FORMAT PELAYANAN BPJS KUNJUNGAN SEHAT

Jenis Kegiatan : Penyuluhan/home visit/konseling/senam/imunisasi

Tanggal Kegiatan : Januari 2023
Lokasi : Majelis
Materi : Pemeriksaan Fisik
Pelaksana : Desy Marina Agustiani

UMUR FISIK TTV

NO NOMOR KARTU NAMA PESERTA JENIS
KEPESERTAAN L P TB BB LP TD RESP NADI
1 0001381415613 YULI SETIAWAN KIS/BPJS 42 160 60 80 120/80 23 82
2 0001381417042 LIA HAMDANI KIS/BPJS 38 155 65 85 110/70 22 83
3 0002393997513 ZULKIFLY OKTAFIANSYAH KIS/BPJS 19 150 50 75 100/70 24 82
4 0002394037337 MITLAN PEBRIANSYAH KIS/BPJS 16 160 62 83 110/80 22 82
5 0002393997524 GUMILANG GUSTIANSYAH KIS/BPJS 4 90 17 21 83
6 0001424709202 NURINI HIDAYATI KIS/BPJS 5 95 17 20 80
7 0000394291438 NYAI SULARTRI KIS/BPJS 27 150 46 66 120/80 18 79
8 0000390080002 RIFAL KIS/BPJS 16 115 15 40 120/80 20 80
9 0000398800542 MUAHAMAD IQBAL KIS/BPJS 12 126 23 47 19 79
10 0000390077155 WARNALI KIS/BPJS 44 155 60 78 110/80 20 80
11 0000390078775 SARKAH KIS/BPJS 39 165 66 80 120/80 20 80
12 0000390745888 HADI MULYADI KIS/BPJS 44 155 54 62 100/80 19 78
13 0000390746349 NENGSIH KIS/BPJS 45 135 20 44 120/80 20 80
14 0000390746854 ARYANTI KIS/BPJS 14 120 18 40 100/80 20 80
15 0000390746452 CASLIFAN KIS/BPJS 22 155 45 40 110/80 19 80
16 0000390935081 ASEP SULAEMAN KIS/BPJS 50 152 54 83 120/80 18 78
17 0000390935171 IMAS IRMAWATI KIS/BPJS 40 165 59 38 120/80 19 79
18 DEDE ILHAM KIS/BPJS 20 156 57 67 110/80 20 80
19 0000390936317 ALMA MUTIA KIS/BPJS 13 115 29 38 18 79
20 0001386092946 HAWISAH KIS/BPJS 40 156 65 80 120/80 20 80
21 0002394023308 NAYLA NUR FAJRIAH KIS/BPJS 5 92 16 38 20 80
22 0001386094184 LISDAWATI KIS/BPJS 31 150 67 82 100/80 20 80
23 0002393943445 SIAHLA VAUZIA KIS/BPJS 11 128 30 76 120/80 20 79
24 0001000671221 ADE WARSUDI KIS/BPJS 42 155 58 79 110/70 20 80
25 0001000671232 YENI YULIA KIS/BPJS 37 153 64 80 100/70 18 79
26 0001000671254 HADI SANTOSO KIS/BPJS 10 108 27 77 110/80 19 78
27 0001000671243 SALSABILA KIS/BPJS 16 151 40 79 120/80 20 80
28 0001272109015 LISNAWATI KIS/BPJS 31 165 61 80 20 80
29 0002393946077 MUHAMAD FATURAHMAN KIS/BPJS 6 100 20 70 120/70 20 80
30 0002394024344 GALIH FEBRIANTO KIS/BPJS 11 110 28 82 110/80 18 79
31 0000391578849 SIWO KIS/BPJS 39 165 76 85 120/80 20 78
32 0000391579457 SUCINI KIS/BPJS 38 156 65 80 100/70 20 80
33 0000391580021 SITI WULANDARI KIS/BPJS 17 98 30 20 85
34 0000391580469 CAKRA HORANDI KIS/BPJS 13 154 65 85 100/80 18 80
35 0002486516668 AIRA NUR RAISIAH KIS/BPJS 2 75 16 21 79
36 0000390112042 NUR ETI KIS/BPJS 29 165 69 80 100/70 18 78
37 0000390256931 UJANG DENA KIS/BPJS 30 158 59 79 120/80 20 80
38 0001326853326 SUDIRA KIS/BPJS 36 159 55 77 110/80 20 79
39 0001263894928 NOPI SULASTRI KIS/BPJS 28 154 57 76 100/70 18 80
40 0001263897461 RAISAL MUHAMAD AKBAR KIS/BPJS 8 120 22 79 20 79
41 0000391619507 ENCE KIS/BPJS 32 148 54 76 110/80 20 80
42 0000389731858 LILIH KIS/BPJS 20 150 62 80 110/70 20 80
43 0000390403844 WAHYU RAMBANA JUNAIDI KIS/BPJS 24 112 16 80 110/70 20 78
44 0000389614915 AMI OKTAVIANI PUTRI KIS/BPJS 21 112 36 110/70 19 78
45 0002744008896 NURANI WAHYUNI KIS/BPJS 1 69 11 24 86
46 0002436062343 MUHAMAD REINO SAPUTRA KIS/BPJS 2 75 16 20 80
47 0002317800936 SYAHIR BAHRI KIS/BPJS 2 75 16 20 90
 48 0000390916991 SAEPUL BAHRI KIS/BPJS 30 165 67 80 110/70 20 87
49 0002323017922 ALLESYA ZAHSYAZZAHRA SANJAYA KIS/BPJS 2 78 14 20 89
50 0002393930924 JELI YANAH KIS/BPJS 23 165 67 84 120/80 19 80
51 0001793183848 DERI RUSMANTO KIS/BPJS 43 150 58 79 100/70 18 79
52 0001793186831 AMELIA KIS/BPJS 86 155 56 78 110/70 18 78
53 0001793206934 ADZMA NURUL AULIA KIS/BPJS 9 120 26 48 18 79
54 0001793203378 AURA NURFADILAH KIS/BPJS 12 130 30 55 20 90
55 0002242066599 ABIZARD FARSRAUFA KIS/BPJS 3 90 18 30 20 80
56 0002393948496 MADKUSOY KIS/BPJS 34 156 67 80 110/70 20 89
57 0002393948507 IRMA BISMAYANTI KIS/BPJS 30 150 65 80 110/70 20 79
58 0002393948518 M ALGHIFARI KHUARARIZMI KIS/BPJS 9 128 23 47 19 76
59 0001274581214 ANDRIYANTO KIS/BPJS 27 167 67 86 120/80 18 87
60 0001274581258 DESTY KIS/BPJS 24 152 67 83 18 78
61 0001000671851 JAMILAH KIS/BPJS 32 167 58 80 100/70 18 82
62 0001000671849 AGUS GUNAEFI KIS/BPJS 45 167 56 80 110/70 18 83
63 0001000671862 SAEPULOH KIS/BPJS 23 152 67 67 100/70 18 82
64 0001000671873 EVA NURMALA KIS/BPJS 19 156 40 86 120/80 20 82
65 0001000671884 SELPI RAMADANI KIS/BPJS 14 130 35 45 110/80 20 83
66 0002322541416 KAISAR AZKA RAPASYA KIS/BPJS 2 78 11.3 30 20 80
67 0002393929855 MAHESA RADITYA PUTRA KIS/BPJS 5 100 20 43 20 79
68 0001662529184 RINA SARI KIS/BPJS 37 167 67 83 100/70 18 80
69 0002260338963 ANDI KIS/BPJS 39 152 69 80 120/80 20 79
70 0002287562141 IMAS MASLIAH KIS/BPJS 35 167 70 80 110/80 20 80
71 0002287562624 DWI SALMA ALWIYAH KIS/BPJS 5 100 20 43 18 80
72 0002287562826 BILQIS AWALIYAH RIZKY KIS/BPJS 8 110 26 50 18 78
73 0000390935351 ILHAM MULYANA KIS/BPJS 23 167 56 80 110/70 18 80
74 0000390412146 DESI MULYATI KIS/BPJS 22 152 67 67 100/70 20 80
75 0000639631898 SITI NURBAETI KIS/BPJS 25 156 40 86 120/80 20 80
76 0001820128678 AISAH HAMDANI KIS/BPJS 28 130 35 45 110/80 20 78
77 0001820130401 IRWANSYAH PRATAMA KIS/BPJS 8 110 26 50 20 79
78 0001832272975 LAELA HAMDANI KIS/BPJS 23 152 67 67 100/70 20 80
79 0001832272255 ENDAM HAMDANI KIS/BPJS 64 156 40 86 120/80 20 79
80 0000390411584 DENA MULYANA KIS/BPJS 30 130 35 45 110/80 20 80
81 0000390701452 LIA MULYA NINGSIH KIS/BPJS 42 156 40 86 120/80 20 80
82 0000390701529 ZUWITA ELIA SARASWATI KIS/BPJS 9 110 26 50 20 80
83 0000390701136 SARIPUDIN KIS/BPJS 44 152 67 67 100/70 20 79
84 0000390014908 SINTA KIS/BPJS 34 156 40 86 120/80 20 80
85 0000061953704 DANI GUSTRIA KIS/BPJS 22 130 35 45 110/80 20 79
86 0000061953693 EMPAY SUPARDI KIS/BPJS 63 156 40 86 120/80 20 78
87 0002393930272 MEGA WATI KIS/BPJS 24 167 67 83 100/70 18 80
88 0001971528355 HERA KURNIAWATI KIS/BPJS 19 152 69 80 120/80 20 89
89 0001971527062 HERDIYANSAH KIS/BPJS 41 167 70 80 110/80 20 80
90 0001971525429 AI ROSMIATI KIS/BPJS 37 156 69 80 120/80 20 79
91 0001971530583 NAHIRA DESTIYA WATI KIS/BPJS 7 110 26 50 20 78
92 0001971529716 MIRA SEPTIAWATI KIS/BPJS 16 152 69 80 120/80 20 80
93 0001261391927 YUNI WAHYUNI KIS/BPJS 29 167 70 80 110/80 20 88
94 0001263708472 MUHAMAD WILDAN KIS/BPJS 5 100 20 43 18 80
95 0002393949396 JUWINDA MANDASARI KIS/BPJS 35 152 69 80 120/80 20 79
96 0002393949385 USE AGUNG PURNOMO KIS/BPJS 45 167 70 80 110/80 20 78
97 0002393949407 SRI AMANDA SEKARWANGI KIS/BPJS 18 167 67 83 100/70 18 80
98 0002393949418 AZMA ASANDA PURNOMO KIS/BPJS 7 100 20 43 18 79
99 0000390158638 ZISKA RAMADANI KIS/BPJS 10 110 26 50 20 80
100 0000390158291 SHELA FEBRIANTI KIS/BPJS 15 140 69 80 120/80 20 79
101 0000390157569 YULIANTI KIS/BPJS 19 152 69 80 120/80 20 80
102 0000390157492 LIA MARYANI KIS/BPJS 39 167 70 80 110/80 20 80
103 0000390157389 CENG SAKIB KIS/BPJS 42 156 69 80 120/80 20 78
104 0001308141314 SRI MULYANI KIS/BPJS 8 100 20 43 18 78
105 0001474577032 TAMINAH KIS/BPJS 70 152 69 80 120/80 20 80
106 0001261383636 PARIDAH KIS/BPJS 32 167 70 80 110/80 20 80
107 0001806707474 FIRMAN HIDAYAT KIS/BPJS 11 130 35 45 20 82
108 0001806710128 KIRANA VALEN RIVANA KIS/BPJS 5 100 20 43 18 80
109 0001261385414 EKO RIANTO KIS/BPJS 40 167 70 80 110/80 20 90
110 0001317327017 IRWANDI KIS/BPJS 39 156 69 80 120/80 20 80
111 0002426567782 PATMA WULAN KIS/BPJS 35 167 70 80 110/80 20 79
112 0001317328648 PITRI NURAENI KIS/BPJS 15 140 69 80 120/80 20 78
113 0001317330494 ANISA NUR MAULIDA KIS/BPJS 6 100 20 43 18 79
114 0000390255761 TITI KIS/BPJS 63 152 69 80 120/80 20 78
115 0000391620396 SARIPAH KIS/BPJS 38 167 70 80 110/80 20 80
116 0000391621419 SANDI RUSMANA KIS/BPJS 17 152 69 80 120/80 20 80
117 0000391623175 RUSLAN MAULANA KIS/BPJS 10 130 35 45 20 82
118 0001798580428 MARNI KIS/BPJS 60 152 69 80 120/80 20 80
119 0001798577739 SUTIMIN KIS/BPJS 64 152 69 80 120/80 20 90
120 0001798581497 SUYADI KIS/BPJS 40 167 70 80 110/80 20 80
121 0002038989352 MARYAM KIS/BPJS 46 167 70 80 110/80 20 79
122 0002038991207 NILAM AZAHRA KIS/BPJS 20 167 70 80 110/80 20 78
123 0001000676755 USEP SUMANTA KIS/BPJS 56 167 70 80 110/80 20 79
124 0001000676766 NOLIS SUSILAWATI KIS/BPJS 47 167 70 80 110/80 20 82
125 0001000676788 YOGI HERMAWAN KIS/BPJS 22 167 70 80 110/80 20 83
126 0001000676799 SELVI CANTIKA KIS/BPJS 13 130 35 45 20 82
127 0001000676777 NENG SISKA RIANTA KIS/BPJS 26 152 69 80 120/80 20 82
128 0000391020895 ELA C KIS/BPJS 46 167 70 80 110/80 20 83
129 0000391022651 DENIS KIS/BPJS 12 130 35 45 20 80
130 0000391019512 DADANG GUNAWAN KIS/BPJS 52 155 60 78 110/80 20 79
131 0000390411426 SUNARSIH KIS/BPJS 53 165 66 80 120/80 20 80
132 0000390412844 DENI MAULANA KIS/BPJS 19 155 54 62 100/80 19 79
133 0001288910237 DEDE KURNAESIH KIS/BPJS 32 135 20 44 120/80 20 80
134 0000391100084 SINTA SHIMTA MUSTIKAWATI KIS/BPJS 23 120 18 40 100/80 20 80
135 0001965138208 OTING KIS/BPJS 62 155 45 40 110/80 19 78
136 0001965139244 DERI KIS/BPJS 36 152 54 83 120/80 18 80
137 0002045693619 DARIS SUTIADI KIS/BPJS 26 165 59 38 120/80 19 80
138 0002045691794 DESTA SUMARWATI KIS/BPJS 24 156 57 67 110/80 20 80
139 0001859439554 METI KIS/BPJS 23 165 59 38 120/80 19 78
140 0002057294147 UTAMI PUSPITA DEWI KIS/BPJS 4 100 20 43 18 79
141 0001859438417 YAYAT HIDAYAT KIS/BPJS 49 165 59 38 120/80 20 80
142 0000390257256 JUJUN KIS/BPJS 27 156 57 67 110/80 20 79
143 0000391038219 YUDA MUHAMAD PERMANA KIS/BPJS 11 130 35 45 20 80
144 0000391036713 JUJU NINGSIH KIS/BPJS 44 155 45 40 110/80 19 80
145 0000390333429 KUJUM JUNAEDI KIS/BPJS 50 152 54 83 120/80 18 80
146 0000390333643 YATI KIS/BPJS 45 165 59 38 120/80 19 79
147 0000390000644 SITI NUR JUHAIRIYAH KIS/BPJS 27 156 57 67 110/80 20 80
148 0000390334318 STI NURAENI KIS/BPJS 21 165 59 38 120/80 19 79
149 0001000670051 SARAH AMELIA KIS/BPJS 11 130 35 45 20 78
150 0001000670045 MIRNA KIS/BPJS 24 155 45 40 110/80 19 80
151 0001000670016 DEDE KIS/BPJS 49 152 54 83 120/80 18 80
152 0001000670027 ENUNG KIS/BPJS 44 165 59 38 120/80 19 80
153 0000390646607 SANDI MUHAMAD KIS/BPJS 23 156 57 67 110/80 20 79
154 0000390646629 NELI NURAENI KIS/BPJS 16 165 59 38 120/80 19 78
155 0000391091422 ASEN KIS/BPJS 55 155 45 40 110/80 19 80
156 0000391091466 IPIT KIS/BPJS 51 152 54 83 120/80 18 85
157 0000391092625 ARI IRAWAN KIS/BPJS 31 165 59 38 120/80 19 80
158 0000391093659 HASAN BASRI KIS/BPJS 15 156 57 67 110/80 20 79
159 0000391092658 NENG RINA KIS/BPJS 22 165 59 38 120/80 19 78
160 0000390403631 UUNG JUNAEDI KIS/BPJS 51 165 59 38 120/80 19 80
161 0000390403776 SRI MARYATI KIS/BPJS 44 156 57 67 110/80 20 79
162 0000390409979 KHARISMA SARI JUNAEDI KIS/BPJS 14 156 57 67 110/80 20 80
163 0000390404992 UJANG HARUMAN JUNAEDI KIS/BPJS 10 130 35 45 20 79
164 0001435683958 ELI KIS/BPJS 65 155 45 40 110/80 19 80
165 0001965546246 YUYUN KIS/BPJS 61 152 54 83 120/80 18 80
166 0001958789496 A. DARSO KIS/BPJS 47 165 59 38 120/80 19 78
167 0001958789744 TUTI LISNAWATI KIS/BPJS 44 156 57 67 110/80 20 78
168 0001958790069 YUNI SUSILAWATI KIS/BPJS 22 165 59 76 120/80 19 86
169 0001958790789 SELOMITA KIS/BPJS 15 155 45 40 110/80 19 80
170 0001958790418 YULI YULIANA KIS/BPJS 18 152 54 83 120/80 18 90
171 0001865324452 RANO KIS/BPJS 42 165 59 77 120/80 19 87
172 0001865325172 ISMAWATI KIS/BPJS 33 156 57 67 110/80 20 89
173 0001865325947 NAHDYA EMIRA A KIS/BPJS 9 130 35 45 20 80
174 0001882854371 NENG SHOPI KIS/BPJS 4 100 20 43 18 79
175 0002081929803 ADE HERMAWAN KIS/BPJS 49 165 59 70 120/80 20 78
176 0002081930376 YUSICA KIS/BPJS 33 156 57 67 110/80 20 79
177 0001088953018 KEMAL HERMAWAN KIS/BPJS 23 165 59 70 120/80 20 90
178 0002081931309 RIPKI MUGIA R KIS/BPJS 14 156 57 67 110/80 20 80
179 0002081930692 OCTA ADE KIRWANSAH KIS/BPJS 6 100 20 43 18 89
180 0001788261851 H. SAKE BANDU KIS/BPJS 57 165 59 70 120/80 20 79
181 0001788263796 HJ. SAHRIAH KIS/BPJS 54 156 57 67 110/80 20 76
182 0001264118916 TINA KIS/BPJS 36 165 59 70 120/80 20 87
183 0001874388306 SUSILAWATI KIS/BPJS 46 165 59 70 120/80 20 78
184 0001874389184 HANNI SHUFFIKA KIS/BPJS 22 156 57 67 110/80 20 82
185 0001278465928 DINA MARYULIANA KIS/BPJS 36 165 59 70 120/80 20 83
186 0001873641047 FAIRUZ IZZATUNNISA KIS/BPJS 5 100 20 43 18 82
187 0002043735388 DENA NURLIANA KIS/BPJS 19 152 54 83 120/80 18 82
188 0001964735155 BASUKI KIS/BPJS 71 165 59 77 120/80 19 83
189 0001850494588 KARISN KIS/BPJS 27 156 57 67 110/80 20 80
190 0001739414158 RISVANY MUZAKY. A KIS/BPJS 7 110 26 50 18 79
191 0001971141693 WARNI KIS/BPJS 57 165 59 70 120/80 20 80
192 0001739414169 RIFFAT MUMTAZ. A KIS/BPJS 4 100 20 43 18 79
193 0001971145888 RAHMAT HIDAYAT KIS/BPJS 30 165 59 77 120/80 19 80
194 0002026072078 ROHAYATI KIS/BPJS 49 156 57 67 110/80 20 80
195 0001264118916 TINA KIS/BPJS 36 165 59 70 120/80 20 78
196 0001315517196 AHMAD FAUZI KIS/BPJS 35 165 59 77 120/80 19 80
197 0001315519029 NENG ILMA. K KIS/BPJS 24 156 57 67 110/80 20 80
198 0001832465384 MUHAMAD FAHIR KIS/BPJS 5 100 20 43 18 80
199 0001786821794 HJ. MALIHAH KIS/BPJS 56 165 59 70 120/80 19 78
200 0001786823234 FAUZAN KIS/BPJS 31 156 57 67 110/80 22 79
201 0001786825146 SILFA SAFAAT KIS/BPJS 22 165 59 70 120/80 20 80
202 0001786825901 HILMA HASANAH KIS/BPJS 17 165 59 70 120/80 20 79
203 0001968685255 RAWIDA KIS/BPJS 75 156 57 67 110/80 21 80
204 0001968685536 DARTI KIS/BPJS 69 165 59 70 120/80 20 80
205 0001786824472 WAHYU NURUS. S KIS/BPJS 27 165 59 70 120/80 19 80
206 0001874387845 D. YUHANDA. YS KIS/BPJS 53 156 57 67 110/80 20 79
207 0000390020229 AAN TURSINA KIS/BPJS 64 165 59 70 120/80 20 80
208 0000390020826 JARIAH KIS/BPJS 57 165 59 70 120/80 18 79
209 0000390021197 AMIN KIS/BPJS 41 156 57 67 110/80 20 78
210 0000390021478 SUSI SULASTRI KIS/BPJS 30 165 59 70 120/80 18 80
211 0000390022593 INDRA. S KIS/BPJS 21 165 59 70 120/80 18 89
212 0000390023302 NENI NURAENI KIS/BPJS 18 165 59 70 120/80 20 80
213 0000291071238 ADNAWI KIS/BPJS 46 156 57 67 110/80 20 79
214 0000391071295 ETI KIS/BPJS 44 165 59 70 120/80 20 78
215 0000391071339 IIS ISMIATI KIS/BPJS 27 165 59 70 120/80 18 80
216 0000391071508 NURAENI KIS/BPJS 22 156 57 67 110/80 20 88
217 0000391071622 SANI KIS/BPJS 17 165 59 70 120/80 21 80
218 0000390109184 BAJURI KIS/BPJS 60 165 59 70 120/80 20 79
219 0000390109937 KARINI KIS/BPJS 57 156 57 67 110/80 22 78
220 0000390110635 ABDUL SOKIM KIS/BPJS 34 165 59 70 120/80 20 80
221 0000390111603 FIRMASYAH KIS/BPJS 32 165 59 70 120/80 20 79
222 0000390112042 NURETI KIS/BPJS 29 165 59 70 120/80 18 80
223 0000390112413 ABDUL SALIM KIS/BPJS 24 156 57 67 110/80 20 79
224 0000390112817 MIA SUMIATI KIS/BPJS 20 165 59 70 120/80 21 80
225 0001000678915 CATIM KIS/BPJS 46 165 59 70 120/80 20 80
226 0001000678926 ERKUNAH KIS/BPJS 40 156 57 67 110/80 22 78
227 0001000678937 RISDAWATI KIS/BPJS 24 165 59 70 120/80 20 78
228 0001000678948 NINGRUM ROHENI KIS/BPJS 23 165 59 70 120/80 21 80
229 0001000678959 AEP ALBAHRIN KIS/BPJS 15 165 59 70 120/80 20 80
230 0000390321663 DASIR KIS/BPJS 67 156 57 67 110/80 22 82
231 0000390321922 DODOY KIS/BPJS 58 165 59 70 120/80 20 80
232 0000390322708 DIANTO KIS/BPJS 38 165 59 70 120/80 20 90
233 0000390323992 YANI KIS/BPJS 31 165 59 70 120/80 18 80
234 0000390324824 NURUL HORIM KIS/BPJS 17 156 57 67 110/80 20 79
235 0000390325331 EPI KIS/BPJS 14 165 59 70 120/80 21 78
236 0000390264197 DAWI KIS/BPJS 61 165 59 70 120/80 20 79
237 0000390270014 ENDANG KIS/BPJS 10 130 35 45 20 78
238 0000390270857 AISAH KIS/BPJS 9 130 35 45 20 80
239 0000390264557 ROHAEDAH KIS/BPJS 58 156 57 67 110/80 22 80
240 0000390266278 KARYANTO KIS/BPJS 31 165 59 70 120/80 20 82
241 0000390266673 JUMIATI KIS/BPJS 25 165 59 70 120/80 20 80
242 0000390267246 WIWIN KIS/BPJS 24 165 59 70 120/80 18 90
243 0000390267325 ERIK KIS/BPJS 18 156 57 67 110/80 20 80
244 0000390268124 WANDI KIS/BPJS 17 165 59 70 120/80 18 79
245 0000390268743 ABDUL KIS/BPJS 12 130 35 45 20 78
246 0000390746169 LELEN KIS/BPJS 43 165 59 70 120/80 21 79
247 000039074608 LISNAWATI KIS/BPJS 19 165 59 70 120/80 20 80
248 0000390746823 DEDE RIPAN KIS/BPJS 16 156 57 67 110/80 22 80
249 0000390324699 ENDANG SURYANA KIS/BPJS 57 165 59 70 120/80 20 82
250 0000390324958 AI YULIANTI KIS/BPJS 50 165 59 70 120/80 21 80
251 0000390325871 TONI LESMANA KIS/BPJS 30 165 59 70 120/80 20 90
252 0000390326501 DONI KIS/BPJS 20 156 57 67 110/80 22 80
253 0001000685801 MULYANA KIS/BPJS 42 165 59 70 120/80 20 79
254 0001000685812 TINI SARTINI KIS/BPJS 39 165 59 70 120/80 20 78
255 0001000685823 SALSA SEPTI AYU KIS/BPJS 17 165 59 70 120/80 18 79
256 0001000685834 BAGAS RAMANDA M KIS/BPJS 14 156 57 67 110/80 20 80
257 0001100116801 TIARA MAULINA KIS/BPJS 4 100 20 43 18 79
258 0000390425275 MOHAMAD TAWI KIS/BPJS 52 165 59 70 120/80 21 80
259 0000390425319 CARSINI KIS/BPJS 48 165 59 70 120/80 20 79
260 0000390427233 DEWI AFRIANI KIS/BPJS 30 156 57 67 110/80 22 80
261 0000390427378 DESTI JULIANTI KIS/BPJS 20 165 59 70 120/80 20 80
262 0000390428223 RADIT KIS/BPJS 11 130 35 45 20 78
263 0000390420504 NURHIDAYAT KIS/BPJS 26 165 59 70 120/80 20 78

NAMA PETUGAS

(…..............................)
 FORMAT PELAYANAN BPJS KUNJUNGAN SEHAT

Jenis Kegiatan : Penyuluhan/home visit/konseling/senam/imunisasi

Tanggal Kegiatan : Februari 2023
Lokasi : Majelis
Materi : Pemeriksaan Fisik
Pelaksana : Desy Marina Agustiani

JENIS UMUR
NO NOMOR KARTU NAMA PESERTA
KEPESERTAAN L
1 0001793183848 DERI RUSMANTO KIS/BPJS 43
2 0001793186831 AMELIA KIS/BPJS
3 0001793206934 ADZMA NURUL AULIA KIS/BPJS
4 0001793203378 AURA NURFADILAH KIS/BPJS
5 0002242066599 ABIZARD FARSRAUFA KIS/BPJS
6 0002393948496 MADKUSOY KIS/BPJS 34
7 0002393948507 IRMA BISMAYANTI KIS/BPJS
8 0002393948518 M ALGHIFARI KHUARARIZMI KIS/BPJS 9
9 0001274581214 ANDRIYANTO KIS/BPJS 27
10 0001274581258 DESTY KIS/BPJS
11 0001263897461 RAISAL MUHAMAD AKBAR KIS/BPJS 8
12 0000391619507 ENCE KIS/BPJS 32
13 0000389731858 LILIH KIS/BPJS
14 0000390403844 WAHYU RAMBANA JUNAIDI KIS/BPJS 24
15 0000389614915 AMI OKTAVIANI PUTRI KIS/BPJS
16 0002744008896 NURANI WAHYUNI KIS/BPJS
17 0002436062343 MUHAMAD REINO SAPUTRA KIS/BPJS 2
18 0002317800936 SYAHIR BAHRI KIS/BPJS 2
19 0000390916991 SAEPUL BAHRI KIS/BPJS 30
20 0002323017922 ALLESYA ZAHSYAZZAHRA SANJAYA KIS/BPJS
21 0002393930924 JELI YANAH KIS/BPJS
22 0002394024344 GALIH FEBRIANTO KIS/BPJS 11
23 0000391578849 SIWO KIS/BPJS 39
24 0000391579457 SUCINI KIS/BPJS
25 0000391580021 SITI WULANDARI KIS/BPJS
26 0000391580469 CAKRA HORANDI KIS/BPJS 13
27 0002486516668 AIRA NUR RAISIAH KIS/BPJS
28 0000390112042 NUR ETI KIS/BPJS
29 0000390256931 UJANG DENA KIS/BPJS 30
30 0001326853326 SUDIRA KIS/BPJS 36
31 0001263894928 NOPI SULASTRI KIS/BPJS
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108 0002393949407 SRI AMANDA SEKARWANGI KIS/BPJS
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128 0001798580428 MARNI KIS/BPJS
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134 0000390646629 NELI NURAENI KIS/BPJS
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148 0002045691794 DESTA SUMARWATI KIS/BPJS
149 0001859439554 METI KIS/BPJS
150 0002057294147 UTAMI PUSPITA DEWI KIS/BPJS
151 0001859438417 YAYAT HIDAYAT KIS/BPJS
152 0000390257256 JUJUN KIS/BPJS 27
153 0000391038219 YUDA MUHAMAD PERMANA KIS/BPJS 11
154 0000391036713 JUJU NINGSIH KIS/BPJS
155 0000390333429 KUJUM JUNAEDI KIS/BPJS 50
156 0000390333643 YATI KIS/BPJS
157 0000390000644 SITI NUR JUHAIRIYAH KIS/BPJS
158 0000390334318 STI NURAENI KIS/BPJS
159 0001000670051 SARAH AMELIA KIS/BPJS
160 0001000670045 MIRNA KIS/BPJS
161 0001865324452 RANO KIS/BPJS 42
162 0001865325172 ISMAWATI KIS/BPJS
163 0001865325947 NAHDYA EMIRA A KIS/BPJS
164 0001882854371 NENG SHOPI KIS/BPJS
165 0002081929803 ADE HERMAWAN KIS/BPJS 49
166 0002081930376 YUSICA KIS/BPJS
167 0001088953018 KEMAL HERMAWAN KIS/BPJS 23
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172 0001264118916 TINA KIS/BPJS
173 0001874388306 SUSILAWATI KIS/BPJS
174 0001874389184 HANNI SHUFFIKA KIS/BPJS
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179 0001850494588 KARISN KIS/BPJS
180 0001739414158 RISVANY MUZAKY. A KIS/BPJS 7
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184 0001435683958 ELI KIS/BPJS
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189 0001958790789 SELOMITA KIS/BPJS
190 0001958790418 YULI YULIANA KIS/BPJS
191 0001786825146 SILFA SAFAAT KIS/BPJS
192 0001786825901 HILMA HASANAH KIS/BPJS
193 0001968685255 RAWIDA KIS/BPJS
194 0001968685536 DARTI KIS/BPJS
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196 0001874387845 D. YUHANDA. YS KIS/BPJS 53
197 0000390020229 AAN TURSINA KIS/BPJS 64
198 0000390020826 JARIAH KIS/BPJS
199 0000390021197 AMIN KIS/BPJS 41
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201 0001971141693 WARNI KIS/BPJS
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203 0001971145888 RAHMAT HIDAYAT KIS/BPJS 30
204 0002026072078 ROHAYATI KIS/BPJS
205 0001264118916 TINA KIS/BPJS
206 0001315517196 AHMAD FAUZI KIS/BPJS 35
207 0001315519029 NENG ILMA. K KIS/BPJS
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209 0001786821794 HJ. MALIHAH KIS/BPJS
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211 0000390266673 JUMIATI KIS/BPJS
212 0000390267246 WIWIN KIS/BPJS
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214 0000390268124 WANDI KIS/BPJS 17
215 0000390268743 ABDUL KIS/BPJS 12
216 0000390746169 LELEN KIS/BPJS
217 000039074608 LISNAWATI KIS/BPJS
218 0000390746823 DEDE RIPAN KIS/BPJS 16
219 0000390324699 ENDANG SURYANA KIS/BPJS 57
220 0000390324958 AI YULIANTI KIS/BPJS
221 0000390022593 INDRA. S KIS/BPJS 21
222 0000390023302 NENI NURAENI KIS/BPJS
223 0000291071238 ADNAWI KIS/BPJS 46
224 0000391071295 ETI KIS/BPJS
225 0000391071339 IIS ISMIATI KIS/BPJS
226 0000391071508 NURAENI KIS/BPJS
227 0000391071622 SANI KIS/BPJS
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229 0000390109937 KARINI KIS/BPJS
230 0000390110635 ABDUL SOKIM KIS/BPJS 34
231 0000390111603 FIRMASYAH KIS/BPJS 32
232 0000390112042 NURETI KIS/BPJS
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234 0000390112817 MIA SUMIATI KIS/BPJS
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237 0000390326501 DONI KIS/BPJS 20
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239 0001000685812 TINI SARTINI KIS/BPJS
240 0001000685823 SALSA SEPTI AYU KIS/BPJS
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244 0000390425319 CARSINI KIS/BPJS
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252 0001000678937 RISDAWATI KIS/BPJS
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258 0000390323992 YANI KIS/BPJS
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261 0000390264197 DAWI KIS/BPJS 61
262 0000390270014 ENDANG KIS/BPJS 10
263 0000390270857 AISAH KIS/BPJS
UNJUNGAN SEHAT

UMUR FISIK TTV

P TB BB LP TD RESP NADI
150 58 79 100/70 18 79
86 155 56 78 110/70 18 80
9 120 26 48 18 80
12 130 30 55 20 78
3 90 18 30 20 78
156 67 80 110/70 20 86
30 150 65 80 110/70 20 80
128 23 47 19 90
167 67 86 120/80 18 87
24 152 67 83 18 89
120 22 79 20 80
148 54 76 110/80 20 80
20 150 62 80 110/70 20 80
112 16 80 110/70 20 78
21 112 36 110/70 19 78
1 69 11 24 86
75 16 20 80
75 16 20 90
165 67 80 110/70 20 87
2 78 14 20 89
23 165 67 84 120/80 19 80
110 28 82 110/80 18 79
165 76 85 120/80 20 78
38 156 65 80 100/70 20 80
17 98 30 20 85
154 65 85 100/80 18 80
2 75 16 21 79
29 165 69 80 100/70 18 78
158 59 79 120/80 20 80
159 55 77 110/80 20 79
28 154 57 76 100/70 18 80
120 22 79 20 79
40 156 65 80 120/80 20 80
5 92 16 38 20 80
31 150 67 82 100/80 20 80
11 128 30 76 120/80 20 79
155 58 79 110/70 20 80
37 153 64 80 100/70 18 79
108 27 77 110/80 19 78
16 151 40 79 120/80 20 80
31 165 61 80 20 80
100 20 70 120/70 20 80
42 160 60 80 120/80 23 82
38 155 65 85 110/70 22 83
150 50 75 100/70 24 82
160 62 83 110/80 22 82
90 17 21 83
5 95 17 20 80
27 150 46 66 120/80 18 79
115 15 40 120/80 20 80
126 23 47 19 79
155 60 78 110/80 20 80
39 165 66 80 120/80 20 80
155 54 62 100/80 19 78
45 135 20 44 120/80 20 80
14 120 18 40 100/80 20 80
155 45 40 110/80 19 80
152 54 83 120/80 18 78
40 165 59 38 120/80 19 79
20 150 62 80 110/70 20 80
13 115 29 38 18 79
32 167 58 80 100/70 18 82
167 56 80 110/70 18 83
152 67 67 100/70 18 82
19 156 40 86 120/80 20 82
14 130 35 45 110/80 20 83
78 11.3 30 20 80
100 20 43 20 79
37 167 67 83 100/70 18 80
152 69 80 120/80 20 79
35 167 70 80 110/80 20 80
42 156 40 86 120/80 20 80
9 110 26 50 20 80
152 67 67 100/70 20 79
34 156 40 86 120/80 20 80
130 35 45 110/80 20 79
156 40 86 120/80 20 78
24 167 67 83 100/70 18 80
19 152 69 80 120/80 20 89
167 70 80 110/80 20 80
5 100 20 43 18 80
8 110 26 50 18 78
167 56 80 110/70 18 80
22 152 67 67 100/70 20 80
25 156 40 86 120/80 20 80
28 130 35 45 110/80 20 78
110 26 50 20 79
23 152 67 67 100/70 20 80
156 40 86 120/80 20 79
130 35 45 110/80 20 80
19 152 69 80 120/80 20 80
39 167 70 80 110/80 20 80
156 69 80 120/80 20 78
8 100 20 43 18 78
70 152 69 80 120/80 20 80
32 167 70 80 110/80 20 80
130 35 45 20 82
5 100 20 43 18 80
167 70 80 110/80 20 90
156 69 80 120/80 20 80
37 156 69 80 120/80 20 79
7 110 26 50 20 78
16 152 69 80 120/80 20 80
29 167 70 80 110/80 20 88
100 20 43 18 80
35 152 69 80 120/80 20 79
167 70 80 110/80 20 78
18 167 67 83 100/70 18 80
7 100 20 43 18 79
10 110 26 50 20 80
15 140 69 80 120/80 20 79
46 167 70 80 110/80 20 79
20 167 70 80 110/80 20 78
167 70 80 110/80 20 79
47 167 70 80 110/80 20 82
167 70 80 110/80 20 83
13 130 35 45 20 82
26 152 69 80 120/80 20 82
46 167 70 80 110/80 20 83
130 35 45 20 80
35 167 70 80 110/80 20 79
15 140 69 80 120/80 20 78
6 100 20 43 18 79
63 152 69 80 120/80 20 78
38 167 70 80 110/80 20 80
152 69 80 120/80 20 80
130 35 45 20 82
60 152 69 80 120/80 20 80
64 152 69 80 120/80 20 90
 167 70 80 110/80 20 80
152 54 83 120/80 18 80
44 165 59 38 120/80 19 80
156 57 67 110/80 20 79
16 165 59 38 120/80 19 78
155 45 40 110/80 19 80
51 152 54 83 120/80 18 85
165 59 38 120/80 19 80
156 57 67 110/80 20 79
22 165 59 38 120/80 19 78
155 60 78 110/80 20 79
53 165 66 80 120/80 20 80
155 54 62 100/80 19 79
135 20 44 120/80 20 80
23 120 18 40 100/80 20 80
155 45 40 110/80 19 78
152 54 83 120/80 18 80
165 59 38 120/80 19 80
24 156 57 67 110/80 20 80
23 165 59 38 120/80 19 78
4 100 20 43 18 79
49 165 59 38 120/80 20 80
156 57 67 110/80 20 79
130 35 45 20 80
44 155 45 40 110/80 19 80
152 54 83 120/80 18 80
45 165 59 38 120/80 19 79
27 156 57 67 110/80 20 80
21 165 59 38 120/80 19 79
11 130 35 45 20 78
24 155 45 40 110/80 19 80
165 59 77 120/80 19 87
33 156 57 67 110/80 20 89
9 130 35 45 20 80
4 100 20 43 18 79
 165 59 70 120/80 20 78
33 156 57 67 110/80 20 79
165 59 70 120/80 20 90
156 57 67 110/80 20 80
100 20 43 18 89
165 59 70 120/80 20 79
54 156 57 67 110/80 20 76
36 165 59 70 120/80 20 87
46 165 59 70 120/80 20 78
22 156 57 67 110/80 20 82
36 165 59 70 120/80 20 83
100 20 43 18 82
19 152 54 83 120/80 18 82
165 59 77 120/80 19 83
27 156 57 67 110/80 20 80
110 26 50 18 79
44 156 57 67 110/80 20 79
14 156 57 67 110/80 20 80
130 35 45 20 79
65 155 45 40 110/80 19 80
61 152 54 83 120/80 18 80
165 59 38 120/80 19 78
44 156 57 67 110/80 20 78
22 165 59 76 120/80 19 86
15 155 45 40 110/80 19 80
18 152 54 83 120/80 18 90
22 165 59 70 120/80 20 80
17 165 59 70 120/80 20 79
75 156 57 67 110/80 21 80
69 165 59 70 120/80 20 80
165 59 70 120/80 19 80
156 57 67 110/80 20 79
165 59 70 120/80 20 80
57 165 59 70 120/80 18 79
156 57 67 110/80 20 78
30 165 59 70 120/80 18 80
57 165 59 70 120/80 20 80
100 20 43 18 79
165 59 77 120/80 19 80
49 156 57 67 110/80 20 80
36 165 59 70 120/80 20 78
165 59 77 120/80 19 80
24 156 57 67 110/80 20 80
100 20 43 18 80
56 165 59 70 120/80 19 78
156 57 67 110/80 22 79
25 165 59 70 120/80 20 80
24 165 59 70 120/80 18 90
156 57 67 110/80 20 80
165 59 70 120/80 18 79
130 35 45 20 78
43 165 59 70 120/80 21 79
19 165 59 70 120/80 20 80
156 57 67 110/80 22 80
165 59 70 120/80 20 82
50 165 59 70 120/80 21 80
165 59 70 120/80 18 89
18 165 59 70 120/80 20 80
156 57 67 110/80 20 79
44 165 59 70 120/80 20 78
27 165 59 70 120/80 18 80
22 156 57 67 110/80 20 88
17 165 59 70 120/80 21 80
165 59 70 120/80 20 79
57 156 57 67 110/80 22 78
165 59 70 120/80 20 80
165 59 70 120/80 20 79
29 165 59 70 120/80 18 80
156 57 67 110/80 20 79
20 165 59 70 120/80 21 80
46 165 59 70 120/80 20 80
165 59 70 120/80 20 90
156 57 67 110/80 22 80
165 59 70 120/80 20 79
39 165 59 70 120/80 20 78
17 165 59 70 120/80 18 79
156 57 67 110/80 20 80
4 100 20 43 18 79
165 59 70 120/80 21 80
48 165 59 70 120/80 20 79
30 156 57 67 110/80 22 80
20 165 59 70 120/80 20 80
130 35 45 20 78
165 59 70 120/80 20 78
58 156 57 67 110/80 22 80
165 59 70 120/80 20 82
40 156 57 67 110/80 22 78
24 165 59 70 120/80 20 78
23 165 59 70 120/80 21 80
165 59 70 120/80 20 80
156 57 67 110/80 22 82
165 59 70 120/80 20 80
165 59 70 120/80 20 90
31 165 59 70 120/80 18 80
17 156 57 67 110/80 20 79
165 59 70 120/80 21 78
165 59 70 120/80 20 79
130 35 45 20 78
9 130 35 45 20 80

(…..............................)