DAFTAR KUNJUNGAN SAKIT RAWAT JALAN PELAYAN

BULAN SEPTEMBER TAH

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 01-09-22 IRAWATI 26 120/60 82 22 36.2 87 60 157 SAPUKA 0003082144487
2 01-09-22 YUDA 25 120/80 96 20 36.2 79 42 143 SAPUKA 0000931236445
3 01-09-22 HASMAWATI 37 130/80 80 20 36.2 95 70 156 SAPUKA 0000929984411
4 01-09-22 JULIADI 37 141/80 80 20 36.2 72 68 168 SAPUKA 0000931245704
5 01-09-22 MELIAWATI 32 100/80 69 22 36.2 69 48 152 SAPUKA 0001934880985
6 01-09-22 RENA 30 120/90 80 22 36.2 78 64 159 SAPUKA 0002976159993
7 01-09-22 MUH. ILHAM 17 100/83 82 22 36.2 78 50 160 SAPUKA 0002850295623
8 02-09-22 RAHMAWATI 26 130/80 84 20 36.4 66 46 150 SAPUKA 0001070278481
9 02-09-22 LU'MU 29 110/87 80 20 36.2 75 45 150 SAPUKA 0000929637257
10 02-09-22 IDAYANTI 37 110/90 82 22 36.2 81 59 153 SAPUKA 0000931153904
11 02-09-22 ARDIANSYAH 26 119/78 82 20 36.4 89 57 166 SAPUKA 0000930473032
12 02-09-22 YUDA 25 120/80 96 20 36.2 79 42 143 SAPUKA 0000931236445
13 02-09-22 HASMAWATI 37 130/80 80 20 36.2 95 70 156 SAPUKA 0000929984411
14 03-09-22 ARHAM 30 130/80 80 24 36.5 86 57 160 SAPUKA 0002828920858
15 03-09-22 SYAFARUDDIN 50 130/80 76 28 36.2 78 54 159 SAPUKA 0002501311601
16 03-09-22 MAKKA 28 120/80 82 20 36.2 64 48 160 SAPUKA 0001562786392
17 03-09-22 ABD LATIF 22 120/80 80 20 36.2 75 45 156 SAPUKA 0001561636822
18 05-09-22 HASAN AL BASRI 24 100/87 90 20 36.2 56 51 156 SAPUKA 0000931738814
19 05-09-22 ARDIANSYAH 26 110/82 80 20 36.2 89 57 166 SAPUKA 0000930473032
20 05-09-22 RADIANA 60 120/80 76 22 36.2 75 38 150 SAPUKA 0002858720949
21 05-09-22 SULASMI 56 120/80 80 20 36.2 85 55 154 SAPUKA 0000931206148
22 05-09-22 ABD. RAHMAN 54 120/80 80 20 36.2 80 72 160 SAPUKA 0001070278468
23 06-09-22 MELIAWATI 32 120/80 72 22 36.2 69 48 152 SAPUKA 0001934880985
24 06-09-22 ZAKARIAH 43 100/80 80 20 36.0 67 49 165 SAPUKA 0001562525537
25 06-09-22 ARMIA 33 110/78 80 20 36.2 69 56 152 SAPUKA 0002606807182
26 06-09-22 YOLANDA 18 100/90 82 22 36.2 75 46 158 SAPUKA 0001070280382
27 06-09-22 HARLAN 9 90/88 80 24 36.1 51 28 124 SAPUKA 0002589717936
28 07-09-22 NURSAMSIA 28 113/83 95 20 36.2 92 71 161 SAPUKA 0001934882098
29 07-09-22 NURHIJRAH 21 100/82 80 20 36.2 79 58 153 SAPUKA 0001070279054
30 07-09-22 SINGARA 17 124/89 77 20 36.4 70 47 154 SAPUKA 0000931156007
31 07-09-22 MUH IRWAN RIDWAN 32 115/80 80 22 36.2 68 46 160 SAPUKA 0001724584151
32 07-09-22 M. YUNUS 19 110/68 92 20 36.2 80 60 165 SAPUKA 0000930647992
33 08-09-22 FITRIANI 38 126/80 82 20 36.2 75 53 157 SAPUKA 0001889596269
34 08-09-22 JAMALUDDIN 57 110/80 80 20 36.2 80 54 151 SAPUKA 0001562550186
35 09-09-22 IRHAM 40 90/70 80 20 36.4 79 54 164 SAPUKA 0002858715854
36 09-09-22 NURDIN 29 120/80 80 20 36.2 77 68 170 SAPUKA 0000929656631
37 10-09-22 HASRAWATI 27 100/70 80 20 36.2 85 51 155 SAPUKA 0003106215955
38 10-09-22 SINGARA 17 110/70 80 20 36.2 70 47 154 SAPUKA 0000931156007
39 12-09-22 JAMALUDDIN 57 110/82 80 20 36.2 80 54 151 SAPUKA 0001562550186
40 SAPUKA
41 SAPUKA
42 SAPUKA
43 SAPUKA
44 SAPUKA
45 SAPUKA
46 SAPUKA
47 SAPUKA
48 SAPUKA
49 SAPUKA
50 SAPUKA
 RAWAT JALAN PELAYANAN JKN PUSKESMAS LK. TANGAYA
BULAN SEPTEMBER TAHUN 2022
S/PUSTU/POSKESDES .....................................................................

PERAWATAN PEMERIKSAAN DIRUJUK

DIAGNOSA UNSUR Icd-x Therapy
Pulpitis Irreversible 28 K04.0 Exo, Amox, Asmef OK
Nekrosis 32 K04.2 Exo, Amox, Asmef OK
Abses 21 K04.7 Premedikasi, Natrium diklofenak, Amox OK
Periodontitis apikal kronis 36 K05.3 Exo, Amox, Asmef, b.com OK
Abses 37 K04.7 Premedikasi, Natrium diklofenak, Amox, B.com OK
Pulpitis Irreversible 15 K04.0 Premedikasi, Natrium diklofenak, Amox, B.com NON AKTIF
Pulpitis Irreversible 16 K04.0 Premedikasi, Natrium diklofenak, Amox, B.com OK
Nekrosis 47 K04.2 Exo, Amox, Asmef, b.com OK
Pulpitis Irreversible 35 K04.0 Premedikasi, Natrium diklofenak, Amox OK
Periodontitis Marginalis kronis 44 K05.3 Premedikasi, Natrium diklofenak, Amox, B.com OK
Pulpitis Irreversible 47 K04.0 Premedikasi, Natrium diklofenak, Amox NON AKTIF
Nekrosis 42 K04.2 Exo, Amox, Asmef OK
Abses 21 K04.7 Premedikasi, Natrium diklofenak, Amox OK
Pulpitis Irreversible 36 K04.0 Premedikasi, Amox, asmef OK
Periodontitis kronis 22 K05.3 Exo, Amox, Asmef OK
Pulpitis Irreversible 15 K04.0 Premedikasi, Amox, asmef OK
Pulpitis Irreversible 24 K04.0 Premedikasi, Amox, asmef OK
Nekrosis 36 K04.2 Exo, Amox, Asmef, B.com OK
Pulpitis Irreversible 47 K04.0 Exo, Amox, Asmef NON AKTIF
Periodontitis Marginalis kronis 24 K05.3 Premedikasi, Natrium diklofenak, Amox, B.com OK
Pulpitis Irreversible 35 K04.0 Premedikasi, Amox, asmef OK
Pulpitis Irreversible 15 K04.0 Premedikasi, Amox, asmef OK
Abses 37 K04.7 Exo, Amox, Asmef OK
Pulpitis Irreversible 24 K04.0 Premedikasi, Amox, asmef OK
Nekrosis 37 K04.2 Exo, Amox, Asmef OK
Periodontitis kronis 17 K05.3 Premedikasi, Amox, asmef OK
Persistensi 52 K00.6 Exo, Vit.C OK
Nekrosis 28 K04.2 Exo, Amox, Asmef OK
Periodontitis kronis 17 K05.3 Premedikasi, Amox, asmef OK
Abses 37 K04.7 Exo, Amox, Asmef OK
Abses 27 K04.7 Premedikasi, Amox, Asmef OK
Nekrosis 46 K04.2 Exo, Amox, Asmef OK
Nekrosis 37 K04.2 Exo, Amox, Asmef OK
Periodontitis kronis 17 K05.3 Premedikasi, Amox, asmef OK
Nekrosis 17 K04.2 Exo, Amox, Asmef OK
Nekrosis 46 K04.2 Exo, Amox, Asmef OK
Nekrosis 47 K04.2 Exo, Amox, Asmef OK
Nekrosis 46 K04.2 Exo, Amox, Asmef OK
Periodontitis kronis 17 K05.3 Exo, Amox, Asmef OK
 TTD
PASIEN