REKAP

TANGGAL TANGGAL JENIS KELAMIN STATUS PULANG
NO NO KUNJUNGAN PELAYANAN ENTRI NO KARTU NAMA PESERTA JENIS PESERTA DIAGNOSA PRB PROLANIS
1 132304010623P000 06-03-2023 03-06-2023 0000111188079 FARIDA P PNS DAERAH Anisometropia and Rujuk Vertikal
003 08:31 KUSUMAWARDANI aniseikonia
MATA KLINIK MATA SMEC MALANG
2 132304010623P000 06-03-2023 03-06-2023 0000111449169 BONASIR L PENERIMA Chronic ischaemic Rujuk Vertikal
020 09:51 PENSIUN TNI heart disease,
unspecified
JANTUNG DAN PEMBULURSI AISYIYAH MALANG
3 132304010623P000 06-03-2023 03-06-2023 0000170603785 MUHAMMAD L - Necrosis of pulp Rujuk Vertikal
008 08:42 YULIANTO
GIGI ENDODONSI RUMAH SAKIT LAVALETTE
4 132304010623P000 06-03-2023 03-06-2023 0000784225282 SUGIATI P PBI (APBN) Other chronic Rujuk Vertikal
006 08:39 obstructive
pulmonary disease
PARU RSI AISYIYAH MALANG
5 132304010623P000 06-03-2023 03-06-2023 0000784872189 PIPIN HERAWATI P PBI (APBN) Stroke, not Rujuk Vertikal
005 08:37 specified as
haemorrhage or
infarction
SARAF RSI AISYIYAH MALANG
6 132304010623P000 06-03-2023 03-06-2023 0001189532373 NATASHA ANGELINE P PEKERJA MANDIRI Anisometropia and Rujuk Vertikal
016 09:21 aniseikonia
MATA RSI AISYIYAH MALANG
7 132304010623P000 06-03-2023 03-06-2023 0001268319609 SUTOMO L PEGAWAI Other chronic Rujuk Vertikal
010 08:48 SWASTA obstructive
pulmonary disease
Pulmonologi RS SOEPRAOEN
8 132304010623P000 03-06-2023 Maternal care due
021 09:55 to uterine scar
from previous
06-03-2023 0001373592014 NUNIK SRI WAHYUNI P - surgery Rujuk Vertikal
OBGYN RSU HERMINA TANGKUBANPRAHU

9 132304010623P000 06-03-2023 03-06-2023 0001407317984 STEFANUS TATAG L PEKERJA MANDIRI Heart failure, Rujuk Vertikal
004 08:34 SUSANTO unspecified
10 132304010623P000 03-06-2023 RATIH WULAN PEKERJA MANDIRI Maternal care due
013 08:54 PUSPASARI to uterine scar
from previous
06-03-2023 0001409234769 P surgery Rujuk Vertikal
OBGYN RSI AISYIYAH MALANG

11 132304010623P000 06-03-2023 03-06-2023 0001438792615 LAY MEI LIE P PEKERJA MANDIRI Stroke, not Rujuk Vertikal
haemorrhage or
infarction
SARAF RSU HERMINA TANGKUBANPRAHU
12 132304010623P000 06-03-2023 03-06-2023 0001647920035 M. SULAIMAN L PEKERJA MANDIRI Schizophrenia Rujuk Vertikal
009 08:46 ABDULLAH
JIWA RSI AISYIYAH MALANG
13 132304010623P000 06-03-2023 03-06-2023 0001813557418 AGUS SUPARNO L - Anisometropia and Rujuk Vertikal
14 132304010623P000 06-03-2023 03-06-2023 0002050623911 MARYAM P - Necrosis of pulp Rujuk Vertikal
011 08:49
GIGI ENDODONSI RSIA PURI
15 132304010623P000 06-03-2023 03-06-2023 0002202968676 ANNISA ACHMA P PBI (APBD) Impacted teeth Rujuk Vertikal
002 08:31 DZIKIRINA
GIGI BEDAH MULUT RS SOEPRAOEN
16 132304010623P000 06-03-2023 03-06-2023 0002204263991 SAMUDJI L - Chronic kidney Rujuk Vertikal
001 08:29 disease
PENYAKIT DALAM RSI AISYIYAH MALANG
17 132304010623P000 03-06-2023 Insulin-dependent
015 09:15 diabetes mellitus
with unspecified
06-03-2023 0002294332413 SUKRISTINA P PBI (APBN) complications Rujuk Vertikal

18 132304010623P000 06-03-2023 03-06-2023 0002681420556 SANDI PUTRA L PBI (APBD) Calculus of kidney Rujuk Vertikal
019 09:38 and ureter
19 132304010623P000 06-03-2023 03-06-2023 0002730247637 VIVI YULI VIJAYANTI P - Necrosis of pulp Rujuk Vertikal
012 08:53
GIGI ENDODONSI RS PANTI NIRMALA
20 132304010623P000 06-03-2023 03-06-2023 0003517139417 BAYI NYONYA L - Umbilical hernia Rujuk Vertikal
014 09:02 ARDINE NOVIAKRISTI
BEDAH ANAK RS PANTI NIRMALA
21 132304010623P000 06-05-2023 05-06-2023 0000111136432 MISTAR L PNS DAERAH Psoriasis Rujuk Vertikal
056 10:25
KULIT KELAMIN RSI AISYIYAH MALANG
22 132304010623P000 06-05-2023 05-06-2023 0000681592735 SITI KHOTIMAH P PBI (APBD) Necrosis of pulp Rujuk Vertikal
068 10:51
GIGI ENDODONSI RSIA MUHAMMADIYAH MALANG
23 132304010623P000 06-05-2023 05-06-2023 0000726510914 DIAN PUTRI FANI P PBI (APBD) Antepartum Rujuk Vertikal
069 10:51 haemorrhage,
unspecified
OBGYN RS MELATI HUSADA
24 132304010623P000 06-05-2023 05-06-2023 0000783216191 MARGINO L PBI (APBN) Heart failure, Rujuk Vertikal
041 09:14 unspecified
25 132304010623P000 05-06-2023 Non-insulin-
037 08:43 dependent diabetes
mellitus with
06-05-2023 0000783836537 MU'MININ P PBI (APBN) unspecified Rujuk Vertikal
complications

26 132304010623P000 05-06-2023 Cerebral infarction
046 09:47 due to cerebral
venous thrombosis,
06-05-2023 0000784070368 SUYANTI P PBI (APBN) nonpyogenic Rujuk Vertikal
SARAF RS SOEPRAOEN
27 132304010623P000 06-05-2023 05-06-2023 0000784328624 MARDIASIH P PBI (APBN) Malignant Rujuk Vertikal
076 11:42 neoplasm of breast
Bedah Onkologi RUMAH SAKIT LAVALETTE
28 132304010623P000 06-05-2023 05-06-2023 0000784592381 BAGAS DWI L PEGAWAI Impacted teeth Rujuk Vertikal
055 10:22 RAMADHANI SWASTA
29 132304010623P000 06-05-2023 05-06-2023 0000784632341 FEBY SINTYA DEWI P - Disruption of Rujuk Vertikal
077 11:42 caesarean section
wound
30 132304010623P000 06-05-2023 05-06-2023 0000784776363 HUSEIN NUR ISLAM L PBI (APBN) Schizoaffective Rujuk Vertikal
063 10:41 disorder,
depressive type
JIWA RS. JIWA LAWANG
31 132304010623P000 06-05-2023 05-06-2023 0000784776903 LINA PUJININGTYAS P PBI (APBD) Calculus of Rujuk Vertikal
067 10:47 gallbladder with
other cholecystitis
BEDAH RSI AISYIYAH MALANG
32 132304010623P000 06-05-2023 05-06-2023 0000784940207 KUSGIANTO L PBI (APBD) Chronic ischaemic Rujuk Vertikal
045 09:44 heart disease,
unspecified
33 132304010623P000 06-05-2023 05-06-2023 0001049552482 SITI CHALIMAH P PBI (APBN) Necrosis of pulp Rujuk Vertikal
061 10:36
GIGI ENDODONSI RSU HERMINA TANGKUBANPRAHU
34 132304010623P000 05-06-2023 PENERIMA Zoster with other
073 11:14 PENSIUN PNS nervous system
06-05-2023 0001079563847 LAMINI P involvement Rujuk Vertikal
SARAF RS SOEPRAOEN
35 132304010623P000 06-05-2023 05-06-2023 0001262381242 TAMAT L PEKERJA MANDIRI Chronic ischaemic Rujuk Vertikal
unspecified
36 132304010623P000 06-05-2023 05-06-2023 0001273173232 MONICA SAHARANI P - Caries of dentine Rujuk Vertikal
035 08:39 RISTANANTA
37 132304010623P000 06-05-2023 05-06-2023 0001328379434 HENI SUHARDINI P PEGAWAI Other disorders of Rujuk Vertikal
054 10:19 SWASTA lens
38 132304010623P000 06-05-2023 05-06-2023 0001403209539 TUKIMIN L PBI (APBD) Cholelithiasis Rujuk Vertikal
043 09:28
39 132304010623P000 06-05-2023 05-06-2023 0001403210564 SRI WAHYUNINGSIH P - Malignant Rujuk Vertikal
080 11:51 neoplasm of
accessory sinuses
THT-KL RSU HERMINA TANGKUBANPRAHU
40 132304010623P000 06-05-2023 05-06-2023 0001403228777 SUMIATI P PBI (APBD) Cervicalgia Rujuk Vertikal
059 10:30
ORTHOPEDI RSI AISYIYAH MALANG
41 132304010623P000 06-05-2023 05-06-2023 0001435701464 RITA HANDAYANI P - Other specified Rujuk Vertikal
078 11:47 surgical follow-up
care
42 132304010623P000 06-05-2023 05-06-2023 0001439494569 ENDRI MUJIONO L PEKERJA MANDIRI Heart failure, Rujuk Vertikal
JANTUNG DAN PEMBULURSU HERMINA TANGKUBANPRAHU
43 132304010623P000 06-05-2023 05-06-2023 0001601308056 SUKAMTO L PBI (APBD) Hyperplasia of Rujuk Vertikal
070 10:57 prostate
UROLOGI RSU HERMINA TANGKUBANPRAHU
44 132304010623P000 06-05-2023 05-06-2023 0001647752499 YOLANDA P - Necrosis of pulp Rujuk Vertikal
079 11:48 ANGGITASARI
45 132304010623P000 06-05-2023 05-06-2023 0001723556373 SOESIANA P - Chronic ulcer of Rujuk Vertikal
081 13:09 skin, not elsewhere
classified
PENYAKIT DALAM RS PANTI WALUYA
46 132304010623P000 06-05-2023 05-06-2023 0001735450683 KEANG HARRY L PEKERJA MANDIRI Sequelae of Rujuk Vertikal
048 09:50 cerebral infarction
47 132304010623P000 06-05-2023 05-06-2023 0001793891338 ROKAYAH P PEKERJA MANDIRI Hypertensive heart Rujuk Vertikal
030 08:21 disease
48 132304010623P000 06-05-2023 05-06-2023 0001827347589 MOKHAMAD ARDHI L PBI (APBD) Impacted teeth Rujuk Vertikal
065 10:43 WURYANTONO
GIGI BEDAH MULUT RSU HERMINA TANGKUBANPRAHU
49 132304010623P000 06-05-2023 05-06-2023 0001863448255 HOSNIYAH P PBI (APBN) Cystitis Rujuk Vertikal
044 09:40
UROLOGI RSI AISYIYAH MALANG
50 132304010623P000 06-05-2023 05-06-2023 0001871059228 MUHAMMAD ARIF L PBI (APBD) Thalassaemia Rujuk Vertikal
031 08:26
Hematologi - Onkologi MeRSI AISYIYAH MALANG
51 132304010623P000 06-05-2023 05-06-2023 0002032150342 INDAH YULIATI P PEKERJA MANDIRI Retained dental Rujuk Vertikal
052 10:12 root
GIGI BEDAH MULUT RS PANTI WALUYA
52 132304010623P000 06-05-2023 05-06-2023 0002037237502 NUR 'AINI P - Gonarthrosis Rujuk Vertikal
071 10:59 [arthrosis of knee]
53 132304010623P000 05-06-2023 Unspecified
039 08:55 abdominal hernia
without obstruction
06-05-2023 0002053688905 SURATMAN L PBI (APBD) or gangrene Rujuk Vertikal

54 132304010623P000 06-05-2023 05-06-2023 0002054975229 NANING SUKARSIH P PBI (APBD) Thyrotoxicosis Rujuk Vertikal
036 08:40 [hyperthyroidism]
55 132304010623P000 06-05-2023 05-06-2023 0002228570583 HENGKY L PEKERJA MANDIRI Other chronic Rujuk Vertikal
pulmonary disease
PARU RS PANTI NIRMALA
56 132304010623P000 06-05-2023 05-06-2023 0002228571022 SRIANI P PEKERJA MANDIRI Stroke, not Rujuk Vertikal
haemorrhage or
infarction
SARAF RS PANTI NIRMALA
57 132304010623P000 06-05-2023 05-06-2023 0002321059206 RISMA FITRI ANISAH P PBI (APBD) Pulpitis Rujuk Vertikal
074 11:14
58 132304010623P000 06-05-2023 05-06-2023 0002416454954 SRI MEI WARDAYATI P PBI (APBD) Benign neoplasm Rujuk Vertikal
033 08:29 of ovary
59 132304010623P000 05-06-2023 Other disorders of
060 10:31 psychological
06-05-2023 0002442954058 INDRA PERMANA L PBI (APBD) development Rujuk Vertikal

60 132304010623P000 06-05-2023 05-06-2023 0002478321775 MIKHAYLA ZAKIA P - Status asthmaticus Rujuk Vertikal
058 10:28 PUTRI JASMINE
ANAK RSIA PURI
61 132304010623P000 06-05-2023 05-06-2023 0002494840239 RAUDATUL P - Other disorders of Rujuk Vertikal
049 09:51 HASANAH lens
62 132304010623P000 06-05-2023 05-06-2023 0002727454678 SONY ANGGA L PBI (APBD) Cauda equina Rujuk Vertikal
057 10:28 KUSUMA syndrome
63 132304010623P000 06-05-2023 05-06-2023 0002727757653 NIKMAH HAMDAN P PBI (APBD) Anisometropia and Rujuk Vertikal
64 132304010623P000 06-05-2023 05-06-2023 0002730360723 INNES NATASYAH P PBI (APBD) Anisometropia and Rujuk Vertikal
042 09:23 FARES FELLA aniseikonia
65 132304010623P000 06-05-2023 05-06-2023 0002814530894 MAMIK HARTATIK P PBI (APBN) Cerebral infarction, Rujuk Vertikal
66 132304010623P000 05-06-2023 Maternal care for
051 10:07 malpresentation of
fetus, unspecified
06-05-2023 0002845957195 DEWI INDRIANI P PBI (APBN) Rujuk Vertikal

67 132304010623P000 05-06-2023 Non-insulin-
mellitus with
06-05-2023 0002845960007 SUGIATI P PBI (APBN) unspecified Rujuk Vertikal
complications

68 132304010623P000 06-05-2023 05-06-2023 0002974914099 NAJWA KHODIJAH P - Pulp degeneration Rujuk Vertikal
050 10:00
69 132304010623P000 06-05-2023 05-06-2023 0003064344579 SU'UD ALIYA FAROUK P PBI (APBD) Impacted teeth Rujuk Vertikal
072 11:02
70 132304010623P000 06-06-2023 06-06-2023 0000100338322 NI MADE SEMIRNI P PNS DAERAH Other spondylosis Rujuk Vertikal
132 11:45 with radiculopathy

71 132304010623P000 06-06-2023 06-06-2023 0000110388532 SURYANTO L PENERIMA Disorders of Rujuk Vertikal
126 10:54 PENSIUN PNS accommodation
72 132304010623P000 06-06-2023 06-06-2023 0000111810519 SRI WULAN P PNS DAERAH Disorders of Rujuk Vertikal
095 08:44 accommodation
MATA Klinik Utama Malang Eye Center
73 132304010623P000 06-06-2023 06-06-2023 0000111810543 OLIVIA ELISABET P - Disorders of Rujuk Vertikal
74 132304010623P000 06-06-2023 06-06-2023 0000171526408 NEVY ARDIANTO L PNS DAERAH Impacted teeth Rujuk Vertikal
105 09:12
75 132304010623P000 06-06-2023 Iodine-deficiency-
125 10:49 related thyroid
disorders and allied
06-06-2023 0000783265983 DARYANI P PBI (APBN) conditions Rujuk Vertikal

76 132304010623P000 06-06-2023 06-06-2023 0000783903475 SITI RUBIATI P PBI (APBD) Other cataract Rujuk Vertikal
119 10:29
77 132304010623P000 06-06-2023 06-06-2023 0000783987423 NURUL P PBI (APBD) Impacted teeth Rujuk Vertikal
109 09:25 PRASETYOWATI
GIGI BEDAH MULUT RSI AISYIYAH MALANG
78 132304010623P000 06-06-2023 06-06-2023 0000784134551 SUMIATI P PBI (APBN) Chronic ischaemic Rujuk Vertikal
unspecified
79 132304010623P000 06-06-2023 06-06-2023 0000784556627 LULUK FARIDA P PBI (APBN) Disorders of Rujuk Vertikal
80 132304010623P000 06-06-2023 06-06-2023 0000785160641 NURUL ROSYIDAH P PBI (APBN) Gonarthrosis, Rujuk Vertikal
SARAF RS SOEPRAOEN
81 132304010623P000 06-06-2023 Embolism and
130 11:35 thrombosis of
06-06-2023 0000785202434 SAIMUN L PBI (APBN) unspecified artery Rujuk Vertikal
82 132304010623P000 06-06-2023 06-06-2023 0001268948968 ASTUTI WIDIJAWATI P PEKERJA MANDIRI Cholelithiasis Rujuk Vertikal
091 08:31
PENYAKIT DALAM RSUD Kota Malang
83 132304010623P000 06-06-2023 06-06-2023 0001271073025 ASMANTUTI P - Other chronic Rujuk Vertikal
pulmonary disease
84 132304010623P000 06-06-2023 06-06-2023 0001287152381 SUKINI P PEKERJA MANDIRI Disorders of Rujuk Vertikal
85 132304010623P000 06-06-2023 06-06-2023 0001543873004 SITI YULIANI P PEGAWAI Impacted teeth Rujuk Vertikal
103 09:06 GINANJAR SLAMET SWASTA
GIGI BEDAH MULUT RS BHIRAWA BHAKTI
86 132304010623P000 06-06-2023 Other specified
135 15:48 diseases and
conditions
complicating
06-06-2023 0001656560158 DELLA OKTAVIYANI P - pregnancy, Rujuk Vertikal
childbirth and the
puerperium
OBGYN RSIA GALERI CANDRA
87 132304010623P000 06-06-2023 06-06-2023 0001847982778 sumarsono L - Stroke, not Rujuk Vertikal
haemorrhage or
infarction
88 132304010623P000 06-06-2023 06-06-2023 0001855173622 ANTOK YUDIONO L PEGAWAI Anisometropia and Rujuk Vertikal
089 08:19 SWASTA aniseikonia
89 132304010623P000 06-06-2023 06-06-2023 0002059113982 NADYA KIRANA P - Necrosis of pulp Rujuk Vertikal
127 11:05 WIBISOVIA
90 132304010623P000 06-06-2023 06-06-2023 0002091768625 ARADEA PAMBAYUN P PNS PUSAT Anisometropia and Rujuk Vertikal
113 09:43 KRISTANTO aniseikonia
91 132304010623P000 06-06-2023 06-06-2023 0002318212888 MURJOKO L - Psoriasis, Rujuk Vertikal
92 132304010623P000 06-06-2023 06-06-2023 0002423570051 MUHAMAD ABDUL L - Chronic apical Rujuk Vertikal
116 10:12 MUKSON periodontitis
GIGI BEDAH MULUT RUMAH SAKIT LAVALETTE
93 132304010623P000 06-06-2023 06-06-2023 0002681277039 IMAWAN PRIYANTO L PBI (APBN) Chronic ischaemic Rujuk Vertikal
unspecified
94 132304010623P000 06-06-2023 06-06-2023 0002730227872 INDRA WATI P PBI (APBD) Other malignant Rujuk Vertikal
088 08:17 SURYAWAN neoplasms of skin
95 132304010623P000 06-06-2023 06-06-2023 0002730354849 NOVINTA FARADILA P PBI (APBD) Benign neoplasm Rujuk Vertikal
133 11:55 ARIANI of ovary
96 132304010623P000 06-06-2023 Non-insulin-
mellitus with
06-06-2023 0002731369184 KARMINAH P PBI (APBD) unspecified Rujuk Vertikal
complications

97 132304010623P000 06-06-2023 Retarded
111 09:31 development
KINARA NAISYA following protein-
06-06-2023 0002753366927 P PBI (APBN) energy Rujuk Vertikal
PUTRI
malnutrition
ANAK RSI AISYIYAH MALANG
98 132304010623P000 06-06-2023 06-06-2023 0002814523716 SUMIARNI P PBI (APBN) Malignant Rujuk Vertikal
BEDAH RSU HERMINA TANGKUBANPRAHU
99 132304010623P000 06-06-2023 06-06-2023 0003051971796 ELIF ERMIATI P PBI (APBD) Supervision of Rujuk Vertikal
134 12:05 other high-risk
pregnancies
OBGYN RSIA MUTIARA BUNDA
from previous
06-06-2023 0003133040308 LATIFA TUNISA P PBI (APBN) surgery Rujuk Vertikal

101 132304010623P000 06-07-2023 07-06-2023 0000108024298 SUTARSIH MARIA P PENERIMA Gonarthrosis, Rujuk Vertikal
149 09:56 MAGDALENA PENSIUN PNS unspecified
ORTHOPEDI RS PANTI WALUYA
102 132304010623P000 06-07-2023 07-06-2023 0000111169282 SRI PURWANTI P - Low back pain Rujuk Vertikal
143 09:40
103 132304010623P000 06-07-2023 07-06-2023 0000111235678 RIYANTI ASIH P PENERIMA Ganglion Rujuk Vertikal
152 10:09 PRATIWI PENSIUN PNS
104 132304010623P000 06-07-2023 07-06-2023 0000201308859 QURROTA PURBO L - Impacted teeth Rujuk Vertikal
140 08:47 WARDANA
105 132304010623P000 06-07-2023 07-06-2023 0000783782965 NOVIKA SANTI P - Pain, not elsewhere Rujuk Vertikal
165 11:19 classified
BEDAH RS BHIRAWA BHAKTI
106 132304010623P000 06-07-2023 07-06-2023 0000784233303 NGATENI P - Disorder of visual Rujuk Vertikal
164 11:09 pathways,
unspecified
107 132304010623P000 06-07-2023 07-06-2023 0000784493684 RIFAS SAINULLAH L PBI (APBN) Chronic ischaemic Rujuk Vertikal
unspecified
108 132304010623P000 06-07-2023 07-06-2023 0000784548696 YASMITHA P PBI (APBN) Hearing loss, Rujuk Vertikal
THT-KL RSI AISYIYAH MALANG
109 132304010623P000 06-07-2023 07-06-2023 0000785138916 YULIANI P PBI (APBD) Cerebral infarction Rujuk Vertikal
139 08:46
SARAF RS SOEPRAOEN
110 132304010623P000 07-06-2023 PEKERJA MANDIRI Non-insulin-
mellitus with
06-07-2023 0001302542381 SUDARNO L unspecified Rujuk Vertikal
complications
PENYAKIT DALAM RSU HERMINA TANGKUBANPRAHU

111 132304010623P000 06-07-2023 07-06-2023 0001400140192 MISTIKAYAH P PEKERJA MANDIRI Malignant Rujuk Vertikal
112 132304010623P000 06-07-2023 07-06-2023 0001403228687 NUR CHOMARIYAH P PBI (APBD) Disorders of Rujuk Vertikal
113 132304010623P000 07-06-2023 Gastric ulcer, acute
137 08:43 without
06-07-2023 0001706211988 PONIMAH P PBI (APBD) haemorrhage or Rujuk Vertikal
perforation
114 132304010623P000 06-07-2023 07-06-2023 0001841734743 ngatini P - Pain, not elsewhere Rujuk Vertikal
115 132304010623P000 06-07-2023 07-06-2023 0001858411642 MA'RUFAH P - Psoriasis Rujuk Vertikal
162 11:06
116 132304010623P000 06-07-2023 07-06-2023 0002065977088 ABDURROSYID L PBI (APBD) Pulp degeneration Rujuk Vertikal
145 09:44
117 132304010623P000 06-07-2023 07-06-2023 0002207273185 SURADI L - Other cataract Rujuk Vertikal
156 10:40
118 132304010623P000 06-07-2023 07-06-2023 0002292998196 KATIYAH P PBI (APBD) Keratitis, Rujuk Vertikal
119 132304010623P000 07-06-2023 Unilateral or
inguinal hernia,
06-07-2023 0002417417313 EDDY SUBAGIO L PBI (APBD) without obstruction Rujuk Vertikal
or gangrene

120 132304010623P000 06-07-2023 07-06-2023 0002730225677 LILIS HANDAYANI P - Heart failure, Rujuk Vertikal
JANTUNG DAN PEMBULURS SOEPRAOEN
121 132304010623P000 06-07-2023 07-06-2023 0002730313664 HARI SUJATMIKO L PBI (APBD) Other chronic Rujuk Vertikal
pulmonary disease
PARU RSU HERMINA TANGKUBANPRAHU
122 132304010623P000 06-07-2023 07-06-2023 0002814518531 MUTIANINGSIH P PBI (APBN) Anisometropia and Rujuk Vertikal
123 132304010623P000 07-06-2023 PEKERJA MANDIRI Developmental
141 08:55 disorder of speech
and language,
06-07-2023 0003085002663 Arsy Calief Rayyan L unspecified Rujuk Vertikal

124 132304010623P000 06-07-2023 07-06-2023 0003292457905 ISMAIL HAMZAH L - Other specified Rujuk Vertikal
163 11:07 KUDDAH disorders of muscle
125 07-06-2023 -
L
132304010623P0 06-07-2023 08:56 1871056787 SUGIONO Schizophrenia Rujuk Vertikal JIWA RS SOEPRAOEN
126 132304010623P000 06-08-2023 08-06-2023 0000111449171 SRI MISINI P PENERIMA Tic disorder, Rujuk Vertikal
206 11:08 PENSIUN TNI unspecified
127 132304010623P000 06-08-2023 08-06-2023 0000111705952 GATOT EDDY L PENERIMA Stroke, not Rujuk Vertikal
197 10:15 SOETJIPTO PENSIUN PNS specified as
haemorrhage or
infarction
128 132304010623P000 06-08-2023 08-06-2023 0000783951006 SYAMSUL SANALI L PBI (APBN) Hyperplasia of Rujuk Vertikal
190 09:49 prostate
129 132304010623P000 06-08-2023 08-06-2023 0000784058927 RIO FAISAL SAHRONI L PBI (APBN) Impacted teeth Rujuk Vertikal
192 09:59
130 132304010623P000 06-08-2023 08-06-2023 0000784146925 ANGGA TRILIA L - Superficial injury Rujuk Vertikal
203 10:56 FRANSISCO of nose
131 132304010623P000 08-06-2023 Diseases of the
187 09:23 respiratory system
complicating
pregnancy,
06-08-2023 0000784192915 CHOIR ROHMAH P - childbirth and the Rujuk Vertikal
puerperium

132 132304010623P000 06-08-2023 08-06-2023 0000784343957 MUINI P PBI (APBN) Cerebral infarction, Rujuk Vertikal
133 132304010623P000 06-08-2023 08-06-2023 0000784812317 FA'AT AMBARHADI L PBI (APBN) Rheumatic chorea Rujuk Vertikal
175 08:33 without heart
involvement
134 132304010623P000 08-06-2023 Non-insulin-
mellitus with
06-08-2023 0000785013838 SUPADMI P PBI (APBN) multiple Rujuk Vertikal
complications

135 132304010623P000 06-08-2023 08-06-2023 0000785344487 SITI RAHMAH P PBI (APBN) Disorders of Rujuk Vertikal
136 132304010623P000 06-08-2023 08-06-2023 0001049547069 MOCH NOER SIFAK L PBI (APBN) Other chronic Rujuk Vertikal
pulmonary disease
137 132304010623P000 06-08-2023 08-06-2023 0001303409406 SATIK P PBI (APBN) Schizophrenia Rujuk Vertikal
177 08:39
138 132304010623P000 06-08-2023 08-06-2023 0001328398198 LISAN HANDAYANI P PEGAWAI Pulpitis Rujuk Vertikal
205 11:04 SWASTA
GIGI ENDODONSI RS BHIRAWA BHAKTI
139 132304010623P000 06-08-2023 08-06-2023 0001389083253 MUKIYIN L PEKERJA MANDIRI Cardiac Rujuk Vertikal
178 08:41 arrhythmia,
unspecified
140 132304010623P000 06-08-2023 08-06-2023 0001434173679 ANIS SUPRIATIN P PBI (APBD) Disruption of Rujuk Vertikal
195 10:05 caesarean section
wound
141 132304010623P000 06-08-2023 08-06-2023 0001451258954 SUTRISNO L PEGAWAI Disorders of Rujuk Vertikal
204 11:03 SWASTA accommodation
MATA RS SOEPRAOEN
142 132304010623P000 06-08-2023 08-06-2023 0001469372152 JUAN CHANDRA L - Adhesive capsulitis Rujuk Vertikal
213 15:00 of shoulder
143 132304010623P000 06-08-2023 08-06-2023 0001471450419 SITI KHOTIJAH P PEKERJA MANDIRI Other cataract Rujuk Vertikal
194 10:04
144 132304010623P000 06-08-2023 08-06-2023 0001822529215 FITRI RULIANA P PBI (APBN) Pulpitis Rujuk Vertikal
181 08:57
145 132304010623P000 06-08-2023 08-06-2023 0001870556027 yatimah P PEKERJA MANDIRI Other cataract Rujuk Vertikal
185 09:10
146 132304010623P000 08-06-2023 Insulin-dependent
186 09:11 diabetes mellitus
with unspecified
06-08-2023 0002037261519 ERNAWATI P - complications Rujuk Vertikal

147 132304010623P000 06-08-2023 08-06-2023 0002283626474 DYAH WAHYU P - Hebephrenic Rujuk Vertikal
201 10:51 KINANTI schizophrenia
148 132304010623P000 06-08-2023 08-06-2023 0002421041253 LUSI NUR MILASARI P - Necrosis of pulp Rujuk Vertikal
202 10:55
149 132304010623P000 06-08-2023 08-06-2023 0002592719897 YOSI WINATA L PBI (APBN) Other cataract Rujuk Vertikal
180 08:55
MATA RS Universitas Brawijaya
150 132304010623P000 06-08-2023 08-06-2023 0002728987266 SITI ROMLAH P PBI (APBD) Cardiomegaly Rujuk Vertikal
182 08:59
151 132304010623P000 08-06-2023 Background
184 09:04 retinopathy and
06-08-2023 0002730355187 SUMILAN M ROWI L PBI (APBD) retinal vascular Rujuk Vertikal
changes
152 132304010623P000 06-08-2023 08-06-2023 0002762120788 SUNARTI P PEKERJA MANDIRI Fracture of upper Rujuk Vertikal
199 10:40 end of humerus
153 132304010623P000 06-08-2023 08-06-2023 0002845956655 KHASAN L PBI (APBN) Hyperplasia of Rujuk Vertikal
191 09:52 prostate
154 132304010623P000 06-08-2023 08-06-2023 0002936714837 MAERAH P PBI (APBD) Tuberculosis of Rujuk Vertikal
193 10:01 other specified
organs
PARU RS PANTI NIRMALA
155 132304010623P000 06-08-2023 08-06-2023 0003292179873 ALYA ZAHIRA P PBI (APBD) Acute renal failure, Rujuk Vertikal
Anak Nefrologi RSI AISYIYAH MALANG
156 132304010623P000 08-06-2023 BAYI NYONYA LILIS Neonatal jaundice
196 10:07 DWI OKTAVIANA associated with
PUTRI preterm delivery
06-08-2023 0003525010615 L - Rujuk Vertikal
ANAK RS MELATI HUSADA

157 132304010623P000 06-09-2023 09-06-2023 0000110576902 ACHMAD DJUNAEDI L PNS DAERAH Heart failure, Rujuk Vertikal
158 132304010623P000 06-09-2023 09-06-2023 0000111131256 MOCH CHUSNUL L PBI (APBD) Bipolar affective Rujuk Vertikal
219 08:28 ABDILLAH disorder
JIWA RSU HERMINA TANGKUBANPRAHU
159 132304010623P000 06-09-2023 09-06-2023 0000784072484 SUPANDRI L PBI (APBN) Chronic ischaemic Rujuk Vertikal
unspecified
160 132304010623P000 06-09-2023 09-06-2023 0000784709741 MARPUAH P PBI (APBN) Other and Rujuk Vertikal
240 09:05 unspecified right
bundle-branch
block
161 132304010623P000 06-09-2023 09-06-2023 0001189532362 LUCIANA ARININGSIH P - Low back pain Rujuk Vertikal
242 09:17
162 132304010623P000 06-09-2023 09-06-2023 0001380415511 ASKUR ARIEF L PEKERJA MANDIRI Hyperplasia of Rujuk Vertikal
243 09:20 prostate
163 132304010623P000 09-06-2023 Systemic lupus
238 06-09-2023 09:01 0001791027246 JUWATI P PBI (APBN) erythematosus, Rujuk Vertikal
unspecified
Reumatologi RS PERSADA HOSPITAL
164 132304010623P000 06-09-2023 09-06-2023 0001792801451 CRECENTIA SIAMAH P PBI (APBN) Heart failure, Rujuk Vertikal
165 132304010623P000 06-09-2023 09-06-2023 0001824303025 MULJO DIHARDJO, P PBI (APBD) Stroke, not Rujuk Vertikal
241 09:07 SUSY ARJANI specified as
haemorrhage or
infarction
SARAF RS PANTI WALUYA
166 132304010623P000 06-09-2023 09-06-2023 0002047390244 NANCY NICKY P - Necrosis of pulp Rujuk Vertikal
236 08:55 SENDUK
GIGI BEDAH MULUT RS PANTI NIRMALA
167 132304010623P000 06-09-2023 09-06-2023 0002199068043 PUTRI AMIRA GUTU P - Necrosis of pulp Rujuk Vertikal
231 08:46 KURNIA
168 132304010623P000 09-06-2023 PEKERJA MANDIRI Human
239 09:03 immunodeficiency
virus [HIV] disease
resulting in
infectious and
06-09-2023 0002257854298 GATOT BOMANTARA L Rujuk Vertikal
parasitic diseases

169 06-09-2023 0003304239118 P Disorders of other Rujuk Vertikal
digestive organs in
diseases classified
132304010623P000 09-06-2023 GENDHIS MUTIA PEGAWAI elsewhere
235 08:52 MUMTAZZAH SWASTA

170 132304010623P000 06-10-2023 10-06-2023 0000110813556 DJOKO SURYADI L PENERIMA Cerebral infarction, Rujuk Vertikal
315 09:30 PENSIUN PNS unspecified
SARAF RSU. UNIVERSITAS MUHAMMADIYAH
171 132304010623P000 06-10-2023 10-06-2023 0000202229559 ROAITUM P - Sequelae of Rujuk Vertikal
302 08:35 cerebrovascular
disease
172 132304010623P000 10-06-2023 Other specified
312 09:23 diseases and
conditions
complicating
06-10-2023 0000681979162 YANUARI NINGTYAS P PBI (APBN) pregnancy, Rujuk Vertikal
childbirth and the
puerperium
173 132304010623P000 06-10-2023 10-06-2023 0000783739664 PONIYEM P PBI (APBN) Chronic ischaemic Rujuk Vertikal
unspecified
174 132304010623P000 06-10-2023 10-06-2023 0000783976342 WIKE DIAN P PBI (APBN) Myasthenia gravis Rujuk Vertikal
308 08:57 KUSUMANINGRUM
175 132304010623P000 06-10-2023 10-06-2023 0000785410301 HALIZA APRILLIA P PBI (APBN) Anxiety disorder, Rujuk Vertikal
176 132304010623P000 06-10-2023 10-06-2023 0001380960044 ABDUL AZIZ L PEKERJA MANDIRI Heart failure, Rujuk Vertikal
JANTUNG DAN PEMBULURS PANTI WALUYA
177 132304010623P000 06-10-2023 10-06-2023 0001472085606 RUPIATI P PEKERJA MANDIRI Sequelae of Rujuk Vertikal
313 09:26 cerebral infarction
178 132304010623P000 06-10-2023 10-06-2023 0001544205014 PUGUH HANDOYO L PNS DAERAH Stroke, not Rujuk Vertikal
haemorrhage or
infarction
179 132304010623P000 06-10-2023 10-06-2023 0001703281757 HARIYANTO BASUKI L PBI (APBN) Hebephrenic Rujuk Vertikal
317 09:45 schizophrenia
180 132304010623P000 06-10-2023 10-06-2023 0001829252979 ALAN BAGUS L - Keratitis Rujuk Vertikal
321 10:13 JONATHAN
181 132304010623P000 06-10-2023 10-06-2023 0002044112668 CHOLIFAH P PBI (APBD) Other abnormal Rujuk Vertikal
297 08:25 uterine and vaginal
bleeding
182 132304010623P000 06-10-2023 10-06-2023 0002155204539 SUPIYAH P - Malignant Rujuk Vertikal
314 09:27 neoplasm of breast,
unspecified
183 132304010623P000 06-10-2023 10-06-2023 0002337187151 KIRAM JABAR KARIM L PEKERJA MANDIRI Pain, not elsewhere Rujuk Vertikal
184 132304010623P000 06-10-2023 10-06-2023 0002420185882 WARSITO L PBI (APBN) Unspecified injury Rujuk Vertikal
316 09:37 of thorax
185 132304010623P000 10-06-2023 aBIYYU DZAKWAN Developmental
311 09:23 FAEYzA disorder of speech
and language,
06-10-2023 0002465380967 L - unspecified Rujuk Vertikal
ANAK RSU HERMINA TANGKUBANPRAHU

186 132304010623P000 10-06-2023 PEGAWAI Disorders of
301 08:34 PEMERINTAH accommodation
DENGAN
06-10-2023 0002521070559 LUSI RAHMAWATI P PERJANJIAN Rujuk Vertikal
KERJA
187 132304010623P000 06-10-2023 10-06-2023 0002729012433 MISIYANTI P PBI (APBD) Cerebral infarction, Rujuk Vertikal
188 132304010623P000 06-10-2023 10-06-2023 0002730314068 HEPI WARSOADI L - Necrosis of pulp Rujuk Vertikal
303 08:36
from previous
06-10-2023 0002730341968 DIAH DWI ISMI AZIS P - surgery Rujuk Vertikal
OBGYN RSIA GALERI CANDRA

190 132304010623P000 06-10-2023 10-06-2023 0003111249723 AHMAD AMMAR L - Pain, not elsewhere Rujuk Vertikal
298 08:28 YULIANSYAH classified
191 132304010623P000 06-12-2023 12-06-2023 0000095146211 ALAN TRI ANAFI L PNS DAERAH Manic episode Rujuk Vertikal
334 08:58
192 132304010623P000 06-12-2023 12-06-2023 0000100342078 SAYUDHA PATRIA L - Disorder of patella, Rujuk Vertikal
ORTHOPEDI RSU HERMINA TANGKUBANPRAHU
193 132304010623P000 06-12-2023 12-06-2023 0000110979764 SOEWADI HADI L - Heart failure, Rujuk Vertikal
378 13:55 SISWOJO unspecified
194 132304010623P000 12-06-2023 PENERIMA Insulin-dependent
336 09:04 PENSIUN TNI diabetes mellitus
with unspecified
AGUS ABDUL complications
06-12-2023 0000111454773 L Rujuk Vertikal
ROCHIEM

195 132304010623P000 06-12-2023 12-06-2023 0000111468071 WARSINI P PENERIMA Presence of Rujuk Vertikal
325 08:27 PENSIUN TNI intraocular lens
196 132304010623P000 06-12-2023 12-06-2023 0000111709541 KASTARI L PENERIMA Other cataract Rujuk Vertikal
349 09:38 PENSIUN PNS
197 132304010623P000 06-12-2023 12-06-2023 0000111793961 SUMIATUN, AMD. PD P PENERIMA Fibromyalgia Rujuk Vertikal
372 10:59 PENSIUN PNS
198 132304010623P000 06-12-2023 12-06-2023 0000155661039 SOPIA FRANSINA P PNS DAERAH Malignant Rujuk Vertikal
347 09:32 WAMBRAUW neoplasm of breast,
unspecified
199 132304010623P000 06-12-2023 12-06-2023 0000197001742 NAZENDA GAEZANY P PNS DAERAH Necrosis of pulp Rujuk Vertikal
362 10:27 PUTRI ANDRARQY
200 132304010623P000 06-12-2023 12-06-2023 0000200891788 SUMARYONO L PENERIMA Chronic ischaemic Rujuk Vertikal
364 10:35 PENSIUN TNI heart disease,
unspecified
201 132304010623P000 06-12-2023 12-06-2023 0000783909707 Rr. YOEL P PBI (APBN) Schizophrenia Rujuk Vertikal
327 08:36 HARINDRATI
202 132304010623P000 06-12-2023 12-06-2023 0000783910462 MUHAMMAD L PBI (APBN) Epilepsy Rujuk Vertikal
326 08:34 SYAIFUDDIN
203 132304010623P000 12-06-2023 Non-insulin-
mellitus with
06-12-2023 0000784143077 TRI SUMARMIATI P PBI (APBN) ophthalmic Rujuk Vertikal
complications

204 132304010623P000 06-12-2023 12-06-2023 0000784163845 TUMIATUN P PBI (APBD) Other chronic Rujuk Vertikal
pulmonary disease
205 132304010623P000 06-12-2023 12-06-2023 0000784269909 SITI AMINAH P PBI (APBN) Chronic kidney Rujuk Vertikal
331 08:55 disease
Ginjal-Hipertensi RS PANTI WALUYA
206 132304010623P000 06-12-2023 12-06-2023 0000784988065 SITI SULAIMAH P PBI (APBN) Prolonged Rujuk Vertikal
340 09:11 pregnancy
207 06-12-2023 0000849014291 YULIANA DUKA P - Viral hepatitis Rujuk Vertikal
complicating
132304010623P000 12-06-2023 pregnancy,
366 10:37 childbirth and the
puerperium
208 132304010623P000 06-12-2023 12-06-2023 0001293536564 NANIK KUSTIANIK P PEKERJA MANDIRI Retained dental Rujuk Vertikal
370 10:51 root
209 132304010623P000 06-12-2023 12-06-2023 0001303884393 KHANZA MEIHRENA P - Necrosis of pulp Rujuk Vertikal
333 08:57 KURNIAPUTRI
GIGI PEDODONTIS RSUD Kota Malang
210 132304010623P000 06-12-2023 12-06-2023 0001316887492 SAYUDIANTO L PEKERJA MANDIRI Chronic kidney Rujuk Vertikal
343 09:18 disease
Ginjal-Hipertensi RS PANTI WALUYA
211 132304010623P000 12-06-2023 PEKERJA MANDIRI Non-insulin-
mellitus with
06-12-2023 0001380023853 ERNI WIDATI P multiple Rujuk Vertikal
complications

212 132304010623P000 12-06-2023 Non-insulin-
mellitus with
06-12-2023 0001385870398 ALI HARIONO L PBI (APBD) unspecified Rujuk Vertikal
complications
PENYAKIT DALAM RS SOEPRAOEN

213 132304010623P000 06-12-2023 12-06-2023 0001398279791 EKO JULI L PEKERJA MANDIRI Other chronic Rujuk Vertikal
352 09:45 ENDROATMOKO obstructive
pulmonary disease
214 132304010623P000 06-12-2023 12-06-2023 0001403205941 Sugondo L PBI (APBD) Parkinson's disease Rujuk Vertikal
339 09:09
215 132304010623P000 06-12-2023 12-06-2023 0001719849047 SRI WILUJENG P PBI (APBD) Disorders of Rujuk Vertikal
216 132304010623P000 06-12-2023 12-06-2023 0001719849071 RAFA ALEXANDRIA L PBI (APBD) Disorders of Rujuk Vertikal
367 10:45 PUTRA HARIYANTO accommodation
217 132304010623P000 06-12-2023 12-06-2023 0001815273224 UMMU MASULAH P PEKERJA MANDIRI Chronic Rujuk Vertikal
342 09:14 periodontitis
GIGI ENDODONSI RS Universitas Brawijaya
218 132304010623P000 06-12-2023 12-06-2023 0002104826218 DICKY ENJASTA L - Impacted teeth Rujuk Vertikal
357 10:05 PUTRA
219 132304010623P000 06-12-2023 12-06-2023 0002221387795 MOCH. ANWAR L PEKERJA MANDIRI Schizophrenia Rujuk Vertikal
324 08:22
220 132304010623P000 06-12-2023 12-06-2023 0002255162163 GINA ANDRIANA P PEKERJA MANDIRI Other Rujuk Vertikal
350 09:39 schizoaffective
disorders
221 132304010623P000 06-12-2023 12-06-2023 0002474501027 HANNA MARIAM P - Necrosis of pulp Rujuk Vertikal
346 09:26
GIGI ENDODONSI RSUD Kota Malang
222 132304010623P000 06-12-2023 12-06-2023 0002483182721 SETYONINGSIH P PEGAWAI Heart failure, Rujuk Vertikal
359 10:11 SWASTA unspecified
JANTUNG DAN PEMBULUKLINIK JANTUNG HASNA MEDIKA
223 132304010623P000 06-12-2023 12-06-2023 0002601990033 ANA INDRAWATI P PBI (APBN) Caries of dentine Rujuk Vertikal
330 08:50
224 132304010623P000 06-12-2023 12-06-2023 0002728834817 JEVONZA QAF JEVA L - Necrosis of pulp Rujuk Vertikal
375 11:10 REBELIO PRADOYO
GIGI PEDODONTIS RSU HERMINA TANGKUBANPRAHU
225 132304010623P000 06-12-2023 12-06-2023 0002730225936 SUTIONO L PBI (APBN) Cerebral infarction Rujuk Vertikal
356 09:57
226 132304010623P000 06-12-2023 12-06-2023 0002730259372 MARIA ULFA P PEGAWAI Retained dental Rujuk Vertikal
355 09:55 SWASTA root
227 132304010623P000 06-12-2023 12-06-2023 0002730308679 RIAN ABDILLAH L - Necrosis of pulp Rujuk Vertikal
361 10:14 NURDZAKY
228 132304010623P000 06-12-2023 12-06-2023 0002732864793 ERNA WATI P PBI (APBN) Malignant Rujuk Vertikal
338 09:08 neoplasm of breast,
unspecified
229 132304010623P000 06-12-2023 12-06-2023 0002752805294 ENI HERLINAWATI P PEKERJA MANDIRI Enlarged lymph Rujuk Vertikal
345 09:24 nodes, unspecified
230 132304010623P000 12-06-2023 Non-insulin-
mellitus with
06-12-2023 0002764307439 MUALIMAH P PBI (APBD) unspecified Rujuk Vertikal
complications

231 132304010623P000 06-12-2023 12-06-2023 0002930250677 BRANDO GIOVI L PEGAWAI Childhood autism Rujuk Vertikal
337 09:08 RASTAWAN SWASTA
Installasi Rehabilitasi MedKLINIK HUSADA ASIH
232 132304010623P000 06-12-2023 12-06-2023 0003525532536 FATIMATUS ZAHRA P PBI (APBD) Patent ductus Rujuk Vertikal
376 11:12 arteriosus
Anak Kardiologi RUMAH SAKIT LAVALETTE
233 132304010623P000 13-06-2023 13-06-2023 0000111725515 SAHID L - Chronic ischaemic Rujuk Vertikal
379 00:00 08:02 heart disease,
unspecified
234 132304010623P000 13-06-2023 13-06-2023 0000784246566 AYU MEGAWATI P - Caries of dentine Rujuk Vertikal
403 00:00 10:08 PUTRI
235 132304010623P000 13-06-2023 13-06-2023 Severe depressive
404 00:00 10:14 episode with
psychotic
0000784383096 ERIK HERMANSSAH L PBI (APBN) symptoms Rujuk Vertikal

236 132304010623P000 13-06-2023 13-06-2023 0000784642419 JANES ANDIKA L PBI (APBN) Retained dental Rujuk Vertikal
391 00:00 09:16 POLESTRINA SUWAJI root
237 132304010623P000 13-06-2023 13-06-2023 0001049548454 SULIKAH. P PBI (APBN) Heart failure, Rujuk Vertikal
398 00:00 09:57 unspecified
238 132304010623P000 13-06-2023 13-06-2023 0001301251972 AHMAD AKHSAN L PNS DAERAH Infantile cerebral Rujuk Vertikal
385 00:00 08:43 HABIBI palsy, unspecified
239 132304010623P000 13-06-2023 13-06-2023 0001384717825 sudarwinarni P PEKERJA MANDIRI Schizophrenia Rujuk Vertikal
389 00:00 08:57
240 132304010623P000 13-06-2023 13-06-2023 0001448280415 FRANSISKA SULIKAH P PBI (APBD) Heart failure, Rujuk Vertikal
241 132304010623P000 13-06-2023 13-06-2023 0001450875598 SUWANDI L - Hyperplasia of Rujuk Vertikal
396 00:00 09:51 prostate
242 132304010623P000 13-06-2023 13-06-2023 0001637285332 LUDIYAH PRASTIWI P PEKERJA MANDIRI Other venous Rujuk Vertikal
384 00:00 08:41 embolism and
thrombosis
243 132304010623P000 13-06-2023 13-06-2023 0001791660958 TRIYANI PRISTIWATI P PBI (APBD) Cerebral infarction, Rujuk Vertikal
244 132304010623P000 13-06-2023 13-06-2023 0001810622079 NANANG L - Spondylolisthesis Rujuk Vertikal
411 00:00 10:58 WICAKSONO
SARAF RSUD Kota Malang
245 132304010623P000 13-06-2023 13-06-2023 0001962353362 TRI MARGONO L PBI (APBN) Keratitis Rujuk Vertikal
381 00:00 08:38
246 132304010623P000 13-06-2023 13-06-2023 0002108062012 DEWI INTAN P - Amenorrhoea, Rujuk Vertikal
412 00:00 11:31 PERMATA SARI R. J. unspecified
PIRAS
247 132304010623P000 13-06-2023 13-06-2023 PEKERJA MANDIRI Specific
386 00:00 08:51 developmental
disorders of speech
0002230874122 alesha keinarra rahendra P and language Rujuk Vertikal

248 132304010623P000 13-06-2023 13-06-2023 0002241488834 DONNY L - Psoriasis Rujuk Vertikal
405 00:00 10:16
249 132304010623P000 13-06-2023 13-06-2023 0002304625443 MOCH ZAINUDIN L PEKERJA MANDIRI Heart failure, Rujuk Vertikal
250 132304010623P000 13-06-2023 13-06-2023 PENERIMA Diseases of vocal
400 00:00 09:59 PENSIUN POLRI cords and larynx,
ENOS IMANUEL not elsewhere
0002441799505 L classified Rujuk Vertikal
SIRAIT
ANAK RSIA MARDI WALOEJA KAUMAN

251 132304010623P000 13-06-2023 13-06-2023 NIRMALA SEKAR Hypertrophy of
413 00:00 13:22 KEDATON tonsils with
0002469815425 P - hypertrophy of Rujuk Vertikal
adenoids
THT-KL RS ISLAM MALANG UNISMA
252 132304010623P000 13-06-2023 13-06-2023 Maternal care due
383 00:00 08:40 to uterine scar
from previous
0002728943144 MILA WINDI ASTUTIK P PBI (APBD) surgery Rujuk Vertikal

253 132304010623P000 13-06-2023 13-06-2023 0002729046745 ANANG MUJOKO L PBI (APBD) Malignant Rujuk Vertikal
406 00:00 10:18 neoplasm of
rectum
254 132304010623P000 13-06-2023 13-06-2023 0002730013198 LELLY AYU P PEGAWAI Haemorrhage in Rujuk Vertikal
392 00:00 09:31 ANGGRAINI SWASTA early pregnancy
255 132304010623P000 13-06-2023 13-06-2023 0002742123598 ANTONIUS DWI L PBI (APBD) Stroke, not Rujuk Vertikal
399 00:00 09:58 SANTOSO specified as
haemorrhage or
infarction
256 132304010623P000 13-06-2023 13-06-2023 0002845959827 SUWANDI L PBI (APBN) Stroke, not Rujuk Vertikal
393 00:00 09:39 specified as
haemorrhage or
infarction
257 132304010623P000 13-06-2023 13-06-2023 0003522971081 BAYI NYONYA ANIS P PBI (APBD) Bacterial sepsis of Rujuk Vertikal
397 00:00 09:56 SUPRIATIN newborn
258 132304010623P000 14-06-2023 14-06-2023 0000111455695 GINI P VETERAN Hereditary Rujuk Vertikal
444 00:00 09:47 sideroblastic
anaemia
259 132304010623P000 14-06-2023 14-06-2023 0000111782428 AV. SUSIYANTONO L - Hypertensive heart Rujuk Vertikal
467 00:00 11:17 disease
260 132304010623P000 14-06-2023 14-06-2023 0000111849467 MOCHAMAD NA'IB L PENERIMA Chronic ischaemic Rujuk Vertikal
438 00:00 09:23 PENSIUN PNS heart disease,
unspecified
JANTUNG DAN PEMBULURS PANTI NIRMALA
261 132304010623P000 14-06-2023 14-06-2023 0000628223523 PUJI SETIOWATI P PBI (APBN) Impacted teeth Rujuk Vertikal
466 00:00 11:12
262 132304010623P000 14-06-2023 14-06-2023 0000723493978 HAQIU NUR DINA P PBI (APBN) Maternal care for Rujuk Vertikal
462 00:00 10:44 UTOMO disproportion,
unspecified
263 132304010623P000 14-06-2023 14-06-2023 0000784158063 ITA RO'AISAH P PBI (APBN) Schizoaffective Rujuk Vertikal
448 00:00 09:55 disorder, manic
type
264 132304010623P000 14-06-2023 14-06-2023 0000784343981 SAFINA P PBI (APBN) Multiple sclerosis Rujuk Vertikal
432 00:00 09:09 KHAIRUNNISA N
265 0000784380857 DULIMA P - Benign neoplasm Rujuk Vertikal
of peripheral
nerves and
132304010623P000 14-06-2023 14-06-2023 autonomic nervous
463 00:00 10:46 system

266 132304010623P000 14-06-2023 14-06-2023 0000784540359 SASHA MALINI P PEGAWAI Anisometropia and Rujuk Vertikal
468 00:00 11:20 SWASTA aniseikonia
267 132304010623P000 14-06-2023 14-06-2023 0000784862561 DIAN ISTIGHFAR RINI P PBI (APBN) Benign neoplasm Rujuk Vertikal
453 00:00 10:01 of breast
268 132304010623P000 14-06-2023 14-06-2023 Abnormal uterine
437 00:00 09:23 and vaginal
bleeding,
0000785173757 SUNARYATI P - unspecified Rujuk Vertikal

269 132304010623P000 14-06-2023 14-06-2023 0001049545462 SUSWATI P PBI (APBN) Impacted teeth Rujuk Vertikal
464 00:00 10:55
GIGI BEDAH MULUT RSI AISYIYAH MALANG
270 132304010623P000 14-06-2023 14-06-2023 0001049546913 WARSIAH P PBI (APBN) Cerebral infarction, Rujuk Vertikal
271 132304010623P000 14-06-2023 14-06-2023 0001279727436 SURYANTI P PEKERJA MANDIRI Fibrosis and Rujuk Vertikal
456 00:00 10:15 cirrhosis of liver
272 132304010623P000 14-06-2023 14-06-2023 0001323435521 KATHARINA ASIH P PEGAWAI Necrosis of pulp Rujuk Vertikal
430 00:00 09:07 WIJATI SWASTA
273 132304010623P000 14-06-2023 14-06-2023 0001403228349 SAMIATI P PBI (APBD) Low back pain Rujuk Vertikal
435 00:00 09:17
274 132304010623P000 14-06-2023 14-06-2023 0001423534331 lasmini P - Sequelae of Rujuk Vertikal
442 00:00 09:40 cerebrovascular
disease
SARAF Klinik Utama Bunga Melati
275 132304010623P000 14-06-2023 14-06-2023 0001424620664 TIQAH AMBARWATI P PEKERJA MANDIRI Pulpitis Rujuk Vertikal
443 00:00 09:46 NINGTYAS
276 132304010623P000 14-06-2023 14-06-2023 PEKERJA MANDIRI Non-insulin-
460 00:00 10:33 dependent diabetes
mellitus with
0001439025006 SUJILAH P unspecified Rujuk Vertikal
complications

277 132304010623P000 14-06-2023 14-06-2023 0001904417561 CASNOAH P PBI (APBD) Other cataract Rujuk Vertikal
439 00:00 09:25
278 132304010623P000 14-06-2023 14-06-2023 0002102056301 DANANG SUKMA L - Anogenital Rujuk Vertikal
481 00:00 12:11 SAPUTRA (venereal) warts
KULIT KELAMIN RSU HERMINA TANGKUBANPRAHU
279 132304010623P000 14-06-2023 14-06-2023 0002155204585 SUGIANTO L PBI (APBN) Heart failure, Rujuk Vertikal
280 132304010623P000 14-06-2023 14-06-2023 0002198203481 suhariyanto L - Other chronic Rujuk Vertikal
454 00:00 10:03 obstructive
pulmonary disease
281 132304010623P000 14-06-2023 14-06-2023 PEKERJA MANDIRI Developmental
469 00:00 11:33 disorder of speech
and language,
0002204843589 aditya natalion susanto L unspecified Rujuk Vertikal

282 132304010623P000 14-06-2023 14-06-2023 PEKERJA MANDIRI Acute upper
446 00:00 09:52 respiratory
infections of
AQEEL MUSA AL multiple and
0002213746896 L Rujuk Vertikal
FATIH unspecified sites
ANAK RSUD Kota Malang

283 132304010623P000 14-06-2023 14-06-2023 AQEELA MARYAM PEKERJA MANDIRI Acute upper
447 00:00 09:54 AZZAHRA respiratory
infections of
0002213747335 P multiple and Rujuk Vertikal
unspecified sites

284 132304010623P000 14-06-2023 14-06-2023 0002241449008 SATIN P PEGAWAI Other cataract Rujuk Vertikal
428 00:00 08:39 SWASTA
285 132304010623P000 14-06-2023 14-06-2023 0002280478263 NURUL HANDAYANI P PEKERJA MANDIRI Malignant Rujuk Vertikal
470 00:00 11:39 neoplasm of cervix
uteri
onkologi ginekologi RUMAH SAKIT LAVALETTE
286 132304010623P000 14-06-2023 14-06-2023 ARCANA LANGIT Developmental
500 00:00 13:23 GIANRASTRA disorder of speech
and language,
0002444797157 L - unspecified Rujuk Vertikal

287 132304010623P000 14-06-2023 14-06-2023 ARSY KHADEEJAH PEKERJA MANDIRI Acute upper
449 00:00 09:56 AZZAHWA respiratory
infections of
0002477158391 P multiple and Rujuk Vertikal
unspecified sites

288 132304010623P000 14-06-2023 14-06-2023 GREGORIUS JOAN Contact with and
457 00:00 10:20 ARION NUGROHO exposure to
communicable
0002498623299 L - diseases Rujuk Vertikal

289 132304010623P000 14-06-2023 14-06-2023 0002610234641 SUNARJO L PBI (APBN) Sequelae of Rujuk Vertikal
426 00:00 08:23 cerebral infarction
290 132304010623P000 14-06-2023 14-06-2023 0002729069919 NUR YADI L PBI (APBD) Other conduction Rujuk Vertikal
451 00:00 09:59 disorders
291 132304010623P000 14-06-2023 14-06-2023 0002730251439 SUTIAH P PBI (APBD) Retained dental Rujuk Vertikal
436 00:00 09:22 root
292 132304010623P000 14-06-2023 14-06-2023 0002730366156 YUDI LISTIONO L PBI (APBD) Chronic kidney Rujuk Vertikal
458 00:00 10:27 disease
from previous
0002845962112 INDRA NURSIAH P PBI (APBN) surgery Rujuk Vertikal
OBGYN RSIA MUHAMMADIYAH MALANG

294 132304010623P000 14-06-2023 14-06-2023 0002903600294 OKTAVIAN AZMI L PBI (APBN) Necrosis of pulp Rujuk Vertikal
440 00:00 09:33 WIDYA PUTRA
295 132304010623P000 15-06-2023 15-06-2023 0000110597286 FREDDYAN LAKSA L - Periapical abscess Rujuk Vertikal
603 00:00 11:36 KUSUMA without sinus
296 132304010623P000 15-06-2023 15-06-2023 0000111104471 SUNARTI P PNS DAERAH Other surgical Rujuk Vertikal
580 00:00 11:15 follow-up care
297 132304010623P000 15-06-2023 15-06-2023 0000111717044 Indajah Soemiati P PENERIMA Myopia Rujuk Vertikal
550 00:00 10:45 PENSIUN PNS
298 132304010623P000 15-06-2023 15-06-2023 0000115793662 SRI WIDYAWATI P PNS DAERAH Necrosis of pulp Rujuk Vertikal
520 00:00 09:39
299 132304010623P000 15-06-2023 15-06-2023 0000783235844 TOHIR L PBI (APBN) Pain, not elsewhere Rujuk Vertikal
581 00:00 11:17 classified
300 132304010623P000 15-06-2023 15-06-2023 0000784039871 PROBONINGRUM L PBI (APBD) Retained dental Rujuk Vertikal
523 00:00 09:46 WURAGIL KUNING root
301 132304010623P000 15-06-2023 15-06-2023 Other specified
514 00:00 09:10 0000784626221 SUPANGAT L - surgical follow-up Rujuk Vertikal
care
302 132304010623P000 15-06-2023 15-06-2023 0001049533931 MOCH MUKTI L PBI (APBN) Hypertensive heart Rujuk Vertikal
518 00:00 09:36 disease
303 132304010623P000 15-06-2023 15-06-2023 0001125482793 ERWIN SANTOSO L PEGAWAI Fever of other and Rujuk Vertikal
517 00:00 09:34 SWASTA unknown origin
304 132304010623P000 15-06-2023 15-06-2023 0001436276171 LISTIANa SUGIARTI P PEKERJA MANDIRI Chronic ischaemic Rujuk Vertikal
unspecified
305 132304010623P000 15-06-2023 15-06-2023 0001815768426 MOCHAMMAD PUTRA L PEGAWAI Necrosis of pulp Rujuk Vertikal
513 00:00 09:07 ARUL PRATAMA SWASTA
306 132304010623P000 15-06-2023 15-06-2023 0002155204517 SUPRAPTI P PBI (APBD) Epilepsy Rujuk Vertikal
510 00:00 08:51
307 132304010623P000 15-06-2023 15-06-2023 0002159261818 WIJI ANDAYANI P PBI (APBD) Anisometropia and Rujuk Vertikal
508 00:00 08:44 aniseikonia
308 132304010623P000 15-06-2023 15-06-2023 0002219233026 RENDRA WIRAWAN L PEGAWAI Cervical disc Rujuk Vertikal
582 00:00 11:19 SWASTA disorder with
myelopathy
Tulang Belakang RS PERSADA HOSPITAL
309 132304010623P000 15-06-2023 15-06-2023 PEKERJA MANDIRI Insulin-dependent
509 00:00 08:49 diabetes mellitus
with unspecified
0002308993277 MULYONO L complications Rujuk Vertikal

310 132304010623P000 15-06-2023 15-06-2023 0002458334924 EDY WINARNO L PBI (APBD) Other specified Rujuk Vertikal
522 00:00 09:45 disorders of kidney
and ureter
UROLOGI RS PANTI WALUYA
311 132304010623P000 15-06-2023 15-06-2023 0002728840015 MOHAMAT AZRIEL L - Osteomyelitis, Rujuk Vertikal
530 00:00 10:11 FIRMANSYAH unspecified
312 132304010623P000 15-06-2023 15-06-2023 MUHAMMAD PEGAWAI Developmental
521 00:00 09:44 ABRISAM ATHAZAKY SWASTA disorder of speech
RAFISQY and language,
0002909589434 L unspecified Rujuk Vertikal

313 132304010623P000 15-06-2023 15-06-2023 Developmental
534 00:00 10:17 disorder of speech
GHAIZAN AHMAD and language,
0003058783132 L PBI (APBD) unspecified Rujuk Vertikal
NABIL

314 132304010623P000 16-06-2023 16-06-2023 0000111735369 SUWANDI L - Senile cataract, Rujuk Vertikal
315 132304010623P000 16-06-2023 16-06-2023 0000783959376 IDAWIYAH P PBI (APBN) Chronic ischaemic Rujuk Vertikal
unspecified
316 132304010623P000 16-06-2023 16-06-2023 0000784379597 KUSMIATI P - Congestive heart Rujuk Vertikal
676 00:00 09:46 failure
317 132304010623P000 16-06-2023 16-06-2023 0000784790346 SITI MARIYAH P PBI (APBN) Cerebral infarction, Rujuk Vertikal
SARAF RS SOEPRAOEN
318 132304010623P000 16-06-2023 16-06-2023 0000785370238 TASLAN L PBI (APBN) Chronic ischaemic Rujuk Vertikal
unspecified
319 132304010623P000 16-06-2023 16-06-2023 0000785405575 MISIONO L PBI (APBD) Schizophrenia Rujuk Vertikal
669 00:00 09:16
JIWA RS SOEPRAOEN
320 132304010623P000 16-06-2023 16-06-2023 0000785406205 MISTUN P PBI (APBD) Cataract, Rujuk Vertikal
321 132304010623P000 16-06-2023 16-06-2023 0000785407162 MOCH. SOBIRIN L PBI (APBD) Periapical abscess Rujuk Vertikal
670 00:00 09:19 without sinus
322 132304010623P000 16-06-2023 16-06-2023 0001438864119 SITI FATIMAH P - Other vitreous Rujuk Vertikal
680 00:00 10:12 opacities
323 132304010623P000 16-06-2023 16-06-2023 0001439479405 MAISARO P PBI (APBD) Scleritis Rujuk Vertikal
665 00:00 08:44
324 132304010623P000 16-06-2023 16-06-2023 Other specified
683 00:00 10:42 diseases and
conditions
complicating
0001701722867 YULIATI P - pregnancy, Rujuk Vertikal
childbirth and the
puerperium
325 132304010623P000 16-06-2023 16-06-2023 0001803719913 T. RAHAYUNINGSIH P PEKERJA MANDIRI Disorder of Rujuk Vertikal
666 00:00 08:52 vitreous body,
unspecified
326 132304010623P000 16-06-2023 16-06-2023 0001963911047 ABIYE P - Disorder of Rujuk Vertikal
673 00:00 09:34 vitreous body,
unspecified
327 132304010623P000 16-06-2023 16-06-2023 0002164755159 NUR ALIFAH P PBI (APBD) Schizophrenia Rujuk Vertikal
663 00:00 08:36
328 0002728965734 RACHMAD YUWONO L - Follow-up Rujuk Vertikal
examination after
treatment for
132304010623P000 16-06-2023 16-06-2023 conditions other
677 00:00 09:58 than malignant
neoplasms

329 132304010623P000 16-06-2023 16-06-2023 0003511754065 ELLY MURNIATI P - Fracture of upper Rujuk Vertikal
678 00:00 10:00 end of humerus
330 132304010623P000 17-06-2023 17-06-2023 0000033145852 ARIES GUNAWAN L - Fracture of upper Rujuk Vertikal
827 00:00 10:21 end of humerus
ORTHOPEDI RSUD Kota Malang
331 132304010623P000 17-06-2023 17-06-2023 0000111244285 DONNY SANDITO L - Anisometropia and Rujuk Vertikal
804 00:00 08:09 WIDOYOKO aniseikonia
332 132304010623P000 17-06-2023 17-06-2023 0000111502989 CAHYA L PNS PUSAT Necrosis of pulp Rujuk Vertikal
817 00:00 09:23 HERLAMBANG
333 132304010623P000 17-06-2023 17-06-2023 0000198078153 GENDIS P - Chronic Rujuk Vertikal
826 00:00 10:17 NIANDRAPRADNYA periodontitis
GIGI PERIODONTI RS BHIRAWA BHAKTI
334 132304010623P000 17-06-2023 17-06-2023 0000205576525 SUROTO L - Calculus of kidney Rujuk Vertikal
816 00:00 09:15 and ureter
335 0000783969682 NGATENI P PBI (APBN) Dislocation, sprain Rujuk Vertikal
and strain of joints
and ligaments of
132304010623P000 17-06-2023 17-06-2023 lumbar spine and
811 00:00 08:55 pelvis

336 132304010623P000 17-06-2023 17-06-2023 0000784316103 SUNARIYAH P - Glaucoma Rujuk Vertikal
805 00:00 08:18
337 132304010623P000 17-06-2023 17-06-2023 PEGAWAI Chronic apical
824 00:00 10:01 PEMERINTAH periodontitis
DENGAN
0000784331864 ELRA SAFA OWENA P PERJANJIAN Rujuk Vertikal
KERJA
338 132304010623P000 17-06-2023 17-06-2023 0000784417588 NUR HAYATI P PBI (APBD) Disorder of visual Rujuk Vertikal
818 00:00 09:24 pathways,
unspecified
339 132304010623P000 17-06-2023 17-06-2023 0000966138557 ROSALINA P - Fibroadenosis of Rujuk Vertikal
822 00:00 09:49 HEATUBUN breast
BEDAH RS MELATI HUSADA
340 132304010623P000 17-06-2023 17-06-2023 0001278792426 LAILATUL MUFIDA P - Isolated proteinuria Rujuk Vertikal
830 00:00 10:36
341 132304010623P000 17-06-2023 17-06-2023 PEKERJA MANDIRI Acute transverse
810 00:00 08:52 myelitis in
demyelinating
disease of central
nervous system
0001407419717 ERICA DIAN KHIRANA P Rujuk Vertikal

342 132304010623P000 17-06-2023 17-06-2023 0001838176874 SITI MAQIKYAH P PNS DAERAH Pulpitis Rujuk Vertikal
815 00:00 09:10
343 132304010623P000 17-06-2023 17-06-2023 0001855492468 MEYLITA SISKA P PBI (APBD) Pulpitis Rujuk Vertikal
808 00:00 08:40 PUTRI
344 132304010623P000 17-06-2023 17-06-2023 0002032150342 INDAH YULIATI P PEKERJA MANDIRI Disorder of visual Rujuk Vertikal
819 00:00 09:29 pathways,
unspecified
345 132304010623P000 17-06-2023 17-06-2023 0002300085808 CINDY MEGARANI P PEKERJA MANDIRI Other infection of Rujuk Vertikal
825 00:00 10:06 genital tract
following delivery
346 132304010623P000 17-06-2023 17-06-2023 0002317725753 M. ZEINADEN-AL L - Necrosis of pulp Rujuk Vertikal
806 00:00 08:27 ABIDIN
347 132304010623P000 17-06-2023 17-06-2023 0003090195369 AALIYA LATHIFAH P PBI (APBD) Juvenile Rujuk Vertikal
821 00:00 09:48 ZUHRA' rheumatoid
arthritis
Anak Alergi Imunologi RUMAH SAKIT LAVALETTE
348 132304010623P001 19-06-2023 19-06-2023 0000110211772 SUBAKRI L PNS DAERAH Glaucoma Rujuk Vertikal
075 00:00 14:59
349 132304010623P001 19-06-2023 19-06-2023 0000111422507 MUSYAROFAH P VETERAN Epilepsy Rujuk Vertikal
068 00:00 14:47
350 132304010623P000 19-06-2023 19-06-2023 0000111793511 SUDORO RUKMI P PENERIMA Parkinson's disease Rujuk Vertikal
991 00:00 09:04 PENSIUN PNS
351 132304010623P000 19-06-2023 19-06-2023 0000194006823 CHANAYA FILZAH P - Impacted teeth Rujuk Vertikal
990 00:00 09:03 IRREZTU
GIGI BEDAH MULUT RUMAH SAKIT LAVALETTE
352 132304010623P000 19-06-2023 19-06-2023 0000783224932 DESTA PUTRI P PBI (APBN) Unspecified Rujuk Vertikal
992 00:00 09:05 MAHARANI haematuria
ANAK RS SOEPRAOEN
353 132304010623P001 19-06-2023 19-06-2023 0000784129522 BOIMIN L PBI (APBN) Paraplegia and Rujuk Vertikal
069 00:00 14:49 tetraplegia
SARAF RS SOEPRAOEN
354 132304010623P000 19-06-2023 19-06-2023 0000784162686 LILIK ANAH P - Periapical abscess Rujuk Vertikal
984 00:00 08:05 without sinus
355 132304010623P001 19-06-2023 19-06-2023 0000784508758 KUSMAWATI P PEKERJA MANDIRI Mechanical Rujuk Vertikal
084 00:00 15:09 complication of
intraocular lens
356 132304010623P001 19-06-2023 19-06-2023 0000784634804 MISURIP P PBI (APBN) Multiple valve Rujuk Vertikal
072 00:00 14:55 diseases
357 132304010623P001 19-06-2023 19-06-2023 0000784796973 GHEA NAJWA P - Chronic apical Rujuk Vertikal
004 00:00 10:21 ALLANIS periodontitis
358 132304010623P001 19-06-2023 19-06-2023 0000976472818 KEVIN ADITYA L PBI (APBD) Fracture of lower Rujuk Vertikal
078 00:00 15:03 PRASETYA end of radius
ORTHOPEDI RS SOEPRAOEN
359 132304010623P001 19-06-2023 19-06-2023 0001271530945 MARJALAN L PBI (APBD) Cerebral infarction, Rujuk Vertikal
360 132304010623P001 19-06-2023 19-06-2023 0001283222755 SETO SUDIHARTADI L PEKERJA MANDIRI Chronic kidney Rujuk Vertikal
070 00:00 14:51 disease
361 132304010623P001 19-06-2023 19-06-2023 0001283223227 A. TYAS NURANI K P PEKERJA MANDIRI Other disorders of Rujuk Vertikal
071 00:00 14:53 lens
362 132304010623P001 19-06-2023 19-06-2023 0001283837005 DIAN RULITA P PBI (APBD) Disorders of Rujuk Vertikal
073 00:00 14:56 accommodation
363 132304010623P001 19-06-2023 19-06-2023 0001310802682 asmari L PEKERJA MANDIRI Chronic myeloid Rujuk Vertikal
076 00:00 15:00 leukaemia
364 132304010623P001 19-06-2023 19-06-2023 0001326036868 YULI PARMASARI P PBI (APBD) Polyp of corpus Rujuk Vertikal
006 00:00 10:25 uteri
365 132304010623P001 19-06-2023 19-06-2023 0001390457351 SUMARAH P PEKERJA MANDIRI Spondylosis, Rujuk Vertikal
366 132304010623P001 19-06-2023 19-06-2023 0001403168837 AMELIA NURAINI P PBI (APBD) Pulpitis Rujuk Vertikal
012 00:00 10:48 FADILA
367 132304010623P001 19-06-2023 19-06-2023 0001471446731 YUAWIN L PBI (APBD) Chronic kidney Rujuk Vertikal
077 00:00 15:01 disease
368 132304010623P001 19-06-2023 19-06-2023 0001601308607 WENI HERU P PBI (APBN) Missed abortion Rujuk Vertikal
007 00:00 10:30 WULANDARI
369 132304010623P001 19-06-2023 19-06-2023 Spontaneous
008 00:00 10:34 abortion,
incomplete,
0001601313996 ANIZZATUZZAHROH P PBI (APBD) without Rujuk Vertikal
complication
OBGYN RSIA MUHAMMADIYAH MALANG
370 132304010623P001 19-06-2023 19-06-2023 0001702872066 MOCHAMAD RONI L - Eustachian tube Rujuk Vertikal
081 00:00 15:06 disorder,
unspecified
THT-KL RS ISLAM MALANG UNISMA
371 132304010623P001 19-06-2023 19-06-2023 0001861181313 EDIKA L - Retained dental Rujuk Vertikal
010 00:00 10:37 root
372 132304010623P001 19-06-2023 19-06-2023 Maternal care for
001 00:00 10:07 known or
suspected
0001903930018 HETI SUMARLINA P PBI (APBN) malpresentation of Rujuk Vertikal
fetus
373 132304010623P001 19-06-2023 19-06-2023 0001908143065 ZAIDAN ALMAHDI L - Fracture of tooth Rujuk Vertikal
014 00:00 11:23
GIGI PEDODONTIS RSIA PURI
374 132304010623P001 19-06-2023 19-06-2023 0001908148116 titik suwarni P PBI (APBD) Cerebral infarction Rujuk Vertikal
079 00:00 15:04
375 132304010623P000 19-06-2023 19-06-2023 0001990140298 DEWI INTAN SARI P - Necrosis of pulp Rujuk Vertikal
989 00:00 08:54
376 132304010623P001 19-06-2023 19-06-2023 0002065977224 MUHAMMAD L PBI (APBD) Congenital Rujuk Vertikal
082 00:00 15:07 KHOIRUDDIIN malformations of
cardiac septa
377 132304010623P000 19-06-2023 19-06-2023 0002227498378 MAULANA HABIB L - Necrosis of pulp Rujuk Vertikal
997 00:00 09:34 YUDYANTO
378 132304010623P001 19-06-2023 19-06-2023 0002241189371 FITRI AUDIA P - Impacted teeth Rujuk Vertikal
013 00:00 11:06
379 132304010623P001 19-06-2023 19-06-2023 Stroke, not
066 00:00 14:45 specified as
0002310864625 SARTINI P - haemorrhage or Rujuk Vertikal
infarction
380 132304010623P001 19-06-2023 19-06-2023 Other spontaneous
064 00:00 14:42 disruption of
ligament(s) of knee
0002427319247 NINDITA AMADEA P - Rujuk Vertikal

381 132304010623P001 19-06-2023 19-06-2023 0002631058571 ISTIANAH P - Disorders of Rujuk Vertikal
063 00:00 14:36 accommodation
382 132304010623P001 19-06-2023 19-06-2023 0002730226151 SUYONO L - Cerebral infarction, Rujuk Vertikal
383 132304010623P001 19-06-2023 19-06-2023 0002730242687 HARIYANTO L PBI (APBD) Other cataract Rujuk Vertikal
080 00:00 15:05
384 132304010623P001 19-06-2023 19-06-2023 0002730244803 FARIDHATUS P PEGAWAI Viral hepatitis Rujuk Vertikal
000 00:00 10:04 SHOLIHAH SWASTA complicating
pregnancy,
childbirth and the
puerperium
from previous
0002750654147 FELLA AGRITASARI P PBI (APBD) surgery Rujuk Vertikal

386 132304010623P001 19-06-2023 19-06-2023 Iodine-deficiency-
083 00:00 15:08 related thyroid
disorders and allied
0002814518272 SRI KUSMIATI P PBI (APBN) conditions Rujuk Vertikal

387 132304010623P000 19-06-2023 19-06-2023 0002845956756 SUMIATI P PBI (APBN) Ulcerative colitis Rujuk Vertikal
988 00:00 08:53
388 132304010623P001 19-06-2023 19-06-2023 0003057182998 AHMAD HAFIDZ L - Other disorders of Rujuk Vertikal
016 00:00 11:43 BILFAQIH ear, not elsewhere
classified
THT-KL RSIA PURI

389 132304010623P001 19-06-2023 19-06-2023 0003077037235 RUNNA AZZAHRA P PEGAWAI Epilepsy Rujuk Vertikal
003 00:00 10:12 CAHYANI SWASTA
390 132304010623P001 20-06-2023 20-06-2023 0000034531367 GENDUT SUGITO L - Other cataract Rujuk Vertikal
090 00:00 09:06
MATA RSU HERMINA TANGKUBANPRAHU
391 132304010623P001 20-06-2023 20-06-2023 0000100460531 SULISTINA P PNS DAERAH Carpal tunnel Rujuk Vertikal
112 00:00 11:01 syndrome
PENYAKIT DALAM RS PANTI WALUYA
392 132304010623P001 20-06-2023 21-06-2023 Insulin-dependent
with unspecified
0000100471162 IRWAN BAGA L PNS DAERAH complications Rujuk Vertikal
Endokrin-Metabolik-DiabeRUMAH SAKIT LAVALETTE

393 132304010623P001 20-06-2023 20-06-2023 0000111454975 M. DJAMIL L PENERIMA Presence of Rujuk Vertikal
086 00:00 08:35 PENSIUN TNI intraocular lens
394 132304010623P001 20-06-2023 20-06-2023 0000111463176 SURATI P PENERIMA Calcific tendinitis, Rujuk Vertikal
096 00:00 09:34 PENSIUN TNI shoulder region
395 132304010623P001 20-06-2023 20-06-2023 0000111754427 SRI UTAMI P - Necrosis of pulp Rujuk Vertikal
092 00:00 09:20
396 132304010623P001 20-06-2023 20-06-2023 0000668595554 MESERI L PBI (APBN) Anisometropia and Rujuk Vertikal
397 132304010623P001 20-06-2023 20-06-2023 0000784038497 SUTIATI P PBI (APBN) Hypertensive heart Rujuk Vertikal
105 00:00 10:27 disease
398 132304010623P001 20-06-2023 20-06-2023 0000784547458 SUPARMI P PEGAWAI Disorder of visual Rujuk Vertikal
110 00:00 10:51 SWASTA pathways,
unspecified
399 132304010623P001 20-06-2023 20-06-2023 0001049534695 WIDYA KARTIKA P PBI (APBD) Inflammatory Rujuk Vertikal
101 00:00 09:46 SARI disease of cervix
uteri
400 132304010623P001 20-06-2023 20-06-2023 0001307746089 TOMIRAN L PEKERJA MANDIRI Heart failure, Rujuk Vertikal
401 132304010623P001 20-06-2023 20-06-2023 0001409046974 EDY SUYITNO L PBI (APBD) Stroke, not Rujuk Vertikal
120 00:00 12:05 specified as
haemorrhage or
infarction
402 132304010623P001 20-06-2023 20-06-2023 0001455748885 MISTI P PBI (APBD) Malignant Rujuk Vertikal
106 00:00 10:31 neoplasm of breast
403 132304010623P001 20-06-2023 20-06-2023 0001481778764 HARI KUSDININGSIH P PENERIMA Chronic ischaemic Rujuk Vertikal
085 00:00 08:34 PENSIUN TNI heart disease,
unspecified
404 132304010623P001 20-06-2023 20-06-2023 0001538851779 ENI P PEGAWAI Pain, not elsewhere Rujuk Vertikal
100 00:00 09:45 SETIOWATININGSIH SWASTA classified
405 132304010623P001 20-06-2023 20-06-2023 0001832036387 MOCHAMAD SYAFII L PBI (APBD) Glaucoma Rujuk Vertikal
102 00:00 09:49
406 132304010623P001 20-06-2023 20-06-2023 0001834612244 ONI YULAEHA P PNS DAERAH Malignant Rujuk Vertikal
099 00:00 09:41 neoplasm of breast,
unspecified
407 132304010623P001 20-06-2023 20-06-2023 0001859109658 DWI RETNO YUNI P - Pulpitis Rujuk Vertikal
107 00:00 10:32 WIJAYANTI
408 132304010623P001 20-06-2023 20-06-2023 0001906978691 SENO PRAMUJOKO L - Abnormal findings Rujuk Vertikal
109 00:00 10:37 on diagnostic
imaging of lung
409 132304010623P001 20-06-2023 20-06-2023 Surveillance of
119 00:00 12:00 JAYANTI FADHILA (intrauterine)
0002199531971 P - contraceptive Rujuk Vertikal
PUTRI
device
410 132304010623P001 20-06-2023 20-06-2023 0002266206737 SULIKATI P PBI (APBD) Stroke, not Rujuk Vertikal
104 00:00 10:22 specified as
haemorrhage or
infarction
SARAF RS SOEPRAOEN
from previous
0002463305927 SRI PURWANINGSIH P PBI (APBD) surgery Rujuk Vertikal

412 132304010623P001 20-06-2023 20-06-2023 0002730242665 SRI KUSWIYANTI P PBI (APBD) Anisometropia and Rujuk Vertikal
413 132304010623P001 20-06-2023 20-06-2023 0002730326286 WIMPI SEPTA ADITYA L PBI (APBD) Chalazion Rujuk Vertikal
094 00:00 09:24
414 132304010623P001 20-06-2023 20-06-2023 0002730362613 MUHAMMAD ZIZAT L - Chronic apical Rujuk Vertikal
095 00:00 09:30 RIZKI SAPUTRA periodontitis
415 132304010623P001 20-06-2023 20-06-2023 0002730366358 SUPINAH P PBI (APBD) Other cataract Rujuk Vertikal
089 00:00 08:45
416 132304010623P001 20-06-2023 20-06-2023 0002891492335 AULIA CITRA P PBI (APBD) Specific Rujuk Vertikal
113 00:00 11:08 RAMADANI developmental
disorder of motor
function
417 132304010623P001 20-06-2023 20-06-2023 0002927307429 ROFIK KURROHMAN L PBI (APBD) Anisometropia and Rujuk Vertikal
418 132304010623P001 20-06-2023 20-06-2023 0003054218567 ARZANKA RAFFA L PEKERJA MANDIRI Pain associated Rujuk Vertikal
093 00:00 09:22 KRISWANTO with micturition
419 132304010623P001 20-06-2023 20-06-2023 Unilateral or
inguinal hernia,
0003089445096 felysia azkia efendi P PBI (APBD) without obstruction Rujuk Vertikal
or gangrene
BEDAH ANAK RS PANTI WALUYA

420 132304010623P001 20-06-2023 20-06-2023 0003121460572 MUHAMMAD AKSAL L PEGAWAI Ingrowing nail Rujuk Vertikal
117 00:00 11:33 FAQIH ANWARI SWASTA
421 132304010623P001 20-06-2023 20-06-2023 0003524605817 BAYI NYONYA L PEKERJA MANDIRI Neonatal jaundice Rujuk Vertikal
116 00:00 11:26 WINDA PEGI MELATI from other
SUKMA specified causes
422 132304010623P001 21-06-2023 21-06-2023 0000100471162 IRWAN BAGA L PNS DAERAH Malignant Rujuk Vertikal
153 00:00 11:01 neoplasm of
thyroid gland
423 132304010623P001 21-06-2023 21-06-2023 0000111108328 ISMIATUN P PNS DAERAH Corneal scar and Rujuk Vertikal
137 00:00 09:27 opacity,
unspecified
424 132304010623P001 21-06-2023 21-06-2023 0000111171251 DRG RINI NURANI P PENERIMA Haemorrhagic Rujuk Vertikal
152 00:00 10:59 PENSIUN PNS condition,
unspecified
Hematologi - Onkologi MeRUMAH SAKIT LAVALETTE
425 132304010623P001 21-06-2023 21-06-2023 0000111726347 SAMSUL HADI L - Heart failure, Rujuk Vertikal
426 132304010623P001 21-06-2023 21-06-2023 0000149499268 WINDIANTO L PNS DAERAH Calculus of kidney Rujuk Vertikal
127 00:00 08:46 PRASTIYO and ureter
427 132304010623P001 21-06-2023 21-06-2023 0000784079875 BUJI HARINI P PBI (APBD) Chronic ischaemic Rujuk Vertikal
141 00:00 09:39 heart disease
428 132304010623P001 21-06-2023 21-06-2023 0000785150965 WIDIYA WIJAYANTI P PBI (APBN) Chronic viral Rujuk Vertikal
142 00:00 09:42 hepatitis,
unspecified
429 132304010623P001 21-06-2023 21-06-2023 0000785153158 RIANA P PBI (APBN) Cerebral infarction, Rujuk Vertikal
430 132304010623P001 21-06-2023 21-06-2023 0000785159504 MISNUR HIDAYATI P PBI (APBD) Other Rujuk Vertikal
146 00:00 10:11 intervertebral disc
disorders
431 132304010623P001 21-06-2023 21-06-2023 0001049552493 ANGGRELIA SAIDA P PBI (APBD) Impacted teeth Rujuk Vertikal
145 00:00 10:07 RAHMADANI
432 132304010623P001 21-06-2023 21-06-2023 0001175682115 LILA FAUZIA P - Anisometropia and Rujuk Vertikal
433 132304010623P001 21-06-2023 21-06-2023 0001175682137 SOFI LAILATUL P - Anisometropia and Rujuk Vertikal
123 00:00 08:17 ANIFTASARI aniseikonia
434 132304010623P001 21-06-2023 21-06-2023 Benign neoplasm
178 00:00 11:23 of other and
unspecified sites
0001435122977 DEDI FEBRIAN L - Rujuk Vertikal

435 132304010623P001 21-06-2023 21-06-2023 0001442900384 ERYANTI YURIA P PEGAWAI Anisometropia and Rujuk Vertikal
133 00:00 08:57 FIRDIANY SWASTA aniseikonia
436 132304010623P001 21-06-2023 21-06-2023 AFFELIA ANASTACIA Bipolar affective
200 00:00 11:53 ELFANI disorder, current
episode manic with
psychotic
0001732187417 P - symptoms Rujuk Vertikal
JIWA RSU HERMINA TANGKUBANPRAHU

437 132304010623P001 21-06-2023 21-06-2023 0001790627646 MESIYEM P - Stroke, not Rujuk Vertikal
170 00:00 11:19 specified as
haemorrhage or
infarction
438 132304010623P001 21-06-2023 21-06-2023 0001791966385 DWI ERNAWATI P PEKERJA MANDIRI Nasal polyp Rujuk Vertikal
126 00:00 08:44
439 132304010623P001 21-06-2023 21-06-2023 0001856791023 LINTANG LAURIA P - Anisometropia and Rujuk Vertikal
124 00:00 08:19 SUKMONO aniseikonia
440 132304010623P001 21-06-2023 21-06-2023 0002066586647 AISYAH PUTRI L - Necrosis of pulp Rujuk Vertikal
139 00:00 09:35 SHABIRA
441 132304010623P001 21-06-2023 21-06-2023 0002066586906 DARIS PUTRA L - Necrosis of pulp Rujuk Vertikal
138 00:00 09:32 ALKHALIFI
442 132304010623P001 21-06-2023 21-06-2023 0002104826218 DICKY ENJASTA L - Anisometropia and Rujuk Vertikal
130 00:00 08:52 PUTRA aniseikonia
443 132304010623P001 21-06-2023 21-06-2023 0002269698581 ACH SAIFUL L - Chronic Rujuk Vertikal
128 00:00 08:48 MOCHSIN periodontitis
GIGI PERIODONTI RS BHIRAWA BHAKTI
444 132304010623P001 21-06-2023 21-06-2023 0002426312226 NIRMA AYU P PEGAWAI Necrosis of pulp Rujuk Vertikal
150 00:00 10:40 SWASTA
445 132304010623P001 21-06-2023 21-06-2023 MUHAMMAD ZAVIER PEKERJA MANDIRI Developmental
144 00:00 09:59 ALFARIZQI disorder of speech
and language,
0002485600187 L unspecified Rujuk Vertikal

446 132304010623P001 21-06-2023 21-06-2023 0002728991597 LUKIYATI NINGSIH P PBI (APBD) Disorders of Rujuk Vertikal
132 00:00 08:56 vitreous body
447 132304010623P001 21-06-2023 21-06-2023 0002728994231 SEVIA DWI JAYANTI P PBI (APBD) Disruption of Rujuk Vertikal
129 00:00 08:49 caesarean section
wound
448 132304010623P001 21-06-2023 21-06-2023 0002729059187 BAMBANG L PBI (APBD) Cerebral infarction, Rujuk Vertikal
140 00:00 09:35 HARIYANTO unspecified
449 132304010623P001 21-06-2023 21-06-2023 0002814526517 SRI SUMARMI P - Multiple fractures Rujuk Vertikal
151 00:00 10:42 of lumbar spine
and pelvis
450 132304010623P001 21-06-2023 21-06-2023 0003064697807 FANNY KUSUMA P PBI (APBD) Malignant Rujuk Vertikal
125 00:00 08:33 neoplasm of
endometrium
onkologi ginekologi RUMAH SAKIT LAVALETTE
451 132304010623P001 21-06-2023 21-06-2023 0003309169331 REZVAN ARZIKI L PEGAWAI Other prurigo Rujuk Vertikal
143 00:00 09:53 RAYYAN SWASTA
452 132304010623P001 22-06-2023 22-06-2023 0000110177717 SRI KUSTIYAH P PNS DAERAH Heart failure, Rujuk Vertikal
453 132304010623P001 22-06-2023 22-06-2023 0000111059021 SADI L PENERIMA Heart failure, Rujuk Vertikal
287 00:00 09:43 PENSIUN PNS unspecified
454 132304010623P001 22-06-2023 22-06-2023 0000112889103 LESTARI L PENERIMA Other cataract Rujuk Vertikal
245 00:00 09:01 PENSIUN PNS
455 132304010623P001 22-06-2023 22-06-2023 0000710369741 ULFATIN ADAWIYAH P PBI (APBN) Impacted teeth Rujuk Vertikal
301 00:00 09:55
456 132304010623P001 22-06-2023 22-06-2023 0000784279258 SULISTIANI P PBI (APBN) Heart failure, Rujuk Vertikal
457 132304010623P001 22-06-2023 22-06-2023 0000784472286 FARIDA P PBI (APBN) Epilepsy Rujuk Vertikal
310 00:00 11:10
458 132304010623P001 22-06-2023 22-06-2023 0000785206809 AYU IKA SAPITRI P PBI (APBN) Myopia Rujuk Vertikal
311 00:00 11:19
459 132304010623P001 22-06-2023 22-06-2023 0001049540916 AGUSTINA P PBI (APBN) Fracture of lower Rujuk Vertikal
305 00:00 10:01 PURWANTI leg, including
ankle
460 132304010623P001 22-06-2023 22-06-2023 MUHAMMAD DIMAS Systemic lupus
306 00:00 10:12 0001162584617 ADI PRATAMA L PBI (APBD) erythematosus, Rujuk Vertikal
SULISTYO unspecified
461 132304010623P001 22-06-2023 22-06-2023 0001312484815 SLAMET SUPRAYITNO L PEKERJA MANDIRI Other cataract Rujuk Vertikal
242 00:00 08:46
462 132304010623P001 22-06-2023 22-06-2023 0001428163806 KUSHARTONO L PEGAWAI Heart failure, Rujuk Vertikal
282 00:00 09:41 SWASTA unspecified
463 132304010623P001 22-06-2023 22-06-2023 0001794549284 MUSLIMIN L PEKERJA MANDIRI Disorder of visual Rujuk Vertikal
308 00:00 10:48 pathways,
unspecified
464 132304010623P001 22-06-2023 22-06-2023 0001973533353 SRI WILUJENG P PBI (APBN) Fracture of other Rujuk Vertikal
241 00:00 08:30 finger
465 132304010623P001 22-06-2023 22-06-2023 0002296419704 SALSABILA P - Fibroadenosis of Rujuk Vertikal
258 00:00 09:13 ATIKASARI breast
466 132304010623P001 22-06-2023 22-06-2023 0002320555072 eka wardana L PEKERJA MANDIRI Schizophrenia Rujuk Vertikal
278 00:00 09:39
467 132304010623P001 22-06-2023 22-06-2023 0002437516269 SUHARTINI P - Nontoxic single Rujuk Vertikal
243 00:00 08:52 thyroid nodule
468 132304010623P001 22-06-2023 22-06-2023 0002471125353 MUHAMMAD ZIDAN L PEKERJA MANDIRI Epilepsy Rujuk Vertikal
244 00:00 08:54
469 132304010623P001 22-06-2023 22-06-2023 AZLAN DHAVA Other
304 00:00 10:00 0002767545764 ADYATAMA L PBI (APBD) nonthrombocytope Rujuk Vertikal
nic purpura
ANAK RSIA MUHAMMADIYAH MALANG
470 132304010623P001 22-06-2023 22-06-2023 0002900055025 IGA NYOMANIAR P - Myopia Rujuk Vertikal
373 00:00 14:12
471 132304010623P001 23-06-2023 23-06-2023 0000111598424 LIK'ANI P PENERIMA Other cataract Rujuk Vertikal
529 00:00 09:31 PENSIUN PNS
472 132304010623P001 23-06-2023 23-06-2023 0000111698943 FARIDAH P PENERIMA Other disorders of Rujuk Vertikal
473 00:00 08:22 NOERIDAJATI PENSIUN PNS thyroid
PENYAKIT DALAM Klinik Utama Bunga Melati
473 132304010623P001 23-06-2023 23-06-2023 0000111769244 MARCELINUS SUSENO L PENERIMA Hypertensive heart Rujuk Vertikal
470 00:00 08:18 ISMAIL PENSIUN PNS disease
474 132304010623P001 23-06-2023 23-06-2023 0000174159426 LILIK DWI LESTARI P - Pulp degeneration Rujuk Vertikal
558 00:00 11:12
GIGI ENDODONSI RSU HERMINA TANGKUBANPRAHU
475 132304010623P001 23-06-2023 23-06-2023 0000681107444 NADIA SEPTI NOVIDA P PBI (APBD) Prolonged Rujuk Vertikal
476 00:00 08:45 pregnancy
476 132304010623P001 23-06-2023 23-06-2023 0000784170281 ROBIAH P PBI (APBN) Other chronic Rujuk Vertikal
pulmonary disease
477 132304010623P001 23-06-2023 23-06-2023 Malignant
533 00:00 09:35 neoplasm of skin
of other and
0000785161236 WAGIMAH P PBI (APBD) unspecified parts Rujuk Vertikal
of face
BEDAH RS PANTI WALUYA

478 132304010623P001 23-06-2023 23-06-2023 0001286211609 KUSNADI L - Other deforming Rujuk Vertikal
518 00:00 09:24 dorsopathies
479 132304010623P001 23-06-2023 23-06-2023 0001407368722 RUKIATI P PBI (APBD) Other cataract Rujuk Vertikal
506 00:00 09:15
480 132304010623P001 23-06-2023 23-06-2023 0001476386684 DIAN EKA NUR JULI P - Retained dental Rujuk Vertikal
475 00:00 08:35 root
481 132304010623P001 23-06-2023 23-06-2023 PEGAWAI Human
535 00:00 09:41 SWASTA immunodeficiency
virus [HIV] disease
resulting in
infectious and
0001645792626 PUTA WICANTRA L Rujuk Vertikal
parasitic diseases

482 132304010623P001 23-06-2023 23-06-2023 0001814070317 TRISNAWATI P PNS DAERAH Necrosis of pulp Rujuk Vertikal
539 00:00 09:57
483 132304010623P001 23-06-2023 23-06-2023 0002088520964 ACHMAD MUSTHAFA L - Fracture at wrist Rujuk Vertikal
542 00:00 09:59 KAMIL JUNDILLAH and hand level
484 132304010623P001 23-06-2023 23-06-2023 0002309092514 BAMBANG SETIAWAN L PEKERJA MANDIRI Other cataract Rujuk Vertikal
534 00:00 09:39
485 132304010623P001 23-06-2023 23-06-2023 Unilateral or
inguinal hernia,
0002417417313 EDDY SUBAGIO L - without obstruction Rujuk Vertikal
or gangrene

486 132304010623P001 23-06-2023 23-06-2023 0002493724781 TYRZA GHEA P - Mastoiditis and Rujuk Vertikal
537 00:00 09:48 AGATHA related conditions
THT-KL RS PANTI NIRMALA
487 132304010623P001 23-06-2023 23-06-2023 0002686786582 SRI MARDIYAH P - Necrosis of pulp Rujuk Vertikal
474 00:00 08:31
488 132304010623P001 23-06-2023 23-06-2023 0002729063171 TUTIK P - Myopia Rujuk Vertikal
545 00:00 10:04
489 0002814525549 AZIZAH MAULIDIA P PBI (APBN) Viral hepatitis Rujuk Vertikal
complicating
132304010623P001 23-06-2023 23-06-2023 pregnancy,
546 00:00 10:27 childbirth and the
puerperium
490 132304010623P001 23-06-2023 23-06-2023 0002885604164 ZAENAL ARIFIN L - Other cataract Rujuk Vertikal
536 00:00 09:42
491 132304010623P001 24-06-2023 24-06-2023 PENERIMA Insulin-dependent
764 00:00 09:18 PENSIUN PNS diabetes mellitus
with unspecified
0000100099179 MINI SULASTRI P complications Rujuk Vertikal

492 132304010623P001 24-06-2023 24-06-2023 0000110550137 HERMAN L PNS DAERAH Myopia Rujuk Vertikal
829 00:00 10:08 WICAKSONO
493 132304010623P001 24-06-2023 24-06-2023 0000110550148 KASIYATI P PNS DAERAH Other visual Rujuk Vertikal
786 00:00 09:36 disturbances
494 132304010623P001 24-06-2023 24-06-2023 PENERIMA
710 00:00 08:40 PENSIUN PNS Chronic kidney
0000111747655 TUTIK SUPRAPTI P Rujuk Vertikal
disease
495 132304010623P001 24-06-2023 24-06-2023 0000783791954 SLAMET SUPRIADI L PBI (APBN) Pain, not elsewhere Rujuk Vertikal
810 00:00 09:53 classified
496 132304010623P001 24-06-2023 24-06-2023 0000784254363 MUHAMMAD ARZY L PEGAWAI Necrosis of pulp Rujuk Vertikal
722 00:00 08:47 ARRAZY SWASTA
GIGI ENDODONSI RS ISLAM MALANG UNISMA
497 132304010623P001 24-06-2023 24-06-2023 0000784798593 TITIN CANDRA WATI P PBI (APBN) Cerebral infarction, Rujuk Vertikal
SARAF RS SOEPRAOEN
498 132304010623P001 24-06-2023 24-06-2023 0001431287111 BAMBANG SUPRIYO L PBI (APBN) Schizophrenia Rujuk Vertikal
723 00:00 08:50
with unspecified
muhammad syuhadak complications
0002032149633 L - Rujuk Vertikal
yasin

500 132304010623P001 24-06-2023 24-06-2023 PEKERJA MANDIRI Maternal care due
from previous
0002090988437 ANIS SYA'BANIA P surgery Rujuk Vertikal
OBGYN RSIA PURI BUNDA

501 132304010623P001 24-06-2023 24-06-2023 0002267710727 EARLYTA ARSYFA P - Epilepsy, Rujuk Vertikal
814 00:00 09:56 SALSABILLA unspecified
ANAK RSU. UNIVERSITAS MUHAMMADIYAH
502 132304010623P001 24-06-2023 24-06-2023 0002845962459 SUPA'AT L - Anisometropia and Rujuk Vertikal
503 132304010623P001 24-06-2023 24-06-2023 0002907641531 kenzo adhitama putra L PEGAWAI Disturbance of Rujuk Vertikal
720 00:00 08:46 negara SWASTA activity and
attention
504 132304010623P002 26-06-2023 26-06-2023 0000111724727 TATIK KASIATI P - Other anxiety Rujuk Vertikal
018 00:00 10:21 disorders
505 132304010623P001 26-06-2023 26-06-2023 0000707658254 DIMAS MARIYANTO L PBI (APBN) Fracture of lower Rujuk Vertikal
993 00:00 08:41 leg, including
ankle
506 132304010623P002 26-06-2023 26-06-2023 0000784088605 SITI AISYAH P PBI (APBN) Pterygium Rujuk Vertikal
023 00:00 10:55
507 132304010623P002 26-06-2023 26-06-2023 0000784233674 YUSWATI P PBI (APBN) Pain, not elsewhere Rujuk Vertikal
004 00:00 09:40 classified
508 132304010623P002 26-06-2023 26-06-2023 0000784282331 ENDAH ANTANI P PBI (APBN) Cellulitis Rujuk Vertikal
001 00:00 09:31 NINGRUM
509 132304010623P002 26-06-2023 26-06-2023 0000784768184 ZIDANE HAQQI L PBI (APBN) Schizophrenia Rujuk Vertikal
010 00:00 10:01 RAHMAN MAULANA
510 132304010623P001 26-06-2023 26-06-2023 0000785171856 ISMAUL CHOIROTIN P - Retained dental Rujuk Vertikal
996 00:00 09:04 root
511 132304010623P001 26-06-2023 26-06-2023 0000785438021 IKA ANGGARISTA P PBI (APBN) Vitiligo Rujuk Vertikal
994 00:00 08:48
512 132304010623P002 26-06-2023 26-06-2023 0001049535821 ADINDA MEISASI LUH P - Benign mammary Rujuk Vertikal
014 00:00 10:09 JINGGA dysplasia
513 132304010623P002 26-06-2023 26-06-2023 0001261407554 HELLA S PURNOMO P PEKERJA MANDIRI Other cataract Rujuk Vertikal
026 00:00 11:27
514 132304010623P002 26-06-2023 26-06-2023 0001262121794 RIRIN TRIS P PEKERJA MANDIRI Epilepsy Rujuk Vertikal
005 00:00 09:41 TIANURININGTIAS
515 132304010623P001 26-06-2023 26-06-2023 Presence of
997 00:00 09:09 0001268962165 RUSMIARSIH P - intraocular lens Rujuk Vertikal
516 132304010623P002 26-06-2023 26-06-2023 0001286211868 HENNY PRATIWI SARI P PBI (APBD) Chronic ischaemic Rujuk Vertikal
unspecified
517 132304010623P002 26-06-2023 26-06-2023 0001373591979 DIDIK NURWAHYUDI L - Necrosis of pulp Rujuk Vertikal
009 00:00 10:01
518 132304010623P001 26-06-2023 26-06-2023 0001373719825 ZAIDAN KEVEN L - Necrosis of pulp Rujuk Vertikal
998 00:00 09:11 HAFIZH
GIGI PEDODONTIS RSIA PURI
519 132304010623P002 26-06-2023 26-06-2023 PEKERJA MANDIRI Benign neoplasm
022 00:00 10:45 of eye and adnexa
0001421122072 AYSAH HURIJAH P Rujuk Vertikal

520 132304010623P002 26-06-2023 26-06-2023 0001439594739 NADYA CHASANAH P PBI (APBD) Pulpitis Rujuk Vertikal
028 00:00 11:36 RAHAYU AFANDI
521 132304010623P002 26-06-2023 26-06-2023 0001478397868 FEBIOLA PUTRI P PEGAWAI Pulpitis Rujuk Vertikal
019 00:00 10:26 ANIDHA SWASTA
522 132304010623P002 26-06-2023 26-06-2023 0001538195949 PONITI P PEGAWAI Fracture at wrist Rujuk Vertikal
007 00:00 09:48 SWASTA and hand level
523 Maternal infectious
and parasitic
diseases
classifiable
elsewhere but
132304010623P002 26-06-2023 26-06-2023 DEWI CAHYA complicating
0001539729696 P - pregnancy, Rujuk Vertikal
032 00:00 11:52 PUSPITA
childbirth and the
puerperium

524 132304010623P002 26-06-2023 26-06-2023 0001785305823 SISWANTO WIJAYA L PEGAWAI Chronic kidney Rujuk Vertikal
021 00:00 10:38 PUTRA, Drs.MM SWASTA disease
Ginjal-Hipertensi RUMAH SAKIT LAVALETTE
525 132304010623P002 26-06-2023 26-06-2023 0001863515643 HABIBI AZZAM L PEGAWAI Dysuria Rujuk Vertikal
011 00:00 10:04 FAEZYA SAPUTRA SWASTA
526 132304010623P002 26-06-2023 26-06-2023 0002162582368 MOHAMMAD IMAM L PBI (APBD) Myopia Rujuk Vertikal
012 00:00 10:06 AL JAELANI
527 132304010623P002 26-06-2023 26-06-2023 Atherosclerotic
020 00:00 10:27 cardiovascular
0002296084689 SUPRIYONO L PBI (APBD) disease, so Rujuk Vertikal
described
528 132304010623P002 26-06-2023 26-06-2023 0002298523037 SUYATNO L - Glaucoma Rujuk Vertikal
013 00:00 10:08
529 132304010623P002 26-06-2023 26-06-2023 0002324275975 MARTHA SETYOWATI P PBI (APBN) Other chronic Rujuk Vertikal
pulmonary disease
530 132304010623P002 26-06-2023 26-06-2023 0002492916333 QONITA ISMAN P PBI (APBD) Fracture of shafts Rujuk Vertikal
025 00:00 11:25 TAQIYYA RAHAYU of both ulna and
AFANDI radius
SITI NUR from previous
0002614117151 P PBI (APBD) surgery Rujuk Vertikal
CAHYANINGSIH

532 132304010623P002 26-06-2023 26-06-2023 0002637715959 MOCHAMAD EDI L PBI (APBN) Other specified Rujuk Vertikal
024 00:00 11:24 SUTIONO surgical follow-up
care
BEDAH RS PANTI WALUYA
533 132304010623P002 26-06-2023 26-06-2023 KHAYLA AZZAHRA Developmental
035 00:00 11:58 MAULANA disorder of speech
and language,
0002728964924 P PBI (APBD) unspecified Rujuk Vertikal

534 132304010623P002 26-06-2023 26-06-2023 0002729064767 IMRON L PBI (APBD) Other chronic Rujuk Vertikal
pulmonary disease
PARU RS SOEPRAOEN
535 132304010623P002 26-06-2023 26-06-2023 0002730251057 SATUPAH P PBI (APBD) Other cataract Rujuk Vertikal
017 00:00 10:19
536 0002812902647 KURROTUL AINIYAH P - Maternal care for Rujuk Vertikal
(suspected) central
nervous system
malformation in
132304010623P002 26-06-2023 26-06-2023 fetus
030 00:00 11:43

537 132304010623P002 26-06-2023 26-06-2023 0002814518608 FIRDAUS WARDANI P - Pulpitis Rujuk Vertikal
031 00:00 11:46
538 132304010623P002 26-06-2023 26-06-2023 0002814543022 ZHARIIFAH FITRI P PBI (APBN) Myopia Rujuk Vertikal
015 00:00 10:13 SADIRA
539 132304010623P002 26-06-2023 26-06-2023 0003057113169 ABDULLAH FATHIR L - Microcephaly Rujuk Vertikal
027 00:00 11:30
540 132304010623P001 26-06-2023 26-06-2023 0003063919533 EKA SARI P PBI (APBD) Pterygium Rujuk Vertikal
992 00:00 08:40
541 0003123587125 L Ventricular septal Rujuk Vertikal
defect as current
complication
132304010623P001 26-06-2023 26-06-2023 MUHAMMAD FAUZAN PEGAWAI following acute
999 00:00 09:14 NASRUL SWASTA myocardial
infarction
Anak Kardiologi RUMAH SAKIT LAVALETTE

542 132304010623P002 27-06-2023 27-06-2023 0000110795725 RELAHATI P PENERIMA Glaucoma Rujuk Vertikal
199 00:00 10:53 PENSIUN PNS
543 132304010623P002 27-06-2023 27-06-2023 0000111747699 MAULIDA PRATAMA P - Pterygium Rujuk Vertikal
194 00:00 10:39 SARI
544 0000785420965 AGUS SUDARWOKO L PBI (APBN) Non-insulin- Rujuk Vertikal
dependent diabetes
mellitus with
132304010623P002 27-06-2023 27-06-2023 neurological
177 00:00 09:11 complications

545 132304010623P002 27-06-2023 27-06-2023 0001403114332 S. YENI P - Anal abscess Rujuk Vertikal
180 00:00 09:16
546 132304010623P002 27-06-2023 27-06-2023 0001403133243 TRI WAHYU SATRIYO L PBI (APBD) Other Rujuk Vertikal
190 00:00 09:48 BUDI HIDAYAT polyneuropathies
547 132304010623P002 27-06-2023 27-06-2023 0001403207335 SITI MARIYAM P - Other cataract Rujuk Vertikal
197 00:00 10:44
548 132304010623P002 27-06-2023 27-06-2023 0001403209192 KARTINI P PBI (APBD) Other chronic Rujuk Vertikal
pulmonary disease
549 132304010623P002 27-06-2023 27-06-2023 0001403228946 DARMI P - Angina pectoris Rujuk Vertikal
189 00:00 09:46
550 132304010623P002 27-06-2023 27-06-2023 0001447353821 suriPAH P PEGAWAI Low back pain Rujuk Vertikal
170 00:00 08:41 SWASTA
551 132304010623P002 27-06-2023 27-06-2023 0001821493427 MAHAYUNINGSIH P PBI (APBD) Other benign Rujuk Vertikal
185 00:00 09:31 WINEDAR neoplasm of other
parts of uterus
552 132304010623P002 27-06-2023 27-06-2023 0001831758939 MARIA IMACULATA P PEGAWAI Oligohydramnios Rujuk Vertikal
186 00:00 09:36 ISAH PUTRI SWASTA
553 132304010623P002 27-06-2023 27-06-2023 0001883811622 FELICIA BELLVANIA P - Hirschsprung's Rujuk Vertikal
193 00:00 10:22 EVANGELYN disease
NUGROHO
BEDAH ANAK RUMAH SAKIT LAVALETTE
554 132304010623P002 27-06-2023 27-06-2023 0002046654922 CHORNELYA ANDRIA P - Other and Rujuk Vertikal
196 00:00 10:43 SARI unspecified
ovarian cysts
555 0002161062279 L Respiratory Rujuk Vertikal
tuberculosis, not
confirmed
132304010623P002 27-06-2023 27-06-2023 AHMAD KHOIRUL PEGAWAI bacteriologically or
182 00:00 09:22 MUSTOFA SWASTA histologically

556 132304010623P002 27-06-2023 27-06-2023 0002202968992 ALFINA ACHMA P PBI (APBD) Impacted teeth Rujuk Vertikal
173 00:00 08:51 RAMADHANI
without
0002246955276 ROSIDI L PBI (APBD) complications Rujuk Vertikal

558 132304010623P002 27-06-2023 27-06-2023 0002303372373 HARRY ELIGUSTY L - Disorders of Rujuk Vertikal
184 00:00 09:28 BUTAR BUTAR accommodation
559 132304010623P002 27-06-2023 27-06-2023 0002623997518 FEBY NABILA PUTRI P PBI (APBD) Pulpitis Rujuk Vertikal
178 00:00 09:12
560 0002730225227 DJUMAATI P - Respiratory Rujuk Vertikal
tuberculosis, not
confirmed
132304010623P002 27-06-2023 27-06-2023 bacteriologically or
201 00:00 11:40 histologically
PARU RS SOEPRAOEN
561 132304010623P002 27-06-2023 27-06-2023 0002857938017 LUPI API SANTO L PBI (APBN) Senile cataract Rujuk Vertikal
179 00:00 09:15
562 132304010623P002 27-06-2023 27-06-2023 AL GHIFARI ACHMAD PEGAWAI Specific
174 00:00 08:52 NA'IM PEMERINTAH developmental
DENGAN disorders of speech
0003120699655 L PERJANJIAN and language Rujuk Vertikal
KERJA
563 132304010623P002 27-06-2023 27-06-2023 0003296230874 BAYI NYONYA LUTFI L PEKERJA MANDIRI Cerebral oedema Rujuk Vertikal
200 00:00 11:37 RISAH WAHYUNI

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TANGGAL TANGGAL JENIS KELAMIN STATUS PULANG

OBGYN RSU HERMINA TANGKUBANPRAHU

OBGYN RSI AISYIYAH MALANG

PENYAKIT DALAM RSI AISYIYAH MALANG

PENYAKIT DALAM RSI AISYIYAH MALANG

BEDAH RSI AISYIYAH MALANG

JIWA RSI AISYIYAH MALANG

OBGYN RS MELATI HUSADA

PENYAKIT DALAM RSI AISYIYAH MALANG

SARAF RSI AISYIYAH MALANG

BEDAH RSI AISYIYAH MALANG

PENYAKIT DALAM RSI AISYIYAH MALANG

OBGYN RS MELATI HUSADA

PENYAKIT DALAM RSU HERMINA TANGKUBANPRAHU

BEDAH RSI AISYIYAH MALANG

ANAK RSI AISYIYAH MALANG

OBGYN RSI AISYIYAH MALANG

PENYAKIT DALAM RSI AISYIYAH MALANG

PENYAKIT DALAM RSI AISYIYAH MALANG

ANAK RS MELATI HUSADA

PENYAKIT DALAM RSI AISYIYAH MALANG

ANAK RSI AISYIYAH MALANG

ANAK RSU HERMINA TANGKUBANPRAHU

OBGYN RSIA GALERI CANDRA

PENYAKIT DALAM RSI AISYIYAH MALANG

MATA RSI AISYIYAH MALANG

PENYAKIT DALAM RSU HERMINA TANGKUBANPRAHU

PENYAKIT DALAM RS SOEPRAOEN

PENYAKIT DALAM RSI AISYIYAH MALANG

JIWA RSI AISYIYAH MALANG

ANAK RSU HERMINA TANGKUBANPRAHU

ANAK RSIA MARDI WALOEJA KAUMAN

OBGYN RSI AISYIYAH MALANG

BEDAH RSI AISYIYAH MALANG

OBGYN RSI AISYIYAH MALANG

PENYAKIT DALAM RSI AISYIYAH MALANG

ANAK RSU HERMINA TANGKUBANPRAHU

ANAK RSUD Kota Malang

ANAK RSUD Kota Malang

ANAK RSU HERMINA TANGKUBANPRAHU

ANAK RSUD Kota Malang

ANAK RSU HERMINA TANGKUBANPRAHU

OBGYN RSIA MUHAMMADIYAH MALANG

PENYAKIT DALAM RSI AISYIYAH MALANG

ANAK RSU HERMINA TANGKUBANPRAHU

ANAK RSI AISYIYAH MALANG

BEDAH RSI AISYIYAH MALANG

ORTHOPEDI RSI AISYIYAH MALANG

SARAF RSI AISYIYAH MALANG

ORTHOPEDI RSU HERMINA TANGKUBANPRAHU

OBGYN RS MELATI HUSADA

PENYAKIT DALAM RSI AISYIYAH MALANG

THT-KL RSIA PURI

Endokrin-Metabolik-DiabeRUMAH SAKIT LAVALETTE

OBGYN RS MELATI HUSADA

BEDAH ANAK RS PANTI WALUYA

BEDAH RSI AISYIYAH MALANG

JIWA RSU HERMINA TANGKUBANPRAHU

ANAK RSU HERMINA TANGKUBANPRAHU

BEDAH RS PANTI WALUYA

PENYAKIT DALAM RS SOEPRAOEN

BEDAH RSI AISYIYAH MALANG