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DAFTAR KUNJUNGAN PESERTA SAKIT

Kantor Cabang : MADIUN (1303)


FKTP : DEMANGAN (13080102)

NO TANGGAL NO KUNJUNGAN NO KARTU NAMA PESERTA SEX JENIS PESERTA DIAGNOSA DIRUJUK
1 31/12/201 130801021218Y002419 0000078780183 UNTUNG L PENERIMA PENSIUN Cataract, unspecified YA
2 31/12/201 130801021218Y002421 0000106315244 SUPARNO L PNS DAERAH Sequelae of other and unspecified YA
3 31/12/201 130801021218Y002432 0000146173757 SUYATMI P PNS PUSAT Cataract, unspecified YA
4 31/12/201 130801021218Y002440 0000786186865 FEMI NUGROHO L PBI (APBN) Benign neoplasm of unspecified site YA
5 31/12/201 130801021218Y002424 0000786698469 SITI AMINAH P PBI (APBN) Abnormal finding on antenatal YA
6 31/12/201 130801021218Y002442 0000786812376 ANDHITA EKA NURCAHYA P PBI (APBN) Ingrowing nail YA
7 31/12/201 130801021218Y002436 0000787117026 BAMBANG HARIYANTO L PBI (APBN) Fracture of shoulder and upper arm YA
8 31/12/201 130801021218Y002430 0001049783501 DIAH AYU KARTIKA P PBI (APBN) Corns and callosities YA
9 31/12/201 130801021218Y002422 0001083594982 SOEPI P PBI (APBN) Dyspepsia YA
10 31/12/201 130801021218Y002434 0001476158758 NABILA NUR KHALIFAH P PEKERJA MANDIRI Hordeolum and chalazion YA
11 31/12/201 130801021218Y002435 0001535989779 PULPITOSARI P PEKERJA MANDIRI Abnormal finding on antenatal YA
12 31/12/201 130801021218Y002445 0001537902292 NISA SALSABILA EKO PUTRI P PEGAWAI BUMN Pulpitis TIDAK
13 31/12/201 130801021218Y002420 0001543956322 RINA P PEGAWAI SWASTA Pleurisy YA
14 31/12/201 130801021218Y002418 0001704729971 RACHMAN L PBI (APBD) Mixed asthma YA
15 31/12/201 130801021218Y002443 0001704730342 LASINI P PBI (APBD) Non-insulin-dependent diabetes YA
16 31/12/201 130801021218Y002439 0001825204195 HIZKIA NOVANDIKA L PEKERJA MANDIRI Psoriasis, unspecified TIDAK
17 31/12/201 130801021218Y002441 0001846762661 WIJI L PEGAWAI SWASTA Chronic sinusitis, unspecified YA
18 31/12/201 130801021218Y002438 0002121545406 PUJI SUROSO L PBI (APBN) Sprain and strain of ankle YA
19 31/12/201 130801021218Y002417 0002163698853 SUHARTONO L PBI (APBD) Chronic obstructive pulmonary disease, YA
20 31/12/201 130801021218Y002429 0002163709282 SULASTRI P PBI (APBD) Chronic kidney disease YA

09/01/2019 16.06.19
DAFTAR KUNJUNGAN PESERTA SAKIT

Kantor Cabang : MADIUN (1303)


FKTP : DEMANGAN (13080102)

NO TANGGAL NO KUNJUNGAN NO KARTU NAMA PESERTA SEX JENIS PESERTA DIAGNOSA DIRUJUK
21 31/12/201 130801021218Y002433 0002242940624 KHALID MAULANA L PEGAWAI SWASTA Other and unspecified infectious YA
22 31/12/201 130801021218Y002437 0002298568015 SUNARTO SUMARWI L PEKERJA MANDIRI Sequelae of other and unspecified YA
23 31/12/201 130801021218Y002426 0002413138397 BRILLIANT AKHYAR AL L PBI (APBD) Gastroenteritis and colitis of YA
24 31/12/201 130801021218Y002447 0002413963449 NANIEK FARIDA P PBI (APBD) Periapical abscess without sinus TIDAK
25 31/12/201 130801021218Y002423 0002413991799 WERDININGSIH P PBI (APBD) Acute and transient psychotic disorder, YA
26 31/12/201 130801021218Y002446 0002447445519 UMI SYAROH P PEGAWAI SWASTA Caries limited to enamel TIDAK
27 31/12/201 130801021218Y002448 0002487252194 SULTHON FAIZI L PEKERJA MANDIRI Necrosis of pulp TIDAK
28 28/12/201 130801021218Y002314 0000078753486 SITI ROCHMANIYAH P PENERIMA PENSIUN Necrosis of pulp TIDAK
29 28/12/201 130801021218Y002345 0000078753486 SITI ROCHMANIYAH P PENERIMA PENSIUN Systemic disorders of connective tissue TIDAK
30 28/12/201 130801021218Y002411 0000078770575 SUKADI L PENERIMA PENSIUN Essential (primary) hypertension TIDAK
31 28/12/201 130801021218Y002316 0000078772048 RUSBANDIATI P PENERIMA PENSIUN Systemic disorders of connective tissue TIDAK
32 28/12/201 130801021218Y002379 0000104772497 RIZA RAHMAWATI P PRAJURIT AU Caries of dentine TIDAK
33 28/12/201 130801021218Y002331 0000104851539 SUWAWI WIDI UTOMO L PNS DAERAH Systemic disorders of connective tissue TIDAK
34 28/12/201 130801021218Y002334 0000105075483 ENY MORTININGSIH P PENERIMA PENSIUN Disorders of vestibular function YA
35 28/12/201 130801021218Y002359 0000105079487 NAFSIYAH P PENERIMA PENSIUN Sequelae of other and unspecified YA
36 28/12/201 130801021218Y002298 0000106315244 SUPARNO L PNS DAERAH Sequelae of other and unspecified YA
37 28/12/201 130801021218Y002380 0000106434797 AHKMAT L PNS DAERAH Necrosis of pulp TIDAK
38 28/12/201 130801021218Y002415 0000106434819 FEBRIAN AIDA MURTI P PNS DAERAH Caries of dentine TIDAK
39 28/12/201 130801021218Y002370 0000149549229 YOSEP SETIAWAN, S.TH L PNS DAERAH Influenza with other manifestations, TIDAK
40 28/12/201 130801021218Y002384 0000200745347 AMIIDAH SALSABILA P PNS DAERAH Supernumerary teeth TIDAK
41 28/12/201 130801021218Y002386 0000737291992 LASENI P PBI (APBN) Non-insulin-dependent diabetes TIDAK

09/01/2019 16.06.19
DAFTAR KUNJUNGAN PESERTA SAKIT

Kantor Cabang : MADIUN (1303)


FKTP : DEMANGAN (13080102)

NO TANGGAL NO KUNJUNGAN NO KARTU NAMA PESERTA SEX JENIS PESERTA DIAGNOSA DIRUJUK
42 28/12/201 130801021218Y002347 0000786084063 KASIRATUN P PBI (APBN) Systemic disorders of connective tissue TIDAK
43 28/12/201 130801021218Y002304 0000786098259 GENDUT L PBI (APBN) Hyperplasia of prostate YA
44 28/12/201 130801021218Y002350 0000786099453 SUNARTI P PBI (APBN) Systemic disorders of connective tissue TIDAK
45 28/12/201 130801021218Y002398 0000786231494 DJUARIYAH P PBI (APBN) Cough TIDAK
46 28/12/201 130801021218Y002385 0000786267257 BIRANTO L PBI (APBN) Cough TIDAK
47 28/12/201 130801021218Y002382 0000786405148 SRI WAHYUNI P PBI (APBN) Non-insulin-dependent diabetes TIDAK
48 28/12/201 130801021218Y002317 0000786428335 SRI MUJIATI P PBI (APBN) Systemic disorders of connective tissue TIDAK
49 28/12/201 130801021218Y002308 0000786432003 MOCHAMAD JAPAR L PBI (APBN) Unilateral or unspecified inguinal YA
50 28/12/201 130801021218Y002300 0000786466967 SUNYOTO L PBI (APBN) Acute and transient psychotic YA
51 28/12/201 130801021218Y002339 0000786505454 TINI P PBI (APBN) Systemic disorders of connective tissue TIDAK
52 28/12/201 130801021218Y002325 0000786748274 WAKIDI L PBI (APBN) Systemic disorders of connective tissue TIDAK
53 28/12/201 130801021218Y002327 0000786752392 SUMARMI P PBI (APBN) Essential (primary) hypertension TIDAK
54 28/12/201 130801021218Y002318 0000786786625 WIWIK P PBI (APBN) Systemic disorders of connective tissue TIDAK
55 28/12/201 130801021218Y002319 0000786787773 DINA AGUSTIN RAHMAWATI P PBI (APBN) Fever, unspecified TIDAK
56 28/12/201 130801021218Y002362 0000786802465 WAHYU DWI LESTARI P PBI (APBN) Influenza with other manifestations, TIDAK
57 28/12/201 130801021218Y002313 0000786803141 RISA IS UTAMI P PBI (APBN) Influenza with other manifestations, TIDAK
58 28/12/201 130801021218Y002412 0000786806177 SITI LATIFAH P PBI (APBN) Essential (primary) hypertension TIDAK
59 28/12/201 130801021218Y002413 0000786806324 FITRI MAHANIK NOER P PBI (APBN) Gastritis, unspecified TIDAK
60 28/12/201 130801021218Y002332 0000786855464 PATONAH P PBI (APBN) Non-insulin-dependent diabetes TIDAK
61 28/12/201 130801021218Y002369 0000787007799 CHINTASHA AGRANATHA P PBI (APBN) Disturbances in tooth eruption TIDAK
62 28/12/201 130801021218Y002401 0000787093648 ANTI ROFIAH P PBI (APBN) Allergic contact dermatitis TIDAK

09/01/2019 16.06.19
DAFTAR KUNJUNGAN PESERTA SAKIT

Kantor Cabang : MADIUN (1303)


FKTP : DEMANGAN (13080102)

NO TANGGAL NO KUNJUNGAN NO KARTU NAMA PESERTA SEX JENIS PESERTA DIAGNOSA DIRUJUK
63 28/12/201 130801021218Y002329 0000787198476 MUSINAH P PBI (APBN) Myalgia TIDAK
64 28/12/201 130801021218Y002344 0000787205889 AMBOROWATI P PBI (APBN) Necrosis of pulp TIDAK
65 28/12/201 130801021218Y002336 0000787228738 SUKINAH P PBI (APBN) Essential (primary) hypertension TIDAK
66 28/12/201 130801021218Y002354 0000787287565 YAYUK SETYOWATI P PBI (APBN) General counselling and advice on TIDAK
67 28/12/201 130801021218Y002356 0000787422249 SRI ISNARNI P PBI (APBN) Systemic disorders of connective tissue TIDAK
68 28/12/201 130801021218Y002400 0001049782421 PURWANINGSIH P PBI (APBN) Cough TIDAK
69 28/12/201 130801021218Y002406 0001049782915 SULASTRI P PBI (APBN) Cough TIDAK
70 28/12/201 130801021218Y002333 0001049783231 SITI WAHJOENI P PBI (APBN) Non-insulin-dependent diabetes TIDAK
71 28/12/201 130801021218Y002391 0001049785031 MARIYAH P PBI (APBN) Systemic disorders of connective tissue TIDAK
72 28/12/201 130801021218Y002405 0001083359597 SUMINEM P PBI (APBN) Non-insulin-dependent diabetes TIDAK
73 28/12/201 130801021218Y002312 0001101141595 SITI SUMARTINI P ANGGOTA POLRI Other and unspecified infectious TIDAK
74 28/12/201 130801021218Y002387 0001149821515 CATUR WIDODO L PEGAWAI SWASTA Otitis externa TIDAK
75 28/12/201 130801021218Y002315 0001274270049 MUHAMMAD IQZA L PEKERJA MANDIRI Influenza with other manifestations, TIDAK
76 28/12/201 130801021218Y002324 0001302639309 SADJIMIN L PENERIMA PENSIUN Non-insulin-dependent diabetes TIDAK
77 28/12/201 130801021218Y002321 0001317779829 DRH.ERNIYATI P ANGGOTA POLRI Necrosis of pulp TIDAK
78 28/12/201 130801021218Y002360 0001445870507 SEAN MIKHAEL PERASIM L PNS DAERAH Influenza with other manifestations, TIDAK
79 28/12/201 130801021218Y002307 0001445870507 SEAN MIKHAEL PERASIM L PNS DAERAH Relapsing fevers TIDAK
80 28/12/201 130801021218Y002393 0001542753303 AFI KUSUMA DEWI P PEKERJA MANDIRI Allergic contact dermatitis TIDAK
81 28/12/201 130801021218Y002377 0001645504604 SRI WAHYUNI WINANTU P PEGAWAI SWASTA Necrosis of pulp TIDAK
82 28/12/201 130801021218Y002351 0001704708821 SATIYEM P PBI (APBD) Other headache syndromes TIDAK
83 28/12/201 130801021218Y002375 0001704709934 SUNARYANTO L PEGAWAI SWASTA Systemic disorders of connective tissue TIDAK

09/01/2019 16.06.19
DAFTAR KUNJUNGAN PESERTA SAKIT

Kantor Cabang : MADIUN (1303)


FKTP : DEMANGAN (13080102)

NO TANGGAL NO KUNJUNGAN NO KARTU NAMA PESERTA SEX JENIS PESERTA DIAGNOSA DIRUJUK
84 28/12/201 130801021218Y002305 0001704713084 SUPENI P PBI (APBD) Non-insulin-dependent diabetes YA
85 28/12/201 130801021218Y002343 0001704715457 PURYANI P PBI (APBD) Gout TIDAK
86 28/12/201 130801021218Y002403 0001704720576 MARSINI P PBI (APBD) Non-insulin-dependent diabetes TIDAK
87 28/12/201 130801021218Y002348 0001704724424 KASNO L PBI (APBD) Gout TIDAK
88 28/12/201 130801021218Y002390 0001704725684 PUTRI GITA C P PBI (APBD) Allergic contact dermatitis TIDAK
89 28/12/201 130801021218Y002365 0001704726753 SIYAM P PBI (APBD) Allergic contact dermatitis, unspecified TIDAK
90 28/12/201 130801021218Y002341 0001704727214 ROBERTHA PRIN P PBI (APBD) Systemic disorders of connective tissue TIDAK
91 28/12/201 130801021218Y002335 0001704846734 PASYA TATA AHMADHAN L PBI (APBD) Supernumerary teeth TIDAK
92 28/12/201 130801021218Y002326 0001704848725 EKA FAYATI MAULIDA P PBI (APBD) Pulpitis TIDAK
93 28/12/201 130801021218Y002407 0001829779334 ANGGITA NOVERICHA P PEGAWAI PEMERINTAH Influenza with other manifestations, TIDAK
94 28/12/201 130801021218Y002399 0001993082692 YULIA PERTIWI ANGGRAINI P PBI (APBN) Influenza with other manifestations, TIDAK
95 28/12/201 130801021218Y002389 0002068160995 IRSYAD YUSUF L PEGAWAI SWASTA Allergic contact dermatitis, unspecified TIDAK
96 28/12/201 130801021218Y002299 0002163555393 MURSINI P PBI (APBD) Carcinoma in situ of cervix, unspecified YA
97 28/12/201 130801021218Y002416 0002163556967 SOIMAN SITANGGANG L PBI (APBD) Caries of dentine TIDAK
98 28/12/201 130801021218Y002366 0002163558688 BAGAS ROYTAKA PUTRA L PBI (APBD) Diarrhoea and gastroenteritis of TIDAK
99 28/12/201 130801021218Y002338 0002163564202 NURFA AULIA RAHMADANI P PBI (APBD) Diarrhoea and gastroenteritis of TIDAK
100 28/12/201 130801021218Y002301 0002163564202 NURFA AULIA RAHMADANI P PBI (APBD) Gastroenteritis and colitis of TIDAK
101 28/12/201 130801021218Y002404 0002163564652 ADELIO AZZAM PRANAJA L PBI (APBD) Influenza with other manifestations, TIDAK
102 28/12/201 130801021218Y002381 0002163570502 GABRIELLA AGATHA P PBI (APBD) Supernumerary teeth TIDAK
103 28/12/201 130801021218Y002409 0002163688119 SUSILO EDY PRANOTO L PBI (APBD) Non-insulin-dependent diabetes TIDAK
104 28/12/201 130801021218Y002414 0002163689302 ENDANG RAHAYU P PBI (APBD) Cough TIDAK

09/01/2019 16.06.19
DAFTAR KUNJUNGAN PESERTA SAKIT

Kantor Cabang : MADIUN (1303)


FKTP : DEMANGAN (13080102)

NO TANGGAL NO KUNJUNGAN NO KARTU NAMA PESERTA SEX JENIS PESERTA DIAGNOSA DIRUJUK
105 28/12/201 130801021218Y002410 0002163689379 ALYA NIDAU FAIZA P PBI (APBD) Influenza with other manifestations, TIDAK
106 28/12/201 130801021218Y002402 0002163690663 UNTUNG SUTJIPTO L PBI (APBD) Essential (primary) hypertension TIDAK
107 28/12/201 130801021218Y002357 0002163690674 SAYEM P PBI (APBD) Essential (primary) hypertension TIDAK
108 28/12/201 130801021218Y002388 0002163691203 ERLIN YUNANING P PBI (APBD) Gastritis, unspecified TIDAK
109 28/12/201 130801021218Y002371 0002163691214 AFIFAH AZ ZAHRA P PBI (APBD) Influenza with other manifestations, TIDAK
110 28/12/201 130801021218Y002408 0002163698864 SOEKATNI P PBI (APBD) Essential (primary) hypertension TIDAK
111 28/12/201 130801021218Y002322 0002163701373 RUJITO L PBI (APBD) Mixed asthma TIDAK
112 28/12/201 130801021218Y002330 0002163706187 SLAMET L PBI (APBD) Chronic obstructive pulmonary disease, TIDAK
113 28/12/201 130801021218Y002323 0002163706424 WINARSIH P PBI (APBD) Systemic disorders of connective tissue TIDAK
114 28/12/201 130801021218Y002367 0002163706694 JUMAATI P PBI (APBD) Congestive heart failure YA
115 28/12/201 130801021218Y002363 0002163714625 CHALISTA NEVA AZALIA P PBI (APBD) Supernumerary teeth TIDAK
116 28/12/201 130801021218Y002346 0002163715659 RUSMINI P PBI (APBD) Essential (primary) hypertension TIDAK
117 28/12/201 130801021218Y002373 0002163717336 WILDAN ATHA BIMA L PBI (APBD) Zoster [herpes zoster] TIDAK
118 28/12/201 130801021218Y002361 0002163718844 NURUL HAYATI P PBI (APBD) Contraceptive management TIDAK
119 28/12/201 130801021218Y002309 0002163720508 WIJI RAHAYU P PBI (APBD) Contraceptive management TIDAK
120 28/12/201 130801021218Y002364 0002163885445 LINDA CHANDRA KUSUMA P PBI (APBD) Necrosis of pulp TIDAK
121 28/12/201 130801021218Y002376 0002281903345 LILIK RUSMINAH P PEKERJA MANDIRI Necrosis of pulp TIDAK
122 28/12/201 130801021218Y002297 0002319235964 DWI KRISTIATI P PEKERJA MANDIRI Cystic kidney disease YA
123 28/12/201 130801021218Y002397 0002327799723 ASKA RADITYA PUTRA L PEKERJA MANDIRI Influenza with other manifestations, TIDAK
124 28/12/201 130801021218Y002355 0002327799723 ASKA RADITYA PUTRA L PEKERJA MANDIRI Influenza with other manifestations, TIDAK
125 28/12/201 130801021218Y002372 0002354078935 SAMIRAH P PBI (APBN) Systemic disorders of connective tissue TIDAK

09/01/2019 16.06.19
DAFTAR KUNJUNGAN PESERTA SAKIT

Kantor Cabang : MADIUN (1303)


FKTP : DEMANGAN (13080102)

NO TANGGAL NO KUNJUNGAN NO KARTU NAMA PESERTA SEX JENIS PESERTA DIAGNOSA DIRUJUK
126 28/12/201 130801021218Y002306 0002413045528 RIO HARTO L PBI (APBD) Sequelae of other and unspecified YA
127 28/12/201 130801021218Y002352 0002413109417 WAHYUDI L PBI (APBD) Acute pharyngitis, unspecified TIDAK
128 28/12/201 130801021218Y002320 0002413111509 ILUD FITRIANI P PBI (APBD) Other and unspecified infectious TIDAK
129 28/12/201 130801021218Y002358 0002413114132 SURYA PRASETYA L PBI (APBD) Systemic disorders of connective tissue TIDAK
130 28/12/201 130801021218Y002368 0002413119047 KWEE SIOE IEN P PBI (APBD) Gonarthrosis [arthrosis of knee] YA
131 28/12/201 130801021218Y002383 0002413137137 YUSI SEPTI WULANDARI P PBI (APBD) Allergic contact dermatitis, unspecified TIDAK
132 28/12/201 130801021218Y002378 0002413145788 BUDIYONO L PBI (APBD) Necrosis of pulp TIDAK
133 28/12/201 130801021218Y002303 0002413153888 WIJI P PBI (APBD) Other benign neoplasm of connective YA
134 28/12/201 130801021218Y002374 0002413849263 SUTJI MARHAENI P PBI (APBD) Non-insulin-dependent diabetes TIDAK
135 28/12/201 130801021218Y002310 0002413896131 SUPARTO L PBI (APBD) Unspecified renal colic YA
136 28/12/201 130801021218Y002394 0002413914772 SRI UTAMI P PBI (APBD) Allergic contact dermatitis TIDAK
137 28/12/201 130801021218Y002353 0002413914772 SRI UTAMI P PBI (APBD) General counselling and advice on TIDAK
138 28/12/201 130801021218Y002395 0002413914783 YUNITA VEREN UTANTO P PBI (APBD) Influenza with other manifestations, TIDAK
139 28/12/201 130801021218Y002396 0002413915492 MALEMI P PBI (APBD) Essential (primary) hypertension TIDAK
140 28/12/201 130801021218Y002392 0002413915593 MURYANINGSIH P PBI (APBD) Essential (primary) hypertension TIDAK
141 28/12/201 130801021218Y002349 0002413926729 MUDJIATI P PBI (APBD) Myalgia TIDAK
142 28/12/201 130801021218Y002311 0002413952504 HASTUTI HERNAWATI P PBI (APBD) Benign neoplasm of breast YA
143 28/12/201 130801021218Y002337 0002413960705 SAMINEM P PBI (APBD) Non-insulin-dependent diabetes TIDAK
144 28/12/201 130801021218Y002302 0002413971977 MUHAMMAD IHSAN L PBI (APBD) Relapsing fevers TIDAK
145 28/12/201 130801021218Y002340 0002413971977 MUHAMMAD IHSAN L PBI (APBD) Fever, unspecified TIDAK
146 28/12/201 130801021218Y002328 0002420801008 SUHADI L PEKERJA MANDIRI Necrosis of pulp TIDAK

09/01/2019 16.06.19
DAFTAR KUNJUNGAN PESERTA SAKIT

Kantor Cabang : MADIUN (1303)


FKTP : DEMANGAN (13080102)

NO TANGGAL NO KUNJUNGAN NO KARTU NAMA PESERTA SEX JENIS PESERTA DIAGNOSA DIRUJUK
147 28/12/201 130801021218Y002342 0002431442103 SABDULLAH WALGOENADI L PEKERJA MANDIRI Essential (primary) hypertension TIDAK
148 27/12/201 130801021218Y002178 0000078533471 ERNI SUBIANTI P PENERIMA PENSIUN TNI Disorder of lipoprotein metabolism, TIDAK
149 27/12/201 130801021218Y002084 0000078549759 SUDARTI P PENERIMA PENSIUN TNI Heart failure, unspecified YA
150 27/12/201 130801021218Y002115 0000078718667 SUHARSIH P PENERIMA PENSIUN Cataract, unspecified YA
151 27/12/201 130801021218Y002239 0000078754779 SEMI L PENERIMA PENSIUN Systemic disorders of connective tissue TIDAK
152 27/12/201 130801021218Y002119 0000104886753 ZASKIA DHEA MUHARROMA P PNS DAERAH Dental caries TIDAK
153 27/12/201 130801021218Y002157 0000105169432 RUSMI P PNS DAERAH Necrosis of pulp TIDAK
154 27/12/201 130801021218Y002151 0000105429576 SAKTIYANINGRUM P PNS DAERAH Systemic disorders of connective tissue TIDAK
155 27/12/201 130801021218Y002240 0000106283676 SARDJU L PNS DAERAH Chronic gingivitis TIDAK
156 27/12/201 130801021218Y002286 0000106283676 SARDJU L PNS DAERAH Chronic gingivitis TIDAK
157 27/12/201 130801021218Y002187 0000106346856 KUSTATIK, S.PD P PNS PUSAT Necrosis of pulp TIDAK
158 27/12/201 130801021218Y002142 0000106347666 CHRISNAWATI ANNA L PNS DAERAH Systemic disorders of connective tissue TIDAK
159 27/12/201 130801021218Y002154 0000196306255 KRISTANTO SAPUTRO L PNS DAERAH Necrosis of pulp TIDAK
160 27/12/201 130801021218Y002118 0000196306536 RATU NADIA P PNS DAERAH Pulpitis TIDAK
161 27/12/201 130801021218Y002177 0000736556679 BUNGA KARTINI P PBI (APBN) Influenza with other manifestations, TIDAK
162 27/12/201 130801021218Y002167 0000737255215 AHMAT SETYAWAN L PBI (APBN) Otitis externa, unspecified TIDAK
163 27/12/201 130801021218Y002291 0000739293513 CANDY ELLIZA CHRISTIANI P PBI (APBN) Influenza with other manifestations, TIDAK
164 27/12/201 130801021218Y002131 0000739415676 SULISTYRINI P PBI (APBN) Oral mucositis (ulcerative) TIDAK
165 27/12/201 130801021218Y002166 0000785250088 SRI WAHYUNI P PBI (APBN) Gastritis, unspecified TIDAK
166 27/12/201 130801021218Y002182 0000786080092 DARMINI P PBI (APBN) Other specified headache syndromes TIDAK
167 27/12/201 130801021218Y002206 0000786102456 ABU PRAYITNO L PBI (APBN) Gastritis, unspecified TIDAK

09/01/2019 16.06.19
DAFTAR KUNJUNGAN PESERTA SAKIT

Kantor Cabang : MADIUN (1303)


FKTP : DEMANGAN (13080102)

NO TANGGAL NO KUNJUNGAN NO KARTU NAMA PESERTA SEX JENIS PESERTA DIAGNOSA DIRUJUK
168 27/12/201 130801021218Y002126 0000786120478 SARIWONO L PBI (APBN) Fever of other and unknown origin TIDAK
169 27/12/201 130801021218Y002201 0000786135363 SARIMUN L PBI (APBN) Gastritis and duodenitis TIDAK
170 27/12/201 130801021218Y002082 0000786135723 SARIYEM P PBI (APBN) Disorders of refraction and YA
171 27/12/201 130801021218Y002174 0000786209332 LILIK PURWANTO L PBI (APBN) Non-insulin-dependent diabetes TIDAK
172 27/12/201 130801021218Y002103 0000786307408 SAHID RIYANTO L PBI (APBN) Peptic ulcer, unspecified as acute or YA
173 27/12/201 130801021218Y002060 0000786328659 MARSILAH P PBI (APBN) Malignant neoplasm of breast, YA
174 27/12/201 130801021218Y002121 0000786378069 MUNDIRAH P PBI (APBN) Gout TIDAK
175 27/12/201 130801021218Y002172 0000786489715 PURMAISELA SARAYA P PBI (APBN) Oral mucositis (ulcerative) TIDAK
176 27/12/201 130801021218Y002197 0000786523419 SURINGAH P PBI (APBN) Essential (primary) hypertension TIDAK
177 27/12/201 130801021218Y002232 0000786532329 RICO NUR CAHYO L PBI (APBN) Influenza with other manifestations, TIDAK
178 27/12/201 130801021218Y002149 0000786700765 SELA TRI NURYANTI P PBI (APBN) Influenza with other manifestations, TIDAK
179 27/12/201 130801021218Y002156 0000786727539 SUKINO L PBI (APBN) Systemic disorders of connective tissue TIDAK
180 27/12/201 130801021218Y002190 0000786750129 LESTARI WARDANI P PBI (APBN) Necrosis of pulp TIDAK
181 27/12/201 130801021218Y002238 0000786750647 SAMINI P PBI (APBN) Non-insulin-dependent diabetes TIDAK
182 27/12/201 130801021218Y002203 0000786760435 BOINAH P PBI (APBN) Other and unspecified infectious TIDAK
183 27/12/201 130801021218Y002059 0000786776602 GUNADI L PBI (APBN) Myalgia YA
184 27/12/201 130801021218Y002236 0000786812376 ANDHITA EKA NURCAHYA P PBI (APBN) Gastritis, unspecified TIDAK
185 27/12/201 130801021218Y002113 0000786853765 KATEMI P PBI (APBN) Benign mammary dysplasia, YA
186 27/12/201 130801021218Y002231 0000786853765 KATEMI P PBI (APBN) Systemic disorders of connective tissue TIDAK
187 27/12/201 130801021218Y002153 0000786854349 AGUS PURWANTO L PBI (APBN) Disorders of lipoprotein metabolism TIDAK
188 27/12/201 130801021218Y002120 0000786865511 SENEN L PBI (APBN) Other and unspecified infectious TIDAK

09/01/2019 16.06.19
DAFTAR KUNJUNGAN PESERTA SAKIT

Kantor Cabang : MADIUN (1303)


FKTP : DEMANGAN (13080102)

NO TANGGAL NO KUNJUNGAN NO KARTU NAMA PESERTA SEX JENIS PESERTA DIAGNOSA DIRUJUK
189 27/12/201 130801021218Y002183 0000786865713 SUMINI P PBI (APBN) Myalgia TIDAK
190 27/12/201 130801021218Y002196 0000786888314 SAMINEM P PBI (APBN) Systemic disorders of connective tissue TIDAK
191 27/12/201 130801021218Y002191 0000787100242 TRIMO L PBI (APBN) Cataract, unspecified TIDAK
192 27/12/201 130801021218Y002229 0000787134104 KUNTORO BAMANTIKA L PBI (APBN) Supernumerary teeth TIDAK
193 27/12/201 130801021218Y002169 0000787263884 SHOFYAN L PBI (APBN) Cough TIDAK
194 27/12/201 130801021218Y002061 0000787311437 MUSINI P PBI (APBN) Hypertensive heart disease without YA
195 27/12/201 130801021218Y002289 0000787727147 YANDIKA BAGUS PRATAMA L PBI (APBN) Influenza with other manifestations, TIDAK
196 27/12/201 130801021218Y002063 0001049783488 SARMI P PBI (APBN) Non-insulin-dependent diabetes YA
197 27/12/201 130801021218Y002116 0001049783578 PRAMiSTI YOGA NINGTYAS P PBI (APBN) Other appendicitis YA
198 27/12/201 130801021218Y002188 0001049784489 HADI SOESENO L PBI (APBN) Cough TIDAK
199 27/12/201 130801021218Y002195 0001049784502 EKO DAMANNURI L PBI (APBN) Acute and transient psychotic TIDAK
200 27/12/201 130801021218Y002205 0001049786875 TH SUDARTI P PBI (APBN) Influenza with other manifestations, TIDAK
201 27/12/201 130801021218Y002207 0001083610348 YULI WINARTI P PBI (APBN) Systemic disorders of connective tissue TIDAK
202 27/12/201 130801021218Y002152 0001110269632 TUMINING P PRAJURIT AL Other headache syndromes TIDAK
203 27/12/201 130801021218Y002235 0001383940157 MINARSIH P PEKERJA MANDIRI Gout TIDAK
204 27/12/201 130801021218Y002162 0001479071283 SITI RAHAYU P PEKERJA MANDIRI Non-insulin-dependent diabetes TIDAK
205 27/12/201 130801021218Y002139 0001530856225 DWIYANA PERTIWI P PEGAWAI SWASTA Other headache syndromes TIDAK
206 27/12/201 130801021218Y002287 0001542004119 HENI PURWATI P PEGAWAI SWASTA Necrosis of pulp TIDAK
207 27/12/201 130801021218Y002140 0001542781719 SUYATI TUMAY WULAN P PEGAWAI SWASTA Influenza with other manifestations, TIDAK
208 27/12/201 130801021218Y002212 0001704706209 MIATI P PBI (APBD) Insulin-dependent diabetes mellitus YA
209 27/12/201 130801021218Y002180 0001704707526 RUM ANGGRAHENI P PBI (APBD) Other headache syndromes TIDAK

09/01/2019 16.06.19
DAFTAR KUNJUNGAN PESERTA SAKIT

Kantor Cabang : MADIUN (1303)


FKTP : DEMANGAN (13080102)

NO TANGGAL NO KUNJUNGAN NO KARTU NAMA PESERTA SEX JENIS PESERTA DIAGNOSA DIRUJUK
210 27/12/201 130801021218Y002133 0001704719024 SOETJIATI P PBI (APBD) Influenza due to other identified TIDAK
211 27/12/201 130801021218Y002168 0001704719698 MUHAMMAD RIZKI L PBI (APBD) Necrosis of pulp TIDAK
212 27/12/201 130801021218Y002175 0001704721724 SITI NURHAYATI P PBI (APBD) Essential (primary) hypertension TIDAK
213 27/12/201 130801021218Y002143 0001704724525 DJUMADI L PBI (APBD) Allergic contact dermatitis, unspecified TIDAK
214 27/12/201 130801021218Y002163 0001704725627 NOTO DIHARJO L PBI (APBD) Essential (primary) hypertension TIDAK
215 27/12/201 130801021218Y002160 0001704727034 IIN KUTIAH P PBI (APBD) Systemic disorders of connective tissue TIDAK
216 27/12/201 130801021218Y002184 0001704727359 RUMIARTI P PBI (APBD) Influenza, virus not identified TIDAK
217 27/12/201 130801021218Y002215 0001704728215 KARTININGRUM P PBI (APBD) Shoulder lesion, unspecified YA
218 27/12/201 130801021218Y002202 0001704732445 MISIYATI P PBI (APBD) Systemic disorders of connective tissue TIDAK
219 27/12/201 130801021218Y002159 0001704845665 PAINI P PBI (APBD) Systemic disorders of connective tissue TIDAK
220 27/12/201 130801021218Y002293 0001704846069 LATIF FATHUS SHOLEHA P PBI (APBD) Influenza with other manifestations, TIDAK
221 27/12/201 130801021218Y002080 0001704846104 AGUS SUSANTO L PBI (APBD) Epilepsy, unspecified YA
222 27/12/201 130801021218Y002230 0001704847601 SHANDY FEBRIAN L PBI (APBD) Supernumerary teeth TIDAK
223 27/12/201 130801021218Y002155 0001830971823 KUSWANTO L PEKERJA MANDIRI Necrosis of pulp TIDAK
224 27/12/201 130801021218Y002158 0001835290405 KATI P PEKERJA MANDIRI Systemic disorders of connective tissue TIDAK
225 27/12/201 130801021218Y002124 0001844118988 DARMINTO L PEGAWAI SWASTA Cough TIDAK
226 27/12/201 130801021218Y002165 0001856574123 HERU SUJATMIKO L PEKERJA MANDIRI Non-insulin-dependent diabetes TIDAK
227 27/12/201 130801021218Y002132 0001871852499 JEFRI PURWANTO L PEGAWAI SWASTA Systemic disorders of connective tissue TIDAK
228 27/12/201 130801021218Y002189 0001871852714 NANIK HARIATI P PEGAWAI SWASTA Contraceptive management TIDAK
229 27/12/201 130801021218Y002136 0001877399616 CHRISTIAN DWI CAHYO L PEGAWAI SWASTA Influenza with other manifestations, TIDAK
230 27/12/201 130801021218Y002144 0001907104994 SULISTIANI P PEKERJA MANDIRI Disorder of urinary system, unspecified TIDAK

09/01/2019 16.06.19
DAFTAR KUNJUNGAN PESERTA SAKIT

Kantor Cabang : MADIUN (1303)


FKTP : DEMANGAN (13080102)

NO TANGGAL NO KUNJUNGAN NO KARTU NAMA PESERTA SEX JENIS PESERTA DIAGNOSA DIRUJUK
231 27/12/201 130801021218Y002145 0002041462934 ARNOLDUS JANSSEN L PEKERJA MANDIRI Influenza with pneumonia, influenza TIDAK
232 27/12/201 130801021218Y002138 0002163553007 RAZYID FARDI ADNANTA L PBI (APBD) Fever, unspecified TIDAK
233 27/12/201 130801021218Y002125 0002163555494 SUKMAWATI KURNIA P PBI (APBD) Acute gingivitis TIDAK
234 27/12/201 130801021218Y002114 0002163556989 WELVIN SITANGGANG L PBI (APBD) Corns and callosities YA
235 27/12/201 130801021218Y002164 0002163558159 SEVANANDA BUDI P PBI (APBD) Necrosis of pulp TIDAK
236 27/12/201 130801021218Y002181 0002163561322 YAYUK P PBI (APBD) Essential (primary) hypertension TIDAK
237 27/12/201 130801021218Y002294 0002163563357 HAPPY DWI YUNI P PBI (APBD) Gastritis, unspecified TIDAK
238 27/12/201 130801021218Y002127 0002163568408 SAKTI FEBRIYAN PUTRA L PBI (APBD) Dental caries TIDAK
239 27/12/201 130801021218Y002147 0002163570491 ELISABET NATALIA P PBI (APBD) Diarrhoea and gastroenteritis of TIDAK
240 27/12/201 130801021218Y002192 0002163572188 EKA NOVITASARI P PBI (APBD) Necrosis of pulp TIDAK
241 27/12/201 130801021218Y002292 0002163688424 SHIFA AYU WIJAYANTI P PBI (APBD) Influenza with other manifestations, TIDAK
242 27/12/201 130801021218Y002091 0002163688547 WINARKO L PBI (APBD) Cystic kidney disease YA
243 27/12/201 130801021218Y002123 0002163690562 DWI PURWATI P PBI (APBD) Systemic disorders of connective tissue TIDAK
244 27/12/201 130801021218Y002173 0002163696491 BEDJO WIYONO L PBI (APBD) Other disorders of urinary system TIDAK
245 27/12/201 130801021218Y002444 0002163699652 SUGIYANTO L PBI (APBD) Dental caries TIDAK
246 27/12/201 130801021218Y002141 0002163699652 SUGIYANTO L PBI (APBD) Low back pain, site unspecified TIDAK
247 27/12/201 130801021218Y002185 0002163704141 WAHYUNINGRUM P PBI (APBD) Candidiasis of vulva and vagina TIDAK
248 27/12/201 130801021218Y002208 0002163704736 ABDULLAH L PBI (APBD) Periapical abscess without sinus TIDAK
249 27/12/201 130801021218Y002086 0002163705041 SUDIRMAN L PBI (APBD) Systemic disorders of connective tissue TIDAK
250 27/12/201 130801021218Y002220 0002163709282 SULASTRI P PBI (APBD) Chronic kidney disease YA
251 27/12/201 130801021218Y002237 0002163710878 SARMINI P PBI (APBD) Non-insulin-dependent diabetes TIDAK

09/01/2019 16.06.19
DAFTAR KUNJUNGAN PESERTA SAKIT

Kantor Cabang : MADIUN (1303)


FKTP : DEMANGAN (13080102)

NO TANGGAL NO KUNJUNGAN NO KARTU NAMA PESERTA SEX JENIS PESERTA DIAGNOSA DIRUJUK
252 27/12/201 130801021218Y002198 0002163720914 NANIK HANDAYANI P PBI (APBD) Influenza due to other identified TIDAK
253 27/12/201 130801021218Y002122 0002197170887 ADAM SYAHPUTRA ALAM L PEGAWAI SWASTA Influenza due to other identified TIDAK
254 27/12/201 130801021218Y002170 0002197170887 ADAM SYAHPUTRA ALAM L PEGAWAI SWASTA Cough TIDAK
255 27/12/201 130801021218Y002204 0002207406475 HARTINI P PEKERJA MANDIRI Essential (primary) hypertension TIDAK
256 27/12/201 130801021218Y002217 0002229058697 SURATI P PEKERJA MANDIRI Disorders of refraction and YA
257 27/12/201 130801021218Y002209 0002242940624 KHALID MAULANA L PEGAWAI SWASTA Dermatophytosis TIDAK
258 27/12/201 130801021218Y002296 0002300018861 ERLANGGA ADHITAMA L PBI (APBN) Influenza with other manifestations, TIDAK
259 27/12/201 130801021218Y002210 0002300018861 ERLANGGA ADHITAMA L PBI (APBN) Influenza due to other identified TIDAK
260 27/12/201 130801021218Y002146 0002312667281 DARREN JUPITER L PEKERJA MANDIRI Influenza with pneumonia, influenza TIDAK
261 27/12/201 130801021218Y002176 0002413057037 EDI SANTOSO L PBI (APBD) Systemic disorders of connective tissue TIDAK
262 27/12/201 130801021218Y002150 0002413079021 RENATA SETIAWATI P PBI (APBD) Nausea and vomiting TIDAK
263 27/12/201 130801021218Y002134 0002413111083 HERDHIKA DWIKI L PBI (APBD) Otitis externa, unspecified TIDAK
264 27/12/201 130801021218Y002200 0002413113052 KASMINI P PBI (APBD) Disorders of lipoprotein metabolism TIDAK
265 27/12/201 130801021218Y002199 0002413116167 IWING MULYANI P PBI (APBD) Cough TIDAK
266 27/12/201 130801021218Y002171 0002413137339 IMAM SUHADAK L PBI (APBD) Systemic disorders of connective tissue TIDAK
267 27/12/201 130801021218Y002234 0002413138318 DWI KARTIKA ANGGRAINI P PBI (APBD) Influenza with other manifestations, TIDAK
268 27/12/201 130801021218Y002128 0002413139117 DESI SUPRAPTI P PBI (APBD) Necrosis of pulp TIDAK
269 27/12/201 130801021218Y002130 0002413139139 DAVINA ALISKA PUTRI P PBI (APBD) Caries of dentine TIDAK
270 27/12/201 130801021218Y002194 0002413143459 MURDANINGSIH P PBI (APBD) Necrosis of pulp TIDAK
271 27/12/201 130801021218Y002193 0002413143461 INTAN DEWI PEBRIANA P PBI (APBD) Caries of dentine TIDAK
272 27/12/201 130801021218Y002295 0002413150896 NURHAYATI P PBI (APBD) Non-insulin-dependent diabetes TIDAK

09/01/2019 16.06.19
DAFTAR KUNJUNGAN PESERTA SAKIT

Kantor Cabang : MADIUN (1303)


FKTP : DEMANGAN (13080102)

NO TANGGAL NO KUNJUNGAN NO KARTU NAMA PESERTA SEX JENIS PESERTA DIAGNOSA DIRUJUK
273 27/12/201 130801021218Y002135 0002413157297 NURYATI P PBI (APBD) Allergic contact dermatitis, unspecified TIDAK
274 27/12/201 130801021218Y002179 0002413839464 SUYATMI P PBI (APBD) Systemic disorders of connective tissue TIDAK
275 27/12/201 130801021218Y002137 0002413843828 FINALES ZOYA ARABELLA P PBI (APBD) Relapsing fever, unspecified TIDAK
276 27/12/201 130801021218Y002288 0002413902958 SRI HASTUTIK P PBI (APBD) Gastritis, unspecified TIDAK
277 27/12/201 130801021218Y002070 0002413914491 TRI MURDIANTI P PBI (APBD) Disorder of refraction, unspecified YA
278 27/12/201 130801021218Y002112 0002413916752 NANIK HARYANI P PBI (APBD) Sequelae of stroke, not specified as YA
279 27/12/201 130801021218Y002111 0002413920993 WAGI RAHAYU P PBI (APBD) Fever of other and unknown origin TIDAK
280 27/12/201 130801021218Y002117 0002413957847 MARIYATUN P PBI (APBD) Cataract, unspecified YA
281 27/12/201 130801021218Y002129 0002413960457 CHUSNUL CHOTIMAH P PBI (APBD) Influenza with other manifestations, TIDAK
282 27/12/201 130801021218Y002062 0002413961504 SUYANTO L PBI (APBD) Panniculitis affecting regions of neck YA
283 27/12/201 130801021218Y002186 0002413962369 SUMIRAN L PBI (APBD) Hypotension, unspecified TIDAK
284 27/12/201 130801021218Y002161 0002413963833 KATINI P PBI (APBD) Non-insulin-dependent diabetes TIDAK
285 27/12/201 130801021218Y002233 0002428217313 ERISKA AJENG ADE PUTRI P PEKERJA MANDIRI Diarrhoea and gastroenteritis of TIDAK
286 27/12/201 130801021218Y002148 0002439761422 SUKARTI P PEKERJA MANDIRI Gastritis, unspecified TIDAK
287 27/12/201 130801021218Y002290 0002502571735 ARZAN KINZA NUR L PEGAWAI SWASTA Influenza with other manifestations, TIDAK
288 26/12/201 130801021218Y001988 0000078527586 KARSINEM P PENERIMA PENSIUN TNI Fever, unspecified TIDAK
289 26/12/201 130801021218Y001954 0000078547577 SARMININGSIH P PENERIMA PENSIUN TNI Disorders of lipoprotein metabolism TIDAK
290 26/12/201 130801021218Y002000 0000078549153 SUDJIATI P PENERIMA PENSIUN TNI Other and unspecified infectious TIDAK
291 26/12/201 130801021218Y001968 0000078551785 SITI ROMLAH P PENERIMA PENSIUN TNI Gastritis and duodenitis TIDAK
292 26/12/201 130801021218Y002005 0000078719038 DJAJANAH P PENERIMA PENSIUN Essential (primary) hypertension TIDAK
293 26/12/201 130801021218Y001974 0000078758144 SURATI P PENERIMA PENSIUN Influenza, virus not identified TIDAK

09/01/2019 16.06.19
DAFTAR KUNJUNGAN PESERTA SAKIT

Kantor Cabang : MADIUN (1303)


FKTP : DEMANGAN (13080102)

NO TANGGAL NO KUNJUNGAN NO KARTU NAMA PESERTA SEX JENIS PESERTA DIAGNOSA DIRUJUK
294 26/12/201 130801021218Y001976 0000078773624 SUPARNO L PENERIMA PENSIUN Caries limited to enamel TIDAK
295 26/12/201 130801021218Y002004 0000104976044 CAHYO PRASETYO L PEGAWAI SWASTA Otitis externa, unspecified TIDAK
296 26/12/201 130801021218Y001997 0000106435271 ROSYID L PNS DAERAH Cough TIDAK
297 26/12/201 130801021218Y002034 0000106441233 LISMIYARTI P PNS DAERAH Necrosis of pulp YA
298 26/12/201 130801021218Y002021 0000170000392 MIHARSI P PNS DAERAH Non-insulin-dependent diabetes TIDAK
299 26/12/201 130801021218Y001971 0000198997029 TRI HANDAYANI P PNS PUSAT Necrosis of pulp TIDAK
300 26/12/201 130801021218Y001957 0000199699424 KASMIATI P PENERIMA PENSIUN Systemic disorders of connective tissue TIDAK
301 26/12/201 130801021218Y002030 0000735621996 LANGGENG SANTOSO L PBI (APBN) Other and unspecified infectious TIDAK
302 26/12/201 130801021218Y002039 0000737544047 UMI SAIDAH P PBI (APBN) Chronic gingivitis TIDAK
303 26/12/201 130801021218Y002046 0000737544047 UMI SAIDAH P PBI (APBN) Chronic gingivitis TIDAK
304 26/12/201 130801021218Y002001 0000739777814 GIYEM P PBI (APBN) Systemic disorders of connective tissue TIDAK
305 26/12/201 130801021218Y001908 0000785238928 SUTI P PBI (APBN) Non-insulin-dependent diabetes YA
306 26/12/201 130801021218Y001910 0000785253565 SUYATMI P PBI (APBN) Heart failure, unspecified YA
307 26/12/201 130801021218Y002019 0000785829767 HARIYANI P PBI (APBN) Influenza with other manifestations, TIDAK
308 26/12/201 130801021218Y002270 0000785833626 KASIDI L PBI (APBN) Non-insulin-dependent diabetes TIDAK
309 26/12/201 130801021218Y001985 0000786097394 SUMINI P PBI (APBN) Gastritis, unspecified TIDAK
310 26/12/201 130801021218Y002271 0000786102456 ABU PRAYITNO L PBI (APBN) Gastritis, unspecified TIDAK
311 26/12/201 130801021218Y001999 0000786114652 SLAMET L PBI (APBN) Essential (primary) hypertension TIDAK
312 26/12/201 130801021218Y001972 0000786131493 MURDANINGSIH P PBI (APBN) Hypotension TIDAK
313 26/12/201 130801021218Y002009 0000786135363 SARIMUN L PBI (APBN) Gastritis and duodenitis TIDAK
314 26/12/201 130801021218Y002015 0000786156118 EKA DEVI SETIANINGRUM P PBI (APBN) Anodontia YA

09/01/2019 16.06.19
DAFTAR KUNJUNGAN PESERTA SAKIT

Kantor Cabang : MADIUN (1303)


FKTP : DEMANGAN (13080102)

NO TANGGAL NO KUNJUNGAN NO KARTU NAMA PESERTA SEX JENIS PESERTA DIAGNOSA DIRUJUK
315 26/12/201 130801021218Y002055 0000786210434 HERU SISWANTO L PBI (APBN) Gingivitis and periodontal diseases TIDAK
316 26/12/201 130801021218Y002008 0000786247323 MURSINI P PBI (APBN) Systemic disorders of connective tissue TIDAK
317 26/12/201 130801021218Y002007 0000786247457 TITIK INDRAWATI P PBI (APBN) Gastritis, unspecified TIDAK
318 26/12/201 130801021218Y001925 0000786257436 LUSI HARI WIDAYANTI P PBI (APBN) Antenatal screening TIDAK
319 26/12/201 130801021218Y001986 0000786284831 SULANDARI P PBI (APBN) Systemic disorders of connective tissue TIDAK
320 26/12/201 130801021218Y001982 0000786317073 SUNDARI P PBI (APBN) General counselling and advice on TIDAK
321 26/12/201 130801021218Y001998 0000786328659 MARSILAH P PBI (APBN) Periapical abscess without sinus TIDAK
322 26/12/201 130801021218Y001969 0000786328659 MARSILAH P PBI (APBN) Gastritis, unspecified TIDAK
323 26/12/201 130801021218Y001890 0000786357448 DWI YUNI PRASETYOWATI P PBI (APBN) Unspecified maternal hypertension YA
324 26/12/201 130801021218Y001928 0000786361162 SHELA OKTAFIA P PBI (APBN) Contraceptive management TIDAK
325 26/12/201 130801021218Y002037 0000786386428 DARMINI P PBI (APBN) Systemic disorders of connective tissue TIDAK
326 26/12/201 130801021218Y001979 0000786389782 KATEMI P PBI (APBN) Essential (primary) hypertension TIDAK
327 26/12/201 130801021218Y002267 0000786414262 RETNO PUJIASTUTI P PBI (APBN) Gastritis, unspecified TIDAK
328 26/12/201 130801021218Y001980 0000786415768 MUSNI L PBI (APBN) Systemic disorders of connective tissue TIDAK
329 26/12/201 130801021218Y001944 0000786503687 HERI SUSANTO L PBI (APBN) Systemic disorders of connective tissue TIDAK
330 26/12/201 130801021218Y001960 0000786519538 SUKARTI P PBI (APBN) Haemorrhoids TIDAK
331 26/12/201 130801021218Y001965 0000786609009 SUHARTINI P PBI (APBN) Disorders of lipoprotein metabolism TIDAK
332 26/12/201 130801021218Y001964 0000786609573 SUGENG PRANOWO L PBI (APBN) Acute and transient psychotic TIDAK
333 26/12/201 130801021218Y001984 0000786647428 SRI MURYANI P PBI (APBN) General counselling and advice on TIDAK
334 26/12/201 130801021218Y001897 0000786657868 SUGIYO L PBI (APBN) Cataract, unspecified YA
335 26/12/201 130801021218Y002013 0000786701182 KASIYEM P PBI (APBN) Systemic disorders of connective tissue TIDAK

09/01/2019 16.06.19
DAFTAR KUNJUNGAN PESERTA SAKIT

Kantor Cabang : MADIUN (1303)


FKTP : DEMANGAN (13080102)

NO TANGGAL NO KUNJUNGAN NO KARTU NAMA PESERTA SEX JENIS PESERTA DIAGNOSA DIRUJUK
336 26/12/201 130801021218Y001962 0000786733198 BAKRI BUDI PRAYITNO L PBI (APBN) Disorders of lipoprotein metabolism TIDAK
337 26/12/201 130801021218Y001894 0000786750647 SAMINI P PBI (APBN) Other headache syndromes YA
338 26/12/201 130801021218Y001963 0000786754168 TASYA EKA PUSPITA P PBI (APBN) Caries limited to enamel TIDAK
339 26/12/201 130801021218Y001942 0000786754214 RIZKY FEBRIANTO L PBI (APBN) Dental caries TIDAK
340 26/12/201 130801021218Y002012 0000786756161 NURSANTA P PBI (APBN) Acute nasopharyngitis [common cold] TIDAK
341 26/12/201 130801021218Y002275 0000786757364 SUNAR L PBI (APBN) Non-insulin-dependent diabetes TIDAK
342 26/12/201 130801021218Y001959 0000786826181 SUNARTI P PBI (APBN) Essential (primary) hypertension TIDAK
343 26/12/201 130801021218Y001885 0000786849175 SUDIRAHAYU P PBI (APBN) Non-insulin-dependent diabetes YA
344 26/12/201 130801021218Y001887 0000786849963 KARINA DEVINTA P PBI (APBN) Orthopaedic follow-up care, YA
345 26/12/201 130801021218Y002043 0000786850931 SRI ATMENAH P PBI (APBN) Systemic disorders of connective tissue TIDAK
346 26/12/201 130801021218Y002038 0000786851021 ALYA ANIESA SALSABILLA P PBI (APBN) Influenza with other manifestations, TIDAK
347 26/12/201 130801021218Y002048 0000786858131 SUPARLAN L PBI (APBN) Systemic disorders of connective tissue TIDAK
348 26/12/201 130801021218Y002285 0000786875354 MARITA TRISNAWATI P PEGAWAI SWASTA Gastritis, unspecified TIDAK
349 26/12/201 130801021218Y001937 0000786875354 MARITA TRISNAWATI P PEGAWAI SWASTA Antenatal screening TIDAK
350 26/12/201 130801021218Y002016 0000786896875 TUMINEM P PBI (APBN) Allergic contact dermatitis, unspecified TIDAK
351 26/12/201 130801021218Y002014 0000786896987 HARIYADI L PBI (APBN) Acute and transient psychotic TIDAK
352 26/12/201 130801021218Y001888 0000786917496 JONI TRILAKSONO L PBI (APBN) Schizophrenia, unspecified YA
353 26/12/201 130801021218Y002024 0000786997822 PURWANINGSIH P PBI (APBN) Routine postpartum follow-up TIDAK
354 26/12/201 130801021218Y001913 0000787046523 MAQRUF L PBI (APBN) Pleurisy YA
355 26/12/201 130801021218Y001929 0000787111659 MUJIATI P PBI (APBN) Contraceptive management TIDAK
356 26/12/201 130801021218Y002052 0000787208218 BIMA PRATAMA L PBI (APBN) Disturbances in tooth eruption TIDAK

09/01/2019 16.06.19
DAFTAR KUNJUNGAN PESERTA SAKIT

Kantor Cabang : MADIUN (1303)


FKTP : DEMANGAN (13080102)

NO TANGGAL NO KUNJUNGAN NO KARTU NAMA PESERTA SEX JENIS PESERTA DIAGNOSA DIRUJUK
357 26/12/201 130801021218Y002280 0000787213484 WAKIT L PBI (APBN) Systemic disorders of connective tissue TIDAK
358 26/12/201 130801021218Y001994 0000787213552 SEMI P PBI (APBN) Essential (primary) hypertension TIDAK
359 26/12/201 130801021218Y001883 0000787228751 MUDINAH P PBI (APBN) Cerebral infarction, unspecified YA
360 26/12/201 130801021218Y002033 0000787276192 RUSMINI P PBI (APBN) Influenza with other manifestations, TIDAK
361 26/12/201 130801021218Y001991 0000787287565 YAYUK SETYOWATI P PBI (APBN) General counselling and advice on TIDAK
362 26/12/201 130801021218Y001911 0000787311437 MUSINI P PBI (APBN) Sequelae of other and unspecified YA
363 26/12/201 130801021218Y001904 0000787443366 MOCH. SOLEH L PBI (APBN) Chronic kidney disease YA
364 26/12/201 130801021218Y001884 0000787714389 PARINUK P PBI (APBN) Chronic ischaemic heart disease, YA
365 26/12/201 130801021218Y001983 0001045266557 SITI ZULIANI P PBI (APBN) General counselling and advice on TIDAK
366 26/12/201 130801021218Y001938 0001045281644 ARIK PURWATI P PBI (APBN) Antenatal screening TIDAK
367 26/12/201 130801021218Y002284 0001045281644 ARIK PURWATI P PBI (APBN) Gastritis, unspecified TIDAK
368 26/12/201 130801021218Y001931 0001049783433 KASIYATI P PBI (APBN) Contraceptive management TIDAK
369 26/12/201 130801021218Y001902 0001049784041 MEI RAHAYU P PBI (APBN) Abnormal finding on antenatal YA
370 26/12/201 130801021218Y001923 0001194525595 NUR LAILY WAKIDIANTY P PEGAWAI SWASTA Antenatal screening TIDAK
371 26/12/201 130801021218Y002025 0001195890546 AFIQAH RAISA NUR AFANTI P PEGAWAI SWASTA Influenza with other manifestations, TIDAK
372 26/12/201 130801021218Y001891 0001296633161 SOERATI P PEKERJA MANDIRI Chronic ischaemic heart disease, YA
373 26/12/201 130801021218Y001958 0001341478383 SUMINI P PENERIMA PENSIUN Non-insulin-dependent diabetes TIDAK
374 26/12/201 130801021218Y001927 0001439269031 ERNAWATI P PBI (APBD) Antenatal screening, unspecified TIDAK
375 26/12/201 130801021218Y001906 0001445104631 MOEHARSIYAH P PEKERJA MANDIRI Sequelae of other and unspecified YA
376 26/12/201 130801021218Y002058 0001535149359 AMI SUPARMI P PEGAWAI SWASTA Necrosis of pulp TIDAK
377 26/12/201 130801021218Y002269 0001535149359 AMI SUPARMI P PEGAWAI SWASTA Non-insulin-dependent diabetes TIDAK

09/01/2019 16.06.19
DAFTAR KUNJUNGAN PESERTA SAKIT

Kantor Cabang : MADIUN (1303)


FKTP : DEMANGAN (13080102)

NO TANGGAL NO KUNJUNGAN NO KARTU NAMA PESERTA SEX JENIS PESERTA DIAGNOSA DIRUJUK
378 26/12/201 130801021218Y001926 0001535989779 PULPITOSARI P PEKERJA MANDIRI Antenatal screening TIDAK
379 26/12/201 130801021218Y001882 0001546138653 SANTI TRIATMOJO P PEGAWAI SWASTA Follow-up examination after surgery YA
380 26/12/201 130801021218Y002042 0001702388474 MURSYID NUR DWIYONO L PEGAWAI SWASTA Pathological dislocation and YA
381 26/12/201 130801021218Y002276 0001704704523 CHAYAT PUDJI R L PBI (APBD) Non-insulin-dependent diabetes TIDAK
382 26/12/201 130801021218Y002272 0001704705906 NINA MARIANA P PBI (APBD) Allergic contact dermatitis TIDAK
383 26/12/201 130801021218Y001996 0001704705939 ERNAWATI P PBI (APBD) Myalgia TIDAK
384 26/12/201 130801021218Y001995 0001704708101 MENOK KASIYEM P PBI (APBD) Systemic disorders of connective tissue TIDAK
385 26/12/201 130801021218Y001992 0001704708797 IDA PUJI HARTANTI P PBI (APBD) Other antenatal screening TIDAK
386 26/12/201 130801021218Y002431 0001704708999 NANA ERNAWATI P PBI (APBD) Necrosis of pulp TIDAK
387 26/12/201 130801021218Y001973 0001704716752 ICIH P PBI (APBD) Other headache syndromes TIDAK
388 26/12/201 130801021218Y001917 0001704718866 MULYONO L PBI (APBD) Chronic ischaemic heart disease, YA
389 26/12/201 130801021218Y002054 0001704718967 ALGA ALFIAN R L PBI (APBD) Chronic gingivitis TIDAK
390 26/12/201 130801021218Y002002 0001704720925 SAYEM P PBI (APBD) Diarrhoea and gastroenteritis of TIDAK
391 26/12/201 130801021218Y001975 0001704724672 TRI WISNU HAPSARI P PBI (APBD) Systemic disorders of connective tissue TIDAK
392 26/12/201 130801021218Y001912 0001704729328 BAMBANG SUKOCO RIYADI L PBI (APBD) Intervertebral disc disorder, YA
393 26/12/201 130801021218Y001916 0001704730342 LASINI P PBI (APBD) Sequelae of other and unspecified YA
394 26/12/201 130801021218Y001951 0001704731512 SELLY ADE LUTFIANTI P PBI (APBD) Conjunctivitis, unspecified TIDAK
395 26/12/201 130801021218Y002031 0001704842458 RATNAWATI P PBI (APBD) Systemic disorders of connective tissue TIDAK
396 26/12/201 130801021218Y001940 0001704843595 KUNTO AJI SETIONO L PBI (APBD) Gingivitis and periodontal diseases TIDAK
397 26/12/201 130801021218Y001889 0001704846093 PUGUH ARI PURNOMO L PBI (APBD) Tuberculosis of other specified organs YA
398 26/12/201 130801021218Y001919 0001704848894 RAPI LISTIANI P PBI (APBD) Contraceptive management TIDAK

09/01/2019 16.06.19
DAFTAR KUNJUNGAN PESERTA SAKIT

Kantor Cabang : MADIUN (1303)


FKTP : DEMANGAN (13080102)

NO TANGGAL NO KUNJUNGAN NO KARTU NAMA PESERTA SEX JENIS PESERTA DIAGNOSA DIRUJUK
399 26/12/201 130801021218Y002010 0001704856026 USAMAH L PBI (APBD) Influenza with other manifestations, TIDAK
400 26/12/201 130801021218Y001921 0001739100791 EKA SUSANTI P PEGAWAI SWASTA Antenatal screening TIDAK
401 26/12/201 130801021218Y001907 0001773235822 INDRA NURDIANSYAH L PEGAWAI SWASTA Fracture of upper end of ulna, closed YA
402 26/12/201 130801021218Y001909 0001774625444 ARTIK SINTYA RAHAYU P PEGAWAI SWASTA Abnormal finding on antenatal YA
403 26/12/201 130801021218Y001945 0001805158326 DIAH AYU MARGARETHA P PEGAWAI SWASTA Necrosis of pulp TIDAK
404 26/12/201 130801021218Y001893 0001829996853 MUJI WALUYO L PBI (APBD) Chronic ischaemic heart disease, YA
405 26/12/201 130801021218Y002279 0001878966022 NADIA CANTIKHA ZAHRANI P PEGAWAI SWASTA Influenza with other manifestations, TIDAK
406 26/12/201 130801021218Y002011 0001896175541 WAHYUDI L PEGAWAI SWASTA Essential (primary) hypertension TIDAK
407 26/12/201 130801021218Y001939 0002037987887 INDRI OKTAVIA P PEGAWAI SWASTA Antenatal screening TIDAK
408 26/12/201 130801021218Y002028 0002037987887 INDRI OKTAVIA P PEGAWAI SWASTA Influenza with other manifestations, TIDAK
409 26/12/201 130801021218Y002020 0002163547271 WIJIARSIH P PBI (APBD) Non-insulin-dependent diabetes TIDAK
410 26/12/201 130801021218Y001961 0002163547719 SULAMI P PBI (APBD) Systemic disorders of connective tissue TIDAK
411 26/12/201 130801021218Y001952 0002163554684 SRI HARTINI P PBI (APBD) Essential (primary) hypertension TIDAK
412 26/12/201 130801021218Y001895 0002163555393 MURSINI P PBI (APBD) Spontaenous abortion, incomplete, YA
413 26/12/201 130801021218Y001993 0002163555393 MURSINI P PBI (APBD) Other soft tissue disorders, not TIDAK
414 26/12/201 130801021218Y002051 0002163556124 SILFANIA ANDITA P PBI (APBD) Disturbances in tooth eruption TIDAK
415 26/12/201 130801021218Y001981 0002163556629 MUHAMMAD AL FATIH L PBI (APBD) Diarrhoea and gastroenteritis of TIDAK
416 26/12/201 130801021218Y001933 0002163556629 MUHAMMAD AL FATIH L PBI (APBD) Cholera due to Vibrio cholerae 01, TIDAK
417 26/12/201 130801021218Y002273 0002163558148 MEIDINA NASYWA AZARIA P PBI (APBD) Influenza with other manifestations, TIDAK
418 26/12/201 130801021218Y002056 0002163558385 SUYANTO L PBI (APBD) Necrosis of pulp TIDAK
419 26/12/201 130801021218Y002057 0002163558407 HANA AURELYA P PBI (APBD) Dental caries TIDAK

09/01/2019 16.06.19
DAFTAR KUNJUNGAN PESERTA SAKIT

Kantor Cabang : MADIUN (1303)


FKTP : DEMANGAN (13080102)

NO TANGGAL NO KUNJUNGAN NO KARTU NAMA PESERTA SEX JENIS PESERTA DIAGNOSA DIRUJUK
420 26/12/201 130801021218Y001920 0002163565552 LINA BUDIARTI P PBI (APBD) Antenatal screening TIDAK
421 26/12/201 130801021218Y001918 0002163571075 SULISTIYO L PBI (APBD) Insulin-dependent diabetes mellitus YA
422 26/12/201 130801021218Y001932 0002163572032 SUYATI P PBI (APBD) Contraceptive management TIDAK
423 26/12/201 130801021218Y001934 0002163572638 PUJI LESTARI P PBI (APBD) Antenatal screening TIDAK
424 26/12/201 130801021218Y002045 0002163689302 ENDANG RAHAYU P PBI (APBD) Influenza with other manifestations, TIDAK
425 26/12/201 130801021218Y001930 0002163691686 SULASTRI P PBI (APBD) Contraceptive management TIDAK
426 26/12/201 130801021218Y002282 0002163692518 REGINA RASYA LARASATI P PBI (APBD) Influenza with other manifestations, TIDAK
427 26/12/201 130801021218Y002040 0002163694195 ZALFA ZAHIYA MAULINA P PBI (APBD) Pulpitis TIDAK
428 26/12/201 130801021218Y002047 0002163694195 ZALFA ZAHIYA MAULINA P PBI (APBD) Pulpitis TIDAK
429 26/12/201 130801021218Y001970 0002163695591 SONI P PBI (APBD) Non-insulin-dependent diabetes TIDAK
430 26/12/201 130801021218Y001892 0002163695905 SARWOTO L PBI (APBD) Benign lipomatous neoplasm of skin YA
431 26/12/201 130801021218Y001886 0002163698818 NADIA HAYA MUSTIKA P PBI (APBD) Irregular menstruation, unspecified YA
432 26/12/201 130801021218Y001966 0002163699663 PARMIASIH P PBI (APBD) Pulpitis TIDAK
433 26/12/201 130801021218Y001978 0002163702767 SUGIARTI P PBI (APBD) Necrosis of pulp TIDAK
434 26/12/201 130801021218Y001922 0002163702971 NORA INDAH WINDRAYANTI P PBI (APBD) Antenatal screening TIDAK
435 26/12/201 130801021218Y002049 0002163703511 KOMARI L PBI (APBD) Chronic obstructive pulmonary disease, TIDAK
436 26/12/201 130801021218Y001956 0002163705794 YULIADI L PBI (APBD) Other and unspecified infectious TIDAK
437 26/12/201 130801021218Y001914 0002163708189 SRIYANI P PBI (APBD) Chronic kidney disease YA
438 26/12/201 130801021218Y002041 0002163708551 ERVAN EFENDI L PBI (APBD) Acute and transient psychotic disorder, TIDAK
439 26/12/201 130801021218Y001955 0002163708865 KATEMI P PBI (APBD) Allergic contact dermatitis, unspecified TIDAK
440 26/12/201 130801021218Y001935 0002163711791 NAORA VENUS PUTRI P PBI (APBD) Stomatitis and related lesions TIDAK

09/01/2019 16.06.19
DAFTAR KUNJUNGAN PESERTA SAKIT

Kantor Cabang : MADIUN (1303)


FKTP : DEMANGAN (13080102)

NO TANGGAL NO KUNJUNGAN NO KARTU NAMA PESERTA SEX JENIS PESERTA DIAGNOSA DIRUJUK
441 26/12/201 130801021218Y002027 0002163711791 NAORA VENUS PUTRI P PBI (APBD) Oral mucositis (ulcerative) TIDAK
442 26/12/201 130801021218Y002274 0002163718743 KEFIN NABINTARA L PBI (APBD) Influenza with other manifestations, TIDAK
443 26/12/201 130801021218Y001967 0002163723399 SITI MARIYAM P PBI (APBD) Essential (primary) hypertension TIDAK
444 26/12/201 130801021218Y001990 0002163723761 JOVIAN KALINGGA L PBI (APBD) Acute tonsillitis, unspecified TIDAK
445 26/12/201 130801021218Y002029 0002235757307 SABARDI L PEGAWAI SWASTA Systemic disorders of connective tissue TIDAK
446 26/12/201 130801021218Y002283 0002263312135 HASBY JALLA PUTRA L PBI (APBN) Influenza with other manifestations, TIDAK
447 26/12/201 130801021218Y002050 0002300979789 SUYATMI P PEKERJA MANDIRI Necrosis of pulp TIDAK
448 26/12/201 130801021218Y002032 0002310049034 ARIWIDYA POERNAMA P PEGAWAI SWASTA Systemic disorders of connective tissue TIDAK
449 26/12/201 130801021218Y001946 0002413028215 LAEDI L PBI (APBD) Influenza with other manifestations, TIDAK
450 26/12/201 130801021218Y002023 0002413060323 GITO L PBI (APBD) Essential (primary) hypertension TIDAK
451 26/12/201 130801021218Y002266 0002413062786 REZA ERLANGGA L PBI (APBD) Allergic contact dermatitis TIDAK
452 26/12/201 130801021218Y002268 0002413063258 RINI SULISTYOWATI P PBI (APBD) Essential (primary) hypertension TIDAK
453 26/12/201 130801021218Y001948 0002413108721 LINTANG GALIH PRATAMA L PBI (APBD) Fever, unspecified TIDAK
454 26/12/201 130801021218Y001915 0002413110273 TRI APRILIANA P PBI (APBD) Abnormal finding on antenatal YA
455 26/12/201 130801021218Y001977 0002413111509 ILUD FITRIANI P PBI (APBD) Other and unspecified infectious TIDAK
456 26/12/201 130801021218Y001989 0002413113658 SUPIYATUN P PBI (APBD) Essential (primary) hypertension TIDAK
457 26/12/201 130801021218Y002022 0002413116461 MUKINI P PBI (APBD) Systemic disorders of connective tissue TIDAK
458 26/12/201 130801021218Y001941 0002413117247 THESYA AGUSTINE P PBI (APBD) Varicella [chickenpox] TIDAK
459 26/12/201 130801021218Y002053 0002413118733 HARI AGUNG L PBI (APBD) Periapical abscess without sinus TIDAK
460 26/12/201 130801021218Y001900 0002413119227 PURWANINGSIH P PBI (APBD) Non-insulin-dependent diabetes YA
461 26/12/201 130801021218Y002017 0002413135326 ENIK KUSRINI P PBI (APBD) General counselling and advice on TIDAK

09/01/2019 16.06.19
DAFTAR KUNJUNGAN PESERTA SAKIT

Kantor Cabang : MADIUN (1303)


FKTP : DEMANGAN (13080102)

NO TANGGAL NO KUNJUNGAN NO KARTU NAMA PESERTA SEX JENIS PESERTA DIAGNOSA DIRUJUK
462 26/12/201 130801021218Y002044 0002413137756 SULIS SETYAWAN L PBI (APBD) Systemic disorders of connective tissue TIDAK
463 26/12/201 130801021218Y002026 0002413138498 SRIYATUN P PBI (APBD) Systemic disorders of connective tissue TIDAK
464 26/12/201 130801021218Y001903 0002413139556 SAMIRIN L PBI (APBD) Sequelae of other and unspecified YA
465 26/12/201 130801021218Y001899 0002413152639 EDY SANTOSO L PBI (APBD) Thromboangiitis obliterans [Buerger] YA
466 26/12/201 130801021218Y001924 0002413153056 IKA SITI SHOLIHAH P PBI (APBD) Fibroadenosis of breast TIDAK
467 26/12/201 130801021218Y002278 0002413154834 GEOFANNY PUTRA L PBI (APBD) Influenza with other manifestations, TIDAK
468 26/12/201 130801021218Y002277 0002413156948 AURELLIA EVELLYN P PBI (APBD) Influenza with other manifestations, TIDAK
469 26/12/201 130801021218Y001949 0002413839464 SUYATMI P PBI (APBD) Essential (primary) hypertension TIDAK
470 26/12/201 130801021218Y001905 0002413840599 YUNTAR ARIANTO L PBI (APBD) Benign neoplasm of major salivary YA
471 26/12/201 130801021218Y002006 0002413841073 SULASMINI P PBI (APBD) Systemic disorders of connective tissue TIDAK
472 26/12/201 130801021218Y001901 0002413915582 SUPRIYANTO L PBI (APBD) Sequelae of stroke, not specified as YA
473 26/12/201 130801021218Y001953 0002413957702 WISNU GENDRO L PBI (APBD) Diarrhoea and gastroenteritis of TIDAK
474 26/12/201 130801021218Y001950 0002413958275 WAWAN SUPRAYOGI L PBI (APBD) Influenza with other manifestations, TIDAK
475 26/12/201 130801021218Y002281 0002413963563 QQ PUTRI PRADANI P PBI (APBD) Influenza with other manifestations, TIDAK
476 26/12/201 130801021218Y002003 0002413963574 TASYA PRADANI P PBI (APBD) Allergic contact dermatitis, unspecified TIDAK
477 26/12/201 130801021218Y001947 0002413964709 BARIAH AMAR P PBI (APBD) Gastritis, unspecified TIDAK
478 26/12/201 130801021218Y001896 0002413970864 SUYITNO L PBI (APBD) Sequelae of other and unspecified YA
479 26/12/201 130801021218Y002018 0002413971977 MUHAMMAD IHSAN L PBI (APBD) Fever, unspecified TIDAK
480 26/12/201 130801021218Y001936 0002413971977 MUHAMMAD IHSAN L PBI (APBD) Relapsing fever, unspecified TIDAK
481 26/12/201 130801021218Y001987 0002419645105 MUHAMMAD JANUAR TRI L PBI (APBN) Influenza, virus not identified TIDAK
482 26/12/201 130801021218Y001943 0002420787172 NIKE ERAWATY P PEKERJA MANDIRI Acute lymphadenitis, unspecified TIDAK

09/01/2019 16.06.19
DAFTAR KUNJUNGAN PESERTA SAKIT

Kantor Cabang : MADIUN (1303)


FKTP : DEMANGAN (13080102)

NO TANGGAL NO KUNJUNGAN NO KARTU NAMA PESERTA SEX JENIS PESERTA DIAGNOSA DIRUJUK
483 26/12/201 130801021218Y001898 0002483822553 YAYUK MEINAWATI P PEGAWAI SWASTA Follow-up examination after surgery YA
484 26/12/201 130801021218Y002035 0002487252194 SULTHON FAIZI L PEKERJA MANDIRI Pulpitis TIDAK
485 26/12/201 130801021218Y002036 0002487252194 SULTHON FAIZI L PEKERJA MANDIRI Necrosis of pulp TIDAK
486 21/12/201 130801021218Y001764 0000078552055 SUMIYATUN P PENERIMA PENSIUN TNI Cataract, unspecified YA
487 21/12/201 130801021218Y001830 0000078558221 SULIYATI P PENERIMA PENSIUN TNI Acute haemorrhagic gastritis TIDAK
488 21/12/201 130801021218Y001765 0000078559334 SUPARMI P PENERIMA PENSIUN TNI Cataract, unspecified YA
489 21/12/201 130801021218Y001792 0000078721209 SURJATI P PENERIMA PENSIUN Non-insulin-dependent diabetes YA
490 21/12/201 130801021218Y001843 0000078749627 ROSA DHAMAYANTI P PENERIMA PENSIUN Necrosis of pulp TIDAK
491 21/12/201 130801021218Y001824 0000078749627 ROSA DHAMAYANTI P PENERIMA PENSIUN Non-insulin-dependent diabetes TIDAK
492 21/12/201 130801021218Y001825 0000106346856 KUSTATIK, S.PD P PNS PUSAT Pulpitis TIDAK
493 21/12/201 130801021218Y001828 0000106350647 YATIMAN L PNS PUSAT Non-insulin-dependent diabetes TIDAK
494 21/12/201 130801021218Y001841 0000106435271 ROSYID L PNS DAERAH Influenza, virus not identified TIDAK
495 21/12/201 130801021218Y001769 0000106471585 SUPRAYITNO L PNS DAERAH Insulin-dependent diabetes mellitus YA
496 21/12/201 130801021218Y001823 0000106490608 YOHANA LILIS SURYANI P PNS DAERAH Gingivitis and periodontal diseases TIDAK
497 21/12/201 130801021218Y001808 0000735952217 SUDARNO L PBI (APBN) Systemic disorders of connective tissue TIDAK
498 21/12/201 130801021218Y001838 0000786097394 SUMINI P PBI (APBN) Influenza, virus not identified TIDAK
499 21/12/201 130801021218Y001809 0000786244059 SUPARTI P PBI (APBN) Essential (primary) hypertension TIDAK
500 21/12/201 130801021218Y002246 0000786247323 MURSINI P PBI (APBN) Essential (primary) hypertension TIDAK
501 21/12/201 130801021218Y001799 0000786342789 HARIANTO SAPTO L PBI (APBN) Systemic disorders of connective tissue TIDAK
502 21/12/201 130801021218Y002110 0000786390557 PARIYEM P PBI (APBN) Essential (primary) hypertension TIDAK
503 21/12/201 130801021218Y001829 0000786479793 DENI ERNAWATI P PBI (APBN) General counselling and advice on TIDAK

09/01/2019 16.06.19
DAFTAR KUNJUNGAN PESERTA SAKIT

Kantor Cabang : MADIUN (1303)


FKTP : DEMANGAN (13080102)

NO TANGGAL NO KUNJUNGAN NO KARTU NAMA PESERTA SEX JENIS PESERTA DIAGNOSA DIRUJUK
504 21/12/201 130801021218Y001807 0000786494608 SADI L PBI (APBN) Systemic disorders of connective tissue TIDAK
505 21/12/201 130801021218Y002253 0000786513802 SUPARTI P PBI (APBN) Essential (primary) hypertension TIDAK
506 21/12/201 130801021218Y002252 0000786771674 MINAH P PBI (APBN) Non-insulin-dependent diabetes TIDAK
507 21/12/201 130801021218Y001793 0000786774868 SUMI NARLIN P PBI (APBN) Angina pectoris, unspecified YA
508 21/12/201 130801021218Y001812 0000786776602 GUNADI L PBI (APBN) Gout TIDAK
509 21/12/201 130801021218Y002250 0000786812376 ANDHITA EKA NURCAHYA P PBI (APBN) Gastritis, unspecified TIDAK
510 21/12/201 130801021218Y001859 0000786857174 SUTARTI P PBI (APBN) Systemic disorders of connective tissue TIDAK
511 21/12/201 130801021218Y001848 0000786894186 HARDJO KADAR L PBI (APBN) Allergic contact dermatitis, unspecified TIDAK
512 21/12/201 130801021218Y001844 0000786942189 SIYEM P PBI (APBN) Essential (primary) hypertension TIDAK
513 21/12/201 130801021218Y001856 0000786952225 SUJIONO L PBI (APBN) Non-insulin-dependent diabetes TIDAK
514 21/12/201 130801021218Y001815 0000786975085 KABUL L PBI (APBN) Acute pharyngitis, unspecified TIDAK
515 21/12/201 130801021218Y002251 0000786985222 TAYEM P PBI (APBN) Non-insulin-dependent diabetes TIDAK
516 21/12/201 130801021218Y001827 0000787008881 SRI WULANDARI P PBI (APBN) Systemic disorders of connective tissue TIDAK
517 21/12/201 130801021218Y002248 0000787053148 WAHYU SETIAWAN L PBI (APBN) Influenza, virus not identified TIDAK
518 21/12/201 130801021218Y001803 0000787096157 SRI INDARTI P PBI (APBN) Disorders of lipoprotein metabolism TIDAK
519 21/12/201 130801021218Y001855 0000787229155 PARTINI P PBI (APBN) Systemic disorders of connective tissue TIDAK
520 21/12/201 130801021218Y001767 0000787329516 EKA SUNARTI P PBI (APBN) Periapical abscess without sinus YA
521 21/12/201 130801021218Y001780 0000787462468 KUSHARYADI L PBI (APBN) Atrioventricular block, complete YA
522 21/12/201 130801021218Y001818 0000787712398 KASINEM P PBI (APBN) Non-insulin-dependent diabetes TIDAK
523 21/12/201 130801021218Y001775 0001045246443 YUYUN PURBANINGRUM P PBI (APBN) General counselling and advice on TIDAK
524 21/12/201 130801021218Y001801 0001045276604 PRASETYO L PBI (APBN) Other disorders of urinary system TIDAK

09/01/2019 16.06.19
DAFTAR KUNJUNGAN PESERTA SAKIT

Kantor Cabang : MADIUN (1303)


FKTP : DEMANGAN (13080102)

NO TANGGAL NO KUNJUNGAN NO KARTU NAMA PESERTA SEX JENIS PESERTA DIAGNOSA DIRUJUK
525 21/12/201 130801021218Y001853 0001049782588 HENGKI AGUS TRIONO L PBI (APBN) Cough TIDAK
526 21/12/201 130801021218Y001813 0001049784456 KARSI P PBI (APBN) Allergic contact dermatitis, unspecified TIDAK
527 21/12/201 130801021218Y002254 0001083359597 SUMINEM P PBI (APBN) Non-insulin-dependent diabetes TIDAK
528 21/12/201 130801021218Y002244 0001083496724 KARTINI P PBI (APBN) Essential (primary) hypertension TIDAK
529 21/12/201 130801021218Y001785 0001085566498 MUJIATI P PENERIMA PENSIUN TNI Thyrotoxicosis, unspecified YA
530 21/12/201 130801021218Y001822 0001185588731 HASANUDIN L PBI (APBD) Systemic disorders of connective tissue TIDAK
531 21/12/201 130801021218Y001821 0001185588731 HASANUDIN L PBI (APBD) Dental caries TIDAK
532 21/12/201 130801021218Y001794 0001317779829 DRH.ERNIYATI P ANGGOTA POLRI Benign neoplasm of breast YA
533 21/12/201 130801021218Y001881 0001388712205 KUSRIN L PEKERJA MANDIRI Dental caries TIDAK
534 21/12/201 130801021218Y001772 0001421988006 VANYA KIRANA NURAINI L PEGAWAI SWASTA Disorders of refraction and YA
535 21/12/201 130801021218Y001837 0001619798894 JUJUK IDAYANI P PEGAWAI SWASTA Caries of dentine TIDAK
536 21/12/201 130801021218Y002256 0001704707616 ARIANI P PBI (APBD) Gastritis, unspecified TIDAK
537 21/12/201 130801021218Y001773 0001704708764 PUJI RAHAYU P PBI (APBD) Supraventricular tachycardia YA
538 21/12/201 130801021218Y001852 0001704709541 LIANA PUSPITASARI P PBI (APBD) General counselling and advice on TIDAK
539 21/12/201 130801021218Y001788 0001704709754 IKA WAHYU ARIANTI P PBI (APBD) Epilepsy, unspecified YA
540 21/12/201 130801021218Y001835 0001704709809 DEWI NATALIYA P PBI (APBD) Allergic contact dermatitis, unspecified TIDAK
541 21/12/201 130801021218Y001862 0001704710957 SHINTA YULIARTA PUTRI P PBI (APBD) Necrosis of pulp TIDAK
542 21/12/201 130801021218Y001872 0001704713848 DEWI HERMIN P PBI (APBD) Systemic disorders of connective tissue TIDAK
543 21/12/201 130801021218Y002249 0001704718539 SUBAGYO L PBI (APBD) Essential (primary) hypertension TIDAK
544 21/12/201 130801021218Y001861 0001704718618 AWANDA SEPTIAN R P PBI (APBD) Chronic gingivitis TIDAK
545 21/12/201 130801021218Y002243 0001704720824 NOTO SUGIONO L PBI (APBD) Essential (primary) hypertension TIDAK

09/01/2019 16.06.19
DAFTAR KUNJUNGAN PESERTA SAKIT

Kantor Cabang : MADIUN (1303)


FKTP : DEMANGAN (13080102)

NO TANGGAL NO KUNJUNGAN NO KARTU NAMA PESERTA SEX JENIS PESERTA DIAGNOSA DIRUJUK
546 21/12/201 130801021218Y002247 0001704721972 DESVINA OKY PRATAMA P PBI (APBD) Influenza with other manifestations, TIDAK
547 21/12/201 130801021218Y001797 0001704726077 SYAFINA SYAHRU R P PBI (APBD) Influenza, virus not identified TIDAK
548 21/12/201 130801021218Y001866 0001704846407 MOCHAMAD HARIS L PBI (APBD) Diarrhoea and gastroenteritis of TIDAK
549 21/12/201 130801021218Y001802 0001704847724 FARREL KURNIAWAN L PBI (APBD) Influenza due to other identified TIDAK
550 21/12/201 130801021218Y001768 0001704848027 SUYONO L PBI (APBD) Heart failure, unspecified YA
551 21/12/201 130801021218Y001863 0001704848725 EKA FAYATI MAULIDA P PBI (APBD) Caries of dentine TIDAK
552 21/12/201 130801021218Y001860 0001803094931 YUNINGSIH P PEGAWAI SWASTA Contraceptive management TIDAK
553 21/12/201 130801021218Y001791 0001806925331 PARSINI P PEKERJA MANDIRI Disorder of urinary system, unspecified YA
554 21/12/201 130801021218Y001766 0001829996853 MUJI WALUYO L PBI (APBD) Chronic ischaemic heart disease, YA
555 21/12/201 130801021218Y001842 0001889964145 MARHABAN L PBI (APBD) Essential (primary) hypertension TIDAK
556 21/12/201 130801021218Y001831 0001906535845 WAHYUNINGSIH RETNO P PEGAWAI SWASTA Other headache syndromes TIDAK
557 21/12/201 130801021218Y001826 0001993136398 NGATINI P PBI (APBN) Influenza with other manifestations, TIDAK
558 21/12/201 130801021218Y001857 0002038256368 YULI KARTIKA SARI P PEKERJA MANDIRI Contraceptive management TIDAK
559 21/12/201 130801021218Y001806 0002079995207 BIMO GALIH PINANDHITO L PEGAWAI SWASTA Gastritis and duodenitis TIDAK
560 21/12/201 130801021218Y001776 0002097952558 MITA FEBRIANA SARI P PEGAWAI SWASTA Postpartum care and examination TIDAK
561 21/12/201 130801021218Y001820 0002143699839 EKO HARTANTO L PEKERJA MANDIRI Chronic gingivitis TIDAK
562 21/12/201 130801021218Y001854 0002163555854 SULISTIYANI P PBI (APBD) Contraceptive management TIDAK
563 21/12/201 130801021218Y001832 0002163558521 NAYLA ZUHAIR P PBI (APBD) Necrosis of pulp TIDAK
564 21/12/201 130801021218Y001858 0002163559994 RAFAEL JONATHAN L PBI (APBD) Allergic contact dermatitis, unspecified TIDAK
565 21/12/201 130801021218Y001851 0002163559994 RAFAEL JONATHAN L PBI (APBD) Allergic contact dermatitis TIDAK
566 21/12/201 130801021218Y001847 0002163562154 ZAHRA SUCI OKTAVIANI P PBI (APBD) Influenza with other manifestations, TIDAK

09/01/2019 16.06.19
DAFTAR KUNJUNGAN PESERTA SAKIT

Kantor Cabang : MADIUN (1303)


FKTP : DEMANGAN (13080102)

NO TANGGAL NO KUNJUNGAN NO KARTU NAMA PESERTA SEX JENIS PESERTA DIAGNOSA DIRUJUK
567 21/12/201 130801021218Y001865 0002163579164 ALVIAN SAPUTRA L PBI (APBD) Influenza with other manifestations, TIDAK
568 21/12/201 130801021218Y001871 0002163640004 ABDULLOH TASLIM L PBI (APBD) Other and unspecified infectious TIDAK
569 21/12/201 130801021218Y002255 0002163689605 WINARSIH P PBI (APBD) Non-insulin-dependent diabetes TIDAK
570 21/12/201 130801021218Y001868 0002163692891 ALYA FELITTA P PBI (APBD) Other and unspecified infectious TIDAK
571 21/12/201 130801021218Y001850 0002163696129 SUMIATI P PBI (APBD) Allergic contact dermatitis, unspecified TIDAK
572 21/12/201 130801021218Y001800 0002163700541 HARUMI WIJAYANTI P PBI (APBD) Otitis externa, unspecified TIDAK
573 21/12/201 130801021218Y001840 0002163704995 SUPRAYITNO L PBI (APBD) Systemic disorders of connective tissue TIDAK
574 21/12/201 130801021218Y001787 0002163705006 SRI DARWATI P PBI (APBD) Stroke, not specified as haemorrhage YA
575 21/12/201 130801021218Y001814 0002163705794 YULIADI L PBI (APBD) Other and unspecified infectious TIDAK
576 21/12/201 130801021218Y001836 0002163706918 TITIK SULISTIYANINGSIH P PBI (APBD) Pulpitis TIDAK
577 21/12/201 130801021218Y001805 0002163707829 OKVAN DWI SAKTYAWAN L PBI (APBD) Allergic contact dermatitis, unspecified TIDAK
578 21/12/201 130801021218Y001880 0002163709203 SRIPENI P PBI (APBD) Other headache syndromes TIDAK
579 21/12/201 130801021218Y001810 0002163709225 YOFIANA PUTRI PAHLEVI P PBI (APBD) Influenza with other manifestations, TIDAK
580 21/12/201 130801021218Y001874 0002163709811 KUS ENDARWATI P PBI (APBD) Systemic disorders of connective tissue TIDAK
581 21/12/201 130801021218Y001870 0002163709822 NOVENDI WAHYU RIZKIADI L PBI (APBD) Acute pharyngitis TIDAK
582 21/12/201 130801021218Y001777 0002163712779 MUHAMMAD REHAN L PBI (APBD) Influenza with pneumonia, influenza TIDAK
583 21/12/201 130801021218Y001834 0002163712779 MUHAMMAD REHAN L PBI (APBD) Influenza with other manifestations, TIDAK
584 21/12/201 130801021218Y001774 0002163712803 ANNASA QOLBI ASY P PBI (APBD) Influenza with pneumonia, influenza TIDAK
585 21/12/201 130801021218Y002245 0002163718348 HAFIDH YAHDILAH BIN L PBI (APBD) Influenza, virus not identified TIDAK
586 21/12/201 130801021218Y001864 0002281903345 LILIK RUSMINAH P PEKERJA MANDIRI Necrosis of pulp TIDAK
587 21/12/201 130801021218Y001811 0002354078687 PONIYEM P PBI (APBN) Gastritis, unspecified TIDAK

09/01/2019 16.06.19
DAFTAR KUNJUNGAN PESERTA SAKIT

Kantor Cabang : MADIUN (1303)


FKTP : DEMANGAN (13080102)

NO TANGGAL NO KUNJUNGAN NO KARTU NAMA PESERTA SEX JENIS PESERTA DIAGNOSA DIRUJUK
588 21/12/201 130801021218Y001846 0002413109441 SRI HANDAYANI P PBI (APBD) Systemic disorders of connective tissue TIDAK
589 21/12/201 130801021218Y001867 0002413110262 ATHA ADH DHUHA L PBI (APBD) Fever, unspecified TIDAK
590 21/12/201 130801021218Y001819 0002413111509 ILUD FITRIANI P PBI (APBD) Other and unspecified infectious TIDAK
591 21/12/201 130801021218Y001876 0002413137756 SULIS SETYAWAN L PBI (APBD) Other headache syndromes TIDAK
592 21/12/201 130801021218Y001873 0002413138498 SRIYATUN P PBI (APBD) Fever, unspecified TIDAK
593 21/12/201 130801021218Y001869 0002413142392 SETIAWAN SAPTONO L PBI (APBD) Other headache syndromes TIDAK
594 21/12/201 130801021218Y001795 0002413142403 NOOR INDAH P PBI (APBD) Non-insulin-dependent diabetes YA
595 21/12/201 130801021218Y001879 0002413143459 MURDANINGSIH P PBI (APBD) Necrosis of pulp TIDAK
596 21/12/201 130801021218Y001877 0002413143461 INTAN DEWI PEBRIANA P PBI (APBD) Dental caries TIDAK
597 21/12/201 130801021218Y001789 0002413144743 YUNIARTI P PBI (APBD) Foreign body in ear YA
598 21/12/201 130801021218Y001875 0002413149243 SRI WAHYUNI P PBI (APBD) Systemic disorders of connective tissue TIDAK
599 21/12/201 130801021218Y001781 0002413150042 SUPRAPTI P PBI (APBD) Benign neoplasm of unspecified site YA
600 21/12/201 130801021218Y001782 0002413150042 SUPRAPTI P PBI (APBD) Benign neoplasm of unspecified site YA
601 21/12/201 130801021218Y001783 0002413150042 SUPRAPTI P PBI (APBD) Benign neoplasm of unspecified site YA
602 21/12/201 130801021218Y001784 0002413150042 SUPRAPTI P PBI (APBD) Benign neoplasm of unspecified site YA
603 21/12/201 130801021218Y001798 0002413150053 NABILLA FISCARINI NUR P PBI (APBD) Gastritis, unspecified TIDAK
604 21/12/201 130801021218Y002241 0002413849195 MARSINAH P PBI (APBD) Allergic contact dermatitis TIDAK
605 21/12/201 130801021218Y002242 0002413913297 AGUSTINA NURAINI P PBI (APBD) Allergic contact dermatitis TIDAK
606 21/12/201 130801021218Y002109 0002413922387 SUPARMI P PBI (APBD) Essential (primary) hypertension TIDAK
607 21/12/201 130801021218Y001771 0002413926549 SUKARTI P PBI (APBD) Non-insulin-dependent diabetes YA
608 21/12/201 130801021218Y001849 0002413960705 SAMINEM P PBI (APBD) Non-insulin-dependent diabetes TIDAK

09/01/2019 16.06.19
DAFTAR KUNJUNGAN PESERTA SAKIT

Kantor Cabang : MADIUN (1303)


FKTP : DEMANGAN (13080102)

NO TANGGAL NO KUNJUNGAN NO KARTU NAMA PESERTA SEX JENIS PESERTA DIAGNOSA DIRUJUK
609 21/12/201 130801021218Y001839 0002413963563 QQ PUTRI PRADANI P PBI (APBD) Pneumonia, organism unspecified TIDAK
610 21/12/201 130801021218Y001786 0002413970864 SUYITNO L PBI (APBD) Sequelae of other and unspecified YA
611 21/12/201 130801021218Y001790 0002413970875 ENDANG DWI KUSNAWATI P PBI (APBD) Disorders of refraction and YA
612 21/12/201 130801021218Y001804 0002413970897 EGA CESAR PUTRA L PBI (APBD) Influenza with other manifestations, TIDAK
613 21/12/201 130801021218Y001878 0002413972146 WAHYU NURSARI P PBI (APBD) Necrosis of pulp TIDAK
614 21/12/201 130801021218Y001817 0002420801008 SUHADI L PEKERJA MANDIRI Pulpitis TIDAK
615 21/12/201 130801021218Y001779 0002431844234 NABIL MAUZA AYIN L PEGAWAI SWASTA Cough TIDAK
616 21/12/201 130801021218Y001845 0002431844234 NABIL MAUZA AYIN L PEGAWAI SWASTA Influenza with other manifestations, TIDAK
617 21/12/201 130801021218Y001816 0002440636457 DZAKI EKA PRAMADANI L PEKERJA MANDIRI Influenza with other manifestations, TIDAK
618 21/12/201 130801021218Y001796 0002466885925 YENNI DEVIYANTI P PEKERJA MANDIRI Respiratory tuberculosis unspecified, YA
619 21/12/201 130801021218Y001778 0002467348648 VIVI ANGGRAINI P PBI (APBN) Influenza due to other identified TIDAK
620 21/12/201 130801021218Y001833 0002467348648 VIVI ANGGRAINI P PBI (APBN) Influenza, virus not identified TIDAK
621 21/12/201 130801021218Y001770 0002483507542 SULASTRI P PNS DAERAH Acute sinusitis, unspecified YA
622 20/12/201 130801021218Y001740 0000078552461 SOEPARDAN L PENERIMA PENSIUN TNI Diarrhoea and gastroenteritis of TIDAK
623 20/12/201 130801021218Y001701 0000078713728 ALI MUKLIS KUNTOSEMONO L PENERIMA PENSIUN Constipation TIDAK
624 20/12/201 130801021218Y001718 0000078722458 HJ. MURBANINGSIH P PENERIMA PENSIUN Non-insulin-dependent diabetes TIDAK
625 20/12/201 130801021218Y001738 0000078738153 MISTINGAH P PENERIMA PENSIUN Essential (primary) hypertension TIDAK
626 20/12/201 130801021218Y001714 0000078744104 KASIRAH P PENERIMA PENSIUN Tuberculosis of other organs TIDAK
627 20/12/201 130801021218Y001713 0000078756041 SITI KHAERUL AMINAH P PENERIMA PENSIUN Gout TIDAK
628 20/12/201 130801021218Y001689 0000104716787 CHANDDRIKHAA WISNU W L PENERIMA PENSIUN Allergic contact dermatitis TIDAK
629 20/12/201 130801021218Y001675 0000105169432 RUSMI P PNS DAERAH Necrosis of pulp TIDAK

09/01/2019 16.06.19
DAFTAR KUNJUNGAN PESERTA SAKIT

Kantor Cabang : MADIUN (1303)


FKTP : DEMANGAN (13080102)

NO TANGGAL NO KUNJUNGAN NO KARTU NAMA PESERTA SEX JENIS PESERTA DIAGNOSA DIRUJUK
630 20/12/201 130801021218Y001674 0000105169454 BUCHORI NUR ICHSAN L PNS DAERAH Supernumerary teeth TIDAK
631 20/12/201 130801021218Y001686 0000106293982 PITOYO L PNS DAERAH Fever, unspecified TIDAK
632 20/12/201 130801021218Y001661 0000106296478 TUTI SETYO HUTAMI P PENERIMA PENSIUN Sequelae of other and unspecified YA
633 20/12/201 130801021218Y001687 0000106487548 HAFIZH NUR AZIZ L PNS DAERAH Disorders of refraction and YA
634 20/12/201 130801021218Y001658 0000116353157 SITI NOERMEI P PENERIMA PENSIUN Disorder of teeth and supporting YA
635 20/12/201 130801021218Y001712 0000158401181 ISMIJATI P PENERIMA PENSIUN Cough TIDAK
636 20/12/201 130801021218Y001737 0000162631495 MISINAH P PNS DAERAH Influenza with other manifestations, TIDAK
637 20/12/201 130801021218Y001692 0000198997029 TRI HANDAYANI P PNS PUSAT Necrosis of pulp TIDAK
638 20/12/201 130801021218Y001754 0000735621996 LANGGENG SANTOSO L PBI (APBN) Other and unspecified infectious TIDAK
639 20/12/201 130801021218Y001735 0000786120996 SRI HASANA P PBI (APBN) Diarrhoea and gastroenteritis of TIDAK
640 20/12/201 130801021218Y001679 0000786123865 LUSI YULIANAWATI P PBI (APBN) Non-insulin-dependent diabetes TIDAK
641 20/12/201 130801021218Y001693 0000786146692 LAMIDI L PBI (APBN) Systemic disorders of connective tissue TIDAK
642 20/12/201 130801021218Y001717 0000786183085 ETTY WAHYUNI P PBI (APBN) Gastritis, unspecified TIDAK
643 20/12/201 130801021218Y001748 0000786225407 RACHMAN NUR ALHADY L PBI (APBN) Influenza with other manifestations, TIDAK
644 20/12/201 130801021218Y001709 0000786307408 SAHID RIYANTO L PBI (APBN) Non-insulin-dependent diabetes TIDAK
645 20/12/201 130801021218Y001699 0000786326376 DJOEMINTEN P PBI (APBN) Gastritis, unspecified TIDAK
646 20/12/201 130801021218Y001702 0000786343151 PERTIWI PREHATIN P PBI (APBN) Necrosis of pulp TIDAK
647 20/12/201 130801021218Y002428 0000786343151 PERTIWI PREHATIN P PBI (APBN) Necrosis of pulp TIDAK
648 20/12/201 130801021218Y001685 0000786388151 WIDIYAWATI P PBI (APBN) Systemic disorders of connective tissue TIDAK
649 20/12/201 130801021218Y001676 0000786471298 JOHAN AMIR L PBI (APBN) Gastritis, unspecified TIDAK
650 20/12/201 130801021218Y001728 0000786752583 WARSINAH P PBI (APBN) Gastritis, unspecified TIDAK

09/01/2019 16.06.19
DAFTAR KUNJUNGAN PESERTA SAKIT

Kantor Cabang : MADIUN (1303)


FKTP : DEMANGAN (13080102)

NO TANGGAL NO KUNJUNGAN NO KARTU NAMA PESERTA SEX JENIS PESERTA DIAGNOSA DIRUJUK
651 20/12/201 130801021218Y001704 0000786754089 DIAN PUSPITASARI P PBI (APBN) Necrosis of pulp TIDAK
652 20/12/201 130801021218Y001749 0000786754168 TASYA EKA PUSPITA P PBI (APBN) Gingivitis and periodontal diseases TIDAK
653 20/12/201 130801021218Y001671 0000786776692 MINATUN P PBI (APBN) Non-insulin-dependent diabetes YA
654 20/12/201 130801021218Y001746 0000786808394 PARMIN L PBI (APBN) Systemic disorders of connective tissue TIDAK
655 20/12/201 130801021218Y001747 0000786808539 SAMINI P PBI (APBN) Systemic disorders of connective tissue TIDAK
656 20/12/201 130801021218Y001663 0000786811252 DESY WAHYUNINGRUM P PBI (APBN) Antenatal screening TIDAK
657 20/12/201 130801021218Y001733 0000786872384 SUSANTI P PBI (APBN) Hypotension, unspecified TIDAK
658 20/12/201 130801021218Y001732 0000786874059 IMA DWI FEBRIANTI P PBI (APBN) Influenza with other manifestations, TIDAK
659 20/12/201 130801021218Y001660 0000786879911 MISPAN L PBI (APBN) Congestive heart failure YA
660 20/12/201 130801021218Y001739 0000786957131 TUKIRAH P PBI (APBN) Essential (primary) hypertension TIDAK
661 20/12/201 130801021218Y001664 0000786978775 TUTIK SETYAWATI P PBI (APBN) Foreign body in ear YA
662 20/12/201 130801021218Y001734 0000787023426 PRIHATIN P PBI (APBN) Carpal tunnel syndrome YA
663 20/12/201 130801021218Y001731 0000787090206 SUTI P PBI (APBN) Essential (primary) hypertension TIDAK
664 20/12/201 130801021218Y001745 0000787177271 HERU SISWANTO L PBI (APBN) Influenza with other manifestations, TIDAK
665 20/12/201 130801021218Y001741 0000787227041 NUROCHMIATI PUSPITA P PBI (APBN) Influenza with other manifestations, TIDAK
666 20/12/201 130801021218Y001736 0000787259114 SUJIRAH P PBI (APBN) Essential (primary) hypertension TIDAK
667 20/12/201 130801021218Y001652 0000787397905 SAKIYEM P PBI (APBN) Orthopaedic follow-up care, YA
668 20/12/201 130801021218Y001683 0000946306304 HARU INDIARSYEH P PBI (APBN) Allergic contact dermatitis, unspecified TIDAK
669 20/12/201 130801021218Y001724 0001049783725 AGAM SURYA ANANTA L PBI (APBN) Otitis externa, unspecified TIDAK
670 20/12/201 130801021218Y001684 0001095047065 DARMINTO L ANGGOTA POLRI Oral mucositis (ulcerative) TIDAK
671 20/12/201 130801021218Y001763 0001098491995 YAAFI RASENDRIYA PUTRA L PNS DAERAH Disturbances in tooth eruption TIDAK

09/01/2019 16.06.19
DAFTAR KUNJUNGAN PESERTA SAKIT

Kantor Cabang : MADIUN (1303)


FKTP : DEMANGAN (13080102)

NO TANGGAL NO KUNJUNGAN NO KARTU NAMA PESERTA SEX JENIS PESERTA DIAGNOSA DIRUJUK
672 20/12/201 130801021218Y001696 0001274993728 LUTHFI ALI HAZMI L PRAJURIT AU Acute pharyngitis, unspecified TIDAK
673 20/12/201 130801021218Y001700 0001295171346 LANDUNG MARGONO L PEKERJA MANDIRI Otitis externa, unspecified TIDAK
674 20/12/201 130801021218Y001752 0001388712205 KUSRIN L PEKERJA MANDIRI Caries limited to enamel TIDAK
675 20/12/201 130801021218Y001666 0001428509619 RULI KUSUMADEWI P PEGAWAI PEMERINTAH Antenatal screening TIDAK
676 20/12/201 130801021218Y002211 0001428509619 RULI KUSUMADEWI P PEGAWAI PEMERINTAH Candidiasis of vulva and vagina TIDAK
677 20/12/201 130801021218Y001716 0001477436455 SUMARNI P PNS PUSAT Influenza with other manifestations, TIDAK
678 20/12/201 130801021218Y001722 0001704706615 MIDJEM P PBI (APBD) Essential (primary) hypertension TIDAK
679 20/12/201 130801021218Y001730 0001704713668 KATINI P PBI (APBD) Influenza, virus not identified TIDAK
680 20/12/201 130801021218Y001703 0001704714344 YUDHO UTOMO L PBI (APBD) Influenza with other manifestations, TIDAK
681 20/12/201 130801021218Y001760 0001704714344 YUDHO UTOMO L PBI (APBD) Periapical abscess without sinus TIDAK
682 20/12/201 130801021218Y001657 0001704720374 LUWES SARASWATI D P PBI (APBD) Corns and callosities YA
683 20/12/201 130801021218Y001695 0001704720565 SUGIK HADI RIANTO L PBI (APBD) Gastritis, unspecified TIDAK
684 20/12/201 130801021218Y001698 0001704720576 MARSINI P PBI (APBD) Disorders of lipoprotein metabolism TIDAK
685 20/12/201 130801021218Y001650 0001704721713 NYONO L PBI (APBD) Heart failure, unspecified YA
686 20/12/201 130801021218Y001727 0001704723524 YOSA ADI P L PBI (APBD) Candidiasis, unspecified TIDAK
687 20/12/201 130801021218Y002105 0001704729047 LEILY ROMADONI RISMA P PBI (APBD) Allergic contact dermatitis TIDAK
688 20/12/201 130801021218Y001672 0001704729047 LEILY ROMADONI RISMA P PBI (APBD) Surveillance of (intrauterine) YA
689 20/12/201 130801021218Y001708 0001704732186 YOYOK HERMANTO L PBI (APBD) Systemic disorders of connective tissue TIDAK
690 20/12/201 130801021218Y001705 0001704733031 MISTUTIK P PBI (APBD) Influenza with other manifestations, TIDAK
691 20/12/201 130801021218Y001673 0001704842897 HILMY TANSA JABBARIZ L PBI (APBD) Disturbances in tooth eruption TIDAK
692 20/12/201 130801021218Y001721 0001704842897 HILMY TANSA JABBARIZ L PBI (APBD) Disturbances in tooth eruption TIDAK

09/01/2019 16.06.19
DAFTAR KUNJUNGAN PESERTA SAKIT

Kantor Cabang : MADIUN (1303)


FKTP : DEMANGAN (13080102)

NO TANGGAL NO KUNJUNGAN NO KARTU NAMA PESERTA SEX JENIS PESERTA DIAGNOSA DIRUJUK
693 20/12/201 130801021218Y001707 0001704845698 SIPON L PBI (APBD) Cough TIDAK
694 20/12/201 130801021218Y001656 0001704848027 SUYONO L PBI (APBD) Heart failure, unspecified YA
695 20/12/201 130801021218Y001762 0001789473161 EKO RAHMAT BUDIARTO L PEGAWAI SWASTA Chronic periodontitis TIDAK
696 20/12/201 130801021218Y001688 0001802199971 SUKATMI P PBI (APBD) Other and unspecified infectious TIDAK
697 20/12/201 130801021218Y001697 0001831426323 SUKOWATI P PEKERJA MANDIRI Influenza with other manifestations, TIDAK
698 20/12/201 130801021218Y001759 0001846748621 RAHAYU P PEGAWAI SWASTA Disorders of lipoprotein metabolism TIDAK
699 20/12/201 130801021218Y001710 0001887996159 MUHAMMAD ZAKY ARYASA L PEKERJA MANDIRI Influenza with other manifestations, TIDAK
700 20/12/201 130801021218Y001649 0001887996159 MUHAMMAD ZAKY ARYASA L PEKERJA MANDIRI Relapsing fevers TIDAK
701 20/12/201 130801021218Y001753 0002163546415 NURWATI P PBI (APBD) Necrosis of pulp TIDAK
702 20/12/201 130801021218Y001726 0002163546955 AIMAN SHIFA ABGARY L PBI (APBD) Influenza with other manifestations, TIDAK
703 20/12/201 130801021218Y001662 0002163546955 AIMAN SHIFA ABGARY L PBI (APBD) Influenza due to other identified TIDAK
704 20/12/201 130801021218Y001725 0002163546966 MUHAMMAD WISNU L PBI (APBD) Influenza with other manifestations, TIDAK
705 20/12/201 130801021218Y001757 0002163548305 AMBARWATI P PBI (APBD) Influenza with other manifestations, TIDAK
706 20/12/201 130801021218Y001742 0002163553683 WIDYANA DWI LESTARI P PBI (APBD) Influenza with other manifestations, TIDAK
707 20/12/201 130801021218Y002104 0002163554087 SITI SUNDARI P PBI (APBD) Cough TIDAK
708 20/12/201 130801021218Y002107 0002163564652 ADELIO AZZAM PRANAJA L PBI (APBD) Influenza with other manifestations, TIDAK
709 20/12/201 130801021218Y001648 0002163569512 ANIK SRI HANDAYANI P PBI (APBD) Contraceptive management TIDAK
710 20/12/201 130801021218Y002102 0002163576508 SUKESI P PBI (APBD) Essential (primary) hypertension TIDAK
711 20/12/201 130801021218Y001691 0002163687355 DIVA FITRI RAMADANI P PBI (APBD) Disturbances in tooth eruption TIDAK
712 20/12/201 130801021218Y002106 0002163688299 SUKARMI P PBI (APBD) Non-insulin-dependent diabetes TIDAK
713 20/12/201 130801021218Y001655 0002163690639 S. SUPRANTOKO L PBI (APBD) Hearing loss, unspecified YA

09/01/2019 16.06.19
DAFTAR KUNJUNGAN PESERTA SAKIT

Kantor Cabang : MADIUN (1303)


FKTP : DEMANGAN (13080102)

NO TANGGAL NO KUNJUNGAN NO KARTU NAMA PESERTA SEX JENIS PESERTA DIAGNOSA DIRUJUK
714 20/12/201 130801021218Y001743 0002163695062 SUYATI P PBI (APBD) Essential (primary) hypertension TIDAK
715 20/12/201 130801021218Y001665 0002163697986 AULIA SALSABHILLA P PBI (APBD) Need for immunization against single TIDAK
716 20/12/201 130801021218Y001744 0002163698864 SOEKATNI P PBI (APBD) Essential (primary) hypertension TIDAK
717 20/12/201 130801021218Y001694 0002163699764 LILIK WAHYUNING ASTUTI P PBI (APBD) Gastritis, unspecified TIDAK
718 20/12/201 130801021218Y001682 0002163706762 KIRANIA CINTA P PBI (APBD) Fever, unspecified TIDAK
719 20/12/201 130801021218Y001681 0002247828715 AFIFAH MARATHUS P PBI (APBD) Gastritis, unspecified TIDAK
720 20/12/201 130801021218Y001667 0002354079464 SUPARMI P PBI (APBN) Sequelae of other and unspecified YA
721 20/12/201 130801021218Y001756 0002413060435 SRIYANI P PBI (APBD) Systemic disorders of connective tissue TIDAK
722 20/12/201 130801021218Y001678 0002413109417 WAHYUDI L PBI (APBD) Systemic disorders of connective tissue TIDAK
723 20/12/201 130801021218Y001719 0002413113658 SUPIYATUN P PBI (APBD) Acute haemorrhagic gastritis TIDAK
724 20/12/201 130801021218Y001653 0002413115908 NUGRAHA AJI SAPUTRA L PBI (APBD) Need for immunization against other TIDAK
725 20/12/201 130801021218Y001751 0002413136125 VITA CYNTHIA MAHARDIKA P PBI (APBD) Necrosis of pulp TIDAK
726 20/12/201 130801021218Y001750 0002413136136 NADA INDANA ZULFA P PBI (APBD) Caries of dentine TIDAK
727 20/12/201 130801021218Y001680 0002413145171 MURNIATI P PBI (APBD) Systemic disorders of connective tissue TIDAK
728 20/12/201 130801021218Y001690 0002413146137 YONGA INEZ CANTIKA P PBI (APBD) Varicella [chickenpox] TIDAK
729 20/12/201 130801021218Y001755 0002413149669 PREMITA BUDI L PBI (APBD) Gastritis, unspecified TIDAK
730 20/12/201 130801021218Y001729 0002413152854 ARI WIDIASTUTI P PBI (APBD) Hypotension TIDAK
731 20/12/201 130801021218Y001715 0002413156893 IQBAL NUR RIZKY L PBI (APBD) Influenza with other manifestations, TIDAK
732 20/12/201 130801021218Y002101 0002413849667 TINAR KISWARIN P PBI (APBD) Essential (primary) hypertension TIDAK
733 20/12/201 130801021218Y001670 0002413852762 SAYEKTI P PBI (APBD) Polyneuropathy, unspecified YA
734 20/12/201 130801021218Y002100 0002413892182 ARSYLA NIMASTURNA P PBI (APBD) Influenza with other manifestations, TIDAK

09/01/2019 16.06.19
DAFTAR KUNJUNGAN PESERTA SAKIT

Kantor Cabang : MADIUN (1303)


FKTP : DEMANGAN (13080102)

NO TANGGAL NO KUNJUNGAN NO KARTU NAMA PESERTA SEX JENIS PESERTA DIAGNOSA DIRUJUK
735 20/12/201 130801021218Y002108 0002413899281 YUNI LINAWATI P PBI (APBD) Cough TIDAK
736 20/12/201 130801021218Y001758 0002413899292 AGUNG GUMELAR SAKTI L PBI (APBD) Influenza, virus not identified TIDAK
737 20/12/201 130801021218Y001720 0002413959006 SUKAMTO L PBI (APBD) Cough TIDAK
738 20/12/201 130801021218Y001677 0002413962459 KUSTANTI P PBI (APBD) Low back pain, site unspecified TIDAK
739 20/12/201 130801021218Y001761 0002413962887 SITI KOMARIYAH P PBI (APBD) Periapical abscess without sinus TIDAK
740 20/12/201 130801021218Y001723 0002413963449 NANIEK FARIDA P PBI (APBD) Allergic contact dermatitis TIDAK
741 20/12/201 130801021218Y001659 0002413963574 TASYA PRADANI P PBI (APBD) Mixed asthma YA
742 20/12/201 130801021218Y001711 0002472686008 JIHAN BADRIYATI KHOTIJAH P PEKERJA MANDIRI Low back pain, site unspecified TIDAK
743 20/12/201 130801021218Y001651 0002478426974 NITA YUNITA WIDWIANA P PEKERJA MANDIRI Follow-up examination after surgery YA
744 20/12/201 130801021218Y001706 0002478426974 NITA YUNITA WIDWIANA P PEKERJA MANDIRI Other and unspecified infectious TIDAK
745 20/12/201 130801021218Y001654 0002500854546 AISYAH RIZKI SA'DIYAH P PBI (APBN) Need for immunization against TIDAK
746 19/12/201 130801021218Y001621 0000078531221 SUJATINI P VETERAN Gonarthrosis [arthrosis of knee] YA
747 19/12/201 130801021218Y001557 0000078749741 RR. SOEBARDINI P PENERIMA PENSIUN Psoriasis, unspecified YA
748 19/12/201 130801021218Y001618 0000078755354 SAMIRAH P PENERIMA PENSIUN Systemic disorders of connective tissue TIDAK
749 19/12/201 130801021218Y001641 0000078773624 SUPARNO L PENERIMA PENSIUN Dyspepsia YA
750 19/12/201 130801021218Y001630 0000100622665 YUDHIANTO L PNS PUSAT Influenza with other manifestations, TIDAK
751 19/12/201 130801021218Y002099 0000104772497 RIZA RAHMAWATI P PRAJURIT AU Necrosis of pulp TIDAK
752 19/12/201 130801021218Y001520 0000104787562 SITI FATIMAH P PNS DAERAH Non-insulin-dependent diabetes YA
753 19/12/201 130801021218Y001552 0000105143815 SUKARMI P PNS DAERAH Palmar fascial fibromatosis YA
754 19/12/201 130801021218Y001542 0000105721277 SUMADJI L PENERIMA PENSIUN Chronic ischaemic heart disease, YA
755 19/12/201 130801021218Y001541 0000105721288 USWATUL K P PENERIMA PENSIUN Congestive heart failure YA

09/01/2019 16.06.19
DAFTAR KUNJUNGAN PESERTA SAKIT

Kantor Cabang : MADIUN (1303)


FKTP : DEMANGAN (13080102)

NO TANGGAL NO KUNJUNGAN NO KARTU NAMA PESERTA SEX JENIS PESERTA DIAGNOSA DIRUJUK
756 19/12/201 130801021218Y001516 0000106294599 CHIPTA RACHMADANI P PEKERJA MANDIRI Other antenatal screening TIDAK
757 19/12/201 130801021218Y001521 0000106359614 IPAH P PENERIMA PENSIUN TNI Non-insulin-dependent diabetes YA
758 19/12/201 130801021218Y001617 0000106421938 MURDJIATI P PNS DAERAH Non-insulin-dependent diabetes TIDAK
759 19/12/201 130801021218Y001523 0000106421949 SUGIYO L PNS DAERAH Non-insulin-dependent diabetes YA
760 19/12/201 130801021218Y002098 0000106441233 LISMIYARTI P PNS DAERAH Necrosis of pulp TIDAK
761 19/12/201 130801021218Y001585 0000106472856 AGUS SUPRIJONO L PEKERJA MANDIRI Necrosis of pulp TIDAK
762 19/12/201 130801021218Y001624 0000207271067 PUJI ASRINI P PENERIMA PENSIUN TNI Other benign neoplasm of connective YA
763 19/12/201 130801021218Y001539 0000522374321 TITIN WIDIAWATI P PBI (APBN) Antenatal screening TIDAK
764 19/12/201 130801021218Y001517 0000660200062 NOVITA YULIANTI P PBI (APBN) Contraceptive management TIDAK
765 19/12/201 130801021218Y001545 0000785238928 SUTI P PBI (APBN) Non-insulin-dependent diabetes YA
766 19/12/201 130801021218Y001605 0000786097394 SUMINI P PBI (APBN) Cough TIDAK
767 19/12/201 130801021218Y001596 0000786389782 KATEMI P PBI (APBN) Gastritis and duodenitis TIDAK
768 19/12/201 130801021218Y001619 0000786471254 SITI RUBIATI P PBI (APBN) Systemic disorders of connective tissue TIDAK
769 19/12/201 130801021218Y001577 0000786479523 DANANG WAHYU SAPUTRO L PBI (APBN) Hordeolum and chalazion YA
770 19/12/201 130801021218Y001566 0000786479793 DENI ERNAWATI P PBI (APBN) Gastritis and duodenitis TIDAK
771 19/12/201 130801021218Y001544 0000786484631 SUYATMI P PBI (APBN) Disorders of refraction and YA
772 19/12/201 130801021218Y002088 0000786588186 ISTRI WULANDARI P PBI (APBN) Influenza with other manifestations, TIDAK
773 19/12/201 130801021218Y001597 0000786731714 RISKA NURHAYATI P PBI (APBN) Influenza with other manifestations, TIDAK
774 19/12/201 130801021218Y001554 0000786733356 SIREP P PBI (APBN) Hypertensive heart disease YA
775 19/12/201 130801021218Y001615 0000786786063 LASMINIATI P PBI (APBN) Systemic disorders of connective tissue TIDAK
776 19/12/201 130801021218Y001540 0000786806177 SITI LATIFAH P PBI (APBN) Other cataract YA

09/01/2019 16.06.19
DAFTAR KUNJUNGAN PESERTA SAKIT

Kantor Cabang : MADIUN (1303)


FKTP : DEMANGAN (13080102)

NO TANGGAL NO KUNJUNGAN NO KARTU NAMA PESERTA SEX JENIS PESERTA DIAGNOSA DIRUJUK
777 19/12/201 130801021218Y001574 0000786871495 SRI HARIYANI P PBI (APBN) Influenza with other manifestations, TIDAK
778 19/12/201 130801021218Y001599 0000786900688 SULIKAH P PBI (APBN) Cough TIDAK
779 19/12/201 130801021218Y001536 0000787007709 TARMI ENGGARWATI P PBI (APBN) Contraceptive management TIDAK
780 19/12/201 130801021218Y002092 0000787093648 ANTI ROFIAH P PBI (APBN) Allergic contact dermatitis TIDAK
781 19/12/201 130801021218Y001592 0000787100242 TRIMO L PBI (APBN) Conjunctivitis, unspecified TIDAK
782 19/12/201 130801021218Y001551 0000787110546 TUMINEM P PBI (APBN) Other female genital prolapse YA
783 19/12/201 130801021218Y001526 0000787228738 SUKINAH P PBI (APBN) Asthma YA
784 19/12/201 130801021218Y001530 0000787229155 PARTINI P PBI (APBN) Asthma YA
785 19/12/201 130801021218Y001628 0001049783488 SARMI P PBI (APBN) Hypertensive heart disease YA
786 19/12/201 130801021218Y001524 0001049784041 MEI RAHAYU P PBI (APBN) Antenatal screening TIDAK
787 19/12/201 130801021218Y001580 0001049784489 HADI SOESENO L PBI (APBN) Chest pain, unspecified TIDAK
788 19/12/201 130801021218Y001627 0001049784682 NURYANTO L PBI (APBN) Allergic contact dermatitis, unspecified TIDAK
789 19/12/201 130801021218Y001543 0001108980055 FARIDA TRI ANGGRAINI P PRAJURIT AU Antenatal screening TIDAK
790 19/12/201 130801021218Y001581 0001302639309 SADJIMIN L PENERIMA PENSIUN Non-insulin-dependent diabetes TIDAK
791 19/12/201 130801021218Y001546 0001626826768 NOVITA YULI ROKAYANI P PEGAWAI BUMN Antenatal screening TIDAK
792 19/12/201 130801021218Y001613 0001626826768 NOVITA YULI ROKAYANI P PEGAWAI BUMN Gestational [pregnancy-induced] TIDAK
793 19/12/201 130801021218Y001600 0001645504604 SRI WAHYUNI WINANTU P PEGAWAI SWASTA Influenza with other manifestations, TIDAK
794 19/12/201 130801021218Y001529 0001703207147 DJUWANI L PEGAWAI SWASTA Malignant neoplasm of upper lobe, YA
795 19/12/201 130801021218Y001647 0001704708843 SUGIMUN L PBI (APBD) Cough TIDAK
796 19/12/201 130801021218Y002085 0001704713578 SITI BUDAYANTI P PBI (APBD) Cough TIDAK
797 19/12/201 130801021218Y001555 0001704714164 HARYONO L PBI (APBD) Dementia in Alzheimer disease YA

09/01/2019 16.06.19
DAFTAR KUNJUNGAN PESERTA SAKIT

Kantor Cabang : MADIUN (1303)


FKTP : DEMANGAN (13080102)

NO TANGGAL NO KUNJUNGAN NO KARTU NAMA PESERTA SEX JENIS PESERTA DIAGNOSA DIRUJUK
798 19/12/201 130801021218Y001632 0001704715863 SAMADI L PBI (APBD) Necrosis of pulp TIDAK
799 19/12/201 130801021218Y001569 0001704719057 YATMI RAHAYU P PBI (APBD) Non-insulin-dependent diabetes TIDAK
800 19/12/201 130801021218Y001584 0001704719362 SITI RAHAYU P PBI (APBD) Non-insulin-dependent diabetes TIDAK
801 19/12/201 130801021218Y001550 0001704719362 SITI RAHAYU P PBI (APBD) Exfoliation of teeth due to systemic YA
802 19/12/201 130801021218Y001626 0001704719698 MUHAMMAD RIZKI L PBI (APBD) Necrosis of pulp TIDAK
803 19/12/201 130801021218Y001518 0001704723759 RISMA LIAYUSTIKA P PBI (APBD) Antenatal screening TIDAK
804 19/12/201 130801021218Y001602 0001704724424 KASNO L PBI (APBD) Gout TIDAK
805 19/12/201 130801021218Y001582 0001704725188 ADAM SUDARNO L PBI (APBD) Necrosis of pulp TIDAK
806 19/12/201 130801021218Y001583 0001704725199 SATIYEM P PBI (APBD) Hypotension, unspecified TIDAK
807 19/12/201 130801021218Y001639 0001704726382 TRI PURNAWATI P PBI (APBD) Systemic disorders of connective tissue TIDAK
808 19/12/201 130801021218Y001609 0001704727214 ROBERTHA PRIN P PBI (APBD) Essential (primary) hypertension TIDAK
809 19/12/201 130801021218Y001610 0001704729576 SRI HARTAWATI P PBI (APBD) Non-insulin-dependent diabetes TIDAK
810 19/12/201 130801021218Y002097 0001704733132 ANI NOFIAYANTI P PBI (APBD) Cough TIDAK
811 19/12/201 130801021218Y001622 0001704789753 NILAM NUR KHARIMA P PBI (APBD) Other conjunctivitis TIDAK
812 19/12/201 130801021218Y001563 0001704842673 PINASTHI MUSTIKA CAHYA P PBI (APBD) Disturbances in tooth eruption TIDAK
813 19/12/201 130801021218Y001611 0001704842706 AGUSTINA SETIARINI P PBI (APBD) Other diseases of upper respiratory TIDAK
814 19/12/201 130801021218Y001589 0001704844203 HERI SUHENDRO L PBI (APBD) Influenza with other manifestations, TIDAK
815 19/12/201 130801021218Y001625 0001704845395 WIWIT WIJI SULASTRI P PBI (APBD) Influenza, virus not identified TIDAK
816 19/12/201 130801021218Y001608 0001705734977 HARSUGIONO L PBI (APBD) Dislocation, sprain and strain of joints YA
817 19/12/201 130801021218Y002093 0001706781666 RADIFFA CAHYA SAPUTRA L PBI (APBD) Influenza with other manifestations, TIDAK
818 19/12/201 130801021218Y001579 0001835290405 KATI P PEKERJA MANDIRI Systemic disorders of connective tissue TIDAK

09/01/2019 16.06.19
DAFTAR KUNJUNGAN PESERTA SAKIT

Kantor Cabang : MADIUN (1303)


FKTP : DEMANGAN (13080102)

NO TANGGAL NO KUNJUNGAN NO KARTU NAMA PESERTA SEX JENIS PESERTA DIAGNOSA DIRUJUK
819 19/12/201 130801021218Y001538 0001888010346 WAHENDA USWATUN P PEGAWAI SWASTA Disorder of refraction, unspecified YA
820 19/12/201 130801021218Y001537 0001888010548 AULIA NURUL HASANAH P PEGAWAI SWASTA Disorders of refraction and YA
821 19/12/201 130801021218Y001642 0001893646405 AULIA DWI NUR ASTUTI P PEGAWAI SWASTA Other benign neoplasm of connective YA
822 19/12/201 130801021218Y001573 0001960599993 ARIYADI L PBI (APBD) Systemic disorders of connective tissue TIDAK
823 19/12/201 130801021218Y001561 0002137303596 LAVENITA SUKMA PRADANI P PEGAWAI SWASTA Antenatal screening TIDAK
824 19/12/201 130801021218Y001588 0002163546808 SUHARMI P PBI (APBD) Non-insulin-dependent diabetes TIDAK
825 19/12/201 130801021218Y001603 0002163548845 RIZKY FERY ARDIANSYAH L PBI (APBD) Allergic contact dermatitis, unspecified TIDAK
826 19/12/201 130801021218Y001614 0002163551872 HAFIDZ ALFARO GAVRIEL L PBI (APBD) Influenza with other manifestations, TIDAK
827 19/12/201 130801021218Y001548 0002163551872 HAFIDZ ALFARO GAVRIEL L PBI (APBD) Cough TIDAK
828 19/12/201 130801021218Y001590 0002163554695 JIHAN HANIFAH P PBI (APBD) Disturbances in tooth eruption TIDAK
829 19/12/201 130801021218Y001604 0002163561322 YAYUK P PBI (APBD) Systemic disorders of connective tissue TIDAK
830 19/12/201 130801021218Y001644 0002163564549 AMEILLY ROSSIE ANWAR P PBI (APBD) Supernumerary teeth TIDAK
831 19/12/201 130801021218Y001559 0002163571863 FANY PUSPANINGSIH P PBI (APBD) Antenatal screening TIDAK
832 19/12/201 130801021218Y001643 0002163572188 EKA NOVITASARI P PBI (APBD) Pulpitis TIDAK
833 19/12/201 130801021218Y001616 0002163572199 TIFFANIA SADIVA P PBI (APBD) Influenza with other manifestations, TIDAK
834 19/12/201 130801021218Y001549 0002163572199 TIFFANIA SADIVA P PBI (APBD) Influenza due to other identified TIDAK
835 19/12/201 130801021218Y001535 0002163572638 PUJI LESTARI P PBI (APBD) Antenatal screening TIDAK
836 19/12/201 130801021218Y001631 0002163689302 ENDANG RAHAYU P PBI (APBD) Influenza with other manifestations, TIDAK
837 19/12/201 130801021218Y001606 0002163693879 WINARNI P PBI (APBD) Fever of other and unknown origin TIDAK
838 19/12/201 130801021218Y001578 0002163694061 SUPARTI P PBI (APBD) Otitis externa, unspecified TIDAK
839 19/12/201 130801021218Y001528 0002163694149 SUPARDI L PBI (APBD) Cataract, unspecified YA

09/01/2019 16.06.19
DAFTAR KUNJUNGAN PESERTA SAKIT

Kantor Cabang : MADIUN (1303)


FKTP : DEMANGAN (13080102)

NO TANGGAL NO KUNJUNGAN NO KARTU NAMA PESERTA SEX JENIS PESERTA DIAGNOSA DIRUJUK
840 19/12/201 130801021218Y001565 0002163695455 SRI WIDAYATI P PBI (APBD) Malignant neoplasm of breast, YA
841 19/12/201 130801021218Y001635 0002163700056 TEGUH SETYA BUDI UTAMA L PBI (APBD) Necrosis of pulp TIDAK
842 19/12/201 130801021218Y001637 0002163703511 KOMARI L PBI (APBD) Non-insulin-dependent diabetes TIDAK
843 19/12/201 130801021218Y001587 0002163704591 SUWITO L PBI (APBD) Systemic disorders of connective tissue TIDAK
844 19/12/201 130801021218Y001640 0002163708279 HARSOYO L PBI (APBD) Systemic disorders of connective tissue TIDAK
845 19/12/201 130801021218Y001612 0002163708325 SUDARMI P PBI (APBD) Low back pain, site unspecified TIDAK
846 19/12/201 130801021218Y001556 0002163712476 ZAINATUL MUNIROH P PBI (APBD) Irregular menstruation, unspecified TIDAK
847 19/12/201 130801021218Y002094 0002163712487 MUHAMMAD JA'FAR ASH- L PBI (APBD) Influenza, virus not identified TIDAK
848 19/12/201 130801021218Y001560 0002163714513 FAIZ DZIKRI NUR ALIF L PBI (APBD) Influenza due to other identified TIDAK
849 19/12/201 130801021218Y001623 0002163714513 FAIZ DZIKRI NUR ALIF L PBI (APBD) Nausea and vomiting TIDAK
850 19/12/201 130801021218Y002096 0002163715389 FAHAD BILLAL EDDISTYA L PBI (APBD) Influenza with other manifestations, TIDAK
851 19/12/201 130801021218Y001601 0002163715424 EMI YULI ASTUTIK P PBI (APBD) Other diseases of upper respiratory TIDAK
852 19/12/201 130801021218Y001558 0002163717415 ITA SURYANTI P PBI (APBD) Hypertrophy of breast TIDAK
853 19/12/201 130801021218Y001620 0002163719913 ARJUNA DWI NUGROHO L PBI (APBD) Cough TIDAK
854 19/12/201 130801021218Y001553 0002163719913 ARJUNA DWI NUGROHO L PBI (APBD) Cough TIDAK
855 19/12/201 130801021218Y001638 0002222561733 ALEDYA ANASTASI WIJAYA P PEKERJA MANDIRI Cough TIDAK
856 19/12/201 130801021218Y001646 0002281903345 LILIK RUSMINAH P PEKERJA MANDIRI Necrosis of pulp TIDAK
857 19/12/201 130801021218Y001570 0002298568015 SUNARTO SUMARWI L PEKERJA MANDIRI Essential (primary) hypertension TIDAK
858 19/12/201 130801021218Y001571 0002298568375 SRI MUMPUNI P PEKERJA MANDIRI Systemic disorders of connective tissue TIDAK
859 19/12/201 130801021218Y002083 0002413010665 SEFTILIA DWI LESTARI P PBI (APBD) Cough TIDAK
860 19/12/201 130801021218Y002090 0002413028237 ALVINDRA ARGHATAMA L PBI (APBD) Influenza with other manifestations, TIDAK

09/01/2019 16.06.19
DAFTAR KUNJUNGAN PESERTA SAKIT

Kantor Cabang : MADIUN (1303)


FKTP : DEMANGAN (13080102)

NO TANGGAL NO KUNJUNGAN NO KARTU NAMA PESERTA SEX JENIS PESERTA DIAGNOSA DIRUJUK
861 19/12/201 130801021218Y002089 0002413028248 SYIFA DWI ARYANTY P PBI (APBD) Influenza with other manifestations, TIDAK
862 19/12/201 130801021218Y001515 0002413038148 FAUZI CANIAGO L PBI (APBD) Non-insulin-dependent diabetes YA
863 19/12/201 130801021218Y001595 0002413049409 ISMINAH P PBI (APBD) Systemic disorders of connective tissue TIDAK
864 19/12/201 130801021218Y001636 0002413060255 SOETINI P PBI (APBD) Systemic disorders of connective tissue TIDAK
865 19/12/201 130801021218Y001591 0002413111509 ILUD FITRIANI P PBI (APBD) Other and unspecified infectious TIDAK
866 19/12/201 130801021218Y001522 0002413112275 SITI AMINAH P PBI (APBD) Heart failure, unspecified YA
867 19/12/201 130801021218Y001645 0002413113658 SUPIYATUN P PBI (APBD) Essential (primary) hypertension TIDAK
868 19/12/201 130801021218Y001547 0002413114525 DESY RAHMAWATI P PBI (APBD) Contraceptive management TIDAK
869 19/12/201 130801021218Y001633 0002413141637 AZZALEA KHALIFA NUR P PBI (APBD) Influenza, virus not identified TIDAK
870 19/12/201 130801021218Y001634 0002413141659 ASIFA ARDANIA SHAFIRA P PBI (APBD) Influenza, virus not identified TIDAK
871 19/12/201 130801021218Y001575 0002413145305 SITI CHOIRIYAH P PBI (APBD) Systemic disorders of connective tissue TIDAK
872 19/12/201 130801021218Y001572 0002413148938 MOHAMAD ALFIAN NUR L PBI (APBD) Influenza with other manifestations, TIDAK
873 19/12/201 130801021218Y001562 0002413149399 RODJIPAH P PBI (APBD) Other headache syndromes TIDAK
874 19/12/201 130801021218Y001564 0002413151201 SUKARNO L PBI (APBD) Non-insulin-dependent diabetes TIDAK
875 19/12/201 130801021218Y001607 0002413152628 SUKAENI P PBI (APBD) Allergic contact dermatitis TIDAK
876 19/12/201 130801021218Y001567 0002413153056 IKA SITI SHOLIHAH P PBI (APBD) Benign lipomatous neoplasm, TIDAK
877 19/12/201 130801021218Y001568 0002413153495 ADILLA RAMADHANI P PBI (APBD) Cough TIDAK
878 19/12/201 130801021218Y001576 0002413840454 SITI AMINAH P PBI (APBD) Hyperlipidaemia, unspecified TIDAK
879 19/12/201 130801021218Y002087 0002413952921 INTANTRI YUNIS PRATIWI P PBI (APBD) Cough TIDAK
880 19/12/201 130801021218Y001525 0002413953371 RIRIN SETYANA P PBI (APBD) Antenatal screening TIDAK
881 19/12/201 130801021218Y001519 0002413958084 DAMAR WAHYU L PBI (APBD) Nasal polyp YA

09/01/2019 16.06.19
DAFTAR KUNJUNGAN PESERTA SAKIT

Kantor Cabang : MADIUN (1303)


FKTP : DEMANGAN (13080102)

NO TANGGAL NO KUNJUNGAN NO KARTU NAMA PESERTA SEX JENIS PESERTA DIAGNOSA DIRUJUK
882 19/12/201 130801021218Y001593 0002413962088 GIYEM P PBI (APBD) Systemic disorders of connective tissue TIDAK
883 19/12/201 130801021218Y001586 0002413963449 NANIEK FARIDA P PBI (APBD) Stomatitis and related lesions TIDAK
884 19/12/201 130801021218Y001534 0002413965756 MINARTI P PBI (APBD) Other arthrosis YA
885 19/12/201 130801021218Y001594 0002413966792 REGINA PUTRI AYU P PBI (APBD) Disturbances in tooth eruption TIDAK
886 19/12/201 130801021218Y001527 0002421564175 ALVINNO ATALAH PUTRA L PBI (APBN) Cough TIDAK
887 19/12/201 130801021218Y001598 0002421564175 ALVINNO ATALAH PUTRA L PBI (APBN) Cough TIDAK
888 19/12/201 130801021218Y001629 0002431997649 ANDHI YUDHA WASKITO L PEGAWAI SWASTA Hypertensive heart disease YA
889 18/12/201 130801021218Y001423 0000078544822 KATINING RAHAYU P PENERIMA PENSIUN TNI Malignant neoplasm of breast, YA
890 18/12/201 130801021218Y001470 0000078565061 YATMI P PENERIMA PENSIUN TNI Disorders of lipoprotein metabolism TIDAK
891 18/12/201 130801021218Y001461 0000078772601 SUMINI P PENERIMA PENSIUN Hypertensive heart disease TIDAK
892 18/12/201 130801021218Y001481 0000104377994 MARDJONO L PENERIMA PENSIUN Essential (primary) hypertension TIDAK
893 18/12/201 130801021218Y001512 0000104976044 CAHYO PRASETYO L PEGAWAI SWASTA Systemic disorders of connective tissue TIDAK
894 18/12/201 130801021218Y001421 0000106292733 GUNARTI P PNS DAERAH Hypertensive heart disease without YA
895 18/12/201 130801021218Y001439 0000106312972 ESTI SILANINGRUM P PNS DAERAH Caries of dentine TIDAK
896 18/12/201 130801021218Y001508 0000339843947 KUSIN L PBI (APBN) Caries limited to enamel TIDAK
897 18/12/201 130801021218Y001484 0000661439867 SUPRIYATUN P PBI (APBN) Systemic disorders of connective tissue TIDAK
898 18/12/201 130801021218Y001443 0000661686254 MISRENI P PBI (APBN) Systemic disorders of connective tissue TIDAK
899 18/12/201 130801021218Y001471 0000786080092 DARMINI P PBI (APBN) Gastritis and duodenitis TIDAK
900 18/12/201 130801021218Y001475 0000786114652 SLAMET L PBI (APBN) Hypertensive heart disease TIDAK
901 18/12/201 130801021218Y001474 0000786116496 BURHANUDIN L PBI (APBN) Hypertensive heart disease TIDAK
902 18/12/201 130801021218Y001466 0000786209332 LILIK PURWANTO L PBI (APBN) Non-insulin-dependent diabetes TIDAK

09/01/2019 16.06.19
DAFTAR KUNJUNGAN PESERTA SAKIT

Kantor Cabang : MADIUN (1303)


FKTP : DEMANGAN (13080102)

NO TANGGAL NO KUNJUNGAN NO KARTU NAMA PESERTA SEX JENIS PESERTA DIAGNOSA DIRUJUK
903 18/12/201 130801021218Y001437 0000786210434 HERU SISWANTO L PBI (APBN) Caries of dentine TIDAK
904 18/12/201 130801021218Y001462 0000786374414 MINAH P PBI (APBN) Systemic disorders of connective tissue TIDAK
905 18/12/201 130801021218Y002074 0000786374559 DWI SUSANTI P PBI (APBN) Cough TIDAK
906 18/12/201 130801021218Y001393 0000786407736 KHOIRON URIPTO L PBI (APBN) Schizophrenia, unspecified YA
907 18/12/201 130801021218Y001496 0000786486194 MELINDA PRATIWI PUTRI P PBI (APBN) Acute lymphadenitis, unspecified TIDAK
908 18/12/201 130801021218Y001491 0000786582505 SARNO L PBI (APBN) Systemic disorders of connective tissue TIDAK
909 18/12/201 130801021218Y001499 0000786595026 SUWANDI L PBI (APBN) Unspecified haematuria YA
910 18/12/201 130801021218Y001497 0000786661751 KUSMINI P PBI (APBN) Systemic disorders of connective tissue TIDAK
911 18/12/201 130801021218Y001434 0000786733198 BAKRI BUDI PRAYITNO L PBI (APBN) Conjunctivitis, unspecified TIDAK
912 18/12/201 130801021218Y001513 0000786775217 MUHAMMAD RAYHAN L PBI (APBN) Pulpitis TIDAK
913 18/12/201 130801021218Y001473 0000786826181 SUNARTI P PBI (APBN) Non-insulin-dependent diabetes TIDAK
914 18/12/201 130801021218Y001472 0000786826618 DESSY PUTRIANI P PBI (APBN) Hypotension, unspecified TIDAK
915 18/12/201 130801021218Y002073 0000786854349 AGUS PURWANTO L PBI (APBN) Cough TIDAK
916 18/12/201 130801021218Y001483 0000786902062 PARMIATUN P PBI (APBN) Allergic contact dermatitis, unspecified TIDAK
917 18/12/201 130801021218Y001502 0000786958986 REZEIKA WAHYU P PBI (APBN) Influenza with other manifestations, TIDAK
918 18/12/201 130801021218Y001489 0000787098115 SINEM P PBI (APBN) Glaucoma, unspecified YA
919 18/12/201 130801021218Y001485 0000787181714 MISIYEM P PBI (APBN) Allergic contact dermatitis, unspecified TIDAK
920 18/12/201 130801021218Y001456 0000787205889 AMBOROWATI P PBI (APBN) Pulpitis TIDAK
921 18/12/201 130801021218Y001480 0000787228738 SUKINAH P PBI (APBN) Asthma TIDAK
922 18/12/201 130801021218Y001490 0000787241777 ACHMAD AINUN ROSYID L PBI (APBN) Epistaxis TIDAK
923 18/12/201 130801021218Y001459 0000787332609 PARIYEM P PBI (APBN) Gastritis, unspecified TIDAK

09/01/2019 16.06.19
DAFTAR KUNJUNGAN PESERTA SAKIT

Kantor Cabang : MADIUN (1303)


FKTP : DEMANGAN (13080102)

NO TANGGAL NO KUNJUNGAN NO KARTU NAMA PESERTA SEX JENIS PESERTA DIAGNOSA DIRUJUK
924 18/12/201 130801021218Y001477 0000787388152 ISWANDI L PBI (APBN) Gastritis and duodenitis TIDAK
925 18/12/201 130801021218Y001413 0000787728058 MISNI L PBI (APBN) Pneumonia in diseases classified YA
926 18/12/201 130801021218Y001391 0001049783578 PRAMiSTI YOGA NINGTYAS P PBI (APBN) Other and unspecified ovarian cysts YA
927 18/12/201 130801021218Y001669 0001049788326 MAREM P PBI (APBN) Sequelae of stroke, not specified as YA
928 18/12/201 130801021218Y001486 0001083359597 SUMINEM P PBI (APBN) Non-insulin-dependent diabetes TIDAK
929 18/12/201 130801021218Y001400 0001274268903 IKE DUWI PUSPITASARI P PEKERJA MANDIRI Insulin-dependent diabetes mellitus YA
930 18/12/201 130801021218Y002075 0001309814796 MARTINI P PEKERJA MANDIRI Non-insulin-dependent diabetes TIDAK
931 18/12/201 130801021218Y001420 0001422006917 PITRI KRISTIYANI P PEGAWAI SWASTA Contraceptive management TIDAK
932 18/12/201 130801021218Y001394 0001423824129 SUMIATUN P PEKERJA MANDIRI Intra-abdominal and pelvic swelling, YA
933 18/12/201 130801021218Y001395 0001427451309 ROESMINI P PEKERJA MANDIRI Vertigo of central origin YA
934 18/12/201 130801021218Y001505 0001434377327 ISMUJI ARMIASIH P PEKERJA MANDIRI Dental caries TIDAK
935 18/12/201 130801021218Y001503 0001704706773 ILHAM SYAH PUTRA L PBI (APBD) Other and unspecified infectious TIDAK
936 18/12/201 130801021218Y001408 0001704709247 RUSMIJATI P PBI (APBD) Insulin-dependent diabetes mellitus YA
937 18/12/201 130801021218Y001431 0001704711712 SUWONDO L PBI (APBD) Essential (primary) hypertension TIDAK
938 18/12/201 130801021218Y001492 0001704711993 SOEDJIATI L PBI (APBD) Systemic disorders of connective tissue TIDAK
939 18/12/201 130801021218Y001428 0001704714164 HARYONO L PBI (APBD) Alzheimer's disease, unspecified TIDAK
940 18/12/201 130801021218Y001425 0001704717404 ANIS NUR AINI P PBI (APBD) Systemic disorders of connective tissue TIDAK
941 18/12/201 130801021218Y002071 0001704720082 FAHSIL RASID ALIEF L PBI (APBD) Influenza with other manifestations, TIDAK
942 18/12/201 130801021218Y001448 0001704720609 KASMINI P PBI (APBD) Systemic disorders of connective tissue TIDAK
943 18/12/201 130801021218Y001511 0001704726753 SIYAM P PBI (APBD) Allergic contact dermatitis, unspecified TIDAK
944 18/12/201 130801021218Y001435 0001704730342 LASINI P PBI (APBD) Other headache syndromes TIDAK

09/01/2019 16.06.19
DAFTAR KUNJUNGAN PESERTA SAKIT

Kantor Cabang : MADIUN (1303)


FKTP : DEMANGAN (13080102)

NO TANGGAL NO KUNJUNGAN NO KARTU NAMA PESERTA SEX JENIS PESERTA DIAGNOSA DIRUJUK
945 18/12/201 130801021218Y001407 0001704730961 SUHARTI P PBI (APBD) Chronic ischaemic heart disease, YA
946 18/12/201 130801021218Y001504 0001704842109 GILANG BAYU SAPUTRA L PBI (APBD) Influenza with other manifestations, TIDAK
947 18/12/201 130801021218Y001441 0001704843483 RAYHAN RIZKY RAMADAN L PBI (APBD) Other and unspecified infectious TIDAK
948 18/12/201 130801021218Y001406 0001743413602 MARIA DINI ELAWATI P PEGAWAI SWASTA Contraceptive management TIDAK
949 18/12/201 130801021218Y001398 0001774625444 ARTIK SINTYA RAHAYU P PEGAWAI SWASTA Abnormal findings on antenatal YA
950 18/12/201 130801021218Y001392 0001826187748 SIONO L PEGAWAI SWASTA Insulin-dependent diabetes mellitus YA
951 18/12/201 130801021218Y001424 0001826187917 MARIYANI P PEGAWAI SWASTA Non-insulin-dependent diabetes TIDAK
952 18/12/201 130801021218Y001396 0001875668646 TUKIRAH P PRAJURIT AD Spondylolysis, lumbar region YA
953 18/12/201 130801021218Y001465 0001876929928 MUASIH P PEKERJA MANDIRI Systemic disorders of connective tissue TIDAK
954 18/12/201 130801021218Y001403 0001878071016 SRI PITOYO L PEGAWAI SWASTA Myalgia YA
955 18/12/201 130801021218Y001495 0002067564982 KANAYA INTAN AMALIA P PEGAWAI SWASTA Disturbances in tooth eruption TIDAK
956 18/12/201 130801021218Y001454 0002163548327 KAMBALI L PBI (APBD) Allergic contact dermatitis, unspecified TIDAK
957 18/12/201 130801021218Y001509 0002163551837 SHALLY BUNIATIE P PBI (APBD) Caries of dentine TIDAK
958 18/12/201 130801021218Y002068 0002163557046 FERNANDO PRATAMA L PBI (APBD) Influenza with other manifestations, TIDAK
959 18/12/201 130801021218Y002069 0002163557057 BILQIS AUFA AZZAHRA P PBI (APBD) Influenza with other manifestations, TIDAK
960 18/12/201 130801021218Y001426 0002163558385 SUYANTO L PBI (APBD) Necrosis of pulp TIDAK
961 18/12/201 130801021218Y001453 0002163558407 HANA AURELYA P PBI (APBD) Necrosis of pulp TIDAK
962 18/12/201 130801021218Y002078 0002163562154 ZAHRA SUCI OKTAVIANI P PBI (APBD) Influenza with other manifestations, TIDAK
963 18/12/201 130801021218Y002076 0002163562536 WINDA MARDIANA P PBI (APBD) Cough TIDAK
964 18/12/201 130801021218Y001450 0002163563875 DWI KUSWAHYUDI L PBI (APBD) Systemic disorders of connective tissue TIDAK
965 18/12/201 130801021218Y001476 0002163570423 SUMINEM P PBI (APBD) Systemic disorders of connective tissue TIDAK

09/01/2019 16.06.19
DAFTAR KUNJUNGAN PESERTA SAKIT

Kantor Cabang : MADIUN (1303)


FKTP : DEMANGAN (13080102)

NO TANGGAL NO KUNJUNGAN NO KARTU NAMA PESERTA SEX JENIS PESERTA DIAGNOSA DIRUJUK
966 18/12/201 130801021218Y001458 0002163640004 ABDULLOH TASLIM L PBI (APBD) Influenza with other manifestations, TIDAK
967 18/12/201 130801021218Y001482 0002163688119 SUSILO EDY PRANOTO L PBI (APBD) Non-insulin-dependent diabetes TIDAK
968 18/12/201 130801021218Y001467 0002163690988 ROHMAHWATI P PBI (APBD) Gastritis, unspecified TIDAK
969 18/12/201 130801021218Y001445 0002163692529 ACHMAD WACHID AKBAAR L PBI (APBD) Systemic disorders of connective tissue TIDAK
970 18/12/201 130801021218Y001514 0002163692867 NAJWA KHOIRUNNISA P PBI (APBD) Dental caries TIDAK
971 18/12/201 130801021218Y001501 0002163693194 NEVI GIYANTI P PBI (APBD) Gingivitis and periodontal diseases TIDAK
972 18/12/201 130801021218Y002072 0002163693238 HOGI KRISNA PUTRI P PBI (APBD) Allergic contact dermatitis TIDAK
973 18/12/201 130801021218Y002067 0002163693306 AQILA QURROTA AIN P PBI (APBD) Influenza with other manifestations, TIDAK
974 18/12/201 130801021218Y001460 0002163693486 HASMA NURHAYATI P PBI (APBD) Necrosis of pulp TIDAK
975 18/12/201 130801021218Y001436 0002163694195 ZALFA ZAHIYA MAULINA P PBI (APBD) Disorders of tooth development and TIDAK
976 18/12/201 130801021218Y001430 0002163700991 ARDI VALENTINO SAPUTRA L PBI (APBD) Influenza with other manifestations, TIDAK
977 18/12/201 130801021218Y001410 0002163702947 SRI NURYANI P PBI (APBD) Abnormal findings on antenatal YA
978 18/12/201 130801021218Y001433 0002163705794 YULIADI L PBI (APBD) Other and unspecified infectious TIDAK
979 18/12/201 130801021218Y001455 0002163707662 SUSANA MEGAWATI P PBI (APBD) Systemic disorders of connective tissue TIDAK
980 18/12/201 130801021218Y001432 0002163708404 SULASIYO L PBI (APBD) Influenza with other manifestations, TIDAK
981 18/12/201 130801021218Y001451 0002163710968 KASIYEM P PBI (APBD) Essential (primary) hypertension TIDAK
982 18/12/201 130801021218Y001506 0002163711172 AAN ADITYA MAHARDIKA L PBI (APBD) Dental caries TIDAK
983 18/12/201 130801021218Y001422 0002163714017 IQHOBAR MUKLIS JIHSABIL L PBI (APBD) Orthopaedic follow-up care, YA
984 18/12/201 130801021218Y001488 0002163715907 SRI RAHAYU P PBI (APBD) Myalgia YA
985 18/12/201 130801021218Y001446 0002163723186 PONIYEM P PBI (APBD) Systemic disorders of connective tissue TIDAK
986 18/12/201 130801021218Y001447 0002163885412 SRI RAHAYU HERWATI P PBI (APBD) Influenza with other manifestations, TIDAK

09/01/2019 16.06.19
DAFTAR KUNJUNGAN PESERTA SAKIT

Kantor Cabang : MADIUN (1303)


FKTP : DEMANGAN (13080102)

NO TANGGAL NO KUNJUNGAN NO KARTU NAMA PESERTA SEX JENIS PESERTA DIAGNOSA DIRUJUK
987 18/12/201 130801021218Y001449 0002207406475 HARTINI P PEKERJA MANDIRI Systemic disorders of connective tissue TIDAK
988 18/12/201 130801021218Y001419 0002295820282 RAMADHAN AHNAF L PEGAWAI SWASTA Influenza due to other identified TIDAK
989 18/12/201 130801021218Y001487 0002295820282 RAMADHAN AHNAF L PEGAWAI SWASTA Influenza with other manifestations, TIDAK
990 18/12/201 130801021218Y001463 0002312820731 MOEGINAH P PEKERJA MANDIRI Essential (primary) hypertension TIDAK
991 18/12/201 130801021218Y001401 0002318331655 WULANDARI KHASANAH P PEKERJA MANDIRI Contraceptive management TIDAK
992 18/12/201 130801021218Y001402 0002318331655 WULANDARI KHASANAH P PEKERJA MANDIRI Contraceptive management TIDAK
993 18/12/201 130801021218Y001444 0002413050186 DEVI WULANDARI P PBI (APBD) Disorders of refraction and TIDAK
994 18/12/201 130801021218Y001668 0002413063449 ERVIN TEGANTARI P PBI (APBD) Sequelae of stroke, not specified as YA
995 18/12/201 130801021218Y001494 0002413112049 SUKARTINAH P PBI (APBD) Zoster [herpes zoster] TIDAK
996 18/12/201 130801021218Y001442 0002413113625 IHSAN BAYU BRAMANTYO L PBI (APBD) Influenza with pneumonia, virus not TIDAK
997 18/12/201 130801021218Y001417 0002413114233 IKA SOFIYANTI P PBI (APBD) Abnormal findings on antenatal YA
998 18/12/201 130801021218Y002064 0002413118035 ABI RIDHATAMA L PBI (APBD) Influenza with other manifestations, TIDAK
999 18/12/201 130801021218Y001464 0002413119914 RENGGA AGUNG AESA L PBI (APBD) Gastritis, unspecified TIDAK
1000 18/12/201 130801021218Y001510 0002413137756 SULIS SETYAWAN L PBI (APBD) Systemic disorders of connective tissue TIDAK
1001 18/12/201 130801021218Y001438 0002413139128 AZKA NOAH FRAZETA L PBI (APBD) Other and unspecified infectious TIDAK
1002 18/12/201 130801021218Y001440 0002413141413 ENDAH WIJAYANTI P PBI (APBD) Other headache syndromes TIDAK
1003 18/12/201 130801021218Y001500 0002413145788 BUDIYONO L PBI (APBD) Necrosis of pulp TIDAK
1004 18/12/201 130801021218Y001418 0002413146352 YULIANA P PBI (APBD) Hypertensive heart disease YA
1005 18/12/201 130801021218Y001399 0002413148477 SOEDARTO L PBI (APBD) Stroke, not specified as haemorrhage YA
1006 18/12/201 130801021218Y001479 0002413150626 BAMBANG PURUHITO L PBI (APBD) Necrosis of pulp TIDAK
1007 18/12/201 130801021218Y001478 0002413150626 BAMBANG PURUHITO L PBI (APBD) Other specified headache syndromes TIDAK

09/01/2019 16.06.19
DAFTAR KUNJUNGAN PESERTA SAKIT

Kantor Cabang : MADIUN (1303)


FKTP : DEMANGAN (13080102)

NO TANGGAL NO KUNJUNGAN NO KARTU NAMA PESERTA SEX JENIS PESERTA DIAGNOSA DIRUJUK
1008 18/12/201 130801021218Y001416 0002413150885 MARIJATUN AL SRI RUKMINI P PBI (APBD) Heart failure, unspecified YA
1009 18/12/201 130801021218Y001507 0002413850422 SARMI P PBI (APBD) Systemic disorders of connective tissue TIDAK
1010 18/12/201 130801021218Y001469 0002413850769 SUDARTO L PBI (APBD) Systemic disorders of connective tissue TIDAK
1011 18/12/201 130801021218Y001404 0002413913095 MUH. SLAMET L PBI (APBD) Pleural plaque without asbestos YA
1012 18/12/201 130801021218Y002065 0002413914491 TRI MURDIANTI P PBI (APBD) Gastritis, unspecified TIDAK
1013 18/12/201 130801021218Y002066 0002413914524 MUHAMMAD RADITYA L PBI (APBD) Influenza with other manifestations, TIDAK
1014 18/12/201 130801021218Y001498 0002413950928 INDI CANTIKA P PBI (APBD) Pneumonia in other diseases classified TIDAK
1015 18/12/201 130801021218Y001493 0002413950928 INDI CANTIKA P PBI (APBD) Pneumonic plague TIDAK
1016 18/12/201 130801021218Y002079 0002413960064 ADINDA SEKAR CEMPAKA P PBI (APBD) Influenza with other manifestations, TIDAK
1017 18/12/201 130801021218Y001415 0002413960064 ADINDA SEKAR CEMPAKA P PBI (APBD) Other and unspecified infectious TIDAK
1018 18/12/201 130801021218Y001405 0002413962009 SIMI P PBI (APBD) Glaucoma YA
1019 18/12/201 130801021218Y001411 0002413964092 IDA HERAWATI P PBI (APBD) Contraceptive management TIDAK
1020 18/12/201 130801021218Y001412 0002413964092 IDA HERAWATI P PBI (APBD) Contraceptive management TIDAK
1021 18/12/201 130801021218Y002077 0002413965418 ISTIANIK P PBI (APBD) Congestive heart failure TIDAK
1022 18/12/201 130801021218Y001409 0002413965418 ISTIANIK P PBI (APBD) Failure of sterile precautions during YA
1023 18/12/201 130801021218Y001452 0002413969841 SUMARTI P PBI (APBD) Non-insulin-dependent diabetes TIDAK
1024 18/12/201 130801021218Y001468 0002413969841 SUMARTI P PBI (APBD) Chronic periodontitis TIDAK
1025 18/12/201 130801021218Y001457 0002413991799 WERDININGSIH P PBI (APBD) Acute and transient psychotic disorder, TIDAK
1026 18/12/201 130801021218Y001427 0002420801008 SUHADI L PEKERJA MANDIRI Gastritis, unspecified TIDAK
1027 18/12/201 130801021218Y001429 0002420801357 SRI SUYATMI P PEKERJA MANDIRI Systemic disorders of connective tissue TIDAK
1028 18/12/201 130801021218Y001397 0002471489954 NUR ILMA HABIBATUS P PEGAWAI SWASTA Contraceptive management TIDAK

09/01/2019 16.06.19
DAFTAR KUNJUNGAN PESERTA SAKIT

Kantor Cabang : MADIUN (1303)


FKTP : DEMANGAN (13080102)

NO TANGGAL NO KUNJUNGAN NO KARTU NAMA PESERTA SEX JENIS PESERTA DIAGNOSA DIRUJUK
1029 18/12/201 130801021218Y001414 0002487577364 NARENDRA ZACHARY AL L PEKERJA MANDIRI Need for immunization against TIDAK
1030 17/12/201 130801021218Y001287 0000078547577 SARMININGSIH P PENERIMA PENSIUN TNI Disorder of lipoprotein metabolism, TIDAK
1031 17/12/201 130801021218Y001302 0000078713728 ALI MUKLIS KUNTOSEMONO L PENERIMA PENSIUN Constipation TIDAK
1032 17/12/201 130801021218Y001203 0000078714189 AMINAH P PENERIMA PENSIUN Hypertensive heart disease without YA
1033 17/12/201 130801021218Y001262 0000078717082 CC. TRIDJUM KISMARIJANTI P PENERIMA PENSIUN Pulpitis TIDAK
1034 17/12/201 130801021218Y001276 0000078724271 MARIATI P PENERIMA PENSIUN Systemic disorders of connective tissue TIDAK
1035 17/12/201 130801021218Y001242 0000105076113 ZULKARNAIN CAHAYA L PNS PUSAT Schizophrenia, unspecified YA
1036 17/12/201 130801021218Y001235 0000105136604 SRI MULYANINGSIH P PNS DAERAH Orthopaedic follow-up care, YA
1037 17/12/201 130801021218Y001206 0000106075776 SADIRUN L PNS DAERAH Paralytic ileus YA
1038 17/12/201 130801021218Y001291 0000106346856 KUSTATIK, S.PD P PNS PUSAT Dental caries TIDAK
1039 17/12/201 130801021218Y001356 0000106350647 YATIMAN L PNS PUSAT Non-insulin-dependent diabetes TIDAK
1040 17/12/201 130801021218Y001252 0000106350669 YUSTI EVIFAJARWATI P PEKERJA MANDIRI Diarrhoea and gastroenteritis of TIDAK
1041 17/12/201 130801021218Y001312 0000106359423 TUMINEM P PENERIMA PENSIUN TNI Systemic disorders of connective tissue TIDAK
1042 17/12/201 130801021218Y001299 0000198997029 TRI HANDAYANI P PNS PUSAT Periapical abscess without sinus TIDAK
1043 17/12/201 130801021218Y001342 0000661072285 AFRIDA KURNIA SUBEKTI P PBI (APBN) Allergic contact dermatitis TIDAK
1044 17/12/201 130801021218Y001269 0000735621996 LANGGENG SANTOSO L PBI (APBN) Other and unspecified infectious TIDAK
1045 17/12/201 130801021218Y001357 0000737253742 SARNIANTO L PBI (APBN) Systemic disorders of connective tissue TIDAK
1046 17/12/201 130801021218Y001310 0000738302231 SRI WULANDARI P PBI (APBN) Chronic kidney disease TIDAK
1047 17/12/201 130801021218Y001223 0000785238928 SUTI P PBI (APBN) Non-insulin-dependent diabetes YA
1048 17/12/201 130801021218Y001213 0000785836956 DESSY NATALIA P PBI (APBN) Candidiasis of vulva and vagina TIDAK
1049 17/12/201 130801021218Y001300 0000785836956 DESSY NATALIA P PBI (APBN) Other and unspecified infectious TIDAK

09/01/2019 16.06.19
DAFTAR KUNJUNGAN PESERTA SAKIT

Kantor Cabang : MADIUN (1303)


FKTP : DEMANGAN (13080102)

NO TANGGAL NO KUNJUNGAN NO KARTU NAMA PESERTA SEX JENIS PESERTA DIAGNOSA DIRUJUK
1050 17/12/201 130801021218Y001199 0000786132731 MUDJIATI P PBI (APBN) Mixed asthma YA
1051 17/12/201 130801021218Y001205 0000786268923 SUSI IRAWATI P PBI (APBN) Abnormal findings on antenatal YA
1052 17/12/201 130801021218Y001272 0000786340271 AULIA BERLIANAMULYA P PBI (APBN) Allergic contact dermatitis TIDAK
1053 17/12/201 130801021218Y001224 0000786406713 NANIK SUPRIHATIN P PBI (APBN) Other antenatal screening TIDAK
1054 17/12/201 130801021218Y001197 0000786432475 SARMIATUN P PBI (APBN) Cardiac arrhythmia, unspecified YA
1055 17/12/201 130801021218Y001209 0000786445108 KATEMI P PBI (APBN) Cataract, unspecified YA
1056 17/12/201 130801021218Y001323 0000786676274 SUJIRAH P PBI (APBN) Gastritis and duodenitis TIDAK
1057 17/12/201 130801021218Y001251 0000786754168 TASYA EKA PUSPITA P PBI (APBN) Supernumerary teeth TIDAK
1058 17/12/201 130801021218Y001234 0000786793252 REMI P PBI (APBN) Mixed asthma YA
1059 17/12/201 130801021218Y001214 0000786796075 NURMA AGUSTINA P PBI (APBN) Other antenatal screening TIDAK
1060 17/12/201 130801021218Y001298 0000786824998 CACAK WIRANTO L PBI (APBN) Non-insulin-dependent diabetes TIDAK
1061 17/12/201 130801021218Y001351 0000786855464 PATONAH P PBI (APBN) Non-insulin-dependent diabetes TIDAK
1062 17/12/201 130801021218Y001352 0000786855521 SUHARI L PBI (APBN) Non-insulin-dependent diabetes TIDAK
1063 17/12/201 130801021218Y001265 0000786858568 MAIMUN L PBI (APBN) Systemic disorders of connective tissue TIDAK
1064 17/12/201 130801021218Y001198 0000786877367 WAGIRAH P PBI (APBN) Acute myocardial infarction, YA
1065 17/12/201 130801021218Y001248 0000786899935 SADIANIK P PBI (APBN) Essential (primary) hypertension TIDAK
1066 17/12/201 130801021218Y001286 0000786900688 SULIKAH P PBI (APBN) Non-insulin-dependent diabetes TIDAK
1067 17/12/201 130801021218Y001309 0000786909058 BONIYEM P PBI (APBN) Systemic disorders of connective tissue TIDAK
1068 17/12/201 130801021218Y001350 0000787077235 HARJO UNTUNG L PBI (APBN) Essential (primary) hypertension TIDAK
1069 17/12/201 130801021218Y001349 0000787077369 KATIMAH P PBI (APBN) Essential (primary) hypertension TIDAK
1070 17/12/201 130801021218Y001347 0000787091027 SAMINI P PBI (APBN) Non-insulin-dependent diabetes TIDAK

09/01/2019 16.06.19
DAFTAR KUNJUNGAN PESERTA SAKIT

Kantor Cabang : MADIUN (1303)


FKTP : DEMANGAN (13080102)

NO TANGGAL NO KUNJUNGAN NO KARTU NAMA PESERTA SEX JENIS PESERTA DIAGNOSA DIRUJUK
1071 17/12/201 130801021218Y001353 0000787117882 DEFI YUNITA P PBI (APBN) Influenza with other manifestations, TIDAK
1072 17/12/201 130801021218Y001345 0000787208275 PUJIATI P PBI (APBN) Gastritis and duodenitis TIDAK
1073 17/12/201 130801021218Y001346 0000787210839 LILI MARIANI P PBI (APBN) Influenza with other manifestations, TIDAK
1074 17/12/201 130801021218Y001306 0000787283864 SUWARTI P PBI (APBN) Disorder of lipoprotein metabolism, TIDAK
1075 17/12/201 130801021218Y001313 0000787301559 MUNIRAH P PBI (APBN) Gastritis and duodenitis TIDAK
1076 17/12/201 130801021218Y001341 0000787329516 EKA SUNARTI P PBI (APBN) Periapical abscess without sinus TIDAK
1077 17/12/201 130801021218Y001307 0000787391785 DJAMIRAH P PBI (APBN) Stomatitis and related lesions TIDAK
1078 17/12/201 130801021218Y001330 0000787397905 SAKIYEM P PBI (APBN) Systemic disorders of connective tissue TIDAK
1079 17/12/201 130801021218Y001282 0001045247128 DYAS SLAS VIRGIAWAN L PBI (APBN) Influenza with other manifestations, TIDAK
1080 17/12/201 130801021218Y001288 0001049784445 DANI L PBI (APBN) Fever, unspecified TIDAK
1081 17/12/201 130801021218Y001267 0001049785345 KATIRAH P PBI (APBN) Systemic disorders of connective tissue TIDAK
1082 17/12/201 130801021218Y001281 0001049789057 ABDUL BASYID L PBI (APBN) Allergic contact dermatitis, unspecified TIDAK
1083 17/12/201 130801021218Y001216 0001290470545 TRINASTITI YULIANTI P. R P PEGAWAI SWASTA Other antenatal screening TIDAK
1084 17/12/201 130801021218Y001334 0001295171346 LANDUNG MARGONO L PEKERJA MANDIRI Otitis externa, unspecified TIDAK
1085 17/12/201 130801021218Y001340 0001301298669 HARTATIK P PENERIMA PENSIUN Influenza with other manifestations, TIDAK
1086 17/12/201 130801021218Y001348 0001341519265 SRI WATIK P PENERIMA PENSIUN Allergic contact dermatitis TIDAK
1087 17/12/201 130801021218Y001327 0001383940157 MINARSIH P PEKERJA MANDIRI Gout TIDAK
1088 17/12/201 130801021218Y001254 0001399541861 FINDY APRILIYANTI P PEGAWAI SWASTA Disturbances in tooth eruption TIDAK
1089 17/12/201 130801021218Y001225 0001535989779 PULPITOSARI P PEKERJA MANDIRI Other antenatal screening TIDAK
1090 17/12/201 130801021218Y001321 0001540049894 TAS MINI P PEGAWAI SWASTA Cough TIDAK
1091 17/12/201 130801021218Y001244 0001702494933 TRI NURHAYATI P PEGAWAI SWASTA Influenza with other manifestations, TIDAK

09/01/2019 16.06.19
DAFTAR KUNJUNGAN PESERTA SAKIT

Kantor Cabang : MADIUN (1303)


FKTP : DEMANGAN (13080102)

NO TANGGAL NO KUNJUNGAN NO KARTU NAMA PESERTA SEX JENIS PESERTA DIAGNOSA DIRUJUK
1092 17/12/201 130801021218Y001245 0001702494955 AZIZA MELLYANI PUTRI P PEGAWAI SWASTA Influenza with other manifestations, TIDAK
1093 17/12/201 130801021218Y001261 0001704708178 SARMINI P PEKERJA MANDIRI Systemic disorders of connective tissue TIDAK
1094 17/12/201 130801021218Y001322 0001704709596 WIDJAYATI P PBI (APBD) Hypotension TIDAK
1095 17/12/201 130801021218Y001315 0001704710845 YUNI PRAWATI P PBI (APBD) Gastritis and duodenitis TIDAK
1096 17/12/201 130801021218Y001344 0001704712893 YUSI P PBI (APBD) Cough TIDAK
1097 17/12/201 130801021218Y001250 0001704713545 AGUS YULIANTORO L PBI (APBD) Systemic disorders of connective tissue TIDAK
1098 17/12/201 130801021218Y001331 0001704713668 KATINI P PBI (APBD) Influenza, virus not identified TIDAK
1099 17/12/201 130801021218Y001277 0001704714153 AISYAH P PBI (APBD) Influenza, virus not identified TIDAK
1100 17/12/201 130801021218Y001285 0001704722038 SITI MASITOH P PBI (APBD) Influenza due to other identified TIDAK
1101 17/12/201 130801021218Y001308 0001704723467 DEVI HARDIANTI P PBI (APBD) Fever of other and unknown origin TIDAK
1102 17/12/201 130801021218Y001279 0001704724784 INDRAWATI P PBI (APBD) Systemic disorders of connective tissue TIDAK
1103 17/12/201 130801021218Y001232 0001704725436 ENDANG JATI MANIK P PBI (APBD) Primary arthrosis of other joints, YA
1104 17/12/201 130801021218Y001222 0001704728013 SUKARNO SAPUTRO L PBI (APBD) Unspecified visual impairment YA
1105 17/12/201 130801021218Y001278 0001704729161 ATIK NURKUMALASARI P PBI (APBD) Gastritis, unspecified TIDAK
1106 17/12/201 130801021218Y001303 0001704732219 SULATIN L PBI (APBD) Non-insulin-dependent diabetes TIDAK
1107 17/12/201 130801021218Y001289 0001704732221 MUJI ASTUTINING RAHAYU P PBI (APBD) Systemic disorders of connective tissue TIDAK
1108 17/12/201 130801021218Y001195 0001704733389 SURATUN P PBI (APBD) Sequelae of stroke, not specified as YA
1109 17/12/201 130801021218Y001266 0001704845463 ZAINAB BUHAIROTULILMI P PBI (APBD) Disturbances in tooth eruption TIDAK
1110 17/12/201 130801021218Y001243 0001814097611 SUPRIHATIN P PEKERJA MANDIRI Gout TIDAK
1111 17/12/201 130801021218Y001295 0001830971823 KUSWANTO L PEKERJA MANDIRI Dental caries TIDAK
1112 17/12/201 130801021218Y001296 0001831426323 SUKOWATI P PEKERJA MANDIRI Influenza with other manifestations, TIDAK

09/01/2019 16.06.19
DAFTAR KUNJUNGAN PESERTA SAKIT

Kantor Cabang : MADIUN (1303)


FKTP : DEMANGAN (13080102)

NO TANGGAL NO KUNJUNGAN NO KARTU NAMA PESERTA SEX JENIS PESERTA DIAGNOSA DIRUJUK
1113 17/12/201 130801021218Y001247 0001846763368 SUWARDI L PEGAWAI SWASTA Systemic disorders of connective tissue TIDAK
1114 17/12/201 130801021218Y001290 0001856574123 HERU SUJATMIKO L PEKERJA MANDIRI Non-insulin-dependent diabetes TIDAK
1115 17/12/201 130801021218Y001229 0001859583554 ANNISA SETYO P PEGAWAI SWASTA Other antenatal screening TIDAK
1116 17/12/201 130801021218Y001314 0001859583554 ANNISA SETYO P PEGAWAI SWASTA Diarrhoea and gastroenteritis of TIDAK
1117 17/12/201 130801021218Y001320 0001906535845 WAHYUNINGSIH RETNO P PEGAWAI SWASTA Other specified headache syndromes TIDAK
1118 17/12/201 130801021218Y001284 0001917566572 ILHAM DWI SAPUTRA L PEGAWAI SWASTA Influenza, virus not identified TIDAK
1119 17/12/201 130801021218Y001326 0001993089317 MAMIK PUJIRAHAYU P PBI (APBN) Systemic disorders of connective tissue TIDAK
1120 17/12/201 130801021218Y001249 0002033453823 PAHING L PEKERJA MANDIRI Systemic disorders of connective tissue TIDAK
1121 17/12/201 130801021218Y001339 0002042871963 SRI SUWARNI P PEKERJA MANDIRI Systemic disorders of connective tissue TIDAK
1122 17/12/201 130801021218Y001246 0002073599965 MULYADI L PEKERJA MANDIRI Influenza with other manifestations, TIDAK
1123 17/12/201 130801021218Y001207 0002090826347 TRI PRASETYANINGRUM P PEGAWAI SWASTA Failure of sterile precautions during YA
1124 17/12/201 130801021218Y001215 0002163555483 HENY PRASETYO WATI P PBI (APBD) Other antenatal screening TIDAK
1125 17/12/201 130801021218Y001231 0002163564562 NADYA EKA ANASTASYA P PBI (APBD) Relapsing fever, unspecified TIDAK
1126 17/12/201 130801021218Y001360 0002163564562 NADYA EKA ANASTASYA P PBI (APBD) Influenza with other manifestations, TIDAK
1127 17/12/201 130801021218Y001317 0002163567442 APRILIA FITRI P PBI (APBD) Mumps TIDAK
1128 17/12/201 130801021218Y001204 0002163574102 ASILAH P PBI (APBD) Other orthopaedic follow-up care YA
1129 17/12/201 130801021218Y001280 0002163689313 EARLENE ANNORA P PBI (APBD) Influenza with other manifestations, TIDAK
1130 17/12/201 130801021218Y001338 0002163689324 ALMIRA MU'AAFII P PBI (APBD) Influenza with other manifestations, TIDAK
1131 17/12/201 130801021218Y001301 0002163695905 SARWOTO L PBI (APBD) Gastritis and duodenitis TIDAK
1132 17/12/201 130801021218Y001202 0002163696737 DJUMITRO L PBI (APBD) Retention of urine YA
1133 17/12/201 130801021218Y001219 0002163699663 PARMIASIH P PBI (APBD) Other antenatal screening TIDAK

09/01/2019 16.06.19
DAFTAR KUNJUNGAN PESERTA SAKIT

Kantor Cabang : MADIUN (1303)


FKTP : DEMANGAN (13080102)

NO TANGGAL NO KUNJUNGAN NO KARTU NAMA PESERTA SEX JENIS PESERTA DIAGNOSA DIRUJUK
1134 17/12/201 130801021218Y001217 0002163702971 NORA INDAH WINDRAYANTI P PBI (APBD) Other antenatal screening TIDAK
1135 17/12/201 130801021218Y001275 0002163703443 BIBIT PUJI LESTARI P PBI (APBD) Systemic disorders of connective tissue TIDAK
1136 17/12/201 130801021218Y001332 0002163703454 KASINEM P PBI (APBD) Essential (primary) hypertension TIDAK
1137 17/12/201 130801021218Y001233 0002163706997 DINA TRI APRILIANI P PBI (APBD) Disorder of refraction, unspecified YA
1138 17/12/201 130801021218Y001292 0002163708865 KATEMI P PBI (APBD) Allergic contact dermatitis, unspecified TIDAK
1139 17/12/201 130801021218Y001294 0002163712342 INDRAWATI P PBI (APBD) Gout TIDAK
1140 17/12/201 130801021218Y001359 0002163712375 MUHAMAD REVO L PBI (APBD) Influenza with other manifestations, TIDAK
1141 17/12/201 130801021218Y001318 0002163713681 SURGIANTO L PBI (APBD) Periapical abscess without sinus TIDAK
1142 17/12/201 130801021218Y001257 0002163713681 SURGIANTO L PBI (APBD) Essential (primary) hypertension TIDAK
1143 17/12/201 130801021218Y001316 0002163713692 EKA PUJIANI P PBI (APBD) Allergic contact dermatitis, unspecified TIDAK
1144 17/12/201 130801021218Y001358 0002163715659 RUSMINI P PBI (APBD) Non-insulin-dependent diabetes TIDAK
1145 17/12/201 130801021218Y001196 0002163715672 NADIA ANDRI P PBI (APBD) Abnormal finding on antenatal YA
1146 17/12/201 130801021218Y001260 0002163716019 EKO PURWANTORO L PBI (APBD) Necrosis of pulp TIDAK
1147 17/12/201 130801021218Y001361 0002163720508 WIJI RAHAYU P PBI (APBD) Gastritis, unspecified TIDAK
1148 17/12/201 130801021218Y001336 0002163720519 AZZAHRA OCTAVYANA P PBI (APBD) Necrosis of pulp TIDAK
1149 17/12/201 130801021218Y001241 0002163722411 MARTINI P PBI (APBD) Contraceptive management TIDAK
1150 17/12/201 130801021218Y001226 0002232171268 IVAN FIRMANSYAH L PEKERJA MANDIRI Disorder of refraction, unspecified YA
1151 17/12/201 130801021218Y001239 0002272749052 SAMADI L PEKERJA MANDIRI Non-insulin-dependent diabetes YA
1152 17/12/201 130801021218Y001355 0002287440764 NAFISA SEPTIANA P PBI (APBN) Influenza with other manifestations, TIDAK
1153 17/12/201 130801021218Y001283 0002413025649 KAYANAH P PBI (APBD) Systemic disorders of connective tissue TIDAK
1154 17/12/201 130801021218Y001304 0002413060413 ENDANG PRAMAWATI P PBI (APBD) Influenza with other manifestations, TIDAK

09/01/2019 16.06.19
DAFTAR KUNJUNGAN PESERTA SAKIT

Kantor Cabang : MADIUN (1303)


FKTP : DEMANGAN (13080102)

NO TANGGAL NO KUNJUNGAN NO KARTU NAMA PESERTA SEX JENIS PESERTA DIAGNOSA DIRUJUK
1155 17/12/201 130801021218Y001293 0002413081798 SUHARTINI P PBI (APBD) Non-insulin-dependent diabetes TIDAK
1156 17/12/201 130801021218Y001333 0002413107472 ROHMAN HARIADI L PBI (APBD) Systemic disorders of connective tissue TIDAK
1157 17/12/201 130801021218Y001311 0002413109766 SULASTRI P PBI (APBD) Systemic disorders of connective tissue TIDAK
1158 17/12/201 130801021218Y001253 0002413111509 ILUD FITRIANI P PBI (APBD) Other and unspecified infectious TIDAK
1159 17/12/201 130801021218Y001212 0002413112128 SUSI KUSNAWATI P PBI (APBD) Failure of sterile precautions during YA
1160 17/12/201 130801021218Y001263 0002413114031 DENY TRISWANTORO L PBI (APBD) Influenza with pneumonia, virus not TIDAK
1161 17/12/201 130801021218Y001220 0002413114233 IKA SOFIYANTI P PBI (APBD) Other antenatal screening TIDAK
1162 17/12/201 130801021218Y001228 0002413114503 HARIYATI P PBI (APBD) Insulin-dependent diabetes mellitus YA
1163 17/12/201 130801021218Y001238 0002413116909 MUHAMMAD LUTHFI L PBI (APBD) Fracture of metatarsal bone, closed YA
1164 17/12/201 130801021218Y001324 0002413117181 RULI PRIA BAWONO L PBI (APBD) Acute pharyngitis, unspecified TIDAK
1165 17/12/201 130801021218Y001236 0002413117315 SLAMET RIADI L PBI (APBD) Fracture of other metacarpal bone, YA
1166 17/12/201 130801021218Y001237 0002413117945 MURDJITO L PBI (APBD) Heart failure, unspecified YA
1167 17/12/201 130801021218Y001256 0002413136878 VANIA PUTRI SARTIKA P PBI (APBD) Dental caries TIDAK
1168 17/12/201 130801021218Y001271 0002413138048 NARENDRA DZAKY L PBI (APBD) Disturbances in tooth eruption TIDAK
1169 17/12/201 130801021218Y001319 0002413141661 TITIK MARIYANI P PBI (APBD) Diarrhoea and gastroenteritis of TIDAK
1170 17/12/201 130801021218Y001240 0002413142469 GHAZA DARIUS ALFARO L PBI (APBD) Hydrocele, unspecified YA
1171 17/12/201 130801021218Y001259 0002413150896 NURHAYATI P PBI (APBD) Non-insulin-dependent diabetes TIDAK
1172 17/12/201 130801021218Y001305 0002413152955 WAGIYEM P PBI (APBD) Gastritis and duodenitis TIDAK
1173 17/12/201 130801021218Y001264 0002413153157 BAMBANG SUNARI L PBI (APBD) Other headache syndromes TIDAK
1174 17/12/201 130801021218Y001337 0002413840599 YUNTAR ARIANTO L PBI (APBD) Otitis externa, unspecified TIDAK
1175 17/12/201 130801021218Y001258 0002413841073 SULASMINI P PBI (APBD) Systemic disorders of connective tissue TIDAK

09/01/2019 16.06.19
DAFTAR KUNJUNGAN PESERTA SAKIT

Kantor Cabang : MADIUN (1303)


FKTP : DEMANGAN (13080102)

NO TANGGAL NO KUNJUNGAN NO KARTU NAMA PESERTA SEX JENIS PESERTA DIAGNOSA DIRUJUK
1176 17/12/201 130801021218Y001273 0002413842287 SAMIATI P PBI (APBD) Non-insulin-dependent diabetes TIDAK
1177 17/12/201 130801021218Y001255 0002413901553 MARULI SANTOSO L PBI (APBD) Necrosis of pulp TIDAK
1178 17/12/201 130801021218Y001227 0002413915525 SUKINI P PBI (APBD) Myalgia YA
1179 17/12/201 130801021218Y001343 0002413917246 SUKEMI P PBI (APBD) Essential (primary) hypertension TIDAK
1180 17/12/201 130801021218Y001208 0002413923208 SISKA TRIANA DEWI P PBI (APBD) Failure of sterile precautions during YA
1181 17/12/201 130801021218Y001268 0002413923513 NIE KIEN NIO P PBI (APBD) Essential (primary) hypertension TIDAK
1182 17/12/201 130801021218Y001211 0002413954282 NOVIA ARDIVA MAHESTA P PBI (APBD) Dislocation, sprain and strain of joints YA
1183 17/12/201 130801021218Y001270 0002413959006 SUKAMTO L PBI (APBD) Cough TIDAK
1184 17/12/201 130801021218Y001210 0002413961144 NARENDRA SATRIA L PBI (APBD) Anomalies of tooth position YA
1185 17/12/201 130801021218Y001297 0002413961638 BEDJO L PBI (APBD) Gastritis and duodenitis TIDAK
1186 17/12/201 130801021218Y001328 0002413963449 NANIEK FARIDA P PBI (APBD) Necrosis of pulp TIDAK
1187 17/12/201 130801021218Y001201 0002413965756 MINARTI P PBI (APBD) Dorsalgia, unspecified YA
1188 17/12/201 130801021218Y001335 0002413967095 SUWARSINI P PBI (APBD) Systemic disorders of connective tissue TIDAK
1189 17/12/201 130801021218Y001329 0002428773592 AFIZA ISKANDAR P PBI (APBN) Influenza, virus not identified TIDAK
1190 17/12/201 130801021218Y001274 0002447445701 RIO ADI SAPUTRA L PEGAWAI SWASTA Zoster without complication TIDAK
1191 17/12/201 130801021218Y001354 0002454728984 AZAHRA LAILATUL LATIFAH P PEKERJA MANDIRI Influenza with other manifestations, TIDAK
1192 17/12/201 130801021218Y001221 0002454728984 AZAHRA LAILATUL LATIFAH P PEKERJA MANDIRI Influenza due to other identified TIDAK
1193 17/12/201 130801021218Y001325 0002458249391 KRISITA KUSWARNIATI P PEGAWAI SWASTA Other specified headache syndromes TIDAK
1194 17/12/201 130801021218Y001230 0002458249391 KRISITA KUSWARNIATI P PEGAWAI SWASTA Other antenatal screening TIDAK
1195 17/12/201 130801021218Y001218 0002500755052 JARWATI P PEKERJA MANDIRI Other antenatal screening TIDAK
1196 17/12/201 130801021218Y001200 0002621986839 NAVELLA MAULYDHA P PBI (APBN) Keratitis YA

09/01/2019 16.06.19
DAFTAR KUNJUNGAN PESERTA SAKIT

Kantor Cabang : MADIUN (1303)


FKTP : DEMANGAN (13080102)

NO TANGGAL NO KUNJUNGAN NO KARTU NAMA PESERTA SEX JENIS PESERTA DIAGNOSA DIRUJUK
1197 14/12/201 130801021218Y001105 0000078712839 ACHMAD DHOIF, BA L PENERIMA PENSIUN Cataract, unspecified YA
1198 14/12/201 130801021218Y001146 0000078780554 WADI SUDJIJO PRANOTO L PENERIMA PENSIUN Influenza, virus not identified TIDAK
1199 14/12/201 130801021218Y001106 0000105136018 SRI HARTINI P PNS DAERAH Chronic ischaemic heart disease, YA
1200 14/12/201 130801021218Y001189 0000105169689 FESTI ANGGRAINI YONASIH P PNS DAERAH Necrosis of pulp TIDAK
1201 14/12/201 130801021218Y001190 0000170000392 MIHARSI P PNS DAERAH Non-insulin-dependent diabetes TIDAK
1202 14/12/201 130801021218Y001182 0000209851108 SUTOPO L PENERIMA PENSIUN TNI Essential (primary) hypertension TIDAK
1203 14/12/201 130801021218Y001108 0000785248391 CATUR RATNANI P PBI (APBN) Epilepsy, unspecified YA
1204 14/12/201 130801021218Y001122 0000785832333 TUMIRIN L PBI (APBN) Gout TIDAK
1205 14/12/201 130801021218Y001148 0000786066658 ROHKIM DARWANTO L PBI (APBN) Scabies TIDAK
1206 14/12/201 130801021218Y002260 0000786116496 BURHANUDIN L PBI (APBN) Cough TIDAK
1207 14/12/201 130801021218Y001127 0000786166986 SITI FATIMAH NURUL P PBI (APBN) Gastritis, unspecified TIDAK
1208 14/12/201 130801021218Y001114 0000786207565 SUDIRO L PBI (APBN) Systemic disorders of connective tissue TIDAK
1209 14/12/201 130801021218Y002262 0000786214157 YUSUF L PBI (APBN) Influenza with other manifestations, TIDAK
1210 14/12/201 130801021218Y002258 0000786284831 SULANDARI P PBI (APBN) Gastritis, unspecified TIDAK
1211 14/12/201 130801021218Y001186 0000786307408 SAHID RIYANTO L PBI (APBN) Non-insulin-dependent diabetes TIDAK
1212 14/12/201 130801021218Y001133 0000786343151 PERTIWI PREHATIN P PBI (APBN) Pulpitis TIDAK
1213 14/12/201 130801021218Y001136 0000786520754 RIYONO L PBI (APBN) Systemic disorders of connective tissue TIDAK
1214 14/12/201 130801021218Y001172 0000786595026 SUWANDI L PBI (APBN) Other disorders of urinary system YA
1215 14/12/201 130801021218Y001135 0000786645731 HARIYANTO L PBI (APBN) Sequelae of other and unspecified TIDAK
1216 14/12/201 130801021218Y001173 0000786750129 LESTARI WARDANI P PBI (APBN) Gastritis, unspecified TIDAK
1217 14/12/201 130801021218Y002259 0000786766757 DEWI WAHYUNI P PBI (APBN) Cough TIDAK

09/01/2019 16.06.19
DAFTAR KUNJUNGAN PESERTA SAKIT

Kantor Cabang : MADIUN (1303)


FKTP : DEMANGAN (13080102)

NO TANGGAL NO KUNJUNGAN NO KARTU NAMA PESERTA SEX JENIS PESERTA DIAGNOSA DIRUJUK
1218 14/12/201 130801021218Y001130 0000786772056 ISWARI P PBI (APBN) Systemic disorders of connective tissue TIDAK
1219 14/12/201 130801021218Y001147 0000786777153 PARMIATI P PBI (APBN) Scabies TIDAK
1220 14/12/201 130801021218Y001116 0000786851199 WIJI MINDARTI P PBI (APBN) Contraceptive management TIDAK
1221 14/12/201 130801021218Y001162 0000786933371 SITI JUARIYAH P PBI (APBN) Essential (primary) hypertension TIDAK
1222 14/12/201 130801021218Y001134 0000787198476 MUSINAH P PBI (APBN) Non-insulin-dependent diabetes TIDAK
1223 14/12/201 130801021218Y001129 0000787258361 SAELAN L PBI (APBN) Influenza, virus not identified TIDAK
1224 14/12/201 130801021218Y001110 0000787311437 MUSINI P PBI (APBN) Sequelae of other and unspecified YA
1225 14/12/201 130801021218Y001193 0000787329516 EKA SUNARTI P PBI (APBN) Periapical abscess without sinus TIDAK
1226 14/12/201 130801021218Y001153 0001083359597 SUMINEM P PBI (APBN) Non-insulin-dependent diabetes TIDAK
1227 14/12/201 130801021218Y001112 0001105269726 KATIRIN L PRAJURIT AD Gout YA
1228 14/12/201 130801021218Y001137 0001303338047 SITI KOMARIYAH P PEKERJA MANDIRI Systemic disorders of connective tissue TIDAK
1229 14/12/201 130801021218Y001157 0001619798894 JUJUK IDAYANI P PEGAWAI SWASTA Systemic disorders of connective tissue TIDAK
1230 14/12/201 130801021218Y001183 0001704709596 WIDJAYATI P PBI (APBD) Other specified headache syndromes TIDAK
1231 14/12/201 130801021218Y001141 0001704718708 SUPRIYONO L PBI (APBD) Hypertensive heart disease TIDAK
1232 14/12/201 130801021218Y001140 0001704718719 GIARTI P PBI (APBD) Systemic disorders of connective tissue TIDAK
1233 14/12/201 130801021218Y001163 0001704720442 MURSIYAM P PBI (APBD) Essential (primary) hypertension TIDAK
1234 14/12/201 130801021218Y002261 0001704722174 RUSMINI P PBI (APBD) Cough TIDAK
1235 14/12/201 130801021218Y001123 0001704722376 SIPAN RIFIYANTO L PBI (APBD) Hypotension, unspecified TIDAK
1236 14/12/201 130801021218Y001166 0001704722387 LASINEM P PBI (APBD) Systemic disorders of connective tissue TIDAK
1237 14/12/201 130801021218Y001152 0001704722589 TASRI P PBI (APBD) Non-insulin-dependent diabetes TIDAK
1238 14/12/201 130801021218Y001126 0001704724479 KIANI P PBI (APBD) Other disorders of urinary system TIDAK

09/01/2019 16.06.19
DAFTAR KUNJUNGAN PESERTA SAKIT

Kantor Cabang : MADIUN (1303)


FKTP : DEMANGAN (13080102)

NO TANGGAL NO KUNJUNGAN NO KARTU NAMA PESERTA SEX JENIS PESERTA DIAGNOSA DIRUJUK
1239 14/12/201 130801021218Y001117 0001704725627 NOTO DIHARJO L PBI (APBD) Essential (primary) hypertension TIDAK
1240 14/12/201 130801021218Y001118 0001704726156 MUHHADI KABUL L PBI (APBD) Systemic disorders of connective tissue TIDAK
1241 14/12/201 130801021218Y001176 0001704726167 SUPARIYEM P PBI (APBD) Other headache syndromes TIDAK
1242 14/12/201 130801021218Y001185 0001704729328 BAMBANG SUKOCO RIYADI L PBI (APBD) Systemic disorders of connective tissue TIDAK
1243 14/12/201 130801021218Y001192 0001704732862 UDCHULUL JANNAH P PBI (APBD) Neonatal difficulty in feeding at breast TIDAK
1244 14/12/201 130801021218Y001125 0001704845665 PAINI P PBI (APBD) Systemic disorders of connective tissue TIDAK
1245 14/12/201 130801021218Y001171 0001808594921 tri widayanti P PEKERJA MANDIRI Otitis externa, unspecified TIDAK
1246 14/12/201 130801021218Y001177 0001825202711 SUDARSIH P PEKERJA MANDIRI Diarrhoea and gastroenteritis of TIDAK
1247 14/12/201 130801021218Y001119 0001828233336 LINDAWATI P PEGAWAI SWASTA Systemic disorders of connective tissue TIDAK
1248 14/12/201 130801021218Y001120 0001828233404 ELVINA APRILIA SABRINA P PEGAWAI SWASTA Relapsing fever, unspecified TIDAK
1249 14/12/201 130801021218Y001155 0001828233404 ELVINA APRILIA SABRINA P PEGAWAI SWASTA Cough TIDAK
1250 14/12/201 130801021218Y001167 0001833120832 SALSABILA NUR RAHMALIA P PEGAWAI PEMERINTAH Necrosis of pulp TIDAK
1251 14/12/201 130801021218Y001168 0001833121023 RAHMANIA MUTTAQIINA P PEGAWAI PEMERINTAH Caries limited to enamel TIDAK
1252 14/12/201 130801021218Y001138 0001875668646 TUKIRAH P PRAJURIT AD Systemic disorders of connective tissue TIDAK
1253 14/12/201 130801021218Y001161 0002077309427 MOHAMAD ALI L PEKERJA MANDIRI Gonarthrosis, unspecified YA
1254 14/12/201 130801021218Y001170 0002158648209 WIWIK SULISTYAWATI P PBI (APBD) Essential (primary) hypertension TIDAK
1255 14/12/201 130801021218Y001142 0002163547923 ALMIRA TUNGGADEWI P PBI (APBD) Influenza with other manifestations, TIDAK
1256 14/12/201 130801021218Y001109 0002163550803 DINAR AYU FAHALA DIYAH P PBI (APBD) Mechanical complication of intrauterine YA
1257 14/12/201 130801021218Y001169 0002163567352 KAMILA MUTTAQIINA P PBI (APBD) Disturbances in tooth eruption TIDAK
1258 14/12/201 130801021218Y001144 0002163572763 SUYITNO L PBI (APBD) Cough TIDAK
1259 14/12/201 130801021218Y001158 0002163688119 SUSILO EDY PRANOTO L PBI (APBD) Non-insulin-dependent diabetes TIDAK

09/01/2019 16.06.19
DAFTAR KUNJUNGAN PESERTA SAKIT

Kantor Cabang : MADIUN (1303)


FKTP : DEMANGAN (13080102)

NO TANGGAL NO KUNJUNGAN NO KARTU NAMA PESERTA SEX JENIS PESERTA DIAGNOSA DIRUJUK
1260 14/12/201 130801021218Y001154 0002163688659 SRIYANI P PBI (APBD) Hypertensive heart disease TIDAK
1261 14/12/201 130801021218Y001113 0002163689324 ALMIRA MU'AAFII P PBI (APBD) Influenza with other manifestations, TIDAK
1262 14/12/201 130801021218Y001132 0002163694599 SUDARTO L PBI (APBD) Hypertensive heart disease TIDAK
1263 14/12/201 130801021218Y001124 0002163695591 SONI P PBI (APBD) Non-insulin-dependent diabetes TIDAK
1264 14/12/201 130801021218Y001151 0002163696175 SUDARMI P PBI (APBD) Non-insulin-dependent diabetes TIDAK
1265 14/12/201 130801021218Y001143 0002163696491 BEDJO WIYONO L PBI (APBD) Systemic disorders of connective tissue TIDAK
1266 14/12/201 130801021218Y001180 0002163697536 MUKINEM P PBI (APBD) Influenza with other manifestations, TIDAK
1267 14/12/201 130801021218Y001149 0002163701373 RUJITO L PBI (APBD) Mixed asthma TIDAK
1268 14/12/201 130801021218Y001188 0002163702767 SUGIARTI P PBI (APBD) Necrosis of pulp TIDAK
1269 14/12/201 130801021218Y001178 0002163707807 HERNING SUSETIYO L PBI (APBD) Other headache syndromes TIDAK
1270 14/12/201 130801021218Y001194 0002163712803 ANNASA QOLBI ASY P PBI (APBD) Influenza with other manifestations, TIDAK
1271 14/12/201 130801021218Y001191 0002163712803 ANNASA QOLBI ASY P PBI (APBD) Relapsing fevers TIDAK
1272 14/12/201 130801021218Y001164 0002163716561 FERNANDO SATRIAWAN L PBI (APBD) Influenza with other manifestations, TIDAK
1273 14/12/201 130801021218Y001131 0002163718721 MUBIN HARTONO L PBI (APBD) Low back pain TIDAK
1274 14/12/201 130801021218Y001165 0002278202444 SRIATOEN P PEKERJA MANDIRI Systemic disorders of connective tissue TIDAK
1275 14/12/201 130801021218Y001179 0002278202444 SRIATOEN P PEKERJA MANDIRI Necrosis of pulp TIDAK
1276 14/12/201 130801021218Y001174 0002283170253 SAMIRIN L PEGAWAI SWASTA Gout TIDAK
1277 14/12/201 130801021218Y001175 0002289510505 SULASTRI P PBI (APBD) Disorders of lipoprotein metabolism TIDAK
1278 14/12/201 130801021218Y001107 0002321077757 SISWALUYO L PEKERJA MANDIRI Nontoxic goitre, unspecified YA
1279 14/12/201 130801021218Y001121 0002324297147 RAFKA ARSHA FATHAN L PEGAWAI SWASTA Influenza due to other identified TIDAK
1280 14/12/201 130801021218Y001156 0002324297147 RAFKA ARSHA FATHAN L PEGAWAI SWASTA Influenza with other manifestations, TIDAK

09/01/2019 16.06.19
DAFTAR KUNJUNGAN PESERTA SAKIT

Kantor Cabang : MADIUN (1303)


FKTP : DEMANGAN (13080102)

NO TANGGAL NO KUNJUNGAN NO KARTU NAMA PESERTA SEX JENIS PESERTA DIAGNOSA DIRUJUK
1281 14/12/201 130801021218Y002265 0002413027034 THERESIA DEBBY P PBI (APBD) Influenza with other manifestations, TIDAK
1282 14/12/201 130801021218Y002264 0002413032996 SUJADI L PBI (APBD) Influenza with other manifestations, TIDAK
1283 14/12/201 130801021218Y001159 0002413080639 SITI ARLIKAH P PBI (APBD) Non-insulin-dependent diabetes YA
1284 14/12/201 130801021218Y001181 0002413113658 SUPIYATUN P PBI (APBD) Essential (primary) hypertension TIDAK
1285 14/12/201 130801021218Y001150 0002413118878 STEFANUS IVAN L PBI (APBD) Allergic contact dermatitis, unspecified TIDAK
1286 14/12/201 130801021218Y001139 0002413136913 NOVA RETNO WARDHANI P PBI (APBD) Gastritis, unspecified TIDAK
1287 14/12/201 130801021218Y002257 0002413140669 RASYIQUL ABID NUGROHO L PBI (APBD) Influenza with other manifestations, TIDAK
1288 14/12/201 130801021218Y001187 0002413142616 DIAN FARIDA P PBI (APBD) Systemic disorders of connective tissue TIDAK
1289 14/12/201 130801021218Y001128 0002413149243 SRI WAHYUNI P PBI (APBD) Systemic disorders of connective tissue TIDAK
1290 14/12/201 130801021218Y002263 0002413917966 FANNY CHANDRA P PBI (APBD) Cough TIDAK
1291 14/12/201 130801021218Y001184 0002413960705 SAMINEM P PBI (APBD) Essential (primary) hypertension TIDAK
1292 14/12/201 130801021218Y001160 0002413970559 ARGO DIYANDONO L PBI (APBD) Sequelae of cerebrovascular disease YA
1293 14/12/201 130801021218Y001111 0002481449095 AHMAD FIRMANSYAH RIZAL L PEKERJA MANDIRI Orthopaedic follow-up care, YA
1294 14/12/201 130801021218Y001145 0002494561149 YULI LESTARININGTYAS P PBI (APBD) Necrosis of pulp TIDAK
1295 14/12/201 130801021218Y001115 0002500755052 JARWATI P PEKERJA MANDIRI Other antenatal screening TIDAK
1296 13/12/201 130801021218Y000990 0000078531219 KASIJONO L VETERAN Sequelae of other and unspecified YA
1297 13/12/201 130801021218Y001052 0000078544462 SUDARNO L PENERIMA PENSIUN TNI Systemic disorders of connective tissue TIDAK
1298 13/12/201 130801021218Y001058 0000078724394 SRI SUKAMTI P PENERIMA PENSIUN Disorder of vestibular function, TIDAK
1299 13/12/201 130801021218Y001072 0000078772048 RUSBANDIATI P PENERIMA PENSIUN Essential (primary) hypertension TIDAK
1300 13/12/201 130801021218Y001017 0000078780183 UNTUNG L PENERIMA PENSIUN Necrosis of pulp TIDAK
1301 13/12/201 130801021218Y000988 0000100472062 EMY SUDARSIH P PENERIMA PENSIUN Other dermatitis YA

09/01/2019 16.06.19
DAFTAR KUNJUNGAN PESERTA SAKIT

Kantor Cabang : MADIUN (1303)


FKTP : DEMANGAN (13080102)

NO TANGGAL NO KUNJUNGAN NO KARTU NAMA PESERTA SEX JENIS PESERTA DIAGNOSA DIRUJUK
1302 13/12/201 130801021218Y000989 0000104791612 SULIKHAH P PENERIMA PENSIUN Insulin-dependent diabetes mellitus YA
1303 13/12/201 130801021218Y001099 0000105896586 SUNARTO BIN L PENERIMA PENSIUN Sequelae of other and unspecified TIDAK
1304 13/12/201 130801021218Y000985 0000106075798 SUWARNI P PNS DAERAH Disorder of patella, unspecified YA
1305 13/12/201 130801021218Y000996 0000106294116 PUJI L PNS DAERAH Other recurrent depressive disorders YA
1306 13/12/201 130801021218Y001079 0000106359423 TUMINEM P PENERIMA PENSIUN TNI Allergic contact dermatitis, unspecified TIDAK
1307 13/12/201 130801021218Y000994 0000106359614 IPAH P PENERIMA PENSIUN TNI Heart failure YA
1308 13/12/201 130801021218Y000998 0000785253565 SUYATMI P PBI (APBN) Rheumatism, unspecified YA
1309 13/12/201 130801021218Y001073 0000786073645 SIPON P PBI (APBN) Essential (primary) hypertension TIDAK
1310 13/12/201 130801021218Y001080 0000786115091 TUMINI P PBI (APBN) Hypotension TIDAK
1311 13/12/201 130801021218Y001085 0000786193942 ABUMANYU NUR ISLAMI L PBI (APBN) Influenza with other manifestations, TIDAK
1312 13/12/201 130801021218Y001094 0000786262015 SUMILAH P PBI (APBN) Systemic disorders of connective tissue TIDAK
1313 13/12/201 130801021218Y001055 0000786267303 SUYATMI P PBI (APBN) Benign lipomatous neoplasm, TIDAK
1314 13/12/201 130801021218Y001057 0000786328659 MARSILAH P PBI (APBN) Malignant neoplasm of breast, TIDAK
1315 13/12/201 130801021218Y001093 0000786411404 RANTI P PBI (APBN) Systemic disorders of connective tissue TIDAK
1316 13/12/201 130801021218Y001102 0000786444096 LAMINI P PBI (APBN) Non-insulin-dependent diabetes TIDAK
1317 13/12/201 130801021218Y001071 0000786507052 KOHAR L PBI (APBN) Myalgia TIDAK
1318 13/12/201 130801021218Y001064 0000786727539 SUKINO L PBI (APBN) Benign lipomatous neoplasm, TIDAK
1319 13/12/201 130801021218Y001040 0000786729069 PUGUH SUBIANTO L PBI (APBN) Angina pectoris, unspecified YA
1320 13/12/201 130801021218Y001045 0000786752921 PANDAN ARUM NILIS DYAN P PBI (APBN) Systemic disorders of connective tissue TIDAK
1321 13/12/201 130801021218Y001056 0000786806673 SUMINEM P PBI (APBN) Systemic disorders of connective tissue TIDAK
1322 13/12/201 130801021218Y001089 0000786813107 JOKO SANTOSO L PBI (APBN) Asthma, unspecified TIDAK

09/01/2019 16.06.19
DAFTAR KUNJUNGAN PESERTA SAKIT

Kantor Cabang : MADIUN (1303)


FKTP : DEMANGAN (13080102)

NO TANGGAL NO KUNJUNGAN NO KARTU NAMA PESERTA SEX JENIS PESERTA DIAGNOSA DIRUJUK
1323 13/12/201 130801021218Y001025 0000786888314 SAMINEM P PBI (APBN) Essential (primary) hypertension TIDAK
1324 13/12/201 130801021218Y001030 0000786900161 HUSEN BUDIANTO L PBI (APBN) Other dermatitis TIDAK
1325 13/12/201 130801021218Y001075 0000786953057 INTAN MAHANTARI PUTRI P PBI (APBN) Otitis externa, unspecified TIDAK
1326 13/12/201 130801021218Y001083 0000786975085 KABUL L PBI (APBN) Acute tonsillitis, unspecified TIDAK
1327 13/12/201 130801021218Y001061 0000786987426 SINEM P PBI (APBN) Non-insulin-dependent diabetes TIDAK
1328 13/12/201 130801021218Y001068 0000787090206 SUTI P PBI (APBN) Essential (primary) hypertension TIDAK
1329 13/12/201 130801021218Y001082 0000787260666 SITI FATIMAH P PBI (APBN) Allergic contact dermatitis TIDAK
1330 13/12/201 130801021218Y001049 0000787706504 KANTI RAHAYU P PBI (APBN) Non-insulin-dependent diabetes TIDAK
1331 13/12/201 130801021218Y001051 0000787714389 PARINUK P PBI (APBN) Systemic disorders of connective tissue TIDAK
1332 13/12/201 130801021218Y001018 0000787714852 YESINIA PUSPITA SARI P PBI (APBN) Necrosis of pulp TIDAK
1333 13/12/201 130801021218Y001023 0001045247376 SUPINAH P PBI (APBN) Gout TIDAK
1334 13/12/201 130801021218Y001087 0001049784412 GIHARTI P PBI (APBN) Systemic disorders of connective tissue TIDAK
1335 13/12/201 130801021218Y001066 0001049786842 DJUMINEM P PBI (APBN) Myalgia TIDAK
1336 13/12/201 130801021218Y001069 0001049789237 WAHYU NUR HIDAYAT L PBI (APBN) Diarrhoea and gastroenteritis of TIDAK
1337 13/12/201 130801021218Y000995 0001083898798 SUPARMI P PBI (APBN) Chronic ischaemic heart disease YA
1338 13/12/201 130801021218Y001091 0001295171346 LANDUNG MARGONO L PEKERJA MANDIRI Systemic disorders of connective tissue TIDAK
1339 13/12/201 130801021218Y001047 0001321068159 JOKO KUSTOYO L KEPOLISIAN RI Conjunctivitis, unspecified TIDAK
1340 13/12/201 130801021218Y001027 0001341476043 ISWOROWATI P PENERIMA PENSIUN Gout TIDAK
1341 13/12/201 130801021218Y001035 0001427890296 ESTI SUFIA KRISANTI P PEGAWAI PEMERINTAH Dental caries TIDAK
1342 13/12/201 130801021218Y001074 0001576654435 ALYA LUBNA H L P PEGAWAI SWASTA Influenza with other manifestations, TIDAK
1343 13/12/201 130801021218Y001050 0001704704523 CHAYAT PUDJI R L PBI (APBD) Non-insulin-dependent diabetes TIDAK

09/01/2019 16.06.19
DAFTAR KUNJUNGAN PESERTA SAKIT

Kantor Cabang : MADIUN (1303)


FKTP : DEMANGAN (13080102)

NO TANGGAL NO KUNJUNGAN NO KARTU NAMA PESERTA SEX JENIS PESERTA DIAGNOSA DIRUJUK
1344 13/12/201 130801021218Y001036 0001704710957 SHINTA YULIARTA PUTRI P PBI (APBD) Necrosis of pulp TIDAK
1345 13/12/201 130801021218Y001041 0001704713894 ILHAM GECI WICAKSONO L PBI (APBD) Other specified headache syndromes TIDAK
1346 13/12/201 130801021218Y001039 0001704717999 SUGIARTi P PBI (APBD) Rheumatoid arthritis, unspecified YA
1347 13/12/201 130801021218Y001076 0001704719981 ANI HARIANI P PBI (APBD) Myalgia TIDAK
1348 13/12/201 130801021218Y000987 0001704722668 SUMARDJI L PBI (APBD) Heart failure YA
1349 13/12/201 130801021218Y001090 0001704723524 YOSA ADI P L PBI (APBD) Disorder of urinary system, unspecified TIDAK
1350 13/12/201 130801021218Y001078 0001704725526 HADI SUPRIYONO L PBI (APBD) Systemic disorders of connective tissue TIDAK
1351 13/12/201 130801021218Y001077 0001704725537 SUWARNI P PBI (APBD) Disorder of lipoprotein metabolism, TIDAK
1352 13/12/201 130801021218Y001095 0001704728564 SUMARYANI P PBI (APBD) Gastritis, unspecified TIDAK
1353 13/12/201 130801021218Y001029 0001704730847 SUHENDRI L PBI (APBD) Myalgia TIDAK
1354 13/12/201 130801021218Y001038 0001704846734 PASYA TATA AHMADHAN L PBI (APBD) Supernumerary teeth TIDAK
1355 13/12/201 130801021218Y001098 0001877400988 KHANZA ALIFIA AZZAHRA L PEGAWAI SWASTA Influenza with other manifestations, TIDAK
1356 13/12/201 130801021218Y001034 0001969475275 LATHIFAH YURI P PEGAWAI SWASTA Supernumerary teeth TIDAK
1357 13/12/201 130801021218Y001062 0002158648738 SITI MUTMAINAH P PBI (APBD) Non-insulin-dependent diabetes TIDAK
1358 13/12/201 130801021218Y001007 0002163546101 GALUH ILLONA MAHARDIKA P PBI (APBD) Follow-up care involving removal of YA
1359 13/12/201 130801021218Y001022 0002163547596 REYHAN SATRIA NUGROHO L PBI (APBD) Pulpitis TIDAK
1360 13/12/201 130801021218Y001024 0002163548946 SITI MAIMUNAH P PBI (APBD) Non-insulin-dependent diabetes TIDAK
1361 13/12/201 130801021218Y001101 0002163548957 MAYKA AMALIA AZ ZAHRA P PBI (APBD) Influenza with other manifestations, TIDAK
1362 13/12/201 130801021218Y001002 0002163548957 MAYKA AMALIA AZ ZAHRA P PBI (APBD) Diaper [napkin] dermatitis TIDAK
1363 13/12/201 130801021218Y001000 0002163550937 MARENDY SAPUTRA L PBI (APBD) Influenza due to other identified TIDAK
1364 13/12/201 130801021218Y001103 0002163550937 MARENDY SAPUTRA L PBI (APBD) Influenza with other manifestations, TIDAK

09/01/2019 16.06.19
DAFTAR KUNJUNGAN PESERTA SAKIT

Kantor Cabang : MADIUN (1303)


FKTP : DEMANGAN (13080102)

NO TANGGAL NO KUNJUNGAN NO KARTU NAMA PESERTA SEX JENIS PESERTA DIAGNOSA DIRUJUK
1365 13/12/201 130801021218Y001104 0002163556596 YUNI KURNIAWATI P PBI (APBD) Influenza with other manifestations, TIDAK
1366 13/12/201 130801021218Y000986 0002163564022 M. ABID HABIBI L PBI (APBD) Unspecified haemorrhoids without YA
1367 13/12/201 130801021218Y001003 0002163568184 MUHAMMAD AKMAL L PBI (APBD) Relapsing fever, unspecified TIDAK
1368 13/12/201 130801021218Y001008 0002163568184 MUHAMMAD AKMAL L PBI (APBD) Convulsions, not elsewhere classified YA
1369 13/12/201 130801021218Y000991 0002163568533 YANUAR BASUKI L PBI (APBD) Non-insulin-dependent diabetes YA
1370 13/12/201 130801021218Y001028 0002163570006 SYIFAUL JIHAN P PBI (APBD) Dental caries TIDAK
1371 13/12/201 130801021218Y001006 0002163639982 NUR IMANSYAH L PBI (APBD) Disorder of urinary system, unspecified YA
1372 13/12/201 130801021218Y001013 0002163684519 WIJIATI P PBI (APBD) Essential (primary) hypertension TIDAK
1373 13/12/201 130801021218Y001086 0002163691901 JUMIRAH P PBI (APBD) Essential (primary) hypertension TIDAK
1374 13/12/201 130801021218Y001059 0002163695499 SUTADI L PBI (APBD) Essential (primary) hypertension TIDAK
1375 13/12/201 130801021218Y001021 0002163700034 M. DICKZA RIZKI AKBAR L PBI (APBD) Supernumerary teeth TIDAK
1376 13/12/201 130801021218Y001037 0002163700056 TEGUH SETYA BUDI UTAMA L PBI (APBD) Necrosis of pulp TIDAK
1377 13/12/201 130801021218Y001092 0002163707289 SRIATUN P PBI (APBD) Other and unspecified infectious TIDAK
1378 13/12/201 130801021218Y001096 0002163709811 KUS ENDARWATI P PBI (APBD) Conjunctivitis, unspecified TIDAK
1379 13/12/201 130801021218Y002427 0002163709833 DYAH AYU HIDAYATI P PBI (APBD) Disturbances in tooth eruption TIDAK
1380 13/12/201 130801021218Y001097 0002163709833 DYAH AYU HIDAYATI P PBI (APBD) Influenza with other manifestations, TIDAK
1381 13/12/201 130801021218Y001044 0002163710136 SUKINI P PBI (APBD) Systemic disorders of connective tissue TIDAK
1382 13/12/201 130801021218Y001081 0002163710823 SUMARSIH P PBI (APBD) Non-insulin-dependent diabetes TIDAK
1383 13/12/201 130801021218Y001046 0002163718721 MUBIN HARTONO L PBI (APBD) Myalgia TIDAK
1384 13/12/201 130801021218Y001067 0002163719439 WINDARTINI P PBI (APBD) Non-insulin-dependent diabetes TIDAK
1385 13/12/201 130801021218Y001043 0002222913982 RINDYAH HANAFI, SE.,MM P PENERIMA PENSIUN TNI Influenza, virus not identified TIDAK

09/01/2019 16.06.19
DAFTAR KUNJUNGAN PESERTA SAKIT

Kantor Cabang : MADIUN (1303)


FKTP : DEMANGAN (13080102)

NO TANGGAL NO KUNJUNGAN NO KARTU NAMA PESERTA SEX JENIS PESERTA DIAGNOSA DIRUJUK
1386 13/12/201 130801021218Y001063 0002246918771 MINEM P PEKERJA MANDIRI Non-insulin-dependent diabetes TIDAK
1387 13/12/201 130801021218Y001054 0002354079159 MARTO KAMIRUN L PBI (APBN) Other and unspecified infectious TIDAK
1388 13/12/201 130801021218Y001011 0002413057331 SOEKARMI P PBI (APBD) Essential (primary) hypertension TIDAK
1389 13/12/201 130801021218Y001012 0002413060143 PARMIATUN P PBI (APBD) Systemic disorders of connective tissue TIDAK
1390 13/12/201 130801021218Y001042 0002413116167 IWING MULYANI P PBI (APBD) Cough TIDAK
1391 13/12/201 130801021218Y000997 0002413118114 PANIJEM P PBI (APBD) Heart failure, unspecified YA
1392 13/12/201 130801021218Y001009 0002413118878 STEFANUS IVAN L PBI (APBD) Allergic contact dermatitis TIDAK
1393 13/12/201 130801021218Y001019 0002413136125 VITA CYNTHIA MAHARDIKA P PBI (APBD) Necrosis of pulp TIDAK
1394 13/12/201 130801021218Y001020 0002413136136 NADA INDANA ZULFA P PBI (APBD) Caries of dentine TIDAK
1395 13/12/201 130801021218Y002213 0002413143966 ELY NANDA P PBI (APBD) Candidiasis of vulva and vagina TIDAK
1396 13/12/201 130801021218Y001014 0002413144293 KASMINI P PBI (APBD) Essential (primary) hypertension TIDAK
1397 13/12/201 130801021218Y000999 0002413152639 EDY SANTOSO L PBI (APBD) Dermatitis, unspecified YA
1398 13/12/201 130801021218Y001033 0002413154226 VANIA EKA DHEWANTI P PBI (APBD) Necrosis of pulp TIDAK
1399 13/12/201 130801021218Y001088 0002413840689 SRI WAHJOENING P PBI (APBD) Systemic disorders of connective tissue TIDAK
1400 13/12/201 130801021218Y001031 0002413842445 MARIYATIN P PBI (APBD) Gastritis and duodenitis TIDAK
1401 13/12/201 130801021218Y001060 0002413850894 SAMINTEN P PBI (APBD) Essential (primary) hypertension TIDAK
1402 13/12/201 130801021218Y000993 0002413852762 SAYEKTI P PBI (APBD) Tetanus neonatorum YA
1403 13/12/201 130801021218Y000992 0002413915481 TAMAN L PBI (APBD) Hyperplasia of prostate YA
1404 13/12/201 130801021218Y001010 0002413915492 MALEMI P PBI (APBD) Essential (primary) hypertension TIDAK
1405 13/12/201 130801021218Y001053 0002413919338 NUR HAYATI P PBI (APBD) Disorder of lipoprotein metabolism, TIDAK
1406 13/12/201 130801021218Y001084 0002413954258 LUTHFIANA ZAHRA TALITA P PBI (APBD) Influenza due to other identified TIDAK

09/01/2019 16.06.19
DAFTAR KUNJUNGAN PESERTA SAKIT

Kantor Cabang : MADIUN (1303)


FKTP : DEMANGAN (13080102)

NO TANGGAL NO KUNJUNGAN NO KARTU NAMA PESERTA SEX JENIS PESERTA DIAGNOSA DIRUJUK
1407 13/12/201 130801021218Y001032 0002413961616 ASHAR L PBI (APBD) Influenza due to other identified TIDAK
1408 13/12/201 130801021218Y001005 0002413962077 SUPARDI L PBI (APBD) Cataract, unspecified YA
1409 13/12/201 130801021218Y001004 0002413962088 GIYEM P PBI (APBD) Cataract, unspecified YA
1410 13/12/201 130801021218Y001070 0002413962369 SUMIRAN L PBI (APBD) Systemic disorders of connective tissue TIDAK
1411 13/12/201 130801021218Y001065 0002413967016 SRI WAHYUNI P PBI (APBD) Influenza, virus not identified TIDAK
1412 13/12/201 130801021218Y001026 0002413969841 SUMARTI P PBI (APBD) Necrosis of pulp TIDAK
1413 13/12/201 130801021218Y001001 0002450383659 SHIN IZZY AR SAKHA L PBI (APBN) Herpesviral vesicular dermatitis TIDAK
1414 13/12/201 130801021218Y001100 0002452741154 EDWARD DAVIAN L PEKERJA MANDIRI Influenza with other manifestations, TIDAK
1415 13/12/201 130801021218Y001048 0002465132534 M IZZUL HAQ IZZUDDIN L PEKERJA MANDIRI Benign lipomatous neoplasm, TIDAK
1416 12/12/201 130801021218Y000866 0000078530804 ARMADITA LUTHFI P P PENERIMA PENSIUN TNI Antenatal screening TIDAK
1417 12/12/201 130801021218Y000862 0000078552055 SUMIYATUN P PENERIMA PENSIUN TNI Congestive heart failure YA
1418 12/12/201 130801021218Y000961 0000078558221 SULIYATI P PENERIMA PENSIUN TNI Gastritis, unspecified TIDAK
1419 12/12/201 130801021218Y000861 0000078559334 SUPARMI P PENERIMA PENSIUN TNI Congestive heart failure YA
1420 12/12/201 130801021218Y000867 0000078736149 RANTI P PENERIMA PENSIUN Heart failure YA
1421 12/12/201 130801021218Y000980 0000104851541 SIH SUHARTINI,S.SOS P PNS DAERAH Dental caries TIDAK
1422 12/12/201 130801021218Y001015 0000106435271 ROSYID L PNS DAERAH Allergic contact dermatitis TIDAK
1423 12/12/201 130801021218Y000943 0000106441233 LISMIYARTI P PNS DAERAH Necrosis of pulp TIDAK
1424 12/12/201 130801021218Y000962 0000106441233 LISMIYARTI P PNS DAERAH Essential (primary) hypertension TIDAK
1425 12/12/201 130801021218Y000968 0000156565023 SRI UTAMI P PENERIMA PENSIUN Systemic disorders of connective tissue TIDAK
1426 12/12/201 130801021218Y000939 0000169424572 SUPRIYANI P PNS PUSAT Caries limited to enamel TIDAK
1427 12/12/201 130801021218Y000891 0000739388957 MARYANI P PBI (APBN) Gastritis, unspecified TIDAK

09/01/2019 16.06.19
DAFTAR KUNJUNGAN PESERTA SAKIT

Kantor Cabang : MADIUN (1303)


FKTP : DEMANGAN (13080102)

NO TANGGAL NO KUNJUNGAN NO KARTU NAMA PESERTA SEX JENIS PESERTA DIAGNOSA DIRUJUK
1428 12/12/201 130801021218Y000932 0000740723185 PAMELA WULANDARI P PBI (APBN) Influenza with other manifestations, TIDAK
1429 12/12/201 130801021218Y000884 0000786082421 BEJO BASUKI L PBI (APBN) Mixed asthma YA
1430 12/12/201 130801021218Y000952 0000786114652 SLAMET L PBI (APBN) Essential (primary) hypertension TIDAK
1431 12/12/201 130801021218Y000918 0000786125992 MOCH DJAENUDIN L PBI (APBN) Gout TIDAK
1432 12/12/201 130801021218Y000935 0000786133361 SRI PURWANI P PBI (APBN) Fever, unspecified TIDAK
1433 12/12/201 130801021218Y000869 0000786138647 CATUR DYAH BUDI P PBI (APBN) Antenatal screening TIDAK
1434 12/12/201 130801021218Y000874 0000786235274 ROLITA PUTRI WISESA P PBI (APBN) Antenatal screening TIDAK
1435 12/12/201 130801021218Y000925 0000786385045 ADITIA PRAMASTA L PBI (APBN) Abdominal and pelvic pain TIDAK
1436 12/12/201 130801021218Y000872 0000786427852 MARIYAH P PBI (APBN) Cystic fibrosis, unspecified TIDAK
1437 12/12/201 130801021218Y000882 0000786427852 MARIYAH P PBI (APBN) Benign neoplasm of liver YA
1438 12/12/201 130801021218Y000976 0000786450835 NYONO SUHARTONO L PBI (APBN) Non-insulin-dependent diabetes TIDAK
1439 12/12/201 130801021218Y000965 0000786557957 RENI DAMAYANTI P PBI (APBN) Acute haemorrhagic gastritis TIDAK
1440 12/12/201 130801021218Y000879 0000786589064 NURUL HANDAYANI P PBI (APBN) Abnormal finding on antenatal YA
1441 12/12/201 130801021218Y000981 0000786611507 SUNARTI P PBI (APBN) Essential (primary) hypertension TIDAK
1442 12/12/201 130801021218Y000887 0000786611507 SUNARTI P PBI (APBN) Contraceptive management TIDAK
1443 12/12/201 130801021218Y000946 0000786729273 ERNA CAHYARINI P PBI (APBN) Influenza with other manifestations, TIDAK
1444 12/12/201 130801021218Y000948 0000786732118 GENDHIS MEDYANA P PBI (APBN) Influenza with other respiratory TIDAK
1445 12/12/201 130801021218Y000947 0000786732309 PRIHATIN PUJO SUBIANTO L PBI (APBN) Influenza with other manifestations, TIDAK
1446 12/12/201 130801021218Y000914 0000786748274 WAKIDI L PBI (APBN) Influenza with other manifestations, TIDAK
1447 12/12/201 130801021218Y000875 0000786780156 FITRI HARIYANTI P PBI (APBN) Contraceptive management TIDAK
1448 12/12/201 130801021218Y000972 0000786913885 SATUN P PBI (APBN) Influenza with other manifestations, TIDAK

09/01/2019 16.06.19
DAFTAR KUNJUNGAN PESERTA SAKIT

Kantor Cabang : MADIUN (1303)


FKTP : DEMANGAN (13080102)

NO TANGGAL NO KUNJUNGAN NO KARTU NAMA PESERTA SEX JENIS PESERTA DIAGNOSA DIRUJUK
1449 12/12/201 130801021218Y000954 0000787090566 SALEH L PBI (APBN) Zoster [herpes zoster] TIDAK
1450 12/12/201 130801021218Y000955 0000787128131 SUTRISNO L PBI (APBN) Tinea pedis TIDAK
1451 12/12/201 130801021218Y000974 0000787249653 ARIFIAN ARGA L PBI (APBN) Diarrhoea and gastroenteritis of TIDAK
1452 12/12/201 130801021218Y000922 0000787261768 WIDODO L PBI (APBN) Cough TIDAK
1453 12/12/201 130801021218Y000967 0000787392516 NINING LESTARI P PBI (APBN) Mixed hyperlipidaemia TIDAK
1454 12/12/201 130801021218Y000942 0000787403801 WAGIYEM P PBI (APBN) Allergic contact dermatitis, unspecified TIDAK
1455 12/12/201 130801021218Y000893 0000787412193 SRI ANDINI P PBI (APBN) Allergic contact dermatitis TIDAK
1456 12/12/201 130801021218Y000919 0001268606902 RR GALUH PUSPA P PEGAWAI SWASTA Other and unspecified infectious TIDAK
1457 12/12/201 130801021218Y000915 0001341457097 ISTI RAHAYU P PENERIMA PENSIUN Conjunctivitis, unspecified TIDAK
1458 12/12/201 130801021218Y000913 0001435329167 TUTIEK SUDARYATI P PEKERJA MANDIRI Necrosis of pulp TIDAK
1459 12/12/201 130801021218Y000888 0001535989779 PULPITOSARI P PEKERJA MANDIRI Maternal care for fetal problem, TIDAK
1460 12/12/201 130801021218Y000984 0001540049894 TAS MINI P PEGAWAI SWASTA Cough TIDAK
1461 12/12/201 130801021218Y000936 0001645504604 SRI WAHYUNI WINANTU P PEGAWAI SWASTA Necrosis of pulp TIDAK
1462 12/12/201 130801021218Y000878 0001704705873 NISA DWI A P PBI (APBD) Antenatal screening TIDAK
1463 12/12/201 130801021218Y000865 0001704706187 ERNI PURNAWATI P PBI (APBD) Antenatal screening TIDAK
1464 12/12/201 130801021218Y000934 0001704708821 SATIYEM P PBI (APBD) Chronic periodontitis TIDAK
1465 12/12/201 130801021218Y000951 0001704709809 DEWI NATALIYA P PBI (APBD) Otitis externa TIDAK
1466 12/12/201 130801021218Y000912 0001704710103 AAN SETIYONO L PBI (APBD) Conjunctivitis, unspecified TIDAK
1467 12/12/201 130801021218Y000963 0001704716875 TEMU MUJIATI P PBI (APBD) Dysmenorrhoea, unspecified TIDAK
1468 12/12/201 130801021218Y000883 0001704716875 TEMU MUJIATI P PBI (APBD) Dysmenorrhoea, unspecified YA
1469 12/12/201 130801021218Y000880 0001704719182 GANDES LARASWATI P PBI (APBD) Antenatal screening TIDAK

09/01/2019 16.06.19
DAFTAR KUNJUNGAN PESERTA SAKIT

Kantor Cabang : MADIUN (1303)


FKTP : DEMANGAN (13080102)

NO TANGGAL NO KUNJUNGAN NO KARTU NAMA PESERTA SEX JENIS PESERTA DIAGNOSA DIRUJUK
1470 12/12/201 130801021218Y000944 0001704721724 SITI NURHAYATI P PBI (APBD) Essential (primary) hypertension TIDAK
1471 12/12/201 130801021218Y000975 0001704724986 SUDARSONO L PBI (APBD) Gastritis, unspecified TIDAK
1472 12/12/201 130801021218Y000923 0001704730421 SUPARLAN L PBI (APBD) Gastritis and duodenitis TIDAK
1473 12/12/201 130801021218Y000979 0001704844888 MURYANI P PBI (APBD) Hypotension TIDAK
1474 12/12/201 130801021218Y000970 0001704847634 LASMINI P PBI (APBD) Non-insulin-dependent diabetes TIDAK
1475 12/12/201 130801021218Y000960 0001704857602 SUTINI P PBI (APBD) Disorders of lipoprotein metabolism TIDAK
1476 12/12/201 130801021218Y001016 0001826063436 IRSYAD MAULANA L PEGAWAI SWASTA Influenza with other manifestations, TIDAK
1477 12/12/201 130801021218Y000909 0001830971823 KUSWANTO L PEKERJA MANDIRI Caries of dentine TIDAK
1478 12/12/201 130801021218Y000983 0001894557532 HARIADI L PEKERJA MANDIRI Systemic disorders of connective tissue TIDAK
1479 12/12/201 130801021218Y000958 0001906535845 WAHYUNINGSIH RETNO P PEGAWAI SWASTA Disorders of vestibular function TIDAK
1480 12/12/201 130801021218Y000941 0002068987195 PURWATININGSIH P PBI (APBD) Other specified headache syndromes TIDAK
1481 12/12/201 130801021218Y000917 0002096200067 FENDY ASPUTRO L PEGAWAI SWASTA Influenza due to other identified TIDAK
1482 12/12/201 130801021218Y000938 0002163552726 PARTI P PBI (APBD) Non-insulin-dependent diabetes TIDAK
1483 12/12/201 130801021218Y000911 0002163564022 M. ABID HABIBI L PBI (APBD) Fever, unspecified TIDAK
1484 12/12/201 130801021218Y000871 0002163566654 EKA LILIS KURNIAWATI P PBI (APBD) Antenatal screening TIDAK
1485 12/12/201 130801021218Y000978 0002163693903 HARNI P PBI (APBD) Systemic disorders of connective tissue TIDAK
1486 12/12/201 130801021218Y000956 0002163697569 SUHATMINI P PBI (APBD) Gastritis and duodenitis TIDAK
1487 12/12/201 130801021218Y000945 0002163697672 MUGIATINI P PBI (APBD) Systemic disorders of connective tissue TIDAK
1488 12/12/201 130801021218Y000863 0002163698818 NADIA HAYA MUSTIKA P PBI (APBD) Other specified irregular menstruation YA
1489 12/12/201 130801021218Y000927 0002163699437 DEAN SAFITRI P PBI (APBD) Fever, unspecified TIDAK
1490 12/12/201 130801021218Y000971 0002163703961 ALI ZULVIAN SYAHRUL L PBI (APBD) Fever, unspecified TIDAK

09/01/2019 16.06.19
DAFTAR KUNJUNGAN PESERTA SAKIT

Kantor Cabang : MADIUN (1303)


FKTP : DEMANGAN (13080102)

NO TANGGAL NO KUNJUNGAN NO KARTU NAMA PESERTA SEX JENIS PESERTA DIAGNOSA DIRUJUK
1491 12/12/201 130801021218Y000964 0002163706165 DJUMIRIN L PBI (APBD) Systemic disorders of connective tissue TIDAK
1492 12/12/201 130801021218Y000929 0002163708549 SUMARMI P PBI (APBD) Systemic disorders of connective tissue TIDAK
1493 12/12/201 130801021218Y000977 0002163708551 ERVAN EFENDI L PBI (APBD) Acute and transient psychotic disorder, TIDAK
1494 12/12/201 130801021218Y000959 0002163712059 OKTISA ASMARA SANDI P PBI (APBD) Necrosis of pulp TIDAK
1495 12/12/201 130801021218Y000957 0002163712364 SUGIARTI P PBI (APBD) Acute pharyngitis, unspecified TIDAK
1496 12/12/201 130801021218Y000930 0002216763674 HARTATIK P PENERIMA PENSIUN Systemic disorders of connective tissue TIDAK
1497 12/12/201 130801021218Y000920 0002222345439 WIWIK WIJANARKO L PEKERJA MANDIRI Gout TIDAK
1498 12/12/201 130801021218Y000924 0002260696432 SANTI ANDRIYANI P PEGAWAI SWASTA Disorders of lipoprotein metabolism TIDAK
1499 12/12/201 130801021218Y000950 0002289454299 PRIYO BAYU YUSANTO L PBI (APBD) Essential (primary) hypertension TIDAK
1500 12/12/201 130801021218Y000949 0002289454299 PRIYO BAYU YUSANTO L PBI (APBD) Necrosis of pulp TIDAK
1501 12/12/201 130801021218Y000860 0002289454694 FITRI HARIYANTI P PBI (APBD) Chronic periodontitis YA
1502 12/12/201 130801021218Y000937 0002413022049 SRI RAHAYU P PBI (APBD) Influenza with other manifestations, TIDAK
1503 12/12/201 130801021218Y000931 0002413022196 AGUS SUSILO L PBI (APBD) Periapical abscess without sinus TIDAK
1504 12/12/201 130801021218Y000894 0002413052357 SRI ARUM P PBI (APBD) Allergic contact dermatitis TIDAK
1505 12/12/201 130801021218Y000864 0002413112139 RISA PUTRI HERMAWATI P PBI (APBD) Antenatal screening TIDAK
1506 12/12/201 130801021218Y000982 0002413114255 ZAYNEZ IZAAZ DHYA P PBI (APBD) Disturbances in tooth eruption TIDAK
1507 12/12/201 130801021218Y000889 0002413114503 HARIYATI P PBI (APBD) Non-insulin-dependent diabetes YA
1508 12/12/201 130801021218Y000870 0002413135236 NURUL LIASTUTIK P PBI (APBD) Abnormal findings on antenatal YA
1509 12/12/201 130801021218Y000868 0002413136182 TARA RIZKIANA ARIANDRI P PBI (APBD) Influenza due to other identified TIDAK
1510 12/12/201 130801021218Y000953 0002413136182 TARA RIZKIANA ARIANDRI P PBI (APBD) Influenza with other manifestations, TIDAK
1511 12/12/201 130801021218Y000916 0002413139455 SUBAGIO L PBI (APBD) Cough TIDAK

09/01/2019 16.06.19
DAFTAR KUNJUNGAN PESERTA SAKIT

Kantor Cabang : MADIUN (1303)


FKTP : DEMANGAN (13080102)

NO TANGGAL NO KUNJUNGAN NO KARTU NAMA PESERTA SEX JENIS PESERTA DIAGNOSA DIRUJUK
1512 12/12/201 130801021218Y000933 0002413145654 ENDANG SUSILOWATI P PBI (APBD) Systemic disorders of connective tissue TIDAK
1513 12/12/201 130801021218Y000886 0002413147757 SILVYANA ANGGRAENI P PBI (APBD) Other antenatal screening TIDAK
1514 12/12/201 130801021218Y000876 0002413149748 MARIJAM P PBI (APBD) Non-insulin-dependent diabetes YA
1515 12/12/201 130801021218Y000921 0002413150626 BAMBANG PURUHITO L PBI (APBD) Pulpitis TIDAK
1516 12/12/201 130801021218Y000890 0002413151458 SUMADI L PBI (APBD) Spondylolysis, lumbar region YA
1517 12/12/201 130801021218Y000928 0002413152663 AYAMA JABAR LANGIT L PBI (APBD) Disturbances in tooth eruption TIDAK
1518 12/12/201 130801021218Y000926 0002413840599 YUNTAR ARIANTO L PBI (APBD) Otitis externa, unspecified TIDAK
1519 12/12/201 130801021218Y000966 0002413843839 TARIYEM P PBI (APBD) Other headache syndromes TIDAK
1520 12/12/201 130801021218Y000910 0002413920655 SUWARSIH P PBI (APBD) Disorders of lipoprotein metabolism TIDAK
1521 12/12/201 130801021218Y000908 0002413960683 KABUL IROWONGSO L PBI (APBD) Necrosis of pulp TIDAK
1522 12/12/201 130801021218Y000892 0002413962088 GIYEM P PBI (APBD) Essential (primary) hypertension TIDAK
1523 12/12/201 130801021218Y000940 0002413963833 KATINI P PBI (APBD) Non-insulin-dependent diabetes TIDAK
1524 12/12/201 130801021218Y000969 0002413967095 SUWARSINI P PBI (APBD) Systemic disorders of connective tissue TIDAK
1525 12/12/201 130801021218Y000885 0002413967681 WANINDRANI DEWI P PBI (APBD) Other thyrotoxicosis YA
1526 12/12/201 130801021218Y000881 0002413971944 NANIK SITI MURYANI P PBI (APBD) Contraceptive management TIDAK
1527 12/12/201 130801021218Y000877 0002413971977 MUHAMMAD IHSAN L PBI (APBD) Diarrhoea and gastroenteritis of YA
1528 12/12/201 130801021218Y000873 0002413971977 MUHAMMAD IHSAN L PBI (APBD) Diarrhoea and gastroenteritis of TIDAK
1529 12/12/201 130801021218Y000973 0002413972146 WAHYU NURSARI P PBI (APBD) Pulpitis TIDAK
1530 11/12/201 130801021218Y000834 0000078531221 SUJATINI P VETERAN Systemic disorders of connective tissue TIDAK
1531 11/12/201 130801021218Y000801 0000078547577 SARMININGSIH P PENERIMA PENSIUN TNI Disorders of lipoprotein metabolism TIDAK
1532 11/12/201 130801021218Y000828 0000078749741 RR. SOEBARDINI P PENERIMA PENSIUN Allergic contact dermatitis, unspecified TIDAK

09/01/2019 16.06.19
DAFTAR KUNJUNGAN PESERTA SAKIT

Kantor Cabang : MADIUN (1303)


FKTP : DEMANGAN (13080102)

NO TANGGAL NO KUNJUNGAN NO KARTU NAMA PESERTA SEX JENIS PESERTA DIAGNOSA DIRUJUK
1533 11/12/201 130801021218Y000768 0000104772497 RIZA RAHMAWATI P PRAJURIT AU Neonatal difficulty in feeding at breast TIDAK
1534 11/12/201 130801021218Y000825 0000104963567 DJAIKOEN L PENERIMA PENSIUN TNI Gingival and edentulous alveolar ridge TIDAK
1535 11/12/201 130801021218Y000842 0000105087082 S.WATINI P PENERIMA PENSIUN Presence of intraocular lens YA
1536 11/12/201 130801021218Y000843 0000105087082 S.WATINI P PENERIMA PENSIUN Presence of intraocular lens YA
1537 11/12/201 130801021218Y000819 0000106305761 AGUNG SANTOSO L PNS DAERAH Essential (primary) hypertension TIDAK
1538 11/12/201 130801021218Y000857 0000106401363 SISWOTO, BA L PENERIMA PENSIUN Systemic disorders of connective tissue TIDAK
1539 11/12/201 130801021218Y000833 0000158401181 ISMIJATI P PENERIMA PENSIUN Gastritis, unspecified TIDAK
1540 11/12/201 130801021218Y000797 0000196306255 KRISTANTO SAPUTRO L PNS DAERAH Necrosis of pulp TIDAK
1541 11/12/201 130801021218Y000839 0000207271067 PUJI ASRINI P PENERIMA PENSIUN TNI Acute lymphadenitis, unspecified TIDAK
1542 11/12/201 130801021218Y000896 0000641752637 AISYAH ANIN REFANI P PBI (APBN) Influenza with other manifestations, TIDAK
1543 11/12/201 130801021218Y000783 0000641754775 MUHAMMAD AZWAR L PBI (APBN) Influenza, virus not identified TIDAK
1544 11/12/201 130801021218Y000776 0000660200062 NOVITA YULIANTI P PBI (APBN) Neonatal difficulty in feeding at breast TIDAK
1545 11/12/201 130801021218Y000782 0000736887958 SITI MUSAROPAH P PBI (APBN) Contraceptive management TIDAK
1546 11/12/201 130801021218Y000826 0000740253868 CANDRA GUNAWAN L PBI (APBN) Pulpitis TIDAK
1547 11/12/201 130801021218Y000754 0000786086572 WINARTI P PBI (APBN) Insulin-dependent diabetes mellitus YA
1548 11/12/201 130801021218Y000903 0000786116496 BURHANUDIN L PBI (APBN) Cough TIDAK
1549 11/12/201 130801021218Y000791 0000786214157 YUSUF L PBI (APBN) Zoster [herpes zoster] TIDAK
1550 11/12/201 130801021218Y000804 0000786342813 LANDEP P PBI (APBN) Influenza with other manifestations, TIDAK
1551 11/12/201 130801021218Y000899 0000786390478 NATHANNAEL EROS L PBI (APBN) Influenza with other manifestations, TIDAK
1552 11/12/201 130801021218Y000817 0000786474652 SLAMET L PBI (APBN) Non-insulin-dependent diabetes TIDAK
1553 11/12/201 130801021218Y000816 0000786474775 SURATI P PBI (APBN) Cough TIDAK

09/01/2019 16.06.19
DAFTAR KUNJUNGAN PESERTA SAKIT

Kantor Cabang : MADIUN (1303)


FKTP : DEMANGAN (13080102)

NO TANGGAL NO KUNJUNGAN NO KARTU NAMA PESERTA SEX JENIS PESERTA DIAGNOSA DIRUJUK
1554 11/12/201 130801021218Y000906 0000786477958 EBAL PURWO FEBRIANTO L PBI (APBN) Allergic contact dermatitis TIDAK
1555 11/12/201 130801021218Y000785 0000786485079 ENDRI YUSPITA SARI P PBI (APBN) Zoster [herpes zoster] TIDAK
1556 11/12/201 130801021218Y000780 0000786497218 SRIYATI P PBI (APBN) Irregular menstruation, unspecified TIDAK
1557 11/12/201 130801021218Y000821 0000786668499 HERTI SUMARNI P PBI (APBN) Gastritis, unspecified TIDAK
1558 11/12/201 130801021218Y000788 0000786668534 RIZAL N H P PBI (APBN) Disorder of external ear, unspecified TIDAK
1559 11/12/201 130801021218Y000795 0000786778097 ANIK P PBI (APBN) Allergic contact dermatitis, unspecified TIDAK
1560 11/12/201 130801021218Y000832 0000786782496 NGATINEM P PBI (APBN) Hypotension TIDAK
1561 11/12/201 130801021218Y000905 0000786806177 SITI LATIFAH P PBI (APBN) Systemic disorders of connective tissue TIDAK
1562 11/12/201 130801021218Y000823 0000786854272 SUWITO L PBI (APBN) Gastritis and duodenitis TIDAK
1563 11/12/201 130801021218Y000810 0000786880539 FITRI SUTINAH P PBI (APBN) Neonatal difficulty in feeding at breast TIDAK
1564 11/12/201 130801021218Y000820 0000786894186 HARDJO KADAR L PBI (APBN) Allergic contact dermatitis TIDAK
1565 11/12/201 130801021218Y000895 0000786928961 KASIATI P PBI (APBN) Allergic contact dermatitis TIDAK
1566 11/12/201 130801021218Y000900 0000787030817 BAMBANG SUTJIPTO L PBI (APBN) Essential (primary) hypertension TIDAK
1567 11/12/201 130801021218Y000751 0000787121752 TUMINI P PBI (APBN) Mixed asthma YA
1568 11/12/201 130801021218Y000789 0000787234454 RUSMIATI P PBI (APBN) Disorders of lipoprotein metabolism TIDAK
1569 11/12/201 130801021218Y000756 0000787333994 SUTILAH P PBI (APBN) Hypertensive heart disease YA
1570 11/12/201 130801021218Y000811 0001049784489 HADI SOESENO L PBI (APBN) Systemic disorders of connective tissue TIDAK
1571 11/12/201 130801021218Y000807 0001049785391 SIYEM P PBI (APBN) Influenza with other manifestations, TIDAK
1572 11/12/201 130801021218Y000808 0001281366775 PARNO SASTRO AMISENO L PEKERJA MANDIRI Systemic disorders of connective tissue TIDAK
1573 11/12/201 130801021218Y000897 0001295171346 LANDUNG MARGONO L PEKERJA MANDIRI Cough TIDAK
1574 11/12/201 130801021218Y000907 0001298868074 REIFANNA FII SALSABILA P PEGAWAI SWASTA Influenza with other manifestations, TIDAK

09/01/2019 16.06.19
DAFTAR KUNJUNGAN PESERTA SAKIT

Kantor Cabang : MADIUN (1303)


FKTP : DEMANGAN (13080102)

NO TANGGAL NO KUNJUNGAN NO KARTU NAMA PESERTA SEX JENIS PESERTA DIAGNOSA DIRUJUK
1575 11/12/201 130801021218Y000803 0001422364634 MARSYAHID L PEGAWAI SWASTA Dental caries TIDAK
1576 11/12/201 130801021218Y000859 0001540719753 WRESTININGSIH P PEGAWAI SWASTA Systemic disorders of connective tissue TIDAK
1577 11/12/201 130801021218Y000787 0001645504648 NAUFAL NUKI WAHYU L PEGAWAI SWASTA Influenza with other manifestations, TIDAK
1578 11/12/201 130801021218Y000809 0001702628381 WIDJIHARSIH P PEGAWAI SWASTA Leiomyoma of uterus YA
1579 11/12/201 130801021218Y000769 0001704706705 DWI RAHAYU P PBI (APBD) Neonatal difficulty in feeding at breast TIDAK
1580 11/12/201 130801021218Y000761 0001704709978 YETIN P PBI (APBD) Glaucoma, unspecified YA
1581 11/12/201 130801021218Y000753 0001704714884 KHUM HARIANTO L PBI (APBD) Non-insulin-dependent diabetes YA
1582 11/12/201 130801021218Y000856 0001704719698 MUHAMMAD RIZKI L PBI (APBD) Periapical abscess without sinus TIDAK
1583 11/12/201 130801021218Y000814 0001704724424 KASNO L PBI (APBD) Gout TIDAK
1584 11/12/201 130801021218Y000840 0001704725368 MARNI L PBI (APBD) Congestive heart failure YA
1585 11/12/201 130801021218Y000858 0001704725763 NANIK KRISTIANI P PBI (APBD) Dental caries TIDAK
1586 11/12/201 130801021218Y000798 0001704726156 MUHHADI KABUL L PBI (APBD) Systemic disorders of connective tissue TIDAK
1587 11/12/201 130801021218Y000799 0001704726167 SUPARIYEM P PBI (APBD) Other headache syndromes TIDAK
1588 11/12/201 130801021218Y000849 0001704727315 LINDA KURNIASIH P PBI (APBD) Influenza with other manifestations, TIDAK
1589 11/12/201 130801021218Y000850 0001704729328 BAMBANG SUKOCO RIYADI L PBI (APBD) Systemic disorders of connective tissue TIDAK
1590 11/12/201 130801021218Y000800 0001704729947 MURYANTO L PBI (APBD) Essential (primary) hypertension TIDAK
1591 11/12/201 130801021218Y000790 0001704730702 TUMINI P PBI (APBD) Disorders of lipoprotein metabolism TIDAK
1592 11/12/201 130801021218Y000852 0001704808528 HANNA KARMINI P PBI (APBD) Non-insulin-dependent diabetes TIDAK
1593 11/12/201 130801021218Y000759 0001704841716 LASTRI P PBI (APBD) Non-insulin-dependent diabetes YA
1594 11/12/201 130801021218Y000796 0001704843663 FATHAN GIO ALVARIZY L PBI (APBD) Allergic contact dermatitis TIDAK
1595 11/12/201 130801021218Y000902 0001704844157 YOGA SUBASTYAN L PBI (APBD) Influenza with other manifestations, TIDAK

09/01/2019 16.06.19
DAFTAR KUNJUNGAN PESERTA SAKIT

Kantor Cabang : MADIUN (1303)


FKTP : DEMANGAN (13080102)

NO TANGGAL NO KUNJUNGAN NO KARTU NAMA PESERTA SEX JENIS PESERTA DIAGNOSA DIRUJUK
1596 11/12/201 130801021218Y000805 0001704845621 NAFSIH P PBI (APBD) Systemic disorders of connective tissue TIDAK
1597 11/12/201 130801021218Y000846 0001704846115 NUR HAFIS MAHENDRA L PBI (APBD) Acute gingivitis TIDAK
1598 11/12/201 130801021218Y000822 0001704847667 SUGENG PRIYANTO L PBI (APBD) Systemic disorders of connective tissue TIDAK
1599 11/12/201 130801021218Y000784 0001789399642 SUPRAPTO L PEGAWAI SWASTA Allergic contact dermatitis, unspecified TIDAK
1600 11/12/201 130801021218Y000841 0001821414453 FITRI HANDAYANI P PEGAWAI PEMERINTAH Pulpitis TIDAK
1601 11/12/201 130801021218Y000818 0001870438623 JUARTINI P TNI ANGKATAN DARAT Essential (primary) hypertension TIDAK
1602 11/12/201 130801021218Y000764 0002059734251 NURUL TRI OKTAVIANA P PEGAWAI SWASTA Anaemia complicating pregnancy, YA
1603 11/12/201 130801021218Y000793 0002071921217 JARWA SUSILA L PNS PUSAT Zoster [herpes zoster] TIDAK
1604 11/12/201 130801021218Y000773 0002073600685 YULITA EKA PRASETYA AYU P PEKERJA MANDIRI Neonatal difficulty in feeding at breast TIDAK
1605 11/12/201 130801021218Y000774 0002073600685 YULITA EKA PRASETYA AYU P PEKERJA MANDIRI Neonatal difficulty in feeding at breast TIDAK
1606 11/12/201 130801021218Y000844 0002079007402 ANTONIUS BUDI SANTOSO L PEKERJA MANDIRI Non-insulin-dependent diabetes YA
1607 11/12/201 130801021218Y000813 0002163546808 SUHARMI P PBI (APBD) Non-insulin-dependent diabetes TIDAK
1608 11/12/201 130801021218Y000757 0002163546821 TRI CITRANINGRUM P PBI (APBD) Anaemia complicating pregnancy, YA
1609 11/12/201 130801021218Y000838 0002163547271 WIJIARSIH P PBI (APBD) Systemic disorders of connective tissue TIDAK
1610 11/12/201 130801021218Y000762 0002163552401 ROHDIYAH P PBI (APBD) Thyrotoxicosis [hyperthyroidism] YA
1611 11/12/201 130801021218Y000836 0002163564538 SRI SUNARSIH P PBI (APBD) Haemorrhoids TIDAK
1612 11/12/201 130801021218Y000827 0002163566204 SRI WAHYUNI EKOWATI P PBI (APBD) Systemic disorders of connective tissue TIDAK
1613 11/12/201 130801021218Y000829 0002163569938 ASHWIN PUTRA CAHYONO L PBI (APBD) Influenza with other manifestations, TIDAK
1614 11/12/201 130801021218Y000766 0002163569938 ASHWIN PUTRA CAHYONO L PBI (APBD) Influenza with pneumonia, influenza TIDAK
1615 11/12/201 130801021218Y000835 0002163694691 MUDJIATI P PBI (APBD) Gastritis and duodenitis TIDAK
1616 11/12/201 130801021218Y000901 0002163705366 SRI YULIATUN P PBI (APBD) Non-insulin-dependent diabetes TIDAK

09/01/2019 16.06.19
DAFTAR KUNJUNGAN PESERTA SAKIT

Kantor Cabang : MADIUN (1303)


FKTP : DEMANGAN (13080102)

NO TANGGAL NO KUNJUNGAN NO KARTU NAMA PESERTA SEX JENIS PESERTA DIAGNOSA DIRUJUK
1617 11/12/201 130801021218Y000779 0002163711069 JUMIATI P PBI (APBD) Neonatal difficulty in feeding at breast TIDAK
1618 11/12/201 130801021218Y000781 0002163715356 ANDIKA DARMAYANTI P PBI (APBD) Neonatal difficulty in feeding at breast TIDAK
1619 11/12/201 130801021218Y000794 0002163720914 NANIK HANDAYANI P PBI (APBD) Dermatophytosis TIDAK
1620 11/12/201 130801021218Y000815 0002201548364 SANTI DWI FARIDA P PEKERJA MANDIRI Allergic contact dermatitis, unspecified TIDAK
1621 11/12/201 130801021218Y000765 0002212203734 ANJANI MARIFATIKA BILLAH P PBI (APBN) Viral conjunctivitis, unspecified TIDAK
1622 11/12/201 130801021218Y000831 0002212203734 ANJANI MARIFATIKA BILLAH P PBI (APBN) Conjunctivitis, unspecified TIDAK
1623 11/12/201 130801021218Y000824 0002285204602 IKA MARIA ULFA FEBRIYANI P PEGAWAI BUMN Systemic disorders of connective tissue TIDAK
1624 11/12/201 130801021218Y000767 0002285204602 IKA MARIA ULFA FEBRIYANI P PEGAWAI BUMN Neonatal difficulty in feeding at breast TIDAK
1625 11/12/201 130801021218Y000854 0002289454299 PRIYO BAYU YUSANTO L PBI (APBD) Necrosis of pulp TIDAK
1626 11/12/201 130801021218Y000853 0002289454694 FITRI HARIYANTI P PBI (APBD) Pulpitis TIDAK
1627 11/12/201 130801021218Y000802 0002354078687 PONIYEM P PBI (APBN) Other headache syndromes TIDAK
1628 11/12/201 130801021218Y000763 0002413058692 BIBIT P PBI (APBD) Sequelae of cerebrovascular disease YA
1629 11/12/201 130801021218Y000847 0002413107382 EKO PRASETYO L PBI (APBD) Allergic contact dermatitis, unspecified TIDAK
1630 11/12/201 130801021218Y000855 0002413107415 GHULAM RADITYA L PBI (APBD) Influenza with other manifestations, TIDAK
1631 11/12/201 130801021218Y000848 0002413107426 FAIRUZ ASWANGGA L PBI (APBD) Influenza with other manifestations, TIDAK
1632 11/12/201 130801021218Y000898 0002413110194 EMANNUEL DUTA SAKTI L PBI (APBD) Influenza with other manifestations, TIDAK
1633 11/12/201 130801021218Y000752 0002413112139 RISA PUTRI HERMAWATI P PBI (APBD) Abnormal finding on antenatal YA
1634 11/12/201 130801021218Y000760 0002413119745 TUTIK P PBI (APBD) Hypertensive heart disease without YA
1635 11/12/201 130801021218Y000812 0002413137137 YUSI SEPTI WULANDARI P PBI (APBD) Conjunctivitis, unspecified TIDAK
1636 11/12/201 130801021218Y000792 0002413148117 SLAMET RIYADI L PBI (APBD) Influenza with other manifestations, TIDAK
1637 11/12/201 130801021218Y000904 0002413148139 AZIMA NOOR BUNGA P PBI (APBD) Influenza with other manifestations, TIDAK

09/01/2019 16.06.19
DAFTAR KUNJUNGAN PESERTA SAKIT

Kantor Cabang : MADIUN (1303)


FKTP : DEMANGAN (13080102)

NO TANGGAL NO KUNJUNGAN NO KARTU NAMA PESERTA SEX JENIS PESERTA DIAGNOSA DIRUJUK
1638 11/12/201 130801021218Y000758 0002413151818 SUHARTI P PBI (APBD) Malignant neoplasm of breast, YA
1639 11/12/201 130801021218Y000837 0002413154316 SANIA PUTRI SUBIANTO P PBI (APBD) Influenza with other manifestations, TIDAK
1640 11/12/201 130801021218Y000755 0002413849825 LILIK SUTINAH P PBI (APBD) Chronic ischaemic heart disease YA
1641 11/12/201 130801021218Y000851 0002413902914 ANIEK KESUMAWATI P PBI (APBD) Dental caries TIDAK
1642 11/12/201 130801021218Y000806 0002413916796 ENDANG HARTATIK P PBI (APBD) Non-insulin-dependent diabetes TIDAK
1643 11/12/201 130801021218Y000786 0002413963258 WIDAYATI P PBI (APBD) Systemic disorders of connective tissue TIDAK
1644 11/12/201 130801021218Y000830 0002413964788 RUCHAINI P PBI (APBD) Non-insulin-dependent diabetes TIDAK
1645 11/12/201 130801021218Y000778 0002437822427 DILLA ANNISA P PNS PUSAT Neonatal difficulty in feeding at breast TIDAK
1646 11/12/201 130801021218Y000777 0002452741154 EDWARD DAVIAN L PEKERJA MANDIRI Need for immunization against TIDAK
1647 11/12/201 130801021218Y000775 0002454728984 AZAHRA LAILATUL LATIFAH P PEKERJA MANDIRI Need for immunization against other TIDAK
1648 11/12/201 130801021218Y000770 0002487460026 AZRIL ARIF MUSTOFA L PEKERJA MANDIRI Need for immunization against TIDAK
1649 11/12/201 130801021218Y000771 0002487460026 AZRIL ARIF MUSTOFA L PEKERJA MANDIRI Need for immunization against TIDAK
1650 11/12/201 130801021218Y000845 0002613305057 CHALISTA ELSA P PEKERJA MANDIRI Other orthopoxvirus infections YA
1651 11/12/201 130801021218Y000772 0002621838137 RAVINDRA KHENAN L PEGAWAI SWASTA Need for immunization against TIDAK
1652 10/12/201 130801021218Y000644 0000078540759 PARNO HP L PENERIMA PENSIUN TNI Disorders of lipoprotein metabolism TIDAK
1653 10/12/201 130801021218Y000654 0000078540772 RULY NURTANTI P PENERIMA PENSIUN TNI Disorders of lipoprotein metabolism TIDAK
1654 10/12/201 130801021218Y000623 0000078544484 SUJOTO L PENERIMA PENSIUN TNI Dyspepsia YA
1655 10/12/201 130801021218Y000716 0000078718138 DARMIJATIN, BA P PENERIMA PENSIUN Diarrhoea and gastroenteritis of TIDAK
1656 10/12/201 130801021218Y000617 0000078741764 MURTINI P PENERIMA PENSIUN Gout YA
1657 10/12/201 130801021218Y000710 0000078772601 SUMINI P PENERIMA PENSIUN Essential (primary) hypertension TIDAK
1658 10/12/201 130801021218Y000622 0000078780824 WAHJUMI P PENERIMA PENSIUN Disorders of refraction and YA

09/01/2019 16.06.19
DAFTAR KUNJUNGAN PESERTA SAKIT

Kantor Cabang : MADIUN (1303)


FKTP : DEMANGAN (13080102)

NO TANGGAL NO KUNJUNGAN NO KARTU NAMA PESERTA SEX JENIS PESERTA DIAGNOSA DIRUJUK
1659 10/12/201 130801021218Y000707 0000104378005 NJUMIK SUDJARWATI P PENERIMA PENSIUN Non-insulin-dependent diabetes TIDAK
1660 10/12/201 130801021218Y000662 0000105459669 RUBININGSIH HAPSARI P PENERIMA PENSIUN Essential (primary) hypertension TIDAK
1661 10/12/201 130801021218Y000612 0000106294116 PUJI L PNS DAERAH Sequelae of other and unspecified YA
1662 10/12/201 130801021218Y000730 0000106296208 SYAMINI P PNS DAERAH Other disorders of urinary system TIDAK
1663 10/12/201 130801021218Y000659 0000169999479 SRI HARTATIK P PENERIMA PENSIUN Influenza with other manifestations, TIDAK
1664 10/12/201 130801021218Y000634 0000736484409 SUMIRAH P PBI (APBN) Insulin-dependent diabetes mellitus YA
1665 10/12/201 130801021218Y000733 0000736770644 SRI RAHAYU P PBI (APBN) Gastritis, unspecified TIDAK
1666 10/12/201 130801021218Y000653 0000737018212 DHABITA NYDZAA H P PBI (APBN) Disturbances in tooth eruption TIDAK
1667 10/12/201 130801021218Y000745 0000737676448 TRI WIJI ASTUTI P PBI (APBN) Gastritis, unspecified TIDAK
1668 10/12/201 130801021218Y000658 0000738079593 LASINEM P PBI (APBN) Non-insulin-dependent diabetes TIDAK
1669 10/12/201 130801021218Y000633 0000738302231 SRI WULANDARI P PBI (APBN) Chronic kidney disease YA
1670 10/12/201 130801021218Y000695 0000739083789 SAMIRANTO L PBI (APBN) Myalgia TIDAK
1671 10/12/201 130801021218Y000621 0000742737194 SUHARTINI P PBI (APBN) Irregular menstruation, unspecified TIDAK
1672 10/12/201 130801021218Y000743 0000786066658 ROHKIM DARWANTO L PBI (APBN) Allergic contact dermatitis TIDAK
1673 10/12/201 130801021218Y000738 0000786116496 BURHANUDIN L PBI (APBN) Cough TIDAK
1674 10/12/201 130801021218Y000722 0000786281523 SUKINEM P PBI (APBN) Systemic disorders of connective tissue TIDAK
1675 10/12/201 130801021218Y000713 0000786307408 SAHID RIYANTO L PBI (APBN) Non-insulin-dependent diabetes TIDAK
1676 10/12/201 130801021218Y000639 0000786428278 BOIMIN SASTRO WIYONO L PBI (APBN) Other disorders of urinary system YA
1677 10/12/201 130801021218Y000701 0000786519538 SUKARTI P PBI (APBN) Haemorrhoids TIDAK
1678 10/12/201 130801021218Y000613 0000786664822 RUKILAH P PBI (APBN) Abnormal finding on antenatal YA
1679 10/12/201 130801021218Y000741 0000786741041 TULANDARI P PBI (APBN) Systemic disorders of connective tissue TIDAK

09/01/2019 16.06.19
DAFTAR KUNJUNGAN PESERTA SAKIT

Kantor Cabang : MADIUN (1303)


FKTP : DEMANGAN (13080102)

NO TANGGAL NO KUNJUNGAN NO KARTU NAMA PESERTA SEX JENIS PESERTA DIAGNOSA DIRUJUK
1680 10/12/201 130801021218Y000744 0000786777153 PARMIATI P PBI (APBN) Gastritis, unspecified TIDAK
1681 10/12/201 130801021218Y000678 0000786800248 MOCH NIZAM L PBI (APBN) Systemic disorders of connective tissue TIDAK
1682 10/12/201 130801021218Y000668 0000786826181 SUNARTI P PBI (APBN) Necrosis of pulp TIDAK
1683 10/12/201 130801021218Y000749 0000786849006 DEWI YULIANTI P PBI (APBN) Influenza with other manifestations, TIDAK
1684 10/12/201 130801021218Y000649 0000786901882 TUKINI P PBI (APBN) Essential (primary) hypertension TIDAK
1685 10/12/201 130801021218Y000663 0000786930794 TUMINI P PBI (APBN) Gastritis, unspecified TIDAK
1686 10/12/201 130801021218Y000608 0000787107508 NINIK KUSWANTINI P PBI (APBN) Zoster [herpes zoster] YA
1687 10/12/201 130801021218Y000632 0000787108915 SUPRIYONO L PBI (APBN) Fracture of femur YA
1688 10/12/201 130801021218Y000638 0000787114269 KATMANTO L PBI (APBN) Cataract, unspecified YA
1689 10/12/201 130801021218Y000643 0000787262826 DJUMIRAN L PBI (APBN) Heart failure, unspecified YA
1690 10/12/201 130801021218Y000693 0001049779157 RAMIYATI P PBI (APBN) Conjunctivitis, unspecified TIDAK
1691 10/12/201 130801021218Y000652 0001101191894 SUDARWATI P KEPOLISIAN RI Myalgia YA
1692 10/12/201 130801021218Y000746 0001243786375 MOCHAMMAD RAFLI L PEKERJA MANDIRI Influenza with other manifestations, TIDAK
1693 10/12/201 130801021218Y000681 0001295106535 YANTI HANDIASTUTI P PEKERJA MANDIRI Necrosis of pulp TIDAK
1694 10/12/201 130801021218Y000706 0001302639309 SADJIMIN L PENERIMA PENSIUN Non-insulin-dependent diabetes TIDAK
1695 10/12/201 130801021218Y000646 0001303644159 ADELIA SEKAR PUTRI P PEKERJA MANDIRI Pulpitis TIDAK
1696 10/12/201 130801021218Y000625 0001427090613 SARINEM P PEKERJA MANDIRI Hypertensive heart disease YA
1697 10/12/201 130801021218Y000676 0001438529681 DIFARHA PRADYANA. P KEPOLISIAN RI Disturbances in tooth eruption TIDAK
1698 10/12/201 130801021218Y000645 0001645504604 SRI WAHYUNI WINANTU P PEGAWAI SWASTA Necrosis of pulp TIDAK
1699 10/12/201 130801021218Y000715 0001704706198 NOPPY ASTUTI P PBI (APBD) Systemic disorders of connective tissue TIDAK
1700 10/12/201 130801021218Y000661 0001704706536 SITI MUTMAINAH P PBI (APBD) Systemic disorders of connective tissue TIDAK

09/01/2019 16.06.19
DAFTAR KUNJUNGAN PESERTA SAKIT

Kantor Cabang : MADIUN (1303)


FKTP : DEMANGAN (13080102)

NO TANGGAL NO KUNJUNGAN NO KARTU NAMA PESERTA SEX JENIS PESERTA DIAGNOSA DIRUJUK
1701 10/12/201 130801021218Y000671 0001704709809 DEWI NATALIYA P PBI (APBD) Otitis externa, unspecified TIDAK
1702 10/12/201 130801021218Y000692 0001704712083 WAGINEM P PBI (APBD) Systemic disorders of connective tissue TIDAK
1703 10/12/201 130801021218Y000628 0001704715266 DIMAS ARYA PUTRA L PBI (APBD) Otitis externa, unspecified YA
1704 10/12/201 130801021218Y000670 0001704715457 PURYANI P PBI (APBD) Systemic disorders of connective tissue TIDAK
1705 10/12/201 130801021218Y000714 0001704717303 ANIK SUWATI P PBI (APBD) Allergic contact dermatitis, unspecified TIDAK
1706 10/12/201 130801021218Y000626 0001704722016 ISTILAH P PBI (APBD) Sequelae of other and unspecified YA
1707 10/12/201 130801021218Y000727 0001704723524 YOSA ADI P L PBI (APBD) Candidiasis, unspecified TIDAK
1708 10/12/201 130801021218Y000657 0001704724209 FERNANDO ADTYA K L PBI (APBD) Influenza with other manifestations, TIDAK
1709 10/12/201 130801021218Y000611 0001704724738 BEDJO L PBI (APBD) Low back pain YA
1710 10/12/201 130801021218Y000660 0001704725188 ADAM SUDARNO L PBI (APBD) Periapical abscess without sinus TIDAK
1711 10/12/201 130801021218Y000704 0001704725199 SATIYEM P PBI (APBD) Other disorders of urinary system TIDAK
1712 10/12/201 130801021218Y000667 0001704727214 ROBERTHA PRIN P PBI (APBD) Essential (primary) hypertension TIDAK
1713 10/12/201 130801021218Y000648 0001704728608 ANANDA BUDI ATIKA P PBI (APBD) Gastritis and duodenitis TIDAK
1714 10/12/201 130801021218Y000748 0001704728823 ACHMADI L PBI (APBD) Essential (primary) hypertension TIDAK
1715 10/12/201 130801021218Y000616 0001704729407 WINARTIN P PBI (APBD) Gonarthrosis, unspecified YA
1716 10/12/201 130801021218Y000723 0001704730601 TRI YUWONO L PBI (APBD) Acute and transient psychotic disorder, TIDAK
1717 10/12/201 130801021218Y000627 0001704732006 SUMILAH P PBI (APBD) Non-insulin-dependent diabetes YA
1718 10/12/201 130801021218Y000721 0001704732309 MURIYANTO L PBI (APBD) Allergic contact dermatitis, unspecified TIDAK
1719 10/12/201 130801021218Y000731 0001704732322 TUTY ANDARWATI P PBI (APBD) Systemic disorders of connective tissue TIDAK
1720 10/12/201 130801021218Y000641 0001704732333 MURIANA ANGGRAINI P PBI (APBD) Other abnormal findings on antenatal YA
1721 10/12/201 130801021218Y000734 0001704759704 SUYATNO L PBI (APBD) Essential (primary) hypertension TIDAK

09/01/2019 16.06.19
DAFTAR KUNJUNGAN PESERTA SAKIT

Kantor Cabang : MADIUN (1303)


FKTP : DEMANGAN (13080102)

NO TANGGAL NO KUNJUNGAN NO KARTU NAMA PESERTA SEX JENIS PESERTA DIAGNOSA DIRUJUK
1722 10/12/201 130801021218Y000664 0001704842032 ILAWATI P PBI (APBD) Gastritis, unspecified TIDAK
1723 10/12/201 130801021218Y000709 0001704844214 MOHAMAD RAFFAEL DEVAN L PBI (APBD) Influenza with other manifestations, TIDAK
1724 10/12/201 130801021218Y000666 0001704845215 SRI SUMARNI P PBI (APBD) Conjunctivitis, unspecified TIDAK
1725 10/12/201 130801021218Y000712 0001704845439 ASTIAR DWI LISTYANTI P PBI (APBD) Non-insulin-dependent diabetes TIDAK
1726 10/12/201 130801021218Y000720 0001704847779 SULASIH P PBI (APBD) Disorders of lipoprotein metabolism TIDAK
1727 10/12/201 130801021218Y000669 0001704848242 DJUMPRIJANI P PBI (APBD) Systemic disorders of connective tissue TIDAK
1728 10/12/201 130801021218Y000665 0001706781655 RAFA CAHYA RAMADHAN L PBI (APBD) Pneumonia in other diseases classified TIDAK
1729 10/12/201 130801021218Y000699 0001803666328 PURWATI P PEKERJA MANDIRI Systemic disorders of connective tissue TIDAK
1730 10/12/201 130801021218Y000655 0001806924205 ABDUL MANAN L PEKERJA MANDIRI Low back pain TIDAK
1731 10/12/201 130801021218Y000619 0001809662051 FITRI RAHMAWATI P PEKERJA MANDIRI Antenatal screening TIDAK
1732 10/12/201 130801021218Y000677 0001897753792 REVANDYTO CAHYO L PEGAWAI SWASTA Supernumerary teeth TIDAK
1733 10/12/201 130801021218Y000650 0001970370494 DIAN SUSANTO L PEGAWAI SWASTA Influenza with other manifestations, TIDAK
1734 10/12/201 130801021218Y000637 0002096200056 LUSVIA MEGA SAPUTRY P PEGAWAI SWASTA Antenatal screening TIDAK
1735 10/12/201 130801021218Y000631 0002138588245 ISMILIA A. GUMELENG P PEKERJA MANDIRI Antenatal screening TIDAK
1736 10/12/201 130801021218Y000672 0002158691567 AGUSTIN ERINA P PEGAWAI SWASTA Influenza with other manifestations, TIDAK
1737 10/12/201 130801021218Y000682 0002163546415 NURWATI P PBI (APBD) Pulpitis TIDAK
1738 10/12/201 130801021218Y000624 0002163548338 YUNUS SURYA ATMAJA L PBI (APBD) Allergic contact dermatitis TIDAK
1739 10/12/201 130801021218Y000739 0002163556596 YUNI KURNIAWATI P PBI (APBD) Gastritis, unspecified TIDAK
1740 10/12/201 130801021218Y000674 0002163558295 VANDIKA WAHYUDHA L PBI (APBD) Disturbances in tooth eruption TIDAK
1741 10/12/201 130801021218Y000629 0002163561805 UMAHATUN MARDIYAH P PBI (APBD) Antenatal screening TIDAK
1742 10/12/201 130801021218Y000688 0002163562389 FAREL OKTAVIANUS L PBI (APBD) Fever, unspecified TIDAK

09/01/2019 16.06.19
DAFTAR KUNJUNGAN PESERTA SAKIT

Kantor Cabang : MADIUN (1303)


FKTP : DEMANGAN (13080102)

NO TANGGAL NO KUNJUNGAN NO KARTU NAMA PESERTA SEX JENIS PESERTA DIAGNOSA DIRUJUK
1743 10/12/201 130801021218Y000620 0002163562885 NAUFAL DWI SEPTIANSYAH L PBI (APBD) Influenza due to other identified TIDAK
1744 10/12/201 130801021218Y000675 0002163570489 JAENAL MA'ARIF L PBI (APBD) Influenza due to other identified TIDAK
1745 10/12/201 130801021218Y000747 0002163570502 GABRIELLA AGATHA P PBI (APBD) Influenza with other manifestations, TIDAK
1746 10/12/201 130801021218Y000724 0002163571233 SITI AMINAH P PBI (APBD) Systemic disorders of connective tissue TIDAK
1747 10/12/201 130801021218Y000684 0002163571233 SITI AMINAH P PBI (APBD) Necrosis of pulp TIDAK
1748 10/12/201 130801021218Y000725 0002163572763 SUYITNO L PBI (APBD) Cough TIDAK
1749 10/12/201 130801021218Y000708 0002163574653 HENY ISWATI P PBI (APBD) Disorders of refraction and TIDAK
1750 10/12/201 130801021218Y000717 0002163672437 SUTRI P PBI (APBD) Other headache syndromes TIDAK
1751 10/12/201 130801021218Y000737 0002163683463 KASIH P PBI (APBD) Essential (primary) hypertension TIDAK
1752 10/12/201 130801021218Y000609 0002163695916 SURINGAH P PBI (APBD) Disorder of vestibular function, YA
1753 10/12/201 130801021218Y000630 0002163698493 SUPARMI P PBI (APBD) Non-insulin-dependent diabetes YA
1754 10/12/201 130801021218Y000610 0002163698853 SUHARTONO L PBI (APBD) Chronic obstructive pulmonary disease, YA
1755 10/12/201 130801021218Y000647 0002163699145 NURAINI RUMATIN P PBI (APBD) Systemic disorders of connective tissue TIDAK
1756 10/12/201 130801021218Y000679 0002163702609 HARIYANTI P PBI (APBD) Systemic disorders of connective tissue TIDAK
1757 10/12/201 130801021218Y000656 0002163703667 SUNARTI P PBI (APBD) Systemic disorders of connective tissue TIDAK
1758 10/12/201 130801021218Y000729 0002163703689 MAILI SULISTYOWATI P PBI (APBD) Other disorders of urinary system TIDAK
1759 10/12/201 130801021218Y000728 0002163703702 SEPTIAN DWI CAHYO L PBI (APBD) Systemic disorders of connective tissue TIDAK
1760 10/12/201 130801021218Y000740 0002163704591 SUWITO L PBI (APBD) Gastritis and duodenitis TIDAK
1761 10/12/201 130801021218Y000698 0002163706435 HADI SUJATMIKA L PBI (APBD) Systemic disorders of connective tissue TIDAK
1762 10/12/201 130801021218Y000702 0002163708865 KATEMI P PBI (APBD) Systemic disorders of connective tissue TIDAK
1763 10/12/201 130801021218Y000683 0002163711172 AAN ADITYA MAHARDIKA L PBI (APBD) Dental caries TIDAK

09/01/2019 16.06.19
DAFTAR KUNJUNGAN PESERTA SAKIT

Kantor Cabang : MADIUN (1303)


FKTP : DEMANGAN (13080102)

NO TANGGAL NO KUNJUNGAN NO KARTU NAMA PESERTA SEX JENIS PESERTA DIAGNOSA DIRUJUK
1764 10/12/201 130801021218Y000642 0002163712803 ANNASA QOLBI ASY P PBI (APBD) Cough TIDAK
1765 10/12/201 130801021218Y000618 0002163719248 AFANDO ALFAT NOPVIANTO L PBI (APBD) Other inflammation of eyelid TIDAK
1766 10/12/201 130801021218Y000673 0002163720519 AZZAHRA OCTAVYANA P PBI (APBD) Necrosis of pulp TIDAK
1767 10/12/201 130801021218Y000700 0002203914126 ALFINO DAFA RAMADHAN L PBI (APBD) Influenza, virus not identified TIDAK
1768 10/12/201 130801021218Y000718 0002263312135 HASBY JALLA PUTRA L PBI (APBN) Fever of other and unknown origin TIDAK
1769 10/12/201 130801021218Y000640 0002354078992 JORDAN ANDIKA ZANALI L PBI (APBN) Ventricular septal defect YA
1770 10/12/201 130801021218Y000703 0002413029813 SUGENG RIYADI L PBI (APBD) Respiratory tuberculosis unspecified, TIDAK
1771 10/12/201 130801021218Y000736 0002413049409 ISMINAH P PBI (APBD) Essential (primary) hypertension TIDAK
1772 10/12/201 130801021218Y000614 0002413109913 LUKINEM P PBI (APBD) Non-insulin-dependent diabetes YA
1773 10/12/201 130801021218Y000680 0002413112062 MEGAWATI P PBI (APBD) Non-insulin-dependent diabetes YA
1774 10/12/201 130801021218Y000691 0002413121049 GIANT ARYA SAMPURNA L PBI (APBD) Influenza with other manifestations, TIDAK
1775 10/12/201 130801021218Y000687 0002413150942 AZHAR AUFA NABIL L PBI (APBD) Conjunctivitis TIDAK
1776 10/12/201 130801021218Y000689 0002413152909 SUNGKONO L PBI (APBD) Essential (primary) hypertension TIDAK
1777 10/12/201 130801021218Y000694 0002413152944 SUKIMAN L PBI (APBD) Non-insulin-dependent diabetes TIDAK
1778 10/12/201 130801021218Y000719 0002413154755 SATI P PBI (APBD) Non-insulin-dependent diabetes TIDAK
1779 10/12/201 130801021218Y000651 0002413154845 DODIK IRAWAN L PBI (APBD) Systemic disorders of connective tissue TIDAK
1780 10/12/201 130801021218Y000726 0002413155666 NABILA ZAZKHYA P PBI (APBD) Influenza with other manifestations, TIDAK
1781 10/12/201 130801021218Y000697 0002413155677 AURELLYA BERLYANA P PBI (APBD) Influenza with other manifestations, TIDAK
1782 10/12/201 130801021218Y000636 0002413896131 SUPARTO L PBI (APBD) Unspecified renal colic YA
1783 10/12/201 130801021218Y000635 0002413901035 ISTHIKA SAKANTI P PBI (APBD) Antenatal screening TIDAK
1784 10/12/201 130801021218Y000732 0002413914478 YY SEBTYAN P PBI (APBD) Influenza with other manifestations, TIDAK

09/01/2019 16.06.19
DAFTAR KUNJUNGAN PESERTA SAKIT

Kantor Cabang : MADIUN (1303)


FKTP : DEMANGAN (13080102)

NO TANGGAL NO KUNJUNGAN NO KARTU NAMA PESERTA SEX JENIS PESERTA DIAGNOSA DIRUJUK
1785 10/12/201 130801021218Y000735 0002413915356 HANDAJANI P PBI (APBD) Essential (primary) hypertension TIDAK
1786 10/12/201 130801021218Y000742 0002413921443 BETI SRI UTAMI P PBI (APBD) Non-insulin-dependent diabetes TIDAK
1787 10/12/201 130801021218Y002214 0002413950761 OKTAFIA KARTIKA SARI P PBI (APBD) Candidiasis of vulva and vagina TIDAK
1788 10/12/201 130801021218Y000696 0002413958927 DURROTUN NASIHAH P PBI (APBD) Gout TIDAK
1789 10/12/201 130801021218Y000685 0002413958938 AHMAD ZADU SHIDQI L PBI (APBD) Other benign neoplasm of connective YA
1790 10/12/201 130801021218Y000711 0002413966296 MUHAMMAD RAFA AZKA L PBI (APBD) Allergic contact dermatitis TIDAK
1791 10/12/201 130801021218Y000690 0002413967589 HENI ASTUTI P PBI (APBD) Zoster [herpes zoster] TIDAK
1792 10/12/201 130801021218Y000686 0002433768862 RUSMIATUN P PEGAWAI SWASTA Systemic disorders of connective tissue TIDAK
1793 10/12/201 130801021218Y000705 0002468292311 MURTI RAHAYU P PEKERJA MANDIRI Systemic disorders of connective tissue TIDAK
1794 10/12/201 130801021218Y000615 0002503428467 MISINEM P PEKERJA MANDIRI Sequelae of other and unspecified YA
1795 07/12/201 130801021218Y000576 0000039112222 SRIATUN P PENERIMA PENSIUN Systemic disorders of connective tissue TIDAK
1796 07/12/201 130801021218Y000540 0000078716621 BONIYEM P PENERIMA PENSIUN Non-insulin-dependent diabetes TIDAK
1797 07/12/201 130801021218Y000596 0000078780508 W. ARIEF HADI SISWOTO, L PENERIMA PENSIUN Hypertensive heart disease TIDAK
1798 07/12/201 130801021218Y000518 0000105164998 YUNI WULANDARI P PEKERJA MANDIRI Contraceptive management TIDAK
1799 07/12/201 130801021218Y000607 0000105169689 FESTI ANGGRAINI YONASIH P PNS DAERAH Necrosis of pulp TIDAK
1800 07/12/201 130801021218Y000584 0000171766405 VETTY NOVIASARI P PNS DAERAH Systemic disorders of connective tissue TIDAK
1801 07/12/201 130801021218Y000550 0000785229423 LATINI P PBI (APBN) Contraceptive management TIDAK
1802 07/12/201 130801021218Y000519 0000785248391 CATUR RATNANI P PBI (APBN) Contraceptive management TIDAK
1803 07/12/201 130801021218Y000593 0000786066658 ROHKIM DARWANTO L PBI (APBN) Allergic contact dermatitis TIDAK
1804 07/12/201 130801021218Y000533 0000786146692 LAMIDI L PBI (APBN) Systemic disorders of connective tissue TIDAK
1805 07/12/201 130801021218Y000594 0000786149886 SUTRISNO L PBI (APBN) Non-insulin-dependent diabetes TIDAK

09/01/2019 16.06.19
DAFTAR KUNJUNGAN PESERTA SAKIT

Kantor Cabang : MADIUN (1303)


FKTP : DEMANGAN (13080102)

NO TANGGAL NO KUNJUNGAN NO KARTU NAMA PESERTA SEX JENIS PESERTA DIAGNOSA DIRUJUK
1806 07/12/201 130801021218Y000537 0000786226443 SUPARDI L PBI (APBN) Systemic disorders of connective tissue TIDAK
1807 07/12/201 130801021218Y000536 0000786226487 MUJINEM P PBI (APBN) Systemic disorders of connective tissue TIDAK
1808 07/12/201 130801021218Y000567 0000786405148 SRI WAHYUNI P PBI (APBN) Non-insulin-dependent diabetes TIDAK
1809 07/12/201 130801021218Y000602 0000786505836 AMALIA KRISTIANINGRUM P PBI (APBN) Necrosis of pulp TIDAK
1810 07/12/201 130801021218Y000589 0000786777153 PARMIATI P PBI (APBN) Gastritis, unspecified TIDAK
1811 07/12/201 130801021218Y000580 0000786786063 LASMINIATI P PBI (APBN) Systemic disorders of connective tissue TIDAK
1812 07/12/201 130801021218Y000562 0000786855464 PATONAH P PBI (APBN) Non-insulin-dependent diabetes TIDAK
1813 07/12/201 130801021218Y000552 0000786855521 SUHARI L PBI (APBN) Non-insulin-dependent diabetes TIDAK
1814 07/12/201 130801021218Y000583 0000786871899 SITI KASIANI P PBI (APBN) Stomatitis and related lesions TIDAK
1815 07/12/201 130801021218Y000549 0000786871899 SITI KASIANI P PBI (APBN) Contraceptive management TIDAK
1816 07/12/201 130801021218Y000527 0000786881867 SUYANTO L PBI (APBN) Gastritis, unspecified TIDAK
1817 07/12/201 130801021218Y000525 0000786900688 SULIKAH P PBI (APBN) Non-insulin-dependent diabetes TIDAK
1818 07/12/201 130801021218Y000586 0000786942189 SIYEM P PBI (APBN) Hypertensive heart disease TIDAK
1819 07/12/201 130801021218Y000554 0000786946476 ROHMIATI P PBI (APBN) Disorders of lipoprotein metabolism TIDAK
1820 07/12/201 130801021218Y000531 0000786976839 PAIKEM P PBI (APBN) Non-insulin-dependent diabetes TIDAK
1821 07/12/201 130801021218Y000561 0000786985222 TAYEM P PBI (APBN) Non-insulin-dependent diabetes TIDAK
1822 07/12/201 130801021218Y000560 0000787198476 MUSINAH P PBI (APBN) Non-insulin-dependent diabetes TIDAK
1823 07/12/201 130801021218Y000544 0000933510611 ASRIANTI P PEKERJA MANDIRI Contraceptive management TIDAK
1824 07/12/201 130801021218Y000581 0001264759694 MUHAMMAD FARHAN L TNI ANGKATAN DARAT Influenza, virus not identified TIDAK
1825 07/12/201 130801021218Y000604 0001301298669 HARTATIK P PENERIMA PENSIUN Necrosis of pulp TIDAK
1826 07/12/201 130801021218Y000528 0001341478383 SUMINI P PENERIMA PENSIUN Non-insulin-dependent diabetes YA

09/01/2019 16.06.19
DAFTAR KUNJUNGAN PESERTA SAKIT

Kantor Cabang : MADIUN (1303)


FKTP : DEMANGAN (13080102)

NO TANGGAL NO KUNJUNGAN NO KARTU NAMA PESERTA SEX JENIS PESERTA DIAGNOSA DIRUJUK
1827 07/12/201 130801021218Y000551 0001476158758 NABILA NUR KHALIFAH P PEKERJA MANDIRI Hordeolum and chalazion YA
1828 07/12/201 130801021218Y000556 0001704701441 KATINAH P PBI (APBD) Systemic disorders of connective tissue TIDAK
1829 07/12/201 130801021218Y000575 0001704713848 DEWI HERMIN P PBI (APBD) Systemic disorders of connective tissue TIDAK
1830 07/12/201 130801021218Y000516 0001704714197 SULANDEP P PBI (APBD) Panniculitis affecting regions of neck YA
1831 07/12/201 130801021218Y000571 0001704718708 SUPRIYONO L PBI (APBD) Non-insulin-dependent diabetes TIDAK
1832 07/12/201 130801021218Y000592 0001704721691 SANI P PBI (APBD) Non-insulin-dependent diabetes TIDAK
1833 07/12/201 130801021218Y000517 0001704722409 SITI MURSIDAH P PBI (APBD) Contraceptive management TIDAK
1834 07/12/201 130801021218Y000569 0001704722589 TASRI P PBI (APBD) Essential (primary) hypertension TIDAK
1835 07/12/201 130801021218Y000555 0001704724479 KIANI P PBI (APBD) Dermatophytosis TIDAK
1836 07/12/201 130801021218Y000572 0001704844552 TRI ARIYA AGUSTONO L PBI (APBD) Influenza, virus not identified TIDAK
1837 07/12/201 130801021218Y000570 0001705734977 HARSUGIONO L PBI (APBD) Allergic contact dermatitis TIDAK
1838 07/12/201 130801021218Y000534 0001806925331 PARSINI P PEKERJA MANDIRI Systemic disorders of connective tissue TIDAK
1839 07/12/201 130801021218Y000605 0001809662051 FITRI RAHMAWATI P PEKERJA MANDIRI Periapical abscess without sinus TIDAK
1840 07/12/201 130801021218Y000524 0001822721916 HARSINI P PEKERJA MANDIRI Systemic disorders of connective tissue TIDAK
1841 07/12/201 130801021218Y000545 0002065801803 SUMINI P PEKERJA MANDIRI Non-insulin-dependent diabetes YA
1842 07/12/201 130801021218Y000579 0002068987195 PURWATININGSIH P PBI (APBD) Hypotension, unspecified TIDAK
1843 07/12/201 130801021218Y000600 0002143699839 EKO HARTANTO L PEKERJA MANDIRI Acute gingivitis TIDAK
1844 07/12/201 130801021218Y000595 0002163550072 RACQUEL BUNGA AGNI P PBI (APBD) Influenza with other manifestations, TIDAK
1845 07/12/201 130801021218Y000520 0002163551872 HAFIDZ ALFARO GAVRIEL L PBI (APBD) Cough TIDAK
1846 07/12/201 130801021218Y000541 0002163551872 HAFIDZ ALFARO GAVRIEL L PBI (APBD) Cough TIDAK
1847 07/12/201 130801021218Y000546 0002163568184 MUHAMMAD AKMAL L PBI (APBD) Relapsing fevers TIDAK

09/01/2019 16.06.19
DAFTAR KUNJUNGAN PESERTA SAKIT

Kantor Cabang : MADIUN (1303)


FKTP : DEMANGAN (13080102)

NO TANGGAL NO KUNJUNGAN NO KARTU NAMA PESERTA SEX JENIS PESERTA DIAGNOSA DIRUJUK
1848 07/12/201 130801021218Y000547 0002163568184 MUHAMMAD AKMAL L PBI (APBD) Other and unspecified convulsions YA
1849 07/12/201 130801021218Y000577 0002163691901 JUMIRAH P PBI (APBD) Essential (primary) hypertension TIDAK
1850 07/12/201 130801021218Y000564 0002163694691 MUDJIATI P PBI (APBD) Essential (primary) hypertension TIDAK
1851 07/12/201 130801021218Y000573 0002163695905 SARWOTO L PBI (APBD) Gastritis and duodenitis TIDAK
1852 07/12/201 130801021218Y000553 0002163697672 MUGIATINI P PBI (APBD) Essential (primary) hypertension TIDAK
1853 07/12/201 130801021218Y000557 0002163698313 SUPRAPTI P PBI (APBD) Diarrhoea and gastroenteritis of TIDAK
1854 07/12/201 130801021218Y000585 0002163698864 SOEKATNI P PBI (APBD) Hypertensive heart disease TIDAK
1855 07/12/201 130801021218Y000606 0002163702767 SUGIARTI P PBI (APBD) Pulpitis TIDAK
1856 07/12/201 130801021218Y000543 0002163702778 JAUZA OLIVIA NASYWA P PBI (APBD) Influenza with other manifestations, TIDAK
1857 07/12/201 130801021218Y000521 0002163702778 JAUZA OLIVIA NASYWA P PBI (APBD) Influenza with pneumonia, influenza TIDAK
1858 07/12/201 130801021218Y000515 0002163706773 SALAMAH P PBI (APBD) Insulin-dependent diabetes mellitus YA
1859 07/12/201 130801021218Y000582 0002163710878 SARMINI P PBI (APBD) Systemic disorders of connective tissue TIDAK
1860 07/12/201 130801021218Y000526 0002163710968 KASIYEM P PBI (APBD) Gout TIDAK
1861 07/12/201 130801021218Y000568 0002163712048 SUTI P PBI (APBD) Non-insulin-dependent diabetes TIDAK
1862 07/12/201 130801021218Y000529 0002163712342 INDRAWATI P PBI (APBD) Systemic disorders of connective tissue TIDAK
1863 07/12/201 130801021218Y000565 0002163712994 NANIK SUMARNI P PBI (APBD) Hypertensive heart disease TIDAK
1864 07/12/201 130801021218Y000574 0002163715391 MISTATIK P PBI (APBD) Influenza with other manifestations, TIDAK
1865 07/12/201 130801021218Y000530 0002163715424 EMI YULI ASTUTIK P PBI (APBD) Gastritis, unspecified TIDAK
1866 07/12/201 130801021218Y000514 0002163717999 ADELIA MULYAMAULIDA P PBI (APBD) Allergic contact dermatitis TIDAK
1867 07/12/201 130801021218Y000539 0002163717999 ADELIA MULYAMAULIDA P PBI (APBD) Influenza with other manifestations, TIDAK
1868 07/12/201 130801021218Y000563 0002163722894 TIWIK WIDJAJANTI WIDJI P PBI (APBD) Influenza, virus not identified TIDAK

09/01/2019 16.06.19
DAFTAR KUNJUNGAN PESERTA SAKIT

Kantor Cabang : MADIUN (1303)


FKTP : DEMANGAN (13080102)

NO TANGGAL NO KUNJUNGAN NO KARTU NAMA PESERTA SEX JENIS PESERTA DIAGNOSA DIRUJUK
1869 07/12/201 130801021218Y000590 0002163722905 RICO IVAN SAMUDRA L PBI (APBD) Influenza with other manifestations, TIDAK
1870 07/12/201 130801021218Y000523 0002203914126 ALFINO DAFA RAMADHAN L PBI (APBD) Influenza with other manifestations, TIDAK
1871 07/12/201 130801021218Y000548 0002281902939 DJUMADI L PEKERJA MANDIRI Insulin-dependent diabetes mellitus YA
1872 07/12/201 130801021218Y000559 0002281903345 LILIK RUSMINAH P PEKERJA MANDIRI Essential (primary) hypertension TIDAK
1873 07/12/201 130801021218Y000750 0002354078992 JORDAN ANDIKA ZANALI L PBI (APBN) Ventricular septal defect YA
1874 07/12/201 130801021218Y000513 0002413137227 DARA CHANTIKA P PBI (APBD) Relapsing fevers TIDAK
1875 07/12/201 130801021218Y000535 0002413137227 DARA CHANTIKA P PBI (APBD) Oral mucositis (ulcerative) TIDAK
1876 07/12/201 130801021218Y000538 0002413138498 SRIYATUN P PBI (APBD) Non-insulin-dependent diabetes TIDAK
1877 07/12/201 130801021218Y000597 0002413149197 SIMOEN GUTOMO L PBI (APBD) Cough TIDAK
1878 07/12/201 130801021218Y000542 0002413150738 SUTRISNO L PBI (APBD) Gastritis, unspecified TIDAK
1879 07/12/201 130801021218Y000591 0002413151289 DJOKO SUTARTO L PBI (APBD) Essential (primary) hypertension TIDAK
1880 07/12/201 130801021218Y000578 0002413888288 METSEN BENING KUSUMA P PBI (APBD) Cough TIDAK
1881 07/12/201 130801021218Y000558 0002413888299 SHERRYLYNE RYZUMA P PBI (APBD) Cough TIDAK
1882 07/12/201 130801021218Y000587 0002413913163 TIO BIEN JOE L PBI (APBD) Essential (primary) hypertension TIDAK
1883 07/12/201 130801021218Y000522 0002413960064 ADINDA SEKAR CEMPAKA P PBI (APBD) Influenza due to other identified TIDAK
1884 07/12/201 130801021218Y000588 0002413960064 ADINDA SEKAR CEMPAKA P PBI (APBD) Influenza with other manifestations, TIDAK
1885 07/12/201 130801021218Y000566 0002451431755 SRI KARIATIK P PEGAWAI SWASTA Cough TIDAK
1886 07/12/201 130801021218Y000601 0002464330667 RENI ERNIA P PEKERJA MANDIRI Necrosis of pulp TIDAK
1887 07/12/201 130801021218Y000512 0002478459903 MUHAMMAD FATHAN ALIF L PEGAWAI SWASTA Influenza due to other identified TIDAK
1888 07/12/201 130801021218Y000532 0002478459903 MUHAMMAD FATHAN ALIF L PEGAWAI SWASTA Influenza with other manifestations, TIDAK
1889 07/12/201 130801021218Y000603 0002494561149 YULI LESTARININGTYAS P PBI (APBD) Pulpitis TIDAK

09/01/2019 16.06.19
DAFTAR KUNJUNGAN PESERTA SAKIT

Kantor Cabang : MADIUN (1303)


FKTP : DEMANGAN (13080102)

NO TANGGAL NO KUNJUNGAN NO KARTU NAMA PESERTA SEX JENIS PESERTA DIAGNOSA DIRUJUK
1890 07/12/201 130801021218Y000598 0002610834502 WIKA JUANA SARI P PEKERJA MANDIRI Dental caries TIDAK
1891 07/12/201 130801021218Y000599 0002610835086 FATHIMAH P PEKERJA MANDIRI Dental caries TIDAK
1892 06/12/201 130801021218Y000397 0000078525292 IKS ISWAHYONO L PENERIMA PENSIUN TNI Injury of eye and orbit YA
1893 06/12/201 130801021218Y000412 0000078531219 KASIJONO L VETERAN Heart failure, unspecified YA
1894 06/12/201 130801021218Y000453 0000078533471 ERNI SUBIANTI P PENERIMA PENSIUN TNI Systemic disorders of connective tissue TIDAK
1895 06/12/201 130801021218Y000456 0000078724394 SRI SUKAMTI P PENERIMA PENSIUN Disorder of vestibular function, TIDAK
1896 06/12/201 130801021218Y000477 0000078738153 MISTINGAH P PENERIMA PENSIUN Essential (primary) hypertension TIDAK
1897 06/12/201 130801021218Y000439 0000078780183 UNTUNG L PENERIMA PENSIUN Caries of dentine TIDAK
1898 06/12/201 130801021218Y000492 0000105114047 FRANDHICA SEPTYAN P PEKERJA MANDIRI Influenza with other manifestations, TIDAK
1899 06/12/201 130801021218Y000423 0000105164987 MARIMUN L PENERIMA PENSIUN General examination and investigation TIDAK
1900 06/12/201 130801021218Y000497 0000105473002 SRI ENDAH WAHYUNI P PEKERJA MANDIRI Pulpitis TIDAK
1901 06/12/201 130801021218Y000510 0000106325381 SUGENG MARIYANTO L PNS PUSAT Caries limited to enamel TIDAK
1902 06/12/201 130801021218Y000482 0000106359614 IPAH P PENERIMA PENSIUN TNI Non-insulin-dependent diabetes TIDAK
1903 06/12/201 130801021218Y000431 0000106434797 AHKMAT L PNS DAERAH Necrosis of pulp TIDAK
1904 06/12/201 130801021218Y000446 0000106443922 FAJAR WIDODO L PNS DAERAH Otitis externa, unspecified TIDAK
1905 06/12/201 130801021218Y000498 0000106495773 TRI SIAM CHIRAWATI P PENERIMA PENSIUN Caries of dentine TIDAK
1906 06/12/201 130801021218Y000408 0000170000526 SRI SUTJI P PENERIMA PENSIUN Lumbar and other intervertebral disc YA
1907 06/12/201 130801021218Y000441 0000196306255 KRISTANTO SAPUTRO L PNS DAERAH Necrosis of pulp TIDAK
1908 06/12/201 130801021218Y000422 0000199253924 LITA PRASETYA ASTUTI P PNS DAERAH Otitis externa, unspecified TIDAK
1909 06/12/201 130801021218Y002218 0000687588805 NUR HATIN P PBI (APBN) Viral conjunctivitis TIDAK
1910 06/12/201 130801021218Y000411 0000697417672 UYUM DEWI SAFITRI P PBI (APBN) Fracture of vault of skull, closed YA

09/01/2019 16.06.19
DAFTAR KUNJUNGAN PESERTA SAKIT

Kantor Cabang : MADIUN (1303)


FKTP : DEMANGAN (13080102)

NO TANGGAL NO KUNJUNGAN NO KARTU NAMA PESERTA SEX JENIS PESERTA DIAGNOSA DIRUJUK
1911 06/12/201 130801021218Y000496 0000737757898 KAILA PUTRI V P PBI (APBN) Allergic contact dermatitis, unspecified TIDAK
1912 06/12/201 130801021218Y000419 0000769026082 MAISYAROH P PBI (APBN) Periapical abscess without sinus TIDAK
1913 06/12/201 130801021218Y000476 0000786229334 ELY ERNAWATI P PBI (APBN) Allergic contact dermatitis, unspecified TIDAK
1914 06/12/201 130801021218Y000486 0000786229558 MEGA PRATIWI P PBI (APBN) Influenza with other manifestations, TIDAK
1915 06/12/201 130801021218Y000444 0000786374414 MINAH P PBI (APBN) Cough TIDAK
1916 06/12/201 130801021218Y000445 0000786374559 DWI SUSANTI P PBI (APBN) Acute and transient psychotic TIDAK
1917 06/12/201 130801021218Y000395 0000786480625 CHOIRUL DESIAN PUTRA P PBI (APBN) Fracture of bone following insertion of YA
1918 06/12/201 130801021218Y000428 0000786540317 SAHARA L PBI (APBN) Systemic disorders of connective tissue TIDAK
1919 06/12/201 130801021218Y000407 0000786540971 KARTIWI P PBI (APBN) Nonorganic sleep disorder, unspecified YA
1920 06/12/201 130801021218Y000465 0000786629867 SAMINAH P PBI (APBN) Gastritis and duodenitis TIDAK
1921 06/12/201 130801021218Y000494 0000786743594 ANGGO KRISTANTO L PBI (APBN) Zoster [herpes zoster] TIDAK
1922 06/12/201 130801021218Y000433 0000786771674 MINAH P PBI (APBN) Non-insulin-dependent diabetes TIDAK
1923 06/12/201 130801021218Y000440 0000786779684 TOEMI P PBI (APBN) Allergic contact dermatitis, unspecified TIDAK
1924 06/12/201 130801021218Y000491 0000786806998 MISWANTO L PBI (APBN) Systemic disorders of connective tissue TIDAK
1925 06/12/201 130801021218Y000400 0000786807235 SUWARNI P PBI (APBN) Contraceptive management TIDAK
1926 06/12/201 130801021218Y000442 0000786824998 CACAK WIRANTO L PBI (APBN) Insulin-dependent diabetes mellitus TIDAK
1927 06/12/201 130801021218Y001533 0000786849006 DEWI YULIANTI P PBI (APBN) Contraceptive management TIDAK
1928 06/12/201 130801021218Y000427 0000786975941 SUPONO L PBI (APBN) Cough TIDAK
1929 06/12/201 130801021218Y002221 0000786997822 PURWANINGSIH P PBI (APBN) Viral conjunctivitis TIDAK
1930 06/12/201 130801021218Y000413 0000786997822 PURWANINGSIH P PBI (APBN) Routine postpartum follow-up YA
1931 06/12/201 130801021218Y000470 0000787191748 SUTIYAH P PBI (APBN) Gastritis and duodenitis TIDAK

09/01/2019 16.06.19
DAFTAR KUNJUNGAN PESERTA SAKIT

Kantor Cabang : MADIUN (1303)


FKTP : DEMANGAN (13080102)

NO TANGGAL NO KUNJUNGAN NO KARTU NAMA PESERTA SEX JENIS PESERTA DIAGNOSA DIRUJUK
1932 06/12/201 130801021218Y000448 0000787227041 NUROCHMIATI PUSPITA P PBI (APBN) Other headache syndromes TIDAK
1933 06/12/201 130801021218Y002223 0000787460848 SRI WAHYUNI P PBI (APBN) Contraceptive management TIDAK
1934 06/12/201 130801021218Y000409 0000787729239 SURATMI P PBI (APBN) Myalgia, site unspecified YA
1935 06/12/201 130801021218Y000421 0000976670842 PUTRI ELYSA ANDHINI P PEGAWAI SWASTA Influenza due to other identified TIDAK
1936 06/12/201 130801021218Y002224 0001049789215 PUKARYATI P PBI (APBN) Contraceptive management TIDAK
1937 06/12/201 130801021218Y000393 0001183419066 SULISTYAWATI P PEKERJA MANDIRI Asthma YA
1938 06/12/201 130801021218Y000493 0001293785076 IRMA INDRAWATI P TNI ANGKATAN DARAT Caries of dentine TIDAK
1939 06/12/201 130801021218Y000417 0001704706435 KASRI MURYANI P PBI (APBD) Systemic disorders of connective tissue TIDAK
1940 06/12/201 130801021218Y000396 0001704708775 PRILA DWI ANDIKA P PBI (APBD) Dyspepsia YA
1941 06/12/201 130801021218Y000430 0001704708821 SATIYEM P PBI (APBD) Cough TIDAK
1942 06/12/201 130801021218Y000420 0001704714287 KASNO L PBI (APBD) Disorders of vestibular function TIDAK
1943 06/12/201 130801021218Y001532 0001704719597 TATIK LESTARI P PBI (APBD) Contraceptive management TIDAK
1944 06/12/201 130801021218Y000475 0001704720183 LAMBANG EKO BUDIWATI P PBI (APBD) Non-insulin-dependent diabetes TIDAK
1945 06/12/201 130801021218Y000443 0001704720576 MARSINI P PBI (APBD) Non-insulin-dependent diabetes TIDAK
1946 06/12/201 130801021218Y002219 0001704722771 MARWATI P PBI (APBD) Viral conjunctivitis TIDAK
1947 06/12/201 130801021218Y000451 0001704723816 WARIYANTO L PBI (APBD) Gastritis, unspecified TIDAK
1948 06/12/201 130801021218Y000410 0001704724828 NUR WIDYANINGSIH P PBI (APBD) Fracture of forearm YA
1949 06/12/201 130801021218Y000466 0001704842032 ILAWATI P PBI (APBD) Gastritis and duodenitis TIDAK
1950 06/12/201 130801021218Y000429 0001704847634 LASMINI P PBI (APBD) Gastritis and duodenitis TIDAK
1951 06/12/201 130801021218Y000468 0001706781587 SOEMARIYANI P PBI (APBD) Myalgia TIDAK
1952 06/12/201 130801021218Y000394 0001815298896 KARYONO L PEKERJA MANDIRI Acute abdomen YA

09/01/2019 16.06.19
DAFTAR KUNJUNGAN PESERTA SAKIT

Kantor Cabang : MADIUN (1303)


FKTP : DEMANGAN (13080102)

NO TANGGAL NO KUNJUNGAN NO KARTU NAMA PESERTA SEX JENIS PESERTA DIAGNOSA DIRUJUK
1953 06/12/201 130801021218Y000452 0001829996853 MUJI WALUYO L PBI (APBD) Disorder of vestibular function, TIDAK
1954 06/12/201 130801021218Y000489 0002037571176 ALNINO PUTRA L PEGAWAI SWASTA Influenza with other manifestations, TIDAK
1955 06/12/201 130801021218Y000418 0002163549903 SAYEM P PBI (APBD) Other gastritis TIDAK
1956 06/12/201 130801021218Y000484 0002163549914 RIYAN DIKI SAPUTRA L PBI (APBD) Influenza with other manifestations, TIDAK
1957 06/12/201 130801021218Y000479 0002163559555 SUGIARTI P PBI (APBD) Systemic disorders of connective tissue TIDAK
1958 06/12/201 130801021218Y000488 0002163563324 ARSYILA ZALFA FARZANA P PBI (APBD) Influenza with other manifestations, TIDAK
1959 06/12/201 130801021218Y000390 0002163563324 ARSYILA ZALFA FARZANA P PBI (APBD) Influenza due to other identified TIDAK
1960 06/12/201 130801021218Y002425 0002163565462 SRI WIDAYATI P PBI (APBD) Necrosis of pulp TIDAK
1961 06/12/201 130801021218Y000473 0002163565462 SRI WIDAYATI P PBI (APBD) Disorder of lipoprotein metabolism, TIDAK
1962 06/12/201 130801021218Y000460 0002163565888 SUSILOWATI P PBI (APBD) Necrosis of pulp TIDAK
1963 06/12/201 130801021218Y000447 0002163688299 SUKARMI P PBI (APBD) Non-insulin-dependent diabetes TIDAK
1964 06/12/201 130801021218Y000402 0002163691631 LESTARI P PBI (APBD) Chronic ischaemic heart disease YA
1965 06/12/201 130801021218Y000401 0002163692283 SULIMI P PBI (APBD) Non-insulin-dependent diabetes YA
1966 06/12/201 130801021218Y000391 0002163692619 KEN AYU CHELSEA DHYA P PBI (APBD) Need for immunization against other TIDAK
1967 06/12/201 130801021218Y000487 0002163694318 ERNA WIBAWATI P PBI (APBD) Non-insulin-dependent diabetes TIDAK
1968 06/12/201 130801021218Y000392 0002163694566 SUPARDI L PBI (APBD) Hypertensive heart disease YA
1969 06/12/201 130801021218Y000405 0002163696175 SUDARMI P PBI (APBD) Other cataract YA
1970 06/12/201 130801021218Y000406 0002163697446 ENDANG PURWATI P PBI (APBD) Heart failure YA
1971 06/12/201 130801021218Y000449 0002163698875 WARINEM P PBI (APBD) Disorder of lipoprotein metabolism, TIDAK
1972 06/12/201 130801021218Y000450 0002163698908 DARSONO L PBI (APBD) Non-insulin-dependent diabetes TIDAK
1973 06/12/201 130801021218Y000469 0002163703342 SITI UTIKAH P PBI (APBD) Gout TIDAK

09/01/2019 16.06.19
DAFTAR KUNJUNGAN PESERTA SAKIT

Kantor Cabang : MADIUN (1303)


FKTP : DEMANGAN (13080102)

NO TANGGAL NO KUNJUNGAN NO KARTU NAMA PESERTA SEX JENIS PESERTA DIAGNOSA DIRUJUK
1974 06/12/201 130801021218Y000478 0002163708922 SRI UTAMI P PBI (APBD) Other and unspecified infectious TIDAK
1975 06/12/201 130801021218Y000480 0002163710529 MARTINI P PBI (APBD) Systemic disorders of connective tissue TIDAK
1976 06/12/201 130801021218Y000495 0002163710542 JALU WINANGPARO L PBI (APBD) Acute tonsillitis, unspecified TIDAK
1977 06/12/201 130801021218Y000424 0002163710823 SUMARSIH P PBI (APBD) Non-insulin-dependent diabetes TIDAK
1978 06/12/201 130801021218Y000458 0002163715659 RUSMINI P PBI (APBD) Non-insulin-dependent diabetes TIDAK
1979 06/12/201 130801021218Y000509 0002201548364 SANTI DWI FARIDA P PEKERJA MANDIRI Necrosis of pulp TIDAK
1980 06/12/201 130801021218Y000455 0002201548364 SANTI DWI FARIDA P PEKERJA MANDIRI Allergic contact dermatitis TIDAK
1981 06/12/201 130801021218Y000472 0002229557905 AYU ANDIRA P PBI (APBN) Influenza due to other identified TIDAK
1982 06/12/201 130801021218Y002216 0002294961399 NOVI RITA SAHARA P PBI (APBD) Viral conjunctivitis TIDAK
1983 06/12/201 130801021218Y000501 0002297647934 MUH. ZAINAL ARIFIN L PEKERJA MANDIRI Necrosis of pulp TIDAK
1984 06/12/201 130801021218Y000459 0002309187745 SUMIJEM P PEKERJA MANDIRI Systemic disorders of connective tissue TIDAK
1985 06/12/201 130801021218Y000462 0002312820731 MOEGINAH P PEKERJA MANDIRI Disorders of lipoprotein metabolism TIDAK
1986 06/12/201 130801021218Y000426 0002375902787 MUHAMMAD AZRO DZIKRI L PEKERJA MANDIRI Otitis externa TIDAK
1987 06/12/201 130801021218Y000461 0002413006367 FADLI HIBATULLAH FAUZI L PBI (APBD) Other and unspecified infectious TIDAK
1988 06/12/201 130801021218Y000474 0002413058286 SUSILOWATI P PBI (APBD) Systemic disorders of connective tissue TIDAK
1989 06/12/201 130801021218Y000483 0002413060468 BAMBANG HARIJANTO L PBI (APBD) Essential (primary) hypertension TIDAK
1990 06/12/201 130801021218Y000457 0002413116731 LILIK KASMIYATI P PBI (APBD) Systemic disorders of connective tissue TIDAK
1991 06/12/201 130801021218Y000434 0002413120735 RETNO YUNIARTATI P PBI (APBD) Systemic disorders of connective tissue TIDAK
1992 06/12/201 130801021218Y000403 0002413143742 DEWI TRISNAYANTI P PBI (APBD) Follow-up examination after surgery YA
1993 06/12/201 130801021218Y000464 0002413143742 DEWI TRISNAYANTI P PBI (APBD) Systemic disorders of connective tissue TIDAK
1994 06/12/201 130801021218Y000415 0002413153708 NURUL CHOIRIYATI P PBI (APBD) Mixed asthma YA

09/01/2019 16.06.19
DAFTAR KUNJUNGAN PESERTA SAKIT

Kantor Cabang : MADIUN (1303)


FKTP : DEMANGAN (13080102)

NO TANGGAL NO KUNJUNGAN NO KARTU NAMA PESERTA SEX JENIS PESERTA DIAGNOSA DIRUJUK
1995 06/12/201 130801021218Y000404 0002413157027 BUDI YUNITA DWIPARLINA P PBI (APBD) Parkinson's disease YA
1996 06/12/201 130801021218Y000438 0002413850782 WARTI P PBI (APBD) Systemic disorders of connective tissue TIDAK
1997 06/12/201 130801021218Y000398 0002413899898 RETNO SAGITA SARI P PBI (APBD) Contraceptive management TIDAK
1998 06/12/201 130801021218Y000490 0002413899909 ARFAIZ DZAKI ASYAMMADA L PBI (APBD) Influenza with other manifestations, TIDAK
1999 06/12/201 130801021218Y000399 0002413899909 ARFAIZ DZAKI ASYAMMADA L PBI (APBD) Diarrhoea and gastroenteritis of TIDAK
2000 06/12/201 130801021218Y000416 0002413913848 JOKO PURNOMO L PBI (APBD) Disorder of vitreous body, unspecified YA
2001 06/12/201 130801021218Y000485 0002413914917 FYKKA BRILLIAN P PBI (APBD) Influenza with other manifestations, TIDAK
2002 06/12/201 130801021218Y000463 0002413916842 WIYANTI P PBI (APBD) Gout TIDAK
2003 06/12/201 130801021218Y000436 0002413959748 KURNI JATMIKO L PBI (APBD) Influenza, virus not identified TIDAK
2004 06/12/201 130801021218Y000437 0002413959759 SRI MULYANI P PBI (APBD) Gastritis and duodenitis TIDAK
2005 06/12/201 130801021218Y000471 0002413962325 SUYITNO L PBI (APBD) General examination and investigation TIDAK
2006 06/12/201 130801021218Y000414 0002413963383 SITI HARIATUN P PBI (APBD) Chronic renal failure, unspecified YA
2007 06/12/201 130801021218Y000435 0002413963991 IKA VERAWATI P PBI (APBD) Gastritis and duodenitis TIDAK
2008 06/12/201 130801021218Y000425 0002413964215 DJAENURI L PBI (APBD) Necrosis of pulp TIDAK
2009 06/12/201 130801021218Y000432 0002413967095 SUWARSINI P PBI (APBD) Systemic disorders of connective tissue TIDAK
2010 06/12/201 130801021218Y000467 0002413968039 NINIK SRI WAHYUNI P PBI (APBD) Glaucoma, unspecified YA
2011 06/12/201 130801021218Y000481 0002413968052 DEBBY SUKMANA P PBI (APBD) Acute and transient psychotic disorder, YA
2012 06/12/201 130801021218Y000499 0002413972517 REIKOSEIF DAIVA L PBI (APBD) Cough TIDAK
2013 06/12/201 130801021218Y000454 0002453956659 HALIMATUN P PEKERJA MANDIRI Necrosis of pulp TIDAK
2014 06/12/201 130801021218Y002222 0002494876252 SRI WIDAYATI P PBI (APBD) Contraceptive management TIDAK
2015 05/12/201 130801021218Y000317 0000078547577 SARMININGSIH P PENERIMA PENSIUN TNI Essential (primary) hypertension TIDAK

09/01/2019 16.06.19
DAFTAR KUNJUNGAN PESERTA SAKIT

Kantor Cabang : MADIUN (1303)


FKTP : DEMANGAN (13080102)

NO TANGGAL NO KUNJUNGAN NO KARTU NAMA PESERTA SEX JENIS PESERTA DIAGNOSA DIRUJUK
2016 05/12/201 130801021218Y000345 0000078552461 SOEPARDAN L PENERIMA PENSIUN TNI Hordeolum and chalazion TIDAK
2017 05/12/201 130801021218Y000356 0000078749741 RR. SOEBARDINI P PENERIMA PENSIUN Disorders of lipoprotein metabolism TIDAK
2018 05/12/201 130801021218Y000295 0000078765862 SUHARTI P PENERIMA PENSIUN Influenza with other manifestations, TIDAK
2019 05/12/201 130801021218Y000285 0000078767392 SRI REDJEKI P PENERIMA PENSIUN Hypertensive heart disease YA
2020 05/12/201 130801021218Y000327 0000078773624 SUPARNO L PENERIMA PENSIUN Chronic periodontitis TIDAK
2021 05/12/201 130801021218Y000381 0000105087082 S.WATINI P PENERIMA PENSIUN Disorders of lipoprotein metabolism TIDAK
2022 05/12/201 130801021218Y000375 0000105114047 FRANDHICA SEPTYAN P PEKERJA MANDIRI Acute pharyngitis, unspecified TIDAK
2023 05/12/201 130801021218Y000354 0000106115332 NURUL HIDAYAH P PNS DAERAH Contraceptive management TIDAK
2024 05/12/201 130801021218Y000286 0000106272641 Rr NOEZIAR OCTAVIA P PNS DAERAH Non-insulin-dependent diabetes YA
2025 05/12/201 130801021218Y000507 0000106422074 SUJUTI P PENERIMA PENSIUN Chronic periodontitis TIDAK
2026 05/12/201 130801021218Y000386 0000159308752 UMI KULSUM P PNS DAERAH Temporomandibular joint disorders YA
2027 05/12/201 130801021218Y000302 0000737035075 GANGSAR WAHYU L PBI (APBN) Influenza with other manifestations, TIDAK
2028 05/12/201 130801021218Y000350 0000737146664 LULUK SUSILOWATI P PBI (APBN) Contraceptive management TIDAK
2029 05/12/201 130801021218Y000385 0000737604786 NOVIA SULISTIYANI P PBI (APBN) Antenatal screening TIDAK
2030 05/12/201 130801021218Y000282 0000785252147 KATIYEM P PBI (APBN) Cataract, unspecified YA
2031 05/12/201 130801021218Y000276 0000785836956 DESSY NATALIA P PBI (APBN) Candidiasis of vulva and vagina TIDAK
2032 05/12/201 130801021218Y000325 0000785836956 DESSY NATALIA P PBI (APBN) Gonococcal infection, unspecified TIDAK
2033 05/12/201 130801021218Y000344 0000786114652 SLAMET L PBI (APBN) Essential (primary) hypertension TIDAK
2034 05/12/201 130801021218Y000333 0000786284831 SULANDARI P PBI (APBN) Systemic disorders of connective tissue TIDAK
2035 05/12/201 130801021218Y000382 0000786390186 SUWARSI P PBI (APBN) Non-insulin-dependent diabetes TIDAK
2036 05/12/201 130801021218Y000290 0000786390186 SUWARSI P PBI (APBN) Leiomyoma of uterus YA

09/01/2019 16.06.19
DAFTAR KUNJUNGAN PESERTA SAKIT

Kantor Cabang : MADIUN (1303)


FKTP : DEMANGAN (13080102)

NO TANGGAL NO KUNJUNGAN NO KARTU NAMA PESERTA SEX JENIS PESERTA DIAGNOSA DIRUJUK
2037 05/12/201 130801021218Y000364 0000786411404 RANTI P PBI (APBN) Pure hypercholesterolaemia TIDAK
2038 05/12/201 130801021218Y000336 0000786442511 IDA RULMIYATI P PBI (APBN) Disorders of lipoprotein metabolism TIDAK
2039 05/12/201 130801021218Y000334 0000786606614 SUTI P PBI (APBN) Non-insulin-dependent diabetes TIDAK
2040 05/12/201 130801021218Y000320 0000786750647 SAMINI P PBI (APBN) Non-insulin-dependent diabetes TIDAK
2041 05/12/201 130801021218Y002225 0000786806324 FITRI MAHANIK NOER P PBI (APBN) Maternal care for other specified fetal TIDAK
2042 05/12/201 130801021218Y000324 0000786807281 DJUMINAH P PBI (APBN) Non-insulin-dependent diabetes TIDAK
2043 05/12/201 130801021218Y000357 0000786812376 ANDHITA EKA NURCAHYA P PBI (APBN) Other and unspecified infectious TIDAK
2044 05/12/201 130801021218Y000380 0000786828273 AMINAH P PBI (APBN) Systemic disorders of connective tissue TIDAK
2045 05/12/201 130801021218Y000360 0000786852224 DIVA KARISMA INSANI P PBI (APBN) Candidiasis of vulva and vagina TIDAK
2046 05/12/201 130801021218Y000384 0000786852224 DIVA KARISMA INSANI P PBI (APBN) Candidiasis TIDAK
2047 05/12/201 130801021218Y000305 0000786856566 TIA NOVITA P PBI (APBN) Antenatal screening TIDAK
2048 05/12/201 130801021218Y000347 0000786860447 RIANI SEPTIANA P PBI (APBN) Antenatal screening TIDAK
2049 05/12/201 130801021218Y000371 0000786860447 RIANI SEPTIANA P PBI (APBN) Iron deficiency anaemia TIDAK
2050 05/12/201 130801021218Y000311 0000786865792 SHITI SETYO RAHMADHANI P PBI (APBN) Pulpitis TIDAK
2051 05/12/201 130801021218Y000299 0000786866758 YUNITA SALSA BELLA P PBI (APBN) Influenza due to other identified TIDAK
2052 05/12/201 130801021218Y000355 0000786886402 SITI YUNI WULANDARI P PBI (APBN) Routine postpartum follow-up TIDAK
2053 05/12/201 130801021218Y000274 0000786908316 PANIYEM P PBI (APBN) Hypertensive heart disease YA
2054 05/12/201 130801021218Y000346 0000786925394 EGA FAJAR FEBRIANDI L PBI (APBN) Other and unspecified infectious TIDAK
2055 05/12/201 130801021218Y000383 0000786949738 SRI ASTUTI P PBI (APBN) Gastritis, unspecified TIDAK
2056 05/12/201 130801021218Y000328 0000786987426 SINEM P PBI (APBN) Non-insulin-dependent diabetes TIDAK
2057 05/12/201 130801021218Y000297 0000787001635 ANDRO WINATA L PBI (APBN) Influenza with other manifestations, TIDAK

09/01/2019 16.06.19
DAFTAR KUNJUNGAN PESERTA SAKIT

Kantor Cabang : MADIUN (1303)


FKTP : DEMANGAN (13080102)

NO TANGGAL NO KUNJUNGAN NO KARTU NAMA PESERTA SEX JENIS PESERTA DIAGNOSA DIRUJUK
2058 05/12/201 130801021218Y000329 0000787007709 TARMI ENGGARWATI P PBI (APBN) Acute haemorrhagic gastritis TIDAK
2059 05/12/201 130801021218Y000289 0000787034979 EKO ADI PRABOWO L PBI (APBN) Gonarthrosis, unspecified YA
2060 05/12/201 130801021218Y000370 0000787301559 MUNIRAH P PBI (APBN) Gastritis, unspecified TIDAK
2061 05/12/201 130801021218Y000309 0000787335423 WAHJUNI P PBI (APBN) Gastritis, unspecified TIDAK
2062 05/12/201 130801021218Y000387 0000787404791 SUNARTI P PBI (APBN) Antenatal screening TIDAK
2063 05/12/201 130801021218Y000365 0001045295076 ANGSUN SULIYATI P PBI (APBN) Antenatal screening TIDAK
2064 05/12/201 130801021218Y000337 0001049784041 MEI RAHAYU P PBI (APBN) Antenatal screening TIDAK
2065 05/12/201 130801021218Y000281 0001085566498 MUJIATI P PENERIMA PENSIUN TNI Hypertensive heart disease without YA
2066 05/12/201 130801021218Y000314 0001125923747 WINARSO L PEGAWAI SWASTA Vascular headache, not elsewhere TIDAK
2067 05/12/201 130801021218Y000308 0001140656297 HARTONO L PEGAWAI SWASTA Necrosis of pulp TIDAK
2068 05/12/201 130801021218Y000368 0001180351642 DINDA SAFITRI P PEKERJA MANDIRI General examination and investigation TIDAK
2069 05/12/201 130801021218Y000508 0001180351642 DINDA SAFITRI P PEKERJA MANDIRI Antenatal screening TIDAK
2070 05/12/201 130801021218Y000503 0001405905704 ERNAWATI P PEGAWAI SWASTA Pulpitis TIDAK
2071 05/12/201 130801021218Y000310 0001442421731 YOSSIDA ROYSIAWATI P PEKERJA MANDIRI Antenatal screening TIDAK
2072 05/12/201 130801021218Y000287 0001478435589 RACHEL PERTIWI PUDJIATI, P PEKERJA MANDIRI Heart failure, unspecified YA
2073 05/12/201 130801021218Y000389 0001625701116 RIZKI ARDYASARI P PEGAWAI BUMN Disorders of refraction and YA
2074 05/12/201 130801021218Y000304 0001704707706 NURITA SARI P PBI (APBD) Contraceptive management TIDAK
2075 05/12/201 130801021218Y000340 0001704708843 SUGIMUN L PBI (APBD) Non-insulin-dependent diabetes TIDAK
2076 05/12/201 130801021218Y000313 0001704711936 IIN YULAIKAH P PBI (APBD) Other specified headache syndromes TIDAK
2077 05/12/201 130801021218Y000369 0001704712173 ANIK P PBI (APBD) Influenza with other manifestations, TIDAK
2078 05/12/201 130801021218Y000379 0001704712184 MUHAMMAD RIZQI L PBI (APBD) Influenza with other manifestations, TIDAK

09/01/2019 16.06.19
DAFTAR KUNJUNGAN PESERTA SAKIT

Kantor Cabang : MADIUN (1303)


FKTP : DEMANGAN (13080102)

NO TANGGAL NO KUNJUNGAN NO KARTU NAMA PESERTA SEX JENIS PESERTA DIAGNOSA DIRUJUK
2079 05/12/201 130801021218Y000339 0001704716752 ICIH P PBI (APBD) Conjunctivitis, unspecified TIDAK
2080 05/12/201 130801021218Y000279 0001704718708 SUPRIYONO L PBI (APBD) Non-insulin-dependent diabetes YA
2081 05/12/201 130801021218Y000332 0001704719362 SITI RAHAYU P PBI (APBD) Systemic disorders of connective tissue TIDAK
2082 05/12/201 130801021218Y000330 0001704720014 SRI ENDANG WATI P PBI (APBD) Non-insulin-dependent diabetes TIDAK
2083 05/12/201 130801021218Y000362 0001704720014 SRI ENDANG WATI P PBI (APBD) Periapical abscess without sinus TIDAK
2084 05/12/201 130801021218Y000341 0001704720317 LISDIATININGRUM P W P PBI (APBD) Essential (primary) hypertension TIDAK
2085 05/12/201 130801021218Y000316 0001704721386 YONATAN L PBI (APBD) Other specified headache syndromes TIDAK
2086 05/12/201 130801021218Y000283 0001704721746 ARIS NURCAHYO L PBI (APBD) Other and unspecified infectious YA
2087 05/12/201 130801021218Y000306 0001704723592 MIARKO L PBI (APBD) Essential (primary) hypertension TIDAK
2088 05/12/201 130801021218Y000359 0001704724986 SUDARSONO L PBI (APBD) Gastritis, unspecified TIDAK
2089 05/12/201 130801021218Y000296 0001704726461 HADI SANTOSO L PBI (APBD) Haemoptysis TIDAK
2090 05/12/201 130801021218Y000500 0001704727438 IDA DWIDARYANTI P PBI (APBD) Necrosis of pulp TIDAK
2091 05/12/201 130801021218Y000338 0001704731646 SRI AGRARIANI P PBI (APBD) Pure hypercholesterolaemia TIDAK
2092 05/12/201 130801021218Y000343 0001704848139 SUPARINI P PBI (APBD) Non-insulin-dependent diabetes TIDAK
2093 05/12/201 130801021218Y002095 0001704848139 SUPARINI P PBI (APBD) Chronic periodontitis TIDAK
2094 05/12/201 130801021218Y000318 0001856574123 HERU SUJATMIKO L PEKERJA MANDIRI Non-insulin-dependent diabetes TIDAK
2095 05/12/201 130801021218Y000361 0001906282359 DENIK KRISNIAWATI P PEGAWAI SWASTA Disorders of lipoprotein metabolism TIDAK
2096 05/12/201 130801021218Y000363 0001906535845 WAHYUNINGSIH RETNO P PEGAWAI SWASTA Other headache syndromes TIDAK
2097 05/12/201 130801021218Y000277 0002059734251 NURUL TRI OKTAVIANA P PEGAWAI SWASTA Antenatal screening TIDAK
2098 05/12/201 130801021218Y000358 0002097952558 MITA FEBRIANA SARI P PEGAWAI SWASTA Antenatal screening TIDAK
2099 05/12/201 130801021218Y000366 0002163555369 ROPIAH P PBI (APBD) Gastritis and duodenitis TIDAK

09/01/2019 16.06.19
DAFTAR KUNJUNGAN PESERTA SAKIT

Kantor Cabang : MADIUN (1303)


FKTP : DEMANGAN (13080102)

NO TANGGAL NO KUNJUNGAN NO KARTU NAMA PESERTA SEX JENIS PESERTA DIAGNOSA DIRUJUK
2100 05/12/201 130801021218Y000352 0002163561028 MUJIATI P PBI (APBD) Non-insulin-dependent diabetes TIDAK
2101 05/12/201 130801021218Y000504 0002163565449 SUMARNIDA P PBI (APBD) Necrosis of pulp TIDAK
2102 05/12/201 130801021218Y000351 0002163569139 SUHARNI P PBI (APBD) Allergic contact dermatitis TIDAK
2103 05/12/201 130801021218Y000275 0002163572548 IMROATUL KHAMIDAH P PBI (APBD) Contraceptive management TIDAK
2104 05/12/201 130801021218Y000349 0002163572548 IMROATUL KHAMIDAH P PBI (APBD) Other headache syndromes TIDAK
2105 05/12/201 130801021218Y000284 0002163572763 SUYITNO L PBI (APBD) Hypertensive heart disease YA
2106 05/12/201 130801021218Y000307 0002163583271 RINTIS UTHITA HERNANDA P PBI (APBD) Gastritis, unspecified TIDAK
2107 05/12/201 130801021218Y000312 0002163690112 PRIMA KOTABIA L PBI (APBD) Conjunctivitis TIDAK
2108 05/12/201 130801021218Y000348 0002163692507 JULIANT SATRIA L PBI (APBD) Influenza, virus not identified TIDAK
2109 05/12/201 130801021218Y000300 0002163694691 MUDJIATI P PBI (APBD) Essential (primary) hypertension TIDAK
2110 05/12/201 130801021218Y000301 0002163694702 AGSHA ARDIANMAS L PBI (APBD) Allergic contact dermatitis TIDAK
2111 05/12/201 130801021218Y000374 0002163703228 CHELYNENA RAHMA P PBI (APBD) Fever, unspecified TIDAK
2112 05/12/201 130801021218Y000372 0002163704747 SAMINEM P PBI (APBD) Gastritis, unspecified TIDAK
2113 05/12/201 130801021218Y000323 0002163706187 SLAMET L PBI (APBD) Chronic obstructive pulmonary disease, TIDAK
2114 05/12/201 130801021218Y000319 0002163710248 SUWARSI P PBI (APBD) Noninflammatory disorder of vagina, TIDAK
2115 05/12/201 130801021218Y000331 0002163710248 SUWARSI P PBI (APBD) Candidiasis of vulva and vagina TIDAK
2116 05/12/201 130801021218Y000326 0002163721724 ABROR FEBIYANTI P PBI (APBD) Disturbances in tooth eruption TIDAK
2117 05/12/201 130801021218Y000335 0002163885434 NITA CHANDRA KARTIKA P PBI (APBD) Antenatal screening TIDAK
2118 05/12/201 130801021218Y000506 0002164990239 DJAKA SANTOSA L PBI (APBD) Necrosis of pulp TIDAK
2119 05/12/201 130801021218Y000321 0002238251117 PRASTI RUFITA SARI P PBI (APBD) Antenatal screening TIDAK
2120 05/12/201 130801021218Y000293 0002296596914 WULAN NOVITASARI P PEKERJA MANDIRI Follow-up examination after surgery YA

09/01/2019 16.06.19
DAFTAR KUNJUNGAN PESERTA SAKIT

Kantor Cabang : MADIUN (1303)


FKTP : DEMANGAN (13080102)

NO TANGGAL NO KUNJUNGAN NO KARTU NAMA PESERTA SEX JENIS PESERTA DIAGNOSA DIRUJUK
2121 05/12/201 130801021218Y000376 0002324297147 RAFKA ARSHA FATHAN L PEGAWAI SWASTA Oral mucositis (ulcerative) TIDAK
2122 05/12/201 130801021218Y000367 0002324297147 RAFKA ARSHA FATHAN L PEGAWAI SWASTA Stomatitis and related lesions TIDAK
2123 05/12/201 130801021218Y000322 0002354078687 PONIYEM P PBI (APBN) Gout TIDAK
2124 05/12/201 130801021218Y000502 0002413108225 SYAHIRA P PBI (APBD) Dental caries TIDAK
2125 05/12/201 130801021218Y000315 0002413109248 SITI ZUMAROH P PBI (APBD) Influenza with other manifestations, TIDAK
2126 05/12/201 130801021218Y000294 0002413114042 SUNARSIH P PBI (APBD) Tuberculosis of other organs YA
2127 05/12/201 130801021218Y000280 0002413145867 ITA KUNTARI P PBI (APBD) Gonarthrosis, unspecified YA
2128 05/12/201 130801021218Y000278 0002413150209 DIAH SUSILONINGRUM P PBI (APBD) Insulin-dependent diabetes mellitus YA
2129 05/12/201 130801021218Y000298 0002413917382 DEWI ANIS AMBAR SARI P PBI (APBD) Systemic disorders of connective tissue TIDAK
2130 05/12/201 130801021218Y000288 0002413917415 SEDIJONO L PBI (APBD) Non-insulin-dependent diabetes YA
2131 05/12/201 130801021218Y000303 0002413920069 DIPA ASSOFA L PBI (APBD) Allergic contact dermatitis, unspecified TIDAK
2132 05/12/201 130801021218Y000505 0002413920069 DIPA ASSOFA L PBI (APBD) Disturbances in tooth eruption TIDAK
2133 05/12/201 130801021218Y000291 0002413921432 WIYANTO L PBI (APBD) Abscess of liver YA
2134 05/12/201 130801021218Y000292 0002413921443 BETI SRI UTAMI P PBI (APBD) Nerve root and plexus disorder, YA
2135 05/12/201 130801021218Y000388 0002413962887 SITI KOMARIYAH P PBI (APBD) Periapical abscess without sinus TIDAK
2136 05/12/201 130801021218Y000342 0002413965082 EMMA WIDYA PRATIWI P PBI (APBD) Antenatal screening TIDAK
2137 05/12/201 130801021218Y000373 0002422602415 SRI HARTINI P PEKERJA MANDIRI Non-insulin-dependent diabetes TIDAK
2138 05/12/201 130801021218Y000377 0002455399506 MOHAMMAD AZRIL AL L PEGAWAI SWASTA Relapsing fevers TIDAK
2139 05/12/201 130801021218Y000378 0002455399506 MOHAMMAD AZRIL AL L PEGAWAI SWASTA Fever, unspecified TIDAK
2140 05/12/201 130801021218Y000353 0002493527264 GIBRAN CATRA L PEGAWAI SWASTA Zoster without complication TIDAK
2141 04/12/201 130801021218Y000193 0000104963567 DJAIKOEN L PENERIMA PENSIUN TNI Necrosis of pulp TIDAK

09/01/2019 16.06.19
DAFTAR KUNJUNGAN PESERTA SAKIT

Kantor Cabang : MADIUN (1303)


FKTP : DEMANGAN (13080102)

NO TANGGAL NO KUNJUNGAN NO KARTU NAMA PESERTA SEX JENIS PESERTA DIAGNOSA DIRUJUK
2142 04/12/201 130801021218Y000190 0000104976044 CAHYO PRASETYO L PEGAWAI SWASTA Other specified headache syndromes TIDAK
2143 04/12/201 130801021218Y000269 0000105169689 FESTI ANGGRAINI YONASIH P PNS DAERAH Periapical abscess without sinus TIDAK
2144 04/12/201 130801021218Y000153 0000106115332 NURUL HIDAYAH P PNS DAERAH Diastasis of muscle, other YA
2145 04/12/201 130801021218Y000259 0000106293497 MOHAMAD MANSUR L PNS DAERAH Essential (primary) hypertension TIDAK
2146 04/12/201 130801021218Y000179 0000106302789 SRI ASTINI P PNS DAERAH Systemic disorders of connective tissue TIDAK
2147 04/12/201 130801021218Y000154 0000106315244 SUPARNO L PNS DAERAH Sequelae of other and unspecified YA
2148 04/12/201 130801021218Y002081 0000164763652 HERY SUGIARTO L ANGGOTA POLRI Tuberculosis of other organs TIDAK
2149 04/12/201 130801021218Y000206 0000170000392 MIHARSI P PNS DAERAH Non-insulin-dependent diabetes TIDAK
2150 04/12/201 130801021218Y000271 0000737490284 KUSMIATUN P PBI (APBN) Dental caries TIDAK
2151 04/12/201 130801021218Y000200 0000786389782 KATEMI P PBI (APBN) Acute haemorrhagic gastritis TIDAK
2152 04/12/201 130801021218Y000175 0000786411674 KORIYAH P PBI (APBN) Hypotension TIDAK
2153 04/12/201 130801021218Y000157 0000786495936 INDAH EKA PURYANTI P PBI (APBN) Abnormal findings on antenatal YA
2154 04/12/201 130801021218Y000165 0000786674935 IKE DWI LESTARI P PBI (APBN) Feeding problems of newborn TIDAK
2155 04/12/201 130801021218Y000266 0000786757645 NOVI INDRIA SARI P PBI (APBN) Necrosis of pulp TIDAK
2156 04/12/201 130801021218Y000255 0000786774868 SUMI NARLIN P PBI (APBN) Allergic contact dermatitis TIDAK
2157 04/12/201 130801021218Y000252 0000786775217 MUHAMMAD RAYHAN L PBI (APBN) Influenza with other manifestations, TIDAK
2158 04/12/201 130801021218Y000221 0000786777445 AMILIYA AYU IRNAWATI P PBI (APBN) Influenza with other manifestations, TIDAK
2159 04/12/201 130801021218Y000170 0000786777445 AMILIYA AYU IRNAWATI P PBI (APBN) Exanthematic febrile disease (MEXICO) TIDAK
2160 04/12/201 130801021218Y000177 0000786785815 SUDARMONO L PBI (APBN) Cough TIDAK
2161 04/12/201 130801021218Y000151 0000786840873 WINIH MURDJONO L PBI (APBN) Heart failure, unspecified YA
2162 04/12/201 130801021218Y001531 0000786860447 RIANI SEPTIANA P PBI (APBN) Antenatal screening TIDAK

09/01/2019 16.06.19
DAFTAR KUNJUNGAN PESERTA SAKIT

Kantor Cabang : MADIUN (1303)


FKTP : DEMANGAN (13080102)

NO TANGGAL NO KUNJUNGAN NO KARTU NAMA PESERTA SEX JENIS PESERTA DIAGNOSA DIRUJUK
2163 04/12/201 130801021218Y000155 0000786877593 SLAMET L PBI (APBN) Other and unspecified hydronephrosis YA
2164 04/12/201 130801021218Y000205 0000787114269 KATMANTO L PBI (APBN) Gastritis and duodenitis TIDAK
2165 04/12/201 130801021218Y000196 0000787227041 NUROCHMIATI PUSPITA P PBI (APBN) Essential (primary) hypertension TIDAK
2166 04/12/201 130801021218Y000262 0000787241935 BIBIT SRI LESTARI P PBI (APBN) Essential (primary) hypertension TIDAK
2167 04/12/201 130801021218Y000198 0000787280231 DARWATI P PBI (APBN) Diarrhoea and gastroenteritis of TIDAK
2168 04/12/201 130801021218Y000147 0001049783073 PINUS ATIBI L PBI (APBN) Glaucoma, unspecified YA
2169 04/12/201 130801021218Y000267 0001049783725 AGAM SURYA ANANTA L PBI (APBN) Dental caries TIDAK
2170 04/12/201 130801021218Y000195 0001049788462 MESIRAH P PBI (APBN) Allergic contact dermatitis TIDAK
2171 04/12/201 130801021218Y000164 0001049788798 SURYA HIKARU PRAKOSO L PBI (APBN) Striae atrophicae YA
2172 04/12/201 130801021218Y002226 0001049789215 PUKARYATI P PBI (APBN) Contraceptive management TIDAK
2173 04/12/201 130801021218Y000212 0001083321562 SUTRISNA L PBI (APBN) Systemic disorders of connective tissue TIDAK
2174 04/12/201 130801021218Y000219 0001083429112 APRIANI P PBI (APBN) Systemic disorders of connective tissue TIDAK
2175 04/12/201 130801021218Y000264 0001098500837 MUHAMMAD SYAFI L KEPOLISIAN RI Disturbances in tooth eruption TIDAK
2176 04/12/201 130801021218Y000180 0001192965063 KAYRIFNA MUHAJIZA P PEGAWAI SWASTA Influenza, virus not identified TIDAK
2177 04/12/201 130801021218Y000145 0001429806194 DWI ASTUTIK P PEKERJA MANDIRI Mild hyperemesis gravidarum YA
2178 04/12/201 130801021218Y000260 0001541881438 CLEAREST A MARVA L PEGAWAI SWASTA Influenza with other manifestations, TIDAK
2179 04/12/201 130801021218Y000272 0001544316052 KHENZU JUWETA KUSUMA P PEKERJA MANDIRI Dental caries TIDAK
2180 04/12/201 130801021218Y000254 0001704704523 CHAYAT PUDJI R L PBI (APBD) Non-insulin-dependent diabetes TIDAK
2181 04/12/201 130801021218Y000149 0001704713084 SUPENI P PBI (APBD) Non-insulin-dependent diabetes YA
2182 04/12/201 130801021218Y000194 0001704719564 SUDARWATI P PBI (APBD) Non-insulin-dependent diabetes TIDAK
2183 04/12/201 130801021218Y000166 0001704723557 ENDANG PURWANTI P PBI (APBD) Overfeeding of newborn TIDAK

09/01/2019 16.06.19
DAFTAR KUNJUNGAN PESERTA SAKIT

Kantor Cabang : MADIUN (1303)


FKTP : DEMANGAN (13080102)

NO TANGGAL NO KUNJUNGAN NO KARTU NAMA PESERTA SEX JENIS PESERTA DIAGNOSA DIRUJUK
2184 04/12/201 130801021218Y000220 0001704723579 DIDIK SUHARWANTO L PBI (APBD) Disorder of facial nerve, unspecified YA
2185 04/12/201 130801021218Y000214 0001704723581 KARNI P PBI (APBD) Other dermatitis YA
2186 04/12/201 130801021218Y000216 0001704724424 KASNO L PBI (APBD) Systemic disorders of connective tissue TIDAK
2187 04/12/201 130801021218Y000142 0001704724672 TRI WISNU HAPSARI P PBI (APBD) Tuboplasty or vasoplasty after previous YA
2188 04/12/201 130801021218Y000202 0001704725526 HADI SUPRIYONO L PBI (APBD) Systemic disorders of connective tissue TIDAK
2189 04/12/201 130801021218Y000201 0001704725537 SUWARNI P PBI (APBD) Systemic disorders of connective tissue TIDAK
2190 04/12/201 130801021218Y000270 0001704725561 NOVA DWI MEKAWATI P PEGAWAI SWASTA Necrosis of pulp TIDAK
2191 04/12/201 130801021218Y000268 0001704725763 NANIK KRISTIANI P PBI (APBD) Necrosis of pulp TIDAK
2192 04/12/201 130801021218Y000217 0001704725774 MAYANG PANTAI A. P PBI (APBD) Gastritis, unspecified TIDAK
2193 04/12/201 130801021218Y000186 0001704726156 MUHHADI KABUL L PBI (APBD) Haemorrhoids TIDAK
2194 04/12/201 130801021218Y000187 0001704726167 SUPARIYEM P PBI (APBD) Other specified headache syndromes TIDAK
2195 04/12/201 130801021218Y000210 0001704726731 FARIDAH AFIFAH P PBI (APBD) Gastritis, unspecified TIDAK
2196 04/12/201 130801021218Y000215 0001704727113 NURUL CHOMARIAH P PBI (APBD) Other specified headache syndromes TIDAK
2197 04/12/201 130801021218Y000273 0001704728529 SUSATYO HADI PURNOMO L PBI (APBD) Necrosis of pulp TIDAK
2198 04/12/201 130801021218Y000511 0001704728529 SUSATYO HADI PURNOMO L PBI (APBD) Necrosis of pulp TIDAK
2199 04/12/201 130801021218Y000158 0001704728564 SUMARYANI P PBI (APBD) Nontoxic goitre, unspecified YA
2200 04/12/201 130801021218Y000148 0001704732478 MISIRAH P PBI (APBD) Senile cataract, unspecified YA
2201 04/12/201 130801021218Y000181 0001704848758 IKA MELIANITA KRISWANTI P PBI (APBD) Influenza, virus not identified TIDAK
2202 04/12/201 130801021218Y000249 0001704857512 AINI FINNA HAMIZAH P PBI (APBD) Influenza with other manifestations, TIDAK
2203 04/12/201 130801021218Y000152 0001828215189 GAVIN NIKO MAHARDIKA L PEGAWAI SWASTA Fracture of upper end of radius, closed YA
2204 04/12/201 130801021218Y000213 0001903562278 SRI LESTARI P PEKERJA MANDIRI Non-insulin-dependent diabetes YA

09/01/2019 16.06.19
DAFTAR KUNJUNGAN PESERTA SAKIT

Kantor Cabang : MADIUN (1303)


FKTP : DEMANGAN (13080102)

NO TANGGAL NO KUNJUNGAN NO KARTU NAMA PESERTA SEX JENIS PESERTA DIAGNOSA DIRUJUK
2205 04/12/201 130801021218Y000207 0002054120578 NUNUL DIAH KRISNAWATI P PEGAWAI SWASTA Hypotension TIDAK
2206 04/12/201 130801021218Y000143 0002158648468 R.A.SUSANTI P PBI (APBD) Leiomyoma of uterus, unspecified YA
2207 04/12/201 130801021218Y000256 0002163554561 ASSYIFA SABYANKA P PBI (APBD) Influenza with other manifestations, TIDAK
2208 04/12/201 130801021218Y000171 0002163554561 ASSYIFA SABYANKA P PBI (APBD) Pneumonic plague TIDAK
2209 04/12/201 130801021218Y000265 0002163559329 NUNUK NOPITASARI P PBI (APBD) Necrosis of pulp TIDAK
2210 04/12/201 130801021218Y000191 0002163689447 MEI WORO DIYAH P PBI (APBD) Non-insulin-dependent diabetes TIDAK
2211 04/12/201 130801021218Y000203 0002163691901 JUMIRAH P PBI (APBD) Essential (primary) hypertension TIDAK
2212 04/12/201 130801021218Y000204 0002163693385 SUDARSIH P PBI (APBD) Systemic disorders of connective tissue TIDAK
2213 04/12/201 130801021218Y000258 0002163693396 ADZAR ZAIDAN AR ROFIF L PBI (APBD) Influenza with other manifestations, TIDAK
2214 04/12/201 130801021218Y000199 0002163695679 RIBUT MARIYANA P PBI (APBD) Influenza due to other identified TIDAK
2215 04/12/201 130801021218Y000156 0002163697828 JONI HASTANANTO H W M L PBI (APBD) Burn of unspecified body region, YA
2216 04/12/201 130801021218Y000173 0002163704049 SRI KUNDARI P PBI (APBD) Systemic disorders of connective tissue TIDAK
2217 04/12/201 130801021218Y000182 0002163706547 PUTRI ERNITA DEWI P PBI (APBD) Other specified headache syndromes TIDAK
2218 04/12/201 130801021218Y000257 0002163708009 FIO ANANTA PUTRI P PBI (APBD) Influenza with other manifestations, TIDAK
2219 04/12/201 130801021218Y000188 0002163710248 SUWARSI P PBI (APBD) Gastritis, unspecified TIDAK
2220 04/12/201 130801021218Y000172 0002163715424 EMI YULI ASTUTIK P PBI (APBD) Necrosis of pulp TIDAK
2221 04/12/201 130801021218Y000263 0002163720374 ZHAFRAN DANISH L PBI (APBD) Influenza with other manifestations, TIDAK
2222 04/12/201 130801021218Y000169 0002163720374 ZHAFRAN DANISH L PBI (APBD) Influenza with pneumonia, influenza TIDAK
2223 04/12/201 130801021218Y000192 0002163723399 SITI MARIYAM P PBI (APBD) Essential (primary) hypertension TIDAK
2224 04/12/201 130801021218Y000159 0002222847077 SITI DARMINI P PEKERJA MANDIRI Schizophrenia, unspecified YA
2225 04/12/201 130801021218Y000150 0002285353203 HARJUNO HERI WIBOWO L PEGAWAI SWASTA Primary arthrosis of other joints, ankle YA

09/01/2019 16.06.19
DAFTAR KUNJUNGAN PESERTA SAKIT

Kantor Cabang : MADIUN (1303)


FKTP : DEMANGAN (13080102)

NO TANGGAL NO KUNJUNGAN NO KARTU NAMA PESERTA SEX JENIS PESERTA DIAGNOSA DIRUJUK
2226 04/12/201 130801021218Y000178 0002319118119 FARA RUMAISYA P PNS PUSAT Dental caries TIDAK
2227 04/12/201 130801021218Y000160 0002320311431 TRI BUDI PEMILU L PEGAWAI SWASTA Other benign neoplasm of connective YA
2228 04/12/201 130801021218Y000197 0002354079025 GENDUT WALUYO L PBI (APBN) Influenza, virus not identified TIDAK
2229 04/12/201 130801021218Y000176 0002413029813 SUGENG RIYADI L PBI (APBD) Mixed asthma TIDAK
2230 04/12/201 130801021218Y000168 0002413030173 FARHAN NUR RAMADHANI L PBI (APBD) Relapsing fever, unspecified TIDAK
2231 04/12/201 130801021218Y000261 0002413030173 FARHAN NUR RAMADHANI L PBI (APBD) Influenza with other manifestations, TIDAK
2232 04/12/201 130801021218Y000209 0002413108304 HERNA P PBI (APBD) Allergic contact dermatitis, unspecified TIDAK
2233 04/12/201 130801021218Y000183 0002413109283 ABIDZAR RAJENDRA L PBI (APBD) Influenza with pneumonia, virus not TIDAK
2234 04/12/201 130801021218Y000184 0002413111083 HERDHIKA DWIKI L PBI (APBD) General examination and investigation TIDAK
2235 04/12/201 130801021218Y000163 0002413115414 DIYAH SRI KUSUMA DEWI P PBI (APBD) Contraceptive management TIDAK
2236 04/12/201 130801021218Y000208 0002413116437 TRI WIDYANINGRUM P PBI (APBD) Tinnitus YA
2237 04/12/201 130801021218Y000161 0002413117102 ONE AZIZAH MARATUS P PBI (APBD) Optic neuritis YA
2238 04/12/201 130801021218Y000185 0002413118867 WARAS P PBI (APBD) Systemic disorders of connective tissue TIDAK
2239 04/12/201 130801021218Y000146 0002413144596 MARSUDI L PBI (APBD) Non-insulin-dependent diabetes YA
2240 04/12/201 130801021218Y000144 0002413144811 MISIRAH P PBI (APBD) Senile cataract, unspecified YA
2241 04/12/201 130801021218Y000162 0002413152617 MOELJANTO L PBI (APBD) Insulin-dependent diabetes mellitus YA
2242 04/12/201 130801021218Y000211 0002413152628 SUKAENI P PBI (APBD) Essential (primary) hypertension TIDAK
2243 04/12/201 130801021218Y000174 0002413152955 WAGIYEM P PBI (APBD) Systemic disorders of connective tissue TIDAK
2244 04/12/201 130801021218Y000248 0002413895387 SUNARTI P PBI (APBD) Gastritis, unspecified TIDAK
2245 04/12/201 130801021218Y000251 0002413914985 IQBAL ARI DWI BAIHAKI L PBI (APBD) Influenza with other manifestations, TIDAK
2246 04/12/201 130801021218Y000250 0002413917685 HARUN SUBANDI L PBI (APBD) Essential (primary) hypertension TIDAK

09/01/2019 16.06.19
DAFTAR KUNJUNGAN PESERTA SAKIT

Kantor Cabang : MADIUN (1303)


FKTP : DEMANGAN (13080102)

NO TANGGAL NO KUNJUNGAN NO KARTU NAMA PESERTA SEX JENIS PESERTA DIAGNOSA DIRUJUK
2247 04/12/201 130801021218Y000218 0002413963901 HENNY MUDJIATMIKO P PBI (APBD) Influenza with other manifestations, TIDAK
2248 04/12/201 130801021218Y000167 0002452236276 SITI CHOMSIYAH P PEKERJA MANDIRI Contraceptive management TIDAK
2249 04/12/201 130801021218Y000189 0002466223468 IDA HERNAWATI P PEKERJA MANDIRI Caries of dentine TIDAK
2250 04/12/201 130801021218Y000253 0002613305057 CHALISTA ELSA P PEKERJA MANDIRI Influenza with other manifestations, TIDAK
2251 03/12/201 130801021218Y000228 0000078551785 SITI ROMLAH P PENERIMA PENSIUN TNI Essential (primary) hypertension TIDAK
2252 03/12/201 130801021218Y000131 0000078721198 DRS. GIJANTO L PENERIMA PENSIUN Allergic contact dermatitis TIDAK
2253 03/12/201 130801021218Y000086 0000078770575 SUKADI L PENERIMA PENSIUN Essential (primary) hypertension TIDAK
2254 03/12/201 130801021218Y000237 0000106305761 AGUNG SANTOSO L PNS DAERAH Non-insulin-dependent diabetes TIDAK
2255 03/12/201 130801021218Y000123 0000106340095 SUDARTO L PENERIMA PENSIUN Other cholelithiasis YA
2256 03/12/201 130801021218Y000231 0000106369929 ASTIE LATIFAH P PNS DAERAH Gastritis, unspecified TIDAK
2257 03/12/201 130801021218Y000098 0000106435271 ROSYID L PNS DAERAH Influenza with other manifestations, TIDAK
2258 03/12/201 130801021218Y000056 0000106435282 MURTININGSIH P PNS DAERAH Systemic disorders of connective tissue TIDAK
2259 03/12/201 130801021218Y000118 0000106460728 ADITYA OKVIAR SANATA L PEGAWAI SWASTA Influenza, virus not identified TIDAK
2260 03/12/201 130801021218Y000100 0000208966241 YULITA NURVIYANTI P PNS DAERAH Systemic disorders of connective tissue TIDAK
2261 03/12/201 130801021218Y000011 0000660200062 NOVITA YULIANTI P PBI (APBN) Contraceptive management TIDAK
2262 03/12/201 130801021218Y000062 0000785128792 NINIK TRESNAWATI P PBI (APBN) Systemic disorders of connective tissue TIDAK
2263 03/12/201 130801021218Y000246 0000785835448 SAMIRAH P PBI (APBN) Gastritis, unspecified TIDAK
2264 03/12/201 130801021218Y000094 0000785835448 SAMIRAH P PBI (APBN) Necrosis of pulp TIDAK
2265 03/12/201 130801021218Y000085 0000786105077 MARNU L PBI (APBN) Influenza with other manifestations, TIDAK
2266 03/12/201 130801021218Y000051 0000786169179 YULIATI P PBI (APBN) Other specified headache syndromes TIDAK
2267 03/12/201 130801021218Y000113 0000786229334 ELY ERNAWATI P PBI (APBN) Allergic contact dermatitis, unspecified TIDAK

09/01/2019 16.06.19
DAFTAR KUNJUNGAN PESERTA SAKIT

Kantor Cabang : MADIUN (1303)


FKTP : DEMANGAN (13080102)

NO TANGGAL NO KUNJUNGAN NO KARTU NAMA PESERTA SEX JENIS PESERTA DIAGNOSA DIRUJUK
2268 03/12/201 130801021218Y000128 0000786267257 BIRANTO L PBI (APBN) Cough TIDAK
2269 03/12/201 130801021218Y000044 0000786267303 SUYATMI P PBI (APBN) Systemic disorders of connective tissue TIDAK
2270 03/12/201 130801021218Y000004 0000786268923 SUSI IRAWATI P PBI (APBN) Antenatal screening TIDAK
2271 03/12/201 130801021218Y000024 0000786406713 NANIK SUPRIHATIN P PBI (APBN) Abnormal finding on antenatal YA
2272 03/12/201 130801021218Y000058 0000786438437 MARTUTI P PBI (APBN) Systemic disorders of connective tissue TIDAK
2273 03/12/201 130801021218Y000031 0000786441295 RISKI SANDI ARNITA L PBI (APBN) Contraceptive management TIDAK
2274 03/12/201 130801021218Y000036 0000786501538 PURNAMI P PBI (APBN) Dyspepsia YA
2275 03/12/201 130801021218Y000061 0000786512406 MOCHAMMAD RIFAI L PBI (APBN) Influenza with other manifestations, TIDAK
2276 03/12/201 130801021218Y000127 0000786553637 SETO PURNOMO L PBI (APBN) Foreign body in ear TIDAK
2277 03/12/201 130801021218Y000053 0000786557349 SUJIATMI P PBI (APBN) Essential (primary) hypertension TIDAK
2278 03/12/201 130801021218Y000104 0000786754034 SINEM P PBI (APBN) Congestive heart failure YA
2279 03/12/201 130801021218Y000140 0000786765284 ANTON CAHYONO L PEGAWAI SWASTA Other and unspecified infectious TIDAK
2280 03/12/201 130801021218Y000077 0000786808271 KAMUDJI L PBI (APBN) Systemic disorders of connective tissue TIDAK
2281 03/12/201 130801021218Y000070 0000786822377 SUYITNO L PBI (APBN) Non-insulin-dependent diabetes TIDAK
2282 03/12/201 130801021218Y000102 0000786858208 NERA DWI RIZKI CAHYA P PBI (APBN) Contraceptive management TIDAK
2283 03/12/201 130801021218Y000041 0000786881867 SUYANTO L PBI (APBN) Gastritis and duodenitis TIDAK
2284 03/12/201 130801021218Y000063 0000786900688 SULIKAH P PBI (APBN) Non-insulin-dependent diabetes TIDAK
2285 03/12/201 130801021218Y000071 0000786925394 EGA FAJAR FEBRIANDI L PBI (APBN) Other and unspecified infectious TIDAK
2286 03/12/201 130801021218Y000066 0000786929984 SOEMARDIONO L PBI (APBN) Other and unspecified infectious TIDAK
2287 03/12/201 130801021218Y000097 0000786984254 AGUS WAHYUDI L PBI (APBN) Necrosis of pulp TIDAK
2288 03/12/201 130801021218Y000229 0000787077235 HARJO UNTUNG L PBI (APBN) Essential (primary) hypertension TIDAK

09/01/2019 16.06.19
DAFTAR KUNJUNGAN PESERTA SAKIT

Kantor Cabang : MADIUN (1303)


FKTP : DEMANGAN (13080102)

NO TANGGAL NO KUNJUNGAN NO KARTU NAMA PESERTA SEX JENIS PESERTA DIAGNOSA DIRUJUK
2289 03/12/201 130801021218Y000230 0000787077369 KATIMAH P PBI (APBN) Essential (primary) hypertension TIDAK
2290 03/12/201 130801021218Y000079 0000787233486 CHOIRUL MISNUN L PBI (APBN) Non-insulin-dependent diabetes TIDAK
2291 03/12/201 130801021218Y000064 0000787714389 PARINUK P PBI (APBN) Gastritis, unspecified TIDAK
2292 03/12/201 130801021218Y000065 0000787714852 YESINIA PUSPITA SARI P PBI (APBN) Periapical abscess without sinus TIDAK
2293 03/12/201 130801021218Y000040 0001049782252 MARIYATUN P PBI (APBN) Non-insulin-dependent diabetes YA
2294 03/12/201 130801021218Y000247 0001049785121 YUS FITRIA P PBI (APBN) Other headache syndromes TIDAK
2295 03/12/201 130801021218Y000105 0001049785121 YUS FITRIA P PBI (APBN) Necrosis of pulp TIDAK
2296 03/12/201 130801021218Y000126 0001049785143 MUHAMMAD FAREL ARYA L PBI (APBN) Influenza with other manifestations, TIDAK
2297 03/12/201 130801021218Y000236 0001083359597 SUMINEM P PBI (APBN) Non-insulin-dependent diabetes TIDAK
2298 03/12/201 130801021218Y000125 0001083603903 BAHTIAR YUSUF HELMI L PBI (APBN) Sequelae of other and unspecified YA
2299 03/12/201 130801021218Y000003 0001083835552 BERNADITTA TIARA PUTRI P PBI (APBN) Antenatal screening TIDAK
2300 03/12/201 130801021218Y000002 0001183419066 SULISTYAWATI P PEKERJA MANDIRI Heart failure YA
2301 03/12/201 130801021218Y000121 0001185588731 HASANUDIN L PBI (APBD) Haemorrhoids TIDAK
2302 03/12/201 130801021218Y000129 0001191418367 RIFKY YANUAR PRATAMA L PEGAWAI SWASTA Influenza with other manifestations, TIDAK
2303 03/12/201 130801021218Y000069 0001261208676 AGUS SUGENG L PEKERJA MANDIRI Influenza, virus not identified TIDAK
2304 03/12/201 130801021218Y000103 0001298844213 SITI JUARIYANI P PEGAWAI SWASTA Antenatal screening TIDAK
2305 03/12/201 130801021218Y000019 0001328118568 LILIK WINARTI P PBI (APBD) Antenatal screening TIDAK
2306 03/12/201 130801021218Y000057 0001540089123 NARIS MALINDA P PEGAWAI SWASTA Hypotension, unspecified TIDAK
2307 03/12/201 130801021218Y000018 0001625700971 DAMAYANTI P PEGAWAI SWASTA Contraceptive management TIDAK
2308 03/12/201 130801021218Y000046 0001701725319 DELA PUTRI HERMAWATI P PEGAWAI SWASTA Other disorders of external ear TIDAK
2309 03/12/201 130801021218Y000111 0001704708281 MARIATUN P PBI (APBD) Non-insulin-dependent diabetes TIDAK

09/01/2019 16.06.19
DAFTAR KUNJUNGAN PESERTA SAKIT

Kantor Cabang : MADIUN (1303)


FKTP : DEMANGAN (13080102)

NO TANGGAL NO KUNJUNGAN NO KARTU NAMA PESERTA SEX JENIS PESERTA DIAGNOSA DIRUJUK
2310 03/12/201 130801021218Y000108 0001704710957 SHINTA YULIARTA PUTRI P PBI (APBD) Pulpitis TIDAK
2311 03/12/201 130801021218Y000099 0001704713376 AGUS PRASTOMO L PEKERJA MANDIRI Chronic periodontitis TIDAK
2312 03/12/201 130801021218Y000033 0001704715918 ELA WAHYUNINGSIH P PBI (APBD) Antenatal screening TIDAK
2313 03/12/201 130801021218Y000081 0001704719981 ANI HARIANI P PBI (APBD) Myalgia TIDAK
2314 03/12/201 130801021218Y000090 0001704722499 YOSEP BAYUNINGTYAS L PBI (APBD) Influenza with other manifestations, TIDAK
2315 03/12/201 130801021218Y000015 0001704722681 DEWI MULYANI P PBI (APBD) Acute lymphadenitis of upper limb YA
2316 03/12/201 130801021218Y000116 0001704726448 PURWANI SETYANINGSIH P PBI (APBD) Contraceptive management TIDAK
2317 03/12/201 130801021218Y000101 0001704729576 SRI HARTAWATI P PBI (APBD) Non-insulin-dependent diabetes TIDAK
2318 03/12/201 130801021218Y000124 0001704730533 SRI MURTINI P PBI (APBD) Cataract, unspecified YA
2319 03/12/201 130801021218Y000072 0001704731589 ERNIK PURWANINGSIH P PBI (APBD) Other and unspecified infectious TIDAK
2320 03/12/201 130801021218Y000009 0001704731837 SRIANA P PBI (APBD) Non-insulin-dependent diabetes YA
2321 03/12/201 130801021218Y000001 0001704732862 UDCHULUL JANNAH P PBI (APBD) Contraceptive management TIDAK
2322 03/12/201 130801021218Y000132 0001704842458 RATNAWATI P PBI (APBD) Gastritis, unspecified TIDAK
2323 03/12/201 130801021218Y002228 0001704842706 AGUSTINA SETIARINI P PBI (APBD) Contraceptive management TIDAK
2324 03/12/201 130801021218Y000092 0001704844552 TRI ARIYA AGUSTONO L PBI (APBD) Influenza with other manifestations, TIDAK
2325 03/12/201 130801021218Y000032 0001704845439 ASTIAR DWI LISTYANTI P PBI (APBD) Contraceptive management TIDAK
2326 03/12/201 130801021218Y000244 0001704845439 ASTIAR DWI LISTYANTI P PBI (APBD) Allergic contact dermatitis TIDAK
2327 03/12/201 130801021218Y000048 0001704847667 SUGENG PRIYANTO L PBI (APBD) Systemic disorders of connective tissue TIDAK
2328 03/12/201 130801021218Y000110 0001704848297 RESTU ARDI SETIAWAN L PBI (APBD) Streptococcal pharyngitis TIDAK
2329 03/12/201 130801021218Y000242 0001774625444 ARTIK SINTYA RAHAYU P PEGAWAI SWASTA Allergic contact dermatitis TIDAK
2330 03/12/201 130801021218Y000008 0001774625444 ARTIK SINTYA RAHAYU P PEGAWAI SWASTA Antenatal screening TIDAK

09/01/2019 16.06.19
DAFTAR KUNJUNGAN PESERTA SAKIT

Kantor Cabang : MADIUN (1303)


FKTP : DEMANGAN (13080102)

NO TANGGAL NO KUNJUNGAN NO KARTU NAMA PESERTA SEX JENIS PESERTA DIAGNOSA DIRUJUK
2331 03/12/201 130801021218Y000045 0001846746235 EKA YUNITA SARA P PEGAWAI SWASTA Antenatal screening TIDAK
2332 03/12/201 130801021218Y000030 0001887995788 WAHYUNINGRUM P PEKERJA MANDIRI Contraceptive management TIDAK
2333 03/12/201 130801021218Y000074 0001992798922 UH ALMEYDA FAUZAN P PBI (APBN) Allergic contact dermatitis TIDAK
2334 03/12/201 130801021218Y000020 0002037067378 DEVITRI SETYO P PEGAWAI SWASTA Allergic contact dermatitis, unspecified YA
2335 03/12/201 130801021218Y000241 0002058204036 DEANDRA NASYA ESTIYANI L PEGAWAI SWASTA Influenza with other manifestations, TIDAK
2336 03/12/201 130801021218Y000073 0002066112279 MARIA GORETTI SRI P PEKERJA MANDIRI Systemic disorders of connective tissue TIDAK
2337 03/12/201 130801021218Y000226 0002070849486 RIDHO L PBI (APBN) Influenza with other manifestations, TIDAK
2338 03/12/201 130801021218Y000095 0002163550072 RACQUEL BUNGA AGNI P PBI (APBD) Supernumerary teeth TIDAK
2339 03/12/201 130801021218Y000239 0002163555393 MURSINI P PBI (APBD) Gastritis, unspecified TIDAK
2340 03/12/201 130801021218Y000017 0002163555393 MURSINI P PBI (APBD) Antenatal screening TIDAK
2341 03/12/201 130801021218Y000059 0002163561322 YAYUK P PBI (APBD) Other headache syndromes TIDAK
2342 03/12/201 130801021218Y000054 0002163564009 NUR SITI AMINAH P PBI (APBD) Cough TIDAK
2343 03/12/201 130801021218Y000107 0002163572291 MOHAMAD RIFAI ADI L PBI (APBD) Disturbances in tooth eruption TIDAK
2344 03/12/201 130801021218Y000135 0002163583866 MAMIK MARMIYANI P PBI (APBD) Gastritis, unspecified TIDAK
2345 03/12/201 130801021218Y000052 0002163687636 ALDIORIVA AZZAHRA GUSTI P PBI (APBD) Influenza with other manifestations, TIDAK
2346 03/12/201 130801021218Y000234 0002163690009 KAYLA FEBRIANA P PBI (APBD) Influenza with other manifestations, TIDAK
2347 03/12/201 130801021218Y000141 0002163690011 AIMA MAR'ATUS SHOLEHAH P PBI (APBD) Influenza with other manifestations, TIDAK
2348 03/12/201 130801021218Y000088 0002163690696 IMAM WALOEYO L PBI (APBD) Essential (primary) hypertension TIDAK
2349 03/12/201 130801021218Y000120 0002163691631 LESTARI P PBI (APBD) Allergic contact dermatitis, unspecified TIDAK
2350 03/12/201 130801021218Y000109 0002163692867 NAJWA KHOIRUNNISA P PBI (APBD) Diarrhoea and gastroenteritis of TIDAK
2351 03/12/201 130801021218Y000238 0002163694599 SUDARTO L PBI (APBD) Non-insulin-dependent diabetes TIDAK

09/01/2019 16.06.20
DAFTAR KUNJUNGAN PESERTA SAKIT

Kantor Cabang : MADIUN (1303)


FKTP : DEMANGAN (13080102)

NO TANGGAL NO KUNJUNGAN NO KARTU NAMA PESERTA SEX JENIS PESERTA DIAGNOSA DIRUJUK
2352 03/12/201 130801021218Y000096 0002163694601 SUKESI P PBI (APBD) Essential (primary) hypertension TIDAK
2353 03/12/201 130801021218Y000084 0002163695062 SUYATI P PBI (APBD) Acute nasopharyngitis [common cold] TIDAK
2354 03/12/201 130801021218Y000222 0002163695343 MURTIRAHAYU P PBI (APBD) Gastritis, unspecified TIDAK
2355 03/12/201 130801021218Y000080 0002163696772 MARPUNGAH P PBI (APBD) Necrosis of pulp TIDAK
2356 03/12/201 130801021218Y000039 0002163697233 KOKOM KUMAIROH P PBI (APBD) Sequelae of other and unspecified YA
2357 03/12/201 130801021218Y000227 0002163699764 LILIK WAHYUNING ASTUTI P PBI (APBD) Gastritis, unspecified TIDAK
2358 03/12/201 130801021218Y000089 0002163701068 SITI MUDAWAMATUL P PBI (APBD) Necrosis of pulp TIDAK
2359 03/12/201 130801021218Y000012 0002163702971 NORA INDAH WINDRAYANTI P PBI (APBD) Antenatal screening TIDAK
2360 03/12/201 130801021218Y000243 0002163702971 NORA INDAH WINDRAYANTI P PBI (APBD) Allergic contact dermatitis TIDAK
2361 03/12/201 130801021218Y000068 0002163704591 SUWITO L PBI (APBD) Other chronic obstructive pulmonary TIDAK
2362 03/12/201 130801021218Y000021 0002163706143 PAINAH P PBI (APBD) Non-insulin-dependent diabetes YA
2363 03/12/201 130801021218Y000115 0002163708281 DEWI ANDAR KASIH P PBI (APBD) Systemic disorders of connective tissue TIDAK
2364 03/12/201 130801021218Y000067 0002163708865 KATEMI P PBI (APBD) Systemic disorders of connective tissue TIDAK
2365 03/12/201 130801021218Y000050 0002163710542 JALU WINANGPARO L PBI (APBD) Acute tonsillitis, unspecified TIDAK
2366 03/12/201 130801021218Y000037 0002163715356 ANDIKA DARMAYANTI P PBI (APBD) Contraceptive management TIDAK
2367 03/12/201 130801021218Y000130 0002163715367 FACHRI EKA DARMARAYA L PBI (APBD) Other and unspecified infectious TIDAK
2368 03/12/201 130801021218Y000013 0002163716831 WULANSARI P PBI (APBD) Follow-up examination after surgery YA
2369 03/12/201 130801021218Y000114 0002163717819 DIDIK KURNIA SUDRAJAT L PBI (APBD) Gingivitis and periodontal diseases TIDAK
2370 03/12/201 130801021218Y000060 0002163720519 AZZAHRA OCTAVYANA P PBI (APBD) Pulpitis TIDAK
2371 03/12/201 130801021218Y000233 0002163721263 ALWANI DYAH ENGGAR P PBI (APBD) Influenza with other manifestations, TIDAK
2372 03/12/201 130801021218Y000082 0002301205555 AMORA CENDIKIAWAN P PEKERJA MANDIRI Influenza with other manifestations, TIDAK

09/01/2019 16.06.20
DAFTAR KUNJUNGAN PESERTA SAKIT

Kantor Cabang : MADIUN (1303)


FKTP : DEMANGAN (13080102)

NO TANGGAL NO KUNJUNGAN NO KARTU NAMA PESERTA SEX JENIS PESERTA DIAGNOSA DIRUJUK
2373 03/12/201 130801021218Y000005 0002301205555 AMORA CENDIKIAWAN P PEKERJA MANDIRI Other inflammation of eyelid TIDAK
2374 03/12/201 130801021218Y000022 0002413023557 NOR HASANAH P PBI (APBD) General counselling and advice on TIDAK
2375 03/12/201 130801021218Y000137 0002413023557 NOR HASANAH P PBI (APBD) Gastritis, unspecified TIDAK
2376 03/12/201 130801021218Y000136 0002413023579 WIDATUL ISNAINI P PBI (APBD) Influenza with other manifestations, TIDAK
2377 03/12/201 130801021218Y000112 0002413052954 TITIK SUBANDIJAH HAJATI P PBI (APBD) Non-insulin-dependent diabetes TIDAK
2378 03/12/201 130801021218Y000093 0002413060018 BAMBANG SUWARNO L PBI (APBD) Non-insulin-dependent diabetes TIDAK
2379 03/12/201 130801021218Y000075 0002413107685 REVALINA YUSTINAWATI P PBI (APBD) Influenza due to other identified TIDAK
2380 03/12/201 130801021218Y000055 0002413113052 KASMINI P PBI (APBD) Systemic disorders of connective tissue TIDAK
2381 03/12/201 130801021218Y002227 0002413115324 FIFIN LISALASARI P PBI (APBD) Maternal care for other specified fetal TIDAK
2382 03/12/201 130801021218Y000223 0002413115346 ZELLA AKIFA NAILA P PBI (APBD) Influenza with other manifestations, TIDAK
2383 03/12/201 130801021218Y000078 0002413117293 DAFFA MUHAMAD AZKA L PBI (APBD) Influenza with other manifestations, TIDAK
2384 03/12/201 130801021218Y000023 0002413117293 DAFFA MUHAMAD AZKA L PBI (APBD) Relapsing fever, unspecified TIDAK
2385 03/12/201 130801021218Y000122 0002413120869 DJUMIRAH P PBI (APBD) Systemic disorders of connective tissue TIDAK
2386 03/12/201 130801021218Y000007 0002413136171 HENDRI FITRIANA P PBI (APBD) Contraceptive management TIDAK
2387 03/12/201 130801021218Y000006 0002413136182 TARA RIZKIANA ARIANDRI P PBI (APBD) Allergic contact dermatitis TIDAK
2388 03/12/201 130801021218Y000083 0002413136182 TARA RIZKIANA ARIANDRI P PBI (APBD) Other and unspecified infectious TIDAK
2389 03/12/201 130801021218Y000025 0002413137071 RITA PURWANTI P PBI (APBD) Malignant neoplasm of breast YA
2390 03/12/201 130801021218Y000028 0002413137813 LIKSA IMAM SUBAGIO L PBI (APBD) Other nonorganic psychotic disorders YA
2391 03/12/201 130801021218Y000240 0002413138498 SRIYATUN P PBI (APBD) Allergic contact dermatitis TIDAK
2392 03/12/201 130801021218Y000049 0002413139365 MUHAMAD AL GIBRAN L PBI (APBD) Influenza with pneumonia, influenza TIDAK
2393 03/12/201 130801021218Y000091 0002413139365 MUHAMAD AL GIBRAN L PBI (APBD) Influenza with other manifestations, TIDAK

09/01/2019 16.06.20
DAFTAR KUNJUNGAN PESERTA SAKIT

Kantor Cabang : MADIUN (1303)


FKTP : DEMANGAN (13080102)

NO TANGGAL NO KUNJUNGAN NO KARTU NAMA PESERTA SEX JENIS PESERTA DIAGNOSA DIRUJUK
2394 03/12/201 130801021218Y000014 0002413140366 KHUSNUL KHOTIMAH P PBI (APBD) Abnormal finding on antenatal YA
2395 03/12/201 130801021218Y000106 0002413140581 SITI KOMARIAH P PBI (APBD) Necrosis of pulp TIDAK
2396 03/12/201 130801021218Y000043 0002413144192 SUDJINEM P PBI (APBD) Systemic disorders of connective tissue TIDAK
2397 03/12/201 130801021218Y000016 0002413145441 DWI MOERTI P PBI (APBD) Heart failure YA
2398 03/12/201 130801021218Y000117 0002413146047 KASIYATI P PBI (APBD) Other headache syndromes TIDAK
2399 03/12/201 130801021218Y000235 0002413149197 SIMOEN GUTOMO L PBI (APBD) Essential (primary) hypertension TIDAK
2400 03/12/201 130801021218Y000026 0002413151818 SUHARTI P PBI (APBD) Other cataract YA
2401 03/12/201 130801021218Y000119 0002413152189 GERARDUS FUJIANTO L PBI (APBD) Other headache syndromes TIDAK
2402 03/12/201 130801021218Y000224 0002413839497 ALVIONA ZATTAYU PUTRI P PBI (APBD) Influenza with other manifestations, TIDAK
2403 03/12/201 130801021218Y000232 0002413894746 SINTIYA BELA AYU P PBI (APBD) Influenza with other manifestations, TIDAK
2404 03/12/201 130801021218Y000035 0002413896039 NOVAN PRASTONO L PBI (APBD) Conjunctivitis, unspecified YA
2405 03/12/201 130801021218Y000042 0002413898662 DAVITA NATHANIA P PBI (APBD) Systemic disorders of connective tissue TIDAK
2406 03/12/201 130801021218Y000138 0002413899472 FARIDA ANGGRAINI P PBI (APBD) Essential (primary) hypertension TIDAK
2407 03/12/201 130801021218Y000133 0002413914276 M. AGUS BAMBANG L PBI (APBD) Gastritis, unspecified TIDAK
2408 03/12/201 130801021218Y000047 0002413921173 HARTINI P PBI (APBD) Systemic disorders of connective tissue TIDAK
2409 03/12/201 130801021218Y000076 0002413951986 JUAN ALIEF RISKY L PBI (APBD) Influenza, virus not identified TIDAK
2410 03/12/201 130801021218Y000134 0002413952662 YAKUP HARIYANTO L PBI (APBD) Gastritis, unspecified TIDAK
2411 03/12/201 130801021218Y000225 0002413963563 QQ PUTRI PRADANI P PBI (APBD) Influenza with other manifestations, TIDAK
2412 03/12/201 130801021218Y000139 0002413967354 ERMA KRISBYANTARI DEWI P PBI (APBD) Gastritis, unspecified TIDAK
2413 03/12/201 130801021218Y000029 0002436126647 RENI ENDARWATI P PEGAWAI SWASTA Contraceptive management TIDAK
2414 03/12/201 130801021218Y000027 0002473553709 RISKA YUNIAWATI P PEKERJA MANDIRI Antenatal screening TIDAK

09/01/2019 16.06.20
DAFTAR KUNJUNGAN PESERTA SAKIT

Kantor Cabang : MADIUN (1303)


FKTP : DEMANGAN (13080102)

NO TANGGAL NO KUNJUNGAN NO KARTU NAMA PESERTA SEX JENIS PESERTA DIAGNOSA DIRUJUK
2415 03/12/201 130801021218Y000010 0002481390551 FADIA THALITA FAYYOLA P PBI (APBN) Diarrhoea and gastroenteritis of TIDAK
2416 03/12/201 130801021218Y000087 0002481390551 FADIA THALITA FAYYOLA P PBI (APBN) Diarrhoea and gastroenteritis of TIDAK
2417 03/12/201 130801021218Y000034 0002481856198 RIA AGUSTIN P PEKERJA MANDIRI Antenatal screening TIDAK
2418 03/12/201 130801021218Y000245 0002481856198 RIA AGUSTIN P PEKERJA MANDIRI Allergic contact dermatitis TIDAK
2419 03/12/201 130801021218Y000038 0002611434115 AYU SRI ENDANG PERTIWI P PNS PUSAT Nephrotic syndrome, unspecified YA
2420 01/12/201 130801021218Y001380 0000076862902 LASMINI P PENERIMA PENSIUN Non-insulin-dependent diabetes TIDAK
2421 01/12/201 130801021218Y001368 0000078738153 MISTINGAH P PENERIMA PENSIUN Non-insulin-dependent diabetes TIDAK
2422 01/12/201 130801021218Y001389 0000090921407 RAMUDI, IR L PENERIMA PENSIUN Non-insulin-dependent diabetes TIDAK
2423 01/12/201 130801021218Y001385 0000106293486 MURJATI P PNS DAERAH Non-insulin-dependent diabetes TIDAK
2424 01/12/201 130801021218Y001364 0000106447228 INSIJAH P PENERIMA PENSIUN Non-insulin-dependent diabetes TIDAK
2425 01/12/201 130801021218Y001373 0000158401181 ISMIJATI P PENERIMA PENSIUN Non-insulin-dependent diabetes TIDAK
2426 01/12/201 130801021218Y001363 0000786326376 DJOEMINTEN P PBI (APBN) Non-insulin-dependent diabetes TIDAK
2427 01/12/201 130801021218Y001362 0000786405148 SRI WAHYUNI P PBI (APBN) Non-insulin-dependent diabetes TIDAK
2428 01/12/201 130801021218Y001375 0000786772056 ISWARI P PBI (APBN) Non-insulin-dependent diabetes TIDAK
2429 01/12/201 130801021218Y001370 0000786787918 SITIN P PBI (APBN) Non-insulin-dependent diabetes TIDAK
2430 01/12/201 130801021218Y001367 0000786841817 SAKINEM P PBI (APBN) Non-insulin-dependent diabetes TIDAK
2431 01/12/201 130801021218Y001381 0000786858568 MAIMUN L PBI (APBN) Non-insulin-dependent diabetes TIDAK
2432 01/12/201 130801021218Y001382 0000786858783 MISRIATUN P PBI (APBN) Non-insulin-dependent diabetes TIDAK
2433 01/12/201 130801021218Y001371 0000786916686 SUKILAH P PBI (APBN) Non-insulin-dependent diabetes TIDAK
2434 01/12/201 130801021218Y001366 0000786930399 KAMINEM P PBI (APBN) Non-insulin-dependent diabetes TIDAK
2435 01/12/201 130801021218Y001379 0000787039018 HARJO MISKUN L PBI (APBN) Non-insulin-dependent diabetes TIDAK

09/01/2019 16.06.20
DAFTAR KUNJUNGAN PESERTA SAKIT

Kantor Cabang : MADIUN (1303)


FKTP : DEMANGAN (13080102)

NO TANGGAL NO KUNJUNGAN NO KARTU NAMA PESERTA SEX JENIS PESERTA DIAGNOSA DIRUJUK
2436 01/12/201 130801021218Y001372 0000787198476 MUSINAH P PBI (APBN) Non-insulin-dependent diabetes TIDAK
2437 01/12/201 130801021218Y001386 0000787403801 WAGIYEM P PBI (APBN) Non-insulin-dependent diabetes TIDAK
2438 01/12/201 130801021218Y001384 0001083603903 BAHTIAR YUSUF HELMI L PBI (APBN) Non-insulin-dependent diabetes TIDAK
2439 01/12/201 130801021218Y001387 0001302639309 SADJIMIN L PENERIMA PENSIUN Non-insulin-dependent diabetes TIDAK
2440 01/12/201 130801021218Y001369 0001383940157 MINARSIH P PEKERJA MANDIRI Non-insulin-dependent diabetes TIDAK
2441 01/12/201 130801021218Y001374 0001704719362 SITI RAHAYU P PBI (APBD) Non-insulin-dependent diabetes TIDAK
2442 01/12/201 130801021218Y001377 0001704722376 SIPAN RIFIYANTO L PBI (APBD) Non-insulin-dependent diabetes TIDAK
2443 01/12/201 130801021218Y001376 0001704722387 LASINEM P PBI (APBD) Non-insulin-dependent diabetes TIDAK
2444 01/12/201 130801021218Y001378 0001704726167 SUPARIYEM P PBI (APBD) Non-insulin-dependent diabetes TIDAK
2445 01/12/201 130801021218Y001383 0001704845665 PAINI P PBI (APBD) Non-insulin-dependent diabetes TIDAK
2446 01/12/201 130801021218Y001390 0001825202711 SUDARSIH P PEKERJA MANDIRI Non-insulin-dependent diabetes TIDAK
2447 01/12/201 130801021218Y001388 0001898173326 YULIANI P PENERIMA PENSIUN Non-insulin-dependent diabetes TIDAK
2448 01/12/201 130801021218Y001365 0002163703612 MISINEM P PBI (APBD) Non-insulin-dependent diabetes TIDAK

09/01/2019 16.06.20

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