LAPORAN PELAYANAN

RAWAT JALAN TINGKAT PERTAMA (RJTP)

BULAN : JULI TAHUN 2014
Nama Faskes : Puskesmas DTP Cibeber
Alamat : Jln Raya Cikotok - Plb Ratu Desa Cikotok Kec.Cibeber

NO TANGGAL NO KARTU PESERTA NAMA PESERTA DIAGNOSA

DI TANDA TANGAN PASIEN
RUJUK

1 8/1/2014 796733763 SUSI ISPA 1 ..................

2 8/1/2014 798590226 SARMEDI GASTRITIS 2 ..................
3 8/1/2014 797085112 RIJAL DERMATITIS 3 ..................
4 8/1/2014 798598462 ASNUDI HYPERTENSI 4 ..................
5 8/1/2014 1051164729 RISKI INFEKSI GIGI 5 ..................
6 8/1/2014 797085461 SUPENDI VERTIGO 6 ..................
7 8/1/2014 797134285 ETIN GASTRITIS 7 ..................
8 8/1/2014 798596379 JUMRIAT ISPA 8 ..................
9 8/1/2014 1051164549 MADSOKI HYPERTENSI 9 ..................
10 8/1/2014 796728003 NIA DERMATITIS 10 ..................
11 8/1/2014 797129684 ASIAH PERIODONTITIS 11 ..................
12 8/1/2014 797163063 AIM Conjungtivitis 12 ..................
13 8/1/2014 797870079 PURNAMA FEBRIS 13 ..................
14 8/1/2014 797855488 INDRA INFLUENSA 14 ..................
15 8/1/2014 1051164718 IDA PERIODONTITIS 15 ..................
16 8/1/2014 1051164786 DADANG KUSNANDAR GASTRITIS 16 ..................
17 8/2/2014 1051165012 SUARSAH HYPERTENSI 17 ..................
18 8/2/2014 796735203 YANTI GASTRITIS 18 ..................
19 8/2/2014 797145401 RIANDI ISPA 19 ..................
20 8/2/2014 797148369 EDI PERIODONTITIS 20 ..................
21 8/2/2014 797139707 JUARDI RA 21 ..................
22 8/2/2014 797107048 ARNESIH HYPERTENSI 22 ..................
23 8/2/2014 797868393 RUYADI HYPERTENSI 23 ..................
24 8/2/2014 797883265 SUNARTI PERIODONTITIS 24 ..................
25 8/2/2014 798596943 KARDILA DERMATITIS 25 ..................
26 8/2/2014 1051164933 ARNASIH GASTRITIS 26 ..................
27 8/2/2014 797489447 MASNI PERIODONTITIS 27 ..................
28 8/2/2014 797492485 DEPIA NURNABILA ISPA 28 ..................
29 8/2/2014 797129493 EDWAR DEMAM TYPOID 29 ..................
30 8/2/2014 797133453 MIS'AN INFLUENSA 30 ..................
31 8/2/2014 797306681 SUKARMA RA 31 ..................
32 8/2/2014 797310898 DIAN ROBIANSYAH TONSILITIS 32 ..................
33 8/2/2014 797052677 AAT GASTRITIS 33 ..................
34 8/2/2014 797056424 MUHAMAD WARDINI Conjungtivitis 34 ..................
35 8/2/2014 1051164898 SUNANDAR FEBRIS 35 ..................
36 8/2/2014 796724256 KAMELA GASTRITIS 36 ..................
37 8/2/2014 796727305 TIAR PERIODONTITIS 37 ..................
38 8/2/2014 797115813 ASMENAH HYPERTENSI 38 ..................
39 8/2/2014 797133633 TATI DERMATITIS 39 ..................
40 8/4/2014 797101266 MAHMUD SIDRI ISPA 40 ..................
41 8/4/2014 797850955 SILPIA NINGSIH ISPA 41 ..................
42 8/4/2014 798606224 MARNI HYPERTENSI 42 ..................
43 8/4/2014 798632054 A SAROI PERIODONTITIS 43 ..................
44 8/4/2014 798616967 SINTA GASTRITIS 44 ..................
45 8/4/2014 1051165001 RENI GASTRITIS 45 ..................
46 8/4/2014 1051164865 SUNIAH HYPERTENSI 46 ..................
47 8/4/2014 797086326 NURKIB DERMATITIS 47 ..................
48 8/4/2014 797107342 JUMHADI PERIODONTITIS 48 ..................
49 8/4/2014 797025688 EGIS TRIANTO GE 49 ..................
50 8/4/2014 797029345 AYAD FARINGITIS 50 ..................
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NO TANGGAL NO KARTU PESERTA NAMA PESERTA DIAGNOSA TANDA TANGAN PASIEN
RUJUK

51 8/4/2014 797028118 RINI DARINI GASTRITIS 51 ..................

52 8/4/2014 797063938 SUNARTA DERMATITIS 52 ..................
53 8/4/2014 798612456 LINA DERMATITIS 53 ..................
54 8/4/2014 798645644 MASDI GE 54 ..................
55 8/4/2014 1051164819 TATANG HYPERTENSI 55 ..................
56 8/4/2014 1051164887 SUMAYATI GASTRITIS 56 ..................
57 8/4/2014 797075954 RASYA ADITIA ISPA 57 ..................
58 8/4/2014 797158664 SARKOSIH HYPERTENSI 58 ..................
59 8/4/2014 797885796 ADSAR PERIODONTITIS 59 ..................
60 8/4/2014 796729026 MARYATI 60 ..................
61 8/4/2014 796733493 SUDENTI GASTRITIS 61 ..................
62 8/4/2014 797149629 RIKI OTITIS MEDIA AKUT 62 ..................
63 8/4/2014 797158405 SURYATI PERIODONTITIS 63 ..................
64 8/4/2014 797165076 ARYADI RA 64 ..................
65 8/4/2014 797143465 ADNA HYPERTENSI 65 ..................
66 8/4/2014 797105654 ALDI PERSISTENSI 66 ..................
67 8/5/2014 797837084 JUKEDI RA 67 ..................
68 8/5/2014 797863702 JUJU JUNAESIH FEBRIS 68 ..................
69 8/5/2014 797875852 SAHRUDIN RA 69 ..................
70 8/5/2014 798599452 SAIKAM HYPERTENSI 70 ..................
71 8/5/2014 798642707 ALDIANSAH DERMATITIS 71 ..................
72 8/5/2014 797777109 RUKI PERIODONTITIS 72 ..................
73 8/5/2014 798574195 SUHENDI HYPERTENSI 73 ..................
74 8/5/2014 797126455 WARDI Conjungtivitis 74 ..................
75 8/5/2014 797061453 RUMNAH GASTRITIS 75 ..................
76 8/5/2014 797067191 SERLIYANTI PERSISTENSI 76 ..................
77 8/5/2014 797070521 SARTIAH RA 77 ..................
78 8/5/2014 797152048 NAPSI HYPERTENSI 78 ..................
79 8/5/2014 797128558 JANATA HYPERTENSI 79 ..................
80 8/5/2014 1051166081 WIDIATI ISPA 80 ..................
81 8/5/2014 1051166428 MISNAH HYPERTENSI 81 ..................
82 8/5/2014 797019838 HERI PERIODONTITIS 82 ..................
83 8/5/2014 797131001 PAHRUL INFLUENSA 83 ..................
84 8/5/2014 797491798 ISAH GASTRITIS 84 ..................
85 8/5/2014 797493655 EMAR GASTRITIS 85 ..................
86 8/5/2014 797502587 SUHERTI ISPA 86 ..................
87 8/5/2014 797441916 EMAH RA 87 ..................
88 8/5/2014 797442895 NURYADIN PERIODONTITIS 88 ..................
89 8/5/2014 797922527 KOMESIH PERIODONTITIS 89 ..................
90 8/5/2014 797925835 MARGANI RA 90 ..................
91 8/5/2014 797939289 ARMANAH HYPERTENSI 91 ..................
92 8/5/2014 797952519 TARJAT FEBRIS 92 ..................
93 8/5/2014 798266891 SURYATI GASTRITIS 93 ..................
94 8/5/2014 798619858 ADI OTITIS MEDIA AKUT 94 ..................
95 8/6/2014 798697945 MARYANTO ISPA 95 ..................
96 8/6/2014 798750821 SUTIARAH GASTRITIS 96 ..................
97 8/6/2014 797127579 JUNENGSIH GASTRITIS 97 ..................
98 8/6/2014 797908004 WAWAN DERMATITIS 98 ..................
99 8/6/2014 797911569 ARMENAH RA 99 ..................
100 8/6/2014 798654622 ADHEWI HYPERTENSI 100 ..................
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NO TANGGAL NO KARTU PESERTA NAMA PESERTA DIAGNOSA TANDA TANGAN PASIEN
RUJUK

101 8/6/2014 798672993 NARHA PERIODONTITIS 101 ..................

102 8/6/2014 797131923 HERI ISPA 102 ..................
103 8/6/2014 797890206 CELSI ISPA 103 ..................
104 8/6/2014 797909297 SUKASIH RA 104 ..................
105 8/6/2014 797945703 SUANTA HYPERTENSI 105 ..................
106 8/6/2014 797949549 RISKI NURDIANSAL CARIES 106 ..................
107 8/6/2014 797019524 SUKIRJAT INFLUENSA 107 ..................
108 8/6/2014 797028862 FEBRIANA ISPA 108 ..................
109 8/6/2014 797031764 SARMAH HYPERTENSI 109 ..................
110 8/6/2014 797057425 HEPRI MAULANA FEBRIS 110 ..................
111 8/6/2014 797060171 MARIAH RA 111 ..................
112 8/6/2014 797068427 DEWI ISPA 112 ..................
113 8/6/2014 797138032 ARWIYAH HYPERTENSI 113 ..................
114 8/6/2014 797102335 OMAH RA 114 ..................
115 8/6/2014 797878001 ALISAH AMARANI DERMATITIS 115 ..................
116 8/6/2014 797930818 SUTI HAYATI GASTRITIS 116 ..................
117 8/6/2014 797955783 JAMA HYPERTENSI 117 ..................
118 8/6/2014 797021436 DERI INDRIANA ISPA 118 ..................
119 8/6/2014 797023541 JUANI HYPERTENSI 119 ..................
120 8/6/2014 797031742 YATI GASTRITIS 120 ..................
121 8/6/2014 797044476 IRJA HYPERTENSI 121 ..................
122 8/6/2014 797048471 MURHAMAH GASTRITIS 122 ..................
123 8/6/2014 797052644 ANONG HYPERTENSI 123 ..................
124 8/6/2014 797975021 ROIB RA 124 ..................
125 8/6/2014 798752665 DANU APRIANSAH DERMATITIS 125 ..................
126 8/7/2014 797785042 DAHLAN FARINGITIS 126 ..................
127 8/7/2014 797919041 SUHENDRI FEBRIS 127 ..................
128 8/7/2014 797937017 AJI DARMAWAN ISPA 128 ..................
129 8/7/2014 797951823 JAENAL CARIES 129 ..................
130 8/7/2014 797957109 SARHEMI ASMA 130 ..................
131 8/7/2014 798271345 MASDI RA 131 ..................
132 8/7/2014 797043172 BEDI SUPRIYADI FEBRIS 132 ..................
133 8/7/2014 797045398 SARMINAH HYPERTENSI 133 ..................
134 8/7/2014 797117376 ALPIAH HYPERTENSI 134 ..................
135 8/7/2014 797119558 ANITA PERSISTENSI 135 ..................
136 8/7/2014 797145478 SARMUJA HYPERTENSI 136 ..................
137 8/7/2014 797146749 SAUDIN RA 137 ..................
138 8/7/2014 797095765 MADNUR CARIES 138 ..................
139 8/7/2014 797435616 MINTARSIH DERMATITIS 139 ..................
140 8/7/2014 797109704 EMI HYPERTENSI 140 ..................
141 8/7/2014 797908612 SANGSANG FEBRIS 141 ..................
142 8/7/2014 797887236 OMSIH GASTRITIS 142 ..................
143 8/7/2014 797955208 DASEP DERMATITIS 143 ..................
144 8/7/2014 797512511 ERNI ISPA 144 ..................
145 8/7/2014 797483384 YANDA MARLIANDA ISPA 145 ..................
146 8/7/2014 797519687 ANING HYPERTENSI 146 ..................
147 8/7/2014 798353381 GITA PILYASARI PERSISTENSI 147 ..................
148 8/7/2014 798354786 JUMRONI HYPERTENSI 148 ..................
149 8/7/2014 798462022 SUHANI GE 149 ..................
150 8/7/2014 798768999 SUPRADI FEBRIS 150 ..................
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NO TANGGAL NO KARTU PESERTA NAMA PESERTA DIAGNOSA TANDA TANGAN PASIEN
RUJUK

151 8/7/2014 798773466 RUSTAM CARIES 151 ..................

152 8/7/2014 797775221 SUTIAWATI GASTRITIS 152 ..................
153 8/7/2014 797776885 MISNAN RA 153 ..................
154 8/7/2014 797466104 JELITA ISPA 154 ..................
155 8/7/2014 797514581 JUANAH HYPERTENSI 155 ..................
156 8/8/2014 798578469 WANTI ISPA 156 ..................
157 8/8/2014 798659627 TATI GASTRITIS 157 ..................
158 8/8/2014 798710973 OTIH GASTRITIS 158 ..................
159 8/8/2014 798757852 DIDI DERMATITIS 159 ..................
160 8/8/2014 798765761 HARIAH GASTRITIS 160 ..................
161 8/8/2014 798723538 SAHDI RA 161 ..................
162 8/8/2014 798737512 ARNI HYPERTENSI 162 ..................
163 8/8/2014 797847568 IYAH HYPERTENSI 163 ..................
164 8/8/2014 797962241 TETI INFEKSI GIGI 164 ..................
165 8/8/2014 798582069 ICAH RA 165 ..................
166 8/8/2014 798651235 NURMASIH GASTRITIS 166 ..................
167 8/8/2014 798679822 SANU PERIODONTITIS 167 ..................
168 8/8/2014 798760078 JARSAN RA 168 ..................
169 8/8/2014 798724754 IRAWAN ISPA 169 ..................
170 8/8/2014 798735251 ASTURA HYPERTENSI 170 ..................
171 8/8/2014 798740291 SUHETI DERMATITIS 171 ..................
172 8/8/2014 797767468 EDAY TYPOID 172 ..................
173 8/8/2014 797771035 BONASIH PERIODONTITIS 173 ..................
174 8/8/2014 797800228 JANAH GASTRITIS 174 ..................
175 8/8/2014 797972444 AMSI HYPERTENSI 175 ..................
176 8/8/2014 1051166766 MADHAYA HYPERTENSI 176 ..................
177 8/8/2014 798600183 MULYADI INFLUENSA 177 ..................
178 8/8/2014 798606156 ARBAIN RA 178 ..................
179 8/8/2014 798650346 HENDRA PERIODONTITIS 179 ..................
180 8/9/2014 798785447 MARTINI GASTRITIS 180 ..................
181 8/9/2014 798769506 JASIAN HYPERTENSI 181 ..................
182 8/9/2014 798673544 SARKA HYPERTENSI 182 ..................
183 8/9/2014 797647678 SUYANDI INFEKSI GIGI LUKA 183 ..................
184 8/9/2014 797651144 ARIS ISPA 184 ..................
185 8/9/2014 798567592 RIANI DERMATITIS 185 ..................
186 8/9/2014 798570358 AEMI ISPA 186 ..................
187 8/9/2014 798689283 SARBINI PERSISTENSI 187 ..................
188 8/9/2014 798690756 UCE GE 188 ..................
189 8/9/2014 798669415 MARAYANI DERMATITIS 189 ..................
190 8/9/2014 797772644 KAWIDAH GE 190 ..................
191 8/9/2014 797774433 MAHYUDIN GASTRITIS 191 ..................
192 8/9/2014 798568108 SAMSURI HYPERTENSI 192 ..................
193 8/9/2014 798573846 UJANG FARINGITIS 193 ..................
194 8/9/2014 798574443 DIANSAH INFEKSI GIGI 194 ..................
195 8/9/2014 798664443 ALSA HYPERTENSI 195 ..................
196 8/9/2014 798688664 SARHASIH GASTRITIS 196 ..................
197 8/9/2014 798752957 ANDRE ISPA 197 ..................
198 8/9/2014 797962105 RINA GASTRITIS 198 ..................
199 8/9/2014 798639996 KOSIM GE 199 ..................
200 8/9/2014 798720873 SUTARYAT DERMATITIS 200 ..................
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NO TANGGAL NO KARTU PESERTA NAMA PESERTA DIAGNOSA TANDA TANGAN PASIEN
RUJUK

201 8/9/2014 798616012 MARSIH TYPOID 201 ..................

202 8/9/2014 798619048 NARA RA 202 ..................
203 8/9/2014 798668447 YUYUM GASTRITIS 203 ..................
204 8/9/2014 798651887 MIRJAYA HYPERTENSI 204 ..................
205 8/9/2014 798766571 ARDIS RA 205 ..................
206 8/11/2014 798731098 GINDA ISPA 206 ..................
207 8/11/2014 798737409 MAHRON HYPERTENSI 207 ..................
208 8/11/2014 797765466 ASJU FEBRIS 208 ..................
209 8/11/2014 797760101 JASI RA 209 ..................
210 8/11/2014 797959967 RATNASIH PULPITIS 210 ..................
211 8/11/2014 797812749 SUKMANAH HYPERTENSI 211 ..................
212 8/11/2014 797815552 SAPTIAH PULPITIS 212 ..................
213 8/11/2014 797248912 HALIMAH GASTRITIS 213 ..................
214 8/11/2014 797250183 ENCIH SUARSIH RA 214 ..................
215 8/11/2014 798155065 FINI PRAHESTI PITRIANI GASTRITIS 215 ..................
216 8/11/2014 798959924 ADE SASTRAWAN DERMATITIS 216 ..................
217 8/11/2014 798641144 KAISAH HYPERTENSI 217 ..................
218 8/11/2014 798676694 NURHANI PULPITIS 218 ..................
219 8/11/2014 798785368 MARYANI GE 219 ..................
220 8/11/2014 798756941 SUHEMI HYPERTENSI 220 ..................
221 8/11/2014 797778696 UCIH GE 221 ..................
222 8/11/2014 797780992 WIKARJA RA 222 ..................
223 8/11/2014 798593139 SUBRIANTO ISPA 223 ..................
224 8/11/2014 798594737 MARSITI PULPITIS 224 ..................
225 8/11/2014 798692905 SUKMA GASTRITIS 225 ..................
226 8/11/2014 798697326 RUDIANTA ISPA 226 ..................
227 8/11/2014 798462854 SARHEWI HYPERTENSI 227 ..................
228 8/11/2014 798464261 DERU R R ISPA 228 ..................
229 8/11/2014 797338912 YUNARTI GASTRITIS 229 ..................
230 8/11/2014 797331431 NURYANA OTITIS MEDIA 230 ..................
231 8/12/2014 797374383 EKA S FEBRIS 231 ..................
232 8/12/2014 798040945 LISKA LISDIANA GASTRITIS 232 ..................
233 8/12/2014 798347046 NENGSIH RA 233 ..................
234 8/12/2014 797852417 KAESIH PULPITIS 234 ..................
235 8/12/2014 797745238 KEROT GASTRITIS 235 ..................
236 8/12/2014 798461381 ARNAWASIH RA 236 ..................
237 8/12/2014 798580001 ANGGA PERMANA DERMATITIS 237 ..................
238 8/12/2014 798628792 DIMAN PERSISTENSI 238 ..................
239 8/12/2014 798632267 SUPIRMAN ISPA 239 ..................
240 8/12/2014 798464428 RISNA O DERMATITIS 240 ..................
241 8/12/2014 797182874 NARAH GASTRITIS 241 ..................
242 8/12/2014 797186237 SALIM PULPITIS 242 ..................
243 8/12/2014 797186979 UMASIH RA 243 ..................
244 8/12/2014 797959438 NADIA FEBRIYANTI INFEKSI GIGI 244 ..................
245 8/12/2014 797962588 ADE GASTRITIS 245 ..................
246 8/12/2014 798040359 SUMARNA INFLUENSA 246 ..................
247 8/12/2014 798376702 RENI GASTRITIS 247 ..................
248 8/12/2014 797214453 MIRAH GASTRITIS 248 ..................
249 8/12/2014 797218503 SURYANI GE 249 ..................
250 8/12/2014 797220202 BUDI RAMDANI ISPA 250 ..................
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RUJUK

251 8/12/2014 798321194 HERU DIANA ISPA 251 ..................

252 8/12/2014 798672971 HATI HYPERTENSI 252 ..................
253 8/12/2014 1051166114 ULIS MERLINA GASTRITIS 253 ..................
254 8/12/2014 797177171 CECEP SUPRIADI FARINGITIS 254 ..................
255 8/12/2014 797996103 RANGGA APRILIANA ISPA 255 ..................
256 8/12/2014 797998072 ARWASIH RA 256 ..................
257 8/12/2014 797998465 SITI SADIAH PERSISTENSI 257 ..................
258 8/12/2014 1051166902 AGUS SARTUKI RA 258 ..................
259 8/12/2014 1051166125 BABAN DERMATITIS 259 ..................
260 8/13/2014 1051166171 SUKRA RA 260 ..................
261 8/13/2014 798387074 DIAH DERMATITIS 261 ..................
262 8/13/2014 798407561 JUMNATA ISPA 262 ..................
263 8/13/2014 798408099 IYAH HYPERTENSI 263 ..................
264 8/13/2014 1051166531 TITIN INFLUENSA 264 ..................
265 8/13/2014 1051166092 SUTISNA RA 265 ..................
266 8/13/2014 1051166136 RATNA GASTRITIS 266 ..................
267 8/13/2014 798415773 SITI RUHMAH N PERSISTENSI 267 ..................
268 8/13/2014 798417011 IRAH ABSSES 268 ..................
269 8/13/2014 1051167644 SARJANA ASMA 269 ..................
270 8/13/2014 1051167385 SASTRA DERMATITIS 270 ..................
271 8/13/2014 798007814 ASTI HYPERTENSI 271 ..................
272 8/13/2014 798008703 SAEPUL ISPA 272 ..................
273 8/13/2014 798457487 ADE GASTRITIS 273 ..................
274 8/13/2014 798460064 TASIAH RA 274 ..................
275 8/13/2014 798403825 FADLAN PERSISTENSI 275 ..................
276 8/13/2014 1051166204 DIKA MAUDLI SAPUTRA ISPA 276 ..................
277 8/13/2014 1051166474 SARMEDI HYPERTENSI 277 ..................
278 8/13/2014 1051166801 ANDRIYANSAH ISPA 278 ..................
279 8/13/2014 798386499 SANUSI C ISPA 279 ..................
280 8/13/2014 798667468 JAYA FARINGITIS 280 ..................
281 8/13/2014 1051166013 INDRA GASTRITIS 281 ..................
282 8/13/2014 1051166834 HASIH RA 282 ..................
283 8/13/2014 1051167745 RUNTASIH GASTRITIS 283 ..................
284 8/13/2014 797242127 KOSIM R DERMATITIS 284 ..................
285 8/13/2014 798020021 SARIP DERMATITIS 285 ..................
286 8/13/2014 798023081 SUARTINI GASTRITIS 286 ..................
287 8/13/2014 798026229 MISRAN RA 287 ..................
288 8/13/2014 797235219 ASTI GE 288 ..................
289 8/13/2014 797240968 KOKOM GASTRITIS 289 ..................
290 8/13/2014 798021551 RUHENDI FEBRIS 290 ..................
291 8/13/2014 798433053 AGIL ISPA 291 ..................
292 8/14/2014 798434616 SUHERLAN DERMATITIS 292 ..................
293 8/14/2014 1051166057 JATIAH RA 293 ..................
294 8/14/2014 1051157878 TOMI AGUSTRIANA ISPA 294 ..................
295 8/14/2014 798668177 SITI NURAPIANI GASTRITIS 295 ..................
296 8/14/2014 1051167576 SUPARTA FARINGITIS 296 ..................
297 8/14/2014 1051166248 SAIDAH RA 297 ..................
298 8/14/2014 797937118 NENIH GASTRITIS 298 ..................
299 8/14/2014 797940854 SARHAN RA 299 ..................
300 8/14/2014 798455979 SUMANTRI ISPA 300 ..................
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301 8/14/2014 798459074 VIKA MILANI ISPA 301 ..................

302 8/14/2014 798403713 NURARIAH ISPA 302 ..................
303 8/14/2014 1051166417 MAIDAN HYPERTENSI 303 ..................
304 8/14/2014 1051167104 FAHRUL AFRIANSAH ISPA 304 ..................
305 8/14/2014 1051166621 MUHRI RA 305 ..................
306 8/14/2014 797272481 SUMAWI ASMA 306 ..................
307 8/14/2014 798003933 CUCUM GASTRITIS 307 ..................
308 8/14/2014 798004967 SUPRADI ANEMIA 308 ..................
309 8/14/2014 798395466 SUHERMAN INFLUENSA 309 ..................
310 8/14/2014 798416289 SARMAT RA 310 ..................
311 8/14/2014 798335278 JUANAH HYPERTENSI 311 ..................
312 8/14/2014 798341499 KOMARTA LUKA INFEKSI GIGI 312 ..................
313 8/14/2014 1051167587 SAMAAN HYPERTENSI 313 ..................
314 8/14/2014 1051165934 SARKIM FARINGITIS 314 ..................
315 8/14/2014 798455755 KARTA WIJAYA ISPA 315 ..................
316 8/14/2014 798457059 MUNATI HYPERTENSI 316 ..................
317 8/14/2014 1051166924 OGI SETIAWAN GASTRITIS 317 ..................
318 8/14/2014 1051167418 PARSAN GE 318 ..................
319 8/15/2014 1051167183 ADE NIKO GASTRITIS 319 ..................
320 8/15/2014 1051167734 MISTA INFLUENSA 320 ..................
321 8/15/2014 797263075 DEDIH GE 321 ..................
322 8/15/2014 798375328 RESTIANI DERMATITIS 322 ..................
323 8/15/2014 798390911 YANI GASTRITIS 323 ..................
324 8/15/2014 1051167633 SUPRONI GE 324 ..................
325 8/15/2014 1051166878 NURHETI GASTRITIS 325 ..................
326 8/15/2014 1051166654 NANAI NIA RAMDANI PULPITIS 326 ..................
327 8/15/2014 798386286 MEISYA ISPA 327 ..................
328 8/15/2014 798386872 RENI PULPITIS 328 ..................
329 8/15/2014 798387085 UUN AMBARASARI GASTRITIS 329 ..................
330 8/15/2014 798405074 MUDIN GE 330 ..................
331 8/15/2014 798463618 SUTIHAT GASTRITIS 331 ..................
332 8/15/2014 797254378 MAMAT RA 332 ..................
333 8/15/2014 797257157 JUARTA HYPERTENSI 333 ..................
334 8/15/2014 797275214 NANI GASTRITIS 334 ..................
335 8/15/2014 798385476 SUMIANTI GE 335 ..................
336 8/15/2014 798372909 ISMAIL MARJUKI PULPITIS 336 ..................
337 8/15/2014 798478435 NARSIH ASMA 337 ..................
338 8/15/2014 798482518 SUNARSIH GASTRITIS 338 ..................
339 8/15/2014 1051167611 SABILA GUSTIANI ISPA 339 ..................
340 8/15/2014 1051166349 RENDI SETIAWAN PULPITIS 340 ..................
341 8/15/2014 1051167521 ADE SURADI FARINGITIS 341 ..................
342 8/15/2014 1051166632 SUTIARSIH GE 342 ..................
343 8/16/2014 797231439 JALKIM HYPERTENSI 343 ..................
344 8/16/2014 798386141 SUPARMA GE 344 ..................
345 8/16/2014 798386938 PUTRI INDRIANI PULPITIS 345 ..................
346 8/16/2014 798335932 AJO RA 346 ..................
347 8/16/2014 798668831 ISNA ISPA 347 ..................
348 8/16/2014 1051167262 ASIAH GASTRITIS 348 ..................
349 8/16/2014 1051166496 PANDI RA 349 ..................
350 8/16/2014 1051167137 RISNA PULPITIS 350 ..................
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RUJUK

351 8/16/2014 1051167249 RAHMAT PERSISTENSI 351 ..................

352 8/16/2014 798983829 PARMI RA 352 ..................
353 8/16/2014 1051158126 TUNI RA 353 ..................
354 8/16/2014 1051158723 APRISA DEA MULYANI GE 354 ..................
355 8/16/2014 1051157755 KUSMONO RA 355 ..................
356 8/16/2014 1051157799 DEDE DAHYATI RA 356 ..................
357 8/16/2014 1051157654 SITI MAEMUNAH GASTRITIS 357 ..................
358 8/16/2014 798064784 SUPARDI GE 358 ..................
359 8/16/2014 798072219 IMAN NURYAMAN FARINGITIS 359 ..................
360 8/16/2014 798098872 IRPHA ISTIQOMAH GE 360 ..................
361 8/16/2014 798959531 ROHAYATI RA 361 ..................
362 8/16/2014 799002404 SUPRIATNA ISPA 362 ..................
363 8/16/2014 799002887 INDIK HYPERTENSI 363 ..................
364 8/16/2014 1051158429 RUSMAYADI INFLUENSA 364 ..................
365 8/16/2014 1051158115 JUMHI RA 365 ..................
366 8/16/2014 1051158396 ANGGI PULPITIS 366 ..................
367 8/16/2014 798172446 AHMAD RA 367 ..................
368 8/16/2014 798173436 MILA KURNIA GASTRITIS 368 ..................
369 8/16/2014 798154132 JANASIH HYPERTENSI 369 ..................
370 8/18/2014 1051157744 DWIFANGKA PERSISTENSI 370 ..................
371 8/18/2014 1051158857 NELA AULIA GE 371 ..................
372 8/18/2014 1051158778 SUMARNI GASTRITIS 372 ..................
373 8/18/2014 1051158058 SARBINI RA 373 ..................
374 8/18/2014 1051158611 RATNASIH RA 374 ..................
375 8/18/2014 797336976 EDI SAPUTRA FEBRIS 375 ..................
376 8/18/2014 797341689 SUKAENAH HYPERTENSI 376 ..................
377 8/18/2014 797363943 ARHEMI GASTRITIS 377 ..................
378 8/18/2014 797693861 KARMA RA 378 ..................
379 8/18/2014 797734629 INA HERLINA GASTRITIS 379 ..................
380 8/18/2014 1051158328 HERI K HYPERTENSI 380 ..................
381 8/18/2014 1051158205 KUSNADI DERMATITIS 381 ..................
382 8/18/2014 1051157812 SUTRISNO FEBRIS 382 ..................
383 8/18/2014 798058809 YETI GASTRITIS 383 ..................
384 8/18/2014 798078249 NOVIA SRI GE 384 ..................
385 8/18/2014 798089602 ETI HYPERTENSI 385 ..................
386 8/18/2014 798166135 MALA PERSISTENSI 386 ..................
387 8/18/2014 798150183 DEVA GE 387 ..................
388 8/18/2014 798980872 HAMI RA 388 ..................
CARIES
389 8/18/2014 798989139 YOYOH 389 ..................
390 8/18/2014 1051158644 TATI RIANTI GASTRITIS 390 ..................
391 8/18/2014 1051158767 JUMHANI DERMATITIS 391 ..................
392 8/18/2014 1051158082 MEGA TRILIANA PERSISTENSI 392 ..................
393 8/18/2014 1051158284 IOH HYPERTENSI 393 ..................
394 8/18/2014 798065807 MARDATA RA 394 ..................
395 8/18/2014 798967012 SUKARTA HYPERTENSI 395 ..................
396 8/18/2014 798970689 BAIH RA 396 ..................
397 8/18/2014 798988757 JOHAN WAWAN GASTRITIS 397 ..................
398 8/18/2014 798993606 RIFA ALVIA ISPA 398 ..................
399 8/18/2014 1051158609 SUPARMAN HYPERTENSI 399 ..................
400 8/18/2014 1051157777 ANITA GE 400 ..................
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RUJUK

401 8/18/2014 1051157676 AFRIAN MAULANA H DERMATITIS 401 ..................

402 8/18/2014 797804853 UMASIH RA 402 ..................
403 8/18/2014 1051183912 PONAH RA 403 ..................
404 8/19/2014 797371795 UNENGSIH GASTRITIS 404 ..................
CARIES
405 8/19/2014 797352794 ELSE EPRIANA 405 ..................
406 8/19/2014 797384035 NOFAL ALDIANSYAH DERMATITIS 406 ..................
407 8/19/2014 797510867 HELI FARINGITIS 407 ..................
408 8/19/2014 797513073 SURHALIM RA 408 ..................
409 8/19/2014 797536585 RINI DERMATITIS 409 ..................
410 8/19/2014 797556982 MUHAMAD EKA HERIANSY ISPA 410 ..................
411 8/19/2014 797558229 YUYUN OVTAPIA PERSISTENSI 411 ..................
412 8/19/2014 797889508 RUMANAH RA 412 ..................
CARIES
413 8/19/2014 797892074 DEPI PRIANI 413 ..................
414 8/19/2014 797893424 ALMAH GASTRITIS 414 ..................
415 8/19/2014 797915575 IRPAN DERMATITIS 415 ..................
416 8/19/2014 797919423 IIP GASTRITIS 416 ..................
417 8/19/2014 798265001 SEPRIANTO FEBRIS 417 ..................
418 8/19/2014 798288939 SARHANI RA 418 ..................
419 8/19/2014 798298334 MIMIN TYPOID 419 ..................
420 8/19/2014 798299886 TUSI HYPERTENSI 420 ..................
421 8/19/2014 798223105 HERLINA GASTRITIS 421 ..................
422 8/19/2014 798251005 SURYADI GE 422 ..................
423 8/19/2014 798254403 WIDIYANTI DERMATITIS 423 ..................
CARIES
424 8/19/2014 798255033 RINA 424 ..................
425 8/19/2014 798357328 JAENAH HYPERTENSI 425 ..................
426 8/19/2014 798330688 YANDA FARINGITIS 426 ..................
427 8/19/2014 798331544 BUHIL RA 427 ..................
428 8/19/2014 798691825 HEMI GASTRITIS 428 ..................
429 8/19/2014 1051161142 ADSARI RA 429 ..................
430 8/19/2014 797498133 MIA GE 430 ..................
431 8/19/2014 797501428 JUMAI HYPERTENSI 431 ..................
432 8/19/2014 797504591 SUGIANA GE 432 ..................
433 8/19/2014 797506334 RESI DERMATITIS 433 ..................
434 8/19/2014 797904325 DADI RA 434 ..................
435 8/19/2014 797907205 WILIYANTI DERMATITIS 435 ..................
436 8/19/2014 798220451 DEDE PUJASANDI DERMATITIS 436 ..................
437 8/19/2014 798223522 ADE PERMANA ISPA 437 ..................
438 8/19/2014 798252849 IRAWATI ISPA 438 ..................
439 8/19/2014 798308561 PUTRI AYU DERMATITIS 439 ..................
440 8/19/2014 798293294 DEDE SUHERLIANA DERMATITIS 440 ..................
441 8/19/2014 798681519 MUHROM ISPA 441 ..................
442 8/20/2014 798276993 NIRWAN ISPA 442 ..................
443 8/20/2014 798325525 RUKIAH GASTRITIS 443 ..................
444 8/20/2014 798330205 KARTONO ISPA 444 ..................
445 8/20/2014 798342636 ACEP RUDIN DERMATITIS 445 ..................
446 8/20/2014 1051161164 HERU ALATAS DERMATITIS 446 ..................
447 8/20/2014 1051161107 RODIAH PERIODENTITIS 447 ..................
448 8/20/2014 1051160995 UJANG SULENDANG GASTRITIS 448 ..................
449 8/20/2014 1051161625 SUHRO FEBRIS 449 ..................
450 8/20/2014 797388186 RUMI GE 450 ..................
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NO TANGGAL NO KARTU PESERTA NAMA PESERTA DIAGNOSA TANDA TANGAN PASIEN
RUJUK

451 8/20/2014 797553832 DINI PAUZIAH PERSISTENSI 451 ..................

452 8/20/2014 797571224 ITI ROSITA GASTRITIS 452 ..................
453 8/20/2014 797590372 MUHAMAD IKBAL ISPA 453 ..................
454 8/20/2014 797710386 WULANSARI ISPA 454 ..................
455 8/20/2014 797943339 NATA HYPERTENSI 455 ..................
456 8/20/2014 797751729 APIP INFEKSI GIGI 456 ..................
457 8/20/2014 798224815 BAHRUDIN FARINGITIS 457 ..................
458 8/20/2014 798305027 MARNO GE 458 ..................
459 8/20/2014 1051161399 ABIDIN FARINGITIS 459 ..................
460 8/20/2014 1051161039 SANI GASTRITIS 460 ..................
461 8/20/2014 797313374 PAREL DERMATITIS 461 ..................
462 8/20/2014 797317154 WENDI JULYANSAH DERMATITIS 462 ..................
463 8/20/2014 797498594 ROSNAWATI GASTRITIS 463 ..................
464 8/20/2014 797501169 ANIS RA 464 ..................
465 8/20/2014 797578053 ARYANDI ISPA 465 ..................
466 8/20/2014 797587784 YULI NOVIANI ISPA 466 ..................
467 8/20/2014 797718407 ALWIN ALPANDI INFEKSI GIGI 467 ..................
468 8/20/2014 797930447 TIOK RA 468 ..................
469 8/20/2014 797742865 JUMENA RA 469 ..................
470 8/20/2014 797754339 ADE M RA 470 ..................
471 8/20/2014 797972139 ERP AN GE 471 ..................
472 8/20/2014 798262198 AZIS SAPUTRA PULPITIS 472 ..................
473 8/20/2014 797482866 GIAN MARGIANA ISPA 473 ..................
474 8/20/2014 797520576 SUKMA ISPA 474 ..................
475 8/21/2014 797530792 NANA GE 475 ..................
476 8/21/2014 797556396 ASTRI APRILIANA PERIODENTITIS 476 ..................
477 8/21/2014 797543155 IYAS HYPERTENSI 477 ..................
478 8/21/2014 797666376 HATA ABDURAHMAN RA 478 ..................
479 8/21/2014 797680866 OMAH GASTRITIS 479 ..................
480 8/21/2014 797707427 SAPTA DERMATITIS 480 ..................
481 8/21/2014 797723886 AJAN HYPERTENSI 481 ..................
482 8/21/2014 797778617 FERI NURINSYAH ISPA 482 ..................
483 8/21/2014 797791116 MUHAMAD FIRZI M ISPA 483 ..................
484 8/21/2014 797857593 IRPAN RIVALDI GE 484 ..................
485 8/21/2014 797867897 SUNARDI GE 485 ..................
CARIES
486 8/21/2014 797742742 ILHAM PAJARUDIN 486 ..................
487 8/21/2014 797485432 SAWAL AHMADI DERMATITIS 487 ..................
488 8/21/2014 797520464 ISUM RA 488 ..................
489 8/21/2014 797557105 PUDIN FARINGITIS 489 ..................
490 8/21/2014 797802794 REPI GE 490 ..................
491 8/21/2014 1051183912 PONAH RA 491 ..................
492 8/21/2014 1051183258 UUM RA 492 ..................
493 8/21/2014 1051183686 HALIMI HYPERTENSI 493 ..................
CARIES
494 8/21/2014 1051183462 SUTARSIH 494 ..................
495 8/21/2014 1051183552 AHNIJAH RA 495 ..................
CARIES
496 8/21/2014 1051183405 RIAN HARDIANA 496 ..................
497 8/21/2014 1051183765 ASEP BIMA FEBRIS 497 ..................
498 8/21/2014 1051183293 SAOGIH GASTRITIS 498 ..................
499 8/21/2014 797551694 SAMI HYPERTENSI 499 ..................
500 8/21/2014 797517731 PAJRI MAULANA REGINA P INFEKSI GIGI 500 ..................
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NO TANGGAL NO KARTU PESERTA NAMA PESERTA DIAGNOSA TANDA TANGAN PASIEN
RUJUK

501 8/21/2014 797484418 SUSI INDRIANI GASTRITIS 501 ..................

CARIES
502 8/21/2014 797526483 JUHI 502 ..................
503 8/21/2014 797528766 UNU RA 503 ..................
504 8/21/2014 797531332 ISRA INFEKSI GIGI 504 ..................
505 8/21/2014 797723054 MITA PATMALA GE 505 ..................
506 8/21/2014 797734269 YADIN ISPA 506 ..................
507 8/22/2014 1051183631 ATI RA 507 ..................
508 8/22/2014 1051183866 SAHRUL PERIODENTITIS 508 ..................
509 8/22/2014 797523603 IRUN HYPERTENSI 509 ..................
510 8/22/2014 797539206 TITA PERSISTENSI 510 ..................
511 8/22/2014 797683511 HENI RA 511 ..................
512 8/22/2014 797704481 UMHADI RA 512 ..................
513 8/22/2014 797747501 SUKANAH HYPERTENSI 513 ..................
514 8/22/2014 797750335 ARSUDIN RA 514 ..................
515 8/22/2014 797862609 KELVIN DERMATITIS 515 ..................
516 8/22/2014 797867853 FATMAWATI GASTRITIS 516 ..................
517 8/22/2014 1051183506 YEKI WELDANI DERMATITIS 517 ..................
518 8/22/2014 1051183348 SITI AISYAH GASTRITIS 518 ..................
519 8/22/2014 1051183427 TARI GE 519 ..................
520 8/22/2014 797779258 TINAH HYPERTENSI 520 ..................
521 8/22/2014 797792253 UCI RA 521 ..................
522 8/22/2014 797524749 YANI GE 522 ..................
523 8/22/2014 797528452 SARMANAH RA 523 ..................
524 8/22/2014 797573529 IWAN SETIAWAN GE 524 ..................
525 8/23/2014 797736857 SURMANTO ISPA 525 ..................
526 8/23/2014 797767716 SALSABILA REGINA P ISPA 526 ..................
527 8/23/2014 797749784 UDAN ISPA 527 ..................
528 8/23/2014 797762081 APANG RA 528 ..................
529 8/23/2014 1051183787 ENED ISPA 529 ..................
530 8/23/2014 1051183888 MURNAH HYPERTENSI 530 ..................
CARIES
531 8/23/2014 797313925 NANANG MARDI PUTRA 531 ..................
532 8/23/2014 798678639 JEJE DERMATITIS 532 ..................
533 8/23/2014 1051159149 JUMYASIH ISPA 533 ..................
534 8/23/2014 1051158947 LIA TRI WULANDARI GE 534 ..................
535 8/23/2014 1051159421 DASIAH HYPERTENSI 535 ..................
536 8/23/2014 797303979 LASNURI HYPERTENSI 536 ..................
537 8/23/2014 797307838 HENI HARTINI GE 537 ..................
538 8/23/2014 797322442 EROH RA 538 ..................
539 8/23/2014 797337786 INTAN NURAENI GE 539 ..................
540 8/23/2014 797732908 PURI GE 540 ..................
541 8/23/2014 797778821 LUTING GASTRITIS 541 ..................
542 8/25/2014 798242073 ROMANAH GASTRITIS 542 ..................
543 8/25/2014 798244244 TOTO HERMANTO RA 543 ..................
544 8/25/2014 797330362 DELI DERMATITIS 544 ..................
545 8/25/2014 797684635 RIDHO ADRIANSYAH GE 545 ..................
AKBAR SEPTIAN NUR
546 8/25/2014 797687008 PADILAH ISPA 546 ..................
MUHAMAD DENI DERMATITIS
547 8/25/2014 797772453 PRIHARTARTO 547 ..................
PERSISTENSI
548 8/25/2014 797733448 MARSAH 548 ..................
ISPA
549 8/25/2014 798205601 SUHERDIANA 549 ..................
ISPA
550 8/25/2014 798208356 ISA MUNAJAR 550 ..................
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NO TANGGAL NO KARTU PESERTA NAMA PESERTA DIAGNOSA TANDA TANGAN PASIEN
RUJUK

GE
551 8/25/2014 798305804 ANDA 551 ..................
GASTRITIS
552 8/25/2014 798617709 TITIN MINTARSIH 552 ..................
DERMATITIS
553 8/25/2014 798644351 DADANG 553 ..................
TYPOID
554 8/25/2014 797693769 OSAH 554 ..................
555 8/25/2014 797697663 CANAH HYPERTENSI 555 ..................
ISPA
556 8/25/2014 797301516 KEKEN SUKENDAR 556 ..................
557 8/25/2014 797459545 SANJAYA RA 557 ..................
INFLUENSA
558 8/25/2014 798309178 UKAN 558 ..................
GASTRITIS
559 8/25/2014 796230077 SUKRIA 559 ..................
RA
560 8/25/2014 796737756 DARMA 560 ..................
561 8/26/2014 797713481 TRIANA ISPA 561 ..................
RA
562 8/26/2014 797695863 LIHIN 562 ..................
563 8/26/2014 797736622 RINA AULIANTI ISPA 563 ..................
GASTRITIS
564 8/26/2014 797766669 INDRA 564 ..................
GASTRITIS
565 8/26/2014 1051159072 MAESIH 565 ..................
566 8/26/2014 1051159487 OCAH RA 566 ..................
DERMATITIS
567 8/26/2014 1051159228 IWAN HERMAWAN 567 ..................
RA
568 8/26/2014 1051159623 OHIB SUBANDI 568 ..................
ISPA
569 8/26/2014 1051159689 YOPI WIDIYANTI 569 ..................
GE
570 8/26/2014 1051159162 KOJAN 570 ..................
DERMATITIS
571 8/26/2014 797316388 RONI 571 ..................
572 8/26/2014 797333253 ZEPANO ISPA 572 ..................
573 8/26/2014 797786807 REHAN ANDRIANSAH ISPA 573 ..................
CARIES
574 8/26/2014 797792769 ISAK 574 ..................
575 8/26/2014 797797956 YULIS TIAWATI DERMATITIS 575 ..................
576 8/26/2014 797710252 ARPAH HYPERTENSI 576 ..................
577 8/26/2014 798410654 JUHEDI HYPERTENSI 577 ..................
GASTRITIS
578 8/26/2014 797545798 MINAH 578 ..................
GASTRITIS
579 8/26/2014 797686863 MURTIAMAH 579 ..................
ISPA
580 8/27/2014 797903638 SEPIAN ANDRIANSAH 580 ..................
581 8/27/2014 797735823 ADI SAPUTRA DERMATITIS 581 ..................
PERSISTENSI
582 8/27/2014 798637173 JUMARIAH 582 ..................
GASTRITIS
583 8/27/2014 797188004 SUHETI 583 ..................
ISPA
584 8/27/2014 1051183539 PILI RIZKY SUMINTO 584 ..................
GASTRITIS
585 8/27/2014 797542536 RUDIN 585 ..................
GASTRITIS
586 8/27/2014 798356531 ELA 586 ..................
587 8/27/2014 798102786 MIMI RA 587 ..................
RA
588 8/27/2014 797226489 MURTEBAH 588 ..................
589 8/27/2014 797231531 UPI RA 589 ..................
ISPA
590 8/27/2014 798373405 MAESAROH 590 ..................
591 8/27/2014 798732101 PIRNI ISPA 591 ..................
592 8/27/2014 798771273 NARMUN RA 592 ..................
GE
593 8/27/2014 797440961 SUHELI 593 ..................
594 8/27/2014 798711546 ENO HYPERTENSI 594 ..................
GE
595 8/27/2014 798730029 ENDANG 595 ..................
GASTRITIS
596 8/27/2014 798742168 HALIMAH 596 ..................
TYPOID
597 8/27/2014 1051157801 SUYETNA 597 ..................
INFLUENSA
598 8/27/2014 1051158464 SUKARTA 598 ..................
RA
599 8/28/2014 1051164876 SUGANI 599 ..................
600 8/28/2014 798595356 MURSA RA 600 ..................
601 8/28/2014 797857852 SAI HYPERTENSI 601 ..................
602 8/28/2014 1051157823 SANGSANG HYPERTENSI 602 ..................
603 8/28/2014 797028344 FAZRI MAULANA ISPA 603 ..................
GE
604 8/28/2014 797529609 RAHAYU 604 ..................
ISPA
605 8/28/2014 797875277 SUKANDA 605 ..................
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NO TANGGAL NO KARTU PESERTA NAMA PESERTA DIAGNOSA TANDA TANGAN PASIEN
RUJUK

ISPA
606 8/28/2014 797736205 ERNASARI 606 ..................
RA
607 8/28/2014 797477027 TOTO 607 ..................
GASTRITIS
608 8/28/2014 797352039 DADI 608 ..................
609 8/28/2014 797880587 MURSIH HYPERTENSI 609 ..................
RA
610 8/28/2014 798089916 JAMALUDIN 610 ..................
GASTRITIS
611 8/28/2014 797171703 MIR'AH 611 ..................
612 8/28/2014 797700824 PIKAL GE 612 ..................
613 8/28/2014 798363009 YUDA DAMAR NUR ALAM DERMATITIS 613 ..................
DERMATITIS
614 8/28/2014 797335975 SUGANDA 614 ..................
ISPA
615 8/28/2014 797326042 WIWI WIDAYANTI 615 ..................
CARIES
616 8/28/2014 797703186 MINAH 616 ..................
FEBRIS
617 8/28/2014 797688865 EEM 617 ..................
618 8/28/2014 797693826 SUHATI HYPERTENSI 618 ..................
619 8/28/2014 797701228 NASMAN HYPERTENSI 619 ..................
FEBRIS
620 8/28/2014 797460006 UDAYA 620 ..................
GE
621 8/28/2014 797500067 SARTAWI 621 ..................
622 8/28/2014 797474182 SAPTIAH RA 622 ..................
GE
623 8/28/2014 797507122 DEDEP 623 ..................
CARIES
624 8/28/2014 797511341 UDAN 624 ..................
DERMATITIS
625 8/29/2014 796241968 OJANG 625 ..................
GE
626 8/29/2014 796254794 YANTO 626 ..................
PULPITIS
627 8/29/2014 797315624 PALAH HUDIN 627 ..................
628 8/29/2014 797364562 PERDIANSAH GE 628 ..................
GE
629 8/29/2014 798167823 ANDI GUNTUR 629 ..................
RA
630 8/29/2014 798179141 IDAH 630 ..................
RA
631 8/29/2014 798157113 ADE JUHARDI 631 ..................
632 8/29/2014 798979353 NURHASAN HYPERTENSI 632 ..................
CARIES
633 8/29/2014 797204079 TITIN 633 ..................
RA
634 8/29/2014 797230721 DULATIF 634 ..................
GASTRITIS
635 8/29/2014 797265134 MARTINI 635 ..................
DERMATITIS
636 8/29/2014 797176833 SURJANI 636 ..................
ISPA
637 8/29/2014 797189951 YANA 637 ..................
638 8/29/2014 797029964 SRIHANDAYANI DERMATITIS 638 ..................
639 8/29/2014 797030651 ISDAN RA 639 ..................
GE
640 8/29/2014 797049707 PURMINAH 640 ..................
CARIES
641 8/29/2014 797064434 JUHENDA 641 ..................
642 8/29/2014 797082489 NURSIAH HYPERTENSI 642 ..................
ISPA
643 8/29/2014 797155176 CUCUN 643 ..................
CARIES
644 8/29/2014 797163309 ROSITA 644 ..................
FEBRIS
645 8/29/2014 797093177 KUSNADI 645 ..................
GASTRITIS
646 8/29/2014 797437091 ARMASIH 646 ..................
GASTRITIS
647 8/29/2014 797120662 SUNENGSIH 647 ..................
ISPA
648 8/29/2014 797129627 ARYANI 648 ..................
CARIES
649 8/29/2014 797135174 SELPI 649 ..................
GASTRITIS
650 8/29/2014 797105417 ARNAH 650 ..................
GASTRITIS
651 8/29/2014 797836241 INA 651 ..................
652 8/30/2014 798644924 AIP PERSISTENSI 652 ..................
RA
653 8/30/2014 798651707 UHI HIDAYAT 653 ..................
ALIH INTAN
654 8/30/2014 1051159364 NURMALASARI DERMATITIS 654 ..................
HYPERTENSI
655 8/30/2014 797758503 ENDANG 655 ..................
CARIES
656 8/30/2014 1051183574 TETI 656 ..................
ISPA
657 8/30/2014 1051183383 IJANG NURHAPIT 657 ..................
GE
658 8/30/2014 798243928 DEKI OTOBERI 658 ..................
659 8/30/2014 798255347 SARI HYPERTENSI 659 ..................
GE
660 8/30/2014 798315671 SUPRIADI 660 ..................
FEBRIS
661 8/30/2014 1051157867 TEDI GUNAWAN 661 ..................
 DI
NO TANGGAL NO KARTU PESERTA NAMA PESERTA DIAGNOSA TANDA TANGAN PASIEN
RUJUK

GE
662 8/30/2014 1051158587 APIP WIJAYA 662 ..................
RA
663 8/30/2014 1051166046 MADHANI 663 ..................
SITI MARWAH GASTRITIS
664 8/30/2014 1051167723 NURYAMSIAH 664 ..................
GASTRITIS
665 8/30/2014 1051167486 ANIS 665 ..................
666 8/30/2014 798734193 MELI AFRILIANI PERSISTENSI 666 ..................
667 8/30/2014 798742607 EMAN OMK 667 ..................
668 8/30/2014 797894335 PERDI DERMATITIS 668 ..................
ISPA
669 8/30/2014 797923034 ASEP TIANA 669 ..................
670 8/30/2014 1051164641 TARMI HYPERTENSI 670 ..................
671 8/30/2014 1051164911 HENI RA 671 ..................
GASTRITIS
672 8/30/2014 797917713 SITI AMINAH 672 ..................
 DI
NO TANGGAL NO KARTU PESERTA NAMA PESERTA DIAGNOSA TANDA TANGAN PASIEN
RUJUK
 LAPORAN PELAYANAN
RAWAT JALAN TINGKAT PERTAMA (RJTP)
BULAN : TAHUN 2014
Nama Faskes : Puskesmas DTP Cibeber
Alamat : Jln Raya Cikotok - Plb Ratu Desa Cikotok Kec.Cibeber

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A (RJTP)

Cibeber

TANDA TANGAN PASIEN

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 NAMA
No TANGGAL No. KARTU PESERTA DIAGNOSA DI RUJUK

1 7/26/2014 796738443 MILASARI Gastritis, unspecified

2 7/26/2014 797102897 JUHANDI Acute periodontitis
3 7/26/2014 797843496 JUMSIH Streptococcal pharyngitis

ALIP
HEDIANSA Seropositive rheumatoid
4 7/26/2014 797876818 H vasculitis

Cutaneous abscess, furuncle

5 7/26/2014 798595547 JUNATA and carbuncle of face
IDA
6 7/26/2014 798626452 ROSIDA Gastritis, unspecified
7 7/26/2014 798639434 SUMENTI Epispadias

AJENG SRI
8 7/26/2014 1051164808 SEPTIANI Conjunctivitis, unspecified

Influenza with pneumonia,

9 7/26/2014 1051164854 UMINI influenza virus identified
10 7/25/2014 797137481 ARSAH Gastritis, unspecified
Other specified intestinal
11 7/25/2014 797140372 ONA infections

Cutaneous abscess, furuncle

12 7/25/2014 798592836 RUMSIH and carbuncle, unspecified
MARWASI Acute upper respiratory
13 7/25/2014 798599766 H infection, unspecified
14 7/25/2014 798629973 SANUJI Pulpitis

Diarrhoea and gastroenteritis

15 7/25/2014 1051164955 SUJANA of presumed infectious origin
Acute upper respiratory
16 7/2/2014 797191244 MELANI infection, unspecified

MISBAHU Cutaneous abscess, furuncle

17 7/2/2014 798169037 DIN and carbuncle, unspecified
KHOLILUL Acute upper respiratory
18 7/1/2014 797231711 AZIZ infection, unspecified

Diarrhoea and gastroenteritis

19 7/1/2014 797257899 SUARI of presumed infectious origin
 DEDE
20 7/1/2014 797261444 SUARNA Fever, unspecified
21 7/1/2014 797660021 JAYA Gastritis, unspecified
22 7/1/2014 797900264 NITA Fever, unspecified

23 7/1/2014 797949562 DEDE JIKRI Scabies

24 7/1/2014 797966717 SUPIANA Pulpitis

AGUNG Diarrhoea and gastroenteritis

25 7/1/2014 797991568 GIANSYAH of presumed infectious origin
UK CETAK HAPUS
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