dr.

Heri Agung, Sp B

dr. Saryanto Sp A
dr. Hari K, Sp OG

dr. Pandu Sp PD

dr. Sardji Sp PD
TANGGAL

NO IDENTITAS PASIEN
UMUR/RM ALAMAT

1 9/3/2019 NY. DAMI 68/030149SUMURBOTO 1/1 JEPON 1

2 9/3/2019 NY. YULI 28/030053PENGKOLR 1
3 9/3/2019 NY. SRI S 34/030197SASAK TU 1
4 9/3/2019 NY. ELSA 23/029793NGLAWIYA 1
5 9/4/2019 NY. SUWA 56/030095PATALAN 1
6 9/4/2019 NY. SRI MA51/26526 BOGOREJO 02/03 1
7 9/4/2019 TN. SUBIY 60/284994JIKEN 01/07 1
8 9/4/2019 NY. INDAH 36 KARANGJATI 03/06 1
9 9/4/2019 TN. SURAD58/030211KESER TUNJUNGAN 1
10 9/4/2019 NY. DIAN 27/012626PURWOSAR 1
11 9/4/2019 NY. ANIK 30/006380KALANGAN 1
12 9/4/2019 NY. DWI I 22/029755KARANGTA 1
13 9/5/2019 TN. MOECH78/027734JL. JENDRAL SUDIRMAN 1
14 9/5/2019 TN. JANAR39/030076KALONGAN BANJAREJO 1
15 9/5/2019 NY. WATIN50/030072KETRINGAN 1/5 1
16 9/5/2019 TN. DARNO70/030089NGIYONO 1
17 9/5/2019 NY. LASIN 60/023592WARU 2/2 JEPON 1
18 9/6/2019 NY. OCTA 25/016998JL. RA KART 1
19 9/6/2019 NY. DEWI 26/030257JL. BAYANG 1
20 9/6/2019 NY. YULIA 34/000893JL. PUNT 1
21 9/6/2019 NY. JAYANT32/028779KUNDURAN 1
22 9/7/2019 NY. SULAST54/027587JEPANGREJO 1
23 9/9/2019 TN. KIMAN78/023958BANDUNGROJO 1
24 9/9/2019 NY. WARTI61/030152PULEDAGEL 1
25 9/9/2019 TN. SAMID71/025505CABAKJIKEN 1
26 ### NY. KASMI57/011898BRUMBUNG 3/1 JEPON 1
27 ### NY. AMINA51/029748NGELOBENER 8/3 JEPON 1
28 ### TN. RAMIN57/030201BERGOLO 13/3 NGAWEN 1
29 ### TN. UNTU 61/028939BANGKLE BLORA 1
30 ### NY. TRI PUJ34/027651JL. RAJAWA 1
31 ### NY. NIKEN 29/030324KLAMPOK 1
32 ### NY. SITI R 34/030101SESO 1
33 ### NY. YASMI 65/029241NGLEBUR 05/02 JIKEN 1
34 ### NY. JUMIN48/030000PALON 03/03 JEPON 1
35 ### TN. SUBIY 42/020399JIKEN 01/07 1
36 ### NY.TITS KR25/030214NGLEBUR 4/1 JIKEN 1
37 ### NY. ANITA 32/030115KEMUNING 05/03 JIK 1
38 ### TN. SUGIY 48/030132SENDANGGAYAM 1
39 ### TN. MOCH.63/029789JL. PRINGGADING MLANGSEN 1
40 ### TN. KASM 57/028546BALONG 5/1 JEPON 1
41 ### NY. RUKINI65/028227SEMANGGI 1
42 ### NY. JASMI 50/028155ADIREJO 6/2 1
43 ### TN. MARS 41/028203JEPON 03/07 1
44 ### NY. HENNY53/016713KARANGJATI 03/06 1
45 ### TN. SUWAJ41/030300BOGOREJO 02/03 1
46 ### NY. TAMIN77/024248SEMAMPIR 03/03 1
47 ### NY. KATINI66/019076NGLOBO 02/03 1
48 ### NY. SULASI50/027790JEPON 04/07 1
49 ### TN. SUCIPT48/014915TAMANREJO 04/02 1
50 ### NY RINI H 40/008415JL. KNPI GG PODANG NO 62 1
51 ### SDR. MUH 18/030286BLORA 1
52 ### NY. RIKA 23/029870SONOREJO 1
53 ### NY. INDAH32/028393GAYAM 2/ 1
54 ### NY. DEVI 20/030390KEMBANG, 1
55 ### TN. SARMI44/030362GENENG 2/1 JEPON 1
56 ### TN. AHMA 23/030325KARANGGENENG 1
57 ### NY. SUMIR64/007869BANGKLE 5/5 1
58 ### SDR. IQBAL18/030342DK. KLAMPOK 1/2 GE 1
59 ### TN. TRI SU 27/029977TANJUNG GENENG 1
60 ### TN. NGARJI64/030172KIDANGAN 4/6 JEPON 1
61 ### TN. BASUKI59/022811TAWANGREJO 1/3 1
62 ### TN. SUTRI 58/018241KETRINGAN 7/1 1
63 ### NY. SUMAR66/020662SAWAHAN 2/1 JEPON 1
64 ### NY. SRIAT 50/030363JEPON 1
65 ### TN. SARIJA58/029562KETRINGAN JIKEN 1
66 ### NY. SUCI M58/027085TEGALGUNUNG 5/2 1
67 ### TN. SUPAR63/029877KIDANGAN 1/6 JEPON 1
68 ### NY. SITI F 88/021513JL. KHA DAHLAN 3/2 1
69 ### NY. SYARI 30/003118SENDANGM 1
70 ### NY. HENI 23/030427NGAMPEL 1
71 ### NY. ERNA 27/030424SONOREJO 1
72 ### NY. SUMIJ 75 ANDONGREJO 3/6 1
73 ### NY. SUHAR 60 GERSI 2/2 1
74 ### NY. SULASTRI GERSI 1
75 ### TN. HADI 55 KAWENGAN 1
76 ### NY. DJOENI 59 JL. KNPI GG PODANG 1
77 ### NY. SRI REJ45/017919NGELOBENER 04/08 1
78 ### TN. SAMB 67/030482TUNJUNGAN 02/04 1
 79 ### NY.NUR HA50/028604MOJOWETAN 1/1 1
80 ### TN. SUGIY 41/030495DK. JIKEN 4/9 1
81 ### NY. SUTATI48/026764BOLERAN 2/10 1
82 ### TN. MARDI68/026720JL. GATOT SUBROTO 1
83 ### NY. SUKAR60/029557JEJERUK 4/1 BLORA 1
84 ### NY. SARTIN68/029111SENDANGHARJO 1/3 1
85 ### TN. IKHWA57/009066JL. NURI PERUMNAS 1
86 ### NY. WARIN69/029279BACEM JEPON 1
87 ### NY. SUMI 69 BRUMBUNG 14/2 1
88 ### NY. JANAR39/030076KALONGAN 2/4 1
89 ### NY. JAWI 42/014847WONOSEM 1
90 ### NY. PONCO37/030402CABAK 1
91 ### NY. ERLINA24/026961JEPANGREJ 1
92 ### NY. RUBIAT27/011491BANGKLE 1
93 ### NY. AGUST27/030102JL. VETERA 1
94 ### TN. WARIJ 49/030531BALONGSARI 2/1 1
95 ### NY. LAMIN62/023812GOMBANG 1/2 1
96 ### AN. NATH 6/ 027366 KALISARI 02/01 1
97 ### NY. SUPAR60/028126SURUHAN 03/02 JIKEN 1
98 ### TN. SUHUD39/022197SENDANGHARJO 01/09 1
99 ### NY. RIDON64/028105KAMOLAN 01/07 1
100 ### TN. SUWAJ41/030300BOGOREJO 02/03 1
101 ### NY. TITIS K25/030214NGLEBUR/04/11 1
102 ### NY. SRI P 61/030523JL. GUNUNG WILIS 5 1
103 ### NY. SUKAR62/030268KEMIRI 3/4 JEPON 1
104 ### TN. SUJI 49/027

SEPTEMBER SDH CEK

 Angka ketepatan waktu tunggu
rawat jalan

Angka Kepuasan pasien dan

keluarga pasien
INDIKATOR UNIT

Angka Kepatuhan petugas dalam

melakukan Identifikasi Pasien

Kerapihan Pakaian Kerja dokter

1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
spesialis

TOTAL

CAPAIAN
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
 dr. Heri Agung, Sp B

dr. Saryanto Sp A
dr. Hari K, Sp OG

dr. Pandu Sp PD

dr. Sardji Sp PD
TANGGAL

NO IDENTITAS PASIEN
UMUR/RM ALAMAT

### NY. SARWI31/008031DK. KLAMPOK 1

1 ### NY. YUMAR47/001792NGAWEN /5/5 JEPON 1
2 ### TN. GUNA 61/011782DS. PENGKOL 1
3 ### NY. SARTIN55/024372DK. BANJARKERTO 3/ 1
4 ### TN. SABAR79/012143KIDANGAN 1/6 JEPON 1
5 ### TN. ROBBI 41/027898JL. JENDRAL SUDIRMAN 1
6 ### NY. LASMIN28/028942DK. KALINJALIN 1/10 1
7 ### NY. SRI P 35/000019KUNDURA 1
8 ### NY. DHIAN27/012662PURWOSARI 1
9 ### NY. ZULYA 23/029610KAMOLAN 1
10 ### NY. SARWI31/008031DK. KLAMPOK 1
11 ### NY. SRI N 56/014399TANJUNG GENENG 2/2 1
12 ### TN. TUNGG42/009081SENDANGHARJO 1/3 1
13 ### TN. SISWO64/007329TANJUNG 3/2 1
14 ### TN. AHMA 70/ 01279 KAUMAN 3/1 1
15 ### TN. JANAR39/030076KALONGAN 2/4 BANJAREJO 1
16 ### NY. SUBIYA39/ 03052 KALIREJO 2/3 JEPON 1
17 ### TN. MARDI45/030522SUMBERAGUNG 8/5 1
18 ### NY. IRA AY27/028063KAMOLAN 1
19 ### NY. AJENG 27/030644JIKEN 1/7 1
20 ### NY. RATMI57/030645TAMBAHRE 1
21 ### NY. TUMIN55/019906WANUTENGAH 1/2 1
22 ### TN. SUWAJ41/029965BOGOREJO 1
23 ### NY. SRI W 50/030007CATAK 1/4 1
24 ### NY. NYAMI67/030001DK. PULO 1/4 MOJOWETAN 1
25 ### NY. SITI AS53/024259JEPANGREJO 1/1 BLORA 1
26 ### NY. SUMIN52/028255KARANG 3/1 BOGOREJO 1
27 ### NY. TARMI70/005686BANGKLE 3/3 BLORA 1
28 ### NY. NYART61/009780SESO 1/4 1
29 ### TN. YUDO 56/016012BRUMBUNG 5/1 JEPON 1
30 ### NY. IRENE 23/029245ARUMDAL 1
31 ### NY. NANIK 37/030304NGAWEN 1
32 ### NY. KADAR35/028669SUMBERA 1
33 ### TN. SUPAR59/030361DS. SAWUR 1/3 SAMBONG 1
34 ### NY. SRI SU 45/017953GENENG 2/2 1
35 ### NY. KASMI57/011898BRUMBUNG JEPON 1
36 ### SDR. SUTI 26/026425BELIK 1/7 TEMUREJO 1
37 ### TN. SOEKI 57/029084JL. BIMA 2 NO 7 BANGKLE 1
38 ### NY. NACSI 39/019370NGRAMNITAN 3/1 1
39 ### NY. RIKA 27/024190KARANGPA 1
40 ### NY. WARSI31/030660SURUHAN 1
41 ### NY. SUSIYA27/0608 BENGIR 1
42 ### TN. SULIS 50/023194BUSALAH ADIREJO 1
43 ### NY. SAWIT46/027440TEMBANG 8/2 ROWOBUNGKUL 1
44 ### NY. SUMIN52/028255KARANG 3/1 BOGOREJO 1
45 ### TN. MASIR68/001113GENJAHAN JIKEN 1
46 ### NY. MANIK29/030222JL. MUSTIKA NO 41 1
47 ### NY. SAMIL 75/ 03056 PALON 5/2 1
48 ### NY. YUMAR47/001792JEPON NGAWEN 5/5 1
49 ### TN. SUWAJ41/030300BOGOREJO 02/03 1
50 ### NY. SRI P 61/030523JL. GUNUNG WILIS 5 1
51 ### NY. RUMI 50/030672PRANTAAN BOGOREJO 1
52 ### NY. ANIS 37/030574DK. KENDURUAN GEDONGSARI 1
53 ### TN. SUPRIY53/030537JL. A YANI IV 1
54 ### NY. MUKAR60/030589JATIREJO 02/02 1
55 ### TN. AGUN 20/029157KAMOLAN 01/07 1
56 ### TN. MURD 32/030535KETRINGAN 05/03 1
57 ### NY. SUKAT51/006190LUBANG 3/2 PULEDAGEL 1
58 ### TN. RAHM 56/030615PULEDAGEL 4/2 1
59 ### NY. SULAST55/ 02789 JEPANGREJO 2/5 BLORA 1
60 ### NY. SUNTI 65/002586SESO 1/1 JEPOM 1
61 ### NY. RINA 39/022002BACEM 2/3 BANJAREJO 1
62 ### TN. ALIP 53/030608SARIMULYO 8/1 NGAWEN 1
63 ### NY. NUR A 30/030731TROBOSO S 1
64 ### NY. FITRIA 27/023444NGAWEN 1
65 ### NY. LIA AG29/030233KARANG 3/ 1
66 ### TN. SUKON60/28994 JL. KISORENG KARANG 1
67 ### NY. AMIN 45/030740JL. REKSODIPUTRO 1
68 ### TN. JURIY 52/030741NGAMPEL 2/6 1
69 ### NY. SULIYA84/001076JOMBLANG 3/2 1
70 ### NY. INDAH29/017820DK. KARANGJATI 2/2 1
71 ### NY. DJOEW73/ 02273 JL. NUSANTAR 1
72 ### TN. DWI S 57/020971BANGKLE 5/5 1
73 ### TN. TONI D26/030632DS. JIKEN 1
74 ### NY. SRI LE 63/ 02939 WARU 1/1 JEPON 1
75 ### AN. DANIS 3/030756 PELEM 1/7 JEPON 1
76 ### NY. MARIY29/030765TUTUP 3/2 TUNJUNGAN 1
77 ### NY. GIMAH51/ 03076 DS. PRANTAAN 1/1 1
 78 ### TN. PARNO45/030560BRUMBUNG 9/1 1
79 ### TN. RAMIN57/030201BERGOLO 13/3 NGAWEN 1
80 ### NY. DINA S22/029489PAYAMAN 2/4 JIKEN 1
81 ### TN. WIDHI 34/003697BRUMBUNG 5/1 JEPON 1
82 ### NY. SIYAM 26/030596SINGONEGORO 1/2 JI 1
83 ### NY. CINCIN30/030662NGLOBO 1/1 JIKEN 1
84 ### NY. SITI R 66/030333DOPLANG 10/2 1
85 ### NY. SUSIL 24/030776MOJOWET 1
86 ### NY. ITA YE 33/028029PURWOREJ 1
87 ### NY. FRANS20/009525SESO 1
88 ### TN. SOMO 63/ 03051 PALON 5/4 JEPON 1
89 ### TN. ABDU 45/030586NGAMPEL 1/3 1
90 ### NY. SRI P 61/ 03053 JL. G. WILIS 1
91 ### NY. SRI L 63/29395 WARU 1/1 JEPON 1
92 ### NY. SEMI 57/009489NGELOBENER 4/8 JEPON 1
93 ### TN. SARPA38/030802KAWENGAN 5/2 JEPO 1
94 ### SDR. DENY 22/030802NGLOBO 1/3 JIKEN 1
95 ### NY. RAMID53/030677KEMIRI 3/4 1
96 ### AN. ZAKI 0/030800 SESO 2/1 JEPON 1
97 ### TN. ARBIY 60/016975JL. A YANI LR 6 1
98 ### NY. DWI RI31/026225ASMIL 410 1
99 ### NY. SRI SU 57/028611JEPON 3/1 1
100 ### ny. Shifa 26/006898jl. Pemuda 1
101 ### ny. Febri 26/030829jl.pringgad 1
102 ### ny. Novemb 24/028780jl. Jendral 1
103 ### NY. YOMI 58/020713DK. TANJUNG 4/ 2 JEPON 1
104 ### TN. MULYA62/025908KETRINGAN 2/5 JIKEN 1
105 ### TN. WAHO68/030670JIKEN 1/7 1
106 ### NY. DWI A 28/026093JEPON 2/6 1
107 ### TN. NUR 60/030210ANDONGREJO 2/6 1
108 ### NY. SITI 46/030697TEGAL GUNUNG 7/1 1
109 ### AN. M. AR 1/030774 JL. KAPUAS NO 29 1
110 ### ny.zulya 23/029610kamolan 1
111 ### ny. Siti z 24/017224bangkle 2/ 1
112 ### ny. Norika 25/030842tamanrejo 1
113 ### TN. LULUK 25/030840JL. PRINGGADING NO 25 1
114 ### TN. MOCH72/012795KAUMAN 3/1 1
115 ### NY. SUFIAH73/017480JL. GATOT SUBROTO 1
116 ### TN. ENDAY51/023402JL. DR. SOETOMO II 1
117 ### NY. M R SU59/027085TEGAL GUNUNG 5/2 1
118 ### TN. ASNAW69/030105KAMOLAN 01/07 1
119 ### NY. TAMIN78/024248SEMAMPIR 3/3 JEPON 1
120 ### DHITA AYU24/015764JL.AHMAD YANI 36 BLORA 1
121 ### NY.SULASIN50/027790JEPON 04/07 1
122 ### NY. PARTI 54/010613SUMURBOTO 03/01 JEPON 1
123 ### SDR. RYAN21/030686PATALAN 2/6 1
124 ### NY. SITI C 46/030846MLANGSEN 1
125 ### NY. DWI SE25/028388NGELOBENER 1/8 1
126 ### ny. Lisawat24/030320turirejo 5/ 1
127 ### ny. Wurirai35/029442jepon 1/2 1
128 ### ny. Naning40/030759jl.pringgad 1
129 ### NY. SUMIJ 59/017870ANDONGREJO 3/6 1
130 ### TN. SARPIN41/030888SESO 2/4 1
131 ### TN. HADI 57/018513DS. KAWENGAN JEPON 1
132 ### NY. SUMIN48/030919PURWOREJO 2/4 1
133 ### TN. AHMA 23/030325KARANGGENENG 1
134 ### NY. SUHAR53/018906GERSI 02/02 1
135 ### TN. PUGER70/000416TAMBAHREJO 4/1 PLOTOT 1
136 ### NY. SITI M 66/000417TAMBAHREJO 4/1 PLOTOT 1
137 ### TN. KASDI 67/022492SONOREJO 1/2 1
138 ### NY. SIANIW59/021465JEPON 1/1 1
139 ### TN. SUDJO64/027266DK. BENGIR 1/5 KESRR 1
140 ### TN. ARIFIN30/030924BANJAREJO 4/3 1
141 ### NY. TITIK 57/029753SAMBONGREJO 1/4 1
142 ### AN. MIKO 16/030789DK. TEMETES 4/5 BA 1
143 ### NY. SRI RO38/030925NGAWEN 2/4 1
144 ### ny. Titik s 29/027076jl. Ra kartin 1
145 ### ny. Pujiatu27/009672kemiri 1
146 ### ny. Lilik s 26/023499karang any 1
147 ### SDR. WIJA 20/030944BULOH 7/3 1
148 ### NY. VIVIAN38/007248JL. GATOT SUBROTO LR 2 1
149 ### TN. SUMA 62/008138JL.CENDANA 1/1 1
150 ### NY. JIMI 78/023111PADAAN JAPAH 1
151 ### NY. ZULFA 29/025328KARANGJATI 2/3 1
152 ### NY. KUSTI 58/029054BERAN 1/1 1
153 ### TN. ADI S 49/030750JL. RAJAWALI 12 A 1
154 ### TN. DUL R 66/030964JEPON 1/3 1
155 ### TN. SUKIM52/030907JATIREJO 1/1 1
156 ### NY. LASMI 68/030798ROWOBUNGKUL 8/1 1
157 ### NY. SUMIN63/019904DK. KEDUNGRINGIN 1
158 ### NY. SUMIN52/028255KARANG 3/1 BOGOREJO 1
159 ### NY. RATNA34/002256JL. VETERAN 95 1
160 ### NY. YENI L 34/003741GEDONGSARI 4/2 BANJAREJO 1
161 ### TN. IKHWA57/009066JL. NURI 22 1
162 ### NY. NOVI 31/030982KUNDURAN 7/3 1
163 ### TN. NUGRO30/030883SENDANGMULYO 5/3 NGAWEN 1
164 ### NY. RIDHO64/028105KAMOLAN 1/7 1
165 ### NY. KETUT 67/023639JL. NUSANTARA 40 1
166 ### TN. SUWA 37/030984JL. AGIL KUSUMODIYO 1
167 ### ny. Lussy 33/006401bangkle 4/ 1
168 ### ny. Samira 65/031001genjahan 1
169 ### ny. Mutika24/030869gandu bogo 1
170 ### NY. SITI F 45/030738SEMAWUR 11/2 NGA 1
171 ### AN. NAURA7/026169 SESO 2/1 JEPON 1
172 ### NY. HENNY53/016713KARANGJATI 3/5 1
173 ### AN. AZMYA1/023092 BANGSRI 1/3 JEPON 1
174 ### AN. FADHIL2/031044 PLUMBON 3/1 NGAW 1
175 ### SDR. TANTR23/031045NGAWEN 1
176 ### TN. MUHAR71/031046SENDANGHARJO 1/1 1
177 ### AN. UMI M14/031047GANG SAWEDA NO 1 1
178 ### TN. PURN 46/031048KALISARI 1/1 RANDU 1
179 ### NY. WARTI37/031005NGLEBUR 5/2 JIKEN 1
180 ### NY. SRIAT 50/030363PELEM 2/3 1
181 ### TN. DASAR67/017064BACEM 7/1 1
182 ### NY. SURTI 33/023316TURIREJO 6/1 JEPON 1
183 ### TN. ALI R 44/025174SENDANGHARJO 1/1 1
184 ### NY. RUFIAN42/029988BANGKLE 2/3 BLORA 1
185 ### ny. Lasturi 33/031063seso 2/3 1
186 ### ny. Safitri 20/031064sarimulyo 1
187 ### ny. Intan 25/030807jomblang 1
188 ### NY. SUKINI73/022973JURANGJERO 01/02 1
189 ### TN. WASIU40/030881GUMIRING 1/4 1
190 ### TN. KASIJA61/021375TURIREJO 03/04 1
191 ### TN. SARDJI56/030973NGLAWIYAN 4/4 KARANGJATI 1
192 ### NY. SARTUT43/031084GEMPOL 4/3 SUMBERAGUNG 1
193 ### NY. MASIY 49/030976BANJAREJO 3/2 1
194 ### TN. SUGEN47/31094 JEPON 4/2 1
195 ### TN. PENO 65/22555 NGLEBUR 1/3 1
196 ### TN. DAUT 58/031095BRUMBUNG 1/1 JEPO 1
197 ### NN. WAHY17/031113BRUMBUNG 1/1 JEPO 1
198 ### NY. NGUDI68/022067KADIWONO 1/1 REMBANG 1
199 ### TN. LESTAR75/029985PULEDAGEL 1/4 1
200 ### NN. FARAD23/031007KADIWONO 2/1 REMBANG 1

OKTOBER SDH CEK

 Angka ketepatan waktu tunggu
rawat jalan

1
1
1
1
1
1
1
Angka Kepuasan pasien dan
keluarga pasien
INDIKATOR UNIT

Angka Kepatuhan petugas dalam

melakukan Identifikasi Pasien

Kerapihan Pakaian Kerja dokter

spesialis
1
1
1

1
1
1
1

1
1
1
1
1
1
1
1
1

1
1
 TANGGAL
NO IDENTITAS PASIEN UMUR/RM ALAMAT

1 11/1/2019 ny. Anik supriyatin 31/019204 brumbung 1/2

2 11/1/2019 ny.sularsih 28/000268 cabak 1/3
3 11/1/2019 ny. Hestiningtyas 30/031124 karangjati
4 11/1/2019 TN. SISWOYO 64/026227 GENENG 3/2
5 11/1/2019 NY. ARI NOVITASARI 28/031119 TEMPELLEMAHBANG 2/4
6 11/1/2019 TN. MARSIDAN 34/030854 KAWENGAN 5/3 JEPON
7 11/1/2019 AN. KHOIRUL ANAM 14/030926 DS. JLODRO 1/2 KENDURUAN TUBAN
8 11/4/2019 TN. WIRO WARDI 89/031157 KALIJALIN 1/11 PATALAN
9 11/4/2019 TN. TUKAIRUN 60/031178 TODANAN 5/2
10 11/4/2019 SDR. SUPRIYANTO 38/031175 KEMIRI 2/4 JEPON
11 11/4/2019 TN. IKHWANTO 57/009066 PERUMNAS 4/5 BLORA
12 11/4/2019 ny rizka dewi 31/031170 jiken 3/9
13 11/4/2019 ny riza s 26/030644 kepuhpermai
14 11/4/2019 ny. Lorina 33/00.05.07 KAMOLAN 03/01
15 11/4/2019 NY. WARINAH 69/029279 BACEM JEPON
16 11/4/2019 TN. JANAR 39/030076 KALONGAN 02/04
17 11/5/2019 NY. SUPRIH GESTARI 52/031091 PADAAN 6/1 JAPAH
18 11/5/2019 NY. SEMI 57/009489 NGELOBENER 4/8 JEPON
19 11/5/2019 NY.SUTIMAH 54/030465 KARANGJATI 01/01 BLORA
20 11/5/2019 TN. SUGENG 47/031094 JEPON 4/8
21 11/5/2019 TN JURIYANTO 52/030741 NGAMPEL 02/06
22 11/5/2019 TN.SUKIRNO 39/030766 SOKO 4/1 JEPON
23 11/6/2019 AN. AHMAD RAFKA 3/031204 JIKEN SURUHAN
24 11/6/2019 NY. SUPRI 53/0310077 SAMBONGREJO 6/1 NGAWEN
25 11/6/2019 NY. NGATMINI 54/031205 CUCAK ROWO 8/4 KARANGJATI
26 11/7/2019 NY. HENNY HENDRAWATI53/016713 KARANGJATI 03/06
27 11/7/2019 NY. SITI PURWATININGSI 61/030523 JL. GUNUNG WILIS 5 1/3
28 11/7/2019 SITI FATIMAH 45/030738 SEMAWUR 11/2 NGAWEN
29 11/7/2019 TN. SUMARJO 62/008138 JL. CENDANA 01/01
30 11/7/2019 NY. SUNTARI 33/031156 BRUMBUNG 14/2 JEPON
31 11/7/2019 NY. PASINAH 42/031057 NGLENGKIR 1/1 BOGOREJO
32 11/7/2019 NY. DJASMI 50/028155 ADIREJO 6/2 TUNJUNGAN
33 11/8/2019 ny suyanti 28/031216 nglobo
34 11/8/2019 ny supri 53/031077 sambongrejo
35 11/8/2019 ny sulipah 31/031101 sambongrejo
36 11/8/2019 TN. SAWIJI 44/031137 JEPON 7/2
37 11/8/2019 AN. KAYLA WIMA 14/025102 KIDANGAN 1/6 JEPON
38 11/8/2019 TN. BIMA AYIKTA 26/031244 JEPON 5/6
39 11/8/2019 TN. MUHARI 71/031046 SENDANGHARJO 1/1 BLORA
40 11/8/2019 TN. DAMIN 59/031244 NGLAROHGUNUNG 2/1 JEPON
41 11/11/2019 NY. LINDA 25/005519 JEPON 4/2
42 11/11/2019 TN. HARMINTO 39/031120 SAMBONG 2/3
43 11/11/2019 NY. SRI HARTINI 50/031168 PATALAN 1/3
44 11/11/2019 NY. SARIYEM 51/027703 KEMIRI / 2/3 JEPON
45 11/11/2019 TN. PENO 64/022555 NGLEBUR 1/3 JIKEN
46 11/11/2019 NY. DJAMI 56/024162 GEMBOL 05/01 BOGOREJO
47 11/11/2019 TN. HARMINTO 39/031120 SAMBONG 02/03
48 11/12/2019 ny dina s 16/031297 mlangsen 10/3
49 11/12/2019 ny. Riris 26/031290 ngawen
50 11/12/2019 ny sulimah 45/031298 mngawen 3/1
51 11/12/2019 AN. BERTHA AMALIA 9/014287 BERAN 3/3
52 11/12/2019 TN. SUYONO 55/026879 JEPON 5/6
53 11/12/2019 TN. TAMIN 83/030936 TEMPUREJO 6/1 BOGOREJO
54 11/12/2019 TN. MARGONO 79/031293 BRUMBUNG 8/1 JEPON
55 11/12/2019 NY. TEGOWATI 52/013068 JEPON 1/7
56 11/12/2019 NY. PATREM 47/013077 JURANGJERO BOGOREJO
57 11/12/2019 TN. SIDIK 59/031305 KALIJALIN 1/10 PATALAN
58 11/13/2019 TN. SULIMAN 65/024111 NGLENGKIR 1/1 BOGOREJO
59 11/13/2019 NY. MUTMAINAH 47/031329 BULUROTO 1/6 BANJAREJO
60 11/13/2019 NY. LASTRI 57/031328 WARU 1/4 JEPON
61 11/18/2019 TN. ANDIKA K 24/029247 KAMOLAN 4/4
62 11/18/2019 TN. KIMIN 57/031394 KEDUNGRINGIN 1/1 TUNJUNGAN
63 11/18/2019 NY. ANIK SUWARNI 67/031390 NGARENG 2/1 TAMBAKSARI
64 11/18/2019 AN. ZAHID HAMIZAH 1/028009 GEDANGDOWO 1/2 JEPON
65 11/19/2019 ny. indah p 35/028675 cabak jiken 2/3
66 11/19/2019 ny. Fera a 23/ 029694 mojopwetan 8/2
67 11/19/2019 ny novemberi 23/029694 sedan
68 11/19/2019 NY. DJAINAH 60/030795 DOLOGAN 3/1 JAPAH
69 11/20/2019 ny anis 26/030777 kunduran 6/1
70 11/20/2019 ny yuli 21/031418 nglaron
71 11/20/2019 ny. Musriah 38/23546 purwosari 1/3 blora
72 11/20/2019 tn. Sunarto 77/005617 tempellemahbang 01/01 jepon
73 11/20/2019 ny. Sartuti 43/31084 gempol 4/3 sumberagung
74 11/21/2019 ny. Sumilah 37/024221 ds. Ngori sumurboto jepon
75 11/21/2019 ny. Ninik 39/027458 ngawen
76 11/21/2019 tn. Djufri 62/031437 jiken 3/9
77 11/21/2019 NY. RAKI 58/030131 GENENG 1/3 JEPON
78 11/21/2019 NY SUHARNI 59/030870 GENJAHAN 01/01
79 11/21/2019 TN. SUKARMAN 75/031355 KAMOLAN 03/01
80 11/21/2019 tn. Nyoto 51/031363 ngampon wetan 3/4 beran
81 11/25/2019 ny. Sumining 65/019904 kedungringin
82 11/25/2019 tn. Ahmad nurulhuda 23/030325 karanggeneng
83 11/25/2019 ny. Aminah 38/029748 NGELOBENER 4/8 JEPON
84 11/25/2019 ny. Siti mahmudah 54/010004 gedongsari 2/1
 85 11/25/2019 ny.supri 53/931077 sambongrejo ngawen
86 11/25/2019 ny. Dwi l 40/031494 nglagah 1/2
87 11/25/2019 ny. Andini 24/030388 knpi bangkle
88 11/25/2019 tn. Markaba 52/030634 jepon 4/1
89 11/25/2019 tn. Suraji 69/019924 kidangulet singonegoro 4/2
90 11/25/2019 ny. Sadji 60/028753 dk. Pelangan 1/4
91 11/26/2019 ny. Suharsih ngwen
92 11/26/2019 ny. Suwanti sumberagung banjarejo
93 11/26/2019 TN. SUWAJI 62/031377 JEJERUK 4/1
94 11/26/2019 NY. SALAMAH 45/031410 WARU 4/1 JEPON
95 11/26/2019 NY. SUTRI 42/027084 TAWANGREJO 2/2
96 11/26/2019 TN. SUPARDI 50/030661 PULEDAGEL 5/2
97 11/26/2019 NY. KARSIYEM 45/031304 TEGALGUNUNG 3/2
98 11/26/2019 NY. REMIK 75/031285 GEDANGDOWO
99 11/27/2019 NY. WELASTRI 31346 SEMAMPIR 02/03 JEPON
100 11/27/2019 TN. SAPUAN 31326 TUNJUNGAN 2/1
101 11/27/2019 NY. SRI WILIS 24092 SUMBEREJO 03/01
102 11/27/2019 NY. SRIYATI 36/009903 SESO 03/03 JEPON
103 11/27/2019 TN. IKHWANTO 57/009066 JL. NURI 22 PERUMNAS
104 11/27/2019 NY. SAMINAH 60/006881 SESO 03/03 JEPON
105 11/28/2019 ny. Lilik r 35/031561 jl. Bima 4 no 3
106 11/28/2019 ny. Setianawati 27/030080 dk. Catak 1/4
107 11/28/2019 ny. Febrika 25/031562 asmil 410
108 11/28/2019 ny. Suciah 55/024454 tempurejo 2/1 bogorejo
109 11/28/2019 tn. supono 70/031162 geneng 2/1 jepon
110 11/28/2019 ny. Sumi 69/031479 janjang 1/3 jiken
111 11/28/2019 TN. SUPONO 70/031162 GENENG 1/2 JEPON
112 11/28/2019 NY. KUMARIYAH 49/031567 BRUMBUNG
113 11/28/2019 NY. BEKTI UTAMI 40/031569 BANGKLE
114 11/29/2019 NY. SITI CHAMDANAH 45/ 019881 KARANGJATI
115 11/29/2019 TN. SUPARDI 50/030661 PULEDAGEL
116 11/29/2019 ny. Yayuk s 33/030580 seso 2/2 jepon
117 11/29/2019 ny. Rusmiati 36/030255 kamolan 2/4
118 11/29/2019 ny. Gia cinta 25/025256 andongrejo 1/1

sdh fik sdh detor

 dr. Hari K, Sp OG

1
1
1
1
1
1
1
1
1
dr. Heri Agung, Sp B

1
1
1
1
1
1
1
1
1
1
dr. Saryanto Sp A

dr. Pandu Sp PD

1
1
1
1
1
1
1
1
1
1
1
1
1
dr. Sardji Sp PD

1
1
1
1

Angka ketepatan waktu tunggu

rawat jalan

Angka Kepuasan pasien dan

keluarga pasien
INDIKATOR UNIT

Angka Kepatuhan petugas dalam

melakukan Identifikasi Pasien

1
1
1
1
1

Kerapihan Pakaian Kerja dokter

spesialis

1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
 1
1
1
1
1
1
1 1
1 1
1 1
1 1
1 1
1 1
1 1
1 1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1 1
1 1
1 1
1
1 1
1 1
1 1
1 1
1 1
1 1
1 1
1 1
1 1
1 1
1 1
1 1
1 1
1 1
1 1
1 1
1 1
1 1
1 1
1 1
1 1
1 1
1
1
1 1
1 1
1 1
1 1
1 1
1 1
1 1
1 1
1 1
1 1
1 1
1 1
1
1
1
1
1
1
1 1
1 1
1 1
1 1
1 1
1
1
1
 dr. Hari K, Sp OG
TANGGAL
NO IDENTITAS PASIEN UMUR/RM ALAMAT

1 12/2/2019 NY. REMIK 75/031285 GEDANGDOWO

2 12/2/2019 NY. WELASTRI 58/031346 SEMAMPIR
3 12/2/2019 NY.MARNI 35/031350 SURUHAN JIKEN
4 12/2/2019 NYANASTASYA 25/030192 JENDRAL SUDIRMAN 1
5 12/2/2019 NY RAMINI 39/031614 PURWOREJO 1
6 12/2/2019 NY ANIK 33/ 019214 BRUMBUNG 1
7 12/3/2019 NY. OVILIA 24/029418 JL. TENTARA PELAJAR NO 38 1
8 12/3/2019 NY. SITI M 22/022988 TUNJUNGAN 1/2 1
9 12/3/2019 NY. MARGARETA 33/006150 WULUNG 1/2 1
10 12/4/2019 NY. SRI WAHYULI 27/019816 WATULUMBUNG 3/14
11 12/4/2019 NY. MUSRIAH 38/23546 PURWOSARI
12 12/4/2019 NY. SUPATMI 59/023455 MRAYUN 01/03 SALE
13 12/4/2019 NY KRISTANTI 29/036662 KAUMAN 1
14 12/4/2019 NY SULIS 26/031321 BRIWIT 1
15 12/4/2019 NY PUJI H 47/031667 BOGEM 1
16 12/5/2019 NY. KASIYAH 70/031545 PLANTUNGAN 1/2
17 12/5/2019 NY. SRI WILIS 38/031545 SUMBEREJO 03/01
18 12/5/2019 NY. SUPRI 33/031528 PRANTAAN 03/02
19 12/5/2019 NY RUSMIATI 36/030255 KAMOLAN 2/4 1
20 12/5/2019 NY MEILA 24/029925 JAPAH 3/1 1
21 12/5/2019 NY KRISTIYANI 32/031510 POWUNG 1
22 12/6/2019 NY WAHYU 25/031707 JEPON 2/2 1
23 12/6/2019 NY YAYUK 33/ 030580 SESO 1
24 12/6/2019 NY RIO P 24/027957 BACEM 1
25 12/6/2019 TN. SUWAJI 41/029965 BOGOREJO 2/3
26 12/6/2019 NY. HENNY. H 54/016713 KARANGJATI
27 12/6/2019 NY. SUMARI 58/031712 KEMLOKO JEPON
28 12/9/2019 NY. YULIANA 32/031752 DS. GAYAM 1
29 12/9/2019 NY. NUR A 29/030737 DS. TRASOBO 3/4 1
30 12/9/2019 NY. TITANIA 31/030098 NGAWEN 1
31 12/10/2019 NY. HEPI 33/031762 BERAN 1
32 12/10/2019 NY. DWI R 24/029693 KETRINGAN 2/5 1
33 12/10/2019 NY. SURATMI 58/024477 SEMAMPIR 3/1 1
34 12/10/2019 TN. PRIYADI 55/009598 BANGKLE 03/03
35 12/10/2019 TN. TRI PRIYANTO 55/024423 GENJAHAN 1/1
36 12/10/2019 NY. SRI MULYATI 60/021984 NGELOBENER
37 12/10/2019 ny mutmainah 29/ 031762 japah 1
38 12/10/2019 NY. LISTARI 28/030766 KALIJALIN 10/02
39 12/11/2019 NY. WASINI 43/031338 KAWENGAN 1
40 12/11/2019 NY. NUR R 25/031777 JIKEN 1
41 12/11/2019 NY. KHOLIFAH 22/026498 BANJAREJO 1
42 12/11/2019 NY. WARNIATI 40/002342 KARANGPACE 9/5
43 12/11/2019 NY. LASINAH 59/030005 KARANGANYAR 02/01
44 12/11/2019 NY. SUMARI 58/031712 KEMLOKO JEPON
45 12/11/2019 TN. DWI PURWANTO 43/031349 GRIYA PRIMA UTAMA
46 12/11/2019 TN. SUTIONO 42/031640 JOMLANG
47 12/16/2019 NY. MURNI 37/031860 BRUMBUNG 1
48 12/16/2019 NY. RIZKA 25/031861 SUMBERAGUNG 1
49 12/16/2019 NY. SITI D 24/031863 BLORA 1
50 12/17/2019 NY. JUMI 22/31884 JATISARI 5/7 1
51 12/17/2019 NY. LINIA 36/029938 GENENG 3/2 1
52 12/17/2019 NY. NAFSIATUN 29/031690 PLOSOREJO 2/3 1
53 12/17/2019 NY DHYNY 31/031885 1
54 12/17/2019 NY. RIZKA 25/031861 SUMBERAGUNG
55 12/17/2019 NY. SITI D 24/031863 BLORA
56 12/19/2019 TN. DJAYUS 66/031788 BANGKLE 02/03
57 12/19/2019 TN. SUPANGAT 64/024820 NGRAYUNG 03/03
58 12/19/2019 TN. JOSRUDI 52/030273 KUNDURAN 9/1
59 12/30/2019 ny murwati 41/ 031815 1
60 12/30/2019 ny kholifah 22/026498 1
61 12/30/2019 NY. YUANITA 25/004565 KETRINGAN 7/1 1
62 12/30/2019 NY. SUYATMI 33/032098 JIKEN 1/1 1
63 12/30/2019 NY. KISWATI 32/032099 NGLOBENER 3/8 1
64 12/31/2019 NY. SUPATMI 39/032126 TEMPELLEMAHBANG 1
65 12/31/2019 NY. LOLA 25/030191 NGAWEN 3/1 1
66 12/31/2019 NY. SULISTYWATI 27/032122 NGAMPON 1
67 12/31/2019 ny yatia 31/031534 1
1
1
1
1
1
1
1
1
1
dr. Heri Agung, Sp B

dr. Saryanto Sp A

1
1
1
dr. Pandu Sp PD

dr. Sardji Sp PD

Angka ketepatan waktu tunggu

rawat jalan

Angka Kepuasan pasien dan

keluarga pasien
INDIKATOR UNIT

Angka Kepatuhan petugas dalam

melakukan Identifikasi Pasien

1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1

Kerapihan Pakaian Kerja dokter

spesialis
 1 1
1 1
1 1
1
1 1
1
1
1
1 1
1 1
1 1
1 1
1 1
1
1
1
1
1
1
1
1
1
1 1
1 1
1 1
1
1

1
 dr. Heri Agung, Sp B
dr. Hari K, Sp OG
TANGGAL

NO IDENTITAS PASIEN UMUR/RM ALAMAT

1 1/2/2020 NY. DYAN AYU 23/031769 TURIREJO 02/01 1

2 1/2/2020 SDR. M. GUNAWAN 18/032028 BALONGREJO 7/2 1
3 2/2/2020 TN. JUPRI 43/007060 KEMIRI 05/03 1
4 1/2/2020 Ny. Siti Murniati 23/030931 Jl. Veteran Bngkle 1
5 1/2/2020 Ny Siti Alfiatur 27/032161 Pelem 03/03 1
6 1/2/2020 Ny. Siti Rofiqoh 28/032160 Sumberagung 04/04 1
7 1/3/2020 Ny. Tiara Destiani 27/009685 Karangjati 1
8 1/3/2020 Ny. Sri Purwati 35/000019 Kunduran 1
9 1/3/2020 Ny. Hilyatun N 23/032187 Talokwohmojo 6/1 1
10 1/6/2020 Ny. Mei Riayani 19/029138 Bacem 02/02 1
11 1/6/2020 Ny. Kristantina 25/011407 Talun 7/5 1
12 1/6/2020 Ny. Siti Nurhidayati 28/029378 Tempellemahbang 1
13 1/6/2020 ny. Lasimah 66/026683 balong 03/01 jepon
14 1/6/2020 ny.sukarmi 60/029557 jejeruk 4/1
15 1/6/2020 ny.sumini 71/032129 sumurboto 01/01
16 1/6/2020 ny. Sri endang 32/032050 ngawen 1
17 1/6/2020 ny.tri handayani 28/031622 banjarejo 1
18 1/6/2020 tn. Sutiono 42/031640 jomblang 1
19 1/7/2020 Ny. Yunita Eskade 34/004098 Jl. Gunung Wilis49 1/2 1
20 1/7/2020 Ny. Miftachus S 26/013343 Karangjati 3/1 1
21 1/7/2020 Ny. Siti Prehatiningsih 30/016815 Singonegoro 3/1 1
22 1/8/2020 Ny. Yuliana M 34/003581 Sendangrejo 01/03 1
23 1/8/2020 Ny. Siti Lestari 30/031197 Genjahan 2/1 1
24 1/8/2020 Ny Febriana K 22/030616 Sendangmulyo 2/1 1
25 1/8/2020 an. Syifa ulya 13/032273 ngawen 2/3 1
26 1/8/2020 ny. Sumini 71/032129 sumurboto 01/01 1
27 1/8/2020 ny. Anita findriyani 26/032272 nglebur 3/3 jiken 1
28 1/8/2020 tn. Sali 75/028506 purwosari 02/03
29 1/8/2020 tn. Jamal 63/012774 turireJO 03/02
30 1/8/2020 ny. Dewi indraning 36/032274 kemiri 8/3
31 1/9/2020 ny. Jarmi 45/032310 jurangjero 1/2 1
32 1/9/2020 tn. Alik 66/031895 sambongrejo 3/1 1
33 1/9/2020 an. M fernando 11/032309 kemiri 3/4 1
34 1/9/2020 Ny. Harmini 36/031938 Ngampon 04/04 1
35 1/9/2020 Ny. Diah Wulantika 22/032304 Klampok 04/02 1
36 1/9/2020 Ny. Alfi Ni'amah 28/032160 Sumberagung 04/04 1
37 1/10/2020 Ny. Irsyadatul Azizah 28/025381 Paalon 01/03 1
38 1/10/2020 Ny. Winarti 57/032278 Jl. Manyar 13 1/5 1
39 1/10/2020 Ny. Fita Intan 30/009969 Tengger 03/02 1
40 1/13/2020 Ny. Ika Irmawati 37/030764 Genjahan 05/02 1
41 1/13/2020 Ny. Siti Chamidah 31/032408 Berbak 04/01 1
42 1/13/2020 Ny. Siti Mutmainah 28/032407 Gotputuk 05/02 1
43 1/13/2020 ny.sumini 71/032129 sumurboto 01/01 1
44 1/13/2020 sdr. Yanuar 20/032193 tegalgunung 05/02 1
45 1/13/2020 an. Ahmad ardianto 11/032331 jatirejo 02/03 1
46 1/13/2020 ny. Suprapti 53/012421 jl. KNPI 05/05
47 1/13/2020 ny wasini 67/032411 tegalgunung 02/02
48 1/13/2020 ny.warti 61/030152 puledagel 4/2
49 1/15/2020 ny. Jami 69/029986 puntodewo 05/01
50 1/15/2020 tn. Samidi 69/026966 puntodewo 05/01
51 1/15/2020 tn. Amik diar 37/001477 bangkle 6/1
52 1/15/2020 tn. Parmin 34/019164 kawengan 4/1 1
53 1/15/2020 ny. Karsiyem 46/031304 tegalgunung 3/2 1
54 1/15/2020 ny. Ketut wiji 67/023639 jetis 4/2 1
55 1/16/2020 ny. Sri endang L 32/032050 ngawen 1/1 1
56 1/16/2020 an. Ahmad ardianto 11/032331 jatirejo 02/03 1
57 1/16/2020 ny. Henny H 53/016713 karangjati 03/05 1
58 1/17/2020 an. Mohamad fajri 11/024475 sambonganyar 1
59 1/17/2020 ny. Siti khoiriah 29/032166 nglengkir 1
60 1/17/2020 ny. Kartini 52/032167 nglengkir 01/02 1
61 1/15/2020 Ny. Arik Almida 20/030578 Banat 4/3 Todanan 1
62 1/15/2020 Ny. Fhuji Rahayu 34/031406 Janjang 1/1 1
63 1/15/2020 Ny. Lyna Puruwita 34/032435 Purwosari 3/3 1
64 1/17/2020 Ny. Bety Handayani 22/031710 Purwosari 1/1 1
65 1/17/2020 Ny. Tutut 25/031764 Tamanrejo 5/3 1
66 1/17/2020 Ny. Siti Mauidotul 24/032318 Ketuwan 3/3 1
67 1/20/2020 Ny. Mamik 28/016825 Bangkle 1
68 1/20/2020 Ny. Hesti Setyo 27/032531 Pelem 2/1 1
69 1/20/2020 Ny. Bella Aprita 24/013870 Kiedangan 3/6 1
70 1/20/2020 an. Ahmad ardianto 11/032331 jatirejo 03/02 1
71 1/20/2020 tn. Jarmin 30/032234 bacem 02/02 1
72 1/20/2020 tn. parmin 34/010964 kawengan 4/1 1
73 1/20/2020 ny. Siti fatimah 45/030738 semawur 11/02
74 1/20/2020 ny. Sutatik 48/026764 boleran 02/10
75 1/20/2020 tn. Suyitno 59/011951 kalirejo 08/01
76 1/21/2020 ny. Sri purwatiningsih 61/030523 jl. gunung Wilis49 1/3 1
77 1/21/2020 ny. Suwati 43/032041 balongrejo 10/2 banjarejo 1
78 1/24/2020 NY. DYAH AYU IRIANTI 23/031769 TURIREJO 02/01 1
 79 1/24/2020 NY. NGATMI 63/032627 BALONG 05/01 1
80 1/24/2020 an. Ahmad ardianto 11/032331 JATIREJO 03/02 1
81 1/24/2020 NY. KASRI 40/017548 TEMPUREJO 01/06
82 1/24/2020 AN. MUH. FURQON 15/032633 SEMAMPIR 2/1
83 1/24/2020 SDR. LASDIYANTO 24/005994 GAPUK 06/01
84 1/29/2020 TN. LESTARI WIDODO 75/029985 PULEDagel 01/04
85 1/29/2020 SDR. ADHITAMA D 18/031021 TAMBAKSARI 1/1
86 29/01/20 20 TN. SUGIHARTO 48/024236 SUKORAME 2/2
87 1/29/2020 NY. SUHARSIH 57/030036 Sumberagung 04/04
88 1/21/2020 Ny. Siti Fadzila 29/032561 Gedangdowo 03/04 1
89 1/21/2020 Ny. Anik Sugiarti 34/002831 Jepon 04/04 1
90 1/21/2020 Ny. Nailatul M 32/032560 Kuryokalangan 2/5 1
91 1/23/2020 Ny. Sri Kadari 34/030734 Rambitan 1
92 1/23/2020 Ny. Lutfia 27/032352 Jepon 3/2 1
93 1/23/2020 Ny. Tri Putri 24/031081 Jepon 1
94 1/24/2020 Ny. Karmi 37/027961 Kawengan 1
95 1/24/2020 Ny. Fita 33/018651 Tengger 1
96 1/24/2020 Ny. Indarti 23/032434 Karangpace 1
97 1/28/2020 Ny. Tunggal Dewi 27/005438 Berbak 6/1 1
98 1/28/2020 Ny. Lastun 33/031063 Seso 2/3 1
99 1/28/2020 Ny. Siti Munthoviah 24/005258 Sambongrejo 3/3 1
100 1/29/2020 Ny. Sri Muntari 36/032625 Sendangmulyo 2/1 1
101 1/29/2020 Ny. Yatia 31/031534 Jepon 3/2 1
102 1/29/2020 Ny. Erna Pujiati 36/011293 Jl. Nusantara 1
103 1/30/2020 Ny. Jarwati 32/032565 Nglengkir 1/2 1
104 1/30/2020 Ny. Cyntia Ernawati 19/032750 Bogorejo 10/4 1
105 1/30/2020 Ny. Sunarti 52/030890 Ketangar 4/1 1
106 1/31/2020 Ny. Lilieh Purwasekti 36/032381 Trembulrejo 01/05 1
107 1/31/2020 Ny. Lutfia Andarini 25/018774 Jl Raya Jepon 3/2 1
108 1/31/2020 Ny. Riska Damayanti 24/029660 Bangking 2/4 1
109 1/31/2020 ny. Guntari 45/020229 kedungringin 2/2
110 1/31/2020 an. Muh fernando 11/032309 kemiri 3/4
111 1/31/2020 ny. Samsidariyah 42/009757 kemiri 04/1
112 1/31/2020 ny. Sukini 90/032619 jiworejo 03/03 1
113 1/31/2020 ny.sarti 77/032544 kalisari 3/2 1
114 1/31/2020 tn. Amik diar 37/001477 bangkle 6/1 1
 dr. Saryanto Sp A

1
1
1
dr. Pandu Sp PD

1
1
1
dr. Sardji Sp PD

Angka ketepatan waktu tunggu

rawat jalan

Angka Kepuasan pasien dan

keluarga pasien
INDIKATOR UNIT

Angka Kepatuhan petugas dalam

melakukan Identifikasi Pasien

1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1

Kerapihan Pakaian Kerja dokter

1
1
1
1
1
1
1
1
1
1
1
spesialis
 1
1
1
1
1
1
1
1
1
1
1
1
1 1
1 1
1 1
1 1
1 1
1 1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1 1
1 1
1 1

1
 1
1
1 1
1 1
1 1
1 1
1 1
1 1
1 1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1 1
1 1
1 1
1
1
1
 dr. Savitri Rahayu, Sp OG

dr. Hari K, Sp OG
TANGGAL

NO IDENTITAS PASIEN UMUR/RM ALAMAT

1 2/1/2020 Ny. Wati Lasmini 45/032805 Geneng 02/02 1

2 2/1/2020 Ny. Dian Irawati 35/032819 jl Puntodewo 2/1 1
3 2/1/2020 Ny. Yanik I 41/000312 Gumiring 2/4 1
4 2/3/2020 ny. Endraswati 49/032607 ngawen 4/1
5 2/3/2020 ny. Sri endang l 32/032050 ngawen 1/1
6 2/3/2020 ny. Siti fatimah 45/030738 ngawen 11/2
7 2/3/2020 Ny. Laili S 27/018962 Tempurrejo 1/5 1
8 2/3/2020 Ny. Karmi 37/0279691 Kawengan 5/1 1
9 2/3/2020 Ny. Nevy Ulfa 23/032251 Bangsri 1
10 2/4/2020 ny.sumining 63/019904 kedungringin 4/1
11 2/4/2020 ny. Siti masfiah 54/029590 bacem 2/1
12 2/4/2020 ny.suminah 35/032872 jatisari 4/1
13 2/4/2020 Ny. Fanda N 25/032858 Tempelan 3/3 1
14 2/4/2020 Ny. Prachilia 23/030960 Kauman 1/2 1
15 2/4/2020 Ny. Ester Yuliana 35/032881 Tempelan 3/2 1
16 2/5/2020 Ny. Sri WijiW 20/020886 Pelem 3/3 1
17 2/5/2020 Ny. Siti Mualifa 26/031218 Nglorog 8/2 1
18 2/5/2020 Ny. Siti Anisa 22/032901 Telapak 01/01 1
19 2/5/2020 Ny. Desi 23/030489 Raji, Demak 1
20 2/5/2020 Ny. Krisliyana 25/032905 Tutup 3/2 1
21 2/5/2020 Ny. Ari S 20/032906 Nglebur 1/7 1
22 2/6/2020 ny.dyan ayu 23/031769 turirejo 02/01
23 2/6/2020 tn. Abdul chafid 29/032482 kunduran 3/3
24 2/6/2020 ny. Sri endang l 32/032050 ngawen 1/1
25 2/6/2020 Ny. Tri Rahayu 27/030927 Nglobo 3/8 1
26 2/6/2020 Ny. Siti Mustamam 27/030826 Sumbrejo 2/1 1
27 2/6/2020 Ny. Elysabeth 35/031775 Gagaan 1/5 1
28 2/10/2020 Ny. Shifa ChoirunNisa 26/006898 Jl. A. Yani 38 1
29 2/10/2020 Ny. Lilik Yunana 51/033021 Kauman 4/3 1
30 2/10/2020 Ny. Sri Laswati 41/032849 Sambongrejo 3/1 1
31 2/10/2020 ny.eka septiana 18/032054 talok 9/1
32 2/10/2020 tn. Darsono 80/026834 turirejo 10/02
33 2/10/2020 ny. Puntari 48/032940 tambahrejo 1/3
34 2/10/2020 tn. Sukarman 49/032761 ngampon 1/1
35 2/10/2020 tn. Mariyati 44/032409 gumiring 1/4
36 2/10/2020 tn. Tamsir 71/032380 beran 3/4
37 2/11/2020 Ny. Sunarti 33/033039 Jiken 2/1 1
38 2/11/2020 Ny. Nawang S 24/030618 Jl. Pringgading 2/4 1
39 2/11/2020 Ny. Neti Ermawati 21/032798 Jl. Tempurejo 2/6 1
40 2/12/2020 NY. PUJI RISTANTI 29/022408 JL.RA KARTINI 6
41 2/12/2020 TN. SUJONO 46/001222 GENENG 4/2
42 2/12/2020 NY. MURNIATI 61/031500 TEMPELAN 6/2
43 2/12/2020 TN. UMAR SYARIEF 61/000414 JETIS
44 2/12/2020 NY. SULASTRI 62/032535 BALONG 1/1
45 2/12/2020 TN. TEKAT TRISNO 44/032033 NGLAROHGNUNG 6/2
46 2/12/2020 Ny. Lyna Puruwita 33/032425 Purwosari 3/4 1
47 2/12/2020 Ny. Mutmainah 29/031763 Japah 1/2 1
48 2/12/2020 Ny. Henny 37/023246 Kemiri 5/4 1
49 2/12/2020 Sri Purwati 35/00019 kunduran 3/3 1
50 2/12/2020 Ny. Hanifa F 27/023561 Kedungjenar 3/3 1
51 2/12/2020 Ny. Evi Handayani 36/33055 Nglawiyan 1
52 2/13/2020 TN. TANTRA KIDUNG 24/032737 JEPON 4/2
53 2/13/2020 NY. SUWARNI 60/032949 SEREN 04/03
54 2/13/2020 TN. SUJONO 46/001222 GENENG 4/1
55 2/13/2020 NY. SRI ENDANG L 32/032050 NGAWEN 1/1
56 2/13/2020 Ny. Serfia 23/033088 Kidangan 1
57 2/13/2020 Ny. Sri W 37/032927 Tutup 1
58 2/13/2020 Ny Suparni 31/033089 Nglamping 1
59 2/14/2020 Ny. Rika Puji 27/034190 Karangpace 9/5 1
60 2/14/2020 Ny. Suciati 25/030999 Kedungjenar 2/3 1
61 2/14/2020 Ny. Erma Dyah 25/033115 Wonorejo 9/10 1
62 2/14/2020 ny. Samsidariyah 42/009757 kemiri 4/1
63 2/14/2020 ny. Sri purwatiningsih 61/030523 gunung wilis 1/3
64 2/14/2020 tn. Sukardi 61/032753 kembang 1/5
65 2/14/2020 ny. Suningsih 60/032978 boleran 3/10
66 2/14/2020 tn. Simin 70/032903 gombang 2/1
67 2/14/2020 tn. Agus heri .S 50/019277 sendangharjo 1/3
68 2/15/2020 Ny. Novita 45/017307 Jl. Rajawali 24 Tempelan 1
69 2/15/2020 Ny. Sumartini 36/031665 Beganjing 2/2 1
70 2/15/2020 Ny. Nita W 26/033141 Jepon 1/5 1
71 2/17/2020 TN. SUKARMIN 65/000948 JOMBLANG 3/2
72 2/17/2020 TN. SAIRIN 52/033024 BANGKLE2/4
73 2/17/2020 TN. SUWARNO 51/033181 SESO 1/3
74 2/17/2020 NN. SANDRA PUSPA 24/019995 BANGKING4/3
75 2/17/2020 TN. SARMINI 60/017607 BANGKLE4/4
76 2/17/2020 TN. JAMAL 63/012774 TURIREJO 03/02
77 2/17/2020 Ny. Siti Zubaidah 24/030583 Klopoduwur 7/1 1
78 2/17/2020 Ny. Saidatun 24/032159 Puledagel 7/1 1
 79 2/17/2020 Ny. Siti Thoatin 32/025933 Balong 5/1 1
80 2/18/2020 Ny. Heramoni 33/031537 Ngampon02/4 1
81 2/18/2020 Ny. Titik Sumarni 31/027076 Kunden 11c 1
82 2/18/2020 Ny. Sri Rejeki 24/033193 Sambiroto 1/1 1
83 2/19/2020 NY.DARMINI 51/033222 SEMAMPIR 3/2
84 2/19/2020 TN. ABDUL CHOLID 65/033101 TAWANGREJO 1/3
85 2/19/2020 SDR. DENDRA .A 14/033095 TEMPELAN 4/2
86 2/19/2020 NY. ROBININGSIH 34/032958 NGLAMPING
87 2/19/2020 NY. USWATUN. H 63/021107 NGRAYUNG 3/3
88 2/19/2020 TN. SIDIK 59/031305 KALIJALIN 1/10
89 2/19/2020 Ny. Dwi Febrianti 23/032734 Nglebur 4/1 1
90 2/19/2020 Ny. Ima Norma 32/007163 Jl. Cemara kridosono 1
91 2/19/2020 Ny. Ika Winarsih 30/013830 Jl. Sumbawa 3/1 1
92 2/19/2020 Ny. Siska Afida 20/029618 Asmil 410 1
93 2/19/2020 Ny. Naila 29/033219 Patalan 1
94 2/20/2020 Ny. Dyah Ayu 25/033220 Kutoharjo 2/4 1
95 2/20/2020 Ny. Devi Eka 30/004705 Jl. A.Yani 1
96 2/20/2020 Ny. Lilis Wijiarti 22/033033 kemiri 4/2 1
97 2/21/2020 Ny. Efi Mia 23/024427 Kamolan 1
98 2/21/2020 Ny. Nyamini 30/033234 Kamolan 5/1 1
99 2/21/2020 Ny. Rumiati 40/022825 Karangjati 1
100 2/22/2020 sdr. Yanuar .r 20/032193 tegalgunung 5/2
101 2/22/2020 ny. Siti fatimah 45/030738 semawur 11/2
102 2/22/2020 ny. Laswi 68/023674 balongan 1/15
103 2/22/2020 ny. Painah 79/027569 bogorejo 3/3
104 2/22/2020 tn. Sukimin 67/030791 tambaksari 03/04
105 2/22/2020 tn. Suparman 71/014823 karangrejo 3/1
106 2/22/2020 NY umi hidayah 26/033120 mlangsen 8/1 1
107 2/22/2020 ny nikmah diana 38/032808 beran 1/1 1
108 2/22/2020 ny silviana s 24/033260 kunduran 6/3 1
109 2/25/2020 ny. Pujiwati 40/033312 gombang 1/3
110 2/25/2020 an. Putri alimah 2/032970 jepon 8/5
111 2/25/2020 tn. Suprianto 37/033025 genjahan 1/2
112 2/26/2020 tn. Siswanto 32/033189 Pelem 3/3
113 2/26/2020 ny. Siti masfufah 56/033022 gedongsari 3/2
114 2/26/2020 ny.Sri purwatiningsih 61/030523 gunung wilis 1/3
115 2/26/2020 ny. Sumi 48/007087 gapuk 6/1
116 2/26/2020 tn. Wiji lestari 59/030430 nglangitan 4/3
117 2/26/2020 tn. Sugiyarto 58/008302 kawengan 1/3
118 2/26/2020 ny sri hartini 26/ 009052 seso 1
119 2/26/2020 ny yunita p 23/030514 andongrejo 1
120 2/26/2020 ny pujiati 31/011189 ngawen jepon 1
121 2/27/2020 ny tya dewi 19/032877 tembelmahbang 1
122 2/27/2020 ny siti koiriyah 23/033352 ngaringan 1
123 2/27/2020 ny dyah w 22/032304 klampok genjahan 1
124 2/28/2020 ny. samsidariyah 42/009757 kemiri 4/1
125 2/28/2020 an. Putri alimah 2/032970 jepon 8/5
126 2/28/2020 ny. Zhauhatul Z 33/020968 plosorejo 5/1
127 2/28/2020 ny imroatin 22/028945 ngrayung 19/3 1
128 2/28/2020 ny sarini 23/032411 singonegoro 6/1 1
129 2/28/2020 ny ngatmi 26/032157 gulingan 1/4 1
130 2/29/2020 ny dyan i 29/008213 kedungjenar 1
131 2/29/2020 ny riza a 41/033390 tempelan 1
132 2/29/2020 ny leni 23/ 033388 jejeruk 1
 dr. Heri Agung, Sp B

1
1
1
1
1
1
1
1
1
dr. Saryanto Sp A

dr. Pandu Sp PD

dr. Sardji Sp PD

1
1
1
INDIKATOR UNIT

Angka ketepatan waktu tunggu

rawat jalan

Angka Kepuasan pasien dan

keluarga pasien

Angka Kepatuhan petugas dalam

melakukan Identifikasi Pasien

Kerapihan Pakaian Kerja dokter

1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1

spesialis
 1 1
1 1
1 1
1
1
1
1 1
1 1
1 1
1 1
1 1
1 1
1
1
1
1
1
1
1 1
1 1
1 1
1 1
1
1
1
1
1
1
1 1
1 1
1 1
1
1
1
1
1
1
1 1
1 1
1 1
1 1
1 1
1 1
1
1
 1
1
1
1
1 1
1 1
1 1
1 1
1 1
1 1
1
1
1
1
1
1
1
1
1
1
1
1 1
1 1
1 1
1 1
1 1
1 1
1
1
1
1 1
1 1
1 1
1 1
1 1
1 1
1 1
1 1
1 1
1
1
1
1
1
1
1 1
1 1
1 1
1
1
1
1
1
1
 TANGGAL
NO IDENTITAS PASIEN UMUR/RM ALAMAT

1 3/2/2020 NY. ENDANG SULISTYOWATI 34/033428 GG.SADEWA 4/1 JEPON

2 3/2/2020 NY. DARMINI 51/033222 SEMAMPIR 3/2 JEPON
3 3/2/2020 TN. NGADIKIN 66/033413 BACEM 1/6 BANJAREJO
4 3/2/2020 TN. SUKONO 50/033216 KALIREJO 1/3
5 3/2/2020 TN. KARMIN 45/033430 KETRINGAN 3/1
6 3/2/2020 NY. NGUDINING RAHAYU 68/022067 KADIWONO 1/1
7 3/2/2020 Ny. Wasis 33/031984 Bangsri 07/03
8 3/2/2020 Ny Siti Mustamiatin 27/030826 Gesik 2/1
9 3/2/2020 Ny. Putri Sholihah 30/001462 Jl. Agilkusumadyo
10 3/3/2020 Ny Wiwit Puji L 22/033449 Sumberagung 6/2
11 3/3/2020 Ny. Herlina P 30/031108 Ngawen 5/3
12 3/3/2020 Ny. Yunita K 26/032806 Sarirejo 4/1
13 3/4/2020 Ny. Siti Nur A 21/033464 Tempurejo 5/1
14 3/4/2020 Ny. Mutatik 35/022086 Jepon 1/4
15 3/4/2020 Ny. Purwantini 25/031619 Andongrejo 2/1
16 3/4/2020 ny. Titin wulandari 29/032773 tawangrejo 2/2
17 3/4/2020 ny. Sulastri 49/033468 kembang 4/4
18 3/4/2020 ny. Susi hayati 48/025548 klampok 1/2
19 3/4/2020 tn. Basuki 60/022811 tawangrejo 1/3
20 3/4/2020 ny. Jasmi 50/032584 pengkol 5/5
21 3/4/2020 sumiyatun 50/025156 cangkringan 14/02
22 3/5/2020 Ny. Rizki Ayu 25/033322 Semawur 1/1
23 3/5/2020 Ny. Tegar Monik 16/033010 Ngelobener 3/8
24 3/5/2020 Ny. Lia Ardhianti 23/033329 Gedongsari 3/2
25 3/6/2020 Ny. Yuliana R 33/000893 Bangkle 3/1
26 3/6/2020 Ny. Tasih 41/030758 Jiken 2/8
27 3/6/2020 Ny. Siti Maryam 29/033057 Sambongrejo 2/2
28 3/6/2020 ny. Pravitaningrum 38/033281 sendangharjo/3/2
29 3/6/2020 ny. Siti fatimah 45/030738 semawur 11/2
30 3/6/2020 ny. Samsidariyah 42/009757 kemiri 4/1
31 3/6/2020 ny. Sri suwarti 45/033225 kunduran 5/1
32 3/6/2020 ny. sulastri 62/032535 balong jepon
33 3/6/2020 tn. S parman 65/031362 tempel lemahbang 1/3
34 3/8/2020 ny. Dina mariana 32/033467 gedongsari 7/2
35 3/8/2020 tn. Marna 57/033434 jepon 7/2
36 3/8/2020 ny. Djumi 60/033423 bangsri 6/2
37 3/8/2020 tn. Suparno 52/030607 ngelobener 1/8
38 3/8/2020 tn. Sardji 72/033416 suruhan 1/2
39 3/8/2020 tn. Ngasiyo 65/031946 gombang 2/2
40 3/9/2020 Ny. Renita 26/031453 Kedungjenar 3/2
41 3/9/2020 Ny. Eni Aviani 30/033556 Bakah 1/3
42 3/9/2020 Ny. Ari Sulistiyowati 19/031397 Jiken 2/9
43 3/10/2020 ny verda valentina 8/13/1998 wuni 5/1 balong
44 3/10/2020 ny sitiksidowati 5/13/1988 dk watur 2/2 ngawen
45 3/10/2020 ny mahmudatun 6/24/1998 jiken 1/6
46 3/11/2020 Ny. Siti Murniati 23/030931 Jl. Veteran Bangkle
47 3/11/2020 Ny. Sivania Mardiyanti 24/030701 Tempel 8/3
48 3/11/2020 Ny. Fhuji Rahayu 33/031406 Janjang 1/1
49 3/11/2020 tn. Sarmin 68/033455 tempel lemahbang 7/3
50 3/11/2020 ny. Sri ngamijah 52/030635 kedungrejo tunjungan
51 3/11/2020 tn. Ngadikin 66/033413 BACEM 1/6 BANJAREJO
52 3/11/2020 tn. Sugiman 52/033472 kembang 2/1
53 3/11/2020 ny. Ngatini 38/033106 bangsri 2/1
54 3/11/2020 ny. Sudarti hasan 68/000305 seso 3/3
55 3/13/2020 tn. Karmu 60/033632 tahunan 2/1
56 3/13/2020 sdr. Rizal alamin 20/033634 sarirejo 5/1
57 3/13/2020 ny. Sri miningsih 47/033637 jetis
58 3/13/2020 tn. Budiono 61/033638 sukolilo 3/7
59 3/13/2020 tn. Yatmin 78/033589 bogorejo
60 3/13/2020 ny. Jumining 48/030000 palon 3/3
61 3/16/2020 ny. Suyati 55/033564 ngelobener 6/8
62 3/16/2020 ny. Satini 29/033585 sumurboto 1/3
63 3/16/2020 ny. Muanah 53/033686 bogorejo 4/2
64 3/16/2020 tn. Sarmin 68/033455 tempellemahbang 7/3
65 3/16/2020 tn. Marna 57/033434 jepon 7/2
66 3/16/2020 tn. Sutrisno 55/033633 sukorame 4/2
67 3/11/2020 Ny. Irma P 24/033600 Kauman
68 3/11/2020 Ny. Nisa F 24/026607 Semawur 8/2
69 3/11/2020 Ny. Wurirai 35/029492 Jepon
70 3/14/2020 Ny. Sri M 38/033595 Jepon 2/2
71 3/14/2020 Ny.Devina 26/033651 Kramat 1/2
72 3/14/2020 Ny. Lestari 41/033597 Semampir
73 3/18/2020 Ny. Mariani 41/033463 Jl. TMP Blora
74 3/18/2020 Ny. Dwi Lestari 24/033719 Jejeruk 3/1
75 3/18/2020 Ny. Yesi Ratna 30/006017 Jepangrejo 1/2
76 3/18/2020 ny. Yayu indarti 47/028990 jln. Veteran 04/04
77 3/18/2020 ny. Sujarmi 48/033338 tambahrejo 5/1
78 3/18/2020 ny. Sri purwaningsih 41/033807 1/1 ngawen
79 3/18/2020 ny. Sri hartini 41/033733 cabak 2/3
80 3/18/2020 an. Zulvandi nurza 0,8/033734 karang 5/2 bogorejo
 81 3/18/2020 tn. Gunanto 28/033403 sambong 2/3
82 3/19/2020 NY. SRI NGAMIJAH 52/030635 GENDONGAN 2/3
83 3/19/2020 TN. DJOEFRI 63/029627 JIKEN 1/4
84 3/19/2020 TN. RUDDY SOEHARTONO 52/033750 1/6 KAUMAN
85 3/19/2020 Ny. Silvia Margareta 26/033038 Tempellemahabang
86 3/19/2020 Ny. Azka Mufarida 26/033488 Sumbergirang 3/7 Lasem
87 3/19/2020 Ny. Ajeng Wijayanti 27/020477 Jiken 1/7
88 3/20/2020 TN. RAKIMIN 105/033635 GANDU4/2
89 3/20/2020 NY. WAHYU SUPRAHAPSARI 38/033727 BAKAH 2/3 KUNDURAN
90 3/20/2020 TN. KADI SUHUD 71/001883 SESO 2/3
91 3/20/2020 TN. SUMARNO 44/014149 SEMBUNGIN 2/2
92 3/20/2020 TN. KASDI 47/004919 JEPON 8/5
93 3/20/2020 NY. SITI FATIMAH 45/030738 SEMAWUR 11/2
94 3/23/2020 Ny. Desi Purnamasari 23/030489 Raji 2/4
95 3/23/2020 Ny Siti Linatul 21/033793 Kendayaan 5/1
96 3/23/2020 Ny. Kasmini 46/006827 Purwosari 1/3
97 3/24/2020 ny yuni 43/033816 kedungsatriyan 5/2 ngawen
98 3/24/2020 ny rizky siti 22/033815 kemiri 5/4 jepon
99 3/24/2020 ny verda valentina 21/033568 wuni5/1 balong
100 3/25/2020 Ny Dahlia 24/032156 tembellemahbang
101 3/25/2020 ny Devi eka 32/004705 jl.a.yani 5
102 3/25/2020 ny erni Puji 19/032111 turirejo jepon
103 3/27/2020 ny. Susi hayati 48/025548 klampok 1/2
104 3/27/2020 ny. samsidariyah 42/009757 kemiri 4/1
105 3/27/2020 ny. Sri lestari 36/032878 jepon 4/6
106 3/27/2020 tn. Ikhwanto 57/009066 jl. Nuri 2
107 3/27/2020 tn. Suwarjan 62/030703 gedongsari 5/2
108 3/27/2020 tn. Sunarno 70/033634 ngampel 3/1
109
110
 dr. Savitri Rahayu, Sp OG

dr. Hari K, Sp OG

1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
dr. Heri Agung, Sp B

1
1
1
1
1
1
1
1
1
1
dr. Saryanto Sp A

dr. Pandu Sp PD

1
1
1
1
1
1
1
1
1

dr. Sardji Sp PD

Angka ketepatan waktu tunggu

INDIKATOR UNIT

rawat jalan

Angka Kepuasan pasien dan

keluarga pasien

Angka Kepatuhan petugas dalam

melakukan Identifikasi Pasien
 1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
 1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
 Kerapihan Pakaian Kerja dokter
spesialis

1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
 TANGGAL

NO IDENTITAS PASIEN UMUR/RM

1 4/1/2019 NY BETI A 33/031710

2 4/1/2019 ny Nita 23/033133
3 4/1/2019 NY Yamini 28/033901
4 4/2/2019 NY Ika Irmawati 37/030764
5 4/2/2019 Ny Mutiah 31/033925
6 4/2/2019 Ny Sabela 26/032739
7 4/3/2019 NY Jihan 21/033985
8 4/3/2019 NY Umaya S 43/033984
9 4/3/2019 NY Nofia Ayu 27/033521
10 ny. Siti muhartini 67/000417
11 ny. Sujarmi 48/033338
12 ny. Rateni 61/031978
13 tn. Puger 70/000416
14 ny. Yatini 69/033801
15 ny. Priyati 72/033794
16 ny. Puji ristanti 29/033408
17 ny. Warmukini 47/033959
18 ny. Siti surini 66/027848
19 tn. Parji 59/030611
20 ny. Sarti 44/025138
21 ny. Supini 68/032451
22 4/6/2020 NY NAFIAH 30/034020
23 4/6/2020 NY ARI SULISTIYOWATI 19/031397
24 4/6/2020 NY ARI FIYANTI 26/034019
25 4/7/2020 NY SRI ENDANG 29/009539
26 4/7/2020 NY SITIK S 31/033569
27 4/7/2020 TRI YULI 24/032624
28 4/8/2020 NY ERTIK 32/033764
29 4/8/2020 NY NUNUNG NUR 33/034040
30 4/8/2020 NY. SUSANTI 27/033939
31 4/8/2020 NY. INDARTI 36/034047
32 4/8/2020 NY. ELLY KRISTINA 36/034039
33 4/8/2020 TN. ABDUL MANAB 54/033395
34 4/8/2020 NY RATNA K 37/032265
35 4/8/2020 NY WAHYU R 26/033172
36 4/8/2020 NY FITRI D 25/014485
37 4/11/2020 NY MIA PUJI 21/034001
38 4/11/2020 NY RANI Y 27/034070
39 4/11/2020 NY SITI NINIK 23/031457
40 4/13/2020 NY DEVI EKA 32/004705
41 4/13/2020 NY DIYAH AYU 26/017701
42 4/13/2020 NY KRISTIYANTI 30/024536
43 4/14/2020 NY FININDYA 26/007324
44 4/14/2020 NY SUTRISNI 21/021646
45 4/14/2020 NY WENI A 29/033500
46 4/15/2020 NY HENNY R 38/023246
47 4/15/2020 NY NYAMINI 28/033901
48 4/15/2020 NY AIDA M 29/015756
49 4/16/2020 NY SRI K 27/018816
50 4/16/2020 NY TITIS A 24/033948
51 4/16/2020 NY AJENG W 27/020477
52 4/22/2020 Ny. Novi kristiana 32/033724
53 4/22/2020 Ny. Siti Dasah Muningsih 30/031423
54 4/22/2020 Ny. Siti Nihayatul 27/019998
55 4/23/2020 NY SABELLA OVI 26/032739
56 4/23/2020 NY INDANG 35/034210
57 4/23/2020 NY SUSI 28/034207
58
59
60
61
62
63
64
65
66
67
68
69
70
71
72
73
74
75
76
77
78
 79
80
81
82
83
84
85
86
87
88
89
90
91
92
93
94
95
96
97
98
99
100
 INDIKATOR U

dr. Savitri Rahayu, Sp OG

dr. Heri Agung, Sp B

dr. Saryanto Sp A
dr. Hari K, Sp OG

dr. Pandu Sp PD
ALAMAT

Purwosari 1/1 1
Cibuluh tuban 1
Sambongrejo ngawen 1
Genjahan 5/2 1
Ngawen 3/7 1
Sabella Ovi 1
Kunduran 1
Jetis 3/1 1
Buluroto Banjarejo 1
tambahrejo 4/1 1
tambahrejo 2/1 1
janjang 2/2 1
tambahrejo 4/1 1
ngapus 4/1 1
kebonrejo 1/1 1
ra. Kartini lr.6 1
suruhan 5/3 1
ngawen 8/2 1
gandu 1/4 1
cabak 1/2 1
bangkle 3/4 1
HARJOWINANGUN JAPAH 1
JIKEN 2/9 1
JIKEN 2/1, 1
KEMIRI 5/1 1
NGAWEN 1
SESO 2/1 JEPON 1
SUMURBOTO 2/1 JEPON 1
JAPAH 8/2 BLORA 1
SRIMULYO 3/2 1
KLOPODUWUR BANJAREJO 1
TEMPELAN 8/1 BLORA 1
PURWOREJO 02/06 BLORA 1
KIDANGAN JEPON 1
TEMPELMAHBANG 7/2 1
SUMBERAGUNG 1
KUNDURAN 1
PLOSOREJO 1
KUNDURAN 1
JL A YANI 75 1
GAYAM 1
TEMPELAN 1
KARANGJATI 1
SUTRISNI 1
JEPON 1
JEPON 1
NGAWEN 1
KUNDEN 1
JOMBLANG 5/1 1
BANGKLE 3/4 1
JIKEN 1/7 1
Karangjati 8/5 1
Puledagel 5/2 1
Puledagel 4/2 1
CABEAN 1/2 1
SEMAMPIR 3/3 JEPON 1
bangkle 3/4 1
 dr. Sardji Sp PD

Angka ketepatan waktu tunggu

INDIKATOR UNIT

rawat jalan

Angka Kepuasan pasien dan

keluarga pasien

Angka Kepatuhan petugas dalam

melakukan Identifikasi Pasien

Kerapihan Pakaian Kerja dokter

1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1

spesialis
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
 dr. Savitri Rahayu, Sp OG

dr. Heri Agung, Sp B

dr. Hari K, Sp OG
TANGGAL

NO IDENTITAS PASIEN UMUR/RM ALAMAT

1 5/4/2020 NY PARAS TRI 23/024183 GONDANG 4/1 NGAWEN 1

2 5/4/2020 NY SIVANIA 28/030701 TEMPELLEMAHBANG 1
3 5/4/2020 NY ANASTASIA V 26/030192 JL JENDRAL SUDIRMAN 1
4 5/5/2020 NY SITI R 26/034254 PULEDAGEL 4/2 1
5 5/5/2020 NY SUPARTI 27/034441 NGAWEN JEPON 1
6 5/5/2020 NY TIA DWI 20/032877 TEMPELMAHBANG 7/2 1
7 5/11/2020 NY FERI L 24/018988 DS DADAPAN 4/4 SINGOROJO 1
8 5/11/2020 NY ENDAH P 28/030519 GEMPOLREJO 1/4 1
9 5/11/2020 NY DESTIANA 30/023447 TURIREJO JEPON 1
10 5/12/2020 NY ANASTASIA V 26/030192 JL JEND SUDIRMAN 1
11 5/12/2020 NY MEIROH NUR 26/033522 SENDANGHARJO BLORA 1
12 5/12/2020 NY VINA ANDRI 33/023299 TAMBAHREJO 1
13 5/13/2020 NY HENNY R 38/023246 KEMIRI 5/4 JEPON 1
14 5/13/2020 NY RIDDAH A 22/034430 GENPOLREJO 1
15 5/13/2020 NY YUSTRIENA 27/032124 NGAWEN 2/7 1
16 5/15/2020 NY YESI A 28/020672 KEDUNG JENAR 1
17 5/15/2020 NY TITIK L 29/034366 MURAHHARJO 4/1 1
18 5/15/2020 NY ELSA DIAN 25/031565 KARANGJATI 1
19 5/22/2020 NY SRI LESTARI 20/34457 DS TEMPELLEMAHBANG 1
20 5/22/2020 NY CHINDY YULI 29/034550 TUGUSARU SUMBERJAYA 1
21 5/22/2020 NY ASIH N 33/009636 GEDONGSARI 4/2 1
22 5/28/2020 NY RINA R 23/025099 DK SAMBIROTO 6/1 NGAWEN 1
23 5/28/2020 NY TITIS A 24/033949 BANGKLE 3/4 1
24 5/28/2020 NY CATUR OKVITA 35/033209 JL BARITO NO 8C 1
25 5/29/2020 NY TIKA H 28/034638 ASMIL 410 1
26 5/29/2020 NY TIKA SARASWATI 29/034637 SASAK 1/1 1
27 5/29/2020 NY SITA A 29/031067 JL KEMUNING 1
 dr. Saryanto Sp A
dr. Pandu Sp PD
dr. Sardji Sp PD

Angka ketepatan waktu tunggu rawat jalan

Angka Kepuasan pasien dan keluarga pasien

INDIKATOR UNIT

Angka Kepatuhan petugas dalam melakukan Identifikasi Pasien

1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
Kerapihan Pakaian Kerja dokter spesialis
1
 TANGGAL
NO IDENTITAS PASIEN UMUR/RM ALAMAT

1 4/6/220 NY IKKO DELFIA 25/33995 SONOREJO 2/2

2 6/4/2020 NY SRI PUJIANTI 51/010130 SENDANGWUNGU 1/1
3 6/4/2020 NY SRI MUNTARI 36/032625 SENDANGMULYO 2/1
4 6/5/2020 NY SUSI MARIYANI 29/3477 SINGONEGORO
5 5/6/220 NY DINA ANDI 35/20932 TUTUP 1/1 TUNJUNGAN
6 5/6/220 NY YUNI KARTIKASARI 25/034769 KARANG 1/1 BOGOREJO
7 6/18/2020 NY. ASIH NURHAYATI 33/009636 DS. GEDONGSARI 4/2
8 6/18/2020 NY. CATUR OCVITA 35/033209 JL. BARITO NO. 8C
9 6/18/2020 NY. TRI YULI ASTUTI 24/032624 SESO 2/1
10 6/18/2020 NY. AMELIA INTANA 28/018883 KLAMPOK 3/2
11 6/18/2020 NY. OSI ANTIKA DIAN 30/034959 SONOREJO 2/2
12
13
14
15
16
17
18
19
20
21
22
23
24
25
 dr. Savitri Rahayu, Sp OG

dr. Hari K, Sp OG

1
1
1
1
1
1
1
1
1
1
1
dr. Heri Agung, Sp B

dr. Saryanto Sp A

dr. Pandu Sp PD

dr. Sardji Sp PD

Angka ketepatan waktu tunggu

INDIKATOR UNIT

rawat jalan

Angka Kepuasan pasien dan

keluarga pasien

Angka Kepatuhan petugas dalam

melakukan Identifikasi Pasien

Kerapihan Pakaian Kerja dokter

spesialis
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1