sheet1 1

No. Tgl. Masuk Tgl. Pulang No. RM

2 21 Jul 2018 1 Agu 2018 078956
8 26 Jul 2018 1 Agu 2018 083635
6 26 Jul 2018 1 Agu 2018 971732
3 30 Jul 2018 1 Agu 2018 956855
4 30 Jul 2018 1 Agu 2018 084122
7 30 Jul 2018 1 Agu 2018 084108
1 30 Jul 2018 1 Agu 2018 084109
5 30 Jul 2018 1 Agu 2018 085002
1 Agu 2018 Cou 8
67 3 Agu 2018 10 Agu 2018 084179
66 4 Agu 2018 10 Agu 2018 070394
68 7 Agu 2018 10 Agu 2018 062604
69 8 Agu 2018 10 Agu 2018 080589
10 Agu 2018 Co 4
74 7 Agu 2018 11 Agu 2018 084238
72 7 Agu 2018 11 Agu 2018 084251
70 9 Agu 2018 11 Agu 2018 074309
75 9 Agu 2018 11 Agu 2018 029700
77 9 Agu 2018 11 Agu 2018 084268
76 10 Agu 2018 11 Agu 2018 955573
73 10 Agu 2018 11 Agu 2018 084288
71 10 Agu 2018 11 Agu 2018 073779
11 Agu 2018 Co 8
82 3 Agu 2018 12 Agu 2018 071271
81 7 Agu 2018 12 Agu 2018 084240
79 9 Agu 2018 12 Agu 2018 085974
83 10 Agu 2018 12 Agu 2018 085009
80 11 Agu 2018 12 Agu 2018 081209
84 9 Agu 2018 12 Agu 2018 088314
78 11 Agu 2018 12 Agu 2018 084295
12 Agu 2018 Co 7
90 27 Jul 2018 13 Agu 2018 083678
87 9 Agu 2018 13 Agu 2018 084267
89 9 Agu 2018 13 Agu 2018 074243
86 12 Agu 2018 13 Agu 2018 084309
85 11 Agu 2018 13 Agu 2018 085011
88 10 Agu 2018 13 Agu 2018 084281
13 Agu 2018 Co 6
91 8 Agu 2018 14 Agu 2018 083113
92 10 Agu 2018 14 Agu 2018 085987
94 11 Agu 2018 14 Agu 2018 084300
93 13 Agu 2018 14 Agu 2018 084327
95 10 Agu 2018 14 Agu 2018 084274
14 Agu 2018 Co 5
106 1 Agu 2018 15 Agu 2018 084243
103 8 Agu 2018 15 Agu 2018 084258
100 9 Agu 2018 15 Agu 2018 084277
96 8 Agu 2018 15 Agu 2018 084255
108 10 Agu 2018 15 Agu 2018 084287
101 12 Agu 2018 15 Agu 2018 085903
109 12 Agu 2018 15 Agu 2018 088312

Page 1
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97 12 Agu 2018 15 Agu 2018 084318

105 13 Agu 2018 15 Agu 2018 340504
104 13 Agu 2018 15 Agu 2018 085931
107 13 Agu 2018 15 Agu 2018 085958
110 13 Agu 2018 15 Agu 2018 084334
111 14 Agu 2018 15 Agu 2018 086062
99 12 Agu 2018 15 Agu 2018 084324
98 14 Agu 2018 15 Agu 2018 084563
102 15 Agu 2018 15 Agu 2018 084567
15 Agu 2018 Co 16
114 13 Agu 2018 16 Agu 2018 086023
113 14 Agu 2018 16 Agu 2018 086066
112 15 Agu 2018 16 Agu 2018 084568
115 16 Agu 2018 16 Agu 2018 084464
16 Agu 2018 Co 4
116 9 Agu 2018 17 Agu 2018 084276
118 12 Agu 2018 17 Agu 2018 084311
117 13 Agu 2018 17 Agu 2018 086007
119 16 Agu 2018 17 Agu 2018 084456
17 Agu 2018 Co 4
120 15 Agu 2018 18 Agu 2018 086108
18 Agu 2018 Co 1
122 13 Agu 2018 19 Agu 2018 085015
121 14 Agu 2018 19 Agu 2018 086056
123 16 Agu 2018 19 Agu 2018 084179
19 Agu 2018 Co 3
12 30 Jul 2018 2 Agu 2018 084119
11 31 Jul 2018 2 Agu 2018 085689
10 31 Jul 2018 2 Agu 2018 085698
9 31 Jul 2018 2 Agu 2018 072864
16 31 Jul 2018 2 Agu 2018 085018
15 31 Jul 2018 2 Agu 2018 085640
14 31 Jul 2018 2 Agu 2018 085801
13 1 Agu 2018 2 Agu 2018 067712
2 Agu 2018 Cou 8
128 16 Agu 2018 20 Agu 2018 086126
124 16 Agu 2018 20 Agu 2018 084558
127 18 Agu 2018 20 Agu 2018 085016
126 18 Agu 2018 20 Agu 2018 081546
125 19 Agu 2018 20 Agu 2018 086106
20 Agu 2018 Co 5
134 4 Agu 2018 21 Agu 2018 085006
133 15 Agu 2018 21 Agu 2018 084574
137 18 Agu 2018 21 Agu 2018 070466
130 19 Agu 2018 21 Agu 2018 079450
135 19 Agu 2018 21 Agu 2018 088331
129 19 Agu 2018 21 Agu 2018 086121
131 19 Agu 2018 21 Agu 2018 084497
136 17 Agu 2018 21 Agu 2018 084470
132 19 Agu 2018 21 Agu 2018 084498
21 Agu 2018 Co 9
143 11 Agu 2018 22 Agu 2018 068503

Page 2
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141 17 Agu 2018 22 Agu 2018 084592

138 20 Agu 2018 22 Agu 2018 084579
140 21 Agu 2018 22 Agu 2018 066302
139 20 Agu 2018 22 Agu 2018 084580
142 18 Agu 2018 22 Agu 2018 084487
22 Agu 2018 Co 6
150 13 Agu 2018 23 Agu 2018 084330
151 14 Agu 2018 23 Agu 2018 084343
148 15 Agu 2018 23 Agu 2018 074952
147 18 Agu 2018 23 Agu 2018 084480
146 18 Agu 2018 23 Agu 2018 083033
144 20 Agu 2018 23 Agu 2018 086099
149 20 Agu 2018 23 Agu 2018 084583
145 21 Agu 2018 23 Agu 2018 085024
23 Agu 2018 Co 8
154 15 Agu 2018 24 Agu 2018 084573
157 17 Agu 2018 24 Agu 2018 079182
156 20 Agu 2018 24 Agu 2018 084593
152 22 Agu 2018 24 Agu 2018 084513
159 22 Agu 2018 24 Agu 2018 054150
158 23 Agu 2018 24 Agu 2018 078409
153 23 Agu 2018 24 Agu 2018 084549
155 22 Agu 2018 24 Agu 2018 085025
24 Agu 2018 Co 8
167 15 Agu 2018 25 Agu 2018 084566
162 19 Agu 2018 25 Agu 2018 085019
166 22 Agu 2018 25 Agu 2018 086050
160 23 Agu 2018 25 Agu 2018 084534
163 24 Agu 2018 25 Agu 2018 084550
161 23 Agu 2018 25 Agu 2018 084535
164 24 Agu 2018 25 Agu 2018 085027
165 23 Agu 2018 25 Agu 2018 085026
25 Agu 2018 Co 8
168 21 Agu 2018 26 Agu 2018 080636
169 23 Agu 2018 26 Agu 2018 085037
26 Agu 2018 Co 2
173 24 Agu 2018 27 Agu 2018 086306
176 26 Agu 2018 27 Agu 2018 086319
172 24 Agu 2018 27 Agu 2018 957286
170 26 Agu 2018 27 Agu 2018 086329
174 26 Agu 2018 27 Agu 2018 957420
177 26 Agu 2018 27 Agu 2018 085034
171 24 Agu 2018 27 Agu 2018 086301
175 26 Agu 2018 27 Agu 2018 086328
27 Agu 2018 Co 8
186 23 Agu 2018 28 Agu 2018 081871
183 23 Agu 2018 28 Agu 2018 062736
180 23 Agu 2018 28 Agu 2018 084533
184 26 Agu 2018 28 Agu 2018 086326
187 27 Agu 2018 28 Agu 2018 085038
179 25 Agu 2018 28 Agu 2018 085032
178 25 Agu 2018 28 Agu 2018 085031

Page 3
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182 26 Agu 2018 28 Agu 2018 086285

185 25 Agu 2018 28 Agu 2018 086313
181 27 Agu 2018 28 Agu 2018 086769
28 Agu 2018 Co 10
194 23 Agu 2018 29 Agu 2018 084536
196 23 Agu 2018 29 Agu 2018 084488
191 24 Agu 2018 29 Agu 2018 086302
190 27 Agu 2018 29 Agu 2018 086333
195 27 Agu 2018 29 Agu 2018 081453
197 27 Agu 2018 29 Agu 2018 086084
188 27 Agu 2018 29 Agu 2018 048965
189 28 Agu 2018 29 Agu 2018 063814
192 28 Agu 2018 29 Agu 2018 961528
193 27 Agu 2018 29 Agu 2018 086335
29 Agu 2018 Co 10
29 18 Jul 2018 3 Agu 2018 078924
24 29 Jul 2018 3 Agu 2018 083698
18 30 Jul 2018 3 Agu 2018 085832
26 30 Jul 2018 3 Agu 2018 054846
28 30 Jul 2018 3 Agu 2018 084114
25 30 Jul 2018 3 Agu 2018 064025
19 30 Jul 2018 3 Agu 2018 078409
20 1 Agu 2018 3 Agu 2018 085748
21 1 Agu 2018 3 Agu 2018 085643
17 1 Agu 2018 3 Agu 2018 085758
22 1 Agu 2018 3 Agu 2018 085703
27 1 Agu 2018 3 Agu 2018 085780
23 2 Agu 2018 3 Agu 2018 085830
3 Agu 2018 Cou 13
202 21 Agu 2018 30 Agu 2018 084166
200 28 Agu 2018 30 Agu 2018 086758
199 28 Agu 2018 30 Agu 2018 083127
198 28 Agu 2018 30 Agu 2018 086817
201 28 Agu 2018 30 Agu 2018 086360
30 Agu 2018 Co 5
203 24 Agu 2018 31 Agu 2018 063742
210 26 Agu 2018 31 Agu 2018 047280
211 24 Agu 2018 31 Agu 2018 068561
204 28 Agu 2018 31 Agu 2018 086343
217 28 Agu 2018 31 Agu 2018 083306
219 28 Agu 2018 31 Agu 2018 086794
208 29 Agu 2018 31 Agu 2018 085041
206 29 Agu 2018 31 Agu 2018 085042
207 29 Agu 2018 31 Agu 2018 085043
218 28 Agu 2018 31 Agu 2018 086789
216 29 Agu 2018 31 Agu 2018 086834
205 29 Agu 2018 31 Agu 2018 085044
209 29 Agu 2018 31 Agu 2018 086361
214 30 Agu 2018 31 Agu 2018 086371
215 28 Agu 2018 31 Agu 2018 086812
212 30 Agu 2018 31 Agu 2018 033362
213 30 Agu 2018 31 Agu 2018 086379

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31 Agu 2018 Co 17
35 2 Agu 2018 4 Agu 2018 954540
32 2 Agu 2018 4 Agu 2018 084968
30 1 Agu 2018 4 Agu 2018 083568
34 2 Agu 2018 4 Agu 2018 084176
31 2 Agu 2018 4 Agu 2018 084163
33 3 Agu 2018 4 Agu 2018 061987
4 Agu 2018 Cou 6
37 2 Agu 2018 5 Agu 2018 084161
36 4 Agu 2018 5 Agu 2018 065674
38 4 Agu 2018 5 Agu 2018 084197
5 Agu 2018 Cou 3
39 30 Jul 2018 6 Agu 2018 084036
45 31 Jul 2018 6 Agu 2018 954944
44 31 Jul 2018 6 Agu 2018 084132
40 2 Agu 2018 6 Agu 2018 085821
42 4 Agu 2018 6 Agu 2018 084186
43 6 Agu 2018 6 Agu 2018 083402
41 5 Agu 2018 6 Agu 2018 064764
6 Agu 2018 Cou 7
47 1 Agu 2018 7 Agu 2018 080411
46 3 Agu 2018 7 Agu 2018 054150
50 5 Agu 2018 7 Agu 2018 084205
48 5 Agu 2018 7 Agu 2018 084213
49 5 Agu 2018 7 Agu 2018 955662
51 4 Agu 2018 7 Agu 2018 084190
7 Agu 2018 Cou 6
55 2 Agu 2018 8 Agu 2018 084166
56 3 Agu 2018 8 Agu 2018 066200
53 6 Agu 2018 8 Agu 2018 085885
54 7 Agu 2018 8 Agu 2018 084231
52 6 Agu 2018 8 Agu 2018 059155
57 7 Agu 2018 8 Agu 2018 085005
8 Agu 2018 Cou 6
61 4 Agu 2018 9 Agu 2018 084189
65 6 Agu 2018 9 Agu 2018 075400
63 6 Agu 2018 9 Agu 2018 084224
64 6 Agu 2018 9 Agu 2018 084219
58 7 Agu 2018 9 Agu 2018 082631
62 7 Agu 2018 9 Agu 2018 084247
59 7 Agu 2018 9 Agu 2018 084215
60 7 Agu 2018 9 Agu 2018 085903
9 Agu 2018 Cou 8
Total
Kode RS: 1801015

Grand Count 219

Page 5
 sheet1 1

Nama Pasien No. SEP INACBG Top Up

MIRAWATI 0805R0010718V001178 K-1-40-I
ARIPIN 0805R0010718V001414 I-4-12-III
VIONA QUEENSA 0805R0010718V001521 N-4-12-I
NOVA PUSPITA 0805R0010718V001592 W-1-11-I
HAMIM 0805R0010718V001605 K-4-15-I
LISNAWATI 0805R0010718V001607 O-6-10-I
MUSLIMI 0805R0010718V001656 L-4-13-I
BAYI NY LISNAWATI 0805R0010718V001666 P-8-08-I

MARYAM 0805R0010818V000183 J-4-20-I

NASRAN 0805R0010818V000188 D-4-13-I
TITIN MARIANTINAH 0805R0010818V000340 N-4-13-I
MUPID 0805R0010818V000402 K-1-14-I

DAMRI 0805R0010818V000342 D-4-13-I

SUPRAPTO 0805R0010818V000431 G-4-10-I
MUSNIDA 0805R0010818V000476 L-1-40-I
ZULYADEN 0805R0010818V000489 B-4-13-II
MAI SAROH 0805R0010818V000528 B-4-13-II
RIDHO FAHRUL ANAM 0805R0010818V000529 G-4-22-I
SULASTRI 0805R0010818V000532 O-6-13-II
SALAMATUL KHUSNIYAH 0805R0010818V000535 W-4-16-I

NORMA 0805R0010818V000167 G-4-15-III

PARSO 0805R0010818V000393 M-4-17-II
MARTA LINA 0805R0010818V000490 O-6-10-I
BAYI NY MARTA LINA 0805R0010818V000520 P-8-08-I
JULINDA SARI 0805R0010818V000530 O-6-11-I
SUKARJO 0805R0010818V000534 J-4-21-I
WAJEM 0805R0010818V000676 O-6-13-II

PUJI ASTUTI 0805R0010718V001514 W-1-20-II

ZAINURI 0805R0010818V000477 K-4-18-II
ROYATI 0805R0010818V000494 I-4-12-II
RATIH 0805R0010818V000542 K-4-15-I
BAYI NY JULINDA SARI 0805R0010818V000569 P-8-13-I
SUGIANTI 0805R0010818V000605 W-4-16-I

ZAINI ZAHRI 0805R0010818V000409 V-1-13-I

SUMARTO 0805R0010818V000527 J-4-20-II
JUBAEDAH 0805R0010818V000558 H-4-12-I
REZA RAPINDA 0805R0010818V000593 K-4-17-I
HASANAH 0805R0010818V000716 M-1-80-I

MUSTAR 0805R0010818V000071 J-4-20-I

RIA JAYA 0805R0010818V000427 J-4-16-II
M. SAFE'I 0805R0010818V000493 J-4-17-I
JENDRI PIKARIYANSYAH 0805R0010818V000518 K-1-40-I
ZAHANA 0805R0010818V000531 B-4-14-I
SITI NURASIAH 0805R0010818V000555 O-6-10-I
ADELIYA 0805R0010818V000640 U-1-15-I

Page 6
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MASNAH 0805R0010818V000641 W-1-11-II

MURNANI 0805R0010818V000642 D-4-13-I
MERTIA SARTIKA 0805R0010818V000651 W-4-16-I
AIDA 0805R0010818V000653 W-1-11-I
TURIYAH 0805R0010818V000659 K-4-18-I
FAHMI HAMID 0805R0010818V000712 I-4-12-II
TITIS AMANAH 0805R0010818V000718 O-6-13-I
MINGAN 0805R0010818V000725 K-4-15-I
NELI SUMARNI 0805R0010818V000749 O-6-13-II

FIKRI A 0805R0010818V000668 I-4-12-I

SEPTIA KUSYANI 0805R0010818V000710 L-1-40-I
BAYI NY NELI SUMARNI 0805R0010818V000752 P-8-08-I
PUSPITA RISTANTI 0805R0010818V000854 W-4-15-II

RUMANAH 0805R0010818V000498 I-4-12-III

RAID 0805R0010818V000621 J-4-18-III
MAT KHOIRI 0805R0010818V000626 D-4-13-I
NELSON 0805R0010818V000847 K-4-18-I

WIWIK PURWANTI 0805R0010818V000958 O-6-10-I

BAYI NY SITI NURASIAH 0805R0010818V000643 P-8-08-I

ROSSY AGUSTINA 0805R0010818V000702 O-6-10-I
MARYAM 0805R0010818V000839 I-4-12-I

KURNIA HARTATI 0805R0010718V001621 O-6-10-I

RIFKI ZANNI 0805R0010718V001653 L-1-40-I
ELIH NURHASANAH 0805R0010718V001654 U-1-30-I
TURSINAH 0805R0010718V001655 D-1-20-I
BAYI NY NURAINI 0805R0010718V001658 P-8-08-I
NURAINI 0805R0010718V001661 O-6-10-I
BONIRAN 0805R0010718V001668 K-1-14-I
IRNA YUNITA 0805R0010818V000153 G-4-25-I

IRYON SYAH 0805R0010818V000844 D-4-13-I

HENDY FIRIZKI PERMANA 0805R0010818V000853 K-4-15-I
BAYI NY YULFITRI AILIAH 0805R0010818V000859 P-8-08-I
YULFITRI AILIAH 0805R0010818V000872 O-6-10-I
METRI MUHAROMAH 0805R0010818V000919 O-6-13-I

BAYI NY RITA SUGIYANTI 0805R0010818V000203 P-8-13-III

ROHANA 0805R0010818V000791 D-4-13-I
AHSAN 0805R0010818V000866 N-4-13-I
LINDA SARI 0805R0010818V000873 W-4-15-I
SEFILA AYUNDA 0805R0010818V000876 U-1-15-I
BEJAN 0805R0010818V000877 K-1-14-I
LEKAS 0805R0010818V000888 K-4-15-I
ZAITUN 0805R0010818V000951 K-4-17-I
AZRIL FAUZAN RASHA 0805R0010818V000957 J-1-20-III

HARUN 0805R0010818V000698 I-4-12-II

Page 7
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SALEHUDIN 0805R0010818V000896 J-4-15-I

KHUSNUL KHOTIMAH 0805R0010818V000954 O-6-10-II
EVA YULIS SAFITRI 0805R0010818V000966 N-4-10-II
DUAYA 0805R0010818V000984 I-4-17-I
SUPRIYANTO 0805R0010818V001032 B-4-13-II

AMINAH 0805R0010818V000671 B-4-13-II

YEDA HENDRIA 0805R0010818V000723 D-4-13-III
M.AMIN 0805R0010818V000790 J-4-16-I
ZAINI 0805R0010818V000905 D-4-13-III
AMRAN 0805R0010818V000906 D-4-13-II
HANA PEBRI CAHYANI 0805R0010818V001010 O-6-10-I
SOLIHIN 0805R0010818V001020 D-4-13-II
BAYI NY KHUSNUL KHOTIMAH 0805R0010818V001102 P-8-08-I

MARWAN 0805R0010818V000805 K-1-14-II

LEKOK ROYANA 0805R0010818V000887 I-4-12-II
MUNAWAN 0805R0010818V001019 J-4-15-II
IRA NOVIANI 0805R0010818V001070 O-6-10-I
EZA RAMADHAN LEONARDO 0805R0010818V001071 S-4-16-II
ERMI YANTI 0805R0010818V001104 S-4-13-I
CANTI 0805R0010818V001144 W-4-12-I
GALIH ASSEGAF 0805R0010818V001508 P-8-08-I

SUPRIYANTO 0805R0010818V000780 V-1-13-I

BAYI NY METRI MUHAROMAH 0805R0010818V000883 P-8-13-I
ISTIKOMAH 0805R0010818V001041 O-6-10-II
MARDA LENA 0805R0010818V001117 O-6-10-I
SUJARI 0805R0010818V001129 I-4-17-I
MARTINI 0805R0010818V001134 O-6-10-I
BAYI NY MARDA LENA 0805R0010818V001148 P-8-08-I
BAYI NY MARTINI 0805R0010818V001153 P-8-08-I

NANIK SUNDARI 0805R0010818V001028 K-4-18-I

BAYI NY ISTIKOMAH 0805R0010818V001108 P-8-08-I

MELI SUSANTI 0805R0010818V001166 O-6-10-I

FARIDA 0805R0010818V001169 K-4-17-I
HORIZAL EFENDI 0805R0010818V001183 J-4-17-I
AYU SUNDARI 0805R0010818V001240 O-6-13-I
ULFA NUR HASANAH 0805R0010818V001248 O-6-13-II
BAYI NY ULFA CHASANAH 0805R0010818V001250 P-8-08-I
YURNA AINI 0805R0010818V001258 K-4-18-I
EEN 0805R0010818V001266 O-6-13-I

ZAINUL 0805R0010818V001139 J-4-20-I

SUMARNI 0805R0010818V001147 G-4-15-I
SAILA 0805R0010818V001154 K-4-17-I
M. BASYARUDIN 0805R0010818V001210 I-4-12-II
BAYI NY AYU SUNDARI 0805R0010818V001239 P-8-08-I
BAYI NY NUR AENI 0805R0010818V001241 P-8-08-I
BAYI NY NUR AENI II 0805R0010818V001242 P-8-13-I

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RIO RAMADANI 0805R0010818V001257 K-1-14-I

NUR AENI 0805R0010818V001261 O-6-10-II
ANDRI 0805R0010818V001309 U-1-15-I

IDAYANA 0805R0010818V001124 O-6-10-I

MURSAN 0805R0010818V001146 J-4-20-II
ARIF BUDIMAN 0805R0010818V001156 C-4-14-I
MUSYANTO 0805R0010818V001243 J-4-20-I
BAYI NY IDA YANA 0805R0010818V001255 P-8-08-I
DEALOPA 0805R0010818V001305 L-1-40-I
RUWAN 0805R0010818V001311 J-4-17-I
SOPIA 0805R0010818V001353 N-4-13-I
NURBAINI 0805R0010818V001365 M-4-10-I
FAUZI 0805R0010818V001405 N-4-10-I

AHMAD NUR KHOLIS 0805R0010718V000922 J-4-15-II

KARTINI 0805R0010718V001524 I-4-10-II
ELMAYANA 0805R0010718V001583 I-4-20-I
EKASUTRI 0805R0010718V001604 E-4-10-I
MURSENAH 0805R0010718V001606 J-4-17-II
KURDI 0805R0010718V001663 J-4-17-II
ERMI YANTI 0805R0010718V001664 W-1-20-I
BUDI GUNAWAN 0805R0010818V000060 K-1-14-I
SUKIMAN 0805R0010818V000061 L-1-40-I
ZAKIRA TALITA ZAHRA 0805R0010818V000078 L-4-12-I
HERMAWATI 0805R0010818V000114 L-1-40-I
FITRAH HAKIM 0805R0010818V000117 U-4-13-I
ZAHERAN 0805R0010818V000142 J-4-20-I

SAMSUL HADI M 0805R0010818V001027 I-4-12-I

PENDI AGUNG.S 0805R0010818V001341 U-1-15-I
YULIANI 0805R0010818V001342 L-1-50-I
IWAN KURNIAWAN 0805R0010818V001343 L-1-40-I
HEMMI RESMIYATI 0805R0010818V001386 K-4-18-I

HAMZAH 0805R0010818V001157 I-4-12-II

SUSANTI 0805R0010818V001245 I-4-12-I
MUHAMAD ADREAN 0805R0010818V001256 J-4-16-I
M. RIKI RIVALDO 0805R0010818V001328 K-1-40-I
YURNIDA 0805R0010818V001357 O-6-10-I
MARYUNITA 0805R0010818V001361 O-6-10-I
BAYI NY YURNIDA 0805R0010818V001404 P-8-13-I
BAYI NY MARYUNITA 0805R0010818V001406 P-8-08-I
BAYI NY INTARTI 0805R0010818V001412 P-8-08-I
INTARTI 0805R0010818V001422 O-6-10-II
LINGGAR WATI 0805R0010818V001425 O-6-10-I
BAYI NY LINGGAR WATI 0805R0010818V001426 P-8-08-I
CALON BY NY SELVIYANA 0805R0010818V001435 I-4-19-I
SANTIKA 0805R0010818V001437 K-4-18-I
M ISROZI 0805R0010818V001449 L-4-13-I
PONIMUN 0805R0010818V001466 K-4-17-I
MIATUN 0805R0010818V001467 K-4-17-I

Page 9
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ASWANDI 0805R0010818V000094 D-4-13-I

CLAURA CERIE TABITHA EDWIND 0805R0010818V000113 U-1-15-I
EDI PRIYANTO 0805R0010818V000115 A-4-11-I
KHUSAINI 0805R0010818V000133 K-4-18-II
SUPARMAN 0805R0010818V000159 L-4-12-I
WARJINA 0805R0010818V000210 G-4-15-I

NDINK MAHFUD 0805R0010818V000138 N-4-13-I

TUKIMAN 0805R0010818V000174 I-4-20-III
SANGKUT HANA 0805R0010818V000176 K-4-18-I

ROHYAH 0805R0010718V001593 W-1-20-I

ALKAT HAYATI 0805R0010718V001603 D-4-13-II
RASMALA HIDA 0805R0010718V001667 D-4-13-III
RITA SUGIYANTI 0805R0010818V000155 O-6-10-I
EDITHA WINDI PUTRI 0805R0010818V000220 A-4-13-I
M. SARNUBI 0805R0010818V000247 I-4-12-II
BINGAN 0805R0010818V000258 K-4-18-I

ERNAWATI 0805R0010818V000137 W-1-20-I

EZA RAMADHAN LEONARDO 0805R0010818V000169 G-4-22-I
BUTINI 0805R0010818V000190 K-4-18-I
AKUAN SATARI 0805R0010818V000192 I-4-10-III
HAIDAR 0805R0010818V000224 G-4-15-I
MUHTAR 0805R0010818V000244 J-4-17-I

SAMSUL HADI M 0805R0010818V000139 J-4-16-II

MAS'UD 0805R0010818V000214 I-4-17-I
SARTIYAH 0805R0010818V000255 L-1-40-I
LIZA 0805R0010818V000319 O-6-13-I
TRI DWI IRMALA P 0805R0010818V000327 L-1-50-I
BAYI NY LIZA 0805R0010818V000380 P-8-08-I

CALON BY NY DWI ASTUTI 0805R0010818V000177 A-4-14-I

ROSNI 0805R0010818V000251 I-4-12-III
ASLAINI 0805R0010818V000323 K-4-18-I
APEN 0805R0010818V000324 K-4-18-I
MINARSIH 0805R0010818V000331 U-1-13-I
SARYAH 0805R0010818V000397 K-4-17-I
TASLIM 0805R0010818V000401 K-1-14-I
SITI NURASIAH 0805R0010818V000410 O-6-10-I

Page 10
 sheet1 1

Total Tarif Tarif RS Jenis

5,838,600 10,999,945 RI
3,614,800 2,880,832 RI
2,174,800 2,198,448 RI
1,672,000 2,182,076 RI
1,955,100 1,679,457 RI
4,873,700 3,551,076 RI
2,287,000 1,558,419 RI
3,876,100 491,718 RI

3,863,300 2,899,800 RI
2,238,000 4,565,535 RI
3,278,900 1,354,802 RI
4,569,700 3,595,999 RI

2,238,000 3,973,788 RI
3,173,900 3,876,358 RI
3,730,200 4,794,230 RI
3,669,800 1,520,299 RI
3,669,800 1,298,438 RI
2,548,100 724,954 RI
1,844,900 1,968,610 RI
2,017,800 1,323,318 RI

5,169,800 3,597,774 RI
3,864,600 1,958,064 RI
4,873,700 4,131,909 RI
3,876,100 556,456 RI
2,574,100 2,877,600 RI
2,684,900 2,529,257 RI
1,844,900 1,759,095 RI

7,737,100 23,733,755 RI
1,781,700 2,745,634 RI
3,012,400 2,991,733 RI
1,955,100 1,411,776 RI
5,034,500 2,175,241 RI
2,017,800 987,781 RI

3,376,800 7,290,260 RI
5,353,000 2,321,189 RI
2,603,300 1,266,121 RI
1,418,900 844,995 RI
6,302,700 7,669,394 RI

3,863,300 7,912,418 RI
4,725,300 4,166,746 RI
2,763,900 2,379,764 RI
5,838,600 5,541,709 RI
3,146,800 2,699,885 RI
4,873,700 4,194,273 RI
3,581,200 5,278,703 RI

Page 11
 sheet1 1

1,845,100 3,572,256 RI
2,238,000 2,090,937 RI
2,017,800 1,262,144 RI
1,672,000 2,521,882 RI
1,253,800 985,914 RI
3,012,400 1,305,270 RI
1,558,800 3,694,601 RI
1,955,100 1,754,930 RI
1,844,900 1,875,315 RI

2,598,800 1,351,589 RI
3,730,200 3,858,830 RI
3,876,100 912,160 RI
1,684,300 1,542,671 RI

3,614,800 5,414,532 RI
2,999,100 2,449,739 RI
2,238,000 2,921,137 RI
1,253,800 763,214 RI

4,873,700 4,962,869 RI

3,876,100 8,339,795 RI
4,873,700 4,964,811 RI
2,598,800 1,911,731 RI

4,873,700 4,981,266 RI
3,730,200 3,967,279 RI
3,858,000 4,735,102 RI
3,869,300 3,924,253 RI
3,876,100 906,773 RI
4,873,700 4,010,201 RI
4,569,700 3,188,159 RI
1,889,900 1,411,153 RI

2,238,000 4,741,161 RI
1,955,100 3,256,193 RI
3,876,100 944,400 RI
4,873,700 3,822,572 RI
1,558,800 1,529,300 RI

10,720,100 5,516,443 RI
2,238,000 9,105,862 RI
3,278,900 1,513,998 RI
1,516,600 1,368,878 RI
3,581,200 4,109,677 RI
4,569,700 3,847,666 RI
1,955,100 2,399,259 RI
1,418,900 8,227,080 RI
18,819,200 4,429,351 RI

3,012,400 4,143,890 RI

Page 12
 sheet1 1

4,035,700 2,508,637 RI
5,147,900 4,535,384 RI
3,003,200 1,241,204 RI
1,774,400 1,069,691 RI
3,669,800 6,020,527 RI

3,669,800 5,118,400 RI
4,051,400 4,656,868 RI
3,362,600 2,560,377 RI
4,051,400 4,909,231 RI
3,167,600 2,239,344 RI
4,873,700 4,411,433 RI
3,167,600 2,059,735 RI
3,876,100 732,213 RI

5,355,500 9,898,194 RI
3,012,400 3,147,208 RI
4,821,500 3,870,298 RI
4,873,700 4,247,313 RI
4,919,300 1,446,505 RI
2,207,000 420,272 RI
2,695,300 740,923 RI
3,876,100 673,113 RI

3,376,800 9,108,304 RI
5,034,500 3,549,265 RI
5,147,900 4,068,331 RI
4,873,700 4,200,014 RI
1,774,400 818,679 RI
4,873,700 4,020,914 RI
3,876,100 849,808 RI
3,876,100 890,028 RI

1,253,800 2,191,366 RI
3,876,100 1,116,229 RI

4,873,700 4,041,689 RI
1,418,900 1,059,673 RI
2,763,900 1,534,118 RI
1,558,800 1,989,122 RI
1,844,900 1,780,534 RI
3,876,100 454,613 RI
1,253,800 1,068,827 RI
1,558,800 1,872,272 RI

3,863,300 1,875,904 RI
3,069,100 2,935,166 RI
1,418,900 3,823,760 RI
3,012,400 2,770,103 RI
3,876,100 403,333 RI
3,876,100 1,156,571 RI
5,034,500 1,143,279 RI

Page 13
 sheet1 1

4,569,700 3,690,284 RI
5,147,900 3,967,867 RI
3,581,200 5,092,173 RI

4,873,700 5,323,374 RI
5,353,000 3,655,367 RI
2,759,300 4,727,232 RI
3,863,300 1,651,949 RI
3,876,100 1,076,633 RI
3,730,200 3,661,638 RI
2,763,900 1,244,884 RI
3,278,900 1,027,962 RI
2,220,200 1,019,045 RI
2,482,900 3,334,108 RI

4,821,500 5,552,396 RI
5,246,900 4,959,421 RI
3,054,400 2,716,135 RI
3,360,600 2,189,373 RI
3,309,800 2,180,918 RI
3,309,800 1,847,863 RI
6,192,100 3,929,957 RI
4,569,700 4,901,350 RI
3,730,200 3,783,256 RI
1,273,800 3,613,081 RI
3,730,200 3,377,035 RI
1,842,800 4,468,695 RI
3,863,300 1,065,579 RI

2,598,800 3,615,413 RI
3,581,200 4,448,879 RI
4,897,000 3,808,641 RI
3,730,200 3,806,830 RI
1,253,800 937,256 RI

3,012,400 3,759,626 RI
2,598,800 2,617,216 RI
3,362,600 4,601,279 RI
5,838,600 6,297,765 RI
4,873,700 4,686,769 RI
4,873,700 3,865,039 RI
5,034,500 1,067,141 RI
3,876,100 908,141 RI
3,876,100 909,336 RI
5,147,900 4,050,405 RI
4,873,700 4,440,916 RI
3,876,100 505,986 RI
2,933,300 1,149,836 RI
1,253,800 853,539 RI
2,287,000 4,700,165 RI
1,418,900 984,388 RI
1,418,900 998,283 RI

Page 14
 sheet1 1

2,238,000 780,140 RI
3,581,200 4,676,796 RI
2,796,400 4,313,265 RI
1,781,700 1,035,321 RI
1,273,800 2,259,766 RI
3,069,100 1,458,192 RI

3,278,900 1,320,358 RI
5,274,800 3,420,689 RI
1,253,800 628,912 RI

6,192,100 4,604,283 RI
3,167,600 5,387,034 RI
4,051,400 6,008,462 RI
4,873,700 3,635,945 RI
1,522,800 1,178,227 RI
3,012,400 1,590,660 RI
1,253,800 972,202 RI

6,192,100 7,664,764 RI
2,548,100 3,682,260 RI
1,253,800 795,155 RI
7,560,000 4,307,350 RI
3,069,100 1,170,507 RI
2,763,900 1,248,858 RI

4,725,300 2,786,913 RI
1,774,400 1,808,741 RI
3,730,200 3,645,494 RI
1,558,800 1,421,364 RI
4,897,000 3,786,177 RI
3,876,100 742,619 RI

2,111,400 1,814,433 RI
3,614,800 1,345,095 RI
1,253,800 1,119,565 RI
1,253,800 1,210,496 RI
4,931,000 3,626,637 RI
1,418,900 870,655 RI
4,569,700 3,149,531 RI
4,873,700 1,155,081 RI

761,070,700 667,917,020

Page 15
Tgl. Masuk Tgl. Pulang Nama Pasien No. SEP
21 Jul 2018 1 Agu 2018 MIRAWATI 0805R0010718V001178
26 Jul 2018 1 Agu 2018 ARIPIN 0805R0010718V001414
26 Jul 2018 1 Agu 2018 VIONA QUEENSA 0805R0010718V001521
30 Jul 2018 1 Agu 2018 NOVA PUSPITA 0805R0010718V001592
30 Jul 2018 1 Agu 2018 HAMIM 0805R0010718V001605
30 Jul 2018 1 Agu 2018 LISNAWATI 0805R0010718V001607
30 Jul 2018 1 Agu 2018 MUSLIMI 0805R0010718V001656
30 Jul 2018 1 Agu 2018 BAYI NY LISNAWATI 0805R0010718V001666
8
3 Agu 2018 10 Agu 2018 MARYAM 0805R0010818V000183
4 Agu 2018 10 Agu 2018 NASRAN 0805R0010818V000188
7 Agu 2018 10 Agu 2018 TITIN MARIANTINAH 0805R0010818V000340
8 Agu 2018 10 Agu 2018 MUPID 0805R0010818V000402
4
7 Agu 2018 11 Agu 2018 DAMRI 0805R0010818V000342
7 Agu 2018 11 Agu 2018 SUPRAPTO 0805R0010818V000431
9 Agu 2018 11 Agu 2018 MUSNIDA 0805R0010818V000476
9 Agu 2018 11 Agu 2018 ZULYADEN 0805R0010818V000489
9 Agu 2018 11 Agu 2018 MAI SAROH 0805R0010818V000528
10 Agu 2018 11 Agu 2018 RIDHO FAHRUL ANAM 0805R0010818V000529
10 Agu 2018 11 Agu 2018 SULASTRI 0805R0010818V000532
10 Agu 2018 11 Agu 2018 SALAMATUL KHUSNIYAH 0805R0010818V000535
8
3 Agu 2018 12 Agu 2018 NORMA 0805R0010818V000167
7 Agu 2018 12 Agu 2018 PARSO 0805R0010818V000393
9 Agu 2018 12 Agu 2018 MARTA LINA 0805R0010818V000490
10 Agu 2018 12 Agu 2018 BAYI NY MARTA LINA 0805R0010818V000520
11 Agu 2018 12 Agu 2018 JULINDA SARI 0805R0010818V000530
9 Agu 2018 12 Agu 2018 SUKARJO 0805R0010818V000534
11 Agu 2018 12 Agu 2018 WAJEM 0805R0010818V000676
7
27 Jul 2018 13 Agu 2018 PUJI ASTUTI 0805R0010718V001514
9 Agu 2018 13 Agu 2018 ZAINURI 0805R0010818V000477
9 Agu 2018 13 Agu 2018 ROYATI 0805R0010818V000494
12 Agu 2018 13 Agu 2018 RATIH 0805R0010818V000542
11 Agu 2018 13 Agu 2018 BAYI NY JULINDA SARI 0805R0010818V000569
10 Agu 2018 13 Agu 2018 SUGIANTI 0805R0010818V000605
6
8 Agu 2018 14 Agu 2018 ZAINI ZAHRI 0805R0010818V000409
10 Agu 2018 14 Agu 2018 SUMARTO 0805R0010818V000527
11 Agu 2018 14 Agu 2018 JUBAEDAH 0805R0010818V000558
13 Agu 2018 14 Agu 2018 REZA RAPINDA 0805R0010818V000593
10 Agu 2018 14 Agu 2018 HASANAH 0805R0010818V000716
5
1 Agu 2018 15 Agu 2018 MUSTAR 0805R0010818V000071
8 Agu 2018 15 Agu 2018 RIA JAYA 0805R0010818V000427
9 Agu 2018 15 Agu 2018 M. SAFE'I 0805R0010818V000493
8 Agu 2018 15 Agu 2018 JENDRI PIKARIYANSYAH 0805R0010818V000518
10 Agu 2018 15 Agu 2018 ZAHANA 0805R0010818V000531
12 Agu 2018 15 Agu 2018 SITI NURASIAH 0805R0010818V000555
12 Agu 2018 15 Agu 2018 ADELIYA 0805R0010818V000640
12 Agu 2018 15 Agu 2018 MASNAH 0805R0010818V000641
13 Agu 2018 15 Agu 2018 MURNANI 0805R0010818V000642
13 Agu 2018 15 Agu 2018 MERTIA SARTIKA 0805R0010818V000651
13 Agu 2018 15 Agu 2018 AIDA 0805R0010818V000653
13 Agu 2018 15 Agu 2018 TURIYAH 0805R0010818V000659
14 Agu 2018 15 Agu 2018 FAHMI HAMID 0805R0010818V000712
12 Agu 2018 15 Agu 2018 TITIS AMANAH 0805R0010818V000718
14 Agu 2018 15 Agu 2018 MINGAN 0805R0010818V000725
15 Agu 2018 15 Agu 2018 NELI SUMARNI 0805R0010818V000749
16
13 Agu 2018 16 Agu 2018 FIKRI A 0805R0010818V000668
14 Agu 2018 16 Agu 2018 SEPTIA KUSYANI 0805R0010818V000710
15 Agu 2018 16 Agu 2018 BAYI NY NELI SUMARNI 0805R0010818V000752
16 Agu 2018 16 Agu 2018 PUSPITA RISTANTI 0805R0010818V000854
4
9 Agu 2018 17 Agu 2018 RUMANAH 0805R0010818V000498
12 Agu 2018 17 Agu 2018 RAID 0805R0010818V000621
13 Agu 2018 17 Agu 2018 MAT KHOIRI 0805R0010818V000626
16 Agu 2018 17 Agu 2018 NELSON 0805R0010818V000847
4
15 Agu 2018 18 Agu 2018 WIWIK PURWANTI 0805R0010818V000958
1
13 Agu 2018 19 Agu 2018 BAYI NY SITI NURASIAH 0805R0010818V000643
14 Agu 2018 19 Agu 2018 ROSSY AGUSTINA 0805R0010818V000702
16 Agu 2018 19 Agu 2018 MARYAM 0805R0010818V000839
3
30 Jul 2018 2 Agu 2018 KURNIA HARTATI 0805R0010718V001621
31 Jul 2018 2 Agu 2018 RIFKI ZANNI 0805R0010718V001653
31 Jul 2018 2 Agu 2018 ELIH NURHASANAH 0805R0010718V001654
31 Jul 2018 2 Agu 2018 TURSINAH 0805R0010718V001655
31 Jul 2018 2 Agu 2018 BAYI NY NURAINI 0805R0010718V001658
31 Jul 2018 2 Agu 2018 NURAINI 0805R0010718V001661
31 Jul 2018 2 Agu 2018 BONIRAN 0805R0010718V001668
1 Agu 2018 2 Agu 2018 IRNA YUNITA 0805R0010818V000153
8
16 Agu 2018 20 Agu 2018 IRYON SYAH 0805R0010818V000844
16 Agu 2018 20 Agu 2018 HENDY FIRIZKI PERMANA 0805R0010818V000853
18 Agu 2018 20 Agu 2018 BAYI NY YULFITRI AILIAH 0805R0010818V000859
18 Agu 2018 20 Agu 2018 YULFITRI AILIAH 0805R0010818V000872
19 Agu 2018 20 Agu 2018 METRI MUHAROMAH 0805R0010818V000919
5
4 Agu 2018 21 Agu 2018 BAYI NY RITA SUGIYANTI 0805R0010818V000203
15 Agu 2018 21 Agu 2018 ROHANA 0805R0010818V000791
18 Agu 2018 21 Agu 2018 AHSAN 0805R0010818V000866
19 Agu 2018 21 Agu 2018 LINDA SARI 0805R0010818V000873
19 Agu 2018 21 Agu 2018 SEFILA AYUNDA 0805R0010818V000876
19 Agu 2018 21 Agu 2018 BEJAN 0805R0010818V000877
19 Agu 2018 21 Agu 2018 LEKAS 0805R0010818V000888
17 Agu 2018 21 Agu 2018 ZAITUN 0805R0010818V000951
19 Agu 2018 21 Agu 2018 AZRIL FAUZAN RASHA 0805R0010818V000957
9
11 Agu 2018 22 Agu 2018 HARUN 0805R0010818V000698
17 Agu 2018 22 Agu 2018 SALEHUDIN 0805R0010818V000896
20 Agu 2018 22 Agu 2018 KHUSNUL KHOTIMAH 0805R0010818V000954
21 Agu 2018 22 Agu 2018 EVA YULIS SAFITRI 0805R0010818V000966
20 Agu 2018 22 Agu 2018 DUAYA 0805R0010818V000984
18 Agu 2018 22 Agu 2018 SUPRIYANTO 0805R0010818V001032
6
13 Agu 2018 23 Agu 2018 AMINAH 0805R0010818V000671
14 Agu 2018 23 Agu 2018 YEDA HENDRIA 0805R0010818V000723
15 Agu 2018 23 Agu 2018 M.AMIN 0805R0010818V000790
18 Agu 2018 23 Agu 2018 ZAINI 0805R0010818V000905
18 Agu 2018 23 Agu 2018 AMRAN 0805R0010818V000906
20 Agu 2018 23 Agu 2018 HANA PEBRI CAHYANI 0805R0010818V001010
20 Agu 2018 23 Agu 2018 SOLIHIN 0805R0010818V001020
21 Agu 2018 23 Agu 2018 BAYI NY KHUSNUL KHOTIMAH 0805R0010818V001102
8
15 Agu 2018 24 Agu 2018 MARWAN 0805R0010818V000805
17 Agu 2018 24 Agu 2018 LEKOK ROYANA 0805R0010818V000887
20 Agu 2018 24 Agu 2018 MUNAWAN 0805R0010818V001019
22 Agu 2018 24 Agu 2018 IRA NOVIANI 0805R0010818V001070
22 Agu 2018 24 Agu 2018 EZA RAMADHAN LEONARDO 0805R0010818V001071
23 Agu 2018 24 Agu 2018 ERMI YANTI 0805R0010818V001104
23 Agu 2018 24 Agu 2018 CANTI 0805R0010818V001144
22 Agu 2018 24 Agu 2018 GALIH ASSEGAF 0805R0010818V001508
8
15 Agu 2018 25 Agu 2018 SUPRIYANTO 0805R0010818V000780
19 Agu 2018 25 Agu 2018 BAYI NY METRI MUHAROMAH 0805R0010818V000883
22 Agu 2018 25 Agu 2018 ISTIKOMAH 0805R0010818V001041
23 Agu 2018 25 Agu 2018 MARDA LENA 0805R0010818V001117
24 Agu 2018 25 Agu 2018 SUJARI 0805R0010818V001129
23 Agu 2018 25 Agu 2018 MARTINI 0805R0010818V001134
24 Agu 2018 25 Agu 2018 BAYI NY MARDA LENA 0805R0010818V001148
23 Agu 2018 25 Agu 2018 BAYI NY MARTINI 0805R0010818V001153
8
21 Agu 2018 26 Agu 2018 NANIK SUNDARI 0805R0010818V001028
23 Agu 2018 26 Agu 2018 BAYI NY ISTIKOMAH 0805R0010818V001108
2
24 Agu 2018 27 Agu 2018 MELI SUSANTI 0805R0010818V001166
26 Agu 2018 27 Agu 2018 FARIDA 0805R0010818V001169
24 Agu 2018 27 Agu 2018 HORIZAL EFENDI 0805R0010818V001183
26 Agu 2018 27 Agu 2018 AYU SUNDARI 0805R0010818V001240
26 Agu 2018 27 Agu 2018 ULFA NUR HASANAH 0805R0010818V001248
26 Agu 2018 27 Agu 2018 BAYI NY ULFA CHASANAH 0805R0010818V001250
24 Agu 2018 27 Agu 2018 YURNA AINI 0805R0010818V001258
26 Agu 2018 27 Agu 2018 EEN 0805R0010818V001266
8
23 Agu 2018 28 Agu 2018 ZAINUL 0805R0010818V001139
23 Agu 2018 28 Agu 2018 SUMARNI 0805R0010818V001147
23 Agu 2018 28 Agu 2018 SAILA 0805R0010818V001154
26 Agu 2018 28 Agu 2018 M. BASYARUDIN 0805R0010818V001210
27 Agu 2018 28 Agu 2018 BAYI NY AYU SUNDARI 0805R0010818V001239
25 Agu 2018 28 Agu 2018 BAYI NY NUR AENI 0805R0010818V001241
25 Agu 2018 28 Agu 2018 BAYI NY NUR AENI II 0805R0010818V001242
26 Agu 2018 28 Agu 2018 RIO RAMADANI 0805R0010818V001257
25 Agu 2018 28 Agu 2018 NUR AENI 0805R0010818V001261
27 Agu 2018 28 Agu 2018 ANDRI 0805R0010818V001309
10
23 Agu 2018 29 Agu 2018 IDAYANA 0805R0010818V001124
23 Agu 2018 29 Agu 2018 MURSAN 0805R0010818V001146
24 Agu 2018 29 Agu 2018 ARIF BUDIMAN 0805R0010818V001156
27 Agu 2018 29 Agu 2018 MUSYANTO 0805R0010818V001243
27 Agu 2018 29 Agu 2018 BAYI NY IDA YANA 0805R0010818V001255
27 Agu 2018 29 Agu 2018 DEALOPA 0805R0010818V001305
27 Agu 2018 29 Agu 2018 RUWAN 0805R0010818V001311
28 Agu 2018 29 Agu 2018 SOPIA 0805R0010818V001353
28 Agu 2018 29 Agu 2018 NURBAINI 0805R0010818V001365
27 Agu 2018 29 Agu 2018 FAUZI 0805R0010818V001405
10
18 Jul 2018 3 Agu 2018 AHMAD NUR KHOLIS 0805R0010718V000922
29 Jul 2018 3 Agu 2018 KARTINI 0805R0010718V001524
30 Jul 2018 3 Agu 2018 ELMAYANA 0805R0010718V001583
30 Jul 2018 3 Agu 2018 EKASUTRI 0805R0010718V001604
30 Jul 2018 3 Agu 2018 MURSENAH 0805R0010718V001606
30 Jul 2018 3 Agu 2018 KURDI 0805R0010718V001663
30 Jul 2018 3 Agu 2018 ERMI YANTI 0805R0010718V001664
1 Agu 2018 3 Agu 2018 BUDI GUNAWAN 0805R0010818V000060
1 Agu 2018 3 Agu 2018 SUKIMAN 0805R0010818V000061
1 Agu 2018 3 Agu 2018 ZAKIRA TALITA ZAHRA 0805R0010818V000078
1 Agu 2018 3 Agu 2018 HERMAWATI 0805R0010818V000114
1 Agu 2018 3 Agu 2018 FITRAH HAKIM 0805R0010818V000117
2 Agu 2018 3 Agu 2018 ZAHERAN 0805R0010818V000142
13
21 Agu 2018 30 Agu 2018 SAMSUL HADI M 0805R0010818V001027
28 Agu 2018 30 Agu 2018 PENDI AGUNG.S 0805R0010818V001341
28 Agu 2018 30 Agu 2018 YULIANI 0805R0010818V001342
28 Agu 2018 30 Agu 2018 IWAN KURNIAWAN 0805R0010818V001343
28 Agu 2018 30 Agu 2018 HEMMI RESMIYATI 0805R0010818V001386
5
24 Agu 2018 31 Agu 2018 HAMZAH 0805R0010818V001157
26 Agu 2018 31 Agu 2018 SUSANTI 0805R0010818V001245
24 Agu 2018 31 Agu 2018 MUHAMAD ADREAN 0805R0010818V001256
28 Agu 2018 31 Agu 2018 M. RIKI RIVALDO 0805R0010818V001328
28 Agu 2018 31 Agu 2018 YURNIDA 0805R0010818V001357
28 Agu 2018 31 Agu 2018 MARYUNITA 0805R0010818V001361
29 Agu 2018 31 Agu 2018 BAYI NY YURNIDA 0805R0010818V001404
29 Agu 2018 31 Agu 2018 BAYI NY MARYUNITA 0805R0010818V001406
29 Agu 2018 31 Agu 2018 BAYI NY INTARTI 0805R0010818V001412
28 Agu 2018 31 Agu 2018 INTARTI 0805R0010818V001422
29 Agu 2018 31 Agu 2018 LINGGAR WATI 0805R0010818V001425
29 Agu 2018 31 Agu 2018 BAYI NY LINGGAR WATI 0805R0010818V001426
29 Agu 2018 31 Agu 2018 CALON BY NY SELVIYANA 0805R0010818V001435
30 Agu 2018 31 Agu 2018 SANTIKA 0805R0010818V001437
28 Agu 2018 31 Agu 2018 M ISROZI 0805R0010818V001449
30 Agu 2018 31 Agu 2018 PONIMUN 0805R0010818V001466
30 Agu 2018 31 Agu 2018 MIATUN 0805R0010818V001467
17
2 Agu 2018 4 Agu 2018 ASWANDI 0805R0010818V000094
2 Agu 2018 4 Agu 2018 CLAURA CERIE TABITHA EDWIND 0805R0010818V000113
1 Agu 2018 4 Agu 2018 EDI PRIYANTO 0805R0010818V000115
2 Agu 2018 4 Agu 2018 KHUSAINI 0805R0010818V000133
2 Agu 2018 4 Agu 2018 SUPARMAN 0805R0010818V000159
3 Agu 2018 4 Agu 2018 WARJINA 0805R0010818V000210
6
2 Agu 2018 5 Agu 2018 NDINK MAHFUD 0805R0010818V000138
4 Agu 2018 5 Agu 2018 TUKIMAN 0805R0010818V000174
4 Agu 2018 5 Agu 2018 SANGKUT HANA 0805R0010818V000176
3
30 Jul 2018 6 Agu 2018 ROHYAH 0805R0010718V001593
31 Jul 2018 6 Agu 2018 ALKAT HAYATI 0805R0010718V001603
31 Jul 2018 6 Agu 2018 RASMALA HIDA 0805R0010718V001667
2 Agu 2018 6 Agu 2018 RITA SUGIYANTI 0805R0010818V000155
4 Agu 2018 6 Agu 2018 EDITHA WINDI PUTRI 0805R0010818V000220
6 Agu 2018 6 Agu 2018 M. SARNUBI 0805R0010818V000247
5 Agu 2018 6 Agu 2018 BINGAN 0805R0010818V000258
7
1 Agu 2018 7 Agu 2018 ERNAWATI 0805R0010818V000137
3 Agu 2018 7 Agu 2018 EZA RAMADHAN LEONARDO 0805R0010818V000169
5 Agu 2018 7 Agu 2018 BUTINI 0805R0010818V000190
5 Agu 2018 7 Agu 2018 AKUAN SATARI 0805R0010818V000192
5 Agu 2018 7 Agu 2018 HAIDAR 0805R0010818V000224
4 Agu 2018 7 Agu 2018 MUHTAR 0805R0010818V000244
6
2 Agu 2018 8 Agu 2018 SAMSUL HADI M 0805R0010818V000139
3 Agu 2018 8 Agu 2018 MAS'UD 0805R0010818V000214
6 Agu 2018 8 Agu 2018 SARTIYAH 0805R0010818V000255
7 Agu 2018 8 Agu 2018 LIZA 0805R0010818V000319
6 Agu 2018 8 Agu 2018 TRI DWI IRMALA P 0805R0010818V000327
7 Agu 2018 8 Agu 2018 BAYI NY LIZA 0805R0010818V000380
6
4 Agu 2018 9 Agu 2018 CALON BY NY DWI ASTUTI 0805R0010818V000177
6 Agu 2018 9 Agu 2018 ROSNI 0805R0010818V000251
6 Agu 2018 9 Agu 2018 ASLAINI 0805R0010818V000323
6 Agu 2018 9 Agu 2018 APEN 0805R0010818V000324
7 Agu 2018 9 Agu 2018 MINARSIH 0805R0010818V000331
7 Agu 2018 9 Agu 2018 SARYAH 0805R0010818V000397
7 Agu 2018 9 Agu 2018 TASLIM 0805R0010818V000401
7 Agu 2018 9 Agu 2018 SITI NURASIAH 0805R0010818V000410
8

219