BUKU CATATAN PASIEN

BULAN : Januari
TAHUN : 2022
PEKERJAAN KEFARMASIAN
PELAYANAN FARMASI KLINIS
DISPENSING
TGL NO NAMA NO.CM
membuat rincian membuat rincian pemakaian
pemakaian obat/dosis obat/biaya

1 SOEBIYONO BA, Tn 703599 √ √

2 MA'RUF, Tn 656631 √ √
3 MAFTUCHIN, Tn 721227 √ √
4 ENI IRIANINGSIH, Ny 760778 √ √
5 SUTOYO, Tn 632084 √ √
6 ABDUL KHANDIR, Tn 761141 √ √
7 ZENI IDA ROSIDA, Ny 724368 √ √
8 MUKHORINI 708479 √ √
9 AMIENTARTO, Tn 762034 √ √
10 ELY FATMAWATI 761165 √ √
11 AHMAD KHANIF, Tn 761163 √ √
12 ELY BUDIYONO, Tn 761092 √ √
13 ANIM SETIYO NINGSIH BY NY 761152 √ √
14 MENIK RESTUNI, Ny 634771 √ √
15 NUFITA SARI BY NY 761164 √ √
16 KUMAIDI, Tn 672118 √ √
17 SUGIYANTI, Ny 757339 √ √
18 WINARNI, Ny 761158 √ √
19 KUSRIYANAH BY NY 761085 √ √
20 IDA FARIDA BY NY 761162 √ √
21 BAMBANG HARIYANTO 761143 √ √
22 SUGIYANTI, Ny 757339 √ √
23 MUHAMMAD IRFANUDIN, An 761047 √ √
24 MUHAMAD GIBRAN HAIDAR 757496 √ √
25 SUGIYANTI, Ny 757339 √ √
26 AMRINA ROSYADAA, An 761046 √ √
27 AHMAD ROJAB 760872 √ √
28 KUNIYARTI BY NY 761117 √ √
29 SRI HADI NUGROHO, Tn 761004 √ √
30 RAHAYU WINURSITA 762073 √ √
31 SRI YANA 759592 √ √
32 SUTIAH, Ny 761037 √ √
33 KUNDONO 757443 √ √
34 SRI YANA 759592 √ √
35 LISTA OKTAVIANA NINGRUM, An 604760 √ √
36 MAHMOUD ATIEH ABDALLAH, Tn 761044 √ √
37 CINDY NURVIANTI, An 720781 √ √
38 DESY WULANDARI 761170 √ √
39 YAQDHAN RAKHA ASSAID 638950 √ √
40 CHELSEA DANISH ISWAHYUDI 550469 √ √
41 NUR INAYATUN NADHIFAH 762058 √ √
42 RUMINAH, Ny 762051 √ √
43 EFA TRISNAWATI, Ny 762141 √ √
44 MUTAKHOYYAROH 761172 √ √
45 DESY WULANDARI BY NY 761191 √ √
46 MUHAMMAD RIFA'I, Tn 762017 √ √
47 MUHAMMAD THOIF 760815 √ √
48 MARTONO, Tn 761022 √ √
49 KHOIROTUL INAYAH, Ny 758993 √ √
50 MARIA ULFA, Ny 636474 √ √
51 SULICHAH, Ny 761115 √ √
52 KUNDORI, Tn 701128 √ √
53 NUR HIDAYAH, Nn 760839 √ √
54 AHMAD RAFI'I 753087 √ √
55 MAYA LAILATUL K BY NY 757240 √ √
56 FUNNY YULIANA, Nn 761123 √ √
57 BAMBANG NURYANTO 761160 √ √
58 MUSTARIKHAH, Ny 602612 √ √
59 ELY BUDIYONO, Tn 761092 √ √
60 SITI FARIDA, Ny 723651 √ √
61 ABDUL AZIS 760824 √ √
62 WIWIN PUJIATI, Ny 762147 √ √
63 ERRI ASMAWANTI, Ny 759814 √ √
64 DESY WULANDARI BY NY 761191 √ √
65 DESY WULANDARI 761170 √ √
66 ABDUL KHANDIR, Tn 761141 √ √
67 KHUMAIYAH 762142 √ √
68 ERRI ASMAWANTI, Ny 759814 √ √
69 MENIK RESTUNI, Ny 634771 √ √
70 DEWI ISTIANI, Ny 666012 √ √
71 KUSRIYANAH BY NY 761085 √ √
72 MUTAKHOYYAROH BY NY 761185 √ √
73 EFA TRISNAWATI, Ny 762141 √ √
74 IDA ERYANI 744066 √ √
75 ULIN NUR HAYATI 571773 √ √
76 AMALIYAH ZULFA, Ny 672034 √ √
77 NUFITA SARI 761156 √ √
78 IDA FARIDA, Ny 761154 √ √
79 ROHMATUL BADRIYAH 529956 √ √
80 ROHMATUL BADRIYAH 529956 √ √
81 LENI MASLIKHAH, Ny 672858 √ √
82 KHOIROTUL INAYAH, Ny 758993 √ √
83 ROHMATUL BADRIYAH 529956 √ √
84 JUMIYANTO, Tn 739616 √ √
85 EFA TRISNAWATI, Ny 762141 √ √
86 MAHMOUD ATIEH ABDALLAH, Tn 761044 √ √
87 ROHMATUL BADRIYAH BY NY 761196 √ √
88 NUR INAYATUN NADHIFAH 762058 √ √
89 WIWIN PUJIATI, Ny 762147 √ √
90 M AKHMAL WAFI ALMINAN, An 761199 √ √
91 SUGIYANTI, Ny 757339 √ √
92 RAHAYU WINURSITA 762073 √ √
93 MR X (CIPTO) , Tn 761128 √ √
94 ROSY NATALIA, Nn 762014 √ √
95 SUMIYATI, Ny 714178 √ √
96 HERMAN JUSUF, Tn 761099 √ √
97 NUR HIDAYAH, Nn 760839 √ √
98 SULICHAH, Ny 761115 √ √
99 MUHAMMAD RIFA'I, Tn 762017 √ √
100 MUHAMMAD THOIF 760815 √ √
101 ZANETTA MUTIARA AZZAHRA, An 761133 √ √
102 HERMAN JUSUF, Tn 761099 √ √
103 MUKHORINI 708479 √ √
104 KHUMAIYAH 762142 √ √
105 HERMAN JUSUF, Tn 761099 √ √
106 MUKHORINI 708479 √ √
107 SUMIYATI, Ny 714178 √ √
108 RANGGA BIMA 761060 √ √
109 MUHAMMAD THOIF 760815 √ √
110 MARTONO, Tn 761022 √ √
111 MARTONO, Tn 761022 √ √
112 RAHAYU WINURSITA 762073 √ √
113 DESY WULANDARI BY NY 761191 √ √
114 HESTI NOVIYANTI, Ny 762061 √ √
115 REPON, Tn 761189 √ √
116 ABDUL AZIS 760824 √ √
117 MUHAMMAD RIFA'I, Tn 762017 √ √
118 SOEBIYONO BA, Tn 703599 √ √
119 SUPARJO, Tn 756887 √ √
120 YULIANTO, Tn 718872 √ √
121 MAFTUCHIN, Tn 721227 √ √
122 SITI IQDATUL AZIZAH 758802 √ √
123 MUHAMMAD ALFIN AZKA SAPUTRA 651027 √ √
124 AHMAD ROJAB 760872 √ √
125 SUTIKAH, Ny 757495 √ √
126 MARIA ULFA, Ny 636474 √ √
127 DESY WULANDARI 761170 √ √
Mengetahui Pelapor
Ka. Instalasi farmasi RSUD RA KARTINI

Sandi Purbaningsih,Msc.Apt Rulita Noor Syafira, A.Md.

NIP. 19770803 200401 2 001 NIP. 19940907 202012 2 003
 BUKU CATATAN PASIEN
BULAN : Februari
TAHUN : 2022
PEKERJAAN KEFARMASIAN
PELAYANAN FARMASI KLINIS
TGL NO NAMA NO.CM DISPENSING
membuat rincian
membuat rincian
pemakaian
pemakaian obat/dosis obat/biaya

1 ULIN NIKMAH 624994 √ √

2 MARIYAH, Ny 573588 √ √
3 SUTOYO, Tn 700333 √ √
4 AHMAD ROJAB 632084 √ √
5 JUMIYANTO, Tn 760872 √ √
6 ANITA, Ny 739616 √ √
7 MUKHORINI 760821 √ √
8 REPON, Tn 708479 √ √
9 ELY BUDIYONO, Tn 761189 √ √
10 RUMINAH, Ny 761092 √ √
11 MUKHORINI 762051 √ √
12 MENIK RESTUNI, Ny 708479 √ √
13 SHOLIKUL HADI 634771 √ √
14 AHMAD FAIKAR ALI SYARI'ATI, Tn 757198 √ √
15 ELY BUDIYONO, Tn 623544 √ √
16 BAMBANG HARIYANTO 761092 √ √
17 TASMI 761143 √ √
18 BAMBANG HARIYANTO 710368 √ √
19 LATIFAH, Ny 761143 √ √
20 KIMAH, Ny 718582 √ √
21 AHMAD KHANIF, Tn 757483 √ √
22 AMIENTARTO, Tn 761163 √ √
23 NUR HIDAYAH, Nn 762034 √ √
24 ZENI IDA ROSIDA, Ny 760839 √ √
25 WINARNI, Ny 724368 √ √
26 SITI MARIFAH, Ny 761158 √ √
27 SUGIYANTI, Ny 760646 √ √
28 AHMAD KHANIF, Tn 757339 √ √
29 SITI ZUMAROH , Ny 761163 √ √
30 MAHMOUD ATIEH ABDALLAH, Tn 761120 √ √
31 IDA FARIDA, Ny 761044 √ √
32 AMALIYAH ZULFA, Ny 761154 √ √
33 KUNDONO 672034 √ √
34 SUTIAH, Ny 757443 √ √
35 NUFITA SARI 761037 √ √
36 FUNNY YULIANA, Nn 761156 √ √
37 SRI HADI NUGROHO, Tn 761123 √ √
38 SRI YANA 761004 √ √
39 MATHORI, Tn 759592 √ √
40 AHMAD FAIKAR ALI SYARI'ATI, Tn 529469 √ √
41 MUHAMAD GIBRAN HAIDAR 623544 √ √
42 MUSTARIKHAH, Ny 757496 √ √
43 PARSO 602612 √ √
44 ANIM SETIYO NINGSIH BY NY 757429 √ √
45 NUR HIDAYAH, Nn 761152 √ √
46 KADARSO, Tn 760839 √ √
47 FILDAZ RAEDITYA GANDARSURYA 761187 √ √
48 SULKAN, Tn 760788 √ √
49 ENI IRIANINGSIH, Ny 527539 √ √
50 SAIRI, Tn 760778 √ √
51 IDA FARIDA BY NY 761188 √ √
52 IDA FARIDA BY NY 761162 √ √
53 SUMADI, Tn 761162 √ √
54 SUKAMTO 702080 √ √
55 AHMAD NAFI' 761194 √ √
56 SRI YANA 707373 √ √
57 ZENI IDA ROSIDA, Ny 759592 √ √
58 KUNIYARTI BY NY 724368 √ √
59 KUNDORI, Tn 761117 √ √
60 NUFITA SARI BY NY 701128 √ √
61 NUR INAYATUN NADHIFAH 761164 √ √
62 MUHAMMAD FATKHUL IMAM 762058 √ √
63 KUSRIYANAH BY NY 757067 √ √
64 MAYA LAILATUL K BY NY 761085 √ √
65 AHMAD RAFI'I 757240 √ √
66 MUHAMMAD IRFANUDIN, An 753087 √ √
67 SAFA' AT, Tn 761047 √ √
68 ARIFIN , Tn 706686 √ √
69 MA'RUF, Tn 713844 √ √
70 JUMIYANTO, Tn 656631 √ √
71 MUHAMMAD ALFIN AZKA SAPUTRA 739616 √ √
72 TUMISIH, Ny 651027 √ √
73 ZAINUR ROKHMAN, Tn 501688 √ √
74 ZAINUR ROKHMAN, Tn 757302 √ √
75 SUDAR, Tn 757302 √ √
76 MUTAKHOYYAROH BY NY 761153 √ √
77 ABDUL KHANDIR, Tn 761185 √ √
78 TYAS MUKTI, Ny 761141 √ √
79 ANITA NUR INDAHSARI 760666 √ √
80 BAMBANG HARIYANTO 546542 √ √
81 ABDUL KHANDIR, Tn 761143 √ √
82 ABDUL KHANDIR, Tn 761141 √ √
83 MENIK RESTUNI, Ny 761141 √ √
84 SIFINA NUROHMAH, Ny 634771 √ √
85 AKHAD 753145 √ √
86 MUHAMMAD ALFIN AZKA SAPUTRA 760837 √ √
87 TYAS MUKTI, Ny 651027 √ √
88 SRI WAHYUNI, Ny 760666 √ √
89 SUNARYO, Tn 718309 √ √
90 KHUMAIYAH 533436 √ √
91 KHUMAIYAH BY NY 762142 √ √
92 SRI YANA 761211 √ √
93 MARIA ULFA, Ny 759592 √ √
94 IDA ERYANI 636474 √ √
95 SUDAR, Tn 744066 √ √
96 LISTA OKTAVIANA NINGRUM, An 761153 √ √
97 WALGITO 604760 √ √
98 KUNDORI, Tn 757432 √ √
99 IDA ERYANI 701128 √ √
100 ULYA SABIELA 744066 √ √
101 WARTINI 762179 √ √
102 WARTINI 761195 √ √
103 SUTOYO, Tn 761195 √ √
104 AMRINA ROSYADAA, An 632084 √ √
105 HENI WATI, NY 761046 √ √
106 CINDY NURVIANTI, An 761186 √ √
107 CHELSEA DANISH ISWAHYUDI 720781 √ √
108 YAQDHAN RAKHA ASSAID 550469 √ √
109 RUMINAH, Ny 638950 √ √
110 MUKHORINI 762051 √ √
111 FATHURROHIM YUSUF, Tn 708479 √ √
112 SAIRI, Tn 762135 √ √
113 SULICHAH, Ny 761188 √ √
114 HERMAN JUSUF, Tn 761115 √ √

Mengetahui Pelapor
Ka. Instalasi farmasi RSUD RA KARTINI

Sandi Purbaningsih,Msc.Apt Rulita Noor Syafira, A.Md.

NIP. 19770803 200401 2 001 NIP. 19940907 202012 2 003
 BUKU CATATAN PASIEN
BULAN : Maret
TAHUN : 2022
PEKERJAAN KEFARMASIAN
PELAYANAN FARMASI KLINIS
DISPENSING
TGL NO NAMA NO.CM
membuat rincian
pemakaian membuat rincian
obat/dosis pemakaian obat/biaya

1 BAMBANG NURYANTO 761160 √ √

2 NIKMATUN, Ny 761208 √ √
3 IDA ERYANI 744066 √ √
4 SHOLIKUL HADI 757198 √ √
5 MUKHORINI 708479 √ √
6 DEWI ISTIANI, Ny 666012 √ √
7 SAFA' AT, Tn 706686 √ √
8 MUHAMMAD FATKHUL IMAM 757067 √ √
9 MAFTAHATIN NOOR, Ny 762173 √ √
10 WARTINI 761195 √ √
11 MUSTARIKHAH, Ny 602612 √ √
12 FUNNY YULIANA, Nn 761123 √ √
13 ROHMATUL BADRIYAH 529956 √ √
14 DWI ELAWATI, Ny 754574 √ √
15 NADIRA AZMINA, An 761228 √ √
16 RATNA MAHARANI RIYANTO, Nn 576774 √ √
17 EFA TRISNAWATI, Ny 762141 √ √
18 DESY WULANDARI BY NY 761191 √ √
19 KHUMAIYAH 762142 √ √
20 DWI ELAWATI, Ny 754574 √ √
21 MAFTAHATIN NOOR, Ny 762173 √ √
22 AMIENTARTO, Tn 762034 √ √
23 IBNU UTOYO 760774 √ √
24 GISELA BUNGA PITALOKA 761239 √ √
25 GISELA BUNGA PITALOKA 761239 √ √
26 ANGGRAENI MELA ROSITA by Ny 761242 √ √
27 YUNITA PROLISYA BY NY 761240 √ √
28 SOLICHATIN BY NY 761241 √ √
29 YUNITA PROLISYA 761207 √ √
30 ANGGRAENI MELA ROSITA, Ny 761237 √ √
31 GISELA BUNGA PITALOKA 761239 √ √
32 AGUNG NUR AINI, Tn 761233 √ √
33 MUHAMMAD RIFA'I, Tn 762017 √ √
34 NUR MAJID 651350 √ √
35 GISELA BUNGA PITALOKA 761239 √ √
36 SUPARJO, Tn 756887 √ √
37 PARSO 757429 √ √
38 HERMAN JUSUF, Tn 761099 √ √
39 AHMAD NAFI' 707373 √ √
40 FIKI NUR ISHMAH, Nn 624994 √ √
41 SUTOYO, Tn 632084 √ √
42 MUHAMMAD ALFIN AZKA SAPUTRA 651027 √ √
43 MARIA ULFA, Ny 636474 √ √
44 CINDY NURVIANTI, An 720781 √ √
45 MUHAMMAD ALFIN AZKA SAPUTRA 651027 √ √
46 ROHMATUL BADRIYAH 529956 √ √
47 EFA TRISNAWATI, Ny 762141 √ √
48 AHMAD ROJAB 760872 √ √
49 NUR INAYATUN NADHIFAH 762058 √ √
50 AHMAD KHANIF, Tn 761163 √ √
51 BAMBANG HARIYANTO 761143 √ √
52 AMIENTARTO, Tn 762034 √ √
53 NUR HIDAYAH, Nn 760839 √ √
54 IBNU UTOYO 760774 √ √
55 TASMI 710368 √ √
56 RATNA MAHARANI RIYANTO, Nn 576774 √ √
57 NIKMATUN, Ny 761208 √ √
58 ZAHROTUS SORAYA, Nn 761238 √ √
59 SUPARJO, Tn 756887 √ √
60 MUHAMMAD RIFA'I, Tn 762017 √ √
61 SRI YANA 759592 √ √
62 AHMAD FAIKAR ALI SYARI'ATI, Tn 623544 √ √
63 GISELA BUNGA PITALOKA 761239 √ √
64 SOLICHATIN 535952 √ √
65 ELY BUDIYONO, Tn 761092 √ √
66 AMRINA ROSYADAA, An 761046 √ √
67 AMIENTARTO, Tn 762034 √ √
68 PRIYAGUNG , Tn 710985 √ √
69 SRI HADI NUGROHO, Tn 761004 √ √
70 MUSTARIKHAH, Ny 602612 √ √
71 FUNNY YULIANA, Nn 761123 √ √
72 KIMAH, Ny 757483 √ √
73 SUMIYATI, Ny 714178 √ √
74 KUNIYARTI BY NY 761117 √ √
75 MUHAMMAD IRFANUDIN, An 761047 √ √
76 ARIESTA PRADINI KURNIA PUTRI DEWI BY NY 761224 √ √
 77 KUSRIYANAH BY NY 761085 √ √
78 ANIM SETIYO NINGSIH BY NY 761152 √ √
79 IDA FARIDA BY NY 761162 √ √
80 MUTAKHOYYAROH BY NY 761185 √ √
81 NUFITA SARI BY NY 761164 √ √
82 MAFTUCHIN, Tn 721227 √ √
83 KHOIROTUL INAYAH, Ny 758993 √ √
84 IDA ERYANI 744066 √ √
85 IDA ERYANI 744066 √ √
86 GISELA BUNGA PITALOKA 761239 √ √
87 TASMADI 761222 √ √
88 IDA ERYANI 744066 √ √
89 ERRI ASMAWANTI, Ny 759814 √ √
90 WALGITO 757432 √ √
91 MUHAMMAD ALI SUKRON, Tn 757334 √ √
92 JAMIL, Tn 761235 √ √
93 FATHURROHIM YUSUF, Tn 762135 √ √
94 HANDAYANI, Ny 757444 √ √
95 ZENI IDA ROSIDA, Ny 724368 √ √
96 AMALIYAH ZULFA, Ny 672034 √ √
97 KHUMAIYAH BY NY 761211 √ √
98 JAMILATIN NADHIFAH, Ny 511501 √ √
99 MUTAKHOYYAROH 761172 √ √
100 MUKHLAS ANWAR, Tn 566813 √ √
101 MAFTAHATIN NOOR, Ny 762173 √ √
102 HANDAYANI, Ny 757444 √ √
103 RIKA SUSILANDARI, Ny 760825 √ √
104 KHUMAIYAH 762142 √ √
105 AHMAD JUNAIDI, Tn 723528 √ √
106 WIWIN PUJIATI, Ny 762147 √ √
107 NADIRA AZMINA, An 761228 √ √
108 MA'RUF, Tn 656631 √ √
109 RUSIKAH, Ny 761219 √ √
110 SUNARYO, Tn 533436 √ √
111 WARTINI 761195 √ √
112 WARTINI 761195 √ √
113 SUDAR, Tn 761153 √ √
114 ABDUL KHANDIR, Tn 761141 √ √
115 TASMADI 761222 √ √
116 SULKAN, Tn 527539 √ √
117 SAIRI, Tn 761188 √ √
118 RUSIKAH, Ny 761219 √ √
119 SAIRI, Tn 761188 √ √
120 RUMINAH, Ny 762051 √ √
121 KADARSO, Tn 761187 √ √
122 KUNDORI, Tn 701128 √ √
123 SHOLIKUL HADI 757198 √ √
124 RUSIKAH, Ny 761219 √ √
125 MUKHORINI 708479 √ √
126 MUKHORINI 708479 √ √
127 SRI YANA 759592 √ √
128 MAHMOUD ATIEH ABDALLAH, Tn 761044 √ √
129 MAHMOUD ATIEH ABDALLAH, Tn 761044 √ √

Mengetahui Pelapor
Ka. Instalasi farmasi RSUD RA KARTINI

Sandi Purbaningsih,Msc.Apt Rulita Noor Syafira, A.Md.

NIP. 19770803 200401 2 001 NIP. 19940907 202012 2 003
 BUKU CATATAN PASIEN
BULAN : April
TAHUN : 2022
PEKERJAAN KEFARMASIAN
PELAYANAN FARMASI KLINIS
DISPENSING
TGL NO NAMA NO.CM
membuat rincian
pemakaian membuat rincian pemakaian
obat/dosis obat/biaya

1 IDA ERYANI 744066 √ √

2 KUSYATI 757405 √ √
3 SUGIYANTI, Ny 757339 √ √
4 SUGIYANTI, Ny 757339 √ √
5 KUNDONO 757443 √ √
6 WINARNI, Ny 761158 √ √
7 SUTIAH, Ny 761037 √ √
8 ULYA SABIELA 762179 √ √
9 JAMIL, Tn 761235 √ √
10 SRI DEWI, Ny 761139 √ √
11 KHOIRUL UMAM 761887 √ √
12 RUSIKAH, Ny 761219 √ √
13 LATIFAH, Ny 718582 √ √
14 SISWANTO, Tn 761231 √ √
15 BAMBANG HARIYANTO 761143 √ √
16 KUMAIDI, Tn 672118 √ √
17 M. YUSUF EFENDI 760705 √ √
18 AHMAD KHANIF, Tn 761163 √ √
19 YAQDHAN RAKHA ASSAID 638950 √ √
20 MUHAMMAD NAUVAL ALI 737445 √ √
21 SYAQIL ALYUSUF HIDAYAT, By 761234 √ √
22 LISTA OKTAVIANA NINGRUM, An 604760 √ √
23 MUHAMMAD ANDI ARDIANSYAH 709934 √ √
24 SELVI DEWI LESTARI 762189 √ √
25 ABDUL KHANDIR, Tn 761141 √ √
26 GISELA BUNGA PITALOKA 761239 √ √
27 ABDUL KHANDIR, Tn 761141 √ √
28 GISELA BUNGA PITALOKA 761239 √ √
29 SITI HADIJAH , Ny 557402 √ √
30 SUKAMTO 761194 √ √
31 DEWI ISTIANI, Ny 666012 √ √
32 GISELA BUNGA PITALOKA 761239 √ √
33 DEWI ISTIANI, Ny 666012 √ √
34 ANGGRAENI MELA ROSITA, Ny 761237 √ √
35 SRI WAHYUNI, Ny 718309 √ √
36 YAYUK SETYOWATI 569724 √ √
37 SITI BAEDAH, Ny 757697 √ √
38 SRI WAHYUNI BY NY 761252 √ √
39 TUMISIH, Ny 501688 √ √
40 DEWI SARTIKA 762029 √ √
41 KHAMIATUROHMAH 761221 √ √
42 LENI MASLIKHAH, Ny 672858 √ √
43 SHOLIKUL HADI 757198 √ √
44 AHMAD EDI SISWANTO 761225 √ √
45 MUKHORINI 708479 √ √
46 ZULAECHAH, Ny 761244 √ √
47 SULICHAH, Ny 761115 √ √
48 SUMADI, Tn 702080 √ √
49 KHUNDORI, Tn 627822 √ √
50 GISELA BUNGA PITALOKA 761239 √ √
51 SAIRI, Tn 761188 √ √
52 KUNDORI, Tn 701128 √ √
53 AGUNG NUR AINI, Tn 761233 √ √
54 SUMINI, Ny 761254 √ √
55 AHMAD EDI SISWANTO 761225 √ √
56 FUNNY YULIANA, Nn 761123 √ √
57 MUSTARIKHAH, Ny 602612 √ √
58 RIKA SUSILANDARI, Ny 760825 √ √
59 LENI MASLIKHAH BY NY 761171 √ √
60 NUR INAYATUN NADHIFAH 762058 √ √
61 SRI WAHYUNI BY NY 761252 √ √
62 SEFTIANA CAHYANINGRUM, Ny 761253 √ √
63 SITI BAEDAH, Ny 757697 √ √
64 YAYUK SETYOWATI 569724 √ √
65 DEWI SARTIKA 762029 √ √
66 NURUL MISKIYAH, Ny 761245 √ √
67 KADARSO, Tn 761187 √ √
68 SUMIATUN, Ny 761243 √ √
69 SAIRI, Tn 761188 √ √
70 SUTIAH, Ny 761037 √ √
71 ULYA SABIELA 762179 √ √
72 M. YUSUF EFENDI 760705 √ √
73 SELVI DEWI LESTARI 762189 √ √
74 SUMINI, Ny 761254 √ √
75 SRI SUMIYATUN, Ny 761251 √ √
76 LISTA OKTAVIANA NINGRUM, An 604760 √ √
 77 KUSRIYANAH BY NY 761085 √ √
78 KUMAIDI, Tn 672118 √ √
79 SOLICHATIN 535952 √ √
80 AHMAD FAIKAR ALI SYARI'ATI, Tn 623544 √ √
81 GISELA BUNGA PITALOKA 761239 √ √
82 SRIYATUN, Ny 761248 √ √
83 KHAMIATUROHMAH 761221 √ √
84 TUMISIH, Ny 501688 √ √
85 BAMBANG HARIYANTO 761143 √ √
86 SITI HADIJAH , Ny 557402 √ √
87 NURUL MISKIYAH, Ny 761245 √ √
88 NURUL MISKIYAH, Ny 761245 √ √
89 NURUL MISKIYAH, Ny 761245 √ √
90 NURUL MISKIYAH BY NY 761263 √ √
91 NURUL MISKIYAH, Ny 761245 √ √
92 MAHMOUD ATIEH ABDALLAH, Tn 761044 √ √
93 ULYA SABIELA 762179 √ √
94 KHOIRUL UMAM 761887 √ √
95 FATHURROHIM YUSUF, Tn 762135 √ √
96 JAMIL, Tn 761235 √ √
97 SRIYATUN, Ny 761248 √ √
98 KHAMIATUROHMAH 761221 √ √
99 ZULIANTO, Tn 761261 √ √
100 NOR KAMID 539316 √ √
101 TUMISIH, Ny 501688 √ √
102 GISELA BUNGA PITALOKA 761239 √ √
103 BAMBANG HARIYANTO 761143 √ √
104 AHMAD KHANIF, Tn 761163 √ √
105 SHOLIKUL HADI 757198 √ √
106 MUKHORINI 708479 √ √
107 NUR MAJID 651350 √ √
108 HERMAN JUSUF, Tn 761099 √ √
109 TATIK SUMIATI, Ny 706262 √ √
110 ZENI IDA ROSIDA, Ny 724368 √ √
111 ZENI IDA ROSIDA, Ny 724368 √ √
112 AHMAD ROJAB 760872 √ √
113 M. YUSUF EFENDI 760705 √ √
114 SUMIATUN, Ny 761243 √ √
115 EFA TRISNAWATI, Ny 762141 √ √
116 SEFTIANA CAHYANINGRUM, Ny 761253 √ √
117 JUNAIDI TN 761277 √ √
118 AMALIYAH ZULFA, Ny 672034 √ √
119 FIKI NUR ISHMAH, Nn 624994 √ √
120 SUDAR, Tn 761153 √ √

Mengetahui Pelapor
Ka. Instalasi farmasi RSUD RA KARTINI

Sandi Purbaningsih,Msc.Apt Rulita Noor Syafira, A.Md.

NIP. 19770803 200401 2 001 NIP. 19940907 202012 2 003
 BUKU CATATAN PASIEN
BULAN : Mei
TAHUN : 2022
PEKERJAAN KEFARMASIAN
PELAYANAN FARMASI KLINIS
TGL NO NAMA NO.CM DISPENSING
membuat rincian membuat rincian
pemakaian pemakaian
obat/dosis obat/biaya

1 SUPARJO, Tn 756887 √ √
2 SUNARYO, Tn 533436 √ √
3 FIKI NUR ISHMAH, Nn 624994 √ √
4 SRI SUMIYATUN, Ny 761251 √ √
5 TASMI 710368 √ √
6 SUMADI, Tn 702080 √ √
7 SAIRI, Tn 761188 √ √
8 ELY BUDIYONO, Tn 761092 √ √
9 AHMAD FAIKAR ALI SYARI'ATI, Tn 623544 √ √
10 SOLICHATIN 535952 √ √
11 SRI SUMIYATUN, Ny 761251 √ √
12 SRI SUMIYATUN, Ny 761251 √ √
13 ANIM SETIYO NINGSIH BY NY 761152 √ √
14 MUTAKHOYYAROH BY NY 761185 √ √
15 NUFITA SARI BY NY 761164 √ √
16 KUNIYARTI BY NY 761117 √ √
17 MUHAMMAD IRFANUDIN, An 761047 √ √
18 SRI HADI NUGROHO, Tn 761004 √ √
19 NADIRA AZMINA, An 761228 √ √
20 MUHAMMAD IRFANUDIN, An 761047 √ √
21 MUSTARIKHAH, Ny 602612 √ √
22 KUSRIYANAH BY NY 761085 √ √
23 IDA FARIDA BY NY 761162 √ √
24 FUNNY YULIANA, Nn 761123 √ √
25 KUNDONO 757443 √ √
26 MUSTARIKHAH, Ny 602612 √ √
27 SUTIAH, Ny 761037 √ √
28 FUNNY YULIANA, Nn 761123 √ √
29 NIKMATUN, Ny 761208 √ √
30 SUPRIYATI NY 761088 √ √
31 SUMINI, Ny 761254 √ √
32 SELLA FAJRI ISLAMI 576800 √ √
33 SITI HADIJAH , Ny 557402 √ √
34 TASMADI 761222 √ √
35 SRI WAHYUNI, Ny 718309 √ √
36 NUR INAYATUN NADHIFAH 762058 √ √
37 MUHAMMAD ANDI ARDIANSYAH 709934 √ √
38 RUSIKAH, Ny 761219 √ √
39 CINDY NURVIANTI, An 720781 √ √
40 SELVI DEWI LESTARI 762189 √ √
41 LENI MASLIKHAH, Ny 672858 √ √
42 MUHAMMAD NAUVAL ALI 737445 √ √
43 SITI HADIJAH , Ny 557402 √ √
44 SEFTIANA CAHYANINGRUM, Ny 761253 √ √
45 RIKA SUSILANDARI, Ny 760825 √ √
46 DARINI, Ny 646597 √ √
47 IDA FARIDA BY NY 761162 √ √
48 WINDHI KUSUMA WANTI 705934 √ √
49 ROHMATUL BADRIYAH 529956 √ √
50 SITI MANAF, Ny 763008 √ √
51 HANDAYANI, Ny 757444 √ √
52 MUHAMMAD ALI SUKRON, Tn 757334 √ √
53 ARIFIN , Tn 713844 √ √
54 NURUL KHOMARIYAH 701068 √ √
55 JAMILATIN NADHIFAH, Ny 511501 √ √
56 AHMAD RAFI'I 753087 √ √
57 KUMAIDI, Tn 672118 √ √
58 BAMBANG HARIYANTO 761143 √ √
59 MUHAMMAD FATKHUL IMAM 757067 √ √
60 SAFA' AT, Tn 706686 √ √
61 MOHAMMAD KHANIF AFIFI-JIWA 527237 √ √
62 MUKHLAS ANWAR, Tn 566813 √ √
63 AHMAD KHANIF, Tn 761163 √ √
64 RATNA MAHARANI RIYANTO, Nn 576774 √ √
65 GISELA BUNGA PITALOKA 761239 √ √
66 ZAHROTUS SORAYA, Nn 761238 √ √
67 MUKHLAS ANWAR, Tn 566813 √ √
68 ZAHROTUS SORAYA, Nn 761238 √ √
69 ZAHROTUS SORAYA, Nn 761238 √ √
70 RATNA MAHARANI RIYANTO, Nn 576774 √ √
71 YAQDHAN RAKHA ASSAID 638950 √ √
72 SUKAMTO 761194 √ √
73 SAIRI, Tn 761188 √ √
74 SRI YANA 759592 √ √
75 SULKAN, Tn 527539 √ √
76 SRI YANA 759592 √ √
77 WARTINI 761195 √ √
78 SRI YANA 759592 √ √
79 KADARSO, Tn 761187 √ √
80 KUNDORI, Tn 701128 √ √
81 SRI DEWI, Ny 761139 √ √
82 RUSIKAH, Ny 761219 √ √
83 ARIFIN, Tn 762059 √ √
84 SISWANTO, Tn 761231 √ √
85 SITI HADIJAH , Ny 557402 √ √
86 JAMIL, Tn 761235 √ √
87 SUDAR, Tn 761153 √ √
88 LATIFAH, Ny 718582 √ √
89 WALGITO 757432 √ √
90 ZUHRI, Tn 754495 √ √
91 WARTINI 761195 √ √
92 SRI HADI NUGROHO, Tn 761004 √ √
93 ABDUL KHANDIR, Tn 761141 √ √
94 SUGIYANTI, Ny 757339 √ √
95 RUSIKAH, Ny 761219 √ √
96 WINARNI, Ny 761158 √ √
97 LISTA OKTAVIANA NINGRUM, An 604760 √ √
98 MOHAMMAD NOOR, Tn 736799 √ √

Mengetahui Pelapor
Ka. Instalasi farmasi RSUD RA KARTINI

Sandi Purbaningsih,Msc.Apt Rulita Noor Syafira, A.Md.

NIP. 19770803 200401 2 001 NIP. 19940907 202012 2 003
 BUKU CATATAN PASIEN
BULAN : Juni
TAHUN : 2022
PEKERJAAN KEFARMASIAN
PELAYANAN FARMASI KLINIS
DISPENSING
TGL NO NAMA NO.CM
membuat rincian
pemakaian membuat rincian
obat/dosis pemakaian obat/biaya

1 SUGIYANTI, Ny 757339 √ √
2 SRI DEWI, Ny 761139 √ √
3 SUTIAH, Ny 761037 √ √
4 KUNDONO 757443 √ √
5 SUGIYANTI, Ny 757339 √ √
6 SUGIYANTI, Ny 757339 √ √
7 SUGIYANTI, Ny 757339 √ √
8 WINARNI, Ny 761158 √ √
9 MUHAMMAD NAUVAL ALI 737445 √ √
10 LISTA OKTAVIANA NINGRUM, An 604760 √ √
11 SHOLIKUL HADI 757198 √ √
12 ZULAECHAH, Ny 761244 √ √
13 MUKHORINI 708479 √ √
14 WINARNI, Ny 761158 √ √
15 FUNNY YULIANA, Nn 761123 √ √
16 MUSTARIKHAH, Ny 602612 √ √
17 NOR KAMID 539316 √ √
18 TUMISIH, Ny 501688 √ √
19 NIKMATUN, Ny 761208 √ √
20 DEWI ISTIANI, Ny 666012 √ √
21 RATNA MAHARANI RIYANTO, Nn 576774 √ √
22 NADIRA AZMINA, An 761228 √ √
23 ULFA CHASANAH 683698 √ √
24 SITI MAEMONAH, Ny 713944 √ √
25 GISELA BUNGA PITALOKA 761239 √ √
26 MUTAKHOYYAROH 761172 √ √
27 WINARNI, Ny 761158 √ √
28 KHUNDORI, Tn 627822 √ √
29 SRI HADI NUGROHO, Tn 761004 √ √
30 GISELA BUNGA PITALOKA 761239 √ √
31 SRI SUMIYATUN, Ny 761251 √ √
32 SRI SUMIYATUN, Ny 761251 √ √
33 TATIK SUMIATI, Ny 706262 √ √
34 SUPRIYATI NY 761088 √ √
35 BAMBANG HARIYANTO 761143 √ √
36 SINTA EKA WAHYUNINGSIH 762186 √ √
37 SITI BAEDAH, Ny 757697 √ √
38 RINA ROHMAWATI 755124 √ √
39 YAYUK SETYOWATI 569724 √ √
40 DEWI SARTIKA 762029 √ √
41 NOR KHABIBAH 762328 √ √
42 SUMINI, Ny 761254 √ √
43 WINDHI KUSUMA WANTI BY NY 761276 √ √
44 SRI WAHYUNI, Ny 718309 √ √
45 AHMAD FAIKAR ALI SYARI'ATI, Tn 623544 √ √
46 MUHAMMAD CHULUQUL MUSTAQIM, Tn 695313 √ √
47 ABDUL KHANDIR, Tn 761141 √ √
48 GISELA BUNGA PITALOKA 761239 √ √
49 MUHAMMAD IRFANUDIN, An 761047 √ √
50 KUNIYARTI BY NY 761117 √ √
51 MUHAMMAD IRFANUDIN, An 761047 √ √
52 MUHAMMAD ANDI ARDIANSYAH 709934 √ √
53 AHMAD FAIKAR ALI SYARI'ATI, Tn 623544 √ √
54 SOLICHATIN 535952 √ √
55 SULKAN, Tn 527539 √ √
56 KUNIYARTI BY NY 761117 √ √
57 SISWANTO, Tn 761231 √ √
58 SUPRIYATI NY 761088 √ √
59 SRI SUMIYATUN, Ny 761251 √ √
60 SRI SUMIYATUN, Ny 761251 √ √
61 SUPARJO, Tn 756887 √ √
62 RADJA MUHAMMAD T E A, An 761286 √ √
63 ZULIANTO, Tn 761261 √ √
64 KHURIYATI, Ny 737071 √ √
65 BAMBANG HARIYANTO 761143 √ √
66 AHMAD KHANIF, Tn 761163 √ √
67 KARDI, Tn 651884 √ √
68 AHMAD KHANIF, Tn 761163 √ √
69 LENI MASLIKHAH BY NY 761171 √ √
70 FUNNY YULIANA, Nn 761123 √ √
71 FUNNY YULIANA, Nn 761123 √ √
72 WINARNI, Ny 761158 √ √
73 SUGIYANTI, Ny 757339 √ √
74 SYAQIL ALYUSUF HIDAYAT, By 761234 √ √
75 SUGIYANTI, Ny 757339 √ √
76 MUHAMMAD ANDI ARDIANSYAH 709934 √ √
 77 MUSTARIKHAH, Ny 602612 √ √
78 WINDHI KUSUMA WANTI 705934 √ √
79 KUNDONO 757443 √ √
80 NIKMATUL ADAWIYAH, Ny 741375 √ √
81 SUTIAH, Ny 761037 √ √
82 WINDHI KUSUMA WANTI BY NY 761276 √ √
83 M HAFIDZ IHYAULUMUDDIN, An 648910 √ √
84 MUHAMMAD RAZKA TIRTA 761262 √ √
85 SELVI DEWI LESTARI 762189 √ √
86 M HAFIDZ IHYAULUMUDDIN, An 648910 √ √
87 NURUL MISKIYAH, Ny 761245 √ √
88 MUHAMMAD CHULUQUL MUSTAQIM, Tn 695313 √ √
89 ELY BUDIYONO, Tn 761092 √ √
90 MUHAMMAD NUR SALIM, An 761285 √ √
91 ANIM SETIYO NINGSIH BY NY 761152 √ √
92 MUTAKHOYYAROH BY NY 761185 √ √
93 NADIRA AZMINA, An 761228 √ √
94 NUFITA SARI BY NY 761164 √ √
95 GISELA BUNGA PITALOKA 761239 √ √
96 NUFITA SARI BY NY 761164 √ √
97 KUSRIYANAH BY NY 761085 √ √
98 KUSRIYANAH BY NY 761085 √ √
99 MUHAMMAD IRFANUDIN, An 761047 √ √
100 KUNIYARTI BY NY 761117 √ √
101 MASIYAH, Ny 630181 √ √
102 SULKAN, Tn 527539 √ √
103 SAIRI, Tn 761188 √ √
104 SAIRI, Tn 761188 √ √
105 KADARSO, Tn 761187 √ √
106 SAIRI, Tn 761188 √ √
107 AHMAD FAIKAR ALI SYARI'ATI, Tn 623544 √ √
108 SULKAN, Tn 527539 √ √
109 WARTINI 761195 √ √
110 KHUNDORI, Tn 627822 √ √
111 KUNDORI, Tn 701128 √ √
112 TATIK SUMIATI, Ny 706262 √ √
113 MUKAITUN 536880 √ √
114 SUDAR, Tn 761153 √ √
115 RUSIKAH, Ny 761219 √ √
116 SUNARYO, Tn 533436 √ √
117 RUSIKAH, Ny 761219 √ √
118 MUNARSIH, Ny 732974 √ √
119 QOYYIMAH, Ny 605962 √ √
120 MOHAMMAD NOOR, Tn 736799 √ √
121 ABDUL KHANDIR, Tn 761141 √ √
122 ABDUL KHANDIR, Tn 761141 √ √
123 ZAHROTUS SORAYA, Nn 761238 √ √

Mengetahui Pelapor
Ka. Instalasi farmasi RSUD RA KARTINI

Sandi Purbaningsih,Msc.Apt Rulita Noor Syafira, A.Md.

NIP. 19770803 200401 2 001 NIP. 19940907 202012 2 003
 BUKU CATATAN PASIEN
BULAN : Juli
TAHUN : 2022
PEKERJAAN KEFARMASIAN
PELAYANAN FARMASI KLINIS
TGL NO NAMA NO.CM DISPENSING
membuat rincian membuat rincian
pemakaian pemakaian
obat/dosis obat/biaya

1 SUMINI, Ny 761254 √ √
2 SELLA FAJRI ISLAMI 576800 √ √
3 LENI MASLIKHAH, Ny 672858 √ √
4 ANIK PURWATI 745210 √ √
5 SITI HADIJAH , Ny 557402 √ √
6 SITI HADIJAH , Ny 557402 √ √
7 AHMAD KHOLIQ, Tn 761287 √ √
8 TASMADI 761222 √ √
9 RATNA MAHARANI RIYANTO, Nn 576774 √ √
10 SRI ANIK, Ny 751008 √ √
11 WINDHI KUSUMA WANTI 705934 √ √
12 SEFTIANA CAHYANINGRUM, Ny 761253 √ √
13 ANGGRAENI MELA ROSITA, Ny 761237 √ √
14 MUKHORINI 708479 √ √
15 MUKHORINI 708479 √ √
16 ZULAECHAH, Ny 761244 √ √
17 SITI SALAMAH, Ny 742024 √ √
18 SOLICHATIN 535952 √ √
19 ULFA CHASANAH 683698 √ √
20 MUHAMMAD CHULUQUL MUSTAQIM, Tn 695313 √ √
21 SITI MUFAROKHAH, Ny 517024 √ √
22 AHMAD KHOLIQ, Tn 761287 √ √
23 SRI HADI NUGROHO, Tn 761004 √ √
24 AHMAD KHOLIQ, Tn 761287 √ √
25 FATHURROHIM YUSUF, Tn 762135 √ √
26 KHANIFATUR RUMISIH, Ny 565840 √ √
27 ZUHRI, Tn 754495 √ √
28 ARIFIN, Tn 762059 √ √
29 DARINI, Ny 646597 √ √
30 ULYA SABIELA 762179 √ √
31 WALGITO 757432 √ √
32 SRI DEWI, Ny 761139 √ √
33 JAMIL, Tn 761235 √ √
34 WALGITO 757432 √ √
35 SRI YANA 759592 √ √
36 SINTA EKA WAHYUNINGSIH 762186 √ √
37 RINA ROHMAWATI 755124 √ √
38 MUHAMMAD HASIM MUBAROQ 761301 √ √
39 RINA ROHMAWATI 755124 √ √
40 ASBIQ AUNALHAQ ANNAJA 747803 √ √
41 ANIM SETIYO NINGSIH BY NY 761152 √ √
42 NURUL MISKIYAH, Ny 761245 √ √
43 KHUMAIYAH 762142 √ √
44 SUMIATUN, Ny 761243 √ √
45 DWI ELAWATI, Ny 754574 √ √
46 ASBIQ AUNALHAQ ANNAJA 747803 √ √
47 SINTA EKA WAHYUNINGSIH 762186 √ √
48 CATUR WAHYU BAHAGIARTI LESTARI, Ny 534015 √ √
49 KHANIFATUR RUMISIH, Ny 565840 √ √
50 ANGGRAENI MELA ROSITA, Ny 761237 √ √
51 GISELA BUNGA PITALOKA 761239 √ √
52 MUHAMMAD IRFANUDIN, An 761047 √ √
53 MUHAMMAD CHULUQUL MUSTAQIM, Tn 695313 √ √
54 ULFA CHASANAH 683698 √ √
55 KHURIYATI, Ny 737071 √ √
56 SUMINI, Ny 761254 √ √
57 MUKHORINI 708479 √ √
58 KHURIYATI, Ny 737071 √ √
59 RADJA MUHAMMAD T E A, An 761286 √ √
60 RADJA MUHAMMAD T E A, An 761286 √ √
61 MOHAMAD RIFQY ROOSDHANI, Tn 599218 √ √
62 VINI SUTARINI ANGGRIANI, Ny 760732 √ √
63 FATKHUR ROHMAH, Ny 724866 √ √
64 SRI SUMIYATUN, Ny 761251 √ √
65 MUNARSIH, Ny 732974 √ √
66 WINARNI, Ny 761158 √ √
67 MOHAMAD RIFQY ROOSDHANI, Tn 599218 √ √
68 MUHAMMAD CHULUQUL MUSTAQIM, Tn 695313 √ √
69 KHURIYATI, Ny 737071 √ √
70 WARTINI 761195 √ √
71 SUPARJO, Tn 756887 √ √
72 NUR MAJID 651350 √ √
73 SRI ANIK, Ny 751008 √ √
74 SEFTIANA CAHYANINGRUM, Ny 761253 √ √
75 ULYA SABIELA 762179 √ √
76 JAMIL, Tn 761235 √ √
77 AHMAD MUSTHOFA, An 761307 √ √
78 MUHAMMAD FAESAL 725234 √ √
 79 SELVI DEWI LESTARI 762189 √ √
80 MUKHORINI 708479 √ √
81 SAFUATIN, Ny 761311 √ √
82 KHURIYATI, Ny 737071 √ √
83 TASMADI 761222 √ √
84 SUPRIYATI NY 761088 √ √
85 MINTARSIH, Ny 761306 √ √
86 KHURIYATI, Ny 737071 √ √
87 BAMBANG HARIYANTO 761143 √ √
88 KARDI, Tn 651884 √ √
89 AHMAD KHANIF, Tn 761163 √ √
90 KHURIYATI, Ny 737071 √ √
91 AHMAD KHANIF, Tn 761163 √ √
92 RUBIYATI 757377 √ √
93 AHMAD KHOLIQ, Tn 761287 √ √
94 ELVI ZARKASAH, Ny 739972 √ √
95 ELY BUDIYONO, Tn 761092 √ √
96 MUHAMMAD FATKHUL IMAM 757067 √ √
97 NUR MAJID 651350 √ √
98 ABDUL MAJID, Sdr 761300 √ √
99 MUSTARIKHAH, Ny 602612 √ √
100 ASBIQ AUNALHAQ ANNAJA 747803 √ √
101 GISELA BUNGA PITALOKA 761239 √ √
102 KUSRIYANAH BY NY 761085 √ √
103 MUHAMMAD CHULUQUL MUSTAQIM, Tn 695313 √ √
104 MUTAKHOYYAROH BY NY 761185 √ √
105 NADIRA AZMINA, An 761228 √ √
106 MUHAMMAD HASIM MUBAROQ 761301 √ √
107 ASBIQ AUNALHAQ ANNAJA 747803 √ √
108 MUHAMMAD NUR SALIM, An 761285 √ √
109 MUHAMMAD IRFANUDIN, An 761047 √ √
110 GISELA BUNGA PITALOKA 761239 √ √
111 BAMBANG HARIYANTO 761143 √ √
112 RANI HIKMAWATI BY NY 761316 √ √
113 KUSRIYANAH BY NY 761085 √ √
114 KUNIYARTI BY NY 761117 √ √
115 FUNNY YULIANA, Nn 761123 √ √
116 AHMAD IQBAL M , An 707267 √ √
117 M HAFIDZ IHYAULUMUDDIN, An 648910 √ √
118 SISWANTO, Tn 761231 √ √
119 KUNDONO 757443 √ √
120 WINARNI, Ny 761158 √ √
 Mengetahui Pelapor
Ka. Instalasi farmasi RSUD RA KARTINI

Sandi Purbaningsih,Msc.Apt Rulita Noor Syafira, A.Md.

NIP. 19770803 200401 2 001 NIP. 19940907 202012 2 003
 BUKU CATATAN PASIEN
BULAN : Agustus
TAHUN : 2022
PEKERJAAN KEFARMASIAN
PELAYANAN FARMASI KLINIS
TGL NO NAMA NO.CM DISPENSING

membuat rincian membuat rincian

pemakaian obat/dosis pemakaian obat/biaya

1 WINARNI, Ny 761158 √ √
2 SULKAN, Tn 527539 √ √
3 SUTIAH, Ny 761037 √ √
4 AHMAD FAIKAR ALI SYARI'ATI, Tn 623544 √ √
5 SUGIYANTI, Ny 757339 √ √
6 SUGIYANTI, Ny 757339 √ √
7 KHUNDORI, Tn 627822 √ √
8 KUNDORI, Tn 701128 √ √
9 KADARSO, Tn 761187 √ √
10 SAIRI, Tn 761188 √ √
11 SAIRI, Tn 761188 √ √
12 MALIKATUN, Ny 761313 √ √
13 MALIKATUN, Ny 761313 √ √
14 MALIKATUN BY NY 761319 √ √
15 ANGGRAENI MELA ROSITA, Ny 761237 √ √
16 MOHAMAD RIFQY ROOSDHANI, Tn 599218 √ √
17 NOR KHABIBAH 762328 √ √
18 YAYUK SETYOWATI 569724 √ √
19 NADIRA AZMINA, An 761228 √ √
20 DEWI SARTIKA 762029 √ √
21 SITI MUFAROKHAH BY NY 761288 √ √
22 LUGIYATI BY NY 761290 √ √
23 NURUL MISKIYAH BY NY 761263 √ √
24 DWI ELAWATI, Ny 754574 √ √
25 DWI ELAWATI, Ny 754574 √ √
26 SOLICHATIN BY NY 761241 √ √
27 KHUMAIYAH 762142 √ √
28 SITI BAEDAH, Ny 757697 √ √
29 FUNNY YULIANA, Nn 761123 √ √
30 MUHAMMAD RAZKA TIRTA 761262 √ √
31 HARIS SAFRUDIN, Sdr 753020 √ √
32 ZAHROTUS SORAYA, Nn 761238 √ √
33 BAMBANG HARIYANTO 761143 √ √
34 ANIK PURWATI 745210 √ √
35 AHMAD KHANIF, Tn 761163 √ √
36 SITI HADIJAH , Ny 557402 √ √
37 ANIK PURWATI 745210 √ √
38 FATKHUR ROHMAH, Ny 724866 √ √
39 SITI HADIJAH , Ny 557402 √ √
40 NIKMATUL ADAWIYAH, Ny 741375 √ √
41 SITI HADIJAH , Ny 557402 √ √
42 GISELA BUNGA PITALOKA 761239 √ √
43 SUMINI, Ny 761254 √ √
44 SELLA FAJRI ISLAMI 576800 √ √
45 RATNA MAHARANI RIYANTO, Nn 576774 √ √
46 SUJONO, Tn 761318 √ √
47 MUKLIM, Tn 647796 √ √
48 MERY JULIANTO, Tn 590163 √ √
49 SUMINI, Ny 761254 √ √
50 ASARI, Tn 723135 √ √
51 SAFA' AT, Tn 706686 √ √
52 MOHAMMAD KHANIF AFIFI-JIWA 527237 √ √
53 RUBIAH, Ny 761274 √ √
54 ELY BUDIYONO, Tn 761092 √ √
55 QOYYIMAH, Ny 605962 √ √
56 SUMINI, Ny 761254 √ √
57 SRI YANTI 600103 √ √
58 MUNARSIH, Ny 732974 √ √
59 SAIRI, Tn 761188 √ √
60 SUPINAH, Ny 677020 √ √
61 WAHYU WIBOWO, Tn 600656 √ √
62 WALGITO 757432 √ √
63 ARIFIN, Tn 762059 √ √
64 LULUK ALFIAH, Ny 713465 √ √
65 SUNARYO, Tn 533436 √ √
66 KHANIFATUR RUMISIH, Ny 565840 √ √
67 SRI REDJEKI , Ny 713502 √ √
68 ABDUL KHANDIR, Tn 761141 √ √
69 ZUHRI, Tn 754495 √ √
70 DARINI, Ny 646597 √ √
71 GISELA BUNGA PITALOKA 761239 √ √
72 ABDUL KHANDIR, Tn 761141 √ √
73 NOR AFIF MARUF 761305 √ √
74 MUKAITUN 536880 √ √
75 SRI DEWI, Ny 761139 √ √
76 WARTINI 761195 √ √
77 WARTINI 761195 √ √
78 SUDAR, Tn 761153 √ √
79 MOHAMMAD NOOR, Tn 736799 √ √
80 ABDUL KHANDIR, Tn 761141 √ √
81 RUSIKAH, Ny 761219 √ √
82 RUSIKAH, Ny 761219 √ √
83 RUSIKAH, Ny 761219 √ √
84 SUDAR, Tn 761153 √ √
85 AHMAD KHOLIQ, Tn 761287 √ √
86 ISTIKOMAH, Ny 763069 √ √
87 SITI SALAMAH, Ny 742024 √ √
88 MUKHORINI 708479 √ √
89 MUHAMMAD IRFANUDIN, An 761047 √ √
90 KARDI, Tn 651884 √ √
91 NINDI DIA PRATIWI 763018 √ √
92 RADJA MUHAMMAD T E A, An 761286 √ √
93 YENI YULIANIK 763016 √ √
94 SITI ISTIQOMAH 756307 √ √
95 ZULAECHAH, Ny 761244 √ √
96 ASARI, Tn 723135 √ √
97 MASIYAH, Ny 630181 √ √
98 TATIK SUMIATI, Ny 706262 √ √
99 SITI MANAF, Ny 763008 √ √
100 VINI SUTARINI ANGGRIANI, Ny 760732 √ √
101 FUNNY YULIANA, Nn 761123 √ √
102 ZULAECHAH, Ny 761244 √ √
103 MOHAMAD RIFQY ROOSDHANI, Tn 599218 √ √
104 NURUL MISKIYAH, Ny 761245 √ √
105 ULFA CHASANAH 683698 √ √
106 MERY JULIANTO, Tn 590163 √ √
107 ASARI, Tn 723135 √ √
108 WAHYU WIBOWO, Tn 600656 √ √
109 SISWATI, Ny 678132 √ √
110 MOHAMAD RIFQY ROOSDHANI, Tn 599218 √ √
111 FATKHUR ROHMAH, Ny 724866 √ √
112 RATNA MAHARANI RIYANTO, Nn 576774 √ √
113 MOHAMMAD SIGIT ARYANTO 717209 √ √
114 SUKARTI, Ny 762754 √ √
115 RUSIKAH, Ny 761219 √ √
116 SUJONO, Tn 761318 √ √
117 SHOLIKHAH, Ny 762074 √ √
118 SUPRIYATI NY 761088 √ √
119 BAMBANG HARIYANTO 761143 √ √
120 ANIK HIDAYATUN 761315 √ √
 121 WINARNI, Ny 761158 √ √

Mengetahui Pelapor
Ka. Instalasi farmasi RSUD RA KARTINI

Sandi Purbaningsih,Msc.Apt Rulita Noor Syafira, A.Md.

NIP. 19770803 200401 2 001 NIP. 19940907 202012 2 003
 BUKU CATATAN PASIEN
BULAN : September
TAHUN : 2022
PEKERJAAN KEFARMASIAN
PELAYANAN FARMASI KLINIS
DISPENSING
TGL NO NAMA NO.CM
membuat rincian
membuat rincian pemakaian
pemakaian obat/dosis obat/biaya

1 MOHAMAD RIFQY ROOSDHANI, Tn 599218 √ √

2 ANIK PURWATI 745210 √ √
3 NUR MAJID 651350 √ √
4 SUPARJO, Tn 756887 √ √
5 KHURIYATI, Ny 737071 √ √
6 BAHITA SYABANIYAH, Ny 761331 √ √
7 AHMAD FAIKAR ALI SYARI'ATI, Tn 623544 √ √
8 SAIRI, Tn 761188 √ √
9 ARIFIN, Tn 762059 √ √
10 KHUNDORI, Tn 627822 √ √
11 TATIK SUMIATI, Ny 706262 √ √
12 KAMTO SUBAGYO, Tn 711710 √ √
13 YENI YULIANIK 763016 √ √
14 YENI YULIANIK BY NY 761341 √ √
15 ANIK HIDAYATUN 761315 √ √
16 MASRUKAN, Tn 761320 √ √
17 NOR AFIF MARUF 761305 √ √
18 ULYA SABIELA 762179 √ √
19 MUNARSIH, Ny 732974 √ √
20 TETIK SUPENTI 761321 √ √
21 SINTA EKA WAHYUNINGSIH 762186 √ √
22 MALIKATUN, Ny 761313 √ √
23 RINA ROHMAWATI 755124 √ √
24 TASMADI 761222 √ √
25 MINTARSIH, Ny 761306 √ √
26 ABDUL KHANDIR, Tn 761141 √ √
27 MUKLIM, Tn 647796 √ √
28 NUR MAJID 651350 √ √
29 NUR MAJID 651350 √ √
30 NOR AFIF MARUF 761305 √ √
31 MASRUKAN, Tn 761320 √ √
32 ULYA SABIELA 762179 √ √
33 MASRUKAN, Tn 761320 √ √
34 SEFTIANA CAHYANINGRUM, Ny 761253 √ √
35 MUHAMMAD CHULUQUL MUSTAQIM, Tn 695313 √ √
36 MINTARSIH, Ny 761306 √ √
37 RADJA MUHAMMAD T E A, An 761286 √ √
38 KHUNDORI, Tn 627822 √ √
39 NGATMONAH, Ny 761339 √ √
40 SHOLIKHAH BY NY 761352 √ √
41 KISWATI, Ny 761334 √ √
42 ASBIQ AUNALHAQ ANNAJA 747803 √ √
43 LENI MASLIKHAH BY NY 761171 √ √
44 ASBIQ AUNALHAQ ANNAJA 747803 √ √
45 GISELA BUNGA PITALOKA 761239 √ √
46 MUHAMMAD HASIM MUBAROQ 761301 √ √
47 NADIRA AZMINA, An 761228 √ √
48 MUHAMMAD NUR SALIM, An 761285 √ √
49 SOLEKAN, Tn 761340 √ √
50 MUKHORINI 708479 √ √
51 SITI MANAF, Ny 763008 √ √
52 SRI YANTI 600103 √ √
53 MUNARSIH, Ny 732974 √ √
54 QOYYIMAH, Ny 605962 √ √
55 CATUR WAHYU BAHAGIARTI LESTARI, Ny 534015 √ √
56 TETIK SUPENTI 761321 √ √
57 SELVI DEWI LESTARI 762189 √ √
58 ANIK PURWATI 745210 √ √
59 KAMTO SUBAGYO, Tn 711710 √ √
60 RATNA MAHARANI RIYANTO, Nn 576774 √ √
61 FUNNY YULIANA, Nn 761123 √ √
62 M HAFIDZ IHYAULUMUDDIN, An 648910 √ √
63 MINTARSIH, Ny 761306 √ √
64 MUHAMMAD IRFANUDIN, An 761047 √ √
65 MUHAMMAD FAESAL 725234 √ √
66 HARIS SAFRUDIN, Sdr 753020 √ √
67 SHOLIKHAH, Ny 762074 √ √
68 SAFUATIN, Ny 761311 √ √
69 SISWATI, Ny 678132 √ √
70 SITI SALAMAH, Ny 742024 √ √
71 BAMBANG HARIYANTO 761143 √ √
72 SUPRIYATI NY 761088 √ √
73 AHMAD KHANIF, Tn 761163 √ √
74 AHMAD KHANIF, Tn 761163 √ √
75 DARINI, Ny 646597 √ √
76 SOLEH, TN 761336 √ √
 77 AHMAD KHANIF, Tn 761163 √ √
78 JAMILATIN NADHIFAH, Ny 511501 √ √
79 AHMAD KHANIF, Tn 761163 √ √
80 SITI HADIJAH , Ny 557402 √ √
81 SUMINI, Ny 761254 √ √
82 AHMAD RAFI'I 753087 √ √
83 MOHAMMAD KHANIF AFIFI-JIWA 527237 √ √
84 SUJONO, Tn 761318 √ √
85 MUKHLAS ANWAR, Tn 566813 √ √
86 MUKHLAS ANWAR, Tn 566813 √ √
87 JUNAIDI, Tn 761342 √ √
88 LULUK ALFIAH, Ny 713465 √ √
89 SRI REDJEKI , Ny 713502 √ √
90 ABDUL MAJID, Sdr 761300 √ √
91 ANIK HIDAYATUN 761315 √ √
92 ARIFIN , Tn 713844 √ √
93 NURUL KHOMARIYAH 701068 √ √
94 MUSTARIKHAH, Ny 602612 √ √
95 SUSANTI, Ny 761337 √ √
96 AHMAD KHOLIQ, Tn 761287 √ √
97 SUDAR, Tn 761153 √ √
98 SUNARYO, Tn 533436 √ √
99 ELY BUDIYONO, Tn 761092 √ √
100 SUNARYO, Tn 533436 √ √
101 AHMAD IQBAL M , An 707267 √ √
102 SITI HADIJAH , Ny 557402 √ √
103 MUHAMMAD RAZKA TIRTA 761262 √ √
104 JUNAIDI, Tn 761353 √ √
105 KARDI, Tn 651884 √ √
106 KUNDORI, Tn 701128 √ √
107 NGATMONAH, Ny 761339 √ √
108 SUMIATUN, Ny 761243 √ √
109 SRI DEWI, Ny 761139 √ √
110 NURUL MISKIYAH, Ny 761245 √ √
111 KHANIFATUR RUMISIH, Ny 565840 √ √
112 ZIADUL MUTTAQIN 524175 √ √
113 WALGITO 757432 √ √
114 SURINAH, Ny 761362 √ √
115 WAHYU WIBOWO, Tn 600656 √ √
116 KARDI, Tn 651884 √ √
117 ELVI ZARKASAH, Ny 739972 √ √
118 SELLA FAJRI ISLAMI 576800 √ √
119 ASBIQ AUNALHAQ ANNAJA 747803 √ √
120 RUSIKAH, Ny 761219 √ √
121 MOHAMMAD NOOR, Tn 736799 √ √

Mengetahui Pelapor
Ka. Instalasi farmasi RSUD RA KARTINI

Sandi Purbaningsih,Msc.Apt Rulita Noor Syafira, A.Md.

NIP. 19770803 200401 2 001 NIP. 19940907 202012 2 003
 BUKU CATATAN PASIEN
BULAN : Oktober
TAHUN : 2022
PEKERJAAN KEFARMASIAN
PELAYANAN FARMASI KLINIS
DISPENSING
TGL NO NAMA NO.CM
membuat rincian membuat rincian pemakaian
pemakaian
obat/dosis obat/biaya

1 SUDAR, Tn 761153 √ √
2 RUSIKAH, Ny 761219 √ √
3 WARTINI 761195 √ √
4 MUKAITUN 536880 √ √
5 WARTINI 761195 √ √
6 SISWATI, Ny 678132 √ √
7 MINTARSIH, Ny 761306 √ √
8 SUPARJO, Tn 756887 √ √
9 ANIS KHUMAIROH 700097 √ √
10 ISTIKOMAH, Ny 763069 √ √
11 ANIK PURWATI 745210 √ √
12 WINARNI, Ny 761158 √ √
13 SUTIAH, Ny 761037 √ √
14 SITI HADIJAH , Ny 557402 √ √
15 KUNDONO 757443 √ √
16 ANIK PURWATI 745210 √ √
17 FATKHUR ROHMAH, Ny 724866 √ √
18 MOHAMMAD SIGIT ARYANTO 717209 √ √
19 SHOFIATUL UMMAH 548691 √ √
20 GISELA BUNGA PITALOKA 761239 √ √
21 MERY JULIANTO, Tn 590163 √ √
22 ASARI, Tn 723135 √ √
23 NUR MAJID 651350 √ √
24 SUPARMI, Ny 762177 √ √
25 ULFA CHASANAH 683698 √ √
26 SUMINI, Ny 761254 √ √
27 SITI HADIJAH , Ny 557402 √ √
28 ABDUL ROKIM, Tn 663489 √ √
29 SITI MUALLIFAH, Ny 714451 √ √
30 NUR AGUS PURWANINGSIH NY 548183 √ √
31 ABDUL KHANDIR, Tn 761141 √ √
32 ARIFIN, Tn 762059 √ √
33 ABDUL KHANDIR, Tn 761141 √ √
34 AHMAD KHOLIQ, Tn 761287 √ √
35 ABDUL KHANDIR, Tn 761141 √ √
36 ASARI, Tn 723135 √ √
37 NINDI DIA PRATIWI 763018 √ √
38 ABDUL KHANDIR, Tn 761141 √ √
39 NINDI DIA PRATIWI BY NY 761378 √ √
40 SUPINAH, Ny 677020 √ √
41 ZULAECHAH, Ny 761244 √ √
42 ZULAECHAH, Ny 761244 √ √
43 MUKHORINI 708479 √ √
44 SRI DEWI, Ny 761139 √ √
45 ZUHRI, Tn 754495 √ √
46 B SOEJONO, Tn 534818 √ √
47 MOHAMMAD SIGIT ARYANTO 717209 √ √
48 FUNNY YULIANA, Nn 761123 √ √
49 KAMTO SUBAGYO, Tn 711710 √ √
50 JAMI'AN, Tn 742183 √ √
51 FUNNY YULIANA, Nn 761123 √ √
52 ANIK HIDAYATUN 761315 √ √
53 SRI HARTATIK 762900 √ √
54 SRI HARTATIK 762900 √ √
55 SRI HARTATIK 762900 √ √
56 FATKHUR ROHMAH, Ny 724866 √ √
57 WALGITO 757432 √ √
58 KUNIYARTI BY NY 761117 √ √
59 ANIK PURWATI 745210 √ √
60 KUNIYARTI BY NY 761117 √ √
61 AHMAD MUSTHOFA, An 761307 √ √
62 ANIK HIDAYATUN 761315 √ √
63 ABDUL KHANDIR, Tn 761141 √ √
64 MUHAMMAD NUR SALIM, An 761285 √ √
65 SAMINI 535129 √ √
66 JUNAIDI, Tn 761342 √ √
67 NUR MAJID 651350 √ √
68 ANIK PURWATI 745210 √ √
69 JUNAIDI, Tn 761353 √ √
70 SRI HARTATIK 762900 √ √
71 ISTIKOMAH, Ny 763069 √ √
72 ELY BUDIYONO, Tn 761092 √ √
73 SHOLIKHAH, Ny 762074 √ √
74 ENY NORMA, Ny 743538 √ √
75 MASIYAH, Ny 630181 √ √
76 TATIK SUMIATI, Ny 706262 √ √
77 AKIFAH HASNA KAMILA 761354 √ √
78 ASBIQ AUNALHAQ ANNAJA 747803 √ √
 79 FARHATUL ULYA 614534 √ √
80 MUHAMMAD FAESAL 725234 √ √
81 HARIS SAFRUDIN, Sdr 753020 √ √
82 SISWATI, Ny 678132 √ √
83 AHMAD MUSTHOFA, An 761307 √ √
84 ASBIQ AUNALHAQ ANNAJA 747803 √ √
85 SISWATI, Ny 678132 √ √
86 TETIK SUPENTI 761321 √ √
87 SAMSIYAH, Ny 508087 √ √
88 SAFUATIN, Ny 761311 √ √
89 NOR AFIF MARUF 761305 √ √
90 SITI ISTIQOMAH 756307 √ √
91 AHMAD MUSTHOFA, An 761307 √ √
92 MUHAMMAD FAESAL 725234 √ √
93 MASRUKAN, Tn 761320 √ √
94 HARIS SAFRUDIN, Sdr 753020 √ √
95 LULUK ALFIAH, Ny 713465 √ √
96 ASARI, Tn 723135 √ √
97 ISTIKOMAH, Ny 763069 √ √
98 MASRUKAN, Tn 761320 √ √
99 ABDUL ROKIM, Tn 663489 √ √
100 SUPARJO, Tn 756887 √ √
101 ABDUL ROKIM, Tn 663489 √ √
102 MUKLIM, Tn 647796 √ √
103 MERY JULIANTO, Tn 590163 √ √
104 WIDYOWATI, Ny 761360 √ √
105 SOLEKAN, Tn 761340 √ √
106 NGATMONAH, Ny 761339 √ √
107 NUR MAJID 651350 √ √
108 KISWATI, Ny 761334 √ √
109 SOLEH, TN 761336 √ √
110 SUPRIYATI NY 761088 √ √
111 NUR MAJID 651350 √ √
112 WAHYU WIBOWO, Tn 600656 √ √
113 WINARNI, Ny 761158 √ √

Mengetahui Pelapor
Ka. Instalasi farmasi RSUD RA KARTINI

Sandi Purbaningsih,Msc.Apt Rulita Noor Syafira, A.Md.

NIP. 19770803 200401 2 001 NIP. 19940907 202012 2 003
 BUKU CATATAN PASIEN
BULAN : November
TAHUN : 2022
PEKERJAAN KEFARMASIAN
PELAYANAN FARMASI KLINIS
DISPENSING
TGL NO NAMA NO.CM
membuat rincian
pemakaian membuat rincian
obat/dosis pemakaian obat/biaya

1 SUPRIYATI NY 761088 √ √
2 VINI SUTARINI ANGGRIANI, Ny 760732 √ √
3 WAHYU WIBOWO, Tn 600656 √ √
4 FUNNY YULIANA, Nn 761123 √ √
5 KAMTO SUBAGYO, Tn 711710 √ √
6 JAMI'AN, Tn 742183 √ √
7 ELY BUDIYONO, Tn 761092 √ √
8 FARHATUL ULYA 614534 √ √
9 ENY NORMA, Ny 743538 √ √
10 MUSTARIKHAH, Ny 602612 √ √
11 SUSANTI, Ny 761337 √ √
12 AHMAD KHOLIQ, Tn 761287 √ √
13 ANIK PURWATI 745210 √ √
14 ANIK HIDAYATUN 761315 √ √
15 MINTARSIH, Ny 761306 √ √
16 MUHAMMAD IZZA AUFIYA 740254 √ √
17 MUHAMMAD IZZA AUFIYA 740254 √ √
18 DZAKIRA TALITA ZAHRA 763222 √ √
19 DANENDRA ZIANDRU MAHMUD 757656 √ √
20 TETIK SUPENTI 761321 √ √
21 MERY JULIANTO, Tn 590163 √ √
22 SUPARJO, Tn 756887 √ √
23 NUR MAJID 651350 √ √
24 WINARNI, Ny 761158 √ √
25 WINARNI, Ny 761158 √ √
26 WINARNI, Ny 761158 √ √
27 SUGIYANTI, Ny 757339 √ √
28 SUGIYANTI, Ny 757339 √ √
29 SUGIYANTI, Ny 757339 √ √
30 VINI SUTARINI ANGGRIANI, Ny 760732 √ √
31 MOHAMAD RIFQY ROOSDHANI, Tn 599218 √ √
32 ABDUL MAJID, Sdr 761300 √ √
33 MUHAMMAD FATKHUL IMAM 757067 √ √
34 HANDAYANI, Ny 757444 √ √
35 SITI HADIJAH , Ny 557402 √ √
36 KAIF AVIAN FAUZA 730056 √ √
37 SITI SUHARTINI, Ny 761356 √ √
38 SUMINI, Ny 761254 √ √
39 KAMTO SUBAGYO, Tn 711710 √ √
40 SUTIAH, Ny 761037 √ √
41 ARKA FITARI 761343 √ √
42 MUHAMMAD HASIM MUBAROQ 761301 √ √
43 JAMI'AN, Tn 742183 √ √
44 FUNNY YULIANA, Nn 761123 √ √
45 NADIRA AZMINA, An 761228 √ √
46 MUHAMMAD NUR SALIM, An 761285 √ √
47 RANI HIKMAWATI BY NY 761316 √ √
48 SHOLIKHAH BY NY 761352 √ √
49 AKIFAH HASNA KAMILA 761354 √ √
50 SURINAH, Ny 761362 √ √
51 KHANIFATUR RUMISIH, Ny 565840 √ √
52 SAMINI 535129 √ √
53 SUPARMI, Ny 762177 √ √
54 SRI REDJEKI , Ny 713502 √ √
55 WIDYOWATI, Ny 761360 √ √
56 ANIS KHUMAIROH 700097 √ √
57 ULFA CHASANAH 683698 √ √
58 MOHAMMAD SIGIT ARYANTO 717209 √ √
59 MOHAMMAD SIGIT ARYANTO 717209 √ √
60 SUJONO, Tn 761318 √ √
61 SITI HADIJAH , Ny 557402 √ √
62 RATNA MAHARANI RIYANTO, Nn 576774 √ √
63 ANIK HIDAYATUN 761315 √ √
64 RUSIKAH, Ny 761219 √ √
65 AKIFAH HASNA KAMILA 761354 √ √
66 NGATMONAH, Ny 761339 √ √
67 KHUNDORI, Tn 627822 √ √
68 FATKHUR ROHMAH, Ny 724866 √ √
69 SAMSIYAH, Ny 508087 √ √
70 SITI HADIJAH , Ny 557402 √ √
71 MUHAMMAD AYRES KIANO EDWYN, An 761377 √ √
72 ASBIQ AUNALHAQ ANNAJA 747803 √ √
73 KAIF AVIAN FAUZA 730056 √ √
74 ANIK PURWATI 745210 √ √
75 WARTINI 761195 √ √
76 SUDAR, Tn 761153 √ √
 77 ANIS KHUMAIROH 700097 √ √
78 KARDI, Tn 651884 √ √
79 ANIK HIDAYATUN 761315 √ √
80 KARDI, Tn 651884 √ √
81 WAHYU WIBOWO, Tn 600656 √ √
82 MUHAMMAD WITANTO 763202 √ √
83 WALGITO 757432 √ √
84 MUKLIM, Tn 647796 √ √
85 ABDUL KHANDIR, Tn 761141 √ √
86 ZUHRI, Tn 754495 √ √
87 ARKA FITARI 761343 √ √
88 MUKAITUN 536880 √ √
89 B SOEJONO, Tn 534818 √ √
90 SRI DEWI, Ny 761139 √ √
91 MOHAMMAD NOOR, Tn 736799 √ √
92 ACHMAD TRI ATMAJA 558771 √ √
93 RUSIKAH, Ny 761219 √ √
94 SUPINAH, Ny 677020 √ √
95 IKA RAMAWATI, Ny 741760 √ √
96 RUSIKAH, Ny 761219 √ √
97 JUNAIDI, Tn 761342 √ √
98 ALI IMRON, Tn 763158 √ √
99 SUGIYANTI, Ny 757339 √ √
100 KUSUMAWATI 732054 √ √
101 EVI SULISTYORINI NY 542599 √ √
102 ENY NORMA, Ny 743538 √ √
103 SITI SALAMAH, Ny 742024 √ √
104 MUHAMMAD ROYYAN ATHALLAH 761382 √ √
105 NUR AGUS PURWANINGSIH NY 548183 √ √
106 SITI MUALLIFAH, Ny 714451 √ √
107 LAILATUL SIFAANAH 640595 √ √
108 SISWATI, Ny 678132 √ √
109 TATIK SUMIATI, Ny 706262 √ √
110 MASIYAH, Ny 630181 √ √
111 SUKARTI, Ny 762754 √ √
112 SITI ISTIQOMAH 756307 √ √
113 MASIYAH, Ny 630181 √ √
114 MOHAMMAD SIGIT ARYANTO 717209 √ √
115 ALI IMRON, Tn 763158 √ √
116 NORMA ZUNITA, Ny 763103 √ √
117 MUSTAANAH, Ny 759489 √ √
118 SUPARMI, Ny 762177 √ √
119 NURIYATI, Ny 761372 √ √
120 WIDYOWATI, Ny 761360 √ √
121 MUNARSIH, Ny 732974 √ √
122 SRI YANTI 600103 √ √
123 ENY NORMA, Ny 743538 √ √

Mengetahui Pelapor
Ka. Instalasi farmasi RSUD RA KARTINI

Sandi Purbaningsih,Msc.Apt Rulita Noor Syafira, A.Md.

NIP. 19770803 200401 2 001 NIP. 19940907 202012 2 003
 BUKU CATATAN PASIEN
BULAN : Desember
TAHUN : 2022
PEKERJAAN KEFARMASIAN
PELAYANAN FARMASI KLINIS
TGL NO NAMA NO.CM DISPENSING
membuat rincian membuat rincian
pemakaian
obat/dosis pemakaian obat/biaya

1 ANIK HIDAYATUN 761315 √ √

2 ANIK HIDAYATUN 761315 √ √
3 ANIK NUR HIDAYATI, Ny 761386 √ √
4 MURNI, Ny 732574 √ √
5 JUMU'IYAH, Ny 761385 √ √
6 FUNNY YULIANA, Nn 761123 √ √
7 JAMI'AN,
MOHAMAD Tn RIFQY 742183 √ √
8 ROOSDHANI, Tn 599218 √ √
9 SUTIAH, Ny 761037 √ √
10 NGATMONAH, Ny 761339 √ √
11 JUMU'IYAH, Ny 761385 √ √
12 MUHAMMAD WITANTO 763202 √ √
13 SRI DEWI, Ny 761139 √ √
14 SITI ISTIQOMAH 756307 √ √
15 ALI IMRON, Tn 763158 √ √
16 JUMU'IYAH, Ny 761385 √ √
17 SOLEH, TN 761336 √ √
18 ERNAWATI 758941 √ √
19 ERNAWATI BY NY
VINI SUTARINI ANGGRIANI, 761397 √ √
20 Ny 760732 √ √
21 MUSTARIKHAH,
MOHAMAD RIFQY Ny 602612 √ √
22 ROOSDHANI, Tn 599218 √ √
23 SUJONO, Tn 761318 √ √
24 ANIK PURWATI 745210 √ √
25 JUMU'IYAH, Ny 761385 √ √
26 MURNI, Ny 732574 √ √
27 NIHAYATUL FAUZIYAH, An 729298 √ √
28 ANIK PURWATI 745210 √ √
29 ELY BUDIYONO, Tn 761092 √ √
30 MUSTARIKHAH, Ny 602612 √ √
31 SUSANTI, Ny
DIANA WAHYU 761337 √ √
32 FIDIANINGSIH BY NY 761406 √ √
33 LAILATUL SIFAANAH 640595 √ √
34 KAIF AVIAN FAUZA 730056 √ √
35 NORMA ZUNITA, Ny 763103 √ √
36 NORMA ZUNITA, Ny 763103 √ √
37 ANIK NUR HIDAYATI, Ny 761386 √ √
38 NOR AFIF MARUF 761305 √ √
39 AHMAD KHOLIQ, Tn 761287 √ √
40 SURINAH, Ny 761362 √ √
41 SAMINI 535129 √ √
42 ZIADUL MUTTAQIN 524175 √ √
43 MASRUKAN, Tn 761320 √ √
44 MINTARSIH, Ny 761306 √ √
45 ARKA FITARI 761343 √ √
46 SHOLIKHAH, Ny 762074 √ √
47 FARHATUL ULYA 614534 √ √
48 ENY NORMA, Ny 743538 √ √
49 SOLEH, TN 761336 √ √
50 SUPRIYATI NY 761088 √ √
51 WIDYOWATI, Ny 761360 √ √
52 TETIK SUPENTI 761321 √ √
53 SITI SALAMAH, Ny 742024 √ √
54 SISWATI, Ny 678132 √ √
55 SAFUATIN, Ny 761311 √ √
56 ANIK HIDAYATUN 761315 √ √
57 MURNI, Ny 732574 √ √
58 SISWATI, Ny 678132 √ √
59 KISWATI, Ny 761334 √ √
60 KAIF AVIAN FAUZA 730056 √ √
61 MUKHLAS ANWAR, Tn 566813 √ √
62 AHMAD RAFI'I 753087 √ √
63 RIZKI ROFICHUL ANAM 617889 √ √
64 ABDUL MAJID, Sdr 761300 √ √
65 AHMAD RAFI'I 753087 √ √
66 ARIFIN
MOHAMMAD, Tn KHANIF 713844 √ √
67 AFIFI-JIWA 527237 √ √
68 MUKHLAS ANWAR, Tn 566813 √ √
69 NURUL KHOMARIYAH 701068 √ √
70 ZAENAL ARIFIN 725335 √ √
71 RUBIAH, Ny 761274 √ √
72 MUSTARIKHAH, Ny 602612 √ √
73 SITI SUHARTINI, Ny 761356 √ √
74 EVI SULISTYORINI NY 542599 √ √
75 SUJONO, Tn 761318 √ √
76 KAIF AVIAN FAUZA 730056 √ √
77 SITI HADIJAH , Ny 557402 √ √
 78 SOLEKAN, Tn 761340 √ √
79 IKA RAMAWATI, Ny 741760 √ √
80 ACHMAD TRI ATMAJA 558771 √ √
81 NGATMONAH, Ny 761339 √ √
82 ISTIKOMAH, Ny 763069 √ √
83 ANIS KHUMAIROH
NUR KHOIROTUL 700097 √ √
84 KHASANAH 761381 √ √
85 MUKLIM, Tn 647796 √ √
86 SUPARJO, Tn 756887 √ √
87 KAIF AVIAN FAUZA 730056 √ √
88 ASARI,
PRAYOGI TnWAHYU 723135 √ √
89 SAPUTRA, An 529736 √ √
90 MUHAMMAD WITANTO 763202 √ √
91 IKA RAMAWATI, Ny 741760 √ √
92 ACHMAD TRI ATMAJA 558771 √ √
93 MUKLIM,
NATASYA Tn ANINDITA 647796 √ √
94 AZZAHRA 763155 √ √
95 MERY JULIANTO, Tn 590163 √ √
96 SRI
NURREDJEKI
AGUS , Ny 713502 √ √
97 PURWANINGSIH NY 548183 √ √
98 WALGITO 757432 √ √
99 NGATMONAH, Ny 761339 √ √
100 SURINAH, Ny 761362 √ √
101 KHANIFATUR RUMISIH, Ny 565840 √ √
102 AHMAD MUSTHOFA, An 761307 √ √
103 ALI IMRON, Tn 763158 √ √
104 HARIS SAFRUDIN, Sdr 753020 √ √
105 AHMAD
MUHAMMAD YUSROILHAM 761399 √ √
106 PRATAMA,
DANENDRAAn ZIANDRU 761367 √ √
107 MAHMUD 757656 √ √
108 SITI KHANIFAH 761404 √ √
109 JUMU'IYAH, Ny 761385 √ √
110 KAMTO SUBAGYO, Tn 711710 √ √
111 TITIK SULISWATI BY NY 761420 √ √
112 FUNNY YULIANA, Nn 761123 √ √
113 SATU 761407 √ √
114 ARKA FITARI ROYYAN
MUHAMMAD 761343 √ √
115 ATHALLAH 761382 √ √
116 SUTIAH, Ny 761037 √ √
117 KARDI,
MUHAMMADTn HASIM 651884 √ √
118 MUBAROQ 761301 √ √
119 NADIRA
MUHAMMAD AZMINA,
NURAn
SALIM, 761228 √ √
120 An 761285 √ √
 121 SUGIYANTI, Ny 757339 √ √
122 SHOLIKHAH BY NY 761352 √ √
123 AKIFAH HASNA KAMILA 761354 √ √

Mengetahui Pelapor
Ka. Instalasi farmasi RSUD RA KARTINI

Sandi Purbaningsih,Msc.Apt Rulita Noor Syafira, A.Md.

NIP. 19770803 200401 2 001 NIP. 19940907 202012 2 003