Patient Disease Index Card of Hospitalized Patients

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<td width="70%" style="text-align:left;font-
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class="tablecontent"> Kartu Indeks Penyakit Penderita Dirawat di Rumah
Sakit</td>
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<td align="center" width="1%" rowspan="2">No.</td>
<td align="center" width="1%" rowspan="2">Tgl. Registrasi</td>
<td align="center" width="10%" rowspan="2">No. RM</td>
<td align="center" width="30%" rowspan="2">Nama</td>
<td align="center" width="15%" rowspan="2">Umur</td>
<td align="center" width="20%" rowspan="2">Alamat</td>
<td align="center" width="15%" rowspan="2">Tgl Masuk RS</td>
<td align="center" width="15%" rowspan="2">Tgl Keluar RS</td>
<td align="center" width="3%" rowspan="2">Lama Dirawat (hari)</td>
<td align="center" width="15%" rowspan="2">Kelas Perawatan</td>
<td align="center" width="15%" rowspan="2">Cara Bayar</td>
<td align="center" width="30%" rowspan="2">Dokter yang Merawat</td>
<td align="center" width="30%" rowspan="2">Kode ICD 10 (Diagnosa
Utama)</td>
<td align="center" width="60%" colspan="12">Kelompok Umur Penderita
(tahun)</td>
<td align="center" width="5%" rowspan="2">Jenis Kelamin</td>
<td align="center" width="30%" rowspan="2">Diagnosa Sekunder</td>
<td align="center" width="30%" rowspan="2">Komplikasi</td>
<td align="center" width="20%" rowspan="2">Cara Keluar</td>
<td align="center" width="30%" rowspan="2">Operasi(Normal,SC,dll)</td>
<td align="center" width="20%" rowspan="2">Meninggal</td>
<td align="center" width="20%" rowspan="2">Ket</td>
<td align="center" width="20%" rowspan="2">Keadaan Keluar</td>
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<tr class="subheader" >
<td align="center" width="8%">0-7 hari</td>
<td align="center" width="8%">8-28 hari</td>
<td align="center" width="8%">< 1 tahun</td>
<td align="center" width="8%">1-4 tahun</td>
<td align="center" width="8%">70> tahun</td>
</tr>
<tr >
<td align="right" class="tablecontent-odd" >1</td>
<td align="left" class="tablecontent-odd" >01-02-2021</td>
<td align="left" class="tablecontent-odd" >20151378</td>
<td align="left" class="tablecontent-odd" >UMI CHOFIFAH, NY</td>
<td align="left" class="tablecontent-odd" >29 tahun 9 bulan 26 hari
</td>
<td align="left" class="tablecontent-odd" valign="top"> TURI RT 2/1
KEDUNGTURI GUDO </td>
<td align="" class="tablecontent-odd" >02-02-2021</td>
<td align="center" class="tablecontent-odd" >1</td>
<td align="left" class="tablecontent-odd" >KELAS 1</td>
<td align="left" class="tablecontent-odd" >JKN / KIS - NON PBI</td>
<td align="" class="tablecontent-odd" >Faria Toma, Sp.OG, dr</td>
<td align="left" class="tablecontent-odd" valign="top">O63.0 Prolonged
first stage (of labor)</td>
<td align="left" class="tablecontent-odd" > </td>
<td align="left" class="tablecontent-odd" >v</td>
<td align="left" class="tablecontent-odd" >Perempuan</td>
<td align="left" class="tablecontent-odd" valign="top"></td>
<td align="left" class="tablecontent-odd" valign="top">73.59 Other
manually assisted delivery</td>
<td align="left" class="tablecontent-odd" valign="top">Diizinkan</td>
<td align="left" class="tablecontent-odd" valign="top">Normal (01-02-
2021)</td>
<td align="left" class="tablecontent-odd" valign="top"> </td>
<td align="left" class="tablecontent-odd" valign="top">Membaik</td>
</tr>
<tr >
<td align="right" class="tablecontent" >2</td>
<td align="left" class="tablecontent" >01-02-2021</td>
<td align="left" class="tablecontent" >21152038</td>
<td align="left" class="tablecontent" >MAHESWARA ALTHAF, H, BY</td>
<td align="left" class="tablecontent" >0 tahun 1 bulan 21 hari </td>
<td align="left" class="tablecontent" valign="top"> DSN PELEM 05 RT
05/01 JATI PELEM DIWEK </td>
<td align="" class="tablecontent" >02-02-2021</td>
<td align="center" class="tablecontent" >1</td>
<td align="left" class="tablecontent" >RGT - VVIP</td>
<td align="left" class="tablecontent" >JKN / KIS - NON PBI</td>
<td align="" class="tablecontent" >Heru Setiawan, Sp.A, dr</td>
<td align="left" class="tablecontent-odd" valign="top">P03.4 Newborn
affected by cesarean delivery </td>
<td align="left" class="tablecontent" > </td>
<td align="left" class="tablecontent" >v</td>
<td align="left" class="tablecontent" >Laki-laki</td>
<td align="left" class="tablecontent-odd" valign="top">90.59
Microscopic examination of blood, other microscopic examination</td>
<td align="left" class="tablecontent" valign="top">Diizinkan</td>
<td align="left" class="tablecontent" valign="top">Membaik</td>
</tr>
<tr >
<td align="left" class="tablecontent-odd" >ALISHA FARHANA ALMAHYRA,
BY</td>
</td>
<td align="left" class="tablecontent-odd" valign="top"> JL MAWAR RT
10/05 SOBOWONO KERTOSONO NGANJUK</td>
<td align="left" class="tablecontent-odd" >RGT - VVIP</td>
<td align="" class="tablecontent-odd" >Heru Setiawan, Sp.A, dr</td>
</tr>
<tr >
<td align="left" class="tablecontent" >DINA LUTFIYATUL K, NY</td>
<td align="left" class="tablecontent" valign="top"> PERUM METRO
GRAHA BLOK S RT 7/6 TUNGGORONO</td>
<td align="left" class="tablecontent" >KELAS 2</td>
<td align="" class="tablecontent" >Faria Toma, Sp.OG, dr</td>
second stage (of labor)</td>
<td align="left" class="tablecontent" >Perempuan</td>
<td align="left" class="tablecontent-odd" valign="top">74.1 Low
cervical cesarean section</td>
<td align="left" class="tablecontent-odd" valign="top">SC </td>
</tr>
<tr >
<td align="left" class="tablecontent-odd" >BOY DWI SETYAWAN, AN</td>
<td align="left" class="tablecontent-odd" >4 tahun 3 bulan 1 hari </td>
<td align="left" class="tablecontent-odd" valign="top"> SUMBERINGIN RT
2/1, KABUH, JOMBANG </td>
<td align="left" class="tablecontent-odd" >Umum</td>
<td align="" class="tablecontent-odd" >Effendy R, SpA, dr.</td>
<td align="left" class="tablecontent-odd" valign="top">R10 Abdominal
and pelvic pain</td>
<td align="left" class="tablecontent-odd" >Laki-laki</td>
Microscopic examination of blood, other microscopic examination | 99.18
Injection or infusion of electrolytes</td>
</tr>
<tr >
<td align="left" class="tablecontent" >SOLICHATIN, NY</td>
<td align="left" class="tablecontent" valign="top"> JL. DARMO JOYO
01/01, BALONG SARI, MEGALUH </td>
<td align="left" class="tablecontent" >Umum</td>
<td align="left" class="tablecontent-odd" valign="top">O32.4 Maternal
care for high head at term</td>
</tr>
<tr >
<td align="left" class="tablecontent-odd" >VIVI ANDRIANI, NY</td>
</td>
<td align="left" class="tablecontent-odd" valign="top"> KEDUNG BETIK
RT 1/1 KESAMBEN</td>
<td align="" class="tablecontent-odd" >I Gusti Njoman Teguh Budhi
Bimantara, SpOG, dr</td>
<td align="left" class="tablecontent-odd" valign="top">O46.9
Antepartum hemorrhage, unspecified</td>
<td align="left" class="tablecontent-odd" valign="top">Sembuh</td>
</tr>
<tr >
<td align="left" class="tablecontent" >LINDA ANGGRAENI P, NY</td>
<td align="left" class="tablecontent" valign="top"> DSN. WAUNG RT
02/02, WAUNG, BARON, NGANJUK</td>
<td align="left" class="tablecontent" >ASURANSI - ASURANSI ADIRA
DINAMIKA, PT</td>
care for transverse and oblique lie</td>
<td align="left" class="tablecontent" valign="top">Sembuh</td>
</tr>
<tr >
<td align="left" class="tablecontent-odd" >GIBRAN ABDURRAHMAN, BY</td>
</td>
<td align="left" class="tablecontent-odd" valign="top"> TURI RT 2/1
KEDUNGTURI GUDO </td>
<td align="left" class="tablecontent-odd" valign="top">Z38.0
Singleton, born in hospital</td>
</tr>
<tr >
<td align="left" class="tablecontent" >ARRAYYAN FAZAL AL GAFI, BY</td>
<td align="left" class="tablecontent" valign="top"> KEDUNG BETIK RT
1/1 KESAMBEN </td>
</tr>
<tr >
<td align="left" class="tablecontent-odd" >REISHA SHAREEFA R, AN</td>
</td>
<td align="left" class="tablecontent-odd" valign="top"> DSN.
KEDUNG TIMONGO RT 2/1 MEGALUH </td>
<td align="left" class="tablecontent-odd" valign="top">J21.9 Acute
bronchiolitis, unspecified</td>
Respiratory medication administered by nebulizer | 99.18 Injection or
infusion of electrolytes | 87.49 Other chest x-ray</td>
</tr>
<tr >
<td align="left" class="tablecontent" >KAFI RAFFASYA, AN</td>
<td align="left" class="tablecontent" valign="top"> DSN. BANJAR
POH RT -/- DS. PULOREJO NGORO</td>
<td align="" class="tablecontent" >Effendy R, SpA, dr.</td>
<td align="left" class="tablecontent-odd" valign="top">J18.0
Bronchopneumonia, unspecified</td>
<td align="left" class="tablecontent-odd" valign="top">D50.9 Iron
deficiency anemia, unspecified</td>
Respiratory medication administered by nebulizer | 99.03 Other transfusion of
whole blood | 99.18 Injection or infusion of electrolytes</td>
</tr>
<tr >
<td align="left" class="tablecontent-odd" >OLINDHEA LUNA, E, BY</td>
</td>
<td align="left" class="tablecontent-odd" valign="top"> DSN. WAUNG RT
<td align="left" class="tablecontent-odd" >ASURANSI - ASURANSI ASTRA
BUANA (GARDA MEDIKA), PT</td>
</tr>
<tr >
<td align="left" class="tablecontent" >NOVI SETIAWATI, NY </td>
<td align="left" class="tablecontent" valign="top"> PERUM GRIYA
KENCANA MULYA 02/12 M6 JOMBANG</td>
<td align="" class="tablecontent" >I Gusti Njoman Teguh Budhi
Obstructed labor due to fetopelvic disproportion, unspecified </td>
care due to uterine scar from previous surgery </td>
</tr>
<tr >
<td align="left" class="tablecontent-odd" >ARI MARDIANAH, NY</td>
</td>
<td align="left" class="tablecontent-odd" valign="top"> DSN. DRENGES
RT2/5 KABUH</td>
</tr>
<tr >
<td align="left" class="tablecontent" >NYONIK YULAIKA, NY</td>
<td align="left" class="tablecontent" valign="top"> PEDES 7/4
SUKOREJO PERAK</td>
<td align="left" class="tablecontent-odd" valign="top">N83.2 Other and
unspecified ovarian cysts</td>
local excision or destruction of ovary | 74.1 Low cervical cesarean
section</td>
</tr>
<tr >
<td align="left" class="tablecontent-odd" >MIKAILA FATIMAH S, AN</td>
</td>
<td align="left" class="tablecontent-odd" valign="top"> DSN PERAK RT
1/2 PERAK JOMBANG </td>
<td align="left" class="tablecontent-odd" valign="top">L50.9
Urticaria, unspecified</td>
<td align="left" class="tablecontent-odd" valign="top">Pulang
Paksa</td>
<td align="left" class="tablecontent-odd" valign="top">Belum
Sembuh</td>
</tr>
<tr >
<td align="left" class="tablecontent" >KEI LENDRA AR-ROSYID, BY</td>
GRAHA BLOK S RT 7/6 TUNGGORONO </td>
</tr>
<tr >
<td align="left" class="tablecontent-odd" >SOLICHATIN, BY, NY</td>
</td>
<td align="left" class="tablecontent-odd" valign="top"> JL. DARMO JOYO
01/01, BALONG SARI, MEGALUH </td>
<td align="left" class="tablecontent-odd" valign="top">P22.1 Transient
tachypnea of newborn</td>
</tr>
<tr >
<td align="left" class="tablecontent" >KUSNUL KHOTIMAH, NY</td>
<td align="left" class="tablecontent" valign="top"> PERUM PERMATA
JINGGA BLOK A NO 28 5/1 JABON</td>
<td align="left" class="tablecontent-odd" valign="top">O80.9 Single
spontaneous delivery, unspecified</td>
</tr>
<tr >
<td align="left" class="tablecontent-odd" >SALSABILA AZZAHRA, BY</td>
</td>
<td align="left" class="tablecontent-odd" valign="top"> PERUM PERMATA
JINGGA BLOK A NO 28 5/1 JABON</td>
<td align="left" class="tablecontent-odd" valign="top">P70.4 Other
neonatal hypoglycemia</td>
</tr>
<tr >
<td align="left" class="tablecontent" >ARINDA PRATIWI, NY</td>
<td align="left" class="tablecontent" valign="top"> JOGOLOYO RT 2/1,
SUMOBITO, </td>
</tr>
<tr >
<td align="left" class="tablecontent-odd" >M. SYAUQI IHSAN, BY</td>
</td>
<td align="left" class="tablecontent-odd" valign="top"> KARANGMANGU
RT. 2/1 KARANG MOJO PLANDAAN</td>
<td align="left" class="tablecontent-odd" valign="top">P59.9 Neonatal
jaundice, unspecified</td>
phototherapy</td>
</tr>
<tr >
<td align="left" class="tablecontent" >FEDREA KAYONNA PUTRIDIVI,
BY</td>
KENCANA MULYA 02/12 M6 JOMBANG</td>
</tr>
<tr >
<td align="left" class="tablecontent-odd" >M. ATHARRIZHA ALFAJRI,
BY</td>
</td>
<td align="left" class="tablecontent-odd" valign="top"> DSN. DRENGES
RT2/5 KABUH</td>
</tr>
<tr >
<td align="left" class="tablecontent" >FABRIZZIO PUTRA K, BY</td>
<td align="left" class="tablecontent" valign="top"> PEDES 7/4 SUKOREJO
PERAK</td>
</tr>
<tr >
<td align="left" class="tablecontent-odd" >ALDEBARA PUTRA, BY</td>
</td>
<td align="left" class="tablecontent-odd" valign="top"> JOGOLOYO RT
2/1, SUMOBITO</td>
</tr>
<tr >
<td align="left" class="tablecontent" >M. BEY FATCHUL GHOZI, AN</td>
<td align="left" class="tablecontent" valign="top"> GADING MANGU
RT4/5 PERAK</td>
<td align="left" class="tablecontent-odd" valign="top">A09 Diarrhea
and gastroenteritis of presumed infectious origin </td>
<td align="left" class="tablecontent-odd" valign="top">E86 Volume
Depletion</td>
</tr>
<tr >
<td align="left" class="tablecontent-odd" >MIKHAILA ARSYA, BY</td>
</td>
<td align="left" class="tablecontent-odd" valign="top">
GEMPOLPADING RT 04/02 GEMPOLPADING PUCUK LAMONGAN</td>
affected by cesarean delivery | P39.9
Infection specific to the perinatal period, unspecified</td>
</tr>
<tr >
<td align="left" class="tablecontent" >ARSHAKA XAQUIL V, BY</td>
<td align="left" class="tablecontent" valign="top"> DSN.
NGRUMEK RT 1/2 NGLELE SUMOBITO </td>
</tr>
<tr >
<td align="left" class="tablecontent-odd" >KAISAR ABIMANYU AL FARISI,
AN</td>
</td>
<td align="left" class="tablecontent-odd" valign="top"> GADINGMANGU
rt 1/1 PERAK JOMBANG</td>
chest x-ray</td>
</tr>
<tr >
<td align="left" class="tablecontent" >MARZELLO KRISANTO, AN</td>
<td align="left" class="tablecontent" valign="top"> SUKOHARJO 3/1
PENGGARON 3/1 MOJOWARNO </td>
Injection or infusion of electrolytes | 87.49 Other chest x-ray</td>
</tr>
<tr >
<td align="left" class="tablecontent-odd" >DIAN IQBAL, AN</td>
<td align="left" class="tablecontent-odd" valign="top"> DSN. TUGU
GG. III 26 A RT 3/5 KEPATIHAN JOMBANG</td>
and gastroenteritis of presumed infectious origin | E86 Volume
Depletion</td>
</tr>
<tr >
<td align="left" class="tablecontent" >ALINDA KRISTIA N, NY</td>
<td align="left" class="tablecontent" valign="top"> PLOSOREJO RT 2/2
KEBONDALEM BARENG </td>
cervical cesarean section | 69.7 Insertion of intrauterine contraceptive
device</td>
</tr>
<tr >
<td align="left" class="tablecontent-odd" >KHOIRUN NISA* , NY</td>
</td>
<td align="left" class="tablecontent-odd" valign="top"> JL
JATIWARINGIN RT 1/5 JATI CEMPAKA PONDOK GEDE BEKASI </td>
<td align="left" class="tablecontent-odd" valign="top">N84.1 Polyp of
cervix uteri | O36.5 Maternal care for poor fetal growth</td>
</tr>
<tr >
<td align="left" class="tablecontent" >SISKA KRISDIANA, NY</td>
<td align="left" class="tablecontent" valign="top"> JL. KENOMBO
SAMBISARI RT 6/1 CEWENG DIWEK</td>
2021)</td>
</tr>
<tr >
<td align="left" class="tablecontent-odd" >DIVA MIFTAHUL F, BY</td>
</td>
KOPENSARI 1/1 REJOAGUNG PLOSO JOMBANG </td>
</tr>
<tr >
<td align="left" class="tablecontent" >NAYLA AD DAKHIL, AN</td>
<td align="left" class="tablecontent" valign="top"> JL.
ANGREK 9 BLOK G 18 CANDIMULYO 3/11 JOMBANG</td>
Depletion</td>
</tr>
<tr >
<td align="left" class="tablecontent-odd" >ALMAHYRA DIAJENG F, BY</td>
</td>
<td align="left" class="tablecontent-odd" valign="top"> JL
JATIWARINGIN RT 1/5 JATI CEMPAKA PONDOK GEDE BEKASI </td>
<td align="left" class="tablecontent-odd" valign="top">P07.1 Other low
birthweight </td>
<td align="left" class="tablecontent-odd" valign="top">P08.2 Postterm
infant, not heavy for gestational age | P05.9 Slow
fetal growth, unspecified </td>
</tr>
<tr >
<td align="left" class="tablecontent" >MEYSA CANTIKA S, AN</td>
<td align="left" class="tablecontent" valign="top"> TAMBAR UTARA 3/5
JOGOROTO</td>
<td align="left" class="tablecontent-odd" valign="top">L23.9 Allergic
contact dermatitis, unspecified cause</td>
</tr>
<tr >
<td align="left" class="tablecontent-odd" >AISYAH ARIFA*UL J, AN</td>
</td>
<td align="left" class="tablecontent-odd" valign="top"> BALONG GADING
RT 1/1, SPANYUL, GUDO </td>
<td align="left" class="tablecontent-odd" valign="top">Q24.9
Congenital malformation of the heart, unspecified</td>
Paksa</td>
Sembuh</td>
</tr>
<tr >
<td align="left" class="tablecontent" >NOVITA JANNATUNNISA, AN</td>
<td align="left" class="tablecontent" valign="top"> BALONG OMBO RT
02/02 PUNDONG, DIWEK</td>
<td align="left" class="tablecontent" >ASURANSI - PRIMA SARANA JASA,
PT</td>
<td align="left" class="tablecontent-odd" valign="top">A01.0 Typhoid
fever</td>
<td align="left" class="tablecontent-odd" valign="top">A90 Dengue
fever [classical dengue]</td>
</tr>
<tr >
<td align="left" class="tablecontent-odd" >AOKI EL ASYIF , BY</td>
</td>
<td align="left" class="tablecontent-odd" valign="top"> DSN PLOSO
KEREP RT 4 /3 SUMOBITO</td>
Microscopic examination of blood, other microscopic examination | 99.83 Other
phototherapy</td>
</tr>
<tr >
<td align="left" class="tablecontent" >ADHITAMA ELVANO S, AN</td>
<td align="left" class="tablecontent" valign="top"> DSN LENGKONG
1/4 JATIGEDONG PLOSO</td>
<td align="left" class="tablecontent-odd" valign="top">B37.9
Candidiasis, unspecified</td>
</tr>
<tr >
<td align="left" class="tablecontent-odd" >DESY MULYA T, NY</td>
</td>
SUMBERSARI RT. 7/3 SUKOSARI JOGOROTO </td>
care for breech presentation</td>
<td align="left" class="tablecontent-odd" ></td>
</tr>
<tr >
<td align="left" class="tablecontent" >ELSA ISNAINI FEBRIANA, BY</td>
<td align="left" class="tablecontent" valign="top"> KALIGLUGU RT 7/2
SUMBERAGUNG PETERONGAN </td>
</tr>
<tr >
<td align="left" class="tablecontent-odd" >NILNA QURROTU A N, NY</td>
</td>
<td align="left" class="tablecontent-odd" valign="top"> DSN
PLOSOKEREP RT 6/2 SUMOBITO JOMBANG</td>
</tr>
<tr >
<td align="left" class="tablecontent" >UMI TRISNOWATI, NY</td>
<td align="left" class="tablecontent" valign="top"> NGLONGKO RT
20/04, KEBONTEMU, PETERONGAN </td>
</tr>
<tr >
<td align="left" class="tablecontent-odd" >SRI WIGATI, NY</td>
</td>
<td align="left" class="tablecontent-odd" valign="top"> DSN. NGLELE
RT 2/1, SUMOBITO</td>
</tr>
<tr >
<td align="left" class="tablecontent" >WILUJENG AGUSTIN, NY</td>
<td align="left" class="tablecontent" valign="top"> NGEMBUL RT.
4/12 KESAMBEN</td>
</tr>
<tr >
<td align="left" class="tablecontent-odd" >SAADATUL ABADIYAH, NY</td>
</td>
<td align="left" class="tablecontent-odd" valign="top"> JL. KH
SULAIMAN DSN. NGEMPLAK RT. 1/5 SIDOKERTO MOJOWARNO </td>
</tr>
<tr >
<td align="left" class="tablecontent" >UMI TRISNOWATI, BY, NY</td>
<td align="left" class="tablecontent" valign="top">NGLONGKO RT 20/04,
KEBONTEMU, PETERONGAN </td>
</tr>
<tr >
<td align="left" class="tablecontent-odd" >NADIA DEWI AYUNDA C, BY</td>
</td>
<td align="left" class="tablecontent-odd" valign="top">. DSN.
SUMBERSARI RT. 7/3 SUKOSARI JOGOROTO </td>
</tr>
<tr >
<td align="left" class="tablecontent" >SITI MUKAYAROH, NY</td>
<td align="left" class="tablecontent" valign="top"> SAMBIREJO 4/1
JOGOROTO </td>
</tr>
<tr >
<td align="left" class="tablecontent-odd" >M. ABHIZAR ALFARESKY,
BY</td>
</td>
<td align="left" class="tablecontent-odd" valign="top">DSN. NGLELE RT
2/1, SUMOBITO </td>
aspiration syndrome, unspecified</td>
preterm infants
</td>
phototherapy</td>
</tr>
<tr >
<td align="left" class="tablecontent" >AL KHALIFI KENZIE. M. D, AN</td>
<td align="left" class="tablecontent" valign="top"> GAMBIH 2/6
KEJAMBON DAPUR KEJAMBON</td>
</tr>
<tr >
<td align="left" class="tablecontent-odd" >CANTIKA KAMALIA A, AN</td>
<td align="left" class="tablecontent-odd" valign="top"> JL MELATI RT
1/ 11 MOJOKRAPAK TEMBELANG</td>
upper respiratory infection, unspecified</td>
</tr>
<tr >
<td align="left" class="tablecontent" >LAILATUL BADRIYAH, NY</td>
<td align="left" class="tablecontent" valign="top"> DSN KAYEN GG 2
RT 2/5 KAYANGAN DIWEK JOMBANG</td>
<td align="left" class="tablecontent-odd" valign="top">O42.0 Premature
rupture of membranes, onset of labor within 24 ho | O34.2 Maternal care due
to uterine scar from previous surgery </td>
</tr>
<tr >
<td align="left" class="tablecontent-odd" >NURUL FADLILLAH, NY</td>
</td>
<td align="left" class="tablecontent-odd" valign="top"> KEDUNG RT
10/1 KEDUNG REJO MEGALUH JOMBANG</td>
cervical cesarean section | 66.39 Other bilateral destruction or occlusion of
fallopian tubes</td>
</tr>
<tr >
<td align="left" class="tablecontent" >MUCHAYANAH, BY, NY</td>
<td align="left" class="tablecontent" valign="top">NGUMPUL RT 4/ 3
JOGOROTO </td>
</tr>
<tr >
<td align="left" class="tablecontent-odd" >IRMA KARTIKA SARI, NY</td>
</td>
<td align="left" class="tablecontent-odd" valign="top"> KRAJAN 2/1
KARANGREJO TULUNGAGUNG</td>
<td align="left" class="tablecontent-odd" valign="top">O14.1 Severe
preeclampsia</td>
</tr>
<tr >
<td align="left" class="tablecontent" >AINUN JARIYAH, NY</td>
<td align="left" class="tablecontent" valign="top"> MLARAS 5/2
SUMOBITO</td>
Oligohydramnios</td>
</tr>
<tr >
<td align="left" class="tablecontent-odd" >ALMAIRA AZKIYA A, BY</td>
</td>
PLOSOKEREP RT 6/2 SUMOBITO JOMBANG</td>
</tr>
<tr >
<td align="left" class="tablecontent" >NURUL FADLILLAH, BY, NY</td>
<td align="left" class="tablecontent" valign="top"> KEDUNG RT 10/1
KEDUNG REJO MEGALUH JOMBANG</td>
</tr>
<tr >
<td align="left" class="tablecontent-odd" >LAILATUL BADRIYAH, BY,
NY</td>
</td>
<td align="left" class="tablecontent-odd" valign="top"> DSN KAYEN
GG 2 RT 2/5 KAYANGAN DIWEK JOMBANG</td>
</tr>
<tr >
<td align="left" class="tablecontent" >RIRIN IRAWATI, NY</td>
<td align="left" class="tablecontent" valign="top"> SORAN RT 6/3 DUWET
NGAWEN KLATEN</td>
<td align="left" class="tablecontent-odd" valign="top">O99.0 Anemia
complicating pregnancy, childbirth, and the puerperium</td>
<td align="left" class="tablecontent-odd" valign="top">D64.9 Anemia,
unspecified | O65.4 Obstructed labor due to fetopelvic disproportion,
unspecified | O34.2 Maternal care due to uterine scar from previous
surgery </td>
</tr>
<tr >
<td align="left" class="tablecontent-odd" >HAFIZHAN AL FARABI, BY</td>
</td>
<td align="left" class="tablecontent-odd" valign="top"> NGEMBUL
RT. 4/12 KESAMBEN</td>
preterm infants
</td>
</tr>
<tr >
<td align="left" class="tablecontent" >SITI MUKAYAROH,BY, NY</td>
<td align="left" class="tablecontent" valign="top"> SAMBIREJO 4/1
JOGOROTO </td>
</tr>
<tr >
<td align="left" class="tablecontent-odd" >HANAN QIURA ZALFA, BY</td>
</td>
<td align="left" class="tablecontent-odd" valign="top"> JL. KH
SULAIMAN DSN. NGEMPLAK RT. 1/5 SIDOKERTO MOJOWARNO </td>
</tr>
<tr >
<td align="left" class="tablecontent" >ERLANGGA ARGANI F, AN</td>
<td align="left" class="tablecontent" valign="top"> DSN. NGUDIREJO
RT 5/2 DIWEK</td>
haemorrhagic fever</td>
</tr>
<tr >
<td align="left" class="tablecontent-odd" >SALWA AZZAHRA, BY</td>
</td>
<td align="left" class="tablecontent-odd" valign="top"> MLARAS 5/2
SUMOBITO</td>
</tr>
<tr >
<td align="left" class="tablecontent" >M. ARGA DWICAHYA, BY</td>
<td align="left" class="tablecontent" valign="top"> SORAN RT 6/3
DUWET NGAWEN KLATEN</td>
preterm infants
</td>
</tr>
<tr >
<td align="left" class="tablecontent-odd" >ALVIN PUTRA SAMUDERA, AN
</td>
</td>
<td align="left" class="tablecontent-odd" valign="top"> REJOSARI RT
5/1 PLOSOKEREP JOMBANG</td>
<td align="left" class="tablecontent-odd" valign="top">A09.0 Other and
unspecified gastroenteritis and colitis of infectious origin</td>
Depletion</td>
</tr>
<tr >
<td align="left" class="tablecontent" >BEIZA ZEL ZEHRA, BY</td>
<td align="left" class="tablecontent" valign="top"> DSN. KEDUNG
WULAN 3/1 BEJIJONG TROWULAN</td>
<td align="left" class="tablecontent-odd" valign="top">P36.9 Bacterial
sepsis of newborn, unspecified</td>
</tr>
<tr >
<td align="left" class="tablecontent-odd" >LULUK PRASETYAWATI, NY</td>
</td>
<td align="left" class="tablecontent-odd" valign="top"> JL BALI KAV.
D 05 RT 5/9 JOMBATAN </td>
<td align="left" class="tablecontent-odd" valign="top">O14.0 Moderate
preeclampsia</td>
</tr>
<tr >
<td align="left" class="tablecontent" >GRESSIDA MIOLASARI, NY</td>
<td align="left" class="tablecontent" valign="top"> PERUM JOMBANG
PERMAI JL JAMBU G 8 RT 9/4 KEPANJEN, JOMBANG</td>
preeclampsia</td>
</tr>
<tr >
<td align="left" class="tablecontent-odd" >ARSYAD AL- HABSYI, AN</td>
</td>
<td align="left" class="tablecontent-odd" valign="top"> JL BALI KAV.
D 05 RT 5/9 JOMBATAN </td>
birthweight </td>
Slow fetal growth, unspecified
</td>
heat therapy</td>
</tr>
<tr >
<td align="left" class="tablecontent" >MAYSHINTA MAHARANI, NY</td>
<td align="left" class="tablecontent" valign="top"> DSN. NGEPEH 8/5
REJOAGUNG NGORO JOMBANG</td>
<td align="left" class="tablecontent" >ASURANSI - ADMINISTRASI MEDIKA,
PT</td>
</tr>
<tr >
<td align="left" class="tablecontent-odd" >KEYSA ALMAHYRA H, BY</td>
</td>
<td align="left" class="tablecontent-odd" valign="top"> DSN. NGEPEH
8/5 REJOAGUNG NGORO JOMBANG</td>
<td align="left" class="tablecontent-odd" >ASURANSI - ADMINISTRASI
MEDIKA, PT</td>
</tr>
<tr >
<td align="left" class="tablecontent" >NUR LAILI FITRIAH, NY</td>
<td align="left" class="tablecontent" valign="top"> DSN. GEDANG RT 1/
5 TAMBAKREJO JOMBANG</td>
Gestational edema
</td>
</tr>
<tr >
<td align="left" class="tablecontent-odd" >TRIA OKTA SUKRIANTI, NY</td>
</td>
<td align="left" class="tablecontent-odd" valign="top"> IBER-IBER
RT 21/10 SUKOIBER GUDO</td>
</tr>
<tr >
<td align="left" class="tablecontent" >FIRZA ALVIAN B, AN</td>
<td align="left" class="tablecontent" valign="top"> KABUNAN RT
10/ KEBONTEMU PETERONGAN</td>
<td align="left" class="tablecontent-odd" valign="top">B08.4
Enteroviral vesicular stomatitis with exanthem</td>
</tr>
<tr >
<td align="left" class="tablecontent-odd" >NI KOMANG AERILYN B, AN</td>
</td>
<td align="left" class="tablecontent-odd" valign="top"> PANEMON
RT. 2/1 BAKALAN RAYUNG KUDU</td>
<td align="" class="tablecontent-odd" >Retno Wulandari, SpA, dr</td>
Depletion</td>
</tr>
<tr >
<td align="left" class="tablecontent" >AYUDIA KIRANA L, AN</td>
<td align="left" class="tablecontent" valign="top"> KRAJAN 2/1
KARANGREJO TULUNGAGUNG</td>
birthweight </td>
preterm infants
</td>
heat therapy</td>
</tr>
<tr >
<td align="left" class="tablecontent-odd" >DESI NINASARI, BY, NY</td>
</td>
<td align="left" class="tablecontent-odd" valign="top"> JL RAYA
TEMBELANG RT 1/1 TEMBELANG </td>
</tr>
<tr >
<td align="left" class="tablecontent" >SYAFANA NADHIFA, BY</td>
<td align="left" class="tablecontent" valign="top"> IBER-IBER RT 21/10
SUKOIBER GUDO </td>
</tr>
<tr >
<td align="left" class="tablecontent-odd" >SEA MAHAYU TSARWA, AN</td>
</td>
<td align="left" class="tablecontent-odd" valign="top"> PONEN RT 6/
4 PULOGEDANG TEMBELANG</td>
</tr>
<tr >
<td align="left" class="tablecontent" >ARJUNA LANGIT S, AN</td>
<td align="left" class="tablecontent" valign="top"> DAPUR KEJAMBON RT
7/2 JOMBANG</td>
<td align="left" class="tablecontent-odd" valign="top">B08.2 Exanthema
subitum (sixth disease)</td>
</tr>
<tr >
<td align="left" class="tablecontent-odd" >ALENA NABILA ZAFIRA, AN</td>
<td align="left" class="tablecontent-odd" valign="top"> BULUBANDAR
02/02</td>
<td align="left" class="tablecontent-odd" valign="top">K12.1 Other
forms of stomatitis</td>
<td align="left" class="tablecontent-odd" valign="top">R63.8 Other
symptoms and signs concerning food and fluid intake</td>
</tr>
<tr >
<td align="left" class="tablecontent" >ANA SURYA, BY, NY</td>
<td align="left" class="tablecontent" valign="top"> DSN. GONGSENG RT
03/06, MEGALUH </td>
aspiration of amniotic fluid and mucus</td>
<td align="left" class="tablecontent" valign="top">Pulang Paksa</td>
<td align="left" class="tablecontent" valign="top">Belum Sembuh</td>
</tr>
<tr >
<td align="left" class="tablecontent-odd" >AXELLE RAFFASYA Z, AN</td>
</td>
<td align="left" class="tablecontent-odd" valign="top"> PLANDAAN
RT. 5/2 JOMBANG</td>
phototherapy</td>
</tr>
<tr >
<td align="left" class="tablecontent" >NOFILIYA KRISTINA, NY</td>
<td align="left" class="tablecontent" valign="top"> PULO GENTENGAN
GG.4 NO.10</td>
<td align="left" class="tablecontent-odd" valign="top">O02.0 Blighted
ovum and nonhydatidiform mole</td>
<td align="left" class="tablecontent-odd" valign="top">69.02 Dilation
and curettage following delivery or abortion</td>
</tr>
<tr >
<td align="left" class="tablecontent-odd" >DENNY KURNIAWATI, NY</td>
</td>
<td align="left" class="tablecontent-odd" valign="top"> KEREMBANGAN
RT. 5/2 GUDO</td>
</tr>
<tr >
<td align="left" class="tablecontent" >HASNA SALSABILA R, AN</td>
<td align="left" class="tablecontent" valign="top"> DSN BORO LOR RT
02/02, SUMBEREJO, PURWOASRI, KEDIRI</td>
<td align="" class="tablecontent" >Retno Wulandari, SpA, dr</td>
</tr>
<tr >
<td align="left" class="tablecontent-odd" >NUR LAILI FITRIAH, BY,
NY</td>
</td>
<td align="left" class="tablecontent-odd" valign="top"> DSN. GEDANG
RT 1/ 5 TAMBAKREJO JOMBANG</td>
</tr>
<tr >
<td align="left" class="tablecontent" >PUTRI ANDRIYANI, NY</td>
<td align="left" class="tablecontent" valign="top"> PUCANGANOM RT
3/ 1 PUCANGSIMO BANDAR KEDUNG MULYO</td>
</tr>
<tr >
<td align="left" class="tablecontent-odd" >ASYIFATUL QOLBI, BY</td>
</td>
PUCANGANOM RT 3/ 1 PUCANGSIMO BANDAR KEDUNG MULYO</td>
birthweight </td>
<td align="left" class="tablecontent-odd" valign="top">P05.9 Slow
fetal growth, unspecified </td>
heat therapy</td>
</tr>
<tr >
<td align="left" class="tablecontent" >FERLYA RAHMA F, NY</td>
<td align="left" class="tablecontent" valign="top"> DSN. TONDOWULAN
RT 2/1, TEMUWULAN, PERAK </td>
<td align="left" class="tablecontent-odd" valign="top">O48 Prolonged
pregnancy</td>
<td align="left" class="tablecontent-odd" valign="top">O61.0 Failed
medical induction of labor</td>
</tr>
<tr >
<td align="left" class="tablecontent-odd" >ETTY RUKMA YUANI, NY</td>
</td>
<td align="left" class="tablecontent-odd" valign="top"> SEKARU RT
03/02 SUKOPINGGIR GUDO</td>
and curettage for termination of pregnancy</td>
</tr>
<tr >
<td align="left" class="tablecontent" >BETHARI NAADHIRA A, AN</td>
<td align="left" class="tablecontent" valign="top"> DSN. KEMODO UTARA
RT 3/1 DS. KUDUH MOJO MOJOAGUNG</td>
PT</td>
bronchiolitis, unspecified</td>
</tr>
<tr >
<td align="left" class="tablecontent-odd" >MAHESWARA ALTHAF, H, BY</td>
</td>
<td align="left" class="tablecontent-odd" valign="top"> DSN PELEM 05
RT 05/01 JATI PELEM DIWEK </td>
phototherapy</td>
</tr>
<tr >
<td align="left" class="tablecontent" >KIRANA FAHIMA S, AN</td>
<td align="left" class="tablecontent" valign="top"> DSN. MIRENG RT
6/4 SUMBER AGUNG MEGALUH</td>
</tr>
<tr >
<td align="left" class="tablecontent-odd" >NAZINDA ALMAHYRA A, BY</td>
</td>
<td align="left" class="tablecontent-odd" valign="top"> KEREMBANGAN
RT. 5/2 GUDO</td>
</tr>
<tr >
<td align="left" class="tablecontent" >MIFTAQUL UYUNN A, NY</td>
<td align="left" class="tablecontent" valign="top"> DSN. REJO MULYO
RT. 2/5 KEBON AGUNG PLOSO </td>
</tr>
<tr >
<td align="left" class="tablecontent-odd" >FAWWAZ KHALID ILYASA, AN
</td>
</td>
<td align="left" class="tablecontent-odd" valign="top"> MANCAR BARAT
2/3 PETERONGAN</td>
pharyngitis, unspecified</td>
<td align="left" class="tablecontent-odd" valign="top">R56.0 Febrile
convulsions</td>
</tr>
<tr >
<td align="left" class="tablecontent" >NIA NUR DINIA R, NY</td>
<td align="left" class="tablecontent" valign="top"> PERUM FIRDAUS
REGENCY BLOK G-16 RT. 33/3 SENGON </td>
</tr>
<tr >
<td align="left" class="tablecontent-odd" >LILIK WAHYUNI, NY</td>
</td>
<td align="left" class="tablecontent-odd" valign="top"> SIDOKAMPIR RT
4/ 1 BUDUGSIDOREJO SUMOBITO</td>
<td align="left" class="tablecontent-odd" valign="top">O48 Prolonged
pregnancy</td>
</tr>
<tr >
<td align="left" class="tablecontent" >AININ AIMATUL I, NY</td>
<td align="left" class="tablecontent" valign="top">CUKIR RT.3/1 DIWEK
</td>
</tr>
<tr >
<td align="left" class="tablecontent-odd" >SYAKIRA NURIL MAHYA C,
AN</td>
<td align="left" class="tablecontent-odd" valign="top"> KUNDEN 2/2
KEDUNGDOWO PLOSO</td>
<td align="left" class="tablecontent-odd" >ASURANSI - ADMINISTRASI
MEDIKA, PT</td>
<td align="left" class="tablecontent-odd" valign="top">H66.9 Otitis
media, unspecified</td>
</tr>
<tr >
<td align="left" class="tablecontent" >NATASYA DUWI W, AN</td>
<td align="left" class="tablecontent" valign="top"> NGEMPLAK 2/1
PAGERWOJO PERAK</td>
<td align="left" class="tablecontent-odd" valign="top">J90 Pleural
effusion, not elsewhere classified</td>
</tr>
<tr >
<td align="left" class="tablecontent-odd" >AHSAN BIMA PRATAMA, AN</td>
</td>
<td align="left" class="tablecontent-odd" valign="top"> PERUM
FIRDAUS REGENCY BLOK G-16 RT. 33/3 SENGON </td>
</tr>
<tr >
<td align="left" class="tablecontent" >ABRINA ANINDITA F, BY</td>
<td align="left" class="tablecontent" valign="top">SIDOKAMPIR RT 4/ 1
BUDUGSIDOREJO SUMOBITO</td>
</tr>
<tr >
<td align="left" class="tablecontent-odd" >AININ AIMATUL I, BY, NY</td>
</td>
<td align="left" class="tablecontent-odd" valign="top"> CUKIR
RT.3/1 DIWEK </td>
</tr>
<tr >
<td align="left" class="tablecontent" >AZKIYA NURSYIFA, BY</td>
<td align="left" class="tablecontent" valign="top"> DSN. REJO MULYO
RT. 2/5 KEBON AGUNG PLOSO </td>
</tr>
<tr >
<td align="left" class="tablecontent-odd" >FERLYA RAHMA F, BY, NY</td>
</td>
<td align="left" class="tablecontent-odd" valign="top">DSN. TONDOWULAN
RT 2/1, TEMUWULAN, PERAK </td>
</tr>
<tr >
<td align="left" class="tablecontent" >M. RASYA AURELLINO, AN</td>
<td align="left" class="tablecontent" valign="top"> DS. GARUN RT 2/1
SAMBENG LAMONGAN</td>
</tr>
<tr >
<td align="left" class="tablecontent-odd" >AHMAD ULUL AZMI, AN</td>
</td>
<td align="left" class="tablecontent-odd" valign="top"> JL AIRLANGGA
NO 82 RT 3/3 JELAKOMBO</td>
</tr>
<tr >
<td align="left" class="tablecontent" >NOVI RIZKI S W, NY</td>
<td align="left" class="tablecontent" valign="top"> MOJOANYAR RT
2/2 MOJOTENGAH BARENG</td>
</tr>
<tr >
<td align="left" class="tablecontent-odd" >RAHAYU, NY</td>
</td>
<td align="left" class="tablecontent-odd" valign="top"> DSN. KEPUH
TIMUR RT 2/1 WANGKAL KEPUH GUDO</td>
</tr>
<tr >
<td align="left" class="tablecontent" >YUNITA RETNO SARI, NY</td>
<td align="left" class="tablecontent" valign="top"> KEDUNG BETIK
RT.3/1 KESAMBEN</td>
</tr>
<tr >
<td align="left" class="tablecontent-odd" >YUNITA RETNO SARI, BY,
NY</td>
</td>
<td align="left" class="tablecontent-odd" valign="top"> KEDUNG BETIK
RT.3/1 KESAMBEN</td>
</tr>
<tr >
<td align="left" class="tablecontent" >RAHAYU, BY, NY</td>
<td align="left" class="tablecontent" valign="top">DSN. KEPUH TIMUR RT
2/1 WANGKAL KEPUH GUDO </td>
</tr>
<tr >
<td align="left" class="tablecontent-odd" >LIYA LISTIYAWATI, NY</td>
</td>
<td align="left" class="tablecontent-odd" valign="top"> PULO DADI RT
7/3, NGOGRI, MEGALUH </td>
<td align="left" class="tablecontent-odd" valign="top">O98.4 Viral
hepatitis complicating pregnancy, childbirth, and the pue | O32.2 Maternal
</tr>
<tr >
<td align="left" class="tablecontent" >DIYA VIDIYANTI, NY</td>
<td align="left" class="tablecontent" valign="top"> BANDUNG RT 1/2,
BANDUNG, DIWEK, JOMBANG </td>
care for intrauterine death</td>
2021)</td>
</tr>
<tr >
<td align="left" class="tablecontent-odd" >LIYA LISTIYAWATI, BY,
NY</td>
</td>
<td align="left" class="tablecontent-odd" valign="top"> PULO DADI RT
7/3, NGOGRI, MEGALUH </td>
</tr>
<tr >
<td align="left" class="tablecontent" >RIMBA PIJAR LENTERA, BY</td>
<td align="left" class="tablecontent" valign="top">MOJOANYAR RT 2/2
MOJOTENGAH BARENG 
</td>
</tr>
<tr >
<td align="left" class="tablecontent-odd" >ICHA ANGGUNNIA ZAHRANI,
AN</td>
</td>
<td align="left" class="tablecontent-odd" valign="top"> SUBENTORO RT
01/15 SUMBERMULYO JOGOROTO </td>
</tr>
<tr >
<td align="left" class="tablecontent" >M. ATHA ABIZAR, AN</td>
<td align="left" class="tablecontent" valign="top"> DSN. COROGO
01/09, JANTI, JOGOROTO, JOMBANG</td>
Depletion</td>
</tr>
<tr >
<td align="left" class="tablecontent-odd" >EGGA DAFA PRAYOGA, AN
</td>
</td>
<td align="left" class="tablecontent-odd" valign="top"> DS. KEDUNG
TURI RT 3/4 GUDO</td>
<td align="left" class="tablecontent-odd" >ASURANSI - AVRIST ASSURANCE,
PT</td>
</tr>
<tr >
<td align="left" class="tablecontent" >ELI SUGIATI, NY</td>
<td align="left" class="tablecontent" valign="top"> DSN KEDUNG
URIRIP 3/2 BRUDU SUMOBITO</td>
</tr>
<tr >
<td align="left" class="tablecontent-odd" >LAILI FITRIA, NY.</td>
</td>
<td align="left" class="tablecontent-odd" valign="top"> PLANDI GG.
MASJID NO. 9 024/004</td>
</tr>
<tr >
<td align="left" class="tablecontent" >REYNA AZZAHRA, NY</td>
<td align="left" class="tablecontent" valign="top"> JL. SEMERU
DS.TANJUNG GONDANG , RT.14/7 KERTOSONO NGANJUK</td>
</tr>
<tr >
<td align="left" class="tablecontent-odd" >KAMILA ANEIRA S, BY</td>
</td>
<td align="left" class="tablecontent-odd" valign="top"> JL. SEMERU
DS.TANJUNG GONDANG , RT.14/7 KERTOSONO NGANJUK</td>
</tr>
<tr >
<td align="left" class="tablecontent" >M. FAZA ARRAHMAN, AN</td>
<td align="left" class="tablecontent" valign="top"> CANDI MULYO RT
4/ 3</td>
convulsions</td>
</tr>
<tr >
<td align="left" class="tablecontent-odd" >ALFUL LAILA, NY</td>
</td>
<td align="left" class="tablecontent-odd" valign="top"> JL.
HALMAHERA III/10 6/2 KALIWUNGU JOMBANG</td>
</tr>
<tr >
<td align="left" class="tablecontent" >NAILIR RAHMAWATI SYAHIDAH,
NY</td>
<td align="left" class="tablecontent" valign="top"> SAMBENG RT 1/2
ARDIREJO SAMBENG LAMONGAN</td>
</tr>
<tr >
<td align="left" class="tablecontent-odd" >HI*MAH EKA NURUL AINI,
NY</td>
</td>
<td align="left" class="tablecontent-odd" valign="top"> PLEMAHAN RT
18/08 BANYUARANG NGORO</td>
</tr>
<tr >
<td align="left" class="tablecontent" >M. ZAHIRUL HAQ AL FIRDAUS,
AN</td>
ARDIREJO SAMBENG LAMONGAN </td>
</tr>
<tr >
<td align="left" class="tablecontent-odd" >M. ITMAM NIAMI, BY</td>
</td>
<td align="left" class="tablecontent-odd" valign="top"> PLEMAHAN RT
18/08 BANYUARANG NGORO </td>
</tr>
<tr >
<td align="left" class="tablecontent" >AYRA MAHREEN A, BY</td>
<td align="left" class="tablecontent" valign="top">JL. HALMAHERA
III/10 6/2 KALIWUNGU JOMBANG </td>
heavy for gestational age infants | Z38.0 Singleton, born in hospital</td>
</tr>
<tr >
<td align="left" class="tablecontent-odd" >RAFARDAN ATHALA. AN</td>
<td align="left" class="tablecontent-odd" valign="top"> DSN BANJAR
KEREP RT 2/6 BANJARDOWO</td>
<td align="left" class="tablecontent-odd" >ASURANSI - PRIMA SARANA
JASA, PT</td>
</tr>
<tr >
<td align="left" class="tablecontent" >FABRIZIO ASKA R, AN</td>
<td align="left" class="tablecontent" valign="top"> KLECO RT 3/5
TANGGUNG KRAMAT PLOSO </td>
fever</td>
</tr>
<tr >
<td align="left" class="tablecontent-odd" >AKBAR RULIANSYAH A, AN</td>
<td align="left" class="tablecontent-odd" valign="top"> SAMBONG
SANTREN RT.5/1 JOMBANG</td>
</tr>
<tr >
<td align="left" class="tablecontent" >ENGGAR KHUROTUN A, NY</td>
<td align="left" class="tablecontent" valign="top"> TANGGUNGAN RT
5/ 2 GUDO</td>
</tr>
<tr >
<td align="left" class="tablecontent-odd" >FITRIA AYU WULANDARI,
NY</td>
</td>
<td align="left" class="tablecontent-odd" valign="top"> DSN SAMBONG
INDAH BLOK F - 12 SAMBONG DUKUH</td>
device</td>
</tr>
<tr >
<td align="left" class="tablecontent" >LYA HIDAYAH, NY</td>
<td align="left" class="tablecontent" valign="top"> PULO WETAN GG. V
6/2 PULO LOR JOMBANG </td>
2021)</td>
</tr>
<tr >
<td align="left" class="tablecontent-odd" >ACHMAD ACHSAN M, AN</td>
<td align="left" class="tablecontent-odd" valign="top"> GLAGAHERUM RT
2/1 DUKUHARUM MEGALUH </td>
</tr>
<tr >
<td align="left" class="tablecontent" >WIDIANTI MIFTAHUL J, NY</td>
<td align="left" class="tablecontent" valign="top">DSN TERMAS JEKEK RT
3/5 JEKEK BARON</td>
<td align="" class="tablecontent" >Iwan Priyono, Sp.OG, dr</td>
</tr>
<tr >
<td align="left" class="tablecontent-odd" >LYA HIDAYAH, BY, NY</td>
</td>
<td align="left" class="tablecontent-odd" valign="top">PULO WETAN GG.
V 6/2 PULO LOR JOMBANG </td>
</tr>
<tr >
<td align="left" class="tablecontent" >ENGGAR KHUROTUN A, BY, NY</td>
<td align="left" class="tablecontent" valign="top"> TANGGUNGAN RT
5/ 2 GUDO</td>
</tr>
<tr >
<td align="left" class="tablecontent-odd" >AXEL DEVANKA A, AN</td>
</td>
<td align="left" class="tablecontent-odd" valign="top"> DSN SAMBONG
INDAH BLOK F - 12 SAMBONG </td>
</tr>
<tr >
<td align="left" class="tablecontent" >WIDIANTI MIFTAHUL, BY, NY</td>
<td align="left" class="tablecontent" valign="top"> TERMAS JEKEK RT
3/5 JEKEK BARON </td>
</tr>
<tr >
<td align="left" class="tablecontent-odd" >ANYZATHUR RIZMA F, NY</td>
</td>
<td align="left" class="tablecontent-odd" valign="top"> JL .RADEN
FATAH NO. 14 RT.5/6 KEPANJEN JOMBANG</td>
</tr>
<tr >
<td align="left" class="tablecontent" >TITIS SEPTRI A, NY</td>
<td align="left" class="tablecontent" valign="top"> PERUM CITRA RAYA
RT 31/08, PANDANWANGI, DIWEK </td>
</tr>
<tr >
<td align="left" class="tablecontent-odd" >LUTMIATI, NY</td>
</td>
<td align="left" class="tablecontent-odd" valign="top"> CEWENG RT
04/01 CEWENG DIWEK</td>
</tr>
<tr >
<td align="left" class="tablecontent" >RIA SAVITRI, NY</td>
<td align="left" class="tablecontent" valign="top"> DSN. BANGSRI RT.
1/3 BANGSRI PLANDAAN</td>
preeclampsia</td>
device</td>
</tr>
<tr >
<td align="left" class="tablecontent-odd" >YENI DEWI MURNI, NY</td>
</td>
<td align="left" class="tablecontent-odd" valign="top"> JL SEMERU RT
4/3 DENANYAR</td>
</tr>
<tr >
<td align="left" class="tablecontent" >NURUL LAILY ZUNAIDA, NY</td>
<td align="left" class="tablecontent" valign="top"> JL. IMAM BONJOL
NO. 153 RT 01/08 TEMBARAK KERTOSONO</td>
local excision or destruction of ovary</td>
</tr>
<tr >
<td align="left" class="tablecontent-odd" >RIA SAVITRI, BY, NY</td>
</td>
<td align="left" class="tablecontent-odd" valign="top"> DSN. BANGSRI
RT. 1/3 BANGSRI PLANDAAN</td>
</tr>
<tr >
<td align="left" class="tablecontent" >TITIS SEPTRIA A, BY, NY</td>
<td align="left" class="tablecontent" valign="top"> PERUM CITRA RAYA
RT 31/08, PANDANWANGI, DIWEK </td>
</tr>
<tr >
<td align="left" class="tablecontent-odd" >OLINDHEA LUNA, E, BY</td>
</td>
<td align="left" class="tablecontent-odd" valign="top"> DSN. WAUNG RT
phototherapy</td>
</tr>
<tr >
<td align="left" class="tablecontent" >MIKHAILA ARSYA, BY</td>
<td align="left" class="tablecontent" valign="top"> GEMPOLPADING
RT 04/02 GEMPOLPADING PUCUK LAMONGAN</td>
phototherapy</td>
</tr>
<tr >
<td align="left" class="tablecontent-odd" >ARSHAKA XAQUIL V, BY</td>
</td>
NGRUMEK RT 1/2 NGLELE SUMOBITO </td>
phototherapy</td>
</tr>
<tr >
<td align="left" class="tablecontent" >PUTRI NURHIDAYATUL, NY</td>
<td align="left" class="tablecontent" valign="top"> JL. KAPTEN
TENDEAN NO. 46 RT 04/06 PULOLOR</td>
</tr>
<tr >
<td align="left" class="tablecontent-odd" >AYUDIA KIRANA L, AN</td>
</td>
<td align="left" class="tablecontent-odd" valign="top"> KRAJAN
2/1 KARANGREJO TULUNGAGUNG</td>
phototherapy</td>
</tr>
<tr >
<td align="left" class="tablecontent" >ARRAYYAN FAZAL AL GAFI, BY</td>
<td align="left" class="tablecontent" valign="top"> KEDUNG BETIK RT
1/1 KESAMBEN </td>
phototherapy</td>
</tr>
<tr >
<td align="left" class="tablecontent-odd" >RAHILA ZILVIA AYUNDA,
AN</td>
</td>
<td align="left" class="tablecontent-odd" valign="top"> DSN INGAS
PENDOWO RT 1/4 SUMOBITO</td>
</tr>
<tr >
<td align="left" class="tablecontent" >RISA MUDHIATUZ Z, NY</td>
<td align="left" class="tablecontent" valign="top"> PERUM WIKARSA
BLOK F -18 6/12 KENANTEN PUTRI MOJOKERTO</td>
<td align="left" class="tablecontent-odd" valign="top">O02.1 Missed
abortion</td>
</tr>
<tr >
<td align="left" class="tablecontent-odd" >PUTRI NURHIDAYATUL, BY,
NY</td>
</td>
<td align="left" class="tablecontent-odd" valign="top"> Y 
 
JL. KAPTEN TENDEAN NO. 46 RT 04/06 PULOLOR</td>
<td align="left" class="tablecontent-odd" >JKN / KIS - </td>
</tr>
<tr >
<td align="left" class="tablecontent" >ANYZATHUR RIZMA F, BY, NY</td>
<td align="left" class="tablecontent" valign="top">JL .RADEN FATAH NO.
14 RT.5/6 KEPANJEN JOMBANG </td>
</tr>
<tr >
<td align="left" class="tablecontent-odd" >ZAHIRA HARDHIAN PUTRI,
BY</td>
</td>
<td align="left" class="tablecontent-odd" valign="top"> CEWENG RT
04/01 CEWENG DIWEK</td>
</tr>
<tr >
<td align="left" class="tablecontent" >GAVIN AHMAD Z, BY</td>
<td align="left" class="tablecontent" valign="top"> JL SEMERU RT 4/3
DENANYAR</td>
</tr>
<tr >
<td align="left" class="tablecontent-odd" >GHANDI OKTOVIANO, AN</td>
<td align="left" class="tablecontent-odd" valign="top"> DSN. PLOSO
GENENG RT 1/1 JOMBANG</td>
Depletion</td>
</tr>
<tr >
<td align="left" class="tablecontent" >AFIKA ALMAIRA Z, AN</td>
<td align="left" class="tablecontent" valign="top">DSN MOJOSONGO RT 2/
7 BALONG BESUK</td>
Depletion</td>
</tr>
<tr >
<td align="left" class="tablecontent-odd" >KURNIATI NURUL L F, NY</td>
</td>
<td align="left" class="tablecontent-odd" valign="top"> JL. CEMPAKA
RT 02/01 KARANGLO MOJOWARNO</td>
rupture of membranes, onset of labor within 24 ho</td>
</tr>
<tr >
<td align="left" class="tablecontent" >ARUNIKA KANAYA CANDRA, BY</td>
<td align="left" class="tablecontent" valign="top">JL. CEMPAKA RT
02/01 KARANGLO MOJOWARNO </td>
</tr>
<tr >
<td align="left" class="tablecontent-odd" >SINCHA HANNA D, BY</td>
</td>
<td align="left" class="tablecontent-odd" valign="top"> JL KRISNA DSN
BLIMBING RT 6/2 KWARON DIWEK </td>
</tr>
<tr >
<td align="left" class="tablecontent" >IZZAN ARKA PRADIPTA, AN</td>
<td align="left" class="tablecontent" valign="top"> PERUM PLANDI
PERMAI BLOK J 3</td>
</tr>
<tr >
<td align="left" class="tablecontent-odd" >ADIVA SHAQUEENA A, AN</td>
</td>
<td align="left" class="tablecontent-odd" valign="top"> JL TERTAI
GG VI RT 2/8 CANDIMULYO JOMBANG</td>
</tr>
<tr >
<td align="left" class="tablecontent" >HUSNIA ROHMATUL, NY</td>
<td align="left" class="tablecontent" valign="top"> SIDOMULYO RT
02/01 SIDOMULYO MEGALUH</td>
<td align="" class="tablecontent" >Suparmin, SpOG, dr</td>
</tr>
<tr >
<td align="left" class="tablecontent-odd" >M. WISNU ASIGIT, AN</td>
</td>
<td align="left" class="tablecontent-odd" valign="top"> DS MORO
SUNGGINGANRT 4/1 PETERONGAN JOMBANG </td>
</tr>
<tr >
<td align="left" class="tablecontent" >ALEESHA HASNA K, BY</td>
<td align="left" class="tablecontent" valign="top"> SIDOMULYO RT
02/01 SIDOMULYO MEGALUH</td>
</tr>
<tr >
<td align="left" class="tablecontent-odd" >GARDINA AGUSTIN, NY</td>
</td>
<td align="left" class="tablecontent-odd" valign="top">DSN PLANDI RT
22/ 5 JOMBANG</td>
care for excessive fetal growth</td>
</tr>
<tr >
<td align="left" class="tablecontent" >AZRIEL KRISNA Y, AN</td>
<td align="left" class="tablecontent" valign="top"> PERUM DENANYAR
ASRI BLOK B-12 DENANYAR</td>
PT</td>
</tr>
<tr >
<td align="left" class="tablecontent-odd" >ZUHRIATUL FITHRIAH, NY</td>
</td>
<td align="left" class="tablecontent-odd" valign="top"> CATAK
GAYAM RT 2/3 MOJOWARNO JOMBANG </td>
<td align="left" class="tablecontent-odd" >ASURANSI - INHEALTH
INDEMNITY (ASURANSI JIWA INHEALTH INDONESIA, PT)</td>
</tr>
<tr >
<td align="left" class="tablecontent" >SITI KHOTIMAH, NY</td>
<td align="left" class="tablecontent" valign="top"> DSN GANGGANG
TINGGAN RT 1/1 NGIMBANG LAMONGAN </td>
<td align="left" class="tablecontent-odd" valign="top">O60.0 Preterm
labour without delivery</td>
</tr>
<tr >
<td align="left" class="tablecontent-odd" >GARDINA AGUSTIN, BY, NY</td>
<td align="left" class="tablecontent-odd" valign="top"> 
DSN PLANDI RT 22/ 5 JOMBANG</td>
Other heavy for gestational age infants </td>
</tr>
<tr >
<td align="left" class="tablecontent" >FARAH SALMA RIZQIYAH, BY</td>
<td align="left" class="tablecontent" valign="top"> CATAK GAYAM RT
2/3 MOJOWARNO JOMBANG </td>
<td align="left" class="tablecontent" >ASURANSI - INHEALTH INDEMNITY
(ASURANSI JIWA INHEALTH INDONESIA, PT)</td>
</tr>
<tr >
<td align="left" class="tablecontent-odd" >ANGGI RESTYANA, NY</td>
</td>
<td align="left" class="tablecontent-odd" valign="top"> REJOSLAMET
RT 1/1 MANCILAN MOJOAGUNG</td>
<td align="" class="tablecontent-odd" >Iwan Priyono, Sp.OG, dr</td>
</tr>
<tr >
<td align="left" class="tablecontent" >SITI ZUNAIDAH, BY, NY</td>
<td align="left" class="tablecontent" valign="top"> SUMBERAGUNG RT 1/4
PERAK</td>
</tr>
<tr >
<td align="left" class="tablecontent-odd" >AYUNINDYA AULIA HAFLA,
BY</td>
REJOSLAMET RT 1/1 MANCILAN MOJOAGUNG </td>
</tr>
<tr >
<td align="left" class="tablecontent" >BETRAND ALFAREZEL P, AN</td>
<td align="left" class="tablecontent" valign="top"> LINGK. SEKAR PUTIH
RT. 3/2 KEDUNDUNG MAGERSARI MOJOKERTO </td>
</tr>
<tr >
<td align="left" class="tablecontent-odd" >AISYAH NUR ROHMAH, BY</td>
</td>
<td align="left" class="tablecontent-odd" valign="top"> GEDANG AN 4/2
SUMOBITO</td>
<td align="left" class="tablecontent-odd" valign="top">P74.1
Dehydration of newborn</td>
phototherapy</td>
</tr>
<tr >
<td align="left" class="tablecontent" >FATHAN ISQIAN A, AN</td>
<td align="left" class="tablecontent" valign="top"> JL BARU KARYA
10/3 MANCAR PETERONGAN</td>
fever</td>
<td align="left" class="tablecontent-odd" valign="top">J17.0 Pneumonia
in bacterial diseases classified elsewhere</td>
</tr>
<tr >
<td align="left" class="tablecontent-odd" >SONIA RADIKA R, NY</td>
</td>
<td align="left" class="tablecontent-odd" valign="top"> KAUMAN UTARA
GG II NO 43 10/01 JOMBANG</td>
2021)</td>
</tr>
<tr >
<td align="left" class="tablecontent" >ERNI WAHYU NINGSIH, NY</td>
<td align="left" class="tablecontent" valign="top"> DSN. JAMBU
JABON GG. 2 NO. 31RT. 1/2 JOMBANG</td>
<td align="left" class="tablecontent-odd" valign="top">O80.9 Single
spontaneous delivery, unspecified</td>
2021)</td>
</tr>
<tr >
<td align="left" class="tablecontent-odd" >KIRANA PUTRI, A, BY</td>
<td align="left" class="tablecontent-odd" valign="top"> DSN. JAMBU
JABON GG. 2 NO. 31RT. 1/2 JOMBANG</td>
</tr>
<tr >
<td align="left" class="tablecontent" >SONIA RADIKA R,BY, NY</td>
<td align="left" class="tablecontent" valign="top"> KAUMAN UTARA GG II
NO 43 10/01 JOMBANG</td>
</tr>
<tr >
<td align="left" class="tablecontent-odd" >NUR ISNAINI, NY</td>
</td>
<td align="left" class="tablecontent-odd" valign="top"> BANJARANYAR
RT 04/01 SUMBERAGUNG PETERONGAN</td>
</tr>
<tr >
<td align="left" class="tablecontent" >CHAYRA ATHAQILLA V, BY</td>
<td align="left" class="tablecontent" valign="top"> BANJARANYAR
RT 04/01 SUMBERAGUNG PETERONGAN</td>
birthweight </td>
heat therapy</td>
</tr>
<tr >
<td align="left" class="tablecontent-odd" >ROBBAL BAROYA, AN</td>
</td>
<td align="left" class="tablecontent-odd" valign="top"> DSN BANJARPOH
RT 3/1 SUMOBITO JOMBANG </td>
</tr>
<tr >
<td align="left" class="tablecontent" >M. REYVAN AQSHOL F, AN </td>
<td align="left" class="tablecontent" valign="top"> JL SERSAN USMAN
NO 23 RT 3/15 BANARAN KERTOSONO NGANJUK</td>
<td align="left" class="tablecontent" >JKN / KIS - </td>
</tr>
<tr >
<td align="left" class="tablecontent-odd" >INAYATUL AINI, NY</td>
</td>
<td align="left" class="tablecontent-odd" valign="top">DSN. NGENDEN
6/1 REJOSLAMET MOJOWARNO</td>
<td align="left" class="tablecontent-odd" valign="top">O99.8 Other
specified diseases and conditions complicating pregnan</td>
<td align="left" class="tablecontent-odd" valign="top">M51.9
Intervertebral disc disorder, unspecified</td>
</tr>
<tr >
<td align="left" class="tablecontent" >MIFTAHUL ADHIMAH, NY</td>
<td align="left" class="tablecontent" valign="top"> DSN KEBUN MELATI
RT 6/14 SUMBERMULYO JOGOROTO JOMBANG </td>
</tr>
<tr >
<td align="left" class="tablecontent-odd" >RISYA AYU ANUGRAH, AN</td>
</td>
<td align="left" class="tablecontent-odd" valign="top"> PERUM DASA
GRAHA MULYA NO. 1 RT 4/5 PULO LOR JOMBANG</td>
<td align="left" class="tablecontent-odd" >ASURANSI - GAMI
(MEDILUM)</td>
</tr>
<tr >
<td align="left" class="tablecontent" >YANUAR SHINTA B, NY</td>
<td align="left" class="tablecontent" valign="top"> JL. LAKSDA ADI
SUCIPTO NO. 3 RT 8/1 DENANYAR</td>
</tr>
<tr >
<td align="left" class="tablecontent-odd" >MIFTAHUL ADHIMAH, BY,
NY</td>
<td align="left" class="tablecontent-odd" valign="top"> DSN KEBUN
MELATI RT 6/14 SUMBERMULYO JOGOROTO JOMBANG </td>
preterm infants
</td>
</tr>
<tr >
<td align="left" class="tablecontent" >INAYATUL AINI, BY, NY</td>
<td align="left" class="tablecontent" valign="top"> DSN. NGENDEN 6/1
REJOSLAMET MOJOWARNO</td>
</tr>
<tr >
<td align="left" class="tablecontent-odd" >NURUL ZAINATUR NY</td>
</td>
<td align="left" class="tablecontent-odd" valign="top"> JL KAPTEN
TENDEAN NO 3 SENGON</td>
Incomplete, complicated by delayed or excessive hemorrhage</td>
</tr>
<tr >
<td align="left" class="tablecontent" >KEI LENDRA AR-ROSYID, BY</td>
GRAHA BLOK S RT 7/6 TUNGGORONO </td>
phototherapy</td>
</tr>
<tr >
<td align="left" class="tablecontent-odd" >HAMID AZZAM A, AN</td>
KARANG PAKIS RT 17/5 TANGGUNGAN GUDO </td>
</tr>
<tr >
<td align="left" class="tablecontent" >ARSYA NALENDRA Z, AN </td>
<td align="left" class="tablecontent" valign="top"> DSN PUNDONG RT
2/1 DS BALONGOMBO, DIWEK</td>
</tr>
<tr >
<td align="left" class="tablecontent-odd" >ELVANO REZVAN A, AN</td>
</td>
<td align="left" class="tablecontent-odd" valign="top"> DSN. NGEPEH
RT. 6/4 REJOAGUNG NGORO </td>
Pneumonia, unspecified</td>
</tr>
<tr >
<td align="left" class="tablecontent" >YANUAR SHINTA B, BY, NY</td>
<td align="left" class="tablecontent" valign="top"> JL. LAKSDA ADI
SUCIPTO NO. 3 RT 8/1 DENANYAR </td>
</tr>
<tr >
<td align="left" class="tablecontent-odd" >DAFFA ARGANI R, AN</td>
</td>
<td align="left" class="tablecontent-odd" valign="top"> JL CEMPAKA RT
6/1 KEDUNGLOSARI, TEMBELANG</td>
</tr>
<tr >
<td align="left" class="tablecontent" >AHMAD JIRJISY M W, AN</td>
<td align="left" class="tablecontent" valign="top"> KAYEN 3/5
KAYANGAN DIWEK</td>
Depletion</td>
</tr>
<tr >
<td align="left" class="tablecontent-odd" >RINA MULYANA, NY</td>
</td>
<td align="left" class="tablecontent-odd" valign="top"> PERUM METRO
GRAHA BLOK BA 10</td>
<td align="" class="tablecontent-odd" >Suparmin, SpOG, dr</td>
2021)</td>
</tr>
<tr >
<td align="left" class="tablecontent" >M. ILYASA PRASETYO, BY</td>
<td align="left" class="tablecontent" valign="top">PERUM METRO GRAHA
BLOK BA 10</td>
</tr>
<tr >
<td align="left" class="tablecontent-odd" >INDAH ASTUTIK, BY, NY</td>
<td align="left" class="tablecontent-odd" valign="top"> DSN. SUKOIBER
RT 6/3 GUDO JOMBANG </td>
</tr>
<tr >
<td align="left" class="tablecontent" >INDAH ASTUTIK, NY</td>
<td align="left" class="tablecontent" valign="top"> DSN. SUKOIBER RT
6/3 GUDO JOMBANG</td>
2021)</td>
</tr>
<tr >
<td align="left" class="tablecontent-odd" >DIVA MIFTAHUL F, BY</td>
</td>
KOPENSARI 1/1 REJOAGUNG PLOSO JOMBANG </td>
phototherapy</td>
</tr>
<tr >
<td align="left" class="tablecontent" >FABIAN ATHAFARIZ H, AN</td>
<td align="left" class="tablecontent" valign="top"> DSN. NGENTAK
RT. 1/1 SUKOSARI, JOGOROTO</td>
Depletion</td>
</tr>
<tr >
<td align="left" class="tablecontent-odd" >TIARA GADIS SAFITRI, NY</td>
</td>
<td align="left" class="tablecontent-odd" valign="top"> NGLONGKO
RT. 19/4 KEBONTEMU PETERONGAN </td>
<td align="left" class="tablecontent-odd" valign="top">N80.1
Endometriosis of ovary</td>
local excision or destruction of ovary</td>
</tr>
<tr >
<td align="left" class="tablecontent" >NUR LAILATUL FATICHAH, NY</td>
<td align="left" class="tablecontent" valign="top"> DSN. BLIMBING
RT. 3/1 GUDO</td>
</tr>
<tr >
<td align="left" class="tablecontent-odd" >ANA KUSWIANTI, NY</td>
</td>
<td align="left" class="tablecontent-odd" valign="top"> BALONG SURUH
RT 02/02 BALONG GEMEK MEGALUH</td>
<td align="left" class="tablecontent-odd" valign="top">Z32.1 Pregnancy
confirmed</td>
Diagnostic ultrasound of gravid uterus</td>
</tr>
<tr >
<td align="left" class="tablecontent" >ANA KUSWIANTI, NY</td>
<td align="left" class="tablecontent" valign="top"> BALONG SURUH RT
02/02 BALONG GEMEK MEGALUH</td>
</tr>
<tr >
<td align="left" class="tablecontent-odd" >PUTRI ANGGUN JAYANTI,
NY</td>
</td>
<td align="left" class="tablecontent-odd" valign="top"> JL DAHLIA 14
RT 2/3, MOJONGAPIT JOMBANG</td>
2021)</td>
</tr>
<tr >
<td align="left" class="tablecontent" >UTIK ANGGRAYANI, NY</td>
<td align="left" class="tablecontent" valign="top"> CARUK WETAN RT.
1/1 JABON JOMBANG </td>
abortion</td>
</tr>
<tr >
<td align="left" class="tablecontent-odd" >KENZO ABI PRADIPA, A,
AN</td>
</td>
SUKOREJO SUKORAME</td>
Depletion</td>
</tr>
<tr >
<td align="left" class="tablecontent" >EMILDA SUSIANA, NY</td>
<td align="left" class="tablecontent" valign="top"> DSN. PULO DADI
3/3 NGOGRI MEGALUH</td>
<td align="left" class="tablecontent-odd" valign="top">O60.0 Preterm
labour without delivery</td>
</tr>
<tr >
<td align="left" class="tablecontent-odd" >ISNAINI FITRIA N, NY</td>
</td>
<td align="left" class="tablecontent-odd" valign="top"> PURI A RT
4/1 PURISEMANDING PLANDAAN</td>
</tr>
<tr >
<td align="left" class="tablecontent" >ENDANG NURYATI, NY</td>
<td align="left" class="tablecontent" valign="top"> GONGSENG RT 2/
5 MEGALUH</td>
abortion</td>
</tr>
<tr >
<td align="left" class="tablecontent-odd" >PUTRI ANGGUN JAYANTI, BY,
NY</td>
<td align="left" class="tablecontent-odd" valign="top"> JL DAHLIA 14
RT 2/3, MOJONGAPIT JOMBANG 
</td>
</tr>
<tr >
<td align="left" class="tablecontent" >KRISTINA YULIATIN, NY</td>
<td align="left" class="tablecontent" valign="top"> BESUK AGUNG RT
2/4 SUMBERAGUNG PETERONGAN </td>
</tr>
<tr >
<td align="left" class="tablecontent-odd" >M. FALAH SHAQUILLE, BY</td>
<td align="left" class="tablecontent-odd" valign="top"> PURI A RT 4/1
PURISEMANDING PLANDAAN</td>
</tr>
<tr >
<td align="left" class="tablecontent" >AMINATUL MUKARROMAH, BY, NY</td>
<td align="left" class="tablecontent" valign="top"> JL RONOHARJO RT
2/1 SUKOMULYO MOJOWARNO JOMBANG</td>
</tr>
<tr >
<td align="left" class="tablecontent-odd" >ERNY MURNIASIH, NY</td>
</td>
<td align="left" class="tablecontent-odd" valign="top"> JL. MERDEKA
GG. SATRIA NO.9 2/6 CANDI MULYO JOMBANG</td>
</tr>
<tr >
<td align="left" class="tablecontent" >AHMAD HANAN ALFARIZI, BY</td>
<td align="left" class="tablecontent" valign="top"> JL. MERDEKA GG.
SATRIA NO.9 2/6 CANDI MULYO JOMBANG </td>
</tr>
<tr >
<td align="left" class="tablecontent-odd" >BEY RIZAL FATHUR G, AN</td>
</td>
<td align="left" class="tablecontent-odd" valign="top"> DSN. GADING
DS. GADINGMANGU RT 4/5 PERAK</td>
Diagnostic ultrasound of abdomen and retroperitoneum | 90.59 Microscopic
examination of blood, other microscopic examination | 99.18 Injection or
infusion of electrolytes</td>
<td align="left" class="tablecontent-odd" valign="top">Dirujuk</td>
Sembuh</td>
</tr>
<tr >
<td align="left" class="tablecontent" >NUR EKA SYIFA A, AN</td>
<td align="left" class="tablecontent" valign="top"> DSN. DS.KEPLAK
SARI RT. 7/1 PETERONGAN</td>
acute gastritis</td>
</tr>
<tr >
<td align="left" class="tablecontent-odd" >PIYA ERNASARI, NY</td>
</td>
<td align="left" class="tablecontent-odd" valign="top"> DSN LAMPEYAN
RT 2/7 KEDUNGKUMPUL SUKORAME LAMONGAN</td>
preeclampsia</td>
</tr>
<tr >
<td align="left" class="tablecontent" >NIKMATUL MAGHFIROH, BY, NY
</td>
<td align="left" class="tablecontent" valign="top">DSN PLANDI RT. 21/5
JOMBANG </td>
</tr>
<tr >
<td align="left" class="tablecontent-odd" >ARNOLD ALVARO G, BY</td>
<td align="left" class="tablecontent-odd" valign="top">DSN LAMPEYAN RT
2/7 KEDUNGKUMPUL SUKORAME LAMONGAN </td>
</tr>
<tr >
<td align="left" class="tablecontent" >ARSAKHA PUTRA S, AN</td>
<td align="left" class="tablecontent" valign="top"> BALONG SURUH RT
02/02 BALONG GEMEK MEGALUH</td>
</tr>
<tr >
<td align="left" class="tablecontent-odd" >SRI SULASTRI, NY</td>
</td>
<td align="left" class="tablecontent-odd" valign="top"> KALIJARING
RT 7/2 KALI KEJAMBON TEMBELANG</td>
Preeclampsia, unspecified</td>
<td align="left" class="tablecontent-odd" valign="top">O82.9 Delivery
by caesarean section, unspecified | Z37.0 Single live birth</td>
Diagnostic ultrasound of gravid uterus</td>
</tr>
<tr >
<td align="left" class="tablecontent" >NUR LAILATUL FATICHAH, BY,
NY</td>
<td align="left" class="tablecontent" valign="top"> DSN. BLIMBING RT.
3/1 GUDO</td>
preterm infants
</td>
</tr>
<tr >
<td align="left" class="tablecontent-odd" >MASLUCHAH, NY</td>
</td>
<td align="left" class="tablecontent-odd" valign="top"> JL. YOS
SUDARSO 12 RT5/3 DENANYAR</td>
2021)</td>
</tr>
<tr >
<td align="left" class="tablecontent" >NONIK DWI PRATIWI, NY</td>
<td align="left" class="tablecontent" valign="top"> DSN NGOGRI
RT. 3/1 MEGALUH</td>
</tr>
<tr >
<td align="left" class="tablecontent-odd" >SHANKARA ABRAR ABIMANYU,
BY</td>
<td align="left" class="tablecontent-odd" valign="top"> DSN NGOGRI
RT. 3/1 MEGALUH</td>
Other heavy for gestational age infants |
 P70.4 Other neonatal hypoglycemia</td>
</tr>
<tr >
<td align="left" class="tablecontent" >SITI FATIMAH, NY</td>
<td align="left" class="tablecontent" valign="top"> JATIDUWUR RT
12/08 KESAMBEN JOMBANG </td>
</tr>
<tr >
<td align="left" class="tablecontent-odd" >NAURA FIRDAUS AL HUDA,
AN</td>
</td>
<td align="left" class="tablecontent-odd" valign="top"> DSN. SONGSONG
RT 11/2 JATIKALEN NGANJUK</td>
<td align="left" class="tablecontent-odd" valign="top">R11 Nausea and
vomiting</td>
</tr>
<tr >
<td align="left" class="tablecontent" >M. RIFKY ADITYA, AN</td>
<td align="left" class="tablecontent" valign="top"> DSN. PAGAK RT.
2/2 SEMBUNG PERAK</td>
PT</td>
fever</td>
</tr>
<tr >
<td align="left" class="tablecontent-odd" >SITI FATIMAH, BY, NY</td>
<td align="left" class="tablecontent-odd" valign="top">JATIDUWUR RT
12/08 KESAMBEN JOMBANG </td>
</tr>
<tr >
<td align="left" class="tablecontent" >NAMIRA ULA, O, AN</td>
<td align="left" class="tablecontent" valign="top"> PENGALANGAN
RT 25/ 8 SEGODOREJO SUMOBITO</td>
<td align="left" class="tablecontent" >JKN / KIS - </td>
</tr>
<tr >
<td align="left" class="tablecontent-odd" >AZRIL ADYA A, AN</td>
</td>
<td align="left" class="tablecontent-odd" valign="top"> DSN. MOJO
DS. MOJOREJO RT. 1/1 , LAMONGAN</td>
Depletion</td>
Paksa</td>
Sembuh</td>
</tr>
<tr >
<td align="left" class="tablecontent" >ANNISA PERTIWI, NY</td>
<td align="left" class="tablecontent" valign="top"> PERMATA JINGGA A
15 JOMBANG</td>
device</td>
</tr>
<tr >
<td align="left" class="tablecontent-odd" >AIDEN AFISA A, AN</td>
</td>
<td align="left" class="tablecontent-odd" valign="top"> DSN SIDOMUKTI
3/4 PUCANGRO GUDO JOMBANG </td>
Depletion</td>
</tr>
<tr >
<td align="left" class="tablecontent" >TANTI ZULI A, NY</td>
<td align="left" class="tablecontent" valign="top"> DSN BANJARDOWO RT
3/ 2 JOMBANG</td>
unilateral salpingo-oophorectomy</td>
</tr>
<tr >
<td align="left" class="tablecontent-odd" >MEI WULANDARI, NY</td>
</td>
<td align="left" class="tablecontent-odd" valign="top"> DSN PANDEAN
RT 5/ 2 MIAGAN MOJOAGUNG 
</td>
device</td>
</tr>
<tr >
<td align="left" class="tablecontent" >GEVARIEL FEIVEL K, BY</td>
<td align="left" class="tablecontent" valign="top"> NGAGELREJO KIDUL
95 RT. 4/2 NGAGELREJO WONOKROMO SURABAYA </td>
</tr>
<tr >
<td align="left" class="tablecontent-odd" >CHEVERLY MOZZELE V, AN</td>
</td>
<td align="left" class="tablecontent-odd" valign="top"> JL.
ADITIAWARMAN NO 87 3/1 KALIWUNGU JOMBANG</td>
</tr>
<tr >
<td align="left" class="tablecontent" >ANNISA PERTIWI, BY, NY</td>
<td align="left" class="tablecontent" valign="top"> PERMATA JINGGA A
15 JOMBANG </td>
<td align="left" class="tablecontent" valign="top"></td>
</tr>
<tr >
<td align="left" class="tablecontent-odd" >ABU BAKAR, AN</td>
</td>
<td align="left" class="tablecontent-odd" valign="top"> JL. PAHLAWAN
NO. 93 JELAKOMBO 1/1 JOMBANG</td>
</tr>
<tr >
<td align="left" class="tablecontent" >ARSYAKHA VIRENDRA D, AN</td>
<td align="left" class="tablecontent" valign="top"> SENTANAN RT 3/1
NGROMBOT PATIANROWO</td>
<td align="left" class="tablecontent-odd" valign="top">G40.9 Epilepsy,
unspecified</td>
</tr>
<tr >
<td align="left" class="tablecontent-odd" >ROSITA NOVAYANTI NUR,
NY</td>
</td>
<td align="left" class="tablecontent-odd" valign="top"> SAMBONG
DUKUH RT 4/7 JOMBANG</td>
2021)</td>
</tr>
<tr >
<td align="left" class="tablecontent" >M. IZDIHARR HAFIZH, BY</td>
<td align="left" class="tablecontent" valign="top"> SAMBONG DUKUH
RT 4/7 JOMBANG</td>
</tr>
<tr >
<td align="left" class="tablecontent-odd" >FEBIAN ARRAJAB, BY</td>
<td align="left" class="tablecontent-odd" valign="top"> DSN PANDEAN RT
5/ 2 MIAGAN MOJOAGUNG </td>
preterm infants
</td>
</tr>
<tr >
<td align="left" class="tablecontent" >M. ZAHIRUL HAQ AL FIRDAUS,
AN</td>
ARDIREJO SAMBENG LAMONGAN </td>
phototherapy</td>
</tr>
<tr >
<td align="left" class="tablecontent-odd" >BETA GHOBIA KHALIMAH,
NY</td>
</td>
<td align="left" class="tablecontent-odd" valign="top"> PERUM PULO
ASRI SEJAHTERA RT. 7/8 PULOLOR JOMBANG</td>
<td align="left" class="tablecontent-odd" valign="top">O98.4 Viral
hepatitis complicating pregnancy, childbirth, and the pue </td>
</tr>
<tr >
<td align="left" class="tablecontent" >KAFI RAFFASYA, AN</td>
<td align="left" class="tablecontent" valign="top"> DSN. BANJAR
POH RT -/- DS. PULOREJO NGORO</td>
<td align="left" class="tablecontent-odd" valign="top">T78.3
Angioneurotic oedema</td>
</tr>
<tr >
<td align="left" class="tablecontent-odd" >SUKMA AISYAH AZZAHRA,
BY</td>
<td align="left" class="tablecontent-odd" valign="top">PERUM PULO ASRI
SEJAHTERA RT. 7/8 PULOLOR </td>
</tr>
<tr >
<td align="left" class="tablecontent" >FAJAR RAHMADANI, BY</td>
<td align="left" class="tablecontent" valign="top">KALIJARING RT 7/2
KALI KEJAMBON TEMBELANG </td>
birthweight </td>
</tr>
<tr >
<td align="left" class="tablecontent-odd" >ARASYA KEENANDRA ARDHANI,
BY</td>
<td align="left" class="tablecontent-odd" valign="top"> DSN. KEPLAK
RT. 7/1 KEPLAKSARI PETERONGAN</td>
</tr>
<tr >
<td align="left" class="tablecontent" >AGUSTINA SAPTA, NY</td>
<td align="left" class="tablecontent" valign="top"> DSN. KEPLAK RT.
7/1 KEPLAKSARI PETERONGAN</td>
</tr>
<tr >
<td align="left" class="tablecontent-odd" >SITI NUR ANIK, NY</td>
</td>
<td align="left" class="tablecontent-odd" valign="top"> BUDUG
TUGU RT. 8/2, PETERONGAN</td>
</tr>
<tr >
<td align="left" class="tablecontent" >ELFATHAN ZAYYAD EFENDI, AN
</td>
<td align="left" class="tablecontent" valign="top"> BOTE RT.11/6
KEDAWONG DIWEK</td>
PT</td>
fever</td>
</tr>
<tr >
<td align="left" class="tablecontent-odd" >M. ZHAFRAN AL FATIH, AN</td>
<td align="left" class="tablecontent-odd" valign="top"> MOJOSONGO
RT 2/ 7 BALONG BESUK DIWEK</td>
Depletion</td>
</tr>
<tr >
<td align="left" class="tablecontent" >ANITA ROSANTI, NY</td>
<td align="left" class="tablecontent" valign="top"> CANGKRINGMALANG
3/3 PUCANGRO GUDO</td>
device</td>
</tr>
<tr >
<td align="left" class="tablecontent-odd" >TITIN HUMAIROH, NY</td>
</td>
<td align="left" class="tablecontent-odd" valign="top"> BOGEM RT 3/9
GROGOL DIWEK</td>
</tr>
<tr >
<td align="left" class="tablecontent" >MERIYA SARA K, NY </td>
<td align="left" class="tablecontent" valign="top"> JL. KUSUMA BANGSA
NO 9 5/1 SENGON JOMBANG</td>
</tr>
<tr >
<td align="left" class="tablecontent-odd" >ALEENA MEHWISH N, BY</td>
<td align="left" class="tablecontent-odd" valign="top"> DSN BUDUG TUGU
RT. 8/2, PETERONGAN </td>
preterm infants
</td>
heat therapy</td>
</tr>
<tr >
<td align="left" class="tablecontent" >IBRAHIM ZHAFRAN E F, BY</td>
<td align="left" class="tablecontent" valign="top"> JL. KUSUMA BANGSA
NO 9 5/1 SENGON JOMBANG </td>
</tr>
<tr >
<td align="left" class="tablecontent-odd" >AZKIA FAIZATUL HUSNA,
BY</td>
CANGKRINGMALANG 3/3 PUCANGRO GUDO</td>
</tr>
<tr >
<td align="left" class="tablecontent" >AGUSTIN IVA YANTI, NY
</td>
<td align="left" class="tablecontent" valign="top"> KEDUNGGALIH 5/8
REJOSO PINGGIR TEMBELANG</td>
<td align="left" class="tablecontent-odd" valign="top">O68.8 Labor and
delivery complicated by other evidence of fetal stre </td>
</tr>
<tr >
<td align="left" class="tablecontent-odd" >NAJMUDDIN HADZIQ, BY</td>
<td align="left" class="tablecontent-odd" valign="top"> DSN BOGEM RT
3/9 GROGOL DIWEK </td>
</tr>
<tr >
<td align="left" class="tablecontent" >FARISA ADLINA, NY</td>
<td align="left" class="tablecontent" valign="top"> DSN BANJARKEREP
RT 1/5 BANJARDOWO JOMBANG </td>
</tr>
<tr >
<td align="left" class="tablecontent-odd" >FARISA ADLINA, BY, NY</td>
BANJARKEREP RT 1/5 BANJARDOWO JOMBANG 
 
</td>
</tr>
<tr >
<td align="left" class="tablecontent" >IBRAHIM, AN</td>
<td align="left" class="tablecontent" valign="top"> JL. PAHLAWAN NO.
93 JELAK OMBO JOMBANG</td>
</tr>
<tr >
<td align="left" class="tablecontent-odd" >ALYA MUKHBITA ZAHRA, AN</td>
</td>
SEGODOREJO RT 11/ 4 SUMOBITO</td>
<td align="left" class="tablecontent-odd" >ASURANSI - PRUDENTIAL</td>
fever</td>
</tr>
<tr >
<td align="left" class="tablecontent" >DWI RIZQI ARISKA, NY</td>
<td align="left" class="tablecontent" valign="top"> DSN. BULUREJO
RT.1/2 DIWEK</td>
</tr>
<tr >
<td align="left" class="tablecontent-odd" >ABID PANDU SATRIYA, BY</td>
BULUREJO RT.1/2 DIWEK </td>
</tr>
<tr >
<td align="left" class="tablecontent" >NIA PUSPITA, NY</td>
<td align="left" class="tablecontent" valign="top"> DSN. PLOSO
REJO RT 1/2 KEBONDALAM BARENG JOMBANG</td>
</tr>
<tr >
<td align="left" class="tablecontent-odd" >M. FAHMI MAULANA, AN
</td>
</td>
<td align="left" class="tablecontent-odd" valign="top"> REJOSO RT 3/6
NGUMPUL JOGOROTO</td>
convulsions</td>
</tr>
<tr >
<td align="left" class="tablecontent" >M. GIBRAN ABIZAR A, BY </td>
<td align="left" class="tablecontent" valign="top"> KEDUNGGALIH 5/8
REJOSO PINGGIR TEMBELANG</td>
</tr>
<tr >
<td align="left" class="tablecontent-odd" >EKA NOFITALIA, NY
</td>
</td>
BANJARDOWO RT.1/4 JOMBANG</td>
care for breech presentation | O41.0 Oligohydramnios</td>
</tr>
<tr >
<td align="left" class="tablecontent" >M. RAFAY AL ANSHORY, AN</td>
<td align="left" class="tablecontent" valign="top"> BETEK BARAT RT
02/02 BETEK MOJOAGUNG</td>
<td align="left" class="tablecontent-odd" valign="top">B08.2 Exanthema
subitum (sixth disease)</td>
</tr>
<tr >
<td align="left" class="tablecontent-odd" >FAKHRAYNA NUR M, AN</td>
</td>
<td align="left" class="tablecontent-odd" valign="top"> JLN KAPTEN
TANDEAN 234 PULO LOR JOMBANG</td>
</tr>
<tr >
<td align="left" class="tablecontent" >VEMAS EZA K, BY </td>
<td align="left" class="tablecontent" valign="top"> BANJARDOWO RT.1/4
JOMBANG</td>
birthweight </td>
heat therapy</td>
</tr>
<tr >
<td align="left" class="tablecontent-odd" >ZULQAIDAH, NY</td>
</td>
CANGKRING RT 4/2 CANGKRINGRANDU PERAK</td>
</tr>
<tr >
<td align="left" class="tablecontent" >YULIA KRISTININGRUM, NY</td>
<td align="left" class="tablecontent" valign="top"> DSN. TAMBAKBERAS
RT 4/2, TAMBAKREJO, JOMBANG </td>
2021)</td>
</tr>
<tr >
<td align="left" class="tablecontent-odd" >YULIA KRISTININGRUM, BY,
NY</td>
DSN. TAMBAKBERAS RT 4/2, TAMBAKREJO, JOMBANG </td>
</tr>
<tr >
<td align="left" class="tablecontent" >GIBRAN FATHIR A, BY</td>
<td align="left" class="tablecontent" valign="top"> DSN CANGKRING RT
4/2 CANGKRINGRANDU PERAK</td>
</tr>
<tr >
<td align="left" class="tablecontent-odd" >DINDA HIDAYATURROYANI,
NY</td>
</td>
<td align="left" class="tablecontent-odd" valign="top"> KETANON RT.
4/2 DIWEK</td>
</tr>
<tr >
<td align="left" class="tablecontent" >M. FATHAN ADHAR, AN</td>
<td align="left" class="tablecontent" valign="top"> ALANG-ALANG
CARUBAN RT 3/ 1 JOGOROTO</td>
</tr>
<tr >
<td align="left" class="tablecontent-odd" >GALUH SANTI PALUPI, NY</td>
</td>
<td align="left" class="tablecontent-odd" valign="top"> JL. MOJOWARNO
RT6/3 GONDEK MOJOWARNO</td>
</tr>
<tr >
<td align="left" class="tablecontent" >WANTRI KURNIA M. NY</td>
<td align="left" class="tablecontent" valign="top"> DSN. DS. GONDANG
MANIS RT. 1/5 BANDAR KEDUNG MULYA</td>
</tr>
<tr >
<td align="left" class="tablecontent-odd" >SULIK TININGSIH, NY</td>
</td>
<td align="left" class="tablecontent-odd" valign="top"> GARU RT
04/01 PODOROTO KESAMBEN</td>
</tr>
<tr >
<td align="left" class="tablecontent" >WANTRI KURNIA M. BY, NY</td>
<td align="left" class="tablecontent" valign="top"> DSN. DS. GONDANG
MANIS RT. 1/5 BANDAR KEDUNG MULYA</td>
</tr>
<tr >
<td align="left" class="tablecontent-odd" >DEMICHELLO JAYDEN T, AN</td>
<td align="left" class="tablecontent-odd" valign="top"> JL. RAYA KABUH
NO. 40A 3/4 KABUH</td>
fever</td>
</tr>
<tr >
<td align="left" class="tablecontent" >QIANA NEYSA, BY</td>
<td align="left" class="tablecontent" valign="top"> KETANON RT. 4/2
DIWEK</td>
</tr>
<tr >
<td align="left" class="tablecontent-odd" >ABRIENDA BEATRICE C, BY</td>
<td align="left" class="tablecontent-odd" valign="top"> JL. MOJOWARNO
RT6/3 GONDEK MOJOWARNO</td>
preterm infants
</td>
</tr>
<tr >
<td align="left" class="tablecontent" >SULIK TININGSIH, BY, NY</td>
<td align="left" class="tablecontent" valign="top">GARU RT 04/01
PODOROTO KESAMBEN </td>
</tr>
<tr >
<td align="left" class="tablecontent-odd" >ZIADATUL FITRI, AN</td>
</td>
<td align="left" class="tablecontent-odd" valign="top"> JL. TIRTA
BUANA GG V NO 14 DSN KEPLAK RT 1/1 DS KEPLAKSARI PETERONGAN</td>
<td align="left" class="tablecontent-odd" valign="top">R56.8 Other and
unspecified convulsions</td>
</tr>
<tr >
<td align="left" class="tablecontent" >DIAH AYU LINGGAR PERTIWI,
NY</td>
<td align="left" class="tablecontent" valign="top"> JAYA ABADI F/13
JOMBANG JOMBATAN</td>
</tr>
<tr >
<td align="left" class="tablecontent-odd" >M. KHULUQIL ADZIM, AN</td>
</td>
<td align="left" class="tablecontent-odd" valign="top"> PELENGKUNG
RT 1/1, SAMBEREJO, JOGOROTO</td>
fever</td>
</tr>
<tr >
<td align="left" class="tablecontent" >AMIROH ISARI, NY</td>
<td align="left" class="tablecontent" valign="top"> DSN BALONGREJO RT
2/1 BADAS SUMOBITO</td>
</tr>
<tr >
<td align="left" class="tablecontent-odd" >AMIROH ISARI, BY, NY</td>
<td align="left" class="tablecontent-odd" valign="top"> DSN BALONGREJO
RT 2/1 BADAS SUMOBITO</td>
<td align="left" class="tablecontent-odd" >JKN / KIS - </td>
</tr>
<tr >
<td align="left" class="tablecontent" >NI KOMANG AERILYN B, AN</td>
<td align="left" class="tablecontent" valign="top"> PANEMON RT.
2/1 BAKALAN RAYUNG KUDU</td>
</tr>
<tr >
<td align="left" class="tablecontent-odd" >ALFIAN RIZQIE M, AN</td>
</td>
<td align="left" class="tablecontent-odd" valign="top"> GETEH JANTI
2/7 JOGOROTO</td>
</tr>
<tr >
<td align="left" class="tablecontent" >ANIK MAHMUDAH, NY</td>
<td align="left" class="tablecontent" valign="top"> JOGOLOYO RT
1/2 SUMOBITO JOMBANG</td>
<td align="left" class="tablecontent-odd" valign="top">N92.0 Excessive
and frequent menstruation with regular cycle</td>
<td align="left" class="tablecontent-odd" valign="top">D64.9 Anemia,
unspecified</td>
dilation and curettage</td>
</tr>
<tr >
<td align="left" class="tablecontent-odd" >MARISKA ANDRIYASARI, NY</td>
</td>
SUROBAYAN RT. 10/3 TENGARAN, PETERONGAN</td>
device</td>
</tr>
<tr >
<td align="left" class="tablecontent" >YUANAH, NY</td>
<td align="left" class="tablecontent" valign="top"> DSN. GANDU RT
6/2, MLARAS, SUMOBITO</td>
Obstructed labor due to fetopelvic disproportion, unspecified | O34.2
Maternal care due to uterine scar from previous surgery </td>
</tr>
<tr >
<td align="left" class="tablecontent-odd" >MAFAZA SYAFARINA AZKIYA,
AN</td>
<td align="left" class="tablecontent-odd" valign="top"> JL WISMA
TENGGER 3/56 C NO.15 KANDANGAN BENOWO SURABYA</td>
fever</td>
</tr>
<tr >
<td align="left" class="tablecontent" >MARITZA ZAILA R, BY</td>
<td align="left" class="tablecontent" valign="top"> DSN. SUROBAYAN RT.
10/3 TENGARAN</td>
</tr>
<tr >
<td align="left" class="tablecontent-odd" >YUANAH, BY, NY</td>
<td align="left" class="tablecontent-odd" valign="top"> DSN. GANDU RT
6/2, MLARAS, SUMOBITO</td>
</tr>
<tr >
<td align="left" class="tablecontent" >HAIDAR HAMDANI, AN</td>
<td align="left" class="tablecontent" valign="top"> KEPUHREJO 3/2
SUKOPINGGIR GUDO</td>
Depletion</td>
</tr>
<tr >
<td align="left" class="tablecontent-odd" >M. ZAINUL MUMAJJAD M, AN
</td>
</td>
<td align="left" class="tablecontent-odd" valign="top"> DSN. SLOMBOK
RT. 1/2 PLEMAHAN 
SUMOBITO</td>
Depletion</td>
</tr>
<tr >
<td align="left" class="tablecontent" >GRESSIDA MIOLASARI, NY</td>
<td align="left" class="tablecontent" valign="top"> PERUM JOMBANG
PERMAI JL JAMBU G 8 RT 9/4 KEPANJEN, JOMBANG</td>
preeclampsia</td>
</tr>
<tr >
<td align="left" class="tablecontent-odd" >M. SYAUQI ALMAN A, AN</td>
</td>
MENDUGO NGIMBANG 1/1 LAMONGAN</td>
</tr>
<tr >
<td align="left" class="tablecontent" >NOVIA PUTRI AULIA, AN
</td>
<td align="left" class="tablecontent" valign="top"> GERBONG
SAMBIREJO 1/3 JOGOROTO</td>
Depletion</td>
</tr>
<tr >
<td align="left" class="tablecontent-odd" >FITROTIN LAILIYAH, NY</td>
</td>
<td align="left" class="tablecontent-odd" valign="top"> JL PATIMURA 2
NO 01 RT 24/5 SENGON</td>
abortion</td>
</tr>
<tr >
<td align="left" class="tablecontent" >SITI MUNAWAROH, NY</td>
JOMBANG INDAH BLOK D 21 RT 03/04 </td>
<td align="left" class="tablecontent-odd" valign="top">D25.9 Leiomyoma
of uterus, unspecified</td>
unilateral salpingo-oophorectomy | 68.59 Other and unspecified vaginal
hysterectomy</td>
</tr>
<tr >
<td align="left" class="tablecontent-odd" >MAYA DWI WIJAYANTI, BY,
NY</td>
<td align="left" class="tablecontent-odd" valign="top">PATRAN 1/5
MANGUNAN KABUH</td>
</tr>
<tr >
<td align="left" class="tablecontent" >MAYA DWI WIJAYANTI, NY</td>
<td align="left" class="tablecontent" valign="top"> PATRAN 1/5
MANGUNAN KABUH</td>
</tr>
<tr >
<td align="left" class="tablecontent-odd" >NOVITA MAGHFIROH, NY</td>
</td>
<td align="left" class="tablecontent-odd" valign="top"> DSN TENGARAN
RT 5/2 PETERONGAN JOMBANG</td>
</tr>
<tr >
<td align="left" class="tablecontent" >OLIVIA ORCHITASARI, NY</td>
<td align="left" class="tablecontent" valign="top"> JANTI RT. 3/4
JOGOROTO</td>
device</td>
</tr>
<tr >
<td align="left" class="tablecontent-odd" >SHINTA LORENZA, BY, NY</td>
</td>
<td align="left" class="tablecontent-odd" valign="top">DSN SOKO KULON
RT 3/1 PACAR PELUK MEGALUH JOMBANG </td>
</tr>
<tr >
<td align="left" class="tablecontent" >M. PANDU PRASTYO, AN</td>
<td align="left" class="tablecontent" valign="top"> DSN. DS.
PUCANGSIMO RT. 2/4 BANDAR KEDUNG MULYO</td>
<td align="left" class="tablecontent-odd" valign="top">G40.9 Epilepsy,
unspecified</td>
</tr>
<tr >
<td align="left" class="tablecontent-odd" >ACASIA FISAR TAVISHA D,
BY</td>
</td>
<td align="left" class="tablecontent-odd" valign="top">PERUM JOMBANG
PERMAI JL JAMBU G 8 RT 9/4 KEPANJEN, JOMBANG </td>
birthweight </td>
preterm infants
</td>
heat therapy</td>
</tr>
<tr >
<td align="left" class="tablecontent" >NOVITA MAGHFIROH, BY, NY</td>
<td align="left" class="tablecontent" valign="top"> DSN TENGARAN RT
5/2 PETERONGAN JOMBANG</td>
</tr>
<tr >
<td align="left" class="tablecontent-odd" >ROSIDATUL ALIYAH, NY</td>
</td>
<td align="left" class="tablecontent-odd" valign="top"> KLAGEN RT. 6/2
KEPUH KEMBENG, PETERONGAN</td>
2021)</td>
</tr>
<tr >
<td align="left" class="tablecontent" >AHMAD ABIDZAR PUTRA P, AN
</td>
<td align="left" class="tablecontent" valign="top"> DSN SANTREN RT
01/03 MEGALUH </td>
</tr>
<tr >
<td align="left" class="tablecontent-odd" >ANNISA MIRZA A, AN</td>
</td>
<td align="left" class="tablecontent-odd" valign="top"> MANCAR
TIMUR RT. 13/1 PETERONGAN</td>
Paksa</td>
Sembuh</td>
</tr>
<tr >
<td align="left" class="tablecontent" >M. FIKRI KHOIRULLOH, AN</td>
<td align="left" class="tablecontent" valign="top"> JL. KENANGA RT.
9/4 KWARON DIWEK</td>
Depletion</td>
</tr>
<tr >
<td align="left" class="tablecontent-odd" >ROSIDATUL ALIYAH, BY,
NY</td>
</td>
<td align="left" class="tablecontent-odd" valign="top"> KLAGEN RT. 6/2
KEPUH KEMBENG, PETERONGAN</td>
</tr>
<tr >
<td align="left" class="tablecontent" >ATHARAZKA MAULANA E F, BY</td>
<td align="left" class="tablecontent" valign="top"> DSN BRUDU RT 4/2
BRUDU SUMOBITO JOMBANG</td>
</tr>
<tr >
<td align="left" class="tablecontent-odd" >OLIVIA ORCHITASARI,BY,
NY</td>
</td>
<td align="left" class="tablecontent-odd" valign="top"> JANTI RT. 3/4
JOGOROTO</td>
</tr>
<tr >
<td align="left" class="tablecontent" >LAVERNA VIANANDRA G, AN </td>
<td align="left" class="tablecontent" valign="top"> JL. IR H. JUANDA
GG.1 NO. 01 RT 7/3 KEPANJEN </td>
</tr>
<tr >
<td align="left" class="tablecontent-odd" >DZAKIANDRA ALTHAF F, AN</td>
</td>
<td align="left" class="tablecontent-odd" valign="top">JL. ANYELIR
PULUNGREJO RT 11/14 TULUNGREJO PARE</td>
<td align="left" class="tablecontent-odd" valign="top">A06.0 Acute
amebic dysentery</td>
<td align="left" class="tablecontent-odd" valign="top">N47 Redundant
prepuce, phimosis, and paraphimosis</td>
Diagnostic ultrasound of abdomen and retroperitoneum | 90.59 Microscopic
examination of blood, other microscopic examination | 99.18 Injection or
infusion of electrolytes</td>
</tr>
<tr >
<td align="left" class="tablecontent" >DANEVAN AZKANANTA A, AN</td>
<td align="left" class="tablecontent" valign="top"> SUKOIBER RT
7/ 4 GUDO</td>
<td align="left" class="tablecontent" >ASURANSI - GAMI (MEDILUM)</td>
tonsillitis, unspecified</td>
<td align="left" class="tablecontent-odd" valign="top">R11 Nausea and
vomiting</td>
</tr>
<tr >
<td align="left" class="tablecontent-odd" >SYAQUILA ADREENATYA, AN</td>
</td>
<td align="left" class="tablecontent-odd" valign="top"> PERUM GREEN
NATURA NO 19 PULO</td>
Depletion</td>
</tr>
<tr >
<td align="left" class="tablecontent" >FERSYANA AYUNINDYA, BY</td>
<td align="left" class="tablecontent" valign="top"> JL. YOS SUDARSO
12 RT5/3 DENANYAR</td>
phototherapy</td>
</tr>
<tr >
<td align="left" class="tablecontent-odd" >SHAKIRA HIFZA K, AN</td>
</td>
<td align="left" class="tablecontent-odd" valign="top"> KADEMANGAN RT
6/2 MOJOAGUNG</td>
fever</td>
</tr>
<tr >
<td align="left" class="tablecontent" >FARAH SALMA RIZQIYAH, BY</td>
<td align="left" class="tablecontent" valign="top"> CATAK GAYAM RT
2/3 MOJOWARNO JOMBANG </td>
phototherapy</td>
</tr>
<tr >
<td align="left" class="tablecontent-odd" >CERITA RAFARDHAN A, BY</td>
</td>
<td align="left" class="tablecontent-odd" valign="top"> JL MAS II RT
2/ 5 PELEM PARE KEDIRI</td>
</tr>
<tr >
<td align="left" class="tablecontent" >MAHIRA KALANDRA, AN</td>
<td align="left" class="tablecontent" valign="top"> PELABUHAN RT 1/ 2
PLANDAAN</td>
</tr>
<tr >
<td align="left" class="tablecontent-odd" >HEMILIA RISKI P, NY</td>
</td>
<td align="left" class="tablecontent-odd" valign="top"> JL MAS II RT
2/ 5 PELEM PARE KEDIRI</td>
2021)</td>
</tr>
<tr >
<td align="left" class="tablecontent" >ENGLINA ROSA A, NY</td>
<td align="left" class="tablecontent" valign="top"> GEDANG RT. 1/5
TAMBAKREJO</td>
device</td>
</tr>
<tr >
<td align="left" class="tablecontent-odd" >LINDA PUSPITTASARI, NY</td>
</td>
<td align="left" class="tablecontent-odd" valign="top"> DSN POJOK
RT.2/2 PLUMBON GAMBANG GUDO</td>
</tr>
<tr >
<td align="left" class="tablecontent" >LAVANYA BRILLIAN A, BY</td>
<td align="left" class="tablecontent" valign="top"> GEDANG RT. 1/5
TAMBAKREJO </td>
preterm infants
</td>
</tr>
<tr >
<td align="left" class="tablecontent-odd" >ETHIS ROMAYA SARI, NY</td>
</td>
<td align="left" class="tablecontent-odd" valign="top"> JL. GUB.
SURYO NO. 13 B RT 03/04 JOMBATAN</td>
</tr>
<tr >
<td align="left" class="tablecontent" >NUR HIDAYATI, NY</td>
<td align="left" class="tablecontent" valign="top"> DSN. DS.BALONG
BESUK RT. 2/4 DIWEK </td>
</tr>
<tr >
<td align="left" class="tablecontent-odd" >ABID PANDU SATRIYA, BY</td>
BULUREJO RT.1/2 DIWEK </td>
phototherapy</td>
</tr>
<tr >
<td align="left" class="tablecontent" >EKA WULANDARI, NY</td>
<td align="left" class="tablecontent" valign="top"> DSN KAPAS RT 2/1
DUKUHKLOPO PETERONGAN JOMBANG </td>
</tr>
<tr >
<td align="left" class="tablecontent-odd" >BRYANT FARZANI, AN</td>
</td>
<td align="left" class="tablecontent-odd" valign="top"> DSN LOSARI
RT 02/01 MEJOYOLOSARI GUDO</td>
</tr>
<tr >
<td align="left" class="tablecontent" >EKA WULANDARI, BY, NY</td>
<td align="left" class="tablecontent" valign="top"> DSN KAPAS RT 2/1
DUKUHKLOPO PETERONGAN JOMBANG</td>
</tr>
<tr >
<td align="left" class="tablecontent-odd" >LINDA PUSPITTASARI, BY,
NY</td>
</td>
<td align="left" class="tablecontent-odd" valign="top">DSN POJOK
RT.2/2 PLUMBON GAMBANG GUDO </td>
</tr>
<tr >
<td align="left" class="tablecontent" >ABQARY AL FATIH P, BY</td>
<td align="left" class="tablecontent" valign="top"> JL. KACILUNG RT
1/1, MOJO DUWUR, MOJOWARNO</td>
</tr>
<tr >
<td align="left" class="tablecontent-odd" >NAYLA ETHA A, BY</td>
</td>
<td align="left" class="tablecontent-odd" valign="top"> JL. GUB.
SURYO NO. 13 B RT 03/04 JOMBATAN</td>
</tr>
<tr >
<td align="left" class="tablecontent" >AKRAM DYLAN A, BY</td>
<td align="left" class="tablecontent" valign="top">DSN. DS.BALONG
BESUK RT. 2/4 DIWEK </td>
</tr>
<tr >
<td align="left" class="tablecontent-odd" >SANTI PUJI S, NY</td>
</td>
<td align="left" class="tablecontent-odd" valign="top"> KARANG
GEBANG RT 6/ 3 MUNUNG KEREP KABUH</td>
</tr>
<tr >
<td align="left" class="tablecontent" >SHANKARA ABRAR ABIMANYU, BY</td>
<td align="left" class="tablecontent" valign="top"> DSN NGOGRI RT.
3/1 MEGALUH</td>
phototherapy</td>
</tr>
<tr >
<td align="left" class="tablecontent-odd" >ZUMROTUL FIRDAUS,NY</td>
</td>
<td align="left" class="tablecontent-odd" valign="top"> DSN PEGANDEN
RT. 14/4 PEGANDEN MANYAR GRSEIK</td>
care for poor fetal growth</td>
device</td>
</tr>
<tr >
<td align="left" class="tablecontent" >KANIA QAIRIN H, AN
</td>
<td align="left" class="tablecontent" valign="top"> DSN KALANGAN RT
2/3 DS JAPANAN GUDO</td>
</tr>
<tr >
<td align="left" class="tablecontent-odd" >KENZO ALFARIZQI P, BY</td>
</td>
<td align="left" class="tablecontent-odd" valign="top">JL. KI. HAJAR
DEWANTARA GG III / 25 RT 03/01 JOMBATAN </td>
</tr>
<tr >
<td align="left" class="tablecontent" >ALGIBRAN RAFA SAMUDRA P, BY</td>
<td align="left" class="tablecontent" valign="top"> 
DSN TEGALSARI RT 3/1 BANJASARI BANDARKEDUNG MULYO</td>
</tr>
<tr >
<td align="left" class="tablecontent-odd" >HAIKAL FATHAN A, BY</td>
</td>
<td align="left" class="tablecontent-odd" valign="top"> DSN PEGANDEN
RT. 14/4 PEGANDEN MANYAR GRSEIK</td>
birthweight </td>
preterm infants |
 P70.4 Other neonatal hypoglycemia | P05.9 Slow fetal growth,
unspecified </td>
heat therapy</td>
</tr>
<tr >
<td align="left" class="tablecontent" >BERTA BUNGA AYRA , AN</td>
<td align="left" class="tablecontent" valign="top"> DSN
BENCAL RT 7/3, PANDANWANGI, DIWEK</td>
</tr>
<tr >
<td align="left" class="tablecontent-odd" >MANGGARANI JOFINA H, BY</td>
</td>
<td align="left" class="tablecontent-odd" valign="top"> DSN GAJAH
01/01 NGORO JOMBANG</td>
</tr>
<tr >
<td align="left" class="tablecontent" >IRADA PUTRI RIZKIA, NY</td>
<td align="left" class="tablecontent" valign="top"> JL. ANGGREK RT
05/11 MOPJOKRAPAK TEMBELANG</td>
</tr>
<tr >
<td align="left" class="tablecontent-odd" >DYLAN ARDHANA P, BY</td>
</td>
<td align="left" class="tablecontent-odd" valign="top"> KARANG GEBANG
RT 6/ 3 MUNUNG KEREP KABUH</td>
</tr>
<tr >
<td align="left" class="tablecontent" >NUR HAMIDAH, BY, NY </td>
<td align="left" class="tablecontent" valign="top"> PP. AL MUHAJIRIN
I BAHRUL ULUM TAMBAK BERAS 
 
</td>
Other low birthweight
</td>
phototherapy</td>
</tr>
<tr >
<td align="left" class="tablecontent-odd" >AHMAD IRHAM BIMASA A,
BY</td>
</td>
<td align="left" class="tablecontent-odd" valign="top"> JL. ANGGREK
RT 05/11 MOPJOKRAPAK TEMBELANG</td>
</tr>
<tr >
<td align="left" class="tablecontent" >M. XAVIER DEWANTORO, AN</td>
<td align="left" class="tablecontent" valign="top"> JL. HAYAM WURUK V
NO. 3 RT 02/09 KEPANJEN</td>
fever</td>
</tr>
<tr >
<td align="left" class="tablecontent-odd" >M. MIRZA BAIHAQI, AN</td>
<td align="left" class="tablecontent-odd" valign="top"> DSN. BENJENG
DS. KEPUH KAJANG RT 1/2 PERAK</td>
</tr>
<tr >
<td align="left" class="tablecontent" >SITI MUHASONAH, NY</td>
<td align="left" class="tablecontent" valign="top"> JL KEMUNING
NO 59 RT 4/ 2 CANDI MULYO JOMBANG</td>
</tr>
<tr >
<td align="left" class="tablecontent-odd" >ANGGI SEPTA M, NY</td>
</td>
<td align="left" class="tablecontent-odd" valign="top"> JL .KH BISRI
SYANSURI NO. 63 RT 7/2</td>
</tr>
<tr >
<td align="left" class="tablecontent" >TRI WULANDARI, NY</td>
<td align="left" class="tablecontent" valign="top"> PAGERWOJO RT 2/
2 PERAK</td>
<td align="left" class="tablecontent-odd" valign="top">O13 Gestational
(pregnancy-induced) hypertension without significa</td>
</tr>
<tr >
<td align="left" class="tablecontent-odd" >ANGGI SEPTA M, BY, NY</td>
</td>
<td align="left" class="tablecontent-odd" valign="top">JL .KH BISRI
SYANSURI NO. 63 RT 7/2</td>
</tr>
<tr >
<td align="left" class="tablecontent" >SARI INDAH W, NY</td>
ASUMTA ASRI BLOK K-15 RT 00/00 NGUMPUL JOGOROTO</td>
<td align="" class="tablecontent" >Aktaruddin Arief Santoso, Sp.PD,
dr</td>
<td align="left" class="tablecontent-odd" valign="top">O98.8 Other
maternal infectious and parasitic diseases complicating </td>
fever</td>
</tr>
<tr >
<td align="left" class="tablecontent-odd" >M. ARFAN ALFAREZEL, BY</td>
</td>
GUYANGAN RT5/3 KEDUNGBETIK KESAMBEN</td>
Depletion</td>
<td align="left" class="tablecontent-odd" valign="top">99.18 Injection
or infusion of electrolytes</td>
</tr>
<tr >
<td align="left" class="tablecontent" >ARSYLA NOURA AZKEEYA, AN </td>
<td align="left" class="tablecontent" valign="top"> DSN SENTUL RT
2/1 TEMBELANG</td>
<td align="left" class="tablecontent" >ASURANSI - PRUDENTIAL</td>
</tr>
<tr >
<td align="left" class="tablecontent-odd" >NADILLA FEBIANI, NY
</td>
</td>
<td align="left" class="tablecontent-odd" valign="top"> PERUM CITRA
CITY RESIDENCE D2 NO. 19 RT 00/00 SIDOARJO</td>
</tr>
<tr >
<td align="left" class="tablecontent" >DINAR AMBAR SARI, NY</td>
<td align="left" class="tablecontent" valign="top">DSN. SAMBONG
SANTREN 6/1 SAMBONG DUKUH JOMBANG</td>
care for poor fetal growth</td>
</tr>
<tr >
<td align="left" class="tablecontent-odd" >RIZKY AMALIA , NY</td>
</td>
<td align="left" class="tablecontent-odd" valign="top"> MOJOJEJER
RT 5/2 MOJOWARNO 
JOMBANG</td>
</tr>
<tr >
<td align="left" class="tablecontent" >RINA SUSANTI, NY</td>
<td align="left" class="tablecontent" valign="top"> MLAGI rt 18/ 6
NGABAN TANGGULANGIN SIDOARJO</td>
device</td>
</tr>
<tr >
<td align="left" class="tablecontent-odd" >NADA FARAH MAULIDA, BY</td>
</td>
<td align="left" class="tablecontent-odd" valign="top"> DSN PAGERWOJO
RT 2/ 2 PERAK </td>
</tr>
<tr >
<td align="left" class="tablecontent" >SITI AWALIYAH, NY</td>
<td align="left" class="tablecontent" valign="top"> GENTENGAN GG.
BUNTU A RT.4/4 PULO LOR</td>
</tr>
<tr >
<td align="left" class="tablecontent-odd" >DINAR AMBAR SARI, BY,
NY</td>
</td>
<td align="left" class="tablecontent-odd" valign="top"> DSN. SAMBONG
SANTREN 6/1 SAMBONG DUKUH JOMBANG</td>
birthweight </td>
preterm infants |
 P05.9 Slow fetal growth, unspecified
</td>
heat therapy</td>
</tr>
<tr >
<td align="left" class="tablecontent" >AL ZAFRAN NATAPRAWIRA, AN</td>
<td align="left" class="tablecontent" valign="top"> DSN. GONGSENG
RT 2/4 MEGALUH </td>
</tr>
<tr >
<td align="left" class="tablecontent-odd" >SALWA AISYAH A, BY</td>
</td>
<td align="left" class="tablecontent-odd" valign="top"> DSN MLAGI RT
18/ 6 NGABAN TANGGULANGIN SIDOARJO</td>
</tr>
<tr >
<td align="left" class="tablecontent" >KALANDRA PUTRA T, AN</td>
<td align="left" class="tablecontent" valign="top">JL. KERTARAJASA 11
RT 04/01</td>
PT</td>
laryngitis</td>
</tr>
<tr >
<td align="left" class="tablecontent-odd" >SHEENA AUFA SYAKIRA, BY</td>
</td>
<td align="left" class="tablecontent-odd" valign="top"> MOJOJEJER RT
5/2 MOJOWARNO JOMBANG</td>
</tr>
<tr >
<td align="left" class="tablecontent" >SITI AWALIYAH, BY, NY</td>
<td align="left" class="tablecontent" valign="top"> GENTENGAN GG.
BUNTU A RT.4/4 PULO LOR</td>
</tr>
<tr >
<td align="left" class="tablecontent-odd" >NADILLA FEBIANI, BY, NY
</td>
</td>
<td align="left" class="tablecontent-odd" valign="top"> PERUM CITRA
CITY RESIDENCE D2 NO. 19 RT 00/00 SIDOARJO </td>
</tr>
<tr >
<td align="left" class="tablecontent" >CINTA AINUMI ALMAY, AN</td>
<td align="left" class="tablecontent" valign="top"> DSN. TUNGGUL II
RT 2/7 TUNGGORONO</td>
Depletion</td>
</tr>
<tr >
<td align="left" class="tablecontent-odd" >M. RAJENDRA D P S, AN</td>
</td>
PUCANGSIMO RT 2/ 7 BANDAR KEDUNG MULYO</td>
<td align="left" class="tablecontent-odd" >ASURANSI - PRUDENTIAL</td>
convulsions</td>
</tr>
<tr >
<td align="left" class="tablecontent" >ZAIN AHSAN AL KARIM, AN</td>
<td align="left" class="tablecontent" valign="top"> MOJOSONGO RT
4/07</td>
PT</td>
</tr>
<tr >
<td align="left" class="tablecontent-odd" >SALSABILA ADIVA, AN</td>
<td align="left" class="tablecontent-odd" valign="top"> SONGO RT. 7/4
SONGOWARENG BLULUK LAMONGAN </td>
fever</td>
</tr>
<tr >
<td align="left" class="tablecontent" >M. ROZIQ W, AN</td>
<td align="left" class="tablecontent" valign="top"> DSN. PULOREJO RT
1/1 PULOREJO NGORO </td>
</tr>
<tr >
<td align="left" class="tablecontent-odd" >ELTIE SETIOWATI, NY</td>
</td>
KEDUNGGLAGAH 2/5 KEDUNGDOWO PLOSO</td>
<td align="left" class="tablecontent-odd" valign="top">O47.0 False
labor before 37 completed weeks of gestation</td>
</tr>
<tr >
<td align="left" class="tablecontent" >EARLYTA ARSYFA ELSABILA, AN</td>
<td align="left" class="tablecontent" valign="top"> DSN TUNGGUL II RT
1/7 TUNGGORONO</td>
convulsions</td>
</tr>
<tr >
<td align="left" class="tablecontent-odd" >CHRISTABEL MANUELLA HERTA,
AN</td>
</td>
<td align="left" class="tablecontent-odd" valign="top"> JL. MADURA
NO. 30 RT 02/08 JOMBATAN</td>
</tr>
<tr >
<td align="left" class="tablecontent" >YANTI, NY</td>
<td align="left" class="tablecontent" valign="top"> NGEMPLAK RT.14/4
TONDOWULAN PLANDAAN</td>
</tr>
<tr >
<td align="left" class="tablecontent-odd" >ARUM TANJUNG, M, NY</td>
</td>
<td align="left" class="tablecontent-odd" valign="top"> JL. TERATAI
1 NO 30 2/7 CANDIMULYO JOMBANG</td>
<td align="" class="tablecontent-odd" >Suparmin, SpOG, dr</td>
</tr>
<tr >
<td align="left" class="tablecontent" >FAUZIA ZAHROTUL, M, AN</td>
<td align="left" class="tablecontent" valign="top"> DSN. MLATEN RT
3/2 GADING MANGU PERAK</td>
Depletion</td>
</tr>
<tr >
<td align="" class="tablecontent-odd" ></td>
</tr>
</table>
</td>
</tr>
</table>

Patient Disease Index Card of Hospitalized Patients

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