MO

PERIODE : MEI 2023

COMPANY : PT. ICS MEDIKA LES
SITE : PT. PERFECT COMP
LOCATION : CIKANDE
REPORTED BY : M.SOLEH SUHARNA

COVER
ACCIDENT RE
 MONTHLY HEALTH REPORT

CS MEDIKA LESTARI
ERFECT COMPANION INDONESIA

OLEH SUHARNA

VER SUMMARY DAILY LO

 EVACUATION VISIT
ACCIDENT REPORT
REPORT
ORT

DAILY LOGBOOK
TION VISIT
ORT
 PT.ICS MEDIKALESTARI
In H o u s e C lin ic S p e c ia lis t RINGKASAN LA

Priode : MEI 2023

Kepada :
Tembusan : Agung Setiawan
Dr. Deby Ayu Anindia Subandi

Dari : M.Soleh Suharna

TOTAL KUNJUNGAN
Jumlah Kunjungan
Jumlah Rujukan
Jumlah Kecelakaan
Klien Asosiate Klien Worker
1st Visit Follow Up 1st Visit Follow Up
91 9

NO DIAGNOSIS
1 Acute Raspiratory Infaction
2 Anemia
3 Pharyngitis Acute
4 Gastritis & Duodenitis
5 Atralgia/Muscule Pain/ Myalgia
6 Cephalgia/dizziness
7 Konjungtivitis
8 Dermatitis contact/allergic
9 Dental Other (specify in comment)
10 Diarrhoea

NO NAMA JABATAN PERUSAHAAN

PT.
1 Tn. Muhyidin Technician Tarumanegara
Bumiyas
2
3

Disiapkan oleh

M.Soleh Suharna
Paramedic
Acne
Acute Gingivitis
Acute laryngitis
Acute Myocard infarction
Acute pharyngitis
Acute sinusitis
Acute tonsilitis
Acute tracheitis
Allergic reaction
Allergic rhinitis
Alocoholism
Amebiasis
Amenorrhea,secondary
Anxiety
Appendicitis acute
Appendicitis chronic/recurent
Arhritis
Arthalgia
Ascariasis
Assault by Poisoning
Asthma
Atopic dermatitis
Atypical PAP
Back pain
Bacterial enteritis
Blepharitis
Blindness & low vision
Breast nodule
Bronchitis
Bruising
Bruising/hematoma
Burns
Bursitis/ tendonitis
Calculus of kidney
Calculus of ureter
Candidiasis
Candidiasis
Carbuncle & Furuncle
Cardiac arrest
Cardiac arrhytmia
Cataract
Cellulitis & Absces
Cerebral contusion
Cervical polyp
Cervicitis
Chalazion / Hordeolum
CHF
Chicken pox
Cholecystitis
Cholelithiasis
Chronic laryngitis
Chronic Gingivitis
Chronic nasopharyngitis
Chronic pharyngitis
Chronic rhinitis
Chronic Sinusitis
Chronic tonsilitis
Circumcision
Colour vision deficiencies
Combination of disease
Common cold
Concussion
Conjunctivitis Allergic
Conjungtivitis,acute
Conjungtivitis,chronic
Constipation
Contact dermatitis
COPD
Corneal abrasion
Crushing injury
Cystitis
Dengue
Dengue hemorrhagic fever
Dental Abscess
Dental caries
Depression
Dermatomycosis
Dermatophytosis
Deviated nasal septum
Diabetes
Diarrhea
Dislocation
Dizziness
Drug Abuse
Dysmenorrhea
Dyspepsia
Emphysema
Epistaxis
Erisipelas
Eschercia coli
Eye Iritation
Eye Trauma
Family maladjustment
Family planning
Febris Observation
Fibrocystic breast
First trimester bleeding
Food poisoning
Food Poisoning
Foreign body in ear
Fracture
Ganglion cyst
Gastritis & Duodenitis
Gastrointestinal hemorrhage
Gen') Abdominal pain
Genital herpes
Glaucoma
Gonococcal infevtion
Gout
Gyanecology examination
Headache
Hearing loss
Hemorrhoid
Hepatitis viral
Hernia, inguinal
Hernia,hiatal
herpes simplex
Herpes Zoster
HIV disease
Hydronephrosis
Hypercholesterolemia
Hyperlipidemia
Hyperlipidemia
Hypertension desease
Hypotension
Hypothiroidism
Hypothyroidism
Impetigo
Infection of kidney
Influenza
Injury to nerve & Spinal cord
Insect Bite
Insomnia
Intussusception
Irregular menstruation
Irritable bowel syndrome
Jaundice
Lipoma
Liver Abscess
Liver Cirrhosis
Malaise/ Fatique
Malaria
Mastitis
Measles
Meningococcal infection
Menopause symtoms
Migrain
Miscarriage
Mumps
Muscle spasm/ pain
Nail Extraction
Nasal polyps
Nephritis
Nephrotic syndrom
Neurosis
Non Spesific Diarhea
Old myocard infarction
Open wound
Other bacterial pneumonia
Otitis Externa
Otitis media
Pancreatitis, acute
Pancreatitis, chronic
Paralytic ileus
Pelvic pain
Peritonitis
Peritonsilar abscess
PID
Pleurisy
Pneumoccocal pneumonia
Pneumothorax
Postpart.Ex,routine
Pregnancy with complications
premenstrual syndrome
Prenatal Ex,routine
Previous C-section
Pruritus & Related condition
Psoriasis
Pterygium
Pulmonary tuberculosis
Renal failure, acute
Renal failure, chronic
Respiratory arrest
Scabies
Sebaceous cyste
Septicemia
Sexual dysfunction
Shigellosis
Single disease
Situational disturbance
Sprains & Strains
Stomatitis
Subarachnoid hemorrhage
Subdural hemorrhage
Suicide & self - inflicted
Superficial injury
Syncope/Collaps
Tension Pneumo Thorax
Thyromegaly
Toxoplasmosis
Trachoma
Typoid & Paratypoid
Ulcerative colitis
Urethritis / G.O
URT hypersensitivity reaction
URTI
Urticaria
UTI
Vaginitis
Venomous animal & plants
Verruca (ward)
Vertigo
Viral enteritis
Viral pneumonia
Visual disturbance
Visual field defect
Volvulus
 RINGKASAN LAPORAN BULANAN MEDICAL

Ketua
Penanggung Jawab Klinik
Dokter Klinik

Paramedic

101 Jumlah Evakuasi Medis

1 Jumlah Rawat Observasi
1
Visitor
TOTAL
1st Visit Follow Up
1
0

GNOSIS TOTAL
27
2
13
8
11
7
5
8
0
3

KASUS KECELAKAAN
DIAGNOSIS LOKASI CEDERA CLASS*

Aksilaris,
Vulnus Lasertaum
Mandibularis
 Diperiksa Oleh

Dr.Debby Ayu Anindia Subandi

Dokter Klinik
ANAN MEDICAL

0
0

RASIO KUNJUNGAN
TOTAL
Klien
Kontraktor
Visitor

TOTAL PERSENTASE
27
2
13
8
11
7
5
8
0
3

KECELAKAAN
TINDAKAN STATUS FITNESS KETERANGAN

MEDICAL TREATMENT Rujuk RS Sari Asih Restricted to work sickness absence- unfit for w
 Disetujui oleh

Agung Setiawan HSE

Penanggung Jawab Klinik
RASIO KUNJUNGAN

PERSENTASE

KETERANGAN

sickness absence- unfit for work

eh

an HSE
ab Klinik
 PATIENT'D
Name PT PT.PCIM & PT.OS
Month MEI
Year 2023

Consultation
No Date Consultation Time Patient's Name Departement

1 2-May-23 8:45 AM TN. IRSAN PASTCONTROL

2 2-May-23 8:55 AM TN. PENDI DRIVER

3 2-May-23 9:13 AM TN. TRIAS RnD

4 2-May-23 11:15 AM TN. MAMAN BATCHING

5 2-May-23 13:15:00 PM TN. HUSNI MAINTENANCE

6 3-May-23 8:15 AM TN. FAUZI TRUCKSCALE

7 3-May-23 8:20 PM NY. ASTYA PE

8 3-May-23 8:45 PM TN. KHAERULLAH PACKING

9 3-May-23 8:50 AM TN. BAYU K MAINTENANCE

10 3-May-23 10:40 PM TN. ARIEF QC

11 3-May-23 10:45 PM NY. SONIA QC

12 4-May-23 8:30 PM TN. NOPRI QC

13 4-May-23 8:55 PM TN. SYAFEI MAINTENANCE

14 4-May-23 14:45:00 PM TN. KAINAN PACKING

15 4-May-23 15:10:00 AM TN. JULI DRIVER

16 5-May-23 8:17 AM NY. MELINA RnD

17 5-May-23 8:30 AM TN. WAHYU QC

18 5-May-23 8:15 AM NY. ERRIN PURCHASING

19 5-May-23 13:35:00 PM TN. BINTANG HRGA

20 5-May-23 15:10:00 PM TN. ALFIAN ACCOUNTING

21 8-May-23 10:15 AM TN. FAUZAN PROCRUMEN

22 8-May-23 10:46 AM TN. RAHMAT PURCHASING

23 8-May-23 10:50 AM TN. ASEP D FG

24 8-May-23 13:33:00 PM TN. REZA WH

25 8-May-23 13:15:00 PM TN. MAMAN BATCHING

26 8-May-23 14:30:00 PM TN. SUSANTO BATCHING

27 8-May-23 14:35:00 PM TN. LUKMAN RM

28 9-May-23 13:40:00 PM TN. BINTANG HRGA

29 9-May-23 15:57:00 PM NY. MELINA RnD

30 10-May-23 9:10 AM TN. NURKIN RM

31 10-May-23 9:45 AM TN. ATEP ENGENERING

32 10-May-23 14:45:00 AM NY. ASTYA PE

33 10-May-23 14:50:00 AM NY. GITA QC

34 10-May-23 15:00:00 AM TN. MISBAH RM

35 10-May-23 15:30:00 AM TN. FAUZI TRUCKSCALE

36 11-May-23 08:15:00 AM TN. JULI DRIVER

37 11-May-23 8:40 AM TN. RADEN MAINTENANCE

38 11-May-23 08:50:00 AM TN. LUKMAN RM

39 11-May-23 08:56:00 AM NY. ASTYA PE

40 11-May-23 10:25 AM TN. ANDRI BOILER

41 11-May-23 10:30 AM TN. NANDANG MAINTENANCE

42 12-May-23 09:25:00 AM TN. BAYU K MAINTENANCE

43 12-May-23 8:30 AM TN. FURQON IT

44 12-May-23 9:32 AM TN. CRISTIAN QC

45 13-May-23 8:32 AM TN. GURUH HRGA

46 13-May-23 8:40 AM TN. DONI MAINTENANCE

47 13-May-23 09:55:00 AM TN. AGUS FG

48 13-May-23 11:35 AM TN. IMAM MAINTENANCE

49 15-May-23 11:00 AM NY. INTAN MAINTENANCE

50 16-May-23 8:45 AM NY. SUSILAWATI PACKING

51 16-May-23 09:45:00 AM TN. FAUZAN PROCRUMEN

52 16-May-23 13:50:00 AM TN. GHALIB QC

53 16-May-23 14:10:00 AM TN. JUIADI BOILER

54 16-May-23 15:30:00 AM TN. TRIAS QC

55 17-May-23 8:30 AM TN. SUHERMAN CLANING

56 17-May-23 08:45:00 AM NY. ERRIN PURCHASING

57 17-May-23 11:00:00 AM TN. LUKMAN RM

58 17-May-23 11:20:00 AM TN. NASRUL PASTCONTROL

59 17-May-23 15:30:00 AM TN. JULI DRIVER

60 19-May-23 08:45:00 AM TN. IMAM MAINTENANCE

61 19-May-23 8:50 AM TN. SUHERMAN CLANING

62 19-May-23 9:30 AM TN. ANDRI BOILER

63 19-May-23 14:20:00 AM NY. HANA PIRCHASING

64 19-May-23 15:35:00 PM TN. YUDA QA

65 20-May-23 8:17 PM TN. AFRIZAL QC

66 20-May-23 8:45 PM TN. SUHERMAN CLANING

67 20-May-23 10:45 PM TN. DONI MAINTENANCE

68 20-May-23 11:45 PM TN. NOPRI QC

69 20-May-23 12:55 PM TN. M. FAUZI TRUCKSCALE

70 22-May-23 13:55:00 PM NY. RAHAYU QC

71 22-May-23 14:00:00 PM NY. SUGIARTI CLANING

72 22-May-23 14:55:00 PM TN. MISBAH RM

73 22-May-23 14:58:00 PM NY. NURWATI PRODACTION

74 23-May-23 8:58 PM TN. TRIAS QC

75 23-May-23 9:58 PM TN. AGUNG EKO S ACCOUNTING

76 23-May-23 13:58:00 PM TN. ABD ROPIQ FG

77 23-May-23 14:20:00 PM TN, ANDRU B TRUCKSCALE

78 23-May-23 14:35:00 PM TN. MARDHA MAINTENANCE

79 23-May-23 15:50:00 PM NY. MELINA RnD

80 23-May-23 15:55:00 PM TN. JULI DRIVER

81 24-May-23 9:55 PM TN. MAUN FG

82 24-May-23 13:55:00 PM TN. RUSYANTO EXTRUDER

83 24-May-23 14:10:00 PM NY. ERRIN PURCHASING

84 24-May-23 15:10:00 PM NY.ASTYA PE

85 24-May-23 15:50:00 PM TN. MISBAH RM

86 25-May-23 10:12 PM NY. FITRI PACKING

87 25-May-23 9:12 PM TN. YAYA QC

88 26-May-23 9:31 PM NY. DUMARIA QA

89 26-May-23 10:31 PM TN. ROBI EXTRUDER

90 26-May-23 11:10 PM TN. HASNI MAINTENANCE

91 26-May-23 14:10:00 AM TN. SUHARTO MAINTENANCE

92 29-May-23 8:12 AM TN. LUKMAN RM

93 29-May-23 13:10:00 AM TN. GILANG PACKAGING

94 29-May-23 14:20:00 AM NY. SUGAIRTI CLANING

95 29-May-23 15:10:00 AM TN. RAHMAT RM

96 30-May-23 14:15:00 AM TN. ALTO RM

97 30-May-23 15:10:00 AM NY. MELINA RnD

98 31-May-23 8:15 AM TN. URYANI MAINTENANCE

99 31-May-23 8:20 AM TN. FAUZAN PROCRUMEN

100 31-May-23 8:27 AM TN. ANDRI B TRUCKSCALE

101 31-May-23 10:40 AM TN. IRSAN PASTCONTROL

PATIENT'DAILY VISIT LOGBOOK

NRP Age Company Gender Subjektif

32 PT.PCIM MALE Patient complains of joint pain

42 PT.PCIM MALE Patient says weak, the body feels

achy

33 PT.PCIM MALE Patient complains of sore throat, pain

when swallowing

31 PT.PCIM MALE The patient complains of weakness,

fever

38 PT.PCIM MALE The patient requires liquid wind

rejection

27 PT.PCIM MALE The patient complains of weakness

31 PT.PCIM FEMALE The patient complains of sore throat,

pain when swallowing
30 PT. PCIM MALE The patient complained of pain in the
right eye area

28 PT. PCIM MALE The patient complains of sore throat,

pain when swallowing

31 PT.PCIM MALE The patient complains of cough and

runny nose

25 PT.PCIM FEMALE The patient complains of dizziness,

fever, coughing

31 PT.PCIM MALE The patient complains of sore throat,

pain when swallowing

25 PT.PCIM MALE Patients come with complaints of

runny nose, fever

27 PT.PCIM MALE The patient complains of dizziness,

fever, coughing

38 MALE The patient complains of weakness

22 PT. PCIM FEMALE The patient complains of a headache

27 PT.PCIM MALE The patient complains of eye pain,

the eye looks red

31 PT. PCIM FEMALE The patient complains of body aches

and weakness
22 PT. PCIM MALE Patient complains of runny nose > 2
days

27 PT. PCIM MALE The patient requires liquid wind

rejection

30 PT.PCIM MALE The patient complains of sore throat,

pain when swallowing

25 PT. PCIM MALE The patient complains of heartburn

33 PT.PCIM MALE Patients complain of runny nose

when exposed to cold weather

37 PT. PCIM MALE Patient comes with complaints of

red, swollen eyes

31 PT. PCIM MALE The patient complains of itching in

both hands

35 PT.PCIM MALE The patient complains of fever,

dizziness, weakness

32 PT.PCIM MALE Pasien mengeluh demam disertai

pilek

22 PT.PCIM MALE Patients come with complaints, fever,

runny nose, dizziness

22 PT.PCIM FEMALE Patients come with complaints, fever,

runny nose, dizziness
42 PT.OS MALE The patient complains of a runny
nose, cough

26 PT.PCIM MALE The patient came with complaints of

lacerations on the right hand

32 PT.PCIM FEMALE The patient complains of dizziness,

fever, coughing

27 PT.PCIM FEMALE Dizziness > 3 days

32 PT.PCIM MALE The patient complains of cough,

runny nose, dizziness

28 PT.PCIM MALE The patient requires liquid wind

rejection

38 PT.PCIM MALE The patient complains of coughing up

phlegm

27 PT.PCIM MALE The patient requires liquid wind

refusal

32 PT.PCIM MALE The patient complains of coughing up

phlegm

32 PT. PCIM FEMALE The patient complains of weakness,

dizziness

31 PT.PCIM MALE The patient came with complaints of

burns on the right palm

30 PT. PCIM MALE The patient complains of sore throat

29 PT.PCIM MALE The patient requires liquid wind
rejection

39 PT.PCIM MALE Patients complain of stomach ache,

nausea, vomiting

32 PT.PCIM MALE The patient requires combantrin

medication

38 PT.PCIM MALE Patients come with complaints of

sore throat, pain when swallowing

24 PT.PCIM MALE Patients come with complaints of

liquid bowel movements, nausea,
vomiting, weakness

44 PT.PCIM MALE Patients come with complaints of

sore throat, pain when swallowing

29 PT.PCIM MALE Patients come with complaints of

cough, runny nose,

22 PT.PCIM MALE The patient complains of dry eyes

29 PT.PCIM FEMALE The patient came with complaints of

an open wound on the right leg

30 PT.PCIM MALE The patient complains of cough with

phlegm, runny nose

25 PT.PCIM MALE The patient came with complaints of

itching in the right leg
48 PT.PCIM MALE The patient complains of weakness
accompanied by body aches

34 PT.PCIM MALE Patient comes with complaints of

red, swollen eyes

48 PT.OS MALE The patient complains of weakness,

body aches

31 PT.PCIM FEMALE The patient complains of a runny

nose

31 PT.PCIM MALE Patients come with complaints of

liquid bowel movements, nausea,
vomiting, weakness

32 PT.OS MALE The patient complains of itching

38 PT.PCIM MALE The patient complains of weakness

and decreased appetite

29 PT.PCIM MALE The patient complains of a runny

nose, cough

38 PT.OS MALE The patient complains of dry throat,

cough

32 PT.PCIM MALE The patient complains of dry throat,

cough

31 PT.PCIM MALE The patient complains of abdominal

pain, nausea, vomiting

27 PT.PCIM MALE The patient complains of muscle pain

27 PT.PCIM MALE The patient complains of a runny
nose, cough

38 PT.OS MALE The patient complains of aches

24 PT.PCIM MALE The patient complains of sore throat,

pain when swallowing

29 PT.PCIM MALE The patient complains of pain in the

knee

27 PT .PCIM MALE The patient requires liquid wind

rejection

24 PT.PCIM FEMALE The patient came with complaints of

sore throat, pain when swallowing

22 PT.OS FEMALE The patient complains of itching

32 PT.PCIM MALE The patient complains of dizziness

30 PT.PCIM FEMALE The patient complains of dizziness

33 PT.PCIM MALE Patients come with complaints of

pain in the abdomen, nausea and
vomiting

31 PT.PCIM MALE The patient complains of runny nose,

dizziness accompanied by weakness

41 PT.PCIM MALE The patient complained of abdominal

pain accompanied by heartburn,
nausea and vomiting
31 PT.PCIM MALE The patient complains of fever,
dizziness, runny nose and cough

25 PT.PCIM MALE Cough with phlegm

23 PT.PCIM FEMALE The patient complained of itching in

the area of ​the right arm

46 PT.PCIM MALE The patient complains of coughing up

phlegm

32 PT.OS MALE The patient complains of fever, runny

nose and cough

32 PT.PCIM MALE The patient complains of abdominal

pain, nausea and vomiting

32 PT.PCIM FEMALE Patients come with complaints of

pain in the abdomen, nausea and
vomiting

32 PT.PCIM FEMALE Patients come with complaints of

weakness, dizziness

32 PT.PCIM MALE The patient complains of a runny

nose, cough

21 PT.PCIM FEMALE The patient complains of dizziness > 2

days

25 PT.PCIM PT.OS The patient complains of fever, runny

nose, dizziness,

46 PT.PCIM FEMALE The patient requires liquid wind

rejection
27 PT.PCIM MALE The patient complains of a runny
nose, cough

38 PT.PCIM MALE The patient complained that the

thumb of his left hand was clamped
by the machine, bruised

40 PT. OS MALE The patient complains of sore throat,

pain when swallowing

30 PT.PCIM MALE The patient complained of itching on

the right hand

24 PT.PCIM MALE Patients complain of nausea, runny

nose > 2 days

22 PT. OS FEMALE The patient complains of itching on

the back

26 PT.PCIM MALE The patient complains of a runny

nose

24 PT.PCIM MALE Cough with phlegm > 3 days

23 PT.PCIM FEMALE The patient complains of swollen and

red eyes
25 PT.PCIM MALE Patients complain of runny nose,
cough with phlegm accompanied by
dizziness

31 PT.PCIM MALE The patient complained of itching in

the right arm

31 PT.PCIM MALE The patient complains of a dry cough

accompanied by dizziness

32 PT.PCIM MALE Pasien mengatakan diare > 3x, pusing

 Faktor Pencetus D/ ( Trigger Factor)
1. Life Style (Prilaku)
2. Psikologi (Psychology)
3. Lingkungan (Environment)
4. Pekerjaan (Profession)
5. Medical Problem (Masalah kesehatan)

Trigger Factor
(Faktor Pencetus
Objektif Diagnosis 1 2 D/) 3 4 5 Medical Officer

100/80 MYALGIA √ Br.Soleh

mmhg

120/70 MYALGIA √ Dr. Debby

mmhg

110/80 GASTRITIS √ Dr. Debby

mmhg

120/80 FEBRIS √ Br.Soleh

mmhg

100/70 OTHER √ Br.Soleh

mmhg

120/90 MYALGIA √ Br.Soleh

mmhg

PHARYNGITIS √ Br.Soleh
 KONJUNGTIVITIS √ Br.Soleh

PHARYNGITIS √ Br.Soleh

110/80 ACUTE √ Dr. Debby

mmhg RESPIRATORY
INFECTION

130/80 ACUTE √ Dr. Debby

mmhg RESPIRATORY
INFECTION

110/70 PHARYNGITIS √ Br.Soleh

mmhg

130/80 ACUTE √ Br.Soleh

mmhg RESPIRATORY
INFECTION

140/80 CEPHALGIA √ Br.Soleh

mmhg

MYALGIA √ Br.Soleh

130/70 CEPHALGIA √ Br.Soleh

mmhg

KONJUNGTIVITIS √ Br.Soleh

120/80 MYALGIA √ Dr. Debby

mmhg
100/80 ACUTE √ Dr. Debby
mmhg RESPIRATORY
INFECTION

110/80 OTHER √ Br.Soleh

mmhg

110/80 PHARYNGITIS √ Br.Soleh

mmhg

110/80 GASTRITIS √ Dr. Debby

mmhg

ACUTE √ Dr. Debby

RESPIRATORY
INFECTION

130/80 KONJUNGTIVITIS √ Br.Soleh

mmhg

√ Br.Soleh
DERMATITIS

120/80 FEBRIS √ Br.Soleh

mmhg

130/80 FEBRIS √ Br.Soleh

mmhg

100/80 ACUTE √ Br.Soleh

mmhg RESPIRATORY
INFECTION

120/80 PHARYNGITIS √ Br.Soleh

mmhg
 110/80 ACUTE √ Br.Soleh
mmhg RESPIRATORY
INFECTION

VL √ Dr. Debby

CEPHALGIA √ Br.Soleh

100/80 CEPHALGIA √ Br.Soleh

mmhg

110/80 ACUTE √ Br.Soleh

mmhg RESPIRATORY
INFECTION

100/70 OTHER √ Br.Soleh

mmhg

90/80 mmhg ACUTE √ Br.Soleh

RESPIRATORY
INFECTION

120/80 OTHER √ Br.Soleh

mmhg

110/80 ACUTE √ Dr. Debby

mmhg RESPIRATORY
INFECTION

AMEMIA √ Br.Soleh

COMBUSTIO √ Br.Soleh

110/80 PHARYNGITIS √ Br.Soleh

mmhg
 OTHER √ Br.Soleh

GASTRITIS √ Dr. Debby

110/80
mmhg

√ Dr. Debby

PHARYNGITIS Dr. Debby

DIARRHEA √ Br.Soleh
100/80
mmhg

PHARYNGITIS √ Br.Soleh

ACUTE √ Dr. Debby

RESPIRATORY
110/80 INFECTION
mmhg

KONJUNGTIVITIS √ Br.Soleh
120/80
mmhg

VL √ Br.Soleh
120/80
mmhg

ACUTE √ Br.Soleh
RESPIRATORY
130/80 INFECTION
mmhg

DERMATITIS √ Br.Soleh
120/80
mmhg
 MYALGIA √ Br.Soleh

KONJUNGTIVITIS √ Br.Soleh

MYALGIA √ Br.Soleh

ACUTE √ Br.Soleh
RESPIRATORY
130/80 INFECTION
mmhg

DIARRHEA √ Br.Soleh
120/80
mmhg

DERMATITIS √ Br.Soleh

MYALGIA √ Br.Soleh
110/80
mmhg

ACUTE √ Br.Soleh
100/80 RESPIRATORY
mmhg INFECTION

PHARYNGITIS √ Dr. Debby

100/80
mmhg

PHARYNGITIS √ Br.Soleh
110/80
mmhg

GASTRITIS √ Br.Soleh
130/70
mmhg

ATRALGIA √ Br.Soleh
 ACUTE √ Dr. Debby
RESPIRATORY
INFECTION

MYALGIA √ Dr. Debby

130/80
mmhg

PHARYNGITIS √ Dr. Debby

127/80
mmhg

ATRALGIA √ Dr. Debby

OTHER √ Br.Soleh

PHARYNGITIS √ Br.Soleh

DERMATITIS √ Br.Soleh

130/80 CEPHALGIA √ Br.Soleh

mmhg
CEPHALGIA √ Br.Soleh
110/70
mmhg

GASTRITIS √ Br.Soleh
120/70
mmhg

ACUTE √ Br.Soleh
RESPIRATORY
INFECTION

GASTRITIS √ Br.Soleh
 ACUTE √ Br.Soleh
RESPIRATORY
INFECTION

ACUTE √ Br.Soleh
RESPIRATORY
INFECTION

DERMATITIS √ Br.Soleh

ACUTE √ Br.Soleh
RESPIRATORY
INFECTION

ACUTE √ Br.Soleh
RESPIRATORY
INFECTION

GASTRITIS √ Dr. Debby

GASTRITIS √ Br.Soleh

ANEMIA Br.Soleh

ACUTE √ Br.Soleh
RESPIRATORY
INFECTION

120/80 CEPHALGIA √ Br.Soleh

mmhg

FEBRIS √ Br.Soleh

P3K √ Br.Soleh
ACUTE √ Br.Soleh
RESPIRATORY
INFECTION

HEMATOMA √ Dr. Debby

PHARYNGITIS √ Br.Soleh

DERMATITIS √ Br.Soleh

ACUTE √ Br.Soleh
RESPIRATORY
INFECTION

DERMATITIS √ Br.Soleh

ACUTE √ Br.Soleh
RESPIRATORY
INFECTION
ACUTE √ Br.Soleh
RESPIRATORY
INFECTION
KONJUNGTIVITIS √ Br.Soleh

ACUTE √ Br.Soleh
RESPIRATORY
INFECTION

DERMATITIS √ Dr. Debby

ACUTE √ Dr. Debby

RESPIRATORY
INFECTION

DIARRHOEA √ Dr. Debby

 DIAGNOSIS
PRIODE : MEI 2023

GRAND
NO KLASIFIKASI
TOTAL
1 Fracture: hand/foot bone 0
2 Diarrhoea 0
3 Pharyngitis Acute 0
4 Gastritis & Duodenitis 0
5 Influenza 0
6 Vertigo/dizziness 0
7 Abrasion/scratch/blister 0
8 Dermatitis contact/allergic 0
9 Dental Other (specify in comment) 0
10 Vulnus Laceratum 0
11 Lymphadenitis acute 0
12 Lymphadenitis non-specific 0
13 Hodgkins disease/lymphoma 0
14 Ruptured spleen traumatic 0
15 Injury blood/lymph/spleen other 0
16 Anaemia other/unspecified 0
17 Purpura/coagulation defect 0
18 Splenomegaly 0
19 HIV-infection/AIDS 0
20 Lymph gland(s) enlarged/painful 0
21 Blood symptom/complaint 0
22 Gastrointestinal infection 0
23 Mumps 0
24 Diarrhea and gastroenteritis from presumed infect 0
25 Bacterial Enteritis 0
26 Amoebiasis 0
27 Functional Dyspepsia 0
28 Peritonitis 0
29 Food Poisoning 0
30 Viral Enteritis 0
31 Foreign body digestive system 0
32 Injury digestive system other 0
33 Mouth/tongue/lip disease 0
34 Oesophagus disease 0
35 Duodenal ulcer 0
36 Peptic ulcer other 0
37 Stomach function disorder 0
38 Acute Appendicitis 0
39 Chronic / Recurrent Appendicitis 0
40 Inguinal hernia 0
41 Hiatus hernia 0
42 Abdominal hernia other 0
43 Irritable bowel syndrome 0
44 Anal fissure/perianal abscess 0
45 Worms/other parasites 0
46 Haemorrhoids 0
47 Paralytic Ileus 0
48 Gastrointestinal Hemorrhage 0
49 Disease digestive system, other 0
50 Abdominal pain/cramps general 0
51 Abdominal pain epigastric 0
52 Heartburn 0
53 Pelvic and perineal pain 0
54 Perianal itching (pruritis ani) 0
55 Abdominal pain localized other 0
56 cataract 0
57 Flatulence 0
58 Nausea 0
59 Vomiting 0
60 Functional Diarrhoea 0
61 Constipation 0
62 Jaundice 0
63 Haematemesis/vomiting blood 0
64 Melaena 0
65 Rectal bleeding 0
66 Change faeces/bowel movements 0
67 Swallowing problem (dysphagia) 0
68 Hepatomegaly 0
69 Abdominal mass NOS 0
70 Abdominal distension 0
71 Digestive symptom/complaint other 0
72 Viral Hepatitis 0
73 Cholecystitis 0
74 Acute Pancreatitis 0
75 Chronic Pancreatitis 0
76 Liver Cirrhosis 0
77 Liver Abcess 0
78 Cholelithiasis (gall stones) 0
79 Jaundice 0
80 Acute Conjunctivitis 0
81 Chronic Conjunctivitis 0
82 Blepharitis/stye/chalazion 0
83 Keratitis 0
84 Eye infection/inflammation other 0
85 Contusion/haemorrhage eye 0
86 Foreign body in eye 0
87 Injury eye other 0
88 Pterygium 0
89 Detached retina 0
90 Corneal Abrasion 0
91 Trachoma 0
92 Visual Field Defects 0
93 Colour Vision Deficiencies 0
94 Visual Disturbance 0
95 Low Vision 0
96 Cataract 0
97 Glaucoma 0
98 Blindness 0
99 Strabismus 0
100 Eye/adnexa disease, other 0
101 Eye pain 0
102 Red eye (conjunctival hyperaemia) 0
103 Eye discharge 0
104 Visual floaters/spots 0
105 Visual disturbance other 0
106 Eye movements abnormal 0
107 Eye appearance abnormal 0
108 Eyelid symptom/complaint 0
109 Glasses symptom/complaint 0
110 Contact lens symptom/complaint 0
111 Limited function/disability (f) 0
112 Eye symptom/complaint other 0
113 Otitis externa 0
114 Acute otitis media 0
115 Serous otitis media 0
116 Chronic otitis media 0
117 Neoplasm of ear 0
118 Foreign body in ear 0
119 Perforation ear drum (tympanic membrane) 0
120 Superficial injury of ear 0
121 Ear injury other 0
122 Congenital anomaly of ear 0
123 Inpacted Cerumen (Ear Wax) 0
124 Presbyacusis (age related hearing loss) 0
125 Acoustic trauma 0
126 Hearing Loss (deafness) 0
127 Ear/mastoid disease, other 0
128 Ear pain/earache 0
129 Hearing complaint 0
130 Tinnitus, ringing/buzzing ear 0
131 Ear discharge (Otorrhea) 0
132 Bleeding ear (Otorrhagia) 0
133 Plugged feeling ear 0
134 Concern with appearance of ears 0
135 Fear of ear disease 0
136 Limited function/disability ear 0
137 Ear symptom/complaint other 0
138 Common Cold (acute nasopharyngitis) 0
139 Whooping cough 0
140 Strep throat (streptococcal pharyngitis) 0
141 Diphteria 0
142 Boil/abscess nose 0
143 Upper respiratory infection acute (URI) 0
144 Rhinitis Allergic 0
145 Rhinitis Chronic 0
146 Sinusitis Acute 0
147 Tonsillitis acute 0
148 Laryngitis/tracheitis acute 0
149 Acute bronchitis/bronchiolitis 0
150 Chronic bronchitis 0
151 Emphysema 0
152 Chronic Nasopharyngitis 0
153 Chronic pharyngitis 0
154 Chronic Sinusitis 0
155 Chronic Tonsillitis 0
156 Peritonsillar Abscess 0
157 Chronic Laryngitis 0
158 Pleurisy/pleural effusion 0
159 Respiratory infection other 0
160 Foreign body nose/larynx/bronch 0
161 Pneumothorax 0
162 Deviated Nasal Septum 0
163 Injury respiratory other 0
164 Hypertrophy tonsils/adenoids 0
165 Chronic obstructive pulmonary disease (COPD) 0
166 Asthma 0
167 Nasal Polyps 0
168 Respiratory disease other 0
169 Pain respiratory system 0
170 Dyspnoea 0
171 Shortness of breath 0
172 Wheezing 0
173 Breathing problem, other 0
174 Cough 0
175 Nose bleed/epistaxis 0
176 Sneezing/nasal congestion 0
177 Postnasal drip 0
178 Nose symptom/complaint other 0
179 Sinus symptom/complaint 0
180 Throat symptom/complaint 0
181 Voice symptom/complaint 0
182 Haemoptysis 0
183 Sputum/phlegm abnormal 0
184 Respiratory Arrest 0
185 Limited function/disability (r) 0
186 Respiratory symptom/complaint oth. 0
187 Rheumatic fever/heart disease 0
188 Ischaemic heart disease w. angina 0
189 Ischaemic heart disease w/o angina 0
190 Acute myocardial infarction 0
191 Old Myocardial Infarction 0
192 Cardiac Arrest 0
193 Heart failure 0
194 Atrial fibrillation/flutter 0
195 Paroxysmal tachycardia 0
196 Cardiac arrhythmia NOS 0
197 Heart/arterial murmur NOS 0
198 Pulmonary heart disease 0
199 Heart valve disease NOS 0
200 Heart disease other 0
201 Elevated blood pressure 0
202 Hypertension uncomplicated 0
203 Hypertension complicated 0
204 Postural hypotension (orthostatic) 0
205 Transient cerebral ischaemia 0
206 Stroke/cerebrovascular accident 0
207 Cerebrovascular disease 0
208 Pulmonary embolism 0
209 Phlebitis/thrombophlebitis 0
210 Varicose veins of leg 0
211 Cardiovascular disease other 0
212 Pressure/tightness of heart 0
213 Palpitations/awareness of heart 0
214 Irregular heartbeat other 0
215 Swollen ankles/oedema 0
216 Risk factor cardiovascular disease 0
217 Limited function/disability (k) 0
218 Cardiovascular sympt./complt. other 0
219 Malignant neoplasm musculoskeletal 0
220 Neoplasm benign/unspec musculo. 0
221 Fracture: radius/ulna 0
222 Fracture: tibia/fibula 0
223 Fracture: femur 0
224 Fracture: other 0
225 Sprain/strain of ankle 0
226 Sprain/strain of knee 0
227 Sprain/strain of joint NOS 0
228 Dislocation/subluxation 0
229 Injury musculoskeletal NOS 0
230 Neck syndrome 0
231 Back syndrome w/o radiating pain 0
232 Acquired deformity of spine 0
233 Back syndrome with radiating pain 0
234 Bursitis/tendinitis/synovitis NOS 0
235 Rheumatoid/seropositive arthritis 0
236 Polyarthritis 0
237 Osteoarthrosis/osteoarthritis of hip 0
238 Osteoarthrosis/osteoarthritis of knee 0
239 Osteoarthrosis/osteoarthritis other 0
240 Shoulder/impingement syndrome 0
241 Tennis elbow (bursitis) 0
242 Intervertebral disc displacement 0
243 Osteochondrosis 0
244 Osteoporosis 0
245 Acute internal damage knee 0
246 Ganglion Cyst 0
247 Acquired deformity of limb 0
248 Burns 0
249 Open Wound 0
250 Superficial Injury (special site) 0
251 Crushing Injury (special site) 0
252 Dislocation (special site) 0
253 Musculoskeletal disease, other 0
254 Injury / Trauma Other (specify in comment) 0
255 Neck symptom/complaint (cervicalgia) 0
256 Back symptom/complaint 0
257 Low back symptom/complaint 0
258 Chest symptom/complaint 0
259 Flank/axilla symptom/complaint 0
260 Jaw symptom/complaint 0
261 Shoulder symptom/complaint 0
262 Arm symptom/complaint 0
263 Elbow symptom/complaint 0
264 Wrist symptom/complaint 0
265 Hand/finger symptom/complaint 0
266 Hip symptom/complaint 0
267 Leg/thigh symptom/complaint 0
268 Knee symptom/complaint 0
269 Ankle symptom/complaint 0
270 Foot/toe symptom/complaint 0
271 Muscle pain/spasm (myalgia) 0
272 Muscle symptom/complaint NOS 0
273 Joint symptom/complaint NOS 0
274 Limited function/disability (l) 0
275 Sympt/complt. Musculoskeletal other 0
276 Meningitis/encephalitis 0
277 Tetanus 0
278 Neurological infection other 0
279 Concussion 0
280 Subarachnoid Hemorrhage 0
281 Subdural Hemorrhage 0
282 Combustio Cerebri 0
283 Cerebral Contusion 0
284 Head injury other 0
285 Injury nervous system other 0
286 Parkinsonism 0
287 Epilepsy 0
288 Migraine 0
289 Cluster headache 0
290 Facial paralysis/Bell's Palsy 0
291 Carpal tunnel syndrome 0
292 Peripheral neuritis/neuropathy 0
293 Tension headache 0
294 Pain face 0
295 Restless legs 0
296 Tingling fingers/feet/toes 0
297 Sensation disturbance other 0
298 Convulsion/seizure 0
299 Abnormal involuntary movements 0
300 Disturbance of smell/taste 0
301 Paralysis/weakness 0
302 Speech disorder 0
303 Limited function/disability (n) 0
304 Neurological symptom/complt. other 0
305 Schizophrenia 0
306 Anxiety disorder/anxiety state 0
307 Somatization disorder 0
308 Depressive disorder 0
309 Suicide/suicide attempt 0
310 Phobia/compulsive disorder 0
311 Personality disorder 0
312 Post-traumatic stress disorder 0
313 Mental retardation 0
314 Anorexia nervosa/bulimia 0
315 Severe Stress & Adjustment Disorders 0
316 Situational Disturbance 0
317 Psychological disorders, other 0
318 Feeling anxious/nervous/tense 0
319 Acute stress reaction 0
320 Feeling depressed 0
321 Feeling/behaving irritable/angry 0
322 Senility, feeling/behaving old 0
323 Sleep disturbance 0
324 Sexual desire reduced 0
325 Sexual fulfilment reduced 0
326 Sexual preference concern 0
327 Stammering/stuttering/tic 0
328 Bedwetting/enuresis 0
329 Chronic alcohol abuse 0
330 Acute alcohol abuse 0
331 Tobacco abuse 0
332 Medication abuse 0
333 Drug abuse 0
334 Memory disturbance 0
335 Adolescent behav. Symptom/complt. 0
336 Phase of life problem adult 0
337 Limited function/disability (p) 0
338 Psychological symptom/complt other 0
339 Wart/Verruca 0
340 Infected finger/toe 0
341 Boil(furuncle)/carbuncle 0
342 Dermatophytosis (ringworm) 0
343 Dermatomycosis (fungal infection) 0
344 Cellulitis & Abcess 0
345 Erysipelas 0
346 Skin infection post-traumatic 0
347 Herpes zoster 0
348 Herpes simplex 0
349 Scabies/other acariasis 0
350 Pediculosis (lice)/skin infestation other 0
351 Dermatophytosis 0
352 Moniliasis/candidiasis skin/nail 0
353 Impetigo 0
354 Molluscum contagiosum 0
355 Skin infection other 0
356 Insect bite/sting 0
357 Animal/human bite 0
358 Burn/scald 0
359 Foreign body in skin 0
360 Bruise/contusion 0
361 Laceration/cut 0
362 Skin injury other 0
363 Malignant neoplasm of skin 0
364 Lipoma 0
365 Neoplasm skin benign/unspecified 0
366 Solar keratosis/sunburn 0
367 Haemangioma/lymphangioma 0
368 Naevus/mole 0
369 Congenital skin anomaly other 0
370 Pilonidal cyst/fistula 0
371 Dermatitis seborrhoeic 0
372 Dermatitis atopic /eczema 0
373 Diaper rash (diaper dermatitis) 0
374 Pityriasis rosea 0
375 Psoriasis 0
376 Sweat gland disease (Hidradenitis suppurativa) 0
377 Sebaceous cyst 0
378 Ingrowing nail 0
379 Acne 0
380 Chronic ulcer skin 0
381 Urticaria 0
382 Skin disease, other 0
383 Pain/tenderness of skin 0
384 Pruritus 0
385 Sunburn 0
386 Lump/swelling 0
387 Rash and other nonspecific skin eruption 0
388 Erythema 0
389 Skin colour change 0
390 Corn/callosity 0
391 Skin texture symptom/complaint 0
392 Nail symptom/complaint 0
393 Hair loss/baldness 0
394 Hair/scalp symptom/complaint 0
395 Fear of cancer of skin 0
396 Fear of skin disease other 0
397 Limited function/disability (s) 0
398 Skin symptom/complaint other 0
399 Obesity 0
400 Overweight 0
401 Hyperthyroidism/thyrotoxicosis 0
402 Hypothyroidism/myxoedema 0
403 Thyromegaly 0
404 Hypoglycaemia 0
405 Diabetes insulin dependent 0
406 Diabetes non-insulin dependent 0
407 Vitamin/nutritional deficiency 0
408 Gout 0
409 Hypercholesterolaemia 0
410 Disorders of purine and pyrimidine 0
411 Hyperlipidaemia 0
412 Lipid disorder other 0
413 Endocrine/metab/nutrit. dis. other 0
414 Loss of appetite 0
415 Feeding problem of infant/child 0
416 Feeding problem of adult 0
417 Weight gain 0
418 Weight loss 0
419 Growth delay (Failure to thrive) 0
420 Dehydration 0
421 Fear of cancer of endocrine system 0
422 Fear endocrine/metabolic dis other 0
423 Limited function/disability (t) 0
424 Endocrine/met./sympt/complt other 0
425 Glomerulonephritis/nephrosis 0
426 Nephrotic Syndrome 0
427 UTI 0
428 Injury urinary tract 0
429 Orthostatic albumin./proteinuria 0
430 Urinary calculus 0
431 Hydronephrosis 0
432 Acute Renal Failure 0
433 Chronic Renal Failure 0
434 Abnormal urine test NOS 0
435 Urinary disease, other 0
436 Urethral discharge 0
437 Dysuria/painful urination 0
438 Urinary frequency/urgency 0
439 Incontinence urine 0
440 Urination problems other 0
441 Haematuria 0
442 Urine symptom/complaint other 0
443 Urinary retention 0
444 Bladder symptom/complaint other 0
445 Kidney symptom/complaint 0
446 Limited function/disability urinary 0
447 Urinary symptom/complaint other 0
448 Puerperal infection/sepsis 0
449 Infection complicating pregnancy 0
450 Injury complicating pregnancy 0
451 Pregnancy 0
452 ANC 0
453 Unwanted pregnancy 0
454 Ectopic pregnancy 0
455 Toxaemia of pregnancy (pre-eclampsia) 0
456 Abortion spontaneous (miscarriage) 0
457 Abortion induced 0
458 Pregnancy high risk 0
459 Uncomplicated labour/delivery 0
460 Complicated labour/delivery 0
461 Livebirth 0
462 Stillbirth 0
463 Puerperal mastitis 0
464 Breast disorder in pregnancy other 0
465 Complications of puerperium other 0
466 Disorder pregnancy/delivery, other 0
467 Routine Prenatal Examination 0
468 Routine Postpartum Examination 0
469 Question of pregnancy 0
470 Fear of pregnancy 0
471 Antepartum bleeding 0
472 Pregnancy vomiting/nausea 0
473 Contraception postcoital 0
474 Contraception oral 0
475 Contraception intrauterine 0
476 Sterilization 0
477 Contraception other 0
478 Female Infertility/subfertility 0
479 Male Infertility 0
480 Post-partum bleeding 0
481 Post-partum symptom/complaint oth. 0
482 Breast/lactation symptom/complaint 0
483 Concern body image in pregnancy 0
484 Fear complications of pregnancy 0
485 Limited function/disability (w) 0
486 Anemia complicating pregnancy 0
487 Pre-eclampsia 0
488 Maternal Hypertension 0
489 First Trimester Bleeding 0
490 Hyperemesis Gravidarum (Vomiting) 0
491 Previous C-Section 0
492 Syphilis female 0
493 Gonorrhoea female 0
494 Chancroid 0
495 Genital candidiasis female 0
496 Genital trichomoniasis female 0
497 Vaginitis/vulvitis NOS 0
498 Cervicitis 0
499 Pelvic inflammatory disease 0
500 Mastitis 0
501 Malignant neoplasm cervix 0
502 Malignant neoplasm breast female 0
503 Malignant neoplasm genital other (f) 0
504 Benign neoplasm breast female 0
505 Benign neoplasm female genital 0
506 Genital neoplasm oth/unspecied (f) 0
507 Injury genital female 0
508 Congenital anomaly genital female 0
509 Cervical disease NOS 0
510 Uterovaginal prolapse 0
511 Breast Nodule 0
512 Fibrocystic disease breast 0
513 Premenstrual tension syndrome 0
514 Genital herpes female 0
515 Condylomata acuminata female 0
516 Chlamydia infection genital (f) 0
517 Genital disease female, other 0
518 Gynaecological Examination 0
519 Pelvic Pain 0
520 Dysmenorrhea 0
521 Intermenstrual pain (Mittelschmerz) 0
522 Painful intercourse female (dyspareunia) 0
523 Absent, scanty and rare menstruation 0
524 Excessive, frequent and irregular menstruation 0
525 Irregular Menstruation 0
526 Other abnormal uterine and vaginal bleeding 0
527 Premenstrual symptom/complaint 0
528 Postponement of menstruation (primary amenorr 0
529 Menopause Symptoms 0
530 Postmenopausal bleeding 0
531 Postcoital bleeding 0
532 Vaginal discharge 0
533 Ulceration of vagina/vulva 0
534 Vaginal symptom/complaint other 0
535 Vulval symptom/complaint 0
536 Pelvis symptom/complaint female 0
537 Breast pain female 0
538 Breast lump/mass female 0
539 Nipple symptom/complaint female 0
540 Breast symptom/complt. female other 0
541 Concern breast appearance female 0
542 Limited function/disability (x) 0
543 Genital symptom/complt female oth. 0
544 Syphilis male 0
545 Gonorrhoea male 0
546 Genital herpes male 0
547 Chancroid 0
548 Orchitis/epididymitis 0
549 Balanitis 0
550 Condylomata acuminata male 0
551 Neoplasm unsp gen. (m) 0
552 Injury male genital 0
553 Phimosis/redundant prepuce 0
554 Hypospadias 0
555 Undescended testicle 0
556 Congenital genl anomaly (m) other 0
557 Benign prostatic hypertrophy 0
558 Male Erectile Disorder 0
559 Circumcision 0
560 Hydrocoele 0
561 Genital disease male, other 0
562 Pain in penis 0
563 Pain in testis/scrotum 0
564 Urethral discharge 0
565 Ulcer of Penis 0
566 Penis symptom/complaint other 0
567 Scrotum/testis sympt/complt. other 0
568 Prostate symptom/complaint 0
569 Impotence NOS 0
570 Sexual function sympt./complt.(m) 0
571 Infertility/subfertility male 0
572 Sterilization male 0
573 Family planning male other 0
574 Breast symptom/complaint male 0
575 Limited function/disability (y) 0
576 Genital sympt./complt.male other 0
577 Tuberculosis 0
578 Measles 0
579 Chickenpox 0
580 Rubella (German Measles) 0
581 Malaria 0
582 Malaria Simple Confirmed 0
583 Malaria Simple Unconfirmed 0
584 Malaria Severe Confirmed 0
585 Malaria Severe Unconfirmed 0
586 Malaria Pregnancy Confirmed 0
587 Malaria Pregnancy Unconfirmed 0
588 Typhoid & Paratyphoid 0
589 Cholera 0
590 Onchocerciasis 0
591 Leprosy [Hansen's disease] 0
592 Meningococcal Infection 0
593 Gonococcal Infections 0
594 Dengue 0
595 Dengue Haemorrhagic Fever 0
596 Candidiasis 0
597 Toxoplasmosis 0
598 Ascariasis 0
599 Viral exanthem other 0
600 Viral disease other/NOS 0
601 Unspecified Viral Haemorrhagic Fever 0
602 Infectious disease other/NOS 0
603 Sunstroke/Heatstroke 0
604 Trauma/injury NOS 0
605 Multiple trauma/injuries 0
606 Secondary effect of trauma 0
607 Poisoning by medical agent 0
608 Adverse effect medical agent 0
609 Toxic effect non-medicinal substance 0
610 Traffic accident injury 0
611 Poisoning occupational 0
612 Snake bite, nonvenomous 0
613 Snake bite, venomous 0
614 Allergy/allergic reaction NOS 0
615 Premature newborn 0
616 Perinatal morbidity other 0
617 Perinatal mortality 0
618 Death 0
619 Pain unspecified (general, multiple sites) 0
620 Chills (without fever) 0
621 Fever, unspecified 0
622 Malaise / Fatigue 0
623 Dizziness 0
624 Headache 0
625 Feeling ill 0
626 Burn-out 0
627 Syncope / Collapse 0
628 Coma 0
629 Swelling 0
630 Sweating problem 0
631 Bleeding/haemorrhage NOS 0
632 General Abdominal Pain 0
633 Chest pain NOS 0
634 Fussy/Irritable infant baby 0
635 Concern about appearance 0
636 General symptom/complaint other 0
637 Disturbance in Tooth Eruption (Impacted Tooth) 0
638 Disorder of Tooth Development 0
639 Dental Caries 0
640 Infected Tooth or Pulp (Pulpitis) 0
641 Dental Cyst 0
642 Acute Gingivitis 0
643 Chronic Gingivitis 0
644 Acute Periodontitis 0
645 Chronic Periodontitis 0
646 Gum Disease 0
647 Impacted Tooth with Abnormal Position 0
648 Loss of Teeth due to Accident, Extraction, or Loca 0
649 Retaine Dental Root 0
650 Disorder of Teeth and Supporting Structures, Uns 0
651 Dry Socket 0
652 Mouth/tongue/lip symptom/complt. 0
653 Fractured Tooth 0
654 Halusinasi 0
655 Pneumonia, Unspecified 0
656 Hypotension unspecified 0
657 Vulnus Punctum 0
658 Stomatitis and related Lesions 0
659 Gangrene, not elsewhere classified 0
660 Control 0
661 Hematoma 0
662 P3K 0
ACUTE RESPIRATORY INFECTION 27
ANEMIA 2 DIAGNOSIS
ALTRALGI 2 MENI NGK ATK AN STAMI NA
DENTAL OTHER 0 OTH ER
CEPHALGIA 7 D I ARRH OEA
COMBUSTIO
DERMATITIS 8
P H ARI NGI TIS
KONJUNGTIVITIS 5 MYAL GIA
GASTRITIS 8 GASTRI TIS
MYALGIA 9 K ONJ UNGTIVITIS
D ERMATI TIS
PHARINGITIS 13
C EP H AL GI A
COMBUSTIO 1 D ENTAL OTH ER
DIARRHOEA 3 AL TRAL GI
OTHER 7 ANEMI A
AC UTE RESP I RATORY I NFEC TI ON
MENINGKATKAN STAMINA 0
0 5 10 15
DIAGNOSIS

5 10 15 20 25 30
 PT.ICS MEDIKALESTARI
In H o u s e C lin ic S p e c ia lis t R
PERIODE : 01 Mei 2023

No Tanggal Nama Pasien Usia Perusahaan

50 PT.
1 11-May-23 Tn. Muhyidin years Tarumanegara
old Bumiyasa

Disiapkan oleh D

M.Soleh Suharna Dr. Debby

Paramedic
250 3/25/2018

Warga
 REPORT ACCIDENT WORK

Jabatan Tempat Kejadian Diagnosis

Technician PT,PCIM VL

Diperiksa Oleh

Dr. Debby Ayu Anindia Subandi

Dokter Klinik
Royla 50 Warga Pisangan
T WORK

Bagian Cedera Penanganan Status Fitness

Aksilaris,Mandibularis Restricted to work

Disetujui oleh

Agung Setiawan
Penanggung Jawab Klinik
PEREMPUAN KONTRAKTOR Indonesia
 Keterangan

sickness absence- unfit for work

k
ILNESS

TD:90/60mmHg, SpO:97, N:90, T:36,2

ERLAMYCET
mata sebelah
BARU
NON
kiri merah
WORK-RELATED
, nyeri
TD:120/80mmHg,
, keluar kotoran
SpO:97,
Chronic
mata saat
N:68,
Conjunctivitis
bangun
T:36,4 tidur
97, N:90, T:36,2

1
MEDICAL
1 TREATMENT
FIT TO WORK
 LAPORAN RUJUKAN

PERIODE : MEI 2023

Jenis
No Tanggal Nama Pasien Usia Perusahaan
Kelamin

11-May-23 50 years PT.

1 Tn. Muhyidin Male
old Tarumanegara

2
3
4
5
6

Disiapkan oleh Diperiksa oleh

M.Soleh Suharna Dr. Debby Ayu Anindia Su

Paramedic Dokter Klinik
250 3/25/2018 Warga Royla
RAN RUJUKAN DAN EVAKUASI

Diagnosis Kerja Tim Pendamping Rujukan Evakuasi Rumah Sakit Tujuan

VL RS. Sari Asih Rs. Sari Asih

Diperiksa oleh Disetujui oleh

Debby Ayu Anindia Subandi Agung Setiawan

Dokter Klinik Penanggung Jawab Klinik
50 Warga Pisangan PEREMPUAN KONTRAKTOR
Rujukan
Evakuasi
 TD:90/60mmHg, SpO:97, N:90, T:36,2

ERLAMYCET 1
Indonesia ILNESS
mata sebelah
BARU
NON
kiri merah
WORK-RELATED
, nyeri
TD:120/80mmHg,
, keluar kotoran
SpO:97,
Chronic
mata saat
N:68,
Conjunctivitis
bangun
T:36,4 tidur MEDICAL
1 TREATMENT
FIT TO WORK