RS ASRI MEDIKA

JL Citanduy Raya Blok L11 NO 1 Simpangan Cikarang Utara, 17530

(021) 89142 968 - (021) 89142 969
NPWP :- LAPORAN PASIEN PULANG

Dari Tgl 01-10-2019 S/D 31-10-2019

No Noreg Rek. MediNama Pasien Ruang Tgl Masuktgl Pulan
1 RI2018C15017 00050537 DINARA AZALEA RAIMA,An 204 204 01-10-2019
2 RI2018C15019 00050540 KARSIH BINTI RAHMAN,By Ny 201 28-09-2019 01-10-2019
3 RI2018C15025 00050538 SANIH,Ny 201 28-09-2019 01-10-2019
4 RI2018C15026 00050075 KARSIH,Ny 201 28-09-2019 01-10-2019
5 RI2018C15095 00050564 SAEPUL,Tn 209 30-09-2019 01-10-2019
6 RI2018C15018 00050539 SANIH,By Ny 201 28-09-2019 02-10-2019
7 RI2018C15049 00050548 OLIM,Tn 205 29-09-2019 02-10-2019
8 RI2018C15075 00050559 NURYANTI,By Ny 210 30-09-2019 02-10-2019
9 RI2018C15094 00050566 RENRYU HAZE MIYAZ,An 203 30-09-2019 02-10-2019
10 RI2018C15129 00050407 NURYANTI,Ny 210 30-09-2019 02-10-2019
11 RI2018C15133 00050576 DAHLIA LINDA A,By Ny 209 01-10-2019 02-10-2019
12 RI2018C15135 00050575 DAHLIA LINDA ASTUTI,Ny 209 01-10-2019 02-10-2019
13 RI2018C15137 00050552 ANNASYA ADREENA SAILA,An 210 29-09-2019 02-10-2019
14 RI2018C15146 00050291 FARIDATUL KHASANAH,Nn 210 01-10-2019 02-10-2019
15 RI2018C15177 00050567 SUSIYAH,Ny 201 02-10-2019 02-10-2019
16 RI2018C15162 00050582 IIN PARLINDA,Nn 207 01-10-2019 03-10-2019
17 RI2018C15163 00050583 HABIBAH,Ny 201 01-10-2019 03-10-2019
18 RI2018C15211 00050593 EVA HANDAYANI,Ny 201 02-10-2019 03-10-2019
19 RI2018C15080 00050555 ELVARO DIVANO FISABILILAH,An 204 30-09-2019 04-10-2019
20 RI2018C15180 00050589 HAMZAH,Tn 205 02-10-2019 04-10-2019
21 RI2018C15201 00050592 SAFIAH JULI ANTI,By Ny 201 02-10-2019 04-10-2019
22 RI2018C15205 00050591 SAFIAH JULI ANTI,Ny 201 02-10-2019 04-10-2019
23 RI2018C15224 00050594 DIAN SUNTARA,Ny 201 03-10-2019 04-10-2019
24 RI2018C15257 00047930 UMIN,Tn 205 04-10-2019 05-10-2019
25 RI2018C15226 00050598 LEON ADHITAMA PRIYADI,An 209 03-10-2019 06-10-2019
26 RI2018C15243 00050601 ADAM,An 204 03-10-2019 06-10-2019
27 RI2018C15307 00050617 AMIH SUWARSIH,Ny 210 05-10-2019 07-10-2019
28 RI2018C15286 00050618 MUHAMAD JAELANI,An 204 05-10-2019 08-10-2019

29 RI2018C15306 00050623 NURLAELAH,By Ny 201 05-10-2019 08-10-2019

30 RI2018C15308 00050622 NURLAELAH,Ny 201 05-10-2019 08-10-2019
31 RI2018C15310 00050625 NOVITASARI,By Ny 201 06-10-2019 08-10-2019
32 RI2018C15316 00050624 NOVITASARI,Ny 201 05-10-2019 08-10-2019
33 RI2018C15319 00050630 IMAS PERMASI,Ny 201 06-10-2019 08-10-2019
34 RI2018C15372 00044438 AULIAN ZULFADHLY SIDDIK,An 209 07-10-2019 08-10-2019
35 RI2018C15373 00050635 INAYA AZMI ATHIFA,An 209 07-10-2019 08-10-2019
36 RI2018C15408 00050646 YENI ROHAENI,Ny 201 07-10-2019 08-10-2019
37 RI2018C15432 00050653 ROFIQOH, 201 07-10-2019 08-10-2019
38 RI2018C15325 00050631 CICIH,Ny 201 06-10-2019 09-10-2019
39 RI2018C15344 00050639 NUR HASANAH,By Ny 210 07-10-2019 09-10-2019
40 RI2018C15355 00050634 SHAIRA ARISHA,An 204 07-10-2019 09-10-2019
41 RI2018C15358 00050374 M NAUVAL HAZIQ,An 204 07-10-2019 09-10-2019
42 RI2018C15360 00042304 LINGGAR PRATAMA M,AN, 204 07-10-2019 09-10-2019
43 RI2018C15374 00050105 NUR HASANAH,Ny 210 07-10-2019 09-10-2019
44 RI2018C15445 00050636 MASKURI,Tn 210 08-10-2019 09-10-2019
45 RI2018C15457 00050647 ATIN,Tn 205 08-10-2019 09-10-2019
46 RI2018C15446 00050657 SAFIA ARRI MAFAZA,An 207 08-10-2019 10-10-2019
47 RI2018C15453 00050660 MARSIH,Ny 201 08-10-2019 10-10-2019
48 RI2018C15479 00050640 HERMAN FELANI,Tn 209 08-10-2019 10-10-2019
49 RI2018C04425 00047914 INTAN PERMATA SARI,An 210 08-10-2019 11-10-2019
50 RI2018C04526 00047937 INTANIA KARADILLAH,An 211 08-10-2019 11-10-2019
51 RI2018C05668 00048196 M RIZKY MULYANA,An 205 08-10-2019 11-10-2019
52 RI2018C05792 00048251 BY NY CARDEWI,By Ny 202 08-10-2019 11-10-2019
53 RI2018C05806 00048247 LAUWVAN YUNINDAR HARTANTO,Tn 213 08-10-2019 11-10-2019
54 RI2018C06667 00048491 YOYOH,By Ny 202 08-10-2019 11-10-2019
55 RI2018C06668 00048490 YOYOH,Ny 201 08-10-2019 11-10-2019
56 RI2018C07175 00048621 BY NY FITRIYANI RAHAYU,By Ny 210 08-10-2019 11-10-2019

57 RI2018C07242 00048633 UNIH,By Ny 201 10/9/2019 11-10-2019

58 RI2018C08062 00048835 BY NY IKA, 202 10/9/2019 11-10-2019
59 RI2018C09042 00049064 MISRIAH,By Ny 202 10/9/2019 11-10-2019
60 RI2018C09072 00049062 MISRIAH,Ny 201 10/9/2019 11-10-2019
61 RI2018C10050 00049331 IRMA YANTI,By Ny 202 10/9/2019 11-10-2019
62 RI2018C13662 00050206 OMIH MARYAMIH,By Ny 201 10/9/2019 11-10-2019
63 RI2018C13805 00050242 DEVI ANJANI,By Ny 202 01-09-2019 11-10-2019
64 RI2018C15160 00050584 HABIBAH,By Ny 201 01-10-2019 11-10-2019
65 RI2018C15476 00043534 ABIZARD ALTAN MUTTAQI,AN,An 211 08-10-2019 11-10-2019
66 RI2018C15500 00050667 UNTAH,Ny 214 09-10-2019 11-10-2019
67 RI2018C15518 00050679 HARUM SARI,Ny 201 10-10-2019 11-10-2019
68 RI2018C15529 046059 AFARA RAHMA JULIANTI, 207 10-10-2019 11-10-2019
69 RI2018C15473 00011347 AULIA CANDRA DEWI,AN,An 203 08-10-2019 12-10-2019
70 RI2018C15484 00047869 MUHAMAD ZIDHAN AL FATTAH,An 206 09-10-2019 12-10-2019
71 RI2018C15513 00050678 RIDA ERVINA LISTIA NOVA,An 204 10-10-2019 12-10-2019
72 RI2018C15545 00050687 ANTI RAHMAWATI,Ny 209 11-10-2019 12-10-2019
73 RI2018C15572 00050702 AYUB,Sdr 204 12-10-2019 12-10-2019
74 RI2018C15592 00050711 ENGKEN,Ny 201 12-10-2019 13-10-2019
75 RI2018C15528 00050684 YATI,Ny 201 10-10-2019 14-10-2019
76 RI2018C15533 00050688 ANTI RAHMAWATI,By Ny 209 11-10-2019 14-10-2019
77 RI2018C15536 00050691 SAVINAH,By Ny 201 11-10-2019 14-10-2019
78 RI2018C15548 00050689 SAVINAH,Ny 201 11-10-2019 14-10-2019
79 RI2018C15565 00050700 NYAI,By Ny 201 11-10-2019 14-10-2019
80 RI2018C15568 00050699 NYAI SUMIATI,Ny 201 11-10-2019 14-10-2019
81 RI2018C15569 00050701 YUMNA FARIHA AD DAEROBI,An 210 11-10-2019 14-10-2019
82 RI2018C15583 00050706 USUP RIATNA,Tn 205 12-10-2019 14-10-2019
83 RI2018C15588 00050710 MAYA DEWI,Ny 207 12-10-2019 14-10-2019
84 RI2018C15595 00050713 UUN,Ny 201 12-10-2019 14-10-2019
85 RI2018C15593 00050712 MUHAMAD NASRI MAJDI,An 209 12-10-2019 15-10-2019
86 RI2018C15596 00050714 DIAS WADI,An 203 13-10-2019 15-10-2019
87 RI2018C15618 00050095 MUHAMAD SUTISNA,Tn 210 13-10-2019 15-10-2019
88 RI2018C15632 00050693 DIANA,An 204 14-10-2019 15-10-2019
89 RI2018C15667 00050732 RUMSINAH,Ny 210 14-10-2019 15-10-2019
90 RI2018C15645 00048786 DARA ADAWIYA ZULFA,An 214 14-10-2019 16-10-2019
91 RI2018C15692 00050738 NENENG JUWITA,Ny 210 14-10-2019 16-10-2019
92 RI2018C15693 00050739 RATNA ROSDIANA, 212 14-10-2019 16-10-2019
93 RI2018C15773 00039128 MUTIARA MEGA,NN, 210 16-10-2019 16-10-2019
94 RI2018C15324 00050632 CICIH,By Ny 201 07-10-2019 17-10-2019
95 RI2018C15670 00050741 ALFIATUL HUMAERA,An 204 14-10-2019 17-10-2019
96 RI2018C15713 00050740 ASIH LESTARI,Ny 201 14-10-2019 17-10-2019
97 RI2018C15718 00041593 SAIDAH,NY,Ny 201 15-10-2019 17-10-2019
98 RI2018C15719 00037412 ADITYA AHMAD RASIDI,AN, 207 15-10-2019 17-10-2019
99 RI2018C15720 00050747 ASIH LESTARI,By Ny 201 15-10-2019 17-10-2019
100 RI2018C15723 00050748 ARSAH ARSITA,By Ny 201 15-10-2019 17-10-2019
101 RI2018C15733 00050730 ARSAH ARSITA,Ny 201 15-10-2019 17-10-2019
102 RI2018C15768 00050756 HANA WIJAYA PUTRI,An NICU 15-10-2019 17-10-2019
103 RI2018C15771 00050759 FITRIANTI RAHMADANI,Ny 201 15-10-2019 17-10-2019
104 RI2018C15769 00043844 M SHARIL PRADANA PUTRA AN, 203 15-10-2019 18-10-2019
105 RI2018C15783 00050302 FATIA MENTARI,An 204 16-10-2019 18-10-2019
106 RI2018C15809 00050767 CICIH,By Ny 201 17-10-2019 19-10-2019
107 RI2018C15811 00050764 GHINA ALIFATUNNISA,An 209 16-10-2019 19-10-2019
108 RI2018C15813 00050770 NURFADILAH,By Ny 201 17-10-2019 19-10-2019
109 RI2018C15816 00050766 CICIH,Ny 201 17-10-2019 19-10-2019
110 RI2018C15818 00050769 NURFADILAH,Ny 201 17-10-2019 19-10-2019
111 RI2018C15858 00037864 RAISYA SALSABILA,AN,An 209 17-10-2019 19-10-2019
112 RI2018C15864 00050774 REKY FAUZY,Tn 208 18-10-2019 19-10-2019

113 RI2018C15883 00050772 ADDIBA SYAQILLA PUTRI,An 204 18-10-2019 19-10-2019

114 RI2018C15953 00050810 EMA MARYAMAH,By Ny 209 20-10-2019 19-10-2019
115 RI2018C15998 00050825 EKA SARI MAULIDUNISA,By Ny 201 21-10-2019 19-10-2019
116 RI2018C16045 00050833 SUHESTI,By Ny 210 22-10-2019 19-10-2019
117 RI2018C16116 00050852 LIANA OKTAVIANI,By Ny 209 23-10-2019 19-10-2019
118 RI2018C16119 00050853 SRI YULIANI,By Ny 203 23-10-2019 19-10-2019
119 RI2018C16121 00050854 NURJUANAH,By Ny 213 23-10-2019 19-10-2019
120 RI2018C16123 00050855 MARSIH,By Ny 201 23-10-2019 19-10-2019
121 RI2018C16175 00050853 SRI YULIANI,By Ny 203 23-10-2019 19-10-2019
122 RI2018C16205 00050879 KARNAH,By Ny 201 24-10-2019 19-10-2019
123 RI2018C15857 00045621 ESHAL MUMTAZA SYARIFAH,AN, 207 17-10-2019 20-10-2019
124 RI2018C15859 00050781 ANI,Ny 201 18-10-2019 20-10-2019
125 RI2018C15863 00050771 M ARSYA,An 207 18-10-2019 20-10-2019
126 RI2018C15910 00050796 SITI MAESAROH,Ny 203 18-10-2019 20-10-2019
127 RI2018C15881 00050784 M.FAJRI ALJABARI,An 204 18-10-2019 21-10-2019
128 RI2018C15908 00050795 TARSIH,Nn 201 18-10-2019 21-10-2019
129 RI2018C15914 00050786 KHANZA HUMAIRA PUTRI,An 204 18-10-2019 21-10-2019
130 RI2018C15943 00050804 SUMIYATI,Ny 209 19-10-2019 21-10-2019
131 RI2018C15957 00050218 SITI JULAEHA,Ny 201 20-10-2019 21-10-2019
132 RI2018C15958 00021884 EMA MARYAMAH, NY, 209 20-10-2019 22-10-2019
133 RI2018C16008 00050823 EKA SARI MAULIDUNISA,Ny 204 21-10-2019 22-10-2019
134 RI2018C16031 00050713 UUN,Ny 201 21-10-2019 22-10-2019
135 RI2018C16041 00050832 EVI TARYANTI,Ny 201 22-10-2019 22-10-2019
136 RI2018C15994 00050816 RAFIFAH LUKMANU RIFDA,An 210 21-10-2019 23-10-2019
137 RI2018C16009 00050826 NADHIRA ADZKIYA GHASSANI,An 203 21-10-2019 23-10-2019
138 RI2018C16018 00050828 NAZWA RAMADANIA,An 204 21-10-2019 23-10-2019
139 RI2018C16047 00050817 MUTIARA INDAH SEKAR ARUM,An 204 22-10-2019 23-10-2019
140 RI2018C16110 00049429 MASWATI HJ,Ny 207 22-10-2019 23-10-2019

141 RI2018C16043 00048764 RIKI DERMAWAN SAPUTRA,Sdr 205 22-10-2019 24-10-2019

142 RI2018C16061 00050692 SUHESTI,Ny 210 22-10-2019 24-10-2019
143 RI2018C16062 00050834 SITI JUBAEDAH,Ny 201 22-10-2019 24-10-2019
144 RI2018C16064 00050840 ALKA DINDA ANDRIYANI,Ny 201 22-10-2019 24-10-2019
145 RI2018C16108 00050847 MARLIA LESTARI,Ny 201 22-10-2019 24-10-2019
146 RI2018C16109 00050848 EDY SUHARTONO,Tn 207 22-10-2019 24-10-2019
147 RI2018C16130 00050851 LIANA OKTAVIANI,Ny 209 23-10-2019 24-10-2019
148 RI2018C16133 00050660 MARSIH,Ny 201 23-10-2019 24-10-2019
149 RI2018C16063 00050811 QIANA HUMAIRA,An 204 22-10-2019 25-10-2019
150 RI2018C16069 00047467 INTAN AYU MAULANI PUTRI,An 206 22-10-2019 25-10-2019
151 RI2018C16131 00050488 SRI YULIANI,Ny 203 23-10-2019 25-10-2019
152 RI2018C16132 00033323 NUR JUANAH, NY, 208 23-10-2019 25-10-2019
153 RI2018C16161 00050859 ANANTA ESTU SHAKYRA,An 203 23-10-2019 26-10-2019
154 RI2018C16162 00050866 BY NY INDAH SEPTIANA,An NICU 23-10-2019 26-10-2019
155 RI2018C16241 046116 MUHAMAD RAFA, 203 25-10-2019 26-10-2019
156 RI2018C16246 00050891 IMAS PERMASI,By Ny 201 26-10-2019 26-10-2019
157 RI2018C16249 00050630 IMAS PERMASI,Ny 201 26-10-2019 26-10-2019
158 RI2018C16261 00050894 CALLIA SYAHLA BIKROEN,An ICU 26-10-2019 26-10-2019
159 RI2018C16201 00037681 MAWAR, AN, 204 24-10-2019 27-10-2019
160 RI2018C16209 00050820 KARNAH,Ny 210 25-10-2019 27-10-2019
161 RI2018C16218 00050882 AL MUQITT,An 204 25-10-2019 28-10-2019
162 RI2018C16248 00050888 HAWA SHAQUEENA SOLIHAN,An 206 26-10-2019 28-10-2019
163 RI2018C16264 00050896 DAFA ABIE PUTRA,An 204 26-10-2019 28-10-2019
164 RI2018C16269 00050900 EDAH,By Ny 207 26-10-2019 28-10-2019
165 RI2018C16273 00050897 EDAH,Ny 207 26-10-2019 28-10-2019
166 RI2018C16276 00050901 NABILA KANZA,An 210 26-10-2019 28-10-2019
167 RI2018C16287 00050904 SARYONO,Tn 204 26-10-2019 28-10-2019
168 RI2018C16289 00050903 ALDI SATYA DAMARA,An 203 27-10-2019 28-10-2019

169 RI2018C16304 00026756 ANDRI FAREZA,TN, 205 27-10-2019 28-10-2019

170 RI2018C16210 00050881 BY NY SISKA WAHYUNI,An NICU 25-10-2019 29-10-2019
171 RI2018C16288 00050906 AI SITI NURAISAH,Ny 207 26-10-2019 29-10-2019
172 RI2018C16384 00050926 SULARMIN,Tn 205 28-10-2019 29-10-2019
173 RI2018C16396 00050933 YANTI,By Ny 204 29-10-2019 29-10-2019
174 RI2018C16282 00050899 EKA SURYA,An 210 26-10-2019 30-10-2019
175 RI2018C16292 00050908 IIN KURNIASIH,Ny 201 27-10-2019 30-10-2019
176 RI2018C16307 00050910 NABILA,An 210 27-10-2019 30-10-2019
177 RI2018C16344 00050912 SAI BIN DERAN,Tn 205 27-10-2019 30-10-2019
178 RI2018C16390 00050927 SANIH,Ny 209 28-10-2019 30-10-2019
179 RI2018C16391 00045717 M ADAM MALIK,AN, 207 28-10-2019 30-10-2019
180 RI2018C16401 00050936 SITI NURYANI,By Ny 201 29-10-2019 30-10-2019
181 RI2018C16408 00050932 YANTI,Ny 201 29-10-2019 30-10-2019
182 RI2018C16388 00050928 MISNAH,An 204 28-10-2019 31-10-2019
183 RI2018C16407 00050934 SITI NURYANI,Ny 201 29-10-2019 31-10-2019
184 RI2018C16414 00050931 ARSHAKA SHAKEEL NAARENDRA,An 203 29-10-2019 31-10-2019
185 RI2018C16415 00036787 ROPIAH ADAWIYAH,NY,Ny 207 29-10-2019 31-10-2019

Tgl cetak : 15-11-2019

HOSPITAL MANAGEMENT SYSTEM (HMS)
 DOCUMENT CONTROL NO :

No. Revisi : 00

EN PULANG
Hal : 1

KeterangaKeadaan Keluar
BPJS KESEHA0 3
4 4
BPJS KESEHA 4 4
BPJS KESEHA 4 4
2 2
BPJS KESEHA 5 5
4 4
JAMKESDA 3 3
BPJS KESEHA 3 3
JAMKESDA 3 3
JAMKESDA 2 2
JAMKESDA 2 2
JAMKESDA 4 4
1
BPJS KESEHA0 1
0 2
0 2
BPJS KESEHA0 1
BPJS KESEHA0 4
BPJS KESEHA0 2
BPJS KESEHA0 2
BPJS KESEHA0 2
BPJS KESEHA0 1
BPJS KESEHA0 1
JAMKESDA 0 3
BPJS KESEHA0 3
JAMKESDA 0 2
JAMKESDA 0 3

BPJS KESEHA0 3
BPJS KESEHA0 3
BPJS KESEHA0 2
BPJS KESEHA0 3
BPJS KESEHA0 2
0 1
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BPJS KESEHA0 1
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BPJS KESEHA0 2
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0 2
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BPJS KESEHA0 2
BPJS KESEHA0 3
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BPJS KESEHA0 3
JAMKESDA 0 2
BPJS KESEHA0 1
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BPJS KESEHA0 4
BPJS KESEHA0 3
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JAMKESDA 0 1
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BPJS KESEHA0 4
JAMKESDA 0 3
BPJS KESEHA0 3
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BPJS KESEHA0 3
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BPJS KESEHA0 2
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BPJS KESEHA0 3
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0 1
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JAMKESDA 0 5
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BPJS KESEHA0 2
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BPJS KESEHA0 1
BPJS KESEHA0 3
JAMKESDA 0 2
0 3
BPJS KESEHA0 2
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BPJS KESEHA0 2
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0 2
0 1

AD MEDIKA-A0 1
BPJS KESEHA0 4
BPJS KESEHA0 3
BPJS KESEHA0 1
BPJS KESEHA0 1
BPJS KESEHA0 4
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JAMKESDA 0 3
0 2
BPJS KESEHA0 2
BPJS KESEHA0 1
BPJS KESEHA0 1
BPJS KESEHA0 3
BPJS KESEHA0 2
0 2
BPJS KESEHA0 2
Jumlah 420
Rata-Rata 2