Kantor Cabang : TAPAKTUAN - 0105

FKTP : UJUNG PADANG RASIAN - 00031001

NO TANGGAL NO KUNJUNGAN NO KARTU NAMA PESERTA SEX

1 29-06-2018 000310010618Y000064 0000211914134 MAHALEH P

2 29-06-2018 000310010618Y000066 0000978367522 BEDON L

3 29-06-2018 000310010618Y000067 0000978379446 ZULBAIDAH P

4 29-06-2018 000310010618Y000065 0001271989214 JUNIBAR L

5 28-06-2018 000310010618Y000057 0000212825586 TAMLEKHA L

6 28-06-2018 000310010618Y000056 0001676752288 NURSIMAH P

7 28-06-2018 000310010618Y000058 0001676836708 NADILA CHAVIRA P

8 28-06-2018 000310010618Y000055 0001814296173 marwi P

9 26-06-2018 000310010618Y000033 0000212097216 DEVISTA REZA P

10 26-06-2018 000310010618Y000020 0000212795662 WARDIAH P

11 26-06-2018 000310010618Y000026 0000978365632 ALFATA L

12 26-06-2018 000310010618Y000054 0000978366216 AINAL FARIDA P

13 26-06-2018 000310010618Y000052 0001676803476 NURAIN P

14 26-06-2018 000310010618Y000072 0001899345745 ELIS SUCI RAHAYU P

15 25-06-2018 000310010618Y000007 0000004091264 RATNAWATI P

16 25-06-2018 000310010618Y000014 0000212455653 M. NASIR L

17 25-06-2018 000310010618Y000008 0000212870564 ZUBIR L

18 25-06-2018 000310010618Y000015 0000978367487 ASMADI L

19 25-06-2018 000310010618Y000013 0001270742679 JALEMAN L

JENIS PESERTA DIAGNOSA STATUS PRB PROLANIS
PULANG

PBI (APBN) Congenital cataract Rujuk Vertikal

PBI (APBN) Chronic obstructive pulmonary Rujuk Vertikal

disease, unspecified

PBI (APBN) Uterovaginal prolapse, Rujuk Vertikal

unspecified
PBI (APBD) Benign neoplasm of breast Rujuk Vertikal

PBI (APBN) Cardiomegaly Rujuk Vertikal

PBI (APBD) Chronic obstructive pulmonary Rujuk Vertikal

disease, unspecified

PNS DAERAH Other strabismus Rujuk Vertikal

PBI (APBD) Benign neoplasm of ovary Rujuk Vertikal

PBI (APBN) Chronic tonsillitis Rujuk Vertikal

PBI (APBN) Epispadias Berobat Jalan

PBI (APBN) Intracranial injury Rujuk Vertikal

PBI (APBN) Myopia Rujuk Vertikal

PBI (APBD) Nontoxic multinodular goitre Rujuk Vertikal

PBI (APBD) Spontaneous vertex delivery Sembuh

PBI (APBD) Non-insulin-dependent Rujuk Vertikal

diabetes mellitus
PBI (APBN) Tuberculosis of lung, confirmed Rujuk Vertikal
by sputum microscopy with or
without culture

PBI (APBN) Chronic obstructive pulmonary Rujuk Vertikal

disease, unspecified

PNS DAERAH Schizophrenia Rujuk Vertikal

PBI (APBD) Insulin-dependent diabetes Rujuk Vertikal

mellitus
Kantor Cabang : TAPAKTUAN - 0105
FKTP : UJUNG PADANG RASIAN - 00031001
20 25-06-2018 000310010618Y000009 0001427043251 HASMIDANI P

21 25-06-2018 000310010618Y000011 0001676765068 MASYITAH P

22 25-06-2018 000310010618Y000019 0001676786769 HAMDAN L

23 25-06-2018 000310010618Y000017 0001676812792 EMA SUSANTI P

24 25-06-2018 000310010618Y000018 0001800225022 BUNGSU P

25 25-06-2018 000310010618Y000016 0001814296173 marwi P

26 25-06-2018 000310010618Y000010 0002076804966 RUSNI P

27 25-06-2018 000310010618Y000012 0002421607252 HERMIDA P

28 22-06-2018 000310010618Y000004 0001292178914 SAFATUL MAYESA P

29 22-06-2018 000310010618Y000005 0001676755809 ASRI L

30 22-06-2018 000310010618Y000006 0002424560117 HASNIDAR P

31 21-06-2018 000310010618Y000002 0000206622729 EMA YULIDA P

32 21-06-2018 000310010618Y000003 0001676794566 SURIANA P

33 21-06-2018 000310010618Y000001 0001676803476 NURAIN P

34 08-06-2018 000310010618Y000071 0000978382991 SAUWATI P

35 06-06-2018 000310010618Y000061 0000004091297 RAMAWI L

36 06-06-2018 000310010618Y000063 0000212111109 ERMA.Z P

PBI (APBD) Supervision of pregnancy with Rujuk Vertikal
history of insufficient antenatal
care
PBI (APBD) Supervision of pregnancy with Rujuk Vertikal
history of insufficient antenatal
care

PBI (APBD) Other specified intervertebral Rujuk Vertikal

disc displacement

PBI (APBD) Malignant neoplasm of Rujuk Vertikal

bronchus and lung
PBI (APBD) Supervision of pregnancy with Rujuk Vertikal
history of insufficient antenatal
care
PBI (APBD) Gastritis, unspecified Rujuk Vertikal

PBI (APBD) Non-insulin-dependent Rujuk Vertikal

diabetes mellitus
PBI (APBD) Supervision of pregnancy with Rujuk Vertikal
history of insufficient antenatal
care
PBI (APBD) Thalassaemia, unspecified Rujuk Vertikal

PBI (APBD) Tuberculosis of lung, confirmed Rujuk Vertikal

by sputum microscopy with or
without culture

PBI (APBD) Tuberculosis of lung, confirmed Rujuk Vertikal

by sputum microscopy with or
without culture

PBI (APBD) Epispadias Berobat Jalan

PBI (APBD) Supervision of pregnancy with Rujuk Vertikal

history of insufficient antenatal
care
PBI (APBD) Tuberculous peripheral Rujuk Vertikal
lymphadenopathy
PBI (APBN) Spontaneous vertex delivery Sembuh

PNS DAERAH Epispadias Berobat Jalan

PBI (APBN) Epispadias Berobat Jalan

Kantor Cabang : TAPAKTUAN - 0105
FKTP : UJUNG PADANG RASIAN - 00031001
37 06-06-2018 000310010618Y000059 0001676786411 MILA WATI P

38 06-06-2018 000310010618Y000060 0001676786433 ZAZULI L

39 06-06-2018 000310010618Y000062 0002020698189 IRNASARLITA P

40 05-06-2018 000310010618Y000044 0000212638678 RUSNI P

41 05-06-2018 000310010618Y000043 0000212753845 SITI RAWAN P

42 05-06-2018 000310010618Y000053 0000978316672 SURYA DEWI P

43 05-06-2018 000310010618Y000046 0001119222472 KASUM P

44 05-06-2018 000310010618Y000050 0001119232978 URULFAN L

45 05-06-2018 000310010618Y000051 0001447700411 RUSLI L

46 05-06-2018 000310010618Y000047 0001676756338 BENU ALI L

47 05-06-2018 000310010618Y000048 0001676756351 TARMIZI L

48 05-06-2018 000310010618Y000045 0001676783406 ZAHARA P

49 05-06-2018 000310010618Y000049 0001676816122 KUSNADI SAPUTRA L

50 04-06-2018 000310010618Y000030 0000004168923 RAMAIDA P

51 04-06-2018 000310010618Y000027 0000004476339 MISTAHUDDIN L

52 04-06-2018 000310010618Y000039 0000212449937 TISA RAIS P

53 04-06-2018 000310010618Y000029 0000212838546 MALEK RAZUAN L

54 04-06-2018 000310010618Y000036 0000978365283 ALI AMRAN L

55 04-06-2018 000310010618Y000022 0001119233496 HUZAIMAH P

56 04-06-2018 000310010618Y000037 0001427043251 HASMIDANI P

57 04-06-2018 000310010618Y000031 0001479698673 ANITA P

58 04-06-2018 000310010618Y000034 0001671075527 MUHAMMAD L

59 04-06-2018 000310010618Y000021 0001674685653 MARHAMAH P

60 04-06-2018 000310010618Y000040 0001676779536 KHAIRUL RAZI L

PBI (APBD) Epispadias Berobat Jalan

PBI (APBD) Epispadias Berobat Jalan

PBI (APBN) Epispadias Berobat Jalan

PBI (APBN) Headache Berobat Jalan

PBI (APBN) Gastritis, unspecified Berobat Jalan

PBI (APBN) Dyspepsia Berobat Jalan

PBI (APBD) Allergy, unspecified Berobat Jalan

PBI (APBD) Dyspepsia Berobat Jalan

PBI (APBD) Headache Berobat Jalan

PBI (APBD) Dyspepsia Berobat Jalan

PBI (APBD) Dyspepsia Berobat Jalan

PBI (APBD) Rheumatoid arthritis, Berobat Jalan

unspecified
PBI (APBD) Allergy, unspecified Berobat Jalan

PNS DAERAH Epispadias Berobat Jalan

PNS DAERAH Epispadias Berobat Jalan

PBI (APBN) Gangrene, not elsewhere Berobat Jalan

classified
PBI (APBN) Epispadias Berobat Jalan

PBI (APBN) Epispadias Berobat Jalan

PBI (APBD) Epispadias Berobat Jalan

PBI (APBD) Epispadias Berobat Jalan

PRAJURIT AD Epispadias Berobat Jalan

PBI (APBD) Diarrhoea and gastroenteritis of Berobat Jalan

presumed infectious origin

PBI (APBD) Puerperal sepsis Berobat Jalan

PBI (APBD) Epispadias Berobat Jalan

Kantor Cabang : TAPAKTUAN - 0105
FKTP : UJUNG PADANG RASIAN - 00031001
61 04-06-2018 000310010618Y000041 0001676786861 MISWAR L

62 04-06-2018 000310010618Y000032 0001676788841 KHAIDIR L

63 04-06-2018 000310010618Y000042 0001676790843 SAMSIDAR P

64 04-06-2018 000310010618Y000024 0001676795308 HASANUDIN L

65 04-06-2018 000310010618Y000070 0001676824749 NURHAYATI P

66 04-06-2018 000310010618Y000025 0001791163787 muhammad al-fata L

67 04-06-2018 000310010618Y000028 0001872430244 HAYATI P

68 04-06-2018 000310010618Y000038 0002079306797 INDRAWATI P

69 04-06-2018 000310010618Y000035 0002310917837 MADI SALJANI L

70 04-06-2018 000310010618Y000023 0002326970518 NURLAILA P

PBI (APBD) Burn and corrosion of head and Berobat Jalan
neck
PBI (APBD) Epispadias Berobat Jalan

PBI (APBD) Epispadias Berobat Jalan Diabetes Mellitus

PBI (APBD) Epispadias Berobat Jalan

PBI (APBD) Spontaneous vertex delivery Sembuh

PBI (APBD) Epispadias Berobat Jalan

PNS DAERAH Dyspepsia Berobat Jalan

PBI (APBD) Diarrhoea and gastroenteritis of Berobat Jalan

presumed infectious origin

PBI (APBD) Epispadias Berobat Jalan

PBI (APBD) Epispadias Berobat Jalan