DINAS KESEHATAN KABUPATEN BANDUNG

PUSKESMAS CIPARAY DTP

JL. RAYA LASWI NO.819 DS.MANGGUNGHARJA KEC.CIPARAY

REGISTER TRACKING DIAGNOSA (E11.9)

Periode Laporan: Maret 2023

Kelurahan/Desa : semua
Kecamatan : CIPARAY

UMUR VITAL SIGN

NO. TGL. NIK NO.BPJS NO.INDEX NAMA PASIEN TGL.LAHIR ALAMAT KUNJ JAMINAN LAYANAN ANAMNESA DIAGNOSA KASUS
L P TD BB/TB SUHU HR/RR

PROLANIS ; DM01 HT02 ;

1 01-03-2023 3204294208800011 0001328868887 2019/19230 SITI KHODIZAH 1980-08-02 - 42Th CIBOTOR RT. 2 RW. 22, KEL.MANGGUNG HARJA LAMA BPJS PBI POLI LANSIA 0001328868887 ; TD 154/88 ; GDP 125/71 / 36 80/20 E11.9 LAMA
226
PROLANIS ; DM02 HT02 ;
2 01-03-2023 3204294803630008 0001296153371 2016/00739 SITI JULAEHA 1963-03-08 - 60Th LELES RT. 01 RW. 13, KEL.MEKARSARI LAMA BPJS NON PBI POLI LANSIA 0001296153371 ; TD 156/84 ; GDP 125/70 / 36 88/20 E11.9 LAMA
102

PROLANIS ; DM02 HT02 ;

CUCU
3 01-03-2023 3204295104600005 0000415568283 2019/22390 1960-04-11 - 62Th PARIGI RT. 3 RW. 7, KEL.CIPARAY LAMA BPJS PBI POLI LANSIA 0000415568283 ; TD 142/77 ; GDP 125/70 / 36 80/20 E11.9 LAMA
YULIANINGSIH
98 KOL 171
PROLANIS ; DM01 HT02 ;
4 01-03-2023 - 0000415317216 2016/00008 EULIS NURHAYATI 1966-01-01 - 50Th KP. CANGKUANG RT. 01 RW. 06, KEL.BIRU LAMA UMUM POLI LANSIA 0000415317216 ; TD 152/82 ; 131/70 / 36 88/22 E11.9 LAMA
GDP185

PROLANIS ; DM02 HT02 ;

KARANGANYAR RT. 02 RW. 03, KEL.MANGGUNG
5 01-03-2023 3204295203550006 0001882292826 2016/06532 ROMLAH 1955-03-12 - 68Th LAMA BPJS NON PBI POLI LANSIA 0001882292826 ; TD 130/54 ; GDP 125/70 / 36 80/20 E11.9 LAMA
HARJA
108 KOL 177

PROLANIS ; DM01 HT02 ;

6 01-03-2023 3204294701910009 0002524182142 2022/38711 NENI FITRIYANI 1991-01-07 - 32Th LEBAK BIRU RT. 4 RW. 11, KEL.CIHEULANG LAMA BPJS PBI POLI LANSIA 0002524182142 ; TD 139/90 ; GDP 116/70 / 36 80/20 E11.9 LAMA
146

PROLANIS ; DM02 HT02 ;

LILIS YAYAN
7 01-03-2023 3204306508650001 0000053855662 2019/16810 1961-08-25 - 57Th CIPEUJEUH RT. 1 RW. 8, KEL.CIPEUJEUH LAMA BPJS NON PBI POLI LANSIA 0000053855662 ; TD 148/68 ; GDP 131/70 / 36 80/20 E11.9 LAMA
RUHYANI
76 KOL 237
PROLANIS ; DM02 HT02 ;
ARINI ISMIYATI
8 01-03-2023 3204293107940007 0000053078038 2016/04892 1994-07-31 - 57Th LELES RT. 02 RW. 11, KEL.MEKARSARI LAMA BPJS NON PBI POLI LANSIA 0000053078038 ; TD 138/82 ; GDP 116/70 / 36 80/20 E11.9 LAMA
DRA
100 KOL 113

PROLANIS ; DM02 HT02 ;

KARANG ANYAR RT. 02 RW. 02, KEL.MANGGUNG
9 01-03-2023 3204294107650255 0000415369697 2016/00193 WATI SETIAWATI 1965-07-01 - 57Th LAMA BPJS PBI POLI LANSIA 0000415369697 ; TD 153/87 ; GDP 125/71 / 36 88/20 E11.9 LAMA
HARJA
128 KOL 135
PROLANIS ; DM01 HT02 ;
10 01-03-2023 3204295009660001 0000415196818 2020/24696 ANA TRIANA 1966-09-10 - 56Th LEBAK BIRU RT. 2 RW. 14, KEL.CIHEULANG LAMA BPJS PBI POLI LANSIA 0000415196818 ; TD 137/84 ; GDP 125/70 / 36 70/20 E11.9 LAMA
152 KOL 235

PROLANIS ; DM02 HT02 ;

11 01-03-2023 3204094606550001 0000053722833 2018/10858 EUIS ROHAYATI 1955-06-07 - 67Th LELES RT. 3 RW. 12, KEL.MEKARSARI LAMA BPJS NON PBI POLI LANSIA 0000053722833 ; TD 125/74 ; GDP 125/70 / 36 80/20 E11.9 LAMA
103

PROLANIS ; DM02 HT02 ;

12 01-03-2023 3204294107670010 0000415383423 2021/35436 ODAH 1967-07-01 - 55Th JATI SARI RT. 2 RW. 15, KEL.SARIMAHI LAMA BPJS PBI POLI LANSIA 0000415383423 ; TD 145/76 ; GDP 125/70 / 36 80/20 E11.9 LAMA
114 KOL 222

PROLANIS ; DM02 HT02 ;

13 01-03-2023 3204320409640001 0002903080421 2019/21014 HENI MAESAROH 1964-09-04 - 52Th ANDIR RT. 3 RW. 7, KEL.PAKUTANDANG LAMA BPJS NON PBI POLI LANSIA 0002903080421 ; TD 133/83 ; GDP 125/70 / 36 80/20 E11.9 LAMA
126 KOL 189
PROLANIS ; DM02 HT02 ;
14 01-03-2023 3204294508120007 0002591581724 2019/22104 ENUR 2012-08-05 - 38Th PANGUPUKAN RT. 1 RW. 6, KEL.MEKARLAKSANA LAMA BPJS PBI POLI LANSIA 0002591581724 ; TD 145/86 ; GDP 125/70 / 36 80/20 E11.9 BARU
112 KOL 193
 UMUR VITAL SIGN
NO. TGL. NIK NO.BPJS NO.INDEX NAMA PASIEN TGL.LAHIR ALAMAT KUNJ JAMINAN LAYANAN ANAMNESA DIAGNOSA KASUS
L P TD BB/TB SUHU HR/RR

PROLANIS ; DM02 HT02 ;

NENDEN
15 01-03-2023 3204295606650002 0002750914585 2017/06167 1965-06-16 - 57Th CIMARIUK RT. 4 RW. 16, KEL.MANGGUNG HARJA LAMA BPJS PBI POLI LANSIA 0002750914585 ; TD 139/78 ; GDP 125/70 / 36 88/20 E11.9 LAMA
WIRATNINGSIH
118

PROLANIS ; DM01 HT02 ;

16 01-03-2023 3204295310740002 0000415380363 2019/19168 NINING CAHYANI 1974-10-13 - 48Th JONGOR RT. 3 RW. 16, KEL.SERANGMEKAR LAMA BPJS PBI POLI LANSIA 0000415380363 ; TD 158/83 ; 131/80 / 36 80/20 E11.9 LAMA
GDP154 KOL197

PROLANIS ; DM02 HT02 ;

17 01-03-2023 3204292104760013 0000039287136 2020/29696 SUMARNA 1976-04-21 46Th - ANDIR RT. 1 RW. 11, KEL.PAKUTANDANG LAMA BPJS NON PBI POLI LANSIA 0000039287136 ; TD 124/79 ; GDP 125/70 / 36 80/20 E11.9 LAMA
126

PROLANIS ; DM01 HT02 ;

18 01-03-2023 3204294502510001 0002759297062 2019/18343 DEWI SURYATI 1951-02-05 - 72Th PARIGI RT. 4 RW. 7, KEL.CIPARAY LAMA BPJS NON PBI POLI LANSIA 0002759297062 ; TD 133/69 ; GDP 125/71 / 36 80/20 E11.9 LAMA
161

PROLANIS ; DM01 HT02 ;

NENENG
19 01-03-2023 3204291310490001 0001337283718 2019/15251 2048-10-13 - 65Th KPLELES RT. 2 RW. 13, KEL.MEKARSARI LAMA BPJS PBI POLI LANSIA 0001337283718 ; TD152/84 ; GDP 125/70 / 36 80/20 E11.9 LAMA
JULAEHA
140 KOL 189

PROLANIS ; DM02 HT02 ;

20 01-03-2023 3204094606550001 0000053722822 2018/10858 HARUN 1955-06-07 73Th - LELES RT. 3 RW. 12, KEL.MEKARSARI LAMA BPJS NON PBI POLI LANSIA 0000053722822 ; TD 144/73 ; GDP 125/70 / 36 80/20 E11.9 LAMA
118

PROLANIS ; DM01 HT02 ;

21 01-03-2023 3204294404640004 0002519737031 2016/03151 LILIS SETIAWATI 1964-04-04 - 58Th LEUWIJAMBU RT. 06 RW. 13, KEL.MEKARSARI LAMA BPJS NON PBI POLI LANSIA 0002519737031 ; TD 149/84 ; GDP 125/70 / 36 80/20 E11.9 LAMA
181

PROLANIS ; DM02 HT02 ;

Y. BENNY
22 01-03-2023 3204292404530002 0000053386097 2016/09830 1952-04-24 69Th - KP.BANDIR RT. 01 RW. 03, KEL.MANGGUNGHARJA LAMA BPJS NON PBI POLI LANSIA 0000053386097 ; TD 149/84 ; GDP 125/70 / 36 80/20 E11.9 LAMA
SUBAGIO
105
PROLANIS ; DM02 HT02 ;
23 01-03-2023 32042966070900002 0001833841203 2016/02938 GUNAWAN 2009-07-26 40Th - KP SUKAGALIH RT. 06 RW. 06, KEL.CIKONENG LAMA BPJS NON PBI POLI LANSIA 0001833841203 ; TD 144/80 ; 125/70 / 36 88/22 E11.9 LAMA
GDP128 KOL232

PROLANIS ; HT02 DM01 ;

24 01-03-2023 3204296311670003 0000976700957 2016/01286 IIS RIZA ORIZA 1967-11-23 - 55Th GANG BUDI DARMA RT. 01 RW. 06, KEL.SARIMAHI LAMA BPJS NON PBI POLI LANSIA 0000976700957 ; TD 150/91 ; 131/70 / 36 88/22 E11.9 LAMA
GDP163 KOL259

PROLANIS ; DM02 HT02 ;

25 01-03-2023 320429811720002 0000414919293 2019/20473 ROHAYATI 1972-11-08 - 50Th LELES RT. 5 RW. 12, KEL.MEKARSARI LAMA BPJS PBI POLI LANSIA 0000414919293 ; TD 127/77 ; GDP 100/70 / 36 80/20 E11.9 LAMA
114

PROLANIS ; DM02 HT02 ;

26 01-03-2023 320429501710007 0002524873724 2019/23566 IIK ATIKAH 1971-01-05 - 52Th CIMARIUK RT. 3 RW. 19, KEL.MANGGUNG HARJA LAMA BPJS PBI POLI LANSIA 0002524873724 ; TD 135/84 ; GDP 125/70 / 36 80/20 E11.9 LAMA
120

PROLANIS ; DM02 HT02 ;

27 01-03-2023 3204291007400003 0000053380877 2017/04902 ADUN SUHENDI 1940-07-10 82Th - GUNUNGLEUTIK RT. 3 RW. 3, KEL.GUNUNGLEUTIK LAMA BPJS NON PBI POLI LANSIA 0000053380877 ; TD 147/75 ; GDP 125/70 / 36 80/20 E11.9 LAMA
90

PROLANIS ; DM02 HT02 ;

28 02-03-2023 3204326507610003 0000053383274 2017/05247 CINTASIH 1961-07-25 - 61Th BOJONG RT. 4 RW. 6, KEL.CIPARAY LAMA BPJS NON PBI POLI LANSIA 0000053383274 ; TD 132/68 ; GDP 125/70 / 36 80/20 E11.9 LAMA
88 KOL 172

PROLANIS ; DM01 HT02 ;

29 02-03-2023 - 0002419113778 2016/04240 PIPIH SARIPAH 1990-12-25 - 64Th STASION RT. 04 RW. 04, KEL.SARIMAHI LAMA BPJS PBI POLI LANSIA 0002419113778 ; TD 158/86 ; GDP 125/70 / 36 80/20 E11.9 LAMA
157 AU 5,2

PROLANIS ; DM02 HT02 ;

30 02-03-2023 3204295201820005 0000416719822 2019/22438 UUN NURHAYATI 1982-01-12 - 41Th LEGOK MIDAR RT. 2 RW. 13, KEL.MEKARLAKSANA LAMA BPJS PBI POLI LANSIA 0000416719822 ; TD 163/89 ; GDP 125/70 / 36 80/20 E11.9 LAMA
106 KOL 195

PROLANIS ; DM02 HT02 ;

31 02-03-2023 3204294101550045 0000415766417 2017/08247 ROKAYAH 1955-01-01 - 68Th JL M RAMDAN RT. 1 RW. 9, KEL.MEKARSARI LAMA BPJS PBI POLI LANSIA 0000415766417 ; TD 125/7 ; GDP 125/70 / 36 80/20 E11.9 LAMA
111

32 02-03-2023 3204295505700001 0001341070975 2021/35183 TATI 1970-05-15 - 52Th LIO MADUR RT. 1 RW. 12, KEL.MEKARLAKSANA LAMA BPJS PBI POLI UMUM PUSING, KONTROL GULA 115/63 50/150 36 95/20 E11.9 BARU
 UMUR VITAL SIGN
NO. TGL. NIK NO.BPJS NO.INDEX NAMA PASIEN TGL.LAHIR ALAMAT KUNJ JAMINAN LAYANAN ANAMNESA DIAGNOSA KASUS
L P TD BB/TB SUHU HR/RR

PROLANIS ; DM01 HT01 ;

LILIS SITI
33 02-03-2023 3204295706570003 0002295897129 2019/22384 1957-06-17 - 65Th LOA ALUN-ALUN RT. 2 RW. 4, KEL.MEKARSARI LAMA BPJS NON PBI POLI LANSIA 0002295897129 ; TD 170/98 ; GDP 116/70 50/150 36 80/20 E11.9 LAMA
SOLIHAH
158 AU 8,3 KOL 231

PROLANIS ; DM02 HT01 ;

EUIS
34 02-03-2023 3204295010540003 0002617870498 2019/17356 1954-10-10 - 68Th CIMARIUK RT. 2 RW. 19, KEL.MANGGUNG HARJA LAMA BPJS PBI POLI LANSIA 0002617870498 ; TD 160/82 ; GDP 145/70 50/150 36 80/20 E11.9 LAMA
HENDRAWATI
123

35 02-03-2023 3204294504650006 0002837234878 2021/33857 FATIMAH 1965-04-05 - 57Th KP RANCAHELANG RT. 1 RW. 9, KEL.MEKARLAKSANA LAMA BPJS PBI POLI UMUM KONTROL GULA 158/70 50/155 36.5 75/20 E11.9 LAMA

PROLANIS ; DM02 HT01 ;

36 02-03-2023 3204295308520001 0000053726815 2019/23307 TUTI SUHATI 1952-08-13 - 70Th JL LASWI RT. 4 RW. 2, KEL.MANGGUNG HARJA LAMA BPJS NON PBI POLI LANSIA 0000053726815 ; TD 168/104 ; GDP 148/70 50/155 36 80/20 E11.9 LAMA
133

PROLANIS ; DM02 HT02 ;

37 02-03-2023 3204295507570002 0002524887382 2021/32854 ENI ROHAENI 1957-07-15 - 65Th KP.STASION RT. 3 RW. 16, KEL.SARIMAHI LAMA BPJS PBI POLI LANSIA 0002524887382 ; TD 130/89 ; GDP 116/70 50/155 36 80/20 E11.9 LAMA
84 KOL 190

SERING HAUS, MAKAN BANYAK, BB

38 02-03-2023 3204294605120004 0001003367417 2018/12749 PIPIT NURHAYATI 2012-05-06 - 43Th CIMARIUK RT. 2 RW. 18, KEL.MANGGUNG HARJA LAMA BPJS PBI POLI UMUM 120/84 50/150 36 94/20 E11.9 BARU
TURUN, BANYAK BAK, PUSING (+)

PROLANIS ; DM02 HT02 ;

39 02-03-2023 3273116210590006 0000057488736 2017/00157 DEDEH 1959-10-22 - 63Th HUJUNG RT. 2 RW. 2, KEL.CIPARAY LAMA BPJS NON PBI POLI LANSIA 0000057488736 ; TD 123/72 ; GDP 100/70 50/150 36 80/20 E11.9 LAMA
134

PROLANIS ; DM02 HT02 ;

40 02-03-2023 3204290104960004 0001003406073 2019/22400 NENENG 1972-12-11 - 50Th PANGUPUKAN RT. 2 RW. 6, KEL.MEKARLAKSANA LAMA BPJS PBI POLI LANSIA 0001003406073 ; TD 148/94 ; GDP 125/70 50/150 36 80/20 E11.9 LAMA
116

PROLANIS ; DM01 HT02 ;

IMAS KALMAH
41 02-03-2023 3204345611500002 0000053765559 2019/16225 1950-11-16 - 72Th KOYOD RT. 1 RW. 11, KEL.RANCAKASUMBA LAMA BPJS NON PBI POLI LANSIA 0000053765559 ; TD 159/89 ; GDP 125/70 50/150 36 80/20 E11.9 LAMA
ERMAYA
146

PROLANIS ; DM01 HT01 ;

42 02-03-2023 3204296409150003 0003113646309 2018/13561 ROSMALA DEWI 2015-09-24 - 43Th BOJONGNANGKA RT. 3 RW. 9, KEL.MEKARLAKSANA LAMA BPJS PBI POLI LANSIA 0003113646309 ; TD 138/104 ; GDP 148/95 50/150 36 80/20 E11.9 LAMA
198 KOL 241

PROLANIS ; DM02 HT02 ;

43 02-03-2023 3204291401700003 0000167254367 2017/03947 ELIS SULIYANAH 1970-01-14 - 52Th CIPAKU RT. 1 RW. 18, KEL.PAKUTANDANG LAMA BPJS NON PBI POLI LANSIA 0000167254367 ; TD 150/101 ; GDP 125/70 50/150 36 80/20 E11.9 LAMA
140

PROLANIS ; DM01 HT01 ;

44 02-03-2023 3204295011520005 0001341194073 2016/04604 E ROHIMAH 1952-11-10 - 70Th LELES RT. 4 RW. 12, KEL.MEKARSARI LAMA BPJS PBI POLI LANSIA 0001341194073 ; TD 159/141 ; GDP 148/71 50/150 36 80/20 E11.9 LAMA
149

PROLANIS ; DM01 HT01 ;

SODIKIN BISRI
45 02-03-2023 320429070347001 0000054109089 2016/08263 1947-03-07 76Th - JONGOR KULON RT. 2 RW. 11, KEL.SARIMAHI LAMA BPJS NON PBI POLI LANSIA 0000054109089 ; TD 163/84 ; GDP 148/70 50/150 36 80/20 E11.9 LAMA
[PROLANIS DM02]
142

PROLANIS ; DM01 HT01 ;

46 02-03-2023 3204296007510001 0002961431526 2022/39407 SITI HODIJAH 1951-07-20 - 71Th JL MOCH RAMDAN RT. 5 RW. 12, KEL.MEKARSARI LAMA BPJS PBI POLI LANSIA 0002961431526 ; TD 170/84 ; GDP 145/70 50/150 36 80/20 E11.9 LAMA
155 KOL 162

PROLANIS ; DM02 HT02 ;

47 02-03-2023 3204335707620001 0002524595668 2016/02808 AYI HAPIDOH 1962-07-17 - 60Th CIDAWOLONG RT. 02 RW. 14, KEL.BIRU LAMA BPJS PBI POLI LANSIA 0002524595668 ; TD 126/86 ; GDP 125/70 50/150 36 80/20 E11.9 LAMA
103

ESA NURJANAH
48 02-03-2023 3204295204640003 0000415210882 2019/15953 [PROLANIS DM00 1964-04-12 - 58Th PAMINGGIR RT. 2 RW. 11, KEL.MANGGUNG HARJA LAMA UMUM POLI UMUM KONTROL GULA, PUSING (+) 183/69 60/155 36,5 82/18 E11.9 BARU
HT00]

PROLANIS ; DM02 HT02 ;

49 02-03-2023 3204291610560004 0002060560855 2019/15586 ENOK ROHAENI 1956-10-16 - 65Th GUNUNGLEUTIK RT. 4 RW. 14, KEL.GUNUNGLEUTIK LAMA BPJS NON PBI POLI LANSIA 0002060560855 ; TD 125/69 ; GDP 116/70 60/155 36 80/20 E11.9 LAMA
119

PROLANIS ; DM02 HT02 ;

50 02-03-2023 3204294308640001 0000415825874 2022/35505 ENTIN S 1964-08-03 - 57Th PANGUPUKAN RT. 1 RW. 6, KEL.MEKARLAKSANA LAMA BPJS PBI POLI LANSIA 0000415825874 ; TD 131/79 ; GDP 116/70 60/155 36 80/20 E11.9 LAMA
82
 UMUR VITAL SIGN
NO. TGL. NIK NO.BPJS NO.INDEX NAMA PASIEN TGL.LAHIR ALAMAT KUNJ JAMINAN LAYANAN ANAMNESA DIAGNOSA KASUS
L P TD BB/TB SUHU HR/RR

PROLANIS ; DM02 HT02 ;

51 02-03-2023 3204291404490002 0000415677385 2019/15888 EDY MULYADI 1949-04-14 73Th - HUJUNG RT. 3 RW. 1, KEL.CIPARAY LAMA BPJS PBI POLI LANSIA 0000415677385 ; TD 87/57 ; GDP 100/70 60/155 36 80/20 E11.9 LAMA
130

PROLANIS ; DM02 HT02 ;

52 02-03-2023 3204296005480002 0002524894356 2020/25392 RATIAH 1948-05-20 - 74Th CIPONGPORANG RT. 2 RW. 19, KEL.SERANGMEKAR LAMA BPJS PBI POLI LANSIA 0002524894356 ; TD 136/71 ; GDP 116/70 60/155 36 80/20 E11.9 LAMA
133

PROLANIS ; DM02 HT02 ;

53 02-03-2023 3204295005550008 0001340552788 2016/01001 NY.OOM 1955-05-10 - 67Th KP. LEUWI JAMBU RT. 05 RW. 13, KEL.MEKARSARI LAMA BPJS PBI POLI LANSIA 0001340552788 ; TD 135/90 ; GDP 116/70 60/155 36 80/20 E11.9 LAMA
96

PROLANIS ; DM02 HT02 ;

54 02-03-2023 3204292710610002 0000054097299 2016/02958 AGUS SUBAGJA 1961-10-27 61Th - CIPARAY INDAH RT. 02 RW. 11, KEL.SARIMAHI LAMA BPJS NON PBI POLI LANSIA 0000054097299 ; TD 128/75 ; GDP 116/70 60/155 36 80/20 E11.9 LAMA
109

PROLANIS ; DM01 HT02 ;

AYI
55 03-03-2023 3211085012840013 0002251893093 2016/09565 1984-12-10 39Th - BBKN TAROGONG RT. 2 RW. 6, KEL.CIPARAY LAMA BPJS PBI POLI LANSIA 0002251893093 ; TD 116/72 ; GDP 120/80 60/155 36 80/20 E11.9 LAMA
SETIADI,M.PD.I
140

PROLANIS ; DM01 HT02 ;

56 03-03-2023 3204295210650004 0002524870293 2020/26388 ETI ROHAETI 1965-10-12 - 57Th ANDIR RT. 1 RW. 10, KEL.PAKUTANDANG LAMA BPJS PBI POLI LANSIA 0002524870293 ; TD 150/95 ; GDP 120/80 60/155 36 80/20 E11.9 LAMA
153 AU 5,8

PROLANIS ; DM01 HT02 ;

57 03-03-2023 3204294707560002 0002063466178 2016/09171 YAYAH ROKAYAH 1956-07-07 - 66Th CIMARIUK RT. 3 RW. 17, KEL.MANGGUNG HARJA LAMA BPJS NON PBI POLI LANSIA 0002063466178 ; TD 147/58 ; GDP 120/80 60/155 36 80/20 E11.9 LAMA
212

PROLANIS ; DM01 HT02 ;

58 03-03-2023 3204295109680001 0002739590267 2017/05055 NURJANAH 1968-09-11 - 54Th LELES RT. 4 RW. 12, KEL.MEKARSARI LAMA BPJS NON PBI POLI LANSIA 0002739590267 ; TD 156/83 ; GDP 120/80 60/155 36 80/20 E11.9 LAMA
153

PROLANIS ; DM02 HT02 ;

EUIS TATI
59 03-03-2023 3273074511570002 0001265138908 2019/14725 1957-11-05 - 65Th PERMATA REGENCY RT. 4 RW. 18, KEL.BUMIWANGI LAMA BPJS NON PBI POLI LANSIA 0001265138908 ; TD 136/66 ; GDP 130/80 60/155 36 80/20 E11.9 LAMA
HARYATI
118 AU 9,6

PROLANIS ; DM02 HT02 ;

60 03-03-2023 3204295605720004 0003094798329 2017/03472 IDAH ROSIDAH 1972-05-16 - 50Th BOJONGKALONG RT. 5 RW. 2, KEL.SUMBERSARI LAMA BPJS NON PBI POLI LANSIA 0003094798329 ; TD 157/83 ; GDP 120/80 60/155 36 80/20 E11.9 LAMA
92 KOL 196

PROLANIS ; DM02 HT02 ;

61 03-03-2023 3204294204450004 0000415669015 2019/23807 CICIH 1945-04-02 - 77Th SUKAGALIH RT. 6 RW. 6, KEL.CIKONENG LAMA BPJS PBI POLI LANSIA 0000415669015 ; TD 144/75 ; GDP 120/80 60/155 36 80/20 E11.9 LAMA
142

62 04-03-2023 3204292001580001 0000057929049 2019/17623 HUSEN 1958-01-20 65Th - LIO TANJUNGLAYA RT. 1 RW. 9, KEL.SARIMAHI LAMA BPJS NON PBI POLI LANSIA PUSING KEPALA 120/80 60/155 36 80/20 E11.9 LAMA

DINA KP. CIHEULANG TONGGOH RT. 1 RW. 17,

63 04-03-2023 3204295807110006 0 2017/04115 2011-07-18 - 35Th LAMA UMUM POLI UMUM KONTROL DM DAN HT 120/70 60/160 36,5 80/20 E11.9 LAMA
ROSMAWANTI KEL.CIHEULANG

SERING BAK DAN BANYAK,

64 06-03-2023 3204290107550019 0002524875232 2019/23373 WARMI 1955-07-01 - 52Th CIBOTOR RT. 2 RW. 22, KEL.MANGGUNG HARJA LAMA BPJS PBI POLI UMUM 177/98 60/156 36,5 80/20 E11.9 LAMA
RIWAYAT DM (+)
ABSES DI KAKI KANAN, BENGKAK,
65 06-03-2023 3273122909100001 0001297998731 2016/04775 AGUS ISMAIL 2010-09-29 56Th - LEUWIJAMBU RT. 06 RW. 13, KEL.MEKARSARI LAMA BPJS NON PBI POLI UMUM 140/78 60/160 36,5 107/20 E11.9 LAMA
RIWAYAT DM (+)
ABSES DI KAKI KANAN, BENGKAK,
66 08-03-2023 3210164909720081 0 2023/42025 ERNAWATI 1972-09-09 - 50Th BOJONG NANGKA RT. 1 RW. 05, KEL.MEKARSARI LAMA UMUM POLI INFEKSIUS 140/78 60/160 36,5 107/20 E11.9 BARU
RIWAYAT DM (+)

PROLANIS ; 0000415677723 ;
67 08-03-2023 3204294101520058 0000053721944 2016/03977 ERAT 1952-01-01 - 71Th SUKADANA RT. 01 RW. 05, KEL.MANGGUNG HARJA LAMA BPJS NON PBI POLI LANSIA 140/70 60/160 36 80/20 E11.9 BARU
140/70 ; GDP 132 CHOL 235
ENUNG
68 09-03-2023 3204291312090003 0 2019/15553 2009-12-13 - 48Th LELES RT. 3 RW. 11, KEL.MEKARSARI LAMA UMUM POLI UMUM NYERI KEPALA, BB TURUN 148/81 55/155 36,7 116/18 E11.9 BARU
NURHAYATI

69 09-03-2023 3204291107690006 0000415769319 2019/15723 AHMAD SOPIAN 1969-07-11 53Th - KARASAK RT. 3 RW. 7, KEL.CIHEULANG LAMA BPJS PBI POLI INFEKSIUS NYERI KEPALA, BB TURUN 148/81 55/155 36,7 116/18 E11.9 LAMA

70 09-03-2023 3204295505780018 0 2021/34258 BETI NOERBAETI 1978-05-15 - 44Th BBK CARINGIN RT. 3 RW. 5, KEL.CIPARAY LAMA UMUM POLI UMUM KONTROL GULA 141/93 55/155 36,7 100/20 E11.9 BARU

71 09-03-2023 3204290504710003 0001464994631 2019/15263 DANI SETIADI 1971-04-05 51Th - LIO RT. 3 RW. 4, KEL.CIPARAY LAMA BPJS NON PBI POLI UMUM SERING BAK, BB TURUN (+) 149/89 60/160 36,7 88/18 E11.9 BARU

72 09-03-2023 320429131030006 0 2016/08285 ATIKAH 2003-01-13 - 50Th PARIGI RT. 5 RW. 7, KEL.CIPARAY LAMA UMUM POLI UMUM PUSING, BB TURUN (+) 132/79 50/155 36,5 93/18 E11.9 BARU

73 10-03-2023 3204295009710004 0002522393199 2022/37225 IIS 1971-09-10 - 51Th JOLOK RT. 1 RW. 8, KEL.MEKARSARI LAMA BPJS PBI POLI UMUM PUSING (+), MUAL DAN LEMAS (+) 112/74 50/155 36.5 95/20 E11.9 BARU

74 10-03-2023 3204295002620003 0000053625598 2016/07752 DIAH 1962-02-10 - 61Th SUKASARI RT. 4 RW. 10, KEL.BUMIWANGI LAMA BPJS NON PBI POLI LANSIA NYERI ULU HATI. MUAL. RIW. DM 120/80 50/155 36 80/20 E11.9 BARU
 UMUR VITAL SIGN
NO. TGL. NIK NO.BPJS NO.INDEX NAMA PASIEN TGL.LAHIR ALAMAT KUNJ JAMINAN LAYANAN ANAMNESA DIAGNOSA KASUS
L P TD BB/TB SUHU HR/RR

NAFSU MAKAN BERTAMBAH,

75 10-03-2023 3204291506560003 0 2019/17501 EMAS 1956-06-15 - 56Th BBK BUAH RT. 3 RW. 3, KEL.CIHEULANG LAMA UMUM POLI UMUM 147/87 60/155 36.7 80/20 E11.9 BARU
TANGAN DAN KAKI

HJ. NANI
76 11-03-2023 3204295708520001 0002263233418 2019/18540 1952-08-17 - 70Th KEBON SAWO RT. 2 RW. 7, KEL.SARIMAHI LAMA BPJS NON PBI POLI LANSIA RUJUK 120/80 60/155 36 80/20 E11.9 BARU
SUMARNI
77 13-03-2023 3204295011690003 0002524894986 2023/41986 ADE KARTINI 1969-11-10 - 53Th PALEDANG RT. 3 RW. 01, KEL.GUNUNGLEUTIK LAMA BPJS PBI POLI UMUM CEK GULA DARAH 130/70 55/160 36 88/22 E11.9 LAMA

78 13-03-2023 3204294511830002 0001725934037 2021/32098 KURNIAWAN 1983-11-05 42Th - LIO RT. 2 RW. 9, KEL.CIPARAY LAMA BPJS NON PBI POLI UMUM KONTROL DM. GDP 197 110/70 50/155 36 79/20 E11.9 BARU
TATING
79 13-03-2023 3204295207620006 0 2023/42086 1964-07-12 - 58Th BUMI ASIH RT. 3 RW. 12, KEL.BUMIWANGI LAMA UMUM POLI UMUM GULA DARAH TINGGI 120/60 55/160 36 88/22 E11.9 LAMA
KARMILAH
80 14-03-2023 3273025810780001 0002087052704 2023/41103 SITI ROHMAH 1978-10-18 - 44Th JL CIDAWOLONG RT. 1 RW. 1, KEL.BIRU LAMA BPJS NON PBI POLI TB DOTS GULA DARAH TINGGI 120/60 55/160 36 88/22 E11.9 BARU

81 15-03-2023 3204292708990001 0000052983213 2016/08237 ADE SUHENDAR 1999-08-27 57Th - BOJONG KALONG RT. 5 RW. 2, KEL.SUMBERSARI LAMA BPJS NON PBI POLI UMUM KONTROL DM 137/85 50/155 36.5 88/20 E11.9 BARU

82 16-03-2023 3204295807600003 0001003373392 2020/29645 RALEM 1960-07-18 - 62Th LELES RT. 3 RW. 11, KEL.MEKARSARI LAMA UMUM POLI LANSIA KONTROL GULA 147/75 50/155 36.5 90/20 E11.9 BARU

NANI RATNA
83 21-03-2023 3204290211980007 0 2017/04416 1998-11-02 - 62Th BANDIR RT. 3 RW. 3, KEL.MANGGUNG HARJA LAMA UMUM POLI UMUM PUSING DISERTAI PEGAL KAKI (+) 118/63 50/155 36.5 88/20 E11.9 LAMA
NINGSIH

84 21-03-2023 3204295002910009 0 2022/37542 NENDEN ARPA 1991-02-10 - 32Th CIHONJE RT. 2 RW. 7, KEL.MEKARLAKSANA LAMA UMUM POLI UMUM BADAN PEGAL (+) 127/92 55/155 36.5 98/20 E11.9 LAMA
PUSING, RIWAYAT GULA (+) DAN
85 21-03-2023 3204296007960005 0000056502909 2017/01544 TOHIROH 1996-07-20 - 73Th KP. LELES RT. 4 RW. 12, KEL.MEKARSARI LAMA BPJS NON PBI POLI LANSIA DARAH TINGGI (+), MUAL DISERTAI 174/105 55/155 36.5 90/20 E11.9 LAMA
NYERI ULU HATI

PUSING, RIWAYAT GULA (+) DAN

86 25-03-2023 3204304102550021 0 2023/41510 NYAI RUHAMAH 1967-02-01 - 56Th JALAN CAGAK RT. 2 RW. 9, KEL.MARUYUNG LAMA UMUM POLI INFEKSIUS DARAH TINGGI (+), MUAL DISERTAI 174/105 55/155 36.5 90/20 E11.9 LAMA
NYERI ULU HATI

KONTROL GULA, KONTROL TENSI,

87 27-03-2023 3204294607660006 0 2023/42277 ELIS SADIYAH 0000-00-00 - 56Th BBKN CIPASUNG RT. 2 RW. 06, KEL.CIHEULANG LAMA UMUM POLI UMUM NYERI SENDI TANGAN KANAN, DAN 150/90 50/155 36 88/22 E11.9 BARU
KAKI KANAN

NYERI PUNDAK. RIW. DM. KOLTOT

88 29-03-2023 0 0 2017/07897 IIS YUHAETI 2017-02-03 - 61Th CIDAWOLONG RT. 3 RW. 19, KEL.BIRU LAMA UMUM POLI LANSIA 180/90 50/155 36 88/20 E11.9 BARU
309, GDS 394

89 29-03-2023 3204294811740002 0000415252001 2018/11301 IHAT SOLIHAT 1974-11-01 - 48Th CIMARIUK RT. 5 RW. 19, KEL.MANGGUNG HARJA LAMA BPJS PBI POLI UMUM KONTROL GULA, DLL 140/80 55/155 36 88/20 E11.9 LAMA
LAMBUNG+, MUAL+, KEMBUNG+,
90 30-03-2023 3204295006710007 0002250420704 2017/06899 ENAN SETIAWAN 1971-10-06 53Th - BBK SRIMAHI RT. 2 RW. 3, KEL.SARIMAHI LAMA BPJS NON PBI POLI UMUM BAB CAIR + 1 KALI, RIW GD SAAT DI 110/80 60/155 36 88/20 E11.9 BARU
IGD AL IHSAN 370