Data Pasien Kamar Inapkhanza

<center>
<h1> Data Pasien Kamar Inap RSIA PURI BUNDA MALANG </h1>
</center>
<table border="1">
<tr style="background-color: blue;">

<td rowspan="2">No
Rawat</td>
<td rowspan="2">No Rekam
Medis</td>
<td rowspan="2">Nama</td>
<td rowspan="2">JK</td>
<td rowspan="2">Tempat
Lahir</td>
<td rowspan="2">Tanggal
Lahir</td>
<td rowspan="2">Umur</td>
<td rowspan="2">Agama</td>
color="white">Bahasa</td>
color="white">Pekerjaan</td>
color="white">Pendidikan</td>
<td rowspan="2">Pekerjaan
PJ</td>
<td rowspan="2">Nama
PJ</td>
color="white">Hubungan</td>
color="white">Alamat</td>
<td rowspan="2">Kd
Asuransi</td>
color="white">Asuransi</td>
color="white">Kelas</td>
<td rowspan="2">Kode

Kamar</td>
<td rowspan="2">Nama
Bangsal</td>
<td rowspan="2">Tarif
Kamar</td>
<td rowspan="2">Diagnosa
Awal</td>
<td rowspan="2">Diagnosa
Akhir</td>
Masuk</td>
<td rowspan="2">Jam
Mssuk</td>
Keluar</td>
<td rowspan="2">Jam
Keluar</td>
<td rowspan="2">Poli
Asal</td>
color="white">Perujuk</td>
color="white">Catatan</td>
<td colspan="8">Kehamilan</td>
<td colspan="9">Status Bayi</td>
color="white">Tindakan</td>
<td rowspan="2">DPJP

1</td>
<td rowspan="2">DPJP
2</td>
<td rowspan="2">TTL
Biaya</td>
<td rowspan="2">Status
Pulang</td>
<td rowspan="2">Lama</td>
<td rowspan="2">Status
Laporan</td>
</tr>
<tr style="background-color: yellow;">
<td>Gravida</td>
<td>Partus</td>
<td>Imature</td>
<td>Premature</td>
<td>Abortus</td>
<td>Hidup</td>
<td>KB</td>
<td>Usia Kehamilan</td>
<td>Berat Lahir</td>
<td>Panjang Badan</td>
<td>JK Bayi</td>
<td>Status</td>
<td>IMD</td>
<td>KU Ibu</td>
<td>HBO</td>
<td>Vit A</td>
<td>Vit K1</td>
</tr>
<tr>
<td> 2022/07/31/000037 </td>
<td> 071443 </td>
<td> NOVI RESTIANI, NY </td>
<td> P </td>
<td> MALANG </td>
<td> 1997-03-07 </td>
<td> 25 Th 4 Bl 24 Hr </td>
<td> ISLAM </td>
<td> INDONESIA </td>
<td> MENGURUS RUMAH TANGGA </td>
<td> S1 </td>
<td> KARYAWAN SWASTA </td>
<td> KUKUH ADI SANTOSO, TN </td>
<td> SUAMI </td>
<td> JL PIRANHA ATAS SELATAN GG IV / 9 RT 11 RW 1, TUNJUNGSEKAR,
LOWOKWARU, KOTA MALANG </td>
<td> BPJ </td>
<td> BPJS KESEHATAN </td>
<td> kelas 3 </td>
<td> A06 </td>
<td> Amarta 5D </td>
<td> 300000 </td>
<td> O03.4 </td>
<td> O80.9 </td>
<td> 2022-07-31 </td>
<td> 21:34:52 </td>
<td> 2022-08-01 </td>
<td> 12:27:06 </td>
<td> IGDK </td>
<td> RSIA PURI BUNDA - KOTA MALANG </td>
<td> 2022/07/31/000037, BPJS KELAS 3, AMARTA 6B </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> VT Bidan, Infus Dewasa oleh Perawat / Bidan </td>

<td> - </td>
<td> dr. IMELDA, Sp.OG. </td>
<td> 300000 </td>
<td> Sehat </td>
<td> 1 </td>
<td> Sudah </td>
</tr>
<tr>
<td> 2022/07/31/000078 </td>
<td> 062817 </td>
<td> AISYAH KHAIRA LUBNA, AN </td>
<td> P </td>
<td> MALANG </td>
<td> 2022-01-05 </td>
<td> 0 Th 6 Bl 26 Hr </td>
<td> ISLAM </td>
<td> BELUM/TIDAK BEKERJA </td>
<td> TS </td>
<td> ACHMAD SOFYAN, TN </td>
<td> AYAH </td>
<td> PERUM GRIYA SINGOSARI INSIDE RT 8 RW 10, CANDIRENGGO,
SINGOSARI, KABUPATEN MALANG </td>
<td> BPJ </td>
<td> kelas 1 </td>
<td> P02 </td>
<td> Pandawa 2 </td>
<td> 650000 </td>
<td> J18.0 </td>
<td> J18.0 </td>
<td> 2022-07-31 </td>
<td> 21:21:37 </td>
<td> 2022-08-04 </td>
<td> 12:06:41 </td>
<td> IGDK </td>
<td> 2022/07/31/000078, BPJS KELAS 2 KONSERVATIF RUANG NATURAL
FLOW TITIP PANDAWA 3 KONFIRMASI
31-7-2022 18:40 AYAH PASIEN MINTA NAIK KELAS, ATAS NAMA ACHMAD SOFYAN. 2 UP 1,
PANDAWA 2 KONFIRMASI
HIKMA </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> Jasa Pelayanan Rumah Sakit , Oksigen 100% Sentral 2 LPM ,

Visite Dokter Spesialis Anak, Visite Dokter Spesialis Anak, Nebulizer , Nebulizer ,
Operasional Rumah Sakit </td>
<td> - </td>
<td> dr. ZAINUDDIN HAMIDI, Sp.A. </td>
<td> 2600000 </td>
<td> Atas Persetujuan Dokter </td>
<td> 4 </td>
<td> Sudah </td>
</tr>
<tr>
<td> 2022/07/31/000124 </td>
<td> 020304 </td>
<td> ADREENA NASHA SHAQEENA, AN </td>
<td> P </td>
<td> MALANG </td>
<td> 2019-06-17 </td>
<td> 3 Th 1 Bl 16 Hr </td>
<td> ISLAM </td>
<td> - </td>
<td> TNI </td>
<td> DENDI, TN </td>
<td> AYAH </td>
<td> ASRAMA YONIF PARA RAIDER 502, KEMANTREN, JABUNG, KABUPATEN
MALANG </td>
<td> BPJ </td>
<td> kelas 2 </td>
<td> D03 </td>
<td> Dwarawati 3/Ayodya 2 </td>
<td> 400000 </td>
<td> R50.9 </td>
<td> R50.9 </td>
<td> 2022-07-31 </td>
<td> 21:21:16 </td>
<td> 2022-08-02 </td>
<td> 10:46:19 </td>
<td> IGDK </td>
<td> 2022/07/31/000124, BPJS KELAS 2 KONSERVATIF AYODYA 2A
KONFIRMASI </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> Visite Dokter Spesialis Anak, Konsultasi Dokter Spesialis

Anak Via Telepon, Infus Anak oleh Perawat / Bidan </td>
<td> - </td>
<td> 800000 </td>
<td> 2 </td>
<td> Sudah </td>
</tr>
<tr>
<td> 2022/07/31/000117 </td>
<td> 073760 </td>
<td> AQILA QISYA ISNAINI,AN </td>
<td> P </td>
<td> MALANG </td>
<td> 2015-04-27 </td>
<td> 7 Th 3 Bl 9 Hr </td>
<td> ISLAM </td>
<td> TS </td>
<td> - </td>
<td> Lutfi Maulidi, Tn </td>
<td> SAUDARA </td>
<td> JL. TELUK BAYUR 58A RT06/RW07, PANDANWANGI, BLIMBING, KOTA
MALANG </td>
<td> BPJ </td>
<td> kelas 1 </td>
<td> H08 </td>
<td> Hastina 8 </td>
<td> 650000 </td>
<td> R11 </td>
<td> - </td>
<td> 2022-07-31 </td>
<td> 21:19:09 </td>
<td> 2022-08-04 </td>
<td> 17:17:18 </td>
<td> IGDK </td>
<td> 2022/07/31/000117, BPJS KELAS 2 UP 1 KONSERVATIF HASTINA 8
</td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> Menyeka Pasien , Visite Dokter Spesialis Anak, Visite

Dokter Spesialis Anak, Visite Dokter Spesialis Anak, Sewa Infus Pump, Sewa Infus
Pump, Sewa Patient Monitor , Sewa Patient Monitor , Oksigen 100% Sentral 2 LPM,
Konsultasi Dokter Spesialis Anak Via Telepon, Oksigen 21% 1 LPM / Jam </td>
<td> 3250000 </td>
<td> Pindah Kamar </td>
<td> 5 </td>
<td> Belum </td>
</tr>
<tr>
<td> 2022/07/31/000059 </td>
<td> 040922 </td>
<td> INTAN MAHARANI HOESNY, NY </td>
<td> P </td>
<td> PAMEKASAN </td>
<td> 1987-12-30 </td>
<td> 34 Th 7 Bl 7 Hr </td>
<td> ISLAM </td>
<td> SMA </td>
<td> KARYAWAN BUMN </td>
<td> SIGIT PORNOMO, TN </td>
<td> SUAMI </td>
<td> PERUM SINGHASARI RESIDENCE A9/25 RT 05 RW 09, PURWOASRI,
<td> BPJ </td>
<td> kelas 2 </td>
<td> D06 </td>
<td> 400000 </td>
<td> O42.9 </td>
<td> O42.9 </td>
<td> 2022-07-31 </td>
<td> 20:30:08 </td>
<td> 2022-08-01 </td>
<td> 12:00:56 </td>
<td> IGDK </td>
<td> 2022/07/31/000059, BPJS KLS 2 AYODYA 3B KONFIRMASI RUANGAN
</td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> USG 2D/3D oleh Dokter Obgyn , Visite Dokter Spesialis Obgyn,
VT Bidan, VT Bidan, Infus Dewasa oleh Perawat / Bidan, Konsultasi Dokter
Umum(IGD) , NST, Konsultasi Dokter Spesialis Obgyn Via Telepon </td>
<td> - </td>
<td> dr. FATMASARI PERDANA MENUR, Sp.OG </td>
<td> 800000 </td>
<td> Sehat </td>
<td> 2 </td>
<td> Sudah </td>
</tr>
<tr>
<td> 2022/07/31/000141 </td>
<td> 009603 </td>
<td> RAISYA MAULIDA ZAHRA, AN </td>
<td> P </td>
<td> Malang </td>
<td> 2018-11-19 </td>
<td> 3 Th 8 Bl 15 Hr </td>
<td> ISLAM </td>
<td> TS </td>
<td> VERI ANDRIAWAN, TN </td>
<td> AYAH </td>
<td> JL. GOLF. PERUM ROYAL KAMPUS A19 RT 04 RW 01, TASIKMADU,
<td> BPJ </td>
<td> kelas 2 </td>
<td> D07 </td>
<td> 400000 </td>
<td> A09 </td>
<td> A09 </td>
<td> 2022-07-31 </td>
<td> 19:30:04 </td>
<td> 2022-08-04 </td>
<td> 22:00:21 </td>
<td> IGDK </td>
<td> 2022/07/31/000141, BPJS KLS 2 DWARAWATI/AYODYA 4A </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> Jasa Pelayanan Rumah Sakit , Visite Dokter Spesialis Anak,

Visite Dokter Spesialis Anak, Visite Dokter Spesialis Anak, Konsultasi Dokter
Spesialis Anak Via Telepon, Operasional Rumah Sakit </td>
<td> - </td>
<td> 2000000 </td>
<td> 5 </td>
<td> Sudah </td>
</tr>
<tr>
<td> 2022/07/31/000063 </td>
<td> 071385 </td>
<td> LIZA PUTRI DJOHAN, NY </td>
<td> P </td>
<td> MALANG </td>
<td> 2003-03-21 </td>
<td> 19 Th 4 Bl 10 Hr </td>
<td> ISLAM </td>
<td> SMA </td>
<td> MUHAMMAD SAMSUN, TN </td>
<td> SUAMI </td>
<td> JL. NAKULA NO 10 RT03 RW05, POLEHAN, BLIMBING, KOTA MALANG
</td>
<td> BPJ </td>
<td> kelas 3 </td>
<td> A04 </td>
<td> Amarta 5B </td>
<td> 300000 </td>
<td> O80.9 </td>
<td> O82.9 </td>
<td> 2022-07-31 </td>
<td> 18:55:11 </td>
<td> 2022-08-02 </td>
<td> 19:33:02 </td>
<td> IGDK </td>
<td> 2022/07/31/000063, BPJS KLS 3 TITIP PANDAWA 6 KONFIRMASI
RUANGAN </td>
<td> 1 </td>
<td> 0 </td>
<td> 0 </td>
<td> 0 </td>
<td> 0 </td>
<td> 0 </td>
<td> Tidak Ada KB </td>
<td> 40-41 </td>

<td> 3500 </td>
<td> 50 </td>
<td> Laki-Laki </td>
<td> Hidup </td>
<td> Tidak </td>
<td> Hidup </td>
<td> Ya </td>
<td> Tidak </td>
<td> Ya </td>
<td> Jasa Pelayanan Rumah Sakit , VT Bidan, VT Bidan, Infus

Dewasa Oleh Dokter Umum , Operasional Rumah Sakit </td>
<td> </td>
<td> Dr.dr. I WAYAN AGUNG INDRAWAN, Sp. OG (K) </td>
<td> 900000 </td>
<td> 3 </td>
<td> Sudah </td>
</tr>
<tr>
<td> 2022/07/31/000121 </td>
<td> 107542 </td>
<td> LIZA PUTRI, BY.NY </td>
<td> L </td>
<td> MALANG </td>
<td> 2022-07-31 </td>
<td> ISLAM </td>
<td> - </td>
<td> MUHAMMAD SAMSUN, TN </td>
<td> AYAH </td>
<td> JL. NAKULA NO.10 RT 03 RW 05, POLEHAN, BLIMBING, KOTA MALANG
</td>
<td> BPJ </td>
<td> kelas 3 </td>
<td> PF16 </td>
<td> KS Fisol 16 </td>
<td> 300000 </td>
<td> P03.4 </td>
<td> P03.4 </td>
<td> 2022-07-31 </td>
<td> 17:48:47 </td>
<td> 2022-08-02 </td>
<td> 18:00:13 </td>
<td> U0030 </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> 3500 </td>
<td> 50 </td>
<td> Hidup </td>
<td> Tidak </td>
<td> Hidup </td>
<td> Ya </td>
<td> Tidak </td>
<td> Ya </td>
<td> Perawatan Bayi SC </td>

<td> - </td>
<td> dr. DEWI NURINDAH, Sp.A, M.Biomed. </td>
<td> 900000 </td>
<td> Sembuh </td>
<td> 3 </td>
<td> Sudah </td>
</tr>
<tr>
<td> 2022/07/31/000122 </td>
<td> 024048 </td>
<td> DIA HERAYU, NY </td>
<td> P </td>
<td> Malang </td>
<td> 1986-07-09 </td>
<td> 36 Th 0 Bl 22 Hr </td>
<td> KRISTEN </td>
<td> SMA </td>
<td> HARRIS ISWANTO, TN </td>
<td> SUAMI </td>
<td> RUKO GREEN SULFAT RESIDENCE RT 1 RW 4, PANDANWANGI,
BLIMBING, KOTA MALANG </td>
<td> BPJ </td>
<td> kelas 1 </td>
<td> H03 </td>
<td> 650000 </td>
<td> O34.3 </td>
<td> O82.9 </td>
<td> 2022-07-31 </td>
<td> 14:43:26 </td>
<td> 2022-08-03 </td>
<td> 16:59:56 </td>
<td> IGDK </td>
<td> 2022/07/31/000122, BPJS KELAS 1 DENDA 45 HARI PX MENGURUS
HASTINA 3 </td>
<td> 4 </td>
<td> 2 </td>
<td> 0 </td>
<td> 0 </td>
<td> 1 </td>
<td> 0 </td>
<td> 30-32 </td>

<td> 1450 </td>
<td> 45 </td>
<td> Perempuan </td>
<td> Hidup </td>
<td> Ya </td>
<td> Hidup </td>
<td> Ya </td>
<td> Tidak </td>
<td> Ya </td>
<td> Jasa Pelayanan Rumah Sakit , USG 2D/3D oleh Dokter Obgyn ,
Visite Dokter Spesialis Obgyn, Visite Dokter Spesialis Obgyn, Visite Dokter Umum,
VT Bidan, Infus Dewasa oleh Perawat / Bidan, Oksigen 100% Sentral 3 LPM ,
Konsultasi Dokter Spesialis Obgyn Via Telepon, Konsultasi Dokter Spesialis Obgyn
Via Telepon, Operasional Rumah Sakit </td>
<td> - </td>
<td> dr. PANDE MADE DWIJAYASA, Sp.OG (K) </td>
<td> 2600000 </td>
<td> 4 </td>
<td> Sudah </td>
</tr>
<tr>
<td> 2022/07/31/000062 </td>
<td> 107535 </td>
<td> HUMAIRA ADZKIYA SYAZANI, AN </td>
<td> P </td>
<td> MALANG </td>
<td> 2022-07-31 </td>
<td> ISLAM </td>
<td> TS </td>
<td> HEPPY SYAHRAHMAT, TN </td>
<td> AYAH </td>
<td> JL. KI AGENG GRIBIG XIV RT 02 RW 04, LESANPURO,
KEDUNGKANDANG, KOTA MALANG </td>
<td> BPJ </td>
<td> kelas 3 </td>
<td> BF34 </td>
<td> 300000 </td>
<td> P03.4 </td>
<td> P03.4 </td>
<td> 2022-07-31 </td>
<td> 12:34:28 </td>
<td> 2022-08-02 </td>
<td> 16:10:57 </td>
<td> U0030 </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> 3300 </td>
<td> 51 </td>
<td> Hidup </td>
<td> Tidak </td>
<td> Hidup </td>
<td> Ya </td>
<td> Tidak </td>
<td> Ya </td>

<td> - </td>
<td> dr. MOHAMMAD MUCHLIS, Sp.A. </td>
<td> 900000 </td>
<td> Sembuh </td>
<td> 3 </td>
<td> Sudah </td>
</tr>
<tr>
<td> 2022/07/31/000022 </td>
<td> 053374 </td>
<td> TRI PURWITASARI, NY </td>
<td> P </td>
<td> MALANG </td>
<td> 1978-12-23 </td>
<td> 43 Th 7 Bl 14 Hr </td>
<td> ISLAM </td>
<td> S1 </td>
<td> PUJI MARDIANTO, TN </td>
<td> SUAMI </td>
<td> JL. LA SUCIPTO XIV/11B RT 01 RW 05, BLIMBING, BLIMBING, KOTA
MALANG </td>
<td> BPJ </td>
<td> kelas 2 </td>
<td> H03 </td>
<td> 400000 </td>
<td> N75.0 </td>
<td> N75.0 </td>
<td> 2022-07-31 </td>
<td> 11:00:00 </td>
<td> 2022-08-01 </td>
<td> 08:32:57 </td>
<td> IGDK </td>
<td> 2022/07/31/000022, BPJS KLS 2 TITIP PANDAWA 5 </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> Oksigen 100% Sentral 8 LPM </td>

<td> - </td>
<td> 800000 </td>
<td> Sehat </td>
<td> 2 </td>
<td> Sudah </td>
</tr>
<tr>
<td> 2022/07/31/000030 </td>
<td> 072621 </td>
<td> SISCA APRILIA HANDAYANI, NY </td>
<td> P </td>
<td> MALANG </td>
<td> 1996-04-21 </td>
<td> 26 Th 3 Bl 10 Hr </td>
<td> ISLAM </td>
<td> S1 </td>
<td> YAYAN LIAN SUARDANA, TN </td>
<td> SUAMI </td>
<td> JL. MADYOPURO I/18 RT 04 RW 01, MADYOPURO, KEDUNGKANDANG,
KOTA MALANG </td>
<td> BPJ </td>
<td> kelas 3 </td>
<td> A06 </td>
<td> 300000 </td>
<td> O80.8 </td>
<td> O80.9 </td>
<td> 2022-07-31 </td>
<td> 11:00:00 </td>
<td> 2022-08-01 </td>
<td> 12:23:06 </td>
<td> IGDK </td>
<td> 2022/07/31/000030, BPJS KLS 3 AMARTA 5B </td>
<td> 1 </td>
<td> 0 </td>
<td> 0 </td>
<td> 0 </td>
<td> 0 </td>
<td> 0 </td>
<td> 38-39 </td>

<td> 2490 </td>
<td> 49 </td>
<td> Hidup </td>
<td> Ya </td>
<td> Hidup </td>
<td> Ya </td>
<td> Tidak </td>
<td> Ya </td>
<td> </td>
<td> - </td>
<td> 600000 </td>
<td> Sehat </td>
<td> 2 </td>
<td> Sudah </td>
</tr>
<tr>
<td> 2022/07/31/000031 </td>
<td> 064155 </td>
<td> MEGA RUSDIANA PUTRI, NY </td>
<td> P </td>
<td> Malang </td>
<td> 1998-08-14 </td>
<td> 23 Th 11 Bl 17 Hr </td>
<td> ISLAM </td>
<td> - </td>
<td> MOCH LUKMAN, Tn. </td>
<td> SUAMI </td>
<td> JL PERMADI RT 4 RW 4, POLEHAN, BLIMBING, KOTA MALANG </td>
<td> BPJ </td>
<td> kelas 3 </td>
<td> A03 </td>
<td> Amarta 5A </td>
<td> 300000 </td>
<td> O63.0 </td>
<td> - </td>
<td> 2022-07-31 </td>
<td> 10:07:37 </td>
<td> 2022-07-31 </td>
<td> 20:22:35 </td>
<td> IGDK </td>
<td> 2022/07/31/000031, BPJS KLS 3, AMARTA 5A </td>
<td> 1 </td>
<td> 0 </td>
<td> 0 </td>
<td> 0 </td>
<td> 0 </td>
<td> 0 </td>
<td> Pasang KB IUD Cooper T </td>
<td> 39-40 </td>

<td> 2800 </td>
<td> 48 </td>
<td> Hidup </td>
<td> Tidak </td>
<td> Hidup </td>
<td> Ya </td>
<td> Tidak </td>
<td> Ya </td>
<td> </td>
<td> - </td>
<td> dr. WAHYUDI JOKO SUSILO,Sp.OG. </td>
<td> 600000 </td>
<td> 2 </td>
<td> Sudah </td>
</tr>
<tr>
<td> 2022/07/31/000049 </td>
<td> 107532 </td>
<td> KILLUA ABRAHAM RAKANUALA BHIMANGGALA, An </td>
<td> L </td>
<td> MALANG </td>
<td> 2022-07-31 </td>
<td> ISLAM </td>
<td> TS </td>
<td> YAYAN LIAN SUARDANA, TN </td>
<td> AYAH </td>
<td> JL. MADYOPURO I/18 RT 04 RW 01, MADYOPURO, KEDUNGKANDANG,
KOTA MALANG </td>
<td> BPJ </td>
<td> kelas 3 </td>
<td> BF33 </td>
<td> 300000 </td>
<td> P00.6 </td>
<td> P00.9 </td>
<td> 2022-07-31 </td>
<td> 09:48:34 </td>
<td> 2022-08-02 </td>
<td> 10:30:27 </td>
<td> U0030 </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> 2490 </td>
<td> 49 </td>
<td> Hidup </td>
<td> Ya </td>
<td> Hidup </td>
<td> Ya </td>
<td> Tidak </td>
<td> Ya </td>
<td> Perawatan Bayi NP , Perawatan Bayi NP </td>
<td> - </td>
<td> 900000 </td>
<td> Sembuh </td>
<td> 3 </td>
<td> Sudah </td>
</tr>
<tr>
<td> 2022/07/31/000143 </td>
<td> 031537 </td>
<td> LLUVIA MAHESWARI PRADANA, AN </td>
<td> P </td>
<td> Malang </td>
<td> 2020-01-30 </td>
<td> ISLAM </td>
<td> - </td>
<td> - </td>
<td> swasta </td>
<td> Bayu Pradana, Tn </td>
<td> AYAH </td>
<td> JL. KOL. SUGIONO V/503 RT 012 RW 003, MERGOSONO,
<td> BPJ </td>
<td> kelas 1 </td>
<td> H06 </td>
<td> 650000 </td>
<td> A09 </td>
<td> A09 </td>
<td> 2022-07-31 </td>
<td> 09:46:10 </td>
<td> 2022-08-05 </td>
<td> 11:34:19 </td>
<td> IGDK </td>
<td> </td>
<td> 2022/07/31/000143, BPJS KLS 1 TITIP DWARAWATI/AYODYA 4B
</td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> Visite Dokter Spesialis Anak, Visite Dokter Spesialis Anak

</td>
<td> 3900000 </td>
<td> Sehat </td>
<td> 6 </td>
<td> Belum </td>
</tr>
<tr>
<td> 2022/07/31/000048 </td>
<td> 107531 </td>
<td> MEGA RUSDIANA,BY NY </td>
<td> L </td>
<td> MALANG </td>
<td> 2022-07-31 </td>
<td> ISLAM </td>
<td> - </td>
<td> - </td>
<td> MOCH LUKMAN, TN </td>
<td> AYAH </td>
<td> JL. PERMADI RT 4 RW 4 , POLEHAN, BLIMBING, KOTA MALANG </td>
<td> BPJ </td>
<td> kelas 3 </td>
<td> PF12 </td>
<td> 300000 </td>
<td> P03.4 </td>
<td> P03.4 </td>
<td> 2022-07-31 </td>
<td> 09:44:11 </td>
<td> 2022-08-02 </td>
<td> 14:08:58 </td>
<td> U0030 </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> 2850 </td>
<td> 49 </td>
<td> Hidup </td>
<td> Tidak </td>
<td> Hidup </td>
<td> Ya </td>
<td> Tidak </td>
<td> Ya </td>

<td> - </td>
<td> 900000 </td>
<td> Sembuh </td>
<td> 3 </td>
<td> Sudah </td>
</tr>
<tr>
<td> 2022/07/31/000054 </td>
<td> 107533 </td>
<td> FILAFTUL MULIA SARI, NY </td>
<td> P </td>
<td> MALANG </td>
<td> 1994-08-11 </td>
<td> 27 Th 11 Bl 21 Hr </td>
<td> ISLAM </td>
<td> SMA </td>
<td> BURUH HARIAN LEPAS </td>
<td> PURNOMO, TN </td>
<td> SUAMI </td>
<td> JL PESANTREN BABAAN RT 4 RW 8, NGENEP, KARANGPLOSO,
KABUPATEN MALANG </td>
<td> A09 </td>
<td> UMUM </td>
<td> kelas 3 </td>
<td> A06 </td>
<td> 300000 </td>
<td> O60.0 </td>
<td> O32.1 </td>
<td> 2022-07-31 </td>
<td> 08:14:25 </td>
<td> 2022-08-01 </td>
<td> 12:26:32 </td>
<td> IGDK </td>
<td> </td>
<td> 2022/07/31/000054, UMUM KELAS 3, AMARTA 5B </td>
<td> 1 </td>
<td> 0 </td>
<td> 0 </td>
<td> 0 </td>
<td> 0 </td>
<td> 0 </td>
<td> 36-37 </td>

<td> 2220 </td>
<td> 47 </td>
<td> Hidup </td>
<td> Ya </td>
<td> Hidup </td>
<td> Ya </td>
<td> Tidak </td>
<td> Ya </td>
<td> VT Bidan, NST </td>

<td> - </td>
<td> 600000 </td>
<td> Sembuh </td>
<td> 2 </td>
<td> Sudah </td>
</tr>
<tr>
<td> 2022/07/31/000036 </td>
<td> 107527 </td>
<td> VASHTI ALMYRA HERFANDA, AN </td>
<td> P </td>
<td> MALANG </td>
<td> 2022-07-31 </td>
<td> ISLAM </td>
<td> TS </td>
<td> VITO ADITYA, TN </td>
<td> AYAH </td>
<td> DUSUN KEDAWUNG RT.04 RW.02, NGIJO, KARANGPLOSO, KABUPATEN
MALANG </td>
<td> BPJ </td>
<td> kelas 3 </td>
<td> PF11 </td>
<td> 300000 </td>
<td> P03.4 </td>
<td> P03.4 </td>
<td> 2022-07-31 </td>
<td> 07:16:28 </td>
<td> 2022-08-02 </td>
<td> 10:28:33 </td>
<td> U0030 </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> 3000 </td>
<td> 48 </td>
<td> Hidup </td>
<td> Tidak </td>
<td> Hidup </td>
<td> Ya </td>
<td> Tidak </td>
<td> Ya </td>

<td> - </td>
<td> 900000 </td>
<td> Sembuh </td>
<td> 3 </td>
<td> Sudah </td>
</tr>
<tr>
<td> 2022/07/31/000139 </td>
<td> 045073 </td>
<td> DIRAYA SABILA ASSHAUQI, AN </td>
<td> P </td>
<td> Malang </td>
<td> 2020-12-13 </td>
<td> 1 Th 7 Bl 18 Hr </td>
<td> ISLAM </td>
<td> - </td>
<td> TS </td>
<td> SWASTA </td>
<td> TOMMY MUHAMMAD CHADIQ, TN </td>
<td> AYAH </td>
<td> JL YOS SUDARSO PERUMDIN TNI AL 012 RT 05 RW 02, BEDALI,
LAWANG, KABUPATEN MALANG </td>
<td> BPJ </td>
<td> kelas 1 </td>
<td> P06 </td>
<td> 650000 </td>
<td> J18.9 </td>
<td> J18.0 </td>
<td> 2022-07-31 </td>
<td> 06:27:14 </td>
<td> 2022-08-04 </td>
<td> 12:22:42 </td>
<td> IGDK </td>
<td> 2022/07/31/000139, BPJS KELAS 1 KONSERVATIF PANDAWA 5
KONFIRMASI </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> Visite Dokter Spesialis Anak, Visite Dokter Spesialis Anak,

Visite Dokter Spesialis Anak, Infus Bayi oleh Perawat / Bidan </td>
<td> - </td>
<td> 3250000 </td>
<td> Sembuh </td>
<td> 5 </td>
<td> Sudah </td>
</tr>
<tr>
<td> 2022/07/31/000133 </td>
<td> 066749 </td>
<td> IRSYAD RAHMAT WIDIYONO, AN </td>
<td> L </td>
<td> MALANG </td>
<td> 2007-10-21 </td>
<td> 14 Th 9 Bl 15 Hr </td>
<td> ISLAM </td>
<td> SMP </td>
<td> WIJI ASTUTI, NY </td>
<td> IBU </td>
<td> JL DANAU PANIAI TERUSAN I H7 D2 RT 01 RW 15, MADYOPURO,
<td> BPJ </td>
<td> kelas 1 </td>
<td> P04 </td>
<td> 650000 </td>
<td> A91 </td>
<td> - </td>
<td> 2022-07-31 </td>
<td> 06:26:50 </td>
<td> </td>
<td> </td>
<td> IGDK </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>

Visite Dokter Spesialis Anak, Visite Dokter Spesialis Anak </td>
<td> </td>
<td> 650000 </td>
<td> - </td>
<td> 1 </td>
<td> Belum </td>
</tr>
<tr>
<td> 2022/07/31/000137 </td>
<td> 014644 </td>
<td> GYANDRA ISYWARA ARKADEWI,AN </td>
<td> P </td>
<td> Malang </td>
<td> 2019-02-28 </td>
<td> ISLAM </td>
<td> TS </td>
<td> - </td>
<td> - </td>
<td> SAUDARA </td>
<td> PERUM ASRIKATON INDAH BLOK D4/9 RT 8 RW 9, ASRIKATON, PAKIS,
<td> BPJ </td>
<td> kelas 1 </td>
<td> P03 </td>
<td> 650000 </td>
<td> R50.9 </td>
<td> R50.9 </td>
<td> 2022-07-31 </td>
<td> 06:25:53 </td>
<td> </td>
<td> </td>
<td> IGDK </td>
<td> 2022/07/31/000137, BPJS KELAS 2 UP 1 PANDAWA 3 KONFIRMASI
KONSERVATIF </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
Visite Dokter Spesialis Anak, Operasional Rumah Sakit </td>
<td> 3250000 </td>
<td> - </td>
<td> 5 </td>
<td> Belum </td>
</tr>
<tr>
<td> 2022/07/31/000023 </td>
<td> 107523 </td>
<td> YUNI NUR I., BY.NY </td>
<td> P </td>
<td> MALANG </td>
<td> 2022-07-31 </td>
<td> ISLAM </td>
<td> - </td>
<td> RENDRA IRDIANTO HARI YUDONO, TN </td>
<td> AYAH </td>
<td> JL. BAYAM DALAM NO.37D RT 05 RW 02, BUMIAYU, KEDUNGKANDANG,
KOTA MALANG </td>
<td> BPJ </td>
<td> kelas 3 </td>
<td> PF10 </td>
<td> 300000 </td>
<td> P00.6 </td>
<td> P00.9 </td>
<td> 2022-07-31 </td>
<td> 06:15:40 </td>
<td> 2022-08-02 </td>
<td> 10:28:21 </td>
<td> U0030 </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> 3565 </td>
<td> 48 </td>
<td> Hidup </td>
<td> Ya </td>
<td> Hidup </td>
<td> Ya </td>
<td> Tidak </td>
<td> Ya </td>
<td> Perawatan Bayi NP </td>

<td> - </td>
<td> 900000 </td>
<td> Sembuh </td>
<td> 3 </td>
<td> Sudah </td>
</tr>
<tr>
<td> 2022/07/31/000126 </td>
<td> 049265 </td>
<td> DJOFIND ATHALA PUTRA IRAWAN, AN </td>
<td> L </td>
<td> MALANG </td>
<td> 2021-03-19 </td>
<td> 1 Th 4 Bl 13 Hr </td>
<td> ISLAM </td>
<td> TS </td>
<td> SWASTA </td>
<td> DJOKO IRAWAN, TN </td>
<td> AYAH </td>
<td> JL GADING NO 8 A, GADINGKASRI, KLOJEN, KOTA MALANG </td>
<td> BPJ </td>
<td> kelas 2 </td>
<td> D09 </td>
<td> 400000 </td>
<td> J18.0 </td>
<td> J18.0 </td>
<td> 2022-07-31 </td>
<td> 06:03:37 </td>
<td> 2022-08-05 </td>
<td> 20:00:24 </td>
<td> IGDK </td>
<td> 2022/07/31/000126, BPJS KELAS 2 KONSERVATIF DWARAWATI 5A
</td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>

Nebulizer , Nebulizer , Nebulizer , Nebulizer , Nebulizer , Nebulizer , Konsultasi
Dokter Spesialis Anak Via Telepon </td>
<td> 2400000 </td>
<td> Sehat </td>
<td> 6 </td>
<td> Belum </td>
</tr>
<tr>
<td> 2022/07/31/000140 </td>
<td> 001872 </td>
<td> ISWARA KANAKA AKSAMALA, AN </td>
<td> P </td>
<td> MALANG </td>
<td> 2017-12-31 </td>
<td> ISLAM </td>
<td> TS </td>
<td> BHENNY JONYDCRY, TN </td>
<td> AYAH </td>
<td> PERMATA BANDARA BLOK D 2 , ASRIKATON, PAKIS, KABUPATEN
MALANG </td>
<td> A09 </td>
<td> UMUM </td>
<td> kelas 2 </td>
<td> D10 </td>
<td> 400000 </td>
<td> J18.9 </td>
<td> - </td>
<td> 2022-07-31 </td>
<td> 05:57:55 </td>
<td> 2022-08-03 </td>
<td> 09:02:15 </td>
<td> IGDK </td>
<td> </td>
<td> 2022/07/31/000142, UMUM KLAS 2 RUANG AYODYA 5 B
PER 2/8/2022 JAM 08.25 UP KELAS I RENCANA DI PANDAWA 8 SUDAH EDIT BERKAS- WD </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> Operasional Rumah Sakit , Jasa Pelayanan Rumah Sakit ,

<td> 1600000 </td>
<td> 4 </td>
<td> Belum </td>
</tr>
<tr>
<td> 2022/07/31/000142 </td>
<td> 054886 </td>
<td> FARIZA ASHADIYA KIRANI, AN </td>
<td> P </td>
<td> Malang </td>
<td> 2020-06-15 </td>
<td> 2 Th 1 Bl 17 Hr </td>
<td> ISLAM </td>
<td> - </td>
<td> - </td>
<td> YUYUN WAHYU SUBAGYO, TN </td>
<td> AYAH </td>
<td> JL. SAWOJAJAR GG. 17 NO. 26 RT 03 RW 03, SAWOJAJAR,
<td> BPJ </td>
<td> kelas 2 </td>
<td> A02 </td>
<td> 400000 </td>
<td> J18.0 </td>
<td> - </td>
<td> 2022-07-31 </td>
<td> 05:56:03 </td>
<td> 2022-08-02 </td>
<td> 09:42:27 </td>
<td> IGDK </td>
<td> 2022/07/31/000142, BPJS KELAS 2 TITIP AMARTA 1 B
(KONFIRMASI) </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> Jasa Pelayanan Rumah Sakit , Operasional Rumah Sakit </td>

<td> - </td>
<td> 1200000 </td>
<td> 3 </td>
<td> Sudah </td>
</tr>
<tr>
<td> 2022/07/30/000132 </td>
<td> 107520 </td>
<td> YUNI NUR ISLAMIYAH, NY </td>
<td> P </td>
<td> MALANG </td>
<td> 1991-06-25 </td>
<td> 31 Th 1 Bl 6 Hr </td>
<td> ISLAM </td>
<td> D3 </td>
<td> RENDRA IRDIANTO HARI YUDONO, TN </td>
<td> SUAMI </td>
<td> JL. BAYAM DALAM NO. 37D RT 05 RW 02, BUMIAYU, KEDUNGKANDANG,
KOTA MALANG </td>
<td> BPJ </td>
<td> kelas 2 </td>
<td> H06 </td>
<td> 400000 </td>
<td> O42.9 </td>
<td> O42.9 </td>
<td> 2022-07-31 </td>
<td> 04:36:14 </td>
<td> 2022-08-01 </td>
<td> 22:39:58 </td>
<td> IGDK </td>
<td> 2022/07/30/000132, BPJS KLS 2 TITIP PANDAWA 6 </td>
<td> 2 </td>
<td> 1 </td>
<td> 0 </td>
<td> 0 </td>
<td> 0 </td>
<td> 0 </td>
<td> 39-40 </td>

<td> 2565 </td>
<td> 48 </td>
<td> Hidup </td>
<td> Ya </td>
<td> Hidup </td>
<td> Ya </td>
<td> Tidak </td>
<td> Ya </td>
<td> Jasa Pelayanan Rumah Sakit </td>

<td> - </td>
<td> 800000 </td>
<td> 2 </td>
<td> Sudah </td>
</tr>
<tr>
<td> 2022/07/31/000129 </td>
<td> 052015 </td>
<td> ADIN NOVITASARI, NY </td>
<td> P </td>
<td> BLITAR </td>
<td> 1996-09-27 </td>
<td> 25 Th 10 Bl 5 Hr </td>
<td> ISLAM </td>
<td> SWASTA </td>
<td> S1 </td>
<td> SWASTA </td>
<td> HAPPY ARFIYANTO, TN </td>
<td> SUAMI </td>
<td> PERUM BULAN TERANG UTAMA KR 24 NO. 33 RT 06 RW 16,
MADYOPURO, KEDUNGKANDANG, KOTA MALANG </td>
<td> BPJ </td>
<td> kelas 1 </td>
<td> P05 </td>
<td> 650000 </td>
<td> O63.0 </td>
<td> O80.8 </td>
<td> 2022-07-31 </td>
<td> 04:29:51 </td>
<td> 2022-08-02 </td>
<td> 08:34:19 </td>
<td> IGDK </td>
<td> 2022/07/31/000126, BPJS KELAS 2 UP 1 RENCANA NP PANDAWA 4
</td>
<td> 2 </td>
<td> 0 </td>
<td> 0 </td>
<td> 0 </td>
<td> 1 </td>
<td> 0 </td>
<td> 39-40 </td>

<td> 3440 </td>
<td> 50 </td>
<td> Hidup </td>
<td> Ya </td>
<td> Hidup </td>
<td> Ya </td>
<td> Tidak </td>
<td> Ya </td>
<td> Jasa Pelayanan Rumah Sakit , VT Bidan, NST, Operasional

Rumah Sakit </td>
<td> - </td>
<td> 1950000 </td>
<td> Sembuh </td>
<td> 3 </td>
<td> Sudah </td>
</tr>
<tr>
<td> 2022/07/30/000058 </td>
<td> 107492 </td>
<td> IZMI SEPTRIANI PUTRI, AN </td>
<td> P </td>
<td> MALANG </td>
<td> 2011-09-11 </td>
<td> 10 Th 10 Bl 23 Hr </td>
<td> ISLAM </td>
<td> D3 </td>
<td> MUH ANWAR, TN </td>
<td> AYAH </td>
<td> JL LA SUCIPTOGG TARUNA I4/29, PANDANWANGI, BLIMBING, KOTA
MALANG </td>
<td> BPJ </td>
<td> kelas 3 </td>
<td> A16 </td>
<td> 300000 </td>
<td> A90 </td>
<td> A90 </td>
<td> 2022-07-30 </td>
<td> 23:50:42 </td>
<td> 2022-08-03 </td>
<td> 23:50:55 </td>
<td> IGDK </td>
<td> 2022/07/30/000058, BPJS KELAS 3, AMARTA 7A (KONFIRMASI)
</td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>

<td> - </td>
<td> 1200000 </td>
<td> 4 </td>
<td> Sudah </td>
</tr>
<tr>
<td> 2022/07/30/000103 </td>
<td> 107506 </td>
<td> ALDEVITO GAVIN ABIZAM WICAKSONO, AN </td>
<td> L </td>
<td> MALANG </td>
<td> 2017-06-04 </td>
<td> 5 Th 1 Bl 28 Hr </td>
<td> ISLAM </td>
<td> - </td>
<td> - </td>
<td> GALIH WICAKSONO, TN </td>
<td> AYAH </td>
<td> JL. MADYOPURO II/22 RT 7 RW 1, MADYOPURO, KEDUNGKANDANG,
KOTA MALANG </td>
<td> A09 </td>
<td> UMUM </td>
<td> kelas 2 </td>
<td> D12 </td>
<td> 400000 </td>
<td> A90 </td>
<td> A90 </td>
<td> 2022-07-30 </td>
<td> 23:43:14 </td>
<td> 2022-08-01 </td>
<td> 20:38:24 </td>
<td> IGDK </td>
<td> </td>
<td> 2022/07/30/000103, UMUM KLS 2 RUJUKAN BIDAN SUMARIYAH AYODYA
6B KONFIRMASI RUANGAN </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>

Konsultasi Dokter Spesialis Anak Via Telepon </td>
<td> - </td>
<td> 800000 </td>
<td> Sehat </td>
<td> 2 </td>
<td> Sudah </td>
</tr>
<tr>
<td> 2022/07/30/000100 </td>
<td> 036109 </td>
<td> JENNAIRA NAWALA DHANESWARI, AN </td>
<td> P </td>
<td> MALANG </td>
<td> 2020-05-03 </td>
<td> 2 Th 2 Bl 27 Hr </td>
<td> ISLAM </td>
<td> - </td>
<td> - </td>
<td> SWASTA </td>
<td> M HIDAYATUL KHULUB, TN </td>
<td> AYAH </td>
<td> JL. MENDIT BARAT RT 1 RW 3, MANGLIAWAN, PAKIS, KABUPATEN
MALANG </td>
<td> A09 </td>
<td> UMUM </td>
<td> kelas 2 </td>
<td> D01 </td>
<td> 400000 </td>
<td> K52.9 </td>
<td> - </td>
<td> 2022-07-30 </td>
<td> 23:42:54 </td>
<td> 2022-08-02 </td>
<td> 08:31:10 </td>
<td> IGDK </td>
<td> </td>
<td> 2022/07/30/000100, BPJS KELAS 2 KONSERVATIF (BPJS NONAKTIF
KARENA DATA BERMASALAH, PX HARI SENIN MENGURUS KE KANTOR BPJS) </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>

<td> - </td>
<td> 1200000 </td>
<td> Sehat </td>
<td> 3 </td>
<td> Sudah </td>
</tr>
<tr>
<td> 2022/07/30/000076 </td>
<td> 051228 </td>
<td> MUHAMMAD RAYN HAQQ, AN </td>
<td> L </td>
<td> MALANG </td>
<td> 2021-05-01 </td>
<td> 1 Th 2 Bl 30 Hr </td>
<td> ISLAM </td>
<td> WIRASWASTA </td>
<td> TS </td>
<td> SWASTA </td>
<td> M. ENGGA HERMAWAN, TN </td>
<td> AYAH </td>
<td> JL RAYA SEGARAN NO 1 , KENDALPAYAK, PAKISAJI, KABUPATEN
MALANG </td>
<td> BPJ </td>
<td> kelas 2 </td>
<td> D02 </td>
<td> 400000 </td>
<td> R50.9 </td>
<td> R50.9 </td>
<td> 2022-07-30 </td>
<td> 23:42:16 </td>
<td> 2022-08-02 </td>
<td> 23:27:58 </td>
<td> IGDK </td>
<td> 2022/07/30/000076, BPJS KELAS 2, TITIP HASTINA 9, RENCANA
DWARAWATI MENYUSUL </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> - </td>
<td> 1200000 </td>
<td> Sehat </td>
<td> 3 </td>
<td> Sudah </td>
</tr>
<tr>
<td> 2022/07/30/000066 </td>
<td> 047238 </td>
<td> MUHAMMAD HASAN AL FAQIH, An </td>
<td> L </td>
<td> MALANG </td>
<td> 2021-02-02 </td>
<td> ISLAM </td>
<td> - </td>
<td> - </td>
<td> SWASTA </td>
<td> AHMAD BUSTOMI, TN </td>
<td> AYAH </td>
<td> JL MUHARTO GANG 7/91 RT 01 RW 07, KOTALAMA, KEDUNGKANDANG,
KOTA MALANG </td>
<td> BPJ </td>
<td> kelas 3 </td>
<td> A13 </td>
<td> KS Amarta 3 (ISOLASI) </td>
<td> 300000 </td>
<td> J18.0 </td>
<td> J18.9 </td>
<td> 2022-07-30 </td>
<td> 23:39:46 </td>
<td> 2022-08-02 </td>
<td> 20:02:04 </td>
<td> IGDK </td>
<td> 2022/07/30/000066, BPJS KELAS 3 RUANG AMARTA 3
( KONFIRMASI ) NATURAL FLOW </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>

<td> - </td>
<td> 900000 </td>
<td> 3 </td>
<td> Sudah </td>
</tr>
<tr>
<td> 2022/07/30/000082 </td>
<td> 052361 </td>
<td> KHADEEJAH ZAYYENA ALMAHYRA, AN </td>
<td> P </td>
<td> MALANG </td>
<td> 2021-05-27 </td>
<td> ISLAM </td>
<td> - </td>
<td> - </td>
<td> SWASTA </td>
<td> RAHMATULLOH RASYID,TN </td>
<td> AYAH </td>
<td> JL SIMPANG DIRGANTARA 4 BLOK A5 , LESANPURO, KEDUNGKANDANG,
KOTA MALANG </td>
<td> BPJ </td>
<td> kelas 3 </td>
<td> A15 </td>
<td> 300000 </td>
<td> K29.1 </td>
<td> K29.1 </td>
<td> 2022-07-30 </td>
<td> 23:34:16 </td>
<td> 2022-08-04 </td>
<td> 19:57:39 </td>
<td> IGDK </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>

<td> </td>
<td> 1500000 </td>
<td> 5 </td>
<td> Sudah </td>
</tr>
<tr>
<td> 2022/07/30/000075 </td>
<td> 002630 </td>
<td> RAFFASA NAZRIL KURNIAWAN, AN </td>
<td> L </td>
<td> Malang </td>
<td> 2018-06-24 </td>
<td> 4 Th 1 Bl 12 Hr </td>
<td> ISLAM </td>
<td> TS </td>
<td> IRFAN ROHMAN MAULIDI, TN </td>
<td> AYAH </td>
<td> JL. SILIKAT PANDEAN 3 RT 05 RW 11, PURWANTORO, BLIMBING,
KOTA MALANG </td>
<td> A09 </td>
<td> UMUM </td>
<td> kelas 3 </td>
<td> H05 </td>
<td> 300000 </td>
<td> J40 </td>
<td> J40 </td>
<td> 2022-07-30 </td>
<td> 22:33:33 </td>
<td> 2022-08-02 </td>
<td> 22:36:00 </td>
<td> IGDK </td>
<td> </td>
<td> 2022/07/30/000075, UMUM KELAS 3, TITIP HASTINA 5
(KONFIRMASI) </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> Nebulizer , Nebulizer , Nebulizer , Nebulizer , Nebulizer ,

Nebulizer , Nebulizer , Nebulizer , Oksigen 100% Sentral 2 LPM, Visite Dokter
Spesialis Anak, Visite Dokter Spesialis Anak, Visite Dokter Spesialis Anak, Oksigen
100% Sentral 2 LPM , Oksigen 100% Sentral 2 LPM , Oksigen 100% Sentral 2 LPM ,
Oksigen 100% Sentral 2 LPM , Konsultasi Dokter Spesialis Anak Via Telepon </td>
<td> - </td>
<td> 900000 </td>
<td> 3 </td>
<td> Sudah </td>
</tr>
<tr>
<td> 2022/07/30/000090 </td>
<td> 049394 </td>
<td> NATASYA AULYA JENSEN, AN </td>
<td> P </td>
<td> MALANG </td>
<td> 2021-03-22 </td>
<td> 1 Th 4 Bl 13 Hr </td>
<td> HINDU </td>
<td> - </td>
<td> - </td>
<td> SWASTA </td>
<td> YENSEN, TN </td>
<td> AYAH </td>
<td> DUSUN SUKOREJO RT 10 RW 3, MULYOASRI, AMPELGADING, KABUPATEN
MALANG </td>
<td> BPJ </td>
<td> kelas 2 </td>
<td> H01 </td>
<td> 400000 </td>
<td> K52.0 </td>
<td> - </td>
<td> 2022-07-30 </td>
<td> 22:27:56 </td>
<td> 2022-07-30 </td>
<td> 22:43:40 </td>
<td> IGDK </td>
<td> 2022/07/30/000090, BPJS KELAS 2, HASTINA 2 (ANAK KARYAWAN)
</td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>

Visite Dokter Spesialis Anak, Visite Dokter Spesialis Anak, Operasional Rumah Sakit
</td>
<td> - </td>
<td> 400000 </td>
<td> 1 </td>
<td> Sudah </td>
</tr>
<tr>
<td> 2022/07/30/000130 </td>
<td> 065378 </td>
<td> VIRGINANTARI NATALIA, NY </td>
<td> P </td>
<td> TANJUNGPANDAN </td>
<td> 1995-12-25 </td>
<td> 26 Th 7 Bl 8 Hr </td>
<td> ISLAM </td>
<td> SMA </td>
<td> TNI </td>
<td> ASEP SURYANA, TN </td>
<td> SUAMI </td>
<td> KOMPLEK AMARTA JL. SERKA LARAKIMA BLOK H NO.22 RT.14 RW.12,
SAPTORENGGO, PAKIS, KABUPATEN MALANG </td>
<td> BPJ </td>
<td> kelas 2 </td>
<td> D05 </td>
<td> 400000 </td>
<td> O80.8 </td>
<td> O47.0 </td>
<td> 2022-07-30 </td>
<td> 21:30:13 </td>
<td> 2022-08-01 </td>
<td> 17:45:20 </td>
<td> IGDK </td>
<td> 2022/07/30/000130, BPJS KLS 2 TITIP HASTINA 3 </td>
<td> 2 </td>
<td> 1 </td>
<td> 0 </td>
<td> 0 </td>
<td> 0 </td>
<td> 0 </td>
<td> Tidak ada KB </td>
<td> 34-35 </td>

<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> Visite Dokter Spesialis Obgyn, VT Bidan, NST </td>

<td> - </td>
<td> 800000 </td>
<td> Sembuh </td>
<td> 2 </td>
<td> Sudah </td>
</tr>
<tr>
<td> 2022/07/30/000079 </td>
<td> 029984 </td>
<td> AZZAMIR BASIRA GHAYDA, AN </td>
<td> L </td>
<td> Malang </td>
<td> 2019-12-27 </td>
<td> ISLAM </td>
<td> - </td>
<td> - </td>
<td> SWASTA </td>
<td> TAUFIK NUR HIDAYAH, TN </td>
<td> AYAH </td>
<td> JL. SAWOJAJAR XXI/ 18 B RT 04 RW 04, SAWOJAJAR,
<td> BPJ </td>
<td> kelas 3 </td>
<td> P01 </td>
<td> 300000 </td>
<td> J18.0 </td>
<td> J18.9 </td>
<td> 2022-07-30 </td>
<td> 19:57:04 </td>
<td> 2022-08-03 </td>
<td> 10:00:00 </td>
<td> IGDK </td>
<td> 2022/07/30/000079, BPJS KELAS 3 TITIP PANDAWA 1 ( KONFIRMASI
) NATURAL FLOW </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> Visite Dokter Spesialis Anak, Nebulizer , Nebulizer ,

Nebulizer , Oksigen 100% Sentral 2 LPM, Oksigen 100% Sentral 2 LPM, Nebulizer ,
Nebulizer , Nebulizer , Nebulizer , Nebulizer </td>
<td> - </td>
<td> 1500000 </td>
<td> 5 </td>
<td> Sudah </td>
</tr>
<tr>
<td> 2022/07/30/000068 </td>
<td> 063451 </td>
<td> SUCIYATI, NY </td>
<td> P </td>
<td> REMBANG </td>
<td> 1987-05-21 </td>
<td> 35 Th 2 Bl 15 Hr </td>
<td> ISLAM </td>
<td> SD </td>
<td> DWI JOHAN,TN </td>
<td> SUAMI </td>
<td> JL GADANG RT 3 RW 6, GADANG, SUKUN, KOTA MALANG </td>
<td> BPJ </td>
<td> kelas 3 </td>
<td> A05 </td>
<td> Amarta 5C </td>
<td> 300000 </td>
<td> O42.9 </td>
<td> O82.0 </td>
<td> 2022-07-30 </td>
<td> 19:16:32 </td>
<td> 2022-08-02 </td>
<td> 13:46:00 </td>
<td> IGDK </td>
<td> 2022/07/30/000068, BPJS KELAS 3 RUANG AMARTA 5C </td>
<td> 2 </td>
<td> 1 </td>
<td> 0 </td>
<td> 0 </td>
<td> 0 </td>
<td> 0 </td>
<td> 38-39 </td>

<td> 2900 </td>
<td> 47 </td>
<td> Hidup </td>
<td> Tidak </td>
<td> Hidup </td>
<td> Ya </td>
<td> Tidak </td>
<td> Ya </td>
<td> Jasa Pelayanan Rumah Sakit , Visite Dokter Spesialis Obgyn,

VT Bidan, Oksigen 100% Sentral 3 LPM , Operasional Rumah Sakit </td>
<td> - </td>
<td> 1200000 </td>
<td> 4 </td>
<td> Sudah </td>
</tr>
<tr>
<td> 2022/07/30/000121 </td>
<td> 107511 </td>
<td> SUCIYATI,BY NY </td>
<td> L </td>
<td> MALANG </td>
<td> 2022-07-30 </td>
<td> ISLAM </td>
<td> - </td>
<td> - </td>
<td> DWI JOHAN, TN </td>
<td> AYAH </td>
<td> JL. GADANG RT 3 RW 6 , GADANG, SUKUN, KOTA MALANG </td>
<td> BPJ </td>
<td> kelas 3 </td>
<td> PF03 </td>
<td> 300000 </td>
<td> P03.4 </td>
<td> P03.4 </td>
<td> 2022-07-30 </td>
<td> 19:11:29 </td>
<td> 2022-08-02 </td>
<td> 10:29:47 </td>
<td> U0030 </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> 2900 </td>
<td> 47 </td>
<td> Hidup </td>
<td> Tidak </td>
<td> Hidup </td>
<td> Ya </td>
<td> Tidak </td>
<td> Ya </td>

<td> - </td>
<td> 1200000 </td>
<td> Sembuh </td>
<td> 4 </td>
<td> Sudah </td>
</tr>
<tr>
<td> 2022/07/30/000071 </td>
<td> 002132 </td>
<td> MUHAMMAD FAHRIL MUZAKKI, AN </td>
<td> L </td>
<td> Malang </td>
<td> 2017-06-07 </td>
<td> 5 Th 1 Bl 23 Hr </td>
<td> ISLAM </td>
<td> TS </td>
<td> NUR CHOLIS, TN </td>
<td> AYAH </td>
<td> JL RA KARTINI RT 09 RW 06, JERU, TUMPANG, KABUPATEN MALANG
</td>
<td> BPJ </td>
<td> kelas 2 </td>
<td> D11 </td>
<td> 400000 </td>
<td> A09 </td>
<td> A09 </td>
<td> 2022-07-30 </td>
<td> 18:38:38 </td>
<td> 2022-08-03 </td>
<td> 08:31:55 </td>
<td> IGDK </td>
<td> 2022/07/30/000071, BPJS KELAS 2, TITIP HASTINA 2, RENCANA
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>

Visite Dokter Spesialis Anak, Konsultasi Dokter Spesialis Anak Via Telepon,
<td> - </td>
<td> 2000000 </td>
<td> 5 </td>
<td> Sudah </td>
</tr>
<tr>
<td> 2022/07/30/000112 </td>
<td> 107509 </td>
<td> VENI WULANDARI, BY NY </td>
<td> P </td>
<td> MALANG </td>
<td> 2022-07-30 </td>
<td> ISLAM </td>
<td> - </td>
<td> - </td>
<td> - </td>
<td> SHOHIBUL ARIFIN, TN </td>
<td> AYAH </td>
<td> JL. KH YUSUF RT 4 RW 5 , TASIKMADU, LOWOKWARU, KOTA MALANG
</td>
<td> BPJ </td>
<td> kelas 3 </td>
<td> BFA02 </td>
<td> 300000 </td>
<td> P00.6 </td>
<td> P00.9 </td>
<td> 2022-07-30 </td>
<td> 18:10:20 </td>
<td> 2022-07-31 </td>
<td> 16:52:03 </td>
<td> U0030 </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> 3105 </td>
<td> 49 </td>
<td> Hidup </td>
<td> Ya </td>
<td> Hidup </td>
<td> Ya </td>
<td> Tidak </td>
<td> Ya </td>
<td> Perawatan Bayi NP , Visite Dokter Spesialis Anak </td>

<td> - </td>
<td> 600000 </td>
<td> Sembuh </td>
<td> 2 </td>
<td> Sudah </td>
</tr>
<tr>
<td> 2022/07/29/000185 </td>
<td> 087095 </td>
<td> VENI WULANDARI, Ny </td>
<td> P </td>
<td> MALANG </td>
<td> 1991-06-08 </td>
<td> 31 Th 1 Bl 28 Hr </td>
<td> ISLAM </td>
<td> PERAWAT </td>
<td> D3 </td>
<td> KARYAWAN HONORER </td>
<td> SHOHIBUL ARIFIN, TN </td>
<td> SUAMI </td>
<td> JL. KH. YUSUF RT 04 RW 05, TASIKMADU, LOWOKWARU, KOTA MALANG
</td>
<td> BPJ </td>
<td> kelas 2 </td>
<td> P03 </td>
<td> 400000 </td>
<td> O63.0 </td>
<td> O63.0 </td>
<td> 2022-07-30 </td>
<td> 17:30:18 </td>
<td> 2022-08-01 </td>
<td> 06:08:56 </td>
<td> IGDK </td>
<td> - </td>
RUANGAN </td>
<td> 2 </td>
<td> 1 </td>
<td> 0 </td>
<td> 0 </td>
<td> 0 </td>
<td> 0 </td>
<td> 39-40 </td>

<td> 3105 </td>
<td> 49 </td>
<td> Hidup </td>
<td> Ya </td>
<td> Hidup </td>
<td> Ya </td>
<td> Tidak </td>
<td> Ya </td>
<td> Jasa Pelayanan Rumah Sakit, VT Bidan, VT Bidan, NST, NST

</td>
<td> </td>
<td> 1200000 </td>
<td> Sehat </td>
<td> 3 </td>
<td> Sudah </td>
</tr>
<tr>
<td> 2022/07/30/000104 </td>
<td> 107505 </td>
<td> MUHAMMAD NICHOLAS AFFANDI, AN </td>
<td> L </td>
<td> MALANG </td>
<td> 2022-07-30 </td>
<td> ISLAM </td>
<td> - </td>
<td> - </td>
<td> - </td>
<td> ACHMAD ZULHAM,TN </td>
<td> AYAH </td>
<td> PERUM HARMONY PLACE B-14, SAPTORENGGO, PAKIS, KABUPATEN
MALANG </td>
<td> BPJ </td>
<td> kelas 3 </td>
<td> BFA05 </td>
<td> 300000 </td>
<td> P00.6 </td>
<td> P00.9 </td>
<td> 2022-07-30 </td>
<td> 17:26:08 </td>
<td> 2022-07-31 </td>
<td> 16:49:37 </td>
<td> U0030 </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> 2905 </td>
<td> 47 </td>
<td> Hidup </td>
<td> Ya </td>
<td> Hidup </td>
<td> Ya </td>
<td> Tidak </td>
<td> Ya </td>

<td> - </td>
<td> 600000 </td>
<td> Sembuh </td>
<td> 2 </td>
<td> Sudah </td>
</tr>
<tr>
<td> 2022/07/30/000064 </td>
<td> 053901 </td>
<td> RAZETA BALQIS AZRAH, AN </td>
<td> P </td>
<td> Malang </td>
<td> 2020-06-22 </td>
<td> 2 Th 1 Bl 13 Hr </td>
<td> ISLAM </td>
<td> TS </td>
<td> ANDRI EKO ADIANTO, Tn </td>
<td> AYAH </td>
<td> JL LA SUCIPTO GANG MAKAM RT 10 RW 03, PANDANWANGI,
<td> A09 </td>
<td> UMUM </td>
<td> kelas 2 </td>
<td> D12 </td>
<td> 400000 </td>
<td> A09 </td>
<td> - </td>
<td> 2022-07-30 </td>
<td> 14:02:36 </td>
<td> 2022-07-30 </td>
<td> 17:45:30 </td>
<td> IGDK </td>
<td> </td>
<td> 2022/07/30/000064, UMUM KELAS 2, TITIP HASTINA 9, RENCANA
DWARAWATI MENYUSUL, PERTANGGAL 30/7/2022 JAM 17:42 PX PINDAH KLS 1 PANDAWA 7 </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>

Oksigen 100% Sentral 2 LPM, Oksigen 100% Sentral 2 LPM, Visite Dokter Spesialis
Anak, Visite Dokter Spesialis Anak, Visite Dokter Spesialis Anak </td>
<td> - </td>
<td> 400000 </td>
<td> 1 </td>
<td> Sudah </td>
</tr>
<tr>
<td> 2022/07/30/000080 </td>
<td> 107499 </td>
<td> ADRYAN FIQRIE YR, AN </td>
<td> L </td>
<td> MALANG </td>
<td> 2009-12-10 </td>
<td> 12 Th 7 Bl 20 Hr </td>
<td> ISLAM </td>
<td> SD </td>
<td> SONY ABDUL ROZAK, TN </td>
<td> AYAH </td>
<td> JL LAKS MARTADINATA V/961 RT 7 RW 2, KOTALAMA,
<td> A09 </td>
<td> UMUM </td>
<td> kelas 1 </td>
<td> IGD10 </td>
<td> KS IGD 10 </td>
<td> 650000 </td>
<td> K52.0 </td>
<td> U07.1 </td>
<td> 2022-07-30 </td>
<td> 11:34:26 </td>
<td> 2022-07-31 </td>
<td> 10:53:33 </td>
<td> IGDK </td>
<td> </td>
<td> 2022/07/30/000080, UMUM KELAS 1, PANDAWA 6 </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> Jasa Pelayanan Rumah Sakit , Sewa Ambulance, Sewa Patient

Monitor , Oksigen 100% Sentral 3 LPM , Konsultasi Dokter Spesialis Anak Via
Telepon, Infus Anak oleh Perawat / Bidan </td>
<td> - </td>
<td> 1300000 </td>
<td> Pindah RS </td>
<td> 2 </td>
<td> Sudah </td>
</tr>
<tr>
<td> 2022/07/29/000191 </td>
<td> 107457 </td>
<td> LIA SUSANTI, NY </td>
<td> P </td>
<td> Malang </td>
<td> 1992-01-13 </td>
<td> 30 Th 6 Bl 17 Hr </td>
<td> ISLAM </td>
<td> SMA </td>
<td> MAULANA RIZQI, TN </td>
<td> SUAMI </td>
<td> PERUM GRIYA SINGOSARI INSIDE BLOK AA-50, CANDIRENGGO,
<td> BPJ </td>
<td> kelas 3 </td>
<td> A08 </td>
<td> 300000 </td>
<td> O02.1 </td>
<td> O02.1 </td>
<td> 2022-07-30 </td>
<td> 10:36:30 </td>
<td> 2022-07-31 </td>
<td> 20:22:08 </td>
<td> IGDK </td>
<td> 2022/07/29/000191, BPJS KELAS 3 PBI KURET AMARTA 6A </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> Jasa Pelayanan Rumah Sakit , VT Bidan, Infus Dewasa oleh

Perawat / Bidan, Operasional Rumah Sakit </td>
<td> </td>
<td> dr. NOVINA PURWITA KARTIKARINI, Sp.OG </td>
<td> 600000 </td>
<td> 2 </td>
<td> Sudah </td>
</tr>
<tr>
<td> 2022/07/30/000069 </td>
<td> 107497 </td>
<td> ZAFRAN KHASAFA SHABIR, An </td>
<td> L </td>
<td> MALANG </td>
<td> 2022-07-30 </td>
<td> ISLAM </td>
<td> TS </td>
<td> KRISNA INDRA MAHENDRA, TN </td>
<td> AYAH </td>
<td> JL. TELUK PELABUHAN RATU 46 C RT 09 RW 01, ARJOSARI,
<td> BPJ </td>
<td> kelas 3 </td>
<td> BFA03 </td>
<td> 300000 </td>
<td> P00.6 </td>
<td> P00.9 </td>
<td> 2022-07-30 </td>
<td> 09:52:45 </td>
<td> 2022-07-31 </td>
<td> 16:49:58 </td>
<td> U0030 </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> 2730 </td>
<td> 50 </td>
<td> Hidup </td>
<td> Ya </td>
<td> Hidup </td>
<td> Ya </td>
<td> Tidak </td>
<td> Ya </td>

<td> - </td>
<td> 600000 </td>
<td> Sembuh </td>
<td> 2 </td>
<td> Sudah </td>
</tr>
<tr>
<td> 2022/07/30/000097 </td>
<td> 066363 </td>
<td> HAYUNING IRLIN ZANALIA, NY </td>
<td> P </td>
<td> MALANG </td>
<td> 1997-02-20 </td>
<td> 25 Th 5 Bl 11 Hr </td>
<td> ISLAM </td>
<td> PEGAWAI NEGERI SIPIL/PNS </td>
<td> D3 </td>
<td> HEPY SYAHRAHMAT, TN </td>
<td> SUAMI </td>
<td> JL. KI AGENG GRIBIG XIV RT 02 RW 04, LESANPURO,
<td> BPJ </td>
<td> kelas 2 </td>
<td> H01 </td>
<td> 400000 </td>
<td> O80.9 </td>
<td> O33.9 </td>
<td> 2022-07-30 </td>
<td> 09:44:48 </td>
<td> 2022-08-02 </td>
<td> 17:44:26 </td>
<td> IGDK </td>
<td> 2022/07/30/000097, BPJS KLS 2 TITIP PANDAWA 2 , DWARAWATI
MENYUSUL, BPJS KLS 2 PNS TAPI DENDA 45 HARI (PERALIHAN DARI MANDIRI KE PNS). SUDAH
CETAK SEP TGL 01-08-2022(TIKA) </td>
<td> 1 </td>
<td> 0 </td>
<td> 0 </td>
<td> 0 </td>
<td> 0 </td>
<td> 0 </td>
<td> 40-41 </td>

<td> 3300 </td>
<td> 51 </td>
<td> Hidup </td>
<td> Tidak </td>
<td> Hidup </td>
<td> Ya </td>
<td> Tidak </td>
<td> Ya </td>
<td> Jasa Pelayanan Rumah Sakit , VT Bidan, VT Bidan, NST,

<td> - </td>
<td> 1600000 </td>
<td> Sembuh </td>
<td> 4 </td>
<td> Sudah </td>
</tr>
<tr>
<td> 2022/07/30/000035 </td>
<td> 107483 </td>
<td> VARADHIBA OKTAVIA,NY </td>
<td> P </td>
<td> MALANG </td>
<td> 2002-10-30 </td>
<td> 19 Th 9 Bl 6 Hr </td>
<td> ISLAM </td>
<td> PELAJAR MAHASISWA </td>
<td> SMA </td>
<td> SONY ANGGARA,TN </td>
<td> SUAMI </td>
<td> JL. SUMPIL I/55C RT.03 RW.04, PURWODADI, BLIMBING, KOTA
MALANG </td>
<td> BPJ </td>
<td> kelas 3 </td>
<td> A06 </td>
<td> 300000 </td>
<td> O80.9 </td>
<td> O80.9 </td>
<td> 2022-07-30 </td>
<td> 09:24:05 </td>
<td> 2022-07-31 </td>
<td> 13:18:34 </td>
<td> IGDK </td>
<td> 2022/07/30/000035, BPJS KELAS 3 RENCANA NP AMARTA 5D </td>
<td> 1 </td>
<td> 0 </td>
<td> 0 </td>
<td> 0 </td>
<td> 0 </td>
<td> 0 </td>
<td> 39-40 </td>

<td> 2871 </td>
<td> 48 </td>
<td> Hidup </td>
<td> Ya </td>
<td> Hidup </td>
<td> Ya </td>
<td> Tidak </td>
<td> Ya </td>

Rumah Sakit </td>
<td> - </td>
<td> 600000 </td>
<td> 2 </td>
<td> Sudah </td>
</tr>
<tr>
<td> 2022/07/30/000042 </td>
<td> 002627 </td>
<td> AINUN NADHIFATUL MACHFUDZOH,NY </td>
<td> P </td>
<td> Malang </td>
<td> 1995-05-16 </td>
<td> 27 Th 2 Bl 19 Hr </td>
<td> ISLAM </td>
<td> S1 </td>
<td> Achmad Saikhu,Tn </td>
<td> SUAMI </td>
<td> DUSUN JAJAR RT 1 RW10, TUNJUNGTIRTO, SINGOSARI, KABUPATEN
MALANG </td>
<td> BPJ </td>
<td> kelas 1 </td>
<td> H07 </td>
<td> 650000 </td>
<td> O82.0 </td>
<td> O82.9 </td>
<td> 2022-07-30 </td>
<td> 09:18:34 </td>
<td> 2022-08-01 </td>
<td> 16:56:05 </td>
<td> IGDK </td>
<td> </td>
<td> 2022/07/30/000042, BPJS KELAS 1 RENCANA SC HASTINA 1
KONFIRMASI </td>
<td> 2 </td>
<td> 1 </td>
<td> 0 </td>
<td> 0 </td>
<td> 0 </td>
<td> 0 </td>
<td> 38-39 </td>

<td> 2900 </td>
<td> 48 </td>
<td> Hidup </td>
<td> Tidak </td>
<td> Hidup </td>
<td> Ya </td>
<td> Tidak </td>
<td> Ya </td>

Infus Dewasa oleh Perawat / Bidan, Operasional Rumah Sakit </td>
<td> - </td>
<td> 1950000 </td>
<td> 3 </td>
<td> Sudah </td>
</tr>
<tr>
<td> 2022/07/29/000166 </td>
<td> 000930 </td>
<td> KHOIRUL UMMAH, NY </td>
<td> P </td>
<td> PASURUAN </td>
<td> 1984-06-18 </td>
<td> 38 Th 1 Bl 17 Hr </td>
<td> ISLAM </td>
<td> IRT </td>
<td> SD </td>
<td> SLAMET RIYADI, TN </td>
<td> SUAMI </td>
<td> JL. CAKALANG NO 3 RT 4 RW 10, POLOWIJEN, BLIMBING, KOTA
MALANG </td>
<td> BPJ </td>
<td> kelas 3 </td>
<td> A07 </td>
<td> 300000 </td>
<td> O82.0 </td>
<td> O82.9 </td>
<td> 2022-07-30 </td>
<td> 09:16:19 </td>
<td> 2022-08-01 </td>
<td> 12:27:20 </td>
<td> IGDK </td>
<td> </td>
<td> 7 </td>
<td> 4 </td>
<td> 0 </td>
<td> 0 </td>
<td> 2 </td>
<td> 0 </td>
<td> MOW Potong </td>
<td> 38-39 </td>

<td> 3000 </td>
<td> 48 </td>
<td> Hidup </td>
<td> Tidak </td>
<td> Hidup </td>
<td> Ya </td>
<td> Tidak </td>
<td> Ya </td>
<td> Jasa Pelayanan Rumah Sakit , Infus Dewasa oleh Perawat /

Bidan, Operasional Rumah Sakit </td>
<td> </td>
<td> 900000 </td>
<td> Sehat </td>
<td> 3 </td>
<td> Sudah </td>
</tr>
<tr>
<td> 2022/07/30/000063 </td>
<td> 107496 </td>
<td> FELYSIA INEZ GIANINA. AN </td>
<td> P </td>
<td> MALANG </td>
<td> 2022-07-30 </td>
<td> ISLAM </td>
<td> TS </td>
<td> SONY ANGGARA, TN </td>
<td> AYAH </td>
<td> JL. SUMPIL I/55C RT.03 RW.04, PURWODADI, BLIMBING, KOTA
MALANG </td>
<td> BPJ </td>
<td> kelas 3 </td>
<td> BPF01 </td>
<td> 300000 </td>
<td> P00.6 </td>
<td> P00.9 </td>
<td> 2022-07-30 </td>
<td> 09:15:29 </td>
<td> 2022-07-31 </td>
<td> 16:51:47 </td>
<td> U0030 </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> 2710 </td>
<td> 48 </td>
<td> Hidup </td>
<td> Ya </td>
<td> Hidup </td>
<td> Ya </td>
<td> Tidak </td>
<td> Ya </td>

<td> - </td>
<td> 600000 </td>
<td> Sembuh </td>
<td> 2 </td>
<td> Sudah </td>
</tr>
<tr>
<td> 2022/07/30/000040 </td>
<td> 033282 </td>
<td> DIANA ENDAH RAHAYU, NY </td>
<td> P </td>
<td> BANYUWANGI </td>
<td> 1992-08-14 </td>
<td> 29 Th 11 Bl 16 Hr </td>
<td> BUDHA </td>
<td> D4 </td>
<td> NANDA JOTI RATANO, TN </td>
<td> SUAMI </td>
<td> PERUM DE GREEN KEDUNGREJO BLOK D16, KEDUNGREJO, PAKIS,
<td> BPJ </td>
<td> kelas 1 </td>
<td> P08 </td>
<td> 650000 </td>
<td> O34.2 </td>
<td> O34.2 </td>
<td> 2022-07-30 </td>
<td> 09:11:04 </td>
<td> 2022-08-01 </td>
<td> 10:17:38 </td>
<td> IGDK </td>
<td> 2022/07/30/000040, BPJS KLS 1, PANDAWA 8 KONFIRMASI RUANGAN
</td>
<td> 2 </td>
<td> 1 </td>
<td> 0 </td>
<td> 0 </td>
<td> 0 </td>
<td> 0 </td>
<td> Pasang KB IUD COOPER-T </td>
<td> 37-38 </td>

<td> 3200 </td>
<td> 49 </td>
<td> Hidup </td>
<td> Tidak </td>
<td> Hidup </td>
<td> Ya </td>
<td> Tidak </td>
<td> Ya </td>

<td> - </td>
<td> 1950000 </td>
<td> Sehat </td>
<td> 3 </td>
<td> Sudah </td>
</tr>
<tr>
<td> 2022/07/30/000060 </td>
<td> 107493 </td>
<td> JASMINKA HANNA KHADEEJAH, AN </td>
<td> P </td>
<td> MALANG </td>
<td> 2022-07-30 </td>
<td> ISLAM </td>
<td> - </td>
<td> ACHMAD SAIKHU, TN </td>
<td> AYAH </td>
<td> DUSUN JAJAR RT 1 RW10, TUNJUNGTIRTO, SINGOSARI, KABUPATEN
MALANG </td>
<td> BPJ </td>
<td> kelas 3 </td>
<td> PF22 </td>
<td> 300000 </td>
<td> P03.4 </td>
<td> P03.4 </td>
<td> 2022-07-30 </td>
<td> 09:00:26 </td>
<td> 2022-08-02 </td>
<td> 10:29:11 </td>
<td> U0030 </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> 2900 </td>
<td> 48 </td>
<td> Hidup </td>
<td> Tidak </td>
<td> Hidup </td>
<td> Ya </td>
<td> Tidak </td>
<td> Ya </td>

<td> - </td>
<td> 1200000 </td>
<td> Sembuh </td>
<td> 4 </td>
<td> Sudah </td>
</tr>
<tr>
<td> 2022/07/30/000057 </td>
<td> 107491 </td>
<td> DIANA ENDAH, BY NY </td>
<td> P </td>
<td> MALANG </td>
<td> 2022-07-30 </td>
<td> BUDHA </td>
<td> - </td>
<td> NANDA JOTI, TN </td>
<td> AYAH </td>
<td> PERUM DE GREEN KEDUNGREJO BLOK D16, KEDUNGREJO, PAKIS,
<td> BPJ </td>
<td> kelas 3 </td>
<td> PF21 </td>
<td> 300000 </td>
<td> P03.4 </td>
<td> P03.4 </td>
<td> 2022-07-30 </td>
<td> 08:34:48 </td>
<td> 2022-08-02 </td>
<td> 10:29:02 </td>
<td> U0030 </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> 3300 </td>
<td> 49 </td>
<td> Hidup </td>
<td> Tidak </td>
<td> Hidup </td>
<td> Ya </td>
<td> Tidak </td>
<td> Ya </td>

<td> - </td>
<td> 1200000 </td>
<td> Sembuh </td>
<td> 4 </td>
<td> Sudah </td>
</tr>
<tr>
<td> 2022/07/30/000053 </td>
<td> 107489 </td>
<td> MUHAMMAD SYARIF HIDAYATULLOH, AN </td>
<td> L </td>
<td> MALANG </td>
<td> 2022-07-30 </td>
<td> ISLAM </td>
<td> TS </td>
<td> SLAMET RIYADI, TN </td>
<td> AYAH </td>
<td> JL. CAKALANG NO 3 RT 4 RW 10, POLOWIJEN, BLIMBING, KOTA
MALANG </td>
<td> BPJ </td>
<td> kelas 3 </td>
<td> PF02 </td>
<td> 300000 </td>
<td> P03.4 </td>
<td> P03.4 </td>
<td> 2022-07-30 </td>
<td> 08:18:46 </td>
<td> 2022-08-02 </td>
<td> 10:28:52 </td>
<td> U0030 </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> 3000 </td>
<td> 48,5 </td>
<td> Hidup </td>
<td> Tidak </td>
<td> Hidup </td>
<td> Ya </td>
<td> Tidak </td>
<td> Ya </td>

<td> - </td>
<td> 1200000 </td>
<td> Sembuh </td>
<td> 4 </td>
<td> Sudah </td>
</tr>
<tr>
<td> 2022/07/30/000129 </td>
<td> 069880 </td>
<td> VANNISA AMALIA MEITA H,NY </td>
<td> P </td>
<td> MALANG </td>
<td> 1994-05-17 </td>
<td> 28 Th 2 Bl 14 Hr </td>
<td> ISLAM </td>
<td> SLTA/SEDERAJAT </td>
<td> VITO ADITYA HERMANTO,TN </td>
<td> SUAMI </td>
<td> DUSUN KEDAWUNG RT.04 RW.02, NGIJO, KARANGPLOSO, KABUPATEN
MALANG </td>
<td> BPJ </td>
<td> kelas 2 </td>
<td> H09 </td>
<td> 400000 </td>
<td> O42.9 </td>
<td> O82.0 </td>
<td> 2022-07-30 </td>
<td> 07:23:35 </td>
<td> 2022-08-02 </td>
<td> 09:41:20 </td>
<td> IGDK </td>
<td> 2022/07/30/000129, BPJS KLS 2 TITIP HASTINA 6, RUJUKAN BIDAN
LILIK YANUAR, Amd. Keb </td>
<td> 1 </td>
<td> 0 </td>
<td> 0 </td>
<td> 0 </td>
<td> 0 </td>
<td> 0 </td>
<td> 37-38 </td>

<td> 3000 </td>
<td> 46 </td>
<td> Hidup </td>
<td> Ya </td>
<td> Hidup </td>
<td> Ya </td>
<td> Tidak </td>
<td> Ya </td>

VT Bidan, NST, Operasional Rumah Sakit </td>
<td> - </td>
<td> 1600000 </td>
<td> Sehat </td>
<td> 4 </td>
<td> Sudah </td>
</tr>
<tr>
<td> 2022/07/30/000041 </td>
<td> 107487 </td>
<td> NESYA KURNIA, By,Ny </td>
<td> P </td>
<td> MALANG </td>
<td> 2022-07-30 </td>
<td> 0 Th 0 Bl -1 Hr </td>
<td> ISLAM </td>
<td> - </td>
<td> - </td>
<td> GUSTI MAULANA M,TN </td>
<td> AYAH </td>
<td> JL. SULTAN AGUNG RT.6 RW.3, KEPANJEN, KEPANJEN, KABUPATEN
MALANG </td>
<td> BPJ </td>
<td> kelas 3 </td>
<td> BFA02 </td>
<td> 300000 </td>
<td> P00.6 </td>
<td> P00.8 </td>
<td> 2022-07-30 </td>
<td> 06:01:29 </td>
<td> 2022-07-30 </td>
<td> 11:24:02 </td>
<td> U0030 </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> 3400 </td>
<td> 50 </td>
<td> Hidup </td>
<td> Tidak </td>
<td> Hidup </td>
<td> Ya </td>
<td> Tidak </td>
<td> Ya </td>

<td> 300000 </td>
<td> 1 </td>
<td> Belum </td>
</tr>
<tr>
<td> 2022/07/30/000034 </td>
<td> 107484 </td>
<td> ALI SYAKIR YAHYA, AN </td>
<td> L </td>
<td> MALANG </td>
<td> 2020-08-08 </td>
<td> 1 Th 11 Bl 22 Hr </td>
<td> ISLAM </td>
<td> - </td>
<td> ZAHIR YAHYA, TN </td>
<td> AYAH </td>
<td> PERUM GRAHA PELITA ASRI A32 RT 07 RW 10, PANDANWANGI,
<td> BPJ </td>
<td> kelas 1 </td>
<td> H04 </td>
<td> 650000 </td>
<td> R11 </td>
<td> R11 </td>
<td> 2022-07-30 </td>
<td> 02:28:00 </td>
<td> 2022-08-02 </td>
<td> 10:22:27 </td>
<td> IGDK </td>
<td> 2022/07/30/000034, BPJS KLS 1, HASTINA 4 . KCC YA GESSSS
</td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>

Visite Dokter Spesialis Anak, Infus Anak oleh Perawat / Bidan </td>
<td> </td>
<td> 2600000 </td>
<td> Sehat </td>
<td> 4 </td>
<td> Sudah </td>
</tr>
<tr>
<td> 2022/07/28/000079 </td>
<td> 072339 </td>
<td> MARIA KLARIZA PUTRI KRISDIANA, Ny </td>
<td> P </td>
<td> MALANG </td>
<td> 2002-03-31 </td>
<td> 20 Th 3 Bl 29 Hr </td>
<td> ISLAM </td>
<td> SMA </td>
<td> MUHAMMAD AFIF ABDUL AZIZ, Tn </td>
<td> SUAMI </td>
<td> JL. KYAI SOFYAN YUSUF NO 38 RT 02 RW 01, KEDUNGKANDANG,
<td> BPJ </td>
<td> kelas 3 </td>
<td> A09 </td>
<td> 300000 </td>
<td> O34.2 </td>
<td> O34.2 </td>
<td> 2022-07-29 </td>
<td> 23:39:22 </td>
<td> 2022-08-04 </td>
<td> 19:58:37 </td>
<td> IGDK </td>
<td> 2022/07/28/000079, BPJS KLS III DI AMARTA 3 (SEMENTARA
KARENA RUANGAN FULL) </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> Jasa Pelayanan Rumah Sakit , Visite Dokter Umum, Infus

Dewasa oleh Perawat / Bidan, Operasional Rumah Sakit </td>
<td> </td>
<td> 1800000 </td>
<td> 6 </td>
<td> Sudah </td>
</tr>
<tr>
<td> 2022/07/29/000144 </td>
<td> 027712 </td>
<td> NESYA KURNIAYANTI, NY </td>
<td> P </td>
<td> MALANG </td>
<td> 1994-11-25 </td>
<td> 27 Th 8 Bl 5 Hr </td>
<td> ISLAM </td>
<td> KARY. SWASTA </td>
<td> S1 </td>
<td> GUSTI MAULANA M, TN </td>
<td> SUAMI </td>
<td> JL. SULTAN AGUNG RT 6 RW 3, KEPANJEN, KEPANJEN, KABUPATEN
MALANG </td>
<td> BPJ </td>
<td> kelas 1 </td>
<td> K0000242 </td>
<td> KS IGD 5 </td>
<td> 650000 </td>
<td> O80.9 </td>
<td> O63.0 </td>
<td> 2022-07-29 </td>
<td> 22:39:37 </td>
<td> 2022-07-30 </td>
<td> 05:44:09 </td>
<td> IGDK </td>
<td> Klinik Melati </td>
<td> 2022/07/29/000144M, BPJS KELAS2 NP. TERKONFIRM COVID 19
TIDAK JADI DIRUJUK TAPI BAYI SDH LAHIR
- DENI </td>
<td> 2 </td>
<td> 1 </td>
<td> 0 </td>
<td> 0 </td>
<td> 0 </td>
<td> 0 </td>
<td> 39-40 </td>

<td> 3400 </td>
<td> 49 </td>
<td> Hidup </td>
<td> Tidak </td>
<td> Baik </td>
<td> Ya </td>
<td> Tidak </td>
<td> Ya </td>
<td> Oksigen 100% Sentral 9 LPM , Oksigen 100% Sentral 9 LPM ,

Oksigen 100% Sentral 9 LPM </td>
<td> - </td>
<td> 1300000 </td>
<td> Sembuh </td>
<td> 2 </td>
<td> Sudah </td>
</tr>
<tr>
<td> 2022/07/29/000157 </td>
<td> 054884 </td>
<td> INA SOFIANA, NY </td>
<td> P </td>
<td> BLITAR </td>
<td> 1985-10-25 </td>
<td> 36 Th 9 Bl 12 Hr </td>
<td> ISLAM </td>
<td> S1 </td>
<td> MUHAMMAD ALAIK, TN </td>
<td> SUAMI </td>
<td> JL. KLUWE PERUM ALAM SUBUR B 7 RT 02 RW 03, BUMIAYU,
<td> BPJ </td>
<td> kelas 1 </td>
<td> H03 </td>
<td> 650000 </td>
<td> O80.8 </td>
<td> O80.0 </td>
<td> 2022-07-29 </td>
<td> 18:30:27 </td>
<td> 2022-07-30 </td>
<td> 23:33:40 </td>
<td> IGDK </td>
<td> 2022/07/29/000157, BPJS KLAS 1 RUANG HASTINA 3 (KONFIRMASI)
</td>
<td> 5 </td>
<td> 2 </td>
<td> 0 </td>
<td> 0 </td>
<td> 2 </td>
<td> 0 </td>
<td> 40-41 </td>

<td> 3130 </td>
<td> 48 </td>
<td> Hidup </td>
<td> Ya </td>
<td> Hidup </td>
<td> Ya </td>
<td> Tidak </td>
<td> Ya </td>

VT Bidan, Hecting / Jahit Luka 1-3, Operasional Rumah Sakit </td>
<td> - </td>
<td> 1300000 </td>
<td> Sehat </td>
<td> 2 </td>
<td> Sudah </td>
</tr>
<tr>
<td> 2022/07/29/000073 </td>
<td> 066356 </td>
<td> KARINA PANORAMA MIRAZ, Ny </td>
<td> P </td>
<td> JAKARTA </td>
<td> 1988-02-28 </td>
<td> 34 Th 5 Bl 2 Hr </td>
<td> ISLAM </td>
<td> D3 </td>
<td> ACHMAD ZULHAM, Tn </td>
<td> SUAMI </td>
<td> PERUM HARMONY PLACE B-14 , SAPTORENGGO, PAKIS, KABUPATEN
MALANG </td>
<td> BPJ </td>
<td> kelas 2 </td>
<td> P02 </td>
<td> 400000 </td>
<td> O80.9 </td>
<td> O80.9 </td>
<td> 2022-07-29 </td>
<td> 18:02:56 </td>
<td> 2022-07-31 </td>
<td> 15:00:00 </td>
<td> IGDK </td>
<td> 2022/07/29/000073, BPJS KLS II TITIP DI KABER DULU RENCANA
DI AYODYA 1A (- KTP SUAMI) </td>
<td> 3 </td>
<td> 2 </td>
<td> 0 </td>
<td> 0 </td>
<td> 0 </td>
<td> 0 </td>
<td> 39-40 </td>

<td> 2905 </td>
<td> 47 </td>
<td> Hidup </td>
<td> Ya </td>
<td> Hidup </td>
<td> Ya </td>
<td> Tidak </td>
<td> Ya </td>

VT Bidan, VT Dokter , NST, Operasional Rumah Sakit </td>
<td> - </td>
<td> 1200000 </td>
<td> 3 </td>
<td> Sudah </td>
</tr>
<tr>
<td> 2022/07/29/000175 </td>
<td> 107480 </td>
<td> KHALISAH AZMIA, An </td>
<td> P </td>
<td> Malang </td>
<td> 2022-07-29 </td>
<td> ISLAM </td>
<td> - </td>
<td> MUHAMMAD ALAIK, TN </td>
<td> AYAH </td>
<td> JL. KLUWE PERUM ALAM SUBUR B 7 RT 02 RW 03, BUMIAYU,
<td> BPJ </td>
<td> kelas 3 </td>
<td> PF10 </td>
<td> 300000 </td>
<td> P00.6 </td>
<td> P00.9 </td>
<td> 2022-07-29 </td>
<td> 17:55:48 </td>
<td> 2022-07-30 </td>
<td> 20:44:36 </td>
<td> U0030 </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> 3130 </td>
<td> 48 </td>
<td> Hidup </td>
<td> Ya </td>
<td> Hidup </td>
<td> Ya </td>
<td> Tidak </td>
<td> Ya </td>

<td> - </td>
<td> 600000 </td>
<td> Sembuh </td>
<td> 2 </td>
<td> Sudah </td>
</tr>
<tr>
<td> 2022/07/29/000136 </td>
<td> 088976 </td>
<td> DIANA GEMITA PAMELIA, NY </td>
<td> P </td>
<td> Sangata </td>
<td> 1991-06-20 </td>
<td> 31 Th 1 Bl 16 Hr </td>
<td> ISLAM </td>
<td> S1 </td>
<td> M. Sulthonul Mubarok, Tn. </td>
<td> SUAMI </td>
<td> JL. RAYA KARANGLO 28 RT 85 RW 2, BANJARARUM, SINGOSARI,
<td> BPJ </td>
<td> kelas 1 </td>
<td> H01 </td>
<td> 650000 </td>
<td> O34.2 </td>
<td> O82.9 </td>
<td> 2022-07-29 </td>
<td> 14:34:20 </td>
<td> 2022-07-31 </td>
<td> 14:55:19 </td>
<td> IGDK </td>
<td> 2022/07/29/000136, BPJS KLS 1 HASTINA 1 </td>
<td> 2 </td>
<td> 1 </td>
<td> 0 </td>
<td> 0 </td>
<td> 0 </td>
<td> 0 </td>
<td> 37-38 </td>

<td> 3000 </td>
<td> 48 </td>
<td> Hidup </td>
<td> Tidak </td>
<td> Hidup </td>
<td> Ya </td>
<td> Tidak </td>
<td> Ya </td>

<td> - </td>
<td> 1950000 </td>
<td> 3 </td>
<td> Sudah </td>
</tr>
<tr>
<td> 2022/07/29/000151 </td>
<td> 107467 </td>
<td> DIANA GEMITA, BY NY </td>
<td> L </td>
<td> Malang </td>
<td> 2022-07-29 </td>
<td> ISLAM </td>
<td> TS </td>
<td> MUHAMMAD SULTHONUL MUBAROK, TN </td>
<td> AYAH </td>
<td> JL. RAYA KARANGLO 28 RT 85 RW 2, BANJARARUM, SINGOSARI,
<td> BPJ </td>
<td> kelas 3 </td>
<td> PF12 </td>
<td> 300000 </td>
<td> P03.4 </td>
<td> P03.4 </td>
<td> 2022-07-29 </td>
<td> 13:15:17 </td>
<td> 2022-07-31 </td>
<td> 08:30:02 </td>
<td> U0030 </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> 3000 </td>
<td> 48 </td>
<td> Hidup </td>
<td> Tidak </td>
<td> Hidup </td>
<td> Ya </td>
<td> Tidak </td>
<td> Ya </td>

<td> - </td>
<td> 900000 </td>
<td> Sembuh </td>
<td> 3 </td>
<td> Sudah </td>
</tr>
<tr>
<td> 2022/07/29/000128 </td>
<td> 070620 </td>
<td> MAXIMILLIAN AUSTIN SKY, AN </td>
<td> L </td>
<td> MALANG </td>
<td> 2021-06-08 </td>
<td> 1 Th 1 Bl 21 Hr </td>
<td> KRISTEN </td>
<td> - </td>
<td> DIMAS ADITYA SUSANTO, TN </td>
<td> AYAH </td>
<td> PERUM BUNUL ASRI JL. TARIKU III/A-25 RT 4 RW 19, BUNULREJO,
<td> BPJ </td>
<td> kelas 3 </td>
<td> A02 </td>
<td> 300000 </td>
<td> A09 </td>
<td> A09 </td>
<td> 2022-07-29 </td>
<td> 11:44:45 </td>
<td> 2022-07-31 </td>
<td> 13:18:14 </td>
<td> IGDK </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>

Konsultasi Dokter Umum(IGD) , Infus Bayi oleh Perawat / Bidan, Infus Bayi oleh
Perawat / Bidan, Infus Bayi oleh Perawat / Bidan, Infus Anak oleh Perawat / Bidan,
Infus Anak oleh Perawat / Bidan, Operasional Rumah Sakit </td>
<td> - </td>
<td> 900000 </td>
<td> 3 </td>
<td> Sudah </td>
</tr>
<tr>
<td> 2022/07/29/000189 </td>
<td> 088838 </td>
<td> AYESHA HANUN PUTRI EFFENDY, AN </td>
<td> P </td>
<td> MALANG </td>
<td> 2015-02-12 </td>
<td> 7 Th 5 Bl 23 Hr </td>
<td> ISLAM </td>
<td> TS </td>
<td> UFRON EFFENDY, TN </td>
<td> AYAH </td>
<td> JL. SEGARAN NO.45 RT 1 RW 10, ARDIMULYO, SINGOSARI,
<td> BPJ </td>
<td> kelas 2 </td>
<td> D01 </td>
<td> 400000 </td>
<td> R50.9 </td>
<td> R50.9 </td>
<td> 2022-07-29 </td>
<td> 10:56:12 </td>
<td> 2022-08-02 </td>
<td> 23:27:14 </td>
<td> IGDK </td>
<td> 2022/07/29/000189, BPJS KELAS 2 KONSERVATIF AYODYA 2B </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>

Visite Dokter Spesialis Anak, Visite Dokter Spesialis Anak, Visite Dokter Spesialis
Anak, Konsultasi Dokter Spesialis Anak Via Telepon, Infus Anak oleh Perawat /
<td> - </td>
<td> 2000000 </td>
<td> Sehat </td>
<td> 5 </td>
<td> Sudah </td>
</tr>
<tr>
<td> 2022/07/29/000146 </td>
<td> 079076 </td>
<td> SAFANIA ZABRINA RAHMADIANTI, NY </td>
<td> P </td>
<td> MALANG </td>
<td> 2003-08-04 </td>
<td> 18 Th 11 Bl 29 Hr </td>
<td> ISLAM </td>
<td> SMA </td>
<td> KRISNA INDRA MAHENDRA, TN </td>
<td> AYAH </td>
<td> JL. TELUK PELABUHAN RATU 46 C RT 09 RW 01, ARJOSARI,
<td> BPJ </td>
<td> kelas 2 </td>
<td> D06 </td>
<td> 400000 </td>
<td> O42.9 </td>
<td> O80.8 </td>
<td> 2022-07-29 </td>
<td> 10:36:46 </td>
<td> 2022-07-31 </td>
<td> 18:53:36 </td>
<td> IGDK </td>
<td> </td>
<td> 2022/07/29/000146, BPJS KSL 2, TITIP PANDAWA 2, KONFIRMASI
RUANGAN, AYODYA MENYUUSUL </td>
<td> 1 </td>
<td> 0 </td>
<td> 0 </td>
<td> 0 </td>
<td> 0 </td>
<td> 0 </td>
<td> 40-41 </td>
<td> 2730 </td>
<td> 50 </td>
<td> Hidup </td>
<td> Ya </td>
<td> Hidup </td>
<td> Ya </td>
<td> Tidak </td>
<td> Ya </td>
<td> Jasa Pelayanan Rumah Sakit, VT Bidan, Infus Dewasa Oleh

Dokter Umum </td>
<td> - </td>
<td> dr. NYOMAN LUWANG WISANA, Sp.OG. </td>
<td> 1200000 </td>
<td> Sembuh </td>
<td> 3 </td>
<td> Sudah </td>
</tr>
<tr>
<td> 2022/07/29/000076 </td>
<td> 070631 </td>
<td> DESSY MARDIKAWATI, NY </td>
<td> P </td>
<td> KUALA SIMPANG </td>
<td> 1981-12-09 </td>
<td> 40 Th 7 Bl 24 Hr </td>
<td> ISLAM </td>
<td> SMA </td>
<td> TNI </td>
<td> BAMBANG HERNANDA PRATOMO, TN </td>
<td> SUAMI </td>
<td> JALAN RAYA PAKIS RT 005 RW 003, SAPTORENGGO, PAKIS,
<td> BPJ </td>
<td> kelas 2 </td>
<td> A09 </td>
<td> 400000 </td>
<td> O82.9 </td>
<td> - </td>
<td> 2022-07-29 </td>
<td> 09:06:32 </td>
<td> 2022-07-29 </td>
<td> 20:52:59 </td>
<td> IGDK </td>
<td> 2022/07/29/000076, BPJS KELAS 2 TITIP KELAS 3 AMARTA 6C
TINDAKAN SC </td>
<td> 2 </td>
<td> 1 </td>
<td> 0 </td>
<td> 0 </td>
<td> 0 </td>
<td> 0 </td>
<td> 38-39 </td>

<td> 3300 </td>
<td> 49 </td>
<td> Hidup </td>
<td> Tidak </td>
<td> Hidup </td>
<td> Ya </td>
<td> Tidak </td>
<td> Ya </td>

<td> - </td>
<td> 800000 </td>
<td> 2 </td>
<td> Sudah </td>
</tr>
<tr>
<td> 2022/07/28/000158 </td>
<td> 049090 </td>
<td> INDRIA PUSPITA SARI, NY </td>
<td> P </td>
<td> MALANG </td>
<td> 1980-05-20 </td>
<td> 42 Th 2 Bl 13 Hr </td>
<td> ISLAM </td>
<td> S1 </td>
<td> SWASTA </td>
<td> BOBBY SATRIAWIBOWO TN </td>
<td> SUAMI </td>
<td> JL. URIP SUMAHARJO G58 RT01 RW08, KESATRIAN, BLIMBING, KOTA
MALANG </td>
<td> BPJ </td>
<td> kelas 1 </td>
<td> A08 </td>
<td> 650000 </td>
<td> N93.9 </td>
<td> - </td>
<td> 2022-07-29 </td>
<td> 08:31:01 </td>
<td> 2022-07-29 </td>
<td> 17:11:46 </td>
<td> IGDK </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>

<td> - </td>
<td> 1300000 </td>
<td> 2 </td>
<td> Sudah </td>
</tr>
<tr>
<td> 2022/07/29/000080 </td>
<td> 107451 </td>
<td> SYAKILA AZALEA AZZAHRA, AN </td>
<td> P </td>
<td> MALANG </td>
<td> 2022-07-29 </td>
<td> ISLAM </td>
<td> TS </td>
<td> TNI </td>
<td> BAMBANG HERNANDA PRATOMO, TN </td>
<td> AYAH </td>
<td> JALAN RAYA PAKIS RT 005 RW 004, SAPTORENGGO, PAKIS,
<td> BPJ </td>
<td> kelas 3 </td>
<td> PF01 </td>
<td> 300000 </td>
<td> P03.4 </td>
<td> P03.4 </td>
<td> 2022-07-29 </td>
<td> 05:47:42 </td>
<td> 2022-08-02 </td>
<td> 10:28:02 </td>
<td> U0030 </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> 3300 </td>
<td> 49 </td>
<td> Hidup </td>
<td> Tidak </td>
<td> Hidup </td>
<td> Ya </td>
<td> Tidak </td>
<td> Ya </td>
<td> Perawatan Bayi SC , Visite Dokter Spesialis Anak </td>

<td> - </td>
<td> 1500000 </td>
<td> Sembuh </td>
<td> 5 </td>
<td> Sudah </td>
</tr>
<tr>
<td> 2022/07/29/000078 </td>
<td> 027471 </td>
<td> SHIDQIA MAULIDIYAH, AN </td>
<td> P </td>
<td> Malang </td>
<td> 2019-11-13 </td>
<td> 2 Th 8 Bl 24 Hr </td>
<td> ISLAM </td>
<td> - </td>
<td> TS </td>
<td> GURU </td>
<td> YUSKI SUDANA, TN </td>
<td> AYAH </td>
<td> DSN KRAJAN RT 1 RW 1, SUMBERPASIR, PAKIS, KABUPATEN MALANG
</td>
<td> BPJ </td>
<td> kelas 3 </td>
<td> A01 </td>
<td> 300000 </td>
<td> R50.9 </td>
<td> A91 </td>
<td> 2022-07-29 </td>
<td> 02:27:21 </td>
<td> 2022-07-31 </td>
<td> 22:38:36 </td>
<td> IGDK </td>
<td> 2022/07/29/000078, BPJS KLS 3, AMARTA 8A KONFIRMASI RUANGAN.
GANTI AMARTA 1A JAM 23:40 </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> Jasa Pelayanan Rumah Sakit , Infus Anak oleh Perawat /

<td> - </td>
<td> 900000 </td>
<td> Sembuh </td>
<td> 3 </td>
<td> Sudah </td>
</tr>
<tr>
<td> 2022/07/28/000195 </td>
<td> 090061 </td>
<td> DEVI RATNA APRILIA, NY </td>
<td> P </td>
<td> MALANG </td>
<td> 1992-04-01 </td>
<td> 30 Th 4 Bl 4 Hr </td>
<td> ISLAM </td>
<td> S1 </td>
<td> HERRY SUDARTO, TN </td>
<td> SUAMI </td>
<td> JL. TELUK BAYUR 60 RT 06 RW 07, PANDANWANGI, BLIMBING, KOTA
MALANG </td>
<td> BPJ </td>
<td> kelas 1 </td>
<td> D06 </td>
<td> 650000 </td>
<td> O80.8 </td>
<td> O80.9 </td>
<td> 2022-07-28 </td>
<td> 23:34:12 </td>
<td> 2022-07-30 </td>
<td> 09:09:11 </td>
<td> IGDK </td>
<td> 2022/07/28/000197, BPJS KELAS 1 TITIP KELAS 2 AYODYA 3B
KONFIRMASI </td>
<td> 4 </td>
<td> 1 </td>
<td> 0 </td>
<td> 0 </td>
<td> 2 </td>
<td> 0 </td>
<td> 39-40 </td>

<td> 3950 </td>
<td> 52 </td>
<td> Hidup </td>
<td> Ya </td>
<td> Hidup </td>
<td> Ya </td>
<td> Tidak </td>
<td> Ya </td>

<td> - </td>
<td> 1300000 </td>
<td> 2 </td>
<td> Sudah </td>
</tr>
<tr>
<td> 2022/07/28/000159 </td>
<td> 057081 </td>
<td> ABBYANKA RAYYANZA AL-KHAWARIZMI, AN </td>
<td> L </td>
<td> MALANG </td>
<td> 2021-06-24 </td>
<td> 1 Th 1 Bl 11 Hr </td>
<td> ISLAM </td>
<td> - </td>
<td> ADI KURNIAWAN, TN </td>
<td> AYAH </td>
<td> JL. KOL SUGIONO 5 RT 05 RW 01, KEMANTREN, JABUNG, KABUPATEN
MALANG </td>
<td> BPJ </td>
<td> kelas 1 </td>
<td> H08 </td>
<td> 650000 </td>
<td> J18.0 </td>
<td> J18.0 </td>
<td> 2022-07-28 </td>
<td> 23:23:25 </td>
<td> 2022-07-31 </td>
<td> 12:00:00 </td>
<td> IGDK </td>
<td> 2022/07/28/000159, BPJS KLS 1, HASTINA 8, KONFIRMASI RUANGNA
</td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>

Visite Dokter Spesialis Anak, Visite Dokter Spesialis Anak, Infus Anak oleh Perawat
/ Bidan, Operasional Rumah Sakit </td>
<td> - </td>
<td> 1950000 </td>
<td> 3 </td>
<td> Sudah </td>
</tr>
<tr>
<td> 2022/07/28/000194 </td>
<td> 107441 </td>
<td> ADREENA NASHA SHAQEENA, AN </td>
<td> P </td>
<td> MALANG </td>
<td> 2021-10-31 </td>
<td> ISLAM </td>
<td> - </td>
<td> SEPTYANY PUJI RAHAYU, NY </td>
<td> AYAH </td>
<td> JL. WARINOI NO 2 RT 005 RW 014, BUNULREJO, BLIMBING, KOTA
MALANG </td>
<td> BPJ </td>
<td> kelas 3 </td>
<td> A12 </td>
<td> Amarta 2 </td>
<td> 300000 </td>
<td> R56.0 </td>
<td> R56.0 </td>
<td> 2022-07-28 </td>
<td> 23:11:27 </td>
<td> 2022-08-02 </td>
<td> 02:00:41 </td>
<td> IGDK </td>
<td> </td>
<td> 2022/07/28/000194, BPJS KLS 3, AMARTA 2 KONFIRMASI RUANGAN
(-) KTP ORANG TUA
PASIEN SUDAH DIKONSELING 3*24 JAM/ SBLM PASIEN PULANG UNTUK MENUNJUKKAN NO BPJS
AKTIF/ NIK UNTUK DI CEKKAN NO BPJS PASIEN. KONSLEING UMUM + BPJS
SUDAH DIKONSELING KE IBU PASIEN, ATAS NAMA SEPTYANY PUJI.
HIKMA
29/07/2022, 16:40 CETAK SEP BPJS KLAS 3 (ERSHA) </td>

<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>

Sewa Patient Monitor , Oksigen 100% Sentral 2 LPM, Infus Anak oleh Perawat / Bidan,
<td> - </td>
<td> 1500000 </td>
<td> 5 </td>
<td> Sudah </td>
</tr>
<tr>
<td> 2022/07/28/000197 </td>
<td> 107443 </td>
<td> ABERCIO HERLANGGA AL GHAZALI, AN </td>
<td> L </td>
<td> MALANG </td>
<td> 2022-07-28 </td>
<td> ISLAM </td>
<td> - </td>
<td> D3 </td>
<td> HERRY SUDARTO,TN </td>
<td> AYAH </td>
<td> JL. TELUK BAYUR 60 RT.06 RW.07, PANDANWANGI, BLIMBING, KOTA
MALANG </td>
<td> BPJ </td>
<td> kelas 3 </td>
<td> BFA05 </td>
<td> 300000 </td>
<td> P00.6 </td>
<td> P00.9 </td>
<td> 2022-07-28 </td>
<td> 22:33:23 </td>
<td> 2022-07-30 </td>
<td> 10:07:59 </td>
<td> U0030 </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> 3950 </td>
<td> 52 </td>
<td> Hidup </td>
<td> Ya </td>
<td> Hidup </td>
<td> Ya </td>
<td> Tidak </td>
<td> Ya </td>

<td> - </td>
<td> 600000 </td>
<td> Sembuh </td>
<td> 2 </td>
<td> Sudah </td>
</tr>
<tr>
<td> 2022/07/28/000094 </td>
<td> 054044 </td>
<td> DWI ARI ERNAWATI, NY </td>
<td> P </td>
<td> Malang </td>
<td> 1989-04-03 </td>
<td> 33 Th 4 Bl 1 Hr </td>
<td> ISLAM </td>
<td> SMA </td>
<td> VERDY WAHYU SETIA, TN </td>
<td> SUAMI </td>
<td> JL IKAN PIRANHA 3 RT1 RW 3 , PURWODADI, BLIMBING, KOTA
MALANG </td>
<td> BPJ </td>
<td> kelas 3 </td>
<td> A05 </td>
<td> 300000 </td>
<td> O80.8 </td>
<td> O80.9 </td>
<td> 2022-07-28 </td>
<td> 21:37:52 </td>
<td> 2022-07-30 </td>
<td> 08:39:10 </td>
<td> IGDK </td>
<td> 2022/07/28/000094 BPJS KELAS 3 DI AMARTA 5D </td>
<td> 2 </td>
<td> 1 </td>
<td> 0 </td>
<td> 0 </td>
<td> 0 </td>
<td> 0 </td>
<td> 35-36 </td>

<td> 2740 </td>
<td> 47 </td>
<td> Hidup </td>
<td> Ya </td>
<td> Hidup </td>
<td> Ya </td>
<td> Tidak </td>
<td> Ya </td>

Rumah Sakit </td>
<td> </td>
<td> 600000 </td>
<td> 2 </td>
<td> Sudah </td>
</tr>
<tr>
<td> 2022/07/28/000088 </td>
<td> 069277 </td>
<td> UMI MASITOH, NY </td>
<td> P </td>
<td> BOJONEGORO </td>
<td> 1984-02-11 </td>
<td> 38 Th 5 Bl 17 Hr </td>
<td> ISLAM </td>
<td> S1 </td>
<td> DWI PRIYO SURAHMAN, TN </td>
<td> SUAMI </td>
<td> DUSUN BINANGUN RT 2 RW 8 , BUMIAJI, BUMIAJI, KOTA BATU </td>
<td> BPJ </td>
<td> kelas 3 </td>
<td> A03 </td>
<td> 300000 </td>
<td> O80.8 </td>
<td> O82.0 </td>
<td> 2022-07-28 </td>
<td> 21:37:19 </td>
<td> 2022-07-30 </td>
<td> 23:38:48 </td>
<td> IGDK </td>
<td> 2022/07/28/000088, BPJS KLAS 3 AMARTA 5C </td>
<td> 3 </td>
<td> 2 </td>
<td> 0 </td>
<td> 0 </td>
<td> 0 </td>
<td> 0 </td>
<td> MOW POTONG </td>
<td> 34-36 </td>

<td> 2300 </td>
<td> 43 </td>
<td> Hidup </td>
<td> Ya </td>
<td> Hidup </td>
<td> Ya </td>
<td> Tidak </td>
<td> Ya </td>

Perawat / Bidan, NST, Konsultasi Dokter Spesialis Obgyn Via Telepon, Operasional
Rumah Sakit </td>
<td> - </td>
<td> 600000 </td>
<td> 2 </td>
<td> Sudah </td>
</tr>
<tr>
<td> 2022/07/28/000190 </td>
<td> 072524 </td>
<td> GAVIN ALVERO ARDIANSAH, AN </td>
<td> L </td>
<td> MALANG </td>
<td> 2022-07-19 </td>
<td> 0 Th 0 Bl 15 Hr </td>
<td> ISLAM </td>
<td> TS </td>
<td> BAMBANG ARDIANSAH, TN </td>
<td> AYAH </td>
<td> WONOREJO RT 017 RW 005, WONOREJO, PONCOKUSUMO, KABUPATEN
MALANG </td>
<td> BPJ </td>
<td> kelas 3 </td>
<td> IGD6 </td>
<td> KS IGD 6 </td>
<td> 300000 </td>
<td> P59.8 </td>
<td> P59.9 </td>
<td> 2022-07-28 </td>
<td> 20:53:22 </td>
<td> 2022-07-28 </td>
<td> 22:20:20 </td>
<td> U0002 </td>
<td> 2022/07/28/000190, BPJS KLS 3 NICU </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> Jasa Pelayanan Rumah Sakit , Sewa Fototerapi , Sewa

Fototerapi , Operasional Rumah Sakit </td>
<td> - </td>
<td> 300000 </td>
<td> Sembuh </td>
<td> 1 </td>
<td> Sudah </td>
</tr>
<tr>
<td> 2022/07/28/000145 </td>
<td> 072767 </td>
<td> ALIZA ELYINA HANANA, AN </td>
<td> P </td>
<td> MALANG </td>
<td> 2022-07-24 </td>
<td> ISLAM </td>
<td> - </td>
<td> IVAN AHSANUL INSAN, TN </td>
<td> AYAH </td>
<td> PERUM PIRANHA RESIDENCE A10 , TUNJUNGSEKAR, LOWOKWARU, KOTA
MALANG </td>
<td> BPJ </td>
<td> Kelas Intensif(Isolasi,ICU,NICU) </td>
<td> PA091 </td>
<td> KS NICU 9 </td>
<td> 400000 </td>
<td> R50.8 </td>
<td> P36.8 </td>
<td> 2022-07-28 </td>
<td> 18:09:51 </td>
<td> 2022-07-31 </td>
<td> 11:00:13 </td>
<td> IGDK </td>
<td> 2022/07/28/000145, BPJS KLS M3, OF H-1 NICU </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>

Visite Dokter Spesialis Anak, Sewa Infus Pump, Sewa Infus Pump, Sewa Infus Pump,
Sewa Syringe Pump, Sewa Syringe Pump, Sewa Syringe Pump, Infus Bayi oleh Perawat /
<td> - </td>
<td> 1600000 </td>
<td> 4 </td>
<td> Sudah </td>
</tr>
<tr>
<td> 2022/07/28/000133 </td>
<td> 019332 </td>
<td> ENDARU DZAKI PRASETYAWAN, AN </td>
<td> L </td>
<td> MALANG </td>
<td> 2019-06-09 </td>
<td> 3 Th 1 Bl 20 Hr </td>
<td> ISLAM </td>
<td> TS </td>
<td> RISCHRAT PRASETYAWAN, TN </td>
<td> AYAH </td>
<td> JL DANAU PANIAI DALAM II C7 C-24 RT 03/ RW 09, MADYOPURO,
<td> BPJ </td>
<td> kelas 2 </td>
<td> D03 </td>
<td> 400000 </td>
<td> R50.9 </td>
<td> R50.0 </td>
<td> 2022-07-28 </td>
<td> 18:07:56 </td>
<td> 2022-07-31 </td>
<td> 16:08:08 </td>
<td> IGDK </td>
<td> 2022/07/28/000133, BPJS KELAS 2 RUANG AYODYA 2A ( KONFIRMASI
) </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>

Visite Dokter Spesialis Anak, Konsultasi Dokter Spesialis Anak Via Telepon </td>
<td> - </td>
<td> 1600000 </td>
<td> Sehat </td>
<td> 4 </td>
<td> Sudah </td>
</tr>
<tr>
<td> 2022/07/28/000067 </td>
<td> 072888 </td>
<td> REYNATA AGNESIA, NY </td>
<td> P </td>
<td> PASURUAN </td>
<td> 2005-08-24 </td>
<td> 16 Th 11 Bl 4 Hr </td>
<td> HINDU </td>
<td> PETANI/PEKEBUN </td>
<td> SMP </td>
<td> SETIAWAN, TN </td>
<td> SUAMI </td>
<td> WONOKITRI RT 003 EW 002, WONOKITRI, TOSARI, PASURUAN KAB
</td>
<td> A09 </td>
<td> UMUM </td>
<td> kelas 3 </td>
<td> A04 </td>
<td> 300000 </td>
<td> O60.0 </td>
<td> - </td>
<td> 2022-07-28 </td>
<td> 15:03:26 </td>
<td> 2022-07-28 </td>
<td> 21:38:09 </td>
<td> IGDK </td>
<td> </td>
<td> 2022/07/28/000067, UMUM KLS III DI AMARTA 5B </td>
<td> 0 </td>
<td> 0 </td>
<td> 0 </td>
<td> 0 </td>
<td> 0 </td>
<td> 0 </td>
<td> 34-36 </td>

<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> VT Bidan, NST, Visite Dokter Spesialis Obgyn, Infus Dewasa

oleh Perawat / Bidan </td>
<td> - </td>
<td> 600000 </td>
<td> 2 </td>
<td> Sudah </td>
</tr>
<tr>
<td> 2022/07/27/000213 </td>
<td> 072879 </td>
<td> NUR INDAH RATNASARI, NY </td>
<td> P </td>
<td> MALANG </td>
<td> 1994-10-03 </td>
<td> 27 Th 9 Bl 25 Hr </td>
<td> ISLAM </td>
<td> S1 </td>
<td> HANIF SEPTIAWAN, TN </td>
<td> SUAMI </td>
<td> JL. KALIMOSODO XII 4A RT 006 RW 006, POLEHAN, BLIMBING, KOTA
MALANG </td>
<td> BPJ </td>
<td> kelas 2 </td>
<td> D01 </td>
<td> 400000 </td>
<td> O80.9 </td>
<td> O82.1 </td>
<td> 2022-07-28 </td>
<td> 14:41:31 </td>
<td> 2022-07-30 </td>
<td> 16:00:05 </td>
<td> IGDK </td>
<td> 2022/07/27/000213, BPJS KLS II DI AYODYA 3B </td>
<td> 1 </td>
<td> 0 </td>
<td> 0 </td>
<td> 0 </td>
<td> 0 </td>
<td> 0 </td>
<td> 38-39 </td>

<td> 3200 </td>
<td> 50 </td>
<td> Hidup </td>
<td> Tidak </td>
<td> Baik </td>
<td> Ya </td>
<td> Tidak </td>
<td> Ya </td>

VT Bidan, Infus Dewasa oleh Perawat / Bidan, Oksigen 100% Sentral 3 LPM, Oksigen
100% Sentral 3 LPM, NST, NST, Operasional Rumah Sakit </td>
<td> - </td>
<td> 1200000 </td>
<td> Sehat </td>
<td> 3 </td>
<td> Sudah </td>
</tr>
<tr>
<td> 2022/07/28/000103 </td>
<td> 072896 </td>
<td> TATIK, NY </td>
<td> P </td>
<td> MALANG </td>
<td> 1954-05-04 </td>
<td> 68 Th 2 Bl 30 Hr </td>
<td> ISLAM </td>
<td> - </td>
<td> IMAM WAHYU INDRAWAN, TN </td>
<td> SUAMI </td>
<td> JL TITAN V K8 RT 3 RW 22, PURWANTORO, BLIMBING, KOTA MALANG
</td>
<td> BPJ </td>
<td> kelas 2 </td>
<td> D06 </td>
<td> 400000 </td>
<td> R51 </td>
<td> - </td>
<td> 2022-07-28 </td>
<td> 13:58:40 </td>
<td> 2022-07-28 </td>
<td> 19:45:40 </td>
<td> IGDK </td>
<td> 2022/07/28/000103, BPJS KLAS 2 (MERTUA DR RIRIS HAK KLAS 1)
TITIP AYODYA 3 B </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> Jasa Pelayanan Rumah Sakit , Visite Dokter Spesialis

Penyakit Dalam, Visite Dokter Spesialis Penyakit Dalam, Infus Dewasa oleh Perawat /
Bidan, Konsultasi Dokter Spesialis Penyakit Dalam Via Telepon, EKG, Operasional
Rumah Sakit </td>
<td> - </td>
<td> dr. DEWI INDIASTARI, Sp.PD. </td>
<td> 400000 </td>
<td> 1 </td>
<td> Sudah </td>
</tr>
<tr>
<td> 2022/07/28/000134 </td>
<td> 107432 </td>
<td> KAYLA AZKIA MAHESWARI, AN </td>
<td> P </td>
<td> MALANG </td>
<td> 2022-07-28 </td>
<td> ISLAM </td>
<td> - </td>
<td> HANIF SEPTIAWAN, Tn </td>
<td> AYAH </td>
<td> JL. KALIMOSODO XII 4A RT 006 RW 006, POLEHAN, BLIMBING, KOTA
MALANG </td>
<td> BPJ </td>
<td> kelas 3 </td>
<td> PF18 </td>
<td> 300000 </td>
<td> P03.4 </td>
<td> P03.4 </td>
<td> 2022-07-28 </td>
<td> 13:18:19 </td>
<td> 2022-07-31 </td>
<td> 16:50:47 </td>
<td> U0030 </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> 3250 </td>
<td> 48 </td>
<td> Hidup </td>
<td> Tidak </td>
<td> Hidup </td>
<td> Ya </td>
<td> Tidak </td>
<td> Ya </td>
<td> Perawatan Bayi SC , Perawatan Bayi NP </td>

<td> </td>
<td> 1200000 </td>
<td> Sembuh </td>
<td> 4 </td>
<td> Sudah </td>
</tr>
<tr>
<td> 2022/07/28/000091 </td>
<td> 042398 </td>
<td> ELMAIRA SHAZIA ZALFA PERMANA, AN </td>
<td> P </td>
<td> MALANG </td>
<td> 2020-09-26 </td>
<td> 1 Th 10 Bl 8 Hr </td>
<td> ISLAM </td>
<td> - </td>
<td> - </td>
<td> GURU </td>
<td> ARIS TANDYA PERMANA PUTRA, TN </td>
<td> AYAH </td>
<td> JL ABDUL QODIR JAELANI 29 RT 1 RW 7, KEDUNGKANDANG,
<td> BPJ </td>
<td> kelas 3 </td>
<td> A10 </td>
<td> 300000 </td>
<td> R50.9 </td>
<td> - </td>
<td> 2022-07-28 </td>
<td> 13:06:14 </td>
<td> 2022-07-28 </td>
<td> 15:20:00 </td>
<td> IGDK </td>
<td> 2022/07/28/000091, BPJS KLAS 3 RUANG AMARTA 8A
28-7-2022 PUKUL 15:20, HIKMA

3 UP 2, PASIEN MNTA NAIK KELAS APS, TITIP HASTINA 8, KONFIRMASI RUANGAN
29-07-2022 PUKUL 19:04:20

TURUN KELAS 3 KARENA RUANGAN PENUH, PX BELUM PERNAH DIPINDAHKAN KE KELAS 2, ACC MAS
DIQIN
WIDI
</td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> Infus Anak oleh Perawat / Bidan </td>

<td> - </td>
<td> 300000 </td>
<td> 1 </td>
<td> Sudah </td>
</tr>
<tr>
<td> 2022/07/28/000062 </td>
<td> 061699 </td>
<td> MASIDA ROSITA, NY </td>
<td> P </td>
<td> BLITAR </td>
<td> 1980-07-08 </td>
<td> 42 Th 0 Bl 28 Hr </td>
<td> ISLAM </td>
<td> D1 </td>
<td> AMA PUJI MAHADIN, TN </td>
<td> SUAMI </td>
<td> PERUM GRAHA PELITA ASRIKATON RT 13 RW 5, ASRIKATON, PAKIS,
<td> BPJ </td>
<td> kelas 3 </td>
<td> A03 </td>
<td> 300000 </td>
<td> O42.9 </td>
<td> - </td>
<td> 2022-07-28 </td>
<td> 12:52:26 </td>
<td> 2022-07-28 </td>
<td> 21:36:52 </td>
<td> IGDK </td>
<td> 2022/07/28/000062, BPJS KELAS 3, AMARTA 5A </td>
<td> 4 </td>
<td> 3 </td>
<td> 0 </td>
<td> 0 </td>
<td> 0 </td>
<td> 0 </td>
<td> 39-40 </td>

<td> 2700 </td>
<td> 48 </td>
<td> Hidup </td>
<td> Ya </td>
<td> Hidup </td>
<td> Ya </td>
<td> Tidak </td>
<td> Ya </td>

Perawat / Bidan, Pasang Kateter Urin oleh Perawat / Bidan, NST, EKG, Operasional
Rumah Sakit </td>
<td> - </td>
<td> 600000 </td>
<td> 2 </td>
<td> Sudah </td>
</tr>
<tr>
<td> 2022/07/28/000130 </td>
<td> 107430 </td>
<td> JAVAS VERDY PRAYATA, AN </td>
<td> L </td>
<td> MALANG </td>
<td> 2022-07-28 </td>
<td> ISLAM </td>
<td> - </td>
<td> VERDY WAHYU SETIA, TN </td>
<td> AYAH </td>
<td> JL IKAN PIRANHA 3 RT 1 RW 3, PURWODADI, BLIMBING, KOTA
MALANG </td>
<td> BPJ </td>
<td> kelas 3 </td>
<td> PF10 </td>
<td> 300000 </td>
<td> P00.6 </td>
<td> P00.9 </td>
<td> 2022-07-28 </td>
<td> 12:42:26 </td>
<td> 2022-07-29 </td>
<td> 13:47:48 </td>
<td> U0030 </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> 2740 </td>
<td> 47 </td>
<td> Hidup </td>
<td> Ya </td>
<td> Hidup </td>
<td> Ya </td>
<td> Tidak </td>
<td> Ya </td>
<td> Perawatan Bayi NP , Visite Dokter Spesialis Anak,

Operasional Rumah Sakit , Jasa Pelayanan Rumah Sakit </td>
<td> - </td>
<td> 600000 </td>
<td> Sembuh </td>
<td> 2 </td>
<td> Sudah </td>
</tr>
<tr>
<td> 2022/07/28/000125 </td>
<td> 107428 </td>
<td> MASIDA ROSITA., BY NY </td>
<td> L </td>
<td> Malang </td>
<td> 2022-07-28 </td>
<td> ISLAM </td>
<td> D3 </td>
<td> AMA PUJI MAHAIN, TN </td>
<td> AYAH </td>
<td> PERUM GRAHA PELITA ASRIKATON RT 13 RW 15, ASRIKATON, PAKIS,
<td> BPJ </td>
<td> kelas 3 </td>
<td> PF16 </td>
<td> 300000 </td>
<td> P03.4 </td>
<td> P03.4 </td>
<td> 2022-07-28 </td>
<td> 11:22:08 </td>
<td> 2022-07-31 </td>
<td> 16:50:12 </td>
<td> U0030 </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> 2750 </td>
<td> 47 </td>
<td> Hidup </td>
<td> Tidak </td>
<td> Hidup </td>
<td> Ya </td>
<td> Tidak </td>
<td> Ya </td>

<td> - </td>
<td> 1200000 </td>
<td> Sembuh </td>
<td> 4 </td>
<td> Sudah </td>
</tr>
<tr>
<td> 2022/07/28/000120 </td>
<td> 107424 </td>
<td> UMI MASITOH., BY NY </td>
<td> P </td>
<td> MALANG </td>
<td> 2022-07-28 </td>
<td> ISLAM </td>
<td> D3 </td>
<td> AYAH </td>
<td> DUSUN BINANGUN RT 2 RW 8, BUMIAJI, BUMIAJI, KOTA BATU </td>
<td> BPJ </td>
<td> PA07 </td>
<td> NICU 7 </td>
<td> 400000 </td>
<td> P03.4 </td>
<td> P03.4 </td>
<td> 2022-07-28 </td>
<td> 10:29:34 </td>
<td> 2022-07-30 </td>
<td> 15:09:23 </td>
<td> U0029 </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> 2350 </td>
<td> 43 </td>
<td> Hidup </td>
<td> Tidak </td>
<td> Hidup </td>
<td> Ya </td>
<td> Tidak </td>
<td> Ya </td>
<td> Perawatan Bayi SC , Jasa Pelayanan Rumah Sakit, Visite

Dokter Spesialis Anak, Visite Dokter Spesialis Anak, Perawatan Infant Warmer,
Konsultasi Dokter Spesialis Anak Via Telepon, Konsultasi Dokter Spesialis Anak Via
Telepon, Operasional Rumah Sakit </td>
<td> - </td>
<td> 1200000 </td>
<td> Sembuh </td>
<td> 3 </td>
<td> Sudah </td>
</tr>
<tr>
<td> 2022/07/28/000075 </td>
<td> 072891 </td>
<td> SHAKILA MAULIDIYA, AN </td>
<td> P </td>
<td> Malang </td>
<td> 2021-10-16 </td>
<td> 0 Th 9 Bl 18 Hr </td>
<td> ISLAM </td>
<td> SD </td>
<td> JONI, TN </td>
<td> AYAH </td>
<td> JL. ABDILLAH GG II RT 01 RW 02, TIRTOMOYO, PAKIS, KABUPATEN
MALANG </td>
<td> BPJ </td>
<td> kelas 3 </td>
<td> A04 </td>
<td> 300000 </td>
<td> R11 </td>
<td> - </td>
<td> 2022-07-28 </td>
<td> 10:17:31 </td>
<td> 2022-07-28 </td>
<td> 21:39:29 </td>
<td> IGDK </td>
<td> 2022/07/28/000075, BPJS KLAS 3 RUANG AMARTA 5B, BPJS
MENYUSUL SUDAH DI KIE 3X24 JAM ATAU SEBELUM PX PULANG MAKA SBGAI PX UMUM (INFO ORTU
BPJSNYA BELUM DI UPDATE)
BPJS SUDAH AKTIF (29-07-2022) PUKUL 12:17, SUDAH CETAK SEP </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>

<td> - </td>
<td> 600000 </td>
<td> 2 </td>
<td> Sudah </td>
</tr>
<tr>
<td> 2022/07/28/000071 </td>
<td> 042955 </td>
<td> ATHALLAH MANNAF WIJAYA, AN </td>
<td> L </td>
<td> Malang </td>
<td> 2020-10-08 </td>
<td> 1 Th 9 Bl 25 Hr </td>
<td> ISLAM </td>
<td> - </td>
<td> SWASTA </td>
<td> SEKAR ZAM-ZAM, TN </td>
<td> AYAH </td>
<td> JL KESATRIAN TERUSAN BLOK C NO 6 RT 3 RW 8, KESATRIAN,
<td> BPJ </td>
<td> kelas 1 </td>
<td> P04 </td>
<td> 650000 </td>
<td> R11 </td>
<td> R11 </td>
<td> 2022-07-28 </td>
<td> 10:06:30 </td>
<td> 2022-08-01 </td>
<td> 06:09:09 </td>
<td> IGDK </td>
<td> 2022/07/28/000071, BPJS KLAS 1 RUANG PANDAWA 4 </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>

Anak, Infus Anak oleh Perawat / Bidan, Operasional Rumah Sakit </td>
<td> - </td>
<td> 3250000 </td>
<td> Sehat </td>
<td> 5 </td>
<td> Sudah </td>
</tr>
<tr>
<td> 2022/07/28/000080 </td>
<td> 090837 </td>
<td> WISMAN ARIYA MURTI, AN </td>
<td> L </td>
<td> MALANG </td>
<td> 2017-05-07 </td>
<td> 5 Th 2 Bl 21 Hr </td>
<td> ISLAM </td>
<td> TS </td>
<td> Swasta </td>
<td> Lingga Mahardika, Tn </td>
<td> AYAH </td>
<td> PERUMNAS JABUNG PERMAI RT008/RW001, KEMANTREN, JABUNG,
<td> BPJ </td>
<td> kelas 2 </td>
<td> A01 </td>
<td> 400000 </td>
<td> R11 </td>
<td> - </td>
<td> 2022-07-28 </td>
<td> 10:05:58 </td>
<td> 2022-07-29 </td>
<td> 23:38:59 </td>
<td> IGDK </td>
<td> 2022/07/28/000080, BPJS KLAS 2 TITIP AMARTA 1A (KONFIRMASI)
29/07/2022 PUKUL 19:51:38 BPJS KLAS 2 UP I RUANG HASTINA 4 (KONFIRMASI)

ERSHA </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>

<td> - </td>
<td> 800000 </td>
<td> 2 </td>
<td> Sudah </td>
</tr>
<tr>
<td> 2022/07/28/000111 </td>
<td> 072898 </td>
<td> MESHAL AL BARRA, An </td>
<td> L </td>
<td> MALANG </td>
<td> 2022-07-28 </td>
<td> ISLAM </td>
<td> - </td>
<td> HENDRA ADI SAPUTRA, TN </td>
<td> AYAH </td>
<td> JL TERMINAL GADANG RT 007 RW 004, GADANG, SUKUN, KOTA MALANG
</td>
<td> BPJ </td>
<td> PA06 </td>
<td> NICU 6 </td>
<td> 400000 </td>
<td> P03.4 </td>
<td> P03.4 </td>
<td> 2022-07-28 </td>
<td> 09:36:29 </td>
<td> 2022-07-30 </td>
<td> 20:53:07 </td>
<td> U0029 </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> 3100 </td>
<td> 51 </td>
<td> Hidup </td>
<td> Ya </td>
<td> Hidup </td>
<td> Ya </td>
<td> Tidak </td>
<td> Ya </td>

Dokter Spesialis Anak, Visite Dokter Spesialis Anak, Infus Bayi oleh Perawat /
<td> - </td>
<td> 1200000 </td>
<td> Sembuh </td>
<td> 3 </td>
<td> Sudah </td>
</tr>
<tr>
<td> 2022/07/28/000060 </td>
<td> 065485 </td>
<td> KHADIJAH RUMAISHA, AN </td>
<td> P </td>
<td> NGANJUK </td>
<td> 2021-09-07 </td>
<td> 0 Th 10 Bl 21 Hr </td>
<td> ISLAM </td>
<td> TS </td>
<td> PERIS SULIANTO, TN </td>
<td> AYAH </td>
<td> LESANPURO GG 8A, LESANPURO, KEDUNGKANDANG, KOTA MALANG </td>
<td> BPJ </td>
<td> kelas 3 </td>
<td> D12 </td>
<td> 300000 </td>
<td> E86 </td>
<td> A09 </td>
<td> 2022-07-28 </td>
<td> 06:25:55 </td>
<td> 2022-07-30 </td>
<td> 09:09:39 </td>
<td> IGDK </td>
<td> 2022/07/28/000060, BPJS KLS 3 TITIP DI AYODYA 6B DENDA 45
29-07-2022 06:44
CETAK SEP, WD </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> Jasa Pelayanan Rumah Sakit, Konsultasi Dokter Umum(IGD) ,

<td> </td>
<td> 900000 </td>
<td> 3 </td>
<td> Sudah </td>
</tr>
<tr>
<td> 2022/07/28/000161 </td>
<td> 107434 </td>
<td> ARKANA SHAKA ALVARENDRA, AN </td>
<td> L </td>
<td> Malang </td>
<td> 2021-09-09 </td>
<td> 0 Th 10 Bl 25 Hr </td>
<td> ISLAM </td>
<td> TS </td>
<td> BAHRUL ULLUM, TN </td>
<td> AYAH </td>
<td> JL. AHMAD YANI KEMANTREN RT 01 RW 03, KEMANTREN, JABUNG,
<td> A09 </td>
<td> UMUM </td>
<td> kelas 2 </td>
<td> A02 </td>
<td> 400000 </td>
<td> R11 </td>
<td> J03.9 </td>
<td> 2022-07-28 </td>
<td> 06:11:28 </td>
<td> 2022-07-29 </td>
<td> 06:24:50 </td>
<td> IGDK </td>
<td> </td>
<td> 2022/07/28/000161, UMUM KLS 2 AYODYA 4B </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> - </td>
<td> 800000 </td>
<td> Sembuh </td>
<td> 2 </td>
<td> Sudah </td>
</tr>
<tr>
<td> 2022/07/27/000204 </td>
<td> 079230 </td>
<td> ULIN SHARA, NY </td>
<td> P </td>
<td> KENDAL </td>
<td> 1992-08-01 </td>
<td> 30 Th 0 Bl 3 Hr </td>
<td> ISLAM </td>
<td> D3 </td>
<td> MULYADI, TN </td>
<td> SUAMI </td>
<td> PERUM. BUMI MONDOROKO RAYA GI/VI NO. 129 RT 11 RW 15 ,
WATUGEDE, SINGOSARI, KABUPATEN MALANG </td>
<td> BPJ </td>
<td> kelas 2 </td>
<td> H02 </td>
<td> 400000 </td>
<td> O82.9 </td>
<td> O82.9 </td>
<td> 2022-07-27 </td>
<td> 23:25:31 </td>
<td> 2022-07-30 </td>
<td> 09:28:34 </td>
<td> IGDK </td>
<td> 2022/07/27/000204, BP[JS KLS 2 KARYAWAN PURI BUNDA TITIP
HASTINA 2 </td>
<td> 2 </td>
<td> 1 </td>
<td> 0 </td>
<td> 0 </td>
<td> 0 </td>
<td> 0 </td>
<td> Pasang KB IUD NOVA-T </td>
<td> 39-40 </td>

<td> 3800 </td>
<td> 50 </td>
<td> Hidup </td>
<td> Tidak </td>
<td> Hidup </td>
<td> Ya </td>
<td> Tidak </td>
<td> Ya </td>

<td> - </td>
<td> 1200000 </td>
<td> 3 </td>
<td> Sudah </td>
</tr>
<tr>
<td> 2022/07/27/000157 </td>
<td> 063280 </td>
<td> SITI SUYATI, NY </td>
<td> P </td>
<td> MALANG </td>
<td> 1964-10-28 </td>
<td> 57 Th 9 Bl 0 Hr </td>
<td> ISLAM </td>
<td> GURU </td>
<td> S1 </td>
<td> SOPIR </td>
<td> HARI WAHONO, TN </td>
<td> SUAMI </td>
<td> JL. LA SUCIPTO GG TARUNA III/47-C RT 04 RW 03, PANDANWANGI,
<td> BPJ </td>
<td> kelas 1 </td>
<td> P03 </td>
<td> 650000 </td>
<td> J18.9 </td>
<td> J18.0 </td>
<td> 2022-07-27 </td>
<td> 23:22:32 </td>
<td> 2022-07-29 </td>
<td> 23:04:47 </td>
<td> IGDK </td>
<td> 2022/07/27/000157, BPJS KLS 1 PANDAWA 3 NATURAL FLOW </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> Jasa Pelayanan Rumah Sakit , Visite Dokter Spesialis

Penyakit Dalam, Visite Dokter Spesialis Penyakit Dalam, Infus Dewasa oleh Perawat /
Bidan, Oksigen 100% Sentral 10 LPM, Oksigen 100% Sentral 8 LPM , Oksigen 100%
Sentral 4 LPM , Oksigen 100% Sentral 3 LPM , Nebulizer , Operasional Rumah Sakit
</td>
<td> - </td>
<td> 1300000 </td>
<td> Rujuk </td>
<td> 2 </td>
<td> Sudah </td>
</tr>
<tr>
<td> 2022/07/27/000205 </td>
<td> 026788 </td>
<td> I PUTU RIVAN ADIAWAN, AN </td>
<td> L </td>
<td> Malang </td>
<td> 2019-10-29 </td>
<td> HINDU </td>
<td> - </td>
<td> - </td>
<td> TNI </td>
<td> I Wayan Indrawan, Tn </td>
<td> AYAH </td>
<td> ASMIL KIKAV 8 KOSTRAD RT 06 RW 07, KEMANTREN, JABUNG,
<td> BPJ </td>
<td> kelas 1 </td>
<td> H05 </td>
<td> 650000 </td>
<td> A09 </td>
<td> A09 </td>
<td> 2022-07-27 </td>
<td> 23:21:13 </td>
<td> 2022-07-30 </td>
<td> 09:42:53 </td>
<td> IGDK </td>
<td> </td>
<td> 2022/07/27/000205, BPJS KLS 2 UP 1 HASTINA 9 </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> - </td>
<td> 1950000 </td>
<td> 3 </td>
<td> Sudah </td>
</tr>
<tr>
<td> 2022/07/27/000209 </td>
<td> 072508 </td>
<td> AZLAN MAHASINUL HAQQ, AN </td>
<td> L </td>
<td> MALANG </td>
<td> 2022-07-18 </td>
<td> 0 Th 0 Bl 16 Hr </td>
<td> ISLAM </td>
<td> TS </td>
<td> GURU </td>
<td> AKHMAD FAUZAN ADHIMA, TN </td>
<td> AYAH </td>
<td> JL. TERNATE GG 1 NO 13 RT 005 RW 002, KASIN, KLOJEN, KOTA
MALANG </td>
<td> BPJ </td>
<td> PA04 </td>
<td> NICU 4 </td>
<td> 400000 </td>
<td> P59.9 </td>
<td> P59.9 </td>
<td> 2022-07-27 </td>
<td> 23:11:37 </td>
<td> 2022-07-29 </td>
<td> 20:01:32 </td>
<td> IGDK </td>
<td> 2022/07/27/000209, BPJS KLS 2 NICU FOTOTERAPI </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> Jasa Pelayanan Rumah Sakit, Visite Dokter Spesialis Anak,

Sewa Fototerapi, Operasional Rumah Sakit , Sewa Fototerapi </td>
<td> - </td>
<td> 800000 </td>
<td> 2 </td>
<td> Sudah </td>
</tr>
<tr>
<td> 2022/07/27/000207 </td>
<td> 072506 </td>
<td> SHABIRA ALULA KHANDRA, AN </td>
<td> P </td>
<td> MALANG </td>
<td> 2022-07-18 </td>
<td> 0 Th 0 Bl 11 Hr </td>
<td> ISLAM </td>
<td> - </td>
<td> SMP </td>
<td> CHANDRA PRASETIA PUTRA, TN </td>
<td> AYAH </td>
<td> JL. SOPONYONO NO. 18 RT 02 RW 02 SINGOSARI LOSARI, LOSARI,
<td> BPJ </td>
<td> PA01 </td>
<td> NICU 1 </td>
<td> 400000 </td>
<td> P59.9 </td>
<td> P59.9 </td>
<td> 2022-07-27 </td>
<td> 23:10:45 </td>
<td> 2022-07-29 </td>
<td> 18:43:15 </td>
<td> IGDK </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>

Sewa Fototerapi, Operasional Rumah Sakit , Sewa Fototerapi </td>
<td> </td>
<td> 800000 </td>
<td> 2 </td>
<td> Sudah </td>
</tr>
<tr>
<td> 2022/07/27/000218 </td>
<td> 072870 </td>
<td> MUHAMMAD HAIDAR SYAUQI, AN </td>
<td> L </td>
<td> MALANG </td>
<td> 2022-07-27 </td>
<td> ISLAM </td>
<td> - </td>
<td> - </td>
<td> MULYADI, TN </td>
<td> AYAH </td>
<td> PERUM BUMI MONDOROKO RAYA GI/VI NO.129 RT 11 RW 15 ,
WATUGEDE, SINGOSARI, KABUPATEN MALANG </td>
<td> BPJ </td>
<td> PA27 </td>
<td> 400000 </td>
<td> P03.4 </td>
<td> P91.6 </td>
<td> 2022-07-27 </td>
<td> 22:48:10 </td>
<td> 2022-07-30 </td>
<td> 11:06:57 </td>
<td> U0029 </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> 3800 </td>
<td> 50 </td>
<td> Hidup </td>
<td> Tidak </td>
<td> Baik </td>
<td> Ya </td>
<td> Tidak </td>
<td> Ya </td>

Dokter Spesialis Anak, Visite Dokter Spesialis Anak, Pasang Patient Monitor oleh
Dokter Umum / Perawat IGD , Pemasangan CPAP Hari Berikutnya, Pemasangan CPAP Hari
Berikutnya, Pemasangan CPAP Hari Pertama, Sewa Inkubator, Sewa Inkubator, Sewa
Inkubator, Sewa Inkubator, Sewa Patient Monitor , Sewa Patient Monitor , Pasang
NGT/OGT, Konsultasi Dokter Spesialis Anak Via Telepon, Operasional Rumah Sakit
</td>
<td> - </td>
<td> 1200000 </td>
<td> Sembuh </td>
<td> 3 </td>
<td> Sudah </td>
</tr>
<tr>
<td> 2022/07/27/000188 </td>
<td> 062241 </td>
<td> NUNGKI NURITA SARI, Ny </td>
<td> P </td>
<td> MALANG </td>
<td> 1989-08-11 </td>
<td> 32 Th 11 Bl 17 Hr </td>
<td> ISLAM </td>
<td> GURU </td>
<td> S1 </td>
<td> TNI </td>
<td> ARIS WAHYUDI, Tn </td>
<td> SUAMI </td>
<td> KOMPLEK AMARTA H-15 RT 04 RW 12, ASRIKATON, PAKIS, KABUPATEN
MALANG </td>
<td> BPJ </td>
<td> kelas 1 </td>
<td> H09 </td>
<td> 650000 </td>
<td> O82.9 </td>
<td> O82.9 </td>
<td> 2022-07-27 </td>
<td> 22:38:45 </td>
<td> 2022-07-30 </td>
<td> 09:00:00 </td>
<td> IGDK </td>
<td> 2 </td>
<td> 1 </td>
<td> 0 </td>
<td> 0 </td>
<td> 0 </td>
<td> 0 </td>
<td> 38-39 </td>

<td> 3200 </td>
<td> 49 </td>
<td> Hidup </td>
<td> Tidak </td>
<td> Hidup </td>
<td> Ya </td>
<td> Tidak </td>
<td> Ya </td>
<td> - </td>
<td> 1950000 </td>
<td> 3 </td>
<td> Sudah </td>
</tr>
<tr>
<td> 2022/07/27/000141 </td>
<td> 105080 </td>
<td> NIRMALA GYTA LAILA RAMADHANI, AN </td>
<td> P </td>
<td> MALANG </td>
<td> 2016-07-04 </td>
<td> 6 Th 0 Bl 28 Hr </td>
<td> ISLAM </td>
<td> TS </td>
<td> TNI - AD </td>
<td> SOGIMIN, TN </td>
<td> AYAH </td>
<td> ASRAMA YONIF PARA RAIDER 502 RT 08 RW 01, KEMANTREN, JABUNG,
<td> BPJ </td>
<td> kelas 2 </td>
<td> D09 </td>
<td> 400000 </td>
<td> R50.9 </td>
<td> R50.0 </td>
<td> 2022-07-27 </td>
<td> 22:29:35 </td>
<td> 2022-07-30 </td>
<td> 23:26:29 </td>
<td> U0002 </td>
<td> KLINIK YONIF 502/K </td>
<td> 2022/07/27/000141, BPJS KLS 2 AYODYA 5B KONFIRMASI
</td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>

</td>
<td> - </td>
<td> 1200000 </td>
<td> Sehat </td>
<td> 3 </td>
<td> Sudah </td>
</tr>
<tr>
<td> 2022/07/27/000177 </td>
<td> 055921 </td>
<td> LEONATHAN NAHAWIRA SARIK, AN </td>
<td> L </td>
<td> MALANG </td>
<td> 2021-08-10 </td>
<td> 0 Th 11 Bl 23 Hr </td>
<td> KRISTEN </td>
<td> TS </td>
<td> TNI </td>
<td> SILAS SARIK, Tn </td>
<td> AYAH </td>
<td> ASRAMA YONIF LINUD 502 RT 02 RW 08, KEMANTREN, JABUNG,
<td> BPJ </td>
<td> kelas 2 </td>
<td> D11 </td>
<td> 400000 </td>
<td> R50.9 </td>
<td> R50.9 </td>
<td> 2022-07-27 </td>
<td> 22:25:29 </td>
<td> 2022-07-29 </td>
<td> 20:50:59 </td>
<td> IGDK </td>
<td> 2022/07/27/000177, AYODYA 6A KONFIRMASI RUANGAN </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>

</td>
<td> - </td>
<td> 800000 </td>
<td> 2 </td>
<td> Sudah </td>
</tr>
<tr>
<td> 2022/07/27/000215 </td>
<td> 072872 </td>
<td> NUNGKI NURITA, By Ny </td>
<td> P </td>
<td> MALANG </td>
<td> 2022-07-27 </td>
<td> ISLAM </td>
<td> - </td>
<td> - </td>
<td> TNI </td>
<td> ARIS WAHYUDI, TN </td>
<td> AYAH </td>
<td> KOMPLEK AMARTA H-15 RT 4 RW 12 , ASRIKATON, PAKIS, KABUPATEN
MALANG </td>
<td> BPJ </td>
<td> kelas 3 </td>
<td> PF11 </td>
<td> 300000 </td>
<td> P03.4 </td>
<td> P03.4 </td>
<td> 2022-07-27 </td>
<td> 22:08:30 </td>
<td> 2022-07-30 </td>
<td> 10:07:34 </td>
<td> U0030 </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> 3200 </td>
<td> 49 </td>
<td> Hidup </td>
<td> Tidak </td>
<td> Hidup </td>
<td> Ya </td>
<td> Tidak </td>
<td> Ya </td>

<td> - </td>
<td> 900000 </td>
<td> Sembuh </td>
<td> 3 </td>
<td> Sudah </td>
</tr>
<tr>
<td> 2022/07/27/000178 </td>
<td> 009760 </td>
<td> CAMELIA GHOZALI, NY </td>
<td> P </td>
<td> MALANG </td>
<td> 1996-04-26 </td>
<td> 26 Th 3 Bl 9 Hr </td>
<td> ISLAM </td>
<td> SMA </td>
<td> GURU </td>
<td> LUKMAN, TN </td>
<td> SUAMI </td>
<td> JL. KAUMAN NO 276 RT 13 RW 2 , GONDANG KULON, GONDANGLEGI,
<td> A09 </td>
<td> UMUM </td>
<td> kelas 1 </td>
<td> P05 </td>
<td> 650000 </td>
<td> O82.9 </td>
<td> O82.9 </td>
<td> 2022-07-27 </td>
<td> 22:04:56 </td>
<td> 2022-07-30 </td>
<td> 09:30:00 </td>
<td> IGDK </td>
<td> </td>
<td> 2022/07/27/000178, UMUM KLS 1 PANDAWA 5 </td>
<td> 2 </td>
<td> 1 </td>
<td> 0 </td>
<td> 0 </td>
<td> 0 </td>
<td> 0 </td>
<td> 40-41 </td>
<td> 2600 </td>
<td> 48 </td>
<td> Hidup </td>
<td> Ya </td>
<td> Baik </td>
<td> Ya </td>
<td> Tidak </td>
<td> Ya </td>
<td> Operasional Rumah Sakit , Visite Dokter Spesialis Obgyn,

Visite Dokter Spesialis Obgyn, Visite Dokter Spesialis Obgyn, Jasa Pelayanan Rumah
Sakit </td>
<td> - </td>
<td> 1950000 </td>
<td> 3 </td>
<td> Sudah </td>
</tr>
<tr>
<td> 2022/07/27/000090 </td>
<td> 072852 </td>
<td> HERIS ALFIANA, NY </td>
<td> P </td>
<td> MALANG </td>
<td> 1994-12-20 </td>
<td> 27 Th 7 Bl 17 Hr </td>
<td> ISLAM </td>
<td> SMA </td>
<td> SAIFUL ANWAR, TN </td>
<td> SUAMI </td>
<td> DUSUN WANGKAL LOR RT 016 RW 004, ARGOSUKO, PONCOKUSUMO,
<td> BPJ </td>
<td> kelas 3 </td>
<td> A07 </td>
<td> 300000 </td>
<td> O80.8 </td>
<td> O80.8 </td>
<td> 2022-07-27 </td>
<td> 20:51:25 </td>
<td> 2022-07-30 </td>
<td> 06:45:13 </td>
<td> IGDK </td>
<td> 2022/07/27/000090,BPJS KELAS 3, AMARTA 5C </td>
<td> 2 </td>
<td> 1 </td>
<td> 0 </td>
<td> 0 </td>
<td> 0 </td>
<td> 0 </td>
<td> 35-36 </td>

<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> Visite Dokter Spesialis Obgyn, Visite Dokter Spesialis

Obgyn, VT Bidan, Infus Dewasa oleh Perawat / Bidan, NST </td>
<td> - </td>
<td> 1200000 </td>
<td> 4 </td>
<td> Sudah </td>
</tr>
<tr>
<td> 2022/07/27/000210 </td>
<td> 072875 </td>
<td> MUHAMMAD ABU BAKAR MASYHUR, An </td>
<td> L </td>
<td> MALANG </td>
<td> 2022-07-27 </td>
<td> ISLAM </td>
<td> - </td>
<td> - </td>
<td> GURU </td>
<td> LUKMAN, TN </td>
<td> AYAH </td>
<td> JL. KAUMAN RT 13 RW 2 , GONDANGLEGI KULON, GONDANGLEGI,
<td> A09 </td>
<td> UMUM </td>
<td> PA11 </td>
<td> 400000 </td>
<td> P03.4 </td>
<td> P39.9 </td>
<td> 2022-07-27 </td>
<td> 20:40:26 </td>
<td> 2022-07-30 </td>
<td> 09:20:34 </td>
<td> U0029 </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> Perawatan Bayi SC , Operasional Rumah Sakit , Jasa

Pelayanan Rumah Sakit , Visite Dokter Spesialis Anak, Visite Dokter Spesialis Anak,
Konsultasi Dokter Spesialis Anak Via Telepon, Infus Bayi oleh Perawat / Bidan </td>
<td> - </td>
<td> 1600000 </td>
<td> Sembuh </td>
<td> 4 </td>
<td> Sudah </td>
</tr>
<tr>
<td> 2022/07/27/000154 </td>
<td> 072862 </td>
<td> HAMDAN SIDKIL AMAL,AN </td>
<td> L </td>
<td> MALANG </td>
<td> 2019-03-01 </td>
<td> 3 Th 4 Bl 26 Hr </td>
<td> ISLAM </td>
<td> - </td>
<td> - </td>
<td> M.RIFAÌ,TN </td>
<td> AYAH </td>
<td> JEBUK SUMBERKRADENAN RT.09 RW.02, SUMBERKRADENAN, PAKIS,
<td> A09 </td>
<td> UMUM </td>
<td> A15 </td>
<td> 400000 </td>
<td> R56.0 </td>
<td> O80.0 </td>
<td> 2022-07-27 </td>
<td> 19:16:08 </td>
<td> 2022-07-30 </td>
<td> 06:44:40 </td>
<td> IGDK </td>
<td> </td>
<td> 2022/07/27/000154, UMUM KELAS 3 KONSERVATIF ICU </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> Oksigen 100% Sentral 2 LPM, Oksigen 100% Sentral 2 LPM,

Oksigen 100% Sentral 2 LPM, Visite Dokter Spesialis Anak, Visite Dokter Spesialis
Anak, Sewa Infus Pump, Sewa Infus Pump, Sewa Patient Monitor , Sewa Patient Monitor
, Sewa Patient Monitor , Sewa Patient Monitor , Oksigen 100% Sentral 14 LPM / Jam,
Oksigen 100% Sentral 10 LPM, Oksigen 100% Sentral 4 LPM , Konsultasi Dokter
Spesialis Anak Via Telepon, Konsultasi Dokter Spesialis Anak Via Telepon, Infus
Anak oleh Perawat / Bidan </td>
<td> - </td>
<td> 1600000 </td>
<td> 4 </td>
<td> Sudah </td>
</tr>
<tr>
<td> 2022/07/27/000118 </td>
<td> 070751 </td>
<td> NINIK TRIYANINGSIH, NY </td>
<td> P </td>
<td> MALANG </td>
<td> 1991-04-04 </td>
<td> 31 Th 3 Bl 28 Hr </td>
<td> ISLAM </td>
<td> D1 </td>
<td> SOFYAN NURHANUDIN, TN </td>
<td> SUAMI </td>
<td> JL. SIMPANG AKORDION 163 RT 9 RW 1, TUNGGULWULUNG,
<td> BPJ </td>
<td> kelas 2 </td>
<td> D02 </td>
<td> 400000 </td>
<td> O82.0 </td>
<td> O82.0 </td>
<td> 2022-07-27 </td>
<td> 14:46:02 </td>
<td> 2022-07-29 </td>
<td> 16:34:39 </td>
<td> IGDK </td>
<td> </td>
<td> 2022/07/27/000118, BPJS KELAS 2 SC AYODYA 6B </td>
<td> 3 </td>
<td> 2 </td>
<td> 0 </td>
<td> 0 </td>
<td> 0 </td>
<td> 0 </td>
<td> 37-38 </td>

<td> 2400 </td>
<td> 46 </td>
<td> Hidup </td>
<td> Tidak </td>
<td> Hidup </td>
<td> Ya </td>
<td> Tidak </td>
<td> Ya </td>

Dewasa oleh Perawat / Bidan, Konsultasi Dokter Spesialis Obgyn Via Telepon,
<td> </td>
<td> 1200000 </td>
<td> 3 </td>
<td> Sudah </td>
</tr>
<tr>
<td> 2022/07/27/000131 </td>
<td> 061924 </td>
<td> RETNO EKO LISTYOWATI, NY </td>
<td> P </td>
<td> NGANJUK </td>
<td> 1987-08-16 </td>
<td> 34 Th 11 Bl 11 Hr </td>
<td> ISLAM </td>
<td> - </td>
<td> - </td>
<td> JOHAN FERI, TN </td>
<td> SUAMI </td>
<td> SITIARJO RT 31 RW 06 , SITIARJO, SUMBERMANJING WETAN,
<td> BPJ </td>
<td> kelas 2 </td>
<td> D01 </td>
<td> 400000 </td>
<td> O82.0 </td>
<td> - </td>
<td> 2022-07-27 </td>
<td> 14:45:35 </td>
<td> 2022-07-27 </td>
<td> 22:01:04 </td>
<td> IGDK </td>
<td> </td>
<td> 2022/07/27/000131, BPJS KELAS 3 UP KELAS 2 AYODYA 6A
KONFIRMASI </td>
<td> 2 </td>
<td> 1 </td>
<td> 0 </td>
<td> 0 </td>
<td> 0 </td>
<td> 0 </td>
<td> 39-40 </td>

<td> 2800 </td>
<td> 48 </td>
<td> Hidup </td>
<td> Ya </td>
<td> Hidup </td>
<td> Ya </td>
<td> Tidak </td>
<td> Ya </td>
<td> </td>
<td> - </td>
<td> 800000 </td>
<td> 2 </td>
<td> Sudah </td>
</tr>
<tr>
<td> 2022/07/27/000134 </td>
<td> 061257 </td>
<td> AYU FITRIYA, Ny. </td>
<td> P </td>
<td> Malang </td>
<td> 1992-07-12 </td>
<td> 30 Th 0 Bl 20 Hr </td>
<td> ISLAM </td>
<td> SMA </td>
<td> Moh Alfan Zuhrufi, Tn </td>
<td> SUAMI </td>
<td> KRAJAN RT 1 RW 2, BUNUT WETAN, PAKIS, KABUPATEN MALANG </td>
<td> A09 </td>
<td> UMUM </td>
<td> kelas 1 </td>
<td> P07 </td>
<td> 650000 </td>
<td> O82.8 </td>
<td> O82.8 </td>
<td> 2022-07-27 </td>
<td> 14:44:36 </td>
<td> 2022-07-29 </td>
<td> 13:11:17 </td>
<td> IGDK </td>
<td> </td>
<td> 2022/07/27/000134 UMUM KELAS 1 DI PANDAWA 3 </td>
<td> 3 </td>
<td> 2 </td>
<td> 0 </td>
<td> 0 </td>
<td> 0 </td>
<td> 0 </td>
<td> 37-38 </td>

<td> 2900 </td>
<td> 49 </td>
<td> Hidup </td>
<td> Ya </td>
<td> Hidup </td>
<td> Ya </td>
<td> Tidak </td>
<td> Ya </td>
<td> Infus Dewasa oleh Perawat / Bidan, Konsultasi Dokter

Spesialis Obgyn Via Telepon </td>
<td> </td>
<td> 1950000 </td>
<td> 3 </td>
<td> Sudah </td>
</tr>
<tr>
<td> 2022/07/27/000160 </td>
<td> 072866 </td>
<td> RETNO EKO L, By.Ny </td>
<td> P </td>
<td> Malang </td>
<td> 2022-07-27 </td>
<td> ISLAM </td>
<td> - </td>
<td> - </td>
<td> JOHAN FERI, TN </td>
<td> AYAH </td>
<td> SITIARJO RT 31 RW 06 , SITIARJO, SUMBERMANJING WETAN,
<td> BPJ </td>
<td> kelas 3 </td>
<td> BF33 </td>
<td> 300000 </td>
<td> P03.4 </td>
<td> P03.4 </td>
<td> 2022-07-27 </td>
<td> 14:01:17 </td>
<td> 2022-07-29 </td>
<td> 13:47:35 </td>
<td> U0030 </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> 2800 </td>
<td> 48 </td>
<td> Hidup </td>
<td> Tidak </td>
<td> Hidup </td>
<td> Ya </td>
<td> Tidak </td>
<td> Ya </td>
<td> Perawatan Bayi SC , Operasional Rumah Sakit , Jasa

Pelayanan Rumah Sakit </td>
<td> </td>
<td> 900000 </td>
<td> Sembuh </td>
<td> 3 </td>
<td> Sudah </td>
</tr>
<tr>
<td> 2022/07/27/000159 </td>
<td> 072865 </td>
<td> ADIBA AQILA AZ ZAHRA, An </td>
<td> P </td>
<td> MALANG </td>
<td> 2022-07-27 </td>
<td> ISLAM </td>
<td> - </td>
<td> - </td>
<td> SOFYAN NURHANUDIN, TN </td>
<td> AYAH </td>
<td> JL. SIMPANG AKORDION 163 RT.9 RW.1, TUNGGULWULUNG,
<td> BPJ </td>
<td> kelas 3 </td>
<td> BFA05 </td>
<td> 300000 </td>
<td> P03.4 </td>
<td> P03.4 </td>
<td> 2022-07-27 </td>
<td> 13:59:36 </td>
<td> 2022-07-27 </td>
<td> 15:25:56 </td>
<td> U0030 </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> 2400 </td>
<td> 46 </td>
<td> Hidup </td>
<td> Tidak </td>
<td> Hidup </td>
<td> Ya </td>
<td> Tidak </td>
<td> Ya </td>

<td> - </td>
<td> 300000 </td>
<td> Sembuh </td>
<td> 1 </td>
<td> Sudah </td>
</tr>
<tr>
<td> 2022/07/27/000158 </td>
<td> 072864 </td>
<td> MUHAMMAD GHANI ZUHRUFI, AN </td>
<td> L </td>
<td> MALANG </td>
<td> 2022-07-27 </td>
<td> 0 Th 0 Bl 10 Hr </td>
<td> ISLAM </td>
<td> - </td>
<td> Moh Alfan Zuhrufi, Tn </td>
<td> AYAH </td>
<td> KRAJAN RT 1 RW 2, BUNUT WETAN, PAKIS, KABUPATEN MALANG </td>
<td> A09 </td>
<td> UMUM </td>
<td> kelas 3 </td>
<td> PF03 </td>
<td> 300000 </td>
<td> P03.4 </td>
<td> P03.4 </td>
<td> 2022-07-27 </td>
<td> 13:54:28 </td>
<td> 2022-07-29 </td>
<td> 13:47:12 </td>
<td> U0030 </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> 2900 </td>
<td> 49 </td>
<td> Hidup </td>
<td> Ya </td>
<td> Baik </td>
<td> Ya </td>
<td> Tidak </td>
<td> Ya </td>
<td> Perawatan Bayi SC , Operasional Rumah Sakit </td>

<td> - </td>
<td> 900000 </td>
<td> Sembuh </td>
<td> 3 </td>
<td> Sudah </td>
</tr>
<tr>
<td> 2022/07/27/000211 </td>
<td> 062257 </td>
<td> RIA EVA AGUSTIN, NY </td>
<td> P </td>
<td> LUMAJANG </td>
<td> 1993-08-03 </td>
<td> 28 Th 11 Bl 25 Hr </td>
<td> ISLAM </td>
<td> BIDAN </td>
<td> D3 </td>
<td> HENDRA ADI SAPUTRA, TN </td>
<td> SUAMI </td>
<td> JL. TERMINAL GADANG RT 007 RW 004, GADANG, SUKUN, KOTA
MALANG </td>
<td> BPJ </td>
<td> kelas 1 </td>
<td> H06 </td>
<td> 650000 </td>
<td> O80.9 </td>
<td> O80.0 </td>
<td> 2022-07-27 </td>
<td> 12:17:15 </td>
<td> 2022-07-30 </td>
<td> 23:33:29 </td>
<td> IGDK </td>
<td> 2022/07/27/000211, BPJS II UP I DI HASTINA 6
</td>
<td> 1 </td>
<td> 0 </td>
<td> 0 </td>
<td> 0 </td>
<td> 0 </td>
<td> 0 </td>
<td> 39-40 </td>

<td> 3400 </td>
<td> 51 </td>
<td> Hidup </td>
<td> Ya </td>
<td> Hidup </td>
<td> Ya </td>
<td> Tidak </td>
<td> Ya </td>
<td> VT Bidan, NST, NST, NST </td>

<td> - </td>
<td> 2600000 </td>
<td> Sehat </td>
<td> 4 </td>
<td> Sudah </td>
</tr>
<tr>
<td> 2022/07/27/000139 </td>
<td> 072859 </td>
<td> DEVITA AYU K, BY,NY </td>
<td> L </td>
<td> MALANG </td>
<td> 2022-07-27 </td>
<td> KATHOLIK </td>
<td> - </td>
<td> - </td>
<td> ALEXANDER AGUNG ADIATMA, TN </td>
<td> AYAH </td>
<td> JL. PAMALI 50 RT.5 RW.17, BUNULREJO, BLIMBING, KOTA MALANG
</td>
<td> BPJ </td>
<td> kelas 3 </td>
<td> PF24 </td>
<td> 300000 </td>
<td> P00.6 </td>
<td> P00.9 </td>
<td> 2022-07-27 </td>
<td> 11:29:58 </td>
<td> 2022-07-31 </td>
<td> 16:51:28 </td>
<td> U0030 </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> 3045 </td>
<td> 50 </td>
<td> Hidup </td>
<td> Ya </td>
<td> Hidup </td>
<td> Ya </td>
<td> Tidak </td>
<td> Ya </td>
<td> Perawatan Bayi NP , Jasa Pelayanan Rumah Sakit, Visite

Dokter Spesialis Anak, Operasional Rumah Sakit </td>
<td> - </td>
<td> 1500000 </td>
<td> Sembuh </td>
<td> 5 </td>
<td> Sudah </td>
</tr>
<tr>
<td> 2022/07/27/000173 </td>
<td> 002674 </td>
<td> ACHMAD FAIZ AL ARKHAN, AN </td>
<td> L </td>
<td> MALANG </td>
<td> 2018-06-25 </td>
<td> 4 Th 1 Bl 10 Hr </td>
<td> ISLAM </td>
<td> TS </td>
<td> PANJI QOMARUZZAMAU, TN </td>
<td> AYAH </td>
<td> JL. KEMBANG KERTAS NO 19 RT 6 RW 4, LOWOKWARU, LOWOKWARU,
KOTA MALANG </td>
<td> BPJ </td>
<td> kelas 2 </td>
<td> A12 </td>
<td> Amarta 2 </td>
<td> 400000 </td>
<td> R11 </td>
<td> J18.0 </td>
<td> 2022-07-27 </td>
<td> 08:32:15 </td>
<td> 2022-07-28 </td>
<td> 20:49:13 </td>
<td> IGDK </td>
<td> 2022/07/27/000173, BPJS KLS 3 AMARTA 1 A </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>

Nebulizer , Nebulizer , Konsultasi Dokter Spesialis Anak Via Telepon, Infus Anak
oleh Perawat / Bidan, Operasional Rumah Sakit </td>
<td> - </td>
<td> 800000 </td>
<td> Sembuh </td>
<td> 2 </td>
<td> Sudah </td>
</tr>
<tr>
<td> 2022/07/27/000087 </td>
<td> 072850 </td>
<td> ATHARA ALGHANI IBRAHIM, AN </td>
<td> L </td>
<td> MALANG </td>
<td> 2022-07-27 </td>
<td> ISLAM </td>
<td> TS </td>
<td> GUNTUR BAYU AJI, TN </td>
<td> AYAH </td>
<td> JL. GUNUNG KELOP RT 05 RW 07, DAMPIT, DAMPIT, KABUPATEN
MALANG </td>
<td> A09 </td>
<td> UMUM </td>
<td> kelas 3 </td>
<td> PF22 </td>
<td> 300000 </td>
<td> P00.6 </td>
<td> P00.9 </td>
<td> 2022-07-27 </td>
<td> 05:33:56 </td>
<td> 2022-07-31 </td>
<td> 16:50:58 </td>
<td> U0030 </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> 3680 </td>
<td> 52 </td>
<td> Hidup </td>
<td> Ya </td>
<td> Hidup </td>
<td> Ya </td>
<td> Tidak </td>
<td> Ya </td>
<td> Perawatan Bayi NP , Operasional Rumah Sakit </td>

<td> - </td>
<td> 1500000 </td>
<td> Sembuh </td>
<td> 5 </td>
<td> Sudah </td>
</tr>
<tr>
<td> 2022/07/26/000176 </td>
<td> 019240 </td>
<td> IDA BAGUS ARSYANENDRA, AN </td>
<td> L </td>
<td> MALANG </td>
<td> 2019-06-03 </td>
<td> 3 Th 1 Bl 23 Hr </td>
<td> HINDU </td>
<td> TS </td>
<td> Dosen </td>
<td> IDA BAGUS ANANTA WIJAYA, TN </td>
<td> AYAH </td>
<td> JL ANILA 2 NO 9 A/ 45 , SAWOJAJAR, KEDUNGKANDANG, KOTA
MALANG </td>
<td> BPJ </td>
<td> kelas 1 </td>
<td> H10 </td>
<td> 650000 </td>
<td> R11 </td>
<td> R11 </td>
<td> 2022-07-26 </td>
<td> 22:18:05 </td>
<td> 2022-07-29 </td>
<td> 19:46:00 </td>
<td> IGDK </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>

Visite Dokter Spesialis Anak, Konsultasi Dokter Spesialis Anak Via Telepon, Infus
Anak oleh Perawat / Bidan, Operasional Rumah Sakit </td>
<td> - </td>
<td> 1950000 </td>
<td> 3 </td>
<td> Sudah </td>
</tr>
<tr>
<td> 2022/07/26/000201 </td>
<td> 072845 </td>
<td> SAVIRA EKA PUTRI MUSYAVANI, AN </td>
<td> P </td>
<td> MALANG </td>
<td> 2012-06-16 </td>
<td> 10 Th 1 Bl 16 Hr </td>
<td> ISLAM </td>
<td> SD </td>
<td> - </td>
<td> RACHMAD BASUKI, TN </td>
<td> AYAH </td>
<td> DUSUN BENDO RT 24 RW 4, SUKOLILO, JABUNG, KABUPATEN MALANG
</td>
<td> A09 </td>
<td> UMUM </td>
<td> kelas 3 </td>
<td> A01 </td>
<td> 300000 </td>
<td> R50.9 </td>
<td> - </td>
<td> 2022-07-26 </td>
<td> 22:16:23 </td>
<td> 2022-07-26 </td>
<td> 23:40:44 </td>
<td> IGDK </td>
<td> </td>
<td> 2022/07/26/000201, BPJS KLS 3, TITIP AYODYA 5B KONFIRMASI
RUANGAN RENCAN AMARTA MENYUSUL. ORTU GAK BAWA KK, DICEK NIK AYAHNYA PUNYA BPJS PBI.
SUDAH KONSELING 3X24 JAM ATAU SEBELUM PLG MENJADI PX UMUM. YG DIKONSELING AYAH PX
(RACHMAD BASUKI, TN). TK </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> Jasa Pelayanan Rumah Sakit, Operasiaonal Rumah Sakit </td>

<td> </td>
<td> 300000 </td>
<td> 1 </td>
<td> Sudah </td>
</tr>
<tr>
<td> 2022/07/26/000187 </td>
<td> 056942 </td>
<td> KALEELA KHUMAIRAH FIRDAUSI NUZULA, An </td>
<td> P </td>
<td> MALANG </td>
<td> 2021-09-02 </td>
<td> 0 Th 11 Bl 2 Hr </td>
<td> ISLAM </td>
<td> - </td>
<td> VINKY NOVIAN DWI CAHYANTO, TN </td>
<td> AYAH </td>
<td> JL CAKALANG PERMAI NO RT 4 RW 6, POLOWIJEN, BLIMBING, KOTA
MALANG </td>
<td> BPJ </td>
<td> kelas 2 </td>
<td> D10 </td>
<td> 400000 </td>
<td> A09 </td>
<td> A09 </td>
<td> 2022-07-26 </td>
<td> 22:08:12 </td>
<td> 2022-07-31 </td>
<td> 18:53:05 </td>
<td> IGDK </td>
<td> 2022/07/26/000187, BPJS KLS 2, AYODYA 5A KONFIRMASI RUANGAN
</td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>

Anak, Infus Anak oleh Perawat / Bidan, Operasional Rumah Sakit </td>
<td> - </td>
<td> 2000000 </td>
<td> Sehat </td>
<td> 5 </td>
<td> Sudah </td>
</tr>
<tr>
<td> 2022/07/26/000181 </td>
<td> 072839 </td>
<td> ARUNA GENDHIS MAHESWARI, AN </td>
<td> P </td>
<td> MALANG </td>
<td> 2020-10-03 </td>
<td> 1 Th 9 Bl 23 Hr </td>
<td> ISLAM </td>
<td> - </td>
<td> HERMAWAN GALIH GUPITA, TN </td>
<td> AYAH </td>
<td> JL DOROWATI BARAT NO 54 RT 02 RW 01, MULYOARJO, LAWANG,
<td> BPJ </td>
<td> kelas 1 </td>
<td> H04 </td>
<td> 650000 </td>
<td> R50.9 </td>
<td> R50.9 </td>
<td> 2022-07-26 </td>
<td> 22:02:28 </td>
<td> 2022-07-29 </td>
<td> 19:46:00 </td>
<td> IGDK </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>

<td> </td>
<td> 1950000 </td>
<td> 3 </td>
<td> Sudah </td>
</tr>
<tr>
<td> 2022/07/26/000116 </td>
<td> 064450 </td>
<td> Dikky Fanala, Ny </td>
<td> P </td>
<td> Malang </td>
<td> 1998-04-22 </td>
<td> 24 Th 3 Bl 12 Hr </td>
<td> ISLAM </td>
<td> SMP </td>
<td> - </td>
<td> SOFIAN PRASETYA, TN </td>
<td> SUAMI </td>
<td> JL. WIROTO RT 07 RW 07, POLEHAN, BLIMBING, KOTA MALANG </td>
<td> A09 </td>
<td> UMUM </td>
<td> kelas 3 </td>
<td> A13 </td>
<td> 300000 </td>
<td> J45.9 </td>
<td> J45.9 </td>
<td> 2022-07-26 </td>
<td> 21:43:06 </td>
<td> 2022-07-28 </td>
<td> 20:49:35 </td>
<td> IGDK </td>
<td> </td>
<td> 2022/07/26/000116, UMUM KELAS 2 RUANG AYODYA 3B. PX GANTI
UMUM KLS 3 TGL 26/07/2022 JAM 14.10. GANTI RUANG ISOLASI AMARTA 3 . YG DIKONSELING
SUAMI. PX TIDAK PUNYA BPJS. TK </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>

Operasional Rumah Sakit , Infus Dewasa oleh Perawat / Bidan, Jasa Pelayanan Rumah
Sakit , Visite Dokter Spesialis Obgyn, Visite Dokter Spesialis Penyakit Dalam,
Konsultasi Dokter Spesialis Obgyn Via Telepon, Konsultasi Dokter Spesialis Penyakit
Dalam Via Telepon </td>
<td> - </td>
<td> 600000 </td>
<td> 2 </td>
<td> Sudah </td>
</tr>
<tr>
<td> 2022/07/26/000192 </td>
<td> 072630 </td>
<td> REYHAN ATHAILLAH SHAQUILLE CALIEF, AN </td>
<td> L </td>
<td> Malang </td>
<td> 2022-07-20 </td>
<td> 0 Th 0 Bl 11 Hr </td>
<td> ISLAM </td>
<td> - </td>
<td> MUHAMMAD NUR SOLEH, TN </td>
<td> AYAH </td>
<td> JL KI AGENG GRIIBIG V NO 30 RT 6 RW 5 , MADYOPURO,
<td> BPJ </td>
<td> PA091 </td>
<td> 400000 </td>
<td> P58.2 </td>
<td> P59.9 </td>
<td> 2022-07-26 </td>
<td> 19:37:18 </td>
<td> 2022-07-27 </td>
<td> 08:54:00 </td>
<td> IGDK </td>
<td> 2022/07/26/000192, BPJS KLS 3, NICU FOTOTERAPI </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>

Sewa Fototerapi, Sewa Fototerapi, Konsultasi Dokter Spesialis Anak Via Telepon,
<td> </td>
<td> 800000 </td>
<td> 2 </td>
<td> Sudah </td>
</tr>
<tr>
<td> 2022/07/26/000174 </td>
<td> 028837 </td>
<td> ZERINA SHAKILA NAFISA, AN </td>
<td> P </td>
<td> Malang </td>
<td> 2019-12-09 </td>
<td> 2 Th 7 Bl 23 Hr </td>
<td> ISLAM </td>
<td> - </td>
<td> - </td>
<td> SWASTA </td>
<td> WISNU RYAN, TN </td>
<td> AYAH </td>
<td> JL. INDRAGIRI IV/KAV 67 RT002/RW001, PURWANTORO, BLIMBING,
KOTA MALANG </td>
<td> BPJ </td>
<td> kelas 1 </td>
<td> H07 </td>
<td> 650000 </td>
<td> R11 </td>
<td> R11 </td>
<td> 2022-07-26 </td>
<td> 18:44:22 </td>
<td> 2022-07-29 </td>
<td> 19:46:00 </td>
<td> IGDK </td>
<td> 2022/07/26/000174, BPJS KLS 1, HASTINA 7 KONFIRMASI RUANGAN
</td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>

Spesialis Anak Via Telepon, Infus Anak oleh Perawat / Bidan, Operasional Rumah
Sakit </td>
<td> - </td>
<td> 2600000 </td>
<td> 4 </td>
<td> Sudah </td>
</tr>
<tr>
<td> 2022/07/26/000094 </td>
<td> 038470 </td>
<td> WARDAH CHOIRIYAH, NY </td>
<td> P </td>
<td> MALANG </td>
<td> 1990-02-10 </td>
<td> 32 Th 5 Bl 22 Hr </td>
<td> ISLAM </td>
<td> SMP </td>
<td> SWASTA </td>
<td> ACHMAD FARID SYADZALI, TN </td>
<td> SUAMI </td>
<td> JL. LA SUCIPTO GANG MAKAM 86 RT 10 RW 03, PANDANWANGI,
<td> BPJ </td>
<td> kelas 3 </td>
<td> A04 </td>
<td> 300000 </td>
<td> O80.8 </td>
<td> O80.8 </td>
<td> 2022-07-26 </td>
<td> 16:20:38 </td>
<td> 2022-07-27 </td>
<td> 22:48:03 </td>
<td> IGDK </td>
<td> 2022/07/26/000094 BPJS KELAS 3 DI AMARTA 5B </td>
<td> 4 </td>
<td> 2 </td>
<td> 0 </td>
<td> 0 </td>
<td> 1 </td>
<td> 0 </td>
<td> 39-40 </td>

<td> 2790 </td>
<td> 47 </td>
<td> Hidup </td>
<td> Ya </td>
<td> Hidup </td>
<td> Ya </td>
<td> Tidak </td>
<td> Ya </td>
<td> VT Bidan, VT Bidan, NST </td>

<td> </td>
<td> 600000 </td>
<td> 2 </td>
<td> Sudah </td>
</tr>
<tr>
<td> 2022/07/26/000167 </td>
<td> 072838 </td>
<td> ALMAHYRA ELSHANUM SYADZALI, AN </td>
<td> P </td>
<td> MALANG </td>
<td> 2022-07-26 </td>
<td> 0 Th 0 Bl 10 Hr </td>
<td> ISLAM </td>
<td> - </td>
<td> ACHMAD FARID SYADZALI, TN </td>
<td> AYAH </td>
<td> JL LA SUCIPTO GANG MAKAM 86 RT 10 RW 03, PANDANWANGI,
<td> BPJ </td>
<td> kelas 3 </td>
<td> BFA03 </td>
<td> 300000 </td>
<td> P00.6 </td>
<td> P00.9 </td>
<td> 2022-07-26 </td>
<td> 15:00:32 </td>
<td> 2022-07-27 </td>
<td> 20:49:46 </td>
<td> U0030 </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> 2790 </td>
<td> 47 </td>
<td> Hidup </td>
<td> Ya </td>
<td> Hidup </td>
<td> Ya </td>
<td> Tidak </td>
<td> Ya </td>

<td> - </td>
<td> 600000 </td>
<td> Sembuh </td>
<td> 2 </td>
<td> Sudah </td>
</tr>
<tr>
<td> 2022/07/26/000129 </td>
<td> 068375 </td>
<td> SIRRI RAHMANINGSIH, NY </td>
<td> P </td>
<td> PRINGGARATA </td>
<td> 1994-01-26 </td>
<td> 28 Th 6 Bl 6 Hr </td>
<td> ISLAM </td>
<td> S1 </td>
<td> TAUFIQ AINUR RIZQI, TN </td>
<td> SUAMI </td>
<td> JL. BOWLING NO. 13 RT 02 RW 01, TASIKMADU, LOWOKWARU, KOTA
MALANG </td>
<td> BPJ </td>
<td> kelas 1 </td>
<td> H05 </td>
<td> 650000 </td>
<td> N84.0 </td>
<td> N84.8 </td>
<td> 2022-07-26 </td>
<td> 14:53:05 </td>
<td> 2022-07-27 </td>
<td> 12:47:21 </td>
<td> IGDK </td>
<td> 2022/07/26/000129, BPJS KELAS 1 RUANG HASTINA 5 </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>

Bidan, Konsultasi Dokter Spesialis Obgyn Via Telepon, Operasional Rumah Sakit
</td>
<td> - </td>
<td> 1300000 </td>
<td> Sehat </td>
<td> 2 </td>
<td> Sudah </td>
</tr>
<tr>
<td> 2022/07/26/000131 </td>
<td> 065879 </td>
<td> ULIPAH, NY </td>
<td> P </td>
<td> BLITAR </td>
<td> 1984-04-01 </td>
<td> 38 Th 4 Bl 5 Hr </td>
<td> ISLAM </td>
<td> SMA </td>
<td> KHOIRUL ANAM, TN </td>
<td> SUAMI </td>
<td> JL. BINOR 6 NO.7 RT 8 RW 14 , BUNULREJO, BLIMBING, KOTA
MALANG </td>
<td> BPJ </td>
<td> kelas 3 </td>
<td> A08 </td>
<td> 300000 </td>
<td> O82.0 </td>
<td> O82.0 </td>
<td> 2022-07-26 </td>
<td> 14:52:29 </td>
<td> 2022-07-28 </td>
<td> 14:12:16 </td>
<td> IGDK </td>
<td> 2022/07/26/000131, BPJS KELAS3 RUANG AMARTA 5C </td>
<td> 3 </td>
<td> 2 </td>
<td> 0 </td>
<td> 0 </td>
<td> 0 </td>
<td> 0 </td>
<td> 39-40 </td>

<td> 3250 </td>
<td> 49 </td>
<td> Hidup </td>
<td> Tidak </td>
<td> Hidup </td>
<td> Ya </td>
<td> Tidak </td>
<td> Ya </td>

VT Bidan, Infus Dewasa oleh Perawat / Bidan, NST, Konsultasi Dokter Spesialis Obgyn
<td> - </td>
<td> 900000 </td>
<td> 3 </td>
<td> Sudah </td>
</tr>
<tr>
<td> 2022/07/26/000160 </td>
<td> 072836 </td>
<td> MUHAMMAD ANIS KHOIRUL ANAM, AN </td>
<td> L </td>
<td> MALANG </td>
<td> 2022-07-26 </td>
<td> ISLAM </td>
<td> TS </td>
<td> KHOIRUL ANAM, TN </td>
<td> AYAH </td>
<td> JL. BINOR 6 NO 7 RT 8 RW 14, BUNULREJO, BLIMBING, KOTA
MALANG </td>
<td> BPJ </td>
<td> kelas 3 </td>
<td> BFA02 </td>
<td> 300000 </td>
<td> P03.4 </td>
<td> P03.4 </td>
<td> 2022-07-26 </td>
<td> 14:07:10 </td>
<td> 2022-07-28 </td>
<td> 12:49:10 </td>
<td> U0030 </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> 3250 </td>
<td> 49 </td>
<td> Hidup </td>
<td> Tidak </td>
<td> Hidup </td>
<td> Ya </td>
<td> Tidak </td>
<td> Ya </td>
<td> Perawatan Bayi SC , Jasa Pelayanan Rumah Sakit, Operasional

Rumah Sakit </td>
<td> - </td>
<td> 900000 </td>
<td> Sembuh </td>
<td> 3 </td>
<td> Sudah </td>
</tr>
<tr>
<td> 2022/07/26/000199 </td>
<td> 041043 </td>
<td> DEVITA AYU KRISTINA, NY </td>
<td> P </td>
<td> MALANG </td>
<td> 1997-12-10 </td>
<td> 24 Th 7 Bl 17 Hr </td>
<td> KATHOLIK </td>
<td> SMA </td>
<td> ALEXANDER AGUNG ADIATMA, TN </td>
<td> SUAMI </td>
<td> JL PAMALI 50 RT 5 RW 17, BUNULREJO, BLIMBING, KOTA MALANG
</td>
<td> BPJ </td>
<td> kelas 3 </td>
<td> A09 </td>
<td> 300000 </td>
<td> O42.9 </td>
<td> O63.1 </td>
<td> 2022-07-26 </td>
<td> 12:55:38 </td>
<td> 2022-07-28 </td>
<td> 21:35:18 </td>
<td> IGDK </td>
<td> 2022/07/26/000199, AMARTA 6C BPJS KLS 3 </td>
<td> 2 </td>
<td> 1 </td>
<td> 0 </td>
<td> 0 </td>
<td> 0 </td>
<td> 0 </td>
<td> 40-41 </td>

<td> 3435 </td>
<td> 50 </td>
<td> Hidup </td>
<td> Ya </td>
<td> Hidup </td>
<td> Ya </td>
<td> Tidak </td>
<td> Ya </td>
<td> Jasa Pelayanan Rumah Sakit , VT Bidan, VT Dokter , NST,
<td> - </td>
<td> 900000 </td>
<td> Sembuh </td>
<td> 3 </td>
<td> Sudah </td>
</tr>
<tr>
<td> 2022/07/26/000091 </td>
<td> 072823 </td>
<td> SALSABILAH AZKA INARA PUTRI, AN </td>
<td> P </td>
<td> MALANG </td>
<td> 2015-06-11 </td>
<td> 7 Th 1 Bl 21 Hr </td>
<td> ISLAM </td>
<td> - </td>
<td> TUGIANTO, TN </td>
<td> AYAH </td>
<td> JL SEBUKU XXIII NO 34 RT 9 RW 8 , BUNULREJO, BLIMBING, KOTA
MALANG </td>
<td> BPJ </td>
<td> kelas 3 </td>
<td> A14 </td>
<td> 300000 </td>
<td> R50.8 </td>
<td> R50.8 </td>
<td> 2022-07-26 </td>
<td> 10:08:58 </td>
<td> 2022-07-29 </td>
<td> 06:10:55 </td>
<td> IGDK </td>
<td> 2022/07/26/000091, BPJS KELAS 3 RUANG AMARTA 4A </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>

<td> - </td>
<td> 1200000 </td>
<td> 4 </td>
<td> Sudah </td>
</tr>
<tr>
<td> 2022/07/26/000073 </td>
<td> 072818 </td>
<td> DIAN PUSPITA RINI, NY </td>
<td> P </td>
<td> MALANG </td>
<td> 1993-01-26 </td>
<td> 29 Th 6 Bl 7 Hr </td>
<td> ISLAM </td>
<td> S1 </td>
<td> WILDANUL MUIZ REGATRA, TN </td>
<td> SUAMI </td>
<td> JL. KYAI PARSEH JAYA GG KENIKIR INDAH RT 11 RW 1, BUMIAYU,
<td> BPJ </td>
<td> kelas 3 </td>
<td> A07 </td>
<td> 300000 </td>
<td> O80.9 </td>
<td> O80.8 </td>
<td> 2022-07-26 </td>
<td> 09:30:58 </td>
<td> 2022-07-27 </td>
<td> 22:47:40 </td>
<td> IGDK </td>
<td> 2022/07/26/000073, BPJS KLS 3 AMARTA 6A </td>
<td> 2 </td>
<td> 1 </td>
<td> 0 </td>
<td> 0 </td>
<td> 0 </td>
<td> 0 </td>
<td> 39-40 </td>

<td> 3075 </td>
<td> 50 </td>
<td> Hidup </td>
<td> Ya </td>
<td> Hidup </td>
<td> Ya </td>
<td> Tidak </td>
<td> Ya </td>
<td> Infus Dewasa oleh Perawat / Bidan </td>

<td> - </td>
<td> 600000 </td>
<td> 2 </td>
<td> Sudah </td>
</tr>
<tr>
<td> 2022/07/26/000097 </td>
<td> 072824 </td>
<td> ALARIC ALFAREEZIL REGATRA, AN </td>
<td> L </td>
<td> MALANG </td>
<td> 2022-07-26 </td>
<td> 0 Th 0 Bl 10 Hr </td>
<td> ISLAM </td>
<td> - </td>
<td> WILDANUL MUIZ REGATRA, TN </td>
<td> AYAH </td>
<td> JL KYAI PARSEH JAYA GG KENIKIR INDAH RT 11 RW 1 , BUMIAYU,
BUMIAYU, BATU KOTA </td>
<td> BPJ </td>
<td> kelas 3 </td>
<td> PF12 </td>
<td> 300000 </td>
<td> P00.6 </td>
<td> P00.9 </td>
<td> 2022-07-26 </td>
<td> 08:34:13 </td>
<td> 2022-07-27 </td>
<td> 16:43:15 </td>
<td> U0030 </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> 3075 </td>
<td> 50 </td>
<td> Hidup </td>
<td> Ya </td>
<td> Hidup </td>
<td> Ya </td>
<td> Tidak </td>
<td> Ya </td>

<td> - </td>
<td> 600000 </td>
<td> Sembuh </td>
<td> 2 </td>
<td> Sudah </td>
</tr>
<tr>
<td> 2022/07/26/000077 </td>
<td> 072821 </td>
<td> MUHAMMAD RAFISQY ALFARIZI, AN </td>
<td> L </td>
<td> MALANG </td>
<td> 2022-07-26 </td>
<td> ISLAM </td>
<td> - </td>
<td> - </td>
<td> ANDI HARTANTO, TN </td>
<td> AYAH </td>
<td> DSN PARIREJO RT 6 RW 1 , PARIJATAH WETAN, SRONO, BANYUWANGI
</td>
<td> BPJ </td>
<td> kelas 3 </td>
<td> PF01 </td>
<td> 300000 </td>
<td> P00.6 </td>
<td> P00.9 </td>
<td> 2022-07-26 </td>
<td> 06:18:50 </td>
<td> 2022-07-27 </td>
<td> 16:42:58 </td>
<td> U0030 </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> 3085 </td>
<td> 49 </td>
<td> Hidup </td>
<td> Ya </td>
<td> Hidup </td>
<td> Ya </td>
<td> Tidak </td>
<td> Ya </td>

<td> - </td>
<td> 600000 </td>
<td> Sembuh </td>
<td> 2 </td>
<td> Sudah </td>
</tr>
<tr>
<td> 2022/07/26/000204 </td>
<td> 094348 </td>
<td> VIVI AULA KUSUMA, NY </td>
<td> P </td>
<td> MALANG </td>
<td> 1986-02-08 </td>
<td> 36 Th 5 Bl 25 Hr </td>
<td> ISLAM </td>
<td> S1 </td>
<td> GUNTUR BAYU AJI, TN </td>
<td> SUAMI </td>
<td> JL. GUNUNG KELOP RT 05 RW 07, DAMPIT, DAMPIT, KABUPATEN
MALANG </td>
<td> BPJ </td>
<td> kelas 1 </td>
<td> H05 </td>
<td> 650000 </td>
<td> O63.1 </td>
<td> O63.1 </td>
<td> 2022-07-26 </td>
<td> 05:46:01 </td>
<td> 2022-07-27 </td>
<td> 18:06:25 </td>
<td> IGDK </td>
</td>
<td> 4 </td>
<td> 2 </td>
<td> 0 </td>
<td> 0 </td>
<td> 1 </td>
<td> 0 </td>
<td> 41-42 </td>

<td> 3680 </td>
<td> 52 </td>
<td> Hidup </td>
<td> Ya </td>
<td> Hidup </td>
<td> Ya </td>
<td> Tidak </td>
<td> Ya </td>
<td> Visite Dokter Spesialis Obgyn, VT Bidan, NST </td>

<td> - </td>
<td> 1300000 </td>
<td> Sembuh </td>
<td> 2 </td>
<td> Sudah </td>
</tr>
<tr>
<td> 2022/07/25/000240 </td>
<td> 012917 </td>
<td> ROHICHUL MACHTUM, AN </td>
<td> L </td>
<td> MALANG </td>
<td> 2015-04-16 </td>
<td> 7 Th 3 Bl 14 Hr </td>
<td> ISLAM </td>
<td> TS </td>
<td> Edy Sanjaya, Tn </td>
<td> AYAH </td>
<td> JL PEMANDIAN WENDIT RT 04/ RW 05, MANGLIAWAN, PAKIS,
<td> A09 </td>
<td> UMUM </td>
<td> kelas 3 </td>
<td> A16 </td>
<td> 300000 </td>
<td> A91 </td>
<td> A91 </td>
<td> 2022-07-25 </td>
<td> 22:07:48 </td>
<td> 2022-07-30 </td>
<td> 12:28:35 </td>
<td> IGDK </td>
<td> </td>
<td> 2022/07/25/000240, UMUM KLS 3 AMARTA 7A </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> Operasional Rumah Sakit , Visite Dokter Spesialis Anak,

Visite Dokter Spesialis Anak, Konsultasi Dokter Spesialis Anak Via Telepon, Jasa
Pelayanan Kelas 3 </td>
<td> - </td>
<td> 1500000 </td>
<td> 5 </td>
<td> Sudah </td>
</tr>
<tr>
<td> 2022/07/25/000239 </td>
<td> 026740 </td>
<td> MUHAMMAD ABIZAR AL GHIFARI ,An </td>
<td> L </td>
<td> Sampang </td>
<td> 2018-10-03 </td>
<td> 3 Th 10 Bl 1 Hr </td>
<td> ISLAM </td>
<td> - </td>
<td> Alin Romsa Putra, Tn </td>
<td> AYAH </td>
<td> JL. LESANPURO B1 RT08 RW03, LESANPURO, KEDUNGKANDANG, KOTA
MALANG </td>
<td> BPJ </td>
<td> kelas 3 </td>
<td> A14 </td>
<td> 300000 </td>
<td> A91 </td>
<td> - </td>
<td> 2022-07-25 </td>
<td> 22:07:32 </td>
<td> 2022-07-27 </td>
<td> 22:48:26 </td>
<td> IGDK </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> Menyeka Pasien , Menyeka Pasien , Jasa Pelayanan Rumah
Sakit , Visite Dokter Spesialis Anak, Visite Dokter Spesialis Anak, Visite Dokter
Spesialis Anak, Sewa Infus Pump, Sewa Infus Pump, Sewa Patient Monitor , Sewa
Patient Monitor , Oksigen 100% Sentral 2 LPM, Oksigen 100% Sentral 2 LPM, Oksigen
100% Sentral 2 LPM, Oksigen 100% Sentral 2 LPM, Konsultasi Dokter Spesialis Anak
Via Telepon, Konsultasi Dokter Spesialis Anak Via Telepon, Konsultasi Dokter
Sakit </td>
<td> </td>
<td> 900000 </td>
<td> 3 </td>
<td> Sudah </td>
</tr>
<tr>
<td> 2022/07/25/000068 </td>
<td> 093131 </td>
<td> RIZKY DWI KURNIASIH, NY </td>
<td> P </td>
<td> MALANG </td>
<td> 1991-07-24 </td>
<td> 31 Th 0 Bl 8 Hr </td>
<td> ISLAM </td>
<td> GURU </td>
<td> S1 </td>
<td> MUHAMMAD WILDAN, TN </td>
<td> SUAMI </td>
<td> JL. SIMPANG PANJI SUROSO I / 34 A RT 08 RW 07, BLIMBING,
<td> BPJ </td>
<td> kelas 2 </td>
<td> D01 </td>
<td> 400000 </td>
<td> O82.8 </td>
<td> O82.8 </td>
<td> 2022-07-25 </td>
<td> 22:07:21 </td>
<td> 2022-07-27 </td>
<td> 22:37:29 </td>
<td> IGDK </td>
<td> 2022/07/25/000068, BPJS KLAS 2 RUANG AYODYA 1B </td>
<td> 1 </td>
<td> 0 </td>
<td> 0 </td>
<td> 0 </td>
<td> 0 </td>
<td> 0 </td>
<td> 39-40 </td>

<td> 3300 </td>
<td> 49 </td>
<td> Hidup </td>
<td> Ya </td>
<td> Hidup </td>
<td> Ya </td>
<td> Tidak </td>
<td> Ya </td>

Visite Dokter Spesialis Obgyn, Operasional Rumah Sakit </td>
<td> - </td>
<td> 800000 </td>
<td> 2 </td>
<td> Sudah </td>
</tr>
<tr>
<td> 2022/07/25/000241 </td>
<td> 072806 </td>
<td> PRINCESS FLORENCIA KIMBERLY, AN </td>
<td> P </td>
<td> Malang </td>
<td> 2012-05-13 </td>
<td> 10 Th 2 Bl 17 Hr </td>
<td> KRISTEN </td>
<td> SD </td>
<td> - </td>
<td> GRACE KARTIKA HALIM, NY </td>
<td> IBU </td>
<td> PERUM GRAHA PELITA ASRIKATON BLOK D. NO. 14 RT 16 RW 05,
ASRIKATON, PAKIS, KABUPATEN MALANG </td>
<td> A09 </td>
<td> UMUM </td>
<td> kelas 3 </td>
<td> A17 </td>
<td> 300000 </td>
<td> A91 </td>
<td> A91 </td>
<td> 2022-07-25 </td>
<td> 22:07:10 </td>
<td> 2022-07-30 </td>
<td> 12:29:21 </td>
<td> IGDK </td>
<td> </td>
<td> 2022/07/25/000241,UMUM KLS 3, AMARTA 7B </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>

Spesialis Anak Via Telepon </td>
<td> - </td>
<td> 1500000 </td>
<td> 5 </td>
<td> Sudah </td>
</tr>
<tr>
<td> 2022/07/25/000071 </td>
<td> 072755 </td>
<td> AGMENIA AYU YUNITHA, Ny </td>
<td> P </td>
<td> Malang </td>
<td> 1997-06-11 </td>
<td> 25 Th 1 Bl 20 Hr </td>
<td> ISLAM </td>
<td> S1 </td>
<td> ARSITEK </td>
<td> ARI ADITYA P., Tn </td>
<td> SUAMI </td>
<td> PERUM BUMI PALAPA BLOK G NO 3 RT 01 RW 11, JATIMULYO,
<td> BPJ </td>
<td> kelas 2 </td>
<td> D02 </td>
<td> 400000 </td>
<td> O80.8 </td>
<td> O82.9 </td>
<td> 2022-07-25 </td>
<td> 10:18:00 </td>
<td> 2022-07-27 </td>
<td> 12:27:53 </td>
<td> IGDK </td>
<td> DR. I WAYAN SP.OG </td>
<td> 2022/07/25/000071, BPJS KLAS 2 RUANG AYODYA 1A (KONFIRMASI)
</td>
<td> 1 </td>
<td> 0 </td>
<td> 0 </td>
<td> 0 </td>
<td> 0 </td>
<td> 0 </td>
<td> 40-41 </td>

<td> 3350 </td>
<td> 50 </td>
<td> Hidup </td>
<td> Tidak </td>
<td> Hidup </td>
<td> Ya </td>
<td> Tidak </td>
<td> Ya </td>
<td> Visite Dokter Spesialis Obgyn </td>
<td> - </td>
<td> 1200000 </td>
<td> 3 </td>
<td> Sudah </td>
</tr>
<tr>
<td> 2022/07/25/000070 </td>
<td> 064515 </td>
<td> LUSI INDRIANI, NY </td>
<td> P </td>
<td> MALANG </td>
<td> 1982-02-02 </td>
<td> 40 Th 5 Bl 29 Hr </td>
<td> ISLAM </td>
<td> D3 </td>
<td> GURU </td>
<td> ANDI PRASETYO, TN </td>
<td> SUAMI </td>
<td> JL. DANAU MANINJAU DALAM VI / B2 F21 RT 05 RW 09, SAWOJAJAR,
<td> BPJ </td>
<td> kelas 3 </td>
<td> A03 </td>
<td> 300000 </td>
<td> O80.9 </td>
<td> O82.8 </td>
<td> 2022-07-25 </td>
<td> 10:15:59 </td>
<td> 2022-07-27 </td>
<td> 22:48:12 </td>
<td> IGDK </td>
<td> 2022/07/25/000070, bpjs kls 3 amarta 5a </td>
<td> 3 </td>
<td> 2 </td>
<td> 0 </td>
<td> 0 </td>
<td> 0 </td>
<td> 0 </td>
<td> 36 </td>
<td> 2200 </td>
<td> 46 </td>
<td> Hidup </td>
<td> Tidak </td>
<td> Hidup </td>
<td> Ya </td>
<td> Tidak </td>
<td> Ya </td>

<td> - </td>
<td> 900000 </td>
<td> 3 </td>
<td> Sudah </td>
</tr>
<tr>
<td> 2022/07/25/000135 </td>
<td> 072796 </td>
<td> AYLEEN ADITYA CALANDRA, An </td>
<td> P </td>
<td> MALANG </td>
<td> 2022-07-25 </td>
<td> 0 Th 0 Bl 12 Hr </td>
<td> ISLAM </td>
<td> TS </td>
<td> ARSITEK </td>
<td> ARI ADITYA P., Tn </td>
<td> AYAH </td>
<td> PERUM BUMI PALAPA BLOK G NO 3 RT 001 RW 011, JATIMULYO,
<td> BPJ </td>
<td> kelas 3 </td>
<td> BPF01 </td>
<td> 300000 </td>
<td> P03.4 </td>
<td> P03.4 </td>
<td> 2022-07-25 </td>
<td> 09:54:10 </td>
<td> 2022-07-28 </td>
<td> 13:49:33 </td>
<td> U0030 </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> 3350 </td>
<td> 50 </td>
<td> Hidup </td>
<td> Tidak </td>
<td> Hidup </td>
<td> Ya </td>
<td> Tidak </td>
<td> Ya </td>

<td> - </td>
<td> 1200000 </td>
<td> Sembuh </td>
<td> 4 </td>
<td> Sudah </td>
</tr>
<tr>
<td> 2022/07/25/000126 </td>
<td> 072793 </td>
<td> NAMEERA ALESYA PHRASTIWI,AN </td>
<td> P </td>
<td> MALANG </td>
<td> 2022-07-25 </td>
<td> ISLAM </td>
<td> TS </td>
<td> GURU </td>
<td> AYAH </td>
<td> JL. DANAU MANINJAU DALAM VI/B2 F21 RT 005 RW 009, SAWOJAJAR,
<td> BPJ </td>
<td> PA11 </td>
<td> 400000 </td>
<td> P03.4 </td>
<td> P07.1 </td>
<td> 2022-07-25 </td>
<td> 09:22:49 </td>
<td> 2022-07-27 </td>
<td> 11:48:12 </td>
<td> U0029 </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> Perawatan Bayi SC , Perawatan Bayi SC , Jasa Pelayanan

Rumah Sakit, Visite Dokter Spesialis Anak, Visite Dokter Spesialis Anak, Sewa
Inkubator, Sewa Inkubator, Operasional Rumah Sakit </td>
<td> - </td>
<td> 1200000 </td>
<td> Sembuh </td>
<td> 3 </td>
<td> Sudah </td>
</tr>
<tr>
<td> 2022/07/25/000069 </td>
<td> 066938 </td>
<td> AINUN IKA PRATIWI, NY </td>
<td> P </td>
<td> MOJOKERTO </td>
<td> 1990-08-05 </td>
<td> 31 Th 11 Bl 20 Hr </td>
<td> ISLAM </td>
<td> BIDAN </td>
<td> D3 </td>
<td> TNI </td>
<td> ANDY CHARISWAN, TN </td>
<td> SUAMI </td>
<td> ASRAMA BRIGIF 18 RT 3 RW 7 , KEMANTREN, JABUNG, KABUPATEN
MALANG </td>
<td> BPJ </td>
<td> kelas 1 </td>
<td> P04 </td>
<td> 650000 </td>
<td> O80.8 </td>
<td> O80.0 </td>
<td> 2022-07-25 </td>
<td> 09:09:05 </td>
<td> 2022-07-26 </td>
<td> 17:47:35 </td>
<td> IGDK </td>
<td> 2022/07/25/000069, BPJS KLAS 2 UP I RUANG PANDAWA 4 </td>
<td> 3 </td>
<td> 2 </td>
<td> 0 </td>
<td> 0 </td>
<td> 0 </td>
<td> 0 </td>
<td> 38-39 </td>

<td> 3530 </td>
<td> 51 </td>
<td> Hidup </td>
<td> Ya </td>
<td> Hidup </td>
<td> Ya </td>
<td> Tidak </td>
<td> Ya </td>
<td> </td>
<td> - </td>
<td> 1300000 </td>
<td> 2 </td>
<td> Sudah </td>
</tr>
<tr>
<td> 2022/07/24/000083 </td>
<td> 073218 </td>
<td> CHANIFAH, NY </td>
<td> P </td>
<td> Malang </td>
<td> 1979-05-25 </td>
<td> 43 Th 2 Bl 0 Hr </td>
<td> ISLAM </td>
<td> GURU </td>
<td> S1 </td>
<td> - </td>
<td> KOKO HERMANTO, TN </td>
<td> SUAMI </td>
<td> JL. GADANG 403-6 RT.05/RW.12, GADANG, SUKUN, KOTA MALANG
</td>
<td> BPJ </td>
<td> kelas 3 </td>
<td> IGD1 </td>
<td> KS IGD 1 </td>
<td> 300000 </td>
<td> O14.9 </td>
<td> O32.1 </td>
<td> 2022-07-25 </td>
<td> 07:42:17 </td>
<td> 2022-07-26 </td>
<td> 08:29:54 </td>
<td> IGDK </td>
<td> KLINIK AR-RAZY </td>
<td> 2022/07/24/000083, BPJS 3 DIRUJUK KE KARSA HUSADA </td>
<td> 3 </td>
<td> 2 </td>
<td> 0 </td>
<td> 0 </td>
<td> 0 </td>
<td> 0 </td>
<td> 39-40 </td>

<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> - </td>
<td> 600000 </td>
<td> Atas Permintaan Sendiri </td>
<td> 2 </td>
<td> Sudah </td>
</tr>
<tr>
<td> 2022/07/25/000077 </td>
<td> 072783 </td>
<td> AINUN IKA P, BY NY </td>
<td> L </td>
<td> MALANG </td>
<td> 2022-07-25 </td>
<td> ISLAM </td>
<td> - </td>
<td> - </td>
<td> TNI </td>
<td> ANDY CHARISWAN, TN </td>
<td> AYAH </td>
<td> ASRAMA BRIGIF 18 RT 3 RW 7 , KEMANTREN, JABUNG, KABUPATEN
MALANG </td>
<td> BPJ </td>
<td> kelas 3 </td>
<td> PF22 </td>
<td> 300000 </td>
<td> P00.6 </td>
<td> P00.9 </td>
<td> 2022-07-25 </td>
<td> 06:22:37 </td>
<td> 2022-07-26 </td>
<td> 16:48:32 </td>
<td> U0030 </td>
<td> 2022/07/25/000077, JENIS KELAMIN DI BPJS SALAH . SUDAH
KONFIRMASI PAK RI PENGURUSAN JK STLAH MASUK KK . </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> 3530 </td>
<td> 51 </td>
<td> Hidup </td>
<td> Ya </td>
<td> Hidup </td>
<td> Ya </td>
<td> Tidak </td>
<td> Ya </td>

<td> - </td>
<td> 600000 </td>
<td> Sembuh </td>
<td> 2 </td>
<td> Sudah </td>
</tr>
<tr>
<td> 2022/07/25/000072 </td>
<td> 072782 </td>
<td> RIZKY DWI K, BY NY </td>
<td> P </td>
<td> MALANG </td>
<td> 2022-07-25 </td>
<td> 0 Th 0 Bl 11 Hr </td>
<td> ISLAM </td>
<td> - </td>
<td> - </td>
<td> MUHAMMAD WILDAN, TN </td>
<td> AYAH </td>
<td> JL. SIMPANG PANJI SUROSO I/34 ART 8 RW 7 , BLIMBING,
<td> BPJ </td>
<td> kelas 3 </td>
<td> PF11 </td>
<td> 300000 </td>
<td> P03.4 </td>
<td> P03.4 </td>
<td> 2022-07-25 </td>
<td> 05:50:45 </td>
<td> 2022-07-27 </td>
<td> 15:22:09 </td>
<td> U0030 </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> 3300 </td>
<td> 49 </td>
<td> Hidup </td>
<td> Tidak </td>
<td> Hidup </td>
<td> Ya </td>
<td> Tidak </td>
<td> Ya </td>

<td> - </td>
<td> 900000 </td>
<td> Sembuh </td>
<td> 3 </td>
<td> Sudah </td>
</tr>
<tr>
<td> 2022/07/25/000221 </td>
<td> 070175 </td>
<td> IRMA SETIANI PUTRI, NY </td>
<td> P </td>
<td> MALANG </td>
<td> 1996-06-25 </td>
<td> 26 Th 1 Bl 10 Hr </td>
<td> ISLAM </td>
<td> D3 </td>
<td> ANDI HARTANTO, TN </td>
<td> SUAMI </td>
<td> DSN PARIREJO RT 06 RW 01 , PARIJATAH WETAN, SRONO,
BANYUWANGI </td>
<td> BPJ </td>
<td> kelas 1 </td>
<td> H06 </td>
<td> 650000 </td>
<td> O42.0 </td>
<td> O80.8 </td>
<td> 2022-07-25 </td>
<td> 05:23:41 </td>
<td> 2022-07-27 </td>
<td> 15:48:29 </td>
<td> IGDK </td>
<td> </td>
<td> 2022/07/25/000221 BPJS KELAS 2 UP 1 DI HASTINA 6 </td>
<td> 1 </td>
<td> 0 </td>
<td> 0 </td>
<td> 0 </td>
<td> 0 </td>
<td> 0 </td>
<td> 39-40 </td>

<td> 3085 </td>
<td> 49 </td>
<td> Hidup </td>
<td> Ya </td>
<td> Hidup </td>
<td> Ya </td>
<td> Tidak </td>
<td> Ya </td>

<td> </td>
<td> 1950000 </td>
<td> Sembuh </td>
<td> 3 </td>
<td> Sudah </td>
</tr>
<tr>
<td> 2022/07/24/000075 </td>
<td> 091953 </td>
<td> MUHAMMAD ZHAFRAN AQILA DIRGANTARA, AN </td>
<td> L </td>
<td> MALANG </td>
<td> 2017-06-02 </td>
<td> 5 Th 1 Bl 29 Hr </td>
<td> ISLAM </td>
<td> TS </td>
<td> PNS </td>
<td> WISNU RYAN HADI SETYA PUTRA, TN </td>
<td> AYAH </td>
<td> JL. INDRAGIRI IV/67 RT002/RW001, PURWANTORO, BLIMBING, KOTA
MALANG </td>
<td> BPJ </td>
<td> kelas 1 </td>
<td> P03 </td>
<td> 650000 </td>
<td> A09 </td>
<td> A09 </td>
<td> 2022-07-24 </td>
<td> 23:56:55 </td>
<td> 2022-07-26 </td>
<td> 18:11:26 </td>
<td> IGDK </td>
<td> </td>
<td> 2022/07/24/000075, BPJS KLS 1 PANDAWA 3 </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>

Sakit </td>
<td> - </td>
<td> 1300000 </td>
<td> 2 </td>
<td> Sudah </td>
</tr>
<tr>
<td> 2022/07/24/000066 </td>
<td> 016586 </td>
<td> Raden Malik Ibrahim, an </td>
<td> L </td>
<td> malang </td>
<td> 2019-04-07 </td>
<td> 3 Th 3 Bl 24 Hr </td>
<td> ISLAM </td>
<td> TS </td>
<td> RIZALDI GUNAWAN PUTRA, Tn </td>
<td> AYAH </td>
<td> JL. DANAU RAWA PENING II/H5C 20 RT1 RW14, MADYOPURO,
<td> BPJ </td>
<td> kelas 2 </td>
<td> H01 </td>
<td> 400000 </td>
<td> A91 </td>
<td> A91 </td>
<td> 2022-07-24 </td>
<td> 23:52:42 </td>
<td> 2022-07-28 </td>
<td> 23:00:00 </td>
<td> IGDK </td>
<td> 2022/07/24/000066, BPJS KELAS 2 TITIP DI HASTINA 1
( KONFIRMASI ) </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> Jasa Pelayanan Rumah Sakit, Infus Dewasa Oleh Dokter Umum ,
Infus Dewasa Oleh Dokter Umum , Konsultasi Dokter Spesialis Anak Via Telepon </td>
<td> - </td>
<td> 1600000 </td>
<td> 4 </td>
<td> Sudah </td>
</tr>
<tr>
<td> 2022/07/24/000074 </td>
<td> 027742 </td>
<td> FAIZ AYDIN RAMADHAN, AN </td>
<td> L </td>
<td> Malang </td>
<td> 2012-07-21 </td>
<td> 10 Th 0 Bl 11 Hr </td>
<td> ISLAM </td>
<td> DOSEN </td>
<td> - </td>
<td> - </td>
<td> Supriyo Tn </td>
<td> AYAH </td>
<td> JL DANAU SURUBEC F3 D12, SAWOJAJAR, KEDUNGKANDANG, KOTA
MALANG </td>
<td> BPJ </td>
<td> kelas 1 </td>
<td> P01 </td>
<td> 650000 </td>
<td> A91 </td>
<td> A91 </td>
<td> 2022-07-24 </td>
<td> 23:49:45 </td>
<td> 2022-07-30 </td>
<td> 09:39:02 </td>
<td> IGDK </td>
<td> 2022/07/24/000074, BPJS KELAS 1 RUANG PANDAWA 1 ( KONFIRMASI
) </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>

<td> - </td>
<td> 3900000 </td>
<td> 6 </td>
<td> Sudah </td>
</tr>
<tr>
<td> 2022/07/24/000077 </td>
<td> 072775 </td>
<td> RADITA GALIH PAWIYARTI, NY </td>
<td> P </td>
<td> BOYOLALI </td>
<td> 1993-06-04 </td>
<td> 29 Th 1 Bl 20 Hr </td>
<td> ISLAM </td>
<td> S1 </td>
<td> YAN IDRAKUS, TN </td>
<td> SUAMI </td>
<td> PERMATA ROYAL GARDEN CLUSTER 3 NO. C1, BUNUT WETAN, PAKIS,
<td> A09 </td>
<td> UMUM </td>
<td> kelas 2 </td>
<td> D10 </td>
<td> 400000 </td>
<td> O21.1 </td>
<td> O21.1 </td>
<td> 2022-07-24 </td>
<td> 22:35:08 </td>
<td> 2022-07-25 </td>
<td> 20:30:22 </td>
<td> IGDK </td>
<td> </td>
<td> 2022/07/24/000077, UMUM KELAS 2 RUANG AYODYA 1B ( KONFIRMASI
) </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>

<td> - </td>
<td> 400000 </td>
<td> Sehat </td>
<td> 1 </td>
<td> Sudah </td>
</tr>
<tr>
<td> 2022/07/24/000037 </td>
<td> 044429 </td>
<td> KEN ALZIO RAFISQY, AN </td>
<td> L </td>
<td> Malang </td>
<td> 2019-11-28 </td>
<td> ISLAM </td>
<td> - </td>
<td> - </td>
<td> SWASTA </td>
<td> SOPYAN HADI SAPUTRO, TN </td>
<td> AYAH </td>
<td> PERUM PAKISJAJAR BLOK R03 RT.04 RW.05, PAKISJAJAR, PAKIS,
<td> BPJ </td>
<td> kelas 2 </td>
<td> P02 </td>
<td> 400000 </td>
<td> A90 </td>
<td> A90 </td>
<td> 2022-07-24 </td>
<td> 18:48:33 </td>
<td> 2022-07-27 </td>
<td> 22:00:41 </td>
<td> IGDK </td>
<td> 2022/07/24/000037, BPJS KELAS 2, TITIP PANDAWA 2 </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>

<td> - </td>
<td> 1600000 </td>
<td> 4 </td>
<td> Sudah </td>
</tr>
<tr>
<td> 2022/07/24/000016 </td>
<td> 085171 </td>
<td> SULASTRI, NY </td>
<td> P </td>
<td> MALANG </td>
<td> 1997-07-21 </td>
<td> 25 Th 0 Bl 11 Hr </td>
<td> ISLAM </td>
<td> SD </td>
<td> BAHRUL ULUM, TN </td>
<td> SUAMI </td>
<td> PAKIS JAJAR RT03/RW04, PAKISJAJAR, PAKIS, KABUPATEN MALANG
</td>
<td> BPJ </td>
<td> kelas 3 </td>
<td> A08 </td>
<td> 300000 </td>
<td> O60.0 </td>
<td> A60.0 </td>
<td> 2022-07-24 </td>
<td> 18:30:26 </td>
<td> 2022-07-26 </td>
<td> 12:03:54 </td>
<td> IGDK </td>
<td> 2022/07/24/000016, BPJS KLS 3, AMARTA 7A KONFIRMASI RUANGAN
</td>
<td> 2 </td>
<td> 1 </td>
<td> 0 </td>
<td> 0 </td>
<td> 0 </td>
<td> 0 </td>
<td> 32-34 </td>

<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> VT Bidan, Infus Dewasa oleh Perawat / Bidan, NST, Konsultasi

Dokter Spesialis Obgyn Via Telepon </td>
<td> - </td>
<td> 900000 </td>
<td> 3 </td>
<td> Sudah </td>
</tr>
<tr>
<td> 2022/07/24/000060 </td>
<td> 072767 </td>
<td> ALIZA ELYINA HANANA, AN </td>
<td> P </td>
<td> MALANG </td>
<td> 2022-07-24 </td>
<td> ISLAM </td>
<td> - </td>
<td> AYAH </td>
<td> PERUM PIRANHA RESIDENCE A10 , TUNJUNGSEKAR, LOWOKWARU, KOTA
MALANG </td>
<td> BPJ </td>
<td> PA09 </td>
<td> 400000 </td>
<td> P03.4 </td>
<td> P39.9 </td>
<td> 2022-07-24 </td>
<td> 16:57:36 </td>
<td> 2022-07-27 </td>
<td> 11:47:46 </td>
<td> U0029 </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>

<td> - </td>
<td> 1600000 </td>
<td> Sembuh </td>
<td> 4 </td>
<td> Sudah </td>
</tr>
<tr>
<td> 2022/07/24/000034 </td>
<td> 072753 </td>
<td> SANIYAH NISRIN, AN </td>
<td> P </td>
<td> Malang </td>
<td> 2009-05-01 </td>
<td> 13 Th 2 Bl 28 Hr </td>
<td> ISLAM </td>
<td> SMP </td>
<td> M AL IMRON ROSADI, TN </td>
<td> AYAH </td>
<td> JL ANGGODO WENDIT TIMUR RT 4 RW 5, MANGLIAWAN, PAKIS,
<td> BPJ </td>
<td> kelas 2 </td>
<td> D04 </td>
<td> 400000 </td>
<td> A90 </td>
<td> A91 </td>
<td> 2022-07-24 </td>
<td> 13:22:52 </td>
<td> 2022-07-29 </td>
<td> 16:36:45 </td>
<td> IGDK </td>
<td> 2022/07/24/000034, BPJS KELAS 2, AYODYA 2B </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>

Anak, Konsultasi Dokter Spesialis Anak Via Telepon, Konsultasi Dokter Spesialis
Anak Via Telepon, Infus Anak oleh Perawat / Bidan, Operasional Rumah Sakit </td>
<td> - </td>
<td> 2400000 </td>
<td> 6 </td>
<td> Sudah </td>
</tr>
<tr>
<td> 2022/07/24/000052 </td>
<td> 072759 </td>
<td> AYLA FAUZIA AZZAHRA, AN </td>
<td> P </td>
<td> MALANG </td>
<td> 2020-12-16 </td>
<td> ISLAM </td>
<td> TS </td>
<td> MOHAMAMD ROIS AMIN, TN </td>
<td> AYAH </td>
<td> JL KH MALIK DALAM TIMUR SUNGAI RT 2 RW 4, KEDUNGKANDANG,
<td> A09 </td>
<td> UMUM </td>
<td> kelas 2 </td>
<td> K0000240 </td>
<td> KS IGD 1 </td>
<td> 400000 </td>
<td> J18.0 </td>
<td> J18.0 </td>
<td> 2022-07-24 </td>
<td> 13:11:05 </td>
<td> 2022-07-26 </td>
<td> 09:58:11 </td>
<td> IGDK </td>
<td> </td>
<td> 2022/07/24/000052, BPJS MASIH MAU MENGURUS, SUDAH
DIKONSELING DITUNGGU 3X 24 JAM ATAU SEBELUM PX PULANG TIDAK BISA MENUNJJUKAN BPJS
AKTIF, BERSEDIA UMUM.
(RUANGAN AYODYA 4B) </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> Oksigen 100% Sentral 7 LPM , Visite Dokter Spesialis Anak,
Resusitasi dengan Suction, Pasang NGT/OGT, Oksigen 100% Sentral 15 LPM , Oksigen
100% Sentral 2 LPM, Nebulizer , Konsultasi Dokter Spesialis Anak Via Telepon,
Operasional Rumah Sakit , Jasa Pelayanan Rumah Sakit </td>
<td> - </td>
<td> 1200000 </td>
<td> Meninggal </td>
<td> 3 </td>
<td> Sudah </td>
</tr>
<tr>
<td> 2022/07/24/000023 </td>
<td> 024048 </td>
<td> P </td>
<td> Malang </td>
<td> 1986-07-09 </td>
<td> 36 Th 0 Bl 22 Hr </td>
<td> KRISTEN </td>
<td> SMA </td>
<td> SUAMI </td>
<td> BPJ </td>
<td> kelas 1 </td>
<td> P08 </td>
<td> 650000 </td>
<td> O60.0 </td>
<td> O47.0 </td>
<td> 2022-07-24 </td>
<td> 11:31:13 </td>
<td> 2022-07-29 </td>
<td> 16:30:00 </td>
<td> IGDK </td>
<td> 2022/07/24/000023, BPJS KELAS 1 DI PANDAWA 8 KONFIRMASI
</td>
<td> 4 </td>
<td> 0 </td>
<td> 0 </td>
<td> 2 </td>
<td> 1 </td>
<td> 0 </td>
<td> 29-30 </td>

<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
Operasional Rumah Sakit , Infus Dewasa oleh Perawat / Bidan, Konsultasi Dokter
<td> - </td>
<td> 3900000 </td>
<td> Sembuh </td>
<td> 6 </td>
<td> Sudah </td>
</tr>
<tr>
<td> 2022/07/23/000122 </td>
<td> 085332 </td>
<td> ISNAWATI, NY </td>
<td> P </td>
<td> Blitar </td>
<td> 1993-06-26 </td>
<td> 29 Th 1 Bl 7 Hr </td>
<td> ISLAM </td>
<td> SMP </td>
<td> FIRMAN ARDIANSYAH, TN </td>
<td> SUAMI </td>
<td> JL. KI AGENG GRIBIG V / 21 RT 05 RW 03, KEDUNGKANDANG,
<td> BPJ </td>
<td> kelas 2 </td>
<td> D11 </td>
<td> 400000 </td>
<td> O82.9 </td>
<td> O82.9 </td>
<td> 2022-07-24 </td>
<td> 08:00:50 </td>
<td> 2022-07-26 </td>
<td> 22:05:55 </td>
<td> IGDK </td>
<td> 2022/07/23/000122, BPJS KLAS 2 RUANG AYODYA 6 A </td>
<td> 2 </td>
<td> 1 </td>
<td> 0 </td>
<td> 0 </td>
<td> 0 </td>
<td> 0 </td>
<td> 40-41 </td>

<td> 3400 </td>
<td> 49 </td>
<td> Hidup </td>
<td> Ya </td>
<td> Hidup </td>
<td> Ya </td>
<td> Tidak </td>
<td> Ya </td>

<td> - </td>
<td> 1200000 </td>
<td> 3 </td>
<td> Sudah </td>
</tr>
<tr>
<td> 2022/07/24/000024 </td>
<td> 072750 </td>
<td> ISNAWATI, By.Ny </td>
<td> P </td>
<td> MALANG </td>
<td> 2022-07-24 </td>
<td> ISLAM </td>
<td> - </td>
<td> FIRMAN ARDIANSYAH, Tn </td>
<td> AYAH </td>
<td> JL. KI AGENG GRIBIG V / 21 RT 05 RW 03, KEDUNGKANDANG,
<td> BPJ </td>
<td> kelas 3 </td>
<td> PF24 </td>
<td> 300000 </td>
<td> P03.4 </td>
<td> P03.4 </td>
<td> 2022-07-24 </td>
<td> 07:00:52 </td>
<td> 2022-07-26 </td>
<td> 17:44:32 </td>
<td> U0030 </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> 3400 </td>
<td> 49 </td>
<td> Hidup </td>
<td> Tidak </td>
<td> Hidup </td>
<td> Ya </td>
<td> Tidak </td>
<td> Ya </td>

<td> </td>
<td> 900000 </td>
<td> Sembuh </td>
<td> 3 </td>
<td> Sudah </td>
</tr>
<tr>
<td> 2022/07/24/000082 </td>
<td> 039899 </td>
<td> WAHYU MUHAMMAD MAULADANA, AN </td>
<td> L </td>
<td> Malang </td>
<td> 2013-02-02 </td>
<td> ISLAM </td>
<td> TS </td>
<td> MISDIANTO, TN </td>
<td> AYAH </td>
<td> DSN. TANJUNG RT 04 RW 09, BANJARARUM, SINGOSARI, KABUPATEN
MALANG </td>
<td> BPJ </td>
<td> kelas 2 </td>
<td> A14 </td>
<td> 400000 </td>
<td> G41.9 </td>
<td> G41.9 </td>
<td> 2022-07-24 </td>
<td> 05:31:10 </td>
<td> 2022-07-26 </td>
<td> 10:03:23 </td>
<td> IGDK </td>
<td> 2022/07/24/00008, BPJS KLAS 2 TITP AMARTA 4A, RENCANA KLAS 2
MENYUSUL DENDA 45 HARI
SUDAH CETAK SEP TGL 26-07-2022 20.13 TIKA </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> Jasa Pelayanan Rumah Sakit, Oksigen 100% Sentral 1 LPM ,

Oksigen 100% Sentral 4 LPM , Oksigen 100% Sentral 4 LPM , Oksigen 100% Sentral
2 LPM </td>
<td> - </td>
<td> 1200000 </td>
<td> Sembuh </td>
<td> 3 </td>
<td> Sudah </td>
</tr>
<tr>
<td> 2022/07/23/000121 </td>
<td> 073289 </td>
<td> UCIK NOFIA, NY </td>
<td> P </td>
<td> KEDIRI </td>
<td> 1996-03-31 </td>
<td> 26 Th 4 Bl 2 Hr </td>
<td> KRISTEN </td>
<td> SMA </td>
<td> YANU RESTIONO, TN </td>
<td> SUAMI </td>
<td> DSN JAMBESARI RT 33 RW 08, RINGINKEMBAR, SUMBERMANJING
WETAN, KABUPATEN MALANG </td>
<td> BPJ </td>
<td> kelas 2 </td>
<td> D02 </td>
<td> 400000 </td>
<td> O80.8 </td>
<td> O80.1 </td>
<td> 2022-07-23 </td>
<td> 23:15:15 </td>
<td> 2022-07-24 </td>
<td> 20:30:27 </td>
<td> IGDK </td>
<td> 2022/07/23/000121, BPJS KLS 2 DWARAWATI/AYODYA 4B </td>
<td> 2 </td>
<td> 1 </td>
<td> 0 </td>
<td> 0 </td>
<td> 0 </td>
<td> 0 </td>
<td> 41-42 </td>

<td> 3150 </td>
<td> 49 </td>
<td> Hidup </td>
<td> Ya </td>
<td> Hidup </td>
<td> Ya </td>
<td> Tidak </td>
<td> Ya </td>
<td> Jasa Pelayanan Rumah Sakit , Visite Dokter Umum, VT Bidan,

NST, Operasional Rumah Sakit </td>
<td> - </td>
<td> 400000 </td>
<td> Sehat </td>
<td> 1 </td>
<td> Sudah </td>
</tr>
<tr>
<td> 2022/07/23/000168 </td>
<td> 072437 </td>
<td> SHEZA AULIA SALSABILA, AN </td>
<td> P </td>
<td> MALANG </td>
<td> 2021-12-05 </td>
<td> 0 Th 7 Bl 29 Hr </td>
<td> ISLAM </td>
<td> TS </td>
<td> ROKHANI, TN </td>
<td> AYAH </td>
<td> JL. HASANUDIN RT 006 RW 003, JERU, TUMPANG, KABUPATEN MALANG
</td>
<td> A09 </td>
<td> UMUM </td>
<td> kelas 2 </td>
<td> D07 </td>
<td> 400000 </td>
<td> R50.9 </td>
<td> R50.9 </td>
<td> 2022-07-23 </td>
<td> 22:53:04 </td>
<td> 2022-07-31 </td>
<td> 19:46:27 </td>
<td> IGDK </td>
<td> </td>
<td> 2022/07/23/000168 UMUM KELAS 2 DI AYODYA 4A KONFIRM </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>

Nebulizer , Nebulizer , Nebulizer , Nebulizer , Nebulizer , Visite Dokter Spesialis
Anak, Visite Dokter Spesialis Anak, Visite Dokter Spesialis Anak, Visite Dokter
Spesialis Anak, Visite Dokter Spesialis Anak, Visite Dokter Spesialis Anak, Visite
Dokter Spesialis Anak, Visite Dokter Spesialis Anak, Oksigen 100% Sentral 1 LPM ,
Konsultasi Dokter Spesialis Anak Via Telepon, Infus Anak oleh Perawat / Bidan </td>
<td> </td>
<td> 3200000 </td>
<td> Sehat </td>
<td> 8 </td>
<td> Sudah </td>
</tr>
<tr>
<td> 2022/07/23/000177 </td>
<td> 072744 </td>
<td> BRYAN JULIAN RESTIONO, AN </td>
<td> L </td>
<td> MALANG </td>
<td> 2022-07-23 </td>
<td> KRISTEN </td>
<td> TS </td>
<td> YANU RESTIONO, TN </td>
<td> AYAH </td>
<td> DSN JAMBESARI RT 33 RW 08, RINGINKEMBAR, SUMBERMANJING
WETAN, KABUPATEN MALANG </td>
<td> BPJ </td>
<td> kelas 3 </td>
<td> PF22 </td>
<td> 300000 </td>
<td> P00.6 </td>
<td> P00.9 </td>
<td> 2022-07-23 </td>
<td> 22:09:39 </td>
<td> 2022-07-27 </td>
<td> 15:25:32 </td>
<td> U0030 </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> 3150 </td>
<td> 49 </td>
<td> Hidup </td>
<td> Ya </td>
<td> Hidup </td>
<td> Ya </td>
<td> Tidak </td>
<td> Ya </td>

<td> - </td>
<td> 1200000 </td>
<td> Sembuh </td>
<td> 4 </td>
<td> Sudah </td>
</tr>
<tr>
<td> 2022/07/23/000096 </td>
<td> 030915 </td>
<td> ALMAN HARUN ABDULLAH, AN </td>
<td> L </td>
<td> MALANG </td>
<td> 2019-01-03 </td>
<td> 3 Th 6 Bl 23 Hr </td>
<td> ISLAM </td>
<td> - </td>
<td> WAHYU AGUS TUBARI, TN </td>
<td> AYAH </td>
<td> JL. DANAU RAWA PENING III H-5 / E 13 RT 04 RW 14, MADYOPURO,
<td> BPJ </td>
<td> kelas 1 </td>
<td> H09 </td>
<td> 650000 </td>
<td> R50.9 </td>
<td> S72.40 </td>
<td> 2022-07-23 </td>
<td> 21:48:21 </td>
<td> 2022-07-26 </td>
<td> 23:43:56 </td>
<td> U0002 </td>
<td> Klinik Elisa </td>
<td> 2022/07/23/000096 BPJS KELAS 1 DI HASTINA 9 KONFIRM </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> Visite Dokter Spesialis Anak, Infus Anak oleh Perawat /

Bidan </td>
<td> </td>
<td> 1950000 </td>
<td> Rujuk </td>
<td> 3 </td>
<td> Sudah </td>
</tr>
<tr>
<td> 2022/07/23/000164 </td>
<td> 028954 </td>
<td> NISRINA NABILAH,NY </td>
<td> P </td>
<td> Malang </td>
<td> 1993-07-22 </td>
<td> 29 Th 0 Bl 15 Hr </td>
<td> ISLAM </td>
<td> S1 </td>
<td> SUAMI </td>
<td> PERUM PIRANHA RESIDENCE A10, TUNJUNGSEKAR, LOWOKWARU, KOTA
MALANG </td>
<td> BPJ </td>
<td> kelas 2 </td>
<td> D12 </td>
<td> 400000 </td>
<td> O80.9 </td>
<td> O82.9 </td>
<td> 2022-07-23 </td>
<td> 17:58:26 </td>
<td> 2022-07-27 </td>
<td> 12:27:04 </td>
<td> IGDK </td>
<td> DR. NOVINA P. KARTIKARINI, SP.OG </td>
<td> 2022/07/23/000164, BPJS KLS III UP II TITIP DI AMARTA 5A.
RUJUKAN DR NOVINA </td>
<td> 2 </td>
<td> 1 </td>
<td> 0 </td>
<td> 0 </td>
<td> 0 </td>
<td> 0 </td>
<td> 40-41 </td>

<td> 3200 </td>
<td> 49 </td>
<td> Hidup </td>
<td> Tidak </td>
<td> Hidup </td>
<td> Ya </td>
<td> Tidak </td>
<td> Ya </td>
<td> Infus Dewasa Oleh Dokter Umum , Oksigen 100% Sentral 2 LPM ,
VT Bidan, NST </td>
<td> </td>
<td> 2000000 </td>
<td> 5 </td>
<td> Sudah </td>
</tr>
<tr>
<td> 2022/07/23/000140 </td>
<td> 072730 </td>
<td> EKA YUNIARTI, NY </td>
<td> P </td>
<td> SURABAYA </td>
<td> 1994-06-10 </td>
<td> 28 Th 1 Bl 15 Hr </td>
<td> ISLAM </td>
<td> SMA </td>
<td> YANU ARIANTO, TN </td>
<td> SUAMI </td>
<td> JL. PLAOSAN TIMUR RT 6 RW 12 , PURWODADI, BLIMBING, KOTA
MALANG </td>
<td> BPJ </td>
<td> kelas 3 </td>
<td> A06 </td>
<td> 300000 </td>
<td> O03.4 </td>
<td> O03.4 </td>
<td> 2022-07-23 </td>
<td> 17:03:17 </td>
<td> 2022-07-24 </td>
<td> 19:06:05 </td>
<td> IGDK </td>
<td> 2022/07/23/000140, BPJS KLS 3 AMARTA 5D </td>
<td> 0 </td>
<td> 0 </td>
<td> 0 </td>
<td> 0 </td>
<td> 0 </td>
<td> 0 </td>
<td> 0 </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> VT Bidan, Oksigen 100% Sentral 3 LPM </td>

<td> - </td>
<td> 600000 </td>
<td> 2 </td>
<td> Sudah </td>
</tr>
<tr>
<td> 2022/07/23/000093 </td>
<td> 022595 </td>
<td> RULLY AITANA DEVITASARI, NY </td>
<td> P </td>
<td> JEMBER </td>
<td> 1987-12-20 </td>
<td> 34 Th 7 Bl 16 Hr </td>
<td> ISLAM </td>
<td> GURU </td>
<td> D4 </td>
<td> GURU </td>
<td> MUJI TRIARSO, TN </td>
<td> SUAMI </td>
<td> DSN TAMBAKASRI RT 8 RW 1, TAMBAKASRI, TAJINAN, KABUPATEN
MALANG </td>
<td> BPJ </td>
<td> kelas 2 </td>
<td> D10 </td>
<td> 400000 </td>
<td> O34.2 </td>
<td> O82.1 </td>
<td> 2022-07-23 </td>
<td> 14:12:04 </td>
<td> 2022-07-25 </td>
<td> 17:00:19 </td>
<td> IGDK </td>
<td> 2022/07/23/000093, BPJS KLS 3 UP 2 DWARAWATI/AYODYA 5B </td>
<td> 2 </td>
<td> 1 </td>
<td> 0 </td>
<td> 0 </td>
<td> 0 </td>
<td> 0 </td>
<td> 38-39 </td>

<td> 3000 </td>
<td> 48 </td>
<td> Hidup </td>
<td> Tidak </td>
<td> Hidup </td>
<td> Ya </td>
<td> Tidak </td>
<td> Ya </td>
<td> </td>
<td> - </td>
<td> 1200000 </td>
<td> Sehat </td>
<td> 3 </td>
<td> Sudah </td>
</tr>
<tr>
<td> 2022/07/23/000123 </td>
<td> 092252 </td>
<td> NUR FARIDA, NY </td>
<td> P </td>
<td> Malang </td>
<td> 1982-08-24 </td>
<td> 39 Th 11 Bl 10 Hr </td>
<td> ISLAM </td>
<td> SMP </td>
<td> SWASTA </td>
<td> DARMAJI, TN </td>
<td> SUAMI </td>
<td> JL. KH. HASYIM V RT. 07/ RW. 03, KEDUNGKANDANG,
<td> BPJ </td>
<td> kelas 3 </td>
<td> A05 </td>
<td> 300000 </td>
<td> O48 </td>
<td> O82.9 </td>
<td> 2022-07-23 </td>
<td> 14:11:35 </td>
<td> 2022-07-25 </td>
<td> 17:46:24 </td>
<td> IGDK </td>
<td> 2022/07/23/000123, BPJS KLS 3 AMARTA 5C </td>
<td> 4 </td>
<td> 2 </td>
<td> 0 </td>
<td> 0 </td>
<td> 0 </td>
<td> 0 </td>
<td> 41-42 </td>

<td> 3000 </td>
<td> 49 </td>
<td> Hidup </td>
<td> Tidak </td>
<td> Hidup </td>
<td> Ya </td>
<td> Tidak </td>
<td> Ya </td>

<td> - </td>
<td> 900000 </td>
<td> 3 </td>
<td> Sudah </td>
</tr>
<tr>
<td> 2022/07/23/000127 </td>
<td> 006036 </td>
<td> VELA VENANDA INDRAYANTI FITRI, NY </td>
<td> P </td>
<td> malang </td>
<td> 2000-05-21 </td>
<td> 22 Th 2 Bl 5 Hr </td>
<td> ISLAM </td>
<td> SMA </td>
<td> Safrizal Pangestu P, Tn </td>
<td> SUAMI </td>
<td> JL TELUK BAYUR NO 62 A RT 06/ RW 07, PANDANWANGI, BLIMBING,
KOTA MALANG </td>
<td> BPJ </td>
<td> kelas 3 </td>
<td> A12 </td>
<td> Amarta 2 </td>
<td> 300000 </td>
<td> A90 </td>
<td> A90 </td>
<td> 2022-07-23 </td>
<td> 13:57:07 </td>
<td> 2022-07-26 </td>
<td> 10:51:45 </td>
<td> IGDK </td>
<td> 2022/07/23/000127, BPJS KLS 3 AMARTA 2 </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>

<td> - </td>
<td> 1200000 </td>
<td> 4 </td>
<td> Sudah </td>
</tr>
<tr>
<td> 2022/07/23/000143 </td>
<td> 072734 </td>
<td> ARYO RAFIF NUR ABDILLA, AN </td>
<td> L </td>
<td> MALANG </td>
<td> 2022-07-23 </td>
<td> ISLAM </td>
<td> TS </td>
<td> DARMAJI, TN </td>
<td> AYAH </td>
<td> JL. KH. HASYIM V RT. 07/ RW. 03, KEDUNGKANDANG,
<td> BPJ </td>
<td> kelas 3 </td>
<td> PF21 </td>
<td> 300000 </td>
<td> P03.4 </td>
<td> P03.4 </td>
<td> 2022-07-23 </td>
<td> 13:56:39 </td>
<td> 2022-07-27 </td>
<td> 15:25:06 </td>
<td> U0030 </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> 3000 </td>
<td> 49 </td>
<td> Hidup </td>
<td> Tidak </td>
<td> Hidup </td>
<td> Ya </td>
<td> Tidak </td>
<td> Ya </td>

<td> - </td>
<td> 1500000 </td>
<td> Sembuh </td>
<td> 5 </td>
<td> Sudah </td>
</tr>
<tr>
<td> 2022/07/23/000139 </td>
<td> 072724 </td>
<td> GAISKA ISHWANA JENAR, AN </td>
<td> P </td>
<td> MALANG </td>
<td> 2022-07-23 </td>
<td> 0 Th 0 Bl 13 Hr </td>
<td> ISLAM </td>
<td> TS </td>
<td> GURU </td>
<td> MUJI TRIARSO, TN </td>
<td> AYAH </td>
<td> DSN TAMBAKASRI RT 8 RW 1, TAMBAKASRI, TAJINAN, KABUPATEN
MALANG </td>
<td> BPJ </td>
<td> PA02 </td>
<td> NICU 2 </td>
<td> 400000 </td>
<td> P03.4 </td>
<td> P22.1 </td>
<td> 2022-07-23 </td>
<td> 13:21:47 </td>
<td> 2022-07-30 </td>
<td> 09:22:46 </td>
<td> U0029 </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> 3000 </td>
<td> 48 </td>
<td> Hidup </td>
<td> Tidak </td>
<td> Hidup </td>
<td> Ya </td>
<td> Tidak </td>
<td> Ya </td>

Rumah Sakit, Visite Dokter Spesialis Anak, Visite Dokter Spesialis Anak, Visite
Dokter Spesialis Anak, Visite Dokter Spesialis Anak, Pemasangan CPAP Hari
Berikutnya, Pemasangan CPAP Hari Berikutnya, Pemasangan CPAP Hari Berikutnya,
Pemasangan CPAP Hari Berikutnya, Pemasangan CPAP Hari Pertama, Sewa Infus Pump,
Sewa Infus Pump, Sewa Infus Pump, Sewa Infus Pump, Sewa Infus Pump, Sewa Inkubator,
Sewa Inkubator, Sewa Inkubator, Sewa Inkubator, Sewa Inkubator, Sewa Inkubator,
Sewa Inkubator, Sewa Patient Monitor , Sewa Patient Monitor , Sewa Patient
Monitor , Sewa Patient Monitor , Sewa Patient Monitor , Sewa Syringe Pump, Sewa
Syringe Pump, Sewa Syringe Pump, Sewa Syringe Pump, Sewa Syringe Pump, Sewa Syringe
Pump, Pasang NGT/OGT, Konsultasi Dokter Spesialis Anak Via Telepon, Konsultasi
Dokter Spesialis Anak Via Telepon, Infus Bayi oleh Perawat / Bidan, Infus Anak oleh
<td> - </td>
<td> 3200000 </td>
<td> Sembuh </td>
<td> 8 </td>
<td> Sudah </td>
</tr>
<tr>
<td> 2022/07/23/000071 </td>
<td> 062726 </td>
<td> ELOK DWISETYORINI, NY </td>
<td> P </td>
<td> AMBON </td>
<td> 1985-09-25 </td>
<td> 36 Th 10 Bl 10 Hr </td>
<td> ISLAM </td>
<td> S1 </td>
<td> AAN WARDONO, TN </td>
<td> SUAMI </td>
<td> PERUM GRIYA ASRI BLOK O-5 RT 11 RW 4, PANDANWANGI, BLIMBING,
KOTA MALANG </td>
<td> BPJ </td>
<td> kelas 2 </td>
<td> D05 </td>
<td> 400000 </td>
<td> O14.9 </td>
<td> O82.1 </td>
<td> 2022-07-23 </td>
<td> 10:57:23 </td>
<td> 2022-07-25 </td>
<td> 18:16:33 </td>
<td> IGDK </td>
<td> 2022/07/23/000071, BPJS KLS 3 UP 2 AYODYA 3A KONFIRMASI
RUANGAN </td>
<td> 3 </td>
<td> 2 </td>
<td> 0 </td>
<td> 0 </td>
<td> 0 </td>
<td> 0 </td>
<td> 37-38 </td>

<td> 3400 </td>
<td> 47 </td>
<td> Hidup </td>
<td> Tidak </td>
<td> Hidup </td>
<td> Ya </td>
<td> Tidak </td>
<td> Ya </td>
<td> </td>
<td> - </td>
<td> 1200000 </td>
<td> 3 </td>
<td> Sudah </td>
</tr>
<tr>
<td> 2022/07/22/000207 </td>
<td> 037741 </td>
<td> NIKE CHOLIFAH, NY </td>
<td> P </td>
<td> Malang </td>
<td> 1994-08-01 </td>
<td> 27 Th 11 Bl 30 Hr </td>
<td> ISLAM </td>
<td> SWASTA </td>
<td> S1 </td>
<td> SWASTA </td>
<td> KUSHARTOYO, TN </td>
<td> AYAH </td>
<td> JL. KEDAWUNG X-C NO. 18 RT.04 RW.07, TULUSREJO, LOWOKWARU,
KOTA MALANG </td>
<td> A09 </td>
<td> UMUM </td>
<td> kelas 1 </td>
<td> P05 </td>
<td> 650000 </td>
<td> O80.9 </td>
<td> O82.0 </td>
<td> 2022-07-23 </td>
<td> 09:05:11 </td>
<td> 2022-07-25 </td>
<td> 16:49:08 </td>
<td> IGDK </td>
<td> </td>
<td> 2022/07/22/000207, ASURANSI MANDIRI INHEALTH INDEMNITY KELAS
I DI HASTINA 8 (BENEFIT NP 8JT, SC 16JT, PENGGUGURAN ATAS INDIKASI MEDIS 4,8JT)
</td>
<td> 1 </td>
<td> 0 </td>
<td> 0 </td>
<td> 0 </td>
<td> 0 </td>
<td> 0 </td>
<td> 39-40 </td>

<td> 3200 </td>
<td> 48 </td>
<td> Hidup </td>
<td> Ya </td>
<td> Hidup </td>
<td> Ya </td>
<td> Tidak </td>
<td> Ya </td>
<td> Visite Dokter Spesialis Obgyn, Visite Dokter Umum, VT Bidan,

Infus Dewasa oleh Perawat / Bidan, Infus Dewasa oleh Perawat / Bidan, Oksigen 100%
Sentral 3 LPM , Oksigen 100% Sentral 2 LPM, NST, NST, NST, Konsultasi Dokter
Spesialis Obgyn Via Telepon, EKG </td>
<td> 1950000 </td>
<td> 3 </td>
<td> Sudah </td>
</tr>
<tr>
<td> 2022/07/23/000102 </td>
<td> 072722 </td>
<td> REVIOLA ELIA AANSHI, AN </td>
<td> P </td>
<td> Malang </td>
<td> 2022-07-23 </td>
<td> ISLAM </td>
<td> TS </td>
<td> AAN WARDONO, TN </td>
<td> AYAH </td>
<td> PERUM GRIYA ASRI BLOK O-5 RT 11 RW 4, PANDANWANGI, BLIMBING,
KOTA MALANG </td>
<td> BPJ </td>
<td> kelas 3 </td>
<td> PF16 </td>
<td> 300000 </td>
<td> P03.4 </td>
<td> P03.4 </td>
<td> 2022-07-23 </td>
<td> 08:41:29 </td>
<td> 2022-07-27 </td>
<td> 15:24:19 </td>
<td> U0030 </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> 3400 </td>
<td> 47 </td>
<td> Hidup </td>
<td> Tidak </td>
<td> Hidup </td>
<td> Ya </td>
<td> Tidak </td>
<td> Ya </td>

<td> - </td>
<td> 1500000 </td>
<td> Sembuh </td>
<td> 5 </td>
<td> Sudah </td>
</tr>
<tr>
<td> 2022/07/23/000070 </td>
<td> 038808 </td>
<td> KEIYONA PRAMUDHITA ARMANDI, AN </td>
<td> P </td>
<td> Malang </td>
<td> 2020-07-07 </td>
<td> 2 Th 0 Bl 25 Hr </td>
<td> ISLAM </td>
<td> - </td>
<td> - </td>
<td> SECURITY </td>
<td> KIKOK ARMANDI, TN </td>
<td> AYAH </td>
<td> JL. TELUK PELABUHAN RATU RT 1 RW 3, ARJOSARI, BLIMBING, KOTA
MALANG </td>
<td> BPJ </td>
<td> kelas 1 </td>
<td> H08 </td>
<td> 650000 </td>
<td> R56.0 </td>
<td> R56.0 </td>
<td> 2022-07-23 </td>
<td> 08:01:42 </td>
<td> 2022-07-28 </td>
<td> 16:10:17 </td>
<td> IGDK </td>
<td> </td>
<td> 2022/07/23/000070, BPJS KLS 1 PANDAWA 5 KONFIRMASI RUANGAN
</td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>

Anak, Oksigen 100% Sentral 2 LPM, Oksigen 100% Sentral 2 LPM, Infus Anak oleh
Perawat / Bidan, Infus Anak oleh Perawat / Bidan, Infus Anak oleh Perawat / Bidan
</td>
<td> - </td>
<td> 3900000 </td>
<td> Sehat </td>
<td> 6 </td>
<td> Sudah </td>
</tr>
<tr>
<td> 2022/07/23/000088 </td>
<td> 072718 </td>
<td> NAZHIEF ATHARRAYHAN ROZAQIE, AN </td>
<td> L </td>
<td> MALANG </td>
<td> 2022-07-23 </td>
<td> ISLAM </td>
<td> TS </td>
<td> NIZAR ROZAQIE SYAHRUL MUNTHAHA, TN </td>
<td> AYAH </td>
<td> JL. KEDAWUNG X-C NO. 18 RT.04 RW.07, TULUSREJO, LOWOKWARU,
KOTA MALANG </td>
<td> A09 </td>
<td> UMUM </td>
<td> kelas 3 </td>
<td> PF02 </td>
<td> 300000 </td>
<td> P03.4 </td>
<td> P03.4 </td>
<td> 2022-07-23 </td>
<td> 07:35:54 </td>
<td> 2022-07-27 </td>
<td> 15:24:46 </td>
<td> U0030 </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> 3200 </td>
<td> 48 </td>
<td> Hidup </td>
<td> Tidak </td>
<td> Hidup </td>
<td> Ya </td>
<td> Tidak </td>
<td> Ya </td>
<td> </td>
<td> - </td>
<td> 1500000 </td>
<td> Sembuh </td>
<td> 5 </td>
<td> Sudah </td>
</tr>
<tr>
<td> 2022/07/23/000068 </td>
<td> 072716 </td>
<td> MUHAMMAD ALWI SIHAB, AN </td>
<td> L </td>
<td> MALANG </td>
<td> 2021-08-14 </td>
<td> 0 Th 11 Bl 9 Hr </td>
<td> ISLAM </td>
<td> TS </td>
<td> MOCHAMMAD IMAM INDRA ABI NUGROHO, TN </td>
<td> AYAH </td>
<td> JL.KAPI SATA BALI IV/16E/10 RT 006 RW 011, SEKARPURO, PAKIS,
<td> A09 </td>
<td> UMUM </td>
<td> kelas 1 </td>
<td> P06 </td>
<td> 650000 </td>
<td> A09 </td>
<td> A09 </td>
<td> 2022-07-23 </td>
<td> 04:28:42 </td>
<td> 2022-07-28 </td>
<td> 17:23:02 </td>
<td> IGDK </td>
<td> </td>
<td> 2022/07/23/000068, UMUM KLS I DI </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>

Anak, Visite Dokter Spesialis Anak, Infus Anak oleh Perawat / Bidan </td>
<td> - </td>
<td> 3900000 </td>
<td> 6 </td>
<td> Sudah </td>
</tr>
<tr>
<td> 2022/07/22/000201 </td>
<td> 072700 </td>
<td> EKA WAHYUNI, NY </td>
<td> P </td>
<td> MALANG </td>
<td> 1999-06-21 </td>
<td> 23 Th 1 Bl 8 Hr </td>
<td> ISLAM </td>
<td> SMA </td>
<td> BAYU CHRISNA DANI, TN </td>
<td> SUAMI </td>
<td> BUGIS KRAJAN RT 2 RW 6 , SAPTORENGGO, PAKIS, KABUPATEN
MALANG </td>
<td> A09 </td>
<td> UMUM </td>
<td> kelas 3 </td>
<td> A04 </td>
<td> 300000 </td>
<td> O21.1 </td>
<td> O21.1 </td>
<td> 2022-07-22 </td>
<td> 23:05:07 </td>
<td> 2022-07-23 </td>
<td> 19:44:18 </td>
<td> IGDK </td>
<td> </td>
<td> 2022/07/22/000201, UMUM KELAS 3, AMARTA 5B </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>

Infus Dewasa oleh Perawat / Bidan, Jasa Pelayanan Kelas 3 </td>
<td> - </td>
<td> 300000 </td>
<td> 1 </td>
<td> Sudah </td>
</tr>
<tr>
<td> 2022/07/22/000202 </td>
<td> 072642 </td>
<td> RENAVA WULAN SARI I, NY </td>
<td> P </td>
<td> MALANG </td>
<td> 1997-01-06 </td>
<td> 25 Th 6 Bl 26 Hr </td>
<td> ISLAM </td>
<td> SMA </td>
<td> SEPTIAN WAHYU S, TN </td>
<td> SUAMI </td>
<td> JL HAMID RUSDI 1/38 RT 04 RW 10 , BUNULREJO, BLIMBING, KOTA
MALANG </td>
<td> BPJ </td>
<td> kelas 2 </td>
<td> D01 </td>
<td> 400000 </td>
<td> O82.9 </td>
<td> O82.9 </td>
<td> 2022-07-22 </td>
<td> 22:29:08 </td>
<td> 2022-07-25 </td>
<td> 11:31:26 </td>
<td> IGDK </td>
<td> 2022/07/22/000202, BPJS KLS 2 AYODYA 1 A </td>
<td> 1 </td>
<td> 0 </td>
<td> 0 </td>
<td> 0 </td>
<td> 0 </td>
<td> 0 </td>
<td> 38-39 </td>

<td> 2900 </td>
<td> 47 </td>
<td> Hidup </td>
<td> Tidak </td>
<td> Hidup </td>
<td> Ya </td>
<td> Tidak </td>
<td> Ya </td>
<td> Jasa Pelayanan Rumah Sakit , Visite Dokter Umum, Operasional

Rumah Sakit </td>
<td> - </td>
<td> 1200000 </td>
<td> Sehat </td>
<td> 3 </td>
<td> Sudah </td>
</tr>
<tr>
<td> 2022/07/22/000206 </td>
<td> 072713 </td>
<td> TAVISHA ERENORA MECCA, AN </td>
<td> P </td>
<td> MALANG </td>
<td> 2022-07-22 </td>
<td> 0 Th 0 Bl 12 Hr </td>
<td> ISLAM </td>
<td> TS </td>
<td> SEPTIAN WAHYU S, TN </td>
<td> AYAH </td>
<td> JL. HAMID RUSDI 1/38 RT 04 RW 10, BUNULREJO, BLIMBING, KOTA
MALANG </td>
<td> BPJ </td>
<td> kelas 3 </td>
<td> PF12 </td>
<td> 300000 </td>
<td> P03.4 </td>
<td> P03.4 </td>
<td> 2022-07-22 </td>
<td> 22:06:31 </td>
<td> 2022-07-25 </td>
<td> 10:09:03 </td>
<td> U0030 </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> 2900 </td>
<td> 47 </td>
<td> Hidup </td>
<td> Tidak </td>
<td> Hidup </td>
<td> Ya </td>
<td> Tidak </td>
<td> Ya </td>

<td> - </td>
<td> 900000 </td>
<td> Sembuh </td>
<td> 3 </td>
<td> Sudah </td>
</tr>
<tr>
<td> 2022/07/22/000030 </td>
<td> 065021 </td>
<td> MUHAMMAD ZHAFI AR RIFKI, AN </td>
<td> L </td>
<td> MALANG </td>
<td> 2022-02-10 </td>
<td> 0 Th 5 Bl 18 Hr </td>
<td> ISLAM </td>
<td> - </td>
<td> PERANGKAT DESA </td>
<td> M. AGHIS WAHIDU ZAMAN, TN </td>
<td> AYAH </td>
<td> JL SIDOMULYO RT 7 RW 3 , SIDOMULYO, JABUNG, KABUPATEN MALANG
</td>
<td> BPJ </td>
<td> kelas 2 </td>
<td> H07 </td>
<td> 400000 </td>
<td> B01.8 </td>
<td> B01.8 </td>
<td> 2022-07-22 </td>
<td> 21:54:25 </td>
<td> 2022-07-26 </td>
<td> 13:45:23 </td>
<td> U0002 </td>
<td> 0212R0100722K001235, BPJS KELAS 2, TITIP HASTINA 7 (DX
DENGAN VARICELLA) </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>

<td> - </td>
<td> 1600000 </td>
<td> 4 </td>
<td> Sudah </td>
</tr>
<tr>
<td> 2022/07/22/000170 </td>
<td> 064500 </td>
<td> BENEDIKTA SANCHIA JANETA CHRISTI, NY </td>
<td> P </td>
<td> Malang </td>
<td> 1995-06-11 </td>
<td> 27 Th 1 Bl 15 Hr </td>
<td> KATHOLIK </td>
<td> S1 </td>
<td> YOSEF SABASTIAN SETYA H, TN </td>
<td> SUAMI </td>
<td> PERUM INDIRISMA REGENCY I/B11 KAV 25 , JEDONG, WAGIR,
<td> BPJ </td>
<td> kelas 1 </td>
<td> H01 </td>
<td> 650000 </td>
<td> O82.8 </td>
<td> O82.0 </td>
<td> 2022-07-22 </td>
<td> 21:38:42 </td>
<td> 2022-07-24 </td>
<td> 17:03:20 </td>
<td> IGDK </td>
<td> 2022/07/22/000170, BPJS KELAS 1, HASTINA 1 </td>
<td> 1 </td>
<td> 0 </td>
<td> 0 </td>
<td> 0 </td>
<td> 0 </td>
<td> 0 </td>
<td> 40-41 </td>

<td> 3200 </td>
<td> 50 </td>
<td> Hidup </td>
<td> Tidak </td>
<td> Hidup </td>
<td> Ya </td>
<td> Tidak </td>
<td> Ya </td>

<td> - </td>
<td> 1300000 </td>
<td> 2 </td>
<td> Sudah </td>
</tr>
<tr>
<td> 2022/07/22/000204 </td>
<td> 072710 </td>
<td> IGNACIO RAIZEL BENETTE AVSHALOM, AN </td>
<td> L </td>
<td> MALANG </td>
<td> 2022-07-22 </td>
<td> 0 Th 0 Bl 10 Hr </td>
<td> KATHOLIK </td>
<td> TS </td>
<td> YOSEF SEBASTIAN SETYA H, TN </td>
<td> AYAH </td>
<td> PERUM INDIRISMA REGENCY I/B11 KAV 25 , JEDONG, WAGIR,
<td> BPJ </td>
<td> kelas 3 </td>
<td> PF11 </td>
<td> 300000 </td>
<td> P03.4 </td>
<td> P03.4 </td>
<td> 2022-07-22 </td>
<td> 20:39:17 </td>
<td> 2022-07-24 </td>
<td> 17:53:50 </td>
<td> U0030 </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> 3200 </td>
<td> 50 </td>
<td> Hidup </td>
<td> Tidak </td>
<td> Hidup </td>
<td> Ya </td>
<td> Tidak </td>
<td> Ya </td>

<td> - </td>
<td> 900000 </td>
<td> Sembuh </td>
<td> 3 </td>
<td> Sudah </td>
</tr>
<tr>
<td> 2022/07/22/000156 </td>
<td> 072371 </td>
<td> AMEERA AMER ALKATIRI, An </td>
<td> P </td>
<td> MALANG </td>
<td> 2022-07-15 </td>
<td> 0 Th 0 Bl 21 Hr </td>
<td> ISLAM </td>
<td> - </td>
<td> - </td>
<td> AMER ALKATIRI, TN </td>
<td> AYAH </td>
<td> PONDOK MBLIMBING INDAH BLOK O 1/32A RT 2 RW 11 , PURWODADI,
<td> BPJ </td>
<td> PA01 </td>
<td> NICU 1 </td>
<td> 400000 </td>
<td> P59.8 </td>
<td> P59.9 </td>
<td> 2022-07-22 </td>
<td> 19:01:26 </td>
<td> 2022-07-24 </td>
<td> 18:33:58 </td>
<td> IGDK </td>
<td> 2022/07/22/000156, BPJS KELAS 1, NICU </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> Visite Dokter Spesialis Anak, Sewa Fototerapi, Sewa

Fototerapi, Sewa Fototerapi </td>
<td> - </td>
<td> 1200000 </td>
<td> 3 </td>
<td> Sudah </td>
</tr>
<tr>
<td> 2022/07/22/000147 </td>
<td> 072555 </td>
<td> ROVIE WIDIYANTI,NY </td>
<td> P </td>
<td> MALANG </td>
<td> 1973-02-17 </td>
<td> 49 Th 5 Bl 12 Hr </td>
<td> ISLAM </td>
<td> SMA </td>
<td> AGOES KOESTADJI,TN </td>
<td> SUAMI </td>
<td> JL. PALMERAH 1/B26A RT.02 RW.07 , CEMOROKANDANG,
<td> BPJ </td>
<td> kelas 1 </td>
<td> H08 </td>
<td> 650000 </td>
<td> C53.0 </td>
<td> C53.0 </td>
<td> 2022-07-22 </td>
<td> 18:51:20 </td>
<td> 2022-07-23 </td>
<td> 04:37:18 </td>
<td> IGDK </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>

EKG, Operasional Rumah Sakit </td>
<td> - </td>
<td> 1300000 </td>
<td> Sehat </td>
<td> 2 </td>
<td> Sudah </td>
</tr>
<tr>
<td> 2022/07/22/000143 </td>
<td> 072697 </td>
<td> MARSHALL PRAKA MAULANA, AN </td>
<td> L </td>
<td> MALANG </td>
<td> 2021-02-19 </td>
<td> ISLAM </td>
<td> TS </td>
<td> MOCHAMAD PRAYUDA MAULAN, TN </td>
<td> AYAH </td>
<td> JL JANTI BARAT BLOK C DALAM I / 24 RT 4 RW 11,
BANDUNGREJOSARI, SUKUN, KOTA MALANG </td>
<td> BPJ </td>
<td> kelas 2 </td>
<td> H10 </td>
<td> 400000 </td>
<td> A90 </td>
<td> A90 </td>
<td> 2022-07-22 </td>
<td> 17:53:27 </td>
<td> 2022-07-25 </td>
<td> 18:12:21 </td>
<td> IGDK </td>
<td> 2022/07/22/000143, BPJS KELAS 2, TITIP HASTINA 10 </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> - </td>
<td> 1600000 </td>
<td> 4 </td>
<td> Sudah </td>
</tr>
<tr>
<td> 2022/07/22/000142 </td>
<td> 044402 </td>
<td> MARLIYAH ISTIAWATI, NY </td>
<td> P </td>
<td> MALANG </td>
<td> 1993-02-25 </td>
<td> 29 Th 5 Bl 3 Hr </td>
<td> ISLAM </td>
<td> IRT </td>
<td> SMA </td>
<td> PAMUJI BUDIARTO, TN </td>
<td> SUAMI </td>
<td> TERONGDOWO RT 02 RW 13, TIRTOMOYO, PAKIS, KABUPATEN MALANG
</td>
<td> A09 </td>
<td> UMUM </td>
<td> kelas 3 </td>
<td> KB04 </td>
<td> KS Kamar Bersalin 4 </td>
<td> 300000 </td>
<td> O03.4 </td>
<td> O03.4 </td>
<td> 2022-07-22 </td>
<td> 17:26:24 </td>
<td> 2022-07-22 </td>
<td> 19:20:01 </td>
<td> IGDK </td>
<td> </td>
<td> 2022/07/22/000142 UMUM KELAS 3 KURETASE DI KABER </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>

<td> </td>
<td> 300000 </td>
<td> 1 </td>
<td> Sudah </td>
</tr>
<tr>
<td> 2022/07/22/000131 </td>
<td> 040957 </td>
<td> ADISTRA GENDHIS PRAMESWARI, AN </td>
<td> P </td>
<td> MALANG </td>
<td> 2020-08-27 </td>
<td> 1 Th 11 Bl 0 Hr </td>
<td> ISLAM </td>
<td> - </td>
<td> SWASTA </td>
<td> ADITYA EKA PUTRA SHOLEH, TN </td>
<td> AYAH </td>
<td> JL. BROMO RT 3 RW 2 , JABUNG, JABUNG, KABUPATEN MALANG </td>
<td> BPJ </td>
<td> kelas 2 </td>
<td> D12 </td>
<td> 400000 </td>
<td> A91 </td>
<td> - </td>
<td> 2022-07-22 </td>
<td> 17:05:14 </td>
<td> 2022-07-22 </td>
<td> 22:18:54 </td>
<td> IGDK </td>
<td> 2022/07/22/000131, BPJS KELAS 2 UP 1, PANDAWA 3 </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>

<td> </td>
<td> 400000 </td>
<td> 1 </td>
<td> Sudah </td>
</tr>
<tr>
<td> 2022/07/22/000122 </td>
<td> 072689 </td>
<td> DINA FITRIA, Nn </td>
<td> P </td>
<td> MALANG </td>
<td> 2005-11-06 </td>
<td> 16 Th 8 Bl 22 Hr </td>
<td> ISLAM </td>
<td> SMA </td>
<td> RENNY ARYANI, Ny </td>
<td> IBU </td>
<td> JL. GADANG GG 6 / 42 RT 03 RW 06, GADANG, SUKUN, KOTA MALANG
</td>
<td> BPJ </td>
<td> kelas 3 </td>
<td> A08 </td>
<td> 300000 </td>
<td> O41.0 </td>
<td> O82.0 </td>
<td> 2022-07-22 </td>
<td> 15:55:24 </td>
<td> 2022-07-24 </td>
<td> 19:06:49 </td>
<td> IGDK </td>
<td> RSUD Kota Malang </td>
<td> 2022/07/22/000122 BPJS KELAS 3 RUJUKAN RSUD KOTA MALANG DI
AMARTA 6B KONFIRMASI </td>
<td> 1 </td>
<td> 0 </td>
<td> 0 </td>
<td> 0 </td>
<td> 0 </td>
<td> 0 </td>
<td> 28-30 </td>

<td> 1000 </td>
<td> 49 </td>
<td> Hidup </td>
<td> Ya </td>
<td> Hidup </td>
<td> Ya </td>
<td> Tidak </td>
<td> Ya </td>

Perawat / Bidan, NST, Konsultasi Dokter Spesialis Obgyn Via Telepon, Operasional
Rumah Sakit </td>
<td> - </td>
<td> 900000 </td>
<td> 3 </td>
<td> Sudah </td>
</tr>
<tr>
<td> 2022/07/22/000067 </td>
<td> 069277 </td>
<td> UMI MASITOH, NY </td>
<td> P </td>
<td> 1984-02-11 </td>
<td> 38 Th 5 Bl 17 Hr </td>
<td> ISLAM </td>
<td> S1 </td>
<td> SUAMI </td>
<td> DUSUN BINANGUN RT 2 RW 8 , BUMIAJI, BUMIAJI, KOTA BATU </td>
<td> BPJ </td>
<td> kelas 3 </td>
<td> A09 </td>
<td> 300000 </td>
<td> O34.2 </td>
<td> O34.2 </td>
<td> 2022-07-22 </td>
<td> 15:08:05 </td>
<td> 2022-07-27 </td>
<td> 05:28:33 </td>
<td> U0001 </td>
<td> 9 </td>
<td> 4 </td>
<td> 0 </td>
<td> 0 </td>
<td> 3 </td>
<td> 0 </td>
<td> 34-35 </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>

Bidan, NST, NST, Operasional Rumah Sakit </td>
<td> - </td>
<td> 1800000 </td>
<td> Sehat </td>
<td> 6 </td>
<td> Sudah </td>
</tr>
<tr>
<td> 2022/07/22/000141 </td>
<td> 072694 </td>
<td> DINA FITRIA., BY NY </td>
<td> P </td>
<td> MALANG </td>
<td> 2022-07-22 </td>
<td> ISLAM </td>
<td> TS </td>
<td> RENNY ARYANI, NY </td>
<td> IBU </td>
<td> JL GADANG GG 6/42 RT 03 RW 06, GADANG, SUKUN, KOTA MALANG
</td>
<td> BPJ </td>
<td> PA08 </td>
<td> NICU 8 </td>
<td> 400000 </td>
<td> P03.4 </td>
<td> J96.0 </td>
<td> 2022-07-22 </td>
<td> 14:53:02 </td>
<td> 2022-07-22 </td>
<td> 18:41:56 </td>
<td> U0029 </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> Pemasangan CPAP Hari Pertama, Sewa Inkubator, Sewa Patient

Monitor , Infus Bayi oleh Perawat / Bidan </td>
<td> - </td>
<td> 400000 </td>
<td> Status Belum Lengkap </td>
<td> 1 </td>
<td> Sudah </td>
</tr>
<tr>
<td> 2022/07/22/000126 </td>
<td> 072686 </td>
<td> ARLIN SHAKILA PUTRI, AN </td>
<td> P </td>
<td> MALANG </td>
<td> 2014-04-04 </td>
<td> 8 Th 3 Bl 24 Hr </td>
<td> ISLAM </td>
<td> TK </td>
<td> EDY SANTOSO, TN </td>
<td> AYAH </td>
<td> MANGLIAWAN RT 006 RW 003, MANGLIAWAN, PAKIS, KABUPATEN
MALANG </td>
<td> BPJ </td>
<td> kelas 2 </td>
<td> D03 </td>
<td> 400000 </td>
<td> A91 </td>
<td> A91 </td>
<td> 2022-07-22 </td>
<td> 13:04:20 </td>
<td> 2022-07-26 </td>
<td> 06:47:01 </td>
<td> IGDK </td>
<td> 2022/07/22/000126, BPJS KLAS 2 RUANG AYODYA 2 A </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>

Konsultasi Dokter Spesialis Anak Via Telepon, Infus Anak oleh Perawat / Bidan,
<td> - </td>
<td> 2000000 </td>
<td> 5 </td>
<td> Sudah </td>
</tr>
<tr>
<td> 2022/07/22/000114 </td>
<td> 072329 </td>
<td> SELINA PUTRI RAFIFA, AN </td>
<td> P </td>
<td> MALANG </td>
<td> 2022-07-14 </td>
<td> 0 Th 0 Bl 14 Hr </td>
<td> ISLAM </td>
<td> - </td>
<td> - </td>
<td> MARGA PUTRA PURNOMO, TN </td>
<td> AYAH </td>
<td> JL. CANDI BADUT 12 RT 02 RW 02, MOJOLANGU, LOWOKWARU, KOTA
MALANG </td>
<td> BPJ </td>
<td> PA091 </td>
<td> 400000 </td>
<td> P58.2 </td>
<td> P59.9 </td>
<td> 2022-07-22 </td>
<td> 13:03:44 </td>
<td> 2022-07-24 </td>
<td> 18:37:45 </td>
<td> IGDK </td>
<td> 2022/07/22/000114, BPJS KLAS 2 RUANG NICU </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>

Sewa Fototerapi, Sewa Fototerapi, Konsultasi Dokter Spesialis Anak Via Telepon,
<td> - </td>
<td> 1200000 </td>
<td> 3 </td>
<td> Sudah </td>
</tr>
<tr>
<td> 2022/07/22/000120 </td>
<td> 046771 </td>
<td> RIZKI ANUGRAH PRATAMA, AN </td>
<td> L </td>
<td> Malang </td>
<td> 2018-12-02 </td>
<td> 3 Th 7 Bl 26 Hr </td>
<td> ISLAM </td>
<td> TS </td>
<td> SUPIR </td>
<td> WAHYU TRI SUSENO, TN </td>
<td> AYAH </td>
<td> JL. LESANPURO 1E/38 RT 5 RW 3, LESANPURO, KEDUNGKANDANG,
KOTA MALANG </td>
<td> BPJ </td>
<td> kelas 3 </td>
<td> A15 </td>
<td> 300000 </td>
<td> A91 </td>
<td> A91 </td>
<td> 2022-07-22 </td>
<td> 13:03:20 </td>
<td> 2022-07-26 </td>
<td> 12:00:20 </td>
<td> IGDK </td>
<td> </td>
<td> 2022/07/22/000120, BPJS KLAS 3 RUANG AMARTA 4 B
(KONFIRMASI) KET BPJS TIDAK DITANGGUNG SUDAH DI ARAHKAN PENGURUSAN KE DINSOS DAN
BPJS DITUNGGU 3X24 JAM
25-07-2022/09:41:00
SUDAH CETAK SEP </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>

<td> - </td>
<td> 1500000 </td>
<td> 5 </td>
<td> Sudah </td>
</tr>
<tr>
<td> 2022/07/22/000109 </td>
<td> 015583 </td>
<td> GARLINGGA GALANG RAMADHAN,An </td>
<td> L </td>
<td> MALANG </td>
<td> 2013-07-20 </td>
<td> 9 Th 0 Bl 11 Hr </td>
<td> ISLAM </td>
<td> TS </td>
<td> - </td>
<td> IMAM S, TN </td>
<td> AYAH </td>
<td> JL H. ALI NASRUDIN RT 05/ RW 02, KEDUNGKANDANG,
<td> BPJ </td>
<td> kelas 1 </td>
<td> H03 </td>
<td> 650000 </td>
<td> A91 </td>
<td> A91 </td>
<td> 2022-07-22 </td>
<td> 13:02:48 </td>
<td> 2022-07-29 </td>
<td> 15:40:29 </td>
<td> IGDK </td>
<td> 2022/07/22/000109, BPJS KLAS 1 HASTINA 3 </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>

Anak, Visite Dokter Spesialis Anak, Visite Dokter Spesialis Anak, Konsultasi Dokter
Sakit </td>
<td> - </td>
<td> 5200000 </td>
<td> 8 </td>
<td> Sudah </td>
</tr>
<tr>
<td> 2022/07/22/000073 </td>
<td> 093941 </td>
<td> RAGIL ANGGRIANI MEI S, NY </td>
<td> P </td>
<td> Malang </td>
<td> 1989-05-18 </td>
<td> 33 Th 2 Bl 17 Hr </td>
<td> ISLAM </td>
<td> SMA </td>
<td> DICKY FEBRI NOVENDI, TN </td>
<td> SUAMI </td>
<td> BELUNG RT 05 RW 05, BELUNG, PONCOKUSUMO, KABUPATEN MALANG
</td>
<td> BPJ </td>
<td> kelas 2 </td>
<td> D10 </td>
<td> 400000 </td>
<td> O82.9 </td>
<td> O82.9 </td>
<td> 2022-07-22 </td>
<td> 10:28:23 </td>
<td> 2022-07-25 </td>
<td> 11:03:03 </td>
<td> IGDK </td>
<td> 2022/07/22/000073, BPJA KLAS 2 AYODYA 5A </td>
<td> 2 </td>
<td> 1 </td>
<td> 0 </td>
<td> 0 </td>
<td> 0 </td>
<td> 0 </td>
<td> 38-39 </td>

<td> 3450 </td>
<td> 49 </td>
<td> Hidup </td>
<td> Ya </td>
<td> Hidup </td>
<td> Ya </td>
<td> Tidak </td>
<td> Ya </td>

<td> - </td>
<td> 1600000 </td>
<td> 4 </td>
<td> Sudah </td>
</tr>
<tr>
<td> 2022/07/22/000063 </td>
<td> 072634 </td>
<td> SUMAH, Ny </td>
<td> P </td>
<td> 1983-08-11 </td>
<td> 38 Th 11 Bl 11 Hr </td>
<td> ISLAM </td>
<td> SMA </td>
<td> ABDUL HAMID, Tn </td>
<td> SUAMI </td>
<td> JL. MUHARTO VII RT 12 RW 07, KOTALAMA, KEDUNGKANDANG, KOTA
MALANG </td>
<td> BPJ </td>
<td> kelas 3 </td>
<td> A07 </td>
<td> 300000 </td>
<td> O82.9 </td>
<td> O82.0 </td>
<td> 2022-07-22 </td>
<td> 10:25:45 </td>
<td> 2022-07-25 </td>
<td> 09:41:38 </td>
<td> IGDK </td>
<td> 2022/07/22/000063, BPJS KLS III DI AMARTA 5C </td>
<td> 3 </td>
<td> 2 </td>
<td> 0 </td>
<td> 0 </td>
<td> 0 </td>
<td> 0 </td>
<td> 39-40 </td>

<td> 3200 </td>
<td> 47 </td>
<td> Hidup </td>
<td> Tidak </td>
<td> Hidup </td>
<td> Ya </td>
<td> Tidak </td>
<td> Ya </td>

<td> - </td>
<td> 1200000 </td>
<td> 4 </td>
<td> Sudah </td>
</tr>
<tr>
<td> 2022/07/22/000116 </td>
<td> 072688 </td>
<td> ALBY IZZAN SABARRA, AN </td>
<td> L </td>
<td> MALANG </td>
<td> 2022-07-22 </td>
<td> 0 Th 0 Bl 10 Hr </td>
<td> ISLAM </td>
<td> - </td>
<td> DICKY FEBRI NOVENDI, Tn </td>
<td> AYAH </td>
<td> BELUNG RT 05 RW 05, BELUNG, PONCOKUSUMO, KABUPATEN MALANG
</td>
<td> BPJ </td>
<td> kelas 3 </td>
<td> PF22 </td>
<td> 300000 </td>
<td> P03.4 </td>
<td> P03.4 </td>
<td> 2022-07-22 </td>
<td> 09:32:41 </td>
<td> 2022-07-27 </td>
<td> 15:25:19 </td>
<td> U0030 </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> 3450 </td>
<td> 49 </td>
<td> Hidup </td>
<td> Tidak </td>
<td> Hidup </td>
<td> Ya </td>
<td> Tidak </td>
<td> Ya </td>

<td> </td>
<td> 1800000 </td>
<td> Sembuh </td>
<td> 6 </td>
<td> Sudah </td>
</tr>
<tr>
<td> 2022/07/22/000101 </td>
<td> 072683 </td>
<td> ADZRA NUR KHALISA, AN </td>
<td> P </td>
<td> MALANG </td>
<td> 2022-07-22 </td>
<td> 0 Th 0 Bl 10 Hr </td>
<td> ISLAM </td>
<td> - </td>
<td> ACHMAD ROZIKIN, TN </td>
<td> AYAH </td>
<td> JL PUNTODEWO II NO 35 RT 10 RW 03, POLEHAN, BLIMBING, KOTA
MALANG </td>
<td> BPJ </td>
<td> kelas 3 </td>
<td> PF01 </td>
<td> 300000 </td>
<td> P03.4 </td>
<td> P21.0 </td>
<td> 2022-07-22 </td>
<td> 08:36:59 </td>
<td> 2022-07-25 </td>
<td> 10:08:39 </td>
<td> U0030 </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> 2800 </td>
<td> 46,5 </td>
<td> Hidup </td>
<td> Tidak </td>
<td> Hidup </td>
<td> Ya </td>
<td> Tidak </td>
<td> Ya </td>

Rumah Sakit </td>
<td> - </td>
<td> 1200000 </td>
<td> Sembuh </td>
<td> 4 </td>
<td> Sudah </td>
</tr>
<tr>
<td> 2022/07/22/000100 </td>
<td> 072684 </td>
<td> SUMAH, By.Ny </td>
<td> P </td>
<td> MALANG </td>
<td> 2022-07-22 </td>
<td> ISLAM </td>
<td> SD </td>
<td> ABDUL HAMID, Tn </td>
<td> AYAH </td>
MALANG </td>
<td> BPJ </td>
<td> kelas 3 </td>
<td> PF10 </td>
<td> 300000 </td>
<td> P03.4 </td>
<td> P03.4 </td>
<td> 2022-07-22 </td>
<td> 08:35:19 </td>
<td> 2022-07-27 </td>
<td> 15:23:57 </td>
<td> U0030 </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> 3200 </td>
<td> 47 </td>
<td> Hidup </td>
<td> Tidak </td>
<td> Hidup </td>
<td> Ya </td>
<td> Tidak </td>
<td> Ya </td>

<td> </td>
<td> 1800000 </td>
<td> Sembuh </td>
<td> 6 </td>
<td> Sudah </td>
</tr>
<tr>
<td> 2022/07/21/000052 </td>
<td> 072359 </td>
<td> YUNIAR VIERINDINI,NY </td>
<td> P </td>
<td> MALANG </td>
<td> 1998-06-11 </td>
<td> 24 Th 1 Bl 11 Hr </td>
<td> ISLAM </td>
<td> D1 </td>
<td> ANDI ISWAHYUDI,TN </td>
<td> SUAMI </td>
<td> JL. PULOSARI I L NO.35 RT.06 RW.07, PURWODADI, BLIMBING,
KOTA MALANG </td>
<td> BPJ </td>
<td> kelas 3 </td>
<td> A05 </td>
<td> 300000 </td>
<td> O80.8 </td>
<td> O80.0 </td>
<td> 2022-07-21 </td>
<td> 23:18:03 </td>
<td> 2022-07-23 </td>
<td> 06:05:45 </td>
<td> IGDK </td>
<td> 2022/07/21/000052, BPJS KLS 3 TITIP HASTINA 4 </td>
<td> 1 </td>
<td> 0 </td>
<td> 0 </td>
<td> 0 </td>
<td> 0 </td>
<td> 0 </td>
<td> 40-41 </td>

<td> 2750 </td>
<td> 48 </td>
<td> Hidup </td>
<td> Ya </td>
<td> Hidup </td>
<td> Ya </td>
<td> Tidak </td>
<td> Ya </td>
<td> Infus Dewasa oleh Perawat / Bidan, Oksigen 100% Sentral 3

LPM , VT Bidan, NST, NST, Konsultasi Dokter Spesialis Obgyn Via Telepon </td>
<td> - </td>
<td> 600000 </td>
<td> 2 </td>
<td> Sudah </td>
</tr>
<tr>
<td> 2022/07/21/000160 </td>
<td> 072676 </td>
<td> ARJUNA KEN ZAFRAN RAFARDHAN, AN </td>
<td> L </td>
<td> MALANG </td>
<td> 2022-07-21 </td>
<td> 0 Th 0 Bl 16 Hr </td>
<td> ISLAM </td>
<td> TS </td>
<td> BASUKI RACHMAD, TN </td>
<td> AYAH </td>
<td> JL. MUJAMIL GANG 2 NO 10 , BANJARARUM, SINGOSARI, KABUPATEN
MALANG </td>
<td> BPJ </td>
<td> PA29 </td>
<td> 400000 </td>
<td> P03.4 </td>
<td> P59.9 </td>
<td> 2022-07-21 </td>
<td> 22:28:49 </td>
<td> 2022-07-29 </td>
<td> 10:10:48 </td>
<td> U0029 </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> 2900 </td>
<td> 48 </td>
<td> Hidup </td>
<td> Tidak </td>
<td> Baik </td>
<td> Ya </td>
<td> Tidak </td>
<td> Ya </td>
<td> Perawatan Bayi SC , Perawatan Bayi SC , Perawatan Bayi SC

, Visite Dokter Spesialis Anak, Visite Dokter Spesialis Anak, Visite Dokter
Pemasangan CPAP Hari Berikutnya, Pemasangan CPAP Hari Pertama, Pemasangan CPAP Hari
Pertama, Sewa Infus Pump, Sewa Infus Pump, Sewa Infus Pump, Sewa Infus Pump, Sewa
Infus Pump, Sewa Infus Pump, Sewa Infus Pump, Sewa Infus Pump, Sewa Infus Pump,
Sewa Inkubator, Sewa Inkubator, Sewa Inkubator, Sewa Inkubator, Sewa Patient
Monitor , Sewa Patient Monitor , Sewa Patient Monitor , Sewa Patient Monitor , Sewa
Patient Monitor , Sewa Patient Monitor , Sewa Syringe Pump, Sewa Syringe Pump, Sewa
Syringe Pump, Sewa Syringe Pump, Sewa Syringe Pump, Pasang NGT/OGT, Sewa Fototera
</td>
<td> - </td>
<td> 3200000 </td>
<td> Sembuh </td>
<td> 8 </td>
<td> Sudah </td>
</tr>
<tr>
<td> 2022/07/21/000159 </td>
<td> 072673 </td>
<td> NAJLA FATIMAH HANANIA, AN </td>
<td> P </td>
<td> MALANG </td>
<td> 2022-07-21 </td>
<td> ISLAM </td>
<td> - </td>
<td> ANDI ISWAHYUDI, TN </td>
<td> SUAMI </td>
<td> JL PULOSARI I L NO 35 RT 6 RW 7 , PURWODADI, BLIMBING, KOTA
MALANG </td>
<td> BPJ </td>
<td> kelas 3 </td>
<td> PF18 </td>
<td> 300000 </td>
<td> P00.6 </td>
<td> P00.9 </td>
<td> 2022-07-21 </td>
<td> 22:20:00 </td>
<td> 2022-07-27 </td>
<td> 15:24:29 </td>
<td> U0030 </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> 2740 </td>
<td> 48 </td>
<td> Hidup </td>
<td> Ya </td>
<td> Hidup </td>
<td> Ya </td>
<td> Tidak </td>
<td> Ya </td>

<td> - </td>
<td> 1800000 </td>
<td> Sembuh </td>
<td> 6 </td>
<td> Sudah </td>
</tr>
<tr>
<td> 2022/07/21/000123 </td>
<td> 073786 </td>
<td> NUR VITAKHUROHMAH, NY </td>
<td> P </td>
<td> MALANG </td>
<td> 1990-06-18 </td>
<td> 32 Th 1 Bl 16 Hr </td>
<td> ISLAM </td>
<td> GURU </td>
<td> S1 </td>
<td> M NUR HUDA, TN </td>
<td> SUAMI </td>
<td> DSN JAMURAN RT 3 RW 1 , SUKODADI, WAGIR, KABUPATEN MALANG
</td>
<td> BPJ </td>
<td> kelas 2 </td>
<td> D05 </td>
<td> 400000 </td>
<td> D64.9 </td>
<td> D64.9 </td>
<td> 2022-07-21 </td>
<td> 20:42:10 </td>
<td> 2022-07-29 </td>
<td> 20:52:26 </td>
<td> IGDK </td>
<td> DR. NOVINA P. KARTIKARINI, SP.OG </td>
<td> 2022/07/21/000123, BPJS KLS 2 AYODYA 3A </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>

Visite Dokter Umum, Visite Dokter Umum, Visite Dokter Umum, Rawat Luka Ringan,
Konsultasi Dokter Spesialis Obgyn Via Telepon, Konsultasi Dokter Spesialis Anak Via
<td> - </td>
<td> 3600000 </td>
<td> 9 </td>
<td> Sudah </td>
</tr>
<tr>
<td> 2022/07/21/000154 </td>
<td> 072670 </td>
<td> YOGA DWI PRANATA, AN </td>
<td> L </td>
<td> MALANG </td>
<td> 2019-04-05 </td>
<td> 3 Th 3 Bl 16 Hr </td>
<td> ISLAM </td>
<td> - </td>
<td> - </td>
<td> PENDIK PRIYO SUBEKTI, TN </td>
<td> AYAH </td>
<td> JL. CEMPAKA RT 20 RW 6 , SEKARPURO, PAKIS, KABUPATEN MALANG
</td>
<td> A09 </td>
<td> UMUM </td>
<td> kelas 3 </td>
<td> K0000239 </td>
<td> KS IGD 1 </td>
<td> 300000 </td>
<td> R11 </td>
<td> R11 </td>
<td> 2022-07-21 </td>
<td> 20:30:04 </td>
<td> 2022-07-26 </td>
<td> 09:57:01 </td>
<td> IGDK </td>
<td> </td>
<td> 2022/07/21/000154, UMUM KLS 3 TITIP AYODYA 2A </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> 1800000 </td>
<td> Pulang Paksa </td>
<td> 6 </td>
<td> Sudah </td>
</tr>
<tr>
<td> 2022/07/21/000100 </td>
<td> 072651 </td>
<td> LUCI ARI WIJAYA, Ny </td>
<td> P </td>
<td> MALANG </td>
<td> 1983-01-13 </td>
<td> 39 Th 6 Bl 18 Hr </td>
<td> ISLAM </td>
<td> TS </td>
<td> MUHAMMAD NUR HASAN, Tn </td>
<td> SUAMI </td>
<td> JL. KOL SUGIONO IX B / 38 RT 07 RW 01, MERGOSONO,
<td> BPJ </td>
<td> kelas 1 </td>
<td> H04 </td>
<td> 650000 </td>
<td> O00.8 </td>
<td> O00.9 </td>
<td> 2022-07-21 </td>
<td> 19:11:39 </td>
<td> 2022-07-23 </td>
<td> 19:00:00 </td>
<td> U0001 </td>
<td> 2022/07/21/000100, BPJS KELAS 1 LAPARATOMY HASTINA 1 </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>

<td> - </td>
<td> 1950000 </td>
<td> Sembuh </td>
<td> 3 </td>
<td> Sudah </td>
</tr>
<tr>
<td> 2022/07/21/000080 </td>
<td> 072284 </td>
<td> TRI LESTARI LANGGENG, NY </td>
<td> P </td>
<td> MALANG </td>
<td> 1978-12-15 </td>
<td> 43 Th 7 Bl 13 Hr </td>
<td> ISLAM </td>
<td> SMP </td>
<td> SARWI, TN </td>
<td> SUAMI </td>
<td> JL BINOR NO 17 RT 9 RW 14, BUNULREJO, BLIMBING, KOTA MALANG
</td>
<td> BPJ </td>
<td> kelas 3 </td>
<td> A04 </td>
<td> 300000 </td>
<td> O03.4 </td>
<td> O03.4 </td>
<td> 2022-07-21 </td>
<td> 19:04:45 </td>
<td> 2022-07-22 </td>
<td> 06:40:32 </td>
<td> U0001 </td>
<td> 2022/07/21/000080, BPJS KELAS 3 KURET, GANTI DPJP DR IMEL
</td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>

<td> - </td>
<td> 600000 </td>
<td> Sehat </td>
<td> 2 </td>
<td> Sudah </td>
</tr>
<tr>
<td> 2022/07/21/000106 </td>
<td> 023228 </td>
<td> AJENG WAHYUNINGTIYAS, NY </td>
<td> P </td>
<td> MADIUN </td>
<td> 1989-08-03 </td>
<td> 32 Th 11 Bl 28 Hr </td>
<td> ISLAM </td>
<td> SWASTA </td>
<td> S1 </td>
<td> SWASTA </td>
<td> DENI FIRMANTO, TN </td>
<td> SUAMI </td>
<td> JL. KERTOSARIRO NO.36 RT 3 RW 3, KETAWANGGEDE, LOWOKWARU,
KOTA MALANG </td>
<td> BPJ </td>
<td> kelas 1 </td>
<td> H10 </td>
<td> 650000 </td>
<td> O02.0 </td>
<td> O02.0 </td>
<td> 2022-07-21 </td>
<td> 19:01:52 </td>
<td> 2022-07-21 </td>
<td> 22:00:00 </td>
<td> IGDK </td>
<td> 2022/07/21/000106, BPJS KELAS 1 KURET HASTINA 9 KONFIRMASI
</td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>

<td> - </td>
<td> 650000 </td>
<td> 1 </td>
<td> Sudah </td>
</tr>
<tr>
<td> 2022/07/21/000108 </td>
<td> 072343 </td>
<td> HIKARI MAYZURA SHEZA, AN </td>
<td> P </td>
<td> MALANG </td>
<td> 2022-07-14 </td>
<td> 0 Th 0 Bl 19 Hr </td>
<td> ISLAM </td>
<td> TS </td>
<td> ANGGA SEPTIAN PRADANA, TN </td>
<td> AYAH </td>
<td> PERUM BANJARARUM ASRI M-7 RT 002 RW 011, BANJARARUM,
<td> BPJ </td>
<td> IGD1 </td>
<td> KS IGD 1 </td>
<td> 400000 </td>
<td> P59.9 </td>
<td> P59.9 </td>
<td> 2022-07-21 </td>
<td> 14:32:34 </td>
<td> 2022-07-21 </td>
<td> 15:49:49 </td>
<td> IGDK </td>
<td> 2022/07/21/000108, BPJS KLS 2 FOTOTERAPI NICU </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> Jasa Pelayanan Rumah Sakit, Sewa Fototerapi, Operasional

Rumah Sakit , Sewa Fototerapi </td>
<td> - </td>
<td> 400000 </td>
<td> Sembuh </td>
<td> 1 </td>
<td> Sudah </td>
</tr>
<tr>
<td> 2022/07/21/000157 </td>
<td> 077501 </td>
<td> NIZAM RAMADHANI, AN </td>
<td> L </td>
<td> MALANG </td>
<td> 2015-06-17 </td>
<td> 7 Th 1 Bl 11 Hr </td>
<td> ISLAM </td>
<td> TS </td>
<td> SITI KHOIRIYAH, NY </td>
<td> IBU </td>
<td> JL. TERUSAN BATU BARA VB/29 , BLIMBING, BLIMBING, KOTA
MALANG </td>
<td> BPJ </td>
<td> kelas 3 </td>
<td> D04 </td>
<td> 300000 </td>
<td> A09 </td>
<td> A09 </td>
<td> 2022-07-21 </td>
<td> 13:34:39 </td>
<td> 2022-07-24 </td>
<td> 10:56:41 </td>
<td> IGDK </td>
<td> </td>
<td> 2022/07/21/000157, BPJS KLS III TITIP DI AYODYA 2B </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>

<td> - </td>
<td> 1200000 </td>
<td> 4 </td>
<td> Sudah </td>
</tr>
<tr>
<td> 2022/07/21/000142 </td>
<td> 072339 </td>
<td> P </td>
<td> MALANG </td>
<td> 2002-03-31 </td>
<td> 20 Th 3 Bl 29 Hr </td>
<td> ISLAM </td>
<td> SMA </td>
<td> SUAMI </td>
<td> BPJ </td>
<td> kelas 3 </td>
<td> A11 </td>
<td> 300000 </td>
<td> T81.4 </td>
<td> O86.0 </td>
<td> 2022-07-21 </td>
<td> 11:16:44 </td>
<td> 2022-07-26 </td>
<td> 10:52:24 </td>
<td> IGDK </td>
<td> 2022/07/21/000142, AMARTA 5B </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>

<td> - </td>
<td> 1800000 </td>
<td> Sembuh </td>
<td> 6 </td>
<td> Sudah </td>
</tr>
<tr>
<td> 2022/07/21/000156 </td>
<td> 070274 </td>
<td> WENNY EKO SULESTYORINI, NY </td>
<td> P </td>
<td> MALANG </td>
<td> 1990-05-23 </td>
<td> 32 Th 2 Bl 13 Hr </td>
<td> ISLAM </td>
<td> SMA </td>
<td> BASUKI RACHMAD, TN </td>
<td> SUAMI </td>
<td> JL. MUJAMIL GANG 2 NO 10 , BANJARARUM, SINGOSARI, KABUPATEN
MALANG </td>
<td> BPJ </td>
<td> kelas 3 </td>
<td> A03 </td>
<td> 300000 </td>
<td> O24.0 </td>
<td> O34.2 </td>
<td> 2022-07-21 </td>
<td> 11:15:11 </td>
<td> 2022-07-23 </td>
<td> 16:19:42 </td>
<td> IGDK </td>
<td> </td>
<td> 3 </td>
<td> 1 </td>
<td> 0 </td>
<td> 0 </td>
<td> 1 </td>
<td> 0 </td>
<td> 34-35 </td>

<td> 2900 </td>
<td> 48 </td>
<td> Hidup </td>
<td> Tidak </td>
<td> Hidup </td>
<td> Ya </td>
<td> Tidak </td>
<td> Ya </td>
<td> </td>
<td> - </td>
<td> 900000 </td>
<td> Sembuh </td>
<td> 3 </td>
<td> Sudah </td>
</tr>
<tr>
<td> 2022/07/19/000220 </td>
<td> 064515 </td>
<td> LUSI INDRIANI, NY </td>
<td> P </td>
<td> MALANG </td>
<td> 1982-02-02 </td>
<td> 40 Th 5 Bl 29 Hr </td>
<td> ISLAM </td>
<td> D3 </td>
<td> GURU </td>
<td> SUAMI </td>
<td> JL. DANAU MANINJAU DALAM VI / B2 F21 RT 05 RW 09, SAWOJAJAR,
<td> BPJ </td>
<td> kelas 3 </td>
<td> A06 </td>
<td> 300000 </td>
<td> O60.0 </td>
<td> O60.0 </td>
<td> 2022-07-21 </td>
<td> 11:11:14 </td>
<td> 2022-07-22 </td>
<td> 11:14:11 </td>
<td> IGDK </td>
<td> RS Melati Husada </td>
<td> 2022/07/19/000220 BPJS KELAS 3 TITIP AYODYA 3A KONFIRM </td>
<td> 3 </td>
<td> 2 </td>
<td> 0 </td>
<td> 0 </td>
<td> 0 </td>
<td> 0 </td>
<td> 35-36 </td>

<td> 0 </td>
<td> 0 </td>
<td> Hidup </td>
<td> Tidak </td>
<td> Hidup </td>
<td> Tidak </td>
<td> Tidak </td>
<td> Tidak </td>
<td> </td>
<td> </td>
<td> 600000 </td>
<td> Sembuh </td>
<td> 2 </td>
<td> Sudah </td>
</tr>
<tr>
<td> 2022/07/20/000244 </td>
<td> 063454 </td>
<td> DIAN MAULANI, Ny </td>
<td> P </td>
<td> MALANG </td>
<td> 1986-11-06 </td>
<td> 35 Th 8 Bl 25 Hr </td>
<td> ISLAM </td>
<td> SMA </td>
<td> IMAM KHOIRUDIN, Tn </td>
<td> SUAMI </td>
<td> JL. MAYJEN PANJAITAN VIII / 20 RT 04 RW 05, PENANGGUNGAN,
KLOJEN, KOTA MALANG </td>
<td> BPJ </td>
<td> kelas 2 </td>
<td> D02 </td>
<td> 400000 </td>
<td> O82.0 </td>
<td> O82.0 </td>
<td> 2022-07-21 </td>
<td> 10:06:05 </td>
<td> 2022-07-23 </td>
<td> 11:12:00 </td>
<td> IGDK </td>
<td> 2022/07/20/000244, BPJS KLS 2 TITIP RR DULU, RENCANA TITIP
PANDAWA 1, DWARAWATI/AYODYA MENYUSUL </td>
<td> 3 </td>
<td> 2 </td>
<td> 0 </td>
<td> 0 </td>
<td> 0 </td>
<td> 0 </td>
<td> 38-39 </td>

<td> 3050 </td>
<td> 47 </td>
<td> Hidup </td>
<td> Ya </td>
<td> Baik </td>
<td> Ya </td>
<td> Tidak </td>
<td> Ya </td>

Infus Dewasa oleh Perawat / Bidan, Konsultasi Dokter Spesialis Obgyn Via Telepon,
<td> </td>
<td> 1200000 </td>
<td> Sehat </td>
<td> 3 </td>
<td> Sudah </td>
</tr>
<tr>
<td> 2022/07/21/000076 </td>
<td> 072641 </td>
<td> DIAN MAULANI, By,Ny </td>
<td> L </td>
<td> Malang </td>
<td> 2022-07-21 </td>
<td> ISLAM </td>
<td> - </td>
<td> - </td>
<td> IMAM KHOIRUDIN, Tn </td>
<td> AYAH </td>
<td> JL. MAYJEN PANJAITAN VIII / 20 RT 04 RW 05, PENANGGUNGAN,
KLOJEN, KOTA MALANG </td>
<td> BPJ </td>
<td> kelas 3 </td>
<td> BF33 </td>
<td> 300000 </td>
<td> P03.4 </td>
<td> P03.4 </td>
<td> 2022-07-21 </td>
<td> 08:58:18 </td>
<td> 2022-07-23 </td>
<td> 11:12:44 </td>
<td> U0030 </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> 3050 </td>
<td> 47 </td>
<td> Hidup </td>
<td> Tidak </td>
<td> Hidup </td>
<td> Ya </td>
<td> Tidak </td>
<td> Ya </td>
<td> Perawatan Bayi SC , Jasa Pelayanan Rumah Sakit ,

<td> - </td>
<td> 900000 </td>
<td> Sembuh </td>
<td> 3 </td>
<td> Sudah </td>
</tr>
<tr>
<td> 2022/07/21/000053 </td>
<td> 072633 </td>
<td> SASKIA DELLA S, BY NY </td>
<td> P </td>
<td> MALANG </td>
<td> 2022-07-21 </td>
<td> ISLAM </td>
<td> TS </td>
<td> MUHAMMAD ISFANADIN, TN </td>
<td> AYAH </td>
<td> JL. MUHARTO V-B NO. 480 RT 08 RW 08, KOTALAMA,
<td> BPJ </td>
<td> kelas 3 </td>
<td> PF21 </td>
<td> 300000 </td>
<td> P00.6 </td>
<td> P00.9 </td>
<td> 2022-07-21 </td>
<td> 05:38:13 </td>
<td> 2022-07-22 </td>
<td> 21:23:34 </td>
<td> U0030 </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> 3110 </td>
<td> 47 </td>
<td> Hidup </td>
<td> Ya </td>
<td> Hidup </td>
<td> Ya </td>
<td> Tidak </td>
<td> Ya </td>
<td> Visite Dokter Spesialis Anak </td>

<td> - </td>
<td> 600000 </td>
<td> Sembuh </td>
<td> 2 </td>
<td> Sudah </td>
</tr>
<tr>
<td> 2022/07/21/000152 </td>
<td> 100296 </td>
<td> ADRIEL IVANO RAQILA PUTRA, AN </td>
<td> L </td>
<td> MALANG </td>
<td> 2017-11-27 </td>
<td> 4 Th 7 Bl 29 Hr </td>
<td> ISLAM </td>
<td> - </td>
<td> TS </td>
<td> Arif Muchtar, Tn. </td>
<td> AYAH </td>
<td> JL. KASEMBON NO. 2A RT 06 RW 05, RAMPALCELAKET, KLOJEN, KOTA
MALANG </td>
<td> BPJ </td>
<td> kelas 1 </td>
<td> H09 </td>
<td> 650000 </td>
<td> R11 </td>
<td> A09 </td>
<td> 2022-07-21 </td>
<td> 00:30:10 </td>
<td> 2022-07-23 </td>
<td> 19:00:00 </td>
<td> IGDK </td>
<td> 2022/07/21/000152, BPJS KLS 2 UP 1 HASTINA 1 KONFIRMASI
RUANGAN </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> - </td>
<td> 1950000 </td>
<td> Sembuh </td>
<td> 3 </td>
<td> Sudah </td>
</tr>
<tr>
<td> 2022/07/20/000211 </td>
<td> 021527 </td>
<td> ARSYANENDRA NATASENNA WIDIANTO,AN </td>
<td> L </td>
<td> Malang </td>
<td> 2019-07-18 </td>
<td> 3 Th 0 Bl 15 Hr </td>
<td> ISLAM </td>
<td> - </td>
<td> - </td>
<td> SWASTA </td>
<td> FAJAR WIDIANTO, TN </td>
<td> AYAH </td>
<td> PONDOK WISATA ESTATE A-11 RT 3 RW 11, ASRIKATON, PAKIS,
<td> BPJ </td>
<td> kelas 2 </td>
<td> D03 </td>
<td> 400000 </td>
<td> R50.9 </td>
<td> - </td>
<td> 2022-07-20 </td>
<td> 23:46:16 </td>
<td> 2022-07-21 </td>
<td> 09:21:25 </td>
<td> IGDK </td>
<td> 2022/07/20/000211, BPJS KLS 2, TITIP AMARTA 7B KONFIRMASI
RUANGAN. RENCANA AYODYA MENYUSUL. ORANG TUA BERSEDIA DITITIPKAN KELAS 3 DULU
2022/07/21/000211, PER JAM 09.00 BPJS KELAS 2 UP KELAS 1 DI PANDAWA 1 </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>

Visite Dokter Spesialis Anak, Nebulizer , Nebulizer , Nebulizer , Nebulizer ,
Konsultasi Dokter Spesialis Anak Via Telepon, Operasional Rumah Sakit </td>
<td> </td>
<td> 800000 </td>
<td> 2 </td>
<td> Sudah </td>
</tr>
<tr>
<td> 2022/07/20/000180 </td>
<td> 072594 </td>
<td> BELLVANIA APRILIA EFENDI, AN </td>
<td> P </td>
<td> JEMBER </td>
<td> 2016-04-02 </td>
<td> 6 Th 3 Bl 25 Hr </td>
<td> ISLAM </td>
<td> TS </td>
<td> YULI EFENDI, TN </td>
<td> AYAH </td>
<td> JL SANAN GANG 10/106 RT 4 RW 16, PURWANTORO, BLIMBING, KOTA
MALANG </td>
<td> BPJ </td>
<td> D04 </td>
<td> 400000 </td>
<td> J18.8 </td>
<td> J18.8 </td>
<td> 2022-07-20 </td>
<td> 23:13:22 </td>
<td> 2022-07-24 </td>
<td> 09:14:57 </td>
<td> U0002 </td>
<td> Almira Medical Clinic </td>
<td> 2022/07/20/000180, BPJS KLS 3, SEMENTARA ICU </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> Jasa Pelayanan Rumah Sakit, Oksigen 100% Sentral 2 LPM,

Oksigen 100% Sentral 2 LPM, Oksigen 100% Sentral 2 LPM, Oksigen 100% Sentral 2 LPM,
Visite Dokter Spesialis Anak, Visite Dokter Spesialis Anak, Sewa Infus Pump, Sewa
Infus Pump, Sewa Infus Pump, Sewa Patient Monitor , Sewa Patient Monitor ,
Nebulizer , Nebulizer , Nebulizer , Nebulizer , Nebulizer , Nebulizer , Nebulizer ,
Nebulizer , Nebulizer , Nebulizer , Nebulizer , Sewa Patient Monitor , Konsultasi
Dokter Spesialis Anak Via Telepon, Infus Bayi oleh Perawat / Bidan, Infus Bayi oleh
Perawat / Bidan, EKG, Operasional Rumah Sakit </td>
<td> - </td>
<td> 1600000 </td>
<td> Sehat </td>
<td> 4 </td>
<td> Sudah </td>
</tr>
<tr>
<td> 2022/07/20/000250 </td>
<td> 072207 </td>
<td> ALCEO PUTRA SUCAHYONO, AN </td>
<td> L </td>
<td> MALANG </td>
<td> 2022-07-11 </td>
<td> 0 Th 0 Bl 15 Hr </td>
<td> KRISTEN </td>
<td> TS </td>
<td> YUSUA AGUS S, TN </td>
<td> AYAH </td>
<td> JL. KH. MALIK DALAM PERUM BIR 3 NEW KAV 5 BLOK C BAWAH,
BURING, KEDUNGKANDANG, KOTA MALANG </td>
<td> BPJ </td>
<td> PA09 </td>
<td> 400000 </td>
<td> P58.2 </td>
<td> P59.8 </td>
<td> 2022-07-20 </td>
<td> 22:35:43 </td>
<td> 2022-07-22 </td>
<td> 19:00:42 </td>
<td> IGDK </td>
<td> 2022/07/20/000250, BPJS, FOTOTERAPI, NICU </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>

Sewa Fototerapi, Sewa Fototerapi, Sewa Fototerapi, Operasional Rumah Sakit , Sewa
Fototerapi </td>
<td> - </td>
<td> 800000 </td>
<td> 2 </td>
<td> Sudah </td>
</tr>
<tr>
<td> 2022/07/20/000206 </td>
<td> 072492 </td>
<td> IVVATUL IHDA QURROTUL AINI, NY </td>
<td> P </td>
<td> MALANG </td>
<td> 1999-06-06 </td>
<td> 23 Th 1 Bl 21 Hr </td>
<td> ISLAM </td>
<td> GURU </td>
<td> S1 </td>
<td> DODIK ARVIANTO, TN </td>
<td> SUAMI </td>
<td> DUSUN KRAJAN BENDOLAWANG RT 04 RW 01, NGADIREJO, JABUNG,
<td> BPJ </td>
<td> kelas 1 </td>
<td> H04 </td>
<td> 650000 </td>
<td> O02.0 </td>
<td> O02.0 </td>
<td> 2022-07-20 </td>
<td> 22:14:34 </td>
<td> 2022-07-21 </td>
<td> 05:50:00 </td>
<td> IGDK </td>
<td> BPJS KLS 1, TITIP AYODYA 1A KONFIRMASI RUANGAN, RENCANA
HASTINA MENYUSUL </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> 650000 </td>
<td> 1 </td>
<td> Sudah </td>
</tr>
<tr>
<td> 2022/07/20/000220 </td>
<td> 072610 </td>
<td> WINARSIH, Ny </td>
<td> P </td>
<td> Malang </td>
<td> 1993-12-19 </td>
<td> 28 Th 7 Bl 5 Hr </td>
<td> ISLAM </td>
<td> SD </td>
<td> RIZKY ADE SALFIANTO, Tn </td>
<td> SUAMI </td>
<td> DSN GADING RT 17 RW 03, GADINGKEMBAR, JABUNG, KABUPATEN
MALANG </td>
<td> BPJ </td>
<td> kelas 3 </td>
<td> A09 </td>
<td> 300000 </td>
<td> O14.9 </td>
<td> O82.8 </td>
<td> 2022-07-20 </td>
<td> 21:34:11 </td>
<td> 2022-07-22 </td>
<td> 11:16:02 </td>
<td> IGDK </td>
<td> PKM Jabung </td>
<td> 2022/07/20/000220 BPJS KELAS 3 RUJUKAN PKM JABUNG DI AMARTA
6C KONFIRM </td>
<td> 3 </td>
<td> 2 </td>
<td> 0 </td>
<td> 0 </td>
<td> 0 </td>
<td> 0 </td>
<td> 38-39 </td>

<td> 2200 </td>
<td> 47 </td>
<td> Hidup </td>
<td> Tidak </td>
<td> Hidup </td>
<td> Ya </td>
<td> Tidak </td>
<td> Ya </td>
<td> </td>
<td> </td>
<td> 600000 </td>
<td> 2 </td>
<td> Sudah </td>
</tr>
<tr>
<td> 2022/07/20/000239 </td>
<td> 072620 </td>
<td> RIA RIZKI, NY </td>
<td> P </td>
<td> MALANG </td>
<td> 1995-01-26 </td>
<td> 27 Th 6 Bl 2 Hr </td>
<td> ISLAM </td>
<td> TS </td>
<td> TEGUH, TN </td>
<td> SUAMI </td>
<td> JL. PESANTREN RT 29 RW 04, KEDOK, TUREN, KABUPATEN MALANG
</td>
<td> BPJ </td>
<td> kelas 2 </td>
<td> P01 </td>
<td> 400000 </td>
<td> N71.9 </td>
<td> N71.9 </td>
<td> 2022-07-20 </td>
<td> 21:33:58 </td>
<td> 2022-07-21 </td>
<td> 08:54:06 </td>
<td> IGDK </td>
<td> </td>
<td> 2022/07/20/000239, BPJS KLS 2, TITIP PANDAWA 1 KONFIRMASI
RUANGAN </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> - </td>
<td> 400000 </td>
<td> Sehat </td>
<td> 1 </td>
<td> Sudah </td>
</tr>
<tr>
<td> 2022/07/20/000253 </td>
<td> 072630 </td>
<td> REYHAN ATHAILLAH SHAQUILLE CALIEF, AN </td>
<td> L </td>
<td> Malang </td>
<td> 2022-07-20 </td>
<td> 0 Th 0 Bl 11 Hr </td>
<td> ISLAM </td>
<td> - </td>
<td> MUHAMMAD NUR SOLEH, TN </td>
<td> AYAH </td>
<td> JL KI AGENG GRIIBIG V NO 30 RT 6 RW 5 , MADYOPURO,
<td> BPJ </td>
<td> kelas 3 </td>
<td> PF08 </td>
<td> 300000 </td>
<td> P00.6 </td>
<td> P00.9 </td>
<td> 2022-07-20 </td>
<td> 21:27:39 </td>
<td> 2022-07-21 </td>
<td> 19:11:50 </td>
<td> U0030 </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> 2890 </td>
<td> 48 </td>
<td> Hidup </td>
<td> Ya </td>
<td> Hidup </td>
<td> Ya </td>
<td> Tidak </td>
<td> Ya </td>

<td> </td>
<td> 300000 </td>
<td> Sembuh </td>
<td> 1 </td>
<td> Sudah </td>
</tr>
<tr>
<td> 2022/07/20/000252 </td>
<td> 072628 </td>
<td> WINARSIH, By.Ny (II) </td>
<td> P </td>
<td> MALANG </td>
<td> 2022-07-20 </td>
<td> ISLAM </td>
<td> TS </td>
<td> AYAH </td>
MALANG </td>
<td> BPJ </td>
<td> kelas 3 </td>
<td> PF02 </td>
<td> 300000 </td>
<td> P03.4 </td>
<td> P03.4 </td>
<td> 2022-07-20 </td>
<td> 20:57:47 </td>
<td> 2022-07-22 </td>
<td> 14:35:53 </td>
<td> U0030 </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> 2100 </td>
<td> 43 </td>
<td> Hidup </td>
<td> Tidak </td>
<td> Hidup </td>
<td> Ya </td>
<td> Tidak </td>
<td> Ya </td>

<td> </td>
<td> 900000 </td>
<td> Sembuh </td>
<td> 3 </td>
<td> Sudah </td>
</tr>
<tr>
<td> 2022/07/20/000251 </td>
<td> 072627 </td>
<td> WINARSIH, By.Ny (I) </td>
<td> P </td>
<td> MALANG </td>
<td> 2022-07-20 </td>
<td> ISLAM </td>
<td> - </td>
<td> AYAH </td>
MALANG </td>
<td> BPJ </td>
<td> kelas 3 </td>
<td> PF16 </td>
<td> 300000 </td>
<td> P03.4 </td>
<td> P07.1 </td>
<td> 2022-07-20 </td>
<td> 20:56:41 </td>
<td> 2022-07-22 </td>
<td> 14:52:49 </td>
<td> U0030 </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> 2300 </td>
<td> 44 </td>
<td> Hidup </td>
<td> Tidak </td>
<td> Hidup </td>
<td> Ya </td>
<td> Tidak </td>
<td> Ya </td>

<td> </td>
<td> 900000 </td>
<td> Sembuh </td>
<td> 3 </td>
<td> Sudah </td>
</tr>
<tr>
<td> 2022/07/20/000192 </td>
<td> 053963 </td>
<td> HAIBA ZIA ALMAHYRA, AN </td>
<td> P </td>
<td> MALANG </td>
<td> 2021-06-27 </td>
<td> ISLAM </td>
<td> - </td>
<td> - </td>
<td> WILDAN ALFAN M, TN </td>
<td> AYAH </td>
<td> JL. SIMPANG GADING 26 RT 1 RW 6, GADINGKASRI, KLOJEN, KOTA
MALANG </td>
<td> BPJ </td>
<td> kelas 1 </td>
<td> D04 </td>
<td> 650000 </td>
<td> A91 </td>
<td> - </td>
<td> 2022-07-20 </td>
<td> 20:53:40 </td>
<td> 2022-07-20 </td>
<td> 22:59:18 </td>
<td> IGDK </td>
<td> 2022/07/20/00019, BPJS KLS 2 UP 1 , PANDAWA 8 </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>

<td> - </td>
<td> 650000 </td>
<td> 1 </td>
<td> Sudah </td>
</tr>
<tr>
<td> 2022/07/23/000136 </td>
<td> 054595 </td>
<td> MUHAMMAD KEENAN DANIAL KARTAWIJAYA, AN </td>
<td> L </td>
<td> Malang </td>
<td> 2021-07-10 </td>
<td> 1 Th 0 Bl 18 Hr </td>
<td> ISLAM </td>
<td> - </td>
<td> GEMA DIRGANTARA, TN </td>
<td> AYAH </td>
<td> PERUM OMA VIEW ATAS GE/20 RT 7 RW 10, CEMOROKANDANG,
<td> BPJ </td>
<td> D08 </td>
<td> 400000 </td>
<td> R11 </td>
<td> - </td>
<td> 2022-07-20 </td>
<td> 20:44:00 </td>
<td> 2022-07-24 </td>
<td> 10:58:11 </td>
<td> IGDK </td>
<td> 2022/07/23/000136, BPJS KLS 1 TITIP DWARAWATI 6B (SUDAH KIE)
</td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>

<td> - </td>
<td> 2000000 </td>
<td> 5 </td>
<td> Sudah </td>
</tr>
<tr>
<td> 2022/07/20/000114 </td>
<td> 050012 </td>
<td> ABHINARA FAWWAZ ALFAREZEL, AN </td>
<td> L </td>
<td> Malang </td>
<td> 2021-04-04 </td>
<td> 1 Th 3 Bl 24 Hr </td>
<td> ISLAM </td>
<td> - </td>
<td> - </td>
<td> SWASTA </td>
<td> Irawan suhatno, Tn </td>
<td> AYAH </td>
<td> JL KAPI SRABA VI 10 I/33 RT 07 RW 16, MANGLIAWAN, PAKIS,
<td> BPJ </td>
<td> kelas 2 </td>
<td> D02 </td>
<td> 400000 </td>
<td> R50.9 </td>
<td> - </td>
<td> 2022-07-20 </td>
<td> 20:30:46 </td>
<td> 2022-07-21 </td>
<td> 09:15:01 </td>
<td> IGDK </td>
<td> </td>
<td> 2022/07/20/000114, BPJS KLAS 2 TITIP KLAS 3 (KONFIRMASI)
2022/07/21/000114, PER JAM 09.00 BPJS KLS 2 UP 1 DI HASTINA 6 (KONFIRMASI) </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>

Anak, Visite Dokter Spesialis Anak, Nebulizer , Nebulizer , Nebulizer , Nebulizer ,
Nebulizer , Nebulizer , Nebulizer , Operasional Rumah Sakit , Visite Dokter
Spesialis Anak </td>
<td> - </td>
<td> 800000 </td>
<td> 2 </td>
<td> Sudah </td>
</tr>
<tr>
<td> 2022/07/20/000243 </td>
<td> 072211 </td>
<td> MAHIRA AISYAH PUTRI WIDIGDA, An </td>
<td> P </td>
<td> MALANG </td>
<td> 2022-07-11 </td>
<td> 0 Th 0 Bl 26 Hr </td>
<td> ISLAM </td>
<td> TS </td>
<td> INDRA CAHYA SETIA, TN </td>
<td> AYAH </td>
<td> JL. SIDOMULYO II/1 RT 03 RW 10, PURWODADI, BLIMBING, KOTA
MALANG </td>
<td> BPJ </td>
<td> IGD6 </td>
<td> KS IGD 6 </td>
<td> 400000 </td>
<td> P58.2 </td>
<td> P59.9 </td>
<td> 2022-07-20 </td>
<td> 19:56:22 </td>
<td> 2022-07-20 </td>
<td> 23:46:54 </td>
<td> IGDK </td>
<td> 2022/07/20/000243 BPJS KELAS 1 FOTOTERAPY </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>

Visite Dokter Spesialis Anak, Sewa Inkubator, Sewa Inkubator, Sewa Inkubator, Sewa
Inkubator, Sewa Fototerapi, Sewa Fototerapi, Sewa Fototerapi, Sewa Fototerapi,
Operasional Rumah Sakit , Sewa Fototerapi </td>
<td> - </td>
<td> 400000 </td>
<td> Sembuh </td>
<td> 1 </td>
<td> Sudah </td>
</tr>
<tr>
<td> 2022/07/20/000190 </td>
<td> 028167 </td>
<td> YOLA ALFIANI PUTRI, NY </td>
<td> P </td>
<td> Malang </td>
<td> 1997-06-09 </td>
<td> 25 Th 1 Bl 13 Hr </td>
<td> ISLAM </td>
<td> - </td>
<td> SWASTA </td>
<td> Achmad Roziqin Fitroni, Tn </td>
<td> SUAMI </td>
<td> JL PUNTODEWO II NO 35 RT 10 RW 03, POLEHAN, BLIMBING, KOTA
MALANG </td>
<td> BPJ </td>
<td> kelas 1 </td>
<td> P04 </td>
<td> 650000 </td>
<td> O80.9 </td>
<td> O80.0 </td>
<td> 2022-07-20 </td>
<td> 19:00:30 </td>
<td> 2022-07-25 </td>
<td> 08:51:07 </td>
<td> IGDK </td>
<td> 2022/07/20/000190, BPJS KLAS 1 TITP KABER RUANGAN MENYUSUL
(KONFIRMASI) </td>
<td> 2 </td>
<td> 1 </td>
<td> 0 </td>
<td> 0 </td>
<td> 0 </td>
<td> 0 </td>
<td> 39-40 </td>

<td> 2800 </td>
<td> 46 </td>
<td> Hidup </td>
<td> Tidak </td>
<td> Hidup </td>
<td> Ya </td>
<td> Tidak </td>
<td> Ya </td>

<td> - </td>
<td> 3900000 </td>
<td> Sehat </td>
<td> 6 </td>
<td> Sudah </td>
</tr>
<tr>
<td> 2022/07/20/000163 </td>
<td> 061596 </td>
<td> SACHIO RYUGA AFRINDO, AN </td>
<td> L </td>
<td> MALANG </td>
<td> 2021-12-13 </td>
<td> 0 Th 7 Bl 21 Hr </td>
<td> ISLAM </td>
<td> - </td>
<td> NANDA YUDIS AFRIANDO, TN </td>
<td> AYAH </td>
<td> JL LETJEN S. PARMAN GG I NO 19 RT 1 RW 5 , PURWANTORO,
<td> BPJ </td>
<td> kelas 3 </td>
<td> A13 </td>
<td> 300000 </td>
<td> R50.9 </td>
<td> R50.9 </td>
<td> 2022-07-20 </td>
<td> 18:49:08 </td>
<td> 2022-07-24 </td>
<td> 13:46:45 </td>
<td> U0002 </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> Jasa Pelayanan Rumah Sakit , Nebulizer , Nebulizer ,

Nebulizer , Nebulizer , Nebulizer , Konsultasi Dokter Spesialis Anak Via Telepon,
<td> </td>
<td> 1500000 </td>
<td> Sehat </td>
<td> 5 </td>
<td> Sudah </td>
</tr>
<tr>
<td> 2022/07/20/000095 </td>
<td> 062547 </td>
<td> NADIA SALSABILA, Ny </td>
<td> P </td>
<td> MALANG </td>
<td> 1999-09-14 </td>
<td> 22 Th 10 Bl 19 Hr </td>
<td> ISLAM </td>
<td> SMA </td>
<td> MUHAMMAD NUR SOLEH, Tn </td>
<td> SUAMI </td>
<td> JL. KI AGENG GRIBIG V NO 30 RT 06 RW 05, MADYOPURO,
<td> BPJ </td>
<td> kelas 3 </td>
<td> A03 </td>
<td> 300000 </td>
<td> O80.8 </td>
<td> O80.8 </td>
<td> 2022-07-20 </td>
<td> 18:45:20 </td>
<td> 2022-07-22 </td>
<td> 11:09:34 </td>
<td> IGDK </td>
<td> 2022/07/20/000095, BPJS KLS 3 TITIP KABER RENCANA AMARTA
</td>
<td> 1 </td>
<td> 0 </td>
<td> 0 </td>
<td> 0 </td>
<td> 0 </td>
<td> 0 </td>
<td> 38-39 </td>

<td> 2890 </td>
<td> 48 </td>
<td> Hidup </td>
<td> Ya </td>
<td> Baik </td>
<td> Ya </td>
<td> Tidak </td>
<td> Ya </td>

VT Bidan, VT Dokter , Oksigen 100% Sentral 3 LPM , NST, Konsultasi Dokter Spesialis
Obgyn Via Telepon, Operasional Rumah Sakit </td>
<td> - </td>
<td> 900000 </td>
<td> 3 </td>
<td> Sudah </td>
</tr>
<tr>
<td> 2022/07/20/000205 </td>
<td> 072606 </td>
<td> AYUSHITA KHIRANIA PUTRI, AN </td>
<td> P </td>
<td> MALANG </td>
<td> 2022-02-27 </td>
<td> 0 Th 4 Bl 24 Hr </td>
<td> ISLAM </td>
<td> TS </td>
<td> BAHRUL ULUM, TN </td>
<td> AYAH </td>
<td> DUSUN PANGGUNG BARAN KIDAL RT 044 RW 04, KIDAL, TUMPANG,
<td> A09 </td>
<td> UMUM </td>
<td> kelas 3 </td>
<td> IGD10 </td>
<td> 300000 </td>
<td> R56.0 </td>
<td> J18.9 </td>
<td> 2022-07-20 </td>
<td> 17:58:17 </td>
<td> 2022-07-21 </td>
<td> 11:11:32 </td>
<td> IGDK </td>
<td> </td>
<td> 2022/07/20/000205, UMUM KLS 3, AMARTA 7B </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> Operasional Rumah Sakit , Infus Bayi oleh Perawat / Bidan,

Jasa Pelayanan Kelas 3 </td>
<td> </td>
<td> 600000 </td>
<td> 2 </td>
<td> Sudah </td>
</tr>
<tr>
<td> 2022/07/20/000166 </td>
<td> 038778 </td>
<td> MIRNA TIARA SANI, NY </td>
<td> P </td>
<td> Malang </td>
<td> 1987-08-08 </td>
<td> 34 Th 11 Bl 23 Hr </td>
<td> ISLAM </td>
<td> SMA </td>
<td> SULISTYO HARDI, TN </td>
<td> SUAMI </td>
<td> PERUM GRAHA PUNTADEWA BLOK D-3 NO 08 RT 01 RW 13,
PAKISJAJAR, PAKIS, KABUPATEN MALANG </td>
<td> BPJ </td>
<td> kelas 1 </td>
<td> P08 </td>
<td> 650000 </td>
<td> O82.9 </td>
<td> O82.9 </td>
<td> 2022-07-20 </td>
<td> 16:59:59 </td>
<td> 2022-07-22 </td>
<td> 15:30:00 </td>
<td> IGDK </td>
<td> 0212R0100722K001040, BPJS KELAS 1, HASTINA 4 </td>
<td> 4 </td>
<td> 2 </td>
<td> 0 </td>
<td> 0 </td>
<td> 1 </td>
<td> 0 </td>
<td> 36-37 </td>

<td> 2500 </td>
<td> 46 </td>
<td> Hidup </td>
<td> Tidak </td>
<td> Baik </td>
<td> Ya </td>
<td> Tidak </td>
<td> Ya </td>

<td> - </td>
<td> 1950000 </td>
<td> 3 </td>
<td> Sudah </td>
</tr>
<tr>
<td> 2022/07/20/000121 </td>
<td> 072546 </td>
<td> PARTI,NY </td>
<td> P </td>
<td> MALANG </td>
<td> 1983-04-05 </td>
<td> 39 Th 3 Bl 20 Hr </td>
<td> ISLAM </td>
<td> - </td>
<td> ROZIKIN,NY </td>
<td> SUAMI </td>
<td> BARAN SONOSARI RT.03 RW.06, LESANPURO, KEDUNGKANDANG, KOTA
MALANG </td>
<td> BPJ </td>
<td> kelas 2 </td>
<td> P05 </td>
<td> 400000 </td>
<td> D26.9 </td>
<td> D26.9 </td>
<td> 2022-07-20 </td>
<td> 15:30:51 </td>
<td> 2022-07-22 </td>
<td> 09:51:43 </td>
<td> IGDK </td>
<td> </td>
<td> 2022/07/20/000121, BPJS KLAS 2 TITIP HASTINA 5 (KONFIRMASI)
</td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> - </td>
<td> 1200000 </td>
<td> 3 </td>
<td> Sudah </td>
</tr>
<tr>
<td> 2022/07/20/000197 </td>
<td> 072599 </td>
<td> KHANAYA FLAVIA PUTRI TYOSANI,AN </td>
<td> P </td>
<td> MALANG </td>
<td> 2022-07-20 </td>
<td> ISLAM </td>
<td> - </td>
<td> - </td>
<td> SULISTYO HARDI, TN </td>
<td> AYAH </td>
<td> PERUM GRAHA PUNTADEWA BLOK D-3 NO 08 RT 01 RW 13,
PAKISJAJAR, PAKIS, KABUPATEN MALANG </td>
<td> BPJ </td>
<td> kelas 3 </td>
<td> PF22 </td>
<td> 300000 </td>
<td> P03.4 </td>
<td> P03.4 </td>
<td> 2022-07-20 </td>
<td> 13:50:56 </td>
<td> 2022-07-22 </td>
<td> 21:22:22 </td>
<td> U0030 </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> 2500 </td>
<td> 46 </td>
<td> Hidup </td>
<td> Tidak </td>
<td> Hidup </td>
<td> Ya </td>
<td> Tidak </td>
<td> Ya </td>

<td> - </td>
<td> 900000 </td>
<td> Sembuh </td>
<td> 3 </td>
<td> Sudah </td>
</tr>
<tr>
<td> 2022/07/20/000156 </td>
<td> 078549 </td>
<td> GWEN CLAIRINE GRACIELLA, AN </td>
<td> P </td>
<td> MALANG </td>
<td> 2015-05-15 </td>
<td> 7 Th 2 Bl 10 Hr </td>
<td> KRISTEN </td>
<td> TS </td>
<td> ZEFA PRITA AMELIA, NY </td>
<td> IBU </td>
<td> LETJEN S. PARMAN I/18B RT05/RW05, BLIMBING, BLIMBING, KOTA
MALANG </td>
<td> BPJ </td>
<td> kelas 3 </td>
<td> A15 </td>
<td> 300000 </td>
<td> A09 </td>
<td> A09 </td>
<td> 2022-07-20 </td>
<td> 12:23:50 </td>
<td> 2022-07-22 </td>
<td> 11:09:20 </td>
<td> IGDK </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> Infus Anak oleh Perawat / Bidan </td>

<td> - </td>
<td> 900000 </td>
<td> 3 </td>
<td> Sudah </td>
</tr>
<tr>
<td> 2022/07/20/000141 </td>
<td> 072509 </td>
<td> ARGIE ZHAFIRAH, AN </td>
<td> P </td>
<td> SANGATTA </td>
<td> 2014-09-01 </td>
<td> 7 Th 10 Bl 19 Hr </td>
<td> ISLAM </td>
<td> SD </td>
<td> ARIES MAULANA, TN </td>
<td> AYAH </td>
<td> BUMI ETAM , SANGATTA SELATAN, SANGATTA, KUTAI TIMUR </td>
<td> A09 </td>
<td> UMUM </td>
<td> kelas 2 </td>
<td> D12 </td>
<td> 400000 </td>
<td> A09 </td>
<td> A09 </td>
<td> 2022-07-20 </td>
<td> 12:07:25 </td>
<td> 2022-07-22 </td>
<td> 14:55:38 </td>
<td> IGDK </td>
<td> </td>
<td> 2022/07/20/000141 UMUM KLAS 1 AYODYA 6B </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>

Spesialis Anak Via Telepon, Konsultasi Dokter Spesialis Anak Via Telepon, Infus
<td> - </td>
<td> 1200000 </td>
<td> Sehat </td>
<td> 3 </td>
<td> Sudah </td>
</tr>
<tr>
<td> 2022/07/20/000116 </td>
<td> 072582 </td>
<td> SABRINA MARSA KIRANA, AN </td>
<td> P </td>
<td> MALANG </td>
<td> 2013-01-07 </td>
<td> 9 Th 6 Bl 18 Hr </td>
<td> ISLAM </td>
<td> TS </td>
<td> PRIONO, TN </td>
<td> AYAH </td>
<td> JLMENDIT BARAT RT 4 RW 3, MANGLIAWAN, PAKIS, KABUPATEN
MALANG </td>
<td> BPJ </td>
<td> kelas 2 </td>
<td> D11 </td>
<td> 400000 </td>
<td> A90 </td>
<td> A90 </td>
<td> 2022-07-20 </td>
<td> 11:32:22 </td>
<td> 2022-07-23 </td>
<td> 23:00:43 </td>
<td> IGDK </td>
<td> 2022/07/20/000116, BPJS KLS II TITIP DI HASTINA 7 </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>

<td> - </td>
<td> 1600000 </td>
<td> Sehat </td>
<td> 4 </td>
<td> Sudah </td>
</tr>
<tr>
<td> 2022/07/20/000214 </td>
<td> 017774 </td>
<td> GIBRAN AZRIL, AN </td>
<td> L </td>
<td> Malang </td>
<td> 2019-04-30 </td>
<td> 3 Th 2 Bl 25 Hr </td>
<td> ISLAM </td>
<td> TS </td>
<td> PEDAGANG </td>
<td> HARIANTO, TN </td>
<td> AYAH </td>
<td> JL. TELUK CENDRAWASIH 12/01 RT 4 RW 3, ARJOSARI, BLIMBING,
KOTA MALANG </td>
<td> BPJ </td>
<td> kelas 3 </td>
<td> A14 </td>
<td> 300000 </td>
<td> A49.9 </td>
<td> A90 </td>
<td> 2022-07-20 </td>
<td> 11:16:15 </td>
<td> 2022-07-23 </td>
<td> 11:45:18 </td>
<td> IGDK </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>

<td> </td>
<td> 1200000 </td>
<td> 4 </td>
<td> Sudah </td>
</tr>
<tr>
<td> 2022/07/20/000167 </td>
<td> 072590 </td>
<td> ARUNA PRAMESTI KUSMANAGARI, NY </td>
<td> P </td>
<td> MALANG </td>
<td> 2022-07-20 </td>
<td> ISLAM </td>
<td> TS </td>
<td> - </td>
<td> IRWAN CATUR PRASETYO, TN </td>
<td> AYAH </td>
<td> JL HAMID RUSDI 51 RT 1 RW 11 , BUNULREJO, BLIMBING, KOTA
MALANG </td>
<td> BPJ </td>
<td> kelas 3 </td>
<td> PF01 </td>
<td> 300000 </td>
<td> P00.6 </td>
<td> P00.9 </td>
<td> 2022-07-20 </td>
<td> 11:03:19 </td>
<td> 2022-07-20 </td>
<td> 20:15:18 </td>
<td> U0030 </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> 3380 </td>
<td> 48 </td>
<td> Hidup </td>
<td> Ya </td>
<td> Hidup </td>
<td> Ya </td>
<td> Tidak </td>
<td> Ya </td>

<td> - </td>
<td> 600000 </td>
<td> Sembuh </td>
<td> 2 </td>
<td> Sudah </td>
</tr>
<tr>
<td> 2022/07/20/000092 </td>
<td> 072542 </td>
<td> SELVI SUPRAPTIN NINGSIH, NY </td>
<td> P </td>
<td> MALANG </td>
<td> 1994-05-24 </td>
<td> 28 Th 2 Bl 1 Hr </td>
<td> ISLAM </td>
<td> SMP </td>
<td> RAVY AGUNG PRADANA, TN </td>
<td> SUAMI </td>
<td> DSN NGAMPRONG NO 127 RT 4 RW 4 , BANJAREJO, PAKIS, KABUPATEN
MALANG </td>
<td> BPJ </td>
<td> kelas 3 </td>
<td> A08 </td>
<td> 300000 </td>
<td> O34.2 </td>
<td> O82.8 </td>
<td> 2022-07-20 </td>
<td> 10:51:05 </td>
<td> 2022-07-22 </td>
<td> 11:15:46 </td>
<td> IGDK </td>
<td> 2022/07/20/000092, BPJS KLS 3 TITIP RR, RUANG AMARTA
MENYUSUL </td>
<td> 2 </td>
<td> 1 </td>
<td> 0 </td>
<td> 0 </td>
<td> 0 </td>
<td> 0 </td>
<td> 37-38 </td>

<td> 3200 </td>
<td> 47 </td>
<td> Hidup </td>
<td> Ya </td>
<td> Hidup </td>
<td> Ya </td>
<td> Tidak </td>
<td> Ya </td>

<td> - </td>
<td> 900000 </td>
<td> 3 </td>
<td> Sudah </td>
</tr>
<tr>
<td> 2022/07/20/000096 </td>
<td> 027975 </td>
<td> SITI AMINATUS SA`DIYAH, NY </td>
<td> P </td>
<td> LUMAJANG </td>
<td> 1994-06-22 </td>
<td> 28 Th 1 Bl 7 Hr </td>
<td> ISLAM </td>
<td> S1 </td>
<td> TRI PURBO HADI WIDODO, TN </td>
<td> SUAMI </td>
<td> JL. PUNTADEWA RT 12 RW 12, TUMPANG, TUMPANG, KABUPATEN
MALANG </td>
<td> BPJ </td>
<td> kelas 2 </td>
<td> D09 </td>
<td> 400000 </td>
<td> O82.8 </td>
<td> - </td>
<td> 2022-07-20 </td>
<td> 10:50:54 </td>
<td> 2022-07-20 </td>
<td> 22:07:14 </td>
<td> IGDK </td>
<td> 2022/07/20/000096, BPJS KLS 2, TITIP RR, RENCANA AYODYA 5A
</td>
<td> 2 </td>
<td> 1 </td>
<td> 0 </td>
<td> 0 </td>
<td> 0 </td>
<td> 0 </td>
<td> 37-38 </td>

<td> 1300 </td>
<td> 47 </td>
<td> Hidup </td>
<td> Ya </td>
<td> Baik </td>
<td> Ya </td>
<td> Tidak </td>
<td> Ya </td>
<td> Visite Dokter Umum </td>

<td> - </td>
<td> 800000 </td>
<td> 2 </td>
<td> Sudah </td>
</tr>
<tr>
<td> 2022/07/20/000093 </td>
<td> 072564 </td>
<td> SAPTA NIRMAWATI, NY </td>
<td> P </td>
<td> MALANG </td>
<td> 1987-04-18 </td>
<td> 35 Th 3 Bl 14 Hr </td>
<td> ISLAM </td>
<td> SMA </td>
<td> DWI WANTORO, TN </td>
<td> SUAMI </td>
<td> JL IKAN PIRANHA ATAS NO 196 - B RT 1 RW 2, TUNJUNGSEKAR,
<td> BPJ </td>
<td> kelas 2 </td>
<td> D05 </td>
<td> 400000 </td>
<td> O82.8 </td>
<td> O82.9 </td>
<td> 2022-07-20 </td>
<td> 10:50:40 </td>
<td> 2022-07-22 </td>
<td> 13:38:26 </td>
<td> IGDK </td>
<td> 2022/07/20/000093, BPJS KL S2, AYODYA 3B, KONFIRMASI
RUANGAN, SEMENTARA TITIP RR </td>
<td> 2 </td>
<td> 1 </td>
<td> 0 </td>
<td> 0 </td>
<td> 0 </td>
<td> 0 </td>
<td> 38-39 </td>

<td> 2900 </td>
<td> 48 </td>
<td> Hidup </td>
<td> Ya </td>
<td> Hidup </td>
<td> Ya </td>
<td> Tidak </td>
<td> Ya </td>

Obgyn, Infus Dewasa oleh Perawat / Bidan, Infus Dewasa oleh Perawat / Bidan, Infus
Dewasa oleh Perawat / Bidan, Infus Dewasa oleh Perawat / Bidan, Konsultasi Dokter
<td> - </td>
<td> 1200000 </td>
<td> 3 </td>
<td> Sudah </td>
</tr>
<tr>
<td> 2022/07/20/000173 </td>
<td> 067692 </td>
<td> SASKIA DELLA SAFIRA, NY </td>
<td> P </td>
<td> MALANG </td>
<td> 1999-07-16 </td>
<td> 23 Th 0 Bl 16 Hr </td>
<td> ISLAM </td>
<td> SMA </td>
<td> MUHAMMAD ISFANADIN, TN </td>
<td> SUAMI </td>
<td> JL. MUHARTO V-B NO. 480 RT 08 RW 08, KOTALAMA,
<td> BPJ </td>
<td> kelas 2 </td>
<td> D01 </td>
<td> 400000 </td>
<td> O42.9 </td>
<td> O80.8 </td>
<td> 2022-07-20 </td>
<td> 10:31:30 </td>
<td> 2022-07-22 </td>
<td> 13:30:59 </td>
<td> IGDK </td>
<td> 2022/07/20/000173, BPJS KLS 2, AYODYA 1A KONFIRMASI </td>
<td> 1 </td>
<td> 0 </td>
<td> 0 </td>
<td> 0 </td>
<td> 0 </td>
<td> 0 </td>
<td> 38-39 </td>

<td> 3110 </td>
<td> 47 </td>
<td> Hidup </td>
<td> Ya </td>
<td> Hidup </td>
<td> Ya </td>
<td> Tidak </td>
<td> Ya </td>
<td> VT Bidan, NST, Konsultasi Dokter Spesialis Obgyn Via Telepon
</td>
<td> - </td>
<td> 1200000 </td>
<td> Sembuh </td>
<td> 3 </td>
<td> Sudah </td>
</tr>
<tr>
<td> 2022/07/20/000111 </td>
<td> 072581 </td>
<td> SITI AMINATUS S, BY NY </td>
<td> L </td>
<td> Malang </td>
<td> 2022-07-20 </td>
<td> ISLAM </td>
<td> TS </td>
<td> TRI PURBO HADI WIDODO, TN </td>
<td> AYAH </td>
<td> JL. PUNTADEWA RT 12 RW 12, TUMPANG, TUMPANG, KABUPATEN
MALANG </td>
<td> BPJ </td>
<td> kelas 3 </td>
<td> PF07 </td>
<td> 300000 </td>
<td> P03.4 </td>
<td> P03.4 </td>
<td> 2022-07-20 </td>
<td> 06:49:51 </td>
<td> 2022-07-22 </td>
<td> 21:22:05 </td>
<td> U0030 </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>

<td> - </td>
<td> 900000 </td>
<td> Sembuh </td>
<td> 3 </td>
<td> Sudah </td>
</tr>
<tr>
<td> 2022/07/20/000086 </td>
<td> 035189 </td>
<td> LINTANG AYU ISWARINI, NY </td>
<td> P </td>
<td> MALANG </td>
<td> 1990-05-07 </td>
<td> 32 Th 2 Bl 15 Hr </td>
<td> ISLAM </td>
<td> SWASTA </td>
<td> SMA </td>
<td> SWASTA </td>
<td> SUAMI </td>
<td> JL HAMID RUSDI 51 RT 1 RW 11, BUNULREJO, BLIMBING, KOTA
MALANG </td>
<td> BPJ </td>
<td> kelas 2 </td>
<td> D01 </td>
<td> 400000 </td>
<td> O63.1 </td>
<td> O80.1 </td>
<td> 2022-07-20 </td>
<td> 06:38:24 </td>
<td> 2022-07-20 </td>
<td> 19:30:43 </td>
<td> IGDK </td>
<td> 2022/07/20/000086, BPJS KLS 2, AYODYA 1
</td>
<td> 4 </td>
<td> 2 </td>
<td> 0 </td>
<td> 0 </td>
<td> 0 </td>
<td> 0 </td>
<td> 38-39 </td>

<td> 3380 </td>
<td> 48 </td>
<td> Hidup </td>
<td> Ya </td>
<td> Hidup </td>
<td> Ya </td>
<td> Tidak </td>
<td> Ya </td>

<td> - </td>
<td> 800000 </td>
<td> Sehat </td>
<td> 2 </td>
<td> Sudah </td>
</tr>
<tr>
<td> 2022/07/20/000098 </td>
<td> 072579 </td>
<td> GAVIN AHDLIO DWI PUTRA, AN </td>
<td> L </td>
<td> MALANG </td>
<td> 2022-07-20 </td>
<td> ISLAM </td>
<td> TS </td>
<td> DWI WANTORO, TN </td>
<td> AYAH </td>
<td> JL IKAN PIRANHA ATAS NO 196 - B RT 1 RW 2, TUNJUNGSEKAR,
<td> BPJ </td>
<td> kelas 3 </td>
<td> BF34 </td>
<td> 300000 </td>
<td> P03.4 </td>
<td> P03.4 </td>
<td> 2022-07-20 </td>
<td> 05:31:33 </td>
<td> 2022-07-22 </td>
<td> 21:23:22 </td>
<td> U0030 </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> 2900 </td>
<td> 48 </td>
<td> Hidup </td>
<td> Tidak </td>
<td> Hidup </td>
<td> Ya </td>
<td> Tidak </td>
<td> Ya </td>

<td> - </td>
<td> 900000 </td>
<td> Sembuh </td>
<td> 3 </td>
<td> Sudah </td>
</tr>
<tr>
<td> 2022/07/20/000097 </td>
<td> 072578 </td>
<td> SAVINO TITO JULIO, An </td>
<td> L </td>
<td> MALANG </td>
<td> 2022-07-20 </td>
<td> ISLAM </td>
<td> TS </td>
<td> SISWANTO, TN </td>
<td> AYAH </td>
<td> DUSUN KETOHAN RT 027 RW 011, KUCUR, DAU, KABUPATEN MALANG
</td>
<td> BPJ </td>
<td> kelas 3 </td>
<td> BFA03 </td>
<td> 300000 </td>
<td> P00.6 </td>
<td> P00.9 </td>
<td> 2022-07-20 </td>
<td> 05:19:29 </td>
<td> 2022-07-21 </td>
<td> 20:24:43 </td>
<td> U0030 </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> 3025 </td>
<td> 51 </td>
<td> Hidup </td>
<td> Ya </td>
<td> Hidup </td>
<td> Ya </td>
<td> Tidak </td>
<td> Ya </td>

<td> - </td>
<td> 600000 </td>
<td> Sembuh </td>
<td> 2 </td>
<td> Sudah </td>
</tr>
<tr>
<td> 2022/07/20/000094 </td>
<td> 072577 </td>
<td> SELVI SUPRAP N., By. Ny </td>
<td> L </td>
<td> MALANG </td>
<td> 2022-07-20 </td>
<td> 0 Th 0 Bl 16 Hr </td>
<td> ISLAM </td>
<td> - </td>
<td> - </td>
<td> RAVY AGUNG PRADANA, TN </td>
<td> AYAH </td>
<td> DSN NGAMPRONG NO 127 RT 04 RW 04, BANJAREJO, PAKIS,
<td> BPJ </td>
<td> kelas 3 </td>
<td> BPF01 </td>
<td> 300000 </td>
<td> P03.4 </td>
<td> P03.4 </td>
<td> 2022-07-20 </td>
<td> 04:46:54 </td>
<td> 2022-07-22 </td>
<td> 21:23:00 </td>
<td> U0030 </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> 3200 </td>
<td> 47 </td>
<td> Hidup </td>
<td> Tidak </td>
<td> Hidup </td>
<td> Ya </td>
<td> Tidak </td>
<td> Ya </td>

<td> </td>
<td> 900000 </td>
<td> Sembuh </td>
<td> 3 </td>
<td> Sudah </td>
</tr>
<tr>
<td> 2022/07/20/000249 </td>
<td> 070829 </td>
<td> ABIGAIL ROSABELLA CHRISTI KINASIH, AN </td>
<td> P </td>
<td> SEMARANG </td>
<td> 2022-02-03 </td>
<td> 0 Th 5 Bl 27 Hr </td>
<td> KATHOLIK </td>
<td> TS </td>
<td> DOKTER </td>
<td> YOHANES DONA CHRISTI UTAMA, TN </td>
<td> AYAH </td>
<td> BULAN TERANG UTAMA GA NO. 49 , MADYOPURO, KEDUNGKANDANG,
KOTA MALANG </td>
<td> BPJ </td>
<td> kelas 1 </td>
<td> H06 </td>
<td> 650000 </td>
<td> A09 </td>
<td> A09 </td>
<td> 2022-07-20 </td>
<td> 00:48:57 </td>
<td> 2022-07-21 </td>
<td> 12:00:17 </td>
<td> IGDK </td>
<td> 2022/07/20/000249, BPJS KLS 1, PANDAWA 7 KONFIRMASI RUANGAN
(ANAK DR ELISA) </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>

Anak, Visite Dokter Spesialis Anak, Konsultasi Dokter Spesialis Anak Via Telepon,
<td> </td>
<td> 1300000 </td>
<td> Sembuh </td>
<td> 2 </td>
<td> Sudah </td>
</tr>
<tr>
<td> 2022/07/19/000216 </td>
<td> 097707 </td>
<td> MOCHAMAD ABYZAR FARDAN, An </td>
<td> L </td>
<td> Malang </td>
<td> 2017-10-07 </td>
<td> 4 Th 9 Bl 12 Hr </td>
<td> ISLAM </td>
<td> TS </td>
<td> Achmad Rifai, Tn </td>
<td> AYAH </td>
<td> DUSUN GENITRI RT 03 RW 01, KEDUNGREJO, PAKIS, KABUPATEN
MALANG </td>
<td> A09 </td>
<td> UMUM </td>
<td> kelas 3 </td>
<td> D07 </td>
<td> 300000 </td>
<td> J20.9 </td>
<td> J20.9 </td>
<td> 2022-07-19 </td>
<td> 23:41:08 </td>
<td> 2022-07-23 </td>
<td> 11:11:35 </td>
<td> IGDK </td>
<td> </td>
<td> 2022/07/19/000216 UMUM KELAS 3 TITIP AYODYA 4A KONFIRM LAMA
</td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> Nebulizer , Nebulizer , Operasional Rumah Sakit , Jasa

Pelayanan Rumah Sakit </td>
<td> </td>
<td> 1200000 </td>
<td> Sehat </td>
<td> 4 </td>
<td> Sudah </td>
</tr>
<tr>
<td> 2022/07/19/000172 </td>
<td> 072555 </td>
<td> ROVIE WIDIYANTI,NY </td>
<td> P </td>
<td> MALANG </td>
<td> 1973-02-17 </td>
<td> 49 Th 5 Bl 12 Hr </td>
<td> ISLAM </td>
<td> SMA </td>
<td> AGOES KOESTADJI,TN </td>
<td> SUAMI </td>
<td> JL. PALMERAH 1/B26A RT.02 RW.07 , CEMOROKANDANG,
<td> BPJ </td>
<td> kelas 1 </td>
<td> P07 </td>
<td> 650000 </td>
<td> C53.0 </td>
<td> C53.0 </td>
<td> 2022-07-19 </td>
<td> 23:01:51 </td>
<td> 2022-07-21 </td>
<td> 08:55:41 </td>
<td> IGDK </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> Infus Dewasa oleh Perawat / Bidan, Pasang Kateter Urin oleh
Perawat / Bidan, Konsultasi Dokter Spesialis Obgyn Via Telepon, EKG </td>
<td> - </td>
<td> 1300000 </td>
<td> Sehat </td>
<td> 2 </td>
<td> Sudah </td>
</tr>
<tr>
<td> 2022/07/19/000177 </td>
<td> 091143 </td>
<td> KRISTIN RAHAYU MANDALASARI, NY </td>
<td> P </td>
<td> Malang </td>
<td> 1989-06-02 </td>
<td> 33 Th 1 Bl 25 Hr </td>
<td> ISLAM </td>
<td> SMP </td>
<td> MOHAMMAD TOHER, TN </td>
<td> SUAMI </td>
<td> JL. KOL SUGIONO G5D RT 14 RW 03, MERGOSONO, KEDUNGKANDANG,
KOTA MALANG </td>
<td> BPJ </td>
<td> kelas 3 </td>
<td> A04 </td>
<td> 300000 </td>
<td> O34.2 </td>
<td> O82.8 </td>
<td> 2022-07-19 </td>
<td> 21:23:39 </td>
<td> 2022-07-22 </td>
<td> 11:09:50 </td>
<td> IGDK </td>
<td> 2022/07/19/000177, BPJS KLS III DI AMARTA 5B (CITO) </td>
<td> 4 </td>
<td> 1 </td>
<td> 2 </td>
<td> 0 </td>
<td> 0 </td>
<td> 0 </td>
<td> 37-38 </td>

<td> 1500 </td>
<td> 36 </td>
<td> Hidup </td>
<td> Tidak </td>
<td> Hidup </td>
<td> Ya </td>
<td> Tidak </td>
<td> Ya </td>
<td> Visite Dokter Spesialis Obgyn, VT Bidan, Infus Dewasa oleh

Perawat / Bidan, Pasang Kateter Urin oleh Perawat / Bidan, NST </td>
<td> - </td>
<td> 900000 </td>
<td> 3 </td>
<td> Sudah </td>
</tr>
<tr>
<td> 2022/07/19/000218 </td>
<td> 072571 </td>
<td> KRISTIN RAHAYU M. By.Ny </td>
<td> P </td>
<td> MALANG </td>
<td> 2022-07-19 </td>
<td> ISLAM </td>
<td> - </td>
<td> MOHAMMAD THOHIR, Tn </td>
<td> AYAH </td>
<td> JL. KOL SUGIONO G5D RT 14 RW 03, MERGOSONO, KEDUNGKANDANG,
KOTA MALANG </td>
<td> BPJ </td>
<td> PA25 </td>
<td> 400000 </td>
<td> P03.4 </td>
<td> P21.1 </td>
<td> 2022-07-19 </td>
<td> 20:27:31 </td>
<td> 2022-07-21 </td>
<td> 12:17:12 </td>
<td> U0029 </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> 1500 </td>
<td> 36 </td>
<td> Hidup </td>
<td> Tidak </td>
<td> Baik </td>
<td> Ya </td>
<td> Tidak </td>
<td> Ya </td>
<td> Perawatan Bayi SC , Resusitasi dengan Intubasi, Resusitasi

dengan Intubasi, Sewa Ambulance, Sewa Ambulance, Pasang NGT/OGT, Perawatan Infant
Warmer, Oksigen 100% Sentral 12 LPM, Sewa Patient Monitor , Konsultasi Dokter
Spesialis Anak Via Telepon, Infus Bayi oleh Perawat / Bidan </td>
<td> </td>
<td> 1200000 </td>
<td> 3 </td>
<td> Sudah </td>
</tr>
<tr>
<td> 2022/07/19/000155 </td>
<td> 055273 </td>
<td> ARKANA SADDAM HAMIZAN, AN </td>
<td> L </td>
<td> MALANG </td>
<td> 2021-07-26 </td>
<td> 0 Th 11 Bl 29 Hr </td>
<td> ISLAM </td>
<td> TS </td>
<td> MUHAMMAD AJIZ, TN </td>
<td> AYAH </td>
<td> JL. LETJEN S PARMAN IIIA / 14 RT 6 RW 18, PURWANTORO,
<td> BPJ </td>
<td> kelas 3 </td>
<td> H07 </td>
<td> 300000 </td>
<td> J18.0 </td>
<td> - </td>
<td> 2022-07-19 </td>
<td> 17:37:50 </td>
<td> 2022-07-19 </td>
<td> 18:25:21 </td>
<td> IGDK </td>
<td> 2022/07/19/000155, BPJS KELAS 3 TITIP HASTINA 7 ( KONFIRMASI
) </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> Visite Dokter Spesialis Anak, Nebulizer , Nebulizer </td>

<td> - </td>
<td> 300000 </td>
<td> 1 </td>
<td> Sudah </td>
</tr>
<tr>
<td> 2022/07/19/000165 </td>
<td> 069040 </td>
<td> NADLYNE ELSANUM HUMAIROH, AN </td>
<td> P </td>
<td> MALANG </td>
<td> 2022-04-24 </td>
<td> ISLAM </td>
<td> TS </td>
<td> ABDUL RACHMAD, TN </td>
<td> AYAH </td>
<td> JL. KEMIRAHAN IB/ 16A, PURWODADI, BLIMBING, KOTA MALANG
</td>
<td> A09 </td>
<td> UMUM </td>
<td> kelas 3 </td>
<td> A01 </td>
<td> 300000 </td>
<td> R50.9 </td>
<td> R50.9 </td>
<td> 2022-07-19 </td>
<td> 17:36:52 </td>
<td> 2022-07-22 </td>
<td> 11:08:35 </td>
<td> IGDK </td>
<td> </td>
<td> 2022/07/19/000165, UMUM KLS III DI AMARTA 1A (KONFIRMASI)
</td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>

<td> - </td>
<td> 1200000 </td>
<td> 4 </td>
<td> Sudah </td>
</tr>
<tr>
<td> 2022/07/19/000156 </td>
<td> 029262 </td>
<td> RAUDHANIA ILMINISA, AN </td>
<td> P </td>
<td> Malang </td>
<td> 2019-12-10 </td>
<td> ISLAM </td>
<td> - </td>
<td> TNI </td>
<td> Deni Ajis, Tn </td>
<td> AYAH </td>
<td> ASRAMA YONIF PARA RAIDER 502 RT.02 RW.08, KEMANTREN, JABUNG,
<td> BPJ </td>
<td> kelas 2 </td>
<td> H08 </td>
<td> 400000 </td>
<td> R50.9 </td>
<td> R50.9 </td>
<td> 2022-07-19 </td>
<td> 16:35:46 </td>
<td> 2022-07-22 </td>
<td> 10:44:31 </td>
<td> U0002 </td>
<td> KLINIK YONIF 502/K </td>
<td> 2022/07/19/000156 BPJS KELAS 2 TITIP HASTINA 8 </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> Jasa Pelayanan Rumah Sakit , Infus Anak oleh Perawat /

<td> - </td>
<td> 1600000 </td>
<td> Sembuh </td>
<td> 4 </td>
<td> Sudah </td>
</tr>
<tr>
<td> 2022/07/19/000021 </td>
<td> 071446 </td>
<td> ALKAF RAZQA MAHENDRA, AN </td>
<td> L </td>
<td> MALANG </td>
<td> 2022-06-24 </td>
<td> ISLAM </td>
<td> - </td>
<td> - </td>
<td> SHOKIB, TN </td>
<td> AYAH </td>
<td> JL MT HARYONO GG 9C NO 295A RT 06 RW 03, DINOYO, LOWOKWARU,
KOTA MALANG </td>
<td> BPJ </td>
<td> PA26 </td>
<td> 400000 </td>
<td> P59.9 </td>
<td> P59.9 </td>
<td> 2022-07-19 </td>
<td> 15:39:57 </td>
<td> 2022-07-20 </td>
<td> 18:55:59 </td>
<td> U0002 </td>
<td> Klinik Nayaka Husada 01 </td>
<td> 2022/07/19/000021, BPJS FOTOTERAPI KLS II </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>

Fototerapi </td>
<td> - </td>
<td> 800000 </td>
<td> Sehat </td>
<td> 2 </td>
<td> Sudah </td>
</tr>
<tr>
<td> 2022/07/19/000182 </td>
<td> 072242 </td>
<td> HAFIZAH NURSYIFA ILMI,AN </td>
<td> P </td>
<td> Malang </td>
<td> 2022-07-12 </td>
<td> 0 Th 0 Bl 14 Hr </td>
<td> ISLAM </td>
<td> TS </td>
<td> TNI </td>
<td> YUSUF ADITAMA, TN </td>
<td> AYAH </td>
<td> BPJ </td>
<td> K0000242 </td>
<td> KS IGD 5 </td>
<td> 400000 </td>
<td> P59.9 </td>
<td> P59.9 </td>
<td> 2022-07-19 </td>
<td> 15:37:18 </td>
<td> 2022-07-19 </td>
<td> 17:05:51 </td>
<td> IGDK </td>
<td> 2022/07/19/000182, BPJS II FOTOTTERAPI NICU </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>

<td> - </td>
<td> 400000 </td>
<td> Sembuh </td>
<td> 1 </td>
<td> Sudah </td>
</tr>
<tr>
<td> 2022/07/19/000138 </td>
<td> 072549 </td>
<td> MUHAMMAD HAJID KHOLIL, AN </td>
<td> L </td>
<td> MALANG </td>
<td> 2018-07-15 </td>
<td> ISLAM </td>
<td> - </td>
<td> CHOIRUL ARIFIN, TN </td>
<td> AYAH </td>
<td> JL TERUSAN SULFAT RT 9 RW 5 , PANDANWANGI, BLIMBING, KOTA
MALANG </td>
<td> BPJ </td>
<td> kelas 3 </td>
<td> D04 </td>
<td> 300000 </td>
<td> A91 </td>
<td> A90 </td>
<td> 2022-07-19 </td>
<td> 14:32:27 </td>
<td> 2022-07-21 </td>
<td> 19:50:44 </td>
<td> IGDK </td>
<td> 2022/07/19/000138, BPJS KELAS 3 TITIP DI AYODYA 2B
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> Visite Dokter Spesialis Anak, Sewa Infus Pump </td>

<td> - </td>
<td> 900000 </td>
<td> Sehat </td>
<td> 3 </td>
<td> Sudah </td>
</tr>
<tr>
<td> 2022/07/19/000058 </td>
<td> 035189 </td>
<td> LINTANG AYU ISWARINI, NY </td>
<td> P </td>
<td> MALANG </td>
<td> 1990-05-07 </td>
<td> 32 Th 2 Bl 15 Hr </td>
<td> ISLAM </td>
<td> SWASTA </td>
<td> SMA </td>
<td> SWASTA </td>
<td> SUAMI </td>
<td> JL HAMID RUSDI 51 RT 1 RW 11, BUNULREJO, BLIMBING, KOTA
MALANG </td>
<td> BPJ </td>
<td> kelas 2 </td>
<td> KB03 </td>
<td> 400000 </td>
<td> O80.9 </td>
<td> O80.8 </td>
<td> 2022-07-19 </td>
<td> 14:25:54 </td>
<td> 2022-07-19 </td>
<td> 20:16:32 </td>
<td> IGDK </td>
<td> 2022/07/19/000058,BPJS KELAS 2 RUANG AYODYA 6A
<td> 4 </td>
<td> 2 </td>
<td> 0 </td>
<td> 0 </td>
<td> 1 </td>
<td> 0 </td>
<td> 38-39 </td>

<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> Visite Dokter Spesialis Obgyn, VT Bidan, VT Bidan, VT Dokter

, NST </td>
<td> - </td>
<td> 400000 </td>
<td> Sehat </td>
<td> 1 </td>
<td> Sudah </td>
</tr>
<tr>
<td> 2022/07/19/000164 </td>
<td> 072558 </td>
<td> AHMAD GIBRAN AMRISYAH, AN </td>
<td> L </td>
<td> Malang </td>
<td> 2022-07-19 </td>
<td> ISLAM </td>
<td> TS </td>
<td> MUH. FAHMI NUR AMRISYAH, Tn </td>
<td> AYAH </td>
<td> JL. DANAU SENTANI TIMUR II H1/139 RT 03 RW 07, MADYOPURO,
<td> BPJ </td>
<td> kelas 3 </td>
<td> PF22 </td>
<td> 300000 </td>
<td> P03.4 </td>
<td> P03.4 </td>
<td> 2022-07-19 </td>
<td> 14:02:25 </td>
<td> 2022-07-21 </td>
<td> 17:23:04 </td>
<td> U0030 </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> 2600 </td>
<td> 48 </td>
<td> Hidup </td>
<td> Tidak </td>
<td> Hidup </td>
<td> Ya </td>
<td> Tidak </td>
<td> Ya </td>

<td> </td>
<td> 900000 </td>
<td> Sembuh </td>
<td> 3 </td>
<td> Sudah </td>
</tr>
<tr>
<td> 2022/07/19/000160 </td>
<td> 072556 </td>
<td> IDAWATI., BY NY </td>
<td> P </td>
<td> MALANG </td>
<td> 2022-07-19 </td>
<td> ISLAM </td>
<td> - </td>
<td> MOCH. AFDJAR, TN </td>
<td> AYAH </td>
<td> JL POLOWIJEN I NO 23 RT 1 RW 1 , POLOWIJEN, BLIMBING, KOTA
MALANG </td>
<td> A09 </td>
<td> UMUM </td>
<td> kelas 3 </td>
<td> BFA05 </td>
<td> 300000 </td>
<td> P00.6 </td>
<td> P00.9 </td>
<td> 2022-07-19 </td>
<td> 13:46:00 </td>
<td> 2022-07-22 </td>
<td> 14:36:42 </td>
<td> U0030 </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> 2840 </td>
<td> 48 </td>
<td> Hidup </td>
<td> Ya </td>
<td> Hidup </td>
<td> Ya </td>
<td> Ya </td>
<td> Ya </td>

<td> - </td>
<td> 1200000 </td>
<td> Sembuh </td>
<td> 4 </td>
<td> Sudah </td>
</tr>
<tr>
<td> 2022/07/19/000061 </td>
<td> 072337 </td>
<td> AYDAN EVANO AKALESVARA, AN </td>
<td> L </td>
<td> MALANG </td>
<td> 2021-02-22 </td>
<td> ISLAM </td>
<td> TS </td>
<td> TNI </td>
<td> ANNAS KAMAL WIJAYA, TN </td>
<td> AYAH </td>
<td> ASRAMA MEN ARMED 2 RT 002 RW 007, KESATRIAN, BLIMBING, KOTA
MALANG </td>
<td> BPJ </td>
<td> kelas 2 </td>
<td> H02 </td>
<td> 400000 </td>
<td> A09 </td>
<td> A09 </td>
<td> 2022-07-19 </td>
<td> 11:00:08 </td>
<td> 2022-07-26 </td>
<td> 13:45:10 </td>
<td> IGDK </td>
<td> 2022/07/19/000061, BPJS KLS II TITIP DI PANDAWA 5 </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>

Anak, Visite Dokter Spesialis Anak, Visite Dokter Spesialis Anak, Nebulizer ,
<td> - </td>
<td> 3200000 </td>
<td> 8 </td>
<td> Sudah </td>
</tr>
<tr>
<td> 2022/07/19/000071 </td>
<td> 069532 </td>
<td> ROIFATUL ALFIATI,NY </td>
<td> P </td>
<td> MALANG </td>
<td> 1996-11-27 </td>
<td> 25 Th 8 Bl 0 Hr </td>
<td> ISLAM </td>
<td> MISERI,TN </td>
<td> SUAMI </td>
<td> JL.SAMPURNA NO.49 RT.04 RW.01, CEMOROKANDANG, KEDUNGKANDANG,
KOTA MALANG </td>
<td> BPJ </td>
<td> kelas 2 </td>
<td> A09 </td>
<td> 400000 </td>
<td> O80.9 </td>
<td> O80.0 </td>
<td> 2022-07-19 </td>
<td> 10:46:19 </td>
<td> 2022-07-20 </td>
<td> 20:25:47 </td>
<td> IGDK </td>
<td> 2022/07/19/000071, BPJS KELAS 3 TITIP DI AYODYA 3B
<td> 3 </td>
<td> 1 </td>
<td> 0 </td>
<td> 0 </td>
<td> 1 </td>
<td> 0 </td>
<td> 38-39 </td>

<td> 3425 </td>
<td> 50 </td>
<td> Hidup </td>
<td> Ya </td>
<td> Hidup </td>
<td> Ya </td>
<td> Tidak </td>
<td> Ya </td>
<td> VT Bidan </td>

<td> - </td>
<td> 800000 </td>
<td> 2 </td>
<td> Sudah </td>
</tr>
<tr>
<td> 2022/07/19/000190 </td>
<td> 099609 </td>
<td> HERA NUR DUNIARTI, NY </td>
<td> P </td>
<td> MADIUN </td>
<td> 1990-07-26 </td>
<td> 32 Th 0 Bl 8 Hr </td>
<td> ISLAM </td>
<td> D3 </td>
<td> KUSDARMANTO SUHADI, TN </td>
<td> SUAMI </td>
<td> JL. DANAU SENTANI UTARA 10 H3N13 RT 5 RW 12, MADYOPURO,
<td> BPJ </td>
<td> kelas 2 </td>
<td> H05 </td>
<td> 400000 </td>
<td> A91 </td>
<td> A91 </td>
<td> 2022-07-19 </td>
<td> 10:44:47 </td>
<td> 2022-07-26 </td>
<td> 10:27:11 </td>
<td> IGDK </td>
<td> 2022/07/19/000190, BPJS KLS II DI AYODYA 6A (KONFIRMASI)
</td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> Visite Dokter Spesialis Penyakit Dalam, Visite Dokter

Spesialis Penyakit Dalam, Infus Dewasa oleh Perawat / Bidan, Nebulizer ,
Konsultasi Dokter Spesialis Penyakit Dalam Via Telepon </td>
<td> - </td>
<td> 3200000 </td>
<td> Sembuh </td>
<td> 8 </td>
<td> Sudah </td>
</tr>
<tr>
<td> 2022/07/19/000070 </td>
<td> 072524 </td>
<td> GAVIN ALVERO ARDIANSAH, AN </td>
<td> L </td>
<td> MALANG </td>
<td> 2022-07-19 </td>
<td> 0 Th 0 Bl 15 Hr </td>
<td> ISLAM </td>
<td> TS </td>
<td> AYAH </td>
<td> WONOREJO RT 017 RW 005, WONOREJO, PONCOKUSUMO, KABUPATEN
MALANG </td>
<td> BPJ </td>
<td> PF03 </td>
<td> 400000 </td>
<td> P03.4 </td>
<td> P03.4 </td>
<td> 2022-07-19 </td>
<td> 10:28:44 </td>
<td> 2022-07-21 </td>
<td> 17:23:15 </td>
<td> U0029 </td>
<td> 2022/07/19/000070, NICU </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> 4000 </td>
<td> 50 </td>
<td> Hidup </td>
<td> Ya </td>
<td> Baik </td>
<td> Ya </td>
<td> Tidak </td>
<td> Ya </td>
<td> Perawatan Bayi SC , Perawatan Bayi SC , Oksigen 100%

Sentral 2 LPM, Konsultasi Dokter Spesialis Anak Via Telepon </td>
<td> - </td>
<td> 1200000 </td>
<td> 3 </td>
<td> Sudah </td>
</tr>
<tr>
<td> 2022/07/19/000068 </td>
<td> 051490 </td>
<td> SRI WAHYUNI, NY </td>
<td> P </td>
<td> 1990-05-12 </td>
<td> 32 Th 2 Bl 19 Hr </td>
<td> ISLAM </td>
<td> SMA </td>
<td> ISMAIL FAUZI, TN </td>
<td> SUAMI </td>
<td> JL. RAJASA XIII RT04 RW05, BUMIAYU, KEDUNGKANDANG, KOTA
MALANG </td>
<td> BPJ </td>
<td> kelas 1 </td>
<td> H01 </td>
<td> 650000 </td>
<td> O34.2 </td>
<td> O34.2 </td>
<td> 2022-07-19 </td>
<td> 09:07:57 </td>
<td> 2022-07-21 </td>
<td> 13:37:12 </td>
<td> IGDK </td>
<td> 2022/07/19/000068, BPJS KLS I DI PANDAWA 8 (KONFIRMASI)
</td>
<td> 4 </td>
<td> 1 </td>
<td> 0 </td>
<td> 0 </td>
<td> 2 </td>
<td> 0 </td>
<td> 34-36 </td>

<td> 2700 </td>
<td> 48 </td>
<td> Hidup </td>
<td> Tidak </td>
<td> Hidup </td>
<td> Ya </td>
<td> Tidak </td>
<td> Ya </td>
<td> Visite Dokter Spesialis Obgyn, Infus Dewasa oleh Perawat /

Bidan, Infus Dewasa oleh Perawat / Bidan, Konsultasi Dokter Spesialis Obgyn Via
Telepon </td>
<td> - </td>
<td> 1950000 </td>
<td> Sehat </td>
<td> 3 </td>
<td> Sudah </td>
</tr>
<tr>
<td> 2022/07/19/000102 </td>
<td> 072537 </td>
<td> ROIFATUL ALFI., BY NY </td>
<td> P </td>
<td> MALANG </td>
<td> 2022-07-19 </td>
<td> ISLAM </td>
<td> - </td>
<td> MISERI, TN </td>
<td> AYAH </td>
<td> JL SAMPURNA NO 49 RT 4 RW 1 , CEMOROKANDANG, KEDUNGKANDANG,
KOTA MALANG </td>
<td> BPJ </td>
<td> kelas 3 </td>
<td> PF06 </td>
<td> 300000 </td>
<td> P00.6 </td>
<td> P00.9 </td>
<td> 2022-07-19 </td>
<td> 08:48:25 </td>
<td> 2022-07-22 </td>
<td> 14:41:18 </td>
<td> U0030 </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> 3425 </td>
<td> 50 </td>
<td> Hidup </td>
<td> Ya </td>
<td> Hidup </td>
<td> Ya </td>
<td> Tidak </td>
<td> Ya </td>

<td> - </td>
<td> 1200000 </td>
<td> Sembuh </td>
<td> 4 </td>
<td> Sudah </td>
</tr>
<tr>
<td> 2022/07/19/000067 </td>
<td> 072521 </td>
<td> AZALEA GRETA ASHADIYA KHIRANI, An </td>
<td> P </td>
<td> MALANG </td>
<td> 2022-07-19 </td>
<td> ISLAM </td>
<td> TS </td>
<td> M AGUNG TRISILA, TN </td>
<td> AYAH </td>
<td> DSN PULUNGAN RT 003 RW 002, PULUNGAN, TUMPANG, KABUPATEN
MALANG </td>
<td> BPJ </td>
<td> PF05 </td>
<td> 400000 </td>
<td> P03.4 </td>
<td> P03.4 </td>
<td> 2022-07-19 </td>
<td> 08:44:37 </td>
<td> 2022-07-21 </td>
<td> 15:06:49 </td>
<td> U0029 </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> 3000 </td>
<td> 50 </td>
<td> Hidup </td>
<td> Tidak </td>
<td> Baik </td>
<td> Ya </td>
<td> Tidak </td>
<td> Ya </td>
<td> Perawatan Bayi SC , Oksigen 100% Sentral 2 LPM, Konsultasi

Dokter Spesialis Anak Via Telepon </td>
<td> - </td>
<td> 1200000 </td>
<td> 3 </td>
<td> Sudah </td>
</tr>
<tr>
<td> 2022/07/19/000064 </td>
<td> 012259 </td>
<td> DEWI PERMATA SARI, NY </td>
<td> P </td>
<td> MALANG </td>
<td> 1999-11-15 </td>
<td> 22 Th 8 Bl 12 Hr </td>
<td> ISLAM </td>
<td> SD </td>
<td> SUAMI </td>
<td> WONOREJO RT 27 RW 5, WONOREJO, BANTUR, KABUPATEN MALANG
</td>
<td> BPJ </td>
<td> kelas 3 </td>
<td> A06 </td>
<td> 300000 </td>
<td> O82.9 </td>
<td> O82.8 </td>
<td> 2022-07-19 </td>
<td> 08:12:41 </td>
<td> 2022-07-22 </td>
<td> 11:10:45 </td>
<td> IGDK </td>
<td> 2022/07/19/000064, BPJS KLS III DI AMARTA 5D </td>
<td> 2 </td>
<td> 1 </td>
<td> 0 </td>
<td> 0 </td>
<td> 0 </td>
<td> 0 </td>
<td> 38-39 </td>

<td> 4000 </td>
<td> 50 </td>
<td> Hidup </td>
<td> Tidak </td>
<td> Hidup </td>
<td> Ya </td>
<td> Tidak </td>
<td> Ya </td>
<td> </td>
<td> - </td>
<td> 1200000 </td>
<td> 4 </td>
<td> Sudah </td>
</tr>
<tr>
<td> 2022/07/19/000062 </td>
<td> 072436 </td>
<td> PUJI ASTUTI, NY </td>
<td> P </td>
<td> MALANG </td>
<td> 1990-01-01 </td>
<td> 32 Th 6 Bl 23 Hr </td>
<td> ISLAM </td>
<td> SMP </td>
<td> PEDAGANG </td>
<td> RUDI HARTONO, YN </td>
<td> SUAMI </td>
<td> JL. MUHARTO VII/48 RT 008 RW 007, KOTALAMA, KEDUNGKANDANG,
KOTA MALANG </td>
<td> BPJ </td>
<td> kelas 3 </td>
<td> A05 </td>
<td> 300000 </td>
<td> O82.9 </td>
<td> O82.9 </td>
<td> 2022-07-19 </td>
<td> 08:12:23 </td>
<td> 2022-07-21 </td>
<td> 12:21:11 </td>
<td> IGDK </td>
<td> 2022/07/19/000062, BPJS KLS 3 TITIK RR DULU RENCANA AMARTA
5C </td>
<td> 2 </td>
<td> 1 </td>
<td> 0 </td>
<td> 0 </td>
<td> 0 </td>
<td> 0 </td>
<td> 38-39 </td>

<td> 3000 </td>
<td> 48 </td>
<td> Hidup </td>
<td> Tidak </td>
<td> Hidup </td>
<td> Ya </td>
<td> Tidak </td>
<td> Ya </td>

<td> - </td>
<td> 900000 </td>
<td> 3 </td>
<td> Sudah </td>
</tr>
<tr>
<td> 2022/07/19/000221 </td>
<td> 072573 </td>
<td> SEPTIVA EKA PRATIWI, NY </td>
<td> P </td>
<td> MALANG </td>
<td> 2002-09-18 </td>
<td> 19 Th 10 Bl 4 Hr </td>
<td> ISLAM </td>
<td> SD </td>
<td> SISWANTO, TN </td>
<td> SUAMI </td>
<td> DUSUN KETOHAN RT 27 RW 11, KUCUR, DAU, KABUPATEN MALANG
</td>
<td> BPJ </td>
<td> kelas 2 </td>
<td> D06 </td>
<td> 400000 </td>
<td> O80.8 </td>
<td> O80.9 </td>
<td> 2022-07-19 </td>
<td> 07:57:47 </td>
<td> 2022-07-21 </td>
<td> 11:08:53 </td>
<td> IGDK </td>
<td> 2022/07/19/000221, BPJS KLS 2 TITIP KABER, DWARAWATI/ AYODYA
MENYUSUL </td>
<td> 1 </td>
<td> 0 </td>
<td> 0 </td>
<td> 0 </td>
<td> 0 </td>
<td> 0 </td>
<td> 39-40 </td>

<td> 3025 </td>
<td> 51 </td>
<td> Hidup </td>
<td> Ya </td>
<td> Baik </td>
<td> Ya </td>
<td> Tidak </td>
<td> Ya </td>

<td> - </td>
<td> 1200000 </td>
<td> 3 </td>
<td> Sudah </td>
</tr>
<tr>
<td> 2022/07/19/000060 </td>
<td> 070781 </td>
<td> NENA MARISCA ANGELINA USMAN, NY </td>
<td> P </td>
<td> MALANG </td>
<td> 1998-11-06 </td>
<td> 23 Th 8 Bl 26 Hr </td>
<td> ISLAM </td>
<td> S1 </td>
<td> M AGUNG TRISILA, TN </td>
<td> SUAMI </td>
<td> DSN PULUNGAN RT 3 RW 2, PULUNGDOWO, TUMPANG, KABUPATEN
MALANG </td>
<td> BPJ </td>
<td> kelas 2 </td>
<td> H03 </td>
<td> 400000 </td>
<td> O82.9 </td>
<td> O82.9 </td>
<td> 2022-07-19 </td>
<td> 07:45:49 </td>
<td> 2022-07-21 </td>
<td> 14:08:39 </td>
<td> IGDK </td>
<td> 2022/07/19/000060, BPJS KLS 2 TITIP HASTINA 2 RENCANA
<td> 1 </td>
<td> 0 </td>
<td> 0 </td>
<td> 0 </td>
<td> 0 </td>
<td> 0 </td>
<td> 40-41 </td>

<td> 3500 </td>
<td> 50 </td>
<td> Hidup </td>
<td> Tidak </td>
<td> Hidup </td>
<td> Ya </td>
<td> Tidak </td>
<td> Ya </td>
<td> </td>
<td> - </td>
<td> 1200000 </td>
<td> 3 </td>
<td> Sudah </td>
</tr>
<tr>
<td> 2022/07/19/000087 </td>
<td> 072530 </td>
<td> AURELIA SAFANIYA AZ-ZAURA,AN </td>
<td> P </td>
<td> MALANG </td>
<td> 2022-07-19 </td>
<td> ISLAM </td>
<td> - </td>
<td> ISMAIL FAUZI, TN </td>
<td> AYAH </td>
<td> JL RAJASA XIII RT 4 RW 5 , BUMIAYU, KEDUNGKANDANG, KOTA
MALANG </td>
<td> BPJ </td>
<td> PA01 </td>
<td> NICU 1 </td>
<td> 400000 </td>
<td> P03.4 </td>
<td> P96.8 </td>
<td> 2022-07-19 </td>
<td> 07:45:37 </td>
<td> 2022-07-21 </td>
<td> 10:04:50 </td>
<td> U0029 </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> Perawatan Bayi SC , Jasa Pelayanan Rumah Sakit, Oksigen

100% Sentral 2 LPM, Oksigen 100% Sentral 2 LPM, Oksigen 100% Sentral 2 LPM, Visite
Dokter Spesialis Anak, Sewa Inkubator, Konsultasi Dokter Spesialis Anak Via
Telepon, Konsultasi Dokter Spesialis Anak Via Telepon, Operasional Rumah Sakit
</td>
<td> - </td>
<td> 1200000 </td>
<td> Sembuh </td>
<td> 3 </td>
<td> Sudah </td>
</tr>
<tr>
<td> 2022/07/19/000074 </td>
<td> 072526 </td>
<td> MARINDA MARE., BY NY </td>
<td> P </td>
<td> MALANG </td>
<td> 2022-07-19 </td>
<td> ISLAM </td>
<td> TS </td>
<td> TNI </td>
<td> SUPARMIN, TN </td>
<td> AYAH </td>
<td> ASRAMA YONKAV 3/AC RT 04 RW 11, RANDUAGUNG, SINGOSARI,
<td> BPJ </td>
<td> kelas 3 </td>
<td> PF04 </td>
<td> 300000 </td>
<td> P00.6 </td>
<td> Q24.8 </td>
<td> 2022-07-19 </td>
<td> 07:12:52 </td>
<td> 2022-07-20 </td>
<td> 09:52:27 </td>
<td> U0030 </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> 2835 </td>
<td> 50 </td>
<td> Hidup </td>
<td> Ya </td>
<td> Hidup </td>
<td> Ya </td>
<td> Tidak </td>
<td> Ya </td>
<td> Perawatan Bayi NP , Tindik oleh Perawat / Bidan, Pasang

NGT/OGT </td>
<td> - </td>
<td> 600000 </td>
<td> 2 </td>
<td> Sudah </td>
</tr>
<tr>
<td> 2022/07/19/000065 </td>
<td> 072522 </td>
<td> SHERLY ALMAYRA PUTRI, An </td>
<td> P </td>
<td> MALANG </td>
<td> 2022-07-19 </td>
<td> ISLAM </td>
<td> - </td>
<td> - </td>
<td> PEDAGANG </td>
<td> RUDI HARTIONO, TN </td>
<td> AYAH </td>
<td> JL. MUHARTO VII/48 RT 8 RW 7, KOTALAMA, KEDUNGKANDANG, KOTA
MALANG </td>
<td> BPJ </td>
<td> kelas 3 </td>
<td> BF31 </td>
<td> 300000 </td>
<td> P03.4 </td>
<td> O03.4 </td>
<td> 2022-07-19 </td>
<td> 05:59:25 </td>
<td> </td>
<td> </td>
<td> U0030 </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> 3000 </td>
<td> 48 </td>
<td> Hidup </td>
<td> Tidak </td>
<td> Hidup </td>
<td> Ya </td>
<td> Tidak </td>
<td> Ya </td>
<td> Perawatan Bayi SC , Visite Dokter Umum </td>

<td> - </td>
<td> 300000 </td>
<td> Sembuh </td>
<td> 1 </td>
<td> Sudah </td>
</tr>
<tr>
<td> 2022/07/19/000063 </td>
<td> 072523 </td>
<td> MUHAMAD FARDHAN, An </td>
<td> L </td>
<td> MALANG </td>
<td> 2022-07-19 </td>
<td> ISLAM </td>
<td> - </td>
<td> TS </td>
<td> AZWAR ANAS, TN </td>
<td> AYAH </td>
<td> JL. SIMPANG SULFAT UTARA 63 , PANDANWANGI, BLIMBING, KOTA
MALANG </td>
<td> A09 </td>
<td> UMUM </td>
<td> kelas 3 </td>
<td> BFA02 </td>
<td> 300000 </td>
<td> P00.6 </td>
<td> P00.9 </td>
<td> 2022-07-19 </td>
<td> 04:27:43 </td>
<td> 2022-07-22 </td>
<td> 14:38:47 </td>
<td> U0030 </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> 2695 </td>
<td> 48 </td>
<td> Hidup </td>
<td> Ya </td>
<td> Hidup </td>
<td> Ya </td>
<td> Tidak </td>
<td> Ya </td>

<td> - </td>
<td> 1200000 </td>
<td> Sembuh </td>
<td> 4 </td>
<td> Sudah </td>
</tr>
<tr>
<td> 2022/07/18/000259 </td>
<td> 072516 </td>
<td> ALEXANDRIA PUTRI JULIAN, AN </td>
<td> P </td>
<td> MALANG </td>
<td> 2022-07-18 </td>
<td> ISLAM </td>
<td> - </td>
<td> S1 </td>
<td> FEBBY JULIAN ARIFIN, TN </td>
<td> AYAH </td>
<td> JL.SINGOSARI DEPAN RADIO SOKA RT 1 RW 39 , KEBONSARI,
SUMBERSARI, JEMBER </td>
<td> BPJ </td>
<td> PA29 </td>
<td> 400000 </td>
<td> P03.4 </td>
<td> P39.9 </td>
<td> 2022-07-18 </td>
<td> 23:16:00 </td>
<td> 2022-07-21 </td>
<td> 12:16:53 </td>
<td> U0029 </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>

Infus Bayi oleh Perawat / Bidan, Operasional Rumah Sakit </td>
<td> - </td>
<td> 1200000 </td>
<td> Sembuh </td>
<td> 3 </td>
<td> Sudah </td>
</tr>
<tr>
<td> 2022/07/18/000198 </td>
<td> 062689 </td>
<td> QIANA ARSYILA FAQIH, An </td>
<td> P </td>
<td> PONOROGO </td>
<td> 2021-04-19 </td>
<td> 1 Th 2 Bl 29 Hr </td>
<td> ISLAM </td>
<td> - </td>
<td> MOH. IMRON FAQIH, Tn </td>
<td> AYAH </td>
<td> JL. JAYA SERUNI I BLOK 7K NO 5, KAUMAN, SUKUN, KOTA MALANG
</td>
<td> BPJ </td>
<td> kelas 2 </td>
<td> P04 </td>
<td> 400000 </td>
<td> A09 </td>
<td> A09 </td>
<td> 2022-07-18 </td>
<td> 22:45:20 </td>
<td> 2022-07-21 </td>
<td> 14:10:27 </td>
<td> U0002 </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>

<td> - </td>
<td> 1200000 </td>
<td> 3 </td>
<td> Sudah </td>
</tr>
<tr>
<td> 2022/07/18/000251 </td>
<td> 072070 </td>
<td> QUEENAYA ZELINE ARUNA,AN </td>
<td> P </td>
<td> MALANG </td>
<td> 2022-07-07 </td>
<td> 0 Th 0 Bl 17 Hr </td>
<td> ISLAM </td>
<td> - </td>
<td> ANDI CANDRA SUSILO, TN </td>
<td> AYAH </td>
<td> JL PERMADI 2A RT 9 RW 4 , POLEHAN, BLIMBING, KOTA MALANG
</td>
<td> BPJ </td>
<td> PA09 </td>
<td> 400000 </td>
<td> P59.9 </td>
<td> P59.9 </td>
<td> 2022-07-18 </td>
<td> 22:39:48 </td>
<td> 2022-07-20 </td>
<td> 18:55:41 </td>
<td> IGDK </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>

Fototerapi </td>
<td> - </td>
<td> 800000 </td>
<td> Sehat </td>
<td> 2 </td>
<td> Sudah </td>
</tr>
<tr>
<td> 2022/07/18/000244 </td>
<td> 056453 </td>
<td> CHALIYATUL KARIMAH, AN </td>
<td> P </td>
<td> Malang </td>
<td> 2013-01-17 </td>
<td> ISLAM </td>
<td> SD </td>
<td> - </td>
<td> Atik Hidayati, Ny </td>
<td> IBU </td>
<td> GANDON TIMUR RT 19 RW 03, SUKOLILO, JABUNG, KABUPATEN MALANG
</td>
<td> A09 </td>
<td> UMUM </td>
<td> kelas 1 </td>
<td> P03 </td>
<td> 650000 </td>
<td> J18.9 </td>
<td> J18.9 </td>
<td> 2022-07-18 </td>
<td> 22:31:36 </td>
<td> 2022-07-22 </td>
<td> 14:07:39 </td>
<td> IGDK </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>

Anak, Konsultasi Dokter Spesialis Anak Via Telepon, Infus Anak oleh Perawat / Bidan
</td>
<td> - </td>
<td> 2600000 </td>
<td> 4 </td>
<td> Sudah </td>
</tr>
<tr>
<td> 2022/07/18/000240 </td>
<td> 069621 </td>
<td> HABIBAH AMELIA, NY </td>
<td> P </td>
<td> MALANG </td>
<td> 1999-11-30 </td>
<td> 22 Th 7 Bl 29 Hr </td>
<td> ISLAM </td>
<td> SMA </td>
<td> SAUDARA </td>
<td> JL. SOPONYONO NO. 18 RT 02 RW 02, LOSARI, SINGOSARI,
<td> BPJ </td>
<td> kelas 3 </td>
<td> A17 </td>
<td> 300000 </td>
<td> O82.0 </td>
<td> O82.8 </td>
<td> 2022-07-18 </td>
<td> 22:26:53 </td>
<td> 2022-07-20 </td>
<td> 23:06:33 </td>
<td> IGDK </td>
<td> </td>
<td> </td>
<td> 2 </td>
<td> 1 </td>
<td> 0 </td>
<td> 0 </td>
<td> 0 </td>
<td> 0 </td>
<td> 38-39 </td>

<td> 3000 </td>
<td> 49 </td>
<td> Hidup </td>
<td> Tidak </td>
<td> Hidup </td>
<td> Ya </td>
<td> Tidak </td>
<td> Ya </td>

<td> - </td>
<td> 600000 </td>
<td> 2 </td>
<td> Sudah </td>
</tr>
<tr>
<td> 2022/07/18/000158 </td>
<td> 072382 </td>
<td> ERNI YUNIATI, NY </td>
<td> P </td>
<td> AMALANG </td>
<td> 1990-06-22 </td>
<td> 32 Th 1 Bl 6 Hr </td>
<td> ISLAM </td>
<td> SMP </td>
<td> SAYUDIK, TN </td>
<td> SUAMI </td>
<td> JL KI AGENG GRIBIG LESANPURO VI RT 05 RW 02, LESANPURO,
<td> BPJ </td>
<td> kelas 3 </td>
<td> A05 </td>
<td> 300000 </td>
<td> O03.4 </td>
<td> O03.4 </td>
<td> 2022-07-18 </td>
<td> 22:16:46 </td>
<td> 2022-07-19 </td>
<td> 11:02:25 </td>
<td> U0001 </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>

<td> - </td>
<td> 300000 </td>
<td> 1 </td>
<td> Sudah </td>
</tr>
<tr>
<td> 2022/07/18/000205 </td>
<td> 072490 </td>
<td> NIFTAQUL WIDJAYANTI MASRUROH, NY </td>
<td> P </td>
<td> NGANJUK </td>
<td> 1990-07-25 </td>
<td> 32 Th 0 Bl 7 Hr </td>
<td> ISLAM </td>
<td> S1 </td>
<td> SAMSUL DUKHA ROFIAN, TN </td>
<td> SUAMI </td>
<td> JL. KI HAJAR DEWANTORO RT 04 RW 06, JERU, TUMPANG, KABUPATEN
MALANG </td>
<td> BPJ </td>
<td> kelas 2 </td>
<td> D01 </td>
<td> 400000 </td>
<td> O60.0 </td>
<td> - </td>
<td> 2022-07-18 </td>
<td> 22:16:23 </td>
<td> 2022-07-18 </td>
<td> 22:57:33 </td>
<td> IGDK </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>

<td> - </td>
<td> 400000 </td>
<td> 1 </td>
<td> Sudah </td>
</tr>
<tr>
<td> 2022/07/18/000177 </td>
<td> 072370 </td>
<td> SANDY REMA NUR CAHYA, NY </td>
<td> P </td>
<td> MALANG </td>
<td> 2003-08-14 </td>
<td> 18 Th 11 Bl 11 Hr </td>
<td> ISLAM </td>
<td> SD </td>
<td> TUKANG LAS/PANDE BESI </td>
<td> KRISNA ADHE WIJAYA, TN </td>
<td> SUAMI </td>
<td> JL. CAKALANG 254 RT 002 RW 006, POLOWIJEN, BLIMBING, KOTA
MALANG </td>
<td> BPJ </td>
<td> kelas 3 </td>
<td> A06 </td>
<td> 300000 </td>
<td> O36.4 </td>
<td> O36.4 </td>
<td> 2022-07-18 </td>
<td> 22:14:47 </td>
<td> 2022-07-19 </td>
<td> 11:02:51 </td>
<td> IGDK </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>

<td> - </td>
<td> 300000 </td>
<td> 1 </td>
<td> Sudah </td>
</tr>
<tr>
<td> 2022/07/18/000255 </td>
<td> 072508 </td>
<td> AZLAN MAHASINUL HAQQ, AN </td>
<td> L </td>
<td> MALANG </td>
<td> 2022-07-18 </td>
<td> 0 Th 0 Bl 16 Hr </td>
<td> ISLAM </td>
<td> TS </td>
<td> GURU </td>
<td> AKHMAD FAUZAN ADHIMA, TN </td>
<td> AYAH </td>
<td> JL. TERNATE GG 1 NO 13 RT 005 RW 002, KASIN, KLOJEN, KOTA
MALANG </td>
<td> BPJ </td>
<td> kelas 3 </td>
<td> BF33 </td>
<td> 300000 </td>
<td> P03.4 </td>
<td> P03.4 </td>
<td> 2022-07-18 </td>
<td> 21:38:17 </td>
<td> 2022-07-20 </td>
<td> 16:42:14 </td>
<td> U0030 </td>
<td> </td>
<td> 2022/07/18/000255, BPJS FISOL </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> 2900 </td>
<td> 48 </td>
<td> Hidup </td>
<td> Tidak </td>
<td> Hidup </td>
<td> Ya </td>
<td> Tidak </td>
<td> Ya </td>

<td> - </td>
<td> 600000 </td>
<td> Sembuh </td>
<td> 2 </td>
<td> Sudah </td>
</tr>
<tr>
<td> 2022/07/18/000252 </td>
<td> 072506 </td>
<td> SHABIRA ALULA KHANDRA, AN </td>
<td> P </td>
<td> MALANG </td>
<td> 2022-07-18 </td>
<td> 0 Th 0 Bl 11 Hr </td>
<td> ISLAM </td>
<td> - </td>
<td> SMP </td>
<td> AYAH </td>
<td> JL. SOPONYONO NO. 18 RT 02 RW 02 SINGOSARI LOSARI, LOSARI,
<td> BPJ </td>
<td> kelas 3 </td>
<td> PF24 </td>
<td> 300000 </td>
<td> P03.4 </td>
<td> P03.4 </td>
<td> 2022-07-18 </td>
<td> 20:51:47 </td>
<td> 2022-07-20 </td>
<td> 19:12:22 </td>
<td> U0030 </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> 3000 </td>
<td> 47 </td>
<td> Hidup </td>
<td> Tidak </td>
<td> Hidup </td>
<td> Ya </td>
<td> Tidak </td>
<td> Ya </td>

<td> - </td>
<td> 900000 </td>
<td> Sembuh </td>
<td> 3 </td>
<td> Sudah </td>
</tr>
<tr>
<td> 2022/07/18/000249 </td>
<td> 072096 </td>
<td> MARYAM INNARA KHAYR, AN </td>
<td> P </td>
<td> MALANG </td>
<td> 2022-07-07 </td>
<td> 0 Th 0 Bl 17 Hr </td>
<td> ISLAM </td>
<td> TS </td>
<td> HERI TRI WAHYUDI, TN </td>
<td> AYAH </td>
<td> PERUM PONDOK PUSPA INDAH A-7 RT 11 RW 2, MULYOREJO, SUKUN,
KOTA MALANG </td>
<td> BPJ </td>
<td> IGD1 </td>
<td> KS IGD 1 </td>
<td> 400000 </td>
<td> P58.2 </td>
<td> P59.9 </td>
<td> 2022-07-18 </td>
<td> 20:11:11 </td>
<td> 2022-07-18 </td>
<td> 22:39:32 </td>
<td> IGDK </td>
<td> 2022/07/18/000249, BPJS KLS 2, FOTOTERAPY . NICU </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>

<td> - </td>
<td> 400000 </td>
<td> Sembuh </td>
<td> 1 </td>
<td> Sudah </td>
</tr>
<tr>
<td> 2022/07/18/000231 </td>
<td> 072489 </td>
<td> M. FADHIL AL- FAJRI, AN </td>
<td> L </td>
<td> MALANG </td>
<td> 2021-11-14 </td>
<td> 0 Th 8 Bl 17 Hr </td>
<td> ISLAM </td>
<td> - </td>
<td> MASHURI, TN </td>
<td> AYAH </td>
<td> BARAN KAMBINGAN RT 21 RW 03, KAMBINGAN, TUMPANG, KABUPATEN
MALANG </td>
<td> A09 </td>
<td> UMUM </td>
<td> kelas 3 </td>
<td> A12 </td>
<td> Amarta 2 </td>
<td> 300000 </td>
<td> J18.9 </td>
<td> J18.0 </td>
<td> 2022-07-18 </td>
<td> 19:52:14 </td>
<td> 2022-07-22 </td>
<td> 11:08:57 </td>
<td> IGDK </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>

Nebulizer , Nebulizer , Operasional Rumah Sakit , Jasa Pelayanan Rumah Sakit ,
Oksigen 100% Sentral 2 LPM, Visite Dokter Spesialis Anak, Oksigen 100% Sentral 2
LPM </td>
<td> - </td>
<td> 1500000 </td>
<td> 5 </td>
<td> Sudah </td>
</tr>
<tr>
<td> 2022/07/18/000247 </td>
<td> 072090 </td>
<td> RAKA ARZANKA RIZKY PURWANTO, AN </td>
<td> L </td>
<td> MALANG </td>
<td> 2022-07-07 </td>
<td> 0 Th 0 Bl 17 Hr </td>
<td> ISLAM </td>
<td> TS </td>
<td> - </td>
<td> DIDIK PURWANTO, TN </td>
<td> AYAH </td>
<td> CANDIRENGGO SINGOSARI RT 04 RW 13, CANDIRENGGO, SINGOSARI,
<td> BPJ </td>
<td> IGD9 </td>
<td> KS IGD 9 </td>
<td> 400000 </td>
<td> P59.9 </td>
<td> P59.9 </td>
<td> 2022-07-18 </td>
<td> 19:51:06 </td>
<td> 2022-07-18 </td>
<td> 20:29:00 </td>
<td> IGDK </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>

<td> - </td>
<td> 400000 </td>
<td> Sembuh </td>
<td> 1 </td>
<td> Sudah </td>
</tr>
<tr>
<td> 2022/07/18/000223 </td>
<td> 066913 </td>
<td> ABU BAKAR SHAFARAZ, AN </td>
<td> L </td>
<td> MALANG </td>
<td> 2014-12-28 </td>
<td> 7 Th 6 Bl 23 Hr </td>
<td> ISLAM </td>
<td> - </td>
<td> HARRY SUSANTO, TN </td>
<td> AYAH </td>
<td> JL DANAU BRATAN TIMUR H2-E50 RT 6 RW 13, MADYOPURO,
<td> BPJ </td>
<td> kelas 2 </td>
<td> H10 </td>
<td> 400000 </td>
<td> R11 </td>
<td> R11 </td>
<td> 2022-07-18 </td>
<td> 19:44:46 </td>
<td> 2022-07-21 </td>
<td> 11:29:26 </td>
<td> IGDK </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> - </td>
<td> 1600000 </td>
<td> Sehat </td>
<td> 4 </td>
<td> Sudah </td>
</tr>
<tr>
<td> 2022/07/18/000189 </td>
<td> 070520 </td>
<td> MUHIMMATIN BASYARIAH, NY </td>
<td> P </td>
<td> MALANG </td>
<td> 2002-01-08 </td>
<td> 20 Th 6 Bl 25 Hr </td>
<td> ISLAM </td>
<td> SMA </td>
<td> DIAN MUJAHIDIN, TN </td>
<td> SUAMI </td>
<td> DS. DUWET RT22 RW05, DUWET KRAJAN, TUMPANG, KABUPATEN MALANG
</td>
<td> A09 </td>
<td> UMUM </td>
<td> kelas 3 </td>
<td> KB05 </td>
<td> 300000 </td>
<td> O36.4 </td>
<td> O36.4 </td>
<td> 2022-07-18 </td>
<td> 17:56:01 </td>
<td> 2022-07-18 </td>
<td> 22:15:08 </td>
<td> IGDK </td>
<td> </td>
<td> 2022/07/18/000189, UMUM KLS 3 KABER </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>

<td> - </td>
<td> 300000 </td>
<td> Sehat </td>
<td> 1 </td>
<td> Sudah </td>
</tr>
<tr>
<td> 2022/07/18/000210 </td>
<td> 072491 </td>
<td> QIANDRA EL SHANUM MAHESWARI, AN </td>
<td> P </td>
<td> MALANG </td>
<td> 2022-07-18 </td>
<td> ISLAM </td>
<td> - </td>
<td> - </td>
<td> MUSLIMIN,TN </td>
<td> AYAH </td>
<td> JL SLAMET NO 7 RT3 RW 3, CEMOROKANDANG, KEDUNGKANDANG, KOTA
MALANG </td>
<td> BPJ </td>
<td> kelas 3 </td>
<td> PF22 </td>
<td> 300000 </td>
<td> P03.4 </td>
<td> P03.4 </td>
<td> 2022-07-18 </td>
<td> 16:08:51 </td>
<td> 2022-07-19 </td>
<td> 12:58:35 </td>
<td> U0030 </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> 3100 </td>
<td> 49 </td>
<td> Hidup </td>
<td> Tidak </td>
<td> Hidup </td>
<td> Ya </td>
<td> Tidak </td>
<td> Ya </td>

<td> - </td>
<td> 600000 </td>
<td> Sembuh </td>
<td> 2 </td>
<td> Sudah </td>
</tr>
<tr>
<td> 2022/07/18/000156 </td>
<td> 072479 </td>
<td> APRILIA ALIFVIAN, NY </td>
<td> P </td>
<td> MALANG </td>
<td> 1998-04-13 </td>
<td> 24 Th 3 Bl 5 Hr </td>
<td> ISLAM </td>
<td> SMA </td>
<td> - </td>
<td> HABIBUN NAZAR, TN </td>
<td> SUAMI </td>
<td> BANJARSARI RT 06 RW 01, BANJAREJO, PAKIS, KABUPATEN MALANG
</td>
<td> BPJ </td>
<td> kelas 2 </td>
<td> D09 </td>
<td> 400000 </td>
<td> O80.8 </td>
<td> O82.9 </td>
<td> 2022-07-18 </td>
<td> 14:44:32 </td>
<td> 2022-07-20 </td>
<td> 10:45:26 </td>
<td> IGDK </td>
<td> 2022/07/18/000156, BPJS KLS 2 AYODYA 1B RUJUKAN PMB SRI
MULYANI. </td>
<td> 1 </td>
<td> 0 </td>
<td> 0 </td>
<td> 0 </td>
<td> 0 </td>
<td> 0 </td>
<td> 37-38 </td>

<td> 2800 </td>
<td> 49 </td>
<td> Hidup </td>
<td> Ya </td>
<td> Hidup </td>
<td> Ya </td>
<td> Tidak </td>
<td> Ya </td>
<td> VT Bidan, Infus Dewasa oleh Perawat / Bidan, Konsultasi

<td> - </td>
<td> 1200000 </td>
<td> 3 </td>
<td> Sudah </td>
</tr>
<tr>
<td> 2022/07/18/000137 </td>
<td> 070251 </td>
<td> NANUNG SOBIYAH,NY </td>
<td> P </td>
<td> MALANG </td>
<td> 1979-01-16 </td>
<td> 43 Th 6 Bl 13 Hr </td>
<td> ISLAM </td>
<td> SMA </td>
<td> HADIYONO,TN </td>
<td> SUAMI </td>
<td> JL.EMBONG BRANTAS IV/1539 RT 06 RW 05, KIDUL DALEM, KLOJEN,
KOTA MALANG </td>
<td> BPJ </td>
<td> kelas 2 </td>
<td> D02 </td>
<td> 400000 </td>
<td> O14.9 </td>
<td> O14.9 </td>
<td> 2022-07-18 </td>
<td> 13:00:16 </td>
<td> 2022-07-19 </td>
<td> 20:20:33 </td>
<td> IGDK </td>
<td> 3 </td>
<td> 2 </td>
<td> 0 </td>
<td> 0 </td>
<td> 0 </td>
<td> 0 </td>
<td> 39-40 </td>

<td> 2700 </td>
<td> 47 </td>
<td> Hidup </td>
<td> Ya </td>
<td> Hidup </td>
<td> Ya </td>
<td> Tidak </td>
<td> Ya </td>

VT Bidan, Infus Dewasa oleh Perawat / Bidan, Pasang Kateter Urin oleh Perawat /
Bidan, Pasang Kateter Urin oleh Perawat / Bidan, Konsultasi Dokter Spesialis Obgyn
Via Telepon, Konsultasi Dokter Spesialis Obgyn Via Telepon, Operasional Rumah Sakit
</td>
<td> - </td>
<td> 800000 </td>
<td> Sehat </td>
<td> 2 </td>
<td> Sudah </td>
</tr>
<tr>
<td> 2022/07/18/000183 </td>
<td> 072485 </td>
<td> APRILIA ALIFV, BY NY </td>
<td> P </td>
<td> MALANG </td>
<td> 2022-07-18 </td>
<td> ISLAM </td>
<td> TS </td>
<td> HABIBUN NAZAR, TN </td>
<td> AYAH </td>
<td> BANJARSARI RT 06 RW 01, BANJAREJO, PAKIS, KABUPATEN MALANG
</td>
<td> BPJ </td>
<td> kelas 3 </td>
<td> PF21 </td>
<td> 300000 </td>
<td> P03.4 </td>
<td> P03.4 </td>
<td> 2022-07-18 </td>
<td> 12:53:13 </td>
<td> 2022-07-20 </td>
<td> 09:53:48 </td>
<td> U0030 </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> 2800 </td>
<td> 48 </td>
<td> Hidup </td>
<td> Tidak </td>
<td> Hidup </td>
<td> Ya </td>
<td> Tidak </td>
<td> Ya </td>

<td> - </td>
<td> 900000 </td>
<td> Sembuh </td>
<td> 3 </td>
<td> Sudah </td>
</tr>
<tr>
<td> 2022/07/18/000090 </td>
<td> 072450 </td>
<td> IRFAN RADITIYA, AN </td>
<td> L </td>
<td> MALANG </td>
<td> 2010-03-29 </td>
<td> 12 Th 3 Bl 19 Hr </td>
<td> ISLAM </td>
<td> SD </td>
<td> ISWANDI, TN </td>
<td> AYAH </td>
<td> JL. H. ALWI-PULESARI RT 002 RW 009, TIRTOMOYO, PAKIS,
<td> BPJ </td>
<td> kelas 3 </td>
<td> A15 </td>
<td> 300000 </td>
<td> R50.9 </td>
<td> R50.9 </td>
<td> 2022-07-18 </td>
<td> 12:34:46 </td>
<td> 2022-07-20 </td>
<td> 11:56:25 </td>
<td> IGDK </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> Konsultasi Dokter Spesialis Anak Via Telepon, Infus Anak

<td> - </td>
<td> 900000 </td>
<td> Sehat </td>
<td> 3 </td>
<td> Sudah </td>
</tr>
<tr>
<td> 2022/07/18/000079 </td>
<td> 062104 </td>
<td> AGUSTINA PERMATA SARI, NY </td>
<td> P </td>
<td> JOMBANG </td>
<td> 1985-08-01 </td>
<td> 36 Th 11 Bl 17 Hr </td>
<td> ISLAM </td>
<td> GURU </td>
<td> S1 </td>
<td> LUKMAN MAWARDI, TN </td>
<td> SUAMI </td>
<td> JL. SERUNI NO. 5 RT 1 RW 5 , WATUGEDE, SINGOSARI, KABUPATEN
MALANG </td>
<td> BPJ </td>
<td> kelas 1 </td>
<td> H07 </td>
<td> 650000 </td>
<td> O42.0 </td>
<td> O42.0 </td>
<td> 2022-07-18 </td>
<td> 11:12:59 </td>
<td> 2022-07-19 </td>
<td> 10:20:37 </td>
<td> IGDK </td>
<td> </td>
<td> 2022/07/18/000079 BPJS KELAS 2 UP 1 DI HASTINA 7 </td>
<td> 2 </td>
<td> 1 </td>
<td> 0 </td>
<td> 0 </td>
<td> 0 </td>
<td> 0 </td>
<td> 38-39 </td>

<td> 3060 </td>
<td> 49 </td>
<td> Hidup </td>
<td> Ya </td>
<td> Baik </td>
<td> Ya </td>
<td> Tidak </td>
<td> Ya </td>
<td> - </td>
<td> 1300000 </td>
<td> 2 </td>
<td> Sudah </td>
</tr>
<tr>
<td> 2022/07/18/000166 </td>
<td> 072476 </td>
<td> MUHAMMAD ARSYAD IBRAHIM HANUNG, AN </td>
<td> L </td>
<td> MALANG </td>
<td> 2022-07-18 </td>
<td> 0 Th 0 Bl 11 Hr </td>
<td> ISLAM </td>
<td> TS </td>
<td> HADIYONO, TN </td>
<td> AYAH </td>
<td> JL.EMBONG BRANTAS IV/1539 RT 06 RW 05, KIDUL DALEM, KLOJEN,
KOTA MALANG </td>
<td> BPJ </td>
<td> kelas 3 </td>
<td> PF02 </td>
<td> 300000 </td>
<td> P00.6 </td>
<td> P00.9 </td>
<td> 2022-07-18 </td>
<td> 11:12:33 </td>
<td> 2022-07-20 </td>
<td> 09:53:15 </td>
<td> U0030 </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> 2700 </td>
<td> 47 </td>
<td> Hidup </td>
<td> Ya </td>
<td> Hidup </td>
<td> Ya </td>
<td> Tidak </td>
<td> Ya </td>

<td> - </td>
<td> 900000 </td>
<td> Sembuh </td>
<td> 3 </td>
<td> Sudah </td>
</tr>
<tr>
<td> 2022/07/18/000080 </td>
<td> 072449 </td>
<td> SITI KOMARIYAH, NY </td>
<td> P </td>
<td> MALANG </td>
<td> 1974-06-03 </td>
<td> 48 Th 1 Bl 22 Hr </td>
<td> ISLAM </td>
<td> SD </td>
<td> FITROTUL KHUSNA, NY </td>
<td> ANAK </td>
<td> JL. DR SUTOMO LORING RT 17 RW 5 , SEKARPURO, JABUNG,
<td> BPJ </td>
<td> kelas 3 </td>
<td> A03 </td>
<td> 300000 </td>
<td> N93.9 </td>
<td> N93.9 </td>
<td> 2022-07-18 </td>
<td> 11:12:31 </td>
<td> 2022-07-19 </td>
<td> 00:32:31 </td>
<td> IGDK </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>

Spesialis Obgyn Via Telepon, EKG </td>
<td> - </td>
<td> 600000 </td>
<td> 2 </td>
<td> Sudah </td>
</tr>
<tr>
<td> 2022/07/18/000179 </td>
<td> 072482 </td>
<td> NUR YENI, NY </td>
<td> P </td>
<td> MALANG </td>
<td> 1979-09-22 </td>
<td> 42 Th 10 Bl 1 Hr </td>
<td> ISLAM </td>
<td> SMP </td>
<td> MUSLIMIN, TN </td>
<td> SUAMI </td>
<td> JL SLAMET NO 7 RT3 RW 3 , CEMOROKANDANG, KEDUNGKANDANG, KOTA
MALANG </td>
<td> BPJ </td>
<td> kelas 3 </td>
<td> A03 </td>
<td> 300000 </td>
<td> O80.8 </td>
<td> O33.9 </td>
<td> 2022-07-18 </td>
<td> 10:00:13 </td>
<td> 2022-07-20 </td>
<td> 23:46:40 </td>
<td> IGDK </td>
<td> 3 </td>
<td> 2 </td>
<td> 0 </td>
<td> 0 </td>
<td> 0 </td>
<td> 0 </td>
<td> 40-41 </td>

<td> 3100 </td>
<td> 49 </td>
<td> Hidup </td>
<td> Tidak </td>
<td> Hidup </td>
<td> Ya </td>
<td> Tidak </td>
<td> Ya </td>

Perawat / Bidan, NST, Konsultasi Dokter Spesialis Obgyn Via Telepon, EKG </td>
<td> - </td>
<td> 900000 </td>
<td> Sembuh </td>
<td> 3 </td>
<td> Sudah </td>
</tr>
<tr>
<td> 2022/07/18/000144 </td>
<td> 072472 </td>
<td> FAWZYA NADHIFA ALHUSNA, AN </td>
<td> P </td>
<td> Malang </td>
<td> 2022-07-18 </td>
<td> ISLAM </td>
<td> TS </td>
<td> SUJIANTO, TN </td>
<td> AYAH </td>
<td> NGEBRUK RT 03 RW 01, NGEBRUK, PONCOKUSUMO, KABUPATEN MALANG
</td>
<td> BPJ </td>
<td> kelas 3 </td>
<td> PF18 </td>
<td> 300000 </td>
<td> P03.4 </td>
<td> P03.4 </td>
<td> 2022-07-18 </td>
<td> 09:58:39 </td>
<td> 2022-07-20 </td>
<td> 09:54:02 </td>
<td> U0030 </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> 3400 </td>
<td> 50 </td>
<td> Hidup </td>
<td> Tidak </td>
<td> Hidup </td>
<td> Ya </td>
<td> Tidak </td>
<td> Ya </td>

<td> - </td>
<td> 900000 </td>
<td> Sembuh </td>
<td> 3 </td>
<td> Sudah </td>
</tr>
<tr>
<td> 2022/07/18/000085 </td>
<td> 071917 </td>
<td> SULISTIYOWATI, NY </td>
<td> P </td>
<td> Malang </td>
<td> 1985-05-25 </td>
<td> 37 Th 2 Bl 0 Hr </td>
<td> ISLAM </td>
<td> GURU </td>
<td> S1 </td>
<td> SUJIANTO, TN </td>
<td> SUAMI </td>
<td> NGEBRUK RT 03 RW 01, NGEBRUK, PONCOKUSUMO, KABUPATEN MALANG
</td>
<td> BPJ </td>
<td> kelas 1 </td>
<td> H05 </td>
<td> 650000 </td>
<td> O82.9 </td>
<td> O82.9 </td>
<td> 2022-07-18 </td>
<td> 09:50:44 </td>
<td> 2022-07-20 </td>
<td> 07:32:31 </td>
<td> IGDK </td>
<td> 2 </td>
<td> 1 </td>
<td> 0 </td>
<td> 0 </td>
<td> 0 </td>
<td> 0 </td>
<td> 39-40 </td>

<td> 3400 </td>
<td> 50 </td>
<td> Hidup </td>
<td> Ya </td>
<td> Hidup </td>
<td> Ya </td>
<td> Tidak </td>
<td> Ya </td>

Bidan, NST </td>
<td> - </td>
<td> 1950000 </td>
<td> Sehat </td>
<td> 3 </td>
<td> Sudah </td>
</tr>
<tr>
<td> 2022/07/18/000130 </td>
<td> 072464 </td>
<td> ARISTA SUHAR, BY NY </td>
<td> L </td>
<td> Malang </td>
<td> 2022-07-18 </td>
<td> ISLAM </td>
<td> TS </td>
<td> HIKARI BETHA NOVIARISTIYA, TN </td>
<td> AYAH </td>
<td> JL. CANDI TELAGA WANGI NO. 44 A, MOJOLANGU, LOWOKWARU, KOTA
MALANG </td>
<td> BPJ </td>
<td> kelas 3 </td>
<td> PF12 </td>
<td> 300000 </td>
<td> P00.6 </td>
<td> P00.9 </td>
<td> 2022-07-18 </td>
<td> 09:10:42 </td>
<td> 2022-07-22 </td>
<td> 14:37:28 </td>
<td> U0030 </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> 2725 </td>
<td> 48 </td>
<td> Hidup </td>
<td> Ya </td>
<td> Hidup </td>
<td> Ya </td>
<td> Tidak </td>
<td> Ya </td>

<td> - </td>
<td> 1500000 </td>
<td> Sembuh </td>
<td> 5 </td>
<td> Sudah </td>
</tr>
<tr>
<td> 2022/07/18/000124 </td>
<td> 072467 </td>
<td> RAFFASYA ARION ZAFLAN,AN </td>
<td> L </td>
<td> Malang </td>
<td> 2022-07-18 </td>
<td> ISLAM </td>
<td> TS </td>
<td> LUKMAN MAWARDI, TN </td>
<td> AYAH </td>
<td> JL. SERUNI NO. 5 RT 1 RW 5 , WATUGEDE, SINGOSARI, KABUPATEN
MALANG </td>
<td> BPJ </td>
<td> kelas 3 </td>
<td> PF11 </td>
<td> 300000 </td>
<td> P00.6 </td>
<td> P00.9 </td>
<td> 2022-07-18 </td>
<td> 09:01:33 </td>
<td> 2022-07-22 </td>
<td> 14:42:26 </td>
<td> U0030 </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> 3065 </td>
<td> 49 </td>
<td> Hidup </td>
<td> Ya </td>
<td> Hidup </td>
<td> Ya </td>
<td> Tidak </td>
<td> Ya </td>

<td> - </td>
<td> 1500000 </td>
<td> Sembuh </td>
<td> 5 </td>
<td> Sudah </td>
</tr>
<tr>
<td> 2022/07/18/000213 </td>
<td> 072493 </td>
<td> MARINDA MARETA SAPUTRI,NY </td>
<td> P </td>
<td> MALANG </td>
<td> 1994-03-28 </td>
<td> 28 Th 3 Bl 21 Hr </td>
<td> ISLAM </td>
<td> D3 </td>
<td> TNI </td>
<td> SUPARMIN,TN </td>
<td> SUAMI </td>
<td> ASRAMA YONKAV 3/AC RT.04 RW.11, RANDUAGUNG, SINGOSARI,
<td> BPJ </td>
<td> kelas 2 </td>
<td> D06 </td>
<td> 400000 </td>
<td> O63.0 </td>
<td> O80.8 </td>
<td> 2022-07-18 </td>
<td> 08:29:36 </td>
<td> 2022-07-20 </td>
<td> 10:45:41 </td>
<td> IGDK </td>
<td> </td>
<td> 2 </td>
<td> 1 </td>
<td> 0 </td>
<td> 0 </td>
<td> 0 </td>
<td> 0 </td>
<td> 40-41 </td>

<td> 2835 </td>
<td> 50 </td>
<td> Hidup </td>
<td> Ya </td>
<td> Baik </td>
<td> Ya </td>
<td> Tidak </td>
<td> Ya </td>

<td> - </td>
<td> 1200000 </td>
<td> Sembuh </td>
<td> 3 </td>
<td> Sudah </td>
</tr>
<tr>
<td> 2022/07/18/000258 </td>
<td> 072515 </td>
<td> IDAWATI, NY </td>
<td> P </td>
<td> MALANG </td>
<td> 1987-05-25 </td>
<td> 35 Th 1 Bl 24 Hr </td>
<td> ISLAM </td>
<td> SD </td>
<td> MOCH. AFDJAR MADJI, TN </td>
<td> SUAMI </td>
<td> JL. POLOWIJEN I NO 23 RT 001 RW 001, POLOWIJEN, BLIMBING,
KOTA MALANG </td>
<td> A09 </td>
<td> UMUM </td>
<td> kelas 3 </td>
<td> H04 </td>
<td> 300000 </td>
<td> O80.9 </td>
<td> O80.9 </td>
<td> 2022-07-18 </td>
<td> 08:29:14 </td>
<td> 2022-07-20 </td>
<td> 17:20:55 </td>
<td> IGDK </td>
<td> </td>
<td> 2022/07/18/000258, UMUM KLS III TITIP DI HASTINA 4 (- KTP
ISTRI) </td>
<td> 2 </td>
<td> 0 </td>
<td> 0 </td>
<td> 0 </td>
<td> 1 </td>
<td> 0 </td>
<td> </td>
<td> 2845 </td>
<td> 48 </td>
<td> Hidup </td>
<td> Ya </td>
<td> Baik </td>
<td> Ya </td>
<td> Tidak </td>
<td> Ya </td>
<td> VT Bidan, VT Bidan, NST </td>

<td> - </td>
<td> 900000 </td>
<td> 3 </td>
<td> Sudah </td>
</tr>
<tr>
<td> 2022/07/18/000263 </td>
<td> 064356 </td>
<td> AGUSNETI, NY </td>
<td> P </td>
<td> PADANG </td>
<td> 1984-08-06 </td>
<td> 37 Th 11 Bl 18 Hr </td>
<td> ISLAM </td>
<td> SMA </td>
<td> AZWAR ANAS, TN </td>
<td> SUAMI </td>
<td> JL. SIMPANG SULFAT UTARA 63, PANDANWANGI, BLIMBING, KOTA
MALANG </td>
<td> A09 </td>
<td> UMUM </td>
<td> kelas 1 </td>
<td> P05 </td>
<td> 650000 </td>
<td> O80.9 </td>
<td> O80.9 </td>
<td> 2022-07-18 </td>
<td> 08:28:52 </td>
<td> 2022-07-20 </td>
<td> 12:20:05 </td>
<td> IGDK </td>
<td> </td>
<td> 2022/07/18/000263, UMUM KLS 1 DI HASTINA 2 </td>
<td> 4 </td>
<td> 3 </td>
<td> 0 </td>
<td> 0 </td>
<td> 0 </td>
<td> 0 </td>
<td> 41-42 </td>

<td> 2695 </td>
<td> 48 </td>
<td> Hidup </td>
<td> Ya </td>
<td> Baik </td>
<td> Ya </td>
<td> Tidak </td>
<td> Ya </td>
<td> Operasional Rumah Sakit , Jasa Pelayanan Rumah Sakit </td>

<td> - </td>
<td> 1950000 </td>
<td> Sehat </td>
<td> 3 </td>
<td> Sudah </td>
</tr>
<tr>
<td> 2022/07/18/000109 </td>
<td> 072458 </td>
<td> ARSYANENDRA PUTRA IRAWAN, AN </td>
<td> L </td>
<td> Malang </td>
<td> 2022-07-17 </td>
<td> ISLAM </td>
<td> TS </td>
<td> ANDIKA NUR BUDI IRAWAN, TN </td>
<td> AYAH </td>
<td> JL MELATI RT 12 RW 4, SEKARPURO, PAKIS, KABUPATEN MALANG
</td>
<td> BPJ </td>
<td> kelas 3 </td>
<td> PF10 </td>
<td> 300000 </td>
<td> P00.6 </td>
<td> P00.9 </td>
<td> 2022-07-18 </td>
<td> 08:12:49 </td>
<td> 2022-07-19 </td>
<td> 20:57:21 </td>
<td> U0030 </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> 3020 </td>
<td> 49 </td>
<td> Hidup </td>
<td> Ya </td>
<td> Hidup </td>
<td> Ya </td>
<td> Tidak </td>
<td> Ya </td>

<td> - </td>
<td> 600000 </td>
<td> Sembuh </td>
<td> 2 </td>
<td> Sudah </td>
</tr>
<tr>
<td> 2022/07/18/000107 </td>
<td> 072456 </td>
<td> MISTIANI, BY NY </td>
<td> L </td>
<td> MALANG </td>
<td> 2022-07-18 </td>
<td> ISLAM </td>
<td> TS </td>
<td> SOHE, TN </td>
<td> AYAH </td>
<td> JL. LESANPURO I L/25B RT 8 RW 3 , LESANPURO, KEDUNGKANDANG,
KOTA MALANG </td>
<td> BPJ </td>
<td> kelas 3 </td>
<td> PF01 </td>
<td> 300000 </td>
<td> P03.4 </td>
<td> P03.4 </td>
<td> 2022-07-18 </td>
<td> 07:56:28 </td>
<td> 2022-07-20 </td>
<td> 09:56:10 </td>
<td> U0030 </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> 3300 </td>
<td> 49 </td>
<td> Hidup </td>
<td> Tidak </td>
<td> Hidup </td>
<td> Ya </td>
<td> Tidak </td>
<td> Ya </td>

<td> - </td>
<td> 900000 </td>
<td> Sembuh </td>
<td> 3 </td>
<td> Sudah </td>
</tr>
<tr>
<td> 2022/07/17/000062 </td>
<td> 071852 </td>
<td> MISTIANI, NY </td>
<td> P </td>
<td> MALANG </td>
<td> 1981-08-05 </td>
<td> 40 Th 11 Bl 23 Hr </td>
<td> ISLAM </td>
<td> SD </td>
<td> SOHE, TN </td>
<td> SUAMI </td>
<td> JL. LESANPURO I L/25B RT 8 RW 3 , LESANPURO, KEDUNGKANDANG,
KOTA MALANG </td>
<td> BPJ </td>
<td> kelas 3 </td>
<td> A08 </td>
<td> 300000 </td>
<td> O82.9 </td>
<td> O82.9 </td>
<td> 2022-07-18 </td>
<td> 07:55:19 </td>
<td> 2022-07-20 </td>
<td> 08:59:27 </td>
<td> IGDK </td>
<td> 4 </td>
<td> 3 </td>
<td> 0 </td>
<td> 0 </td>
<td> 0 </td>
<td> 0 </td>
<td> 37-38 </td>

<td> 3300 </td>
<td> 49 </td>
<td> Hidup </td>
<td> Ya </td>
<td> Baik </td>
<td> Ya </td>
<td> Tidak </td>
<td> Ya </td>

Bidan, EKG </td>
<td> - </td>
<td> 900000 </td>
<td> 3 </td>
<td> Sudah </td>
</tr>
<tr>
<td> 2022/07/18/000094 </td>
<td> 072452 </td>
<td> DITA ANGGRA, BY NY </td>
<td> P </td>
<td> Malang </td>
<td> 2022-07-18 </td>
<td> ISLAM </td>
<td> TS </td>
<td> WEDIK PURNOMO, TN </td>
<td> AYAH </td>
<td> DSN BANARAN RT 01 RW 06, BABADAN, NGAJUM, KABUPATEN MALANG
</td>
<td> A09 </td>
<td> UMUM </td>
<td> kelas 3 </td>
<td> PF16 </td>
<td> 300000 </td>
<td> P03.4 </td>
<td> P03.4 </td>
<td> 2022-07-18 </td>
<td> 07:19:38 </td>
<td> 2022-07-20 </td>
<td> 09:53:31 </td>
<td> U0030 </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> 3500 </td>
<td> 50 </td>
<td> Hidup </td>
<td> Tidak </td>
<td> Hidup </td>
<td> Ya </td>
<td> Tidak </td>
<td> Ya </td>
<td> Perawatan Bayi SC , Tindik oleh Perawat / Bidan </td>

<td> - </td>
<td> 900000 </td>
<td> Sembuh </td>
<td> 3 </td>
<td> Sudah </td>
</tr>
<tr>
<td> 2022/07/18/000169 </td>
<td> 061338 </td>
<td> CHAMIDA NABILA, NY </td>
<td> P </td>
<td> Malang </td>
<td> 1996-09-14 </td>
<td> 25 Th 10 Bl 14 Hr </td>
<td> ISLAM </td>
<td> S1 </td>
<td> MUH. FAHMI NUR AMRISYAH, TN </td>
<td> SUAMI </td>
<td> JL. DANAU SENTANI TIMUR II H1/139 RT 03 RW 07, MADYOPURO,
<td> BPJ </td>
<td> kelas 2 </td>
<td> D02 </td>
<td> 400000 </td>
<td> O41.0 </td>
<td> O41.0 </td>
<td> 2022-07-18 </td>
<td> 06:57:25 </td>
<td> 2022-07-20 </td>
<td> 22:07:44 </td>
<td> IGDK </td>
<td> 2022/07/18/000169,B PJS KLS 2 AYODYA 3A </td>
<td> 1 </td>
<td> 0 </td>
<td> 0 </td>
<td> 0 </td>
<td> 0 </td>
<td> 0 </td>
<td> 38-39 </td>

<td> 2600 </td>
<td> 48 </td>
<td> Hidup </td>
<td> Tidak </td>
<td> Hidup </td>
<td> Ya </td>
<td> Tidak </td>
<td> Ya </td>
<td> VT Bidan, Infus Dewasa oleh Perawat / Bidan </td>

<td> - </td>
<td> 1200000 </td>
<td> Sembuh </td>
<td> 3 </td>
<td> Sudah </td>
</tr>
<tr>
<td> 2022/07/18/000113 </td>
<td> 026207 </td>
<td> ARISTA SUHARTANTI, Ny. </td>
<td> P </td>
<td> Malang </td>
<td> 1996-05-05 </td>
<td> 26 Th 2 Bl 13 Hr </td>
<td> ISLAM </td>
<td> SMA </td>
<td> SWASTA </td>
<td> HIKARI BETHA NOVIARISTIYA, TN </td>
<td> SUAMI </td>
<td> JL. CANDI TELAGA WANGI NO. 44 A, MOJOLANGU, LOWOKWARU, KOTA
MALANG </td>
<td> BPJ </td>
<td> kelas 2 </td>
<td> D01 </td>
<td> 400000 </td>
<td> O80.8 </td>
<td> O80.8 </td>
<td> 2022-07-18 </td>
<td> 06:39:38 </td>
<td> 2022-07-19 </td>
<td> 10:04:38 </td>
<td> IGDK </td>
<td> 2022/07/18/000113, BPJS KLS 2 DWARAWATI/AYODYA 5A </td>
<td> 2 </td>
<td> 1 </td>
<td> 0 </td>
<td> 0 </td>
<td> 0 </td>
<td> 0 </td>
<td> 36-37 </td>

<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> Konsultasi Dokter Spesialis Obgyn Via Telepon </td>

<td> - </td>
<td> 800000 </td>
<td> Sembuh </td>
<td> 2 </td>
<td> Sudah </td>
</tr>
<tr>
<td> 2022/07/18/000257 </td>
<td> 072514 </td>
<td> GANDA OKTAVARO, AN </td>
<td> L </td>
<td> MALANG </td>
<td> 2020-10-09 </td>
<td> 1 Th 9 Bl 10 Hr </td>
<td> ISLAM </td>
<td> - </td>
<td> - </td>
<td> SOPIR </td>
<td> GATOT SUPRAPTO, TN </td>
<td> AYAH </td>
<td> JL. MELATI RT 15 RW 8 , SEKARPURO, PAKIS, KABUPATEN MALANG
</td>
<td> A09 </td>
<td> UMUM </td>
<td> kelas 3 </td>
<td> A02 </td>
<td> 300000 </td>
<td> R50.9 </td>
<td> J18.9 </td>
<td> 2022-07-18 </td>
<td> 04:07:24 </td>
<td> 2022-07-21 </td>
<td> 12:57:34 </td>
<td> IGDK </td>
<td> </td>
<td> 2022/07/18/000257, UMUM KLS 3 AMARTA 1B KONFIRMASI RUANGAN
</td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>

Bidan, Infus Anak oleh Perawat / Bidan </td>
<td> - </td>
<td> 1200000 </td>
<td> Sembuh </td>
<td> 4 </td>
<td> Sudah </td>
</tr>
<tr>
<td> 2022/07/18/000250 </td>
<td> 086890 </td>
<td> LAILATUL MAHFIROH, NY </td>
<td> P </td>
<td> Malang </td>
<td> 1995-05-19 </td>
<td> 27 Th 2 Bl 3 Hr </td>
<td> ISLAM </td>
<td> SMA </td>
<td> MOCH. RIDWAN, TN </td>
<td> SUAMI </td>
<td> DUSUN BAMBAN RT 5 RW 5, ASRIKATON, PAKIS, KABUPATEN MALANG
</td>
<td> A09 </td>
<td> UMUM </td>
<td> kelas 3 </td>
<td> A11 </td>
<td> 300000 </td>
<td> A91 </td>
<td> A91 </td>
<td> 2022-07-18 </td>
<td> 00:30:44 </td>
<td> 2022-07-22 </td>
<td> 11:16:28 </td>
<td> IGDK </td>
<td> </td>
<td> 2022/07/18/000250, UMUM KLS 3 AMARTA 8B </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
Oksigen 100% Sentral 2 LPM, Infus Dewasa oleh Perawat / Bidan </td>
<td> - </td>
<td> 1500000 </td>
<td> Sembuh </td>
<td> 5 </td>
<td> Sudah </td>
</tr>
<tr>
<td> 2022/07/17/000092 </td>
<td> 072446 </td>
<td> TIANA, NY </td>
<td> P </td>
<td> BLITAR </td>
<td> 2001-02-25 </td>
<td> 21 Th 4 Bl 25 Hr </td>
<td> ISLAM </td>
<td> SMA </td>
<td> BIMA IDIYA FITRIA, TN </td>
<td> SUAMI </td>
<td> JL SIMPANG SULFAT SELATAN NO 80 , PANDANWANGI, BLIMBING,
KOTA MALANG </td>
<td> A09 </td>
<td> UMUM </td>
<td> kelas 1 </td>
<td> P02 </td>
<td> 650000 </td>
<td> O42.9 </td>
<td> O42.9 </td>
<td> 2022-07-17 </td>
<td> 23:14:17 </td>
<td> 2022-07-20 </td>
<td> 15:20:00 </td>
<td> IGDK </td>
<td> </td>
<td> 2022/07/17/000092, UMUM KELAS 1, PANDAWA 2 </td>
<td> 1 </td>
<td> 0 </td>
<td> 0 </td>
<td> 0 </td>
<td> 0 </td>
<td> 0 </td>
<td> 34-36 </td>

<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> USG 2D/3D oleh Dokter Obgyn , USG 2D/3D oleh Dokter Obgyn ,
Operasional Rumah Sakit , Jasa Pelayanan Rumah Sakit , Visite Dokter Spesialis
Obgyn, Visite Dokter Spesialis Obgyn, Konsultasi Dokter Spesialis Obgyn Via Telepon
</td>
<td> - </td>
<td> 1950000 </td>
<td> 3 </td>
<td> Sudah </td>
</tr>
<tr>
<td> 2022/07/17/000028 </td>
<td> 045938 </td>
<td> RENITA KHULFIANA,NY </td>
<td> P </td>
<td> MALANG </td>
<td> 1994-10-23 </td>
<td> 27 Th 9 Bl 1 Hr </td>
<td> ISLAM </td>
<td> - </td>
<td> ASEP HARI SANTOSO,TN </td>
<td> SUAMI </td>
<td> JL. KI AGENG GRIBIG RT 01 RW 03, LESANPURO, KEDUNGKANDANG,
KOTA MALANG </td>
<td> BPJ </td>
<td> kelas 1 </td>
<td> H03 </td>
<td> 650000 </td>
<td> O42.0 </td>
<td> O42.0 </td>
<td> 2022-07-17 </td>
<td> 22:00:02 </td>
<td> 2022-07-18 </td>
<td> 21:29:04 </td>
<td> IGDK </td>
<td> </td>
<td> 2022/07/17/000028 BPJS KELAS 1 DI HASTINA 3 </td>
<td> 2 </td>
<td> 0 </td>
<td> 0 </td>
<td> 0 </td>
<td> 1 </td>
<td> 0 </td>
<td> 38-39 </td>

<td> 2820 </td>
<td> 48 </td>
<td> Hidup </td>
<td> Ya </td>
<td> Hidup </td>
<td> Ya </td>
<td> Tidak </td>
<td> Ya </td>
<td> VT Bidan, Infus Dewasa oleh Perawat / Bidan, Oksigen 100%

Sentral 3 LPM , NST, NST, Konsultasi Dokter Spesialis Obgyn Via Telepon </td>
<td> - </td>
<td> 650000 </td>
<td> 1 </td>
<td> Sudah </td>
</tr>
<tr>
<td> 2022/07/17/000098 </td>
<td> 051817 </td>
<td> MIKAILA RAMADHANI, AN </td>
<td> P </td>
<td> MALANG </td>
<td> 2018-05-19 </td>
<td> ISLAM </td>
<td> PELAJAR </td>
<td> SD </td>
<td> SWASTA </td>
<td> USMAN, TN </td>
<td> AYAH </td>
<td> JL KIDAL RT 2 RW 24, KIDAL, TUMPANG, KABUPATEN MALANG </td>
<td> A09 </td>
<td> UMUM </td>
<td> kelas 3 </td>
<td> A12 </td>
<td> Amarta 2 </td>
<td> 300000 </td>
<td> J18.0 </td>
<td> J18.0 </td>
<td> 2022-07-17 </td>
<td> 20:40:07 </td>
<td> 2022-07-21 </td>
<td> 12:20:42 </td>
<td> IGDK </td>
<td> </td>
<td> 2022/07/17/000098, UMUM KELAS 3 RUANG AMARTA 2
( KONFIRMASI ) NATURAL FLOW </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> Nebulizer , Nebulizer , Nebulizer , Oksigen 100% Sentral 2

LPM, Visite Dokter Spesialis Anak, Visite Dokter Spesialis Anak </td>
<td> - </td>
<td> 1500000 </td>
<td> 5 </td>
<td> Sudah </td>
</tr>
<tr>
<td> 2022/07/17/000096 </td>
<td> 072448 </td>
<td> GHAZAN ALBIRRU SANTOSO, AN </td>
<td> L </td>
<td> MALANG </td>
<td> 2022-07-17 </td>
<td> ISLAM </td>
<td> - </td>
<td> - </td>
<td> ASEP HARI SANTOSO,TN </td>
<td> AYAH </td>
<td> JL. KI AGENG GRIBIG RT 01 RW 03, LESANPURO, KEDUNGKANDANG,
KOTA MALANG </td>
<td> BPJ </td>
<td> kelas 3 </td>
<td> BF31 </td>
<td> 300000 </td>
<td> P00.6 </td>
<td> P00.9 </td>
<td> 2022-07-17 </td>
<td> 20:18:51 </td>
<td> 2022-07-18 </td>
<td> 23:43:17 </td>
<td> U0030 </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> 2820 </td>
<td> 48 </td>
<td> Hidup </td>
<td> Ya </td>
<td> Hidup </td>
<td> Ya </td>
<td> Tidak </td>
<td> Ya </td>

<td> - </td>
<td> 600000 </td>
<td> Sembuh </td>
<td> 2 </td>
<td> Sudah </td>
</tr>
<tr>
<td> 2022/07/17/000035 </td>
<td> 101873 </td>
<td> TRIANA PRASETYA PUTRI, NY </td>
<td> P </td>
<td> Balikpapan </td>
<td> 1996-09-30 </td>
<td> 25 Th 9 Bl 25 Hr </td>
<td> ISLAM </td>
<td> IRT </td>
<td> SMA </td>
<td> Meta Andri Setiawan, Tn </td>
<td> SUAMI </td>
<td> JL. SURABAYA NO. 17 RT 07 RW 03, GADINGKASRI, KLOJEN, KOTA
MALANG </td>
<td> BPJ </td>
<td> kelas 3 </td>
<td> A06 </td>
<td> 300000 </td>
<td> O80.8 </td>
<td> O80.0 </td>
<td> 2022-07-17 </td>
<td> 14:14:29 </td>
<td> 2022-07-19 </td>
<td> 00:33:22 </td>
<td> IGDK </td>
<td> 2022/07/17/000035, BPJS KLS 3 AMARTA 5D </td>
<td> 3 </td>
<td> 2 </td>
<td> 0 </td>
<td> 0 </td>
<td> 0 </td>
<td> 0 </td>
<td> 38-39 </td>

<td> 2860 </td>
<td> 47 </td>
<td> Hidup </td>
<td> Ya </td>
<td> Hidup </td>
<td> Ya </td>
<td> Tidak </td>
<td> Ya </td>

<td> - </td>
<td> 900000 </td>
<td> 3 </td>
<td> Sudah </td>
</tr>
<tr>
<td> 2022/07/17/000056 </td>
<td> 072437 </td>
<td> SHEZA AULIA SALSABILA, AN </td>
<td> P </td>
<td> MALANG </td>
<td> 2021-12-05 </td>
<td> 0 Th 7 Bl 29 Hr </td>
<td> ISLAM </td>
<td> TS </td>
<td> ROKHANI, TN </td>
<td> AYAH </td>
<td> JL. HASANUDIN RT 006 RW 003, JERU, TUMPANG, KABUPATEN MALANG
</td>
<td> A09 </td>
<td> UMUM </td>
<td> kelas 2 </td>
<td> D08 </td>
<td> 400000 </td>
<td> J18.0 </td>
<td> J18.0 </td>
<td> 2022-07-17 </td>
<td> 13:45:25 </td>
<td> 2022-07-20 </td>
<td> 10:45:08 </td>
<td> IGDK </td>
<td> </td>
<td> 2022/07/17/000056, UMUM KLS II DI AYODYA 4B </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> Nebulizer , Operasional Rumah Sakit , Jasa Pelayanan Rumah

Sakit , Visite Dokter Spesialis Anak, Visite Dokter Spesialis Anak, Infus Anak oleh
Perawat / Bidan </td>
<td> - </td>
<td> 1600000 </td>
<td> 4 </td>
<td> Sudah </td>
</tr>
<tr>
<td> 2022/07/17/000055 </td>
<td> 085679 </td>
<td> ALVIRA PUTRI ARILIA, AN </td>
<td> P </td>
<td> Malang </td>
<td> 2007-12-31 </td>
<td> 14 Th 6 Bl 25 Hr </td>
<td> ISLAM </td>
<td> SD </td>
<td> ARI WICAKSONO, TN </td>
<td> AYAH </td>
<td> JL. WIJAYA KUSUMA NO. 21 RT 03 RW 10, MANGLIAWAN, PAKIS,
<td> BPJ </td>
<td> kelas 2 </td>
<td> D03 </td>
<td> 400000 </td>
<td> R50.9 </td>
<td> J03.9 </td>
<td> 2022-07-17 </td>
<td> 13:43:02 </td>
<td> 2022-07-20 </td>
<td> 20:00:42 </td>
<td> IGDK </td>
<td> 2022/07/17/000055, BPJS KLS 3 UP 2 DWARAWATI/AYODYA 5A </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> - </td>
<td> 1600000 </td>
<td> Sehat </td>
<td> 4 </td>
<td> Sudah </td>
</tr>
<tr>
<td> 2022/07/17/000057 </td>
<td> 082680 </td>
<td> NURUL LAILI, NY </td>
<td> P </td>
<td> Malang </td>
<td> 1991-01-23 </td>
<td> 31 Th 6 Bl 11 Hr </td>
<td> ISLAM </td>
<td> GURU </td>
<td> S1 </td>
<td> GURU </td>
<td> Akhmad Fauzan Adhima, Tn </td>
<td> SUAMI </td>
<td> JL. TERNATE GG. 1 NO.13 RT 05 RW 02, KASIN, KLOJEN, KOTA
MALANG </td>
<td> BPJ </td>
<td> kelas 2 </td>
<td> D10 </td>
<td> 400000 </td>
<td> O99.0 </td>
<td> - </td>
<td> 2022-07-17 </td>
<td> 13:42:38 </td>
<td> 2022-07-18 </td>
<td> 20:47:22 </td>
<td> IGDK </td>
<td> 2022/07/17/000057, BPJS KLS 2 DWARAWATI/AYODYA 5B </td>
<td> 6 </td>
<td> 2 </td>
<td> 0 </td>
<td> 0 </td>
<td> 3 </td>
<td> 0 </td>
<td> 37-38 </td>

<td> 2900 </td>
<td> 48 </td>
<td> Hidup </td>
<td> Tidak </td>
<td> Hidup </td>
<td> Ya </td>
<td> Tidak </td>
<td> Ya </td>

VT Bidan, Infus Dewasa oleh Perawat / Bidan, NST, Konsultasi Dokter Spesialis Obgyn
<td> - </td>
<td> 800000 </td>
<td> 2 </td>
<td> Sudah </td>
</tr>
<tr>
<td> 2022/07/17/000058 </td>
<td> 072438 </td>
<td> ARTEMIS ALMERIA SETIAWAN, AN </td>
<td> P </td>
<td> MALANG </td>
<td> 2022-07-17 </td>
<td> ISLAM </td>
<td> TS </td>
<td> META ANDRI SETIAWAN,TN </td>
<td> AYAH </td>
<td> JL. SURABAYA NO. 17 RT 007 RW 003, GADINGKASRI, KLOJEN, KOTA
MALANG </td>
<td> BPJ </td>
<td> kelas 3 </td>
<td> BF34 </td>
<td> 300000 </td>
<td> P00.6 </td>
<td> P00.9 </td>
<td> 2022-07-17 </td>
<td> 12:32:00 </td>
<td> 2022-07-18 </td>
<td> 09:08:11 </td>
<td> U0030 </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> 2860 </td>
<td> 47 </td>
<td> Hidup </td>
<td> Ya </td>
<td> Hidup </td>
<td> Ya </td>
<td> Tidak </td>
<td> Ya </td>

<td> - </td>
<td> 600000 </td>
<td> Sembuh </td>
<td> 2 </td>
<td> Sudah </td>
</tr>
<tr>
<td> 2022/07/17/000043 </td>
<td> 067407 </td>
<td> NOVA ARI SANDRA, NY </td>
<td> P </td>
<td> MALANG </td>
<td> 1998-02-28 </td>
<td> 24 Th 4 Bl 27 Hr </td>
<td> ISLAM </td>
<td> S1 </td>
<td> DIAN MEI ANUGROHO, TN </td>
<td> SUAMI </td>
<td> JL. AHMAD YANI PAMOTAN RT 01 RW 01, DAMPIT, DAMPIT,
<td> A09 </td>
<td> UMUM </td>
<td> kelas 1 </td>
<td> P08 </td>
<td> 650000 </td>
<td> O36.4 </td>
<td> - </td>
<td> 2022-07-17 </td>
<td> 11:44:01 </td>
<td> 2022-07-18 </td>
<td> 12:39:37 </td>
<td> IGDK </td>
<td> </td>
<td> 2022/07/17/000043, UMUM KLS 1 PANDAWA 8 </td>
<td> 1 </td>
<td> 0 </td>
<td> 0 </td>
<td> 0 </td>
<td> 0 </td>
<td> 0 </td>
<td> 22-24 </td>

<td> 600 </td>
<td> 20 </td>
<td> Mati </td>
<td> Tidak </td>
<td> Hidup </td>
<td> Tidak </td>
<td> Tidak </td>
<td> Tidak </td>

Visite Dokter Spesialis Obgyn </td>
<td> - </td>
<td> 1300000 </td>
<td> 2 </td>
<td> Sudah </td>
</tr>
<tr>
<td> 2022/07/17/000037 </td>
<td> 072429 </td>
<td> SUYANTI, NY </td>
<td> P </td>
<td> MALANG </td>
<td> 1988-08-03 </td>
<td> 33 Th 11 Bl 19 Hr </td>
<td> ISLAM </td>
<td> SMP </td>
<td> PEDAGANG </td>
<td> MUH. MUCHLIS, TN </td>
<td> SUAMI </td>
<td> JL. MUHARTO V B RT 003 RW 008, KOTALAMA, KEDUNGKANDANG, KOTA
MALANG </td>
<td> BPJ </td>
<td> kelas 2 </td>
<td> D05 </td>
<td> 400000 </td>
<td> O80.9 </td>
<td> O80.9 </td>
<td> 2022-07-17 </td>
<td> 11:10:42 </td>
<td> 2022-07-19 </td>
<td> 10:28:22 </td>
<td> IGDK </td>
<td> 2022/07/17/000037, BPJS KLS II DI AYODYA 3A
(-) KTP SUAMI </td>
<td> 4 </td>
<td> 2 </td>
<td> 1 </td>
<td> 0 </td>
<td> 0 </td>
<td> 0 </td>
<td> 40-41 </td>

<td> 4200 </td>
<td> 52 </td>
<td> Hidup </td>
<td> Ya </td>
<td> Hidup </td>
<td> Ya </td>
<td> Tidak </td>
<td> Ya </td>

<td> - </td>
<td> 1200000 </td>
<td> 3 </td>
<td> Sudah </td>
</tr>
<tr>
<td> 2022/07/17/000032 </td>
<td> 045126 </td>
<td> LINDA NOVIANA, NY </td>
<td> P </td>
<td> PROBOLINGGO </td>
<td> 1992-11-14 </td>
<td> 29 Th 8 Bl 12 Hr </td>
<td> ISLAM </td>
<td> S1 </td>
<td> SWASTA </td>
<td> FATHUR RAHMAD FITRIAWAN, TN </td>
<td> SUAMI </td>
<td> JL. KELUD GG KRAMAT RT 08 RW 11, SISIR, BATU, KOTA BATU
</td>
<td> BPJ </td>
<td> kelas 1 </td>
<td> H01 </td>
<td> 650000 </td>
<td> O82.8 </td>
<td> O82.8 </td>
<td> 2022-07-17 </td>
<td> 10:32:04 </td>
<td> 2022-07-19 </td>
<td> 06:41:48 </td>
<td> IGDK </td>
<td> 3 </td>
<td> 1 </td>
<td> 0 </td>
<td> 0 </td>
<td> 1 </td>
<td> 0 </td>
<td> 38-39 </td>

<td> 2900 </td>
<td> 48 </td>
<td> Hidup </td>
<td> Ya </td>
<td> Baik </td>
<td> Ya </td>
<td> Tidak </td>
<td> Ya </td>
<td> Infus Dewasa oleh Perawat / Bidan, NST </td>

<td> </td>
<td> 1950000 </td>
<td> Sehat </td>
<td> 3 </td>
<td> Sudah </td>
</tr>
<tr>
<td> 2022/07/17/000047 </td>
<td> 072435 </td>
<td> AHMAD AFRAN AZZAMY, AN </td>
<td> L </td>
<td> MALANG </td>
<td> 2022-07-17 </td>
<td> ISLAM </td>
<td> TS </td>
<td> PEDAGANG </td>
<td> MUH. MUCLIS, TN </td>
<td> AYAH </td>
<td> JL. MUHARTO VB RT 003 RW 008, KOTALAMA, KEDUNGKANDANG, KOTA
MALANG </td>
<td> BPJ </td>
<td> kelas 3 </td>
<td> BFA05 </td>
<td> 300000 </td>
<td> P00.6 </td>
<td> P00.9 </td>
<td> 2022-07-17 </td>
<td> 09:53:20 </td>
<td> 2022-07-19 </td>
<td> 08:47:01 </td>
<td> U0030 </td>
<td> </td>
<td> 2022/07/17/000047, FISOL </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> 4200 </td>
<td> 52 </td>
<td> Hidup </td>
<td> Ya </td>
<td> Hidup </td>
<td> Ya </td>
<td> Tidak </td>
<td> Ya </td>

<td> - </td>
<td> 900000 </td>
<td> Sembuh </td>
<td> 3 </td>
<td> Sudah </td>
</tr>
<tr>
<td> 2022/07/17/000048 </td>
<td> 072433 </td>
<td> AKIRA NADISHA ALMIRA, AN </td>
<td> P </td>
<td> MALANG </td>
<td> 2022-07-17 </td>
<td> 0 Th 0 Bl 12 Hr </td>
<td> ISLAM </td>
<td> TS </td>
<td> FATHUR RAHMAD FITRIAWAN, TN </td>
<td> AYAH </td>
<td> JL. KELUD GG KRAMAT RT 08 RW 11, PESISIR, BATU, KOTA BATU
</td>
<td> BPJ </td>
<td> kelas 3 </td>
<td> BFA03 </td>
<td> 300000 </td>
<td> P03.4 </td>
<td> P03.4 </td>
<td> 2022-07-17 </td>
<td> 09:53:03 </td>
<td> 2022-07-19 </td>
<td> 08:46:31 </td>
<td> U0030 </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> 2900 </td>
<td> 48 </td>
<td> Hidup </td>
<td> Tidak </td>
<td> Hidup </td>
<td> Ya </td>
<td> Tidak </td>
<td> Ya </td>

<td> - </td>
<td> 900000 </td>
<td> Sembuh </td>
<td> 3 </td>
<td> Sudah </td>
</tr>
<tr>
<td> 2022/07/17/000041 </td>
<td> 072432 </td>
<td> NAO DANADYAKSA, AN </td>
<td> L </td>
<td> MALANG </td>
<td> 2022-07-17 </td>
<td> ISLAM </td>
<td> TS </td>
<td> SEPTIYAN DWI ANDIKA, TN </td>
<td> AYAH </td>
<td> JL KAPI PRAMUJA 4 BLOK 18B NO 18, SEKARPURO, PAKIS,
<td> BPJ </td>
<td> kelas 3 </td>
<td> PF03 </td>
<td> 300000 </td>
<td> P03.4 </td>
<td> P03.4 </td>
<td> 2022-07-17 </td>
<td> 09:08:04 </td>
<td> 2022-07-19 </td>
<td> 08:46:50 </td>
<td> U0030 </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> 3400 </td>
<td> 50 </td>
<td> Hidup </td>
<td> Tidak </td>
<td> Hidup </td>
<td> Ya </td>
<td> Tidak </td>
<td> Ya </td>

<td> - </td>
<td> 900000 </td>
<td> Sembuh </td>
<td> 3 </td>
<td> Sudah </td>
</tr>
<tr>
<td> 2022/07/17/000100 </td>
<td> 067726 </td>
<td> DITA ANGGRAENI, NY </td>
<td> P </td>
<td> MALANG </td>
<td> 1995-06-10 </td>
<td> 27 Th 1 Bl 17 Hr </td>
<td> ISLAM </td>
<td> SMA </td>
<td> WEDIK PURNOMO, TN </td>
<td> SUAMI </td>
<td> DSN BANARAN RT 01 RW 06, BABADAN, NGAJUM, KABUPATEN MALANG
</td>
<td> A09 </td>
<td> UMUM </td>
<td> kelas 3 </td>
<td> A07 </td>
<td> 300000 </td>
<td> O80.8 </td>
<td> O32.2 </td>
<td> 2022-07-17 </td>
<td> 07:42:07 </td>
<td> 2022-07-20 </td>
<td> 08:59:03 </td>
<td> IGDK </td>
<td> </td>
<td> 2022/07/17/000100 UMUM KELAS 3 DI AMARTA 5C </td>
<td> 1 </td>
<td> 0 </td>
<td> 0 </td>
<td> 0 </td>
<td> 0 </td>
<td> 0 </td>
<td> 39-40 </td>

<td> 3500 </td>
<td> 50 </td>
<td> Hidup </td>
<td> Ya </td>
<td> Hidup </td>
<td> Ya </td>
<td> Tidak </td>
<td> Ya </td>
<td> VT Bidan, NST, NST, Visite Dokter Spesialis Obgyn, Visite

Dokter Umum, Konsultasi Dokter Spesialis Obgyn Via Telepon, Oksigen 21% 3 LPM / Jam
</td>
<td> - </td>
<td> 1200000 </td>
<td> Sembuh </td>
<td> 4 </td>
<td> Sudah </td>
</tr>
<tr>
<td> 2022/07/17/000095 </td>
<td> 072447 </td>
<td> ATIK RETNO NUR PALUPIANTI, NY </td>
<td> P </td>
<td> MALANG </td>
<td> 1992-09-09 </td>
<td> 29 Th 10 Bl 9 Hr </td>
<td> ISLAM </td>
<td> SMA </td>
<td> ANDIKA NUR BUDI IRAWAN, TN </td>
<td> SUAMI </td>
<td> JL MELATI RT 12 RW 4, SEKARPURO, PAKIS, KABUPATEN MALANG
</td>
<td> BPJ </td>
<td> kelas 3 </td>
<td> A03 </td>
<td> 300000 </td>
<td> O80.9 </td>
<td> O80.8 </td>
<td> 2022-07-17 </td>
<td> 02:07:41 </td>
<td> 2022-07-19 </td>
<td> 09:59:59 </td>
<td> IGDK </td>
<td> </td>
<td> 2022/07/17/000095, BPJS KELAS 3, AMARTA 5A
- SEP, BPJS PASIEN KET TIDAK DITANGGUNG, PASIEN MAU MENGURUS KE KANTOR BPJS,
APABILA DALAM WAKTU 3X 24 JAM ATAU SEBELUM PX PULANG TIDAK BISA MENUNJUKKAN BPJS
AKTIF, BERSEDIA UMUM. </td>
<td> 2 </td>
<td> 1 </td>
<td> 0 </td>
<td> 0 </td>
<td> 0 </td>
<td> 0 </td>
<td> 38-39 </td>

<td> 3020 </td>
<td> 49 </td>
<td> Hidup </td>
<td> Ya </td>
<td> Hidup </td>
<td> Ya </td>
<td> Tidak </td>
<td> Ya </td>
<td> Visite Dokter Spesialis Obgyn, VT Bidan, VT Bidan, NST,

Konsultasi Dokter Spesialis Obgyn Via Telepon </td>
<td> - </td>
<td> 900000 </td>
<td> Sembuh </td>
<td> 3 </td>
<td> Sudah </td>
</tr>
<tr>
<td> 2022/07/17/000073 </td>
<td> 047484 </td>
<td> TUSIANTI, NY </td>
<td> P </td>
<td> MALANG </td>
<td> 1979-08-19 </td>
<td> 42 Th 11 Bl 13 Hr </td>
<td> ISLAM </td>
<td> SWASTA </td>
<td> SD </td>
<td> IRT </td>
<td> PUPUT DWI PURWATI, NY </td>
<td> SAUDARA </td>
<td> JL. SANTOSO RT04 RW05, CEMOROKANDANG, KEDUNGKANDANG, KOTA
MALANG </td>
<td> BPJ </td>
<td> kelas 3 </td>
<td> A13 </td>
<td> 300000 </td>
<td> D26.0 </td>
<td> D25.9 </td>
<td> 2022-07-17 </td>
<td> 00:28:29 </td>
<td> 2022-07-20 </td>
<td> 23:05:33 </td>
<td> IGDK </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>

Penyakit Dalam, Infus Dewasa oleh Perawat / Bidan, Oksigen 100% Sentral 2 LPM,
Oksigen 100% Sentral 2 LPM, Konsultasi Dokter Spesialis Obgyn Via Telepon, EKG
</td>
<td> - </td>
<td> 1200000 </td>
<td> Sembuh </td>
<td> 4 </td>
<td> Sudah </td>
</tr>
<tr>
<td> 2022/07/16/000142 </td>
<td> 027513 </td>
<td> ARABELLA KHANSA PERMATA CHANDRA, AN </td>
<td> P </td>
<td> Malang </td>
<td> 2019-11-15 </td>
<td> 2 Th 8 Bl 10 Hr </td>
<td> ISLAM </td>
<td> - </td>
<td> - </td>
<td> SWASTA </td>
<td> THUFI DHIRARTO, TN </td>
<td> AYAH </td>
<td> PERUM DAMI PERMAI B15, AMPELDENTO, PAKIS, KABUPATEN MALANG
</td>
<td> BPJ </td>
<td> kelas 1 </td>
<td> P06 </td>
<td> 650000 </td>
<td> R50.9 </td>
<td> R50.9 </td>
<td> 2022-07-16 </td>
<td> 23:38:09 </td>
<td> 2022-07-21 </td>
<td> 01:07:00 </td>
<td> IGDK </td>
<td> 2022/07/16/000142, BPJS KELAS 1 RUANG PANDAWA 6 ( KONFIRMASI
) </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>

Anak, Visite Dokter Spesialis Anak, Operasional Rumah Sakit </td>
<td> - </td>
<td> 3250000 </td>
<td> 5 </td>
<td> Sudah </td>
</tr>
<tr>
<td> 2022/07/16/000138 </td>
<td> 068115 </td>
<td> KIRANIA SHAKILLA JENAKA, AN </td>
<td> P </td>
<td> MALANG </td>
<td> 2020-02-25 </td>
<td> 2 Th 4 Bl 23 Hr </td>
<td> ISLAM </td>
<td> - </td>
<td> - </td>
<td> AIRUS, TN </td>
<td> AYAH </td>
<td> JL. DANAU GENALI C3 J7, SAWOJAJAR, KEDUNGKANDANG, KOTA
MALANG </td>
<td> BPJ </td>
<td> kelas 1 </td>
<td> P04 </td>
<td> 650000 </td>
<td> A91 </td>
<td> A91 </td>
<td> 2022-07-16 </td>
<td> 23:31:35 </td>
<td> 2022-07-18 </td>
<td> 17:45:23 </td>
<td> IGDK </td>
<td> 2022/07/16/000138, BPJS KELAS 1 RUANG PANDAWA 4 </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>

</td>
<td> - </td>
<td> 1300000 </td>
<td> 2 </td>
<td> Sudah </td>
</tr>
<tr>
<td> 2022/07/16/000159 </td>
<td> 061344 </td>
<td> NOVI INDRIANI, NY </td>
<td> P </td>
<td> MALANG </td>
<td> 1989-11-08 </td>
<td> 32 Th 8 Bl 9 Hr </td>
<td> ISLAM </td>
<td> SMA </td>
<td> SURYONO, TN </td>
<td> SUAMI </td>
<td> JL. SUROPATI TIMUR NO. 418 RT 02 RW 03, LOSARI, SINGOSARI,
<td> BPJ </td>
<td> kelas 3 </td>
<td> A09 </td>
<td> 300000 </td>
<td> O82.0 </td>
<td> O82.0 </td>
<td> 2022-07-16 </td>
<td> 22:07:12 </td>
<td> 2022-07-19 </td>
<td> 10:00:36 </td>
<td> IGDK </td>
<td> 2022/07/16/000159, BPJS KELAS 3 RUANG AMARTA 6C ( KONFIRMASI
) </td>
<td> 2 </td>
<td> 1 </td>
<td> 0 </td>
<td> 0 </td>
<td> 0 </td>
<td> 0 </td>
<td> 40-41 </td>
<td> 2900 </td>
<td> 47 </td>
<td> Hidup </td>
<td> Ya </td>
<td> Baik </td>
<td> Ya </td>
<td> Tidak </td>
<td> Ya </td>

<td> - </td>
<td> 900000 </td>
<td> 3 </td>
<td> Sudah </td>
</tr>
<tr>
<td> 2022/07/16/000164 </td>
<td> 072422 </td>
<td> RAGIL AYU PUSPITASARI,NY </td>
<td> P </td>
<td> MALANG </td>
<td> 1992-08-20 </td>
<td> 29 Th 11 Bl 14 Hr </td>
<td> ISLAM </td>
<td> S1 </td>
<td> FEBBY JULIAN ARIFIN,TN </td>
<td> SUAMI </td>
<td> JL. SINGOSARI DEPAN RADIO SOKA RT.01 RW.39, KEBONSARI,
SUMBERSARI, JEMBER </td>
<td> BPJ </td>
<td> kelas 1 </td>
<td> H09 </td>
<td> 650000 </td>
<td> O63.0 </td>
<td> - </td>
<td> 2022-07-16 </td>
<td> 21:52:06 </td>
<td> 2022-07-17 </td>
<td> 13:59:38 </td>
<td> IGDK </td>
<td> </td>
<td> 1 </td>
<td> 0 </td>
<td> 0 </td>
<td> 0 </td>
<td> 0 </td>
<td> 0 </td>
<td> 40-41 </td>

<td> 3350 </td>
<td> 50 </td>
<td> Hidup </td>
<td> Tidak </td>
<td> Hidup </td>
<td> Ya </td>
<td> Tidak </td>
<td> Ya </td>

Perawat / Bidan, Infus Dewasa oleh Perawat / Bidan, Oksigen 100% Sentral 3 LPM ,
Oksigen 100% Sentral 3 LPM , NST, NST </td>
<td> - </td>
<td> 1300000 </td>
<td> 2 </td>
<td> Sudah </td>
</tr>
<tr>
<td> 2022/07/16/000166 </td>
<td> 069275 </td>
<td> MUHAMMAD ARKANANTA H., AN </td>
<td> L </td>
<td> MALANG </td>
<td> 2019-04-09 </td>
<td> 3 Th 3 Bl 15 Hr </td>
<td> ISLAM </td>
<td> TS </td>
<td> SYARIF SYAMSUDIN, TN </td>
<td> AYAH </td>
<td> BARAN SONOSARI RT 3 RW 6 , LESANPURO, KEDUNGKANDANG, KOTA
MALANG </td>
<td> BPJ </td>
<td> kelas 2 </td>
<td> D07 </td>
<td> 400000 </td>
<td> J18.0 </td>
<td> J18.0 </td>
<td> 2022-07-16 </td>
<td> 21:47:36 </td>
<td> 2022-07-19 </td>
<td> 22:20:27 </td>
<td> IGDK </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>

Visite Dokter Spesialis Anak, Oksigen 100% Sentral 2 LPM, Oksigen 100% Sentral 2
LPM, Oksigen 100% Sentral 2 LPM, Oksigen 100% Sentral 2 LPM, Nebulizer ,
Nebulizer , Nebulizer , Nebulizer , Oksigen 21% 2 LPM / Jam, Oksigen 21% 2 LPM /
Jam, Infus Anak oleh Perawat / Bidan, Operasional Rumah Sakit </td>
<td> - </td>
<td> 1200000 </td>
<td> 3 </td>
<td> Sudah </td>
</tr>
<tr>
<td> 2022/07/16/000171 </td>
<td> 072424 </td>
<td> SHANUM ANINDYA KHALISA, AN </td>
<td> P </td>
<td> MALANG </td>
<td> 2022-07-16 </td>
<td> ISLAM </td>
<td> - </td>
<td> SURYONO, TN </td>
<td> AYAH </td>
<td> JL SUROPATI TIMUR NO 418 RT 2 RW 3 , LOSARI, SINGOSARI,
<td> BPJ </td>
<td> kelas 3 </td>
<td> BPF01 </td>
<td> 300000 </td>
<td> P03.4 </td>
<td> P03.4 </td>
<td> 2022-07-16 </td>
<td> 20:58:09 </td>
<td> 2022-07-19 </td>
<td> 09:28:09 </td>
<td> U0030 </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> 2900 </td>
<td> 47 </td>
<td> Hidup </td>
<td> Tidak </td>
<td> Hidup </td>
<td> Ya </td>
<td> Tidak </td>
<td> Ya </td>

Rumah Sakit </td>
<td> - </td>
<td> 1200000 </td>
<td> Sembuh </td>
<td> 4 </td>
<td> Sudah </td>
</tr>
<tr>
<td> 2022/07/16/000088 </td>
<td> 027203 </td>
<td> AGNES KHUSNUL KHOTIMAH, NY </td>
<td> P </td>
<td> Malang </td>
<td> 1993-02-04 </td>
<td> 29 Th 5 Bl 12 Hr </td>
<td> ISLAM </td>
<td> SMA </td>
<td> MIFTAHUL SAHRONI, TN </td>
<td> SUAMI </td>
<td> PERUM PANORAMA GARDEN BLOK H-80, SUKODADI, WAGIR, KABUPATEN
MALANG </td>
<td> BPJ </td>
<td> kelas 1 </td>
<td> H05 </td>
<td> 650000 </td>
<td> O80.8 </td>
<td> O80.9 </td>
<td> 2022-07-16 </td>
<td> 17:06:34 </td>
<td> 2022-07-17 </td>
<td> 13:58:37 </td>
<td> IGDK </td>
<td> 2022/07/16/000088, BPJS KLAS 1 MENEMPATI HASTINA 5 </td>
<td> 5 </td>
<td> 2 </td>
<td> 0 </td>
<td> 1 </td>
<td> 1 </td>
<td> 0 </td>
<td> 39-40 </td>

<td> 3050 </td>
<td> 47 </td>
<td> Hidup </td>
<td> Ya </td>
<td> Hidup </td>
<td> Ya </td>
<td> Tidak </td>
<td> Ya </td>

<td> - </td>
<td> 1300000 </td>
<td> 2 </td>
<td> Sudah </td>
</tr>
<tr>
<td> 2022/07/16/000131 </td>
<td> 072393 </td>
<td> SRI MARIYANI, NY </td>
<td> P </td>
<td> MALANG </td>
<td> 1998-07-14 </td>
<td> 24 Th 0 Bl 7 Hr </td>
<td> ISLAM </td>
<td> SMA </td>
<td> MUHAMMAD YASIN, TN </td>
<td> SUAMI </td>
<td> JL MUHARTO GG VII RT 11 RW 7, KOTALAMA, KEDUNGKANDANG, KOTA
MALANG </td>
<td> BPJ </td>
<td> kelas 3 </td>
<td> A07 </td>
<td> 300000 </td>
<td> O80.9 </td>
<td> O80.9 </td>
<td> 2022-07-16 </td>
<td> 17:05:35 </td>
<td> 2022-07-17 </td>
<td> 19:05:00 </td>
<td> IGDK </td>
<td> 1 </td>
<td> 0 </td>
<td> 0 </td>
<td> 0 </td>
<td> 0 </td>
<td> 0 </td>
<td> 38-39 </td>

<td> 2760 </td>
<td> 47 </td>
<td> Hidup </td>
<td> Ya </td>
<td> Hidup </td>
<td> Ya </td>
<td> Tidak </td>
<td> Ya </td>
<td> </td>
<td> - </td>
<td> 600000 </td>
<td> 2 </td>
<td> Sudah </td>
</tr>
<tr>
<td> 2022/07/16/000122 </td>
<td> 072410 </td>
<td> AL FATIH ABBAS TYOWARDHANA, AN </td>
<td> L </td>
<td> TUMPANG </td>
<td> 2022-06-02 </td>
<td> 0 Th 1 Bl 23 Hr </td>
<td> ISLAM </td>
<td> TS </td>
<td> SIYONO, TN </td>
<td> AYAH </td>
<td> JL. WISNUWARDANA RT 009 RW 008, TUMPANG, TUMPANG, KABUPATEN
MALANG </td>
<td> A09 </td>
<td> UMUM </td>
<td> PA04 </td>
<td> NICU 4 </td>
<td> 400000 </td>
<td> J18.0 </td>
<td> J15.9 </td>
<td> 2022-07-16 </td>
<td> 16:32:22 </td>
<td> 2022-07-21 </td>
<td> 12:18:05 </td>
<td> IGDK </td>
<td> </td>
<td> 2022/07/16/000122, UMUM KELAS 2 TITP PANDAWA 1 (KONFIRMASI
RUANAGAN) </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>

Nebulizer , Nebulizer , Nebulizer , Nebulizer , Operasional Rumah Sakit , Infus
Bayi oleh Dokter Umum , Oksigen 100% Sentral 2 LPM, Visite Dokter Spesialis Anak,
Visite Dokter Spesialis Anak, Sewa Infus Pump, Sewa Infus Pump, Sewa Infus Pump,
Sewa Infus Pump, Sewa Infus Pump, Sewa Inkubator, Sewa Inkubator, Sewa Patient
Monitor , Sewa Patient Monitor , Sewa Patient Monitor , Sewa Patient Monitor , Sewa
Suction Pump, Sewa Suction Pump, Sewa Syringe Pump, Infus Anak oleh Perawat / Bidan
</td>
<td> - </td>
<td> 2400000 </td>
<td> 6 </td>
<td> Sudah </td>
</tr>
<tr>
<td> 2022/07/16/000146 </td>
<td> 072420 </td>
<td> AGNES KHUSNUL., BY NY </td>
<td> P </td>
<td> MALANG </td>
<td> 2022-07-16 </td>
<td> ISLAM </td>
<td> - </td>
<td> MIFTAHUL SAHRONI, TN </td>
<td> AYAH </td>
<td> PERUM PANORAMA GARDEN BLOK H-80 , SUKODADI, WAGIR, KABUPATEN
MALANG </td>
<td> BPJ </td>
<td> kelas 3 </td>
<td> PF04 </td>
<td> 300000 </td>
<td> P00.6 </td>
<td> P00.9 </td>
<td> 2022-07-16 </td>
<td> 16:09:52 </td>
<td> 2022-07-17 </td>
<td> 18:50:36 </td>
<td> U0030 </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> 3050 </td>
<td> 47 </td>
<td> Hidup </td>
<td> Ya </td>
<td> Hidup </td>
<td> Ya </td>
<td> Tidak </td>
<td> Ya </td>

<td> - </td>
<td> 600000 </td>
<td> Sembuh </td>
<td> 2 </td>
<td> Sudah </td>
</tr>
<tr>
<td> 2022/07/16/000143 </td>
<td> 072418 </td>
<td> MUHAMMAD ALWI NUR IBRAHIM, AN </td>
<td> L </td>
<td> MALANG </td>
<td> 2022-07-16 </td>
<td> ISLAM </td>
<td> - </td>
<td> - </td>
<td> MUHAMMAD YASIN,TN </td>
<td> AYAH </td>
<td> JL MUHARTO GG VII RT 11 RW 7, KEDUNGKANDANG, KEDUNGKANDANG,
KOTA MALANG </td>
<td> BPJ </td>
<td> kelas 3 </td>
<td> BF33 </td>
<td> 300000 </td>
<td> P00.6 </td>
<td> P00.9 </td>
<td> 2022-07-16 </td>
<td> 15:17:13 </td>
<td> 2022-07-17 </td>
<td> 14:51:23 </td>
<td> U0030 </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>

<td> - </td>
<td> 600000 </td>
<td> Sembuh </td>
<td> 2 </td>
<td> Sudah </td>
</tr>
<tr>
<td> 2022/07/16/000110 </td>
<td> 083181 </td>
<td> HAFIZAH BRILIANI PUTRI N R, AN </td>
<td> P </td>
<td> MALANG </td>
<td> 2011-07-03 </td>
<td> 11 Th 0 Bl 19 Hr </td>
<td> ISLAM </td>
<td> SD </td>
<td> GUNAWAN, TN </td>
<td> AYAH </td>
<td> JL. BATU AMARIL NO. 33 RT. 06/ RW. 04, PANDANWANGI,
<td> BPJ </td>
<td> kelas 1 </td>
<td> H06 </td>
<td> 650000 </td>
<td> A90 </td>
<td> A90 </td>
<td> 2022-07-16 </td>
<td> 13:30:33 </td>
<td> 2022-07-20 </td>
<td> 17:58:57 </td>
<td> IGDK </td>
<td> 2022/07/16/000110, BPJS KLAS 1 MENEMPATI HASTINA 6
(KONFIRMASI) </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>

</td>
<td> - </td>
<td> 3250000 </td>
<td> 5 </td>
<td> Sudah </td>
</tr>
<tr>
<td> 2022/07/15/000055 </td>
<td> 093964 </td>
<td> LILIK KOMARIYATI,NY </td>
<td> P </td>
<td> SURABAYA </td>
<td> 1983-11-25 </td>
<td> 38 Th 7 Bl 26 Hr </td>
<td> ISLAM </td>
<td> SMA </td>
<td> - </td>
<td> Nuriadi, Tn. </td>
<td> SUAMI </td>
<td> JL.SEBUKU XIV/9 RT.04/RW.08, BUNULREJO, BLIMBING, KOTA
MALANG </td>
<td> BPJ </td>
<td> kelas 3 </td>
<td> A17 </td>
<td> 300000 </td>
<td> O82.0 </td>
<td> O82.0 </td>
<td> 2022-07-16 </td>
<td> 13:17:23 </td>
<td> 2022-07-19 </td>
<td> 00:33:52 </td>
<td> IGDK </td>
<td> 2022/07/15/000055, BPJS KLAS 3 PBI (KONFIRMASI) </td>
<td> 4 </td>
<td> 3 </td>
<td> 0 </td>
<td> 0 </td>
<td> 0 </td>
<td> 0 </td>
<td> 39-40 </td>

<td> 2300 </td>
<td> 43 </td>
<td> Hidup </td>
<td> Tidak </td>
<td> Hidup </td>
<td> Ya </td>
<td> Tidak </td>
<td> Tidak </td>

<td> - </td>
<td> 1200000 </td>
<td> 4 </td>
<td> Sudah </td>
</tr>
<tr>
<td> 2022/07/16/000103 </td>
<td> 024048 </td>
<td> P </td>
<td> Malang </td>
<td> 1986-07-09 </td>
<td> 36 Th 0 Bl 22 Hr </td>
<td> KRISTEN </td>
<td> SMA </td>
<td> SUAMI </td>
<td> A09 </td>
<td> UMUM </td>
<td> kelas 3 </td>
<td> A16 </td>
<td> 300000 </td>
<td> O80.9 </td>
<td> O80.9 </td>
<td> 2022-07-16 </td>
<td> 12:29:14 </td>
<td> 2022-07-20 </td>
<td> 23:07:48 </td>
<td> IGDK </td>
<td> </td>
<td> 2022/07/16/000103, UMUM KLAS 3 AMARTA 7 A </td>
<td> 4 </td>
<td> 0 </td>
<td> 0 </td>
<td> 2 </td>
<td> 1 </td>
<td> 0 </td>
<td> 26-28 </td>

<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>

Visite Dokter Spesialis Obgyn, Infus Dewasa oleh Perawat / Bidan, Konsultasi Dokter
<td> - </td>
<td> 1500000 </td>
<td> 5 </td>
<td> Sudah </td>
</tr>
<tr>
<td> 2022/07/16/000135 </td>
<td> 072415 </td>
<td> AZZAHRA ZHAFIRA NIHALA, AN </td>
<td> P </td>
<td> MALANG </td>
<td> 2022-07-16 </td>
<td> ISLAM </td>
<td> - </td>
<td> - </td>
<td> MUSLIMIN, TN </td>
<td> SUAMI </td>
<td> JL. SEBUKU XIV /9, BUNULREJO, BLIMBING, KOTA MALANG </td>
<td> BPJ </td>
<td> kelas 3 </td>
<td> PF22 </td>
<td> 300000 </td>
<td> P03.4 </td>
<td> P03.4 </td>
<td> 2022-07-16 </td>
<td> 12:23:17 </td>
<td> 2022-07-18 </td>
<td> 09:07:28 </td>
<td> U0030 </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> 2300 </td>
<td> 43 </td>
<td> Hidup </td>
<td> Tidak </td>
<td> Hidup </td>
<td> Ya </td>
<td> Tidak </td>
<td> Ya </td>
<td> Perawatan Bayi SC , Jasa Pelayanan Rumah Sakit, Tindik oleh

<td> </td>
<td> 900000 </td>
<td> Sembuh </td>
<td> 3 </td>
<td> Sudah </td>
</tr>
<tr>
<td> 2022/07/16/000172 </td>
<td> 060193 </td>
<td> ANGGAR DWI MERDEKASARI, NY </td>
<td> P </td>
<td> Malang </td>
<td> 1993-08-17 </td>
<td> 28 Th 11 Bl 8 Hr </td>
<td> ISLAM </td>
<td> D2 </td>
<td> SEPTIYAN DWI ANDIKA, Tn </td>
<td> SUAMI </td>
<td> JL KAPI PRAMUJA 4 BLOK 18B NO 18, SEKARPURO, PAKIS,
<td> BPJ </td>
<td> kelas 1 </td>
<td> H08 </td>
<td> 650000 </td>
<td> O42.9 </td>
<td> O82.9 </td>
<td> 2022-07-16 </td>
<td> 10:31:20 </td>
<td> 2022-07-19 </td>
<td> 09:30:36 </td>
<td> IGDK </td>
<td> </td>
<td> 2022/07/16/000172, BPJS KLS 2 UP 1, HASTINA 8 </td>
<td> 1 </td>
<td> 0 </td>
<td> 0 </td>
<td> 0 </td>
<td> 0 </td>
<td> 0 </td>
<td> 40-41 </td>

<td> 3400 </td>
<td> 50 </td>
<td> Hidup </td>
<td> Ya </td>
<td> Hidup </td>
<td> Ya </td>
<td> Tidak </td>
<td> Ya </td>
<td> VT Bidan, Infus Dewasa Oleh Dokter Umum </td>

<td> </td>
<td> 2600000 </td>
<td> 4 </td>
<td> Sudah </td>
</tr>
<tr>
<td> 2022/07/16/000107 </td>
<td> 072407 </td>
<td> DEWI SARTIKA S., By.Ny </td>
<td> L </td>
<td> MALANG </td>
<td> 2022-07-15 </td>
<td> ISLAM </td>
<td> TS </td>
<td> PURWANTO, TN </td>
<td> AYAH </td>
<td> JL. HAMID RUSDI TIMUR V RT 001 RW 007, BUNULREJO, BLIMBING,
KOTA MALANG </td>
<td> BPJ </td>
<td> kelas 3 </td>
<td> PF24 </td>
<td> 300000 </td>
<td> P00.6 </td>
<td> P00.9 </td>
<td> 2022-07-16 </td>
<td> 08:24:50 </td>
<td> 2022-07-17 </td>
<td> 11:54:34 </td>
<td> U0030 </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> 3170 </td>
<td> 48 </td>
<td> Hidup </td>
<td> Ya </td>
<td> Hidup </td>
<td> Ya </td>
<td> Tidak </td>
<td> Ya </td>

<td> - </td>
<td> 600000 </td>
<td> Sembuh </td>
<td> 2 </td>
<td> Sudah </td>
</tr>
<tr>
<td> 2022/07/16/000101 </td>
<td> 072405 </td>
<td> DERREN OSMAN ISMAIL, AN </td>
<td> L </td>
<td> MALANG </td>
<td> 2022-07-16 </td>
<td> ISLAM </td>
<td> - </td>
<td> - </td>
<td> HUSNI ISMAIL, TN </td>
<td> AYAH </td>
<td> JL ABDUL QODIR JAELANI RT 3 RW 7, KEDUNGKANDANG,
<td> BPJ </td>
<td> kelas 3 </td>
<td> PF21 </td>
<td> 300000 </td>
<td> P00.6 </td>
<td> P00.9 </td>
<td> 2022-07-16 </td>
<td> 07:43:49 </td>
<td> 2022-07-17 </td>
<td> 20:47:49 </td>
<td> U0030 </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> 2690 </td>
<td> 46 </td>
<td> Hidup </td>
<td> Ya </td>
<td> Hidup </td>
<td> Ya </td>
<td> Tidak </td>
<td> Ya </td>

<td> - </td>
<td> 600000 </td>
<td> Sembuh </td>
<td> 2 </td>
<td> Sudah </td>
</tr>
<tr>
<td> 2022/07/16/000076 </td>
<td> 057838 </td>
<td> KENZO AZKA PUTRA AFFANDI, AN </td>
<td> L </td>
<td> MALANG </td>
<td> 2021-09-21 </td>
<td> 0 Th 10 Bl 3 Hr </td>
<td> ISLAM </td>
<td> TS </td>
<td> HENDRI TRI ARI, TN </td>
<td> AYAH </td>
<td> JL. SIMPANG TELUK GRAJAKAN PERUM PANDANWANGI INDAH 18E RT.11
RW.02, PANDANWANGI, BLIMBING, KOTA MALANG </td>
<td> BPJ </td>
<td> kelas 2 </td>
<td> H05 </td>
<td> 400000 </td>
<td> J18.0 </td>
<td> - </td>
<td> 2022-07-16 </td>
<td> 06:50:17 </td>
<td> 2022-07-16 </td>
<td> 11:41:18 </td>
<td> IGDK </td>
<td> 2022/07/16/000076 BPJS KELAS 2 KARYAWAN DI PANDAWA 5
KONFIRMASI </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> Jasa Pelayanan Rumah Sakit, Nebulizer , Nebulizer ,

Nebulizer , Nebulizer </td>
<td> </td>
<td> 400000 </td>
<td> 1 </td>
<td> Sudah </td>
</tr>
<tr>
<td> 2022/07/16/000086 </td>
<td> 072402 </td>
<td> HAJAR NADIA, AN </td>
<td> P </td>
<td> MALANG </td>
<td> 2022-07-16 </td>
<td> ISLAM </td>
<td> TS </td>
<td> MADERIKUL HUDA, TN </td>
<td> AYAH </td>
<td> DUSUN PANGGUNG RT 44 RW 4 , KIDAL, TUMPANG, KABUPATEN MALANG
</td>
<td> A09 </td>
<td> UMUM </td>
<td> kelas 3 </td>
<td> PF10 </td>
<td> 300000 </td>
<td> P00.6 </td>
<td> P00.9 </td>
<td> 2022-07-16 </td>
<td> 06:28:56 </td>
<td> 2022-07-17 </td>
<td> 15:44:48 </td>
<td> U0030 </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> 2650 </td>
<td> 47 </td>
<td> Hidup </td>
<td> Ya </td>
<td> Hidup </td>
<td> Ya </td>
<td> Tidak </td>
<td> Ya </td>

<td> - </td>
<td> 600000 </td>
<td> Sembuh </td>
<td> 2 </td>
<td> Sudah </td>
</tr>
<tr>
<td> 2022/07/16/000079 </td>
<td> 072399 </td>
<td> AGISNA FIKAMALINA, AN </td>
<td> P </td>
<td> Malang </td>
<td> 2022-07-16 </td>
<td> 0 Th 0 Bl 19 Hr </td>
<td> ISLAM </td>
<td> - </td>
<td> NASRULLOH, Tn </td>
<td> AYAH </td>
<td> WONOREJO PONCOKUSUMO RT 11 RW 2, WONOREJO, BANTUR, KABUPATEN
MALANG </td>
<td> A09 </td>
<td> UMUM </td>
<td> kelas 3 </td>
<td> PF02 </td>
<td> 300000 </td>
<td> P00.6 </td>
<td> P00.9 </td>
<td> 2022-07-16 </td>
<td> 06:01:20 </td>
<td> 2022-07-17 </td>
<td> 11:47:26 </td>
<td> U0030 </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> 2155 </td>
<td> 43 </td>
<td> Hidup </td>
<td> Ya </td>
<td> Hidup </td>
<td> Ya </td>
<td> Tidak </td>
<td> Ya </td>

<td> </td>
<td> 600000 </td>
<td> Sembuh </td>
<td> 2 </td>
<td> Sudah </td>
</tr>
<tr>
<td> 2022/07/15/000176 </td>
<td> 054387 </td>
<td> AL FATIH YUSUF, AN </td>
<td> L </td>
<td> MALANG </td>
<td> 2021-07-05 </td>
<td> 1 Th 0 Bl 15 Hr </td>
<td> ISLAM </td>
<td> - </td>
<td> MAULANA YUSUF, TN </td>
<td> AYAH </td>
<td> JL. SANAN IX/60 RT.05 RW.16, PURWANTORO, BLIMBING, KOTA
MALANG </td>
<td> A09 </td>
<td> UMUM </td>
<td> kelas 1 </td>
<td> H05 </td>
<td> 650000 </td>
<td> A08.3 </td>
<td> A08.3 </td>
<td> 2022-07-15 </td>
<td> 23:34:47 </td>
<td> 2022-07-16 </td>
<td> 03:26:10 </td>
<td> IGDK </td>
<td> </td>
<td> 2022/07/15/000176 UMUM KELAS 1 DI HASTINA 5 </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>

<td> </td>
<td> 650000 </td>
<td> 1 </td>
<td> Sudah </td>
</tr>
<tr>
<td> 2022/07/15/000130 </td>
<td> 072377 </td>
<td> ACHMAD NAUFAL ALFAHRI, AN </td>
<td> L </td>
<td> MALANG </td>
<td> 2021-08-23 </td>
<td> 0 Th 11 Bl 3 Hr </td>
<td> ISLAM </td>
<td> TS </td>
<td> AKHMAD MUHAJIR, TN </td>
<td> AYAH </td>
<td> BORO SEKARAN RT 003 RW 007, ASRIKATON, PAKIS, KABUPATEN
MALANG </td>
<td> A09 </td>
<td> UMUM </td>
<td> kelas 1 </td>
<td> P03 </td>
<td> 650000 </td>
<td> J18.8 </td>
<td> J18.8 </td>
<td> 2022-07-15 </td>
<td> 23:24:17 </td>
<td> 2022-07-18 </td>
<td> 16:30:00 </td>
<td> IGDK </td>
<td> </td>
<td> 2022/07/15/000130, UMUM KELAS 1 RUANG PANDAWA 5 ( KONFIRMASI
) </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>

Nebulizer , Oksigen 100% Sentral 2 LPM, Oksigen 100% Sentral 2 LPM, Visite Dokter
Spesialis Anak, Visite Dokter Spesialis Anak, Visite Dokter Spesialis Anak, Oksigen
21% 2 LPM / Jam, Infus Anak oleh Perawat / Bidan </td>
<td> - </td>
<td> 1950000 </td>
<td> 3 </td>
<td> Sudah </td>
</tr>
<tr>
<td> 2022/07/15/000156 </td>
<td> 072378 </td>
<td> AISYAH AZKYAH PUTRI, AN </td>
<td> P </td>
<td> MALANG </td>
<td> 2020-12-16 </td>
<td> ISLAM </td>
<td> TS </td>
<td> MUSJAQIM, TN </td>
<td> AYAH </td>
<td> JL. ANGGREK MEDURAN KASEMBON RT 18 RW 04, KASEMBON,
BULULAWANG, KABUPATEN MALANG </td>
<td> BPJ </td>
<td> kelas 2 </td>
<td> D04 </td>
<td> 400000 </td>
<td> A09 </td>
<td> A09 </td>
<td> 2022-07-15 </td>
<td> 23:20:53 </td>
<td> 2022-07-19 </td>
<td> 10:27:59 </td>
<td> IGDK </td>
<td> 2022/07/15/000156, BPJS KELAS 2 TITIP DI PANDAWA 3 RENCANA
DI AYODYA 2B ( KONFIRMASI ) </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>

<td> - </td>
<td> 1600000 </td>
<td> 4 </td>
<td> Sudah </td>
</tr>
<tr>
<td> 2022/07/15/000172 </td>
<td> 099109 </td>
<td> Amelia Erwinawati,Ny </td>
<td> P </td>
<td> Batam </td>
<td> 1996-01-16 </td>
<td> 26 Th 6 Bl 6 Hr </td>
<td> ISLAM </td>
<td> SMA </td>
<td> Eko Setiawan, Tn </td>
<td> SUAMI </td>
<td> JL. BINOR GG 8 RT09 RW14, BUNULREJO, BLIMBING, KOTA MALANG
</td>
<td> BPJ </td>
<td> kelas 3 </td>
<td> A08 </td>
<td> 300000 </td>
<td> O82.0 </td>
<td> O82.0 </td>
<td> 2022-07-15 </td>
<td> 22:26:17 </td>
<td> 2022-07-17 </td>
<td> 19:05:33 </td>
<td> IGDK </td>
<td> 2022/07/15/000172, BPJS KELAS 3 RUANG AMARTA 5B ( KONFIRMASI
) </td>
<td> 2 </td>
<td> 1 </td>
<td> 0 </td>
<td> 0 </td>
<td> 0 </td>
<td> 0 </td>
<td> 38-39 </td>

<td> 3000 </td>
<td> 47 </td>
<td> Hidup </td>
<td> Tidak </td>
<td> Hidup </td>
<td> Ya </td>
<td> Tidak </td>
<td> Ya </td>

<td> - </td>
<td> 600000 </td>
<td> 2 </td>
<td> Sudah </td>
</tr>
<tr>
<td> 2022/07/15/000177 </td>
<td> 072394 </td>
<td> NIZAR SATYA SETIAWAN, AN </td>
<td> L </td>
<td> MALANG </td>
<td> 2022-07-15 </td>
<td> ISLAM </td>
<td> TS </td>
<td> EKO SETIAWAN, TN </td>
<td> AYAH </td>
<td> JL. BINOR GG 8 RT09 RW14, BUNULREJO, BLIMBING, KOTA MALANG
</td>
<td> BPJ </td>
<td> PA01 </td>
<td> NICU 1 </td>
<td> 400000 </td>
<td> P03.4 </td>
<td> P39.9 </td>
<td> 2022-07-15 </td>
<td> 21:54:57 </td>
<td> 2022-07-18 </td>
<td> 12:00:06 </td>
<td> U0029 </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> Perawatan Bayi SC , Infus Bayi oleh Perawat / Bidan </td>

<td> - </td>
<td> 1200000 </td>
<td> Sembuh </td>
<td> 3 </td>
<td> Sudah </td>
</tr>
<tr>
<td> 2022/07/15/000109 </td>
<td> 072320 </td>
<td> RISKA ARINO FITRI, NY </td>
<td> P </td>
<td> MALANG </td>
<td> 2005-11-05 </td>
<td> 16 Th 8 Bl 11 Hr </td>
<td> ISLAM </td>
<td> - </td>
<td> MOHAMMAD YUSUF, TN </td>
<td> SUAMI </td>
<td> JL LESTI UTARA 37 RT 3 RW 3 , BUNULREJO, BLIMBING, KOTA
MALANG </td>
<td> BPJ </td>
<td> kelas 3 </td>
<td> A06 </td>
<td> 300000 </td>
<td> O80.9 </td>
<td> O80.9 </td>
<td> 2022-07-15 </td>
<td> 21:26:17 </td>
<td> 2022-07-17 </td>
<td> 13:36:43 </td>
<td> IGDK </td>
<td> 2022/07/15/000109, BPJS KLS 3, AMARTA 6B, KONFIRMASI RUANGAN
</td>
<td> 1 </td>
<td> 0 </td>
<td> 0 </td>
<td> 0 </td>
<td> 0 </td>
<td> 0 </td>
<td> 40-41 </td>

<td> 2820 </td>
<td> 47 </td>
<td> Hidup </td>
<td> Ya </td>
<td> Hidup </td>
<td> Ya </td>
<td> Tidak </td>
<td> Ya </td>

<td> - </td>
<td> 600000 </td>
<td> Sehat </td>
<td> 2 </td>
<td> Sudah </td>
</tr>
<tr>
<td> 2022/07/15/000173 </td>
<td> 072392 </td>
<td> RISKA ARINO., BY NY </td>
<td> L </td>
<td> MALANG </td>
<td> 2022-07-15 </td>
<td> ISLAM </td>
<td> - </td>
<td> MOHAMMAD YUSUF, TN </td>
<td> AYAH </td>
<td> JL LESTI UTARA 37 RT 3 RW 3, BUNULREJO, BLIMBING, KOTA
MALANG </td>
<td> BPJ </td>
<td> kelas 3 </td>
<td> PF18 </td>
<td> 300000 </td>
<td> P00.6 </td>
<td> P00.9 </td>
<td> 2022-07-15 </td>
<td> 20:55:00 </td>
<td> 2022-07-17 </td>
<td> 11:47:01 </td>
<td> U0030 </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> 2820 </td>
<td> 47 </td>
<td> Hidup </td>
<td> Ya </td>
<td> Hidup </td>
<td> Ya </td>
<td> Tidak </td>
<td> Ya </td>

<td> - </td>
<td> 900000 </td>
<td> Sembuh </td>
<td> 3 </td>
<td> Sudah </td>
</tr>
<tr>
<td> 2022/07/15/000104 </td>
<td> 061104 </td>
<td> AMIRA SOFIA CLARINTA, AN </td>
<td> P </td>
<td> Malang </td>
<td> 2012-07-13 </td>
<td> 10 Th 0 Bl 9 Hr </td>
<td> ISLAM </td>
<td> - </td>
<td> MUHAMMAD ARIS SETIAWAN, TN </td>
<td> AYAH </td>
<td> KEDUNGREJO RT. 02 RW.01, KEDUNGREJO, PAKIS, KABUPATEN MALANG
</td>
<td> BPJ </td>
<td> kelas 3 </td>
<td> A01 </td>
<td> 300000 </td>
<td> A90 </td>
<td> A90 </td>
<td> 2022-07-15 </td>
<td> 17:17:19 </td>
<td> 2022-07-20 </td>
<td> 00:08:51 </td>
<td> IGDK </td>
<td> KLINIK SIFA VICIIS MEDICA </td>
<td> 2022/07/15/000104, BPJS KLS 3, TITIP AYODYA 3B, KONFIRMASI
RUANGAN (-)KTP ORANG TUA </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>

<td> - </td>
<td> 1800000 </td>
<td> 6 </td>
<td> Sudah </td>
</tr>
<tr>
<td> 2022/07/15/000103 </td>
<td> 013436 </td>
<td> AZZAHRA MECCAYLA SABIYA, AN </td>
<td> P </td>
<td> Malang </td>
<td> 2018-07-04 </td>
<td> 4 Th 0 Bl 18 Hr </td>
<td> ISLAM </td>
<td> TS </td>
<td> ATOK YOGA, TN </td>
<td> AYAH </td>
<td> JL. RAYA SEKARPURO NO. 77 RT 18 RW 6, SEKARPURO, PAKIS,
<td> BPJ </td>
<td> kelas 3 </td>
<td> A12 </td>
<td> Amarta 2 </td>
<td> 300000 </td>
<td> J18.0 </td>
<td> J18.0 </td>
<td> 2022-07-15 </td>
<td> 11:33:44 </td>
<td> 2022-07-17 </td>
<td> 22:53:50 </td>
<td> IGDK </td>
<td> 2022/07/15/000103, BPJS KLS III TITIP DI PANDAWA 1
</td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>

<td> - </td>
<td> 900000 </td>
<td> 3 </td>
<td> Sudah </td>
</tr>
<tr>
<td> 2022/07/15/000085 </td>
<td> 072278 </td>
<td> HALWA NAFISAH ADZKIYA PUTRI, AN </td>
<td> P </td>
<td> MADIUN </td>
<td> 2013-12-02 </td>
<td> 8 Th 7 Bl 16 Hr </td>
<td> ISLAM </td>
<td> TS </td>
<td> DIMAS ARDIANTO, TN </td>
<td> AYAH </td>
<td> PERUM BULAN TERANG UTAMA BLOK UJ 27/08 RT 5 RW 17,
MADYOPURO, KEDUNGKANDANG, KOTA MALANG </td>
<td> BPJ </td>
<td> kelas 2 </td>
<td> H03 </td>
<td> 400000 </td>
<td> A09 </td>
<td> A09 </td>
<td> 2022-07-15 </td>
<td> 11:17:11 </td>
<td> 2022-07-16 </td>
<td> 22:24:13 </td>
<td> IGDK </td>
<td> </td>
<td> 2022/07/15/000085, BPJS KLS 2 TITIP HASTINA 3 RENCANA
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>

<td> - </td>
<td> 800000 </td>
<td> 2 </td>
<td> Sudah </td>
</tr>
<tr>
<td> 2022/07/15/000056 </td>
<td> 062444 </td>
<td> PUTRI AMALIA, NY </td>
<td> P </td>
<td> MALANG </td>
<td> 2000-11-11 </td>
<td> 21 Th 8 Bl 21 Hr </td>
<td> ISLAM </td>
<td> SMA </td>
<td> MUCHAMAT SONY SETIAWAN, TN </td>
<td> SUAMI </td>
<td> JL. ZAENAL ZAKSE III/26 RT 12 RW 01, KOTALAMA,
<td> BPJ </td>
<td> kelas 3 </td>
<td> A10 </td>
<td> 300000 </td>
<td> O82.9 </td>
<td> O82.9 </td>
<td> 2022-07-15 </td>
<td> 09:17:43 </td>
<td> 2022-07-17 </td>
<td> 13:37:03 </td>
<td> IGDK </td>
<td> 1 </td>
<td> 1 </td>
<td> 0 </td>
<td> 0 </td>
<td> 0 </td>
<td> 0 </td>
<td> 38-39 </td>

<td> 2900 </td>
<td> 48 </td>
<td> Hidup </td>
<td> Tidak </td>
<td> Hidup </td>
<td> Ya </td>
<td> Tidak </td>
<td> Ya </td>
<td> </td>
<td> - </td>
<td> 900000 </td>
<td> Sehat </td>
<td> 3 </td>
<td> Sudah </td>
</tr>
<tr>
<td> 2022/07/14/000130 </td>
<td> 061824 </td>
<td> HAIFA HUSEIN, NY </td>
<td> P </td>
<td> MEDAN </td>
<td> 1983-12-28 </td>
<td> 38 Th 7 Bl 0 Hr </td>
<td> ISLAM </td>
<td> SMA </td>
<td> SUAMI </td>
<td> PONDOK BLIMBING INDA BLOK O 1 / 32A RT 02 RW 11, PURWODADI,
<td> BPJ </td>
<td> kelas 1 </td>
<td> H07 </td>
<td> 650000 </td>
<td> O82.0 </td>
<td> O82.0 </td>
<td> 2022-07-15 </td>
<td> 09:15:50 </td>
<td> 2022-07-17 </td>
<td> 20:00:00 </td>
<td> IGDK </td>
<td> </td>
<td> </td>
<td> 2 </td>
<td> 1 </td>
<td> 0 </td>
<td> 0 </td>
<td> 0 </td>
<td> 0 </td>
<td> 39-40 </td>

<td> 3250 </td>
<td> 49 </td>
<td> Hidup </td>
<td> Tidak </td>
<td> Hidup </td>
<td> Ya </td>
<td> Tidak </td>
<td> Ya </td>

<td> </td>
<td> 1950000 </td>
<td> 3 </td>
<td> Sudah </td>
</tr>
<tr>
<td> 2022/07/15/000087 </td>
<td> 072372 </td>
<td> MUHAMMAD RAFKA ARRASYA N S, AN </td>
<td> L </td>
<td> MALANG </td>
<td> 2022-07-15 </td>
<td> ISLAM </td>
<td> - </td>
<td> - </td>
<td> MUCHAMAT SONY SETIAWAN, TN </td>
<td> AYAH </td>
<td> JL. ZAENAL ZAKSE III/26 RT 12 RW 1 , KOTALAMA,
<td> BPJ </td>
<td> kelas 3 </td>
<td> PF16 </td>
<td> 300000 </td>
<td> P03.4 </td>
<td> P03.4 </td>
<td> 2022-07-15 </td>
<td> 08:59:53 </td>
<td> 2022-07-17 </td>
<td> 16:46:28 </td>
<td> U0030 </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> 2700 </td>
<td> 48 </td>
<td> Hidup </td>
<td> Tidak </td>
<td> Hidup </td>
<td> Ya </td>
<td> Tidak </td>
<td> Ya </td>

<td> - </td>
<td> 900000 </td>
<td> Sembuh </td>
<td> 3 </td>
<td> Sudah </td>
</tr>
<tr>
<td> 2022/07/15/000162 </td>
<td> 040167 </td>
<td> HENI WAHYUNINGTYAS, NY </td>
<td> P </td>
<td> MALANG </td>
<td> 1987-01-11 </td>
<td> 35 Th 6 Bl 12 Hr </td>
<td> ISLAM </td>
<td> IRT </td>
<td> SMA </td>
<td> SWASTA </td>
<td> HUSNI ISMAIL, TN </td>
<td> SUAMI </td>
<td> JL. ABDUL QODIR JAELANI RT 3 RW 7, KEDUNGKANDANG,
<td> BPJ </td>
<td> kelas 3 </td>
<td> A05 </td>
<td> 300000 </td>
<td> O80.9 </td>
<td> O82.0 </td>
<td> 2022-07-15 </td>
<td> 08:40:58 </td>
<td> 2022-07-17 </td>
<td> 19:06:14 </td>
<td> IGDK </td>
<td> 2022/07/15/000162, BPJS KELAS 3 , DENDA 45 HARI RUANG AMARTA
5C </td>
<td> 3 </td>
<td> 1 </td>
<td> 0 </td>
<td> 0 </td>
<td> 0 </td>
<td> 0 </td>
<td> 37-38 </td>

<td> 2690 </td>
<td> 46 </td>
<td> Hidup </td>
<td> Ya </td>
<td> Hidup </td>
<td> Ya </td>
<td> Tidak </td>
<td> Ya </td>

<td> - </td>
<td> 900000 </td>
<td> 3 </td>
<td> Sudah </td>
</tr>
<tr>
<td> 2022/07/15/000082 </td>
<td> 072371 </td>
<td> AMEERA AMER ALKATIRI, An </td>
<td> P </td>
<td> MALANG </td>
<td> 2022-07-15 </td>
<td> 0 Th 0 Bl 21 Hr </td>
<td> ISLAM </td>
<td> - </td>
<td> - </td>
<td> AYAH </td>
<td> PONDOK MBLIMBING INDAH BLOK O 1/32A RT 2 RW 11 , PURWODADI,
<td> BPJ </td>
<td> kelas 3 </td>
<td> PF12 </td>
<td> 300000 </td>
<td> P03.4 </td>
<td> P21.1 </td>
<td> 2022-07-15 </td>
<td> 08:37:41 </td>
<td> 2022-07-17 </td>
<td> 19:45:59 </td>
<td> U0030 </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> 3250 </td>
<td> 49 </td>
<td> Hidup </td>
<td> Tidak </td>
<td> Hidup </td>
<td> Ya </td>
<td> Tidak </td>
<td> Ya </td>

<td> - </td>
<td> 900000 </td>
<td> Sembuh </td>
<td> 3 </td>
<td> Sudah </td>
</tr>
<tr>
<td> 2022/07/15/000057 </td>
<td> 072363 </td>
<td> SULASTRI,BY,NY </td>
<td> P </td>
<td> MALANG </td>
<td> 2022-07-15 </td>
<td> ISLAM </td>
<td> - </td>
<td> MAIJO,TN </td>
<td> SAUDARA </td>
<td> JL. MUHARTO II/22 RT.04 RW.07, JODIPAN, BLIMBING, KOTA
MALANG </td>
<td> BPJ </td>
<td> kelas 3 </td>
<td> BFA02 </td>
<td> 300000 </td>
<td> P03.4 </td>
<td> P03.4 </td>
<td> 2022-07-15 </td>
<td> 06:00:36 </td>
<td> 2022-07-17 </td>
<td> 17:49:19 </td>
<td> U0030 </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> 2600 </td>
<td> 47 </td>
<td> Hidup </td>
<td> Tidak </td>
<td> Hidup </td>
<td> Ya </td>
<td> Tidak </td>
<td> Ya </td>

<td> - </td>
<td> 900000 </td>
<td> Sembuh </td>
<td> 3 </td>
<td> Sudah </td>
</tr>
<tr>
<td> 2022/07/15/000179 </td>
<td> 054315 </td>
<td> DEWI SARTIKA SARI,NY </td>
<td> P </td>
<td> MALANG </td>
<td> 1982-04-08 </td>
<td> 40 Th 3 Bl 8 Hr </td>
<td> ISLAM </td>
<td> SMA </td>
<td> PURWANTO,TN </td>
<td> SUAMI </td>
<td> JL HAMID RUSDI TIMUR V RT 01 RW 07, BUNULREJO, BLIMBING,
KOTA MALANG </td>
<td> BPJ </td>
<td> kelas 3 </td>
<td> D02 </td>
<td> 300000 </td>
<td> O80.8 </td>
<td> O80.8 </td>
<td> 2022-07-15 </td>
<td> 04:27:50 </td>
<td> 2022-07-17 </td>
<td> 11:18:40 </td>
<td> IGDK </td>
<td> 2022/07/15/000179, BPJS KELAS 3, TITIP AYODYA 1B, RENCANA
KELAS 3 MENYUSUL </td>
<td> 8 </td>
<td> 7 </td>
<td> 0 </td>
<td> 0 </td>
<td> 0 </td>
<td> 0 </td>
<td> 38-39 </td>

<td> 3170 </td>
<td> 48 </td>
<td> Hidup </td>
<td> Ya </td>
<td> Hidup </td>
<td> Ya </td>
<td> Tidak </td>
<td> Ya </td>
<td> </td>
<td> - </td>
<td> 900000 </td>
<td> 3 </td>
<td> Sudah </td>
</tr>
<tr>
<td> 2022/07/15/000175 </td>
<td> 034592 </td>
<td> WINDA KARISTA, Ny. </td>
<td> P </td>
<td> MALANG </td>
<td> 1999-11-19 </td>
<td> 22 Th 7 Bl 27 Hr </td>
<td> ISLAM </td>
<td> SMP </td>
<td> TANI </td>
<td> NASRULLOH, Tn </td>
<td> SUAMI </td>
<td> WONOREJO PONCOKUSUMO RT 11 RW 2, WONOREJO, BANTUR, KABUPATEN
MALANG </td>
<td> A09 </td>
<td> UMUM </td>
<td> kelas 1 </td>
<td> P05 </td>
<td> 650000 </td>
<td> O42.0 </td>
<td> O80.8 </td>
<td> 2022-07-15 </td>
<td> 04:27:38 </td>
<td> 2022-07-16 </td>
<td> 17:33:26 </td>
<td> IGDK </td>
<td> </td>
<td> 2022/07/15/000175 UMUM KELAS 1 DI PANDAWA 5 </td>
<td> 4 </td>
<td> 0 </td>
<td> 0 </td>
<td> 0 </td>
<td> 3 </td>
<td> 0 </td>
<td> 37-38 </td>

<td> 2155 </td>
<td> 43 </td>
<td> Hidup </td>
<td> Ya </td>
<td> Hidup </td>
<td> Ya </td>
<td> Tidak </td>
<td> Ya </td>
<td> Visite Dokter Spesialis Obgyn, Konsultasi Dokter Spesialis

Obgyn Via Telepon </td>
<td> </td>
<td> 1300000 </td>
<td> Sembuh </td>
<td> 2 </td>
<td> Sudah </td>
</tr>
<tr>
<td> 2022/07/15/000097 </td>
<td> 072373 </td>
<td> LIANAH, NY </td>
<td> P </td>
<td> MALANG </td>
<td> 1985-05-10 </td>
<td> 37 Th 2 Bl 22 Hr </td>
<td> ISLAM </td>
<td> SMP </td>
<td> MADERIKUL HUDA, TN </td>
<td> SUAMI </td>
<td> DUSUN PANGGUNG RT 44 RW 4 , KIDAL, TUMPANG, KABUPATEN MALANG
</td>
<td> A09 </td>
<td> UMUM </td>
<td> kelas 3 </td>
<td> A11 </td>
<td> 300000 </td>
<td> O80.9 </td>
<td> O13 </td>
<td> 2022-07-15 </td>
<td> 04:27:22 </td>
<td> 2022-07-17 </td>
<td> 13:37:21 </td>
<td> IGDK </td>
<td> DR. NOVINA SP.OG (K) </td>
<td> 2022/07/15/000097, UMUM KLS 3 AMARTA 8B RUJUKAN DR NOV
GARBIS </td>
<td> 2 </td>
<td> 1 </td>
<td> 0 </td>
<td> 0 </td>
<td> 0 </td>
<td> 0 </td>
<td> 41-42 </td>

<td> 2690 </td>
<td> 47 </td>
<td> Hidup </td>
<td> Ya </td>
<td> Hidup </td>
<td> Ya </td>
<td> Tidak </td>
<td> Ya </td>

<td> - </td>
<td> 900000 </td>
<td> Sembuh </td>
<td> 3 </td>
<td> Sudah </td>
</tr>
<tr>
<td> 2022/07/14/000165 </td>
<td> 072360 </td>
<td> SULASTRI,NY </td>
<td> P </td>
<td> MALANG </td>
<td> 1974-09-07 </td>
<td> 47 Th 10 Bl 26 Hr </td>
<td> ISLAM </td>
<td> SD </td>
<td> PEDAGANG </td>
<td> MAIJO,TN </td>
<td> SUAMI </td>
<td> JL. MUHARTO II/22 RT/04 RW/07, JODIPAN, BLIMBING, KOTA
MALANG </td>
<td> BPJ </td>
<td> kelas 3 </td>
<td> A03 </td>
<td> 300000 </td>
<td> O63.0 </td>
<td> O82.8 </td>
<td> 2022-07-14 </td>
<td> 22:37:28 </td>
<td> 2022-07-17 </td>
<td> 19:04:24 </td>
<td> IGDK </td>
<td> </td>
<td> 3 </td>
<td> 2 </td>
<td> 0 </td>
<td> 0 </td>
<td> 0 </td>
<td> 0 </td>
<td> 37-38 </td>

<td> 2600 </td>
<td> 47 </td>
<td> Hidup </td>
<td> Ya </td>
<td> Hidup </td>
<td> Ya </td>
<td> Tidak </td>
<td> Ya </td>
<td> Infus Dewasa oleh Perawat / Bidan, Infus Dewasa oleh Perawat
/ Bidan, Konsultasi Dokter Spesialis Obgyn Via Telepon, EKG, EKG, EKG, EKG, EKG
</td>
<td> - </td>
<td> 900000 </td>
<td> 3 </td>
<td> Sudah </td>
</tr>
<tr>
<td> 2022/07/14/000111 </td>
<td> 072339 </td>
<td> P </td>
<td> MALANG </td>
<td> 2002-03-31 </td>
<td> 20 Th 3 Bl 29 Hr </td>
<td> ISLAM </td>
<td> SMA </td>
<td> SUAMI </td>
<td> BPJ </td>
<td> kelas 3 </td>
<td> A03 </td>
<td> 300000 </td>
<td> O42.0 </td>
<td> - </td>
<td> 2022-07-14 </td>
<td> 22:32:16 </td>
<td> 2022-07-15 </td>
<td> 00:16:56 </td>
<td> IGDK </td>
<td> </td>
<td> 2022/07/14/000111 BPJS KELAS 3 DI AMARTA 6A </td>
<td> 1 </td>
<td> 0 </td>
<td> 0 </td>
<td> 0 </td>
<td> 0 </td>
<td> 0 </td>
<td> 36-37 </td>

<td> 3100 </td>
<td> 47 </td>
<td> Hidup </td>
<td> Tidak </td>
<td> Hidup </td>
<td> Ya </td>
<td> Tidak </td>
<td> Ya </td>
<td> VT Dokter , Infus Dewasa oleh Perawat / Bidan, Konsultasi

<td> - </td>
<td> 600000 </td>
<td> 2 </td>
<td> Sudah </td>
</tr>
<tr>
<td> 2022/07/14/000131 </td>
<td> 072149 </td>
<td> MUHAMMAD ZHAFRAN ALVARONIZAM, AN </td>
<td> L </td>
<td> BONDOWOSO </td>
<td> 2022-03-02 </td>
<td> 0 Th 4 Bl 18 Hr </td>
<td> ISLAM </td>
<td> - </td>
<td> MUHAMAD ALVIN, TN </td>
<td> AYAH </td>
<td> PERUM SERENIA GARDEN A33 , TUNJUNGTIRTO, SINGOSARI,
<td> BPJ </td>
<td> kelas 1 </td>
<td> H04 </td>
<td> 650000 </td>
<td> R50.9 </td>
<td> R50.0 </td>
<td> 2022-07-14 </td>
<td> 21:54:43 </td>
<td> 2022-07-17 </td>
<td> 16:57:06 </td>
<td> IGDK </td>
<td> 2022/07/14/000131, BPJS KLS 2 UP 1, HASTINA 4 KONFIRMASI
RUANGAN </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> 1950000 </td>
<td> 3 </td>
<td> Sudah </td>
</tr>
<tr>
<td> 2022/07/14/000135 </td>
<td> 097615 </td>
<td> ALFARIZ AZRIL PRADITYA, AN </td>
<td> L </td>
<td> MALANG </td>
<td> 2017-10-06 </td>
<td> 4 Th 9 Bl 14 Hr </td>
<td> ISLAM </td>
<td> TS </td>
<td> ENDRIK DWI PRASTYO, TN </td>
<td> AYAH </td>
<td> JL. DANAU BRATAN TIMUR X / K 28 RT 09 RW 11, MADYOPURO,
<td> BPJ </td>
<td> kelas 1 </td>
<td> H10 </td>
<td> 650000 </td>
<td> A08.0 </td>
<td> A09 </td>
<td> 2022-07-14 </td>
<td> 21:54:17 </td>
<td> 2022-07-17 </td>
<td> 20:00:57 </td>
<td> IGDK </td>
</td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>

Visite Dokter Spesialis Anak, Visite Dokter Spesialis Anak, Infus Anak oleh Perawat
/ Bidan, Operasional Rumah Sakit </td>
<td> </td>
<td> 1950000 </td>
<td> 3 </td>
<td> Sudah </td>
</tr>
<tr>
<td> 2022/07/14/000161 </td>
<td> 072357 </td>
<td> GEFANDA AFRISSA SYAFAZEA, AN </td>
<td> P </td>
<td> MALANG </td>
<td> 2022-07-14 </td>
<td> 0 Th 0 Bl 12 Hr </td>
<td> ISLAM </td>
<td> TS </td>
<td> MUHAMMAD AFIF ABDUL AZIZ, TN </td>
<td> AYAH </td>
<td> JL. KYAI SOFYAN YUSUF NO.38 RT 02 RW 01, KEDUNGKANDANG,
<td> BPJ </td>
<td> kelas 3 </td>
<td> PF02 </td>
<td> 300000 </td>
<td> P03.4 </td>
<td> P59.9 </td>
<td> 2022-07-14 </td>
<td> 21:02:58 </td>
<td> 2022-07-15 </td>
<td> 05:08:18 </td>
<td> U0030 </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> 3100 </td>
<td> 47 </td>
<td> Hidup </td>
<td> Tidak </td>
<td> Hidup </td>
<td> Ya </td>
<td> Tidak </td>
<td> Ya </td>
<td> Perawatan Bayi SC , Perawatan Bayi SC , Perawatan Bayi SC

, Perawatan Bayi SC , Sewa Fototerapi , Visite Dokter Spesialis Anak, Visite
Dokter Spesialis Anak, Visite Dokter Spesialis Anak, Visite Dokter Spesialis Anak,
Visite Dokter Spesialis Anak, Infus Dewasa Oleh Perawat / Bidan , Infus Dewasa Oleh
Perawat / Bidan , Infus Dewasa Oleh Perawat / Bidan , Konsultasi Dokter Spesialis
Anak Via Telepon, Konsultasi Dokter Spesialis Anak Via Telepon </td>
<td> - </td>
<td> 600000 </td>
<td> Sembuh </td>
<td> 2 </td>
<td> Sudah </td>
</tr>
<tr>
<td> 2022/07/14/000132 </td>
<td> 072346 </td>
<td> MARIYAM, NY </td>
<td> P </td>
<td> MALANG </td>
<td> 1985-11-14 </td>
<td> 36 Th 8 Bl 18 Hr </td>
<td> ISLAM </td>
<td> SD </td>
<td> SYAMSUL ARIFIN, TN </td>
<td> SUAMI </td>
MALANG </td>
<td> BPJ </td>
<td> kelas 3 </td>
<td> A07 </td>
<td> 300000 </td>
<td> O80.8 </td>
<td> O82.9 </td>
<td> 2022-07-14 </td>
<td> 19:03:06 </td>
<td> 2022-07-16 </td>
<td> 12:20:08 </td>
<td> IGDK </td>
<td> 3 </td>
<td> 2 </td>
<td> 0 </td>
<td> 0 </td>
<td> 0 </td>
<td> 0 </td>
<td> 38-39 </td>

<td> 3200 </td>
<td> 49 </td>
<td> Hidup </td>
<td> Tidak </td>
<td> Hidup </td>
<td> Ya </td>
<td> Tidak </td>
<td> Ya </td>

<td> - </td>
<td> 900000 </td>
<td> Sehat </td>
<td> 3 </td>
<td> Sudah </td>
</tr>
<tr>
<td> 2022/07/14/000147 </td>
<td> 072347 </td>
<td> MARIYAM, BY. NY. </td>
<td> L </td>
<td> MALANG </td>
<td> 2022-07-14 </td>
<td> ISLAM </td>
<td> - </td>
<td> SYAMSUL ARIFIN, TN </td>
<td> AYAH </td>
MALANG </td>
<td> BPJ </td>
<td> PF02 </td>
<td> 400000 </td>
<td> P03.4 </td>
<td> - </td>
<td> 2022-07-14 </td>
<td> 18:39:04 </td>
<td> 2022-07-14 </td>
<td> 18:58:37 </td>
<td> U0029 </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> 3200 </td>
<td> 49 </td>
<td> Hidup </td>
<td> Tidak </td>
<td> Hidup </td>
<td> Ya </td>
<td> Tidak </td>
<td> Ya </td>
<td> </td>
<td> 400000 </td>
<td> 1 </td>
<td> Sudah </td>
</tr>
<tr>
<td> 2022/07/14/000158 </td>
<td> 072353 </td>
<td> ELZAHIRA DEVINA, AN </td>
<td> P </td>
<td> MALANG </td>
<td> 2021-08-20 </td>
<td> 0 Th 10 Bl 24 Hr </td>
<td> ISLAM </td>
<td> TS </td>
<td> FRENDIK SUSILO, TN </td>
<td> AYAH </td>
<td> JL. BANTARAN TERUSAN II NO. 68 RT 02 RW 02, TULUSREJO,
<td> BPJ </td>
<td> kelas 3 </td>
<td> A02 </td>
<td> 300000 </td>
<td> R50.8 </td>
<td> R50.0 </td>
<td> 2022-07-14 </td>
<td> 17:17:53 </td>
<td> 2022-07-19 </td>
<td> 00:34:46 </td>
<td> IGDK </td>
<td> 2022/07/14/000158, BPJS KLAS 3 TITIP AYODYA 6 RENCANA AMARTA
</td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> - </td>
<td> 1800000 </td>
<td> 6 </td>
<td> Sudah </td>
</tr>
<tr>
<td> 2022/07/14/000118 </td>
<td> 072345 </td>
<td> DINA TASYA, NY </td>
<td> P </td>
<td> MEDAN </td>
<td> 1986-10-25 </td>
<td> 35 Th 8 Bl 19 Hr </td>
<td> ISLAM </td>
<td> - </td>
<td> LIA SUTANTIN, NY </td>
<td> SAUDARA </td>
<td> JL. W ISKANDAR NO 30 LK XI , KOTA MEDAN, MEDAN TEMBUNG,
MEDAN </td>
<td> A09 </td>
<td> UMUM </td>
<td> kelas 3 </td>
<td> A04 </td>
<td> 300000 </td>
<td> O00.9 </td>
<td> O00.9 </td>
<td> 2022-07-14 </td>
<td> 16:03:00 </td>
<td> 2022-07-16 </td>
<td> 16:05:30 </td>
<td> IGDK </td>
<td> </td>
<td> 2022/07/14/000118, UMUM KLS III DI AMARTA 5B (CITO) </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> Visite Dokter Spesialis Bedah, Infus Dewasa oleh Perawat /

Bidan, Pasang Kateter Urin oleh Perawat / Bidan </td>
<td> - </td>
<td> 900000 </td>
<td> Sehat </td>
<td> 3 </td>
<td> Sudah </td>
</tr>
<tr>
<td> 2022/07/14/000117 </td>
<td> 072343 </td>
<td> HIKARI MAYZURA SHEZA, AN </td>
<td> P </td>
<td> MALANG </td>
<td> 2022-07-14 </td>
<td> 0 Th 0 Bl 19 Hr </td>
<td> ISLAM </td>
<td> TS </td>
<td> AYAH </td>
<td> PERUM BANJARARUM ASRI M-7 RT 002 RW 011, BANJARARUM,
<td> BPJ </td>
<td> kelas 3 </td>
<td> PF11 </td>
<td> 300000 </td>
<td> P03.4 </td>
<td> P03.4 </td>
<td> 2022-07-14 </td>
<td> 13:48:02 </td>
<td> 2022-07-16 </td>
<td> 17:52:07 </td>
<td> U0030 </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> 3100 </td>
<td> 48 </td>
<td> Hidup </td>
<td> Tidak </td>
<td> Hidup </td>
<td> Ya </td>
<td> Tidak </td>
<td> Ya </td>

<td> - </td>
<td> 900000 </td>
<td> Sembuh </td>
<td> 3 </td>
<td> Sudah </td>
</tr>
<tr>
<td> 2022/07/14/000094 </td>
<td> 096079 </td>
<td> SYAHIRA KANZIA ASHEEQA QIRANI, An </td>
<td> P </td>
<td> MALANG </td>
<td> 2017-09-04 </td>
<td> 4 Th 10 Bl 12 Hr </td>
<td> ISLAM </td>
<td> TS </td>
<td> ANANG RONIADI, TN </td>
<td> AYAH </td>
<td> JL.POLOWIJEN 2 NO.382 RT.02/RW.03, POLOWIJEN, BLIMBING, KOTA
MALANG </td>
<td> BPJ </td>
<td> kelas 2 </td>
<td> D11 </td>
<td> 400000 </td>
<td> R50.9 </td>
<td> - </td>
<td> 2022-07-14 </td>
<td> 13:05:43 </td>
<td> 2022-07-15 </td>
<td> 12:11:23 </td>
<td> IGDK </td>
<td> </td>
<td> 2022/07/14/000094, BPJS KLS 2, AYODYA 6B, KONFIRMASI RUANGAN
</td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>

Anak Via Telepon, Konsultasi Dokter Spesialis Anak Via Telepon, Infus Anak oleh
<td> - </td>
<td> 800000 </td>
<td> 2 </td>
<td> Sudah </td>
</tr>
<tr>
<td> 2022/07/14/000115 </td>
<td> 045454 </td>
<td> UDHA NOVITA SARI, NY </td>
<td> P </td>
<td> Malang </td>
<td> 1991-11-20 </td>
<td> 30 Th 7 Bl 28 Hr </td>
<td> ISLAM </td>
<td> S1 </td>
<td> SUAMI </td>
<td> PERUMAHAN BANJARARUM ASRI M-7 RT 2 RW 11, BANJARARUM,
<td> BPJ </td>
<td> kelas 2 </td>
<td> D09 </td>
<td> 400000 </td>
<td> O82.0 </td>
<td> O41.0 </td>
<td> 2022-07-14 </td>
<td> 12:25:32 </td>
<td> 2022-07-16 </td>
<td> 15:43:09 </td>
<td> IGDK </td>
<td> </td>
<td> 2022/07/14/000115, BPJS KLS 2, TITIP HASTINA 9, KONFIRMASI
RUANGAN </td>
<td> 2 </td>
<td> 0 </td>
<td> 1 </td>
<td> 0 </td>
<td> 0 </td>
<td> 0 </td>
<td> 38-39 </td>

<td> 3100 </td>
<td> 48 </td>
<td> Hidup </td>
<td> Tidak </td>
<td> Hidup </td>
<td> Ya </td>
<td> Tidak </td>
<td> Ya </td>

<td> - </td>
<td> 1200000 </td>
<td> Sembuh </td>
<td> 3 </td>
<td> Sudah </td>
</tr>
<tr>
<td> 2022/07/14/000101 </td>
<td> 036985 </td>
<td> ALVARO KASRO PURBA,AN </td>
<td> L </td>
<td> MALANG </td>
<td> 2019-04-02 </td>
<td> 3 Th 3 Bl 15 Hr </td>
<td> KRISTEN </td>
<td> SWASTA </td>
<td> - </td>
<td> SWASTA </td>
<td> ERADO FRANKY PURBA,TN </td>
<td> AYAH </td>
<td> JL BANDARA ADULRAHMAN SALEH BLIK GD 28 RT 02 RW 10,
CEMOROKANDANG, KEDUNGKANDANG, KOTA MALANG </td>
<td> BPJ </td>
<td> kelas 3 </td>
<td> A15 </td>
<td> 300000 </td>
<td> R11 </td>
<td> R11 </td>
<td> 2022-07-14 </td>
<td> 12:20:31 </td>
<td> 2022-07-17 </td>
<td> 13:37:48 </td>
<td> IGDK </td>
<td> 2022/07/14/000101 BPJS KELAS 3 (PREMI +DENDA) DI AMARTA 8B
</td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>

<td> - </td>
<td> 1200000 </td>
<td> Sehat </td>
<td> 4 </td>
<td> Sudah </td>
</tr>
<tr>
<td> 2022/07/14/000051 </td>
<td> 074356 </td>
<td> INDRAWATI, Ny. </td>
<td> P </td>
<td> MALANG </td>
<td> 1985-08-14 </td>
<td> 36 Th 11 Bl 15 Hr </td>
<td> ISLAM </td>
<td> SMA </td>
<td> - </td>
<td> Setia Eka Wijaya, Tn. </td>
<td> SAUDARA </td>
<td> JL. CEMPAKA RT 10 RW 2, SLAMPAREJO, JABUNG, KABUPATEN MALANG
</td>
<td> BPJ </td>
<td> kelas 2 </td>
<td> D01 </td>
<td> 400000 </td>
<td> O82.0 </td>
<td> O82.9 </td>
<td> 2022-07-14 </td>
<td> 11:54:58 </td>
<td> 2022-07-16 </td>
<td> 11:13:31 </td>
<td> IGDK </td>
<td> </td>
<td> </td>
<td> 3 </td>
<td> 2 </td>
<td> 0 </td>
<td> 0 </td>
<td> 0 </td>
<td> 0 </td>
<td> 38-39 </td>

<td> 3000 </td>
<td> 47 </td>
<td> Hidup </td>
<td> Tidak </td>
<td> Hidup </td>
<td> Ya </td>
<td> Tidak </td>
<td> Ya </td>
<td> </td>
<td> - </td>
<td> 1200000 </td>
<td> 3 </td>
<td> Sudah </td>
</tr>
<tr>
<td> 2022/07/14/000076 </td>
<td> 072332 </td>
<td> GABRIELLE AURORA WIJAYA, AN </td>
<td> P </td>
<td> MALANG </td>
<td> 2022-07-14 </td>
<td> ISLAM </td>
<td> - </td>
<td> - </td>
<td> SETIA EKA WIJAYA, TN </td>
<td> AYAH </td>
<td> JL. CEMPAKA RT 010 RW 002, SLAMPAREJO, JABUNG, KABUPATEN
MALANG </td>
<td> BPJ </td>
<td> kelas 3 </td>
<td> BFA03 </td>
<td> 300000 </td>
<td> P03.4 </td>
<td> P03.4 </td>
<td> 2022-07-14 </td>
<td> 08:47:58 </td>
<td> 2022-07-16 </td>
<td> 10:27:24 </td>
<td> U0030 </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> 3000 </td>
<td> 47 </td>
<td> Hidup </td>
<td> Tidak </td>
<td> Hidup </td>
<td> Ya </td>
<td> Tidak </td>
<td> Ya </td>

<td> - </td>
<td> 900000 </td>
<td> Sembuh </td>
<td> 3 </td>
<td> Sudah </td>
</tr>
<tr>
<td> 2022/07/14/000068 </td>
<td> 072329 </td>
<td> SELINA PUTRI RAFIFA, AN </td>
<td> P </td>
<td> MALANG </td>
<td> 2022-07-14 </td>
<td> 0 Th 0 Bl 14 Hr </td>
<td> ISLAM </td>
<td> - </td>
<td> - </td>
<td> AYAH </td>
<td> JL. CANDI BADUT 12 RT 02 RW 02, MOJOLANGU, LOWOKWARU, KOTA
MALANG </td>
<td> BPJ </td>
<td> kelas 3 </td>
<td> PF10 </td>
<td> 300000 </td>
<td> P00.6 </td>
<td> P00.9 </td>
<td> 2022-07-14 </td>
<td> 08:19:23 </td>
<td> 2022-07-15 </td>
<td> 15:56:01 </td>
<td> U0030 </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> 3200 </td>
<td> 50 </td>
<td> Hidup </td>
<td> Ya </td>
<td> Hidup </td>
<td> Ya </td>
<td> Tidak </td>
<td> Ya </td>

<td> - </td>
<td> 600000 </td>
<td> Sembuh </td>
<td> 2 </td>
<td> Sudah </td>
</tr>
<tr>
<td> 2022/07/14/000050 </td>
<td> 043216 </td>
<td> AISYAH AYUDIA INARA,AN </td>
<td> P </td>
<td> MALANG </td>
<td> 2020-10-14 </td>
<td> ISLAM </td>
<td> - </td>
<td> - </td>
<td> SWASTA </td>
<td> MOHAMMAD SAFIUDIN, TN </td>
<td> AYAH </td>
<td> BUNUT KIDUL RT 3RW 4, ASRIKATON, PAKIS, KABUPATEN MALANG
</td>
<td> BPJ </td>
<td> kelas 3 </td>
<td> IGD8 </td>
<td> KS IGD 8 </td>
<td> 300000 </td>
<td> R56.0 </td>
<td> G40.9 </td>
<td> 2022-07-14 </td>
<td> 05:50:38 </td>
<td> 2022-07-14 </td>
<td> 17:19:06 </td>
<td> IGDK </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> Jasa Pelayanan Rumah Sakit, Operasional Rumah Sakit </td>

<td> - </td>
<td> 600000 </td>
<td> 2 </td>
<td> Sudah </td>
</tr>
<tr>
<td> 2022/07/13/000083 </td>
<td> 092060 </td>
<td> ARSYANA RAMADHAN, AN </td>
<td> L </td>
<td> Malang </td>
<td> 2017-06-04 </td>
<td> 5 Th 1 Bl 15 Hr </td>
<td> ISLAM </td>
<td> TS </td>
<td> - </td>
<td> Andy Wijaya, Tn </td>
<td> AYAH </td>
<td> PERUM BANDARA SANTIKA BLOK C2-22, ASRIKATON, PAKIS,
<td> BPJ </td>
<td> kelas 2 </td>
<td> H02 </td>
<td> 400000 </td>
<td> G40.9 </td>
<td> G40.9 </td>
<td> 2022-07-13 </td>
<td> 23:22:25 </td>
<td> 2022-07-17 </td>
<td> 17:16:37 </td>
<td> IGDK </td>
<td> 2022/07/13/000083, BPJS KELAS 2 TITIP DI PANDAWA 05
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>

<td> - </td>
<td> 1600000 </td>
<td> 4 </td>
<td> Sudah </td>
</tr>
<tr>
<td> 2022/07/13/000182 </td>
<td> 072295 </td>
<td> MUHAMMAD ELNATHAN MILKY N., An </td>
<td> L </td>
<td> MALANG </td>
<td> 2022-01-02 </td>
<td> 0 Th 6 Bl 16 Hr </td>
<td> ISLAM </td>
<td> - </td>
<td> ERNANSA MARIO, Tn </td>
<td> AYAH </td>
<td> JL. KEDAWUNG XI A / 10 RT 02 RW 07, TULUSREJO, LOWOKWARU,
KOTA MALANG </td>
<td> BPJ </td>
<td> kelas 3 </td>
<td> A16 </td>
<td> 300000 </td>
<td> A09 </td>
<td> A09 </td>
<td> 2022-07-13 </td>
<td> 22:30:35 </td>
<td> 2022-07-16 </td>
<td> 09:03:33 </td>
<td> U0002 </td>
<td> 2022/07/13/000182, BPJS KLS III DI AMARTA 7A </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>

<td> - </td>
<td> 900000 </td>
<td> Sehat </td>
<td> 3 </td>
<td> Sudah </td>
</tr>
<tr>
<td> 2022/07/13/000222 </td>
<td> 085390 </td>
<td> MUHAMMAD UWAIS AL-QARNI, AN </td>
<td> L </td>
<td> Malang </td>
<td> 2017-01-08 </td>
<td> 5 Th 6 Bl 12 Hr </td>
<td> ISLAM </td>
<td> TS </td>
<td> MOCHAMMAD FACHRIS RIFÀN, TN </td>
<td> AYAH </td>
<td> JL. POLOWIJEN I RT 01 RW 01, BLIMBING, BLIMBING, KOTA MALANG
</td>
<td> BPJ </td>
<td> kelas 1 </td>
<td> H06 </td>
<td> 650000 </td>
<td> E86 </td>
<td> - </td>
<td> 2022-07-13 </td>
<td> 22:30:15 </td>
<td> 2022-07-16 </td>
<td> 10:51:44 </td>
<td> IGDK </td>
<td> 2022/07/13/000222, BPJS KLS II UP I DI HASTINA 6
(KONFIRMASI) </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> - </td>
<td> 1950000 </td>
<td> Sehat </td>
<td> 3 </td>
<td> Sudah </td>
</tr>
<tr>
<td> 2022/07/13/000224 </td>
<td> 069810 </td>
<td> NUR AVNI SALISA MAULIDYA, NY </td>
<td> P </td>
<td> MALANG </td>
<td> 2002-08-15 </td>
<td> 19 Th 11 Bl 17 Hr </td>
<td> ISLAM </td>
<td> SMP </td>
<td> MOH FIRMAN, TN </td>
<td> SUAMI </td>
<td> JL TUNGGUL AMETUNG II RT 8 RW 9 , TUMPANG, TUMPANG,
<td> BPJ </td>
<td> kelas 3 </td>
<td> A06 </td>
<td> 300000 </td>
<td> O82.9 </td>
<td> O82.8 </td>
<td> 2022-07-13 </td>
<td> 22:21:05 </td>
<td> 2022-07-15 </td>
<td> 20:40:46 </td>
<td> IGDK </td>
<td> 2022/07/13/000224, BPJS KLS III DI AMARTA 5D (CITO) </td>
<td> 1 </td>
<td> 0 </td>
<td> 0 </td>
<td> 0 </td>
<td> 0 </td>
<td> 0 </td>
<td> 39-40 </td>

<td> 3000 </td>
<td> 48 </td>
<td> Hidup </td>
<td> Tidak </td>
<td> Hidup </td>
<td> Ya </td>
<td> Tidak </td>
<td> Ya </td>

Konsultasi Dokter Spesialis Obgyn Via Telepon, EKG, Operasional Rumah Sakit </td>
<td> - </td>
<td> 600000 </td>
<td> 2 </td>
<td> Sudah </td>
</tr>
<tr>
<td> 2022/07/11/000280 </td>
<td> 070606 </td>
<td> DWI WINARNI, NY </td>
<td> P </td>
<td> MALANG </td>
<td> 1975-11-15 </td>
<td> 46 Th 8 Bl 2 Hr </td>
<td> ISLAM </td>
<td> S1 </td>
<td> LUKMAN WIJI W., TN </td>
<td> SUAMI </td>
<td> JL. LA SUCIPTO XXII A NO.7 RT 2 RW 10 , PANDANWANGI,
<td> BPJ </td>
<td> kelas 3 </td>
<td> A03 </td>
<td> 300000 </td>
<td> N93.9 </td>
<td> - </td>
<td> 2022-07-13 </td>
<td> 22:19:38 </td>
<td> 2022-07-14 </td>
<td> 09:35:40 </td>
<td> IGDK </td>
<td> 2022/07/11/000280, BPJS KLS III DI AMARTA 6A (KONFIRMASI
RUANGAN) </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>

<td> - </td>
<td> 600000 </td>
<td> 2 </td>
<td> Sudah </td>
</tr>
<tr>
<td> 2022/07/13/000233 </td>
<td> 072318 </td>
<td> BERYL SAYYIDINA AL BAREEQ, AN </td>
<td> L </td>
<td> MALANG </td>
<td> 2022-07-13 </td>
<td> 0 Th 0 Bl 10 Hr </td>
<td> ISLAM </td>
<td> - </td>
<td> AGUS DWI S., TN </td>
<td> AYAH </td>
<td> JL. BANTARAN VA NO. 25 RT 003 RW. 003, TULUSREJO, LOWOKWARU,
KOTA MALANG </td>
<td> BPJ </td>
<td> kelas 3 </td>
<td> PF04 </td>
<td> 300000 </td>
<td> P00.6 </td>
<td> P00.9 </td>
<td> 2022-07-13 </td>
<td> 21:55:05 </td>
<td> 2022-07-14 </td>
<td> 19:35:55 </td>
<td> U0030 </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> 2700 </td>
<td> 48 </td>
<td> Hidup </td>
<td> Ya </td>
<td> Hidup </td>
<td> Ya </td>
<td> Tidak </td>
<td> Ya </td>

<td> - </td>
<td> 300000 </td>
<td> Sembuh </td>
<td> 1 </td>
<td> Sudah </td>
</tr>
<tr>
<td> 2022/07/13/000231 </td>
<td> 072316 </td>
<td> NUR AVNI S., BY NY </td>
<td> P </td>
<td> MALANG </td>
<td> 2022-07-13 </td>
<td> ISLAM </td>
<td> - </td>
<td> MOH FIRMAN, TN </td>
<td> AYAH </td>
<td> JL TUNGGUL AMETUNG II RT 8 RW 9 , TUMPANG, TUMPANG,
<td> BPJ </td>
<td> kelas 3 </td>
<td> PF01 </td>
<td> 300000 </td>
<td> P03.4 </td>
<td> P03.4 </td>
<td> 2022-07-13 </td>
<td> 21:05:46 </td>
<td> 2022-07-16 </td>
<td> 16:42:54 </td>
<td> U0030 </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> 3000 </td>
<td> 48 </td>
<td> Hidup </td>
<td> Tidak </td>
<td> Hidup </td>
<td> Ya </td>
<td> Tidak </td>
<td> Ya </td>
<td> Perawatan Bayi SC , Jasa Pelayanan Rumah Sakit, Tindik oleh

<td> - </td>
<td> 900000 </td>
<td> Sembuh </td>
<td> 3 </td>
<td> Sudah </td>
</tr>
<tr>
<td> 2022/07/13/000195 </td>
<td> 072299 </td>
<td> MIANAH, NY </td>
<td> P </td>
<td> MALANG </td>
<td> 1983-08-12 </td>
<td> 38 Th 11 Bl 6 Hr </td>
<td> ISLAM </td>
<td> SD </td>
<td> IMAM SLAMET, TN </td>
<td> SUAMI </td>
<td> DSN GENTONG RT 018 RW 003, ARGOSARI, JABUNG, KABUPATEN
MALANG </td>
<td> A09 </td>
<td> UMUM </td>
<td> kelas 3 </td>
<td> A05 </td>
<td> 300000 </td>
<td> O14.9 </td>
<td> O82.8 </td>
<td> 2022-07-13 </td>
<td> 20:17:23 </td>
<td> 2022-07-15 </td>
<td> 20:41:27 </td>
<td> IGDK </td>
<td> PKM Jabung </td>
<td> 2022/07/13/000195, UMUM KLS III DI AMARTA 5C RUJUKAN PKM
JABUNG </td>
<td> 3 </td>
<td> 2 </td>
<td> 0 </td>
<td> 0 </td>
<td> 0 </td>
<td> 0 </td>
<td> 38-39 </td>

<td> 3000 </td>
<td> 45 </td>
<td> Hidup </td>
<td> Ya </td>
<td> Hidup </td>
<td> Ya </td>
<td> Tidak </td>
<td> Ya </td>

Visite Dokter Spesialis Obgyn </td>
<td> - </td>
<td> 900000 </td>
<td> 3 </td>
<td> Sudah </td>
</tr>
<tr>
<td> 2022/07/13/000226 </td>
<td> 072314 </td>
<td> MIANAH, By Ny </td>
<td> L </td>
<td> MALANG </td>
<td> 2022-07-13 </td>
<td> ISLAM </td>
<td> TS </td>
<td> IMAM SLAMET, TN </td>
<td> AYAH </td>
<td> DSN GENTONG RT 018 RW 003, ARGOSARI, JABUNG, KABUPATEN
MALANG </td>
<td> A09 </td>
<td> UMUM </td>
<td> kelas 3 </td>
<td> PF18 </td>
<td> 300000 </td>
<td> P03.4 </td>
<td> P03.4 </td>
<td> 2022-07-13 </td>
<td> 19:53:19 </td>
<td> 2022-07-15 </td>
<td> 15:17:33 </td>
<td> U0030 </td>
<td> </td>
<td> 2022/07/13/000226, FISOL </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> 3000 </td>
<td> 48 </td>
<td> Hidup </td>
<td> Tidak </td>
<td> Hidup </td>
<td> Ya </td>
<td> Tidak </td>
<td> Ya </td>

<td> - </td>
<td> 900000 </td>
<td> Sembuh </td>
<td> 3 </td>
<td> Sudah </td>
</tr>
<tr>
<td> 2022/07/13/000219 </td>
<td> 071946 </td>
<td> ULTRA MAVISHA MARYAM, AN </td>
<td> P </td>
<td> MALANG </td>
<td> 2022-07-04 </td>
<td> 0 Th 0 Bl 16 Hr </td>
<td> ISLAM </td>
<td> TS </td>
<td> M. NUR KHOLIS, TN </td>
<td> AYAH </td>
<td> JL. BIMA NO 22 RT 002 RW 011, TUMPANG, TUMPANG, KABUPATEN
MALANG </td>
<td> BPJ </td>
<td> kelas 2 </td>
<td> K0000242 </td>
<td> KS IGD 5 </td>
<td> 400000 </td>
<td> P59.9 </td>
<td> P59.9 </td>
<td> 2022-07-13 </td>
<td> 18:53:05 </td>
<td> 2022-07-13 </td>
<td> 22:42:55 </td>
<td> IGDK </td>
<td> 2022/07/13/000219, BPJS KLS III FOFOTERAPI NICU </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>

Visite Dokter Spesialis Anak, Sewa Fototerapi , Sewa Fototerapi , Sewa Fototerapi ,
<td> - </td>
<td> 400000 </td>
<td> Sembuh </td>
<td> 1 </td>
<td> Sudah </td>
</tr>
<tr>
<td> 2022/07/13/000186 </td>
<td> 072298 </td>
<td> ZHAFIRA SHAKINAH MECCA, AN </td>
<td> P </td>
<td> MALANG </td>
<td> 2022-07-13 </td>
<td> ISLAM </td>
<td> TS </td>
<td> YUSRON ANSORI, TN </td>
<td> AYAH </td>
<td> JL DARUSSALAM RT 6 RW 3 , WRINGINPITU, MOJOWARNO, JOMBANG
</td>
<td> BPJ </td>
<td> PA26 </td>
<td> 400000 </td>
<td> P03.4 </td>
<td> P96.8 </td>
<td> 2022-07-13 </td>
<td> 14:49:40 </td>
<td> 2022-07-16 </td>
<td> 11:09:52 </td>
<td> U0029 </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> 2500 </td>
<td> 47 </td>
<td> Hidup </td>
<td> Tidak </td>
<td> Baik </td>
<td> Ya </td>
<td> Tidak </td>
<td> Ya </td>

<td> - </td>
<td> 1600000 </td>
<td> Sembuh </td>
<td> 4 </td>
<td> Sudah </td>
</tr>
<tr>
<td> 2022/07/13/000215 </td>
<td> 072296 </td>
<td> BRAM KAIVAN ASEGAF, AN </td>
<td> L </td>
<td> MALANG </td>
<td> 2021-04-20 </td>
<td> ISLAM </td>
<td> TS </td>
<td> ERILE ARIYANTO, TN </td>
<td> AYAH </td>
<td> JL. BATU AMARIL NO 4 RT 001 RW 004, PANDANWANGI, BLIMBING,
KOTA MALANG </td>
<td> BPJ </td>
<td> kelas 3 </td>
<td> A14 </td>
<td> 300000 </td>
<td> R50.9 </td>
<td> R50.9 </td>
<td> 2022-07-13 </td>
<td> 13:16:07 </td>
<td> 2022-07-21 </td>
<td> 12:55:19 </td>
<td> IGDK </td>
<td> 2022/07/13/000215, BPJS KLS III TITIP DI AYODYA 4A </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>

<td> - </td>
<td> 2700000 </td>
<td> 9 </td>
<td> Sudah </td>
</tr>
<tr>
<td> 2022/07/13/000168 </td>
<td> 072289 </td>
<td> LATASHA LEONA NORA, AN </td>
<td> P </td>
<td> MALANG </td>
<td> 2022-07-13 </td>
<td> 0 Th 0 Bl 23 Hr </td>
<td> KATHOLIK </td>
<td> TS </td>
<td> DAVID YORDAN, TN </td>
<td> AYAH </td>
<td> GRAHA PELITA ASRI B36 RT 07 RW 10, PANDANWANGI, BLIMBING,
KOTA MALANG </td>
<td> BPJ </td>
<td> kelas 3 </td>
<td> BFA02 </td>
<td> 300000 </td>
<td> P00.6 </td>
<td> P00.9 </td>
<td> 2022-07-13 </td>
<td> 11:32:14 </td>
<td> 2022-07-19 </td>
<td> 04:26:46 </td>
<td> U0030 </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> 3465 </td>
<td> 50 </td>
<td> Hidup </td>
<td> Ya </td>
<td> Hidup </td>
<td> Ya </td>
<td> Tidak </td>
<td> Ya </td>
<td> Perawatan Bayi NP , Visite Dokter Spesialis Anak, Tindik

<td> - </td>
<td> 2100000 </td>
<td> Sembuh </td>
<td> 7 </td>
<td> Sudah </td>
</tr>
<tr>
<td> 2022/07/13/000092 </td>
<td> 088427 </td>
<td> SRI YULIANI, NY </td>
<td> P </td>
<td> MALANG </td>
<td> 1986-07-12 </td>
<td> 36 Th 0 Bl 9 Hr </td>
<td> ISLAM </td>
<td> TUKANG JAHIT </td>
<td> PURYANTO, TN </td>
<td> SUAMI </td>
<td> JL. LA SUCIPTO 29 RT 01 RW 03, PANDANWANGI, BLIMBING, KOTA
MALANG </td>
<td> BPJ </td>
<td> kelas 2 </td>
<td> D09 </td>
<td> 400000 </td>
<td> O63.1 </td>
<td> O63.1 </td>
<td> 2022-07-13 </td>
<td> 11:00:17 </td>
<td> 2022-07-16 </td>
<td> 06:00:29 </td>
<td> IGDK </td>
<td> 2022/07/13/000092, BPJS KLS 2, AYODYA 1B, KONFIRMASI RUANGAN
</td>
<td> 3 </td>
<td> 2 </td>
<td> 0 </td>
<td> 0 </td>
<td> 0 </td>
<td> 0 </td>
<td> 38-39 </td>

<td> 3100 </td>
<td> 49 </td>
<td> Hidup </td>
<td> Tidak </td>
<td> Hidup </td>
<td> Ya </td>
<td> Tidak </td>
<td> Ya </td>

<td> - </td>
<td> 1600000 </td>
<td> Sehat </td>
<td> 4 </td>
<td> Sudah </td>
</tr>
<tr>
<td> 2022/07/13/000154 </td>
<td> 072283 </td>
<td> CANDRA LANGIT JULIAN, AN </td>
<td> L </td>
<td> MALANG </td>
<td> 2022-07-13 </td>
<td> 0 Th 0 Bl 10 Hr </td>
<td> ISLAM </td>
<td> TS </td>
<td> PURYANTO, TN </td>
<td> AYAH </td>
<td> JL. LA. SUCIPTO 29 RT 01 RW 03, PANDANWANGI, BLIMBING, KOTA
MALANG </td>
<td> BPJ </td>
<td> kelas 3 </td>
<td> PF22 </td>
<td> 300000 </td>
<td> P03.4 </td>
<td> P03.4 </td>
<td> 2022-07-13 </td>
<td> 10:21:56 </td>
<td> 2022-07-16 </td>
<td> 06:27:36 </td>
<td> U0030 </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> 3100 </td>
<td> 49 </td>
<td> Hidup </td>
<td> Tidak </td>
<td> Hidup </td>
<td> Ya </td>
<td> Tidak </td>
<td> Ya </td>

<td> - </td>
<td> 1200000 </td>
<td> Sembuh </td>
<td> 4 </td>
<td> Sudah </td>
</tr>
<tr>
<td> 2022/07/13/000079 </td>
<td> 092746 </td>
<td> KENZIE MAGIKA FARITAMA, An </td>
<td> L </td>
<td> Malang </td>
<td> 2017-06-21 </td>
<td> 5 Th 0 Bl 28 Hr </td>
<td> ISLAM </td>
<td> TS </td>
<td> Khoirul Anam, Tn </td>
<td> AYAH </td>
<td> JL. BATUBARA NO.68 RT 06 RW 08, PURWANTORO, BLIMBING, KOTA
MALANG </td>
<td> BPJ </td>
<td> kelas 2 </td>
<td> A17 </td>
<td> 400000 </td>
<td> E86 </td>
<td> E86 </td>
<td> 2022-07-13 </td>
<td> 09:37:37 </td>
<td> 2022-07-16 </td>
<td> 12:20:38 </td>
<td> IGDK </td>
<td> 2022/07/13/000079, BPJS KELAS 2 TITIP DI KELAS 3 RUANG
AMARTA 8B ( KONFIRMASI ) </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>

<td> - </td>
<td> 1600000 </td>
<td> Sehat </td>
<td> 4 </td>
<td> Sudah </td>
</tr>
<tr>
<td> 2022/07/13/000029 </td>
<td> 061831 </td>
<td> CHANDRA NUR AFIFAH, NY </td>
<td> P </td>
<td> MALANG </td>
<td> 1995-03-17 </td>
<td> 27 Th 4 Bl 5 Hr </td>
<td> ISLAM </td>
<td> D3 </td>
<td> SUAMI </td>
<td> JL CANDI BADUT 12 RT 2 RW 2, MOJOLANGU, LOWOKWARU, KOTA
MALANG </td>
<td> BPJ </td>
<td> kelas 2 </td>
<td> D02 </td>
<td> 400000 </td>
<td> O14.9 </td>
<td> O14.1 </td>
<td> 2022-07-13 </td>
<td> 09:14:08 </td>
<td> 2022-07-15 </td>
<td> 13:53:32 </td>
<td> U0001 </td>
<td> 2022/07/13/000029, BPJS KLS 2, AYODYA 1B </td>
<td> 1 </td>
<td> 0 </td>
<td> 0 </td>
<td> 0 </td>
<td> 0 </td>
<td> 0 </td>
<td> 39-40 </td>

<td> 3200 </td>
<td> 50 </td>
<td> Hidup </td>
<td> Ya </td>
<td> Hidup </td>
<td> Ya </td>
<td> Tidak </td>
<td> Ya </td>
<td> Jasa Pelayanan Rumah Sakit , Konsultasi Dokter Spesialis

Obgyn Via Telepon, Konsultasi Dokter Spesialis Obgyn Via Telepon, Operasional Rumah
Sakit </td>
<td> - </td>
<td> 1200000 </td>
<td> Sehat </td>
<td> 3 </td>
<td> Sudah </td>
</tr>
<tr>
<td> 2022/07/13/000204 </td>
<td> 052768 </td>
<td> AZQIARA CLAUZIA HAFLAIKA, AN </td>
<td> P </td>
<td> MALANG </td>
<td> 2021-06-04 </td>
<td> ISLAM </td>
<td> - </td>
<td> - </td>
<td> SWASTA </td>
<td> BUDI SETIAWAN, TN </td>
<td> AYAH </td>
<td> JL. LESANPURO II RT 4 RW 1, LESANPURO, KEDUNGKANDANG, KOTA
MALANG </td>
<td> BPJ </td>
<td> kelas 3 </td>
<td> D08 </td>
<td> 300000 </td>
<td> R50.9 </td>
<td> J18.0 </td>
<td> 2022-07-13 </td>
<td> 09:00:47 </td>
<td> 2022-07-16 </td>
<td> 15:42:19 </td>
<td> IGDK </td>
<td> 2022/07/13/000204 BPJS KELAS 3 TITIP DWARAWATI / AYODYA 4B
</td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> Oksigen 100% Sentral 2 LPM, Oksigen 100% Sentral 2 LPM </td>
<td> - </td>
<td> 1200000 </td>
<td> Sembuh </td>
<td> 4 </td>
<td> Sudah </td>
</tr>
<tr>
<td> 2022/07/13/000227 </td>
<td> 056604 </td>
<td> MUHAMMAD SYAUQI AL AZIZI, AN </td>
<td> L </td>
<td> MALANG </td>
<td> 2021-08-26 </td>
<td> 0 Th 10 Bl 24 Hr </td>
<td> ISLAM </td>
<td> TS </td>
<td> IMAM HANAFI,TN </td>
<td> AYAH </td>
<td> JL. PERMADI NO.18B RT 8 RW 4 , POLEHAN, BLIMBING, KOTA
MALANG </td>
<td> BPJ </td>
<td> kelas 3 </td>
<td> D04 </td>
<td> 300000 </td>
<td> R56.0 </td>
<td> R56.0 </td>
<td> 2022-07-13 </td>
<td> 08:55:29 </td>
<td> 2022-07-15 </td>
<td> 19:19:59 </td>
<td> IGDK </td>
<td> 2022/07/13/000227, BPJS KLS III TITIP DI AYODYA 2B </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> - </td>
<td> 900000 </td>
<td> Sembuh </td>
<td> 3 </td>
<td> Sudah </td>
</tr>
<tr>
<td> 2022/07/13/000084 </td>
<td> 072227 </td>
<td> NADYRA ALMAHYRA MAULANA, AN </td>
<td> P </td>
<td> MALANG </td>
<td> 2022-07-13 </td>
<td> ISLAM </td>
<td> - </td>
<td> RENDY OKTA MAULANA,TN </td>
<td> AYAH </td>
<td> ALAMATJL PULOSARI I NO 45 RT 4 RW 7, PANDANWANGI, BLIMBING,
KOTA MALANG </td>
<td> BPJ </td>
<td> kelas 3 </td>
<td> PF11 </td>
<td> 300000 </td>
<td> P00.6 </td>
<td> P00.9 </td>
<td> 2022-07-13 </td>
<td> 05:50:30 </td>
<td> 2022-07-14 </td>
<td> 09:59:10 </td>
<td> U0030 </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> 3095 </td>
<td> 50 </td>
<td> Hidup </td>
<td> Tidak </td>
<td> Hidup </td>
<td> Ya </td>
<td> Tidak </td>
<td> Ya </td>

<td> - </td>
<td> 600000 </td>
<td> Sembuh </td>
<td> 2 </td>
<td> Sudah </td>
</tr>
<tr>
<td> 2022/07/13/000197 </td>
<td> 068647 </td>
<td> CITRA SUCIE RAISSA, NY </td>
<td> P </td>
<td> MALANG </td>
<td> 1986-10-28 </td>
<td> 35 Th 8 Bl 15 Hr </td>
<td> ISLAM </td>
<td> SMA </td>
<td> AGUS DWI S., TN </td>
<td> SUAMI </td>
<td> JL. BANTARAN VA NO. 25 RT 003 RW. 003, TULUSREJO, LOWOKWARU,
KOTA MALANG </td>
<td> BPJ </td>
<td> kelas 3 </td>
<td> A03 </td>
<td> 300000 </td>
<td> O80.9 </td>
<td> O13 </td>
<td> 2022-07-13 </td>
<td> 05:34:13 </td>
<td> 2022-07-15 </td>
<td> 10:30:08 </td>
<td> IGDK </td>
<td> 2022/07/13/000197, BPJS KLS III DI AMARTA 8B </td>
<td> 2 </td>
<td> 1 </td>
<td> 0 </td>
<td> 0 </td>
<td> 0 </td>
<td> 0 </td>
<td> 39-40 </td>

<td> 2700 </td>
<td> 48 </td>
<td> Hidup </td>
<td> Ya </td>
<td> Hidup </td>
<td> Ya </td>
<td> Tidak </td>
<td> Ya </td>
<td> Visite Dokter Spesialis Obgyn, Visite Dokter Umum, Infus

Dewasa oleh Perawat / Bidan </td>
<td> - </td>
<td> 900000 </td>
<td> Sembuh </td>
<td> 3 </td>
<td> Sudah </td>
</tr>
<tr>
<td> 2022/07/13/000229 </td>
<td> 070315 </td>
<td> HAFIZHA PUTRI ILMIRA, AN </td>
<td> P </td>
<td> Malang </td>
<td> 2015-08-16 </td>
<td> 6 Th 11 Bl 3 Hr </td>
<td> ISLAM </td>
<td> TS </td>
<td> WASITO, TN </td>
<td> AYAH </td>
<td> WENDIT BARAT RT 06 RW 03, MANGLIAWAN, PAKIS, KABUPATEN
MALANG </td>
<td> BPJ </td>
<td> kelas 2 </td>
<td> H01 </td>
<td> 400000 </td>
<td> A91 </td>
<td> A91 </td>
<td> 2022-07-13 </td>
<td> 00:01:20 </td>
<td> 2022-07-16 </td>
<td> 22:04:36 </td>
<td> IGDK </td>
<td> 2022/07/13/000229, BPJS KLS II TITIP DI HASTINA 1 </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> - </td>
<td> 1600000 </td>
<td> Sembuh </td>
<td> 4 </td>
<td> Sudah </td>
</tr>
<tr>
<td> 2022/07/12/000314 </td>
<td> 071861 </td>
<td> KHAIRA SYAFA GANTARI, An </td>
<td> P </td>
<td> MALANG </td>
<td> 2022-07-03 </td>
<td> 0 Th 0 Bl 16 Hr </td>
<td> ISLAM </td>
<td> - </td>
<td> HENDRIK FRANSISDA, Tn </td>
<td> AYAH </td>
<td> JL. DANAU SENTANI DALAM 1/ H1 E15 RT 06 RW 07, MADYOPURO,
<td> BPJ </td>
<td> PA091 </td>
<td> 400000 </td>
<td> P58.2 </td>
<td> P59.9 </td>
<td> 2022-07-12 </td>
<td> 23:15:50 </td>
<td> 2022-07-14 </td>
<td> 19:33:38 </td>
<td> IGDK </td>
<td> 2022/07/12/000314 BPJS KELAS 1 FOTOTERAPY </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>

Visite Dokter Spesialis Anak, Visite Dokter Spesialis Anak, Sewa Fototerapi, Sewa
Fototerapi, Sewa Fototerapi, Operasional Rumah Sakit </td>
<td> - </td>
<td> 800000 </td>
<td> 2 </td>
<td> Sudah </td>
</tr>
<tr>
<td> 2022/07/12/000129 </td>
<td> 045307 </td>
<td> JAYANTI WIDI PROBORINI, Ny </td>
<td> P </td>
<td> Malang </td>
<td> 1987-04-02 </td>
<td> 35 Th 3 Bl 14 Hr </td>
<td> ISLAM </td>
<td> SMA </td>
<td> Moch. Sodiq, Tn. </td>
<td> SUAMI </td>
<td> DESA PARANGARGO RT 09 RW 02, PARANGARGO, WAGIR, KABUPATEN
MALANG </td>
<td> BPJ </td>
<td> kelas 2 </td>
<td> H08 </td>
<td> 400000 </td>
<td> A90 </td>
<td> A90 </td>
<td> 2022-07-12 </td>
<td> 20:21:09 </td>
<td> 2022-07-16 </td>
<td> 18:31:20 </td>
<td> IGDK </td>
<td> 2022/07/12/000129 BPJS KELAS 2 KARYAWAN DI HASTINA 8
KONFIRMASI </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> Visite Dokter Spesialis Penyakit Dalam, Visite Dokter

Spesialis Penyakit Dalam, Oksigen 100% Sentral 2 LPM, Infus Anak oleh Perawat /
Bidan </td>
<td> - </td>
<td> 2000000 </td>
<td> 5 </td>
<td> Sudah </td>
</tr>
<tr>
<td> 2022/07/12/000142 </td>
<td> 074229 </td>
<td> ASHILA CALYSTA RABBANI, An </td>
<td> P </td>
<td> Malang </td>
<td> 2016-03-15 </td>
<td> 6 Th 3 Bl 27 Hr </td>
<td> ISLAM </td>
<td> - </td>
<td> KASTURI, Tn </td>
<td> AYAH </td>
<td> JL. TERUSAN WISNU WARDANA NO. 1, MANGLIAWAN, PAKIS,
<td> A09 </td>
<td> UMUM </td>
<td> kelas 3 </td>
<td> A15 </td>
<td> 300000 </td>
<td> R11 </td>
<td> R11 </td>
<td> 2022-07-12 </td>
<td> 20:20:14 </td>
<td> 2022-07-14 </td>
<td> 09:34:15 </td>
<td> IGDK </td>
<td> </td>
<td> 2022/07/12/000142 UMUM KELAS 3 DI AMARTA 7B </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> Oksigen 100% Sentral 2 LPM, Visite Dokter Spesialis Anak,

Infus Anak oleh Perawat / Bidan </td>
<td> - </td>
<td> 900000 </td>
<td> 3 </td>
<td> Sudah </td>
</tr>
<tr>
<td> 2022/07/12/000282 </td>
<td> 072254 </td>
<td> ARSHAKA KEVIN NUGRAHA, AN </td>
<td> L </td>
<td> MALANG </td>
<td> 2021-08-28 </td>
<td> 0 Th 10 Bl 14 Hr </td>
<td> ISLAM </td>
<td> - </td>
<td> MARIAH ULFA, NY </td>
<td> IBU </td>
<td> JL. ANGGREK RT 5 RW 2, SEKARPURO, PAKIS, KABUPATEN MALANG
</td>
<td> A09 </td>
<td> UMUM </td>
<td> kelas 2 </td>
<td> D08 </td>
<td> 400000 </td>
<td> J45.8 </td>
<td> J18.9 </td>
<td> 2022-07-12 </td>
<td> 20:03:44 </td>
<td> 2022-07-13 </td>
<td> 15:26:24 </td>
<td> IGDK </td>
<td> </td>
<td> 2022/07/12/000282 UMUM KELAS 2 DI DWARA / AYODYA 4B </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> Nebulizer , Nebulizer , Operasional Rumah Sakit , Jasa

Pelayanan Rumah Sakit , Visite Dokter Spesialis Anak, Infus Anak oleh Perawat /
Bidan, Infus Anak oleh Perawat / Bidan </td>
<td> </td>
<td> 800000 </td>
<td> 2 </td>
<td> Sudah </td>
</tr>
<tr>
<td> 2022/07/12/000103 </td>
<td> 062292 </td>
<td> CHAIRA ARINA GULFAM, AN </td>
<td> P </td>
<td> Malang </td>
<td> 2021-12-25 </td>
<td> 0 Th 6 Bl 24 Hr </td>
<td> ISLAM </td>
<td> - </td>
<td> BAYU DWI ARIYULIANTO, TN </td>
<td> AYAH </td>
<td> GUBUGKLAKAH RT 03 RW 05, GUBUKKLAKAH, PONCOKUSUMO, KABUPATEN
MALANG </td>
<td> BPJ </td>
<td> kelas 3 </td>
<td> A01 </td>
<td> 300000 </td>
<td> J18.0 </td>
<td> J18.9 </td>
<td> 2022-07-12 </td>
<td> 19:21:16 </td>
<td> 2022-07-16 </td>
<td> 12:21:00 </td>
<td> IGDK </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> Menyeka Pasien , Menyeka Pasien , Menyeka Pasien , Visite

Sewa Infus Pump, Sewa Patient Monitor , Oksigen 100% Sentral 3 LPM , Oksigen 100%
Sentral 2 LPM, Oksigen 100% Sentral 2 LPM, Oksigen 100% Sentral 2 LPM, Oksigen 100%
Sentral 2 LPM, Nebulizer , Nebulizer , Nebulizer , Nebulizer , Nebulizer ,
Nebulizer , Nebulizer , Nebulizer , Konsultasi Dokter Spesialis Anak Via Telepon,
Telepon, Konsultasi Dokter Spesialis Anak Via Telepon, Infus Bayi oleh Perawat /
Bidan, Infus Anak oleh Perawat / Bidan, Infus Anak oleh Perawat / Bidan </td>
<td> - </td>
<td> 1500000 </td>
<td> Sehat </td>
<td> 5 </td>
<td> Sudah </td>
</tr>
<tr>
<td> 2022/07/12/000289 </td>
<td> 044659 </td>
<td> NURHAYATI, NY </td>
<td> P </td>
<td> BLITAR </td>
<td> 1986-08-11 </td>
<td> 35 Th 11 Bl 18 Hr </td>
<td> ISLAM </td>
<td> SWASTA </td>
<td> SMA </td>
<td> SWASTA </td>
<td> HENDRA BUDIANTO, TN </td>
<td> SUAMI </td>
<td> JL. SILIKAT BLOK H NO.2 RT.05 RW.11, PURWANTORO, BLIMBING,
KOTA MALANG </td>
<td> BPJ </td>
<td> kelas 3 </td>
<td> A09 </td>
<td> 300000 </td>
<td> O46.9 </td>
<td> O46.9 </td>
<td> 2022-07-12 </td>
<td> 19:10:53 </td>
<td> 2022-07-15 </td>
<td> 00:16:33 </td>
<td> IGDK </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>

Visite Dokter Spesialis Obgyn, Infus Dewasa oleh Perawat / Bidan, Operasional Rumah
Sakit </td>
<td> - </td>
<td> 1200000 </td>
<td> 4 </td>
<td> Sudah </td>
</tr>
<tr>
<td> 2022/07/12/000125 </td>
<td> 057639 </td>
<td> KIRANA ISWARA DANTI, NN </td>
<td> P </td>
<td> Malang </td>
<td> 2001-04-29 </td>
<td> 21 Th 2 Bl 13 Hr </td>
<td> ISLAM </td>
<td> S1 </td>
<td> GUNTUR BUDI SANYOTO, TN </td>
<td> AYAH </td>
<td> SIMPANG SULFAT UTARA XI I NO. 18 D RT 04 RW 05, PANDANWANGI,
<td> BPJ </td>
<td> kelas 3 </td>
<td> A03 </td>
<td> 300000 </td>
<td> R10.4 </td>
<td> R10.0 </td>
<td> 2022-07-12 </td>
<td> 18:47:55 </td>
<td> 2022-07-14 </td>
<td> 09:35:00 </td>
<td> IGDK </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> Visite Dokter Spesialis Bedah, Infus Dewasa oleh Perawat /

Bidan, Nebulizer </td>
<td> - </td>
<td> 900000 </td>
<td> 3 </td>
<td> Sudah </td>
</tr>
<tr>
<td> 2022/07/11/000271 </td>
<td> 045826 </td>
<td> ALIS AMALIA PRIHUTARI, NY </td>
<td> P </td>
<td> MALANG </td>
<td> 1971-08-17 </td>
<td> 50 Th 10 Bl 25 Hr </td>
<td> ISLAM </td>
<td> SMA </td>
<td> PENSIUNAN </td>
<td> SUGENG, TN </td>
<td> SUAMI </td>
<td> JL. D. LIMBOTO BARAT DALAM RT.02 RW.11, SAWOJAJAR,
<td> BPJ </td>
<td> kelas 3 </td>
<td> A08 </td>
<td> 300000 </td>
<td> N93.9 </td>
<td> N93.9 </td>
<td> 2022-07-12 </td>
<td> 15:35:22 </td>
<td> 2022-07-13 </td>
<td> 06:46:14 </td>
<td> IGDK </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>

Bidan, Oksigen 100% Sentral 2 LPM, Konsultasi Dokter Spesialis Obgyn Via Telepon,
EKG, Operasional Rumah Sakit </td>
<td> </td>
<td> 600000 </td>
<td> 2 </td>
<td> Sudah </td>
</tr>
<tr>
<td> 2022/07/12/000097 </td>
<td> 072236 </td>
<td> WILDA AKWILA NENOHARAN, NY </td>
<td> P </td>
<td> TESBATAN </td>
<td> 1990-04-16 </td>
<td> 32 Th 3 Bl 1 Hr </td>
<td> KRISTEN </td>
<td> SMP </td>
<td> RONALDI NUBATONIS, TN </td>
<td> SUAMI </td>
<td> JL. BANTARAN V NO. 16 RT 01 RW 11, TULUSREJO, LOWOKWARU,
KOTA MALANG </td>
<td> BPJ </td>
<td> kelas 3 </td>
<td> A05 </td>
<td> 300000 </td>
<td> D17.9 </td>
<td> D17.9 </td>
<td> 2022-07-12 </td>
<td> 15:35:06 </td>
<td> 2022-07-13 </td>
<td> 06:43:15 </td>
<td> IGDK </td>
<td> 2022/07/12/000097, BPJS KLS 3 AMARTA 5C RUJUKAN DR. PANDE,
SP. OG </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>

Bidan, Oksigen 100% Sentral 3 LPM , Konsultasi Dokter Spesialis Obgyn Via Telepon,
<td> - </td>
<td> 600000 </td>
<td> 2 </td>
<td> Sudah </td>
</tr>
<tr>
<td> 2022/07/12/000121 </td>
<td> 068684 </td>
<td> SYAUQI ATHAILLAH MUHAMMAD H., AN </td>
<td> L </td>
<td> MALANG </td>
<td> 2022-04-27 </td>
<td> 0 Th 2 Bl 21 Hr </td>
<td> ISLAM </td>
<td> - </td>
<td> - </td>
<td> ANDRI HERMAWANSYAH, TN </td>
<td> AYAH </td>
<td> PERUM SULFAT GARDEN C-09 RT 02 RW 4, PANDANWANGI, BLIMBING,
KOTA MALANG </td>
<td> BPJ </td>
<td> kelas 1 </td>
<td> H05 </td>
<td> 650000 </td>
<td> A90 </td>
<td> A90 </td>
<td> 2022-07-12 </td>
<td> 15:24:51 </td>
<td> 2022-07-15 </td>
<td> 18:54:45 </td>
<td> IGDK </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>

</td>
<td> - </td>
<td> 2600000 </td>
<td> Sehat </td>
<td> 4 </td>
<td> Sudah </td>
</tr>
<tr>
<td> 2022/07/11/000213 </td>
<td> 067976 </td>
<td> AZIZAH HASNA NAJWA MUMTAZAH, AN </td>
<td> P </td>
<td> MALANG </td>
<td> 2022-04-10 </td>
<td> ISLAM </td>
<td> TS </td>
<td> TAUFIK ROHMAN, TN </td>
<td> AYAH </td>
<td> JL. UNTUNG SUROPATI SELATAN 10 RT 01 RW 02, KESATRIAN,
<td> BPJ </td>
<td> kelas 3 </td>
<td> A04 </td>
<td> 300000 </td>
<td> J18.9 </td>
<td> J18.9 </td>
<td> 2022-07-12 </td>
<td> 15:19:47 </td>
<td> 2022-07-15 </td>
<td> 20:40:34 </td>
<td> IGDK </td>
<td> </td>
<td> 2022/07/11/000213, BPJS KELAS 3, AMARTA 3 (NATURAL FLOW)
</td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>

Nebulizer , Nebulizer </td>
<td> - </td>
<td> 1200000 </td>
<td> Sembuh </td>
<td> 4 </td>
<td> Sudah </td>
</tr>
<tr>
<td> 2022/07/12/000070 </td>
<td> 040685 </td>
<td> MIRA AISYAH NENDYA, NY </td>
<td> P </td>
<td> Malang </td>
<td> 1996-11-15 </td>
<td> 25 Th 8 Bl 10 Hr </td>
<td> ISLAM </td>
<td> - </td>
<td> ALFAN RAMADHAN, Tn. </td>
<td> SUAMI </td>
<td> JL SAWOJAJAR VC NO 63 RT 4 RW 1, SAWOJAJAR, KEDUNGKANDANG,
KOTA MALANG </td>
<td> BPJ </td>
<td> kelas 3 </td>
<td> A10 </td>
<td> 300000 </td>
<td> O36.4 </td>
<td> - </td>
<td> 2022-07-12 </td>
<td> 14:42:39 </td>
<td> 2022-07-13 </td>
<td> 15:19:47 </td>
<td> IGDK </td>
<td> 2022/07/12/000070, BPJS KLS 3, PBI, AMARTA 5B
SUDAH KONSELING UMUM DAN BPJS
KONSERVATIF, OD, PASANG BALON +- 500.000 (MBAK EARLY), KURET BIUS DAN NON BIUS
</td>
<td> 1 </td>
<td> 0 </td>
<td> 0 </td>
<td> 0 </td>
<td> 0 </td>
<td> 0 </td>
<td> 22-23 </td>

<td> 200 </td>
<td> 15 </td>
<td> Mati </td>
<td> Tidak </td>
<td> Hidup </td>
<td> Tidak </td>
<td> Tidak </td>
<td> Tidak </td>
<td> USG 2D/3D oleh Dokter Obgyn , Visite Dokter Spesialis Obgyn
</td>
<td> - </td>
<td> 600000 </td>
<td> 2 </td>
<td> Sudah </td>
</tr>
<tr>
<td> 2022/07/12/000118 </td>
<td> 061023 </td>
<td> EKA VITJAYANTI, NY </td>
<td> P </td>
<td> MANNA </td>
<td> 1995-06-09 </td>
<td> 27 Th 1 Bl 12 Hr </td>
<td> ISLAM </td>
<td> D3 </td>
<td> TNI </td>
<td> SUAMI </td>
<td> BPJ </td>
<td> kelas 2 </td>
<td> D10 </td>
<td> 400000 </td>
<td> O82.0 </td>
<td> O82.0 </td>
<td> 2022-07-12 </td>
<td> 14:34:24 </td>
<td> 2022-07-15 </td>
<td> 06:04:57 </td>
<td> IGDK </td>
<td> 2022/07/12/000118, BPJS KLS 2 DWARAWATI/ AYODYA 5A </td>
<td> 1 </td>
<td> 0 </td>
<td> 0 </td>
<td> 0 </td>
<td> 0 </td>
<td> 0 </td>
<td> 39-40 </td>

<td> 3700 </td>
<td> 50 </td>
<td> Hidup </td>
<td> Tidak </td>
<td> Hidup </td>
<td> Ya </td>
<td> Tidak </td>
<td> Ya </td>

<td> - </td>
<td> 1600000 </td>
<td> 4 </td>
<td> Sudah </td>
</tr>
<tr>
<td> 2022/07/12/000065 </td>
<td> 044232 </td>
<td> SYAHIRA AULIA RAHMA, AN </td>
<td> P </td>
<td> Malang </td>
<td> 2020-11-09 </td>
<td> ISLAM </td>
<td> - </td>
<td> - </td>
<td> SWASTA </td>
<td> SETYO WANTO, TN </td>
<td> AYAH </td>
<td> JL KELAPA SAWIT IV/II RT 06 RW 03 , PISANG CANDI, SUKUN,
KOTA MALANG </td>
<td> BPJ </td>
<td> kelas 2 </td>
<td> D12 </td>
<td> 400000 </td>
<td> R56.0 </td>
<td> R56.0 </td>
<td> 2022-07-12 </td>
<td> 13:53:31 </td>
<td> 2022-07-15 </td>
<td> 06:14:23 </td>
<td> IGDK </td>
<td> 2022/07/12/000065, BPJS KLS 2, TITIP PANDAWA 3, DWARAWATI
MENYUSUL, (-) KTP ORANG TUA </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>

<td> - </td>
<td> 1600000 </td>
<td> 4 </td>
<td> Sudah </td>
</tr>
<tr>
<td> 2022/07/12/000130 </td>
<td> 072242 </td>
<td> HAFIZAH NURSYIFA ILMI,AN </td>
<td> P </td>
<td> Malang </td>
<td> 2022-07-12 </td>
<td> 0 Th 0 Bl 14 Hr </td>
<td> ISLAM </td>
<td> TS </td>
<td> TNI </td>
<td> AYAH </td>
<td> BPJ </td>
<td> kelas 3 </td>
<td> PF02 </td>
<td> 300000 </td>
<td> P03.4 </td>
<td> P03.4 </td>
<td> 2022-07-12 </td>
<td> 13:26:18 </td>
<td> 2022-07-14 </td>
<td> 16:08:09 </td>
<td> U0030 </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> 3700 </td>
<td> 50 </td>
<td> Hidup </td>
<td> Tidak </td>
<td> Hidup </td>
<td> Ya </td>
<td> Tidak </td>
<td> Ya </td>

<td> - </td>
<td> 900000 </td>
<td> Sembuh </td>
<td> 3 </td>
<td> Sudah </td>
</tr>
<tr>
<td> 2022/07/12/000320 </td>
<td> 070970 </td>
<td> TIARA INTAN GRACIELLA, NY </td>
<td> P </td>
<td> MALANG </td>
<td> 1997-07-25 </td>
<td> 24 Th 11 Bl 25 Hr </td>
<td> KATHOLIK </td>
<td> SMA </td>
<td> DAVID YORDAN, TN </td>
<td> SUAMI </td>
<td> GRAHA PELITA ASRI B36 RT07 RW10, PANDANWANGI, BLIMBING, KOTA
MALANG </td>
<td> BPJ </td>
<td> kelas 1 </td>
<td> H03 </td>
<td> 650000 </td>
<td> O80.9 </td>
<td> O80.0 </td>
<td> 2022-07-12 </td>
<td> 13:01:12 </td>
<td> 2022-07-14 </td>
<td> 19:46:45 </td>
<td> IGDK </td>
<td> 2022/07/12/000320, BPJS KLAS 1 HASTINA 2 </td>
<td> 1 </td>
<td> 0 </td>
<td> 0 </td>
<td> 0 </td>
<td> 0 </td>
<td> 0 </td>
<td> 41-42 </td>

<td> 3465 </td>
<td> 50 </td>
<td> Hidup </td>
<td> Ya </td>
<td> Hidup </td>
<td> Ya </td>
<td> Tidak </td>
<td> Ya </td>
<td> Visite Dokter Spesialis Obgyn, Oksigen 100% Sentral 3 LPM

</td>
<td> - </td>
<td> 1950000 </td>
<td> 3 </td>
<td> Sudah </td>
</tr>
<tr>
<td> 2022/07/12/000114 </td>
<td> 072238 </td>
<td> SHELY ARIYANTI NOOR, AN </td>
<td> P </td>
<td> BONTANG </td>
<td> 2012-03-13 </td>
<td> 10 Th 4 Bl 6 Hr </td>
<td> ISLAM </td>
<td> SD </td>
<td> ISNAWATI, NY </td>
<td> IBU </td>
<td> PERUM GRAHA BANDARA BLOK C1/18 RT 02 RW 12, ASRIKATON,
PAKIS, KABUPATEN MALANG </td>
<td> BPJ </td>
<td> kelas 3 </td>
<td> A02 </td>
<td> 300000 </td>
<td> A91 </td>
<td> - </td>
<td> 2022-07-12 </td>
<td> 12:47:53 </td>
<td> 2022-07-14 </td>
<td> 09:33:18 </td>
<td> IGDK </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>

<td> - </td>
<td> 900000 </td>
<td> 3 </td>
<td> Sudah </td>
</tr>
<tr>
<td> 2022/07/12/000316 </td>
<td> 016863 </td>
<td> ISABELLA YUANISA ANWAR, AN </td>
<td> P </td>
<td> Malang </td>
<td> 2017-09-18 </td>
<td> 4 Th 9 Bl 28 Hr </td>
<td> ISLAM </td>
<td> TS </td>
<td> - </td>
<td> BAYU FAROSI, TN </td>
<td> AYAH </td>
<td> JL. KERAMAT RT 13 RW 03, SUKOLILO, WAJAK, KABUPATEN MALANG
</td>
<td> BPJ </td>
<td> kelas 3 </td>
<td> A12 </td>
<td> Amarta 2 </td>
<td> 300000 </td>
<td> A91 </td>
<td> A91 </td>
<td> 2022-07-12 </td>
<td> 11:11:05 </td>
<td> 2022-07-16 </td>
<td> 12:19:22 </td>
<td> IGDK </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>

Visite Dokter Spesialis Anak, Visite Dokter Umum, Nebulizer , Nebulizer , Nebulizer
, Nebulizer , Nebulizer , Konsultasi Dokter Spesialis Anak Via Telepon, Operasional
Rumah Sakit </td>
<td> - </td>
<td> 1500000 </td>
<td> Sehat </td>
<td> 5 </td>
<td> Sudah </td>
</tr>
<tr>
<td> 2022/07/12/000063 </td>
<td> 052114 </td>
<td> RIZKIANA, NY </td>
<td> P </td>
<td> MALANG </td>
<td> 1993-08-11 </td>
<td> 28 Th 11 Bl 7 Hr </td>
<td> ISLAM </td>
<td> S1 </td>
<td> RENDY OKTA MAUALANA, TN </td>
<td> SUAMI </td>
<td> JL PULOSARI I NO 45 RT 4 RW 7, PURWODADI, BLIMBING, KOTA
MALANG </td>
<td> BPJ </td>
<td> kelas 2 </td>
<td> D01 </td>
<td> 400000 </td>
<td> O63.0 </td>
<td> O80.9 </td>
<td> 2022-07-12 </td>
<td> 05:50:46 </td>
<td> 2022-07-14 </td>
<td> 11:50:42 </td>
<td> IGDK </td>
<td> 2022/07/12/000063, BPJS KLS 2, AYODYA 1A </td>
<td> 1 </td>
<td> 0 </td>
<td> 0 </td>
<td> 0 </td>
<td> 0 </td>
<td> 0 </td>
<td> 39-40 </td>

<td> 3095 </td>
<td> 50 </td>
<td> Hidup </td>
<td> Ya </td>
<td> Hidup </td>
<td> Ya </td>
<td> Tidak </td>
<td> Ya </td>

<td> - </td>
<td> 1200000 </td>
<td> 3 </td>
<td> Sudah </td>
</tr>
<tr>
<td> 2022/07/12/000315 </td>
<td> 072259 </td>
<td> ALESHA ZOE QUEEN SAFA, AN </td>
<td> P </td>
<td> MALANG </td>
<td> 2018-07-18 </td>
<td> 3 Th 11 Bl 28 Hr </td>
<td> ISLAM </td>
<td> - </td>
<td> - </td>
<td> AHMAD SYAFIÌ, TN </td>
<td> AYAH </td>
<td> JL. JEMBAWAN 4M/2 , MANGLIAWAN, PAKIS, KABUPATEN MALANG
</td>
<td> A09 </td>
<td> UMUM </td>
<td> kelas 1 </td>
<td> P08 </td>
<td> 650000 </td>
<td> A91 </td>
<td> A91 </td>
<td> 2022-07-12 </td>
<td> 01:10:17 </td>
<td> 2022-07-16 </td>
<td> 22:25:45 </td>
<td> IGDK </td>
<td> </td>
<td> 2022/07/12/000315, UMUM KELAS 1 RUANG PANDAWA 2 ( KONFIRMASI
) </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>

<td> - </td>
<td> 3250000 </td>
<td> Sembuh </td>
<td> 5 </td>
<td> Sudah </td>
</tr>
<tr>
<td> 2022/07/12/000313 </td>
<td> 096728 </td>
<td> DZIKRI NABIEL PUTRA PRATAMA, An </td>
<td> L </td>
<td> Malang </td>
<td> 2017-09-17 </td>
<td> 4 Th 9 Bl 25 Hr </td>
<td> ISLAM </td>
<td> - </td>
<td> RIO PRATAMA PUTRA, Tn </td>
<td> AYAH </td>
<td> JL. LETJEN SUTOYO III/59 RT 4 RW 3, LOWOKWARU, LOWOKWARU,
KOTA MALANG </td>
<td> BPJ </td>
<td> kelas 1 </td>
<td> P06 </td>
<td> 650000 </td>
<td> A09 </td>
<td> A09 </td>
<td> 2022-07-12 </td>
<td> 01:08:23 </td>
<td> 2022-07-16 </td>
<td> 10:06:37 </td>
<td> IGDK </td>
<td> 2022/07/12/000313 BPJS KELAS 2 UP 1 DI PANDAWA 6 KONFIRM
</td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>

</td>
<td> - </td>
<td> 3250000 </td>
<td> 5 </td>
<td> Sudah </td>
</tr>
<tr>
<td> 2022/07/12/000284 </td>
<td> 049495 </td>
<td> KENT ELENIO ARIOSHA FERNANDO, AN </td>
<td> L </td>
<td> Malang </td>
<td> 2010-09-21 </td>
<td> 11 Th 9 Bl 21 Hr </td>
<td> ISLAM </td>
<td> TS </td>
<td> RIO SYAGITA FERNANDO, TN </td>
<td> AYAH </td>
<td> JL. TIMAH NO. 10 RT. 03/ RW. 024, BLIMBING, BLIMBING, KOTA
MALANG </td>
<td> BPJ </td>
<td> kelas 2 </td>
<td> P07 </td>
<td> 400000 </td>
<td> J45.9 </td>
<td> J18.0 </td>
<td> 2022-07-12 </td>
<td> 00:45:52 </td>
<td> 2022-07-16 </td>
<td> 10:49:49 </td>
<td> IGDK </td>
<td> </td>
<td> 2022/07/12/000284 BPJS KELAS 2 TITIP PANDAWA 7 KONFIRM </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>

Visite Dokter Spesialis Anak, Oksigen 100% Sentral 2 LPM, Oksigen 100% Sentral 2
Nebulizer , Nebulizer , Nebulizer , Nebulizer , Operasional Rumah Sakit </td>
<td> - </td>
<td> 2000000 </td>
<td> Sembuh </td>
<td> 5 </td>
<td> Sudah </td>
</tr>
<tr>
<td> 2022/07/12/000318 </td>
<td> 072260 </td>
<td> MUHAMMAD ELFATHAN AL KAUTSAR, AN </td>
<td> L </td>
<td> MALANG </td>
<td> 2021-05-19 </td>
<td> 1 Th 1 Bl 29 Hr </td>
<td> ISLAM </td>
<td> TS </td>
<td> BAGUS SOBIRIN, TN </td>
<td> AYAH </td>
<td> JL DAHLIA 23 RT 11 RW 05, MALANGSUKO, TUMPANG, KABUPATEN
MALANG </td>
<td> BPJ </td>
<td> kelas 2 </td>
<td> P02 </td>
<td> 400000 </td>
<td> J18.0 </td>
<td> J18.0 </td>
<td> 2022-07-12 </td>
<td> 00:45:30 </td>
<td> 2022-07-17 </td>
<td> 13:59:12 </td>
<td> IGDK </td>
<td> 2022/07/12/000318, BPJS KLAS 2 TITIP PANDAWA 2 (KONFIRMASI
RUANGAN) </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>

Visite Dokter Spesialis Anak, Visite Dokter Spesialis Anak, Oksigen 100% Sentral 2
Nebulizer , Nebulizer , Nebulizer , Nebulizer , Nebulizer , Infus Anak oleh Perawat
/ Bidan </td>
<td> - </td>
<td> 2400000 </td>
<td> Sembuh </td>
<td> 6 </td>
<td> Sudah </td>
</tr>
<tr>
<td> 2022/07/12/000082 </td>
<td> 056158 </td>
<td> NAZURAZIA MEVISH SHAQUEENA EL SHANUM, AN </td>
<td> P </td>
<td> MALANG </td>
<td> 2021-08-16 </td>
<td> 0 Th 10 Bl 26 Hr </td>
<td> ISLAM </td>
<td> - </td>
<td> REGA SUBEKTI, TN </td>
<td> AYAH </td>
<td> JL. IKAN TOMBRO BARAT NO. 2 RT.05 RW.04, TUNJUNGSEKAR,
<td> BPJ </td>
<td> kelas 2 </td>
<td> D06 </td>
<td> 400000 </td>
<td> A09 </td>
<td> A09 </td>
<td> 2022-07-12 </td>
<td> 00:19:55 </td>
<td> 2022-07-15 </td>
<td> 12:19:04 </td>
<td> U0002 </td>
<td> 2022/07/12/000082 BPJS KELAS 2 DI DAWARA / AYODYA 3B KONFIRM
</td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>

<td> - </td>
<td> 1600000 </td>
<td> Sembuh </td>
<td> 4 </td>
<td> Sudah </td>
</tr>
<tr>
<td> 2022/07/12/000304 </td>
<td> 015496 </td>
<td> M GAZZAL ABQORY AL-BAYAN,AN </td>
<td> L </td>
<td> Malang </td>
<td> 2018-09-20 </td>
<td> 3 Th 10 Bl 0 Hr </td>
<td> ISLAM </td>
<td> TS </td>
<td> Didik Wahyudi, Tn </td>
<td> AYAH </td>
<td> DSN GLAGAHDOWO RT 3 RW 6, PULUNGDOWO, TUMPANG, KABUPATEN
MALANG </td>
<td> BPJ </td>
<td> kelas 2 </td>
<td> D05 </td>
<td> 400000 </td>
<td> R50.9 </td>
<td> A91 </td>
<td> 2022-07-12 </td>
<td> 00:17:32 </td>
<td> 2022-07-16 </td>
<td> 15:43:50 </td>
<td> IGDK </td>
<td> 2022/07/12/000304 BPJS KELAS 2 DI DWARA / AYODYA 3A KONFIRM
</td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>

Telepon </td>
<td> - </td>
<td> 2000000 </td>
<td> Sembuh </td>
<td> 5 </td>
<td> Sudah </td>
</tr>
<tr>
<td> 2022/07/12/000319 </td>
<td> 072261 </td>
<td> LIYA FITRIYANA, NY </td>
<td> P </td>
<td> LAMONGAN </td>
<td> 1986-06-26 </td>
<td> 36 Th 0 Bl 26 Hr </td>
<td> ISLAM </td>
<td> TS </td>
<td> YUSRON ANSORI, TN </td>
<td> SUAMI </td>
<td> JL DARUSSALAM RT 6 RW 3 , WRINGINPITU, MOJOWARNO, JOMBANG
</td>
<td> BPJ </td>
<td> kelas 3 </td>
<td> A08 </td>
<td> 300000 </td>
<td> O44.0 </td>
<td> O34.2 </td>
<td> 2022-07-12 </td>
<td> 00:04:12 </td>
<td> 2022-07-13 </td>
<td> 15:19:26 </td>
<td> IGDK </td>
<td> </td>
<td> 2022/07/12/000319, BPJS KELAS 3 RUANG AMARTA 5C ( BIDAN
RUJUKAN DARI BIDAN DELIMA " SUPIANAH" ) </td>
<td> 3 </td>
<td> 2 </td>
<td> 0 </td>
<td> 0 </td>
<td> 0 </td>
<td> 0 </td>
<td> 38-39 </td>

<td> 2500 </td>
<td> 47 </td>
<td> Hidup </td>
<td> Ya </td>
<td> Hidup </td>
<td> Ya </td>
<td> Tidak </td>
<td> Ya </td>
Visite Dokter Spesialis Obgyn, Operasional Rumah Sakit </td>
<td> - </td>
<td> 600000 </td>
<td> Sembuh </td>
<td> 2 </td>
<td> Sudah </td>
</tr>
<tr>
<td> 2022/07/11/000279 </td>
<td> 072226 </td>
<td> KIANA MIKAYLA HUSNA, An </td>
<td> P </td>
<td> MALANG </td>
<td> 2022-07-11 </td>
<td> ISLAM </td>
<td> - </td>
<td> DIDIT PRILASTYO, TN </td>
<td> SAUDARA </td>
<td> PERUM GRIYA ASRI BLOK L-15 , PANDANWANGI, BLIMBING, KOTA
MALANG </td>
<td> BPJ </td>
<td> kelas 3 </td>
<td> PF18 </td>
<td> 300000 </td>
<td> P03.4 </td>
<td> P03.4 </td>
<td> 2022-07-11 </td>
<td> 22:52:49 </td>
<td> 2022-07-13 </td>
<td> 16:41:06 </td>
<td> U0030 </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> 3150 </td>
<td> 48 </td>
<td> Hidup </td>
<td> Tidak </td>
<td> Hidup </td>
<td> Ya </td>
<td> Tidak </td>
<td> Ya </td>

<td> - </td>
<td> 600000 </td>
<td> Sembuh </td>
<td> 2 </td>
<td> Sudah </td>
</tr>
<tr>
<td> 2022/07/11/000274 </td>
<td> 046656 </td>
<td> SHAQUEENA AZALEA, AN </td>
<td> P </td>
<td> MALANG </td>
<td> 2020-12-10 </td>
<td> ISLAM </td>
<td> - </td>
<td> SWASTA </td>
<td> ICHSAN VOIN, TN </td>
<td> AYAH </td>
<td> JL BANTARAN VD NO 50 RT 5 RW 3, TULUSREJO, LOWOKWARU, KOTA
MALANG </td>
<td> BPJ </td>
<td> kelas 1 </td>
<td> H10 </td>
<td> 650000 </td>
<td> A09 </td>
<td> A09 </td>
<td> 2022-07-11 </td>
<td> 22:24:25 </td>
<td> 2022-07-14 </td>
<td> 12:53:59 </td>
<td> IGDK </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>

Visite Dokter Spesialis Anak, Infus Anak oleh Perawat / Bidan, Operasional Rumah
Sakit </td>
<td> </td>
<td> 1950000 </td>
<td> Sehat </td>
<td> 3 </td>
<td> Sudah </td>
</tr>
<tr>
<td> 2022/07/11/000275 </td>
<td> 037634 </td>
<td> NAQYYA KAYLA ANEESA, AN </td>
<td> P </td>
<td> MALANG </td>
<td> 2019-10-28 </td>
<td> 2 Th 8 Bl 13 Hr </td>
<td> ISLAM </td>
<td> - </td>
<td> TS </td>
<td> SWASTA </td>
<td> M YAJID, TN </td>
<td> AYAH </td>
<td> JL TELUK CENDRAWASIH NO 174 RT 3 RW 2, ARJOSARI, BLIMBING,
KOTA MALANG </td>
<td> A09 </td>
<td> UMUM </td>
<td> kelas 2 </td>
<td> P01 </td>
<td> 400000 </td>
<td> A09 </td>
<td> A09 </td>
<td> 2022-07-11 </td>
<td> 22:18:34 </td>
<td> 2022-07-14 </td>
<td> 10:26:20 </td>
<td> IGDK </td>
<td> </td>
<td> 2022/07/11/000275, UMUM KLS 2 TITIP PANDAWA 1 RENCANA KLS 2
MENYUSUL </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>

Visite Dokter Spesialis Anak </td>
<td> - </td>
<td> 1200000 </td>
<td> Sehat </td>
<td> 3 </td>
<td> Sudah </td>
</tr>
<tr>
<td> 2022/07/11/000174 </td>
<td> 093500 </td>
<td> EVIT YULIANA, NY </td>
<td> P </td>
<td> Malang </td>
<td> 1991-07-02 </td>
<td> 31 Th 0 Bl 15 Hr </td>
<td> ISLAM </td>
<td> GURU </td>
<td> SMA </td>
<td> Swasta </td>
<td> Abhi Buthi Dhagsina, Tn </td>
<td> SUAMI </td>
<td> DSN TEGAL PASANGAN RT 2 RW 6, PAKISKEMBAR, PAKIS, KABUPATEN
MALANG </td>
<td> BPJ </td>
<td> kelas 2 </td>
<td> D09 </td>
<td> 400000 </td>
<td> O80.8 </td>
<td> O80.9 </td>
<td> 2022-07-11 </td>
<td> 21:38:39 </td>
<td> 2022-07-12 </td>
<td> 15:30:52 </td>
<td> IGDK </td>
<td> 2022/07/11/000174, BPJS KELAS 2, AYODYA 5B </td>
<td> 3 </td>
<td> 1 </td>
<td> 0 </td>
<td> 0 </td>
<td> 1 </td>
<td> 0 </td>
<td> 39-40 </td>

<td> 3290 </td>
<td> 47 </td>
<td> Hidup </td>
<td> Ya </td>
<td> Hidup </td>
<td> Ya </td>
<td> Tidak </td>
<td> Ya </td>

<td> - </td>
<td> 400000 </td>
<td> Sehat </td>
<td> 1 </td>
<td> Sudah </td>
</tr>
<tr>
<td> 2022/07/11/000273 </td>
<td> 072095 </td>
<td> ZIYAN NIZAMI JAYA, AN </td>
<td> L </td>
<td> MALANG </td>
<td> 2022-07-07 </td>
<td> 0 Th 0 Bl 10 Hr </td>
<td> ISLAM </td>
<td> TS </td>
<td> DOSEN </td>
<td> FIRMAN JAYA, TN </td>
<td> AYAH </td>
<td> ALAM DIENG RESIDENCE B-11 RT 09 RW 94, PISANG CANDI, SUKUN,
KOTA MALANG </td>
<td> BPJ </td>
<td> K0000236 </td>
<td> KS IGD 1 </td>
<td> 400000 </td>
<td> P58.2 </td>
<td> P59.9 </td>
<td> 2022-07-11 </td>
<td> 20:03:56 </td>
<td> 2022-07-11 </td>
<td> 21:32:50 </td>
<td> IGDK </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> Sewa Fototerapi </td>

<td> - </td>
<td> 400000 </td>
<td> Sembuh </td>
<td> 1 </td>
<td> Sudah </td>
</tr>
<tr>
<td> 2022/07/11/000269 </td>
<td> 072110 </td>
<td> FESYA ALLEA GHEAFANY, AN </td>
<td> P </td>
<td> MALANG </td>
<td> 2022-06-29 </td>
<td> ISLAM </td>
<td> - </td>
<td> FANANI ANWAR, TN </td>
<td> AYAH </td>
<td> JL SIMPANG SULFAT UTARA XII-I 14 RT 7 RW 5, PANDANWANGI,
<td> BPJ </td>
<td> K0000239 </td>
<td> KS IGD 1 </td>
<td> 400000 </td>
<td> P59.9 </td>
<td> P59.9 </td>
<td> 2022-07-11 </td>
<td> 19:36:37 </td>
<td> 2022-07-11 </td>
<td> 21:32:30 </td>
<td> IGDK </td>
<td> 2022/07/11/000269, BPJS KLS 2 FOTOTERAPI NICU </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>

Fototerapi, Operasional Rumah Sakit , Sewa Fototerapi </td>
<td> - </td>
<td> 400000 </td>
<td> Sembuh </td>
<td> 1 </td>
<td> Sudah </td>
</tr>
<tr>
<td> 2022/07/11/000266 </td>
<td> 072223 </td>
<td> ANNAFI GHANIA ABHIBUTHI, AN </td>
<td> P </td>
<td> MALANG </td>
<td> 2022-07-11 </td>
<td> ISLAM </td>
<td> - </td>
<td> - </td>
<td> ABHI BUTHI DHAGSINA, TN </td>
<td> AYAH </td>
<td> DSN TEGAL PASANGAN RT 2 RW 6 , PAKISKEMBAR, PAKIS, KABUPATEN
MALANG </td>
<td> BPJ </td>
<td> kelas 3 </td>
<td> PF11 </td>
<td> 300000 </td>
<td> P00.6 </td>
<td> P00.9 </td>
<td> 2022-07-11 </td>
<td> 19:16:28 </td>
<td> 2022-07-12 </td>
<td> 16:27:08 </td>
<td> U0030 </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> 3290 </td>
<td> 47 </td>
<td> Hidup </td>
<td> Ya </td>
<td> Hidup </td>
<td> Ya </td>
<td> Tidak </td>
<td> Ya </td>

<td> - </td>
<td> 600000 </td>
<td> Sembuh </td>
<td> 2 </td>
<td> Sudah </td>
</tr>
<tr>
<td> 2022/07/11/000252 </td>
<td> 071806 </td>
<td> MUHAMMAD KHALID, AN </td>
<td> L </td>
<td> MALANG </td>
<td> 2022-07-02 </td>
<td> ISLAM </td>
<td> - </td>
<td> GILANG ANUGRAH, TN </td>
<td> AYAH </td>
<td> JL RANUGRATI II B / 3 RT 1 RW 6 , KEDUNGKANDANG,
<td> BPJ </td>
<td> IGD1 </td>
<td> KS IGD 1 </td>
<td> 400000 </td>
<td> P59.9 </td>
<td> P59.9 </td>
<td> 2022-07-11 </td>
<td> 18:37:44 </td>
<td> 2022-07-11 </td>
<td> 21:31:53 </td>
<td> IGDK </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>

Fototerapi, Sewa Fototerapi, Operasional Rumah Sakit </td>
<td> - </td>
<td> 400000 </td>
<td> Sembuh </td>
<td> 1 </td>
<td> Sudah </td>
</tr>
<tr>
<td> 2022/07/11/000196 </td>
<td> 070233 </td>
<td> MAYA ANDRIANI, NY </td>
<td> P </td>
<td> Malang </td>
<td> 1978-05-23 </td>
<td> 44 Th 1 Bl 29 Hr </td>
<td> ISLAM </td>
<td> SMP </td>
<td> MOH HANDOKO, TN </td>
<td> SUAMI </td>
<td> MELOAN RT.03 RW.02, SIDOREJO, PAGELARAN, KABUPATEN MALANG
</td>
<td> BPJ </td>
<td> kelas 1 </td>
<td> H04 </td>
<td> 650000 </td>
<td> N83.0 </td>
<td> N83.0 </td>
<td> 2022-07-11 </td>
<td> 15:24:33 </td>
<td> 2022-07-14 </td>
<td> 12:41:49 </td>
<td> IGDK </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>

<td> </td>
<td> 2600000 </td>
<td> 4 </td>
<td> Sudah </td>
</tr>
<tr>
<td> 2022/07/11/000192 </td>
<td> 062002 </td>
<td> PUTRI LARAS TRISNAWATI, NY </td>
<td> P </td>
<td> TULUNGAGUNG </td>
<td> 1997-07-01 </td>
<td> 25 Th 0 Bl 18 Hr </td>
<td> ISLAM </td>
<td> GURU </td>
<td> S1 </td>
<td> INDRA CAHYA SETIA WIDIGDA, Tn </td>
<td> SUAMI </td>
MALANG </td>
<td> BPJ </td>
<td> kelas 1 </td>
<td> H01 </td>
<td> 650000 </td>
<td> O30.0 </td>
<td> O30.0 </td>
<td> 2022-07-11 </td>
<td> 15:00:25 </td>
<td> 2022-07-13 </td>
<td> 17:53:00 </td>
<td> IGDK </td>
<td> 1 </td>
<td> 0 </td>
<td> 0 </td>
<td> 0 </td>
<td> 0 </td>
<td> 0 </td>
<td> 39-40 </td>

<td> 2300 </td>
<td> 46 </td>
<td> Hidup </td>
<td> Tidak </td>
<td> Hidup </td>
<td> Ya </td>
<td> Tidak </td>
<td> Ya </td>

Obgyn, Sewa Infus Pump, Infus Dewasa oleh Perawat / Bidan, Konsultasi Dokter
<td> - </td>
<td> 1950000 </td>
<td> Sehat </td>
<td> 3 </td>
<td> Sudah </td>
</tr>
<tr>
<td> 2022/07/11/000197 </td>
<td> 072203 </td>
<td> RUMHANA, NY </td>
<td> P </td>
<td> MALANG </td>
<td> 1997-12-03 </td>
<td> 24 Th 7 Bl 13 Hr </td>
<td> ISLAM </td>
<td> SMP </td>
<td> MAULANA, TN </td>
<td> SUAMI </td>
<td> JL MUHARTO GG VB RT 3 RW 8 , KEDUNGKANDANG, KEDUNGKANDANG,
KOTA MALANG </td>
<td> BPJ </td>
<td> kelas 3 </td>
<td> A06 </td>
<td> 300000 </td>
<td> N83.0 </td>
<td> N83.0 </td>
<td> 2022-07-11 </td>
<td> 14:53:57 </td>
<td> 2022-07-13 </td>
<td> 17:34:56 </td>
<td> IGDK </td>
<td> 2022/07/11/000197, BPJS KELAS 3, AMARTA 6A ( - SEP, BPJS KET
TIDAK DITANGGUNG, MASIH MAU NGURUS, DITUNGGU 3X24 JAM ATAU SEBELUM PX PULANG TIDAK
BISA MENUNJUKKAN BPJS AKTIF, BERSEDIA MENJADI PX UMUM)
TGL 11-07-2022 PUKUL 18:11 SEP SUDAH BISA TERCETAK - DQ </td>

<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>

<td> - </td>
<td> 900000 </td>
<td> 3 </td>
<td> Sudah </td>
</tr>
<tr>
<td> 2022/07/11/000136 </td>
<td> 048789 </td>
<td> ARSYA DANIYAL DANINDRA,AN </td>
<td> L </td>
<td> MALANG </td>
<td> 2021-03-08 </td>
<td> ISLAM </td>
<td> TS </td>
<td> SWASTA </td>
<td> MOCHAMAD SOLEH, TN </td>
<td> AYAH </td>
<td> JL. WONOREJO GG. 3 RT 21 RW 4, WONOREJO, PONCOKUSUMO,
<td> BPJ </td>
<td> kelas 2 </td>
<td> D11 </td>
<td> 400000 </td>
<td> R11 </td>
<td> R11 </td>
<td> 2022-07-11 </td>
<td> 14:53:04 </td>
<td> 2022-07-14 </td>
<td> 07:56:06 </td>
<td> IGDK </td>
<td> 2022/07/11/000136, BPJS KELAS 2, AYODYA 6B (KONFIRMASI)
</td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>

Telepon, Infus Anak oleh Perawat / Bidan </td>
<td> - </td>
<td> 1600000 </td>
<td> 4 </td>
<td> Sudah </td>
</tr>
<tr>
<td> 2022/07/11/000200 </td>
<td> 009636 </td>
<td> AGATHA SUHARTINI SATYA R., Ny </td>
<td> P </td>
<td> Malang </td>
<td> 1983-01-08 </td>
<td> 39 Th 6 Bl 5 Hr </td>
<td> KATHOLIK </td>
<td> S1 </td>
<td> Theresia Farida, Ny </td>
<td> IBU </td>
<td> JL. BANTARAN I/57 RT 2 RW 4, LOWOKWARU, LOWOKWARU, KOTA
MALANG </td>
<td> BPJ </td>
<td> kelas 2 </td>
<td> A05 </td>
<td> 400000 </td>
<td> T83.4 </td>
<td> T83.3 </td>
<td> 2022-07-11 </td>
<td> 14:00:00 </td>
<td> 2022-07-12 </td>
<td> 06:05:31 </td>
<td> IGDK </td>
<td> 2022/07/11/000200, BPJS KELAS 2, AYODYA 1A </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> - </td>
<td> 800000 </td>
<td> Sembuh </td>
<td> 2 </td>
<td> Sudah </td>
</tr>
<tr>
<td> 2022/07/11/000218 </td>
<td> 072212 </td>
<td> NAMIRA MEDINA PUTRI WIDIGDA, AN </td>
<td> P </td>
<td> MALANG </td>
<td> 2022-07-11 </td>
<td> 0 Th 0 Bl 26 Hr </td>
<td> ISLAM </td>
<td> TS </td>
<td> AYAH </td>
MALANG </td>
<td> BPJ </td>
<td> PA07 </td>
<td> NICU 7 </td>
<td> 400000 </td>
<td> P03.4 </td>
<td> P07.1 </td>
<td> 2022-07-11 </td>
<td> 13:32:06 </td>
<td> 2022-07-19 </td>
<td> 09:44:51 </td>
<td> U0029 </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>

Rumah Sakit, Oksigen 100% Sentral 2 LPM, Visite Dokter Spesialis Anak, Visite
Pemasangan CPAP Hari Berikutnya, Pemasangan CPAP Hari Berikutnya, Pemasangan CPAP
Hari Pertama, Sewa Infus Pump, Sewa Infus Pump, Sewa Infus Pump, Sewa Infus Pump,
Sewa Infus Pump, Sewa Infus Pump, Sewa Inkubator, Sewa Inkubator, Sewa Inkubator,
Sewa Inkubator, Sewa Patient Monitor , Sewa Patient Monitor , Sewa Patient
Monitor , Sewa Patient Monitor , Sewa Syringe Pump, Sewa Syringe Pump, Sewa Syringe
Pump, Sewa Syringe Pump, Sewa Syringe Pump, Sewa Syringe Pump, Visite Dokter
Spesialis Anak, Sewa Patient Monitor , Sewa Patient Monitor , Infus Bayi oleh
<td> - </td>
<td> 3600000 </td>
<td> Sembuh </td>
<td> 9 </td>
<td> Sudah </td>
</tr>
<tr>
<td> 2022/07/11/000217 </td>
<td> 072211 </td>
<td> MAHIRA AISYAH PUTRI WIDIGDA, An </td>
<td> P </td>
<td> MALANG </td>
<td> 2022-07-11 </td>
<td> 0 Th 0 Bl 26 Hr </td>
<td> ISLAM </td>
<td> TS </td>
<td> AYAH </td>
MALANG </td>
<td> BPJ </td>
<td> kelas 3 </td>
<td> PF10 </td>
<td> 300000 </td>
<td> P03.4 </td>
<td> P07.1 </td>
<td> 2022-07-11 </td>
<td> 13:30:54 </td>
<td> 2022-07-13 </td>
<td> 20:05:52 </td>
<td> U0030 </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> 2300 </td>
<td> 46 </td>
<td> Hidup </td>
<td> Tidak </td>
<td> Hidup </td>
<td> Ya </td>
<td> Tidak </td>
<td> Ya </td>
<td> - </td>
<td> 900000 </td>
<td> Sembuh </td>
<td> 3 </td>
<td> Sudah </td>
</tr>
<tr>
<td> 2022/07/11/000172 </td>
<td> 101052 </td>
<td> DWI HAPSARI PUTRI, Ny </td>
<td> P </td>
<td> Tulungagung </td>
<td> 1992-09-27 </td>
<td> 29 Th 9 Bl 23 Hr </td>
<td> KRISTEN </td>
<td> S1 </td>
<td> Yusua Agus Sucahyono, Tn </td>
<td> SUAMI </td>
<td> BPJ </td>
<td> kelas 1 </td>
<td> H06 </td>
<td> 650000 </td>
<td> O82.9 </td>
<td> O82.9 </td>
<td> 2022-07-11 </td>
<td> 13:27:07 </td>
<td> 2022-07-13 </td>
<td> 14:15:05 </td>
<td> IGDK </td>
<td> </td>
<td> 3 </td>
<td> 1 </td>
<td> 0 </td>
<td> 0 </td>
<td> 1 </td>
<td> 0 </td>
<td> 38-39 </td>

<td> 2800 </td>
<td> 42 </td>
<td> Hidup </td>
<td> Tidak </td>
<td> Hidup </td>
<td> Ya </td>
<td> Tidak </td>
<td> Ya </td>

<td> </td>
<td> 1950000 </td>
<td> Sehat </td>
<td> 3 </td>
<td> Sudah </td>
</tr>
<tr>
<td> 2022/07/11/000180 </td>
<td> 017673 </td>
<td> AULIA SALMA, AN </td>
<td> P </td>
<td> malang </td>
<td> 2017-12-31 </td>
<td> 4 Th 6 Bl 15 Hr </td>
<td> ISLAM </td>
<td> TS </td>
<td> GURU </td>
<td> AHMAD KOMAR, TN </td>
<td> AYAH </td>
<td> KLAYATAN 3 GG MELATI NO IIB RT 01/ RW 02, BANDUNGREJOSARI,
SUKUN, KOTA MALANG </td>
<td> BPJ </td>
<td> kelas 2 </td>
<td> H03 </td>
<td> 400000 </td>
<td> A90 </td>
<td> A90 </td>
<td> 2022-07-11 </td>
<td> 12:52:09 </td>
<td> 2022-07-13 </td>
<td> 13:00:11 </td>
<td> IGDK </td>
<td> 2022/07/11/000180, BPJS KELAS 2, TITIP HASTINA 3 (BPJS MASIH
MAU NGURUS. SUDAH DIKONSELING 3X24 JAM ATAUA SEBELUM PX PULANG TIDAK BISA
MENUNJUKKAN BPJS AKTIF, BERSEDIA UMUM) ' TGL 11-7-2022 JAM 15.17 SUDAH CETAK SEP
RANAP DAN BPJS AKTIF . BTK </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>

<td> - </td>
<td> 1200000 </td>
<td> Sehat </td>
<td> 3 </td>
<td> Sudah </td>
</tr>
<tr>
<td> 2022/07/11/000183 </td>
<td> 052633 </td>
<td> AIRA PUTRI NIRMALA, AN </td>
<td> P </td>
<td> MALANG </td>
<td> 2021-06-01 </td>
<td> 1 Th 1 Bl 14 Hr </td>
<td> ISLAM </td>
<td> TS </td>
<td> RAMA ARIGO NOVIAN, TN </td>
<td> AYAH </td>
<td> JL. BATUBARA NO.38 RT 03 RW 08, PURWANTORO, BLIMBING, KOTA
MALANG </td>
<td> BPJ </td>
<td> kelas 1 </td>
<td> H02 </td>
<td> 650000 </td>
<td> A90 </td>
<td> A90 </td>
<td> 2022-07-11 </td>
<td> 12:50:19 </td>
<td> 2022-07-12 </td>
<td> 20:51:14 </td>
<td> IGDK </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>

<td> - </td>
<td> 1300000 </td>
<td> 2 </td>
<td> Sudah </td>
</tr>
<tr>
<td> 2022/07/11/000202 </td>
<td> 072207 </td>
<td> ALCEO PUTRA SUCAHYONO, AN </td>
<td> L </td>
<td> MALANG </td>
<td> 2022-07-11 </td>
<td> 0 Th 0 Bl 15 Hr </td>
<td> KRISTEN </td>
<td> TS </td>
<td> YUSUA AGUS S, TN </td>
<td> AYAH </td>
<td> BPJ </td>
<td> kelas 3 </td>
<td> PF01 </td>
<td> 300000 </td>
<td> P03.4 </td>
<td> P03.4 </td>
<td> 2022-07-11 </td>
<td> 11:47:29 </td>
<td> 2022-07-13 </td>
<td> 16:40:46 </td>
<td> U0030 </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> 2800 </td>
<td> 47 </td>
<td> Hidup </td>
<td> Tidak </td>
<td> Hidup </td>
<td> Ya </td>
<td> Tidak </td>
<td> Ya </td>

<td> - </td>
<td> 900000 </td>
<td> Sembuh </td>
<td> 3 </td>
<td> Sudah </td>
</tr>
<tr>
<td> 2022/07/11/000189 </td>
<td> 072201 </td>
<td> PUTRI HAFLANI AL ANSORI, AN </td>
<td> P </td>
<td> Malang </td>
<td> 2022-06-11 </td>
<td> ISLAM </td>
<td> TS </td>
<td> ACHMAD ANSORI, TN </td>
<td> AYAH </td>
<td> JL LA SUCIPTO GG 19 RT 5 RW 1, PANDANWANGI, BLIMBING, KOTA
MALANG </td>
<td> BPJ </td>
<td> K0000240 </td>
<td> KS IGD 1 </td>
<td> 400000 </td>
<td> R56.0 </td>
<td> D64.8 </td>
<td> 2022-07-11 </td>
<td> 10:17:04 </td>
<td> 2022-07-11 </td>
<td> 16:59:30 </td>
<td> IGDK </td>
<td> 2022/07/11/000189, BPJS KELAS 2, NICU (BPJS MASIH MAU
NGURUS, SUDAH KONSELING 3X24 JAM ATAU SEBELUM PX PULANG TIDAK BISA MENUNJUKKAN BPJS
AKTIF, BERSEDIA UMUM )
TGL 12-07-2022 JAM 16:36 SEP TERCETAK, PENERIMA AYAHNYA </td>

<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> Oksigen 100% Sentral 2 LPM, Visite Dokter Spesialis Anak,

Visite Dokter Spesialis Anak, Visite Dokter Umum, Resusitasi dengan Intubasi, Sewa
Ambulance, Sewa Infus Pump, Sewa Infus Pump, Sewa Inkubator, Sewa Inkubator, Sewa
Patient Monitor , Sewa Patient Monitor , Sewa Syringe Pump, Oksigen 100% Sentral 9
LPM </td>
<td> - </td>
<td> 800000 </td>
<td> 2 </td>
<td> Sudah </td>
</tr>
<tr>
<td> 2022/07/11/000122 </td>
<td> 052536 </td>
<td> IFATUL FITRIYAH, NY </td>
<td> P </td>
<td> MALANG </td>
<td> 1998-11-01 </td>
<td> 23 Th 8 Bl 18 Hr </td>
<td> ISLAM </td>
<td> SMP </td>
<td> ARDIN ACHMAD FACHRUDIN, TN </td>
<td> SUAMI </td>
<td> GRAHA TUMPANG ASRI BLOK C-19 RT 19 RW 02, TUMPANG, TUMPANG,
<td> BPJ </td>
<td> kelas 3 </td>
<td> A03 </td>
<td> 300000 </td>
<td> T83.3 </td>
<td> T83.2 </td>
<td> 2022-07-11 </td>
<td> 09:28:00 </td>
<td> 2022-07-12 </td>
<td> 16:46:43 </td>
<td> IGDK </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>

Infus Dewasa oleh Perawat / Bidan, Infus Dewasa oleh Perawat / Bidan, Konsultasi
Dokter Spesialis Obgyn Via Telepon, Operasional Rumah Sakit </td>
<td> - </td>
<td> 600000 </td>
<td> 2 </td>
<td> Sudah </td>
</tr>
<tr>
<td> 2022/07/11/000119 </td>
<td> 068808 </td>
<td> DIAN EKA PUSPITA, NY </td>
<td> P </td>
<td> Malang </td>
<td> 1994-01-03 </td>
<td> 28 Th 6 Bl 15 Hr </td>
<td> ISLAM </td>
<td> D1 </td>
<td> RYAN ANDY ANGRYAWAN, TN </td>
<td> SUAMI </td>
<td> JL BANDARA PALMERAH XII BLOK L NO 18 C RT 2 RW 8,
<td> BPJ </td>
<td> kelas 1 </td>
<td> H05 </td>
<td> 650000 </td>
<td> O63.0 </td>
<td> O63.0 </td>
<td> 2022-07-11 </td>
<td> 06:22:05 </td>
<td> 2022-07-12 </td>
<td> 11:50:49 </td>
<td> IGDK </td>
<td> 2022/07/11/000119, BPJS KLS 1, HASTINA 5, (-) KTP SUAMI
</td>
<td> 1 </td>
<td> 0 </td>
<td> 0 </td>
<td> 0 </td>
<td> 0 </td>
<td> 0 </td>
<td> 37-38 </td>

<td> 2100 </td>
<td> 45 </td>
<td> Hidup </td>
<td> Ya </td>
<td> Hidup </td>
<td> Ya </td>
<td> Tidak </td>
<td> Ya </td>

Oksigen 100% Sentral 3 LPM , Oksigen 100% Sentral 3 LPM , Operasional Rumah Sakit
</td>
<td> - </td>
<td> 1300000 </td>
<td> Sehat </td>
<td> 2 </td>
<td> Sudah </td>
</tr>
<tr>
<td> 2022/07/11/000123 </td>
<td> 072176 </td>
<td> ALSHAKA KALIEF DANENDRA, AN </td>
<td> L </td>
<td> MALANG </td>
<td> 2022-07-11 </td>
<td> ISLAM </td>
<td> TS </td>
<td> RYAN ANDY ANGRYAWAN, TN </td>
<td> AYAH </td>
<td> JL. BANDARA PALMERAH XII BLOK L NO 18C RT 02 RW 08,
<td> BPJ </td>
<td> kelas 3 </td>
<td> PF24 </td>
<td> 300000 </td>
<td> P00.6 </td>
<td> P00.9 </td>
<td> 2022-07-11 </td>
<td> 05:05:09 </td>
<td> 2022-07-12 </td>
<td> 10:57:50 </td>
<td> U0030 </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> 2100 </td>
<td> 45 </td>
<td> Hidup </td>
<td> Ya </td>
<td> Hidup </td>
<td> Ya </td>
<td> Tidak </td>
<td> Ya </td>

<td> - </td>
<td> 600000 </td>
<td> Sembuh </td>
<td> 2 </td>
<td> Sudah </td>
</tr>
<tr>
<td> 2022/07/11/000121 </td>
<td> 072175 </td>
<td> BANYU SAGARA BIRU, AN </td>
<td> L </td>
<td> MALANG </td>
<td> 2022-07-11 </td>
<td> ISLAM </td>
<td> - </td>
<td> - </td>
<td> - </td>
<td> LUYUNG OCTA, TN </td>
<td> AYAH </td>
<td> JL. MT HARYONO GG.7 NO.283 RT 7 RW 3 , DINOYO, LOWOKWARU,
KOTA MALANG </td>
<td> BPJ </td>
<td> PA29 </td>
<td> 400000 </td>
<td> P00.6 </td>
<td> P91.6 </td>
<td> 2022-07-11 </td>
<td> 00:51:51 </td>
<td> 2022-07-16 </td>
<td> 11:08:49 </td>
<td> U0029 </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> 2800 </td>
<td> 51 </td>
<td> Hidup </td>
<td> Tidak </td>
<td> Hidup </td>
<td> Ya </td>
<td> Tidak </td>
<td> Ya </td>
<td> Perawatan Bayi NP , Perawatan Bayi NP , Jasa Pelayanan

Rumah Sakit, Oksigen 100% Sentral 2 LPM, Visite Dokter Spesialis Anak, Visite
Sewa Infus Pump, Sewa Infus Pump, Sewa Infus Pump, Sewa Infus Pump, Sewa Infus
Pump, Sewa Inkubator, Sewa Inkubator, Sewa Inkubator, Sewa Inkubator, Sewa
Inkubator, Sewa Patient Monitor , Sewa Patient Monitor , Sewa Patient Monitor ,
Sewa Patient Monitor , Sewa Suction Pump, Sewa Syringe Pump, Sewa Syringe Pump,
Sewa Syringe Pump, Sewa Syringe Pump, Sewa Syringe Pump, Oksigen 100% Sentral 3
LPM, Sewa Patient Monitor , Sewa Patient Monitor , Infus Bayi oleh Perawat / Bidan,
<td> - </td>
<td> 2400000 </td>
<td> Sembuh </td>
<td> 6 </td>
<td> Sudah </td>
</tr>
<tr>
<td> 2022/07/11/000215 </td>
<td> 061035 </td>
<td> HILMI MAULUK DIAH MUSYARROFAH, NY </td>
<td> P </td>
<td> MALANG </td>
<td> 1992-10-07 </td>
<td> 29 Th 9 Bl 12 Hr </td>
<td> ISLAM </td>
<td> SMP </td>
<td> DIDIT PRILASTYO, TN </td>
<td> SUAMI </td>
<td> PERUM GRIYA ASRI BLOK L-15, PANDANWANGI, BLIMBING, KOTA
MALANG </td>
<td> BPJ </td>
<td> kelas 3 </td>
<td> A07 </td>
<td> 300000 </td>
<td> O80.8 </td>
<td> O34.2 </td>
<td> 2022-07-11 </td>
<td> 00:08:07 </td>
<td> 2022-07-13 </td>
<td> 17:35:25 </td>
<td> IGDK </td>
<td> 2 </td>
<td> 1 </td>
<td> 0 </td>
<td> 0 </td>
<td> 0 </td>
<td> 0 </td>
<td> 39-40 </td>

<td> 3150 </td>
<td> 48 </td>
<td> Hidup </td>
<td> Tidak </td>
<td> Hidup </td>
<td> Ya </td>
<td> Tidak </td>
<td> Ya </td>

Visite Dokter Umum, Infus Dewasa oleh Perawat / Bidan, Operasional Rumah Sakit
</td>
<td> - </td>
<td> 900000 </td>
<td> Sembuh </td>
<td> 3 </td>
<td> Sudah </td>
</tr>
<tr>
<td> 2022/07/10/000052 </td>
<td> 072173 </td>
<td> SRI MUDALIFAH, NY </td>
<td> P </td>
<td> MALANG </td>
<td> 1994-01-20 </td>
<td> 28 Th 5 Bl 20 Hr </td>
<td> ISLAM </td>
<td> SD </td>
<td> SEMOG AGUS, TN </td>
<td> SUAMI </td>
<td> DSN BUSU RT 29 RW 4 , SLAMPAREJO, JABUNG, KABUPATEN MALANG
</td>
<td> A09 </td>
<td> UMUM </td>
<td> kelas 3 </td>
<td> KB02 </td>
<td> 300000 </td>
<td> O20.0 </td>
<td> O20.0 </td>
<td> 2022-07-10 </td>
<td> 23:50:57 </td>
<td> 2022-07-11 </td>
<td> 17:00:41 </td>
<td> IGDK </td>
<td> </td>
<td> 2022/07/10/000052, UMUM KLS 3 KURET KABER </td>
<td> 0 </td>
<td> 0 </td>
<td> 0 </td>
<td> 0 </td>
<td> 0 </td>
<td> 0 </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> USG 2D/3D oleh Dokter Obgyn , Operasional Rumah Sakit ,

Infus Dewasa oleh Perawat / Bidan, Jasa Pelayanan Kelas 3 </td>
<td> - </td>
<td> 300000 </td>
<td> 1 </td>
<td> Sudah </td>
</tr>
<tr>
<td> 2022/07/10/000039 </td>
<td> 072167 </td>
<td> M. ABDULLAH SIDDIQ, AN </td>
<td> L </td>
<td> MALANG </td>
<td> 2021-08-07 </td>
<td> 0 Th 11 Bl 3 Hr </td>
<td> ISLAM </td>
<td> TS </td>
<td> ROICHU FARHAN, TN </td>
<td> AYAH </td>
<td> DUSUN TRAJENG RT 01 RW 09, PAKISJAJAR, PAKIS, KABUPATEN
MALANG </td>
<td> A09 </td>
<td> UMUM </td>
<td> kelas 3 </td>
<td> A01 </td>
<td> 300000 </td>
<td> A09 </td>
<td> A09 </td>
<td> 2022-07-10 </td>
<td> 23:31:18 </td>
<td> 2022-07-13 </td>
<td> 11:37:43 </td>
<td> IGDK </td>
<td> </td>
<td> 2022/07/10/000039, UMUM KLS 3, AMARTA 1B </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>

Visite Dokter Spesialis Anak, Visite Dokter Spesialis Anak, Oksigen 21% 1 LPM,
<td> - </td>
<td> 900000 </td>
<td> 3 </td>
<td> Sudah </td>
</tr>
<tr>
<td> 2022/07/10/000046 </td>
<td> 030663 </td>
<td> SYAUQI ALMAN, AN </td>
<td> L </td>
<td> MALANG </td>
<td> 2020-01-10 </td>
<td> ISLAM </td>
<td> - </td>
<td> MUHAMMAD MASRUH, TN </td>
<td> AYAH </td>
<td> JL. CANDI TELAGAWANGI NO. 48 RT 3 RW 1, MOJOLANGU,
<td> BPJ </td>
<td> kelas 2 </td>
<td> D12 </td>
<td> 400000 </td>
<td> R50.9 </td>
<td> - </td>
<td> 2022-07-10 </td>
<td> 23:05:26 </td>
<td> 2022-07-11 </td>
<td> 22:22:05 </td>
<td> IGDK </td>
<td> 2022/07/10/000046, BPJS KLS 2, AYODYA 6B KONFIRMASI RUANGAN.
BPJS PENANGGUHAN PESERTA. KONSELING 3X24 JAM . JIKA BELUM SELESAI MENJADI PASIEN
UMUM
PASIEN NAIK KELAS 2 UP 1. 10 JULI 2022 22:50

SUDAH DIKONSELING JIKA SAMPAI PULANG BPJS MASIH BLM AKTIF, MAKA AKAN MENJADI PASIEN
UMUM
CETAK SEP (SUDAH BAYAR DENDA) 13:37 TGL 11/7/22 - WD </td>

<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>

Bidan </td>
<td> </td>
<td> 800000 </td>
<td> 2 </td>
<td> Sudah </td>
</tr>
<tr>
<td> 2022/07/10/000045 </td>
<td> 048927 </td>
<td> ALFARIZQI ZAFRAN ALHABSY, AN </td>
<td> L </td>
<td> MALANG </td>
<td> 2018-08-07 </td>
<td> 3 Th 11 Bl 12 Hr </td>
<td> ISLAM </td>
<td> - </td>
<td> SMA </td>
<td> SWASTA </td>
<td> PRIMA ALFAN, TN </td>
<td> AYAH </td>
<td> JL. ANGGREK NO. 9 RT.05 RW. 02, SEKARPURO, PAKIS, KABUPATEN
MALANG </td>
<td> BPJ </td>
<td> kelas 2 </td>
<td> D11 </td>
<td> 400000 </td>
<td> R50.9 </td>
<td> R50.9 </td>
<td> 2022-07-10 </td>
<td> 22:10:24 </td>
<td> 2022-07-15 </td>
<td> 06:05:16 </td>
<td> IGDK </td>
</td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>

Spesialis Anak Via Telepon, Konsultasi Dokter Spesialis Anak Via Telepon,
<td> </td>
<td> 2000000 </td>
<td> 5 </td>
<td> Sudah </td>
</tr>
<tr>
<td> 2022/07/10/000034 </td>
<td> 010084 </td>
<td> ALYA ADANNAYA SAHQUITA, An </td>
<td> P </td>
<td> Malang </td>
<td> 2018-11-30 </td>
<td> 3 Th 7 Bl 17 Hr </td>
<td> ISLAM </td>
<td> TS </td>
<td> Karyawan Swasta </td>
<td> Anita Maulida, Ny </td>
<td> IBU </td>
<td> JL. LA. SUCIPTO 300 F RT 06 RW 01 KEL. PANDANWANGI - KEC.
BLIMBING, PANDANWANGI, BLIMBING, KOTA MALANG </td>
<td> BPJ </td>
<td> kelas 2 </td>
<td> D04 </td>
<td> 400000 </td>
<td> R50.9 </td>
<td> R50.9 </td>
<td> 2022-07-10 </td>
<td> 21:57:00 </td>
<td> 2022-07-13 </td>
<td> 11:00:35 </td>
<td> IGDK </td>
<td> dr. Kurnia Widyaningrum, MMRS </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>

Anak oleh Perawat / Bidan, Operasional Rumah Sakit </td>
<td> - </td>
<td> 1200000 </td>
<td> Sehat </td>
<td> 3 </td>
<td> Sudah </td>
</tr>
<tr>
<td> 2022/07/10/000006 </td>
<td> 043916 </td>
<td> AQILA ANINDIA KHANZA SHAQUEENA, AN </td>
<td> P </td>
<td> MALANG </td>
<td> 2020-09-08 </td>
<td> 1 Th 10 Bl 9 Hr </td>
<td> ISLAM </td>
<td> - </td>
<td> TS </td>
<td> TNI-AD </td>
<td> ANDYS SETIAWAN, TN </td>
<td> AYAH </td>
<td> ASRAMA SKODAM V/BRAWIJAYA C-14 RT3 RW 8, BLIMBING, BLIMBING,
KOTA MALANG </td>
<td> BPJ </td>
<td> kelas 1 </td>
<td> H09 </td>
<td> 650000 </td>
<td> R50.9 </td>
<td> R50.9 </td>
<td> 2022-07-10 </td>
<td> 20:55:07 </td>
<td> 2022-07-14 </td>
<td> 11:00:00 </td>
<td> IGDK </td>
<td> 2022/07/10/000006, BPJS KLS 2 UP 1 , HASTINA 9 </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>

<td> </td>
<td> 3250000 </td>
<td> 5 </td>
<td> Sudah </td>
</tr>
<tr>
<td> 2022/07/10/000018 </td>
<td> 051611 </td>
<td> FIFI JANUAR, NY </td>
<td> P </td>
<td> Malang </td>
<td> 1997-01-17 </td>
<td> 25 Th 6 Bl 12 Hr </td>
<td> ISLAM </td>
<td> IRT </td>
<td> SMP </td>
<td> DICKY PUTRA RAMADHAN, RN </td>
<td> SUAMI </td>
<td> JL. DIRGANTARA PERMAI A1-23 RT 10 RW 10, LESANPURO,
<td> BPJ </td>
<td> kelas 1 </td>
<td> H03 </td>
<td> 650000 </td>
<td> O82.9 </td>
<td> - </td>
<td> 2022-07-10 </td>
<td> 17:44:28 </td>
<td> 2022-07-10 </td>
<td> 20:53:30 </td>
<td> IGDK </td>
<td> 2022/07/10/000018, BPJS KELAS 1 RUANG HASTINA 3 , DENDA 45
HARI </td>
<td> 2 </td>
<td> 1 </td>
<td> 0 </td>
<td> 0 </td>
<td> 0 </td>
<td> 0 </td>
<td> 39-40 </td>

<td> 2900 </td>
<td> 48 </td>
<td> Hidup </td>
<td> Tidak </td>
<td> Hidup </td>
<td> Ya </td>
<td> Tidak </td>
<td> Ya </td>

Infus Dewasa oleh Perawat / Bidan, Oksigen 100% Sentral 3 LPM , Konsultasi Dokter
Spesialis Obgyn Via Telepon, Operasional Rumah Sakit </td>
<td> - </td>
<td> 650000 </td>
<td> 1 </td>
<td> Sudah </td>
</tr>
<tr>
<td> 2022/07/10/000042 </td>
<td> 072170 </td>
<td> FIFI JANU, BY.NY. </td>
<td> P </td>
<td> MALANG </td>
<td> 2022-07-10 </td>
<td> ISLAM </td>
<td> TS </td>
<td> DICKY PUTRA RAMADHAN, TN </td>
<td> AYAH </td>
<td> JL. DIRGANTARA PERMAI A1-23 RT 10 RW 10, LESANPURO,
<td> BPJ </td>
<td> kelas 3 </td>
<td> BFA02 </td>
<td> 300000 </td>
<td> P03.4 </td>
<td> P03.4 </td>
<td> 2022-07-10 </td>
<td> 17:21:48 </td>
<td> 2022-07-12 </td>
<td> 09:28:14 </td>
<td> U0030 </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> 2900 </td>
<td> 48 </td>
<td> Hidup </td>
<td> Tidak </td>
<td> Hidup </td>
<td> Ya </td>
<td> Tidak </td>
<td> Ya </td>
<td> Perawatan Bayi SC , Visite Dokter Spesialis Anak,

<td> - </td>
<td> 900000 </td>
<td> Sembuh </td>
<td> 3 </td>
<td> Sudah </td>
</tr>
<tr>
<td> 2022/07/10/000033 </td>
<td> 019974 </td>
<td> AYUNINDYA DAVIRA FREDELLA HESTY, AN </td>
<td> P </td>
<td> MALANG </td>
<td> 2019-06-14 </td>
<td> ISLAM </td>
<td> - </td>
<td> TNI </td>
<td> KUSNANTO, TN </td>
<td> AYAH </td>
<td> ASRAMA YONIF LINUD 502 RT.06 RW.08, KEMANTREN, JABUNG,
<td> BPJ </td>
<td> kelas 2 </td>
<td> D03 </td>
<td> 400000 </td>
<td> R11 </td>
<td> R11 </td>
<td> 2022-07-10 </td>
<td> 17:07:13 </td>
<td> 2022-07-16 </td>
<td> 15:41:43 </td>
<td> IGDK </td>
<td> 2022/07/10/000033, BPJS KLS II DI AYODYA 2A </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>

<td> - </td>
<td> 2800000 </td>
<td> 7 </td>
<td> Sudah </td>
</tr>
<tr>
<td> 2022/07/10/000021 </td>
<td> 072161 </td>
<td> SALWA DAVINA ZAHIDI, AN </td>
<td> P </td>
<td> MALANG </td>
<td> 2018-09-05 </td>
<td> 3 Th 10 Bl 9 Hr </td>
<td> ISLAM </td>
<td> - </td>
<td> M. SYAPRIN, TN </td>
<td> AYAH </td>
<td> PERUM DE SAXOFONE TOWN HOUSE TAHAP 4 RT 3 RW 6 , JATIMULYO,
<td> BPJ </td>
<td> kelas 2 </td>
<td> D05 </td>
<td> 400000 </td>
<td> R50.9 </td>
<td> R50.9 </td>
<td> 2022-07-10 </td>
<td> 12:48:14 </td>
<td> 2022-07-13 </td>
<td> 11:13:05 </td>
<td> IGDK </td>
<td> 2022/07/10/000021, BPJS KELAS 2 RUANG AYODYA 3A </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>

</td>
<td> - </td>
<td> 1600000 </td>
<td> 4 </td>
<td> Sudah </td>
</tr>
<tr>
<td> 2022/07/10/000009 </td>
<td> 071004 </td>
<td> TRI UTAMI, NY </td>
<td> P </td>
<td> MALANG </td>
<td> 1990-01-04 </td>
<td> 32 Th 6 Bl 6 Hr </td>
<td> ISLAM </td>
<td> SD </td>
<td> SURYA, TN </td>
<td> SUAMI </td>
<td> JL MUHARTO V RT 14 RW 08 , KOTALAMA, KEDUNGKANDANG, KOTA
MALANG </td>
<td> BPJ </td>
<td> kelas 3 </td>
<td> A04 </td>
<td> 300000 </td>
<td> O80.8 </td>
<td> O80.0 </td>
<td> 2022-07-10 </td>
<td> 11:20:17 </td>
<td> 2022-07-12 </td>
<td> 06:04:58 </td>
<td> IGDK </td>
<td> 4 </td>
<td> 2 </td>
<td> 0 </td>
<td> 0 </td>
<td> 1 </td>
<td> 0 </td>
<td> Pasang KB IUD Nova T </td>
<td> 39-40 </td>

<td> 2355 </td>
<td> 47 </td>
<td> Hidup </td>
<td> Ya </td>
<td> Hidup </td>
<td> Ya </td>
<td> Tidak </td>
<td> Ya </td>

<td> - </td>
<td> 900000 </td>
<td> Sehat </td>
<td> 3 </td>
<td> Sudah </td>
</tr>
<tr>
<td> 2022/07/10/000008 </td>
<td> 072076 </td>
<td> HABIBATUL ULA, NY </td>
<td> P </td>
<td> MALANG </td>
<td> 1993-01-05 </td>
<td> 29 Th 6 Bl 17 Hr </td>
<td> ISLAM </td>
<td> SMA </td>
<td> ROKY ILHAM, TN </td>
<td> SUAMI </td>
<td> JL. KH MALIK DALAM NO. 35 RT 001 RW 006, BURING,
<td> BPJ </td>
<td> kelas 3 </td>
<td> A09 </td>
<td> 300000 </td>
<td> O82.9 </td>
<td> O82.9 </td>
<td> 2022-07-10 </td>
<td> 10:32:03 </td>
<td> 2022-07-12 </td>
<td> 17:37:42 </td>
<td> IGDK </td>
<td> </td>
<td> 2 </td>
<td> 1 </td>
<td> 0 </td>
<td> 0 </td>
<td> 0 </td>
<td> 0 </td>
<td> 41-42 </td>

<td> 2700 </td>
<td> 48 </td>
<td> Hidup </td>
<td> Tidak </td>
<td> Hidup </td>
<td> Ya </td>
<td> Tidak </td>
<td> Ya </td>
Sakit </td>
<td> - </td>
<td> 900000 </td>
<td> 3 </td>
<td> Sudah </td>
</tr>
<tr>
<td> 2022/07/10/000022 </td>
<td> 072162 </td>
<td> TRI UTAMI., BY NY </td>
<td> L </td>
<td> Malang </td>
<td> 2022-07-10 </td>
<td> ISLAM </td>
<td> - </td>
<td> SURYA, TN </td>
<td> AYAH </td>
<td> JL MUHARTO V RT 14 RW 08, KOTALAMA, KEDUNGKANDANG, KOTA
MALANG </td>
<td> BPJ </td>
<td> kelas 3 </td>
<td> BPF01 </td>
<td> 300000 </td>
<td> P00.6 </td>
<td> P07.1 </td>
<td> 2022-07-10 </td>
<td> 10:08:40 </td>
<td> 2022-07-11 </td>
<td> 12:30:04 </td>
<td> U0030 </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> 2355 </td>
<td> 47 </td>
<td> Hidup </td>
<td> Ya </td>
<td> Hidup </td>
<td> Ya </td>
<td> Tidak </td>
<td> Ya </td>

<td> </td>
<td> 600000 </td>
<td> Sembuh </td>
<td> 2 </td>
<td> Sudah </td>
</tr>
<tr>
<td> 2022/07/10/000017 </td>
<td> 072160 </td>
<td> ARKANA ZAYYAN HABIBI, AN </td>
<td> L </td>
<td> MALANG </td>
<td> 2022-07-10 </td>
<td> 0 Th 0 Bl 17 Hr </td>
<td> ISLAM </td>
<td> - </td>
<td> ROKY ILHAM, TN </td>
<td> AYAH </td>
<td> JL KH MALIK DALAM NO 35 RT 1 RW 6 , BURING, KEDUNGKANDANG,
KOTA MALANG </td>
<td> BPJ </td>
<td> kelas 3 </td>
<td> PF22 </td>
<td> 300000 </td>
<td> P03.4 </td>
<td> Q53.1 </td>
<td> 2022-07-10 </td>
<td> 08:41:58 </td>
<td> 2022-07-12 </td>
<td> 08:59:58 </td>
<td> U0030 </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> 2700 </td>
<td> 48 </td>
<td> Hidup </td>
<td> Tidak </td>
<td> Hidup </td>
<td> Ya </td>
<td> Tidak </td>
<td> Ya </td>

<td> - </td>
<td> 900000 </td>
<td> Sembuh </td>
<td> 3 </td>
<td> Sudah </td>
</tr>
<tr>
<td> 2022/07/10/000016 </td>
<td> 072157 </td>
<td> YUNITA RAHMA., BY NY </td>
<td> L </td>
<td> MALANG </td>
<td> 2022-07-10 </td>
<td> ISLAM </td>
<td> - </td>
<td> PUTRA SETIA BRIANSYAH, TN </td>
<td> SAUDARA </td>
<td> JL SUDIMORO NO 21 RT 06 RW 06, MOJOLANGU, LOWOKWARU, KOTA
MALANG </td>
<td> BPJ </td>
<td> kelas 3 </td>
<td> PF21 </td>
<td> 300000 </td>
<td> P03.4 </td>
<td> P03.4 </td>
<td> 2022-07-10 </td>
<td> 08:38:23 </td>
<td> 2022-07-12 </td>
<td> 10:29:23 </td>
<td> U0030 </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> 3400 </td>
<td> 50 </td>
<td> Hidup </td>
<td> Tidak </td>
<td> Hidup </td>
<td> Ya </td>
<td> Tidak </td>
<td> Ya </td>

<td> </td>
<td> 900000 </td>
<td> Sembuh </td>
<td> 3 </td>
<td> Sudah </td>
</tr>
<tr>
<td> 2022/07/10/000031 </td>
<td> 072063 </td>
<td> INÀM AFIFIN, NY </td>
<td> P </td>
<td> Malang </td>
<td> 1994-01-25 </td>
<td> 28 Th 5 Bl 24 Hr </td>
<td> ISLAM </td>
<td> SMA </td>
<td> - </td>
<td> LUYUNG OCTA, TN </td>
<td> SUAMI </td>
<td> JL. MT. HARYONO GG. 7 NO 283 RT 07 RW 03, DINOYO, LOWOKWARU,
KOTA MALANG </td>
<td> BPJ </td>
<td> kelas 2 </td>
<td> D01 </td>
<td> 400000 </td>
<td> O80.9 </td>
<td> O63.0 </td>
<td> 2022-07-10 </td>
<td> 05:40:17 </td>
<td> 2022-07-12 </td>
<td> 15:20:39 </td>
<td> IGDK </td>
<td> 2022/07/10/000031, BPJS KELAS 2 RUANG AYODYA 1 B
<td> 1 </td>
<td> 0 </td>
<td> 0 </td>
<td> 0 </td>
<td> 0 </td>
<td> 0 </td>
<td> 39-40 </td>

<td> 3030 </td>
<td> 51 </td>
<td> Hidup </td>
<td> Tidak </td>
<td> Baik </td>
<td> Ya </td>
<td> Tidak </td>
<td> Ya </td>
<td> Visite Dokter Umum, Oksigen 100% Sentral 3 LPM </td>

<td> - </td>
<td> 1200000 </td>
<td> Sembuh </td>
<td> 3 </td>
<td> Sudah </td>
</tr>
<tr>
<td> 2022/07/09/000144 </td>
<td> 072122 </td>
<td> NADHEERA AISYAH HANDOYO, AN </td>
<td> P </td>
<td> Malang </td>
<td> 2021-11-27 </td>
<td> 0 Th 7 Bl 12 Hr </td>
<td> ISLAM </td>
<td> TS </td>
<td> VIKI HANDOYO, TN </td>
<td> AYAH </td>
<td> KONANG RT 02 RW 04, SIDOREJO, JABUNG, KABUPATEN MALANG </td>
<td> A09 </td>
<td> UMUM </td>
<td> kelas 3 </td>
<td> A10 </td>
<td> 300000 </td>
<td> K52.0 </td>
<td> K52.0 </td>
<td> 2022-07-09 </td>
<td> 23:50:55 </td>
<td> 2022-07-13 </td>
<td> 11:47:49 </td>
<td> IGDK </td>
<td> </td>
<td> 2022/07/09/000144, UMUM KELAS 3, AMARTA 8A </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>

</td>
<td> - </td>
<td> 1200000 </td>
<td> 4 </td>
<td> Sudah </td>
</tr>
<tr>
<td> 2022/07/09/000141 </td>
<td> 059166 </td>
<td> MUHAMMAD IQBAL, An. </td>
<td> L </td>
<td> MALANG </td>
<td> 2020-06-11 </td>
<td> 2 Th 0 Bl 28 Hr </td>
<td> ISLAM </td>
<td> TS </td>
<td> ALFIANTO, Tn. </td>
<td> AYAH </td>
<td> DSN. NGEDEM RT 04 RW 01, PAKISKEMBAR, PAKIS, KABUPATEN
MALANG </td>
<td> A09 </td>
<td> UMUM </td>
<td> kelas 3 </td>
<td> A11 </td>
<td> 300000 </td>
<td> R56.0 </td>
<td> R56.0 </td>
<td> 2022-07-09 </td>
<td> 23:25:57 </td>
<td> 2022-07-11 </td>
<td> 20:01:25 </td>
<td> IGDK </td>
<td> </td>
<td> 2022/07/09/000141, UMUM KELAS 3 RUANG AMARTA 8
( KONFIRMASI ) - KTP ORANG TUA </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>

Telepon, Infus Anak oleh Perawat / Bidan, Infus Anak oleh Perawat / Bidan, Jasa
<td> - </td>
<td> 600000 </td>
<td> 2 </td>
<td> Sudah </td>
</tr>
<tr>
<td> 2022/07/09/000055 </td>
<td> 096893 </td>
<td> Ignatius Dimas Agung Setiawan, An. </td>
<td> L </td>
<td> Malang </td>
<td> 2016-01-17 </td>
<td> 6 Th 6 Bl 19 Hr </td>
<td> ISLAM </td>
<td> TS </td>
<td> Andik Setiawan </td>
<td> AYAH </td>
<td> JL. BANGO UTARA I/ 9 RT. 08/ RW. 03, BUNULREJO, BLIMBING,
KOTA MALANG </td>
<td> BPJ </td>
<td> kelas 3 </td>
<td> A02 </td>
<td> 300000 </td>
<td> A08.3 </td>
<td> A08.3 </td>
<td> 2022-07-09 </td>
<td> 22:41:14 </td>
<td> 2022-07-11 </td>
<td> 20:00:41 </td>
<td> IGDK </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>

<td> - </td>
<td> 600000 </td>
<td> 2 </td>
<td> Sudah </td>
</tr>
<tr>
<td> 2022/07/09/000138 </td>
<td> 072151 </td>
<td> MUHAMMAD RAJA ALFAREZEL A.P., AN </td>
<td> L </td>
<td> MALANG </td>
<td> 2022-07-09 </td>
<td> 0 Th 0 Bl 10 Hr </td>
<td> ISLAM </td>
<td> - </td>
<td> ANDY SETIAWAN, TN </td>
<td> AYAH </td>
<td> JL GADANG XIIA/65 RT 3 RW 5 , GADANG, SUKUN, KOTA MALANG
</td>
<td> BPJ </td>
<td> kelas 3 </td>
<td> PF16 </td>
<td> 300000 </td>
<td> P03.4 </td>
<td> P03.4 </td>
<td> 2022-07-09 </td>
<td> 19:28:54 </td>
<td> 2022-07-11 </td>
<td> 09:28:51 </td>
<td> U0030 </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> 2800 </td>
<td> 48 </td>
<td> Hidup </td>
<td> Tidak </td>
<td> Hidup </td>
<td> Ya </td>
<td> Tidak </td>
<td> Ya </td>

<td> - </td>
<td> 900000 </td>
<td> Sembuh </td>
<td> 3 </td>
<td> Sudah </td>
</tr>
<tr>
<td> 2022/07/09/000105 </td>
<td> 044060 </td>
<td> AQILA NURAINI IZMI, AN </td>
<td> P </td>
<td> Malang </td>
<td> 2019-03-17 </td>
<td> 3 Th 3 Bl 28 Hr </td>
<td> ISLAM </td>
<td> - </td>
<td> TS </td>
<td> SWASTA </td>
<td> EKO, TN </td>
<td> AYAH </td>
<td> JEDONG RT.02 RW.01, JEDONG, WAGIR, KABUPATEN MALANG </td>
<td> BPJ </td>
<td> kelas 3 </td>
<td> A12 </td>
<td> Amarta 2 </td>
<td> 300000 </td>
<td> R50.9 </td>
<td> R50.8 </td>
<td> 2022-07-09 </td>
<td> 19:20:41 </td>
<td> 2022-07-12 </td>
<td> 17:36:58 </td>
<td> IGDK </td>
<td> 2022/07/09/000105, BPJS KLS III
TGL 12/7/22 SUDAH CETAK SEP JAM 12:32 WD </td>

<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>

Visite Dokter Spesialis Anak, Infus Dewasa oleh Perawat / Bidan, Nebulizer ,
<td> - </td>
<td> 1200000 </td>
<td> 4 </td>
<td> Sudah </td>
</tr>
<tr>
<td> 2022/07/09/000013 </td>
<td> 071849 </td>
<td> ALEXANDER JULIO NATANAEL, AN </td>
<td> L </td>
<td> MALANG </td>
<td> 2022-07-02 </td>
<td> KATHOLIK </td>
<td> - </td>
<td> TS </td>
<td> PINDA NATANAEL, TN </td>
<td> AYAH </td>
<td> PERUM GRAHA VALENCIA A8 NO 3 , SAPTORENGGO, PAKIS, KABUPATEN
MALANG </td>
<td> BPJ </td>
<td> PA03 </td>
<td> NICU 3 </td>
<td> 400000 </td>
<td> P59.8 </td>
<td> P59.9 </td>
<td> 2022-07-09 </td>
<td> 18:29:49 </td>
<td> 2022-07-10 </td>
<td> 19:49:29 </td>
<td> U0002 </td>
<td> 2022/07/09/000013, BPJS KELAS 2 RUANG NICU </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>

Fototerapi, Operasional Rumah Sakit </td>
<td> - </td>
<td> 800000 </td>
<td> 2 </td>
<td> Sudah </td>
</tr>
<tr>
<td> 2022/07/09/000125 </td>
<td> 071879 </td>
<td> AYDIN FIRHAN KURNIAWAN, AN </td>
<td> L </td>
<td> Malang </td>
<td> 2022-07-03 </td>
<td> ISLAM </td>
<td> - </td>
<td> HEBING KURNIAWAN, Tn </td>
<td> AYAH </td>
<td> PERUMAHAN MEKAR SARI NO 2 , SAPTORENGGO, PAKIS, KABUPATEN
MALANG </td>
<td> A09 </td>
<td> UMUM </td>
<td> PA02 </td>
<td> NICU 2 </td>
<td> 400000 </td>
<td> P59.8 </td>
<td> P59.9 </td>
<td> 2022-07-09 </td>
<td> 18:29:19 </td>
<td> 2022-07-10 </td>
<td> 19:48:55 </td>
<td> IGDK </td>
<td> </td>
<td> 2022/07/09/000125, UMUM DI RUANG NICU </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> Sewa Fototerapi , Sewa Fototerapi , Operasional Rumah

Sakit , Visite Dokter Spesialis Anak </td>
<td> - </td>
<td> 800000 </td>
<td> 2 </td>
<td> Sudah </td>
</tr>
<tr>
<td> 2022/07/09/000100 </td>
<td> 033171 </td>
<td> M. ARFA DHIYAULHAQ PRABASUNU, AN </td>
<td> L </td>
<td> MALANG </td>
<td> 2020-02-24 </td>
<td> 2 Th 4 Bl 20 Hr </td>
<td> - </td>
<td> - </td>
<td> - </td>
<td> SWASTA- </td>
<td> SULTON MAARIF, TN. </td>
<td> AYAH </td>
<td> JL MELATI RT 24 RW 9, MALANGSUKO, TUMPANG, KABUPATEN MALANG
</td>
<td> BPJ </td>
<td> kelas 1 </td>
<td> D08 </td>
<td> 650000 </td>
<td> R50.9 </td>
<td> - </td>
<td> 2022-07-09 </td>
<td> 17:00:15 </td>
<td> 2022-07-09 </td>
<td> 19:05:09 </td>
<td> IGDK </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>

Nebulizer , Nebulizer , Nebulizer , Nebulizer </td>
<td> - </td>
<td> 650000 </td>
<td> 1 </td>
<td> Sudah </td>
</tr>
<tr>
<td> 2022/07/09/000092 </td>
<td> 072128 </td>
<td> ARIFAH, NY </td>
<td> P </td>
<td> Malang </td>
<td> 1961-10-01 </td>
<td> 60 Th 9 Bl 8 Hr </td>
<td> ISLAM </td>
<td> SD </td>
<td> DEWI SAFURIANI, NY </td>
<td> ANAK </td>
<td> JL. MEMBERAMO VI/12 RT 04 RW 14, BUNULREJO, BLIMBING, KOTA
MALANG </td>
<td> BPJ </td>
<td> kelas 3 </td>
<td> A11 </td>
<td> 300000 </td>
<td> R10.4 </td>
<td> - </td>
<td> 2022-07-09 </td>
<td> 14:10:12 </td>
<td> 2022-07-09 </td>
<td> 17:04:55 </td>
<td> IGDK </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>

<td> - </td>
<td> 300000 </td>
<td> 1 </td>
<td> Sudah </td>
</tr>
<tr>
<td> 2022/07/09/000085 </td>
<td> 091067 </td>
<td> Devy Agista Syahputri, Ny. </td>
<td> P </td>
<td> Madiun </td>
<td> 1996-12-11 </td>
<td> 25 Th 7 Bl 7 Hr </td>
<td> ISLAM </td>
<td> D1 </td>
<td> Rizaldi Prakasa, Tn. </td>
<td> SUAMI </td>
<td> JL. DANAU SENTANI UTARA I H3B8 RT. 02/ RW. 12, MADYOPURO,
<td> BPJ </td>
<td> kelas 3 </td>
<td> A01 </td>
<td> 300000 </td>
<td> O03.4 </td>
<td> O03.0 </td>
<td> 2022-07-09 </td>
<td> 12:20:21 </td>
<td> 2022-07-10 </td>
<td> 23:34:26 </td>
<td> IGDK </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>

LPM </td>
<td> - </td>
<td> 600000 </td>
<td> Sehat </td>
<td> 2 </td>
<td> Sudah </td>
</tr>
<tr>
<td> 2022/07/09/000031 </td>
<td> 033127 </td>
<td> QONITA FAIRUZ SYAHIRAH, NY </td>
<td> P </td>
<td> SURABAYA </td>
<td> 1995-09-04 </td>
<td> 26 Th 10 Bl 6 Hr </td>
<td> ISLAM </td>
<td> S1 </td>
<td> GURU </td>
<td> MOHAMAD WAHYU AKBAR, TN </td>
<td> SUAMI </td>
<td> PERUM TIRTASANI ROYAL RESORT CLUSTER RIVER PLACE 7/3,
NGENEP, KARANGPLOSO, KABUPATEN MALANG </td>
<td> A09 </td>
<td> UMUM </td>
<td> kelas 2 </td>
<td> D01 </td>
<td> 400000 </td>
<td> O80.9 </td>
<td> O80.9 </td>
<td> 2022-07-09 </td>
<td> 11:20:30 </td>
<td> 2022-07-11 </td>
<td> 18:46:54 </td>
<td> IGDK </td>
<td> </td>
<td> 2022/07/09/000031, UMUM KLS 2, AYODYA 1A, KONFIRMASI RUANGAN
(-) KTP PASIEN </td>
<td> 2 </td>
<td> 1 </td>
<td> 0 </td>
<td> 0 </td>
<td> 0 </td>
<td> 0 </td>
<td> 40-41 </td>

<td> 3900 </td>
<td> 51 </td>
<td> Hidup </td>
<td> Tidak </td>
<td> Hidup </td>
<td> Ya </td>
<td> Tidak </td>
<td> Ya </td>

Visite Dokter Umum, Infus Dewasa oleh Perawat / Bidan, Konsultasi Dokter Spesialis
Obgyn Via Telepon, Konsultasi Dokter Spesialis Obgyn Via Telepon </td>
<td> - </td>
<td> 1200000 </td>
<td> 3 </td>
<td> Sudah </td>
</tr>
<tr>
<td> 2022/07/09/000096 </td>
<td> 072139 </td>
<td> SILVIANA PRATIWI., BY NY </td>
<td> L </td>
<td> MALANG </td>
<td> 2022-07-09 </td>
<td> 0 Th 0 Bl 27 Hr </td>
<td> ISLAM </td>
<td> - </td>
<td> RAHMADIK FITRIANTO, TN </td>
<td> AYAH </td>
<td> DSN KRAJAN RT 09 RW 02, NGADIREJO, KROMENGAN, KABUPATEN
MALANG </td>
<td> A09 </td>
<td> UMUM </td>
<td> kelas 3 </td>
<td> PF12 </td>
<td> 300000 </td>
<td> P03.4 </td>
<td> P03.4 </td>
<td> 2022-07-09 </td>
<td> 11:07:09 </td>
<td> 2022-07-11 </td>
<td> 10:28:32 </td>
<td> U0030 </td>
<td> </td>
<td> 2022/07/09/000096, BAYI UMUM FISOL </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> 3000 </td>
<td> 47 </td>
<td> Hidup </td>
<td> Tidak </td>
<td> Hidup </td>
<td> Ya </td>
<td> Tidak </td>
<td> Ya </td>

<td> - </td>
<td> 900000 </td>
<td> Sembuh </td>
<td> 3 </td>
<td> Sudah </td>
</tr>
<tr>
<td> 2022/07/09/000032 </td>
<td> 072117 </td>
<td> ALFATH ADNAN GHIFAR, AN </td>
<td> L </td>
<td> BANGILAN </td>
<td> 2022-03-11 </td>
<td> ISLAM </td>
<td> - </td>
<td> LUTHFI ABDUL FATTAH, TN </td>
<td> AYAH </td>
<td> JL. DANAU DIBARUH F1.C5, SAWOJAJAR, KEDUNGKANDANG, KOTA
MALANG </td>
<td> BPJ </td>
<td> kelas 2 </td>
<td> P04 </td>
<td> 400000 </td>
<td> A09 </td>
<td> A09 </td>
<td> 2022-07-09 </td>
<td> 10:43:27 </td>
<td> 2022-07-16 </td>
<td> 10:21:28 </td>
<td> IGDK </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> - </td>
<td> 3200000 </td>
<td> 8 </td>
<td> Sudah </td>
</tr>
<tr>
<td> 2022/07/09/000145 </td>
<td> 060684 </td>
<td> Yunita Rahmawati, Ny. </td>
<td> P </td>
<td> Malang </td>
<td> 1991-06-10 </td>
<td> 31 Th 1 Bl 9 Hr </td>
<td> ISLAM </td>
<td> SMA </td>
<td> Karyawan Swasta </td>
<td> Putra Setia Abriansah, Tn. </td>
<td> SUAMI </td>
<td> JL. SUDIMORO NO. 21 RT. 06/ RW. 06, MOJOLANGU, LOWOKWARU,
KOTA MALANG </td>
<td> BPJ </td>
<td> kelas 3 </td>
<td> A08 </td>
<td> 300000 </td>
<td> O80.8 </td>
<td> O82.9 </td>
<td> 2022-07-09 </td>
<td> 10:39:47 </td>
<td> 2022-07-12 </td>
<td> 17:37:20 </td>
<td> IGDK </td>
<td> </td>
<td> 4 </td>
<td> 2 </td>
<td> 0 </td>
<td> 0 </td>
<td> 0 </td>
<td> 0 </td>
<td> 39-40 </td>

<td> 3400 </td>
<td> 50 </td>
<td> Hidup </td>
<td> Tidak </td>
<td> Hidup </td>
<td> Ya </td>
<td> Tidak </td>
<td> Ya </td>

<td> - </td>
<td> 1200000 </td>
<td> 4 </td>
<td> Sudah </td>
</tr>
<tr>
<td> 2022/07/09/000066 </td>
<td> 072126 </td>
<td> SATRIA BRYNA AHNAF M, AN </td>
<td> L </td>
<td> MALANG </td>
<td> 2014-09-25 </td>
<td> 7 Th 9 Bl 17 Hr </td>
<td> ISLAM </td>
<td> SD </td>
<td> - </td>
<td> ALY MUSTHOFA, TN </td>
<td> SAUDARA </td>
<td> JL KETELA PERUM GRAHA BAHAGIA, BUMIAYU, KEDUNGKANDANG, KOTA
MALANG </td>
<td> A09 </td>
<td> UMUM </td>
<td> kelas 2 </td>
<td> D05 </td>
<td> 400000 </td>
<td> A90 </td>
<td> - </td>
<td> 2022-07-09 </td>
<td> 10:38:39 </td>
<td> 2022-07-10 </td>
<td> 12:47:56 </td>
<td> IGDK </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>

<td> - </td>
<td> 800000 </td>
<td> 2 </td>
<td> Sudah </td>
</tr>
<tr>
<td> 2022/07/09/000083 </td>
<td> 072135 </td>
<td> QONITA FAIRUZ,BY,NY </td>
<td> L </td>
<td> MALANG </td>
<td> 2022-07-09 </td>
<td> ISLAM </td>
<td> - </td>
<td> GURU </td>
<td> MOHAMAD WAHYU AKBAR,TN </td>
<td> AYAH </td>
<td> PERUM TIRTASANI ROYAL RESORT CLUSTER RIVER PLACE RT.7 RW.3,
NGENEP, KARANGPLOSO, KABUPATEN MALANG </td>
<td> BPJ </td>
<td> kelas 3 </td>
<td> PF20 </td>
<td> 300000 </td>
<td> P03.4 </td>
<td> P03.4 </td>
<td> 2022-07-09 </td>
<td> 10:19:53 </td>
<td> </td>
<td> </td>
<td> U0030 </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> 3900 </td>
<td> 51 </td>
<td> Hidup </td>
<td> Tidak </td>
<td> Hidup </td>
<td> Ya </td>
<td> Tidak </td>
<td> Ya </td>

<td> - </td>
<td> 300000 </td>
<td> Sembuh </td>
<td> 1 </td>
<td> Sudah </td>
</tr>
<tr>
<td> 2022/07/09/000036 </td>
<td> 072119 </td>
<td> HANIFAH UZLIFATUL JANNAH, AN </td>
<td> P </td>
<td> MALANG </td>
<td> 2021-07-12 </td>
<td> 0 Th 11 Bl 27 Hr </td>
<td> ISLAM </td>
<td> TS </td>
<td> M. JA`FAR ISMAIL, TN </td>
<td> AYAH </td>
<td> JL. LA SUCIPTO 22A RT 03 RW 10, PANDANWANGI, BLIMBING, KOTA
MALANG </td>
<td> BPJ </td>
<td> kelas 3 </td>
<td> A15 </td>
<td> 300000 </td>
<td> A09 </td>
<td> A09 </td>
<td> 2022-07-09 </td>
<td> 06:49:24 </td>
<td> 2022-07-10 </td>
<td> 23:35:49 </td>
<td> IGDK </td>
<td> </td>
<td> 2022/07/09/000036, BPJS KLS 3, AMARTA 1A KONFIRMASI RUANGAN.
BPJS PBI TIDAK DITANGGUNG SUDAH KONSELING PENGURUSAN 3X24 JAM . BERSEDIA MENJADI
PASIEN UMUM. AYAH PASIEN YG DIKONSELING+ MENDAFTARKAN. TK
14-7-2022 (09:16) SUDAH CETAK SEP AMBIL DEPOSIT

</td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> 600000 </td>
<td> 2 </td>
<td> Sudah </td>
</tr>
<tr>
<td> 2022/07/09/000040 </td>
<td> 072118 </td>
<td> CHOIRIAH, BY.NY. </td>
<td> P </td>
<td> MALANG </td>
<td> 2022-07-08 </td>
<td> ISLAM </td>
<td> - </td>
<td> MUHAMMAD GATA, TN </td>
<td> AYAH </td>
<td> JL. LAKS MARTADINATA VI/18 RT 09 RW 02, KOTALAMA,
<td> BPJ </td>
<td> kelas 3 </td>
<td> PF11 </td>
<td> 300000 </td>
<td> P00.6 </td>
<td> P00.9 </td>
<td> 2022-07-09 </td>
<td> 05:59:19 </td>
<td> 2022-07-11 </td>
<td> 07:28:15 </td>
<td> U0030 </td>
<td> </td>
<td> 2022/07/09/000040, BBL LAHIR TGL 08/07/2022 DAFTAR BAYI TGL
09/07/2022 JAM 06.00 </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> 3435 </td>
<td> 47 </td>
<td> Hidup </td>
<td> Ya </td>
<td> Hidup </td>
<td> Ya </td>
<td> Tidak </td>
<td> Ya </td>

<td> - </td>
<td> 900000 </td>
<td> Sembuh </td>
<td> 3 </td>
<td> Sudah </td>
</tr>
<tr>
<td> 2022/07/09/000143 </td>
<td> 072109 </td>
<td> ZIONATHAN GANENDRA OKTOVIO, AN </td>
<td> L </td>
<td> SEMARANG </td>
<td> 2021-10-21 </td>
<td> 0 Th 9 Bl 14 Hr </td>
<td> ISLAM </td>
<td> SMA </td>
<td> HENDRA PUTRA YOGATAMA, TN </td>
<td> AYAH </td>
<td> JL BALIWINATA IV 17A/22, SEKARPURO, PAKIS, KABUPATEN MALANG
</td>
<td> BPJ </td>
<td> kelas 1 </td>
<td> H10 </td>
<td> 650000 </td>
<td> A09 </td>
<td> A09 </td>
<td> 2022-07-09 </td>
<td> 02:38:32 </td>
<td> 2022-07-11 </td>
<td> 19:52:44 </td>
<td> IGDK </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>

<td> - </td>
<td> 1950000 </td>
<td> Sembuh </td>
<td> 3 </td>
<td> Sudah </td>
</tr>
<tr>
<td> 2022/07/09/000128 </td>
<td> 037666 </td>
<td> LIA APRIANTI, NY </td>
<td> P </td>
<td> Malang </td>
<td> 1991-04-11 </td>
<td> 31 Th 3 Bl 9 Hr </td>
<td> ISLAM </td>
<td> SWASTA </td>
<td> SMA </td>
<td> RIYAN DANA, TN </td>
<td> SUAMI </td>
<td> JL BATU AMARIL, PERUM GRIYA ASRI RT 10 RW 4, PANDANWANGI,
<td> BPJ </td>
<td> kelas 2 </td>
<td> D09 </td>
<td> 400000 </td>
<td> O03.4 </td>
<td> O06.4 </td>
<td> 2022-07-09 </td>
<td> 00:11:49 </td>
<td> 2022-07-10 </td>
<td> 08:30:00 </td>
<td> IGDK </td>
<td> 2022/07/09/000128, BPJS KLS 2, AYODYA 5B </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> Jasa Pelayanan Rumah Sakit , Infus Bayi oleh Perawat /

<td> - </td>
<td> 800000 </td>
<td> Sembuh </td>
<td> 2 </td>
<td> Sudah </td>
</tr>
<tr>
<td> 2022/07/08/000095 </td>
<td> 018028 </td>
<td> Ria Gejora Permata Sari, Ny </td>
<td> P </td>
<td> Malang </td>
<td> 1995-11-14 </td>
<td> 26 Th 8 Bl 12 Hr </td>
<td> ISLAM </td>
<td> SMA </td>
<td> Mochammad Maulana Ishaq, Tn </td>
<td> SUAMI </td>
<td> JL. KH MALIK DALAM RT 2 RW 4, BURING, KEDUNGKANDANG, KOTA
MALANG </td>
<td> BPJ </td>
<td> kelas 2 </td>
<td> D10 </td>
<td> 400000 </td>
<td> O14.9 </td>
<td> - </td>
<td> 2022-07-08 </td>
<td> 22:21:04 </td>
<td> 2022-07-08 </td>
<td> 23:43:56 </td>
<td> IGDK </td>
<td> 2022/07/08/000095, BPJS KELAS2, AYODYA 5A </td>
<td> 5 </td>
<td> 1 </td>
<td> 0 </td>
<td> 0 </td>
<td> 3 </td>
<td> 0 </td>
<td> 37-38 </td>

<td> 2800 </td>
<td> 47 </td>
<td> Hidup </td>
<td> Tidak </td>
<td> Hidup </td>
<td> Ya </td>
<td> Tidak </td>
<td> Ya </td>

<td> - </td>
<td> 400000 </td>
<td> 1 </td>
<td> Sudah </td>
</tr>
<tr>
<td> 2022/07/08/000106 </td>
<td> 067229 </td>
<td> SITI AISYAH, NY </td>
<td> P </td>
<td> MALANG </td>
<td> 1984-04-04 </td>
<td> 38 Th 3 Bl 13 Hr </td>
<td> ISLAM </td>
<td> SMA </td>
<td> SOPIR </td>
<td> ANDY SETIAWAN, TN </td>
<td> SUAMI </td>
<td> JL. GADANG XIIA/65 RT 3 RW 5 , GADANG, SUKUN, KOTA MALANG
</td>
<td> BPJ </td>
<td> kelas 3 </td>
<td> A07 </td>
<td> 300000 </td>
<td> O82.0 </td>
<td> O82.8 </td>
<td> 2022-07-08 </td>
<td> 21:44:14 </td>
<td> 2022-07-11 </td>
<td> 11:44:21 </td>
<td> IGDK </td>
<td> </td>
<td> </td>
<td> 4 </td>
<td> 2 </td>
<td> 0 </td>
<td> 0 </td>
<td> 1 </td>
<td> 0 </td>
<td> 40-41 </td>

<td> 2800 </td>
<td> 48 </td>
<td> Hidup </td>
<td> Tidak </td>
<td> Hidup </td>
<td> Ya </td>
<td> Tidak </td>
<td> Ya </td>

Bidan, Infus Dewasa oleh Perawat / Bidan, Operasional Rumah Sakit </td>
<td> - </td>
<td> 900000 </td>
<td> Sehat </td>
<td> 3 </td>
<td> Sudah </td>
</tr>
<tr>
<td> 2022/07/08/000149 </td>
<td> 072114 </td>
<td> RIA GEJORA, BY NY </td>
<td> L </td>
<td> MALANG </td>
<td> 2022-07-08 </td>
<td> ISLAM </td>
<td> TS </td>
<td> M. MAULANA ISHAQ, TN </td>
<td> AYAH </td>
<td> JL. KH MALIK DALAM RT 2 RW 4, BURING, KEDUNGKANDANG, KOTA
MALANG </td>
<td> BPJ </td>
<td> kelas 3 </td>
<td> PF10 </td>
<td> 300000 </td>
<td> P03.4 </td>
<td> P03.4 </td>
<td> 2022-07-08 </td>
<td> 20:46:21 </td>
<td> 2022-07-11 </td>
<td> 07:28:02 </td>
<td> U0030 </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> 2800 </td>
<td> 47 </td>
<td> Hidup </td>
<td> Tidak </td>
<td> Hidup </td>
<td> Ya </td>
<td> Tidak </td>
<td> Ya </td>

<td> - </td>
<td> 1200000 </td>
<td> Sembuh </td>
<td> 4 </td>
<td> Sudah </td>
</tr>
<tr>
<td> 2022/07/08/000142 </td>
<td> 078032 </td>
<td> Alifa Naufalyn Fikria Rabbani, An </td>
<td> P </td>
<td> Malang </td>
<td> 2016-07-26 </td>
<td> 5 Th 11 Bl 19 Hr </td>
<td> ISLAM </td>
<td> TS </td>
<td> Hidayat, Tn </td>
<td> AYAH </td>
<td> JL. ABDILLAH 4/ 212B RT. 02/ RW. 02, TIRTOMOYO, PAKIS,
<td> BPJ </td>
<td> kelas 1 </td>
<td> P02 </td>
<td> 650000 </td>
<td> A09 </td>
<td> A09 </td>
<td> 2022-07-08 </td>
<td> 20:05:28 </td>
<td> 2022-07-12 </td>
<td> 22:01:17 </td>
<td> IGDK </td>
<td> 2022/07/08/000142, BPJS KELAS 2 UP 1, PANDAWA 2 </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> - </td>
<td> 3250000 </td>
<td> 5 </td>
<td> Sudah </td>
</tr>
<tr>
<td> 2022/07/08/000137 </td>
<td> 072112 </td>
<td> INDAH PURWANTI, NY </td>
<td> P </td>
<td> GRESIK </td>
<td> 1995-03-04 </td>
<td> 27 Th 4 Bl 14 Hr </td>
<td> ISLAM </td>
<td> SMA </td>
<td> PUGUH WIDIANTORO, TN </td>
<td> SUAMI </td>
<td> JL LA SUCIPTO NO 24, PANDANWANGI, BLIMBING, KOTA MALANG
</td>
<td> BPJ </td>
<td> kelas 3 </td>
<td> A06 </td>
<td> 300000 </td>
<td> O36.4 </td>
<td> O80.8 </td>
<td> 2022-07-08 </td>
<td> 19:45:04 </td>
<td> 2022-07-09 </td>
<td> 11:57:21 </td>
<td> IGDK </td>
<td> 2022/07/08/000137, BPJS KELAS 3, AMARTA 5D (BPJS PREMI)
</td>
<td> 2 </td>
<td> 1 </td>
<td> 0 </td>
<td> 0 </td>
<td> 0 </td>
<td> 0 </td>
<td> 24-26 </td>

<td> 400 </td>
<td> 20 </td>
<td> Mati </td>
<td> Tidak </td>
<td> Baik </td>
<td> Tidak </td>
<td> Tidak </td>
<td> Tidak </td>

<td> - </td>
<td> 600000 </td>
<td> Sehat </td>
<td> 2 </td>
<td> Sudah </td>
</tr>
<tr>
<td> 2022/07/08/000056 </td>
<td> 070186 </td>
<td> IRMA AGRICA WARDHANI, NY </td>
<td> P </td>
<td> 1988-03-24 </td>
<td> 34 Th 3 Bl 14 Hr </td>
<td> ISLAM </td>
<td> S1 </td>
<td> ABDUL AZIS, TN </td>
<td> SUAMI </td>
<td> JL WISNU WARDHANA NO 35 RT 24 RW 1, SEKARPURO, PAKIS,
<td> BPJ </td>
<td> kelas 3 </td>
<td> A04 </td>
<td> 300000 </td>
<td> O36.4 </td>
<td> O36.4 </td>
<td> 2022-07-08 </td>
<td> 14:28:46 </td>
<td> 2022-07-09 </td>
<td> 11:52:58 </td>
<td> IGDK </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>

<td> - </td>
<td> 600000 </td>
<td> Sehat </td>
<td> 2 </td>
<td> Sudah </td>
</tr>
<tr>
<td> 2022/07/08/000150 </td>
<td> 102831 </td>
<td> SILVIANA PRATIWI, NY </td>
<td> P </td>
<td> JAKARTA </td>
<td> 1984-10-27 </td>
<td> 37 Th 8 Bl 12 Hr </td>
<td> ISLAM </td>
<td> D3 </td>
<td> RAHMADIK FITRIANTO, TN </td>
<td> SUAMI </td>
<td> DSN. KRAJAN RT09 RW02, NGADIREJO, KROMENGAN, KABUPATEN
MALANG </td>
<td> A09 </td>
<td> UMUM </td>
<td> kelas 2 </td>
<td> D09 </td>
<td> 400000 </td>
<td> O42.9 </td>
<td> O42.9 </td>
<td> 2022-07-08 </td>
<td> 11:20:50 </td>
<td> 2022-07-11 </td>
<td> 16:23:19 </td>
<td> IGDK </td>
<td> </td>
<td> 2022/07/08/000150, UMUM KLS 2, AYODYA 6B KONFIRMASI RUANGAN
</td>
<td> 4 </td>
<td> 2 </td>
<td> 0 </td>
<td> 0 </td>
<td> 1 </td>
<td> 0 </td>
<td> 38-39 </td>

<td> 3900 </td>
<td> 3000 </td>
<td> Hidup </td>
<td> Tidak </td>
<td> Hidup </td>
<td> Ya </td>
<td> Tidak </td>
<td> Ya </td>

Visite Dokter Umum, Konsultasi Dokter Spesialis Obgyn Via Telepon, Infus Bayi oleh
<td> - </td>
<td> 1600000 </td>
<td> 4 </td>
<td> Sudah </td>
</tr>
<tr>
<td> 2022/07/08/000154 </td>
<td> 068284 </td>
<td> RAFADHAN ZHAFFARIZQI AMINULLAH, AN </td>
<td> L </td>
<td> MALANG </td>
<td> 2021-10-06 </td>
<td> 0 Th 9 Bl 11 Hr </td>
<td> ISLAM </td>
<td> TS </td>
<td> SAIFUD AMIN, TN </td>
<td> AYAH </td>
<td> JL LA SUCIPTO PANDANAWANGI GANG MAKAM NO 450CRT 2 RW 4,
PANDANWANGI, BLIMBING, KOTA MALANG </td>
<td> BPJ </td>
<td> kelas 3 </td>
<td> D07 </td>
<td> 300000 </td>
<td> J20.9 </td>
<td> J18.0 </td>
<td> 2022-07-08 </td>
<td> 01:48:26 </td>
<td> 2022-07-13 </td>
<td> 10:57:45 </td>
<td> IGDK </td>
<td> </td>
<td> 2022/07/08/000154, BPJS KLS 3, TITIP AYODYA 4B KONFIRMASI
RUANGAN. (+) KONFIRMASI AMARTA . BPJS NON AKTIF KARENA PREMI SUDAH KONSELING 3X24
JAM . BERSEDIA MENJADI PASIEN UMUM. YG DIKONSELING DAN YG MENDAFTARKAN KAKEKNYA. TK
</td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> Visite Dokter Spesialis Anak, Jasa Pelayanan Rumah Sakit ,

Oksigen 100% Sentral 2 LPM, Oksigen 100% Sentral 2 LPM, Nebulizer , Nebulizer ,
Nebulizer , Nebulizer , Nebulizer , Nebulizer , Nebulizer , Konsultasi Dokter
Spesialis Anak Via Telepon, Operasional Rumah Sakit , Visite Dokter Spesialis Anak
</td>
<td> </td>
<td> 1800000 </td>
<td> Sembuh </td>
<td> 6 </td>
<td> Sudah </td>
</tr>
<tr>
<td> 2022/07/08/000152 </td>
<td> 049869 </td>
<td> CHOIRIAH, NY </td>
<td> P </td>
<td> MALANG </td>
<td> 1998-06-13 </td>
<td> 24 Th 0 Bl 26 Hr </td>
<td> ISLAM </td>
<td> MUHAMMAD GATA, TN </td>
<td> SUAMI </td>
<td> JL. LAKS MARTADINATA VI/18 RT09 RW02, KOTALAMA,
<td> BPJ </td>
<td> kelas 3 </td>
<td> A08 </td>
<td> 300000 </td>
<td> O63.1 </td>
<td> O80.8 </td>
<td> 2022-07-08 </td>
<td> 01:11:45 </td>
<td> 2022-07-10 </td>
<td> 10:38:36 </td>
<td> IGDK </td>
<td> 2022/07/08/000152, BPJS KLS 3, AMARTA 6B </td>
<td> 2 </td>
<td> 1 </td>
<td> 0 </td>
<td> 0 </td>
<td> 0 </td>
<td> 0 </td>
<td> 40-41 </td>

<td> 3435 </td>
<td> 47 </td>
<td> Hidup </td>
<td> Ya </td>
<td> Hidup </td>
<td> Ya </td>
<td> Tidak </td>
<td> Ya </td>

<td> - </td>
<td> 900000 </td>
<td> Sembuh </td>
<td> 3 </td>
<td> Sudah </td>
</tr>
<tr>
<td> 2022/07/08/000151 </td>
<td> 028645 </td>
<td> MUHAMMAD HANIF RABBANI,AN </td>
<td> L </td>
<td> MALANG </td>
<td> 2019-12-02 </td>
<td> 2 Th 7 Bl 12 Hr </td>
<td> ISLAM </td>
<td> - </td>
<td> TS </td>
<td> SWASTA </td>
<td> DWI ANGGA SSAPUTRA, TN </td>
<td> AYAH </td>
<td> JL PALMERAH XX BLOK V NO 10 RT 4 RW 8, CEMOROKANDANG,
<td> BPJ </td>
<td> kelas 3 </td>
<td> A16 </td>
<td> 300000 </td>
<td> R50.9 </td>
<td> A91 </td>
<td> 2022-07-08 </td>
<td> 00:53:23 </td>
<td> 2022-07-12 </td>
<td> 11:48:48 </td>
<td> IGDK </td>
<td> 2022/07/08/000151, BPJS KLS 3, AMARTA 7A </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>

<td> - </td>
<td> 1500000 </td>
<td> Sembuh </td>
<td> 5 </td>
<td> Sudah </td>
</tr>
<tr>
<td> 2022/07/07/000189 </td>
<td> 072098 </td>
<td> RIRIN WIDAYATI, Ny </td>
<td> P </td>
<td> PASURUAN </td>
<td> 1987-06-06 </td>
<td> 35 Th 1 Bl 2 Hr </td>
<td> HINDU </td>
<td> SD </td>
<td> RIANTO, Tn </td>
<td> SUAMI </td>
<td> DSN KALITEJO RT 05 RW 02, KANDANGAN, TOSARI, PASURUAN KAB
</td>
<td> A09 </td>
<td> UMUM </td>
<td> kelas 3 </td>
<td> A07 </td>
<td> 300000 </td>
<td> O80.0 </td>
<td> O82.8 </td>
<td> 2022-07-07 </td>
<td> 23:39:32 </td>
<td> 2022-07-09 </td>
<td> 16:23:18 </td>
<td> IGDK </td>
<td> BIDAN NUR JOKO </td>
<td> 2022/07/07/000189 UMUM KELAS 3 PAHE BD NUR JOKO DI AMARTA
6A </td>
<td> 2 </td>
<td> 0 </td>
<td> 1 </td>
<td> 0 </td>
<td> 0 </td>
<td> 0 </td>
<td> 39-40 </td>

<td> 2650 </td>
<td> 45 </td>
<td> Hidup </td>
<td> Tidak </td>
<td> Hidup </td>
<td> Ya </td>
<td> Tidak </td>
<td> Ya </td>
<td> Operasional Rumah Sakit , Visite Dokter Umum, Infus Dewasa

oleh Perawat / Bidan, Jasa Pelayanan Kelas 3 </td>
<td> - </td>
<td> 600000 </td>
<td> 2 </td>
<td> Sudah </td>
</tr>
<tr>
<td> 2022/07/07/000191 </td>
<td> 072100 </td>
<td> RIRIN WIDAYATI,By.Ny </td>
<td> L </td>
<td> Malang </td>
<td> 2022-07-07 </td>
<td> HINDU </td>
<td> - </td>
<td> RIANTO, Tn </td>
<td> AYAH </td>
<td> DSN KALITEJO RT 05 RW 02, KANDANGAN, TUTUR, PASURUAN KAB
</td>
<td> A09 </td>
<td> UMUM </td>
<td> kelas 3 </td>
<td> PF02 </td>
<td> 300000 </td>
<td> P03.4 </td>
<td> P03.4 </td>
<td> 2022-07-07 </td>
<td> 22:55:22 </td>
<td> 2022-07-11 </td>
<td> 07:30:13 </td>
<td> U0030 </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> 2650 </td>
<td> 45 </td>
<td> Hidup </td>
<td> Tidak </td>
<td> Hidup </td>
<td> Ya </td>
<td> Tidak </td>
<td> Ya </td>

<td> </td>
<td> 1200000 </td>
<td> Sembuh </td>
<td> 4 </td>
<td> Sudah </td>
</tr>
<tr>
<td> 2022/07/07/000127 </td>
<td> 044284 </td>
<td> MUHAMMAD ISAAC JOVIC PRAHARJO, AN </td>
<td> L </td>
<td> Malang </td>
<td> 2020-11-11 </td>
<td> 1 Th 7 Bl 29 Hr </td>
<td> ISLAM </td>
<td> - </td>
<td> - </td>
<td> SWASTA </td>
<td> MOHAMMAD ROY, TN </td>
<td> AYAH </td>
<td> JL DANAU TEMPE III/ F3 D-7 RT 10 RW 12, SAWOJAJAR,
<td> BPJ </td>
<td> kelas 1 </td>
<td> H08 </td>
<td> 650000 </td>
<td> A90 </td>
<td> A90 </td>
<td> 2022-07-07 </td>
<td> 22:48:24 </td>
<td> 2022-07-10 </td>
<td> 11:57:24 </td>
<td> IGDK </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> - </td>
<td> 1950000 </td>
<td> 3 </td>
<td> Sudah </td>
</tr>
<tr>
<td> 2022/07/07/000170 </td>
<td> 071965 </td>
<td> NAZIA FARYAL NANEZZA,AN </td>
<td> P </td>
<td> HST </td>
<td> 2021-11-23 </td>
<td> 0 Th 7 Bl 19 Hr </td>
<td> ISLAM </td>
<td> - </td>
<td> NESFI KETLIN,NY </td>
<td> IBU </td>
<td> JL.BRIGJEND H.HASAN BASERI RT.01 RW.01 , BARABAI BARAT,
BARABAI, HULU SUNGAI TENGAH </td>
<td> BPJ </td>
<td> kelas 1 </td>
<td> H05 </td>
<td> 650000 </td>
<td> A08.0 </td>
<td> A08.0 </td>
<td> 2022-07-07 </td>
<td> 22:48:07 </td>
<td> 2022-07-10 </td>
<td> 12:06:48 </td>
<td> IGDK </td>
<td> 2022/07/07/000170, BPJS KLS 1. TITIP AYODYA 2A KONFIRMASI
RUANGAN. RENCANA HASTINA MENYUSUL </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> - </td>
<td> 1950000 </td>
<td> Sehat </td>
<td> 3 </td>
<td> Sudah </td>
</tr>
<tr>
<td> 2022/07/07/000125 </td>
<td> 038241 </td>
<td> RAZKA SAGHARA ADITYA, AN </td>
<td> L </td>
<td> Malang </td>
<td> 2020-06-13 </td>
<td> 2 Th 0 Bl 29 Hr </td>
<td> ISLAM </td>
<td> TS </td>
<td> ADITYA PUTRA PERDANA, TN </td>
<td> AYAH </td>
<td> JL. RANUGRATI NO.36 RT.2 RW.1, SAWOJAJAR, KEDUNGKANDANG,
KOTA MALANG </td>
<td> BPJ </td>
<td> kelas 1 </td>
<td> P01 </td>
<td> 650000 </td>
<td> A09 </td>
<td> A09 </td>
<td> 2022-07-07 </td>
<td> 22:47:26 </td>
<td> 2022-07-10 </td>
<td> 11:55:47 </td>
<td> IGDK </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>

Sakit </td>
<td> - </td>
<td> 1950000 </td>
<td> 3 </td>
<td> Sudah </td>
</tr>
<tr>
<td> 2022/07/07/000162 </td>
<td> 049764 </td>
<td> DEWI ZAHROÙL AFIATI, NY </td>
<td> P </td>
<td> Malang </td>
<td> 1995-10-16 </td>
<td> 26 Th 8 Bl 27 Hr </td>
<td> ISLAM </td>
<td> GURU </td>
<td> S1 </td>
<td> GURU </td>
<td> ABDUL ROÙF, TN </td>
<td> SUAMI </td>
<td> DUSUN PANCURAN RT.21 RW.09, KARANGANYAR, PONCOKUSUMO,
<td> BPJ </td>
<td> kelas 3 </td>
<td> A04 </td>
<td> 300000 </td>
<td> O03.4 </td>
<td> O03.4 </td>
<td> 2022-07-07 </td>
<td> 21:19:00 </td>
<td> 2022-07-08 </td>
<td> 10:17:22 </td>
<td> IGDK </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>

<td> - </td>
<td> 300000 </td>
<td> 1 </td>
<td> Sudah </td>
</tr>
<tr>
<td> 2022/07/07/000148 </td>
<td> 072092 </td>
<td> GIBRAN NAUFAL RIZAL, AN </td>
<td> L </td>
<td> MALANG </td>
<td> 2021-04-04 </td>
<td> ISLAM </td>
<td> TS </td>
<td> JANUAR ARIF, TN </td>
<td> AYAH </td>
<td> BUNUT WETAN RT 3 RW 4, BUNUT WETAN, PAKIS, KABUPATEN MALANG
</td>
<td> A09 </td>
<td> UMUM </td>
<td> kelas 3 </td>
<td> A02 </td>
<td> 300000 </td>
<td> A09 </td>
<td> A90 </td>
<td> 2022-07-07 </td>
<td> 19:22:55 </td>
<td> 2022-07-09 </td>
<td> 20:07:38 </td>
<td> IGDK </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>

Visite Dokter Spesialis Anak, Jasa Pelayanan Kelas 3 </td>
<td> - </td>
<td> 900000 </td>
<td> APS </td>
<td> 3 </td>
<td> Sudah </td>
</tr>
<tr>
<td> 2022/07/07/000138 </td>
<td> 003826 </td>
<td> DYAH AYU GALUH CANDRAKIRANA, NY </td>
<td> P </td>
<td> 1987-09-16 </td>
<td> 34 Th 9 Bl 25 Hr </td>
<td> ISLAM </td>
<td> SMA </td>
<td> SUAMI </td>
KOTA MALANG </td>
<td> BPJ </td>
<td> kelas 2 </td>
<td> D11 </td>
<td> 400000 </td>
<td> O82.0 </td>
<td> - </td>
<td> 2022-07-07 </td>
<td> 18:40:21 </td>
<td> 2022-07-09 </td>
<td> 19:09:39 </td>
<td> IGDK </td>
<td> 2022/07/07/000138, BPJS KLS 2, TITIP AMARTA 6C, DWARAWATI
MENYUSUL </td>
<td> 2 </td>
<td> 1 </td>
<td> 0 </td>
<td> 0 </td>
<td> 0 </td>
<td> 0 </td>
<td> 38-39 </td>

<td> 2800 </td>
<td> 45 </td>
<td> Hidup </td>
<td> Ya </td>
<td> Hidup </td>
<td> Ya </td>
<td> Tidak </td>
<td> Ya </td>
<td> </td>
<td> - </td>
<td> 1200000 </td>
<td> 3 </td>
<td> Sudah </td>
</tr>
<tr>
<td> 2022/07/07/000164 </td>
<td> 072096 </td>
<td> MARYAM INNARA KHAYR, AN </td>
<td> P </td>
<td> MALANG </td>
<td> 2022-07-07 </td>
<td> 0 Th 0 Bl 17 Hr </td>
<td> ISLAM </td>
<td> TS </td>
<td> AYAH </td>
KOTA MALANG </td>
<td> BPJ </td>
<td> kelas 3 </td>
<td> PF18 </td>
<td> 300000 </td>
<td> P03.4 </td>
<td> P03.4 </td>
<td> 2022-07-07 </td>
<td> 17:32:49 </td>
<td> 2022-07-11 </td>
<td> 07:28:26 </td>
<td> U0030 </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> 2750 </td>
<td> 47 </td>
<td> Hidup </td>
<td> Tidak </td>
<td> Hidup </td>
<td> Ya </td>
<td> Tidak </td>
<td> Ya </td>

<td> - </td>
<td> 1500000 </td>
<td> Sembuh </td>
<td> 5 </td>
<td> Sudah </td>
</tr>
<tr>
<td> 2022/07/07/000158 </td>
<td> 072095 </td>
<td> ZIYAN NIZAMI JAYA, AN </td>
<td> L </td>
<td> MALANG </td>
<td> 2022-07-07 </td>
<td> 0 Th 0 Bl 10 Hr </td>
<td> ISLAM </td>
<td> TS </td>
<td> DOSEN </td>
<td> FIRMAN JAYA, TN </td>
<td> AYAH </td>
KOTA MALANG </td>
<td> BPJ </td>
<td> kelas 3 </td>
<td> PF16 </td>
<td> 300000 </td>
<td> P00.6 </td>
<td> P00.9 </td>
<td> 2022-07-07 </td>
<td> 16:54:58 </td>
<td> 2022-07-08 </td>
<td> 19:29:26 </td>
<td> U0030 </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> 3065 </td>
<td> 49 </td>
<td> Hidup </td>
<td> Ya </td>
<td> Hidup </td>
<td> Ya </td>
<td> Tidak </td>
<td> Ya </td>

<td> </td>
<td> 600000 </td>
<td> Sembuh </td>
<td> 2 </td>
<td> Sudah </td>
</tr>
<tr>
<td> 2022/07/07/000136 </td>
<td> 066275 </td>
<td> Riski Kusmayanti, Ny </td>
<td> P </td>
<td> MALANG </td>
<td> 1988-02-01 </td>
<td> 34 Th 5 Bl 14 Hr </td>
<td> ISLAM </td>
<td> S1 </td>
<td> - </td>
<td> Didik Purwanto, Tn </td>
<td> SAUDARA </td>
<td> Candirenggo Singosari Rt 04 Rw 13, CANDIRENGGO, SINGOSARI,
<td> BPJ </td>
<td> kelas 1 </td>
<td> H10 </td>
<td> 650000 </td>
<td> O82.0 </td>
<td> O82.0 </td>
<td> 2022-07-07 </td>
<td> 16:14:45 </td>
<td> 2022-07-09 </td>
<td> 16:30:01 </td>
<td> IGDK </td>
<td> </td>
<td> </td>
<td> 3 </td>
<td> 1 </td>
<td> 0 </td>
<td> 1 </td>
<td> 0 </td>
<td> 0 </td>
<td> 37-38 </td>
<td> 2600 </td>
<td> 46 </td>
<td> Hidup </td>
<td> Tidak </td>
<td> Hidup </td>
<td> Ya </td>
<td> Tidak </td>
<td> Ya </td>
<td> </td>
<td> - </td>
<td> 1950000 </td>
<td> 3 </td>
<td> Sudah </td>
</tr>
<tr>
<td> 2022/07/07/000128 </td>
<td> 091553 </td>
<td> SILVIATAS SHOFFI, NY </td>
<td> P </td>
<td> 1994-12-31 </td>
<td> 27 Th 6 Bl 16 Hr </td>
<td> ISLAM </td>
<td> BIDAN </td>
<td> D3 </td>
<td> FIRMAN JATI, TN </td>
<td> SUAMI </td>
<td> JL. PERMATA HIJAU E86 RT 4 RW 9, TLOGOMAS, LOWOKWARU, KOTA
MALANG </td>
<td> BPJ </td>
<td> kelas 2 </td>
<td> D09 </td>
<td> 400000 </td>
<td> N70.0 </td>
<td> - </td>
<td> 2022-07-07 </td>
<td> 16:14:17 </td>
<td> 2022-07-08 </td>
<td> 15:19:26 </td>
<td> IGDK </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> Jasa Pelayanan Rumah Sakit, Infus Dewasa Oleh Dokter Umum ,
Visite Dokter Umum </td>
<td> - </td>
<td> 800000 </td>
<td> Sehat </td>
<td> 2 </td>
<td> Sudah </td>
</tr>
<tr>
<td> 2022/07/07/000139 </td>
<td> 054724 </td>
<td> HARDIANA DWI ANDINI, Ny </td>
<td> P </td>
<td> PASURUAN </td>
<td> 2002-08-07 </td>
<td> 19 Th 11 Bl 0 Hr </td>
<td> ISLAM </td>
<td> SMP </td>
<td> DEDIK SETIAWAN, Tn </td>
<td> SUAMI </td>
<td> DSN. GEMBOYO RT 01 RW 01 , MOROREJO, TOSARI, PASURUAN KAB
</td>
<td> A09 </td>
<td> UMUM </td>
<td> kelas 2 </td>
<td> A09 </td>
<td> 400000 </td>
<td> O34.2 </td>
<td> O82.8 </td>
<td> 2022-07-07 </td>
<td> 16:14:01 </td>
<td> 2022-07-09 </td>
<td> 16:23:31 </td>
<td> IGDK </td>
<td> 2022/07/07/000139, UMUM PAHE RUJUKAN BIDAN NUR JOKO DI
AMARTA 5B </td>
<td> 2 </td>
<td> 0 </td>
<td> 0 </td>
<td> 0 </td>
<td> 1 </td>
<td> 0 </td>
<td> 38-39 </td>

<td> 2600 </td>
<td> 46 </td>
<td> Hidup </td>
<td> Ya </td>
<td> Baik </td>
<td> Ya </td>
<td> Tidak </td>
<td> Ya </td>
<td> Operasional Rumah Sakit , Visite Dokter Umum, VT Dokter ,

Jasa Pelayanan Kelas 3 </td>
<td> - </td>
<td> 1200000 </td>
<td> 3 </td>
<td> Sudah </td>
</tr>
<tr>
<td> 2022/07/07/000147 </td>
<td> 072091 </td>
<td> HARDIANA DWI, BY.NY. </td>
<td> P </td>
<td> MALANG </td>
<td> 2022-07-07 </td>
<td> ISLAM </td>
<td> TS </td>
<td> DEDIK SETIAWAN, TN </td>
<td> AYAH </td>
<td> DSN GEMBOYO RT 01 RW 01, MOROREJO, TOSARI, PASURUAN KAB
</td>
<td> A09 </td>
<td> UMUM </td>
<td> PA05 </td>
<td> NICU 5 </td>
<td> 400000 </td>
<td> P03.4 </td>
<td> P39.9 </td>
<td> 2022-07-07 </td>
<td> 14:48:21 </td>
<td> 2022-07-09 </td>
<td> 15:25:04 </td>
<td> U0029 </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> Perawatan Bayi SC , Visite Dokter Spesialis Anak, Visite

Dokter Spesialis Anak, Infus Anak oleh Perawat / Bidan </td>
<td> - </td>
<td> 1200000 </td>
<td> Sembuh </td>
<td> 3 </td>
<td> Sudah </td>
</tr>
<tr>
<td> 2022/07/07/000146 </td>
<td> 072090 </td>
<td> RAKA ARZANKA RIZKY PURWANTO, AN </td>
<td> L </td>
<td> MALANG </td>
<td> 2022-07-07 </td>
<td> 0 Th 0 Bl 17 Hr </td>
<td> ISLAM </td>
<td> TS </td>
<td> - </td>
<td> DIDIK PURWANTO, TN </td>
<td> AYAH </td>
<td> CANDIRENGGO SINGOSARI RT 04 RW 13, CANDIRENGGO, SINGOSARI,
<td> BPJ </td>
<td> kelas 3 </td>
<td> PF01 </td>
<td> 300000 </td>
<td> P03.4 </td>
<td> P03.4 </td>
<td> 2022-07-07 </td>
<td> 14:34:36 </td>
<td> 2022-07-11 </td>
<td> 07:27:41 </td>
<td> U0030 </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> 2750 </td>
<td> 47 </td>
<td> Hidup </td>
<td> Tidak </td>
<td> Hidup </td>
<td> Ya </td>
<td> Tidak </td>
<td> Ya </td>

<td> </td>
<td> 1500000 </td>
<td> Sembuh </td>
<td> 5 </td>
<td> Sudah </td>
</tr>
<tr>
<td> 2022/07/07/000140 </td>
<td> 072087 </td>
<td> ZIYA ALLINSQY PUTRI HAREFA, AN </td>
<td> P </td>
<td> MALANG </td>
<td> 2022-07-06 </td>
<td> 0 Th 0 Bl 30 Hr </td>
<td> ISLAM </td>
<td> TS </td>
<td> IMMANUEL HAREFA, TN </td>
<td> AYAH </td>
<td> BANDULAN BARU 144 RT 002 RW 005, BANDULAN, SUKUN, KOTA
MALANG </td>
<td> BPJ </td>
<td> kelas 3 </td>
<td> PF09 </td>
<td> 300000 </td>
<td> P00.6 </td>
<td> P00.9 </td>
<td> 2022-07-07 </td>
<td> 13:08:09 </td>
<td> 2022-07-08 </td>
<td> 19:32:43 </td>
<td> U0030 </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> 3290 </td>
<td> 49 </td>
<td> Hidup </td>
<td> Ya </td>
<td> Hidup </td>
<td> Ya </td>
<td> Tidak </td>
<td> Ya </td>

<td> - </td>
<td> 600000 </td>
<td> Sembuh </td>
<td> 2 </td>
<td> Sudah </td>
</tr>
<tr>
<td> 2022/07/07/000104 </td>
<td> 071700 </td>
<td> ARKHA ARDIANSYIAH, AN </td>
<td> L </td>
<td> MALANG </td>
<td> 2022-06-30 </td>
<td> 0 Th 0 Bl 15 Hr </td>
<td> ISLAM </td>
<td> TS </td>
<td> MISDI, TN </td>
<td> AYAH </td>
<td> JL. SAMPURNO RT 02 RW 02, CEMOROKANDANG, KEDUNGKANDANG, KOTA
MALANG </td>
<td> BPJ </td>
<td> PA29 </td>
<td> 400000 </td>
<td> P59.9 </td>
<td> P59.9 </td>
<td> 2022-07-07 </td>
<td> 12:16:14 </td>
<td> 2022-07-10 </td>
<td> 12:35:40 </td>
<td> U0002 </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>

Visite Dokter Spesialis Anak, Sewa Inkubator, Sewa Inkubator, Sewa Fototerapi,
Operasional Rumah Sakit , Sewa Fototerapi, Jasa Pelayanan Kelas 3 </td>
<td> - </td>
<td> 1600000 </td>
<td> Sembuh </td>
<td> 4 </td>
<td> Sudah </td>
</tr>
<tr>
<td> 2022/07/07/000081 </td>
<td> 072075 </td>
<td> BRISHIA ORLY NAVIDA,AN </td>
<td> P </td>
<td> MALANG </td>
<td> 2022-07-07 </td>
<td> 0 Th 0 Bl 11 Hr </td>
<td> KRISTEN </td>
<td> TS </td>
<td> VIKI SETYAWAN,TN </td>
<td> AYAH </td>
<td> JL. ARGOPURO 40A RT.001 RW.012, KALIREJO, LAWANG, KABUPATEN
MALANG </td>
<td> BPJ </td>
<td> kelas 3 </td>
<td> PF08 </td>
<td> 300000 </td>
<td> P00.6 </td>
<td> P00.9 </td>
<td> 2022-07-07 </td>
<td> 07:29:15 </td>
<td> 2022-07-08 </td>
<td> 08:11:42 </td>
<td> U0030 </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> 3025 </td>
<td> 48 </td>
<td> Hidup </td>
<td> Ya </td>
<td> Hidup </td>
<td> Ya </td>
<td> Tidak </td>
<td> Ya </td>

<td> - </td>
<td> 600000 </td>
<td> Sembuh </td>
<td> 2 </td>
<td> Sudah </td>
</tr>
<tr>
<td> 2022/07/07/000061 </td>
<td> 063695 </td>
<td> INDRIANI RESPATI PUTRI, NY </td>
<td> P </td>
<td> MALANG </td>
<td> 1980-05-31 </td>
<td> 42 Th 1 Bl 17 Hr </td>
<td> ISLAM </td>
<td> S1 </td>
<td> BEJO HERI UTOMO, TN </td>
<td> SUAMI </td>
<td> JL BANDARA JUANDA 2 BB 21 RT 1 RW 7, CEMOROKANDANG,
<td> BPJ </td>
<td> kelas 1 </td>
<td> P06 </td>
<td> 650000 </td>
<td> O82.0 </td>
<td> O82.9 </td>
<td> 2022-07-07 </td>
<td> 06:45:26 </td>
<td> 2022-07-09 </td>
<td> 14:56:58 </td>
<td> IGDK </td>
<td> 2022/07/07/000061, BPJS KELAS 2 UP 1 RUANG PANDAWA 6 </td>
<td> 4 </td>
<td> 2 </td>
<td> 0 </td>
<td> 0 </td>
<td> 1 </td>
<td> 0 </td>
<td> 38-39 </td>

<td> 3100 </td>
<td> 48 </td>
<td> Hidup </td>
<td> Tidak </td>
<td> Hidup </td>
<td> Ya </td>
<td> Tidak </td>
<td> Ya </td>
<td> Infus Dewasa Oleh Dokter Umum </td>

<td> - </td>
<td> 1950000 </td>
<td> 3 </td>
<td> Sudah </td>
</tr>
<tr>
<td> 2022/07/06/000115 </td>
<td> 103540 </td>
<td> Eni Farida, Ny </td>
<td> P </td>
<td> Malang </td>
<td> 1985-07-16 </td>
<td> 37 Th 0 Bl 2 Hr </td>
<td> ISLAM </td>
<td> SMA </td>
<td> Andi Candra Susilo, Tn </td>
<td> SUAMI </td>
<td> JL. PERMADI 2A RT 9 RW 4, POLEHAN, BLIMBING, KOTA MALANG
</td>
<td> BPJ </td>
<td> kelas 2 </td>
<td> D01 </td>
<td> 400000 </td>
<td> O82.0 </td>
<td> O82.0 </td>
<td> 2022-07-07 </td>
<td> 06:44:56 </td>
<td> 2022-07-09 </td>
<td> 13:43:45 </td>
<td> IGDK </td>
<td> 2022/07/06/000115, BPJS KELAS 2 RUANG AYODYA 1B ( KONFIRMASI
) </td>
<td> 2 </td>
<td> 1 </td>
<td> 0 </td>
<td> 0 </td>
<td> 0 </td>
<td> 0 </td>
<td> 37-38 </td>

<td> 3100 </td>
<td> 48 </td>
<td> Hidup </td>
<td> Ya </td>
<td> Baik </td>
<td> Ya </td>
<td> Tidak </td>
<td> Ya </td>
<td> Jasa Pelayanan Rumah Sakit , Visite Dokter Spesialis Bedah,

Sakit </td>
<td> </td>
<td> 1200000 </td>
<td> 3 </td>
<td> Sudah </td>
</tr>
<tr>
<td> 2022/07/07/000067 </td>
<td> 072074 </td>
<td> MAULANA AHMAD AL AYYUBI, AN </td>
<td> L </td>
<td> MALANG </td>
<td> 2022-07-07 </td>
<td> ISLAM </td>
<td> TS </td>
<td> HENRI SETIAWAN, TN </td>
<td> AYAH </td>
<td> JL. SEMBILANG III/28 RT 03 RW 01, POLOWIJEN, BLIMBING, KOTA
MALANG </td>
<td> BPJ </td>
<td> PA04 </td>
<td> NICU 4 </td>
<td> 400000 </td>
<td> P03.4 </td>
<td> P39.9 </td>
<td> 2022-07-07 </td>
<td> 06:01:58 </td>
<td> 2022-07-09 </td>
<td> 23:20:01 </td>
<td> U0029 </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> Perawatan Bayi SC , Visite Dokter Spesialis Anak, Visite

Dokter Spesialis Anak, Infus Bayi oleh Perawat / Bidan </td>
<td> - </td>
<td> 1200000 </td>
<td> Sembuh </td>
<td> 3 </td>
<td> Sudah </td>
</tr>
<tr>
<td> 2022/07/07/000066 </td>
<td> 072073 </td>
<td> GHANIYA CHAYRA ASSYABIA, AN </td>
<td> P </td>
<td> Malang </td>
<td> 2022-07-07 </td>
<td> 0 Th 0 Bl 30 Hr </td>
<td> ISLAM </td>
<td> TS </td>
<td> ZAINUL ARIFIN, TN </td>
<td> AYAH </td>
<td> PERUM BTU UJ NO.23, MADYOPURO, KEDUNGKANDANG, KOTA MALANG
</td>
<td> BPJ </td>
<td> kelas 3 </td>
<td> PF07 </td>
<td> 300000 </td>
<td> P00.6 </td>
<td> P00.9 </td>
<td> 2022-07-07 </td>
<td> 05:56:35 </td>
<td> 2022-07-08 </td>
<td> 09:43:09 </td>
<td> U0030 </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> 3180 </td>
<td> 50 </td>
<td> Hidup </td>
<td> Ya </td>
<td> Hidup </td>
<td> Ya </td>
<td> Tidak </td>
<td> Ya </td>
<td> Perawatan Bayi SC , Visite Dokter Spesialis Anak, Tindik

<td> - </td>
<td> 600000 </td>
<td> Sembuh </td>
<td> 2 </td>
<td> Sudah </td>
</tr>
<tr>
<td> 2022/07/07/000065 </td>
<td> 072072 </td>
<td> MADE WISHAKA GENTA PRASETYA, AN </td>
<td> L </td>
<td> Malang </td>
<td> 2022-07-07 </td>
<td> 0 Th 0 Bl 11 Hr </td>
<td> HINDU </td>
<td> TS </td>
<td> NYOMAN WIRA PRASETYA, TN </td>
<td> AYAH </td>
<td> JL COMAL VI / 7A RT 4 RW 17, BUNULREJO, BLIMBING, KOTA
MALANG </td>
<td> BPJ </td>
<td> kelas 3 </td>
<td> PF06 </td>
<td> 300000 </td>
<td> P03.4 </td>
<td> P03.4 </td>
<td> 2022-07-07 </td>
<td> 05:43:23 </td>
<td> 2022-07-09 </td>
<td> 17:43:13 </td>
<td> U0030 </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> 3200 </td>
<td> 49,5 </td>
<td> Hidup </td>
<td> Tidak </td>
<td> Hidup </td>
<td> Ya </td>
<td> Tidak </td>
<td> Ya </td>

<td> - </td>
<td> 900000 </td>
<td> Sembuh </td>
<td> 3 </td>
<td> Sudah </td>
</tr>
<tr>
<td> 2022/07/07/000064 </td>
<td> 072071 </td>
<td> SHANUM SABIYA UTOMO, AN </td>
<td> P </td>
<td> MALANG </td>
<td> 2022-07-07 </td>
<td> 0 Th 0 Bl 11 Hr </td>
<td> ISLAM </td>
<td> - </td>
<td> BEJO HERI UTOMO, TN </td>
<td> AYAH </td>
<td> JL BANDARA JUANDA 2 BB 21 RT 1 RW 7 , CEMOROKANDANG,
<td> BPJ </td>
<td> kelas 3 </td>
<td> PF05 </td>
<td> 300000 </td>
<td> P03.4 </td>
<td> P03.4 </td>
<td> 2022-07-07 </td>
<td> 04:40:23 </td>
<td> 2022-07-11 </td>
<td> 07:30:41 </td>
<td> U0030 </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> 3000 </td>
<td> 50 </td>
<td> Hidup </td>
<td> Tidak </td>
<td> Hidup </td>
<td> Ya </td>
<td> Tidak </td>
<td> Ya </td>

<td> - </td>
<td> 1500000 </td>
<td> Sembuh </td>
<td> 5 </td>
<td> Sudah </td>
</tr>
<tr>
<td> 2022/07/07/000063 </td>
<td> 072070 </td>
<td> QUEENAYA ZELINE ARUNA,AN </td>
<td> P </td>
<td> MALANG </td>
<td> 2022-07-07 </td>
<td> 0 Th 0 Bl 17 Hr </td>
<td> ISLAM </td>
<td> - </td>
<td> ANDI CANDRA SUSILO, TN </td>
<td> AYAH </td>
<td> JL PERMADI 2A RT 9 RW 4 , POLEHAN, BLIMBING, KOTA MALANG
</td>
<td> BPJ </td>
<td> kelas 3 </td>
<td> PF04 </td>
<td> 300000 </td>
<td> P03.4 </td>
<td> P03.4 </td>
<td> 2022-07-07 </td>
<td> 03:45:24 </td>
<td> 2022-07-09 </td>
<td> 10:53:28 </td>
<td> U0030 </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> 3100 </td>
<td> 48 </td>
<td> Hidup </td>
<td> Tidak </td>
<td> Hidup </td>
<td> Ya </td>
<td> Tidak </td>
<td> Ya </td>
<td> Perawatan Bayi SC , Tindik oleh Perawat / Bidan,

<td> - </td>
<td> 900000 </td>
<td> Sembuh </td>
<td> 3 </td>
<td> Sudah </td>
</tr>
<tr>
<td> 2022/07/07/000187 </td>
<td> 045367 </td>
<td> HAMDAH SITI QOMARIYAH, AN </td>
<td> P </td>
<td> Malang </td>
<td> 2020-12-20 </td>
<td> 1 Th 6 Bl 17 Hr </td>
<td> ISLAM </td>
<td> TS </td>
<td> SWASTA </td>
<td> FRENDY FIRMANSYAH PUTRA WICAKSONO, TN </td>
<td> AYAH </td>
<td> JL. KAPI JANULA/15 C/12 SAWOJAJAR II RT03 RW14, SEKARPURO,
<td> BPJ </td>
<td> kelas 3 </td>
<td> A12 </td>
<td> Amarta 2 </td>
<td> 300000 </td>
<td> A09 </td>
<td> A09 </td>
<td> 2022-07-07 </td>
<td> 02:41:28 </td>
<td> 2022-07-09 </td>
<td> 16:23:58 </td>
<td> IGDK </td>
<td> 2022/07/07/000187, BPJS KELAS 3, AMARTA 2 </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>

<td> - </td>
<td> 900000 </td>
<td> Sembuh </td>
<td> 3 </td>
<td> Sudah </td>
</tr>
<tr>
<td> 2022/07/07/000185 </td>
<td> 007551 </td>
<td> AR-RAYYAN ABRISAM ATHAFARIZ, AN </td>
<td> L </td>
<td> MALANG </td>
<td> 2018-10-10 </td>
<td> 3 Th 8 Bl 27 Hr </td>
<td> ISLAM </td>
<td> - </td>
<td> TS </td>
<td> FARIS FIKTI AKVAN, TN </td>
<td> AYAH </td>
<td> JL. KOLONEL SUGIONO IA 35 RT.07 RW.06, MERGOSONO,
<td> BPJ </td>
<td> kelas 2 </td>
<td> D04 </td>
<td> 400000 </td>
<td> A09 </td>
<td> A09 </td>
<td> 2022-07-07 </td>
<td> 00:55:19 </td>
<td> 2022-07-09 </td>
<td> 22:00:00 </td>
<td> IGDK </td>
<td> 2022/07/07/000185, BPJS KLS 2, AYODYA 2B KONFIRMASI RUANGAN
</td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>

<td> - </td>
<td> 1200000 </td>
<td> Sembuh </td>
<td> 3 </td>
<td> Sudah </td>
</tr>
<tr>
<td> 2022/07/07/000184 </td>
<td> 034685 </td>
<td> AZKAYRA NAYYARA AKFAN, AN </td>
<td> P </td>
<td> Malang </td>
<td> 2020-03-25 </td>
<td> 2 Th 3 Bl 13 Hr </td>
<td> ISLAM </td>
<td> - </td>
<td> FARIS FIKTI, TN </td>
<td> AYAH </td>
<td> JL KOL SUGIONO IA RT 7 RW 6, MERGOSONO, KEDUNGKANDANG, KOTA
MALANG </td>
<td> BPJ </td>
<td> kelas 2 </td>
<td> D03 </td>
<td> 400000 </td>
<td> R11 </td>
<td> A09 </td>
<td> 2022-07-07 </td>
<td> 00:54:31 </td>
<td> 2022-07-09 </td>
<td> 22:00:00 </td>
<td> IGDK </td>
</td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>

<td> - </td>
<td> 1200000 </td>
<td> Sembuh </td>
<td> 3 </td>
<td> Sudah </td>
</tr>
<tr>
<td> 2022/07/07/000059 </td>
<td> 072067 </td>
<td> SULTAN ALVARO DARMAWAN, AN </td>
<td> L </td>
<td> Malang </td>
<td> 2022-07-06 </td>
<td> ISLAM </td>
<td> TS </td>
<td> ROBBY DARMAWAN, TN </td>
<td> AYAH </td>
<td> DSN KRAJAN II RT 04 RW 02, ANDONO SARI, TUTUR, PASURUAN KAB
</td>
<td> BPJ </td>
<td> kelas 3 </td>
<td> BFA02 </td>
<td> 300000 </td>
<td> P00.6 </td>
<td> P00.9 </td>
<td> 2022-07-07 </td>
<td> 00:29:56 </td>
<td> 2022-07-08 </td>
<td> 08:12:01 </td>
<td> U0030 </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> 3060 </td>
<td> 48 </td>
<td> Hidup </td>
<td> Ya </td>
<td> Hidup </td>
<td> Ya </td>
<td> Tidak </td>
<td> Ya </td>

<td> - </td>
<td> 600000 </td>
<td> Sembuh </td>
<td> 2 </td>
<td> Sudah </td>
</tr>
<tr>
<td> 2022/07/07/000058 </td>
<td> 072066 </td>
<td> LENI KRISNAWATI., BY NY </td>
<td> P </td>
<td> Malang </td>
<td> 2022-07-06 </td>
<td> 0 Th 0 Bl 10 Hr </td>
<td> ISLAM </td>
<td> - </td>
<td> EFRAN BUDI, TN </td>
<td> AYAH </td>
<td> BANARAN RT 1 RW 6 , BABADAN, NGAJUM, KABUPATEN MALANG </td>
<td> BPJ </td>
<td> kelas 3 </td>
<td> BF33 </td>
<td> 300000 </td>
<td> P00.6 </td>
<td> P00.9 </td>
<td> 2022-07-07 </td>
<td> 00:26:32 </td>
<td> 2022-07-08 </td>
<td> 08:12:30 </td>
<td> U0030 </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> 2545 </td>
<td> 48 </td>
<td> Hidup </td>
<td> Ya </td>
<td> Hidup </td>
<td> Ya </td>
<td> Tidak </td>
<td> Ya </td>

<td> - </td>
<td> 600000 </td>
<td> Sembuh </td>
<td> 2 </td>
<td> Sudah </td>
</tr>
<tr>
<td> 2022/07/06/000204 </td>
<td> 072014 </td>
<td> HATIMAH, NY </td>
<td> P </td>
<td> 1980-05-03 </td>
<td> 42 Th 2 Bl 8 Hr </td>
<td> ISLAM </td>
<td> PEDAGANG </td>
<td> SD </td>
<td> SOPIR </td>
<td> IRWANTO, TN </td>
<td> SUAMI </td>
<td> JL. GADANG VII/16B RT 11 RW 01, GADANG, SUKUN, KOTA MALANG
</td>
<td> BPJ </td>
<td> kelas 3 </td>
<td> H04 </td>
<td> 300000 </td>
<td> O82.9 </td>
<td> O82.9 </td>
<td> 2022-07-06 </td>
<td> 22:15:28 </td>
<td> 2022-07-08 </td>
<td> 20:33:06 </td>
<td> IGDK </td>
<td> 2022/07/06/000204, BPJS KLS III DI HASTINA 4 (HbsAg+) </td>
<td> 2 </td>
<td> 1 </td>
<td> 0 </td>
<td> 0 </td>
<td> 0 </td>
<td> 0 </td>
<td> 38-39 </td>

<td> 3000 </td>
<td> 48 </td>
<td> Hidup </td>
<td> Tidak </td>
<td> Hidup </td>
<td> Ya </td>
<td> Tidak </td>
<td> Ya </td>
<td> </td>
<td> - </td>
<td> 600000 </td>
<td> 2 </td>
<td> Sudah </td>
</tr>
<tr>
<td> 2022/07/06/000235 </td>
<td> 072062 </td>
<td> RHENA AMELIA, AN </td>
<td> P </td>
<td> MALANG </td>
<td> 2022-07-06 </td>
<td> ISLAM </td>
<td> TS </td>
<td> SOPIR </td>
<td> IRWANTO, TN </td>
<td> AYAH </td>
<td> JL. GADANG VII/16B RT 11 RW 01, GADANG, SUKUN, KOTA MALANG
</td>
<td> BPJ </td>
<td> kelas 3 </td>
<td> BFA05 </td>
<td> 300000 </td>
<td> P03.4 </td>
<td> P03.4 </td>
<td> 2022-07-06 </td>
<td> 21:57:15 </td>
<td> 2022-07-08 </td>
<td> 09:44:44 </td>
<td> U0030 </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> 3000 </td>
<td> 47 </td>
<td> Hidup </td>
<td> Tidak </td>
<td> Hidup </td>
<td> Ya </td>
<td> Tidak </td>
<td> Ya </td>

<td> - </td>
<td> 600000 </td>
<td> Sembuh </td>
<td> 2 </td>
<td> Sudah </td>
</tr>
<tr>
<td> 2022/07/06/000234 </td>
<td> 072061 </td>
<td> SITI NUR S., BY NY </td>
<td> P </td>
<td> MALANG </td>
<td> 2022-07-06 </td>
<td> ISLAM </td>
<td> - </td>
<td> ABDUS SALAM, TN </td>
<td> AYAH </td>
<td> JL KI AGENG GRIBIG RT 2 RW 3 , BLIMBING, KEDUNGKANDANG, KOTA
MALANG </td>
<td> A09 </td>
<td> UMUM </td>
<td> PA031 </td>
<td> NICU 3 </td>
<td> 400000 </td>
<td> P03.4 </td>
<td> P24.0 </td>
<td> 2022-07-06 </td>
<td> 21:49:16 </td>
<td> 2022-07-07 </td>
<td> 15:06:48 </td>
<td> U0029 </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> Perawatan Bayi SC , Oksigen 100% Sentral 2 LPM, Visite

Dokter Spesialis Anak, Visite Dokter Umum, Resusitasi dengan Suction dan VTP, Sewa
Patient Monitor , Sewa Suction Pump, Infus Anak oleh Perawat / Bidan </td>
<td> - </td>
<td> 400000 </td>
<td> Rujuk </td>
<td> 1 </td>
<td> Sudah </td>
</tr>
<tr>
<td> 2022/07/06/000218 </td>
<td> 071699 </td>
<td> ZUNAIRA PUTRI AFSHEENA, AN </td>
<td> P </td>
<td> MALANG </td>
<td> 2022-06-30 </td>
<td> ISLAM </td>
<td> - </td>
<td> - </td>
<td> AVIERY ANDRIAN PUTRA, TN </td>
<td> AYAH </td>
<td> JL. TELUK PELABUHAN RATU 93 RT 6 RW 2 , ARJOSARI, BLIMBING,
KOTA MALANG </td>
<td> BPJ </td>
<td> IGD10 </td>
<td> 400000 </td>
<td> P59.9 </td>
<td> P59.9 </td>
<td> 2022-07-06 </td>
<td> 19:32:58 </td>
<td> 2022-07-10 </td>
<td> 23:37:50 </td>
<td> IGDK </td>
<td> 2022/07/06/000218, BPJS KLS III FOTOTERAPI NICU </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> 2000000 </td>
<td> Sehat </td>
<td> 5 </td>
<td> Belum </td>
</tr>
<tr>
<td> 2022/07/06/000180 </td>
<td> 072027 </td>
<td> OKTAVIA ARNO, BY.NY. </td>
<td> P </td>
<td> MALANG </td>
<td> 2022-07-06 </td>
<td> ISLAM </td>
<td> - </td>
<td> SONY SUSANTO, TN </td>
<td> AYAH </td>
<td> JL. NAKULA DALAM RT 05 RW 05, POLEHAN, BLIMBING, KOTA MALANG
</td>
<td> BPJ </td>
<td> kelas 3 </td>
<td> PA01 </td>
<td> NICU 1 </td>
<td> 300000 </td>
<td> P03.4 </td>
<td> P23.9 </td>
<td> 2022-07-06 </td>
<td> 18:33:53 </td>
<td> 2022-07-08 </td>
<td> 11:10:39 </td>
<td> U0030 </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> 2850 </td>
<td> 47 </td>
<td> Hidup </td>
<td> Tidak </td>
<td> Hidup </td>
<td> Ya </td>
<td> Tidak </td>
<td> Ya </td>
<td> Perawatan Bayi SC , Visite Dokter Spesialis Anak,

Resusitasi dengan Intubasi, Infus Dewasa Oleh Perawat / Bidan , Oksigen 100%
Sentral 10 LPM , Perawatan Infant Warmer, Konsultasi Dokter Spesialis Anak Via
Telepon </td>
<td> - </td>
<td> 900000 </td>
<td> Rujuk </td>
<td> 3 </td>
<td> Sudah </td>
</tr>
<tr>
<td> 2022/07/06/000112 </td>
<td> 062558 </td>
<td> INGGITH SASMITHA SYAMPUTRI, NY </td>
<td> P </td>
<td> SERANG </td>
<td> 1996-09-10 </td>
<td> 25 Th 9 Bl 27 Hr </td>
<td> ISLAM </td>
<td> - </td>
<td> DOSEN </td>
<td> FIRMAN JAYA, Tn </td>
<td> SUAMI </td>
KOTA MALANG </td>
<td> BPJ </td>
<td> kelas 1 </td>
<td> P05 </td>
<td> 650000 </td>
<td> O80.8 </td>
<td> O80.8 </td>
<td> 2022-07-06 </td>
<td> 18:14:22 </td>
<td> 2022-07-08 </td>
<td> 18:29:24 </td>
<td> IGDK </td>
<td> </td>
<td> </td>
<td> 2 </td>
<td> 1 </td>
<td> 0 </td>
<td> 0 </td>
<td> 0 </td>
<td> 0 </td>
<td> 41-42 </td>

<td> 3065 </td>
<td> 48 </td>
<td> Hidup </td>
<td> Ya </td>
<td> Hidup </td>
<td> Ya </td>
<td> Tidak </td>
<td> Ya </td>
<td> Visite Dokter Spesialis Obgyn, Visite Dokter Umum, VT

Dokter, VT Dokter, Infus Dewasa oleh Perawat / Bidan, Konsultasi Dokter Spesialis
<td> </td>
<td> 1950000 </td>
<td> 3 </td>
<td> Sudah </td>
</tr>
<tr>
<td> 2022/07/06/000148 </td>
<td> 071976 </td>
<td> DEWI HANDAYANI, NY </td>
<td> P </td>
<td> MALANG </td>
<td> 1983-01-20 </td>
<td> 39 Th 6 Bl 4 Hr </td>
<td> ISLAM </td>
<td> S1 </td>
<td> ANDI RUDI SETIAWAN, TN </td>
<td> SUAMI </td>
<td> JL. GADANG RT 02 RW 05, GADANG, SUKUN, KOTA MALANG </td>
<td> A09 </td>
<td> UMUM </td>
<td> kelas 2 </td>
<td> D12 </td>
<td> 400000 </td>
<td> O82.8 </td>
<td> O82.8 </td>
<td> 2022-07-06 </td>
<td> 17:35:23 </td>
<td> 2022-07-08 </td>
<td> 23:43:07 </td>
<td> IGDK </td>
<td> </td>
<td> 2022/07/06/000148 UMUM KELAS 2 DI AYODIA 6B KONFIRM </td>
<td> 3 </td>
<td> 1 </td>
<td> 0 </td>
<td> 0 </td>
<td> 1 </td>
<td> 0 </td>
<td> 39-40 </td>

<td> 2500 </td>
<td> 48 </td>
<td> Hidup </td>
<td> Tidak </td>
<td> Hidup </td>
<td> Ya </td>
<td> Tidak </td>
<td> Ya </td>

Visite Dokter Spesialis Obgyn, Visite Dokter Umum, Infus Dewasa oleh Perawat /
Bidan, Konsultasi Dokter Spesialis Obgyn Via Telepon </td>
<td> </td>
<td> 1200000 </td>
<td> Sehat </td>
<td> 3 </td>
<td> Sudah </td>
</tr>
<tr>
<td> 2022/07/06/000163 </td>
<td> 065684 </td>
<td> ERNA DESI MELATI SUCI, NY </td>
<td> P </td>
<td> SURABAYA </td>
<td> 1994-12-26 </td>
<td> 27 Th 6 Bl 19 Hr </td>
<td> ISLAM </td>
<td> - </td>
<td> FERDYAN ECHO DEVANTO </td>
<td> SUAMI </td>
<td> PERUM PAKIS PERMATA ASRI BLOK L NO 18 RT. 2 RW. 12, PAKIS,
<td> BPJ </td>
<td> kelas 1 </td>
<td> H07 </td>
<td> 650000 </td>
<td> O82.9 </td>
<td> O82.9 </td>
<td> 2022-07-06 </td>
<td> 17:22:10 </td>
<td> 2022-07-08 </td>
<td> 10:08:47 </td>
<td> IGDK </td>
<td> 2022/07/06/000163, BPJS KLS I TITIP DI DWARAWATI 1A, DENDA
45 HARI (CITO) </td>
<td> 1 </td>
<td> 0 </td>
<td> 0 </td>
<td> 0 </td>
<td> 0 </td>
<td> 0 </td>
<td> 39-40 </td>

<td> 3100 </td>
<td> 48 </td>
<td> Hidup </td>
<td> Tidak </td>
<td> Hidup </td>
<td> Ya </td>
<td> Tidak </td>
<td> Ya </td>
<td> </td>
<td> - </td>
<td> 1950000 </td>
<td> Sehat </td>
<td> 3 </td>
<td> Sudah </td>
</tr>
<tr>
<td> 2022/07/06/000197 </td>
<td> 072042 </td>
<td> MIKHAYLA TIARA JASMINE, AN </td>
<td> P </td>
<td> MALANG </td>
<td> 2022-07-06 </td>
<td> ISLAM </td>
<td> TS </td>
<td> FERDYAN ECHO DEVANTO, TN </td>
<td> AYAH </td>
<td> PERUM PAKIS PERMATA ASRI BLOKL NO 18 RT 002 RW 012, PAKIS,
<td> BPJ </td>
<td> kelas 3 </td>
<td> BF31 </td>
<td> 300000 </td>
<td> P03.4 </td>
<td> P03.4 </td>
<td> 2022-07-06 </td>
<td> 16:54:46 </td>
<td> 2022-07-08 </td>
<td> 19:31:45 </td>
<td> U0030 </td>
<td> </td>
<td> 2022/07/06/000197, FISOL </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> 3100 </td>
<td> 49 </td>
<td> Hidup </td>
<td> Tidak </td>
<td> Hidup </td>
<td> Ya </td>
<td> Tidak </td>
<td> Ya </td>
<td> Perawatan Bayi SC , Visite Dokter Spesialis Anak, Tindik

<td> - </td>
<td> 900000 </td>
<td> Sembuh </td>
<td> 3 </td>
<td> Sudah </td>
</tr>
<tr>
<td> 2022/07/06/000194 </td>
<td> 072039 </td>
<td> ANDI ZHAFIRAH KHAIRUNNISA, AN </td>
<td> P </td>
<td> MALANG </td>
<td> 2022-07-06 </td>
<td> ISLAM </td>
<td> TS </td>
<td> ANDI RUDI SETIAWNA, TN </td>
<td> AYAH </td>
<td> JL. GADANG RT 002 RW 005, GADANG, SUKUN, KOTA MALANG </td>
<td> A09 </td>
<td> UMUM </td>
<td> kelas 3 </td>
<td> PF03 </td>
<td> 300000 </td>
<td> P03.4 </td>
<td> P03.4 </td>
<td> 2022-07-06 </td>
<td> 16:42:47 </td>
<td> 2022-07-08 </td>
<td> 09:43:38 </td>
<td> U0030 </td>
<td> </td>
<td> 2022/07/06/000194, FISOL UMUM </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> 2500 </td>
<td> 45 </td>
<td> Hidup </td>
<td> Tidak </td>
<td> Hidup </td>
<td> Ya </td>
<td> Tidak </td>
<td> Ya </td>

<td> - </td>
<td> 900000 </td>
<td> Sembuh </td>
<td> 3 </td>
<td> Sudah </td>
</tr>
<tr>
<td> 2022/07/06/000150 </td>
<td> 072026 </td>
<td> KHUSNUL KHOTIMAH, Ny </td>
<td> P </td>
<td> PASURUAN </td>
<td> 2002-02-19 </td>
<td> 20 Th 4 Bl 17 Hr </td>
<td> ISLAM </td>
<td> SD </td>
<td> EKA IRMAWAN, Tn </td>
<td> SUAMI </td>
<td> DUSUN KANDANGSARI RT 01 RW 01, MOROREJO, TOSARI, PASURUAN
KAB </td>
<td> A09 </td>
<td> UMUM </td>
<td> kelas 3 </td>
<td> A06 </td>
<td> 300000 </td>
<td> O82.8 </td>
<td> O82.8 </td>
<td> 2022-07-06 </td>
<td> 16:29:06 </td>
<td> 2022-07-08 </td>
<td> 10:21:17 </td>
<td> IGDK </td>
<td> 2022/07/06/000150 UMUM KELAS 3 PAHE BD NUR JOKO </td>
<td> 1 </td>
<td> 0 </td>
<td> 0 </td>
<td> 0 </td>
<td> 0 </td>
<td> 0 </td>
<td> 37-38 </td>

<td> 2600 </td>
<td> 48 </td>
<td> Hidup </td>
<td> Ya </td>
<td> Baik </td>
<td> Ya </td>
<td> Tidak </td>
<td> Ya </td>

Bidan, Konsultasi Dokter Spesialis Obgyn Via Telepon </td>
<td> </td>
<td> 900000 </td>
<td> 3 </td>
<td> Sudah </td>
</tr>
<tr>
<td> 2022/07/06/000179 </td>
<td> 024996 </td>
<td> ADZKIA GERALDINE, AN </td>
<td> P </td>
<td> Malang </td>
<td> 2019-08-31 </td>
<td> 2 Th 10 Bl 13 Hr </td>
<td> ISLAM </td>
<td> - </td>
<td> JOKO CAESAR, TN </td>
<td> AYAH </td>
<td> JL. NGRANGIH NO. 19 RT 16 RW 5, SUMBERPASIR, PAKIS,
<td> BPJ </td>
<td> kelas 1 </td>
<td> H07 </td>
<td> 650000 </td>
<td> A09 </td>
<td> A09 </td>
<td> 2022-07-06 </td>
<td> 15:58:19 </td>
<td> 2022-07-10 </td>
<td> 16:48:00 </td>
<td> IGDK </td>
<td> 2022/07/06/000179, BPJS KLS II DI DWARAWATI 3B (KONFIRMASI)
PER TGL 8-7-2022 NAIK KELAS 1 HASTINA 7 PK. 13.32. WT

</td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>

Anak Via Telepon </td>
<td> - </td>
<td> 3250000 </td>
<td> Sembuh </td>
<td> 5 </td>
<td> Sudah </td>
</tr>
<tr>
<td> 2022/07/06/000146 </td>
<td> 042117 </td>
<td> Oktavia Arno Yoeanita, Ny. </td>
<td> P </td>
<td> Sidoarjo </td>
<td> 1987-10-11 </td>
<td> 34 Th 9 Bl 8 Hr </td>
<td> ISLAM </td>
<td> SMA </td>
<td> Sony Susanto, Tn. </td>
<td> SUAMI </td>
<td> JL. NAKULA DALAM RT. 05/ RW. 05, POLEHAN, BLIMBING, KOTA
MALANG </td>
<td> BPJ </td>
<td> kelas 1 </td>
<td> P02 </td>
<td> 650000 </td>
<td> O82.8 </td>
<td> O82.8 </td>
<td> 2022-07-06 </td>
<td> 15:55:26 </td>
<td> 2022-07-08 </td>
<td> 15:09:02 </td>
<td> IGDK </td>
<td> </td>
<td> 2022/07/06/000146 BPJS KELAS 1 DI PANDAWA 2 KONFIRM </td>
<td> 2 </td>
<td> 1 </td>
<td> 0 </td>
<td> 0 </td>
<td> 0 </td>
<td> 0 </td>
<td> 37-38 </td>

<td> 2850 </td>
<td> 50 </td>
<td> Hidup </td>
<td> Ya </td>
<td> Hidup </td>
<td> Ya </td>
<td> Tidak </td>
<td> Ya </td>

<td> </td>
<td> 1950000 </td>
<td> 3 </td>
<td> Sudah </td>
</tr>
<tr>
<td> 2022/07/06/000149 </td>
<td> 007609 </td>
<td> DEVI NOVITA SARI, NY </td>
<td> P </td>
<td> Malang </td>
<td> 1992-06-22 </td>
<td> 30 Th 0 Bl 19 Hr </td>
<td> ISLAM </td>
<td> SMA </td>
<td> AHMAD FAUZI, TN </td>
<td> SUAMI </td>
<td> DSN TONDO ASRI RT 42 RW 9, PAJARAN, PONCOKUSUMO, KABUPATEN
MALANG </td>
<td> BPJ </td>
<td> kelas 2 </td>
<td> D11 </td>
<td> 400000 </td>
<td> N75.0 </td>
<td> N75.0 </td>
<td> 2022-07-06 </td>
<td> 15:55:04 </td>
<td> 2022-07-07 </td>
<td> 16:32:19 </td>
<td> IGDK </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> Visite Dokter Umum, Infus Dewasa oleh Perawat / Bidan,

<td> </td>
<td> 800000 </td>
<td> Sehat </td>
<td> 2 </td>
<td> Sudah </td>
</tr>
<tr>
<td> 2022/07/06/000091 </td>
<td> 061022 </td>
<td> RISKA AYU WULANDARI, NY </td>
<td> P </td>
<td> MALANG </td>
<td> 1996-12-01 </td>
<td> 25 Th 7 Bl 5 Hr </td>
<td> ISLAM </td>
<td> S1 </td>
<td> MUSA PRANA DESTA MANZRA SURATI, TN </td>
<td> SUAMI </td>
<td> JL LA SUCIPTO 22 C RT 10 RW 9, PANDANWANGI, BLIMBING, KOTA
MALANG </td>
<td> BPJ </td>
<td> kelas 1 </td>
<td> H05 </td>
<td> 650000 </td>
<td> O42.0 </td>
<td> O42.0 </td>
<td> 2022-07-06 </td>
<td> 15:40:45 </td>
<td> 2022-07-07 </td>
<td> 16:50:52 </td>
<td> IGDK </td>
<td> </td>
<td> 2022/07/06/000091 BPJS KELAS 2 UP 1 DI HASTINA 5 KONFIRMASI
</td>
<td> 1 </td>
<td> 0 </td>
<td> 0 </td>
<td> 0 </td>
<td> 0 </td>
<td> 0 </td>
<td> 37-38 </td>

<td> 3130 </td>
<td> 50 </td>
<td> Hidup </td>
<td> Ya </td>
<td> Hidup </td>
<td> Ya </td>
<td> Tidak </td>
<td> Ya </td>
<td> </td>
<td> - </td>
<td> 1300000 </td>
<td> Sehat </td>
<td> 2 </td>
<td> Sudah </td>
</tr>
<tr>
<td> 2022/07/06/000181 </td>
<td> 072033 </td>
<td> KHUSUNUL KHOT., By Ny </td>
<td> P </td>
<td> MALANG </td>
<td> 2022-07-06 </td>
<td> ISLAM </td>
<td> TS </td>
<td> EKA IRMAWAN, TN </td>
<td> AYAH </td>
<td> DSN KANDANGSARI RT 001 RW 001, MOROREJO, TOSARI, PASURUAN
KAB </td>
<td> A09 </td>
<td> UMUM </td>
<td> kelas 3 </td>
<td> BFA03 </td>
<td> 300000 </td>
<td> P03.4 </td>
<td> P03.4 </td>
<td> 2022-07-06 </td>
<td> 15:35:16 </td>
<td> 2022-07-08 </td>
<td> 19:31:25 </td>
<td> U0030 </td>
<td> </td>
<td> 2022/07/06/000181, FISOL UMUM </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> 2600 </td>
<td> 48 </td>
<td> Hidup </td>
<td> Tidak </td>
<td> Hidup </td>
<td> Ya </td>
<td> Tidak </td>
<td> Ya </td>

<td> - </td>
<td> 900000 </td>
<td> Sembuh </td>
<td> 3 </td>
<td> Sudah </td>
</tr>
<tr>
<td> 2022/07/06/000143 </td>
<td> 085900 </td>
<td> ARUM PRATIWI, NY </td>
<td> P </td>
<td> Malang </td>
<td> 1993-09-09 </td>
<td> 28 Th 10 Bl 7 Hr </td>
<td> ISLAM </td>
<td> TUKANG JAHIT </td>
<td> SMA </td>
<td> DARIYONO, TN </td>
<td> SUAMI </td>
<td> JL.IKAN HIU 44 RT 2 RW 5, TUNJUNGSEKAR, LOWOKWARU, KOTA
MALANG </td>
<td> BPJ </td>
<td> kelas 3 </td>
<td> A06 </td>
<td> 300000 </td>
<td> O82.8 </td>
<td> O82.0 </td>
<td> 2022-07-06 </td>
<td> 14:57:13 </td>
<td> 2022-07-06 </td>
<td> 16:56:15 </td>
<td> IGDK </td>
<td> </td>
<td> 3 </td>
<td> 1 </td>
<td> 0 </td>
<td> 0 </td>
<td> 1 </td>
<td> 0 </td>
<td> 40-41 </td>

<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> Visite Dokter Spesialis Obgyn, VT Dokter , Infus Dewasa oleh

Perawat / Bidan, Konsultasi Dokter Spesialis Obgyn Via Telepon </td>
<td> </td>
<td> 300000 </td>
<td> 1 </td>
<td> Sudah </td>
</tr>
<tr>
<td> 2022/07/06/000166 </td>
<td> 072029 </td>
<td> MUHAMMAD AKMAL ZUHDIY, AN </td>
<td> L </td>
<td> MALANG </td>
<td> 2022-07-06 </td>
<td> 0 Th 0 Bl 10 Hr </td>
<td> ISLAM </td>
<td> - </td>
<td> DARIYONO, TN </td>
<td> AYAH </td>
<td> JL. IKAN HIU 44 RT 2 RW 5, TUNJUNGSEKAR, LOWOKWARU, KOTA
MALANG </td>
<td> BPJ </td>
<td> kelas 3 </td>
<td> PF24 </td>
<td> 300000 </td>
<td> P03.4 </td>
<td> P03.4 </td>
<td> 2022-07-06 </td>
<td> 14:21:13 </td>
<td> 2022-07-08 </td>
<td> 19:30:36 </td>
<td> U0030 </td>
<td> </td>
<td> 2022/07/06/000166, FISOL </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> 3300 </td>
<td> 50 </td>
<td> Hidup </td>
<td> Tidak </td>
<td> Hidup </td>
<td> Ya </td>
<td> Tidak </td>
<td> Ya </td>

<td> - </td>
<td> 900000 </td>
<td> Sembuh </td>
<td> 3 </td>
<td> Sudah </td>
</tr>
<tr>
<td> 2022/07/06/000118 </td>
<td> 058622 </td>
<td> FENNY APRIYAWATI NAINGGOLAN, NY </td>
<td> P </td>
<td> banda aceh </td>
<td> 1987-04-04 </td>
<td> 35 Th 3 Bl 6 Hr </td>
<td> ISLAM </td>
<td> GURU </td>
<td> S1 </td>
<td> GURU </td>
<td> Deny Dwi Prasetyo, Tn </td>
<td> SUAMI </td>
<td> JL. DANAU MANINJAU TENGAH 1B 3E RT 11 RW 9, KEDUNGKANDANG,
<td> BPJ </td>
<td> kelas 2 </td>
<td> D07 </td>
<td> 400000 </td>
<td> O46.9 </td>
<td> O46.9 </td>
<td> 2022-07-06 </td>
<td> 13:37:37 </td>
<td> 2022-07-08 </td>
<td> 06:57:39 </td>
<td> IGDK </td>
<td> </td>
<td> 2022/07/06/000118 BPJS KELAS 2 DI AYO 4 A </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> VT Dokter , Infus Dewasa oleh Perawat / Bidan, Konsultasi

<td> </td>
<td> 1200000 </td>
<td> 3 </td>
<td> Sudah </td>
</tr>
<tr>
<td> 2022/07/06/000151 </td>
<td> 072024 </td>
<td> KAYANNA GANTARI PUTRI AGNAYA,AN </td>
<td> P </td>
<td> Malang </td>
<td> 2022-07-06 </td>
<td> ISLAM </td>
<td> - </td>
<td> Jlitheng Agasta, Tn </td>
<td> AYAH </td>
<td> JL. MANYAR NO 10 RT007/RW009, SUKUN, SUKUN, KOTA MALANG
</td>
<td> BPJ </td>
<td> kelas 3 </td>
<td> PF10 </td>
<td> 300000 </td>
<td> P00.6 </td>
<td> P00.9 </td>
<td> 2022-07-06 </td>
<td> 12:33:32 </td>
<td> 2022-07-07 </td>
<td> 19:10:41 </td>
<td> U0030 </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> 2915 </td>
<td> 49 </td>
<td> Hidup </td>
<td> Ya </td>
<td> Hidup </td>
<td> Ya </td>
<td> Tidak </td>
<td> Ya </td>

<td> </td>
<td> 600000 </td>
<td> Sembuh </td>
<td> 2 </td>
<td> Sudah </td>
</tr>
<tr>
<td> 2022/07/06/000104 </td>
<td> 072008 </td>
<td> MUHAMMAD AZZAM MAULIDIN IRKHAMI, An </td>
<td> L </td>
<td> Malang </td>
<td> 2017-12-17 </td>
<td> 4 Th 6 Bl 19 Hr </td>
<td> ISLAM </td>
<td> - </td>
<td> PERANGKAT DESA </td>
<td> ARIP NURYAKIN, Tn </td>
<td> AYAH </td>
<td> DSN GASEK WETAN RT 09 RW 02, GADING KEMBAR, JABUNG,
<td> BPJ </td>
<td> kelas 2 </td>
<td> D06 </td>
<td> 400000 </td>
<td> R11 </td>
<td> A09 </td>
<td> 2022-07-06 </td>
<td> 12:01:35 </td>
<td> 2022-07-10 </td>
<td> 10:30:00 </td>
<td> IGDK </td>
<td> PKM Pakis </td>
<td> 2022/07/06/000104 BPJS KELAS 2 DI DWARAWATI AYODYA 1
( RUJUKAN PKM PAKIS) </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>

<td> </td>
<td> 2000000 </td>
<td> 5 </td>
<td> Sudah </td>
</tr>
<tr>
<td> 2022/07/06/000207 </td>
<td> 081415 </td>
<td> NAOMI IKA HERAWATI, NY </td>
<td> P </td>
<td> MALANG </td>
<td> 1991-05-31 </td>
<td> 31 Th 1 Bl 18 Hr </td>
<td> KRISTEN </td>
<td> S1 </td>
<td> VIKI SETYAWAN, TN </td>
<td> SUAMI </td>
<td> JL. ARGOPURO 40 A RT 001 RW 012, KALIREJO, LAWANG, KABUPATEN
MALANG </td>
<td> BPJ </td>
<td> kelas 2 </td>
<td> H09 </td>
<td> 400000 </td>
<td> O80.9 </td>
<td> O80.8 </td>
<td> 2022-07-06 </td>
<td> 10:39:56 </td>
<td> 2022-07-08 </td>
<td> 10:52:56 </td>
<td> IGDK </td>
<td> 2022/07/06/000207, BPJS KLS II RENCANA DI AYODYA 1A
( KONFIRMASI ) TGL 07-07-2022
TGL 07/07/22 BPJS KELAS 2 UP 1 RENCANA HASTINA 09 ( KONFIRMASI ) </td>

<td> 2 </td>
<td> 1 </td>
<td> 0 </td>
<td> 0 </td>
<td> 0 </td>
<td> 0 </td>
<td> 37-38 </td>

<td> 3025 </td>
<td> 48 </td>
<td> Hidup </td>
<td> Ya </td>
<td> Baik </td>
<td> Ya </td>
<td> Tidak </td>
<td> Ya </td>
<td> </td>
<td> - </td>
<td> 1200000 </td>
<td> Sehat </td>
<td> 3 </td>
<td> Sudah </td>
</tr>
<tr>
<td> 2022/07/06/000189 </td>
<td> 070304 </td>
<td> NUR HANIK, NY </td>
<td> P </td>
<td> MALANG </td>
<td> 1980-08-08 </td>
<td> 41 Th 11 Bl 24 Hr </td>
<td> ISLAM </td>
<td> SMA </td>
<td> HENRI SETIAWAN, TN </td>
<td> SUAMI </td>
<td> JL. SEMBILANG III/28 RT 03 RW 01, POLOWIJEN, BLIMBING, KOTA
MALANG </td>
<td> BPJ </td>
<td> kelas 3 </td>
<td> A10 </td>
<td> 300000 </td>
<td> O80.9 </td>
<td> O82.0 </td>
<td> 2022-07-06 </td>
<td> 10:37:57 </td>
<td> 2022-07-09 </td>
<td> 11:59:29 </td>
<td> IGDK </td>
<td> 2022/07/06/000189, BPJS KLS III DI AMARTA 8A --> AMARTA 8B
</td>
<td> 2 </td>
<td> 1 </td>
<td> 0 </td>
<td> 0 </td>
<td> 0 </td>
<td> 0 </td>
<td> 39-40 </td>

<td> 3200 </td>
<td> 49 </td>
<td> Hidup </td>
<td> Tidak </td>
<td> Hidup </td>
<td> Ya </td>
<td> Tidak </td>
<td> Ya </td>

<td> - </td>
<td> 1200000 </td>
<td> Sehat </td>
<td> 4 </td>
<td> Sudah </td>
</tr>
<tr>
<td> 2022/07/06/000063 </td>
<td> 053747 </td>
<td> Diana Purbo Siwi, Ny </td>
<td> P </td>
<td> MALANG </td>
<td> 1990-07-20 </td>
<td> 31 Th 11 Bl 16 Hr </td>
<td> ISLAM </td>
<td> APOTEKER </td>
<td> S1 </td>
<td> TNI </td>
<td> Musman, Tn </td>
<td> SUAMI </td>
<td> ASRAMA KIKAVTAI 2 KOSTRAD RT 06 RW 07, KEMANTREN, JABUNG,
<td> BPJ </td>
<td> kelas 1 </td>
<td> P04 </td>
<td> 650000 </td>
<td> O34.2 </td>
<td> O82.9 </td>
<td> 2022-07-06 </td>
<td> 10:37:48 </td>
<td> 2022-07-08 </td>
<td> 17:57:37 </td>
<td> IGDK </td>
<td> 2022/07/06/000063, BPJS KLS 1, PANDAWA 4, KONFIRMASI </td>
<td> 3 </td>
<td> 2 </td>
<td> 0 </td>
<td> 0 </td>
<td> 0 </td>
<td> 0 </td>
<td> 38-39 </td>

<td> 3350 </td>
<td> 50 </td>
<td> Hidup </td>
<td> Tidak </td>
<td> Baik </td>
<td> Ya </td>
<td> Tidak </td>
<td> Ya </td>
<td> Visite Dokter Umum, Infus Dewasa oleh Perawat / Bidan,

<td> - </td>
<td> 1950000 </td>
<td> 3 </td>
<td> Sudah </td>
</tr>
<tr>
<td> 2022/07/06/000133 </td>
<td> 072018 </td>
<td> DIANA PURBO By.Ny </td>
<td> L </td>
<td> MALANG </td>
<td> 2022-07-06 </td>
<td> ISLAM </td>
<td> - </td>
<td> TNI </td>
<td> MUSMAN, Tn </td>
<td> AYAH </td>
<td> ASRAMA KIKAVTAI 2 KOSTRAD RT 06 RW 07, KEMANTREN, JABUNG,
<td> BPJ </td>
<td> kelas 3 </td>
<td> PF22 </td>
<td> 300000 </td>
<td> P03.4 </td>
<td> P03.4 </td>
<td> 2022-07-06 </td>
<td> 10:28:25 </td>
<td> 2022-07-08 </td>
<td> 19:30:49 </td>
<td> U0030 </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> 3350 </td>
<td> 50 </td>
<td> Hidup </td>
<td> Tidak </td>
<td> Hidup </td>
<td> Ya </td>
<td> Tidak </td>
<td> Ya </td>

<td> </td>
<td> 900000 </td>
<td> Sembuh </td>
<td> 3 </td>
<td> Sudah </td>
</tr>
<tr>
<td> 2022/07/06/000208 </td>
<td> 072046 </td>
<td> SITI NUR SAIDAH, NY </td>
<td> P </td>
<td> MALANG </td>
<td> 1986-09-13 </td>
<td> 35 Th 9 Bl 24 Hr </td>
<td> ISLAM </td>
<td> SMP </td>
<td> ABDUS SALAM, TN </td>
<td> SUAMI </td>
<td> JL. KI AGENG GRIBIG RT 002 RW 003 , MADYOPURO,
<td> A09 </td>
<td> UMUM </td>
<td> kelas 3 </td>
<td> A03 </td>
<td> 300000 </td>
<td> O82.9 </td>
<td> O41.0 </td>
<td> 2022-07-06 </td>
<td> 10:13:06 </td>
<td> 2022-07-09 </td>
<td> 20:05:02 </td>
<td> IGDK </td>
<td> </td>
<td> 2022/07/06/000208, UMUM KLS III DI AMARTA 8A (SUDAH DEPOSIT)
</td>
<td> 3 </td>
<td> 2 </td>
<td> 0 </td>
<td> 0 </td>
<td> 0 </td>
<td> 0 </td>
<td> 38-39 </td>

<td> 2000 </td>
<td> 45 </td>
<td> Hidup </td>
<td> Ya </td>
<td> Hidup </td>
<td> Ya </td>
<td> Tidak </td>
<td> Ya </td>

Visite Dokter Spesialis Obgyn, Jasa Pelayanan Kelas 3 </td>
<td> - </td>
<td> 1200000 </td>
<td> Sembuh </td>
<td> 4 </td>
<td> Sudah </td>
</tr>
<tr>
<td> 2022/07/06/000127 </td>
<td> 072017 </td>
<td> SHANKARA KAIVAN MAHATMA EL HAZMI, An </td>
<td> L </td>
<td> Malang </td>
<td> 2022-07-06 </td>
<td> 0 Th 0 Bl 19 Hr </td>
<td> ISLAM </td>
<td> - </td>
<td> MUSA PRANA DESTA MANZRA SURATI, TN </td>
<td> AYAH </td>
<td> JL LA SUCIPTO 22 C RT 10 RW 9, PANDANWANGI, BLIMBING, KOTA
MALANG </td>
<td> BPJ </td>
<td> kelas 3 </td>
<td> PF11 </td>
<td> 300000 </td>
<td> P00.6 </td>
<td> P00.9 </td>
<td> 2022-07-06 </td>
<td> 10:03:25 </td>
<td> 2022-07-07 </td>
<td> 17:54:28 </td>
<td> U0030 </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> 3130 </td>
<td> 51 </td>
<td> Hidup </td>
<td> Tidak </td>
<td> Hidup </td>
<td> Ya </td>
<td> Tidak </td>
<td> Ya </td>

<td> </td>
<td> 600000 </td>
<td> Sembuh </td>
<td> 2 </td>
<td> Sudah </td>
</tr>
<tr>
<td> 2022/07/06/000124 </td>
<td> 072015 </td>
<td> ZUHROTUL AULIA, An </td>
<td> P </td>
<td> Malang </td>
<td> 2022-07-06 </td>
<td> 0 Th 0 Bl 10 Hr </td>
<td> ISLAM </td>
<td> - </td>
<td> PEDAGANG </td>
<td> MUHAMMAD IKHWAN, TN </td>
<td> AYAH </td>
<td> JL. TELUK GRAJAKAN 6 RT 11 RW 02, PANDANWANGI, BLIMBING,
KOTA MALANG </td>
<td> A09 </td>
<td> UMUM </td>
<td> kelas 3 </td>
<td> PF21 </td>
<td> 300000 </td>
<td> P03.4 </td>
<td> P03.4 </td>
<td> 2022-07-06 </td>
<td> 09:42:12 </td>
<td> 2022-07-08 </td>
<td> 19:30:10 </td>
<td> U0030 </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> 3150 </td>
<td> 49 </td>
<td> Hidup </td>
<td> Tidak </td>
<td> Hidup </td>
<td> Ya </td>
<td> Tidak </td>
<td> Ya </td>

<td> </td>
<td> 900000 </td>
<td> Sembuh </td>
<td> 3 </td>
<td> Sudah </td>
</tr>
<tr>
<td> 2022/07/06/000117 </td>
<td> 072011 </td>
<td> NUR VITAKHU By.Ny </td>
<td> L </td>
<td> Malang </td>
<td> 2022-07-06 </td>
<td> ISLAM </td>
<td> - </td>
<td> M. NUR HUDA, Tn </td>
<td> AYAH </td>
</td>
<td> BPJ </td>
<td> PA28 </td>
<td> 400000 </td>
<td> P03.4 </td>
<td> P07.1 </td>
<td> 2022-07-06 </td>
<td> 09:11:14 </td>
<td> 2022-07-08 </td>
<td> 10:58:21 </td>
<td> U0029 </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> 1200000 </td>
<td> Rujuk </td>
<td> 3 </td>
<td> Sudah </td>
</tr>
<tr>
<td> 2022/07/06/000239 </td>
<td> 070906 </td>
<td> PUSPARANI PRADANTIKA, NY </td>
<td> P </td>
<td> MALANG </td>
<td> 1996-06-27 </td>
<td> 26 Th 0 Bl 20 Hr </td>
<td> ISLAM </td>
<td> PERAWAT </td>
<td> D3 </td>
<td> ZAINUL ARIFIN, TN </td>
<td> SUAMI </td>
<td> PERUM BTU UJ NO.23, MADYOPURO, KEDUNGKANDANG, KOTA MALANG
</td>
<td> BPJ </td>
<td> kelas 2 </td>
<td> D02 </td>
<td> 400000 </td>
<td> O80.8 </td>
<td> O80.8 </td>
<td> 2022-07-06 </td>
<td> 07:46:23 </td>
<td> 2022-07-08 </td>
<td> 23:36:44 </td>
<td> IGDK </td>
<td> 2022/07/06/000239, BPJS KLS 2 TITIP KABER </td>
<td> 1 </td>
<td> 0 </td>
<td> 0 </td>
<td> 0 </td>
<td> 0 </td>
<td> 0 </td>
<td> 38-39 </td>

<td> 3180 </td>
<td> 50 </td>
<td> Hidup </td>
<td> Ya </td>
<td> Hidup </td>
<td> Ya </td>
<td> Tidak </td>
<td> Ya </td>
<td> Visite Dokter Umum, Konsultasi Dokter Spesialis Obgyn Via

Telepon </td>
<td> - </td>
<td> 1200000 </td>
<td> Sehat </td>
<td> 3 </td>
<td> Sudah </td>
</tr>
<tr>
<td> 2022/07/06/000162 </td>
<td> 022101 </td>
<td> NI MADE AYU WULANSARI, NY </td>
<td> P </td>
<td> SEMARANGT </td>
<td> 1993-09-12 </td>
<td> 28 Th 10 Bl 2 Hr </td>
<td> HINDU </td>
<td> PELAJAR </td>
<td> S1 </td>
<td> PENGAJAR </td>
<td> NYOMAN WIRA PRASETYA, TN </td>
<td> SUAMI </td>
<td> JL COMAL VI / 7A RT 4 RW 17, BUNULREJO, BLIMBING, KOTA
MALANG </td>
<td> BPJ </td>
<td> kelas 3 </td>
<td> A10 </td>
<td> 300000 </td>
<td> O82.0 </td>
<td> O82.0 </td>
<td> 2022-07-06 </td>
<td> 07:28:27 </td>
<td> 2022-07-12 </td>
<td> 06:06:08 </td>
<td> IGDK </td>
<td> 2022/07/06/000162, BPJS KELAS 2 RENCNA DI PANDAWA 08
( KONFIRMASI )
SEP SUDAH DI EDIT HIKMA, TGL 7/7/2022. SUDAH DIKONSELING BIAYA SC NAIK KELAS, 2 UP
1 </td>
<td> 2 </td>
<td> 1 </td>
<td> 0 </td>
<td> 0 </td>
<td> 0 </td>
<td> 0 </td>
<td> 39-40 </td>

<td> 3200 </td>
<td> 49 </td>
<td> Hidup </td>
<td> Tidak </td>
<td> Hidup </td>
<td> Ya </td>
<td> Tidak </td>
<td> Ya </td>

<td> - </td>
<td> 2100000 </td>
<td> 7 </td>
<td> Sudah </td>
</tr>
<tr>
<td> 2022/07/06/000062 </td>
<td> 038460 </td>
<td> ALARIC ZAFRANDI ROSID, AN </td>
<td> L </td>
<td> MALANG </td>
<td> 2020-05-02 </td>
<td> ISLAM </td>
<td> - </td>
<td> PERAWAT </td>
<td> AFRUR ROSID, TN </td>
<td> AYAH </td>
<td> JL. ARIF RAHMAN HAKIM IV A/838 RT.03 RW.02, KAUMAN, KLOJEN,
KOTA MALANG </td>
<td> BPJ </td>
<td> kelas 1 </td>
<td> H06 </td>
<td> 650000 </td>
<td> R50.9 </td>
<td> A91 </td>
<td> 2022-07-06 </td>
<td> 06:48:19 </td>
<td> 2022-07-09 </td>
<td> 21:54:02 </td>
<td> IGDK </td>
<td> 2022/07/06/000062, BPJS KLS 2 UP 1 HASTINA 6 </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>

<td> - </td>
<td> 2600000 </td>
<td> Sembuh </td>
<td> 4 </td>
<td> Sudah </td>
</tr>
<tr>
<td> 2022/07/06/000077 </td>
<td> 072001 </td>
<td> AXELNO ABHINAYA MAHESA ATMADEWA, AN </td>
<td> L </td>
<td> Malang </td>
<td> 2022-07-06 </td>
<td> 0 Th 0 Bl 10 Hr </td>
<td> HINDU </td>
<td> TS </td>
<td> ADAM HANIDA, TN </td>
<td> AYAH </td>
<td> DS. KESAMBEN RT 02 RW 03, KESAMBEN, NGAJUM, KABUPATEN MALANG
</td>
<td> BPJ </td>
<td> kelas 3 </td>
<td> PF02 </td>
<td> 300000 </td>
<td> P00.6 </td>
<td> P00.9 </td>
<td> 2022-07-06 </td>
<td> 06:43:51 </td>
<td> 2022-07-07 </td>
<td> 15:20:57 </td>
<td> U0030 </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> 2970 </td>
<td> 46 </td>
<td> Hidup </td>
<td> Ya </td>
<td> Hidup </td>
<td> Ya </td>
<td> Tidak </td>
<td> Ya </td>

<td> - </td>
<td> 600000 </td>
<td> Sembuh </td>
<td> 2 </td>
<td> Sudah </td>
</tr>
<tr>
<td> 2022/07/06/000066 </td>
<td> 071998 </td>
<td> MUHAMMAD ALWY ARSALAN, AN </td>
<td> L </td>
<td> MALANG </td>
<td> 2022-07-06 </td>
<td> ISLAM </td>
<td> TS </td>
<td> PRASETYO, TN </td>
<td> AYAH </td>
<td> JL. KOL SUGIONO I/20 RT 04 RW 06, MERGOSONO, KEDUNGKANDANG,
KOTA MALANG </td>
<td> BPJ </td>
<td> kelas 3 </td>
<td> PF18 </td>
<td> 300000 </td>
<td> P00.6 </td>
<td> P00.9 </td>
<td> 2022-07-06 </td>
<td> 05:51:46 </td>
<td> 2022-07-07 </td>
<td> 15:21:25 </td>
<td> U0030 </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> 3500 </td>
<td> 51 </td>
<td> Hidup </td>
<td> Ya </td>
<td> Hidup </td>
<td> Ya </td>
<td> Tidak </td>
<td> Ya </td>

<td> - </td>
<td> 600000 </td>
<td> Sembuh </td>
<td> 2 </td>
<td> Sudah </td>
</tr>
<tr>
<td> 2022/07/06/000225 </td>
<td> 072054 </td>
<td> ANISA AKILA, AN </td>
<td> P </td>
<td> MALANG </td>
<td> 2022-04-02 </td>
<td> ISLAM </td>
<td> TS </td>
<td> M YUSUF, TN </td>
<td> AYAH </td>
<td> CURAH AMPEL RT 2 RW 2, AMPELDENTO, PAKIS, KABUPATEN MALANG
</td>
<td> A09 </td>
<td> UMUM </td>
<td> kelas 3 </td>
<td> A01 </td>
<td> 300000 </td>
<td> A09 </td>
<td> A09 </td>
<td> 2022-07-06 </td>
<td> 01:51:31 </td>
<td> 2022-07-08 </td>
<td> 10:20:47 </td>
<td> IGDK </td>
<td> </td>
<td> 2022/07/06/000225, UMUM KLS III DIAMARTA 4A </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>

<td> - </td>
<td> 900000 </td>
<td> Sembuh </td>
<td> 3 </td>
<td> Sudah </td>
</tr>
<tr>
<td> 2022/07/06/000233 </td>
<td> 072059 </td>
<td> M ALTHAFUR RAHMAN JAFAR, AN </td>
<td> L </td>
<td> MALANG </td>
<td> 2019-10-03 </td>
<td> ISLAM </td>
<td> - </td>
<td> GURU </td>
<td> MOCH JAFAR, TN </td>
<td> AYAH </td>
<td> JL LAKSADA ADI SUCIPTO GG 22 A, PANDANWANGI, BLIMBING, KOTA
MALANG </td>
<td> BPJ </td>
<td> kelas 3 </td>
<td> A14 </td>
<td> 300000 </td>
<td> A09 </td>
<td> A09 </td>
<td> 2022-07-06 </td>
<td> 01:50:43 </td>
<td> 2022-07-10 </td>
<td> 23:35:13 </td>
<td> IGDK </td>
<td> </td>
<td> 2022/07/06/000233, BPJS KELAS 3 RUANG AMARTA 1 B </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>

<td> - </td>
<td> 1500000 </td>
<td> Sembuh </td>
<td> 5 </td>
<td> Sudah </td>
</tr>
<tr>
<td> 2022/07/06/000136 </td>
<td> 019217 </td>
<td> SRI INTAN IRGAWATI,NY </td>
<td> P </td>
<td> Pasuruan </td>
<td> 1992-03-11 </td>
<td> 30 Th 4 Bl 3 Hr </td>
<td> ISLAM </td>
<td> S1 </td>
<td> Robby Darmawan, Tn </td>
<td> SUAMI </td>
<td> DSN KRAJAN II RT 04 RW 02, ANDONO SARI, TUTUR, PASURUAN KAB
</td>
<td> BPJ </td>
<td> kelas 2 </td>
<td> D08 </td>
<td> 400000 </td>
<td> O48 </td>
<td> O80.8 </td>
<td> 2022-07-06 </td>
<td> 00:52:03 </td>
<td> 2022-07-08 </td>
<td> 08:46:37 </td>
<td> IGDK </td>
<td> DR. NOVINA SP.OG (K) </td>
<td> </td>
<td> 2 </td>
<td> 1 </td>
<td> 0 </td>
<td> 0 </td>
<td> 0 </td>
<td> 0 </td>
<td> 40-41 </td>

<td> 3060 </td>
<td> 48 </td>
<td> Hidup </td>
<td> Ya </td>
<td> Hidup </td>
<td> Ya </td>
<td> Tidak </td>
<td> Ya </td>
<td> </td>
<td> </td>
<td> 1200000 </td>
<td> Sembuh </td>
<td> 3 </td>
<td> Sudah </td>
</tr>
<tr>
<td> 2022/07/06/000178 </td>
<td> 072031 </td>
<td> LENI KRISNAWATI, NY </td>
<td> P </td>
<td> MALANG </td>
<td> 2001-11-30 </td>
<td> 20 Th 7 Bl 7 Hr </td>
<td> ISLAM </td>
<td> SMA </td>
<td> EFRAN BUDI PRANATA, TN </td>
<td> SUAMI </td>
<td> BANARAN RT 001 RW 006, BABADAN, NGAJUM, KABUPATEN MALANG
</td>
<td> BPJ </td>
<td> kelas 3 </td>
<td> A11 </td>
<td> 300000 </td>
<td> O80.9 </td>
<td> O80.8 </td>
<td> 2022-07-06 </td>
<td> 00:51:51 </td>
<td> 2022-07-08 </td>
<td> 10:20:03 </td>
<td> IGDK </td>
<td> 2022/07/06/000178, BPJS KLS III DI AMARTA 5A (DENDA 45 HARI)
UPDATE 7/7 SUDAH BAYAR DENDA DAN DICETAKKAN SEP (WD) </td>
<td> 1 </td>
<td> 0 </td>
<td> 0 </td>
<td> 0 </td>
<td> 0 </td>
<td> 0 </td>
<td> 38-39 </td>

<td> 2545 </td>
<td> 48 </td>
<td> Hidup </td>
<td> Ya </td>
<td> Hidup </td>
<td> Ya </td>
<td> Tidak </td>
<td> Ya </td>

<td> - </td>
<td> 900000 </td>
<td> Sembuh </td>
<td> 3 </td>
<td> Sudah </td>
</tr>
<tr>
<td> 2022/07/05/000089 </td>
<td> 071960 </td>
<td> ARLINA WULANDARI SAPUTRI, AN </td>
<td> P </td>
<td> MALANG </td>
<td> 2020-09-14 </td>
<td> 1 Th 9 Bl 27 Hr </td>
<td> ISLAM </td>
<td> TS </td>
<td> ARI MAULANA, TN </td>
<td> AYAH </td>
<td> JL. KAPIWORO II RT 03 RW 11, MANGLIAWAN, PAKIS, KABUPATEN
MALANG </td>
<td> A09 </td>
<td> UMUM </td>
<td> kelas 3 </td>
<td> A16 </td>
<td> 300000 </td>
<td> R11 </td>
<td> R11 </td>
<td> 2022-07-05 </td>
<td> 23:40:03 </td>
<td> 2022-07-08 </td>
<td> 10:20:24 </td>
<td> IGDK </td>
<td> </td>
<td> 2022/07/05/000089, UMUM KELAS 3 TITIP DI AYODYA 3A </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> Visite Dokter Spesialis Anak, Infus Dewasa Oleh

Perawat/Bidan </td>
<td> - </td>
<td> 900000 </td>
<td> 3 </td>
<td> Sudah </td>
</tr>
<tr>
<td> 2022/07/05/000065 </td>
<td> 071947 </td>
<td> SITI FATIMAH, Ny </td>
<td> P </td>
<td> MALANG </td>
<td> 1996-05-23 </td>
<td> 26 Th 1 Bl 24 Hr </td>
<td> ISLAM </td>
<td> SMP </td>
<td> ANANG WIJAYANTO, Tn </td>
<td> SUAMI </td>
<td> JL. SUDIRMAN RT 18 RW 02, KAMBINGAN, TUMPANG, KABUPATEN
MALANG </td>
<td> BPJ </td>
<td> kelas 3 </td>
<td> A05 </td>
<td> 300000 </td>
<td> O34.2 </td>
<td> O82.8 </td>
<td> 2022-07-05 </td>
<td> 22:47:34 </td>
<td> 2022-07-09 </td>
<td> 16:23:04 </td>
<td> IGDK </td>
<td> 2022/07/05/000065 BPJS KELAS 3 DI AMARTA 5C </td>
<td> 3 </td>
<td> 2 </td>
<td> 0 </td>
<td> 0 </td>
<td> 0 </td>
<td> 0 </td>
<td> 41-42 </td>

<td> 4800 </td>
<td> 53 </td>
<td> Hidup </td>
<td> Tidak </td>
<td> Hidup </td>
<td> Ya </td>
<td> Tidak </td>
<td> Ya </td>

Dewasa oleh Perawat / Bidan, Oksigen 100% Sentral 3 LPM , Operasional Rumah Sakit
</td>
<td> </td>
<td> 1200000 </td>
<td> 4 </td>
<td> Sudah </td>
</tr>
<tr>
<td> 2022/07/05/000214 </td>
<td> 071994 </td>
<td> SITI FATIMAH, By Ny </td>
<td> L </td>
<td> MALANG </td>
<td> 2022-07-05 </td>
<td> ISLAM </td>
<td> TS </td>
<td> ANANG WIJAYANTO, TN </td>
<td> AYAH </td>
<td> JL. SUDIRMAN RT 018 RW 002, KAMBINGAN, TUMPANG, KABUPATEN
MALANG </td>
<td> BPJ </td>
<td> kelas 3 </td>
<td> PF18 </td>
<td> 300000 </td>
<td> P03.4 </td>
<td> P21.1 </td>
<td> 2022-07-05 </td>
<td> 20:43:37 </td>
<td> 2022-07-05 </td>
<td> 23:05:15 </td>
<td> U0030 </td>
<td> 2022/07/05/000214, BPJS FISOL
</td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> 4800 </td>
<td> 53 </td>
<td> Hidup </td>
<td> Tidak </td>
<td> Hidup </td>
<td> Ya </td>
<td> Tidak </td>
<td> Ya </td>

<td> - </td>
<td> 300000 </td>
<td> Sembuh </td>
<td> 1 </td>
<td> Sudah </td>
</tr>
<tr>
<td> 2022/07/05/000211 </td>
<td> 071856 </td>
<td> AYESHA PUTRI JULIAVIRA, AN </td>
<td> P </td>
<td> MALANG </td>
<td> 2022-07-03 </td>
<td> 0 Th 0 Bl 10 Hr </td>
<td> ISLAM </td>
<td> - </td>
<td> TRENDI DJUNIANTA, Tn </td>
<td> AYAH </td>
<td> WONOREJO 1/10-A RT 01 RW 03, WONOREJO, TEGAL SARI, SURABAYA
</td>
<td> BPJ </td>
<td> K0000239 </td>
<td> KS IGD 1 </td>
<td> 400000 </td>
<td> G40.9 </td>
<td> - </td>
<td> 2022-07-05 </td>
<td> 20:19:51 </td>
<td> 2022-07-06 </td>
<td> 18:38:10 </td>
<td> IGDK </td>
<td> 2022/07/05/000211,BPJS KELAS 2, NICU </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> Visite Dokter Spesialis Anak, Sewa Infus Pump, Sewa Syringe
Pump, Infus Bayi oleh Perawat / Bidan </td>
<td> - </td>
<td> 800000 </td>
<td> 2 </td>
<td> Sudah </td>
</tr>
<tr>
<td> 2022/07/05/000122 </td>
<td> 071968 </td>
<td> SUBAIDAH, NY </td>
<td> P </td>
<td> SAMPANG </td>
<td> 1995-06-10 </td>
<td> 27 Th 1 Bl 6 Hr </td>
<td> ISLAM </td>
<td> SMP </td>
<td> EMBRAN,TN </td>
<td> SUAMI </td>
<td> DSN PANCOR RT 0 RW 0 , PAMOLAAN, CAMPLONG, SAMPANG </td>
<td> BPJ </td>
<td> kelas 3 </td>
<td> A04 </td>
<td> 300000 </td>
<td> O03.4 </td>
<td> O03.4 </td>
<td> 2022-07-05 </td>
<td> 15:26:28 </td>
<td> 2022-07-05 </td>
<td> 18:53:20 </td>
<td> IGDK </td>
<td> 2022/07/05/000122, BPJS KELAS 3 RUANG AMARTA 5D </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>

LPM , Konsultasi Dokter Spesialis Obgyn Via Telepon </td>
<td> - </td>
<td> 300000 </td>
<td> 1 </td>
<td> Sudah </td>
</tr>
<tr>
<td> 2022/07/05/000141 </td>
<td> 072936 </td>
<td> NARA SATRIA ZILQIAH, An </td>
<td> P </td>
<td> MALANG </td>
<td> 2013-10-19 </td>
<td> 8 Th 8 Bl 24 Hr </td>
<td> ISLAM </td>
<td> TS </td>
<td> - </td>
<td> SRI MUJI HARTATIK, NY </td>
<td> IBU </td>
<td> PERUM SULFAT GARDEN KAV 9 RT02/RW04, PANDANWANGI, BLIMBING,
KOTA MALANG </td>
<td> BPJ </td>
<td> kelas 1 </td>
<td> H02 </td>
<td> 650000 </td>
<td> A91 </td>
<td> A91 </td>
<td> 2022-07-05 </td>
<td> 15:03:05 </td>
<td> 2022-07-10 </td>
<td> 11:58:49 </td>
<td> IGDK </td>
<td> 2022/07/05/000141, BPJS KELAS 1 RUANG HASTINA 2 </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>

<td> - </td>
<td> 3900000 </td>
<td> 6 </td>
<td> Sudah </td>
</tr>
<tr>
<td> 2022/07/05/000140 </td>
<td> 098790 </td>
<td> WILDAN SATRIA ABIMANYU, AN </td>
<td> L </td>
<td> Malang </td>
<td> 2009-10-17 </td>
<td> 12 Th 8 Bl 26 Hr </td>
<td> ISLAM </td>
<td> TS </td>
<td> TNI </td>
<td> Satria Candra, Tn </td>
<td> AYAH </td>
<td> PERUM SULFAT GARDEN RT 15 RW 4, PANDANWANGI, BLIMBING, KOTA
MALANG </td>
<td> BPJ </td>
<td> kelas 1 </td>
<td> H01 </td>
<td> 650000 </td>
<td> A91 </td>
<td> A91 </td>
<td> 2022-07-05 </td>
<td> 15:02:46 </td>
<td> 2022-07-10 </td>
<td> 11:58:22 </td>
<td> IGDK </td>
<td> 2022/07/05/000140, BPJS KELAS1 RUANG HASTINA 1 </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>

<td> - </td>
<td> 3900000 </td>
<td> 6 </td>
<td> Sudah </td>
</tr>
<tr>
<td> 2022/07/05/000187 </td>
<td> 093779 </td>
<td> Hana Leony Luvitasari, Ny </td>
<td> P </td>
<td> Malang </td>
<td> 1992-08-10 </td>
<td> 29 Th 10 Bl 26 Hr </td>
<td> ISLAM </td>
<td> D1 </td>
<td> Jlitheng Agasta, Tn </td>
<td> SUAMI </td>
<td> JL. MANYAR NO 10 RT007/RW009, SUKUN, SUKUN, KOTA MALANG
</td>
<td> BPJ </td>
<td> kelas 2 </td>
<td> H08 </td>
<td> 400000 </td>
<td> O80.8 </td>
<td> O80.8 </td>
<td> 2022-07-05 </td>
<td> 13:38:08 </td>
<td> 2022-07-07 </td>
<td> 20:49:31 </td>
<td> IGDK </td>
<td> 2022/07/05/000187, BPJS KELAS 2, RENCANA RUANGAN PANDAWA 1
(HBSAG POSITIF) </td>
<td> 3 </td>
<td> 1 </td>
<td> 0 </td>
<td> 0 </td>
<td> 1 </td>
<td> 0 </td>
<td> 41-42 </td>

<td> 2915 </td>
<td> 49 </td>
<td> Hidup </td>
<td> Ya </td>
<td> Hidup </td>
<td> Ya </td>
<td> Tidak </td>
<td> Ya </td>
<td> VT Dokter </td>

<td> - </td>
<td> 1200000 </td>
<td> Sehat </td>
<td> 3 </td>
<td> Sudah </td>
</tr>
<tr>
<td> 2022/07/05/000135 </td>
<td> 071610 </td>
<td> ACHMAD REYHAN ALFARIZQI,AN </td>
<td> L </td>
<td> MALANG </td>
<td> 2022-06-28 </td>
<td> 0 Th 0 Bl 13 Hr </td>
<td> ISLAM </td>
<td> TS </td>
<td> ZAINUL ROMA DHONA, TN </td>
<td> AYAH </td>
<td> JL. SILIKAT I/17A RT 01 RW 11, PURWANTORO, BLIMBING, KOTA
MALANG </td>
<td> BPJ </td>
<td> kelas 3 </td>
<td> PA031 </td>
<td> NICU 3 </td>
<td> 300000 </td>
<td> P59.8 </td>
<td> P59.8 </td>
<td> 2022-07-05 </td>
<td> 13:34:16 </td>
<td> 2022-07-07 </td>
<td> 14:56:28 </td>
<td> IGDK </td>
<td> 2022/07/05/000135, BPJS KELAS 3 RUANG NICU </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>

Sewa Fototerapi , Sewa Fototerapi , Konsultasi Dokter Spesialis Anak Via Telepon,
<td> - </td>
<td> 900000 </td>
<td> Sehat </td>
<td> 3 </td>
<td> Sudah </td>
</tr>
<tr>
<td> 2022/07/05/000126 </td>
<td> 071568 </td>
<td> EKA IRVATUL LAILIYA, NY </td>
<td> P </td>
<td> MALANG </td>
<td> 1997-09-27 </td>
<td> 24 Th 9 Bl 8 Hr </td>
<td> ISLAM </td>
<td> SD </td>
<td> ABDUL HAMID, TN </td>
<td> SUAMI </td>
<td> SUMBERSUKO RT023 RW005, SUMBERSUKO, WAGIR, KABUPATEN MALANG
</td>
<td> BPJ </td>
<td> kelas 3 </td>
<td> A09 </td>
<td> 300000 </td>
<td> O82.8 </td>
<td> O82.9 </td>
<td> 2022-07-05 </td>
<td> 12:55:01 </td>
<td> 2022-07-07 </td>
<td> 10:08:53 </td>
<td> IGDK </td>
<td> 2022/07/05/000126, BPJS KLS 3, AMARTA 6C </td>
<td> 3 </td>
<td> 2 </td>
<td> 0 </td>
<td> 0 </td>
<td> 0 </td>
<td> 0 </td>
<td> 38-39 </td>

<td> 2900 </td>
<td> 47 </td>
<td> Hidup </td>
<td> Tidak </td>
<td> Hidup </td>
<td> Ya </td>
<td> Tidak </td>
<td> Ya </td>

<td> </td>
<td> 900000 </td>
<td> 3 </td>
<td> Sudah </td>
</tr>
<tr>
<td> 2022/07/05/000066 </td>
<td> 060078 </td>
<td> INDAH AYU SAFITRI, NY </td>
<td> P </td>
<td> MALANG </td>
<td> 1994-04-01 </td>
<td> 28 Th 3 Bl 19 Hr </td>
<td> ISLAM </td>
<td> S1 </td>
<td> ABDURRAHMAN ARIF KASIM </td>
<td> SUAMI </td>
<td> PERUM ASRIKATON INDAH BLOK AI/06 RT 01 W 09, ASRIKATON,
<td> BPJ </td>
<td> kelas 1 </td>
<td> H09 </td>
<td> 650000 </td>
<td> O80.8 </td>
<td> O82.0 </td>
<td> 2022-07-05 </td>
<td> 12:54:47 </td>
<td> 2022-07-07 </td>
<td> 10:03:38 </td>
<td> IGDK </td>
<td> 1 </td>
<td> 1 </td>
<td> 0 </td>
<td> 0 </td>
<td> 0 </td>
<td> 0 </td>
<td> 40-41 </td>

<td> 3200 </td>
<td> 47.5 </td>
<td> Hidup </td>
<td> Tidak </td>
<td> Hidup </td>
<td> Ya </td>
<td> Tidak </td>
<td> Ya </td>
<td> Visite Dokter Spesialis Obgyn, VT Dokter, Infus Dewasa oleh

Perawat / Bidan, Infus Dewasa oleh Perawat / Bidan </td>
<td> - </td>
<td> 1950000 </td>
<td> Sehat </td>
<td> 3 </td>
<td> Sudah </td>
</tr>
<tr>
<td> 2022/07/05/000173 </td>
<td> 071978 </td>
<td> SENJA AMALIA YUNITA, AN </td>
<td> P </td>
<td> MALANG </td>
<td> 2021-01-06 </td>
<td> 1 Th 5 Bl 29 Hr </td>
<td> ISLAM </td>
<td> TS </td>
<td> TAUFIK HENDRA HIDAYAT, TN </td>
<td> AYAH </td>
<td> WONOREJO RT 13 RW 3, WONOREJO, PONCOKUSUMO, KABUPATEN MALANG
</td>
<td> BPJ </td>
<td> kelas 3 </td>
<td> A15 </td>
<td> 300000 </td>
<td> A09 </td>
<td> A09 </td>
<td> 2022-07-05 </td>
<td> 12:43:07 </td>
<td> 2022-07-08 </td>
<td> 10:16:41 </td>
<td> IGDK </td>
<td> 2022/07/05/000173, BPJS KELAS 3, TITIP AYODYA 1A </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> - </td>
<td> 1200000 </td>
<td> Sembuh </td>
<td> 4 </td>
<td> Sudah </td>
</tr>
<tr>
<td> 2022/07/05/000147 </td>
<td> 071973 </td>
<td> EKA IRVATUL L., BY NY </td>
<td> L </td>
<td> MALANG </td>
<td> 2022-07-05 </td>
<td> ISLAM </td>
<td> - </td>
<td> ABDUL HAMID, TN </td>
<td> AYAH </td>
<td> SUMBERSUKO RT 23 RW 5 , SUMBERSUKO, WAGIR, KABUPATEN MALANG
</td>
<td> BPJ </td>
<td> PA26 </td>
<td> 400000 </td>
<td> P03.4 </td>
<td> P91.6 </td>
<td> 2022-07-05 </td>
<td> 12:17:47 </td>
<td> 2022-07-12 </td>
<td> 23:24:36 </td>
<td> U0029 </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> 2900 </td>
<td> 47 </td>
<td> Hidup </td>
<td> Tidak </td>
<td> Baik </td>
<td> Ya </td>
<td> Tidak </td>
<td> Ya </td>
<td> Perawatan Bayi SC , Perawatan Bayi SC , Visite Dokter

Pemasangan CPAP Hari Pertama, Sewa Infus Pump, Sewa Infus Pump, Sewa Infus Pump,
Sewa Infus Pump, Sewa Inkubator, Sewa Inkubator, Sewa Inkubator, Sewa Inkubator,
Sewa Inkubator, Sewa Inkubator, Sewa Syringe Pump, Sewa Syringe Pump, Sewa Syringe
Pump, Sewa Syringe Pump, Sewa Patient Monitor , Sewa Patient Monitor , Sewa Patient
Monitor , Sewa Patient Monitor , Sewa Fototerapi, Sewa Fototerapi, Sewa Fototerapi,
Infus Bayi oleh Perawat / Bidan </td>
<td> - </td>
<td> 3200000 </td>
<td> Sembuh </td>
<td> 8 </td>
<td> Sudah </td>
</tr>
<tr>
<td> 2022/07/05/000142 </td>
<td> 071971 </td>
<td> NUHA AL BIRRU USMAN KASIM, AN </td>
<td> L </td>
<td> MALANG </td>
<td> 2022-07-05 </td>
<td> 0 Th 0 Bl 19 Hr </td>
<td> ISLAM </td>
<td> - </td>
<td> ABDURRAHMAN ARIF KASIM, TN </td>
<td> AYAH </td>
<td> PERUM ASRIKATON INDAH BLOK AI/06 RT 01 RW 09, ASRIKATON,
<td> BPJ </td>
<td> kelas 3 </td>
<td> PF20 </td>
<td> 300000 </td>
<td> P03.4 </td>
<td> P03.4 </td>
<td> 2022-07-05 </td>
<td> 11:18:43 </td>
<td> 2022-07-08 </td>
<td> 09:44:18 </td>
<td> U0030 </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> 3200 </td>
<td> 47,5 </td>
<td> Hidup </td>
<td> Tidak </td>
<td> Hidup </td>
<td> Ya </td>
<td> Tidak </td>
<td> Ya </td>

<td> - </td>
<td> 1200000 </td>
<td> Sembuh </td>
<td> 4 </td>
<td> Sudah </td>
</tr>
<tr>
<td> 2022/07/05/000221 </td>
<td> 035308 </td>
<td> SOFIATUL FARDANIYAH, NY </td>
<td> P </td>
<td> MALANG </td>
<td> 1999-08-26 </td>
<td> 22 Th 10 Bl 19 Hr </td>
<td> ISLAM </td>
<td> SMA </td>
<td> PEDAGANG </td>
<td> MUHAMMAD IKHWAN, TN </td>
<td> SUAMI </td>
<td> JL. TELUK GRAJAKAN 6 RT 11 RW 02, PANDANWANGI, BLIMBING,
KOTA MALANG </td>
<td> A09 </td>
<td> UMUM </td>
<td> kelas 1 </td>
<td> H03 </td>
<td> 650000 </td>
<td> O80.9 </td>
<td> O82.0 </td>
<td> 2022-07-05 </td>
<td> 10:20:17 </td>
<td> 2022-07-08 </td>
<td> 18:20:07 </td>
<td> IGDK </td>
<td> </td>
<td> 2022/07/05/000221, UMUM KLS 1, INPARTU, PANDAWA 4 ,
KONFIRMASI RUANGAN
SUAMI PASIEN SUDAH DITAWARI MENGGUNAKAN BPJS, TAPI MEMILIH MENGGUNAKAN UMUM </td>
<td> 1 </td>
<td> 0 </td>
<td> 0 </td>
<td> 0 </td>
<td> 0 </td>
<td> 0 </td>
<td> 39-40 </td>

<td> 3150 </td>
<td> 49 </td>
<td> Hidup </td>
<td> Tidak </td>
<td> Hidup </td>
<td> Ya </td>
<td> Tidak </td>
<td> Ya </td>
<td> Visite Dokter Umum, Konsultasi Dokter Spesialis Obgyn Via

Telepon </td>
<td> - </td>
<td> 2600000 </td>
<td> 4 </td>
<td> Sudah </td>
</tr>
<tr>
<td> 2022/07/05/000175 </td>
<td> 070838 </td>
<td> PUJI RAHAYU, NY </td>
<td> P </td>
<td> MALANG </td>
<td> 2000-03-04 </td>
<td> 22 Th 4 Bl 7 Hr </td>
<td> HINDU </td>
<td> SMA </td>
<td> ADAM HANIDA, TN </td>
<td> SUAMI </td>
<td> DS. KESAMBEN RT 02 RW 03, KESAMBEN, NGAJUM, KABUPATEN MALANG
</td>
<td> BPJ </td>
<td> kelas 2 </td>
<td> D09 </td>
<td> 400000 </td>
<td> O42.9 </td>
<td> O80.8 </td>
<td> 2022-07-05 </td>
<td> 08:18:33 </td>
<td> 2022-07-07 </td>
<td> 15:10:20 </td>
<td> IGDK </td>
<td> 2022/07/05/000175, BPJS KELAS 2, TITIP AMARTA 6A </td>
<td> 1 </td>
<td> 0 </td>
<td> 0 </td>
<td> 0 </td>
<td> 0 </td>
<td> 0 </td>
<td> 39-40 </td>

<td> 2950 </td>
<td> 46 </td>
<td> Hidup </td>
<td> Ya </td>
<td> Hidup </td>
<td> Ya </td>
<td> Tidak </td>
<td> Ya </td>
<td> </td>
<td> - </td>
<td> 1200000 </td>
<td> Sembuh </td>
<td> 3 </td>
<td> Sudah </td>
</tr>
<tr>
<td> 2022/07/05/000213 </td>
<td> 062463 </td>
<td> ROSALIA TRISNAWATI, NY </td>
<td> P </td>
<td> MALANG </td>
<td> 1997-09-01 </td>
<td> 24 Th 10 Bl 9 Hr </td>
<td> ISLAM </td>
<td> SMA </td>
<td> PRASETYO, TN </td>
<td> SUAMI </td>
<td> JL KOL SUGIONO I/20 RT 4 RW 6, MERGOSONO, KEDUNGKANDANG,
KOTA MALANG </td>
<td> BPJ </td>
<td> kelas 2 </td>
<td> A04 </td>
<td> 400000 </td>
<td> O80.9 </td>
<td> O80.8 </td>
<td> 2022-07-05 </td>
<td> 06:18:20 </td>
<td> 2022-07-07 </td>
<td> 12:34:35 </td>
<td> IGDK </td>
<td> 2022/07/05/000213, BPJS KELAS 2, TITIP AMARTA 5D, RENCANA
KELAS 2 MENYUSUL </td>
<td> 1 </td>
<td> 0 </td>
<td> 0 </td>
<td> 0 </td>
<td> 0 </td>
<td> 0 </td>
<td> 40-41 </td>

<td> 3500 </td>
<td> 51 </td>
<td> Hidup </td>
<td> Ya </td>
<td> Hidup </td>
<td> Ya </td>
<td> Tidak </td>
<td> Ya </td>
<td> </td>
<td> - </td>
<td> 1200000 </td>
<td> Sembuh </td>
<td> 3 </td>
<td> Sudah </td>
</tr>
<tr>
<td> 2022/07/05/000068 </td>
<td> 071948 </td>
<td> FASYA AHMAD MELVIANO SOFYAN, AN </td>
<td> L </td>
<td> Malang </td>
<td> 2022-07-05 </td>
<td> ISLAM </td>
<td> - </td>
<td> PEDAGANG </td>
<td> MOCHAMAD SOFYAN, Tn </td>
<td> AYAH </td>
<td> JL. BATUBARA NO.13A RT 01 RW 08, PURWANTORO, BLIMBING, KOTA
MALANG </td>
<td> BPJ </td>
<td> kelas 3 </td>
<td> PF16 </td>
<td> 300000 </td>
<td> P00.6 </td>
<td> P00.9 </td>
<td> 2022-07-05 </td>
<td> 05:13:30 </td>
<td> 2022-07-07 </td>
<td> 15:22:04 </td>
<td> U0030 </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> 2895 </td>
<td> 47 </td>
<td> Hidup </td>
<td> Ya </td>
<td> Hidup </td>
<td> Ya </td>
<td> Tidak </td>
<td> Ya </td>
<td> Perawatan Bayi NP , Konsultasi Dokter Spesialis Anak Via

Telepon </td>
<td> - </td>
<td> 900000 </td>
<td> Sembuh </td>
<td> 3 </td>
<td> Sudah </td>
</tr>
<tr>
<td> 2022/07/05/000191 </td>
<td> 090298 </td>
<td> Ramdhan Satriyo Wicaksono, An </td>
<td> L </td>
<td> Malang </td>
<td> 2013-07-16 </td>
<td> 8 Th 11 Bl 25 Hr </td>
<td> ISLAM </td>
<td> TS </td>
<td> PERAWAT </td>
<td> ATIK KHOFIFAHTUROHMAH, NY </td>
<td> IBU </td>
<td> PERUM PONDOK MULIA A004 JL. TERUSAN KAYAN RT, ARJOSARI,
<td> A09 </td>
<td> UMUM </td>
<td> kelas 1 </td>
<td> P01 </td>
<td> 650000 </td>
<td> G40.9 </td>
<td> G40.9 </td>
<td> 2022-07-05 </td>
<td> 03:02:46 </td>
<td> 2022-07-07 </td>
<td> 10:30:40 </td>
<td> IGDK </td>
<td> </td>
<td> 2022/07/05/000191, UMUM KELAS 1 HASTINA 6 </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>

<td> - </td>
<td> 1950000 </td>
<td> Sembuh </td>
<td> 3 </td>
<td> Sudah </td>
</tr>
<tr>
<td> 2022/07/05/000177 </td>
<td> 040977 </td>
<td> IRAWATI, NY </td>
<td> P </td>
<td> Malang </td>
<td> 1990-01-01 </td>
<td> 32 Th 6 Bl 6 Hr </td>
<td> ISLAM </td>
<td> D3 </td>
<td> SWASTA </td>
<td> IMMANUEL HAREFA, TN </td>
<td> SUAMI </td>
<td> BANDULAN BARU 144 RT02 RW05, BANDULAN, SUKUN, KOTA MALANG
</td>
<td> BPJ </td>
<td> kelas 1 </td>
<td> H06 </td>
<td> 650000 </td>
<td> O80.8 </td>
<td> O82.9 </td>
<td> 2022-07-05 </td>
<td> 00:51:17 </td>
<td> 2022-07-07 </td>
<td> 10:21:43 </td>
<td> IGDK </td>
<td> 5 </td>
<td> 1 </td>
<td> 0 </td>
<td> 0 </td>
<td> 3 </td>
<td> 0 </td>
<td> 39-40 </td>

<td> 3290 </td>
<td> 49 </td>
<td> Hidup </td>
<td> Ya </td>
<td> Hidup </td>
<td> Ya </td>
<td> Tidak </td>
<td> Ya </td>
<td> Visite Dokter Umum, VT Dokter , Konsultasi Dokter Spesialis

<td> - </td>
<td> 1950000 </td>
<td> 3 </td>
<td> Sudah </td>
</tr>
<tr>
<td> 2022/07/04/000230 </td>
<td> 071946 </td>
<td> ULTRA MAVISHA MARYAM, AN </td>
<td> P </td>
<td> MALANG </td>
<td> 2022-07-04 </td>
<td> 0 Th 0 Bl 16 Hr </td>
<td> ISLAM </td>
<td> TS </td>
<td> AYAH </td>
<td> JL. BIMA NO 22 RT 002 RW 011, TUMPANG, TUMPANG, KABUPATEN
MALANG </td>
<td> BPJ </td>
<td> kelas 3 </td>
<td> PF12 </td>
<td> 300000 </td>
<td> P00.6 </td>
<td> P00.9 </td>
<td> 2022-07-04 </td>
<td> 23:36:24 </td>
<td> 2022-07-08 </td>
<td> 19:29:56 </td>
<td> U0030 </td>
<td> 2022/07/04/000230, FISOL </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> 2635 </td>
<td> 48 </td>
<td> Hidup </td>
<td> Ya </td>
<td> Hidup </td>
<td> Ya </td>
<td> Tidak </td>
<td> Ya </td>

<td> - </td>
<td> 1200000 </td>
<td> Sembuh </td>
<td> 4 </td>
<td> Sudah </td>
</tr>
<tr>
<td> 2022/07/04/000124 </td>
<td> 071901 </td>
<td> NOVITASARI, NY </td>
<td> P </td>
<td> MALANG </td>
<td> 1990-11-13 </td>
<td> 31 Th 8 Bl 7 Hr </td>
<td> ISLAM </td>
<td> SD </td>
<td> M FITROTUL IROM, TN </td>
<td> SUAMI </td>
<td> JL. KOL SUGIONO RT 10 RW 1 , KEMANTREN, JABUNG, KABUPATEN
MALANG </td>
<td> BPJ </td>
<td> kelas 3 </td>
<td> A03 </td>
<td> 300000 </td>
<td> O46.9 </td>
<td> - </td>
<td> 2022-07-04 </td>
<td> 23:20:34 </td>
<td> 2022-07-06 </td>
<td> 09:13:32 </td>
<td> IGDK </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
Visite Dokter Spesialis Obgyn, VT Dokter , Infus Dewasa oleh Perawat / Bidan,
Konsultasi Dokter Spesialis Obgyn Via Telepon, Operasional Rumah Sakit </td>
<td> - </td>
<td> 600000 </td>
<td> Sehat </td>
<td> 2 </td>
<td> Sudah </td>
</tr>
<tr>
<td> 2022/07/04/000152 </td>
<td> 057893 </td>
<td> ACHALENDRA FAAZ ALBIRRU, AN </td>
<td> L </td>
<td> MALANG </td>
<td> 2021-09-23 </td>
<td> 0 Th 9 Bl 19 Hr </td>
<td> ISLAM </td>
<td> TS </td>
<td> NDARU PURWANTO, TN </td>
<td> AYAH </td>
<td> JL. SUROPATI NO. 14 RT 3 RW 1 , KLOJEN, KLOJEN, KOTA MALANG
</td>
<td> BPJ </td>
<td> kelas 3 </td>
<td> A10 </td>
<td> 300000 </td>
<td> R50.9 </td>
<td> - </td>
<td> 2022-07-04 </td>
<td> 20:32:55 </td>
<td> 2022-07-05 </td>
<td> 19:03:08 </td>
<td> IGDK </td>
<td> </td>
<td> 2022/07/04/000152, BPJS KLS 3 AMARTA 8A ,(BPJS DENDA 45
HARI) </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>

<td> - </td>
<td> 600000 </td>
<td> 2 </td>
<td> Sudah </td>
</tr>
<tr>
<td> 2022/07/04/000228 </td>
<td> 071942 </td>
<td> MUHAMMAD ABIZARD REYNDIA WAHYUDI, AN </td>
<td> L </td>
<td> MALANG </td>
<td> 2021-10-31 </td>
<td> 0 Th 8 Bl 10 Hr </td>
<td> ISLAM </td>
<td> TS </td>
<td> OKTA KRISTIYO WAHYUDI, TN </td>
<td> AYAH </td>
<td> DSN KRAJAN RT 010 RW 003, SUMBERPASIR, PAKIS, KABUPATEN
MALANG </td>
<td> A09 </td>
<td> UMUM </td>
<td> kelas 3 </td>
<td> A13 </td>
<td> 300000 </td>
<td> J18.0 </td>
<td> O80.0 </td>
<td> 2022-07-04 </td>
<td> 19:44:13 </td>
<td> 2022-07-08 </td>
<td> 10:14:55 </td>
<td> IGDK </td>
<td> </td>
<td> 2022/07/04/000228, UMUM KLS III TITIP DI PANDAWA 1
(NATURALFLOW) </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> Infus Dewasa Oleh Perawat/Bidan , Oksigen 100% Sentral 2 LPM

</td>
<td> - </td>
<td> 1500000 </td>
<td> 5 </td>
<td> Sudah </td>
</tr>
<tr>
<td> 2022/07/04/000090 </td>
<td> 043815 </td>
<td> FARHAN HAIDAS GHASANI, AN </td>
<td> L </td>
<td> Malang </td>
<td> 2009-12-21 </td>
<td> 12 Th 7 Bl 14 Hr </td>
<td> ISLAM </td>
<td> PELAJAR </td>
<td> SD </td>
<td> SWASTA </td>
<td> APPIS DWI LOTJANA, TN </td>
<td> AYAH </td>
<td> JL MUHARTO NO 48 RT 01 RW 07 , KOTALAMA, KEDUNGKANDANG, KOTA
MALANG </td>
<td> BPJ </td>
<td> kelas 2 </td>
<td> P02 </td>
<td> 400000 </td>
<td> A90 </td>
<td> A91 </td>
<td> 2022-07-04 </td>
<td> 17:28:31 </td>
<td> 2022-07-06 </td>
<td> 13:21:46 </td>
<td> IGDK </td>
<td> 2022/07/04/000090, BPJS KLS II TITIP DI PANDAWA 2 (DX DF)
(KONFIRMASI). NAIK KLS 1 TGL 4/7/2022 JAM 18.34 </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>

Nebulizer , Visite Dokter Spesialis Anak, Konsultasi Dokter Spesialis Anak Via
Telepon </td>
<td> - </td>
<td> 1200000 </td>
<td> Sembuh </td>
<td> 3 </td>
<td> Sudah </td>
</tr>
<tr>
<td> 2022/07/04/000096 </td>
<td> 036194 </td>
<td> ZUHROTUS SOLICHAH, NY </td>
<td> P </td>
<td> LAMONGAN </td>
<td> 1978-07-13 </td>
<td> 44 Th 0 Bl 15 Hr </td>
<td> HINDU </td>
<td> PERAWAT </td>
<td> - </td>
<td> Swasta </td>
<td> Rianto, Tn </td>
<td> SUAMI </td>
<td> JL. D. PANIAI TERUSAN I H7E20 RT01 RW15, MADYOPURO,
<td> BPJ </td>
<td> kelas 2 </td>
<td> H06 </td>
<td> 400000 </td>
<td> R51 </td>
<td> - </td>
<td> 2022-07-04 </td>
<td> 16:46:20 </td>
<td> 2022-07-04 </td>
<td> 18:19:09 </td>
<td> IGDK </td>
<td> 2022/07/04/000096, BPJS KLS 2 HASTINA 6 ISTRI PAK RIANTO
</td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> - </td>
<td> 400000 </td>
<td> 1 </td>
<td> Sudah </td>
</tr>
<tr>
<td> 2022/07/04/000169 </td>
<td> 008730 </td>
<td> KHALIILA QIANA AZKADINA, AN </td>
<td> P </td>
<td> malang </td>
<td> 2017-06-12 </td>
<td> 5 Th 0 Bl 28 Hr </td>
<td> ISLAM </td>
<td> - </td>
<td> TS </td>
<td> ILYASUN ALAZIS, TN </td>
<td> AYAH </td>
<td> JL. DANAU SENTANI TIMUR I/H1C1 RT 1 RW 7, MADYOPURO,
<td> A09 </td>
<td> UMUM </td>
<td> kelas 2 </td>
<td> D01 </td>
<td> 400000 </td>
<td> R50.9 </td>
<td> - </td>
<td> 2022-07-04 </td>
<td> 16:42:46 </td>
<td> 2022-07-04 </td>
<td> 20:21:05 </td>
<td> IGDK </td>
<td> </td>
<td> 2022/07/04/000169, ASURANSI BRI LIFE PLAFON KLS 2 SUDAH
TERCOVER ASURANSI SESUAI KELAS KONFIRMASI RUANGAN . PX NAIK KELAS APS KLS 1 TGL
4/7/2022 JAM 16.12 BIAYA NAIK KELAS TERTANGGUNG ASURANSI. RENCANA HASTINA 10 .
KONFIRMASI RUANGAN
JAMINAN AWAL SUDAH TERBIT, KASIR = FARIDA 21:00 TGL 4-7-2022 </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> 400000 </td>
<td> 1 </td>
<td> Sudah </td>
</tr>
<tr>
<td> 2022/07/04/000188 </td>
<td> 009828 </td>
<td> KAYONNA NAOMI ELEANORA, AN </td>
<td> P </td>
<td> MALANG </td>
<td> 2020-07-10 </td>
<td> ISLAM </td>
<td> - </td>
<td> TS </td>
<td> SWASTA </td>
<td> JOKO WAHYUDI, TN </td>
<td> AYAH </td>
<td> PONCOKUSUMO RT 3 RW 11, PONCOKUSUMO, PONCOKUSUMO, KABUPATEN
MALANG </td>
<td> BPJ </td>
<td> kelas 2 </td>
<td> H04 </td>
<td> 400000 </td>
<td> R50.9 </td>
<td> R50.9 </td>
<td> 2022-07-04 </td>
<td> 16:40:58 </td>
<td> 2022-07-06 </td>
<td> 16:59:10 </td>
<td> IGDK </td>
<td> 2022/07/04/000188, BPJS KLS 2 UP 1 HASTINA 4 KONFIRMASI
RUANGAN </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> - </td>
<td> 1200000 </td>
<td> 3 </td>
<td> Sudah </td>
</tr>
<tr>
<td> 2022/07/04/000174 </td>
<td> 071924 </td>
<td> HANIFAH KHANZA AL MAHIRA, AN . </td>
<td> P </td>
<td> MALANG </td>
<td> 2021-12-22 </td>
<td> 0 Th 6 Bl 12 Hr </td>
<td> ISLAM </td>
<td> - </td>
<td> TS </td>
<td> M ARIF EDI NUR IMANSYAH, TN </td>
<td> AYAH </td>
<td> JL. KRAJAN RT 6 RW 2 , BUNUT WETAN, PAKIS, KABUPATEN MALANG
</td>
<td> A09 </td>
<td> UMUM </td>
<td> kelas 3 </td>
<td> A11 </td>
<td> 300000 </td>
<td> R11 </td>
<td> R11 </td>
<td> 2022-07-04 </td>
<td> 16:40:15 </td>
<td> 2022-07-05 </td>
<td> 23:10:47 </td>
<td> IGDK </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>

<td> - </td>
<td> 600000 </td>
<td> 2 </td>
<td> Sudah </td>
</tr>
<tr>
<td> 2022/07/04/000178 </td>
<td> 071502 </td>
<td> ACHMAD RAYYANZA IHSAN ANNAFIS, AN </td>
<td> L </td>
<td> MALANG </td>
<td> 2022-06-25 </td>
<td> 0 Th 0 Bl 27 Hr </td>
<td> ISLAM </td>
<td> - </td>
<td> - </td>
<td> ACHMAD QORNI, TN </td>
<td> AYAH </td>
<td> JL SIDOMAKMUR 71 RT 01 RW 04, MULYOAGUNG, DAU, KABUPATEN
MALANG </td>
<td> BPJ </td>
<td> kelas 1 </td>
<td> PA091 </td>
<td> 650000 </td>
<td> P59.9 </td>
<td> P59.9 </td>
<td> 2022-07-04 </td>
<td> 15:38:26 </td>
<td> 2022-07-05 </td>
<td> 15:27:06 </td>
<td> IGDK </td>
<td> 2022/07/04/000178, BPJS KLS 1 NICU FOTO </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>

<td> - </td>
<td> 1300000 </td>
<td> Sehat </td>
<td> 2 </td>
<td> Sudah </td>
</tr>
<tr>
<td> 2022/07/04/000176 </td>
<td> 071511 </td>
<td> LUHUR ADHINATA, AN </td>
<td> L </td>
<td> MALANG </td>
<td> 2022-06-25 </td>
<td> 0 Th 0 Bl 15 Hr </td>
<td> ISLAM </td>
<td> TS </td>
<td> DALU KURNIAWAN PUTRA, TN </td>
<td> AYAH </td>
<td> JL. D. KERINCI IV G 6B 15 RT 10 RW 07, KEDUNGKANDANG,
<td> BPJ </td>
<td> K0000241 </td>
<td> KS IGD 2 </td>
<td> 400000 </td>
<td> P59.9 </td>
<td> P59.9 </td>
<td> 2022-07-04 </td>
<td> 12:47:42 </td>
<td> 2022-07-04 </td>
<td> 15:38:39 </td>
<td> IGDK </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>

<td> - </td>
<td> 400000 </td>
<td> Sembuh </td>
<td> 1 </td>
<td> Sudah </td>
</tr>
<tr>
<td> 2022/07/04/000231 </td>
<td> 060657 </td>
<td> HAN OMAR DEMIRAL, AN </td>
<td> L </td>
<td> MALANG </td>
<td> 2021-11-25 </td>
<td> 0 Th 7 Bl 10 Hr </td>
<td> ISLAM </td>
<td> - </td>
<td> ABD HAFIDZ WAHYUDY, Tn </td>
<td> AYAH </td>
<td> JL. MERGAN VETERAN NO.45 RT 07 RW 11, TUNJUNGREJO, SUKUN,
KOTA MALANG </td>
<td> BPJ </td>
<td> kelas 2 </td>
<td> P03 </td>
<td> 400000 </td>
<td> J18.0 </td>
<td> J18.0 </td>
<td> 2022-07-04 </td>
<td> 12:05:57 </td>
<td> 2022-07-10 </td>
<td> 06:00:00 </td>
<td> IGDK </td>
<td> 2022/07/04/000231 BPJS KELAS 2 TITIP PANDAWA 3 NATURAL FLOW
</td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>

Nebulizer </td>
<td> - </td>
<td> 2800000 </td>
<td> Sembuh </td>
<td> 7 </td>
<td> Sudah </td>
</tr>
<tr>
<td> 2022/07/04/000225 </td>
<td> 060107 </td>
<td> MUHAMMAD ZIDAN ALFARISKY, AN </td>
<td> L </td>
<td> MALANG </td>
<td> 2021-11-11 </td>
<td> 0 Th 7 Bl 25 Hr </td>
<td> ISLAM </td>
<td> - </td>
<td> AGUS IRAWAN, Tn </td>
<td> AYAH </td>
<td> TANJUNG BANJARARUM RT 03 RW 07, BANJARARUM, SINGOSARI,
<td> BPJ </td>
<td> kelas 3 </td>
<td> A16 </td>
<td> 300000 </td>
<td> R56.0 </td>
<td> R56.0 </td>
<td> 2022-07-04 </td>
<td> 11:43:20 </td>
<td> 2022-07-07 </td>
<td> 10:08:26 </td>
<td> IGDK </td>
<td> 2022/07/04/000225, BPJS KLS3, AYODYA 6A. RENCANA AMARTA
MENYUSUL. DENDA 45 HARI SUDAH KIE 3X24 JAM PENGURUSAN.BERSEDIA MENJADI PX UMUM.
</td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> Oksigen 100% Sentral 2 LPM, Konsultasi Dokter Spesialis Anak

Via Telepon, Oksigen 21% 2 LPM / Jam </td>
<td> </td>
<td> 1200000 </td>
<td> Sembuh </td>
<td> 4 </td>
<td> Sudah </td>
</tr>
<tr>
<td> 2022/07/04/000167 </td>
<td> 071918 </td>
<td> GARVI VISHAKA AZZUBAIR, AN </td>
<td> L </td>
<td> MALANG </td>
<td> 2022-07-04 </td>
<td> ISLAM </td>
<td> TS </td>
<td> ARI DWI P, TN </td>
<td> AYAH </td>
<td> JL. NGAGLIH IVB/45, SUKUN, SUKUN, KOTA MALANG </td>
<td> BPJ </td>
<td> kelas 3 </td>
<td> PF16 </td>
<td> 300000 </td>
<td> P00.6 </td>
<td> P21.9 </td>
<td> 2022-07-04 </td>
<td> 11:32:00 </td>
<td> 2022-07-04 </td>
<td> 17:16:05 </td>
<td> U0030 </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> 3020 </td>
<td> 47 </td>
<td> Hidup </td>
<td> Ya </td>
<td> Hidup </td>
<td> Ya </td>
<td> Tidak </td>
<td> Ya </td>

<td> - </td>
<td> 300000 </td>
<td> Sembuh </td>
<td> 1 </td>
<td> Sudah </td>
</tr>
<tr>
<td> 2022/07/04/000211 </td>
<td> 073786 </td>
<td> NUR VITAKHUROHMAH, NY </td>
<td> P </td>
<td> MALANG </td>
<td> 1990-06-18 </td>
<td> 32 Th 1 Bl 16 Hr </td>
<td> ISLAM </td>
<td> GURU </td>
<td> S1 </td>
<td> M NUR HUDA, TN </td>
<td> SUAMI </td>
</td>
<td> BPJ </td>
<td> kelas 2 </td>
<td> D10 </td>
<td> 400000 </td>
<td> O60.0 </td>
<td> - </td>
<td> 2022-07-04 </td>
<td> 10:19:31 </td>
<td> 2022-07-07 </td>
<td> 17:45:16 </td>
<td> IGDK </td>
<td> </td>
<td> 4 </td>
<td> 1 </td>
<td> 0 </td>
<td> 0 </td>
<td> 2 </td>
<td> 0 </td>
<td> 30-32 </td>

<td> 1100 </td>
<td> 30 </td>
<td> Hidup </td>
<td> Tidak </td>
<td> Hidup </td>
<td> Ya </td>
<td> Tidak </td>
<td> Ya </td>
<td> Jasa Pelayanan Rumah Sakit, Operasional Rumah Sakit </td>

<td> </td>
<td> 1600000 </td>
<td> 4 </td>
<td> Sudah </td>
</tr>
<tr>
<td> 2022/07/04/000092 </td>
<td> 071895 </td>
<td> IDA MAIMUNAH, NY </td>
<td> P </td>
<td> MALANG </td>
<td> 1987-09-11 </td>
<td> 34 Th 10 Bl 3 Hr </td>
<td> ISLAM </td>
<td> SMA </td>
<td> MOCHAMMAD HANI, TN </td>
<td> SUAMI </td>
<td> DUSUN PULESARI RT 004 RW 011, TIRTOMOYO, PAKIS, KABUPATEN
MALANG </td>
<td> BPJ </td>
<td> kelas 2 </td>
<td> D01 </td>
<td> 400000 </td>
<td> O03.3 </td>
<td> O03.3 </td>
<td> 2022-07-04 </td>
<td> 08:51:11 </td>
<td> 2022-07-04 </td>
<td> 19:57:28 </td>
<td> IGDK </td>
<td> 2022/07/04/000092, BPJS KLS II TITIP DI AMARTA 5B RENCANA
DWARAWATI MENYUSUL, ACC SUAMI PX </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> - </td>
<td> 800000 </td>
<td> Sehat </td>
<td> 2 </td>
<td> Sudah </td>
</tr>
<tr>
<td> 2022/07/04/000089 </td>
<td> 034415 </td>
<td> MUHAMMAD AZRI AL FATIH, AN </td>
<td> L </td>
<td> MALANG </td>
<td> 2019-06-28 </td>
<td> ISLAM </td>
<td> TS </td>
<td> NOVIA ROWICHAH, NY </td>
<td> IBU </td>
<td> JL. BATU AMARIL NO.1 RT 01 RW 04, PANDANWANGI, BLIMBING,
KOTA MALANG </td>
<td> BPJ </td>
<td> kelas 3 </td>
<td> A17 </td>
<td> 300000 </td>
<td> R56.0 </td>
<td> R56.8 </td>
<td> 2022-07-04 </td>
<td> 08:31:48 </td>
<td> 2022-07-06 </td>
<td> 10:43:32 </td>
<td> IGDK </td>
<td> 2022/07/04/000089, BPJS KLS III DI AMARTA 7B </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>

Oksigen 100% Sentral 2 LPM, Konsultasi Dokter Spesialis Anak Via Telepon,
Infus Anak oleh Perawat / Bidan, Infus Anak oleh Perawat / Bidan, Infus Anak oleh
<td> - </td>
<td> 900000 </td>
<td> Sehat </td>
<td> 3 </td>
<td> Sudah </td>
</tr>
<tr>
<td> 2022/07/04/000100 </td>
<td> 071896 </td>
<td> WINDA PERMA., By Ny </td>
<td> P </td>
<td> MALANG </td>
<td> 2022-07-04 </td>
<td> ISLAM </td>
<td> TS </td>
<td> GURU </td>
<td> M. GHOFIR AL JAROH, TN </td>
<td> AYAH </td>
<td> JL. KH HASYIM GANG V RT 003 RW 003, KEDUNGKANDANG,
<td> BPJ </td>
<td> kelas 3 </td>
<td> BF34 </td>
<td> 300000 </td>
<td> P03.4 </td>
<td> P03.4 </td>
<td> 2022-07-04 </td>
<td> 06:48:46 </td>
<td> 2022-07-06 </td>
<td> 18:40:39 </td>
<td> U0030 </td>
<td> 2022/07/04/000100, FISOL </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> 2900 </td>
<td> 48 </td>
<td> Hidup </td>
<td> Tidak </td>
<td> Hidup </td>
<td> Ya </td>
<td> Tidak </td>
<td> Ya </td>
<td> - </td>
<td> 900000 </td>
<td> Sembuh </td>
<td> 3 </td>
<td> Sudah </td>
</tr>
<tr>
<td> 2022/07/04/000091 </td>
<td> 097521 </td>
<td> EARLYTA FAYYOLA PUTRI TUNGGAL, AN </td>
<td> P </td>
<td> Malang </td>
<td> 2017-10-03 </td>
<td> ISLAM </td>
<td> TS </td>
<td> HADI PURNA WIRAWAN, TN </td>
<td> IBU </td>
<td> JL. TELUK BAYUR RT. 02 RW. 08, PANDANWANGI, BLIMBING, KOTA
MALANG </td>
<td> BPJ </td>
<td> kelas 2 </td>
<td> A14 </td>
<td> 400000 </td>
<td> J18.0 </td>
<td> J18.0 </td>
<td> 2022-07-04 </td>
<td> 06:39:36 </td>
<td> 2022-07-07 </td>
<td> 00:34:39 </td>
<td> IGDK </td>
<td> 2022/07/04/000091, BPJS KLS 2, TITIP AMARTA 4A RENCANA
DWARAWATI MENYUSUL. SPRI BUTUH NATURAL FLOW. RUANG NF FULL SEMUA . KONFIRMASI DR
PUTU BOOKING KAMAR BIASA DULU MAU KONFIRMASI KE DR ZAI. AYAH BERSEDIA JIKA
DITITIPKAN DI KLS 3 </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>

Visite Dokter Spesialis Anak </td>
<td> </td>
<td> 1600000 </td>
<td> Sehat </td>
<td> 4 </td>
<td> Sudah </td>
</tr>
<tr>
<td> 2022/07/04/000165 </td>
<td> 060643 </td>
<td> YANIK IKA RETNO PUTRIANA, NY </td>
<td> P </td>
<td> Malang </td>
<td> 1994-09-19 </td>
<td> 27 Th 9 Bl 23 Hr </td>
<td> ISLAM </td>
<td> D3 </td>
<td> SUAMI </td>
<td> JL. BIMA NO 22 RT02 RW11, TUMPANG, TUMPANG, KABUPATEN MALANG
</td>
<td> BPJ </td>
<td> kelas 2 </td>
<td> D07 </td>
<td> 400000 </td>
<td> O80.9 </td>
<td> O80.9 </td>
<td> 2022-07-04 </td>
<td> 03:06:43 </td>
<td> 2022-07-06 </td>
<td> 11:37:24 </td>
<td> IGDK </td>
<td> 2022/07/04/000165, BPJS KLS 2 AYODYA 5A KONFIRMASI RUANGAN
</td>
<td> 1 </td>
<td> 0 </td>
<td> 0 </td>
<td> 0 </td>
<td> 0 </td>
<td> 0 </td>
<td> 39-40 </td>

<td> 2635 </td>
<td> 48 </td>
<td> Hidup </td>
<td> Ya </td>
<td> Hidup </td>
<td> Ya </td>
<td> Tidak </td>
<td> Ya </td>

<td> - </td>
<td> 1200000 </td>
<td> 3 </td>
<td> Sudah </td>
</tr>
<tr>
<td> 2022/07/04/000226 </td>
<td> 061151 </td>
<td> ROSAHIKA WAHYU PRANITASARI, NY </td>
<td> P </td>
<td> Malang </td>
<td> 1993-07-20 </td>
<td> 28 Th 11 Bl 21 Hr </td>
<td> ISLAM </td>
<td> - </td>
<td> SMA </td>
<td> PEDAGANG </td>
<td> MOCHAMAD SOFYAN, TN </td>
<td> SUAMI </td>
<td> JL. BATUBARA NO.13A RT 01 RW 08, PURWANTORO, BLIMBING, KOTA
MALANG </td>
<td> BPJ </td>
<td> kelas 2 </td>
<td> D08 </td>
<td> 400000 </td>
<td> O80.9 </td>
<td> - </td>
<td> 2022-07-04 </td>
<td> 02:31:20 </td>
<td> 2022-07-05 </td>
<td> 11:11:43 </td>
<td> IGDK </td>
<td> 2022/07/04/000226, BPJS KELAS 2 RUANG AYODYA 4A
<td> 2 </td>
<td> 1 </td>
<td> 0 </td>
<td> 0 </td>
<td> 0 </td>
<td> 0 </td>
<td> 40-41 </td>

<td> 2895 </td>
<td> 47 </td>
<td> Hidup </td>
<td> Ya </td>
<td> Hidup </td>
<td> Ya </td>
<td> Tidak </td>
<td> Ya </td>
<td> </td>
<td> - </td>
<td> 800000 </td>
<td> 2 </td>
<td> Sudah </td>
</tr>
<tr>
<td> 2022/07/03/000147 </td>
<td> 033533 </td>
<td> AHMAD ALI ARSHAVIN, AN </td>
<td> L </td>
<td> MALANG </td>
<td> 2020-03-06 </td>
<td> ISLAM </td>
<td> TS </td>
<td> IDAM KOLIQ, TN </td>
<td> AYAH </td>
<td> JL. LETJEN S. PARMAN II /27 RT.01 RW.18, PURWANTORO,
<td> BPJ </td>
<td> kelas 1 </td>
<td> H07 </td>
<td> 650000 </td>
<td> A09 </td>
<td> A09 </td>
<td> 2022-07-03 </td>
<td> 23:56:10 </td>
<td> 2022-07-06 </td>
<td> 13:07:30 </td>
<td> IGDK </td>
<td> </td>
<td> 2022/07/03/000147, BPJS KLS 1, HASTINA 7 </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>

<td> - </td>
<td> 1950000 </td>
<td> Sehat </td>
<td> 3 </td>
<td> Sudah </td>
</tr>
<tr>
<td> 2022/07/03/000146 </td>
<td> 060721 </td>
<td> MUHAMMAD ZAYN HAZMI, AN </td>
<td> L </td>
<td> MALANG </td>
<td> 2021-05-07 </td>
<td> 1 Th 2 Bl 28 Hr </td>
<td> ISLAM </td>
<td> - </td>
<td> M. RISQON HAZMI, TN </td>
<td> AYAH </td>
<td> DSN GLAGAH DOWO RT 1 RW 7 , PULUNGDOWO, TUMPANG, KABUPATEN
MALANG </td>
<td> BPJ </td>
<td> kelas 2 </td>
<td> D03 </td>
<td> 400000 </td>
<td> J69.0 </td>
<td> J12.8 </td>
<td> 2022-07-03 </td>
<td> 23:48:49 </td>
<td> 2022-07-07 </td>
<td> 18:04:27 </td>
<td> IGDK </td>
<td> </td>
<td> 2022/07/03/000146 BPJS KELAS 2 DI DWARWATI/AYODIA 2A KONFIRM
</td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>

<td> - </td>
<td> 1600000 </td>
<td> Sehat </td>
<td> 4 </td>
<td> Sudah </td>
</tr>
<tr>
<td> 2022/07/03/000112 </td>
<td> 062775 </td>
<td> JORDANINGTYAS AGUSTININGRUM, NY </td>
<td> P </td>
<td> MALANG </td>
<td> 1990-08-28 </td>
<td> 31 Th 10 Bl 14 Hr </td>
<td> ISLAM </td>
<td> RANGGA CILINDA WANGSA, TN </td>
<td> SUAMI </td>
<td> JL. TELUK BAYUR RT10 RW07, PANDANWANGI, BLIMBING, KOTA
MALANG </td>
<td> BPJ </td>
<td> kelas 2 </td>
<td> H09 </td>
<td> 400000 </td>
<td> O80.9 </td>
<td> O82.9 </td>
<td> 2022-07-03 </td>
<td> 23:26:40 </td>
<td> 2022-07-05 </td>
<td> 11:50:43 </td>
<td> IGDK </td>
<td> 2022/07/03/000112, BPJS KLS 2, AYODYA 4A/DWARAWATI 7,
KONFIRMASI RUANGAN </td>
<td> 2 </td>
<td> 1 </td>
<td> 0 </td>
<td> 0 </td>
<td> 0 </td>
<td> 0 </td>
<td> 39-40 </td>

<td> 3400 </td>
<td> 49 </td>
<td> Hidup </td>
<td> Tidak </td>
<td> Hidup </td>
<td> Ya </td>
<td> Tidak </td>
<td> Ya </td>

<td> - </td>
<td> 800000 </td>
<td> 2 </td>
<td> Sudah </td>
</tr>
<tr>
<td> 2022/07/03/000062 </td>
<td> 071870 </td>
<td> FILZA ALIYA HILYA, AN </td>
<td> P </td>
<td> MALANG </td>
<td> 2021-06-12 </td>
<td> 1 Th 0 Bl 21 Hr </td>
<td> ISLAM </td>
<td> - </td>
<td> - </td>
<td> M MUNAWIRUL U, TN </td>
<td> AYAH </td>
<td> BUGIS KRAJAN SAPTORENGGO RT 02 RW 01, SAPTORENGGO, PAKIS,
<td> A09 </td>
<td> UMUM </td>
<td> kelas 3 </td>
<td> A01 </td>
<td> 300000 </td>
<td> R50.9 </td>
<td> R50.9 </td>
<td> 2022-07-03 </td>
<td> 23:15:25 </td>
<td> 2022-07-05 </td>
<td> 23:10:18 </td>
<td> IGDK </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> Operasional Rumah Sakit , Oksigen 100% Sentral 2 LPM,

Anak, Sewa Infus Pump, Sewa Infus Pump, Infus Anak oleh Perawat / Bidan, Jasa
<td> - </td>
<td> 600000 </td>
<td> 2 </td>
<td> Sudah </td>
</tr>
<tr>
<td> 2022/07/03/000144 </td>
<td> 071396 </td>
<td> AFIZA HAURA ALFARIZQIA AFRIGA, AN </td>
<td> P </td>
<td> MALANG </td>
<td> 2022-06-23 </td>
<td> 0 Th 0 Bl 17 Hr </td>
<td> ISLAM </td>
<td> - </td>
<td> FRIZA DESKANANDA,TN </td>
<td> AYAH </td>
<td> PERUM NIRWANA SULFAT A/30 RT.01 RW.04, PANDANWANGI,
<td> BPJ </td>
<td> kelas 3 </td>
<td> PA031 </td>
<td> NICU 3 </td>
<td> 300000 </td>
<td> P59.8 </td>
<td> P59.9 </td>
<td> 2022-07-03 </td>
<td> 22:49:52 </td>
<td> 2022-07-05 </td>
<td> 20:53:52 </td>
<td> IGDK </td>
<td> 2022/07/03/000144, BPJS KLS 3 NICU </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>

Sewa Fototerapi , Konsultasi Dokter Spesialis Anak Via Telepon, Operasional Rumah
Sakit </td>
<td> - </td>
<td> 600000 </td>
<td> 2 </td>
<td> Sudah </td>
</tr>
<tr>
<td> 2022/07/03/000137 </td>
<td> 071394 </td>
<td> NADYA ZHAFIRA, AN </td>
<td> P </td>
<td> MALANG </td>
<td> 2022-06-23 </td>
<td> ISLAM </td>
<td> TS </td>
<td> DWI SUJATMIKO,TN </td>
<td> AYAH </td>
<td> BORO BUGIS RT.10 RW.3, SAPTORENGGO, PAKIS, KABUPATEN MALANG
</td>
<td> BPJ </td>
<td> PA01 </td>
<td> NICU 1 </td>
<td> 400000 </td>
<td> P58.2 </td>
<td> P59.9 </td>
<td> 2022-07-03 </td>
<td> 22:47:51 </td>
<td> 2022-07-05 </td>
<td> 20:53:10 </td>
<td> IGDK </td>
<td> 2022/07/03/000137, BPJS KLS 2, FOTOTERAPI </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> Visite Dokter Spesialis Anak, Visite Dokter Spesialis Bedah,

Sewa Fototerapi, Operasional Rumah Sakit </td>
<td> - </td>
<td> 800000 </td>
<td> 2 </td>
<td> Sudah </td>
</tr>
<tr>
<td> 2022/07/03/000145 </td>
<td> 071261 </td>
<td> LAYYINA ALMAHYRA AHSYAR, An </td>
<td> P </td>
<td> Malang </td>
<td> 2022-06-20 </td>
<td> 0 Th 0 Bl 15 Hr </td>
<td> ISLAM </td>
<td> - </td>
<td> DOKTER </td>
<td> OTHE AHMAD SYARIFUDDIN, Tn </td>
<td> AYAH </td>
<td> JL. RAYA TITAN ASRI NO J2, PANDANWANGI, BLIMBING, KOTA
MALANG </td>
<td> BPJ </td>
<td> PA03 </td>
<td> NICU 3 </td>
<td> 400000 </td>
<td> P58.2 </td>
<td> P59.9 </td>
<td> 2022-07-03 </td>
<td> 22:47:06 </td>
<td> 2022-07-05 </td>
<td> 20:53:37 </td>
<td> IGDK </td>
<td> 2022/07/03/000145, BPJS KLS 2, FOTOTERAPI -KTP ORTU </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
Sewa Fototerapi, Sewa Fototerapi, Operasional Rumah Sakit </td>
<td> - </td>
<td> 800000 </td>
<td> 2 </td>
<td> Sudah </td>
</tr>
<tr>
<td> 2022/07/03/000150 </td>
<td> 071886 </td>
<td> AUFAR JULIANO GHIFARRY, AN </td>
<td> L </td>
<td> MALANG </td>
<td> 2022-07-03 </td>
<td> ISLAM </td>
<td> TS </td>
<td> RANGGA CILINDA WANGSA, TN </td>
<td> AYAH </td>
<td> JL. TELUK BAYUR RT 010 RW 007, PANDANWANGI, BLIMBING, KOTA
MALANG </td>
<td> BPJ </td>
<td> kelas 3 </td>
<td> BFA03 </td>
<td> 300000 </td>
<td> P03.4 </td>
<td> P03.4 </td>
<td> 2022-07-03 </td>
<td> 22:45:26 </td>
<td> 2022-07-05 </td>
<td> 11:55:54 </td>
<td> U0030 </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> 3400 </td>
<td> 49 </td>
<td> Hidup </td>
<td> Tidak </td>
<td> Hidup </td>
<td> Ya </td>
<td> Tidak </td>
<td> Ya </td>

<td> - </td>
<td> 600000 </td>
<td> Sembuh </td>
<td> 2 </td>
<td> Sudah </td>
</tr>
<tr>
<td> 2022/07/03/000106 </td>
<td> 013529 </td>
<td> AIRA RHENATA VILIANT PUTRI, AN </td>
<td> P </td>
<td> MALANG </td>
<td> 2014-12-09 </td>
<td> 7 Th 6 Bl 28 Hr </td>
<td> ISLAM </td>
<td> SD </td>
<td> RIRIN CUSNIAH ULFA, NY </td>
<td> IBU </td>
<td> JL. MEMBERANO VII/4 RT 2 RW 14, BUNULREJO, BLIMBING, KOTA
MALANG </td>
<td> BPJ </td>
<td> kelas 3 </td>
<td> A16 </td>
<td> 300000 </td>
<td> R11 </td>
<td> R11 </td>
<td> 2022-07-03 </td>
<td> 21:58:50 </td>
<td> 2022-07-05 </td>
<td> 23:11:12 </td>
<td> IGDK </td>
<td> 2022/07/03/000106, BPJS KLS 3 PBI, AMARTA 7B </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>

</td>
<td> - </td>
<td> 600000 </td>
<td> 2 </td>
<td> Sudah </td>
</tr>
<tr>
<td> 2022/07/03/000034 </td>
<td> 071858 </td>
<td> HADRIANA AMIRA KANA RAYA, AN </td>
<td> P </td>
<td> MALANG </td>
<td> 2022-07-03 </td>
<td> ISLAM </td>
<td> - </td>
<td> AHMAD BURHAN, Tn </td>
<td> AYAH </td>
<td> JL. TERUSAN BATUBARA VB RT 8 RW 9, PANDANWANGI, BLIMBING,
KOTA MALANG </td>
<td> BPJ </td>
<td> PF01 </td>
<td> 400000 </td>
<td> P03.4 </td>
<td> P03.4 </td>
<td> 2022-07-03 </td>
<td> 20:41:01 </td>
<td> 2022-07-07 </td>
<td> 14:27:25 </td>
<td> U0029 </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> 2550 </td>
<td> 48 </td>
<td> Hidup </td>
<td> Tidak </td>
<td> Baik </td>
<td> Ya </td>
<td> Tidak </td>
<td> Ya </td>

</td>
<td> </td>
<td> 2000000 </td>
<td> 5 </td>
<td> Sudah </td>
</tr>
<tr>
<td> 2022/07/03/000067 </td>
<td> 071490 </td>
<td> TARISA NURMALA, NY </td>
<td> P </td>
<td> 2001-12-26 </td>
<td> 20 Th 6 Bl 7 Hr </td>
<td> ISLAM </td>
<td> SMP </td>
<td> HEBING KURNIAWAN, TN </td>
<td> SUAMI </td>
MALANG </td>
<td> A09 </td>
<td> UMUM </td>
<td> kelas 1 </td>
<td> H02 </td>
<td> 650000 </td>
<td> O80.9 </td>
<td> O80.9 </td>
<td> 2022-07-03 </td>
<td> 19:25:45 </td>
<td> 2022-07-04 </td>
<td> 17:04:59 </td>
<td> IGDK </td>
<td> </td>
<td> 2022/07/03/000067, UMUM KLS 1 PANDAWA 2 KONFIRMASI RUANGAN
</td>
<td> 1 </td>
<td> 0 </td>
<td> 0 </td>
<td> 0 </td>
<td> 0 </td>
<td> 0 </td>
<td> 39-40 </td>

<td> 2630 </td>
<td> 47 </td>
<td> Hidup </td>
<td> Ya </td>
<td> Hidup </td>
<td> Ya </td>
<td> Tidak </td>
<td> Ya </td>

<td> - </td>
<td> 1300000 </td>
<td> 2 </td>
<td> Sudah </td>
</tr>
<tr>
<td> 2022/07/03/000128 </td>
<td> 071880 </td>
<td> RIZKI WIRA P, BY. NY </td>
<td> L </td>
<td> MALANG </td>
<td> 2022-07-03 </td>
<td> ISLAM </td>
<td> TS </td>
<td> EDWIE BENING SAMUDRA, TN </td>
<td> AYAH </td>
<td> JL. KARYA TIMUR DALAM KAV.1 RT 02 RW 06, PURWANTORO,
<td> A09 </td>
<td> UMUM </td>
<td> kelas 3 </td>
<td> BPF01 </td>
<td> 300000 </td>
<td> P03.4 </td>
<td> P03.4 </td>
<td> 2022-07-03 </td>
<td> 17:16:44 </td>
<td> 2022-07-08 </td>
<td> 19:31:05 </td>
<td> U0030 </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> 3450 </td>
<td> 47 </td>
<td> Hidup </td>
<td> Tidak </td>
<td> Hidup </td>
<td> Ya </td>
<td> Tidak </td>
<td> Ya </td>

<td> - </td>
<td> 1800000 </td>
<td> Sembuh </td>
<td> 6 </td>
<td> Sudah </td>
</tr>
<tr>
<td> 2022/07/03/000119 </td>
<td> 071879 </td>
<td> AYDIN FIRHAN KURNIAWAN, AN </td>
<td> L </td>
<td> Malang </td>
<td> 2022-07-03 </td>
<td> ISLAM </td>
<td> - </td>
<td> HEBING KURNIAWAN, Tn </td>
<td> AYAH </td>
MALANG </td>
<td> A09 </td>
<td> UMUM </td>
<td> kelas 3 </td>
<td> PF11 </td>
<td> 300000 </td>
<td> P00.6 </td>
<td> P00.9 </td>
<td> 2022-07-03 </td>
<td> 16:16:18 </td>
<td> 2022-07-04 </td>
<td> 15:38:09 </td>
<td> U0030 </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> 2630 </td>
<td> 47 </td>
<td> Hidup </td>
<td> Ya </td>
<td> Hidup </td>
<td> Ya </td>
<td> Tidak </td>
<td> Ya </td>

<td> </td>
<td> 600000 </td>
<td> Sembuh </td>
<td> 2 </td>
<td> Sudah </td>
</tr>
<tr>
<td> 2022/07/03/000058 </td>
<td> 056388 </td>
<td> ALSHAMIRA KHAILEENA ANANDARA, An </td>
<td> P </td>
<td> MALANG </td>
<td> 2021-08-22 </td>
<td> 0 Th 10 Bl 19 Hr </td>
<td> ISLAM </td>
<td> - </td>
<td> ACHMAD FIQKY RUDIANTO, Tn </td>
<td> AYAH </td>
<td> JL. TUMBAL NEGARA NO.24 RT.08 RW.09, MADYOPURO,
<td> BPJ </td>
<td> kelas 1 </td>
<td> P06 </td>
<td> 650000 </td>
<td> J18.9 </td>
<td> J18.9 </td>
<td> 2022-07-03 </td>
<td> 14:29:06 </td>
<td> 2022-07-06 </td>
<td> 16:54:59 </td>
<td> IGDK </td>
<td> </td>
<td> 2022/07/03/000058, BPJS KLS 1 HASTINA 2 KONFIRMASI RUANGAN
</td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>

Visite Dokter Spesialis Bedah, Nebulizer , Nebulizer , Konsultasi Dokter Spesialis
Anak Via Telepon, Oksigen 21% 2 LPM / Jam, Infus Anak oleh Perawat / Bidan </td>
<td> </td>
<td> 2600000 </td>
<td> 4 </td>
<td> Sudah </td>
</tr>
<tr>
<td> 2022/07/03/000032 </td>
<td> 059836 </td>
<td> ZERINA SHEEVA SALSABILA, AN </td>
<td> P </td>
<td> MOJOKERTO </td>
<td> 2021-10-08 </td>
<td> 0 Th 8 Bl 25 Hr </td>
<td> ISLAM </td>
<td> - </td>
<td> TNI </td>
<td> ROMDA SUHERDI, TN </td>
<td> AYAH </td>
<td> GRAHA PERMATA RESIDANCE BLOK V-1, PAKISJAJAR, PAKIS,
<td> BPJ </td>
<td> kelas 1 </td>
<td> H05 </td>
<td> 650000 </td>
<td> R11 </td>
<td> R11 </td>
<td> 2022-07-03 </td>
<td> 14:27:54 </td>
<td> 2022-07-06 </td>
<td> 13:07:14 </td>
<td> IGDK </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>

<td> - </td>
<td> 2600000 </td>
<td> Sehat </td>
<td> 4 </td>
<td> Sudah </td>
</tr>
<tr>
<td> 2022/07/03/000048 </td>
<td> 071865 </td>
<td> INDAH PERMATASARI, NY </td>
<td> P </td>
<td> MALANG </td>
<td> 1997-02-28 </td>
<td> 25 Th 5 Bl 6 Hr </td>
<td> ISLAM </td>
<td> SMA </td>
<td> ARI DWI P, TN </td>
<td> SUAMI </td>
<td> JL NGAGLIH IVB/45, SUKUN, SUKUN, KOTA MALANG </td>
<td> BPJ </td>
<td> kelas 2 </td>
<td> D09 </td>
<td> 400000 </td>
<td> O80.9 </td>
<td> O80.9 </td>
<td> 2022-07-03 </td>
<td> 12:43:49 </td>
<td> 2022-07-06 </td>
<td> 11:38:43 </td>
<td> IGDK </td>
RUANGAN </td>
<td> 2 </td>
<td> 0 </td>
<td> 0 </td>
<td> 0 </td>
<td> 1 </td>
<td> 0 </td>
<td> 39-40 </td>

<td> 3020 </td>
<td> 47 </td>
<td> Hidup </td>
<td> Ya </td>
<td> Hidup </td>
<td> Ya </td>
<td> Tidak </td>
<td> Ya </td>

Oksigen 100% Sentral 5 LPM , Konsultasi Dokter Spesialis Obgyn Via Telepon,
<td> - </td>
<td> 1600000 </td>
<td> 4 </td>
<td> Sudah </td>
</tr>
<tr>
<td> 2022/07/03/000061 </td>
<td> 071871 </td>
<td> ARKANA IBRAHIM HARIYANTO, AN </td>
<td> L </td>
<td> MALANG </td>
<td> 2022-07-03 </td>
<td> ISLAM </td>
<td> - </td>
<td> - </td>
<td> RICKY HARIANTO, TN </td>
<td> AYAH </td>
<td> JL. IR RAIS GG 14 NO.15 RT 3 RW 5 , TANJUNGREJO, SUKUN, KOTA
MALANG </td>
<td> BPJ </td>
<td> kelas 3 </td>
<td> PF10 </td>
<td> 300000 </td>
<td> P03.4 </td>
<td> P03.4 </td>
<td> 2022-07-03 </td>
<td> 10:46:40 </td>
<td> 2022-07-05 </td>
<td> 20:37:32 </td>
<td> U0030 </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> 2600 </td>
<td> 47 </td>
<td> Hidup </td>
<td> Tidak </td>
<td> Hidup </td>
<td> Ya </td>
<td> Tidak </td>
<td> Ya </td>
<td> Perawatan Bayi SC , Jasa Pelayanan Rumah Sakit ,

<td> - </td>
<td> 900000 </td>
<td> Sembuh </td>
<td> 3 </td>
<td> Sudah </td>
</tr>
<tr>
<td> 2022/07/03/000046 </td>
<td> 071862 </td>
<td> ALMIRA FELIA SHANUM, AN </td>
<td> P </td>
<td> Lumajang </td>
<td> 2020-03-12 </td>
<td> 2 Th 3 Bl 29 Hr </td>
<td> ISLAM </td>
<td> - </td>
<td> TS </td>
<td> RIFQI RAHMANDA, TN </td>
<td> AYAH </td>
<td> PERUM SULFAT ERFINA BLOK D43, BUNULREJO, BLIMBING, KOTA
MALANG </td>
<td> BPJ </td>
<td> kelas 2 </td>
<td> D04 </td>
<td> 400000 </td>
<td> R56.8 </td>
<td> R56.0 </td>
<td> 2022-07-03 </td>
<td> 10:33:11 </td>
<td> 2022-07-05 </td>
<td> 12:08:20 </td>
<td> IGDK </td>
<td> 2022/07/03/000046, BPJS KLS 2 AYODYA 2B KONFIRMASI RUANGAN
</td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> Oksigen 100% Sentral 2 LPM, Oksigen 100% Sentral 2 LPM,

Anak, Konsultasi Dokter Spesialis Anak Via Telepon, Oksigen 21% 2 LPM / Jam,
Oksigen 21% 2 LPM / Jam, Infus Anak oleh Perawat / Bidan </td>
<td> - </td>
<td> 1200000 </td>
<td> 3 </td>
<td> Sudah </td>
</tr>
<tr>
<td> 2022/07/03/000040 </td>
<td> 071698 </td>
<td> CHESSY SHAQUEENA VANCIA, AN </td>
<td> P </td>
<td> MALANG </td>
<td> 2021-06-09 </td>
<td> 1 Th 0 Bl 24 Hr </td>
<td> ISLAM </td>
<td> TS </td>
<td> ERFAN SANDYA MADYA PUTRA, TN </td>
<td> AYAH </td>
<td> JL. TELUK BAYUR 2B RT 01 RW 07, PANDANWANGI, BLIMBING, KOTA
MALANG </td>
<td> A09 </td>
<td> UMUM </td>
<td> kelas 1 </td>
<td> H02 </td>
<td> 650000 </td>
<td> A08.3 </td>
<td> - </td>
<td> 2022-07-03 </td>
<td> 08:43:29 </td>
<td> 2022-07-03 </td>
<td> 10:00:06 </td>
<td> IGDK </td>
<td> </td>
<td> 2022/07/03/000040 UMUM KELAS 1 DI HASTINA 2 KONFIRM </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>

Telepon, Konsultasi Dokter Spesialis Anak Via Telepon, Infus Anak oleh Perawat /
Bidan </td>
<td> </td>
<td> 650000 </td>
<td> 1 </td>
<td> Sudah </td>
</tr>
<tr>
<td> 2022/07/03/000051 </td>
<td> 070676 </td>
<td> WINDA PERMATASARI, Ny </td>
<td> P </td>
<td> BLITAR </td>
<td> 1995-08-04 </td>
<td> 26 Th 11 Bl 8 Hr </td>
<td> ISLAM </td>
<td> GURU </td>
<td> S1 </td>
<td> GURU </td>
<td> M. GHOFIR AL JAROH, Tn </td>
<td> SUAMI </td>
<td> JL. KH HASYIM GANG V NO RT 3 RW 3, KEDUNGKANDANG,
<td> BPJ </td>
<td> kelas 3 </td>
<td> A08 </td>
<td> 300000 </td>
<td> O80.9 </td>
<td> O82.0 </td>
<td> 2022-07-03 </td>
<td> 08:23:28 </td>
<td> 2022-07-06 </td>
<td> 16:56:54 </td>
<td> IGDK </td>
<td> 1 </td>
<td> 0 </td>
<td> 0 </td>
<td> 0 </td>
<td> 0 </td>
<td> 0 </td>
<td> 39-40 </td>

<td> 2900 </td>
<td> 48 </td>
<td> Hidup </td>
<td> Tidak </td>
<td> Hidup </td>
<td> Ya </td>
<td> Tidak </td>
<td> Ya </td>
<td> Visite Dokter Spesialis Obgyn, VT Dokter , Infus Dewasa oleh

Perawat / Bidan, Konsultasi Dokter Spesialis Obgyn Via Telepon </td>
<td> - </td>
<td> 1200000 </td>
<td> 4 </td>
<td> Sudah </td>
</tr>
<tr>
<td> 2022/07/03/000027 </td>
<td> 071855 </td>
<td> ANI PRISTIWI YANTI, Ny </td>
<td> P </td>
<td> MALANG </td>
<td> 1989-08-07 </td>
<td> 32 Th 10 Bl 26 Hr </td>
<td> ISLAM </td>
<td> SMA </td>
<td> SUAMI </td>
</td>
<td> BPJ </td>
<td> kelas 2 </td>
<td> D10 </td>
<td> 400000 </td>
<td> O80.8 </td>
<td> O80.8 </td>
<td> 2022-07-03 </td>
<td> 07:50:06 </td>
<td> 2022-07-04 </td>
<td> 13:06:51 </td>
<td> IGDK </td>
<td> 2022/07/03/000027 BPJS KELAS 2 TITIP PANDAWA 1 KONFIRMASI
</td>
<td> 4 </td>
<td> 2 </td>
<td> 0 </td>
<td> 0 </td>
<td> 1 </td>
<td> 0 </td>
<td> 39-40 </td>

<td> 3365 </td>
<td> 49 </td>
<td> Hidup </td>
<td> Ya </td>
<td> Hidup </td>
<td> Ya </td>
<td> Tidak </td>
<td> Ya </td>
<td> </td>
<td> </td>
<td> 800000 </td>
<td> Sehat </td>
<td> 2 </td>
<td> Sudah </td>
</tr>
<tr>
<td> 2022/07/03/000029 </td>
<td> 011855 </td>
<td> Siti Juariyah Arda, Ny </td>
<td> P </td>
<td> Jember </td>
<td> 1998-04-06 </td>
<td> 24 Th 2 Bl 27 Hr </td>
<td> ISLAM </td>
<td> PEDAGANG </td>
<td> SMA </td>
<td> PEDAGANG </td>
<td> ABDUR ROHIM, TN </td>
<td> SUAMI </td>
<td> JL. SILIKAT 6 NO.45A RT 3 RW 11, PURWANTORO, BLIMBING, KOTA
MALANG </td>
<td> A09 </td>
<td> UMUM </td>
<td> kelas 3 </td>
<td> A06 </td>
<td> 300000 </td>
<td> O80.0 </td>
<td> O80.0 </td>
<td> 2022-07-03 </td>
<td> 07:49:05 </td>
<td> 2022-07-05 </td>
<td> 06:54:31 </td>
<td> IGDK </td>
<td> </td>
<td> </td>
<td> 2 </td>
<td> 1 </td>
<td> 0 </td>
<td> 0 </td>
<td> 0 </td>
<td> 0 </td>
<td> 41-42 </td>

<td> 3010 </td>
<td> 48 </td>
<td> Hidup </td>
<td> Ya </td>
<td> Hidup </td>
<td> Ya </td>
<td> Tidak </td>
<td> Ya </td>
<td> Visite Dokter Umum, EKG, Konsultasi Dokter Spesialis Obgyn

Via Telepon </td>
<td> - </td>
<td> 900000 </td>
<td> 3 </td>
<td> Sudah </td>
</tr>
<tr>
<td> 2022/07/03/000041 </td>
<td> 071861 </td>
<td> KHAIRA SYAFA GANTARI, An </td>
<td> P </td>
<td> MALANG </td>
<td> 2022-07-03 </td>
<td> 0 Th 0 Bl 16 Hr </td>
<td> ISLAM </td>
<td> - </td>
<td> HENDRIK FRANSISDA, Tn </td>
<td> AYAH </td>
<td> BPJ </td>
<td> kelas 3 </td>
<td> PF21 </td>
<td> 300000 </td>
<td> P03.4 </td>
<td> P03.4 </td>
<td> 2022-07-03 </td>
<td> 06:19:33 </td>
<td> 2022-07-06 </td>
<td> 06:34:15 </td>
<td> U0030 </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> 3750 </td>
<td> 51 </td>
<td> Hidup </td>
<td> Tidak </td>
<td> Hidup </td>
<td> Ya </td>
<td> Tidak </td>
<td> Ya </td>

<td> </td>
<td> 1200000 </td>
<td> Sembuh </td>
<td> 4 </td>
<td> Sudah </td>
</tr>
<tr>
<td> 2022/07/03/000035 </td>
<td> 071859 </td>
<td> SITI JUARIYAH A.By.Ny </td>
<td> P </td>
<td> MALANG </td>
<td> 2022-07-03 </td>
<td> ISLAM </td>
<td> - </td>
<td> PEDAGANG </td>
<td> ABDUR ROHIM, Tn </td>
<td> AYAH </td>
<td> JL. SILIKAT 6 NO.45A RT 3 RW 11, PURWANTORO, BLIMBING, KOTA
MALANG </td>
<td> A09 </td>
<td> UMUM </td>
<td> kelas 3 </td>
<td> PF18 </td>
<td> 300000 </td>
<td> P00.6 </td>
<td> P00.9 </td>
<td> 2022-07-03 </td>
<td> 04:42:26 </td>
<td> 2022-07-05 </td>
<td> 20:38:45 </td>
<td> U0030 </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> 3010 </td>
<td> 48 </td>
<td> Hidup </td>
<td> Ya </td>
<td> Hidup </td>
<td> Ya </td>
<td> Tidak </td>
<td> Ya </td>
<td> </td>
<td> 900000 </td>
<td> Sembuh </td>
<td> 3 </td>
<td> Sudah </td>
</tr>
<tr>
<td> 2022/07/03/000031 </td>
<td> 071856 </td>
<td> AYESHA PUTRI JULIAVIRA, AN </td>
<td> P </td>
<td> MALANG </td>
<td> 2022-07-03 </td>
<td> 0 Th 0 Bl 10 Hr </td>
<td> ISLAM </td>
<td> - </td>
<td> AYAH </td>
</td>
<td> BPJ </td>
<td> kelas 3 </td>
<td> PF16 </td>
<td> 300000 </td>
<td> P00.6 </td>
<td> P00.9 </td>
<td> 2022-07-03 </td>
<td> 03:17:22 </td>
<td> 2022-07-04 </td>
<td> 11:00:53 </td>
<td> U0030 </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> 3365 </td>
<td> 49 </td>
<td> Hidup </td>
<td> Ya </td>
<td> Hidup </td>
<td> Ya </td>
<td> Tidak </td>
<td> Ya </td>
<td> Perawatan Bayi NP , Perawatan Bayi NP , Visite Dokter

Spesialis Anak </td>
<td> - </td>
<td> 600000 </td>
<td> Sembuh </td>
<td> 2 </td>
<td> Sudah </td>
</tr>
<tr>
<td> 2022/07/03/000138 </td>
<td> 104751 </td>
<td> M. AFIF SARFARAZ AKHDAN, AN </td>
<td> L </td>
<td> MALANG </td>
<td> 2018-03-06 </td>
<td> ISLAM </td>
<td> TS </td>
<td> PELAUT </td>
<td> Muharis, Tn. </td>
<td> AYAH </td>
<td> KRAJAN BARAT RT. 04/ RW. 04, AMPELDENTO, PAKIS, KABUPATEN
MALANG </td>
<td> BPJ </td>
<td> kelas 2 </td>
<td> D06 </td>
<td> 400000 </td>
<td> R50.9 </td>
<td> J40 </td>
<td> 2022-07-03 </td>
<td> 00:38:28 </td>
<td> 2022-07-06 </td>
<td> 11:38:59 </td>
<td> IGDK </td>
<td> 2022/07/03/000138, BPJS KLS 2, AYODYA 3A/DWARAWATI 5 </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>

<td> - </td>
<td> 1600000 </td>
<td> Sembuh </td>
<td> 4 </td>
<td> Sudah </td>
</tr>
<tr>
<td> 2022/07/03/000063 </td>
<td> 011281 </td>
<td> MUHAMMAD ARSYAD ALFARIZQI, AN </td>
<td> L </td>
<td> MALANG </td>
<td> 2018-12-22 </td>
<td> 3 Th 6 Bl 22 Hr </td>
<td> ISLAM </td>
<td> - </td>
<td> - </td>
<td> - </td>
<td> Berlianti Perwitasari, Ny </td>
<td> IBU </td>
<td> JL. SIMPANG GRAJAKAN BLOK 1/22 RT 14 RW 2, PANDANWANGI,
<td> BPJ </td>
<td> kelas 1 </td>
<td> P07 </td>
<td> 650000 </td>
<td> R50.9 </td>
<td> J18.0 </td>
<td> 2022-07-03 </td>
<td> 00:29:53 </td>
<td> 2022-07-06 </td>
<td> 06:03:10 </td>
<td> IGDK </td>
<td> 2022/07/03/000063, BPJS KLS 1 PANDAWA 7 KONFIRMASI RUANGAN
</td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> Oksigen 100% Sentral 2 LPM , Visite Dokter Spesialis Anak,

Visite Dokter Spesialis Anak, Oksigen 100% Sentral 1 LPM, Nebulizer , Nebulizer
</td>
<td> </td>
<td> 2600000 </td>
<td> Sembuh </td>
<td> 4 </td>
<td> Sudah </td>
</tr>
<tr>
<td> 2022/07/02/000190 </td>
<td> 001523 </td>
<td> MUH. ABRISSAM QUTBY NAWASENA P., AN </td>
<td> L </td>
<td> Malang </td>
<td> 2018-05-28 </td>
<td> 4 Th 1 Bl 10 Hr </td>
<td> ISLAM </td>
<td> TS </td>
<td> GURU </td>
<td> LILIK SUPRATIWI, NY </td>
<td> IBU </td>
<td> JL. CEMPAKA NO 45 GEMPOL RT 20 RW 6, SEKARPURO, PAKIS,
<td> BPJ </td>
<td> kelas 1 </td>
<td> P04 </td>
<td> 650000 </td>
<td> R50.9 </td>
<td> R50.9 </td>
<td> 2022-07-02 </td>
<td> 23:34:16 </td>
<td> 2022-07-06 </td>
<td> 06:00:17 </td>
<td> IGDK </td>
<td> 2022/07/02/000190, BPJS KLS 2 UP 1, PANDAWA 4 KONFIRMASI
RUANGAN </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>

<td> - </td>
<td> 2600000 </td>
<td> 4 </td>
<td> Sudah </td>
</tr>
<tr>
<td> 2022/07/02/000123 </td>
<td> 071805 </td>
<td> WIDYAWATI, NY </td>
<td> P </td>
<td> MALANG </td>
<td> 1996-12-20 </td>
<td> 25 Th 6 Bl 23 Hr </td>
<td> ISLAM </td>
<td> SMA </td>
<td> PONCO SETYO, TN </td>
<td> SUAMI </td>
<td> BANARAN BABADAN RT 1 RW 6, BABADAN, NGAJUM, KABUPATEN MALANG
</td>
<td> BPJ </td>
<td> kelas 2 </td>
<td> D09 </td>
<td> 400000 </td>
<td> O80.9 </td>
<td> O80.9 </td>
<td> 2022-07-02 </td>
<td> 23:13:04 </td>
<td> 2022-07-04 </td>
<td> 13:05:14 </td>
<td> IGDK </td>
<td> 2022/07/02/000123, BPJS II DI DWARAWATI 5A/AYODYA 3 </td>
<td> 1 </td>
<td> 0 </td>
<td> 0 </td>
<td> 0 </td>
<td> 0 </td>
<td> 0 </td>
<td> 40-41 </td>

<td> 3200 </td>
<td> 49 </td>
<td> Hidup </td>
<td> Tidak </td>
<td> Baik </td>
<td> Ya </td>
<td> Tidak </td>
<td> Ya </td>

Bidan, Oksigen 100% Sentral 3 LPM </td>
<td> - </td>
<td> 800000 </td>
<td> Sehat </td>
<td> 2 </td>
<td> Sudah </td>
</tr>
<tr>
<td> 2022/07/02/000175 </td>
<td> 063287 </td>
<td> ACHMAD SAMUDERA HAZA, AN </td>
<td> L </td>
<td> MALANG </td>
<td> 2022-01-13 </td>
<td> 0 Th 6 Bl 23 Hr </td>
<td> ISLAM </td>
<td> - </td>
<td> - </td>
<td> RUDI HARTONO, Tn. </td>
<td> AYAH </td>
<td> JL KENDALSARI I /73 RT 3 RW 9, TULUSREJO, LOWOKWARU, KOTA
MALANG </td>
<td> A09 </td>
<td> UMUM </td>
<td> kelas 2 </td>
<td> P01 </td>
<td> 400000 </td>
<td> A09 </td>
<td> A09 </td>
<td> 2022-07-02 </td>
<td> 21:00:34 </td>
<td> 2022-07-04 </td>
<td> 18:24:22 </td>
<td> IGDK </td>
<td> </td>
<td> 2022/07/02/000175, UMUM KLS 2. AYODYA 2A KONFIRMASI
RUANGAN,L PERTANGGAL 3-4-2022 JAM 08.36 PX NAIK KLS 1 PANDAWA 1 </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>

Konsultasi Dokter Spesialis Anak Via Telepon, Infus Bayi oleh Perawat / Bidan </td>
<td> - </td>
<td> 800000 </td>
<td> Sehat </td>
<td> 2 </td>
<td> Sudah </td>
</tr>
<tr>
<td> 2022/07/02/000207 </td>
<td> 071849 </td>
<td> ALEXANDER JULIO NATANAEL, AN </td>
<td> L </td>
<td> MALANG </td>
<td> 2022-07-02 </td>
<td> KATHOLIK </td>
<td> - </td>
<td> TS </td>
<td> AYAH </td>
MALANG </td>
<td> BPJ </td>
<td> kelas 3 </td>
<td> BFA05 </td>
<td> 300000 </td>
<td> P03.4 </td>
<td> P96.8 </td>
<td> 2022-07-02 </td>
<td> 20:15:11 </td>
<td> 2022-07-04 </td>
<td> 11:41:03 </td>
<td> U0030 </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> 3800 </td>
<td> 50 </td>
<td> Hidup </td>
<td> Tidak </td>
<td> Hidup </td>
<td> Ya </td>
<td> Tidak </td>
<td> Ya </td>

<td> - </td>
<td> 900000 </td>
<td> Sembuh </td>
<td> 3 </td>
<td> Sudah </td>
</tr>
<tr>
<td> 2022/07/02/000093 </td>
<td> 068301 </td>
<td> PATRICIA MEYANA DIKPASARI, NY </td>
<td> P </td>
<td> MALANG </td>
<td> 1996-05-31 </td>
<td> 26 Th 1 Bl 10 Hr </td>
<td> KATHOLIK </td>
<td> S1 </td>
<td> SUAMI </td>
MALANG </td>
<td> BPJ </td>
<td> kelas 1 </td>
<td> H01 </td>
<td> 650000 </td>
<td> O80.9 </td>
<td> O80.0 </td>
<td> 2022-07-02 </td>
<td> 20:13:30 </td>
<td> 2022-07-04 </td>
<td> 16:28:42 </td>
<td> IGDK </td>
<td> 2022/07/02/000093, BPJS KELAS 2 UP 1 RENCANA DI PANDAWA 8
<td> 1 </td>
<td> 0 </td>
<td> 0 </td>
<td> 0 </td>
<td> 0 </td>
<td> 0 </td>
<td> 40-41 </td>

<td> 3800 </td>
<td> 54 </td>
<td> Hidup </td>
<td> Ya </td>
<td> Hidup </td>
<td> Ya </td>
<td> Tidak </td>
<td> Ya </td>
<td> VT Dokter, Infus Dewasa oleh Perawat / Bidan, Oksigen 100%

Sentral 3 LPM </td>
<td> - </td>
<td> 1950000 </td>
<td> 3 </td>
<td> Sudah </td>
</tr>
<tr>
<td> 2022/07/02/000174 </td>
<td> 084624 </td>
<td> DELIA KANIA AZZAHRA PUTRI, AN </td>
<td> P </td>
<td> PROBOLINGGO </td>
<td> 2016-04-06 </td>
<td> 6 Th 2 Bl 26 Hr </td>
<td> ISLAM </td>
<td> TS </td>
<td> PERAWAT </td>
<td> DEKA ARIA CAHYA, TN </td>
<td> AYAH </td>
<td> JL. KI AGENG GRIBIG II RT 04 RW 03, MADYOPURO,
<td> BPJ </td>
<td> kelas 2 </td>
<td> D06 </td>
<td> 400000 </td>
<td> R50.9 </td>
<td> R50.9 </td>
<td> 2022-07-02 </td>
<td> 18:53:03 </td>
<td> 2022-07-03 </td>
<td> 16:36:14 </td>
<td> IGDK </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>

<td> - </td>
<td> 800000 </td>
<td> 2 </td>
<td> Sudah </td>
</tr>
<tr>
<td> 2022/07/02/000170 </td>
<td> 067930 </td>
<td> ATHAYA RAMADHANI PUTRI ADIZA, An </td>
<td> P </td>
<td> Malang </td>
<td> 2022-04-08 </td>
<td> ISLAM </td>
<td> SMA </td>
<td> PERAWAT </td>
<td> ADY SANJAYA PUTRA, TN </td>
<td> AYAH </td>
<td> JL. SANAN III-H/23 RT.5 RW.15, BUNULREJO, BLIMBING, KOTA
MALANG </td>
<td> BPJ </td>
<td> kelas 2 </td>
<td> P08 </td>
<td> 400000 </td>
<td> A09 </td>
<td> A09 </td>
<td> 2022-07-02 </td>
<td> 17:29:06 </td>
<td> 2022-07-06 </td>
<td> 20:23:44 </td>
<td> IGDK </td>
<td> 2022/07/02/000170, BPJS KLS 2 . PANDAWA 8. ANAK KARYAWAN MAS
ADI OK </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>

<td> - </td>
<td> 2000000 </td>
<td> 5 </td>
<td> Sudah </td>
</tr>
<tr>
<td> 2022/07/02/000149 </td>
<td> 067467 </td>
<td> ATHAYA QAWIM ZAAHIRULHAQ P G., AN </td>
<td> L </td>
<td> MALANG </td>
<td> 2015-12-05 </td>
<td> 6 Th 6 Bl 29 Hr </td>
<td> ISLAM </td>
<td> - </td>
<td> ARIEF GUNAWAN, TN </td>
<td> IBU </td>
<td> JL. MENDIT TIMUR NO. 6 RT 03 RW 05, MANGLIAWAN, PAKIS,
<td> BPJ </td>
<td> kelas 1 </td>
<td> P03 </td>
<td> 650000 </td>
<td> A90 </td>
<td> A90 </td>
<td> 2022-07-02 </td>
<td> 15:45:58 </td>
<td> 2022-07-04 </td>
<td> 16:02:19 </td>
<td> IGDK </td>
<td> 2022/07/02/000149, BPJS KLS II UP I DI PANDAWA 3
(KONFIRMASI) </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>

<td> - </td>
<td> 1950000 </td>
<td> 3 </td>
<td> Sudah </td>
</tr>
<tr>
<td> 2022/07/02/000154 </td>
<td> 071825 </td>
<td> ARSYANENDRA ATHAYA MANGUN WIBOWO, AN </td>
<td> L </td>
<td> MALANG </td>
<td> 2022-07-02 </td>
<td> ISLAM </td>
<td> TS </td>
<td> PONCO SETYO, TN </td>
<td> AYAH </td>
<td> BANARAN BABADAN RT 1 RW 6, BABADAN, NGAJUM, KABUPATEN MALANG
</td>
<td> BPJ </td>
<td> kelas 3 </td>
<td> PF01 </td>
<td> 300000 </td>
<td> P03.4 </td>
<td> P03.4 </td>
<td> 2022-07-02 </td>
<td> 14:20:24 </td>
<td> 2022-07-04 </td>
<td> 15:37:44 </td>
<td> U0030 </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> 3200 </td>
<td> 49 </td>
<td> Hidup </td>
<td> Tidak </td>
<td> Hidup </td>
<td> Ya </td>
<td> Tidak </td>
<td> Ya </td>

<td> - </td>
<td> 900000 </td>
<td> Sembuh </td>
<td> 3 </td>
<td> Sudah </td>
</tr>
<tr>
<td> 2022/07/02/000086 </td>
<td> 017010 </td>
<td> Kasih Astuti, Ny </td>
<td> P </td>
<td> BAnyumas </td>
<td> 1993-07-02 </td>
<td> 29 Th 0 Bl 9 Hr </td>
<td> ISLAM </td>
<td> SMA </td>
<td> - </td>
<td> Gilang Anugrah, Tn </td>
<td> SAUDARA </td>
<td> JL. RANUGRATI II B / 3 RT 01 RW 06, KEDUNGKANDANG,
<td> BPJ </td>
<td> kelas 1 </td>
<td> H06 </td>
<td> 650000 </td>
<td> O80.0 </td>
<td> O80.0 </td>
<td> 2022-07-02 </td>
<td> 13:08:41 </td>
<td> 2022-07-03 </td>
<td> 22:39:06 </td>
<td> IGDK </td>
<td> </td>
<td> </td>
<td> 2 </td>
<td> 1 </td>
<td> 0 </td>
<td> 0 </td>
<td> 0 </td>
<td> 0 </td>
<td> 40-41 </td>

<td> 3010 </td>
<td> 48 </td>
<td> Hidup </td>
<td> Ya </td>
<td> Hidup </td>
<td> Ya </td>
<td> Tidak </td>
<td> Ya </td>

<td> - </td>
<td> 1300000 </td>
<td> 2 </td>
<td> Sudah </td>
</tr>
<tr>
<td> 2022/07/02/000085 </td>
<td> 071116 </td>
<td> NURI VINA MAWADDAH, NY </td>
<td> P </td>
<td> DEMAK </td>
<td> 1999-06-23 </td>
<td> 23 Th 0 Bl 24 Hr </td>
<td> ISLAM </td>
<td> S1 </td>
<td> AHMAD BURHAN, TN </td>
<td> SUAMI </td>
<td> JL. TERUSAN BATUBARA VB RT 8 RW 9, PANDANWANGI, BLIMBING,
KOTA MALANG </td>
<td> BPJ </td>
<td> kelas 3 </td>
<td> A07 </td>
<td> 300000 </td>
<td> O80.0 </td>
<td> O82.9 </td>
<td> 2022-07-02 </td>
<td> 12:55:50 </td>
<td> 2022-07-07 </td>
<td> 17:18:10 </td>
<td> IGDK </td>
<td> </td>
<td> </td>
<td> 1 </td>
<td> 0 </td>
<td> 0 </td>
<td> 0 </td>
<td> 0 </td>
<td> 0 </td>
<td> 41-42 </td>

<td> 2550 </td>
<td> 48 </td>
<td> Hidup </td>
<td> Tidak </td>
<td> Hidup </td>
<td> Ya </td>
<td> Tidak </td>
<td> Ya </td>
<td> VT Dokter, Oksigen 100% Sentral 10 LPM, Konsultasi Dokter

Umum(IGD), Visite Dokter Umum, Oksigen 100% Sentral 7 LPM , Konsultasi Dokter
Spesialis Obgyn Via Telepon, OD </td>
<td> - </td>
<td> 1800000 </td>
<td> 6 </td>
<td> Sudah </td>
</tr>
<tr>
<td> 2022/07/02/000148 </td>
<td> 071823 </td>
<td> KAMANIYA SALMA, AN </td>
<td> P </td>
<td> MALANG </td>
<td> 2022-07-02 </td>
<td> ISLAM </td>
<td> TS </td>
<td> AWAL SYUHADA, TN </td>
<td> AYAH </td>
<td> JL. TERUSAN SURABAYA 28 RT 7 RW 3, GADINGKASRI, KLOJEN, KOTA
MALANG </td>
<td> BPJ </td>
<td> kelas 3 </td>
<td> PF20 </td>
<td> 300000 </td>
<td> P00.6 </td>
<td> P00.9 </td>
<td> 2022-07-02 </td>
<td> 12:27:08 </td>
<td> 2022-07-04 </td>
<td> 14:28:03 </td>
<td> U0030 </td>
<td> </td>
<td> 2022/07/02/000148, FISOL </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> 2610 </td>
<td> 45 </td>
<td> Hidup </td>
<td> Ya </td>
<td> Hidup </td>
<td> Ya </td>
<td> Tidak </td>
<td> Ya </td>

<td> - </td>
<td> 900000 </td>
<td> Sembuh </td>
<td> 3 </td>
<td> Sudah </td>
</tr>
<tr>
<td> 2022/07/02/000212 </td>
<td> 067862 </td>
<td> ELIN INDAH SARI, NY </td>
<td> P </td>
<td> MALANG </td>
<td> 1998-08-07 </td>
<td> 23 Th 11 Bl 5 Hr </td>
<td> ISLAM </td>
<td> SMA </td>
<td> RICKY HARIYANTO, NT </td>
<td> SUAMI </td>
<td> JL. IR RAIS GG 14 NO.15 RT 3 RW 5 , TANJUNGREJO, SUKUN, KOTA
MALANG </td>
<td> BPJ </td>
<td> kelas 3 </td>
<td> A07 </td>
<td> 300000 </td>
<td> O42.9 </td>
<td> O82.0 </td>
<td> 2022-07-02 </td>
<td> 11:26:35 </td>
<td> 2022-07-05 </td>
<td> 18:53:47 </td>
<td> IGDK </td>
<td> 2022/07/02/000212, BPJS KLS 3, AMARTA 8A, TGL 3-7-2022 JAM
09.20 PINDAH DR JOKO </td>
<td> 1 </td>
<td> 0 </td>
<td> 0 </td>
<td> 0 </td>
<td> 0 </td>
<td> 0 </td>
<td> 40-41 </td>

<td> 2600 </td>
<td> 47 </td>
<td> Hidup </td>
<td> Tidak </td>
<td> Hidup </td>
<td> Ya </td>
<td> Tidak </td>
<td> Ya </td>

Visite Dokter Umum, Infus Dewasa oleh Perawat / Bidan, EKG, Operasional Rumah Sakit
</td>
<td> - </td>
<td> 1200000 </td>
<td> 4 </td>
<td> Sudah </td>
</tr>
<tr>
<td> 2022/07/02/000138 </td>
<td> 071819 </td>
<td> MIKHAIL UKASYAH AL AUN, AN </td>
<td> L </td>
<td> MALANG </td>
<td> 2022-07-02 </td>
<td> ISLAM </td>
<td> TS </td>
<td> GURU </td>
<td> MOCHAMAD SHOLEH, TN </td>
<td> AYAH </td>
<td> PERUM CANDRA KIRANA REGENCY D6 RT 003 RW 001, WATUGEDE,
<td> BPJ </td>
<td> kelas 3 </td>
<td> PF02 </td>
<td> 300000 </td>
<td> P00.6 </td>
<td> P00.9 </td>
<td> 2022-07-02 </td>
<td> 10:41:39 </td>
<td> 2022-07-04 </td>
<td> 10:40:42 </td>
<td> U0030 </td>
<td> </td>
<td> 2022/07/02/000138. FISOL </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> 2865 </td>
<td> 47 </td>
<td> Hidup </td>
<td> Ya </td>
<td> Hidup </td>
<td> Ya </td>
<td> Tidak </td>
<td> Ya </td>

<td> - </td>
<td> 900000 </td>
<td> Sembuh </td>
<td> 3 </td>
<td> Sudah </td>
</tr>
<tr>
<td> 2022/07/02/000129 </td>
<td> 071815 </td>
<td> NESYA AULIA ZAHRA, AN </td>
<td> P </td>
<td> MALANG </td>
<td> 2022-07-02 </td>
<td> ISLAM </td>
<td> TS </td>
<td> PRASTIYO DWI SYAPUTRO, TN </td>
<td> AYAH </td>
<td> JL. ARIS MUNANDAR IIIB/727 RT 009 RW 001, SUKOHARJO, KLOJEN,
KOTA MALANG </td>
<td> BPJ </td>
<td> kelas 3 </td>
<td> PF10 </td>
<td> 300000 </td>
<td> P03.4 </td>
<td> P03.4 </td>
<td> 2022-07-02 </td>
<td> 10:16:12 </td>
<td> 2022-07-02 </td>
<td> 16:22:34 </td>
<td> U0030 </td>
<td> 2022/07/02/000129, FISOL </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> 2500 </td>
<td> 47 </td>
<td> Hidup </td>
<td> Tidak </td>
<td> Hidup </td>
<td> Ya </td>
<td> Tidak </td>
<td> Ya </td>

<td> - </td>
<td> 600000 </td>
<td> Sembuh </td>
<td> 2 </td>
<td> Sudah </td>
</tr>
<tr>
<td> 2022/07/02/000127 </td>
<td> 020180 </td>
<td> MEI HIDIANAWATI, NY </td>
<td> P </td>
<td> BLITAR </td>
<td> 1972-05-09 </td>
<td> 50 Th 1 Bl 29 Hr </td>
<td> ISLAM </td>
<td> SMA </td>
<td> PENJAHIT </td>
<td> UMAR AMRULLAH, TN </td>
<td> SUAMI </td>
<td> JL. LESANPURO I/25 RT 004 RW 003, LESANPURO, KEDUNGKANDANG,
KOTA MALANG </td>
<td> BPJ </td>
<td> kelas 3 </td>
<td> A09 </td>
<td> 300000 </td>
<td> N93.9 </td>
<td> N93.9 </td>
<td> 2022-07-02 </td>
<td> 06:59:25 </td>
<td> 2022-07-04 </td>
<td> 13:47:18 </td>
<td> IGDK </td>
<td> 2022/07/02/000127, BPJS KLS III PBI DI AMARTA 6C </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> Infus Dewasa oleh Perawat / Bidan, EKG </td>

<td> - </td>
<td> 900000 </td>
<td> Sembuh </td>
<td> 3 </td>
<td> Sudah </td>
</tr>
<tr>
<td> 2022/07/02/000087 </td>
<td> 071806 </td>
<td> MUHAMMAD KHALID, AN </td>
<td> L </td>
<td> MALANG </td>
<td> 2022-07-02 </td>
<td> ISLAM </td>
<td> - </td>
<td> GILANG ANUGRAH, TN </td>
<td> AYAH </td>
<td> JL RANUGRATI II B / 3 RT 1 RW 6 , KEDUNGKANDANG,
<td> BPJ </td>
<td> kelas 3 </td>
<td> PF12 </td>
<td> 300000 </td>
<td> P00.6 </td>
<td> P00.9 </td>
<td> 2022-07-02 </td>
<td> 04:20:41 </td>
<td> 2022-07-04 </td>
<td> 11:00:38 </td>
<td> U0030 </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> 3031 </td>
<td> 48 </td>
<td> Hidup </td>
<td> Ya </td>
<td> Hidup </td>
<td> Ya </td>
<td> Tidak </td>
<td> Ya </td>

<td> - </td>
<td> 900000 </td>
<td> Sembuh </td>
<td> 3 </td>
<td> Sudah </td>
</tr>
<tr>
<td> 2022/07/02/000076 </td>
<td> 071802 </td>
<td> JULIA DWI ANGGRAINI, AN </td>
<td> P </td>
<td> MALANG </td>
<td> 2022-07-02 </td>
<td> ISLAM </td>
<td> - </td>
<td> SUMAIYAH, NY </td>
<td> SAUDARA </td>
<td> JL LESANPURO RT 5 RW 5 , LESANPURO, KEDUNGKANDANG, KOTA
MALANG </td>
<td> BPJ </td>
<td> PA02 </td>
<td> NICU 2 </td>
<td> 400000 </td>
<td> P00.6 </td>
<td> P07.1 </td>
<td> 2022-07-02 </td>
<td> 00:23:02 </td>
<td> 2022-07-04 </td>
<td> 17:13:19 </td>
<td> U0029 </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> Oksigen 21% 1 LPM </td>

<td> - </td>
<td> 1200000 </td>
<td> Sembuh </td>
<td> 3 </td>
<td> Sudah </td>
</tr>
<tr>
<td> 2022/07/01/000207 </td>
<td> 055915 </td>
<td> KARL ELLENIO YOFA ANGGORO, An </td>
<td> L </td>
<td> MALANG </td>
<td> 2021-08-10 </td>
<td> 0 Th 10 Bl 21 Hr </td>
<td> ISLAM </td>
<td> - </td>
<td> FAJAR TRI ANGGORO, Tn </td>
<td> AYAH </td>
<td> JL. SIMPANG GRAJAKAN I/58 RT 14 RW 2, PANDANWANGI, BLIMBING,
KOTA MALANG </td>
<td> BPJ </td>
<td> kelas 1 </td>
<td> D04 </td>
<td> 650000 </td>
<td> R56.8 </td>
<td> - </td>
<td> 2022-07-01 </td>
<td> 22:26:33 </td>
<td> 2022-07-02 </td>
<td> 17:11:30 </td>
<td> IGDK </td>
<td> </td>
<td> 2022/07/01/000207, BPJS KLS 1 TITIP AYODYA 2A ( SUDAH
KONSELING PASIEN KLO DI TITIPKAN KLS DI BAWAHNYA </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> Oksigen 100% Sentral 3 LPM, Oksigen 21% 2 LPM / Jam </td>
<td> - </td>
<td> 1300000 </td>
<td> 2 </td>
<td> Sudah </td>
</tr>
<tr>
<td> 2022/07/01/000210 </td>
<td> 071788 </td>
<td> KEINARA AISYAH ADREENA G, AN </td>
<td> P </td>
<td> MALANG </td>
<td> 2016-12-06 </td>
<td> 5 Th 6 Bl 27 Hr </td>
<td> ISLAM </td>
<td> TS </td>
<td> ARIF GUNAWAN, TN </td>
<td> AYAH </td>
<td> JL. ARJUNO GG I NO 115 RT 008 RW 001, KAUMAN, KLOJEN, KOTA
MALANG </td>
<td> BPJ </td>
<td> kelas 1 </td>
<td> H10 </td>
<td> 650000 </td>
<td> A90 </td>
<td> A90 </td>
<td> 2022-07-01 </td>
<td> 22:22:37 </td>
<td> 2022-07-04 </td>
<td> 14:22:22 </td>
<td> IGDK </td>
<td> 2022/07/01/000210, BPJS KLS 1, HASTINA 10 </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>

Bidan </td>
<td> - </td>
<td> 1950000 </td>
<td> Sehat </td>
<td> 3 </td>
<td> Sudah </td>
</tr>
<tr>
<td> 2022/07/01/000191 </td>
<td> 071781 </td>
<td> M ABRIZAM REYNAND, AN </td>
<td> L </td>
<td> MALANG </td>
<td> 2021-04-19 </td>
<td> 1 Th 2 Bl 21 Hr </td>
<td> ISLAM </td>
<td> - </td>
<td> - </td>
<td> - </td>
<td> RENDI BAGUS PRAYOGO, TN </td>
<td> AYAH </td>
<td> JL. BINOR V NO.6 RT 8 RW 14 , BUNULREJO, BLIMBING, KOTA
MALANG </td>
<td> A09 </td>
<td> UMUM </td>
<td> kelas 3 </td>
<td> A02 </td>
<td> 300000 </td>
<td> J18.0 </td>
<td> J18.9 </td>
<td> 2022-07-01 </td>
<td> 20:35:01 </td>
<td> 2022-07-07 </td>
<td> 00:29:54 </td>
<td> IGDK </td>
<td> </td>
<td> 2022/07/01/000191, UMUM KLS 3 AMARTA 1 A </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> Konsultasi Dokter Spesialis Anak Via Telepon, Oksigen 100%

Sentral 2 LPM, Visite Dokter Spesialis Anak, Visite Dokter Spesialis Obgyn, Sewa
Infus Pump, Oksigen 100% Sentral 3 LPM , Infus Anak oleh Perawat / Bidan </td>
<td> - </td>
<td> 2100000 </td>
<td> Sehat </td>
<td> 7 </td>
<td> Sudah </td>
</tr>
<tr>
<td> 2022/07/01/000053 </td>
<td> 071383 </td>
<td> CHRISTOPHER HARVEY LIMANTO, An </td>
<td> L </td>
<td> MALANG </td>
<td> 2022-06-23 </td>
<td> 0 Th 0 Bl 15 Hr </td>
<td> KRISTEN </td>
<td> - </td>
<td> GERALD STEPHANUS,TN </td>
<td> AYAH </td>
<td> PONDOK BLIMBING INDAH C2-15 RT.5 RW.5, POLOWIJEN, BLIMBING,
KOTA MALANG </td>
<td> BPJ </td>
<td> PA04 </td>
<td> NICU 4 </td>
<td> 400000 </td>
<td> P59.9 </td>
<td> P59.9 </td>
<td> 2022-07-01 </td>
<td> 19:08:52 </td>
<td> 2022-07-03 </td>
<td> 19:20:12 </td>
<td> U0002 </td>
<td> </td>
<td> 0212R0100722K000046, BPJS KLS 2 FOTOTERAPI NICU </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> - </td>
<td> 1200000 </td>
<td> 3 </td>
<td> Sudah </td>
</tr>
<tr>
<td> 2022/07/01/000152 </td>
<td> 071765 </td>
<td> AFRINA MAULIA, AN </td>
<td> P </td>
<td> Malang </td>
<td> 2006-04-10 </td>
<td> 16 Th 3 Bl 1 Hr </td>
<td> ISLAM </td>
<td> SMP </td>
<td> ISTIQOMAH, NY </td>
<td> IBU </td>
<td> JL. BANTARAN 1A NO. 26 RT 03 RW 01, TULUSREJO, LOWOKWARU,
KOTA MALANG </td>
<td> BPJ </td>
<td> kelas 2 </td>
<td> D05 </td>
<td> 400000 </td>
<td> A90 </td>
<td> A90 </td>
<td> 2022-07-01 </td>
<td> 17:12:20 </td>
<td> 2022-07-06 </td>
<td> 16:38:16 </td>
<td> IGDK </td>
<td> </td>
<td> 2022/07/01/000152, BPJS KLS 2 AYODYA 3B </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>

Telepon, Konsultasi Dokter Spesialis Anak Via Telepon, Infus Anak oleh Perawat /
Bidan </td>
<td> - </td>
<td> 2400000 </td>
<td> Sehat </td>
<td> 6 </td>
<td> Sudah </td>
</tr>
<tr>
<td> 2022/07/01/000117 </td>
<td> 071624 </td>
<td> SITI MUNTARI, Ny </td>
<td> P </td>
<td> BLITAR </td>
<td> 1981-05-20 </td>
<td> 41 Th 1 Bl 17 Hr </td>
<td> ISLAM </td>
<td> SMA </td>
<td> SOPIR </td>
<td> ZULKIFLI, Tn </td>
<td> SUAMI </td>
<td> JL. PROGO 5B RT 03 RW 02, BUNULREJO, BLIMBING, KOTA MALANG
</td>
<td> BPJ </td>
<td> kelas 3 </td>
<td> A04 </td>
<td> 300000 </td>
<td> O02.0 </td>
<td> O02.0 </td>
<td> 2022-07-01 </td>
<td> 16:43:38 </td>
<td> 2022-07-02 </td>
<td> 12:45:05 </td>
<td> IGDK </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>

<td> - </td>
<td> 600000 </td>
<td> 2 </td>
<td> Sudah </td>
</tr>
<tr>
<td> 2022/07/01/000167 </td>
<td> 071769 </td>
<td> HARISMA QURROTUÀINI, NY </td>
<td> P </td>
<td> MALANG </td>
<td> 1993-05-17 </td>
<td> 29 Th 1 Bl 15 Hr </td>
<td> ISLAM </td>
<td> S1 </td>
<td> AWAL SYUHADA, TN </td>
<td> SUAMI </td>
<td> JL. TERUSAN SURABAYA 28 RT 7 RW 3 , GADINGKASRI, KLOJEN,
KOTA MALANG </td>
<td> BPJ </td>
<td> kelas 3 </td>
<td> D08 </td>
<td> 300000 </td>
<td> O42.9 </td>
<td> O42.9 </td>
<td> 2022-07-01 </td>
<td> 15:06:57 </td>
<td> 2022-07-04 </td>
<td> 13:26:57 </td>
<td> IGDK </td>
<td> </td>
<td> 2022/07/01/000167, BPJS KLS 3 UP 2 AYODYA 4B </td>
<td> 1 </td>
<td> 0 </td>
<td> 0 </td>
<td> 0 </td>
<td> 0 </td>
<td> 0 </td>
<td> 39-40 </td>

<td> 2610 </td>
<td> 45 </td>
<td> Hidup </td>
<td> Ya </td>
<td> Hidup </td>
<td> Ya </td>
<td> Tidak </td>
<td> Ya </td>

<td> - </td>
<td> 1200000 </td>
<td> Sehat </td>
<td> 4 </td>
<td> Sudah </td>
</tr>
<tr>
<td> 2022/07/01/000149 </td>
<td> 016824 </td>
<td> Arka Naufal Rajendra, An </td>
<td> L </td>
<td> Malang </td>
<td> 2018-06-30 </td>
<td> ISLAM </td>
<td> TS </td>
<td> DIAN AGUNG SAPUTRO, TN </td>
<td> AYAH </td>
<td> JL.DANAU BRATAN TIMUR IV D36 RT 3 RW 11, MADYOPURO,
<td> A09 </td>
<td> UMUM </td>
<td> kelas 2 </td>
<td> D02 </td>
<td> 400000 </td>
<td> J18.0 </td>
<td> J18.1 </td>
<td> 2022-07-01 </td>
<td> 12:36:22 </td>
<td> 2022-07-04 </td>
<td> 19:58:30 </td>
<td> IGDK </td>
<td> </td>
<td> 2022/07/01/000149, UMUM KLS 2 DWARAWATI/AYODYA 1B </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>

Oksigen 100% Sentral 2 LPM, Oksigen 100% Sentral 2 LPM, Visite Dokter Spesialis
Anak, Visite Dokter Spesialis Anak, Oksigen 21% 2 LPM / Jam, Oksigen 21% 2 LPM /
Jam, Oksigen 21% 2 LPM / Jam, Oksigen 21% 2 LPM / Jam, Oksigen 21% 2 LPM / Jam,
<td> - </td>
<td> 1600000 </td>
<td> Sehat </td>
<td> 4 </td>
<td> Sudah </td>
</tr>
<tr>
<td> 2022/07/01/000211 </td>
<td> 071794 </td>
<td> NADILA RAHARDIANI, NY </td>
<td> P </td>
<td> SURABAYA </td>
<td> 1998-06-02 </td>
<td> 24 Th 1 Bl 6 Hr </td>
<td> ISLAM </td>
<td> SMA </td>
<td> PRASTIYO DWI SYAPUTRO, TN </td>
<td> SUAMI </td>
<td> JL. ARIS MUNANDAR IIIB/727 RT 9 RW 1 , SUKOHARJO, KLOJEN,
KOTA MALANG </td>
<td> BPJ </td>
<td> kelas 3 </td>
<td> A05 </td>
<td> 300000 </td>
<td> O42.9 </td>
<td> O82.8 </td>
<td> 2022-07-01 </td>
<td> 12:34:10 </td>
<td> 2022-07-04 </td>
<td> 17:40:37 </td>
<td> IGDK </td>
<td> 1 </td>
<td> 0 </td>
<td> 0 </td>
<td> 0 </td>
<td> 0 </td>
<td> 0 </td>
<td> 36-37 </td>

<td> 2500 </td>
<td> 47 </td>
<td> Hidup </td>
<td> Tidak </td>
<td> Hidup </td>
<td> Ya </td>
<td> Tidak </td>
<td> Ya </td>

Obgyn, Visite Dokter Spesialis Obgyn, Infus Dewasa oleh Perawat / Bidan </td>
<td> - </td>
<td> 1200000 </td>
<td> 4 </td>
<td> Sudah </td>
</tr>
<tr>
<td> 2022/07/01/000130 </td>
<td> 071763 </td>
<td> SULISTYOWATI, NY </td>
<td> P </td>
<td> BLITAR </td>
<td> 1968-12-05 </td>
<td> 53 Th 7 Bl 3 Hr </td>
<td> ISLAM </td>
<td> D2 </td>
<td> GALUH GANDHI GATI, NN </td>
<td> ANAK </td>
<td> JL. KAPI PRAMUJA II 18 A NO. 25 RT 01 RW 12, SEKARPURO,
<td> BPJ </td>
<td> kelas 3 </td>
<td> A13 </td>
<td> 300000 </td>
<td> A90 </td>
<td> A90 </td>
<td> 2022-07-01 </td>
<td> 12:33:17 </td>
<td> 2022-07-04 </td>
<td> 12:29:35 </td>
<td> IGDK </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> Visite Dokter Spesialis Penyakit Dalam, Visite Dokter Umum,

Visite Dokter Umum, Infus Dewasa oleh Perawat / Bidan, Oksigen 100% Sentral 3 LPM ,
Oksigen 100% Sentral 3 LPM , Oksigen 100% Sentral 2 LPM, Konsultasi Dokter
Spesialis Penyakit Dalam Via Telepon, EKG </td>
<td> - </td>
<td> 1200000 </td>
<td> Sehat </td>
<td> 4 </td>
<td> Sudah </td>
</tr>
<tr>
<td> 2022/07/01/000224 </td>
<td> 063095 </td>
<td> ANIK FIDIYANTI, Ny </td>
<td> P </td>
<td> MALANG </td>
<td> 1982-10-10 </td>
<td> 39 Th 8 Bl 26 Hr </td>
<td> ISLAM </td>
<td> GURU </td>
<td> S1 </td>
<td> GURU </td>
<td> MOCHAMAD SHOLEH, Tn </td>
<td> SUAMI </td>
<td> PERUM CANDRA KIRANA REGENCY D6 RT 03 RW 01, WATUGEDE,
<td> BPJ </td>
<td> kelas 3 </td>
<td> A03 </td>
<td> 300000 </td>
<td> O80.9 </td>
<td> - </td>
<td> 2022-07-01 </td>
<td> 12:04:06 </td>
<td> 2022-07-02 </td>
<td> 12:59:59 </td>
<td> IGDK </td>
<td> 2 </td>
<td> 1 </td>
<td> 0 </td>
<td> 0 </td>
<td> 0 </td>
<td> 0 </td>
<td> 39-40 </td>

<td> 2845 </td>
<td> 47 </td>
<td> Hidup </td>
<td> Ya </td>
<td> Hidup </td>
<td> Ya </td>
<td> Tidak </td>
<td> Ya </td>
<td> </td>
<td> - </td>
<td> 600000 </td>
<td> 2 </td>
<td> Sudah </td>
</tr>
<tr>
<td> 2022/07/01/000110 </td>
<td> 071755 </td>
<td> ZAINAB, BY NY </td>
<td> P </td>
<td> Malang </td>
<td> 2022-07-01 </td>
<td> ISLAM </td>
<td> TS </td>
<td> JAFAR SHADIQ, TN </td>
<td> AYAH </td>
<td> PERUM GRAHA PELITA ASRI , PANDANWANGI, BLIMBING, KOTA MALANG
</td>
<td> BPJ </td>
<td> kelas 3 </td>
<td> PA031 </td>
<td> NICU 3 </td>
<td> 300000 </td>
<td> P03.4 </td>
<td> P22.1 </td>
<td> 2022-07-01 </td>
<td> 11:08:50 </td>
<td> 2022-07-04 </td>
<td> 08:35:01 </td>
<td> U0030 </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> 3000 </td>
<td> 49 </td>
<td> Hidup </td>
<td> Tidak </td>
<td> Hidup </td>
<td> Ya </td>
<td> Tidak </td>
<td> Ya </td>
<td> </td>
<td> - </td>
<td> 1200000 </td>
<td> Rujuk </td>
<td> 4 </td>
<td> Sudah </td>
</tr>
<tr>
<td> 2022/07/01/000220 </td>
<td> 071796 </td>
<td> LULUK IRAWATI,NY </td>
<td> P </td>
<td> MALANG </td>
<td> 1982-02-26 </td>
<td> 40 Th 4 Bl 6 Hr </td>
<td> ISLAM </td>
<td> SMP </td>
<td> SUMAIYAH,NY </td>
<td> SAUDARA </td>
<td> JL.LESANPURO RT.05 RW.05, LESANPURO, KEDUNGKANDANG, KOTA
MALANG </td>
<td> BPJ </td>
<td> kelas 3 </td>
<td> A07 </td>
<td> 300000 </td>
<td> O63.0 </td>
<td> O14.9 </td>
<td> 2022-07-01 </td>
<td> 10:19:34 </td>
<td> 2022-07-02 </td>
<td> 13:04:46 </td>
<td> IGDK </td>
<td> </td>
<td> 2 </td>
<td> 1 </td>
<td> 0 </td>
<td> 0 </td>
<td> 0 </td>
<td> 0 </td>
<td> 34-36 </td>

<td> 2345 </td>
<td> 45 </td>
<td> Hidup </td>
<td> Ya </td>
<td> Hidup </td>
<td> Ya </td>
<td> Tidak </td>
<td> Ya </td>
<td> Visite Dokter Spesialis Obgyn, Pasang Kateter Urin oleh

<td> - </td>
<td> 600000 </td>
<td> Sembuh </td>
<td> 2 </td>
<td> Sudah </td>
</tr>
<tr>
<td> 2022/06/30/000148 </td>
<td> 005027 </td>
<td> ZAINAB, NY </td>
<td> P </td>
<td> PASURUAN </td>
<td> 1996-09-14 </td>
<td> 25 Th 9 Bl 17 Hr </td>
<td> ISLAM </td>
<td> SMA </td>
<td> JAFAR SHADIQ, TN </td>
<td> SUAMI </td>
<td> PERUM GRAHA PELITA ASRI , PANDANWANGI, BLIMBING, KOTA MALANG
</td>
<td> BPJ </td>
<td> kelas 1 </td>
<td> P05 </td>
<td> 650000 </td>
<td> O34.2 </td>
<td> O82.9 </td>
<td> 2022-07-01 </td>
<td> 09:04:10 </td>
<td> 2022-07-03 </td>
<td> 10:22:10 </td>
<td> IGDK </td>
<td> </td>
<td> 2022/06/30/000148, BPJS KLS 1 PANDAWA 5 </td>
<td> 2 </td>
<td> 1 </td>
<td> 0 </td>
<td> 0 </td>
<td> 0 </td>
<td> 0 </td>
<td> 40-41 </td>

<td> 3000 </td>
<td> 49 </td>
<td> Hidup </td>
<td> Tidak </td>
<td> Hidup </td>
<td> Ya </td>
<td> Tidak </td>
<td> Ya </td>
<td> </td>
<td> - </td>
<td> 1950000 </td>
<td> 3 </td>
<td> Sudah </td>
</tr>
<tr>
<td> 2022/07/01/000073 </td>
<td> 087917 </td>
<td> DELLA PUTRI VERNIKASARI, NY </td>
<td> P </td>
<td> MALANG </td>
<td> 1994-12-22 </td>
<td> 27 Th 6 Bl 18 Hr </td>
<td> ISLAM </td>
<td> SMA </td>
<td> Bambang Adiwijaya, Tn </td>
<td> SUAMI </td>
<td> DSN PULUNGAN RT 001 RW 003, PULUNGDOWO, TUMPANG, KABUPATEN
MALANG </td>
<td> BPJ </td>
<td> kelas 2 </td>
<td> D07 </td>
<td> 400000 </td>
<td> O82.9 </td>
<td> O82.9 </td>
<td> 2022-07-01 </td>
<td> 09:00:38 </td>
<td> 2022-07-04 </td>
<td> 13:05:46 </td>
<td> IGDK </td>
<td> 2022/07/01/000073, BPJS KLS II DI AYODYA 4A </td>
<td> 4 </td>
<td> 2 </td>
<td> 0 </td>
<td> 0 </td>
<td> 1 </td>
<td> 0 </td>
<td> 39-40 </td>

<td> 2800 </td>
<td> 48 </td>
<td> Hidup </td>
<td> Tidak </td>
<td> Baik </td>
<td> Ya </td>
<td> Tidak </td>
<td> Ya </td>
<td> </td>
<td> - </td>
<td> 1600000 </td>
<td> Sehat </td>
<td> 4 </td>
<td> Sudah </td>
</tr>
<tr>
<td> 2022/07/01/000085 </td>
<td> 071749 </td>
<td> MELVIANO ARSYA GHAISAN W, AN </td>
<td> L </td>
<td> MALANG </td>
<td> 2022-07-01 </td>
<td> ISLAM </td>
<td> TS </td>
<td> BAMBANG ADIWIJAYA, TN </td>
<td> AYAH </td>
<td> DSN PULUNGAN RT 001 RW 003, PULUNG DOWO, TUMPANG, KABUPATEN
MALANG </td>
<td> BPJ </td>
<td> kelas 3 </td>
<td> PA091 </td>
<td> 300000 </td>
<td> P03.4 </td>
<td> P36.9 </td>
<td> 2022-07-01 </td>
<td> 09:00:10 </td>
<td> 2022-07-04 </td>
<td> 11:56:09 </td>
<td> U0030 </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> 2800 </td>
<td> 48 </td>
<td> Hidup </td>
<td> Tidak </td>
<td> Hidup </td>
<td> Ya </td>
<td> Tidak </td>
<td> Ya </td>
<td> </td>
<td> - </td>
<td> 1200000 </td>
<td> Sehat </td>
<td> 4 </td>
<td> Sudah </td>
</tr>
<tr>
<td> 2022/06/30/000116 </td>
<td> 061086 </td>
<td> ILA SUSILOWATI, Ny </td>
<td> P </td>
<td> MALANG </td>
<td> 1984-12-21 </td>
<td> 37 Th 6 Bl 21 Hr </td>
<td> ISLAM </td>
<td> SMP </td>
<td> M RONI, Tn </td>
<td> SUAMI </td>
<td> JL. TELUK CENDRAWASIH RT 04 RW 03, ARJOSARI, BLIMBING, KOTA
MALANG </td>
<td> BPJ </td>
<td> kelas 2 </td>
<td> P02 </td>
<td> 400000 </td>
<td> O82.0 </td>
<td> O82.8 </td>
<td> 2022-07-01 </td>
<td> 07:48:16 </td>
<td> 2022-07-03 </td>
<td> 16:38:15 </td>
<td> IGDK </td>
<td> 2022/06/30/000116, BPJS KLS II DI PANDAWA 2 </td>
<td> 2 </td>
<td> 1 </td>
<td> 0 </td>
<td> 0 </td>
<td> 0 </td>
<td> 0 </td>
<td> 38-39 </td>

<td> 3050 </td>
<td> 48 </td>
<td> Hidup </td>
<td> Tidak </td>
<td> Baik </td>
<td> Ya </td>
<td> Tidak </td>
<td> Ya </td>
<td> </td>
<td> - </td>
<td> 1200000 </td>
<td> 3 </td>
<td> Sudah </td>
</tr>
<tr>
<td> 2022/07/01/000087 </td>
<td> 071748 </td>
<td> AISYAH SHANUM DANYYAH, AN </td>
<td> P </td>
<td> MALANG </td>
<td> 2022-07-01 </td>
<td> ISLAM </td>
<td> - </td>
<td> - </td>
<td> M RONI, TN </td>
<td> AYAH </td>
<td> JL. TELUK CENDRAWASIH RT 4 RW 3 , ARJOSARI, BLIMBING, KOTA
MALANG </td>
<td> BPJ </td>
<td> kelas 3 </td>
<td> PF22 </td>
<td> 300000 </td>
<td> P03.4 </td>
<td> P03.4 </td>
<td> 2022-07-01 </td>
<td> 06:37:35 </td>
<td> 2022-07-04 </td>
<td> 11:00:04 </td>
<td> U0030 </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> 3050 </td>
<td> 48 </td>
<td> Hidup </td>
<td> Tidak </td>
<td> Hidup </td>
<td> Ya </td>
<td> Tidak </td>
<td> Ya </td>

<td> </td>
<td> 1200000 </td>
<td> Sembuh </td>
<td> 4 </td>
<td> Sudah </td>
</tr>
<tr>
<td> 2022/07/01/000060 </td>
<td> 071745 </td>
<td> DINA PRADIANA, NY </td>
<td> P </td>
<td> MALANG </td>
<td> 2003-03-23 </td>
<td> 19 Th 3 Bl 15 Hr </td>
<td> ISLAM </td>
<td> SMP </td>
<td> MUHAMAD SETIYO SOPIÌ, TN </td>
<td> SUAMI </td>
<td> JL. PANGLIMA SUDIRMAN RT 002 RW 003, JERU, TUMPANG,
<td> BPJ </td>
<td> kelas 3 </td>
<td> A08 </td>
<td> 300000 </td>
<td> O68.8 </td>
<td> O82.1 </td>
<td> 2022-07-01 </td>
<td> 02:56:27 </td>
<td> 2022-07-03 </td>
<td> 12:54:28 </td>
<td> IGDK </td>
<td> 2022/07/01/000060, BPJS KLS III DI AMARTA 6B (RUJUKAN RS
PERMATA BUNDA)
SEP RUJUKAN TERTULIS RAWAT JALAN, BUKAN RAWAT INAP. </td>
<td> 1 </td>
<td> 0 </td>
<td> 0 </td>
<td> 0 </td>
<td> 0 </td>
<td> 0 </td>
<td> 33-34 </td>

<td> 2400 </td>
<td> 44.5 </td>
<td> Hidup </td>
<td> Ya </td>
<td> Hidup </td>
<td> Ya </td>
<td> Tidak </td>
<td> Ya </td>
<td> Visite Dokter Spesialis Obgyn, Visite Dokter Umum </td>

<td> - </td>
<td> 900000 </td>
<td> 3 </td>
<td> Sudah </td>
</tr>
<tr>
<td> 2022/07/01/000113 </td>
<td> 060274 </td>
<td> Ratih Prabowo Putri, Ny </td>
<td> P </td>
<td> MALANG </td>
<td> 1992-10-07 </td>
<td> 29 Th 8 Bl 26 Hr </td>
<td> ISLAM </td>
<td> SMA </td>
<td> Hendrik Fransisda, Tn </td>
<td> SUAMI </td>
<td> BPJ </td>
<td> kelas 1 </td>
<td> H08 </td>
<td> 650000 </td>
<td> O80.8 </td>
<td> O66.2 </td>
<td> 2022-07-01 </td>
<td> 02:48:13 </td>
<td> 2022-07-02 </td>
<td> 18:28:08 </td>
<td> IGDK </td>
<td> </td>
<td> 1 </td>
<td> 0 </td>
<td> 0 </td>
<td> 0 </td>
<td> 0 </td>
<td> 0 </td>
<td> 38-39 </td>

<td> 3350 </td>
<td> 57 </td>
<td> Hidup </td>
<td> Tidak </td>
<td> Hidup </td>
<td> Ya </td>
<td> Tidak </td>
<td> Ya </td>

<td> - </td>
<td> 1300000 </td>
<td> Sembuh </td>
<td> 2 </td>
<td> Sudah </td>
</tr>
<tr>
<td> 2022/07/01/000072 </td>
<td> 071746 </td>
<td> DINA PRADIANA, BY NY </td>
<td> L </td>
<td> MALANG </td>
<td> 2022-07-01 </td>
<td> ISLAM </td>
<td> TS </td>
<td> MUHAMAD SETIYO SOPIÌ, TN </td>
<td> AYAH </td>
<td> JL. PANGLIMA SUDIRMAN RT 002 RW 003, JERU, TUMPANG,
<td> BPJ </td>
<td> PA09 </td>
<td> 400000 </td>
<td> P03.4 </td>
<td> P59.9 </td>
<td> 2022-07-01 </td>
<td> 02:23:33 </td>
<td> 2022-07-10 </td>
<td> 12:35:56 </td>
<td> U0029 </td>
<td> 2022/07/01/000072, NICU </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
<td> 2400 </td>
<td> 44.5 </td>
<td> Hidup </td>
<td> Tidak </td>
<td> Hidup </td>
<td> Ya </td>
<td> Tidak </td>
<td> Ya </td>

Anak, Visite Dokter Spesialis Anak, Pemasangan CPAP Hari Berikutnya, Pemasangan
CPAP Hari Berikutnya, Pemasangan CPAP Hari Berikutnya, Sewa Infus Pump, Sewa Infus
Pump, Sewa Infus Pump, Sewa Inkubator, Sewa Inkubator, Sewa Inkubator, Sewa Patient
Monitor , Sewa Syringe Pump, Sewa Syringe Pump, Sewa Syringe Pump, Sewa Patient
Monitor , Sewa Patient Monitor , Sewa Fototerapi, Sewa Fototerapi, Operasional
Rumah Sakit </td>
<td> - </td>
<td> 4000000 </td>
<td> Sembuh </td>
<td> 10 </td>
<td> Sudah </td>
</tr>
</table>

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<center>

<tr style="background-color: blue;">

<td rowspan="2"><b><font color="white">Kode

<td rowspan="2"><b><font color="white">DPJP

<tr style="background-color: yellow;">

<td> VT Bidan, Infus Dewasa oleh Perawat / Bidan </td>

<td> Jasa Pelayanan Rumah Sakit , Oksigen 100% Sentral 2 LPM ,

<td> Visite Dokter Spesialis Anak, Konsultasi Dokter Spesialis

<td> Menyeka Pasien , Visite Dokter Spesialis Anak, Visite

<td> Jasa Pelayanan Rumah Sakit , Visite Dokter Spesialis Anak,

<td> 40-41 </td>

<td> Jasa Pelayanan Rumah Sakit , VT Bidan, VT Bidan, Infus

<td> Perawatan Bayi SC </td>

<td> 30-32 </td>

<td> Perawatan Bayi SC </td>

<td> Oksigen 100% Sentral 8 LPM </td>

<td> 38-39 </td>

<td> 39-40 </td>

<td> Visite Dokter Spesialis Anak, Visite Dokter Spesialis Anak

<td> Perawatan Bayi SC </td>

<td> 36-37 </td>

<td> VT Bidan, NST </td>

<td> Perawatan Bayi SC </td>

<td> Visite Dokter Spesialis Anak, Visite Dokter Spesialis Anak,

<td> Visite Dokter Spesialis Anak, Visite Dokter Spesialis Anak,

<td> Perawatan Bayi NP </td>

<td> Visite Dokter Spesialis Anak, Visite Dokter Spesialis Anak,

<td> Operasional Rumah Sakit , Jasa Pelayanan Rumah Sakit ,

<td> Jasa Pelayanan Rumah Sakit , Operasional Rumah Sakit </td>

<td> 39-40 </td>

<td> Jasa Pelayanan Rumah Sakit </td>

<td> 39-40 </td>

<td> Jasa Pelayanan Rumah Sakit , VT Bidan, NST, Operasional

<td> Jasa Pelayanan Rumah Sakit , Operasional Rumah Sakit </td>

<td> Visite Dokter Spesialis Anak, Visite Dokter Spesialis Anak,

<td> Jasa Pelayanan Rumah Sakit , Visite Dokter Spesialis Anak,

<td> Jasa Pelayanan Rumah Sakit , Operasional Rumah Sakit </td>

<td> Jasa Pelayanan Rumah Sakit , Operasional Rumah Sakit </td>

<td> Nebulizer , Nebulizer , Nebulizer , Nebulizer , Nebulizer ,

<td> Jasa Pelayanan Rumah Sakit , Visite Dokter Spesialis Anak,

<td> 34-35 </td>

<td> Visite Dokter Spesialis Obgyn, VT Bidan, NST </td>

<td> Visite Dokter Spesialis Anak, Nebulizer , Nebulizer ,

<td> 38-39 </td>

<td> Jasa Pelayanan Rumah Sakit , Visite Dokter Spesialis Obgyn,

<td> Perawatan Bayi SC </td>

<td> Jasa Pelayanan Rumah Sakit , Visite Dokter Spesialis Anak,

<td> Perawatan Bayi NP , Visite Dokter Spesialis Anak </td>

<td> 39-40 </td>

<td> Jasa Pelayanan Rumah Sakit, VT Bidan, VT Bidan, NST, NST

<td> Perawatan Bayi NP , Visite Dokter Spesialis Anak </td>

<td> Operasional Rumah Sakit , Jasa Pelayanan Rumah Sakit ,

<td> Jasa Pelayanan Rumah Sakit , Sewa Ambulance, Sewa Patient

<td> Jasa Pelayanan Rumah Sakit , VT Bidan, Infus Dewasa oleh

<td> Perawatan Bayi NP </td>

<td> 40-41 </td>

<td> Jasa Pelayanan Rumah Sakit , VT Bidan, VT Bidan, NST,

<td> 39-40 </td>

<td> Jasa Pelayanan Rumah Sakit , VT Bidan, NST, Operasional

<td> 38-39 </td>

<td> Jasa Pelayanan Rumah Sakit , Visite Dokter Spesialis Obgyn,

<td> 38-39 </td>

<td> Jasa Pelayanan Rumah Sakit , Infus Dewasa oleh Perawat /