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  • Chechlist Rujukan

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    Uba Deo Rusdin
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    This document is a check list of required documents for non-capital claim submissions containing the names of 22 patients, their identification card numbers, and whether they submitted a pregnancy book, partograph, or family planning acceptance card. It is signed by the head of administrative affairs at Puskesmas Penanae.

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    chechlist rujukan

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    This document is a check list of required documents for non-capital claim submissions containing the names of 22 patients, their identification card numbers, and whether they submitted a pregnancy book, partograph, or family planning acceptance card. It is signed by the head of administrative affairs at Puskesmas Penanae.

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    © All Rights Reserved
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    3 views7 pages

    Chechlist Rujukan

    Uploaded by

    Uba Deo Rusdin
    This document is a check list of required documents for non-capital claim submissions containing the names of 22 patients, their identification card numbers, and whether they submitted a pregnancy book, partograph, or family planning acceptance card. It is signed by the head of administrative affairs at Puskesmas Penanae.

    Copyright:

    © All Rights Reserved
    Download as XLSX, PDF, TXT or read online from Scribd
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    of 7

    CHECK LIST KELENGKAPAN DOKUMEN

    PENGAJUAN KLAIM NON KAPITASI

    JENIS BERKAS
    NO NAMA PASIEN NO. KARTU
    Buku KIA Partograf FKPP
    1 INDARWATI (0002107567596)
    2 ROSLINA (0003287775273)
    3 SUMIATI (0003505471536)
    4 JUMRIATI (0000849175031)
    5 JUMIATI (0000848498657)
    6 MUSLIMAH (0000848373838)
    7 FAJAR AISAH (0001797200651)
    8 SULASTRI (0002478242529)
    9 NURWAHIDAH (0002847872417)
    10 dinda faniati saputri (0001888404581)
    11 KHAIRUNISAH (0002848057953)
    12 YUSRIANI (0000849222224)
    13 NABILLAH (0000848766565)
    14 JAENATUN (0002110446167)
    15 LENI MARLINA (0001058520802)
    16 SAIDAH NAPISAH (0000849105988
    17 SUMIATI (0000847898008)
    18 SRI SUSANTI (0000847357255)
    19 EMILIA (0000849089597)
    20 SRIANI (0000843980703)
    21 NURJANA (0000848840073)
    22 NURJANAH (0000848119779)

    TGL :
    PEMERIKSA,
    Kasubag Tata Usaha
    Puskesmas Penanae

    R. Guntur Wijaya, SKM


    LINDES

    NAMA PENDERITA

    NO. KARTU

    GODU U

    Winda depitasari

    Nurdiati

    82025694

    8533

    8.49E+08

    8383

    AE

    Nuraeni

    2.41E+09

    858

    OMPU B

    Nuraeni

    8.49E+08

    Indati Lestari

    0001058568974 0852

    GODU S

    Jumratul Fatihah
    1.1E+09

    853

    Sa adiatun Quraini

    2.11E+09

    813

    8.48E+08

    823

    GA

    2.11E+09

    853

    Fitriani Saipul Bahri

    Auliyah Hanani

    Ety Aryani

    Nuryuliana

    5.27E+18

    1.58E+09

    823

    Ruwaidah

    2.76E+09

    853

    Nuraini

    1.58E+09

    Aunal Latifah
    Miratun Syarifah

    3.31E+09

    85

    Nurinayah

    000846191272 00023047713125

    82

    MPU T MAS/KBR

    Tita Kusmiati

    85

    Fahrunnisah

    2.11E+09

    081 081

    Dewi wulandari

    8.48E+08

    5272026503870000…
    LENI MARLINA (0001058520802)
    SAIDAH NAPISAH (0000849105988
    SUMIATI (0000847898008)
    INDARWATI (0002107567596)
    ROSLINA (0003287775273)
    SUMIATI (0003505471536)
    JUMRIATI (0000849175031)
    JUMIATI (0000848498657)
    MUSLIMAH (0000848373838)
    FAJAR AISAH (0001797200651)
    SULASTRI (0002478242529)
    NURWAHIDAH (0002847872417)
    dinda faniati saputri (0001888404581)
    KHAIRUNISAH (0002848057953)
    YUSRIANI (0000849222224)
    NABILLAH (0000848766565)
    JAENATUN (0002110446167)
    SRI SUSANTI (0000847357255)
    EMILIA (0000849089597)
    SRIANI (0000843980703)
    NURJANA (0000848840073)
    NURJANAH (0000848119779)

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