Laporan Daftar Rujukan Rumah Sakit: RS: Rsu Mitra Paramedika Bulan Pelayanan: Agustus

LAPORAN DAFTAR RUJUKAN RUMAH SAKIT
RS : RSU Mitra Paramedika

BULAN PELAYANAN : Agustus
No No Rujukan Tgl Pelayanan (RJ/RI) No.SEP No Kartu Nama

1 0179B5180918Y000001 ### RJ 0179R0150918V000017 0001263715536 DWI PUTRA BIMA S
2 120217010818Y001493 ### RJ 0179R0150918V000006 0002344998341 DWI PURWANTO
3 120217010818Y001498 ### RJ 0179R0150918V000016 0002165370726 ELY KUSUMAWATI
4 120217010818Y001405 ### RJ 0179R0150918V000013 0000656415369 PUJI LESTARI
5 0180B0080818Y000360 ### RJ 0179R0150918V000021 0001106152288 SUPARMI
6 0179U0020818Y001447 ### RJ 0179R0150918V000023 0001806203496 INTAN PUSPITA D
7 120217010918Y000012 ### RJ 0179R0150918V000010 0001035926493 SAMIYEM
8 120211020918Y000017 ### RJ 0179R0150918V000012 0001273355919 ICHSAN SETIAWAN
9 0179R0150918B000001 ### RI 0179R0150918V000008 1859041449 mulyati
10 0179R0150918B000002 ### RJ 0179R0150918V000023 1806203496 INTAN PUSPITA DEWI
11 0179R0150918B000003 ### RJ 0179R0150918V000014 2287594528 HARINI
12 0179R0150918B000004 ### RJ 0179R0150918V000006 2344998341 Dwi Purwanto
13 0179R0150918B000008 ### RJ 0179R0150918V000012 1273355919 ICHSAN SETIAWAN
14 120217010918Y000079 ### RJ 0179R0150918V000117 0000657170561 SIYO
15 120212010918Y000088 ### RJ 0179R0150918V000099 0001814731997 SLAMET RAHAYU
16 0179R0150918V000086 ### RJ 0179R0150918V000086 0000562246119 NGATINAH PRAPTO D
17 120210010818Y001014 ### RJ 0179R0150918V000094 0000656891201 SANTOSA
18 120217010818Y001499 ### RJ 0179R0150918V000064 0000657507745 PAIRAH
19 120212010818Y001245 ### RJ 0179R0150918V000046 0001695706075 PRAPTO SUWIGNYO
20 120216010918Y000019 ### RJ 0179R0150918V000047 0000096221169 SITI DJUMAINAH
21 1123U0780818Y000771 ### RJ 0179R0150918V000054 0002212031992 TUGINEM DWIJO W
22 112316010918Y000046 ### RJ 0179R0150918V000056 0001256649759 SARJONO
23 120210010818Y001743 ### RJ 0179R0150918V000059 0000655116669 WASIYEM
24 112316010918Y000098 ### RJ 0179R0150918V000067 0000559859218 TUGINAH
25 120217010818Y001381 ### RJ 0179R0150918V000069 0000657685304 HADI WARSITO
26 120211020918Y000026 ### RJ 0179R0150918V000072 0001854191226 WINARTI
27 0179U0500918Y000002 ### RJ 0179R0150918V000078 0000096210112 SUDARSIH
28 112316010918Y000122 ### RJ 0179R0150918V000082 0000560064339 MARINAH
29 0179U0020918Y000071 ### RJ 0179R0150918V000091 0000087088522 AMIR SOEMIDJO
30 120217010918Y000091 ### RI 0179R0150918V000143 0000657482106 HAFSHOH NUR A
31 120217010918Y000022 ### RI 0179R0150918V000148 0000657987748 ARIFA WIDYA P
32 0179R0150918B000005 ### RJ 0179R0150918V000084 2241228982 BISMA ARYA BAYU PUTRA
33 0179R0150918B000006 ### RJ 0179R0150918V000078 96210112 SUDARSIH
34 0179R0150918B000007 ### RJ 0179R0150918V000137 96213701 SUTOMO
35 0179R0150918B000011 ### RJ 0179R0150918V000117 657170561 SIYO
36 112316010918Y000162 ### RJ 0179R0150918V000154 0000558767237 ANANDA VELENTINO
37 120207010918Y000117 ### RJ 0179R0150918V000165 0000205199144 SRI SUPADMI N
38 120217010818Y001341 ### RJ 0179R0150918V000159 0000658299587 SURADI
39 120216010818Y000647 ### RJ 0179R0150918V000164 0000097262054 RIDWAN GANDA S
40 0179B5140818Y000304 ### RJ 0179R0150918V000194 0001696370253 DARNO MARYOTO
41 120211010918Y000124 ### RJ 0179R0150918V000185 0000656802641 MUNTAMAH
42 120217010918Y000141 ### RJ 0179R0150918V000188 0000657537131 SUKIRAH
43 120217010918Y000142 ### RJ 0179R0150918V000163 0000658299205 SUYATMI
44 120217010918Y000155 ### RJ 0179R0150918V000177 0000657789862 REJO WIYONO
45 120215010918Y000060 ### RJ 0179R0150918V000191 0000656368683 NURHAYATI
46 112312010918Y000053 ### RJ 0179R0150918V000195 0002053734759 MUJIYEM
47 120217010918Y000099 ### RJ 0179R0150918V000178 0000657396055 PRAKTO SUYITNO W
48 0179U0020918Y000082 ### RJ 0179R0150918V000189 0000087376375 DJASMIN/H.MUH JUPRI
49 120217010918Y000145 ### RJ 0179R0150918V000173 0000657549966 ALISA FEBRIYANI P
50 0179R0150918B000009 ### RJ 0179R0150918V000164 97262054 RIDWAN GANDA SAPUTRA
51 0179R0150918B000010 ### RJ 0179R0150918V000187 2256957202 MUHAMMAD SYAKIR
52 0179R0150918B000012 ### RI 0179R0150918V000233 558713079 RITA WULANDARI
53 0179R0150918B000013 ### RJ 0179R0150918V000220 1278944954 ANASTASya febryani
54 0179R0150918B000014 ### RJ 0179R0150918V000235 1085089397 NGATIYEM SUMI ATMOJO
55 0179R0150918B000015 ### RJ 0179R0150918V000258 656041511 SUDARMI
56 0179R0150918B000016 ### RJ 0179R0150918V000237 96219268 SRI HIDAYATUN
57 0179R0150918B000017 ### RJ 0179R0150918V000267 656622099 NGADIYO
58 0179R0150918B000018 ### RJ 0179R0150918V000266 2478197002 IMAN HASTUTI
59 0179R0150918B000019 ### RJ 0179R0150918V000257 2480240992 SUKRAN
60 0179R0150918B000020 ### RJ 0179R0150918V000228 657070018 SUSIATUN
61 0179R0150918B000021 ### RJ 0179R0150918V000224 1020965681 SUBEKTI DWIJO SUNDOYO
62 0179R0150918B000022 ### RI 0179R0150918V000119 1695578095 HERU WIDODO
63 0179R0150918B000023 ### RJ 0179R0150918V000324 1696090151 JADUK AKMALUDDIN QHONI
64 0179R0150918B000024 ### RJ 0179R0150918V000298 656290271 CATUR PURNOMO
65 0179R0150918B000025 ### RJ 0179R0150918V000307 96099309 NY. HJ. SUWARTINI
66 0179R0150918B000026 ### RJ 0179R0150918V000323 1020974771 KUWAT WIDODO
67 0179R0150918B000027 ### RJ 0179R0150918V000308 2129948008 DWI KISWANTO
68 0179R0150918B000028 ### RJ 0179R0150918V000335 1695795276 PAIYEM NY
69 0179R0150918B000029 ### RJ 0179R0150918V000331 657549966 ALISA FEBYANI PRIHATIN
70 0179R0150918B000030 ### RI 0179R0150918V000289 658067141 MUJIMAN
71 120217010918Y000255 ### RJ 0179R0150918V000255 0000657396562 PARTO WIHARJO
72 1202U5020918Y000022 ### RJ 0179R0150918V000440 0000096407548 MUJIRAH
73 120209010918Y000262 ### RJ 0179R0150918V000414 0000158126736 SUWARTA
74 0179B0050818Y002442 ### RJ 0179R0150918V000419 0001316058737 HJAMAL
75 120211020918Y000170 ### RJ 0179R0150918V000415 0002457937697 KAMINTEN ADI YUWONO
76 120217010918Y000031 ### RJ 0179R0150918V000358 0002208715547 IKA YULIATUN
77 120217010918Y000075 ### RJ 0179R0150918V000373 0001697544606 PAIYEM YADI M
78 112306020918Y000172 ### RJ 0179R0150918V000382 0000559277706 NGATIJO
79 120211010918Y000206 ### RJ 0179R0150918V000443 0000655519252 LUTFI ANGGRAINI NUR R
80 1202U5020918Y000024 ### RJ 0179R0150918V000410 0001695578106 SUBARDI
81 0179U0460918Y000068 ### RJ 0179R0150918V000457 0002458071055 DASIYAH ABDUL MUNIR
82 112316010918Y000270 ### RJ 0179R0150918V000455 0002419027413 TUHONO MARDI W
83 120211010818Y000839 ### RJ 0179R0150918V000363 0001785062507 YUNITA HENRY A
84 120211020918Y000228 ### RJ 0179R0150918V000396 0001696096732 SATIRAH
85 0179U0240918Y000088 ### RJ 0179R0150918V000425 0001528468582 SUWARJA
86 112316010918Y000222 ### RJ 0179R0150918V000452 0000077824416 YOHANES SUTOMO
87 0179B0080918Y000028 ### RJ 0179R0150918V000428 0001102250856 MARYUDI
88 120217010918Y000270 ### RJ 0179R0150918V000450 0000657946427 RINI UTAMI
89 120216010918Y000280 ### RJ 0179R0150918V000357 0002063676058 NGADIMAN
90 120217010918Y000267 ### RJ 0179R0150918V000449 0001034817502 DASMI
91 120211010818Y000840 ### RJ 0179R0150918V000367 0001785064588 ANASTASIA SORCHA R
92 1123U0780918Y000008 ### RJ 0179R0150918V000398 0000977618406 SADEMI
93 1202U5020818Y000198 ### RJ 0179R0150918V000394 00000964076638 SUGENG WINARTA
94 1123U0780918Y000073 ### RJ 0179R0150918V000464 0001296856563 WARTO MARSONO S
95 112316010818Y001681 ### RJ 0179R0150918V000354 0000560410841 PARNO
96 120217010918Y000164 ### RJ 0179R0150918V000399 0000657685304 HADI WASITO
97 112316010918Y000282 ### RJ 0179R0150918V000388 0001020959447 ANA RIYANTI
98 0179B0110818Y000944 ### RJ 0179R0150918V000411 0001161019489 SULASMI
99 120211010918Y000183 ### RJ 0179R0150918V000424 0000656824217 SUMARYATI
100 112316010918Y000230 ### RJ 0179R0150918V000393 0001729400027 CASTRO
101 120217010918Y000271 ### RJ 0179R0150918V000442 0002344996978 PIRMO UTOMO
102 112316010918Y000262 ### RJ 0179R0150918V000403 0002311137821 WINARNI
103 0179R0150918B000031 ### RJ 0179R0150918V000444 656428195 SAMUDI BIN AMAD
104 0179R0150918B000032 ### RJ 0179R0150918V000464 1296856563 warto marsono sumarjo
105 0179R0150918B000033 ### RJ 0179R0150918V000369 1695679503 SUPARMI
106 0179R0150918B000034 ### RJ 0179R0150918V000359 95698585 WAHDANI
107 0179R0150918B000035 ### RJ 0179R0150918V000420 2283947054 TUGIMAN YOTO WINARJO
108 0179R0150918B000036 ### RJ 0179R0150918V000370 656135908 SATIDJO
109 0179R0150918B000072 ### RJ 0179R0150918V000403 2311137821 WINARNI
110 0179R0150918B000073 ### RJ 0179R0150918V000385 2079146092 NURYANTI
111 120217010918Y000188 ### RJ 0179R0150918V000515 0002449164982 PRADIPTA DIMANTARA
112 0179U5100918Y000023 ### RJ 0179R0150918V000477 0001093721016 Y. BAMBANG SUNARTO
113 120216010918Y000297 ### RJ 0179R0150918V000492 0000657949228 JAMINEM
114 0150U0290918Y000050 ### RJ 0179R0150918V000513 0000087993099 DINA SURYANI
115 120217010918Y000291 ### RJ 0179R0150918V000480 0000657482106 HAFSHOH NUR ALIFAH
116 120217010918Y000263 ### RJ 0179R0150918V000497 0000657629526 MIRADI
117 120210010918Y000295 ### RJ 0179R0150918V000487 0001035758204 WAKIJO
118 120217010818Y000401 ### RJ 0179R0150918V000484 0000657192868 SULASTRI
119 120211020818Y000776 ### RJ 0179R0150918V000496 0001259547603 SURYA ANDIKA PUTRA
120 0179R0150918B000037 ### RJ 0179R0150918V000500 168348431 HJ. DALIYAH
121 0179R0150918B000038 ### RJ 0179R0150918V000497 657629526 MIRADI
122 0179R0150918B000039 ### RJ 0179R0150918V000484 657192868 SULASTRI
123 0179R0150918B000041 ### RJ 0179R0150918V000487 1035758204 WAKIJO
124 0179R0150918B000042 ### RJ 0179R0150918V000481 657987748 ARIFA WIDYA PRATIWI
125 0179R0150918B000043 ### RJ 0179R0150918V000480 657482106 HAFSHOH NUR ALIFAH
126 0179R0150918B000044 ### RJ 0179R0150918V000475 1263715536 DWI PUTRA BIMA SENTOSA
127 0179R0150918B000045 ### RJ 0179R0150918V000479 1996559886 SALINDRI
128 112316010918Y000312 ### RJ 0179R0150918V000555 0000558593921 SABAR BARJO WIYONO
129 120210010918Y000383 ### RJ 0179R0150918V000631 0000655372361 CATUR AMBARUKMI
130 0179U0540918Y000166 ### RJ 0179R0150918V000547 0001788871634 DALIJO
131 120217010918Y000388 ### RJ 0179R0150918V000590 0000656879534 MARKINI
132 120211020918U000334 ### RJ 0179R0150918V000630 0001695718067 SUGIYONO
133 112316010918Y000322 ### RJ 0179R0150918V000571 0000558151558 KARIYEM
134 120211010918Y000301 ### RJ 0179R0150918V000585 0000656304715 NGADIYONO
135 120216010918Y000427 ### RJ 0179R0150918V000618 0000658105053 PADMA WIYANA
136 112316010918Y000314 ### RJ 0179R0150918V000607 0002288727988 SUMIYATI
137 0179B0100918Y000269 ### RJ 0179R0150918V000623 0001445955524 MUJIONO
138 120217010918Y000441 ### RJ 0179R0150918V000639 0002239635789 RIZAL DWI KURNIAWAN
139 120217010918Y000422 ### RJ 0179R0150918V000637 0002344996978 PRIMO UTOMO
140 0179U0470918Y000329 ### RJ 0179R0150918V000621 0000087088656 BADARUDDIN
141 120211010918Y000229 ### RJ 0179R0150918V000638 0001838541936 SUTIARTO
142 120217010918Y000195 ### RJ 0179R0150918V000605 0001035934029 SOSRO PAWIRO
143 120216010918Y000518 ### RJ 0179R0150918V000648 0001695645832 JUNDUB
144 112312010918Y000088 ### RJ 0179R0150918V000580 0000559975678 KAMTO MIHARJO
145 120217010918Y000398 ### RJ 0179R0150918V000592 0001035928517 SUPRAPTI ZULFAINAH
146 120210010918Y000526 ### RJ 0179R0150918V000610 0000656520671 TUMIRAH
147 120210010918Y000524 ### RJ 0179R0150918V000609 0000656520107 SAPARI
148 112316010918Y000342 ### RJ 0179R0150918V000598 0000559025291 PONIYEM
149 120211010918Y000071 ### RJ 0179R0150918V000565 0000655301801 SUGIYANTO
150 120217010918Y000434 ### RJ 0179R0150918V000626 0000657538301 YITNO SUWITO
151 0179B0100818Y001366 ### RJ 0179R0150918V000615 0002211449973 SUYANTI
152 120216010818Y000683 ### RJ 0179R0150918V000652 0000586546075 SRIATUN
153 120216010918Y000539 ### RJ 0179R0150918V000583 0001697510878 MURDI WIYATI
154 0179R0150918B000057 ### RJ 0179R0150918V000552 1695917529 DULLAH MARSUDI NY
155 0179R0150918B000055 ### RJ 0179R0150918V000558 559709155 IRVAN ARDIYANTO
156 0179R0150918B000056 ### RJ 0179R0150918V000561 2165445707 Sudiharjo
157 0179R0150918B000047 ### RJ 0179R0150918V000570 95865423 YULIANA MULYANI
158 0179R0150918B000050 ### RJ 0179R0150918V000583 1697510878 MURDI WIYATI
159 0179R0150918B000052 ### RJ 0179R0150918V000586 96120461 DALILAH
160 0179R0150918B000048 ### RJ 0179R0150918V000594 1384672724 SIGIT PURWANTO
161 0179R0150918B000046 ### RJ 0179R0150918V000608 2486429559 bayi ny TUMPENI
162 0179R0150918B000054 ### RJ 0179R0150918V000614 1695558576 REPTO MULYONO
163 0179R0150918B000049 ### RJ 0179R0150918V000618 658105053 PADMA WIYANA
164 0179R0150918B000059 ### RJ 0179R0150918V000628 1734150993 NY. MUJIYONO
165 0179R0150918B000058 ### RJ 0179R0150918V000642 96060508 SENEN TRISNO WINARDI NY
166 0179R0150918B000053 ### RJ 0179R0150918V000644 1695711251 ASMO REJO, NY.
167 0179R0150918B000060 ### RJ 0179R0150918V000653 1696571403 SRI WIDAYATI
168 0179U5100918Y000036 ### RJ 0179R0150918V000664 0000096454506 ELSIE SOFIA DIKKY
169 112316010918Y000333 ### RJ 0179R0150918V000663 0001731826923 SUDIMAN WARNO SUWARSO
170 0179R0150918B000051 ### RJ 0179R0150918V000664 96454506 ELSIE SOFIA DIKKY M
171 0179U0020918Y000470 ### RJ 0179R0150918V000742 0000087246303 SADIYO
172 120217010918Y000484 ### RJ 0179R0150918V000703 0001035930745 HANIFAH SALMA P
173 0179B5090918Y000062 ### RJ 0179R0150918V000726 0000676613518 GEMI SRIANI
174 120217010918Y000486 ### RJ 0179R0150918V000486 0001035925209 ENDAH EMIL YA MASJID
175 120217010918Y000501 ### RJ 0179R0150918V000739 0000096120415 SURANTA
176 120211020918Y000063 ### RJ 0179R0150918V000712 0001696098194 NGATINEM
177 120217010918Y000146 ### RJ 0179R0150918V000690 0002241633846 MUJINEM
178 0179B0100918Y000360 ### RJ 0179R0150918V000711 0001696101592 TUKINEM
179 0179U0020918Y000457 ### RJ 0179R0150918V000736 0001275614346 SRI ATUN
180 120217010918Y000383 ### RJ 0179R0150918V000684 0000656845018 BOINEM
181 120217010918Y000493 ### RJ 0179R0150918V000721 0002480240992 SUKRAN
182 0179U0460918Y000089 ### RJ 0179R0150918V000744 0000088099997 KASIMIN
183 120211010918Y000222 ### RJ 0179R0150918V000732 0002378043292 MARIYO SUDI W
184 120217010818Y001339 ### RJ 0179R0150918V000713 0001697532456 GITO PRAYITNO
185 120211020918Y000298 ### RJ 0179R0150918V000687 0000656828109 MUKIMAN
186 120217010918Y000490 ### RJ 0179R0150918V000717 0000657242313 NURMIYATI
187 120211010918Y000330 ### RJ 0179R0150918V000691 0002165131181 WARTINI
188 120211010918Y000351 ### RJ 0179R0150918V000697 0000210923122 SARDJUWI
189 120211020918Y000333 ### RJ 0179R0150918V000706 0002345040843 TRISNO MINTARJO/JUMIYEM
190 120217010918Y000427 ### RJ 0179R0150918V000686 0000657884913 SUMIARTI
191 120212020918Y000282 ### RJ 0179R0150918V000699 0001960792018 ADI WARSITO
192 120217010918Y000405 ### RJ 0179R0150918V000705 0000658317666 NUR SYAMSIYAH
193 0179R0150918B000063 ### RJ 0179R0150918V000680 2345116072 Siswati
194 0179R0150918B000068 ### RJ 0179R0150918V000695 657424787 ADI UMI
195 0179R0150918B000066 ### RJ 0179R0150918V000696 2310020111 SUDARYADI
196 0179R0150918B000069 ### RJ 0179R0150918V000699 1960792018 adi warsito
197 0179R0150918B000067 ### RJ 0179R0150918V000704 656532843 NGATINEM
198 0179R0150918B000062 ### RJ 0179R0150918V000708 657636805 SAMIYEM
199 0179R0150918B000071 ### RJ 0179R0150918V000710 655627937 TRISNO HADI WIYONO NY/SOLIKAH
200 0179R0150918B000070 ### RJ 0179R0150918V000717 657242313 NURMIYATI
201 0179R0150918B000075 ### RJ 0179R0150918V000721 2480240992 SUKRAN
202 0179R0150918B000065 ### RJ 0179R0150918V000722 658144091 SUPARDI
203 0179R0150918B000061 ### RI 0179R0150918V000730 656907131 SULASIH
204 0179R0150918B000064 ### RJ 0179R0150918V000731 1035772918 RUBIYATI NY
205 0179R0150918B000074 ### RJ 0179R0150918V000732 2378043292 MARIYO SUDI WIYONO
206 0179U0120918Y000143 ### RJ 0179R0150918V000761 0002312622606 WAKIJAH
207 0179U0020918Y000520 ### RJ 0179R0150918V000776 0001805058797 SUMIRAN
208 120212020918Y000335 ### RJ 0179R0150918V000760 0002165184494 ARJO SUWITO
209 120211020918Y000374 ### RJ 0179R0150918V000787 0002483977487 SURAJI
210 120217010918Y000499 ### RJ 0179R0150918V000755 0001697554383 SUDJINAH
211 120217010918Y000581 ### RJ 0179R0150918V000807 0002290223744 NAJWA ASYILA A
212 120217010918Y000510 ### RJ 0179R0150918V000510 0002236728892 AZRIL HANIF A
213 120217010918Y000546 ### RJ 0179R0150918V000793 0002175755826 NURUL HIDAYAH S
214 120217010918Y000583 ### RJ 0179R0150918V000583 0000657494695 SAMIASIH
215 120211020818Y000390 ### RJ 0179R0150918V000778 0001695814165 YUPIKA YUNIANA
216 120217010918Y000498 ### RJ 0179R0150918V000757 0000657644679 DUDI KAHONO
217 120217010918Y000547 ### RJ 0179R0150918V000779 0000657131354 MUSINAH ALIAS YAMDI
218 1123U0780918Y000138 ### RJ 0179R0150918V000751 0002444914113 SUMINEM
219 0179B5090918Y000090 ### RJ 0179R0150918V000783 0000096027614 SRI WIDYANINGSIH
220 120217010918Y000325 ### RJ 0179R0150918V000780 0000096119381 SUWATI
221 112316010918Y000577 ### RJ 0179R0150918V000752 0000558593921 SABAR BARJO M
222 120210010918Y000615 ### RJ 0179R0150918V000789 0000657316102 SLAMET RIYANTO
223 120216010918Y000597 ### RI 0179R0150918V000788 0001284058247 FAADILA ZACKY R
224 112316010918Y000603 ### RI 0179R0150918V000812 0000559853278 SURANTI
225 120211020918Y000409 ### RI 0179R0150918V000811 0002283414017 ERWANTO WIDIYATMOKO
226 0179U513918Y000299 ### RI 0179R0150918V000802 0001203309652 SULTON HIDAYAT EKO F
227 0179R0150918B000084 ### RJ 0179R0150918V000517 1697472718 MUH YAMRONI
228 0179R0150918B000082 ### RJ 0179R0150918V000766 657715206 LIVIA PRAYEKTI
229 0179R0150918B000076 ### RJ 0179R0150918V000777 88026849 TUSRIYANI HADI SUMARNO
230 0179R0150918B000106 ### RJ 0179R0150918V000792 2233409398 ENI SUPARTINI
231 0179R0150918B000079 ### RJ 0179R0150918V000793 2175755826 NURUL HIDAYAH SIREGAR
232 0179R0150918B000083 ### RJ 0179R0150918V000796 656448287 SLAMET
233 0179R0150918B000078 ### RJ 0179R0150918V000803 1465241973 MUJIRAH / DWIJO SUHARTO
234 0179R0150918B000080 ### RJ 0179R0150918V000806 2236728892 azril hanif al fariq
235 0179R0150918B000081 ### RJ 0179R0150918V000807 2290223744 NAJWA ASYILA AZ-ZAHRA
236 120212020918Y000411 ### RJ 0179R0150918V000836 0001035800144 TUMPENI
237 120211020918Y000371 ### RJ 0179R0150918V000831 0002165127197 SUMARJA
238 112312010918Y000091 ### RJ 0179R0150918V000827 0000559988818 SUMITRI
239 0179U0020918Y000057 ### RJ 0179R0150918V000895 0000095829377 ANNISA IKHFANA
240 112316010918Y000239 ### RJ 0179R0150918V000862 0002065560895 ISYATUL KHOLIFAH
241 120211020918Y000426 ### RJ 0179R0150918V000877 0002305757867 SUMIRAH
242 1123U0780918Y000143 ### RJ 0179R0150918V000891 0001477068333 PARTINEM
243 112316010918Y000584 ### RJ 0179R0150918V000871 0001020959458 ARINA MANASIKANA
244 120212020818Y000684 ### RJ 0179R0150918V000875 0002165198387 WIYONO
245 0179B5090918Y000093 ### RJ 0179R0150918V000872 0001636471866 MURTINI RAHAYU
246 0179B0100918Y000417 ### RJ 0179R0150918V000840 0001696101592 TUKINEM
247 112316010918Y000702 ### RJ 0179R0150918V000899 0000558713079 RITA WULANDARI
248 112316010918Y000622 ### RJ 0179R0150918V000833 0000558815657 ISNAINI AMBAR S
249 120217010818Y000552 ### RJ 0179R0150918V000838 0001697553415 MURYANI/NY, MITRO WIYONO
250 0179B0050918Y000369 ### RJ 0179R0150918V000900 0001093036544 SUPRAPTO
251 120211020918Y000364 ### RJ 0179R0150918V000828 0001469734659 SARDI ADI PUTRA
252 120210010918Y000018 ### RJ 0179R0150918V000851 0002091632905 SRI WIDODO
253 0179R0150918V000832 ### RJ 0179R0150918V000832 0001801813915 NURMANIS
254 120215010918Y000298 ### RJ 0179R0150918V000890 0001695644537 ENI SUSILASTUTI
255 112316010918Y000608 ### RJ 0179R0150918V000884 0001020967053 SUKONO PONO MIARJO
256 120210010918Y000076 ### RJ 0179R0150918V000830 0000656339848 KAMIYEM
257 120217010918Y000597 ### RJ 0179R0150918V000839 0000657274454 PURWO SAMSUDI
258 0179R0150918V000794 ### RJ 0179R0150918V000794 0002165443244 TUKIYAH
259 120210010918Y000791 ### RJ 0179R0150918V000857 0000095928838 MUSIRAH
260 0179U0500918Y000283 ### RJ 0179R0150918V000842 0002287685586 MUHADI WIRATNO
261 120216010918Y000667 ### RJ 0179R0150918V000865 0001959802042 EMI WIDIASTUTI
262 120217010918Y000494 ### RJ 0179R0150918V000887 0000657997661 MURIJEM
263 120217010918Y000556 ### RJ 0179R0150918V000913 0000657620831 WIDI SUMARNO
264 120211010918Y000329 ### RJ 0179R0150918V000881 0000656469955 SRI UMI HIDAYATI
265 0179U0500918Y000285 ### RJ 0179R0150918V000843 0002287685712 SUPARSIH
266 0179B0050918Y000204 ### RJ 0179R0150918V000640 0001160784843 KUSTIYAH
267 0179U0020918Y000485 ### RJ 0179R0150918V000823 0001127942829 SUWARSIYAH
268 120212020818Y000855 ### RJ 0179R0150918V000873 0001035804587 SUPIYEM
269 120216010918Y000199 ### RJ 0179R0150918V000888 0000155526647 DHAELAN SUTADI
270 0179R0150918B000087 ### RJ 0179R0150918V000826 657537131 SUKIRAH
271 0179R0150918B000092 ### RJ 0179R0150918V000828 1469734659 SARDI ADI PUTRA
272 0179R0150918B000098 ### RJ 0179R0150918V000829 657426699 SURTINI
273 0179R0150918B000097 ### RJ 0179R0150918V000830 656339848 KAMIYEM
274 0179R0150918B000096 ### RJ 0179R0150918V000833 558815657 ISNAINI AMBAR SUDARMI
275 0179R0150918B000093 ### RJ 0179R0150918V000843 2287685812 SUPARSIH
276 0179R0150918B000088 ### RJ 0179R0150918V000845 657819257 SITI KHOTIJAH
277 0179R0150918B000095 ### RJ 0179R0150918V000853 167571112 SUMIYATI
278 0179R0150918B000086 ### RJ 0179R0150918V000860 657407125 sudiyono
279 0179R0150918B000099 ### RJ 0179R0150918V000869 2462856276 PURWO SUTRISNO
280 0179R0150918B000085 ### RJ 0179R0150918V000874 2450981259 sheilvania nadella winanda sari
281 0179R0150918B000089 ### RJ 0179R0150918V000879 1035933052 SUPONO
282 0179R0150918B000094 ### RJ 0179R0150918V000885 47247006 SIHONO
283 0179R0150918B000090 ### RJ 0179R0150918V000886 1100536176 RAFID UBAIDILLAH ADITAMA
284 0179R0150918B000101 ### RJ 0179R0150918V000897 1808420545 SUBADI budi mulyo harjono
285 120217010918Y000711 ### RI 0179R0150918V000947 0000657961312 MANGUN UTOMO
286 0179R0150918B000105 ### RJ 0179R0150918V000921 1905691048 SANTI RUSDIANI
287 0179R0150918B000104 ### RJ 0179R0150918V000927 559607332 TRI TARTO MARMIN
288 0179R0150918B000103 ### RJ 0179R0150918V000929 657403413 SUGIYONO
289 0179R0150918B000102 ### RJ 0179R0150918V000941 656594256 SRI ASTUTI RAHAYU
290 120217010918Y000772 ### RI 0179R0150918V001037 0000658256681 DAVITA EKO N
291 0179R0150918B000107 ### RJ 0179R0150918V000977 2165449803 Wakinem
292 0179R0150918B000111 ### RJ 0179R0150918V000982 559853278 SURANTI
293 0179R0150918B000108 ### RJ 0179R0150918V000998 2239635789 RIZAL DWI KURNIAWAN
294 0179R0150918B000109 ### RJ 0179R0150918V001002 1696571403 SRI WIDAYATI
295 0179R0150918B000112 ### RJ 0179R0150918V001005 2283414017 ERWANTO WIDIYATMOKO
296 0179R0150918B000110 ### RJ 0179R0150918V001024 657494695 SAMIASIH
297 120216010918Y000735 ### RJ 0179R0150918V001055 0002478976413 BY NY ALDIRA FITRANA JASMIN
298 120212010918Y000594 ### RJ 0179R0150918V001065 0000656879646 RR. BARKHINIYAH
299 120217010918Y000786 ### RJ 0179R0150918V001052 0002345118906 PARJIMAN
300 120217010918Y000655 ### RI 0179R0150918V001066 0001695577386 SRI WAHYUNI
301 120207010918Y000600 ### RI 0179R0150918V001058 0000095749716 PONIMAN
302 0179R0150918B000113 ### RI 0179R0150918V000883 1696097057 HARTO SUWARNO NY
303 0179R0150918B000118 ### RI 0179R0150918V000925 658214919 NY. MARDI WIYONO
304 0179R0150918B000114 ### RJ 0179R0150918V001045 562094526 SRI SUTARTI
305 0179R0150918B000115 ### RJ 0179R0150918V001046 1382601014 GABRIEL ARYA DANURDARA SME
306 0179R0150918B000117 ### RJ 0179R0150918V001050 658009078 ANDRI BAYU SETIAWAN
307 0179R0150918B000116 ### RJ 0179R0150918V001054 559657315 WARTI LESTARI
308 120217010918Y000841 ### RJ 0179R0150918V001115 0000656932893 YITNO WIYONO
309 120216010918Y001075 ### RJ 0179R0150918V001122 0002165349036 NGATIYEM NITI
310 120211020918Y000534 ### RJ 0179R0150918V001093 0001320105003 ANIS NURDIYANAH
311 0179R0150918V001111 ### RJ 0179R0150918V001111 0000096035523 SRI ISDYATUN
312 120210010918Y001157 ### RJ 0179R0150918V001139 0000657432562 PUJO WIYONO
313 112316010918Y001039 ### RJ 0179R0150918V001130 0001021272232 WAGINU PEDHI UTOMO
314 112316010918Y000849 ### RJ 0179R0150918V001154 00002484505686 SUYUDI ADISUMARNO
315 0150B0110918Y000194 ### RJ 0179R0150918V001128 0002377985758 PAIYO HARTO SUNARIMO
316 0179B0100918Y000817 ### RJ 0179R0150918V001109 0002250090088 RIYADI UTOMO
317 120212010918Y000829 ### RJ 0179R0150918V001085 0000656398664 YATINEM
318 120217010918Y000872 ### RJ 0179R0150918V001113 0002248550515 PUJI WIYONO
319 120212010918Y000601 ### RJ 0179R0150918V001112 0001100664246 MURSINAH
320 120211020918Y000536 ### RJ 0179R0150918V001090 0000096207243 SARJIYEM
321 0179B5090918Y000144 ### RJ 0179R0150918V001138 0000096340061 SUPRANTI
322 1123U0780918Y000115 ### RJ 0179R0150918V001123 0001296856563 WARTO MARSONO S
323 1202U5020918Y000084 ### RJ 0179R0150918V001088 0001853760993 KAMIYEM
324 120211010918Y000716 ### RJ 0179R0150918V001129 0001695711339 SITI ROKAYAH
325 120207020918Y000338 ### RJ 0179R0150918V001150 0002066303272 MURSIH
326 0179R0150918B000120 ### RJ 0179R0150918V001091 87246617 YATINI
327 0179R0150918B000124 ### RJ 0179R0150918V001133 1876514534 SRI ISTUTI MONIK
328 0179R0150918B000119 ### RJ 0179R0150918V001134 570477161 GATOT CAHYONO
329 0179R0150918B000123 ### RJ 0179R0150918V001154 2484505686 SUYUDI ADISUMARNO
330 120212020918Y000572 ### RJ 0179R0150918V001185 0000656755176 BELLA WIDYANINGTYAS
331 120211020918Y000569 ### RJ 0179R0150918V001175 0000656572252 TENTREM
332 120211010918Y000743 ### RJ 0179R0150918V001179 0001473840538 KADARIYAH SISWA RAHARJA
333 120211020918Y000609 ### RJ 0179R0150918V001177 0001035767261 ERIK DWI PRATMADYO
334 120217010918Y000938 ### RJ 0179R0150918V001184 0001802654943 MUHAMAD ADI FAIRUS
335 0179R0150918B000125 ### RJ 0179R0150918V000955 1035770512 SURAMI
336 0179R0150918B000126 ### RI 0179R0150918V000967 87247495 ABDUL HADI
337 0179R0150918B000127 ### RJ 0179R0150918V001176 1193525381 MAHARDIKA WAHYU W
338 0179R0150918B000128 ### RJ 0179R0150918V001180 558779117 DIDIK KURNIAWAN
339 0179R0150918B000129 ### RJ 0179R0150918V001184 1802654943 MUHAMAD ADI FAIRUS
340 120211010918Y000259 ### RJ 0179R0150918V001247 0001035777115 WARSIYEM
341 120217010918Y000962 ### RJ 0179R0150918V001303 0001035924232 ALFIAH
342 1123U0780918Y000301 ### RJ 0179R0150918V001218 0001908106345 BAMBANG SUDIBYO
343 120217010918Y000836 ### RJ 0179R0150918V001245 0000657889143 SULASTRI
344 120217010718Y001319 ### RJ 0179R0150918V001276 0001697542424 WIRYO SARJONO
345 120217010918Y001031 ### RJ 0179R0150918V001273 0001697540567 SUKIMAN
346 120211010918Y000775 ### RJ 0179R0150918V001243 0002215446759 PAIDJO
347 1123U0780918Y000427 ### RJ 0179R0150918V001224 0001145815569 BAMBANG SISWANTORO
348 120217010918Y000965 ### RJ 0179R0150918V001232 0000656858259 TARNO SUJIONO
349 1123U0780918Y000286 ### RJ 0179R0150918V001254 0000088087329 SRI KLUMPUK
350 1123U0780918Y000288 ### RJ 0179R0150918V001241 0000087675939 SUGIJO BUDIARTO
351 120211010918Y000776 ### RJ 0179R0150918V001229 0000656894068 SURIPTO
352 120217010918Y001004 ### RJ 0179R0150918V001251 0001695577871 SASMITA WIJAYANTI
353 120212020918Y000534 ### RJ 0179R0150918V001255 0000657407125 SUDIYONO
354 120217010918Y000949 ### RJ 0179R0150918V001248 0000637740652 ADE ROSIYANI
355 120217010918Y000767 ### RJ 0179R0150918V001270 0000657819257 SITI KHOTIJAH
356 120217010918Y000595 ### RJ 0179R0150918V001277 0002248550515 PUJI WIYONO
357 120211010918Y000636 ### RJ 0179R0150918V001208 0001695717639 SISWO PUJO HARTONO
358 120217010918Y000854 ### RJ 0179R0150918V001220 0001734916329 SUGIYARTI
359 120216010918Y001096 ### RJ 0179R0150918V001238 0002295302297 MARDI UTOMO
360 0179U0020918Y000948 ### RJ 0179R0150918V001251 0000087092267 KASIJEM
361 120217010918Y000885 ### RJ 0179R0150918V001214 0000658210397 ADI PRISTIANTO
362 120217010918Y001030 ### RJ 0179R0150918V001274 0001697540578 SRI HARYATI
363 120217010918Y000889 ### RJ 0179R0150918V001263 0000657765663 IRO INANGUN
364 0179U0020918Y000947 ### RJ 0179R0150918V001262 0000087092256 SUGIYONO
365 120211010918Y000644 ### RJ 0179R0150918V001246 0000087090186 MOHAMAD SATARI
366 120217010918Y001021 ### RJ 0179R0150918V001256 0000096119267 SRI SULARSIH
367 0179B0060918Y001232 ### RJ 0179R0150918V001219 0000088002729 SUJUDI
368 0179U0360918Y000164 ### RJ 0179R0150918V001223 0000100881101 GIJONO
369 0150U1110918Y000299 ### RJ 0179R0150918V001279 0002325620529 YOSO SUDARMO
370 0179U0240918Y000321 ### RJ 0179R0150918V001299 0001261510018 KRIDO WIYONO
371 0179R0150918B000134 ### RI 0179R0150918V001204 1734736959 ALEK SUKO RIYANTO
372 0179R0150918B000132 ### RJ 0179R0150918V001255 657407125 sudiyono
373 0179R0150918B000131 ### RJ 0179R0150918V001258 656322502 WITO SUWARNO NY
374 0179R0150918B000130 ### RJ 0179R0150918V001275 1734174178 RISKI AHMAD NOOR SHODIQ
375 0179R0150918B000133 ### RJ 0179R0150918V001303 1035924232 ALFIAH
376 0179R0150918B000135 ### RJ 0179R0150918V001310 87376364 ASRORIYAH
377 0179R0150918B000136 ### RJ 0179R0150918V001327 559442136 RAMBAT
378 0179R0150918B000137 ### RJ 0179R0150918V001329 658256681 DAVITA EKO NUGROHO
379 0179R0150918B000139 ### RJ 0179R0150918V001332 657715206 LIVIA PRAYEKTI
380 0179R0150918B000140 ### RJ 0179R0150918V001333 656879534 MARKINI
381 0179R0150918B000165 ### RJ 0179R0150918V001338 656321297 DIANA AGUSTIN PERSADA
382 0179R0150918B000138 ### RJ 0179R0150918V001345 656968691 AMINI
383 0179R0150918B000142 ### RJ 0179R0150918V001376 1693532158 DESINTA AMELIA MUKTI
384 0179R0150918B000145 ### RJ 0179R0150918V001381 658522855 PARJIYONO
385 0179R0150918B000141 ### RI 0179R0150918V001428 559728595 SURANI
386 0179R0150918B000143 ### RJ 0179R0150918V001458 657540189 SAMIYEM
387 0179R0150918B000150 ### RJ 0179R0150918V001377 1876662729 ISMIYATI
388 0179R0150918B000153 ### RJ 0179R0150918V001387 1528469616 SUNARTO
389 0179R0150918B000146 ### RJ 0179R0150918V001402 1734736994 RIO DWI ALTRIAN
390 0179R0150918B000147 ### RJ 0179R0150918V001434 1696568062 Putri Isnaini Syaban
391 0179R0150918B000159 ### RJ 0179R0150918V001443 657763211 SANIKEM ARJO PARDI
392 0179R0150918B000148 ### RJ 0179R0150918V001450 656511658 SUYANTO
393 0179R0150918B000151 ### RJ 0179R0150918V001453 657085937 NY. MARTO SUHARJO
394 0179R0150918B000149 ### RJ 0179R0150918V001457 658119453 SRIYATI
395 0179R0150918B000158 ### RJ 0179R0150918V001462 2040776109 suranti
396 0179R0150918B000154 ### RJ 0179R0150918V001481 1695577386 SRI WAHYUNI
397 0179R0150918B000156 ### RJ 0179R0150918V001489 1127942829 SUWARSIYAH
398 0179R0150918B000157 ### RJ 0179R0150918V001490 1035773875 PUTRI ANGGUN WIDHIA
399 0179R0150918B000152 ### RJ 0179R0150918V001498 1320050428 SRI SUGIYANTI
400 0179R0150918B000155 ### RJ 0179R0150918V001510 657419231 INE ASEANI WIDYANINGSIH
401 0179R0150918B000161 ### RJ 0179R0150918V001539 656144223 PONIYEM
402 0179R0150918B000163 ### RJ 0179R0150918V001557 562217084 NGADINO RADI SUMARNO
403 0179R0150918B000166 ### RJ 0179R0150918V001576 658256681 DAVITA EKO NUGROHO
404 0179R0150918B000164 ### RJ 0179R0150918V001586 1449514642 SITI BADRIYATUT THOYYIBAH
405 0179R0150918B000168 ### RJ 0179R0150918V001587 657259457 TRI SUYANTI
406 0179R0150918B000162 ### RJ 0179R0150918V001603 559090282 NGATMI
407 0179R0150918B000160 ### RJ 0179R0150918V001605 95774387 PANGAD SUPRIYADI
408 0179R0150918B000167 ### RJ 0179R0150918V001608 2377985758 PAIYO HARTO SUNARIMO
409 0179R0150918B000169 ### RJ 0179R0150918V001618 2021713525 ANGGRAINI PUTRI LESTARI
410 0179R0150918B000172 ### RJ 0179R0150918V001623 2175816778 NY PODO KARIYO
411 0179R0150918B000173 ### RJ 0179R0150918V001628 558920586 CANDRA PRAKOSO
412 0179R0150918B000171 ### RJ 0179R0150918V001629 1328665836 SRI SUKARMI
413 0179R0150918B000170 ### RJ 0179R0150918V001651 1082999507 SRI MARFUATUN ZAHRA AMALIA
414 0179R0150918B000178 ### RJ 0179R0150918V001667 657134021 ANJARWATI
415 0179R0150918B000182 ### RJ 0179R0150918V001680 1697542209 SRI HARTUTI
416 0179R0150918B000190 ### RJ 0179R0150918V001696 84866938 SIH WAHYUNI
417 0179R0150918B000176 ### RJ 0179R0150918V001700 657770062 SAMIRAH
418 0179R0150918B000183 ### RJ 0179R0150918V001701 1728288764 JUWAJI PURBO SAPUTRO
419 0179R0150918B000180 ### RJ 0179R0150918V001711 1035782954 MALYUDI
420 0179R0150918B000175 ### RJ 0179R0150918V001712 96201505 ny. ROCHEMI
421 0179R0150918B000179 ### RJ 0179R0150918V001727 656548852 KAMINEM
422 0179R0150918B000177 ### RJ 0179R0150918V001729 1035665155 DOSO WALUYO
423 0179R0150918B000184 ### RJ 0179R0150918V001739 656812629 NUR CHAMIMAH
424 0179R0150918B000181 ### RJ 0179R0150918V001742 203719004 AIP IRAWAN
425 0179R0150918B000174 ### RJ 0179R0150918V001744 96482957 DJUWARIYAH
426 0179R0150918B000192 ### RJ 0179R0150918V001746 561947038 SUROTO
427 0179R0150918B000193 ### RJ 0179R0150918V001748 1380026485 HARIYANTO
428 0179R0150918B000194 ### RJ 0179R0150918V001773 657631956 SRI RESTUNINGSIH
429 0179R0150918B000191 ### RJ 0179R0150918V001778 1821047804 DWI ASIH LESTARYATI
430 0179R0150918B000186 ### RJ 0179R0150918V001787 168348431 HJ. DALIYAH
431 0179R0150918B000187 ### RJ 0179R0150918V001789 2220951767 RATNA WARDANI
432 0179R0150918B000185 ### RJ 0179R0150918V001792 2478076121 QUEENNINA CITRA AYU
433 0179R0150918B000188 ### RJ 0179R0150918V001804 656978128 DWI WIDYASTUTI
434 0179R0150918B000189 ### RJ 0179R0150918V001808 656625958 AMAT DAINI
UKAN RUMAH SAKIT
Jenis Rujukan diisi : Menerima Rujukan dari
1. Rujuk karena kompetensiDiisi jika RSUMP mendapat
2. Rujukan Internal rujukan baru dari PPK 1
3. Rujukan Parsial ataupun RS lain
4. Rujuk Balik
PPK Tujuan Rujukan Jenis Rujukan Menerima Rujukan dari
RSU MITRA PARAMEDIKA Menerima Rujukan KLINIK SATRIA GADINGAN
RSU MITRA PARAMEDIKA Menerima Rujukan CANGKRINGAN
RSU MITRA PARAMEDIKA Menerima Rujukan KLINIK DENKESYAH 04.04.02
RSU MITRA PARAMEDIKA Menerima Rujukan DR. KUMALA SARI
RSU MITRA PARAMEDIKA Menerima Rujukan NGEMPLAK II
RS HERMINA YOGYA Merujuk antar RS
RSUP DR. SARDJITO Merujuk antar RS
RSIY PDHI Merujuk antar RS
Cangkringan Rujuk Balik
RSU MITRA PARAMEDIKA Menerima Rujukan NGAGLIK I
POLI DALAM Rujuk Internal POLI JANTUNG
RSU MITRA PARAMEDIKA Menerima Rujukan KALASAN
RSU MITRA PARAMEDIKA Menerima Rujukan PAKEM
RSU MITRA PARAMEDIKA Menerima Rujukan DR. TRI NYANTOSANI
RSU MITRA PARAMEDIKA Menerima Rujukan MANISRENGGO
RSU MITRA PARAMEDIKA Menerima Rujukan DR. ALEXANDER PRASUDI M.KES
RSUD SLEMAN Merujuk antar RS
RSU MITRA PARAMEDIKA Menerima Rujukan DEPOK I
RSU MITRA PARAMEDIKA Menerima Rujukan KLINIK PERMATA KELUARGA
RSU MITRA PARAMEDIKA Menerima Rujukan NGEMPLAK I
RSU MITRA PARAMEDIKA Menerima Rujukan TURI
RSU MITRA PARAMEDIKA Menerima Rujukan KEMALANG
RS UGM Merujuk antar RS
Ngemplak II Rujuk Balik
Manisrenggo Rujuk Balik
Kalasan Rujuk Balik
dr. Tunggul Birowo Rujuk Balik
Ngemplak I Rujuk Balik
RS BETHESDA Merujuk antar RS
Ngaglik II Rujuk Balik
dr. Joko Hastaryo, M.Kes Rujuk Balik
RSU MITRA PARAMEDIKA Menerima Rujukan DR. JOKO HASTARYO, M.KES
RSU MITRA PARAMEDIKA Menerima Rujukan PRAMBANAN
RSU MITRA PARAMEDIKA Menerima Rujukan KLINIK CHANDRA BRATA MEDIKA
RSU MITRA PARAMEDIKA Menerima Rujukan JOGONALAN 2
RSU MITRA PARAMEDIKA Menerima Rujukan DR. ANNA RATIH WARDANI, MPH
RSU MITRA PARAMEDIKA Menerima Rujukan DR. SRI HARYATI, M.KES
RSU MITRA PARAMEDIKA Menerima Rujukan KLINIK KARTIKA
RSU MITRA PARAMEDIKA Menerima Rujukan KLINIK CENDRAWASIH LANUD
dr. Tri Nyantosani W Rujuk Balik
Ngaglik I Rujuk Balik
Klinik PKU Muh. Cangkringan Rujuk Balik
Ngaglik I Rujuk Balik
RSU MITRA PARAMEDIKA Menerima Rujukan DR. APRILIA DYAH K
RSU MITRA PARAMEDIKA Menerima Rujukan DR. YUNIANTO DWI S
Klinik Satria Gadingan Rujuk Balik
RSU MITRA PARAMEDIKA Menerima Rujukan DR SESHY TINARTAYU
RSU MITRA PARAMEDIKA Menerima Rujukan KLINIK KELUARGA SEMBADA
RSU MITRA PARAMEDIKA Menerima Rujukan DR KHAMIDAH YULIATI
dr. Anna Ratih Wardani, MPH Rujuk Balik
Pakem Rujuk Balik
Klinik PKU Muh. Cangkringan Rujuk Balik
RSU MITRA PARAMEDIKA Menerima Rujukan DR APRILIA DYAH KUSUMAWATI
RSU MITRA PARAMEDIKA Menerima Rujukan KLINIK PKU MUH. CANGKRINGAN
RSU MITRA PARAMEDIKA Menerima Rujukan DR. ANNA RATIH WARDANI, MPH
RSU MITRA PARAMEDIKA Menerima Rujukan NGAGLIK II
Kalasan Rujuk Balik
RS MATA DR.YAP Merujuk antar RS
RSU MITRA PARAMEDIKA Menerima Rujukan DR. AM SAJARWADI
RSU MITRA PARAMEDIKA Menerima Rujukan DR. SARJOKO, M.KES
RS jih Merujuk antar RS
dr. Aprilia Dyah Kusumawati Rujuk Balik
POLI SARAF Rujuk Internal POLI JANTUNG
RSU MITRA PARAMEDIKA Menerima Rujukan TURI
Kalasan Rujuk Balik
dr. Kumala Sari Rujuk Balik
Tempel I Rujuk Balik
Kalasan Rujuk Balik
dr. Henni Widiarini Rujuk Balik
dr. Henni Widiarini Rujuk Balik
RSU MITRA PARAMEDIKA Menerima Rujukan DEPOK I
Kemalang Rujuk Balik
Klinik Matahari Rujuk Balik
POLI MATA Rujuk Internal POLI DALAM
RSU MITRA PARAMEDIKA Menerima Rujukan KLINIK SEKAR LANGIT
RSU MITRA PARAMEDIKA Menerima Rujukan DEPOK II
RS MATA DR.YAP Merujuk antar RS
RSU MITRA PARAMEDIKA Menerima Rujukan KLINIK DK
RSU MITRA PARAMEDIKA Menerima Rujukan DR. TUNGGUL BIROWO
RSU MITRA PARAMEDIKA Menerima Rujukan DR. SRI SUHARTANTI AGUSTRIANI
RSU MITRA PARAMEDIKA Menerima Rujukan DR. SRI HARYATI, M.KES
RS jih Merujuk antar RS
Pakem Rujuk Balik
RSUD KOTA YOGYAKARTA Merujuk antar RS
Kemalang Rujuk Balik
RS. DR.SUHARDI HARDJOLUKITO Merujuk antar RS
Klinik Sekar Langit Rujuk Balik
RSUD KOTA YOGYAKARTA Merujuk antar RS
Kalasan Rujuk Balik
RS. DR.SUHARDI HARDJOLUKITO Merujuk antar RS
RSUP DR.SURAJI TIRTONEGORO Merujuk antar RS
RSUP DR.SURAJI TIRTONEGORO Merujuk antar RS
LAPORAN RUJUKAN RUMAH SAKIT
RS : RSU Mitra Paramedika Rekap Laporan Rujukan RSU Mitra Paramedika

BULAN PELAYANAN : September
Jumlah
No Bulan Pelayanan Keterangan
Menerima Rujukan Rujukan Intern Rujukan Parsial Rujukan Balik Merujuk (antar RS)
1 Januari 1 5 1 0 35 42
2 Febuari 384 3 0 1 36 424
3 Maret 541 8 0 20 44 613
4 April 329 9 0 9 39 386
5 Mei 300 8 0 40 38 386
6 Juni 318 5 0 16 40 379
7 Juli 235 6 0 7 45 293
8 Agustus 416 8 0 28 51 503
9 September 244 3 0 128 78 453
Mengetahui
Direktur RSU Mitra Paramedika
dr. Ichsan Priyotomo
LAPORAN REGISTER PROGRAM RUJUK BALIK (PRB) Diagnosa PRB : DM, HT, JANTUNG,
RSU MITRA PARAMEDIKA EPILEPSY, SCHIZOPRENIA, STROKE
BULAN SEPTEMBERTAHUN 2018 SYSTEMIC LUPUS ERYTHEMATOSU
No. No.SRB No.Kartu Nama Peserta Program PRB No.SEP

1 1553787 2420696474 RUMI Stroke 0179R0150918V000402
2 1568976 96460301 SRI DARYATI Hypertensi 0179R0150918V000979
3 1568954 2242935281 TEGUH Hypertensi 0179R0150918V000987
4 1568967 2376607847 JAIMAN JARWO SUMITRO Hypertensi 0179R0150918V000989
5 1574102 656131836 SRI ASIH Diabetes Mellitus 0179R0150918V001136
6 1574105 657110294 SRI HARYANI Stroke 0179R0150918V001110
7 1574120 1100664246 MURSINAH Stroke 0179R0150918V001112
8 1578413 657674572 MENTO REJO Penyakit Jantung 0179R0150918V001242
9 1578414 1445801927 ADI PRAWOTO Penyakit Jantung 0179R0150918V001213
10 1578418 1695651906 BADIRAN DIRJO SUWARNO Penyakit Jantung 0179R0150918V001235
11 1578425 1695816786 SARIJO Stroke 0179R0150918V001222
12 1578429 561420696 TUKIJO PARMO SUWIRYO Penyakit Jantung 0179R0150918V001212
13 1578416 656900774 ENDANG PRIHATIN Penyakit Jantung 0179R0150918V001280
14 1578430 2202289119 ENDANG SRI SUTIYARTI, Hypertensi 0179R0150918V001230
15 1578417 2279547101 TARJO Penyakit Jantung 0179R0150918V001233
16 1578763 1035797501 SRI MARYATUN Penyakit Jantung 0179R0150918V001311
17 1580647 657103959 ANTIN SUMARTINI Penyakit Jantung 0179R0150918V001375
18 1591173 657154743 sipon Stroke 0179R0150918V001702
19 1591170 1969311251 BAMBANG BUDI SANTOSO Stroke 0179R0150918V001675
20 9/5/2018 96120461 DALILAH Sequelae of stroke, not specified as haemorrhage 0179R0150918B000015
or infarction
21 9/7/2018 1695558576 REPTO MULYONO Non-insulin-dependent diabetes mellitus with 0179R0150918B000032
unspecified complications
22 9/7/2018 1695711251 ASMO REJO, NY. Chronic ischaemic heart disease, unspecified 0179R0150918B000033
23 9/7/2018 2310020111 SUDARYADI Hypertensive heart disease with (congestive) 0179R0150918B000034
heart failure
24 9/7/2018 656532843 NGATINEM Congestive heart failure 0179R0150918B000035
25 9/7/2018 655627937 TRISNO HADI WIYONO NY/SOLIKAH Sequelae of stroke, not specified as haemorrhage
0179R0150918B000036
or infarction
26 9/7/2018 658144091 SUPARDI Heart failure 0179R0150918B000072
27 9/7/2018 1035772918 RUBIYATI NY Chronic ischaemic heart disease, unspecified 0179R0150918B000073
28 9/10/2018 657426699 SURTINI Non-insulin-dependent diabetes mellitus with 0179R0150918B000057
peripheral circulatory complications
29 9/10/2018 2462856276 PURWO SUTRISNO
0179R0150918B000052
Subsequent myocardial infarction of anterior wall
30 9/10/2018 1808420545 SUBADI budi mulyo harjono Angina pectoris 0179R0150918B000054
31 9/10/2018 657134021 ANJARWATI Congestive heart failure 0179R0150918B000053
32 9/12/2018 1035782954 MALYUDI Hypertensive heart disease without (congestive) 0179R0150918B000066
heart failure
33 9/12/2018 656548852 KAMINEM Non-insulin-dependent diabetes mellitus with 0179R0150918B000067
34 9/12/2018 656041511 SUDARMI Congestive heart failure 0179R0150918B000071
35 9/12/2018 1296856563 warto marsono sumarjo Congestive heart failure 0179R0150918B000065
36 9/12/2018 1695679503 SUPARMI Non-insulin-dependent diabetes mellitus with 0179R0150918B000064
37 9/14/2018 95698585 WAHDANI Sequelae of stroke, not specified as haemorrhage 0179R0150918B000098
or infarction
38 9/14/2018 2283947054 TUGIMAN YOTO WINARJO Sequelae of stroke, not specified as haemorrhage 0179R0150918B000099
or infarction
39 9/14/2018 656135908 SATIDJO Sequelae of cerebral infarction 0179R0150918B000101
40 9/28/2018 2311137821 WINARNI Chronic obstructive pulmonary disease, 0179R0150918B000178
unspecified
41 9/28/2018 2079146092 NURYANTI Chronic obstructive pulmonary disease, 0179R0150918B000180
unspecified
42 9/28/2018 1695917529 DULLAH MARSUDI NY Chronic obstructive pulmonary disease, 0179R0150918B000179
unspecified
DM, HT, JANTUNG, ASMA, PPOK
ZOPRENIA, STROKE
S ERYTHEMATOSUS (SLE)
Spesialis/Subspesialis Status
SAR Dilayani Faskes 1
JAN Baru
JAN Baru
JAN Baru
SAR Baru
JAN Dilayani Faskes 1
JAN Baru
JAN Baru
SAR Baru
JAN Baru
JAN Baru
JAN Baru
INT Baru
INT Baru
SAR Baru
Kalasan
SAR
dr. Tri Nyantosani W
INT
JAN Ngaglik I
Klinik PKU Muh.
JAN Cangkringan
JAN Ngemplak I
Ngaglik II
SAR
JAN Manisrenggo
JAN Ngaglik I
Ngemplak I
INT
dr. Anna Ratih Wardani,
JAN MPH
JAN Cangkringan
JAN Ngemplak II
Ngemplak II
JAN
Kalasan
INT
JAN Ngemplak II
JAN Cangkringan
Ngemplak II
INT
Kalasan
SAR
Cangkringan
SAR
SAR dr. Henni Widiarini
Cangkringan
INT
Ngaglik II
INT
Kalasan
INT
LAPORAN REGISTER RUJUK BALIK
RSU MITRA PARAMEDIKA
BULAN SEPTEMBERTAHUN 2018
No No Kartu Nama Peserta No Rujuk Balik Tgl Rujuk balik Tujuan Rujuk Balik (PPK1)
1 2344998341 Dwi Purwanto 0179R0150918B000004 9/1/2018 Cangkringan
2 2241228982 BISMA ARYA BAYU PUTRA 0179R0150918B000005 9/3/2018 Cangkringan
3 1278944954 ANASTASya febryani 0179R0150918B000013 9/5/2018 Ngemplak II
4 1085089397 NGATIYEM SUMI ATMOJO 0179R0150918B000014 9/5/2018 Manisrenggo
5 656622099 NGADIYO 0179R0150918B000017 9/5/2018 dr. Tunggul Birowo
6 2478197002 IMAN HASTUTI 0179R0150918B000018 9/5/2018 Ngemplak I
2480240992 SUKRAN 9/5/2018 Cangkringan
0179R0150918B000019
7
8 657070018 SUSIATUN 0179R0150918B000020 9/5/2018 Cangkringan
9 1696090151 JADUK AKMALUDDIN QHONI 0179R0150918B000023 9/6/2018 Ngemplak I
10 656290271 CATUR PURNOMO 0179R0150918B000024 9/6/2018 Ngaglik II
11 96099309 NY. HJ. SUWARTINI 0179R0150918B000025 9/6/2018 dr. Joko Hastaryo, M.Kes
12 1020974771 KUWAT WIDODO 0179R0150918B000026 9/6/2018 Manisrenggo
13 1695795276 PAIYEM NY 0179R0150918B000028 9/6/2018 Ngemplak I
656428195 SAMUDI BIN AMAD 9/7/2018 Ngemplak I
0179R0150918B000031
14
15 168348431 HJ. DALIYAH 0179R0150918B000037 9/8/2018 dr. Joko Hastaryo, M.Kes
16 657192868 SULASTRI 0179R0150918B000039 9/8/2018 Cangkringan
17 657987748 ARIFA WIDYA PRATIWI 0179R0150918B000042 9/8/2018 Cangkringan
18 657482106 HAFSHOH NUR ALIFAH 0179R0150918B000043 9/8/2018 Cangkringan
19 1263715536 DWI PUTRA BIMA SENTOSA 0179R0150918B000044 9/8/2018 Klinik Satria Gadingan
20 1996559886 SALINDRI 0179R0150918B000045 9/8/2018 Cangkringan
21 559709155 IRVAN ARDIYANTO 0179R0150918B000055 9/10/2018 Manisrenggo
22 2165445707 Sudiharjo 0179R0150918B000056 9/10/2018 Ngemplak II
23 95865423 YULIANA MULYANI 0179R0150918B000047 9/10/2018 Ngemplak I
24 1384672724 SIGIT PURWANTO 0179R0150918B000048 9/10/2018 Cangkringan
25 2486429559 bayi ny TUMPENI 0179R0150918B000046 9/10/2018 Ngaglik II
26 658105053 PADMA WIYANA 0179R0150918B000049 9/10/2018 Pakem
27 1734150993 NY. MUJIYONO 0179R0150918B000059 9/10/2018 Klinik PKU Muh. Cangkringan
28 96060508 SENEN TRISNO WINARDI NY 0179R0150918B000058 9/10/2018 Ngemplak II
29 1696571403 SRI WIDAYATI 0179R0150918B000060 9/10/2018 Cangkringan
30 2345116072 Siswati 0179R0150918B000063 9/12/2018 Cangkringan
31 657424787 ADI UMI 0179R0150918B000068 9/12/2018 Ngemplak II
32 1960792018 adi warsito 0179R0150918B000069 9/12/2018 Ngaglik II
33 657636805 SAMIYEM 0179R0150918B000062 9/12/2018 Cangkringan
657242313 NURMIYATI 9/12/2018 Cangkringan
0179R0150918B000070
34
35 657715206 LIVIA PRAYEKTI 0179R0150918B000082 9/13/2018 Cangkringan
2233409398 ENI SUPARTINI 9/13/2018 dr. Aprilia Dyah Kusumawati
0179R0150918B000106
36
37 2175755826 NURUL HIDAYAH SIREGAR 0179R0150918B000079 9/13/2018 Cangkringan
38 656448287 SLAMET 0179R0150918B000083 9/13/2018 Ngemplak II
39 1465241973 MUJIRAH / DWIJO SUHARTO 0179R0150918B000078 9/13/2018 Ngemplak I
40 2290223744 NAJWA ASYILA AZ-ZAHRA 0179R0150918B000081 9/13/2018 Cangkringan
41 657537131 SUKIRAH 0179R0150918B000087 9/14/2018 Cangkringan
42 558815657 ISNAINI AMBAR SUDARMI 0179R0150918B000096 9/14/2018 Manisrenggo
43 657819257 SITI KHOTIJAH 0179R0150918B000088 9/14/2018 Cangkringan
44 167571112 SUMIYATI 0179R0150918B000095 9/14/2018 dr. Kumala Sari
45 657407125 sudiyono 0179R0150918B000086 9/14/2018 Ngaglik II
46 2450981259 sheilvania nadella winanda sari 0179R0150918B000085 9/14/2018 Cangkringan
47 1035933052 SUPONO 0179R0150918B000089 9/14/2018 Cangkringan
48 47247006 SIHONO 0179R0150918B000094 9/14/2018 Tempel I
49 1100536176 RAFID UBAIDILLAH ADITAMA 0179R0150918B000090 9/14/2018 Kalasan
50 1905691048 SANTI RUSDIANI 0179R0150918B000105 9/15/2018 dr. Henni Widiarini
51 559607332 TRI TARTO MARMIN 0179R0150918B000104 9/15/2018 Manisrenggo
52 657403413 SUGIYONO 0179R0150918B000103 9/15/2018 Cangkringan
53 656594256 SRI ASTUTI RAHAYU 0179R0150918B000102 9/15/2018 Cangkringan
2165449803 Wakinem 9/17/2018 Cangkringan
0179R0150918B000107
54
55 559853278 SURANTI 0179R0150918B000111 9/17/2018 Manisrenggo
56 2239635789 RIZAL DWI KURNIAWAN 0179R0150918B000108 9/17/2018 Cangkringan
1696571403 SRI WIDAYATI 9/17/2018 Cangkringan
0179R0150918B000109
57
58 2283414017 ERWANTO WIDIYATMOKO 0179R0150918B000112 9/17/2018 Ngemplak II
59 657494695 SAMIASIH 0179R0150918B000110 9/17/2018 Cangkringan
60 562094526 SRI SUTARTI 0179R0150918B000114 9/18/2018 Kemalang
61 1382601014 GABRIEL ARYA DANURDARA SME 0179R0150918B000115 9/18/2018 Klinik Matahari
62 658009078 ANDRI BAYU SETIAWAN 0179R0150918B000117 9/18/2018 Cangkringan
63 559657315 WARTI LESTARI 0179R0150918B000116 9/18/2018 Manisrenggo
64 1193525381 MAHARDIKA WAHYU W 0179R0150918B000127 9/20/2018 dr. Joko Hastaryo, M.Kes
65 558779117 DIDIK KURNIAWAN 0179R0150918B000128 9/20/2018 Manisrenggo
66 657407125 sudiyono 0179R0150918B000132 9/21/2018 Ngaglik II
67 656322502 WITO SUWARNO NY 0179R0150918B000131 9/21/2018 Ngemplak I
68 1734174178 RISKI AHMAD NOOR SHODIQ 0179R0150918B000130 9/21/2018 Ngemplak II
69 87376364 ASRORIYAH 0179R0150918B000135 9/22/2018 dr. Kumala Sari
70 658256681 DAVITA EKO NUGROHO 0179R0150918B000137 9/22/2018 Cangkringan
71 657715206 LIVIA PRAYEKTI 0179R0150918B000139 9/22/2018 Cangkringan
72 656879534 MARKINI 0179R0150918B000140 9/22/2018 Cangkringan
656968691 AMINI 9/22/2018 Ngaglik II
0179R0150918B000138
73
74 1693532158 DESINTA AMELIA MUKTI 0179R0150918B000142 9/24/2018 Manisrenggo
75 657540189 SAMIYEM 0179R0150918B000143 9/24/2018 Cangkringan
1734736994 RIO DWI ALTRIAN 9/24/2018 Ngemplak I
0179R0150918B000146
76
1696568062 Putri Isnaini Syaban 9/24/2018 Pakem
0179R0150918B000147
77
78 658119453 SRIYATI 0179R0150918B000149 9/24/2018 Cangkringan
1695577386 SRI WAHYUNI 9/25/2018 Cangkringan
0179R0150918B000154
79
80 1127942829 SUWARSIYAH 0179R0150918B000156 9/25/2018 dr. Kumala Sari
81 1035773875 PUTRI ANGGUN WIDHIA 0179R0150918B000157 9/25/2018 Ngemplak I
562217084 NGADINO RADI SUMARNO 9/26/2018 Kemalang
0179R0150918B000163
82
83 2377985758 PAIYO HARTO SUNARIMO 0179R0150918B000167 9/26/2018 Klinik Sekar Langit
84 168348431 HJ. DALIYAH 0179R0150918B000186 9/29/2018 dr. Joko Hastaryo, M.Kes
2220951767 RATNA WARDANI 9/29/2018 Ngemplak I
0179R0150918B000187
85
656978128 DWI WIDYASTUTI 9/29/2018 Ngemplak I
0179R0150918B000188
86
Sleman,
Pembuat Laporan
(___________________________)
Diagnosa
Other benign neoplasms of connective and other soft tissue
Bronchitis, not specified as acute or chronic
Dyspepsia
Cervicocranial syndrome, cervical region
Presence of intraocular lens
Umbilical hernia without obstruction or gangrene
Unilateral or unspecified inguinal hernia, without obstruction or
gangrene
Fracture of lower leg, part unspecified, closed
Fracture of clavicle
Fracture of femur, part unspecified
Fracture of upper end of radius
Myalgia
Unilateral or unspecified femoral hernia, without obstruction or
gangrene
Stage III decubitus ulcer
Benign neoplasm of breast
Soft tissue disorder, unspecified
Acute appendicitis, other and unspecified
Lipomatosis, not elsewhere classified
Cutaneous abscess, furuncle and carbuncle, unspecified
Parkinson's disease
Typhoid fever
Neonatal jaundice, unspecified
Urinary tract infection, site not specified
Chronic ulcer of skin, not elsewhere classified
Other specified surgical follow-up care
Benign neoplasm of thyroid gland
Typhoid fever
Lumbago with sciatica, lumbar region
Typhoid fever
Cervical disc disorder with radiculopathy
Other benign neoplasm of connective and other soft tissue of trunk,
unspecified
Other benign neoplasm of connective and other soft tissue of upper
limb, including shoulder
Acute pharyngitis
Burns involving 30-39% of body surface
Gonarthrosis, unspecified
Gastroenteritis and colitis of unspecified origin
Cellulitis
Gastro-oesophageal reflux disease without oesophagitis
Senile cataract
Parkinson's disease
Nonspecific lymphadenitis
Adhesive capsulitis of shoulder
Benign lipomatous neoplasm, unspecified
Acute appendicitis, unspecified
Gastroenteritis and colitis of unspecified origin
Dysphagia
Typhoid fever
Other benign neoplasm of connective and other soft tissue of head,
face and neck
Synovial cyst of popliteal space [Baker], lower leg
Hydrocele, unspecified
face and neck
Hypertrophy of breast
Other specified disorders of kidney and ureter
Orthopaedic follow-up care, unspecified
Dengue fever [classical dengue]
Typhoid fever
Gonarthrosis, unspecified
face and neck
Urinary tract infection, site not specified
Gastritis, unspecified
Other benign neoplasm of connective and other soft tissue of upper
limb, including shoulder
face and neck
Benign neoplasm of other specified sites
face and neck
Umbilical hernia without obstruction or gangrene
Unilateral or unspecified inguinal hernia, without obstruction or
gangrene
Aortic aneurysm and dissection
Stage III decubitus ulcer
Other benign neoplasm of connective and other soft tissue, unspecified

face and neck
__________)

Laporan Daftar Rujukan Rumah Sakit: RS: Rsu Mitra Paramedika Bulan Pelayanan: Agustus

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Laporan Daftar Rujukan Rumah Sakit: RS: Rsu Mitra Paramedika Bulan Pelayanan: Agustus

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LAPORAN DAFTAR RUJUKAN RUMAH SAKIT

RS : RSU Mitra Paramedika

No No Rujukan Tgl Pelayanan (RJ/RI) No.SEP No Kartu Nama

RS : RSU Mitra Paramedika Rekap Laporan Rujukan RSU Mitra Paramedika

RSU MITRA PARAMEDIKA EPILEPSY, SCHIZOPRENIA, STROKE

BULAN SEPTEMBERTAHUN 2018 SYSTEMIC LUPUS ERYTHEMATOSU

No. No.SRB No.Kartu Nama Peserta Program PRB No.SEP

Other benign neoplasm of connective and other soft tissue, unspecified

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