FORMULIR

No Nama Pasien No.RM Tgl Masuk

General Pasien Informed Second Spiritual Permintaan
Consent Terminal Consent Tind.Medis DNR Opinion Record Yan.Kerohanian
y t y t y t ya tdk y t y t y t y t
1 0 1 0 1 0 1 0 0 1 1 0 1 0 0 1
1 0 1 0 1 0 1 0 0 1 1 0 1 0 0 1
1 0 1 0 1 0 1 0 0 1 1 0 1 0 0 1
1 0 1 0 1 0 0 1 0 1 1 0 1 0 0 1
1 0 1 0 1 0 0 1 0 1 1 0 0 1 0 1
1 0 1 0 0 1 0 1 0 1 0 1 0 1 0 1
1 0 1 0 0 1 0 1 1 0 0 1 0 1 0 1
1 0 1 0 0 1 0 1 1 0 0 1 0 1 1 0
0 1 1 0 0 1 0 1 1 0 0 1 0 1 1 0
0 1 1 0 0 1 0 1 1 0 0 1 0 1 1 0
1 0 0 1 0 1 0 1 1 0 0 1 0 1 1 0
1 0 0 1 0 1 1 0 1 0 0 1 1 1 1 0
0 1 0 1 0 1 1 0 1 0 0 1 1 1 1 0
0 1 0 1 0 1 1 0 0 1 0 1 1 0 1 0
1 0 0 1 0 1 1 0 0 1 0 1 1 0 1 0
1 0 0 1 1 0 1 0 0 1 1 0 1 0 0 1
1 0 0 1 1 0 1 0 0 1 1 0 1 0 0 1
1 0 0 1 1 0 1 0 1 0 1 0 1 0 0 1
1 0 0 1 1 0 1 0 1 0 1 0 1 0 0 1
1 0 0 1 1 0 1 0 1 0 1 0 0 0 0 1
1 0 0 1 1 0 0 1 1 0 1 0 0 0 0 1
1 0 0 1 1 0 0 1 1 0 1 0 0 1 0 1
1 0 0 1 1 0 0 1 1 0 0 1 0 1 0 1
1 0 1 0 1 0 0 1 1 0 0 1 0 1 1 0
 1 0 1 0 1 0 1 0 1 0 0 1 0 1 1 0
total 21 4 12 13 15 10 13 12 15 10 12 13 12 13 10 15
Penyimpanan
Barang milik
pasien
y t form Gc PT IC TM DNR SO
0 1 0.84 0.48 0.6 0.52 0.6 0.96
0 1
0 1
0 1
0 1 25 25 25 25 25 25
1 0
1 0
1 0
1 0
1 0
1 0
1 0
1 0
0 1
0 1
0 1
0 1
0 1
0 1
0 1
0 1
1 0
1 0
1 0
 1 0
12 13
SR PK PBP
0.48 0.4 0.48

25 25 25
 FORMULIR

No Nama Pasien No.RM Tgl Masuk

General Pasien Informed Second Spiritual Permintaan
Consent Terminal Consent Tind.Medis DNR Opinion Record Yan.Kerohanian
y t y t y t ya tdk y t y t y t y t
1 0 1 0 1 0 1 0 0 1 1 0 1 0 0 1
1 0 1 0 1 0 1 0 0 1 1 0 1 0 0 1
1 0 1 0 1 0 1 0 0 1 1 0 1 0 0 1
1 0 1 0 1 0 0 1 0 1 1 0 1 0 0 1
1 0 1 0 1 0 0 1 0 1 1 0 0 1 0 1
1 0 1 0 0 1 0 1 0 1 0 1 0 1 0 1
1 0 1 0 0 1 0 1 1 0 0 1 0 1 0 1
1 0 1 0 0 1 0 1 1 0 0 1 0 1 1 0
0 1 1 0 0 1 0 1 1 0 0 1 0 1 1 0
0 1 1 0 0 1 0 1 1 0 0 1 0 1 1 0
1 0 0 1 0 1 0 1 1 0 0 1 0 1 1 0
1 0 0 1 0 1 1 0 1 0 0 1 1 1 1 0
0 1 0 1 0 1 1 0 1 0 0 1 1 1 1 0
0 1 0 1 0 1 1 0 0 1 0 1 1 0 1 0
1 0 0 1 0 1 1 0 0 1 0 1 1 0 1 0
1 0 0 1 1 0 1 0 0 1 1 0 1 0 0 1
1 0 0 1 1 0 1 0 0 1 1 0 1 0 0 1
1 0 0 1 1 0 1 0 1 0 1 0 1 0 0 1
1 0 0 1 1 0 1 0 1 0 1 0 1 0 0 1
1 0 0 1 1 0 1 0 1 0 1 0 0 0 0 1
1 0 0 1 1 0 0 1 1 0 1 0 0 0 0 1
1 0 0 1 1 0 0 1 1 0 1 0 0 1 0 1
1 0 0 1 1 0 0 1 1 0 0 1 0 1 0 1
1 0 1 0 1 0 0 1 1 0 0 1 0 1 1 0
 1 0 1 0 1 0 1 0 1 0 0 1 0 1 1 0
total 21 4 12 13 15 10 13 12 15 10 12 13 12 13 10 15
Penyimpanan
Barang milik
pasien
y t form Gc PT IC TM DNR SO
0 1 0.84 0.48 0.6 0.52 0.6 0.96
0 1
0 1
0 1
0 1 25 25 25 25 25 25
1 0
1 0
1 0
1 0
1 0
1 0
1 0
1 0
0 1
0 1
0 1
0 1
0 1
0 1
0 1
0 1
1 0
1 0
1 0
 1 0
12 13
SR PK PBP
0.48 0.4 0.48

25 25 25
Agustus
FORMULIR
No Nama Pasien No.RM Tgl Masuk General Pasien Informed Tind. Permintaan Penyimpanan
Second Spiritual
DNR Yan. Barang milik
Consent Terminal Consent Medis Opinion Record
Kerohanian pasien
y t y t y t ya t y t y t y t y t y t
1 0 1 0 1 0 1 0 0 1 1 0 1 0 0 1 0 1
1 0 1 0 1 0 1 0 0 1 1 0 1 0 0 1 0 1
1 0 1 0 1 0 1 0 0 1 1 0 1 0 0 1 0 1
1 0 1 0 1 0 0 1 0 1 1 0 1 0 0 1 0 1
1 0 1 0 1 0 0 1 0 1 1 0 0 1 0 1 0 1
1 0 1 0 0 1 0 1 0 1 0 1 0 1 0 1 1 0
1 0 1 0 0 1 0 1 1 0 0 1 0 1 0 1 1 0
1 0 1 0 0 1 0 1 1 0 0 1 0 1 1 0 1 0
0 1 1 0 0 1 0 1 1 0 0 1 0 1 1 0 1 0
0 1 1 0 0 1 0 1 1 0 0 1 0 1 1 0 1 0
1 0 0 1 0 1 0 1 1 0 0 1 0 1 1 0 1 0
1 0 0 1 0 1 1 0 1 0 0 1 1 1 1 0 1 0
0 1 0 1 0 1 1 0 1 0 0 1 1 1 1 0 1 0
0 1 0 1 0 1 1 0 0 1 0 1 1 0 1 0 0 1
1 0 0 1 0 1 1 0 0 1 0 1 1 0 1 0 0 1
1 0 0 1 1 0 1 0 0 1 1 0 1 0 0 1 0 1
1 0 0 1 1 0 1 0 0 1 1 0 1 0 0 1 0 1
1 0 0 1 1 0 1 0 1 0 1 0 1 0 0 1 0 1
1 0 0 1 1 0 1 0 1 0 1 0 1 0 0 1 0 1
1 0 0 1 1 0 1 0 1 0 1 0 0 0 0 1 0 1
1 0 0 1 1 0 0 1 1 0 1 0 0 0 0 1 0 1
1 0 0 1 1 0 0 1 1 0 1 0 0 1 0 1 1 0
1 0 0 1 1 0 0 1 1 0 0 1 0 1 0 1 1 0
1 0 1 0 1 0 0 1 1 0 0 1 0 1 1 0 1 0
1 0 1 0 1 0 1 0 1 0 0 1 0 1 1 0 1 0
total 21 4 12 13 15 10 13 12 15 10 12 13 12 13 10 15 12 13
form Gc PT IC TM DNR SO SR
0.84 0.48 0.6 0.52 0.6 0.96 0.48

25 25 25 25 25 25 25
PK PBP
0.4 0.48

25 25
 FORMULIR

No Nama Pasien No.RM Tgl Masuk

General Pasien Informed Second Spiritual Permintaan
Consent Terminal Consent Tind.Medis DNR Opinion Record Yan.Kerohanian
y t y t y t ya tdk y t y t y t y t
1 0 1 0 1 0 1 0 0 1 1 0 1 0 0 1
1 0 1 0 1 0 1 0 0 1 1 0 1 0 0 1
1 0 1 0 1 0 1 0 0 1 1 0 1 0 0 1
1 0 1 0 1 0 0 1 0 1 1 0 1 0 0 1
1 0 1 0 1 0 0 1 0 1 1 0 0 1 0 1
1 0 1 0 0 1 0 1 0 1 0 1 0 1 0 1
1 0 1 0 0 1 0 1 1 0 0 1 0 1 0 1
1 0 1 0 0 1 0 1 1 0 0 1 0 1 1 0
0 1 1 0 0 1 0 1 1 0 0 1 0 1 1 0
0 1 1 0 0 1 0 1 1 0 0 1 0 1 1 0
1 0 0 1 0 1 0 1 1 0 0 1 0 1 1 0
1 0 0 1 0 1 1 0 1 0 0 1 1 1 1 0
0 1 0 1 0 1 1 0 1 0 0 1 1 1 1 0
0 1 0 1 0 1 1 0 0 1 0 1 1 0 1 0
1 0 0 1 0 1 1 0 0 1 0 1 1 0 1 0
1 0 0 1 1 0 1 0 0 1 1 0 1 0 0 1
1 0 0 1 1 0 1 0 0 1 1 0 1 0 0 1
1 0 0 1 1 0 1 0 1 0 1 0 1 0 0 1
1 0 0 1 1 0 1 0 1 0 1 0 1 0 0 1
1 0 0 1 1 0 1 0 1 0 1 0 0 0 0 1
1 0 0 1 1 0 0 1 1 0 1 0 0 0 0 1
1 0 0 1 1 0 0 1 1 0 1 0 0 1 0 1
1 0 0 1 1 0 0 1 1 0 0 1 0 1 0 1
1 0 1 0 1 0 0 1 1 0 0 1 0 1 1 0
 1 0 1 0 1 0 1 0 1 0 0 1 0 1 1 0
total 21 4 12 13 15 10 13 12 15 10 12 13 12 13 10 15
Penyimpanan
Barang milik
pasien
y t form Gc PT IC TM DNR SO
0 1 0.84 0.48 0.6 0.52 0.6 0.96
0 1
0 1
0 1
0 1 25 25 25 25 25 25
1 0
1 0
1 0
1 0
1 0
1 0
1 0
1 0
0 1
0 1
0 1
0 1
0 1
0 1
0 1
0 1
1 0
1 0
1 0
 1 0
12 13
SR PK PBP
0.48 0.4 0.48

25 25 25
 FORMULIR

No Nama Pasien No.RM Tgl Masuk

General Pasien Informed Second Spiritual Permintaan
Consent Terminal Consent Tind.Medis DNR Opinion Record Yan.Kerohanian
y t y t y t ya tdk y t y t y t y t
1 0 1 0 1 0 1 0 0 1 1 0 1 0 0 1
1 0 1 0 1 0 1 0 0 1 1 0 1 0 0 1
1 0 1 0 1 0 1 0 0 1 1 0 1 0 0 1
1 0 1 0 1 0 0 1 0 1 1 0 1 0 0 1
1 0 1 0 1 0 0 1 0 1 1 0 0 1 0 1
1 0 1 0 0 1 0 1 0 1 0 1 0 1 0 1
1 0 1 0 0 1 0 1 1 0 0 1 0 1 0 1
1 0 1 0 0 1 0 1 1 0 0 1 0 1 1 0
0 1 1 0 0 1 0 1 1 0 0 1 0 1 1 0
0 1 1 0 0 1 0 1 1 0 0 1 0 1 1 0
1 0 0 1 0 1 0 1 1 0 0 1 0 1 1 0
1 0 0 1 0 1 1 0 1 0 0 1 1 1 1 0
0 1 0 1 0 1 1 0 1 0 0 1 1 1 1 0
0 1 0 1 0 1 1 0 0 1 0 1 1 0 1 0
1 0 0 1 0 1 1 0 0 1 0 1 1 0 1 0
1 0 0 1 1 0 1 0 0 1 1 0 1 0 0 1
1 0 0 1 1 0 1 0 0 1 1 0 1 0 0 1
1 0 0 1 1 0 1 0 1 0 1 0 1 0 0 1
1 0 0 1 1 0 1 0 1 0 1 0 1 0 0 1
1 0 0 1 1 0 1 0 1 0 1 0 0 0 0 1
1 0 0 1 1 0 0 1 1 0 1 0 0 0 0 1
1 0 0 1 1 0 0 1 1 0 1 0 0 1 0 1
1 0 0 1 1 0 0 1 1 0 0 1 0 1 0 1
1 0 1 0 1 0 0 1 1 0 0 1 0 1 1 0
 1 0 1 0 1 0 1 0 1 0 0 1 0 1 1 0
total 21 4 12 13 15 10 13 12 15 10 12 13 12 13 10 15
Penyimpanan
Barang milik
pasien
y t form Gc PT IC TM DNR SO
0 1 0.84 0.48 0.6 0.52 0.6 0.96
0 1
0 1
0 1
0 1 25 25 25 25 25 25
1 0
1 0
1 0
1 0
1 0
1 0
1 0
1 0
0 1
0 1
0 1
0 1
0 1
0 1
0 1
0 1
1 0
1 0
1 0
 1 0
12 13
SR PK PBP
0.48 0.4 0.48

25 25 25
 R. Iskandar Muda Bulan Agt 2018
FORMULIR
NO Nama Pasien No.RM Tgl Masuk Diagnosa
Spiritual Record Permintaan
Kerohanian
y t y t
01 Juli ardiasyah 20 40 95 06 Agust 2018 osteone0losis 1 0 0 0
02 Nurdin 22 01 52 06 Agust 2018 DHF 1 0 0 0
03 Rumiati 42 51 46 06 Agust 2018 Hypertensi 1 0 0 0
04 Ratam 10.29.78 06 Agust 2018 Brest Neoplasma 1 0 0 0
05 Siti 07.21.23 03 Agust 2018 Bronchitis Acut 1 0 0 0
06 Sainem 13.36.80 06 Agust 2018 Infeksius Diare 1 0 0 0
07 Husnul fatta 19.43.39 08 Agust 2018 Dyspepsia + Chepalgia 1 0 0 0
08 Bilon Munte 16.45.71 04 Agust 2018 Oral Infeksion 1 0 0 0
09 Karnaini 12.77.07 05 Agust 2018 DM Type II 1 0 0 0
10 Jumadi 22.03.54 05 Agustus 2018, Oa Lumbal 1 0 0 0
11 Maulizar syahputra 22 01 56 02 Agustus 2018, Faringitis 1 0 0 0
12 Sukidi 18 07 72 01 Agustus 2018, Febris 1 0 0 0
13 Pidar 21 96 72 01 Agustus 2018, Alo 1 0 0 0
14 Nurlaili 14 71 04 02 Agustus 2018, GEA 1 0 0 0
15 Supangat 22 01 68 2 Agustus 2018, Pnemonia+Hemaptu 1 0 0 0
16 Edi sutrisno 18 33 68 05 Agustus 2018, Abd Pain 1 0 0 0
17 Jemiringsyah 22 02 84 04 Agustus 2018, DHF 1 0 0 0
18 Sumiati 2003 66 06 Agustus 2018, thypoid peper 1 0 0 0
19 Yaumil achiri 18 61 40 05 Agustus 2018, Pnemonia 1 0 0 0
20 Irwansyahputra 1938 43 07 Agustus 2018, Febris 1 0 0 0
21 Musa z 22 02 93 04 Agustus 2018, Pnemonia + ppok 1 0 0 0
22 Kasno 19 92 74 05 Agutus 2018 ABD Pain 1 0 0 0
23 Sugiatik 05 41 42 03 Agustus 2018, Hepatitis 1 0 0 0
24 Pat laili 22 03 73 06 Agustus 2018, Penemonia + tB milier 1 0 0 0
25 Sardi 22 03 69 06 Agustus 2018, HHD 1 0 0 0
26 Mulyadi 22 04 83 07 Agustus 2018, thypoid peper 1 0 0 0
27 Cut Mardiah 19 24 78 04 Agustus 2018, Bronchitis 1 0 0 0
28 Azuan 12 79 12 09 Agustus 2018, Pnemonia +sepsis 1 0 0 0
29 Fani fadilah 20 28 31 06 Agustus 2018, Dyspepsia + Chepalgia 1 0 0 0
30 Amajid 15 19 64 06 Agustus 2018, CKD 1 0 0 0
31 Atoy 09 98 84 06 Agustus 2018, HT Emergency 1 0 0 0
32 Leni Marlina p 12 97 63 08 Agustus 2018, Asma ekserbasi Acut 1 0 0 0
33 Muhammad Nasir 22 02 47 02 Agustus 2018, STT 1 0 0 0
34 Alamsyah 21 69 00 06 Agustus 2018, Pnemonia +sepsis 1 0 0 0
35 Jumiati 21 53 73 04 Agustus 2018, Vertigo uap 1 0 0 0
36 Putri Ayunda 11 37 29 09 Agustus 2018, Dyspepsia +GE+Cefalgia 1 0 0 0
38 Rudiansyah 22 05 12 08 Agustus 2018, Nstemi 1 0 0 0
39 Sukiran 12 48 64 07 Agustus 2018, Nstemi 1 0 0 0
40 Ponimin 21 56 65 09 Agustus 2018, PPOPK Exarbasi Akut 1 0 0 0
41 Yunita Ademuslima 20 61 43 08 Agustus 2018, Dyspepsia + Chepalgia 1 0 0 0
42 Naimah 16 15 34 07 Agustus 2018, Bronchitis Acut 1 0 0 0
43 Abdur Rasid WH 07 04 41 02 Agustus 2018, parkinson 1 0 0 0
44 Eliyana 10 70 99 11 Agustus 2018, Bronchitis Acut 1 0 0 0
45 Saniah 22 05 75 10 agustus 2018, Exarbasi Akut 1 0 0 0
46 Ainun jariah 22 05 20 09 Agustus 2018, Dyspepsia 1 0 0 0
47 Saodah 22 01 98 4 Agustus 2018, SNH + CHF 1 0 0 0
48 Nurbaiti 05 48 21 05 Agustus 2018, CHF + HHD 1 0 0 0
49 Trisuratmi 22 01 18 02 Agustus 2018, ( R ) Breast Neoplasma 1 0 0 0
50 Aisyah 22 05 36 10 agustus 2018, Bronchitis Acut + Hemaptoe 1 0 0 0
51 M. Saleh 22 05 29 09 Agustus 2018, DM .Tipe II + Susp. CA paru 1 0 0 0
52 Pristiwani 22 05 84 11 Agustus 2018, CKD + Anemi 1 0 0 0
53 Zainab 20 75 51 08 Agustus 2018, GEA 1 0 0 0
54 ny.salamiah 00 48 70 08 Agustus 2018, Dyspepsia 1 0 0 0
55 Rahmawati 22 05 08 08 Agustus 2018, Cephalgia 1 0 0 0
56 Ahmad fauzi 22 05 47 09 Agustus 2018, APP 1 0 0 0
57 Melda susanti 17 67 22 10 agustus 2018, Dyspepsia + Chepalgia 1 0 0 0
58 suyatni 21 80 90 09 Agustus 2018, SNH 1 0 0 0
59 Sri suci Pratiwi 22 05 68 10 agustus 2018, Cephalgia + ISPA 1 0 0 0
60 Herman darmawan 05 31 51 13 Agustus 2018, AF 1 0 0 0
61 Jariah 19 45 71 12 Agustus 2018, SNH 1 0 0 0
62 Yupi rahmayanti 20 06 68 14 Agustus 2018, + Cephalgia 1 0 0 0
63 Saniah 20 61 52 15 Agustus 2018, Selulitis 1 0 0 0
64 Khadijah 20 18 49 08 Agustus 2018, typhoid Fever 1 0 0 0
65 Nurul aini 18 60 75 13 Agustus 2018, Dyspepsia + cephalgia 1 0 0 0
66 Amir 22 06 86 15 Agustus 2018, Anereksia Pd bariatri 1 0 0 0
67 Yatemi 19 74 10 11 Agustus 2018, SNH 1 0 0 0
68 Juni Gaputra 15 03 39 07 Agustus 2018, DBD 1 0 0 0
69 Julinda intan sari 22 05 63 10 agustus 2018, Dyspepsia + Cephalgia 1 0 0 0
70 Supiah 15 21 95 14 Agustus 2018, HHD + HT 1 0 0 0
71 Herawati 22 06 35 13 Agustus 2018, GE Akut 1 0 0 0
72 Widiyanti 21 24 93 15 Agustus 2018, Dyspepsia 1 0 0 0
73 Siti mulia sari 14 42 55 13 Agustus 2018, GEA 1 0 0 0
74 Seila zahiraShafa 178 31 22 13 Agustus 2018, + Dyspepsia 1 0 0 0
75 Nurhayati 22 00 35 14 Agustus 2018, Cystitis 1 0 0 0
76 M. Yusuf 14 35 45 13 Agustus 2018, pneumonia + PPOK 1 0 0 0
77 Rusman 21 11 74 27 Juli 2018, Pneumonia + Efusi flura 1 0 0 0
78 Sudarto 21 99 27 30 Juli 2018, Hernia Inguinal 1 0 0 0
79 Usman 22 05 93 12 Agustus 2018, DBD 1 0 0 0
80 kokoArdianto 21 33 32 19 Agustus 2018, ABD Pain 1 0 0 0
81 Suli arfi/Juli Arfi 14 92 53 08 Agustus 2018, rongga Peritonious 1 0 0 0
82 Naza ruddin 19 62 13 10 agustus 2018, TB Paru 1 0 0 0
83 Khairul annisa 20 98 61 16 Agustus 2018, Dyspepsia 1 0 0 0
84 Atik 16 65 84 14 Agustus 2018, CHF cc HHD 1 0 0 0
85 Suratno 15 19 09 10 agustus 2018, OA Gauu 1 0 0 0
86 M. Idrus 04 23 40 31 Juli 2018, Neoplasma 1 0 0 0
87 Jamaiyah 19 98 96 15 Agustus 2018, PSMBA 1 0 0 0
88 Aulia 17 69 68 19 Agustus 2018, typhoid F. + Dyspepsia 1 0 0 0
89 Syarifuddin 21 79 83 06 Agustus 2018, blader and ureter 1 0 0 0
90 M. Fa'i 12 36 63 06 Agustus 2018, blader and ureter 1 0 0 0
91 Misnawati 22 06 31 13 Agustus 2018, Tumor intra Abdomen 1 0 0 0
92 Juliandi 19 95b 55 23 Agustus 2018, varicella zooster 1 0 0 0
93 Suryanti 09 30 29 26 Agustus 2018, Graves Dislase 1 0 0 0
94 Abusammah 08 81 84 20 Agustus 2018, 1 0 0 0
95 Wahyudi 22 12 22 23 Agustus 2018, Febris 1 0 0 0
96 Zahara hayati 22 12 32 23 Agustus 2018, Konstipasi 1 0 0 0
97 Iskandar 22 12 08 22 Agustus 2018, DHF 1 0 0 0
98 Abdul Rahman 21 84 96 13 Agustus 2018, Dyspepsia + sirosis Hati 1 0 0 0
99 Nyai Nurjannah 18 13 95 23 Agustus 2018, Dyspepsia 1 0 0 0
100 ovi marita 18 07 24 21 Agustus 2018, Febris 1 0 0 0
101 Aisyah 18 19 46 18 Agustus 2018, DM 1 0 0 0
102 abu Bakar 22 06 84 15 Agustus 2018, Pneumonia+susp. Ca Paru 1 0 0 0
103 Eka Fauzi 18 29 16 16 Agustus 2018, pneumonia+Hemaptoe 1 0 0 0
104 Nurhayati 19 92 58 23 Agustus 2018, Dm 1 0 0 0
105 Nurdin 18 85 29 18 Agustus 2018, pmeumonia 1 0 0 0
106 Kartini 04 71 51 24 Agustus 2018, Dm 1 0 0 0
107 Mariyatin 21 62 28 11 Agustus 2018, Abd pain 1 0 0 0
108 Hajian Munir G.Ade 22 12 26 23 Agustus 2018, Bronchitis 1 0 0 0
109 Samsudin 22 06 40 13 Agustus 2018, PSMBA 1 0 0 0
110 Dewi Susanti, A. MA 22 11 27 21 Agustus 2018, Dyspepsia 1 0 0 0
111 Nuraini 22 12 34 23 Agustus 2018, Hipoglikemi cc low intake 1 0 0 0
112 Nurman 22 12 24 23 Agustus 2018, febris 1 0 0 0
113 Nurliana 09 62 16 22 Agustus 2018, Tb paru 1 0 0 0
114 Mustafa lutfi 10 68 87 25 Agustus 2018, febris 1 0 0 0
115 Rami 14 59 39 28 Agustus 2018, CKD +over fluid 1 0 0 0
116 Siti 22 00 11 14 Agustus 2018, susp. Tb Paru, hipoglikemi 1 0 0 0
117 Pairin 19 15 61 18 Agustus 2018, pneumonia + PPOK 1 0 0 0
118 Nadia septiani 21 99 29 3 Agustus 2018, APP Kronik cc Akut 1 0 0 0
119 Alexander 22 06 38 13 Agustus 2018, +of bilateral inguinal 1 0 0 0
120 Suparno 14 49 28 15 Agustus 2018, App kronis cc Akut 1 0 0 0
121 Arif Fadillah 22 04 71 15 Agustus 2018, Kista Montbel 1 0 0 0
122 Fatimah 22 04 96 8 Agutus 2018, Gangren + DM 1 0 0 0
123 Nurhasimah 17 18 18 6 Agustus 2018, Breast karsinoma + abses 1 0 0 0
124 Mariani 21 95 26 27 Agustus 2018, CKD + CHF + HHD + CDL 1 0 0 0
125 Muhammad muzamil 12 92 35 25 Agustus 2018, Ileus Paralitik 1 0 0 0
126 Nurjannah hamid 21 95 24 25 Agustus 2018, Efusi plura bilateral 1 0 0 0
127 Ahmad Muklis 05 92 74 27 Agustus 2018, WPW 1 0 0 0
128 Yuwano 22 14 45 27 Agustus 2018, TB Paru 1 0 0 0
129 Sutrisman 17 27 03 23 Agustus 2018, Hepatitis Induce obat 1 0 0 0
130 Pajaruddin 21 10 02 16 Agustus 2018, Radial Arteri ruptur muscle 1 0 0 0
131 Mariah 21 99 19 19 Agustus 2018, DHF 1 0 0 0
132 Ida fahrida 16 47 73 3 Agustus 2018, Gangren + DM 1 0 0 0
133 Jayanti 14 54 87 27 Agustus 2018, Abd pain 1 0 0 0
134 Ismawati 20 68 34 25 Agustus 2018, LBP 1 0 0 0
135 Ahmad 15 32 23 20 Agustus 2018, CHF 1 0 0 0
138 Sandi mulyadi 22 06 28 13 Agustus 2018, pneumonia 1 0 0 0
139 Zainal Abidin 22 05 91 11 Agustus 2018, cephalgia post traumatik 1 0 0 0
140 Rahmad kurniawan 21 14 40 26 Agustus 2018, typhoid fever 1 0 0 0
141 Nurleli Putri 22 11 47 22 Agustus 2018, dypepsia 1 0 0 0
142 Sukadi 21 68 74 25 Agustus 2018, SH 1 0 0 0
143 M. Basri 20 77 40 14 Agustus 2018, post Op open prostate 1 0 0 0
144 Siti Aminah 21 89 76 23 Agustus 2018, Gangren + DM 1 0 0 0
145 Siti Maulia 22 14 24 26 Agustus 2018, acute long odem 1 0 0 0
146 Sugianto. N 12 18 76 20 Agustus 2018, tumor supra obita 1 0 0 0
147 Syamsul Rizal 17 31 50 18 Agustus 2018, SNH 1 0 0 0
148 Rafani 22 10 67 19 Agustus 2018, Asma ekserbasi Acut + CHF 1 0 0 0
149 Elimarlinda Astani 22 08 33 28 Agustus 2018 Mammae aberans 1 0 0 0
150 Aminah 15 56 88 25 Agustus 2018, CHF cc CAD 1 0 0 0
151 Rubi 15 93 88 27 Agustus 2018, angina pectoris 1 0 0 0
152 Surep 14 81 81 26 Agustus 2018, Dyspepsia 1 0 0 0
153 Amren 22 14 49 27 Agustus 2018, Pneumonia PPOK eks akut 1 0 0 0
154 Lasimin 22 04 93 8 Agutus 2018, BPH 1 0 0 0
155 Suyono 07 16 46 8 Agutus 2018, Cystitis + Sparm pelvic 1 0 0 0
156 Agung yuda 22 04 98 8 Agutus 2018, hemoroid 1 0 0 0
157 Sapon 22 12 15 23 Agustus 2018, open wiht 1 0 0 0
158 Boimin 22 14 74 28 Agustus 2018, PPOK exaberasi akut 1 0 0 0
159 Jasiah 14 15 28 27 Agustus 2018, CHF 1 0 0 0
160 Tukiran 02 19 07 28 Agustus 2018, bronchtis Acut 1 0 0 0
161 Maidil Aswan 12 37 71 29 Agustus 2018, DBD 1 0 0 0
162 Afrizal 22 14 84 28 Agustus 2018, Efusi plura kanan 1 0 0 0
163 Ngatimin 10 05 46 28 Agustus 2018, PPOK 1 0 0 0
164 Poniem 20 10 31 20 Agustus 2018, PSMBA + PPOK 1 0 0 0
165 Yudadermawan 15 62 42 9 Agustus 2018, Dissura Ani 1 0 0 0
166 Maryam 18 62 95 18 Agustus 2018, GERD 1 0 0 0
167 Sukini 17 11 20 26 Agustus 2018, SNH 1 0 0 0
168 Abdulrahman 13 46 71 29 Agustus 2018, LBP 1 0 0 0
169 Basuki 1824 45 5 Agustus 2018, ingunal stranglata 1 0 0 0
170 Cut Ainun Mardiah 20 181 21 28 Agustus 2018, SNH 1 0 0 0
171 Muhammad. S 11 22 87 27 Agustus 2018, cephalgia 1 0 0 0
172 Sunar 14 93 66 22 Agustus 2018, CKD 1 0 0 0
173 Oman 16 58 99 27 Agustus 2018, Dyspepsia 1 0 0 0
174 Samin 17 52 71 26 Agustus 2018, HI GCS 15 1 0 0 0
175 Agustina 12 18 35 30 Agustus 2018, APP perporasi 1 0 0 0
176 Faisal Amir 22 14 32 26 Agustus 2018, HI GCS 15 1 0 0 0
177 Risdayanti Simamora 12 33 65 26 Agustus 2018, Dyspepsia 1 0 0 0
178 Serly Farlina 22 12 13 23 Agustus 2018, intoksikasi 1 0 0 0
179 Kiki Syahputri 22 14 86 28 Agustus 2018, PSMBA 1 0 0 0
180 Halija 18 39 73 31 Agustus 2018, Febris 1 0 0 0
181 Mariana 12 30 45 31 Agustus 2018, Febris 1 0 0 0
182 Reza Aulia Putri 07 64 46 30 Agustus 2018, Dengue Fever 1 0 0 0
183 Basuki 16 67 72 27 Agustus 2018, Malaria 1 0 0 0
184 Jumiati 22 16 32 31 Agustus 2018, Febris 1 0 0 0
185 Kaseh 17 61 35 31 Agustus 2018, Febris 1 0 0 0
186 Siti Aisyah 22 15 96 31 Agustus 2018, Febris 1 0 0 0
187 Sri Yanti 13 14 28 30 Agustus 2018, Dyspepsia 1 0 0 0
188 Tumiarah 19 70 12 31 Agustus 2018, PPOK Exarbasi Akut 1 0 0 0
189 Endra 22 14 33 26 Agustus 2018, Tendon Vastus Lateralis 1 0 0 0
190 Jariyah 21 21 59 31 Agustus 2018, TB paru + DM II + Pneumonia 1 0 0 0
191 Amalia 22 15 76 30 Aguistus 2018, (R) Breast Neoplasma 1 0 0 0
192 Jubaidah 21 55 60 30 Agustus 2018, Hernia Inguinal 1 0 0 0
193 Aswanto 19 18 03 29 Agustus 2018, PPOK 1 0 0 0
195 Rustam 01 60 67 30 Agustus 2018, Febris 1 0 0 0
196 M. Darwis Siregar 17 40 98 30 Agustus 2018, GEA 1 0 0 0
197 Jumiati Hsb 09 20 85 23 Agustus 2018, CHF cc CHD 1 0 0 0
 R. Iskandar Muda Bulan Sept 2018
FORMULIR
NO No.RM Tgl Masuk
Nama pasien Diagnosa Spiritual Record Permintaan Kerohanian

y t y t
01 Yusnaini 18 24 47 02 September 2018, Goat Atritis 1 0 0 0
02 Rina Wati 18 84 47 03 September 2018, Efusi Pleura kanan 1 0 0 0
03 Indah Lestari SNG 22 16 63 02 September 2018, Efusi Pleura kanan 1 0 0 0
04 Leli Rantika 22 16 93 03 September 2018, Kolesistitis 1 0 0 0
05 Aulia indriani 21 23 18 03 September 2018, PSMBA 1 0 0 0
06 Nurmaini 22 16 78 03 September 2018, Febris 1 0 0 0
07 Zoedy Auliqa 13 39 85 08 September 2018, Abdominal Pain 1 0 0 0
08 Nurmaini 22 19 12 06 September 2018, Dyspepsia 1 0 0 0
09 Muhammad Nur 22 13 16 06 September 2018, Pneumonia + Anemia 1 0 0 0
10 Siti Nurhaliza 21 67 06 03 September 2018, Pneumonia + Dyspepsia 1 0 0 0
11 Nurhayati 21 83 04 September 2018, Febris + DM + HT 1 0 0 0
12 M. Ridwan 16 16 85 04 September 2018, Febris 1 0 0 0
13 Ilyas 15 18 90 04 September 2018, PSMBA + Sirosis Hepatic 1 0 0 0
14 Triana 22 17 82 04 September 2018, Anorexia + kista ovarium (R) 1 0 0 0
15 Faridah 15 55 63 05 September 2018, DM + Neurophaty 1 0 0 0
16 Rumiati 14 10 17 04 September 2018, SH 1 0 0 0
17 Nur Hasanah 14 49 35 06 September 2018, Cephalgia 1 0 0 0
18 Mustaza Hadi 22 20 11 08 September 2018, Infection Bacteri 1 0 0 0
19 Mardiana 15 38 08 10 September 2018, Pnemonia+Asma Exarbasi Akut 1 0 0 0
20 Aisyah 22 20 21 09 September 2018, CHF + HHD 1 0 0 0
21 Jonny 16 75 98 08 September 2018, Konstipasi 1 0 0 0
22 Khairul Bahri 06 95 44 07 September 2018, Febris 1 0 0 0
23 Tukiyem 12 02 86 09 September 2018, CHF cc HHD 1 0 0 0
24 Marwan 09 74 56 09 September 2018, Dengue Fever 1 0 0 0
25 Erwin 22 14 56 09 September 2018, Pneumonia + tumor paru kanan 1 0 0 0
26 Saniyem 21 10 23 10 September 2018, Hipoglikemi 1 0 0 0
27 Irma Septia 07 12 21 03 September 2018, Appendicitis 1 0 0 0
28 Afrizal 14 27 59 09 September 2018, Febris 1 0 0 0
29 Sumiyem 14 27 59 09 September 2018, Susp. Masa Intra Abdomen 1 0 0 0
30 Ella Ariska 22 15 43 29 Agustus 2018, Dengue Fever 1 0 0 0
31 Aminah 22 15 66 30 September 2018, Dengue Fever 1 0 0 0
32 Fitriana 19 46 08 05 September 2018, Ca.Mamae susp. Metastase liver 1 0 0 0
33 Syafaruddin 21 63 61 03 September 2018, Nasofaring Carsinoma 1 0 0 0
34 Misnan 22 20 58 12 September 2018, Dyspepsia 1 0 0 0
35 Romi Affandi 22 20 43 10 September 2018, Dyspepsia 1 0 0 0
36 Syahrul Bahri 06 28 70 11 September 2018, Appendicitis Inguinal 1 0 0 0
37 Topan 20 60 23 11 September 2018, Abdominal Pain 1 0 0 0
38 Mutia Sarah 18 27 37 15 September 2018, Pneumonia 1 0 0 0
39 Khairunnisak 22 19 14 06 September 2018, Ascites 1 0 0 0
40 Suprafti 18 01 20 14 September 2018, HT Emergency 1 0 0 0
41 Kamarudin 06 77 05 13 September 2018, PPOK + HT 1 0 0 0
42 Asanusi 22 20 28 09 September 2018, SH 1 0 0 0
43 Putri Hardianti 18 99 25 09 September 2018, HI GCS 15 1 0 0 0
44 Maulana Maghribi 22 10 95 10 September 2018, LBP 1 0 0 0
45 Nuraini 21 15 95 13 September 2018, Dengue Fever 1 0 0 0
46 Jainuddin 18 18 59 13 September 2018, PPOK Exarbasi Akut 1 0 0 0
47 Hamzah 13 46 06 14 September 2018, GEA 1 0 0 0
48 Khairudin 03 36 89 13 September 2018, PPOK Exa Akut + Dyspepsia 1 0 0 0
49 Jatmiko 22 20 99 13 September 2018, Dengue Fever 1 0 0 0
50 Nurmiati 22 22 53 16 September 2018, Gastropati Diabetik 1 0 0 0
51 Rubinah 22 05 57 06 September 2018, Burger Deases 1 0 0 0
52 Ika Purnama Sari 22 15 47 29 Agustus 2018, Hemoroid Interna gr I-II 1 0 0 0
53 Listina 10 35 48 14 September 2018, ISK 1 0 0 0
54 Numaini 22 19 12 14 September 2018, Gastritis 1 0 0 0
55 Erwiyanto 17 65 88 11 September 2018, Cephalgia 1 0 0 0
56 Rohani 22 22 26 15 September 2018, CHF cc HHD 1 0 0 0
57 Rostina 13 85 74 13 September 2018, Dengue Fever 1 0 0 0
58 Purnamawati 15 81 32 14 September 2018, Asma Exarbasi Akut 1 0 0 0
59 Muhammad Anwar 21 84 78 16 September 2018, Trombo thopenia 1 0 0 0
60 Kaswati 22 14 76 05 September 2018, CKD Sta V + CDL 1 0 0 0
61 Ahmad 15 32 23 16 September 2018, CHF +CAD 1 0 0 0
62 Darlisma 14 84 59 03 September 2018, CHF 1 0 0 0
63 Nasir Arafat 22 20 13 08 September 2018, Diare Kronik 1 0 0 0
64 Larasaty 22 19 78 07 September 2018, Benign Breast neoplasma 1 0 0 0
65 Irham Novirgi 12 80 98 13September 2018, Dislokasi Shoulder joint 1 0 0 0
66 Junaidi 22 20 34 10 September 2018, Corpus 1 0 0 0
67 Nurhayati 22 00 37 05 September 2018, Nstemi + PSMBA 1 0 0 0
68 Samingun 05 89 85 17 September 2018, pneumonia + Heamaptoe 1 0 0 0
69 Idris 21 76 21 10 September 2018, Internal hemoroid grd IV with 1 0 0 0
70 Salmiah 00 48 70 11 September 2018, LBP 1 0 0 0
71 Dora Wita 16 64 94 16 September 2018, Local Infection of foot 1 0 0 0
72 Nasiem 07 55 86 14 September 2018, Pneumonia 1 0 0 0
73 Abdul Manap 09 65 15 12 September 2018, Cephalgia 1 0 0 0
74 Jamari 22 24 18 18 September 2018, pneumonia + Heamaptoe 1 0 0 0
75 Jumiati 09 20 85 14 September 2018, CKD Sta V + Over Flura+CHF 1 0 0 0
76 Ginah 14 98 20 17 September 2018, CKD + Anemi 1 0 0 0
77 Syarifuddin 22 24 71 18 September 2018, Benign Neoplasma of (R) 1 0 0 0
78 Nurhayati 17 17 97 17 September 2018, Pneumonia + CHF + CHD 1 0 0 0
79 Zakaria 04 71 73 19 September 2018, Nstemi 1 0 0 0
80 Fatimah 16 70 83 03 September 2018, Gangreen Pedis + sepsis DM 1 0 0 0
81 Wiwik Sunarni 20 95 98 12 September 2018, (R) Breast Neoplasma 1 0 0 0
82 Djuanda 15 27 72 20 September 2018, PPOK Exa Akut + HT 1 0 0 0
83 Santoso 22 22 18 14 September 2018, Non Insulin depend gangren DM 1 0 0 0
84 Murah 22 25 58 20 September 2018, Dyspepsia 1 0 0 0
85 Mai Sarah 20 80 26 20 September 2018, Dyspepsia 1 0 0 0
86 Safri Akbar 22 19 19 10 September 2018, ISK 1 0 0 0
87 Menik 22 21 46 12 September 2018, Skin tumor pedis 1 0 0 0
88 purwo kanti 22 22 66 17 September 2018, PPOK CHF cc CAD 1 0 0 0
89 Erni Rukmana 15 68 94 20 September 2018, Kista Mandibula Sinistra 1 0 0 0
90 Maimunah 22 24 17 18 September 2018, Febris 1 0 0 0
91 Aminah 22 24 43 19 September 2018, CHF cc CAD 1 0 0 0
92 Ika Arif 22 26 00 20 September 2018, Febris 1 0 0 0
93 Jamilah 15 02 69 18 September 2018, Hipoglikemi + DM 1 0 0 0
94 Sahlias 22 20 87 13 September 2018, Febris 1 0 0 0
95 Baren 22 20 62 12 September 2018, Pneumonia 1 0 0 0
96 Musyawir 22 25 35 19 September 2018, Stemi 1 0 0 0
97 Ade Adrian 11 20 77 11 September 2018, DBD 1 0 0 0
98 Zulkifli 16 61 81 18 September 2018, DM 1 0 0 0
99 Kasian 18 95 59 18 September 2018, Cephalgia 1 0 0 0
100 Lilis Suryani Hsb 15 31 94 22 September 2018, Bronchitis Akut 1 0 0 0
101 Suri Darmayanti 12 79 54 21 September 2018, PPOK Exarbasi Akut 1 0 0 0
102 Paisal Amir 22 26 28 21 September 2018, Febris ec.Infeksi viral non spesifik 1 0 0 0
103 Mutiah 21 58 33 17 September 2018, Acute Long oedema 1 0 0 0
104 Siti Asmah 22 25 56 20 September 2018, Dengue Fever 1 0 0 0
105 Deliana 12 17 90 18 September 2018, DBD 1 0 0 0
106 Delpita 22 24 15 18 September 2018, DBD 1 0 0 0
107 Ari Susanna 09 06 34 17 September 2018, Abdominal Pain 1 0 0 0
108 Suriono 22 00 33 17 September 2018, CHF cc CAD + Dyspepsia 1 0 0 0
109 Jasmani 22 20 85 13 September 2018, CHF cc HHD + Dyspepsia 1 0 0 0
110 Nukman 16 10 88 19 September 2018, Pneumonia + PPOK + CHF 1 0 0 0
111 Heru Kurniawan 22 26 04 19 September 2018, Bronchitis 1 0 0 0
112 Rusmini 22 24 14 18 September 2018, Cephalgia 1 0 0 0
113 Mariana 17 26 24 21 September 2018, ISK 1 0 0 0
114 Suwarni 19 36 65 22 September 2018, Febrite Neutropenia 1 0 0 0
115 Diana Sari 20 67 14 24 September 2018, Dyspepsia + Cephalgia 1 0 0 0
116 Tugiman 20 89 88 20 September 2018, GEA 1 0 0 0
117 Trio Fenanda 22 24 13 18 September 2018, Hernia 1 0 0 0
118 Desi Heriani 22 17 70 04 September 2018, Kolik Abdomen 1 0 0 0
119 Yunni 16 24 66 09 September 2018, Cholic ureter susp. BSK 1 0 0 0
120 Nurmaila 22 17 76 04 September 2018, Cephalgia 1 0 0 0
121 Neneng Indriani 13 78 50 18 September 2018, SNH 1 0 0 0
122 Erna Br Sembiring 22 27 34 24 September 2018, Syndrome Nefrotis 1 0 0 0
123 Budi Armansyah Tarigan 22 27 40 24 September 2018, Tonsila Akut 1 0 0 0
124 Sulinem 16 15 15 23 September 2018, Diare Akut cc Infeksi Bacteri 1 0 0 0
125 Lasiah 22 25 98 24 September 2018, Diseksi Aorta 1 0 0 0
126 Fitriani 22 22 91 26 September 2018, APP Kronis 1 0 0 0
127 Saidi 22 27 84 26 September 2018, HT 1 0 0 0
128 Aisyah 22 20 21 09 September 2018, CHF + HHD 1 0 0 0
129 Misno Sembiring Miala 22 27 88 26 September 2018, Akut Long Oedema + Pneumoni 1 0 0 0
130 Bani Husin 11 21 63 21 September 2018, Pneumonia + sepsis PPOK 1 0 0 0
131 Zainab 05 65 92 24 September 2018, Pneumonia + PPOK 1 0 0 0
132 Nuraidah 22 25 97 24 September 2018, Cephalgia 1 0 0 0
133 Rita Wati 19 61 33 23 September 2018, Neoplasma 1 0 0 0
134 Suwati 20 16 62 21 September 2018, SNH 1 0 0 0
135 Sri Widia 21 36 22 25 September 2018, Dyspepsia + Obs.Febris + sefalgia 1 0 0 0
136 Saryani 22 27 64 25 September 2018, Febris 1 0 0 0
137 Sopiyan 22 26 97 23 September 2018, PSMBA + Anemia + Pneumonia 1 0 0 0
138 Samun 22 27 44 25 September 2018, Batu LK 1 0 0 0
139 zainal Abidin 18 40 26 22 September 2018, Pneumonia + PPOK + CHF 1 0 0 0
140 Eli Frimasari 21 18 27 26 September 2018, Dengue Fever 1 0 0 0
141 Ponijem 17 24 84 26 September 2018, Dengue Fever 1 0 0 0
142 Supriati 19 71 75 28 September 2018, HT 1 0 0 0
143 Aswarni Hayati 10 08 53 23 September 2018, Stemi Anterm 1 0 0 0
144 Tasya Indah Rusmawati 22 27 81 26 September 2018, Anemia cc Peny. Kronis+sefalgia 1 0 0 0
145 Zuraidah 16 49 58 27 September 2018, PPOK + CHF 1 0 0 0
146 Nurjannah 19 14 47 25 September 2018, DBD 1 0 0 0
147 Wirda hanum 12 96 37 23 September 2018, DM+ Pneumonia + Asma 1 0 0 0
148 Saidin 15 80 98 21 September 2018, Non Insulin DM with Peripheral 1 0 0 0
149 Rukiah 22 24 76 26 September 2018, Abses Sub Mandibula + DM 1 0 0 0
150 Roswati 16 72 73 21 September 2018, VAP 1 0 0 0
151 Hamdani 05 38 24 26 September 2018, Febris 1 0 0 0
152 Rifki Akbar 16 92 44 22 September 2018, (R) Tendon Flexor and extension 1 0 0 0
153 Sayed Muchtar 22 27 33 24 September 2018, Reretensio Urine cc BPH 1 0 0 0
154 Syarifuddin 22 27 25 25 September 2018, Benign Neoplasma of (R) foot 1 0 0 0
155 Jamaluddin 22 22 01 13 September 2018, Efusi Pleura (D) + Pneumonia 1 0 0 0
157 Anissah 22 01 13 04 September 2018, APP Kronik 1 0 0 0
158 Rahul Ramadhan 33 37 62 25 September 2018, Open Fracture metatarsal III + 1 0 0 0
159 Julinda intan Sari 22 05 63 03 September 2018, App Kronis 1 0 0 0
160 Harimin 12 70 73 17 September 2018, Fistula Perianal Kompleks + 1 0 0 0
161 Juamiati 22 26 82 22 September 2018, HT 1 0 0 0
162 Khairul Sujjai 12 04 91 14 September 2018, App Akut 1 0 0 0
163 Jumiati Hsb 09 20 85 27 September 2018, Anemia 1 0 0 0
164 Syamnur 10 23 15 29 September 2018, Pneumoni+sepsis ppok exa akut 1 0 0 0
165 Juremi. S 15 02 07 23 September 2018, Subcutan fistula + Infection 1 0 0 0
166 Mariana 22 26 92 23 September 2018, SNH 1 0 0 0
167 Habsah Binti Abd Rahman 22 01 54 09 September 2018, Anemia 1 0 0 0
168 Muktar 16 67 79 10 September 2018, Gangren DM + Sepsis Anemia 1 0 0 0
169 M.Aidil Syafitra 22 26 71 22 September 2018, App Akut 1 0 0 0
170 Baharuddin AR 16 24 53 16 September 2018, Non Insulin Dependen DM + 1 0 0 0
171 Frengki 19 58 77 21 September 2018, Blunt Thorax injury 1 0 0 0
172 Ratna Wati 22 27 74 26 September 2018, CKD 1 0 0 0
173 Sahri 22 29 40 28 September 2018, Bacterial Infection 1 0 0 0
176 Rini 20 43 38 29 September 2018, CHF 1 0 0 0
177 Putri Indah Sari 22 29 71 29 September 2018, Febris cc ISK + Dyspepsia 1 0 0 0
178 Muliaydi 22 28 88 27 September 2018, BPH 1 0 0 0
179 Sri Wahyuni 22 29 08 30 September 2018, Dyspepsia + Febris + Cephalgia 1 0 0 0
180 Rahmadani 22 29 60 29 September 2018, Anemia cc peny Kronis 1 0 0 0
181 Kamsatun 22 26 90 22 September 2018, Colistitis 1 0 0 0
182 Salmiah 00 48 70 29 September 2018, HT 1 0 0 0
183 Risnawati 09 21 24 29 September 2018, Gastropati Diabetik 1 0 0 0
184 Saryamam manik 22 27 97 26 September 2018, PPOK 1 0 0 0
185 Sulastri 10 45 31 26 September 2018, Dyspepsia 1 0 0 0
186 Suriyanti 04 51 00 30 September 2018, HT 1 0 0 0
187 Toinem 19 06 98 27 September 2018, Ht 1 0 0 0
188 Marni 10 39 09 30 September 2018, Cephalgia 1 0 0 0
189 Gimun 22 28 99 28 September 2018, LBP DD HNP 1 0 0 0
 R. Iskandar Muda Bulan Okt 2018
FORMULIR
NO Nama Pasien No.RM Tgl Masuk Diagnosa
Spiritual Record Permintaan
Kerohanian
y t y t
01 Fadli Laini 04 26 99 01 Oktober 2018, Abdominal pain 1 0 0 0
02 Nurul Fajri 21 15 60 01 Oktober 2018, Abdominal pain 1 0 0 0
03 Rosmala dewiTarigan 06 25 48 01 Oktober 2018, GE Akut 1 0 0 0
04 Halimatussakdiah 20 41 74 01 Oktober 2018, Cephalgia 1 0 0 0
05 Susianto 12 47 94 27 September 2018, LBP DD HNP 1 0 0 0
06 suryadi 15 10 22 02 Oktober 2018, Batu LK 1 0 0 0
07 Zulpan Yeni 13 64 52 04 Oktober 2018, Dyspepsia 1 0 0 0
08 Nuraini 22 30 63 04 Oktober 2018, DM 1 0 0 0
09 Hamidah 22 29 82 01 Oktober 2018, Febris 1 0 0 0
10 Sudarni 22 29 76 30 Oktober 2018, DM + HT + LBP 1 0 0 0
11 Sanubari 16 14 50 01 Oktober 2018, Benjolan di payudara kanan 1 0 0 0
12 Harianto 05 61 14 01 Oktober 2018, Herpes Zooster 1 0 0 0
13 Siti Raizah 18 36 37 06 Oktober 2018, HT 1 0 0 0
14 Radiah 06 42 72 27 Oktober 2018, Asma + DM Tipe II 1 0 0 0
15 Miftahul Yusra 18 24 75 30 September 2018, Nefrolik Syndrome + CKD 1 0 0 0
16 Legiman 22 33 08 06 Oktober 2018, Hipoglikemi 1 0 0 0
17 Fitriani 21 95 38 03 Oktober 2018, CKD 1 0 0 0
18 Samiran 21 61 12 03 Oktober 2018, Hepatoma 1 0 0 0
19 Radikun 12 40 10 06 Oktober 2018, PSMBA 1 0 0 0
20 Siti Saftiana 22 30 79 05 Oktober 2018, Dengue Fever 1 0 0 0
21 Jamaludin 22 33 14 06 Oktober 2018, DHF 1 0 0 0
22 Lis maryani 22 33 92 07 Oktober 2018, DHF 1 0 0 0
23 Abu Bakar 22 06 84 04 Oktober 2018, Tumor Paru + Efusi Pleura 1 0 0 0
24 Wagini 18 13 48 07 Oktober 2018, HT 1 0 0 0
25 Juli Arfi 14 92 53 06 Oktober 2018, Endro Clistomy fistule 1 0 0 0
26 Halimatussakdiah 18 35 39 08 Oktober 2018, DHF 1 0 0 0
27 Nurjannah 19 01 43 08 Oktober 2018, Pneumonia + Bronchitis 1 0 0 0
28 Kidi 16 16 76 08 Oktober 2018, Pnomonia + PPOK + HHD 1 0 0 0
29 Hendi Prianto 17 37 27 08 Oktober 2018, Pneumonia + PPOK 1 0 0 0
30 Julia 22 33 26 06 Oktober 2018, Viral Infection 1 0 0 0
31 Darwan 22 33 16 06 Oktober 2018, Blunt Thorax injury 1 0 0 0
32 Idawati 21 39 99 30 September 2018, Dengue Fever 1 0 0 0
33 Ravani 22 10 67 04 Oktober 2018, Pneumonia 1 0 0 0
34 Siti Maimunah 20 98 48 06 Oktober 2018, Hipoglikemi 1 0 0 0
35 Nirwana 17 02 41 05 Oktober 2018, Viral Infection 1 0 0 0
36 Suwaita 21 68 32 03 Oktober 2018, Hepatoma 1 0 0 0
37 Roro Ajeng Priyatna 22 33 98 07 Oktober 2018, Intoksikasi Asam jengkol 1 0 0 0
38 Suyatinem 22 33 41 07 Oktober 2018, HI 1 0 0 0
39 Nurhayati 10 66 04 04 Oktober 2018, Susp. Haepatoma 1 0 0 0
40 Sumiati 14 82 47 14 Oktober 2018, Pneumonia + PPOK + CHF 1 0 0 0
41 Supartik 07 92 24 10 Oktober 2018, Pneumonia 1 0 0 0
42 Sumarni 22 27 07 01 Oktober 2018, App Kronis 1 0 0 0
43 Nurhayati 19 94 78 10 Oktober 2018, Dengue Fever 1 0 0 0
44 Nasrun Khadafi 22 36 60 11 Oktober 2018, Cystitis 1 0 0 0
45 Ngatiyem 19 63 63 04 Oktober 2018, CHF + CAD + Efusi Pleura 1 0 0 0
46 Zulkfli 22 35 29 10 Oktober 2018, HT 1 0 0 0
47 Susilawati 19 77 64 06 Oktober 2018, Pneumonia 1 0 0 0
48 Bambang Sofyan 18 71 18 12 Oktober 2018, Dengue Fever 1 0 0 0
49 Sularso 22 36 71 11 Oktober 2018, Pneumonia + PPOK 1 0 0 0
50 Beri Syahputra 19 42 56 10 Oktober 2018, Abses 1 0 0 0
51 Saniah 16 50 00 09 Oktober 2018, Pneumonia + PPOK exa Akut 1 0 0 0
52 Muhardiansyah 22 31 51 03 Oktober 2018, Neoplasma maxilla 1 0 0 0
53 Isra Muntara 22 05 28 03 Oktober 2018, Frakture Maxilla & Mandibulla 1 0 0 0
54 Zulkarnain 22 30 61 03 Oktober 2018, gangren + DM 1 0 0 0
55 Widianto 17 29 83 07 Oktober 2018, Cephalgia 1 0 0 0
56 Ridwan 22 29 45 07 Oktober 2018, App 1 0 0 0
57 Nasip 22 30 00 01 Oktober 2018, LBP 1 0 0 0
58 Turinah 22 22 09 05 Oktober 2018, LBP 1 0 0 0
59 Ramnawati 19 13 13 09 Oktober 2018, Febris 1 0 0 0
60 Samaria Br ginting 29 16 36 09 Oktober 2018, Dyspepsia 1 0 0 0
61 Sudirman 17 26 87 09 Oktober 2018, Febris 1 0 0 0
62 Mardiah 16 20 97 13 Oktober 2018, Bronchitis Akut 1 0 0 0
63 Faridah Hanum 22 36 65 11 Oktober 2018, Efusi Pleura Kiri + TB Paru 1 0 0 0
64 Pamela 22 37 11 12 Oktober 2018, PSMBA 1 0 0 0
65 Asniati Ningsih 21 01 37 10 Oktober 2018, Brinchitis 1 0 0 0
66 Ruswandi 14 31 57 08 Oktober 2018, Pneumonia 1 0 0 0
67 Febby Zaifa Chairati 22 37 30 13 Oktober 2018, PSMBA 1 0 0 0
68 Nurhayati 2237 44 14 Oktober 2018, Febris 1 0 0 0
69 Wahidin 08 58 76 09 Oktober 2018, Pneumonia 1 0 0 0
70 Luciana 23 37 40 14 Oktober 2018, Dyspepsia 1 0 0 0
71 Sri Awani 09 16 65 08 Oktober 2018, Abses Pedis + DM 1 0 0 0
72 Asiah 18 83 85 11 Oktober 2018, Susp.Metastase Modulla spinal 1 0 0 0
73 Heni Saskia 22 37 03 12 Oktober 2018, Dengue Fever 1 0 0 0
74 Misran 22 36 70 11 Oktober 2018, PSMBA 1 0 0 0
75 Dinar Haninda Dersa 12 09 78 13 Oktober 2018, Bacterial Infection 1 0 0 0
76 Mujiman 22 36 72 11 Oktober 2018, Pneumonia + PPOK 1 0 0 0
77 Salmiah 00 48 70 09 Oktober 2018, LBP 1 0 0 0
78 Amat Sari 22 01 49 13 Oktober 2018, Gastropati Diabetik 1 0 0 0
79 Putri Rahmadani 21 56 71 07 Oktober 2018, Dyspepsia 1 0 0 0
80 Kelpin Ariandi 17 76 23 11 Oktober 2018, Febris + Dyspepsia + Sefalgia 1 0 0 0
81 Muhammd April Ryan Nur 22 37 58 14 Oktober 2018, DHF + Dyspepsia 1 0 0 0
82 Samin 20 18 17 10 Oktober 2018, Retensio Urine + BPH 1 0 0 0
83 Nur Ulvaziah 20 85 20 07 Oktober 2018, Cephalgia kronis + cystitis 1 0 0 0
84 Susanto 22 30 14 11 Oktober 2018, Electric Burn 1 0 0 0
85 Rajul Praka Pahlefi 22 30 44 11 Oktober 2018, App 1 0 0 0
86 M. Solihin 22 33 39 07 Oktober 2018, HI GCS 15 + multiple VE 1 0 0 0
87 Siti mulia Sari 14 42 55 04 Oktober 2018, HI GCS 15 + multiple VE 1 0 0 0
88 Ade Prasetia 22 35 21 09 Oktober 2018, Pneumonia + Sepsis + TB Paru 1 0 0 0
89 Suhaibah 17 26 00 15 Oktober 2018, HT 1 0 0 0
90 Zakaria 05 54 47 12 Oktober 2018, Uremik Syndrome 1 0 0 0
91 Suradiansyah 22 30 15 03 Oktober 2018, HI GCS 15 + multiple VE 1 0 0 0
92 Tri Afridawati 14 88 22 15 Oktober 2018, Pneumonia 1 0 0 0
93 Sukriadi 22 31 15 02 Oktober 2018, Hypertophy of breast 1 0 0 0
94 Siti Rahma Antika 21 20 12 04 Oktober 2018, STT of Naile 1 0 0 0
95 Abdul Wahab 22 36 06 10 Oktober 2018, STT 1 0 0 0
96 Suriadi 14 49 29 18 Oktober 2018, Dengue Fever 1 0 0 0
97 Sirun 20 60 49 17 Oktober 2018, Pneumonia + TB, Paru 1 0 0 0
98 Ismail Siregar 20 22 04 11 Oktober 2018, Acute Long Oedema 1 0 0 0
99 Aminah 22 38 15 17 Oktober 2018, Asma 1 0 0 0
100 Chadijah 22 37 27 10 Oktober 2018, Infection Bacterial 1 0 0 0
101 Wawan Hermaan 05 92 03 02 Oktober 2018, Kolesterol 1 0 0 0
102 Siti Akbari 22 37 76 15 Oktober 2018, Febris 1 0 0 0
103 Salmiah 00 48 70 19 Oktober 2018, CHF + HHD 1 0 0 0
104 Atik 15 65 84 20 Oktober 2018, Hipoglikemi 1 0 0 0
105 Suratik 22 39 08 19 Oktober 2018, OA Lumbal 1 0 0 0
106 Sri Wahyuni 21 20 63 18 Oktober 2018, Dyspepsia 1 0 0 0
107 Dewi Kumala Sari 06 10 34 16 Oktober 2018, Konstipasi 1 0 0 0
108 Suparni 21 68 69 13 Oktober 2018, Dengue Fever 1 0 0 0
109 Maini 19 63 26 17 Oktober 2018, Bacterial Infection 1 0 0 0
110 Wartini 22 38 74 17 Oktober 2018, Dyspepsia 1 0 0 0
111 Boimin 22 33 95 07 Oktober 2018, Cephalgia 1 0 0 0
112 Guswati 22 37 46 14 Oktober 2018, Cholesistitis 1 0 0 0
113 Nabet 10 27 89 20 Oktober 2018, CHF + CAD 1 0 0 0
114 Suarno 20 28 10 18 Oktober 2018, Gangren + DM 1 0 0 0
115 Srinah 13 36 18 22 Oktober 2018, Hypoglikemi + DM 1 0 0 0
116 Poniman Budiman 19 47 06 15 Oktober 2018, SNH 1 0 0 0
117 Afni Mardiah 20 29 26 21 Oktober 2018, Epilepsi 1 0 0 0
118 Syafrizal 22 35 27 09 Oktober 2018, Pneumonia +PPOK + CHF+HHD 1 0 0 0
119 Maijar Pohan 22 40 07 22 Oktober 2018, Abdominal pain 1 0 0 0
120 M. Yahya 18 90 54 17 Oktober 2018, TB.Paru + Haemaptoe 1 0 0 0
121 Piyati Ningsih 22 37 66 15 Oktober 2018, PSMBA + DBD 1 0 0 0
122 Sutiman 22 31 61 10 Oktober 2018, Breast Neoplasma 1 0 0 0
123 Fadilah 22 39 91 21 Oktober 2018, Asma Bronchial 1 0 0 0
124 Anggi Syahputra 22 39 83 21 Oktober 2018, BDB 1 0 0 0
125 Siti Hajar 10 73 34 18 Oktober 2018, Nstemi 1 0 0 0
126 Nuraini Daulay 22 40 14 22 Oktober 2018, Abdominal Pain 1 0 0 0
127 Rita Suryani 422 40 24 23 Oktober 2018, DBD 1 0 0 0
128 Sukri 22 28 35 26 Oktober 2018, Prostat Neoplasma 1 0 0 0
129 Tamrin 22 40 02 22 Oktober 2018, Pneumonia 1 0 0 0
130 Selamat 10 13 56 21 Oktober 2018, CKD st IV 1 0 0 0
131 Tuimah 10 49 64 21 Oktober 2018, Susp PSA DD SH + CHF 1 0 0 0
132 Bahtiar Efendi 22 39 45 18 Oktober 2018, Hernia Inguinal Lateralis 1 0 0 0
133 Erwin 14 99 25 22 Oktober 2018, Pneumonia 1 0 0 0
134 Buntak 22 39 24 20 Oktober 2018, SNH 1 0 0 0
135 Dei Purnama Sari 10 73 52 26 Oktober 2018, Cystitis 1 0 0 0
136 M. Rico Affandi 22 59 72 22 Oktober 2018, Benign Neoplasma of Nasal 1 0 0 0
137 M. Al Haris Habib 22 30 56 03 Oktober 2018, App Kronis 1 0 0 0
138 Hasbi Yusuf 20 26 67 15 Oktober 2018, Gangren 1 0 0 0
139 Putri Munia 08 08 20 23 Oktober 2018, Typhoid 1 0 0 0
140 Erika Fitri Maldayani 22 33 61 08 Oktober 2018, DBD + Acites 1 0 0 0

Murah 20 18 87 15 Oktober 2018, Mammae Abberant + Krisis HT + 1

141 Resisten Hipotensi 0 0 0
142 Muliani 110 59 73 23 Oktober 2018, Tumor Scalp 1 0 0 0
143 M. Nur 22 20 56 24 Oktober 2018, Pneumonia + TB, Paru + Anemia 1 0 0 0
144 Sukartik 15 94 09 28 Oktober 2018, GEA 1 0 0 0
145 Najarudin Lubis 21 95 23 21 Oktober 2018, Tb Paru + PPOK + DM 1 0 0 0
146 Nurliana 09 62 16 27 Oktober 2018, Bronchitis Akut 1 0 0 0
147 Nur Fitri Annisa 22 41 33 24 Oktober 2018, DBD 1 0 0 0
148 Sunar 14 93 66 12 Oktober 2018, CKD + Anemia 1 0 0 0
149 Asiah 13 71 08 28 Oktober 2018, CHF +PJK 1 0 0 0
150 M. Syah Raja 22 42 73 28 Oktober 2018, Febris 1 0 0 0
151 Sukadi 22 41 49 24 Oktober 2018, DF 1 0 0 0
152 Nuriati 22 42 19 26 Oktober 2018, Dyspepsia 1 0 0 0
153 Jimat 12 35 96 24 Oktober 2018, Asma 1 0 0 0
154 Ngateman 22 42 31 26 Oktober 2018, Febris 1 0 0 0
155 Rio Juniawan 22 39 93 21 Oktober 2018, DF 1 0 0 0
156 Rantika Dewi 22 42 39 27 Oktober 2018, Dyspepsia 1 0 0 0
157 Mariana 22 41 45 24 Oktober 2018, TB Paru 1 0 0 0
158 Warimin 07 42 91 27 Oktober 2018, Dyspepsia 1 0 0 0
159 Rahmi Apriliani 20 32 00 27 Oktober 2018, Dyspepsia 1 0 0 0
160 Wahyudin 22 41 39 24 Oktober 2018, Cystitis 1 0 0 0
161 Darmawati 17 48 11 28 Oktober 2018, HT 1 0 0 0
162 Bayu Hendrianto 22 41 73 25 Oktober 2018, Typhoid Fever 1 0 0 0
163 Lili Aprilini 14 89 00 26 Oktober 2018, App 1 0 0 0
164 Kapsiah 22 39 17 19 Oktober 2018, Closed(R) Middle third clavicula 1 0 0 0
165 Herman Dermawan 05 31 51 26 Oktober 2018, Dyspepsia 1 0 0 0
166 Bukhari Muslim 22 39 35 21 Oktober 2018, Aveolar Fx & Open Wound 1 0 0 0
167 Rinaldi 22 38 71 17 Oktober 2018, Colic Renal 1 0 0 0
168 Samsul Bahri 16 37 45 17 Oktober 2018, Open Wound at Nose 1 0 0 0
169 M. Kusman 22 38 85 18 Oktober 2018, Closed(L) Scapula Fx 1 0 0 0
170 Bambang Syahputra 15 50 75 17 Oktober 2018, Cholesistitis 1 0 0 0
171 Saniah 22 39 79 22 Oktober 2018, Breast Neoplasma 1 0 0 0
172 Zaniah 18 49 41 18 Oktober 2018, Breast Neoplasma 1 0 0 0
173 Yuliani 22 41 79 18 Oktober 2018, App 1 0 0 0
174 Tarmini 22 31 31 08 Oktober 2018, Neoplasma Trakus Posterior 1 0 0 0
175 Suratmin 22 23 87 22 Oktober 2018, STT Of Head 1 0 0 0
176 siti 21 23 87 22 Oktober 2018, Calallus of Kidney and ureter 1 0 0 0
177 Diska Febriyanti 22 22 52 15 Oktober 2018, Illeus Obstruksi Parsial 1 0 0 0
178 Suriadi 22 26 52 19 Oktober 2018, Nefrolitiasis 1 0 0 0
179 Roni Setiawan 22 36 03 23 Oktober 2018, App Kronik Exarbasi Akut 1 0 0 0
180 Ngatemi 22 42 68 28 Oktober 2018, DBD 1 0 0 0
181 Intan Ayu Safitri 22 42 59 28 Oktober 2018, DBD 1 0 0 0
182 M.Yahya 22 30 93 25 Oktober 2018, Ca. prostat 1 0 0 0
183 Widia Lestari 16 11 39 17 Oktober 2018, GEA 1 0 0 0
184 Adriano 22 37 91 16 Oktober 2018, Dengue Fever 1 0 0 0
185 Ngatiyem 10 27 92 14 Oktober 2018, Dengue Fever + Cephalgia 1 0 0 0
186 Nur Azizah 22 38 13 17 Oktober 2018, Syok Hiovolemik 1 0 0 0
187 Zulia 22 39 06 19 Oktober 2018, DHF 1 0 0 0
188 Siti Zainah 14 45 60 12 Oktober 2018, Abdominal pain 1 0 0 0
189 Fadilah Adira 22 37 78 16 Oktober 2018, Dyspepsia 1 0 0 0
190 Retno Efendi 22 37 27 20 Oktober 2018, Colic Abdomen 1 0 0 0
191 Habsah Bin Abdul Rahman 22 39 27 20 Oktober 2018, CKD 1 0 0 0
192 Misnan 22 37 83 16 Oktober 2018, Frontalis Muscle Rupture 1 0 0 0
193 Zahlia Saputri 18 67 41 28 Oktober 2018, Dyspepsia 1 0 0 0
194 Alfina Darmayanti 22 42 78 28 Oktober 2018, Dyspepsia 1 0 0 0
195 Nurhanita 22 41 64 24 Oktober 2018, SH 1 0 0 0
196 Rohani 22 41 64 24 Oktober 2018, LBP 1 0 0 0
197 Marsina 22 41 47 24 Oktober 2018, LBP 1 0 0 0
198 Yusnawati 16 27 69 25 Oktober 2018, SH 1 0 0 0
199 Rulisyah 22 40 17 22 Oktober 2018, Cephalgia 1 0 0 0
200 Riski Ramadhani 22 39 98 22 Oktober 2018, ISPA 1 0 0 0
201 Dina Guwardi 22 42 24 26 Oktober 2018, ISPA 1 0 0 0
202 Dara 10 38 78 30 Oktober 2018, DBD 1 0 0 0
203 Sawaliah 08 76 09 12 Oktober 2018, CHF cc CAD 1 0 0 0
204 Sri Pamrih 22 38 26 17 Oktober 2018, Dengue Fever 1 0 0 0
205 Raju Praka Pahlefi 22 30 44 03 Oktober 2018, App Kronis 1 0 0 0
206 Supiani 22 41 63 24 Oktober 2018, LBP 1 0 0 0
207 Afta Afriandi 21 31 75 23 Oktober 2018, Post Orif Metacarpal Fracture 1 0 0 0
208 Marwansyah 22 42 15 26 Oktober 2018, Nstemi 1 0 0 0
209 Azman 22 42 15 26 Oktober 2018, Sprain Injury o/t (R)Inguninal 1 0 0 0
210 M. Rasydin 19 06 74 21 Oktober 2018, ISPA 1 0 0 0
211 M. Sultan 22 30 52 15 Oktober 2018, Perdarahan Saluran Cerna 1 0 0 0
212 Susanto 22 30 14 02 Oktober 2018, Electric Burn 1 0 0 0
213 Murah 21 18 87 31 Oktober 2018, Nstemi 1 0 0 0
214 Meliza Sabrina 17 25 90 30 Oktober 2018, Asma Exarbasi Akut 1 0 0 0
215 Rumilah 22 43 67 30 Oktober 2018, Pneumonia + DM + TB Paru 1 0 0 0
216 Lelawati 17 66 93 30 Oktober 2018, Pneumonia + PPOK 1 0 0 0
217 Sudiah 22 42 60 28 Oktober 2018, Pnoumoia + Sepsis + Asma 1 0 0 0
218 Aisah 10 11 33 30 Oktober 2018, Hipoglikemi + Anemi 1 0 0 0
219 Hanafiah 22 43 74 30 Oktober 2018, Gangren + DM 1 0 0 0
220 Paridah Hanum 22 42 74 28 Oktober 2018, DBD 1 0 0 0
221 Siti Fatimah 21 01 67 31 Oktober 2018, Dyspepsia 1 0 0 0
222 Mudia Hamdani 20 56 59 30 Oktober 2018, Pneumonia + PPOK 1 0 0 0
223 Supariem 22 47 58 30 Oktober 2018, DF 1 0 0 0
224 Sartono 03 44 27 30 Oktober 2018, Bronchitis + CHF + HHD 1 0 0 0
225 Sapi'i 22 45 06 03 Oktober 2018, Febris 1 0 0 0
226 Supriyanti 13 11 44 30 Oktober 2018, Nstemi 1 0 0 0
227 Adnin 22 43 78 30 Oktober 2018, DBD 1 0 0 0
228 Supratmanto 22 44 26 30 Oktober 2018, Benign Neoplasma 1 0 0 0
229 Nasip 22 43 60 30 Oktober 2018, Retensio Urine 1 0 0 0
230 Nurlina 17 57 29 30 Oktober 2018, Tumor Intra Abdomen 1 0 0 0
231 Jamaliah 22 12 07 30 Oktober 2018, Nstemi 1 0 0 0
232 Rosmawar 19 30 07 28 Oktober 2018, CHF HHD 1 0 0 0
233 Ibnu Mumar 22 00 15 28 Oktober 2018, Skizoferis tak terinci 1 0 0 0
234 Vera Anggraini 18 09 74 27 November 2018, Vertigo 1 0 0 0
235 Kasuma 18 06 02 29 Oktober 2018, Gangren + DM 1 0 0 0
236 Ponatun 14 87 67 29 Oktober 2018, App Infiltrate 1 0 0 0
 R. Iskandar Muda Bulan Nov 2018
FORMULIR
NO Nama Pasien No.RM Tgl Masuk Diagnosa
Spiritual Record Permintaan Kerohanian
y T Y T
01 Nurjannah 19 01 43 05 November 2018, Pneumonia + Brochitis 1 0 0 0
02 Khaidir 21 42 42 09 November 2018, Pneumonia 1 0 0 0
03 Yusnaini 18 24 47 09 November 2018, Neuropati 1 0 0 0
04 Nuraini 14 43 76 09 November 2018, PSMBA 1 0 0 0
05 Adi 22 47 83 08 November 2018, Bronchitis 1 0 0 0
06 Sumiyem 22 44 96 02 November 2018, LBP 1 0 0 0
07 Ismawati 20 68 34 02 November 2018, Cholestiasis 1 0 0 0
08 Arina Sari 04 51 53 09 November 2018, Hipertensi 1 0 0 0
09 Salamah 17 39 74 02 November 2018, HT 1 0 0 0
10 Ngatimin P 15 20 55 03 November 2018, Hipoglikemi 1 0 0 0
11 Rusli T 22 37 75 02 November 2018, HT 1 0 0 0
12 Sri Rahayu 22 44 85 02 November 2018, Sincope 1 0 0 0
13 Karmen 22 46 77 05 November 2018, CHF 1 0 0 0
14 Zainal Abidin 18 40 26 03 November 2018, Pneumonia 1 0 0 0
16 Khairul Umri 21 96 86 01 November 2018, Pneumonia PPOK 1 0 0 0
17 Wagiono 22 46 94 06 November 2018, PPOK + Dyspepsia 1 0 0 0
18 Ali Hanapian 21 49 70 30 November 2018, Pneumonia + Haemaptoe 1 0 0 0
19 Selamat 14 82 07 05 November 2018, Pneumonia 1 0 0 0
20 Misriati 22 44 92 02 November 2018, Pneumonia 1 0 0 0
21 Tukiman 15 27 20 02 November 2018, Pneumonia + PPOK 1 0 0 0
22 Sarimanah 19 86 25 03 November 2018, Pneumonia + PPOK 1 0 0 0
23 Aisah 10 11 33 30 Oktober 2018, Hipoglikemi + Anemi 1 0 0 0
24 Ely Safitri 22 43 72 30 November 2018, Asma Bronchial 1 0 0 0
25 Jul Dandy 22 47 45 06 November 2018, PSMBA + Typhoid 1 0 0 0
26 Nurul Mustafa 15 52 18 07 November 2018, Febris 1 0 0 0
27 Chinta Rahayu 22 48 94 12 November 2018, Tonsilitis 1 0 0 0
28 Rahman 22 48 86 11 November 2018, DBD 1 0 0 0
29 Supian 16 09 54 28 November 2018, DBD 1 0 0 0
30 Abdul Salam 14 81 97 28 November 2018, Febris 1 0 0 0
31 Jaidar 15 60 47 05 November 2018, DBD 1 0 0 0
32 Marwan Dwi Parmansyah 13 01 28 06 November 2018, Gastropati Diabetik 1 0 0 0
33 Kamisah 15 48 71 07 November 2018, Pneumonia 1 0 0 0
34 Tumini 22 47 74 08 November 2018, Pneumonia 1 0 0 0
35 Nurhayati 22 48 71 10 November 2018, PSMBA 1 0 0 0
36 Baharudin 22 46 49 04 November 2018, GEA 1 0 0 0
37 M. Herry Suseno 22 47 65 07 November 2018, Dengue Fever 1 0 0 0
38 Fatma Zaitun 19 96 73 09 November 2018, CKD + Anemia 1 0 0 0
39 Suriana 22 43 79 30 November 2018, DBD 1 0 0 0
40 M.Idrus 04 23 40 03 November 2018, Peumonia 1 0 0 0
41 Desy Ramadhani 14 81 08 04 November 2018, Hipoglikemi 1 0 0 0
42 Nurmaini 18 86 99 04 November 2018, PSMBA 1 0 0 0
43 Sri Wahyuningsih 22 47 99 09 November 2018, Abdominal Pain 1 0 0 0
44 Legiem 21 96 80 02 November 2018, CKDstd V + Trombos Drain 1 0 0 0
45 Nur Asiah 22 46 53 02 November 2018, Benign Neoplasma 1 0 0 0
46 Lindawati 22 47 56 07 November 2018, Dengue Fever 1 0 0 0
47 Risa Aryani 17 22 24 08 November 2018, LBP 1 0 0 0
48 Jamari 22 24 18 13 November 2018, TB Paru + Pneumonia 1 0 0 0
49 Yuda Darmawan 15 62 42 13 November 2018, Bronchitis Akut + Haemaptoe 1 0 0 0
50 M. Thalib 22 48 40 08 November 2018, Dengue Fever 1 0 0 0
51 Sutrisno 20 73 96 08 November 2018, Pneumoia + TB Paru 1 0 0 0
52 Siti Rahmawati 16 15 81 08 November 2018, CKD + Anemia 1 0 0 0
53 Ismail Gani 22 06 84 10 November 2018, Susp. SGB 1 0 0 0
54 Abu Bakar 22 06 84 10 November 2018, Pneumonia +PPOK + TB.Paru 1 0 0 0
55 Muhammad Muzakir 14 39 05 10 November 2018, Nstemi 1 0 0 0
56 Ratna Wulan 12 92 19 06 November 2018, Cerebral Infark 1 0 0 0
57 Paijem 22 46 99 06 November 2018, CHF 1 0 0 0
58 Mirah 20 18 87 08 November 2018, STT 1 0 0 0
59 Suriani 19 53 58 09 November 2018, Febris 1 0 0 0
60 Hindun 13 28 57 06 November 2018, Dyspepsia + Pneumonia 1 0 0 0
61 Suparno 20 59 69 11 November 2018, Pneumonia 1 0 0 0
62 Rahayu 21 59 65 08 November 2018, Dyspepsia 1 0 0 0
63 Ponijem 17 24 84 01 November 2018, Abdominal Pain 1 0 0 0
64 Yatini 14 25 25 01 November 2018, Dypepsia 1 0 0 0
65 Fathul Rahmah 19 44 10 07 November 2018, Febris 1 0 0 0
66 Silon 13 61 19 09 November 2018, HT 1 0 0 0
67 Nuraidah 18 93 76 09 November 2018, HT 1 0 0 0
68 Suriati 20 94 34 11 November 2018, Btuk RK 1 0 0 0
69 Husen 22 47 75 08 November 2018, Bronchitis 1 0 0 0
70 Adnin 22 43 78 30 Oktober 2018, DBD 1 0 0 0
71 Suryadawati 09 34 64 01 November 2018, susp ISK 1 0 0 0
72 Khairul Syah 14 97 18 02 November 2018, Nstemi 1 0 0 0
73 Dahlia 07 16 00 07 November 2018, Febris 1 0 0 0
74 M. Juned 17 86 86 11 November 2018, DBD + AB 1 0 0 0
75 Azizah 22 45 20 03 November 2018, Gastropati Diabetik 1 0 0 0
76 Sandy Himawan 16 48 66 08 November 2018, DF 1 0 0 0
77 Erna Lestari 10 58 57 12 November 2018, DBD 1 0 0 0
78 Mariani 19 52 11 09 November 2018, Tonsilo faringitis 1 0 0 0
79 Nurhayati 19 50 25 29 Oktober 2018, STT of Head 1 0 0 0
80 Cut Putri 19 4707 08 November 2018, Cephalgia 1 0 0 0
81 Lisa Dina Silfia 22 49 79 15 November 2018, Febris + Dyspepsia + Cephalgia 1 0 0 0
82 Rini Susanti 22 48 91 12 November 2018, DBD 1 0 0 0
83 Depra Alfatah 05 66 07 17 November 2018, Dyspepsia + GE + Cephalgia 1 0 0 0
84 Fahreza 17 48 36 15 November 2018, Febris + Dyspepsia + Cephalgia 1 0 0 0
85 Nurbinun 20 02 75 15 November 2018, Nstemi 1 0 0 0
86 Padhilah 22 49 37 14 November 2018, Nstemi 1 0 0 0
87 Oli Nadiah 14 42 13 17 November 2018, Febris + Dyspepsia + Cephalgia 1 0 0 0
88 Darmawati Ningsih 22 50 59 13 November 2018, App 1 0 0 0
89 Safa Nurahmah 18 59 37 13 November 2018, Febris + Dyspepsia + Bronchitis 1 0 0 0
90 Edi Susanto 17 03 00 08 November 2018, CHF + CAD + PPOK + HHD 1 0 0 0
91 Armansyah sembiring 19 98 41 17 November 2018, TB Paru + Drug Alerg 1 0 0 0
92 Fajar Banta Ayyun 15 78 38 16 November 2018, Dyspepsia + Febris + Cephalgia 1 0 0 0
93 Mariani 22 43 41 12 November 2018, Tumor Dinding Perut 1 0 0 0
94 Hendri Maryadi 19 80 91 12 November 2018, Hepatitis N 1 0 0 0
95 Rada Surya 22 52 16 19 November 2018, Febris 1 0 0 0
96 Wulan Sabrina 17 51 71 12 November 2018, Breast Neoplasma 1 0 0 0
97 Muhammmad 22 47 28 06 November 2018, (L) Unilateral Inguinal Hernia 1 0 0 0
98 Mutiara Mahala Al Mahdi 22 48 09 09 November 2018, Grastitis Akut 1 0 0 0
99 Endang Partinem 06 77 30 19 November 2018, Febris 1 0 0 0
100 Safariah 15 37 02 13 November 2018, GE Akut 1 0 0 0
101 Oktavia Annisa 22 52 03 18 November 2018, Dyspepsia 1 0 0 0
102 Nurul 22 46 44 04 November 2018, GEA 1 0 0 0
103 Nazla Mutiara Dewi 22 47 60 07 November 2018, DHF 1 0 0 0
104 Irwansyah 22 49 64 07 November 2018, Typhoid 1 0 0 0
105 M. Afandi Pratama 19 96 68 15 November 2018, DHF 1 0 0 0
106 Wulan Dari 20 47 34 04 November 2018, Tonsilo faringitis 1 0 0 0
107 Sutio 06 17 45 06 November 2018, CKD 1 0 0 0
108 Al Vina Zahra 16 78 75 08 November 2018, ISPA 1 0 0 0
109 Putri Nabiala Julia 18 63 63 19 November 2018, Dyspepsia 1 0 0 0
110 Riski Ramadhani 21 16 46 07 November 2018, GEA 1 0 0 0
111 Eliza Muara Sucia 22 28 58 10 November 2018, Oedema paru + Peneumonia 1 0 0 0
112 Nadiatul Silfana 13 15 57 10 November 2018, Dyspepsia 1 0 0 0
113 Sapiah 16 76 95 11 November 2018, SH 1 0 0 0
114 Nofrizal 21 97 90 22 November 2018, PPOK Exarbasi Akut 1 0 0 0
115 Suroso 22 51 97 18 November 2018, DBD 1 0 0 0
116 Abdullah 22 48 98 12 November 2018, Pneumonia 1 0 0 0
117 Nuraina Sari 15 66 26 06 November 2018, Hipotermi 1 0 0 0
118 Abdullah AS 22 35 39 21 November 2018, Pneumonia 1 0 0 0
119 Suparman 22 49 27 13 November 2018, Gastro Esofagus 1 0 0 0
120 Idham Khalid 19 44 78 07 November 2018, ISPA 1 0 0 0
121 Putri Zaskia Maharani 09 54 03 07 November 2018, Dengue Fever 1 0 0 0
122 Siti Maryam 22 44 98 02 November 2018, ISPA 1 0 0 0
123 Riska Masmiranti 10 48 92 16 November 2018, Dyspepsia 1 0 0 0
124 Muhammad Isa 22 44 40 06 November 2018, Open (L) Phalanx proximal 1 0 0 0
125 Sukiyem 13 10 94 20 November 2018, HT 1 0 0 0
126 Yeni Widiana 19 97 83 20 November 2018, GEA 1 0 0 0
127 Sakem 19 02 53 19 November 2018, Febris + HT 1 0 0 0
128 Holma 15 23 56 20 November 2018, Abdominal Pain 1 0 0 0
129 Marliani 22 47 93 09 November 2018, PPOK 1 0 0 0
130 Maimunnah 14 04 14 02 November 2018, Anemia 1 0 0 0
131 Zulkifli 22 46 56 04 November 2018, Dengue Fever 1 0 0 0
132 Wagino 21 63 27 10 November 2018, Oedema paru Akut 1 0 0 0
133 Maya Wirahayu 22 44 75 01 November 2018, DHF 1 0 0 0
134 Rukiah 22 44 66 01 November 2018, Febris 1 0 0 0
135 Candra Dewi putra 22 50 01 16 November 2018, DF 1 0 0 0
136 Nurleli 22 49 53 14 November 2018, Dypepsia 1 0 0 0
137 T. Syafridah 06 53 18 16 November 2018, Asma 1 0 0 0
138 Mukini 05 66 87 17 November 2018, DM 1 0 0 0
139 Sabaruddin 16 46 99 14 November 2018, DF 1 0 0 0
140 Siti Maslan 10 27 02 14 November 2018, Bronchitis 1 0 0 0
141 Nurzainah 10 28 29 17 November 2018, Bronchitis 1 0 0 0
142 Rosdiana 07 12 02 17 November 2018, Bronchitis 1 0 0 0
143 Dedi Irwadi 22 00 08 14 November 2018, Febris 1 0 0 0
144 Tanoaya Rulyan Habsani 15 89 64 16 November 2018, Dyspepsia 1 0 0 0
145 Irwati 13 24 05 16 November 2018, Febris 1 0 0 0
146 Roro Ajeng apriani 22 49 48 14 November 2018, DF 1 0 0 0
147 Eriadi A 14 60 17 17 November 2018, Febris 1 0 0 0
148 Zainudin 22 42 22 26 November 2018, Pneumonia 1 0 0 0
149 Deni Andreansyah 22 53 71 22 November 2018, DF 1 0 0 0
150 Yuliani 06 67 37 23 November 2018, Abdominal Pain 1 0 0 0
151 Juniah 08 06 68 23 November 2018, ISPA 1 0 0 0
152 Suwardi 22 55 18 25 November 2018, DF 1 0 0 0
153 Najaruddin Lubis 21 95 23 22 November 2018, PPOK + TB Paru + CHF + HHD 1 0 0 0
154 Ngatiem 22 54 90 24 November 2018, ISPA 1 0 0 0
155 Nurhalijah 22 50 09 16 November 2018, Trauma Pelvic 1 0 0 0
156 Yahya Bukhari 15 91 53 14 November 2018, Kolic Abdomen 1 0 0 0
157 T.Lutfi Fauza 22 50 08 16 November 2018, Open (L) Humerus Fx 1 0 0 0
158 Karim 22 54 46 27 November 2018, CHF + PJK + HT 1 0 0 0
159 Saiman 22 55 22 25 November 2018, HT 1 0 0 0
160 Aisyah 22 53 68 22 November 2018, Pneumonia 1 0 0 0
161 Sukirah 15 93 85 23 November 2018, Pneumonia 1 0 0 0
162 Faisal 20 38 33 25 November 2018, PSMBA 1 0 0 0
163 Mingan 15 39 42 25 November 2018, Infeksi Bateri 1 0 0 0
164 Fauziah 09 37 22 14 November 2018, Fx (R ) Multiple V 1 0 0 0
165 Legiman 22 55 04 24 November 2018, Pneumonia 1 0 0 0
166 Irwansyah 15 98 83 22 November 2018, Dengue Fever 1 0 0 0
167 Tumin 22 52 09 19 November 2018, Pneumonia + CHF 1 0 0 0
168 Nur Haji 22 53 64 21 November 2018, Bronchitis 1 0 0 0
169 Siti Khadijah Alfah 20 68 89 20 November 2018, Dyspepsia + Cephalgia + ISPA 1 0 0 0
170 Nur Asiah 22 54 73 23 November 2018, DHF + Dyspepsia + Cephalgia 1 0 0 0
171 Cut Risky Syah Putri 19 83 34 24 November 2018, Pneumonia + Dyspepsia 1 0 0 0
172 Triono 22 55 31 25 November 2018, ISPA 1 0 0 0
173 Rahmad Hidayat 07 18 97 01 November 2018, Serangan Epilepsi 1 0 0 0
174 Rahmad Hidayat 22 52 85 21 November 2018, Typhoid Fever + Dyspepsia + GE 1 0 0 0
175 Salmiah 00 48 70 20 November 2018, HT 1 0 0 0
176 Rini Junaidi 20 58 00 30 November 2018, DBD +Typhoid 1 0 0 0
177 Melda Susanti 17 67 22 20 November 2018, Dyspepsia + DHF + Cephalgia 1 0 0 0
178 Yazid 19 10 26 27 November 2018, Oedema paru + Peneumonia 1 0 0 0
179 Nurmaidah 14 15 58 19 November 2018, CHF + CAD 1 0 0 0
180 Nuraisah 17 08 30 23 November 2018, Candidiasis Osofaring 1 0 0 0
181 M.Ridwan 19 38 45 07 November 2018, Grastitis Akut 1 0 0 0
182 Faridah 15 96 87 07 November 2018, Benign Neoplasma 1 0 0 0
183 Bharuddin 22 53 73 22 November 2018, SNH 1 0 0 0
184 BagasArya Rajasa 17 64 18 27 November 2018, LBP 1 0 0 0
185 Frengki 22 51 45 16 November 2018, STT 1 0 0 0
186 Juli 13 60 26 21 November 2018, STT 1 0 0 0
187 Silawati 22 54 53 22 November 2018, App 1 0 0 0
188 Hotden Sitanggang 22 53 58 21 November 2018, Dengue Fever 1 0 0 0
189 Febi Utami 20 66 77 07 November 2018, ISPA 1 0 0 0
190 Nadia Zahrina 22 53 79 22 November 2018, Dyspepsia + Cephalgia + DHF 1 0 0 0
191 Muhammad Iqbal 14 44 82 20 November 2018, Dyspepsia + Cephalgia + ISPA 1 0 0 0
192 Nazwa Deswita Hsb 22 52 58 20 November 2018, DHF + Dyspepsia + Cephalgia 1 0 0 0
193 Paijah 63 64 67 21 November 2018, Pneumonia 1 0 0 0
194 Dana Nabila 13 52 39 17 November 2018, DF 1 0 0 0
196 Sariyah 17 27 46 28 November 2018, CHF 1 0 0 0
197 Jauhari 17 45 75 28 November 2018, DF 1 0 0 0
198 Nasib 22 53 80 22 November 2018, SNH 1 0 0 0
199 Jhony Pranata 17 43 60 24 November 2018, Bronchitis 1 0 0 0
200 Panjaya Arafat 16 20 66 26 November 2018, Pneumonia 1 0 0 0
201 Sakinah 03 42 91 23 November 2018, Nstemi + Pneumonia 1 0 0 0
202 Sofian 16 96 71 27 November 2018, CHF cc CAD 1 0 0 0
203 Surya Bhaskara 22 55 06 24 November 2018, DHF + Dyspepsia + Cephalgia 1 0 0 0
204 Sarinah 22 53 94 22 November 2018, App 1 0 0 0
205 Yuni Hariani 22 52 70 21 November 2018, App 1 0 0 0
206 Syafwan 19 63 75 26 November 2018, LBP + Colic Abdomen 1 0 0 0
207 Saimawarti 16 23 01 01 November 2018, Abdominal Pain 1 0 0 0
208 Rini Andriayana 22 48 45 13 November 2018, Benign Neoplasma of lower Arm 1 0 0 0
209 Selamat 14 82 07 16 November 2018, STT + TB. Paru 1 0 0 0
210 Elviani 22 40 25 26 November 2018, CKD + Stemi 1 0 0 0
211 An Rohaja 22 55 41 26 November 2018, STT 1 0 0 0
212 Sulaiman 22 55 01 24 November 2018, Pneumonia 1 0 0 0
213 Hadi Setiawan 09 43 02 25 November 2018, kolik Ureter + BSK 1 0 0 0
214 Mustafa 22 45 89 24 November 2018, Efusi Pleura 1 0 0 0
215 Asmawani 22 56 70 27 November 2018, Febris 1 0 0 0
216 M. Ali Abdullah 15 53 74 08 November 2018, CHF 1 0 0 0
217 Suprianti 22 55 36 26 November 2018, SNH 1 0 0 0
218 MHD Arief 2254 45 27 November 2018, DHF 1 0 0 0
219 Vera Anggraini 18 09 74 27 November 2018, Vertigo 1 0 0 0
220 Fadilah Sari 22 51 85 17 November 2018, Abses App 1 0 0 0
221 Ihsan Alfarisi 22 51 82 17 November 2018, App Kronis 1 0 0 0
222 Usman 222 05 93 23 November 2018, kolik Abdomen 1 0 0 0
223 Anisa Chairani 22 42 34 12 November 2018, App Akut 1 0 0 0
224 Rahmad 22 51 91 18 November 2018, Calculus of Kidnep Ureter 1 0 0 0
225 Haliza Pasya 18 81 88 30 November 2018, HI GCS 15 1 0 0 0
226 Sarimanah 22 56 82 28 November 2018, Colic Abdomen + Angina Pectori 1 0 0 0
227 Legiyem 22 44 36 14 November 2018, App 1 0 0 0
228 Yuri Yurina 09 71 50 16 November 2018, Abses Maxilla + Anemi 1 0 0 0
229 Nursilin 22 57 87 28 November 2018, Stemi 1 0 0 0
230 Ngatinah 17 49 53 27 November 2018, DBD 1 0 0 0
231 Mirda Amanda 12 13 47 27 November 2018, Asma Exarbasi Akut 1 0 0 0
232 Taslim 05 66 55 30 November 2018, Pneumonia 1 0 0 0
233 Dwi Setiawan 17 66 76 29 November 2018, Pneumonia 1 0 0 0
234 Yeti Wahyuni 14 19 52 30 November 2018, ISPA 1 0 0 0
235 Usman 10 32 90 28 November 2018, PPOK + Anemia 1 0 0 0
236 Painem 02 19 33 03 November 2018, 1 0 0 0
237 Katijah 22 57 04 28 November 2018, Typhoid 1 0 0 0
238 Tuyem 16 73 23 30 November 2018, Anemia Sedang 1 0 0 0
239 Giarno 22 56 95 28 November 2018, Stemi 1 0 0 0
 R. Iskandar Muda Bulan Des 2018
FORMULIR
No Nama Pasien No.RM Diagnosa
Tgal Masuk Spiritual Record Permintaan Kerohanian

y t y t
01 Ramli 04 33 57 01 Desember 2018, Anemi Berat 1 0 0 0
02 Nur Afnidar 20 34 23 02 Desember 2018, Pneumonia 1 0 0 0
03 Saman 17 20 03 03 Desember 2018, Nstemi 1 0 0 0
04 yusnaini 18 24 47 01 Desember 2018, APP 1 0 0 0
05 Taslim 05 66 55 30 November 2018, Pneumonia 1 0 0 0
06 Paenah 14 80 57 04 Desember 2018, Anemia + Kista Sepsis 1 0 0 0
07 Surianto 21 85 21 02 Desember 2018, Pneumonia 1 0 0 0
08 Effendi 2015 60 29 November 2018, Pneumonia + sepsisi + PPOK 1 0 0 0
09 Ngarini 22 57 21 29 November 2018, Pneumonia 1 0 0 0
10 Ratnawati rahman 05 56 09 08 Desember 2018, Gastropati Diabetik 1 0 0 0
11 Wakidi 20 63 26 03 Desember 2018, Osteopati Lumbal 1 0 0 0
12 Zulkifli Ibda 19 23 60 07 Desember 2018, ISPA 1 0 0 0
13 nur Muhammad 22 61 97 09 Desember 2018, Dengue Fever 1 0 0 0
14 Nurmaini 14 73 41 07 Desember 2018, ISPA 1 0 0 0
15 Zainal IB 14 73 41 07 Desember 2018, HT 1 0 0 0
16 Jamaiyah 22 61 83 08 Desember 2018, Bacterial Infection 1 0 0 0
17 Zupikar 19 38 41 07 Desember 2018, Ileus prostitele 1 0 0 0
18 Marko Leonardo 22 58 95 02 Desember 2018, DHF 1 0 0 0
19 Rehan Frandika 22 58 80 01 Desember 2018, ISPA 1 0 0 0
20 Ogies Faundra 05 45 18 03 Desember 2018, ISPA 1 0 0 0
21 Dodi Fernanda 15 81 16 01 Desember 2018, ISPA 1 0 0 0
22 Mauliza 22 58 81 01 Desember 2018, DHF 1 0 0 0
23 Hafizah Nahwa Firdaus 22 57 18 29 November 2018, ISPA 1 0 0 0
24 Muhammad Yasin 20 15 87 10 Desember 2018, ISPA + DHF + GE + Cephalgia 1 0 0 0
25 Silfiawati 18 35 44 06 Desember 2018, Varicella 1 0 0 0
26 Paimin 18 10 14 22 November 2018, ( R) Opn Fx Tibia Fibula 1 0 0 0
27 Mauliza 20 33 85 04 Desember 2018, DHF + Dypepsia + Cephalgia 1 0 0 0
28 Novran Willyandoro Siantri 20 87 52 05 Desember 2018, DF 1 0 0 0
29 Herianto 20 19 18 05 Desember 2018, DF 1 0 0 0
30 Siti Fatimah 21 01 67 05 Desember 2018, Dyspepsia 1 0 0 0
31 Hamzah 13 46 06 07 Desember 2018, Supra Venticular tracycardia 1 0 0 0
32 Marik 22 60 76 06 Desember 2018, pneumonia +PPOK + DM 1 0 0 0
33 M. Rifki Muzaimi 22 61 86 08 Desember 2018, DHF + Dypepsia + Cephalgia 1 0 0 0
34 M. Salim 22 60 08 01 Desember 2018, DM + GangrenDava Putra Perdana 1 0 0 0

Dava Putran Perdana 22 59 83 04 Desember 2018, Syndrome Nefrolitist + HT + Hypo 0

35 Albumin 1 0 0
36 Rahmad Syahputra 22 60 27 05 Desember 2018, Benign Neoplasma of back 1 0 0 0
37 Linda Pandiagaan 22 60 75 06 Desember 2018, Febris 1 0 0 0
38 Novika Sari 22 60 72 05 Desember 2018, DF 1 0 0 0
39 Nuraini 22 00 09 04 Desember 2018, Bacterial Infection 1 0 0 0
40 Saiyah 22 60 09 04 Desember 2018, Nstemi 1 0 0 0
41 Zulkifli 16 61 81 03 Desember 2018, DM 1 0 0 0
42 M.Yasin 22 59 21 03 Desember 2018, Dyspepsia 1 0 0 0
43 YuliaAgustina 20 26 91 04 Desember 2018, Typhoid 1 0 0 0
44 Sumarni 13 74 74 05 Desember 2018, Anemia 1 0 0 0
45 Sarah Yulis 20 21 59 10 Desember 2018, Viral Infection 1 0 0 0
46 Suginem 22 61 23 10 Desember 2018, CHF 1 0 0 0
47 M. Wahyu 22 62 12 09 Desember 2018, DHF + Dypepsia + Cephalgia 1 0 0 0
48 Yusnita 13 70 55 07 Desember 2018, Dyspepsia 1 0 0 0
49 Dedi Junianto 22 58 36 30 November 2018, Dyspepsia 1 0 0 0
50 Nasriya 22 58 82 01 Desember 2018, Anemia 1 0 0 0
51 Suaida 22 59 06 03 Desember 2018, Abdominal Pain 1 0 0 0
52 Hnedri Maryadi 19 80 91 01 Desember 2018, AKI 1 0 0 0
53 Salmiah 0048 70 06 Desember 2018, Dyspepsia 1 0 0 0
54 Surep 22 60 53 05 Desember 2018, DM 1 0 0 0
55 M. Hidayatullah 22 60 58 05 Desember 2018, Epilepsi 1 0 0 0
56 Aminah 17 05 53 03 Desember 2018, CHF cc CAD 1 0 0 0
57 Edy Susanto 17 03 00 02 Desember 2018, CHF cc CAD 1 0 0 0
58 Jamaliah 22 12 07 01 Desember 2018, Nstemi 1 0 0 0
59 Hartini 18 95 69 07 Desember 2018, Atcial FIB+LHT 1 0 0 0
60 Siti Hawa 05 33 42 02 Desember 2018, VAP 1 0 0 0
61 Rinaldi Syah Putra 22 61 63 07 Desember 2018, TB Paru + Gangguan Psikotik 1 0 0 0
62 Safrida 22 62 46 11 D Dyspepsia 1 0 0 0
63 AinunaSitorus 20 92 72 09 Desember 2018, Anemia+ CKD 1 0 0 0
64 Azwandi 22 60 71 06 Desember 2018, Cephalgia + Vertigo + TB Paru 1 0 0 0
65 Sukartik 19 71 42 05 Desember 2018, Gangren + DM 1 0 0 0
66 Nurdin 22 55 09 25 Nvembr 2018, App 1 0 0 0
67 Hariadi 20 52 79 12 Desember 2018, Dyspepsia 1 0 0 0
68 M. Sunanda 22 62 92 13 Desember 2018, DHF 1 0 0 0
69 Muhammad Junaidi 22 59 90 04 Desember 2018, HT 1 0 0 0
70 Alhakiman 22 62 39 11 Desember 2018, ISPA 1 0 0 0
71 Lena Losari 22 62 67 12 Desember 2018, HT 1 0 0 0
72 Rasinem 20 44 86 14 Desember 2018, CHF cc CAD 1 0 0 0
73 Nyak Wati 17 03 41 11 Desember 2018, ISPA 1 0 0 0
74 Sulaiman 17 69 99 11 Desember 2018, Nstemi 1 0 0 0
75 Leo Candra 22 61 71 07 Desember 2018, Dengue Shok Syndrome 1 0 0 0
76 Karno Muhajir 22 63 99 15 Desember 2018, Pneumonia 1 0 0 0
77 Rahmad Syahputra 22 62 43 11 Desember 2018, Bacterial Infection 1 0 0 0
78 Jon Nijar 21 73 07 15 Desember 2018, ISPA 1 0 0 0
79 Abdurrahman 16 67 78 17 November 2018, Tb Paru + CHF + CAD + HT 1 0 0 0
80 Danila Hendrawan 10 29 92 16 Desember 2018, Febris 1 0 0 0
81 Khairul Ajriah 15 40 73 15 Desember 2018, Asma Bronchial 1 0 0 0
82 Mayanti 12 67 25 14 Desember 2018, Abdominal Pain 1 0 0 0
83 Ayub 19 68 47 08 Desember 2018, Anemia Berat 1 0 0 0
84 Zulkifli 05 71 76 10 Desember 2018, Gastropati Diabetik 1 0 0 0
85 Ratna Sairi 14 20 73 17 Desember 2018, Pneumonia 1 0 0 0
86 Tarsiyem 0635 68 13 Desember 2018, GEA 1 0 0 0
87 Maimunah 12 30 61 08 Desember 2018, Anemi + CKD 1 0 0 0
88 Fitrriani 21 95 38 09 Desember 2018, Anemi + CKD 1 0 0 0
89 Saad Husen 22 61 85 06 Desember 2018, Pneumonia + Anemia + PPOK 1 0 0 0
90 Suhaibah 17 26 00 13 Desember 2018, VAP 1 0 0 0
91 Mardiana 22 59 59 10 Desember 2018, Spondititis Lumbal 1 0 0 0
92 Pita Sari 22 63 92 15 Desember 2018, Angina Pectoris 1 0 0 0
93 Amiruddin 22 63 88 14 Desember 2018, Angina Pectoris 1 0 0 0
94 Sariman 22 63 98 15 Desember 2018, CHD 1 0 0 0
95 Nuraini 07 62 20 19 Desember 2018, CHF 1 0 0 0
96 Siti Aminah 17 25 07 20 Desember 2018, Febris 1 0 0 0
97 Lisa 15 96 25 20 Desember 2018, Febris 1 0 0 0
98 Rusli 22 33 75 20 Desember 2018, CKD 1 0 0 0
99 Rusmawati A 13 36 04 12 Desember 2018, LBP 1 0 0 0
100 Ilyas 15 29 31 12 Desember 2018, GEA 1 0 0 0
101 Ratna Sari 22 65 11 11 Desember 2018, Asccariatis 1 0 0 0
102 Siti Ariani 22 64 50 18 Desember 2018, Asma Bronchial 1 0 0 0
103 Ilpan 22 65 34 19 Desember 2018, Asma Bronchial 1 0 0 0
104 Juminten 22 65 37 19 Desember 2018, Dyspepsia 1 0 0 0
105 Syahrul Bahri 16 62 39 14 Desember 2018, CHF cc CAD 1 0 0 0
106 Sudiyio 22 64 15 16 Desember 2018, AF SVR + Pneumonia Lumbal 1 0 0 0
107 Fitriani 22 65 11 11 Desember 2018, Asccariatis 1 0 0 0
108 M. Yunus 21 68 09 19 Desember 2018, CHF 1 0 0 0
109 Nurizah 19 72 64 19 Desember 2018, CHF 1 0 0 0
110 Setia Madaningsih 22 24 87 23 Desember 2018, Febris 1 0 0 0
111 Tiraha 22 62 47 11 Desember 2018, Closed (L) Calvicula Fx 1 0 0 0
112 Nurmiyah 19 93 06 22 Desember 2018, PPOK Exarbasi Akut 1 0 0 0
113 Eka Prasetya 16 54 34 18 Desember 2018, Pneumonia + PPOK 1 0 0 0
114 Yatmiati 09 03 44 06 Desember 2018, Gingivitis + Sub Mandibula Abses 1 0 0 0
115 Hasanudin 22 64 04 15 Desember 2018, HT 1 0 0 0
116 Syafriatur 16 12 55 15 Desember 2018, SNH 1 0 0 0
117 Sulaseh 22 65 31 19 Desember 2018, PPOK 1 0 0 0
118 Wartini 20 33 92 04 Desember 2018, Frozen Shoulder + Asma 1 0 0 0
119 Sutini 22 67 59 20 Desember 2018, SNH 1 0 0 0
120 Siti Hartati 10 07 11 18 Desember 2018, CHF + HHD 1 0 0 0
121 Devi Kurniawan 20 45 98 19 Desember 2018, Dengue Fever 1 0 0 0
122 Najaeuddin Lubis 21 95 23 19 Desember 2018, Pneumonia + PPOK + CHF 1 0 0 0
123 Leha Sumiati 22 68 92 25 Desember 2018, Cephalgia Chest Discomfort 1 0 0 0
124 Rohana 21 85 13 28 Desember 2018, CHF + HHD 1 0 0 0
125 Idhar 21 09 72 27 Desember 2018, Gout Artitis 1 0 0 0
126 Rejo 22 69 89 27 Desember 2018, Nstemi 1 0 0 0
127 Salmiah 00 48 70 28 Desember 2018, Sistolik Isolated Hipotensi 1 0 0 0
128 Rido 22 69 56 28 Desember 2018, Abdominal Pain 1 0 0 0
129 Alizah 16 10 24 14 Desember 2018, LBB 1 0 0 0
130 Priyadi 22 69 49 28 Desember 2018, Dengue Fever 1 0 0 0
131 M. Ali Hanapiah 21 49 70 28 Desember 2018, Hemeoptisi 1 0 0 0
132 Agustiono 22 68 57 24 Desember 2018, Sub Ileus 1 0 0 0
133 Tia Puspita Ningsih 22 68 76 24 Desember 2018, PSMBA 1 0 0 0
134 Jhon Hardi 13 88 46 24 Desember 2018, Febris 1 0 0 0
135 Hasan Basri 12 40 28 21 Desember 2018, DBD + Typhoid 1 0 0 0
136 Khalid Irwansyah 18 64 47 21 Desember 2018, DBD + Typhoid 1 0 0 0
137 Sa'dah 15 91 66 16 Desember 2018, Febris 1 0 0 0
138 Samawati 20 90 56 25 Desember 2018, CKD 1 0 0 0
139 Meti Mustika Dewi 21 82 41 21 Desember 2018, Febris 1 0 0 0
140 Nia Darwita 10 38 28 24 Desember 2018, Alergi 1 0 0 0
141 sulasmi 22 70 10 24 Desember 2018, PSMBA 1 0 0 0
142 Hasbullah 14 21 58 21 Desember 2018, CKD 1 0 0 0
143 Abu Hurairah 22 58 90 02 Desember 2018, CKD 1 0 0 0
144 Hermansyah 14 93 21 17 Desember 2018, DHF 1 0 0 0
145 Novita Angraini 22 57 35 30 November 2018, ISPA 1 0 0 0
146 Jawiyah 21 57 75 18 Desember 2018, Gastropati Diabetik 1 0 0 0
147 Mariani 20 09 78 18 Desember 2018, HT 1 0 0 0
148 Ratmi 21 76 02 07 Desember 2018, SNH 1 0 0 0
149 Linaldi 22 57 02 09 Desember 2018, App 1 0 0 0
150 Kurniasih 15 76 94 21 Desember 2018, app 1 0 0 0
151 Sri Agustina 14 34 02 27 Desember 2018, STT 1 0 0 0
152 Sarudin 07 42 04 29 Desember 2018, Abdominal Pain 1 0 0 0
153 Juliarti 16 65 56 26 Desember 2018, CHF 1 0 0 0
154 Hamidah 22 63 86 14 Desember 2018, kolistitis + chf 1 0 0 0
155 Ponirah 22 68 44 23 Desember 2018, HT 1 0 0 0
156 Mulianto 16 36 37 26 Desember 2018, Dyspepsia 1 0 0 0
157 Ridwani 22 65 39 19 Desember 2018, Febris 1 0 0 0
158 Rama Hayatul Kamal 16 75 75 28 Desember 2018, Dyspepsia 1 0 0 0
159 Azhar Fauzi 06 28 89 26 Desember 2018, STT 1 0 0 0
160 Zusra 22 69 05 26 Desember 2018, CHF 1 0 0 0
161 Erni 06 96 40 19 Desember 2018, Asma + CHF + Dyspepsia 1 0 0 0
162 Muhammad Fa'i 12 36 65 16 Desember 2018, Colic Abdomen 1 0 0 0
163 Efendi 04 59 30 13 Desember 2018, Ca Buli 1 0 0 0
164 Sriyanti 13 14 28 18 Desember 2018, Tb Paru + Efusi pleura 1 0 0 0
165 Suhermanto 22 68 12 23 Desember 2018, CKD + Anemi 1 0 0 0
166 Rita Andiarsih 12 47 07 18 Desember 2018, LBP 1 0 0 0
167 Nurhayati 04 12 77 19 Desember 2018, Neoplasma 1 0 0 0
168 Ismawati 20 68 34 25 Novembr 2018, DM 1 0 0 0
169 Gianda Sapamar 22 70 28 26 Desember 2018, STT of Pedis 1 0 0 0
170 Umairah maidina Liza 19 23 39 14 Desember 2018, App 1 0 0 0
171 Susilawati 13 79 09 24 Desember 2018, Cholestiasis 1 0 0 0
172 Usman 22 68 15 23 Desember 2018, Multiple Tohos 1 0 0 0
173 Selvia Mega Muspita 22 00 50 26 Desember 2018, Dyspepsia 1 0 0 0
174 Wulansari 20 47 34 24 Desember 2018, Dengue Fever 1 0 0 0
175 Idris 22 62 14 09 Desember 2018, Abses Pental 1 0 0 0
176 Suriani 22 64 87 17 Desember 2018, Breast neoplasma 1 0 0 0
177 Herianto 14 99 91 16 Desember 2018, Over Fluid + CKD 1 0 0 0
178 Aris Budiman 12 51 31 21 Desember 2018, Calcullus of kidnep & Ureter 1 0 0 0
179 Romah 15 7763 22 Desember 2018, DM +GE 1 0 0 0
180 Fadli 22 67 74 21 Desember 2018, Blunt Abdominal Injury 1 0 0 0
181 Samawati 20 90 56 13 Desember 2018, CKD + Over Fluid 1 0 0 0
182 Asiah 22 68 48 24 Desember 2018, Cephalgia 1 0 0 0
183 Aida Aulia Permata 22 65 32 19 Desember 2018, Dengue Fever 1 0 0 0
184 Nisma Wulandari 22 65 17 19 Desember 2018, DHF 1 0 0 0
185 Riski Syahputra 22 89 35 27 Desember 2018, ISPA 1 0 0 0
total 204 0
 R. Iskandar Muda Bulan Jan 2018
FORMULIR

NO Nama Pasien No.RM Tgl Masuk

Diagnosa
Spiritual Record Permintaan Kerohanian
y t y t
01 Aminah 14 52 76 09 Januari 2019 Pneumonia 1 0 0 0
02 M. Nurdin 22 59 91 09 Januari 2019 Nstemi 1 0 0 0
03 Rajimin 14 83 42 11 Januari 2019 Cholestitis 1 0 0 0
04 Salamah 22 74 66 12 Januari 2019 HT 1 0 0 0
05 M. Yusuf 22 72 46 03 Januari 2019 Pneumonia 1 0 0 0
06 Suhada 22 60 78 11 Januari 2019 Typhoid abd 1 0 0 0
07 Hamdan 16 16 25 04 Januari 2019 Pneumonia 1 0 0 0
08 Agustiar 15 50 25 07 Januari 2019 Abses Petunel 1 0 0 0
09 Jainem 22 08 52 07 Januari 2019 CKS 1 0 0 0
10 Nursiah 19 77 36 13 Januari 2019 PSMBA 1 0 0 0
11 Nusa Antari 22 74 43 11 Januari 2019 Bacterial Infection 1 0 0 0
12 Umi Kasom 22 74 34 11 Januari 2019 Pneumonia 1 0 0 0
13 Hasil 22 76 19 09 Januari 2019 Hernia Inguinal 1 0 0 0
14 Suerni 14 02 02 11 Januari 2019 Pneumonia 1 0 0 0
15 Mutiara Danisa 17 94 62 02 Januari 2019 Breast Neoplasma 1 0 0 0
16 Diva Ramanda 20 41 79 02 Januari 2019 DHF + GE + ISPA 1 0 0 0
17 Inem 14 36 77 04 Januari 2019 Typhoid Fever 1 0 0 0
18 Kasim 17 39 61 03 Januari 2019 Pneumonia + PPOK 1 0 0 0
19 Edi Sanjaya 22 56 83 08 Januari 2019 Cholestitis + Pneumonia 1 0 0 0
20 Khairuddin 11 14 71 04 Januari 2019 Hipoglikemia 1 0 0 0
21 Darmi 20 59 67 04 Januari 2019 OA Gen (D) 1 0 0 0
22 Siti Pura 20 35 12 30 Desember 2018 CHF + HHD 1 0 0 0
23 Nurmawan 22 72 06 03 Januari 2019 Pneumonia 1 0 0 0
24 Darul Fuadi 16 97 44 07 Januari 2019 Hydronefrotik RK 1 0 0 0
25 Sulaiman 22 53 52 07 Januari 2019 PPOK 1 0 0 0
26 Ngatimah 22 71 99 03 Januari 2019 Infectious GE 1 0 0 0
27 Radiah 22 73 46 02 Januari 2019 Dyspepsia 1 0 0 0
28 Rasidah 22 73 08 Januari 2019 GE Akut 1 0 0 0
29 Kasun 18 47 02 06 Januari 2019 GE Akut 1 0 0 0
30 Fachrizal Kurniawan 09 50 48 10 Januari 2019 Dyspepsia 1 0 0 0
31 Syafridawati 21 74 26 04 Januari 2019 BPPV 1 0 0 0
32 Sri Maidiani 22 74 26 11 Januari 2019 Dyspepsia 1 0 0 0
33 Wahyudi 22 73 83 09 Januari 2019 Dengue Fever 1 0 0 0
34 Nurliana 20 26 28 16 Januari 2019 Susp Ulkus 1 0 0 0
35 Sarni 14 89 62 10 Januari 2019 Dengue Fever 1 0 0 0
36 Nurul Aini 18 60 75 03 Januari 2019 Dyspepsia 1 0 0 0
37 Salbiah 22 74 13 10 Januari 2019 Dyspepsia 1 0 0 0
38 Aliem Maharis 22 73 47 07 Januari 2019 Dengue Fever 1 0 0 0
39 Islamaiati 02 63 68 08 Januari 2019 SNH 1 0 0 0
40 Rahmawati 22 05 08 08 Januari 2019 Cephalgia 1 0 0 0
41 Sudarmi 22 73 07 06 Januari 2019 Febris 1 0 0 0
42 Reza Fahlevi 22 59 92 06 Januari 2019 Febris 1 0 0 0
43 Yogie Prasetia 22 73 21 06 Januari 2019 DBD 1 0 0 0
44 Ismail 21 87 88 07 Januari 2019 Febris 1 0 0 0
45 Rusmah 16 24 43 10 Januari 2019 Bronchitis Akut 1 0 0 0
46 As Sari 06 13 48 03 Januari 2019 GEA 1 0 0 0
47 Sugito 20 45 02 02 Januari 2019 GEA 1 0 0 0
48 Yatinah 18 91 29 11 Januari 2019 PSMBA 1 0 0 0
49 Wan Khairunnisak 12 72 57 02 Januari 2019 Dyspepsia 1 0 0 0
50 Muhammadh Ikhsan Alfatah 21 59 02 09 Januari 2019 Febris 1 0 0 0
51 Ainal Wardah Gea 22 56 44 17 Januari 2019 Dyspepsia + Cephalgia 1 0 0 0
52 Ayub 19 68 47 07 Januari 2019 Anemia Aplastik 1 0 0 0
53 Anisa 06 49 47 17 Januari 2019 Dyspepsia 1 0 0 0
54 Ok Ismail 22 73 09 06 Januari 2019 Pneumonia + Sepsis + TB Millier 1 0 0 0
55 Paini 22 53 78 13 Januari 2019 Pneumonia + TB Paru 1 0 0 0
56 Mariati 22 74 86 14 Januari 2019 Pneumonia 1 0 0 0
57 Lena br Sihgiro 14 35 36 18 Januari 2019 Pneumonai + DHF 1 0 0 0
58 Nurma 19 71 08 18 Januari 2019 Pneumonia 1 0 0 0
59 Wilda Hidayat 14 35 36 18 Januari 2019 Dyspepsia + Cephalgia 1 0 0 0
60 Muliaono 22 69 94 29 Desember 2018 Hi GCS 15 + Multiple injury 1 0 0 0
61 Lisman 22 72 23 04 Januari 2019 Colic Abdomen 1 0 0 0
62 Juliarti 16 65 56 08 Januari 2019 Nstemi 1 0 0 0
63 Mariani 05 44 96 07 Januari 2019 CHF + HHD + Dyspepsia 1 0 0 0
64 Meila Angraini 22 7478 13 Januari 2019 Dengue Fever 1 0 0 0
65 Salmiah 22 72 93 05 Januari 2019 SH 1 0 0 0
66 Tarsiwen 22 73 19 06 Januari 2019 SNH 1 0 0 0
67 Lisa 22 75 65 08 Januari 2019 SH 1 0 0 0
68 Mansyur Mardian 16 15 20 14 Januari 2019 SNH 1 0 0 0
69 Abdul Manan 22 74 96 14 Januari 2019 LBP 1 0 0 0
70 Ramlah 16 27 14 01 Januari 2019 Hipoglikemia 1 0 0 0
71 Fauzan Putra 22 73 68 08 Januari 2019 App 1 0 0 0
total 71 0 0 0