AAAAAAAAA

<table class='tabel' width='90%'>
<tr class="form">
<td align="center" colspan="9">
<big><big><span style="font-weight: bold;">
LAPORAN UNIVERSAL POLI UMUM<br>
BULAN 01-05-2019 - 31-05-2019 </span></big></big>
</td>
</tr>
</table>
<table align='center'>
<tr>
<td>Total</td>
<td>:</td>
<td>437</td>
</tr>
</table>
<table align="center" width="98%" border="1">
<tr class="row1">
<td align="center" width='3%'>No</td>
<td align="center" width='6%'>Tanggal</td>
<td align="center" width='6%'>No RM</td>
<td align="center" width='10%'>Nama</td>
<td align="center" >NIK</td>
<td align="center" >KK</td>
<td align="center" width='6%'>Desa</td>
<td align="center" width='5%'>Kecamatan</td>
<td align="center" width='5%'>Kabupaten</td>
<td align="center" width='6%'>Tgl Lahir</td>
<td align="center" width='6%'>Umur<br>Th</td>
<td align="center" width='2%'>L/P</td>
<td align="center" width='7%'>Pekerjaan</td>
<td align="center" width='7%'>Ruangan</td>
<td align="center" width='7%'>Petugas</td>
<td align="center" width='4%'>Status</td>
<td align="center" >Kasus</td>
<td align="center" >Cara Bayar</td>
<td align="center" >Jenis BPJS</td>
<td align="center" >No Asuransi</td>
<td align="center" >Kode Bridging</td>
<td>Diagnosa</td>
</tr>
<tr align="left" valign="top">

<td>1</td>
<td>02-05-2019</td>
<td>012072</td>
<td>HENI WAHYU RIYANTI</td>
<td>`3519016112860001</td>
<td>`</td>
<td>KEBONSARI</td>
<td>KEBONSARI</td>
<td>MADIUN</td>
<td>21-12-1986</td>
<td>32</td>
<td>P</td>
<td>Pegawai Negeri Sipil</td>
<td>POLI UMUM</td>
<td>dr. Agustina Dwi Wulansari</td>
<td>BARU</td>
<td>KASUS BARU</td>
<td>BPJS</td>
<td>PNS DAERAH</td>
<td>`0000205613065</td>
<td>130802030519Y000052</td>
<td align='center'>
J02.9 </td>
</tr>

<td>2</td>
<td>02-05-2019</td>
<td>012079</td>
<td>DUDUNG PRASETYO</td>
<td>`3577011306900001</td>
<td>`3577010704160002</td>
<td>REJOMULYO</td>
<td>KARTOHARJO</td>
<td>KOTA MADIUN</td>
<td>13-06-1990</td>
<td>28</td>
<td>L</td>
<td>Karyawan Swasta</td>
<td>POLI UMUM</td>
<td>BARU</td>
<td>KASUS BARU</td>
<td>BPJS</td>
<td>PEGAWAI PEMERINTAH DENGAN PERJANJIAN KERJA</td>
<td>`0001837097188</td>
<td>130802030519Y000048</td>
<td align='center'>
S82.30 </td>
</tr>

<td>3</td>
<td>02-05-2019</td>
<td>012082</td>
<td>TITIK ANDAYANI</td>
<td>`3577016210640001</td>
<td>`3577012312100046</td>
<td>REJOMULYO</td>
<td>KARTOHARJO</td>
<td>22-10-1964</td>
<td>54</td>
<td>P</td>
<td>Mengurus Rumah Tangga</td>
<td>POLI UMUM</td>
<td>BARU</td>
<td>KASUS BARU</td>
<td>BPJS</td>
<td>PBI (APBD)</td>
<td>`0002413946924</td>
<td>130802030519Y000068</td>
<td align='center'>
R05 </td>
</tr>

<td>4</td>
<td>02-05-2019</td>
<td>007446</td>
<td>ISMAIL</td>
<td>`</td>
<td>`</td>
<td>BETEK</td>
<td>MADIUN</td>
<td>MADIUN</td>
<td>07-02-1977</td>
<td>42</td>
<td>L</td>
<td>Pedagang</td>
<td>POLI UMUM</td>
<td>LAMA</td>
<td>KUNJUNGAN KASUS LAMA</td>
<td>BPJS</td>
<td></td>
<td>`0002741018084</td>
<td>130802030519Y000011</td>
<td align='center'>
A16.9 </td>
</tr>

<td>5</td>
<td>02-05-2019</td>
<td>004108</td>
<td>YUNITA ANA TRIHADI</td>
<td>`3577015606780003</td>
<td>`3577010310110003</td>
<td>KELUN</td>
<td>KARTOHARJO</td>
<td>16-06-1978</td>
<td>40</td>
<td>P</td>
<td>POLI UMUM</td>
<td>LAMA</td>
<td>KASUS BARU</td>
<td>BPJS</td>
<td>PBI (APBD)</td>
<td>`0002202208468</td>
<td>130802030519Y000023</td>
<td align='center'>
M79.1 </td>
</tr>
<td>6</td>
<td>02-05-2019</td>
<td>011404</td>
<td>SURADI</td>
<td>`3577011903690003</td>
<td>`3577012104071631</td>
<td>TAWANG REJO</td>
<td>KARTOHARJO</td>
<td>19-03-1969</td>
<td>50</td>
<td>L</td>
<td>POLI UMUM</td>
<td>LAMA</td>
<td>KASUS BARU</td>
<td>BPJS</td>
<td>PBI (APBN)</td>
<td>`0000787220638</td>
<td>130802030519Y000024</td>
<td align='center'>
H60.9 </td>
</tr>

<td>7</td>
<td>02-05-2019</td>
<td>000894</td>
<td>SARMINI</td>
<td>`</td>
<td>`</td>
<td>TAWANGREJO</td>
<td>KARTOHARJO</td>
<td>10-10-1974</td>
<td>44</td>
<td>P</td>
<td>POLI UMUM</td>
<td>LAMA</td>
<td>KASUS BARU</td>
<td>BPJS</td>
<td></td>
<td>`0002163611788</td>
<td>130802030519Y000014</td>
<td align='center'>
D34 </td>
</tr>

<td>8</td>
<td>02-05-2019</td>
<td>002925</td>
<td>KAMBALI</td>
<td>`</td>
<td>`</td>
<td>TAWANGREJO</td>
<td>KARTOHARJO</td>
<td>17-05-1969</td>
<td>50</td>
<td>L</td>
<td>POLI UMUM</td>
<td>LAMA</td>
<td>KASUS BARU</td>
<td>BPJS</td>
<td>PBI (APBD)</td>
<td>`0001704815111</td>
<td>130802030519Y000016</td>
<td align='center'>
H60.9 </td>
</tr>

<td>9</td>
<td>02-05-2019</td>
<td>002019</td>
<td>NANING NURAINI</td>
<td>`3577016301760001</td>
<td>`3577012307130003</td>
<td>KARTOHARJO</td>
<td>23-01-1976</td>
<td>43</td>
<td>P</td>
<td>POLI UMUM</td>
<td>LAMA</td>
<td>KASUS BARU</td>
<td>BPJS</td>
<td>PBI (APBD)</td>
<td>`0001704820094</td>
<td>130802030519Y000015</td>
<td align='center'>
E28.2 </td>
</tr>

<td>10</td>
<td>02-05-2019</td>
<td>003712</td>
<td>SUWARTI</td>
<td>`3577014812750004</td>
<td>`3577012104071718</td>
<td>KARTOHARJO</td>
<td>08-12-1975</td>
<td>43</td>
<td>P</td>
<td>POLI UMUM</td>
<td>LAMA</td>
<td>KASUS LAMA</td>
<td>BPJS</td>
<td>PEGAWAI SWASTA</td>
<td>`0001536594445</td>
<td>130802030519Y000026</td>
<td align='center'>
I10 </td>
</tr>

<td>11</td>
<td>02-05-2019</td>
<td>001585</td>
<td>SULASTRI</td>
<td>`3577015110770001</td>
<td>`3577012004077453</td>
<td>REJOMULYO</td>
<td>KARTOHARJO</td>
<td>11-10-1977</td>
<td>41</td>
<td>P</td>
<td>POLI UMUM</td>
<td>LAMA</td>
<td>KASUS BARU</td>
<td>BPJS</td>
<td></td>
<td>`0002413935729</td>
<td>130802030519Y000053</td>
<td align='center'>
R51 </td>
</tr>

<td>12</td>
<td>02-05-2019</td>
<td>002744</td>
<td>TRIYANA JULAIKA</td>
<td>`3520035007920001</td>
<td>`3577010703170003</td>
<td>KARTOHARJO</td>
<td>10-07-1992</td>
<td>26</td>
<td>P</td>
<td>POLI UMUM</td>
<td>LAMA</td>
<td>KASUS BARU</td>
<td>UMUM</td>
<td>PEKERJA MANDIRI</td>
<td>`0002233888266</td>
<td></td>
<td align='center'>
N39.9 </td>
</tr>

<td>13</td>
<td>02-05-2019</td>
<td>011763</td>
<td>JARWANTO</td>
<td>`3577013112760003</td>
<td>`3577012004077808</td>
<td>REJOMULYO</td>
<td>KARTOHARJO</td>
<td>31-12-1976</td>
<td>42</td>
<td>L</td>
<td>POLI UMUM</td>
<td>LAMA</td>
<td>BPJS</td>
<td>PBI (APBD)</td>
<td>`0002413937081</td>
<td>130802030519Y000080</td>
<td align='center'>
E11 </td>
</tr>

<td>14</td>
<td>02-05-2019</td>
<td>010895</td>
<td>PURNANING DYAH BUNTARI</td>
<td>`3577015212760003</td>
<td>`3577012004110001</td>
<td>PILANGBANGO</td>
<td>KARTOHARJO</td>
<td>12-12-1976</td>
<td>42</td>
<td>P</td>
<td>POLI UMUM</td>
<td>LAMA</td>
<td>KASUS BARU</td>
<td>BPJS</td>
<td></td>
<td>`0002163606682</td>
<td>130802030519Y000046</td>
<td align='center'>
S93.4 </td>
</tr>

<td>15</td>
<td>02-05-2019</td>
<td>004647</td>
<td>MUNICALIAN KRISTI</td>
<td>`3577014308930001</td>
<td>`3577012104071832</td>
<td>KARTOHARJO</td>
<td>03-08-1993</td>
<td>25</td>
<td>P</td>
<td>Pelajar / Mahasiswa</td>
<td>POLI UMUM</td>
<td>LAMA</td>
<td>KASUS BARU</td>
<td>UMUM</td>
<td>`0001705504961</td>
<td></td>
<td align='center'>
J00 </td>
</tr>

<td>16</td>
<td>02-05-2019</td>
<td>004988</td>
<td>RUSDIANTO</td>
<td>`3577030902810001</td>
<td>`3577010510160004</td>
<td>REJOMULYO</td>
<td>KARTOHARJO</td>
<td>MADIUN</td>
<td>09-02-1981</td>
<td>38</td>
<td>L</td>
<td>POLI UMUM</td>
<td>LAMA</td>
<td>KASUS BARU</td>
<td>BPJS</td>
<td></td>
<td>`0002413929183</td>
<td>130802030519Y000058</td>
<td align='center'>
M79.1 </td>
</tr>

<td>17</td>
<td>02-05-2019</td>
<td>007839</td>
<td>ENDRA DWINUR CAHYO</td>
<td>`</td>
<td>`</td>
<td>NGLAMES</td>
<td>MADIUN</td>
<td>MADIUN</td>
<td>27-05-1992</td>
<td>27</td>
<td>L</td>
<td>Wiraswasta</td>
<td>POLI UMUM</td>
<td>LAMA</td>
<td>KASUS BARU</td>
<td>BPJS</td>
<td>`0001655885968</td>
<td>130802030519Y000084</td>
<td align='center'>
J00 </td>
</tr>

<td>18</td>
<td>02-05-2019</td>
<td>011980</td>
<td>M SUPRIHATIN</td>
<td>`3577015604670001</td>
<td>`3577012004077481</td>
<td>REJOMULYO</td>
<td>KARTOHARJO</td>
<td>16-04-1967</td>
<td>52</td>
<td>P</td>
<td>POLI UMUM</td>
<td>LAMA</td>
<td>KASUS BARU</td>
<td>BPJS</td>
<td>PBI (APBD)</td>
<td>`0002413935821</td>
<td>130802030519Y000060</td>
<td align='center'>
M79.1 </td>
</tr>

<td>19</td>
<td>02-05-2019</td>
<td>012076</td>
<td>IRNAWATI PANE</td>
<td>`</td>
<td>`</td>
<td>TEMPURSARI</td>
<td>WUNGU</td>
<td>MADIUN</td>
<td>07-07-1979</td>
<td>39</td>
<td>P</td>
<td>POLI UMUM</td>
<td>BARU</td>
<td>KASUS BARU</td>
<td>UMUM</td>
<td></td>
<td>`</td>
<td></td>
<td align='center'>
M79.1 </td>
</tr>

<td>20</td>
<td>02-05-2019</td>
<td>011998</td>
<td>YULIANA KRISTANTI</td>
<td>`3577016407950001</td>
<td>`3577012211130001</td>
<td>REJOMULYO</td>
<td>KARTOHARJO</td>
<td>24-07-1995</td>
<td>23</td>
<td>P</td>
<td>POLI UMUM</td>
<td>LAMA</td>
<td>KASUS BARU</td>
<td>BPJS</td>
<td>PBI (APBD)</td>
<td>`0002413946215</td>
<td>130802030519Y000085</td>
<td align='center'>
K30 </td>
</tr>

<td>21</td>
<td>02-05-2019</td>
<td>004852</td>
<td>RAMINI</td>
<td>`3519084706730001</td>
<td>`</td>
<td>BANJARSARI</td>
<td>MADIUN</td>
<td>MADIUN</td>
<td>07-06-1973</td>
<td>45</td>
<td>P</td>
<td>POLI UMUM</td>
<td>LAMA</td>
<td>KASUS BARU</td>
<td>BPJS</td>
<td>`0002499336933</td>
<td>130802030519Y000070</td>
<td align='center'>
J00 </td>
</tr>

<td>22</td>
<td>02-05-2019</td>
<td>008748</td>
<td>SETYO BUDI HANDOKO</td>
<td>`3577012009720005</td>
<td>`3577012104071731</td>
<td>KARTOHARJO</td>
<td>20-09-1972</td>
<td>46</td>
<td>L</td>
<td>POLI UMUM</td>
<td>LAMA</td>
<td>KASUS BARU</td>
<td>BPJS</td>
<td>PBI (APBD)</td>
<td>`0001704876636</td>
<td>130802030519Y000088</td>
<td align='center'>
E11.0 </td>
</tr>

<td>23</td>
<td>02-05-2019</td>
<td>008805</td>
<td>NIHAYAH TUROHMAH</td>
<td>`3519086707640002</td>
<td>`</td>
<td>SUMBEREJO</td>
<td>MADIUN</td>
<td>MADIUN</td>
<td>27-07-1964</td>
<td>54</td>
<td>P</td>
<td>Guru</td>
<td>POLI UMUM</td>
<td>LAMA</td>
<td>KASUS BARU</td>
<td>BPJS</td>
<td>`0001860078914</td>
<td></td>
<td align='center'>
M54.5 </td>
</tr>

<td>24</td>
<td>03-05-2019</td>
<td>012113</td>
<td>NUNING WAHYU WERDIASTUTI</td>
<td>`3577014403690003</td>
<td>`3577012105180004</td>
<td>KELUN</td>
<td>KARTOHARJO</td>
<td>04-03-1969</td>
<td>50</td>
<td>P</td>
<td>POLI UMUM</td>
<td>dr. NOFIYANTI DWI PRIHANTINI</td>
<td>BARU</td>
<td>KASUS BARU</td>
<td>BPJS</td>
<td>PBI (APBD)</td>
<td>`0002163617548</td>
<td>130802030519Y002324</td>
<td align='center'>
J06.9 </td>
</tr>

<td>25</td>
<td>03-05-2019</td>
<td>012115</td>
<td>PUJI LESTARI</td>
<td>`3577014702830001</td>
<td>`3577012104070518</td>
<td>KARTOHARJO</td>
<td>07-02-1983</td>
<td>36</td>
<td>P</td>
<td>POLI UMUM</td>
<td>BARU</td>
<td>KASUS BARU</td>
<td>BPJS</td>
<td>PBI (APBD)</td>
<td>`0001704812051</td>
<td>130802030519Y000111</td>
<td align='center'>
E11 </td>
</tr>

<td>26</td>
<td>03-05-2019</td>
<td>012121</td>
<td>LASINEM</td>
<td>`</td>
<td>`</td>
<td>KARTOHARJO</td>
<td>01-01-1966</td>
<td>53</td>
<td>P</td>
<td>POLI UMUM</td>
<td>BARU</td>
<td>KASUS LAMA</td>
<td>BPJS</td>
<td>PBI (APBN)</td>
<td>`0000786614747</td>
<td>130802030519Y000599</td>
<td align='center'>
A09 </td>
</tr>

<td>27</td>
<td>03-05-2019</td>
<td>012130</td>
<td>RIRINDRA AYUNANI</td>
<td>`3519084709930002</td>
<td>`</td>
<td>TIRON</td>
<td>MADIUN</td>
<td>MADIUN</td>
<td>07-09-1993</td>
<td>25</td>
<td>P</td>
<td>POLI UMUM</td>
<td>BARU</td>
<td>KASUS BARU</td>
<td>BPJS</td>
<td>`0001539390892</td>
<td>130802030519Y000154</td>
<td align='center'>
M67.4 </td>
</tr>

<td>28</td>
<td>03-05-2019</td>
<td>012139</td>
<td>AGUS PRIYANTO</td>
<td>`3577012905770002</td>
<td>`3577012312100040</td>
<td>REJOMULYO</td>
<td>KARTOHARJO</td>
<td>29-05-1977</td>
<td>42</td>
<td>L</td>
<td>POLI UMUM</td>
<td>BARU</td>
<td>KASUS BARU</td>
<td>BPJS</td>
<td>`0002413946889</td>
<td>130802030519Y000156</td>
<td align='center'>
E05 </td>
</tr>

<td>29</td>
<td>03-05-2019</td>
<td>002943</td>
<td>JUMANI</td>
<td>`3577011604670001</td>
<td>`3577012104071004</td>
<td>KARTOHARJO</td>
<td>16-04-1967</td>
<td>52</td>
<td>L</td>
<td>POLI UMUM</td>
<td>LAMA</td>
<td>KASUS LAMA</td>
<td>BPJS</td>
<td>PEGAWAI PEMERINTAH NON PNS</td>
<td>`0001832560356</td>
<td>130802030519Y000247</td>
<td align='center'>
M13 </td>
</tr>
<td>30</td>
<td>03-05-2019</td>
<td>009463</td>
<td>SUGIANA</td>
<td>`3173062703840002</td>
<td>`</td>
<td>DEMPELAN</td>
<td>MADIUN</td>
<td>MADIUN</td>
<td>27-03-1984</td>
<td>35</td>
<td>L</td>
<td>POLI UMUM</td>
<td>LAMA</td>
<td>KASUS LAMA</td>
<td>UMUM</td>
<td>PBI (APBD)</td>
<td>`0001220464427</td>
<td></td>
<td align='center'>
A15 </td>
</tr>

<td>31</td>
<td>03-05-2019</td>
<td>000224</td>
<td>DAMIYANTI</td>
<td>`3519075212770003</td>
<td>`</td>
<td>TEMPURSARI</td>
<td>WUNGU</td>
<td>MADIUN</td>
<td>12-12-1977</td>
<td>41</td>
<td>P</td>
<td>POLI UMUM</td>
<td>LAMA</td>
<td>KASUS LAMA</td>
<td>BPJS</td>
<td>`0001289643333</td>
<td></td>
<td align='center'>
E11 </td>
</tr>

<td>32</td>
<td>03-05-2019</td>
<td>001133</td>
<td>PRIYANTO</td>
<td>`3577010404730002</td>
<td>`3577012104070594</td>
<td>KARTOHARJO</td>
<td>04-04-1973</td>
<td>46</td>
<td>L</td>
<td>Perdagangan</td>
<td>POLI UMUM</td>
<td>LAMA</td>
<td>KASUS BARU</td>
<td>BPJS</td>
<td>PBI (APBD)</td>
<td>`0001704812264</td>
<td>130802030519Y000119</td>
<td align='center'>
L08 </td>
</tr>

<td>33</td>
<td>03-05-2019</td>
<td>000835</td>
<td>SAMIUN</td>
<td>`3577010803660002</td>
<td>`3577012104071601</td>
<td>KARTOHARJO</td>
<td>08-03-1966</td>
<td>53</td>
<td>L</td>
<td>POLI UMUM</td>
<td>LAMA</td>
<td>KASUS BARU</td>
<td>BPJS</td>
<td></td>
<td>`0001542671245</td>
<td>130802030519Y000124</td>
<td align='center'>
E11 </td>
</tr>

<td>34</td>
<td>03-05-2019</td>
<td>002010</td>
<td>SUKARTI</td>
<td>`</td>
<td>`</td>
<td>TAWANGREJO</td>
<td>KARTOHARJO</td>
<td>05-11-1970</td>
<td>48</td>
<td>P</td>
<td>POLI UMUM</td>
<td>LAMA</td>
<td>KASUS BARU</td>
<td>BPJS</td>
<td>PNS DAERAH</td>
<td>`0000106450481</td>
<td>130802030519Y000120</td>
<td align='center'>
J00 </td>
</tr>

<td>35</td>
<td>03-05-2019</td>
<td>006497</td>
<td>ALVIAN ANGGA TRI ATMAJA</td>
<td>`3519071411930001</td>
<td>`</td>
<td>TEMPURSARI</td>
<td>WUNGU</td>
<td>MADIUN</td>
<td>14-11-1993</td>
<td>25</td>
<td>L</td>
<td>POLI UMUM</td>
<td>LAMA</td>
<td>KASUS LAMA</td>
<td>UMUM</td>
<td>`0001147051629</td>
<td></td>
<td align='center'>
J06 </td>
</tr>

<td>36</td>
<td>03-05-2019</td>
<td>009414</td>
<td>NINDITA PUTRI JAYANTI</td>
<td>`3577016105940003</td>
<td>`3577012104078773</td>
<td>KANIGORO</td>
<td>KARTOHARJO</td>
<td>21-05-1994</td>
<td>25</td>
<td>P</td>
<td>POLI UMUM</td>
<td>LAMA</td>
<td>KASUS BARU</td>
<td>BPJS</td>
<td>PBI (APBN)</td>
<td>`0000786507276</td>
<td>130802030519Y000155</td>
<td align='center'>
D24 </td>
</tr>

<td>37</td>
<td>03-05-2019</td>
<td>005200</td>
<td>ENDANG KUSUMA RATIH TJAHJAWATI</td>
<td>`3577015511710002</td>
<td>`3577012712100069</td>
<td>REJOMULYO</td>
<td>KARTOHARJO</td>
<td>15-11-1971</td>
<td>47</td>
<td>P</td>
<td>POLI UMUM</td>
<td>LAMA</td>
<td>KASUS BARU</td>
<td>BPJS</td>
<td>PBI (APBD)</td>
<td>`0002413948612</td>
<td>130802030519Y000150</td>
<td align='center'>
F20.9 </td>
</tr>

<td>38</td>
<td>03-05-2019</td>
<td>011840</td>
<td>MARSINI</td>
<td>`</td>
<td>`</td>
<td>NGLAMES</td>
<td>MADIUN</td>
<td>MADIUN</td>
<td>15-12-1965</td>
<td>53</td>
<td>P</td>
<td>POLI UMUM</td>
<td>LAMA</td>
<td>KASUS BARU</td>
<td>BPJS</td>
<td>`0002480562821</td>
<td>130802030519Y000173</td>
<td align='center'>
D17.3 </td>
</tr>

<td>39</td>
<td>03-05-2019</td>
<td>001186</td>
<td>NURANI</td>
<td>`3577015506820005</td>
<td>`3577011901080037</td>
<td>REJOMULYO</td>
<td>KARTOHARJO</td>
<td>15-06-1982</td>
<td>36</td>
<td>P</td>
<td>POLI UMUM</td>
<td>LAMA</td>
<td>KASUS BARU</td>
<td>BPJS</td>
<td>PBI (APBD)</td>
<td>`0001704807562</td>
<td>130802030519Y000152</td>
<td align='center'>
R42 </td>
</tr>

<td>40</td>
<td>03-05-2019</td>
<td>000458</td>
<td>WAHYU TRIANA</td>
<td>`</td>
<td>`</td>
<td>TAWANGREJO</td>
<td>KARTOHARJO</td>
<td>30-05-1991</td>
<td>28</td>
<td>P</td>
<td>POLI UMUM</td>
<td>LAMA</td>
<td>KASUS BARU</td>
<td>BPJS</td>
<td></td>
<td>`0002163587466</td>
<td>130802030519Y000616</td>
<td align='center'>
J11 </td>
</tr>

<td>41</td>
<td>03-05-2019</td>
<td>006768</td>
<td>SUSILO JOKO WARDONO</td>
<td>`</td>
<td>`3577011412110002</td>
<td>TAWANGREJO</td>
<td>KARTOHARJO</td>
<td>24-05-1981</td>
<td>38</td>
<td>L</td>
<td>Petani / Pekebun</td>
<td>POLI UMUM</td>
<td>LAMA</td>
<td>KASUS BARU</td>
<td>BPJS</td>
<td>PNS DAERAH</td>
<td>`0001081079019</td>
<td>130802030519Y000618</td>
<td align='center'>
H10 </td>
</tr>

<td>42</td>
<td>04-05-2019</td>
<td>012153</td>
<td>LUQYANA MURJIANTI</td>
<td>`35770155005970005</td>
<td>`3577010512180004</td>
<td>KELUN</td>
<td>KARTOHARJO</td>
<td>15-05-1997</td>
<td>22</td>
<td>P</td>
<td>Belum / Tidak Bekerja</td>
<td>POLI UMUM</td>
<td>BARU</td>
<td>KASUS BARU</td>
<td>BPJS</td>
<td></td>
<td>`</td>
<td></td>
<td align='center'>
Z39 </td>
</tr>

<td>43</td>
<td>06-05-2019</td>
<td>012166</td>
<td>FADILA LIWALIDA AKSARI</td>
<td>`350604</td>
<td>`</td>
<td>MANGUNREJO</td>
<td>NGADILUWIH</td>
<td>KEDIRI</td>
<td>01-04-1995</td>
<td>24</td>
<td>P</td>
<td>POLI UMUM</td>
<td>dr. TITO RUSTANTO N</td>
<td>BARU</td>
<td>KASUS BARU</td>
<td>BPJS</td>
<td>`0000109882528</td>
<td>130802030519Y000244</td>
<td align='center'>
N60.2 </td>
</tr>

<td>44</td>
<td>06-05-2019</td>
<td>012168</td>
<td>SRI SURYATI</td>
<td>`3519085002680001</td>
<td>`</td>
<td>BETEK</td>
<td>MADIUN</td>
<td>MADIUN</td>
<td>10-02-1968</td>
<td>51</td>
<td>P</td>
<td>POLI UMUM</td>
<td>BARU</td>
<td>KASUS BARU</td>
<td>BPJS</td>
<td>`0001877727892</td>
<td></td>
<td align='center'>
I10 </td>
</tr>

<td>45</td>
<td>06-05-2019</td>
<td>012172</td>
<td>ANNIK MATURRODHIYYA</td>
<td>`3519086810990002</td>
<td>`</td>
<td>DEMPELAN</td>
<td>MADIUN</td>
<td>MADIUN</td>
<td>28-10-1999</td>
<td>19</td>
<td>P</td>
<td>POLI UMUM</td>
<td>BARU</td>
<td>KASUS BARU</td>
<td>BPJS</td>
<td>`0002416638868</td>
<td>130802030519Y000300</td>
<td align='center'>
L02.8 </td>
</tr>

<td>46</td>
<td>06-05-2019</td>
<td>012181</td>
<td>SUJIATUN</td>
<td>`3519084201700001</td>
<td>`</td>
<td>DEMPELAN</td>
<td>MADIUN</td>
<td>MADIUN</td>
<td>02-01-1970</td>
<td>49</td>
<td>P</td>
<td>POLI UMUM</td>
<td>BARU</td>
<td>KASUS BARU</td>
<td>BPJS</td>
<td>`0002483805205</td>
<td>130802030519Y000302</td>
<td align='center'>
B26.3 </td>
</tr>

<td>47</td>
<td>06-05-2019</td>
<td>009196</td>
<td>SULASTRI</td>
<td>`</td>
<td>`</td>
<td>NGLAMES</td>
<td>MADIUN</td>
<td>MADIUN</td>
<td>30-06-1967</td>
<td>51</td>
<td>P</td>
<td>Guru</td>
<td>POLI UMUM</td>
<td>LAMA</td>
<td>KASUS BARU</td>
<td>BPJS</td>
<td>`0002272229526</td>
<td>130802030519Y000254</td>
<td align='center'>
R50.9 </td>
</tr>

<td>48</td>
<td>06-05-2019</td>
<td>003704</td>
<td>NOVIAN RIZKINANTO</td>
<td>`</td>
<td>`</td>
<td>KARTOHARJO</td>
<td>09-11-1992</td>
<td>26</td>
<td>L</td>
<td>POLI UMUM</td>
<td>LAMA</td>
<td>KASUS BARU</td>
<td>BPJS</td>
<td></td>
<td>`0002416309029</td>
<td>130802030519Y000260</td>
<td align='center'>
J11 </td>
</tr>

<td>49</td>
<td>06-05-2019</td>
<td>006819</td>
<td>MUDANINGSIH</td>
<td>`3577016310880001</td>
<td>`3577012004077718</td>
<td>REJOMULYO</td>
<td>KARTOHARJO</td>
<td>23-10-1988</td>
<td>30</td>
<td>P</td>
<td>POLI UMUM</td>
<td>LAMA</td>
<td>KASUS LAMA</td>
<td>BPJS</td>
<td>`0001869948551</td>
<td>130802030519Y000262</td>
<td align='center'>
L23 </td>
</tr>

<td>50</td>
<td>06-05-2019</td>
<td>002507</td>
<td>SUYONO</td>
<td>`3577011501720001</td>
<td>`3577012104078136</td>
<td>KELUN</td>
<td>KARTOHARJO</td>
<td>15-01-1972</td>
<td>47</td>
<td>L</td>
<td>Buruh Tani / Perkebunan</td>
<td>POLI UMUM</td>
<td>LAMA</td>
<td>KASUS BARU</td>
<td>BPJS</td>
<td>PBI (APBN)</td>
<td>`0000786808001</td>
<td>130802030519Y000265</td>
<td align='center'>
M79.1 </td>
</tr>

<td>51</td>
<td>06-05-2019</td>
<td>011403</td>
<td>SUKARDI</td>
<td>`3577012009700002</td>
<td>`3577012104072336</td>
<td>KARTOHARJO</td>
<td>20-09-1970</td>
<td>48</td>
<td>L</td>
<td>POLI UMUM</td>
<td>LAMA</td>
<td>KASUS BARU</td>
<td>BPJS</td>
<td>PBI (APBN)</td>
<td>`0000787316444</td>
<td>130802030519Y000351</td>
<td align='center'>
M79.1 </td>
</tr>

<td>52</td>
<td>06-05-2019</td>
<td>003071</td>
<td>SULIS SETIAWATI</td>
<td>`</td>
<td>`</td>
<td>KARTOHARJO</td>
<td>21-05-1969</td>
<td>50</td>
<td>P</td>
<td>POLI UMUM</td>
<td>LAMA</td>
<td>KASUS BARU</td>
<td>BPJS</td>
<td>PBI (APBD)</td>
<td>`0001704813311</td>
<td>130802030519Y000267</td>
<td align='center'>
W49 </td>
</tr>

<td>53</td>
<td>06-05-2019</td>
<td>003270</td>
<td>MOH. YUSRI</td>
<td>`3518131511820001</td>
<td>`</td>
<td>PATIHAN</td>
<td>MANGUHARJO</td>
<td>15-11-1982</td>
<td>36</td>
<td>L</td>
<td>POLI UMUM</td>
<td>LAMA</td>
<td>KASUS BARU</td>
<td>BPJS</td>
<td>`0001428542256</td>
<td>130802030519Y000272</td>
<td align='center'>
H10 </td>
</tr>

<td>54</td>
<td>06-05-2019</td>
<td>003690</td>
<td>PRASETIAWATI</td>
<td>`3519086602840002</td>
<td>`</td>
<td>NGLAMES</td>
<td>MADIUN</td>
<td>MADIUN</td>
<td>26-02-1984</td>
<td>35</td>
<td>P</td>
<td>POLI UMUM</td>
<td>LAMA</td>
<td>KASUS LAMA</td>
<td>BPJS</td>
<td>`0001537127111</td>
<td>130802030519Y000273</td>
<td align='center'>
K30 </td>
</tr>

<td>55</td>
<td>06-05-2019</td>
<td>004250</td>
<td>PAIMAN</td>
<td>`3519072110400001</td>
<td>`</td>
<td>NGLAMBANGAN</td>
<td>WUNGU</td>
<td>MADIUN</td>
<td>01-01-1970</td>
<td>49</td>
<td>L</td>
<td>POLI UMUM</td>
<td>LAMA</td>
<td>BPJS</td>
<td>PNS PUSAT</td>
<td>`0001290007113</td>
<td>130802030519Y000276</td>
<td align='center'>
I84.9 </td>
</tr>

<td>56</td>
<td>06-05-2019</td>
<td>001133</td>
<td>PRIYANTO</td>
<td>`3577010404730002</td>
<td>`3577012104070594</td>
<td>KARTOHARJO</td>
<td>04-04-1973</td>
<td>46</td>
<td>L</td>
<td>POLI UMUM</td>
<td>LAMA</td>
<td>KASUS BARU</td>
<td>BPJS</td>
<td>PBI (APBD)</td>
<td>`0001704812264</td>
<td>130802030519Y000279</td>
<td align='center'>
W49 </td>
</tr>

<td>57</td>
<td>06-05-2019</td>
<td>003419</td>
<td>SRI NURASIH</td>
<td>`3577035306930002</td>
<td>`3577010711130002</td>
<td>KELUN</td>
<td>KARTOHARJO</td>
<td>13-06-1993</td>
<td>25</td>
<td>P</td>
<td>POLI UMUM</td>
<td>LAMA</td>
<td>KASUS BARU</td>
<td>BPJS</td>
<td>PBI (APBD)</td>
<td>`0001704873137</td>
<td>130802030519Y000349</td>
<td align='center'>
J11 </td>
</tr>

<td>58</td>
<td>06-05-2019</td>
<td>003277</td>
<td>LAMI</td>
<td>`</td>
<td>`</td>
<td>KARTOHARJO</td>
<td>KARTOHARJO</td>
<td>01-01-1971</td>
<td>48</td>
<td>P</td>
<td>POLI UMUM</td>
<td>LAMA</td>
<td>KASUS BARU</td>
<td>BPJS</td>
<td>PBI (APBN)</td>
<td>`0000786814165</td>
<td>130802030519Y000306</td>
<td align='center'>
E11 </td>
</tr>

<td>59</td>
<td>06-05-2019</td>
<td>004133</td>
<td>NURYANI</td>
<td>`3577016511720001</td>
<td>`3577012104077847</td>
<td>KELUN</td>
<td>KARTOHARJO</td>
<td>25-11-1972</td>
<td>46</td>
<td>P</td>
<td>POLI UMUM</td>
<td>LAMA</td>
<td>KASUS BARU</td>
<td>BPJS</td>
<td>PBI (APBD)</td>
<td>`0002413881404</td>
<td>130802030519P000251</td>
<td align='center'>
M67.4 </td>
</tr>

<td>60</td>
<td>06-05-2019</td>
<td>001929</td>
<td>SRI MULYANI</td>
<td>`3577014601870001</td>
<td>`3577012909160003</td>
<td>KARTOHARJO</td>
<td>MADIUN</td>
<td>06-01-1987</td>
<td>32</td>
<td>P</td>
<td>POLI UMUM</td>
<td>LAMA</td>
<td>KASUS BARU</td>
<td>BPJS</td>
<td>PBI (APBN)</td>
<td>`0000787218816</td>
<td>130802030519Y000350</td>
<td align='center'>
J11 </td>
</tr>

<td>61</td>
<td>06-05-2019</td>
<td>003169</td>
<td>ANIK KASIATUN</td>
<td>`</td>
<td>`</td>
<td>TAWANGREJO</td>
<td>KARTOHARJO</td>
<td>09-02-1971</td>
<td>48</td>
<td>P</td>
<td>POLI UMUM</td>
<td>LAMA</td>
<td>KASUS BARU</td>
<td>BPJS</td>
<td>PENERIMA PENSIUN PNS</td>
<td>`0000106272898</td>
<td>130802030519P000290</td>
<td align='center'>
H52.7 </td>
</tr>

<td>62</td>
<td>06-05-2019</td>
<td>003010</td>
<td>ROSAWATI</td>
<td>`3577035507810010</td>
<td>`3577011104120004</td>
<td>REJOMULYO</td>
<td>KARTOHARJO</td>
<td>15-07-1981</td>
<td>37</td>
<td>P</td>
<td>Wiraswasta</td>
<td>POLI UMUM</td>
<td>LAMA</td>
<td>KASUS BARU</td>
<td>BPJS</td>
<td></td>
<td>`0002413931073</td>
<td>130802030519Y000320</td>
<td align='center'>
J11 </td>
</tr>

<td>63</td>
<td>06-05-2019</td>
<td>007697</td>
<td>SUJARWOKO</td>
<td>`3519081510840001</td>
<td>`</td>
<td>TULUNGREJO</td>
<td>MADIUN</td>
<td>MADIUN</td>
<td>15-10-1984</td>
<td>34</td>
<td>L</td>
<td>Guru</td>
<td>POLI UMUM</td>
<td>LAMA</td>
<td>KASUS LAMA</td>
<td>BPJS</td>
<td>`0001870748627</td>
<td></td>
<td align='center'>
A15 </td>
</tr>

<td>64</td>
<td>06-05-2019</td>
<td>007471</td>
<td>DONY ROMA SILFANA</td>
<td>`3577012108780001</td>
<td>`3577012004079692</td>
<td>REJOMULYO</td>
<td>KARTOHARJO</td>
<td>21-08-1978</td>
<td>40</td>
<td>L</td>
<td>POLI UMUM</td>
<td>LAMA</td>
<td>KASUS BARU</td>
<td>BPJS</td>
<td>`0001893629608</td>
<td>130802030519Y000283</td>
<td align='center'>
H66.4 </td>
</tr>
<td>65</td>
<td>06-05-2019</td>
<td>004911</td>
<td>SUPARTINI</td>
<td>`3519075507820007</td>
<td>`</td>
<td>NGLANDUK</td>
<td>WUNGU</td>
<td>MADIUN</td>
<td>15-07-1982</td>
<td>36</td>
<td>P</td>
<td>POLI UMUM</td>
<td>LAMA</td>
<td>KASUS BARU</td>
<td>BPJS</td>
<td>`0001536587199</td>
<td>130802030519Y000327</td>
<td align='center'>
K29 </td>
</tr>

<td>66</td>
<td>06-05-2019</td>
<td>005743</td>
<td>SUNARNI</td>
<td>`3577016705760004</td>
<td>`3577012107090005</td>
<td>KARTOHARJO</td>
<td>27-05-1976</td>
<td>43</td>
<td>P</td>
<td>POLI UMUM</td>
<td>LAMA</td>
<td>KASUS BARU</td>
<td>BPJS</td>
<td>PBI (APBD)</td>
<td>`0001706779844</td>
<td>130802030519Y000332</td>
<td align='center'>
L23 </td>
</tr>

<td>67</td>
<td>06-05-2019</td>
<td>003075</td>
<td>SUTINI</td>
<td>`</td>
<td>`</td>
<td>KARTOHARJO</td>
<td>07-03-1979</td>
<td>40</td>
<td>P</td>
<td>POLI UMUM</td>
<td>LAMA</td>
<td></td>
<td>BPJS</td>
<td>PBI (APBD)</td>
<td>`0001704807663</td>
<td>130802030519P000289</td>
<td align='center'>
H40.5 </td>
</tr>

<td>68</td>
<td>06-05-2019</td>
<td>003036</td>
<td>NUR HIDAYATI</td>
<td>`3577014312990002</td>
<td>`3577012104071955</td>
<td>TAWANGREJO</td>
<td>KARTOHARJO</td>
<td>01-12-1999</td>
<td>19</td>
<td>P</td>
<td>POLI UMUM</td>
<td>LAMA</td>
<td>KASUS BARU</td>
<td>BPJS</td>
<td>PBI (APBN)</td>
<td>`0000787426154</td>
<td>130802030519Y000336</td>
<td align='center'>
I88 </td>
</tr>

<td>69</td>
<td>06-05-2019</td>
<td>000461</td>
<td>PANIKEM</td>
<td>`3577015212680003</td>
<td>`3577012104071955</td>
<td>KARTOHARJO</td>
<td>12-12-1968</td>
<td>50</td>
<td>P</td>
<td>POLI UMUM</td>
<td>LAMA</td>
<td>KASUS BARU</td>
<td>BPJS</td>
<td></td>
<td>`0000787425445</td>
<td>130802030519Y000337</td>
<td align='center'>
M13 </td>
</tr>

<td>70</td>
<td>06-05-2019</td>
<td>000303</td>
<td>ANIK MARIANINGSIH</td>
<td>`3577016411700003</td>
<td>`3577012104078758</td>
<td>KELUN</td>
<td>KARTOHARJO</td>
<td>24-11-1970</td>
<td>48</td>
<td>P</td>
<td>POLI UMUM</td>
<td>LAMA</td>
<td>BPJS</td>
<td>PBI (APBN)</td>
<td>`0000786763372</td>
<td>130802030519Y000339</td>
<td align='center'>
I64 </td>
</tr>

<td>71</td>
<td>06-05-2019</td>
<td>012199</td>
<td>ABDULL FIRDAUS</td>
<td>`3577021803970002</td>
<td>`3577022004073881</td>
<td>PATIHAN</td>
<td>MANGUHARJO</td>
<td>18-03-1997</td>
<td>22</td>
<td>L</td>
<td>POLI UMUM</td>
<td>BARU</td>
<td>KASUS BARU</td>
<td>UMUM</td>
<td></td>
<td>`</td>
<td></td>
<td align='center'>
G43 </td>
</tr>

<td>72</td>
<td>06-05-2019</td>
<td>000448</td>
<td>AFIF SYAIFUDDIN</td>
<td>`3519080806790004</td>
<td>`</td>
<td>SUMBEREJO</td>
<td>MADIUN</td>
<td>MADIUN</td>
<td>08-06-1979</td>
<td>39</td>
<td>L</td>
<td>POLI UMUM</td>
<td>LAMA</td>
<td>KASUS BARU</td>
<td>BPJS</td>
<td>PBI (APBN)</td>
<td>`0000738381857</td>
<td>130802030519Y000344</td>
<td align='center'>
K30 </td>
</tr>

<td>73</td>
<td>06-05-2019</td>
<td>004063</td>
<td>SUKINI</td>
<td>`</td>
<td>`</td>
<td>TAWANGREJO</td>
<td>KARTOHARJO</td>
<td>01-06-1974</td>
<td>44</td>
<td>P</td>
<td>POLI UMUM</td>
<td>LAMA</td>
<td>KASUS BARU</td>
<td>BPJS</td>
<td>PBI (APBN)</td>
<td>`0000740122615</td>
<td>130802030519Y002325</td>
<td align='center'>
I10 </td>
</tr>

<td>74</td>
<td>06-05-2019</td>
<td>000723</td>
<td>TUTIK HARIYANI</td>
<td>`3519086505740004</td>
<td>`</td>
<td>NGLAMES</td>
<td>MADIUN</td>
<td>MADIUN</td>
<td>25-05-1974</td>
<td>45</td>
<td>P</td>
<td>POLI UMUM</td>
<td>LAMA</td>
<td>KASUS LAMA</td>
<td>BPJS</td>
<td>`0001425938591</td>
<td>130802030519P000292</td>
<td align='center'>
A18 </td>
</tr>

<td>75</td>
<td>07-05-2019</td>
<td>012208</td>
<td>NANDA NURAHMAD</td>
<td>`3577010205000006</td>
<td>`3577012104071470</td>
<td>KARTOHARJO</td>
<td>02-05-2000</td>
<td>19</td>
<td>L</td>
<td>POLI UMUM</td>
<td>BARU</td>
<td>KASUS BARU</td>
<td>BPJS</td>
<td>PBI (APBD)</td>
<td>`0001706779664</td>
<td>130802030519Y000391</td>
<td align='center'>
R50 </td>
</tr>

<td>76</td>
<td>07-05-2019</td>
<td>012213</td>
<td>IDA FATMAWATI</td>
<td>`3577016810740003</td>
<td>`3577010201180004</td>
<td>REJOMULYO</td>
<td>KARTOHARJO</td>
<td>28-10-1974</td>
<td>44</td>
<td>P</td>
<td>POLI UMUM</td>
<td>BARU</td>
<td>KASUS BARU</td>
<td>BPJS</td>
<td>`0001844942231</td>
<td>130802030519Y000366</td>
<td align='center'>
F20.9 </td>
</tr>

<td>77</td>
<td>07-05-2019</td>
<td>012220</td>
<td>ANIK PURWATI</td>
<td>`3577014902750002</td>
<td>`3577012104071670</td>
<td>KARTOHARJO</td>
<td>09-02-1975</td>
<td>44</td>
<td>P</td>
<td>POLI UMUM</td>
<td>BARU</td>
<td>KASUS BARU</td>
<td>BPJS</td>
<td>PBI (APBN)</td>
<td>`0000787276787</td>
<td>130802030519Y000373</td>
<td align='center'>
D23 </td>
</tr>

<td>78</td>
<td>07-05-2019</td>
<td>012223</td>
<td>MARIATI</td>
<td>`3577014103710002</td>
<td>`3577012104077929</td>
<td>KELUN</td>
<td>KARTOHARJO</td>
<td>01-03-1971</td>
<td>48</td>
<td>P</td>
<td>POLI UMUM</td>
<td>BARU</td>
<td>KASUS BARU</td>
<td>BPJS</td>
<td>PBI (APBD)</td>
<td>`0002163614365</td>
<td>130802030519Y000393</td>
<td align='center'>
M79 </td>
</tr>

<td>79</td>
<td>07-05-2019</td>
<td>012238</td>
<td>YOYOK MISDIONO.</td>
<td>`3519082508820005</td>
<td>`</td>
<td>BANJARSARI</td>
<td>MADIUN</td>
<td>MADIUN</td>
<td>25-08-1982</td>
<td>36</td>
<td>L</td>
<td>POLI UMUM</td>
<td>BARU</td>
<td>KASUS BARU</td>
<td>BPJS</td>
<td>`0002064974578</td>
<td>130802030519Y000401</td>
<td align='center'>
J11 </td>
</tr>

<td>80</td>
<td>07-05-2019</td>
<td>012240</td>
<td>CUT NUZHULIA TIARA ARYA DP</td>
<td>`3577016512990002</td>
<td>`3577012104078448</td>
<td>KELUN</td>
<td>KARTOHARJO</td>
<td>25-12-1999</td>
<td>19</td>
<td>P</td>
<td>POLI UMUM</td>
<td>BARU</td>
<td>KASUS BARU</td>
<td>BPJS</td>
<td>PBI (APBD)</td>
<td>`0002163615941</td>
<td>130802030519Y000402</td>
<td align='center'>
K30 </td>
</tr>

<td>81</td>
<td>07-05-2019</td>
<td>012244</td>
<td>ANIK KRISNAWATI</td>
<td>`3519085006930001</td>
<td>`3519082602180001</td>
<td>KEPEL</td>
<td>KARE</td>
<td>MADIUN</td>
<td>10-06-1993</td>
<td>25</td>
<td>P</td>
<td>POLI UMUM</td>
<td>LAMA</td>
<td>KASUS BARU</td>
<td>BPJS</td>
<td>`0001896175484</td>
<td>130802030519Y002327</td>
<td align='center'>
K30 </td>
</tr>

<td>82</td>
<td>07-05-2019</td>
<td>003070</td>
<td>PUPUT SANTOSO</td>
<td>`</td>
<td>`</td>
<td>KARTOHARJO</td>
<td>01-03-1997</td>
<td>22</td>
<td>L</td>
<td>POLI UMUM</td>
<td>LAMA</td>
<td>KASUS BARU</td>
<td>BPJS</td>
<td>PBI (APBN)</td>
<td>`0000786811781</td>
<td>130802030519Y000403</td>
<td align='center'>
J02.9 </td>
</tr>

<td>83</td>
<td>07-05-2019</td>
<td>000584</td>
<td>SANEM</td>
<td>`</td>
<td>`3577012104072138</td>
<td>TAWANGREJO</td>
<td>KARTOHARJO</td>
<td>MADIUN</td>
<td>08-04-1971</td>
<td>48</td>
<td>P</td>
<td>POLI UMUM</td>
<td>LAMA</td>
<td>BPJS</td>
<td></td>
<td>`0000787457542</td>
<td>130802030519Y000407</td>
<td align='center'>
M79.1 </td>
</tr>

<td>84</td>
<td>07-05-2019</td>
<td>004852</td>
<td>RAMINI</td>
<td>`3519084706730001</td>
<td>`</td>
<td>BANJARSARI</td>
<td>MADIUN</td>
<td>MADIUN</td>
<td>07-06-1973</td>
<td>45</td>
<td>P</td>
<td>POLI UMUM</td>
<td>LAMA</td>
<td>BPJS</td>
<td>`0002499336933</td>
<td>130802030519Y000412</td>
<td align='center'>
R05 </td>
</tr>

<td>85</td>
<td>07-05-2019</td>
<td>000133</td>
<td>SITI MARIJAM</td>
<td>`3519086802680001</td>
<td>`</td>
<td>SUMBEREJO</td>
<td>MADIUN</td>
<td>MADIUN</td>
<td>28-02-1968</td>
<td>51</td>
<td>P</td>
<td>POLI UMUM</td>
<td>LAMA</td>
<td>KASUS BARU</td>
<td>UMUM</td>
<td>`0001865632757</td>
<td></td>
<td align='center'>
J11 </td>
</tr>

<td>86</td>
<td>07-05-2019</td>
<td>004141</td>
<td>SUPARMI</td>
<td>`</td>
<td>`</td>
<td>TAWANGREJO</td>
<td>KARTOHARJO</td>
<td>31-12-1975</td>
<td>43</td>
<td>P</td>
<td>POLI UMUM</td>
<td>LAMA</td>
<td>BPJS</td>
<td>PBI (APBD)</td>
<td>`0002163612262</td>
<td>130802030519Y000365</td>
<td align='center'>
I10 </td>
</tr>

<td>87</td>
<td>07-05-2019</td>
<td>011235</td>
<td>KASINEM</td>
<td>`3577017008640001</td>
<td>`3577012004078393</td>
<td>REJOMULYO</td>
<td>KARTOHARJO</td>
<td>30-08-1964</td>
<td>54</td>
<td>P</td>
<td>POLI UMUM</td>
<td>LAMA</td>
<td></td>
<td>BPJS</td>
<td>PBI (APBD)</td>
<td>`0002742948292</td>
<td>130802030519Y000430</td>
<td align='center'>
E11.0 </td>
</tr>

<td>88</td>
<td>07-05-2019</td>
<td>004337</td>
<td>TRIWINDAYANI</td>
<td>`</td>
<td>`</td>
<td>BANJARSARI</td>
<td>MADIUN</td>
<td>MADIUN</td>
<td>10-02-1970</td>
<td>49</td>
<td>P</td>
<td>POLI UMUM</td>
<td>LAMA</td>
<td>KASUS BARU</td>
<td>BPJS</td>
<td>`0002216755506</td>
<td>130802030519Y000432</td>
<td align='center'>
I10 </td>
</tr>
<td>89</td>
<td>07-05-2019</td>
<td>004222</td>
<td>YULIS SETIYANA</td>
<td>`3577014308780001</td>
<td>`3577012303170004</td>
<td>REJOMULYO</td>
<td>KARTOHARJO</td>
<td>03-08-1978</td>
<td>40</td>
<td>P</td>
<td>POLI UMUM</td>
<td>LAMA</td>
<td>KASUS BARU</td>
<td>BPJS</td>
<td></td>
<td>`0002413946518</td>
<td>130802030519Y000376</td>
<td align='center'>
D21.9 </td>
</tr>

<td>90</td>
<td>07-05-2019</td>
<td>006740</td>
<td>IDHAM CHALID</td>
<td>`3577010803660001</td>
<td>`3577012004078003</td>
<td>REJOMULYO</td>
<td>KARTOHARJO</td>
<td>08-03-1966</td>
<td>53</td>
<td>L</td>
<td>POLI UMUM</td>
<td>LAMA</td>
<td>KASUS LAMA</td>
<td>BPJS</td>
<td>PBI (APBD)</td>
<td>`0001704808719</td>
<td>130802030519Y000457</td>
<td align='center'>
K29 </td>
</tr>

<td>91</td>
<td>07-05-2019</td>
<td>010893</td>
<td>INTAN RETNO DEWANTI</td>
<td>`</td>
<td>`</td>
<td>KELUN</td>
<td>KARTOHARJO</td>
<td>14-08-1998</td>
<td>20</td>
<td>P</td>
<td>POLI UMUM</td>
<td>LAMA</td>
<td>KASUS BARU</td>
<td>BPJS</td>
<td>`0002034488114</td>
<td>130802030519Y000446</td>
<td align='center'>
K29.1 </td>
</tr>

<td>92</td>
<td>07-05-2019</td>
<td>003473</td>
<td>DWI LESTARI</td>
<td>`3577010309830002</td>
<td>`3577012412100049</td>
<td>TAWANGREJO</td>
<td>KARTOHARJO</td>
<td>03-09-1983</td>
<td>35</td>
<td>L</td>
<td>POLI UMUM</td>
<td>LAMA</td>
<td>KASUS BARU</td>
<td>BPJS</td>
<td>`0001536799779</td>
<td>130802030519Y000450</td>
<td align='center'>
M79.1 </td>
</tr>

<td>93</td>
<td>07-05-2019</td>
<td>009016</td>
<td>UMI HABIBAH</td>
<td>`</td>
<td>`</td>
<td>KARTOHARJO</td>
<td>KARTOHARJO</td>
<td>25-07-1997</td>
<td>21</td>
<td>P</td>
<td>POLI UMUM</td>
<td>LAMA</td>
<td>KASUS BARU</td>
<td>BPJS</td>
<td>PNS PUSAT</td>
<td>`0000107203566</td>
<td></td>
<td align='center'>
R07.4 </td>
</tr>

<td>94</td>
<td>07-05-2019</td>
<td>011169</td>
<td>USMAN</td>
<td>`</td>
<td>`</td>
<td>KARTOHARJO</td>
<td>31-07-1971</td>
<td>47</td>
<td>L</td>
<td>POLI UMUM</td>
<td>LAMA</td>
<td>KASUS BARU</td>
<td>BPJS</td>
<td>PBI (APBD)</td>
<td>`0001704812455</td>
<td>130802030519Y000390</td>
<td align='center'>
I50.0 </td>
</tr>

<td>95</td>
<td>08-05-2019</td>
<td>012256</td>
<td>TUTIK BINTARI</td>
<td>`3519086601820001</td>
<td>`</td>
<td>GUNUNGSARI</td>
<td>MADIUN</td>
<td>MADIUN</td>
<td>26-01-1982</td>
<td>37</td>
<td>P</td>
<td>POLI UMUM</td>
<td>BARU</td>
<td>KASUS BARU</td>
<td>UMUM</td>
<td>PBI (APBN)</td>
<td>`0002631278485</td>
<td></td>
<td align='center'>
M79.1 </td>
</tr>

<td>96</td>
<td>08-05-2019</td>
<td>012272</td>
<td>SHEILA AYU HARLISTIA</td>
<td>`3519085807940001</td>
<td>`</td>
<td>NGLAMES</td>
<td>MADIUN</td>
<td>MADIUN</td>
<td>18-07-1994</td>
<td>24</td>
<td>P</td>
<td>POLI UMUM</td>
<td>BARU</td>
<td>KASUS BARU</td>
<td>BPJS</td>
<td>`0002314207967</td>
<td>130802030519Y000487</td>
<td align='center'>
I88.9 </td>
</tr>

<td>97</td>
<td>08-05-2019</td>
<td>001246</td>
<td>MARLIN ENDRASTUTI</td>
<td>`3577015104740003</td>
<td>`3577012104071645</td>
<td>KARTOHARJO</td>
<td>11-04-1974</td>
<td>45</td>
<td>P</td>
<td>POLI UMUM</td>
<td>LAMA</td>
<td>KASUS BARU</td>
<td>BPJS</td>
<td>PBI (APBN)</td>
<td>`0000786747701</td>
<td>130802030519Y000492</td>
<td align='center'>
H82 </td>
</tr>

<td>98</td>
<td>08-05-2019</td>
<td>012251</td>
<td>JOKO SUSANTO</td>
<td>`</td>
<td>`</td>
<td>TIRON</td>
<td>MADIUN</td>
<td>MADIUN</td>
<td>27-11-1994</td>
<td>24</td>
<td>L</td>
<td>POLI UMUM</td>
<td>BARU</td>
<td>KASUS BARU</td>
<td>UMUM</td>
<td></td>
<td>`</td>
<td></td>
<td align='center'>
R50.9 </td>
</tr>

<td>99</td>
<td>08-05-2019</td>
<td>000895</td>
<td>SUNARTI</td>
<td>`3577015205810004</td>
<td>`3577012104078243</td>
<td>KELUN</td>
<td>KARTOHARJO</td>
<td>12-05-1981</td>
<td>38</td>
<td>P</td>
<td>POLI UMUM</td>
<td>LAMA</td>
<td>KASUS LAMA</td>
<td>BPJS</td>
<td>`0001537134671</td>
<td>130802030519Y000500</td>
<td align='center'>
E11 </td>
</tr>

<td>100</td>
<td>08-05-2019</td>
<td>002014</td>
<td>HARSONO</td>
<td>`3519081709780002</td>
<td>`</td>
<td>BANJARSARI</td>
<td>MADIUN</td>
<td>MADIUN</td>
<td>17-09-1978</td>
<td>40</td>
<td>L</td>
<td>POLI UMUM</td>
<td>LAMA</td>
<td>KASUS BARU</td>
<td>BPJS</td>
<td>`0001437656128</td>
<td>130802030519Y000504</td>
<td align='center'>
J11 </td>
</tr>

<td>101</td>
<td>08-05-2019</td>
<td>010825</td>
<td>SUPRIYADI</td>
<td>`3519030909790009</td>
<td>`3577012401120002</td>
<td>REJOMULYO</td>
<td>KARTOHARJO</td>
<td>09-09-1979</td>
<td>39</td>
<td>L</td>
<td>POLI UMUM</td>
<td>LAMA</td>
<td>KASUS BARU</td>
<td>BPJS</td>
<td>PBI (APBD)</td>
<td>`0002414004884</td>
<td>130802030519Y000475</td>
<td align='center'>
H52 </td>
</tr>

<td>102</td>
<td>08-05-2019</td>
<td>001619</td>
<td>MISIRAH</td>
<td>`3519076701660002</td>
<td>`</td>
<td>TEMPURSARI</td>
<td>WUNGU</td>
<td>MADIUN</td>
<td>27-01-1966</td>
<td>53</td>
<td>P</td>
<td>POLI UMUM</td>
<td>LAMA</td>
<td>KASUS BARU</td>
<td>UMUM</td>
<td>`0002320591858</td>
<td></td>
<td align='center'>
G43.9 </td>
</tr>

<td>103</td>
<td>08-05-2019</td>
<td>000437</td>
<td>SULASMI</td>
<td>`3577015106650002</td>
<td>`3577012104072067</td>
<td>KARTOHARJO</td>
<td>11-06-1965</td>
<td>53</td>
<td>P</td>
<td>POLI UMUM</td>
<td>LAMA</td>
<td>BPJS</td>
<td>PBI (APBD)</td>
<td>`0001704877075</td>
<td>130802030519Y000516</td>
<td align='center'>
G43.9 </td>
</tr>

<td>104</td>
<td>08-05-2019</td>
<td>011198</td>
<td>KHOLIQ</td>
<td>`3525123003710002</td>
<td>`</td>
<td>BANJARSARI</td>
<td>MADIUN</td>
<td>MADIUN</td>
<td>30-03-1971</td>
<td>48</td>
<td>L</td>
<td>Wiraswasta</td>
<td>POLI UMUM</td>
<td>LAMA</td>
<td>KASUS BARU</td>
<td>BPJS</td>
<td>`0002236806472</td>
<td>130802030519Y000477</td>
<td align='center'>
L02.1 </td>
</tr>

<td>105</td>
<td>08-05-2019</td>
<td>012266</td>
<td>SUWARNI</td>
<td>`</td>
<td>`</td>
<td>SUMBEREJO</td>
<td>MADIUN</td>
<td>MADIUN</td>
<td>18-12-1972</td>
<td>46</td>
<td>P</td>
<td>POLI UMUM</td>
<td>BARU</td>
<td>KASUS BARU</td>
<td>UMUM</td>
<td></td>
<td>`</td>
<td></td>
<td align='center'>
I15 </td>
</tr>

<td>106</td>
<td>08-05-2019</td>
<td>003564</td>
<td>RETNO MURYANINGRUM, S.PD</td>
<td>`3519086212680001</td>
<td>`</td>
<td>BANJARSARI</td>
<td>MADIUN</td>
<td>MADIUN</td>
<td>22-12-1968</td>
<td>50</td>
<td>P</td>
<td>POLI UMUM</td>
<td>LAMA</td>
<td>KASUS BARU</td>
<td>BPJS</td>
<td>PNS DAERAH</td>
<td>`0000106458658</td>
<td>130802030519Y000480</td>
<td align='center'>
Z20.1 </td>
</tr>

<td>107</td>
<td>08-05-2019</td>
<td>004128</td>
<td>SLAMET SETIAWAN</td>
<td>`3577011008780007</td>
<td>`</td>
<td>TAWANGREJO</td>
<td>KARTOHARJO</td>
<td>10-08-1978</td>
<td>40</td>
<td>L</td>
<td>POLI UMUM</td>
<td>LAMA</td>
<td>BPJS</td>
<td>PBI (APBN)</td>
<td>`0000787471492</td>
<td>130802030519Y000479</td>
<td align='center'>
S72 </td>
</tr>

<td>108</td>
<td>08-05-2019</td>
<td>006763</td>
<td>YELMI GUSTI</td>
<td>`</td>
<td>`</td>
<td>TAWANGREJO</td>
<td>KARTOHARJO</td>
<td>14-08-1977</td>
<td>41</td>
<td>P</td>
<td>POLI UMUM</td>
<td>LAMA</td>
<td>KASUS LAMA</td>
<td>BPJS</td>
<td>`0001792395483</td>
<td>130802030519Y000483</td>
<td align='center'>
I64 </td>
</tr>

<td>109</td>
<td>08-05-2019</td>
<td>007843</td>
<td>NAWANG SARI ENDAH LESTARI</td>
<td>`</td>
<td>`</td>
<td>TAWANGREJO</td>
<td>GEMARANG</td>
<td>MADIUN</td>
<td>01-05-2001</td>
<td>18</td>
<td>P</td>
<td>POLI UMUM</td>
<td>LAMA</td>
<td>KASUS BARU</td>
<td>BPJS</td>
<td>PBI (APBN)</td>
<td>`0000786841839</td>
<td>130802030519Y000532</td>
<td align='center'>
M79.1 </td>
</tr>

<td>110</td>
<td>09-05-2019</td>
<td>012286</td>
<td>SUKARMI</td>
<td>`3577016202770003</td>
<td>`3577012104078780</td>
<td>KELUN</td>
<td>KARTOHARJO</td>
<td>22-02-1977</td>
<td>42</td>
<td>P</td>
<td>POLI UMUM</td>
<td>BARU</td>
<td>KASUS BARU</td>
<td>BPJS</td>
<td>PBI (APBN)</td>
<td>`0000786494575</td>
<td>130802030519Y000559</td>
<td align='center'>
J11 </td>
</tr>

<td>111</td>
<td>09-05-2019</td>
<td>012291</td>
<td>KUSWO UNIYANTORO</td>
<td>`</td>
<td>`</td>
<td>KARTOHARJO</td>
<td>22-10-1967</td>
<td>51</td>
<td>L</td>
<td>POLI UMUM</td>
<td>BARU</td>
<td>KASUS BARU</td>
<td>BPJS</td>
<td>PBI (APBD)</td>
<td>`0002416858615</td>
<td>130802030519Y000622</td>
<td align='center'>
S92.31 </td>
</tr>

<td>112</td>
<td>09-05-2019</td>
<td>012304</td>
<td>SINGGIH ANUGRAH JATI</td>
<td>`</td>
<td>`</td>
<td>REJOMULYO</td>
<td>KARTOHARJO</td>
<td>21-12-1976</td>
<td>42</td>
<td>L</td>
<td>POLI UMUM</td>
<td>BARU</td>
<td>KASUS BARU</td>
<td>BPJS</td>
<td>PBI (APBD)</td>
<td>`0002413878265</td>
<td>130802030519Y000642</td>
<td align='center'>
J11 </td>
</tr>

<td>113</td>
<td>09-05-2019</td>
<td>012308</td>
<td>IIN WIDYA WIJAYANTI</td>
<td>`3577014711870001</td>
<td>`3577012712100020</td>
<td>REJOMULYO</td>
<td>KARTOHARJO</td>
<td>07-11-1987</td>
<td>31</td>
<td>P</td>
<td>POLI UMUM</td>
<td>BARU</td>
<td>KASUS BARU</td>
<td>BPJS</td>
<td>PBI (APBD)</td>
<td>`0001182768478</td>
<td>130802030519Y000645</td>
<td align='center'>
K30 </td>
</tr>

<td>114</td>
<td>09-05-2019</td>
<td>000424</td>
<td>WURYANINGSIH</td>
<td>`</td>
<td>`</td>
<td>TAWANGREJO</td>
<td>KARTOHARJO</td>
<td>06-05-1971</td>
<td>48</td>
<td>P</td>
<td>POLI UMUM</td>
<td>LAMA</td>
<td>KASUS BARU</td>
<td>BPJS</td>
<td></td>
<td>`0002163594756</td>
<td>130802030519Y000560</td>
<td align='center'>
J11 </td>
</tr>

<td>115</td>
<td>09-05-2019</td>
<td>003108</td>
<td>SUKARMI</td>
<td>`3519086704650002</td>
<td>`</td>
<td>TIRON</td>
<td>MADIUN</td>
<td>MADIUN</td>
<td>27-04-1965</td>
<td>54</td>
<td>P</td>
<td>POLI UMUM</td>
<td>LAMA</td>
<td>KASUS BARU</td>
<td>BPJS</td>
<td>TNI ANGKATAN DARAT</td>
<td>`0001281998261</td>
<td>130802030519Y000564</td>
<td align='center'>
H66.9 </td>
</tr>

<td>116</td>
<td>09-05-2019</td>
<td>003071</td>
<td>`</td>
<td>`</td>
<td>KARTOHARJO</td>
<td>21-05-1969</td>
<td>50</td>
<td>P</td>
<td>POLI UMUM</td>
<td>LAMA</td>
<td>KASUS BARU</td>
<td>BPJS</td>
<td>PBI (APBD)</td>
<td>`0001704813311</td>
<td>130802030519Y000565</td>
<td align='center'>
L30.3 </td>
</tr>

<td>117</td>
<td>09-05-2019</td>
<td>000206</td>
<td>MARIYONO</td>
<td>` -</td>
<td>`3577012303150001</td>
<td>KELUN</td>
<td>KARTOHARJO</td>
<td>05-09-1969</td>
<td>49</td>
<td>L</td>
<td>POLI UMUM</td>
<td>LAMA</td>
<td>KASUS LAMA</td>
<td>BPJS</td>
<td>PBI (APBN)</td>
<td>`0000786815381</td>
<td>130802030519Y000558</td>
<td align='center'>
I64 </td>
</tr>

<td>118</td>
<td>09-05-2019</td>
<td>001862</td>
<td>HARTINI</td>
<td>`3577017009750006</td>
<td>`3577010610110002</td>
<td>KELUN</td>
<td>KARTOHARJO</td>
<td>30-09-1975</td>
<td>43</td>
<td>P</td>
<td>POLI UMUM</td>
<td>LAMA</td>
<td>KASUS LAMA</td>
<td>BPJS</td>
<td>PBI (APBD)</td>
<td>`0002163589031</td>
<td>130802030519Y000572</td>
<td align='center'>
M79.1 </td>
</tr>

<td>119</td>
<td>09-05-2019</td>
<td>001133</td>
<td>PRIYANTO</td>
<td>`3577010404730002</td>
<td>`3577012104070594</td>
<td>KARTOHARJO</td>
<td>04-04-1973</td>
<td>46</td>
<td>L</td>
<td>POLI UMUM</td>
<td>LAMA</td>
<td>BPJS</td>
<td>PBI (APBD)</td>
<td>`0001704812264</td>
<td>130802030519Y000573</td>
<td align='center'>
W49 </td>
</tr>

<td>120</td>
<td>09-05-2019</td>
<td>000059</td>
<td>SUGINEM</td>
<td>`3577015411690004</td>
<td>`3577011712100010</td>
<td>KELUN</td>
<td>KARTOHARJO</td>
<td>14-11-1969</td>
<td>49</td>
<td>P</td>
<td>POLI UMUM</td>
<td>LAMA</td>
<td>KASUS BARU</td>
<td>BPJS</td>
<td>PBI (APBN)</td>
<td>`0001049800926</td>
<td>130802030519Y000576</td>
<td align='center'>
J11 </td>
</tr>

<td>121</td>
<td>09-05-2019</td>
<td>011350</td>
<td>SULASTRI</td>
<td>`</td>
<td>`</td>
<td>NGLANDUK</td>
<td>WUNGU</td>
<td>MADIUN</td>
<td>20-02-1979</td>
<td>40</td>
<td>P</td>
<td>POLI UMUM</td>
<td>LAMA</td>
<td>KASUS BARU</td>
<td>BPJS</td>
<td>`0001827755515</td>
<td>130802030519Y000653</td>
<td align='center'>
H00 </td>
</tr>

<td>122</td>
<td>09-05-2019</td>
<td>007243</td>
<td>HARMINATUN</td>
<td>`</td>
<td>`</td>
<td>SENDANGREJO</td>
<td>MADIUN</td>
<td>MADIUN</td>
<td>07-03-1966</td>
<td>53</td>
<td>P</td>
<td>POLI UMUM</td>
<td>LAMA</td>
<td>KASUS BARU</td>
<td>BPJS</td>
<td></td>
<td>`0002375548571</td>
<td>130802030519Y000657</td>
<td align='center'>
M13 </td>
</tr>

<td>123</td>
<td>09-05-2019</td>
<td>007953</td>
<td>NUR HIDAYATI</td>
<td>`3519085802710002</td>
<td>`</td>
<td>SUMBEREJO</td>
<td>MADIUN</td>
<td>MADIUN</td>
<td>01-02-1971</td>
<td>48</td>
<td>P</td>
<td>POLI UMUM</td>
<td>LAMA</td>
<td>KASUS BARU</td>
<td>BPJS</td>
<td>PBI (APBN)</td>
<td>`0000738429039</td>
<td>130802030519Y000660</td>
<td align='center'>
M79.1 </td>
</tr>
<td>124</td>
<td>09-05-2019</td>
<td>001220</td>
<td>MIDARSIH</td>
<td>`3577014311650002</td>
<td>`3577012104072087</td>
<td>KARTOHARJO</td>
<td>03-11-1965</td>
<td>53</td>
<td>P</td>
<td>POLI UMUM</td>
<td>LAMA</td>
<td>KASUS BARU</td>
<td>BPJS</td>
<td>PBI (APBD)</td>
<td>`0001704877086</td>
<td>130802030519Y000661</td>
<td align='center'>
R51 </td>
</tr>

<td>125</td>
<td>09-05-2019</td>
<td>002970</td>
<td>SUKARNO</td>
<td>`3519081208840002</td>
<td>`</td>
<td>DEMPELAN</td>
<td>MADIUN</td>
<td>MADIUN</td>
<td>12-08-1984</td>
<td>34</td>
<td>L</td>
<td>POLI UMUM</td>
<td>LAMA</td>
<td>KASUS BARU</td>
<td>BPJS</td>
<td>`0001536803493</td>
<td>130802030519Y000664</td>
<td align='center'>
H10 </td>
</tr>

<td>126</td>
<td>09-05-2019</td>
<td>010238</td>
<td>ISMIATY</td>
<td>`3519084110620001</td>
<td>`</td>
<td>BANJARSARI</td>
<td>MADIUN</td>
<td>MADIUN</td>
<td>01-10-1965</td>
<td>53</td>
<td>P</td>
<td>POLI UMUM</td>
<td>LAMA</td>
<td>KASUS BARU</td>
<td>BPJS</td>
<td>PENERIMA PENSIUN TNI</td>
<td>`0000174100498</td>
<td>130802030519Y000665</td>
<td align='center'>
M79.1 </td>
</tr>

<td>127</td>
<td>09-05-2019</td>
<td>011633</td>
<td>NANANG WICAKSONO</td>
<td>`3577010212780002</td>
<td>`3577012001080008</td>
<td>REJOMULYO</td>
<td>KARTOHARJO</td>
<td>02-12-1978</td>
<td>40</td>
<td>L</td>
<td>POLI UMUM</td>
<td>LAMA</td>
<td>KASUS BARU</td>
<td>BPJS</td>
<td>PBI (APBD)</td>
<td>`0002413934291</td>
<td>130802030519Y000632</td>
<td align='center'>
B19 </td>
</tr>

<td>128</td>
<td>09-05-2019</td>
<td>002236</td>
<td>ANDIKA SEPTI RAHAYU</td>
<td>`3519146309900001</td>
<td>`</td>
<td>BANJARSARI</td>
<td>MADIUN</td>
<td>MADIUN</td>
<td>01-01-1970</td>
<td>49</td>
<td>P</td>
<td>POLI UMUM</td>
<td>LAMA</td>
<td>KASUS BARU</td>
<td>BPJS</td>
<td>`0002236807214</td>
<td>130802030519Y000670</td>
<td align='center'>
Z20.1 </td>
</tr>

<td>129</td>
<td>09-05-2019</td>
<td>012300</td>
<td>DIMAS INDRA PERMANA</td>
<td>`</td>
<td>`</td>
<td>REJOMULYO</td>
<td>KARTOHARJO</td>
<td>03-07-1994</td>
<td>24</td>
<td>L</td>
<td>POLI UMUM</td>
<td>BARU</td>
<td>KASUS BARU</td>
<td>UMUM</td>
<td></td>
<td>`</td>
<td></td>
<td align='center'>
R50.9 </td>
</tr>

<td>130</td>
<td>09-05-2019</td>
<td>002171</td>
<td>SUMINEM</td>
<td>`3577014912640001</td>
<td>`3577012004071971</td>
<td>REJOMULYO</td>
<td>KARTOHARJO</td>
<td>09-12-1964</td>
<td>54</td>
<td>P</td>
<td>POLI UMUM</td>
<td>LAMA</td>
<td>KASUS BARU</td>
<td>BPJS</td>
<td></td>
<td>`0002413934381</td>
<td>130802030519Y000672</td>
<td align='center'>
E10 </td>
</tr>

<td>131</td>
<td>09-05-2019</td>
<td>000925</td>
<td>LASMIYATUN</td>
<td>`3577017005690001</td>
<td>`3577012104070633</td>
<td>KARTOHARJO</td>
<td>30-05-1969</td>
<td>50</td>
<td>P</td>
<td>POLI UMUM</td>
<td>LAMA</td>
<td>KASUS BARU</td>
<td>BPJS</td>
<td>PBI (APBD)</td>
<td>`0001704812409</td>
<td>130802030519Y000634</td>
<td align='center'>
H81.3 </td>
</tr>

<td>132</td>
<td>09-05-2019</td>
<td>001971</td>
<td>SUMARNI</td>
<td>`</td>
<td>`</td>
<td>KELUN</td>
<td>KARTOHARJO</td>
<td>01-12-1965</td>
<td>53</td>
<td>P</td>
<td>POLI UMUM</td>
<td>LAMA</td>
<td>KASUS BARU</td>
<td>BPJS</td>
<td>PBI (APBN)</td>
<td>`0000786367023</td>
<td>130802030519Y000679</td>
<td align='center'>
H82 </td>
</tr>

<td>133</td>
<td>09-05-2019</td>
<td>004911</td>
<td>SUPARTINI</td>
<td>`3519075507820007</td>
<td>`</td>
<td>NGLANDUK</td>
<td>WUNGU</td>
<td>MADIUN</td>
<td>15-07-1982</td>
<td>36</td>
<td>P</td>
<td>POLI UMUM</td>
<td>LAMA</td>
<td>KASUS BARU</td>
<td>BPJS</td>
<td>`0001536587199</td>
<td>130802030519Y000681</td>
<td align='center'>
K21 </td>
</tr>

<td>134</td>
<td>09-05-2019</td>
<td>003916</td>
<td>DEWI PERWITASARI</td>
<td>`</td>
<td>`</td>
<td>BETEK</td>
<td>MADIUN</td>
<td>MADIUN</td>
<td>17-02-1992</td>
<td>27</td>
<td>P</td>
<td>POLI UMUM</td>
<td>LAMA</td>
<td>KASUS BARU</td>
<td>BPJS</td>
<td>`0001870614257</td>
<td>130802030519Y000638</td>
<td align='center'>
L04.9 </td>
</tr>

<td>135</td>
<td>10-05-2019</td>
<td>012320</td>
<td>ENING WIDAYATI</td>
<td>`3519076511730002</td>
<td>`</td>
<td>NGLANDUK</td>
<td>WUNGU</td>
<td>MADIUN</td>
<td>25-11-1973</td>
<td>45</td>
<td>P</td>
<td>POLI UMUM</td>
<td>BARU</td>
<td>KASUS BARU</td>
<td>BPJS</td>
<td>`0002624841887</td>
<td>130802030519Y000741</td>
<td align='center'>
M06.9 </td>
</tr>

<td>136</td>
<td>10-05-2019</td>
<td>012322</td>
<td>PARYONO</td>
<td>`3577010101380010</td>
<td>`3577012104071061</td>
<td>KARTOHARJO</td>
<td>01-01-1970</td>
<td>49</td>
<td>L</td>
<td>POLI UMUM</td>
<td>LAMA</td>
<td>KASUS BARU</td>
<td>BPJS</td>
<td>PBI (APBN)</td>
<td>`0000787552389</td>
<td>130802030519P000720</td>
<td align='center'>
N40 </td>
</tr>

<td>137</td>
<td>10-05-2019</td>
<td>000705</td>
<td>SUWARTI</td>
<td>`3519084808650001</td>
<td>`</td>
<td>BANJARSARI</td>
<td>MADIUN</td>
<td>MADIUN</td>
<td>08-08-1965</td>
<td>53</td>
<td>P</td>
<td>POLI UMUM</td>
<td>LAMA</td>
<td>KASUS LAMA</td>
<td>BPJS</td>
<td>`0002227577589</td>
<td>130802030519Y000711</td>
<td align='center'>
E11.8 </td>
</tr>

<td>138</td>
<td>10-05-2019</td>
<td>000206</td>
<td>MARIYONO</td>
<td>` -</td>
<td>`3577012303150001</td>
<td>KELUN</td>
<td>KARTOHARJO</td>
<td>05-09-1969</td>
<td>49</td>
<td>L</td>
<td>POLI UMUM</td>
<td>LAMA</td>
<td>KASUS BARU</td>
<td>BPJS</td>
<td>PBI (APBN)</td>
<td>`0000786815381</td>
<td>130802030519Y000714</td>
<td align='center'>
I64 </td>
</tr>

<td>139</td>
<td>10-05-2019</td>
<td>004108</td>
<td>YUNITA ANA TRIHADI</td>
<td>`3577015606780003</td>
<td>`3577010310110003</td>
<td>KELUN</td>
<td>KARTOHARJO</td>
<td>16-06-1978</td>
<td>40</td>
<td>P</td>
<td>POLI UMUM</td>
<td>LAMA</td>
<td>KASUS BARU</td>
<td>BPJS</td>
<td>PBI (APBD)</td>
<td>`0002202208468</td>
<td>130802030519Y000709</td>
<td align='center'>
R07.3 </td>
</tr>

<td>140</td>
<td>10-05-2019</td>
<td>001900</td>
<td>INDAH TRI SETIOWATI</td>
<td>`3519075607760004</td>
<td>`</td>
<td>TEMPURSARI</td>
<td>WUNGU</td>
<td>MADIUN</td>
<td>16-07-1976</td>
<td>42</td>
<td>P</td>
<td>POLI UMUM</td>
<td>LAMA</td>
<td>BPJS</td>
<td>PNS DAERAH</td>
<td>`0000106307289</td>
<td>130802030519Y000755</td>
<td align='center'>
E11 </td>
</tr>

<td>141</td>
<td>10-05-2019</td>
<td>002847</td>
<td>WITTY SARANITA RAHAYU</td>
<td>`2171075405879004</td>
<td>`3577010304180001</td>
<td>KELUN</td>
<td>KARTOHARJO</td>
<td>14-05-1987</td>
<td>32</td>
<td>P</td>
<td>POLI UMUM</td>
<td>LAMA</td>
<td>KASUS BARU</td>
<td>BPJS</td>
<td>PBI (APBD)</td>
<td>`0000365137391</td>
<td>130802030519Y001126</td>
<td align='center'>
H60.9 </td>
</tr>

<td>142</td>
<td>10-05-2019</td>
<td>011403</td>
<td>SUKARDI</td>
<td>`3577012009700002</td>
<td>`3577012104072336</td>
<td>KARTOHARJO</td>
<td>20-09-1970</td>
<td>48</td>
<td>L</td>
<td>POLI UMUM</td>
<td>LAMA</td>
<td>KASUS BARU</td>
<td>BPJS</td>
<td>PBI (APBN)</td>
<td>`0000787316444</td>
<td>130802030519Y000757</td>
<td align='center'>
W49 </td>
</tr>

<td>143</td>
<td>10-05-2019</td>
<td>003070</td>
<td>`</td>
<td>`</td>
<td>KARTOHARJO</td>
<td>01-03-1997</td>
<td>22</td>
<td>L</td>
<td>POLI UMUM</td>
<td>LAMA</td>
<td>KASUS BARU</td>
<td>BPJS</td>
<td>PBI (APBN)</td>
<td>`0000786811781</td>
<td>130802030519Y000758</td>
<td align='center'>
R50.9 </td>
</tr>

<td>144</td>
<td>10-05-2019</td>
<td>010199</td>
<td>MARIYA HARTANTI</td>
<td>`3519074511880002</td>
<td>`</td>
<td>WUNGU</td>
<td>MADIUN</td>
<td>05-11-1988</td>
<td>30</td>
<td>P</td>
<td>POLI UMUM</td>
<td>LAMA</td>
<td>KASUS BARU</td>
<td>BPJS</td>
<td>`0002312653397</td>
<td>130802030519Y000759</td>
<td align='center'>
K12 </td>
</tr>

<td>145</td>
<td>10-05-2019</td>
<td>005532</td>
<td>SIYAM</td>
<td>`</td>
<td>`</td>
<td>BANJARSARI</td>
<td>MADIUN</td>
<td>MADIUN</td>
<td>24-05-1966</td>
<td>53</td>
<td>P</td>
<td>POLI UMUM</td>
<td>LAMA</td>
<td>KASUS LAMA</td>
<td>BPJS</td>
<td>PBI (APBN)</td>
<td>`0001995325997</td>
<td>130802030519Y000719</td>
<td align='center'>
E11 </td>
</tr>

<td>146</td>
<td>10-05-2019</td>
<td>002301</td>
<td>JARENDA DEVEGA KUSUMAWARDHANI</td>
<td>`3577016712940001</td>
<td>`3577012104078736</td>
<td>KELUN</td>
<td>KARTOHARJO</td>
<td>27-12-1994</td>
<td>24</td>
<td>P</td>
<td>POLI UMUM</td>
<td>LAMA</td>
<td>KASUS BARU</td>
<td>BPJS</td>
<td>`0002269639618</td>
<td>130802030519Y000763</td>
<td align='center'>
K30 </td>
</tr>

<td>147</td>
<td>10-05-2019</td>
<td>012315</td>
<td>KRISMA ALDI PUTRA</td>
<td>`</td>
<td>`</td>
<td>SUKOSARI</td>
<td>KARTOHARJO</td>
<td>MADIUN</td>
<td>28-12-1998</td>
<td>20</td>
<td>P</td>
<td>POLI UMUM</td>
<td>LAMA</td>
<td>KASUS BARU</td>
<td>BPJS</td>
<td>PBI (APBN)</td>
<td>`0000786730702</td>
<td>130802030519Y000722</td>
<td align='center'>
T15.9 </td>
</tr>
<td>148</td>
<td>10-05-2019</td>
<td>010560</td>
<td>DWI LESTARI</td>
<td>`3577016401860003</td>
<td>`3577012805150003</td>
<td>KARTOHARJO</td>
<td>24-01-1986</td>
<td>33</td>
<td>P</td>
<td>POLI UMUM</td>
<td>LAMA</td>
<td>KASUS BARU</td>
<td>BPJS</td>
<td>PBI (APBD)</td>
<td>`0001704820511</td>
<td>130802030519Y000734</td>
<td align='center'>
J45 </td>
</tr>

<td>149</td>
<td>10-05-2019</td>
<td>005111</td>
<td>DARTI</td>
<td>`</td>
<td>`</td>
<td>REJOMULYO</td>
<td>KARTOHARJO</td>
<td>17-07-1976</td>
<td>42</td>
<td>P</td>
<td>POLI UMUM</td>
<td>LAMA</td>
<td>KASUS BARU</td>
<td>BPJS</td>
<td>PBI (APBD)</td>
<td>`0001704807358</td>
<td>130802030519Y000766</td>
<td align='center'>
M79.1 </td>
</tr>

<td>150</td>
<td>10-05-2019</td>
<td>009403</td>
<td>SELVIE ARSITA ARIEN SAPUTRI</td>
<td>`3577016703910002</td>
<td>`3577012104078495</td>
<td>KELUN</td>
<td>KARTOHARJO</td>
<td>27-03-1991</td>
<td>28</td>
<td>P</td>
<td>POLI UMUM</td>
<td>LAMA</td>
<td>KASUS BARU</td>
<td>BPJS</td>
<td>PBI (APBD)</td>
<td>`0001276639457</td>
<td>130802030519Y000770</td>
<td align='center'>
J11 </td>
</tr>

<td>151</td>
<td>10-05-2019</td>
<td>009963</td>
<td>YENNI PUJIANTO</td>
<td>`3577014810820004</td>
<td>`3577012701100006</td>
<td>REJOMULYO</td>
<td>KARTOHARJO</td>
<td>08-10-1982</td>
<td>36</td>
<td>P</td>
<td>POLI UMUM</td>
<td>LAMA</td>
<td>KASUS BARU</td>
<td>BPJS</td>
<td>PBI (APBD)</td>
<td>`0002200047974</td>
<td>130802030519Y000731</td>
<td align='center'>
G44 </td>
</tr>

<td>152</td>
<td>10-05-2019</td>
<td>011124</td>
<td>FITRIA SARI</td>
<td>`</td>
<td>`</td>
<td>SIRAPAN</td>
<td>MADIUN</td>
<td>MADIUN</td>
<td>05-11-1988</td>
<td>30</td>
<td>P</td>
<td>POLI UMUM</td>
<td>LAMA</td>
<td>KASUS BARU</td>
<td>BPJS</td>
<td>`0002197891416</td>
<td>130802030519Y000772</td>
<td align='center'>
H10 </td>
</tr>

<td>153</td>
<td>10-05-2019</td>
<td>006740</td>
<td>IDHAM CHALID</td>
<td>`3577010803660001</td>
<td>`3577012004078003</td>
<td>REJOMULYO</td>
<td>KARTOHARJO</td>
<td>08-03-1966</td>
<td>53</td>
<td>L</td>
<td>POLI UMUM</td>
<td>LAMA</td>
<td>KASUS BARU</td>
<td>BPJS</td>
<td>PBI (APBD)</td>
<td>`0001704808719</td>
<td>130802030519Y000735</td>
<td align='center'>
H40.9 </td>
</tr>

<td>154</td>
<td>10-05-2019</td>
<td>004133</td>
<td>NURYANI</td>
<td>`3577016511720001</td>
<td>`3577012104077847</td>
<td>KELUN</td>
<td>KARTOHARJO</td>
<td>25-11-1972</td>
<td>46</td>
<td>P</td>
<td>POLI UMUM</td>
<td>LAMA</td>
<td>KASUS BARU</td>
<td>BPJS</td>
<td>PBI (APBD)</td>
<td>`0002413881404</td>
<td>130802030519Y000736</td>
<td align='center'>
M67.4 </td>
</tr>

<td>155</td>
<td>13-05-2019</td>
<td>012348</td>
<td>GALIH SETYO BASWOKO</td>
<td>`3577011206810003</td>
<td>`3577010209100006</td>
<td>KARTOHARJO</td>
<td>12-06-1981</td>
<td>37</td>
<td>L</td>
<td>POLI UMUM</td>
<td>BARU</td>
<td>KASUS BARU</td>
<td>BPJS</td>
<td>`0001822129255</td>
<td>130802030519Y000835</td>
<td align='center'>
J00 </td>
</tr>

<td>156</td>
<td>13-05-2019</td>
<td>012368</td>
<td>NURYANTI</td>
<td>`3577015710700003</td>
<td>`3577012104078523</td>
<td>KELUN</td>
<td>KARTOHARJO</td>
<td>17-10-1970</td>
<td>48</td>
<td>P</td>
<td>POLI UMUM</td>
<td>BARU</td>
<td>KASUS BARU</td>
<td>BPJS</td>
<td>PBI (APBD)</td>
<td>`0002163616097</td>
<td>130802030519Y000840</td>
<td align='center'>
H60.8 </td>
</tr>

<td>157</td>
<td>13-05-2019</td>
<td>007548</td>
<td>WIJI LESTARI</td>
<td>`</td>
<td>`</td>
<td>REJOMULYO</td>
<td>KARTOHARJO</td>
<td>MADIUN</td>
<td>18-02-1989</td>
<td>30</td>
<td>P</td>
<td>POLI UMUM</td>
<td>LAMA</td>
<td>KASUS BARU</td>
<td>BPJS</td>
<td>PBI (APBN)</td>
<td>`0000786424961</td>
<td>130802030519Y000847</td>
<td align='center'>
R51 </td>
</tr>

<td>158</td>
<td>13-05-2019</td>
<td>000190</td>
<td>DHEVA PRATAMA ADY SAPUTRA</td>
<td>`3577011107000004</td>
<td>`3577012104072693</td>
<td>KARTOHARJO</td>
<td>11-07-2000</td>
<td>18</td>
<td>L</td>
<td>POLI UMUM</td>
<td>LAMA</td>
<td>BPJS</td>
<td>PBI (APBD)</td>
<td>`0001704818452</td>
<td>130802030519Y000799</td>
<td align='center'>
F99 </td>
</tr>

<td>159</td>
<td>13-05-2019</td>
<td>001535</td>
<td>RETNO DEWI WULANDARI</td>
<td>`</td>
<td>`</td>
<td>TAWANGREJO</td>
<td>KARTOHARJO</td>
<td>12-02-1987</td>
<td>32</td>
<td>P</td>
<td>POLI UMUM</td>
<td>LAMA</td>
<td>BPJS</td>
<td></td>
<td>`0002163611248</td>
<td>130802030519Y000796</td>
<td align='center'>
C50 </td>
</tr>

<td>160</td>
<td>13-05-2019</td>
<td>012208</td>
<td>NANDA NURAHMAD</td>
<td>`3577010205000006</td>
<td>`3577012104071470</td>
<td>KARTOHARJO</td>
<td>02-05-2000</td>
<td>19</td>
<td>L</td>
<td>POLI UMUM</td>
<td>LAMA</td>
<td>KASUS LAMA</td>
<td>BPJS</td>
<td>PBI (APBD)</td>
<td>`0001706779664</td>
<td>130802030519Y000853</td>
<td align='center'>
K30 </td>
</tr>

<td>161</td>
<td>13-05-2019</td>
<td>009084</td>
<td>NIKEN YEVININGTYAS</td>
<td>`3519017108910001</td>
<td>`3577010808160002</td>
<td>KARTOHARJO</td>
<td>31-08-1991</td>
<td>27</td>
<td>P</td>
<td>POLI UMUM</td>
<td>LAMA</td>
<td>KASUS BARU</td>
<td>BPJS</td>
<td>PBI (APBD)</td>
<td>`0002163590469</td>
<td>130802030519Y000855</td>
<td align='center'>
J00 </td>
</tr>

<td>162</td>
<td>13-05-2019</td>
<td>000067</td>
<td>SULASTRININGSIH</td>
<td>`3519086904690001</td>
<td>`</td>
<td>NGLAMES</td>
<td>MADIUN</td>
<td>MADIUN</td>
<td>01-04-1969</td>
<td>50</td>
<td>P</td>
<td>POLI UMUM</td>
<td>LAMA</td>
<td>KASUS BARU</td>
<td>BPJS</td>
<td>PBI (APBN)</td>
<td>`0000738256241</td>
<td>130802030519Y000856</td>
<td align='center'>
M13 </td>
</tr>

<td>163</td>
<td>13-05-2019</td>
<td>003071</td>
<td>`</td>
<td>`</td>
<td>KARTOHARJO</td>
<td>21-05-1969</td>
<td>50</td>
<td>P</td>
<td>POLI UMUM</td>
<td>LAMA</td>
<td>KASUS BARU</td>
<td>BPJS</td>
<td>PBI (APBD)</td>
<td>`0001704813311</td>
<td>130802030519Y000798</td>
<td align='center'>
L03.9 </td>
</tr>

<td>164</td>
<td>13-05-2019</td>
<td>001253</td>
<td>SUTIYAR</td>
<td>`3519086303670002</td>
<td>`</td>
<td>SUMBEREJO</td>
<td>MADIUN</td>
<td>MADIUN</td>
<td>01-01-1967</td>
<td>52</td>
<td>P</td>
<td>POLI UMUM</td>
<td>LAMA</td>
<td>KASUS LAMA</td>
<td>BPJS</td>
<td>PNS DAERAH</td>
<td>`0000100481747</td>
<td></td>
<td align='center'>
E10Insulin </td>
</tr>

<td>165</td>
<td>13-05-2019</td>
<td>004852</td>
<td>RAMINI</td>
<td>`3519084706730001</td>
<td>`</td>
<td>BANJARSARI</td>
<td>MADIUN</td>
<td>MADIUN</td>
<td>07-06-1973</td>
<td>45</td>
<td>P</td>
<td>POLI UMUM</td>
<td>LAMA</td>
<td>KASUS BARU</td>
<td>BPJS</td>
<td>`0002499336933</td>
<td>130802030519Y000865</td>
<td align='center'>
M13 </td>
</tr>

<td>166</td>
<td>13-05-2019</td>
<td>009807</td>
<td>SULASTRININGSIH</td>
<td>`3577015001820003</td>
<td>`3577012705150003</td>
<td>KARTOHARJO</td>
<td>10-01-1982</td>
<td>37</td>
<td>P</td>
<td>POLI UMUM</td>
<td>LAMA</td>
<td>KASUS BARU</td>
<td>BPJS</td>
<td></td>
<td>`0000787283785</td>
<td>130802030519Y000867</td>
<td align='center'>
H82 </td>
</tr>

<td>167</td>
<td>13-05-2019</td>
<td>003193</td>
<td>LILIK YUNI ISTILAH</td>
<td>`3577016106650006</td>
<td>`</td>
<td>KELUN</td>
<td>KARTOHARJO</td>
<td>21-06-1965</td>
<td>53</td>
<td>P</td>
<td>POLI UMUM</td>
<td>LAMA</td>
<td>KASUS BARU</td>
<td>BPJS</td>
<td>PBI (APBD)</td>
<td>`0002163617199</td>
<td>130802030519Y000800</td>
<td align='center'>
D17 </td>
</tr>

<td>168</td>
<td>13-05-2019</td>
<td>005827</td>
<td>ANDRIANA SUSANTI</td>
<td>`</td>
<td>`</td>
<td>TAWANGREJO</td>
<td>KARTOHARJO</td>
<td>10-09-1975</td>
<td>43</td>
<td>P</td>
<td>POLI UMUM</td>
<td>LAMA</td>
<td>KASUS BARU</td>
<td>BPJS</td>
<td>PBI (APBD)</td>
<td>`0002163610023</td>
<td>130802030519Y000870</td>
<td align='center'>
K29.7 </td>
</tr>

<td>169</td>
<td>13-05-2019</td>
<td>001980</td>
<td>SUTRI</td>
<td>`3577017112660005</td>
<td>`3577010301110014</td>
<td>KARTOHARJO</td>
<td>31-12-1966</td>
<td>52</td>
<td>P</td>
<td>POLI UMUM</td>
<td>LAMA</td>
<td>KASUS BARU</td>
<td>BPJS</td>
<td>PBI (APBN)</td>
<td>`0000786599943</td>
<td>130802030519Y000872</td>
<td align='center'>
M79.1 </td>
</tr>

<td>170</td>
<td>13-05-2019</td>
<td>010311</td>
<td>OKI TRI KUNCORO</td>
<td>`3577011307980004</td>
<td>`3577012004078673</td>
<td>REJOMULYO</td>
<td>KARTOHARJO</td>
<td>13-07-1998</td>
<td>20</td>
<td>L</td>
<td>POLI UMUM</td>
<td>LAMA</td>
<td>KASUS BARU</td>
<td>BPJS</td>
<td>PBI (APBN)</td>
<td>`0000786392695</td>
<td>130802030519Y000881</td>
<td align='center'>
J11 </td>
</tr>

<td>171</td>
<td>13-05-2019</td>
<td>001619</td>
<td>MISIRAH</td>
<td>`3519076701660002</td>
<td>`</td>
<td>TEMPURSARI</td>
<td>WUNGU</td>
<td>MADIUN</td>
<td>27-01-1966</td>
<td>53</td>
<td>P</td>
<td>POLI UMUM</td>
<td>LAMA</td>
<td>KASUS LAMA</td>
<td>BPJS</td>
<td>`0002320591858</td>
<td>130802030519Y000810</td>
<td align='center'>
R10 </td>
</tr>

<td>172</td>
<td>13-05-2019</td>
<td>012197</td>
<td>FITRI YULIANA</td>
<td>`1471074809810041</td>
<td>`</td>
<td>BANJARSARI</td>
<td>MADIUN</td>
<td>MADIUN</td>
<td>08-09-1981</td>
<td>37</td>
<td>P</td>
<td>POLI UMUM</td>
<td>LAMA</td>
<td>KASUS BARU</td>
<td>BPJS</td>
<td>PRAJURIT AD</td>
<td>`0001107538266</td>
<td>130802030519Y000888</td>
<td align='center'>
K29 </td>
</tr>

<td>173</td>
<td>13-05-2019</td>
<td>006961</td>
<td>SAMSUL ARIFIN</td>
<td>`3577013011000001</td>
<td>`</td>
<td>KARTOHARJO</td>
<td>30-11-2000</td>
<td>18</td>
<td>L</td>
<td>POLI UMUM</td>
<td>LAMA</td>
<td></td>
<td>BPJS</td>
<td>PBI (APBD)</td>
<td>`0001704811825</td>
<td>130802030519Y000889</td>
<td align='center'>
J00 </td>
</tr>

<td>174</td>
<td>13-05-2019</td>
<td>008255</td>
<td>YAHMA</td>
<td>`3577011706650005</td>
<td>`3577012104079122</td>
<td>KELUN</td>
<td>KARTOHARJO</td>
<td>17-07-1965</td>
<td>53</td>
<td>L</td>
<td>Pensiunan</td>
<td>POLI UMUM</td>
<td>LAMA</td>
<td>KASUS LAMA</td>
<td>BPJS</td>
<td>PRAJURIT AD</td>
<td>`0001104770766</td>
<td>130802030519Y000815</td>
<td align='center'>
I25.2 </td>
</tr>

<td>175</td>
<td>13-05-2019</td>
<td>003092</td>
<td>ISTIRUNI</td>
<td>`</td>
<td>`3577012811080008</td>
<td>TAWANGREJO</td>
<td>KARTOHARJO</td>
<td>30-08-1976</td>
<td>42</td>
<td>P</td>
<td>POLI UMUM</td>
<td>LAMA</td>
<td>KASUS BARU</td>
<td>BPJS</td>
<td></td>
<td>`0002158644284</td>
<td>130802030519Y000893</td>
<td align='center'>
R51 </td>
</tr>

<td>176</td>
<td>13-05-2019</td>
<td>000562</td>
<td>SULIKAH</td>
<td>`3519074906770004</td>
<td>`</td>
<td>TEMPURSARI</td>
<td>WUNGU</td>
<td>MADIUN</td>
<td>09-06-1977</td>
<td>41</td>
<td>P</td>
<td>POLI UMUM</td>
<td>LAMA</td>
<td>KASUS BARU</td>
<td>BPJS</td>
<td>`0002083143543</td>
<td>130802030519Y000895</td>
<td align='center'>
E11 </td>
</tr>

<td>177</td>
<td>13-05-2019</td>
<td>011384</td>
<td>RITA DWININGSIH</td>
<td>`</td>
<td>`</td>
<td>REJOMULYO</td>
<td>KARTOHARJO</td>
<td>19-03-1973</td>
<td>46</td>
<td>P</td>
<td>POLI UMUM</td>
<td>LAMA</td>
<td>KASUS BARU</td>
<td>BPJS</td>
<td>PBI (APBD)</td>
<td>`0002413884824</td>
<td>130802030519Y000896</td>
<td align='center'>
J06 </td>
</tr>

<td>178</td>
<td>13-05-2019</td>
<td>001310</td>
<td>NURLYLA HAYATI</td>
<td>`3577016903700001</td>
<td>`3577012004078178</td>
<td>REJOMULYO</td>
<td>KARTOHARJO</td>
<td>29-03-1970</td>
<td>49</td>
<td>P</td>
<td>POLI UMUM</td>
<td>LAMA</td>
<td>BPJS</td>
<td>PBI (APBD)</td>
<td>`0002413938666</td>
<td>130802030519Y000913</td>
<td align='center'>
E11 </td>
</tr>

<td>179</td>
<td>13-05-2019</td>
<td>006927</td>
<td>KARNITI</td>
<td>`</td>
<td>`</td>
<td>TIRON</td>
<td>MADIUN</td>
<td>MADIUN</td>
<td>10-11-1964</td>
<td>54</td>
<td>P</td>
<td>POLI UMUM</td>
<td>LAMA</td>
<td>KASUS BARU</td>
<td>BPJS</td>
<td>`0002470435749</td>
<td>130802030519Y000829</td>
<td align='center'>
C50.9 </td>
</tr>

<td>180</td>
<td>13-05-2019</td>
<td>007683</td>
<td>SRI MARTINI</td>
<td>`</td>
<td>`</td>
<td>REJOMULYO</td>
<td>KARTOHARJO</td>
<td>17-11-1966</td>
<td>52</td>
<td>P</td>
<td>POLI UMUM</td>
<td>LAMA</td>
<td>KASUS BARU</td>
<td>BPJS</td>
<td>PBI (APBD)</td>
<td>`0002413941838</td>
<td>130802030519Y000906</td>
<td align='center'>
W49 </td>
</tr>

<td>181</td>
<td>13-05-2019</td>
<td>012370</td>
<td>INDRAS SEVTINA SANTOSO</td>
<td>`</td>
<td>`</td>
<td>TIRON</td>
<td>MADIUN</td>
<td>MADIUN</td>
<td>30-09-1987</td>
<td>31</td>
<td>P</td>
<td>POLI UMUM</td>
<td>LAMA</td>
<td>KASUS BARU</td>
<td>UMUM</td>
<td></td>
<td>`</td>
<td></td>
<td align='center'>
H60 </td>
</tr>

<td>182</td>
<td>13-05-2019</td>
<td>002596</td>
<td>SOTIPATUN</td>
<td>`</td>
<td>`</td>
<td>REJOMULYO</td>
<td>KARTOHARJO</td>
<td>18-09-1964</td>
<td>54</td>
<td>P</td>
<td>Pensiunan</td>
<td>POLI UMUM</td>
<td>LAMA</td>
<td>BPJS</td>
<td>`0001275531063</td>
<td>130802030519Y000914</td>
<td align='center'>
I25.9 </td>
</tr>
<td>183</td>
<td>14-05-2019</td>
<td>012392</td>
<td>IMAM MUZAIDIN</td>
<td>`3577011103710001</td>
<td>`3577012104071793</td>
<td>KARTOHARJO</td>
<td>11-03-1971</td>
<td>48</td>
<td>L</td>
<td>POLI UMUM</td>
<td>BARU</td>
<td>KASUS BARU</td>
<td>BPJS</td>
<td>PBI (APBD)</td>
<td>`0001704815627</td>
<td>130802030519Y000936</td>
<td align='center'>
I21 </td>
</tr>

<td>184</td>
<td>14-05-2019</td>
<td>012395</td>
<td>AGUS PRAMONO</td>
<td>`3577011410650001</td>
<td>`3577012104071504</td>
<td>KARTOHARJO</td>
<td>14-10-1965</td>
<td>53</td>
<td>L</td>
<td>POLI UMUM</td>
<td>BARU</td>
<td>KASUS BARU</td>
<td>BPJS</td>
<td>PBI (APBD)</td>
<td>`0001704814828</td>
<td>130802030519Y000940</td>
<td align='center'>
R10 </td>
</tr>

<td>185</td>
<td>14-05-2019</td>
<td>012401</td>
<td>SHINTA AYU TRI SUGIARTO</td>
<td>`</td>
<td>`</td>
<td>NGLAMES</td>
<td>MADIUN</td>
<td>MADIUN</td>
<td>03-04-2000</td>
<td>19</td>
<td>P</td>
<td>POLI UMUM</td>
<td>BARU</td>
<td>KASUS BARU</td>
<td>BPJS</td>
<td>`0002758572292</td>
<td>130802030519Y000982</td>
<td align='center'>
J03.9 </td>
</tr>

<td>186</td>
<td>14-05-2019</td>
<td>012403</td>
<td>WIWIK NURAINI</td>
<td>`3577016308940001</td>
<td>`3577011902140003</td>
<td>REJOMULYO</td>
<td>KARTOHARJO</td>
<td>23-08-1994</td>
<td>24</td>
<td>P</td>
<td>POLI UMUM</td>
<td>BARU</td>
<td>KASUS BARU</td>
<td>BPJS</td>
<td>PBI (APBN)</td>
<td>`0000786561298</td>
<td>130802030519Y001032</td>
<td align='center'>
B02 </td>
</tr>

<td>187</td>
<td>14-05-2019</td>
<td>012417</td>
<td>PRASETYANINGRUM</td>
<td>`3578012901830003</td>
<td>`</td>
<td>KARTOHARJO</td>
<td>29-11-1976</td>
<td>42</td>
<td>P</td>
<td>POLI UMUM</td>
<td>BARU</td>
<td>KASUS BARU</td>
<td>BPJS</td>
<td>`0001652232723</td>
<td>130802030519Y001034</td>
<td align='center'>
H10 </td>
</tr>

<td>188</td>
<td>14-05-2019</td>
<td>003042</td>
<td>SRI UMIYATI</td>
<td>`3519086612670001</td>
<td>`3577013001180006</td>
<td>KELUN</td>
<td>KARTOHARJO</td>
<td>26-12-1967</td>
<td>51</td>
<td>P</td>
<td>POLI UMUM</td>
<td>LAMA</td>
<td>KASUS BARU</td>
<td>BPJS</td>
<td>`0001962097569</td>
<td>130802030519Y000944</td>
<td align='center'>
M79.1 </td>
</tr>

<td>189</td>
<td>14-05-2019</td>
<td>011821</td>
<td>NUR SAPUTRA</td>
<td>`</td>
<td>`</td>
<td>WUNGU</td>
<td>MADIUN</td>
<td>23-03-1982</td>
<td>37</td>
<td>L</td>
<td>POLI UMUM</td>
<td>LAMA</td>
<td>KASUS BARU</td>
<td>BPJS</td>
<td>`0002750129796</td>
<td>130802030519Y000946</td>
<td align='center'>
E11.4 </td>
</tr>

<td>190</td>
<td>14-05-2019</td>
<td>001842</td>
<td>UMI SALAMAH</td>
<td>`3519085812680002</td>
<td>`</td>
<td>DEMPELAN</td>
<td>MADIUN</td>
<td>MADIUN</td>
<td>18-12-1968</td>
<td>50</td>
<td>P</td>
<td>POLI UMUM</td>
<td>LAMA</td>
<td>KASUS BARU</td>
<td>BPJS</td>
<td>`0002457429535</td>
<td>130802030519Y000951</td>
<td align='center'>
H01.9 </td>
</tr>

<td>191</td>
<td>14-05-2019</td>
<td>009084</td>
<td>NIKEN YEVININGTYAS</td>
<td>`3519017108910001</td>
<td>`3577010808160002</td>
<td>KARTOHARJO</td>
<td>31-08-1991</td>
<td>27</td>
<td>P</td>
<td>POLI UMUM</td>
<td>LAMA</td>
<td>KASUS BARU</td>
<td>BPJS</td>
<td>PBI (APBD)</td>
<td>`0002163590469</td>
<td>130802030519Y000961</td>
<td align='center'>
R50 </td>
</tr>

<td>192</td>
<td>14-05-2019</td>
<td>011779</td>
<td>SITI AISAH</td>
<td>`3577014707660002</td>
<td>`3577012502140007</td>
<td>KARTOHARJO</td>
<td>07-07-1966</td>
<td>52</td>
<td>P</td>
<td>POLI UMUM</td>
<td>LAMA</td>
<td>KASUS BARU</td>
<td>BPJS</td>
<td>PBI (APBD)</td>
<td>`0002163620856</td>
<td>130802030519Y000964</td>
<td align='center'>
E11.0 </td>
</tr>

<td>193</td>
<td>14-05-2019</td>
<td>001207</td>
<td>ASNGARI</td>
<td>`3404052701760003</td>
<td>`3577012610100005</td>
<td>KELUN</td>
<td>KARTOHARJO</td>
<td>27-01-1976</td>
<td>43</td>
<td>L</td>
<td>POLI UMUM</td>
<td>LAMA</td>
<td>KASUS LAMA</td>
<td>BPJS</td>
<td>PBI (APBN)</td>
<td>`0000786325904</td>
<td>130802030519Y000965</td>
<td align='center'>
E11 </td>
</tr>

<td>194</td>
<td>14-05-2019</td>
<td>007637</td>
<td>DIMAS NUR CAHYO</td>
<td>` 3577011403970001</td>
<td>`3577010901090002</td>
<td>REJOMULYO</td>
<td>KARTOHARJO</td>
<td>14-03-1997</td>
<td>22</td>
<td>L</td>
<td>POLI UMUM</td>
<td>dr. YOHANES YOYOK W A</td>
<td>LAMA</td>
<td>KASUS BARU</td>
<td>BPJS</td>
<td>PBI (APBN)</td>
<td>`0000787065107</td>
<td>130802030519Y000930</td>
<td align='center'>
J45 </td>
</tr>

<td>195</td>
<td>14-05-2019</td>
<td>012394</td>
<td>RETNO DJUMILAH</td>
<td>`</td>
<td>`</td>
<td>TIRON</td>
<td>MADIUN</td>
<td>MADIUN</td>
<td>06-05-1974</td>
<td>45</td>
<td>P</td>
<td>POLI UMUM</td>
<td>BARU</td>
<td>KASUS BARU</td>
<td>UMUM</td>
<td></td>
<td>`</td>
<td></td>
<td align='center'>
M54.5 </td>
</tr>

<td>196</td>
<td>14-05-2019</td>
<td>003092</td>
<td>ISTIRUNI</td>
<td>`</td>
<td>`3577012811080008</td>
<td>TAWANGREJO</td>
<td>KARTOHARJO</td>
<td>30-08-1976</td>
<td>42</td>
<td>P</td>
<td>POLI UMUM</td>
<td>LAMA</td>
<td>KASUS BARU</td>
<td>BPJS</td>
<td></td>
<td>`0002158644284</td>
<td>130802030519Y000934</td>
<td align='center'>
H52.7 </td>
</tr>

<td>197</td>
<td>14-05-2019</td>
<td>003581</td>
<td>IIF YULIANA</td>
<td>`</td>
<td>`</td>
<td>KARTOHARJO</td>
<td>05-11-1967</td>
<td>51</td>
<td>P</td>
<td>POLI UMUM</td>
<td>LAMA</td>
<td>KASUS LAMA</td>
<td>BPJS</td>
<td>PBI (APBD)</td>
<td>`0001704814839</td>
<td>130802030519Y000931</td>
<td align='center'>
I25.2 </td>
</tr>

<td>198</td>
<td>14-05-2019</td>
<td>012397</td>
<td>SRI SAYUTI</td>
<td>`</td>
<td>`</td>
<td>SUMBEREJO</td>
<td>MADIUN</td>
<td>MADIUN</td>
<td>16-06-1967</td>
<td>51</td>
<td>P</td>
<td>POLI UMUM</td>
<td>BARU</td>
<td></td>
<td>UMUM</td>
<td></td>
<td>`</td>
<td></td>
<td align='center'>
L23 </td>
</tr>

<td>199</td>
<td>14-05-2019</td>
<td>001934</td>
<td>ANITA MEGAWATI</td>
<td>`3577014111870004</td>
<td>`3577012311170002</td>
<td>KARTOHARJO</td>
<td>01-11-1987</td>
<td>31</td>
<td>P</td>
<td>POLI UMUM</td>
<td>LAMA</td>
<td>KASUS BARU</td>
<td>BPJS</td>
<td>PBI (APBN)</td>
<td>`0000786923043</td>
<td>130802030519Y000973</td>
<td align='center'>
R51 </td>
</tr>

<td>200</td>
<td>14-05-2019</td>
<td>008210</td>
<td>YOGGA DWI HARDHIANTO</td>
<td>`</td>
<td>`</td>
<td>REJOMULYO</td>
<td>KARTOHARJO</td>
<td>27-05-1991</td>
<td>28</td>
<td>L</td>
<td>Wiraswasta</td>
<td>POLI UMUM</td>
<td>LAMA</td>
<td>KASUS LAMA</td>
<td>BPJS</td>
<td>`0002413930375</td>
<td>130802030519Y000939</td>
<td align='center'>
S42.20 </td>
</tr>

<td>201</td>
<td>14-05-2019</td>
<td>011403</td>
<td>SUKARDI</td>
<td>`3577012009700002</td>
<td>`3577012104072336</td>
<td>KARTOHARJO</td>
<td>20-09-1970</td>
<td>48</td>
<td>L</td>
<td>POLI UMUM</td>
<td>LAMA</td>
<td>BPJS</td>
<td>PBI (APBN)</td>
<td>`0000787316444</td>
<td>130802030519Y001025</td>
<td align='center'>
I84.5 </td>
</tr>

<td>202</td>
<td>14-05-2019</td>
<td>003108</td>
<td>SUKARMI</td>
<td>`3519086704650002</td>
<td>`</td>
<td>TIRON</td>
<td>MADIUN</td>
<td>MADIUN</td>
<td>27-04-1965</td>
<td>54</td>
<td>P</td>
<td>POLI UMUM</td>
<td>LAMA</td>
<td>KASUS BARU</td>
<td>BPJS</td>
<td>`0001281998261</td>
<td>130802030519Y001023</td>
<td align='center'>
H69.9 </td>
</tr>

<td>203</td>
<td>14-05-2019</td>
<td>007940</td>
<td>DINDRA MEGA LUTFIANSA</td>
<td>`3577015310930002</td>
<td>`3577011805110011</td>
<td>REJOMULYO</td>
<td>KARTOHARJO</td>
<td>13-10-1993</td>
<td>25</td>
<td>P</td>
<td>Karyawan BUMN</td>
<td>POLI UMUM</td>
<td>LAMA</td>
<td>KASUS BARU</td>
<td>BPJS</td>
<td>`0001820484562</td>
<td>130802030519Y001064</td>
<td align='center'>
A06.0 </td>
</tr>

<td>204</td>
<td>14-05-2019</td>
<td>002946</td>
<td>ENDAH SURYANINGRUM</td>
<td>`3577010000 </td>
<td>`</td>
<td>KELUN</td>
<td>KARTOHARJO</td>
<td>01-06-1965</td>
<td>53</td>
<td>P</td>
<td>POLI UMUM</td>
<td>LAMA</td>
<td>KASUS LAMA</td>
<td>BPJS</td>
<td>PNS DAERAH</td>
<td>`0000105095204</td>
<td>130802030519Y000980</td>
<td align='center'>
I15 </td>
</tr>

<td>205</td>
<td>14-05-2019</td>
<td>012413</td>
<td>RIFAI GHOFILIN</td>
<td>`</td>
<td>`</td>
<td>BANJARSARI</td>
<td>MADIUN</td>
<td>MADIUN</td>
<td>04-07-1996</td>
<td>22</td>
<td>L</td>
<td>POLI UMUM</td>
<td>BARU</td>
<td>KASUS BARU</td>
<td>UMUM</td>
<td></td>
<td>`</td>
<td></td>
<td align='center'>
J11 </td>
</tr>

<td>206</td>
<td>14-05-2019</td>
<td>008805</td>
<td>`3519086707640002</td>
<td>`</td>
<td>SUMBEREJO</td>
<td>MADIUN</td>
<td>MADIUN</td>
<td>27-07-1964</td>
<td>54</td>
<td>P</td>
<td>Guru</td>
<td>POLI UMUM</td>
<td>LAMA</td>
<td>KASUS BARU</td>
<td>BPJS</td>
<td>`0001860078914</td>
<td>130802030519Y001067</td>
<td align='center'>
J06.9 </td>
</tr>
<td>207</td>
<td>14-05-2019</td>
<td>012418</td>
<td>YULAIKA</td>
<td>`</td>
<td>`</td>
<td>TIRON</td>
<td>MADIUN</td>
<td>MADIUN</td>
<td>15-05-1969</td>
<td>50</td>
<td>P</td>
<td>POLI UMUM</td>
<td>BARU</td>
<td>KASUS BARU</td>
<td>UMUM</td>
<td></td>
<td>`</td>
<td></td>
<td align='center'>
M54.58 </td>
</tr>

<td>208</td>
<td>14-05-2019</td>
<td>012408</td>
<td>ANITA PRAWARDANI</td>
<td>`3577015908890001</td>
<td>`3577012806130007</td>
<td>KLEGEN</td>
<td>KARTOHARJO</td>
<td>19-08-1989</td>
<td>29</td>
<td>P</td>
<td>POLI UMUM</td>
<td>BARU</td>
<td>KASUS BARU</td>
<td>BPJS</td>
<td>`0001880741518</td>
<td>130802030519Y001070</td>
<td align='center'>
M54.5 </td>
</tr>

<td>209</td>
<td>15-05-2019</td>
<td>012431</td>
<td>RIZKY PRAMUDYA</td>
<td>`3577010209000002</td>
<td>`3577012104071841</td>
<td>KARTOHARJO</td>
<td>02-09-2000</td>
<td>18</td>
<td>L</td>
<td>POLI UMUM</td>
<td>BARU</td>
<td>KASUS BARU</td>
<td>BPJS</td>
<td>`0000787201795</td>
<td>130802030519Y001095</td>
<td align='center'>
R52 </td>
</tr>

<td>210</td>
<td>15-05-2019</td>
<td>012433</td>
<td>ARDYAN MOCHTARROFIQ AJI</td>
<td>`3519072903980001</td>
<td>`</td>
<td>TEMPURSARI</td>
<td>WUNGU</td>
<td>MADIUN</td>
<td>01-03-1998</td>
<td>21</td>
<td>L</td>
<td>POLI UMUM</td>
<td>BARU</td>
<td>KASUS BARU</td>
<td>UMUM</td>
<td>PBI (APBN)</td>
<td>`0001045293816</td>
<td></td>
<td align='center'>
R50.9 </td>
</tr>

<td>211</td>
<td>15-05-2019</td>
<td>012443</td>
<td>BUDIYAH</td>
<td>`3519085308670002</td>
<td>`</td>
<td>SUMBEREJO</td>
<td>MADIUN</td>
<td>MADIUN</td>
<td>13-08-1967</td>
<td>51</td>
<td>P</td>
<td>POLI UMUM</td>
<td>BARU</td>
<td>KASUS BARU</td>
<td>BPJS</td>
<td>`0002760253402</td>
<td>130802030519Y001150</td>
<td align='center'>
L08 </td>
</tr>

<td>212</td>
<td>15-05-2019</td>
<td>001801</td>
<td>ANIK SETIANI</td>
<td>` </td>
<td>`3577011005110003</td>
<td>KELUN</td>
<td>KARTOHARJO</td>
<td>01-01-1985</td>
<td>34</td>
<td>P</td>
<td>POLI UMUM</td>
<td>LAMA</td>
<td>KASUS BARU</td>
<td>BPJS</td>
<td>PBI (APBN)</td>
<td>`0000786690887</td>
<td>130802030519Y001100</td>
<td align='center'>
H10.9 </td>
</tr>

<td>213</td>
<td>15-05-2019</td>
<td>009194</td>
<td>PUJI LESTARI</td>
<td>`</td>
<td>`</td>
<td>REJOMULYO</td>
<td>KARTOHARJO</td>
<td>01-06-1977</td>
<td>41</td>
<td>P</td>
<td>POLI UMUM</td>
<td>LAMA</td>
<td>KASUS BARU</td>
<td>BPJS</td>
<td>PBI (APBN)</td>
<td>`0000787034182</td>
<td>130802030519Y001102</td>
<td align='center'>
J45.9 </td>
</tr>

<td>214</td>
<td>15-05-2019</td>
<td>007891</td>
<td>HARYONO</td>
<td>`3577011911750002</td>
<td>`3577012104071638</td>
<td>KARTOHARJO</td>
<td>19-11-1975</td>
<td>43</td>
<td>L</td>
<td>POLI UMUM</td>
<td>LAMA</td>
<td>KASUS BARU</td>
<td>BPJS</td>
<td>`0001155699628</td>
<td>130802030519Y001103</td>
<td align='center'>
M79.1 </td>
</tr>

<td>215</td>
<td>15-05-2019</td>
<td>002567</td>
<td>BUDI PURNOMO</td>
<td>`351932106730003</td>
<td>`</td>
<td>NGLAMES</td>
<td>MADIUN</td>
<td>MADIUN</td>
<td>21-06-1973</td>
<td>45</td>
<td>L</td>
<td>Tentara Nasional Indonesia</td>
<td>POLI UMUM</td>
<td>LAMA</td>
<td>KASUS LAMA</td>
<td>BPJS</td>
<td></td>
<td>`0001103209481</td>
<td>130802030519Y001086</td>
<td align='center'>
E11.8 </td>
</tr>

<td>216</td>
<td>15-05-2019</td>
<td>004956</td>
<td>TULIS SETYORINI</td>
<td>`3519084406780001</td>
<td>`</td>
<td>GUNUNGSARI</td>
<td>MADIUN</td>
<td>MADIUN</td>
<td>04-06-1978</td>
<td>40</td>
<td>P</td>
<td>POLI UMUM</td>
<td>LAMA</td>
<td>KASUS BARU</td>
<td>BPJS</td>
<td>`0001536589653</td>
<td>130802030519Y001105</td>
<td align='center'>
M06 </td>
</tr>

<td>217</td>
<td>15-05-2019</td>
<td>004337</td>
<td>`</td>
<td>`</td>
<td>BANJARSARI</td>
<td>MADIUN</td>
<td>MADIUN</td>
<td>10-02-1970</td>
<td>49</td>
<td>P</td>
<td>POLI UMUM</td>
<td>LAMA</td>
<td>BPJS</td>
<td>`0002216755506</td>
<td>130802030519Y001106</td>
<td align='center'>
I10 </td>
</tr>

<td>218</td>
<td>15-05-2019</td>
<td>001980</td>
<td>SUTRI</td>
<td>`3577017112660005</td>
<td>`3577010301110014</td>
<td>KARTOHARJO</td>
<td>31-12-1966</td>
<td>52</td>
<td>P</td>
<td>POLI UMUM</td>
<td>LAMA</td>
<td>BPJS</td>
<td>PBI (APBN)</td>
<td>`0000786599943</td>
<td>130802030519Y001108</td>
<td align='center'>
I10 </td>
</tr>

<td>219</td>
<td>15-05-2019</td>
<td>009312</td>
<td>SUYATUN</td>
<td>`3519086507810001</td>
<td>`</td>
<td>BANJARSARI</td>
<td>MADIUN</td>
<td>MADIUN</td>
<td>25-07-1981</td>
<td>37</td>
<td>P</td>
<td>POLI UMUM</td>
<td>LAMA</td>
<td>KASUS BARU</td>
<td>BPJS</td>
<td>`0002324706928</td>
<td>130802030519Y001109</td>
<td align='center'>
M79.1 </td>
</tr>

<td>220</td>
<td>15-05-2019</td>
<td>009310</td>
<td>FENDY YOGA PRATAMA</td>
<td>`3519080407000001</td>
<td>`</td>
<td>BANJARSARI</td>
<td>MADIUN</td>
<td>MADIUN</td>
<td>04-07-2000</td>
<td>18</td>
<td>L</td>
<td>POLI UMUM</td>
<td>LAMA</td>
<td>KASUS BARU</td>
<td>BPJS</td>
<td>`0002324707378</td>
<td>130802030519Y001110</td>
<td align='center'>
J00 </td>
</tr>

<td>221</td>
<td>15-05-2019</td>
<td>011631</td>
<td>RENGGA SETYO WIDODO</td>
<td>`3577010811930003</td>
<td>`3577012104079062</td>
<td>KELUN</td>
<td>KARTOHARJO</td>
<td>08-11-1993</td>
<td>25</td>
<td>L</td>
<td>POLI UMUM</td>
<td>LAMA</td>
<td>KASUS BARU</td>
<td>BPJS</td>
<td>`0000106471001</td>
<td>130802030519Y001156</td>
<td align='center'>
R50.9 </td>
</tr>

<td>222</td>
<td>15-05-2019</td>
<td>012220</td>
<td>ANIK PURWATI</td>
<td>`3577014902750002</td>
<td>`3577012104071670</td>
<td>KARTOHARJO</td>
<td>09-02-1975</td>
<td>44</td>
<td>P</td>
<td>POLI UMUM</td>
<td>LAMA</td>
<td>BPJS</td>
<td>PBI (APBN)</td>
<td>`0000787276787</td>
<td>130802030519Y001158</td>
<td align='center'>
D23 </td>
</tr>

<td>223</td>
<td>15-05-2019</td>
<td>011509</td>
<td>HERI CAHYONO</td>
<td>`3577011209940002</td>
<td>`3577012104079007</td>
<td>KELUN</td>
<td>KARTOHARJO</td>
<td>12-09-1994</td>
<td>24</td>
<td>L</td>
<td>POLI UMUM</td>
<td>LAMA</td>
<td>BPJS</td>
<td>PBI (APBD)</td>
<td>`0001245947321</td>
<td>130802030519Y001140</td>
<td align='center'>
G40.9 </td>
</tr>

<td>224</td>
<td>15-05-2019</td>
<td>000437</td>
<td>SULASMI</td>
<td>`3577015106650002</td>
<td>`3577012104072067</td>
<td>KARTOHARJO</td>
<td>11-06-1965</td>
<td>53</td>
<td>P</td>
<td>POLI UMUM</td>
<td>LAMA</td>
<td>KASUS LAMA</td>
<td>BPJS</td>
<td>PBI (APBD)</td>
<td>`0001704877075</td>
<td>130802030519Y001162</td>
<td align='center'>
K30 </td>
</tr>

<td>225</td>
<td>15-05-2019</td>
<td>002681</td>
<td>SUMARNI</td>
<td>`</td>
<td>`</td>
<td>TAWANGREJO</td>
<td>KARTOHARJO</td>
<td>MADIUN</td>
<td>04-11-1977</td>
<td>41</td>
<td>P</td>
<td>POLI UMUM</td>
<td>LAMA</td>
<td>KASUS BARU</td>
<td>BPJS</td>
<td></td>
<td>`0002158643564</td>
<td>130802030519Y001163</td>
<td align='center'>
K30 </td>
</tr>

<td>226</td>
<td>15-05-2019</td>
<td>002522</td>
<td>YAYUK PUJI ASTUTIK</td>
<td>`3519084104750003</td>
<td>`</td>
<td>MADIUN</td>
<td>MADIUN</td>
<td>01-04-1975</td>
<td>44</td>
<td>P</td>
<td>POLI UMUM</td>
<td>LAMA</td>
<td>KASUS BARU</td>
<td>BPJS</td>
<td>`0001801494279</td>
<td>130802030519Y001142</td>
<td align='center'>
C50.9 </td>
</tr>

<td>227</td>
<td>15-05-2019</td>
<td>005854</td>
<td>NIDYA SUKMA DEWI</td>
<td>`</td>
<td>`</td>
<td>KELUN</td>
<td>KARTOHARJO</td>
<td>19-11-1999</td>
<td>19</td>
<td>P</td>
<td>POLI UMUM</td>
<td>LAMA</td>
<td>KASUS BARU</td>
<td>BPJS</td>
<td>PBI (APBD)</td>
<td>`0001704819789</td>
<td>130802030519Y001167</td>
<td align='center'>
H00.0 </td>
</tr>

<td>228</td>
<td>15-05-2019</td>
<td>001818</td>
<td>HESTI WARDIYANI</td>
<td>`3577016505720001</td>
<td>`3577012004078909</td>
<td>REJOMULYO</td>
<td>KARTOHARJO</td>
<td>25-05-1972</td>
<td>47</td>
<td>P</td>
<td>POLI UMUM</td>
<td>LAMA</td>
<td>KASUS BARU</td>
<td>BPJS</td>
<td>PBI (APBN)</td>
<td>`0002176969724</td>
<td>130802030519Y001178</td>
<td align='center'>
F20.8 </td>
</tr>

<td>229</td>
<td>16-05-2019</td>
<td>012470</td>
<td>WACHID DWI CANDRA</td>
<td>`3577011309870002</td>
<td>`3577012405130002</td>
<td>KARTOHARJO</td>
<td>13-09-1987</td>
<td>31</td>
<td>L</td>
<td>POLI UMUM</td>
<td>BARU</td>
<td>KASUS BARU</td>
<td>BPJS</td>
<td>PBI (APBD)</td>
<td>`0001704820173</td>
<td>130802030519Y001207</td>
<td align='center'>
S52.5 </td>
</tr>

<td>230</td>
<td>16-05-2019</td>
<td>012471</td>
<td>TETRAWANTI ARUMI</td>
<td>`3577034609700005</td>
<td>`3577011204130003</td>
<td>KARTOHARJO</td>
<td>06-09-1970</td>
<td>48</td>
<td>P</td>
<td>POLI UMUM</td>
<td>BARU</td>
<td>KASUS BARU</td>
<td>BPJS</td>
<td>PBI (APBD)</td>
<td>`0002414003409</td>
<td>130802030519Y001223</td>
<td align='center'>
K59.0 </td>
</tr>

<td>231</td>
<td>16-05-2019</td>
<td>012475</td>
<td>ENDANG SUMARMIATI</td>
<td>`3577015309730003</td>
<td>`3577011502100009</td>
<td>KARTOHARJO</td>
<td>13-09-1973</td>
<td>45</td>
<td>P</td>
<td>POLI UMUM</td>
<td>BARU</td>
<td>KASUS BARU</td>
<td>BPJS</td>
<td>PBI (APBN)</td>
<td>`0000787236164</td>
<td>130802030519Y001225</td>
<td align='center'>
M79.1 </td>
</tr>

<td>232</td>
<td>16-05-2019</td>
<td>012484</td>
<td>HERU BASUKI</td>
<td>`</td>
<td>`</td>
<td>REJOMULYO</td>
<td>KARTOHARJO</td>
<td>09-10-1992</td>
<td>26</td>
<td>L</td>
<td>POLI UMUM</td>
<td>LAMA</td>
<td>BPJS</td>
<td>PBI (APBD)</td>
<td>`0002413946621</td>
<td>130802030519P001286</td>
<td align='center'>
K30 </td>
</tr>

<td>233</td>
<td>16-05-2019</td>
<td>011403</td>
<td>SUKARDI</td>
<td>`3577012009700002</td>
<td>`3577012104072336</td>
<td>KARTOHARJO</td>
<td>20-09-1970</td>
<td>48</td>
<td>L</td>
<td>POLI UMUM</td>
<td>LAMA</td>
<td>BPJS</td>
<td>PBI (APBN)</td>
<td>`0000787316444</td>
<td>130802030519Y001228</td>
<td align='center'>
W49 </td>
</tr>

<td>234</td>
<td>16-05-2019</td>
<td>003070</td>
<td>`</td>
<td>`</td>
<td>KARTOHARJO</td>
<td>01-03-1997</td>
<td>22</td>
<td>L</td>
<td>POLI UMUM</td>
<td>LAMA</td>
<td>KASUS BARU</td>
<td>BPJS</td>
<td>PBI (APBN)</td>
<td>`0000786811781</td>
<td>130802030519Y001198</td>
<td align='center'>
R10 </td>
</tr>

<td>235</td>
<td>16-05-2019</td>
<td>002507</td>
<td>SUYONO</td>
<td>`3577011501720001</td>
<td>`3577012104078136</td>
<td>KELUN</td>
<td>KARTOHARJO</td>
<td>15-01-1972</td>
<td>47</td>
<td>L</td>
<td>Buruh Tani / Perkebunan</td>
<td>POLI UMUM</td>
<td>LAMA</td>
<td>KASUS BARU</td>
<td>BPJS</td>
<td>PBI (APBN)</td>
<td>`0000786808001</td>
<td>130802030519Y001241</td>
<td align='center'>
M79.1 </td>
</tr>

<td>236</td>
<td>16-05-2019</td>
<td>012388</td>
<td>FEGI ADI RAMADANI</td>
<td>`</td>
<td>`</td>
<td>REJOMULYO</td>
<td>KARTOHARJO</td>
<td>13-01-1999</td>
<td>20</td>
<td>L</td>
<td>POLI UMUM</td>
<td>LAMA</td>
<td>KASUS BARU</td>
<td>BPJS</td>
<td>PBI (APBD)</td>
<td>`0002416467047</td>
<td>130802030519Y001247</td>
<td align='center'>
R50.9 </td>
</tr>

<td>237</td>
<td>16-05-2019</td>
<td>006961</td>
<td>SAMSUL ARIFIN</td>
<td>`3577013011000001</td>
<td>`</td>
<td>KARTOHARJO</td>
<td>30-11-2000</td>
<td>18</td>
<td>L</td>
<td>POLI UMUM</td>
<td>LAMA</td>
<td>KASUS BARU</td>
<td>BPJS</td>
<td>PBI (APBD)</td>
<td>`0001704811825</td>
<td>130802030519Y001259</td>
<td align='center'>
R50.9 </td>
</tr>

<td>238</td>
<td>16-05-2019</td>
<td>004250</td>
<td>PAIMAN</td>
<td>`3519072110400001</td>
<td>`</td>
<td>WUNGU</td>
<td>MADIUN</td>
<td>01-01-1970</td>
<td>49</td>
<td>L</td>
<td>POLI UMUM</td>
<td>LAMA</td>
<td>KASUS LAMA</td>
<td>BPJS</td>
<td>PNS PUSAT</td>
<td>`0001290007113</td>
<td>130802030519Y001214</td>
<td align='center'>
I84.9 </td>
</tr>

<td>239</td>
<td>16-05-2019</td>
<td>008457</td>
<td>DIAN NOVITASARI KUNCORO</td>
<td>`3577015711930003</td>
<td>`3577012303180002</td>
<td>KELUN</td>
<td>KARTOHARJO</td>
<td>17-11-1993</td>
<td>25</td>
<td>P</td>
<td>POLI UMUM</td>
<td>LAMA</td>
<td>KASUS LAMA</td>
<td>BPJS</td>
<td>PBI (APBN)</td>
<td>`0000786792767</td>
<td>130802030519Y001212</td>
<td align='center'>
M17 </td>
</tr>

<td>240</td>
<td>16-05-2019</td>
<td>002215</td>
<td>ADILA CITA LEKSANA</td>
<td>`3577016701920002</td>
<td>`3577012104078499</td>
<td>KELUN</td>
<td>KARTOHARJO</td>
<td>27-01-1992</td>
<td>27</td>
<td>P</td>
<td>POLI UMUM</td>
<td>LAMA</td>
<td>BPJS</td>
<td>PBI (APBD)</td>
<td>`0002163616018</td>
<td>130802030519Y001217</td>
<td align='center'>
F23.9 </td>
</tr>

<td>241</td>
<td>17-05-2019</td>
<td>012486</td>
<td>ERLIES YUNARWATI</td>
<td>`3577014806800006</td>
<td>`3577012505110005</td>
<td>KARTOHARJO</td>
<td>08-06-1980</td>
<td>38</td>
<td>P</td>
<td>POLI UMUM</td>
<td>BARU</td>
<td>KASUS BARU</td>
<td>BPJS</td>
<td>PBI (APBD)</td>
<td>`0002414009621</td>
<td>130802030519Y001329</td>
<td align='center'>
H10 </td>
</tr>
<td>242</td>
<td>17-05-2019</td>
<td>000382</td>
<td>IKA SUSILOWATI</td>
<td>`3577015010900001</td>
<td>`3577012004079744</td>
<td>REJOMULYO</td>
<td>KARTOHARJO</td>
<td>MADIUN</td>
<td>10-10-1990</td>
<td>28</td>
<td>P</td>
<td>POLI UMUM</td>
<td>LAMA</td>
<td>BPJS</td>
<td></td>
<td>`0002413943155</td>
<td>130802030519Y001331</td>
<td align='center'>
F23.9 </td>
</tr>

<td>243</td>
<td>17-05-2019</td>
<td>000262</td>
<td>HANDAWIYAH MAHA</td>
<td>`3519084502800001</td>
<td>`</td>
<td>BANJARSARI</td>
<td>MADIUN</td>
<td>MADIUN</td>
<td>05-02-1980</td>
<td>39</td>
<td>P</td>
<td>POLI UMUM</td>
<td>LAMA</td>
<td>KASUS BARU</td>
<td>BPJS</td>
<td>`0001537134816</td>
<td>130802030519Y001333</td>
<td align='center'>
H82 </td>
</tr>

<td>244</td>
<td>17-05-2019</td>
<td>002749</td>
<td>TARNIK</td>
<td>`3310235602850001</td>
<td>`</td>
<td>MADIUN</td>
<td>MADIUN</td>
<td>16-02-1985</td>
<td>34</td>
<td>P</td>
<td>POLI UMUM</td>
<td>LAMA</td>
<td>KASUS LAMA</td>
<td>BPJS</td>
<td>`0001890359324</td>
<td>130802030519Y001298</td>
<td align='center'>
H33.5 </td>
</tr>

<td>245</td>
<td>17-05-2019</td>
<td>012443</td>
<td>BUDIYAH</td>
<td>`3519085308670002</td>
<td>`</td>
<td>SUMBEREJO</td>
<td>MADIUN</td>
<td>MADIUN</td>
<td>13-08-1967</td>
<td>51</td>
<td>P</td>
<td>POLI UMUM</td>
<td>LAMA</td>
<td>KASUS LAMA</td>
<td>BPJS</td>
<td>`0002760253402</td>
<td>130802030519Y001334</td>
<td align='center'>
E11 </td>
</tr>

<td>246</td>
<td>17-05-2019</td>
<td>001416</td>
<td>MARSINI</td>
<td>`</td>
<td>`</td>
<td>TAWANGREJO</td>
<td>KARTOHARJO</td>
<td>25-09-1970</td>
<td>48</td>
<td>P</td>
<td>POLI UMUM</td>
<td>LAMA</td>
<td>KASUS LAMA</td>
<td>BPJS</td>
<td>PNS DAERAH</td>
<td>`0000106334662</td>
<td>130802030519Y001296</td>
<td align='center'>
H52.7 </td>
</tr>

<td>247</td>
<td>17-05-2019</td>
<td>012492</td>
<td>SUJARWO</td>
<td>`</td>
<td>`</td>
<td>GLONGGONG</td>
<td>BALEREJO</td>
<td>MADIUN</td>
<td>14-04-1974</td>
<td>45</td>
<td>L</td>
<td>Wiraswasta</td>
<td>POLI UMUM</td>
<td>BARU</td>
<td>KASUS BARU</td>
<td>UMUM</td>
<td></td>
<td>`</td>
<td></td>
<td align='center'>
K30 </td>
</tr>

<td>248</td>
<td>17-05-2019</td>
<td>003277</td>
<td>LAMI</td>
<td>`</td>
<td>`</td>
<td>KARTOHARJO</td>
<td>KARTOHARJO</td>
<td>01-01-1971</td>
<td>48</td>
<td>P</td>
<td>POLI UMUM</td>
<td>LAMA</td>
<td>KASUS BARU</td>
<td>BPJS</td>
<td>PBI (APBN)</td>
<td>`0000786814165</td>
<td>130802030519Y001347</td>
<td align='center'>
E11 </td>
</tr>

<td>249</td>
<td>17-05-2019</td>
<td>012495</td>
<td>BAGUS CAHYONIC</td>
<td>`3519080805970001</td>
<td>`</td>
<td>TIRON</td>
<td>MADIUN</td>
<td>MADIUN</td>
<td>08-05-1997</td>
<td>22</td>
<td>L</td>
<td>POLI UMUM</td>
<td>LAMA</td>
<td>KASUS BARU</td>
<td>UMUM</td>
<td></td>
<td>`</td>
<td></td>
<td align='center'>
J02.9 </td>
</tr>

<td>250</td>
<td>17-05-2019</td>
<td>000962</td>
<td>NGALINAH</td>
<td>`3519074707760004</td>
<td>`</td>
<td>MOJORAYUNG</td>
<td>WUNGU</td>
<td>MADIUN</td>
<td>01-07-1976</td>
<td>42</td>
<td>P</td>
<td>POLI UMUM</td>
<td>LAMA</td>
<td>KASUS BARU</td>
<td>BPJS</td>
<td>PBI (APBN)</td>
<td>`0001045290148</td>
<td>130802030519Y001355</td>
<td align='center'>
M79.1 </td>
</tr>

<td>251</td>
<td>20-05-2019</td>
<td>012530</td>
<td>YUSWANTI</td>
<td>`351908 </td>
<td>`</td>
<td>NGLAMES</td>
<td>MADIUN</td>
<td>MADIUN</td>
<td>08-04-1966</td>
<td>53</td>
<td>P</td>
<td>POLI UMUM</td>
<td>BARU</td>
<td>KASUS BARU</td>
<td>BPJS</td>
<td>PNS PUSAT</td>
<td>`0000106321803</td>
<td>130802030519Y001416</td>
<td align='center'>
A63.0 </td>
</tr>

<td>252</td>
<td>20-05-2019</td>
<td>012540</td>
<td>SRI WAHYUNI</td>
<td>`3519085010880001</td>
<td>`</td>
<td>TIRON</td>
<td>MADIUN</td>
<td>MADIUN</td>
<td>10-10-1988</td>
<td>30</td>
<td>P</td>
<td>POLI UMUM</td>
<td>BARU</td>
<td>KASUS BARU</td>
<td>BPJS</td>
<td>`0002759247426</td>
<td>130802030519Y001454</td>
<td align='center'>
B00 </td>
</tr>

<td>253</td>
<td>20-05-2019</td>
<td>012549</td>
<td>ANGGA WAHYU YULISTYO</td>
<td>`3577010503000003</td>
<td>`3577011006130001</td>
<td>REJOMULYO</td>
<td>KARTOHARJO</td>
<td>05-03-2000</td>
<td>19</td>
<td>L</td>
<td>POLI UMUM</td>
<td>BARU</td>
<td>KASUS BARU</td>
<td>UMUM</td>
<td>`0002475307528</td>
<td></td>
<td align='center'>
B66 </td>
</tr>

<td>254</td>
<td>20-05-2019</td>
<td>012551</td>
<td>ROHMAH</td>
<td>`3519075201770002</td>
<td>`</td>
<td>TEMPURSARI</td>
<td>WUNGU</td>
<td>MADIUN</td>
<td>12-01-1977</td>
<td>42</td>
<td>P</td>
<td>POLI UMUM</td>
<td>BARU</td>
<td>KASUS BARU</td>
<td>UMUM</td>
<td>`0001316105392</td>
<td></td>
<td align='center'>
R50 </td>
</tr>

<td>255</td>
<td>20-05-2019</td>
<td>012552</td>
<td>RISZAL PUJI AFFANDI</td>
<td>`3577012006950002</td>
<td>`3577012104078598</td>
<td>KELUN</td>
<td>KARTOHARJO</td>
<td>20-06-1995</td>
<td>23</td>
<td>L</td>
<td>POLI UMUM</td>
<td>BARU</td>
<td>KASUS BARU</td>
<td>BPJS</td>
<td>`0001425585071</td>
<td>130802030519Y001457</td>
<td align='center'>
M70 </td>
</tr>

<td>256</td>
<td>20-05-2019</td>
<td>012566</td>
<td>M HAFIDH IZZUDDIN</td>
<td>`3577011112660001</td>
<td>`3577012104071814</td>
<td>KARTOHARJO</td>
<td>11-12-1966</td>
<td>52</td>
<td>L</td>
<td>Wiraswasta</td>
<td>POLI UMUM</td>
<td>LAMA</td>
<td>KASUS BARU</td>
<td>BPJS</td>
<td>PBI (APBD)</td>
<td>`0002163610563</td>
<td>130802030519Y001534</td>
<td align='center'>
I64 </td>
</tr>

<td>257</td>
<td>20-05-2019</td>
<td>002433</td>
<td>YENI SULASTRI</td>
<td>`3519085709680001</td>
<td>`</td>
<td>BANJARSARI</td>
<td>MADIUN</td>
<td>MADIUN</td>
<td>17-09-1968</td>
<td>50</td>
<td>P</td>
<td>POLI UMUM</td>
<td>LAMA</td>
<td>KASUS BARU</td>
<td>BPJS</td>
<td>`0002219025701</td>
<td>130802030519Y001462</td>
<td align='center'>
M79.1 </td>
</tr>

<td>258</td>
<td>20-05-2019</td>
<td>000262</td>
<td>HANDAWIYAH MAHA</td>
<td>`3519084502800001</td>
<td>`</td>
<td>BANJARSARI</td>
<td>MADIUN</td>
<td>MADIUN</td>
<td>05-02-1980</td>
<td>39</td>
<td>P</td>
<td>POLI UMUM</td>
<td>LAMA</td>
<td>KASUS BARU</td>
<td>BPJS</td>
<td>`0001537134816</td>
<td>130802030519Y001463</td>
<td align='center'>
R51 </td>
</tr>

<td>259</td>
<td>20-05-2019</td>
<td>012484</td>
<td>HERU BASUKI</td>
<td>`</td>
<td>`</td>
<td>REJOMULYO</td>
<td>KARTOHARJO</td>
<td>09-10-1992</td>
<td>26</td>
<td>L</td>
<td>POLI UMUM</td>
<td>LAMA</td>
<td>BPJS</td>
<td>PBI (APBD)</td>
<td>`0002413946621</td>
<td>130802030519Y001413</td>
<td align='center'>
F20.9 </td>
</tr>

<td>260</td>
<td>20-05-2019</td>
<td>011161</td>
<td>RINDIANTIKA PRAMESWARI</td>
<td>`</td>
<td>`</td>
<td>BANJARSARI</td>
<td>MADIUN</td>
<td>MADIUN</td>
<td>10-08-1998</td>
<td>20</td>
<td>P</td>
<td>POLI UMUM</td>
<td>LAMA</td>
<td>KASUS BARU</td>
<td>BPJS</td>
<td>`0001436523287</td>
<td>130802030519Y001467</td>
<td align='center'>
J00 </td>
</tr>

<td>261</td>
<td>20-05-2019</td>
<td>007446</td>
<td>ISMAIL</td>
<td>`</td>
<td>`</td>
<td>BETEK</td>
<td>MADIUN</td>
<td>MADIUN</td>
<td>07-02-1977</td>
<td>42</td>
<td>L</td>
<td>Pedagang</td>
<td>POLI UMUM</td>
<td>LAMA</td>
<td>BPJS</td>
<td></td>
<td>`0002741018084</td>
<td>130802030519Y001482</td>
<td align='center'>
A16.9 </td>
</tr>

<td>262</td>
<td>20-05-2019</td>
<td>000533</td>
<td>MIRDAS SUKSESI</td>
<td>`3577012503870002</td>
<td>`3577012104078882</td>
<td>KELUN</td>
<td>KARTOHARJO</td>
<td>25-03-1987</td>
<td>32</td>
<td>P</td>
<td>POLI UMUM</td>
<td>LAMA</td>
<td>KASUS LAMA</td>
<td>BPJS</td>
<td>`0000106314298</td>
<td>130802030519Y001485</td>
<td align='center'>
F20 </td>
</tr>

<td>263</td>
<td>20-05-2019</td>
<td>004227</td>
<td>CANDRA ADHIATMA</td>
<td>`</td>
<td>`</td>
<td>KARTOHARJO</td>
<td>01-05-1990</td>
<td>29</td>
<td>L</td>
<td>POLI UMUM</td>
<td>LAMA</td>
<td>KASUS BARU</td>
<td>BPJS</td>
<td>PBI (APBN)</td>
<td>`0000786607705</td>
<td>130802030519Y001486</td>
<td align='center'>
J06 </td>
</tr>

<td>264</td>
<td>20-05-2019</td>
<td>012395</td>
<td>AGUS PRAMONO</td>
<td>`3577011410650001</td>
<td>`3577012104071504</td>
<td>KARTOHARJO</td>
<td>14-10-1965</td>
<td>53</td>
<td>L</td>
<td>POLI UMUM</td>
<td>LAMA</td>
<td>KASUS BARU</td>
<td>BPJS</td>
<td>PBI (APBD)</td>
<td>`0001704814828</td>
<td>130802030519Y001487</td>
<td align='center'>
L23.9 </td>
</tr>

<td>265</td>
<td>20-05-2019</td>
<td>009463</td>
<td>SUGIANA</td>
<td>`3173062703840002</td>
<td>`</td>
<td>DEMPELAN</td>
<td>MADIUN</td>
<td>MADIUN</td>
<td>27-03-1984</td>
<td>35</td>
<td>L</td>
<td>POLI UMUM</td>
<td>LAMA</td>
<td>KASUS BARU</td>
<td>UMUM</td>
<td>PBI (APBD)</td>
<td>`0001220464427</td>
<td></td>
<td align='center'>
K29 </td>
</tr>
<td>266</td>
<td>20-05-2019</td>
<td>001661</td>
<td>PURNAMA ERNAWATI</td>
<td>`3374064502930003</td>
<td>`</td>
<td>BODAG</td>
<td>KARE</td>
<td>MADIUN</td>
<td>05-02-1993</td>
<td>26</td>
<td>P</td>
<td>POLI UMUM</td>
<td>LAMA</td>
<td>KASUS BARU</td>
<td>BPJS</td>
<td>`0000642578095</td>
<td>130802030519Y001489</td>
<td align='center'>
B36.9 </td>
</tr>

<td>267</td>
<td>20-05-2019</td>
<td>002431</td>
<td>SULASTRI</td>
<td>`3577034504680001</td>
<td>`3577032004074623</td>
<td>PANDEAN</td>
<td>TAMAN</td>
<td>05-04-1968</td>
<td>51</td>
<td>P</td>
<td>POLI UMUM</td>
<td>LAMA</td>
<td>KASUS LAMA</td>
<td>BPJS</td>
<td>PNS DAERAH</td>
<td>`0000106295501</td>
<td>130802030519Y001421</td>
<td align='center'>
D05.9 </td>
</tr>

<td>268</td>
<td>20-05-2019</td>
<td>002420</td>
<td>SUGIARTI</td>
<td>`3577015405690002</td>
<td>`3577012104078397</td>
<td>KELUN</td>
<td>KARTOHARJO</td>
<td>14-05-1969</td>
<td>50</td>
<td>P</td>
<td>POLI UMUM</td>
<td>LAMA</td>
<td>KASUS BARU</td>
<td>BPJS</td>
<td>`0002300159586</td>
<td>130802030519Y001492</td>
<td align='center'>
J10 </td>
</tr>

<td>269</td>
<td>20-05-2019</td>
<td>005312</td>
<td>HERLIN SULISTYOWATI</td>
<td>`</td>
<td>`</td>
<td>TAWANGREJO</td>
<td>KARTOHARJO</td>
<td>10-10-1978</td>
<td>40</td>
<td>P</td>
<td>POLI UMUM</td>
<td>LAMA</td>
<td>KASUS BARU</td>
<td>BPJS</td>
<td>PBI (APBN)</td>
<td>`0001049800061</td>
<td>130802030519Y001510</td>
<td align='center'>
K29 </td>
</tr>

<td>270</td>
<td>20-05-2019</td>
<td>000930</td>
<td>RATIH SAMININGSIH</td>
<td>`3276026909650013</td>
<td>`3577010305170001</td>
<td>KARTOHARJO</td>
<td>29-09-1965</td>
<td>53</td>
<td>P</td>
<td>POLI UMUM</td>
<td>LAMA</td>
<td>BPJS</td>
<td>`0001157095168</td>
<td>130802030519Y001441</td>
<td align='center'>
J45 </td>
</tr>

<td>271</td>
<td>20-05-2019</td>
<td>004583</td>
<td>SUNARTI</td>
<td>`</td>
<td>`</td>
<td>KARTOHARJO</td>
<td>01-05-1973</td>
<td>46</td>
<td>P</td>
<td>POLI UMUM</td>
<td>LAMA</td>
<td>KASUS BARU</td>
<td>BPJS</td>
<td>PBI (APBN)</td>
<td>`0000786585464</td>
<td>130802030519Y001512</td>
<td align='center'>
H60.9 </td>
</tr>

<td>272</td>
<td>20-05-2019</td>
<td>012489</td>
<td>SITI JULAIKAH</td>
<td>`3577016602990002</td>
<td>`3577012104078950</td>
<td>KELUN</td>
<td>KARTOHARJO</td>
<td>26-02-1999</td>
<td>20</td>
<td>P</td>
<td>POLI UMUM</td>
<td>LAMA</td>
<td>KASUS BARU</td>
<td>BPJS</td>
<td>PBI (APBN)</td>
<td>`0000786678118</td>
<td>130802030519Y001515</td>
<td align='center'>
I84 </td>
</tr>

<td>273</td>
<td>20-05-2019</td>
<td>001324</td>
<td>SUPRIATI</td>
<td>`3577016002730003</td>
<td>`3577012104078144</td>
<td>KELUN</td>
<td>KARTOHARJO</td>
<td>20-02-1973</td>
<td>46</td>
<td>P</td>
<td>POLI UMUM</td>
<td>LAMA</td>
<td>KASUS BARU</td>
<td>BPJS</td>
<td>PBI (APBN)</td>
<td>`0000786347043</td>
<td>130802030519Y001517</td>
<td align='center'>
R51 </td>
</tr>

<td>274</td>
<td>20-05-2019</td>
<td>005709</td>
<td>JOIS KARTIKA</td>
<td>`</td>
<td>`</td>
<td>KARTOHARJO</td>
<td>01-05-1972</td>
<td>47</td>
<td>P</td>
<td>POLI UMUM</td>
<td>LAMA</td>
<td>BPJS</td>
<td>PBI (APBD)</td>
<td>`0002163609573</td>
<td>130802030519Y001518</td>
<td align='center'>
L20.9 </td>
</tr>

<td>275</td>
<td>20-05-2019</td>
<td>000464</td>
<td>VENDI WIJAYA SAKTI KURNIAWAN</td>
<td>`3577012801900001</td>
<td>`3577010401120002</td>
<td>REJOMULYO</td>
<td>KARTOHARJO</td>
<td>28-01-1990</td>
<td>29</td>
<td>L</td>
<td>POLI UMUM</td>
<td>LAMA</td>
<td>BPJS</td>
<td></td>
<td>`0002413928643</td>
<td>130802030519Y001445</td>
<td align='center'>
F23.9 </td>
</tr>

<td>276</td>
<td>20-05-2019</td>
<td>009181</td>
<td>RIESKE KARTIKA</td>
<td>`</td>
<td>`</td>
<td>KARTOHARJO</td>
<td>01-07-1986</td>
<td>32</td>
<td>P</td>
<td>POLI UMUM</td>
<td>LAMA</td>
<td>KASUS LAMA</td>
<td>BPJS</td>
<td></td>
<td>`0002747678771</td>
<td>130802030519Y001503</td>
<td align='center'>
E05 </td>
</tr>

<td>277</td>
<td>20-05-2019</td>
<td>002046</td>
<td>SUSILOWATI</td>
<td>`3577017009740004</td>
<td>`3577011104180005</td>
<td>KARTOHARJO</td>
<td>30-09-1974</td>
<td>44</td>
<td>P</td>
<td>POLI UMUM</td>
<td>LAMA</td>
<td>KASUS LAMA</td>
<td>BPJS</td>
<td>PBI (APBN)</td>
<td>`0000787309277</td>
<td>130802030519Y001444</td>
<td align='center'>
I15 </td>
</tr>

<td>278</td>
<td>20-05-2019</td>
<td>002951</td>
<td>ANIK ROHAYATI</td>
<td>`3577014905860002</td>
<td>`3577012104070716</td>
<td>KARTOHARJO</td>
<td>09-05-1986</td>
<td>33</td>
<td>P</td>
<td>POLI UMUM</td>
<td>LAMA</td>
<td>BPJS</td>
<td>`0001536808419</td>
<td>130802030519Y001448</td>
<td align='center'>
G40.9 </td>
</tr>

<td>279</td>
<td>20-05-2019</td>
<td>009726</td>
<td>NURUL NINANINGSIH</td>
<td>`3577017011840002</td>
<td>`</td>
<td>KELUN</td>
<td>KARTOHARJO</td>
<td>01-11-1984</td>
<td>34</td>
<td>P</td>
<td>POLI UMUM</td>
<td>LAMA</td>
<td>KASUS BARU</td>
<td>BPJS</td>
<td>PBI (APBN)</td>
<td>`0000787511845</td>
<td>130802030519Y001530</td>
<td align='center'>
K29 </td>
</tr>

<td>280</td>
<td>20-05-2019</td>
<td>001478</td>
<td>TUTIK SUJANI</td>
<td>`3577016212660002</td>
<td>`3577012104078560</td>
<td>KELUN</td>
<td>KARTOHARJO</td>
<td>22-12-1966</td>
<td>52</td>
<td>P</td>
<td>Pensiunan</td>
<td>POLI UMUM</td>
<td>LAMA</td>
<td>BPJS</td>
<td>`0000977277183</td>
<td>130802030519Y001502</td>
<td align='center'>
E05 </td>
</tr>

<td>281</td>
<td>20-05-2019</td>
<td>008805</td>
<td>`3519086707640002</td>
<td>`</td>
<td>SUMBEREJO</td>
<td>MADIUN</td>
<td>MADIUN</td>
<td>27-07-1964</td>
<td>54</td>
<td>P</td>
<td>Guru</td>
<td>POLI UMUM</td>
<td>LAMA</td>
<td>KASUS BARU</td>
<td>BPJS</td>
<td>`0001860078914</td>
<td>130802030519Y001531</td>
<td align='center'>
J06 </td>
</tr>

<td>282</td>
<td>21-05-2019</td>
<td>012579</td>
<td>SUDARNO</td>
<td>`3577013112650013</td>
<td>`3577012104071354</td>
<td>KARTOHARJO</td>
<td>31-12-1965</td>
<td>53</td>
<td>L</td>
<td>POLI UMUM</td>
<td>BARU</td>
<td>KASUS BARU</td>
<td>BPJS</td>
<td>PBI (APBN)</td>
<td>`0000786634604</td>
<td>130802030519Y001562</td>
<td align='center'>
I50.9 </td>
</tr>

<td>283</td>
<td>21-05-2019</td>
<td>012581</td>
<td>TRI WAHYUNINGSIH</td>
<td>` </td>
<td>`3577010309100003</td>
<td>KARTOHARJO</td>
<td>18-05-1984</td>
<td>35</td>
<td>P</td>
<td>POLI UMUM</td>
<td>BARU</td>
<td>KASUS BARU</td>
<td>BPJS</td>
<td>PBI (APBN)</td>
<td>`0000786747418</td>
<td>130802030519Y001637</td>
<td align='center'>
M79.1 </td>
</tr>

<td>284</td>
<td>21-05-2019</td>
<td>012583</td>
<td>NANANG NUR FITRIYANI</td>
<td>`</td>
<td>`</td>
<td>TIRON</td>
<td>MADIUN</td>
<td>MADIUN</td>
<td>08-05-1989</td>
<td>30</td>
<td>L</td>
<td>POLI UMUM</td>
<td>BARU</td>
<td>KASUS BARU</td>
<td>BPJS</td>
<td>`0001899288033</td>
<td>130802030519Y001579</td>
<td align='center'>
J00 </td>
</tr>

<td>285</td>
<td>21-05-2019</td>
<td>012586</td>
<td>FIRLY ANAVI</td>
<td>`3577016812960001</td>
<td>`3577012104078670</td>
<td>KELUN</td>
<td>KARTOHARJO</td>
<td>28-12-1996</td>
<td>22</td>
<td>P</td>
<td>POLI UMUM</td>
<td>BARU</td>
<td>KASUS BARU</td>
<td>BPJS</td>
<td>PBI (APBN)</td>
<td>`0000786774464</td>
<td>130802030519Y001639</td>
<td align='center'>
J02.9 </td>
</tr>

<td>286</td>
<td>21-05-2019</td>
<td>012587</td>
<td>ABDUL MAJID</td>
<td>`</td>
<td>`</td>
<td>BETEK</td>
<td>MADIUN</td>
<td>MADIUN</td>
<td>27-02-1986</td>
<td>33</td>
<td>L</td>
<td>POLI UMUM</td>
<td>BARU</td>
<td>KASUS BARU</td>
<td>BPJS</td>
<td>`0002758964073</td>
<td>130802030519Y001572</td>
<td align='center'>
T15.0 </td>
</tr>

<td>287</td>
<td>21-05-2019</td>
<td>012588</td>
<td>PANJI PANILIH </td>
<td>`3577011612920002</td>
<td>`</td>
<td>KARTOHARJO</td>
<td>16-12-1991</td>
<td>27</td>
<td>L</td>
<td>POLI UMUM</td>
<td>BARU</td>
<td>KASUS BARU</td>
<td>BPJS</td>
<td>PBI (APBD)</td>
<td>`0002416858571</td>
<td>130802030519Y001640</td>
<td align='center'>
R50.9 </td>
</tr>

<td>288</td>
<td>21-05-2019</td>
<td>012594</td>
<td>RULLY KUSUMANINGSIH</td>
<td>`3519084310800000</td>
<td>`</td>
<td>NGLAMES</td>
<td>MADIUN</td>
<td>MADIUN</td>
<td>03-10-1980</td>
<td>38</td>
<td>P</td>
<td>POLI UMUM</td>
<td>BARU</td>
<td>KASUS BARU</td>
<td>BPJS</td>
<td>ANGGOTA POLRI</td>
<td>`0001267913035</td>
<td>130802030519Y001641</td>
<td align='center'>
M79.1 </td>
</tr>

<td>289</td>
<td>21-05-2019</td>
<td>012601</td>
<td>AKUR SANTASO</td>
<td>`</td>
<td>`</td>
<td>NGLAMES</td>
<td>MADIUN</td>
<td>MADIUN</td>
<td>25-04-1974</td>
<td>45</td>
<td>L</td>
<td>POLI UMUM</td>
<td>LAMA</td>
<td>KASUS BARU</td>
<td>UMUM</td>
<td>PBI (APBD)</td>
<td>`0002761576751</td>
<td></td>
<td align='center'>
K30 </td>
</tr>

<td>290</td>
<td>21-05-2019</td>
<td>012605</td>
<td>TRI PUJIWATI</td>
<td>`3577017012690002</td>
<td>`3577012104072255</td>
<td>KARTOHARJO</td>
<td>30-12-1969</td>
<td>49</td>
<td>P</td>
<td>POLI UMUM</td>
<td>BARU</td>
<td>KASUS BARU</td>
<td>BPJS</td>
<td>PBI (APBD)</td>
<td>`0001704817168</td>
<td>130802030519Y001642</td>
<td align='center'>
M79.1 </td>
</tr>

<td>291</td>
<td>21-05-2019</td>
<td>011303</td>
<td>ANTIK PRASETYANTI UTAMI</td>
<td>`</td>
<td>`</td>
<td>ORO ORO OMBO</td>
<td>KARTOHARJO</td>
<td>14-05-1976</td>
<td>43</td>
<td>P</td>
<td>POLI UMUM</td>
<td>LAMA</td>
<td>BPJS</td>
<td>PNS DAERAH</td>
<td>`0000122462054</td>
<td>130802030519Y001542</td>
<td align='center'>
E10.9 </td>
</tr>

<td>292</td>
<td>21-05-2019</td>
<td>000879</td>
<td>PUSPITA MARIANA</td>
<td>`3519086504820002</td>
<td>`</td>
<td>NGLAMES</td>
<td>MADIUN</td>
<td>MADIUN</td>
<td>25-04-1982</td>
<td>37</td>
<td>P</td>
<td>POLI UMUM</td>
<td>LAMA</td>
<td>KASUS BARU</td>
<td>BPJS</td>
<td>`0001537127201</td>
<td>130802030519Y001587</td>
<td align='center'>
J06.9 </td>
</tr>

<td>293</td>
<td>21-05-2019</td>
<td>010833</td>
<td>DENI AGUS SETYONO</td>
<td>`3577011108990002</td>
<td>`3577012004078273</td>
<td>REJOMULYO</td>
<td>KARTOHARJO</td>
<td>11-08-1999</td>
<td>19</td>
<td>L</td>
<td>POLI UMUM</td>
<td>LAMA</td>
<td>KASUS BARU</td>
<td>BPJS</td>
<td>PBI (APBD)</td>
<td>`0001704808945</td>
<td>130802030519Y001548</td>
<td align='center'>
J03 </td>
</tr>

<td>294</td>
<td>21-05-2019</td>
<td>002188</td>
<td>YENI PRATIKANINGSIH</td>
<td>`3577016811780001</td>
<td>`3577012104071804</td>
<td>KARTOHARJO</td>
<td>28-11-1978</td>
<td>40</td>
<td>P</td>
<td>POLI UMUM</td>
<td>LAMA</td>
<td>KASUS BARU</td>
<td>BPJS</td>
<td>PBI (APBN)</td>
<td>`0000787150912</td>
<td>130802030519Y001660</td>
<td align='center'>
J11 </td>
</tr>

<td>295</td>
<td>21-05-2019</td>
<td>000881</td>
<td>YULIANI NGGALUKU</td>
<td>`3519087107670001</td>
<td>`</td>
<td>MADIUN</td>
<td>MADIUN</td>
<td>31-07-1967</td>
<td>51</td>
<td>P</td>
<td>POLI UMUM</td>
<td>LAMA</td>
<td>KASUS LAMA</td>
<td>BPJS</td>
<td>PNS DAERAH</td>
<td>`0000104869934</td>
<td>130802030519Y001568</td>
<td align='center'>
C50.9 </td>
</tr>

<td>296</td>
<td>21-05-2019</td>
<td>004337</td>
<td>`</td>
<td>`</td>
<td>BANJARSARI</td>
<td>MADIUN</td>
<td>MADIUN</td>
<td>10-02-1970</td>
<td>49</td>
<td>P</td>
<td>POLI UMUM</td>
<td>LAMA</td>
<td>KASUS BARU</td>
<td>BPJS</td>
<td>`0002216755506</td>
<td>130802030519Y001603</td>
<td align='center'>
J11 </td>
</tr>

<td>297</td>
<td>21-05-2019</td>
<td>000718</td>
<td>WIDIATI</td>
<td>`3577016909720002</td>
<td>`3577013008100009</td>
<td>KELUN</td>
<td>KARTOHARJO</td>
<td>29-09-1972</td>
<td>46</td>
<td>P</td>
<td>POLI UMUM</td>
<td>LAMA</td>
<td>KASUS BARU</td>
<td>BPJS</td>
<td>PBI (APBN)</td>
<td>`0000787486689</td>
<td>130802030519Y001672</td>
<td align='center'>
M79.1 </td>
</tr>

<td>298</td>
<td>21-05-2019</td>
<td>008000</td>
<td>NOVA SAPUTRA</td>
<td>`</td>
<td>`</td>
<td>REJOMULYO</td>
<td>KARTOHARJO</td>
<td>01-11-1998</td>
<td>20</td>
<td>L</td>
<td>POLI UMUM</td>
<td>LAMA</td>
<td>KASUS LAMA</td>
<td>BPJS</td>
<td>PBI (APBN)</td>
<td>`0000786403956</td>
<td>130802030519Y001631</td>
<td align='center'>
G40.9 </td>
</tr>

<td>299</td>
<td>21-05-2019</td>
<td>002236</td>
<td>`3519146309900001</td>
<td>`</td>
<td>BANJARSARI</td>
<td>MADIUN</td>
<td>MADIUN</td>
<td>01-01-1970</td>
<td>49</td>
<td>P</td>
<td>POLI UMUM</td>
<td>LAMA</td>
<td>KASUS BARU</td>
<td>BPJS</td>
<td>`0002236807214</td>
<td>130802030519Y001678</td>
<td align='center'>
L04.9 </td>
</tr>

<td>300</td>
<td>22-05-2019</td>
<td>012618</td>
<td>BAYU RHAMADAN</td>
<td>`3577012912980002</td>
<td>`3577012004078008</td>
<td>REJOMULYO</td>
<td>KARTOHARJO</td>
<td>29-12-1998</td>
<td>20</td>
<td>L</td>
<td>POLI UMUM</td>
<td>BARU</td>
<td>KASUS BARU</td>
<td>BPJS</td>
<td>PBI (APBN)</td>
<td>`0000786879731</td>
<td>130802030519Y001701</td>
<td align='center'>
R50.9 </td>
</tr>
<td>301</td>
<td>22-05-2019</td>
<td>012629</td>
<td>SUYATI</td>
<td>`</td>
<td>`</td>
<td>KELUN</td>
<td>KARTOHARJO</td>
<td>23-10-1965</td>
<td>53</td>
<td>P</td>
<td>POLI UMUM</td>
<td>BARU</td>
<td>KASUS BARU</td>
<td>BPJS</td>
<td>`0001903144432</td>
<td>130802030519Y001757</td>
<td align='center'>
M79.1 </td>
</tr>

<td>302</td>
<td>22-05-2019</td>
<td>012635</td>
<td>YOYON KUNCAHYONO</td>
<td>`3577010303650002</td>
<td>`3577012004079745</td>
<td>REJOMULYO</td>
<td>KARTOHARJO</td>
<td>03-03-1965</td>
<td>54</td>
<td>L</td>
<td>POLI UMUM</td>
<td>BARU</td>
<td>KASUS BARU</td>
<td>BPJS</td>
<td>PBI (APBD)</td>
<td>`0002413943166</td>
<td>130802030519Y001715</td>
<td align='center'>
T15.9 </td>
</tr>

<td>303</td>
<td>22-05-2019</td>
<td>012644</td>
<td>SUJIANTO</td>
<td>`3577010809710001</td>
<td>`3577012312100061</td>
<td>REJOMULYO</td>
<td>KARTOHARJO</td>
<td>08-09-1971</td>
<td>47</td>
<td>L</td>
<td>POLI UMUM</td>
<td>BARU</td>
<td>KASUS BARU</td>
<td>BPJS</td>
<td>PBI (APBD)</td>
<td>`0002413947036</td>
<td>130802030519Y001758</td>
<td align='center'>
H60.9 </td>
</tr>

<td>304</td>
<td>22-05-2019</td>
<td>012612</td>
<td>DARSINI</td>
<td>`</td>
<td>`</td>
<td>BANJARSARI</td>
<td>MADIUN</td>
<td>MADIUN</td>
<td>23-01-1968</td>
<td>51</td>
<td>P</td>
<td>POLI UMUM</td>
<td>BARU</td>
<td>KASUS BARU</td>
<td>UMUM</td>
<td></td>
<td>`</td>
<td></td>
<td align='center'>
G43.9 </td>
</tr>

<td>305</td>
<td>22-05-2019</td>
<td>004222</td>
<td>YULIS SETIYANA</td>
<td>`3577014308780001</td>
<td>`3577012303170004</td>
<td>REJOMULYO</td>
<td>KARTOHARJO</td>
<td>03-08-1978</td>
<td>40</td>
<td>P</td>
<td>POLI UMUM</td>
<td>LAMA</td>
<td>KASUS BARU</td>
<td>BPJS</td>
<td></td>
<td>`0002413946518</td>
<td>130802030519Y001688</td>
<td align='center'>
D21.9 </td>
</tr>

<td>306</td>
<td>22-05-2019</td>
<td>005558</td>
<td>AIN SETYANINGRUM</td>
<td>`3577015111960001</td>
<td>`3577011912170004</td>
<td>KARTOHARJO</td>
<td>11-11-1996</td>
<td>22</td>
<td>P</td>
<td>POLI UMUM</td>
<td>LAMA</td>
<td>KASUS BARU</td>
<td>BPJS</td>
<td></td>
<td>`0001450372847</td>
<td>130802030519Y001694</td>
<td align='center'>
J11 </td>
</tr>

<td>307</td>
<td>22-05-2019</td>
<td>003690</td>
<td>PRASETIAWATI</td>
<td>`3519086602840002</td>
<td>`</td>
<td>NGLAMES</td>
<td>MADIUN</td>
<td>MADIUN</td>
<td>26-02-1984</td>
<td>35</td>
<td>P</td>
<td>POLI UMUM</td>
<td>LAMA</td>
<td>BPJS</td>
<td>`0001537127111</td>
<td>130802030519Y001726</td>
<td align='center'>
G43 </td>
</tr>

<td>308</td>
<td>22-05-2019</td>
<td>004462</td>
<td>EKO PRASETYO RAHARJO</td>
<td>`</td>
<td>`</td>
<td>REJOMULYO</td>
<td>KARTOHARJO</td>
<td>MADIUN</td>
<td>27-03-2001</td>
<td>18</td>
<td>L</td>
<td>POLI UMUM</td>
<td>LAMA</td>
<td>KASUS BARU</td>
<td>BPJS</td>
<td>PBI (APBN)</td>
<td>`0001049799025</td>
<td>130802030519Y001729</td>
<td align='center'>
R50 </td>
</tr>

<td>309</td>
<td>22-05-2019</td>
<td>004977</td>
<td>KARNELI</td>
<td>`</td>
<td>`</td>
<td>WAYUT</td>
<td>JIWAN</td>
<td>MADIUN</td>
<td>08-10-1966</td>
<td>52</td>
<td>L</td>
<td>POLI UMUM</td>
<td>dr. KESI WAHYU WIDARTI</td>
<td>LAMA</td>
<td>KASUS BARU</td>
<td>BPJS</td>
<td>PNS DAERAH</td>
<td>`0000106273697</td>
<td>130802030519Y001700</td>
<td align='center'>
I10 </td>
</tr>

<td>310</td>
<td>22-05-2019</td>
<td>012615</td>
<td>WISNU PRASETIYA</td>
<td>`</td>
<td>`</td>
<td>REJOMULYO</td>
<td>KARTOHARJO</td>
<td>26-01-2000</td>
<td>19</td>
<td>L</td>
<td>POLI UMUM</td>
<td>BARU</td>
<td>KASUS BARU</td>
<td>UMUM</td>
<td>PBI (APBN)</td>
<td>`0001995634067</td>
<td></td>
<td align='center'>
R51 </td>
</tr>

<td>311</td>
<td>22-05-2019</td>
<td>007243</td>
<td>HARMINATUN</td>
<td>`</td>
<td>`</td>
<td>MADIUN</td>
<td>MADIUN</td>
<td>07-03-1966</td>
<td>53</td>
<td>P</td>
<td>POLI UMUM</td>
<td>LAMA</td>
<td>KASUS BARU</td>
<td>BPJS</td>
<td></td>
<td>`0002375548571</td>
<td>130802030519Y001743</td>
<td align='center'>
M17 </td>
</tr>

<td>312</td>
<td>22-05-2019</td>
<td>012636</td>
<td>IMMAS KINANTHI RISQI</td>
<td>`3577014411900001</td>
<td>`3577012303160003</td>
<td>REJOMULYO</td>
<td>KARTOHARJO</td>
<td>04-11-1990</td>
<td>28</td>
<td>P</td>
<td>POLI UMUM</td>
<td>BARU</td>
<td>KASUS BARU</td>
<td>BPJS</td>
<td>PBI (APBD)</td>
<td>`0002413883384</td>
<td>130802030519Y001706</td>
<td align='center'>
K21 </td>
</tr>

<td>313</td>
<td>22-05-2019</td>
<td>006539</td>
<td>KRESNANTI</td>
<td>`3577014612920002</td>
<td>`3577012606090003</td>
<td>KARTOHARJO</td>
<td>05-12-1997</td>
<td>21</td>
<td>P</td>
<td>POLI UMUM</td>
<td>LAMA</td>
<td>KASUS BARU</td>
<td>BPJS</td>
<td></td>
<td>`000787161881</td>
<td></td>
<td align='center'>
A09 </td>
</tr>

<td>314</td>
<td>22-05-2019</td>
<td>005198</td>
<td>HERY SULISTYONO</td>
<td>`3577013005770001</td>
<td>`3577012104072617</td>
<td>KARTOHARJO</td>
<td>30-05-1977</td>
<td>42</td>
<td>L</td>
<td>POLI UMUM</td>
<td>LAMA</td>
<td>BPJS</td>
<td></td>
<td>`0001804437955</td>
<td>130802030519P001751</td>
<td align='center'>
A16.9 </td>
</tr>

<td>315</td>
<td>22-05-2019</td>
<td>001525</td>
<td>MUHAMMAD RIDHO FANTRIADI</td>
<td>`3519082204000001</td>
<td>`</td>
<td>BANJARSARI</td>
<td>MADIUN</td>
<td>MADIUN</td>
<td>22-04-2000</td>
<td>19</td>
<td>L</td>
<td>POLI UMUM</td>
<td>LAMA</td>
<td>KASUS BARU</td>
<td>BPJS</td>
<td>`0001272323957</td>
<td>130802030519Y001752</td>
<td align='center'>
H40.9 </td>
</tr>

<td>316</td>
<td>22-05-2019</td>
<td>004209</td>
<td>ARI ROCHIMAWATI</td>
<td>`3578024401810005</td>
<td>`</td>
<td>KELUN</td>
<td>KARTOHARJO</td>
<td>04-01-1981</td>
<td>38</td>
<td>P</td>
<td>POLI UMUM</td>
<td>LAMA</td>
<td>KASUS BARU</td>
<td>BPJS</td>
<td>`0001256884582</td>
<td>130802030519Y001768</td>
<td align='center'>
H66.9 </td>
</tr>

<td>317</td>
<td>23-05-2019</td>
<td>012663</td>
<td>ARUM CAHYANING TIYAS</td>
<td>`3577014503900004</td>
<td>`3577010610110007</td>
<td>KARTOHARJO</td>
<td>05-03-1990</td>
<td>29</td>
<td>P</td>
<td>POLI UMUM</td>
<td>BARU</td>
<td>KASUS BARU</td>
<td>BPJS</td>
<td>PBI (APBD)</td>
<td>`0001520034568</td>
<td>130802030519Y001789</td>
<td align='center'>
K29.7 </td>
</tr>

<td>318</td>
<td>23-05-2019</td>
<td>012664</td>
<td>MARIYANI</td>
<td>`3577014404660003</td>
<td>`3577011512100074</td>
<td>KARTOHARJO</td>
<td>04-04-1966</td>
<td>53</td>
<td>P</td>
<td>POLI UMUM</td>
<td>BARU</td>
<td>KASUS BARU</td>
<td>BPJS</td>
<td>`0001856082137</td>
<td>130802030519Y001790</td>
<td align='center'>
K30 </td>
</tr>

<td>319</td>
<td>23-05-2019</td>
<td>001584</td>
<td>INDASAH</td>
<td>`3577015109740004</td>
<td>`3577012104071599</td>
<td>KARTOHARJO</td>
<td>11-09-1974</td>
<td>44</td>
<td>P</td>
<td>POLI UMUM</td>
<td>LAMA</td>
<td>KASUS BARU</td>
<td>BPJS</td>
<td>PBI (APBN)</td>
<td>`0000787301695</td>
<td>130802030519Y001793</td>
<td align='center'>
K29.7 </td>
</tr>

<td>320</td>
<td>23-05-2019</td>
<td>001822</td>
<td>SANTI</td>
<td>`3577014704810003</td>
<td>`3577010710100001</td>
<td>REJOMULYO</td>
<td>KARTOHARJO</td>
<td>MADIUN</td>
<td>07-04-1981</td>
<td>38</td>
<td>P</td>
<td>POLI UMUM</td>
<td>LAMA</td>
<td>KASUS BARU</td>
<td>BPJS</td>
<td>PBI (APBN)</td>
<td>`0000786986932</td>
<td>130802030519Y001794</td>
<td align='center'>
R42 </td>
</tr>

<td>321</td>
<td>23-05-2019</td>
<td>000607</td>
<td>SLAMET</td>
<td>`3577010809680003</td>
<td>`</td>
<td>KELUN</td>
<td>KARTOHARJO</td>
<td>01-09-1968</td>
<td>50</td>
<td>L</td>
<td>POLI UMUM</td>
<td>LAMA</td>
<td>KASUS BARU</td>
<td>BPJS</td>
<td>PBI (APBN)</td>
<td>`0000786809349</td>
<td>130802030519Y001802</td>
<td align='center'>
J00 </td>
</tr>

<td>322</td>
<td>23-05-2019</td>
<td>001007</td>
<td>WAGIK</td>
<td>`3519086205840002</td>
<td>`</td>
<td>DEMPELAN</td>
<td>MADIUN</td>
<td>MADIUN</td>
<td>22-05-1984</td>
<td>35</td>
<td>P</td>
<td>POLI UMUM</td>
<td>LAMA</td>
<td>KASUS LAMA</td>
<td>BPJS</td>
<td>`0002074466272</td>
<td>130802030519Y001777</td>
<td align='center'>
E04.1 </td>
</tr>

<td>323</td>
<td>23-05-2019</td>
<td>001133</td>
<td>PRIYANTO</td>
<td>`3577010404730002</td>
<td>`3577012104070594</td>
<td>KARTOHARJO</td>
<td>04-04-1973</td>
<td>46</td>
<td>L</td>
<td>POLI UMUM</td>
<td>LAMA</td>
<td>KASUS BARU</td>
<td>BPJS</td>
<td>PBI (APBD)</td>
<td>`0001704812264</td>
<td>130802030519Y001776</td>
<td align='center'>
J01 </td>
</tr>

<td>324</td>
<td>23-05-2019</td>
<td>001253</td>
<td>SUTIYAR</td>
<td>`3519086303670002</td>
<td>`</td>
<td>SUMBEREJO</td>
<td>MADIUN</td>
<td>MADIUN</td>
<td>01-01-1967</td>
<td>52</td>
<td>P</td>
<td>POLI UMUM</td>
<td>LAMA</td>
<td>KASUS BARU</td>
<td>BPJS</td>
<td>PNS DAERAH</td>
<td>`0000100481747</td>
<td>130802030519Y001808</td>
<td align='center'>
I10 </td>
</tr>
<td>325</td>
<td>23-05-2019</td>
<td>002094</td>
<td>NURWATIK</td>
<td>`3519086012750001</td>
<td>`</td>
<td>SUMBEREJO</td>
<td>MADIUN</td>
<td>MADIUN</td>
<td>20-12-1975</td>
<td>43</td>
<td>P</td>
<td>POLI UMUM</td>
<td>LAMA</td>
<td>KASUS BARU</td>
<td>BPJS</td>
<td>`0001539718244</td>
<td>130802030519Y001778</td>
<td align='center'>
W49 </td>
</tr>

<td>326</td>
<td>23-05-2019</td>
<td>011113</td>
<td>HARTINI</td>
<td>`3577015211650002</td>
<td>`3577012104070302</td>
<td>REJOMULYO</td>
<td>KARTOHARJO</td>
<td>12-11-1965</td>
<td>53</td>
<td>P</td>
<td>POLI UMUM</td>
<td>LAMA</td>
<td>BPJS</td>
<td>PBI (APBD)</td>
<td>`0002414004388</td>
<td>130802030519Y001780</td>
<td align='center'>
E11.8 </td>
</tr>

<td>327</td>
<td>23-05-2019</td>
<td>002097</td>
<td>ENNY DIANAWATI</td>
<td>`3577015112800002</td>
<td>`3577012104071760</td>
<td>KARTOHARJO</td>
<td>11-12-1980</td>
<td>38</td>
<td>P</td>
<td>POLI UMUM</td>
<td>LAMA</td>
<td>KASUS BARU</td>
<td>BPJS</td>
<td>PBI (APBN)</td>
<td>`0000786726088</td>
<td>130802030519Y001813</td>
<td align='center'>
J02.9 </td>
</tr>

<td>328</td>
<td>23-05-2019</td>
<td>002370</td>
<td>TARMINAH</td>
<td>`3519076712880005</td>
<td>`</td>
<td>WUNGU</td>
<td>MADIUN</td>
<td>27-12-1988</td>
<td>30</td>
<td>P</td>
<td>POLI UMUM</td>
<td>LAMA</td>
<td>KASUS BARU</td>
<td>BPJS</td>
<td>PNS DAERAH</td>
<td>`0000199009383</td>
<td>130802030519Y001814</td>
<td align='center'>
J11 </td>
</tr>

<td>329</td>
<td>23-05-2019</td>
<td>004141</td>
<td>SUPARMI</td>
<td>`</td>
<td>`</td>
<td>TAWANGREJO</td>
<td>KARTOHARJO</td>
<td>31-12-1975</td>
<td>43</td>
<td>P</td>
<td>POLI UMUM</td>
<td>LAMA</td>
<td>KASUS BARU</td>
<td>BPJS</td>
<td>PBI (APBD)</td>
<td>`0002163612262</td>
<td>130802030519Y001822</td>
<td align='center'>
M06.9 </td>
</tr>

<td>330</td>
<td>23-05-2019</td>
<td>000302</td>
<td>SRI UTAMI</td>
<td>`3577015703740003</td>
<td>`3577012104077814</td>
<td>KELUN</td>
<td>KARTOHARJO</td>
<td>MADIUN</td>
<td>17-03-1974</td>
<td>45</td>
<td>P</td>
<td>POLI UMUM</td>
<td>LAMA</td>
<td>KASUS BARU</td>
<td>BPJS</td>
<td>PBI (APBN)</td>
<td>`0000786305452</td>
<td>130802030519Y001833</td>
<td align='center'>
M79.1 </td>
</tr>

<td>331</td>
<td>23-05-2019</td>
<td>009592</td>
<td>SUROSO</td>
<td>`3519081210660001</td>
<td>`</td>
<td>DEMPELAN</td>
<td>MADIUN</td>
<td>MADIUN</td>
<td>12-10-1966</td>
<td>52</td>
<td>L</td>
<td>POLI UMUM</td>
<td>LAMA</td>
<td>KASUS LAMA</td>
<td>BPJS</td>
<td>`0002232913318</td>
<td>130802030519Y001784</td>
<td align='center'>
N20.0 </td>
</tr>

<td>332</td>
<td>23-05-2019</td>
<td>004261</td>
<td>AMBARIRI LUDVIYANA AGUSTIN</td>
<td>`3577014808950002</td>
<td>`3577011512100074</td>
<td>KARTOHARJO</td>
<td>08-08-1995</td>
<td>23</td>
<td>P</td>
<td>POLI UMUM</td>
<td>LAMA</td>
<td>KASUS BARU</td>
<td>BPJS</td>
<td>`0001856082453</td>
<td>130802030519Y001836</td>
<td align='center'>
J11 </td>
</tr>

<td>333</td>
<td>23-05-2019</td>
<td>010328</td>
<td>SULISTYANINGSIH</td>
<td>`</td>
<td>`</td>
<td>NGLAMES</td>
<td>MADIUN</td>
<td>MADIUN</td>
<td>13-12-1967</td>
<td>51</td>
<td>P</td>
<td>POLI UMUM</td>
<td>LAMA</td>
<td>KASUS BARU</td>
<td>BPJS</td>
<td>`0002623499324</td>
<td>130802030519Y001838</td>
<td align='center'>
M79.1 </td>
</tr>

<td>334</td>
<td>23-05-2019</td>
<td>005438</td>
<td>SUPARDI</td>
<td>`</td>
<td>`</td>
<td>KARTOHARJO</td>
<td>06-07-1967</td>
<td>51</td>
<td>L</td>
<td>POLI UMUM</td>
<td>LAMA</td>
<td>KASUS LAMA</td>
<td>BPJS</td>
<td>PBI (APBD)</td>
<td>`0002289411235</td>
<td>130802030519Y001785</td>
<td align='center'>
I25.9 </td>
</tr>

<td>335</td>
<td>23-05-2019</td>
<td>002917</td>
<td>TRI ASTUTI</td>
<td>`</td>
<td>`</td>
<td>TAWANGREJO</td>
<td>KARTOHARJO</td>
<td>MADIUN</td>
<td>24-06-1982</td>
<td>36</td>
<td>P</td>
<td>POLI UMUM</td>
<td>LAMA</td>
<td>KASUS BARU</td>
<td>BPJS</td>
<td>PBI (APBD)</td>
<td>`0002158642912</td>
<td>130802030519Y001839</td>
<td align='center'>
H10.9 </td>
</tr>

<td>336</td>
<td>23-05-2019</td>
<td>008012</td>
<td>SUNARSIH</td>
<td>`</td>
<td>`</td>
<td>TEMPURSARI</td>
<td>WUNGU</td>
<td>MADIUN</td>
<td>14-05-1970</td>
<td>49</td>
<td>P</td>
<td>POLI UMUM</td>
<td>LAMA</td>
<td>KASUS BARU</td>
<td>BPJS</td>
<td>`0002314170865</td>
<td>130802030519Y001841</td>
<td align='center'>
M54.5 </td>
</tr>

<td>337</td>
<td>24-05-2019</td>
<td>012685</td>
<td>HANNY ROBERT SARVIDAES</td>
<td>`3519080412650002</td>
<td>`3577011506120004</td>
<td>REJOMULYO</td>
<td>KARTOHARJO</td>
<td>04-12-1965</td>
<td>53</td>
<td>L</td>
<td>POLI UMUM</td>
<td>BARU</td>
<td>KASUS BARU</td>
<td>BPJS</td>
<td>PBI (APBD)</td>
<td>`0001787254751</td>
<td>130802030519Y001885</td>
<td align='center'>
R50.9 </td>
</tr>

<td>338</td>
<td>24-05-2019</td>
<td>012688</td>
<td>SHARA VINISE HERDILLA SAPUTRI</td>
<td>`3577026801930003</td>
<td>`3577011306170010</td>
<td>KLEGEN</td>
<td>KARTOHARJO</td>
<td>28-01-1993</td>
<td>26</td>
<td>P</td>
<td>POLI UMUM</td>
<td>BARU</td>
<td>KASUS BARU</td>
<td>UMUM</td>
<td>`0001098302725</td>
<td></td>
<td align='center'>
Q54.4 </td>
</tr>

<td>339</td>
<td>24-05-2019</td>
<td>012694</td>
<td>JERRY KUSUMA PRATAMA</td>
<td>`3577010301010002</td>
<td>`3577011104180001</td>
<td>REJOMULYO</td>
<td>KARTOHARJO</td>
<td>03-01-2001</td>
<td>18</td>
<td>L</td>
<td>POLI UMUM</td>
<td>BARU</td>
<td>KASUS BARU</td>
<td>BPJS</td>
<td>PBI (APBD)</td>
<td>`0002413931152</td>
<td>130802030519Y001888</td>
<td align='center'>
J02.9 </td>
</tr>

<td>340</td>
<td>24-05-2019</td>
<td>007340</td>
<td>WAHYU KAHFIANA SANJAYA</td>
<td>`3577015910960001</td>
<td>`3577011605160002</td>
<td>REJOMULYO</td>
<td>KARTOHARJO</td>
<td>19-10-1996</td>
<td>22</td>
<td>P</td>
<td>POLI UMUM</td>
<td>LAMA</td>
<td>KASUS BARU</td>
<td>BPJS</td>
<td>`0001801516318</td>
<td>130802030519Y001858</td>
<td align='center'>
T18.1 </td>
</tr>

<td>341</td>
<td>24-05-2019</td>
<td>011731</td>
<td>HENDRIK SETIAWAN</td>
<td>`3577012511900003</td>
<td>`</td>
<td>REJOMULYO</td>
<td>KARTOHARJO</td>
<td>25-11-1991</td>
<td>27</td>
<td>L</td>
<td>POLI UMUM</td>
<td>LAMA</td>
<td>KASUS BARU</td>
<td>BPJS</td>
<td>PBI (APBD)</td>
<td>`0002416308546</td>
<td>130802030519Y001860</td>
<td align='center'>
D37.9 </td>
</tr>

<td>342</td>
<td>24-05-2019</td>
<td>012681</td>
<td>SUMARNO</td>
<td>`</td>
<td>`</td>
<td>TEMPURSARI</td>
<td>WUNGU</td>
<td>MADIUN</td>
<td>20-07-1976</td>
<td>42</td>
<td>L</td>
<td>POLI UMUM</td>
<td>LAMA</td>
<td>KASUS BARU</td>
<td>UMUM</td>
<td></td>
<td>`</td>
<td></td>
<td align='center'>
M79.1 </td>
</tr>

<td>343</td>
<td>24-05-2019</td>
<td>002014</td>
<td>HARSONO</td>
<td>`3519081709780002</td>
<td>`</td>
<td>BANJARSARI</td>
<td>MADIUN</td>
<td>MADIUN</td>
<td>17-09-1978</td>
<td>40</td>
<td>L</td>
<td>POLI UMUM</td>
<td>LAMA</td>
<td>KASUS LAMA</td>
<td>BPJS</td>
<td>`0001437656128</td>
<td>130802030519Y001893</td>
<td align='center'>
R05 </td>
</tr>

<td>344</td>
<td>24-05-2019</td>
<td>012588</td>
<td>PANJI PANILIH </td>
<td>`3577011612920002</td>
<td>`</td>
<td>KARTOHARJO</td>
<td>16-12-1991</td>
<td>27</td>
<td>L</td>
<td>POLI UMUM</td>
<td>LAMA</td>
<td>KASUS BARU</td>
<td>BPJS</td>
<td>PBI (APBD)</td>
<td>`0002416858571</td>
<td>130802030519Y001895</td>
<td align='center'>
R50.9 </td>
</tr>

<td>345</td>
<td>24-05-2019</td>
<td>003266</td>
<td>SULISTYOWATI</td>
<td>`</td>
<td>`</td>
<td>KELUN</td>
<td>KARTOHARJO</td>
<td>05-05-1980</td>
<td>39</td>
<td>P</td>
<td>POLI UMUM</td>
<td>LAMA</td>
<td>KASUS LAMA</td>
<td>BPJS</td>
<td>`0000787201446</td>
<td>130802030519Y001862</td>
<td align='center'>
J45 </td>
</tr>

<td>346</td>
<td>24-05-2019</td>
<td>000282</td>
<td>SUJIANI</td>
<td>`3519084910780003</td>
<td>`</td>
<td>SUMBEREJO</td>
<td>MADIUN</td>
<td>MADIUN</td>
<td>07-09-1978</td>
<td>40</td>
<td>P</td>
<td>POLI UMUM</td>
<td>LAMA</td>
<td>KASUS BARU</td>
<td>BPJS</td>
<td>TNI ANGKATAN UDARA</td>
<td>`0001108884699</td>
<td>130802030519Y001898</td>
<td align='center'>
J11 </td>
</tr>

<td>347</td>
<td>24-05-2019</td>
<td>012684</td>
<td>IRDA MEGA PUSPITA</td>
<td>`</td>
<td>`</td>
<td>NGLAMES</td>
<td>MADIUN</td>
<td>MADIUN</td>
<td>24-04-1990</td>
<td>29</td>
<td>P</td>
<td>POLI UMUM</td>
<td>LAMA</td>
<td>KASUS BARU</td>
<td>UMUM</td>
<td></td>
<td>`</td>
<td></td>
<td align='center'>
R50.9 </td>
</tr>

<td>348</td>
<td>24-05-2019</td>
<td>012443</td>
<td>BUDIYAH</td>
<td>`3519085308670002</td>
<td>`</td>
<td>SUMBEREJO</td>
<td>MADIUN</td>
<td>MADIUN</td>
<td>13-08-1967</td>
<td>51</td>
<td>P</td>
<td>POLI UMUM</td>
<td>LAMA</td>
<td>KASUS BARU</td>
<td>BPJS</td>
<td>`0002760253402</td>
<td>130802030519Y001901</td>
<td align='center'>
L60.9 </td>
</tr>

<td>349</td>
<td>24-05-2019</td>
<td>002236</td>
<td>`3519146309900001</td>
<td>`</td>
<td>BANJARSARI</td>
<td>MADIUN</td>
<td>MADIUN</td>
<td>01-01-1970</td>
<td>49</td>
<td>P</td>
<td>POLI UMUM</td>
<td>LAMA</td>
<td>KASUS BARU</td>
<td>BPJS</td>
<td>`0002236807214</td>
<td>130802030519Y001866</td>
<td align='center'>
I88.9 </td>
</tr>

<td>350</td>
<td>24-05-2019</td>
<td>002381</td>
<td>ENDANG INTRIYANI</td>
<td>`3577016110650003</td>
<td>`3577012104079046</td>
<td>KELUN</td>
<td>KARTOHARJO</td>
<td>21-10-1965</td>
<td>53</td>
<td>P</td>
<td>Pensiunan</td>
<td>POLI UMUM</td>
<td>LAMA</td>
<td>KASUS LAMA</td>
<td>BPJS</td>
<td>PENERIMA PENSIUN PNS</td>
<td>`0000106273539</td>
<td>130802030519Y001864</td>
<td align='center'>
F41.9 </td>
</tr>

<td>351</td>
<td>24-05-2019</td>
<td>004583</td>
<td>SUNARTI</td>
<td>`</td>
<td>`</td>
<td>KARTOHARJO</td>
<td>01-05-1973</td>
<td>46</td>
<td>P</td>
<td>POLI UMUM</td>
<td>LAMA</td>
<td>KASUS BARU</td>
<td>BPJS</td>
<td>PBI (APBN)</td>
<td>`0000786585464</td>
<td>130802030519Y001905</td>
<td align='center'>
H66.9 </td>
</tr>

<td>352</td>
<td>24-05-2019</td>
<td>001478</td>
<td>TUTIK SUJANI</td>
<td>`3577016212660002</td>
<td>`3577012104078560</td>
<td>KELUN</td>
<td>KARTOHARJO</td>
<td>22-12-1966</td>
<td>52</td>
<td>P</td>
<td>Pensiunan</td>
<td>POLI UMUM</td>
<td>LAMA</td>
<td>KASUS LAMA</td>
<td>BPJS</td>
<td>`0000977277183</td>
<td>130802030519Y001867</td>
<td align='center'>
E05 </td>
</tr>

<td>353</td>
<td>24-05-2019</td>
<td>002915</td>
<td>KHOLIFAH NUR SYAMSYAH</td>
<td>`</td>
<td>`</td>
<td>KELUN</td>
<td>KARTOHARJO</td>
<td>01-11-2000</td>
<td>18</td>
<td>P</td>
<td>POLI UMUM</td>
<td>LAMA</td>
<td>KASUS LAMA</td>
<td>BPJS</td>
<td>PBI (APBN)</td>
<td>`0000786776365</td>
<td>130802030519Y001874</td>
<td align='center'>
E25.0 </td>
</tr>

<td>354</td>
<td>24-05-2019</td>
<td>012696</td>
<td>LAKSONO WIDODO</td>
<td>`</td>
<td>`</td>
<td>TIRON</td>
<td>MADIUN</td>
<td>MADIUN</td>
<td>19-02-1991</td>
<td>28</td>
<td>L</td>
<td>POLI UMUM</td>
<td>LAMA</td>
<td>KASUS BARU</td>
<td>UMUM</td>
<td></td>
<td>`</td>
<td></td>
<td align='center'>
L02.2 </td>
</tr>

<td>355</td>
<td>24-05-2019</td>
<td>012605</td>
<td>TRI PUJIWATI</td>
<td>`3577017012690002</td>
<td>`3577012104072255</td>
<td>KARTOHARJO</td>
<td>30-12-1969</td>
<td>49</td>
<td>P</td>
<td>POLI UMUM</td>
<td>LAMA</td>
<td>KASUS BARU</td>
<td>BPJS</td>
<td>PBI (APBD)</td>
<td>`0001704817168</td>
<td>130802030519Y001909</td>
<td align='center'>
B00 </td>
</tr>

<td>356</td>
<td>27-05-2019</td>
<td>012727</td>
<td>NURHAYATI</td>
<td>`3520024206860002</td>
<td>`3577013004140008</td>
<td>KARTOHARJO</td>
<td>02-06-1986</td>
<td>32</td>
<td>P</td>
<td>POLI UMUM</td>
<td>BARU</td>
<td>KASUS BARU</td>
<td>BPJS</td>
<td>`0001824490181</td>
<td>130802030519Y001964</td>
<td align='center'>
J11 </td>
</tr>

<td>357</td>
<td>27-05-2019</td>
<td>012728</td>
<td>PURWANTO</td>
<td>`3577010105740002</td>
<td>`3577010610110002</td>
<td>KELUN</td>
<td>KARTOHARJO</td>
<td>01-05-1974</td>
<td>45</td>
<td>L</td>
<td>POLI UMUM</td>
<td>BARU</td>
<td></td>
<td>BPJS</td>
<td>PBI (APBD)</td>
<td>`0002163589029</td>
<td>130802030519Y001953</td>
<td align='center'>
S99.9 </td>
</tr>

<td>358</td>
<td>27-05-2019</td>
<td>012737</td>
<td>ENDRA WIDIYANTO</td>
<td>`3504161804860001</td>
<td>`3577010201180006</td>
<td>KARTOHARJO</td>
<td>18-04-1986</td>
<td>33</td>
<td>L</td>
<td>POLI UMUM</td>
<td>LAMA</td>
<td></td>
<td>UMUM</td>
<td>`0001821660276</td>
<td></td>
<td align='center'>
J11 </td>
</tr>

<td>359</td>
<td>27-05-2019</td>
<td>012768</td>
<td>MARIANI</td>
<td>`3519085205990001</td>
<td>`3577011702110009</td>
<td>KARTOHARJO</td>
<td>12-05-1999</td>
<td>20</td>
<td>P</td>
<td>POLI UMUM</td>
<td>BARU</td>
<td>KASUS BARU</td>
<td>BPJS</td>
<td>PBI (APBD)</td>
<td>`0002163596499</td>
<td>130802030519Y002039</td>
<td align='center'>
J11 </td>
</tr>
<td>360</td>
<td>27-05-2019</td>
<td>007639</td>
<td>SUWANTO</td>
<td>` 3577012002770001</td>
<td>`3577012104078978</td>
<td>KELUN</td>
<td>KARTOHARJO</td>
<td>20-02-1977</td>
<td>42</td>
<td>L</td>
<td>POLI UMUM</td>
<td>LAMA</td>
<td>BPJS</td>
<td>PBI (APBN)</td>
<td>`0001049801152</td>
<td>130802030519Y001946</td>
<td align='center'>
J44.9 </td>
</tr>

<td>361</td>
<td>27-05-2019</td>
<td>001822</td>
<td>SANTI</td>
<td>`3577014704810003</td>
<td>`3577010710100001</td>
<td>REJOMULYO</td>
<td>KARTOHARJO</td>
<td>MADIUN</td>
<td>07-04-1981</td>
<td>38</td>
<td>P</td>
<td>POLI UMUM</td>
<td>LAMA</td>
<td>KASUS BARU</td>
<td>BPJS</td>
<td>PBI (APBN)</td>
<td>`0000786986932</td>
<td>130802030519Y001968</td>
<td align='center'>
D64.9 </td>
</tr>

<td>362</td>
<td>27-05-2019</td>
<td>007541</td>
<td>SRIATUN</td>
<td>`3519074507760009</td>
<td>`</td>
<td>WUNGU</td>
<td>MADIUN</td>
<td>05-07-1976</td>
<td>42</td>
<td>P</td>
<td>POLI UMUM</td>
<td>LAMA</td>
<td>KASUS BARU</td>
<td>BPJS</td>
<td></td>
<td>`0002266328103</td>
<td>130802030519Y001970</td>
<td align='center'>
I15.9 </td>
</tr>

<td>363</td>
<td>27-05-2019</td>
<td>007891</td>
<td>HARYONO</td>
<td>`3577011911750002</td>
<td>`3577012104071638</td>
<td>KARTOHARJO</td>
<td>19-11-1975</td>
<td>43</td>
<td>L</td>
<td>POLI UMUM</td>
<td>LAMA</td>
<td>KASUS BARU</td>
<td>BPJS</td>
<td>`0001155699628</td>
<td>130802030519Y002040</td>
<td align='center'>
M79.1 </td>
</tr>

<td>364</td>
<td>27-05-2019</td>
<td>000065</td>
<td>SARMINAH</td>
<td>`3577016001730003</td>
<td>`3577011802100007</td>
<td>KARTOHARJO</td>
<td>20-01-1973</td>
<td>46</td>
<td>P</td>
<td>POLI UMUM</td>
<td>LAMA</td>
<td>KASUS BARU</td>
<td>BPJS</td>
<td>PBI (APBN)</td>
<td>`0000787219255</td>
<td>130802030519Y001973</td>
<td align='center'>
I10 </td>
</tr>

<td>365</td>
<td>27-05-2019</td>
<td>001862</td>
<td>HARTINI</td>
<td>`3577017009750006</td>
<td>`3577010610110002</td>
<td>KELUN</td>
<td>KARTOHARJO</td>
<td>30-09-1975</td>
<td>43</td>
<td>P</td>
<td>POLI UMUM</td>
<td>LAMA</td>
<td>KASUS BARU</td>
<td>BPJS</td>
<td>PBI (APBD)</td>
<td>`0002163589031</td>
<td>130802030519Y001955</td>
<td align='center'>
M65 </td>
</tr>

<td>366</td>
<td>27-05-2019</td>
<td>004426</td>
<td>YOYON PURWANTO</td>
<td>`</td>
<td>`</td>
<td>KARTOHARJO</td>
<td>09-05-1980</td>
<td>39</td>
<td>L</td>
<td>POLI UMUM</td>
<td>LAMA</td>
<td>KASUS LAMA</td>
<td>BPJS</td>
<td>PBI (APBD)</td>
<td>`0001847822455</td>
<td>130802030519Y001957</td>
<td align='center'>
I15.9 </td>
</tr>

<td>367</td>
<td>27-05-2019</td>
<td>001584</td>
<td>INDASAH</td>
<td>`3577015109740004</td>
<td>`3577012104071599</td>
<td>KARTOHARJO</td>
<td>11-09-1974</td>
<td>44</td>
<td>P</td>
<td>POLI UMUM</td>
<td>LAMA</td>
<td>KASUS BARU</td>
<td>BPJS</td>
<td>PBI (APBN)</td>
<td>`0000787301695</td>
<td>130802030519Y002029</td>
<td align='center'>
A09 </td>
</tr>

<td>368</td>
<td>27-05-2019</td>
<td>011169</td>
<td>USMAN</td>
<td>`</td>
<td>`</td>
<td>KARTOHARJO</td>
<td>31-07-1971</td>
<td>47</td>
<td>L</td>
<td>POLI UMUM</td>
<td>LAMA</td>
<td>BPJS</td>
<td>PBI (APBD)</td>
<td>`0001704812455</td>
<td>130802030519Y002030</td>
<td align='center'>
R05 </td>
</tr>

<td>369</td>
<td>27-05-2019</td>
<td>004247</td>
<td>ANITA RIYANA R</td>
<td>`</td>
<td>`</td>
<td>REJOMULYO</td>
<td>KARTOHARJO</td>
<td>10-07-1996</td>
<td>22</td>
<td>P</td>
<td>POLI UMUM</td>
<td>LAMA</td>
<td>KASUS BARU</td>
<td>BPJS</td>
<td></td>
<td>`0001704810183</td>
<td>130802030519Y001994</td>
<td align='center'>
H52.7 </td>
</tr>

<td>370</td>
<td>27-05-2019</td>
<td>002301</td>
<td>JARENDA DEVEGA KUSUMAWARDHANI</td>
<td>`3577016712940001</td>
<td>`3577012104078736</td>
<td>KELUN</td>
<td>KARTOHARJO</td>
<td>27-12-1994</td>
<td>24</td>
<td>P</td>
<td>POLI UMUM</td>
<td>LAMA</td>
<td>KASUS LAMA</td>
<td>BPJS</td>
<td>`0002269639618</td>
<td>130802030519Y001996</td>
<td align='center'>
L40.0 </td>
</tr>

<td>371</td>
<td>27-05-2019</td>
<td>002903</td>
<td>SITI MUAWANAH</td>
<td>`</td>
<td>`</td>
<td>KELUN</td>
<td>KARTOHARJO</td>
<td>27-07-1973</td>
<td>45</td>
<td>P</td>
<td>POLI UMUM</td>
<td>LAMA</td>
<td>KASUS BARU</td>
<td>BPJS</td>
<td>PNS DAERAH</td>
<td>`0000105201246</td>
<td>130802030519Y001999</td>
<td align='center'>
T31.0 </td>
</tr>

<td>372</td>
<td>27-05-2019</td>
<td>005709</td>
<td>`</td>
<td>`</td>
<td>KARTOHARJO</td>
<td>01-05-1972</td>
<td>47</td>
<td>P</td>
<td>POLI UMUM</td>
<td>LAMA</td>
<td>KASUS BARU</td>
<td>BPJS</td>
<td>PBI (APBD)</td>
<td>`0002163609573</td>
<td>130802030519Y002019</td>
<td align='center'>
E11 </td>
</tr>

<td>373</td>
<td>27-05-2019</td>
<td>012322</td>
<td>PARYONO</td>
<td>`3577010101380010</td>
<td>`3577012104071061</td>
<td>KARTOHARJO</td>
<td>01-01-1970</td>
<td>49</td>
<td>L</td>
<td>POLI UMUM</td>
<td>LAMA</td>
<td>KASUS LAMA</td>
<td>BPJS</td>
<td>PBI (APBN)</td>
<td>`0000787552389</td>
<td>130802030519Y002013</td>
<td align='center'>
N40 </td>
</tr>

<td>374</td>
<td>27-05-2019</td>
<td>002740</td>
<td>AKHMAD YURIANTO WARIMAN</td>
<td>`3577012303840002</td>
<td>`3577012004077910</td>
<td>REJOMULYO</td>
<td>KARTOHARJO</td>
<td>23-03-1984</td>
<td>35</td>
<td>L</td>
<td>POLI UMUM</td>
<td>LAMA</td>
<td>KASUS LAMA</td>
<td>BPJS</td>
<td></td>
<td>`0002416857884</td>
<td>130802030519Y002015</td>
<td align='center'>
F23.9 </td>
</tr>

<td>375</td>
<td>27-05-2019</td>
<td>010728</td>
<td>EKA BUYA HARI</td>
<td>`3519062101900001</td>
<td>`</td>
<td>TAWANGREJO</td>
<td>GEMARANG</td>
<td>MADIUN</td>
<td>21-01-1990</td>
<td>29</td>
<td>L</td>
<td>POLI UMUM</td>
<td>LAMA</td>
<td>KASUS BARU</td>
<td>BPJS</td>
<td>`0002508112912</td>
<td></td>
<td align='center'>
R05 </td>
</tr>

<td>376</td>
<td>27-05-2019</td>
<td>012774</td>
<td>SUYANTI</td>
<td>`</td>
<td>`</td>
<td>SUMBEREJO</td>
<td>MADIUN</td>
<td>MADIUN</td>
<td>28-11-1975</td>
<td>43</td>
<td>P</td>
<td>POLI UMUM</td>
<td>LAMA</td>
<td>KASUS BARU</td>
<td>UMUM</td>
<td></td>
<td>`</td>
<td></td>
<td align='center'>
I84 </td>
</tr>

<td>377</td>
<td>28-05-2019</td>
<td>012792</td>
<td>SRI WAHYUNI SULISTYOWATI</td>
<td>`</td>
<td>`</td>
<td>SIDOMULYO</td>
<td>SAWAHAN</td>
<td>MADIUN</td>
<td>22-06-1982</td>
<td>36</td>
<td>P</td>
<td>POLI UMUM</td>
<td>BARU</td>
<td>KASUS BARU</td>
<td>BPJS</td>
<td>`0001438433019</td>
<td>130802030519Y002081</td>
<td align='center'>
H10 </td>
</tr>

<td>378</td>
<td>28-05-2019</td>
<td>012795</td>
<td>MULA WARDHANA</td>
<td>`3577013008710001</td>
<td>`3577012104071813</td>
<td>KARTOHARJO</td>
<td>30-08-1971</td>
<td>47</td>
<td>L</td>
<td>POLI UMUM</td>
<td>BARU</td>
<td>KASUS BARU</td>
<td>BPJS</td>
<td>PBI (APBD)</td>
<td>`0002163610539</td>
<td>130802030519Y002082</td>
<td align='center'>
J00 </td>
</tr>

<td>379</td>
<td>28-05-2019</td>
<td>012797</td>
<td>DARMAYADI</td>
<td>`3577011509640002</td>
<td>`3577010404110002</td>
<td>KELUN</td>
<td>KARTOHARJO</td>
<td>15-09-1964</td>
<td>54</td>
<td>L</td>
<td>POLI UMUM</td>
<td>BARU</td>
<td>KASUS BARU</td>
<td>BPJS</td>
<td>PBI (APBD)</td>
<td>`0002163587398</td>
<td>130802030519Y002083</td>
<td align='center'>
R50.9 </td>
</tr>

<td>380</td>
<td>28-05-2019</td>
<td>012818</td>
<td>RUSMIATI</td>
<td>`3519084509640002</td>
<td>`</td>
<td>BETEK</td>
<td>MADIUN</td>
<td>MADIUN</td>
<td>05-09-1964</td>
<td>54</td>
<td>P</td>
<td>POLI UMUM</td>
<td>BARU</td>
<td>KASUS BARU</td>
<td>UMUM</td>
<td>`0002471666679</td>
<td></td>
<td align='center'>
R05 </td>
</tr>

<td>381</td>
<td>28-05-2019</td>
<td>012833</td>
<td>EVI JUWARNINGSIH</td>
<td>`3577025103820002</td>
<td>`3577013005120006</td>
<td>KARTOHARJO</td>
<td>11-03-1982</td>
<td>37</td>
<td>P</td>
<td>POLI UMUM</td>
<td>BARU</td>
<td>KASUS BARU</td>
<td>BPJS</td>
<td>PBI (APBD)</td>
<td>`0002163624401</td>
<td></td>
<td align='center'>
J11 </td>
</tr>

<td>382</td>
<td>28-05-2019</td>
<td>004308</td>
<td>RISTIYAH</td>
<td>`3519144901900002</td>
<td>`</td>
<td>BETEK</td>
<td>MADIUN</td>
<td>MADIUN</td>
<td>09-01-1990</td>
<td>29</td>
<td>P</td>
<td>POLI UMUM</td>
<td>LAMA</td>
<td>KASUS BARU</td>
<td>BPJS</td>
<td>`0002217302651</td>
<td>130802030519Y002111</td>
<td align='center'>
J02.9 </td>
</tr>

<td>383</td>
<td>28-05-2019</td>
<td>011701</td>
<td>MERLINDA KRISTIANA</td>
<td>`3577014103970003</td>
<td>`3577012104078923</td>
<td>KELUN</td>
<td>KARTOHARJO</td>
<td>01-03-1997</td>
<td>22</td>
<td>P</td>
<td>POLI UMUM</td>
<td>LAMA</td>
<td>KASUS BARU</td>
<td>BPJS</td>
<td></td>
<td>`0000786376451</td>
<td>130802030519Y002059</td>
<td align='center'>
J45.0 </td>
</tr>
<td>384</td>
<td>28-05-2019</td>
<td>009299</td>
<td>SRI UTAMI</td>
<td>`3577016106700001</td>
<td>`3577012104072511</td>
<td>KARTOHARJO</td>
<td>21-06-1970</td>
<td>48</td>
<td>P</td>
<td>POLI UMUM</td>
<td>LAMA</td>
<td>KASUS BARU</td>
<td>BPJS</td>
<td>PBI (APBD)</td>
<td>`0002416467159</td>
<td>130802030519Y002114</td>
<td align='center'>
G71.9 </td>
</tr>

<td>385</td>
<td>28-05-2019</td>
<td>012286</td>
<td>SUKARMI</td>
<td>`3577016202770003</td>
<td>`3577012104078780</td>
<td>KELUN</td>
<td>KARTOHARJO</td>
<td>22-02-1977</td>
<td>42</td>
<td>P</td>
<td>POLI UMUM</td>
<td>LAMA</td>
<td>BPJS</td>
<td>PBI (APBN)</td>
<td>`0000786494575</td>
<td>130802030519Y002121</td>
<td align='center'>
R05 </td>
</tr>

<td>386</td>
<td>28-05-2019</td>
<td>005165</td>
<td>HARTONO</td>
<td>`</td>
<td>`</td>
<td>NGLAMES</td>
<td>MADIUN</td>
<td>MADIUN</td>
<td>16-10-1970</td>
<td>48</td>
<td>L</td>
<td>POLI UMUM</td>
<td>LAMA</td>
<td>KASUS LAMA</td>
<td>BPJS</td>
<td>`0002471173716</td>
<td>130802030519Y002061</td>
<td align='center'>
J44.1 </td>
</tr>

<td>387</td>
<td>28-05-2019</td>
<td>012676</td>
<td>ENDAH SUSILOWATI</td>
<td>`</td>
<td>`</td>
<td>TEMPURSARI</td>
<td>WUNGU</td>
<td>MADIUN</td>
<td>23-10-1968</td>
<td>50</td>
<td>P</td>
<td>POLI UMUM</td>
<td>LAMA</td>
<td>KASUS BARU</td>
<td>UMUM</td>
<td></td>
<td>`</td>
<td></td>
<td align='center'>
T30.0 </td>
</tr>

<td>388</td>
<td>28-05-2019</td>
<td>005853</td>
<td>DADIK SUPRIANTORO</td>
<td>`</td>
<td>`</td>
<td>KARTOHARJO</td>
<td>01-08-1974</td>
<td>44</td>
<td>L</td>
<td>POLI UMUM</td>
<td>LAMA</td>
<td>KASUS BARU</td>
<td>BPJS</td>
<td>PBI (APBN)</td>
<td>`0000786651513</td>
<td>130802030519Y002127</td>
<td align='center'>
G43.9 </td>
</tr>

<td>389</td>
<td>28-05-2019</td>
<td>012814</td>
<td>SUKONO </td>
<td>`</td>
<td>`</td>
<td>GUNUNGSARI</td>
<td>MADIUN</td>
<td>MADIUN</td>
<td>09-09-1972</td>
<td>46</td>
<td>L</td>
<td>POLI UMUM</td>
<td>LAMA</td>
<td>KASUS BARU</td>
<td>UMUM</td>
<td></td>
<td>`</td>
<td></td>
<td align='center'>
K30 </td>
</tr>

<td>390</td>
<td>28-05-2019</td>
<td>002124</td>
<td>INNA ARSYALITA</td>
<td>`3519085504990001</td>
<td>`</td>
<td>BANJARSARI</td>
<td>MADIUN</td>
<td>MADIUN</td>
<td>01-04-1999</td>
<td>20</td>
<td>P</td>
<td>POLI UMUM</td>
<td>LAMA</td>
<td>KASUS BARU</td>
<td>BPJS</td>
<td>PBI (APBN)</td>
<td>`0000739024672</td>
<td>130802030519Y002132</td>
<td align='center'>
K21 </td>
</tr>

<td>391</td>
<td>28-05-2019</td>
<td>004423</td>
<td>SUPRIATI</td>
<td>`3519086602650001</td>
<td>`</td>
<td>BANJARSARI</td>
<td>MADIUN</td>
<td>MADIUN</td>
<td>26-02-1965</td>
<td>54</td>
<td>P</td>
<td>POLI UMUM</td>
<td>LAMA</td>
<td>KASUS LAMA</td>
<td>BPJS</td>
<td>`0002044184949</td>
<td>130802030519Y002062</td>
<td align='center'>
I25.9 </td>
</tr>

<td>392</td>
<td>28-05-2019</td>
<td>000458</td>
<td>WAHYU TRIANA</td>
<td>`</td>
<td>`</td>
<td>TAWANGREJO</td>
<td>KARTOHARJO</td>
<td>30-05-1991</td>
<td>28</td>
<td>P</td>
<td>POLI UMUM</td>
<td>LAMA</td>
<td>KASUS BARU</td>
<td>BPJS</td>
<td></td>
<td>`0002163587466</td>
<td>130802030519Y002141</td>
<td align='center'>
M13 </td>
</tr>

<td>393</td>
<td>28-05-2019</td>
<td>007391</td>
<td>TRI EMI</td>
<td>`</td>
<td>`</td>
<td>NGLAMES</td>
<td>MADIUN</td>
<td>MADIUN</td>
<td>25-01-1968</td>
<td>51</td>
<td>P</td>
<td>POLI UMUM</td>
<td>LAMA</td>
<td>KASUS BARU</td>
<td>UMUM</td>
<td></td>
<td>`</td>
<td></td>
<td align='center'>
M13 </td>
</tr>

<td>394</td>
<td>28-05-2019</td>
<td>012825</td>
<td>YUYUN INDRA WATI</td>
<td>`</td>
<td>`</td>
<td>TIRON</td>
<td>MADIUN</td>
<td>MADIUN</td>
<td>26-04-1981</td>
<td>38</td>
<td>P</td>
<td>POLI UMUM</td>
<td>BARU</td>
<td>KASUS BARU</td>
<td>UMUM</td>
<td></td>
<td>`</td>
<td></td>
<td align='center'>
R50.9 </td>
</tr>

<td>395</td>
<td>28-05-2019</td>
<td>004250</td>
<td>PAIMAN</td>
<td>`3519072110400001</td>
<td>`</td>
<td>WUNGU</td>
<td>MADIUN</td>
<td>01-01-1970</td>
<td>49</td>
<td>L</td>
<td>POLI UMUM</td>
<td>LAMA</td>
<td>KASUS LAMA</td>
<td>BPJS</td>
<td>PNS PUSAT</td>
<td>`0001290007113</td>
<td>130802030519Y002064</td>
<td align='center'>
I84.9 </td>
</tr>

<td>396</td>
<td>28-05-2019</td>
<td>005709</td>
<td>`</td>
<td>`</td>
<td>KARTOHARJO</td>
<td>01-05-1972</td>
<td>47</td>
<td>P</td>
<td>POLI UMUM</td>
<td>LAMA</td>
<td>KASUS BARU</td>
<td>BPJS</td>
<td>PBI (APBD)</td>
<td>`0002163609573</td>
<td>130802030519Y002065</td>
<td align='center'>
E11 </td>
</tr>

<td>397</td>
<td>28-05-2019</td>
<td>002851</td>
<td>DWI PRAPTINI</td>
<td>`</td>
<td>`</td>
<td>KARTOHARJO</td>
<td>01-05-1969</td>
<td>50</td>
<td>P</td>
<td>POLI UMUM</td>
<td>LAMA</td>
<td>KASUS LAMA</td>
<td>BPJS</td>
<td>PBI (APBN)</td>
<td>`0000786618922</td>
<td>130802030519Y002068</td>
<td align='center'>
E11.8 </td>
</tr>

<td>398</td>
<td>28-05-2019</td>
<td>000451</td>
<td>SUMADI</td>
<td>`3577010505650002</td>
<td>`3577012104071291</td>
<td>KARTOHARJO</td>
<td>MADIUN</td>
<td>05-05-1965</td>
<td>54</td>
<td>L</td>
<td>Buruh Harian Lepas</td>
<td>POLI UMUM</td>
<td>LAMA</td>
<td>BPJS</td>
<td>PBI (APBN)</td>
<td>`0000786880348</td>
<td>130802030519Y002149</td>
<td align='center'>
E11 </td>
</tr>

<td>399</td>
<td>29-05-2019</td>
<td>012880</td>
<td>KUSNO</td>
<td>`3577012808780004</td>
<td>`3577012802170005</td>
<td>KELUN</td>
<td>KARTOHARJO</td>
<td>28-08-1978</td>
<td>40</td>
<td>L</td>
<td>POLI UMUM</td>
<td>BARU</td>
<td>KASUS BARU</td>
<td>BPJS</td>
<td>PBI (APBN)</td>
<td>`0000786775825</td>
<td></td>
<td align='center'>
J11 </td>
</tr>

<td>400</td>
<td>29-05-2019</td>
<td>009491</td>
<td>WINARTI</td>
<td>`3577037006740001</td>
<td>`3577032004070834</td>
<td>MOJOREJO</td>
<td>TAMAN</td>
<td>30-06-1974</td>
<td>44</td>
<td>P</td>
<td>POLI UMUM</td>
<td>LAMA</td>
<td>KASUS BARU</td>
<td>BPJS</td>
<td>`0002376606374</td>
<td>130802030519Y002209</td>
<td align='center'>
J11 </td>
</tr>

<td>401</td>
<td>29-05-2019</td>
<td>008933</td>
<td>WAHYU TRI R W</td>
<td>`</td>
<td>`</td>
<td>REJOMULYO</td>
<td>KARTOHARJO</td>
<td>31-03-1992</td>
<td>27</td>
<td>L</td>
<td>POLI UMUM</td>
<td>LAMA</td>
<td>KASUS BARU</td>
<td>BPJS</td>
<td>PBI (APBN)</td>
<td>`0000787014516</td>
<td>130802030519Y002212</td>
<td align='center'>
R50.0 </td>
</tr>

<td>402</td>
<td>29-05-2019</td>
<td>000264</td>
<td>GANDIYONO</td>
<td>`3519080407660002</td>
<td>`</td>
<td>TIRON</td>
<td>MADIUN</td>
<td>MADIUN</td>
<td>04-07-1966</td>
<td>52</td>
<td>L</td>
<td>POLI UMUM</td>
<td>LAMA</td>
<td>BPJS</td>
<td>`0002436332409</td>
<td>130802030519Y002215</td>
<td align='center'>
I11 </td>
</tr>

<td>403</td>
<td>29-05-2019</td>
<td>000533</td>
<td>MIRDAS SUKSESI</td>
<td>`3577012503870002</td>
<td>`3577012104078882</td>
<td>KELUN</td>
<td>KARTOHARJO</td>
<td>25-03-1987</td>
<td>32</td>
<td>P</td>
<td>POLI UMUM</td>
<td>LAMA</td>
<td>KASUS LAMA</td>
<td>BPJS</td>
<td>`0000106314298</td>
<td>130802030519Y002216</td>
<td align='center'>
F23 </td>
</tr>

<td>404</td>
<td>29-05-2019</td>
<td>000524</td>
<td>HANIK DWIANTO</td>
<td>`3519081805650002</td>
<td>`</td>
<td>BANJARSARI</td>
<td>MADIUN</td>
<td>MADIUN</td>
<td>18-05-1965</td>
<td>54</td>
<td>L</td>
<td>POLI UMUM</td>
<td>LAMA</td>
<td>KASUS BARU</td>
<td>BPJS</td>
<td>`0001303196657</td>
<td>130802030519Y002217</td>
<td align='center'>
J11 </td>
</tr>

<td>405</td>
<td>29-05-2019</td>
<td>009463</td>
<td>SUGIANA</td>
<td>`3173062703840002</td>
<td>`</td>
<td>DEMPELAN</td>
<td>MADIUN</td>
<td>MADIUN</td>
<td>27-03-1984</td>
<td>35</td>
<td>L</td>
<td>POLI UMUM</td>
<td>LAMA</td>
<td>UMUM</td>
<td>PBI (APBD)</td>
<td>`0001220464427</td>
<td></td>
<td align='center'>
A16.9 </td>
</tr>

<td>406</td>
<td>29-05-2019</td>
<td>011992</td>
<td>PURNOMO</td>
<td>`3519081112740001</td>
<td>`3577010111120001</td>
<td>REJOMULYO</td>
<td>KARTOHARJO</td>
<td>11-12-1974</td>
<td>44</td>
<td>L</td>
<td>POLI UMUM</td>
<td>LAMA</td>
<td>KASUS BARU</td>
<td>BPJS</td>
<td>PBI (APBD)</td>
<td>`0002158641606</td>
<td>130802030519Y002229</td>
<td align='center'>
K12 </td>
</tr>

<td>407</td>
<td>29-05-2019</td>
<td>007541</td>
<td>SRIATUN</td>
<td>`3519074507760009</td>
<td>`</td>
<td>WUNGU</td>
<td>MADIUN</td>
<td>05-07-1976</td>
<td>42</td>
<td>P</td>
<td>POLI UMUM</td>
<td>LAMA</td>
<td>KASUS LAMA</td>
<td>BPJS</td>
<td></td>
<td>`0002266328103</td>
<td>130802030519Y002231</td>
<td align='center'>
I15.9 </td>
</tr>

<td>408</td>
<td>29-05-2019</td>
<td>006922</td>
<td>SITI MAIMUNAH</td>
<td>`3519086412720001</td>
<td>`</td>
<td>NGLAMES</td>
<td>MADIUN</td>
<td>MADIUN</td>
<td>24-12-1972</td>
<td>46</td>
<td>P</td>
<td>POLI UMUM</td>
<td>LAMA</td>
<td>KASUS BARU</td>
<td>BPJS</td>
<td>`0001900175218</td>
<td>130802030519Y002245</td>
<td align='center'>
J02.9 </td>
</tr>

<td>409</td>
<td>29-05-2019</td>
<td>010159</td>
<td>MURYANTO</td>
<td>`3519087606680002</td>
<td>`</td>
<td>NGLAMES</td>
<td>MADIUN</td>
<td>MADIUN</td>
<td>16-06-1968</td>
<td>50</td>
<td>L</td>
<td>POLI UMUM</td>
<td>LAMA</td>
<td>KASUS BARU</td>
<td>BPJS</td>
<td>`0001900174217</td>
<td>130802030519Y002247</td>
<td align='center'>
J00 </td>
</tr>

<td>410</td>
<td>29-05-2019</td>
<td>001604</td>
<td>INDRA WIDYAWATI</td>
<td>`3577016812830004</td>
<td>`3577011112080002</td>
<td>KARTOHARJO</td>
<td>28-12-1983</td>
<td>35</td>
<td>P</td>
<td>POLI UMUM</td>
<td>LAMA</td>
<td>KASUS BARU</td>
<td>BPJS</td>
<td>PBI (APBN)</td>
<td>`0000786863799</td>
<td>130802030519Y002251</td>
<td align='center'>
J02.9 </td>
</tr>

<td>411</td>
<td>29-05-2019</td>
<td>012003</td>
<td>KRISTIN EKAWATI</td>
<td>`3519076212940001</td>
<td>`</td>
<td>KELUN</td>
<td>KARTOHARJO</td>
<td>22-12-1994</td>
<td>24</td>
<td>P</td>
<td>POLI UMUM</td>
<td>LAMA</td>
<td>KASUS BARU</td>
<td>BPJS</td>
<td>`0002740550049</td>
<td></td>
<td align='center'>
R51 </td>
</tr>

<td>412</td>
<td>29-05-2019</td>
<td>011169</td>
<td>USMAN</td>
<td>`</td>
<td>`</td>
<td>KARTOHARJO</td>
<td>31-07-1971</td>
<td>47</td>
<td>L</td>
<td>POLI UMUM</td>
<td>LAMA</td>
<td>KASUS BARU</td>
<td>BPJS</td>
<td>PBI (APBD)</td>
<td>`0001704812455</td>
<td></td>
<td align='center'>
W49 </td>
</tr>

<td>413</td>
<td>29-05-2019</td>
<td>004930</td>
<td>SRI HARTINI</td>
<td>`</td>
<td>`</td>
<td>TAWANGREJO</td>
<td>KARTOHARJO</td>
<td>02-08-1968</td>
<td>50</td>
<td>P</td>
<td>POLI UMUM</td>
<td>LAMA</td>
<td>BPJS</td>
<td>PNS DAERAH</td>
<td>`0000106332041</td>
<td></td>
<td align='center'>
I10 </td>
</tr>

<td>414</td>
<td>29-05-2019</td>
<td>004834</td>
<td>NINUK SUWARNI</td>
<td>`</td>
<td>`</td>
<td>NGLAMES</td>
<td>MADIUN</td>
<td>MADIUN</td>
<td>01-05-1965</td>
<td>54</td>
<td>P</td>
<td>POLI UMUM</td>
<td>LAMA</td>
<td>KASUS BARU</td>
<td>BPJS</td>
<td>PBI (APBN)</td>
<td>`0001045409679</td>
<td></td>
<td align='center'>
J00 </td>
</tr>

<td>415</td>
<td>29-05-2019</td>
<td>002264</td>
<td>YUNITA KRISTIANA</td>
<td>`3577015206820002</td>
<td>`3577010610150006</td>
<td>KARTOHARJO</td>
<td>12-06-1982</td>
<td>36</td>
<td>P</td>
<td>POLI UMUM</td>
<td>LAMA</td>
<td>KASUS BARU</td>
<td>BPJS</td>
<td>`0002078225548</td>
<td></td>
<td align='center'>
R05 </td>
</tr>

<td>416</td>
<td>31-05-2019</td>
<td>012894</td>
<td>RIRIN WIDANARTI</td>
<td>`3577016804810001</td>
<td>`3577012004070472</td>
<td>REJOMULYO</td>
<td>KARTOHARJO</td>
<td>28-04-1981</td>
<td>38</td>
<td>P</td>
<td>POLI UMUM</td>
<td>BARU</td>
<td>KASUS BARU</td>
<td>BPJS</td>
<td>PBI (APBN)</td>
<td>`0000786958975</td>
<td>130802030519Y002392</td>
<td align='center'>
L23 </td>
</tr>

<td>417</td>
<td>31-05-2019</td>
<td>012902</td>
<td>AQMARINA DYANI SYAHPUTRI</td>
<td>`3577017103000001</td>
<td>`3577012104070401</td>
<td>REJOMULYO</td>
<td>KARTOHARJO</td>
<td>31-03-2000</td>
<td>19</td>
<td>P</td>
<td>POLI UMUM</td>
<td>BARU</td>
<td>KASUS BARU</td>
<td>BPJS</td>
<td>PBI (APBD)</td>
<td>`0001704811691</td>
<td>130802030519Y002394</td>
<td align='center'>
J11 </td>
</tr>

<td>418</td>
<td>31-05-2019</td>
<td>012913</td>
<td>RAHADYAN ADITYA DEWANTORO</td>
<td>`</td>
<td>`</td>
<td>KARTOHARJO</td>
<td>03-05-2000</td>
<td>19</td>
<td>L</td>
<td>POLI UMUM</td>
<td>BARU</td>
<td>KASUS BARU</td>
<td>BPJS</td>
<td>PBI (APBD)</td>
<td>`0002742896349</td>
<td>130802030519Y002396</td>
<td align='center'>
W49 </td>
</tr>
<td>419</td>
<td>31-05-2019</td>
<td>012916</td>
<td>HARIS RESPATI BANGUN W.</td>
<td>`3519084410790001</td>
<td>`</td>
<td>NGLAMES</td>
<td>MADIUN</td>
<td>MADIUN</td>
<td>04-10-1979</td>
<td>39</td>
<td>P</td>
<td>POLI UMUM</td>
<td>LAMA</td>
<td>KASUS BARU</td>
<td>UMUM</td>
<td>`0001538702537</td>
<td></td>
<td align='center'>
W49 </td>
</tr>

<td>420</td>
<td>31-05-2019</td>
<td>004035</td>
<td>IKA PUJI WAHYUNI</td>
<td>`3577016806890004</td>
<td>`3577011605160001</td>
<td>REJOMULYO</td>
<td>KARTOHARJO</td>
<td>28-06-1989</td>
<td>29</td>
<td>P</td>
<td>POLI UMUM</td>
<td>LAMA</td>
<td>KASUS BARU</td>
<td>BPJS</td>
<td>`0001801514744</td>
<td>130802030519Y002397</td>
<td align='center'>
M79.1 </td>
</tr>

<td>421</td>
<td>31-05-2019</td>
<td>012795</td>
<td>MULA WARDHANA</td>
<td>`3577013008710001</td>
<td>`3577012104071813</td>
<td>KARTOHARJO</td>
<td>30-08-1971</td>
<td>47</td>
<td>L</td>
<td>POLI UMUM</td>
<td>LAMA</td>
<td>KASUS BARU</td>
<td>BPJS</td>
<td>PBI (APBD)</td>
<td>`0002163610539</td>
<td>130802030519Y002399</td>
<td align='center'>
R50.9 </td>
</tr>

<td>422</td>
<td>31-05-2019</td>
<td>007194</td>
<td>RAHMAWATININGSIH</td>
<td>`</td>
<td>`</td>
<td>KELUN</td>
<td>KARTOHARJO</td>
<td>01-08-1973</td>
<td>45</td>
<td>P</td>
<td>POLI UMUM</td>
<td>LAMA</td>
<td>KASUS BARU</td>
<td>BPJS</td>
<td>PBI (APBN)</td>
<td>`0000787497276</td>
<td>130802030519Y002332</td>
<td align='center'>
H52.7 </td>
</tr>

<td>423</td>
<td>31-05-2019</td>
<td>003042</td>
<td>SRI UMIYATI</td>
<td>`3519086612670001</td>
<td>`3577013001180006</td>
<td>KELUN</td>
<td>KARTOHARJO</td>
<td>26-12-1967</td>
<td>51</td>
<td>P</td>
<td>POLI UMUM</td>
<td>LAMA</td>
<td>KASUS BARU</td>
<td>BPJS</td>
<td>`0001962097569</td>
<td>130802030519Y002402</td>
<td align='center'>
M79.1 </td>
</tr>

<td>424</td>
<td>31-05-2019</td>
<td>008056</td>
<td>AGUS BUDI SETIJONO</td>
<td>`</td>
<td>`</td>
<td>KARTOHARJO</td>
<td>01-08-1973</td>
<td>45</td>
<td>L</td>
<td>Buruh Harian Lepas</td>
<td>POLI UMUM</td>
<td>LAMA</td>
<td>KASUS BARU</td>
<td>BPJS</td>
<td>PBI (APBN)</td>
<td>`0000786660118</td>
<td>130802030519Y002330</td>
<td align='center'>
S05.9 </td>
</tr>

<td>425</td>
<td>31-05-2019</td>
<td>007277</td>
<td>HARIJANTO</td>
<td>`</td>
<td>`</td>
<td>KELUN</td>
<td>KARTOHARJO</td>
<td>01-09-1965</td>
<td>53</td>
<td>L</td>
<td>Wiraswasta</td>
<td>POLI UMUM</td>
<td>LAMA</td>
<td>KASUS BARU</td>
<td>BPJS</td>
<td>PBI (APBN)</td>
<td>`0000786300366</td>
<td>130802030519Y002403</td>
<td align='center'>
E11 </td>
</tr>

<td>426</td>
<td>31-05-2019</td>
<td>010165</td>
<td>MOCH. HIDAYAT</td>
<td>`3577011205990001</td>
<td>`3577013110130010</td>
<td>KARTOHARJO</td>
<td>01-05-1999</td>
<td>20</td>
<td>L</td>
<td>POLI UMUM</td>
<td>LAMA</td>
<td>KASUS BARU</td>
<td>BPJS</td>
<td>PBI (APBN)</td>
<td>`0000787453198</td>
<td>130802030519Y002404</td>
<td align='center'>
J06.9 </td>
</tr>

<td>427</td>
<td>31-05-2019</td>
<td>004896</td>
<td>SUWANDI</td>
<td>`</td>
<td>`</td>
<td>TAWANGREJO</td>
<td>KARTOHARJO</td>
<td>01-03-1970</td>
<td>49</td>
<td>L</td>
<td>POLI UMUM</td>
<td>LAMA</td>
<td>KASUS BARU</td>
<td>BPJS</td>
<td>PBI (APBN)</td>
<td>`0000787218377</td>
<td>130802030519Y002406</td>
<td align='center'>
R10 </td>
</tr>

<td>428</td>
<td>31-05-2019</td>
<td>001584</td>
<td>INDASAH</td>
<td>`3577015109740004</td>
<td>`3577012104071599</td>
<td>KARTOHARJO</td>
<td>11-09-1974</td>
<td>44</td>
<td>P</td>
<td>POLI UMUM</td>
<td>LAMA</td>
<td>KASUS BARU</td>
<td>BPJS</td>
<td>PBI (APBN)</td>
<td>`0000787301695</td>
<td>130802030519Y002410</td>
<td align='center'>
R51 </td>
</tr>

<td>429</td>
<td>31-05-2019</td>
<td>002681</td>
<td>SUMARNI</td>
<td>`</td>
<td>`</td>
<td>TAWANGREJO</td>
<td>KARTOHARJO</td>
<td>MADIUN</td>
<td>04-11-1977</td>
<td>41</td>
<td>P</td>
<td>POLI UMUM</td>
<td>LAMA</td>
<td>KASUS BARU</td>
<td>BPJS</td>
<td></td>
<td>`0002158643564</td>
<td>130802030519Y002412</td>
<td align='center'>
R10 </td>
</tr>

<td>430</td>
<td>31-05-2019</td>
<td>000382</td>
<td>IKA SUSILOWATI</td>
<td>`3577015010900001</td>
<td>`3577012004079744</td>
<td>REJOMULYO</td>
<td>KARTOHARJO</td>
<td>MADIUN</td>
<td>10-10-1990</td>
<td>28</td>
<td>P</td>
<td>POLI UMUM</td>
<td>LAMA</td>
<td>BPJS</td>
<td></td>
<td>`0002413943155</td>
<td>130802030519Y002426</td>
<td align='center'>
F23.9 </td>
</tr>

<td>431</td>
<td>31-05-2019</td>
<td>012663</td>
<td>ARUM CAHYANING TIYAS</td>
<td>`3577014503900004</td>
<td>`3577010610110007</td>
<td>KARTOHARJO</td>
<td>05-03-1990</td>
<td>29</td>
<td>P</td>
<td>POLI UMUM</td>
<td>LAMA</td>
<td>KASUS BARU</td>
<td>BPJS</td>
<td>PBI (APBD)</td>
<td>`0001520034568</td>
<td>130802030519Y002357</td>
<td align='center'>
K35.9 </td>
</tr>

<td>432</td>
<td>31-05-2019</td>
<td>012286</td>
<td>SUKARMI</td>
<td>`3577016202770003</td>
<td>`3577012104078780</td>
<td>KELUN</td>
<td>KARTOHARJO</td>
<td>22-02-1977</td>
<td>42</td>
<td>P</td>
<td>POLI UMUM</td>
<td>LAMA</td>
<td>BPJS</td>
<td>PBI (APBN)</td>
<td>`0000786494575</td>
<td>130802030519Y002428</td>
<td align='center'>
J00 </td>
</tr>

<td>433</td>
<td>31-05-2019</td>
<td>006665</td>
<td>ATIK LISTIYANI</td>
<td>`3577016908720003</td>
<td>`3577012104070401</td>
<td>REJOMULYO</td>
<td>KARTOHARJO</td>
<td>29-08-1972</td>
<td>46</td>
<td>P</td>
<td>POLI UMUM</td>
<td>LAMA</td>
<td>KASUS BARU</td>
<td>BPJS</td>
<td>PBI (APBD)</td>
<td>`0001704811678</td>
<td>130802030519Y002430</td>
<td align='center'>
R07.4 </td>
</tr>

<td>434</td>
<td>31-05-2019</td>
<td>002971</td>
<td>RURI SILVANA DEWI</td>
<td>`3519085912860001</td>
<td>`</td>
<td>NGLAMES</td>
<td>MADIUN</td>
<td>MADIUN</td>
<td>19-12-1986</td>
<td>32</td>
<td>P</td>
<td>POLI UMUM</td>
<td>LAMA</td>
<td>KASUS BARU</td>
<td>BPJS</td>
<td>`0001194080624</td>
<td>130802030519Y002443</td>
<td align='center'>
J00 </td>
</tr>

<td>435</td>
<td>31-05-2019</td>
<td>012818</td>
<td>RUSMIATI</td>
<td>`3519084509640002</td>
<td>`</td>
<td>BETEK</td>
<td>MADIUN</td>
<td>MADIUN</td>
<td>05-09-1964</td>
<td>54</td>
<td>P</td>
<td>POLI UMUM</td>
<td>LAMA</td>
<td>UMUM</td>
<td>`0002471666679</td>
<td></td>
<td align='center'>
R05 </td>
</tr>

<td>436</td>
<td>31-05-2019</td>
<td>003266</td>
<td>SULISTYOWATI</td>
<td>`</td>
<td>`</td>
<td>KELUN</td>
<td>KARTOHARJO</td>
<td>05-05-1980</td>
<td>39</td>
<td>P</td>
<td>POLI UMUM</td>
<td>LAMA</td>
<td>KASUS BARU</td>
<td>BPJS</td>
<td>`0000787201446</td>
<td>130802030519Y002445</td>
<td align='center'>
R10 </td>
</tr>

<td>437</td>
<td>31-05-2019</td>
<td>009507</td>
<td>MUJIONO</td>
<td>` </td>
<td>`3577012004077569</td>
<td>REJOMULYO</td>
<td>KARTOHARJO</td>
<td>06-07-1972</td>
<td>46</td>
<td>L</td>
<td>Wiraswasta</td>
<td>POLI UMUM</td>
<td>LAMA</td>
<td>KASUS BARU</td>
<td>BPJS</td>
<td>PBI (APBN)</td>
<td>`0001049799003</td>
<td>130802030519Y002449</td>
<td align='center'>
J00 </td>
</tr>
</table>

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