DAFTAR KUNJUNGAN PESERTA SAKIT

Kantor Cabang : PRABUMULIH - 0604

FKTP : BUANA PEMACA - 04321003

NO TANGGAL NO KUNJUNGAN NO KARTU NAMA PESERTA SEX JENIS PESERTA DIAGNOSA STATUS PRB PROLANIS
PULANG

1 29-06-2020 043210030620P000127 0000317273297 ALEX SETIAWAN L PBI (APBN) Measles complicated by Rujuk Vertikal
otitis media
2 29-06-2020 043210030620P000129 0000318475721 FITRI YANI P PBI (APBN) Myalgia Berobat Jalan

3 29-06-2020 043210030620P000128 0000318991105 RESANDA ARISMA L PBI (APBN) Acute upper respiratory Berobat Jalan
infection, unspecified
4 29-06-2020 043210030620P000130 0002601901754 ARIYA MULYADI L PBI (APBN) Allergic contact dermatitis Berobat Jalan

5 27-06-2020 043210030620P000112 0000317618864 NURSITI P PBI (APBN) Pregnancy-related Berobat Jalan

condition, unspecified
6 27-06-2020 043210030620P000106 0000318207385 SABARUDIN L PBI (APBN) Calculus of ureter Rujuk Vertikal

7 27-06-2020 043210030620P000105 0000318391705 DARNIYATI P PBI (APBN) Hypertensive heart Berobat Jalan Hipertensi Hipertensi
disease
8 27-06-2020 043210030620P000111 0000318649871 KHOLIL EPENDI L PBI (APBN) Chronic gastritis, Berobat Jalan
unspecified
9 27-06-2020 043210030620P000104 0000991510503 HELNALIA P PBI (APBN) Benign neoplasm of breast Rujuk Vertikal

10 27-06-2020 043210030620P000109 0000991511223 KASTAMAN L PBI (APBN) Gastritis, unspecified Berobat Jalan

11 27-06-2020 043210030620P000107 0001508737342 sarika P PBI (APBD) Contraceptive Berobat Jalan

management
12 27-06-2020 043210030620P000113 0002589039382 ERNI SAFIRA P PBI (APBN) Acute upper respiratory Berobat Jalan
infection, unspecified
13 27-06-2020 043210030620P000114 0002673284038 andriyansah L PBI (APBD) Allergic contact dermatitis Berobat Jalan

14 27-06-2020 043210030620P000108 0002787471077 RATMI P PBI (APBN) Asthma Berobat Jalan

15 27-06-2020 043210030620P000110 0002932941767 HALIMAH P PEKERJA MANDIRI Other seropositive Berobat Jalan
rheumatoid arthritis, ankle
and foot
16 26-06-2020 043210030620P000125 0000029582458 MARIA P PNS DAERAH Other seropositive Berobat Jalan
rheumatoid arthritis,
shoulder region
17 26-06-2020 043210030620P000115 0000318668567 ZAINAL BAHRI L PBI (APBN) Inguinal hernia Rujuk Vertikal

18 26-06-2020 043210030620P000122 0000318746013 RUSNITA P PBI (APBN) Myalgia Berobat Jalan

19 26-06-2020 043210030620P000123 0000318793792 SARI P PBI (APBN) Cough Berobat Jalan

20 26-06-2020 043210030620P000124 0000991509726 WAGIYEM P PBI (APBN) Vertigo of central origin Berobat Jalan
 DAFTAR KUNJUNGAN PESERTA SAKIT

Kantor Cabang : PRABUMULIH - 0604

FKTP : BUANA PEMACA - 04321003

21 26-06-2020 043210030620P000126 0002767337302 SAIDO L PBI (APBN) Other gastritis Berobat Jalan

22 25-06-2020 043210030620P000100 0000317289148 SUMIYATI P PBI (APBN) Dyspepsia Berobat Jalan

23 25-06-2020 043210030620P000099 0000317509042 ROHUNA P PBI (APBN) Hypertensive heart Berobat Jalan
disease
24 25-06-2020 043210030620P000120 0000317778153 EDI YANTO L PBI (APBN) Allergic contact dermatitis Berobat Jalan

25 25-06-2020 043210030620P000116 0000318270644 SAWAL L PBI (APBD) Dyspepsia Berobat Jalan

26 25-06-2020 043210030620P000118 0000318660434 KADIR L PBI (APBN) Myalgia Berobat Jalan

27 25-06-2020 043210030620P000119 0000318796931 NONI YANI P PBI (APBN) Gastritis, unspecified Berobat Jalan

28 25-06-2020 043210030620P000098 0000318997462 EDI KURNIAWAN L PBI (APBN) Schizophrenia Berobat Jalan

29 25-06-2020 043210030620P000101 0000319015337 NURLELA P PBI (APBN) Non-insulin-dependent Berobat Jalan Hipertensi
diabetes mellitus
30 25-06-2020 043210030620P000097 0000319051394 JALALLUDIN L PBI (APBN) Acute upper respiratory Berobat Jalan
infection, unspecified
31 25-06-2020 043210030620P000117 0002737190529 IWAN ADISASI L PBI (APBD) Schizophrenia Berobat Jalan

32 25-06-2020 043210030620P000102 0002855630867 BULAN P PBI (APBN) Essential (primary) Berobat Jalan
hypertension
33 25-06-2020 043210030620P000121 0002919885186 ERMAWATI P PEKERJA MANDIRI Gastritis, unspecified Berobat Jalan

34 24-06-2020 043210030620P000090 0000029511641 FIRMANSYAH L PBI (APBD) Blindness, one eye, low Rujuk Vertikal
vision other eye
35 24-06-2020 043210030620P000095 0000318649689 HERNANI P PBI (APBN) Contraceptive Berobat Jalan
management
36 24-06-2020 043210030620P000096 0000991510896 SUHAIDA P PBI (APBN) Myalgia Berobat Jalan

37 23-06-2020 043210030620P000103 0001857224057 DARWIS L PNS DAERAH Allergic contact dermatitis Berobat Jalan Diabetes Mellitus Diabetes
Mellitus
38 23-06-2020 043210030620P000089 0002932941767 HALIMAH P PEKERJA MANDIRI Other single delivery by Rujuk Vertikal
caesarean section
39 22-06-2020 043210030620P000088 0000317272623 ALADIN L PBI (APBN) Dyspepsia Berobat Jalan

40 22-06-2020 043210030620P000075 0000317506959 WANARITA P PBI (APBN) Measles complicated by Rujuk Vertikal
otitis media
41 22-06-2020 043210030620P000076 0000318080283 NURSILA P PBI (APBN) Other benign neoplasms Rujuk Vertikal
of connective and other
soft tissue
42 22-06-2020 043210030620P000086 0000318582448 JUMIATI P PBI (APBN) Essential (primary) Berobat Jalan Diabetes
hypertension Mellitus
 DAFTAR KUNJUNGAN PESERTA SAKIT

Kantor Cabang : PRABUMULIH - 0604

FKTP : BUANA PEMACA - 04321003

43 22-06-2020 043210030620P000083 0000318796931 NONI YANI P PBI (APBN) Gastritis, unspecified Berobat Jalan

44 22-06-2020 043210030620P000093 0000318997462 EDI KURNIAWAN L PBI (APBN) Acute upper respiratory Berobat Jalan
infection, unspecified
45 22-06-2020 043210030620P000082 0000319009217 SAKRONI L PBI (APBN) Dyspepsia Berobat Jalan

46 22-06-2020 043210030620P000085 0000319091229 EIS MINTARSIH P PBI (APBN) Acute nasopharyngitis Berobat Jalan
[common cold]
47 22-06-2020 043210030620P000084 0000991513348 CIK INA P PBI (APBN) Acute upper respiratory Berobat Jalan
infection, unspecified
48 22-06-2020 043210030620P000094 0001508738141 M. Nuh L PBI (APBN) Allergic contact dermatitis Berobat Jalan

49 22-06-2020 043210030620P000087 0002567218623 EKA RAHMADONA. S P PBI (APBD) Myalgia Berobat Jalan

50 20-06-2020 043210030620P000072 0000318649871 KHOLIL EPENDI L PBI (APBN) Other gastritis Berobat Jalan

51 20-06-2020 043210030620P000091 0000319009217 SAKRONI L PBI (APBN) Rheumatic heart disease, Berobat Jalan
unspecified
52 20-06-2020 043210030620P000092 0000991511166 SURYATI P PBI (APBN) Other gastritis Berobat Jalan

53 20-06-2020 043210030620P000074 0002787471077 RATMI P PBI (APBN) Asthma Berobat Jalan

54 20-06-2020 043210030620P000073 0002913061667 M. ALIF PRATAMA L PBI (APBD) Diarrhoea and Berobat Jalan
gastroenteritis of
presumed infectious origin

55 19-06-2020 043210030620P000071 0000991510817 RUSMALA DEWI P PBI (APBN) Non-insulin-dependent Berobat Jalan
diabetes mellitus
56 19-06-2020 043210030620P000070 0002637098739 DEWI IRYANI P PBI (APBN) Myalgia Berobat Jalan

57 19-06-2020 043210030620P000069 0002673284938 arzha lala azakura P PBI (APBD) Acute upper respiratory Berobat Jalan
infection, unspecified
58 19-06-2020 043210030620P000068 0002673284949 egi arka prayoga L PBI (APBD) Acute upper respiratory Berobat Jalan
infection, unspecified
59 18-06-2020 043210030620P000077 0000318391705 DARNIYATI P PBI (APBN) Allergic contact dermatitis Berobat Jalan Hipertensi Hipertensi

60 18-06-2020 043210030620P000078 0000318786985 NURMAN L PBI (APBN) Non-insulin-dependent Berobat Jalan Diabetes Mellitus
diabetes mellitus
61 18-06-2020 043210030620P000080 0000318848668 LUSI RATNA SARI P PBI (APBN) Acute nasopharyngitis Berobat Jalan
[common cold]
62 18-06-2020 043210030620P000066 0000318994672 FATIMAH P PBI (APBN) Contraceptive Berobat Jalan
management
63 18-06-2020 043210030620P000081 0001508715101 LEKOK P PBI (APBD) Gastritis, unspecified Berobat Jalan
 DAFTAR KUNJUNGAN PESERTA SAKIT

Kantor Cabang : PRABUMULIH - 0604

FKTP : BUANA PEMACA - 04321003

64 18-06-2020 043210030620P000067 0002673285118 raissa kirana larasati P PBI (APBN) Acute upper respiratory Berobat Jalan
infection, unspecified
65 18-06-2020 043210030620P000079 0002767337368 RUBAIDAH P PBI (APBN) Asthma, unspecified Berobat Jalan

66 17-06-2020 043210030620P000065 0000318692518 PATMAWATI P PBI (APBN) Dyspepsia Berobat Jalan

67 17-06-2020 043210030620P000064 0000319016981 LEPIANA P PBI (APBN) Other infective otitis Berobat Jalan
externa
68 17-06-2020 043210030620P000063 0002567221525 SARI LESTIKA P PBI (APBD) Gastritis, unspecified Berobat Jalan

69 16-06-2020 043210030620P000061 0000319006991 BURHANUDIN Y. L PBI (APBN) Blindness, one eye, low Rujuk Vertikal
vision other eye
70 15-06-2020 043210030620P000062 0000317828046 SERIPAH P PBI (APBN) Secondary hypertension Berobat Jalan

71 15-06-2020 043210030620P000060 0000318588726 ERLIANA P PBI (APBN) Disorder of eyelid, Berobat Jalan
unspecified
72 15-06-2020 043210030620P000056 0000318761223 DENDIKA L PBI (APBN) Schizophrenia Berobat Jalan

73 15-06-2020 043210030620P000058 0000319006991 BURHANUDIN Y. L PBI (APBN) Other specified rheumatic Berobat Jalan
heart diseases
74 15-06-2020 043210030620P000057 0000991513844 SEFTI YUNITA SARI P PBI (APBN) Benign neoplasm of Berobat Jalan
stomach
75 15-06-2020 043210030620P000059 0002787473024 BAHRUDI L PBI (APBN) Myalgia Berobat Jalan

76 14-06-2020 043210030620P000049 0000029536108 SYAMSUD DAHRI L PNS DAERAH Measles complicated by Rujuk Vertikal
otitis media
77 12-06-2020 043210030620P000054 0002567218893 APRILIA SAPUTRI P PBI (APBN) Diarrhoea and Berobat Jalan
gastroenteritis of
presumed infectious origin

78 12-06-2020 043210030620P000055 0002767337302 SAIDO L PBI (APBN) Other gastritis Berobat Jalan

79 10-06-2020 043210030620P000051 0000029554604 NASRIA L PNS DAERAH Dyspepsia Berobat Jalan

80 10-06-2020 043210030620P000040 0000318207385 SABARUDIN L PBI (APBN) Calculus of kidney and Rujuk Vertikal
ureter
81 10-06-2020 043210030620P000052 0001279056227 CIK IMAH P PENERIMA PENSIUN Non-insulin-dependent Berobat Jalan Diabetes Mellitus Diabetes
PNS diabetes mellitus Mellitus
82 10-06-2020 043210030620P000053 0002673285129 SANTI P PBI (APBD) Dyspepsia Berobat Jalan

83 09-06-2020 043210030620P000019 0000317407972 ANGGUN P PBI (APBD) Secondary amenorrhoea Rujuk Vertikal

84 09-06-2020 043210030620P000050 0002787474249 HALIJA P PBI (APBN) Acute rheumatic heart Berobat Jalan
disease, unspecified
 DAFTAR KUNJUNGAN PESERTA SAKIT

Kantor Cabang : PRABUMULIH - 0604

FKTP : BUANA PEMACA - 04321003

85 08-06-2020 043210030620P000037 0000317299836 CIK UMAR L PBI (APBN) Hypoglycaemia, Berobat Jalan
unspecified
86 08-06-2020 043210030620P000018 0000317506959 WANARITA P PBI (APBN) Measles complicated by Rujuk Vertikal
otitis media
87 08-06-2020 043210030620P000048 0000318783137 EVI P PBI (APBN) Gastritis, unspecified Berobat Jalan

88 08-06-2020 043210030620P000039 0000319004133 DEVI LIANA P PBI (APBN) Gastritis, unspecified Berobat Jalan

89 08-06-2020 043210030620P000045 0000991510503 HELNALIA P PBI (APBN) Gastritis, unspecified Berobat Jalan

90 08-06-2020 043210030620P000046 0000991510817 RUSMALA DEWI P PBI (APBN) Non-insulin-dependent Berobat Jalan
diabetes mellitus
91 08-06-2020 043210030620P000044 0001508737566 RISKI AFRIYANZAH L PBI (APBN) Acute upper respiratory Berobat Jalan
infection, unspecified
92 08-06-2020 043210030620P000038 0002567222065 HENDRIK GUNAWAN L PBI (APBD) Atopic dermatitis, Berobat Jalan
unspecified
93 08-06-2020 043210030620P000047 0002787470032 SITI ROHIDA P PBI (APBN) Gastritis, unspecified Berobat Jalan

94 06-06-2020 043210030620P000022 0000317188732 HERI YANSYAH L PBI (APBN) Schizophrenia Berobat Jalan

95 06-06-2020 043210030620P000025 0000318401572 YULIANI P PBI (APBN) Vertigo of central origin Berobat Jalan

96 06-06-2020 043210030620P000023 0000318649871 KHOLIL EPENDI L PBI (APBN) Other gastritis Berobat Jalan

97 06-06-2020 043210030620P000043 0000318991105 RESANDA ARISMA L PBI (APBN) Allergic contact dermatitis Berobat Jalan
due to plants, except food

98 06-06-2020 043210030620P000021 0002767337302 SAIDO L PBI (APBN) Dyspepsia Berobat Jalan

99 06-06-2020 043210030620P000024 0002767337368 RUBAIDAH P PBI (APBN) Acute rheumatic Berobat Jalan
myocarditis
100 06-06-2020 043210030620P000020 0002787471077 RATMI P PBI (APBN) Asthma Berobat Jalan

101 05-06-2020 043210030620P000035 0000317188708 RUSMINI P PBI (APBN) Myalgia Berobat Jalan

102 05-06-2020 043210030620P000041 0000317202377 ABDUL RAHMAN L PBI (APBN) Rheumatic heart disease, Berobat Jalan
unspecified
103 05-06-2020 043210030620P000036 0000318397634 EKA SUSANTI P PBI (APBN) Other acute gastritis Berobat Jalan

104 05-06-2020 043210030620P000015 0000318761223 DENDIKA L PBI (APBN) Schizophrenia Berobat Jalan

105 05-06-2020 043210030620P000017 0000318974387 SARKOMI L PBI (APBN) Rheumatoid lung disease Berobat Jalan

106 05-06-2020 043210030620P000016 0000991509603 KEMIS L PBI (APBN) Dyspepsia Berobat Jalan

107 05-06-2020 043210030620P000034 0000991514046 ARBAIN L PBI (APBN) Dyspepsia Berobat Jalan
 DAFTAR KUNJUNGAN PESERTA SAKIT

Kantor Cabang : PRABUMULIH - 0604

FKTP : BUANA PEMACA - 04321003

108 05-06-2020 043210030620P000042 0002598760168 YOGI DINATA L PBI (APBN) Acute upper respiratory Berobat Jalan
infection, unspecified
109 04-06-2020 043210030620P000014 0000317202377 ABDUL RAHMAN L PBI (APBN) Dyspepsia Berobat Jalan

110 04-06-2020 043210030620P000012 0000318801982 MIDUN P PBI (APBD) Dyspepsia Berobat Jalan

111 04-06-2020 043210030620P000005 0001508715641 KAMZUL EFENDI L PBI (APBN) Gastric ulcer, chronic or Rujuk Vertikal
unspecified with
perforation
112 04-06-2020 043210030620P000013 0002636773031 ANITA P PBI (APBN) Acute upper respiratory Berobat Jalan
infection, unspecified
113 04-06-2020 043210030620P000004 0002932941767 HALIMAH P PEKERJA MANDIRI Premature rupture of Rujuk Vertikal
membranes
114 03-06-2020 043210030620P000031 0000317216968 A. SAFE'I L PBI (APBN) Acute upper respiratory Berobat Jalan
infection, unspecified
115 03-06-2020 043210030620P000026 0000318475721 FITRI YANI P PBI (APBN) Acute nasopharyngitis Berobat Jalan
[common cold]
116 03-06-2020 043210030620P000027 0000318538089 WELAS P PBI (APBD) Acute nasopharyngitis Berobat Jalan
[common cold]
117 03-06-2020 043210030620P000032 0000318590368 SOLYAH P PBI (APBN) Acute rheumatic Berobat Jalan
myocarditis
118 03-06-2020 043210030620P000011 0000318786985 NURMAN L PBI (APBN) Non-insulin-dependent Berobat Jalan Diabetes Mellitus
diabetes mellitus
119 03-06-2020 043210030620P000028 0000318974422 SUMIYATI P PBI (APBN) Acute upper respiratory Berobat Jalan
infection, unspecified
120 03-06-2020 043210030620P000029 0000991510119 MAISAROH P PBI (APBN) Secondary hypertension, Berobat Jalan
unspecified
121 03-06-2020 043210030620P000033 0000991511234 BUNAMI P PBI (APBN) Dyspepsia Berobat Jalan

122 03-06-2020 043210030620P000030 0001857224057 DARWIS L PNS DAERAH Non-insulin-dependent Berobat Jalan Diabetes Mellitus Diabetes
diabetes mellitus Mellitus
123 03-06-2020 043210030620P000003 0002787466263 RAHMAD HADI FAUZAN L PBI (APBN) Inguinal hernia Rujuk Vertikal

124 02-06-2020 043210030620P000009 0000317188732 HERI YANSYAH L PBI (APBN) Schizophrenia Berobat Jalan

125 02-06-2020 043210030620P000007 0000318099082 ONANG P PBI (APBN) Dyspepsia Berobat Jalan

126 02-06-2020 043210030620P000006 0000318688997 SURYANI P PBI (APBN) Chronic gastritis, Berobat Jalan
unspecified
127 02-06-2020 043210030620P000002 0002475821316 RULAIMI L PEKERJA MANDIRI Hypertensive heart Berobat Jalan Hipertensi
disease
128 02-06-2020 043210030620P000010 0002567220838 BAMBANG IRAWAN L PBI (APBN) Dyspepsia Berobat Jalan
 DAFTAR KUNJUNGAN PESERTA SAKIT

Kantor Cabang : PRABUMULIH - 0604

FKTP : BUANA PEMACA - 04321003

129 02-06-2020 043210030620P000008 0002673284027 jumtiana P PBI (APBD) Contraceptive Berobat Jalan
management
130 02-06-2020 043210030620P000001 0002787466263 RAHMAD HADI FAUZAN L PBI (APBN) Inguinal hernia Rujuk Vertikal