RM GIGI Sementara

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UMU

TANGGAL NO NAMA PASIEN INDEX

5TH-7TH
0-4TH
L P L
10 1 Elvi Hidayati 3043101
2 Nur Faizah 90197401
3 Ahmad Syakir 2116400
4 Muh Luqman 4221000
5 Dinana Sofwa 2050202
6 Atqia Nawal 90079303 1
11 1 Istianah 109501
2 Nurul Khikma 2007401
3 Faeyza Deris 90200902 1
4 Ghiya Nur K. 1040610
5 Fahad 1138403
6 Eka Turyanti 4014602
7 Casmuri Aisy 90235100
8 Sidqia 90235104
9 Latifa 3021801
10 Muhammad Ri 4002603
UMUR ( TAHUN )

15TH-45TH
8TH-14TH
5TH-7TH

≥45TH
P L P L P L P
1
1
1
1
1

1
1

1
1
1
1
1
1
1
LAMA
BARU

DW

LW

LK
L P L P
1 1
1 1
1 1
1
1 1
1 1
1 1
1 1
1 1
1 1
1 1
1 1
1 1
1 1
1 1
1 1
INDEX GIGI DX

K00.6

K01.1

K02.1
L P L P L
46
36.46
17
17.44 1
62 1
74
24
26.28
61 1
14
47
46
25
85
14
36
K02.1

1
1
1
L
P
L K.03

1
K04.0
P

1
1
1
L

K04.1
P

1
1
DIAGNOSA

K05.0

K05.2

K05.3

K.06
L P L P L P L

1
1

1
K.06

P
L
P
L K.073

K07.6
P
L

K08.3
p

1
L
K09

P
L

K12
P
L

K12.5
P
L

TGP
CGT
TGP

TGS

TS
P L P L P L P
1
2

1
1
L

1
CGS

1
THERAPI

SCALLING
P
L

PENG.PULPA
P

1
1
L

PENG.PERIOD
PENG.PERIOD

1
1
1
L
P
L PENG.ABSES

LAIN2
P

BAYAR

1
1
1
1
1
1
1
1
1
1
1

HI/BPJS NON PBI


1
RETRIBUSI
RETRIBUSI
BPJS PBI/JAMKESMAS KUNJUNGAN PASIEN

JAMKESDA
KETERANGAN

GRATIS
BARU
LAMA
1 deit+c, amox,asmef,ctm
tkf+c, eug+c, amox,asmef,dexa
rujuk BPU, GDS 283
eug+c, amox,asmef,dexa
exo ce
amox syr, pct syr
amox,asmef,dexa
1 eug+c, amox,asmef,dexa
exo ce
amox,asmef,dexa,ctm
1 tkf+c, asmef
1 clinda,pct,dexa
eug+c, amox,pct
amox,pct,dexa
calplus+zn+GIC
devit+c, amox,asmef,dexa,ctm
L P TOTAL JUMLAH

0 0 0
0 0 0

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