DATA SAMPLING RAWAT JALAN LAB.

NOVEMBER-DESMBER 2013

Tanggal No.Lab. Analis dr. Nama Pasien Sampling Bagian

11/26/2013 189 RN DY An. M. Zaini Renny Laboratorium

193 TA APS Ny. Hj. Sanah (ortu icha) Tia Laboratorium

11/27/2013 197 EM hafiz An. Rahma Azizah (dr hfz) Mawaddah Laboratorium
198 EM PR An. Praya Mawaddah Laboratorium
199 EM APS Ny. Marlina Mawaddah Laboratorium
204 IF SY An. Abyasa Hifni Laboratorium

11/29/2013 221 TA APS Ny. Tri Rifa Tia Laboratorium

222 TA APS An. Justin Maulana Tia Laboratorium
223 TA APS mb. Pipin (admin) Tia Laboratorium
224 EM APS Ny. Zahrah Mawaddah Laboratorium
225 EM DY An. Fauza Hasna x

11/30/2013 230 RN APS mb. Pipin (admin) Renny Laboratorium

12/1/2013 2 IF SY An. Nur Syifa k' yulida UGD

4 IF ifiq Ny. Nurmawati Desi UGD
5 IF ifiq An. Angelo Hifni Laboratorium

12/2/2013 12 EM APS bu I'in (resepsionis) Mawaddah Laboratorium

13 EM APS Pak Budi (CS) Mawaddah Laboratorium
15 EM DY An. Fauza Haasna x
16 EM anin Tn. Ari Wahyudin k' yulida UGD
17 EM DN Tn. Jiat Sapuani Olla UGD

12/3/2013 22 IF DY An. Fatih Razi R. Hifni Laboratorium

12/5/2013 27 IF DY An. Abdul Halim Hifni Laboratorium

30 RN/TA hafiz Tn. H. Fahmi Renny Laboratorium
34 TA RY Ny. Rezeki Tia Laboratorium

12/7/2013 39 IF APS Ny. Lisa x

12/9/2013 52 RN DY An. Teresia Renny Laboratorium

53 RN DY An. Malika Naomi Renny Laboratorium
57 RN APS Ny. Reni Setiowati (mas andri) Renny Laboratorium
58 TA APS Ny. Zubaidah TA Laboratorium

12/11/2013 61 TA APS Ny. Mutmainah TA Laboratorium

12/12/2013 67 RN DH Ny. Sartika x

12/13/2013 72 TA DH Ny. Nurhayati Tia Laboratorium

73 RN APS Ny. Hj. Syarifah Icun x

12/14/2013 75 IF APS Ny. Marulliah Hifni Laboratorium

77 TA SY An. Naja k' yulida UGD

12/15/2013 79 EM APS Tn. Rizal (suami imas) Mawaddah Laboratorium

12/16/2013 80 EM APS Ny. Hj. Fathiyah (klg em) Mawaddah Laboratorium

83 TA anindya Ny. Hj. St. Aisyah (klg mas anin) k' yulida UGD
85 RN DH Ny. Desita x
12/17/2013 92 RN hafiz An. Kirana Zaviroh Fatur UGD

12/18/2013 100 RN RY Ny. Hj. St. Aspari x

101 RN ISD An. A. Syaifullah Renny Laboratorium
102 RN RY Ny. Desi Renny Laboratorium
103 RN DY An. Almira x
104 IF RY Ny. Iis Marinda Hifni Laboratorium

12/19/2013 107 RN APS Tn. M. Zakir Renny Laboratorium

108 RN APS Ny. Retno Dwi (perawat) Renny Laboratorium

12/20/2013 115 EM ifiq An. Nazira Desi UGD

116 EM APS Tn. H. Baihaqi (ortu Mawadah) Mawaddah Laboratorium
117 EM APS Ny. Hj. Fatimah (ortu mawaddah) Mawaddah Laboratorium
119 EM APS Ny. Alwiyah Mawaddah Laboratorium
 DATA SAMPLING RAWAT JALAN LAB. NOVEMBER-DESMBER 2013

Tanggal No.Lab. Analis dr. Nama Pasien Bagian

12/21/2013 120 IF APS Ny. St. Hamriah Hifni Laboratorium

121 IF APS Ny. Mbah (k'asniah) k' asniah Ruang Bersalin
122 RN APS Ny. Desi (perawat) Renny Laboratorium
124 RN ISD Tn. Eko Fathur UGD

12/22/2013 127 EM SY An. Gt. Zaldi K' Yulida UGD

12/23/2013 128 RN APS Ny. Zubaidah Tia Laboratorium

130 RN APS Ny. Ayuniati Renny Laboratorium
132 EM RZ An. M. Fadil Mawaddah Laboratorium
133 EM APS Ny. Mei Anma x

12/24/2013 135 RN DY An. Ahmad Rosih Renny Laboratorium

136 IF Ifiq An. M. Heidy Hifni Laboratorium

12/25/2013 137 IF DH Ny. Diah x

Total Biaya
UGD 10 Rp 100,000
Ruang Anak 0 Rp -
Ruang Bersalin 1 Rp 10,000
Laboratorium 42 Rp 420,000

Total Rp 530,000
 DATA SAMPLING RAWAT INAP LAB. NOVEMBER-DESEMBER 2013

No. Lab Kamar Analis dr. Nama Pasien Tanggal

187RB1113 C7 RN DH Ny. Zakiah 11/26/2013 santi

188RB1113 A4 RN DH NY. Juaeriyah 11/26/2013 santi

190RB1113 RN 11/26/2013 wiwin

191RB1113 A6 RN RY Ny. Anita Amelina 11/26/2013 wiwin

192RB1113 A5 RN RY Ny. Melina 11/26/2013 vk?
194RA1113 K8 IF ifiq An. M. Afif W. 11/26/2013 Hifni

195RB1113 A4 IF RY Ny. khairani Fatma 11/27/2013 vk?

203RB1113 IF 11/27/2013 vk?
206RB1113 EM 11/28/2013 vk?
218RB1113 RN 11/29/2013 Renny

200RB1113 B2 EM DH Ny. Sariyah 11/27/2013 vk?

215RB1113 RN 11/29/2013 linda
227RB1113 EM 11/29/2013 vk?
231RB1113 TA 11/30/2013 vk?
006RB1213 RN 12/1/2013 Renny
011RB1213 EM 12/2/2013 x

201RA1113 K12 EM IH An. Cyndi 11/27/2013 x

202RB1113 A4 IF RZ By. Ny. Chairani Fatma 11/27/2013 Hifni

205RB1113 C8 EM RY Ny. Erna 11/28/2013 vk?

212RB1113 IF 11/28/2013 Hifni

207RB1113 C9 EM RY Ny. Ayu 11/28/2013 vk?

208RA1113 K2 IF hfz Bny. Ny. Erna 11/28/2013 Hifni

209RA1113 K5 IF RZ Nn. Nia 11/28/2013 k' yulida

217RA1113 RN Sf 11/29/2013 rully
228RA1113 EM An. Nia Ramadhani 11/30/2013 novi
003RA1213 IF 12/1/2013 vina

210RA1113 K2 IF SF By. Ny. Sariyah 1 11/28/2013 HIfni

211RA1113 K2 IF SF By. Ny. Sariyah 2 11/28/2013 HIfni
213RB1113 A5 RN RY Ny. Anggie Thesa 11/28/2013 wirna

214RA1113 K1 RN ISD An. M. Nasuha 11/29/2013 koniah

220RA1113 TA DY 11/29/2013 x
216RB1113 C9 RN AA Ny. Syefi 11/29/2013 linda
219RA1113 K12 RN IH An. Marcelinus 11/29/2013 x
226RB1113 A6 EM RY Ny. Nikade 11/29/2013 vk?

229RA1113 K7 RN RZ An. M. Alvin 11/30/2013 lutfhi

001RA1213 K3 IF SF An. Noor Fajri 12/1/2013 k' yulida

007RA1213 K10 RN Ridha An. M. Widodo 12/1/2013 Renny

020RA1213 IF SF 12/3/2013 Hifni

008RB1213 C7 TA RW Nn. Rifka 12/2/2013 x

009RB1213 A5 TA BD Ny. dr. Rahma 12/2/2013 nurul
010RA1213 K6 EM hafiz An. Azizah 12/2/2013 Mawaddah

014RB1213 C7 EM hfz Nn. Putri Pancar Indah 12/2/2013 Olla

018RB1213 RN RW 12/2/2013 x

019RA1213 K3 RN IH An. M. Ragam 12/2/2013 desi

023RA1213 K8 TA DY An. M. Afrizal 12/3/2013 maria

024RB1213 A4 RN DH Ny. Ika Andriani 12/3/2013 vk?

027RB1213 EM 12/4/2013 vk?

025RA1213 K12 RN PR An. Adelia Putri 12/3/2013 fatur

026RB1213 C8 TA DH Ny. Hj. Maulidah 12/4/2013 vk?
 DATA SAMPLING RAWAT INAP LAB. NOVEMBER-DESEMBER 2013

No. Lab Kamar Analis dr. Nama Pasien Tanggal

028RB1213 B2 EM DH Ny. Abidah 12/4/2013 vk?

024RB1213 C7 IF DH Ny. Rabiatul 12/4/2013 vk?

026RB1213 IF 12/5/2013 vk?

025RB1213 A6 IF DH Ny. Syarifah nur farah 12/5/2013 icha

031RB1213 TA 12/5/2013 vk?

028RA1213 K5 RN hfz An. M. Wildan 12/5/2013 desi

032RA1213 TA 12/5/2013 x

029RB1213 A5 RN RY Ny. Helmiyati 12/5/2013 santi

033RB1213 B2 TA BD Ny. Iriana Lestari 12/5/2013 vk?

035RA1213 K3 IF DY An. Gina Rahmatika 12/6/2013 eka

046RA1213 RN 12/8/2013 ra?

036RB1213 A6 EM IH By. Ny. Syarifah Nur Farah 12/6/2013 Mawaddah

037RB1213 A4 RN IH By. Ny. Ika Andriani 12/6/2013 wiwin

038RB1213 A6 IF DH Ny. Jamilah 12/6/2013 vk?

042RB1213 IF 12/7/2013 vk?
044RB1213 TA 12/7/2013 vk?
055RB1213 RN 12/9/2013 rahma

041RB1213 rb IF felita Tn. M. Feri Mahmud 12/7/2013 lutfhi

043RB1213 B2 TA RY Ny. Hiliwatin Nazwa 12/7/2013 vk?

045RA1213 K2 RN IH By. Ny. Jamilah 12/8/2013 vk?

069RA1213 TA 12/13/2013 maria

047RB1213 vk IF RY Ny. Ledy Tia Saputry 12/8/2013 wirna

048RA1213 K3 IF DY An. Nazira 12/8/2013 Hifni
049RB1213 A4 TA wahyu Ny. Norhasanah 12/8/2013 vk?
050RB1213 C9 TA AA Ny. Windi 12/8/2013 vk?
051RB1213 C9 EM hfz By. Ny. Windi 12/9/2013 Mawaddah

054RA1213 K8 RN ISD An. M. Naufal 12/9/2013 Renny

064RA1213 RN SF 12/11/2013 x
056RA1213 K10 RN ISD An. Rasya nabil 12/9/2013 Renny
059RB1213 B2 IF RY Ny. Sholehah 12/9/2013 vk?
060RA1213 K5 RN RZ An. Vigor Hanasta Sinaga 12/10/2013 lutfhi
062RA1213 K6 TA RZ An. Sweety 12/11/2013 Tia
065RB1213 C9 RN DH Ny. Toyibah (om dadang) 12/11/2013 icha
066RA1213 K4 EM SY An. M. Zaki 12/12/2013 Mawaddah
068RB1213 A5 IF RY Ny. Rezeki Damayanti 12/13/2013 martha
070RB1213 C7 TA AA Ny. Fatma 12/13/2013 santi
071RB1213 A6 TA RY Ny. Rini Indrawati 12/13/2013 vk?

074RB1213 B2 RN AA Ny. Sahdiah 12/13/2013 rahma

076RB1213 IF 12/14/2013 vk?

077RA1213 ra TA SY An. Naja 12/14/2013 k' yulida

081RA1213 K7 TA hfz An. Syifa Azkia 12/16/2013 k' yulida

082RA1213 K8 TA hfz An. Ayyas Fiqri 12/16/2013 k' yulida

089RA1213 TA DY 12/17/2013 maria
097RB1213 EM 12/18/2013 kamila

084RB1213 C8 TA RY Ny. Muliana Ulfah 12/16/2013 vk?

086RB1213 C9 RN RY Ny. Erna Setyawati 12/16/2013 icha

087RB1213 C7 IF DH Ny. Aini 12/17/2013 vk?

090RB1213 TA 12/17/2013 wardah

088RA1213 K2 TA SF By. Ny. Muliana Ulfah 12/17/2013 Tia

 DATA SAMPLING RAWAT INAP LAB. NOVEMBER-DESEMBER 2013

No. Lab Kamar Analis dr. Nama Pasien Tanggal

093RA1213 K2 RN hfz An. Siti Munawarah 12/17/2013 fatur

094RB1213 A4 EM RY Ny. Tika 12/18/2013 vk?

095RA1213 K11 EM ifiq An. Naufal 12/18/2013 desi

111RA1213 IF DY 12/19/2013 raudah

098RB1213 A6 RN BD Ny. Hevi 12/18/2013 vk?

099RB1213 B2 RN AA Ny. Sri Rezeki 12/18/2013 wiwin
105RA1213 K2 IF SF By. Ny. Hevi 12/18/2013 hamdanah
106RA1213 K4 IF ridha An. Kamil Zaidan 12/18/2013 fatur
109RB1213 vk RN RY Ny. Rahmatul 12/19/2013 icha
110RB1213 C9 IF DH Ny. Mariatul 12/19/2013 icha

112RA1213 K5 TA ISD By. Aditya 12/20/2013 Tia

113RA1213 EM 12/20/2013 x

114RB1213 A5 EM RY Ny. Qurratul 12/20/2013 vk?

118RA1213 K3 EM ISD An. Syafa 12/20/2013 desi
123RB1213 A4 RN RY Ny. Fatmawati 12/21/2013 rahma
125RA1213 K6 TA ISD An. Rifki Azka 12/21/2013 fatur

126RB1213 A5 IF RY Ny. Masitoh 12/22/2013 vk?

131RB1213 EM 12/23/2013 wirna

129RB1213 A4 RN AA Ny. Debby 12/23/2013 marta

134RA1213 K3 TA Ridha An. Nurhayah 12/23/2013 ra?
138RB1213 A6 TA RY Ny. Endang 12/25/2013 k'asniah

UGD 17 Rp 170,000
 Ruang Anak 14 Rp 140,000
Ruang Bersalin 60 Rp 600,000
Laboratorium 19 Rp 190,000

Total Rp 1,100,000
 Bagian

Ruang Bersalin

Ruang Bersalin
Ruang Bersalin

Ruang Bersalin
Ruang Bersalin
Laboratorium

Ruang Bersalin
Ruang Bersalin
Ruang Bersalin
Laboratorium

Ruang Bersalin
Ruang Bersalin
Ruang Bersalin
Ruang Bersalin
Laboratorium

Laboratorium

Ruang Bersalin
Laboratorium

Ruang Bersalin
Laboratorium

UGD
Ruang Anak
Ruang Anak
Ruang Anak

Laboratorium
Laboratorium
Ruang Bersalin

Ruang Anak
Ruang Bersalin

Ruang Bersalin

UGD
UGD

Laboratorium
Laboratorium

Ruang Bersalin
Laboratorium

UGD

UGD
Ruang Anak

Ruang Bersalin
Ruang Bersalin

UGD
Ruang Bersalin
 Bagian

Ruang Bersalin

Ruang Bersalin
Ruang Bersalin

Ruang Bersalin
Ruang Bersalin

UGD

Ruang Bersalin
Ruang Bersalin

Ruang Anak
Ruang Anak

Laboratorium
Ruang Bersalin

Ruang Bersalin
Ruang Bersalin
Ruang Bersalin
Ruang Bersalin

UGD
Ruang Bersalin

Ruang Bersalin
Ruang Anak

Ruang Bersalin
Laboratorium
Ruang Bersalin
Ruang Bersalin
Ruang Anak

Laboratorium
Laboratorium
Ruang Bersalin
UGD
Laboratorium
Ruang Bersalin
Laboratorium
Ruang Bersalin
Ruang Bersalin
Ruang Bersalin

Ruang Bersalin
Ruang Bersalin

UGD
UGD

UGD
Ruang Anak
Ruang Anak

Ruang Bersalin
Ruang Bersalin

Ruang Bersalin
Ruang Bersalin

Laboratorium
 Bagian

UGD
Ruang Bersalin

UGD
Ruang Anak

Ruang Bersalin
Ruang Bersalin
Ruang Anak
UGD
Ruang Bersalin
Ruang Bersalin

Laboratorium

Ruang Bersalin
UGD
Ruang Bersalin
UGD

Ruang Bersalin
Ruang Bersalin

Ruang Bersalin
Ruang Anak
Ruang Bersalin
 DATA SAMPLING RAWAT JALAN LAB. NOVEMBER - DESEMBER 2014

Tanggal No.Lab. Analis dr. Nama Pasien Sampling

11/26/2014 219 EM ifiq An. Ibrahim k'yulida

221 EM RY Ny. Fatmawati Gemalasari Mawaddah

11/27/2014 225 TA DH Ny. Rohatul Aina x

11/28/2014 231 RN ifiq An. Azzura Renny

233 RN aps Nn. Elva Yulianti Renny
234 RN aps Ny. Normilawati (acil ila dapur) Renny

11/29/2014 240 TA aps Ny. Siti Hamriah Tia

241 TA/EM DY An. Atna Sabila Nugraha Tia
242 EM aps Ny. Marlina Mawaddah

11/30/2014 257 EM idola An. M. Diandra K' Yulida

12/1/2014 4 DN Anin Tn. Akhmad khairani Lutfhi

12/2/2014 9 RN DY An. Denovan Siska

10 RN ifiq Ny. Farida Hildawati (mertua dr ifiq) dr. Ifiq
11 RN isd Ny. Sri Jumiati (mertua ari) siska
12 EM aps Ny. Siti Mu'minah Mawaddah
13 EM ifiq Tn. M. Fakhrianoor siska

12/3/2014 16 EM DY An. Gt. Zaini Mufid Mawaddah

17 EM DY An. Azza Mawaddah
18 TA aps Ny. Iin (resepsionis) Mawaddah
21 TA aps Ny. St. Hamriah Tia
22 TA DH Ny. Liza Widyawati x

12/6/2014 31 RN Nn. Kusri Ningsih Tri Astuti Renny

32 RN Nn. Syarifa Nurul Huda Renny

12/8/2014 41 RN DY An. Rizki Marcel Tololiu Renny

45 TA aps Tn. M. Jamil kamali Tia
46 TA DH Ny. Sari Dely x

12/9/2014 48 TA DY An. M. Auki Yuda Ardani Tia

49 TA DY An. M. Zaki Tia
53 DN hfz Ny. Nadya Lutfhi

12/10/2014 57 DN aps Ny. Eny Hadiyati Dhoni

61 RN DY An. M. Zaki Renny

12/11/2014 68 RN DH Ny. A'an x

 69 RN DH Ny. Siti Fatimah x
70 RN DH Ny, Trisna Renny

12/12/2014 71 DN Tn. M. Zainurrahaman Dhoni

73 DN ifiq An. Tazkia Putri Fathur

12/13/2014 79 TA DY An. Siti Atikah Tia

80 TA DY An. Nur Aisyah Tia

12/14/2014 83 RN DY An. Siti Atikah Renny

84 RN Idola An. M. Irza Renny

12/18/2014 104 DN DY An. M. Nasuha x

106 RN RY Ny. Nani Fatmawati Renny
107 EM aps Ny. Esti Puji Prikasih Mawaddah
108 EM aps Nn. Mega Ananda Mawaddah
109 EM DY An. M. Irza x
110 EM SY An. Ihsan kamil (dr. Lia) Lutfhi
 DATA SAMPLING RAWAT JALAN LAB. NOVEMBER - DESEMBER 2014

Tanggal No.Lab. Analis dr. Nama Pasien Sampling

12/19/2014 113 RN RY Ny. Sukesi Renny

114 RN SF An. M. Naufal Renny
115 RN DY An. M. Zaini x

12/20/2014 118 DN ifiq An. Alifa Putri k'yulida

12/21/2014 124 EM aps Ny. Rina Mawaddah

125 EM aps Ny. Gusti kardina x

12/22/2014 127 DN aps Ny. Hj. Hanifah Dhoni

128 RN aps Ny. Hj. Zahrah Renny
129 RN aps Tn. Abdul hadi Renny
130 RN aps Ny. Hj. Fadluniah Renny
131 RN aps An. M. Lutfhi Renny
132 RN aps An. Habibi Hasyim Renny
135 RN aps Tn. Fauzi Ridwan (adik renny) Renny

12/23/2014 137 TA aps Ny. Gusti Kardina Tia

139 RN aps Tn. Gt. Hafizinnur Renny
140 RN DH Ny. Yulianor x

12/25/2014 146 TA aps Tn. Abdullah Tia

147 EM aps Cahyo (karyawan dulu) Mawaddah

UGD 10
Ruang Anak 0
Ruang Bersalin 0
Laboratorium 43
Dokter 1

Total 54

Mengetahui,
Ttd, Kepala Ruangan Laboratorium
Renny Sislia dr. M. Hafidz Maulana
BER 2014

Bagian

UGD
Laboratorium

Laboratorium
Laboratorium
Laboratorium

Laboratorium
Laboratorium
Laboratorium

UGD

UGD

UGD
dr. Ifiq
UGD
Laboratorium
UGD

Laboratorium
Laboratorium
Laboratorium
Laboratorium

Laboratorium
Laboratorium

Laboratorium
Laboratorium

Laboratorium
Laboratorium
UGD

Laboratorium
Laboratorium
Laboratorium

Laboratorium
UGD

Laboratorium
Laboratorium

Laboratorium
Laboratorium

Laboratorium
Laboratorium
Laboratorium

UGD
BER 2014

Bagian

Laboratorium
Laboratorium

UGD

Laboratorium

Laboratorium
Laboratorium
Laboratorium
Laboratorium
Laboratorium
Laboratorium
Laboratorium

Laboratorium
Laboratorium

Laboratorium
Laboratorium

Total Biaya
Rp 100,000
Rp -
Rp -
Rp 430,000
Rp 10,000

Rp 540,000

an Laboratorium
fidz Maulana
 DATA SAMPLING RAWAT INAP LAB. NOVEMBER - DESEMBER 2014

No. Lab Kamar Analis dr. Nama Pasien Tanggal

220RA1114 K7 EM ifiq An. Bilqis 11/26/2014

222RA1114 K8 DN SY Nn. Nisa Mala Hayani 11/26/2014

223RA1114 K10 TA hfz An. M Riyaru 11/27/2014

230RA1114 EM SF 11/28/2014

224RA1114 K13 TA SF An. Ubaidillah 11/27/2014

226RB1114 A4 DN RY Ny. Hamdanah (perawat anak) 11/27/2014

235RB1114 RN 11/28/2014

227RA1114 K1 DN hfz An. Galuh 11/27/2014

228RB1114 C9 EM RY Ny. Sulistiawati 11/27/2014

229RB1114 C7 EM AA Ny. Astuti 11/27/2014

247RB1114 RN 11/29/2014

232RB1114 A5 RN DH Ny. Misnaini 11/28/2014

238RB1114 TA 11/28/2014
255RB1114 EM 11/30/2014

236RB1114 A5 RN DY By. Ny. Misnaini 11/28/2014

237RB1114 B2 TA AA Ny. Yanti (perawat anak) 11/28/2014
239RB1114 C8 TA Fathur Ny. Nurul Hikmah 11/29/2014

243RA1114 K5 EM hfz An. Adelia Putri 11/29/2014

246RA1114 RN SF 11/29/2014

244RB1114 A6 EM AA Ny. Salawatul Awaliyah 11/29/2014

245RA1114 K2.2 EM DY By. Ny. Hamdanah II (perawat) 11/29/2014

015RA1214 EM 12/2/2014

248RA1114 K12 RN SY An. AL Khalifi 11/29/2014

249RA1114 K1 RN HFZ An. Bagas 11/29/2014

254RA1114 EM 11/30/2014

250RA1114 K4 RN hfz An. Abimael 11/29/2014

251RB1114 C8 RN DH Ny. Helmiah 11/29/2014
252RB1114 A6 RN RY Ny. Marnilawati 11/30/2014
253RB1114 B2 RN RY Ny. Husniah 11/30/2014
256RB1114 B1 EM RY Ny. Asiah 11/30/2014
258RB1114 B1 DN hfz By. Ny. Aisyah 11/30/2014
259RB1114 C7 DN RY Ny. Devi 11/30/2014

001RB1214 C9 EM BD Ny. Helda Rahmawati 12/1/2014

008RB1214 RN 02/12/12014

002RB1214 B2 DN DY By. Ny. Husniah 12/1/2014

003RB1214 C7 DN ifiq By. Ny. Devi 12/1/2014
005RA1214 K5 TA PR An. M. Bisri 12/1/2014
006RA1214 K10 TA Anin An. M. Agus Fiqri 12/1/2014
007RB1214 C9 TA DY By. Ny. Helda Rahmawati 12/2/2014

014RA1214 K1 EM ISD An. Saira Asyfa 12/2/2014

020RA1214 TA SF 12/3/2014

019RA1214 K8 TA DY An. Ayyas 12/3/2014

023RB1214 B2 RN RW Ny. Sri Jumiaty (mertua ari) 12/4/2014

025RB1214 TA 12/4/2014
026RB1214 TA 12/5/2014
029RB1214 DN 12/6/2014
 DATA SAMPLING RAWAT INAP LAB. NOVEMBER - DESEMBER 2014

No. Lab Kamar Analis dr. Nama Pasien Tanggal

024RA1214 K1 TA SF An. M. Rizki 12/4/2014

027RA1214 K7 TA IH An. M. Indra 12/5/2014
028RB1214 C9 DN DH Ny. Siti Faizah 12/5/2014
030RA1214 K1 DN DY An. Queen Bee 12/6/2014
033RB1214 C7 EM RY Ny. Noor Jannah 12/6/2014

034RA1214 K7 EM DY An. M. Adli 12/6/2014

035RA1214 EM 12/6/2014
037RA1214 TA 12/7/2014
043RA1214 RN 12/8/2014
047RA1214 TA 12/9/2014

036RB1214 A4 EM DH Ny. Nor Hamidah 12/7/2014

038RA1214 K12 RN SY An. Taufik Rahman 12/7/2014

044RA1214 TA SF 12/8/2014

039RB1214 A4 RN SY By. Ny. Hamidah 12/7/2014

040RB1214 A6 RN DH Ny. Padila Sandi 12/7/2014
042RB1214 C7 RN AA Ny. Noor Halidah 12/8/2014
043RA1214 K10 DN HFZ Ny. Helda Rahmawati 12/8/2014

050RB1214 C8 TA BD Ny. Falahiatul 12/9/2014

052RB1214 DN 12/9/2014
055RB1214 DN 12/10/2014
062RB1214 EM 12/10/2014

051RB1214 A6 TA/EM RY Ny. Febriana 12/9/2014

063RB1214 EM 12/10/2014
065RB1214 TA 12/11/2014

053RA1214 K3 DN DY By. Ibra Arkana 12/9/2014

056RA1214 DN 12/10/2014

054RB1214 C9 DN RY Ny. Siti Wulansari 12/9/2014

058RA1214 R/Anak RN ifiq An. Yunita 12/10/2014
059RB1214 A6 RN SF By. Ny. Febriana 12/10/2014
060RB1214 A5 RN BD Ny. Ratna Putri 12/10/2014
064RA1214 K2.2 EM DY By. Rizky Marcel 12/11/2014

066RA1214 K2.2 TA SF By. Ny. Falahiatul 12/11/2014

076RA1214 DN 12/13/2014

067RB1214 A4 RN RY Ny. Lucia Ika Heni Rahmawati 12/11/2014

075RB1214 DN 12/12/2014

072RA1214 K2.1 DN SF By. Ny. Lucia 12/12/2014

077RB1214 C7 EM BD Ny. Ida 12/13/2014
078RB1214 B2 EM DY By. Ny. Ida R. 12/13/2014
081RB1214 A5 TA RY Ny. Mimi 12/14/2014
082RB1214 vk TA RY Ny. Dwi Astuti 12/14/2014
085RB1214 A6 EM RY Ny. Reni 12/14/2014
086RA1214 K8 EM ISD An. M. Ramadhan 12/14/2014
087RA1214 K1 EM ISD An. Larisa E.S 12/15/2014
088RA1214 K7 EM ISD An. Emir Ali R. 12/15/2014
089RA1214 K4 RN ifiq An. Qiandra A.S (anak dr. Ifiq) 12/15/2014

090RA1214 K12 RN Ifiq An. Akmal Sidiq 12/15/2014

096RA1214 TA SF 12/17/2014

091RB1214 C8 RN DH Ny. Dewi Fajarwati 12/15/2014

092RB1214 vk RN AA Ny. Erlina 12/15/2014

093RA1214 K8 RN Anin An. A. Fadil 12/16/2014

094RA1214 K10 RN Anin An. Fatimah Azzahra (anak Ari) 12/16/2014
095RA1214 K1 TA SF An. Sayyid Husein 12/16/2014
 DATA SAMPLING RAWAT INAP LAB. NOVEMBER - DESEMBER 2014

No. Lab Kamar Analis dr. Nama Pasien Tanggal

097RB1214 C8 TA NN Ny. Hj. Rukiah 12/17/2014

102RB1214 DN 12/18/2014

098RB1214 C7 TA RL Ny. Gusti Kardina 12/17/2014

099RB1214 TA 12/17/2014

100RA1214 K9 EM ifiq An. Helena Cindy 12/17/2014

101RA1214 K4 DN SF An. Tazkiatul Maula 12/18/2014

103RA1214 DN 12/18/2014
120RA1214 DN 12/20/2014

105RB1214 K12 RN DY An. Ahmad Rifa'i (anak acil lina) 12/18/2014

111RB1214 A6 EM RY Ny. Mina 12/19/2014
112RA1214 K7 EM IH An. Marcellinus (Adik Helena Cindy) 12/19/2014
116RB1214 A5 RN AA Ny. Diana 12/20/2014

117RB1214 A4 DN RY Ny. Nani 12/20/2014

119RB1214 DN 12/20/2014
121RB1214 DN 12/20/2014

119RB1214 A6 DN RY Ny. Uly 12/20/2014

122RA1214 K6 TA SF An. Ghina Lien 12/21/2014

123RA1214 K3 EM SY An. Hilyah Aulia 12/21/2014

136RA1214 TA DY 12/23/2014

126RA1214 K7 EM SF An. Alya Salsabila 12/21/2014

133RB1214 C7 RN RY Ny. Wulan Tri Utami 12/22/2014
134RB1214 A5 RN RY Ny. Dewi Lestari 12/22/2014
138RB1214 B2 TA RY Ny. Reka 12/23/2014

141RB1214 A5 TA RY Ny. Apri Ramadani 12/24/2014

145RB1214 TA 12/25/2014

142RA1214 K2 TA DY By. Ny. Hj. Latifah 12/24/2014

143RB1214 A5 TA DY By. Ny. Apri Ramadani 12/24/2014
144RB1214 A4 TA DH Ny. Hj. Latifah 12/24/2014

148RA1214 K5 DN SF An. Ahad Aqila 12/25/2014

150RA1214 DN 12/25/2014
149RA1214 C8 DN idola An. Randi (Om. Andre admin) 12/25/2014

UGD 28
Ruang Anak 10
Ruang Bersalin 35
Laboratorium 41
Dokter 1

Total 115

Ttd, Kepala Ruangan Laboratorium

Renny Sislia dr. M. Hafidz Maulana

R - DESEMBER 2014

Sampling Bagian

k'yulida UGD
k'yulida UGD

lutfi UGD
rina Ruang anak

lutfi UGD

rahma Ruang bersalin

renny Laboratorium

k'yulida UGD
wardah Ruang bersalin

marta Ruang bersalin

renny Laboratorium

marta Ruang bersalin

tia Laboratorium
mawaddah Laboratorium

renny Laboratorium
vk? Ruang bersalin
umi Ruang bersalin

fathur UGD
x

mawaddah Laboratorium

rina Ruang anak

x

fathur UGD

renny Laboratorium
x

lutfi UGD
wiwin Ruang bersalin
marta Ruang bersalin
 marta Ruang bersalin
k'yulida UGD
dhoni Laboratorium
rahma Ruang bersalin

linda Ruang bersalin

rahma Ruang bersalin

mawaddah Laboratorium
mawaddah Laboratorium
UGD? UGD
retno Ruang anak
tia Laboratorium

lutfi UGD
x

ervina Ruang anak

renny Laboratorium
x
tia Laboratorium
dhoni Laboratorium
R - DESEMBER 2014

Sampling Bagian

k'yulida UGD
x
icha Ruang Bersalin
k'yulida UGD
rahma Ruang Bersalin

mawaddah Laboratorium
siska UGD
tia Laboratorium
renny Laboratorium
tia Laboratorium

umi Ruang Bersalin

fatur UGD
x

renny Laboratorium
linda Ruang Bersalin
vk? Ruang Bersalin
k'yulida UGD

lita Ruang Bersalin

dhoni Laboratorium
dhoni Laboratorium
mawaddah Laboratorium

vk? Ruang Bersalin

mawaddah Laboratorium
tia Laboratorium

k'yulida UGD
dhoni Laboratorium

icha Ruang Bersalin

novi Ruang Anak
renny Laboratorium
wiwin Ruang Bersalin
mawaddah Laboratorium

tia Laboratorium
 rina Ruang Anak

rahma Ruang Bersalin

dhoni Laboratorium

novi Ruang Anak

nurul Ruang Bersalin
mawaddah Laboratorium
umi Ruang Bersalin
icha Ruang Bersalin
marta Ruang Bersalin
lutfi UGD
x
lutfi UGD
fatur UGD

fatur UGD
x

wirna Ruang Bersalin

wardah Ruang Anak

renny Laboratorium
siska UGD
tia Laboratorium
R - DESEMBER 2014

Sampling Bagian

tia Laboratorium
dhoni Laboratorium

tia Laboratorium
x

lutfi UGD

k'yulida UGD
x
x

renny Laboratorium
nurul Ruang Bersalin
pony Ruang Anak
santi Ruang Bersalin

wardah Ruang Bersalin

x
dhoni Laboratorium

umi Ruang Bersalin

fatur UGD

lutfi UGD
ervina Ruang Anak

dr. Idola dr. Idola

rahma Ruang Bersalin
rahma Ruang Bersalin
lita Ruang Bersalin

umi Ruang Bersalin

tia Laboratorium

tia Laboratorium
tia Laboratorium
tia Laboratorium

Ltfhi UGD
x
 Lutfhi UGD

Rp 280,000
Rp 100,000
Rp 350,000
Rp 410,000
Rp 10,000

Rp 1,150,000

Mengetahui,
Kepala Ruangan Laboratorium

dr. M. Hafidz Maulana

 DATA SAMPLING RAWAT INAP LAB. DESEMBER 2014 - JANUARI 2015

No. Lab Kamar Analis dr. Nama Pasien Tanggal

155RA1214 K2 EM ISD By. Fawas Anwar 12/26/2014

168RA1214 DN DY 12/28/2014

156RA1214 K5 EM DY An. Atnan 12/26/2014

157RA1214 K2 EM Anin By. Sabilina 12/26/2014

164RA1214 TA DY 12/27/2014

158RA1214 K6 EM Anin An. Fatir Rizky 12/26/2014

159RB1214 K7 EM Anin Tn. Kaspul Anwar 12/27/2014
162RB1214 A6 TA AA Ny. Sri Agustina 12/27/2014
163RB1214 A6 TA DY By. Ny. Sri Agustina 12/27/2014

165RA1214 K6 TA HFZ An. Noel Sembiring 12/27/2014

166RA1214 DN 12/28/2014
187RA1214 RN/RT DY 12/30/2014

167RA1214 K5 DN DY An. Adnan 12/28/2014

174RA1214 DN 12/29/2014
182RA1214 TA 12/30/2014
191RA1214 TA 12/31/2014

169RA1214 K1 DN DY An. Ziazka Rezky 12/28/2014

170RB1214 A4 DN DH Ny. Safwah 12/28/2014
171RA1214 K3 DN DY An. Raudatul Hafina 12/28/2014

172RB1214 C8 DN RL Ny. Wiwik 12/28/2014

175RB1214 EM/RT 12/29/2014
185RB1214 TA 12/30/2014
190RB1214 TA 12/31/2014
195RB1214 RN 12/31/2014
001RB0115 RN 1/1/2015
007RA0115 DN 1/2/2015
013RB0115 EM 1/2/2015
021RB0115 TA 1/3/2015

173RA1214 K4 DN ISD An. Faris Ahmad 12/28/2014

176RB1214 C9 EM/RT RY Ny. Ida Mariyana 12/29/2014
177RA1214 K10 EM/RT Ifiq An. Aqila Rezky 12/29/2014

178RA1214 K7 EM/RT Ifiq An. M. Lutfi 12/29/2014

183RA1214 TA DY 12/30/2014
192RA1214 TA 12/31/2014

179RA1214 K8 EM/TA idola An. Zulfa Husna 12/29/2014

193RA1214 DN 12/31/2014

181RA1214 K12 TA DY An. Rifqi 12/30/2014

188RB1214 C7 EM BD Ny. Nurwasihan 12/30/2014
189RB1214 A4 TA DH Ny. Halimah 12/30/2014
196RA1214 K3 RN DY An. Naura 12/31/2014
197RA1214 K5 RN DY An. Khodijatun Nafiza 12/31/2014

002RA0115 K1 DN Anin Ny. Mardiah (ortu An. Prama P.) 1/1/2015

011RA0115 EM/RT RL 1/2/2015
018RA0115 TA 1/3/2015

003RB0115 C7 DN Anin Ny. Pratiwi Ayu Wulandari 1/1/2015

004RA0115 K1 DN Anin An. Prama Pramudia 1/1/2015

008RA0115 DN DY 1/2/2015
019RA0115 TA 1/3/2015
028RA0115 DN 1/4/2015
043RA0115 RN/RT 1/5/2015
047RA0115 DN/RT 1/5/2015
 DATA SAMPLING RAWAT INAP LAB. DESEMBER 2014 - JANUARI 2015

No. Lab Kamar Analis dr. Nama Pasien Tanggal

005RA0115 K6 DN ISD An. M. Ridho 1/1/2015

016RA0115 TA DY 1/3/2015

006RB0115 A6 DN DH Ny. Yunnisa 1/1/2015

012RA0115 A4 EM/RT RY Ny. Yusnita 1/2/2015
015RA1214 K3 TA HFZ An. Gt. Nelam 1/2/2015

017RA0115 K5 TA DY An. M. Fadly 1/3/2015

026RA0115 DN 1/4/2015
041RA0115 RN 1/5/2015
057RA0115 EM/RT 1/6/2015
064RA0115 DN 1/7/2015

029RB1214 vk DN RY Ny. Elvy Supiati 1/4/2015

032RA0115 K7 DN DY An. Putri Nayla 1/4/2015

042RA0115 RN/RT 1/5/2015

034RB0115 C10 RN RL Nn. Pratiwi 1/4/2015

035RB0115 K4 RN HFZ Tn. Winarto (ortu An. M. Ridho) 1/4/2015

036RB0115 C8 RN HFZ Ny. Aina 1/4/2015

045RB0115 DN/RT RL 1/5/2015
055RB0115 TA 1/6/2015

039RA0115 K6 RN ISD An. Haidar 1/4/2015

048RB0115 B2 DN/RT RY Ny. Amah 1/5/2015
049RA0115 K8 DN/RT DY An. Aufar 1/5/2015

050RB0115 C9 TA DH Ny. Helmiah 1/5/2015

096RB0115 TA 1/9/2015

051RA0115 K7 TA DY An. Rezqiya Khair A. 1/5/2015

052RA0115 K12 TA SF An. Azka 1/5/2015
053RA0115 K2 TA ifiq An. Naura 1/5/2015

054RA0115 K1 TA SF An. Nayla Salsabila 1/6/2015

058RA0115 EM/RT 1/6/2015
065RA0115 DN 1/7/2015
077RA0115 EM 1/8/2015
088RA0115 DN/RT 1/9/2015
100RA0115 TA 1/10/2015

059RA0115 K10 DN SF An. Alifa Hijriya 1/6/2015

066RA0115 DN 1/7/2015
078RA0115 EM 1/8/2015

060RB0115 A6 DN DH Ny. Wida Sintya Putri 1/6/2015

062RB0115 DN 1/7/2015
084RB0115 TA 1/8/2015

061RA0115 K3 DN SF An. Saufia Zafira 1/6/2015

063RB0115 A4 DN RY Ny. Agustia 1/7/2015
067RA0115 K4 DN DY An. Haidar 1/7/2015

069RA0115 K5 RT/TA ifiq An. Nayla 1/7/2015

070RA0115 EM 1/7/2015

073RB0115 C7 EM DH Ny. Rizki Purnama Sari 1/7/2015

095RB0115 TA 1/9/2015

075RB0115 C8 EM RY Ny. Dian 1/7/2015

076RA0115 K6 EM SF An. Zahira P.K. 1/8/2015
079RB0115 A4 TA DH Ny. Ade Febriani 1/8/2015
 DATA SAMPLING RAWAT INAP LAB. DESEMBER 2014 - JANUARI 2015

No. Lab Kamar Analis dr. Nama Pasien Tanggal

082RB0115 B2 TA RY Ny. Tuti 1/8/2015

087RB0115 DN 1/9/2015

085RB0115 B1 DN RY Ny. Monalita 1/9/2015

086RB0115 C9 DN DH Ny. Nor Halimah 1/9/2015
091RA0115 K1 EM/RT SF An. Chika (Kakak Nayla Salsabila) 1/9/2015

092RB0115 A6 EM/RT RY Ny. Mila Karmila 1/9/2015

099RB0115 TA 1/10/2015

094RA0115 K7 TA isd An. Seema 1/9/2015

104RA0115 EM/RT DY 1/10/2015

097RA0115 K12 TA Fatma Ny. Hj. Norliani 1/9/2015

098RA0115 K1 TA Anin An. M. Syahrani 1/9/2015

102RB0115 C8 EM/RT RY Ny. Trifia 1/10/2015

115RB0115 EM 1/11/2015

105RB0115 A5 EM/RT AA Ny. Nor Hidayati 1/10/2015

106RA0115 K5 EM/RT ifiq An. Hazza 1/10/2015

111RA0115 DN IH 1/11/2015

107RB0115 B2 DN/RT IH By. Ny. Tuti 1/10/2015

108RA0115 K6 DN idola An. Eghi 1/10/2015

131RA0115 DN/RT DY 1/13/2015

110RB0115 A4 DN AA Ny. Herlita 1/10/2015

112RB0115 TA 1/11/2015

117RA0115 K4 EM DY An. Alisa 1/11/2015

118RA0115 K10 EM isd Tn. Zari Pandowo 1/11/2015

126RA0115 TA RW 1/13/2015

119RB0115 A5 EM RY Ny. Syarifah 1/12/2015

122RB0115 DN/RT 1/12/2015

123RB0115 K12 DN isd NY. Dini 1/12/2015

124RA0115 DN 1/12/2015

128RB0115 A6 RT/DN RY Ny. Triwira 1/13/2015

138RB0115 TA 1/14/2015

129RA0115 K7 RT/DN ifiq An. M. Alif Fatahillah 1/13/2015

140RA0115 RN SF 1/14/2015

130RA0115 K1 RT/DN ifiq An. Hafizah Rahmah 1/13/2015

139RB0115 A6 EM/RT DY By. Ny. Triwira 1/14/2015
143RA0115 K7 RN Anin An. Elfida Nor Aulia 1/14/2015

144RA0115 K3 RN DY An. Rizkya Dyah 1/15/2015

153RA0115 RN 1/16/2015
160RA0115 RN 1/17/2015
165RA0115 K4 TA 1/17/2015
170RA0115 DN/RT 1/18/2015
181RA0115 RN 1/19/2015

145RA0115 RA DN/RT ifiq An. Nadia 1/15/2015

147RB0115 C8 DN/RT ifiq Ny. Wiwik 1/15/2015
150RA0115 K4 EM SF An. Fariz 10/15/2015

158RA0115 K7 RN SF An. Avelina 1/16/2015

159RA0115 RN 1/17/2015
 DATA SAMPLING RAWAT INAP LAB. DESEMBER 2014 - JANUARI 2015

No. Lab Kamar Analis dr. Nama Pasien Tanggal

161RA0115 K3 EM/RT aps An. Siti Rohidatul Aisyah 1/17/2015

166RA0115 K4 TA DY 1/17/2015
169RA0115 TA 1/18/2015
173RA0115 DN 1/19/2015
180RA0115 RN 1/19/2015
193RA0115 DN 1/20/2015
201RA0115 RN/RT 1/21/2015

162RA0115 VK EM/RT AA Ny. Ayu Widawati 1/17/2015

163RB0115 A6 EM/RT RY Ny. Hj. Bulkis 1/17/2015
164RA0115 K10 EM/RT ifiq An. Nur Latisya P. 1/17/2015

171RA0115 K9/10 DN/RT SY An. Julia Dwi 1/18/2015

179RA0115 K10 RN SF 1/19/2015
194RA0115 DN 1/20/2015
202RA0115 RN/RT 1/21/2015
214RA0115 EM 1/22/2015

172RB0115 A5 DN/RT DH Ny. Hj. Rifqoh 1/18/2015

186RB0115 EM 1/19/2015

174RA0115 K5 DN Anin An. Kevin 1/19/2015

184RA0115 EM 1/19/2015

176RA0115 K1 DN IH An. Nor Latifa 1/19/2015

183RA0115 K6 EM DY An. M. Ihza Saputra 1/19/2015

192RA0115 DN 1/19/2015

187RB0115 A6 EM AA Ny. Nurul Huda 1/19/2015

197RB0115 C7 RN/RT hfz Ny. Tri Yulianti 1/20/2015

218RB0115 EM RL 1/22/2015
224RB0115 DN 1/22/2015
246RB0115 EM 1/23/2015
249RB0115 EM 1/24/2015
281RB0115 TA 1/25/2015

198RA0115 K4 RN/RT DY An. Alif Hasan 1/20/2015

237RA0115 RN/RT 1/23/2015
253RA0115 EM 1/24/2015
203RA0115 K6 TA/RT ifiq An. Hafna Fatiya Tasla 1/21/2015
256RA0115 TA IH 1/24/2015

205RA0115 K7 TA/RT ifiq An. Nasia Putri 1/21/2015

215RA0115 EM DY 1/22/2015
236RA0115 RN/RT 1/23/2015
255RA0115 TA 1/24/2015
266RA0115 RN 1/25/2015

212RA0115 K4 EM isd An. Naira 1/22/2015

228RA0115 DN 1/22/2015

213RA0115 K1 EM DY An. Dina Nabila 1/22/2015

216RB0115 A4 EM RY Ny. Ana 1/22/2015

221RA0115 K3 DN DY An. Nurul Huda 1/22/2015

234RA0115 RN/RT 1/23/2015
251RA0115 EM 1/24/2015
268RA0115 RN 1/25/2015

222RB0115 C8 DN ifiq Ny. Hj. Bustamiah 1/22/2015

225RB0115 A5 DN RY Ny. Herlina 1/22/2015

 DATA SAMPLING RAWAT INAP LAB. DESEMBER 2014 - JANUARI 2015

No. Lab Kamar Analis dr. Nama Pasien Tanggal

227RA0115 K8 DN hfz An. Raditya Najwan 1/22/2015

263RA0115 RN/RT DY 1/24/2015
267RA0115 RN 1/25/2015
277RA0115 TA 1/25/2015

229RB0115 A6 RN RY Ny. Mila Astun 1/22/2015

231RA0115 K12 RN RD An. Adinda Nurus Syifa 1/22/2015

259RA0115 TA/RT DY 1/24/2015

233RA0115 K10 RN SF An. Amilia Putri 1/23/2015

254RA0115 EM 1/24/2015
269RA0115 RN 1/25/2015

235RA0115 C9 RN/RT NN Nn. Siti Raudah 1/23/2015

250RB0115 EM 1/24/2015

243RA0115 K1 RN/RT DY An. Zidan 1/23/2015

247RA0115 K9 EM Anin An. Mirza 1/23/2015

252RA0115 K13 EM DY 1/24/2015
262RA0115 RN/RT 1/24/2015
270RA0115 RN 1/25/2015

248RA0115 B1 EM DY An. Kaisa 1/23/2015

258RB0115 A4 TA DH Ny. Dian Novayanti 1/24/2015

261RB0115 TA/RT 1/24/2015

264RB0115 B2 RN hfz An. Gibran 1/25/2015

274RB0115 A5 EM SF By. Ny. Siti Hindun 1/25/2015
275RB0115 C8 EM NN Tn. A. Thohir 1/25/2015

278RB0115 A5 TA/EM HS Ny. Siti Hindun 1/25/2015

280RB0115 TA 1/25/2015

279RB0115 A6 TA RY Ny. Nova Damayanti 1/25/2015

014 - JANUARI 2015

Sampling Bagian

siska UGD
dhoni Laboratorium

rully Ruang Anak

mawaddah Laboratorium
x

mawaddah Laboratorium
mawaddah Laboratorium
lita Ruang Bersalin
tia Laboratorium

nisa Ruang Anak

x
x

dhoni Laboratorium
dhoni Laboratorium
tia Laboratorium
tia Laboratorium

k'yulida UGD
icha Ruang Bersalin
k'yulida UGD

k'yulida UGD
mawaddah Laboratorium
tia Laboratorium
tia Laboratorium
renny Laboratorium
renny Laboratorium
dhoni Laboratorium
mawaddah Laboratorium
tia Laboratorium

fatur UGD
linda Ruang Bersalin
lutfi UGD

lutfi UGD
 tia Laboratorium
tia Laboratorium

mawaddah Laboratorium
ervina Ruang Anak

tia Laboratorium
rahma Ruang Bersalin
umi Ruang Bersalin
fatur UGD
R/Anak Ruang Anak

lutfi UGD
x
retno Ruang Anak

lutfi UGD

dhoni Laboratorium
rina Ruang Anak
tia Laboratorium
dhoni Laboratorium
renny Laboratorium
x
014 - JANUARI 2015

Sampling Bagian

fatur UGD
ervina Ruang Anak

lita Ruang Bersalin

vk? Ruang Bersalin
ervina Ruang Anak

ervina Ruang Anak

dhoni Laboratorium
R/Anak Ruang Anak
novi Ruang Anak
dhoni Laboratorium

marta Ruang Bersalin

dhoni Laboratorium
R/Anak Ruang Anak

x
lutfi UGD

lutfi UGD
dhoni Laboratorium
tia Laboratorium

fatur UGD
umi Ruang Bersalin
olla Ruang Anak

linda Ruang Bersalin

tia Laboratorium

fatur UGD
fatur UGD
fatur UGD

fatur UGD
sisa sampel UGD
dhoni Laboratorium
mawaddah Laboratorium
dhoni Laboratorium
 tia Laboratorium

hafizah UGD
dhoni Laboratorium
mawaddah Laboratorium

icha Ruang Bersalin

dhoni Laboratorium
linda Ruang Bersalin

R/Anak Ruang Anak

icha Ruang Bersalin
retno Ruang Anak

taufik Laboratorium
x

k'asniah Ruang Bersalin

tia Laboratorium

susan Ruang Bersalin

desy Ruang Anak
linda Ruang Bersalin
014 - JANUARI 2015

Sampling Bagian

linda Ruang Bersalin

dhoni Laboratorium

vk? Ruang Bersalin

vk? Ruang Bersalin
mawaddah Laboratorium

umi Ruang Bersalin

tia Laboratorium

tia Laboratorium
x

tia Laboratorium
fatur UGD

marta Ruang Bersalin

mawaddah Laboratorium

marta Ruang Bersalin

taufik Laboratorium
x

dhoni Laboratorium

lutfi UGD
dhoni Laboratorium

icha Ruang Bersalin

tia Laboratorium

siska UGD

lutfi UGD
x

marta Ruang Bersalin

taufik Laboratorium

fatur UGD
 x

icha Ruang Bersalin

tia Laboratorium

tia Laboratorium
x

hafizah UGD
tia Laboratorium
hafizah UGD

ervina Ruang Anak

k'maria Ruang Anak
novi Ruang Anak
tia Laboratorium
R/Anak Ruang Anak
renny Laboratorium

R/Anak Ruang Anak

siska UGD
mawaddah Laboratorium

fatur UGD
x
014 - JANUARI 2015

Sampling Bagian

taufik Laboratorium
tia Laboratorium
tia Laboratorium
dhoni Laboratorium
renny Laboratorium
dhoni Laboratorium
k'novi Ruang Anak

wardah Ruang Bersalin

wardah Ruang Bersalin
k'maria Ruang Anak

lutfi UGD
ervina Ruang Anak
dhoni Laboratorium
renny Laboratorium
mawaddah Laboratorium

nurul Ruang Bersalin

mawaddah Laboratorium

dhoni Laboratorium
x

siska UGD
x

rahma Ruang Bersalin

renny Laboratorium
mawaddah Laboratorium
dhoni Laboratorium
mawaddah Laboratorium
mawaddah Laboratorium
tia Laboratorium

renny Laboratorium
taufik Laboratorium
R/Anak Ruang Anak
 renny Laboratorium
mawaddah Laboratorium

UGD? UGD
mawaddah Laboratorium
renny Laboratorium
mawaddah Laboratorium
renny Laboratorium

fatur UGD
x

x
santi Ruang Bersalin

taufik Laboratorium
renny Laboratorium
mawaddah Laboratorium
renny Laboratorium

lutfi UGD

nurul Ruang Bersalin

014 - JANUARI 2015

Sampling Bagian

lutfi UGD
renny Laboratorium
nisa Ruang Anak
tia Laboratorium

vk? Ruang Bersalin

hafizah UGD
tia Laboratorium

R/Anak Ruang Anak

R/Anak Ruang Anak
nisa Ruang Anak

vk? Ruang Bersalin

mawaddah Laboratorium

siska UGD

lutfi UGD
R/Anak Ruang Anak
renny Laboratorium
nisa Ruang Anak

mawaddah Laboratorium

linda Ruang Bersalin

lita Ruang Bersalin

fatur UGD
mawaddah Laboratorium
vk? Ruang Bersalin

vk? Ruang Bersalin

tia Laboratorium

linda Ruang Bersalin

 DATA SAMPLING RAWAT JALAN LAB. JANUARI 2015

Tanggal No.Lab. Analis dr. Nama Pasien Sampling

12/26/2014 151 RN DY An. Nasya Putri x

152 RN ifiq Ny. Asniah siska
153 RN ifiq An. Danish siska
154 EM DY An. M. Fathi Mawaddah

12/27/2014 160 TA ifiq An. Afifa Rahman x

161 TA/EM ifiq An. Hernawati siska

12/29/2014 180 TA idola An. Davina Soraya Tia

12/30/2014 184 TA DY An. Narsya Regita Tia

186 RN/RT DY An. Nararia Renny

12/31/2014 194 DN/RT RY Ny. Nur Faridah Dhoni

1/2/2015 9 EM/RT DY An. Nararia Mawaddah

10 EM/RT DY An. Siti Nor syifa Mawaddah
14 EM hfz An. Putri k'yulida

1/3/2015 20 TA aps Tn. Djunaidi Tia

22 EM/RT aps An. M. Syarif Habibi Mawaddah
23 RN DY An. Ahyan Mawaddah
24 RN DY An. Nararia Mawaddah

1/4/2015 25 DN isd Tn. Wahyu Kurniawan lutfi

27 DN aps Ny. Siti Hamriah dhoni
30 TA DY An. Nararia tia
31 TA RS Mutia An. M. Dafa tia
33 TA aps Ny. Gusti Kardina tia
37 RN Anin An. M. Amar (anak pipit) renny
38 RN hfz Nn. Marlina x

1/5/2015 40 RN DY An. Wari Nugroho renny

44 RN/RT aps Tn. Abdul Hadi taufik
46 DN/RT aps Ny. Muriaty (loundry) dhoni
56 EM/RT DY An. Afifa Mikaila mawaddah

1/7/2015 68 RT/TA DH Ny. Dewi taufik

71 EM DH Ny. Dina mawaddah
72 EM aps Ny. Reka mawaddah
1/8/2015 80 TA aps Tn. Poniran tia
81 TA aps Ny. Marlina tia
83 TA idola Ny. Nor Hassanah fatur
1/9/2015 89 DN DY An. Haikal x
90 DN/RT DY An. Karisa dhoni
91 EM/RT SF An. Chika mawaddah
93 EM/RT DY An. Karisa x

1/10/2015 101 TA DY An. Ayra tia

103 EM/RT ifiq An. Lailatus Saadah mawaddah
109 DN Anin An. Yudi dhoni

1/11/2015 113 TA DH Ny. Nanik Maryani x

114 TA DH Ny. Ernawati x
116 EM aps Tn. Edy Ariansyah mawaddah

1/12/2015 120 DN/RT aps Nn. Supriatin (Admin) mawaddah

121 DN/RT aps Ny. Imas (kasir) dhoni

1/13/2015 125 TA DH Ny. Yanti tia

127 RT/DN aps Ny. Hj. Zunaidah taufik
132 RT/DN ifiq An. Yona Maudita taufik
134 EM DH Ny. Mursidah mawaddah
135 EM SY An. Ahmad Aditya Lutfi hafizah
136 EM Anin Tn. Aspihani (mertua dr. Anin) mawaddah
137 EM Anin Ny. Jumiatun (mertua dr. Anin) mawaddah

1/14/2015 141 RN Idola An. Nadia Khairunnisa Lutfhi

142 RN DH Ny. Marina x
 DATA SAMPLING RAWAT JALAN LAB. JANUARI 2015

Tanggal No.Lab. Analis dr. Nama Pasien Sampling

1/15/2015 146 DN/RT ifiq An. Antin siska

147 EM DY An. Khodijah Mawaddah
148 EM idola Ny. Noor Hasanah Mawaddah
149 EM idola An. M. Elvian Mawaddah

1/16/2015 151 EM DY An. Febri Aulia Mawaddah

152 EM DY An. Aldito Mawaddah
154 DN/RT APS Ny. Marlina Taufik
155 RN DY An. Abdurrahman Hafiz Renny
156 RN DY An. M. Khairul Fikri Fathur
157 RN SY Tn. M. Kahirul Syafi'i Fathur

1/17/2015 167 TA aps Ny. Marlina Tia

1/18/2015 168 TA RD An. Nazamah Huda Fathur

1/19/2015 175 DN anin An. M. Zibran B. Kaflin Dhoni

178 RN/DN DY An. Nasya Putri Renny
182 RN/DN DY An. M. Sayuti Renny
185 EM aps Ny. Nia x
188 EM ifiq An. Elvian siska
189 DN AA Ny. Yuli Ananda (mutia) Dhoni
190 EM DH Ny. Heliana Mawaddah
191 DN DY By. M. Ananda Ilhami Dhoni

1/20/2015 195 TA PR An. Rahmatullah (mutia) Tia

196 RN/RT APS Ny. Mahdayani Taufik

1/21/2015 199 RN/RT DY An. Nurul Huda Taufik

200 RN/RT DY An. Dina Nabila Renny
204 TA/RT ifiq Tn. Adi Rosyadi Taufik
206 TA DY An. Talita Alifah Tia
207 TA SY An. Rizka Aulia Putri Hafizah
208 TA DY An. Ahmad Zaini Hafizah
209 TA aps An. Fathan (kaka dina) Tia
210 TA aps An. Dina Nabila x
211 TA SY Tn. Lukman Wahyudi Hafizah

1/22/2015 217 EM isd An. M. Nasir Fathur

219 EM DY An. M. Syahid Mawaddah
220 DN ifiq An. Ayu x
223 DN/RT ifiq An. Zahra Lutfhi
226 DN hfz An. Sebastia Lutfhi
230 RN Ridha An. Ajeng Ayu Hafizah
1/23/2015 232 RN ridha An. Dwi Handayani Renny
238 RN/RT DY An. AzkiaSamha Saufa Renny
239 RN/RT DY An. Nanda Amelia Renny
240 RN/RT isd Ny. Yayuk Siska
241 RN/RT RY Ny. Dr. Rahayu, Sp.OG Renny
242 RN/RT RL Ny. Hj. Fadluniah Taufik
244 EM/RT Idola An. M. Fajar siska
245 EM idola Tn. Yunus (suami K'yulida) siska

1/24/2015 257 TA DY An. Kenzi Mawaddah

260 TA/RT aps An. Medina Tia

1/25/2015 265 RN aps Tn. Sofiyan noor Renny

271 EM RD An. M. Putra Fajar Ramadhan Hafizah
272 EM RD Ny. Noor Aisyah k'yulida
273 EM aps Ny. Hj. Zahrah Mawaddah
276 TA hfz tn. dr. M. Hafidz Tia
2015

Bagian

UGD
UGD
Laboratorium

UGD

Laboratorium

Laboratorium
Laboratorium

Laboratorium

Laboratorium
Laboratorium
UGD

Laboratorium
Laboratorium
Laboratorium
Laboratorium

UGD
Laboratorium
Laboratorium
Laboratorium
Laboratorium
Laboratorium

Laboratorium
Laboratorium
Laboratorium
Laboratorium

Laboratorium
Laboratorium
Laboratorium
Laboratorium
Laboratorium
UGD
Laboratorium
Laboratorium

Laboratorium
Laboratorium
Laboratorium

Laboratorium

Laboratorium
Laboratorium

Laboratorium
Laboratorium
Laboratorium
Laboratorium
UGD
Laboratorium
Laboratorium

UGD
2015

Bagian

UGD
Laboratorium
Laboratorium
Laboratorium

Laboratorium
Laboratorium
Laboratorium
Laboratorium
UGD
UGD

Laboratorium

UGD

Laboratorium
Laboratorium
Laboratorium

UGD
Laboratorium
Laboratorium
Laboratorium

Laboratorium
Laboratorium

Laboratorium
Laboratorium
Laboratorium
Laboratorium
UGD
UGD
Laboratorium

UGD

UGD
Laboratorium

UGD
UGD
UGD
Laboratorium
Laboratorium
Laboratorium
UGD
Laboratorium
Laboratorium
UGD
UGD

Laboratorium
Laboratorium

Laboratorium
UGD
UGD
Laboratorium
Laboratorium
 DATA SAMPLING RAWAT JALAN LAB. APRIL 2015

Tanggal No.Lab. Analis dr. Nama Pasien Sampling

12/26/2014 151 RN DY An. Nasya Putri x

152 RN ifiq Ny. Asniah siska
153 RN ifiq An. Danish siska
154 EM DY An. M. Fathi Mawaddah

12/27/2014 160 TA ifiq An. Afifa Rahman x

161 TA/EM ifiq An. Hernawati siska

12/29/2014 180 TA idola An. Davina Soraya Tia

12/30/2014 184 TA DY An. Narsya Regita Tia

186 RN/RT DY An. Nararia Renny

12/31/2014 194 DN/RT RY Ny. Nur Faridah Dhoni

1/2/2015 9 EM/RT DY An. Nararia Mawaddah

10 EM/RT DY An. Siti Nor syifa Mawaddah
14 EM hfz An. Putri k'yulida

1/3/2015 20 TA aps Tn. Djunaidi Tia

22 EM/RT aps An. M. Syarif Habibi Mawaddah
23 RN DY An. Ahyan Mawaddah
24 RN DY An. Nararia Mawaddah

1/4/2015 25 DN isd Tn. Wahyu Kurniawan lutfi

27 DN aps Ny. Siti Hamriah dhoni
30 TA DY An. Nararia tia
31 TA RS Mutia An. M. Dafa tia
33 TA aps Ny. Gusti Kardina tia
37 RN Anin An. M. Amar (anak pipit) renny
38 RN hfz Nn. Marlina x

1/5/2015 40 RN DY An. Wari Nugroho renny

44 RN/RT aps Tn. Abdul Hadi taufik
46 DN/RT aps Ny. Muriaty (loundry) dhoni
56 EM/RT DY An. Afifa Mikaila mawaddah

1/7/2015 68 RT/TA DH Ny. Dewi taufik

71 EM DH Ny. Dina mawaddah
72 EM aps Ny. Reka mawaddah
1/8/2015 80 TA aps Tn. Poniran tia
 81 TA aps Ny. Marlina tia
83 TA idola Ny. Nor Hassanah fatur

1/9/2015 89 DN DY An. Haikal x

90 DN/RT DY An. Karisa dhoni
91 EM/RT SF An. Chika mawaddah
93 EM/RT DY An. Karisa x

1/10/2015 101 TA DY An. Ayra tia

103 EM/RT ifiq An. Lailatus Saadah mawaddah
109 DN Anin An. Yudi dhoni

1/11/2015 113 TA DH Ny. Nanik Maryani x

114 TA DH Ny. Ernawati x
116 EM aps Tn. Edy Ariansyah mawaddah

1/12/2015 120 DN/RT aps Nn. Supriatin (Admin) mawaddah

121 DN/RT aps Ny. Imas (kasir) dhoni

1/13/2015 125 TA DH Ny. Yanti tia

127 RT/DN aps Ny. Hj. Zunaidah taufik
132 RT/DN ifiq An. Yona Maudita taufik
134 EM DH Ny. Mursidah mawaddah
135 EM SY An. Ahmad Aditya Lutfi hafizah
136 EM Anin Tn. Aspihani (mertua dr. Anin) mawaddah
137 EM Anin Ny. Jumiatun (mertua dr. Anin) mawaddah

1/14/2015 141 RN Idola An. Nadia Khairunnisa Lutfhi

142 RN DH Ny. Marina x

DATA SAMPLING RAWAT JALAN LAB. JANUARI 2015

Tanggal No.Lab. Analis dr. Nama Pasien Sampling

1/15/2015 146 DN/RT ifiq An. Antin siska

147 EM DY An. Khodijah Mawaddah
148 EM idola Ny. Noor Hasanah Mawaddah
149 EM idola An. M. Elvian Mawaddah

1/16/2015 151 EM DY An. Febri Aulia Mawaddah

152 EM DY An. Aldito Mawaddah
154 DN/RT APS Ny. Marlina Taufik
155 RN DY An. Abdurrahman Hafiz Renny
 156 RN DY An. M. Khairul Fikri Fathur
157 RN SY Tn. M. Kahirul Syafi'i Fathur

1/17/2015 167 TA aps Ny. Marlina Tia

1/18/2015 168 TA RD An. Nazamah Huda Fathur

1/19/2015 175 DN anin An. M. Zibran B. Kaflin Dhoni

178 RN/DN DY An. Nasya Putri Renny
182 RN/DN DY An. M. Sayuti Renny
185 EM aps Ny. Nia x
188 EM ifiq An. Elvian siska
189 DN AA Ny. Yuli Ananda (mutia) Dhoni
190 EM DH Ny. Heliana Mawaddah
191 DN DY By. M. Ananda Ilhami Dhoni

1/20/2015 195 TA PR An. Rahmatullah (mutia) Tia

196 RN/RT APS Ny. Mahdayani Taufik

1/21/2015 199 RN/RT DY An. Nurul Huda Taufik

200 RN/RT DY An. Dina Nabila Renny
204 TA/RT ifiq Tn. Adi Rosyadi Taufik
206 TA DY An. Talita Alifah Tia
207 TA SY An. Rizka Aulia Putri Hafizah
208 TA DY An. Ahmad Zaini Hafizah
209 TA aps An. Fathan (kaka dina) Tia
210 TA aps An. Dina Nabila x
211 TA SY Tn. Lukman Wahyudi Hafizah

1/22/2015 217 EM isd An. M. Nasir Fathur

219 EM DY An. M. Syahid Mawaddah
220 DN ifiq An. Ayu x
223 DN/RT ifiq An. Zahra Lutfhi
226 DN hfz An. Sebastia Lutfhi
230 RN Ridha An. Ajeng Ayu Hafizah

1/23/2015 232 RN ridha An. Dwi Handayani Renny

238 RN/RT DY An. AzkiaSamha Saufa Renny
239 RN/RT DY An. Nanda Amelia Renny
240 RN/RT isd Ny. Yayuk Siska
241 RN/RT RY Ny. Dr. Rahayu, Sp.OG Renny
242 RN/RT RL Ny. Hj. Fadluniah Taufik
244 EM/RT Idola An. M. Fajar siska
245 EM idola Tn. Yunus (suami K'yulida) siska
1/24/2015 257 TA DY An. Kenzi Mawaddah
260 TA/RT aps An. Medina Tia

1/25/2015 265 RN aps Tn. Sofiyan noor Renny

271 EM RD An. M. Putra Fajar Ramadhan Hafizah
272 EM RD Ny. Noor Aisyah k'yulida
273 EM aps Ny. Hj. Zahrah Mawaddah
276 TA hfz tn. dr. M. Hafidz Tia

UGD 25
Ruang Anak 0
Ruang Bersalin 0
Laboratorium 70
Dokter 0

Total 95

Mengetahui,
Ttd, Kepala Ruangan Laboratorium

Renny Sislia dr. M. Hafidz Maulana

015

Bagian

UGD
UGD
Laboratorium

UGD

Laboratorium

Laboratorium
Laboratorium

Laboratorium

Laboratorium
Laboratorium
UGD

Laboratorium
Laboratorium
Laboratorium
Laboratorium

UGD
Laboratorium
Laboratorium
Laboratorium
Laboratorium
Laboratorium

Laboratorium
Laboratorium
Laboratorium
Laboratorium

Laboratorium
Laboratorium
Laboratorium
Laboratorium
 Laboratorium
UGD

Laboratorium
Laboratorium

Laboratorium
Laboratorium
Laboratorium

Laboratorium

Laboratorium
Laboratorium

Laboratorium
Laboratorium
Laboratorium
Laboratorium
UGD
Laboratorium
Laboratorium

UGD

2015

Bagian

UGD
Laboratorium
Laboratorium
Laboratorium

Laboratorium
Laboratorium
Laboratorium
Laboratorium
 UGD
UGD

Laboratorium

UGD

Laboratorium
Laboratorium
Laboratorium

UGD
Laboratorium
Laboratorium
Laboratorium

Laboratorium
Laboratorium

Laboratorium
Laboratorium
Laboratorium
Laboratorium
UGD
UGD
Laboratorium

UGD

UGD
Laboratorium

UGD
UGD
UGD

Laboratorium
Laboratorium
Laboratorium
UGD
Laboratorium
Laboratorium
UGD
UGD
 Laboratorium
Laboratorium

Laboratorium
UGD
UGD
Laboratorium
Laboratorium

Total Biaya
Rp 250,000
Rp -
Rp -
Rp 700,000
Rp -

Rp 950,000