Tanggal Informed

No. Unit Kerja Nama Pasien Usia Pasien Alamat

Consent

1 Laboratorium 1 Des 2016 Afandi 65 Cibinong 5/5

2 7 Des 2016 Yanah 63 Pabuaran
3 14 Des 2016 Ibnu 24 Cibinong 5/5
4 27 Des 2016 Fitri N 41 Cirimekar
5 5 Jan 2017 Mawat 51 Ciriung 6/8
6 12 Jan 2017 Yuliat 36 Sukmajaya
7 19 Jan 2017 Mila Tasya 15 Pakan Sari
8 1 Febr 2017 Wasir 65 Pabuaran
9 10 Feb 2017 Danang 30 Citeureup
10 4 Mar 2017 Sri W 50 Harapan Jaya

11 Poli Gigi 25-Mar-17 Fathullah 23 Harapan Jaya 5/1

12 25-Mar-17 Wasni 45 Pabuaran 4/11
13 25-Mar-17 Arsya Hanif 6 Pakan Sari
14 25-Mar-17
15 25-Mar-17
16 Herlan Seta 17 Cibinong 3/8
17 Laila 40 Harapan Jaya 3/2
18 Ali 35 Cirimekar
19 Saepudin 21 Pabuaran 5/4
20 Sri Purnamawat 25 Babakan Gn.Putri

21 Rosalina 21 Nanggewer Mekar

22 Nurhalimah 19 Pabuaran 6/11
23 Riski Priyani 28 Cibinong 1/2
24
25
26 M Amir 1 Cirimekar 3/3
27 Raihan A 1 Pabuaran
28 Alia Shaqila 1 Cirimekar 3/3
29 M Hafidz 3 bln Cirimekar 4/4
30
Compliance Rate

90%
90%
90%
90%
90%
90%
90%
90%
90%
100%

100%
100%
100%

No. Nama Pasien Usia Pasien

100% 1 Herlan Seta 17
100% 2 Laila 40
100% 3 Ali 35
100% 4 Saepudin 21
100% 5 Sri Purnamawat 25

100% Rosalina 21
100% Nurhalimah 19
90% Riski Priyani 28

90%
90%
100%
100%
 Alamat Compliance Rate
Cibinong 3/8 100%
Harapan Jaya 3/2 100%
Cirimekar 100%
Pabuaran 5/4 100%
Babakan Gn.Putri 100%
100%

Nanggewer Mekar 100%

Pabuaran 6/11 100%
Cibinong 1/2 90%