Sensus RMO

User: SILOAMHOSPITALS\hope.shtr

No MR No Name Birth Date Age Sex Mobile No1 Admission

Date
IPD LANTAI 2
1 00-03-00-78 HJ ISTIQOMAH 06-Jul-1948 74y 3m 5d Femal 081226903912 07-Oct-2022
e
2 00-04-00-04 ARRAYYAN ZAFIER 13-Dec-2020 1y 9m 28d Male 085876157573 09-Oct-2022
AKHTAR
3 00-04-00-01 ALYA RIHADATUL AISY 11-Oct-2002 20y Femal 085601905940 09-Oct-2022
HANIFAH e
4 00-03-53-15 YOFFA AQILA HANNY 27-Nov-2015 6y 10m Femal 081394470678 08-Oct-2022
SOFY 14d e
5 00-03-88-47 NESHA AULIA RAHMAN 31-Mar-2004 18y 6m Femal 081270239432 07-Oct-2022
11d e
6 00-04-00-09 MUHAMMAD REYHAN 13-Oct-2018 3y 11m Male 085714087876 10-Oct-2022
CANDRA ARDANI 28d
7 00-03-99-26 ARSHAKA PUTRA HANKA 03-Jun-2022 4m 8d Male 081908194594 05-Oct-2022
8 00-02-72-05 IR PUDJO SISWANTO 24-Apr-1954 68y 5m Male 085743331778 10-Oct-2022
17d
9 00-04-00-22 DARODJI 05-Sep-1953 69y 1m 6d Male 083130631603 10-Oct-2022
10 00-00-10-24 SRI DEVI NUR 17-Oct-1996 25y 11m Femal 08557020150 07-Oct-2022
OKTAVIANI 24d e
11 00-03-99-81 SORO YANTRININGSIH 03-Jan-1974 48y 9m 8d Femal 08156587195 09-Oct-2022
e
12 00-03-99-64 TAROSO 31-Dec-1950 71y 9m Male 082133655313 07-Oct-2022
11d
13 00-03-99-90 WARDANI 21-Sep-1959 63y 20d Male 08175469311 08-Oct-2022
14 00-03-79-26 TARMIN 06-Jul-1956 66y 3m 5d Male 085700914599 08-Oct-2022
15 00-04-00-19 MUJIYONO 28-Aug-1950 72y 1m Male 081222317901 10-Oct-2022
13d
16 00-02-95-75 SUDAR 16-Sep-1955 67y 25d Male 082111779576 09-Oct-2022
17 00-04-00-12 UDREG 10-Sep-1957 65y 1m 1d Male 085876111675 10-Oct-2022
18 00-03-99-55 USUP 13-Sep-1996 26y 28d Male 00000000000 10-Oct-2022
19 00-03-99-58 TARMIDI 25-Dec-1983 38y 9m Male 0000000000000 10-Oct-2022
16d
20 00-03-99-51 PANCA AJI PAMUNGKAS 21-Jan-2003 19y 8m Male 085799748679 10-Oct-2022
20d
21 00-03-55-22 MARITO 31-Dec-1955 66y 9m Male 081326943284 10-Oct-2022
11d
22 00-03-99-83 PARNEN 01-Jan-1957 65y 9m Male 000000000000 08-Oct-2022
10d
23 00-00-40-80 NILNA RUSYDA SA'IDA 10-Apr-2005 17y 6m 1d Femal 085848739538 10-Oct-2022
e
24 00-03-99-37 MUN SUMIYATI 17-Oct-1973 48y 11m Femal 085876139585 05-Oct-2022
24d e
25 00-01-83-51 SUMITRI 12-Aug-1958 64y 1m Femal 085647407037 08-Oct-2022
29d e
26 00-03-99-72 LIA DAMAYANTI 22-Mar-2005 17y 6m Femal 081954441036 07-Oct-2022
19d e
27 00-03-99-69 ELIN WULANDARI 31-Oct-1997 24y 11m Femal 087738382121 07-Oct-2022
11d e
28 00-02-95-67 PONIYAH 13-Jan-1969 53y 8m Femal 000000000 09-Oct-2022
28d e
29 00-03-78-28 SITI SAKDIJAH 31-Dec-1955 66y 9m Femal 081280341231 10-Oct-2022
11d e
30 00-03-99-86 NGATINI 31-Dec-1963 58y 9m Femal 081476665595 08-Oct-2022
11d e
31 00-03-94-02 PAAH 06-Nov-1955 66y 11m Femal 085863637853 10-Oct-2022
5d e
32 00-00-22-10 ALYA ARIFFATUL UMMA 18-Sep-2006 16y 23d Femal 081225583344 07-Oct-2022
e
33 00-02-88-61 RIZKA NABILA 02-May-2008 14y 5m 9d Femal 085225637239 10-Oct-2022
e
34 00-03-99-84 ERGI IRFANO YUSUF 05-Dec-2011 10y 10m Male 088221130392 08-Oct-2022
BISMARK 6d
35 00-03-32-93 ROKHIM 26-Feb-1986 36y 7m Male 082134753373 04-Oct-2022
15d
Count = 35
Total Count = 35

Generated on 11-Oct-2022 06:58:13 by SILOAMHOSPITALS\\hope.shtr

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 Report Date: 11-Oct-2022 06:58:13

Duration Ward Bed Bed Type Class Religion

(Days)

4 IPD LANTAI 2 A01 Normal Bed VIP ISLAM

2 IPD LANTAI 2 A02 Normal Bed VIP ISLAM
2 IPD LANTAI 2 A03 Normal Bed DELUXE ISLAM
3 IPD LANTAI 2 A04 Normal Bed DELUXE ISLAM
4 IPD LANTAI 2 A05 Normal Bed STANDARD ISLAM
1 IPD LANTAI 2 A06 Normal Bed STANDARD ISLAM
6 IPD LANTAI 2 A07 Normal Bed STANDARD ISLAM
1 IPD LANTAI 2 A09 Normal Bed DELUXE ISLAM
1 IPD LANTAI 2 A10 Normal Bed STANDARD ISLAM
4 IPD LANTAI 2 A11 Normal Bed STANDARD ISLAM
2 IPD LANTAI 2 A12 Normal Bed STANDARD KATOLIK
4 IPD LANTAI 2 A13 Normal Bed BASIC ISLAM
3 IPD LANTAI 2 A14 Normal Bed DELUXE ISLAM
3 IPD LANTAI 2 B01 Normal Bed BASIC ISLAM
1 IPD LANTAI 2 B02 Normal Bed BASIC ISLAM
2 IPD LANTAI 2 B03 Normal Bed BASIC ISLAM
1 IPD LANTAI 2 B06 Normal Bed BASIC ISLAM
1 IPD LANTAI 2 B12 Normal Bed BASIC ISLAM
1 IPD LANTAI 2 B13 Normal Bed BASIC ISLAM
1 IPD LANTAI 2 B14 Normal Bed BASIC ISLAM
1 IPD LANTAI 2 B15 Normal Bed BASIC ISLAM
3 IPD LANTAI 2 B16 Normal Bed BASIC ISLAM
1 IPD LANTAI 2 C01 Normal Bed BASIC ISLAM
6 IPD LANTAI 2 C02 Normal Bed BASIC ISLAM
3 IPD LANTAI 2 C03 Normal Bed BASIC ISLAM
4 IPD LANTAI 2 C05 Normal Bed BASIC ISLAM
4 IPD LANTAI 2 C06 Normal Bed BASIC ISLAM
2 IPD LANTAI 2 C07 Normal Bed BASIC ISLAM
1 IPD LANTAI 2 C11 Normal Bed BASIC ISLAM
3 IPD LANTAI 2 C14 Normal Bed BASIC ISLAM
1 IPD LANTAI 2 C15 Normal Bed BASIC ISLAM
4 IPD LANTAI 2 D01 Pediatric Bed BASIC ISLAM
1 IPD LANTAI 2 D14 Pediatric Bed BASIC ISLAM
3 IPD LANTAI 2 D16 Pediatric Bed BASIC ISLAM
7 IPD LANTAI 2 IPD ISO Isolation BASIC ISLAM

Generated on 11-Oct-2022 06:58:13 by SILOAMHOSPITALS\\hope.shtr

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Report Date: 11-Oct-2022 06:58:13

Doctor Specialty Referral Type

dr. Sri Harso, M. Kes, SpN NEUROLOGY Internal Doctor

Referral
dr. Resa Gratya, SpA PEDIATRICS Internal Doctor
Referral
dr. Tatag Primiawan, SpPD INTERNAL MEDICINE Internal Doctor
Referral
dr. Resa Gratya, SpA PEDIATRICS Internal Doctor
Referral
dr. Tatag Primiawan, SpPD INTERNAL MEDICINE Internal Doctor
Referral
dr. Resa Gratya, SpA PEDIATRICS Internal Doctor
Referral
dr. Resa Gratya, SpA PEDIATRICS Internal Doctor
Referral
dr. Wildan Ferdian, SpP PULMONOLOGY Internal Doctor
Referral
dr. Tomy Agustinus Sutikno, SpPD INTERNAL MEDICINE Internal Doctor
Referral
dr. Tatag Primiawan, SpPD INTERNAL MEDICINE Internal Doctor
Referral
dr. Adhita Kartyanto, SpPD INTERNAL MEDICINE Internal Doctor
Referral
dr. Wildan Ferdian, SpP PULMONOLOGY Internal Doctor
Referral
dr. Adhita Kartyanto, SpPD INTERNAL MEDICINE Internal Doctor
Referral
dr. Adhita Kartyanto, SpPD INTERNAL MEDICINE Internal Doctor
Referral
dr. Tomy Agustinus Sutikno, SpPD INTERNAL MEDICINE Internal Doctor
Referral
dr. Tatag Primiawan, SpPD INTERNAL MEDICINE Internal Doctor
Referral
dr. Wildan Ferdian, SpP PULMONOLOGY Internal Doctor
Referral
dr. Gerard G Philips, SpB GENERAL SURGERY Internal Doctor
Referral
dr. Dudy Disyadi Nurkusuma, SpB (FICS), GENERAL SURGERY Internal Doctor
MSiMed, MMR Referral
dr. Dudy Disyadi Nurkusuma, SpB (FICS), GENERAL SURGERY Internal Doctor
MSiMed, MMR Referral
dr. Gerard G Philips, SpB GENERAL SURGERY Internal Doctor
Referral
dr. Gerard G Philips, SpB GENERAL SURGERY Internal Doctor
Referral
dr. Tomy Agustinus Sutikno, SpPD INTERNAL MEDICINE Internal Doctor
Referral
dr. Adhita Kartyanto, SpPD INTERNAL MEDICINE Internal Doctor
Referral
dr. Adhita Kartyanto, SpPD INTERNAL MEDICINE Internal Doctor
Referral
dr. Tatag Primiawan, SpPD INTERNAL MEDICINE Internal Doctor
Referral
dr. Tatag Primiawan, SpPD INTERNAL MEDICINE Internal Doctor
Referral
dr. Wildan Ferdian, SpP PULMONOLOGY Internal Doctor
Referral
dr. Gerard G Philips, SpB GENERAL SURGERY Internal Doctor
Referral
dr. Adhita Kartyanto, SpPD INTERNAL MEDICINE Internal Doctor
Referral
dr. Dudy Disyadi Nurkusuma, SpB (FICS), GENERAL SURGERY Internal Doctor
MSiMed, MMR Referral
dr. Resa Gratya, SpA PEDIATRICS Internal Doctor
Referral
dr. Gerard G Philips, SpB GENERAL SURGERY Internal Doctor
Referral
dr. Resa Gratya, SpA PEDIATRICS Internal Doctor
Referral
dr. Tomy Agustinus Sutikno, SpPD INTERNAL MEDICINE Internal Doctor
Referral

Generated on 11-Oct-2022 06:58:13 by SILOAMHOSPITALS\\hope.shtr

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Referral Doctor Referral External Doctor Diagnosa

dr. Fahmi Rizal Aulya Rahman CKR, Susp. trauma cervical

dr. Dyah Anindya Rani Kejang Demam Sederhana
dr. Dyah Anindya Rani GEA Dehidrasi Ringan Sedang
dr. Tiwi Harjanti Cakranita Obs dyspneu ec susp Bronkopneumonia
dr. Fahmi Rizal Aulya Rahman Obs Abdominal pain ec susp. Appendicitis dd
Dyspepsia
dr. Wegig Setiaji obs Febris H3 susp bronkitis dd BRPN
dr. Wegig Setiaji Bronkopneumonia
dr. Wildan Ferdian, SpP PPOK eksaserbasi akut, pneumonia komunitas,
CHF fc 2
dr. Wegig Setiaji GEA dehidrasi ringan-sedang susp. food
poisoning
dr. Wegig Setiaji DCA dengan dhidrasi ringan sedang susp.
Disentri
dr. Sigit Dwi Prastyanto Obs Vomitus profuse dengan dehidrasi ringan
sedang
dr. Wegig Setiaji Obs. dyspneu ec susp. PPOK eksaserbasi akut
Hiperglikemia
dr. Sigit Dwi Prastyanto AKI dd akut on CKD, obstruksi uropathy, BPH
dr. Sigit Dwi Prastyanto CKD ON HD, Oedema pulmo akut, anemia
renal, asites
dr. Dyah Anindya Rani HT urgency
AKI dd CKD
dr. Dyah Anindya Rani Anemia, suspect Gastritis Erosif
dr. Wegig Setiaji Obs Dyspneu ec susp Bronkopneumonia
Abdominal pain
dr. Gerard G Philips, SpB Nekrotik + ILO ec Vulnus Laceratum a/r
Femur Dextra ec KLL
dr. Dudy Disyadi Nurkusuma, SpB STT manus sinistra
(FICS), MSiMed, MMR
dr. Dudy Disyadi Nurkusuma, SpB Hernia Inguinalis Lateralis Sinistra
(FICS), MSiMed, MMR
dr. Gerard G Philips, SpB Benigna neoplasma
dr. Tiwi Harjanti Cakranita VL regio Alar Wing sinistra
dr. Wegig Setiaji GEA dg Dehidrasi Ringan-Sedang Obs
Hematomesis
dr. Wegig Setiaji HT urgency, obs febris, hipokalemia, riwayat
stroke non hemoragic
dr. Tiwi Harjanti Cakranita Hiperglikemia pada DM tipe 2
dr. Fahmi Rizal Aulya Rahman Obs. abdominal pain ec susp Appendicitis akut
dr. Fahmi Rizal Aulya Rahman Abdominal pain
Susp. Konstipasi
dr. Dyah Anindya Rani Asma Attack
dr. Gerard G Philips, SpB Hemoroid Interna Grade III
dr. Tiwi Harjanti Cakranita Hematemesisi melena, anoreksia geriatric,
dyspepsia dengan dehidrasi sedang, AKI
dr. Dudy Disyadi Nurkusuma, SpB Ca mammae dextra
(FICS), MSiMed, MMR
dr. Fahmi Rizal Aulya Rahman Abdominal pain
dr. Wegig Setiaji CKR
dr. Tiwi Harjanti Cakranita Obs Vomitus profuse dengan dehidrasi ringan
sedang
dr. Tomy Agustinus Sutikno, SpPD Efusi pleura dextra, Grave disease, Thyroid
heart disease

Generated on 11-Oct-2022 06:58:13 by SILOAMHOSPITALS\\hope.shtr

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Payer Notes

BPJS KESEHATAN naik kelas 1 ke VIP

BPJS KESEHATAN NAIK KELAS 1 KE VIP
46
BPJS KESEHATAN titip di kelas 2 karena kelas 1 full
no 4
BPJS KESEHATAN SESUAI KELAS NO 42
BPJS KESEHATAN SESUAI KELAS 2
BPJS KESEHATAN sesuai kelas 2
BPJS KESEHATAN SESUAI KELAS BPJS KELAS 2
BPJS KESEHATAN HAK KELAS 1 , TITIP DULU DI KELAS 2 KARENA KELAS 1 PENUH
BPJS KESEHATAN SESUAI KELAS
BPJS KESEHATAN SESUAI
BPJS KESEHATAN SESUAI
BPJS KESEHATAN SESUAI KELAS (BPJS KELAS 3 PBI)
BPJS KESEHATAN SESUAI
BPJS KESEHATAN SESUAI KELAS (BPJS KELAS 3 PBI)
tdk ada bpjs
BPJS KESEHATAN SESUAI
TIDAK PUNYA BPJS
BPJS KESEHATAN SESUAI KELAS PBI
BPJS KESEHATAN SESUAI KELAS (BPJS KELAS 3 PBI)
BPJS KESEHATAN SESUAI KELAS
NO 45
BPJS KESEHATAN SESUAI KELAS PBI
BPJS KESEHATAN bpjs belum dipulangkan dari RST
BPJS KESEHATAN SESUAI KELAS PBI
BPJS KESEHATAN SESUAI KELAS 3
BPJS KESEHATAN SESUAI
BPJS KESEHATAN sesuai
BPJS KESEHATAN sesuai
BPJS KESEHATAN SESUAI KELAS
29
BPJS KESEHATAN KELAS 3 PBI
BPJS KESEHATAN SESUAI KELAS (BPJS KELAS 3 PBI)
BPJS KESEHATAN SESUAI KELAS
NO 5
YAYASAN SYUBBANUL WATHON SESUAI PERMINTAAN DI KELAS 3
(KSWT)
BPJS KESEHATAN SESUAI KELAS (BPJS KELAS 3 PBI)
BPJS KESEHATAN SESUAI KELAS
BPJS KESEHATAN SESUAI KELAS PBI

Generated on 11-Oct-2022 06:58:13 by SILOAMHOSPITALS\\hope.shtr

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