI12/1/2022 BPJS RJ
228 520001 DWI IND 13/1/2022 BPJS RI
229 53768 REFANZA13/1/2022 BPJS RJ
230 53352 MARIDI 13/1/2022 BPJS RJ
231 53528 KEMIYAT13/1/2022 BPJS RJ
232 50400 SULARMI13/1/2022 BPJS RJ
233 51708 SUYEM 13/1/2022 BPJS RJ
234 53643 RAJIKEM 13/1/2022 BPJS RJ
235 40625 SUHARDI13/1/2022 BPJS RJ
236 48186 RISKI 13/1/2022 BPJS RJ
237 41836 RIYANTO13/1/2022 BPJS RJ
238 52844 KARIDI 13/1/2022 BPJS RJ
239 54006 MANIDI 13/1/2022 BPJS RJ
240 52029 PARJAN 13/1/2022 BPJS RJ
241 54018 TARWI 13/1/2022 BPJS RJ
242 53347 PARTI 13/1/2022 BPJS RJ
243 54412 SUPATMI13/1/2022 BPJS RJ
244 54406 PURYANT13/1/2022 BPJS RJ
245 53364 KATIMAN13/1/2022 BPJS RJ
246 48381 TITIK 13/1/2022 BPJS RJ
247 52276 SRI HAR 13/1/2022 BPJS RJ
248 40856 PAIKEM 13/1/2022 BPJS RJ
249 54011 YULI 13/1/2022 BPJS RJ
250 53363 QUMAIRA13/1/2022 BPJS RJ
251 40862 MIKEM 14/1/2022 BPJS RI
252 47611 BUDI 14/1/2022 BPJS RJ
253 51336 HIRO 14/1/2022 BPJS RJ
254 48779 MADIYAN14/1/2022 BPJS RI
255 33733 SAKINEM14/1/2022 BPJS RI
256 47699 AISYAH 14/1/2022 BPJS RJ
257 50466 TUMIYAT14/1/2022 BPJS RJ
258 50193 ROSYID 14/1/2022 BPJS RJ
259 53337 MARYON14/1/2022 BPJS RJ
260 50242 WAGINE 14/1/2022 BPJS RJ
261 38204 TUKIMEN14/1/2022 BPJS RJ
262 53645 GIYEM 14/1/2022 BPJS RJ
263 51978 SUKADI 14/1/2022 BPJS RJ
264 49388 SUTARNO14/1/2022 BPJS RJ
265 37216 SUTINEM14/1/2022 BPJS RJ
266 53703 GIRI 14/1/2022 BPJS RJ
267 52373 SUGIYART 14/1/2022 BPJS RJ
268 46237 SUMIKEM14/1/2022 BPJS RJ
269 51717 BERLIAN 14/1/2022 BPJS RJ
270 51716 LILIS 14/1/2022 BPJS RJ
271 51409 SRI WIDO14/1/2022 BPJS RJ
272 528872 KARIYEM14/1/2022 BPJS RJ
273 54021 ANISA 15/1/2022 BPJS RI
274 533432 SURATMI15/1/2022 BPJS RJ
275 53615 YATI 15/1/2022 BPJS RJ
276 5729 SELFIA 15/1/2022 BPJS RJ
277 36915 TAYEM 15/1/2022 BPJS RJ
278 39797 SILFESTE15/1/2022 BPJS RJ
279 54408 WARDI 15/1/2022 BPJS RJ
280 48842 ENI 15/1/2022 BPJS RJ
281 46740 SITI MAR15/1/2022 BPJS RJ
282 43366 TUGI WAS15/1/2022 BPJS RJ
283 53036 JUMADI 15/1/2022 BPJS RJ
284 52848 TUKIYEM15/1/2022 BPJS RJ
285 52340 SARMI 15/1/2022 BPJS RJ
286 54407 TRIYANT15/1/2022 BPJS RJ
287 54076 KRISERI 15/1/2022 BPJS RJ
288 52899 SUMARNI15/1/2022 BPJS RJ
289 51467 YOSI 15/1/2022 BPJS RJ
290 53445 PANIYEM15/1/2022 BPJS RJ
291 53771 SUPARMI15/1/2022 BPJS RJ
292 41880 SITI 15/1/2022 BPJS RJ
293 54070 SULARTI 15/1/2022 BPJS RJ
294 4337 MARSITI 15/1/2022 BPJS RJ
295 28971 ADARA 15/1/2022 BPJS RJ
296 35596 JAVIAR 15/1/2022 BPJS RJ
297 54103 AGUS 15/1/2022 BPJS RJ
298 54106 TULARNI15/1/2022 BPJS RJ
299 38297 KUSNARI15/1/2022 BPJS RI
300 54075 IWAT 15/1/2022 BPJS RJ
301 37580 TIYARNO15/1/2022 BPJS RJ
302 51413 ANUT 17/1/2022 BPJS RJ
303 337022 SUKAMTI17/1/2022 BPJS RJ
304 39112 SRI PINIL17/1/2022 BPJS RJ
305 52760 KARTI 17/1/2022 BPJS RJ
306 51907 APRI 17/1/2022 BPJS RJ
307 53776 SUWARMI17/1/2022 BPJS RJ
308 53787 SUTIMAN17/1/2022 BPJS RJ
309 53728 SAMINI 17/1/2022 BPJS RJ
310 38065 UMI 17/1/2022 BPJS RJ
311 48358 MARDI 17/1/2022 BPJS RI
312 522181 SIGIT 17/1/2022 BPJS RJ
313 508818 SRI SUPA17/1/2022 BPJS RJ
314 422763 PARJINE 17/1/2022 BPJS RJ
315 10176 GANESA 17/1/2022 BPJS RJ
316 43543 WARTINI 17/1/2022 BPJS RJ
317 53498 SRIYONO17/1/2022 BPJS RJ
318 46381 GANDI 17/1/2022 BPJS RJ
319 52554 KASINO 17/1/2022 BPJS RJ
320 SRI REJEK17/1/2022 BPJS RJ
321 54163 ERNA 17/1/2022 BPJS RI
322 51723 VERONIK17/1/2022 BPJS RI
323 52598 SUTIYATI18/1/2022 BPJS RJ
324 49303 TUMIRAH18/1/2022 BPJS RJ
325 49408 MAYSENL18/1/2022 BPJS RJ
326 53008 INDAH 18/1/2022 BPJS RJ
327 42211 BENI 18/1/2022 BPJS RJ
328 40632 WASTINI 18/1/2022 BPJS RJ
329 53817 WAKINO 18/1/2022 BPJS RJ
330 53047 SAMURI 18/1/2022 BPJS RJ
331 53800 SARIKEM18/1/2022 BPJS RJ
332 53783 TUGIYEM18/1/2022 BPJS RJ
333 48781 MARYATI18/1/2022 BPJS RJ
334 40495 SATRIA 18/1/2022 BPJS RJ
335 35566 SUKINEM18/1/2022 BPJS RJ
336 35608 RUSMINI 18/1/2022 BPJS RJ
337 54205 SADIYEM18/1/2022 BPJS RI
338 46180 SUTARTI 18/1/2022 BPJS RJ
339 52500 SARTINI 18/1/2022 BPJS RJ
340 53343 WIJI 18/1/2022 BPJS RJ
341 50058 DINI 18/1/2022 BPJS RJ
342 53437 KHAIRUL18/1/2022 BPJS RJ
343 54193 SINEM, 18/1/2022 BPJS RJ
344 53207 KHAIRUL18/1/2022 BPJS RJ
345 53502 SUMIYAT18/1/2022 BPJS RJ
346 54073 SRI WARN18/1/2022 BPJS RJ
347 52063 NANIK 18/1/2022 BPJS RJ
348 54218 SUTINI 18/1/2022 BPJS RJ
349 37799 RETNO 18/1/2022 BPJS RJ
350 41432 SUGIYAT18/1/2022 BPJS RJ
351 532261 WIJI 18/1/2022 BPJS RJ
352 40071 WARTIYE18/1/2022 BPJS RI
353 53926 BAGUS 21/1/2022 BPJS RJ
354 40780 MARIDIM21/1/2022 BPJS RJ
355 52046 SUMARNI21/1/2022 BPJS RJ
356 54333 ANGGITA21/1/2022 BPJS RI
357 477699 AISYAH 21/1/2022 BPJS RJ
358 54248 BINA 21/1/2022 BPJS RI
359 52483 MARWAN21/1/2022 BPJS RJ
360 53531 MEI 21/1/2022 BPJS RJ
361 52874 DARMO 21/1/2022 BPJS RJ
362 52001 DWI IND 21/1/2022 BPJS RJ
363 53645 TUKIRAN21/1/2022 BPJS RJ
364 522816 GIYEM 21/1/2022 BPJS RJ
365 53703 GIRI 21/1/2022 BPJS RJ
366 17799 NABIL 21/1/2022 BPJS RJ
367 35596 JAVIAR 22/1/2022 BPJS RI
368 40377 NARNI 22/1/2022 BPJS RI
369 54382 SUTOPO 22/1/2022 BPJS RI
370 51333 SARDI 22/1/2022 BPJS RJ
371 40682 MIKEM 22/1/2022 BPJS RJ
372 48779 MARDIAN22/1/2022 BPJS RJ
373 54029 HERI 22/1/2022 BPJS RJ
374 53615 YATI 22/1/2022 BPJS RJ
375 54002 SUKADI 22/1/2022 BPJS RJ
376 42587 SUWAJI 22/1/2022 BPJS RJ
377 37820 SRI MARY22/1/2022 BPJS RJ
378 35142 KARTI 22/1/2022 BPJS RJ
379 49788 GABRIEL 22/1/2022 BPJS RJ
380 54084 KRISTAN 22/1/2022 BPJS RJ
381 50247 WAKINAH22/1/2022 BPJS RJ
382 49775 SITI MILI 22/1/2022 BPJS RI
383 43150 PAIJEM 22/1/2022 BPJS RJ
384 53774 KARIYEM22/1/2022 BPJS RJ
385 450017 SAMIYEM22/1/2022 BPJS RJ
386 52613 SUTARNI 22/1/2022 BPJS RJ
387 40795 SURANTO22/1/2022 BPJS RJ
388 46191 SUNARTI 22/1/2022 BPJS RJ
389 54383 MARYANI22/1/2022 BPJS RJ
390 36302 JUMINI 22/1/2022 BPJS RJ
391 51152 SADIYEM24/1/2022 BPJS RJ
392 53362 PURWANT24/1/2022 BPJS RJ
393 54097 MULYATI24/1/2022 BPJS RJ
394 49210 SADIYAH24/1/2022 BPJS RJ
395 52718 RINI 24/1/2022 BPJS RJ
396 53831 MEYUNAT 24/1/2022 BPJS RJ
397 510105 SARI 24/1/2022 BPJS RJ
398 54113 HERI 24/1/2022 BPJS RJ
399 54021 ANISA 24/1/2022 BPJS RJ
400 53728 SAMINI 24/1/2022 BPJS RJ
401 53788 SRI HARJ 24/1/2022 BPJS RJ
402 53010 ANANDA 24/1/2022 BPJS RJ
403 52269 LOSO 24/1/2022 BPJS RJ
404 40320 SUMARNI24/1/2022 BPJS RJ
405 49207 TRI HARY24/1/2022 BPJS RJ
406 53218 YOHANES24/1/2022 BPJS RJ
407 40100 TUKIRAN24/1/2022 BPJS RJ
408 53776 SUWARNI24/1/2022 BPJS RJ
409 39182 SEMMI 24/1/2022 BPJS RJ
410 51477 WARNI 24/1/2022 BPJS RJ
411 15474 BALKIS 24/1/2022 BPJS RJ
412 54756 PAIMIN 25/1/2022 BPJS RI
413 50194 DARSONO25/1/2022 BPJS RI
414 54122 ALBERT 25/1/2022 BPJS RI
415 52456 UBAIDIL 25/1/2022 BPJS RJ
416 54561 FRANSIS 25/1/2022 BPJS RI
417 38297 KUSNARI25/1/2022 BPJS RJ
418 52831 SUTARDI 25/1/2022 BPJS RJ
419 54095 INDAH 25/1/2022 BPJS RJ
420 48358 MARDI 25/1/2022 BPJS RJ
421 53848 JUWANIT25/1/2022 BPJS RJ
422 51444 SITI 25/1/2022 BPJS RJ
423 54671 KASMI 25/1/2022 BPJS RI
424 37034 KONEM, 25/1/2022 BPJS RJ
425 52496 SUKIYEM25/1/2022 BPJS RJ
426 54164 ERNA 25/1/2022 BPJS RJ
427 40632 WASTINI 25/1/2022 BPJS RJ
428 52736 SUDIMAN25/1/2022 BPJS RJ
429 40588 SRI SUYA25/1/2022 BPJS RJ
430 50942 SUMATI 25/1/2022 BPJS RJ
431 44570 TUMI 25/1/2022 BPJS RJ
432 49408 MEYSENL25/1/2022 BPJS RJ
433 52732 RIYANTI 25/1/2022 BPJS RJ
434 50633 MARDATM 25/1/2022 BPJS RJ
435 53318 SUMARNI25/1/2022 BPJS RJ
436 459662 TUMIYEM25/1/2022 BPJS RJ
437 52934 SUSILOW25/1/2022 BPJS RJ
438 54559 HARYANT25/1/2022 BPJS RJ
439 54560 YATMI 25/1/2022 BPJS RJ
440 33733 SAKIMAN25/1/2022 BPJS RJ
441 53817 WAKINO 25/1/2022 BPJS RJ
442 50551 TUKINI 25/1/2022 BPJS RJ
443 54675 SRI WAH 25/1/2022 BPJS RJ
444 54671 KASMI 26/1/2022 BPJS RI
445 46740 SITI MAR26/1/2022 BPJS RJ
446 53894 SRI SUNA26/1/2022 BPJS RJ
447 40071 WARTIYE26/1/2022 BPJS RJ
448 54231 ALEX 26/1/2022 BPJS RJ
449 53366 JOKO 26/1/2022 BPJS RJ
450 41135 BUDI 26/1/2022 BPJS RJ
451 51225 SRI JARW26/1/2022 BPJS RJ
452 54690 UTAMI 26/1/2022 BPJS RJ
453 53800 SARIKEM26/1/2022 BPJS RJ
454 39157 SUMIJATI26/1/2022 BPJS RJ
455 42114 SADIKIN 26/1/2022 BPJS RJ
456 54692 ZANETA 26/1/2022 BPJS RJ
457 54709 MARYAT 26/1/2022 BPJS RJ
458 54691 SARTINII 26/1/2022 BPJS RJ
459 44183 KANTIYE26/1/2022 BPJS RJ
460 39446 KARJO 26/1/2022 BPJS RJ
461 54728 NUNIK 27/1/2022 BPJS RI
462 54172 SARIYAN27/1/2022 BPJS RJ
463 48595 WARSIYA27/1/2022 BPJS RJ
464 54194 ADITYA 27/1/2022 BPJS RJ
465 42047 YUSUF 27/1/2022 BPJS RJ
466 52177 MARINO 27/1/2022 BPJS RI
467 53347 SUHARNO27/1/2022 BPJS RJ
468 49074 WARTI 27/1/2022 BPJS RJ
469 54018 TARWI 27/1/2022 BPJS RJ
470 54194 ADITYA 27/1/2022 BPJS RJ
471 39298 LATINEM27/1/2022 BPJS RJ
472 54412 SUPATMI27/1/2022 BPJS RJ
473 30508 SUKINO 27/1/2022 BPJS RJ
474 53364 KATIMAN27/1/2022 BPJS RJ
475 51723 VERONIK27/1/2022 BPJS RJ
476 54272 SRIYATM27/1/2022 BPJS RJ
477 20236 ADRAFA 27/1/2022 BPJS RJ
478 40856 PAINEM 27/1/2022 BPJS RJ
479 40594 MARINO 27/1/2022 BPJS RJ
480 53768 RINANZA27/1/2022 BPJS RJ
481 53357 ERNA 27/1/2022 BPJS RJ
482 54726 KIYEM 27/1/2022 BPJS RJ
483 36536 SUWARSI27/1/2022 BPJS RJ
484 54740 SUFI 27/1/2022 BPJS RJ
485 54745 PAIKEM 27/1/2022 BPJS RJ
486 54006 MANIDI 27/1/2022 BPJS RJ
487 46736 SUKARTI 27/1/2022 BPJS RJ
488 51956 SARJONO29/1/2022 BPJS RJ
489 53432 SURATMI29/1/2022 BPJS RJ
490 53445 PANIYEM29/1/2022 BPJS RJ
491 41810 SITI 29/1/2022 BPJS RJ
492 52899 SUMARNI29/1/2022 BPJS RJ
493 54248 BINA 29/1/2022 BPJS RJ
494 52149 KATINI 29/1/2022 BPJS RJ
495 53771 SUPARMI29/1/2022 BPJS RJ
496 40662 MIKEM 29/1/2022 BPJS RJ
497 48779 MADIYAN29/1/2022 BPJS RJ
498 54072 IWAT 29/1/2022 BPJS RJ
499 54365 SARTITI 29/1/2022 BPJS RJ
500 40377 NARNI 29/1/2022 BPJS RJ
501 54333 ANGGITA29/1/2022 BPJS RJ
502 35596 JAVIAR 29/1/2022 BPJS RJ
503 49775 SITI MILI 29/1/2022 BPJS RJ
504 54392 SUJATMI 29/1/2022 BPJS RJ
505 39794 RINANZA29/1/2022 BPJS RJ
506 54355 BENEDIK29/1/2022 BPJS RJ
507 51721 SUTRIMIY29/1/2022 BPJS RJ
508 54176 TULARNI29/1/2022 BPJS RJ
509 54076 KRISERI 29/1/2022 BPJS RJ
510 54029 HERI 29/1/2022 BPJS RJ
511 54408 WARDI 29/1/2022 BPJS RJ
512 54817 ATIFAH 29/1/2022 BPJS RJ
513 49142 NINING 29/1/2022 BPJS RJ
514 54002 SUKADI 29/1/2022 BPJS RJ
515 54816 AMRIANI29/1/2022 BPJS RJ
516 40351 GIYANTO29/1/2022 BPJS RI
517 50129 SINO 29/1/2022 BPJS RJ
518 50577 UHATI 29/1/2022 BPJS RJ
519 49833 SURYANI29/1/2022 BPJS RJ
520 54205 SAADIYE28/1/2022 BPJS RJ
521 45881 JOKO 28/1/2022 BPJS RJ
522 54000 SUPARTI 28/1/2022 BPJS RJ
523 39521 SUDARYA28/1/2022 BPJS RJ
524 53926 BAGUS 28/1/2022 BPJS RJ
525 5000 LASMINI 28/1/2022 BPJS RJ
526 49800 SUMARMI28/1/2022 BPJS RJ
527 50466 TUMIYAT28/1/2022 BPJS RJ
528 50242 WAGINE 28/1/2022 BPJS RJ
529 53772 BAYU 28/1/2022 BPJS RJ
530 52001 DWI 28/1/2022 BPJS RJ
531 49375 PAINO 28/1/2022 BPJS RJ
532 35427 SRI HATM28/1/2022 BPJS RJ
533 54769 RACHEL 28/1/2022 BPJS RJ
534 46636 PARSI 31/1/2022 BPJS RJ
535 52369 SUROJI 31/1/2022 BPJS RJ
536 54882 SUTOPO 31/1/2022 BPJS RJ
537 42703 SUHARMI31/1/2022 BPJS RI
538 44760 HARTATI31/1/2022 BPJS RJ
539 59112 SRI PINIL31/1/2022 BPJS RJ
540 53875 ANTANAS31/1/2022 BPJS RJ
541 54893 FINA 31/1/2022 BPJS RI
542 52444 HASANUD31/1/2022 BPJS RJ
543 53498 SRIYONO31/1/2022 BPJS RJ
544 45709 MARDIYA31/1/2022 BPJS RJ
545 37022 SUKAMTI31/1/2022 BPJS RJ
546 53436 MARNO 31/1/2022 BPJS RJ
547 49870 SLAMET 31/1/2022 BPJS RJ
548 54112 HERI 31/1/2022 BPJS RJ
549 ANA 31/1/2022 BPJS RJ
550 36313 MIYATI 31/1/2022 BPJS RJ
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SUSIANA 5/1/2022 JR RJ
PRATAMI 7/1/2022 JR RJ
SAFIOLA 7/1/2022 JR RJ
DONNA 8/1/2022 JR RI
SARJUNI 8/1/2022 JR RJ
PAIDI 10/1/2022 JR RJ
SUKIYEM10/1/2022 JR RJ
YENI 10/1/2022 JR RJ
TAUFIK 10/1/2022 JR RJ
TRI WUL 11/1/2022 JR RI
ILHAM 11/1/2022 JR RJ
SULASMI11/1/2022 JR RJ
ANNAS 12/1/2022 JR RJ
KARIDI 13/1/2022 JR RJ
TUMINI 14/1/2022 JR RJ
DONNA 15/1/2022 JR RJ
PAIDI 18/1/2022 JR RI
TRI WUL 19/1/1022 JR RJ
SUSIANA 19/1/1022 JR RJ
PUJIATI 19/1/1022 JR RJ
ANNAS 19/1/1022 JR RJ
TUMINI 21/1/2022 JR RJ
DONNA 22/1/2022 JR RJ
NINA 22/1/2022 JR RJ
CALVIN 24/1/2022 JR RJ
SULASMI25/1/2022 JR RJ
DESHINT 26/1/2022 JR RJ
TRISNO 27/1/2022 JR RJ
ADI 27/1/2022 JR RJ
PUJIATI 27/1/2022 JR RJ
NUR IND 27/1/2022 JR RJ
M HUSEI 28/1/2022 JR RJ
NANANG 28/1/2022 JR RJ
SAFIRA 31/1/2022 JR RJ
PASIEN = 710
PASIEN BPJS = 550
PASIEN UMUM = 120

RAJAL = 116
RANAP = 4
PASIEN JASARAHARJA = 40
HARJA RAJAL = 36
HARJA RANAP= 4
LAPORAN RAWAT JALAN SPESIALIS DALAM
Dr.RIEZKY YURRY R Sp.PD
BULAN JANUARI 2022
TANGG CARA KET
NO RM NAMA NO
AL BAYAR RJ RI
1 52462 SUMINO 3/1/2022 BPJS RJ 1
2 51963 SRI RUSM3/1/2022 BPJS RJ 2
3 53188 SRIYATI 3/1/2022 BPJS RJ 3
4 53372 MARJANT3/1/2022 BPJS RJ 4
5 53408 SUMIYAT 3/1/2022 BPJS RJ 5
6 45089 TARMI 3/1/2022 BPJS RJ 6
7 53538 PUJO 3/1/2022 BPJS RJ 7
8 53187 NANIK 3/1/2022 BPJS RJ 8
9 52725 NYAMAN 3/1/2022 BPJS RJ 9
10 52708 WIJIATI 3/1/2022 BPJS RJ 10
11 53411 KEMIYAT4/1/2022 BPJS RJ 11
12 53174 WIDODO 4/1/2022 BPJS RJ 12
13 52267 TUMIYEM4/1/2022 BPJS RJ 13
14 51728 SUKIYAH 4/1/2022 BPJS RI 14
15 53239 KADIMIN 4/1/2022 BPJS RJ 15
16 53629 TRIYONO 5/1/2022 BPJS RJ 16
17 53629 SUSANTO5/1/2022 BPJS RJ 17
18 53659 SURATMI 6/1/2022 BPJS RJ 18
19 44267 SUWART 6/1/2022 BPJS RJ 19
20 49760 ENIK 6/1/2022 BPJS RJ 20
21 52568 JUMIYAN 6/1/2022 BPJS RJ 21
22 52992 SUPRIH 6/1/2022 BPJS RJ 22
23 51560 TUTIK 6/1/2022 BPJS RJ 23
24 52139 NURLELY6/1/2022 BPJS RJ 24
25 53073 SUPARMI 6/1/2022 BPJS RJ 25
26 52950 TUGIYEM7/1/2022 BPJS RJ 26
27 52556 TRIYATM 7/1/2022 BPJS RJ 27
28 51440 MASRIFA 7/1/2022 BPJS RJ 28
29 52211 JARNO 9/1/2022 BPJS RJ 29
30 51688 TARMO 9/1/2022 BPJS RJ 30
31 39251 RIDHO 9/1/2022 BPJS RJ 31
32 52725 NYAMAN10/1/2022 BPJS RJ 32
33 53469 FEBRIAN 10/1/2022 BPJS RJ 33
34 51938 SUKIMO 10/1/2022 BPJS RJ 34
35 53804 SUPATMI10/1/2022 BPJS RJ 35
36 53813 TRI HARI 10/1/2022 BPJS RJ 36
37 53809 SULARNO10/1/2022 BPJS RJ 37
38 53810 TRIMANI 10/1/2022 BPJS RJ 38
39 52714 WIRYOTO10/1/2022 BPJS RJ 39
40 53188 SRIYATI 10/1/2022 BPJS RJ 40
41 53372 MARJANT10/1/2022 BPJS RJ 41
42 53451 SATINAH11/1/2022 BPJS RJ 42
43 52791 DWI RIYA11/1/2022 BPJS RJ 43
44 37014 SARTINI 11/1/2022 BPJS RJ 44
45 51406 SRIYANTI11/1/2022 BPJS RJ 45
46 52267 TUMIYEM11/1/2022 BPJS RJ 46
47 38719 SUTARMI11/1/2022 BPJS RJ 47
48 44769 SUNARDI11/1/2022 BPJS RJ 48
49 53892 TUKINEM12/1/2022 BPJS RJ 49
50 53913 SUPARMI12/1/2022 BPJS RJ 50
51 43184 MARLINA12/1/2022 BPJS RJ 51
52 53174 WIDODO 12/1/2022 BPJS RJ 52
53 53529 SRI HART13/1/2022 BPJS RJ 53
54 53660 MARYAN13/1/2022 BPJS RJ 54
55 51728 SUKIYAH13/1/2022 BPJS RJ 55
56 53659 SURATMI13/1/2022 BPJS RJ 56
57 49021 DWI YAN13/1/2022 BPJS RJ 57
58 52097 SRI RAH 13/1/2022 BPJS RJ 58
59 52670 MURNI 13/1/2022 BPJS RJ 59
60 52708 WIJIATI 13/1/2022 BPJS RJ 60
61 52246 WASI 13/1/2022 BPJS RI 61
62 52950 TUGIYEM14/1/2022 BPJS RI 62
63 54041 PARTINI 14/1/2022 BPJS RI 63
64 SRI HART14/1/2022 BPJS RJ 64
65 54047 MICHAEL14/1/2022 BPJS RJ 65
66 54038 NARTO 14/1/2022 BPJS RJ 66
67 53360 SURANTO14/1/2022 BPJS RJ 67
68 51440 MARIFAH14/1/2022 BPJS RJ 68
69 44606 TIYEM 14/1/2022 BPJS RJ 69
70 50988 SRI SULA15/1/2022 BPJS RJ 70
71 52303 KATIYEM15/1/2022 BPJS RJ 71
72 53679 JARNO 17/1/2022 BPJS RJ 72
73 53812 TRI HARI 17/1/2022 BPJS RJ 73
74 53230 SUMINI 17/1/2022 BPJS RJ 74
75 53725 LARTI 17/1/2022 BPJS RJ 75
76 52566 TRIYATM17/1/2022 BPJS RJ 76
77 51963 SRI RUSM17/1/2022 BPJS RJ 77
78 46736 YUNIATI 17/1/2022 BPJS RJ 78
79 554169 MUDJIYO17/1/2022 BPJS RI
80 49722 SAMIJO 17/1/2022 BPJS RI
81 34728 ERNA 18/1/2022 BPJS RJ
82 53451 SATINAH18/1/2022 BPJS RJ
83 53782 DWI HAST18/1/2022 BPJS RJ
84 37014 SARTINI 18/1/2022 BPJS RJ
85 53637 CHERADI18/1/2022 BPJS RJ
86 53756 YULIANI 18/1/2022 BPJS RJ
87 53031 SUPARMI18/1/2022 BPJS RJ
88 53759 BOBI 18/1/2022 BPJS RJ TOTAL PASIEN = 258
89 52791 DWI RIYA18/1/2022 BPJS RJ
90 1570 SRI PURW18/1/2022 BPJS RJ TOTAL PASIEN BPJS =18
91 38719 SUTARMI18/1/2022 BPJS RJ BPJS RAJAL = 166
92 53372 MARJANT18/1/2022 BPJS RJ BPJS RANAP = 14
93 44769 SUNARDI18/1/2022 BPJS RJ
94 5044 SUCI RA 18/1/2022 BPJS RJ TOTAL PASIEN UMUM =
95 36738 SUYATMI18/1/2022 BPJS RI UMUM RAJAL = 77
96 40470 TOTOK 19/1/2022 BPJS RJ UMUM RANAP = 1
97 53892 TUKINEM19/1/2022 BPJS RJ
98 53373 DILLA 19/1/2022 BPJS RJ
99 53788 SULARMI19/1/2022 BPJS RJ
100 53775 SLAMET 19/1/2022 BPJS RJ
101 54295 SUWARTI19/1/2022 BPJS RI
102 44267 SUWART 20/1/2022 BPJS RJ
103 40793 SLAMET 20/1/2022 BPJS RJ
104 51728 SUKIYAH20/1/2022 BPJS RJ
105 53913 SUPARMI20/1/2022 BPJS RJ
106 50113 PURWANT20/1/2022 BPJS RJ
107 40074 HADI 20/1/2022 BPJS RJ
108 52349 SUNASIH 20/1/2022 BPJS RJ
109 54287 IIM MARY20/1/2022 BPJS RJ
110 53660 MARYAN20/1/2022 BPJS RJ
111 53659 SURATMI20/1/2022 BPJS RJ
112 TASIYEM20/1/2022 BPJS RJ
113 54170 KATIJEM 20/1/2022 BPJS RI
114 54038 NARTO 21/1/2022 BPJS RJ
115 53411 KEMIYAT21/1/2022 BPJS RJ
116 51440 MARIFAH21/1/2022 BPJS RJ
117 54047 MICHAEL21/1/2022 BPJS RJ
118 54332 CIPTO 21/1/2022 BPJS RI
119 53720 AGUS 21/1/2022 BPJS RJ
120 53519 SAEFUDI 21/1/2022 BPJS RJ
121 54350 SARYATM21/1/2022 BPJS RJ
122 52950 TUGIYEM24/1/2022 BPJS RJ
123 52010 SUYANTO24/1/2022 BPJS RJ
124 52010 WARTIYE24/1/2022 BPJS RJ
125 53868 YUNIATI 24/1/2022 BPJS RJ
126 47636 SITI 24/1/2022 BPJS RJ
127 51690 SUMINI 24/1/2022 BPJS RJ
128 544776 FEBRIAN 24/1/2022 BPJS RJ
129 51688 TARMO 24/1/2022 BPJS RJ
130 54049 SAMNO 24/1/2022 BPJS RJ
131 54041 PARTINI 24/1/2022 BPJS RJ
132 52725 NYAMAN24/1/2022 BPJS RJ
133 53735 LARTI 24/1/2022 BPJS RJ
134 53230 SUMINI 24/1/2022 BPJS RJ
135 46736 YUNIATI 24/1/2022 BPJS RJ
136 54498 SUKIYO 24/1/2022 BPJS RI
137 54488 KROMO 25/1/2022 BPJS RJ
138 5380 SUTIYAR 25/1/2022 BPJS RJ
139 52267 TUMIYEM25/1/2022 BPJS RJ
140 52179 KARMI 25/1/2022 BPJS RJ
141 54434 SRI YANT25/1/2022 BPJS RI
142 53756 YULIANI 25/1/2022 BPJS RJ
143 54566 MARTINI 25/1/2022 BPJS RJ
144 53773 DILLA 26/1/2022 BPJS RJ
145 40470 TOTOK 26/1/2022 BPJS RJ
146 54120 SRI SURY26/1/2022 BPJS RJ
147 47060 GIMO 26/1/2022 BPJS RJ
148 49722 SAMIJO 26/1/2022 BPJS RJ
149 54169 MUDJIYO27/1/2022 BPJS RJ
150 51937 SUMARNI27/1/2022 BPJS RJ
151 52708 WIJIATI 27/1/2022 BPJS RJ
152 52670 MURNI 27/1/2022 BPJS RJ
153 54287 IIM MARY27/1/2022 BPJS RJ
154 51943 SIHMANT27/1/2022 BPJS RI
155 54038 NARTO 28/1/2022 BPJS RJ
156 54047 MICHAEL28/1/2022 BPJS RJ
157 53411 KEMIYAT28/1/2022 BPJS RJ
158 53791 DWI RIYA28/1/2022 BPJS RJ
159 36738 SUYATMI28/1/2022 BPJS RJ
160 52246 WASI 28/1/2022 BPJS RJ
161 54350 SARYATM28/1/2022 BPJS RJ
162 47068 VENY 28/1/2022 BPJS RJ
163 54233 AGUNG 28/1/2022 BPJS RJ
164 54259 SUWARTI29/1/2022 BPJS RJ
165 54279 KASIYEM29/1/2022 BPJS RJ
166 53615 YATI 29/1/2022 BPJS RJ
167 52789 WARIMA 29/1/2022 BPJS RJ
168 52217 SRI LEST 29/1/2022 BPJS RJ
169 41445 HANEVA 29/1/2022 BPJS RI
170 54810 MULYAN29/1/2022 BPJS RJ
171 51915 KARTINI 31/1/2022 BPJS RJ
172 52933 SANTI 31/1/2022 BPJS RJ
173 54774 SUTIRAH 31/1/2022 BPJS RJ
174 SARTINI 31/1/2022 BPJS RJ
175 52566 TRIYATM31/1/2022 BPJS RJ
176 54472 SUMINI 31/1/2022 BPJS RJ
177 53782 DWI HAST31/1/2022 BPJS RJ
178 54049 SAMNO 31/1/2022 BPJS RJ
179 54342 TUSIYEM31/1/2022 BPJS RJ
180 52950 TUGIYEM31/1/2022 BPJS RJ
TANGG CARA KET
RM NAMA
AL BAYAR RJ RI
53525 TUMIJEM 3/1/2022 UMUM RJ
53530 RAY 3/1/2022 UMUM RJ
53022 SURANTO3/1/2022 UMUM RJ
54404 HARYANT3/1/2022 UMUM RJ
53376 MULYON 3/1/2022 UMUM RJ
53519 SYAIFUDI3/1/2022 UMUM RJ
53083 ZAKAT 3/1/2022 UMUM RJ
37710 SRI AGU 3/1/2022 UMUM RJ
53403 GIYATNO 4/1/2022 UMUM RJ
53636 WAHYU S5/1/2022 UMUM RJ
53681 YATIMIN 6/1/2022 UMUM RJ
53679 JARNO 6/1/2022 UMUM RJ
54411 MARINI 7/1/2022 UMUM RJ
53720 AGUS 7/1/2022 UMUM RJ
53753 WIDI 9/1/2022 UMUM RJ
51662 MUKINEM9/1/2022 UMUM RJ
53761 SLAMET 9/1/2022 UMUM RJ
53804 SUPATMI10/1/2022 UMUM RJ
53720 AGUS 10/1/2022 UMUM RJ
53083 ZAKAT 10/1/2022 UMUM RJ
53679 JARNO 10/1/2022 UMUM RJ
53376 MULYON10/1/2022 UMUM RJ
53530 RAY 10/1/2022 UMUM RJ
54411 MARINI 11/1/2022 UMUM RJ
53031 SUPARMI11/1/2022 UMUM RJ
53403 GIYATNO11/1/2022 UMUM RJ
52138 SHOLIKIN12/1/2022 UMUM RJ
539907 NGATIYE12/1/2022 UMUM RJ
53636 WAHYU S12/1/2022 UMUM RJ
53720 AGUS 13/1/2022 UMUM RJ
53993 SULARMI13/1/2022 UMUM RJ
54044 SUCI 14/1/2022 UMUM RJ
54039 SUGIHAR14/1/2022 UMUM RJ
54085 NUR HAY15/1/2022 UMUM RJ
34728 ERNA 15/1/2022 UMUM RJ
53469 FEBRIAN 17/1/2022 UMUM RJ
53022 SURANTO17/1/2022 UMUM RJ
53907 NGATIYE17/1/2022 UMUM RJ
48943 SUTARMI17/1/2022 UMUM RJ
53062 ZAKAT 17/1/2022 UMUM RJ
53170 KATIJEM 17/1/2022 UMUM RJ
53083 ZAKAT 17/1/2022 UMUM RJ
34420 GINO 18/1/2022 UMUM RJ
41110 FITRIYAH20/1/2022 UMUM RJ
54278 WAGIYO 20/1/2022 UMUM RJ
54710 KATIJEM 20/1/2022 UMUM RI
54369 WIYONO 22/1/2022 UMUM RJ
53489 FEBRIAN 24/1/2022 UMUM RJ
54278 WAGIYO 24/1/2022 UMUM RJ
54369 WIYONO 25/1/2022 UMUM RJ
54170 KATIJEM 26/1/2022 UMUM RJ
54332 CIPTO 26/1/2022 UMUM RJ
54617 TINO 27/1/2022 UMUM RJ
54774 SUTIRAH 29/1/2022 UMUM RJ
54498 SUKIYO 29/1/2022 UMUM RJ
53887 WARTIYE31/1/2022 UMUM RJ
TOTAL PASIEN = 258
TOTAL PASIEN BPJS =180

BPJS RAJAL = 166
BPJS RANAP = 14
TOTAL PASIEN UMUM = 78

UMUM RAJAL = 77
UMUM RANAP = 1
Dr.HEPY WIJAYANTI Sp.PD
BULAN JANUARI 2022
TANGG CARA KET

NO RM NAMA NO RM
AL BAYAR RJ RI
1 49499 TINI 3/1/2022 BPJS RJ 1 53539
2 51840 CIPTO 3/1/2022 BPJS RJ 2 53042
3 50356 MARIJEM 3/1/2022 BPJS RJ 3 52850
4 50053 SRI SUHA 3/1/2022 BPJS RJ 4 52645
5 52222 NUGRAH 3/1/2022 BPJS RJ 5 53644
6 40100 EDI 3/1/2022 BPJS RJ 6 53641
7 49246 MARIMA 3/1/2022 BPJS RJ 7 53825
8 433430 SITI 3/1/2022 BPJS RJ 8 54058
9 50548 SUPARNO3/1/2022 BPJS RJ 9 53644
10 53537 TULINEM 3/1/2022 BPJS RJ 10 52642
11 49696 SUGITO 3/1/2022 BPJS RJ 11 52814
12 50646 WAHYUDI3/1/2022 BPJS RJ 12 53917
13 53543 SURIP 3/1/2022 BPJS RI 13 54270
14 52797 SUNARWI3/1/2022 BPJS RJ 14 54349
15 51730 SUNARMI3/1/2022 BPJS RJ 15 53218
16 53294 SURIPTO 5/1/2022 BPJS RJ 16 54270
17 50148 INTAN 5/1/2022 BPJS RJ 17 50993
18 51694 ENDAH S 5/1/2022 BPJS RJ 18 54886
19 49818 SUMIYAT 5/1/2022 BPJS RJ 19 54877
20 53299 MANTOM 5/1/2022 BPJS RJ 20 43056
21 37271 ANIK 5/1/2022 BPJS RJ
22 53612 SAKINEM 5/1/2022 BPJS RJ
23 53303 SUMIYEM5/1/2022 BPJS RJ
24 51111 SUNARSI 5/1/2022 BPJS RJ
25 53230 SUMINI 5/1/2022 BPJS RJ
26 53646 WIYADI 5/1/2022 BPJS RJ TOTAL PASIEN = 190
27 50590 RAHAMAR 10/1/2022 BPJS RJ
28 48692 YAHTINI 10/1/2022 BPJS RJ TOTAL PASIEN BPJS =170
29 497649 NINIK 10/1/2022 BPJS RJ BPJS RAJAL = 166
30 50028 SURATO 10/1/2022 BPJS RJ BPJS RANAP = 4
31 51164 MUH SUD10/1/2022 BPJS RJ
32 49304 SURATMA10/1/2022 BPJS RJ TOTAL PASIEN UMUM = 20
33 53830 SRI LEST 10/1/2022 BPJS RJ UMUM RAJAL =19
34 30184 SARTO 10/1/2022 BPJS RJ UMUM RANAP = 1
35 52214 SUDARMI10/1/2022 BPJS RJ
36 50753 YONO 10/1/2022 BPJS RJ
37 50613 SUPRAPTI10/1/2022 BPJS RJ
38 44933 HARIYAD10/1/2022 BPJS RJ
39 50816 SUHARDI10/1/2022 BPJS RJ
40 53453 RATMO 10/1/2022 BPJS RJ
41 53718 DALI 10/1/2022 BPJS RJ
42 53805 SUKIDJO 10/1/2022 BPJS RJ
43 50604 MURSITI 10/1/2022 BPJS RJ
44 44432 RISKI 10/1/2022 BPJS RJ
45 46544 SUTINAH10/1/2022 BPJS RJ
46 42710 RETNO 10/1/2022 BPJS RJ
47 51398 SARIYEM10/1/2022 BPJS RJ
48 49116 SUMIYAT10/1/2022 BPJS RJ
49 53807 DARMO 10/1/2022 BPJS RJ
50 50374 KARNI 10/1/2022 BPJS RJ
51 53812 AGUS 10/1/2022 BPJS RJ
52 53823 JEFRY 10/1/2022 BPJS RJ
53 51839 SUKADI 10/1/2022 BPJS RJ
54 52731 ELISABE 10/1/2022 BPJS RJ
55 52124 TUKINAH10/1/2022 BPJS RJ
56 43953 RIPAH 12/1/2022 BPJS RJ
57 53294 SURIPTO 12/1/2022 BPJS RJ
58 36311 DARMAW12/1/2022 BPJS RJ
59 53530 MARYATI12/1/2022 BPJS RJ
60 50699 MARMI 12/1/2022 BPJS RJ
61 52227 SAMINEM12/1/2022 BPJS RJ
62 49282 PUJIATI 12/1/2022 BPJS RJ
63 50831 SUPARNO12/1/2022 BPJS RJ
64 53987 CICILIA 12/1/2022 BPJS RJ
65 38842 S.WAN K 12/1/2022 BPJS RJ
66 53928 SRI LEST 12/1/2022 BPJS RJ
67 53544 BRYAN 14/1/2022 BPJS RJ
68 53531 MEI 14/1/2022 BPJS RJ
69 5056 RISGIYA 14/1/2022 BPJS RJ
70 48316 WINURYA14/1/2022 BPJS RJ
71 52850 JAMAN 14/1/2022 BPJS RI
72 44271 NURYATI14/1/2022 BPJS RJ
73 50987 PARINO 17/1/2022 BPJS RJ
74 53646 WIYADI 17/1/2022 BPJS RJ
75 49485 ASIH 17/1/2022 BPJS RJ
76 53812 AGUS 17/1/2022 BPJS RJ
77 49246 MARIMA 17/1/2022 BPJS RJ
78 47658 SURATNO17/1/2022 BPJS RJ
79 42942 TUYEM 17/1/2022 BPJS RJ
80 53453 RATMO 17/1/2022 BPJS RJ
81 59161 SUMARY 17/1/2022 BPJS RJ
82 51730 SUWARMI17/1/2022 BPJS RJ
83 53537 TULINEM17/1/2022 BPJS RJ
84 54048 SUTINI 17/1/2022 BPJS RJ
85 50458 SUPARNO17/1/2022 BPJS RJ
86 49410 HINDUN 17/1/2022 BPJS RJ
87 50827 SRI RAH 17/1/2022 BPJS RJ
88 51014 KASIKEM17/1/2022 BPJS RJ
89 53298 SRI LEST 19/1/2022 BPJS RI
90 53718 DALI 19/1/2022 BPJS RJ
91 46285 GUNAWA19/1/2022 BPJS RJ
92 52790 KATMI 19/1/2022 BPJS RJ
93 53794 ERNITA 19/1/2022 BPJS RJ
94 54262 HENDI 19/1/2022 BPJS RJ
95 52124 TUKINAH19/1/2022 BPJS RJ
96 50148 INTAN 19/1/2022 BPJS RJ
97 50457 MARGIYO19/1/2022 BPJS RJ
98 37271 ANIK 19/1/2022 BPJS RJ
99 50137 SARTINI 21/1/2022 BPJS RJ
100 50929 SUTRISN 21/1/2022 BPJS RJ
101 54462 TUMIYEM21/1/2022 BPJS RJ
102 53987 CICILIA 21/1/2022 BPJS RJ
103 52858 SUKINI 21/1/2022 BPJS RJ
104 51631 SULARNI 21/1/2022 BPJS RJ
105 48316 WINURYA21/1/2022 BPJS RJ
106 49252 SATIYO 21/1/2022 BPJS RJ
107 49858 SUPARMI21/1/2022 BPJS RJ
108 48692 YATINI 24/1/2022 BPJS RJ
109 52866 TUKINI 24/1/2022 BPJS RJ
110 53929 UTAMI 24/1/2022 BPJS RJ
111 50129 SINO 24/1/2022 BPJS RJ
112 51398 SARIYEM24/1/2022 BPJS RJ
113 51857 WIJI 24/1/2022 BPJS RJ
114 49116 SUMIYAT24/1/2022 BPJS RJ
115 52850 JAMAN 24/1/2022 BPJS RJ
116 51124 SUWANDI24/1/2022 BPJS RJ
117 49900 SRI WAH 24/1/2022 BPJS RJ
118 52035 PATMO 24/1/2022 BPJS RJ
119 52529 SUNARSO24/1/2022 BPJS RJ
120 52571 SUMIRAH24/1/2022 BPJS RJ
121 54490 YUSTION24/1/2022 BPJS RJ
122 50034 SITI SUK 24/1/2022 BPJS RJ
123 52675 KARTI 24/1/2022 BPJS RJ
124 53294 SURIPTO 26/1/2022 BPJS RJ
125 52855 KARTI 26/1/2022 BPJS RJ
126 54177 NOVI 26/1/2022 BPJS RJ
127 54262 HENDI 26/1/2022 BPJS RJ
128 49813 TEGUH 26/1/2022 BPJS RJ
129 49610 ENI 26/1/2022 BPJS RJ
130 53885 GIMANTO26/1/2022 BPJS RJ
131 50749 KATIJEM 26/1/2022 BPJS RJ
132 51223 DARNI 26/1/2022 BPJS RJ
133 50888 MULYON26/1/2022 BPJS RJ
134 41917 ALEK 26/1/2022 BPJS RJ
135 48608 TUGINAH26/1/2022 BPJS RJ
136 50080 SUWART 26/1/2022 BPJS RJ
137 48316 WINURYA28/1/2022 BPJS RI
138 36539 MUSRIFA28/1/2022 BPJS RJ
139 40041 SUMARMI28/1/2022 BPJS RJ
140 54161 SUYEJTI 28/1/2022 BPJS RJ
141 49325 SATIYO 28/1/2022 BPJS RJ
142 53928 SRI LEST 28/1/2022 BPJS RJ
143 50542 KASMI 28/1/2022 BPJS RJ
144 53539 ENDANG 28/1/2022 BPJS RJ
145 53531 MEI 28/1/2022 BPJS RJ
146 53190 WIWIK 28/1/2022 BPJS RJ
147 50506 YEKTI 28/1/2022 BPJS RJ
148 54125 PARNO 28/1/2022 BPJS RJ
149 42438 IIS SURY 28/1/2022 BPJS RJ
150 3148 SRI LEST 28/1/2022 BPJS RJ
151 53812 AGUS 31/1/2022 BPJS RJ
152 54490 YUSTION31/1/2022 BPJS RJ
153 51292 KUSWINA31/1/2022 BPJS RJ
154 52235 SUPARNO31/1/2022 BPJS RJ
155 50147 INA 31/1/2022 BPJS RJ
156 50203 TINI 31/1/2022 BPJS RJ
157 36886 AGUS S 31/1/2022 BPJS RJ
158 49624 MARIMA 31/1/2022 BPJS RJ
159 53537 TULINEM31/1/2022 BPJS RJ
160 53537 SUPARSI 31/1/2022 BPJS RJ
161 50701 MISTING 31/1/2022 BPJS RJ
162 51664 SUWARMI31/1/2022 BPJS RJ
163 51263 TRIYANTI31/1/2022 BPJS RJ
164 51324 CIPTO 31/1/2022 BPJS RJ
165 54869 FERRY 31/1/2022 BPJS RJ
166 54885 SRI RAH 31/1/2022 BPJS RJ
167 54889 FRANSIS 31/1/2022 BPJS RJ
168 51122 RATMIN 31/1/2022 BPJS RJ
169 53343 PRIYONO31/1/2022 BPJS RJ
170 36026 MUHAMM31/1/2022 BPJS RJ
TANGG CARA KET
NAMA
AL BAYAR RJ RI
ENDANG 3/1/2022 UMUM RJ
SARINI 3/1/2022 UMUM RJ
JAMAN 5/1/2022 UMUM RJ
SULARMO5/1/2022 UMUM RJ
IKEM 5/1/2022 UMUM RJ
NURUL 5/1/2022 UMUM RJ
JEFRY 10/1/2022 UMUM RJ
SUTINI 14/1/2022 UMUM RJ
IKEM 17/1/2022 UMUM RI
SULARMO19/1/2022 UMUM RJ
JESIAN 19/1/2022 UMUM RJ
EKO 19/1/2022 UMUM RJ
JUMADI 19/1/2022 UMUM RJ
FATAINI 21/1/2022 UMUM RJ
YOHANES26/1/2022 UMUM RJ
JUMADI 26/1/2022 UMUM RJ
PARIJA 31/1/2022 UMUM RJ
SRI SUNA31/1/2022 UMUM RJ
MARIYEM31/1/2022 UMUM RJ
WAHYUNI31/1/2022 UMUM RJ
PASIEN = 190
PASIEN BPJS =170
PASIEN UMUM = 20
RAJAL =19
RANAP = 1
Dr.DIKSI NOVITASARI, Sp.D
BULAN JANUARI 2022
REGISTE TANGGA CARA KETERANGAN REGISTE
NO NAMA NO
R L BAYAR RJ RI R
1 53173 PARIJO 1/4/2022 BPJS RJ 1 53248
2 50611 PURWANI 1/4/2022 BPJS RJ 2 53249
3 39388 SUHARNO1/4/2022 BPJS RJ 3 53346
4 45152 SUYATNI 1/4/2022 BPJS RJ 4 53594
5 39112 SRI PINIL 1/4/2022 BPJS RJ 5 53564
6 48688 KARMAN 1/4/2022 BPJS RJ 6 46690
7 51235 PRIHADI 1/4/2022 BPJS RJ 7 40842
8 53127 NI NYOM 1/4/2022 BPJS RJ 8 53760
9 45497 SULIMAN 1/4/2022 BPJS RI 9 46690
10 40030 DALJID 1/4/2022 BPJS RJ 10 53691
11 46068 SUSILOW 1/4/2022 BPJS RJ 11 38683
12 38325 ERNA P 1/4/2022 BPJS RJ 12 33674
13 50167 SLAMET 1/4/2022 BPJS RJ 13 54057
14 52020 NGATMI 1/4/2022 BPJS RJ 14 53670
15 41432 SUGIYAT 1/4/2022 BPJS RJ 15 54374
16 46335 JOKO TR 1/4/2022 BPJS RJ 16 46869
17 46314 PUJI AST 1/4/2022 BPJS RJ 17 54567
18 53571 SUTARNO1/4/2022 BPJS RJ 18 52278
19 53573 SUTIYON 1/4/2022 BPJS RJ 19 54747
20 53265 SITI SUN 1/4/2022 BPJS RJ
21 48864 SRI SUND 1/4/2022 BPJS RJ
22 45108 JINAH 1/4/2022 BPJS RJ
23 53557 ENI SETY 1/4/2022 BPJS RJ TOTAL PASIEN = 243
24 49826 SRI MURS1/4/2022 BPJS RJ
25 45596 ANDHIKA1/4/2022 BPJS RJ TOTAL PASIEN BPJS =224
26 50513 SRI LAST 1/6/2022 BPJS RJ BPJS RAJAL = 224
27 50516 SATIJEM 1/6/2022 BPJS RJ BPJS RANAP = 2
28 39045 SUYUD H 1/6/2022 BPJS RJ
29 49921 MUH EKO1/6/2022 BPJS RJ TOTAL PASIEN UMUM = 19
30 43825 SUPINI 1/6/2022 BPJS RJ UMUM RAJAL =19
31 53659 SURATMI 1/6/2022 BPJS RJ UMUM RANAP = -
32 53269 SRIYONO 1/6/2022 BPJS RJ
33 48612 MARIMA 1/6/2022 BPJS RJ
34 47832 YATINI 1/6/2022 BPJS RJ
35 44279 SARNI 1/6/2022 BPJS RJ
36 48717 WARNO 1/6/2022 BPJS RJ
37 42787 SAGIYEM 1/6/2022 BPJS RJ
38 54403 KEMAN 1/6/2022 BPJS RJ
39 37378 ERNA WID1/6/2022 BPJS RJ
40 39641 NURDIAN1/6/2022 BPJS RJ
41 31018 SUTARNO1/7/2022 BPJS RJ
42 53471 YOHANES1/7/2022 BPJS RJ
43 50541 SUDARNO1/7/2022 BPJS RJ
44 50406 AGUS DW1/7/2022 BPJS RJ
45 52361 TEGUH B 1/7/2022 BPJS RJ
46 41904 SRI MURN1/7/2022 BPJS RJ
47 47230 SARIMO 1/7/2022 BPJS RJ
48 53415 GIYATI 1/7/2022 BPJS RJ
49 53361 SUKINEM 1/7/2022 BPJS RJ
50 38803 TUGIYAH 1/7/2022 BPJS RJ
51 39967 TUKINO 1/8/2022 BPJS RJ
52 50568 SRI SUMA1/8/2022 BPJS RJ
53 41810 SITI RAH 1/8/2022 BPJS RJ
54 51412 SWANDAY1/8/2022 BPJS RJ
55 52600 TRI SUSI 1/8/2022 BPJS RJ
56 46590 WAHJU PU1/8/2022 BPJS RJ
57 46706 YOGI SU 1/8/2022 BPJS RJ
58 45629 SARTINI 1/8/2022 BPJS RJ
59 50632 BAMBANG1/8/2022 BPJS RJ
60 53430 SUTIMIN 1/8/2022 BPJS RJ
61 37623 SALIMIN 1/8/2022 BPJS RJ
62 44121 KARTI 1/8/2022 BPJS RJ
63 40039 TUNARNO1/8/2022 BPJS RJ
64 36737 PARWI 1/8/2022 BPJS RJ
65 40714 PARIYEM 1/8/2022 BPJS RJ
66 48969 DIAZ AN 1/8/2022 BPJS RJ
67 47492 FRANSIS 1/8/2022 BPJS RJ
68 52342 TABRI H 1/8/2022 BPJS RJ
69 40359 SRI HAN 1/8/2022 BPJS RJ
70 53576 SARYATM1/8/2022 BPJS RJ
71 52373 SUGIARTI1/8/2022 BPJS RJ
72 52229 MURSIH 1/8/2022 BPJS RJ
73 38462 ISMEIDI 1/11/2022 BPJS RJ
74 50570 NINIK 1/11/2022 BPJS RJ
75 48697 DWI HAR1/11/2022 BPJS RJ
76 53557 ENI SETY1/11/2022 BPJS RJ
77 49863 ISWANTI 1/11/2022 BPJS RJ
78 44030 PETRUS S1/11/2022 BPJS RJ
79 53416 SUYARNI1/11/2022 BPJS RJ
80 48231 TUGIYEM1/11/2022 BPJS RJ
81 50630 KASIYEM1/11/2022 BPJS RJ
82 46829 WARSINO1/11/2022 BPJS RJ
83 49210 SADIYAH1/11/2022 BPJS RJ
84 42222 DANI KU 1/11/2022 BPJS RJ
85 46835 SUTINO 1/11/2022 BPJS RJ
86 49553 ROSALIA 1/11/2022 BPJS RJ
87 48029 SUMARSI1/11/2022 BPJS RJ
88 44765 DIMAN 1/11/2022 BPJS RJ
89 45637 SLAMET 1/11/2022 BPJS RJ
90 53863 PANUT 1/11/2022 BPJS RJ
91 48051 DYAH WI1/11/2022 BPJS RJ
92 41681 PURWANT1/11/2022 BPJS RJ
93 49828 SUMARM1/11/2022 BPJS RJ
94 58866 BAMBAN1/11/2022 BPJS RJ
95 53840 KARSOM 1/11/2022 BPJS RJ
96 45497 SULIMAN1/13/2022 BPJS RJ
97 49237 SUPARTI 1/13/2022 BPJS RJ
98 53686 EUSTASI 1/13/2022 BPJS RJ
99 43125 MENIEK S1/13/2022 BPJS RJ
100 54016 PARNO 1/13/2022 BPJS RJ
101 39122 FRANSIS 1/13/2022 BPJS RJ
102 54018 TARWI 1/13/2022 BPJS RJ
103 38219 SUWARMI1/13/2022 BPJS RJ
104 52265 SISWANT1/13/2022 BPJS RJ
105 43307 SRI MULY1/13/2022 BPJS RJ
106 49848 WAKINE 1/13/2022 BPJS RJ
107 50591 MULYANI1/13/2022 BPJS RJ
108 47135 JUMIYATI1/13/2022 BPJS RJ
109 50437 WARNI 1/13/2022 BPJS RJ
110 36502 SITI MUS 1/13/2022 BPJS RJ
111 47624 SUGIYAT1/14/2022 BPJS RJ
112 54057 SUMARY 1/14/2022 BPJS RJ
113 49589 NURYANI1/15/2022 BPJS RJ
114 39328 OFI 1/15/2022 BPJS RJ
115 43630 SULARTO1/15/2022 BPJS RJ
116 39328 NUNING 1/15/2022 BPJS RJ
117 39000 KARJONO1/15/2022 BPJS RJ
118 43254 SUHARNO1/15/2022 BPJS RJ
119 49914 SUKARNO1/15/2022 BPJS RJ
120 52249 SUMIYEM1/15/2022 BPJS RJ
121 46533 YULI 1/15/2022 BPJS RJ
122 47623 SUTARSI 1/15/2022 BPJS RJ
123 54104 PARMI 1/15/2022 BPJS RJ
124 50415 SUTARNI 1/15/2022 BPJS RJ
125 54094 NINIS 1/15/2022 BPJS RJ
126 52820 TUMINAH1/15/2022 BPJS RJ
127 54100 SITI 1/15/2022 BPJS RJ
128 36747 SRI YATU1/15/2022 BPJS RJ
129 54212 PURWANT1/18/2022 BPJS RJ
130 50062 ERNI 1/18/2022 BPJS RJ
131 53557 SUYARNI1/18/2022 BPJS RJ
132 53416 SUNARMI1/18/2022 BPJS RJ
133 52733 AGUS S 1/18/2022 BPJS RJ
134 47725 HARYATI1/18/2022 BPJS RJ
135 53425 PURWANT1/18/2022 BPJS RJ
136 39056 DIAN 1/18/2022 BPJS RJ
137 52243 SARMI 1/18/2022 BPJS RJ
138 40730 TRI HAST1/18/2022 BPJS RJ
139 47052 SUYATI 1/18/2022 BPJS RJ
140 54202 DARMAW1/18/2022 BPJS RJ
141 53299 MANTOM1/18/2022 BPJS RJ RI
142 53268 SRIYONO1/18/2022 BPJS RJ
143 45540 TUKIMAN1/18/2022 BPJS RJ
144 40856 PAINEM 1/18/2022 BPJS RJ
145 51935 PUJI AST 1/18/2022 BPJS RJ
146 45161 SETIYO 1/18/2022 BPJS RJ
147 41800 SUTARTI 1/18/2022 BPJS RJ
148 37323 TRI HAN 1/20/2022 BPJS RJ
149 54313 ANGGRAE1/20/2022 BPJS RJ
150 53909 NIGEL 1/20/2022 BPJS RJ
151 34663 RATNA 1/20/2022 BPJS RJ
152 37795 MIKEM 1/20/2022 BPJS RJ
153 48353 AMBAR 1/20/2022 BPJS RJ
154 54142 SRI MULY1/20/2022 BPJS RJ
155 50910 MISMAN 1/20/2022 BPJS RJ
156 38610 SUMARMI1/20/2022 BPJS RJ
157 51424 TUKIJEM 1/20/2022 BPJS RJ
158 49451 KATMINI 1/21/2022 BPJS RJ
159 48342 SULIYO 1/21/2022 BPJS RJ
160 51357 TUKIMAN1/21/2022 BPJS RJ
161 41090 SANDIJE 1/21/2022 BPJS RJ
162 53862 ANDREAS1/22/2022 BPJS RJ
163 54094 NINIS 1/22/2022 BPJS RJ
164 54378 SRI WAH 1/22/2022 BPJS RJ
165 52937 SRIYATU 1/22/2022 BPJS RJ
166 51333 SARDI 1/22/2022 BPJS RJ
167 54003 TRIMULY1/22/2022 BPJS RJ
168 36039 MARIANA1/25/2022 BPJS RJ
169 52930 MULYATI1/25/2022 BPJS RJ
170 45524 SATIJEM 1/25/2022 BPJS RJ
171 53416 SURYANI1/25/2022 BPJS RJ
172 37406 SRI LEST 1/25/2022 BPJS RJ
173 35094 WAKIJAH1/25/2022 BPJS RJ
174 48066 ROMANTI1/25/2022 BPJS RJ
175 54567 ENDANG 1/25/2022 BPJS RJ
176 46191 SUNARTI 1/25/2022 BPJS RJ
177 50222 AGUS 1/25/2022 BPJS RJ
178 36598 LATINAH1/25/2022 BPJS RJ
179 35995 NUR AZI 1/25/2022 BPJS RJ
180 50818 ESTI 1/25/2022 BPJS RJ
181 41111 SADMON 1/27/2022 BPJS RJ
182 45791 SUNARMI1/27/2022 BPJS RJ
183 53299 MANTOM1/27/2022 BPJS RJ
184 38610 SUMARSI1/27/2022 BPJS RJ
185 54722 SUGIYO 1/27/2022 BPJS RJ
186 50846 SRI WAH 1/27/2022 BPJS RJ
187 52278 TIMIN 1/27/2022 BPJS RJ
188 54271 SARIYAN1/27/2022 BPJS RJ
189 548747 ENDAH 1/27/2022 BPJS RJ
190 39298 LATINEM1/27/2022 BPJS RJ
191 42405 SULARNO1/28/2022 BPJS RJ
192 36011 DAJA 1/28/2022 BPJS RJ
193 40027 SUPARNI 1/28/2022 BPJS RJ
194 52209 PILANGN1/28/2022 BPJS RJ
195 36159 WAHYUNI1/28/2022 BPJS RJ
196 48636 SRI RAH 1/28/2022 BPJS RJ
197 47491 MAMIEK 1/28/2022 BPJS RJ
198 41191 RIYANTI 1/28/2022 BPJS RJ
199 39829 AGUNG 1/28/2022 BPJS RJ
200 3479 KARMI 1/28/2022 BPJS RJ
201 44772 DJAMI 1/28/2022 BPJS RJ
202 42082 ROHMADI1/28/2022 BPJS RJ
203 47415 DJUMIYA1/28/2022 BPJS RJ
204 54205 SADIYEM1/28/2022 BPJS RJ
205 49516 DEDY 1/29/2022 BPJS RJ
206 49513 SUWARTI1/29/2022 BPJS RJ
207 50397 DWI ANI 1/29/2022 BPJS RJ
208 35041 SUYOTO 1/29/2022 BPJS RJ
209 36027 BAMBAN1/29/2022 BPJS RJ
210 47327 HARTANT1/29/2022 BPJS RJ
211 35783 SUPARTO1/29/2022 BPJS RJ
212 40780 MARDIM 1/29/2022 BPJS RJ
213 54803 PARSI 1/29/2022 BPJS RJ
214 44526 SULAMTO1/29/2022 BPJS RJ
215 40701 SADINO 1/29/2022 BPJS RJ
216 54759 ARIP 1/29/2022 BPJS RJ
217 38942 SUPARMI1/29/2022 BPJS RJ
218 41196 SUKARJO1/29/2022 BPJS RJ
219 53774 KARIYEM1/29/2022 BPJS RJ
220 42439 TARNO 1/29/2022 BPJS RJ
221 36933 TUMIRAH1/29/2022 BPJS RJ
222 35265 SRI SUKA1/29/2022 BPJS RJ
223 39525 KARYATI1/29/2022 BPJS RJ
224 42864 SULARTO1/29/2022 BPJS RJ
TANGGA CARA KETERANGAN
NAMA
L BAYAR RJ RI
SANI 1/4/2022 UMUM RJ
MARWAN1/4/2022 UMUM RJ
SURATI 1/4/2022 UMUM RJ
SUMIYAR 1/4/2022 UMUM RJ
PAIYEM 1/4/2022 UMUM RJ
KADIRAN 1/7/2022 UMUM RJ
EKO FAQI1/7/2022 UMUM RJ
SEPTI DW 1/8/2022 UMUM RJ
KADIRAN1/14/2022 UMUM RJ
SARNI 1/14/2022 UMUM RJ
REZZA 1/18/2022 UMUM RJ
ROESTIYA1/20/2022 UMUM RJ
SUMARY 1/22/2022 UMUM RJ
SEPTI DW1/22/2022 UMUM RJ
YULI 1/22/2022 UMUM RJ
SRIYONO1/22/2022 UMUM RJ
ENDANG 1/25/2022 UMUM RJ
TIMIN 1/27/2022 UMUM RJ
ENDAH 1/27/2022 UMUM RJ
PASIEN = 243
PASIEN BPJS =224
PASIEN UMUM = 19
RAJAL =19
LAPORAN POLIKLINIK UROLO
Dr. ANDRI KUSUMA, Sp U
BULAN JANUARI 2022

BAYAR RJ RI
1 40625 SUHARDI SISWO 1/3/2022 BPJS RJ
2 52050 DALIMAN 1/3/2022 BPJS RJ
3 52133 PAINO 1/3/2022 BPJS RJ
4 53180 SUPINI 1/3/2022 BPJS RJ
5 53278 DWI HARJANTO 1/3/2022 BPJS RJ
6 48411 SARDI 1/5/2022 BPJS RJ
7 37667 SRIYATMO 1/5/2022 BPJS RJ
8 50191 MANTONO 1/5/2022 BPJS RJ
9 53195 SAIDI 1/5/2022 BPJS RJ
10 53129 DAWITO 1/5/2022 BPJS RJ
11 53362 PARJO 1/5/2022 BPJS RI
12 50881 KARINO 1/5/2022 BPJS RJ
13 52846 SULARNO 1/5/2022 BPJS RI
14 49552 NINING 1/7/2022 BPJS RJ
15 53444 TARMIN 1/7/2022 BPJS RI
16 52984 WAHYUNINGSIH 1/7/2022 BPJS RJ
17 53722 SAIYEM 1/7/2022 BPJS RJ
18 51652 NURWANI 1/7/2022 BPJS RJ
19 36278 SAIMUN 1/7/2022 BPJS RJ
20 53177 BUDI SANTOSO 1/7/2022 BPJS RJ
21 40625 SUHARDI SISWO 1/10/2022 BPJS RJ
23 53410 KURNIAWATI 1/10/2022 BPJS RJ
24 53517 SUNARMO 1/10/2022 BPJS RJ
25 53195 SAIDI 1/10/2022 BPJS RJ
26 46020 SUTINO 1/10/2022 BPJS RJ
27 44173 GIMO 1/10/2022 BPJS RJ
28 45594 SUYANTO 1/10/2022 BPJS RJ
29 53073 SUPARMI 1/10/2022 BPJS RJ
30 49611 M.NUR ROHMAN 1/10/2022 BPJS RJ
61 54442 SARWINI 1/19/2022 BPJS RJ

62 53809 SULARNO ARY 1/19/2022 BPJS RJ
63 41073 EKO NUSWANTORO 1/19/2022 BPJS RJ
64 47060 GIMO 1/19/2022 BPJS RJ
65 43800 IGNATIUS 1/19/2022 BPJS RJ
66 51235 PRIHADI 1/19/2022 BPJS RJ
67 52489 KARYONO 1/19/2022 BPJS RJ
68 53444 TARMIN 1/21/2022 BPJS RJ
69 37665 SURATNO 1/21/2022 BPJS RJ
70 42086 NURFATAN 1/21/2022 BPJS RJ
71 54334 SUTAMI 1/21/2022 BPJS RJ
73 39388 SUHARNO 1/24/2022 BPJS RJ
74 53269 SRIYONO 1/24/2022 BPJS RJ
75 54235 PULUNG 1/24/2022 BPJS RJ
76 54499 SITI SYAMSIYAH 1/24/2022 BPJS RJ
77 50458 SUPARNO 1/24/2022 BPJS RJ
78 53525 TUMIJEM 1/24/2022 BPJS RJ
79 54052 SAMIN 1/24/2022 BPJS RJ
80 54492 LAMAN 1/24/2022 BPJS RJ
81 36397 AGUS TRIYONO 1/24/2022 BPJS RJ
82 45254 M. YUSUF 1/24/2022 BPJS RJ
83 54491 SUTRISNO 1/24/2022 BPJS RJ
84 42190 RASTOTO 1/24/2022 BPJS RJ
85 54144 SUWARNO 1/24/2022 BPJS RJ
86 51235 PRIHADI 1/26/2022 BPJS RJ
87 45042 SARIYO 1/26/2022 BPJS RJ
88 53884 KARJO 1/26/2022 BPJS RJ
89 53905 TOKARNO 1/26/2022 BPJS RJ
90 54687 SYAHRO EDI 1/26/2022 BPJS RJ
91 43598 SLAMET WIDODO 1/26/2022 BPJS RJ
92 33371 SRI MURNI 1/26/2022 BPJS RJ
93 53468 SUMI 1/26/2022 BPJS RJ
94 36280 SUPOMO 1/28/2022 BPJS RJ
95 54334 SUTAMI 1/28/2022 BPJS RJ
PASIEN BPJS : 106

BPJS RAJAL : 100
BPJS RANAP :6
PASIEN UMUM : 23
UMUM RAJAL : 23
UMUM RANAP :-
TOTAL PASIEN : 129

N POLIKLINIK UROLOGI
NDRI KUSUMA, Sp U
LAN JANUARI 2022

BAYAR RJ RI
31 41266 SOETRISNO 1/10/2022 BPJS RJ
32 52846 SULARNO 1/12/2022 BPJS RJ
33 51235 PRIHADI 1/12/2022 BPJS RJ
34 53362 PARJO 1/12/2022 BPJS RJ
35 53809 SULARNO ARY 1/12/2022 BPJS RI
36 48062 JARIRUDIN 1/12/2022 BPJS RJ
37 53905 TOKARNO 1/12/2022 BPJS RJ
38 53884 KARJO 1/12/2022 BPJS RJ
39 53887 KARNEN 1/12/2022 BPJS RJ
40 31018 SUTARNO 1/14/2022 BPJS RJ
41 37755 SRI RUNTINI 1/14/2022 BPJS RJ
42 38117 KASI 1/14/2022 BPJS RJ
43 53444 TARMIN 1/14/2022 BPJS RJ
44 52563 SULARTO 1/14/2022 BPJS RJ
45 47429 RAGIT MARTO 1/14/2022 BPJS RJ
46 54163 MARYADI 1/17/2022 BPJS RJ
47 46680 GIYARSO 1/17/2022 BPJS RJ
48 45594 SUYANTO 1/17/2022 BPJS RJ
49 39388 SUHARNO 1/17/2022 BPJS RJ
50 54144 SUWARNO 1/17/2022 BPJS RJ
51 36011 DAJA 1/17/2022 BPJS RJ
52 51611 YUNUS 1/17/2022 BPJS RJ
53 40625 SUHARDI 1/17/2022 BPJS RJ
54 54052 SAMIN 1/17/2022 BPJS RI
55 53884 KARJO 1/19/2022 BPJS RJ
56 53905 TOKARNO 1/19/2022 BPJS RJ
57 SRIYATMO 1/19/2022 BPJS RJ
58 45042 SARIYO 1/19/2022 BPJS RJ
59 35718 SUMARNO 1/19/2022 BPJS RJ
60 53362 PARJO 1/19/2022 BPJS RJ
96 38776 SATIMIN 1/28/2022 BPJS RJ

97 54758 SLAMET 1/28/2022 BPJS RI
98 54882 SATIMIN 1/31/2022 BPJS RJ
99 54892 SUMI 1/31/2022 BPJS RJ
100 54052 SAMIN 1/31/2022 BPJS RJ
101 54491 SUTRISNO 1/31/2022 BPJS RJ
102 54879 EKO WIDODO 1/31/2022 BPJS RJ
103 53189 WISMAN 1/31/2022 BPJS RJ
104 36615 SIRUN 1/31/2022 BPJS RJ
105 42086 NUR FATHAN 1/31/2022 BPJS RJ
106 46664 SUNARDI 1/31/2022 BPJS RJ
BAYAR RJ RI
1 53518 JUJUR ISWAHYUDI 1/3/2022 UMUM RJ
2 53631 FAHRUDIN 1/5/2022 UMUM RJ
3 51235 PRIHADI 1/5/2022 UMUM RJ
4 53801 BROTO SUGIANTO 1/10/2022 UMUM RJ
5 53095 MULYANTO 1/10/2022 UMUM RJ
6 53705 MARIDI 1/10/2022 UMUM RJ
7 48165 SULARDI 1/10/2022 UMUM RJ
8 53518 JUJUR ISWAHYUDI 1/10/2022 UMUM RJ
9 53802 ALFIAN DOHAN 1/10/2022 UMUM RJ
10 53278 DWI HARJANTO 1/10/2022 UMUM RJ
11 49248 MARTOMO 1/12/2022 UMUM RJ
12 53904 NGATMO 1/12/2022 UMUM RJ
13 53906 TRI PRIYO 1/12/2022 UMUM RJ
14 53597 IRO SENTONO 1/14/2022 UMUM RJ
15 54052 SAMIN 1/14/2022 UMUM RJ
16 54176 MARINO 1/17/2022 UMUM RJ
17 53801 BROTO SUGIANTO 1/17/2022 UMUM RJ
18 53095 MULYANTO 1/17/2022 UMUM RJ
19 54235 PULUNG 1/19/2022 UMUM RJ
20 52645 S.SULARMO 1/21/2022 UMUM RJ
21 54266 SRI SUWARTO 1/24/2022 UMUM RJ
22 54698 YUSUF SUBANDI 1/26/2022 UMUM RJ
23 54766 DIDIK NUR CAHYO 1/28/2022 UMUM RJ
LAPORAN POLIKLINIK BEDAH
Dr. DIAN IBNU WAHID, Sp.B
BULAN JANUARI 2022
N0 RM NAMA TANGGAL CARA KET N0

BAYAR RJ RI
1 53414 YESI AYUSARI 1/3/2022 BPJS RI 31
2 51683 LUKY CAHYO 1/3/2022 BPJS RJ 32
3 52906 RISMA WIDIAWATI 1/3/2022 BPJS RJ 33
4 53154 WASIMAN 1/3/2022 BPJS RJ 34
5 21039 AHMAD MUZAKI 1/3/2022 BPJS RJ 35
6 53232 BAGAS PANJERINO 1/3/2022 BPJS RJ 36
7 52756 KAMIN 1/3/2022 BPJS RI 37
8 52396 ARIF WICAKSONO 1/3/2022 BPJS RJ 38
9 52818 SUMARYONO 1/3/2022 BPJS RJ 39
10 51462 SUROTO 1/3/2022 BPJS RJ 40
11 52675 KARTI 1/3/2022 BPJS RJ 41
12 53434 TEGAR ROHMADI 1/3/2022 BPJS RI 42
13 46736 YUNIATI 1/4/2022 BPJS RI 43
14 53312 WASIOKO 1/4/2022 BPJS RJ 44
15 52205 SUMARNING 1/4/2022 BPJS RJ 45
16 52578 ELFIYANI 1/4/2022 BPJS RJ 46
17 52828 LISATUL MARHAMAH 1/4/2022 BPJS RJ 47
18 52886 TUGINEM 1/4/2022 BPJS RJ 48
19 52209 PILANGO 1/4/2022 BPJS RJ 49
20 53382 JUMIATUN 1/4/2022 BPJS RJ 50
21 53086 SINGGIH 1/4/2022 BPJS RJ 51
22 53591 DENDI WIANDHANI 1/5/2022 BPJS RI 52
23 53313 SUPARDI 1/5/2022 BPJS RJ 53
24 52165 AINA DURROTUN 1/5/2022 BPJS RJ 54
25 53133 WAGINAH 1/5/2022 BPJS RJ 55
26 83124 SAHIR 1/5/2022 BPJS RJ 56
27 53131 RESMINI 1/5/2022 BPJS RJ 57
28 53353 MELANI 1/5/2022 BPJS RJ 58
29 53042 SARINI 1/6/2022 BPJS RJ 59
30 50972 MASIMIN 1/6/2022 BPJS RJ 60
61 54442 SARWINI 1/11/2022 BPJS RJ 96

62 52209 PILANGNO 1/11/2022 BPJS RJ 97
63 53414 YESSI AYUSARI 1/11/2022 BPJS RJ 98
64 52305 PONIYATI 1/11/2022 BPJS RJ 99
65 52673 WARSINI 1/11/2022 BPJS RJ 100
66 53312 WASKIYOKO 1/11/2022 BPJS RJ 101
67 53086 SINGGIH 1/11/2022 BPJS RJ 102
68 50541 SUDARNO 1/11/2022 BPJS RJ 103
69 53434 TEGAR ROHMADI 1/11/2022 BPJS RJ 104
70 52756 KAMIN 1/11/2022 BPJS RJ 105
71 53382 JUMIATUN 1/11/2022 BPJS RJ 106
72 53869 EVA ANITA 1/12/2022 BPJS RI 107
73 53850 SUTIYARSO 1/12/2022 BPJS RI 108
74 53835 SUTIMAN 1/12/2022 BPJS RI 109
75 53818 TUKINI 1/12/2022 BPJS RI 110
76 53816 PONIYEM 1/12/2022 BPJS RI 111
77 33832 PAIDI 1/12/2022 BPJS RI 112
78 53353 MELANI FAHMI 1/12/2022 BPJS RJ 113
79 53591 DENDI WIANDANI 1/12/2022 BPJS RJ 114
80 53133 WAGINAH 1/12/2022 BPJS RJ 115
81 53927 SASKYA ANJANI 1/13/2022 BPJS RI 116
82 53914 INTAN 1/13/2022 BPJS RI 117
83 53931 GIYARSI 1/13/2022 BPJS RI 118
84 52623 SANIKEM 1/13/2022 BPJS RI 119
85 37037 MARMI 1/13/2022 BPJS RJ 120
86 53204 GINO 1/13/2022 BPJS RJ 121
87 50972 MASIMIN 1/13/2022 BPJS RJ 122
88 53042 SARINI 1/13/2022 BPJS RJ 123
89 53125 PARMIN 1/13/2022 BPJS RJ 124
90 50142 SUKINO 1/13/2022 BPJS RJ 125
91 40491 SUTARTI 1/14/2022 BPJS RJ 126
92 53143 OKTARA RIZANG 1/14/2022 BPJS RJ 127
93 52020 NGATMI 1/14/2022 BPJS RJ 128
94 53309 GALEH DWI 1/14/2022 BPJS RJ 129
95 53340 SEPTIAN 1/14/2022 BPJS RI 130
130 54319 ZAIN AKBAR 1/20/2022 BPJS RJ 166

131 53835 SUTIMAN 1/21/2022 BPJS RJ 167
132 53143 OKTARA RIZANG 1/21/2022 BPJS RJ 168
133 53818 TUKINI 1/21/2022 BPJS RJ 169
134 53309 GALEH DWI 1/21/2022 BPJS RJ 170
135 36311 DARMAWAN 1/21/2022 BPJS RJ 171
136 51837 SUWARTO 1/21/2022 BPJS RJ 172
137 53832 PAIDI 1/21/2022 BPJS RJ 173
138 53889 ANDI CAHYONO 1/21/2022 BPJS RJ 174
139 53927 SASKYA ANJANI 1/21/2022 BPJS RJ 175
140 53914 INTAN PUSPITASARI 1/21/2022 BPJS RJ 176
141 54352 PRAPTININGSIH 1/21/2022 BPJS RJ 177
142 54347 ROBI SUGANDA 1/21/2022 BPJS RI 178
143 48601 SAIMAN 1/21/2022 BPJS RJ 179
144 53082 WIDODO 1/22/2022 BPJS RJ 180
145 45682 SISWANTO 1/22/2022 BPJS RJ 181
146 50324 SRI LESTARI 1/22/2022 BPJS RJ 182
147 53931 GIYARSI 1/22/2022 BPJS RJ 183
148 53695 IDA RAHMAWATI 1/22/2022 BPJS RJ 184
149 54368 ILHAM MAULANA 1/24/2022 BPJS RI 185
150 53374 AJI TITIS 1/24/2022 BPJS RI 186
151 54188 PRAPTININGSIH 1/24/2022 BPJS RI 187
152 54352 AGUS DIAN 1/24/2022 BPJS RJ 188
153 52623 SANIKEM 1/24/2022 BPJS RJ 189
154 52649 SUKIDI 1/24/2022 BPJS RJ 190
155 21039 AHMAD MUZAKI 1/24/2022 BPJS RJ 191
156 54181 ETIK 1/24/2022 BPJS RJ 192
157 51389 GUTOMO 1/24/2022 BPJS RJ 193
158 54486 WASINI 1/25/2022 BPJS RJ RI 194
159 54504 SRI MULYANI 1/25/2022 BPJS RJ RI 195
160 52305 PONIYATI 1/25/2022 BPJS RJ 196
161 43207 TONY ANGGARA 1/25/2022 BPJS RJ 197
162 54090 WIDI WISMASARI 1/25/2022 BPJS RJ 198
163 43394 KAMINEM 1/25/2022 BPJS RJ 199
164 52756 KAMIN 1/25/2022 BPJS RJ 200
201 54181 ETIK 1/31/2022 BPJS RJ

202 48750 AZKAYRA 1/31/2022 BPJS RI
203 54804 KUAT 1/31/2022 BPJS RI
204 21039 AHMAD MUZAKY 1/31/2022 BPJS RJ

BAYAR RJ RI
1 52660 HADI MUHASIM 1/3/2022 UMUM RJ
2 52583 SRIYATNO 1/3/2022 UMUM RJ
3 53232 BAGAS 1/10/2022 UMUM RJ
4 53861 ARFAN RIFKY 1/11/2022 UMUM RJ
5 53207 KHAIRUL UMAM 1/11/2022 UMUM RJ
6 53558 BENI TULUS 1/12/2022 UMUM RJ
7 53313 SUPARDI 1/13/2022 UMUM RJ
8 53935 SAIKEM 1/13/2022 UMUM RI
9 53907 NGATIYEM 1/17/2022 UMUM RJ
10 45271 URSULA 1/17/2022 UMUM RJ
11 51939 SUNDARI 1/18/2022 UMUM RJ
12 53558 BENI TULUS 1/19/2022 UMUM RJ
13 54067 EXCELINE 1/20/2022 UMUM RJ
14 45271 URSULA 1/24/2022 UMUM RJ
15 54180 MULYADI 1/25/2022 UMUM RJ
16 53907 NGATIYEM 27/0I/2022 UMUM RJ
17 54253 YUSRONI 1/27/2022 UMUM RJ
18 45271 URSULA 1/29/2022 UMUM RJ
OLIKLINIK BEDAH
BNU WAHID, Sp.B
JANUARI 2022
RM NAMA TANGGAL CARA KET

BAYAR RJ RI
50142 SUKINO 1/6/2022 BPJS RJ
37037 MARMI 1/6/2022 BPJS RJ
53204 GINO 1/6/2022 BPJS RJ
52623 SANIKEM 1/6/2022 BPJS RJ
53558 BENI 1/7/2022 BPJS RI
53695 IDA 1/7/2022 BPJS RI
53309 GALEH DWI 1/7/2022 BPJS RJ
53143 OKTARA 1/7/2022 BPJS RJ
53203 ANGGAR 1/7/2022 BPJS RJ
53373 MARMIN 1/7/2022 BPJS RJ
40491 SUTARTI 1/7/2022 BPJS RJ
53082 WIDODO 1/7/2022 BPJS RJ
52020 NGATMIN 1/7/2022 BPJS RJ
53340 TRI ASOFAH 1/7/2022 BPJS RJ
46295 SARWINI 1/7/2022 BPJS RJ
53198 WINARSIH 1/7/2022 BPJS RJ
52064 TRI SUSI 1/8/2022 BPJS RJ
50324 SRI LESTARI 1/8/2022 BPJS RJ
45271 URSULA 1/10/2022 BPJS RI
52396 ARIF WICAKSONO 1/10/2022 BPJS RJ
52178 SARIYEM 1/10/2022 BPJS RJ
53820 MUHTAR 1/10/2022 BPJS RI
52818 SUMARYONO 1/10/2022 BPJS RJ
46511 LANGKIR 1/10/2022 BPJS RJ
21039 AHMAD MUZAKI 1/10/2022 BPJS RJ
52675 KARTI 1/10/2022 BPJS RJ
53154 WASIMAN 1/10/2022 BPJS RJ
47636 YUNIATI 1/10/2022 BPJS RJ
52583 SRIYATNO 1/10/2022 BPJS RJ
53833 SUNARNO 1/11/2022 BPJS RI
50324 SRI LESTARI 1/15/2022 BPJS RJ

53695 IDA RAHMAWATI 1/15/2022 BPJS RJ
53702 VADILLLA BERLIANY 1/15/2022 BPJS RJ
53602 KIRDI 1/17/2022 BPJS RI
54090 WIDI WISMASARI 1/17/2022 BPJS RI
53232 BAGAS PANJERINO 1/17/2022 BPJS RJ
52178 SARIYEM 1/17/2022 BPJS RJ
51361 SULARNI 1/17/2022 BPJS RJ
52818 SUMARYONO 1/17/2022 BPJS RJ
21039 AHMAD MUZAKI 1/17/2022 BPJS RJ
52035 PATMO SUWITO 1/17/2022 BPJS RJ
40721 ABBAS NUR 1/17/2022 BPJS RJ
51662 MUKINEM 1/17/2022 BPJS RJ
46511 LANGKIR KROMO 1/17/2022 BPJS RJ
52675 KARTI 1/17/2022 BPJS RJ
44606 TIYEM 1/18/2022 BPJS RI
43207 TONY ANGGARA 1/18/2022 BPJS RI
54181 ETIK 1/18/2022 BPJS RI
54184 FAUZIAH 1/18/2022 BPJS RI
52305 PONIYATI 1/18/2022 BPJS RJ
53820 MUHTAR KHUDORI 1/18/2022 BPJS RJ
53414 YESSI AYUSARI 1/18/2022 BPJS RJ
52756 KAMIN 1/18/2022 BPJS RJ
53434 TEGAR 1/18/2022 BPJS RJ
53850 SUTIYARSO 1/18/2022 BPJS RJ
53312 WASIYOKO 1/18/2022 BPJS RJ
54195 DWI SUSANA 1/19/2022 BPJS RI
35923 SUKENDI 1/19/2022 BPJS RI
53833 SUNARNO 1/19/2022 BPJS RJ
52165 AINA DURROTUN 1/19/2022 BPJS RJ
54244 SARAH NOVIANTI 1/19/2022 BPJS RJ
53816 PONIYEM 1/20/2022 BPJS RI
53869 EVA ANITA 1/20/2022 BPJS RI
53907 NGATIYEM 1/20/2022 BPJS RI
54012 SEPTYAN ARDILA 1/20/2022 BPJS RJ
53820 MUHTAR KHUDORI 1/25/2022 BPJS RJ

54674 SUPRIYATI 1/26/2022 BPJS RJ
53318 SUMARNI 1/26/2022 BPJS RJ
54442 SARWINI 1/26/2022 BPJS RJ
54184 FAUZIAH RESMA 1/26/2022 BPJS RJ
53833 SUNARNO 1/26/2022 BPJS RJ
54696 RAKINO 1/26/2022 BPJS RJ
54689 BOIMIN 1/27/2022 BPJS RI
50417 AMAR NUR 1/27/2022 BPJS RI
53816 PONIYEM 1/27/2022 BPJS RJ
53602 KIRDI 1/27/2022 BPJS RJ
35923 SUKENDI 1/27/2022 BPJS RJ
54738 MUSTOFA 1/27/2022 BPJS RI
53869 EVA ANITA 1/27/2022 BPJS RJ
53913 SUPARMI 1/28/2022 BPJS RI
53835 SUTIMAN 1/28/2022 BPJS RJ
48750 AZKAYRA 1/28/2022 BPJS RJ
53927 SASKYA ANJANI 1/28/2022 BPJS RJ
53818 TUKINI 1/28/2022 BPJS RJ
53914 INTAN 1/28/2022 BPJS RJ
53889 ANDI CAHYONO 1/28/2022 BPJS RJ
52205 SUMARNING 1/29/2022 BPJS RJ
53312 WASIYOKO 1/29/2022 BPJS RJ
44606 TIYEM 1/29/2022 BPJS RJ
53931 GIYARSI 1/29/2022 BPJS RJ
53695 IDA RAHMAWWATI 1/29/2022 BPJS RJ
45682 SISWANTO 1/31/2022 BPJS RI
52623 SANIKEM 1/31/2022 BPJS RJ
52675 KARTI 1/31/2022 BPJS RJ
52035 PATMO SUWITO 1/31/2022 BPJS RJ
54188 AGUS DIAN 1/31/2022 BPJS RJ
53125 PARMIN 1/31/2022 BPJS RJ
54384 SUWANDI 1/31/2022 BPJS RJ
54368 ILHAM MAULANA 1/31/2022 BPJS RJ
53374 AJI TITIS 1/31/2022 BPJS RJ
PASIEN BPJS : 204

BPJS RAJAL : 159
BPJS RANAP : 45
PASIEN UMUM : 18
UMUM RAJAL : 17
UMUM RANAP :1
TOTAL PASIEN : 222

LAPORAN POLIKLINIK OBGINE
Dr. M.KHOMEINI PRIBADI, Sp.OG
BULAN JANUARI 2022

BAYAR RJ RI
1 53918 SANIKEM 1/12/2022 UMUM RJ
2 54263 ESTUNING RAHAYU 1/19/2022 UMUM RJ
3 54058 SUTINI 1/19/2022 UMUM RI
4 54508 DESI FITIKA 1/24/2022 UMUM RJ
5 54058 SUTINI 1/26/2022 UMUM RJ
6 54296 DESTANIA RIZKY 1/26/2022 UMUM RJ
7 54508 DESI FITIKA 1/26/2022 UMUM RI
PASIEN UMUM RJ :5
PASIEN UMUM RI :2
TOTAL PASIEN :7
LAPORAN POLIKLINIK AN
Dr. M.SURYANTO,Sp.A
BULAN JANUARI 2022

BAYAR RJ RI
1 53244 BERLIANO 1/3/2022 BPJS RJ
2 53148 AJENG AYU 1/3/2022 BPJS RJ
3 53378 TRI PEBRIANTI 1/3/2022 BPJS RJ
4 26113 ARJUNA GIBRAN 1/3/2022 BPJS RJ
5 48654 SUMAYYAH 1/3/2022 BPJS RJ
6 53167 AULIAN AZAM 1/3/2022 BPJS RJ
7 53556 AULIA NAZWA 1/4/2022 BPJS RJ
8 29641 NAZWA MIKAILA 1/4/2022 BPJS RJ
9 29261 AHMAD TETUKO 1/4/2022 BPJS RJ
10 53577 KIRANA 1/4/2022 BPJS RI
11 51098 VANILA 1/5/2022 BPJS RJ
12 36407 TALITHA 1/5/2022 BPJS RJ
13 20556 JAVAS FAYAD 1/6/2022 BPJS RJ
14 31370 HERJUNA NUR 1/6/2022 BPJS RJ
15 37253 NAILA AYUN 1/6/2022 BPJS RJ
16 38428 ADISKA 1/6/2022 BPJS RJ
17 53395 HYO DEMETRIO 1/7/2022 BPJS RJ
18 53766 SUSILO 1/8/2022 BPJS RI
19 53378 TRI PEBRIANTI 1/8/2022 BPJS RJ
20 53768 RENANZA 1/8/2022 BPJS RJ
21 46340 AZIFAH 1/8/2022 BPJS RJ
22 53555 HABIB FADHIL 1/10/2022 BPJS RJ
23 53603 FATABAYOMI 1/10/2022 BPJS RJ
24 30210 RASYID HISYAM 1/10/2022 BPJS RJ
25 17625 REZA WAHYU 1/10/2022 BPJS RJ
26 53522 ABHI PAWITRA 1/11/2022 BPJS RJ
27 56667 ABILA ZOYA 1/11/2022 BPJS RJ
29 53853 DIKA SALDA 1/11/2022 BPJS RJ
30 46170 ABDUL KARIM 1/11/2022 BPJS RJ
31 36490 REYVALIA 1/12/2022 BPJS RJ
32 53865 ELZIO ALFARIZQY 1/12/2022 BPJS RJ
33 53768 RENANZA 1/13/2022 BPJS RJ
34 26834 ARGANTA 1/13/2022 BPJS RJ
35 31440 CYRINDA NAVYA 1/13/2022 BPJS RJ
36 54007 TSABITHA 1/13/2022 BPJS RJ
37 54045 HANAN RAUSAN 1/14/2022 BPJS RJ
38 35951 MAHES FADLU 1/15/2022 BPJS RJ
39 45131 NUR ANISA 1/15/2022 BPJS RJ
40 53512 ADRIAN TRISTAN 1/15/2022 BPJS RJ
41 53734 KANAYA VIRA 1/15/2022 BPJS RJ
42 25609 NIZAM AL FADILLAH 1/15/2022 BPJS RJ
43 16898 NAIYA NAFISA 1/15/2022 BPJS RJ
44 53766 SUSILO NUGRAHA 1/15/2022 BPJS RJ
45 27176 PUSPA AYU 1/15/2022 BPJS RJ
46 22607 M.ALDO 1/15/2022 BPJS RJ
47 53826 AHMAD NUR 1/16/2022 BPJS RJ
48 54446 OKTAVIA SALSA 1/16/2022 BPJS RJ
49 54171 ATQIA KINANTI 1/17/2022 BPJS RJ
50 54452 AYUN PUTRI 1/17/2022 BPJS RJ
51 52303 ALKA RANSI 1/17/2022 BPJS RJ
52 46666 THALITA KHANZA 1/18/2022 BPJS RJ
54 23192 HARSHAD NAUVAL 1/18/2022 BPJS RJ
55 53484 ATS TSAQIF 1/18/2022 BPJS RJ
56 54196 ALVIE DYAS 1/18/2022 BPJS RJ
58 52210 ASYIFA PUTRI 1/18/2022 BPJS RJ
59 53878 SERGIONINO 1/19/2022 BPJS RJ
60 53877 AINUN 1/19/2022 BPJS RJ
61 53934 SATRIA SUNJA 1/19/2022 BPJS RJ
62 53867 ABDULLAH HASAN 1/19/2022 BPJS RJ
63 53865 ELZIO ALFARIZQI 1/19/2022 BPJS RJ
64 53896 ERLANGGA SATRIO 1/20/2022 BPJS RJ
65 10445 ILHAM MUH 1/20/2022 BPJS RJ
66 25061 HAFIZ RAMADAN 1/20/2022 BPJS RJ
67 54300 M. HASAN 1/20/2022 BPJS RJ
68 38875 YAZID MUFA 1/20/2022 BPJS RJ
69 54037 ARFAN GHAISAN 1/21/2022 BPJS RJ
70 54043 QORI QURROTA 1/21/2022 BPJS RJ
71 22607 M.ALDO 1/21/2022 BPJS RJ
72 36402 ALIFIANO 1/22/2022 BPJS RJ
73 35272 RENDI 1/22/2022 BPJS RJ
74 54372 KEINZHU 1/22/2022 BPJS RJ
75 54196 ALVIE DYAH 1/25/2022 BPJS RJ
77 54186 HANIF RAQILA 1/25/2022 BPJS RJ
78 27365 HAFIZ AZZAM 1/25/2022 BPJS RJ
79 54427 LOUIS MAHREZ 1/25/2022 BPJS RJ
80 36843 ALIFA H 1/25/2022 BPJS RJ
82 35296 KANAKA 1/27/2022 BPJS RJ
83 52968 BAHY SABIT 1/27/2022 BPJS RJ
84 44539 REZA WAHYU 1/27/2022 BPJS RJ
85 54503 GEVANO 1/28/2022 BPJS RJ
86 22671 FIRMANSYAH 1/28/2022 BPJS RJ
87 15592 YESI AGUSTINA 1/28/2022 BPJS RJ
88 54118 LUTHFIA 1/29/2022 BPJS RJ
89 54358 ALIFA ILMA 1/29/2022 BPJS RJ
90 35059 JOSEP YESURUN 1/29/2022 BPJS RJ
91 54806 HANIFA YAHYA 1/29/2022 BPJS RJ
92 54300 M.HASAN 1/29/2022 BPJS RJ
93 54664 NAYLA 1/31/2022 BPJS RJ
94 48467 AHMAD SHAQIL 1/31/2022 BPJS RJ
95 54395 LUQMAN FAUZIL 1/31/2022 BPJS RJ
96 54735 RATISA 1/31/2022 BPJS RJ
PASIEN BPJS : 96
BPJS RAJAL : 94
BPJS RANAP :2
PASIEN UMUM : 94
UMUM RAJAL : 92
UMUM RANAP :2
TOTAL PASIEN : 190

ORAN POLIKLINIK ANAK
Dr. M.SURYANTO,Sp.A
BULAN JANUARI 2022

BAYAR RJ RI
1 53532 ALIFATA 1/3/2022 UMUM RJ
2 34778 ARSYILA 1/3/2022 UMUM RJ
3 53536 AZKAYRA 1/3/2022 UMUM RJ
4 53501 M.AHNAF 1/3/2022 UMUM RJ
5 39170 NAFISHA SAFA 1/3/2022 UMUM RJ
6 53289 NADHIRA 1/3/2022 UMUM RJ
7 53302 M.RAFIF 1/3/2022 UMUM RJ
8 31626 ARTHA NABIL 1/4/2022 UMUM RJ
9 53570 KEN NOZA 1/4/2022 UMUM RJ
10 51098 VANILA SABRINA 1/5/2022 UMUM RJ
11 36407 TALITA SAFA 1/5/2022 UMUM RJ
12 53677 RASYA ADITYA 1/6/2022 UMUM RJ
13 53501 M.AHNAF 1/6/2022 UMUM RJ
14 53536 AZKAYRA 1/6/2022 UMUM RJ
15 14514 M.ZIDAN 1/6/2022 UMUM RJ
16 53532 ALIFATA 1/6/2022 UMUM RJ
17 53724 MIKHAILA 1/7/2022 UMUM RJ
18 53717 ZAIN MALIK 1/7/2022 UMUM RJ
19 36628 FEODORA 1/8/2022 UMUM RJ
20 53290 GUNTUR PRASETYO 1/8/2022 UMUM RJ
21 53742 FEBI ALZAN 1/8/2022 UMUM RJ
22 51098 VANILA SABRINA 1/8/2022 UMUM RJ
23 53857 ASSHOFI SYABANI 1/11/2022 UMUM RJ
24 20590 NAURA QAIRIN 1/11/2022 UMUM RJ
25 53899 DAFFA ANJAR 1/12/2022 UMUM RJ
26 58901 ALYA PRAMESTI 1/12/2022 UMUM RJ
27 53910 M.HAFIDZ 1/12/2022 UMUM RJ
28 43505 ALEXANDER GILBERT 1/12/2022 UMUM RI
29 29294 FALISHA 1/12/2022 UMUM RJ
30 53995 SATRIYA BANGUN 1/13/2022 UMUM RJ
31 27841 FAHRUL NOVA 1/13/2022 UMUM RJ
32 36643 LUSYANA 1/13/2022 UMUM RJ
33 54014 ARKADAVI 1/13/2022 UMUM RJ
34 53081 ATHAFARIS 1/14/2022 UMUM RJ
35 54051 NATHAN ALHAFIZ 1/14/2022 UMUM RJ
36 23998 ABIDZAR 1/14/2022 UMUM RJ
37 50260 ROUF FAHREZA 1/15/2022 UMUM RJ
38 54098 SANDRA 1/15/2022 UMUM RJ
39 54101 SALSA HUMAIRA 1/15/2022 UMUM RJ
40 49964 BOBY BERLYNO 1/17/2022 UMUM RJ
41 52678 M.YASIN 1/17/2022 UMUM RJ
42 54014 ARKADAVI 1/17/2022 UMUM RJ
43 23998 ABIDZAR ARYA 1/17/2022 UMUM RJ
44 54165 CHIKA MURNIATI 1/17/2022 UMUM RJ
45 23340 DANIS SAPUTRA 1/17/2022 UMUM RJ
46 33529 ALIF RIFIA 1/17/2022 UMUM RJ
47 54098 SANDRA 1/17/2022 UMUM RJ
48 54174 NASYA G.S 1/17/2022 UMUM RJ
49 54171 ATQIA KINANTI 1/17/2022 UMUM RI
50 54145 ARZHETA GALVIN 1/18/2022 UMUM RJ
51 54189 SALSA AULIA 1/18/2022 UMUM RJ
52 54101 SALSA HUMAIRAH 1/19/2022 UMUM RJ
53 52378 NAUFAL AULIAN 1/19/2022 UMUM RJ
54 54260 SHAREFFA 1/19/2022 UMUM RJ
55 54261 AZHRI ALFATHAN 1/19/2022 UMUM RJ
56 54290 YUNITA NUR 1/20/2022 UMUM RJ
57 51038 BERYL ARSYA 1/20/2022 UMUM RJ
58 53192 ATAHYA ZAKKY 1/20/2022 UMUM RJ
59 54308 AFRIAN QOSIM 1/20/2022 UMUM RJ
60 54310 NAILA SHIFA 1/20/2022 UMUM RJ
61 54343 KAYSAN DELVIN 1/21/2022 UMUM RJ
62 24408 ANISA AYU 1/22/2022 UMUM RJ
64 34539 ALIFAH 1/22/2022 UMUM RJ
65 54371 ARUMI 1/22/2022 UMUM RJ
66 46832 ADEVA REVANI 1/22/2022 UMUM RJ
67 54261 AZHRI ALFATHAN 1/22/2022 UMUM RJ
68 53477 RAKA RAFIF 1/22/2022 UMUM RJ
69 43075 M. FARIS 1/22/2022 UMUM RJ
70 54290 YUNITA NUR 1/24/2022 UMUM RJ
71 54260 SHAFERA 1/24/2022 UMUM RJ
72 54506 PUTRI ZHAFIRA 1/24/2022 UMUM RJ
73 RUFID 1/24/2022 UMUM RJ
74 46384 ARUMI 1/25/2022 UMUM RJ
75 54663 HAFIZAM AKBAR 1/25/2022 UMUM RJ
76 38929 KENAN GUSTIAN 1/26/2022 UMUM RJ
77 54703 RAYDEN ARSHAKA 1/26/2022 UMUM RJ
79 ARDINA PUTRI 1/26/2022 UMUM RJ
80 BELLA SUCI 1/26/2022 UMUM RJ
81 54267 FINA DIAS 1/26/2022 UMUM RJ
82 54735 RATISA NOVA 1/27/2022 UMUM RJ
83 52378 NAUFAL AULIAN 1/27/2022 UMUM RJ
84 14489 IFTINAN MASAYA 1/27/2022 UMUM RJ
85 54506 PUTRI ZHAFIRA 1/27/2022 UMUM RJ
86 54744 RARENDRA 1/27/2022 UMUM RJ
87 54663 HAFIZAM AKBAR 1/28/2022 UMUM RJ
88 54330 FITRI EKA 1/28/2022 UMUM RJ
89 54765 KHALILA MAITSA 1/28/2022 UMUM RJ
90 45825 JOVINKA 1/28/2022 UMUM RJ
91 54298 DESTANIA 1/28/2022 UMUM RJ
92 54809 KHADIJAH 1/29/2022 UMUM RJ
93 45595 ADINATA 1/29/2022 UMUM RJ
94 43075 M.FARIS 1/31/2022 UMUM RJ
LAPORAN POLIKLINIK A
Dr. DEWINDA,Sp.A
BULAN JANUARI 2022

BAYAR RJ RI
1 31270 M.RIDWAN 1/3/2022 BPJS RJ
2 52136 SAKHA ADLI 1/3/2022 BPJS RJ
3 53319 SHOFIA NURUL 1/4/2022 BPJS RJ
4 40654 ISNAN NURUL 1/4/2022 BPJS RJ
5 53338 AFFIN DANIEL 1/4/2022 BPJS RJ
6 52713 GANDHI 1/4/2022 BPJS RJ
7 53349 REVANSA 1/5/2022 BPJS RJ
8 52401 KHALISA NUHA 1/6/2022 BPJS RJ
9 37731 AHZA RANDIKA 1/7/2022 BPJS RJ
10 52317 NABILA PUAN 1/8/2022 BPJS RJ
11 54440 JIHAN AYUNDA 1/8/2022 BPJS RJ
12 53090 JASMINE 1/10/2022 BPJS RJ
13 53691 MAULANA 1/10/2022 BPJS RJ
14 53680 AZIGHA MAHIRA 1/11/2022 BPJS RJ
15 28937 FARENDRA 1/13/2022 BPJS RJ
16 22966 ADYATMA 1/13/2022 BPJS RJ
17 54026 HARIS DWI 1/13/2022 BPJS RI
18 52189 ROSSI DELVANOSA 1/13/2022 BPJS RJ
19 53654 ELIZABETH 1/14/2022 BPJS RJ
20 53572 DINI ARISKA 1/14/2022 BPJS RJ
21 53683 ALVIN PUTRA 1/14/2022 BPJS RJ
22 54053 BRATADHIKARA 1/14/2022 BPJS RJ
23 51793 RIZKY PUJI 1/15/2022 BPJS RJ
24 DELISHA 1/15/2022 BPJS RJ
25 54025 ARSLAN 1/15/2022 BPJS RJ
26 30531 SELLA SINTIA 1/17/2022 BPJS RJ
27 53656 ZOELVA AL HABSY 1/17/2022 BPJS RJ
28 51873 NINGRUM SUKMA 1/17/2022 BPJS RJ
29 52039 AQSHA 1/18/2022 BPJS RJ
30 53672 AKBAR RAKA 1/18/2022 BPJS RJ
31 42086 NUR FATAN 1/18/2022 BPJS RJ
32 53879 AGNES MEITARA 1/19/2022 BPJS RJ
33 53997 ARKANANTA 1/21/2022 BPJS RJ
34 38345 SAFIN AL FATIH 1/22/2022 BPJS RJ
35 54020 AZKADINA 1/22/2022 BPJS RJ
36 54089 SHENDY 1/24/2022 BPJS RJ
37 54512 RIZKY ROMANSA 1/24/2022 BPJS RJ
38 51873 NINGRUM SUKMA 1/25/2022 BPJS RJ
39 27870 MISHELA 1/25/2022 BPJS RJ
40 54681 ADEEVA 1/25/2022 BPJS RJ
41 54026 HARIS DWI 1/26/2022 BPJS RJ
42 54208 AZKA NATA 1/28/2022 BPJS RJ
43 54786 EVOLETTA 1/28/2022 BPJS RJ
44 47357 ADITYA GUSTI 1/29/2022 BPJS RJ
45 46597 VARLENE 1/29/2022 BPJS RJ
46 54512 RIZKY ROMANSA 1/31/2022 BPJS RJ
PASIEN BPJS : 46
BPJS RAJAL : 45
BPJS RANAP :1
PASIEN UMUM : 61
UMUM RAJAL : 61
UMUM RANAP :-
TOTAL PASIEN : 107

AN POLIKLINIK ANAK
Dr. DEWINDA,Sp.A
LAN JANUARI 2022

BAYAR RJ RI
1 53224 M.HAFIDZUL 1/3/2022 UMUM RJ
2 53311 M.AQLAN 1/3/2022 UMUM RJ
3 53339 BRIAN CAHYA 1/3/2022 UMUM RJ
4 53171 RARA 1/4/2022 UMUM RJ
5 53700 TAJ MUH.HAIKAL 1/6/2022 UMUM RJ
6 53698 ALHANAN YAFIQ 1/6/2022 UMUM RJ
7 51325 DEVANDRA 1/7/2022 UMUM RJ
8 53737 KEENAN ALGHAFI 1/7/2022 UMUM RJ
9 53777 CHANARAYYA 1/8/2022 UMUM RJ
10 30454 DEBINAR 1/8/2022 UMUM RJ
11 50943 LANA SHEZAN 1/8/2022 UMUM RJ
12 46597 VARLENE 1/8/2022 UMUM RJ
13 30454 DEBINAR 1/10/2022 UMUM RJ
14 53834 FAMELA 1/10/2022 UMUM RJ
15 53824 AMELIYA 1/10/2022 UMUM RJ
16 52822 CLARISA 1/10/2022 UMUM RJ
17 53586 AJENG RHEVA 1/10/2022 UMUM RJ
18 53279 ABID ZIKRI 1/11/2022 UMUM RJ
19 53110 NAYLA 1/12/2022 UMUM RJ
20 53694 VELLA MEGA 1/12/2022 UMUM RJ
21 53891 FARADZIVA 1/12/2022 UMUM RJ
22 29443 CLARISSA 1/13/2022 UMUM RJ
23 54025 ARSLAN ISMAIL 1/13/2022 UMUM RJ
24 54028 FARELLIO 1/13/2022 UMUM RJ
25 52057 ROMI MARCELINO 1/14/2022 UMUM RJ
26 54108 GAZALA ZIYA 1/15/2022 UMUM RJ
27 53171 RARA 1/15/2022 UMUM RJ
28 54187 SELINA 1/17/2022 UMUM RJ
29 54185 QUINZHA 1/17/2022 UMUM RJ
30 54145 RINELDA 1/17/2022 UMUM RJ
31 19829 ZIAN HILMI 1/17/2022 UMUM RJ
32 33176 ACHMAD AZZAM 1/17/2022 UMUM RJ
33 53171 RARA 1/18/2022 UMUM RJ
34 54221 RAINA SELOKILAN 1/18/2022 UMUM RJ
35 54232 ABELIA 1/19/2022 UMUM RJ
36 54268 KHANSA 1/19/2022 UMUM RJ
37 43075 MUH. FARIS 1/19/2022 UMUM RJ
38 54318 NAFISHA 1/20/2022 UMUM RJ
39 54110 DITA AMELIA 1/20/2022 UMUM RJ
40 28841 ALISHA 1/20/2022 UMUM RJ
41 52823 ABIDAN DZAKI 1/21/2022 UMUM RJ
42 54107 MUH. ASHAF 1/21/2022 UMUM RJ
43 54353 VALENDRA 1/21/2022 UMUM RJ
44 54380 RASYAD 1/22/2022 UMUM RJ
45 19829 ZIAN HILMI 1/22/2022 UMUM RJ
46 54318 NAFISHA 1/24/2022 UMUM RJ
47 54228 NADEO 1/25/2022 UMUM RJ
48 54291 MUH. NIZAM 1/25/2022 UMUM RJ
49 54323 JOVANKA 1/25/2022 UMUM RJ
50 54325 IZZUHU AHMAD 1/26/2022 UMUM RJ
51 54126 M.AZKA ASY'ARI 1/26/2022 UMUM RJ
52 54366 ZHIFARA 1/28/2022 UMUM RJ
53 54387 FIDELYA 1/28/2022 UMUM RJ
54 54790 ALYA HUSNA 1/28/2022 UMUM RJ
55 54823 MUH. ARFAN 1/29/2022 UMUM RJ
56 28134 AISYAH WAHYUDA 1/29/2022 UMUM RJ
57 54822 ARSYILA 1/29/2022 UMUM RJ
58 54821 MUH. VADIL 1/29/2022 UMUM RJ
59 53683 ALVIN PUTRA 1/29/2022 UMUM RJ
60 54318 NAFISHA 1/31/2022 UMUM RJ
61 53311 MUH. AQLAN 1/31/2022 UMUM RJ
REKAPAN POLIKLINIK BULAN JANUARI 2022
1 POLI ANAK DR.SURYANTO,Sp.A 5 POLI SYARAF DR. MISNAHATI,Sp.S

PASIEN BPJS : 96 PASIEN BPJS
BPJS RAJAL : 94 BPJS RAJAL
BPJS RANAP :2 BPJS RANAP
PASIEN UMUM : 94 PASIEN UMUM

UMUM RAJAL : 92 UMUM RAJAL
UMUM RANAP :2 UMUM RANAP
PASIEN JASA RAH
TOTAL PASIEN : 190
TOTAL PASIEN
2 POLI ANAK DR.DEWINDA,Sp.A
PASIEN BPJS : 46 6 POLI JANTUNG DR.FIRDA JAYA, S
BPJS RAJAL : 45 PASIEN BPJS
BPJS RANAP :1 BPJS RAJAL
BPJS RANAP
PASIEN UMUM : 61
UMUM RAJAL : 61 PASIEN UMUM
UMUM RANAP :- UMUM RAJAL
UMUM RANAP
TOTAL PASIEN : 107
TOTAL PASIEN : 370
3 POLI UROLOGI DR.ANDRI KUSUMA,Sp.U
PASIEN BPJS : 106 7 POLI JANTUNG DR.ADI BESTARA,
BPJS RAJAL : 100 PASIEN BPJS
BPJS RANAP :6 BPJS RAJAL
BPJS RANAP
PASIEN UMUM : 23
UMUM RAJAL : 23 PASIEN UMUM
UMUM RANAP :- UMUM RAJAL
UMUM RANAP
TOTAL PASIEN : 129
TOTAL PASIEN
4 POLI BEDAH DR.DIAN IBNU WAHID,Sp.B
PASIEN BPJS : 204 8 POLI OBGINE DR.M.KHOMEINI PR
BPJS RAJAL : 159
BPJS RANAP : 45 PASIEN : 5
PASIEN : 2
PASIEN UMUM : 18
UMUM RAJAL : 17 TOTAL PA: 7
UMUM RANAP :1
TOTAL PASIEN : 222

022
ARAF DR. MISNAHATI,Sp.S

: 186
: 182
:4
:8
:8
:-
:2
: 196
NTUNG DR.FIRDA JAYA, SpJP FIHA

: 351
: 350
:1
: 19
: 19
:-
ASIEN : 370
NTUNG DR.ADI BESTARA, SpJP FIHA

: 420
: 419
:1
: 19
: 19
:-
: 439
BGINE DR.M.KHOMEINI PRIBADI, Sp.OG

Poliklinik Depan Belakang Januari 2022

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Poliklinik Depan Belakang Januari 2022

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LAPORAN POLIKLINIK JANT

Dr. ADI BESTARA, Sp.JP FI

N0 RM NAMA TANGGAL CARA KET

61 37755 SRI RUNTINI 1/7/2022 BPJS RJ

131 47758 SUNARDI 1/11/2022 BPJS RJ

201 53713 EMI SUNDARI 1/15/2022 BPJS RJ

341 49179 SRI SUGIYARTI 1/25/2022 BPJS RJ

N0 RM NAMA TANGGAL CARA KET

N0 RM NAMA TANGGAL CARA KET

96 41460 ANDARWATI 1/8/2022 BPJS RJ

166 36511 DIJASANTO 1/14/2022 BPJS RJ

236 38141 SRININGSIH 1/18/2022 BPJS RJ

376 51955 KATARINA 1/29/2022 BPJS RJ

411 50913 SURIPTI 1/29/2022 BPJS RJ

PASIEN BPJS : 420

TOTAL PASIEN : 439

N0 RM NAMA TANGGAL CARA KET

61 49869 SANTOYO 1/6/2022 BPJS RJ

131 49719 TRIYATMI 1/13/2022 BPJS RJ

201 54257 PURWANTO 1/19/2022 BPJS RJ

341 42654 NGAPINI 1/31/2022 BPJS RJ

TOTAL PASIEN : 370

N0 RM NAMA TANGGAL CARA KET

96 41951 SUPI HARTANTO 1/10/2022 BPJS RJ

166 43962 PURNOMO 1/17/2022 BPJS RJ

236 37019 SUWARDI TIGOR 1/20/2022 BPJS RJ

N0 RM NAMA TANGGAL CARA KET

N0 RM NAMA TANGGAL CARA KET

61 38737 KUSTINI 1/11/2022 BPJS RJ

131 54405 SUPARNI 1/20/2022 BPJS RJ

PASIEN BPJS : 186

TOTAL PASIEN : 196

N0 RM NAMA TANGGAL CARA KET

96 54192 SUKARNO 1/18/2022 BPJS RJ

166 49592 MARMADI 1/27/2022 BPJS RJ

N0 RM NAMA TANGGAL CARA KET

N0 RM NAMA TANGGAL CARA KET

TANGG CARA KET

TANGG CARA KET

TANGG CARA KET

PASIEN UMUM = 120

TOTAL PASIEN BPJS =180

TOTAL PASIEN UMUM = 78

TANGG CARA KET

PASIEN BPJS =170

PASIEN BPJS =224

N0 RM NAMA TANGGAL CARA KET

61 54442 SARWINI 1/19/2022 BPJS RJ

PASIEN BPJS : 106

TOTAL PASIEN : 129

N0 RM NAMA TANGGAL CARA KET

96 38776 SATIMIN 1/28/2022 BPJS RJ

N0 RM NAMA TANGGAL CARA KET N0

61 54442 SARWINI 1/11/2022 BPJS RJ 96

130 54319 ZAIN AKBAR 1/20/2022 BPJS RJ 166

201 54181 ETIK 1/31/2022 BPJS RJ

N0 RM NAMA TANGGAL CARA KET

RM NAMA TANGGAL CARA KET

50324 SRI LESTARI 1/15/2022 BPJS RJ

53820 MUHTAR KHUDORI 1/25/2022 BPJS RJ

PASIEN BPJS : 204

TOTAL PASIEN : 222

N0 RM NAMA TANGGAL CARA KET

N0 RM NAMA TANGGAL CARA KET