<table class='tabel' width='90%'>

<tr class="form">
<td align="center" colspan="9">
<big><big><span style="font-weight: bold;">
LAPORAN UNIVERSAL PUSTU WONOCOYO<br>
BULAN 16-01-2023 - 20-01-2023 </span></big></big>
</td>
</tr>
</table>
<table align='center'>
<tr>
<td>Total</td>
<td>:</td>
<td>7</td>
</tr>
</table>
<table align="center" width="98%" border="1">
<tr class="row1">
<td width='3%'>No</td>
<td width='6%'>Tanggal</td>
<td width='6%'>PKM</td>
<td width='6%'>No RM</td>
<td width='10%'>Nama</td>
<td width='10%'>NIK</td>
<td width='10%'>Alamat</td>
<td width='6%'>Desa</td>
<td width='5%'>Kecamatan</td>
<td width='5%'>Kabupaten</td>
<td width='6%'>Tgl Lahir</td>
<td width='6%'>Umur<br>Th</td>
<td width='2%'>L/P</td>
<td width='7%'>Pekerjaan</td>
<td width='7%'>Ruangan</td>
<td width='7%'>Petugas</td>
<td width='4%'>Status</td>
<td>Kasus</td>
<td>Cara Bayar</td>
<td>Jenis BPJS</td>
<td>No BPJS</td>
<td>Kode Bridging</td>
<td>ICD-10</td>
<td>Diagnosa</td>

</tr>

<tr align="left" valign="top">

<td>1</td>
<td>16-01-2023</td>
<td>PUSKESMAS POGALAN</td>
<td>017711</td>
<td>KENZO BASTIA ALFARIZKI</td>
<td>'</td>
<td>RT 19 BENDIL</td>
<td>WONOCOYO</td>
<td>POGALAN</td>
<td>TRENGGALEK</td>
<td>19-07-2022</td>
<td>0</td>
 <td>L</td>
<td>Belum / Tidak Bekerja</td>
<td>PUSTU WONOCOYO</td>
<td>Aris wahyu utami,A.M D.Keb</td>
<td>LAMA</td>
<td>KASUS BARU</td>
<td>UMUM</td>
<td>PBI (APBN)</td>
<td>'0003281749929</td>
<td></td>
<td align='center'>
J06.9 </td>
<td align='center'>
<font color='black'>Acute upper respiratory infection,
unspecified</font> </td>

</tr>

<tr align="left" valign="top">

<td>2</td>
<td>19-01-2023</td>
<td>PUSKESMAS POGALAN</td>
<td>018898</td>
<td>PAIMAN</td>
<td>'3503063112550013</td>
<td>DUSUN WONOCOYO RT.008 RW.004 WONOCOYO. POGALAN. TRENGGALEK, RT :
8,RW :4 </td>
<td>WONOCOYO</td>
<td>POGALAN</td>
<td>TRENGGALEK</td>
<td>31-12-1955</td>
<td>67</td>
<td>L</td>
<td>Tukang Kayu</td>
<td>PUSTU WONOCOYO</td>
<td>DEDY ACHMAT WIJAYA</td>
<td>LAMA</td>
<td>KASUS BARU</td>
<td>UMUM</td>
<td></td>
<td>'</td>
<td></td>
<td align='center'>
J00 </td>
<td align='center'>
<font color='red'>Acute nasopharyngitis [common cold]</font>
</td>

</tr>

<tr align="left" valign="top">

<td>3</td>
<td>19-01-2023</td>
<td>PUSKESMAS POGALAN</td>
<td>012610</td>
<td>ISWANTO</td>
<td>'3503121803680008</td>
 <td>DUSUN WONOCOYO RT.06 RW.03 WONOCOYO. POGALAN. TRENGGALEK, RT : 6,RW
:3 </td>
<td>WONOCOYO</td>
<td>POGALAN</td>
<td>TRENGGALEK</td>
<td>18-03-1968</td>
<td>54</td>
<td>L</td>
<td>Lainnya</td>
<td>PUSTU WONOCOYO</td>
<td>DEDY ACHMAT WIJAYA</td>
<td>LAMA</td>
<td>KASUS BARU</td>
<td>UMUM</td>
<td>PEKERJA MANDIRI</td>
<td>'0001326542681</td>
<td></td>
<td align='center'>
V20 </td>
<td align='center'>
<font color='black'>Motorcycle rider injured in collision with
pedestrian or animal</font> </td>

</tr>

<tr align="left" valign="top">

<td>4</td>
<td>20-01-2023</td>
<td>PUSKESMAS POGALAN</td>
<td>018887</td>
<td>GHISKA GHEA </td>
<td>'</td>
<td>BENDIL RT 21</td>
<td>WONOCOYO</td>
<td>POGALAN</td>
<td>TRENGGALEK</td>
<td>21-11-2022</td>
<td>0</td>
<td>P</td>
<td>Belum / Tidak Bekerja</td>
<td>PUSTU WONOCOYO</td>
<td>Aris wahyu utami,A.M D.Keb</td>
<td>BARU</td>
<td>KASUS BARU</td>
<td>UMUM</td>
<td></td>
<td>'</td>
<td></td>
<td align='center'>
Z23.2 </td>
<td align='center'>
<font color='black'>Need for immunization against tuberculosis
[BCG]</font> </td>

</tr>

<tr align="left" valign="top">

 <td>5</td>
<td>20-01-2023</td>
<td>PUSKESMAS POGALAN</td>
<td>018888</td>
<td>SAFWA JENNAIRA</td>
<td>'</td>
<td>BENDIL</td>
<td>WONOCOYO</td>
<td>POGALAN</td>
<td>TRENGGALEK</td>
<td>31-10-2022</td>
<td>0</td>
<td>P</td>
<td>Belum / Tidak Bekerja</td>
<td>PUSTU WONOCOYO</td>
<td>Aris wahyu utami,A.M D.Keb</td>
<td>BARU</td>
<td>KASUS BARU</td>
<td>UMUM</td>
<td></td>
<td>'</td>
<td></td>
<td align='center'>
Z27.1 </td>
<td align='center'>
<font color='red'>Need for immunization against diphtheria-tetanus-
pertussis, combined [DTP]</font> </td>

</tr>

<tr align="left" valign="top">

<td>6</td>
<td>20-01-2023</td>
<td>PUSKESMAS POGALAN</td>
<td>018889</td>
<td>AFIYA</td>
<td>'</td>
<td>BENDIL RT 21</td>
<td>WONOCOYO</td>
<td>POGALAN</td>
<td>TRENGGALEK</td>
<td>06-09-2021</td>
<td>1</td>
<td>P</td>
<td>Belum / Tidak Bekerja</td>
<td>PUSTU WONOCOYO</td>
<td>Aris wahyu utami,A.M D.Keb</td>
<td>BARU</td>
<td>KASUS BARU</td>
<td>UMUM</td>
<td></td>
<td>'</td>
<td></td>
<td align='center'>
Z24.0 </td>
<td align='center'>
<font color='black'>Need for immunization against poliomyelitis</font>
</td>
 </tr>

<tr align="left" valign="top">

<td>7</td>
<td>20-01-2023</td>
<td>PUSKESMAS POGALAN</td>
<td>018890</td>
<td>SAMBARA</td>
<td>'</td>
<td>BLENGOK RT 25</td>
<td>WONOCOYO</td>
<td>POGALAN</td>
<td>TRENGGALEK</td>
<td>11-07-2021</td>
<td>1</td>
<td>L</td>
<td>Belum / Tidak Bekerja</td>
<td>PUSTU WONOCOYO</td>
<td>Aris wahyu utami,A.M D.Keb</td>
<td>BARU</td>
<td>KASUS BARU</td>
<td>UMUM</td>
<td></td>
<td>'</td>
<td></td>
<td align='center'>
Z27.1 </td>
<td align='center'>
<font color='red'>Need for immunization against diphtheria-tetanus-
pertussis, combined [DTP]</font> </td>

</tr>
</table>