Tanggal : 01/03/2024 MB : 11 MBRG : MBDM : 1 PUASA:

Ruangan : Khadijah MLRG:1 Mml 7 MLRS :

DIET
KET (KIS &
NO KAMAR KELAS NAMA PASIEN UMUR NO RM DIAGNOSA ALERGI SOND REKAP JMLH P S M
MB ML TC MC NTS DL DM RG TKTP RS JAMINAN)
E
Ny. Wira abd pain ec sindrom dispepsia+ht Gr II
1 315 III 30 190200123 √ √ MLRG 3x1 bpjs pbi √ √ √

2 311 I 15 240200191 √ MB 3X1 bpjs askes √ √ √

An. T. Syarifah Azzahra post laparatomy debulking a/I Tumor ovarium permagna
3 315 III 25 240200904 √ ML 3X1 bpjs pbi √ √ √
Ny. Laksmi irwandi HEG
4 319 II 24 240200913 √ ML 3X1 UMUM √ √ √
Ny. Sri putri G1p0a0h0 gr 9-10 mg + heg drs intake sulit + dyspepsia
5 322 II 26 210600101 √ MB 3X1 bpjs pbi √ √ √
Ny. Inriyani SC
6 322 III 24 240200896 √ MB 3X1 bpjs pbi √ √ √
Ny. Feni Rindiani SC
7 317 III 45 240200238 √ MB 3X1 bpjs mandiri √ √ √
Ny. Seri maharani Post debulking
8 422 II 33 231000358 √ ML 3X1 bpjs swasta √ √ √
Ny. Rika rahmadani hiperpireksia ec viral inf drs low intake
9 321 III 31 240200938 √ MB 3X1 bpjs pbi √ √ √
Ny. Nia puspita sari psp
10 321 II 26 240200861 √ MB 3X1 bpjs swasta √ √ √
Ny. Elsyinta Dwi Putri PSP
11 318 III 29 221000886 √ MB 3X1 Bpjs PBI (apbd) √ √ √
Ny. Nurul Arifah PSP
12 406 I 39 231200926 √ ML 3X1 Bjs swasta √ √ √
Ny. Iis sugiarti febris h3 ec viral inf dd susp dhf+intake sulit
13 317 III Ny. Jusni erma ningsih 31 240200942 SC √ MB 3X1 bpjs pbi √ √ √

14 323 II Ny. Nova Khairunnisa 33 220800451 psp √ MB 3X1 bpjs swasta √ √ √

15 320 III An. Queensha Wafi H 3th 11 bln 240200889 Post debridement √ ML 3X1 bpjs pbi √ √ √

16 √ MB 3X1 √ √ √
415 III Ny. Nurjannah 24 240200908 g2p1a0h1 gr 36-37 + fetal takikaedi + febris bpjs pbi
17 √ √ MBDM 3X1 √ √ √
316 III Ny. Rahmawati 27 230200800 SC + IUD bpjs mandiri
18 √ MB 3X1 √ √ √
318 II Ny. Beby wulan khaida 23 240200648 SC bpjs swasta
19 √ ML 3X1 √ √ √
319 II ny. Amelya shyntya 29 221000790 g2p1a0h1 gr 9-10 mgg+ heg sindrom dyspepsia bpjs swasta
20 319 II ny. Serah Rumi 180400129 HEB √ ML 3X1 √ √ √
29 bpjs non pns
21 323 II Ny.Dwi Lestari 25 240100133 SC √ MB 3X1 bpjs mandiri √ √ √
22 320 III Ny.Melda wati 34 200600879 HEG √ ML 3X1 bpjs pbi √ √ √
23 310 I Ny. Mita Hudiyatna 30 201000251 HIPERPIREKSIA √ MB 3X1 bpjs swasta √ √ √
24 312 II-I erlinda wati 36 160200727 sc √ MB 3X1 Bpjs swasta √ √ √
25 308 I Ratih Rosanita 29 240200774 sc+iud √ MB 3X1 Bpjs NON PNS √ √ √
26 325 III Rice Trisnawati 32 240100585 sc √ MB 3X1 Bpjs PBI √ √ √
27 325 III Nn. Hafizah nurul 21 240300014 prolnged fever + sind disepsia + intake sulit √ ML 3X1 bpjs pbi √ √ √
28 325 III Ny.Novia 24 240200367 Hiperpireksia ec tonsilofaringitis +drs +Low intake √ ML 3X1 bpjs pbi √ √ √
29 307 I Ny.Cika Selvia 23 240200513 PSP √ MB 3X1 Bpjs TNI √ √ √
30 301 I Ny.Yuliet 29 210600085 SC √ ML 3X1 bpjs mandiri √ √ √
 Tanggal : 02/03/2024 MB : MBRG : MBDM : PUASA:
Ruangan : Khadijah MLRG:1 Mml MLRS :
DIET
KET (KIS
REKA
NO KAMAR KELAS NAMA PASIEN UMUR NO RM DIAGNOSA ALERGI SON TKT JMLH &
MB ML TC MC NTS DL DM RG RS P
DE P JAMINAN)

1 315 III Ny. Wira 30 190200123 abd pain ec sindrom dispepsia+ht Gr II √ √ MLRG 3x1 bpjs pbi
2 311 I An. T. Syarifah Azzahra 15 240200191 post laparatomy debulking a/I Tumor ovarium permagna √ MB 3X1 bpjs askes
3 406 I Ny. Iis sugiarti 39 231200926 febris h3 ec viral inf dd susp dhf+intake sulit √ MB 3X1 Bjs swasta
4 317 III Ny. Jusni erma ningsih 31 240200942 SC √ MB 3X1 bpjs pbi
5 320 III An. Queensha Wafi H 3th 11 bln 240200889 Post debridement √ √ ML 3X1 bpjs pbi
6 415 III Ny. Nurjannah 24 240200908 g2p1a0h1 gr 36-37 + fetal takikaedi + febris √ MB 3X1 bpjs pbi
7 316 III Ny. Rahmawati 27 230200800 SC + IUD √ √ MBDM 3X1 bpjs mandiri
8 318 II Ny. Beby wulan khaida 23 240200648 SC √ MB 3X1 bpjs swasta
9 319 II ny. Amelya shyntya 29 221000790 g2p1a0h1 gr 9-10 mgg+ heg sindrom dyspepsia √ ML 3X1 bpjs swasta
10 323 II Ny.Dwi Lestari 25 240100133 SC √ MB 3X1 bpjs mandiri
11 320 III Ny.Melda wati 34 200600879 HEG √ ML 3X1 bpjs pbi
12 312 II-I erlinda wati 36 160200727 sc √ MB 3X1 Bpjs swasta
13 308 I Ratih Rosanita 29 240200774 sc+iud √ MB 3X1 Bpjs NON PN
14 325 III Rice Trisnawati 32 240100585 sc √ MB 3X1 Bpjs PBI
15 325 III Ny. Hafizah nurul 21 240300014 prolonged fever+syndrom dyspepsia √ ML 3X1 BPJS
16 306 s.vip Ny. Irene Fransisca 21 240300014 post sc √ MB 3X1 UMUM
17 303 I Ny.Rita,S 43 240200633 g5p2a2h2 gr. 10-11minggu+bsc 2x+ppv ec mola hidatidosa ikan laut √ MB 3X1 bpjs swasta
18 325 III Ny. Kartika 28 240200972 psp √ MB 3X1 bpjs pbi (apb
19 302 II-I Ny. Dewi Angriani 31 240200090 ilo post sc h6 √ √ MBTKTP 3X1 bpjs swasta
20 322 II Ny. MildaSari 32 240300004 post sc a/I g1p0a0h0 gr. 37-38 minggu+kala 1 fase laten+_letak sungsang √ MB 3X1 bpjs swasta
21 301 II(promo) Ny.Yuliet Wirda 29 210600085 post sc+tubektomi a/I g3p2a0h2 gr. 37-38 minggu+pre sc 2x+cpd √ MB 3X1 bpjs swasta
22 315 II Ny. Sriani 30 240300007 post sc a/I gr. Aterm+kala 1 fase laten+letak obligh+bsc 1x √ MB 3X1 bpjs swasta
23 321 II Ny.Riva Septia Azimma 27 170400799 hiperpireksia ec tyfoid fever +drs+low intake √ ML 3X1 bpjs swasta
24 411 I Ny.Ny. Intan Rahmadani 31 240100706 hiperpireksia ec viral infection +drs+low intake √ ML 3X1 bpjs swasta
25 317 III Ny. Seri maharani 45 240200238 Post debulking √ MB 3X1 bpjs mandiri
26 310 I Ny. Mita Hudiyatna 30 201000251 HIPERPIREKSIA √ ML 3X1 bpjs swasta
27 309 I Ny. Yofa herangi 32 240300011 g43a0h3 gr 29-30 mgg + kontraksi prematur + gea √ MB 3X1 bpjs swasta
28 325 III Ny. Sri Agustina 29 210500326 Post sc a/I G2P1A0H1 GR 40 MNGG + BSC 1X + ET. OBLIGH + HIPERTENSI √ MB 3X1 bpjs pbi
29 304 I Ny.Fitri Fauziah 27 231001003 g1p0a0h0 gr 24-25 mg+gea drs+Low intake+PPI √ ML 3X1 bpjs swasta
 P S M

√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √

√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
 Tanggal : 03/03/2024 MB : 18 ML :5 MBDM : PUASA:
Ruangan : Khadijah MBTKTP : 1 MLRG :1 MLRS : MLRGDM : 1
DIET KET (KIS &
NO KAMAR KELAS NAMA PASIEN UMUR NO RM DIAGNOSA ALERGI REKAP JMLH P S M
MB ML TC SONDE MC NTS DL DM RG TKTP RS JAMINAN)
1 315 III Ny. Wira 30 190200123 abd pain ec sindrom dispepsia+ht Gr II √ √ MLRG 3x1 bpjs pbi √ √ √
2 312 II-I Ny. erlinda wati 36 160200727 sc √ MB 3X1 Bpjs swasta √ √ √
3 308 I Ny. Ratih Rosanita 29 240200774 sc+iud √ MB 3X1 Bpjs NON PNS √ √ √
4 325 III Ny. Rice Trisnawati 32 240100585 sc √ MB 3X1 Bpjs PBI √ √ √
5 325 III Ny. Hafizah nurul 21 240300014 prolonged fever+syndrom dyspepsia √ ML 3X1 BPJS √ √ √
6 306 s.vip Ny. Irene Fransisca 21 240300014 post sc √ MB 3X1 UMUM √ √ √
7 302 II-I Ny. Dewi Angriani 31 240200090 ilo post sc h6 √ √ MBTKTP 3X1 bpjs swasta √ √ √
8 322 II Ny. MildaSari 32 240300004 SC √ MB 3X1 bpjs swasta √ √ √
9 301 II(promo) Ny.Yuliet Wirda 29 210600085 SC + Tubektomi √ MB 3X1 bpjs swasta √ √ √
10 315 II Ny. Sriani 30 240300007 SC √ MB 3X1 bpjs swasta √ √ √
11 321 II Ny.Riva Septia Azimma 27 170400799 Hiperpireksia √ ML 3X1 bpjs swasta √ √ √
12 411 I Ny. Intan Rahmadani 31 240100706 Hiperpireksia √ ML 3X1 bpjs swasta √ √ √
13 317 III Ny. Seri maharani 45 240200238 Post debulking √ MB 3X1 bpjs mandiri √ √ √
14 310 I Ny. Mita Hudiyatna 30 201000251 Hiperpireksia √ ML 3X1 bpjs swasta √ √ √
15 325 III Ny. Sri Agustina 29 210500326 SC √ MB 3X1 bpjs pbi √ √ √
16 307 I Ny.Cika Selvia 23 240200513 PSP √ MB 3X1 Bpjs tni √ √ √
17 304 I Ny.Fitri Fauziah 27 231001003 g1p0a0h0 gr 24-25 mg+gea drs √ ML 3X1 bpjs swasta √ √ √
18 325 III Ny.Novia Pangandaeng 24 240200367 Hiperpireksia √ ML 3X1 bpjs pbi √ √ √
19 311 I Ny. Dewi Yuwanita Mahardika 38 230800362 SC + MOW √ MB 3X1 bpjs askes √ √ √
20 318 II Ny. Sastri Asih 28 240200960 SC √ MB 3X1 bpjs swasta √ √ √
21 317 II Ny. Septhia sumadi 22 191100929 abd pain ec dispepsia+drs+low intake √ ML 3X1 Bpjs mandiri √ √ √
22 323 II Ny.Uci Ramayani 30 220500419 post adhesiolisis+histerektomi+myomektomi √ MB 3X1 Bpjs polri √ √ √
23 316 I Ny. Usmi Juniar Matondang 38 200400248 giant fibroid+anemia+vomitus drs low intake √ MB 3X1 Bpjs pns √ √ √
24 320 I Ny. Decy Pramitasari Yuna 31 240200258 sc Ayam √ MB 3X1 bpjs pns √ √ √
25 309 II Ny. Rafiqah Wuandari Tanjung 22 240300060 abortus imminiens √ MB 3X1 bpjs swasta √ √ √
26 319 II Ny. Yuli Erda 66 240200823 Hiperpireksia + ht + dm + hipoglikemia √ √ √ MLRGDM 3X2 Bpjs mandiri √ √ √
27 308 II Ny.Rika gusvita 34 170600215 post sc a/ig2p1a0h1 gr 37 mg+Letsu+b'sc 1x+cpd √ ML 3X1 bpjs swasta √ √ √
28 322 II Ny.Uri Tramega 31 240100250 POST SC A/Ig3p1a0h1 gr 37-38 mg+b'sc 1x √ ML 3X1 bpjs askes √ √ √
29 317 II Ny.Fadila Rahmi 32 240300073 sc √ ML 3X1 bpjs swasta √ √ √
30 325 III Ny.Mardayana 31 170300471 g3p1a0h1 gr 8-9 mg+HEG drs low intake+syndrom dyspepsia √ ML 3X1 bpjs mandiri √ √ √
31 312 II An..Farzan atharazka 6 170900316 abd pain ec susp app akut √ ML 3X1 bpjs swasta √ √ √
32 307 I Ny. Hariyanti novita 33 240300071 psp √ MB 3X1 bpjs swasta √ √ √
33 301 I Ny. Meri ika putri 34 211100741 post sc √ ML 3X1 bpjs faskes √ √ √
34 322 II Ny. Ulfa saumi 32 190900197 post sc a/I g2p1aoh1 gr 38-39 mgg bsc 1x+ cpd √ ML 3X1 bpjs swasta √ √ √
35 325 III Ny. Yuliyanti 29 240300089 g1p0 gr 11-12 mgg + heg + dyspepsia √ ML 3X1 BPJS PBI √ √ √
36 310 I Ny. Nadya velta 29 240300069 psp √ MB 3X1 BPJS SWASTA √ √ √
 Tanggal : 04/03/2024
Ruangan : Khadijah

NO KAMAR KELAS NAMA PASIEN UMUR NO RM

1 325 III Ny. Hafizah nurul 21 240300014

2 302 II-I Ny. Dewi Angriani 31 240200090
3 321 II Ny.Riva Septia Azimma 27 170400799
4 411 I Ny. Intan Rahmadani 31 240100706
5 311 I Ny. Dewi Yuwanita Mahardika 38 230800362
6 318 II Ny. Sastri Asih 28 240200960
7 317 II Ny. Septhia sumadi 22 191100929
8 323 II Ny.Uci Ramayani 30 220500419
9 316 I Ny. Usmi Juniar Matondang 38 200400248
10 320 I Ny. Decy Pramitasari Yuna 31 240200258
11 309 II Ny. Rafiqah Wuandari Tanjung 22 240300060
12 319 II Ny. Yuli Erda 66 240200823
13 308 II Ny.Rika gusvita 34 170600215
14 322 II Ny.Uri Tramega 31 240100250
15 317 II Ny.Fadila Rahmi 32 240300073
16 325 III Ny.Mardayana 31 170300471
17 312 II An..Farzan atharazka 6 170900316
18 307 I Ny. Hariyanti novita 33 240300071
19 301 I Ny. Meri ika putri 34 211100741
20 322 II Ny. Ulfa saumi 32 190900197
21 325 III Ny. Yuliyanti 29 240300089
22 310 I Ny. Nadya velta 29 240300069
23 325 III Ny. Erma yunita 29 231200145
24 421 II Ny. T. masri 60 240300139
25 323 II Ny. Biru purwati 28 181100672
26 422 III Ny. Rahmadani 29 240300144
27 323 III Ny. Sulaiha 24 240300067
MB : 12 ML : 11
MBTKTP : 1 MLRG :

DIAGNOSA ALERGI
MB ML TC
prolonged fever+syndrom dyspepsia √
ilo post sc h6 √
Hiperpireksia √
Hiperpireksia √
SC + MOW √
SC √
abd pain ec dispepsia+drs+low intake √
post adhesiolisis+histerektomi+myomektomi √
giant fibroid+anemia+vomitus drs low intake √
sc Ayam √
abortus imminiens √
Hiperpireksia + ht + dm + hipoglikemia √
post sc a/ig2p1a0h1 gr 37 mg+Letsu+b'sc 1x+cpd √
POST SC A/Ig3p1a0h1 gr 37-38 mg+b'sc 1x √
sc √
g3p1a0h1 gr 8-9 mg+HEG drs low intake+syndrom dyspepsia √
abd pain ec susp app akut √
psp √
post sc √
post sc a/I g2p1aoh1 gr 38-39 mgg bsc 1x+ cpd √
g1p0 gr 11-12 mgg + heg + dyspepsia √
psp √
sc √
prolong fever ec viral infection drs low intake + geatrik problem √
g3p2a0h2 gr 11-12 mgg + heg + sindrom dispepsia + low intake √
febris h3 ec inf + drs low intake+ sindrom dispepsia √
psp √
MBDM : PUASA:
MLRS : MLRGDM 1
DIET
REKAP JMLH
SONDE MC NTS DL DM RG TKTP RS
ML 3X1
√ MBTKTP 3X1
ML 3X1
ML 3X1
MB 3X1
MB 3X1
ML 3X1
MB 3X1
MB 3X1
MB 3X1
MB 3X1
√ √ MLRGDM 3X2
ML 3X1
ML 3X1
ML 3X1
ML 3X1
ML 3X1
MB 3X1
ML 3X1
ML 3X1
ML 3X1
MB 3X1
MB 3X1
ML 3X1
ML 3X1
ML 3X1
MB 3X1
 KET (KIS & JAMINAN) P S M

BPJS √ √ √
bpjs swasta √ √ √
bpjs swasta √ √ √
bpjs swasta √ √ √
bpjs askes √ √ √
bpjs swasta √ √ √
Bpjs mandiri √ √ √
Bpjs polri √ √ √
Bpjs pns √ √ √
bpjs pns √ √ √
bpjs swasta √ √ √
Bpjs mandiri √ √ √
bpjs swasta √ √ √
bpjs askes √ √ √
bpjs swasta √ √ √
bpjs mandiri √ √ √
bpjs swasta √ √ √
bpjs swasta √ √ √
bpjs faskes √ √ √
bpjs swasta √ √ √
BPJS PBI √ √ √
BPJS SWASTA √ √ √
bpjs pbi (apbd) √ √ √
bpjs pensiunan askes √ √ √
bpjs swasta √ √ √
bpjs mandiri √ √ √
bpjs pbi √ √ √
 Tanggal : 05/03/2024 MB : 15 ML : 14 MBDM : PUASA:
Ruangan : Khadijah MBTKTP : 1 MLRG : MLRS : MLRGDM :
DIET KET (KIS &
NO KAMAR KELAS NAMA PASIEN UMUR NO RM DIAGNOSA ALERGI REKAP JMLH P S M
MB ML TC SONDE MC NTS DL DM RG TKTP RS JAMINAN)
1 302 II-I Ny. Dewi Angriani 31 240200090 ilo post sc h6 √ √ MBTKTP 3X1 bpjs swasta √ √ √
2 318 II Ny. Sastri Asih 28 240200960 SC √ MB 3X1 bpjs swasta √ √ √
3 320 I Ny. Decy Pramitasari Yuna 31 240200258 sc Ayam √ MB 3X1 bpjs pns √ √ √
4 308 II Ny.Rika gusvita 34 170600215 post sc a/ig2p1a0h1 gr 37 mg+Letsu+b'sc 1x+cpd √ ML 3X1 bpjs swasta √ √ √
5 322 II Ny.Uri Tramega 31 240100250 POST SC A/Ig3p1a0h1 gr 37-38 mg+b'sc 1x √ ML 3X1 bpjs askes √ √ √
6 317 II Ny.Fadila Rahmi 32 240300073 sc √ ML 3X1 bpjs swasta √ √ √
7 325 III Ny.Mardayana 31 170300471 g3p1a0h1 gr 8-9 mg+HEG drs low intake+syndrom dyspepsia √ ML 3X1 bpjs mandiri √ √ √
8 312 II An..Farzan atharazka 6 170900316 abd pain ec susp app akut √ ML 3X1 bpjs swasta √ √ √
9 301 I Ny. Meri ika putri 34 211100741 post sc √ ML 3X1 bpjs faskes √ √ √
10 322 II Ny. Ulfa saumi 32 190900197 post sc a/I g2p1aoh1 gr 38-39 mgg bsc 1x+ cpd √ ML 3X1 bpjs swasta √ √ √
11 325 III Ny. Erma yunita 29 231200145 sc √ MB 3X1 bpjs pbi (apbd) √ √ √
12 311 I Ny. Neta Muati 31 240200684 PSP √ MB 3X1 bpjs swasta √ √ √
13 303 VIP Ny. Ananda Tiara Sawendra 28 231200067 post sc a/I g2p1 gr 38-39 mgg + letak obliq + bekas sc √ MB 3X1 bpjs cob inhealth √ √ √
14 304 III Ny.Sarah Novani 36 231000159 syndrom dyspepsia +HT Urgency √ ML 3X1 bpjs mandiri √ √ √
15 310 I Nn. Annes Tasya Putri 26 231200126 obs febris h5 + viral inf + sups dhf grade II + drs + lw intake √ ML 3X1 bpjs mandiri √ √ √
16 325 III Ny. Maulana 33 190600534 post resc3x a/I gr aterm+letak obligh+perlengketan berat √ MB 3X1 bpjs pbi √ √ √
17 309 II Ny. Dewi Oktaviani 36 231000943 post sc a/I gr aterm+bsc 2x+kala 1 fase laten √ MB 3X1 bpjs polri √ √ √
18 307 I Ny. Gusti Wulandari 26 200900620 psp √ MB 3X1 bpjs swasta √ √ √
19 321 II Ny.Ayu anggita 26 240100203 post sc+iud a/I g2p1a0h1 gr 40-41 mg susp cpd+pasang iud √ MB 3X1 bpjs swasta √ √ √
20 319 III Ny. Lisa Juliani 17 240300095 psp √ MB 3X1 bpjs pbi √ √ √
21 319 III Ny. Ovi Ade Saputri 18 240300102 psp √ MB 3X1 bpjs pbi √ √ √
22 317 III Ny.Idfi Purnamasari 28 240300106 Hiperpireksia ec mastitis dx+low intake+anemia √ MB 3X1 bpjs pbi √ √ √
23 325 III Ny. Juana Dewi 27 231200428 g2p0a1h0 gr. 36-37 minggu+hiperpireksia ec viral infection+drs low intake √ ML 3x1 bpjs pbi √ √ √
24 315 III Tn. Rafi Raudho Pamungkas 17 240300100 abdominal pain ec konstipasi √ ML 3x1 bpjs pbi √ √ √
25 321 II Ny. Annisa AW 27 220101014 post sc+iud a/I g4p1a2 gr. 37-38 minggu+bsc+cpd √ MB 3x1 bpjs swasta √ √ √
26 325 III Ny. Ika Aryani 27 180300129 post sc+iud a/I gr. Aterm+bsc+cpd √ MB 3x1 bpjs mandiri √ √ √
27 422 III Ny. Rahmadani 29 240300144 febris h3 ec inf + drs low intake+ sindrom dispepsia √ ML 3x1 bpjs mandiri √ √ √
28 323 III Ny. Sulaiha 24 240300067 psp √ MB 3x1 bpjs pbi √ √ √
29 421 II Ny. T. Masri 60 240300139 prolong fever ec viral infection drs low intake + geatrik problem √ ML 3x1 bpjs pensiunan( √ √ √
30 323 II Biru purwanti 28 181100672 g3p2a0h2 gr 11-12 mgg + heg + sindrom dispepsia + low intake √ ML 3x1 bpjs swasta √ √ √
31 308 I Ny. Zamzamah 64 231000684 abd pain ec sindrom dispepsia drs low intake √ ML 3x1 bpjs pns √ √ √
32 302 I Ny. Desi damiyanti 37 240300159 abd pain ec syndrom dispepsia √ ML 3x1 bpjs pns √ √ √
33 325 III Ny. Rezki amelia 32 240100776 post sc a/I fase laten + cpd + kpd 8jam + inpartu 6jam √ MB 3x1 bpjs mandiri √ √ √
 Tanggal : 06/03/2024
Ruangan : Khadijah

N KAM
KELAS NAMA PASIEN UMUR
O AR

1 312 II An..Farzan atharazka 6

2 301 I Ny. Meri ika putri 34
3 303 VIP Ny. Ananda Tiara Sawendra 28
4 304 III Ny.Sarah Novani 36
5 310 I Nn. Annes Tasya Putri 26
6 325 III Ny. Maulana 33
7 309 II Ny. Dewi Oktaviani 36
8 321 II Ny.Ayu anggita 26
9 317 III Ny.Idfi Purnamasari 28
10 325 III Ny. Juana Dewi 27
11 315 III Tn. Rafi Raudho Pamungkas 17
12 321 II Ny. Annisa AW 27
13 325 III Ny. Ika Aryani 27
14 422 III Ny. Rahmadani 29
15 323 III Ny. Sulaiha 24
16 421 II Ny. T. Masri 60
17 323 II Biru purwanti 28
18 422 III Ny. Rahmadani 29
19 323 III Ny. Sulaiha 24
20 325 III Ny. Darni Yanti Halawah 24
21 325 III Ny. Afira Yenita Putri 21
31 308 I Ny. Zamzamah 64
32 302 I Ny. Desi damiyanti 37
33 325 III Ny. Rezki amelia 32
NO RM

170900316
211100741
231200067
231000159
231200126
190600534
231000943
240100203
240300106
231200428
240300100
220101014
180300129
240300144
240300067
240300139
181100672
240300144
240300067
231000573
240200717
231000684
240300159
240100776
MB : 15
MBTKTP : 1

DIAGNOSA

abd pain ec susp app akut

post sc
post sc a/I g2p1 gr 38-39 mgg + letak obliq + bekas sc
syndrom dyspepsia +HT Urgency
obs febris h5 + viral inf + sups dhf grade II + drs + lw intake
post resc3x a/I gr aterm+letak obligh+perlengketan berat
post sc a/I gr aterm+bsc 2x+kala 1 fase laten
post sc+iud a/I g2p1a0h1 gr 40-41 mg susp cpd+pasang iud
Hiperpireksia ec mastitis dx+low intake+anemia
g2p0a1h0 gr. 36-37 minggu+hiperpireksia ec viral infection+drs low intake
abdominal pain ec konstipasi
post sc+iud a/I g4p1a2 gr. 37-38 minggu+bsc+cpd
post sc+iud a/I gr. Aterm+bsc+cpd
febris h3 ec inf + drs low intake+ sindrom dispepsia
psp
prolong fever ec viral infection drs low intake + geatrik problem
g3p2a0h2 gr 11-12 mgg + heg + sindrom dispepsia + low intake
febris h3 ec inf + drs low intake+ sindrom dispepsia
psp
G1P0A0H0 gr 35-36 mg + kontraksi premature
Post sc + iud a/I G1P0A0H0 gr 37-38 mg + CPD + Riw. Asma
abd pain ec sindrom dispepsia drs low intake
abd pain ec syndrom dispepsia
post sc a/I fase laten + cpd + kpd 8jam + inpartu 6jam
ML : 14 MBDM :
MLRG : MLRS :
DIET
ALERGI SOND
MB ML TC MC NTS DL DM
E
√
√
√
√
√
√
√
√
√
√
√
√
√
√
√
Telur + ayam √
√
√
√
√
√
√
√
√
PUASA:
MLRGDM :
KET (KIS
REKA
JMLH & P S M
RG TKTP RS P
JAMINAN)
ML 3X1 bpjs swasta √ √ √
ML 3X1 bpjs faskes √ √ √
MB 3X1 bpjs cob inhe√ √ √
ML 3X1 bpjs mandiri√ √ √
MB 3X1 bpjs mandiri√ √ √
MB 3X1 bpjs pbi √ √ √
MB 3X1 bpjs polri √ √ √
MB 3X1 bpjs swasta √ √ √
MB 3X1 bpjs pbi √ √ √
ML 3x1 bpjs pbi √ √ √
ML 3x1 bpjs pbi √ √ √
MB 3x1 bpjs swasta √ √ √
MB 3x1 bpjs mandiri√ √ √
ML 3x1 bpjs mandiri√ √ √
MB 3x1 bpjs pbi √ √ √
ML 3x1 bpjs pensiun √ √ √
ML 3x1 bpjs swasta √ √ √
ML 3x1 bpjs mandiri√ √ √
MB 3x1 bpjs pbi √ √ √
MB 3x1 bpjs pbi √ √ √
MB 3x1 bpjs mandiri√ √ √
ML 3x1 bpjs pns √ √ √
ML 3x1 bpjs pns √ √ √
MB 3x1 bpjs mandiri√ √ √
√
√
√
 Tanggal : 10/03/2024
Ruangan : Khadijah
NO KAMAR KELAS NAMA PASIEN UMUR NO RM

1 303 II Ny. Siti Lailani 26 200200884

2 308 III Ny. Devi eka putri 39 180200285
3 325 II Ny.Yuni Erti 34 230900248
4 318 III Ny. Rara Wetri 27 231000922
5 318 III Ny. Melati oktaviani 25 210200353
6 315 III Tn.Samuel parluhutan 19 240300271
7 302 I Ny. Merissa Asrina 33 211100112
8 319 III Ny. Rita Harefa 46 231100277
9 311 I Ny. Masmianti 46 240300283
10 325 III Ny. Novalianti 38 240200525
11 318 II Ny. Julisa 29 170800013
12 405 I Nn. Novita sari 30 201000626
13 307 I Ny. Meiriau khasana/tn solihin 27 230700732
14 325 III Ny. Pretty asyifa nazani 20 240200675
15 323 II Ny. Nila Naswati 42 240300325
16 323 II Nn. Faza hadaina 29 231200703
17 324 II Ny. Tio natalia sitorus 28 240300294
18 312 II-I Ny. Yayuk irawati 34 240300297
19 309 II Ny. Siti nur pujiasih 33 160400687
20 320 II Ny. Betriuliana sinaga 26 240100119
21 319 II Ny. Rizki Amalia 27 200701009
22 325 III Ny. Rahmatan Fathonah 22 240300049
23 316 II Ny. Novella Alnaira 25 190600106
24 308 II Ny. Riska Wanti / Tn. Rayus 35 240300016
25 325 III Ny. Ria Anggraini / Tn. Juli 49 170700032
26 325 III Ny. Putri Novrianti / Tn. Rudi Ha 33 201000177
27 320 I Ny. Izza Ifkarina / Tn. M. Hasan 25 231200599
28 304 umum VIP Ny. Rahmawati 31 210101067
29 311 II-1 Ny. Jihan aprida 22 230700866
30 302 I Ny. Usmi juniar 23 200400248
31 *303 vip Ny. Raja ernalius / tn 63 240300352
MB : 18 ML :4
MBTKTP : MLRG :
DIAGNOSA ALERGI DIET

MB

post debridement √
SC √
SC + Steril √
SC √
SC √
abdominal pain ec susp app
post re sc + adhesiolisis √
post adhesiolisis anemia √
PUA √
post sc Udang √
psp √
sindrom dispepsia
psp √
post sc a/I kpd √
HEG
post adhesiolisi debulking √
SC √
SC + IUD √
VE √
SC Udang √
gea drs + low intake + sindrom dyspepsia
PSP √
psp √
Post sc + iud
HT gr II + Abdominal Pain ec syndrom dyspepsia + kosntipasi + Drs Low Intake
Post SC
Reheacting
G4p3a0h3 gr 20-21mgg + ppv ec susp plasenta previa √
psp √
abdominal paint ec vaginal bleding ec giant fibroid + anemia + obs vomitus
obs febris h3h3 ec viral inf drs low intake sindrom dispsia dm + ht ontritmean
 MBDM : PUASA:
MLRS : MLRGDM :
DIET REKAP JMLH

ML TC SON MC NTS DL DM RG TKTP RS

DE
MB 3X1
MB 3X1
MB 3X1
MB 3X1
MB 3X1
√ ML 3X1
MB 3X1
MB 3X1
MB 3X1
MB 3X1
MB 3X1
√ ML 3X1
MB 3X1
MB 3X1
√ ML 3X1
MB 3X1
MB 3X1
MB 3X1
MB 3X1
MB 3X1
√ ML 3X1
MB 3X1
MB 3X1
√ ML 3X1
√ ML 3X1
√ ML 3X1
√ ML 3X1
MB 3X1
MB 3X1
√ ML 3X1
√ √ √ ML 3X1
KET (KIS & P S M
JAMINAN)

bpjs PNS √ √ √
bpjs swasta √ √ √
bpjs mandiri √ √ √
bpjs tni √ √ √
bpjs swasta √ √ √
bpjs pbi √ √ √
bpjs PNS √ √ √
bpjs pbi √ √ √
bpjs PNS √ √ √
bpjs mandiri √ √ √
bpjs swasta √ √ √
bpjs swasta √ √ √
uir sehat cob bpjs √ √ √
bpjs pbi(apbn) √ √ √
bpjs swasta √ √ √
bpjs swasta √ √ √
bpjs swasta √ √ √
bpjs mandiri √ √ √
bpjs cob ptpn √ √ √
bpjs askes √ √ √
bpjs non pns √ √ √
bpjs pbi √ √ √
bpjs swasta √ √ √
bpjs polri √ √ √
bpjs pbi √ √ √
bpjs pbi √ √ √
bpjs bumn √ √ √
umum VIP √ √ √
bpjs pns √ √ √
bpjs swasta √ √ √
bpjsm mandiri √ √ √
 Tanggal : 11/03/2024 MB :8 ML :8 MBDM : PUASA:
Ruangan : Khadijah MBTKTP : MLRG : MLRS : MLRGDM :
DIET
KET (KIS &
NO KAMAR KELAS NAMA PASIEN UMUR NO RM DIAGNOSA ALERGI REKAP JMLH P S M
MB ML TC SONDE MC NTS DL DM RG TKTP RS JAMINAN)

1 319 III Ny. Rita Harefa 46 231100277 post adhesiolisis anemia √ MB 3X1 bpjs pbi √ √ √
2 323 II Ny. Nila Naswati 42 240300325 HEG √ ML 3X1 bpjs swasta √ √ √
3 323 II Nn. Faza hadaina 29 231200703 post adhesiolisi debulking √ MB 3X1 bpjs swasta √ √ √
4 324 II Ny. Tio natalia sitorus 28 240300294 SC √ MB 3X1 bpjs swasta √ √ √
5 319 II Ny. Rizki Amalia 27 200701009 GEA √ ML 3X1 bpjs non pns √ √ √
6 325 III Ny. Rahmatan Fathonah 22 240300049 PSP √ MB 3X1 bpjs pbi √ √ √
7 316 II Ny. Novella Alnaira 25 190600106 psp √ MB 3X1 bpjs swasta √ √ √
8 308 II Ny. Riska Wanti / Tn. Rayus 35 240300016 Post sc + iud √ ML 3X1 bpjs polri √ √ √
9 325 III Ny. Ria Anggraini / Tn. Juli 49 170700032 HT gr II syndrom dyspepsia √ ML 3X1 bpjs pbi √ √ √
10 325 III Ny. Putri Novrianti / Tn. Rudi H 33 201000177 Post SC √ ML 3X1 bpjs pbi √ √ √
11 320 I Ny. Izza Ifkarina / Tn. M. Hasan 25 231200599 Reheacting √ ML 3X1 bpjs bumn √ √ √
12 304 umum VIP Ny. Rahmawati 31 210101067 ppv ec susp plasenta previa √ MB 3X1 umum VIP √ √ √
13 311 II-1 Ny. Jihan aprida 22 230700866 psp √ MB 3X1 bpjss swasta √ √ √
14 302 I Ny. Usmi juniar 23 200400248 abdominal paint ec vaginal bleding √ ML 3X1 bpjs pns √ √ √
15 310 I Ny. Deasy Dwi cahyani 32 220600563 PPV ec susp ab. Iminens √ ML 3X1 bpjs swasta √ √ √
16 307 I Ny. Roslina yanti br simbolon 35 230200737 syndrom dispepsia ikan asin, ikan asin, telur √ MB 3X1 bpjs COB PTPN√ √ √
17 *303 vip Ny. Raja ernalius / tn 63 240300352 obs febris h3h3 ec viral inf drs low intake sindrom dispsia dm + ht ontritmean √ √ √ ML 3X1 bpjsm mandiri √ √ √
18 315 II Ny. Dewi shinta 25 40300349 psp √ MB 3X1 bpjss mandiri √ √ √
19 324 II Ny. Rani andikha al husna 26 200900967 psp √ MB 3X1 bpjss swasta √ √ √
20 325 III Ny. Juita ramilinda 28 210501086 hiperpireksia ec viral infection +drs+low intake √ ML 3X1 bpjs pbi √ √ √
21 315 II Ny. Siska anggria 31 240200272 post sc a/I g2p1a0h1 gr 35-40 letsu +makrosemia √ ML 3X1 bpjs swasta √ √ √
22 325 III Ny. Dwiyanti 36 181000095 post sc + mow a/I g5p3 gr 38-39mgg + bsc 3x + cukup anak √ ML 3X1 bpjs infertor √ √ √
23 312 I Ny. Devi Nafalia Hutapea 30 240200183 Post sc a/I G2P1A0H0 gr 38-39 mg + kala 1 fase aktif + KPD + PTM √ ML 3X1 bpjs mandiri √ √ √
24 324 II Ny. Puji Astuti 29 201000864 Vertigo serangan akut + abdominal pain ec sindrom dispepsia √ ML 3X1 bpjs swasta √ √ √
 Tanggal : 12/03/2024 MB :9 ML :8 MBDM : PUASA:
Ruangan : Khadijah MBTKTP : MLRG : MLRS : MLRGDM1
DIET KET (KIS &
NO KAMAR KELAS NAMA PASIEN UMUR NO RM DIAGNOSA ALERGI REKAP JMLH
MB ML TC SONDE MC NTS DL DM RG TKTP RS JAMINAN)
1 319 III Ny. Rita Harefa 46 231100277 post adhesiolisis anemia √ MB 3X1 bpjs pbi
2 323 II Nn. Faza hadaina 29 231200703 post adhesiolisi debulking √ MB 3X1 bpjs swasta
3 319 II Ny. Rizki Amalia 27 200701009 GEA √ ML 3X1 bpjs non pns
4 308 II Ny. Riska Wanti 35 240300016 Post sc + iud √ MB 3X1 bpjs polri
5 325 III Ny. Ria Anggraini 49 170700032 HT gr II syndrom dyspepsia √ ML 3X1 bpjs pbi
6 320 I Ny. Izza Ifkarina 25 231200599 Reheacting √ ML 3X1 bpjs bumn
7 304 umum VIP Ny. Rahmawati 31 210101067 ppv ec susp plasenta previa √ MB 3X1 umum VIP
8 302 I Ny. Usmi juniar 23 200400248 abdominal paint ec vaginal bleding √ ML 3X1 bpjs pns
9 310 I Ny. Deasy Dwi cahyani 32 220600563 PPV ec susp ab. Iminens √ ML 3X1 bpjs swasta
10 307 I Ny. Roslina yanti br simbolon 35 230200737 syndrom dispepsia ikan asin, ikan asin, telur √ MB 3X1 bpjs COB PTPN
11 *303 vip Ny. Raja ernalius 63 240300352 obs febris h3h3 ec viral inf drs low intake sindrom dispsia dm + ht ontritmean √ √ √ MLRGDM 3X1
: bpjsm mandiri
12 315 II Ny. Dewi shinta 25 40300349 psp √ MB 3X1 bpjss mandiri
13 324 II Ny. Rani andikha al husna 26 200900967 psp √ MB 3X1 bpjss swasta
14 325 III Ny. Juita ramilinda 28 210501086 hiperpireksia ec viral infection √ ML 3X1 bpjs pbi
15 315 II Ny. Siska anggria 31 240200272 post sc a/I g2p1a0h1 gr 35-40 letsu +makrosemia √ ML 3X1 bpjs swasta
16 325 III Ny. Dwiyanti 36 181000095 post sc + mow √ MB 3X1 bpjs infertor
17 312 I Ny. Devi Nafalia Hutapea 30 240200183 Post sc √ ML 3X1 bpjs mandiri
18 324 II Ny. Puji Astuti 29 201000864 Vertigo serangan akut + abdominal pain ec sindrom dispepsia √ ML 3X1 bpjs swasta
19 323 II Ny. Ulfa mawaddah 25 190300584 post sc a/I g2p1a0h1 gr 38-39 mgg + bsc 1x √ ML 3x1 bpjs mandiri
20 321 III Ny. Atnatul fatwa 27 240300330 post sc a/I g1p0a0 gr 39-40 mgg kala 1 fase laten + kpd √ ML 3x1 bpjs pbi
21 309 I Ny. Yanni fransiska 36 190500613 post sc a/I g4p2a1h2 gr 37-38 mgg bsc 2x + mow √ ML 3x1 bpjs non pns
22 311 II Ny. Intan tri putri 27 240300374 post sc a/I g1p0a0 gr 37-38 mgg + kala 1 fase laten + cpd + iud √ ML 3x1 bpjs mandiri
23 322 II Ny. Siti jahro 29 240300111 Post sc a/I G3P1A1H1 gr aterm + fs. Laten + BSC + CPD √ ML 3x1 bpjs swasta
24 318 II Ny. Dewi hartati 34 171100433 psp √ MB 3x1 bpjs mandiri
P S M
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
 Tanggal : 13/03/2024 MB : 11 ML :5 MBRG : 1 PUASA:
Ruangan : Khadijah MBTKTP : MLRG :1 MLRS : MLRGDM : 1
DIET KET (KIS &
NO KAMAR KELAS NAMA PASIEN UMUR NO RM DIAGNOSA ALERGI REKAP JMLH P S M
MB ML TC SONDE MC NTS DL DM RG TKTP RS JAMINAN)
1 325 III Ny. Ria Anggraini 49 170700032 HT gr II syndrom dyspepsia √ ML 3X1 bpjs pbi √ √ √
2 304 umum VIP Ny. Rahmawati 31 210101067 psp √ MB 3X1 umum VIP √ √ √
3 307 I Ny. Roslina yanti br simbolon 35 230200737 syndrom dispepsia ikan asin, ikan asin, telur √ MB 3X1 bpjs COB PTPN √ √ √
4 *303 vip Ny. Raja ernalius 63 240300352 obs febris h3h3 ec viral inf drs low intake sindrom dispsia dm + ht ontritmean √ √ √ MLRGDM 3: X1 bpjsm mandiri √ √ √
5 312 I Ny. Devi Nafalia Hutapea 30 240200183 Post sc √ ML 3X1 bpjs mandiri √ √ √
6 324 II Ny. Puji Astuti 29 201000864 Vertigo serangan akut + abdominal pain ec sindrom dispepsia √ ML 3X1 bpjs swasta √ √ √
7 325 III Ny. Cica wulandari 22 240300368 g1p0a0h0 gr 6-7 mgg heg sindrom dyispepsia drs low intake √ MB 3X1 bpjs pbi √ √ √
8 325 III Ny. Nur bima 24 240300365 psp √ MB 3X1 bpjs pbi √ √ √
9 317 II Ny. Fanny windra sari 37 211108887 post sc a/I g5p3a0h2 gr 34-35mgg + hdk +ppi+bsc3x +mow √ √ MBRG 3X1 bpjs swasta √ √ √
10 323 II Ny. Ulfa mawaddah 25 190300584 SC √ MB 3X1 bpjs mandiri √ √ √
11 321 III Ny. Atnatul fatwa 27 240300330 post sc a/I g1p0a0 gr 39-40 mgg kala 1 fase laten + kpd √ MB 3X1 bpjs pbi √ √ √
12 309 I Ny. Yanni fransiska 36 190500613 post sc a/I g4p2a1h2 gr 37-38 mgg bsc 2x + mow √ MB 3X1 bpjs non pns √ √ √
13 322 II Ny. Siti Jahro 29 240300111 Post sc a/I G3P1A1H1 gr aterm + fs. Laten + BSC + CPD √ MB 3X1 bpjs swasta √ √ √
14 311 II Ny. Intan Tri Putri 27 240300374 post sc a/I g1p0a0 gr 37-38 mgg + kala 1 fase laten + cpd + iud √ MB 3X1 bpjs mandiri √ √ √
15 310 I Ny. Norlela 82 240300344 gea+drs low intake+parotitis √ √ MLRG 3X1 bpjs swasta √ √ √
16 319 III Ny. Monna Angreani 37 240300038 psp √ MB 3X1 bpjs mandiri √ √ √
17 325 III Ny. Nani Agustina 25 240200624 psp √ MB 3X1 bpjs pbi √ √ √
18 318 II Ny. Nurlaila 37 240300382 post sc+steril a/I g6p3a0h3+gr. Aterm+letak lintang √ MB 3X1 bpjs swasta √ √ √
19 325 III Ny. Revi Gloria 24 240300410 g1p0a0h0 gr. 13-14 minggu+heg+drs low intake √ ML 3X1 bpjs pbi √ √ √
20 323 II Ny. Fitria noviani 20 230801000 heg √ ML 3X1 bpjs swsata √ √ √
21 308 II Ny. Melisa yolanda 32 220200174 sc √ MB 3X1 bpjs swsata √ √ √
22 325 III Ny. Susanti mekayasa 39 230600123 sc √ MB 3X1 bpjs pbi √ √ √
23 321 II Ny. Siti zubaidah 26 240200906 heg √ ML 3X1 bpjs pbi √ √ √
24 316 III An. Shofia syauqia 11 181200790 susp app √ ML 3X1 bpjs pbi √ √ √
25 325 III Ny. Winda Eka Saputri 36 240300415 Post sc + steril a/I G3P2A0H2 gr aterm + fs. Laten + let. Lintang + anak cukup √ ML 3X1 bpjs mandiri √ √ √
26 312 I Ny. Elpa sari singap sinamo 31 240200954 post sc a/I g2p1a0h1 gr 38-39mgg+ kala 1 fs laten +kpd 8jam √ MB 3X1 bpjs swsata √ √ √
27 302 I Ny. Nasrifa rahmah 33 180200539 Tumor ovarium bilateral+inpatensi tuba gila √ MB 3X1 bpjs swsata √ √ √
 Tanggal : 14/03/2024 MB : ML : MBRG : PUASA:
Ruangan : Khadijah MBTKTP : MLRG : MLRS : MLR1
KAMA UMU DIET KET (KIS &
NO KELAS NAMA PASIEN NO RM DIAGNOSA ALERGI SON M NT D TKT REKAP JMLH P S M
R R MB ML TC DL RG RS JAMINAN)
DE C S M P
1 325 III Ny. Ria Anggraini 49 170700032 HT gr II syndrom dyspepsia √ ML 3X1 bpjs pbi √ √ √
2 317 II Ny. Fanny windra sari 37 211108887 post sc+mow + hdk √ √ MBRG 3X1 bpjs swasta √ √ √
3 323 II Ny. Ulfa mawaddah 25 190300584 SC √ MB 3X1 bpjs pbi √ √ √
4 321 III Ny. Atnatul fatwa 27 240300330 SC √ MB 3X1 bpjs pbi √ √ √
5 309 I Ny. Yanni fransiska 36 190500613 SC √ MBRG 3X1 bpjs swasta √ √ √
6 322 II Ny. Siti Jahro 29 240300111 SC √ MB 3X1 bpjs mandiri √ √ √
7 311 II Ny. Intan Tri Putri 27 240300374 SC √ MB 3X1 bpjs pbi √ √ √
8 310 I Ny. Norlela 82 240300344 GEA √ √ MB 3X1 bpjs non pns √ √ √
9 318 II Ny. Nurlaila 37 240300382 SC + Steril √ MLRG 3X1 bpjs swasta √ √ √
10 325 III Ny. Revi Gloria 24 240300410 HEG √ MB 3X1 bpjs mandiri √ √ √
11 323 III Ny. Fitria Noviani 20 230801000 g1 gr 33-34 mgg + dypepsia + ppi √ MB 3X1 bpjs pbi √ √ √
12 308 II Ny. Melisa yolanda 32 220200174 SC √ ML 3X1 bpjs pbi √ √ √
13 325 III Ny. Susanti mekayasa 39 230600123 SC √ ML 3X1 bpjs pbi √ √ √
14 321 II Ny. Siti zubaidah 26 240200906 HEG √ ML 3X1 bpjs swsata √ √ √
15 301 I Ny. Santi mustika 26 240300414 SC √ MB 3X1 bpjs swsata √ √ √
16 315 II Ny. Agnes khustiani 25 240300407 SC √ MB 3X1 bpjs pbi √ √ √
17 325 III Ny. Winda Eka Saputri 36 240300415 Post sc + steril √ ML 3X1 bpjs pbi √ √ √
18 312 I Ny. Elpa sari singap sinamo 31 240200954 post sc √ MB 3X1 bpjs akes √ √ √
19 302 I Ny. Nasrifa rahmah 33 180200539 Tumor ovarium bilateral √ MB 3X1 bpjs tni √ √ √
20 318 III Ny. Risha janelia 231000299 g2p1a0h1 gea gr 36-37 mgg √ ML 3X1 bpjs mandiri √ √ √
21 316 III An.Shofia syauqia 11 181200790 susp app √ ML 3X1 bpjs pbi √ √ √
22 315 II Ny. Emy khustiari 25 240300407 sc √ MB 3X1 bpjs tni √ √ √
23 325 III Ny. Juana dewi 27 231200428 psp √ MB 3X1 bpjs pbi √ √ √
 Tanggal : 15/03/2024 MB :16 ML :4 MBRG : 1 PUASA: 1
Ruangan : Khadijah MBTKTP : MLRG : MLRG : MLRGDM :
DIET KET (KIS &
NO KAMAR KELAS NAMA PASIEN UMUR NO RM DIAGNOSA ALERGI REKAP JMLH P S M
MB ML TC SONDE MC NTS DL DM RG TKTP RS JAMINAN)
1 311 I Ny. Norlela 82 240300344 GEA+HT √ ML 3X1 bpjs non pns √ √ √
2 302 I Ny. Nasrifa rahmah 33 180200539 post debulking+kistektomi √ MB 3X1 bpjs tni √ √ √
325 III Ny. Yuli Susanti 26 240300445 √ Bpjs Pbi
3 SC MB 3x1 √ √ √
322 III Ny. Murdianti 30 190900901 √ bpjs mandiri
4 SC MB 3x1 √ √ √
5 325 III Ny. Ikke aneke 34 240300429 SC √ MB 3x1 bpjs mandiri √ √ √
6 318 III Ny. Tika Suryani 26 240300215 SC Ikan Tongkol √ MB 3x1 bpjs mandiri √ √ √
7 321 II Ny. Wella Wulandari 30 210700495 obesitas+hdk+dm √ √ MBDM 3x1 bpjs polri √ √ √
8 323 II Ny. Izza bahial choiri amalia 27 240300455 SC √ MB 3X1 bpjs swasta √ √ √
9 410 II Tn. Abdul Rahman 28 240300479 GEA + DRS + febris ec viral inf + low intake √ ML 3X1 bpjs swasta √ √ √
10 409 I Ny. Aisyah 35 190900770 DRS + Obs febris ec Viral Inf + Low Intake √ ML 3X1 bpjs swasta √ √ √
11 322 III Ny. Pitri Wahyuni 35 240100969 G6P4A1H3 gr 35-36 mngg + Letsu PPI √ MB 3X1 Bpjs Pbi √ √ √
12 318 III Ny. Neneng Anjar Wati 21 240300484 G1P0A0H0 Gr 12-13 mg+heg+drs+low intake+dyspepsia √ ML 3X1 Bpjs Pbi √ √ √
13 308 I Ny. Wella Danillia 26 200900896 SC √ MB 3X1 bpjs swasta √ √ √
14 320 II Ny. Yanti Ofita 29 240300101 SC √ MB 3X1 bpjs swasta √ √ √
15 325 III Ny. Reni Agustin 32 240100041 SC √ MB 3X1 bpjs mandiri √ √ √
16 306 I Ny. Santy Octavia Mauris 42 160200896 SC Alergi seafood √ MB 3X1 bpjs swasta √ √ √
17 307 I Ny. Meltafina 31 240300485 SC √ MB 3X1 bpjs non pns √ √ √
18 324 III Ny. Sri wahyuni 21 220600141 SC √ MB 3X1 bpjs mandiri √ √ √
19 304 I Ny.Siska juliana 29 190200032 SC √ MB 3X1 bpjs swasta √ √ √
20 316 I Ny.Miska maulidya 32 200100226 SC √ MB 3X1 bpjs non pns √ √ √
21 303 I Ny.Ayu kurniasari 40 240300417 mioma uteri Puasa
22 324 III Ny.Nur'aini 29 240300498 SC √ mb 3X1 bpjs non pns √ √ √
23 312 I Ny. Riska Julya 35 240300461 SC √ MB 3X1 bpjs swasta √ √ √
24 301 II Ny. Anggria Roza 39 240200917 post debulking √ MB 3X1 Bpjs tni √ √ √
25 325 III Ny. Nilawati 50 240200203 AUB+adhenomiosis+anemia puasa
26 325 III Ny. Rosmala Rici 31 240300486 SC √ MB 3X1 bpjs mandiri √ √ √
27 317 III Ny. Wira 30 190200123 GEA + DRS + febris ec viral inf + low intake √ ML 3X1 Bpjs Pbi √ √ √
28 405 II Ny. Diah 30 190900536 Febris √ ML 3X1 Bpjs TNI √ √ √
 Tanggal : 16/03/2024 MB : 19 ML :4 MBRG : PUASA: 2
Ruangan : Khadijah MBTKTP : MLRS :1 MLRG : MBDM1
DIET
KET (KIS &
NO KAMAR KELAS NAMA PASIEN UMUR NO RM DIAGNOSA ALERGI SOND REKAP JMLH P S M
MB ML TC MC NTS DL DM RG TKTP RS JAMINAN)
E
1 321 II Ny. Wella Wulandari 30 210700495 obesitas+hdk+dm √ √ MBDM 3x1 bpjs polri √ √ √
2 323 II Ny. Izza bahial choiri amalia 27 240300455 SC √ MB 3X1 bpjs swasta √ √ √
3 409 I Ny. Aisyah 35 190900770 DRS + Obs febris ec Viral Inf √ ML 3X1 bpjs swasta √ √ √
4 308 I Ny. Wella Danillia 26 200900896 SC √ MB 3X1 bpjs swasta √ √ √
5 320 II Ny. Yanti Ofita 29 240300101 SC √ MB 3X1 bpjs swasta √ √ √
6 325 III Ny. Reni Agustin 32 240100041 SC √ MB 3X1 bpjs mandiri √ √ √
7 306 I Ny. Santy Octavia Mauris 42 160200896 SC seafood √ MB 3X1 bpjs swasta √ √ √
8 307 I Ny. Meltafina 31 240300485 SC √ MB 3X1 bpjs non pns √ √ √
9 324 III Ny. Sri wahyuni 21 220600141 SC √ MB 3X1 bpjs mandiri √ √ √
10 304 I Ny.Siska juliana 29 190200032 SC √ MB 3X1 bpjs swasta √ √ √
11 316 I Ny.Miska maulidya 32 200100226 SC √ MB 3X1 bpjs non pns √ √ √
12 303 I Ny.Ayu kurniasari 40 240300417 mioma uteri √ MB 3X1 bpjs askes √ √ √
13 324 III Ny.Nur'aini 29 240300498 SC √ mb 3X1 bpjs non pns √ √ √
14 312 I Ny. Riska Julya 35 240300461 SC √ MB 3X1 bpjs swasta √ √ √
15 301 II Ny. Anggria Roza 39 240200917 post debulking √ MB 3X1 Bpjs tni √ √ √
16 325 III Ny. Nilawati 50 240200203 AUB+adhenomiosis+anemia √ MB 3X1 bpjs pbi √ √ √
17 325 III Ny. Rosmala Rici 31 240300486 SC √ MB 3X1 bpjs mandiri √ √ √
18 317 III Ny. Wira 30 190200123 GEA + DRS + febris ec viral inf √ √ MLRS 3X1 Bpjs Pbi √ √ √
19 405 II Ny. Diah 30 190900536 Febris √ ML 3X1 Bpjs TNI √ √ √
20 309 I Ny.Citra nur hidayati 39 240300529 Vertigo √ ML 3X1 bpjs mandiri √ √ √
21 323 III Ny.Wahyuni 29 220800636 SC √ ML 3X1 Bpjs Pbi √ √ √
22 323 III Ny.Rena aulia 15 240100093 SC √ ML 3X1 Bpjs Pbi √ √ √
23 315 II Ny. Cici Nurul Zulda 27 240300433 sc √ MB 3X1 bpjs mandiri √ √ √
24 302 I Ny. Novia Indri Lestari 26 240100900 psp √ MB 3X1 bpjs bumn √ √ √
25 325 III Nn. Fitri Erni Tanjung 16 240300521 sc √ MB 3X1 bpjs pbi √ √ √
26 322 II Ny. Miralyn Afrini 42 240300554 psp √ MB 3X1 bpjs swasta √ √ √
 Tanggal : 17/03/2024 MB : 19 ML :6 MBRG : PUASA:
Ruangan : Khadijah MBTKTP : MLRS :1 MLRG : MBDM: 1
DIET KET (KIS &
NO KAMAR KELAS NAMA PASIEN UMUR NO RM DIAGNOSA ALERGI SOND TKT REKAP JMLH P S M
MB ML TC MC NTS DL DM RG RS JAMINAN)
E P
1 321 II Ny. Wella Wulandari 30 210700495 obesitas+hdk+dm √ √ MBDM 3x1 bpjs polri √ √ √
2 409 I Ny. Aisyah 35 190900770 DRS + Obs febris ec Viral Inf √ ML 3X1 bpjs swasta √ √ √
3 308 I Ny. Wella Danillia 26 200900896 SC √ MB 3X1 bpjs swasta √ √ √
4 320 II Ny. Yanti Ofita 29 240300101 SC √ MB 3X1 bpjs swasta √ √ √
5 325 III Ny. Reni Agustin 32 240100041 SC √ MB 3X1 bpjs mandiri √ √ √
6 306 I Ny. Santy Octavia Mauris 42 160200896 SC seafood √ MB 3X1 bpjs swasta √ √ √
7 307 I Ny. Meltafina 31 240300485 SC √ MB 3X1 bpjs non pns √ √ √
8 324 III Ny. Sri wahyuni 21 220600141 SC √ MB 3X1 bpjs mandiri √ √ √
9 304 I Ny.Siska juliana 29 190200032 SC √ MB 3X1 bpjs swasta √ √ √
10 316 I Ny.Miska maulidya 32 200100226 SC √ MB 3X1 bpjs non pns √ √ √
11 303 I Ny.Ayu kurniasari 40 240300417 mioma uteri √ MB 3X1 bpjs askes √ √ √
12 324 III Ny.Nur'aini 29 240300498 SC √ mb 3X1 bpjs non pns √ √ √
13 312 I Ny. Riska Julya 35 240300461 SC √ MB 3X1 bpjs swasta √ √ √
14 301 II Ny. Anggria Roza 39 240200917 post debulking √ MB 3X1 Bpjs tni √ √ √
15 325 III Ny. Nilawati 50 240200203 AUB+adhenomiosis+anemia √ MB 3X1 bpjs pbi √ √ √
16 325 III Ny. Rosmala Rici 31 240300486 SC √ MB 3X1 bpjs mandiri √ √ √
17 317 III Ny. Wira 30 190200123 GEA + DRS + febris ec viral inf √ √ MLRS 3X1 Bpjs Pbi √ √ √
18 405 II Ny. Diah 30 190900536 Febris √ ML 3X1 Bpjs TNI √ √ √
19 317 III An. Astrid Intan Viola, 9 thn 220700790 sups spp √ ML 3X1 Bpjs Pbi √ √ √
20 316 II Ny. Yulia Nur A. 25 240100862 G1P0 gr + obs. Febris + PPI √ ML 3X2 Bpjs PNS √ √ √
21 309 I Ny.Citra nur hidayati 39 240300529 Vertigo √ ML 3X1 bpjs mandiri √ √ √
22 323 III Ny.Wahyuni 29 220800636 SC √ ML 3X1 Bpjs Pbi √ √ √
23 323 III Ny.Rena aulia 15 240100093 SC √ ML 3X1 Bpjs Pbi √ √ √
24 315 II Ny. Cici Nurul Zulda 27 240300433 sc √ MB 3X1 bpjs mandiri √ √ √
25 302 I Ny. Novia Indri Lestari 26 240100900 psp √ MB 3X1 bpjs bumn √ √ √
26 325 III Nn. Fitri Erni Tanjung 16 240300521 sc √ MB 3X1 bpjs pbi √ √ √
27 322 II Ny. Miralyn Afrini 42 240300554 psp √ MB 3X1 bpjs swasta √ √ √
28 311 I An. Adiba syakila azzahra 8 240300573 susp appendiciti akut dd isk √ ML 3X1 bpjs askes √ √ √
 Tanggal : 18/03/2024 MB :9 ML :5 MBRG : PUASA:
Ruangan : Khadijah MBTKTP : MLRS 1 MLRG : MBDM: 1
DIET KET (KIS &
NO KAMAR KELAS NAMA PASIEN UMUR NO RM DIAGNOSA ALERGI REKAP JMLH P S M
MB ML TC SONDE MC NTS DL DM RG TKTP RS JAMINAN)
1 321 II Ny. Wella Wulandari 30 210700495 obesitas+hdk+dm √ √ MBDM 3x1 bpjs polri √ √ √
2 409 I Ny. Aisyah 35 190900770 DRS + Obs febris ec Viral Inf √ ML 3X1 bpjs swasta √ √ √
3 303 I Ny.Ayu kurniasari 30 190900536 post debulking √ ML 3X1 Bpjs Pbi √ √ √
4 324 III Ny.Nur'aini 26 220700790 SC √ ML 3X1 Bpjs PNS √ √ √
5 325 III Ny. Nilawati 50 240200203 Post histerektomi √ MB 3X1 bpjs pbi √ √ √
6 301 II Ny. Anggria Roza 39 240300529 post debulking √ MB 3X1 Bpjs Pbi √ √ √
7 317 III Ny. Wira 15 240100093 colesistitis √ ML 3X1 bpjs mandiri √ √ √
8 405 II Ny. Diah 27 240300433 Febris √ MB 3X1 bpjs bumn √ √ √
9 323 III Ny.Wahyuni 29 220800636 SC √ MB 3X1 Bpjs Pbi √ √ √
10 325 III Nn. Fitri Erni Tanjung 16 240300521 sc √ MB 3X1 bpjs pbi √ √ √
11 323 III Ny.Rena aulia 15 240100093 SC √ MB 3X1 Bpjs Pbi √ √ √
12 316 II Ny. Yulia Nur A. 25 240100862 G1P0 gr + obs. Febris + PPI √ MB 3X1 Bpjs PNS √ √ √
13 310 I Ny. Fitriani Suyanto 28 170300523 gea+drs seafood √ √ MLRS 3X1 umum √ √ √
14 417 II Ny. Revini 32 230100140 TFA+drs+syndrom dyspepsia √ ML 3X1 bpjs swasta √ √ √
15 325 III Ny. Yeni Kartika 25 240200327 P0A1 + PPV ec √ MB 3X1 Bpjs Pbi √ √ √
16 325 III Ny.Devi sri melati sianturi 26 240300530 psp √ MB 3X1 Bpjs Pbi √ √ √
17 311 I An. Adiba syakila azzahra 8 240300573 susp appendiciti akut dd isk √ ML 3X1 bpjs askes √ √ √
18 308 I ny. Vivi zainir 34 240300214 g2p1a0h1 gr 38-39 mgg + gea drs dyspepsia sindrom dyspepsia √ ML 3X1 bpjs mandiri √ √ √
19 302 I Ny. Raudhatul Jannah 28 221100355 Post sc + iud a/I G2P1A0H1 gr 39-40 mngg + inpartu kala 1 fs laten + KPD 10 jam + bsc <2th ML 3X1 bpjs askes √ √ √
20 324 III Ny.Ega 28 240300571 SC ML 3X1 bpjs mandiri √ √ √
21 325 III Ny.Mardiah 23 240100750 SC ML 3X1 bpjs mandiri √ √ √
22 324 III Ny.Citra Aismana 30 190400797 SC ML 3X1 Bpjs Pbi √ √ √
23 325 III Ny.Ari sandi 43 240300228 SC ML 3X1 bpjs mandiri √ √ √
24 325 III Ny.Nicke zulkarnain 38 240300581 SC ML 3X1 bpjs mandiri √ √ √
25 322 II Ny.Heni Natalia 32 180800675 gea drs +Low intake ML 3X1 bpjs swasta √ √ √
 Tanggal : 19/03/2024 MB : 10 ML :3 MBRG : PUASA:
Ruangan : Khadijah MBTKTP : MLRS 3 MLRG : MBDM: 1
DIET
KET (KIS &
NO KAMAR KELAS NAMA PASIEN UMUR NO RM DIAGNOSA ALERGI SOND REKAP JMLH P S M
MB ML TC MC NTS DL DM RG TKTP RS JAMINAN)
E
1 303 I Ny.Ayu kurniasari 30 190900536 sindrom dispepsia tipe mixed + intake sulit + √ MB 3X1 bpjs askes √ √ √
2 325 III Ny. Nilawati 50 240200203 Post histerektomi √ MB 3X1 bpjs pbi √ √ √
3 317 III Ny. Wira 15 240100093 colesistitis √ ML 3X1 bpjs mandiri √ √ √
4 310 I Ny. Fitriani Suyanto 28 170300523 gea+drs seafood √ √ MLRS 3X1 umum √ √ √
5 417 II Ny. Revini 32 230100140 TFA+drs+syndrom dyspepsia √ ML 3X1 bpjs swasta √ √ √
6 325 III Ny. Yeni Kartika 25 240200327 P0A1 + PPV ec √ MB 3X1 Bpjs Pbi √ √ √
7 308 I ny. Vivi zainir 34 240300214 gea drs sindrom dyspepsia √ √ MLRS 3X1 bpjs mandiri √ √ √
8 302 I Ny. Raudhatul Jannah 28 221100355 SC √ MB 3X1 bpjs askes √ √ √
9 324 III Ny.Ega 28 240300571 curet √ MB 3X1 bpjs mandiri √ √ √
10 325 III Ny.Mardiah 23 240100750 SC √ MB 3X1 bpjs mandiri √ √ √
11 324 III Ny.Citra Aismana 30 190400797 SC √ MB 3X1 Bpjs Pbi √ √ √
12 325 III Ny.Ari sandi 43 240300228 SC √ MB 3X1 bpjs mandiri √ √ √
13 325 III Ny.Nicke zulkarnain 38 240300581 SC √ MB 3X1 bpjs mandiri √ √ √
14 322 II Ny.Heni Natalia 32 180800675 gea drs +Low intake √ √ MLRS 3X1 bpjs swasta √ √ √
15 316 II Ny.Miska maulidya 32 200100226 SC √ MB 3X1 bpjs non pns √ √ √
16 312 II Ny. M. Arianza 37 240300579 colesistitis √ ML 3X1 bpjs swasta √ √ √
17 323 III Ny. Yunisa Putri Imran 28 230900647 sc+ilo √ MB 3X1 bpjs pbi √ √ √
18 325 III Ny. Sivira wardana 30 230800446 sc √ MB 3X1 Bpjs Pbi √ √ √
19 317 III Ny.Nurasia 34 221001204 obs febris h3+ec bacterial iufectu+tfa+drs+parotis+ √ ML 3X2 bpjs swasta √ √ √
20 316 III Ny. Fifi Wulandari 23 211100634 post sc √ ML 3X1 bpjs pbi √ √ √
21 310 I Ny. Ferry sugiarti 39 220200969 sindrom dispepsia tipe mixed + intake sulit + ISPA √ ML 3x1 bpjs swasta √ √ √
 Tanggal : 20/03/2024 MB : 11 ML :4 MBRG : PUASA:
Ruangan : Khadijah MBTKTP : MLRS MLRG : MBDM:
DIET
KET (KIS &
NO KAMAR KELAS NAMA PASIEN UMUR NO RM DIAGNOSA ALERGI SOND REKAP JMLH P S M
MB ML TC MC NTS DL DM RG TKTP RS JAMINAN)
E
1 417 II Ny. Revini 32 230100140 TFA+drs+syndrom dyspepsia √ ML 3X1 bpjs swasta √ √ √
2 325 III Ny. Yeni Kartika 25 240200327 P0A1 + PPV ec √ MB 3X1 Bpjs Pbi √ √ √
3 302 I Ny. Raudhatul Jannah 28 221100355 SC √ MB 3X1 bpjs askes √ √ √
4 325 III Ny.Mardiah 23 240100750 SC √ MB 3X1 bpjs mandiri √ √ √
5 324 III Ny.Citra Aismana 30 190400797 SC √ MB 3X1 Bpjs Pbi √ √ √
6 325 III Ny.Ari sandi 43 240300228 SC √ MB 3X1 bpjs mandiri √ √ √
7 325 III Ny.Nicke zulkarnain 38 240300581 SC √ MB 3X1 bpjs mandiri √ √ √
8 323 III Ny. Yunisa Putri Imran 28 230900647 sc+ilo √ MB 3X1 bpjs pbi √ √ √
9 325 III Ny. Silvira wardana 30 230800446 sc √ MB 3X1 Bpjs Pbi √ √ √
10 317 III Ny.Nurasia 34 221001204 parotis+syndrom dyspepsia √ ML 3X1 bpjs swasta √ √ √
11 316 III Ny. Fifi Wulandari 23 211100634 post sc √ MB 3X1 bpjs pbi √ √ √
12 310 I Ny. Ferry sugiarti 39 220200969 sindrom dispepsia+ISPA √ ML 3X1 bpjs swasta √ √ √
13 303 I Ny. Reni Wahyuni 38 231100032 ppv ec ppi √ MB 3X1 bpjs cob uir √ √ √
14 301 I Ny. Tuti Herlis Daeli 46 240300610 PUA+anemia √ MB 3X1 bpjs swasta √ √ √
15 317 II Ny.Deanika Adrisel 22 240100345 tfa+syndrom dyspepsia √ ML 3X1 bpjs swasta √ √ √
16 318 III Tn. Henrayanto Hutagalung 33 240300618 dyspepsia syndrom type ulcer √ ML 3X1 bpjs mandiri √ √ √
17 325 III Ny. Jenisari Zagoto 33 190300268 ppi+viral infectin+ISPA √ ML 3X1 Bpjs Pbi √ √ √
18 319 III Ny. Dini Karina 27 240300249 Post sc eracs bpjs √ MB 3X1 bpjs mandiri √ √ √
19 316 II Nn. Maya Rizki Ananda 24 240300621 viral infection+drs+ispa √ ML 3X1 bpjs swasta √ √ √
20 319 III Ny. Elvita 25 240300604 psp √ MB 3X1 bpjs pbi √ √ √
21 403 I Ny. Ridha Khairunnisa 28 230800475 asma udang √ MB 3X1 bpjs polri √ √ √
22 325 III Ny.Desi novita 32 171200468 g2p1a0h1 gr 19-20 mg √ MB 3X1 bpjs mandiri √ √ √
23 323 III Ny.Yunisa putri 28 230900647 post sc + ILO √ MB 3X1 bpjs pbi √ √ √
24 325 III Ny. Jusni erma ningsih 31 240200942 post sc + ilo + gagal fisioterapi √ MB 3X1 bpjs pbi √ √ √
 Tanggal : 21/03/2024 MB : 14 ML :1 MBRG : PUASA:
Ruangan : Khadijah MBTKTP : MLRS MLRG : MBDM:
DIET
KET (KIS &
NO KAMAR KELAS NAMA PASIEN UMUR NO RM DIAGNOSA ALERGI SOND REKAP JMLH P S M
MB ML TC MC NTS DL DM RG TKTP RS JAMINAN)
E
1 325 III Ny. Yeni Kartika 29 240200327 P0A1 + PPV ec √ MB 3X1 Bpjs Pbi √ √ √
2 323 III Ny. Yunisa Putri Imran 28 230900647 sc+ilo √ MB 3X1 bpjs pbi √ √ √
3 316 III Ny. Fifi Wulandari 23 211100634 post sc √ MB 3X1 bpjs pbi √ √ √
4 303 I Ny. Reni Wahyuni 38 231100032 ppv ec ppi √ MB 3X1 bpjs cob uir √ √ √
5 301 I Ny. Tuti Herlis Daeli 46 240300610 PUA+anemia √ MB 3X1 bpjs swasta √ √ √
6 318 III Tn. Henrayanto Hutagalung 33 240300618 dyspepsia syndrom type ulcer √ ML 3X1 bpjs mandiri √ √ √
7 325 III Ny. Jenisari Zagoto 33 190300268 ppi+viral infectin+ISPA √ ML 3X1 Bpjs Pbi √ √ √
8 319 III Ny. Dini Karina 27 240300249 Post sc eracs bpjs √ MB 3X1 bpjs mandiri √ √ √
9 316 II Nn. Maya Rizki Ananda 24 240300621 viral infection+drs+ispa √ ML 3X1 bpjs swasta √ √ √
10 403 I Ny. Ridha Khairunnisa 28 230800475 asma udang √ MB 3X1 bpjs polri √ √ √
11 325 III Ny. Jusni erma ningsih 31 240200942 post sc + ilo + gagal fisioterapi √ MB 3X1 bpjs pbi √ √ √
12 308 I Ny.Desi novita 32 171200468 g2p1a0h1 gr 19-20 mg √ MB 3X1 umum √ √ √
13 325 III Ny. Lisa ariska 29 230800872 post sc √ MB 3X1 bpjs pbi √ √ √
14 317 II Ny. Rini asmaini 24 240300627 psp √ MB 3x1 bpjs mandiri √ √ √
15 325 III Ny. Danis susantri 29 201100757 psp √ MB 3x1 bpjs pbi √ √ √
16 302 II Ny. Melisa 35 240200837 G4P2A1H2 Gr 38-39 mg kala I fase laten bsc 1X + mow √ ML 3x1 bpjs polri √ √ √
17 325 III Ny. Yusni 56 240300173 gea+ dm t2 +drs low intake √ ML 3x1 bpjs pbi √ √ √
321 II Iin Nurbaity 29 220701091 post sc a/I g1p0a0h0 gr aterm + kpd + gagal induksi √ ML 3x1 bpjs mandiri √ √ √
325 III Ny. Siti zubaidah 27 240200906 g2p1a0h1 gr 13-14mgg + febris h1 ec viral inf + heg drs low intake sulit √ ML 3x1 bpjs pbi √ √ √
310 II Ny. Yersi Yurismi 22 240300157 post resc + pasang IUD a/I g1p0a0h0 gr aterm + kala 1 fase laten + liliput √ ML 3x1 bpjs swasta √ √ √
 Tanggal : 22/03/2024 MB : 14 ML : 1 MBRG : PUASA:
Ruangan : Khadijah MBTKTP : MLRS MLRG : MBDM:
DIET
KET (KIS &
NO KAMAR KELAS NAMA PASIEN UMUR NO RM DIAGNOSA ALERGI SOND TKT REKAP JMLH P S M
MB ML TC MC NTS DL DM RG RS JAMINAN)
E P
1 323 III Ny. Yunisa Putri Imran 28 230900647 post sc + ilo √ √ MBTKTP 3x1 bpjs pbi √ √ √
2 319 III Ny. Dini Karina 27 240300249 Post SC Eracs BPJS √ MB 3x1 bpjs mandiri √ √ √
3 325 III Ny. Jusni erma ningsih 31 240200942 post sc + ilo + DM √ √ MBDM 3x1 bpjs pbi √ √ √
4 325 III Ny. Lisa ariska 29 230800872 post sc √ MB 3x1 bpjs pbi √ √ √
5 317 II Ny. Rini asmaini 24 240300627 psp √ MB 3x1 bpjs mandiri √ √ √
6 325 III Ny. Danis susantri 29 201100757 psp √ MB 3x1 bpjs pbi √ √ √
7 302 II Ny. Melisa 35 240200837 post sc + mow √ MB 3x1 bpjs polri √ √ √
8 325 III Ny. Yusni 56 240300173 gea+ dm t2 +drs low intake √ √ √ MLDMRS 3x1 bpjs pbi √ √ √
9 321 II Ny. Iin Nurbaity 29 220701091 post sc Seafood √ MB 3x1 bpjs mandiri √ √ √
10 325 III Ny. Siti zubaidah 27 240200906 G2P1 gr 13-14mgg + febris ec viral inf + heg √ ML 3x1 bpjs pbi √ √ √
11 310 II Ny. Yersi Yurismi 22 240300157 post re sc + pasang IUD √ MB 3x1 bpjs swasta √ √ √
12 308 I Ny. Ulfa Yusti 27 230900626 post sc √ MB 3x1 bpjs mandiri √ √ √
13 325 III Nn. Suci Rahmatul 24 240300664 pua ec susp hyperplasia endometrium √ MB 3x1 bpjs pbi √ √ √
14 417 II Tn. Agustiwan 39 240300667 prolong fever ec susp typoid fever √ ML 3x1 bpjs polri √ √ √
 Tanggal : 23/03/2024 MB :7 ML :4 MLDMRS :1 PUASA:
Ruangan : Khadijah MBDMTKTP : 1 MLRS MLRG : MBDM:
DIET KET (KIS &
NO KAMAR KELAS NAMA PASIEN UMUR NO RM DIAGNOSA ALERGI REKAP JMLH P S M
MB ML TC SONDE MC NTS DL DM RG TKTP RS JAMINAN)
1 325 III Ny. Jusni erma ningsih 31 240200942 post sc + ilo + DM √ √ √ MBDMTKTP 3x1 bpjs pbi √ √ √
2 302 II Ny. Melisa 35 240200837 sc √ MB 3x1 bpjs polri √ √ √
3 325 III Ny. Yusni 56 240300173 gea+ dm t2 +drs low intake √ √ √ MLDMRS 3x1 bpjs pbi √ √ √
4 321 II Ny. Iin Nurbaity 29 220701091 sc Seafood √ MB 3x1 bpjs mandiri √ √ √
5 325 III Ny. Siti zubaidah 27 240200906 febris ec viral inf + heg √ ML 3x1 bpjs pbi √ √ √
6 310 II Ny. Yersi Yurismi 22 240300157 sc √ MB 3x1 bpjs swasta √ √ √
7 308 I Ny. Ulfa Yusti 27 230900626 sc √ MB 3x1 bpjs mandiri √ √ √
8 325 III Nn. Suci Rahmatul 24 240300664 pua ec susp hyperplasia endometrium √ MB 3x1 bpjs pbi √ √ √
9 417 II Tn. Agustiwan 39 240300667 prolong fever ec susp typoid fever √ ML 3x1 bpjs polri √ √ √
 Tanggal : 24/03/2024 MB : 11 ML 5 MLDMRS :1 PUASA:
Ruangan : Khadijah MBDMTKTP : MLRS MLRG : MBDM: 1
DIET KET (KIS &
NO KAMAR KELAS NAMA PASIEN UMUR NO RM DIAGNOSA ALERGI SOND TKT REKAP JMLH P S M
MB ML TC MC NTS DL DM RG RS JAMINAN)
E P
1 325 III Ny. Yusni 56 240300173 gea+ dm t2 +drs low intake √ √ √ MLDMRS 3x1 bpjs pbi √ √ √
2 325 III Ny. Siti zubaidah 27 240200906 febris ec viral inf + heg √ ML 3x1 bpjs pbi √ √ √
3 325 III Nn. Suci Rahmatul 24 240300664 pua ec susp hyperplasia endometrium √ MB 3x1 bpjs pbi √ √ √
4 309 I Ny. Vivi Zainir 34 240300214 sc √ MB 3x1 bpjs mandiri √ √ √
5 323 II Ny. Sherlina Adinda 22 240200450 sc √ MB 3x1 bpjs swasta √ √ √
7 321 II Ny. Yuliana 33 221100641 abd pain ec susp cholestitis diare akut √ ML 3x1 bpjs mandiri √ √ √
8 323 III Ny. Sari safitri 26 220300220 gr 26-27 mgg+ppv ec Ppi √ MB 3x1 Bpjs Mandiri COB √ √ √
9 323 II Ny. Aisyah 35 180300579 psp √ MB 3x1 bpjs swasta √ √ √
10 302 I Ny. Putri Mahardika 31 231100919 psp √ MB 3x1 bpjs swasta √ √ √
11 301 I Ny. Alittia Mayang Sari 40 230800165 sc √ MB 3x1 bpjs swasta √ √ √
12 315 II Ny. Winda Mega Mustika 29 240100468 psp √ MB 3x1 bpjs swasta √ √ √
13 315 II Ny. Shanti Warni 42 240300682 G5P3A1 Gr 5-6 mg+ppv √ MB 3x1 bpjs swasta √ √ √
14 310 I Ny. Dewi puji astut 38 231200306 sc + mow √ ML 3x1 bpjs swasra √ √ √
15 322 II Ny. Raudhatul hilma 28 200900161 g2p1 gr 12-13 mgg ppv + heg √ ML 3x1 bpjs swasta √ √ √
16 320 II Ny. Ridha chairunisa 28 211000979 abd pain ec dyspepsia low intake √ MB 3x1 bpjs polri √ √ √
17 319 II Ny. Silvia Erlis 32 180200459 sc √ ML 3X1 BPJS SWASTA √ √ √
18 325 III Ny. putri ayu. 32 220700201 SC √ ML 3X1 BPJS MANDIR √ √ √
19 325 III Ny. Fitri sri utami 29 240200383 SC √ ML 3X1 BPJS √ √ √
20 322 II Ny. Yurnima Waruwu 20 240300713 PSP √ MB 3X1 BPJS PBI √ √ √
21 325 III Ny. Diana tamima 25 240300707 SC √ ML 3X1 Bpjs mandiri √ √ √
22 321 II Ny. Maya sari 31 170500369 SC √ ML 3x1 bpjs swsata √ √ √
 Tanggal : 25/03/2024
Ruangan : Khadijah

NO KAMAR KELAS NAMA PASIEN UMUR NO RM

1 301 I Ny. Alittia Mayang Sari 40 230800165

2 310 I Ny. Dewi puji astut 38 231200306
3 322 II Ny. Raudhatul hilma 28 200900161
4 320 II Ny. Ridha chairunisa 28 211000979
5 319 II Ny. Silvia Erlis 32 180200459
6 325 III Ny. putri ayu. 32 220700201
7 325 III Ny. Fitri sri utami 29 240200383
8 322 II Ny. Yurnima Waruwu 20 240300713
9 325 III Ny. Diana tamima 25 240300707
10 321 II Ny. Maya sari 31 170500369
11 325 III Ny. Raja Mira Nofrianti 25 200300695
12 325 III Ny. Ika Sanjaya 27 240100063
13 323 III Ny. Elyeni Fera 22 230800638
14 312 I Ny. Afrillia Tri Ayuna 28 231000475
15 323 III Ny. Vivi Veronica 23 231000553
16 322 III Ny. Dewi puji astuti 38 240300383
17 324 II Ny. Raudhatul hilma 28 240300735
18 215 II Tn. Ardian saputra 17 231000277
19 324 III Ny.sherly nova delsya 25 170400036
20 309 I Ny. Kesumawaty 53 240300740
21 306 super vipNy. Tantri Ummu Hani 28 240300705
22 318 III Ny. Tugiatun 32 240100989
23 317 III Ny. Tita Safitri 37 231001000
24 318 III Ny. Santhy Dewi Putri Purba / Tn. R 26 240300743

25 316 II Ny. Riza Oktavia / Tn. 35 231000266

26 317 II Ny. Yusy Erni / Tn. Abdul Ghoni 29 210700005

27
MB :7 ML :7 MLDMRS :
MBDMTKTP : MLRS MLRG :
DIET

DIAGNOSA ALERGI SON

MB ML TC MC NTS
DE

sc √
sc + mow √
g2p1 gr 12-13 mgg ppv + heg √
abd pain ec dyspepsia low intake √
sc √
SC √
SC √
PSP √
SC √
SC √
PSP √
SC √
PSP √
abd pain ec sups isk √
PSP √
post sc a/I g1 + kpd + ptm √
psp √
sindrom dyspepsia √
prolong fever ec viral inf dd typod + sindrom dispepsi √
Abdominal pain ec syndrom dyspepsia type ulser+HT g √
sc+peb √
post sc + iud √
Post sc + mow √
Sc + iud √
Sc + Mow √
√
 PUASA:
MBDM:
DIET
KET (KIS &
TKT REKAP JMLH P S M
DL DM RG RS JAMINAN)
P

MB 3x1 bpjs swasta √ √ √

ML 3x1 bpjs swasra √ √ √
ML 3x1 bpjs swasta √ √ √
MB 3x1 bpjs polri √ √ √
ML 3X1 BPJS SWASTA √ √ √
ML 3X1 BPJS MANDIR √ √ √
ML 3X1 BPJS √ √ √
MB 3X1 BPJS PBI √ √ √
ML 3X1 Bpjs mandiri √ √ √
ML 3x1 bpjs swsata √ √ √
MB 3X1 BPJS PBI √ √ √
MB 3X1 bpjs mandiri √ √ √
MB 3X1 BPJS PBI √ √ √
MB 3X1 bpjs swata √ √ √
MB 3X1 BPJS PBI √ √ √
MB 3X1 bpjs pbi √ √ √
MB 3X1 bpjs non pns √ √ √
ML 3X1 umum √ √ √
ML 3X1 bpjs pbi √ √ √
√ MLRG 3X1 bpjs pnd √ √ √
√ MBRG 3X1 Bpjs Swasta √ √ √
ML 3X1 bpjs pbi √ √ √
ML 3X1 sc+ mow √ √ √
ML 3X1 sc + iud √ √ √
ML 3X1 sc + mow √ √ √
√ MLRG 3X1 sc + peb √ √ √
 Tanggal : 26/03/2024
Ruangan : Khadijah

NO KAMAR KELAS NAMA PASIEN UMUR

1 325 III Ny. putri ayu. 32

2 325 III Ny. Fitri sri utami 29
3 325 III Ny. Diana tamima 25
4 321 II Ny. Maya sari 31
5 325 III Ny. Ika Sanjaya 27
6 312 I Ny. Afrillia Tri Ayuna 28
7 322 III Ny. Fitri eli susanti 35
8 324 II Ny. Siti Aisyah 31
9 324 III Ny.sherly nova delsya 25
10 309 I Ny. Kesumawaty 53
11 306 I Ny. Tantri Ummu Hani 28
12 318 III Ny. Tugiatun 32
13 317 III Ny. Tita Safitri 37
14 318 III Ny. Santhy Dewi Putri Purba 26
15 316 II Ny. Riza Oktavia 35
16 317 II Ny. Yusy Erni 29
17 302 I Ny. Reskayani 27
18 308 I Ny. Azzatul Syuqriya 28
19 316 III Ny. Ester 23
20 416 II Ny.Dwi elvia 24
21 319 III Ny.Suwarti 76
22 322 III Ny. Destia Tarigan 30
23 325 III Ny. Lili wahyuni 29
24 319 III Ny. Rahmi safitri 25
25 325 III Ny. Arfah 28

26 324 324 Ny. Zainab arfin 28

27 325 325 Ny. Shelin fransisc 18

28 324 III Ny. Putri Gian T 29

29 320 II Ny.wulan sari/ tn 28
 MB : 15 ML :4
MBDMTKTP : MBRG :1

NO RM DIAGNOSA ALERGI
MB ML

220700201 SC √
240200383 SC √
240300707 SC √
170500369 SC √
240100063 SC √
231000475 abd pain ec sups isk √
240300383 SC √
240300735 psp √
170400036 prolong fever + sindrom dispepsia √
240300740 Abdominal pain ec syndrom dyspepsia + HT √
240300705 sc+peb √
240100989 post sc + iud √
231001000 Post sc + mow √
240300743 Sc + iud √
231000266 Sc + Mow √
210700005 SC √
240300745 SC + IUD √
240300745 PSP √
211000210 SC √
240300777 Hiperpireksia ec ispa +drs low intake √
240300775 syndrom dyspepsia +Ht +Hipokalemi √
231100476 r' histerektomi + kistektomi
230800082 psp √
240300789 heg √
180700623 curratge √
240100481 post sc+peb √
240300668 post sc a/I g1 CPD+gr atrem √
240300766 PSP √
240100557 post sc a/I g1p0a0h0 gr 39-40 mg+ cpd √
 MLDMRS : PUASA:
MLRG : 1 MBDM:
DIET
REKAP JMLH
TC SONDE MC NTS DL DM RG TKTP RS

ML 3X1
ML 3X1
ML 3X1
ML 3X1
MB 3X1
ML 3X1
MB 3X1
MB 3X1
ML 3X1
√ MLRG 3X1
√ MBRG 3X1
ML 3X1
ML 3X1
ML 3X1
ML 3X1
MB 3X1
MB 3X1
MB 3X1
MB 3X1
ML 3X1
ML 3X1
PUASA
MB 3x1
ML 3x1
MB 3x1
√ MBRG 3x1
MB 3x1
MB 3x1
MB 3x1
 KET (KIS &
P S M
JAMINAN)
BPJS MANDIR √ √ √
BPJS √ √ √
Bpjs mandiri √ √ √
bpjs swsata √ √ √
bpjs mandiri √ √ √
bpjs swata √ √ √
bpjs pbi √ √ √
bpjs non pns √ √ √
bpjs pbi √ √ √
bpjs pnd √ √ √
Bpjs Swasta √ √ √
bpjs pbi √ √ √
Bpjs Mandiri √ √ √
bpjs mandiri √ √ √
bpjs swasta √ √ √
bpjs swasta √ √ √
bpjs swasta √ √ √
bpjs swasta √ √ √
Bpjs Mandiri √ √ √
bpjs swasta √ √ √
Bpjs Mandiri √ √ √
bpjs pbi
bpjs pbi √ √ √
bpjs pbi √ √ √
Bpjs Mandiri √ √ √
Bpjs PBI √ √ √
Bpjs PBI √ √ √
Bpjs PBI √ √ √
bpjs swasta √ √ √
 Tanggal : 27/03/2024 MB : 13 ML :5 MLDMRS : PUASA:
Ruangan : Khadijah MBDMTKTP : MBRG :1 MLRG : MBDM:
NO KAMAR KELAS NAMA PASIEN UMUR NO RM DIAGNOSA ALERGI DIET REKA JMLH KET (KIS & P S M
MB ML TC SON MC NTS DL DM RG TKT RS P JAMINAN)
DE P

1 421 III Ny.sherly nova delsya 25 170400036 prolong fever + sindrom dispepsia √ ML 3X1 bpjs pbi √ √ √
2 318 III Ny. Tugiatun 32 240100989 post sc + iud √ ML 3X1 bpjs pbi √ √ √
3 317 III Ny. Tita Safitri 37 231001000 Post sc + mow √ ML 3X1 Bpjs Mandiri √ √ √
4 318 III Ny. Santhy Dewi Putri Purba 26 240300743 Sc + iud √ ML 3X1 bpjs mandiri √ √ √
5 316 II Ny. Riza Oktavia 35 231000266 Sc + Mow √ ML 3X1 bpjs swasta √ √ √
6 302 I Ny. Reskayani 27 240300745 SC + IUD √ MB 3X1 bpjs swasta √ √ √
7 316 III Ny. Ester 23 211000210 SC √ MB 3X1 Bpjs Mandiri √ √ √
8 416 II Ny.Dwi elvia 24 240300777 Hiperpireksia ec ispa +drs low intake √ ML 3X1 bpjs swasta √ √ √
9 319 III Ny.Suwarti 76 240300775 syndrom dyspepsia +Ht +Hipokalemi √ ML 3X1 Bpjs Mandiri √ √ √
10 322 III Ny. Destia Tarigan 30 231100476 r' histerektomi + kistektomi √ MB 3X1 bpjs pbi √ √ √
11 325 III Ny. Lili wahyuni 29 230800082 psp √ MB 3x1 bpjs pbi √ √ √
12 319 III Ny. Rahmi safitri 25 240300789 heg √ ML 3x1 bpjs pbi √ √ √
13 325 III Ny. Merlin 34 240300754 sc √ MB 3x1 bpjs pbi √ √ √
14 324 II Ny. Zainab arfin 28 240100481 post sc+peb √ √ MBRG 3x1 Bpjs PBI √ √ √
15 325 III Ny. Shelin fransisc 18 240300668 post sc a/I g1 CPD+gr atrem √ MB 3x1 Bpjs PBI √ √ √
16 324 III Ny. Putri Gian T 29 240300766 PSP √ MB 3x1 Bpjs PBI √ √ √
17 320 II Ny.wulan sari/ tn 28 240100557 post sc a/I g1p0a0h0 gr 39-40 mg+ cpd √ MB 3x1 bpjs swasta √ √ √
18 320 III Ny. Eva Sukmawati 41 240300795 post sc √ MB 3x1 Bpjs PBI √ √ √
19 422 III Tn. Bagus Pratama 21 240300816 DHF √ ML 3x1 Bpjs Mandiri √ √ √
20 325 III Ny. Nandriati eka fitri 32 190800265 kontraksi premature √ MB 3x1 Bpjs PBI √ √ √
21 325 III Ny.Lia Melisa 32 231100533 PSP √ MB 3x1 Bpjs PBI √ √ √
22 318 III Ny. Shinta Bella 22 240300820 SC √ MB 3x1 Bpjs PBI √ √ √
23 318 III Ny. Ilva riswati 35 240200060 SC √ MB 3x1 Bpjs PBI √ √ √
 Tanggal : 28/03/2024 MB :9 ML 3 MLDMRS : PUASA:
Ruangan : Khadijah MBDMTKTP : MBRGDM :1 MLRG : MBDM:
DIET
REKA KET (KIS &
NO KAMAR KELAS NAMA PASIEN UMUR NO RM DIAGNOSA ALERGI SON TKT JMLH P S M
MB ML TC MC NTS DL DM RG RS P JAMINAN)
DE P

1 322 III Ny. Destia Tarigan 30 231100476 r' histerektomi + kistektomi √ MB 3X1 bpjs pbi √ √ √
2 319 III Ny. Rahmi safitri 25 240300789 heg √ ML 3x1 bpjs pbi √ √ √
3 325 III Ny. Merlin 34 240300754 sc √ MB 3x1 bpjs pbi √ √ √
4 325 III Ny. Shelin fransisc 18 240300668 post sc a/I g1 CPD+gr atrem √ MB 3x1 Bpjs PBI √ √ √
5 320 II Ny.wulan sari 28 240100557 post sc a/I g1p0a0h0 gr 39-40 mg+ cpd √ MB 3x1 bpjs swasta √ √ √
6 320 III Ny. Eva Sukmawati 41 240300795 post sc √ MB 3x1 Bpjs PBI √ √ √
7 422 III Tn. Bagus Pratama 21 240300816 dhf √ ML 3x1 Bpjs Mandiri √ √ √
8 325 III Ny. Nandriati eka fitri 32 190800265 kontraksi premature √ MB 3x1 Bpjs PBI √ √ √
9 325 III Ny.Lia Melisa 32 231100533 PSP √ MB 3x1 Bpjs PBI √ √ √
10 318 III Ny. Shinta Bella 22 240300820 SC √ MB 3x1 Bpjs PBI √ √ √
11 318 III Ny. Ilva riswati 35 240200060 SC √ MB 3x1 Bpjs PBI √ √ √
12 309 I Ny. Nurazizah 24 240300780 sc √ √ √ MBRGDM 3x1 Bpjs Mandiri √ √ √
13 319 II Ny. Rini Purnama 30 240300840 Ab. Iminens + prolonged fever √ ML 3x1 bpjs √ √ √
14 308 I Ny. Suswinda 40 240300458 post debulking tumor ovarium+adhesiolisis a/I tumor ovar √ MB 3x1 bpjs askes √ √ √
15 325 III Ny. Rianti Fepti 32 240300844 post eksterpasi a/I mioma geburt + anemia √ MB 3x1 UMUM √ √ √
16 317 II-I Ny. Nadya Fadillah Putri 28 230800739 PSP √ MB 3x1 bpjs swasta √ √ √
17 311 I Ny. Welly iskandar 26 230800498 PSP √ MB 3x1 bpjs mandiri √ √ √
18 322 II Ny. Agustina Susanti 30 190700812 PSP √ MB 3x1 bpjs swasta √ √ √
19 321 II Ny. Defi amelia jusman 27 240300850 G1p0a0h0 gr 18-19 mgg+ HEG DRS+dispepsia+ispa √ ML 3x1 Bpjs swasta √ √ √
20 *301 I Ny. Novi Bandari 30 240300857 G2P1A0H1 Gr 8-9 mg+heg+syndrom dyspepsia √ ML 3x1 bpjs pns √ √ √
21 *325 III Ny. Risha Janelia 32 231000299 post sc a/I cpd+bsc √ MB 3x1 bpjs mandiri √ √ √
22 *321 II Ny.Melisa Lestari 31 201100254 G3P2A0H1 gr 4-5 mg+ppu sc susp abortus iminien+heg √ ML 3x1 Bpjs swasta √ √ √
23 *302 I Ny. Hermarina Astifa Yanti 25 240300851 PSP √ MB 3x1 bpjs bumn √ √ √
24 325 III Ny. Mia audina 25 240300854 post sc pasang iud a/ g4 gr aterm + post miomektomi + let. √ MB 3x1 bpjs pbi √ √ √
25 303 I Ny. Reni indriwati 34 180300853 post sc cito a/I 40mg + bsc 2x + inpartu √ MB 3x1 bpjs swasta √ √ √
26 325 III Ny. Helma amalia 27 240300838 hematom vagina √ MB 3x1 Bpjs swasta √ √ √
17 319 II Ny.Fitri erina 26 240300846 PSP √ MB 3x1 Bpjs swasta √ √ √
 Tanggal : 29/03/2024 MB : 15 ML 2 MLDMRS : PUASA:
Ruangan : Khadijah MBDMTKTP : MBRGDM MLRG : MBDM:
DIET
REKA KET (KIS &
NO KAMAR KELAS NAMA PASIEN UMUR NO RM DIAGNOSA ALERGI SON TKT JMLH P S M
MB ML TC MC NTS DL DM RG RS P JAMINAN)
DE P

1 318 III Ny. Shinta Bella 22 240300820 SC √ MB 3x1 Bpjs PBI √ √ √

2 318 III Ny. Ilva riswati 35 240200060 SC √ MB 3x1 Bpjs PBI √ √ √
3 319 I Ny. Rini Purnama 30 240300840 Ab. Iminens + prolonged fever √ MB 3x1 bpjs √ √ √
4 308 I Ny. Suswinda 40 240300458 post debulking √ MB 3x1 bpjs askes √ √ √
5 325 III Ny. Rianti Fepti 32 240300844 post eksterpasi √ MB 3x1 UMUM √ √ √
6 317 II-I Ny. Nadya Fadillah Putri 28 230800739 PSP √ MB 3x1 bpjs swasta √ √ √
7 311 I Ny. Welly iskandar 26 230800498 PSP √ MB 3x1 bpjs mandiri √ √ √
8 322 II Ny. Agustina Susanti 30 190700812 PSP √ MB 3x1 bpjs swasta √ √ √
9 321 II Ny. Defi amelia jusman 27 240300850 GHEG DRS+dispepsia+ispa udang √ ML 3x1 Bpjs swasta √ √ √
10 *301 I Ny. Novi Bandari 30 240300857 heg+syndrom dyspepsia √ ML 3x1 bpjs pns √ √ √
11 *325 III Ny. Risha Janelia 32 231000299 post sc a/I cpd+bsc √ MB 3x1 bpjs mandiri √ √ √
12 *321 II Ny.Melisa Lestari 31 201100254 ppv sc susp abortus iminien+heg √ MB 3x1 Bpjs swasta √ √ √
13 *302 I Ny. Hermalina Astifa Yanti 25 240300851 PSP √ MB 3x1 bpjs bumn √ √ √
14 325 III Ny. Mia audina 25 240300854 SC √ MB 3x1 bpjs pbi √ √ √
15 303 I Ny. Reni indriwati 34 180300853 SC √ MB 3x1 bpjs swasta √ √ √
16 325 III Ny. Helma amalia 27 240300838 Post reheacting hematom vagina √ MB 3x1 Bpjs swasta √ √ √
17 319 II Ny.Fitri erina 26 240300846 PSP √ MB 3x1 Bpjs swasta √ √ √
18 325 III Ny. Poppy Maylisa 32 181100107 PSP √ MB 3x1 bpjs pbi √ √ √
19 322 III Ny Nazidah 26 220400538 psp √ MB 3x1 bpjs pbi √ √ √
20 322 III Ny.sri mulyati 40 210300385 post sc a/I g4p1a2h1 gr 37-38 mmg+ kala 1 fase alten bekas sc 1x √ ML 3x1 bpjs mandiri √ √ √
21 318 II Ny. Silvia 24 230101041 G3P0A2H0 Gr 8-9 mg+heg+gea+syndrom dyspepsia √ √ MLRS 3x1 bpjs mandiri √ √ √
22 304 I-VIP Ny. Sri Mulayanis 42 231200915 psp √ MB 3x1 bpjs cob uir √ √ √
23 320 II Ny.Desy Dewi 31 230200604 G2P0A1H0 gr 35-36 mg+PER+PPI √ MB 3x1 bpjs mandiri √ √ √
22 311 I Ny. Hana Meiwanagia 23 231100415 Post SC atas indikasi KPD 8 jam+bradikardi √ √ MB TKTP 3x1 bpjs mandiri √ √ √
22 324 III Ny. Andani Junaira 31 201100633 post sc cito mow a/i bekas sc 2 x+inpartu+anak cukup (djj+) √ MB 3x1 bpjs mandiri √ √ √
22 309 I Ny. Siti Sanggira Bella Pertiw 30 211200660 post sv cito a/I bekas sc 1 x + letak obligh+inpartu √ MB 3x1 bpjs mandiri √ √ √
23 310 I Ny. Destri annisa M 17 240300896 abd pain ec susp dyspepsia+ disminore+ low intake √ ML 3x1 bpjs pns √ √ √
24 302 I Ny. Sentri davia 29 210300353 psp √ MB 3x1 bpjs pns √ √ √
 Tanggal : 30/03/2024
Ruangan : Khadijah

NO KAMAR KELAS NAMA PASIEN UMUR NO RM

1 308 I Ny. Suswinda 40 240300458

2 *301 I Ny. Novi Bandari 30 240300857
3 *325 III Ny. Risha Janelia 32 231000299
4 325 III Ny. Mia audina 25 240300854
5 303 I Ny. Reni indriwati 34 180300853
6 319 II Ny.Fitri erina 26 240300846
7 325 III Ny. Poppy Maylisa 32 181100107
8 322 III Ny. Nazidah 26 220400538
9 324 III Ny.sri mulyati 40 210300385
10 318 II Ny. Silvia 24 230101041
11 304 I-VIP Ny. Sri Mulayanis 42 231200915
12 320 II Ny. Desy Dewi 31 230200604
13 311 I Ny. Hana Meiwanagia 23 231100415
14 324 III Ny. Andani Junaira 31 201100633
15 309 I Ny. Siti Sanggira Bella Pertiwi 30 211200660
16 310 I Ny. Destri annisa M 17 240300896
17 302 I Ny. Sentri davia 29 210300353
18 318 II Ny. Defi Amalia 27 240300850
19 325 III Ny. Tetti Ayu 23 240300903
20 323 I Ny. Sri wulan K 38 201000423
21 411 III Ny. Fatmawati 32 230200740
MB : 12 ML 3
MBDMTKTP : MBRGDM

DIAGNOSA ALERGI
MB

post debulking √
heg+syndrom dyspepsia
post sc a/I cpd+bsc √
SC √
SC √
PSP √
PSP √
psp √
post sc a/I g4p1a2h1 gr 37-38 mmg+ kala 1 fase alten bekas sc 1x
G3P0A2H0 Gr 8-9 mg+heg+gea+syndrom dyspepsia
psp √
G2P0A1H0 gr 35-36 mg+PER+PPI √
Post SC atas indikasi KPD 8 jam+bradikardi √
post sc cito mow a/i bekas sc 2 x+inpartu+anak cukup (djj+) √
post sv cito a/I bekas sc 1 x + letak obligh+inpartu √
abd pain ec susp dyspepsia+ disminore+ low intake
psp √
G1P0 gr 18-19 mg + abd. Pain + dyspepsia
gg1p0gr 6-7 mg +ppv ec susp ab.iminens √
PSP √
Acute gastroetritis drs loe intake dyspepsia syndrom+type ulcer
 MLDMRS : PUASA: MBTKTP : 1
MLRG : MBDM: MLRS : 1
DIET
REKA
SON TKT JMLH
ML TC MC NTS DL DM RG RS P
DE P

MB 3x1
√ ML 3x1
MB 3x1
MB 3x1
MB 3x1
MB 3x1
MB 3x1
MB 3x1
√ ML 3x1
√ √ MLRS 3x1
MB 3x1
MB 3x1
√ MB TKTP 3x1
MB 3x1
MB 3x1
√ ML 3x1
MB 3x1
√ ML 3x1
MB 3x1
MB 3x1
√ MB 3x1
KET (KIS &
P S M
JAMINAN)

bpjs askes √ √ √
bpjs pns √ √ √
bpjs mandiri √ √ √
bpjs pbi √ √ √
bpjs swasta √ √ √
Bpjs swasta √ √ √
bpjs pbi √ √ √
bpjs pbi √ √ √
bpjs mandiri √ √ √
bpjs mandiri √ √ √
bpjs cob uir √ √ √
bpjs mandiri √ √ √
bpjs mandiri √ √ √
bpjs mandiri √ √ √
bpjs mandiri √ √ √
bpjs pns √ √ √
bpjs pns √ √ √
bpjs swasta √ √ √
bpjs pbi √ √ √
bpjs pns √ √ √
bpjs mandiri √ √ √
 Tanggal : 30/03/2024
Ruangan : Khadijah

NO KAMAR KELAS NAMA PASIEN UMUR NO RM

1 308 I Ny. Suswinda 40 240300458
2 324 III Ny.sri mulyati 40 210300385
3 318 II Ny. Silvia 24 230101041
4 324 III Ny. Andani Junaira 31 201100633
5 309 I Ny. Siti Sanggira Bella Pertiwi 30 211200660
6 310 I Ny. Destri annisa M 17 240300896
7 318 II Ny. Defi Amalia 27 240300850
8 325 III Ny. Tetti Ayu 23 240300903
9 323 I Ny. Sri wulan K 38 201000423
10 411 III Ny. Fatmawati 32 230200740
11 325 III Ny. Rifa Putri 26 240300902
12 319 II Ny.T.Syarifah Ulandari 29 200100843
13 325 III Ny. Rica Ravita Putri 25 231200193
14 318 III Ny. Pariawati 38 240300471
15 301 I Ny. Venny anpika 29 210500788
16 325 III Ny. Refi gloria 24 240300410
17 325 III Ny. Purnama 32 240100213
MB :9 ML
MBDMTKTP : MBRGDM

DIAGNOSA ALERGI
post debulking
sc
heg+gea+syndrom dyspepsia
sc
sc
abd pain ec susp dyspepsia+ disminore+ low intake
G1P0 gr 18-19 mg + abd. Pain + dyspepsia alergi udang
gg1p0gr 6-7 mg +ppv ec susp ab.iminens
PSP
Acute gastroetritis drs loe intake dyspepsia syndrom+type ulcer
PSP
sc
post debridemant a/i amame dextra
abd. Pain
susp ab. Iminens
abd. Pain ec komstipasi
psp
 3 MLDMRS : PUASA: MBTKTP :
MLRG : MBDM: MLRS : 1
DIET

SON TKT REKA

MB ML TC DE MC NTS DL DM RG P RS P JMLH
√ MB 3x1
√ ML 3x1
√ √ MLRS 3x1
√ MB 3x1
√ MB 3x1
√ ML 3x1
√ ML 3x1
√ MB 3x1
√ MB 3x1
√ MB 3x1
√ MB 3x1
√ MB 3x1
√ MB 3x1
√ ML 3x1
√ MB 3x1
√ ML 3x1
√ s MB 3x2
KET (KIS &
JAMINAN) P S M
bpjs askes √ √ √
bpjs mandiri √ √ √
bpjs mandiri √ √ √
bpjs mandiri √ √ √
bpjs mandiri √ √ √
bpjs pns √ √ √
bpjs swasta √ √ √
bpjs pbi √ √ √
bpjs pns √ √ √
bpjs mandiri √ √ √
bpjs pbi √ √ √
bpjs mandiri √ √ √
bpjs mandiri √ √ √
bpjs pbi √ √ √
bpjs mandiri √ √ √
bpjs pbi √ √ √
bpjs mandiri √ √ √
 Tanggal : 30/03/2024
Ruangan : Khadijah

NO KAMAR KELAS NAMA PASIEN UMUR NO RM

1 324 III Ny.sri mulyati 40 210300385

2 324 III Ny. Andani Junaira 31 201100633
3 309 I Ny. Siti Sanggira Bella Pert 30 211200660
4 325 III Ny. Tetti Ayu 23 240300903
5 323 I Ny. Sri wulan K 38 201000423
6 411 III Ny. Fatmawati 32 230200740
7 325 III Ny. Rifa Putri 26 240300902
8 319 II Ny.T.Syarifah Ulandari 29 200100843
9 318 III Ny. Pariawati 38 240300471
10 301 I Ny. Venny anpika 29 210500788
11 325 III Ny. Refi gloria 24 240300410
12 325 III Ny. Purnama 32 240100213
13 319 II Ny. Ade Fitriani 29 240300310
14 325 III Ny.Febri Juliana N 40 240300930
15 320 II Ny. Nevi Ika A 26 240300931
MB :9 ML 3 MLDMRS : PUASA:
MBDMTKTP : MBRGDM MLRG : MBDM:
DIET
DIAGNOSA ALERGI SO
MB ML TC ND MC NTS DL DM
E
sc √
sc √
sc √
gg1p0gr 6-7 mg +ppv ec susp ab.iminens √
PSP √
Acute gastroetritis drs loe intake dyspepsia syndrom √
PSP √
sc √
abd. Pain √
susp ab. Iminens √
abd. Pain ec komstipasi √
psp √
post cerelage √
DRS + Febris + ec viral inf + obs. Vomitus + low intake √
Prolonged fever √
PUASA: MBTKTP :
MBDM: MLRS : 1

RE KET (KIS
JML
TKT KA & P S M
RG RS P H
P JAMINAN)

ML 3x1 bpjs mandiri √ √ √

MB 3x1 bpjs mandiri √ √ √
MB 3x1 bpjs mandiri √ √ √
MB 3x1 bpjs pbi √ √ √
MB 3x1 bpjs pns √ √ √
MB 3x1 bpjs mandiri √ √ √
MB 3x1 bpjs pbi √ √ √
MB 3x1 bpjs mandiri √ √ √
ML 3x1 bpjs pbi √ √ √
MB 3x1 bpjs mandiri √ √ √
ML 3x1 bpjs pbi √ √ √
MB 3x2 bpjs mandiri √ √ √
MB 3x2 bpjs pns √ √ √
ML 3x2 bpjs pbi √ √ √
MB 3x2 bpjs askes √ √ √
 Tanggal : 30/03/2024
Ruangan : Khadijah

NO KAMAR KELAS NAMA PASIEN UMUR NO RM

1 324 III Ny.sri mulyati 40 210300385

2 324 III Ny. Andani Junaira 31 201100633
3 309 I Ny. Siti Sanggira Bella Pert 30 211200660
4 325 III Ny. Tetti Ayu 23 240300903
5 323 I Ny. Sri wulan K 38 201000423
6 411 III Ny. Fatmawati 32 230200740
7 325 III Ny. Rifa Putri 26 240300902
8 319 II Ny.T.Syarifah Ulandari 29 200100843
9 318 III Ny. Pariawati 38 240300471
10 301 I Ny. Venny anpika 29 210500788
11 325 III Ny. Refi gloria 24 240300410
12 325 III Ny. Purnama 32 240100213
13 319 II Ny. Ade Fitriani 29 240300310
14 325 III Ny.Febri Juliana N 40 240300930
15 320 II Ny. Nevi Ika A 26 240300931
MB :9 ML 3 MLDMRS : PUASA:
MBDMTKTP : MBRGDM MLRG : MBDM:
DIET
DIAGNOSA ALERGI SO
MB ML TC ND MC NTS DL DM
E
sc √
sc √
sc √
gg1p0gr 6-7 mg +ppv ec susp ab.iminens √
PSP √
Acute gastroetritis drs loe intake dyspepsia syndrom √
PSP √
sc √
abd. Pain √
susp ab. Iminens √
abd. Pain ec komstipasi √
psp √
post cerelage √
DRS + Febris + ec viral inf + obs. Vomitus + low intake √
Prolonged fever √
PUASA: MBTKTP :
MBDM: MLRS : 1

RE KET (KIS
JML
TKT KA & P S M
RG RS P H
P JAMINAN)

ML 3x1 bpjs mandiri √ √ √

MB 3x1 bpjs mandiri √ √ √
MB 3x1 bpjs mandiri √ √ √
MB 3x1 bpjs pbi √ √ √
MB 3x1 bpjs pns √ √ √
MB 3x1 bpjs mandiri √ √ √
MB 3x1 bpjs pbi √ √ √
MB 3x1 bpjs mandiri √ √ √
ML 3x1 bpjs pbi √ √ √
MB 3x1 bpjs mandiri √ √ √
ML 3x1 bpjs pbi √ √ √
MB 3x2 bpjs mandiri √ √ √
MB 3x2 bpjs pns √ √ √
ML 3x2 bpjs pbi √ √ √
MB 3x2 bpjs askes √ √ √