DAFTAR KUNJUNGAN SAKIT RAWAT JALAN PELAYAN

BULAN JUNI TAHUN 2

PELAYANAN PUSKESMAS/PUSTU/POSKESDES .......

UMUR TTV NO NO. IDENTITAS

NO. TGL NAMA ALAMAT
L P TD N P S LP BB TB Rec. Med NIK / BPJS
1 02/06/22 ZAKARIAH 43 100/80 86 24 36.0 67 49 165 SAPUKA 0001562525537
03/06/22 HAFIFAH 28 100/80 80 20 36.5 78 44 147 SAPUKA 0002858720861
3 04/06/22 HASMIATI 25 100/70 80 20 36.4 87 57 149 SAPUKA 0000931259709
4 06/06/22 BALUDDIN 32 100/70 72 20 36.2 68 58 164 SAPUKA UMUM
5 07/06/22 SAKMAWATI 40 100/70 80 20 36.2 68 44 145 SAPUKA 0000931168978
6 08/06/22 ABD. RAHMAN 54 120/70 82 20 36.2 80 72 160 SAPUKA 0001070278468
7 16/06/22 MARNI 110/80 90 20 36.2 72 56 152 SAPUKA UMUM
8 16/06/22 MAKKA 120/89 80 20 36.3 64 48 160 SAPUKA 0001562786392
9 SAPUKA
10 SAPUKA
11 SAPUKA
12 SAPUKA
13 SAPUKA
14 SAPUKA
15 SAPUKA
16 SAPUKA
17 SAPUKA
18 SAPUKA
 RAWAT JALAN PELAYANAN JKN PUSKESMAS LK. TANGAYA
BULAN JUNI TAHUN 2022
S/PUSTU/POSKESDES .....................................................................

PERAWATAN PEMERIKSAAN DIRUJUK

DIAGNOSA UNSUR Icd-x Therapy
Nekrosis 54 K04.2 Exo, Amox, Vit.c
Nekrosis 27 K04.2 Exo, Amox
Nekrosis 37 K04.2 Exo, Amox, Asmef
Nekrosis 36 K04.2 Exo, Amox, Asmef
Nekrosis 36 K04.2 Exo, Amox, Asmef
Periodontitis Marginalis kronis 11 K05.3 Exo, Amox, Asmef
Nekrosis 47 K04.2 Exo, Amox, Asmef
Nekrosis 37 K04.2 Exo, Amox, Asmef
Pulpitis Irreversible 37 K04.0 Exo, Amox, Asmef
Abses 18 K04.7 Premedikasi, Natrium diklofenak, Amox
Nekrosis 45 K04.2 Exo, Amox, Asmef
Nekrosis 48 K04.2 Exo, Amox, Asmef
Persistensi 51 K00.6 Exo, Vit.C
Periodontitis Marginalis kronis 36 K05.3 Exo, Amox, Asmef
Periodontitis Marginalis kronis 24 K05.3 Exo, Amox, Asmef
Periodontitis Marginalis kronis 26 K05.3 Exo, Amox, Asmef
Persistensi 51 K00.6 Exo, Vit.C
Abses 35 K04.7 Premedikasi, Natrium diklofenak, Amox
 TTD
PASIEN