LAPORAN BULANAN POLI SARAF

RSUD SULTAN SURIANSYAH

BULAN / TAHUN : JANUARI 2022
NO RM NAMA PASIEN JK TTL/UMUR ALAMAT LENGKAP KUNJ. KASUS STATUS PASIEN DIAGNOSA MEDIS KODE TINDAKAN/PENGOBATAN DPJP KET

UMUM / BPJS /
P/L B/L B/L ICD
JKD
 LAPORAN BULANAN POLI SARAF
RSUD SULTAN SURIANSYAH
BULAN / TAHUN : Februari 2021
JK KUNJ. KASUS STATUS PASIEN KODE
TANGGAL
NO NO RM NAMA PASIEN TTL/UMUR ALAMAT LENGKAP DIAGNOSA MEDIS TINDAKAN/PENGOBATAN DPJP KET
KUNJ. UMUM / BPJS /
P/L B/L B/L ICD
JKD
 LAPORAN BULANAN POLI SARAF
RSUD SULTAN SURIANSYAH
BULAN / TAHUN : Maret 2021
TANGGAL
JK KUNJ. KASUS STATUS PASIEN KODE
KUNJ.
NO NO RM NAMA PASIEN TTL/UMUR ALAMAT LENGKAP DIAGNOSA MEDIS TINDAKAN/PENGOBATAN DPJP KET
UMUM / BPJS /
P/L B/L B/L ICD
JKD
Banjarmasin, 14-3- Gabapentine, Meloxicam, Mecobalamine,
1 00-16-21 Ny. Sri Astuti P Jl. Djok mentaya Gg. Guntur No. 17 L L B HNP Lumbal , Neuropati, CTS
1/3/2022 1969 Ranitidin dr. Indah Ariyati, Sp.S 09.30 am
Jl. Tembus Mantuil mess balimas no
2 01-10-38 Ny. Bahrah P Barabai, 10-3-1961 L L B HNP Lumbal Meloxicam, Zitanid, Calk, Mecobalamine
10 dr. Indah Ariyati, Sp.S 09.35 am

3 00-11-61 Ny. Nor Salasiah P Banjarmasin, 20-07- Jl. Teluk kelayan RT.7 No.20 L L B HNP Lumbal, Oa Genue S Gabapentine, Meloxicam, Kapsul racik, Osteor,
1971 Lansoprazole dr. Indah Ariyati, Sp.S 09.40 am
Banjarmasin, 18-5-
4 00-54-21 Ny. Rusinah P Jl. Kelayan A II 17/1 L L B Cervical Spasme, HNP Lumbal Alpentine, Meloxicam, B Comp, Zitanid, Omz
1963 dr. Indah Ariyati, Sp.S 09.45 am
Banjarmasin, 25-04- Amlodipine, Cande, Piracetam, Atorvastatine,
5 02-45-18 Ny. Maryati P Jl. H Anang Adenensi No.02 L L B Vertigo Sentral, HT gr I
1954 Flunarizine dr. Indah Ariyati, Sp.S 09.50 am

6 01-25-44 Tn. Anang Husni L Banjarmasin, 10-02- Jl.Kelayan A II Gg. Sri Rezeki L L B Oa Genue Co" Paru, Meloxicam, MP, Calk osteor
1956 dr. Indah Ariyati, Sp.S 09.55 am
Banjarmasin, 25-06- Jl. Gerilya Gg. Bambu No.15 R/Ro", Alpentine, meloxicam, Ranitidin,
7 02-63-70 Ny. Nordiani P B B B Susp HNP Lumbal
1963 RT.029 RW.002 Zitanid dr. Indah Ariyati, Sp.S 10.00 am

8 02-63-05 Ny. Norsiah, Hj P Amuntai, 24-11-1956 Jl. Kelayan A Gg. 66 No.49 II/I B B B Oa Genue B, HT gr I Amlodipine, MP, Ranitidin, Osteor, diclotenal
gel, Meloxicam dr. Indah Ariyati, Sp.S 10.05 am

9 00-39-61 Tn. Baderi H Terang L Banjarmasin, 20-06- Jl. 9 November L L B

1953 HNP Lumbal, Cervical spasme Meloxicam, Gabapentine, Osteor, Diazepam dr. Indah Ariyati, Sp.S 10.10 am

Banjarmasin, 18-08- Spondilosis lumbalis, Co"RM, Alpentine, Meloxicam, Atorvastatine,

10 02-63-73 Ny. Salbiah P Jl. 9 November B B B hipercholesterolemia, HT gr II,
1966 Allopurinol, amlodipine, Furosemide, Concor
Hiperuresemia, HNP dr. Indah Ariyati, Sp.S 10.15 am
Banjarmasin, 10-04- Jl. Sejahtera Gg. II 003/001 Post SNH, HT, DM, Cephalgia, Metformine, CPG, Amlodipine, Kapsul Racik,
11 02-62-04 Tn. Zainal Arifin L L L B
1963 Hemiparase S Citicolin Co"RM dr. Indah Ariyati, Sp.S 10.20 am

12 02-61-09 Ny. Radiah P Banjarmasin, 05-09- B B B SNH, Hemiparase s, vertigo Citicolin, atorvastatine, miniaspi, betahistine,
1970 Jl. Mantuil Permai No. 03 10/02 sentral, DM flunarizine dr. Indah Ariyati, Sp.S 10.25 am
Banjarmasin, 23-3- Co"RM, Amlodipine, Kapsul racik,
13 01-02-09 Ny. Noordiah P Jl. Kuin utara 12/2 L L B HNP Lumbal, HT
1961 Gabapentine, Meloxicam, Osteor dr. Indah Ariyati, Sp.S 10.30 am
Banjarmasin, 1-1-
14 01-93-86 Ny. Jumrah P Jl. Bahagia 8/1 L L B HNP Lumbal Gabapentine,Calk, B Comp, meloxicam dr. Indah Ariyati, Sp.S
1959 10.35 am

15 02-61-42 Ny. Yuningsih P Jl. Teluk Tiram Darat Gg. Tiram L L B Tringger Finger S, Oa genue S Ro", meloxicam, alpentine, calk, zitanid, osteor
Bandung, 29-08-1965 dr. Indah Ariyati, Sp.S 10.40 am

16 00-34-58 Ny. Samsiah P Banjarmasin, 08-06- Jl. A. Yani KM.4.5 Komp. Bulan L L B Parkinson disease, Susp Oa Pramifol, THP, stalevo, meloxicam, glukosamin
1954 Mas 2 Genue dr. Indah Ariyati, Sp.S 10.45 am

17 00-46-30 Tn. Isnanto L Banjarmasin, 09-08- Jl. Aes Nasution RT. 004/001 B B B Post stroke infark, HT, Epilepsi, amlodipine, candesartan, phenitoin,
1968 cephalgia, myalgia meloxicam, kapsul racik dr. Indah Ariyati, Sp.S 10.50 am
Gabapentin, Meloxicam, Mecobalamine, B
18 01-07-28 Ny. Hj. Munjiah P Alabio, 7-2-1952 Jl. Kelayan B Gg. Jais No. 28 9/1 L L B HNP Lumbal
Comp, Alprazolam, Co"Paru dr. Indah Ariyati, Sp.S 10.55 am
Jl. HKSN Komp. Abdi no.92
19 02-63-87 Ny. Siti Cahya Dewi Sekar U P Banjarmasin, 11-08- RT.018 RW.007 Persada blok B B B Migrain type headche Co" Paru, Trampara, Flunarizine, omz
2000 scorpio IV dr. Indah Ariyati, Sp.S 11.00 am

20 02-60-24 Tn. Rusbandi L Gambut, 01-10-1960 Jl. Kelayan A Gg. Sejiran RT.07 L L B Stroke infark, afasia, HHD Co"Jantung, CPG, Piracetam, atorvastatine,
RW.01 Ramipril, B Comp dr. Indah Ariyati, Sp.S 11.05 am
Cervical Spasme, spoliosis et
Banjarmasin, 5-2- Zitanid, meloxicam, gabapentine, lansoprazole,
21 01-31-15 Ny. Noer Hayati P Jl. Batu Benawa 5 no 59 47/4 L L B spondilosis lumbal, HT, dr. Indah Ariyati, Sp.S
1968 B Comp
dispepsia, Frozen Shoulder 10.00 am
Banjarmasin, 02-09- Jl. Kelayan A Gg. Sejiran RT.008
22 02-36-60 Tn. Ratno L L L B Fr. Kompresi, LBP Meloxicam, Calk, Alpentine, Kapsul Racik dr. Indah Ariyati, Sp.S
1980 RW.001 10.05 am
Banjarmasin, 6-12- Alpentine, Meloxicam, Omz, Amlodipine,
23 01-07-22 Ny. Sofiah P JL. Gerilya komp bumi Handayani L L B HNP Lumbal, Dispepsia, HT dr. Indah Ariyati, Sp.S
1962 Kapsul Racik 10.10 am

24 02-59-45 Tn. Sudahnan L kargean, 27-03-1966 Jl. Sejahtera IV RT.010 RW.001 L L B HNP Lumbal, Kompresi VT l2, Gabapentin, Meloxicam, Mecobalamine, dr. Indah Ariyati, Sp.S
HT gr II Zitanid, Amlodipine 10.15 am
 Yogyakarta, 29-08- Jl. Soetoyo S Gg. 9 No.83 RT.016 HT, HNP Lumbal, OA Genue,
25 02-38-55 Ny. Maria Agustina P L L B Gabapentin, meloxicam, Kapsul Racik, Zitanid dr. Indah Ariyati, Sp.S
1957 RW.001 Trigger Finger, CTS B
10.20 am
Banjarmasin, 10-09- Jl. Tembus Mantuil komp permata
26 02-26-33 Tn. Munir L L L B Bellis Palsy Dextra Alpentine, Mecobalamine, Bcomp dr. Indah Ariyati, Sp.S
1974 bunda 10.25 am

27 02-53-44 Tn. Selamat S L Banjarmasin, 05-05- Jl. Kelayan B Cahaya Tatas No.16 L L B Hnp Lumbal, Spondilosis dr. Indah Ariyati, Sp.S
1955 Lumtalis Alpentine, Calk, Zitanid, Meloxicam, Omz 10.30 am
Banjarmasin, 27-01-
28 02.36.76 Ny. Heriyani P Jl. Haryono MT No.16 5/1 70111 L L B HNP lumbal, OA Genue Meloxicam, Osteor, Alpentine, Zitanid, Bcomp dr. Indah Ariyati, Sp.S
1968 10.35 am

2/3/2022
 LAPORAN BULANAN POLI SARAF
RSUD SULTAN SURIANSYAH
BULAN / TAHUN : April 2021
JK KUNJ. KASUS STATUS PASIEN KODE
TANGGAL
NO NO RM NAMA PASIEN TTL/UMUR ALAMAT LENGKAP DIAGNOSA MEDIS TINDAKAN/PENGOBATAN DPJP KET
KUNJ. UMUM / BPJS /
P/L B/L B/L ICD
JKD
Banjarmasin, 3-4- Post SNH, Hemiparesis dextra, dr. M.Ichsan
1 01-34-61 Tn. Ismail Jl. Aes Nasution, Gg. Syiar Islam 8/1 L L B Piracetam, Asam folat, atorvastatin, CPG 09.00 am
L 1961 afasia Safwannoor, Sp.S
Post Stroke Infark, MCI, HT, CPG, Amlodipin, amitriptilin, B12, tebokan, dr. M.Ichsan
2 01-37-97 Ny. Mustinah P Kediri, 31-12-1938 Jl. Teluk tiram darat Gg. Tiram L L B 09.05 am
Neuropati meloxicam Safwannoor, Sp.S
Banjarmasin, 22-9- Lab, amlodipin, CPG, atorvastatin, B12, calc, dr. M.Ichsan
3 01-23-76 Ny. Hj. Noor Jannah P Jl. Kelayan B Timur no 37 14/1 L L B SNH, HT, OA Genue 09.15 am
1954 citicolin Safwannoor, Sp.S
Banjarmasin, 6-10- Jl. Kelayan B Gg. Annajah no 27 dr. M.Ichsan
4 00-60-67 Tn. Masrifa'i L L L B Post Stroke Infark, HT amlodipin, CPG, Bcomp, astria 09.25 am
1963 RT.03 Safwannoor, Sp.S
dr. M.Ichsan
5 00-75-86 Ny. Marfuah P Anjir, 30-11-1956 Jl. Ir P M Noor RT. 64 L L B HNP Lumbal, neuropati Alpentin, amitriptilin, calc, mecobalamin, K.dic 09.30 am
Safwannoor, Sp.S
Banjarmasin, 15-3- Jl. Kelayan A2 Gg. Rahimi Ujung dr. M.Ichsan
6 00-88-85 Ny. Mahmudah P L L B HNP Lumbal, OA Genue Alpentin, Osteor, mecobalamin, kapsul racik 09.35 am
1983 018/006 Safwannoor, Sp.S
Banjarmasin, 25-12- Jl. A Yani KM 5.5 Sei Tuan no 40 Metil prednisolon, kapsul racik, alpentin, calc, dr. M.Ichsan
7 01-50-74 Tn. Budi Fitriadi L L L B HNP Lumbal 09.40 am
1977 RT/RW 23/03 ranitidin Safwannoor, Sp.S
1/4/2021
Banjarmasin, 10-7- dr. M.Ichsan
8 01-03-36 Ny. Yuliana P Jl. Rawasari IX No.12 53/05 L L B Vertigo central Flunarizin, piracetam, mecobalamin, curcuma 09.45 am
1979 Safwannoor, Sp.S
Banjarmasin, 24-5- dr. M.Ichsan
9 01-10-60 Ny. Mursilawati P Jl. Ampera gg. Afiat no 41 L L B Cervicogenic Headeache kapsul racik, piracetam, mecobalamin 09.50 am
1980 Safwannoor, Sp.S
Banjarmasin, 24-4- dr. M.Ichsan
10 00-39-25 Tn. Freddy Suradilaga L Jl. K P Tandean komp. P dan K no 3 L L B HNP Lumbnal, Neuropati gabapentin, osteor, kapsul racik, mecobalamin 09.50 am
1952 Safwannoor, Sp.S
dr. M.Ichsan
11 01-53-41 Tn. Farhan L Martapura, 26-1-1980 Jl. A Yani no 125 RT 06/02 B B UMUM Muscle spasme Ro", USG, kapsul racik, eperison, mecobalamin 09.55 am
Safwannoor, Sp.S
CPG, amlodipin, candesartan, calc, B12, dr. M.Ichsan
12 01-23-53 Ny. Jumberiah P Rantau, 18-1-1975 Jl. Pekapuran raya L L B Post SNH 10.30 am
amitriptilin Safwannoor, Sp.S
Banjarmasin, 23-3- Lab, Co" rehab, Metil prednisolon, calc, alpentin, dr. M.Ichsan
13 01-02-09 Ny. Noordiah P Jl. Kuin utara 12/2 L L B LBP, OA Genue, Osteoporosis 10.40 am
1961 osteor, kapsul racik Safwannoor, Sp.S
Kandangan, 10-7- dr. M.Ichsan
14 01-39-67 Ny. Nor Ainah P Jl. Tunas Baru Gg. Teluk baru no.67 L L B Post SNH, Hemiparase CPG, B12, citicolin, calc 11.20 am
1965 Safwannoor, Sp.S
Banjarmasin, 31-3- Tremor Esensial, Cervical Root
15 00-69-69 Nn. Ayu marianti P Jl. Rawasari komp. Guru STM L L B Propanolol, Calk, eperison dr. Mardi Utomo, Sp.S 08.45 am
1994 syndrom

16 00-64-59 Ny. Sukarmi P Surabaya, 3-2-1959 Jl. 9 Okt Komp. Nusa Indah L L B Degenarative disc disease kapsul racik, Caps Racik, Calk dr. Mardi Utomo, Sp.S 08.50 am

Jl. Pekapuran B Laut Gg. Makmur Depakote, clobazam, mecobalamin, calc,

17 00-81-99 Ny. Maya Puspasari P Jakarta, 27-9-1976 L L B GAD, Epilepsi Lobus temporal dr. Mardi Utomo, Sp.S 09.00 am
no 39 7/1 lansoprazole
Caps Racik, Caps Racik, Calk, glimepirid,
18 01-32-89 Tn. Jawahir L Nganjuk, 26-5-1955 Jl. Tanjung berkat ujung L L B HNP Lumbal dr. Mardi Utomo, Sp.S 09.05 am
metformin, herbesser
Banjarmasin, 9-3- kapsul racik, candesartan, sprinolacton,
19 01-06-61 Ny. Masnah P Jl. Ampera Gg. Afiat L L B Cervical Root Syndrom, HT dr. Mardi Utomo, Sp.S 09.15 am
1958 meloxicam, eperison
Banjarmasin, 1-2-
20 00-25-80 Ny. Pin Setiawati P Komp. Polri malkon temon/ IIB B B U Vertigo sentral ec stroke infark kapsul racik, tebokan, propanolol, frego dr. Mardi Utomo, Sp.S 09.20 am
1962
Banjarmasin, 15-10- Post acute simptomatik seizure,
21 01-06-33 Ny. Haniah P Jl. Benua Anyar 31 B B B Herbesser, candesartan, phenitoin, mecobalamin dr. Mardi Utomo, Sp.S 09.25 am
1977 HT
Banjarmasin, 29-3-
22 01 -00-12 An. Atikah P Jl. TTD Gg. Pendamai Tiram 22 B B B Cervicogenic Headeache Caps Racik, Eperison, Calk, Meloxicam dr. Mardi Utomo, Sp.S 09.50 am
2007
Banjarmasin, 2-9-
23 3/4/2021 01-00-12 Ny. Arbainah P Jl. Bandarmasih komp. DPR Gg. Iia B B B LBP Ro", calc, myorest, lansoprazole, cal-95 dr. Mardi Utomo, Sp.S 09.55 an
1952
Banjarmasin, 9-3-
24 00-72-54 Ny. Maria Ulfah P Jl. Veteran Komp. Kenari raya L L B Fascitis plantaris kapsul racik, calc, meloxicam, Eperisone dr. Mardi Utomo, Sp.S 10.00 am
1958
Banjarmasin, 26-5-
25 00-52-92 Tn. Muhammad Habibi L Jl. Kelayan A1 RT.1 No.28 L L B Epilepsi Lobus Temporal Phenitoin, clobazam, lansoprazole, mecobalamin dr. Mardi Utomo, Sp.S 10.10 am
1998
Banjarmasin, 20-8- piracetam, eperison, caps racik, Alprazolam,
26 01-14-17 Ny. Rohannah P Jl. Aes Nasution RT. 004/001 L L B Stroke Infark, Frozen Shoulder dr. Mardi Utomo, Sp.S 10.20 am
1972 CPG, Amlodipin
Banjarmasin, 3-7- Piracetam, amlodipin, CPG, candesartan,
27 00-59-80 Ny. Sairah P Jl. Mutiara 1/1 kelayan selatan L L B Stroke Infark, HT, Insomnia dr. Mardi Utomo, Sp.S 10.30 am
1953 alprazolam

28 01-39-64 Ny. Retno Wahyu Suminar P Malang, 23-7-1965 Jl. A Yani Km. 1 no.36 L L B HNP Lumbal Meloxicam, calk, eperison, caps racik dr. Mardi Utomo, Sp.S 10.50 am
 Jl. Mutiara dalam Gg. Baru indah
29 00-59-12 Ny. Rahimah P Negara, 30-5-1981 L L B HNP Lumbal lansoprazole, calc, kapsul racik dr. Mardi Utomo, Sp.S 11.00 am
No.97
Jl. A Yani KM 3 no 9 RT/RW
30 01-33-07 Tn. Buserani L Amuntai, 9-8-1949 L L B HNP Lumbal Kapsul racik, kapsul racik, eperison dr. Mardi Utomo, Sp.S 11.10 am
001/001
 LAPORAN BULANAN POLI SARAF
RSUD SULTAN SURIANSYAH
BULAN / TAHUN : MEI 2021
JK KUNJ. KASUS STATUS PASIEN KODE
TANGGAL
NO NO RM NAMA PASIEN TTL/UMUR ALAMAT LENGKAP DIAGNOSA MEDIS TINDAKAN/PENGOBATAN DPJP KET
KUNJ. UMUM / BPJS /
P/L B/L B/L ICD
JKD
 LAPORAN BULANAN POLI SARAF
RSUD SULTAN SURIANSYAH
BULAN / TAHUN : JUNI 2021
JK KUNJ. KASUS STATUS PASIEN KODE
TANGGAL
NO NO RM NAMA PASIEN TTL/UMUR ALAMAT LENGKAP DIAGNOSA MEDIS TINDAKAN/PENGOBATAN DPJP KET
KUNJ. UMUM / BPJS /
P/L B/L B/L ICD
JKD
Banjarmasin, 1-1- Carbamazepin, Luminal, Asam folat, Clobazam, dr. M.Ichsan
1 00-36-84 Ny. Yuri Ilinah P Jl. P Antasari Gg. Hasanudin L L B Epilepsi, dyslipidemia 09.00 am
1963 atorvastatin Safwannoor, Sp.S
Banjarmasin, 5-5- Spondilosis TB, DM, Alpentin, meloxicam, amitripilin, cpg, dr. M.Ichsan
2 01-71-23 Ny. Helda P Jl. Hikmah Banua B B B 10.00 am
1972 Kolelitiasis, Post SNH neurosanbe, konsul PD Safwannoor, Sp.S
Banjarmasin, 12-1- Jl. Ujung benteng banjarmasin RT. dr. M.Ichsan
3 01-59-55 Tn. Askawi L L L B Syndrom piriformis, LBP, HT Amlodipin, alpentin, Meloxicam, MP, amitripilin 10.10 am
1961 04/03 Safwannoor, Sp.S
Banjarmasin, 3-3- Miniaspi, Amlodipin, Caps Racik, Atorvastatin, dr. M.Ichsan
4 01-15-58 Tn. Sariyanto L Jl. 9 Oktober Gg. Sidodadi L L B Post SNH, HT, Hemiparesis 10.35 am
1972 B12, Citicolin Safwannoor, Sp.S
Banjarmasin, 15-9- Post SNH, Hemiparesis, Vertigo amlodipin, candesartan, miniaspi, piracetam, dr. M.Ichsan
5 2/6/2021 01-26-70 Tn. Jumaidi L Jl. Tembus mantuil Gg. Gandapura L L B 10.40 am
1962 sentral, demensia ariceft Safwannoor, Sp.S
Banjarmasin, 22-6- dr. M.Ichsan
6 00-38-64 Ny. Maulidah P Jl. Tatah Belayung RT/RW 012/002 L L B Epilepsi lobus temporal Phenitoin, Asam folat, Curcuma, neurosanbe 10.45 am
1998 Safwannoor, Sp.S
Banjarmasin, 2-2- dr. M.Ichsan
7 00-55-11 Ny. Bahjatul P Jl. 9 November no 27 RT 10/01 L L B HNP Lumbal Alpentin, amitripilin, calk, meloxicam, eperison 11.30 am
1968 Safwannoor, Sp.S
Pamangkih, 29-9- Jl. Pekapuran raya komp. Pasar CPG, lansoprazole, amlodipin, candesartan, dr. M.Ichsan
8 01-67-24 Ny. Ulfah masliani P L L B Post SNH, HT, Hemiparesis 11.45 am
1966 binjau Rt. 016/001 atorvastatin, caps racik Safwannoor, Sp.S
Jl. Kelayan A gg. H. Syukuri No.9 dr. M.Ichsan
9 01-10-16 Ny. Lamina P Negara, 26-6-1965 L L B CTS Bilateral,neuropati Alpentin, mecobalamin, caps racik, meloxicam 11.50 am
RT. 18 Safwannoor, Sp.S
Banjarmasin, 27-12- Jl. Pramuka Komp. Semanda IV dr. M.Ichsan
10 00-39-21 Ny. Nor'an ainiah P L L B Epilepsi Amlodipin, depakote, kapsul racik, sucralfat 09.10 am
1961 RT/RW 020/002 Safwannoor, Sp.S
Jl. K S Tubun no 110 RT/RW dr. M.Ichsan
11 01-36-04 Tn. Ahmad Syaifuddin N L Surabaya, 10-1-1987 L L B HNP Cervical, Neuropati Alpentin, Caps Racik 09.15 am
010/001 Safwannoor, Sp.S
Banjarmasin, 24-4- dr. M.Ichsan
12 00-39-25 Tn. Freddy Suradilaga L Jl. K P Tandean komp. P dan K no 3 L L B HNP Lumbal, neuropati Nadic, caps racik, alpentin, mecobalamin 09.20 am
1952 Safwannoor, Sp.S
Bojonegoro, 9-6- gabapentin, caps racik, calk, amitripilin, dr. M.Ichsan
13 00-88-61 Ny. Patimah P Jl. Dahlia kebun sayur RT. 14/02 L L B HNP Lumbal 09.25 am
1970 mecobalamin, nadic Safwannoor, Sp.S
Jl. H. Djok Menyata Gg. Sawi Post SNH, Hemiparase, HT, OA Amlodipin, candesartan, meloxicam, cpg, dr. M.Ichsan
14 01-10-91 Ny. Nurhamidah P Barabai, 25-4-1965 L L B 09.30 am
Sabumi Geno atorvastatin, Osteor Safwannoor, Sp.S
HNP Lumbal, OA Geno dr. M.Ichsan
15 01-07-28 Ny. Hj. Munjiah P Alabio, 7-2-1952 Jl. Kelayan B Gg. Jais No. 28 9/1 L L B Alpentin, nadic, zitanid, kapsul racik, osteor 09.35 am
bilateral Safwannoor, Sp.S
Citicolin, amlodipin, candesartan, amitripilin, cpg, dr. M.Ichsan
16 01-66-98 Ny. Juhriah P Pemurus, 8-8-1960 Jl. Ir Phm Noor gg. 88 no 55 L L B Post SNH, HT, Hemiparesis 09.40 am
atorvastatin Safwannoor, Sp.S
Jl. Tembus Mantuil mess balimas no HNP Lumbal, OA Geno, mecobalamin, alpentin, amlodipin, ibuprofen, dr. M.Ichsan
17 01-10-38 Ny. Bahrah P Barabai, 10-3-1961 L L B 09.45 am
10 neuropati osteor Safwannoor, Sp.S
Banjarmasin, 5-1- Post SNH, central post stroke dr. M.Ichsan
18 01-13-96 Ny. Irawaty P Jl. P Antasari Gg. Hasanudin L L B Alpentin, cpg, mecobalamin, caps racik 09.50 am
1982 pain Safwannoor, Sp.S
Jl. Pekapuran Raya Gg. Swadaya dr. M.Ichsan
19 00-75-28 Ny. Rusmini P Birayang, 1-3-1962 L L B Post SNH, Hipertensi, Neuropati Miniaspi, amlodipin, candesartan, B12, Ibuprofen 09.55 am
RT/RW 009/001 Safwannoor, Sp.S
Banjarmasin, 10-7- Cervical spasme, cervicogenic dr. M.Ichsan
20 01-03-36 Ny. Yuliana P Jl. Rawasari IX No.12 53/05 L L B caps racik, mecobalamin, flunarizin, curcuma 10.00 am
1979 headeache Safwannoor, Sp.S
Banjarmasin, 26-1- dr. M.Ichsan
21 01-71-74 Tn. M. Zabidie L Jl. HKSN Surya gemilang 125 B B B Post ICH, HT Alpentin, mecobalamin, miniaspi, Lab NW 10.05 am
1962 Safwannoor, Sp.S
Banjarmasin, 14-3- dr. M.Ichsan
22 00-39-16 Ny. Gusti Solatiah P Jl. A Yani Gg. 21 No, 36 C L L B Epilepsi Bamgetol, Bcomp, PCT 10.10 am
1986 Safwannoor, Sp.S
Gabapentin, meloxicam, calk, mecobalamin, dr. M.Ichsan
23 01-55-75 Ny. Saniah P Marabahan, 7-3-1965 Jl. Komp. Yuka RT.04 L L B HNP Lumbal, Neuropati 10.15 am
zitanid Safwannoor, Sp.S
Banjarmasin, 23-5- Jl. Gajah mada no 76 komp. BRI CTS, Neuropati, Frozen dr. M.Ichsan
24 00-54-85 Ny. Hj. Yuliansari P L L B Alpentin, mecobalamin, NaDic, Konsul RM 10.20 am
1956 Jaya RT/RW 043/004 Shoulder S Safwannoor, Sp.S
Sungai gula, 21-12- Jl. Tembus mantuil komp. Wengga dr. M.Ichsan
25 00-01-35 Ny. Wahatine P L L B Demensia, Parkinson disease Ariceft, Sifrol, B Comp, Levofar 10.25 am
1946 blok m no.32 Safwannoor, Sp.S
Banjarmasin, 15-6- Jl. Laksana Intan no 6 RT/RW dr. M.Ichsan
26 01-28-43 Ny. Jum'ah P L L B Bell's Palsy, Paralisis NVII MP, calk, lansoprazole, mecobalamin, Alpentin 10.30 am
3/6/2021 1976 012/00 Safwannoor, Sp.S
Amlodipin, CPG, Asam folat, piracetam, dr. M.Ichsan
27 01-34-07 Tn. Sumani L Kediri, 19-11-1957 Jl. Tatah Hampalam RT. 5/02 L L B Post SNH, HT, afasia 10.35 am
Fluoxetin Safwannoor, Sp.S
dr. M.Ichsan
28 00-93-32 Tn. Nurdiansyah L Negara, 12-10-1965 Jl. Kelayan B komp. 10 no 53 L L B HNP Lumbal Alpentin, mecobalamin, eperison, calk, nadic 10.40 am
Safwannoor, Sp.S
 LAPORAN BULANAN POLI SARAF
RSUD SULTAN SURIANSYAH
BULAN / TAHUN : Juli 2021
JK KUNJ. KASUS STATUS PASIEN KODE
TANGGAL
NO NO RM NAMA PASIEN TTL/UMUR ALAMAT LENGKAP DIAGNOSA MEDIS TINDAKAN/PENGOBATAN DPJP KET
KUNJ. UMUM / BPJS /
P/L B/L B/L ICD
JKD
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2
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 LAPORAN BULANAN POLI SARAF
RSUD SULTAN SURIANSYAH
BULAN / TAHUN : AGUSTUS 2021
JK KUNJ. KASUS STATUS PASIEN KODE
TANGGAL
NO NO RM NAMA PASIEN TTL/UMUR ALAMAT LENGKAP DIAGNOSA MEDIS TINDAKAN/PENGOBATAN DPJP KET
KUNJ. UMUM / BPJS /
P/L B/L B/L ICD
JKD
Gabapentin, Metil Prednisolon, Mecobalamin, dr. M.Ichsan
1 00-50-96 Tn. Andy Mulyani L Jember, 13-12-1960 Jl. Sutoyo S Bina Setia RT. 002/001 L L B CTS, Neuropati 08.20 am
analtram, amitriptilin Safwannoor, Sp.S
Bojonegoro, 9-6- dr. M.Ichsan
2 00-88-61 Ny. Patimah P Jl. Dahlia Kebun sayur RT. 14/02 L L JKD HNP Lumbal Konsul IPD, Pregabalin, tramadol, B12, OMZ 08.50 am
1970 Safwannoor, Sp.S
Mojokerto, 31-12- dr. M.Ichsan
3 00-86-25 Ny. Poniti P Sumbersono RT. 001/006 L L B Neuropati diabetika Calc, mecobalamin, pregabalin, amitriptilin 08.55 am
1956 Safwannoor, Sp.S
CPG, MP, Mecobalamin, amlodipin, OMZ, dr. M.Ichsan
4 00-83-05 Ny. Maimunah P Bangkalan, 5-2-1964 Jl. Tanjung berkat ujung 017/001 L L B Bells Palsy, HT, Vertigo sentral 09.10 am
Betahistin Safwannoor, Sp.S
Cervicogenis Headache,
Banjarmasin, 2-12- dr. M.Ichsan
5 00-53-68 Ny. Mutiah P Jl. Melayu laut no 32 L L B Spasmofili, General Anxiety Mecobalamin, clobazam, myorest, calc 09.15 am
1981 Safwannoor, Sp.S
Disorder
3/8/2020 Banjarmasin, 7-2- Post Stroke Infark, HT, dr. M.Ichsan
6 00-57-41 Ny. Norliana P Jl. Kelayan A gg. Setuju no 26 L L B Amlodipin, candesartan, CPG, aricept 09.40 am
1956 Demensia Safwannoor, Sp.S
Jl. Sei Miai Komp. Bulakindo Blok dr. M.Ichsan
7 00-85-31 Ny. Mustika Ratna P Kotabaru, 6-5-1966 L L B HNP Lumbal, Faseitis plantaris MP, Pregabalin, calc, amitriptilin, B12 09.45 am
F no 82 022/002 Safwannoor, Sp.S
Banjarmasin, 25-10- dr. M.Ichsan
8 00-89-49 Ny. Rusdiani, S.Ap P Komp Meranti 10 no 10 035/003 L L B CTS Bilateral MP, Mecobalamin, OMZ, alpentin 10.05 am
1960 Safwannoor, Sp.S
dr. M.Ichsan
9 00-41-23 Tn. Anang Kamberanie L HST, 7-7-1946 Jl. Simp Wildan Sari VIIB no 48 L L B Post Stroke, HT Amlodipin, B12, CPG, Meloxicam 10.15 am
Safwannoor, Sp.S
Jl. Pekapuran Raya gg. Keluarga no Meloxicam, eperison, kapsul racik, injeksi triger dr. M.Ichsan
10 00-87-96 Tn. Gani Basuni L Amuntai, 1-7-1938 L L B Cervical spasme 10.50 am
23/002 point (MP+Lidocain), Co" fisioterapi Safwannoor, Sp.S
dr. M.Ichsan
11 00-92-95 Tn. Winardi L Boyolali, 5-1-1985 Jl. Yos Sudarso gg. Sidomulyo B B B LBp, Muscle Spasme Meloxicam, eperison, meocbalamin, OMZ 10.20 am
Safwannoor, Sp.S
dr. M.Ichsan
12 00-75-86 Ny. Marfuah P Anjir, 30-11-1956 Jl. Ir P M Noor RT. 64 L L B HNP Lumbal Kapsul racik, calc, pregabalin, B12 09.30 am
Safwannoor, Sp.S
Banjarmasin, 21-8- Gabapentin, eperison, analtram, amitriptilin, dr. M.Ichsan
13 4/8/2020 00-87-11 Tn. Gusti Aria Wardana L Jl. Alalak Selatan RT/RW 001/001 L L B HNP Lumbal 09.55 am
1996 lansoprazol Safwannoor, Sp.S
Cervical root syndrome, dr. M.Ichsan
14 00-40-27 Ny. Nunung Yuliani P Kapuas, 7-3-1966 Jl. Madang no 32 RT 32/03 L L B Metil prednisolon, alpentin, paracetamol, OMZ 10.00 am
neuropati Safwannoor, Sp.S
dr. M.Ichsan
15 00-50-96 Tn. Andy Mulyani L Jember, 13-12-1960 Jl. Sutoyo S Bina Setia RT. 002/001 L L B CTS, Neuropati Gabapentin, Tramadol, Mecobalamin
Safwannoor, Sp.S 08.30 am
Banjarmasin, 15-2- Jl. Kelayan A 2 Gg. Rahmi Ujung Eperison, Meloxicam, Mecobalamin, OMZ, Rujuk dr. M.Ichsan
16 00-88-85 Ny. Mahmudah P L L B Susp HNP
1983 018/006 Ansari Saleh Safwannoor, Sp.S 08.40 am
Banjarmasin, 03-04- dr. M.Ichsan
17 00-79-69 Tn. Muhammad Hadiyanoor L Jl. Ampera 004/003 L L B Epilepsi Rujuk Poli Anak Ansari Saleh
2002 Safwannoor, Sp.S 08.50 am
HNP, Hipertensi, Muscle Meloxicam, gabapentin, Lisinopril, MP, Injeksi dr. M.Ichsan
18 00-93-32 Tn. Nurdiansyah L Negara, 12-10-1965 Jl. Kelayan B Komp.10 No.53 B B U
Spasme Lido + MP Safwannoor, Sp.S 09.20 am
5/8/2020
Banjarmasin, 18-02- dr. M.Ichsan
19 00-88-96 Tn. Muhammad Saipu L Jl. Kelayan A L L B Afasia, Hemiparese Citicolin, Piracetam, Bcomp
1969 Safwannoor, Sp.S 09.40 am
Ny. Syarifah Rahima Banjarmasin, 24-12- dr. M.Ichsan
20 00-86-24 P Jl. Gerilya Komp Tata Buana Indah L L B HNP Lumbal MP, Alpentin, OMZ, Mecobalamin
Annisa 1996 Safwannoor, Sp.S 09.45 am
Banjarmasin, 23-05- HNP Lumbal, Paralumbal dr. M.Ichsan
21 00-87-68 Ny. Rusmiyati P Komp. Persada permai Jalur 24 L L B Pregabalin, MP, Calk, OMZ, Mecobalamin
1961 Muscle Spasme Safwannoor, Sp.S 10.10 am
Banjarmasin, 10-8- Jl. Djok Mentaya No. 018 Hemiparese, Kontraktur, dr. M.Ichsan
22 00-43-41 Ny. Yulianan Abnun P L L B Simvastatin, Eperison, B12
1967 RT.001/001 Hiperkolesterolemia Safwannoor, Sp.S 10.20 am
Jl. Mutiara dalam Gg. Baru Indah dr. M.Ichsan
23 00-59-12 Ny. Rahimah P Negara, 30-5-1981 L L B HNP Lumbal Gabapentin, Meloxicam, Calk, Eperison, OMZ 09.05 am
No.97 RT.016/002 Safwannoor, Sp.S
Banjarmasin, 5-5- Jl. Tembus Mantuil perum wengga dr. M.Ichsan
24 00-39-33 Ny. Mariana P L L B HNP Lumbal Gabapentin, amitripilin, Mecobalamin, Meloxicam 09.45 am
1967 blok p9 no.158 Safwannoor, Sp.S
Banjarmasin, 4-6- dr. M.Ichsan
25 6/8/2020 00-68-70 Tn. Sophian Natsir L Jl. Kelayan B No.1 RT. 022/002 L L B HNP Lumbal Alpentin, Caps Racik, Mecobalamin, Calk 10.00 am
1960 Safwannoor, Sp.S
Banjarmasin, 21-1- LBP, Tendinitis de Quervain, dr. M.Ichsan
26 00-79-81 Ny. Hamsinah P Jl. Kelayan B No.1 RT. 022/003 L L B MP, Ostoer, Calk, OMZ 10.05 am
1963 OA Genu Safwannoor, Sp.S
Jl. Pekapuran Raya Gg.Melati I dr. M.Ichsan
27 00-69-44 Ny. Badiah P Amuntai, 20-5-1952 L L B LBP, Muscle Spasme, OA Geno Nadic, OMZ, B12, Osteor 10.35 am
No.46 Safwannoor, Sp.S
Banjarmasin, 26-3- Aspilet, CPG, Candesartan, piracetam, glimepirid,
28 7/8/2020 00-93-84 Tn. Syaiful Anwar L Jl. Simpang Limau RT?RW 007/001 B B B Stroke Infark, Hiperglikemi, HT dr. Mardi Utomo, Sp.S 10.20 am
1973 metformin
 LAPORAN BULANAN POLI SARAF
RSUD SULTAN SURIANSYAH
BULAN / TAHUN : SEPTEMBER 2021
JK KUNJ. KASUS STATUS PASIEN KODE
TANGGAL
NO NO RM NAMA PASIEN TTL/UMUR ALAMAT LENGKAP DIAGNOSA MEDIS TINDAKAN/PENGOBATAN DPJP KET
KUNJ. UMUM / BPJS /
P/L B/L B/L ICD
JKD
 LAPORAN BULANAN POLI SARAF
RSUD SULTAN SURIANSYAH
BULAN / TAHUN : OKTOBER 2021
JK KUNJ. KASUS STATUS PASIEN KODE
TANGGAL
NO NO RM NAMA PASIEN TTL/UMUR ALAMAT LENGKAP DIAGNOSA MEDIS TINDAKAN/PENGOBATAN DPJP KET
KUNJ. UMUM / BPJS /
P/L B/L B/L ICD
JKD
 LAPORAN BULANAN POLI SARAF
RSUD SULTAN SURIANSYAH
BULAN / TAHUN : NOVEMBER 2021
JK KUNJ. KASUS STATUS PASIEN KODE
TANGGAL
NO NO RM NAMA PASIEN TTL/UMUR ALAMAT LENGKAP DIAGNOSA MEDIS TINDAKAN/PENGOBATAN DPJP KET
KUNJ. UMUM / BPJS /
P/L B/L B/L ICD
JKD
 LAPORAN BULANAN POLI SARAF
RSUD SULTAN SURIANSYAH
BULAN / TAHUN : DESEMBER 2021
JK KUNJ. KASUS STATUS PASIEN KODE
TANGGAL
NO NO RM NAMA PASIEN TTL/UMUR ALAMAT LENGKAP DIAGNOSA MEDIS TINDAKAN/PENGOBATAN DPJP KET
KUNJ. UMUM / BPJS /
P/L B/L B/L ICD
JKD
 LAPORAN BULANAN POLI PENYAKIT DALAM
RSUD SULTAN SURIANSYAH
BULAN / TAHUN : OKTOBER
TANGGAL JK KUNJ. KASUS STATUS PASIEN KODE
NO NO RM NAMA PASIEN TTL/UMUR ALAMAT LENGKAP DIAGNOSA MEDIS TINDAKAN/PENGOBATAN DPJP KET
KUNJ. PR LK B L B L UMUM BPJS JKD ICD
1 24/9/2019 00.07.59 Ny. Meliana Tan √ 25-03-1954 / 65 thn √ √ Hiperuremia Hemafort dr. Bayu E.N, Sp.PD
2 00.07.28 Nn. Erlin Aprianty √ 04-04-2000 /19 thn √ √ Dyspepsia, cefalgia Lanzo, PCT, B complex dr. Dodo Sp.PD
3 00.07.39 Ny. Dra.Suliyawati √ 10-11-1963/ 56 thn √ √ OA Genue Bilateral Meloxicam, Lanzo dr. Bayu E.N, Sp.PD
4 00.08.19 Nn. Marini Octavia √ 18-10-1990/ 19 thn √ √ Allupurinol dr. Bayu E.N, Sp.PD
5 00. 08.50 Ny. Normiati √ 72 th √ √ DM, HT, Dyspepsia Amlodipin 10mg, Metformin, Rantin dr. Dodo Sp.PD
6 00.08.25 Ny. Siti Huriah √ 10-10-1969/ 50 thn √ √ OA Genue bilateral Ibuprofen, Tablet kalsium, Allopurinol dr. Dodo Sp.PD
7 00.08.43 Ny. Mariany Bongso √ 25-08-1985 / 34 thn √ √ Dyspepsia, TSH Ibuprofen, simvastatin dr. Bayu E.N, Sp.PD
8 00.05.84 Tn. Rapiyadi √ 04-12-1984 / 35 thn √ √ Dyspepsia Lanzo dr. Bayu E.N, Sp.PD
10 00.07.37 Ny. Melati √ 21-02-1992 / 27 thn √ √ Abdominal paint Ibuprofen dr. Bayu E.N, Sp.PD
11 00.07.45 Tn. Humaidi √ 09-06-1972 / 47 thn √ √ DM Glimepirid, dr. Bayu E.N, Sp.PD
12 00.07.41 Nn. Ambar Kartika Dewi √ 10-06-1996 / 23 thn √ √ Vertigo, Dyspepsia Mertigo, Lanzo, Ambroxol dr. Dodo Sp.PD
13 00.07.33 Ny. Norhayati √ 07-10-1975 / 44 thn √ √ Dyspepsia Rantin, Ibuprofen, B komplek dr. Dodo Sp.PD
14 00.07.61 Ny. Neneng Rika √ 05-05-1972 / 47 thn √ √ HT, Dyspepsia Amlodipin 5mg, lanzo dr. Bayu E.N, Sp.PD
15 00. 07.32 Ny. Lasmawati √ 13-04-1981 /38 thn √ √ Hepatitis B Lanzoprazole dr. Bayu E.N, Sp.PD
16 00.07.64 Ny. Hj. Yuliani √ √ √ DM Glimepirid, dr. Bayu E.N, Sp.PD
17 00.07.34 Ny. Rusmini √ 28-12-1956 / 63 thn √ √ HT, OA Genue Candesartan, PCT, Tablet kalsium dr. Dodo Sp.PD
18 00.07.36 Tn. Yudi Endra √ 27-06- 1968 / 51 thn √ √ HT, Neuralgia Neurodex, Amlodipin dr. Dodo Sp.PD
19 00.05.92 Ny. Mariana Ferly √ 05-01-1965 / 54 thn √ √ dr. Bayu E.N, Sp.PD
20 00.07.25 Ny. Risna Adelia √ 26-04-1995 / 24 thn √ √ Vertigo Mertigo, B complex dr. Dodo Sp.PD
21 00.05.94 Ny. Mariani Ferly √ 05-05-1958 / 61 thn √ √ OA Genue dr. Bayu E.N, Sp.PD
GRAFIK PENYAKIT TERBANYAK POLI SARAF

Penyakit Tebanyak Poli Saraf Jumlah

Headache 8
LBP 5
Parkinson disease 3
Ischialgia 3
Epilepsi 2
 5 Penyakit
5 Penyakit
terbanyak
Terbanyak
Poli saraf
8
9
8
8
7
7
66 5
55 Jumlah
44 3 3
33 2
22
11
00
Headache LBP
LBP Parkinson
Parkinson Ischialgia
Ischialgia Epilepsi
Epilepsi
disease
disease