FORMAT PELAPORAN PESERTA PRB AKTIF

PUSKESMAS ANGGADITA TAHUN 2020

BULAN : MARET 2020

DAFTAR PESERTA PRB AKTIF BERKUNJUNG

NO TANGGAL NAMA PESERTA NO NO HP DIAGNOSA ALAMAT KETERANGAN PENGAMBILAN

BERKUNJU KIS/BPJS OBAT
NG 23 HR 30 HR
1 2-3-2020 ARIS 0000482716449 CHRONIC OBSTRUCTIVE PULMONARY GINTUNG TENGAH V
DISEASE, UNSPECIFIED
2. 2-3-2020 AAM AMANAH 0000445964308 BENIGN NEOPLASM OF BREAST DI RUJUK
3. 3-3-2020 ALI 0000482589865 HYPERPLASIA OF PROSTATE DI RUJUK
4. 3-3-2020 YAYAT RUHIYAT 0002694674294 SUPERFICIAL INJURY OF ANKLE AND SUKARESMI DI RUJUK
FOOT, UNSPECIFIED
5. 4-3-2020 KOSWARA 0000482449959 0821 2234 6822 CONGESTIVE HEART FAILURE GINTUNGSALAM V
6. 4-3-2020 OMAH HERYATI 0001010359326 CORNEAL ULCER SUKA MULYA DI RUJUK
7. 4-3-2020 SITI AISYAH 0002428155178 EPILEPSY DI RUJUK
8. 6-3-2020 ONYIH 0000482525752 ASTHMA V
9. 6-3-2020 DADAN SETIAWAN 0000482526742 SCHIZOPHRENIA V
10. 9-3-2020 ENTIN SUTINI 0000482370535 SCHIZOPHRENIA V
11 9-3-2020 DIAN NURJANAH 0001294442684 CONGESTIVE HEART FAILURE DI RUJUK
12 9-3-2020 SUMIRAH 0002283748075 0812 9454 5735 CONGESTIVE HEART FAILURE KRAJAN II V
13. 11-3-2020 TITI ROHAETI 0000064072157 081294548320 CONGESTIVE HEART FAILURE KARAWANG JAYA V
14. 17-3-2020 EUIS SUPRIATIN 0000449347162 0856 95031766 CONGESTIVE HEART FAILURE SUKARESMI V
15. 17-3-2020 ENTIN SUTINI 0000482370535 SCHIZOPHRENIA V
16. 17-3-2020 KARDI 0000483268601 ASTHMA V
17. 19-3-2020 EUIS SUPRIATIN 0000449347162 0856 95031766 CONGESTIVE HEART FAILURE SUKARESMI V
18. 20-3-2020 SUKARLIM 0000482987439 CONGESTIVE HEART FAILURE V
19. 27-3-2020 OMAN ROHMAN 0002271276505 CONGESTIVE HEART FAILURE DI RUJUK
20 28-3-2020 NILA NURDIYANTI 0000482371773 ASTHMA V
Karawang, 11 April 2020

Memet Komarudin, SKM,MM.Kes

NIP. 19630512 198703 1 011