<h2>DATA DIAGNOSIS PASIEN PUSKESMAS</h2>

Periode : 01-05-2023 s/d 31-05-2023<br>

<table class='grid' border='1'>
<tr>
<th>Kode Penyakit</th>
<th>Nama Diagnosis</th>
<th>ICDX</th>
<th>Keluhan</th>
<th>No.<br>Registrasi</th>
<th>No.Index</th>
<th>Tanggal</th>
<th>Nama</th>
<th>NamaKK</th>
<th>Pekerjaan</th>
<th>No. HP</th>
<th>Tgl. Lahir</th>
<th>Alamat</th>
<th>Dusun</th>
<th>Desa</th>
<th>Tempat Periksa</th>
<th>Petugas Medis</th>
<th>Perawat Bidan</th>
<th>JK</th>
<th>Kelompok<br>Umur</th>
<th>Pengirim</th>
<th>Kunjungan</th>
<th>Jenis<br>Pasien</th>
<th>Tindak<br>Lanjut</th>
<th>Hari</th>
<th>Bulan</th>
<th>Tahun</th>
<th>Unit</th>
<th>Poli Rujuk</th>
<th>Rumah Sakit</th>
<th>Wilayah</th>
<th>Kartu Sehat</th>
<th>NIK</th>
<th>Systole</th>
<th>Diastole</th>
<th>Denyut Jantung</th>
<th>Suhu Badan</th>
<th>Respiration Rate</th>
<th>Tinggi</th>
<th>Berat</th>
<th>Gol Darah</th>
<th>Rencana Keperawatan</th>
<th>Tindakan Keperawatan</th>
</tr><tr><td align='right'>K00.6</td><td>Disturbances in
tooth eruption</td><td></td><td>pasien datang ingin cabut gigi</td><td
align='right'>1953</td><td align='right'>07000049</td><td>02-05-2023</td><td>ADELIA
ANINDYA AILANI</td><td>BUDIONO</td><td></td><td>'</td><td>07-04-2016</td><td>SLEKER
RT 02 RW 03</td><td>SLEKER</td><td>KOPENG</td><td>PUSKESMAS INDUK</td><td>drg.Ade
Indranila</td><td>Maulida Rahma K N,A.Md.KG</td><td>P</td><td>5-9
Thn.</td><td>Keluarga</td><td>Baru</td><td>Umum</td><td>Rajal</td><td
align='right'>25</td><td align='right'>0</td><td align='right'>7</td><td>BP.
Gigi</td><td></td><td></td><td>Dalam
Wilayah</td><td>'</td><td>'</td><td>100</td><td>70</td><td>87</td><td>36.2</
td><td>22</td><td>102</td><td>21</td><td></td><td></td><td>pencabutan gigi
susu</td></tr><tr><td align='right'>K00.6</td><td>Disturbances in tooth
eruption</td><td></td><td>pasien datang dengan keluhaningin cabut gigi</td><td
align='right'>1941</td><td align='right'>1000513</td><td>02-05-2023</td><td>AFNAN
PRAMUDYA
ABIMANTARA</td><td></td><td></td><td>'</td><td>03-01-2016</td><td>SIDOMUKTI RT
05/05</td><td></td><td>KOPENG</td><td>PUSKESMAS INDUK</td><td>drg.Ade
Indranila</td><td>drg.Ade Indranila</td><td>L</td><td>5-9
Thn.</td><td>Keluarga</td><td>Baru</td><td>BPJS NON PBI</td><td>Rajal</td><td
align='right'>29</td><td align='right'>3</td><td align='right'>7</td><td>BP.
Gigi</td><td></td><td></td><td>Dalam
Wilayah</td><td>'0002208809024</td><td>'3322010301160000</td><td>100</td><td>70</
td><td>78</td><td></td><td>22</td><td>102</td><td>28</td><td></td><td></td><td>exo
gigi susu</td></tr><tr><td align='right'>J06.9</td><td>Acute upper respiratory
infection, unspecified</td><td></td><td>panas, batuk, pilek</td><td
align='right'>1957</td><td
align='right'>1021026</td><td>02-05-2023</td><td>ALDEBELLA TYA
AISYAH</td><td></td><td></td><td>'</td><td>18-10-2018</td><td>KARANGOMBO RT
03/03</td><td></td><td>Luar Wilayah</td><td>PUSKESMAS INDUK</td><td>dr.Arninta
Rahma Khoirunnisa</td><td>Sri Hartini,S.S.T.Keb</td><td>P</td><td>1-4
Thn.</td><td>Keluarga</td><td>Baru</td><td>Umum</td><td>Rajal</td><td
align='right'>14</td><td align='right'>6</td><td
align='right'>4</td><td>MTBS</td><td></td><td></td><td>Luar
Wilayah</td><td>'</td><td>'3322015810180001</td><td>90</td><td>60</td><td>130</
td><td>37</td><td>38</td><td>103</td><td>16</td><td></td><td>penkkes cara pemberian
obat di rumah, penkes cara pemberian makan/ minum di rumah</td><td>memberikan
penkkes cara pemberian obat di rumah, memberikan penkes cara pemberian makan/ minum
di rumah</td></tr><tr><td align='right'>K01.1</td><td>Impacted
teeth</td><td></td><td>pasien datang dengan keluhan gigi bawah pojok sakit</td><td
align='right'>1930</td><td align='right'>1010138</td><td>02-05-2023</td><td>ANDRI
</td><td></td><td></td><td>'</td><td>16-07-1996</td><td>PIJI
SUMOGAWE</td><td></td><td>Luar Wilayah</td><td>PUSKESMAS INDUK</td><td>drg.Ade
Indranila</td><td>Maulida Rahma K N,A.Md.KG</td><td>L</td><td>20-44
Thn.</td><td>Keluarga</td><td>Baru</td><td>Umum</td><td>Rajal</td><td
align='right'>16</td><td align='right'>9</td><td align='right'>26</td><td>BP.
Gigi</td><td></td><td></td><td>Luar
Wilayah</td><td>'</td><td>'</td><td>120</td><td>70</td><td>78</td><td>36.2</
td><td>22</td><td>165</td><td>60</td><td></td><td>pencabutan setelah gigi sudah
tidak sakit</td><td>premedikasi</td></tr><tr><td
align='right'>K08.3</td><td>Retained dental root</td><td></td><td>pasien datang
dengan keluhan ingin cabut gigi </td><td align='right'>1911</td><td
align='right'>04000003</td><td>02-05-2023</td><td>ARDI RAMADAN
SETIAWAN</td><td></td><td></td><td>'</td><td>22-09-2007</td><td>NGRAWAN RT 03 RW
01</td><td>NGRAWAN</td><td>NGRAWAN</td><td>PUSKESMAS INDUK</td><td>drg.Ade
Indranila</td><td>Maulida Rahma K N,A.Md.KG</td><td>L</td><td>15-19
Thn.</td><td>Keluarga</td><td>Lama</td><td>Umum</td><td>Rajal</td><td
align='right'>10</td><td align='right'>7</td><td align='right'>15</td><td>BP.
Gigi</td><td></td><td></td><td>Dalam
Wilayah</td><td>'</td><td>'</td><td>147</td><td>85</td><td>68</td><td>36</
td><td>22</td><td>168</td><td>56</td><td></td><td>gigi 4.6 + 3.7 Pro exo
</td><td>gigi 4.7 TKF+Cavit
</td></tr><tr><td align='right'>Z76.2</td><td>Health supervision and care of other
healthy infant and child</td><td></td><td>IMUNISASI DPT</td><td
align='right'>1904</td><td align='right'>06000040</td><td>02-05-2023</td><td>DEVANI
ALMAHYRA SAFANA</td><td></td><td></td><td>'</td><td>12-02-2023</td><td>SENDEN RT 03
RW 10</td><td>SENDEN</td><td>BATUR</td><td>PUSKESMAS INDUK</td><td>dr.Arninta Rahma
Khoirunnisa</td><td>Sri Mulyani,AMK</td><td>P</td><td><1
Thn.</td><td>Keluarga</td><td>Baru</td><td>Umum</td><td>Rajal</td><td
align='right'>18</td><td align='right'>2</td><td
align='right'>0</td><td>MTBS</td><td></td><td></td><td>Dalam
Wilayah</td><td>'</td><td>'</td><td></td><td></td><td>120</td><td>37</td><td>42</
td><td>50</td><td>5</td><td></td><td>OBAT DI MIUNUM SESUI
ANJURAN</td><td>MEMBERIKAN PENKES CARA MEMINUM OBAT DI RUMAH</td></tr><tr><td
align='right'>K05.1</td><td>Chronic gingivitis</td><td></td><td>pasien datang
dengan keluhan gigi bawah bengkak dan sakit</td><td align='right'>1956</td><td
align='right'>1023966</td><td>02-05-2023</td><td>DEWI
WIDYANINGSIH</td><td></td><td></td><td>'</td><td>21-10-2009</td><td>GEDAD RT 11 RW
1</td><td></td><td>WATES</td><td>PUSKESMAS INDUK</td><td>drg.Ade
Indranila</td><td>Maulida Rahma K N,A.Md.KG</td><td>P</td><td>10-14
Thn.</td><td>Keluarga</td><td>Baru</td><td>Umum</td><td>Rajal</td><td
align='right'>11</td><td align='right'>6</td><td align='right'>13</td><td>BP.
Gigi</td><td></td><td></td><td>Dalam
Wilayah</td><td>'0002424620338</td><td>'3322016110090004</td><td>120</td><td>70</
td><td>78</td><td>36.2</td><td>22</td><td>155</td><td>70</td><td></
td><td>pembersihan karang gigi</td><td>premedikasi</td></tr><tr><td
align='right'>K04.0</td><td>Pulpitis</td><td></td><td>pasien datang gigi bawah
sakit</td><td align='right'>1928</td><td align='right'>1012213</td><td>02-05-
2023</td><td>FAJAR WAHYU ADI PRASETYA</td><td></td><td></td><td>'</td><td>17-06-
2018</td><td>PLOSO RT 15/02</td><td>PLOSO</td><td>NGRAWAN</td><td>PUSKESMAS
INDUK</td><td>drg.Ade Indranila</td><td>drg.Ade Indranila</td><td>L</td><td>1-4
Thn.</td><td>Keluarga</td><td>Baru</td><td>BPJS PBI</td><td>Rajal</td><td
align='right'>15</td><td align='right'>10</td><td align='right'>4</td><td>BP.
Gigi</td><td></td><td></td><td>Dalam
Wilayah</td><td>'0002465557514</td><td>'3322011706180001</td><td>100</td><td>70</
td><td>87</td><td>36.2</td><td>22</td><td>98</td><td>14</td><td></td><td>penambalan
setelah gigi nya sembuh</td><td>premedikasi</td></tr><tr><td
align='right'>Z76.2</td><td>Health supervision and care of other healthy infant and
child</td><td></td><td>ibu mengatakan umbilikal bau</td><td
align='right'>1908</td><td
align='right'>04000006</td><td>02-05-2023</td><td>FELICIA MEITA
ADELINE</td><td></td><td></td><td>'</td><td>09-03-2023</td><td>NGRAWAN RT 003
RW001</td><td>NGRAWAN</td><td>NGRAWAN</td><td>PUSKESMAS INDUK</td><td>dr.Arninta
Rahma Khoirunnisa</td><td>Wiwin,A.Md.Keb</td><td>P</td><td><1
Thn.</td><td>Keluarga</td><td>Lama</td><td>BPJS NON PBI</td><td>Rajal</td><td
align='right'></td><td align='right'>1</td><td
align='right'></td><td>MTBS</td><td></td><td></td><td>Dalam
Wilayah</td><td>'0003518434945</td><td>'3322014903230001</td><td></td><td></
td><td>130</td><td>37</td><td>42</td><td>53</td><td>5</td><td></td><td>penkes
supaya di bawa ke dokter spesiali</td><td>memberikan penkes supaya di bawa ke
spsialis</td></tr><tr><td align='right'>Z76.2</td><td>Health supervision and care
of other healthy infant and child</td><td></td><td>KONSULTASI HASIL LABORAT
</td><td align='right'>1947</td><td
align='right'>1023814</td><td>02-05-2023</td><td>KEENANDRA HERO
SUHARNAZIL</td><td>RONY
SUHARNAZIL</td><td></td><td>'</td><td>24-04-2022</td><td>PANDANAN RT 03 RW
03</td><td></td><td>GETASAN</td><td>PUSKESMAS INDUK</td><td>dr.Arninta Rahma
Khoirunnisa</td><td>Supomo,A.Md.Kep</td><td>L</td><td>1-4
Thn.</td><td>Keluarga</td><td>Baru</td><td>BPJS NON PBI</td><td>Rajal</td><td
align='right'>8</td><td align='right'></td><td
align='right'>1</td><td>MTBS</td><td></td><td></td><td>Dalam
Wilayah</td><td>'0003519406664</td><td>'3322012404220002</td><td></td><td></
td><td>130</td><td>37</td><td>38</td><td>68</td><td>8</td><td></td><td>-</td><td>-
</td></tr><tr><td align='right'>Z76.2</td><td>Health supervision and care of other
healthy infant and child</td><td></td><td>kontrol bbl, mau SHK</td><td
align='right'>1891</td><td align='right'>07000045</td><td>02-05-2023</td><td>KHAIRA
MALYA ALMAHYRA</td><td></td><td></td><td>'</td><td>25-04-2023</td><td>KASIRAN RT 03
RW 09</td><td>KASIRAN</td><td>KOPENG</td><td>PUSKESMAS INDUK</td><td>dr.Arninta
Rahma Khoirunnisa</td><td>Uci Novitawati,A.Md.Keb</td><td>P</td><td>0-7
hari</td><td>Keluarga</td><td>Baru</td><td>Umum</td><td>Rajal</td><td
align='right'>7</td><td align='right'>0</td><td
align='right'>0</td><td>MTBS</td><td></td><td></td><td>Dalam
Wilayah</td><td>'</td><td>'</td><td></td><td></td><td>130</td><td>37</td><td>46</
td><td>48</td><td>3</td><td></td><td>PENKES CARA MENYUSUI YANG BENAR, PENKES TTG
ASI EKSKKLUSIF</td><td>MEMBERIKAN PENKES CARA MENYUSUI YANG BENAR, MEMBERIKAN
PENKES TENTANG ASI EKSKLUSIFF</td></tr><tr><td align='right'>K08.3</td><td>Retained
dental root</td><td></td><td>pasien datang dengan keluhan gigi sakit sampai
kepala</td><td align='right'>1929</td><td align='right'>1023945</td><td>02-05-
2023</td><td>M YUNUS EDO
BARKAH</td><td></td><td></td><td>'</td><td>29-08-1970</td><td>PENDINGAN RT 04 RW
01</td><td></td><td>Luar Wilayah</td><td>PUSKESMAS INDUK</td><td>drg.Ade
Indranila</td><td>drg.Ade Indranila</td><td>L</td><td>45-54
Thn.</td><td>Keluarga</td><td>Baru</td><td>BPJS PBI</td><td>Rajal</td><td
align='right'>3</td><td align='right'>8</td><td align='right'>52</td><td>BP.
Gigi</td><td></td><td></td><td>Luar
Wilayah</td><td>'0000546183898</td><td>'3307022908700002</td><td>154</td><td>84</
td><td>89</td><td>36.2</td><td>22</td><td>165</td><td>60</td><td></td><td></
td><td></td></tr><tr><td align='right'>Z76.2</td><td>Health supervision and care of
other healthy infant and child</td><td></td><td>KONTROL BBL . MAU SHKK</td><td
align='right'>1948</td><td
align='right'>07000048</td><td>02-05-2023</td><td>MADEENA SAFIYYA
PRASTYOPUTRI</td><td>EKO
PRASTYO</td><td></td><td>'</td><td>26-04-2023</td><td>PLALAR RT 04 RW
04</td><td>PLALAR</td><td>KOPENG</td><td>PUSKESMAS INDUK</td><td>dr.Arninta Rahma
Khoirunnisa</td><td>Uci Novitawati,A.Md.Keb</td><td>P</td><td>0-7
hari</td><td>Keluarga</td><td>Baru</td><td>Umum</td><td>Rajal</td><td
align='right'>6</td><td align='right'>0</td><td
align='right'>0</td><td>MTBS</td><td></td><td></td><td>Dalam
Wilayah</td><td>'</td><td>'</td><td></td><td></td><td>120</td><td>37</td><td>46</
td><td>48</td><td>4</td><td></td><td>PENKES TENTANG ASI EKSKLUSIF, PENKKES TENTANG
CARA MENYUSUI YANG BENAR</td><td>MEMBERIKAN PENKES TTG ASI EKSKKLUSIF, MEMBERIKAN
PENKES TTG CARA MENYUSUI YANG BENAR</td></tr><tr><td
align='right'>J06.9</td><td>Acute upper respiratory infection,
unspecified</td><td></td><td>panas, batruk, pilek</td><td
align='right'>1894</td><td align='right'>1024749</td><td>02-05-2023</td><td>MEYDITA
ATAYA SHAFANA</td><td></td><td></td><td>'</td><td>19-05-2022</td><td>NOGOSAREN RT
07 RW 01</td><td>NOGOSAREN</td><td>NOGOSAREN</td><td>PUSKESMAS
INDUK</td><td>dr.Arninta Rahma
Khoirunnisa</td><td>Wiwin,A.Md.Keb</td><td>P</td><td><1
Thn.</td><td>Keluarga</td><td>Lama</td><td>BPJS PBI</td><td>Rajal</td><td
align='right'></td><td align='right'>11</td><td
align='right'></td><td>MTBS</td><td></td><td></td><td>Dalam
Wilayah</td><td>'0003289494194</td><td>'3322015905220001</td><td></td><td></
td><td>120</td><td>38</td><td>38</td><td>85</td><td>13</td><td></td><td>penkes cara
pemberian obat kdi rumah, penkkes cara pemberian makan/ minum di
rumah</td><td>memberikan penkes cara pemberian makan/ minum di rumah, memberikan
penkes cara pemberian obat di rumah</td></tr><tr><td
align='right'>K08.3</td><td>Retained dental root</td><td></td><td>pasien datang
ingi cabut gigi</td><td align='right'>1926</td><td
align='right'>1025568</td><td>02-05-2023</td><td>MUNDIYAH</td><td></td><td></
td><td>'</td><td>09-11-1960</td><td>SRANTI RT 08 RW
02</td><td></td><td>WATES</td><td>PUSKESMAS INDUK</td><td>drg.Ade
Indranila</td><td>drg.Ade Indranila</td><td>P</td><td>60-69
Thn.</td><td>Keluarga</td><td>Lama</td><td>BPJS PBI</td><td>Rajal</td><td
align='right'>23</td><td align='right'>5</td><td align='right'>62</td><td>BP.
Gigi</td><td></td><td></td><td>Dalam
Wilayah</td><td>'0002349067601</td><td>'3322016911600001</td><td>165</td><td>90</
td><td>89</td><td>36.2</td><td>22</td><td>155</td><td>60</td><td></
td><td>pencabutan gigi setelah bengkak sembuh dan tensi
turun</td><td>premedikasi</td></tr><tr><td align='right'>B98.1</td><td>Vibrio
vulnificus as the cause of diseases classified to other
chapters</td><td></td><td>NYERI</td><td align='right'>1876</td><td
align='right'>99000039</td><td>02-05-2023</td><td>RIRIT MEI HAPSARI PUTRI
LESTIYADI</td><td></td><td></td><td>'</td><td>08-05-2003</td><td>CANDIREJO RT 15 RW
00 KWAGEN SRAGEN</td><td></td><td>Luar kabupaten</td><td>PUSKESMAS
INDUK</td><td>dr.Arninta Rahma Khoirunnisa</td><td>Retno Sri
Hastuti,Amd.Kep</td><td>P</td><td>15-19
Thn.</td><td>Keluarga</td><td>Baru</td><td>BPJS NON PBI</td><td>Rajal</td><td
align='right'>25</td><td align='right'>11</td><td align='right'>19</td><td>BP.
Umum</td><td></td><td></td><td>Luar
Wilayah</td><td>'0001898778903</td><td>'3314134805030004</td><td>120</td><td>80</
td><td></td><td>36</td><td>22</td><td>157</td><td>55</td><td>Tdk Th</td><td>KONTROL
LUKA</td><td>MEDIKASI</td></tr><tr><td align='right'>K05.3</td><td>Chronic
periodontitis</td><td></td><td>pasien datang dengan keluhan ingin cabut
gigi</td><td align='right'>1946</td><td
align='right'>1006983</td><td>02-05-2023</td><td>SITI
ALFIYAH</td><td></td><td></td><td>'</td><td>18-09-1953</td><td>DEPLONGAN RT 01 RW
02</td><td></td><td>WATES</td><td>PUSKESMAS INDUK</td><td>drg.Ade
Indranila</td><td>drg.Ade Indranila</td><td>P</td><td>60-69
Thn.</td><td>Keluarga</td><td>Baru</td><td>BPJS NON PBI</td><td>Rajal</td><td
align='right'>14</td><td align='right'>7</td><td align='right'>69</td><td>BP.
Gigi</td><td></td><td></td><td>Dalam
Wilayah</td><td>'0000074744616</td><td>'3322015809530002</td><td>120</td><td>76</
td><td>78</td><td>36.2</td><td>22</td><td>155</td><td>60</td><td></
td><td>pencabutan gigi susu</td><td>pencabutan gigi susu</td></tr><tr><td
align='right'>K04.0</td><td>Pulpitis</td><td></td><td>pasien datang derngan keluhan
gigi sakit, mau tambal </td><td align='right'>1889</td><td
align='right'>07000030</td><td>02-05-2023</td><td>SLAMET BUDIONO</td><td>SLAMET
BUDIONO</td><td></td><td>'0859159908168</td><td>05-12-1983</td><td>KOPENG RT 01 RW
02</td><td>KOPENG</td><td>KOPENG</td><td>PUSKESMAS INDUK</td><td>drg.Ade
Indranila</td><td>drg.Ade Indranila</td><td>L</td><td>20-44
Thn.</td><td>Keluarga</td><td>Lama</td><td>BPJS PBI</td><td>Rajal</td><td
align='right'>27</td><td align='right'>4</td><td align='right'>39</td><td>BP.
Gigi</td><td></td><td></td><td>Dalam
Wilayah</td><td>'0000600852576</td><td>'3322010512830001</td><td>141</td><td>97</
td><td>68</td><td>36</td><td>24</td><td>162</td><td>54</td><td></td><td></
td><td>devitalisasi gigi 4.5 tumpat semnetara </td></tr><tr><td
align='right'>K04.1</td><td>Necrosis of pulp</td><td></td><td>pasien datang gigi
bawah sakit dan ingin di cabut</td><td align='right'>1923</td><td
align='right'>1024994</td><td>02-05-2023</td><td>SRI
SULIYAH</td><td></td><td></td><td>'</td><td>24-05-1971</td><td>SENDEN RT 04 RW
09</td><td>SENDEN</td><td>BATUR</td><td>PUSKESMAS INDUK</td><td>drg.Ade
Indranila</td><td>Maulida Rahma K N,A.Md.KG</td><td>P</td><td>45-54
Thn.</td><td>Keluarga</td><td>Lama</td><td>Umum</td><td>Rajal</td><td
align='right'>8</td><td align='right'>11</td><td align='right'>51</td><td>BP.
Gigi</td><td></td><td></td><td>Dalam
Wilayah</td><td>'</td><td>'3322016405710000</td><td>123</td><td>104</td><td>97</
td><td>36.2</td><td>22</td><td>155</td><td>60</td><td></td><td>pencabutan setelah
tekanan darah menurun</td><td>premedikasi</td></tr><tr><td
align='right'>K00.6</td><td>Disturbances in tooth eruption</td><td></td><td>pasien
datang dengan keluhan ingin cabut gigi</td><td align='right'>1954</td><td
align='right'>1009794</td><td>02-05-2023</td><td>VERZA FITRA
ANDIKA</td><td></td><td></td><td>'</td><td>19-07-2015</td><td>SLEKER RT
7/3</td><td>SLEKER</td><td>KOPENG</td><td>PUSKESMAS INDUK</td><td>drg.Ade
Indranila</td><td>Maulida Rahma K N,A.Md.KG</td><td>L</td><td>5-9
Thn.</td><td>Keluarga</td><td>Baru</td><td>Umum</td><td>Rajal</td><td
align='right'>13</td><td align='right'>9</td><td align='right'>7</td><td>BP.
Gigi</td><td></td><td></td><td>Dalam
Wilayah</td><td>'</td><td>'</td><td>100</td><td>70</td><td>78</td><td>36.2</
td><td>22</td><td>102</td><td>24</td><td></td><td></td><td>p</td></tr><tr><td
align='right'>K05.2</td><td>Acute periodontitis</td><td></td><td>pasien datang
dengasn keluhan gigi bawah sakit</td><td align='right'>2006</td><td
align='right'>1021014</td><td>03-05-2023</td><td>ABEDNEGO DWI
CHRISTIANO</td><td></td><td></td><td>'</td><td>11-04-2012</td><td>GEDAD RT 10 RW
01</td><td></td><td>WATES</td><td>PUSKESMAS INDUK</td><td>drg.Ade
Indranila</td><td>Maulida Rahma K N,A.Md.KG</td><td>L</td><td>10-14
Thn.</td><td>Keluarga</td><td>Lama</td><td>Umum</td><td>Rajal</td><td
align='right'>22</td><td align='right'></td><td align='right'>11</td><td>BP.
Gigi</td><td></td><td></td><td>Dalam
Wilayah</td><td>'</td><td>'</td><td>100</td><td>70</td><td>78</td><td>36.2</
td><td>22</td><td>121</td><td>24</td><td></td><td>pro
konservasi</td><td>premedikasi</td></tr><tr><td
align='right'>K00.6</td><td>Disturbances in tooth eruption</td><td></td><td>pasien
datang dengan keluhan ingin cabut gigi</td><td align='right'>2022</td><td
align='right'>1012286</td><td>03-05-2023</td><td>ALYA JAZILA
KALANI</td><td></td><td></td><td>'</td><td>17-02-2016</td><td>NGROTO RT 8/05
SUMOGAWE</td><td></td><td>Luar Wilayah</td><td>PUSKESMAS INDUK</td><td>drg.Ade
Indranila</td><td>Maulida Rahma K N,A.Md.KG</td><td>P</td><td>5-9
Thn.</td><td>Keluarga</td><td>Lama</td><td>Umum</td><td>Rajal</td><td
align='right'>16</td><td align='right'>2</td><td align='right'>7</td><td>BP.
Gigi</td><td></td><td></td><td>Luar
Wilayah</td><td>'</td><td>'3322015702160001</td><td>100</td><td>70</td><td>78</
td><td>36.2</td><td>22</td><td>105</td><td>25</td><td></td><td>pencabutan gigi
susu</td><td>pencabutan gigi susu</td></tr><tr><td
align='right'>E05</td><td>Thyrotoxicosis
[hyperthyroidism]</td><td></td><td></td><td align='right'>1996</td><td
align='right'>1008853</td><td>03-05-2023</td><td>APRILIA DWI
LESTARI</td><td></td><td></td><td>'</td><td>30-04-1992</td><td>BUMIHARJO RT 05 RW
04</td><td></td><td>Luar Wilayah</td><td>PUSKESMAS INDUK</td><td>dr.Gani
Kriswanto</td><td>Suwoto,A.Md.Kep</td><td>P</td><td>20-44
Thn.</td><td>Keluarga</td><td>Baru</td><td>BPJS PBI</td><td>Rujuk</td><td
align='right'>3</td><td align='right'></td><td align='right'>31</td><td>BP.
Umum</td><td>Penyakit Dalam </td><td>RS PURI ASIH SALATIGA</td><td>Luar
Wilayah</td><td>'0000602815476</td><td>'3322027004920001</td><td>146</td><td>100</
td><td>84</td><td>36.2</td><td>24</td><td>155</td><td>43</td><td></td><td></
td><td></td></tr><tr><td align='right'>J06.9</td><td>Acute upper respiratory
infection, unspecified</td><td></td><td>IBU MENGATAKAN ANAKNYA PANAS, BATUK,
PILEK</td><td align='right'>1986</td><td align='right'>1020040</td><td>03-05-
2023</td><td>CLARISSA UTAMI PRAMONO</td><td></td><td></td><td>'</td><td>26-08-
2020</td><td>BUMIAYU RT 02 RW 04</td><td></td><td>Luar Wilayah</td><td>PUSKESMAS
INDUK</td><td>Wiwin,A.Md.Keb</td><td>Sutini,A.Md.Keb</td><td>P</td><td>1-4
Thn.</td><td>Keluarga</td><td>Baru</td><td>BPJS NON PBI</td><td>Rajal</td><td
align='right'>7</td><td align='right'>8</td><td
align='right'>2</td><td>MTBS</td><td></td><td></td><td>Luar
Wilayah</td><td>'0003048288592</td><td>'3322016608200001</td><td></td><td></
td><td>100</td><td>36</td><td>38</td><td>92</td><td>13</td><td></td><td>PENKES CARA
PEMBERIAN OBAT DI RUMAH, PENKKES CARA PEMBERIAN MAKAN / MINUM SELAMA
SAKIT</td><td>MEMBERIKAN PENKES CARA PEMBERIAN OBAT DI RUMAH , MEMBERIKAN PENKES
CARA PEMBERIAN MAKAN MINUM DI RUMAH</td></tr><tr><td
align='right'>K12</td><td>Stomatitis and related lesions</td><td></td><td></td><td
align='right'>1983</td><td align='right'>1004913</td><td>03-05-2023</td><td>DANU
PRATAMA</td><td></td><td></td><td>'087700288255</td><td>06-04-2008</td><td>DIWAK
RT.2 RW.8</td><td>DIWAK</td><td>BATUR</td><td>PUSKESMAS INDUK</td><td>dr.Arninta
Rahma Khoirunnisa</td><td>Suwoto,A.Md.Kep</td><td>L</td><td>15-19
Thn.</td><td>Keluarga</td><td>Baru</td><td>BPJS PBI</td><td>Rajal</td><td
align='right'>27</td><td align='right'></td><td align='right'>15</td><td>BP.
Umum</td><td></td><td></td><td>Dalam
Wilayah</td><td>'0002349073394</td><td>'3322010604080002</td><td>110</td><td>70</
td><td>84</td><td>36.5</td><td>24</td><td>160</td><td>56</td><td></td><td></
td><td></td></tr><tr><td
align='right'>R51</td><td>Headache</td><td></td><td></td><td
align='right'>2025</td><td align='right'>1023990</td><td>03-05-2023</td><td>DODI
RIYANTO</td><td></td><td></td><td>'</td><td>11-07-1989</td><td>BAGONGAN RT 13 RW
02</td><td>BAGONGAN</td><td>TOLOKAN</td><td>PUSKESMAS INDUK</td><td>dr.Gani
Kriswanto</td><td>Suwoto,A.Md.Kep</td><td>L</td><td>20-44
Thn.</td><td>Keluarga</td><td>Baru</td><td>BPJS PBI</td><td>Rajal</td><td
align='right'>22</td><td align='right'>9</td><td align='right'>33</td><td>BP.
Umum</td><td></td><td></td><td>Dalam
Wilayah</td><td>'0003142230467</td><td>'3322011107890001</td><td>125</td><td>75</
td><td>84</td><td>36.5</td><td>24</td><td>165</td><td>87</td><td></td><td></
td><td></td></tr><tr><td align='right'>K05.1</td><td>Chronic
gingivitis</td><td></td><td>pasien datang dengan keluhan ngin membersihkan karang
gigi</td><td align='right'>2028</td><td align='right'>07000053</td><td>03-05-
2023</td><td>EILLEEN HANNY STEPHANIE</td><td></td><td></td><td>'</td><td>05-09-
2003</td><td>SLEKER RT 07 RW 03</td><td>SLEKER</td><td>KOPENG</td><td>PUSKESMAS
INDUK</td><td>drg.Ade Indranila</td><td>Maulida Rahma K
N,A.Md.KG</td><td>P</td><td>15-19
Thn.</td><td>Keluarga</td><td>Baru</td><td>Umum</td><td>Rajal</td><td
align='right'>28</td><td align='right'>7</td><td align='right'>19</td><td>BP.
Gigi</td><td></td><td></td><td>Dalam
Wilayah</td><td>'</td><td>'3322014509030002</td><td>120</td><td>70</td><td>98</
td><td>36.2</td><td>22</td><td>155</td><td>70</td><td></td><td>scalling
RB</td><td>Scalling RB</td></tr><tr><td align='right'>J06.9</td><td>Acute upper
respiratory infection, unspecified</td><td></td><td></td><td
align='right'>1987</td><td align='right'>1013716</td><td>03-05-2023</td><td>EKO
PRAMONO</td><td></td><td></td><td>'</td><td>17-04-1980</td><td>BUMIAYU RT
2/4</td><td></td><td>Luar Wilayah</td><td>PUSKESMAS INDUK</td><td>dr.Arninta Rahma
Khoirunnisa</td><td>Suwoto,A.Md.Kep</td><td>L</td><td>20-44
Thn.</td><td>Keluarga</td><td>Baru</td><td>BPJS NON PBI</td><td>Rajal</td><td
align='right'>16</td><td align='right'></td><td align='right'>43</td><td>BP.
Umum</td><td></td><td></td><td>Luar
Wilayah</td><td>'0002376415541</td><td>'3171051704800002</td><td>110</td><td>70</
td><td>84</td><td>36.3</td><td>24</td><td>153</td><td>52</td><td></td><td></
td><td></td></tr><tr><td align='right'>Z09.8</td><td>Follow-up examination after
other treatment for other conditions</td><td></td><td></td><td
align='right'>1981</td><td
align='right'>1019186</td><td>03-05-2023</td><td>ERFINA</td><td></td><td></
td><td>'</td><td>20-10-1995</td><td>DEPLONGAN RT 03 RW
02</td><td>DEPLONGAN</td><td>WATES</td><td>PUSKESMAS INDUK</td><td>dr.Arninta Rahma
Khoirunnisa</td><td>Suwoto,A.Md.Kep</td><td>P</td><td>20-44
Thn.</td><td>Keluarga</td><td>Baru</td><td>BPJS NON PBI</td><td>Rajal</td><td
align='right'>13</td><td
align='right'>6</td><td align='right'>27</td><td>BP.
Umum</td><td></td><td></td><td>Dalam
Wilayah</td><td>'0000552096797</td><td>'3308146010950001</td><td>120</td><td>80</
td><td>84</td><td>36.2</td><td>24</td><td>160</td><td>56</td><td></td><td></
td><td></td></tr><tr><td align='right'>K29.7</td><td>Gastritis,
unspecified</td><td></td><td></td><td align='right'>2012</td><td
align='right'>1012314</td><td>03-05-2023</td><td>FAREL ANUGRAH
WICAKSONO</td><td></td><td></td><td>'</td><td>09-01-2012</td><td>NGELO RT 02 RW
03</td><td></td><td>GETASAN</td><td>PUSKESMAS INDUK</td><td>dr.Gani
Kriswanto</td><td>Suwoto,A.Md.Kep</td><td>L</td><td>10-14
Thn.</td><td>Keluarga</td><td>Baru</td><td>Umum</td><td>Rajal</td><td
align='right'>24</td><td align='right'>3</td><td align='right'>11</td><td>BP.
Umum</td><td></td><td></td><td>Dalam
Wilayah</td><td>'0001831085651</td><td>'3322010901120000</td><td>100</td><td>60</
td><td>84</td><td>36.2</td><td>24</td><td>140</td><td>35</td><td></td><td></
td><td></td></tr><tr><td align='right'>K00.6</td><td>Disturbances in tooth
eruption</td><td></td><td>pasien datang ingin cabut gigi</td><td
align='right'>2024</td><td align='right'>1023842</td><td>03-05-2023</td><td>FAYRUZ
SAKHA HABIBAH</td><td>DOSI
RIYANTONO</td><td></td><td>'</td><td>03-01-2016</td><td>BAGONGAN RT 13 RW
02</td><td>BAGONGAN</td><td>TOLOKAN</td><td>PUSKESMAS INDUK</td><td>drg.Ade
Indranila</td><td>drg.Ade Indranila</td><td>P</td><td>5-9
Thn.</td><td>Keluarga</td><td>Baru</td><td>BPJS PBI</td><td>Rajal</td><td
align='right'></td><td align='right'>4</td><td align='right'>7</td><td>BP.
Gigi</td><td></td><td></td><td>Dalam
Wilayah</td><td>'0003142230478</td><td>'3322014301160003</td><td>100</td><td>70</
td><td>78</td><td>36.2</td><td>22</td><td>105</td><td>25</td><td></
td><td>pencabutan gigi susu</td><td>pencabutan gigi susu</td></tr><tr><td
align='right'>K08.3</td><td>Retained dental root</td><td></td><td>pasien datang
dengan keluhan gigi bawah sakit</td><td align='right'>2023</td><td
align='right'>1002004</td><td>03-05-2023</td><td>FIKI
WIDIYANTO</td><td></td><td></td><td>'</td><td>01-09-2010</td><td>SIDOMUKTI RT
02/05</td><td></td><td>KOPENG</td><td>PUSKESMAS INDUK</td><td>drg.Ade
Indranila</td><td>Maulida Rahma K N,A.Md.KG</td><td>L</td><td>10-14
Thn.</td><td>Keluarga</td><td>Baru</td><td>Umum</td><td>Rajal</td><td
align='right'>2</td><td align='right'>8</td><td align='right'>12</td><td>BP.
Gigi</td><td></td><td></td><td>Dalam
Wilayah</td><td>'</td><td>'</td><td>120</td><td>60</td><td>80</td><td>36.2</
td><td>20</td><td>132</td><td>30</td><td></td><td>exo setelah gigi
sembuh</td><td>premedikasi</td></tr><tr><td align='right'>J06.9</td><td>Acute upper
respiratory infection, unspecified</td><td></td><td>PANAS, BATUK, PILEK</td><td
align='right'>1992</td><td align='right'>02000027</td><td>03-05-2023</td><td>GIBRAN
ARFAN ALHUSAYN</td><td>MUHAIMIN</td><td></td><td>'085326171666</td><td>08-12-
2019</td><td>NGAGRONG RT 08 RW 01</td><td>NGAGRONG</td><td>WATES</td><td>PUSKESMAS
INDUK</td><td>dr.Arninta Rahma
Khoirunnisa</td><td>Sutini,A.Md.Keb</td><td>L</td><td>1-4
Thn.</td><td>Keluarga</td><td>Baru</td><td>BPJS PBI</td><td>Rajal</td><td
align='right'>25</td><td align='right'>4</td><td
align='right'>3</td><td>MTBS</td><td></td><td></td><td>Dalam
Wilayah</td><td>'0003142237162</td><td>'3322010812190001</td><td></td><td></
td><td>130</td><td>37</td><td>37</td><td>100</td><td>12</td><td></td><td></
td><td>PENKES CARA MINUM OBAT DI RUMAH, PENKES CARA PEMBERIAN MAKAN / MINUM SELAMA
SAKIT</td></tr><tr><td align='right'>Z09.8</td><td>Follow-up examination after
other treatment for other conditions</td><td></td><td></td><td
align='right'>2002</td><td
align='right'>99000041</td><td>03-05-2023</td><td>GIYANTI</td><td></td><td>MENGURUS
RUMAH TANGGA</td><td>'</td><td>25-04-1971</td><td>BELIMBING RT 06RW 03 BATANG
GANGSAL RIAU</td><td></td><td>Luar kabupaten</td><td>PUSKESMAS
INDUK</td><td>dr.Gani Kriswanto</td><td>Suwoto,A.Md.Kep</td><td>P</td><td>45-54
Thn.</td><td>Keluarga</td><td>Baru</td><td>BPJS NON PBI</td><td>Rajal</td><td
align='right'>8</td><td align='right'>0</td><td align='right'>52</td><td>BP.
Umum</td><td></td><td></td><td>Luar
Wilayah</td><td>'0001801634692</td><td>'1402086504710002</td><td>129</td><td>80</
td><td>84</td><td>36.2</td><td>24</td><td>155</td><td>50</td><td></td><td></
td><td></td></tr><tr><td align='right'>K29.7</td><td>Gastritis,
unspecified</td><td></td><td></td><td align='right'>1982</td><td
align='right'>1000621</td><td>03-05-2023</td><td>GIYEM</td><td></td><td></
td><td>'</td><td>10-08-1956</td><td>MULUNGAN RT.10
RW.2</td><td>MULUNGAN</td><td>NOGOSAREN</td><td>PUSKESMAS INDUK</td><td>dr.Arninta
Rahma Khoirunnisa</td><td>Suwoto,A.Md.Kep</td><td>P</td><td>60-69
Thn.</td><td>Keluarga</td><td>Lama</td><td>BPJS NON PBI</td><td>Rajal</td><td
align='right'>23</td><td align='right'>8</td><td align='right'>66</td><td>BP.
Umum</td><td></td><td></td><td>Dalam
Wilayah</td><td>'0002054474346</td><td>'3322015008560003</td><td>130</td><td>80</
td><td>84</td><td>36.2</td><td>24</td><td>152</td><td>50</td><td></td><td></
td><td></td></tr><tr><td align='right'>K00.6</td><td>Disturbances in tooth
eruption</td><td></td><td>pasien mau cabut gigi bawah kiri
gigi nya sudah tumbuh </td><td align='right'>2020</td><td
align='right'>900000100</td><td>03-05-2023</td><td>HAFIZA MUTIARA
AGUSTIN</td><td>RUDIANTO</td><td>PELAJAR/MAHASISWA</td><td>'</td><td>11-08-2017</
td><td>PERUM GAWE MUKTI RT 04 RW 06 SUMOGAWE</td><td></td><td>Luar
Wilayah</td><td>PUSKESMAS INDUK</td><td>drg.Ade Indranila</td><td> -
</td><td>P</td><td>5-9 Thn.</td><td>Keluarga</td><td>Baru</td><td>BPJS
PBI</td><td>Rajal</td><td align='right'>23</td><td align='right'>8</td><td
align='right'>5</td><td>BP. Gigi</td><td></td><td></td><td>Luar
Wilayah</td><td>'0003270882183</td><td>'3322015108170001</td><td>90</td><td>60</
td><td>88</td><td>36</td><td>24</td><td>115</td><td>35</td><td></td><td></
td><td>exo gigi 7.1 persistensi luxasai der 2 </td></tr><tr><td
align='right'>K05.1</td><td>Chronic gingivitis</td><td></td><td>pasien datang
dengan keluhan ingin memberishkan karang gigi</td><td align='right'>2027</td><td
align='right'>07000052</td><td>03-05-2023</td><td>ITA PRAMITA
AGUSTIN</td><td></td><td></td><td>'</td><td>25-08-1984</td><td>SLEKER RT 07 RW
03</td><td>SLEKER</td><td>KOPENG</td><td>PUSKESMAS INDUK</td><td>drg.Ade
Indranila</td><td>Maulida Rahma K N,A.Md.KG</td><td>P</td><td>20-44
Thn.</td><td>Keluarga</td><td>Baru</td><td>Umum</td><td>Rajal</td><td
align='right'>9</td><td align='right'>8</td><td align='right'>38</td><td>BP.
Gigi</td><td></td><td></td><td>Dalam
Wilayah</td><td>'</td><td>'3322016508840002</td><td>120</td><td>70</td><td>98</
td><td>36.2</td><td>22</td><td>155</td><td>65</td><td></td><td>scalling
RB</td><td>Scalling RB</td></tr><tr><td align='right'>J06.9</td><td>Acute upper
respiratory infection, unspecified</td><td></td><td></td><td
align='right'>2015</td><td
align='right'>1003229</td><td>03-05-2023</td><td>JATINEM</td><td></td><td></
td><td>'</td><td>06-01-1955</td><td>DUKUH RT 04 RW
08</td><td>DUKUH</td><td>KOPENG</td><td>PUSKESMAS INDUK</td><td>dr.Gani
Kriswanto</td><td>Suwoto,A.Md.Kep</td><td>P</td><td>60-69
Thn.</td><td>Keluarga</td><td>Baru</td><td>Umum</td><td>Rajal</td><td
align='right'>27</td><td align='right'>3</td><td align='right'>68</td><td>BP.
Umum</td><td></td><td></td><td>Dalam
Wilayah</td><td>'</td><td>'</td><td>173</td><td>89</td><td>88</td><td>36.4</
td><td>24</td><td>160</td><td>56</td><td></td><td></td><td></td></tr><tr><td
align='right'>I10</td><td>Essential (primary)
hypertension</td><td></td><td></td><td align='right'>2015</td><td
align='right'>1003229</td><td>03-05-2023</td><td>JATINEM</td><td></td><td></
td><td>'</td><td>06-01-1955</td><td>DUKUH RT 04 RW
08</td><td>DUKUH</td><td>KOPENG</td><td>PUSKESMAS INDUK</td><td>dr.Gani
Kriswanto</td><td>Suwoto,A.Md.Kep</td><td>P</td><td>60-69
Thn.</td><td>Keluarga</td><td>Baru</td><td>Umum</td><td>Rajal</td><td
align='right'>27</td><td align='right'>3</td><td align='right'>68</td><td>BP.
Umum</td><td></td><td></td><td>Dalam
Wilayah</td><td>'</td><td>'</td><td>173</td><td>89</td><td>88</td><td>36.4</
td><td>24</td><td>160</td><td>56</td><td></td><td></td><td></td></tr><tr><td
align='right'>R51</td><td>Headache</td><td></td><td></td><td
align='right'>2009</td><td
align='right'>1013837</td><td>03-05-2023</td><td>JUMIRAH</td><td></td><td></
td><td>'</td><td>08-01-1965</td><td>CUNTEL RT 02 RW 01
</td><td></td><td>KOPENG</td><td>PUSKESMAS INDUK</td><td>dr.Gani
Kriswanto</td><td>Suwoto,A.Md.Kep</td><td>P</td><td>55-59
Thn.</td><td>Keluarga</td><td>Baru</td><td>BPJS PBI</td><td>Rajal</td><td
align='right'>25</td><td align='right'>3</td><td align='right'>58</td><td>BP.
Umum</td><td></td><td></td><td>Dalam
Wilayah</td><td>'0002349070795</td><td>'3322014801650002</td><td>139</td><td>90</
td><td>84</td><td>36.3</td><td>24</td><td>146</td><td>56</td><td></td><td></
td><td></td></tr><tr><td align='right'>L30.9</td><td>Dermatitis,
unspecified</td><td></td><td></td><td align='right'>2001</td><td
align='right'>1000027</td><td>03-05-2023</td><td>JUNI</td><td></td><td></
td><td>'</td><td>01-07-1963</td><td>SALARAN RT 15 RW
02</td><td>SALARAN</td><td>TOLOKAN</td><td>PUSKESMAS INDUK</td><td>dr.Gani
Kriswanto</td><td>Suwoto,A.Md.Kep</td><td>P</td><td>55-59
Thn.</td><td>Keluarga</td><td>Baru</td><td>BPJS PBI</td><td>Rajal</td><td
align='right'>2</td><td align='right'>10</td><td align='right'>59</td><td>BP.
Umum</td><td></td><td></td><td>Dalam
Wilayah</td><td>'0001027445859</td><td>'3322015607630001</td><td>120</td><td>80</
td><td>84</td><td>36.3</td><td>24</td><td>153</td><td>63</td><td></td><td></
td><td></td></tr><tr><td align='right'>I11.9</td><td>Hypertensive heart disease
without (congestive) heart failure</td><td></td><td></td><td
align='right'>1999</td><td align='right'>90000097</td><td>03-05-2023</td><td>MUGI
RAHAYU</td><td>SUTIMAN</td><td>WIRASWASTA</td><td>'085325426044</td><td>12-05-
1969</td><td>KEBONPETE RT 03 RW 02 POLOBOGO</td><td></td><td>Luar
Wilayah</td><td>PUSKESMAS INDUK</td><td>dr.Arninta Rahma
Khoirunnisa</td><td>Suwoto,A.Md.Kep</td><td>P</td><td>45-54
Thn.</td><td>Keluarga</td><td>Baru</td><td>BPJS NON PBI</td><td>Rujuk</td><td
align='right'>22</td><td align='right'>11</td><td align='right'>53</td><td>BP.
Umum</td><td></td><td></td><td>Luar
Wilayah</td><td>'0002933038181</td><td>'3322015205690002</td><td>147</td><td>77</
td><td>84</td><td>36.3</td><td>24</td><td>155</td><td>65</td><td></td><td></
td><td></td></tr><tr><td align='right'>J06.9</td><td>Acute upper respiratory
infection, unspecified</td><td></td><td></td><td align='right'>2014</td><td
align='right'>1013015</td><td>03-05-2023</td><td>NOOR LINA
RACHMADANI</td><td></td><td></td><td>'</td><td>03-04-1976</td><td>KENTENG RT 05 RW
05 SUMOGAWE</td><td></td><td>Luar Wilayah</td><td>PUSKESMAS INDUK</td><td>dr.Gani
Kriswanto</td><td>Suwoto,A.Md.Kep</td><td>P</td><td>45-54
Thn.</td><td>Keluarga</td><td>Lama</td><td>Umum</td><td>Rajal</td><td
align='right'></td><td align='right'>1</td><td align='right'>47</td><td>BP.
Umum</td><td></td><td></td><td>Luar
Wilayah</td><td>'0002494770322</td><td>'5371044304760002</td><td>130</td><td>80</
td><td>84</td><td>36.3</td><td>24</td><td>155</td><td>45</td><td></td><td></
td><td></td></tr><tr><td align='right'>A09</td><td>Diarrhoea and gastroenteritis of
presumed infectious origin</td><td></td><td></td><td align='right'>2026</td><td
align='right'>1025554</td><td>03-05-2023</td><td>NURUL
AMBARWATI</td><td></td><td></td><td>'</td><td>24-10-1998</td><td>MUJO RT 04 RW 04
SUMOGAWE</td><td></td><td>Luar Wilayah</td><td>PUSKESMAS INDUK</td><td>dr.Gani
Kriswanto</td><td>Suwoto,A.Md.Kep</td><td>P</td><td>20-44
Thn.</td><td>Keluarga</td><td>Lama</td><td>BPJS PBI</td><td>Rajal</td><td
align='right'>9</td><td align='right'>6</td><td align='right'>24</td><td>BP.
Umum</td><td></td><td></td><td>Luar
Wilayah</td><td>'0000602524214</td><td>'3322016410980001</td><td>120</td><td>80</
td><td>88</td><td>36.5</td><td>24</td><td>155</td><td>50</td><td></td><td></
td><td></td></tr><tr><td align='right'>Z00</td><td>General examination and
investigation of persons without complaint and reported
diagnosis</td><td></td><td></td><td align='right'>1980</td><td
align='right'>07000051</td><td>03-05-2023</td><td>NURUL SHOLECHAH</td><td>PRAPTO
JAPAR</td><td>KARYAWAN SWASTA</td><td>'</td><td>10-07-2000</td><td>CUNTEL RT 04 RW
01</td><td>CUNTEL</td><td>KOPENG</td><td>PUSKESMAS INDUK</td><td>dr.Arninta Rahma
Khoirunnisa</td><td>Suwoto,A.Md.Kep</td><td>P</td><td>20-44
Thn.</td><td>Keluarga</td><td>Baru</td><td>BPJS NON PBI</td><td>Rajal</td><td
align='right'>24</td><td align='right'>9</td><td align='right'>22</td><td>BP.
Umum</td><td></td><td></td><td>Dalam
Wilayah</td><td>'0000601589891</td><td>'3322015007000002</td><td>120</td><td>80</
td><td>84</td><td>36.2</td><td>24</td><td>155</td><td>50</td><td></td><td></
td><td></td></tr><tr><td
align='right'>K30</td><td>Dyspepsia</td><td></td><td></td><td
align='right'>2031</td><td
align='right'>1005834</td><td>03-05-2023</td><td>PARIYAH</td><td></td><td></
td><td>'</td><td>31-12-1945</td><td>NGRAWAN RT.2
RW.1</td><td></td><td>NGRAWAN</td><td>PUSKESMAS INDUK</td><td>dr.Gani
Kriswanto</td><td>Suwoto,A.Md.Kep</td><td>P</td><td>>70
Thn.</td><td>Keluarga</td><td>Baru</td><td>Umum</td><td>Rajal</td><td
align='right'>2</td><td align='right'>4</td><td align='right'>77</td><td>BP.
Umum</td><td></td><td></td><td>Dalam
Wilayah</td><td>'0002232911766</td><td>'3322017112450010</td><td>176</td><td>88</
td><td>88</td><td>36.3</td><td>24</td><td>155</td><td>45</td><td></td><td></
td><td></td></tr><tr><td align='right'>K29.7</td><td>Gastritis,
unspecified</td><td></td><td></td><td align='right'>2008</td><td
align='right'>1007265</td><td>03-05-2023</td><td>RINA
ZULININGSIH</td><td></td><td></td><td>'</td><td>16-07-1983</td><td>BUMIAYU RT 01 RW
04</td><td></td><td>Luar Wilayah</td><td>PUSKESMAS INDUK</td><td>dr.Gani
Kriswanto</td><td>Suwoto,A.Md.Kep</td><td>P</td><td>20-44
Thn.</td><td>Keluarga</td><td>Baru</td><td>Umum</td><td>Rajal</td><td
align='right'>17</td><td align='right'>9</td><td align='right'>39</td><td>BP.
Umum</td><td></td><td></td><td>Luar
Wilayah</td><td>'0002448941499</td><td>'3402155607830001</td><td>109</td><td>80</
td><td>88</td><td>36.3</td><td>24</td><td>156</td><td>50</td><td></td><td></
td><td></td></tr><tr><td align='right'>A09</td><td>Diarrhoea and gastroenteritis of
presumed infectious origin</td><td></td><td></td><td align='right'>2021</td><td
align='right'>1023459</td><td>03-05-2023</td><td>SANDI
SURYADI</td><td></td><td></td><td>'</td><td>12-12-1969</td><td>SRUWEN III RT 10 RW
03</td><td></td><td>Luar Wilayah</td><td>PUSKESMAS INDUK</td><td>dr.Gani
Kriswanto</td><td>Suwoto,A.Md.Kep</td><td>L</td><td>45-54
Thn.</td><td>Keluarga</td><td>Baru</td><td>BPJS NON PBI</td><td>Rajal</td><td
align='right'>21</td><td align='right'>4</td><td align='right'>53</td><td>BP.
Umum</td><td></td><td></td><td>Luar
Wilayah</td><td>'0001530645445</td><td>'3322021212690003</td><td>142</td><td>80</
td><td>84</td><td>36.6</td><td>24</td><td>160</td><td>60</td><td></td><td></
td><td></td></tr><tr><td
align='right'>Z09.8</td><td>Follow-up examination after other treatment for other
conditions</td><td></td><td></td><td align='right'>2029</td><td
align='right'>1004243</td><td>03-05-2023</td><td>SARYANTO</td><td></td><td></
td><td>'</td><td>27-07-1989</td><td>PADAN RT.13
RW.2</td><td></td><td>NGRAWAN</td><td>PUSKESMAS INDUK</td><td>dr.Gani
Kriswanto</td><td>Suwoto,A.Md.Kep</td><td>L</td><td>20-44
Thn.</td><td>Keluarga</td><td>Baru</td><td>BPJS NON PBI</td><td>Rajal</td><td
align='right'>6</td><td align='right'>9</td><td align='right'>33</td><td>BP.
Umum</td><td></td><td></td><td>Dalam
Wilayah</td><td>'0002041874122</td><td>'3322012707890001</td><td>166</td><td>67</
td><td>88</td><td>36.5</td><td>24</td><td>160</td><td>80</td><td></td><td></
td><td></td></tr><tr><td align='right'>E05.9</td><td>Thyrotoxicosis,
unspecified</td><td></td><td></td><td align='right'>1979</td><td
align='right'>1001254</td><td>03-05-2023</td><td>SITI
KORIAH</td><td>JUMARNO</td><td>BURUH HARIAN LEPAS</td><td>'085643309906</td><td>06-
10-1984</td><td>MANGGIHAN RT 01 RW
01</td><td>MANGGIHAN</td><td>MANGGIHAN</td><td>PUSKESMAS INDUK</td><td>dr.Arninta
Rahma Khoirunnisa</td><td>Suwoto,A.Md.Kep</td><td>P</td><td>20-44
Thn.</td><td>Keluarga</td><td>Baru</td><td>BPJS PBI</td><td>Rujuk</td><td
align='right'>27</td><td align='right'>6</td><td align='right'>38</td><td>BP.
Umum</td><td>Penyakit Dalam </td><td>RS DR.ASMIR SALATIGA</td><td>Dalam
Wilayah</td><td>'0002349085735</td><td>'3305124610840001</td><td>100</td><td>60</
td><td>84</td><td>36.2</td><td>24</td><td>153</td><td>46</td><td></td><td></
td><td></td></tr><tr><td align='right'>I10</td><td>Essential (primary)
hypertension</td><td></td><td></td><td align='right'>2017</td><td
align='right'>1019156</td><td>03-05-2023</td><td>SURATI</td><td></td><td></
td><td>'</td><td>20-07-1970</td><td>DUKUH RT 04 RW
08</td><td></td><td>KOPENG</td><td>PUSKESMAS INDUK</td><td>dr.Gani
Kriswanto</td><td>Suwoto,A.Md.Kep</td><td>P</td><td>45-54
Thn.</td><td>Keluarga</td><td>Baru</td><td>BPJS PBI</td><td>Rajal</td><td
align='right'>13</td><td align='right'>9</td><td align='right'>52</td><td>BP.
Umum</td><td></td><td></td><td>Dalam
Wilayah</td><td>'0000601021495</td><td>'3322016007700002</td><td>163</td><td>97</
td><td>88</td><td>36.5</td><td>24</td><td>156</td><td>50</td><td></td><td></
td><td></td></tr><tr><td align='right'>I64</td><td>Stroke, not specified as
haemorrhage or infarction</td><td></td><td></td><td align='right'>2005</td><td
align='right'>1015600</td><td>03-05-2023</td><td>SURYANTO</td><td></td><td></
td><td>'</td><td>12-12-1968</td><td>SOKOWOLU RT 09 RW 03
TAJUK</td><td></td><td>Luar Wilayah</td><td>PUSKESMAS INDUK</td><td>dr.Gani
Kriswanto</td><td>Suwoto,A.Md.Kep</td><td>L</td><td>45-54
Thn.</td><td>Keluarga</td><td>Baru</td><td>BPJS NON PBI</td><td>Rujuk</td><td
align='right'>21</td><td align='right'>4</td><td align='right'>54</td><td>BP.
Umum</td><td>Saraf</td><td>RS PURI ASIH SALATIGA</td><td>Luar
Wilayah</td><td>'0001530729281</td><td>'3322011212680008</td><td>150</td><td>100</
td><td>84</td><td>36.3</td><td>24</td><td>160</td><td>65</td><td></td><td></
td><td></td></tr><tr><td align='right'>E11</td><td>Non-insulin-dependent diabetes
mellitus</td><td></td><td></td><td align='right'>2000</td><td
align='right'>90000098</td><td>03-05-2023</td><td>SUTIMAN</td><td>SUTIMAN</
td><td>KARYAWAN SWASTA</td><td>'085325426044</td><td>31-12-1965</td><td>KEBONPETE
RT 03 RW 12 POLOBOGO</td><td></td><td>Luar Wilayah</td><td>PUSKESMAS
INDUK</td><td>dr.Gani Kriswanto</td><td>Suwoto,A.Md.Kep</td><td>L</td><td>55-59
Thn.</td><td>Keluarga</td><td>Baru</td><td>BPJS NON PBI</td><td>Rajal</td><td
align='right'>3</td><td align='right'>4</td><td align='right'>57</td><td>BP.
Umum</td><td></td><td></td><td>Luar
Wilayah</td><td>'0002933037911</td><td>'3322013112650043</td><td>127</td><td>74</
td><td>84</td><td>36.3</td><td>24</td><td>156</td><td>50</td><td></td><td></
td><td></td></tr><tr><td align='right'>J06.9</td><td>Acute upper respiratory
infection, unspecified</td><td></td><td></td><td align='right'>2011</td><td
align='right'>1004879</td><td>03-05-2023</td><td>TEGAR ADITYA
WICAKSONO</td><td></td><td></td><td>'</td><td>07-05-2010</td><td>NGELO RT 03 RW
02</td><td></td><td>GETASAN</td><td>PUSKESMAS INDUK</td><td>dr.Gani
Kriswanto</td><td>Suwoto,A.Md.Kep</td><td>L</td><td>10-14
Thn.</td><td>Keluarga</td><td>Baru</td><td>Umum</td><td>Rajal</td><td
align='right'>26</td><td align='right'>11</td><td align='right'>12</td><td>BP.
Umum</td><td></td><td></td><td>Dalam
Wilayah</td><td>'</td><td>'</td><td>100</td><td>60</td><td>84</td><td>36.3</
td><td>24</td><td>145</td><td>45</td><td></td><td></td><td></td></tr><tr><td
align='right'>K04.1</td><td>Necrosis of pulp</td><td></td><td>pasien datang dengan
keluhan ingin cabut gigi</td><td align='right'>1993</td><td
align='right'>1006682</td><td>03-05-2023</td><td>TRI
UTAMI</td><td></td><td></td><td>'</td><td>09-11-1977</td><td>SUMOGAWE RT.2
RW.2</td><td></td><td>Luar Wilayah</td><td>PUSKESMAS INDUK</td><td>drg.Ade
Indranila</td><td>Maulida Rahma K N,A.Md.KG</td><td>P</td><td>45-54
Thn.</td><td>Keluarga</td><td>Lama</td><td>Umum</td><td>Rajal</td><td
align='right'>24</td><td align='right'>5</td><td align='right'>45</td><td>BP.
Gigi</td><td></td><td></td><td>Luar
Wilayah</td><td>'0002188209003</td><td>'3322014911770002</td><td>130</td><td>70</
td><td>78</td><td>36.2</td><td>22</td><td>155</td><td>65</td><td></
td><td>pencabutan </td><td>premedikasi</td></tr><tr><td
align='right'>I10</td><td>Essential (primary)
hypertension</td><td></td><td></td><td align='right'>2010</td><td
align='right'>90000099</td><td>03-05-2023</td><td>TUGI</td><td></td><td></
td><td>'</td><td>11-07-1964</td><td>TOSORO RT 14 RW 06 JETAK</td><td></td><td>Luar
Wilayah</td><td>PUSKESMAS INDUK</td><td>dr.Gani
Kriswanto</td><td>Suwoto,A.Md.Kep</td><td>P</td><td>55-59
Thn.</td><td>Keluarga</td><td>Baru</td><td>BPJS PBI</td><td>Rajal</td><td
align='right'>23</td><td align='right'>9</td><td align='right'>58</td><td>BP.
Umum</td><td></td><td></td><td>Luar
Wilayah</td><td>'0000601632731</td><td>'3322015107640002</td><td>170</td><td>84</
td><td>88</td><td>36.3</td><td>24</td><td>156</td><td>50</td><td></td><td></
td><td></td></tr><tr><td align='right'>Z71.9</td><td>Counselling,
unspecified</td><td></td><td>pasien datang dengan keluhan mau cabut gigi,
tidak pusing, obat sudah habis, gigi sudah tidak sakit </td><td
align='right'>1990</td><td
align='right'>1000696</td><td>03-05-2023</td><td>WINARNI</td><td></td><td></
td><td>'</td><td>27-04-1984</td><td>GETASAN RT 02 RW
01</td><td>GETASAN</td><td>GETASAN</td><td>PUSKESMAS INDUK</td><td>drg.Ade
Indranila</td><td> - </td><td>P</td><td>20-44
Thn.</td><td>Keluarga</td><td>Lama</td><td>BPJS NON PBI</td><td>Rajal</td><td
align='right'>6</td><td align='right'></td><td align='right'>39</td><td>BP.
Gigi</td><td></td><td></td><td>Dalam
Wilayah</td><td>'0001526922628</td><td>'3322018704840002</td><td>100</td><td>70</
td><td>80</td><td>36</td><td>24</td><td>153</td><td>69</td><td></td><td>pro exo
</td><td>konsultasi</td></tr><tr><td align='right'>J06.9</td><td>Acute upper
respiratory infection, unspecified</td><td></td><td></td><td
align='right'>2018</td><td align='right'>1014597</td><td>03-05-2023</td><td>YOHANA
SULIYEM</td><td></td><td></td><td>'</td><td>14-01-1975</td><td>GEDAD RT 10 RW
01</td><td>GEDAD</td><td>WATES</td><td>PUSKESMAS INDUK</td><td>dr.Gani
Kriswanto</td><td>Suwoto,A.Md.Kep</td><td>P</td><td>45-54
Thn.</td><td>Keluarga</td><td>Lama</td><td>Umum</td><td>Rajal</td><td
align='right'>19</td><td align='right'>3</td><td align='right'>48</td><td>BP.
Umum</td><td></td><td></td><td>Dalam
Wilayah</td><td>'</td><td>'3322015401750004</td><td>149</td><td>87</td><td>88</
td><td>36.3</td><td>24</td><td>151</td><td>63</td><td></td><td></td><td></td></
tr><tr><td align='right'>J06.9</td><td>Acute upper respiratory infection,
unspecified</td><td></td><td>PANAS, BATUK, PILEKK</td><td
align='right'>2013</td><td align='right'>1024427</td><td>03-05-2023</td><td>ZEFANYA
CHISTA ARIDYA
RAWESTRI</td><td></td><td></td><td>'</td><td>17-11-2021</td><td>SIDOMUKTI RT 03 RW
05</td><td></td><td>KOPENG</td><td>PUSKESMAS INDUK</td><td>dr.Arninta Rahma
Khoirunnisa</td><td>Sutini,A.Md.Keb</td><td>P</td><td>1-4
Thn.</td><td>Keluarga</td><td>Baru</td><td>Umum</td><td>Rajal</td><td
align='right'>16</td><td align='right'>5</td><td
align='right'>1</td><td>MTBS</td><td></td><td></td><td>Dalam
Wilayah</td><td>'</td><td>'</td><td></td><td></td><td>130</td><td>37</td><td>39</
td><td>75</td><td>11</td><td></td><td>PENKES CARA MEMINUM OBAT DI RUMAH, PENKES
CARA PEMBERIAN MAKAN/ MINUM DI RUMAH</td><td>MEMBERIKAN PENKES CARA MEMINUM OBAT DI
RUMAH, MEMBERIKAN PENKES CARA PEMBERIAN MAKAN MINUM DI RUMAH</td></tr><tr><td
align='right'>K00.6</td><td>Disturbances in tooth eruption</td><td></td><td>pasien
datang mau cabut gigi anak</td><td align='right'>2084</td><td
align='right'>1003788</td><td>04-05-2023</td><td>ADELLE NATANIA
AFIGAIL</td><td></td><td></td><td>'</td><td>06-05-2015</td><td>KASIRAN RT
5/9</td><td>KASIRAN</td><td>KOPENG</td><td>PUSKESMAS INDUK</td><td>drg.Ade
Indranila</td><td> - </td><td>P</td><td>5-9
Thn.</td><td>Keluarga</td><td>Baru</td><td>BPJS PBI</td><td>Rajal</td><td
align='right'>28</td><td align='right'>11</td><td align='right'>7</td><td>BP.
Gigi</td><td></td><td></td><td>Dalam
Wilayah</td><td>'0002969777788</td><td>'3322014605160001</td><td>100</td><td>60</
td><td>83</td><td>36</td><td>24</td><td>132</td><td>21</td><td></td><td></
td><td>exo gigi 7.1 dan 8.1
persistensi dengan CE</td></tr><tr><td align='right'>E13</td><td>Other specified
diabetes mellitus</td><td></td><td>KONTROL</td><td align='right'>2053</td><td
align='right'>1019963</td><td>04-05-2023</td><td>AHMAT
AS`ARI</td><td></td><td></td><td>'</td><td>09-12-1979</td><td>GEJAYAN RT 09 RW
02</td><td>GEJAYAN</td><td>NOGOSAREN</td><td>PUSKESMAS
INDUK</td><td>Suwoto,A.Md.Kep</td><td>Riska
Wulandari,A.Md.Kep</td><td>L</td><td>20-44
Thn.</td><td>Keluarga</td><td>Baru</td><td>BPJS NON PBI</td><td>Rujuk</td><td
align='right'>25</td><td align='right'>4</td><td align='right'>43</td><td>BP.
Umum</td><td>Penyakit Dalam </td><td>RS PURI ASIH SALATIGA</td><td>Dalam
Wilayah</td><td>'0002924205535</td><td>'3322010912790001</td><td>140</td><td>80</
td><td>80</td><td>36.2</td><td>22</td><td>160</td><td>79</td><td></td><td></
td><td></td></tr><tr><td align='right'>I84.2</td><td>Internal haemorrhoids without
complication</td><td></td><td></td><td align='right'>2052</td><td
align='right'>1019182</td><td>04-05-2023</td><td>ANTON DENI
IRAWAN</td><td></td><td></td><td>'</td><td>20-08-1978</td><td>SLEKER RT 09 RW
03</td><td>SLEKER</td><td>KOPENG</td><td>PUSKESMAS
INDUK</td><td>Suwoto,A.Md.Kep</td><td>Riska
Wulandari,A.Md.Kep</td><td>L</td><td>20-44
Thn.</td><td>Keluarga</td><td>Baru</td><td>BPJS NON PBI</td><td>Rajal</td><td
align='right'>14</td><td align='right'>8</td><td align='right'>44</td><td>BP.
Umum</td><td></td><td></td><td>Dalam
Wilayah</td><td>'0002749354773</td><td>'3322012808780001</td><td>120</td><td>80</
td><td>80</td><td>37.4</td><td>23</td><td>161</td><td>75</td><td></td><td></
td><td></td></tr><tr><td align='right'>J11.0</td><td>Influenza with pneumonia,
virus not identified</td><td></td><td>panas, batuk, pilek</td><td
align='right'>2038</td><td align='right'>1017242</td><td>04-05-2023</td><td>ARKA
REYNAND KALANDRA</td><td></td><td></td><td>'</td><td>21-07-2019</td><td>SRANTI RT
09 RW 02</td><td>SRANTI</td><td>WATES</td><td>PUSKESMAS INDUK</td><td>dr.Gani
Kriswanto</td><td>Suwoto,A.Md.Kep</td><td>L</td><td>1-4
Thn.</td><td>Keluarga</td><td>Lama</td><td>Umum</td><td>Rajal</td><td
align='right'>13</td><td align='right'>9</td><td
align='right'>3</td><td>MTBS</td><td></td><td></td><td>Dalam
Wilayah</td><td>'</td><td>'</td><td></td><td></td><td>100</td><td>37</td><td>44</
td><td>0</td><td>15</td><td>Tdk Th</td><td>penkes cara minum obat di
rumah</td><td>memberikan penkes cara meminum obat di rumah</td></tr><tr><td
align='right'>K04.1</td><td>Necrosis of pulp</td><td></td><td>pasien datang untuk
kontrol, mU TmbL, </td><td align='right'>2081</td><td
align='right'>1007276</td><td>04-05-2023</td><td>DANU RENMI
WIJAYA</td><td></td><td></td><td>'</td><td>19-10-1998</td><td>SLEKER RT 1
RW3</td><td>SLEKER</td><td>KOPENG</td><td>PUSKESMAS INDUK</td><td>drg.Ade
Indranila</td><td>Maulida Rahma K N,A.Md.KG</td><td>L</td><td>20-44
Thn.</td><td>Keluarga</td><td>Lama</td><td>Umum</td><td>Rajal</td><td
align='right'>15</td><td align='right'>6</td><td align='right'>24</td><td>BP.
Gigi</td><td></td><td></td><td>Dalam
Wilayah</td><td>'0001271275942</td><td>'3322011910980001</td><td>120</td><td>80</
td><td>80</td><td>36</td><td>24</td><td>165</td><td>56</td><td></td><td></
td><td>CHKM+cavit
tambal sementra</td></tr><tr><td align='right'>K08.3</td><td>Retained dental
root</td><td></td><td>pasien datang dengan keluhan ingin cabut gigi</td><td
align='right'>2040</td><td
align='right'>06000044</td><td>04-05-2023</td><td>DARMADI</td><td></td><td>PETANI/
PEKEBUN</td><td>'</td><td>01-09-1958</td><td>MADU RT 02 RW
04</td><td>MADU</td><td>BATUR</td><td>PUSKESMAS INDUK</td><td>drg.Ade
Indranila</td><td>Maulida Rahma K N,A.Md.KG</td><td>L</td><td>60-69
Thn.</td><td>Keluarga</td><td>Baru</td><td>Umum</td><td>Rajal</td><td
align='right'>3</td><td align='right'>8</td><td align='right'>64</td><td>BP.
Gigi</td><td></td><td></td><td>Dalam
Wilayah</td><td>'</td><td>'3322102409580001</td><td>146</td><td>83</td><td>85</
td><td>36.2</td><td>22</td><td>165</td><td>60</td><td>Tdk Th</td><td>pro exo
setelah gigi sembuh</td><td>premedikasi</td></tr><tr><td
align='right'>J06.9</td><td>Acute upper respiratory infection,
unspecified</td><td></td><td></td><td align='right'>2068</td><td
align='right'>1000458</td><td>04-05-2023</td><td>DEFI
PERMATASARI</td><td></td><td></td><td>'</td><td>11-01-1990</td><td>PLALAR RT.1
RW.4</td><td>PLALAR</td><td>KOPENG</td><td>PUSKESMAS INDUK</td><td>dr.Arninta Rahma
Khoirunnisa</td><td>Riska Wulandari,A.Md.Kep</td><td>P</td><td>20-44
Thn.</td><td>Keluarga</td><td>Baru</td><td>BPJS NON PBI</td><td>Rajal</td><td
align='right'>23</td><td align='right'>3</td><td align='right'>33</td><td>BP.
Umum</td><td></td><td></td><td>Dalam
Wilayah</td><td>'0001191051213</td><td>'3373025101900001</td><td>110</td><td>70</
td><td>84</td><td>36.2</td><td>24</td><td>154</td><td>68</td><td></td><td></
td><td></td></tr><tr><td align='right'>J06</td><td>Acute upper respiratory
infections of multiple and unspecified sites</td><td></td><td>BAPIL</td><td
align='right'>2036</td><td align='right'>99000043</td><td>04-05-2023</td><td>DELSI
RUSITAIMI PUTRI</td><td>ARIF GIAN
PRATAMA</td><td></td><td>'</td><td>14-05-1997</td><td>SRI TUNGGAL RT 01 RW 01
LAMPUNG</td><td></td><td>Luar kabupaten</td><td>PUSKESMAS
INDUK</td><td>Suwoto,A.Md.Kep</td><td>Riska
Wulandari,A.Md.Kep</td><td>P</td><td>20-44
Thn.</td><td>Keluarga</td><td>Baru</td><td>BPJS NON PBI</td><td>Rajal</td><td
align='right'>21</td><td align='right'>11</td><td align='right'>25</td><td>BP.
Umum</td><td></td><td></td><td>Luar
Wilayah</td><td>'0003130378064</td><td>'1605195405970001</td><td>110</td><td>80</
td><td>88</td><td>36.4</td><td>23</td><td>148</td><td>46</td><td></td><td>MINUM AIR
PUTIH BANYAK</td><td></td></tr><tr><td align='right'>R50.9</td><td>Fever,
unspecified</td><td></td><td></td><td align='right'>2083</td><td
align='right'>07000055</td><td>04-05-2023</td><td>EKO
NUGROHO</td><td></td><td></td><td>'</td><td>18-03-1978</td><td>KOPENG RT 05 RW
02</td><td>KOPENG</td><td>KOPENG</td><td>PUSKESMAS INDUK</td><td>dr.Arninta Rahma
Khoirunnisa</td><td>Riska Wulandari,A.Md.Kep</td><td>L</td><td>45-54
Thn.</td><td>Keluarga</td><td>Baru</td><td>Umum</td><td>Ranap</td><td
align='right'>17</td><td align='right'>1</td><td align='right'>45</td><td>BP.
Umum</td><td></td><td></td><td>Dalam
Wilayah</td><td>'</td><td>'3322011803780001</td><td>110</td><td>80</td><td>84</
td><td>38</td><td>24</td><td>160</td><td>56</td><td></td><td></td><td></td></
tr><tr><td align='right'>E11</td><td>Non-insulin-dependent diabetes
mellitus</td><td></td><td>KONTROL</td><td align='right'>2037</td><td
align='right'>1013734</td><td>04-05-2023</td><td>ERASTUS A S
W</td><td></td><td></td><td>'085802929703</td><td>23-03-1979</td><td>WATES RT
3/1</td><td>WATES</td><td>WATES</td><td>PUSKESMAS
INDUK</td><td>Suwoto,A.Md.Kep</td><td>Riska
Wulandari,A.Md.Kep</td><td>L</td><td>20-44
Thn.</td><td>Keluarga</td><td>Baru</td><td>BPJS PBI</td><td>Rajal</td><td
align='right'>11</td><td align='right'>1</td><td align='right'>44</td><td>BP.
Umum</td><td></td><td></td><td>Dalam
Wilayah</td><td>'0001084343826</td><td>'3322012303790004</td><td>122</td><td>78</
td><td>90</td><td>36.2</td><td>23</td><td>165</td><td>73</td><td>Tdk
Th</td><td></td><td></td></tr><tr><td align='right'>J06.9</td><td>Acute upper
respiratory infection, unspecified</td><td></td><td>panas, batuk, pilek</td><td
align='right'>2033</td><td align='right'>90000101</td><td>04-05-2023</td><td>GIBRAN
ARSAKA</td><td>SETIAWAN</td><td></td><td>'</td><td>09-08-2022</td><td>NGROTO RT 07
RW 05 SUMOGAWE</td><td></td><td>Luar Wilayah</td><td>PUSKESMAS
INDUK</td><td>dr.Gani Kriswanto</td><td>Suwoto,A.Md.Kep</td><td>L</td><td><1
Thn.</td><td>Keluarga</td><td>Baru</td><td>Umum</td><td>Rajal</td><td
align='right'>26</td><td align='right'>8</td><td
align='right'>0</td><td>MTBS</td><td></td><td></td><td>Luar
Wilayah</td><td>'</td><td>'</td><td></td><td></td><td>120</td><td>37</td><td>35</
td><td>0</td><td>8</td><td></td><td>penkes cara minum obat di rumah
</td><td>memberikan penkes cara meminum obat di rumh</td></tr><tr><td
align='right'>D33.2</td><td>Benign neoplasm of brain,
unspecified</td><td></td><td></td><td align='right'>2073</td><td
align='right'>1004700</td><td>04-05-2023</td><td>HENI
ASTUTININGSIH</td><td></td><td></td><td>'</td><td>20-03-1998</td><td>SIDOMUKTI RT
10 RW 05</td><td>SIDOMUKTI</td><td>KOPENG</td><td>PUSKESMAS
INDUK</td><td>dr.Arninta Rahma Khoirunnisa</td><td>Riska
Wulandari,A.Md.Kep</td><td>P</td><td>20-44
Thn.</td><td>Keluarga</td><td>Baru</td><td>BPJS PBI</td><td>Rujuk</td><td
align='right'>14</td><td align='right'>1</td><td align='right'>25</td><td>BP.
Umum</td><td></td><td></td><td>Dalam
Wilayah</td><td>'0001872747292</td><td>'3322016003980002</td><td>120</td><td>80</
td><td>88</td><td>36</td><td>24</td><td>157</td><td>61</td><td></td><td></
td><td></td></tr><tr><td align='right'>J06.9</td><td>Acute upper respiratory
infection, unspecified</td><td></td><td></td><td align='right'>2058</td><td
align='right'>1014553</td><td>04-05-2023</td><td>JUMERI</td><td></td><td></
td><td>'</td><td>31-12-1961</td><td>BLONGORAN RT 05 RW 03</td><td></td><td>Luar
Wilayah</td><td>PUSKESMAS INDUK</td><td>Suwoto,A.Md.Kep</td><td>Riska
Wulandari,A.Md.Kep</td><td>L</td><td>60-69
Thn.</td><td>Keluarga</td><td>Baru</td><td>Umum</td><td>Rajal</td><td
align='right'>3</td><td align='right'>4</td><td align='right'>61</td><td>BP.
Umum</td><td></td><td></td><td>Luar
Wilayah</td><td>'</td><td>'3322011610630001</td><td>120</td><td>80</td><td>88</
td><td>36.4</td><td>24</td><td>153</td><td>45</td><td></td><td></td><td></td></
tr><tr><td align='right'>Z00</td><td>General examination and investigation of
persons without complaint and reported diagnosis</td><td></td><td></td><td
align='right'>2041</td><td
align='right'>01000034</td><td>04-05-2023</td><td>JUMIATI</td><td></td><td></
td><td>'</td><td>03-11-1978</td><td>GETASAN RT 04 RW
01</td><td>GETASAN</td><td>GETASAN</td><td>PUSKESMAS
INDUK</td><td>Suwoto,A.Md.Kep</td><td>Riska
Wulandari,A.Md.Kep</td><td>P</td><td>20-44
Thn.</td><td>Keluarga</td><td>Baru</td><td>Umum</td><td>Rajal</td><td
align='right'>1</td><td align='right'>6</td><td align='right'>44</td><td>BP.
Umum</td><td></td><td></td><td>Dalam
Wilayah</td><td>'</td><td>'3322014311780002</td><td>110</td><td>90</td><td>88</
td><td>37</td><td>22</td><td>158</td><td>52</td><td></td><td></td><td></td></
tr><tr><td align='right'>Z09.8</td><td>Follow-up examination after other treatment
for other conditions</td><td></td><td></td><td align='right'>2060</td><td
align='right'>90000102</td><td>04-05-2023</td><td>KASIATI</td><td>SUROSO</
td><td></td><td>'</td><td>01-05-1964</td><td>BLONGORAN RT 05 RW 03
POLOBOGO</td><td></td><td>Luar Wilayah</td><td>PUSKESMAS
INDUK</td><td>Suwoto,A.Md.Kep</td><td>Riska
Wulandari,A.Md.Kep</td><td>P</td><td>55-59
Thn.</td><td>Keluarga</td><td>Baru</td><td>Umum</td><td>Rajal</td><td
align='right'>3</td><td align='right'>0</td><td align='right'>59</td><td>BP.
Umum</td><td></td><td></td><td>Luar
Wilayah</td><td>'</td><td>'3322014105640001</td><td>130</td><td>80</td><td>88</
td><td>36</td><td>24</td><td>150</td><td>50</td><td></td><td></td><td></td></
tr><tr><td align='right'>M79.1</td><td>Myalgia</td><td></td><td></td><td
align='right'>2051</td><td
align='right'>1003571</td><td>04-05-2023</td><td>KETEL</td><td></td><td></
td><td>'</td><td>01-12-1975</td><td>NOGOSAREN RT 07 RW
01</td><td>NOGOSAREN</td><td>NOGOSAREN</td><td>PUSKESMAS
INDUK</td><td>Suwoto,A.Md.Kep</td><td>Riska
Wulandari,A.Md.Kep</td><td>P</td><td>45-54
Thn.</td><td>Keluarga</td><td>Baru</td><td>BPJS PBI</td><td>Rajal</td><td
align='right'>3</td><td align='right'>5</td><td align='right'>47</td><td>BP.
Umum</td><td></td><td></td><td>Dalam
Wilayah</td><td>'0000601706349</td><td>'3322017112750010</td><td>130</td><td>90</
td><td>88</td><td>36.3</td><td>23</td><td>151</td><td>76</td><td></td><td></
td><td></td></tr><tr><td align='right'>K04.1</td><td>Necrosis of
pulp</td><td></td><td>pasien datang mau tambal gigi </td><td
align='right'>2062</td><td align='right'>1024446</td><td>04-05-2023</td><td>LILIS
SETYANINGSIH</td><td></td><td></td><td>'</td><td>06-08-1979</td><td>SEMARE RT 08 RW
03</td><td>SLEKER</td><td>KOPENG</td><td>PUSKESMAS INDUK</td><td>drg.Ade
Indranila</td><td>Maulida Rahma K N,A.Md.KG</td><td>P</td><td>20-44
Thn.</td><td>Keluarga</td><td>Baru</td><td>Umum</td><td>Rajal</td><td
align='right'>28</td><td align='right'>8</td><td align='right'>43</td><td>BP.
Gigi</td><td></td><td></td><td>Dalam
Wilayah</td><td>'</td><td>'3322054608790005</td><td>120</td><td>75</td><td>80</
td><td>36</td><td>20</td><td>150</td><td>43</td><td></td><td>pro
konservasi</td><td>tkf+znpo4
tambal sementara </td></tr><tr><td align='right'>J06.9</td><td>Acute upper
respiratory infection, unspecified</td><td></td><td></td><td
align='right'>2057</td><td
align='right'>1020786</td><td>04-05-2023</td><td>MAKMUR</td><td></td><td></
td><td>'</td><td>04-06-1962</td><td>BUMIAYU RT 01 RW 04</td><td></td><td>Luar
Wilayah</td><td>PUSKESMAS INDUK</td><td>Suwoto,A.Md.Kep</td><td>Riska
Wulandari,A.Md.Kep</td><td>L</td><td>60-69
Thn.</td><td>Keluarga</td><td>Baru</td><td>BPJS PBI</td><td>Rajal</td><td
align='right'></td><td align='right'>11</td><td align='right'>60</td><td>BP.
Umum</td><td></td><td></td><td>Luar
Wilayah</td><td>'0002640437987</td><td>'3322010406620001</td><td>130</td><td>80</
td><td>88</td><td>36</td><td>24</td><td>163</td><td>46</td><td></td><td></
td><td></td></tr><tr><td
align='right'>M79.1</td><td>Myalgia</td><td></td><td></td><td
align='right'>2080</td><td
align='right'>1002102</td><td>04-05-2023</td><td>MUGISARI</td><td></td><td></
td><td>'</td><td>15-08-1977</td><td>KEBONPETE RT 02 RW 02
POLOBOGO</td><td></td><td>Luar Wilayah</td><td>PUSKESMAS INDUK</td><td>dr.Arninta
Rahma Khoirunnisa</td><td>Riska Wulandari,A.Md.Kep</td><td>P</td><td>45-54
Thn.</td><td>Keluarga</td><td>Lama</td><td>Umum</td><td>Rajal</td><td
align='right'>19</td><td align='right'>8</td><td align='right'>45</td><td>BP.
Umum</td><td></td><td></td><td>Luar
Wilayah</td><td>'</td><td>'3322015508770002</td><td>130</td><td>80</td><td>84</
td><td>36.3</td><td>24</td><td>153</td><td>58</td><td></td><td></td><td></td></
tr><tr><td align='right'>K04.1</td><td>Necrosis of pulp</td><td></td><td>ada pilek
sedikit , ada karang gigi, gigi atas ada lubang </td><td align='right'>2048</td><td
align='right'>07000054</td><td>04-05-2023</td><td>MUNDRIATUN
RETNOWATI</td><td>MUHAMMAD
ALWI</td><td></td><td>'</td><td>20-03-1987</td><td>SIDOMUKTI RT 04 RW
05</td><td>SIDOMUKTI</td><td>KOPENG</td><td>PUSKESMAS INDUK</td><td>drg.Ade
Indranila</td><td>Maulida Rahma K N,A.Md.KG</td><td>P</td><td>20-44
Thn.</td><td>Keluarga</td><td>Baru</td><td>Umum</td><td>Rajal</td><td
align='right'>15</td><td align='right'>1</td><td align='right'>36</td><td>BP.
Gigi</td><td></td><td></td><td>Dalam
Wilayah</td><td>'</td><td>'3322016003870004</td><td>120</td><td>73</td><td>80</
td><td>36</td><td>24</td><td>153</td><td>56</td><td></td><td></td><td>devit + znoe
</td></tr><tr><td align='right'>J06.9</td><td>Acute upper respiratory infection,
unspecified</td><td></td><td></td><td align='right'>2055</td><td
align='right'>1023952</td><td>04-05-2023</td><td>MUSLIKAH</td><td></td><td></
td><td>'</td><td>25-03-1973</td><td>DUKUH RT 01 RW
01</td><td>DUKUH</td><td>BATUR</td><td>PUSKESMAS
INDUK</td><td>Suwoto,A.Md.Kep</td><td>Riska
Wulandari,A.Md.Kep</td><td>P</td><td>45-54
Thn.</td><td>Keluarga</td><td>Baru</td><td>Umum</td><td>Rajal</td><td
align='right'>9</td><td align='right'>1</td><td align='right'>50</td><td>BP.
Umum</td><td></td><td></td><td>Dalam
Wilayah</td><td>'</td><td>'3508116503730004</td><td>140</td><td>80</td><td>84</
td><td>36</td><td>24</td><td>145</td><td>55</td><td></td><td></td><td></td></
tr><tr><td align='right'>J06.9</td><td>Acute upper respiratory infection,
unspecified</td><td></td><td>panas, batuk, pilek</td><td align='right'>2032</td><td
align='right'>1022767</td><td>04-05-2023</td><td>NAILA</td><td>KRISTIN
SETYOWATI</td><td>PELAJAR/MAHASISWA</td><td>'</td><td>01-11-2018</td><td>NGROTO RT
07 RW 05</td><td></td><td>Luar Wilayah</td><td>PUSKESMAS INDUK</td><td>dr.Gani
Kriswanto</td><td>Suwoto,A.Md.Kep</td><td>P</td><td>1-4
Thn.</td><td>Keluarga</td><td>Lama</td><td>Umum</td><td>Rajal</td><td
align='right'>3</td><td align='right'>6</td><td
align='right'>4</td><td>MTBS</td><td></td><td></td><td>Luar
Wilayah</td><td>'</td><td>'</td><td></td><td></td><td>130</td><td>36</td><td>35</
td><td>0</td><td>16</td><td></td><td>penkes cara minum obat di rumah, penkes cara
pemberian makan/ minum di rumah</td><td>memberikan penkes cara pemberian obat di
rumah , memberikan penkes cara pemberian makan/ minum di rumah</td></tr><tr><td
align='right'>K00.6</td><td>Disturbances in tooth eruption</td><td></td><td>pasien
mau cabut gigi
gigi depan atas </td><td align='right'>2046</td><td
align='right'>08000009</td><td>04-05-2023</td><td>NAUFAL DZAKI
ARIAWAN</td><td>MUSTARI</td><td></td><td>'</td><td>17-04-2012</td><td>NOGOSAREN RT
03 RW 01</td><td>NOGOSAREN</td><td>NOGOSAREN</td><td>PUSKESMAS
INDUK</td><td>drg.Ade Indranila</td><td>Maulida Rahma K
N,A.Md.KG</td><td>L</td><td>10-14
Thn.</td><td>Keluarga</td><td>Baru</td><td>Umum</td><td>Rajal</td><td
align='right'>17</td><td align='right'>0</td><td align='right'>11</td><td>BP.
Gigi</td><td></td><td></td><td>Dalam
Wilayah</td><td>'</td><td>'</td><td>80</td><td>60</td><td>80</td><td>36</
td><td>22</td><td>0</td><td>32</td><td></td><td></td><td></td></tr><tr><td
align='right'>J06.9</td><td>Acute upper respiratory infection,
unspecified</td><td></td><td>panas, batuk, pilek</td><td align='right'>2059</td><td
align='right'>1015033</td><td>04-05-2023</td><td>NUHA ALYSSA
AZZAHRA</td><td>WIDARGO</td><td></td><td>'</td><td>12-03-2019</td><td>TOLOKAN RT 02
RW 01</td><td>TOLOKAN</td><td>TOLOKAN</td><td>PUSKESMAS INDUK</td><td>dr.Gani
Kriswanto</td><td>Suwoto,A.Md.Kep</td><td>P</td><td>1-4
Thn.</td><td>Keluarga</td><td>Baru</td><td>BPJS NON PBI</td><td>Rajal</td><td
align='right'>22</td><td align='right'>1</td><td
align='right'>4</td><td>MTBS</td><td></td><td></td><td>Dalam
Wilayah</td><td>'0002751557332</td><td>'3322015203190002</td><td></td><td></
td><td>100</td><td>38</td><td>38</td><td>0</td><td>15</td><td></td><td>penkes cara
meminum obat di rumah, penkes cara pemberian makan/ minum di
rumah</td><td>memberikan penkes cara minum obat di rumah, memberikan penkes cara
pemberian makan/ minum di rumah</td></tr><tr><td
align='right'>I10</td><td>Essential (primary)
hypertension</td><td></td><td>KESEMUTAN</td><td align='right'>2034</td><td
align='right'>03000027</td><td>04-05-2023</td><td>PARINI</td><td>SUMARDI</
td><td>PETANI/PEKEBUN</td><td>'</td><td>29-12-1950</td><td>TOLOKAN RT 04 RW
01</td><td>TOLOKAN</td><td>TOLOKAN</td><td>PUSKESMAS
INDUK</td><td>Suwoto,A.Md.Kep</td><td>Riska
Wulandari,A.Md.Kep</td><td>P</td><td>>70
Thn.</td><td>Keluarga</td><td>Baru</td><td>BPJS PBI</td><td>Rajal</td><td
align='right'>6</td><td align='right'>4</td><td align='right'>72</td><td>BP.
Umum</td><td></td><td></td><td>Dalam
Wilayah</td><td>'0000601627961</td><td>'3322016912500002</td><td>180</td><td>110</
td><td>88</td><td>36.4</td><td>23</td><td>151</td><td>58</td><td></td><td></
td><td></td></tr><tr><td align='right'>G40.9</td><td>Epilepsy,
unspecified</td><td></td><td></td><td align='right'>2056</td><td
align='right'>1012411</td><td>04-05-2023</td><td>RISKI
ARDIANSYAH</td><td></td><td></td><td>'</td><td>01-12-2006</td><td>TEGALSARI RT 17
RW 02</td><td>TEGALSARI</td><td>NGRAWAN</td><td>PUSKESMAS
INDUK</td><td>Suwoto,A.Md.Kep</td><td>Riska
Wulandari,A.Md.Kep</td><td>L</td><td>15-19
Thn.</td><td>Keluarga</td><td>Baru</td><td>BPJS PBI</td><td>Rujuk</td><td
align='right'>3</td><td align='right'>5</td><td align='right'>16</td><td>BP.
Umum</td><td>Saraf</td><td>RS PURI ASIH SALATIGA</td><td>Dalam
Wilayah</td><td>'0000601528983</td><td>'3322012012060002</td><td>110</td><td>70</
td><td>88</td><td>36</td><td>24</td><td>142</td><td>47</td><td></td><td></
td><td></td></tr><tr><td align='right'>J06.9</td><td>Acute upper respiratory
infection, unspecified</td><td></td><td></td><td align='right'>2079</td><td
align='right'>1002347</td><td>04-05-2023</td><td>RIZA
ANNIHAYA</td><td></td><td></td><td>'</td><td>28-03-2005</td><td>TOLOKAN RT.3
RW.1</td><td>TOLOKAN</td><td>TOLOKAN</td><td>PUSKESMAS INDUK</td><td>dr.Arninta
Rahma Khoirunnisa</td><td>Riska Wulandari,A.Md.Kep</td><td>P</td><td>15-19
Thn.</td><td>Keluarga</td><td>Lama</td><td>BPJS NON PBI</td><td>Rajal</td><td
align='right'>6</td><td align='right'>1</td><td align='right'>18</td><td>BP.
Umum</td><td></td><td></td><td>Dalam
Wilayah</td><td>'0002086896047</td><td>'3322016803050001</td><td>100</td><td>60</
td><td>84</td><td>36.3</td><td>24</td><td>157</td><td>79</td><td></td><td></
td><td></td></tr><tr><td align='right'>K08.3</td><td>Retained dental
root</td><td></td><td>pasien datang dengan keluhan gigi atas dan bawah kiri sakit
</td><td align='right'>2039</td><td
align='right'>1015378</td><td>04-05-2023</td><td>RUBINI</td><td>RUBINI</td><td></
td><td>'082135541733</td><td>01-01-1963</td><td>NOGOSAREN RT 07 RW
01</td><td>NOGOSAREN</td><td>NOGOSAREN</td><td>PUSKESMAS INDUK</td><td>drg.Ade
Indranila</td><td>drg.Ade Indranila</td><td>L</td><td>60-69
Thn.</td><td>Keluarga</td><td>Lama</td><td>BPJS PBI</td><td>Rajal</td><td
align='right'>3</td><td align='right'>4</td><td align='right'>60</td><td>BP.
Gigi</td><td></td><td></td><td>Dalam
Wilayah</td><td>'0002443667949</td><td>'3322010101630005</td><td>132</td><td>84</
td><td>56</td><td>36.2</td><td>22</td><td>155</td><td>60</td><td>Tdk Th</td><td>pro
exo setelah gigi sembuh</td><td>premedikasi</td></tr><tr><td
align='right'>Z09.8</td><td>Follow-up examination after other treatment for other
conditions</td><td></td><td></td><td align='right'>2082</td><td
align='right'>1004243</td><td>04-05-2023</td><td>SARYANTO</td><td></td><td></
td><td>'</td><td>27-07-1989</td><td>PADAN RT.13
RW.2</td><td></td><td>NGRAWAN</td><td>PUSKESMAS INDUK</td><td>dr.Arninta Rahma
Khoirunnisa</td><td>Riska Wulandari,A.Md.Kep</td><td>L</td><td>20-44
Thn.</td><td>Keluarga</td><td>Lama</td><td>BPJS NON PBI</td><td>Rajal</td><td
align='right'>7</td><td align='right'>9</td><td align='right'>33</td><td>BP.
Umum</td><td></td><td></td><td>Dalam
Wilayah</td><td>'0002041874122</td><td>'3322012707890001</td><td>120</td><td>80</
td><td>84</td><td>36.3</td><td>24</td><td>160</td><td>56</td><td></td><td></
td><td></td></tr><tr><td align='right'>J06.9</td><td>Acute upper respiratory
infection, unspecified</td><td></td><td></td><td align='right'>2054</td><td
align='right'>1023949</td><td>04-05-2023</td><td>SAZKIA TRI
ANJANI</td><td>MUSLIKAH</td><td></td><td>'</td><td>05-04-2014</td><td>DUKUH RT 02
RW 01</td><td>DUKUH</td><td>BATUR</td><td>PUSKESMAS
INDUK</td><td>Suwoto,A.Md.Kep</td><td>Riska Wulandari,A.Md.Kep</td><td>P</td><td>5-
9 Thn.</td><td>Keluarga</td><td>Lama</td><td>Umum</td><td>Rajal</td><td
align='right'>29</td><td align='right'></td><td align='right'>9</td><td>BP.
Umum</td><td></td><td></td><td>Dalam
Wilayah</td><td>'</td><td>'3322014504140004</td><td>100</td><td>60</td><td>84</
td><td>36</td><td>24</td><td>122</td><td>21</td><td></td><td></td><td></td></
tr><tr><td align='right'>K05.3</td><td>Chronic
periodontitis</td><td></td><td>pasien datang dengan keluhan gigi kanan bawah sakit
sudah 3 hari </td><td align='right'>2061</td><td align='right'>1001145</td><td>04-
05-2023</td><td>SITI
KOLIPAH</td><td></td><td></td><td>'</td><td>07-06-1970</td><td>JAMPELAN RT 01 RW
02</td><td>JAMPELAN</td><td>GETASAN</td><td>PUSKESMAS INDUK</td><td>drg.Ade
Indranila</td><td> - </td><td>P</td><td>45-54
Thn.</td><td>Keluarga</td><td>Lama</td><td>BPJS NON PBI</td><td>Rajal</td><td
align='right'>27</td><td align='right'>10</td><td align='right'>52</td><td>BP.
Gigi</td><td></td><td></td><td>Dalam
Wilayah</td><td>'0002088014319</td><td>'3322014706700004</td><td>127</td><td>90</
td><td>80</td><td>36</td><td>24</td><td>154</td><td>54</td><td></td><td>exo setelah
gigi sembuh</td><td>premedikasi</td></tr><tr><td
align='right'>K04.1</td><td>Necrosis of pulp</td><td></td><td>pasien datang dengan
keluhan gigi yang di tambal, tambalanya lepas</td><td align='right'>2043</td><td
align='right'>07000030</td><td>04-05-2023</td><td>SLAMET BUDIONO</td><td>SLAMET
BUDIONO</td><td></td><td>'0859159908168</td><td>05-12-1983</td><td>KOPENG RT 01 RW
02</td><td>KOPENG</td><td>KOPENG</td><td>PUSKESMAS INDUK</td><td>drg.Ade
Indranila</td><td>drg.Ade Indranila</td><td>L</td><td>20-44
Thn.</td><td>Keluarga</td><td>Lama</td><td>BPJS PBI</td><td>Rajal</td><td
align='right'>29</td><td align='right'>4</td><td align='right'>39</td><td>BP.
Gigi</td><td></td><td></td><td>Dalam
Wilayah</td><td>'0000600852576</td><td>'3322010512830001</td><td>150</td><td>106</
td><td>68</td><td>36.2</td><td>22</td><td>165</td><td>70</td><td></
td><td>konservasi </td><td>konservasi</td></tr><tr><td
align='right'>J06.9</td><td>Acute upper respiratory infection,
unspecified</td><td></td><td>BATUK,PILEK,NYERI TELAN</td><td
align='right'>2042</td><td align='right'>1007416</td><td>04-05-2023</td><td>SRI
LASMIYATI</td><td>JARWONDO</td><td></td><td>'</td><td>06-01-1982</td><td>SALARAN RT
15 / 2 </td><td>SALARAN</td><td>TOLOKAN</td><td>PUSKESMAS
INDUK</td><td>Suwoto,A.Md.Kep</td><td>Riska
Wulandari,A.Md.Kep</td><td>P</td><td>20-44
Thn.</td><td>Keluarga</td><td>Lama</td><td>BPJS PBI</td><td>Rajal</td><td
align='right'>28</td><td align='right'>3</td><td align='right'>41</td><td>BP.
Umum</td><td></td><td></td><td>Dalam
Wilayah</td><td>'0002309222125</td><td>'3322014601820001</td><td>180</td><td>110</
td><td>80</td><td>37</td><td>23</td><td>150</td><td>68</td><td></td><td></
td><td></td></tr><tr><td align='right'>K08.3</td><td>Retained dental
root</td><td></td><td>pasien datang ingin cabut gigi</td><td
align='right'>2050</td><td align='right'>1024994</td><td>04-05-2023</td><td>SRI
SULIYAH</td><td></td><td></td><td>'</td><td>24-05-1971</td><td>SENDEN RT 04 RW
09</td><td>SENDEN</td><td>BATUR</td><td>PUSKESMAS INDUK</td><td>drg.Ade
Indranila</td><td>Maulida Rahma K N,A.Md.KG</td><td>P</td><td>45-54
Thn.</td><td>Keluarga</td><td>Lama</td><td>Umum</td><td>Rajal</td><td
align='right'>10</td><td align='right'>11</td><td align='right'>51</td><td>BP.
Gigi</td><td></td><td></td><td>Dalam
Wilayah</td><td>'</td><td>'3322016405710001</td><td>130</td><td>80</td><td>104</
td><td>36.2</td><td>22</td><td>155</td><td>60</td><td></td><td></td><td>exo gigi
1.1 2.1</td></tr><tr><td
align='right'>R51</td><td>Headache</td><td></td><td></td><td
align='right'>2078</td><td
align='right'>1023531</td><td>04-05-2023</td><td>SUSANTI</td><td></td><td></
td><td>'</td><td>14-01-1982</td><td>BARUKAN RT 13 RW 05</td><td></td><td>Luar
kabupaten</td><td>PUSKESMAS INDUK</td><td>dr.Arninta Rahma
Khoirunnisa</td><td>Riska Wulandari,A.Md.Kep</td><td>P</td><td>20-44
Thn.</td><td>Keluarga</td><td>Baru</td><td>BPJS NON PBI</td><td>Rajal</td><td
align='right'>20</td><td align='right'>3</td><td align='right'>41</td><td>BP.
Umum</td><td></td><td></td><td>Luar
Wilayah</td><td>'0001529397426</td><td>'3310095401820001</td><td>140</td><td>80</
td><td>88</td><td>36.3</td><td>24</td><td>160</td><td>62</td><td></td><td></
td><td></td></tr><tr><td
align='right'>K04.0</td><td>Pulpitis</td><td></td><td>pasien datng nyeri gigi nya
bagian atas bawah kriri </td><td align='right'>2066</td><td
align='right'>1013202</td><td>04-05-2023</td><td>SUSI KRISTIYANI PUJI
ASTUTI</td><td></td><td></td><td>'</td><td>28-10-1975</td><td>WATES RT 03 RW
01</td><td></td><td>WATES</td><td>PUSKESMAS INDUK</td><td>drg.Ade
Indranila</td><td> - </td><td>P</td><td>45-54
Thn.</td><td>Keluarga</td><td>Lama</td><td>BPJS NON PBI</td><td>Rajal</td><td
align='right'>6</td><td align='right'>6</td><td align='right'>47</td><td>BP.
Gigi</td><td></td><td></td><td>Dalam
Wilayah</td><td>'0000074517041</td><td>'3322016810750001</td><td>158</td><td>97</
td><td>80</td><td>36</td><td>24</td><td>154</td><td>55</td><td></td><td></
td><td></td></tr><tr><td align='right'>M19.16</td><td>Post-traumatic arthrosis of
other joints, lower leg</td><td></td><td>kontrol luka di kakio</td><td
align='right'>2044</td><td align='right'>1018136</td><td>04-05-2023</td><td>TATA
EKA PRATAMA</td><td></td><td></td><td>'</td><td>03-12-2019</td><td>NGAGRONG RT 08
RW 01</td><td>NGAGRONG</td><td>WATES</td><td>PUSKESMAS INDUK</td><td>dr.Gani
Kriswanto</td><td>Suwoto,A.Md.Kep</td><td>L</td><td>1-4
Thn.</td><td>Keluarga</td><td>Lama</td><td>BPJS PBI</td><td>Rajal</td><td
align='right'>1</td><td align='right'>5</td><td
align='right'>3</td><td>MTBS</td><td></td><td></td><td>Dalam
Wilayah</td><td>'0003142233189</td><td>'3322010312190002</td><td></td><td></
td><td>100</td><td>37</td><td>34</td><td>0</td><td>13</td><td></td><td>penkes cara
perawatan luka di rumah , penkes cara meminum obat di rumah</td><td>memberikkan
penkes cara perawatan di rumah, memberikan penkes cara minum obat di
rumah</td></tr><tr><td align='right'>K04.1</td><td>Necrosis of
pulp</td><td></td><td>pasien datang dengan keluhan gigi sakit sudah 3 hari </td><td
align='right'>2075</td><td align='right'>1000035</td><td>04-05-2023</td><td>URIP
SUGIYARTI</td><td></td><td></td><td>'</td><td>01-07-1963</td><td>GETASAN RT 07 RW
01</td><td></td><td>GETASAN</td><td>PUSKESMAS INDUK</td><td>drg.Ade
Indranila</td><td> - </td><td>P</td><td>55-59
Thn.</td><td>Keluarga</td><td>Baru</td><td>BPJS PBI</td><td>Rajal</td><td
align='right'>3</td><td align='right'>10</td><td align='right'>59</td><td>BP.
Gigi</td><td></td><td></td><td>Dalam
Wilayah</td><td>'0001027441596</td><td>'3322015403630003</td><td>123</td><td>78</
td><td>80</td><td>36</td><td>23</td><td>153</td><td>55</td><td></td><td>pro
konservasi </td><td>medikasi </td></tr><tr><td align='right'>K02.8</td><td>Other
dental caries</td><td></td><td>pasien datang mau tambal gigi </td><td
align='right'>2067</td><td
align='right'>06000014</td><td>04-05-2023</td><td>WAHYONO</td><td></td><td></
td><td>'085156178424</td><td>15-01-1993</td><td>SANGGAR RT 01 RW
07</td><td>SANGGAR</td><td>BATUR</td><td>PUSKESMAS INDUK</td><td>drg.Ade
Indranila</td><td> - </td><td>L</td><td>20-44
Thn.</td><td>Keluarga</td><td>Lama</td><td>BPJS PBI</td><td>Rajal</td><td
align='right'>19</td><td align='right'>3</td><td align='right'>30</td><td>BP.
Gigi</td><td></td><td></td><td>Dalam
Wilayah</td><td>'0001027419614</td><td>'3322011501930001</td><td>110</td><td>80</
td><td>80</td><td>36</td><td>24</td><td>167</td><td>57</td><td></td><td>pasien
datang dengan keluhan mau tmabal gigi , </td><td></td></tr><tr><td
align='right'>K04.1</td><td>Necrosis of pulp</td><td></td><td>pasien datang dengan
keluhan tambalan gigi copot </td><td align='right'>2076</td><td
align='right'>1007037</td><td>04-05-2023</td><td>WICHDAH SRI
HARYANTI</td><td></td><td></td><td>'</td><td>23-05-1965</td><td>WATES RT 01 RW
01</td><td>WATES</td><td>WATES</td><td>PUSKESMAS INDUK</td><td>drg.Ade
Indranila</td><td> - </td><td>P</td><td>55-59
Thn.</td><td>Keluarga</td><td>Lama</td><td>BPJS NON PBI</td><td>Rajal</td><td
align='right'>11</td><td align='right'>11</td><td align='right'>57</td><td>BP.
Gigi</td><td></td><td></td><td>Dalam
Wilayah</td><td>'0000074974138</td><td>'3322016305650002</td><td>123</td><td>78</
td><td>80</td><td>36</td><td>21</td><td>154</td><td>54</td><td></td><td></
td><td>karies pulpa masih ada polip </td></tr><tr><td
align='right'>K04.1</td><td>Necrosis of pulp</td><td></td><td>pasienmau cabut gigi
kanan bawah </td><td align='right'>2069</td><td align='right'>1000696</td><td>04-
05-2023</td><td>WINARNI</td><td></td><td></td><td>'</td><td>27-04-1984</
td><td>GETASAN RT 02 RW 01</td><td>GETASAN</td><td>GETASAN</td><td>PUSKESMAS
INDUK</td><td>drg.Ade Indranila</td><td> - </td><td>P</td><td>20-44
Thn.</td><td>Keluarga</td><td>Lama</td><td>BPJS NON PBI</td><td>Rajal</td><td
align='right'>7</td><td align='right'></td><td align='right'>39</td><td>BP.
Gigi</td><td></td><td></td><td>Dalam
Wilayah</td><td>'0001526922628</td><td>'3322018704840002</td><td>127</td><td>80</
td><td>80</td><td>36</td><td>20</td><td>154</td><td>65</td><td></td><td></
td><td>exo gigi 4.6 GP
exo dengan infiltrasi lidocaine </td></tr><tr><td
align='right'>S02.5</td><td>Fracture of tooth</td><td></td><td>pasienmau cabut gigi
kanan bawah </td><td align='right'>2069</td><td align='right'>1000696</td><td>04-
05-2023</td><td>WINARNI</td><td></td><td></td><td>'</td><td>27-04-1984</
td><td>GETASAN RT 02 RW 01</td><td>GETASAN</td><td>GETASAN</td><td>PUSKESMAS
INDUK</td><td>drg.Ade Indranila</td><td> - </td><td>P</td><td>20-44
Thn.</td><td>Keluarga</td><td>Lama</td><td>BPJS NON PBI</td><td>Rajal</td><td
align='right'>7</td><td align='right'></td><td align='right'>39</td><td>BP.
Gigi</td><td></td><td></td><td>Dalam
Wilayah</td><td>'0001526922628</td><td>'3322018704840002</td><td>127</td><td>80</
td><td>80</td><td>36</td><td>20</td><td>154</td><td>65</td><td></td><td></
td><td>exo gigi 4.6 GP
exo dengan infiltrasi lidocaine </td></tr><tr><td
align='right'>N18.9</td><td>Chronic renal failure,
unspecified</td><td></td><td></td><td align='right'>2070</td><td
align='right'>1000598</td><td>04-05-2023</td><td>YOHANA
SURIP</td><td></td><td></td><td>'</td><td>21-03-1963</td><td>CUNTEL RT.3
RW.1</td><td>CUNTEL</td><td>KOPENG</td><td>PUSKESMAS INDUK</td><td>dr.Arninta Rahma
Khoirunnisa</td><td>Riska Wulandari,A.Md.Kep</td><td>P</td><td>60-69
Thn.</td><td>Keluarga</td><td>Baru</td><td>BPJS NON PBI</td><td>Rujuk</td><td
align='right'>13</td><td align='right'>1</td><td align='right'>60</td><td>BP.
Umum</td><td>Penyakit Dalam </td><td>RS DR.ASMIR SALATIGA</td><td>Dalam
Wilayah</td><td>'0001842534944</td><td>'3322016103630002</td><td>150</td><td>90</
td><td>88</td><td>36.3</td><td>24</td><td>155</td><td>50</td><td></td><td></
td><td></td></tr><tr><td align='right'>J06.9</td><td>Acute upper respiratory
infection, unspecified</td><td></td><td>panas, batuk, pilek</td><td
align='right'>2035</td><td align='right'>99000042</td><td>04-05-2023</td><td>ZALFA
TYAGA ASFA GIAN</td><td>ARIF GIAN
PRATAMA</td><td></td><td>'</td><td>16-04-2022</td><td>SRI TUNGGAL RT 01 RW 01
LAMPUNG</td><td></td><td>Luar kabupaten</td><td>PUSKESMAS INDUK</td><td>dr.Gani
Kriswanto</td><td>Suwoto,A.Md.Kep</td><td>L</td><td>1-4
Thn.</td><td>Keluarga</td><td>Baru</td><td>BPJS NON PBI</td><td>Rajal</td><td
align='right'>18</td><td align='right'>0</td><td
align='right'>1</td><td>MTBS</td><td></td><td></td><td>Luar
Wilayah</td><td>'0003266417294</td><td>'1808131604220001</td><td></td><td></
td><td>120</td><td>38</td><td>38</td><td>0</td><td>9</td><td></td><td>penkes cara
perawatan di rumah , penkkes cara meminum obat di rumah</td><td>memberikan penkes
cara perawatan di rumah, memberikan penkes cara meminum obat di
rumah</td></tr><tr><td align='right'>J11.0</td><td>Influenza with pneumonia, virus
not identified</td><td></td><td>panas, batuk, pilek</td><td
align='right'>2103</td><td align='right'>1021120</td><td>05-05-2023</td><td>ADINDA
TAULIYA NAFSHA SEFRINA
DEWI</td><td></td><td></td><td>'</td><td>10-03-2021</td><td>SETURUN RT 02 RW
03</td><td>SETURUN</td><td>MANGGIHAN</td><td>PUSKESMAS INDUK</td><td>dr.Gani
Kriswanto</td><td>Sri Hartini,S.S.T.Keb</td><td>P</td><td>1-4
Thn.</td><td>Keluarga</td><td>Lama</td><td>Umum</td><td>Rajal</td><td
align='right'>25</td><td align='right'>1</td><td
align='right'>2</td><td>MTBS</td><td></td><td></td><td>Dalam
Wilayah</td><td>'</td><td>'</td><td></td><td></td><td>130</td><td>37</td><td>42</
td><td>85</td><td>11</td><td></td><td>penkes cara pemberian obat di rumah, penkes
cara pemberian makan/ minum di frumah</td><td>memberikan penkes cara pemberian obat
ndi rumah, memberikan penkes cara pemberian makkan/ minum di rumah</td></tr><tr><td
align='right'>Z47</td><td>Other orthopaedic follow-up
care</td><td></td><td></td><td align='right'>2110</td><td
align='right'>1020823</td><td>05-05-2023</td><td>ALDI BAYU
SETIAWAN</td><td></td><td></td><td>'</td><td>11-07-2002</td><td>BLONGOREN RT 05 RW
03</td><td>GETASAN</td><td>GETASAN</td><td>PUSKESMAS INDUK</td><td>dr.Arninta Rahma
Khoirunnisa</td><td>Supomo,A.Md.Kep</td><td>L</td><td>20-44
Thn.</td><td>Keluarga</td><td>Lama</td><td>BPJS NON PBI</td><td>Rujuk</td><td
align='right'>24</td><td align='right'>9</td><td align='right'>20</td><td>BP.
Umum</td><td>Orthopedi</td><td>RS KEN SARAS</td><td>Dalam
Wilayah</td><td>'0002876802186</td><td>'3322011107020000</td><td>100</td><td>70</
td><td>84</td><td>36.2</td><td>24</td><td>164</td><td>48</td><td></td><td></
td><td></td></tr><tr><td align='right'>J06.9</td><td>Acute upper respiratory
infection, unspecified</td><td></td><td>panas, batuk, pilekk</td><td
align='right'>2095</td><td align='right'>1022318</td><td>05-05-2023</td><td>AQILA
ULFA NADHIFA</td><td></td><td></td><td>'</td><td>05-07-2021</td><td>KRAJAN RT 07 RW
01</td><td>SELODUWUR</td><td>BATUR</td><td>PUSKESMAS INDUK</td><td>dr.Gani
Kriswanto</td><td>Sri Hartini,S.S.T.Keb</td><td>P</td><td>1-4
Thn.</td><td>Keluarga</td><td>Lama</td><td>Umum</td><td>Rajal</td><td
align='right'></td><td align='right'>10</td><td
align='right'>1</td><td>MTBS</td><td></td><td></td><td>Dalam
Wilayah</td><td>'</td><td>'</td><td></td><td></td><td>128</td><td>36</td><td>39</
td><td>76</td><td>10</td><td></td><td>penkes cara pemberian obat di rumah, p-enkes
cara pemberian makan/ minum di rumah</td><td>memberikan penkes cara pemberikan obat
di rumah, memberikan penkes cara pemberian makan, minum di rumah</td></tr><tr><td
align='right'>J06.9</td><td>Acute upper respiratory infection,
unspecified</td><td></td><td>panas. batuk, pilek</td><td align='right'>2107</td><td
align='right'>1013697</td><td>05-05-2023</td><td>ARFADHIA FAKHRI
PRATAMA</td><td>MUMAD REFAI</td><td></td><td>'</td><td>07-11-2018</td><td>JURUG RT
07 RW 01</td><td></td><td>GETASAN</td><td>PUSKESMAS INDUK</td><td>dr.Gani
Kriswanto</td><td>Uci Novitawati,A.Md.Keb</td><td>L</td><td>1-4
Thn.</td><td>Keluarga</td><td>Lama</td><td>BPJS NON PBI</td><td>Rajal</td><td
align='right'>28</td><td align='right'>5</td><td
align='right'>4</td><td>MTBS</td><td></td><td></td><td>Dalam
Wilayah</td><td>'0002612596588</td><td>'3322010711180000</td><td></td><td></
td><td>120</td><td>36</td><td>38</td><td>89</td><td>13</td><td></td><td>penkes cara
pemberian obat di rumah, penkes cara pemberianh makan/ minum di
rumah</td><td>memberikan penkkes tentang pemberian obat di rumah, memberikan penkes
cara pemberian makan minum di rumah</td></tr><tr><td
align='right'>J06.9</td><td>Acute upper respiratory infection,
unspecified</td><td></td><td>panas, batu, pilek</td><td align='right'>2097</td><td
align='right'>1019573</td><td>05-05-2023</td><td>ARIF BILAL
IBRAHIM</td><td></td><td></td><td>'</td><td>19-05-2020</td><td>DEPLONGAN RT 03 RW
02</td><td></td><td>WATES</td><td>PUSKESMAS INDUK</td><td>dr.Gani
Kriswanto</td><td>Sri Hartini,S.S.T.Keb</td><td>L</td><td>1-4
Thn.</td><td>Keluarga</td><td>Lama</td><td>Umum</td><td>Rajal</td><td
align='right'>16</td><td align='right'>11</td><td
align='right'>2</td><td>MTBS</td><td></td><td></td><td>Dalam
Wilayah</td><td>'</td><td>'</td><td></td><td></td><td>132</td><td>36</td><td>38</
td><td>89</td><td>13</td><td></td><td>penkes cara pemberian obat di rumah, penkes
cara pemberian makan/ minum di rumah</td><td>memberikan penkes cara pemberian obat
di rumah, memberikan penkes cara pemberian makan / minum di rumah</td></tr><tr><td
align='right'>K30</td><td>Dyspepsia</td><td></td><td></td><td
align='right'>2088</td><td align='right'>1014744</td><td>05-05-2023</td><td>CANTIKA
NOVI AMELIA</td><td></td><td></td><td>'</td><td>02-12-2012</td><td>GEDAD RT 11 RW
01</td><td></td><td>WATES</td><td>PUSKESMAS INDUK</td><td>dr.Gani
Kriswanto</td><td>Joko Susanto,AMK</td><td>P</td><td>10-14
Thn.</td><td>Keluarga</td><td>Lama</td><td>Umum</td><td>Rajal</td><td
align='right'>3</td><td align='right'>5</td><td align='right'>10</td><td>BP.
Umum</td><td></td><td></td><td>Dalam
Wilayah</td><td>'</td><td>'3322014212120000</td><td>100</td><td>60</td><td>84</
td><td>36.3</td><td>24</td><td>120</td><td>16</td><td></td><td></td><td></td></
tr><tr><td align='right'>H10.9</td><td>Conjunctivitis,
unspecified</td><td></td><td></td><td align='right'>2106</td><td
align='right'>1025182</td><td>05-05-2023</td><td>DEWI NUR
HIDAYAH</td><td></td><td></td><td>'</td><td>03-10-1996</td><td>GADING RT 04 RW
03</td><td></td><td>GETASAN</td><td>PUSKESMAS INDUK</td><td>dr.Gani
Kriswanto</td><td>Supomo,A.Md.Kep</td><td>P</td><td>20-44
Thn.</td><td>Keluarga</td><td>Baru</td><td>BPJS PBI</td><td>Rajal</td><td
align='right'>2</td><td align='right'>7</td><td align='right'>26</td><td>BP.
Umum</td><td></td><td></td><td>Dalam
Wilayah</td><td>'0003142231042</td><td>'3308174310960000</td><td>120</td><td>80</
td><td>84</td><td>36.2</td><td>24</td><td>154</td><td>60</td><td></td><td></
td><td></td></tr><tr><td align='right'>Z09.8</td><td>Follow-up examination after
other treatment for other conditions</td><td></td><td></td><td
align='right'>2099</td><td
align='right'>99000046</td><td>05-05-2023</td><td>DIONO</td><td></td><td></
td><td>'088983183014</td><td>04-05-1990</td><td>KLEDOKAN RT 01 RW 06 SUMBEREJO
NGABLAK</td><td></td><td>Luar kabupaten</td><td>PUSKESMAS INDUK</td><td>dr.Gani
Kriswanto</td><td>Supomo,A.Md.Kep</td><td>L</td><td>20-44
Thn.</td><td>Keluarga</td><td>Lama</td><td>BPJS PBI</td><td>Rajal</td><td
align='right'>1</td><td align='right'>0</td><td align='right'>33</td><td>BP.
Umum</td><td></td><td></td><td>Luar
Wilayah</td><td>'0000553980565</td><td>'3308170405900004</td><td>120</td><td>80</
td><td>88</td><td>36.3</td><td>24</td><td>160</td><td>56</td><td></td><td></
td><td></td></tr><tr><td align='right'>Z08.9</td><td>Follow-up examination after
unspecified treatment for malignant neoplasm</td><td></td><td></td><td
align='right'>2085</td><td
align='right'>06000045</td><td>05-05-2023</td><td>ELEAZAR HENDRI
HARTANTO</td><td>SUTRISNO</td><td>PELAJAR/MAHASISWA</td><td>'088806406294</
td><td>05-06-2006</td><td>SENDEN RT 04 RW
09</td><td>SENDEN</td><td>BATUR</td><td>PUSKESMAS INDUK</td><td>dr.Gani
Kriswanto</td><td>Joko Susanto,AMK</td><td>L</td><td>15-19
Thn.</td><td>Keluarga</td><td>Baru</td><td>Umum</td><td>Rajal</td><td
align='right'>0</td><td align='right'>11</td><td align='right'>16</td><td>BP.
Umum</td><td></td><td></td><td>Dalam
Wilayah</td><td>'</td><td>'</td><td>120</td><td>80</td><td>84</td><td>36.3</
td><td>24</td><td>160</td><td>50</td><td></td><td></td><td></td></tr><tr><td
align='right'>D21</td><td>Other benign neoplasms of connective and other soft
tissue</td><td></td><td></td><td align='right'>2096</td><td
align='right'>99000041</td><td>05-05-2023</td><td>GIYANTI</td><td></td><td>MENGURUS
RUMAH TANGGA</td><td>'</td><td>25-04-1971</td><td>BELIMBING RT 06RW 03 BATANG
GANGSAL RIAU</td><td></td><td>Luar kabupaten</td><td>PUSKESMAS
INDUK</td><td>dr.Arninta Rahma
Khoirunnisa</td><td>Supomo,A.Md.Kep</td><td>P</td><td>45-54
Thn.</td><td>Keluarga</td><td>Lama</td><td>BPJS NON PBI</td><td>Rujuk</td><td
align='right'>10</td><td align='right'></td><td align='right'>52</td><td>BP.
Umum</td><td>Bedah</td><td>RS DR.ASMIR SALATIGA</td><td>Luar
Wilayah</td><td>'0001801634692</td><td>'1402086504710002</td><td>120</td><td>80</
td><td>84</td><td>36.2</td><td>24</td><td>156</td><td>50</td><td></td><td></
td><td></td></tr><tr><td align='right'>Z09.8</td><td>Follow-up examination after
other treatment for other conditions</td><td></td><td></td><td
align='right'>2101</td><td align='right'>90000103</td><td>05-05-2023</td><td>IMAM
PRASETIYO</td><td></td><td>WIRASWASTA</td><td>'081212812321</td><td>26-07-1988</
td><td>REKSOSARI RT 09 RW 01 SURUH</td><td></td><td>Luar Wilayah</td><td>PUSKESMAS
INDUK</td><td>dr.Gani Kriswanto</td><td>Supomo,A.Md.Kep</td><td>L</td><td>20-44
Thn.</td><td>Keluarga</td><td>Baru</td><td>Umum</td><td>Rajal</td><td
align='right'>10</td><td align='right'>9</td><td align='right'>34</td><td>BP.
Umum</td><td></td><td></td><td>Luar
Wilayah</td><td>'</td><td>'3173012607880014</td><td>110</td><td>70</td><td>84</
td><td>36.3</td><td>24</td><td>156</td><td>50</td><td></td><td></td><td></td></
tr><tr><td align='right'>R51</td><td>Headache</td><td></td><td></td><td
align='right'>2100</td><td
align='right'>1014453</td><td>05-05-2023</td><td>KRISTANTI</td><td></td><td></
td><td>'</td><td>03-01-1982</td><td>NGELO RT
3/2</td><td></td><td>GETASAN</td><td>PUSKESMAS INDUK</td><td>dr.Gani
Kriswanto</td><td>Supomo,A.Md.Kep</td><td>P</td><td>20-44
Thn.</td><td>Keluarga</td><td>Lama</td><td>Umum</td><td>Rajal</td><td
align='right'>2</td><td align='right'>4</td><td align='right'>41</td><td>BP.
Umum</td><td></td><td></td><td>Dalam
Wilayah</td><td>'0002427225366</td><td>'3322014301820000</td><td>131</td><td>89</
td><td>88</td><td>36.2</td><td>24</td><td>155</td><td>60</td><td></td><td></
td><td></td></tr><tr><td align='right'>M54.16</td><td>Radiculopathy, lumbar
region</td><td></td><td></td><td align='right'>2111</td><td
align='right'>1000608</td><td>05-05-2023</td><td>LANNY
YOHAN</td><td></td><td></td><td>'</td><td>22-11-1962</td><td>DEPLONGAN RT 03 RW
02</td><td></td><td>WATES</td><td>PUSKESMAS INDUK</td><td>dr.Arninta Rahma
Khoirunnisa</td><td>Supomo,A.Md.Kep</td><td>P</td><td>60-69
Thn.</td><td>Keluarga</td><td>Lama</td><td>BPJS NON PBI</td><td>Rujuk</td><td
align='right'>13</td><td align='right'>5</td><td align='right'>60</td><td>BP.
Umum</td><td>Saraf</td><td>RS KEN SARAS</td><td>Dalam
Wilayah</td><td>'0001260411737</td><td>'3603196211620000</td><td>137</td><td>89</
td><td>88</td><td>36.2</td><td>24</td><td>160</td><td>72</td><td></td><td></
td><td></td></tr><tr><td align='right'>K00.6</td><td>Disturbances in tooth
eruption</td><td></td><td>pasien datang ingin cabut gigi</td><td
align='right'>2108</td><td
align='right'>07000057</td><td>05-05-2023</td><td>MUHAMMAD ALI</td><td>MUHAMAD
BARIDA</td><td>PELAJAR/MAHASISWA</td><td>'</td><td>18-03-2014</td><td>DUKUH RT 02
RW 08 KOPENG GETASAN</td><td>DUKUH</td><td>KOPENG</td><td>PUSKESMAS
INDUK</td><td>drg.Ade Indranila</td><td>Maulida Rahma K
N,A.Md.KG</td><td>L</td><td>5-9
Thn.</td><td>Keluarga</td><td>Baru</td><td>Umum</td><td>Rajal</td><td
align='right'>18</td><td align='right'>1</td><td align='right'>9</td><td>BP.
Gigi</td><td></td><td></td><td>Dalam
Wilayah</td><td>'0002076045298</td><td>'3322011803140001</td><td>100</td><td>70</
td><td>98</td><td></td><td>22</td><td>102</td><td>32</td><td></td><td></
td><td>pencabutan gigi susu</td></tr><tr><td
align='right'>K00.6</td><td>Disturbances in tooth eruption</td><td></td><td>pasien
datang ingin cabut gigi</td><td align='right'>2113</td><td
align='right'>1007835</td><td>05-05-2023</td><td>NAYLA ARUMINGRATRI
SUGIYONO</td><td>SUGIYONO</td><td></td><td>'</td><td>21-08-2017</td><td>KASIRAN
RT02/09 KOPENG</td><td></td><td>KOPENG</td><td>PUSKESMAS INDUK</td><td>drg.Ade
Indranila</td><td>Maulida Rahma K N,A.Md.KG</td><td>P</td><td>5-9
Thn.</td><td>Keluarga</td><td>Baru</td><td>Umum</td><td>Rajal</td><td
align='right'>14</td><td align='right'>8</td><td align='right'>5</td><td>BP.
Gigi</td><td></td><td></td><td>Dalam
Wilayah</td><td>'</td><td>'3322016108170003</td><td>100</td><td>70</td><td>78</
td><td>36.2</td><td>22</td><td>100</td><td>21</td><td></td><td></td><td></td></
tr><tr><td align='right'>R51</td><td>Headache</td><td></td><td></td><td
align='right'>2109</td><td align='right'>07000058</td><td>05-05-2023</td><td>NUR
HASANAH</td><td></td><td></td><td>'</td><td>20-01-1969</td><td>SLEKER RT 6 RW
3</td><td>SLEKER</td><td>KOPENG</td><td>PUSKESMAS INDUK</td><td>dr.Arninta Rahma
Khoirunnisa</td><td>Supomo,A.Md.Kep</td><td>P</td><td>45-54
Thn.</td><td>Keluarga</td><td>Baru</td><td>BPJS PBI</td><td>Rajal</td><td
align='right'>16</td><td align='right'>3</td><td align='right'>54</td><td>BP.
Umum</td><td></td><td></td><td>Dalam
Wilayah</td><td>'0003142232774</td><td>'3322016001690003</td><td>138</td><td>93</
td><td>84</td><td>36.2</td><td>24</td><td>160</td><td>56</td><td></td><td></
td><td></td></tr><tr><td
align='right'>M79.1</td><td>Myalgia</td><td></td><td></td><td
align='right'>2102</td><td
align='right'>07000015</td><td>05-05-2023</td><td>RAHMI</td><td></td><td>PETANI/
PEKEBUN</td><td>'</td><td>20-08-1972</td><td>KOPENG RT 01 RW
02</td><td>KOPENG</td><td>KOPENG</td><td>PUSKESMAS INDUK</td><td>dr.Gani
Kriswanto</td><td>Supomo,A.Md.Kep</td><td>P</td><td>45-54
Thn.</td><td>Keluarga</td><td>Lama</td><td>BPJS NON PBI</td><td>Rajal</td><td
align='right'>15</td><td align='right'>8</td><td align='right'>50</td><td>BP.
Umum</td><td></td><td></td><td>Dalam
Wilayah</td><td>'0001545716259</td><td>'3322016008720001</td><td>128</td><td>82</
td><td>88</td><td>36.3</td><td>24</td><td>160</td><td>56</td><td></td><td></
td><td></td></tr><tr><td
align='right'>K30</td><td>Dyspepsia</td><td></td><td></td><td
align='right'>2093</td><td align='right'>07000056</td><td>05-05-2023</td><td>SATRIA
ALMAULANA</td><td></td><td>PELAJAR/MAHASISWA</td><td>'</td><td>11-06-2000</
td><td>SLEKER RT 09 RW 03 KOPENG
GETASAN</td><td>SLEKER</td><td>KOPENG</td><td>PUSKESMAS INDUK</td><td>dr.Arninta
Rahma Khoirunnisa</td><td>Supomo,A.Md.Kep</td><td>L</td><td>20-44
Thn.</td><td>Keluarga</td><td>Baru</td><td>BPJS NON PBI</td><td>Rajal</td><td
align='right'>24</td><td align='right'>10</td><td align='right'>22</td><td>BP.
Umum</td><td></td><td></td><td>Dalam
Wilayah</td><td>'0001525932167</td><td>'3322011106000002</td><td>106</td><td>70</
td><td>84</td><td>36.2</td><td>24</td><td>156</td><td>50</td><td></td><td></
td><td></td></tr><tr><td align='right'>K08.3</td><td>Retained dental
root</td><td></td><td>pasien datang gigi atas akit dan ingin di cabut</td><td
align='right'>2090</td><td
align='right'>02000029</td><td>05-05-2023</td><td>SUMADI</td><td>SUMADI</
td><td>PETANI/PEKEBUN</td><td>'</td><td>00-00-0000</td><td>SRANTI RT 09 RW 02 WATES
GETASAN</td><td>SRANTI</td><td>WATES</td><td>PUSKESMAS INDUK</td><td>drg.Ade
Indranila</td><td>Maulida Rahma K N,A.Md.KG</td><td>L</td><td>0-7
hari</td><td>Keluarga</td><td>Baru</td><td>Umum</td><td>Rajal</td><td
align='right'>5</td><td align='right'>4</td><td align='right'>21</td><td>BP.
Gigi</td><td></td><td></td><td>Dalam
Wilayah</td><td>'0003309903876</td><td>'3322013112570049</td><td>121</td><td>72</
td><td>79</td><td>36.2</td><td>22</td><td>170</td><td>65</td><td></td><td>pro exo
setelah gigi sembuh</td><td>premedikasi</td></tr><tr><td
align='right'>J00</td><td>Acute nasopharyngitis [common
cold]</td><td></td><td></td><td align='right'>2086</td><td
align='right'>1004992</td><td>05-05-2023</td><td>SUMARNI</td><td></td><td></
td><td>'</td><td>12-08-1977</td><td>PANDANAN RT 1 RW
3</td><td>PANDANAN</td><td>GETASAN</td><td>PUSKESMAS INDUK</td><td>dr.Gani
Kriswanto</td><td>Supomo,A.Md.Kep</td><td>P</td><td>45-54
Thn.</td><td>Keluarga</td><td>Lama</td><td>BPJS PBI</td><td>Rajal</td><td
align='right'>23</td><td align='right'>8</td><td align='right'>45</td><td>BP.
Umum</td><td></td><td></td><td>Dalam
Wilayah</td><td>'0000602617252</td><td>'3322015208770004</td><td>137</td><td>87</
td><td>88</td><td>36.3</td><td>24</td><td>145</td><td>50</td><td></td><td></
td><td></td></tr><tr><td align='right'>Z08.9</td><td>Follow-up examination after
unspecified treatment for malignant neoplasm</td><td></td><td></td><td
align='right'>2092</td><td
align='right'>1017225</td><td>05-05-2023</td><td>SUPARNI</td><td></td><td></
td><td>'</td><td>19-03-1958</td><td>KEDAYON RT 06 RW
01</td><td>KEDAYON</td><td>WATES</td><td>PUSKESMAS INDUK</td><td>dr.Gani
Kriswanto</td><td>Supomo,A.Md.Kep</td><td>P</td><td>60-69
Thn.</td><td>Keluarga</td><td>Lama</td><td>Umum</td><td>Rajal</td><td
align='right'>16</td><td align='right'>1</td><td align='right'>65</td><td>BP.
Umum</td><td></td><td></td><td>Dalam
Wilayah</td><td>'0001027444836</td><td>'3322015903580001</td><td>128</td><td>80</
td><td>84</td><td>36.3</td><td>24</td><td>151</td><td>51</td><td></td><td></
td><td></td></tr><tr><td align='right'>K04.1</td><td>Necrosis of
pulp</td><td></td><td>pasien datang dengan keluhan gigi bawah sakit</td><td
align='right'>2149</td><td
align='right'>1021014</td><td>06-05-2023</td><td>ABEDNEGO DWI
CHRISTIANO</td><td></td><td></td><td>'</td><td>11-04-2012</td><td>GEDAD RT 10 RW
01</td><td></td><td>WATES</td><td>PUSKESMAS INDUK</td><td>drg.Ade
Indranila</td><td>drg.Ade Indranila</td><td>L</td><td>10-14
Thn.</td><td>Keluarga</td><td>Lama</td><td>Umum</td><td>Rajal</td><td
align='right'>25</td><td align='right'></td><td align='right'>11</td><td>BP.
Gigi</td><td></td><td></td><td>Dalam
Wilayah</td><td>'</td><td>'</td><td>100</td><td>70</td><td>78</td><td>36</
td><td>22</td><td>123</td><td>24</td><td></td><td>penabalan setelah gigi
sembuh</td><td>premedikasi</td></tr><tr><td align='right'>K02.1</td><td>Caries of
dentine</td><td></td><td>pasien datang gigi bawah ngilu</td><td
align='right'>2120</td><td align='right'>1015593</td><td>06-05-2023</td><td>ADINDA
RISKY DERIKA PUTRI</td><td></td><td></td><td>'</td><td>13-08-1998</td><td>PERUM
GAWE MUKTI JL. LAWU RT 02 RW 06</td><td></td><td>GETASAN</td><td>PUSKESMAS
INDUK</td><td>drg.Ade Indranila</td><td>drg.Ade Indranila</td><td>P</td><td>20-44
Thn.</td><td>Keluarga</td><td>Lama</td><td>BPJS NON PBI</td><td>Rajal</td><td
align='right'>23</td><td align='right'>8</td><td align='right'>24</td><td>BP.
Gigi</td><td></td><td></td><td>Dalam
Wilayah</td><td>'0000074673303</td><td>'3322015308980000</td><td>120</td><td>70</
td><td>88</td><td>36.2</td><td>22</td><td>155</td><td>70</td><td></td><td></
td><td>ketak molar</td></tr><tr><td
align='right'>K04.0</td><td>Pulpitis</td><td></td><td>pasien datang sakit gigi kiri
bawah, sudah 2 hari yang lalu, gigi bawah kanan belum n=begiti goyang </td><td
align='right'>2114</td><td align='right'>1011890</td><td>06-05-2023</td><td>AHMAD
ALWI AZIDAN</td><td>SLAMET
RIYADI</td><td></td><td>'</td><td>06-01-2013</td><td>MULUNGAN RT 11 RW
02</td><td></td><td>NOGOSAREN</td><td>PUSKESMAS INDUK</td><td>drg.Ade
Indranila</td><td>drg.Ade Indranila</td><td>L</td><td>10-14
Thn.</td><td>Keluarga</td><td>Lama</td><td>BPJS PBI</td><td>Rajal</td><td
align='right'></td><td align='right'>4</td><td align='right'>10</td><td>BP.
Gigi</td><td></td><td></td><td>Dalam
Wilayah</td><td>'0002600406707</td><td>'3322010601130000</td><td>90</td><td>70</
td><td>80</td><td>36</td><td>24</td><td>123</td><td>21</td><td></td><td></
td><td>premedikasi</td></tr><tr><td align='right'>K00.6</td><td>Disturbances in
tooth eruption</td><td></td><td>pasien datang sakit gigi kiri bawah, sudah 2 hari
yang lalu, gigi bawah kanan belum n=begiti goyang </td><td
align='right'>2114</td><td align='right'>1011890</td><td>06-05-2023</td><td>AHMAD
ALWI AZIDAN</td><td>SLAMET
RIYADI</td><td></td><td>'</td><td>06-01-2013</td><td>MULUNGAN RT 11 RW
02</td><td></td><td>NOGOSAREN</td><td>PUSKESMAS INDUK</td><td>drg.Ade
Indranila</td><td>drg.Ade Indranila</td><td>L</td><td>10-14
Thn.</td><td>Keluarga</td><td>Lama</td><td>BPJS PBI</td><td>Rajal</td><td
align='right'></td><td align='right'>4</td><td align='right'>10</td><td>BP.
Gigi</td><td></td><td></td><td>Dalam
Wilayah</td><td>'0002600406707</td><td>'3322010601130000</td><td>90</td><td>70</
td><td>80</td><td>36</td><td>24</td><td>123</td><td>21</td><td></td><td></
td><td>premedikasi</td></tr><tr><td
align='right'>R51</td><td>Headache</td><td></td><td></td><td
align='right'>2138</td><td
align='right'>1020020</td><td>06-05-2023</td><td>AMILAH</td><td></td><td></
td><td>'</td><td>06-01-1973</td><td>TOLOKAN RT 05 RW
01</td><td></td><td>GETASAN</td><td>PUSKESMAS INDUK</td><td>dr.Gani
Kriswanto</td><td>Suwoto,A.Md.Kep</td><td>P</td><td>45-54
Thn.</td><td>Keluarga</td><td>Lama</td><td>BPJS PBI</td><td>Rajal</td><td
align='right'></td><td align='right'>4</td><td align='right'>50</td><td>BP.
Umum</td><td></td><td></td><td>Dalam
Wilayah</td><td>'0000602607328</td><td>'3322014601730000</td><td>170</td><td>97</
td><td>88</td><td>36.3</td><td>24</td><td>150</td><td>61</td><td></td><td></
td><td></td></tr><tr><td align='right'>I10</td><td>Essential (primary)
hypertension</td><td></td><td></td><td align='right'>2138</td><td
align='right'>1020020</td><td>06-05-2023</td><td>AMILAH</td><td></td><td></
td><td>'</td><td>06-01-1973</td><td>TOLOKAN RT 05 RW
01</td><td></td><td>GETASAN</td><td>PUSKESMAS INDUK</td><td>dr.Gani
Kriswanto</td><td>Suwoto,A.Md.Kep</td><td>P</td><td>45-54
Thn.</td><td>Keluarga</td><td>Lama</td><td>BPJS PBI</td><td>Rajal</td><td
align='right'></td><td align='right'>4</td><td align='right'>50</td><td>BP.
Umum</td><td></td><td></td><td>Dalam
Wilayah</td><td>'0000602607328</td><td>'3322014601730000</td><td>170</td><td>97</
td><td>88</td><td>36.3</td><td>24</td><td>150</td><td>61</td><td></td><td></
td><td></td></tr><tr><td align='right'>K04.1</td><td>Necrosis of
pulp</td><td></td><td>pasien datang dengan kleuhan gigi bawah kanan kiri
sakit</td><td align='right'>2146</td><td align='right'>1002271</td><td>06-05-
2023</td><td>ANANDA MAYA EKA PUTRI</td><td></td><td></td><td>'</td><td>14-05-
2006</td><td>SLEKER RT 10 RW 3 KOPENG</td><td></td><td>GETASAN</td><td>PUSKESMAS
INDUK</td><td>drg.Ade Indranila</td><td>drg.Ade Indranila</td><td>P</td><td>15-19
Thn.</td><td>Keluarga</td><td>Lama</td><td>Umum</td><td>Rajal</td><td
align='right'>22</td><td align='right'>11</td><td align='right'>16</td><td>BP.
Gigi</td><td></td><td></td><td>Dalam
Wilayah</td><td>'</td><td>'3322015406060001</td><td>120</td><td>70</td><td>98</
td><td>36</td><td>22</td><td>155</td><td>60</td><td></td><td>pencabutan setelah
gigi sembuh</td><td>premedikasi</td></tr><tr><td
align='right'>J11.0</td><td>Influenza with pneumonia, virus not
identified</td><td></td><td>panas, batuk, pilek</td><td align='right'>2122</td><td
align='right'>1023870</td><td>06-05-2023</td><td>ARSYLA PUTRI
CALLISTA</td><td></td><td></td><td>'</td><td>01-06-2022</td><td>MADU RT 01 RW
04</td><td></td><td>BATUR</td><td>PUSKESMAS INDUK</td><td>dr.Gani
Kriswanto</td><td>Suwoto,A.Md.Kep</td><td>P</td><td><1
Thn.</td><td>Keluarga</td><td>Lama</td><td>Umum</td><td>Rajal</td><td
align='right'></td><td align='right'>11</td><td
align='right'></td><td>MTBS</td><td></td><td></td><td>Dalam
Wilayah</td><td>'</td><td>'3322014106220001</td><td></td><td></td><td>138</
td><td>37</td><td>50</td><td>69</td><td>99</td><td></td><td>penkes cara pemberiasn
obat di rumah, penkes cara pemberian makan/ minum di rumah</td><td>memberikan
penkes cara pemberian obat di rumah , memberikan penkes cara pemberian makan/ minum
di rumah</td></tr><tr><td align='right'>Z09.8</td><td>Follow-up examination after
other treatment for other conditions</td><td></td><td>minta rujukan kkontrol ke
rsgm ( bblsr )</td><td align='right'>2118</td><td
align='right'>01000037</td><td>06-05-2023</td><td>BAYI NYONYA DWI SETYOWATI
ELLY</td><td>WAHONO</td><td></td><td>'</td><td>08-04-2023</td><td>GETASAN RT 7 RW
1</td><td></td><td>GETASAN</td><td>PUSKESMAS INDUK</td><td>dr.Gani
Kriswanto</td><td>Suwoto,A.Md.Kep</td><td>L</td><td>8-30
hari</td><td>Keluarga</td><td>Baru</td><td>BPJS NON PBI</td><td>Rajal</td><td
align='right'>28</td><td align='right'>0</td><td
align='right'>0</td><td>MTBS</td><td></td><td></td><td>Dalam
Wilayah</td><td>'0003517138811</td><td>'3322012908220004</td><td></td><td></
td><td>138</td><td>37</td><td>48</td><td>44</td><td>2</td><td></td><td>-</td><td>-
</td></tr><tr><td align='right'>Z00</td><td>General examination and investigation
of persons without complaint and reported diagnosis</td><td></td><td></td><td
align='right'>2144</td><td align='right'>1006198</td><td>06-05-2023</td><td>DAMAR
BONANG SAMUDRA</td><td></td><td></td><td>'</td><td>27-11-2007</td><td>SODONGAN
RT.17 RW.6</td><td></td><td>Luar kabupaten</td><td>PUSKESMAS INDUK</td><td>dr.Gani
Kriswanto</td><td>Suwoto,A.Md.Kep</td><td>L</td><td>15-19
Thn.</td><td>Keluarga</td><td>Lama</td><td>BPJS NON PBI</td><td>Rajal</td><td
align='right'>9</td><td align='right'>5</td><td align='right'>15</td><td>BP.
Umum</td><td></td><td></td><td>Luar
Wilayah</td><td>'0000976359341</td><td>'3308022711070000</td><td>120</td><td>80</
td><td>84</td><td>36.3</td><td>24</td><td>156</td><td>50</td><td></td><td></
td><td></td></tr><tr><td align='right'>J02</td><td>Acute
pharyngitis</td><td></td><td></td><td align='right'>2125</td><td
align='right'>1023961</td><td>06-05-2023</td><td>DODIK BAGUS
SAPUTRO</td><td></td><td></td><td>'</td><td>07-07-1999</td><td>GONDANG RT 01 RW
01</td><td></td><td>BATUR</td><td>PUSKESMAS INDUK</td><td>dr.Gani
Kriswanto</td><td>Suwoto,A.Md.Kep</td><td>L</td><td>20-44
Thn.</td><td>Keluarga</td><td>Lama</td><td>BPJS PBI</td><td>Rajal</td><td
align='right'>29</td><td align='right'>9</td><td align='right'>23</td><td>BP.
Umum</td><td></td><td></td><td>Dalam
Wilayah</td><td>'0001532011544</td><td>'3322010707990000</td><td>120</td><td>78</
td><td>84</td><td>36</td><td>24</td><td>160</td><td>48</td><td></td><td></
td><td></td></tr><tr><td align='right'>F90.0</td><td>Disturbance of activity and
attention</td><td></td><td></td><td align='right'>2133</td><td
align='right'>1008287</td><td>06-05-2023</td><td>FIRHAN TEGAR KURNIA</td><td>HERU
CRISTIANTO</td><td></td><td>'</td><td>25-04-2006</td><td>PANDANAN RT.3
RW.3</td><td></td><td>GETASAN</td><td>PUSKESMAS INDUK</td><td>dr.Gani
Kriswanto</td><td>Suwoto,A.Md.Kep</td><td>L</td><td>15-19
Thn.</td><td>Keluarga</td><td>Lama</td><td>BPJS NON PBI</td><td>Rujuk</td><td
align='right'>11</td><td align='right'></td><td align='right'>17</td><td>BP.
Umum</td><td>JIWA</td><td>RSUD dr. Gunawan Mangunkusumo</td><td>Dalam
Wilayah</td><td>'0002913124072</td><td>'3322012504060000</td><td>120</td><td>80</
td><td>84</td><td>36.2</td><td>24</td><td>164</td><td>68</td><td></td><td></
td><td></td></tr><tr><td align='right'>K05.6</td><td>Periodontal disease,
unspecified</td><td></td><td></td><td align='right'>2145</td><td
align='right'>1003653</td><td>06-05-2023</td><td>H. ABDUL
CHALIM</td><td></td><td></td><td>'</td><td>28-02-1955</td><td>DUKUH RT 11 RW
02</td><td>DUKUH</td><td>KOPENG</td><td>PUSKESMAS INDUK</td><td>drg.Ade
Indranila</td><td>Suwoto,A.Md.Kep</td><td>L</td><td>60-69
Thn.</td><td>Keluarga</td><td>Lama</td><td>BPJS NON PBI</td><td>Rujuk</td><td
align='right'>8</td><td align='right'>2</td><td align='right'>68</td><td>BP.
Umum</td><td>GIGI BEDAH MULUT</td><td>RS KEN SARAS</td><td>Dalam
Wilayah</td><td>'0002091920951</td><td>'3322012802550001</td><td>107</td><td>60</
td><td>84</td><td>36.2</td><td>24</td><td>163</td><td>52</td><td></td><td></
td><td></td></tr><tr><td align='right'>J44.8</td><td>Other specified chronic
obstructive pulmonary disease</td><td></td><td></td><td align='right'>2145</td><td
align='right'>1003653</td><td>06-05-2023</td><td>H. ABDUL
CHALIM</td><td></td><td></td><td>'</td><td>28-02-1955</td><td>DUKUH RT 11 RW
02</td><td>DUKUH</td><td>KOPENG</td><td>PUSKESMAS INDUK</td><td>drg.Ade
Indranila</td><td>Suwoto,A.Md.Kep</td><td>L</td><td>60-69
Thn.</td><td>Keluarga</td><td>Lama</td><td>BPJS NON PBI</td><td>Rujuk</td><td
align='right'>8</td><td align='right'>2</td><td align='right'>68</td><td>BP.
Umum</td><td>GIGI BEDAH MULUT</td><td>RS KEN SARAS</td><td>Dalam
Wilayah</td><td>'0002091920951</td><td>'3322012802550001</td><td>107</td><td>60</
td><td>84</td><td>36.2</td><td>24</td><td>163</td><td>52</td><td></td><td></
td><td></td></tr><tr><td align='right'>I50.0</td><td>Congestive heart
failure</td><td></td><td></td><td align='right'>2145</td><td
align='right'>1003653</td><td>06-05-2023</td><td>H. ABDUL
CHALIM</td><td></td><td></td><td>'</td><td>28-02-1955</td><td>DUKUH RT 11 RW
02</td><td>DUKUH</td><td>KOPENG</td><td>PUSKESMAS INDUK</td><td>drg.Ade
Indranila</td><td>Suwoto,A.Md.Kep</td><td>L</td><td>60-69
Thn.</td><td>Keluarga</td><td>Lama</td><td>BPJS NON PBI</td><td>Rujuk</td><td
align='right'>8</td><td align='right'>2</td><td align='right'>68</td><td>BP.
Umum</td><td>GIGI BEDAH MULUT</td><td>RS KEN SARAS</td><td>Dalam
Wilayah</td><td>'0002091920951</td><td>'3322012802550001</td><td>107</td><td>60</
td><td>84</td><td>36.2</td><td>24</td><td>163</td><td>52</td><td></td><td></
td><td></td></tr><tr><td align='right'>K29.7</td><td>Gastritis,
unspecified</td><td></td><td></td><td align='right'>2134</td><td
align='right'>1002144</td><td>06-05-2023</td><td>HERU
CRISTIANTO</td><td></td><td></td><td>'</td><td>12-05-1984</td><td>PANDANAN RT 3 RW
3 GETASAN</td><td></td><td>GETASAN</td><td>PUSKESMAS INDUK</td><td>dr.Gani
Kriswanto</td><td>Suwoto,A.Md.Kep</td><td>L</td><td>20-44
Thn.</td><td>Keluarga</td><td>Lama</td><td>BPJS NON PBI</td><td>Rajal</td><td
align='right'>24</td><td align='right'>11</td><td align='right'>38</td><td>BP.
Umum</td><td></td><td></td><td>Dalam
Wilayah</td><td>'0002913122542</td><td>'3322011205840004</td><td>125</td><td>60</
td><td>88</td><td>36.2</td><td>24</td><td>164</td><td>76</td><td></td><td></
td><td></td></tr><tr><td align='right'>Z09.8</td><td>Follow-up examination after
other treatment for other conditions</td><td></td><td></td><td
align='right'>2123</td><td align='right'>90000103</td><td>06-05-2023</td><td>IMAM
PRASETIYO</td><td></td><td>WIRASWASTA</td><td>'081212812321</td><td>26-07-1988</
td><td>REKSOSARI RT 09 RW 01 SURUH</td><td></td><td>Luar Wilayah</td><td>PUSKESMAS
INDUK</td><td>dr.Gani Kriswanto</td><td>Suwoto,A.Md.Kep</td><td>L</td><td>20-44
Thn.</td><td>Keluarga</td><td>Lama</td><td>Umum</td><td>Rajal</td><td
align='right'>10</td><td align='right'>9</td><td align='right'>34</td><td>BP.
Umum</td><td></td><td></td><td>Luar
Wilayah</td><td>'</td><td>'3173012607880014</td><td>110</td><td>70</td><td>84</
td><td>36.2</td><td>24</td><td>156</td><td>50</td><td></td><td></td><td></td></
tr><tr><td align='right'>M79.1</td><td>Myalgia</td><td></td><td></td><td
align='right'>2131</td><td align='right'>1012414</td><td>06-05-2023</td><td>JOKO
SUROTO</td><td></td><td></td><td>'</td><td>06-08-1958</td><td>GETASAN RT 07 RW
01</td><td>GETASAN</td><td>GETASAN</td><td>PUSKESMAS INDUK</td><td>dr.Gani
Kriswanto</td><td>Suwoto,A.Md.Kep</td><td>L</td><td>60-69
Thn.</td><td>Keluarga</td><td>Lama</td><td>BPJS NON PBI</td><td>Rajal</td><td
align='right'></td><td align='right'>9</td><td align='right'>64</td><td>BP.
Umum</td><td></td><td></td><td>Dalam
Wilayah</td><td>'0000074935866</td><td>'3322010608580001</td><td>120</td><td>80</
td><td>84</td><td>36.2</td><td>24</td><td>155</td><td>55</td><td></td><td></
td><td></td></tr><tr><td align='right'>Z00</td><td>General examination and
investigation of persons without complaint and reported
diagnosis</td><td></td><td></td><td align='right'>2148</td><td
align='right'>01000042</td><td>06-05-2023</td><td>JURI</td><td></td><td></
td><td>'</td><td>31-10-1959</td><td>MULUNGAN RT 10 RW 2 NOGOSAREN
</td><td></td><td>GETASAN</td><td>PUSKESMAS INDUK</td><td>dr.Gani
Kriswanto</td><td>Suwoto,A.Md.Kep</td><td>L</td><td>60-69
Thn.</td><td>Keluarga</td><td>Baru</td><td>BPJS PBI</td><td>Rajal</td><td
align='right'>6</td><td align='right'>6</td><td align='right'>63</td><td>BP.
Umum</td><td></td><td></td><td>Dalam
Wilayah</td><td>'0000601290955</td><td>'3322013110590001</td><td>120</td><td>80</
td><td>84</td><td>36.3</td><td>24</td><td>156</td><td>50</td><td></td><td></
td><td></td></tr><tr><td align='right'>Z09.8</td><td>Follow-up examination after
other treatment for other conditions</td><td></td><td></td><td
align='right'>2121</td><td
align='right'>90000102</td><td>06-05-2023</td><td>KASIATI</td><td>SUROSO</
td><td></td><td>'</td><td>01-05-1964</td><td>BLONGORAN RT 05 RW 03
POLOBOGO</td><td></td><td>Luar Wilayah</td><td>PUSKESMAS INDUK</td><td>dr.Gani
Kriswanto</td><td>Suwoto,A.Md.Kep</td><td>P</td><td>55-59
Thn.</td><td>Keluarga</td><td>Lama</td><td>Umum</td><td>Rajal</td><td
align='right'>5</td><td align='right'></td><td align='right'>59</td><td>BP.
Umum</td><td></td><td></td><td>Luar
Wilayah</td><td>'</td><td>'3322014105640001</td><td>120</td><td>80</td><td>84</
td><td>36.3</td><td>24</td><td>156</td><td>50</td><td></td><td></td><td></td></
tr><tr><td align='right'>J00</td><td>Acute nasopharyngitis [common
cold]</td><td></td><td></td><td align='right'>2142</td><td
align='right'>01000041</td><td>06-05-2023</td><td>KURMAISAH</td><td></
td><td>WIRASWASTA</td><td>'0859159815188</td><td>16-08-1989</td><td>TAMBANGAN RT 4
RW 3 SUMOGAWE</td><td></td><td>GETASAN</td><td>PUSKESMAS INDUK</td><td>dr.Gani
Kriswanto</td><td>Suwoto,A.Md.Kep</td><td>P</td><td>20-44
Thn.</td><td>Keluarga</td><td>Baru</td><td>BPJS NON PBI</td><td>Rajal</td><td
align='right'>21</td><td align='right'>8</td><td align='right'>33</td><td>BP.
Umum</td><td></td><td></td><td>Dalam
Wilayah</td><td>'0001027435781</td><td>'3322015608890001</td><td>113</td><td>76</
td><td>84</td><td>36.2</td><td>24</td><td>155</td><td>45</td><td></td><td></
td><td></td></tr><tr><td align='right'>Z09.8</td><td>Follow-up examination after
other treatment for other conditions</td><td></td><td></td><td
align='right'>2129</td><td
align='right'>01000038</td><td>06-05-2023</td><td>MARJIONO</td><td></td><td></
td><td>'</td><td>16-06-1973</td><td>BUMIAYU RT 2 RW 4
SUMOGAWE</td><td></td><td>GETASAN</td><td>PUSKESMAS INDUK</td><td>dr.Gani
Kriswanto</td><td>Suwoto,A.Md.Kep</td><td>L</td><td>45-54
Thn.</td><td>Keluarga</td><td>Baru</td><td>BPJS NON PBI</td><td>Rajal</td><td
align='right'>20</td><td align='right'>10</td><td align='right'>49</td><td>BP.
Umum</td><td></td><td></td><td>Dalam
Wilayah</td><td>'0000074986288</td><td>'3322011606730001</td><td>120</td><td>80</
td><td>84</td><td>36.2</td><td>24</td><td>160</td><td>56</td><td></td><td></
td><td></td></tr><tr><td align='right'>J06.9</td><td>Acute upper respiratory
infection, unspecified</td><td></td><td></td><td align='right'>2119</td><td
align='right'>1002297</td><td>06-05-2023</td><td>MUGIYEM</td><td></td><td></
td><td>'</td><td>10-02-1969</td><td>SLEKER RT 02 RW
09</td><td>SLEKER</td><td>KOPENG</td><td>PUSKESMAS INDUK</td><td>dr.Gani
Kriswanto</td><td>Suwoto,A.Md.Kep</td><td>P</td><td>45-54
Thn.</td><td>Keluarga</td><td>Lama</td><td>BPJS PBI</td><td>Rajal</td><td
align='right'>26</td><td align='right'>2</td><td align='right'>54</td><td>BP.
Umum</td><td></td><td></td><td>Dalam
Wilayah</td><td>'0000601619567</td><td>'3322015002690002</td><td>167</td><td>88</
td><td>84</td><td>36.2</td><td>24</td><td>149</td><td>58</td><td></td><td></
td><td></td></tr><tr><td
align='right'>B86</td><td>Scabies</td><td></td><td></td><td
align='right'>2136</td><td
align='right'>01000040</td><td>06-05-2023</td><td>MUHAMMAD AFFAN
RAHARDIAN</td><td>WARNO</td><td></td><td>'</td><td>01-03-2018</td><td>NGRAWAN RT 3
RW 1</td><td></td><td>GETASAN</td><td>PUSKESMAS INDUK</td><td>dr.Gani
Kriswanto</td><td>Suwoto,A.Md.Kep</td><td>L</td><td>5-9
Thn.</td><td>Keluarga</td><td>Baru</td><td>Umum</td><td>Rajal</td><td
align='right'>5</td><td align='right'>2</td><td align='right'>5</td><td>BP.
Umum</td><td></td><td></td><td>Dalam
Wilayah</td><td>'0002579763194</td><td>'3322010103180001</td><td>100</td><td>60</
td><td>84</td><td>36.2</td><td>24</td><td>124</td><td>19</td><td></td><td></
td><td></td></tr><tr><td align='right'>L30.9</td><td>Dermatitis,
unspecified</td><td></td><td></td><td align='right'>2124</td><td
align='right'>1001346</td><td>06-05-2023</td><td>MUHAMMAD
FAHRI</td><td></td><td></td><td>'</td><td>23-02-2014</td><td>NOGOSAREN RT 02 RW
01</td><td>NOGOSAREN</td><td>NOGOSAREN</td><td>PUSKESMAS INDUK</td><td>dr.Gani
Kriswanto</td><td>Suwoto,A.Md.Kep</td><td>L</td><td>5-9
Thn.</td><td>Keluarga</td><td>Lama</td><td>BPJS PBI</td><td>Rajal</td><td
align='right'>13</td><td align='right'>2</td><td align='right'>9</td><td>BP.
Umum</td><td></td><td></td><td>Dalam
Wilayah</td><td>'0001531591198</td><td>'3322012302140001</td><td>100</td><td>60</
td><td>84</td><td>36.3</td><td>24</td><td>123</td><td>24</td><td></td><td></
td><td></td></tr><tr><td align='right'>A09</td><td>Diarrhoea and gastroenteritis of
presumed infectious origin</td><td></td><td></td><td align='right'>2137</td><td
align='right'>1008070</td><td>06-05-2023</td><td>MUHAMMAD RIZQI MAULANA
IBRAHIM</td><td></td><td></td><td>'</td><td>23-08-2017</td><td>CLOWOK RT 07 RW
02</td><td></td><td>GETASAN</td><td>PUSKESMAS INDUK</td><td>dr.Gani
Kriswanto</td><td>Joko Susanto,AMK</td><td>L</td><td>5-9
Thn.</td><td>Keluarga</td><td>Lama</td><td>Umum</td><td>Rajal</td><td
align='right'>13</td><td align='right'>8</td><td align='right'>5</td><td>BP.
Umum</td><td></td><td></td><td>Dalam
Wilayah</td><td>'</td><td>'3322012308170000</td><td>100</td><td>60</td><td>84</
td><td>36.2</td><td>24</td><td>100</td><td>15</td><td></td><td></td><td></td></
tr><tr><td align='right'>K00.6</td><td>Disturbances in tooth
eruption</td><td></td><td>mau cabut ggi depan atas </td><td
align='right'>2115</td><td align='right'>08000009</td><td>06-05-2023</td><td>NAUFAL
DZAKI
ARIAWAN</td><td>MUSTARI</td><td></td><td>'</td><td>17-04-2012</td><td>NOGOSAREN RT
03 RW 01</td><td>NOGOSAREN</td><td>NOGOSAREN</td><td>PUSKESMAS
INDUK</td><td>drg.Ade Indranila</td><td> - </td><td>L</td><td>10-14
Thn.</td><td>Keluarga</td><td>Lama</td><td>Umum</td><td>Rajal</td><td
align='right'>19</td><td align='right'></td><td align='right'>11</td><td>BP.
Gigi</td><td></td><td></td><td>Dalam
Wilayah</td><td>'</td><td>'</td><td>90</td><td>60</td><td>80</td><td>36</
td><td>20</td><td>123</td><td>25</td><td></td><td></td><td>exo CE gigi
5.2</td></tr><tr><td align='right'>M79.1</td><td>Myalgia</td><td></td><td></td><td
align='right'>2141</td><td
align='right'>06000046</td><td>06-05-2023</td><td>NGATIMIN </td><td>TUKIMIN
TUGIONO</td><td></td><td>'</td><td>06-11-1978</td><td>SANGGAR RT 2 RW 7
</td><td></td><td>BATUR</td><td>PUSKESMAS INDUK</td><td>dr.Gani
Kriswanto</td><td>Suwoto,A.Md.Kep</td><td>L</td><td>20-44
Thn.</td><td>Keluarga</td><td>Baru</td><td>BPJS PBI</td><td>Rajal</td><td
align='right'>0</td><td align='right'>6</td><td align='right'>44</td><td>BP.
Umum</td><td></td><td></td><td>Dalam
Wilayah</td><td>'0000601812268</td><td>'3322010611780002</td><td>120</td><td>80</
td><td>88</td><td>36.2</td><td>24</td><td>150</td><td>61</td><td></td><td></
td><td></td></tr><tr><td
align='right'>B86</td><td>Scabies</td><td></td><td></td><td
align='right'>2135</td><td align='right'>01000039</td><td>06-05-2023</td><td>RAFFA
ADHITYA</td><td>WARNO</td><td></td><td>'</td><td>23-03-2010</td><td>NGRAWAN RT 3 RW
1 GETASAN</td><td></td><td>GETASAN</td><td>PUSKESMAS INDUK</td><td>dr.Gani
Kriswanto</td><td>Suwoto,A.Md.Kep</td><td>L</td><td>10-14
Thn.</td><td>Keluarga</td><td>Baru</td><td>Umum</td><td>Rajal</td><td
align='right'>14</td><td align='right'>1</td><td align='right'>13</td><td>BP.
Umum</td><td></td><td></td><td>Dalam
Wilayah</td><td>'0001530768216</td><td>'3322012303100001</td><td>100</td><td>60</
td><td>84</td><td>36.2</td><td>24</td><td>140</td><td>40</td><td></td><td></
td><td></td></tr><tr><td align='right'>Z00</td><td>General examination and
investigation of persons without complaint and reported
diagnosis</td><td></td><td></td><td align='right'>2147</td><td
align='right'>1018169</td><td>06-05-2023</td><td>REZA NUARY
RAMADHAN</td><td></td><td></td><td>'</td><td>27-01-1998</td><td>KENTENG RT 01 RW
05</td><td></td><td>GETASAN</td><td>PUSKESMAS INDUK</td><td>dr.Gani
Kriswanto</td><td>Suwoto,A.Md.Kep</td><td>L</td><td>20-44
Thn.</td><td>Keluarga</td><td>Lama</td><td>Umum</td><td>Rajal</td><td
align='right'>9</td><td align='right'>3</td><td align='right'>25</td><td>BP.
Umum</td><td></td><td></td><td>Dalam
Wilayah</td><td>'0001027429727</td><td>'3322012701980000</td><td>120</td><td>80</
td><td>84</td><td>36.3</td><td>24</td><td>160</td><td>56</td><td></td><td></
td><td></td></tr><tr><td align='right'>J06.9</td><td>Acute upper respiratory
infection, unspecified</td><td></td><td></td><td align='right'>2139</td><td
align='right'>1023459</td><td>06-05-2023</td><td>SANDI
SURYADI</td><td></td><td></td><td>'</td><td>12-12-1969</td><td>SRUWEN III RT 10 RW
03</td><td></td><td>Luar Wilayah</td><td>PUSKESMAS INDUK</td><td>dr.Gani
Kriswanto</td><td>Suwoto,A.Md.Kep</td><td>L</td><td>45-54
Thn.</td><td>Keluarga</td><td>Lama</td><td>BPJS NON PBI</td><td>Rajal</td><td
align='right'>24</td><td align='right'>4</td><td align='right'>53</td><td>BP.
Umum</td><td></td><td></td><td>Luar
Wilayah</td><td>'0001530645445</td><td>'3322021212690003</td><td>136</td><td>88</
td><td>84</td><td>36.2</td><td>24</td><td>158</td><td>56</td><td></td><td></
td><td></td></tr><tr><td align='right'>K08.3</td><td>Retained dental
root</td><td></td><td>pasien datang mau cabut gigi
gigi depan atas </td><td align='right'>2116</td><td
align='right'>1024994</td><td>06-05-2023</td><td>SRI
SULIYAH</td><td></td><td></td><td>'</td><td>24-05-1971</td><td>SENDEN RT 04 RW
09</td><td>SENDEN</td><td>BATUR</td><td>PUSKESMAS INDUK</td><td>drg.Ade
Indranila</td><td> - </td><td>P</td><td>45-54
Thn.</td><td>Keluarga</td><td>Lama</td><td>Umum</td><td>Rajal</td><td
align='right'>12</td><td align='right'>11</td><td align='right'>51</td><td>BP.
Gigi</td><td></td><td></td><td>Dalam
Wilayah</td><td>'</td><td>'3322016405710001</td><td>139</td><td>95</td><td>80</
td><td>36</td><td>24</td><td>153</td><td>52</td><td></td><td></td><td>exo gig 2.1
dan 2.2 dengan infiltrasi lidocain </td></tr><tr><td
align='right'>R55</td><td>Syncope and collapse</td><td></td><td></td><td
align='right'>2140</td><td
align='right'>1000911</td><td>06-05-2023</td><td>SUDARMI</td><td></td><td></
td><td>'</td><td>27-05-1976</td><td>SIDOMUKTI RT 07 RW
05</td><td></td><td>KOPENG</td><td>PUSKESMAS INDUK</td><td>dr.Gani
Kriswanto</td><td>Suwoto,A.Md.Kep</td><td>P</td><td>45-54
Thn.</td><td>Keluarga</td><td>Lama</td><td>Umum</td><td>Rajal</td><td
align='right'>9</td><td align='right'>11</td><td align='right'>46</td><td>BP.
Umum</td><td></td><td></td><td>Dalam
Wilayah</td><td>'0003101071296</td><td>'3322016705750000</td><td>100</td><td>60</
td><td>84</td><td>36.2</td><td>24</td><td>158</td><td>56</td><td></td><td></
td><td></td></tr><tr><td
align='right'>K05.4</td><td>Periodontosis</td><td></td><td>pasien datang mau cabut
didi, sudah goyang gigi depan bawah </td><td align='right'>2117</td><td
align='right'>1004621</td><td>06-05-2023</td><td>SUHARIYANTO</td><td></td><td></
td><td>'</td><td>12-12-1960</td><td>GETASAN RT 08 RW
01</td><td></td><td>GETASAN</td><td>PUSKESMAS INDUK</td><td>drg.Ade
Indranila</td><td> - </td><td>L</td><td>60-69
Thn.</td><td>Keluarga</td><td>Lama</td><td>BPJS NON PBI</td><td>Rajal</td><td
align='right'>24</td><td align='right'>4</td><td align='right'>62</td><td>BP.
Gigi</td><td></td><td></td><td>Dalam
Wilayah</td><td>'0000075017643</td><td>'3322011212600000</td><td>131</td><td>78</
td><td>75</td><td>36</td><td>24</td><td>156</td><td>56</td><td></td><td>pro exo
</td><td>exo gigi 3.1 CE </td></tr><tr><td align='right'>J00</td><td>Acute
nasopharyngitis [common cold]</td><td></td><td></td><td align='right'>2143</td><td
align='right'>90000099</td><td>06-05-2023</td><td>TUGI</td><td></td><td></
td><td>'</td><td>11-07-1964</td><td>TOSORO RT 14 RW 06 JETAK</td><td></td><td>Luar
Wilayah</td><td>PUSKESMAS INDUK</td><td>dr.Gani
Kriswanto</td><td>Suwoto,A.Md.Kep</td><td>P</td><td>55-59
Thn.</td><td>Keluarga</td><td>Lama</td><td>BPJS PBI</td><td>Rajal</td><td
align='right'>25</td><td align='right'>9</td><td align='right'>58</td><td>BP.
Umum</td><td></td><td></td><td>Luar
Wilayah</td><td>'0000601632731</td><td>'3322015107640002</td><td>113</td><td>70</
td><td>84</td><td>36.3</td><td>24</td><td>156</td><td>50</td><td></td><td></
td><td></td></tr><tr><td align='right'>K04.1</td><td>Necrosis of
pulp</td><td></td><td>pasien datang dengan keluhan kanan atas sakit </td><td
align='right'>2187</td><td align='right'>1010739</td><td>08-05-2023</td><td>AHMAD
SALEH</td><td></td><td></td><td>'</td><td>26-05-1994</td><td>KALIDUREN RT 01 RW
05</td><td></td><td>BATUR</td><td>PUSKESMAS INDUK</td><td>drg.Ade
Indranila</td><td> - </td><td>L</td><td>20-44
Thn.</td><td>Keluarga</td><td>Lama</td><td>BPJS NON PBI</td><td>Rajal</td><td
align='right'>12</td><td align='right'>11</td><td align='right'>28</td><td>BP.
Gigi</td><td></td><td></td><td>Dalam
Wilayah</td><td>'0001027419006</td><td>'3322012605940000</td><td>126</td><td>63</
td><td>78</td><td>36</td><td>21</td><td>156</td><td>54</td><td></td><td></
td><td>medikasi </td></tr><tr><td align='right'>K00.6</td><td>Disturbances in tooth
eruption</td><td></td><td>pasien datang mau cabut gigi</td><td
align='right'>2199</td><td
align='right'>1004143</td><td>08-05-2023</td><td>AINUNNAYYA
FATHIYYATURAHMA</td><td></td><td></td><td>'</td><td>10-02-2015</td><td>GETASAN RT 2
RW 1 </td><td></td><td>GETASAN</td><td>PUSKESMAS INDUK</td><td>drg.Ade
Indranila</td><td> - </td><td>P</td><td>5-9
Thn.</td><td>Keluarga</td><td>Lama</td><td>Umum</td><td>Rajal</td><td
align='right'>28</td><td align='right'>2</td><td align='right'>8</td><td>BP.
Gigi</td><td></td><td></td><td>Dalam
Wilayah</td><td>'</td><td>'</td><td>100</td><td>70</td><td>88</td><td>36</
td><td>24</td><td>134</td><td>26</td><td></td><td></td><td></td></tr><tr><td
align='right'>J06.9</td><td>Acute upper respiratory infection,
unspecified</td><td></td><td>PANAS, BATUK, PILEK</td><td align='right'>2159</td><td
align='right'>1020715</td><td>08-05-2023</td><td>ALESHA KURNIA
FADHILA</td><td>SURAMIN</td><td></td><td>'</td><td>11-12-2020</td><td>THEKELAN RT
02 RW 17</td><td></td><td>BATUR</td><td>PUSKESMAS INDUK</td><td>dr.Arninta Rahma
Khoirunnisa</td><td> - </td><td>P</td><td>1-4
Thn.</td><td>Keluarga</td><td>Lama</td><td>BPJS PBI</td><td>Rajal</td><td
align='right'>27</td><td align='right'>4</td><td
align='right'>2</td><td>MTBS</td><td></td><td></td><td>Dalam
Wilayah</td><td>'0003142227521</td><td>'3322015812200001</td><td></td><td></
td><td>136</td><td>37</td><td>39</td><td>86</td><td>11</td><td></td><td>penkes cara
pemberian obat di rumah</td><td>memberikan penkes cara pemberian obat di
rumah</td></tr><tr><td align='right'>J06.9</td><td>Acute upper respiratory
infection, unspecified</td><td></td><td>batuk pilek</td><td
align='right'>2157</td><td
align='right'>1012024</td><td>08-05-2023</td><td>ALFIANDRA TEGAR
AFANDI</td><td></td><td></td><td>'</td><td>28-07-2011</td><td>SLEKER RT 06 RW
03</td><td></td><td>KOPENG</td><td>PUSKESMAS INDUK</td><td>dr.Arninta Rahma
Khoirunnisa</td><td>Suwoto,A.Md.Kep</td><td>L</td><td>10-14
Thn.</td><td>Keluarga</td><td>Lama</td><td>Umum</td><td>Rajal</td><td
align='right'>10</td><td align='right'>9</td><td align='right'>11</td><td>BP.
Umum</td><td></td><td></td><td>Dalam
Wilayah</td><td>'</td><td>'</td><td>90</td><td>60</td><td>88</td><td>37</
td><td>28</td><td>121</td><td>18</td><td></td><td>hidari mkn ciki
m/m teratur</td><td>hidari mkn ciki
m/m teratur</td></tr><tr><td align='right'>J06.9</td><td>Acute upper respiratory
infection, unspecified</td><td></td><td>batuk</td><td align='right'>2204</td><td
align='right'>1001337</td><td>08-05-2023</td><td>ANIK
YULIANA</td><td></td><td></td><td>'</td><td>01-07-1989</td><td>KEDAYON RT 06 RW
01</td><td>KEDAYON</td><td>WATES</td><td>PUSKESMAS INDUK</td><td>dr.Arninta Rahma
Khoirunnisa</td><td>Suwoto,A.Md.Kep</td><td>P</td><td>20-44
Thn.</td><td>Keluarga</td><td>Lama</td><td>BPJS PBI</td><td>Rajal</td><td
align='right'>7</td><td align='right'>10</td><td align='right'>33</td><td>BP.
Umum</td><td></td><td></td><td>Dalam
Wilayah</td><td>'0000601611491</td><td>'3322015207890000</td><td>120</td><td>80</
td><td>80</td><td>36</td><td>24</td><td>148</td><td>51</td><td></td><td></
td><td></td></tr><tr><td align='right'>J06.9</td><td>Acute upper respiratory
infection, unspecified</td><td></td><td>PANAS, BATUK, PILEK</td><td
align='right'>2163</td><td align='right'>1016839</td><td>08-05-2023</td><td>AQILA
ANANDA PUTRI</td><td></td><td></td><td>'</td><td>09-08-2019</td><td>PIJI RT 11 RW
05</td><td></td><td>GETASAN</td><td>PUSKESMAS INDUK</td><td>dr.Arninta Rahma
Khoirunnisa</td><td>Sri Hartini,S.S.T.Keb</td><td>P</td><td>1-4
Thn.</td><td>Keluarga</td><td>Lama</td><td>Umum</td><td>Rajal</td><td
align='right'>29</td><td align='right'>8</td><td
align='right'>3</td><td>MTBS</td><td></td><td></td><td>Dalam
Wilayah</td><td>'</td><td>'</td><td></td><td></td><td>130</td><td>37</td><td>39</
td><td>99</td><td>15</td><td></td><td>PENKES CARA PEMBERIAN OBAT DI RUMAH, PENKES
CARA PEMBERIAN MAKAN/ MINUM DI RUMAH</td><td>MEMBERIKAN PENKES CARA PEMBERIAN OBAT
DI RUMAH, MEMBERIKAN PENKES CARA PEMBERIAN MAKAN , MINUM DI RUMAH</td></tr><tr><td
align='right'>J06.9</td><td>Acute upper respiratory infection,
unspecified</td><td></td><td>demam</td><td align='right'>2152</td><td
align='right'>1005519</td><td>08-05-2023</td><td>ARDHANI PAKSI YUDHA
HANSOYO</td><td></td><td>PELAJAR/MAHASISWA</td><td>'</td><td>01-12-2003</
td><td>GETASAN RT 4 RW 1</td><td></td><td>GETASAN</td><td>PUSKESMAS
INDUK</td><td>dr.Arninta Rahma
Khoirunnisa</td><td>Suwoto,A.Md.Kep</td><td>L</td><td>15-19
Thn.</td><td>Keluarga</td><td>Lama</td><td>BPJS PBI</td><td>Rajal</td><td
align='right'>7</td><td align='right'>5</td><td align='right'>19</td><td>BP.
Umum</td><td></td><td></td><td>Dalam Wilayah</td><td>'0000601790466</td><td>'
332201131203000</td><td>110</td><td>70</td><td>84</td><td>37</td><td>28</
td><td>164</td><td>56</td><td></td><td>m/m teratur
minum banyak</td><td>m/m teratur
minum banyak</td></tr><tr><td align='right'>Z00</td><td>General examination and
investigation of persons without complaint and reported
diagnosis</td><td></td><td>surat sehat</td><td align='right'>2189</td><td
align='right'>02000031</td><td>08-05-2023</td><td>ARKAN ZAKY RAMADHAN</td><td>BAYU
PURSTYANTO</td><td>BELUM/TIDAK BEKERJA</td><td>'</td><td>09-09-2007</td><td>WATES
RT 2 RW 1 </td><td></td><td>WATES</td><td>PUSKESMAS INDUK</td><td>dr.Arninta Rahma
Khoirunnisa</td><td>Suwoto,A.Md.Kep</td><td>L</td><td>15-19
Thn.</td><td>Keluarga</td><td>Baru</td><td>Umum</td><td>Rajal</td><td
align='right'>29</td><td align='right'>7</td><td align='right'>15</td><td>BP.
Umum</td><td></td><td></td><td>Dalam
Wilayah</td><td>'0002323825446</td><td>'3322010909070001</td><td>120</td><td>80</
td><td>80</td><td>36</td><td>24</td><td>150</td><td>52</td><td></td><td></
td><td></td></tr><tr><td align='right'>K01.1</td><td>Impacted
teeth</td><td></td><td>pasien datang gigi tumbuh, rahang sakit </td><td
align='right'>2198</td><td align='right'>99000048</td><td>08-05-2023</td><td>BAYU
BAHTIAR</td><td></td><td>WIRASWASTA</td><td>'</td><td>20-10-1996</td><td>BENER
KULON RT 3 RW 5 </td><td></td><td>Luar kabupaten</td><td>PUSKESMAS
INDUK</td><td>drg.Ade Indranila</td><td> - </td><td>L</td><td>20-44
Thn.</td><td>Keluarga</td><td>Baru</td><td>BPJS NON PBI</td><td>Rajal</td><td
align='right'>19</td><td align='right'>6</td><td align='right'>26</td><td>BP.
Gigi</td><td></td><td></td><td>Luar
Wilayah</td><td>'0001532917045</td><td>'3309022010960003</td><td>127</td><td>77</
td><td>80</td><td>36</td><td>23</td><td>165</td><td>54</td><td></td><td>pro exo
</td><td>medikasi
kontrol ulang </td></tr><tr><td align='right'>J06.9</td><td>Acute upper respiratory
infection, unspecified</td><td></td><td>pinggang nyeri
batuk</td><td align='right'>2208</td><td align='right'>01000046</td><td>08-05-
2023</td><td>BIELDAD SURYONO</td><td></td><td>PETANI/PEKEBUN</td><td>'</td><td>00-
00-0000</td><td>NGELO RT 4 RW 2 </td><td></td><td>GETASAN</td><td>PUSKESMAS
INDUK</td><td>dr.Arninta Rahma
Khoirunnisa</td><td>Suwoto,A.Md.Kep</td><td>L</td><td>0-7
hari</td><td>Keluarga</td><td>Baru</td><td>BPJS PBI</td><td>Rajal</td><td
align='right'>11</td><td align='right'>4</td><td align='right'>22</td><td>BP.
Umum</td><td></td><td></td><td>Dalam
Wilayah</td><td>'0001027441675</td><td>'3322012812700001</td><td>120</td><td>80</
td><td>80</td><td>37</td><td>24</td><td>150</td><td>55</td><td></td><td>hidari
minum banyak
kurangi karbohidrat</td><td>hidari minum banyak
kurangi karbohidrat</td></tr><tr><td align='right'>H10.9</td><td>Conjunctivitis,
unspecified</td><td></td><td>MATA BENGKAK, SAKIT</td><td align='right'>2190</td><td
align='right'>1020040</td><td>08-05-2023</td><td>CLARISSA UTAMI
PRAMONO</td><td></td><td></td><td>'</td><td>26-08-2020</td><td>BUMIAYU RT 02 RW
04</td><td></td><td>GETASAN</td><td>PUSKESMAS INDUK</td><td>dr.Arninta Rahma
Khoirunnisa</td><td> - </td><td>P</td><td>1-4
Thn.</td><td>Keluarga</td><td>Lama</td><td>BPJS NON PBI</td><td>Rajal</td><td
align='right'>12</td><td align='right'>8</td><td
align='right'>2</td><td>MTBS</td><td></td><td></td><td>Dalam
Wilayah</td><td>'0003048288592</td><td>'3322016608200001</td><td></td><td></
td><td>120</td><td>36</td><td>37</td><td>92</td><td>13</td><td></td><td>PENKES
TENTANG CARA PEMBERIAN OBAT DI RUMAH</td><td>MEMBERIKAN PENKES TENTANG CARA
PEMBERIAN OBAT DI RUMAH</td></tr><tr><td align='right'>K02.1</td><td>Caries of
dentine</td><td></td><td>pasien datang mau kntrol gigi </td><td
align='right'>2153</td><td
align='right'>06000044</td><td>08-05-2023</td><td>DARMADI</td><td></td><td>PETANI/
PEKEBUN</td><td>'</td><td>01-09-1958</td><td>MADU RT 02 RW
04</td><td>MADU</td><td>BATUR</td><td>PUSKESMAS INDUK</td><td>drg.Ade
Indranila</td><td> - </td><td>L</td><td>60-69
Thn.</td><td>Keluarga</td><td>Lama</td><td>Umum</td><td>Rajal</td><td
align='right'>7</td><td align='right'>8</td><td align='right'>64</td><td>BP.
Gigi</td><td></td><td></td><td>Dalam
Wilayah</td><td>'0000602537973</td><td>'3322102409580001</td><td>143</td><td>90</
td><td>80</td><td>36</td><td>24</td><td>155</td><td>54</td><td>Tdk
Th</td><td></td><td></td></tr><tr><td align='right'>K04.1</td><td>Necrosis of
pulp</td><td></td><td>pasien datang mau kntrol gigi </td><td
align='right'>2153</td><td
align='right'>06000044</td><td>08-05-2023</td><td>DARMADI</td><td></td><td>PETANI/
PEKEBUN</td><td>'</td><td>01-09-1958</td><td>MADU RT 02 RW
04</td><td>MADU</td><td>BATUR</td><td>PUSKESMAS INDUK</td><td>drg.Ade
Indranila</td><td> - </td><td>L</td><td>60-69
Thn.</td><td>Keluarga</td><td>Lama</td><td>Umum</td><td>Rajal</td><td
align='right'>7</td><td align='right'>8</td><td align='right'>64</td><td>BP.
Gigi</td><td></td><td></td><td>Dalam
Wilayah</td><td>'0000602537973</td><td>'3322102409580001</td><td>143</td><td>90</
td><td>80</td><td>36</td><td>24</td><td>155</td><td>54</td><td>Tdk
Th</td><td></td><td></td></tr><tr><td align='right'>H81.1</td><td>Benign paroxysmal
verti</td><td></td><td>bingung mual</td><td align='right'>2216</td><td
align='right'>1007323</td><td>08-05-2023</td><td>DARYONO</td><td></td><td>BURUH
HARIAN LEPAS</td><td>'</td><td>04-10-1972</td><td>SLEKER RT.6
RW.3</td><td></td><td>KOPENG</td><td>PUSKESMAS INDUK</td><td>dr.Arninta Rahma
Khoirunnisa</td><td>Suwoto,A.Md.Kep</td><td>L</td><td>45-54
Thn.</td><td>Keluarga</td><td>Lama</td><td>BPJS PBI</td><td>Rajal</td><td
align='right'>4</td><td align='right'>7</td><td align='right'>50</td><td>BP.
Umum</td><td></td><td></td><td>Dalam
Wilayah</td><td>'0001436849414</td><td>'3322010410720000</td><td>120</td><td>80</
td><td>80</td><td>36</td><td>24</td><td>158</td><td>65</td><td></td><td>m/m teratur
istirahat yg cukup</td><td>m/m teratur
istirahat yg cukup</td></tr><tr><td align='right'>R50.9</td><td>Fever,
unspecified</td><td></td><td>pusing demam</td><td align='right'>2196</td><td
align='right'>1012900</td><td>08-05-2023</td><td>DESTY
ARDIANDANI</td><td></td><td></td><td>'</td><td>22-12-2012</td><td>BUMIAYU RT 01 RW
04</td><td></td><td>GETASAN</td><td>PUSKESMAS INDUK</td><td>dr.Arninta Rahma
Khoirunnisa</td><td>Suwoto,A.Md.Kep</td><td>P</td><td>10-14
Thn.</td><td>Keluarga</td><td>Lama</td><td>BPJS PBI</td><td>Rajal</td><td
align='right'>16</td><td align='right'>4</td><td align='right'>10</td><td>BP.
Umum</td><td></td><td></td><td>Dalam
Wilayah</td><td>'0002349063898</td><td>'3322016212120000</td><td>100</td><td>70</
td><td>80</td><td>36</td><td>24</td><td>105</td><td>14</td><td></td><td></
td><td></td></tr><tr><td align='right'>N12</td><td>Tubulo-interstitial nephritis,
not specified as acute or chronic</td><td></td><td>bak sakit</td><td
align='right'>2192</td><td align='right'>1002160</td><td>08-05-2023</td><td>DESVITA
AYU TRI ASTUTI</td><td></td><td></td><td>'</td><td>01-12-2006</td><td>SIDOMUKTI RT
5 RW 3</td><td>SIDOMUKTI</td><td>KOPENG</td><td>PUSKESMAS INDUK</td><td>dr.Arninta
Rahma Khoirunnisa</td><td>Suwoto,A.Md.Kep</td><td>P</td><td>15-19
Thn.</td><td>Keluarga</td><td>Lama</td><td>BPJS PBI</td><td>Rajal</td><td
align='right'>7</td><td align='right'>5</td><td align='right'>16</td><td>BP.
Umum</td><td></td><td></td><td>Dalam
Wilayah</td><td>'0000600868091</td><td>'3322016412060003</td><td>110</td><td>70</
td><td>80</td><td>36</td><td>24</td><td>145</td><td>42</td><td></td><td>minum
banyak air putih</td><td>minum banyak air putih</td></tr><tr><td
align='right'>K08.3</td><td>Retained dental root</td><td></td><td>pasien datang mau
can=but gigi </td><td align='right'>2158</td><td align='right'>1022402</td><td>08-
05-2023</td><td>DINA KARTINI ALS KARTINI</td><td></td><td></td><td>'</td><td>07-07-
1970</td><td>KOPENG RT 03 RW 02</td><td></td><td>GETASAN</td><td>PUSKESMAS
INDUK</td><td>drg.Ade Indranila</td><td> - </td><td>P</td><td>45-54
Thn.</td><td>Keluarga</td><td>Lama</td><td>BPJS NON PBI</td><td>Rajal</td><td
align='right'>1</td><td align='right'>10</td><td align='right'>52</td><td>BP.
Gigi</td><td></td><td></td><td>Dalam
Wilayah</td><td>'0001839782193</td><td>'3322015203930000</td><td>129</td><td>93</
td><td>77</td><td>36</td><td>21</td><td>154</td><td>56</td><td></td><td>pro exo
</td><td>medikasi penurun tensi
tunda exo </td></tr><tr><td align='right'>M79.0</td><td>Rheumatism,
unspecified</td><td></td><td>pusing</td><td align='right'>2200</td><td
align='right'>06000047</td><td>08-05-2023</td><td>DIYAH RAHMA
DANI</td><td></td><td></td><td>'085795887602</td><td>11-12-2011</td><td>SELODUWUR
RT 3RW 16 </td><td></td><td>BATUR</td><td>PUSKESMAS INDUK</td><td>dr.Arninta Rahma
Khoirunnisa</td><td>Suwoto,A.Md.Kep</td><td>P</td><td>10-14
Thn.</td><td>Keluarga</td><td>Baru</td><td>Umum</td><td>Rajal</td><td
align='right'>28</td><td align='right'>4</td><td align='right'>11</td><td>BP.
Umum</td><td></td><td></td><td>Dalam
Wilayah</td><td>'</td><td>'</td><td>120</td><td>90</td><td>80</td><td>36</
td><td>24</td><td>138</td><td>46</td><td></td><td></td><td></td></tr><tr><td
align='right'>K04.1</td><td>Necrosis of pulp</td><td></td><td>psien gigi bawah
kanan sakit, berlubang </td><td align='right'>2218</td><td
align='right'>1014865</td><td>08-05-2023</td><td>EKO AGUS
RIYANTO</td><td></td><td></td><td>'</td><td>22-02-2002</td><td>DUKUH RT 03 RW
08</td><td></td><td>KOPENG</td><td>PUSKESMAS INDUK</td><td>drg.Ade
Indranila</td><td> - </td><td>L</td><td>20-44
Thn.</td><td>Keluarga</td><td>Lama</td><td>BPJS NON PBI</td><td>Rajal</td><td
align='right'>16</td><td align='right'>2</td><td align='right'>21</td><td>BP.
Gigi</td><td></td><td></td><td>Dalam
Wilayah</td><td>'0003103399552</td><td>'3322012202020000</td><td>127</td><td>76</
td><td>80</td><td>36</td><td>24</td><td>155</td><td>54</td><td></td><td></
td><td></td></tr><tr><td align='right'>S51.7</td><td>Multiple open wounds of
forearm</td><td></td><td>ganti balut</td><td align='right'>2154</td><td
align='right'>06000045</td><td>08-05-2023</td><td>ELEAZAR HENDRI
HARTANTO</td><td>SUTRISNO</td><td>PELAJAR/MAHASISWA</td><td>'088806406294</
td><td>05-06-2006</td><td>SENDEN RT 04 RW
09</td><td>SENDEN</td><td>BATUR</td><td>PUSKESMAS INDUK</td><td>dr.Arninta Rahma
Khoirunnisa</td><td>Suwoto,A.Md.Kep</td><td>L</td><td>15-19
Thn.</td><td>Keluarga</td><td>Lama</td><td>Umum</td><td>Rajal</td><td
align='right'>3</td><td align='right'>11</td><td align='right'>16</td><td>BP.
Umum</td><td></td><td></td><td>Dalam
Wilayah</td><td>'</td><td>'</td><td>120</td><td>80</td><td>80</td><td>36</
td><td>24</td><td>150</td><td>50</td><td></td><td>jangan kena air
m/m teratur</td><td>jangan kena air
m/m teratur</td></tr><tr><td align='right'>K08.3</td><td>Retained dental
root</td><td></td><td>pasien datang giginya sakit </td><td
align='right'>2181</td><td align='right'>1012206</td><td>08-05-2023</td><td>ELMIRA
MIKE WIJAYANTI</td><td></td><td></td><td>'</td><td>27-06-2018</td><td>TOLOKAN RT 04
RW 01</td><td>TOLOKAN</td><td>TOLOKAN</td><td>PUSKESMAS INDUK</td><td>drg.Ade
Indranila</td><td> - </td><td>P</td><td>1-4
Thn.</td><td>Keluarga</td><td>Lama</td><td>BPJS NON PBI</td><td>Rajal</td><td
align='right'>11</td><td align='right'>10</td><td align='right'>4</td><td>BP.
Gigi</td><td></td><td></td><td>Dalam
Wilayah</td><td>'0002467672154</td><td>'3322016706180000</td><td>100</td><td>70</
td><td>80</td><td>36</td><td>24</td><td>123</td><td>19</td><td></td><td></
td><td></td></tr><tr><td align='right'>M79.0</td><td>Rheumatism,
unspecified</td><td></td><td>badan sakit semua</td><td align='right'>2182</td><td
align='right'>1001039</td><td>08-05-2023</td><td>ESTER SRI
LESTARAI</td><td></td><td></td><td>'</td><td>26-03-1979</td><td>NGELO RT 03 RW
02</td><td></td><td>GETASAN</td><td>PUSKESMAS INDUK</td><td>dr.Arninta Rahma
Khoirunnisa</td><td>Suwoto,A.Md.Kep</td><td>L</td><td>20-44
Thn.</td><td>Keluarga</td><td>Lama</td><td>BPJS NON PBI</td><td>Rajal</td><td
align='right'>12</td><td align='right'>1</td><td align='right'>44</td><td>BP.
Umum</td><td></td><td></td><td>Dalam
Wilayah</td><td>'0001266464349</td><td>'3322014308790000</td><td>150</td><td>90</
td><td>80</td><td>36</td><td>24</td><td>150</td><td>49</td><td></td><td></
td><td></td></tr><tr><td align='right'>D33.2</td><td>Benign neoplasm of brain,
unspecified</td><td></td><td>rujuk</td><td align='right'>2173</td><td
align='right'>1004700</td><td>08-05-2023</td><td>HENI
ASTUTININGSIH</td><td></td><td></td><td>'</td><td>20-03-1998</td><td>SIDOMUKTI RT
10 RW 05</td><td>SIDOMUKTI</td><td>KOPENG</td><td>PUSKESMAS
INDUK</td><td>dr.Arninta Rahma
Khoirunnisa</td><td>Suwoto,A.Md.Kep</td><td>P</td><td>20-44
Thn.</td><td>Keluarga</td><td>Lama</td><td>BPJS PBI</td><td>Rujuk</td><td
align='right'>18</td><td align='right'>1</td><td align='right'>25</td><td>BP.
Umum</td><td>Poli Bedah</td><td>RS KEN SARAS</td><td>Dalam
Wilayah</td><td>'0001872747292</td><td>'3322016003980002</td><td>130</td><td>90</
td><td>80</td><td>36</td><td>24</td><td>150</td><td>50</td><td></td><td></
td><td></td></tr><tr><td align='right'>I50</td><td>Heart
failure</td><td></td><td>rujuk</td><td align='right'>2185</td><td
align='right'>1000469</td><td>08-05-2023</td><td>JUMIATI</td><td></td><td></
td><td>'</td><td>01-12-1956</td><td>JURUG RT 07 RW
01</td><td>JURUG</td><td>WATES</td><td>PUSKESMAS INDUK</td><td>dr.Arninta Rahma
Khoirunnisa</td><td>Suwoto,A.Md.Kep</td><td>P</td><td>60-69
Thn.</td><td>Keluarga</td><td>Lama</td><td>BPJS PBI</td><td>Rujuk</td><td
align='right'>7</td><td align='right'>5</td><td align='right'>66</td><td>BP.
Umum</td><td>Penyakit Dalam </td><td>RS DR.ASMIR SALATIGA</td><td>Dalam
Wilayah</td><td>'0000601852555</td><td>'3322017112560030</td><td>140</td><td>90</
td><td>80</td><td>36</td><td>24</td><td>150</td><td>50</td><td></td><td></
td><td></td></tr><tr><td align='right'>K04.1</td><td>Necrosis of
pulp</td><td></td><td>pasien fatamg mau kontrol gigi sakit </td><td
align='right'>2183</td><td
align='right'>1009748</td><td>08-05-2023</td><td>JUMSARI</td><td></td><td></
td><td>'</td><td>28-04-1977</td><td>BATUR KIDUL RT 05 RW 14</td><td>BATUR
KIDUL</td><td>BATUR</td><td>PUSKESMAS INDUK</td><td>drg.Ade Indranila</td><td> -
</td><td>L</td><td>45-54 Thn.</td><td>Keluarga</td><td>Lama</td><td>BPJS
PBI</td><td>Rajal</td><td align='right'>10</td><td align='right'></td><td
align='right'>46</td><td>BP. Gigi</td><td></td><td></td><td>Dalam
Wilayah</td><td>'0001997095432</td><td>'3322012804770002</td><td></td><td></
td><td></td><td></td><td></td><td>0</td><td>0</td><td></td><td></td><td>chkm+ cavit
</td></tr><tr><td align='right'>K00.6</td><td>Disturbances in tooth
eruption</td><td></td><td>pasien jdatang dengan keluhan gigi depan goyang, mau
cabut </td><td align='right'>2186</td><td align='right'>1007802</td><td>08-05-
2023</td><td>KADIMIN</td><td></td><td></td><td>'</td><td>12-12-1972</
td><td>KALIDUREN RT I/5</td><td></td><td>BATUR</td><td>PUSKESMAS
INDUK</td><td>drg.Ade Indranila</td><td> - </td><td>L</td><td>45-54
Thn.</td><td>Keluarga</td><td>Lama</td><td>BPJS PBI</td><td>Rajal</td><td
align='right'>26</td><td align='right'>4</td><td align='right'>50</td><td>BP.
Gigi</td><td></td><td></td><td>Dalam
Wilayah</td><td>'0001027418984</td><td>'3322011212720000</td><td>113</td><td>85</
td><td>83</td><td>36</td><td>21</td><td>155</td><td>56</td><td></td><td>PRO EXO
</td><td>EXO GIGI 7.1 DAN 8.1 DENGAN CE </td></tr><tr><td
align='right'>K08.3</td><td>Retained dental root</td><td></td><td>pasien jdatang
dengan keluhan gigi depan goyang, mau cabut </td><td align='right'>2186</td><td
align='right'>1007802</td><td>08-05-2023</td><td>KADIMIN</td><td></td><td></
td><td>'</td><td>12-12-1972</td><td>KALIDUREN RT
I/5</td><td></td><td>BATUR</td><td>PUSKESMAS INDUK</td><td>drg.Ade
Indranila</td><td> - </td><td>L</td><td>45-54
Thn.</td><td>Keluarga</td><td>Lama</td><td>BPJS PBI</td><td>Rajal</td><td
align='right'>26</td><td align='right'>4</td><td align='right'>50</td><td>BP.
Gigi</td><td></td><td></td><td>Dalam
Wilayah</td><td>'0001027418984</td><td>'3322011212720000</td><td>113</td><td>85</
td><td>83</td><td>36</td><td>21</td><td>155</td><td>56</td><td></td><td>PRO EXO
</td><td>EXO GIGI 7.1 DAN 8.1 DENGAN CE </td></tr><tr><td
align='right'>K29.7</td><td>Gastritis, unspecified</td><td></td><td>MUAL,
MUNTAH</td><td align='right'>2212</td><td align='right'>1018935</td><td>08-05-
2023</td><td>KHAILA NUR
AISYAH</td><td></td><td></td><td>'</td><td>23-02-2020</td><td>KOPENG RT 01 RW
02</td><td></td><td>KOPENG</td><td>PUSKESMAS INDUK</td><td>dr.Arninta Rahma
Khoirunnisa</td><td>Sri Hartini,S.S.T.Keb</td><td>P</td><td>1-4
Thn.</td><td>Keluarga</td><td>Lama</td><td>Umum</td><td>Rajal</td><td
align='right'>15</td><td align='right'>2</td><td
align='right'>3</td><td>MTBS</td><td></td><td></td><td>Dalam
Wilayah</td><td>'</td><td>'</td><td></td><td></td><td>128</td><td>36</td><td>37</
td><td>93</td><td>16</td><td></td><td>PENKES CARA MEMBERIKAN OBAT DI
RUMAH</td><td>MEMBERIKAN PENKES CCAR PEMBERIAN OBAT DI RUMAH</td></tr><tr><td
align='right'>J06.9</td><td>Acute upper respiratory infection,
unspecified</td><td></td><td>batuk</td><td align='right'>2205</td><td
align='right'>1023276</td><td>08-05-2023</td><td>LATIFA ULFA
PRADITA</td><td></td><td></td><td>'</td><td>09-12-1993</td><td>KEBONAN RT 06 RW
01</td><td></td><td>TOLOKAN</td><td>PUSKESMAS INDUK</td><td>dr.Arninta Rahma
Khoirunnisa</td><td>Suwoto,A.Md.Kep</td><td>P</td><td>20-44
Thn.</td><td>Keluarga</td><td>Lama</td><td>BPJS PBI</td><td>Rajal</td><td
align='right'>29</td><td align='right'>4</td><td align='right'>29</td><td>BP.
Umum</td><td></td><td></td><td>Dalam
Wilayah</td><td>'0000642303538</td><td>'3374114912930000</td><td>110</td><td>70</
td><td>80</td><td>37</td><td>24</td><td>156</td><td>76</td><td></td><td></
td><td></td></tr><tr><td align='right'>L23.0</td><td>Allergic contact dermatitis
due to metals</td><td></td><td>gatal</td><td align='right'>2201</td><td
align='right'>1000643</td><td>08-05-2023</td><td>MARSIYEM</td><td></td><td></
td><td>'</td><td>01-07-1960</td><td>KASIRAN RT
04/09</td><td></td><td>KOPENG</td><td>PUSKESMAS INDUK</td><td>dr.Arninta Rahma
Khoirunnisa</td><td>Suwoto,A.Md.Kep</td><td>P</td><td>60-69
Thn.</td><td>Keluarga</td><td>Lama</td><td>BPJS PBI</td><td>Rajal</td><td
align='right'>7</td><td align='right'>10</td><td align='right'>62</td><td>BP.
Umum</td><td></td><td></td><td>Dalam
Wilayah</td><td>'0001027415182</td><td>'3322015207600000</td><td>140</td><td>90</
td><td>80</td><td>36</td><td>24</td><td>145</td><td>49</td><td></td><td></
td><td></td></tr><tr><td align='right'>E13</td><td>Other specified diabetes
mellitus</td><td></td><td>lemes</td><td align='right'>2170</td><td
align='right'>03000018</td><td>08-05-2023</td><td>MIATUN</td><td></td><td></
td><td>'</td><td>04-02-1968</td><td>TOLOKAN RT 04 RW
01</td><td>TOLOKAN</td><td>TOLOKAN</td><td>PUSKESMAS INDUK</td><td>dr.Arninta Rahma
Khoirunnisa</td><td>Suwoto,A.Md.Kep</td><td>P</td><td>55-59
Thn.</td><td>Keluarga</td><td>Lama</td><td>BPJS PBI</td><td>Rajal</td><td
align='right'>4</td><td align='right'>3</td><td align='right'>55</td><td>BP.
Umum</td><td></td><td></td><td>Dalam
Wilayah</td><td>'0003142247681</td><td>'3322014402680002</td><td>110</td><td>70</
td><td>80</td><td>36</td><td>24</td><td>150</td><td>50</td><td></td><td>hidari
minum manis
kurangi karbohidrat</td><td>hidari minum manis
kurangi karbohidrat</td></tr><tr><td align='right'>K00.6</td><td>Disturbances in
tooth eruption</td><td></td><td>pasien datang mau cabut gigi </td><td
align='right'>2215</td><td align='right'>1004495</td><td>08-05-2023</td><td>MIKE
HANI </td><td></td><td></td><td>'</td><td>05-06-2016</td><td>NGELO RT 03 RW
02</td><td>NGELO</td><td>GETASAN</td><td>PUSKESMAS INDUK</td><td>drg.Ade
Indranila</td><td> - </td><td>P</td><td>5-9
Thn.</td><td>Keluarga</td><td>Baru</td><td>Umum</td><td>Rajal</td><td
align='right'>3</td><td align='right'>11</td><td align='right'>6</td><td>BP.
Gigi</td><td></td><td></td><td>Dalam
Wilayah</td><td>'</td><td>'</td><td>100</td><td>70</td><td>87</td><td>36</
td><td>24</td><td>135</td><td>38</td><td></td><td></td><td>exo dengan CE
</td></tr><tr><td align='right'>J11.0</td><td>Influenza with pneumonia, virus not
identified</td><td></td><td>PANAS, BATUK, PILEK</td><td align='right'>2210</td><td
align='right'>1024342</td><td>08-05-2023</td><td>MUHAMMAD FAIQ
AL-AZZAM</td><td></td><td></td><td>'</td><td>02-03-2022</td><td>KARANGBAWANG RT 12
RW 02</td><td></td><td>NOGOSAREN</td><td>PUSKESMAS INDUK</td><td>dr.Arninta Rahma
Khoirunnisa</td><td>Sri Hartini,S.S.T.Keb</td><td>L</td><td>1-4
Thn.</td><td>Keluarga</td><td>Lama</td><td>Umum</td><td>Rajal</td><td
align='right'>6</td><td align='right'>2</td><td
align='right'>1</td><td>MTBS</td><td></td><td></td><td>Dalam
Wilayah</td><td>'</td><td>'</td><td></td><td></td><td>120</td><td>37</td><td>43</
td><td>80</td><td>10</td><td></td><td>PENKES CARA PEMBERIAN OBAT DI RUMAH, PENKES
TTG CARA PEMBERIAN MAKAN/ MINUM DI RUMAH</td><td>MEMBERIKAN PENKES CARA PEMBERIAN
OBAT DI RUMAH , MEMBERIKAN PENKES CARA PEMBERIAN MAKAN/ MINUM DI
RUMAH</td></tr><tr><td align='right'>J06.9</td><td>Acute upper respiratory
infection, unspecified</td><td></td><td>batuk sesek</td><td
align='right'>2168</td><td
align='right'>99000047</td><td>08-05-2023</td><td>MUHAMMAD GILANG
PRATAMA</td><td></td><td>PELAJAR/MAHASISWA</td><td>'082390913766</td><td>18-01-
1999</td><td> JL INTAN III NO 131</td><td></td><td>Luar kabupaten</td><td>PUSKESMAS
INDUK</td><td>dr.Arninta Rahma
Khoirunnisa</td><td>Suwoto,A.Md.Kep</td><td>L</td><td>20-44
Thn.</td><td>Keluarga</td><td>Baru</td><td>Umum</td><td>Rajal</td><td
align='right'>21</td><td align='right'>3</td><td align='right'>24</td><td>BP.
Umum</td><td></td><td></td><td>Luar
Wilayah</td><td>'0000004932562</td><td>'1371021801990001</td><td>130</td><td>80</
td><td>80</td><td>36</td><td>24</td><td>150</td><td>49</td><td></td><td>hidari
mkn/gorengan
m/m teratur</td><td>hidari mkn gorengan
m/m teratur</td></tr><tr><td align='right'>J06.9</td><td>Acute upper respiratory
infection, unspecified</td><td></td><td>panas, batuk, pilek</td><td
align='right'>2211</td><td
align='right'>04000012</td><td>08-05-2023</td><td>MUHAMMAD ROSYID
HUSAENY</td><td>LUWIH</td><td></td><td>'</td><td>20-07-2018</td><td>PLOSO RT 16 RW
2 </td><td></td><td>NGRAWAN</td><td>PUSKESMAS INDUK</td><td>dr.Arninta Rahma
Khoirunnisa</td><td>Sri Hartini,S.S.T.Keb</td><td>L</td><td>1-4
Thn.</td><td>Keluarga</td><td>Baru</td><td>Umum</td><td>Rajal</td><td
align='right'>19</td><td align='right'>9</td><td
align='right'>4</td><td>MTBS</td><td></td><td></td><td>Dalam
Wilayah</td><td>'</td><td>'3308162007180001</td><td></td><td></td><td>128</
td><td>36</td><td>39</td><td>95</td><td>14</td><td></td><td>penkes cara minum oobat
di rumah</td><td>memberikan penkes cara minum oobat di rumah</td></tr><tr><td
align='right'>J06.9</td><td>Acute upper respiratory infection,
unspecified</td><td></td><td>PANAS, BATUK, PILEK</td><td align='right'>2206</td><td
align='right'>03000028</td><td>08-05-2023</td><td>MUHAMMAD ZIDANE
ALFAREZI</td><td>SONY AJI
PRASETYO</td><td></td><td>'</td><td>28-04-2022</td><td>KEBONAN RT 6 RW 1
</td><td></td><td>TOLOKAN</td><td>PUSKESMAS INDUK</td><td>dr.Arninta Rahma
Khoirunnisa</td><td>Sri Hartini,S.S.T.Keb</td><td>L</td><td>1-4
Thn.</td><td>Keluarga</td><td>Baru</td><td>Umum</td><td>Rajal</td><td
align='right'>10</td><td align='right'>0</td><td
align='right'>1</td><td>MTBS</td><td></td><td></td><td>Dalam
Wilayah</td><td>'</td><td>'3322012804220001</td><td></td><td></td><td>130</
td><td>36</td><td>37</td><td>75</td><td>13</td><td></td><td>PENKES CARA MINUM OBAT
DI RUMAH, PENKES CARA PEMBERIAN MAKAN/ MINUM DI RUMAH</td><td>MEMBERIKAN PENKES
CARA PEMBERIAN OBAT DI RUMAH, MEMBERIKAN PENKES CARA PEMBERIAN MAKAN/ MINUM DI
RUMAH</td></tr><tr><td align='right'>M79.0</td><td>Rheumatism,
unspecified</td><td></td><td>tangan nyeri</td><td align='right'>2214</td><td
align='right'>1017192</td><td>08-05-2023</td><td>MUHDIYONO</td><td></td><td></
td><td>'</td><td>16-03-1968</td><td>JURUG RT 7 RW
</td><td></td><td>WATES</td><td>PUSKESMAS INDUK</td><td>dr.Arninta Rahma
Khoirunnisa</td><td>Suwoto,A.Md.Kep</td><td>L</td><td>55-59
Thn.</td><td>Keluarga</td><td>Lama</td><td>Umum</td><td>Rajal</td><td
align='right'>22</td><td align='right'>1</td><td align='right'>55</td><td>BP.
Umum</td><td></td><td></td><td>Dalam
Wilayah</td><td>'</td><td>'3322011603680000</td><td>130</td><td>80</td><td>80</
td><td>36</td><td>24</td><td>150</td><td>50</td><td></td><td>kurangi angkat berat
minum air putih </td><td>kurangi angkat berat
minum air putih </td></tr><tr><td align='right'>J06.9</td><td>Acute upper
respiratory infection, unspecified</td><td></td><td>batuk</td><td
align='right'>2184</td><td
align='right'>02000030</td><td>08-05-2023</td><td>MUNARIYAH</td><td></td><td></
td><td>'085325345513</td><td>05-07-1981</td><td>JURUG RT 7 RW 1
</td><td></td><td>WATES</td><td>PUSKESMAS INDUK</td><td>dr.Arninta Rahma
Khoirunnisa</td><td>Suwoto,A.Md.Kep</td><td>P</td><td>20-44
Thn.</td><td>Keluarga</td><td>Baru</td><td>Umum</td><td>Rajal</td><td
align='right'>3</td><td align='right'>10</td><td align='right'>41</td><td>BP.
Umum</td><td></td><td></td><td>Dalam
Wilayah</td><td>'</td><td>'</td><td>130</td><td>80</td><td>80</td><td>36</
td><td>24</td><td>150</td><td>53</td><td></td><td></td><td></td></tr><tr><td
align='right'>J06.9</td><td>Acute upper respiratory infection,
unspecified</td><td></td><td>PANAS, BATUK, PILEK</td><td align='right'>2155</td><td
align='right'>1025645</td><td>08-05-2023</td><td>NAUREEN AZQILA
FAYOLA</td><td></td><td></td><td>'</td><td>13-01-2023</td><td>SRANTI RT 09 RW
02</td><td>SRANTI</td><td>WATES</td><td>PUSKESMAS INDUK</td><td>dr.Arninta Rahma
Khoirunnisa</td><td>Sri Hartini,S.S.T.Keb</td><td>P</td><td><1
Thn.</td><td>Keluarga</td><td>Lama</td><td>Umum</td><td>Rajal</td><td
align='right'></td><td align='right'>3</td><td
align='right'></td><td>MTBS</td><td></td><td></td><td>Dalam
Wilayah</td><td>'</td><td>'</td><td></td><td></td><td>138</td><td>37</td><td>38</
td><td>50</td><td>6</td><td></td><td>PENKES TTG CARA PEMBERIAN OBAT DI
RUMAH</td><td>MEMBERIKAN PENKES TTG CARA PEMBERIAN OBAT DI RUMAH</td></tr><tr><td
align='right'>M79.0</td><td>Rheumatism, unspecified</td><td></td><td>tangan
sakit</td><td align='right'>2209</td><td align='right'>01000047</td><td>08-05-
2023</td><td>QURAINIS WAHYU
NILASARI</td><td></td><td>PELAJAR/MAHASISWA</td><td>'088216191436</td><td>22-08-
2002</td><td>KENTENG RT 3 RW 5</td><td></td><td>GETASAN</td><td>PUSKESMAS
INDUK</td><td>dr.Arninta Rahma
Khoirunnisa</td><td>Suwoto,A.Md.Kep</td><td>P</td><td>20-44
Thn.</td><td>Keluarga</td><td>Baru</td><td>BPJS NON PBI</td><td>Rajal</td><td
align='right'>17</td><td align='right'>8</td><td align='right'>20</td><td>BP.
Umum</td><td></td><td></td><td>Dalam
Wilayah</td><td>'0002776857489</td><td>'3322016208020001</td><td>120</td><td>80</
td><td>80</td><td>36</td><td>24</td><td>168</td><td>70</td><td></td><td></
td><td></td></tr><tr><td align='right'>J03</td><td>Acute
tonsillitis</td><td></td><td>AMANDEL</td><td align='right'>2151</td><td
align='right'>1024633</td><td>08-05-2023</td><td>RAIHANDIKAS YUDA
PRATAMA</td><td></td><td></td><td>'</td><td>19-09-2009</td><td>WATES RT
3/1</td><td></td><td>WATES</td><td>PUSKESMAS INDUK</td><td>dr.Arninta Rahma
Khoirunnisa</td><td>Suwoto,A.Md.Kep</td><td>L</td><td>10-14
Thn.</td><td>Keluarga</td><td>Lama</td><td>BPJS NON PBI</td><td>Rajal</td><td
align='right'>19</td><td align='right'>7</td><td align='right'>13</td><td>BP.
Umum</td><td></td><td></td><td>Dalam
Wilayah</td><td>'0001447733103</td><td>'3373031909090000</td><td>100</td><td>70</
td><td>84</td><td>37</td><td>24</td><td>160</td><td>50</td><td></td><td>KURANGI
MINUM MANIS SM ES</td><td>KURANGI MINUM MANIS SM ES</td></tr><tr><td
align='right'>J06.9</td><td>Acute upper respiratory infection,
unspecified</td><td></td><td>batuk</td><td align='right'>2160</td><td
align='right'>1023988</td><td>08-05-2023</td><td>RENJI AZKA
WARADANA</td><td></td><td></td><td>'</td><td>20-12-2017</td><td>DANGKLIK RT 09 RW
01</td><td></td><td>TOLOKAN</td><td>PUSKESMAS INDUK</td><td>dr.Arninta Rahma
Khoirunnisa</td><td>Suwoto,A.Md.Kep</td><td>L</td><td>5-9
Thn.</td><td>Keluarga</td><td>Lama</td><td>Umum</td><td>Rajal</td><td
align='right'>18</td><td align='right'>4</td><td align='right'>5</td><td>BP.
Umum</td><td></td><td></td><td>Dalam
Wilayah</td><td>'0003133204198</td><td>'3322012012170000</td><td>90</td><td>60</
td><td>88</td><td>37</td><td>32</td><td>121</td><td>17</td><td></td><td>hidari mkn
ciki
m/m teratur</td><td>hidari mkn ciki
m/m teratur</td></tr><tr><td align='right'>J06.9</td><td>Acute upper respiratory
infection, unspecified</td><td></td><td>panas, batuk, pilek</td><td
align='right'>2161</td><td align='right'>1023987</td><td>08-05-2023</td><td>RHEE
RAZKA SHAQUILLE
NARESWARA</td><td></td><td></td><td>'</td><td>04-02-2022</td><td>DANGKLIK RT 09 RW
01</td><td>DANGKLIK</td><td>TOLOKAN</td><td>PUSKESMAS INDUK</td><td>dr.Arninta
Rahma Khoirunnisa</td><td>Sri Hartini,S.S.T.Keb</td><td>L</td><td>1-4
Thn.</td><td>Keluarga</td><td>Lama</td><td>Umum</td><td>Rajal</td><td
align='right'>4</td><td align='right'>3</td><td
align='right'>1</td><td>MTBS</td><td></td><td></td><td>Dalam
Wilayah</td><td>'</td><td>'3373040402220001</td><td></td><td></td><td>130</
td><td>38</td><td>38</td><td>74</td><td>10</td><td></td><td>penkes cara meminum
obatn di rumah</td><td>memberikan penkes cara meminum obat di
rumah</td></tr><tr><td align='right'>K00.6</td><td>Disturbances in tooth
eruption</td><td></td><td>pasien mau cabut gigi atas sudah goyang </td><td
align='right'>2213</td><td align='right'>1005633</td><td>08-05-2023</td><td>RIFKY
FATURROHMAN SYAHID</td><td></td><td></td><td>'</td><td>27-04-2015</td><td>GETASAN
RT 1/1</td><td></td><td>GETASAN</td><td>PUSKESMAS INDUK</td><td>drg.Ade
Indranila</td><td> - </td><td>L</td><td>5-9
Thn.</td><td>Keluarga</td><td>Lama</td><td>Umum</td><td>Rajal</td><td
align='right'>11</td><td align='right'></td><td align='right'>8</td><td>BP.
Gigi</td><td></td><td></td><td>Dalam
Wilayah</td><td>'</td><td>'</td><td>100</td><td>60</td><td>80</td><td>36</
td><td>20</td><td>123</td><td>18</td><td></td><td>pro exo </td><td>gigi 7.3
persistensi </td></tr><tr><td align='right'>J06.9</td><td>Acute upper respiratory
infection, unspecified</td><td></td><td>batuk</td><td align='right'>2194</td><td
align='right'>1007881</td><td>08-05-2023</td><td>RINTO MASTHURIN
ACHMAD</td><td></td><td></td><td>'</td><td>07-09-1974</td><td>TOLOKAN RT
1/1</td><td></td><td>TOLOKAN</td><td>PUSKESMAS INDUK</td><td>dr.Arninta Rahma
Khoirunnisa</td><td>Suwoto,A.Md.Kep</td><td>L</td><td>45-54
Thn.</td><td>Keluarga</td><td>Lama</td><td>BPJS NON PBI</td><td>Rajal</td><td
align='right'>1</td><td align='right'>8</td><td align='right'>48</td><td>BP.
Umum</td><td></td><td></td><td>Dalam
Wilayah</td><td>'0003100774296</td><td>'3322010709740000</td><td>110</td><td>80</
td><td>80</td><td>37</td><td>24</td><td>160</td><td>66</td><td></td><td></
td><td></td></tr><tr><td align='right'>J06.9</td><td>Acute upper respiratory
infection, unspecified</td><td></td><td>batuk</td><td align='right'>2162</td><td
align='right'>1014330</td><td>08-05-2023</td><td>ROHMIYATUN</td><td></td><td></
td><td>'</td><td>22-08-1983</td><td>MULUNGAN RT 10 RW
02</td><td></td><td>NOGOSAREN</td><td>PUSKESMAS INDUK</td><td>dr.Arninta Rahma
Khoirunnisa</td><td>Suwoto,A.Md.Kep</td><td>P</td><td>20-44
Thn.</td><td>Keluarga</td><td>Lama</td><td>Umum</td><td>Rajal</td><td
align='right'>16</td><td align='right'>8</td><td align='right'>39</td><td>BP.
Umum</td><td></td><td></td><td>Dalam
Wilayah</td><td>'0001693551352</td><td>'3322016208830000</td><td>130</td><td>90</
td><td>80</td><td>36</td><td>24</td><td>150</td><td>56</td><td></td><td>hidari mkn
ciki
m/m teratur</td><td>hidari mkn ciki
m/m teratur</td></tr><tr><td align='right'>K08.3</td><td>Retained dental
root</td><td></td><td>pasien datang mau kontrol gigi </td><td
align='right'>2178</td><td
align='right'>1015378</td><td>08-05-2023</td><td>RUBINI</td><td>RUBINI</td><td></
td><td>'082135541733</td><td>01-01-1963</td><td>NOGOSAREN RT 07 RW
01</td><td>NOGOSAREN</td><td>NOGOSAREN</td><td>PUSKESMAS INDUK</td><td>drg.Ade
Indranila</td><td> - </td><td>L</td><td>60-69
Thn.</td><td>Keluarga</td><td>Lama</td><td>BPJS PBI</td><td>Rajal</td><td
align='right'>7</td><td align='right'>4</td><td align='right'>60</td><td>BP.
Gigi</td><td></td><td></td><td>Dalam
Wilayah</td><td>'0002443667949</td><td>'3322010101630005</td><td>109</td><td>67</
td><td>67</td><td>36</td><td>21</td><td>165</td><td>54</td><td>Tdk Th</td><td>pro
exo </td><td>medikasi </td></tr><tr><td align='right'>S01.0</td><td>Open wound of
scalp</td><td></td><td>medikasi</td><td align='right'>2175</td><td
align='right'>1004243</td><td>08-05-2023</td><td>SARYANTO</td><td></td><td></
td><td>'</td><td>27-07-1989</td><td>PADAN RT.13
RW.2</td><td></td><td>NGRAWAN</td><td>PUSKESMAS INDUK</td><td>dr.Arninta Rahma
Khoirunnisa</td><td>Suwoto,A.Md.Kep</td><td>L</td><td>20-44
Thn.</td><td>Keluarga</td><td>Lama</td><td>BPJS NON PBI</td><td>Rajal</td><td
align='right'>11</td><td align='right'>9</td><td align='right'>33</td><td>BP.
Umum</td><td></td><td></td><td>Dalam
Wilayah</td><td>'0002041874122</td><td>'3322012707890001</td><td>100</td><td>70</
td><td>80</td><td>36</td><td>24</td><td>150</td><td>49</td><td></td><td></
td><td></td></tr><tr><td align='right'>J44.9</td><td>Chronic obstructive pulmonary
disease, unspecified</td><td></td><td>kontrol</td><td align='right'>2217</td><td
align='right'>1010695</td><td>08-05-2023</td><td>SHOLEKAH</td><td></td><td></
td><td>'</td><td>24-06-1970</td><td>GETASAN RT 03 RW
01</td><td></td><td>GETASAN</td><td>PUSKESMAS INDUK</td><td>dr.Arninta Rahma
Khoirunnisa</td><td>Suwoto,A.Md.Kep</td><td>P</td><td>45-54
Thn.</td><td>Keluarga</td><td>Lama</td><td>BPJS NON PBI</td><td>Rujuk</td><td
align='right'>14</td><td align='right'>10</td><td align='right'>52</td><td>BP.
Umum</td><td>PARU</td><td>RS PURI ASIH SALATIGA</td><td>Dalam
Wilayah</td><td>'0002454331656</td><td>'3322016406700000</td><td>120</td><td>80</
td><td>80</td><td>36</td><td>24</td><td>148</td><td>45</td><td></td><td></
td><td></td></tr><tr><td align='right'>J06.9</td><td>Acute upper respiratory
infection, unspecified</td><td></td><td>batuk</td><td align='right'>2193</td><td
align='right'>1002895</td><td>08-05-2023</td><td>SITI
MACHFUDHOH</td><td></td><td></td><td>'</td><td>23-03-1986</td><td>TOLOKAN RT 01 RW
01</td><td></td><td>TOLOKAN</td><td>PUSKESMAS INDUK</td><td>dr.Arninta Rahma
Khoirunnisa</td><td>Suwoto,A.Md.Kep</td><td>P</td><td>20-44
Thn.</td><td>Keluarga</td><td>Lama</td><td>Umum</td><td>Rajal</td><td
align='right'>15</td><td align='right'>1</td><td align='right'>37</td><td>BP.
Umum</td><td></td><td></td><td>Dalam
Wilayah</td><td>'</td><td>'3322016303860000</td><td>110</td><td>70</td><td>80</
td><td>36</td><td>24</td><td>156</td><td>74</td><td></td><td></td><td></td></
tr><tr><td align='right'>G43</td><td>Migraine</td><td></td><td>pusing</td><td
align='right'>2207</td><td align='right'>1000311</td><td>08-05-2023</td><td>SLAMET
RAHARJO</td><td></td><td></td><td>'</td><td>09-01-1959</td><td>DIWAK RT.1 RW.8
BATUR</td><td>DIWAK</td><td>BATUR</td><td>PUSKESMAS INDUK</td><td>dr.Arninta Rahma
Khoirunnisa</td><td>Suwoto,A.Md.Kep</td><td>L</td><td>60-69
Thn.</td><td>Keluarga</td><td>Lama</td><td>BPJS NON PBI</td><td>Rajal</td><td
align='right'>29</td><td align='right'>3</td><td align='right'>64</td><td>BP.
Umum</td><td></td><td></td><td>Dalam
Wilayah</td><td>'0002073838138</td><td>'3322010901690001</td><td>130</td><td>90</
td><td>80</td><td>36</td><td>24</td><td>158</td><td>62</td><td></td><td></
td><td></td></tr><tr><td align='right'>H25.0</td><td>Senile incipient
cataract</td><td></td><td>rujukan</td><td align='right'>2165</td><td
align='right'>1000297</td><td>08-05-2023</td><td>SOEHIRMAN</td><td></td><td></
td><td>'</td><td>20-05-1953</td><td>GETASAN RT
06/01</td><td></td><td>GETASAN</td><td>PUSKESMAS INDUK</td><td>dr.Arninta Rahma
Khoirunnisa</td><td>Suwoto,A.Md.Kep</td><td>L</td><td>60-69
Thn.</td><td>Keluarga</td><td>Lama</td><td>BPJS NON PBI</td><td>Rujuk</td><td
align='right'>18</td><td align='right'>11</td><td align='right'>69</td><td>BP.
Umum</td><td>Mata</td><td>RS PURI ASIH SALATIGA</td><td>Dalam
Wilayah</td><td>'0000088294353</td><td>'3322012005530001</td><td>140</td><td>90</
td><td>80</td><td>37</td><td>24</td><td>162</td><td>56</td><td></td><td></
td><td></td></tr><tr><td align='right'>J06.9</td><td>Acute upper respiratory
infection, unspecified</td><td></td><td>batuk pilek</td><td
align='right'>2203</td><td align='right'>1022763</td><td>08-05-2023</td><td>SRI
WARSINEM</td><td></td><td></td><td>'</td><td>16-06-1994</td><td>BANARAN RT 04 RW
02</td><td></td><td>GETASAN</td><td>PUSKESMAS INDUK</td><td>dr.Arninta Rahma
Khoirunnisa</td><td>Suwoto,A.Md.Kep</td><td>P</td><td>20-44
Thn.</td><td>Keluarga</td><td>Lama</td><td>Umum</td><td>Rajal</td><td
align='right'>22</td><td align='right'>10</td><td align='right'>28</td><td>BP.
Umum</td><td></td><td></td><td>Dalam
Wilayah</td><td>'0001534693059</td><td>'3322015606940000</td><td>130</td><td>90</
td><td>80</td><td>36</td><td>24</td><td>150</td><td>50</td><td></td><td>m/n teratur
kurangi gorengan
minum air putih </td><td>m/n teratur kurangi gorengan
minum air putih </td></tr><tr><td align='right'>L23</td><td>Allergic contact
dermatitis</td><td></td><td>gatal</td><td align='right'>2202</td><td
align='right'>1002804</td><td>08-05-2023</td><td>SRIYANI</td><td></td><td></
td><td>'</td><td>11-06-1997</td><td>KASIRAN RT 04 RW
09</td><td></td><td>KOPENG</td><td>PUSKESMAS INDUK</td><td>dr.Arninta Rahma
Khoirunnisa</td><td>Suwoto,A.Md.Kep</td><td>P</td><td>20-44
Thn.</td><td>Keluarga</td><td>Lama</td><td>BPJS PBI</td><td>Rajal</td><td
align='right'>27</td><td align='right'>10</td><td align='right'>25</td><td>BP.
Umum</td><td></td><td></td><td>Dalam
Wilayah</td><td>'0001027415204</td><td>'3322015106970000</td><td>90</td><td>60</
td><td>80</td><td>36</td><td>24</td><td>150</td><td>51</td><td></td><td></
td><td></td></tr><tr><td align='right'>M54.16</td><td>Radiculopathy, lumbar
region</td><td></td><td>rujuk</td><td align='right'>2176</td><td
align='right'>1005973</td><td>08-05-2023</td><td>SUMINDARYATI</td><td></td><td></
td><td>'</td><td>15-10-1965</td><td>SLEKER RT.6
RW.3</td><td></td><td>KOPENG</td><td>PUSKESMAS INDUK</td><td>dr.Arninta Rahma
Khoirunnisa</td><td>Suwoto,A.Md.Kep</td><td>P</td><td>55-59
Thn.</td><td>Keluarga</td><td>Lama</td><td>BPJS NON PBI</td><td>Rujuk</td><td
align='right'>23</td><td align='right'>6</td><td align='right'>57</td><td>BP.
Umum</td><td>Saraf</td><td>RS PURI ASIH SALATIGA</td><td>Dalam
Wilayah</td><td>'0000074940928</td><td>'3322015510650000</td><td>105</td><td>70</
td><td>80</td><td>36</td><td>24</td><td>145</td><td>55</td><td></td><td></
td><td></td></tr><tr><td align='right'>D50</td><td>Iron deficiency
anaemia</td><td></td><td>kontrol rujuk
lemes</td><td align='right'>2191</td><td align='right'>07000059</td><td>08-05-
2023</td><td>SUMITRO GIMIN</td><td>SUMITRO GIMIN</td><td></td><td>'</td><td>05-09-
1945</td><td>TAYEMAN RT 2 RW 7</td><td></td><td>KOPENG</td><td>PUSKESMAS
INDUK</td><td>dr.Arninta Rahma
Khoirunnisa</td><td>Suwoto,A.Md.Kep</td><td>L</td><td>>70
Thn.</td><td>Keluarga</td><td>Baru</td><td>BPJS PBI</td><td>Rujuk</td><td
align='right'>3</td><td align='right'>8</td><td align='right'>77</td><td>BP.
Umum</td><td>Penyakit Dalam </td><td>RS DR.ASMIR SALATIGA</td><td>Dalam
Wilayah</td><td>'0002775524411</td><td>'3322010509450001</td><td>150</td><td>90</
td><td>80</td><td>36</td><td>24</td><td>150</td><td>40</td><td></td><td></
td><td></td></tr><tr><td align='right'>I10</td><td>Essential (primary)
hypertension</td><td></td><td>cengel kaku pusing</td><td align='right'>2166</td><td
align='right'>01000044</td><td>08-05-2023</td><td>SURANI</td><td></td><td></
td><td>'</td><td>30-12-1960</td><td>DIWAK RT 2 RW 8
</td><td></td><td>GETASAN</td><td>PUSKESMAS INDUK</td><td>dr.Arninta Rahma
Khoirunnisa</td><td>Suwoto,A.Md.Kep</td><td>P</td><td>60-69
Thn.</td><td>Keluarga</td><td>Baru</td><td>BPJS PBI</td><td>Rajal</td><td
align='right'>9</td><td align='right'>4</td><td align='right'>62</td><td>BP.
Umum</td><td></td><td></td><td>Dalam
Wilayah</td><td>'0000602400969</td><td>'3322017012600033</td><td>150</td><td>100</
td><td>80</td><td>37</td><td>24</td><td>149</td><td>45</td><td></td><td>kurangi
asin</td><td>kurangi asin</td></tr><tr><td
align='right'>K05.4</td><td>Periodontosis</td><td></td><td>pasien datang gigi
goyang </td><td align='right'>2150</td><td align='right'>01000043</td><td>08-05-
2023</td><td>SURAT</td><td></td><td></td><td>'</td><td>05-07-1940</td><td>KOPENG RT
1 RW 2 </td><td></td><td>GETASAN</td><td>PUSKESMAS INDUK</td><td>drg.Ade
Indranila</td><td> - </td><td>L</td><td>>70
Thn.</td><td>Keluarga</td><td>Baru</td><td>BPJS PBI</td><td>Rajal</td><td
align='right'>3</td><td align='right'>10</td><td align='right'>82</td><td>BP.
Gigi</td><td></td><td></td><td>Dalam
Wilayah</td><td>'0000601814981</td><td>'3322010507400001</td><td>153</td><td>99</
td><td>80</td><td>36</td><td>24</td><td>155</td><td>54</td><td></td><td></
td><td>medikasi </td></tr><tr><td align='right'>D61.9</td><td>Aplastic anaemia,
unspecified</td><td></td><td>rujuk</td><td align='right'>2174</td><td
align='right'>1013281</td><td>08-05-2023</td><td>SUSIATI</td><td></td><td></
td><td>'</td><td>29-11-1988</td><td>NGELO RT 05 RW
02</td><td></td><td>GETASAN</td><td>PUSKESMAS INDUK</td><td>dr.Arninta Rahma
Khoirunnisa</td><td>Suwoto,A.Md.Kep</td><td>P</td><td>20-44
Thn.</td><td>Keluarga</td><td>Lama</td><td>BPJS PBI</td><td>Rujuk</td><td
align='right'>9</td><td align='right'>5</td><td align='right'>34</td><td>BP.
Umum</td><td>Penyakit Dalam </td><td>RSUD dr. Gunawan Mangunkusumo</td><td>Dalam
Wilayah</td><td>'0001084537247</td><td>'3322016911880000</td><td>100</td><td>70</
td><td>80</td><td>36</td><td>24</td><td>150</td><td>79</td><td></td><td></
td><td></td></tr><tr><td align='right'>J06.9</td><td>Acute upper respiratory
infection, unspecified</td><td></td><td>batuk</td><td align='right'>2171</td><td
align='right'>1015142</td><td>08-05-2023</td><td>SUTINI</td><td></td><td></
td><td>'</td><td>31-12-1938</td><td>NGELO RT 03
</td><td>NGELO</td><td>GETASAN</td><td>PUSKESMAS INDUK</td><td>dr.Arninta Rahma
Khoirunnisa</td><td>Suwoto,A.Md.Kep</td><td>P</td><td>>70
Thn.</td><td>Keluarga</td><td>Lama</td><td>Umum</td><td>Rajal</td><td
align='right'>7</td><td align='right'>4</td><td align='right'>84</td><td>BP.
Umum</td><td></td><td></td><td>Dalam
Wilayah</td><td>'</td><td>'3322014412550003</td><td>100</td><td>70</td><td>80</
td><td>36</td><td>24</td><td>150</td><td>50</td><td></td><td></td><td></td></
tr><tr><td align='right'>G20</td><td>Parkinson's
disease</td><td></td><td>rujukan</td><td align='right'>2169</td><td
align='right'>1018421</td><td>08-05-2023</td><td>SUWARDI</td><td></td><td></
td><td>'</td><td>12-01-1953</td><td>NGRAWAN RT 02 RW
01</td><td></td><td>NGRAWAN</td><td>PUSKESMAS INDUK</td><td>dr.Arninta Rahma
Khoirunnisa</td><td>Suwoto,A.Md.Kep</td><td>L</td><td>>70
Thn.</td><td>Keluarga</td><td>Lama</td><td>BPJS PBI</td><td>Rujuk</td><td
align='right'>26</td><td align='right'>3</td><td align='right'>70</td><td>BP.
Umum</td><td>Saraf</td><td>RSUD dr. Gunawan Mangunkusumo</td><td>Dalam
Wilayah</td><td>'0002754436612</td><td>'3322011201530001</td><td>110</td><td>80</
td><td>84</td><td>36</td><td>24</td><td>150</td><td>50</td><td></td><td></
td><td></td></tr><tr><td align='right'>K02.1</td><td>Caries of
dentine</td><td></td><td>pasien datang dengan keluhan gigi kanan bawah lubang mau
tambal </td><td align='right'>2172</td><td align='right'>1009830</td><td>08-05-
2023</td><td>TUTIK
WINARNI</td><td></td><td></td><td>'</td><td>09-11-1974</td><td>NOTOYUDAN GT 11/1004
RT 76 RW 22</td><td></td><td>GETASAN</td><td>PUSKESMAS INDUK</td><td>drg.Ade
Indranila</td><td> - </td><td>P</td><td>45-54
Thn.</td><td>Keluarga</td><td>Lama</td><td>BPJS NON PBI</td><td>Rajal</td><td
align='right'>29</td><td align='right'>5</td><td align='right'>48</td><td>BP.
Gigi</td><td></td><td></td><td>Dalam
Wilayah</td><td>'0002237170937</td><td>'3404114911740000</td><td>126</td><td>77</
td><td>80</td><td>36</td><td>21</td><td>156</td><td>54</td><td></td><td></
td><td>konservasi ketak molar gigi 4.7</td></tr><tr><td
align='right'>J11.0</td><td>Influenza with pneumonia, virus not
identified</td><td></td><td>panas, batuk, pilek</td><td align='right'>2179</td><td
align='right'>1016914</td><td>08-05-2023</td><td>VANIA MEITA
ANGELINA</td><td>MEILIS YUWONO</td><td></td><td>'</td><td>18-07-2019</td><td>PLOSO
RT 16 RW 02</td><td></td><td>NGRAWAN</td><td>PUSKESMAS INDUK</td><td>dr.Arninta
Rahma Khoirunnisa</td><td> - </td><td>P</td><td>1-4
Thn.</td><td>Keluarga</td><td>Lama</td><td>BPJS NON PBI</td><td>Rajal</td><td
align='right'>20</td><td align='right'>9</td><td
align='right'>3</td><td>MTBS</td><td></td><td></td><td>Dalam
Wilayah</td><td>'0002905310169</td><td>'3322015807190000</td><td></td><td></
td><td>130</td><td>37</td><td>42</td><td>0</td><td>15</td><td></td><td>penkes cara
minum obat</td><td>memberikan penkes cara meminum oobat</td></tr><tr><td
align='right'>I64</td><td>Stroke, not specified as haemorrhage or
infarction</td><td></td><td>rujukan</td><td align='right'>2156</td><td
align='right'>1025541</td><td>08-05-2023</td><td>WAIDI</td><td></td><td></
td><td>'</td><td>16-01-1963</td><td>NGRAWAN RT 02 RW
01</td><td></td><td>NGRAWAN</td><td>PUSKESMAS INDUK</td><td>dr.Arninta Rahma
Khoirunnisa</td><td>Suwoto,A.Md.Kep</td><td>L</td><td>60-69
Thn.</td><td>Keluarga</td><td>Lama</td><td>BPJS PBI</td><td>Rujuk</td><td
align='right'>22</td><td align='right'>3</td><td align='right'>60</td><td>BP.
Umum</td><td>JANTUNG DAN PEMBULUH DARAH</td><td>RS DR.ASMIR SALATIGA</td><td>Dalam
Wilayah</td><td>'0000601337834</td><td>'3322011601630000</td><td>160</td><td>65</
td><td>80</td><td>36</td><td>24</td><td>159</td><td>62</td><td></td><td></
td><td></td></tr><tr><td
align='right'>B86</td><td>Scabies</td><td></td><td></td><td
align='right'>2285</td><td
align='right'>1014610</td><td>09-05-2023</td><td>ABDULLAH SYAFI`I PUTRA
SEBAYANG</td><td></td><td></td><td>'</td><td>09-03-2010</td><td>KEDAYON RT 06 RW
01</td><td></td><td>WATES</td><td>PUSKESMAS INDUK</td><td>dr.Arninta Rahma
Khoirunnisa</td><td>Suwoto,A.Md.Kep</td><td>L</td><td>10-14
Thn.</td><td>Keluarga</td><td>Lama</td><td>Umum</td><td>Rajal</td><td
align='right'></td><td align='right'>2</td><td align='right'>13</td><td>BP.
Umum</td><td></td><td></td><td>Dalam
Wilayah</td><td>'0002761972481</td><td>'3322010903100000</td><td>90</td><td>60</
td><td>84</td><td>36.3</td><td>24</td><td>156</td><td>42</td><td></td><td></
td><td></td></tr><tr><td align='right'>J06.9</td><td>Acute upper respiratory
infection, unspecified</td><td></td><td></td><td align='right'>2307</td><td
align='right'>99000051</td><td>09-05-2023</td><td>ANNISA
SETYANINGRUM</td><td></td><td></td><td>'0895414866118</td><td>15-03-2002</
td><td>PURWOSARI RT 1 RW 2 </td><td></td><td>Luar kabupaten</td><td>PUSKESMAS
INDUK</td><td>dr.Arninta Rahma
Khoirunnisa</td><td>Suwoto,A.Md.Kep</td><td>P</td><td>20-44
Thn.</td><td>Keluarga</td><td>Baru</td><td>BPJS NON PBI</td><td>Rajal</td><td
align='right'>25</td><td align='right'>1</td><td align='right'>21</td><td>BP.
Umum</td><td></td><td></td><td>Luar
Wilayah</td><td>'0001821120039</td><td>'3321045503020006</td><td>108</td><td>70</
td><td>84</td><td>36.2</td><td>24</td><td>145</td><td>40</td><td></td><td></
td><td></td></tr><tr><td
align='right'>I84</td><td>Haemorrhoids</td><td></td><td></td><td
align='right'>2290</td><td
align='right'>1018758</td><td>09-05-2023</td><td>FELISITAS VERENA
ARDHINI</td><td></td><td></td><td>'</td><td>12-04-2004</td><td>JAMPELAN RT 02 RW
02</td><td></td><td>GETASAN</td><td>PUSKESMAS INDUK</td><td>dr.Arninta Rahma
Khoirunnisa</td><td>Suwoto,A.Md.Kep</td><td>P</td><td>15-19
Thn.</td><td>Keluarga</td><td>Lama</td><td>BPJS NON PBI</td><td>Rajal</td><td
align='right'>27</td><td align='right'></td><td align='right'>19</td><td>BP.
Umum</td><td></td><td></td><td>Dalam
Wilayah</td><td>'0003507129854</td><td>'3173065204041005</td><td>103</td><td>78</
td><td>84</td><td>36.2</td><td>24</td><td>150</td><td>54</td><td></td><td></
td><td></td></tr><tr><td
align='right'>K04.0</td><td>Pulpitis</td><td></td><td>pasien datang gigi bawah
kanan nyeri, baru semalam , tidak bisa tidur </td><td align='right'>2299</td><td
align='right'>1003927</td><td>09-05-2023</td><td>INDRI
YANI</td><td></td><td></td><td>'</td><td>27-09-1997</td><td>PLALAR RT 05 RW
04</td><td>PLALAR</td><td>KOPENG</td><td>PUSKESMAS INDUK</td><td>drg.Ade
Indranila</td><td> - </td><td>P</td><td>20-44
Thn.</td><td>Keluarga</td><td>Lama</td><td>BPJS NON PBI</td><td>Rajal</td><td
align='right'>12</td><td align='right'>7</td><td align='right'>25</td><td>BP.
Gigi</td><td></td><td></td><td>Dalam
Wilayah</td><td>'0002167495323</td><td>'3322016709970003</td><td>93</td><td>69</
td><td>89</td><td>36</td><td>21</td><td>153</td><td>54</td><td></td><td>pro
konservasi pasca ,elahirkan </td><td>medikasi </td></tr><tr><td
align='right'>Z09.0</td><td>Follow-up examination after surgery for other
conditions</td><td></td><td></td><td align='right'>2283</td><td
align='right'>1008232</td><td>09-05-2023</td><td>JESIKA MARTA
TILOVA</td><td></td><td></td><td>'</td><td>12-06-2009</td><td>SELONGISOR RT 03 RW
15</td><td>SELONGISOR</td><td>BATUR</td><td>PUSKESMAS INDUK</td><td>dr.Arninta
Rahma Khoirunnisa</td><td>Suwoto,A.Md.Kep</td><td>P</td><td>10-14
Thn.</td><td>Keluarga</td><td>Lama</td><td>BPJS PBI</td><td>Rajal</td><td
align='right'>27</td><td align='right'>10</td><td align='right'>13</td><td>BP.
Umum</td><td></td><td></td><td>Dalam
Wilayah</td><td>'0002132167871</td><td>'3322015206090001</td><td>110</td><td>70</
td><td>84</td><td>36.2</td><td>24</td><td>149</td><td>54</td><td></td><td></
td><td></td></tr><tr><td align='right'>J06.9</td><td>Acute upper respiratory
infection, unspecified</td><td></td><td></td><td align='right'>2275</td><td
align='right'>1003701</td><td>09-05-2023</td><td>KARNI</td><td></td><td></
td><td>'</td><td>05-03-1992</td><td>SENGON RT
2/2</td><td></td><td>MANGGIHAN</td><td>PUSKESMAS INDUK</td><td>dr.Arninta Rahma
Khoirunnisa</td><td>Suwoto,A.Md.Kep</td><td>P</td><td>20-44
Thn.</td><td>Keluarga</td><td>Lama</td><td>BPJS PBI</td><td>Rajal</td><td
align='right'>4</td><td align='right'>2</td><td align='right'>31</td><td>BP.
Umum</td><td></td><td></td><td>Dalam
Wilayah</td><td>'0000602356149</td><td>'3322014503920000</td><td>118</td><td>80</
td><td>88</td><td>36.2</td><td>24</td><td>146</td><td>52</td><td></td><td></
td><td></td></tr><tr><td align='right'>J06.9</td><td>Acute upper respiratory
infection, unspecified</td><td></td><td></td><td align='right'>2261</td><td
align='right'>1023914</td><td>09-05-2023</td><td>KHANZA QONITA
AZZAHRA</td><td></td><td></td><td>'</td><td>09-02-2017</td><td>WATES RT 03 RW
01</td><td>WATES</td><td>WATES</td><td>PUSKESMAS INDUK</td><td>dr.Arninta Rahma
Khoirunnisa</td><td>Suwoto,A.Md.Kep</td><td>P</td><td>5-9
Thn.</td><td>Keluarga</td><td>Lama</td><td>BPJS NON PBI</td><td>Rajal</td><td
align='right'></td><td align='right'>3</td><td align='right'>6</td><td>BP.
Umum</td><td></td><td></td><td>Dalam
Wilayah</td><td>'0003111258598</td><td>'3373034902170000</td><td>100</td><td>60</
td><td>84</td><td>36.3</td><td>24</td><td>115</td><td>16</td><td></td><td></
td><td></td></tr><tr><td align='right'>J06.9</td><td>Acute upper respiratory
infection, unspecified</td><td></td><td>panas, batuk, pilek</td><td
align='right'>2279</td><td align='right'>1024905</td><td>09-05-2023</td><td>LATISHA
ERCILIA TABITHA</td><td>YUSUP
ARIANTO</td><td></td><td>'</td><td>07-10-2022</td><td>SIDOMUKTI RT03 RW
05</td><td></td><td>KOPENG</td><td>PUSKESMAS INDUK</td><td>dr.Arninta Rahma
Khoirunnisa</td><td>Uci Novitawati,A.Md.Keb</td><td>P</td><td><1
Thn.</td><td>Keluarga</td><td>Lama</td><td>BPJS NON PBI</td><td>Rajal</td><td
align='right'></td><td align='right'>7</td><td
align='right'></td><td>MTBS</td><td></td><td></td><td>Dalam
Wilayah</td><td>'0003297394934</td><td>'3322014710220001</td><td></td><td></
td><td>130</td><td>36</td><td>38</td><td>0</td><td>8</td><td></td><td>penkes cara
pemberian obat di rumah, penkes cara pemberian obat di rumah</td><td>memberikkan
penkes cara pemberian obat di rumah, memberikan penkes cara pemberian makan minum
di rumah</td></tr><tr><td align='right'>I10</td><td>Essential (primary)
hypertension</td><td></td><td>PUSING</td><td align='right'>2225</td><td
align='right'>1004968</td><td>09-05-2023</td><td>MARSIDI</td><td>MARSIDI</
td><td></td><td>'</td><td>27-10-1962</td><td>GADING RT 04 RW
03</td><td>GADING</td><td>GETASAN</td><td>PUSKESMAS INDUK</td><td>dr.Arninta Rahma
Khoirunnisa</td><td>Suwoto,A.Md.Kep</td><td>L</td><td>60-69
Thn.</td><td>Keluarga</td><td>Lama</td><td>BPJS PBI</td><td>Rajal</td><td
align='right'>12</td><td align='right'>6</td><td align='right'>60</td><td>BP.
Umum</td><td></td><td></td><td>Dalam
Wilayah</td><td>'0002349077681</td><td>'3322012710620001</td><td>164</td><td>95</
td><td>87</td><td>36.5</td><td>20</td><td>156</td><td>62</td><td></td><td></
td><td></td></tr><tr><td align='right'>L30.9</td><td>Dermatitis,
unspecified</td><td></td><td></td><td align='right'>2241</td><td
align='right'>080000010</td><td>09-05-2023</td><td>MARWA RIZKY
RAMADHON</td><td></td><td>PELAJAR/MAHASISWA</td><td>'</td><td>22-08-2011</
td><td>GAJAYAN RT 8 RW 2 </td><td></td><td>NOGOSAREN</td><td>PUSKESMAS
INDUK</td><td>dr.Arninta Rahma
Khoirunnisa</td><td>Suwoto,A.Md.Kep</td><td>L</td><td>10-14
Thn.</td><td>Keluarga</td><td>Baru</td><td>Umum</td><td>Rajal</td><td
align='right'>18</td><td align='right'>8</td><td align='right'>11</td><td>BP.
Umum</td><td></td><td></td><td>Dalam
Wilayah</td><td>'</td><td>'</td><td>100</td><td>60</td><td>84</td><td>36.3</
td><td>24</td><td>140</td><td>27</td><td></td><td></td><td></td></tr><tr><td
align='right'>K59.0</td><td>Constipation</td><td></td><td></td><td
align='right'>2249</td><td
align='right'>1000583</td><td>09-05-2023</td><td>MARYANI</td><td></td><td></
td><td>'</td><td>20-07-1952</td><td>KRANGKENG RT 03 RW
12</td><td>KRANGKENG</td><td>BATUR</td><td>PUSKESMAS INDUK</td><td>dr.Arninta Rahma
Khoirunnisa</td><td>Suwoto,A.Md.Kep</td><td>P</td><td>>70
Thn.</td><td>Keluarga</td><td>Lama</td><td>BPJS NON PBI</td><td>Rajal</td><td
align='right'>19</td><td align='right'>9</td><td align='right'>70</td><td>BP.
Umum</td><td></td><td></td><td>Dalam
Wilayah</td><td>'0000074940388</td><td>'3322016007520001</td><td>130</td><td>70</
td><td>84</td><td>36.3</td><td>24</td><td>148</td><td>45</td><td></td><td></
td><td></td></tr><tr><td align='right'>I50</td><td>Heart
failure</td><td></td><td></td><td align='right'>2309</td><td
align='right'>06000005</td><td>09-05-2023</td><td>MUAH</td><td></td><td></
td><td>'</td><td>30-11-1948</td><td>SELONGISOR RT 03 RW
15</td><td>SELONGISOR</td><td>BATUR</td><td>PUSKESMAS INDUK</td><td>dr.Arninta
Rahma Khoirunnisa</td><td>Suwoto,A.Md.Kep</td><td>P</td><td>>70
Thn.</td><td>Keluarga</td><td>Lama</td><td>BPJS PBI</td><td>Rajal</td><td
align='right'>9</td><td align='right'>5</td><td align='right'>74</td><td>BP.
Umum</td><td></td><td></td><td>Dalam
Wilayah</td><td>'0001442458146</td><td>'3322017011480001</td><td>136</td><td>80</
td><td>84</td><td>36.3</td><td>24</td><td>145</td><td>40</td><td></td><td></
td><td></td></tr><tr><td align='right'>D21.4</td><td>Other benign neoplasm of
connective and other soft tissue of abdomen</td><td></td><td></td><td
align='right'>2260</td><td
align='right'>1008446</td><td>09-05-2023</td><td>NADHIFATUL
MUKAROMAH</td><td></td><td></td><td>'</td><td>06-05-1995</td><td>SIDODADI RT.3
RW.2</td><td></td><td>Luar kabupaten</td><td>PUSKESMAS INDUK</td><td>dr.Arninta
Rahma Khoirunnisa</td><td>Suwoto,A.Md.Kep</td><td>P</td><td>20-44
Thn.</td><td>Keluarga</td><td>Lama</td><td>BPJS NON PBI</td><td>Rajal</td><td
align='right'>3</td><td align='right'></td><td align='right'>28</td><td>BP.
Umum</td><td></td><td></td><td>Luar
Wilayah</td><td>'0001291451758</td><td>'3324084605950000</td><td>110</td><td>70</
td><td>84</td><td>36.3</td><td>24</td><td>154</td><td>50</td><td></td><td></
td><td></td></tr><tr><td align='right'>J11.0</td><td>Influenza with pneumonia,
virus not identified</td><td></td><td>panas, batuk, pilek</td><td
align='right'>2277</td><td
align='right'>1021539</td><td>09-05-2023</td><td>NAUFALYN AVIONA
RABBANI</td><td></td><td></td><td>'</td><td>24-04-2021</td><td>THEKELAN RT 05 RW
17</td><td></td><td>BATUR</td><td>PUSKESMAS INDUK</td><td>dr.Arninta Rahma
Khoirunnisa</td><td>Uci Novitawati,A.Md.Keb</td><td>P</td><td>1-4
Thn.</td><td>Keluarga</td><td>Lama</td><td>Umum</td><td>Rajal</td><td
align='right'>15</td><td align='right'></td><td
align='right'>2</td><td>MTBS</td><td></td><td></td><td>Dalam
Wilayah</td><td>'</td><td>'</td><td></td><td></td><td>120</td><td>38</td><td>43</
td><td>69</td><td>11</td><td></td><td>penkes cara minum obat di rumah, p-enkes cara
pemberian makan/ minum di rumah</td><td>memberikan penkes cara pemberian obat di
rumah, memberikan penkkes cara pemberian makan/ minum dsi rumah</td></tr><tr><td
align='right'>K08.3</td><td>Retained dental root</td><td></td><td>pasien mau cabut
gigi </td><td align='right'>2268</td><td align='right'>06000049</td><td>09-05-
2023</td><td>NURYANTI</td><td></td><td></td><td>'</td><td>12-07-1976</td><td>BATUR
WETAN RT 3 RW 13 </td><td></td><td>BATUR</td><td>PUSKESMAS INDUK</td><td>drg.Ade
Indranila</td><td> - </td><td>P</td><td>45-54
Thn.</td><td>Keluarga</td><td>Baru</td><td>Umum</td><td>Rajal</td><td
align='right'>28</td><td align='right'>9</td><td align='right'>46</td><td>BP.
Gigi</td><td></td><td></td><td>Dalam
Wilayah</td><td>'</td><td>'3322015207760006</td><td>127</td><td>96</td><td>97</
td><td>36</td><td>20</td><td>154</td><td>56</td><td></td><td>pro exo, medikasi
</td><td>medikasi
</td></tr><tr><td align='right'>M79.1</td><td>Myalgia</td><td></td><td></td><td
align='right'>2234</td><td
align='right'>1007305</td><td>09-05-2023</td><td>PURWANTI</td><td></td><td></
td><td>'</td><td>15-08-1956</td><td>NGRAWAN RT
02/01</td><td></td><td>NGRAWAN</td><td>PUSKESMAS INDUK</td><td>dr.Arninta Rahma
Khoirunnisa</td><td>Suwoto,A.Md.Kep</td><td>P</td><td>60-69
Thn.</td><td>Keluarga</td><td>Lama</td><td>BPJS PBI</td><td>Rajal</td><td
align='right'>24</td><td align='right'>8</td><td align='right'>66</td><td>BP.
Umum</td><td></td><td></td><td>Dalam
Wilayah</td><td>'0000601569235</td><td>'3322014206630000</td><td>120</td><td>80</
td><td>88</td><td>36.3</td><td>24</td><td>149</td><td>54</td><td></td><td></
td><td></td></tr><tr><td align='right'>J06.9</td><td>Acute upper respiratory
infection, unspecified</td><td></td><td></td><td align='right'>2278</td><td
align='right'>1000449</td><td>09-05-2023</td><td>RAFARSYA YAFED
ARIANTO</td><td></td><td></td><td>'</td><td>25-11-2015</td><td>SIDOMUKTI RT
03/05</td><td></td><td>KOPENG</td><td>PUSKESMAS INDUK</td><td>dr.Arninta Rahma
Khoirunnisa</td><td>Suwoto,A.Md.Kep</td><td>L</td><td>5-9
Thn.</td><td>Keluarga</td><td>Lama</td><td>BPJS NON PBI</td><td>Rajal</td><td
align='right'>14</td><td align='right'>5</td><td align='right'>7</td><td>BP.
Umum</td><td></td><td></td><td>Dalam
Wilayah</td><td>'0002297677511</td><td>'3322012511150000</td><td>90</td><td>60</
td><td>84</td><td>36.3</td><td>24</td><td>123</td><td>33</td><td></td><td></
td><td></td></tr><tr><td align='right'>I10</td><td>Essential (primary)
hypertension</td><td></td><td></td><td align='right'>2274</td><td
align='right'>99000003</td><td>09-05-2023</td><td>ROBERTO
SIMANJUNTAK</td><td></td><td></td><td>'</td><td>02-11-1968</td><td>KARET PS BARU
BARAT II RT 09 RW 07 KARET TENGSIN TANAH ABANG</td><td></td><td>Luar
kabupaten</td><td>PUSKESMAS INDUK</td><td>dr.Arninta Rahma
Khoirunnisa</td><td>Suwoto,A.Md.Kep</td><td>L</td><td>45-54
Thn.</td><td>Keluarga</td><td>Lama</td><td>BPJS NON PBI</td><td>Rajal</td><td
align='right'>7</td><td align='right'>6</td><td align='right'>54</td><td>BP.
Umum</td><td></td><td></td><td>Luar
Wilayah</td><td>'0001454487344</td><td>'3171070211680006</td><td>180</td><td>102</
td><td>84</td><td>36.3</td><td>24</td><td>154</td><td>45</td><td></td><td></
td><td></td></tr><tr><td align='right'>I63.9</td><td>Cerebral infarction,
unspecified</td><td></td><td></td><td align='right'>2306</td><td
align='right'>1018546</td><td>09-05-2023</td><td>SABAR</td><td></td><td></
td><td>'</td><td>17-08-1967</td><td>NGROTO RT 07 RW
05</td><td></td><td>GETASAN</td><td>PUSKESMAS INDUK</td><td>dr.Arninta Rahma
Khoirunnisa</td><td>Suwoto,A.Md.Kep</td><td>L</td><td>55-59
Thn.</td><td>Keluarga</td><td>Lama</td><td>BPJS NON PBI</td><td>Rujuk</td><td
align='right'>22</td><td align='right'>8</td><td align='right'>55</td><td>BP.
Umum</td><td></td><td></td><td>Dalam
Wilayah</td><td>'0002214367299</td><td>'3322011708670000</td><td>180</td><td>100</
td><td>84</td><td>36.2</td><td>24</td><td>156</td><td>56</td><td></td><td></
td><td></td></tr><tr><td align='right'>I10</td><td>Essential (primary)
hypertension</td><td></td><td></td><td align='right'>2246</td><td
align='right'>1012546</td><td>09-05-2023</td><td>SAMINI</td><td></td><td></
td><td>'</td><td>16-08-1978</td><td>GEJAYAN RT 8 RW 2
NOGOSAREN</td><td></td><td>NOGOSAREN</td><td>PUSKESMAS INDUK</td><td>dr.Arninta
Rahma Khoirunnisa</td><td>Suwoto,A.Md.Kep</td><td>P</td><td>20-44
Thn.</td><td>Keluarga</td><td>Lama</td><td>BPJS NON PBI</td><td>Rajal</td><td
align='right'>23</td><td align='right'>8</td><td align='right'>44</td><td>BP.
Umum</td><td></td><td></td><td>Dalam
Wilayah</td><td>'0001692818741</td><td>'3322015608780000</td><td>180</td><td>100</
td><td>84</td><td>36.2</td><td>24</td><td>155</td><td>50</td><td></td><td></
td><td></td></tr><tr><td align='right'>M54.5</td><td>Low back
pain</td><td></td><td></td><td align='right'>2246</td><td
align='right'>1012546</td><td>09-05-2023</td><td>SAMINI</td><td></td><td></
td><td>'</td><td>16-08-1978</td><td>GEJAYAN RT 8 RW 2
NOGOSAREN</td><td></td><td>NOGOSAREN</td><td>PUSKESMAS INDUK</td><td>dr.Arninta
Rahma Khoirunnisa</td><td>Suwoto,A.Md.Kep</td><td>P</td><td>20-44
Thn.</td><td>Keluarga</td><td>Lama</td><td>BPJS NON PBI</td><td>Rajal</td><td
align='right'>23</td><td align='right'>8</td><td align='right'>44</td><td>BP.
Umum</td><td></td><td></td><td>Dalam
Wilayah</td><td>'0001692818741</td><td>'3322015608780000</td><td>180</td><td>100</
td><td>84</td><td>36.2</td><td>24</td><td>155</td><td>50</td><td></td><td></
td><td></td></tr><tr><td align='right'>K08.3</td><td>Retained dental
root</td><td></td><td>pasiendatang untuk kontrol </td><td
align='right'>2264</td><td align='right'>07000030</td><td>09-05-2023</td><td>SLAMET
BUDIONO</td><td>SLAMET BUDIONO</td><td></td><td>'0859159908168</td><td>05-12-
1983</td><td>KOPENG RT 01 RW 02</td><td>KOPENG</td><td>KOPENG</td><td>PUSKESMAS
INDUK</td><td>drg.Ade Indranila</td><td> - </td><td>L</td><td>20-44
Thn.</td><td>Keluarga</td><td>Lama</td><td>BPJS PBI</td><td>Rajal</td><td
align='right'>4</td><td align='right'>5</td><td align='right'>39</td><td>BP.
Gigi</td><td></td><td></td><td>Dalam
Wilayah</td><td>'0000600852576</td><td>'3322010512830001</td><td>138</td><td>94</
td><td>77</td><td>36</td><td>24</td><td>156</td><td>55</td><td></td><td></
td><td>exo gigi 2.6 GR lidocaine</td></tr><tr><td align='right'>K05.5</td><td>Other
periodontal diseases</td><td></td><td>pasien datang gusimkanan bawah bengkak
</td><td align='right'>2281</td><td
align='right'>1024903</td><td>09-05-2023</td><td>SLAMET
RIYADI</td><td></td><td></td><td>'</td><td>06-05-1973</td><td>KENTENG RT
02/07</td><td></td><td>Luar Wilayah</td><td>PUSKESMAS INDUK</td><td>drg.Ade
Indranila</td><td> - </td><td>L</td><td>45-54
Thn.</td><td>Keluarga</td><td>Lama</td><td>BPJS NON PBI</td><td>Rajal</td><td
align='right'>3</td><td align='right'></td><td align='right'>50</td><td>BP.
Gigi</td><td></td><td></td><td>Luar
Wilayah</td><td>'0001104503861</td><td>'3373030605730001</td><td>153</td><td>108</
td><td>79</td><td>36</td><td>23</td><td>154</td><td>55</td><td></td><td>pro
konservasi </td><td>open bur , spulling </td></tr><tr><td
align='right'>K08.3</td><td>Retained dental root</td><td></td><td>pasiendTng gigi
sakit </td><td align='right'>2231</td><td align='right'>1022915</td><td>09-05-
2023</td><td>SRI ENI
ASTUTI</td><td></td><td></td><td>'</td><td>31-08-1976</td><td>PERUM GRIYA GAWE
MUKTI RT 04 RW 06</td><td></td><td>GETASAN</td><td>PUSKESMAS INDUK</td><td>drg.Ade
Indranila</td><td> - </td><td>P</td><td>45-54
Thn.</td><td>Keluarga</td><td>Lama</td><td>BPJS NON PBI</td><td>Rajal</td><td
align='right'>8</td><td align='right'>8</td><td align='right'>46</td><td>BP.
Gigi</td><td></td><td></td><td>Dalam
Wilayah</td><td>'0001161075339</td><td>'3322017108760000</td><td>120</td><td>77</
td><td>80</td><td>36</td><td>20</td><td>155</td><td>56</td><td></td><td></
td><td></td></tr><tr><td align='right'>I10</td><td>Essential (primary)
hypertension</td><td></td><td></td><td align='right'>2308</td><td
align='right'>1003737</td><td>09-05-2023</td><td>SRI
PARTININGSIH</td><td></td><td>WIRASWASTA</td><td>'</td><td>24-04-1974</
td><td>SUMOGAWE RT 5/2</td><td></td><td>GETASAN</td><td>PUSKESMAS
INDUK</td><td>dr.Arninta Rahma
Khoirunnisa</td><td>Suwoto,A.Md.Kep</td><td>P</td><td>45-54
Thn.</td><td>Keluarga</td><td>Lama</td><td>BPJS NON PBI</td><td>Rajal</td><td
align='right'>15</td><td align='right'></td><td align='right'>49</td><td>BP.
Umum</td><td></td><td></td><td>Dalam
Wilayah</td><td>'0003508233546</td><td>'3322016404740002</td><td>160</td><td>100</
td><td>84</td><td>37.9</td><td>24</td><td>160</td><td>65</td><td></td><td></
td><td></td></tr><tr><td align='right'>K04.1</td><td>Necrosis of
pulp</td><td></td><td>pasien mau cabut gigi </td><td align='right'>2222</td><td
align='right'>1024994</td><td>09-05-2023</td><td>SRI
SULIYAH</td><td></td><td></td><td>'</td><td>24-05-1971</td><td>SENDEN RT 04 RW
09</td><td>SENDEN</td><td>BATUR</td><td>PUSKESMAS INDUK</td><td>drg.Ade
Indranila</td><td> - </td><td>P</td><td>45-54
Thn.</td><td>Keluarga</td><td>Lama</td><td>Umum</td><td>Rajal</td><td
align='right'>15</td><td align='right'>11</td><td align='right'>51</td><td>BP.
Gigi</td><td></td><td></td><td>Dalam
Wilayah</td><td>'</td><td>'3322016405710001</td><td>147</td><td>92</td><td>77</
td><td>36</td><td>20</td><td>153</td><td>48</td><td></td><td></td><td></td></
tr><tr><td align='right'>K02.1</td><td>Caries of dentine</td><td></td><td>pasien
mau cabut gigi </td><td align='right'>2222</td><td
align='right'>1024994</td><td>09-05-2023</td><td>SRI
SULIYAH</td><td></td><td></td><td>'</td><td>24-05-1971</td><td>SENDEN RT 04 RW
09</td><td>SENDEN</td><td>BATUR</td><td>PUSKESMAS INDUK</td><td>drg.Ade
Indranila</td><td> - </td><td>P</td><td>45-54
Thn.</td><td>Keluarga</td><td>Lama</td><td>Umum</td><td>Rajal</td><td
align='right'>15</td><td align='right'>11</td><td align='right'>51</td><td>BP.
Gigi</td><td></td><td></td><td>Dalam
Wilayah</td><td>'</td><td>'3322016405710001</td><td>147</td><td>92</td><td>77</
td><td>36</td><td>20</td><td>153</td><td>48</td><td></td><td></td><td></td></
tr><tr><td align='right'>I10</td><td>Essential (primary)
hypertension</td><td></td><td></td><td align='right'>2280</td><td
align='right'>1000736</td><td>09-05-2023</td><td>SUHANTI</td><td></td><td></
td><td>'</td><td>21-04-1948</td><td>WATES RT.1
RW.1</td><td></td><td>WATES</td><td>PUSKESMAS INDUK</td><td>dr.Arninta Rahma
Khoirunnisa</td><td>Suwoto,A.Md.Kep</td><td>P</td><td>>70
Thn.</td><td>Keluarga</td><td>Lama</td><td>BPJS NON PBI</td><td>Rajal</td><td
align='right'>18</td><td align='right'></td><td align='right'>75</td><td>BP.
Umum</td><td></td><td></td><td>Dalam
Wilayah</td><td>'0001792815895</td><td>'3322016104480000</td><td>185</td><td>97</
td><td>88</td><td>36.3</td><td>24</td><td>150</td><td>50</td><td></td><td></
td><td></td></tr><tr><td
align='right'>I10</td><td>Essential (primary)
hypertension</td><td></td><td></td><td align='right'>2226</td><td
align='right'>1000301</td><td>09-05-2023</td><td>SULIYEM</td><td></td><td></
td><td>'</td><td>05-10-1954</td><td>KENTENG RT 03 RW 05</td><td></td><td>Luar
Wilayah</td><td>PUSKESMAS INDUK</td><td>dr.Arninta Rahma
Khoirunnisa</td><td>Suwoto,A.Md.Kep</td><td>P</td><td>60-69
Thn.</td><td>Keluarga</td><td>Lama</td><td>BPJS PBI</td><td>Rajal</td><td
align='right'>4</td><td align='right'>7</td><td align='right'>68</td><td>BP.
Umum</td><td></td><td></td><td>Luar
Wilayah</td><td>'0000602117987</td><td>'3322014510540003</td><td>170</td><td>100</
td><td>84</td><td>36.2</td><td>24</td><td>145</td><td>78</td><td></td><td></
td><td></td></tr><tr><td align='right'>M54.16</td><td>Radiculopathy, lumbar
region</td><td></td><td></td><td align='right'>2287</td><td
align='right'>1004205</td><td>09-05-2023</td><td>TUKIN</td><td></td><td></
td><td>'</td><td>02-05-1974</td><td>SUMOGAWE RT.1
RW.2</td><td></td><td>GETASAN</td><td>PUSKESMAS INDUK</td><td>dr.Arninta Rahma
Khoirunnisa</td><td>Suwoto,A.Md.Kep</td><td>P</td><td>45-54
Thn.</td><td>Keluarga</td><td>Lama</td><td>BPJS PBI</td><td>Rujuk</td><td
align='right'>7</td><td align='right'></td><td align='right'>49</td><td>BP.
Umum</td><td>Saraf</td><td>RS PURI ASIH SALATIGA</td><td>Dalam
Wilayah</td><td>'0001531590682</td><td>'3322014205740000</td><td>142</td><td>97</
td><td>84</td><td>36.3</td><td>24</td><td>153</td><td>60</td><td></td><td></
td><td></td></tr><tr><td align='right'>G44</td><td>Other headache
syndromes</td><td></td><td></td><td align='right'>2263</td><td
align='right'>1000573</td><td>09-05-2023</td><td>TUKINI
</td><td></td><td></td><td>'</td><td>07-09-1967</td><td>NGRAWAN RT 05 RW
01</td><td>NGRAWAN</td><td>NGRAWAN</td><td>PUSKESMAS INDUK</td><td>dr.Arninta Rahma
Khoirunnisa</td><td>Suwoto,A.Md.Kep</td><td>P</td><td>55-59
Thn.</td><td>Keluarga</td><td>Lama</td><td>BPJS PBI</td><td>Rujuk</td><td
align='right'>2</td><td align='right'>8</td><td align='right'>55</td><td>BP.
Umum</td><td>Saraf</td><td>RS PURI ASIH SALATIGA</td><td>Dalam
Wilayah</td><td>'0001325184063</td><td>'3322014709670001</td><td>155</td><td>83</
td><td>84</td><td>36.3</td><td>24</td><td>150</td><td>50</td><td></td><td></
td><td></td></tr><tr><td align='right'>K04.1</td><td>Necrosis of
pulp</td><td></td><td>pasien datang sakit gigi </td><td align='right'>2239</td><td
align='right'>1023541</td><td>09-05-2023</td><td>TUTUT
WIDIASMARA</td><td></td><td></td><td>'</td><td>24-12-1999</td><td>DUSUN KALIMANGLI
RT 01 RW 03</td><td></td><td>Luar Wilayah</td><td>PUSKESMAS INDUK</td><td>drg.Ade
Indranila</td><td> - </td><td>P</td><td>20-44
Thn.</td><td>Keluarga</td><td>Lama</td><td>Umum</td><td>Rajal</td><td
align='right'>15</td><td align='right'>4</td><td align='right'>23</td><td>BP.
Gigi</td><td></td><td></td><td>Luar
Wilayah</td><td>'</td><td>'3322066412990000</td><td>120</td><td>79</td><td>77</
td><td>36</td><td>24</td><td>155</td><td>56</td><td></td><td></td><td>medikasi
</td></tr><tr><td align='right'>K08.3</td><td>Retained dental
root</td><td></td><td>pasien datang mau cabut gigi </td><td
align='right'>2266</td><td align='right'>1009331</td><td>09-05-2023</td><td>USWATUN
KHASANAH</td><td></td><td></td><td>'</td><td>07-10-1994</td><td>BATUR WETAN RT 01
RW 13</td><td></td><td>BATUR</td><td>PUSKESMAS INDUK</td><td>drg.Ade
Indranila</td><td> - </td><td>P</td><td>20-44
Thn.</td><td>Keluarga</td><td>Lama</td><td>BPJS NON PBI</td><td>Rajal</td><td
align='right'>2</td><td align='right'>7</td><td align='right'>28</td><td>BP.
Gigi</td><td></td><td></td><td>Dalam
Wilayah</td><td>'0000601924803</td><td>'3322014710940000</td><td>139</td><td>83</
td><td>80</td><td>36</td><td>21</td><td>152</td><td>54</td><td></td><td></
td><td></td></tr><tr><td align='right'>K05</td><td>Gingivitis and periodontal
diseases</td><td></td><td>pasien datang mau cabut gigi </td><td
align='right'>2266</td><td align='right'>1009331</td><td>09-05-2023</td><td>USWATUN
KHASANAH</td><td></td><td></td><td>'</td><td>07-10-1994</td><td>BATUR WETAN RT 01
RW 13</td><td></td><td>BATUR</td><td>PUSKESMAS INDUK</td><td>drg.Ade
Indranila</td><td> - </td><td>P</td><td>20-44
Thn.</td><td>Keluarga</td><td>Lama</td><td>BPJS NON PBI</td><td>Rajal</td><td
align='right'>2</td><td align='right'>7</td><td align='right'>28</td><td>BP.
Gigi</td><td></td><td></td><td>Dalam
Wilayah</td><td>'0000601924803</td><td>'3322014710940000</td><td>139</td><td>83</
td><td>80</td><td>36</td><td>21</td><td>152</td><td>54</td><td></td><td></
td><td></td></tr><tr><td align='right'>K02.1</td><td>Caries of
dentine</td><td></td><td>pasien datang degan keluhan mau tambal gigi </td><td
align='right'>2272</td><td align='right'>1007037</td><td>09-05-2023</td><td>WICHDAH
SRI HARYANTI</td><td></td><td></td><td>'</td><td>23-05-1965</td><td>WATES RT 01 RW
01</td><td>WATES</td><td>WATES</td><td>PUSKESMAS INDUK</td><td>drg.Ade
Indranila</td><td> - </td><td>P</td><td>55-59
Thn.</td><td>Keluarga</td><td>Lama</td><td>BPJS NON PBI</td><td>Rajal</td><td
align='right'>16</td><td align='right'>11</td><td align='right'>57</td><td>BP.
Gigi</td><td></td><td></td><td>Dalam
Wilayah</td><td>'0000074974138</td><td>'3322016305650002</td><td>120</td><td>70</
td><td>80</td><td>36</td><td>21</td><td>156</td><td>56</td><td></td><td></
td><td>konservasi ketak molar gigi
gigi 2.5, 2.6, 2.7 HP</td></tr><tr><td align='right'>J06.9</td><td>Acute upper
respiratory infection, unspecified</td><td></td><td>panas, batuyk, pek</td><td
align='right'>2323</td><td align='right'>1024239</td><td>10-05-2023</td><td>ADZRIL
RAFIF ALFAREZI</td><td></td><td></td><td>'</td><td>23-06-2022</td><td>SIDOMUKTI RT
02 RW 05</td><td>SIDOMUKTI</td><td>KOPENG</td><td>PUSKESMAS
INDUK</td><td>dr.Arninta Rahma Khoirunnisa</td><td>Uci
Novitawati,A.Md.Keb</td><td>L</td><td><1
Thn.</td><td>Keluarga</td><td>Lama</td><td>Umum</td><td>Rajal</td><td
align='right'></td><td align='right'>10</td><td
align='right'></td><td>MTBS</td><td></td><td></td><td>Dalam
Wilayah</td><td>'</td><td>'3322012306220001</td><td></td><td></td><td>100</
td><td>37</td><td>37</td><td>72</td><td>10</td><td></td><td>penkes cara pemberian
makan / minum, penkes cara pemberian obat di rumah</td><td>memberikanpenkes cara
pemberian makan/ minum di rumah, memberikan penkes cara pemberian obat di
rumah</td></tr><tr><td align='right'>J06.9</td><td>Acute upper respiratory
infection, unspecified</td><td></td><td></td><td align='right'>2326</td><td
align='right'>1007214</td><td>10-05-2023</td><td>AGES
RIANDIKA</td><td></td><td></td><td>'</td><td>12-03-2001</td><td>NGELO RT 04 RW
02</td><td></td><td>GETASAN</td><td>PUSKESMAS INDUK</td><td>dr.Gani
Kriswanto</td><td>Supomo,A.Md.Kep</td><td>P</td><td>20-44
Thn.</td><td>Keluarga</td><td>Lama</td><td>BPJS PBI</td><td>Rajal</td><td
align='right'>28</td><td align='right'>1</td><td align='right'>22</td><td>BP.
Umum</td><td></td><td></td><td>Dalam
Wilayah</td><td>'0001202145726</td><td>'3322015203010000</td><td>118</td><td>70</
td><td>80</td><td>36</td><td>23</td><td>155</td><td>53</td><td></td><td></
td><td></td></tr><tr><td align='right'>J06.9</td><td>Acute upper respiratory
infection, unspecified</td><td></td><td>panas, batuk , pilek</td><td
align='right'>2325</td><td align='right'>1024258</td><td>10-05-2023</td><td>AIRA
NABILA TANISHA</td><td></td><td></td><td>'</td><td>03-08-2022</td><td>NGELO RT 04
RW 02</td><td></td><td>GETASAN</td><td>PUSKESMAS INDUK</td><td>dr.Arninta Rahma
Khoirunnisa</td><td>Sri Hartini,S.S.T.Keb</td><td>P</td><td><1
Thn.</td><td>Keluarga</td><td>Lama</td><td>Umum</td><td>Rajal</td><td
align='right'></td><td align='right'>9</td><td
align='right'></td><td>MTBS</td><td></td><td></td><td>Dalam
Wilayah</td><td>'</td><td>'</td><td></td><td></td><td>128</td><td>37</td><td>38</
td><td>69</td><td>7</td><td></td><td>penkes cara pemberian obat di rumah, penkes
cara pemberian makan/ minum di rumah</td><td>memberikan penkes cara pemberian obat
ndi rumah, memberikan penkes car pemberianmkan/ minum di rumah</td></tr><tr><td
align='right'>J06.9</td><td>Acute upper respiratory infection,
unspecified</td><td></td><td></td><td align='right'>2355</td><td
align='right'>1012024</td><td>10-05-2023</td><td>ALFIANDRA TEGAR
AFANDI</td><td>SETYO HANDOYO</td><td></td><td>'</td><td>28-07-2011</td><td>SLEKER
RT 06 RW 03</td><td></td><td>KOPENG</td><td>PUSKESMAS INDUK</td><td>dr.Gani
Kriswanto</td><td>Supomo,A.Md.Kep</td><td>L</td><td>10-14
Thn.</td><td>Keluarga</td><td>Lama</td><td>Umum</td><td>Rajal</td><td
align='right'>12</td><td align='right'>9</td><td align='right'>11</td><td>BP.
Umum</td><td></td><td></td><td>Dalam
Wilayah</td><td>'</td><td>'3322012807110001</td><td>90</td><td>70</td><td>89</
td><td>39.1</td><td>23</td><td>131</td><td>27</td><td></td><td></td><td></td></
tr><tr><td align='right'>J06.9</td><td>Acute upper respiratory infection,
unspecified</td><td></td><td></td><td align='right'>2321</td><td
align='right'>1025012</td><td>10-05-2023</td><td>ALIFIYYAH ZHAFIRAH
RAMADHANI</td><td></td><td></td><td>'</td><td>05-07-2015</td><td>PULIHAN RT 02 RW
01</td><td></td><td>GETASAN</td><td>PUSKESMAS INDUK</td><td>dr.Gani
Kriswanto</td><td>Supomo,A.Md.Kep</td><td>P</td><td>5-9
Thn.</td><td>Keluarga</td><td>Lama</td><td>BPJS NON PBI</td><td>Rajal</td><td
align='right'>5</td><td align='right'>10</td><td align='right'>7</td><td>BP.
Umum</td><td></td><td></td><td>Dalam
Wilayah</td><td>'0001877439519</td><td>'3322014507150000</td><td>100</td><td>60</
td><td>81</td><td>36.5</td><td>23</td><td>130</td><td>23</td><td></td><td></
td><td></td></tr><tr><td align='right'>A01.0</td><td>Typhoid
fever</td><td></td><td>PANAS BATUK PILEK, MUNTAH 2X, BAB CAIR 3X</td><td
align='right'>2317</td><td
align='right'>1004571</td><td>10-05-2023</td><td>ANINDITA KAESA
ZAHRA</td><td></td><td></td><td>'</td><td>13-02-2017</td><td>SIDOMUKTI RT 09 RW
05</td><td></td><td>KOPENG</td><td>PUSKESMAS INDUK</td><td>dr.Gani
Kriswanto</td><td>Supomo,A.Md.Kep</td><td>P</td><td>5-9
Thn.</td><td>Keluarga</td><td>Lama</td><td>Umum</td><td>Rajal</td><td
align='right'>27</td><td align='right'>2</td><td align='right'>6</td><td>BP.
Umum</td><td></td><td></td><td>Dalam
Wilayah</td><td>'</td><td>'3322015302170000</td><td>100</td><td>70</td><td>88</
td><td>38</td><td>24</td><td>105</td><td>15</td><td></td><td>RAWAT
INAP</td><td>IVFD RL
TERAPI ORAL + REHIDRASI</td></tr><tr><td align='right'>R50.9</td><td>Fever,
unspecified</td><td></td><td>PANAS BATUK PILEK, MUNTAH 2X, BAB CAIR 3X</td><td
align='right'>2317</td><td
align='right'>1004571</td><td>10-05-2023</td><td>ANINDITA KAESA
ZAHRA</td><td></td><td></td><td>'</td><td>13-02-2017</td><td>SIDOMUKTI RT 09 RW
05</td><td></td><td>KOPENG</td><td>PUSKESMAS INDUK</td><td>dr.Gani
Kriswanto</td><td>Supomo,A.Md.Kep</td><td>P</td><td>5-9
Thn.</td><td>Keluarga</td><td>Lama</td><td>Umum</td><td>Rajal</td><td
align='right'>27</td><td align='right'>2</td><td align='right'>6</td><td>BP.
Umum</td><td></td><td></td><td>Dalam
Wilayah</td><td>'</td><td>'3322015302170000</td><td>100</td><td>70</td><td>88</
td><td>38</td><td>24</td><td>105</td><td>15</td><td></td><td>RAWAT
INAP</td><td>IVFD RL
TERAPI ORAL + REHIDRASI</td></tr><tr><td align='right'>K00.6</td><td>Disturbances
in tooth eruption</td><td></td><td>pasien datang mau cabut gigi </td><td
align='right'>2344</td><td align='right'>1005608</td><td>10-05-2023</td><td>AYURA
AISAFARA</td><td></td><td></td><td>'</td><td>22-01-2009</td><td>TAYEMAN RT
3/7</td><td></td><td>KOPENG</td><td>PUSKESMAS INDUK</td><td>drg.Ade
Indranila</td><td> - </td><td>P</td><td>10-14
Thn.</td><td>Keluarga</td><td>Lama</td><td>BPJS PBI</td><td>Rajal</td><td
align='right'>18</td><td align='right'>3</td><td align='right'>14</td><td>BP.
Gigi</td><td></td><td></td><td>Dalam
Wilayah</td><td>'0002613454187</td><td>'3322016201090000</td><td>100</td><td>70</
td><td>80</td><td>36</td><td>24</td><td>145</td><td>39</td><td></td><td></
td><td>exo gigi 7.4 denagn CE </td></tr><tr><td
align='right'>J02.0</td><td>Streptococcal pharyngitis</td><td></td><td></td><td
align='right'>2320</td><td align='right'>1010709</td><td>10-05-2023</td><td>CLARA
ANJANI</td><td></td><td></td><td>'</td><td>05-03-2006</td><td>SLEKER RT 08 RW
03</td><td></td><td>KOPENG</td><td>PUSKESMAS INDUK</td><td>dr.Gani
Kriswanto</td><td>Supomo,A.Md.Kep</td><td>P</td><td>15-19
Thn.</td><td>Keluarga</td><td>Lama</td><td>BPJS PBI</td><td>Rajal</td><td
align='right'>5</td><td align='right'>2</td><td align='right'>17</td><td>BP.
Umum</td><td></td><td></td><td>Dalam
Wilayah</td><td>'0001027417239</td><td>'3322014503060000</td><td>112</td><td>77</
td><td>80</td><td>36</td><td>23</td><td>156</td><td>56</td><td></td><td></
td><td></td></tr><tr><td align='right'>H25.9</td><td>Senile cataract,
unspecified</td><td></td><td>KONTROL ULANG</td><td align='right'>2338</td><td
align='right'>1000145</td><td>10-05-2023</td><td>DASNI</td><td></td><td></
td><td>'</td><td>21-12-1950</td><td>DUKUH RT 01 RW
02</td><td></td><td>BATUR</td><td>PUSKESMAS INDUK</td><td>dr.Gani
Kriswanto</td><td>Supomo,A.Md.Kep</td><td>P</td><td>>70
Thn.</td><td>Keluarga</td><td>Lama</td><td>Umum</td><td>Rujuk</td><td
align='right'>19</td><td align='right'>4</td><td align='right'>72</td><td>BP.
Umum</td><td>Poli Mata</td><td>RS DR.ASMIR SALATIGA</td><td>Dalam
Wilayah</td><td>'0001829254645</td><td>'3322016112500000</td><td>181</td><td>106</
td><td>91</td><td>36.6</td><td>22</td><td>138</td><td>59</td><td></td><td></
td><td></td></tr><tr><td align='right'>K00.6</td><td>Disturbances in tooth
eruption</td><td></td><td>pasien datang mau cabut gigi kiri bawah </td><td
align='right'>2342</td><td align='right'>1013131</td><td>10-05-2023</td><td>DEA
ANANDA</td><td></td><td>PELAJAR/MAHASISWA</td><td>'</td><td>06-01-2005</
td><td>SIDOMUKTI RT 06/05</td><td></td><td>KOPENG</td><td>PUSKESMAS
INDUK</td><td>drg.Ade Indranila</td><td> - </td><td>P</td><td>15-19
Thn.</td><td>Keluarga</td><td>Lama</td><td>BPJS NON PBI</td><td>Rajal</td><td
align='right'>4</td><td align='right'>4</td><td align='right'>18</td><td>BP.
Gigi</td><td></td><td></td><td>Dalam
Wilayah</td><td>'0002314297563</td><td>'3322014601050001</td><td>100</td><td>60</
td><td>80</td><td>36</td><td>24</td><td>135</td><td>44</td><td></td><td></
td><td>exo gigi 7.4 sisa akar
exo dengan CE </td></tr><tr><td align='right'>M79.2</td><td>Neuralgia and neuritis,
unspecified</td><td></td><td></td><td align='right'>2350</td><td
align='right'>1010631</td><td>10-05-2023</td><td>FERA HANA
PERMATA</td><td></td><td></td><td>'</td><td>19-09-1996</td><td>SLEKER RT
007/003</td><td></td><td>KOPENG</td><td>PUSKESMAS INDUK</td><td>dr.Gani
Kriswanto</td><td>Supomo,A.Md.Kep</td><td>P</td><td>20-44
Thn.</td><td>Keluarga</td><td>Lama</td><td>BPJS NON PBI</td><td>Rajal</td><td
align='right'>21</td><td align='right'>7</td><td align='right'>26</td><td>BP.
Umum</td><td></td><td></td><td>Dalam
Wilayah</td><td>'0000194854858</td><td>'3322015909960000</td><td>110</td><td>60</
td><td>88</td><td>36</td><td>22</td><td>163</td><td>78</td><td></td><td></
td><td></td></tr><tr><td
align='right'>M79.1</td><td>Myalgia</td><td></td><td>PEGAL, KAKI SAKIT</td><td
align='right'>2340</td><td
align='right'>01000048</td><td>10-05-2023</td><td>HABSORO
SOEBAGIYO</td><td></td><td></td><td>'</td><td>30-12-1977</td><td>GETASAN RT 6 RW
1</td><td></td><td>GETASAN</td><td>PUSKESMAS INDUK</td><td>dr.Gani
Kriswanto</td><td>Supomo,A.Md.Kep</td><td>L</td><td>45-54
Thn.</td><td>Keluarga</td><td>Baru</td><td>BPJS PBI</td><td>Rajal</td><td
align='right'>11</td><td align='right'>4</td><td align='right'>45</td><td>BP.
Umum</td><td></td><td></td><td>Dalam
Wilayah</td><td>'0002349078535</td><td>'3322013012770004</td><td>125</td><td>83</
td><td>85</td><td>36.4</td><td>22</td><td>156</td><td>50</td><td></td><td></
td><td></td></tr><tr><td align='right'>M19.0</td><td>Primary arthrosis of other
joints</td><td></td><td>JATUH</td><td align='right'>2347</td><td
align='right'>01000049</td><td>10-05-2023</td><td>JASMAN</td><td></td><td></
td><td>'</td><td>06-09-1954</td><td>NGROTO RT 8 RW
5</td><td></td><td>GETASAN</td><td>PUSKESMAS INDUK</td><td>dr.Gani
Kriswanto</td><td>Supomo,A.Md.Kep</td><td>L</td><td>60-69
Thn.</td><td>Keluarga</td><td>Baru</td><td>Umum</td><td>Rajal</td><td
align='right'>10</td><td align='right'>4</td><td align='right'>65</td><td>BP.
Umum</td><td></td><td></td><td>Dalam
Wilayah</td><td>'</td><td>'</td><td>160</td><td>100</td><td>88</td><td>36.5</
td><td>22</td><td>158</td><td>51</td><td></td><td></td><td></td></tr><tr><td
align='right'>B00.1</td><td>Herpesviral vesicular
dermatitis</td><td></td><td></td><td align='right'>2319</td><td
align='right'>1000700</td><td>10-05-2023</td><td>JUMIATI</td><td></td><td></
td><td>'</td><td>26-03-1956</td><td>PIJI RT 10 RW
05</td><td></td><td>GETASAN</td><td>PUSKESMAS INDUK</td><td>dr.Gani
Kriswanto</td><td>Supomo,A.Md.Kep</td><td>P</td><td>60-69
Thn.</td><td>Keluarga</td><td>Lama</td><td>BPJS NON PBI</td><td>Rajal</td><td
align='right'>14</td><td align='right'>1</td><td align='right'>67</td><td>BP.
Umum</td><td></td><td></td><td>Dalam
Wilayah</td><td>'0002880265746</td><td>'3322017112460040</td><td>141</td><td>68</
td><td>80</td><td>36</td><td>23</td><td>154</td><td>51</td><td></td><td></
td><td></td></tr><tr><td align='right'>M79.1</td><td>Myalgia</td><td></td><td>PEGAL
LINU</td><td align='right'>2333</td><td
align='right'>1003402</td><td>10-05-2023</td><td>KURYATI</td><td></td><td></
td><td>'</td><td>15-06-1978</td><td>MANGGIHAN RT
01/01</td><td></td><td>MANGGIHAN</td><td>PUSKESMAS INDUK</td><td>dr.Gani
Kriswanto</td><td>Supomo,A.Md.Kep</td><td>P</td><td>20-44
Thn.</td><td>Keluarga</td><td>Lama</td><td>BPJS PBI</td><td>Rajal</td><td
align='right'>25</td><td align='right'>10</td><td align='right'>44</td><td>BP.
Umum</td><td></td><td></td><td>Dalam
Wilayah</td><td>'0001531606184</td><td>'3322015506780000</td><td>114</td><td>73</
td><td>85</td><td>36.7</td><td>22</td><td>152</td><td>66</td><td></td><td></
td><td></td></tr><tr><td align='right'>J11.0</td><td>Influenza with pneumonia,
virus not identified</td><td></td><td>panas, batuk, pilek</td><td
align='right'>2330</td><td align='right'>1024905</td><td>10-05-2023</td><td>LATISHA
ERCILIA TABITHA</td><td>YUSUP
ARIANTO</td><td></td><td>'</td><td>07-10-2022</td><td>SIDOMUKTI RT03 RW
05</td><td></td><td>KOPENG</td><td>PUSKESMAS INDUK</td><td>dr.Arninta Rahma
Khoirunnisa</td><td>Uci Novitawati,A.Md.Keb</td><td>P</td><td><1
Thn.</td><td>Keluarga</td><td>Lama</td><td>BPJS NON PBI</td><td>Rajal</td><td
align='right'></td><td align='right'>7</td><td
align='right'></td><td>MTBS</td><td></td><td></td><td>Dalam
Wilayah</td><td>'0003297394934</td><td>'3322014710220001</td><td></td><td></
td><td>128</td><td>36</td><td>40</td><td>0</td><td>8</td><td></td><td>PENKER
TENTANG PERAWATAN DI RUMAH SELAMA SAKIT</td><td>MEMBERIKAN PENKES TENTANG PERAWATAN
DI RUMAH SELAMA SAKIT</td></tr><tr><td
align='right'>K30</td><td>Dyspepsia</td><td></td><td></td><td
align='right'>2351</td><td
align='right'>07000062</td><td>10-05-2023</td><td>LESTARI</td><td></td><td></
td><td>'</td><td>15-11-1976</td><td>SLEKER 3/3
KOPENG</td><td></td><td>KOPENG</td><td>PUSKESMAS INDUK</td><td>dr.Gani
Kriswanto</td><td>Supomo,A.Md.Kep</td><td>P</td><td>45-54
Thn.</td><td>Keluarga</td><td>Lama</td><td>BPJS PBI</td><td>Rajal</td><td
align='right'>25</td><td align='right'>5</td><td align='right'>46</td><td>BP.
Umum</td><td></td><td></td><td>Dalam
Wilayah</td><td>'0002345504679</td><td>'</td><td>120</td><td>70</td><td>86</
td><td>36</td><td>22</td><td>158</td><td>58</td><td></td><td></td><td></td></
tr><tr><td align='right'>K04.1</td><td>Necrosis of pulp</td><td></td><td>pasien
datang dengan keluhan mau tambal gigi depan atas, dulu pernah sakit sekarang tidak
</td><td align='right'>2316</td><td
align='right'>1006163</td><td>10-05-2023</td><td>LITA
YULIANTI</td><td></td><td></td><td>'085601536016</td><td>10-07-2000</
td><td>KALITENGAH RT 01 RW 06</td><td></td><td>BATUR</td><td>PUSKESMAS
INDUK</td><td>drg.Ade Indranila</td><td> - </td><td>P</td><td>20-44
Thn.</td><td>Keluarga</td><td>Lama</td><td>BPJS PBI</td><td>Rajal</td><td
align='right'></td><td align='right'>10</td><td align='right'>22</td><td>BP.
Gigi</td><td></td><td></td><td>Dalam
Wilayah</td><td>'0002349072731</td><td>'3322015007000000</td><td>110</td><td>67</
td><td>79</td><td>36</td><td>20</td><td>151</td><td>40</td><td></td><td>pro
konservasi gigi 1.1 </td><td>medikasi tunda konservasi </td></tr><tr><td
align='right'>R51</td><td>Headache</td><td></td><td>PUSING JIKA HABIS JONGKOK TERUS
BERDIRI</td><td align='right'>2335</td><td align='right'>1013519</td><td>10-05-
2023</td><td>LUSIANA
</td><td></td><td></td><td>'</td><td>28-02-2001</td><td>PRINGAPUS RT
012/01</td><td></td><td>GETASAN</td><td>PUSKESMAS INDUK</td><td>dr.Gani
Kriswanto</td><td>Supomo,A.Md.Kep</td><td>P</td><td>20-44
Thn.</td><td>Keluarga</td><td>Lama</td><td>BPJS NON PBI</td><td>Rajal</td><td
align='right'>12</td><td align='right'>2</td><td align='right'>22</td><td>BP.
Umum</td><td></td><td></td><td>Dalam
Wilayah</td><td>'0001027436793</td><td>'3322016802010000</td><td>114</td><td>81</
td><td>92</td><td>36.3</td><td>22</td><td>155</td><td>57</td><td></td><td></
td><td></td></tr><tr><td align='right'>A09</td><td>Diarrhoea and gastroenteritis of
presumed infectious origin</td><td></td><td>BAB CAIR 4 KL, MUAL, MUNTAH 4
KL</td><td align='right'>2343</td><td
align='right'>1021691</td><td>10-05-2023</td><td>MUHAMMAD ABDUL
FATTAH</td><td></td><td></td><td>'</td><td>26-04-2021</td><td>SANGGAR RT 01 RW
07</td><td></td><td>BATUR</td><td>PUSKESMAS INDUK</td><td>dr.Arninta Rahma
Khoirunnisa</td><td>Sri Hartini,S.S.T.Keb</td><td>L</td><td>1-4
Thn.</td><td>Keluarga</td><td>Lama</td><td>Umum</td><td>Rajal</td><td
align='right'>14</td><td align='right'></td><td
align='right'>2</td><td>MTBS</td><td></td><td></td><td>Dalam
Wilayah</td><td>'</td><td>'3322012604210001</td><td></td><td></td><td>130</
td><td>36</td><td>36</td><td>80</td><td>11</td><td></td><td>PENKES CARA PEMBERIAN
OBAT DI RUMAH, PENKES CARA PEMBERIAN MAKAN/ MINUM DI RUMAH</td><td>MEMBERIKAN
PENKES CARA PEMBERIAN MAKAN MINUM DI RUMAH, MEMBERIKAN PENKES CARA PEMBERIAN OBAT
DI RUMAH</td></tr><tr><td align='right'>K05.6</td><td>Periodontal disease,
unspecified</td><td></td><td>pasien datang gigi sakit kiri bawah </td><td
align='right'>2349</td><td
align='right'>1015150</td><td>10-05-2023</td><td>MUHAMMAD AL
HAFIZI</td><td></td><td>BELUM/TIDAK
BEKERJA</td><td>'</td><td>08-08-2016</td><td>NOGOSAREN RT 07 RW
01</td><td></td><td>GETASAN</td><td>PUSKESMAS INDUK</td><td>drg.Ade
Indranila</td><td> - </td><td>L</td><td>5-9
Thn.</td><td>Keluarga</td><td>Lama</td><td>Umum</td><td>Rajal</td><td
align='right'>2</td><td align='right'>9</td><td align='right'>6</td><td>BP.
Gigi</td><td></td><td></td><td>Dalam
Wilayah</td><td>'</td><td>'</td><td>100</td><td>60</td><td>80</td><td>36</
td><td>24</td><td>139</td><td>41</td><td></td><td></td><td>medikas
</td></tr><tr><td align='right'>M51.0</td><td>Lumbar and other intervertebral disc
disorders with myelopathy</td><td></td><td>PERUT MULES, KAKI LUKA</td><td
align='right'>2348</td><td
align='right'>06000046</td><td>10-05-2023</td><td>NGATIMIN </td><td>TUKIMIN
TUGIONO</td><td></td><td>'</td><td>06-11-1978</td><td>SANGGAR RT 2 RW 7
</td><td></td><td>BATUR</td><td>PUSKESMAS INDUK</td><td>dr.Gani
Kriswanto</td><td>Supomo,A.Md.Kep</td><td>L</td><td>20-44
Thn.</td><td>Keluarga</td><td>Lama</td><td>BPJS PBI</td><td>Rujuk</td><td
align='right'>4</td><td align='right'>6</td><td align='right'>44</td><td>BP.
Umum</td><td>Saraf</td><td>RS DR.ASMIR SALATIGA</td><td>Dalam
Wilayah</td><td>'0000601812268</td><td>'3322010611780002</td><td>118</td><td>73</
td><td>82</td><td>36.2</td><td>22</td><td>158</td><td>56</td><td></td><td></
td><td></td></tr><tr><td align='right'>R56</td><td>Convulsions, not elsewhere
classified</td><td></td><td></td><td align='right'>2331</td><td
align='right'>07000060</td><td>10-05-2023</td><td>RIBUT</td><td>SUYADI</td><td></
td><td>'</td><td>10-12-1960</td><td>SIDOMUKTI RT 1 RW
5</td><td></td><td>KOPENG</td><td>PUSKESMAS INDUK</td><td>dr.Gani
Kriswanto</td><td>Supomo,A.Md.Kep</td><td>P</td><td>60-69
Thn.</td><td>Keluarga</td><td>Baru</td><td>BPJS
PBI</td><td>Rujuk</td><td align='right'>0</td><td align='right'>5</td><td
align='right'>62</td><td>BP. Umum</td><td>Saraf</td><td>RS PURI ASIH
SALATIGA</td><td>Dalam
Wilayah</td><td>'0002574172978</td><td>'3322015012600001</td><td>150</td><td>80</
td><td>80</td><td>36.5</td><td>23</td><td>150</td><td>56</td><td></td><td></
td><td></td></tr><tr><td align='right'>K00.6</td><td>Disturbances in tooth
eruption</td><td></td><td>pasien datang mau cabut gigi depan atas </td><td
align='right'>2339</td><td align='right'>1023949</td><td>10-05-2023</td><td>SAZKIA
TRI ANJANI</td><td>MUSLIKAH</td><td></td><td>'</td><td>05-04-2014</td><td>DUKUH RT
02 RW 01</td><td>DUKUH</td><td>BATUR</td><td>PUSKESMAS INDUK</td><td>drg.Ade
Indranila</td><td> - </td><td>P</td><td>5-9
Thn.</td><td>Keluarga</td><td>Lama</td><td>Umum</td><td>Rajal</td><td
align='right'>5</td><td align='right'>1</td><td align='right'>9</td><td>BP.
Gigi</td><td></td><td></td><td>Dalam
Wilayah</td><td>'0002615215342</td><td>'3322014504140004</td><td>100</td><td>60</
td><td>79</td><td>36</td><td>22</td><td>136</td><td>39</td><td></td><td></
td><td>exo gigi 6.1 Persistensi dengan CE</td></tr><tr><td
align='right'>M79.1</td><td>Myalgia</td><td></td><td>kaki bengkak</td><td
align='right'>2329</td><td align='right'>90000074</td><td>10-05-2023</td><td>SITI
FATIMAH</td><td>SUJAKNO</td><td></td><td>'085726523221</td><td>11-05-1978</
td><td>BLONGORAN RT 05 RW 03 POLOBOGO</td><td></td><td>Luar
Wilayah</td><td>PUSKESMAS INDUK</td><td>dr.Gani
Kriswanto</td><td>Supomo,A.Md.Kep</td><td>P</td><td>20-44
Thn.</td><td>Keluarga</td><td>Lama</td><td>BPJS PBI</td><td>Rajal</td><td
align='right'>29</td><td align='right'>11</td><td align='right'>44</td><td>BP.
Umum</td><td></td><td></td><td>Luar
Wilayah</td><td>'0001132372416</td><td>'3322015105780001</td><td>109</td><td>70</
td><td>85</td><td>36.7</td><td>22</td><td>151</td><td>51</td><td></td><td></
td><td></td></tr><tr><td align='right'>M79.1</td><td>Myalgia</td><td></td><td>PERUT
MULES, KAKI LUKA</td><td align='right'>2346</td><td
align='right'>02000029</td><td>10-05-2023</td><td>SUMADI</td><td>SUMADI</
td><td>PETANI/PEKEBUN</td><td>'</td><td>00-00-0000</td><td>SRANTI RT 09 RW 02 WATES
GETASAN</td><td>SRANTI</td><td>WATES</td><td>PUSKESMAS INDUK</td><td>dr.Gani
Kriswanto</td><td>Supomo,A.Md.Kep</td><td>L</td><td>0-7
hari</td><td>Keluarga</td><td>Lama</td><td>BPJS PBI</td><td>Rajal</td><td
align='right'>0</td><td align='right'>0</td><td align='right'>0</td><td>BP.
Umum</td><td></td><td></td><td>Dalam
Wilayah</td><td>'0003309903876</td><td>'3322013112570049</td><td>110</td><td>68</
td><td>96</td><td>36.2</td><td>22</td><td>155</td><td>50</td><td></td><td></
td><td></td></tr><tr><td align='right'>K30</td><td>Dyspepsia</td><td></td><td>PERUT
MULES, KAKI LUKA</td><td align='right'>2346</td><td
align='right'>02000029</td><td>10-05-2023</td><td>SUMADI</td><td>SUMADI</
td><td>PETANI/PEKEBUN</td><td>'</td><td>00-00-0000</td><td>SRANTI RT 09 RW 02 WATES
GETASAN</td><td>SRANTI</td><td>WATES</td><td>PUSKESMAS INDUK</td><td>dr.Gani
Kriswanto</td><td>Supomo,A.Md.Kep</td><td>L</td><td>0-7
hari</td><td>Keluarga</td><td>Lama</td><td>BPJS PBI</td><td>Rajal</td><td
align='right'>0</td><td align='right'>0</td><td align='right'>0</td><td>BP.
Umum</td><td></td><td></td><td>Dalam
Wilayah</td><td>'0003309903876</td><td>'3322013112570049</td><td>110</td><td>68</
td><td>96</td><td>36.2</td><td>22</td><td>155</td><td>50</td><td></td><td></
td><td></td></tr><tr><td align='right'>J06.9</td><td>Acute upper respiratory
infection, unspecified</td><td></td><td></td><td align='right'>2345</td><td
align='right'>07000061</td><td>10-05-2023</td><td>SURYADI</td><td></td><td></
td><td>'</td><td>05-03-1969</td><td>SLEKER 4/3 KOPENG, GETASAN, KAB.
SEMARANG</td><td>SLEKER</td><td>KOPENG</td><td>PUSKESMAS INDUK</td><td>dr.Gani
Kriswanto</td><td>Supomo,A.Md.Kep</td><td>L</td><td>45-54
Thn.</td><td>Keluarga</td><td>Lama</td><td>BPJS PBI</td><td>Rajal</td><td
align='right'>5</td><td align='right'>2</td><td align='right'>54</td><td>BP.
Umum</td><td></td><td></td><td>Dalam
Wilayah</td><td>'0002345504668</td><td>'</td><td>110</td><td>70</td><td>85</
td><td>36</td><td>22</td><td>155</td><td>52</td><td></td><td></td><td></td></
tr><tr><td align='right'>R51</td><td>Headache</td><td></td><td></td><td
align='right'>2352</td><td
align='right'>04000009</td><td>10-05-2023</td><td>SURYONO</td><td>SURYONO</
td><td></td><td>'</td><td>01-01-1971</td><td>TEGALSARI RT 17 RW
02</td><td>TEGALSARI</td><td>NGRAWAN</td><td>PUSKESMAS INDUK</td><td>dr.Gani
Kriswanto</td><td>Supomo,A.Md.Kep</td><td>L</td><td>45-54
Thn.</td><td>Keluarga</td><td>Lama</td><td>Umum</td><td>Rajal</td><td
align='right'>9</td><td align='right'>4</td><td align='right'>52</td><td>BP.
Umum</td><td></td><td></td><td>Dalam
Wilayah</td><td>'</td><td>'</td><td>120</td><td>70</td><td>86</td><td>36</
td><td>22</td><td>158</td><td>59</td><td></td><td></td><td></td></tr><tr><td
align='right'>K30</td><td>Dyspepsia</td><td></td><td></td><td
align='right'>2354</td><td align='right'>99000053</td><td>10-05-2023</td><td>TITIK
ELSI AMBARWATI</td><td>TRI JUMENO</td><td>MENGURUS RUMAH
TANGGA</td><td>'085747439844</td><td>21-02-1989</td><td>KEBONAGUNG RT 3 RW 3
</td><td></td><td>Luar kabupaten</td><td>PUSKESMAS INDUK</td><td>dr.Gani
Kriswanto</td><td>Supomo,A.Md.Kep</td><td>P</td><td>20-44
Thn.</td><td>Keluarga</td><td>Baru</td><td>BPJS PBI</td><td>Rajal</td><td
align='right'>17</td><td align='right'>2</td><td align='right'>34</td><td>BP.
Umum</td><td></td><td></td><td>Luar
Wilayah</td><td>'0000574400992</td><td>'3315016102890004</td><td>140</td><td>80</
td><td>84</td><td>36</td><td>20</td><td>150</td><td>58</td><td></td><td></
td><td></td></tr><tr><td align='right'>K00.6</td><td>Disturbances in tooth
eruption</td><td></td><td>pasien datang mau cabut ggi kiri bawah </td><td
align='right'>2337</td><td
align='right'>1016251</td><td>10-05-2023</td><td>TUKINI</td><td></td><td></
td><td>'</td><td>28-08-1981</td><td>GETASAN RT
6/1</td><td>GETASAN</td><td>GETASAN</td><td>PUSKESMAS INDUK</td><td>drg.Ade
Indranila</td><td> - </td><td>P</td><td>20-44
Thn.</td><td>Keluarga</td><td>Lama</td><td>BPJS PBI</td><td>Rajal</td><td
align='right'>12</td><td align='right'>8</td><td align='right'>41</td><td>BP.
Gigi</td><td></td><td></td><td>Dalam
Wilayah</td><td>'0002349078546</td><td>'3322016808810000</td><td>100</td><td>70</
td><td>80</td><td>36</td><td>24</td><td>135</td><td>31</td><td></td><td></
td><td>exo gigi 7.4 dengan CE </td></tr><tr><td align='right'>K02.9</td><td>Dental
caries, unspecified</td><td></td><td>pasen datang dengan keluhan gogo bawah sering
sakit </td><td align='right'>2380</td><td align='right'>1021014</td><td>11-05-
2023</td><td>ABEDNEGO DWI CHRISTIANO</td><td></td><td></td><td>'</td><td>11-04-
2012</td><td>GEDAD RT 10 RW 01</td><td></td><td>WATES</td><td>PUSKESMAS
INDUK</td><td>drg.Ade Indranila</td><td> - </td><td>L</td><td>10-14
Thn.</td><td>Keluarga</td><td>Lama</td><td>Umum</td><td>Rajal</td><td
align='right'></td><td align='right'>1</td><td align='right'>11</td><td>BP.
Gigi</td><td></td><td></td><td>Dalam
Wilayah</td><td>'</td><td>'</td><td>100</td><td>60</td><td>80</td><td>36</
td><td>24</td><td>135</td><td>30</td><td></td><td>pro konservasi </td><td>gigi 4.6
kapas eug + ZNOE</td></tr><tr><td align='right'>K02.1</td><td>Caries of
dentine</td><td></td><td>pasen datang dengan keluhan gogo bawah sering sakit
</td><td align='right'>2380</td><td
align='right'>1021014</td><td>11-05-2023</td><td>ABEDNEGO DWI
CHRISTIANO</td><td></td><td></td><td>'</td><td>11-04-2012</td><td>GEDAD RT 10 RW
01</td><td></td><td>WATES</td><td>PUSKESMAS INDUK</td><td>drg.Ade
Indranila</td><td> - </td><td>L</td><td>10-14
Thn.</td><td>Keluarga</td><td>Lama</td><td>Umum</td><td>Rajal</td><td
align='right'></td><td align='right'>1</td><td align='right'>11</td><td>BP.
Gigi</td><td></td><td></td><td>Dalam
Wilayah</td><td>'</td><td>'</td><td>100</td><td>60</td><td>80</td><td>36</
td><td>24</td><td>135</td><td>30</td><td></td><td>pro konservasi </td><td>gigi 4.6
kapas eug + ZNOE</td></tr><tr><td align='right'>E13</td><td>Other specified
diabetes mellitus</td><td></td><td>kontrol</td><td align='right'>2390</td><td
align='right'>1012533</td><td>11-05-2023</td><td>AGUS
SUGIONO</td><td></td><td></td><td>'</td><td>17-11-1973</td><td>PERUM SEHATI H NO
302 BLOTONGAN </td><td></td><td>Luar Wilayah</td><td>PUSKESMAS
INDUK</td><td>dr.Arninta Rahma Khoirunnisa</td><td>Riska
Wulandari,A.Md.Kep</td><td>L</td><td>45-54
Thn.</td><td>Keluarga</td><td>Lama</td><td>BPJS NON PBI</td><td>Rujuk</td><td
align='right'>24</td><td align='right'>5</td><td align='right'>49</td><td>BP.
Umum</td><td>Penyakit Dalam </td><td>RS KEN SARAS</td><td>Luar
Wilayah</td><td>'0002220405579</td><td>'3373011711730003</td><td>120</td><td>70</
td><td>80</td><td>36</td><td>22</td><td>162</td><td>81</td><td></td><td></
td><td></td></tr><tr><td align='right'>J06.9</td><td>Acute upper respiratory
infection, unspecified</td><td></td><td>panas, batukk, pilek</td><td
align='right'>2364</td><td align='right'>1018463</td><td>11-05-2023</td><td>AHMAD
KHOIRI</td><td></td><td></td><td>'</td><td>12-12-2019</td><td>KRANGKENG RT 02 RW
12</td><td></td><td>BATUR</td><td>PUSKESMAS INDUK</td><td>dr.Arninta Rahma
Khoirunnisa</td><td>Suwoto,A.Md.Kep</td><td>L</td><td>1-4
Thn.</td><td>Keluarga</td><td>Lama</td><td>BPJS PBI</td><td>Rajal</td><td
align='right'>29</td><td align='right'>4</td><td
align='right'>3</td><td>MTBS</td><td></td><td></td><td>Dalam
Wilayah</td><td>'0002911375359</td><td>'</td><td></td><td></td><td>128</
td><td>37</td><td>38</td><td>98</td><td>16</td><td></td><td>penkes cara pemberian
obat di rumag</td><td>memberikan penkes cara pemberian obat di
rumah</td></tr><tr><td align='right'>K02.9</td><td>Dental caries,
unspecified</td><td></td><td>pasien datang mau kontrol gigi
rencana mau cabut ggi</td><td align='right'>2358</td><td
align='right'>06000044</td><td>11-05-2023</td><td>DARMADI</td><td></td><td>PETANI/
PEKEBUN</td><td>'</td><td>01-09-1958</td><td>MADU RT 02 RW
04</td><td>MADU</td><td>BATUR</td><td>PUSKESMAS INDUK</td><td>drg.Ade
Indranila</td><td> - </td><td>L</td><td>60-69
Thn.</td><td>Keluarga</td><td>Lama</td><td>Umum</td><td>Rajal</td><td
align='right'>10</td><td align='right'>8</td><td align='right'>64</td><td>BP.
Gigi</td><td></td><td></td><td>Dalam
Wilayah</td><td>'0000602537973</td><td>'3322102409580001</td><td>148</td><td>80</
td><td>80</td><td>36</td><td>24</td><td>155</td><td>56</td><td>Tdk
Th</td><td></td><td>konservasi gigi 4.2 dan 4.3 ketK MOLAR </td></tr><tr><td
align='right'>H10.9</td><td>Conjunctivitis, unspecified</td><td></td><td>GATAL-
GATAL</td><td align='right'>2382</td><td align='right'>1014238</td><td>11-05-
2023</td><td>DESTI AZIRA
BINTANG</td><td></td><td></td><td>'</td><td>17-12-2012</td><td>BATUR WETAN RT 03 RW
13</td><td></td><td>BATUR</td><td>PUSKESMAS INDUK</td><td>dr.Arninta Rahma
Khoirunnisa</td><td>Riska Wulandari,A.Md.Kep</td><td>P</td><td>10-14
Thn.</td><td>Keluarga</td><td>Lama</td><td>Umum</td><td>Rajal</td><td
align='right'>24</td><td align='right'>4</td><td align='right'>10</td><td>BP.
Umum</td><td></td><td></td><td>Dalam
Wilayah</td><td>'</td><td>'3322015712120000</td><td>100</td><td>80</td><td>80</
td><td>36.2</td><td>22</td><td>137</td><td>37</td><td></td><td></td><td></td></
tr><tr><td align='right'>Z00</td><td>General examination and investigation of
persons without complaint and reported diagnosis</td><td></td><td>MEDIKASI
LUKA</td><td align='right'>2357</td><td align='right'>06000045</td><td>11-05-
2023</td><td>ELEAZAR HENDRI
HARTANTO</td><td>SUTRISNO</td><td>PELAJAR/MAHASISWA</td><td>'088806406294</
td><td>05-06-2006</td><td>SENDEN RT 04 RW
09</td><td>SENDEN</td><td>BATUR</td><td>PUSKESMAS INDUK</td><td>dr.Arninta Rahma
Khoirunnisa</td><td>Riska Wulandari,A.Md.Kep</td><td>L</td><td>15-19
Thn.</td><td>Keluarga</td><td>Lama</td><td>Umum</td><td>Rajal</td><td
align='right'>6</td><td align='right'>11</td><td align='right'>16</td><td>BP.
Umum</td><td></td><td></td><td>Dalam
Wilayah</td><td>'</td><td>'</td><td>120</td><td>70</td><td>88</td><td>36</
td><td>22</td><td>149</td><td>32</td><td></td><td></td><td></td></tr><tr><td
align='right'>J06.9</td><td>Acute upper respiratory infection,
unspecified</td><td></td><td>BATUK, PILEK</td><td align='right'>2370</td><td
align='right'>07000063</td><td>11-05-2023</td><td>EUNIKHE AMELIA
N</td><td></td><td></td><td>'</td><td>27-11-2006</td><td>KOPENG RT 5 RW 2
</td><td></td><td>KOPENG</td><td>PUSKESMAS INDUK</td><td>dr.Arninta Rahma
Khoirunnisa</td><td>Riska Wulandari,A.Md.Kep</td><td>P</td><td>15-19
Thn.</td><td>Keluarga</td><td>Baru</td><td>Umum</td><td>Rajal</td><td
align='right'>14</td><td align='right'>5</td><td align='right'>16</td><td>BP.
Umum</td><td></td><td></td><td>Dalam
Wilayah</td><td>'</td><td>'</td><td>100</td><td>80</td><td>88</td><td>37.8</
td><td>23</td><td>124</td><td>20</td><td></td><td></td><td></td></tr><tr><td
align='right'>K04.1</td><td>Necrosis of pulp</td><td></td><td>pasien datang mau
kontrol gigi kiri atas </td><td align='right'>2387</td><td
align='right'>90000104</td><td>11-05-2023</td><td>KAFIE EL AZZAM</td><td>MUH
YUNIANTO</td><td>PELAJAR/MAHASISWA</td><td>'</td><td>29-11-2013</td><td>SEMARE RT 8
RW 3 </td><td></td><td>Luar Wilayah</td><td>PUSKESMAS INDUK</td><td>drg.Ade
Indranila</td><td> - </td><td>L</td><td>5-9
Thn.</td><td>Keluarga</td><td>Baru</td><td>BPJS PBI</td><td>Rajal</td><td
align='right'>12</td><td align='right'>5</td><td align='right'>9</td><td>BP.
Gigi</td><td></td><td></td><td>Luar
Wilayah</td><td>'0001373028682</td><td>'3322052911130001</td><td>120</td><td>70</
td><td>80</td><td>36</td><td>24</td><td>155</td><td>50</td><td></td><td></
td><td></td></tr><tr><td align='right'>H28</td><td>Cataract and other disorders of
lens in diseases classified elsewhere</td><td></td><td>PENGLIHATAN KABUR</td><td
align='right'>2363</td><td
align='right'>1018898</td><td>11-05-2023</td><td>KASINI</td><td></td><td></
td><td>'</td><td>31-12-1956</td><td>PONGANGAN RT 02 RW
01</td><td></td><td>GETASAN</td><td>PUSKESMAS INDUK</td><td>dr.Arninta Rahma
Khoirunnisa</td><td>Riska Wulandari,A.Md.Kep</td><td>P</td><td>60-69
Thn.</td><td>Keluarga</td><td>Lama</td><td>BPJS PBI</td><td>Rajal</td><td
align='right'>10</td><td align='right'>4</td><td align='right'>66</td><td>BP.
Umum</td><td></td><td></td><td>Dalam
Wilayah</td><td>'0002380330056</td><td>'3322017112560060</td><td>164</td><td>90</
td><td>89</td><td>37</td><td>22</td><td>148</td><td>60</td><td></td><td></
td><td></td></tr><tr><td align='right'>J06.9</td><td>Acute upper respiratory
infection, unspecified</td><td></td><td>BATUK, PILEK</td><td
align='right'>2367</td><td
align='right'>1004203</td><td>11-05-2023</td><td>KASMIYONO</td><td></td><td></
td><td>'</td><td>11-07-1970</td><td>SALARAN RT
15/02</td><td></td><td>TOLOKAN</td><td>PUSKESMAS INDUK</td><td>dr.Arninta Rahma
Khoirunnisa</td><td>Riska Wulandari,A.Md.Kep</td><td>L</td><td>45-54
Thn.</td><td>Keluarga</td><td>Lama</td><td>Umum</td><td>Rajal</td><td
align='right'></td><td align='right'>10</td><td align='right'>52</td><td>BP.
Umum</td><td></td><td></td><td>Dalam
Wilayah</td><td>'</td><td>'3374131107700000</td><td>140</td><td>90</td><td>80</
td><td>37.5</td><td>22</td><td>168</td><td>96</td><td></td><td></td><td></td></
tr><tr><td align='right'>K02.9</td><td>Dental caries,
unspecified</td><td></td><td>pasein datang mau kontrol gigi, kemaren datng drg
tidak ada </td><td align='right'>2386</td><td align='right'>1024446</td><td>11-05-
2023</td><td>LILIS
SETYANINGSIH</td><td></td><td></td><td>'</td><td>06-08-1979</td><td>SEMARE RT 08 RW
03</td><td>SLEKER</td><td>KOPENG</td><td>PUSKESMAS INDUK</td><td>drg.Ade
Indranila</td><td> - </td><td>P</td><td>20-44
Thn.</td><td>Keluarga</td><td>Lama</td><td>Umum</td><td>Rajal</td><td
align='right'>5</td><td align='right'>9</td><td align='right'>43</td><td>BP.
Gigi</td><td></td><td></td><td>Dalam
Wilayah</td><td>'0001373484609</td><td>'3322054608790005</td><td>110</td><td>70</
td><td>80</td><td>36</td><td>24</td><td>155</td><td>56</td><td></td><td>pro
conservasi </td><td>tumpat semntara CHKM + Znpo4</td></tr><tr><td
align='right'>K04.1</td><td>Necrosis of pulp</td><td></td><td>pasien dfatang dengan
keluhan mau konsul gigi
mau minta rujukam ke RS</td><td align='right'>2376</td><td
align='right'>1019642</td><td>11-05-2023</td><td>MUHAMAD HAFID
ANANDA</td><td></td><td></td><td>'</td><td>12-07-2012</td><td>PRINGAPUS RT 13 RW 01
SUMOGAWE</td><td></td><td>GETASAN</td><td>PUSKESMAS INDUK</td><td>drg.Ade
Indranila</td><td> - </td><td>L</td><td>10-14
Thn.</td><td>Keluarga</td><td>Lama</td><td>BPJS PBI</td><td>Rujuk</td><td
align='right'>29</td><td align='right'>9</td><td align='right'>10</td><td>BP.
Gigi</td><td></td><td></td><td>Dalam
Wilayah</td><td>'0002343918306</td><td>'3322011207120003</td><td>120</td><td>70</
td><td>80</td><td>36</td><td>24</td><td>162</td><td>55</td><td></td><td></
td><td></td></tr><tr><td align='right'>K08.3</td><td>Retained dental
root</td><td></td><td>Pasien datng mau cabut gigi atas </td><td
align='right'>2374</td><td
align='right'>1025568</td><td>11-05-2023</td><td>MUNDIYAH</td><td></td><td></
td><td>'</td><td>09-11-1960</td><td>SRANTI RT 08 RW
02</td><td></td><td>WATES</td><td>PUSKESMAS INDUK</td><td>drg.Ade
Indranila</td><td> - </td><td>P</td><td>60-69
Thn.</td><td>Keluarga</td><td>Lama</td><td>BPJS PBI</td><td>Rajal</td><td
align='right'>2</td><td align='right'>6</td><td align='right'>62</td><td>BP.
Gigi</td><td></td><td></td><td>Dalam
Wilayah</td><td>'0002349067601</td><td>'3322016911600001</td><td>173</td><td>90</
td><td>80</td><td>36</td><td>24</td><td>154</td><td>52</td><td></td><td>pro exo
</td><td>tunda exo karena setelah dianestesi , tensi naik </td></tr><tr><td
align='right'>K08.3</td><td>Retained dental root</td><td></td><td>pasein datang
dengan kelu=uhan gigi atas dan bawah goyang </td><td align='right'>2391</td><td
align='right'>1022319</td><td>11-05-2023</td><td>NABILA SALSABILA
NADHIFA</td><td></td><td></td><td>'</td><td>22-11-2014</td><td>MADU RT 01 RW
04</td><td>MADU</td><td>BATUR</td><td>PUSKESMAS INDUK</td><td>drg.Ade
Indranila</td><td> - </td><td>P</td><td>5-9
Thn.</td><td>Keluarga</td><td>Lama</td><td>BPJS PBI</td><td>Rajal</td><td
align='right'>19</td><td align='right'>5</td><td align='right'>8</td><td>BP.
Gigi</td><td></td><td></td><td>Dalam
Wilayah</td><td>'0001532108136</td><td>'3322016211140000</td><td>100</td><td>60</
td><td>80</td><td>36</td><td>24</td><td>135</td><td>32</td><td></td><td></
td><td>exo gigi 5.4 dan 8.4 dengan infiltrasi lidocain tanpa komplikasi
</td></tr><tr><td align='right'>K05.6</td><td>Periodontal disease,
unspecified</td><td></td><td>pasien jdatng dengan keluhan mau kontrol </td><td
align='right'>2360</td><td
align='right'>06000049</td><td>11-05-2023</td><td>NURYANTI</td><td></td><td></
td><td>'</td><td>12-07-1976</td><td>BATUR WETAN RT 3 RW 13
</td><td></td><td>BATUR</td><td>PUSKESMAS INDUK</td><td>drg.Ade Indranila</td><td>
- </td><td>P</td><td>45-54
Thn.</td><td>Keluarga</td><td>Lama</td><td>Umum</td><td>Rajal</td><td
align='right'>29</td><td align='right'>9</td><td align='right'>46</td><td>BP.
Gigi</td><td></td><td></td><td>Dalam
Wilayah</td><td>'</td><td>'3322015207760006</td><td>158</td><td>112</td><td>100</
td><td>36</td><td>20</td><td>153</td><td>50</td><td></td><td></td><td>tunda exo
tensi tinggi </td></tr><tr><td align='right'>K08.3</td><td>Retained dental
root</td><td></td><td>pasien jdatng dengan keluhan mau kontrol </td><td
align='right'>2360</td><td
align='right'>06000049</td><td>11-05-2023</td><td>NURYANTI</td><td></td><td></
td><td>'</td><td>12-07-1976</td><td>BATUR WETAN RT 3 RW 13
</td><td></td><td>BATUR</td><td>PUSKESMAS INDUK</td><td>drg.Ade Indranila</td><td>
- </td><td>P</td><td>45-54
Thn.</td><td>Keluarga</td><td>Lama</td><td>Umum</td><td>Rajal</td><td
align='right'>29</td><td align='right'>9</td><td align='right'>46</td><td>BP.
Gigi</td><td></td><td></td><td>Dalam
Wilayah</td><td>'</td><td>'3322015207760006</td><td>158</td><td>112</td><td>100</
td><td>36</td><td>20</td><td>153</td><td>50</td><td></td><td></td><td>tunda exo
tensi tinggi </td></tr><tr><td align='right'>K00.6</td><td>Disturbances in tooth
eruption</td><td></td><td>pasien datang dengan keluhan gigi atas dan bawah ingin
dcabut </td><td align='right'>2383</td><td align='right'>1012290</td><td>11-05-
2023</td><td>RITA MULYANI
</td><td></td><td></td><td>'</td><td>04-11-2003</td><td>KENTENG RT
05/05</td><td></td><td>GETASAN</td><td>PUSKESMAS INDUK</td><td>drg.Ade
Indranila</td><td> - </td><td>P</td><td>15-19
Thn.</td><td>Keluarga</td><td>Lama</td><td>Umum</td><td>Rajal</td><td
align='right'>7</td><td align='right'>6</td><td align='right'>19</td><td>BP.
Gigi</td><td></td><td></td><td>Dalam
Wilayah</td><td>'0002293449816</td><td>'3322014411030000</td><td>100</td><td>70</
td><td>80</td><td>36</td><td>24</td><td>145</td><td>40</td><td></td><td></
td><td>medikasi
tunda exo masih sakit</td></tr><tr><td align='right'>K08.3</td><td>Retained dental
root</td><td></td><td>pasein datang dengan keluhan mau cabut gigi atas kanan
</td><td align='right'>2366</td><td
align='right'>1015378</td><td>11-05-2023</td><td>RUBINI</td><td>RUBINI</td><td></
td><td>'082135541733</td><td>01-01-1963</td><td>NOGOSAREN RT 07 RW
01</td><td>NOGOSAREN</td><td>NOGOSAREN</td><td>PUSKESMAS INDUK</td><td>drg.Ade
Indranila</td><td> - </td><td>L</td><td>60-69
Thn.</td><td>Keluarga</td><td>Lama</td><td>BPJS PBI</td><td>Rajal</td><td
align='right'>10</td><td align='right'>4</td><td align='right'>60</td><td>BP.
Gigi</td><td></td><td></td><td>Dalam
Wilayah</td><td>'0002443667949</td><td>'3322010101630005</td><td>117</td><td>71</
td><td>80</td><td>36</td><td>24</td><td>167</td><td>50</td><td>Tdk
Th</td><td></td><td>exo lido gigi 2.8 GR dengan infiltrasi </td></tr><tr><td
align='right'>K08.3</td><td>Retained dental root</td><td></td><td>pasien datang mau
kontrol mau cabut gigi </td><td align='right'>2372</td><td
align='right'>1024994</td><td>11-05-2023</td><td>SRI
SULIYAH</td><td></td><td></td><td>'</td><td>24-05-1971</td><td>SENDEN RT 04 RW
09</td><td>SENDEN</td><td>BATUR</td><td>PUSKESMAS INDUK</td><td>drg.Ade
Indranila</td><td> - </td><td>P</td><td>45-54
Thn.</td><td>Keluarga</td><td>Lama</td><td>Umum</td><td>Rajal</td><td
align='right'>17</td><td align='right'>11</td><td align='right'>51</td><td>BP.
Gigi</td><td></td><td></td><td>Dalam
Wilayah</td><td>'</td><td>'3322016405710001</td><td>134</td><td>85</td><td>96</
td><td>36</td><td>24</td><td>155</td><td>56</td><td></td><td></td><td>exo lido gigi
2.4 dan 2.6 GR </td></tr><tr><td align='right'>K05.6</td><td>Periodontal disease,
unspecified</td><td></td><td>pasien datang mau kontrol mau cabut gigi </td><td
align='right'>2372</td><td align='right'>1024994</td><td>11-05-2023</td><td>SRI
SULIYAH</td><td></td><td></td><td>'</td><td>24-05-1971</td><td>SENDEN RT 04 RW
09</td><td>SENDEN</td><td>BATUR</td><td>PUSKESMAS INDUK</td><td>drg.Ade
Indranila</td><td> - </td><td>P</td><td>45-54
Thn.</td><td>Keluarga</td><td>Lama</td><td>Umum</td><td>Rajal</td><td
align='right'>17</td><td align='right'>11</td><td align='right'>51</td><td>BP.
Gigi</td><td></td><td></td><td>Dalam
Wilayah</td><td>'</td><td>'3322016405710001</td><td>134</td><td>85</td><td>96</
td><td>36</td><td>24</td><td>155</td><td>56</td><td></td><td></td><td>exo lido gigi
2.4 dan 2.6 GR </td></tr><tr><td align='right'>K08.3</td><td>Retained dental
root</td><td></td><td>pasien datang dengan keluhan gigi bawah sakit </td><td
align='right'>2373</td><td align='right'>1014953</td><td>11-05-2023</td><td>SUKMA
ARIANI</td><td></td><td></td><td>'</td><td>19-03-1999</td><td>WONOSARI RT 02 RW 11
</td><td></td><td>BATUR</td><td>PUSKESMAS INDUK</td><td>drg.Ade Indranila</td><td>
- </td><td>P</td><td>20-44 Thn.</td><td>Keluarga</td><td>Lama</td><td>BPJS NON
PBI</td><td>Rajal</td><td align='right'>22</td><td align='right'>1</td><td
align='right'>24</td><td>BP. Gigi</td><td></td><td></td><td>Dalam
Wilayah</td><td>'0002454601419</td><td>'3322015903990000</td><td>127</td><td>78</
td><td>80</td><td>36</td><td>24</td><td>155</td><td>50</td><td></td><td></
td><td>medikasi </td></tr><tr><td align='right'>K05.6</td><td>Periodontal disease,
unspecified</td><td></td><td>pasei datang mau kontrol </td><td
align='right'>2359</td><td
align='right'>01000043</td><td>11-05-2023</td><td>SURAT</td><td></td><td></
td><td>'</td><td>05-07-1940</td><td>KOPENG RT 1 RW 2
</td><td></td><td>GETASAN</td><td>PUSKESMAS INDUK</td><td>drg.Ade
Indranila</td><td> - </td><td>L</td><td>>70
Thn.</td><td>Keluarga</td><td>Lama</td><td>BPJS PBI</td><td>Rajal</td><td
align='right'>6</td><td align='right'>10</td><td align='right'>82</td><td>BP.
Gigi</td><td></td><td></td><td>Dalam
Wilayah</td><td>'0000601814981</td><td>'3322010507400001</td><td>125</td><td>70</
td><td>80</td><td>36</td><td>24</td><td>155</td><td>50</td><td></td><td></
td><td>exo lio gigi 3.2</td></tr><tr><td align='right'>E05</td><td>Thyrotoxicosis
[hyperthyroidism]</td><td></td><td>KONTROL</td><td align='right'>2369</td><td
align='right'>1001353</td><td>11-05-2023</td><td>SURATMI</td><td></td><td></
td><td>'</td><td>16-03-1987</td><td>NGRAWAN RT 05 RW
01</td><td></td><td>NGRAWAN</td><td>PUSKESMAS INDUK</td><td>dr.Arninta Rahma
Khoirunnisa</td><td>Riska Wulandari,A.Md.Kep</td><td>P</td><td>20-44
Thn.</td><td>Keluarga</td><td>Lama</td><td>BPJS PBI</td><td>Rujuk</td><td
align='right'>25</td><td align='right'>1</td><td align='right'>36</td><td>BP.
Umum</td><td>Penyakit Dalam </td><td>RS PURI ASIH SALATIGA</td><td>Dalam
Wilayah</td><td>'0001325186998</td><td>'3322015603870002</td><td>140</td><td>90</
td><td>88</td><td>37</td><td>23</td><td>154</td><td>97</td><td></td><td></
td><td></td></tr><tr><td align='right'>K29.5</td><td>Chronic gastritis,
unspecified</td><td></td><td>PERUT SAKIT</td><td align='right'>2384</td><td
align='right'>1005793</td><td>11-05-2023</td><td>SUTARMI</td><td></td><td></
td><td>'</td><td>11-03-1966</td><td>PENDINGAN RT
03/01</td><td></td><td>GETASAN</td><td>PUSKESMAS INDUK</td><td>dr.Arninta Rahma
Khoirunnisa</td><td>Riska Wulandari,A.Md.Kep</td><td>P</td><td>55-59
Thn.</td><td>Keluarga</td><td>Lama</td><td>Umum</td><td>Rajal</td><td
align='right'></td><td align='right'>2</td><td align='right'>57</td><td>BP.
Umum</td><td></td><td></td><td>Dalam
Wilayah</td><td>'</td><td>'3322015103660000</td><td>131</td><td>81</td><td>80</
td><td>36</td><td>24</td><td>150</td><td>53</td><td></td><td></td><td></td></
tr><tr><td align='right'>J06.9</td><td>Acute upper respiratory infection,
unspecified</td><td></td><td>BATUK, PILEK,LUTUT SAKIT</td><td
align='right'>2365</td><td
align='right'>1012710</td><td>11-05-2023</td><td>SUWARNI</td><td></td><td></
td><td>'</td><td>30-12-1965</td><td>NOGOSAREN RT 07 RW
01</td><td>NOGOSAREN</td><td>NOGOSAREN</td><td>PUSKESMAS INDUK</td><td>dr.Arninta
Rahma Khoirunnisa</td><td>Riska Wulandari,A.Md.Kep</td><td>P</td><td>55-59
Thn.</td><td>Keluarga</td><td>Lama</td><td>BPJS NON PBI</td><td>Rajal</td><td
align='right'>11</td><td align='right'>4</td><td align='right'>57</td><td>BP.
Umum</td><td></td><td></td><td>Dalam
Wilayah</td><td>'0002443668041</td><td>'3322017012650014</td><td>99</td><td>66</
td><td>80</td><td>36.7</td><td>22</td><td>152</td><td>56</td><td></td><td></
td><td></td></tr><tr><td align='right'>K04.1</td><td>Necrosis of
pulp</td><td></td><td>PASIEN DATANG MAU CABUT GIGI </td><td
align='right'>2389</td><td
align='right'>06000014</td><td>11-05-2023</td><td>WAHYONO</td><td></td><td></
td><td>'085156178424</td><td>15-01-1993</td><td>SANGGAR RT 01 RW
07</td><td>SANGGAR</td><td>BATUR</td><td>PUSKESMAS INDUK</td><td>drg.Ade
Indranila</td><td> - </td><td>L</td><td>20-44
Thn.</td><td>Keluarga</td><td>Lama</td><td>BPJS PBI</td><td>Rajal</td><td
align='right'>26</td><td align='right'>3</td><td align='right'>30</td><td>BP.
Gigi</td><td></td><td></td><td>Dalam
Wilayah</td><td>'0001027419614</td><td>'3322011501930001</td><td>117</td><td>80</
td><td>80</td><td>36</td><td>24</td><td>157</td><td>56</td><td></td><td></
td><td>EXO LIDO GIGI 4.7 gp
INFILTRASI TANPA KOMPK=LIKASI </td></tr><tr><td align='right'>I64</td><td>Stroke,
not specified as haemorrhage or infarction</td><td></td><td>KONTROL</td><td
align='right'>2361</td><td
align='right'>1025541</td><td>11-05-2023</td><td>WAIDI</td><td></td><td></
td><td>'</td><td>16-01-1963</td><td>NGRAWAN RT 02 RW
01</td><td></td><td>NGRAWAN</td><td>PUSKESMAS INDUK</td><td>dr.Arninta Rahma
Khoirunnisa</td><td>Riska Wulandari,A.Md.Kep</td><td>L</td><td>60-69
Thn.</td><td>Keluarga</td><td>Lama</td><td>BPJS PBI</td><td>Rujuk</td><td
align='right'>25</td><td align='right'>3</td><td align='right'>60</td><td>BP.
Umum</td><td>Saraf</td><td>RS DR.ASMIR SALATIGA</td><td>Dalam
Wilayah</td><td>'0000601337834</td><td>'3322011601630000</td><td>173</td><td>103</
td><td>88</td><td>36.5</td><td>23</td><td>161</td><td>80</td><td></td><td></
td><td></td></tr><tr><td align='right'>M79.1</td><td>Myalgia</td><td></td><td>KAKI
KEMENG-KEMENG, BATUK, PILEK</td><td align='right'>2375</td><td
align='right'>1010221</td><td>11-05-2023</td><td>WASITO
WASIDI</td><td></td><td></td><td>'</td><td>18-04-1952</td><td>BANARAN RT 4 RW
2</td><td></td><td>WATES</td><td>PUSKESMAS INDUK</td><td>dr.Arninta Rahma
Khoirunnisa</td><td>Riska Wulandari,A.Md.Kep</td><td>L</td><td>>70
Thn.</td><td>Keluarga</td><td>Lama</td><td>BPJS NON PBI</td><td>Rajal</td><td
align='right'>23</td><td align='right'></td><td align='right'>71</td><td>BP.
Umum</td><td></td><td></td><td>Dalam
Wilayah</td><td>'0002434099116</td><td>'3322011804520002</td><td>140</td><td>110</
td><td>80</td><td>36.8</td><td>22</td><td>160</td><td>62</td><td></td><td></
td><td></td></tr><tr><td align='right'>M79.1</td><td>Myalgia</td><td></td><td>KAKI
KESEMUTAN</td><td align='right'>2377</td><td align='right'>1003845</td><td>11-05-
2023</td><td>YARMINI</td><td></td><td></td><td>'</td><td>16-04-1976</td><td>PIJI RT
09 RW 05</td><td></td><td>GETASAN</td><td>PUSKESMAS INDUK</td><td>dr.Arninta Rahma
Khoirunnisa</td><td>Riska Wulandari,A.Md.Kep</td><td>P</td><td>45-54
Thn.</td><td>Keluarga</td><td>Lama</td><td>BPJS NON PBI</td><td>Rajal</td><td
align='right'>25</td><td align='right'></td><td align='right'>47</td><td>BP.
Umum</td><td></td><td></td><td>Dalam
Wilayah</td><td>'0001899084194</td><td>'3322015604760001</td><td>110</td><td>70</
td><td>88</td><td>36.5</td><td>22</td><td>150</td><td>60</td><td></td><td></
td><td></td></tr><tr><td align='right'>K00.6</td><td>Disturbances in tooth
eruption</td><td></td><td>pasien datang dengan keluhan ingin cabut gigi</td><td
align='right'>2428</td><td align='right'>1003258</td><td>12-05-2023</td><td>AFZA
KHAIREEN NADIFAH</td><td></td><td></td><td>'</td><td>24-07-2015</td><td>PLALAR RT
02/04</td><td></td><td>KOPENG</td><td>PUSKESMAS INDUK</td><td>drg.Ade
Indranila</td><td>Maulida Rahma K N,A.Md.KG</td><td>P</td><td>5-9
Thn.</td><td>Keluarga</td><td>Lama</td><td>Umum</td><td>Rajal</td><td
align='right'>18</td><td align='right'>9</td><td align='right'>7</td><td>BP.
Gigi</td><td></td><td></td><td>Dalam
Wilayah</td><td>'</td><td>'</td><td>100</td><td>70</td><td>87</td><td>36.2</
td><td>22</td><td>120</td><td>23</td><td></td><td></td><td></td></tr><tr><td
align='right'>K05.1</td><td>Chronic gingivitis</td><td></td><td>pasien datang
dengan keluhan ingin membersihkan karang gigi</td><td align='right'>2411</td><td
align='right'>90000105</td><td>12-05-2023</td><td>ALBERTUS BUDIONO
PRAJITNO</td><td></td><td></td><td>'085225026000</td><td>24-04-1971</td><td>JL
PATIMURA NO 96 RT 4 RW 7</td><td></td><td>Luar Wilayah</td><td>PUSKESMAS
INDUK</td><td>drg.Ade Indranila</td><td>drg.Ade Indranila</td><td>L</td><td>45-54
Thn.</td><td>Keluarga</td><td>Baru</td><td>BPJS NON PBI</td><td>Rajal</td><td
align='right'>18</td><td align='right'>0</td><td align='right'>52</td><td>BP.
Gigi</td><td></td><td></td><td>Luar
Wilayah</td><td>'0002626925758</td><td>'3373012404710001</td><td>135</td><td>87</
td><td>89</td><td>36.2</td><td>22</td><td>170</td><td>76</td><td></td><td></
td><td>scaling</td></tr><tr><td align='right'>G51</td><td>Facial nerve
disorders</td><td></td><td></td><td align='right'>2418</td><td
align='right'>1011588</td><td>12-05-2023</td><td>ALFI
SUSANTI</td><td></td><td></td><td>'</td><td>01-10-2004</td><td>TANON RT
12/01</td><td>TANON</td><td>NGRAWAN</td><td>PUSKESMAS INDUK</td><td>dr.Arninta
Rahma Khoirunnisa</td><td>Suwoto,A.Md.Kep</td><td>P</td><td>15-19
Thn.</td><td>Keluarga</td><td>Lama</td><td>BPJS PBI</td><td>Rujuk</td><td
align='right'>11</td><td align='right'>7</td><td align='right'>18</td><td>BP.
Umum</td><td></td><td></td><td>Dalam
Wilayah</td><td>'0000602644667</td><td>'3322016210040001</td><td>100</td><td>67</
td><td>87</td><td>36.5</td><td>20</td><td>156</td><td>48</td><td></td><td></
td><td></td></tr><tr><td align='right'>G51.0</td><td>Bell's
palsy</td><td></td><td></td><td align='right'>2418</td><td
align='right'>1011588</td><td>12-05-2023</td><td>ALFI
SUSANTI</td><td></td><td></td><td>'</td><td>01-10-2004</td><td>TANON RT
12/01</td><td>TANON</td><td>NGRAWAN</td><td>PUSKESMAS INDUK</td><td>dr.Arninta
Rahma Khoirunnisa</td><td>Suwoto,A.Md.Kep</td><td>P</td><td>15-19
Thn.</td><td>Keluarga</td><td>Lama</td><td>BPJS PBI</td><td>Rujuk</td><td
align='right'>11</td><td align='right'>7</td><td align='right'>18</td><td>BP.
Umum</td><td></td><td></td><td>Dalam
Wilayah</td><td>'0000602644667</td><td>'3322016210040001</td><td>100</td><td>67</
td><td>87</td><td>36.5</td><td>20</td><td>156</td><td>48</td><td></td><td></
td><td></td></tr><tr><td align='right'>G52</td><td>Disorders of other cranial
nerves</td><td></td><td></td><td align='right'>2418</td><td
align='right'>1011588</td><td>12-05-2023</td><td>ALFI
SUSANTI</td><td></td><td></td><td>'</td><td>01-10-2004</td><td>TANON RT
12/01</td><td>TANON</td><td>NGRAWAN</td><td>PUSKESMAS INDUK</td><td>dr.Arninta
Rahma Khoirunnisa</td><td>Suwoto,A.Md.Kep</td><td>P</td><td>15-19
Thn.</td><td>Keluarga</td><td>Lama</td><td>BPJS PBI</td><td>Rujuk</td><td
align='right'>11</td><td align='right'>7</td><td align='right'>18</td><td>BP.
Umum</td><td></td><td></td><td>Dalam
Wilayah</td><td>'0000602644667</td><td>'3322016210040001</td><td>100</td><td>67</
td><td>87</td><td>36.5</td><td>20</td><td>156</td><td>48</td><td></td><td></
td><td></td></tr><tr><td align='right'>G54.9</td><td>Nerve root and plexus
disorder, unspecified</td><td></td><td></td><td align='right'>2418</td><td
align='right'>1011588</td><td>12-05-2023</td><td>ALFI
SUSANTI</td><td></td><td></td><td>'</td><td>01-10-2004</td><td>TANON RT
12/01</td><td>TANON</td><td>NGRAWAN</td><td>PUSKESMAS INDUK</td><td>dr.Arninta
Rahma Khoirunnisa</td><td>Suwoto,A.Md.Kep</td><td>P</td><td>15-19
Thn.</td><td>Keluarga</td><td>Lama</td><td>BPJS PBI</td><td>Rujuk</td><td
align='right'>11</td><td align='right'>7</td><td align='right'>18</td><td>BP.
Umum</td><td></td><td></td><td>Dalam
Wilayah</td><td>'0000602644667</td><td>'3322016210040001</td><td>100</td><td>67</
td><td>87</td><td>36.5</td><td>20</td><td>156</td><td>48</td><td></td><td></
td><td></td></tr><tr><td align='right'>G54</td><td>Nerve root and plexus
disorders</td><td></td><td></td><td align='right'>2418</td><td
align='right'>1011588</td><td>12-05-2023</td><td>ALFI
SUSANTI</td><td></td><td></td><td>'</td><td>01-10-2004</td><td>TANON RT
12/01</td><td>TANON</td><td>NGRAWAN</td><td>PUSKESMAS INDUK</td><td>dr.Arninta
Rahma Khoirunnisa</td><td>Suwoto,A.Md.Kep</td><td>P</td><td>15-19
Thn.</td><td>Keluarga</td><td>Lama</td><td>BPJS PBI</td><td>Rujuk</td><td
align='right'>11</td><td align='right'>7</td><td align='right'>18</td><td>BP.
Umum</td><td></td><td></td><td>Dalam
Wilayah</td><td>'0000602644667</td><td>'3322016210040001</td><td>100</td><td>67</
td><td>87</td><td>36.5</td><td>20</td><td>156</td><td>48</td><td></td><td></
td><td></td></tr><tr><td align='right'>G50</td><td>Disorders of trigeminal
nerve</td><td></td><td></td><td align='right'>2418</td><td
align='right'>1011588</td><td>12-05-2023</td><td>ALFI
SUSANTI</td><td></td><td></td><td>'</td><td>01-10-2004</td><td>TANON RT
12/01</td><td>TANON</td><td>NGRAWAN</td><td>PUSKESMAS INDUK</td><td>dr.Arninta
Rahma Khoirunnisa</td><td>Suwoto,A.Md.Kep</td><td>P</td><td>15-19
Thn.</td><td>Keluarga</td><td>Lama</td><td>BPJS PBI</td><td>Rujuk</td><td
align='right'>11</td><td align='right'>7</td><td align='right'>18</td><td>BP.
Umum</td><td></td><td></td><td>Dalam
Wilayah</td><td>'0000602644667</td><td>'3322016210040001</td><td>100</td><td>67</
td><td>87</td><td>36.5</td><td>20</td><td>156</td><td>48</td><td></td><td></
td><td></td></tr><tr><td align='right'>G50.9</td><td>Disorder of trigeminal nerve,
unspecified</td><td></td><td></td><td align='right'>2418</td><td
align='right'>1011588</td><td>12-05-2023</td><td>ALFI
SUSANTI</td><td></td><td></td><td>'</td><td>01-10-2004</td><td>TANON RT
12/01</td><td>TANON</td><td>NGRAWAN</td><td>PUSKESMAS INDUK</td><td>dr.Arninta
Rahma Khoirunnisa</td><td>Suwoto,A.Md.Kep</td><td>P</td><td>15-19
Thn.</td><td>Keluarga</td><td>Lama</td><td>BPJS PBI</td><td>Rujuk</td><td
align='right'>11</td><td align='right'>7</td><td align='right'>18</td><td>BP.
Umum</td><td></td><td></td><td>Dalam
Wilayah</td><td>'0000602644667</td><td>'3322016210040001</td><td>100</td><td>67</
td><td>87</td><td>36.5</td><td>20</td><td>156</td><td>48</td><td></td><td></
td><td></td></tr><tr><td align='right'>M79.2</td><td>Neuralgia and neuritis,
unspecified</td><td></td><td></td><td align='right'>2418</td><td
align='right'>1011588</td><td>12-05-2023</td><td>ALFI
SUSANTI</td><td></td><td></td><td>'</td><td>01-10-2004</td><td>TANON RT
12/01</td><td>TANON</td><td>NGRAWAN</td><td>PUSKESMAS INDUK</td><td>dr.Arninta
Rahma Khoirunnisa</td><td>Suwoto,A.Md.Kep</td><td>P</td><td>15-19
Thn.</td><td>Keluarga</td><td>Lama</td><td>BPJS PBI</td><td>Rujuk</td><td
align='right'>11</td><td align='right'>7</td><td align='right'>18</td><td>BP.
Umum</td><td></td><td></td><td>Dalam
Wilayah</td><td>'0000602644667</td><td>'3322016210040001</td><td>100</td><td>67</
td><td>87</td><td>36.5</td><td>20</td><td>156</td><td>48</td><td></td><td></
td><td></td>
</tr><tr><td align='right'>G62</td><td>Other
polyneuropathies</td><td></td><td></td><td align='right'>2418</td><td
align='right'>1011588</td><td>12-05-2023</td><td>ALFI
SUSANTI</td><td></td><td></td><td>'</td><td>01-10-2004</td><td>TANON RT
12/01</td><td>TANON</td><td>NGRAWAN</td><td>PUSKESMAS INDUK</td><td>dr.Arninta
Rahma Khoirunnisa</td><td>Suwoto,A.Md.Kep</td><td>P</td><td>15-19
Thn.</td><td>Keluarga</td><td>Lama</td><td>BPJS PBI</td><td>Rujuk</td><td
align='right'>11</td><td align='right'>7</td><td align='right'>18</td><td>BP.
Umum</td><td></td><td></td><td>Dalam
Wilayah</td><td>'0000602644667</td><td>'3322016210040001</td><td>100</td><td>67</
td><td>87</td><td>36.5</td><td>20</td><td>156</td><td>48</td><td></td><td></
td><td></td></tr><tr><td align='right'>G62.9</td><td>Polyneuropathy,
unspecified</td><td></td><td></td><td align='right'>2418</td><td
align='right'>1011588</td><td>12-05-2023</td><td>ALFI
SUSANTI</td><td></td><td></td><td>'</td><td>01-10-2004</td><td>TANON RT
12/01</td><td>TANON</td><td>NGRAWAN</td><td>PUSKESMAS INDUK</td><td>dr.Arninta
Rahma Khoirunnisa</td><td>Suwoto,A.Md.Kep</td><td>P</td><td>15-19
Thn.</td><td>Keluarga</td><td>Lama</td><td>BPJS PBI</td><td>Rujuk</td><td
align='right'>11</td><td align='right'>7</td><td align='right'>18</td><td>BP.
Umum</td><td></td><td></td><td>Dalam
Wilayah</td><td>'0000602644667</td><td>'3322016210040001</td><td>100</td><td>67</
td><td>87</td><td>36.5</td><td>20</td><td>156</td><td>48</td><td></td><td></
td><td></td></tr><tr><td align='right'>G51.9</td><td>Disorder of facial nerve,
unspecified</td><td></td><td></td><td align='right'>2418</td><td
align='right'>1011588</td><td>12-05-2023</td><td>ALFI
SUSANTI</td><td></td><td></td><td>'</td><td>01-10-2004</td><td>TANON RT
12/01</td><td>TANON</td><td>NGRAWAN</td><td>PUSKESMAS INDUK</td><td>dr.Arninta
Rahma Khoirunnisa</td><td>Suwoto,A.Md.Kep</td><td>P</td><td>15-19
Thn.</td><td>Keluarga</td><td>Lama</td><td>BPJS PBI</td><td>Rujuk</td><td
align='right'>11</td><td align='right'>7</td><td align='right'>18</td><td>BP.
Umum</td><td></td><td></td><td>Dalam
Wilayah</td><td>'0000602644667</td><td>'3322016210040001</td><td>100</td><td>67</
td><td>87</td><td>36.5</td><td>20</td><td>156</td><td>48</td><td></td><td></
td><td></td></tr><tr><td align='right'>G50.1</td><td>Atypical facial
pain</td><td></td><td></td><td align='right'>2418</td><td
align='right'>1011588</td><td>12-05-2023</td><td>ALFI
SUSANTI</td><td></td><td></td><td>'</td><td>01-10-2004</td><td>TANON RT
12/01</td><td>TANON</td><td>NGRAWAN</td><td>PUSKESMAS INDUK</td><td>dr.Arninta
Rahma Khoirunnisa</td><td>Suwoto,A.Md.Kep</td><td>P</td><td>15-19
Thn.</td><td>Keluarga</td><td>Lama</td><td>BPJS PBI</td><td>Rujuk</td><td
align='right'>11</td><td align='right'>7</td><td align='right'>18</td><td>BP.
Umum</td><td></td><td></td><td>Dalam
Wilayah</td><td>'0000602644667</td><td>'3322016210040001</td><td>100</td><td>67</
td><td>87</td><td>36.5</td><td>20</td><td>156</td><td>48</td><td></td><td></
td><td></td></tr><tr><td align='right'>G52.1</td><td>Disorders of glossopharyngeal
nerve</td><td></td><td></td><td align='right'>2418</td><td
align='right'>1011588</td><td>12-05-2023</td><td>ALFI
SUSANTI</td><td></td><td></td><td>'</td><td>01-10-2004</td><td>TANON RT
12/01</td><td>TANON</td><td>NGRAWAN</td><td>PUSKESMAS INDUK</td><td>dr.Arninta
Rahma Khoirunnisa</td><td>Suwoto,A.Md.Kep</td><td>P</td><td>15-19
Thn.</td><td>Keluarga</td><td>Lama</td><td>BPJS PBI</td><td>Rujuk</td><td
align='right'>11</td><td align='right'>7</td><td align='right'>18</td><td>BP.
Umum</td><td></td><td></td><td>Dalam
Wilayah</td><td>'0000602644667</td><td>'3322016210040001</td><td>100</td><td>67</
td><td>87</td><td>36.5</td><td>20</td><td>156</td><td>48</td><td></td><td></
td><td></td></tr><tr><td align='right'>S04.5</td><td>Injury of facial
nerve</td><td></td><td></td><td align='right'>2418</td><td
align='right'>1011588</td><td>12-05-2023</td><td>ALFI
SUSANTI</td><td></td><td></td><td>'</td><td>01-10-2004</td><td>TANON RT
12/01</td><td>TANON</td><td>NGRAWAN</td><td>PUSKESMAS INDUK</td><td>dr.Arninta
Rahma Khoirunnisa</td><td>Suwoto,A.Md.Kep</td><td>P</td><td>15-19
Thn.</td><td>Keluarga</td><td>Lama</td><td>BPJS PBI</td><td>Rujuk</td><td
align='right'>11</td><td align='right'>7</td><td align='right'>18</td><td>BP.
Umum</td><td></td><td></td><td>Dalam
Wilayah</td><td>'0000602644667</td><td>'3322016210040001</td><td>100</td><td>67</
td><td>87</td><td>36.5</td><td>20</td><td>156</td><td>48</td><td></td><td></
td><td></td></tr><tr><td
align='right'>K04.0</td><td>Pulpitis</td><td></td><td>pasein datang dengan keluhan
gigi sakit </td><td align='right'>2401</td><td align='right'>1009694</td><td>12-05-
2023</td><td>ASYILA NASYA
MAULIDHA</td><td></td><td></td><td>'085601588546</td><td>08-01-2018</td><td>BATUR
KIDUL RT 01/14</td><td></td><td>BATUR</td><td>PUSKESMAS INDUK</td><td>drg.Ade
Indranila</td><td> - </td><td>P</td><td>5-9
Thn.</td><td>Keluarga</td><td>Lama</td><td>BPJS NON PBI</td><td>Rajal</td><td
align='right'>4</td><td align='right'>4</td><td align='right'>5</td><td>BP.
Gigi</td><td></td><td></td><td>Dalam
Wilayah</td><td>'0002420263653</td><td>'3322014801180000</td><td>100</td><td>60</
td><td>88</td><td>36</td><td>24</td><td>135</td><td>23</td><td></td><td></
td><td></td></tr><tr><td align='right'>K00.6</td><td>Disturbances in tooth
eruption</td><td></td><td>pasien datang dengan keluhan ingin cabut gigi</td><td
align='right'>2427</td><td align='right'>1018874</td><td>12-05-2023</td><td>DAFFA
HAFISUDIN AZKA</td><td></td><td></td><td>'</td><td>27-01-2016</td><td>SLEKER RT 08
RW 03</td><td></td><td>KOPENG</td><td>PUSKESMAS INDUK</td><td>drg.Ade
Indranila</td><td>drg.Ade Indranila</td><td>P</td><td>5-9
Thn.</td><td>Keluarga</td><td>Lama</td><td>BPJS PBI</td><td>Rajal</td><td
align='right'>15</td><td align='right'>3</td><td align='right'>7</td><td>BP.
Gigi</td><td></td><td></td><td>Dalam
Wilayah</td><td>'0003142245925</td><td>'3322012701160000</td><td>100</td><td>70</
td><td>78</td><td>36.2</td><td>22</td><td>132</td><td>29</td><td></td><td></
td><td>exo gigi susu</td></tr><tr><td align='right'>H60</td><td>Otitis
externa</td><td></td><td></td><td align='right'>2396</td><td
align='right'>02000036</td><td>12-05-2023</td><td>DEWI NUR
ANNISA</td><td></td><td></td><td>'</td><td>18-12-2005</td><td>KEDAYON RT 12 RW 1
</td><td></td><td>WATES</td><td>PUSKESMAS INDUK</td><td>dr.Arninta Rahma
Khoirunnisa</td><td>Suwoto,A.Md.Kep</td><td>P</td><td>15-19
Thn.</td><td>Keluarga</td><td>Baru</td><td>BPJS PBI</td><td>Rajal</td><td
align='right'>25</td><td align='right'>4</td><td align='right'>17</td><td>BP.
Umum</td><td></td><td></td><td>Dalam
Wilayah</td><td>'0001027442902</td><td>'3322015812050005</td><td>120</td><td>70</
td><td>87</td><td>36.5</td><td>20</td><td>155</td><td>50</td><td></td><td></
td><td></td></tr><tr><td align='right'>K08.3</td><td>Retained dental
root</td><td></td><td>pasei datang untuk kontrol gigi </td><td
align='right'>2397</td><td align='right'>1022402</td><td>12-05-2023</td><td>DINA
KARTINI ALS KARTINI</td><td></td><td></td><td>'</td><td>07-07-1970</td><td>KOPENG
RT 03 RW 02</td><td></td><td>GETASAN</td><td>PUSKESMAS INDUK</td><td>drg.Ade
Indranila</td><td> - </td><td>P</td><td>45-54
Thn.</td><td>Keluarga</td><td>Lama</td><td>BPJS NON PBI</td><td>Rajal</td><td
align='right'>5</td><td align='right'>10</td><td align='right'>52</td><td>BP.
Gigi</td><td></td><td></td><td>Dalam
Wilayah</td><td>'0001839782193</td><td>'3322015203930000</td><td>139</td><td>82</
td><td>80</td><td>36</td><td>24</td><td>155</td><td>52</td><td></td><td></
td><td></td></tr><tr><td align='right'>K05</td><td>Gingivitis and periodontal
diseases</td><td></td><td>pasei datang untuk kontrol gigi </td><td
align='right'>2397</td><td align='right'>1022402</td><td>12-05-2023</td><td>DINA
KARTINI ALS KARTINI</td><td></td><td></td><td>'</td><td>07-07-1970</td><td>KOPENG
RT 03 RW 02</td><td></td><td>GETASAN</td><td>PUSKESMAS INDUK</td><td>drg.Ade
Indranila</td><td> - </td><td>P</td><td>45-54
Thn.</td><td>Keluarga</td><td>Lama</td><td>BPJS NON PBI</td><td>Rajal</td><td
align='right'>5</td><td align='right'>10</td><td align='right'>52</td><td>BP.
Gigi</td><td></td><td></td><td>Dalam
Wilayah</td><td>'0001839782193</td><td>'3322015203930000</td><td>139</td><td>82</
td><td>80</td><td>36</td><td>24</td><td>155</td><td>52</td><td></td><td></
td><td></td></tr><tr><td align='right'>Z35.8</td><td>Supervision of other high-risk
pregnancies</td><td></td><td>periksa hamil dan cek lab</td><td
align='right'>2405</td><td align='right'>1008392</td><td>12-05-2023</td><td>ENI
MAHMUDAH</td><td></td><td></td><td>'</td><td>25-06-1995</td><td>REJOSARI RT 01 RW
10</td><td></td><td>BATUR</td><td>PUSKESMAS INDUK</td><td>dr.Steven Budi
Setiawan</td><td>Wiwik Arditarini,A.Md.Keb</td><td>P</td><td>20-44
Thn.</td><td>Keluarga</td><td>Lama</td><td>BPJS NON PBI</td><td>Rujuk</td><td
align='right'>17</td><td align='right'>10</td><td
align='right'>27</td><td>KIA</td><td>obgyn</td><td>RS PURI ASIH
SALATIGA</td><td>Dalam
Wilayah</td><td>'0002419278096</td><td>'3322016506950000</td><td>90</td><td>70</
td><td>88</td><td>36</td><td>22</td><td>130</td><td>38</td><td></td><td>kolab dg
dr.SpoG</td><td></td></tr><tr><td align='right'>J06</td><td>Acute upper respiratory
infections of multiple and unspecified sites</td><td></td><td></td><td
align='right'>2422</td><td align='right'>1000160</td><td>12-05-2023</td><td>ERNA
YUNIYATI</td><td></td><td></td><td>'</td><td>03-06-2005</td><td>SLEKER RT 03 RW
03</td><td></td><td>KOPENG</td><td>PUSKESMAS INDUK</td><td>dr.Arninta Rahma
Khoirunnisa</td><td>Suwoto,A.Md.Kep</td><td>P</td><td>15-19
Thn.</td><td>Keluarga</td><td>Lama</td><td>BPJS PBI</td><td>Rajal</td><td
align='right'>9</td><td align='right'>11</td><td align='right'>17</td><td>BP.
Umum</td><td></td><td></td><td>Dalam
Wilayah</td><td>'0000602493175</td><td>'3322014306050001</td><td>90</td><td>70</
td><td>87</td><td>36.5</td><td>20</td><td>156</td><td>62</td><td></td><td></
td><td></td></tr><tr><td
align='right'>K01.1</td><td>Impacted teeth</td><td></td><td>pasien datang dengan
keluhan gigi bawah sakit</td><td align='right'>2419</td><td
align='right'>1000436</td><td>12-05-2023</td><td>GRACEA AUDRY
LESTARI</td><td>PASIDI</td><td></td><td>'</td><td>22-01-2011</td><td>KENDAL RT 06
RW 01</td><td></td><td>GETASAN</td><td>PUSKESMAS INDUK</td><td>drg.Ade
Indranila</td><td>Maulida Rahma K N,A.Md.KG</td><td>P</td><td>10-14
Thn.</td><td>Keluarga</td><td>Lama</td><td>Umum</td><td>Rajal</td><td
align='right'>20</td><td align='right'>3</td><td align='right'>12</td><td>BP.
Gigi</td><td></td><td></td><td>Dalam
Wilayah</td><td>'</td><td>'3322016201110003</td><td>100</td><td>70</td><td>98</
td><td>36.2</td><td>22</td><td>145</td><td>55</td><td></td><td>exo</
td><td>premedikasi</td></tr><tr><td align='right'>I63.9</td><td>Cerebral
infarction, unspecified</td><td></td><td>kontrol</td><td align='right'>2395</td><td
align='right'>1025456</td><td>12-05-2023</td><td>HERY
PRAMONO</td><td></td><td></td><td>'</td><td>18-03-1990</td><td>WATES RT 04 RW
01</td><td></td><td>WATES</td><td>PUSKESMAS INDUK</td><td>dr.Arninta Rahma
Khoirunnisa</td><td>Suwoto,A.Md.Kep</td><td>L</td><td>20-44
Thn.</td><td>Keluarga</td><td>Lama</td><td>BPJS PBI</td><td>Rujuk</td><td
align='right'>24</td><td align='right'>1</td><td align='right'>33</td><td>BP.
Umum</td><td>Saraf</td><td>RS DR.ASMIR SALATIGA</td><td>Dalam
Wilayah</td><td>'0002485946992</td><td>'3322011803900000</td><td>110</td><td>70</
td><td>80</td><td>36.5</td><td>24</td><td>168</td><td>72</td><td></td><td></
td><td></td></tr><tr><td align='right'>Z34.8</td><td>Supervision of other normal
pregnancy</td><td></td><td>ingin periksa kehamilan dan cek lab</td><td
align='right'>2406</td><td align='right'>1025376</td><td>12-05-2023</td><td>HILDA
ROHMAH SETYOWATI</td><td>EKO
YULIANTO</td><td></td><td>'</td><td>17-11-2001</td><td>NGRAWAN RT 05 RW
01</td><td>NGRAWAN</td><td>NGRAWAN</td><td>PUSKESMAS INDUK</td><td>dr.Steven Budi
Setiawan</td><td>Wiwik Arditarini,A.Md.Keb</td><td>P</td><td>20-44
Thn.</td><td>Keluarga</td><td>Lama</td><td>BPJS NON PBI</td><td>Rajal</td><td
align='right'>25</td><td align='right'>5</td><td
align='right'>21</td><td>KIA</td><td></td><td></td><td>Dalam
Wilayah</td><td>'0001090295752</td><td>'3373015711010002</td><td>120</td><td>80</
td><td>82</td><td>37</td><td>25</td><td>158</td><td>55</td><td>Tdk
Th</td><td>periksa rutin</td><td>-</td></tr><tr><td
align='right'>R10</td><td>Abdominal and pelvic pain</td><td></td><td></td><td
align='right'>2426</td><td
align='right'>01000049</td><td>12-05-2023</td><td>JASMAN</td><td></td><td></
td><td>'</td><td>06-09-1954</td><td>NGROTO RT 8 RW
5</td><td></td><td>GETASAN</td><td>PUSKESMAS INDUK</td><td>dr.Arninta Rahma
Khoirunnisa</td><td>Suwoto,A.Md.Kep</td><td>L</td><td>60-69
Thn.</td><td>Keluarga</td><td>Lama</td><td>BPJS PBI</td><td>Rajal</td><td
align='right'>6</td><td align='right'>8</td><td align='right'>68</td><td>BP.
Umum</td><td></td><td></td><td>Dalam
Wilayah</td><td>'0000601313049</td><td>'3322010609540001</td><td>120</td><td>95</
td><td>87</td><td>37</td><td>23</td><td>163</td><td>56</td><td></td><td></
td><td></td></tr><tr><td align='right'>J06</td><td>Acute upper respiratory
infections of multiple and unspecified sites</td><td></td><td></td><td
align='right'>2410</td><td align='right'>1011750</td><td>12-05-2023</td><td>JULIANA
NOFA SIBURIAN</td><td></td><td></td><td>'</td><td>03-07-1983</td><td>BUMIAYU RT 02
RW 04 SUMOGAWE</td><td></td><td>Luar Wilayah</td><td>PUSKESMAS
INDUK</td><td>dr.Arninta Rahma
Khoirunnisa</td><td>Suwoto,A.Md.Kep</td><td>P</td><td>20-44
Thn.</td><td>Keluarga</td><td>Lama</td><td>BPJS NON PBI</td><td>Rajal</td><td
align='right'>9</td><td align='right'>10</td><td align='right'>39</td><td>BP.
Umum</td><td></td><td></td><td>Luar
Wilayah</td><td>'0002376415552</td><td>'3171044307830005</td><td>130</td><td>80</
td><td>83</td><td>36.5</td><td>22</td><td>163</td><td>65</td><td></td><td></
td><td></td></tr><tr><td align='right'>K25</td><td>Gastric
ulcer</td><td></td><td></td><td align='right'>2421</td><td
align='right'>1000828</td><td>12-05-2023</td><td>JUMIAH</td><td></td><td></
td><td>'</td><td>12-10-1975</td><td>SLEKER RT 03 RW
03</td><td>SLEKER</td><td>KOPENG</td><td>PUSKESMAS INDUK</td><td>dr.Arninta Rahma
Khoirunnisa</td><td>Suwoto,A.Md.Kep</td><td>P</td><td>45-54
Thn.</td><td>Keluarga</td><td>Lama</td><td>BPJS PBI</td><td>Rajal</td><td
align='right'></td><td align='right'>7</td><td align='right'>47</td><td>BP.
Umum</td><td></td><td></td><td>Dalam
Wilayah</td><td>'0000602492512</td><td>'3322015210750004</td><td>110</td><td>70</
td><td>88</td><td>36.5</td><td>23</td><td>155</td><td>56</td><td></td><td></
td><td></td></tr><tr><td align='right'>M79</td><td>Other soft tissue disorders, not
elsewhere classified</td><td></td><td></td><td align='right'>2415</td><td
align='right'>08000011</td><td>12-05-2023</td><td>KASINI</td><td></td><td></
td><td>'</td><td>31-12-1953</td><td>NOGOSAREN RT 1 RW 1
</td><td></td><td>NOGOSAREN</td><td>PUSKESMAS INDUK</td><td>dr.Arninta Rahma
Khoirunnisa</td><td>Suwoto,A.Md.Kep</td><td>P</td><td>60-69
Thn.</td><td>Keluarga</td><td>Baru</td><td>BPJS NON PBI</td><td>Rajal</td><td
align='right'>12</td><td align='right'>4</td><td align='right'>69</td><td>BP.
Umum</td><td></td><td></td><td>Dalam
Wilayah</td><td>'0003138268149</td><td>'3322017112530069</td><td>129</td><td>95</
td><td>87</td><td>36.5</td><td>20</td><td>156</td><td>62</td><td></td><td></
td><td></td></tr><tr><td align='right'>J06</td><td>Acute upper respiratory
infections of multiple and unspecified sites</td><td></td><td></td><td
align='right'>2420</td><td align='right'>1023914</td><td>12-05-2023</td><td>KHANZA
QONITA AZZAHRA</td><td></td><td></td><td>'</td><td>09-02-2017</td><td>WATES RT 03
RW 01</td><td>WATES</td><td>WATES</td><td>PUSKESMAS INDUK</td><td>dr.Arninta Rahma
Khoirunnisa</td><td>Suwoto,A.Md.Kep</td><td>P</td><td>5-9
Thn.</td><td>Keluarga</td><td>Lama</td><td>BPJS NON PBI</td><td>Rajal</td><td
align='right'>3</td><td align='right'>3</td><td align='right'>6</td><td>BP.
Umum</td><td></td><td></td><td>Dalam
Wilayah</td><td>'0003111258598</td><td>'3373034902170000</td><td>90</td><td>70</
td><td>87</td><td>36.5</td><td>24</td><td>134</td><td>37</td><td></td><td></
td><td></td></tr><tr><td align='right'>K01.1</td><td>Impacted
teeth</td><td></td><td>pasien datang dengan keluhan gigi bawah pojok sakit</td><td
align='right'>2407</td><td align='right'>1025460</td><td>12-05-2023</td><td>KRIS
SUNDARI</td><td></td><td></td><td>'081329448901</td><td>11-11-1993</td><td>GADING
LEGOK RT3/16 SAWANGAN MAGELANG</td><td></td><td>Luar kabupaten</td><td>PUSKESMAS
INDUK</td><td>drg.Ade Indranila</td><td>drg.Ade Indranila</td><td>P</td><td>20-44
Thn.</td><td>Keluarga</td><td>Lama</td><td>BPJS NON PBI</td><td>Rajal</td><td
align='right'>1</td><td align='right'>6</td><td align='right'>29</td><td>BP.
Gigi</td><td></td><td></td><td>Luar
Wilayah</td><td>'0001691290067</td><td>'3308175111930001</td><td>120</td><td>70</
td><td>98</td><td>36.2</td><td>22</td><td>155</td><td>58</td><td></td><td>pro
exo</td><td>premedikasi</td></tr><tr><td align='right'>K29</td><td>Gastritis and
duodenitis</td><td></td><td></td><td align='right'>2431</td><td
align='right'>01000051</td><td>12-05-2023</td><td>MUHAMMAD BAGUS
SETIAWAN</td><td></td><td>PELAJAR/MAHASISWA</td><td>'</td><td>27-10-2011</
td><td>SUMOGAWE RT 11 RW 1</td><td></td><td>GETASAN</td><td>PUSKESMAS
INDUK</td><td>dr.Arninta Rahma
Khoirunnisa</td><td>Suwoto,A.Md.Kep</td><td>L</td><td>10-14
Thn.</td><td>Keluarga</td><td>Baru</td><td>BPJS PBI</td><td>Rajal</td><td
align='right'>15</td><td align='right'>6</td><td align='right'>11</td><td>BP.
Umum</td><td></td><td></td><td>Dalam
Wilayah</td><td>'0001915927255</td><td>'</td><td>90</td><td>60</td><td>87</
td><td>37</td><td>20</td><td>140</td><td>37</td><td></td><td></td><td></td></
tr><tr><td align='right'>K25</td><td>Gastric ulcer</td><td></td><td></td><td
align='right'>2425</td><td
align='right'>90000106</td><td>12-05-2023</td><td>MUHAMMAD BONDAN
JATMIKO</td><td></td><td>KARYAWAN
SWASTA</td><td>'</td><td>14-11-1996</td><td>KRASAK SARI RT 6 RW 7
</td><td></td><td>Luar Wilayah</td><td>PUSKESMAS INDUK</td><td>dr.Arninta Rahma
Khoirunnisa</td><td>Suwoto,A.Md.Kep</td><td>L</td><td>20-44
Thn.</td><td>Keluarga</td><td>Baru</td><td>BPJS PBI</td><td>Rajal</td><td
align='right'>28</td><td align='right'>5</td><td align='right'>26</td><td>BP.
Umum</td><td></td><td></td><td>Luar
Wilayah</td><td>'0000601758865</td><td>'3322011411960001</td><td>110</td><td>80</
td><td>87</td><td>36.5</td><td>20</td><td>160</td><td>56</td><td></td><td></
td><td></td></tr><tr><td
align='right'>K30</td><td>Dyspepsia</td><td></td><td>mual , muntah</td><td
align='right'>2409</td><td
align='right'>1021749</td><td>12-05-2023</td><td>MUHAMMAD IBNU
MAS`UD</td><td></td><td></td><td>'</td><td>09-05-2021</td><td>SANGGAR RT 01 RW
07</td><td></td><td>BATUR</td><td>PUSKESMAS INDUK</td><td>dr.Arninta Rahma
Khoirunnisa</td><td>Sutini,A.Md.Keb</td><td>L</td><td>1-4
Thn.</td><td>Keluarga</td><td>Lama</td><td>BPJS PBI</td><td>Rajal</td><td
align='right'>3</td><td align='right'></td><td
align='right'>2</td><td>MTBS</td><td></td><td></td><td>Dalam
Wilayah</td><td>'0003089658611</td><td>'3322010905210001</td><td></td><td></
td><td>130</td><td>37</td><td>37</td><td>84</td><td>11</td><td></td><td>penkes
pemberian obat di rumah</td><td>mermberikan penkes cara pemberian obat di
rumah</td></tr><tr><td align='right'>K02.1</td><td>Caries of
dentine</td><td></td><td>pasien dfatrng dengan keluhan mau konrol gig </td><td
align='right'>2393</td><td
align='right'>1023481</td><td>12-05-2023</td><td>PAINI</td><td></td><td></
td><td>'</td><td>31-12-1953</td><td>MANGGIHARJO 5/1
</td><td></td><td>MANGGIHAN</td><td>PUSKESMAS INDUK</td><td>drg.Ade
Indranila</td><td>drg.Ade Indranila</td><td>P</td><td>60-69
Thn.</td><td>Keluarga</td><td>Lama</td><td>BPJS
PBI</td><td>Rajal</td><td align='right'>11</td><td align='right'>4</td><td
align='right'>69</td><td>BP. Gigi</td><td></td><td></td><td>Dalam
Wilayah</td><td>'0001483309214</td><td>'3322017112530070</td><td>135</td><td>87</
td><td>87</td><td>36.2</td><td>22</td><td>155</td><td>65</td><td></td><td>pro
exo</td><td>penambalan ketak molar</td></tr><tr><td
align='right'>G51.9</td><td>Disorder of facial nerve,
unspecified</td><td></td><td></td><td align='right'>2398</td><td
align='right'>1023979</td><td>12-05-2023</td><td>PARMI</td><td></td><td></
td><td>'</td><td>21-04-1963</td><td>JL.KALIMANTAN 75 RT 03 RW
07</td><td></td><td>Luar kabupaten</td><td>PUSKESMAS INDUK</td><td>dr.Arninta Rahma
Khoirunnisa</td><td>Suwoto,A.Md.Kep</td><td>P</td><td>60-69
Thn.</td><td>Keluarga</td><td>Lama</td><td>BPJS NON PBI</td><td>Rajal</td><td
align='right'>21</td><td align='right'></td><td align='right'>60</td><td>BP.
Umum</td><td></td><td></td><td>Luar
Wilayah</td><td>'0000075008788</td><td>'3373036104630001</td><td>164</td><td>79</
td><td>87</td><td>36.5</td><td>20</td><td>155</td><td>55</td><td></td><td></
td><td></td></tr><tr><td align='right'>E78</td><td>Disorders of lipoprotein
metabolism and other lipidaemias</td><td></td><td></td><td
align='right'>2398</td><td
align='right'>1023979</td><td>12-05-2023</td><td>PARMI</td><td></td><td></
td><td>'</td><td>21-04-1963</td><td>JL.KALIMANTAN 75 RT 03 RW
07</td><td></td><td>Luar kabupaten</td><td>PUSKESMAS INDUK</td><td>dr.Arninta Rahma
Khoirunnisa</td><td>Suwoto,A.Md.Kep</td><td>P</td><td>60-69
Thn.</td><td>Keluarga</td><td>Lama</td><td>BPJS NON PBI</td><td>Rajal</td><td
align='right'>21</td><td align='right'></td><td align='right'>60</td><td>BP.
Umum</td><td></td><td></td><td>Luar
Wilayah</td><td>'0000075008788</td><td>'3373036104630001</td><td>164</td><td>79</
td><td>87</td><td>36.5</td><td>20</td><td>155</td><td>55</td><td></td><td></
td><td></td></tr><tr><td align='right'>E78.0</td><td>Pure
hypercholesterolaemia</td><td></td><td></td><td align='right'>2398</td><td
align='right'>1023979</td><td>12-05-2023</td><td>PARMI</td><td></td><td></
td><td>'</td><td>21-04-1963</td><td>JL.KALIMANTAN 75 RT 03 RW
07</td><td></td><td>Luar kabupaten</td><td>PUSKESMAS INDUK</td><td>dr.Arninta Rahma
Khoirunnisa</td><td>Suwoto,A.Md.Kep</td><td>P</td><td>60-69
Thn.</td><td>Keluarga</td><td>Lama</td><td>BPJS NON PBI</td><td>Rajal</td><td
align='right'>21</td><td align='right'></td><td align='right'>60</td><td>BP.
Umum</td><td></td><td></td><td>Luar
Wilayah</td><td>'0000075008788</td><td>'3373036104630001</td><td>164</td><td>79</
td><td>87</td><td>36.5</td><td>20</td><td>155</td><td>55</td><td></td><td></
td><td></td></tr><tr><td align='right'>S01</td><td>Open wound of
head</td><td></td><td></td><td align='right'>2423</td><td
align='right'>1004243</td><td>12-05-2023</td><td>SARYANTO</td><td></td><td></
td><td>'</td><td>27-07-1989</td><td>PADAN RT.13
RW.2</td><td></td><td>NGRAWAN</td><td>PUSKESMAS INDUK</td><td>dr.Arninta Rahma
Khoirunnisa</td><td>Suwoto,A.Md.Kep</td><td>L</td><td>20-44
Thn.</td><td>Keluarga</td><td>Lama</td><td>BPJS NON PBI</td><td>Rajal</td><td
align='right'>15</td><td align='right'>9</td><td align='right'>33</td><td>BP.
Umum</td><td></td><td></td><td>Dalam
Wilayah</td><td>'0002041874122</td><td>'3322012707890001</td><td>110</td><td>80</
td><td>87</td><td>36.5</td><td>20</td><td>164</td><td>64</td><td></td><td></
td><td></td></tr><tr><td align='right'>S01.2</td><td>Open wound of
nose</td><td></td><td></td><td align='right'>2423</td><td
align='right'>1004243</td><td>12-05-2023</td><td>SARYANTO</td><td></td><td></
td><td>'</td><td>27-07-1989</td><td>PADAN RT.13
RW.2</td><td></td><td>NGRAWAN</td><td>PUSKESMAS INDUK</td><td>dr.Arninta Rahma
Khoirunnisa</td><td>Suwoto,A.Md.Kep</td><td>L</td><td>20-44
Thn.</td><td>Keluarga</td><td>Lama</td><td>BPJS NON PBI</td><td>Rajal</td><td
align='right'>15</td><td align='right'>9</td><td align='right'>33</td><td>BP.
Umum</td><td></td><td></td><td>Dalam
Wilayah</td><td>'0002041874122</td><td>'3322012707890001</td><td>110</td><td>80</
td><td>87</td><td>36.5</td><td>20</td><td>164</td><td>64</td><td></td><td></
td><td></td></tr><tr><td align='right'>S01.7</td><td>Multiple open wounds of
head</td><td></td><td></td><td align='right'>2423</td><td
align='right'>1004243</td><td>12-05-2023</td><td>SARYANTO</td><td></td><td></
td><td>'</td><td>27-07-1989</td><td>PADAN RT.13
RW.2</td><td></td><td>NGRAWAN</td><td>PUSKESMAS INDUK</td><td>dr.Arninta Rahma
Khoirunnisa</td><td>Suwoto,A.Md.Kep</td><td>L</td><td>20-44
Thn.</td><td>Keluarga</td><td>Lama</td><td>BPJS NON PBI</td><td>Rajal</td><td
align='right'>15</td><td align='right'>9</td><td align='right'>33</td><td>BP.
Umum</td><td></td><td></td><td>Dalam
Wilayah</td><td>'0002041874122</td><td>'3322012707890001</td><td>110</td><td>80</
td><td>87</td><td>36.5</td><td>20</td><td>164</td><td>64</td><td></td><td></
td><td></td></tr><tr><td align='right'>I50</td><td>Heart
failure</td><td></td><td></td><td align='right'>2399</td><td
align='right'>1021370</td><td>12-05-2023</td><td>SUMARJOKO</td><td></td><td></
td><td>'</td><td>12-12-1956</td><td>JL.KALIMANTAN 75 RT 03 RW
07</td><td></td><td>Luar Wilayah</td><td>PUSKESMAS INDUK</td><td>dr.Steven Budi
Setiawan</td><td>Retno Sri Hastuti,Amd.Kep</td><td>L</td><td>60-69
Thn.</td><td>Keluarga</td><td>Lama</td><td>BPJS NON PBI</td><td>Rujuk</td><td
align='right'></td><td align='right'>5</td><td align='right'>66</td><td>BP.
Umum</td><td>JANTUNG DAN PEMBULUH DARAH</td><td>RS PURI ASIH SALATIGA</td><td>Luar
Wilayah</td><td>'0000075008799</td><td>'3373031212560000</td><td>160</td><td>65</
td><td>83</td><td>36.5</td><td>20</td><td>165</td><td>65</td><td></td><td></
td><td></td></tr><tr><td align='right'>J06</td><td>Acute upper respiratory
infections of multiple and unspecified sites</td><td></td><td></td><td
align='right'>2429</td><td
align='right'>06000051</td><td>12-05-2023</td><td>SURADI</td><td></td><td></
td><td>'</td><td>31-12-1972</td><td>KRANGKENG RT 1 RW
12</td><td></td><td>BATUR</td><td>PUSKESMAS INDUK</td><td>dr.Arninta Rahma
Khoirunnisa</td><td>Suwoto,A.Md.Kep</td><td>L</td><td>45-54
Thn.</td><td>Keluarga</td><td>Baru</td><td>Umum</td><td>Rajal</td><td
align='right'>12</td><td align='right'>4</td><td align='right'>50</td><td>BP.
Umum</td><td></td><td></td><td>Dalam
Wilayah</td><td>'</td><td>'</td><td>120</td><td>88</td><td>87</td><td>36.5</
td><td>22</td><td>150</td><td>55</td><td></td><td></td><td></td></tr><tr><td
align='right'>J06</td><td>Acute upper respiratory infections of multiple and
unspecified sites</td><td></td><td></td><td align='right'>2392</td><td
align='right'>1007283</td><td>12-05-2023</td><td>SUTARMI</td><td></td><td></
td><td>'</td><td>26-01-1979</td><td>KEBONAN RT.7
RW.1</td><td></td><td>TOLOKAN</td><td>PUSKESMAS INDUK</td><td>dr.Arninta Rahma
Khoirunnisa</td><td>Suwoto,A.Md.Kep</td><td>P</td><td>20-44
Thn.</td><td>Keluarga</td><td>Lama</td><td>BPJS PBI</td><td>Rajal</td><td
align='right'>16</td><td align='right'>3</td><td align='right'>44</td><td>BP.
Umum</td><td></td><td></td><td>Dalam
Wilayah</td><td>'0000602067521</td><td>'3322016601790000</td><td>100</td><td>60</
td><td>87</td><td>36.5</td><td>20</td><td>148</td><td>39</td><td></td><td></
td><td></td></tr><tr><td align='right'>I50</td><td>Heart
failure</td><td></td><td>kontrol</td><td align='right'>2394</td><td
align='right'>1021634</td><td>12-05-2023</td><td>TRIMO</td><td></td><td></
td><td>'</td><td>06-06-1979</td><td>KEDAYON RT 12 RW
01</td><td></td><td>WATES</td><td>PUSKESMAS INDUK</td><td>dr.Arninta Rahma
Khoirunnisa</td><td>Suwoto,A.Md.Kep</td><td>L</td><td>20-44
Thn.</td><td>Keluarga</td><td>Lama</td><td>BPJS PBI</td><td>Rujuk</td><td
align='right'>6</td><td align='right'>11</td><td align='right'>43</td><td>BP.
Umum</td><td>JANTUNG DAN PEMBULUH DARAH</td><td>RS PURI ASIH SALATIGA</td><td>Dalam
Wilayah</td><td>'0001027442878</td><td>'3322010606790002</td><td>131</td><td>97</
td><td>80</td><td>36.5</td><td>24</td><td>163</td><td>66</td><td></td><td></
td><td></td></tr><tr><td align='right'>C50</td><td>Malignant neoplasm of
breast</td><td></td><td></td><td align='right'>2424</td><td
align='right'>01000050</td><td>12-05-2023</td><td>VERONICA YULI
WIDYASARI</td><td></td><td></td><td>'081390523552</td><td>09-07-1973</
td><td>JAMPELAN RT 1 RW 2</td><td></td><td>GETASAN</td><td>PUSKESMAS
INDUK</td><td>dr.Arninta Rahma
Khoirunnisa</td><td>Suwoto,A.Md.Kep</td><td>P</td><td>45-54
Thn.</td><td>Keluarga</td><td>Baru</td><td>BPJS NON PBI</td><td>Rajal</td><td
align='right'>3</td><td align='right'>10</td><td align='right'>49</td><td>BP.
Umum</td><td></td><td></td><td>Dalam
Wilayah</td><td>'0001525810386</td><td>'3322014907730003</td><td>140</td><td>90</
td><td>80</td><td>36.5</td><td>20</td><td>160</td><td>62</td><td></td><td></
td><td></td></tr><tr><td align='right'>H91</td><td>Other hearing
loss</td><td></td><td></td><td align='right'>2412</td><td
align='right'>04000013</td><td>12-05-2023</td><td>WAGINAH</td><td>SUGIARTO
SURADI</td><td>PETANI/PEKEBUN</td><td>'085225403782</td><td>17-08-1948</
td><td>TEGALSARI RT 17 RW 2 </td><td></td><td>NGRAWAN</td><td>PUSKESMAS
INDUK</td><td>dr.Arninta Rahma
Khoirunnisa</td><td>Suwoto,A.Md.Kep</td><td>P</td><td>>70
Thn.</td><td>Keluarga</td><td>Baru</td><td>Umum</td><td>Rajal</td><td
align='right'>26</td><td align='right'>8</td><td align='right'>74</td><td>BP.
Umum</td><td></td><td></td><td>Dalam
Wilayah</td><td>'</td><td>'3322015708480001</td><td>169</td><td>94</td><td>78</
td><td>36.5</td><td>20</td><td>150</td><td>48</td><td></td><td></td><td></td></
tr><tr><td align='right'>K08.3</td><td>Retained dental root</td><td></td><td>pasien
datang dengan keluhan ingin cabut gigi</td><td align='right'>2416</td><td
align='right'>1014898</td><td>12-05-2023</td><td>WIDHI NUR
FATIMAH</td><td></td><td></td><td>'</td><td>06-12-2003</td><td>PERUM GAWE MUKTI RT
04 RW 06</td><td></td><td>GETASAN</td><td>PUSKESMAS INDUK</td><td>drg.Ade
Indranila</td><td>drg.Ade Indranila</td><td>P</td><td>15-19
Thn.</td><td>Keluarga</td><td>Lama</td><td>BPJS PBI</td><td>Rajal</td><td
align='right'>6</td><td align='right'>5</td><td align='right'>19</td><td>BP.
Gigi</td><td></td><td></td><td>Dalam
Wilayah</td><td>'0003142234034</td><td>'3322014612030000</td><td>100</td><td>70</
td><td>98</td><td>36.2</td><td>22</td><td>132</td><td>32</td><td></td><td></
td><td>exo gigi susu</td></tr><tr><td align='right'>J02</td><td>Acute
pharyngitis</td><td></td><td></td><td align='right'>2413</td><td
align='right'>1001362</td><td>12-05-2023</td><td>YOHANES
YONATAN</td><td></td><td></td><td>'</td><td>08-12-1962</td><td>SENDEN RT 02 RW
09</td><td>SENDEN</td><td>BATUR</td><td>PUSKESMAS INDUK</td><td>dr.Arninta Rahma
Khoirunnisa</td><td>Suwoto,A.Md.Kep</td><td>L</td><td>60-69
Thn.</td><td>Keluarga</td><td>Lama</td><td>BPJS NON PBI</td><td>Rajal</td><td
align='right'>4</td><td align='right'>5</td><td align='right'>60</td><td>BP.
Umum</td><td></td><td></td><td>Dalam
Wilayah</td><td>'0001690964188</td><td>'3322010812620001</td><td>140</td><td>97</
td><td>80</td><td>36.5</td><td>20</td><td>165</td><td>82</td><td></td><td></
td><td></td></tr><tr><td align='right'>B86</td><td>Scabies</td><td></td><td>gatal 2
di tangan</td><td align='right'>2404</td><td align='right'>1024979</td><td>12-05-
2023</td><td>YUDA ABDUL AZIZ</td><td>YUSUP BAHTIAR</td><td></td><td>'</td><td>27-
01-2020</td><td>SUMOGAWE RT 02 RW 02</td><td></td><td>GETASAN</td><td>PUSKESMAS
INDUK</td><td>dr.Arninta Rahma
Khoirunnisa</td><td>Sutini,A.Md.Keb</td><td>L</td><td>1-4
Thn.</td><td>Keluarga</td><td>Lama</td><td>BPJS NON PBI</td><td>Rajal</td><td
align='right'>15</td><td align='right'>3</td><td
align='right'>3</td><td>MTBS</td><td></td><td></td><td>Dalam
Wilayah</td><td>'0003119518844</td><td>'3322012701200001</td><td></td><td></
td><td>130</td><td>37</td><td>35</td><td>88</td><td>133</td><td></td><td>penkes
cara pemberian obat</td><td>memberikan penkes cara pemberian obat</td></tr><tr><td
align='right'>J06</td><td>Acute upper respiratory infections of multiple and
unspecified sites</td><td></td><td></td><td align='right'>2417</td><td
align='right'>1002810</td><td>12-05-2023</td><td>ZAHRA NUR
ANISA</td><td></td><td></td><td>'</td><td>29-09-2004</td><td>SUMOGAWE RT.1
RW.2</td><td></td><td>GETASAN</td><td>PUSKESMAS INDUK</td><td>dr.Arninta Rahma
Khoirunnisa</td><td>Suwoto,A.Md.Kep</td><td>P</td><td>15-19
Thn.</td><td>Keluarga</td><td>Lama</td><td>BPJS PBI</td><td>Rajal</td><td
align='right'>13</td><td align='right'>7</td><td align='right'>18</td><td>BP.
Umum</td><td></td><td></td><td>Dalam
Wilayah</td><td>'0001027435432</td><td>'3322016909040004</td><td>100</td><td>70</
td><td>87</td><td>36.5</td><td>20</td><td>155</td><td>50</td><td></td><td></
td><td></td></tr><tr><td align='right'>J02</td><td>Acute
pharyngitis</td><td></td><td></td><td align='right'>2433</td><td
align='right'>1008251</td><td>13-05-2023</td><td>AINUN DEWI
LESTARI</td><td></td><td></td><td>'</td><td>14-12-2013</td><td>SRANTI RT.9
RW.2</td><td>SRANTI</td><td>WATES</td><td>PUSKESMAS INDUK</td><td>dr.Gani
Kriswanto</td><td>Retno Sri Hastuti,Amd.Kep</td><td>P</td><td>5-9
Thn.</td><td>Keluarga</td><td>Lama</td><td>Umum</td><td>Rajal</td><td
align='right'>29</td><td align='right'>4</td><td align='right'>9</td><td>BP.
Umum</td><td></td><td></td><td>Dalam
Wilayah</td><td>'</td><td>'3322015412130001</td><td>90</td><td>70</td><td>87</
td><td>36.5</td><td>20</td><td>123</td><td>21</td><td></td><td></td><td></td></
tr><tr><td align='right'>K04.1</td><td>Necrosis of pulp</td><td></td><td>pasien
datang mau tambal gigi, kontrol </td><td align='right'>2463</td><td
align='right'>1006593</td><td>13-05-2023</td><td>ALFI
KURNIA</td><td></td><td></td><td>'</td><td>28-10-1998</td><td>TOLOKAN RT 05 RW
01</td><td>TOLOKAN</td><td>TOLOKAN</td><td>PUSKESMAS INDUK</td><td>drg.Ade
Indranila</td><td> - </td><td>P</td><td>20-44
Thn.</td><td>Keluarga</td><td>Lama</td><td>Umum</td><td>Rajal</td><td
align='right'>15</td><td align='right'>6</td><td align='right'>24</td><td>BP.
Gigi</td><td></td><td></td><td>Dalam
Wilayah</td><td>'</td><td>'3322016810980001</td><td>110</td><td>76</td><td>80</
td><td>36</td><td>24</td><td>155</td><td>50</td><td></td><td></td><td>tumpat
sementara
TKF+ZNOE</td></tr><tr><td align='right'>K04.1</td><td>Necrosis of
pulp</td><td></td><td>pasien datang mau kontrol gigi </td><td
align='right'>2443</td><td align='right'>1008107</td><td>13-05-2023</td><td>ANNA
ANISA MURDITASARI</td><td></td><td>KARYAWAN
SWASTA</td><td>'</td><td>04-06-1998</td><td>SIDOMUKTI RT 09 RW
05</td><td>SIDOMUKTI</td><td>KOPENG</td><td>PUSKESMAS INDUK</td><td>drg.Ade
Indranila</td><td> - </td><td>P</td><td>20-44
Thn.</td><td>Keluarga</td><td>Lama</td><td>BPJS NON PBI</td><td>Rajal</td><td
align='right'>9</td><td align='right'>11</td><td align='right'>24</td><td>BP.
Gigi</td><td></td><td></td><td>Dalam
Wilayah</td><td>'0001694402706</td><td>'3322014406980001</td><td>110</td><td>70</
td><td>80</td><td>36</td><td>24</td><td>155</td><td>50</td><td></td><td></
td><td>tumpat sementara TKF + ZNOE</td></tr><tr><td
align='right'>Z00</td><td>General examination and investigation of persons without
complaint and reported diagnosis</td><td></td><td></td><td
align='right'>2439</td><td align='right'>99000055</td><td>13-05-2023</td><td>AYUB
JULIANTO ADI
NUGROHO</td><td></td><td></td><td>'</td><td>08-07-1997</td><td>JOLOTIGO RT 02 RW 02
PEKALONGAN</td><td></td><td>Luar kabupaten</td><td>PUSKESMAS INDUK</td><td>dr.Gani
Kriswanto</td><td>Retno Sri Hastuti,Amd.Kep</td><td>L</td><td>20-44
Thn.</td><td>Keluarga</td><td>Baru</td><td>BPJS NON PBI</td><td>Rajal</td><td
align='right'>5</td><td align='right'>10</td><td align='right'>25</td><td>BP.
Umum</td><td></td><td></td><td>Luar
Wilayah</td><td>'0002169936404</td><td>'3326050807970001</td><td>112</td><td>78</
td><td>81</td><td>37</td><td>22</td><td>155</td><td>56</td><td></td><td></
td><td></td></tr><tr><td align='right'>R50.9</td><td>Fever,
unspecified</td><td></td><td></td><td align='right'>2435</td><td
align='right'>1021366</td><td>13-05-2023</td><td>BRIELLA IVANA
STEFANI</td><td>SLAMET</td><td></td><td>'</td><td>22-03-2021</td><td>NGLELO RT 03
RW 19</td><td>NGLELO</td><td>BATUR</td><td>PUSKESMAS INDUK</td><td>dr.Arninta Rahma
Khoirunnisa</td><td>Sri Hartini,S.S.T.Keb</td><td>P</td><td>1-4
Thn.</td><td>Keluarga</td><td>Lama</td><td>Umum</td><td>Rajal</td><td
align='right'>21</td><td align='right'>1</td><td
align='right'>2</td><td>MTBS</td><td></td><td></td><td>Dalam
Wilayah</td><td>'</td><td>'3322016203210002</td><td></td><td></td><td></td><td></
td><td></td><td>0</td><td>0</td><td></td><td>penkkes cara pemberian obat di
rumah</td><td>memberikan penkes cara pembefrian obat di rumah</td></tr><tr><td
align='right'>Z00</td><td>General examination and investigation of persons without
complaint and reported diagnosis</td><td></td><td></td><td
align='right'>2437</td><td
align='right'>1023776</td><td>13-05-2023</td><td>DARMI</td><td></td><td></
td><td>'087700413193</td><td>06-09-1966</td><td>POLOBOGO RT 06 RW 11
POLOBOGO</td><td></td><td>Luar Wilayah</td><td>PUSKESMAS INDUK</td><td>dr.Gani
Kriswanto</td><td>Retno Sri Hastuti,Amd.Kep</td><td>P</td><td>55-59
Thn.</td><td>Keluarga</td><td>Lama</td><td>BPJS PBI</td><td>Rajal</td><td
align='right'>7</td><td align='right'>8</td><td align='right'>56</td><td>BP.
Umum</td><td></td><td></td><td>Luar
Wilayah</td><td>'0003005896127</td><td>'3322014609660004</td><td>148</td><td>95</
td><td>87</td><td>36.5</td><td>20</td><td>156</td><td>55</td><td></td><td></
td><td></td></tr><tr><td align='right'>S01.3</td><td>Open wound of
ear</td><td></td><td></td><td align='right'>2446</td><td
align='right'>06000045</td><td>13-05-2023</td><td>ELEAZAR HENDRI
HARTANTO</td><td>SUTRISNO</td><td>PELAJAR/MAHASISWA</td><td>'088806406294</
td><td>05-06-2006</td><td>SENDEN RT 04 RW
09</td><td>SENDEN</td><td>BATUR</td><td>PUSKESMAS INDUK</td><td>dr.Gani
Kriswanto</td><td>Retno Sri Hastuti,Amd.Kep</td><td>L</td><td>15-19
Thn.</td><td>Keluarga</td><td>Lama</td><td>Umum</td><td>Rajal</td><td
align='right'>8</td><td align='right'>11</td><td align='right'>16</td><td>BP.
Umum</td><td></td><td></td><td>Dalam
Wilayah</td><td>'</td><td>'</td><td>110</td><td>70</td><td>84</td><td>36.5</
td><td>22</td><td>165</td><td>58</td><td></td><td></td><td></td></tr><tr><td
align='right'>Z00</td><td>General examination and investigation of persons without
complaint and reported diagnosis</td><td></td><td></td><td
align='right'>2453</td><td
align='right'>1009648</td><td>13-05-2023</td><td>IGNATIUS ALDYTH ADI
PRAMONO</td><td></td><td></td><td>'</td><td>26-02-2001</td><td>DUKUH RT
06/08</td><td>DUKUH</td><td>KOPENG</td><td>PUSKESMAS INDUK</td><td>dr.Gani
Kriswanto</td><td>Retno Sri Hastuti,Amd.Kep</td><td>L</td><td>20-44
Thn.</td><td>Keluarga</td><td>Baru</td><td>BPJS NON PBI</td><td>Rajal</td><td
align='right'>17</td><td align='right'>2</td><td align='right'>22</td><td>BP.
Umum</td><td></td><td></td><td>Dalam
Wilayah</td><td>'0001161166882</td><td>'3322012602010001</td><td>110</td><td>80</
td><td>84</td><td>36.5</td><td>22</td><td>167</td><td>60</td><td></td><td></
td><td></td></tr><tr><td align='right'>S01.1</td><td>Open wound of eyelid and
periocular area</td><td></td><td></td><td align='right'>2434</td><td
align='right'>1025420</td><td>13-05-2023</td><td>IMAM
PRASTIYO</td><td></td><td></td><td>'085747435336</td><td>09-08-2004</td><td>SRANTI
RT 09 RW 02</td><td>SRANTI</td><td>WATES</td><td>PUSKESMAS INDUK</td><td>dr.Gani
Kriswanto</td><td>Retno Sri Hastuti,Amd.Kep</td><td>L</td><td>15-19
Thn.</td><td>Keluarga</td><td>Lama</td><td>BPJS PBI</td><td>Rajal</td><td
align='right'>4</td><td align='right'>9</td><td align='right'>18</td><td>BP.
Umum</td><td></td><td></td><td>Dalam
Wilayah</td><td>'0000601510522</td><td>'3322010908040001</td><td>100</td><td>70</
td><td>82</td><td>36.5</td><td>22</td><td>164</td><td>58</td><td></td><td></
td><td></td></tr><tr><td align='right'>K04.1</td><td>Necrosis of
pulp</td><td></td><td>pasien datang mau kontrol gigi </td><td
align='right'>2458</td><td align='right'>90000104</td><td>13-05-2023</td><td>KAFIE
EL AZZAM</td><td>MUH YUNIANTO</td><td>PELAJAR/MAHASISWA</td><td>'</td><td>29-11-
2013</td><td>SEMARE RT 8 RW 3 </td><td></td><td>Luar Wilayah</td><td>PUSKESMAS
INDUK</td><td>drg.Ade Indranila</td><td> - </td><td>L</td><td>5-9
Thn.</td><td>Keluarga</td><td>Lama</td><td>BPJS PBI</td><td>Rajal</td><td
align='right'>14</td><td align='right'>5</td><td align='right'>9</td><td>BP.
Gigi</td><td></td><td></td><td>Luar
Wilayah</td><td>'0001373028682</td><td>'3322052911130001</td><td>120</td><td>70</
td><td>80</td><td>36</td><td>24</td><td>155</td><td>50</td><td></td><td></
td><td>tumpat sementara
TKF+ ZNOE</td></tr><tr><td align='right'>B20.0</td><td>HIV disease resulting in
mycobacterial infection</td><td></td><td></td><td align='right'>2460</td><td
align='right'>99000057</td><td>13-05-2023</td><td>KUWATI</td><td></td><td>MENGURUS
RUMAH TANGGA</td><td>'</td><td>12-07-1979</td><td>JL.TAMBAK BOYO RT 09 RW 02 KOTA
SEMARANG</td><td></td><td>Luar kabupaten</td><td>PUSKESMAS INDUK</td><td>dr.Gani
Kriswanto</td><td>Retno Sri Hastuti,Amd.Kep</td><td>P</td><td>20-44
Thn.</td><td>Keluarga</td><td>Baru</td><td>BPJS PBI</td><td>Rajal</td><td
align='right'>1</td><td align='right'>10</td><td align='right'>43</td><td>BP.
Umum</td><td></td><td></td><td>Luar
Wilayah</td><td>'0002064768761</td><td>'3374045207790007</td><td>133</td><td>84</
td><td>87</td><td>36</td><td>22</td><td>155</td><td>60</td><td></td><td></
td><td></td></tr><tr><td align='right'>K02.1</td><td>Caries of
dentine</td><td></td><td>pasien datang maumkontrol gigi </td><td
align='right'>2457</td><td align='right'>1024446</td><td>13-05-2023</td><td>LILIS
SETYANINGSIH</td><td></td><td></td><td>'</td><td>06-08-1979</td><td>SEMARE RT 08 RW
03</td><td>SLEKER</td><td>KOPENG</td><td>PUSKESMAS INDUK</td><td>drg.Ade
Indranila</td><td> - </td><td>P</td><td>20-44
Thn.</td><td>Keluarga</td><td>Lama</td><td>Umum</td><td>Rajal</td><td
align='right'>7</td><td align='right'>9</td><td align='right'>43</td><td>BP.
Gigi</td><td></td><td></td><td>Dalam
Wilayah</td><td>'0001373484609</td><td>'3322054608790005</td><td>120</td><td>78</
td><td>80</td><td>36</td><td>24</td><td>155</td><td>62</td><td></td><td></
td><td>tumoat gigi tetap ketak olar </td></tr><tr><td
align='right'>K04.1</td><td>Necrosis of pulp</td><td></td><td>pasien mau tambal
gigi depan atas </td><td align='right'>2432</td><td
align='right'>1006163</td><td>13-05-2023</td><td>LITA
YULIANTI</td><td></td><td></td><td>'085601536016</td><td>10-07-2000</
td><td>KALITENGAH RT 01 RW 06</td><td>KALITENGAH</td><td>BATUR</td><td>PUSKESMAS
INDUK</td><td>drg.Ade Indranila</td><td> - </td><td>P</td><td>20-44
Thn.</td><td>Keluarga</td><td>Lama</td><td>BPJS PBI</td><td>Rajal</td><td
align='right'>3</td><td align='right'>10</td><td align='right'>22</td><td>BP.
Gigi</td><td></td><td></td><td>Dalam
Wilayah</td><td>'0002349072731</td><td>'3322015007000001</td><td>110</td><td>70</
td><td>82</td><td>36</td><td>24</td><td>151</td><td>45</td><td></td><td>pro
konservasi </td><td>yumpat sementara
TKF + ZNOE</td></tr><tr><td align='right'>I10</td><td>Essential (primary)
hypertension</td><td></td><td></td><td align='right'>2452</td><td
align='right'>08000012</td><td>13-05-2023</td><td>MINDARSIH</td><td></
td><td>PETANI/PEKEBUN</td><td>'</td><td>23-10-1977</td><td>GEJAYAN RT 08 RW
02</td><td>GEJAYAN</td><td>NOGOSAREN</td><td>PUSKESMAS INDUK</td><td>dr.Gani
Kriswanto</td><td>Retno Sri Hastuti,Amd.Kep</td><td>P</td><td>45-54
Thn.</td><td>Keluarga</td><td>Baru</td><td>BPJS PBI</td><td>Rajal</td><td
align='right'>21</td><td align='right'>6</td><td align='right'>45</td><td>BP.
Umum</td><td></td><td></td><td>Dalam
Wilayah</td><td>'0003142256714</td><td>'3322015903710001</td><td>168</td><td>100</
td><td>87</td><td>36.5</td><td>22</td><td>150</td><td>64</td><td></td><td></
td><td></td></tr><tr><td align='right'>K62.2</td><td>Anal
prolapse</td><td></td><td></td><td align='right'>2444</td><td
align='right'>1018505</td><td>13-05-2023</td><td>MUKIMIN
ISKAK</td><td></td><td></td><td>'</td><td>14-03-1966</td><td>BLANCIR RT 02 RW
06</td><td>BLANCIR</td><td>KOPENG</td><td>PUSKESMAS INDUK</td><td>dr.Gani
Kriswanto</td><td>Retno Sri Hastuti,Amd.Kep</td><td>L</td><td>55-59
Thn.</td><td>Keluarga</td><td>Lama</td><td>BPJS PBI</td><td>Rujuk</td><td
align='right'>29</td><td align='right'>1</td><td align='right'>57</td><td>BP.
Umum</td><td>Bedah</td><td>RS PURI ASIH SALATIGA</td><td>Dalam
Wilayah</td><td>'0001027415957</td><td>'3322011403660001</td><td>110</td><td>80</
td><td>87</td><td>36.5</td><td>22</td><td>158</td><td>64</td><td></td><td></
td><td></td></tr><tr><td align='right'>L20</td><td>Atopic
dermatitis</td><td></td><td></td><td align='right'>2441</td><td
align='right'>1015156</td><td>13-05-2023</td><td>PARIEM</td><td></td><td></
td><td>'</td><td>03-02-1966</td><td>BLANCIR RT 03 RW
06</td><td>BLANCIR</td><td>KOPENG</td><td>PUSKESMAS INDUK</td><td>dr.Gani
Kriswanto</td><td>Retno Sri Hastuti,Amd.Kep</td><td>P</td><td>55-59
Thn.</td><td>Keluarga</td><td>Baru</td><td>BPJS PBI</td><td>Rajal</td><td
align='right'>10</td><td align='right'>3</td><td align='right'>57</td><td>BP.
Umum</td><td></td><td></td><td>Dalam
Wilayah</td><td>'0000602110012</td><td>'3322014302660001</td><td>188</td><td>111</
td><td>84</td><td>36.5</td><td>22</td><td>150</td><td>50</td><td></td><td></
td><td></td></tr><tr><td
align='right'>M79.1</td><td>Myalgia</td><td></td><td></td><td
align='right'>2451</td><td
align='right'>1006513</td><td>13-05-2023</td><td>PURWANTI</td><td></td><td></
td><td>'</td><td>01-12-1998</td><td>KRANGKENG RT
05/02</td><td>KRANGKENG</td><td>BATUR</td><td>PUSKESMAS INDUK</td><td>dr.Gani
Kriswanto</td><td>Retno Sri Hastuti,Amd.Kep</td><td>P</td><td>20-44
Thn.</td><td>Keluarga</td><td>Baru</td><td>Umum</td><td>Rajal</td><td
align='right'>12</td><td align='right'>5</td><td align='right'>24</td><td>BP.
Umum</td><td></td><td></td><td>Dalam
Wilayah</td><td>'0000602311476</td><td>'3322015112980003</td><td>121</td><td>78</
td><td>78</td><td>36</td><td>22</td><td>150</td><td>5</td><td></td><td></td><td></
td></tr><tr><td align='right'>K00.6</td><td>Disturbances in tooth
eruption</td><td></td><td>pasien mau cabut gigi </td><td align='right'>2449</td><td
align='right'>1023421</td><td>13-05-2023</td><td>RAYZHARD RAFA
PRADIPTA</td><td></td><td></td><td>'</td><td>22-11-2015</td><td>BUMIAYU RT 01 RW
04</td><td></td><td>Luar Wilayah</td><td>PUSKESMAS INDUK</td><td>drg.Ade
Indranila</td><td> - </td><td>L</td><td>5-9
Thn.</td><td>Keluarga</td><td>Lama</td><td>Umum</td><td>Rajal</td><td
align='right'>21</td><td align='right'>5</td><td align='right'>7</td><td>BP.
Gigi</td><td></td><td></td><td>Luar
Wilayah</td><td>'</td><td>'3322012211150003</td><td>100</td><td>70</td><td>80</
td><td>36</td><td>24</td><td>125</td><td>21</td><td></td><td></td><td>exo gigi
5.1</td></tr><tr><td align='right'>K00.6</td><td>Disturbances in tooth
eruption</td><td></td><td>pasien mau cabut gigi </td><td align='right'>2450</td><td
align='right'>1012290</td><td>13-05-2023</td><td>RITA MULYANI
</td><td></td><td></td><td>'</td><td>04-11-2003</td><td>KENTENG RT
05/05</td><td></td><td>Luar Wilayah</td><td>PUSKESMAS INDUK</td><td>drg.Ade
Indranila</td><td> - </td><td>P</td><td>15-19
Thn.</td><td>Keluarga</td><td>Lama</td><td>Umum</td><td>Rajal</td><td
align='right'>9</td><td align='right'>6</td><td align='right'>19</td><td>BP.
Gigi</td><td></td><td></td><td>Luar
Wilayah</td><td>'0002293449816</td><td>'3322014411030002</td><td>100</td><td>72</
td><td>80</td><td>36</td><td>24</td><td>155</td><td>52</td><td></td><td></
td><td>exo CE gigi 5.1 dan 7.1 </td></tr><tr><td
align='right'>S52.1</td><td>Fracture of upper end of
radius</td><td></td><td></td><td align='right'>2436</td><td
align='right'>1025463</td><td>13-05-2023</td><td>SAMINI</td><td></td><td>PETANI/
PEKEBUN</td><td>'081904365210</td><td>12-11-1976</td><td>SENDEN RT 03 RW
09</td><td>SENDEN</td><td>BATUR</td><td>PUSKESMAS INDUK</td><td>dr.Gani
Kriswanto</td><td>Retno Sri Hastuti,Amd.Kep</td><td>P</td><td>45-54
Thn.</td><td>Keluarga</td><td>Lama</td><td>BPJS PBI</td><td>Rujuk</td><td
align='right'>1</td><td align='right'>6</td><td align='right'>46</td><td>BP.
Umum</td><td>Orthopedi</td><td>RS PURI ASIH SALATIGA</td><td>Dalam
Wilayah</td><td>'0000601989838</td><td>'3322015211760002</td><td>146</td><td>91</
td><td>87</td><td>36.5</td><td>20</td><td>156</td><td>55</td><td></td><td></
td><td></td></tr><tr><td align='right'>A09</td><td>Diarrhoea and gastroenteritis of
presumed infectious origin</td><td></td><td>kontrol post opnam</td><td
align='right'>2440</td><td align='right'>99000056</td><td>13-05-2023</td><td>SAVIRA
PUTRI EFENDI</td><td>AGUS
EFENDI</td><td></td><td>'</td><td>06-02-2023</td><td>DALANGAN RT 02 RW 01 PANDEAN
NGABLAK</td><td></td><td>Luar kabupaten</td><td>PUSKESMAS INDUK</td><td>dr.Arninta
Rahma Khoirunnisa</td><td> - </td><td>P</td><td><1
Thn.</td><td>Keluarga</td><td>Baru</td><td>BPJS PBI</td><td>Rajal</td><td
align='right'>7</td><td align='right'>3</td><td
align='right'>0</td><td>MTBS</td><td></td><td></td><td>Luar
Wilayah</td><td>'0003505540465</td><td>'</td><td></td><td></td><td>100</
td><td>37</td><td>35</td><td>54</td><td>5</td><td></td><td>penkkes cara pemberian
obat</td><td>memberikan penkes cara pemberian obat</td></tr><tr><td
align='right'>M79.1</td><td>Myalgia</td><td></td><td></td><td
align='right'>2447</td><td
align='right'>1004026</td><td>13-05-2023</td><td>SIYAM</td><td></td><td></
td><td>'</td><td>12-03-1961</td><td>PLALAR RT 03 RW
04</td><td>PLALAR</td><td>KOPENG</td><td>PUSKESMAS INDUK</td><td>dr.Gani
Kriswanto</td><td>Retno Sri Hastuti,Amd.Kep</td><td>P</td><td>60-69
Thn.</td><td>Keluarga</td><td>Lama</td><td>Umum</td><td>Rajal</td><td
align='right'>1</td><td align='right'>2</td><td align='right'>62</td><td>BP.
Umum</td><td></td><td></td><td>Dalam
Wilayah</td><td>'0002455622853</td><td>'3322015203610002</td><td>140</td><td>95</
td><td>80</td><td>36.5</td><td>22</td><td>148</td><td>62</td><td></td><td></
td><td></td></tr><tr><td
align='right'>M79.1</td><td>Myalgia</td><td></td><td></td><td
align='right'>2462</td><td
align='right'>1015642</td><td>13-05-2023</td><td>SUPARMIN</td><td></td><td></
td><td>'</td><td>28-04-1969</td><td>MUJO RT 03 RW 04</td><td></td><td>Luar
Wilayah</td><td>PUSKESMAS INDUK</td><td>dr.Gani Kriswanto</td><td>Retno Sri
Hastuti,Amd.Kep</td><td>L</td><td>45-54
Thn.</td><td>Keluarga</td><td>Baru</td><td>BPJS PBI</td><td>Rajal</td><td
align='right'>15</td><td align='right'></td><td align='right'>54</td><td>BP.
Umum</td><td></td><td></td><td>Luar
Wilayah</td><td>'0000602380888</td><td>'3322012804690001</td><td>118</td><td>68</
td><td>87</td><td>36.5</td><td>22</td><td>162</td><td>57</td><td></td><td></
td><td></td></tr><tr><td align='right'>K29</td><td>Gastritis and
duodenitis</td><td></td><td></td><td align='right'>2461</td><td
align='right'>1015387</td><td>13-05-2023</td><td>SUPRIHATI</td><td></td><td></
td><td>'</td><td>25-02-1972</td><td>MUJO RT 03 RW 04</td><td></td><td>Luar
Wilayah</td><td>PUSKESMAS INDUK</td><td>dr.Gani Kriswanto</td><td>Retno Sri
Hastuti,Amd.Kep</td><td>P</td><td>45-54
Thn.</td><td>Keluarga</td><td>Baru</td><td>BPJS PBI</td><td>Rajal</td><td
align='right'>18</td><td align='right'>2</td><td align='right'>51</td><td>BP.
Umum</td><td></td><td></td><td>Luar
Wilayah</td><td>'0000602381395</td><td>'3322016502720001</td><td>112</td><td>95</
td><td>86</td><td>36.5</td><td>23</td><td>152</td><td>67</td><td></td><td></
td><td></td></tr><tr><td align='right'>K12</td><td>Stomatitis and related
lesions</td><td></td><td>pasien datang dengan keluhancabut igi sebulan yang lalau
masih sakit saat pasang gigi palsu </td><td align='right'>2454</td><td
align='right'>90000107</td><td>13-05-2023</td><td>YAMTI</td><td>PARJO
PARTONO</td><td></td><td>'</td><td>08-12-1972</td><td>DALANGAN RT 02 RW 03
SUMOGAWE</td><td></td><td>Luar Wilayah</td><td>PUSKESMAS INDUK</td><td>drg.Ade
Indranila</td><td> - </td><td>P</td><td>45-54
Thn.</td><td>Keluarga</td><td>Baru</td><td>Umum</td><td>Rajal</td><td
align='right'>5</td><td align='right'>5</td><td align='right'>50</td><td>BP.
Gigi</td><td></td><td></td><td>Luar
Wilayah</td><td>'</td><td>'3322014812720001</td><td>110</td><td>70</td><td>80</
td><td>36</td><td>24</td><td>155</td><td>50</td><td></td><td></td><td>medikasi
</td></tr><tr><td align='right'>M79.1</td><td>Myalgia</td><td></td><td></td><td
align='right'>2464</td><td
align='right'>1004499</td><td>13-05-2023</td><td>YATEMI</td><td></td><td></
td><td>'</td><td>14-04-1955</td><td>TAWANG RT 02 RW
18</td><td>TAWANG</td><td>BATUR</td><td>PUSKESMAS INDUK</td><td>dr.Gani
Kriswanto</td><td>Retno Sri Hastuti,Amd.Kep</td><td>P</td><td>60-69
Thn.</td><td>Keluarga</td><td>Lama</td><td>BPJS PBI</td><td>Rajal</td><td
align='right'>29</td><td align='right'></td><td align='right'>68</td><td>BP.
Umum</td><td></td><td></td><td>Dalam
Wilayah</td><td>'0001027421019</td><td>'3322015404550001</td><td>100</td><td>78</
td><td>80</td><td>36.5</td><td>20</td><td>145</td><td>39</td><td></td><td></
td><td></td></tr><tr><td align='right'>A88.1</td><td>Epidemic
verti</td><td></td><td></td><td align='right'>2483</td><td
align='right'>1010727</td><td>15-05-2023</td><td>ADE
KRISTINA</td><td></td><td></td><td>'</td><td>05-05-1980</td><td>PLALAR RT 03 RW
04</td><td></td><td>KOPENG</td><td>PUSKESMAS INDUK</td><td>dr.Arninta Rahma
Khoirunnisa</td><td>Supomo,A.Md.Kep</td><td>P</td><td>20-44
Thn.</td><td>Keluarga</td><td>Lama</td><td>BPJS PBI</td><td>Rajal</td><td
align='right'>10</td><td align='right'></td><td align='right'>43</td><td>BP.
Umum</td><td></td><td></td><td>Dalam
Wilayah</td><td>'0002462104473</td><td>'3322014505800004</td><td>125</td><td>83</
td><td>82</td><td>36.5</td><td>20</td><td>142</td><td>78</td><td></td><td></
td><td></td></tr><tr><td align='right'>J11.0</td><td>Influenza with pneumonia,
virus not identified</td><td></td><td>PANAS, BATUK, PILEK</td><td
align='right'>2526</td><td align='right'>90000109</td><td>15-05-2023</td><td>AGUNG
WAHYU GURITNO</td><td>MUHAMAD MUJIANTO</td><td>BELUM/TIDAK
BEKERJA</td><td>'</td><td>22-10-2019</td><td>KRAJAN RT 05 RW 05
SURUH</td><td></td><td>Luar Wilayah</td><td>PUSKESMAS INDUK</td><td>dr.Arninta
Rahma Khoirunnisa</td><td> - </td><td>L</td><td>1-4
Thn.</td><td>Keluarga</td><td>Baru</td><td>BPJS PBI</td><td>Rajal</td><td
align='right'>24</td><td align='right'>6</td><td
align='right'>3</td><td>MTBS</td><td></td><td></td><td>Luar
Wilayah</td><td>'0003321421986</td><td>'3322042210190002</td><td></td><td></
td><td>130</td><td>37</td><td>43</td><td>95</td><td>12</td><td></td><td>PENKES
TENTANG PEMBERIAN OBAT DI RUMAH</td><td>MEMBERIKAN PENKES TENTANG CARA PEMBERIAN
OBAT DI RUMAH</td></tr><tr><td align='right'>A09</td><td>Diarrhoea and
gastroenteritis of presumed infectious origin</td><td></td><td></td><td
align='right'>2496</td><td align='right'>01000052</td><td>15-05-2023</td><td>AISAH
NUHA ALAYA</td><td></td><td></td><td>'</td><td>07-12-2015</td><td>JAMPELAN RT 1 RW
2</td><td></td><td>GETASAN</td><td>PUSKESMAS INDUK</td><td>dr.Arninta Rahma
Khoirunnisa</td><td>Supomo,A.Md.Kep</td><td>P</td><td>5-9
Thn.</td><td>Keluarga</td><td>Baru</td><td>Umum</td><td>Rajal</td><td
align='right'>8</td><td align='right'>5</td><td align='right'>7</td><td>BP.
Umum</td><td></td><td></td><td>Dalam
Wilayah</td><td>'</td><td>'</td><td>80</td><td>50</td><td>80</td><td>36</
td><td>20</td><td>130</td><td>22</td><td></td><td></td><td></td></tr><tr><td
align='right'>Q20.1</td><td>Double outlet right ventricle</td><td></td><td>MINTA
RUJUKAN KE RS</td><td align='right'>2499</td><td align='right'>1023921</td><td>15-
05-2023</td><td>ALONA ATHASYA LASIKIN</td><td></td><td></td><td>'</td><td>01-05-
2022</td><td>MUJO RT 03 RW 04</td><td></td><td>GETASAN</td><td>PUSKESMAS
INDUK</td><td>dr.Arninta Rahma
Khoirunnisa</td><td>Supomo,A.Md.Kep</td><td>P</td><td>1-4
Thn.</td><td>Keluarga</td><td>Lama</td><td>BPJS NON PBI</td><td>Rajal</td><td
align='right'>14</td><td align='right'></td><td
align='right'>1</td><td>MTBS</td><td></td><td></td><td>Dalam
Wilayah</td><td>'0003274234784</td><td>'</td><td></td><td></td><td>130</
td><td>37</td><td>35</td><td>69</td><td>8</td><td></td><td>-</td><td>-</td></
tr><tr><td align='right'>Z48.8</td><td>Other specified surgical follow-up
care</td><td></td><td></td><td align='right'>2487</td><td
align='right'>1001806</td><td>15-05-2023</td><td>ANDIKA LUKI
VERDIANTO</td><td></td><td></td><td>'</td><td>01-04-2009</td><td>PANDANAN</
td><td></td><td>GETASAN</td><td>PUSKESMAS INDUK</td><td>dr.Arninta Rahma
Khoirunnisa</td><td>Supomo,A.Md.Kep</td><td>L</td><td>10-14
Thn.</td><td>Keluarga</td><td>Lama</td><td>BPJS PBI</td><td>Rujuk</td><td
align='right'>14</td><td align='right'>1</td><td align='right'>14</td><td>BP.
Umum</td><td>Orthopedi</td><td>RS PURI ASIH SALATIGA</td><td>Dalam
Wilayah</td><td>'0000602656896</td><td>'3322010204090001</td><td>90</td><td>70</
td><td>87</td><td>36.5</td><td>20</td><td>136</td><td>40</td><td></td><td></
td><td></td></tr><tr><td align='right'>J06.9</td><td>Acute upper respiratory
infection, unspecified</td><td></td><td></td><td align='right'>2485</td><td
align='right'>1004571</td><td>15-05-2023</td><td>ANINDITA KAESA
ZAHRA</td><td></td><td></td><td>'</td><td>13-02-2017</td><td>SIDOMUKTI RT 09 RW
05</td><td></td><td>KOPENG</td><td>PUSKESMAS INDUK</td><td>dr.Arninta Rahma
Khoirunnisa</td><td>Supomo,A.Md.Kep</td><td>P</td><td>5-9
Thn.</td><td>Keluarga</td><td>Lama</td><td>Umum</td><td>Rajal</td><td
align='right'>2</td><td align='right'>3</td><td align='right'>6</td><td>BP.
Umum</td><td></td><td></td><td>Dalam
Wilayah</td><td>'</td><td>'3322015302170000</td><td>132</td><td>15</td><td>80</
td><td>36</td><td>20</td><td>132</td><td>15</td><td></td><td></td><td></td></
tr><tr><td align='right'>K05.1</td><td>Chronic gingivitis</td><td></td><td>pasien
datang dengan keluhan ingin membersihkan karang gigi</td><td
align='right'>2504</td><td align='right'>1010128</td><td>15-05-2023</td><td>ANTHONY
DANIEL MONONIMBAR</td><td></td><td></td><td>'085780827423</td><td>24-02-2006</
td><td>PERUM GAWE MUKTI RT 3/6</td><td></td><td>Luar Wilayah</td><td>PUSKESMAS
INDUK</td><td>drg.Ade Indranila</td><td>drg.Ade Indranila</td><td>L</td><td>15-19
Thn.</td><td>Keluarga</td><td>Baru</td><td>BPJS NON PBI</td><td>Rajal</td><td
align='right'>21</td><td align='right'>2</td><td align='right'>17</td><td>BP.
Gigi</td><td></td><td></td><td>Luar
Wilayah</td><td>'0002271768423</td><td>'3322012402060002</td><td>120</td><td>70</
td><td>78</td><td>36.1</td><td>22</td><td>165</td><td>55</td><td></td><td></
td><td>pembersihan karang gigi</td></tr><tr><td align='right'>J02</td><td>Acute
pharyngitis</td><td></td><td></td><td align='right'>2475</td><td
align='right'>1000135</td><td>15-05-2023</td><td>AULIA PUTRI
RAMADANI</td><td></td><td></td><td>'</td><td>21-07-2014</td><td>GETASAN RT 4 RW
1</td><td>GETASAN</td><td>GETASAN</td><td>PUSKESMAS INDUK</td><td>dr.Arninta Rahma
Khoirunnisa</td><td>Supomo,A.Md.Kep</td><td>P</td><td>5-9
Thn.</td><td>Keluarga</td><td>Lama</td><td>Umum</td><td>Rajal</td><td
align='right'>24</td><td align='right'>9</td><td align='right'>8</td><td>BP.
Umum</td><td></td><td></td><td>Dalam
Wilayah</td><td>'</td><td>'</td><td>90</td><td>60</td><td>80</td><td>36.5</
td><td>20</td><td>150</td><td>50</td><td></td><td></td><td></td></tr><tr><td
align='right'>R50.9</td><td>Fever, unspecified</td><td></td><td>panas</td><td
align='right'>2469</td><td
align='right'>1020040</td><td>15-05-2023</td><td>CLARISSA UTAMI
PRAMONO</td><td></td><td></td><td>'</td><td>26-08-2020</td><td>BUMIAYU RT 02 RW
04</td><td></td><td>GETASAN</td><td>PUSKESMAS INDUK</td><td>dr.Arninta Rahma
Khoirunnisa</td><td> - </td><td>P</td><td>1-4
Thn.</td><td>Keluarga</td><td>Lama</td><td>BPJS NON PBI</td><td>Rajal</td><td
align='right'>19</td><td align='right'>8</td><td
align='right'>2</td><td>MTBS</td><td></td><td></td><td>Dalam
Wilayah</td><td>'0003048288592</td><td>'3322016608200001</td><td></td><td></
td><td>100</td><td>37</td><td>37</td><td>92</td><td>13</td><td></td><td>penkes cara
pemberian obat di rumah</td><td>memberikan penkes cara pemberian obat di
rumah</td></tr><tr><td
align='right'>K30</td><td>Dyspepsia</td><td></td><td></td><td
align='right'>2472</td><td align='right'>1023519</td><td>15-05-2023</td><td>DARMI
</td><td></td><td></td><td>'</td><td>09-06-1955</td><td>SELONGIS0R RT
02/01</td><td>SELONGISOR</td><td>BATUR</td><td>PUSKESMAS INDUK</td><td>dr.Arninta
Rahma Khoirunnisa</td><td>Supomo,A.Md.Kep</td><td>P</td><td>60-69
Thn.</td><td>Keluarga</td><td>Lama</td><td>BPJS PBI</td><td>Rajal</td><td
align='right'>6</td><td align='right'>11</td><td align='right'>67</td><td>BP.
Umum</td><td></td><td></td><td>Dalam
Wilayah</td><td>'0001027421706</td><td>'3322014906550002</td><td>137</td><td>91</
td><td>81</td><td>36</td><td>20</td><td>145</td><td>56</td><td></td><td></
td><td></td></tr><tr><td align='right'>Z00</td><td>General examination and
investigation of persons without complaint and reported
diagnosis</td><td></td><td></td><td align='right'>2503</td><td
align='right'>1008467</td><td>15-05-2023</td><td>DEBORA GRECIA SUCI
ANGGRAINY</td><td>ELISABET
SUMIYATI</td><td></td><td>'</td><td>10-01-2011</td><td>PANDANAN RT
3/3</td><td>PANDANAN</td><td>GETASAN</td><td>PUSKESMAS INDUK</td><td>dr.Arninta
Rahma Khoirunnisa</td><td>Supomo,A.Md.Kep</td><td>P</td><td>10-14
Thn.</td><td>Keluarga</td><td>Lama</td><td>Umum</td><td>Rajal</td><td
align='right'>5</td><td align='right'>4</td><td align='right'>12</td><td>BP.
Umum</td><td></td><td></td><td>Dalam
Wilayah</td><td>'</td><td>'3322015001110001</td><td>80</td><td>60</td><td>81</
td><td>36.5</td><td>20</td><td>125<
/td><td>21</td><td></td><td></td><td></td></tr><tr><td
align='right'>H66</td><td>Suppurative and unspecified otitis
media</td><td></td><td></td><td align='right'>2495</td><td
align='right'>02000036</td><td>15-05-2023</td><td>DEWI NUR
ANNISA</td><td></td><td></td><td>'</td><td>18-12-2005</td><td>KEDAYON RT 12 RW 1
</td><td></td><td>WATES</td><td>PUSKESMAS INDUK</td><td>dr.Arninta Rahma
Khoirunnisa</td><td>Supomo,A.Md.Kep</td><td>P</td><td>15-19
Thn.</td><td>Keluarga</td><td>Lama</td><td>BPJS PBI</td><td>Rajal</td><td
align='right'>27</td><td align='right'>4</td><td align='right'>17</td><td>BP.
Umum</td><td></td><td></td><td>Dalam
Wilayah</td><td>'0001027442902</td><td>'3322015812050005</td><td>80</td><td>70</
td><td>87</td><td>36.5</td><td>20</td><td>153</td><td>50</td><td></td><td></
td><td></td></tr><tr><td align='right'>K04.1</td><td>Necrosis of
pulp</td><td></td><td>pasien datang dengan keluhan gigi bawah ingin di
tambal</td><td align='right'>2521</td><td align='right'>1014718</td><td>15-05-
2023</td><td>EDI SAPUTRA
TARIGAN</td><td></td><td></td><td>'</td><td>12-03-2000</td><td>PONDOK PENUAI
KEDAYON</td><td></td><td>WATES</td><td>PUSKESMAS INDUK</td><td>drg.Ade
Indranila</td><td>drg.Ade Indranila</td><td>L</td><td>20-44
Thn.</td><td>Keluarga</td><td>Baru</td><td>BPJS PBI</td><td>Rajal</td><td
align='right'>3</td><td align='right'>2</td><td align='right'>23</td><td>BP.
Gigi</td><td></td><td></td><td>Dalam
Wilayah</td><td>'0000244306945</td><td>'1206031203000001</td><td>100</td><td>70</
td><td>78</td><td>36</td><td>22</td><td>175</td><td>70</td><td></td><td></
td><td>penambalan pada gigi 3.6</td></tr><tr><td align='right'>J06.9</td><td>Acute
upper respiratory infection, unspecified</td><td></td><td>panas, batuk,
pilek</td><td align='right'>2467</td><td align='right'>1022572</td><td>15-05-
2023</td><td>ENDANG
LESTARI</td><td></td><td></td><td>'</td><td>04-11-2021</td><td>KALITENGAH RT 02 RW
06</td><td></td><td>BATUR</td><td>PUSKESMAS INDUK</td><td>dr.Arninta Rahma
Khoirunnisa</td><td>Sri Hartini,S.S.T.Keb</td><td>P</td><td>1-4
Thn.</td><td>Keluarga</td><td>Lama</td><td>Umum</td><td>Rajal</td><td
align='right'>11</td><td align='right'>6</td><td
align='right'>1</td><td>MTBS</td><td></td><td></td><td>Dalam
Wilayah</td><td>'</td><td>'</td><td></td><td></td><td>128</td><td>37</td><td>39</
td><td>80</td><td>11</td><td></td><td>penkes cara pemberian oobat ddi
rumah</td><td>memberikan penkes cara pemberian obat di rumah</td></tr><tr><td
align='right'>K05.3</td><td>Chronic periodontitis</td><td></td><td>pasien datang
dengan keluhan gigi yang di tambal sakit</td><td align='right'>2508</td><td
align='right'>1001039</td><td>15-05-2023</td><td>ESTER SRI
LESTARAI</td><td></td><td></td><td>'</td><td>26-03-1979</td><td>NGELO RT 03 RW
02</td><td></td><td>GETASAN</td><td>PUSKESMAS INDUK</td><td>drg.Ade
Indranila</td><td>drg.Ade Indranila</td><td>L</td><td>20-44
Thn.</td><td>Keluarga</td><td>Lama</td><td>BPJS NON PBI</td><td>Rajal</td><td
align='right'>19</td><td align='right'>1</td><td align='right'>44</td><td>BP.
Gigi</td><td></td><td></td><td>Dalam
Wilayah</td><td>'0001266464349</td><td>'3322014308790003</td><td>120</td><td>70</
td><td>78</td><td>36</td><td>22</td><td>165</td><td>90</td><td></td><td>pro
konservasi</td><td>premedikasi</td></tr><tr><td align='right'>J06.9</td><td>Acute
upper respiratory infection, unspecified</td><td></td><td></td><td
align='right'>2519</td><td align='right'>1011996</td><td>15-05-2023</td><td>EXCEL
VINO AVALTYAN</td><td></td><td></td><td>'</td><td>26-08-2012</td><td>GEDAD RT
09/01</td><td>GEDAD</td><td>WATES</td><td>PUSKESMAS INDUK</td><td>dr.Arninta Rahma
Khoirunnisa</td><td>Supomo,A.Md.Kep</td><td>L</td><td>10-14
Thn.</td><td>Keluarga</td><td>Baru</td><td>BPJS NON PBI</td><td>Rajal</td><td
align='right'>19</td><td align='right'>8</td><td align='right'>10</td><td>BP.
Umum</td><td></td><td></td><td>Dalam
Wilayah</td><td>'0002253391525</td><td>'3322012608120001</td><td>80</td><td>60</
td><td>82</td><td>36.5</td><td>20</td><td>136</td><td>36</td><td></td><td></
td><td></td></tr><tr><td align='right'>K04.1</td><td>Necrosis of
pulp</td><td></td><td>pasien datang dengan keluhan gigi bawah sakit</td><td
align='right'>2477</td><td align='right'>07000068</td><td>15-05-2023</td><td>FATINA
CANDRAWATI</td><td></td><td></td><td>'</td><td>07-06-2013</td><td>BLANCIR RT 2 RW
6</td><td></td><td>KOPENG</td><td>PUSKESMAS INDUK</td><td>drg.Ade
Indranila</td><td>Maulida Rahma K N,A.Md.KG</td><td>P</td><td>5-9
Thn.</td><td>Keluarga</td><td>Baru</td><td>Umum</td><td>Rajal</td><td
align='right'>8</td><td align='right'>11</td><td align='right'>9</td><td>BP.
Gigi</td><td></td><td></td><td>Dalam
Wilayah</td><td>'</td><td>'</td><td>100</td><td>70</td><td>87</td><td>36.2</
td><td>22</td><td>123</td><td>35</td><td></td><td>pro
exo</td><td>premedikasi</td></tr><tr><td align='right'>J11.0</td><td>Influenza with
pneumonia, virus not identified</td><td></td><td>panas, batuk, pilek</td><td
align='right'>2468</td><td align='right'>1020017</td><td>15-05-2023</td><td>GELEN
SAMUDRA DEWANADA</td><td></td><td></td><td>'</td><td>14-11-2018</td><td>NGADUMAN RT
04 RW 04</td><td></td><td>Luar Wilayah</td><td>PUSKESMAS INDUK</td><td>dr.Arninta
Rahma Khoirunnisa</td><td>Sri Hartini,S.S.T.Keb</td><td>L</td><td>1-4
Thn.</td><td>Keluarga</td><td>Lama</td><td>Umum</td><td>Rajal</td><td
align='right'>1</td><td align='right'>6</td><td
align='right'>4</td><td>MTBS</td><td></td><td></td><td>Luar
Wilayah</td><td>'</td><td>'</td><td></td><td></td><td>133</td><td>37</td><td>42</
td><td>98</td><td>15</td><td></td><td>penkes cara pemberian obat di
rumah</td><td>memberikan penkes cara pemberian obat di rumah</td></tr><tr><td
align='right'>Z76.2</td><td>Health supervision and care of other healthy infant and
child</td><td></td><td>KONSULTASI KESEHATAN</td><td align='right'>2506</td><td
align='right'>03000029</td><td>15-05-2023</td><td>HUMAIRA AQILA</td><td>SRI
UTOMO</td><td>BELUM/TIDAK BEKERJA</td><td>'</td><td>21-04-2023</td><td>TOLOKAN RT
05 RW 01</td><td>TOLOKAN</td><td>TOLOKAN</td><td>PUSKESMAS INDUK</td><td>dr.Arninta
Rahma Khoirunnisa</td><td>Wiwin,A.Md.Keb</td><td>P</td><td>8-30
hari</td><td>Keluarga</td><td>Baru</td><td>Umum</td><td>Rajal</td><td
align='right'>24</td><td align='right'>0</td><td
align='right'>0</td><td>MTBS</td><td></td><td></td><td>Dalam
Wilayah</td><td>'</td><td>'</td><td></td><td></td><td>130</td><td>37</td><td>43</
td><td>50</td><td>4</td><td></td><td>PENKES TTG IMUNISASI</td><td>MEMBERIKAN PENKES
TENTANG IMUNISASI</td></tr><tr><td align='right'>T14.9</td><td>Injury,
unspecified</td><td></td><td></td><td align='right'>2522</td><td
align='right'>01000049</td><td>15-05-2023</td><td>JASMAN</td><td></td><td></
td><td>'</td><td>06-09-1954</td><td>NGROTO RT 8 RW 5</td><td></td><td>Luar
Wilayah</td><td>PUSKESMAS INDUK</td><td>dr.Arninta Rahma
Khoirunnisa</td><td>Supomo,A.Md.Kep</td><td>L</td><td>60-69
Thn.</td><td>Keluarga</td><td>Lama</td><td>BPJS PBI</td><td>Rajal</td><td
align='right'>9</td><td align='right'>8</td><td align='right'>68</td><td>BP.
Umum</td><td></td><td></td><td>Luar
Wilayah</td><td>'0000601313049</td><td>'3322010609540001</td><td>134</td><td>90</
td><td>87</td><td>36.5</td><td>20</td><td>167</td><td>54</td><td></td><td></
td><td></td></tr><tr><td align='right'>J06.9</td><td>Acute upper respiratory
infection, unspecified</td><td></td><td></td><td align='right'>2470</td><td
align='right'>1011750</td><td>15-05-2023</td><td>JULIANA NOFA
SIBURIAN</td><td></td><td></td><td>'</td><td>03-07-1983</td><td>BUMIAYU RT 02 RW 04
SUMOGAWE</td><td></td><td>Luar Wilayah</td><td>PUSKESMAS INDUK</td><td>dr.Arninta
Rahma Khoirunnisa</td><td>Supomo,A.Md.Kep</td><td>P</td><td>20-44
Thn.</td><td>Keluarga</td><td>Lama</td><td>BPJS NON PBI</td><td>Rajal</td><td
align='right'>12</td><td align='right'>10</td><td align='right'>39</td><td>BP.
Umum</td><td></td><td></td><td>Luar
Wilayah</td><td>'0002376415552</td><td>'3171044307830005</td><td>132</td><td>95</
td><td>80</td><td>36</td><td>20</td><td>154</td><td>62</td><td></td><td></
td><td></td></tr><tr><td align='right'>K04.1</td><td>Necrosis of
pulp</td><td></td><td>pasien datang dengan keluhan ingin kontrol lanjutan</td><td
align='right'>2482</td><td
align='right'>1009748</td><td>15-05-2023</td><td>JUMSARI</td><td></td><td></
td><td>'</td><td>28-04-1977</td><td>BATUR KIDUL RT 05 RW 14</td><td>BATUR
KIDUL</td><td>BATUR</td><td>PUSKESMAS INDUK</td><td>drg.Ade
Indranila</td><td>drg.Ade Indranila</td><td>L</td><td>45-54
Thn.</td><td>Keluarga</td><td>Lama</td><td>BPJS PBI</td><td>Rajal</td><td
align='right'>17</td><td align='right'></td><td align='right'>46</td><td>BP.
Gigi</td><td></td><td></td><td>Dalam
Wilayah</td><td>'0001997095432</td><td>'3322012804770002</td><td>149</td><td>99</
td><td>78</td><td>36.2</td><td>22</td><td>165</td><td>60</td><td></td><td></
td><td>penambalan pada gigi 3.5</td></tr><tr><td
align='right'>H10.9</td><td>Conjunctivitis, unspecified</td><td></td><td></td><td
align='right'>2524</td><td
align='right'>1005488</td><td>15-05-2023</td><td>KONIPAH</td><td></td><td></
td><td>'</td><td>01-05-1974</td><td>TOLOKAN RT 05 RW
01</td><td>TOLOKAN</td><td>TOLOKAN</td><td>PUSKESMAS INDUK</td><td>dr.Arninta Rahma
Khoirunnisa</td><td>Supomo,A.Md.Kep</td><td>P</td><td>45-54
Thn.</td><td>Keluarga</td><td>Baru</td><td>BPJS PBI</td><td>Rajal</td><td
align='right'>14</td><td align='right'></td><td align='right'>49</td><td>BP.
Umum</td><td></td><td></td><td>Dalam
Wilayah</td><td>'0000603052244</td><td>'3322014201740000</td><td>130</td><td>95</
td><td>87</td><td>36.5</td><td>20</td><td>156</td><td>89</td><td></td><td></
td><td></td></tr><tr><td align='right'>K08.3</td><td>Retained dental
root</td><td></td><td>pasien datang dengan keluhan ingin cabut gigi</td><td
align='right'>2484</td><td align='right'>1025460</td><td>15-05-2023</td><td>KRIS
SUNDARI</td><td></td><td></td><td>'081329448901</td><td>11-11-1993</td><td>GADING
LEGOK RT3/16 SAWANGAN MAGELANG</td><td></td><td>Luar kabupaten</td><td>PUSKESMAS
INDUK</td><td>drg.Ade Indranila</td><td>drg.Ade Indranila</td><td>P</td><td>20-44
Thn.</td><td>Keluarga</td><td>Lama</td><td>BPJS NON PBI</td><td>Rajal</td><td
align='right'>4</td><td align='right'>6</td><td align='right'>29</td><td>BP.
Gigi</td><td></td><td></td><td>Luar
Wilayah</td><td>'0001691290067</td><td>'3308175111930001</td><td>117</td><td>78</
td><td>76</td><td>36</td><td>22</td><td>155</td><td>60</td><td></td><td></
td><td>pencabutan gigi 3.6</td></tr><tr><td align='right'>Z00</td><td>General
examination and investigation of persons without complaint and reported
diagnosis</td><td></td><td></td><td align='right'>2474</td><td
align='right'>07000067</td><td>15-05-2023</td><td>LUTFY
SANTONI</td><td></td><td></td><td>'</td><td>04-01-2008</td><td>KOPENG RT 2 RW
2</td><td></td><td>KOPENG</td><td>PUSKESMAS INDUK</td><td>dr.Arninta Rahma
Khoirunnisa</td><td>Supomo,A.Md.Kep</td><td>L</td><td>15-19
Thn.</td><td>Keluarga</td><td>Baru</td><td>Umum</td><td>Rajal</td><td
align='right'>11</td><td align='right'>4</td><td align='right'>15</td><td>BP.
Umum</td><td></td><td></td><td>Dalam
Wilayah</td><td>'</td><td>'</td><td>120</td><td>54</td><td>82</td><td>36.5</
td><td>20</td><td>160</td><td>51</td><td></td><td></td><td></td></tr><tr><td
align='right'>K05.3</td><td>Chronic periodontitis</td><td></td><td>pasien datang
dengan keluhan ingin cabut gigi</td><td align='right'>2509</td><td
align='right'>1019732</td><td>15-05-2023</td><td>MARSIDI</td><td>MARSIDI</
td><td></td><td>'</td><td>30-10-1960</td><td>KEBONPETE RT 1 RW
2</td><td></td><td>Luar Wilayah</td><td>PUSKESMAS INDUK</td><td>drg.Ade
Indranila</td><td>drg.Ade Indranila</td><td>L</td><td>60-69
Thn.</td><td>Keluarga</td><td>Baru</td><td>BPJS NON PBI</td><td>Rajal</td><td
align='right'>15</td><td align='right'>6</td><td align='right'>62</td><td>BP.
Gigi</td><td></td><td></td><td>Luar
Wilayah</td><td>'0002931891287</td><td>'3322013010600001</td><td>117</td><td>76</
td><td>78</td><td>36</td><td>22</td><td>165</td><td>60</td><td></td><td></
td><td>pencabutan gigi 4.3</td></tr><tr><td align='right'>I10</td><td>Essential
(primary) hypertension</td><td></td><td></td><td align='right'>2498</td><td
align='right'>1005365</td><td>15-05-2023</td><td>MARTO
TARUNO</td><td></td><td></td><td>'</td><td>31-12-1949</td><td>DUKUH RT 01 RW
02</td><td>DUKUH</td><td>BATUR</td><td>PUSKESMAS INDUK</td><td>dr.Arninta Rahma
Khoirunnisa</td><td>Supomo,A.Md.Kep</td><td>L</td><td>>70
Thn.</td><td>Keluarga</td><td>Lama</td><td>Umum</td><td>Rajal</td><td
align='right'>14</td><td align='right'>4</td><td align='right'>73</td><td>BP.
Umum</td><td></td><td></td><td>Dalam
Wilayah</td><td>'</td><td>'3322013112490027</td><td>187</td><td>100</td><td>87</
td><td>36.5</td><td>20</td><td>161</td><td>58</td><td></td><td></td><td></td></
tr><tr><td align='right'>J06.9</td><td>Acute upper respiratory infection,
unspecified</td><td></td><td>PANAS, BATUK, PILEK MATA KELUAR KOTORAN</td><td
align='right'>2523</td><td align='right'>1024916</td><td>15-05-2023</td><td>MARYAM
ERINA CHALISA</td><td></td><td></td><td>'</td><td>03-08-2022</td><td>TOLOKAN RT 05
RW 01</td><td>TOLOKAN</td><td>TOLOKAN</td><td>PUSKESMAS INDUK</td><td>dr.Arninta
Rahma Khoirunnisa</td><td>Sri Hartini,S.S.T.Keb</td><td>P</td><td><1
Thn.</td><td>Keluarga</td><td>Lama</td><td>Umum</td><td>Rajal</td><td
align='right'></td><td align='right'>9</td><td
align='right'></td><td>MTBS</td><td></td><td></td><td>Dalam
Wilayah</td><td>'</td><td>'</td><td></td><td></td><td>100</td><td>39</td><td>38</
td><td>66</td><td>7</td><td></td><td>PENKES CARA PEMBERIAN OBAT DI
RUMAH</td><td>MEMBERIKAN PENKES TENTANG CARA PEMBERIAN OBAT</td></tr><tr><td
align='right'>T14.9</td><td>Injury, unspecified</td><td></td><td></td><td
align='right'>2518</td><td align='right'>90000108</td><td>15-05-2023</td><td>MUH
ABDUL ROZAK</td><td></td><td></td><td>'085865048758</td><td>17-08-1982</
td><td>KARANGASEM RT 05 RW 06 KETAPANG SUSUKAN</td><td></td><td>Luar
Wilayah</td><td>PUSKESMAS INDUK</td><td>dr.Arninta Rahma
Khoirunnisa</td><td>Supomo,A.Md.Kep</td><td>L</td><td>20-44
Thn.</td><td>Keluarga</td><td>Baru</td><td>BPJS PBI</td><td>Rajal</td><td
align='right'>29</td><td align='right'>8</td><td align='right'>40</td><td>BP.
Umum</td><td></td><td></td><td>Luar
Wilayah</td><td>'0000602847123</td><td>'3322031708820006</td><td>130</td><td>80</
td><td>80</td><td>36.5</td><td>20</td><td>156</td><td>56</td><td></td><td></
td><td></td></tr><tr><td align='right'>J06.9</td><td>Acute upper respiratory
infection, unspecified</td><td></td><td>panas, batuk , pilek</td><td
align='right'>2493</td><td
align='right'>1024342</td><td>15-05-2023</td><td>MUHAMMAD FAIQ
AL-AZZAM</td><td></td><td></td><td>'</td><td>02-03-2022</td><td>KARANGBAWANG RT 12
RW 02</td><td></td><td>NOGOSAREN</td><td>PUSKESMAS INDUK</td><td>dr.Arninta Rahma
Khoirunnisa</td><td>Sri Hartini,S.S.T.Keb</td><td>L</td><td>1-4
Thn.</td><td>Keluarga</td><td>Lama</td><td>Umum</td><td>Rajal</td><td
align='right'>13</td><td align='right'>2</td><td
align='right'>1</td><td>MTBS</td><td></td><td></td><td>Dalam
Wilayah</td><td>'</td><td>'</td><td></td><td></td><td>100</td><td>37</td><td>38</
td><td>80</td><td>10</td><td></td><td>penkes vara pemberian obat di
rumah</td><td>memberikan penkes cara pemberian obat di rumah</td></tr><tr><td
align='right'>J06.9</td><td>Acute upper respiratory infection,
unspecified</td><td></td><td></td><td align='right'>2481</td><td
align='right'>1005594</td><td>15-05-2023</td><td>MURTIYAH
</td><td></td><td>PETANI/PEKEBUN</td><td>'</td><td>07-02-1995</td><td>BATUR KIDUL
RT 04 /014</td><td></td><td>BATUR</td><td>PUSKESMAS INDUK</td><td>dr.Arninta Rahma
Khoirunnisa</td><td>Supomo,A.Md.Kep</td><td>P</td><td>20-44
Thn.</td><td>Keluarga</td><td>Lama</td><td>Umum</td><td>Rajal</td><td
align='right'>8</td><td align='right'>3</td><td align='right'>28</td><td>BP.
Umum</td><td></td><td></td><td>Dalam
Wilayah</td><td>'</td><td>'3322015702950001</td><td>140</td><td>82</td><td>88</
td><td>36.5</td><td>20</td><td>147</td><td>62</td><td></td><td></td><td></td></
tr><tr><td align='right'>K00.6</td><td>Disturbances in tooth
eruption</td><td></td><td>pasien datang dengan keluhan ingin cabut gigi</td><td
align='right'>2480</td><td
align='right'>07000070</td><td>15-05-2023</td><td>NAUFALANA
ASKA</td><td>MURWANTO</td><td>PELAJAR/MAHASISWA</td><td>'08239020726</td><td>14-10-
2016</td><td>KOPENG RT 4 RW 2</td><td></td><td>KOPENG</td><td>PUSKESMAS
INDUK</td><td>drg.Ade Indranila</td><td>Maulida Rahma K
N,A.Md.KG</td><td>L</td><td>5-9
Thn.</td><td>Keluarga</td><td>Baru</td><td>Umum</td><td>Rajal</td><td
align='right'>1</td><td align='right'>7</td><td align='right'>6</td><td>BP.
Gigi</td><td></td><td></td><td>Dalam
Wilayah</td><td>'</td><td>'3322011410160002</td><td>100</td><td>70</td><td>98</
td><td>36.2</td><td>22</td><td>100</td><td>23</td><td></td><td></td><td>pencabutan
gigi susu</td></tr><tr><td align='right'>K00.6</td><td>Disturbances in tooth
eruption</td><td></td><td>pasien datang dengan keluhan ingin cabut gigi</td><td
align='right'>2525</td><td align='right'>03000030</td><td>15-05-2023</td><td>RAISYA
TRIANIKA</td><td>IR. ISMA'UN</td><td>PELAJAR/MAHASISWA</td><td>'</td><td>15-09-
2015</td><td>TOLOKAN RT 05 RW 01</td><td>TOLOKAN</td><td>TOLOKAN</td><td>PUSKESMAS
INDUK</td><td>drg.Ade Indranila</td><td>Maulida Rahma K
N,A.Md.KG</td><td>P</td><td>5-9
Thn.</td><td>Keluarga</td><td>Baru</td><td>Umum</td><td>Rajal</td><td
align='right'>0</td><td align='right'>8</td><td align='right'>7</td><td>BP.
Gigi</td><td></td><td></td><td>Dalam
Wilayah</td><td>'</td><td>'3322015509150001</td><td>100</td><td>70</td><td>78</
td><td>36</td><td>22</td><td>123</td><td>18</td><td></td><td></td><td>pencabutan
gigi susu</td></tr><tr><td
align='right'>M79.1</td><td>Myalgia</td><td></td><td></td><td
align='right'>2512</td><td
align='right'>1000977</td><td>15-05-2023</td><td>RAMINI</td><td></td><td></
td><td>'</td><td>29-10-1959</td><td>SIDOMUKTI RT 03 RW
05</td><td>SIDOMUKTI</td><td>KOPENG</td><td>PUSKESMAS INDUK</td><td>dr.Arninta
Rahma Khoirunnisa</td><td>Supomo,A.Md.Kep</td><td>P</td><td>60-69
Thn.</td><td>Keluarga</td><td>Lama</td><td>BPJS NON PBI</td><td>Rajal</td><td
align='right'>16</td><td align='right'>6</td><td align='right'>63</td><td>BP.
Umum</td><td></td><td></td><td>Dalam
Wilayah</td><td>'0000074743391</td><td>'3322016910590001</td><td>119</td><td>82</
td><td>78</td><td>36.5</td><td>20</td><td>143</td><td>55</td><td></td><td></
td><td></td></tr><tr><td align='right'>A88.1</td><td>Epidemic
verti</td><td></td><td></td><td align='right'>2479</td><td
align='right'>1015594</td><td>15-05-2023</td><td>RENISA WIGATINING
TYAS</td><td></td><td>PELAJAR/MAHASISWA</td><td>'</td><td>24-01-1999</
td><td>PANDANAN RT 01 RW 03</td><td></td><td>GETASAN</td><td>PUSKESMAS
INDUK</td><td>dr.Arninta Rahma
Khoirunnisa</td><td>Supomo,A.Md.Kep</td><td>P</td><td>20-44
Thn.</td><td>Keluarga</td><td>Lama</td><td>Umum</td><td>Rajal</td><td
align='right'>21</td><td align='right'>3</td><td align='right'>24</td><td>BP.
Umum</td><td></td><td></td><td>Dalam
Wilayah</td><td>'0001442509536</td><td>'3322016401990001</td><td>114</td><td>83</
td><td>82</td><td>36</td><td>20</td><td>156</td><td>48</td><td></td><td></
td><td></td></tr><tr><td align='right'>Z76.2</td><td>Health supervision and care of
other healthy infant and child</td><td></td><td>KONTROL BBL</td><td
align='right'>2507</td><td align='right'>07000071</td><td>15-05-2023</td><td>RIZQIA
AMEERA SHABILA</td><td>SLAMET EDI N</td><td>BELUM/TIDAK
BEKERJA</td><td>'0882003375192</td><td>11-05-2023</td><td>KOPENG RT 01 RW
02</td><td>KOPENG</td><td>KOPENG</td><td>PUSKESMAS INDUK</td><td>dr.Arninta Rahma
Khoirunnisa</td><td>Wiwin,A.Md.Keb</td><td>P</td><td>0-7
hari</td><td>Keluarga</td><td>Baru</td><td>Umum</td><td>Rajal</td><td
align='right'>4</td><td align='right'>0</td><td
align='right'>0</td><td>MTBS</td><td></td><td></td><td>Dalam
Wilayah</td><td>'</td><td>'</td><td></td><td></td><td>130</td><td>37</td><td>42</
td><td>50</td><td>3</td><td></td><td>PENKES TENTANG ASI
EKSKLUSIFF</td><td>MEMBERIKAN PENKES TTG ASI EKSKLUSIFF</td></tr><tr><td
align='right'>K80</td><td>Cholelithiasis</td><td></td><td></td><td
align='right'>2520</td><td
align='right'>07000072</td><td>15-05-2023</td><td>ROBINI</td><td>RUSWANTO</
td><td>PETANI/PEKEBUN</td><td>'085726224921</td><td>14-07-1975</td><td>PLALAR RT 04
RW 04</td><td>PLALAR</td><td>KOPENG</td><td>PUSKESMAS INDUK</td><td>dr.Arninta
Rahma Khoirunnisa</td><td>Supomo,A.Md.Kep</td><td>P</td><td>45-54
Thn.</td><td>Keluarga</td><td>Baru</td><td>BPJS NON PBI</td><td>Rujuk</td><td
align='right'>1</td><td align='right'>10</td><td align='right'>47</td><td>BP.
Umum</td><td>Penyakit Dalam </td><td>RS DR.ASMIR SALATIGA</td><td>Dalam
Wilayah</td><td>'0003514678277</td><td>'3322015407750003</td><td>141</td><td>81</
td><td>87</td><td>36.5</td><td>20</td><td>148</td><td>72</td><td></td><td></
td><td></td></tr><tr><td align='right'>E11</td><td>Non-insulin-dependent diabetes
mellitus</td><td></td><td></td><td align='right'>2476</td><td
align='right'>1013417</td><td>15-05-2023</td><td>RUKAYAH</td><td></td><td></
td><td>'</td><td>05-06-1976</td><td>MANNGIHAN RT
03/01</td><td></td><td>MANGGIHAN</td><td>PUSKESMAS INDUK</td><td>dr.Arninta Rahma
Khoirunnisa</td><td>Supomo,A.Md.Kep</td><td>P</td><td>45-54
Thn.</td><td>Keluarga</td><td>Lama</td><td>BPJS PBI</td><td>Rajal</td><td
align='right'>10</td><td align='right'>11</td><td align='right'>46</td><td>BP.
Umum</td><td></td><td></td><td>Dalam
Wilayah</td><td>'0002349066543</td><td>'3309164506760004</td><td>122</td><td>76</
td><td>80</td><td>36</td><td>20</td><td>148</td><td>49</td><td></td><td></
td><td></td></tr><tr><td
align='right'>I84</td><td>Haemorrhoids</td><td></td><td></td><td
align='right'>2486</td><td
align='right'>1013315</td><td>15-05-2023</td><td>SARINIATI</td><td></td><td></
td><td>'</td><td>03-11-1976</td><td>PANDANAN RT 1 RW
3</td><td></td><td>GETASAN</td><td>PUSKESMAS INDUK</td><td>dr.Arninta Rahma
Khoirunnisa</td><td>Supomo,A.Md.Kep</td><td>P</td><td>45-54
Thn.</td><td>Keluarga</td><td>Lama</td><td>BPJS PBI</td><td>Rajal</td><td
align='right'>12</td><td align='right'>6</td><td align='right'>46</td><td>BP.
Umum</td><td></td><td></td><td>Dalam
Wilayah</td><td>'0000602655287</td><td>'3322014311760002</td><td>138</td><td>80</
td><td>80</td><td>36.5</td><td>20</td><td>138</td><td>52</td><td></td><td></
td><td></td></tr><tr><td align='right'>I63.9</td><td>Cerebral infarction,
unspecified</td><td></td><td></td><td align='right'>2473</td><td
align='right'>1022241</td><td>15-05-2023</td><td>SARJU
MAFI</td><td></td><td></td><td>'</td><td>01-12-1974</td><td>CLOWOK RT 06 RW
02</td><td></td><td>Luar Wilayah</td><td>PUSKESMAS INDUK</td><td>dr.Arninta Rahma
Khoirunnisa</td><td>Supomo,A.Md.Kep</td><td>L</td><td>45-54
Thn.</td><td>Keluarga</td><td>Lama</td><td>BPJS PBI</td><td>Rujuk</td><td
align='right'>14</td><td align='right'>5</td><td align='right'>48</td><td>BP.
Umum</td><td>Saraf</td><td>RS PURI ASIH SALATIGA</td><td>Luar
Wilayah</td><td>'0002222152053</td><td>'3322010112740000</td><td>140</td><td>80</
td><td>87</td><td>36.5</td><td>20</td><td>160</td><td>71</td><td></td><td></
td><td></td></tr><tr><td align='right'>J06.9</td><td>Acute upper respiratory
infection, unspecified</td><td></td><td></td><td align='right'>2465</td><td
align='right'>1004374</td><td>15-05-2023</td><td>SITI
FATIMAH</td><td></td><td></td><td>'</td><td>08-03-1984</td><td>BATUR WETAN RT.2
RW.13</td><td></td><td>BATUR</td><td>PUSKESMAS INDUK</td><td>dr.Arninta Rahma
Khoirunnisa</td><td>Supomo,A.Md.Kep</td><td>P</td><td>20-44
Thn.</td><td>Keluarga</td><td>Lama</td><td>BPJS PBI</td><td>Rajal</td><td
align='right'>7</td><td align='right'>2</td><td align='right'>39</td><td>BP.
Umum</td><td></td><td></td><td>Dalam
Wilayah</td><td>'0002349069816</td><td>'3322014803840010</td><td>115</td><td>75</
td><td>80</td><td>36</td><td>21</td><td>147</td><td>66</td><td></td><td></
td><td></td></tr><tr><td align='right'>I10</td><td>Essential (primary)
hypertension</td><td></td><td></td><td align='right'>2497</td><td
align='right'>1000423</td><td>15-05-2023</td><td>SUHARTINI</td><td></td><td></
td><td>'</td><td>26-03-1956</td><td>PENDINGAN RT 05 RW
01</td><td></td><td>GETASAN</td><td>PUSKESMAS INDUK</td><td>dr.Arninta Rahma
Khoirunnisa</td><td>Supomo,A.Md.Kep</td><td>P</td><td>60-69
Thn.</td><td>Keluarga</td><td>Lama</td><td>Umum</td><td>Rajal</td><td
align='right'>19</td><td align='right'>1</td><td align='right'>67</td><td>BP.
Umum</td><td></td><td></td><td>Dalam
Wilayah</td><td>'0002469689965</td><td>'3322014403620000</td><td>161</td><td>102</
td><td>87</td><td>36.5</td><td>20</td><td>158</td><td>76</td><td></td><td></
td><td></td></tr><tr><td align='right'>J00</td><td>Acute nasopharyngitis [common
cold]</td><td></td><td></td><td align='right'>2527</td><td
align='right'>1004120</td><td>15-05-2023</td><td>SUMARLI</td><td></td><td></
td><td>'</td><td>15-01-1982</td><td>TAJUK RT 02 RW 03 TAJUK</td><td></td><td>Luar
Wilayah</td><td>PUSKESMAS INDUK</td><td>dr.Arninta Rahma
Khoirunnisa</td><td>Supomo,A.Md.Kep</td><td>L</td><td>20-44
Thn.</td><td>Keluarga</td><td>Lama</td><td>BPJS PBI</td><td>Rajal</td><td
align='right'></td><td align='right'>4</td><td align='right'>41</td><td>BP.
Umum</td><td></td><td></td><td>Luar
Wilayah</td><td>'0001532016573</td><td>'3322011501820001</td><td>99</td><td>74</
td><td>87</td><td>36.5</td><td>20</td><td>167</td><td>68</td><td></td><td></
td><td></td></tr><tr><td align='right'>H61.2</td><td>Impacted
cerumen</td><td></td><td></td><td align='right'>2466</td><td
align='right'>06000052</td><td>15-05-2023</td><td>SURAMI</td><td></td><td></
td><td>'</td><td>31-12-1962</td><td>KALIDUREN RT 1
</td><td></td><td>BATUR</td><td>PUSKESMAS INDUK</td><td>dr.Arninta Rahma
Khoirunnisa</td><td>Supomo,A.Md.Kep</td><td>P</td><td>60-69
Thn.</td><td>Keluarga</td><td>Baru</td><td>Umum</td><td>Rajal</td><td
align='right'>15</td><td align='right'>4</td><td align='right'>60</td><td>BP.
Umum</td><td></td><td></td><td>Dalam
Wilayah</td><td>'</td><td>'</td><td>166</td><td>102</td><td>87</td><td>36.5</
td><td>20</td><td>156</td><td>56</td><td></td><td></td><td></td></tr><tr><td
align='right'>J06.9</td><td>Acute upper respiratory infection,
unspecified</td><td></td><td></td><td align='right'>2501</td><td
align='right'>1024409</td><td>15-05-2023</td><td>SURYANTO</td><td></td><td></
td><td>'</td><td>01-11-1984</td><td>KRANGKENG RT 01 RW
12</td><td></td><td>BATUR</td><td>PUSKESMAS INDUK</td><td>dr.Arninta Rahma
Khoirunnisa</td><td>Supomo,A.Md.Kep</td><td>L</td><td>20-44
Thn.</td><td>Keluarga</td><td>Lama</td><td>BPJS PBI</td><td>Rajal</td><td
align='right'>14</td><td align='right'>6</td><td align='right'>38</td><td>BP.
Umum</td><td></td><td></td><td>Dalam
Wilayah</td><td>'0002265354898</td><td>'3322010111840000</td><td>107</td><td>65</
td><td>80</td><td>36.5</td><td>20</td><td>156</td><td>54</td><td></td><td></
td><td></td></tr><tr><td align='right'>N18.9</td><td>Chronic renal failure,
unspecified</td><td></td><td></td><td align='right'>2490</td><td
align='right'>1022708</td><td>15-05-2023</td><td>SUTARNO</td><td></td><td></
td><td>'</td><td>07-07-1973</td><td>POLOBOGO RT 05 RW
01</td><td></td><td>GETASAN</td><td>PUSKESMAS INDUK</td><td>dr.Arninta Rahma
Khoirunnisa</td><td>Supomo,A.Md.Kep</td><td>L</td><td>45-54
Thn.</td><td>Keluarga</td><td>Lama</td><td>BPJS NON PBI</td><td>Rajal</td><td
align='right'>8</td><td align='right'>10</td><td align='right'>49</td><td>BP.
Umum</td><td></td><td></td><td>Dalam
Wilayah</td><td>'0002419885855</td><td>'3322010707730000</td><td>121</td><td>80</
td><td>80</td><td>36</td><td>20</td><td>166</td><td>79</td><td></td><td></
td><td></td></tr><tr><td align='right'>J02</td><td>Acute
pharyngitis</td><td></td><td></td><td align='right'>2491</td><td
align='right'>1005308</td><td>15-05-2023</td><td>TRI
MULYANI</td><td></td><td></td><td>'</td><td>28-03-1982</td><td>KEDAYON RT 06 RW
01</td><td>KEDAYON</td><td>WATES</td><td>PUSKESMAS INDUK</td><td>dr.Arninta Rahma
Khoirunnisa</td><td>Supomo,A.Md.Kep</td><td>P</td><td>20-44
Thn.</td><td>Keluarga</td><td>Lama</td><td>Umum</td><td>Rajal</td><td
align='right'>17</td><td align='right'>1</td><td align='right'>41</td><td>BP.
Umum</td><td></td><td></td><td>Dalam
Wilayah</td><td>'</td><td>'3322016803820006</td><td>127</td><td>90</td><td>82</
td><td>36.5</td><td>20</td><td>149</td><td>55</td><td></td><td></td><td></td></
tr><tr><td align='right'>I10</td><td>Essential (primary)
hypertension</td><td></td><td></td><td align='right'>2494</td><td
align='right'>1004099</td><td>15-05-2023</td><td>TRI
MUNARSIH</td><td></td><td></td><td>'</td><td>21-05-1975</td><td>DUKUH RT
4/8</td><td></td><td>KOPENG</td><td>PUSKESMAS INDUK</td><td>dr.Arninta Rahma
Khoirunnisa</td><td>Supomo,A.Md.Kep</td><td>P</td><td>45-54
Thn.</td><td>Keluarga</td><td>Lama</td><td>Umum</td><td>Rajal</td><td
align='right'>24</td><td align='right'>11</td><td align='right'>47</td><td>BP.
Umum</td><td></td><td></td><td>Dalam
Wilayah</td><td>'0002616972399</td><td>'3322016105750000</td><td>140</td><td>89</
td><td>80</td><td>36</td><td>20</td><td>150</td><td>58</td><td></td><td></
td><td></td></tr><tr><td align='right'>K02.1</td><td>Caries of
dentine</td><td></td><td>pasien datang dengan keluhan ingin tambal gigi</td><td
align='right'>2500</td><td
align='right'>1016251</td><td>15-05-2023</td><td>TUKINI</td><td></td><td></
td><td>'</td><td>28-08-1981</td><td>GETASAN RT
6/1</td><td>GETASAN</td><td>GETASAN</td><td>PUSKESMAS INDUK</td><td>drg.Ade
Indranila</td><td>drg.Ade Indranila</td><td>P</td><td>20-44
Thn.</td><td>Keluarga</td><td>Lama</td><td>BPJS PBI</td><td>Rajal</td><td
align='right'>17</td><td align='right'>8</td><td align='right'>41</td><td>BP.
Gigi</td><td></td><td></td><td>Dalam
Wilayah</td><td>'0002349078546</td><td>'3322016808810000</td><td>118</td><td>87</
td><td>88</td><td>36.1</td><td>22</td><td>155</td><td>65</td><td></td><td></t
d><td>penambalan ketak molar</td></tr><tr><td
align='right'>M79.1</td><td>Myalgia</td><td></td><td></td><td
align='right'>2492</td><td
align='right'>1003845</td><td>15-05-2023</td><td>YARMINI</td><td></td><td></
td><td>'</td><td>16-04-1976</td><td>PIJI RT 09 RW
05</td><td></td><td>GETASAN</td><td>PUSKESMAS INDUK</td><td>dr.Arninta Rahma
Khoirunnisa</td><td>Supomo,A.Md.Kep</td><td>P</td><td>45-54
Thn.</td><td>Keluarga</td><td>Lama</td><td>BPJS NON PBI</td><td>Rajal</td><td
align='right'>29</td><td align='right'></td><td align='right'>47</td><td>BP.
Umum</td><td></td><td></td><td>Dalam
Wilayah</td><td>'0001899084194</td><td>'3322015604760001</td><td>120</td><td>70</
td><td>87</td><td>36.5</td><td>20</td><td>147</td><td>58</td><td></td><td></
td><td></td></tr><tr><td align='right'>J06.9</td><td>Acute upper respiratory
infection, unspecified</td><td></td><td>PANAS, BATUK PILEK</td><td
align='right'>2514</td><td align='right'>1024427</td><td>15-05-2023</td><td>ZEFANYA
CHISTA ARIDYA
RAWESTRI</td><td></td><td></td><td>'</td><td>17-11-2021</td><td>SIDOMUKTI RT 03 RW
05</td><td>SIDOMUKTI</td><td>KOPENG</td><td>PUSKESMAS INDUK</td><td>dr.Arninta
Rahma Khoirunnisa</td><td>Wiwin,A.Md.Keb</td><td>P</td><td>1-4
Thn.</td><td>Keluarga</td><td>Lama</td><td>BPJS NON PBI</td><td>Rajal</td><td
align='right'>28</td><td align='right'>5</td><td
align='right'>1</td><td>MTBS</td><td></td><td></td><td>Dalam
Wilayah</td><td>'0003313324732</td><td>'3322015711210002</td><td>90</td><td>60</
td><td>100</td><td>36</td><td>37</td><td>75</td><td>11</td><td></td><td>PENKES CARA
PEMBERIAN OBAT DI RUMAH</td><td>MEMBERIKAN PENKES CARA PEMBERIAN OBAT DI
RUMAH</td></tr><tr><td align='right'>J06</td><td>Acute upper respiratory infections
of multiple and unspecified sites</td><td></td><td></td><td
align='right'>2513</td><td align='right'>1000411</td><td>15-05-2023</td><td>ZINNETA
CYNARA LUMASISKA</td><td></td><td></td><td>'</td><td>23-03-2015</td><td>SIDOMUKTI
RT 03/05</td><td>SIDOMUKTI</td><td>KOPENG</td><td>PUSKESMAS
INDUK</td><td>dr.Arninta Rahma
Khoirunnisa</td><td>Supomo,A.Md.Kep</td><td>P</td><td>5-9
Thn.</td><td>Keluarga</td><td>Baru</td><td>BPJS NON PBI</td><td>Rajal</td><td
align='right'>22</td><td align='right'>1</td><td align='right'>8</td><td>BP.
Umum</td><td></td><td></td><td>Dalam
Wilayah</td><td>'0002199676228</td><td>'3322016303150001</td><td>70</td><td>50</
td><td>87</td><td>36.5</td><td>20</td><td>126</td><td>16</td><td></td><td></
td><td></td></tr><tr><td align='right'>B38.1</td><td>Chronic pulmonary
coccidioidomycosis</td><td></td><td>MINT RUJUKN KE RS</td><td
align='right'>2568</td><td align='right'>1022327</td><td>16-05-2023</td><td>ADEKA
IVANDER MICHAEL
IBANEZ</td><td></td><td></td><td>'</td><td>24-09-2021</td><td>SIDOMUKTI RT 03 RW
05</td><td></td><td>KOPENG</td><td>PUSKESMAS INDUK</td><td>dr.Arninta Rahma
Khoirunnisa</td><td>Uci Novitawati,A.Md.Keb</td><td>L</td><td>1-4
Thn.</td><td>Keluarga</td><td>Lama</td><td>BPJS NON PBI</td><td>Rajal</td><td
align='right'>22</td><td align='right'>7</td><td
align='right'>1</td><td>MTBS</td><td></td><td></td><td>Dalam
Wilayah</td><td>'0003101631142</td><td>'3322010903200004</td><td></td><td></
td><td>120</td><td>36</td><td>35</td><td>89</td><td>16</td><td></td><td>-</td><td>-
</td></tr><tr><td align='right'>J06.9</td><td>Acute upper respiratory infection,
unspecified</td><td></td><td>pnas, btuk, pilek</td><td align='right'>2573</td><td
align='right'>1022474</td><td>16-05-2023</td><td>ADRIELLA PUTRI
KURNIA</td><td></td><td></td><td>'</td><td>13-09-2021</td><td>KALITENGAH RT 01 RW
06</td><td></td><td>BATUR</td><td>PUSKESMAS INDUK</td><td>dr.Arninta Rahma
Khoirunnisa</td><td>Sri Hartini,S.S.T.Keb</td><td>P</td><td>1-4
Thn.</td><td>Keluarga</td><td>Lama</td><td>Umum</td><td>Rajal</td><td
align='right'>3</td><td align='right'>8</td><td
align='right'>1</td><td>MTBS</td><td></td><td></td><td>Dalam
Wilayah</td><td>'</td><td>'</td><td></td><td></td><td>20</td><td>37</td><td>38</
td><td>76</td><td>11</td><td></td><td>penkes car pemberian obt di
rumh</td><td>memberikn penkes cr pemberian oba3t di rumh</td></tr><tr><td
align='right'>J06.9</td><td>Acute upper respiratory infection,
unspecified</td><td></td><td>panas, btuk, pilek</td><td align='right'>2549</td><td
align='right'>1023889</td><td>16-05-2023</td><td>ADZKIYA NAILA
SAFA</td><td></td><td></td><td>'</td><td>20-05-2022</td><td>TAYEMAN RT 03 RW
07</td><td></td><td>KOPENG</td><td>PUSKESMAS INDUK</td><td>dr.Arninta Rahma
Khoirunnisa</td><td>Sri Hartini,S.S.T.Keb</td><td>P</td><td><1
Thn.</td><td>Keluarga</td><td>Lama</td><td>Umum</td><td>Rajal</td><td
align='right'></td><td align='right'>11</td><td
align='right'></td><td>MTBS</td><td></td><td></td><td>Dalam
Wilayah</td><td>'</td><td>'</td><td></td><td></td><td>139</td><td>36</td><td>39</
td><td>72</td><td>8</td><td></td><td>penkes cara pemberian obat di
rumah</td><td>memberikan penkes cara pemberian obat di rumah</td></tr><tr><td
align='right'>J06.9</td><td>Acute upper respiratory infection,
unspecified</td><td></td><td>panas, batuk, pilek</td><td align='right'>2589</td><td
align='right'>1024258</td><td>16-05-2023</td><td>AIRA NABILA
TANISHA</td><td></td><td></td><td>'</td><td>03-08-2022</td><td>NGELO RT 04 RW
02</td><td></td><td>GETASAN</td><td>PUSKESMAS INDUK</td><td>dr.Arninta Rahma
Khoirunnisa</td><td>Sri Hartini,S.S.T.Keb</td><td>P</td><td><1
Thn.</td><td>Keluarga</td><td>Lama</td><td>Umum</td><td>Rajal</td><td
align='right'></td><td align='right'>9</td><td
align='right'></td><td>MTBS</td><td></td><td></td><td>Dalam
Wilayah</td><td>'</td><td>'</td><td></td><td></td><td>120</td><td>37</td><td>39</
td><td>69</td><td>7</td><td></td><td>penkes cara pemberian obat di
rumah</td><td>memberikan penkes cara pemberian obat di rumah</td></tr><tr><td
align='right'>J06.9</td><td>Acute upper respiratory infection,
unspecified</td><td></td><td>BATUK, PILEK</td><td align='right'>2600</td><td
align='right'>1003380</td><td>16-05-2023</td><td>ALIKA NAYLA
PUTRI</td><td></td><td></td><td>'</td><td>01-02-2016</td><td>WATES RT 01 RW
02</td><td></td><td>WATES</td><td>PUSKESMAS INDUK</td><td>dr.Arninta Rahma
Khoirunnisa</td><td>Riska Wulandari,A.Md.Kep</td><td>P</td><td>5-9
Thn.</td><td>Keluarga</td><td>Lama</td><td>BPJS NON PBI</td><td>Rajal</td><td
align='right'>15</td><td align='right'>3</td><td align='right'>7</td><td>BP.
Umum</td><td></td><td></td><td>Dalam
Wilayah</td><td>'0002909141919</td><td>'3322014102160000</td><td>100</td><td>80</
td><td>88</td><td>37</td><td>22</td><td>114</td><td>17</td><td></td><td></
td><td></td></tr><tr><td align='right'>Z00</td><td>General examination and
investigation of persons without complaint and reported
diagnosis</td><td></td><td>KONTROL</td><td align='right'>2583</td><td
align='right'>1020004</td><td>16-05-2023</td><td>ANA
SOFIYATUN</td><td></td><td></td><td>'</td><td>09-09-1973</td><td>KEPOSONG RT 01 RW
01</td><td></td><td>Luar kabupaten</td><td>PUSKESMAS INDUK</td><td>dr.Arninta Rahma
Khoirunnisa</td><td>Riska Wulandari,A.Md.Kep</td><td>P</td><td>45-54
Thn.</td><td>Keluarga</td><td>Lama</td><td>BPJS NON PBI</td><td>Rajal</td><td
align='right'>7</td><td align='right'>8</td><td align='right'>49</td><td>BP.
Umum</td><td></td><td></td><td>Luar
Wilayah</td><td>'0002094441085</td><td>'3306164909730007</td><td>120</td><td>80</
td><td>88</td><td>36.5</td><td>22</td><td>145</td><td>56</td><td></td><td></
td><td></td></tr><tr><td align='right'>J06.9</td><td>Acute upper respiratory
infection, unspecified</td><td></td><td>BATUK, PILEK</td><td
align='right'>2575</td><td align='right'>1015063</td><td>16-05-2023</td><td>ANISA
TRI ASTUTI</td><td></td><td></td><td>'</td><td>17-01-1998</td><td>GOWONGAN RT 04 RW
02</td><td></td><td>MANGGIHAN</td><td>PUSKESMAS INDUK</td><td>dr.Arninta Rahma
Khoirunnisa</td><td>Riska Wulandari,A.Md.Kep</td><td>P</td><td>20-44
Thn.</td><td>Keluarga</td><td>Lama</td><td>BPJS NON PBI</td><td>Rajal</td><td
align='right'>29</td><td align='right'>3</td><td align='right'>25</td><td>BP.
Umum</td><td></td><td></td><td>Dalam
Wilayah</td><td>'0002581549277</td><td>'3322065712980001</td><td>120</td><td>80</
td><td>88</td><td>36.9</td><td>22</td><td>154</td><td>58</td><td></td><td></
td><td></td></tr><tr><td align='right'>Z00</td><td>General examination and
investigation of persons without complaint and reported
diagnosis</td><td></td><td>KONTROL</td><td align='right'>2587</td><td
align='right'>99000061</td><td>16-05-2023</td><td>ASTUTIK
WICAKSANI</td><td></td><td>KARYAWAN
SWASTA</td><td>'</td><td>10-02-1982</td><td>PAPRINGAN RT 14 RW
5</td><td></td><td>Luar kabupaten</td><td>PUSKESMAS INDUK</td><td>dr.Arninta Rahma
Khoirunnisa</td><td>Riska Wulandari,A.Md.Kep</td><td>P</td><td>20-44
Thn.</td><td>Keluarga</td><td>Baru</td><td>Umum</td><td>Rajal</td><td
align='right'>6</td><td align='right'>3</td><td align='right'>41</td><td>BP.
Umum</td><td></td><td></td><td>Luar
Wilayah</td><td>'0001385346126</td><td>'3323015002820004</td><td>110</td><td>90</
td><td>88</td><td>36</td><td>24</td><td>145</td><td>55</td><td></td><td></
td><td></td></tr><tr><td align='right'>J06.9</td><td>Acute upper respiratory
infection, unspecified</td><td></td><td>BATUK, PILEK</td><td
align='right'>2566</td><td align='right'>1010203</td><td>16-05-2023</td><td>DIAN
LESTIYANINGSIH</td><td></td><td></td><td>'</td><td>20-10-1999</td><td>TOLOKAN RT
05/01</td><td></td><td>TOLOKAN</td><td>PUSKESMAS INDUK</td><td>dr.Arninta Rahma
Khoirunnisa</td><td>Riska Wulandari,A.Md.Kep</td><td>P</td><td>20-44
Thn.</td><td>Keluarga</td><td>Lama</td><td>BPJS NON PBI</td><td>Rajal</td><td
align='right'>26</td><td align='right'>6</td><td align='right'>23</td><td>BP.
Umum</td><td></td><td></td><td>Dalam
Wilayah</td><td>'0002579974749</td><td>'3322016010990002</td><td>120</td><td>80</
td><td>88</td><td>36</td><td>22</td><td>159</td><td>57</td><td></td><td></
td><td></td></tr><tr><td align='right'>Z00</td><td>General examination and
investigation of persons
without complaint and reported diagnosis</td><td></td><td>VCT</td><td
align='right'>2576</td><td align='right'>99000059</td><td>16-05-2023</td><td>DWI
HASTUTI</td><td></td><td>MENGURUS RUMAH
TANGGA</td><td>'</td><td>29-05-1975</td><td>SURUHAN RT 1 RW 2
</td><td></td><td>Luar kabupaten</td><td>PUSKESMAS INDUK</td><td>dr.Arninta Rahma
Khoirunnisa</td><td>Riska Wulandari,A.Md.Kep</td><td>P</td><td>45-54
Thn.</td><td>Keluarga</td><td>Baru</td><td>BPJS NON PBI</td><td>Rajal</td><td
align='right'>18</td><td align='right'>11</td><td align='right'>47</td><td>BP.
Umum</td><td></td><td></td><td>Luar
Wilayah</td><td>'0003290200918</td><td>'3322176905750001</td><td>130</td><td>80</
td><td>88</td><td>36</td><td>22</td><td>153</td><td>56</td><td></td><td></
td><td></td></tr><tr><td align='right'>K04.1</td><td>Necrosis of
pulp</td><td></td><td>Pasien mau cabit gigi</td><td align='right'>2579</td><td
align='right'>1018693</td><td>16-05-2023</td><td>EFRAYIM ADAR
WIBOWO</td><td></td><td></td><td>'</td><td>24-03-2012</td><td>GETASAN RT 08 RW
01</td><td></td><td>GETASAN</td><td>PUSKESMAS INDUK</td><td>drg.Ade
Indranila</td><td> - </td><td>L</td><td>10-14
Thn.</td><td>Keluarga</td><td>Baru</td><td>Umum</td><td>Rajal</td><td
align='right'>22</td><td align='right'>1</td><td align='right'>11</td><td>BP.
Gigi</td><td></td><td></td><td>Dalam
Wilayah</td><td>'0001289249886</td><td>'3276022403120000</td><td>100</td><td>60</
td><td>88</td><td>36</td><td>22</td><td>135</td><td>25</td><td></td><td>Pro exo
</td><td>Tunda exo
Premesikasi </td></tr><tr><td align='right'>K12.0</td><td>Recurrent oral
aphthae</td><td></td><td>Pasien mau cabit gigi</td><td align='right'>2579</td><td
align='right'>1018693</td><td>16-05-2023</td><td>EFRAYIM ADAR
WIBOWO</td><td></td><td></td><td>'</td><td>24-03-2012</td><td>GETASAN RT 08 RW
01</td><td></td><td>GETASAN</td><td>PUSKESMAS INDUK</td><td>drg.Ade
Indranila</td><td> - </td><td>L</td><td>10-14
Thn.</td><td>Keluarga</td><td>Baru</td><td>Umum</td><td>Rajal</td><td
align='right'>22</td><td align='right'>1</td><td align='right'>11</td><td>BP.
Gigi</td><td></td><td></td><td>Dalam
Wilayah</td><td>'0001289249886</td><td>'3276022403120000</td><td>100</td><td>60</
td><td>88</td><td>36</td><td>22</td><td>135</td><td>25</td><td></td><td>Pro exo
</td><td>Tunda exo
Premesikasi </td></tr><tr><td align='right'>L30.9</td><td>Dermatitis,
unspecified</td><td></td><td>GATAL-GATAL</td><td align='right'>2567</td><td
align='right'>1016925</td><td>16-05-2023</td><td>FENDI
IRAWAN</td><td></td><td></td><td>'</td><td>01-01-1996</td><td>SODONG RT 10 RW
02</td><td></td><td>GETASAN</td><td>PUSKESMAS INDUK</td><td>dr.Arninta Rahma
Khoirunnisa</td><td>Riska Wulandari,A.Md.Kep</td><td>L</td><td>20-44
Thn.</td><td>Keluarga</td><td>Lama</td><td>BPJS NON PBI</td><td>Rajal</td><td
align='right'>15</td><td align='right'>4</td><td align='right'>27</td><td>BP.
Umum</td><td></td><td></td><td>Dalam
Wilayah</td><td>'0002344194483</td><td>'3322013101960001</td><td>117</td><td>71</
td><td>88</td><td>36.2</td><td>22</td><td>150</td><td>43</td><td></td><td></
td><td></td></tr><tr><td align='right'>J06.9</td><td>Acute upper respiratory
infection, unspecified</td><td></td><td>BATUK PILEK</td><td
align='right'>2596</td><td
align='right'>1024119</td><td>16-05-2023</td><td>GABRIELLA CHRISTIANA PUTRI
SANAJI</td><td></td><td></td><td>'</td><td>12-08-2016</td><td>BANTUKAN RT 13 RW
05</td><td></td><td>Luar kabupaten</td><td>PUSKESMAS INDUK</td><td>dr.Arninta Rahma
Khoirunnisa</td><td>Riska Wulandari,A.Md.Kep</td><td>P</td><td>5-9
Thn.</td><td>Keluarga</td><td>Lama</td><td>BPJS NON PBI</td><td>Rajal</td><td
align='right'>4</td><td align='right'>9</td><td align='right'>6</td><td>BP.
Umum</td><td></td><td></td><td>Luar
Wilayah</td><td>'0002919228715</td><td>'3310095208160001</td><td>100</td><td>80</
td><td>87</td><td>36</td><td>22</td><td>110</td><td>17</td><td></td><td></
td><td></td></tr><tr><td align='right'>J06.9</td><td>Acute upper respiratory
infection, unspecified</td><td></td><td>panas, batuk, pilek</td><td
align='right'>2559</td><td align='right'>1023935</td><td>16-05-2023</td><td>HANAN
ARKA NARENDRA</td><td></td><td></td><td>'</td><td>12-05-2022</td><td>THEKELAN RT 05
RW 17</td><td>THEKELAN</td><td>BATUR</td><td>PUSKESMAS INDUK</td><td>dr.Arninta
Rahma Khoirunnisa</td><td>Sri Hartini,S.S.T.Keb</td><td>L</td><td>1-4
Thn.</td><td>Keluarga</td><td>Lama</td><td>Umum</td><td>Rajal</td><td
align='right'>4</td><td align='right'></td><td
align='right'>1</td><td>MTBS</td><td></td><td></td><td>Dalam
Wilayah</td><td>'</td><td>'</td><td></td><td></td><td>130</td><td>37</td><td>37</
td><td>73</td><td>10</td><td></td><td>penkes cara pemberian obat di
rumah</td><td>memberikan penkes cara pemberian obat di rumah</td></tr><tr><td
align='right'>K30</td><td>Dyspepsia</td><td></td><td>DIARE, PERUT MELILIT</td><td
align='right'>2577</td><td align='right'>04000014</td><td>16-05-2023</td><td>ILHAM
YUSUF MAULANA</td><td></td><td>PELAJAR/MAHASISWA</td><td>'</td><td>02-06-2005</
td><td>PADAN RT 14 RW 2 </td><td></td><td>NGRAWAN</td><td>PUSKESMAS
INDUK</td><td>dr.Arninta Rahma Khoirunnisa</td><td>Riska
Wulandari,A.Md.Kep</td><td>L</td><td>15-19
Thn.</td><td>Keluarga</td><td>Baru</td><td>Umum</td><td>Rajal</td><td
align='right'>14</td><td align='right'>11</td><td align='right'>17</td><td>BP.
Umum</td><td></td><td></td><td>Dalam
Wilayah</td><td>'</td><td>'3322010206050001</td><td>96</td><td>66</td><td>88</
td><td>37.6</td><td>22</td><td>179</td><td>80</td><td></td><td></td><td></td></
tr><tr><td align='right'>J06.9</td><td>Acute upper respiratory infection,
unspecified</td><td></td><td>BATUK PILEK</td><td align='right'>2594</td><td
align='right'>1017780</td><td>16-05-2023</td><td>KOMALASARI</td><td></td><td></
td><td>'</td><td>09-12-1990</td><td>SLEKER RT 02 RW
03</td><td></td><td>KOPENG</td><td>PUSKESMAS INDUK</td><td>dr.Arninta Rahma
Khoirunnisa</td><td>Riska Wulandari,A.Md.Kep</td><td>P</td><td>20-44
Thn.</td><td>Keluarga</td><td>Lama</td><td>Umum</td><td>Rajal</td><td
align='right'>7</td><td align='right'>5</td><td align='right'>32</td><td>BP.
Umum</td><td></td><td></td><td>Dalam
Wilayah</td><td>'0001862680285</td><td>'3175064912900009</td><td>110</td><td>80</
td><td>89</td><td>37</td><td>24</td><td>150</td><td>58</td><td></td><td></
td><td></td></tr><tr><td align='right'>Z00</td><td>General examination and
investigation of persons without complaint and reported
diagnosis</td><td></td><td>VCT</td><td align='right'>2586</td><td
align='right'>90000111</td><td>16-05-2023</td><td>LASMI</td><td></
td><td>WIRASWASTA</td><td>'</td><td>07-01-1983</td><td>KEBONAGUNG RT 1 RW 1
</td><td></td><td>Luar Wilayah</td><td>PUSKESMAS INDUK</td><td>dr.Arninta Rahma
Khoirunnisa</td><td>Riska Wulandari,A.Md.Kep</td><td>P</td><td>20-44
Thn.</td><td>Keluarga</td><td>Baru</td><td>BPJS PBI</td><td>Rajal</td><td
align='right'>9</td><td align='right'>4</td><td align='right'>40</td><td>BP.
Umum</td><td></td><td></td><td>Luar
Wilayah</td><td>'0000602156777</td><td>'3322094701830001</td><td>133</td><td>98</
td><td>88</td><td>36.5</td><td>22</td><td>155</td><td>57</td><td></td><td></
td><td></td></tr><tr><td align='right'>J06.9</td><td>Acute upper respiratory
infection, unspecified</td><td></td><td>BATUK PILEK</td><td
align='right'>2598</td><td align='right'>1002117</td><td>16-05-2023</td><td>LUTFI
LAILAWATI</td><td></td><td></td><td>'</td><td>01-08-2004</td><td>KOPENG RT 06 RW
02</td><td>KOPENG</td><td>KOPENG</td><td>PUSKESMAS INDUK</td><td>dr.Arninta Rahma
Khoirunnisa</td><td>Riska Wulandari,A.Md.Kep</td><td>P</td><td>15-19
Thn.</td><td>Keluarga</td><td>Lama</td><td>Umum</td><td>Rajal</td><td
align='right'>15</td><td align='right'>9</td><td align='right'>18</td><td>BP.
Umum</td><td></td><td></td><td>Dalam
Wilayah</td><td>'0001027415711</td><td>'3322014108040003</td><td>110</td><td>80</
td><td>88</td><td>36</td><td>22</td><td>144</td><td>44</td><td></td><td></
td><td></td></tr><tr><td align='right'>J06.9</td><td>Acute upper respiratory
infection, unspecified</td><td></td><td>panas, batuk, pilek</td><td
align='right'>2533</td><td align='right'>1020162</td><td>16-05-2023</td><td>MANAF
LUTFI ALFARIZQI</td><td></td><td></td><td>'</td><td>01-09-2020</td><td>NGRINGIN RT
01 RW 03</td><td>NGRINGIN</td><td>BATUR</td><td>PUSKESMAS INDUK</td><td>dr.Arninta
Rahma Khoirunnisa</td><td>Sri Hartini,S.S.T.Keb</td><td>L</td><td>1-4
Thn.</td><td>Keluarga</td><td>Lama</td><td>Umum</td><td>Rajal</td><td
align='right'>15</td><td align='right'>8</td><td
align='right'>2</td><td>MTBS</td><td></td><td></td><td>Dalam
Wilayah</td><td>'</td><td>'3322010109200001</td><td></td><td></td><td>100</
td><td>37</td><td>39</td><td>84</td><td>12</td><td></td><td>penkes cara pemberian
obat di rumah</td><td>memberikan penkes cara pemberian obat di
rumah</td></tr><tr><td align='right'>J06.9</td><td>Acute upper respiratory
infection, unspecified</td><td></td><td>BATUK PILEK</td><td
align='right'>2602</td><td align='right'>1004255</td><td>16-05-2023</td><td>MARIA
NONA ENDARWATI</td><td></td><td></td><td>'</td><td>24-11-1973</td><td>BATUR WETAN
RT 02 RW 13</td><td></td><td>BATUR</td><td>PUSKESMAS INDUK</td><td>dr.Arninta Rahma
Khoirunnisa</td><td>Riska Wulandari,A.Md.Kep</td><td>P</td><td>45-54
Thn.</td><td>Keluarga</td><td>Lama</td><td>BPJS NON PBI</td><td>Rajal</td><td
align='right'>22</td><td align='right'>5</td><td align='right'>49</td><td>BP.
Umum</td><td></td><td></td><td>Dalam
Wilayah</td><td>'0001027421155</td><td>'3322016411730000</td><td>120</td><td>80</
td><td>88</td><td>36.4</td><td>22</td><td>140</td><td>60</td><td></td><td></
td><td></td></tr><tr><td align='right'>L30.9</td><td>Dermatitis,
unspecified</td><td></td><td>GATAL-GATAL</td><td align='right'>2591</td><td
align='right'>1011439</td><td>16-05-2023</td><td>MARYONO</td><td></td><td></
td><td>'</td><td>11-06-1979</td><td>KOPENG RT 02 RW
02</td><td></td><td>KOPENG</td><td>PUSKESMAS INDUK</td><td>dr.Arninta Rahma
Khoirunnisa</td><td>Riska Wulandari,A.Md.Kep</td><td>L</td><td>20-44
Thn.</td><td>Keluarga</td><td>Lama</td><td>BPJS NON PBI</td><td>Rajal</td><td
align='right'>5</td><td align='right'>11</td><td align='right'>43</td><td>BP.
Umum</td><td></td><td></td><td>Dalam
Wilayah</td><td>'0002120884986</td><td>'3322011106790002</td><td>115</td><td>79</
td><td>88</td><td>36.6</td><td>22</td><td>160</td><td>66</td><td></td><td></
td><td></td></tr><tr><td align='right'>K08.3</td><td>Retained dental
root</td><td></td><td>Paaiwn datang mau cabut gigi kanan atas </td><td
align='right'>2551</td><td
align='right'>1025568</td><td>16-05-2023</td><td>MUNDIYAH</td><td></td><td></
td><td>'</td><td>09-11-1960</td><td>SRANTI RT 08 RW
02</td><td></td><td>WATES</td><td>PUSKESMAS INDUK</td><td>drg.Ade
Indranila</td><td> - </td><td>P</td><td>60-69
Thn.</td><td>Keluarga</td><td>Lama</td><td>BPJS PBI</td><td>Rajal</td><td
align='right'>7</td><td align='right'>6</td><td align='right'>62</td><td>BP.
Gigi</td><td></td><td></td><td>Dalam
Wilayah</td><td>'0002349067601</td><td>'3322016911600001</td><td>140</td><td>73</
td><td>80</td><td>36</td><td>22</td><td>152</td><td>65</td><td></td><td></
td><td>Exo dengan infiltrasi lidocain, gigi 1.4 dan 1.5 GR
Anjuran gigit tampon 1/2 jam
Tdk boleh makan dan minim panas dlu </td></tr><tr><td
align='right'>K08.3</td><td>Retained dental root</td><td></td><td>Pasien datang
dengan keluhan mau peeiksa gigi </td><td align='right'>2578</td><td
align='right'>1006725</td><td>16-05-2023</td><td>NAVA AYU
FRADITTA</td><td></td><td></td><td>'</td><td>09-11-2012</td><td>SELONGISOR RT.1
RW.4</td><td></td><td>BATUR</td><td>PUSKESMAS INDUK</td><td>drg.Ade
Indranila</td><td> - </td><td>P</td><td>10-14
Thn.</td><td>Keluarga</td><td>Lama</td><td>BPJS NON PBI</td><td>Rajal</td><td
align='right'>7</td><td align='right'>6</td><td align='right'>10</td><td>BP.
Gigi</td><td></td><td></td><td>Dalam
Wilayah</td><td>'0003258985926</td><td>'3322014911120001</td><td>100</td><td>70</
td><td>88</td><td>36</td><td>22</td><td>136</td><td>38</td><td></td><td>Pro exo
tunggu goyang dan gifi 1m1 tumbuh dlu</td><td>Tunda exo gigi 5.1 belum goyang
</td></tr><tr><td align='right'>A09</td><td>Diarrhoea and gastroenteritis of
presumed infectious origin</td><td></td><td>bab lbh dari 3 kkl, mual ,
muntah</td><td align='right'>2608</td><td align='right'>1019190</td><td>16-05-
2023</td><td>NENGMAS SUCI ANUGRAH SARI</td><td></td><td></td><td>'</td><td>05-04-
2020</td><td>KALIDUREN RT 01 RW 05</td><td></td><td>BATUR</td><td>PUSKESMAS
INDUK</td><td>dr.Arninta Rahma Khoirunnisa</td><td>Sri
Hartini,S.S.T.Keb</td><td>P</td><td>1-4
Thn.</td><td>Keluarga</td><td>Lama</td><td>Umum</td><td>Rajal</td><td
align='right'>11</td><td align='right'>1</td><td
align='right'>3</td><td>MTBS</td><td></td><td></td><td>Dalam
Wilayah</td><td>'</td><td>'</td><td></td><td></td><td>130</td><td>37</td><td>36</
td><td>88</td><td>11</td><td></td><td>penkes cara pemberiuan obat di
rumag</td><td>memberikan penkes cara pemberian obat di rumah</td></tr><tr><td
align='right'>C49.2</td><td>Malignant neoplasm of connective and soft tissue of
lower limb, including hip</td><td></td><td>KONTROL</td><td
align='right'>2539</td><td align='right'>1025363</td><td>16-05-2023</td><td>NOTO
NIMALADHEVA</td><td></td><td></td><td>'</td><td>02-05-1967</td><td>DEPLONGAN RT 03
RW 02</td><td></td><td>WATES</td><td>PUSKESMAS INDUK</td><td>dr.Arninta Rahma
Khoirunnisa</td><td>Riska Wulandari,A.Md.Kep</td><td>L</td><td>55-59
Thn.</td><td>Keluarga</td><td>Lama</td><td>BPJS NON PBI</td><td>Rujuk</td><td
align='right'>14</td><td align='right'></td><td align='right'>56</td><td>BP.
Umum</td><td>Bedah Onkologi </td><td>RS KEN SARAS</td><td>Dalam
Wilayah</td><td>'0003311491972</td><td>'3322010205670000</td><td>130</td><td>80</
td><td>88</td><td>36.5</td><td>22</td><td>156</td><td>66</td><td></td><td></
td><td></td></tr><tr><td align='right'>E11</td><td>Non-insulin-dependent diabetes
mellitus</td><td></td><td>KONTROL</td><td align='right'>2546</td><td
align='right'>06000054</td><td>16-05-2023</td><td>RUKINI</td><td></td><td></
td><td>'</td><td>19-02-1959</td><td>BATUR WETAN RT 1 RW 13
</td><td></td><td>BATUR</td><td>PUSKESMAS INDUK</td><td>dr.Arninta Rahma
Khoirunnisa</td><td>Riska Wulandari,A.Md.Kep</td><td>P</td><td>60-69
Thn.</td><td>Keluarga</td><td>Baru</td><td>BPJS PBI</td><td>Rujuk</td><td
align='right'>25</td><td align='right'>2</td><td align='right'>64</td><td>BP.
Umum</td><td>Penyakit Dalam </td><td>RSU BINA KASIH AMBARAWA</td><td>Dalam
Wilayah</td><td>'0001027420659</td><td>'3322015902590004</td><td>160</td><td>90</
td><td>88</td><td>36.5</td><td>22</td><td>155</td><td>65</td><td></td><td></
td><td></td></tr><tr><td align='right'>J06.9</td><td>Acute upper respiratory
infection, unspecified</td><td></td><td>BATUK, PILEK</td><td
align='right'>2548</td><td
align='right'>1023066</td><td>16-05-2023</td><td>RUMINI</td><td></td><td></
td><td>'</td><td>24-11-1999</td><td>KRANGKENG RT 02 RW
12</td><td></td><td>KOPENG</td><td>PUSKESMAS INDUK</td><td>dr.Arninta Rahma
Khoirunnisa</td><td>Riska Wulandari,A.Md.Kep</td><td>P</td><td>20-44
Thn.</td><td>Keluarga</td><td>Lama</td><td>BPJS PBI</td><td>Rajal</td><td
align='right'>22</td><td align='right'>5</td><td align='right'>23</td><td>BP.
Umum</td><td></td><td></td><td>Dalam
Wilayah</td><td>'0000602484186</td><td>'3322016411990003</td><td>120</td><td>80</
td><td>88</td><td>36</td><td>22</td><td>147</td><td>45</td><td></td><td></
td><td></td></tr><tr><td align='right'>I50</td><td>Heart
failure</td><td></td><td>KONTROL</td><td align='right'>2601</td><td
align='right'>1006990</td><td>16-05-2023</td><td>SHOBARI
SATRIO</td><td></td><td></td><td>'</td><td>20-11-1972</td><td>BATUR WETAN RT 02 RW
13</td><td>BATUR WETAN</td><td>BATUR</td><td>PUSKESMAS INDUK</td><td>dr.Arninta
Rahma Khoirunnisa</td><td>Riska Wulandari,A.Md.Kep</td><td>L</td><td>45-54
Thn.</td><td>Keluarga</td><td>Lama</td><td>BPJS NON PBI</td><td>Rujuk</td><td
align='right'>26</td><td align='right'>5</td><td align='right'>50</td><td>BP.
Umum</td><td>JANTUNG DAN PEMBULUH DARAH</td><td>RS DR.ASMIR SALATIGA</td><td>Dalam
Wilayah</td><td>'0001027421144</td><td>'3322012011720004</td><td>104</td><td>74</
td><td>88</td><td>36</td><td>22</td><td>159</td><td>56.6</td><td></td><td></
td><td></td></tr><tr><td align='right'>Z00</td><td>General examination and
investigation of persons without complaint and reported
diagnosis</td><td></td><td>KONTROL</td><td align='right'>2584</td><td
align='right'>99000060</td><td>16-05-2023</td><td>SITI
KHAROMAH</td><td></td><td></td><td>'</td><td>02-06-2008</td><td>TIRTO RT 4 RW 3
</td><td></td><td>Luar kabupaten</td><td>PUSKESMAS INDUK</td><td>dr.Arninta Rahma
Khoirunnisa</td><td>Riska Wulandari,A.Md.Kep</td><td>P</td><td>10-14
Thn.</td><td>Keluarga</td><td>Baru</td><td>Umum</td><td>Rajal</td><td
align='right'>14</td><td align='right'>11</td><td align='right'>14</td><td>BP.
Umum</td><td></td><td></td><td>Luar
Wilayah</td><td>'</td><td>'</td><td>134</td><td>87</td><td>89</td><td>36.4</
td><td>22</td><td>155</td><td>57</td><td></td><td></td><td></td></tr><tr><td
align='right'>I10</td><td>Essential (primary) hypertension</td><td></td><td>KAKI
LEMES, PUSING</td><td align='right'>2593</td><td align='right'>1004026</td><td>16-
05-2023</td><td>SIYAM</td><td></td><td></td><td>'</td><td>12-03-1961</td><td>PLALAR
RT 03 RW 04</td><td>PLALAR</td><td>KOPENG</td><td>PUSKESMAS
INDUK</td><td>dr.Arninta Rahma Khoirunnisa</td><td>Riska
Wulandari,A.Md.Kep</td><td>P</td><td>60-69
Thn.</td><td>Keluarga</td><td>Lama</td><td>BPJS NON PBI</td><td>Rajal</td><td
align='right'>4</td><td align='right'>2</td><td align='right'>62</td><td>BP.
Umum</td><td></td><td></td><td>Dalam
Wilayah</td><td>'0002455622853</td><td>'3322015203610002</td><td>159</td><td>85</
td><td>89</td><td>36.8</td><td>22</td><td>148</td><td>60</td><td></td><td></
td><td></td></tr><tr><td align='right'>M15.0</td><td>Primary generalized
(osteo)arthrosis</td><td></td><td>KONTROL</td><td align='right'>2531</td><td
align='right'>1010796</td><td>16-05-2023</td><td>SUGINEM</td><td></td><td>PETANI/
PEKEBUN</td><td>'</td><td>14-02-1953</td><td>DUKUH RT
2/2</td><td></td><td>BATUR</td><td>PUSKESMAS INDUK</td><td>dr.Arninta Rahma
Khoirunnisa</td><td>Riska Wulandari,A.Md.Kep</td><td>P</td><td>>70
Thn.</td><td>Keluarga</td><td>Lama</td><td>BPJS PBI</td><td>Rujuk</td><td
align='right'>2</td><td align='right'>3</td><td align='right'>70</td><td>BP.
Umum</td><td>Penyakit Dalam </td><td>RS PURI ASIH SALATIGA</td><td>Dalam
Wilayah</td><td>'0001532106595</td><td>'3322015402530002</td><td>218</td><td>116</
td><td>88</td><td>37</td><td>23</td><td>154</td><td>95</td><td></td><td></
td><td></td></tr><tr><td align='right'>L84</td><td>Corns and
callosities</td><td></td><td>JEMPOL BENGKAK</td><td align='right'>2561</td><td
align='right'>07000074</td><td>16-05-2023</td><td>SUPRIHATI</td><td></td><td></
td><td>'</td><td>10-12-1972</td><td>SLEKER RT 7 RW 3
</td><td></td><td>KOPENG</td><td>PUSKESMAS INDUK</td><td>dr.Arninta Rahma
Khoirunnisa</td><td>Riska Wulandari,A.Md.Kep</td><td>P</td><td>45-54
Thn.</td><td>Keluarga</td><td>Baru</td><td>BPJS NON PBI</td><td>Rajal</td><td
align='right'>6</td><td align='right'>5</td><td align='right'>50</td><td>BP.
Umum</td><td></td><td></td><td>Dalam
Wilayah</td><td>'0000196250242</td><td>'3322155012720006</td><td>163</td><td>90</
td><td>88</td><td>36.2</td><td>22</td><td>150</td><td>55</td><td></td><td></
td><td></td></tr><tr><td align='right'>Z00</td><td>General examination and
investigation of persons without complaint and reported
diagnosis</td><td></td><td>KONTROL</td><td align='right'>2585</td><td
align='right'>90000110</td><td>16-05-2023</td><td>SURYANTI</td><td></td><td></
td><td>'</td><td>06-08-1983</td><td>BANDUNGAN RT 5 RW 2 </td><td></td><td>Luar
Wilayah</td><td>PUSKESMAS INDUK</td><td>dr.Arninta Rahma Khoirunnisa</td><td>Riska
Wulandari,A.Md.Kep</td><td>P</td><td>20-44
Thn.</td><td>Keluarga</td><td>Baru</td><td>Umum</td><td>Rajal</td><td
align='right'>10</td><td align='right'>9</td><td align='right'>39</td><td>BP.
Umum</td><td></td><td></td><td>Luar
Wilayah</td><td>'</td><td>'</td><td>133</td><td>87</td><td>88</td><td>36.7</
td><td>23</td><td>146</td><td>62</td><td></td><td></td><td></td></tr><tr><td
align='right'>Z00</td><td>General examination and investigation of persons without
complaint and reported diagnosis</td><td></td><td>KONTROL</td><td
align='right'>2572</td><td
align='right'>99000058</td><td>16-05-2023</td><td>SUSANTI</td><td></td><td>KARYAWAN
SWASTA</td><td>'</td><td>27-07-1978</td><td>SONO KULON RT 1 RW
29</td><td></td><td>Luar kabupaten</td><td>PUSKESMAS INDUK</td><td>dr.Arninta Rahma
Khoirunnisa</td><td>Riska Wulandari,A.Md.Kep</td><td>P</td><td>20-44
Thn.</td><td>Keluarga</td><td>Baru</td><td>BPJS PBI</td><td>Rajal</td><td
align='right'>20</td><td align='right'>9</td><td align='right'>44</td><td>BP.
Umum</td><td></td><td></td><td>Luar
Wilayah</td><td>'0000657166048</td><td>'3404146707780003</td><td>172</td><td>113</
td><td>88</td><td>36.5</td><td>22</td><td>145</td><td>60</td><td></td><td></
td><td></td></tr><tr><td align='right'>J06.9</td><td>Acute upper respiratory
infection, unspecified</td><td></td><td>BATUK,
PILEK</td><td align='right'>2574</td><td align='right'>1002378</td><td>16-05-
2023</td><td>SUTARMI</td><td></td><td></td><td>'</td><td>01-08-1955</td><td>SLEKER
RT 3 RW 3</td><td></td><td>KOPENG</td><td>PUSKESMAS INDUK</td><td>dr.Arninta Rahma
Khoirunnisa</td><td>Riska Wulandari,A.Md.Kep</td><td>P</td><td>60-69
Thn.</td><td>Keluarga</td><td>Lama</td><td>BPJS PBI</td><td>Rajal</td><td
align='right'>15</td><td align='right'>9</td><td align='right'>67</td><td>BP.
Umum</td><td></td><td></td><td>Dalam
Wilayah</td><td>'0001027415755</td><td>'3322015608580000</td><td>155</td><td>80</
td><td>88</td><td>37</td><td>22</td><td>156</td><td>62</td><td></td><td></
td><td></td></tr><tr><td align='right'>H35</td><td>Other retinal
disorders</td><td></td><td>KONTROL</td><td align='right'>2532</td><td
align='right'>1023964</td><td>16-05-2023</td><td>SUTI</td><td></td><td></
td><td>'</td><td>12-02-1963</td><td>NGELO RT 06 RW
02</td><td></td><td>GETASAN</td><td>PUSKESMAS INDUK</td><td>dr.Arninta Rahma
Khoirunnisa</td><td>Riska Wulandari,A.Md.Kep</td><td>P</td><td>60-69
Thn.</td><td>Keluarga</td><td>Lama</td><td>BPJS NON PBI</td><td>Rujuk</td><td
align='right'>4</td><td align='right'>3</td><td align='right'>60</td><td>BP.
Umum</td><td>Mata</td><td>RS DR.ASMIR SALATIGA</td><td>Dalam
Wilayah</td><td>'0002438782468</td><td>'3322015202630004</td><td>150</td><td>92</
td><td>80</td><td>36.2</td><td>22</td><td>150</td><td>88</td><td></td><td></
td><td></td></tr><tr><td align='right'>E11</td><td>Non-insulin-dependent diabetes
mellitus</td><td></td><td>KONTROL GDS</td><td align='right'>2544</td><td
align='right'>90000098</td><td>16-05-2023</td><td>SUTIMAN</td><td>SUTIMAN</
td><td>KARYAWAN SWASTA</td><td>'085325426044</td><td>31-12-1965</td><td>KEBONPETE
RT 03 RW 12 POLOBOGO</td><td></td><td>Luar Wilayah</td><td>PUSKESMAS
INDUK</td><td>dr.Arninta Rahma Khoirunnisa</td><td>Riska
Wulandari,A.Md.Kep</td><td>L</td><td>55-59
Thn.</td><td>Keluarga</td><td>Lama</td><td>BPJS NON PBI</td><td>Rajal</td><td
align='right'>15</td><td align='right'>4</td><td align='right'>57</td><td>BP.
Umum</td><td></td><td></td><td>Luar
Wilayah</td><td>'0002933037911</td><td>'3322013112650043</td><td>136</td><td>81</
td><td>88</td><td>36.1</td><td>22</td><td>165</td><td>76</td><td></td><td></
td><td></td></tr><tr><td align='right'>J06.9</td><td>Acute upper respiratory
infection, unspecified</td><td></td><td>BATUK PILEK</td><td
align='right'>2597</td><td
align='right'>1007883</td><td>16-05-2023</td><td>SUTRISNO</td><td></td><td></
td><td>'</td><td>08-09-1978</td><td>KOPENG RT 06 RW
02</td><td></td><td>KOPENG</td><td>PUSKESMAS INDUK</td><td>dr.Arninta Rahma
Khoirunnisa</td><td>Riska Wulandari,A.Md.Kep</td><td>L</td><td>20-44
Thn.</td><td>Keluarga</td><td>Lama</td><td>Umum</td><td>Rajal</td><td
align='right'>8</td><td align='right'>8</td><td align='right'>44</td><td>BP.
Umum</td><td></td><td></td><td>Dalam
Wilayah</td><td>'0001027415698</td><td>'3322010809780003</td><td>133</td><td>90</
td><td>88</td><td>37</td><td>22</td><td>140</td><td>48</td><td></td><td></
td><td></td></tr><tr><td align='right'>A88.1</td><td>Epidemic
verti</td><td></td><td>PUSING BERPUTAR, MUAL</td><td align='right'>2545</td><td
align='right'>1011041</td><td>16-05-2023</td><td>TATI
SUMIYATI</td><td></td><td></td><td>'</td><td>28-09-1960</td><td>SLEKER RT 09 RW
03</td><td>SLEKER</td><td>KOPENG</td><td>PUSKESMAS INDUK</td><td>dr.Arninta Rahma
Khoirunnisa</td><td>Riska Wulandari,A.Md.Kep</td><td>P</td><td>60-69
Thn.</td><td>Keluarga</td><td>Lama</td><td>BPJS NON PBI</td><td>Rajal</td><td
align='right'>18</td><td align='right'>7</td><td align='right'>62</td><td>BP.
Umum</td><td></td><td></td><td>Dalam
Wilayah</td><td>'0000072153898</td><td>'3278106809600002</td><td>128</td><td>74</
td><td>88</td><td>36</td><td>22</td><td>146</td><td>57</td><td></td><td></
td><td></td></tr><tr><td align='right'>L30.9</td><td>Dermatitis,
unspecified</td><td></td><td>GATAL</td><td align='right'>2547</td><td
align='right'>1023472</td><td>16-05-2023</td><td>TRI
JOKO</td><td></td><td></td><td>'</td><td>19-05-1976</td><td>NOGOSAREN RT 01 RW
01</td><td></td><td>NOGOSAREN</td><td>PUSKESMAS INDUK</td><td>dr.Arninta Rahma
Khoirunnisa</td><td>Riska Wulandari,A.Md.Kep</td><td>L</td><td>45-54
Thn.</td><td>Keluarga</td><td>Lama</td><td>BPJS NON PBI</td><td>Rajal</td><td
align='right'>27</td><td align='right'>11</td><td align='right'>46</td><td>BP.
Umum</td><td></td><td></td><td>Dalam
Wilayah</td><td>'0001831975525</td><td>'3322011905760000</td><td>138</td><td>89</
td><td>88</td><td>36</td><td>22</td><td>155</td><td>60</td><td></td><td></
td><td></td></tr><tr><td
align='right'>G40</td><td>Epilepsy</td><td></td><td>KONTROL</td><td
align='right'>2552</td><td
align='right'>1014615</td><td>16-05-2023</td><td>TUMIYAH</td><td></td><td></
td><td>'</td><td>05-07-1982</td><td>KRANGKENG RT 05 RW
12</td><td></td><td>BATUR</td><td>PUSKESMAS INDUK</td><td>dr.Arninta Rahma
Khoirunnisa</td><td>Riska Wulandari,A.Md.Kep</td><td>P</td><td>20-44
Thn.</td><td>Keluarga</td><td>Baru</td><td>BPJS PBI</td><td>Rujuk</td><td
align='right'>11</td><td align='right'>10</td><td align='right'>40</td><td>BP.
Umum</td><td>Saraf</td><td>RS PURI ASIH SALATIGA</td><td>Dalam
Wilayah</td><td>'0000601620489</td><td>'3322014507820005</td><td>110</td><td>80</
td><td>87</td><td>36.5</td><td>20</td><td>156</td><td>55</td><td></td><td></
td><td></td></tr><tr><td align='right'>P07.0</td><td>Extremely low birth
weight</td><td></td><td>minta rujukn ke rs</td><td align='right'>2538</td><td
align='right'>1025028</td><td>16-05-2023</td><td>VALENCIA
HANDRIANA</td><td></td><td></td><td>'</td><td>04-10-2022</td><td>BATUR WETAN RT 02
RW 13</td><td>BATUR WETAN</td><td>BATUR</td><td>PUSKESMAS INDUK</td><td>dr.Arninta
Rahma Khoirunnisa</td><td>Uci Novitawati,A.Md.Keb</td><td>P</td><td><1
Thn.</td><td>Keluarga</td><td>Lama</td><td>BPJS PBI</td><td>Rajal</td><td
align='right'></td><td align='right'>7</td><td
align='right'></td><td>MTBS</td><td></td><td></td><td>Dalam
Wilayah</td><td>'0003305876207</td><td>'3322014410220002</td><td></td><td></
td><td></td><td></td><td></td><td>0</td><td>0</td><td></td><td>=</td><td>-</td></
tr><tr><td align='right'>A09</td><td>Diarrhoea and gastroenteritis of presumed
infectious origin</td><td></td><td>DIARE, GREGESI</td><td
align='right'>2580</td><td
align='right'>1000455</td><td>16-05-2023</td><td>WAHYU</td><td></td><td></
td><td>'</td><td>07-11-1991</td><td>SELONGISOR RT.1
RW.4</td><td></td><td>BATUR</td><td>PUSKESMAS INDUK</td><td>dr.Arninta Rahma
Khoirunnisa</td><td>Riska Wulandari,A.Md.Kep</td><td>P</td><td>20-44
Thn.</td><td>Keluarga</td><td>Lama</td><td>BPJS NON PBI</td><td>Rajal</td><td
align='right'>9</td><td align='right'>6</td><td align='right'>31</td><td>BP.
Umum</td><td></td><td></td><td>Dalam
Wilayah</td><td>'0001027421471</td><td>'3322014711910000</td><td>122</td><td>71</
td><td>88</td><td>36.6</td><td>23</td><td>156</td><td>60</td><td></td><td></
td><td></td></tr><tr><td
align='right'>F20</td><td>Schizophrenia</td><td></td><td>KONTROL</td><td
align='right'>2603</td><td
align='right'>1014594</td><td>16-05-2023</td><td>WAHYUDI</td><td></td><td></
td><td>'</td><td>01-05-1982</td><td>KEDAYON RT 01 RW
12</td><td></td><td>WATES</td><td>PUSKESMAS INDUK</td><td>dr.Arninta Rahma
Khoirunnisa</td><td>Riska Wulandari,A.Md.Kep</td><td>L</td><td>20-44
Thn.</td><td>Keluarga</td><td>Lama</td><td>BPJS PBI</td><td>Rujuk</td><td
align='right'>15</td><td align='right'></td><td align='right'>41</td><td>BP.
Umum</td><td>JIWA</td><td>RS DR.ASMIR SALATIGA</td><td>Dalam
Wilayah</td><td>'0002349076678</td><td>'3322010105820000</td><td>130</td><td>86</
td><td>88</td><td>37.2</td><td>22</td><td>158</td><td>68</td><td></td><td></
td><td></td></tr><tr><td align='right'>J06.9</td><td>Acute upper respiratory
infection, unspecified</td><td></td><td>SESEK BATUK</td><td
align='right'>2607</td><td
align='right'>1010731</td><td>16-05-2023</td><td>WAQIDATUL
FITRI</td><td></td><td></td><td>'</td><td>17-01-1997</td><td>SRANDIL RT
02/017</td><td></td><td>Luar Wilayah</td><td>PUSKESMAS INDUK</td><td>dr.Arninta
Rahma Khoirunnisa</td><td>Riska Wulandari,A.Md.Kep</td><td>P</td><td>20-44
Thn.</td><td>Keluarga</td><td>Lama</td><td>BPJS NON PBI</td><td>Rajal</td><td
align='right'>29</td><td align='right'>3</td><td align='right'>26</td><td>BP.
Umum</td><td></td><td></td><td>Luar
Wilayah</td><td>'0001423228724</td><td>'3322015701970000</td><td>103</td><td>80</
td><td>88</td><td>36.5</td><td>23</td><td>153</td><td>47</td><td></td><td></
td><td></td></tr><tr><td align='right'>Z00</td><td>General examination and
investigation of persons without complaint and reported
diagnosis</td><td></td><td>KONTROL</td><td align='right'>2588</td><td
align='right'>99000062</td><td>16-05-2023</td><td>WULANDARI</td><td></td><td>BURUH
HARIAN LEPAS</td><td>'</td><td>27-09-1998</td><td>SEDAYU RT 2 RW
4</td><td></td><td>Luar kabupaten</td><td>PUSKESMAS INDUK</td><td>dr.Arninta Rahma
Khoirunnisa</td><td>Riska Wulandari,A.Md.Kep</td><td>P</td><td>20-44
Thn.</td><td>Keluarga</td><td>Baru</td><td>Umum</td><td>Rajal</td><td
align='right'>19</td><td align='right'>7</td><td align='right'>24</td><td>BP.
Umum</td><td></td><td></td><td>Luar
Wilayah</td><td>'</td><td>'3308136709980006</td><td>121</td><td>81</td><td>88</
td><td>37</td><td>22</td><td>156</td><td>76</td><td></td><td></td><td></td></
tr><tr><td align='right'>M54.16</td><td>Radiculopathy, lumbar
region</td><td></td><td>KONTROL</td><td align='right'>2530</td><td
align='right'>06000053</td><td>16-05-2023</td><td>YATINI</td><td></td><td></
td><td>'</td><td>15-06-1978</td><td>SELONGISOR RT 2 RW 15
</td><td></td><td>BATUR</td><td>PUSKESMAS INDUK</td><td>dr.Arninta Rahma
Khoirunnisa</td><td>Riska Wulandari,A.Md.Kep</td><td>P</td><td>20-44
Thn.</td><td>Keluarga</td><td>Baru</td><td>BPJS NON PBI</td><td>Rujuk</td><td
align='right'>1</td><td align='right'>11</td><td align='right'>44</td><td>BP.
Umum</td><td>Saraf</td><td>RS
PURI ASIH SALATIGA</td><td>Dalam
Wilayah</td><td>'0001806354516</td><td>'3322015506760003</td><td>177</td><td>104</
td><td>88</td><td>36.5</td><td>22</td><td>155</td><td>65</td><td></td><td></
td><td></td></tr><tr><td align='right'>H66.9</td><td>Otitis media,
unspecified</td><td></td><td></td><td align='right'>2659</td><td
align='right'>1000712</td><td>17-05-2023</td><td>AHMAD FAISAL
MAULANA</td><td></td><td></td><td>'</td><td>25-08-2015</td><td>KASIRAN RT 4 RW
9</td><td></td><td>KOPENG</td><td>PUSKESMAS INDUK</td><td>dr.Gani
Kriswanto</td><td>Suwoto,A.Md.Kep</td><td>L</td><td>5-9
Thn.</td><td>Keluarga</td><td>Lama</td><td>Umum</td><td>Rajal</td><td
align='right'>22</td><td align='right'>8</td><td align='right'>7</td><td>BP.
Umum</td><td></td><td></td><td>Dalam
Wilayah</td><td>'</td><td>'</td><td>90</td><td>60</td><td>84</td><td>36.2</
td><td>24</td><td>120</td><td>18</td><td></td><td></td><td></td></tr><tr><td
align='right'>K29.7</td><td>Gastritis, unspecified</td><td></td><td></td><td
align='right'>2679</td><td align='right'>1005117</td><td>17-05-2023</td><td>DIMAS
RAMADANI</td><td></td><td></td><td>'</td><td>24-08-2011</td><td>PLALAR RT 1 RW
4</td><td></td><td>KOPENG</td><td>PUSKESMAS INDUK</td><td>dr.Gani
Kriswanto</td><td>Suwoto,A.Md.Kep</td><td>L</td><td>10-14
Thn.</td><td>Keluarga</td><td>Lama</td><td>BPJS PBI</td><td>Rajal</td><td
align='right'>23</td><td align='right'>8</td><td align='right'>11</td><td>BP.
Umum</td><td></td><td></td><td>Dalam
Wilayah</td><td>'0002623439981</td><td>'3322012408110000</td><td>90</td><td>60</
td><td>84</td><td>36.2</td><td>24</td><td>120</td><td>32</td><td></td><td></
td><td></td></tr><tr><td align='right'>Z47.8</td><td>Other specified orthopaedic
follow-up care</td><td></td><td></td><td align='right'>2635</td><td
align='right'>07000077</td><td>17-05-2023</td><td>EVA SETYA
ALVIOLA</td><td></td><td>PELAJAR/MAHASISWA</td><td>'</td><td>30-07-2001</
td><td>CUNTEL RT 2 RW 1</td><td></td><td>KOPENG</td><td>PUSKESMAS
INDUK</td><td>dr.Gani Kriswanto</td><td>Suwoto,A.Md.Kep</td><td>P</td><td>20-44
Thn.</td><td>Keluarga</td><td>Baru</td><td>BPJS PBI</td><td>Rujuk</td><td
align='right'>18</td><td align='right'>9</td><td align='right'>21</td><td>BP.
Umum</td><td>Bedah</td><td>RS PURI ASIH SALATIGA</td><td>Dalam
Wilayah</td><td>'0002349074834</td><td>'3322017007010001</td><td>108</td><td>70</
td><td>84</td><td>36.2</td><td>24</td><td>160</td><td>85</td><td></td><td></
td><td></td></tr><tr><td align='right'>J06.9</td><td>Acute upper respiratory
infection, unspecified</td><td></td><td></td><td align='right'>2645</td><td
align='right'>1012488</td><td>17-05-2023</td><td>FARES HIZAM
ADNAM</td><td></td><td></td><td>'</td><td>06-03-2018</td><td>BUMIAYU RT. 04 RW.
05</td><td></td><td>Luar Wilayah</td><td>PUSKESMAS INDUK</td><td>dr.Gani
Kriswanto</td><td>Suwoto,A.Md.Kep</td><td>L</td><td>5-9
Thn.</td><td>Keluarga</td><td>Lama</td><td>Umum</td><td>Rajal</td><td
align='right'>11</td><td align='right'>2</td><td align='right'>5</td><td>BP.
Umum</td><td></td><td></td><td>Luar
Wilayah</td><td>'</td><td>'</td><td>100</td><td>60</td><td>84</td><td>36.3</
td><td>24</td><td>101</td><td>15</td><td></td><td></td><td></td></tr><tr><td
align='right'>J06.9</td><td>Acute upper respiratory infection,
unspecified</td><td></td><td>panas, batuk, pile</td><td align='right'>2663</td><td
align='right'>04000015</td><td>17-05-2023</td><td>FARHAN RAMADHAN
PRATAMA</td><td></td><td></td><td>'</td><td>05-04-2023</td><td>NGRAWAN RT 9 RW
2</td><td></td><td>NGRAWAN</td><td>PUSKESMAS INDUK</td><td>dr.Arninta Rahma
Khoirunnisa</td><td>Sri Hartini,S.S.T.Keb</td><td>L</td><td><1
Thn.</td><td>Keluarga</td><td>Baru</td><td>Umum</td><td>Rajal</td><td
align='right'>12</td><td align='right'>1</td><td
align='right'>0</td><td>MTBS</td><td></td><td></td><td>Dalam
Wilayah</td><td>'</td><td>'</td><td></td><td></td><td>130</td><td>37</td><td>46</
td><td>54</td><td>5</td><td></td><td>penkes cara minum obat di
rumah</td><td>memberikan penkes cara minum obat di rumah</td></tr><tr><td
align='right'>A49.2</td><td>Haemophilus influenzae infection,
unspecified</td><td></td><td>panas, pilek</td><td align='right'>2649</td><td
align='right'>1025050</td><td>17-05-2023</td><td>FATHAN YASYFI AL
HAFIZ</td><td></td><td></td><td>'</td><td>10-09-2022</td><td>SALARAN RT 14 RW
02</td><td></td><td>TOLOKAN</td><td>PUSKESMAS INDUK</td><td>dr.Arninta Rahma
Khoirunnisa</td><td>Sri Hartini,S.S.T.Keb</td><td>L</td><td><1
Thn.</td><td>Keluarga</td><td>Lama</td><td>Umum</td><td>Rajal</td><td
align='right'></td><td align='right'>8</td><td
align='right'></td><td>MTBS</td><td></td><td></td><td>Dalam
Wilayah</td><td>'</td><td>'3322011009220001</td><td></td><td></td><td>120</
td><td>37</td><td>37</td><td>66</td><td>9</td><td></td><td>penkes cara pemberian
obat di rumah</td><td>memberikan penkes cara pemberian obat di
rumah</td></tr><tr><td align='right'>J06.9</td><td>Acute upper respiratory
infection, unspecified</td><td></td><td>panas, batuk, pilek</td><td
align='right'>2664</td><td
align='right'>01000056</td><td>17-05-2023</td><td>JONATAN
PRATAMA</td><td></td><td></td><td>'</td><td>04-12-2021</td><td>NGROTO RT 6 RW 5
</td><td></td><td>GETASAN</td><td>PUSKESMAS INDUK</td><td>dr.Arninta Rahma
Khoirunnisa</td><td>Sri Hartini,S.S.T.Keb</td><td>L</td><td>1-4
Thn.</td><td>Keluarga</td><td>Baru</td><td>Umum</td><td>Rajal</td><td
align='right'>13</td><td align='right'>5</td><td
align='right'>1</td><td>MTBS</td><td></td><td></td><td>Dalam
Wilayah</td><td>'</td><td>'</td><td></td><td></td><td>100</td><td>37</td><td>39</
td><td>88</td><td>13</td><td></td><td>penkes cara pemberian makan di
rumah</td><td>memberikan penkes cara pemberian obat di rumah</td></tr><tr><td
align='right'>L30.9</td><td>Dermatitis, unspecified</td><td></td><td></td><td
align='right'>2648</td><td
align='right'>1000027</td><td>17-05-2023</td><td>JUNI</td><td></td><td></
td><td>'</td><td>01-07-1963</td><td>SALARAN RT 15 RW
02</td><td>SALARAN</td><td>TOLOKAN</td><td>PUSKESMAS INDUK</td><td>dr.Gani
Kriswanto</td><td>Suwoto,A.Md.Kep</td><td>P</td><td>55-59
Thn.</td><td>Keluarga</td><td>Lama</td><td>BPJS PBI</td><td>Rajal</td><td
align='right'>16</td><td align='right'>10</td><td align='right'>59</td><td>BP.
Umum</td><td></td><td></td><td>Dalam
Wilayah</td><td>'0001027445859</td><td>'3322015607630001</td><td>113</td><td>65</
td><td>84</td><td>36.2</td><td>24</td><td>153</td><td>65</td><td></td><td></
td><td></td></tr><tr><td align='right'>I10</td><td>Essential (primary)
hypertension</td><td></td><td></td><td align='right'>2653</td><td
align='right'>1017944</td><td>17-05-2023</td><td>JUREMI</td><td></td><td></
td><td>'</td><td>18-03-1967</td><td>MADU RT 01 RW
04</td><td></td><td>BATUR</td><td>PUSKESMAS INDUK</td><td>dr.Gani
Kriswanto</td><td>Suwoto,A.Md.Kep</td><td>L</td><td>55-59
Thn.</td><td>Keluarga</td><td>Lama</td><td>BPJS PBI</td><td>Rajal</td><td
align='right'>29</td><td align='right'>1</td><td align='right'>56</td><td>BP.
Umum</td><td></td><td></td><td>Dalam
Wilayah</td><td>'0001442410885</td><td>'3322011803670001</td><td>190</td><td>97</
td><td>84</td><td>36.3</td><td>24</td><td>160</td><td>65</td><td></td><td></
td><td></td></tr><tr><td align='right'>J06.9</td><td>Acute upper respiratory
infection, unspecified</td><td></td><td></td><td align='right'>2678</td><td
align='right'>1014436</td><td>17-05-2023</td><td>KARSINI</td><td></td><td></
td><td>'</td><td>25-04-1950</td><td>GETASAN RT 03 RW
01</td><td>GETASAN</td><td>GETASAN</td><td>PUSKESMAS INDUK</td><td>dr.Gani
Kriswanto</td><td>Suwoto,A.Md.Kep</td><td>P</td><td>>70
Thn.</td><td>Keluarga</td><td>Lama</td><td>Umum</td><td>Rajal</td><td
align='right'>22</td><td align='right'>0</td><td align='right'>73</td><td>BP.
Umum</td><td></td><td></td><td>Dalam
Wilayah</td><td>'0002288706546</td><td>'3322016504500001</td><td>166</td><td>97</
td><td>84</td><td>36.3</td><td>24</td><td>155</td><td>67</td><td></td><td></
td><td></td></tr><tr><td align='right'>I50</td><td>Heart
failure</td><td></td><td></td><td align='right'>2673</td><td
align='right'>06000056</td><td>17-05-2023</td><td>KARSIYEM</td><td></
td><td>PETANI/PEKEBUN</td><td>'</td><td>18-04-1962</td><td>KRANGKENG RT 6 RW
12</td><td></td><td>BATUR</td><td>PUSKESMAS INDUK</td><td>dr.Gani
Kriswanto</td><td>Suwoto,A.Md.Kep</td><td>P</td><td>60-69
Thn.</td><td>Keluarga</td><td>Baru</td><td>BPJS PBI</td><td>Rujuk</td><td
align='right'>29</td><td align='right'>0</td><td align='right'>61</td><td>BP.
Umum</td><td></td><td></td><td>Dalam
Wilayah</td><td>'0002574172686</td><td>'3322015804620001</td><td></td><td></
td><td></td><td></td><td></td><td>0</td><td>0</td><td></td><td></td><td></td></
tr><tr><td align='right'>K00.6</td><td>Disturbances in tooth
eruption</td><td></td><td>Pasien mau cabut gigi</td><td align='right'>2642</td><td
align='right'>01000055</td><td>17-05-2023</td><td>KHANSA
SIDQIA</td><td>MUKLIS</td><td></td><td>'085802511878</td><td>07-07-2016</
td><td>NGELO RT 4 RW 2 </td><td></td><td>GETASAN</td><td>PUSKESMAS
INDUK</td><td>drg.Ade Indranila</td><td> - </td><td>P</td><td>5-9
Thn.</td><td>Keluarga</td><td>Baru</td><td>Umum</td><td>Rajal</td><td
align='right'>10</td><td align='right'>10</td><td align='right'>6</td><td>BP.
Gigi</td><td></td><td></td><td>Dalam
Wilayah</td><td>'</td><td>'</td><td></td><td></td><td></td><td></td><td></
td><td>0</td><td>0</td><td></td><td></td><td>Exo CE </td></tr><tr><td
align='right'>J06.9</td><td>Acute upper respiratory infection,
unspecified</td><td></td><td></td><td align='right'>2651</td><td
align='right'>1017840</td><td>17-05-2023</td><td>LUKAS
DASIRAN</td><td></td><td></td><td>'</td><td>06-05-1966</td><td>BULUREJO RT 02 RW
01</td><td></td><td>Luar kabupaten</td><td>PUSKESMAS INDUK</td><td>dr.Gani
Kriswanto</td><td>Suwoto,A.Md.Kep</td><td>L</td><td>55-59
Thn.</td><td>Keluarga</td><td>Lama</td><td>BPJS NON PBI</td><td>Rajal</td><td
align='right'>11</td><td align='right'></td><td align='right'>57</td><td>BP.
Umum</td><td></td><td></td><td>Luar
Wilayah</td><td>'0001969978059</td><td>'3518160605660002</td><td>118</td><td>70</
td><td>88</td><td>36.3</td><td>24</td><td>155</td><td>73</td><td></td><td></
td><td></td></tr><tr><td align='right'>J02</td><td>Acute
pharyngitis</td><td></td><td></td><td align='right'>2650</td><td
align='right'>99000047</td><td>17-05-2023</td><td>MUHAMMAD GILANG
PRATAMA</td><td></td><td>PELAJAR/MAHASISWA</td><td>'082390913766</td><td>18-01-
1999</td><td> JL INTAN III NO 131</td><td></td><td>Luar kabupaten</td><td>PUSKESMAS
INDUK</td><td>dr.Gani Kriswanto</td><td>Suwoto,A.Md.Kep</td><td>L</td><td>20-44
Thn.</td><td>Keluarga</td><td>Lama</td><td>Umum</td><td>Rajal</td><td
align='right'>29</td><td align='right'>3</td><td align='right'>24</td><td>BP.
Umum</td><td></td><td></td><td>Luar
Wilayah</td><td>'0000004932562</td><td>'1371021801990001</td><td>116</td><td>70</
td><td>84</td><td>36.2</td><td>24</td><td>156</td><td>50</td><td></td><td></
td><td></td></tr><tr><td align='right'>J06.9</td><td>Acute upper respiratory
infection, unspecified</td><td></td><td></td><td align='right'>2676</td><td
align='right'>1024895</td><td>17-05-2023</td><td>MUHAMMAD KHABIT
ABIA</td><td></td><td></td><td>'</td><td>15-10-2017</td><td>NOGOSAREN RT
06/01</td><td></td><td>NOGOSAREN</td><td>PUSKESMAS INDUK</td><td>dr.Gani
Kriswanto</td><td>Suwoto,A.Md.Kep</td><td>L</td><td>5-9
Thn.</td><td>Keluarga</td><td>Lama</td><td>Umum</td><td>Rajal</td><td
align='right'>2</td><td align='right'>7</td><td align='right'>5</td><td>BP.
Umum</td><td></td><td></td><td>Dalam
Wilayah</td><td>'</td><td>'</td><td>90</td><td>60</td><td>84</td><td>37.5</
td><td>24</td><td>100</td><td>15</td><td></td><td></td><td></td></tr><tr><td
align='right'>I84</td><td>Haemorrhoids</td><td></td><td></td><td
align='right'>2672</td><td align='right'>01000021</td><td>17-05-2023</td><td>NUR
KHOLIS</td><td></td><td></td><td>'</td><td>16-06-1991</td><td>NGELO RT 06 RW
02</td><td>NGELO</td><td>GETASAN</td><td>PUSKESMAS INDUK</td><td>dr.Gani
Kriswanto</td><td>Suwoto,A.Md.Kep</td><td>L</td><td>20-44
Thn.</td><td>Keluarga</td><td>Lama</td><td>BPJS PBI</td><td>Rajal</td><td
align='right'>1</td><td align='right'>11</td><td align='right'>31</td><td>BP.
Umum</td><td></td><td></td><td>Dalam
Wilayah</td><td>'0000602621447</td><td>'3322011606910002</td><td>90</td><td>60</
td><td>84</td><td>36.2</td><td>24</td><td>156</td><td>50</td><td></td><td></
td><td></td></tr><tr><td
align='right'>K30</td><td>Dyspepsia</td><td></td><td></td><td
align='right'>2657</td><td
align='right'>99000064</td><td>17-05-2023</td><td>PAINEM</td><td></td><td>PETANI/
PEKEBUN</td><td>'</td><td>13-01-0002</td><td>DELES RT 7 RW 2 </td><td></td><td>Luar
kabupaten</td><td>PUSKESMAS INDUK</td><td>dr.Gani
Kriswanto</td><td>Suwoto,A.Md.Kep</td><td>P</td><td>20-44
Thn.</td><td>Keluarga</td><td>Baru</td><td>Umum</td><td>Rajal</td><td
align='right'>16</td><td align='right'>3</td><td align='right'>10</td><td>BP.
Umum</td><td></td><td></td><td>Luar
Wilayah</td><td>'</td><td>'3308175306620006</td><td>171</td><td>80</td><td>88</
td><td>36.3</td><td>24</td><td>150</td><td>45</td><td></td><td></td><td></td></
tr><tr><td align='right'>R51</td><td>Headache</td><td></td><td></td><td
align='right'>2652</td><td
align='right'>1017510</td><td>17-05-2023</td><td>PUJIYANTI</td><td></td><td></
td><td>'</td><td>02-02-1973</td><td>MADU RT 01 RW
04</td><td>MADU</td><td>BATUR</td><td>PUSKESMAS INDUK</td><td>dr.Gani
Kriswanto</td><td>Suwoto,A.Md.Kep</td><td>P</td><td>45-54
Thn.</td><td>Keluarga</td><td>Lama</td><td>BPJS PBI</td><td>Rajal</td><td
align='right'>15</td><td align='right'>3</td><td align='right'>50</td><td>BP.
Umum</td><td></td><td></td><td>Dalam
Wilayah</td><td>'0001027499984</td><td>'3322034202730001</td><td>107</td><td>70</
td><td>84</td><td>36.3</td><td>24</td><td>152</td><td>78</td><td></td><td></
td><td></td></tr><tr><td align='right'>H02.8</td><td>Other specified disorders of
eyelid</td><td></td><td></td><td align='right'>2644</td><td
align='right'>08000014</td><td>17-05-2023</td><td>PURJI</td><td></
td><td>WIRASWASTA</td><td>'085860777779</td><td>01-09-1977</td><td>GEJAYAN RT 8 RW
2</td><td></td><td>NOGOSAREN</td><td>PUSKESMAS INDUK</td><td>dr.Gani
Kriswanto</td><td>Suwoto,A.Md.Kep</td><td>L</td><td>45-54
Thn.</td><td>Keluarga</td><td>Baru</td><td>BPJS PBI</td><td>Rujuk</td><td
align='right'>16</td><td align='right'>8</td><td align='right'>45</td><td>BP.
Umum</td><td>Mata</td><td>RS DR.ASMIR SALATIGA</td><td>Dalam
Wilayah</td><td>'0001027446759</td><td>'3322010109770004</td><td>189</td><td>125</
td><td>84</td><td>36.3</td><td>24</td><td>150</td><td>61</td><td></td><td></
td><td></td></tr><tr><td align='right'>J06.9</td><td>Acute upper respiratory
infection, unspecified</td><td></td><td></td><td align='right'>2643</td><td
align='right'>1000918</td><td>17-05-2023</td><td>SUMARLI</td><td></td><td></
td><td>'</td><td>15-04-1955</td><td>NGRAWAN RT 06 RW
01</td><td></td><td>NGRAWAN</td><td>PUSKESMAS INDUK</td><td>dr.Gani
Kriswanto</td><td>Suwoto,A.Md.Kep</td><td>L</td><td>60-69
Thn.</td><td>Keluarga</td><td>Lama</td><td>BPJS PBI</td><td>Rajal</td><td
align='right'>2</td><td align='right'>1</td><td align='right'>68</td><td>BP.
Umum</td><td></td><td></td><td>Dalam
Wilayah</td><td>'0001442185097</td><td>'3322011504550000</td><td>142</td><td>98</
td><td>84</td><td>36.3</td><td>24</td><td>158</td><td>49</td><td></td><td></
td><td></td></tr><tr><td align='right'>K05.6</td><td>Periodontal disease,
unspecified</td><td></td><td>Gigi atas kanan ngilu, sudah ganti pasta gigi tidak
sembuh</td><td align='right'>2667</td><td align='right'>1025193</td><td>17-05-
2023</td><td>SUROSO</td><td></td><td></td><td>'</td><td>07-08-1994</td><td>GETASAN
RT 05 RW 01</td><td></td><td>GETASAN</td><td>PUSKESMAS INDUK</td><td>drg.Ade
Indranila</td><td> - </td><td>L</td><td>20-44
Thn.</td><td>Keluarga</td><td>Lama</td><td>BPJS PBI</td><td>Rajal</td><td
align='right'>10</td><td align='right'>9</td><td align='right'>28</td><td>BP.
Gigi</td><td></td><td></td><td>Dalam
Wilayah</td><td>'0001532894433</td><td>'3322010706940003</td><td></td><td></
td><td></td><td></td><td></td><td>0</td><td>0</td><td></td><td>Peo
scalling</td><td>Premedikasi </td></tr><tr><td align='right'>I10</td><td>Essential
(primary) hypertension</td><td></td><td></td><td align='right'>2671</td><td
align='right'>1000616</td><td>17-05-2023</td><td>SUTARPIN</td><td></td><td></
td><td>'</td><td>01-02-1953</td><td>DUKUH RT.1
RW.2</td><td></td><td>BATUR</td><td>PUSKESMAS INDUK</td><td>dr.Gani
Kriswanto</td><td>Suwoto,A.Md.Kep</td><td>P</td><td>>70
Thn.</td><td>Keluarga</td><td>Lama</td><td>BPJS PBI</td><td>Rajal</td><td
align='right'>16</td><td align='right'>3</td><td align='right'>70</td><td>BP.
Umum</td><td></td><td></td><td>Dalam
Wilayah</td><td>'0001966165716</td><td>'3322014102530001</td><td>208</td><td>125</
td><td>88</td><td>36.2</td><td>24</td><td>156</td><td>50</td><td></td><td></
td><td></td></tr><tr><td align='right'>Q25.0</td><td>Patent ductus
arteriosus</td><td></td><td></td><td align='right'>2681</td><td
align='right'>1011595</td><td>17-05-2023</td><td>TITIK
MARSELA</td><td></td><td></td><td>'</td><td>04-04-2000</td><td>MULUNGAN RT 11 RW
02</td><td></td><td>NOGOSAREN</td><td>PUSKESMAS INDUK</td><td>dr.Gani
Kriswanto</td><td>Suwoto,A.Md.Kep</td><td>P</td><td>20-44
Thn.</td><td>Keluarga</td><td>Lama</td><td>BPJS PBI</td><td>Rujuk</td><td
align='right'>13</td><td align='right'>1</td><td align='right'>23</td><td>BP.
Umum</td><td>JANTUNG DAN PEMBULUH DARAH</td><td>RS PURI ASIH SALATIGA</td><td>Dalam
Wilayah</td><td>'0002349085972</td><td>'3322014404000000</td><td>139</td><td>84</
td><td>84</td><td>36.2</td><td>24</td><td>157</td><td>53</td><td></td><td></
td><td></td></tr><tr><td align='right'>K04.1</td><td>Necrosis of
pulp</td><td></td><td>Pasien datang ingin cabut gigi depan </td><td
align='right'>2666</td><td align='right'>1011025</td><td>17-05-2023</td><td>TRI
LESTARI</td><td></td><td></td><td>'</td><td>22-04-1983</td><td>TAYEMAN RT
03/07</td><td></td><td>KOPENG</td><td>PUSKESMAS INDUK</td><td>drg.Ade
Indranila</td><td> - </td><td>P</td><td>20-44
Thn.</td><td>Keluarga</td><td>Lama</td><td>BPJS PBI</td><td>Rajal</td><td
align='right'>25</td><td align='right'></td><td align='right'>40</td><td>BP.
Gigi</td><td></td><td></td><td>Dalam
Wilayah</td><td>'0000601577447</td><td>'3322016204830001</td><td>153</td><td>100</
td><td>80</td><td>36</td><td>20</td><td>163</td><td>52</td><td></td><td></
td><td>Premedikasi </td></tr><tr><td align='right'>J02</td><td>Acute
pharyngitis</td><td></td><td></td><td align='right'>2655</td><td
align='right'>1005308</td><td>17-05-2023</td><td>TRI
MULYANI</td><td></td><td></td><td>'</td><td>28-03-1982</td><td>KEDAYON RT 06 RW
01</td><td>KEDAYON</td><td>WATES</td><td>PUSKESMAS INDUK</td><td>dr.Gani
Kriswanto</td><td>Suwoto,A.Md.Kep</td><td>P</td><td>20-44
Thn.</td><td>Keluarga</td><td>Lama</td><td>Umum</td><td>Rajal</td><td
align='right'>19</td><td align='right'>1</td><td align='right'>41</td><td>BP.
Umum</td><td></td><td></td><td>Dalam
Wilayah</td><td>'</td><td>'3322016803820006</td><td>136</td><td>90</td><td>84</
td><td>36.2</td><td>24</td><td>149</td><td>55</td><td></td><td></td><td></td></
tr><tr><td align='right'>A09</td><td>Diarrhoea and gastroenteritis of presumed
infectious origin</td><td></td><td></td><td align='right'>2641</td><td
align='right'>1016496</td><td>17-05-2023</td><td>WAHYUNINGSIH</td><td></td><td></
td><td>'</td><td>12-02-1990</td><td>SLEKER RT 03 RW
06</td><td></td><td>KOPENG</td><td>PUSKESMAS INDUK</td><td>dr.Gani
Kriswanto</td><td>Suwoto,A.Md.Kep</td><td>P</td><td>20-44
Thn.</td><td>Keluarga</td><td>Lama</td><td>Umum</td><td>Rajal</td><td
align='right'>5</td><td align='right'>3</td><td align='right'>33</td><td>BP.
Umum</td><td></td><td></td><td>Dalam
Wilayah</td><td>'</td><td>'3308175202900003</td><td>103</td><td>70</td><td>84</
td><td>36.3</td><td>24</td><td>150</td><td>53</td><td></td><td></td><td></td></
tr><tr><td
align='right'>I10</td><td>Essential (primary)
hypertension</td><td></td><td></td><td align='right'>2647</td><td
align='right'>1010221</td><td>17-05-2023</td><td>WASITO
WASIDI</td><td></td><td></td><td>'</td><td>18-04-1952</td><td>BANARAN RT 4 RW
2</td><td></td><td>WATES</td><td>PUSKESMAS INDUK</td><td>dr.Gani
Kriswanto</td><td>Suwoto,A.Md.Kep</td><td>L</td><td>>70
Thn.</td><td>Keluarga</td><td>Lama</td><td>BPJS NON PBI</td><td>Rajal</td><td
align='right'>29</td><td align='right'></td><td align='right'>71</td><td>BP.
Umum</td><td></td><td></td><td>Dalam
Wilayah</td><td>'0002434099116</td><td>'3322011804520002</td><td>160</td><td>85</
td><td>84</td><td>36.3</td><td>24</td><td>165</td><td>80</td><td></td><td></
td><td></td></tr><tr><td align='right'>H54.2</td><td>Low vision, both
eyes</td><td></td><td></td><td align='right'>2661</td><td
align='right'>02000038</td><td>17-05-2023</td><td>WATINI</td><td></td><td>PETANI/
PEKEBUN</td><td>'</td><td>31-12-1966</td><td>BANARAN RT 6 RW 2
</td><td></td><td>WATES</td><td>PUSKESMAS INDUK</td><td>dr.Gani
Kriswanto</td><td>Suwoto,A.Md.Kep</td><td>P</td><td>55-59
Thn.</td><td>Keluarga</td><td>Baru</td><td>BPJS PBI</td><td>Rujuk</td><td
align='right'>17</td><td align='right'>4</td><td align='right'>56</td><td>BP.
Umum</td><td>Mata</td><td>RS DR.ASMIR SALATIGA</td><td>Dalam
Wilayah</td><td>'0000601934139</td><td>'3322017112660062</td><td>167</td><td>97</
td><td>88</td><td>36.5</td><td>24</td><td>160</td><td>62</td><td></td><td></
td><td></td></tr><tr><td align='right'>I10</td><td>Essential (primary)
hypertension</td><td></td><td></td><td align='right'>2674</td><td
align='right'>01000058</td><td>17-05-2023</td><td>YARMI</td><td></td><td></
td><td>'</td><td>05-01-1956</td><td>CLOWOK RT 6 RW 2
</td><td></td><td>GETASAN</td><td>PUSKESMAS INDUK</td><td>dr.Gani
Kriswanto</td><td>Suwoto,A.Md.Kep</td><td>P</td><td>60-69
Thn.</td><td>Keluarga</td><td>Baru</td><td>Umum</td><td>Rajal</td><td
align='right'>12</td><td align='right'>4</td><td align='right'>67</td><td>BP.
Umum</td><td></td><td></td><td>Dalam
Wilayah</td><td>'</td><td>'3322014501560002</td><td>198</td><td>96</td><td>88</
td><td>36.3</td><td>24</td><td>156</td><td>45</td><td></td><td></td><td></td></
tr><tr><td align='right'>K00.6</td><td>Disturbances in tooth
eruption</td><td></td><td>Pasien datang dengan keluhan mau cabut gigi </td><td
align='right'>2668</td><td align='right'>1006871</td><td>17-05-2023</td><td>YUSUP
PRASETYA</td><td></td><td></td><td>'</td><td>23-01-2016</td><td>KALITENGAH
RT.001/006</td><td></td><td>BATUR</td><td>PUSKESMAS INDUK</td><td>drg.Ade
Indranila</td><td>Maulida Rahma K N,A.Md.KG</td><td>L</td><td>5-9
Thn.</td><td>Keluarga</td><td>Lama</td><td>Umum</td><td>Rajal</td><td
align='right'>24</td><td align='right'>3</td><td align='right'>7</td><td>BP.
Gigi</td><td></td><td></td><td>Dalam
Wilayah</td><td>'</td><td>'</td><td>100</td><td>60</td><td>88</td><td>36</
td><td>24</td><td>132</td><td>31</td><td></td><td>Pro exo gigi 8.2</td><td>Exo 7.2
CE </td></tr><tr><td align='right'>A49.2</td><td>Haemophilus influenzae infection,
unspecified</td><td></td><td>panas, pilek</td><td align='right'>2709</td><td
align='right'>1024644</td><td>19-05-2023</td><td>ADI LINGGA DWI
CAHYA</td><td></td><td></td><td>'</td><td>02-03-2021</td><td>GETASAN RT 07 RW
01</td><td></td><td>GETASAN</td><td>PUSKESMAS INDUK</td><td>dr.Arninta Rahma
Khoirunnisa</td><td>Sri Hartini,S.S.T.Keb</td><td>L</td><td>1-4
Thn.</td><td>Keluarga</td><td>Lama</td><td>Umum</td><td>Rajal</td><td
align='right'>17</td><td align='right'>2</td><td
align='right'>2</td><td>MTBS</td><td></td><td></td><td>Dalam
Wilayah</td><td>'</td><td>'</td><td></td><td></td><td>120</td><td>37</td><td>34</
td><td>80</td><td>12</td><td></td><td>PENKES CARA PEMBERIAN OBAT DI
RUMAH</td><td>MEMBERIKAN PENKES CARA PEMBERIAN OBAT DI RUMAH</td></tr><tr><td
align='right'>J06</td><td>Acute upper respiratory infections of multiple and
unspecified sites</td><td></td><td></td><td align='right'>2713</td><td
align='right'>99000068</td><td>19-05-2023</td><td>ADITYA DHANI
WIRAYUDHA</td><td></td><td>PELAJAR/MAHASISWA</td><td>'</td><td>29-09-2001</
td><td>KALIPANG RT 1 RW 1 SARANG</td><td></td><td>Luar kabupaten</td><td>PUSKESMAS
INDUK</td><td>dr.Arninta Rahma
Khoirunnisa</td><td>Supomo,A.Md.Kep</td><td>L</td><td>20-44
Thn.</td><td>Keluarga</td><td>Baru</td><td>Umum</td><td>Rajal</td><td
align='right'>20</td><td align='right'>7</td><td align='right'>21</td><td>BP.
Umum</td><td></td><td></td><td>Luar
Wilayah</td><td>'0000092191858</td><td>'3317052909010005</td><td>118</td><td>80</
td><td>20</td><td>36</td><td>20</td><td>150</td><td>56</td><td></td><td></
td><td></td></tr><tr><td align='right'>L85.3</td><td>Xerosis
cutis</td><td></td><td>gatal 2 di dagu</td><td align='right'>2692</td><td
align='right'>1019231</td><td>19-05-2023</td><td>ANDIKA DEVAN MAHENDRA
SUSILO</td><td></td><td></td><td>'</td><td>06-04-2020</td><td>KRASAK RT 09 RT 01
</td><td></td><td>GETASAN</td><td>PUSKESMAS INDUK</td><td>dr.Arninta Rahma
Khoirunnisa</td><td>Sri Hartini,S.S.T.Keb</td><td>L</td><td>1-4
Thn.</td><td>Keluarga</td><td>Lama</td><td>Umum</td><td>Rajal</td><td
align='right'>13</td><td align='right'>1</td><td
align='right'>3</td><td>MTBS</td><td></td><td></td><td>Dalam
Wilayah</td><td>'</td><td>'</td><td></td><td></td><td>100</td><td>36</td><td>36</
td><td>0</td><td>23</td><td></td><td>penkes cara pemberian obat di
rumah</td><td>memberikan penkes cara pemberian obat di rumah</td></tr><tr><td
align='right'>K04.1</td><td>Necrosis of pulp</td><td></td><td>pasien datang dengan
keluhan mau tam</td><td align='right'>2694</td><td
align='right'>1008107</td><td>19-05-2023</td><td>ANNA ANISA
MURDITASARI</td><td></td><td>KARYAWAN
SWASTA</td><td>'</td><td>04-06-1998</td><td>SIDOMUKTI RT 09 RW
05</td><td>SIDOMUKTI</td><td>KOPENG</td><td>PUSKESMAS INDUK</td><td>drg.Ade
Indranila</td><td>Arum Fatmawati,S.Farm,Apt</td><td>P</td><td>20-44
Thn.</td><td>Keluarga</td><td>Lama</td><td>BPJS NON PBI</td><td>Rajal</td><td
align='right'>15</td><td align='right'>11</td><td align='right'>24</td><td>BP.
Gigi</td><td></td><td></td><td>Dalam
Wilayah</td><td>'0001694402706</td><td>'3322014406980001</td><td>100</td><td>70</
td><td>80</td><td>36</td><td>22</td><td>155</td><td>54</td><td></td><td></
td><td>gigi 2.5 GP TKF + ZNOE </td></tr><tr><td align='right'>S01</td><td>Open
wound of head</td><td></td><td></td><td align='right'>2701</td><td
align='right'>1009614</td><td>19-05-2023</td><td>ARLITA
DEWI</td><td></td><td></td><td>'</td><td>10-04-2012</td><td>DEPLONGAN RT
001/002</td><td></td><td>WATES</td><td>PUSKESMAS INDUK</td><td>dr.Arninta Rahma
Khoirunnisa</td><td>Supomo,A.Md.Kep</td><td>P</td><td>10-14
Thn.</td><td>Keluarga</td><td>Lama</td><td>Umum</td><td>Rajal</td><td
align='right'>9</td><td align='right'>1</td><td align='right'>11</td><td>BP.
Umum</td><td></td><td></td><td>Dalam
Wilayah</td><td>'</td><td>'3322016004120000</td><td>120</td><td>80</td><td>80</
td><td>36</td><td>20</td><td>88</td><td>45</td><td></td><td></td><td></td></
tr><tr><td align='right'>H40</td><td>Glaucoma</td><td></td><td></td><td
align='right'>2714</td><td
align='right'>1000570</td><td>19-05-2023</td><td>ATHANASIUS YOSEP EDY PURWANTO
</td><td></td><td></td><td>'</td><td>22-04-1956</td><td>JL.WILIS 17 PERUMGAWE MUKTI
RT 03 RW 06</td><td></td><td>Luar Wilayah</td><td>PUSKESMAS
INDUK</td><td>dr.Arninta Rahma
Khoirunnisa</td><td>Supomo,A.Md.Kep</td><td>L</td><td>60-69
Thn.</td><td>Keluarga</td><td>Lama</td><td>BPJS NON PBI</td><td>Rajal</td><td
align='right'>27</td><td align='right'></td><td align='right'>67</td><td>BP.
Umum</td><td></td><td></td><td>Luar
Wilayah</td><td>'0000091510762</td><td>'3313112204560001</td><td>130</td><td>80</
td><td>88</td><td>36</td><td>24</td><td>160</td><td>60</td><td></td><td></
td><td></td></tr><tr><td align='right'>Z00.1</td><td>Routine child health
examination</td><td></td><td>-</td><td align='right'>2691</td><td
align='right'>1000135</td><td>19-05-2023</td><td>AULIA PUTRI
RAMADANI</td><td></td><td></td><td>'</td><td>21-07-2014</td><td>GETASAN RT 4 RW
1</td><td>GETASAN</td><td>GETASAN</td><td>PUSKESMAS INDUK</td><td>dr.Arninta Rahma
Khoirunnisa</td><td>Supomo,A.Md.Kep</td><td>P</td><td>5-9
Thn.</td><td>Keluarga</td><td>Lama</td><td>Umum</td><td>Rajal</td><td
align='right'>28</td><td align='right'>9</td><td align='right'>8</td><td>BP.
Umum</td><td></td><td></td><td>Dalam
Wilayah</td><td>'</td><td>'</td><td>100</td><td>80</td><td>77</td><td>36</
td><td>20</td><td>138</td><td>25</td><td></td><td></td><td></td></tr><tr><td
align='right'>Z76.2</td><td>Health supervision and care of other healthy infant and
child</td><td></td><td>KONTROL SEHAT</td><td align='right'>2703</td><td
align='right'>07000079</td><td>19-05-2023</td><td>BERLIAN FEODORA
BELOVA</td><td>MARWANTO</td><td></td><td>'</td><td>06-05-2023</td><td>KRAJAN RT 2
RW 2 </td><td></td><td>KOPENG</td><td>PUSKESMAS INDUK</td><td>dr.Arninta Rahma
Khoirunnisa</td><td>Sri Hartini,S.S.T.Keb</td><td>P</td><td>8-30
hari</td><td>Keluarga</td><td>Baru</td><td>Umum</td><td>Rajal</td><td
align='right'>13</td><td align='right'>0</td><td
align='right'>0</td><td>MTBS</td><td></td><td></td><td>Dalam
Wilayah</td><td>'</td><td>'</td><td></td><td></td><td>120</td><td>37</td><td>45</
td><td>48</td><td>3</td><td></td><td>PENKES ASI EKSKLUSIFF</td><td>MEMBERIKAN
PENKES TENTANG ASI EKSKLUSIFF</td></tr><tr><td align='right'>K04.1</td><td>Necrosis
of pulp</td><td></td><td>pasien mau tambal gigi </td><td align='right'>2720</td><td
align='right'>99000065</td><td>19-05-2023</td><td>CHEPPY MDJ
RUNTURAMBI</td><td></td><td></td><td>'08984223110</td><td>09-05-2003</td><td>JL
RATNA NO 2 </td><td></td><td>Luar kabupaten</td><td>PUSKESMAS INDUK</td><td>drg.Ade
Indranila</td><td> - </td><td>L</td><td>20-44
Thn.</td><td>Keluarga</td><td>Lama</td><td>BPJS NON PBI</td><td>Rajal</td><td
align='right'>10</td><td align='right'></td><td align='right'>20</td><td>BP.
Gigi</td><td></td><td></td><td>Luar
Wilayah</td><td>'0001507283818</td><td>'1671012905030005</td><td>120</td><td>79</
td><td>80</td><td>36</td><td>22</td><td>155</td><td>54</td><td></td><td></
td><td>TKF + ZNOE</td></tr><tr><td
align='right'>L08.0</td><td>Pyoderma</td><td></td><td>GATAL</td><td
align='right'>2689</td><td align='right'>1011355</td><td>19-05-2023</td><td>ELVANO
ZAKARIA DERIL AL
YUSUF</td><td></td><td></td><td>'</td><td>25-02-2018</td><td>DANGKLIK RT
08/01</td><td></td><td>TOLOKAN</td><td>PUSKESMAS INDUK</td><td>dr.Arninta Rahma
Khoirunnisa</td><td>Supomo,A.Md.Kep</td><td>L</td><td>5-9
Thn.</td><td>Keluarga</td><td>Lama</td><td>Umum</td><td>Rajal</td><td
align='right'>24</td><td align='right'>2</td><td align='right'>5</td><td>BP.
Umum</td><td></td><td></td><td>Dalam
Wilayah</td><td>'</td><td>'</td><td>110</td><td>80</td><td>78</td><td>36</
td><td>20</td><td>145</td><td>35</td><td></td><td></td><td></td></tr><tr><td
align='right'>H66.9</td><td>Otitis media, unspecified</td><td></td><td>NYERI
TELINGA KLUAR CAIRAN</td><td align='right'>2698</td><td
align='right'>1009472</td><td>19-05-2023</td><td>KASMINAH</td><td></td><td></
td><td>'</td><td>15-05-1997</td><td>GONDANG RT.3
RW.1</td><td></td><td>BATUR</td><td>PUSKESMAS INDUK</td><td>dr.Arninta Rahma
Khoirunnisa</td><td>Supomo,A.Md.Kep</td><td>P</td><td>20-44
Thn.</td><td>Keluarga</td><td>Lama</td><td>Umum</td><td>Rajal</td><td
align='right'>4</td><td align='right'></td><td align='right'>26</td><td>BP.
Umum</td><td></td><td></td><td>Dalam
Wilayah</td><td>'0000601286927</td><td>'3322015505970004</td><td>130</td><td>30</
td><td>80</td><td>36</td><td>20</td><td>155</td><td>50</td><td></td><td></
td><td></td></tr><tr><td align='right'>Z71.9</td><td>Counselling,
unspecified</td><td></td><td>pasien udatang mau kontrol habis cabut
luka pencabutan </td><td align='right'>2700</td><td
align='right'>1025460</td><td>19-05-2023</td><td>KRIS
SUNDARI</td><td></td><td></td><td>'081329448901</td><td>11-11-1993</td><td>GADING
LEGOK RT3/16 SAWANGAN MAGELANG</td><td></td><td>Luar kabupaten</td><td>PUSKESMAS
INDUK</td><td>drg.Ade Indranila</td><td> - </td><td>P</td><td>20-44
Thn.</td><td>Keluarga</td><td>Lama</td><td>BPJS NON PBI</td><td>Rajal</td><td
align='right'>8</td><td align='right'>6</td><td align='right'>29</td><td>BP.
Gigi</td><td></td><td></td><td>Luar
Wilayah</td><td>'0001691290067</td><td>'3308175111930001</td><td>120</td><td>70</
td><td>80</td><td>36</td><td>24</td><td>155</td><td>56</td><td></td><td></
td><td></td></tr><tr><td align='right'>I10</td><td>Essential (primary)
hypertension</td><td></td><td>NYERI LEHER</td><td align='right'>2684</td><td
align='right'>1015754</td><td>19-05-2023</td><td>MARNI</td><td></td><td></
td><td>'</td><td>09-06-1975</td><td>GETASAN RT
04/01</td><td></td><td>GETASAN</td><td>PUSKESMAS INDUK</td><td>dr.Arninta Rahma
Khoirunnisa</td><td>Supomo,A.Md.Kep</td><td>P</td><td>45-54
Thn.</td><td>Keluarga</td><td>Lama</td><td>BPJS PBI</td><td>Rajal</td><td
align='right'>10</td><td align='right'>11</td><td align='right'>47</td><td>BP.
Umum</td><td></td><td></td><td>Dalam
Wilayah</td><td>'0002380330282</td><td>'3322014906750000</td><td>190</td><td>110</
td><td>20</td><td>36</td><td>24</td><td>155</td><td>56</td><td></td><td></
td><td></td></tr><tr><td align='right'>Z76.2</td><td>Health supervision and care of
other healthy infant and child</td><td></td><td>KONTROL BBL</td><td
align='right'>2697</td><td
align='right'>07000078</td><td>19-05-2023</td><td>NAELATU
SIDQIAH</td><td></td><td></td><td>'</td><td>16-05-2023</td><td>PLALAR RT6 RW 4
</td><td></td><td>KOPENG</td><td>PUSKESMAS INDUK</td><td>dr.Arninta Rahma
Khoirunnisa</td><td>Sri Hartini,S.S.T.Keb</td><td>P</td><td>0-7
hari</td><td>Keluarga</td><td>Baru</td><td>Umum</td><td>Rajal</td><td
align='right'>3</td><td align='right'>0</td><td
align='right'>0</td><td>MTBS</td><td></td><td></td><td>Dalam
Wilayah</td><td>'</td><td>'</td><td></td><td></td><td>130</td><td>37</td><td>46</
td><td>46</td><td>3</td><td></td><td>KONSELING ASI EKSKLUSIFF</td><td>MEMBERIKAN
KONSELING ASI EKSKLUSIFF</td></tr><tr><td align='right'>J06</td><td>Acute upper
respiratory infections of multiple and unspecified sites</td><td></td><td></td><td
align='right'>2715</td><td
align='right'>1007836</td><td>19-05-2023</td><td>NARNO</td><td></td><td></
td><td>'</td><td>14-04-1959</td><td>POLOBOGO RT 02 RW
01</td><td></td><td>GETASAN</td><td>PUSKESMAS INDUK</td><td>dr.Arninta Rahma
Khoirunnisa</td><td>Supomo,A.Md.Kep</td><td>L</td><td>60-69
Thn.</td><td>Keluarga</td><td>Lama</td><td>BPJS PBI</td><td>Rajal</td><td
align='right'>5</td><td align='right'>1</td><td align='right'>64</td><td>BP.
Umum</td><td></td><td></td><td>Dalam
Wilayah</td><td>'0002230295117</td><td>'3322011404590001</td><td>120</td><td>80</
td><td>88</td><td>36</td><td>20</td><td>155</td><td>65</td><td></td><td></
td><td></td></tr><tr><td align='right'>K05.6</td><td>Periodontal disease,
unspecified</td><td></td><td>pasien datang au cabut gigi
dan gigi depan bawah goyang </td><td align='right'>2711</td><td
align='right'>90000113</td><td>19-05-2023</td><td>NGATEMI</td><td></td><td>PETANI/
PEKEBUN</td><td>'</td><td>19-06-1977</td><td>KEBOPETE RT 5 RW
2</td><td></td><td>Luar Wilayah</td><td>PUSKESMAS INDUK</td><td>drg.Ade
Indranila</td><td> - </td><td>P</td><td>45-54
Thn.</td><td>Keluarga</td><td>Baru</td><td>BPJS PBI</td><td>Rajal</td><td
align='right'>0</td><td align='right'>11</td><td align='right'>45</td><td>BP.
Gigi</td><td></td><td></td><td>Luar
Wilayah</td><td>'0003192854332</td><td>'3322015906770002</td><td>127</td><td>87</
td><td>91</td><td>36</td><td>24</td><td>156</td><td>56</td><td></td><td></
td><td>exo gigi 3.1 dan 4.1 dengan infiltrasi </td></tr><tr><td
align='right'>J06</td><td>Acute upper respiratory infections of multiple and
unspecified sites</td><td></td><td>ISPA</td><td align='right'>2706</td><td
align='right'>1006996</td><td>19-05-2023</td><td>PASMI</td><td>RUWAN</td><td></
td><td>'085742076253</td><td>07-09-1983</td><td>BANARAN RT 06 RW
02</td><td>WATES</td><td>WATES</td><td>PUSKESMAS INDUK</td><td>dr.Arninta Rahma
Khoirunnisa</td><td>Supomo,A.Md.Kep</td><td>P</td><td>20-44
Thn.</td><td>Keluarga</td><td>Lama</td><td>BPJS PBI</td><td>Rajal</td><td
align='right'>12</td><td align='right'>8</td><td align='right'>39</td><td>BP.
Umum</td><td></td><td></td><td>Dalam
Wilayah</td><td>'0002748549947</td><td>'3322014709830001</td><td>120</td><td>80</
td><td>80</td><td>38</td><td>20</td><td>155</td><td>65</td><td></td><td></
td><td></td></tr><tr><td align='right'>A49.2</td><td>Haemophilus influenzae
infection, unspecified</td><td></td><td>PANAS, PILEK</td><td
align='right'>2708</td><td align='right'>1014307</td><td>19-05-2023</td><td>RADITYA
RISKI PRATAMA</td><td></td><td></td><td>'</td><td>22-01-2019</td><td>GETASAN RT 07
RW 01</td><td></td><td>GETASAN</td><td>PUSKESMAS INDUK</td><td>dr.Arninta Rahma
Khoirunnisa</td><td>Sri Hartini,S.S.T.Keb</td><td>L</td><td>1-4
Thn.</td><td>Keluarga</td><td>Lama</td><td>Umum</td><td>Rajal</td><td
align='right'>27</td><td align='right'>3</td><td
align='right'>4</td><td>MTBS</td><td></td><td></td><td>Dalam
Wilayah</td><td>'</td><td>'</td><td></td><td></td><td>100</td><td>37</td><td>38</
td><td>95</td><td>16</td><td></td><td>P3ENKES CARA MINUM OBAT DI
RUMAH</td><td>MEMBERIKAN PENKES CAR MINUM OBAT DI RUMAH</td></tr><tr><td
align='right'>A49.2</td><td>Haemophilus influenzae infection,
unspecified</td><td></td><td>PANAS, PILEK</td><td align='right'>2705</td><td
align='right'>02000037</td><td>19-05-2023</td><td>RAFANDRA
ALFARISKI</td><td>RUWAN</td><td>BELUM/TIDAK
BEKERJA</td><td>'</td><td>17-04-2023</td><td>BANARAN RT 06 RW
02</td><td>BANARAN</td><td>WATES</td><td>PUSKESMAS INDUK</td><td>dr.Arninta Rahma
Khoirunnisa</td><td>Sri Hartini,S.S.T.Keb</td><td>L</td><td><1
Thn.</td><td>Keluarga</td><td>Lama</td><td>Umum</td><td>Rajal</td><td
align='right'></td><td align='right'>1</td><td
align='right'></td><td>MTBS</td><td></td><td></td><td>Dalam
Wilayah</td><td>'</td><td>'</td><td></td><td></td><td>134</td><td>37</td><td>42</
td><td>59</td><td>3</td><td></td><td>OBAT DI BERIKAN SESUAI
ANJURAN</td><td>MEMBERIKAN PENKES CARA PEMBERIAN OBAT DI RUMAH</td></tr><tr><td
align='right'>A78</td><td>Q fever</td><td></td><td></td><td
align='right'>2717</td><td
align='right'>1023421</td><td>19-05-2023</td><td>RAYZHARD RAFA
PRADIPTA</td><td></td><td></td><td>'</td><td>22-11-2015</td><td>BUMIAYU RT 01 RW
04</td><td></td><td>Luar Wilayah</td><td>PUSKESMAS INDUK</td><td>dr.Arninta Rahma
Khoirunnisa</td><td>Supomo,A.Md.Kep</td><td>L</td><td>5-9
Thn.</td><td>Keluarga</td><td>Lama</td><td>Umum</td><td>Rajal</td><td
align='right'>27</td><td align='right'>5</td><td align='right'>7</td><td>BP.
Umum</td><td></td><td></td><td>Luar
Wilayah</td><td>'</td><td>'3322012211150003</td><td>110</td><td>80</td><td>80</
td><td>38</td><td>20</td><td>145</td><td>26</td><td></td><td></td><td></td></
tr><tr><td align='right'>M54.59</td><td>Low back pain, site
unspecified</td><td></td><td></td><td align='right'>2704</td><td
align='right'>1001064</td><td>19-05-2023</td><td>RIMAWATI</td><td></td><td></
td><td>'</td><td>01-11-1998</td><td>SLEKER RT 01 RW
03</td><td></td><td>KOPENG</td><td>PUSKESMAS INDUK</td><td>dr.Arninta Rahma
Khoirunnisa</td><td>Supomo,A.Md.Kep</td><td>P</td><td>20-44
Thn.</td><td>Keluarga</td><td>Lama</td><td>BPJS PBI</td><td>Rajal</td><td
align='right'>18</td><td align='right'>6</td><td align='right'>24</td><td>BP.
Umum</td><td></td><td></td><td>Dalam
Wilayah</td><td>'0000602092912</td><td>'3322016511980001</td><td>130</td><td>80</
td><td>88</td><td>36</td><td>20</td><td>155</td><td>58</td><td></td><td></
td><td></td></tr><tr><td
align='right'>K30</td><td>Dyspepsia</td><td></td><td>SESEG</td><td
align='right'>2696</td><td align='right'>1007265</td><td>19-05-2023</td><td>RINA
ZULININGSIH</td><td></td><td></td><td>'</td><td>16-07-1983</td><td>BUMIAYU RT 01 RW
04</td><td></td><td>Luar Wilayah</td><td>PUSKESMAS INDUK</td><td>dr.Arninta Rahma
Khoirunnisa</td><td>Supomo,A.Md.Kep</td><td>P</td><td>20-44
Thn.</td><td>Keluarga</td><td>Lama</td><td>Umum</td><td>Rajal</td><td
align='right'>3</td><td align='right'>10</td><td align='right'>39</td><td>BP.
Umum</td><td></td><td></td><td>Luar
Wilayah</td><td>'0002448941499</td><td>'3402155607830001</td><td>100</td><td>60</
td><td>80</td><td>36</td><td>36</td><td>155</td><td>60</td><td></td><td></
td><td></td></tr><tr><td align='right'>J06</td><td>Acute upper respiratory
infections of multiple and unspecified sites</td><td></td><td></td><td
align='right'>2707</td><td align='right'>1011414</td><td>19-05-2023</td><td>RUWAN
</td><td></td><td></td><td>'</td><td>05-07-1978</td><td>BANARAN RT
06/02</td><td></td><td>WATES</td><td>PUSKESMAS INDUK</td><td>dr.Arninta Rahma
Khoirunnisa</td><td>Supomo,A.Md.Kep</td><td>L</td><td>20-44
Thn.</td><td>Keluarga</td><td>Lama</td><td>BPJS PBI</td><td>Rajal</td><td
align='right'>14</td><td align='right'>10</td><td align='right'>44</td><td>BP.
Umum</td><td></td><td></td><td>Dalam
Wilayah</td><td>'0002748549879</td><td>'3322010507780000</td><td>120</td><td>80</
td><td>80</td><td>36</td><td>20</td><td>156</td><td>58</td><td></td><td></
td><td></td></tr><tr><td align='right'>E78.5</td><td>Hyperlipidaemia,
unspecified</td><td></td><td></td><td align='right'>2710</td><td
align='right'>1004875</td><td>19-05-2023</td><td>SABAR</td><td></td><td></
td><td>'</td><td>15-10-1966</td><td>NGAGRONG
08/01</td><td></td><td>WATES</td><td>PUSKESMAS INDUK</td><td>dr.Arninta Rahma
Khoirunnisa</td><td>Supomo,A.Md.Kep</td><td>L</td><td>55-59
Thn.</td><td>Keluarga</td><td>Lama</td><td>BPJS NON PBI</td><td>Rajal</td><td
align='right'>4</td><td align='right'>7</td><td align='right'>56</td><td>BP.
Umum</td><td></td><td></td><td>Dalam
Wilayah</td><td>'0000074986413</td><td>'3322011510660000</td><td></td><td></
td><td></td><td></td><td></td><td>0</td><td>0</td><td></td><td></td><td></td></
tr><tr><td align='right'>J06</td><td>Acute upper respiratory infections of multiple
and unspecified sites</td><td></td><td></td><td align='right'>2718</td><td
align='right'>1003038</td><td>19-05-2023</td><td>SUDARMAN</td><td></td><td></
td><td>'</td><td>30-09-1958</td><td>PANDANAN RT 03 RW
03</td><td></td><td>GETASAN</td><td>PUSKESMAS INDUK</td><td>dr.Arninta Rahma
Khoirunnisa</td><td>Supomo,A.Md.Kep</td><td>L</td><td>60-69
Thn.</td><td>Keluarga</td><td>Lama</td><td>BPJS NON PBI</td><td>Rajal</td><td
align='right'>19</td><td align='right'>7</td><td align='right'>64</td><td>BP.
Umum</td><td></td><td></td><td>Dalam
Wilayah</td><td>'0000074673549</td><td>'332201</td><td>150</td><td>100</
td><td>88</td><td>36</td><td>24</td><td>162</td><td>65</td><td></td><td></
td><td></td></tr><tr><td align='right'>J45.9</td><td>Asthma,
unspecified</td><td></td><td>BATUK SESEG</td><td align='right'>2686</td><td
align='right'>1023647</td><td>19-05-2023</td><td>SUTARMI</td><td></td><td></
td><td>'</td><td>01-12-1971</td><td>GINTUNG RT 09 RW 05</td><td></td><td>Luar
kabupaten</td><td>PUSKESMAS INDUK</td><td>dr.Arninta Rahma
Khoirunnisa</td><td>Supomo,A.Md.Kep</td><td>P</td><td>45-54
Thn.</td><td>Keluarga</td><td>Lama</td><td>BPJS PBI</td><td>Rajal</td><td
align='right'>18</td><td align='right'>5</td><td align='right'>51</td><td>BP.
Umum</td><td></td><td></td><td>Luar
Wilayah</td><td>'0000602244404</td><td>'3322014112710000</td><td>130</td><td>80</
td><td>26</td><td>36</td><td>30</td><td>150</td><td>42</td><td></td><td></
td><td></td></tr><tr><td align='right'>K08.3</td><td>Retained dental
root</td><td></td><td>pasien datang mau cabut gigi
tunggak2kan </td><td align='right'>2682</td><td align='right'>1004862</td><td>19-
05-2023</td><td>WAHYU
DIONO</td><td></td><td></td><td>'</td><td>22-09-1980</td><td>SENDEN RT
01/01</td><td>SENDEN</td><td>BATUR</td><td>PUSKESMAS INDUK</td><td>drg.Ade
Indranila</td><td> - </td><td>L</td><td>20-44
Thn.</td><td>Keluarga</td><td>Lama</td><td>Umum</td><td>Rajal</td><td
align='right'>27</td><td align='right'>7</td><td align='right'>42</td><td>BP.
Gigi</td><td></td><td></td><td>Dalam
Wilayah</td><td>'0000602246452</td><td>'3322012209800000</td><td>108</td><td>62</
td><td>80</td><td>36</td><td>22</td><td>165</td><td>54</td><td></td><td></
td><td>premedikasi
tunda exo </td></tr><tr><td align='right'>I11</td><td>Hypertensive heart
disease</td><td></td><td></td><td align='right'>2712</td><td
align='right'>1014994</td><td>19-05-2023</td><td>WAKINEM
</td><td></td><td></td><td>'</td><td>18-01-1960</td><td>PULIHAN RT 03 RW
01</td><td></td><td>GETASAN</td><td>PUSKESMAS INDUK</td><td>dr.Arninta Rahma
Khoirunnisa</td><td>Supomo,A.Md.Kep</td><td>P</td><td>60-69
Thn.</td><td>Keluarga</td><td>Lama</td><td>BPJS PBI</td><td>Rajal</td><td
align='right'>1</td><td align='right'>4</td><td align='right'>63</td><td>BP.
Umum</td><td></td><td></td><td>Dalam
Wilayah</td><td>'0001531582839</td><td>'3322015801600001</td><td>150</td><td>100</
td><td>80</td><td>36</td><td>24</td><td>155</td><td>56</td><td></td><td></
td><td></td></tr><tr><td align='right'>L20.8</td><td>Other atopic
dermatitis</td><td></td><td></td><td align='right'>2719</td><td
align='right'>1000696</td><td>19-05-2023</td><td>WINARNI</td><td></td><td></
td><td>'</td><td>27-04-1984</td><td>GETASAN RT 02 RW
01</td><td>GETASAN</td><td>GETASAN</td><td>PUSKESMAS INDUK</td><td>dr.Arninta Rahma
Khoirunnisa</td><td>Supomo,A.Md.Kep</td><td>P</td><td>20-44
Thn.</td><td>Keluarga</td><td>Lama</td><td>BPJS NON PBI</td><td>Rajal</td><td
align='right'>22</td><td align='right'></td><td align='right'>39</td><td>BP.
Umum</td><td></td><td></td><td>Dalam
Wilayah</td><td>'0001526922628</td><td>'3322018704840002</td><td>120</td><td>80</
td><td>88</td><td>36</td><td>24</td><td>150</td><td>56</td><td></td><td></
td><td></td></tr><tr><td align='right'>J06.9</td><td>Acute upper respiratory
infection, unspecified</td><td></td><td>PAQNAS, BATUK, PILEK</td><td
align='right'>2688</td><td align='right'>1024414</td><td>19-05-2023</td><td>YISWI
RAMBU JIEVA</td><td></td><td></td><td>'</td><td>22-03-2022</td><td>PLOSO RT 16 RW
02</td><td>NGRAWAN</td><td>NGRAWAN</td><td>PUSKESMAS INDUK</td><td>dr.Arninta Rahma
Khoirunnisa</td><td>Sri Hartini,S.S.T.Keb</td><td>P</td><td>1-4
Thn.</td><td>Keluarga</td><td>Lama</td><td>Umum</td><td>Rajal</td><td
align='right'>27</td><td align='right'>1</td><td
align='right'>1</td><td>MTBS</td><td></td><td></td><td>Dalam
Wilayah</td><td>'0003286030342</td><td>'3322016203220002</td><td></td><td></
td><td>130</td><td>37</td><td>39</td><td>78</td><td>9</td><td></td><td>PENKES CARA
PEMBERIAN OBAT DI RUMAH</td><td>MEMBERIKAN PENKES CARA PEMBERIAN OBAT DI
RUMAH</td></tr><tr><td align='right'>K04.0</td><td>Pulpitis</td><td></td><td>pasien
datang mau cabut gigi </td><td align='right'>2726</td><td
align='right'>1011890</td><td>20-05-2023</td><td>AHMAD ALWI AZIDAN</td><td>SLAMET
RIYADI</td><td></td><td>'</td><td>06-01-2013</td><td>MULUNGAN RT 11 RW
02</td><td></td><td>NOGOSAREN</td><td>PUSKESMAS INDUK</td><td>drg.Ade
Indranila</td><td> - </td><td>L</td><td>10-14
Thn.</td><td>Keluarga</td><td>Lama</td><td>BPJS PBI</td><td>Rajal</td><td
align='right'>14</td><td align='right'>4</td><td align='right'>10</td><td>BP.
Gigi</td><td></td><td></td><td>Dalam
Wilayah</td><td>'0002600406707</td><td>'3322010601130001</td><td>100</td><td>60</
td><td>88</td><td>36</td><td>20</td><td>134</td><td>29</td><td></td><td>pro
konservasi </td><td>premedikasi
</td></tr><tr><td align='right'>Z76.2</td><td>Health supervision and care of other
healthy infant and child</td><td></td><td>KONTRL BBL</td><td
align='right'>2754</td><td align='right'>06000058</td><td>20-05-2023</td><td>ALBY
LUTFY</td><td></td><td></td><td>'</td><td>15-05-2023</td><td>KALIDUREN RT 5 RW 2
</td><td></td><td>BATUR</td><td>PUSKESMAS INDUK</td><td>dr.Arninta Rahma
Khoirunnisa</td><td>Sri Hartini,S.S.T.Keb</td><td>L</td><td>0-7
hari</td><td>Keluarga</td><td>Baru</td><td>Umum</td><td>Rajal</td><td
align='right'>5</td><td align='right'>0</td><td
align='right'>0</td><td>MTBS</td><td></td><td></td><td>Dalam
Wilayah</td><td>'</td><td>'</td><td></td><td></td><td>130</td><td>37</td><td>45</
td><td>50</td><td>3</td><td></td><td>PENKES TTG ASI EKSKLUSIF</td><td>MEMBERIKAN
PENKES TTG ASI EKSKLUSIFF</td></tr><tr><td align='right'>J06.9</td><td>Acute upper
respiratory infection, unspecified</td><td></td><td>panas, batuk, pilek</td><td
align='right'>2721</td><td align='right'>1020466</td><td>20-05-2023</td><td>ALINA
LAFATHUNISA</td><td></td><td></td><td>'</td><td>25-10-2020</td><td>GONDANG RT 02 RW
01</td><td></td><td>BATUR</td><td>PUSKESMAS INDUK</td><td>dr.Arninta Rahma
Khoirunnisa</td><td>Sri Hartini,S.S.T.Keb</td><td>P</td><td>1-4
Thn.</td><td>Keluarga</td><td>Lama</td><td>Umum</td><td>Rajal</td><td
align='right'>25</td><td align='right'>6</td><td
align='right'>2</td><td>MTBS</td><td></td><td></td><td>Dalam
Wilayah</td><td>'</td><td>'</td><td></td><td></td><td>120</td><td>36</td><td>38</
td><td>85</td><td>13</td><td></td><td>penkes cara pemberian obat di
rumah</td><td>memberikan penkes cara pemberian obat di rumah</td></tr><tr><td
align='right'>L30.9</td><td>Dermatitis, unspecified</td><td></td><td>GATAL</td><td
align='right'>2763</td><td align='right'>90000116</td><td>20-05-2023</td><td>ALLEN
KURNIA SARI</td><td></td><td>PELAJAR/MAHASISWA</td><td>'</td><td>24-06-2008</
td><td>BLONGORAN RT 5 RW 3 </td><td></td><td>Luar Wilayah</td><td>PUSKESMAS
INDUK</td><td>dr.Arninta Rahma Khoirunnisa</td><td>Riska
Wulandari,A.Md.Kep</td><td>P</td><td>10-14
Thn.</td><td>Keluarga</td><td>Baru</td><td>Umum</td><td>Rajal</td><td
align='right'>26</td><td align='right'>10</td><td align='right'>14</td><td>BP.
Umum</td><td></td><td></td><td>Luar
Wilayah</td><td>'0000553659153</td><td>'3308176406080001</td><td>90</td><td>80</
td><td>80</td><td>36.2</td><td>22</td><td>152</td><td>42</td><td></td><td></
td><td></td></tr><tr><td align='right'>L30.9</td><td>Dermatitis,
unspecified</td><td></td><td>GATAL</td><td align='right'>2762</td><td
align='right'>90000008</td><td>20-05-2023</td><td>ANDRIAN JANU
WICAKSONO</td><td></td><td></td><td>'085290811560</td><td>07-01-2016</
td><td>BLONGORAN RT 05 RW 03</td><td></td><td>Luar Wilayah</td><td>PUSKESMAS
INDUK</td><td>dr.Arninta Rahma Khoirunnisa</td><td>Riska
Wulandari,A.Md.Kep</td><td>L</td><td>5-9
Thn.</td><td>Keluarga</td><td>Lama</td><td>Umum</td><td>Rajal</td><td
align='right'>13</td><td align='right'>4</td><td align='right'>7</td><td>BP.
Umum</td><td></td><td></td><td>Luar
Wilayah</td><td>'0002924145742</td><td>'3308170701160001</td><td>110</td><td>80</
td><td>80</td><td>36.2</td><td>22</td><td>132</td><td>28</td><td></td><td></
td><td></td></tr><tr><td align='right'>Z76.3</td><td>Healthy person accompanying
sick person</td><td></td><td>KONTROL BBL</td><td align='right'>2739</td><td
align='right'>02000039</td><td>20-05-2023</td><td>ANINDITA WIDYA
PARAMISANTI</td><td>ADHITYA EKO BAYU
AJI</td><td></td><td>'</td><td>16-05-2023</td><td>BANARAN RT 5RW
2</td><td></td><td>WATES</td><td>PUSKESMAS INDUK</td><td>dr.Arninta Rahma
Khoirunnisa</td><td>Sri Hartini,S.S.T.Keb</td><td>P</td><td>0-7
hari</td><td>Keluarga</td><td>Baru</td><td>Umum</td><td>Rajal</td><td
align='right'>4</td><td align='right'>0</td><td
align='right'>0</td><td>MTBS</td><td></td><td></td><td>Dalam
Wilayah</td><td>'</td><td>'</td><td></td><td></td><td>134</td><td>36</td><td>47</
td><td>0</td><td>0</td><td></td><td>PENKES TENTANG ASI EKSKLUSIF</td><td>MEMBERIKAN
PENKES PEMBERIAN OBAT DI RUMAH</td></tr><tr><td
align='right'>K04.1</td><td>Necrosis of pulp</td><td></td><td>pasien datang mau
kontrol tambalan </td><td align='right'>2736</td><td
align='right'>1008107</td><td>20-05-2023</td><td>ANNA ANISA
MURDITASARI</td><td></td><td>KARYAWAN
SWASTA</td><td>'</td><td>04-06-1998</td><td>SIDOMUKTI RT 09 RW
05</td><td>SIDOMUKTI</td><td>KOPENG</td><td>PUSKESMAS INDUK</td><td>drg.Ade
Indranila</td><td> - </td><td>P</td><td>20-44
Thn.</td><td>Keluarga</td><td>Lama</td><td>BPJS NON PBI</td><td>Rajal</td><td
align='right'>16</td><td align='right'>11</td><td align='right'>24</td><td>BP.
Gigi</td><td></td><td></td><td>Dalam
Wilayah</td><td>'0001694402706</td><td>'3322014406980001</td><td>100</td><td>70</
td><td>80</td><td>36</td><td>24</td><td>155</td><td>50</td><td></td><td>pro
conservasi </td><td>CHKM + Fletcher </td></tr><tr><td
align='right'>Z00.0</td><td>General medical examination</td><td></td><td>SURAT
SEHAT</td><td align='right'>2752</td><td align='right'>1019524</td><td>20-05-
2023</td><td>BAGUS
KRISTIAWAN</td><td></td><td></td><td>'</td><td>18-05-2006</td><td>PANDANAN RT 03 RW
03</td><td></td><td>GETASAN</td><td>PUSKESMAS INDUK</td><td>dr.Arninta Rahma
Khoirunnisa</td><td>Riska Wulandari,A.Md.Kep</td><td>L</td><td>15-19
Thn.</td><td>Keluarga</td><td>Lama</td><td>Umum</td><td>Rajal</td><td
align='right'>2</td><td align='right'></td><td align='right'>17</td><td>BP.
Umum</td><td></td><td></td><td>Dalam
Wilayah</td><td>'0000602605135</td><td>'3322011805060000</td><td>120</td><td>80</
td><td>80</td><td>36.2</td><td>22</td><td>160</td><td>58</td><td></td><td></
td><td></td></tr><tr><td align='right'>Z00.0</td><td>General medical
examination</td><td></td><td>SURAT SEHAT</td><td align='right'>2722</td><td
align='right'>1014559</td><td>20-05-2023</td><td>DHANANG WILDAN MUQTADZIL
KHIJA</td><td></td><td></td><td>'</td><td>30-11-2007</td><td>DUKUH RT 01 RW
02</td><td></td><td>BATUR</td><td>PUSKESMAS INDUK</td><td>dr.Arninta Rahma
Khoirunnisa</td><td>Riska Wulandari,A.Md.Kep</td><td>L</td><td>15-19
Thn.</td><td>Keluarga</td><td>Lama</td><td>Umum</td><td>Rajal</td><td
align='right'>20</td><td align='right'>5</td><td align='right'>15</td><td>BP.
Umum</td><td></td><td></td><td>Dalam
Wilayah</td><td>'0002280758782</td><td>'3322013010070000</td><td>120</td><td>80</
td><td>88</td><td>36</td><td>22</td><td>152</td><td>40</td><td></td><td></
td><td></td></tr><tr><td align='right'>A09</td><td>Diarrhoea and gastroenteritis of
presumed infectious origin</td><td></td><td>BAB CAIR LBH DARI 3 KL, MUAL
MJUNTAH</td><td align='right'>2766</td><td align='right'>1018762</td><td>20-05-
2023</td><td>DIVIA RERE MUDAWAMAH</td><td>RUR MAHRUS</td><td></td><td>'</td><td>09-
02-2020</td><td>SETURUN RT 03 RW 03</td><td></td><td>Luar Wilayah</td><td>PUSKESMAS
INDUK</td><td>dr.Arninta Rahma
Khoirunnisa</td><td>Sutini,A.Md.Keb</td><td>P</td><td>1-4
Thn.</td><td>Keluarga</td><td>Lama</td><td>BPJS NON PBI</td><td>Rajal</td><td
align='right'>11</td><td align='right'>3</td><td
align='right'>3</td><td>MTBS</td><td></td><td></td><td>Luar
Wilayah</td><td>'0002974689808</td><td>'3322014902200001</td><td></td><td></
td><td>100</td><td>37</td><td>37</td><td>88</td><td>13</td><td></td><td>PENKES CARA
MINUM OBAT DI RUMAH </td><td>MEMBERIKAN PENKES CARA MINUM OBAT DI
RUMAH</td></tr><tr><td align='right'>Z00.0</td><td>General medical
examination</td><td></td><td>KONTROL LUKA</td><td align='right'>2767</td><td
align='right'>1008855</td><td>20-05-2023</td><td>EBEN HAEZER APRILLIO
SANTOSO</td><td></td><td></td><td>'</td><td>06-04-2015</td><td>KRANGKENG RT.3
RW.12</td><td></td><td>BATUR</td><td>PUSKESMAS INDUK</td><td>dr.Arninta Rahma
Khoirunnisa</td><td>Riska Wulandari,A.Md.Kep</td><td>L</td><td>5-9
Thn.</td><td>Keluarga</td><td>Lama</td><td>Umum</td><td>Rajal</td><td
align='right'>14</td><td align='right'>1</td><td align='right'>8</td><td>BP.
Umum</td><td></td><td></td><td>Dalam
Wilayah</td><td>'0002926497227</td><td>'3322010604150000</td><td>90</td><td>80</
td><td>80</td><td>36.2</td><td>22</td><td>128</td><td>26</td><td></td><td></
td><td></td></tr><tr><td align='right'>Z00.0</td><td>General medical
examination</td><td></td><td>SURAT SEHAT</td><td align='right'>2725</td><td
align='right'>99000069</td><td>20-05-2023</td><td>ELEGAN VICTORIOOS
AGAPE</td><td></td><td></td><td>'</td><td>30-04-2001</td><td>WONOSOBO RT 2 RW 8
SRAGEN</td><td></td><td>Luar kabupaten</td><td>PUSKESMAS INDUK</td><td>dr.Arninta
Rahma Khoirunnisa</td><td>Riska Wulandari,A.Md.Kep</td><td>L</td><td>20-44
Thn.</td><td>Keluarga</td><td>Baru</td><td>Umum</td><td>Rajal</td><td
align='right'>20</td><td align='right'>0</td><td align='right'>22</td><td>BP.
Umum</td><td></td><td></td><td>Luar
Wilayah</td><td>'</td><td>'2171103004019001</td><td>120</td><td>70</td><td>88</
td><td>36.4</td><td>22</td><td>150</td><td>48</td><td></td><td></td><td></td></
tr><tr><td align='right'>R50.8</td><td>Other specified
fever</td><td></td><td>PANAS, SULIT BAB</td><td align='right'>2761</td><td
align='right'>1018557</td><td>20-05-2023</td><td>ELVIA AGUSTIN WIDYA
PUTRI</td><td></td><td></td><td>'</td><td>13-08-2019</td><td>PIJI RT 10 RW
05</td><td></td><td>Luar Wilayah</td><td>PUSKESMAS INDUK</td><td>dr.Arninta Rahma
Khoirunnisa</td><td> - </td><td>P</td><td>1-4
Thn.</td><td>Keluarga</td><td>Lama</td><td>BPJS PBI</td><td>Rajal</td><td
align='right'>7</td><td align='right'>9</td><td
align='right'>3</td><td>MTBS</td><td></td><td></td><td>Luar
Wilayah</td><td>'0003256206963</td><td>'3322015308190002</td><td></td><td></
td><td>100</td><td>37</td><td>35</td><td>64</td><td>16</td><td></td><td>PENKES CARA
MINUM OBAT DI RUMAH, PENKES CARA PEMBERIAN OBAT SELAMA SAKIT</td><td>MEMBERIKAN
PENKES CARA MINUM OBAT DI RUMAH, MEMBERIKAN PENKES CARA PEMBERIAN MAKAN SELAMA
SAKIT</td></tr><tr><td align='right'>Z71.9</td><td>Counselling,
unspecified</td><td></td><td>konsul</td><td align='right'>2727</td><td
align='right'>1024448</td><td>20-05-2023</td><td>ERIKA
SETYAWATI</td><td></td><td></td><td>'</td><td>15-06-1999</td><td>DEPLONGAN RT 01 RW
02</td><td></td><td>WATES</td><td>PUSKESMAS INDUK</td><td>dr.Arninta Rahma
Khoirunnisa</td><td>Anna Joeni Astoeti,S.Tr.Keb</td><td>P</td><td>20-44
Thn.</td><td>Keluarga</td><td>Lama</td><td>Umum</td><td>Rajal</td><td
align='right'>5</td><td align='right'>11</td><td
align='right'>23</td><td>KIA</td><td></td><td></td><td>Dalam
Wilayah</td><td>'0002434683982</td><td>'3322015506990002</td><td>120</td><td>80</
td><td>88</td><td>36</td><td>22</td><td>150</td><td>56</td><td></td><td>kolab dg
dokter</td><td></td></tr><tr><td align='right'>Z00.0</td><td>General medical
examination</td><td></td><td>SURAT SEHAT</td><td align='right'>2723</td><td
align='right'>06000057</td><td>20-05-2023</td><td>FAREL
MAULANA</td><td></td><td></td><td>'</td><td>23-05-2008</td><td>SELONGISOR RT 1 RW
15</td><td></td><td>BATUR</td><td>PUSKESMAS INDUK</td><td>dr.Arninta Rahma
Khoirunnisa</td><td>Riska Wulandari,A.Md.Kep</td><td>L</td><td>10-14
Thn.</td><td>Keluarga</td><td>Baru</td><td>Umum</td><td>Rajal</td><td
align='right'>28</td><td align='right'>11</td><td align='right'>14</td><td>BP.
Umum</td><td></td><td></td><td>Dalam
Wilayah</td><td>'</td><td>'</td><td>103</td><td>78</td><td>88</td><td>36.2</
td><td>22</td><td>155</td><td>43</td><td></td><td></td><td></td></tr><tr><td
align='right'>Z34</td><td>Supervision of normal pregnancy</td><td></td><td>periksa
hamil</td><td align='right'>2731</td><td align='right'>1003110</td><td>20-05-
2023</td><td>FATIMATUS YAHRO</td><td>TRI
MULYANTO</td><td></td><td>'081358603455</td><td>29-06-2003</td><td>NGAGRONG RT 08
RW 01</td><td></td><td>WATES</td><td>PUSKESMAS INDUK</td><td>dr.Arninta Rahma
Khoirunnisa</td><td> - </td><td>P</td><td>15-19
Thn.</td><td>Keluarga</td><td>Lama</td><td>BPJS NON PBI</td><td>Rajal</td><td
align='right'>21</td><td align='right'>10</td><td
align='right'>19</td><td>KIA</td><td></td><td></td><td>Dalam
Wilayah</td><td>'0002133608883</td><td>'3322016906030002</td><td></td><td></
td><td></td><td></td><td></td><td>0</td><td>0</td><td></td><td>anjurkan kontrol 1
bln lagi</td><td></td></tr><tr><td align='right'>J06.9</td><td>Acute upper
respiratory infection, unspecified</td><td></td><td>BATUK</td><td
align='right'>2750</td><td
align='right'>07000080</td><td>20-05-2023</td><td>HARIYANTO</td><td></
td><td>WIRASWASTA</td><td>'</td><td>17-09-1981</td><td>SLEKER RT 9 RW 3
</td><td></td><td>KOPENG</td><td>PUSKESMAS INDUK</td><td>dr.Arninta Rahma
Khoirunnisa</td><td>Riska Wulandari,A.Md.Kep</td><td>L</td><td>20-44
Thn.</td><td>Keluarga</td><td>Baru</td><td>BPJS NON PBI</td><td>Rajal</td><td
align='right'>3</td><td align='right'>8</td><td align='right'>41</td><td>BP.
Umum</td><td></td><td></td><td>Dalam
Wilayah</td><td>'0002263416568</td><td>'3322011709810001</td><td>167</td><td>80</
td><td>80</td><td>36.4</td><td>22</td><td>158</td><td>65</td><td></td><td></
td><td></td></tr><tr><td align='right'>Z00.0</td><td>General medical
examination</td><td></td><td>SURAT SEHAT</td><td align='right'>2724</td><td
align='right'>1015467</td><td>20-05-2023</td><td>HENDRI
KURNIAWAN</td><td></td><td></td><td>'</td><td>10-12-2007</td><td>MANGGIHAN RT 04 RW
01</td><td></td><td>MANGGIHAN</td><td>PUSKESMAS INDUK</td><td>dr.Arninta Rahma
Khoirunnisa</td><td>Riska Wulandari,A.Md.Kep</td><td>L</td><td>15-19
Thn.</td><td>Keluarga</td><td>Lama</td><td>BPJS PBI</td><td>Rajal</td><td
align='right'>10</td><td align='right'>5</td><td align='right'>15</td><td>BP.
Umum</td><td></td><td></td><td>Dalam
Wilayah</td><td>'0001531506609</td><td>'3322011012070000</td><td>171</td><td>54</
td><td>88</td><td>36.5</td><td>22</td><td>156</td><td>46</td><td></td><td></
td><td></td></tr><tr><td align='right'>A09</td><td>Diarrhoea and gastroenteritis of
presumed infectious origin</td><td></td><td>DIARE</td><td
align='right'>2764</td><td align='right'>1002972</td><td>20-05-2023</td><td>IBNU
ALFAREL MAHARDIKA</td><td></td><td></td><td>'</td><td>06-02-2014</td><td>SLEKER RT
02/03</td><td></td><td>KOPENG</td><td>PUSKESMAS INDUK</td><td>dr.Arninta Rahma
Khoirunnisa</td><td>Riska Wulandari,A.Md.Kep</td><td>L</td><td>5-9
Thn.</td><td>Keluarga</td><td>Lama</td><td>Umum</td><td>Rajal</td><td
align='right'>14</td><td align='right'>3</td><td align='right'>9</td><td>BP.
Umum</td><td></td><td></td><td>Dalam
Wilayah</td><td>'</td><td>'</td><td>90</td><td>80</td><td>80</td><td>36.4</
td><td>22</td><td>135</td><td>24</td><td></td><td></td><td></td></tr><tr><td
align='right'>J06.9</td><td>Acute upper respiratory infection,
unspecified</td><td></td><td>GREGES, BATUK</td><td align='right'>2729</td><td
align='right'>1023588</td><td>20-05-2023</td><td>KOTIJAH</td><td></td><td></
td><td>'</td><td>20-04-1968</td><td>GEJAYAN RT 08 RW
02</td><td></td><td>NOGOSAREN</td><td>PUSKESMAS INDUK</td><td>dr.Arninta Rahma
Khoirunnisa</td><td>Riska Wulandari,A.Md.Kep</td><td>P</td><td>55-59
Thn.</td><td>Keluarga</td><td>Lama</td><td>Umum</td><td>Rajal</td><td
align='right'></td><td align='right'>1</td><td align='right'>55</td><td>BP.
Umum</td><td></td><td></td><td>Dalam
Wilayah</td><td>'</td><td>'3322018004680000</td><td>192</td><td>114</td><td>88</
td><td>36.7</td><td>22</td><td>151</td><td>64</td><td></td><td></td><td></td></
tr><tr><td align='right'>I10</td><td>Essential (primary)
hypertension</td><td></td><td>GREGES, BATUK</td><td align='right'>2729</td><td
align='right'>1023588</td><td>20-05-2023</td><td>KOTIJAH</td><td></td><td></
td><td>'</td><td>20-04-1968</td><td>GEJAYAN RT 08 RW
02</td><td></td><td>NOGOSAREN</td><td>PUSKESMAS INDUK</td><td>dr.Arninta Rahma
Khoirunnisa</td><td>Riska Wulandari,A.Md.Kep</td><td>P</td><td>55-59
Thn.</td><td>Keluarga</td><td>Lama</td><td>Umum</td><td>Rajal</td><td
align='right'></td><td align='right'>1</td><td align='right'>55</td><td>BP.
Umum</td><td></td><td></td><td>Dalam
Wilayah</td><td>'</td><td>'3322018004680000</td><td>192</td><td>114</td><td>88</
td><td>36.7</td><td>22</td><td>151</td><td>64</td><td></td><td></td><td></td></
tr><tr><td align='right'>K04.1</td><td>Necrosis of pulp</td><td></td><td>pasien
datang dengan keluhan mau kontrol </td><td align='right'>2735</td><td
align='right'>1006163</td><td>20-05-2023</td><td>LITA
YULIANTI</td><td></td><td></td><td>'085601536016</td><td>10-07-2000</
td><td>KALITENGAH RT 01 RW 06</td><td>KALITENGAH</td><td>BATUR</td><td>PUSKESMAS
INDUK</td><td>drg.Ade Indranila</td><td> - </td><td>P</td><td>20-44
Thn.</td><td>Keluarga</td><td>Lama</td><td>BPJS PBI</td><td>Rajal</td><td
align='right'>10</td><td align='right'>10</td><td align='right'>22</td><td>BP.
Gigi</td><td></td><td></td><td>Dalam
Wilayah</td><td>'0002349072731</td><td>'3322015007000001</td><td>100</td><td>70</
td><td>80</td><td>36</td><td>24</td><td>155</td><td>54</td><td></td><td>tumpat
semnetara </td><td></td></tr><tr><td align='right'>Z34</td><td>Supervision of
normal pregnancy</td><td></td><td>periksa hamil</td><td align='right'>2730</td><td
align='right'>01000059</td><td>20-05-2023</td><td>MARLIYAH</td><td>MUHAMMAD ALDI
BUSRO</td><td>PETANI/PEKEBUN</td><td>'085728118852</td><td>13-02-1988</td><td>NGELO
RT 4 RW 2 </td><td></td><td>GETASAN</td><td>PUSKESMAS INDUK</td><td>dr.Arninta
Rahma Khoirunnisa</td><td>Anna Joeni Astoeti,S.Tr.Keb</td><td>P</td><td>20-44
Thn.</td><td>Keluarga</td><td>Baru</td><td>Umum</td><td>Rajal</td><td
align='right'>7</td><td align='right'>3</td><td
align='right'>35</td><td>KIA</td><td></td><td></td><td>Dalam
Wilayah</td><td>'0003522376438</td><td>'3322015302880003</td><td>120</td><td>80</
td><td>88</td><td>36</td><td>22</td><td>143</td><td>50</td><td></td><td>anjurkan
kontrol 1 bln lagi</td><td></td></tr><tr><td align='right'>K02.2</td><td>Caries of
cementum</td><td></td><td>pasien datang mau tambal gigi </td><td
align='right'>2728</td><td align='right'>1004086</td><td>20-05-2023</td><td>MAYA
SEPTIA ANGGRAEINI</td><td></td><td></td><td>'</td><td>30-09-2003</td><td>SALARAN RT
15 RW 02</td><td></td><td>TOLOKAN</td><td>PUSKESMAS INDUK</td><td>drg.Ade
Indranila</td><td> - </td><td>P</td><td>15-19
Thn.</td><td>Keluarga</td><td>Lama</td><td>BPJS NON PBI</td><td>Rajal</td><td
align='right'>20</td><td align='right'>7</td><td align='right'>19</td><td>BP.
Gigi</td><td></td><td></td><td>Dalam
Wilayah</td><td>'0003283481068</td><td>'3322017009030000</td><td>100</td><td>60</
td><td>80</td><td>36</td><td>21</td><td>144</td><td>34</td><td></td><td>konservasi
</td><td>ketak molar gigi 1.2 HP </td></tr><tr><td
align='right'>K00.6</td><td>Disturbances in tooth eruption</td><td></td><td>pasien
datang mau cabut gigi </td><td align='right'>2759</td><td
align='right'>1023721</td><td>20-05-2023</td><td>MIKHA TIMOTHY
CHRISTIANO</td><td></td><td></td><td>'</td><td>04-07-2016</td><td>GEDAD RT 10 RW
01</td><td></td><td>WATES</td><td>PUSKESMAS INDUK</td><td>drg.Ade
Indranila</td><td> - </td><td>L</td><td>5-9
Thn.</td><td>Keluarga</td><td>Lama</td><td>Umum</td><td>Rajal</td><td
align='right'>16</td><td align='right'>10</td><td align='right'>6</td><td>BP.
Gigi</td><td></td><td></td><td>Dalam
Wilayah</td><td>'</td><td>'</td><td>100</td><td>60</td><td>80</td><td>36</
td><td>24</td><td>135</td><td>29</td><td></td><td>exo </td><td>exo dengan CE gigi
8.2</td></tr><tr><td align='right'>K04.1</td><td>Necrosis of
pulp</td><td></td><td>pasien datang dengan keluhan gigi bawah sakit sudah 2 hari
</td><td align='right'>2755</td><td
align='right'>1011438</td><td>20-05-2023</td><td>NUR AISYAH
RAMADHANI</td><td></td><td></td><td>'</td><td>28-05-2018</td><td>PLALAR RT 03 RW
04</td><td>PLALAR</td><td>KOPENG</td><td>PUSKESMAS INDUK</td><td>drg.Ade
Indranila</td><td> - </td><td>P</td><td>1-4
Thn.</td><td>Keluarga</td><td>Lama</td><td>BPJS PBI</td><td>Rajal</td><td
align='right'>22</td><td align='right'>11</td><td align='right'>4</td><td>BP.
Gigi</td><td></td><td></td><td>Dalam
Wilayah</td><td>'0003142236857</td><td>'3322016805180001</td><td>100</td><td>70</
td><td>80</td><td>36</td><td>24</td><td>135</td><td>35</td><td></td><td>pro
konservasi </td><td>premedikasi </td></tr><tr><td align='right'>E13</td><td>Other
specified diabetes mellitus</td><td></td><td>KONTROL</td><td
align='right'>2748</td><td
align='right'>1024838</td><td>20-05-2023</td><td>PRIYATINI</td><td></td><td></
td><td>'</td><td>09-12-1970</td><td>GOMPYONG RT 07 RW 01
POLOBOGO</td><td></td><td>Luar Wilayah</td><td>PUSKESMAS INDUK</td><td>dr.Arninta
Rahma Khoirunnisa</td><td>Riska Wulandari,A.Md.Kep</td><td>P</td><td>45-54
Thn.</td><td>Keluarga</td><td>Lama</td><td>BPJS PBI</td><td>Rujuk</td><td
align='right'>11</td><td align='right'>5</td><td align='right'>52</td><td>BP.
Umum</td><td>Penyakit Dalam </td><td>RSUD dr. Gunawan Mangunkusumo</td><td>Luar
Wilayah</td><td>'0003192854624</td><td>'3322014912700001</td><td>150</td><td>80</
td><td>80</td><td>36</td><td>22</td><td>140</td><td>44</td><td></td><td></
td><td></td></tr><tr><td align='right'>I10</td><td>Essential (primary)
hypertension</td><td></td><td>KONTROL</td><td align='right'>2748</td><td
align='right'>1024838</td><td>20-05-2023</td><td>PRIYATINI</td><td></td><td></
td><td>'</td><td>09-12-1970</td><td>GOMPYONG RT 07 RW 01
POLOBOGO</td><td></td><td>Luar Wilayah</td><td>PUSKESMAS INDUK</td><td>dr.Arninta
Rahma Khoirunnisa</td><td>Riska Wulandari,A.Md.Kep</td><td>P</td><td>45-54
Thn.</td><td>Keluarga</td><td>Lama</td><td>BPJS PBI</td><td>Rujuk</td><td
align='right'>11</td><td align='right'>5</td><td align='right'>52</td><td>BP.
Umum</td><td>Penyakit Dalam </td><td>RSUD dr. Gunawan Mangunkusumo</td><td>Luar
Wilayah</td><td>'0003192854624</td><td>'3322014912700001</td><td>150</td><td>80</
td><td>80</td><td>36</td><td>22</td><td>140</td><td>44</td><td></td><td></
td><td></td></tr><tr><td align='right'>Z00.0</td><td>General medical
examination</td><td></td><td>SURAT SEHAT</td><td align='right'>2751</td><td
align='right'>90000115</td><td>20-05-2023</td><td>PUJIATI</td><td></td><td></
td><td>'</td><td>04-04-2004</td><td>PANDANA GETASAN</td><td></td><td>Luar
Wilayah</td><td>PUSKESMAS INDUK</td><td>dr.Arninta Rahma Khoirunnisa</td><td>Riska
Wulandari,A.Md.Kep</td><td>P</td><td>15-19
Thn.</td><td>Keluarga</td><td>Baru</td><td>Umum</td><td>Rajal</td><td
align='right'>16</td><td align='right'>1</td><td align='right'>19</td><td>BP.
Umum</td><td></td><td></td><td>Luar
Wilayah</td><td>'</td><td>'</td><td>120</td><td>80</td><td>88</td><td>36.5</
td><td>22</td><td>155</td><td>55</td><td></td><td></td><td></td></tr><tr><td
align='right'>J45</td><td>Asthma</td><td></td><td>SESEK, RIWAYAT ASMA</td><td
align='right'>2760</td><td align='right'>1006602</td><td>20-05-2023</td><td>RAHEL
ADI CANDRA</td><td></td><td></td><td>'</td><td>30-10-2010</td><td>KEMBANG RT.11
RW.3</td><td></td><td>Luar Wilayah</td><td>PUSKESMAS INDUK</td><td>dr.Arninta Rahma
Khoirunnisa</td><td>Riska Wulandari,A.Md.Kep</td><td>L</td><td>10-14
Thn.</td><td>Keluarga</td><td>Lama</td><td>BPJS PBI</td><td>Rajal</td><td
align='right'>20</td><td align='right'>6</td><td align='right'>12</td><td>BP.
Umum</td><td></td><td></td><td>Luar
Wilayah</td><td>'0002420824623</td><td>'3322013010100000</td><td>100</td><td>80</
td><td>80</td><td>36.5</td><td>24</td><td>146</td><td>32</td><td></td><td></
td><td></td></tr><tr><td align='right'>K00.6</td><td>Disturbances in tooth
eruption</td><td></td><td>mau cabut gigi sebelah atas </td><td
align='right'>2765</td><td align='right'>90000117</td><td>20-05-2023</td><td>RENDY
NATHANAEL</td><td>KABUL
WIDODO</td><td>PELAJAR/MAHASISWA</td><td>'083108148139</td><td>07-02-2016</
td><td>MUJO RT 3 RW 4 </td><td></td><td>Luar Wilayah</td><td>PUSKESMAS
INDUK</td><td>drg.Ade Indranila</td><td> - </td><td>L</td><td>5-9
Thn.</td><td>Keluarga</td><td>Baru</td><td>BPJS NON PBI</td><td>Rajal</td><td
align='right'>13</td><td align='right'>3</td><td align='right'>7</td><td>BP.
Gigi</td><td></td><td></td><td>Luar
Wilayah</td><td>'0002061907762</td><td>'3322010702160001</td><td>100</td><td>60</
td><td>80</td><td>36</td><td>22</td><td>143</td><td>33</td><td></td><td>exo gigi
susu </td><td>exo dengan CE </td></tr><tr><td align='right'>I10</td><td>Essential
(primary) hypertension</td><td></td><td>KONTROL TENSI</td><td
align='right'>2734</td><td
align='right'>99000003</td><td>20-05-2023</td><td>ROBERTO
SIMANJUNTAK</td><td></td><td></td><td>'</td><td>02-11-1968</td><td>KARET PS BARU
BARAT II RT 09 RW 07 KARET TENGSIN TANAH ABANG</td><td></td><td>Luar
kabupaten</td><td>PUSKESMAS INDUK</td><td>dr.Arninta Rahma
Khoirunnisa</td><td>Riska Wulandari,A.Md.Kep</td><td>L</td><td>45-54
Thn.</td><td>Keluarga</td><td>Lama</td><td>BPJS NON PBI</td><td>Rajal</td><td
align='right'>18</td><td align='right'>6</td><td align='right'>54</td><td>BP.
Umum</td><td></td><td></td><td>Luar
Wilayah</td><td>'0001454487344</td><td>'3171070211680006</td><td>140</td><td>100</
td><td>88</td><td>36.4</td><td>22</td><td>158</td><td>53</td><td></td><td></
td><td></td></tr><tr><td align='right'>J06.9</td><td>Acute upper respiratory
infection, unspecified</td><td></td><td>PUSING, BATUK, PILEK</td><td
align='right'>2746</td><td
align='right'>1017123</td><td>20-05-2023</td><td>RUSIYANI</td><td></
td><td>WIRASWASTA</td><td>'</td><td>13-08-1987</td><td>KENTENG RT 05 RW 05
SUMOGAWE</td><td></td><td>Luar Wilayah</td><td>PUSKESMAS INDUK</td><td>dr.Arninta
Rahma Khoirunnisa</td><td>Riska Wulandari,A.Md.Kep</td><td>P</td><td>20-44
Thn.</td><td>Keluarga</td><td>Lama</td><td>Umum</td><td>Rajal</td><td
align='right'>7</td><td align='right'>9</td><td align='right'>35</td><td>BP.
Umum</td><td></td><td></td><td>Luar
Wilayah</td><td>'</td><td>'3322015308870000</td><td>115</td><td>77</td><td>88</
td><td>36.2</td><td>22</td><td>150</td><td>48</td><td></td><td></td><td></td></
tr><tr><td align='right'>I50</td><td>Heart failure</td><td></td><td>KONTROL</td><td
align='right'>2745</td><td
align='right'>1024547</td><td>20-05-2023</td><td>RUSIYONO</td><td></td><td></
td><td>'</td><td>25-07-1953</td><td>GETASAN RT 05 RW
01</td><td></td><td>GETASAN</td><td>PUSKESMAS INDUK</td><td>dr.Arninta Rahma
Khoirunnisa</td><td>Riska Wulandari,A.Md.Kep</td><td>L</td><td>60-69
Thn.</td><td>Keluarga</td><td>Lama</td><td>BPJS NON PBI</td><td>Rujuk</td><td
align='right'>25</td><td align='right'>9</td><td align='right'>69</td><td>BP.
Umum</td><td>JANTUNG DAN PEMBULUH DARAH</td><td>RS DR.ASMIR SALATIGA</td><td>Dalam
Wilayah</td><td>'0003340554366</td><td>'3322012507530001</td><td>101</td><td>74</
td><td>88</td><td>36.5</td><td>22</td><td>154</td><td>64</td><td></td><td></
td><td></td></tr><tr><td align='right'>I10</td><td>Essential (primary)
hypertension</td><td></td><td>BATUK, PUSING, SESEK</td><td
align='right'>2738</td><td
align='right'>90000114</td><td>20-05-2023</td><td>SALIYEM</td><td></td><td></
td><td>'</td><td>12-06-1954</td><td>DALANGAN RT 2 RW </td><td></td><td>Luar
Wilayah</td><td>PUSKESMAS INDUK</td><td>dr.Arninta Rahma Khoirunnisa</td><td>Riska
Wulandari,A.Md.Kep</td><td>P</td><td>60-69
Thn.</td><td>Keluarga</td><td>Baru</td><td>BPJS PBI</td><td>Rajal</td><td
align='right'>8</td><td align='right'>11</td><td align='right'>68</td><td>BP.
Umum</td><td></td><td></td><td>Luar
Wilayah</td><td>'0000602715609</td><td>'3322015206540001</td><td>160</td><td>100</
td><td>88</td><td>36.5</td><td>22</td><td>150</td><td>60</td><td></td><td></
td><td></td></tr><tr><td align='right'>I50</td><td>Heart
failure</td><td></td><td>KONTROL</td><td align='right'>2740</td><td
align='right'>99000070</td><td>20-05-2023</td><td>SARBI</td><td></td><td>PETANI/
PEKEBUN</td><td>'</td><td>31-12-1966</td><td>KEDITAN RT 1 RW 1
NGABLAK</td><td></td><td>Luar kabupaten</td><td>PUSKESMAS INDUK</td><td>dr.Arninta
Rahma Khoirunnisa</td><td>Riska Wulandari,A.Md.Kep</td><td>L</td><td>55-59
Thn.</td><td>Keluarga</td><td>Baru</td><td>BPJS PBI</td><td>Rujuk</td><td
align='right'>20</td><td align='right'>4</td><td align='right'>56</td><td>BP.
Umum</td><td>Penyakit Dalam </td><td>RS DR.ASMIR SALATIGA</td><td>Luar
Wilayah</td><td>'0000553708776</td><td>'3308173112660065</td><td>139</td><td>94</
td><td>89</td><td>36.5</td><td>22</td><td>156</td><td>56</td><td></td><td></
td><td></td></tr><tr><td align='right'>I50</td><td>Heart
failure</td><td></td><td>KONTROL</td><td align='right'>2742</td><td
align='right'>1015211</td><td>20-05-2023</td><td>SRI
SUKARSIH</td><td></td><td></td><td>'</td><td>21-07-1983</td><td>NOGOSAREN RT 07 RW
01</td><td></td><td>NOGOSAREN</td><td>PUSKESMAS INDUK</td><td>dr.Arninta Rahma
Khoirunnisa</td><td>Riska Wulandari,A.Md.Kep</td><td>P</td><td>20-44
Thn.</td><td>Keluarga</td><td>Lama</td><td>BPJS PBI</td><td>Rajal</td><td
align='right'>29</td><td align='right'>9</td><td align='right'>39</td><td>BP.
Umum</td><td></td><td></td><td>Dalam
Wilayah</td><td>'0002349063685</td><td>'3322016107830000</td><td>164</td><td>80</
td><td>88</td><td>36.4</td><td>22</td><td>150</td><td>50</td><td></td><td></
td><td></td></tr><tr><td align='right'>K04.1</td><td>Necrosis of
pulp</td><td></td><td>pasien datang mau kontrol tambalan </td><td
align='right'>2737</td><td align='right'>1024994</td><td>20-05-2023</td><td>SRI
SULIYAH</td><td></td><td></td><td>'</td><td>24-05-1971</td><td>SENDEN RT 04 RW
09</td><td>SENDEN</td><td>BATUR</td><td>PUSKESMAS INDUK</td><td>drg.Ade
Indranila</td><td> - </td><td>P</td><td>45-54
Thn.</td><td>Keluarga</td><td>Lama</td><td>Umum</td><td>Rajal</td><td
align='right'>26</td><td align='right'>11</td><td align='right'>51</td><td>BP.
Gigi</td><td></td><td></td><td>Dalam
Wilayah</td><td>'</td><td>'3322016405710001</td><td>125</td><td>91</td><td>80</
td><td>36</td><td>24</td><td>155</td><td>56</td><td></td><td>pro conservasi
</td><td>tumpat semnetara CHKM + Fletcher </td></tr><tr><td
align='right'>K05.6</td><td>Periodontal disease,
unspecified</td><td></td><td>pasien datang dengan keluhan gigi ats kiri goyang ,
kaki sering kesemutan </td><td align='right'>2758</td><td
align='right'>1001456</td><td>20-05-2023</td><td>SUPARJONO</td><td></td><td></
td><td>'</td><td>01-09-1971</td><td>SRANTI RT
07 RW 02</td><td>SRANTI</td><td>WATES</td><td>PUSKESMAS INDUK</td><td>drg.Ade
Indranila</td><td> - </td><td>L</td><td>45-54
Thn.</td><td>Keluarga</td><td>Lama</td><td>BPJS PBI</td><td>Rajal</td><td
align='right'>19</td><td align='right'>8</td><td align='right'>51</td><td>BP.
Gigi</td><td></td><td></td><td>Dalam
Wilayah</td><td>'0000601575489</td><td>'3322012609710002</td><td>117</td><td>79</
td><td>80</td><td>36</td><td>24</td><td>162</td><td>55</td><td></td><td>pro Exo
</td><td>premedikasi </td></tr><tr><td align='right'>J06.9</td><td>Acute upper
respiratory infection, unspecified</td><td></td><td>BATUK, PILEK</td><td
align='right'>2753</td><td
align='right'>1009309</td><td>20-05-2023</td><td>TRIMAH</td><td></td><td></
td><td>'</td><td>04-06-1962</td><td>PANDANAN RT.3
RW.3</td><td>PANDANAN</td><td>GETASAN</td><td>PUSKESMAS INDUK</td><td>dr.Arninta
Rahma Khoirunnisa</td><td>Riska Wulandari,A.Md.Kep</td><td>P</td><td>60-69
Thn.</td><td>Keluarga</td><td>Lama</td><td>Umum</td><td>Rajal</td><td
align='right'>16</td><td align='right'>11</td><td align='right'>60</td><td>BP.
Umum</td><td></td><td></td><td>Dalam
Wilayah</td><td>'</td><td>'3322014406620002</td><td>116</td><td>68</td><td>88</
td><td>36.7</td><td>22</td><td>148</td><td>65</td><td></td><td></td><td></td></
tr><tr><td align='right'>Z00.0</td><td>General medical
examination</td><td></td><td>KONTROL POST KLL</td><td align='right'>2757</td><td
align='right'>1020285</td><td>20-05-2023</td><td>TRIYADI</td><td></td><td></
td><td>'</td><td>24-05-1983</td><td>DUKUH RT 05 RW
08</td><td></td><td>KOPENG</td><td>PUSKESMAS INDUK</td><td>dr.Arninta Rahma
Khoirunnisa</td><td>Riska Wulandari,A.Md.Kep</td><td>L</td><td>20-44
Thn.</td><td>Keluarga</td><td>Lama</td><td>Umum</td><td>Rajal</td><td
align='right'>26</td><td align='right'>11</td><td align='right'>39</td><td>BP.
Umum</td><td></td><td></td><td>Dalam
Wilayah</td><td>'</td><td>'3322052405830000</td><td>120</td><td>80</td><td>80</
td><td>36.2</td><td>22</td><td>156</td><td>68</td><td></td><td></td><td></td></
tr><tr><td align='right'>K30</td><td>Dyspepsia</td><td></td><td>PERUT SAKIT,
BATUK</td><td align='right'>2756</td><td align='right'>1001670</td><td>20-05-
2023</td><td>YAMTINAH</td><td></td><td></td><td>'</td><td>13-08-1969</
td><td>PANDANAN RT 01 RW 03</td><td>PANDANAN</td><td>GETASAN</td><td>PUSKESMAS
INDUK</td><td>dr.Arninta Rahma Khoirunnisa</td><td>Riska
Wulandari,A.Md.Kep</td><td>P</td><td>45-54
Thn.</td><td>Keluarga</td><td>Lama</td><td>BPJS NON PBI</td><td>Rajal</td><td
align='right'>7</td><td align='right'>9</td><td align='right'>53</td><td>BP.
Umum</td><td></td><td></td><td>Dalam
Wilayah</td><td>'0002233139332</td><td>'3322015308690002</td><td>123</td><td>85</
td><td>80</td><td>36.2</td><td>22</td><td>150</td><td>67</td><td></td><td></
td><td></td></tr><tr><td align='right'>K08.3</td><td>Retained dental
root</td><td></td><td>pasien dfatang dengan keluhan gusi bengkak dan susah buka
mulut </td><td align='right'>2743</td><td align='right'>1010469</td><td>20-05-
2023</td><td>YOSIA ADI
NUGROHO</td><td></td><td></td><td>'</td><td>27-01-1995</td><td>NGLELO RT
01/19</td><td></td><td>BATUR</td><td>PUSKESMAS INDUK</td><td>drg.Ade
Indranila</td><td> - </td><td>L</td><td>20-44
Thn.</td><td>Keluarga</td><td>Baru</td><td>Umum</td><td>Rajal</td><td
align='right'>23</td><td align='right'>3</td><td align='right'>28</td><td>BP.
Gigi</td><td></td><td></td><td>Dalam
Wilayah</td><td>'0001532107528</td><td>'3322012701960003</td><td>120</td><td>70</
td><td>80</td><td>36</td><td>24</td><td>162</td><td>55</td><td></td><td>pro exo
</td><td>premedikasi
</td></tr><tr><td align='right'>K04.7</td><td>Periapical abscess without
sinus</td><td></td><td>pasien dfatang dengan keluhan gusi bengkak dan susah buka
mulut </td><td align='right'>2743</td><td align='right'>1010469</td><td>20-05-
2023</td><td>YOSIA ADI
NUGROHO</td><td></td><td></td><td>'</td><td>27-01-1995</td><td>NGLELO RT
01/19</td><td></td><td>BATUR</td><td>PUSKESMAS INDUK</td><td>drg.Ade
Indranila</td><td> - </td><td>L</td><td>20-44
Thn.</td><td>Keluarga</td><td>Baru</td><td>Umum</td><td>Rajal</td><td
align='right'>23</td><td align='right'>3</td><td align='right'>28</td><td>BP.
Gigi</td><td></td><td></td><td>Dalam
Wilayah</td><td>'0001532107528</td><td>'3322012701960003</td><td>120</td><td>70</
td><td>80</td><td>36</td><td>24</td><td>162</td><td>55</td><td></td><td>pro exo
</td><td>premedikasi
</td></tr><tr><td align='right'>J06.9</td><td>Acute upper respiratory infection,
unspecified</td><td></td><td>PANAS, BATUK, PILEK</td><td align='right'>2747</td><td
align='right'>1006972</td><td>20-05-2023</td><td>ZABIL EZAR
AUFALEN</td><td></td><td></td><td>'</td><td>02-12-2013</td><td>KENTENG RT
5/5</td><td></td><td>Luar Wilayah</td><td>PUSKESMAS INDUK</td><td>dr.Arninta Rahma
Khoirunnisa</td><td>Riska Wulandari,A.Md.Kep</td><td>L</td><td>5-9
Thn.</td><td>Keluarga</td><td>Lama</td><td>Umum</td><td>Rajal</td><td
align='right'>18</td><td align='right'>5</td><td align='right'>9</td><td>BP.
Umum</td><td></td><td></td><td>Luar
Wilayah</td><td>'</td><td>'</td><td>100</td><td>80</td><td>88</td><td>37.8</
td><td>22</td><td>134</td><td>28</td><td></td><td></td><td></td></tr><tr><td
align='right'>J06.9</td><td>Acute upper respiratory infection,
unspecified</td><td></td><td>panas, batuk, pilek</td><td align='right'>2784</td><td
align='right'>1024202</td><td>22-05-2023</td><td>ABYAN GILANG
ADITYA</td><td>RIYANTO</td><td></td><td>'</td><td>25-06-2022</td><td>KARANG BAWANG
RT 12 RW 02</td><td>KARANGBAWANG</td><td>NOGOSAREN</td><td>PUSKESMAS
INDUK</td><td>dr.Arninta Rahma Khoirunnisa</td><td>Sri
Hartini,S.S.T.Keb</td><td>L</td><td><1
Thn.</td><td>Keluarga</td><td>Lama</td><td>Umum</td><td>Rajal</td><td
align='right'></td><td align='right'>10</td><td
align='right'></td><td>MTBS</td><td></td><td></td><td>Dalam
Wilayah</td><td>'</td><td>'</td><td></td><td></td><td>120</td><td>36</td><td>37</
td><td>75</td><td>11</td><td></td><td>penkes cara pemberian obat di
rumah</td><td>memberikan penkes cara pemberian obat di rumah</td></tr><tr><td
align='right'>S93</td><td>Dislocation, sprain and strain of joints and ligaments at
ankle and foot level</td><td></td><td>jatuh kaki bengkak</td><td
align='right'>2778</td><td align='right'>1015525</td><td>22-05-2023</td><td>ANNISA
SALSABILA</td><td></td><td></td><td>'</td><td>23-09-2000</td><td>TOLOKAN RT 05 RW
01</td><td></td><td>TOLOKAN</td><td>PUSKESMAS INDUK</td><td>dr.Arninta Rahma
Khoirunnisa</td><td>Supomo,A.Md.Kep</td><td>P</td><td>20-44
Thn.</td><td>Keluarga</td><td>Lama</td><td>BPJS NON PBI</td><td>Rujuk</td><td
align='right'>29</td><td align='right'>7</td><td align='right'>22</td><td>BP.
Umum</td><td>Orthopedi</td><td>RS DR.ASMIR SALATIGA</td><td>Dalam
Wilayah</td><td>'0000074673371</td><td>'3322016309000000</td><td>110</td><td>70</
td><td>80</td><td>36</td><td>24</td><td>156</td><td>65</td><td></td><td></
td><td></td></tr><tr><td align='right'>Z09.8</td><td>Follow-up examination after
other treatment for other conditions</td><td></td><td></td><td
align='right'>2780</td><td
align='right'>90000118</td><td>22-05-2023</td><td>BINTANG JULLIANUS
SAPUTRA</td><td>TENY DEKY
OKTAVIANUS</td><td>PELAJAR/MAHASISWA</td><td>'</td><td>03-07-2007</
td><td>TAMBAKREJO RT 02 RW 03 TAMBAKBOYO AMBARAWA</td><td></td><td>Luar
Wilayah</td><td>PUSKESMAS INDUK</td><td>dr.Arninta Rahma
Khoirunnisa</td><td>Supomo,A.Md.Kep</td><td>L</td><td>15-19
Thn.</td><td>Keluarga</td><td>Baru</td><td>BPJS PBI</td><td>Rajal</td><td
align='right'>19</td><td align='right'>10</td><td align='right'>15</td><td>BP.
Umum</td><td></td><td></td><td>Luar
Wilayah</td><td>'0001692734725</td><td>'3322100207070001</td><td>150</td><td>45</
td><td>87</td><td>36.5</td><td>20</td><td>145</td><td>52</td><td></td><td></
td><td></td></tr><tr><td align='right'>J06.9</td><td>Acute upper respiratory
infection, unspecified</td><td></td><td></td><td align='right'>2802</td><td
align='right'>1012702</td><td>22-05-2023</td><td>CYINTA
PURNAMASARI</td><td></td><td></td><td>'</td><td>31-08-2012</td><td>GETASAN RT 02 RW
01</td><td>GETASAN</td><td>GETASAN</td><td>PUSKESMAS INDUK</td><td>dr.Arninta Rahma
Khoirunnisa</td><td>Supomo,A.Md.Kep</td><td>P</td><td>10-14
Thn.</td><td>Keluarga</td><td>Lama</td><td>Umum</td><td>Rajal</td><td
align='right'>21</td><td align='right'>8</td><td align='right'>10</td><td>BP.
Umum</td><td></td><td></td><td>Dalam
Wilayah</td><td>'0002133609131</td><td>'3322017108120001</td><td>90</td><td>50</
td><td>87</td><td>36.5</td><td>20</td><td>134</td><td>24</td><td></td><td></
td><td></td></tr><tr><td align='right'>E11</td><td>Non-insulin-dependent diabetes
mellitus</td><td></td><td></td><td align='right'>2770</td><td
align='right'>1002272</td><td>22-05-2023</td><td>DARMI</td><td></td><td>PETANI/
PEKEBUN</td><td>'</td><td>11-10-1958</td><td>SIDOMUKTI RT 04 RW
05</td><td></td><td>KOPENG</td><td>PUSKESMAS INDUK</td><td>dr.Arninta Rahma
Khoirunnisa</td><td>Supomo,A.Md.Kep</td><td>P</td><td>60-69
Thn.</td><td>Keluarga</td><td>Lama</td><td>Umum</td><td>Rajal</td><td
align='right'>11</td><td align='right'>7</td><td align='right'>64</td><td>BP.
Umum</td><td></td><td></td><td>Dalam
Wilayah</td><td>'</td><td>'3322015110580001</td><td>194</td><td>101</td><td>87</
td><td>36.5</td><td>20</td><td>148</td><td>56</td><td></td><td></td><td></td></
tr><tr><td align='right'>Z76.1</td><td>Health supervision and care of
foundling</td><td></td><td></td><td align='right'>2782</td><td
align='right'>99000066</td><td>22-05-2023</td><td>DAVA ZAHIRUL
WIJAYA</td><td></td><td></td><td>'</td><td>19-06-2020</td><td>DELES RT 12 RW 03
NGABLAK</td><td></td><td>Luar kabupaten</td><td>PUSKESMAS INDUK</td><td>dr.Arninta
Rahma Khoirunnisa</td><td>Sri Hartini,S.S.T.Keb</td><td>L</td><td>1-4
Thn.</td><td>Keluarga</td><td>Lama</td><td>Umum</td><td>Rajal</td><td
align='right'>3</td><td align='right'>11</td><td
align='right'>2</td><td>MTBS</td><td></td><td></td><td>Luar
Wilayah</td><td>'</td><td>'</td><td></td><td></td><td>100</td><td>36</td><td>37</
td><td>0</td><td>13</td><td></td><td>penkes cara perawatan lanjutan di
rumah</td><td>memberikan penkes cara perawatan lanjutan di rumah</td></tr><tr><td
align='right'>K02.2</td><td>Caries of cementum</td><td></td><td>pasien datang
dengan keluhan gigi kanan atas sakit </td><td align='right'>2791</td><td
align='right'>1016452</td><td>22-05-2023</td><td>DAVEN DARRELL
</td><td></td><td></td><td>'</td><td>17-08-2014</td><td>GETASAN RT 07 RW
01</td><td></td><td>GETASAN</td><td>PUSKESMAS INDUK</td><td>drg.Ade
Indranila</td><td> - </td><td>L</td><td>5-9
Thn.</td><td>Keluarga</td><td>Baru</td><td>BPJS NON PBI</td><td>Rajal</td><td
align='right'>5</td><td align='right'>9</td><td align='right'>8</td><td>BP.
Gigi</td><td></td><td></td><td>Dalam
Wilayah</td><td>'0002756454153</td><td>'3374131708140002</td><td>100</td><td>60</
td><td>80</td><td>36</td><td>24</td><td>135</td><td>32</td><td></td><td>pro exo
</td><td>premedikasi </td></tr><tr><td align='right'>K04.1</td><td>Necrosis of
pulp</td><td></td><td>pasien datang dengan keluhan gigi kanan atas sakit </td><td
align='right'>2791</td><td align='right'>1016452</td><td>22-05-2023</td><td>DAVEN
DARRELL </td><td></td><td></td><td>'</td><td>17-08-2014</td><td>GETASAN RT 07 RW
01</td><td></td><td>GETASAN</td><td>PUSKESMAS INDUK</td><td>drg.Ade
Indranila</td><td> - </td><td>L</td><td>5-9
Thn.</td><td>Keluarga</td><td>Baru</td><td>BPJS NON PBI</td><td>Rajal</td><td
align='right'>5</td><td align='right'>9</td><td align='right'>8</td><td>BP.
Gigi</td><td></td><td></td><td>Dalam
Wilayah</td><td>'0002756454153</td><td>'3374131708140002</td><td>100</td><td>60</
td><td>80</td><td>36</td><td>24</td><td>135</td><td>32</td><td></td><td>pro exo
</td><td>premedikasi </td></tr><tr><td
align='right'>K30</td><td>Dyspepsia</td><td></td><td></td><td
align='right'>2804</td><td
align='right'>1000577</td><td>22-05-2023</td><td>EL.KARYANA</td><td></td><td></
td><td>'</td><td>30-04-1951</td><td>KRANGKENG RT 03 RW
12</td><td>KRANGKENG</td><td>BATUR</td><td>PUSKESMAS INDUK</td><td>dr.Arninta Rahma
Khoirunnisa</td><td>Supomo,A.Md.Kep</td><td>L</td><td>>70
Thn.</td><td>Keluarga</td><td>Lama</td><td>BPJS NON PBI</td><td>Rajal</td><td
align='right'>22</td><td align='right'></td><td align='right'>72</td><td>BP.
Umum</td><td></td><td></td><td>Dalam
Wilayah</td><td>'0000074940399</td><td>'3322013004510001</td><td>128</td><td>84</
td><td>87</td><td>36.5</td><td>20</td><td>160</td><td>78</td><td></td><td></
td><td></td></tr><tr><td align='right'>L85.3</td><td>Xerosis
cutis</td><td></td><td>gatal 2 di telinga , kaki dan keluar cairan dr
telinga</td><td align='right'>2810</td><td align='right'>90000119</td><td>22-05-
2023</td><td>FAEYZA ATHAR ADYATAMA</td><td>MUJIYONO</td><td>BELUM/TIDAK
BEKERJA</td><td>'</td><td>11-08-2020</td><td>BREYON RT 08 RW
03</td><td></td><td>Luar Wilayah</td><td>PUSKESMAS INDUK</td><td>dr.Arninta Rahma
Khoirunnisa</td><td>Sri Hartini,S.S.T.Keb</td><td>L</td><td>1-4
Thn.</td><td>Keluarga</td><td>Baru</td><td>Umum</td><td>Rajal</td><td
align='right'>11</td><td align='right'>9</td><td
align='right'>2</td><td>MTBS</td><td></td><td></td><td>Luar
Wilayah</td><td>'</td><td>'</td><td></td><td></td><td>100</td><td>37</td><td>36</
td><td>97</td><td>15</td><td></td><td>penkes cara pemberian obat di
rumaH</td><td>MEMBERIKKAN PENKES CARA PEMBERIAN OBAT DI RUMAH</td></tr><tr><td
align='right'>K12.0</td><td>Recurrent oral aphthae</td><td></td><td></td><td
align='right'>2786</td><td
align='right'>1003540</td><td>22-05-2023</td><td>HARTANA</td><td></td><td></
td><td>'085801277724</td><td>18-08-1971</td><td>KRANGEAN RT 02/02 NGABLAK
MAGELANG</td><td></td><td>Luar kabupaten</td><td>PUSKESMAS INDUK</td><td>dr.Arninta
Rahma Khoirunnisa</td><td>Supomo,A.Md.Kep</td><td>L</td><td>45-54
Thn.</td><td>Keluarga</td><td>Lama</td><td>BPJS NON PBI</td><td>Rujuk</td><td
align='right'>4</td><td align='right'>9</td><td align='right'>51</td><td>BP.
Umum</td><td></td><td></td><td>Luar
Wilayah</td><td>'0001806483429</td><td>'3308171808710001</td><td>162</td><td>68</
td><td>87</td><td>36.5</td><td>20</td><td>162</td><td>68</td><td></td><td></
td><td></td></tr><tr><td align='right'>K05.6</td><td>Periodontal disease,
unspecified</td><td></td><td>pasien datang demham keluhan mau cabut gigi </td><td
align='right'>2793</td><td
align='right'>1025471</td><td>22-05-2023</td><td>KARSIYEM</td><td></td><td></
td><td>'</td><td>31-12-1976</td><td>KEBONPETE
RT 01 RW 02</td><td></td><td>Luar Wilayah</td><td>PUSKESMAS INDUK</td><td>drg.Ade
Indranila</td><td> - </td><td>P</td><td>45-54
Thn.</td><td>Keluarga</td><td>Lama</td><td>BPJS PBI</td><td>Rajal</td><td
align='right'>21</td><td align='right'>4</td><td align='right'>46</td><td>BP.
Gigi</td><td></td><td></td><td>Luar
Wilayah</td><td>'0003505023977</td><td>'3322017112450091</td><td>139</td><td>79</
td><td>80</td><td>36</td><td>24</td><td>151</td><td>45</td><td></td><td></
td><td>exo lidocain tanpa komplikasi </td></tr><tr><td
align='right'>F45.2</td><td>Hypochondriacal disorder</td><td></td><td></td><td
align='right'>2814</td><td
align='right'>1006810</td><td>22-05-2023</td><td>KHASANAH</td><td></td><td></
td><td>'</td><td>09-04-1983</td><td>GETASAN RT 3
/1</td><td>GETASAN</td><td>GETASAN</td><td>PUSKESMAS INDUK</td><td>dr.Arninta Rahma
Khoirunnisa</td><td>Supomo,A.Md.Kep</td><td>P</td><td>20-44
Thn.</td><td>Keluarga</td><td>Baru</td><td>Umum</td><td>Rajal</td><td
align='right'>13</td><td align='right'>1</td><td align='right'>40</td><td>BP.
Umum</td><td></td><td></td><td>Dalam
Wilayah</td><td>'0002307156524</td><td>'3307064904830000</td><td>110</td><td>70</
td><td>87</td><td>36.5</td><td>20</td><td>146</td><td>57</td><td></td><td></
td><td></td></tr><tr><td align='right'>S52.5</td><td>Fracture of lower end of
radius</td><td></td><td></td><td align='right'>2788</td><td
align='right'>1004824</td><td>22-05-2023</td><td>LASTRININGSIH</td><td>SUTARLAN</
td><td></td><td>'085641283076</td><td>20-02-1981</td><td>WATES RT
04/01</td><td>WATES</td><td>WATES</td><td>PUSKESMAS INDUK</td><td>dr.Arninta Rahma
Khoirunnisa</td><td>Supomo,A.Md.Kep</td><td>P</td><td>20-44
Thn.</td><td>Keluarga</td><td>Lama</td><td>BPJS NON PBI</td><td>Rajal</td><td
align='right'>2</td><td align='right'>3</td><td align='right'>42</td><td>BP.
Umum</td><td></td><td></td><td>Dalam
Wilayah</td><td>'0000173779209</td><td>'3322016002810001</td><td>120</td><td>70</
td><td>87</td><td>36.5</td><td>20</td><td>155</td><td>53</td><td></td><td></
td><td></td></tr><tr><td align='right'>G51.0</td><td>Bell's
palsy</td><td></td><td></td><td align='right'>2795</td><td
align='right'>1008471</td><td>22-05-2023</td><td>LILIS
SUSANTI</td><td>SUSILO</td><td></td><td>'</td><td>24-04-1993</td><td>GETASAN RT 04
RW 01</td><td>GETASAN</td><td>GETASAN</td><td>PUSKESMAS INDUK</td><td>dr.Arninta
Rahma Khoirunnisa</td><td>Supomo,A.Md.Kep</td><td>P</td><td>20-44
Thn.</td><td>Keluarga</td><td>Lama</td><td>Umum</td><td>Rajal</td><td
align='right'>28</td><td align='right'></td><td align='right'>30</td><td>BP.
Umum</td><td></td><td></td><td>Dalam
Wilayah</td><td>'</td><td>'3308166404930003</td><td>165</td><td>109</td><td>87</
td><td>36.5</td><td>20</td><td>162</td><td>78</td><td></td><td></td><td></td></
tr><tr><td align='right'>J06.9</td><td>Acute upper respiratory infection,
unspecified</td><td></td><td></td><td align='right'>2811</td><td
align='right'>1024092</td><td>22-05-2023</td><td>LUSIANA EGA
APRIANI</td><td></td><td></td><td>'</td><td>07-04-2001</td><td>PANDANAN RT 03 RW
03</td><td>PANDANAN</td><td>GETASAN</td><td>PUSKESMAS INDUK</td><td>dr.Arninta
Rahma Khoirunnisa</td><td>Supomo,A.Md.Kep</td><td>P</td><td>20-44
Thn.</td><td>Keluarga</td><td>Baru</td><td>BPJS PBI</td><td>Rajal</td><td
align='right'>15</td><td align='right'>1</td><td align='right'>22</td><td>BP.
Umum</td><td></td><td></td><td>Dalam
Wilayah</td><td>'0002345504973</td><td>'3322014704010000</td><td>98</td><td>67</
td><td>87</td><td>36.5</td><td>20</td><td>156</td><td>62</td><td></td><td></
td><td></td></tr><tr><td
align='right'>K30</td><td>Dyspepsia</td><td></td><td></td><td
align='right'>2805</td><td
align='right'>1000583</td><td>22-05-2023</td><td>MARYANI</td><td></td><td></
td><td>'</td><td>20-07-1952</td><td>KRANGKENG RT 03 RW
12</td><td>KRANGKENG</td><td>BATUR</td><td>PUSKESMAS INDUK</td><td>dr.Arninta Rahma
Khoirunnisa</td><td>Supomo,A.Md.Kep</td><td>P</td><td>>70
Thn.</td><td>Keluarga</td><td>Lama</td><td>BPJS NON PBI</td><td>Rajal</td><td
align='right'>2</td><td align='right'>10</td><td align='right'>70</td><td>BP.
Umum</td><td></td><td></td><td>Dalam
Wilayah</td><td>'0000074940388</td><td>'3322016007520001</td><td>147</td><td>78</
td><td>87</td><td>36.5</td><td>20</td><td>140</td><td>41</td><td></td><td></
td><td></td></tr><tr><td align='right'>H00.0</td><td>Hordeolum and other deep
inflammation of eyelid</td><td></td><td></td><td align='right'>2787</td><td
align='right'>1009399</td><td>22-05-2023</td><td>MERTYU
PAVITAGANI</td><td></td><td></td><td>'085712707355</td><td>22-12-1996</td><td>MADU
RT 02 RW 04</td><td>MADU</td><td>BATUR</td><td>PUSKESMAS INDUK</td><td>dr.Arninta
Rahma Khoirunnisa</td><td>Supomo,A.Md.Kep</td><td>P</td><td>20-44
Thn.</td><td>Keluarga</td><td>Lama</td><td>BPJS PBI</td><td>Rajal</td><td
align='right'></td><td align='right'>5</td><td align='right'>26</td><td>BP.
Umum</td><td></td><td></td><td>Dalam
Wilayah</td><td>'0000744411093</td><td>'3521162212960001</td><td>124</td><td>78</
td><td>87</td><td>36.5</td><td>20</td><td>156</td><td>48</td><td></td><td></
td><td></td></tr><tr><td align='right'>J06.9</td><td>Acute upper respiratory
infection, unspecified</td><td></td><td>panas, batuk, pilek</td><td
align='right'>2785</td><td
align='right'>1021836</td><td>22-05-2023</td><td>MICHELLA NATHALIA
PUTRI</td><td>ARYONO</td><td></td><td>'085799590082</td><td>23-09-2020</
td><td>TAMBANGAN RT 04 RW 03</td><td></td><td>Luar Wilayah</td><td>PUSKESMAS
INDUK</td><td>dr.Arninta Rahma
Khoirunnisa</td><td>Wiwin,A.Md.Keb</td><td>P</td><td>1-4
Thn.</td><td>Keluarga</td><td>Lama</td><td>BPJS NON PBI</td><td>Rajal</td><td
align='right'>29</td><td align='right'>7</td><td
align='right'>2</td><td>MTBS</td><td></td><td></td><td>Luar
Wilayah</td><td>'0003095617601</td><td>'3322016309200001</td><td></td><td></
td><td>100</td><td>37</td><td>39</td><td>80</td><td>10</td><td></td><td>penkes cara
minum obat di rumah</td><td>memberikan penkes cara minum obat di
rumah</td></tr><tr><td align='right'>I10</td><td>Essential (primary)
hypertension</td><td></td><td></td><td align='right'>2807</td><td
align='right'>08000012</td><td>22-05-2023</td><td>MINDARSIH</td><td></
td><td>PETANI/PEKEBUN</td><td>'</td><td>23-10-1977</td><td>GEJAYAN RT 08 RW
02</td><td>GEJAYAN</td><td>NOGOSAREN</td><td>PUSKESMAS INDUK</td><td>dr.Arninta
Rahma Khoirunnisa</td><td>Supomo,A.Md.Kep</td><td>P</td><td>45-54
Thn.</td><td>Keluarga</td><td>Lama</td><td>BPJS PBI</td><td>Rajal</td><td
align='right'>29</td><td align='right'>6</td><td align='right'>45</td><td>BP.
Umum</td><td></td><td></td><td>Dalam
Wilayah</td><td>'0003142256714</td><td>'3322015903710001</td><td>163</td><td>90</
td><td>87</td><td>36.5</td><td>20</td><td>156</td><td>53</td><td></td><td></
td><td></td></tr><tr><td
align='right'>R04.0</td><td>Epistaxis</td><td></td><td>mimisen</td><td
align='right'>2797</td><td align='right'>1019463</td><td>22-05-2023</td><td>MUHAMAD
RAFAN AL FATIH</td><td></td><td></td><td>'</td><td>11-05-2020</td><td>SIDOMUKTI RT
04 RW 05</td><td>SIDOMUKTI</td><td>KOPENG</td><td>PUSKESMAS
INDUK</td><td>dr.Arninta Rahma Khoirunnisa</td><td>Sri
Hartini,S.S.T.Keb</td><td>L</td><td>1-4
Thn.</td><td>Keluarga</td><td>Lama</td><td>Umum</td><td>Rajal</td><td
align='right'>11</td><td align='right'></td><td
align='right'>3</td><td>MTBS</td><td></td><td></td><td>Dalam
Wilayah</td><td>'</td><td>'</td><td></td><td></td><td>100</td><td>36</td><td>37</
td><td>96</td><td>16</td><td></td><td>penkes cara pemberian obat di
rumah</td><td>memberikan penkes cara pemberian obat di rumah</td></tr><tr><td
align='right'>K05.6</td><td>Periodontal disease,
unspecified</td><td></td><td>pasien datng mau cabut ggi</td><td
align='right'>2819</td><td
align='right'>90000113</td><td>22-05-2023</td><td>NGATEMI</td><td></td><td>PETANI/
PEKEBUN</td><td>'</td><td>19-06-1977</td><td>KEBOPETE RT 5 RW
2</td><td></td><td>Luar Wilayah</td><td>PUSKESMAS INDUK</td><td>drg.Ade
Indranila</td><td> - </td><td>P</td><td>45-54
Thn.</td><td>Keluarga</td><td>Lama</td><td>BPJS PBI</td><td>Rajal</td><td
align='right'>3</td><td align='right'>11</td><td align='right'>45</td><td>BP.
Gigi</td><td></td><td></td><td>Luar
Wilayah</td><td>'0003192854332</td><td>'3322015906770002</td><td>100</td><td>70</
td><td>80</td><td>36</td><td>24</td><td>155</td><td>50</td><td></td><td></
td><td>tunda exo </td></tr><tr><td
align='right'>R51</td><td>Headache</td><td></td><td></td><td
align='right'>2800</td><td
align='right'>1008540</td><td>22-05-2023</td><td>PARTI</td><td>SAMIJAN</
td><td>KARYAWAN SWASTA</td><td>'081228528128</td><td>13-06-1986</td><td>NGELO RT
06/02</td><td>NGELO</td><td>GETASAN</td><td>PUSKESMAS INDUK</td><td>dr.Arninta
Rahma Khoirunnisa</td><td>Supomo,A.Md.Kep</td><td>P</td><td>20-44
Thn.</td><td>Keluarga</td><td>Lama</td><td>BPJS PBI</td><td>Rajal</td><td
align='right'>9</td><td align='right'>11</td><td align='right'>36</td><td>BP.
Umum</td><td></td><td></td><td>Dalam
Wilayah</td><td>'0000602621256</td><td>'3322015306860002</td><td>130</td><td>82</
td><td>87</td><td>36.5</td><td>20</td><td>145</td><td>46</td><td></td><td></
td><td></td></tr><tr><td
align='right'>H15.1</td><td>Episcleritis</td><td></td><td></td><td
align='right'>2769</td><td align='right'>04000016</td><td>22-05-2023</td><td>RAHMAT
PUJIONO</td><td></td><td></td><td>'085606003103</td><td>10-12-1990</td><td>NGRAWAN
RT RT 2 RW 1 </td><td></td><td>NGRAWAN</td><td>PUSKESMAS INDUK</td><td>dr.Arninta
Rahma Khoirunnisa</td><td>Supomo,A.Md.Kep</td><td>L</td><td>20-44
Thn.</td><td>Keluarga</td><td>Baru</td><td>BPJS NON PBI</td><td>Rujuk</td><td
align='right'>12</td><td align='right'>5</td><td align='right'>32</td><td>BP.
Umum</td><td>Mata</td><td>RS PURI ASIH SALATIGA</td><td>Dalam
Wilayah</td><td>'0003088269854</td><td>'3322011012900003</td><td>131</td><td>70</
td><td>87</td><td>36.5</td><td>20</td><td>165</td><td>72</td><td></td><td></
td><td></td></tr><tr><td align='right'>J06.9</td><td>Acute upper
respiratory infection, unspecified</td><td></td><td></td><td
align='right'>2809</td><td align='right'>1024576</td><td>22-05-2023</td><td>RIYAN
KURNIA RIZKI</td><td>AHMAD MUSTOFA</td><td></td><td>'085806085297</td><td>22-05-
1998</td><td>KASIRAN RT 05 RW 09</td><td>KASIRAN</td><td>KOPENG</td><td>PUSKESMAS
INDUK</td><td>dr.Arninta Rahma
Khoirunnisa</td><td>Supomo,A.Md.Kep</td><td>L</td><td>20-44
Thn.</td><td>Keluarga</td><td>Lama</td><td>BPJS NON PBI</td><td>Rajal</td><td
align='right'></td><td align='right'></td><td align='right'>25</td><td>BP.
Umum</td><td></td><td></td><td>Dalam
Wilayah</td><td>'0000601967193</td><td>'3322012205980001</td><td>120</td><td>71</
td><td>87</td><td>36.5</td><td>20</td><td>156</td><td>53</td><td></td><td></
td><td></td></tr><tr><td
align='right'>R51</td><td>Headache</td><td></td><td></td><td
align='right'>2803</td><td
align='right'>1000217</td><td>22-05-2023</td><td>RUMINEM</td><td></td><td></
td><td>'</td><td>01-02-1982</td><td>GETASAN RT 02 RW
01</td><td>GETASAN</td><td>GETASAN</td><td>PUSKESMAS INDUK</td><td>dr.Arninta Rahma
Khoirunnisa</td><td>Supomo,A.Md.Kep</td><td>P</td><td>20-44
Thn.</td><td>Keluarga</td><td>Lama</td><td>BPJS PBI</td><td>Rajal</td><td
align='right'>21</td><td align='right'>3</td><td align='right'>41</td><td>BP.
Umum</td><td></td><td></td><td>Dalam
Wilayah</td><td>'0002133609129</td><td>'3322015403840000</td><td>136</td><td>94</
td><td>87</td><td>36.5</td><td>20</td><td>156</td><td>51</td><td></td><td></
td><td></td></tr><tr><td align='right'>J06.9</td><td>Acute upper respiratory
infection, unspecified</td><td></td><td></td><td align='right'>2808</td><td
align='right'>1022293</td><td>22-05-2023</td><td>SETYANINGSIH</td><td></td><td></
td><td>'</td><td>29-09-2003</td><td>GONDANG RT 02 RW
01</td><td>GONDANG</td><td>BATUR</td><td>PUSKESMAS INDUK</td><td>dr.Arninta Rahma
Khoirunnisa</td><td>Supomo,A.Md.Kep</td><td>P</td><td>15-19
Thn.</td><td>Keluarga</td><td>Lama</td><td>BPJS PBI</td><td>Rajal</td><td
align='right'>23</td><td align='right'>7</td><td align='right'>19</td><td>BP.
Umum</td><td></td><td></td><td>Dalam
Wilayah</td><td>'0000602333379</td><td>'3322016909030000</td><td>121</td><td>80</
td><td>87</td><td>36.5</td><td>20</td><td>156</td><td>56</td><td></td><td></
td><td></td></tr><tr><td align='right'>M54.9</td><td>Dorsalgia,
unspecified</td><td></td><td></td><td align='right'>2812</td><td
align='right'>1015875</td><td>22-05-2023</td><td>SRI
LESTARI</td><td></td><td></td><td>'</td><td>13-08-1972</td><td>PANDANAN RT 03 RW
03</td><td>PANDANAN</td><td>GETASAN</td><td>PUSKESMAS INDUK</td><td>dr.Arninta
Rahma Khoirunnisa</td><td>Supomo,A.Md.Kep</td><td>P</td><td>45-54
Thn.</td><td>Keluarga</td><td>Lama</td><td>BPJS PBI</td><td>Rajal</td><td
align='right'>9</td><td align='right'>9</td><td align='right'>50</td><td>BP.
Umum</td><td></td><td></td><td>Dalam
Wilayah</td><td>'0002345504962</td><td>'3322015308720000</td><td>88</td><td>68</
td><td>87</td><td>36.5</td><td>20</td><td>153</td><td>55</td><td></td><td></
td><td></td></tr><tr><td align='right'>R25.2</td><td>Cramp and
spasm</td><td></td><td>pasen mau rujuk ke RS</td><td align='right'>2794</td><td
align='right'>1002349</td><td>22-05-2023</td><td>SUGIYANTI</td><td></td><td></
td><td>'</td><td>13-05-1960</td><td>MUJO RT 03/04</td><td></td><td>Luar
Wilayah</td><td>PUSKESMAS INDUK</td><td>drg.Ade Indranila</td><td> -
</td><td>P</td><td>60-69 Thn.</td><td>Keluarga</td><td>Baru</td><td>BPJS NON
PBI</td><td>Rujuk</td><td align='right'>9</td><td align='right'></td><td
align='right'>63</td><td>BP. Gigi</td><td>GIGI BEDAH MULUT</td><td>RS KEN
SARAS</td><td>Luar
Wilayah</td><td>'0002252317691</td><td>'3322015305600001</td><td>130</td><td>105</
td><td>119</td><td>36</td><td>22</td><td>156</td><td>52</td><td></td><td></
td><td></td></tr><tr><td align='right'>I15.9</td><td>Secondary hypertension,
unspecified</td><td></td><td>pasen mau rujuk ke RS</td><td
align='right'>2794</td><td
align='right'>1002349</td><td>22-05-2023</td><td>SUGIYANTI</td><td></td><td></
td><td>'</td><td>13-05-1960</td><td>MUJO RT 03/04</td><td></td><td>Luar
Wilayah</td><td>PUSKESMAS INDUK</td><td>drg.Ade Indranila</td><td> -
</td><td>P</td><td>60-69 Thn.</td><td>Keluarga</td><td>Baru</td><td>BPJS NON
PBI</td><td>Rujuk</td><td align='right'>9</td><td align='right'></td><td
align='right'>63</td><td>BP. Gigi</td><td>GIGI BEDAH MULUT</td><td>RS KEN
SARAS</td><td>Luar
Wilayah</td><td>'0002252317691</td><td>'3322015305600001</td><td>130</td><td>105</
td><td>119</td><td>36</td><td>22</td><td>156</td><td>52</td><td></td><td></
td><td></td></tr><tr><td align='right'>K04.7</td><td>Periapical abscess without
sinus</td><td></td><td>pasen mau rujuk ke RS</td><td align='right'>2794</td><td
align='right'>1002349</td><td>22-05-2023</td><td>SUGIYANTI</td><td></td><td></
td><td>'</td><td>13-05-1960</td><td>MUJO RT 03/04</td><td></td><td>Luar
Wilayah</td><td>PUSKESMAS INDUK</td><td>drg.Ade Indranila</td><td> -
</td><td>P</td><td>60-69 Thn.</td><td>Keluarga</td><td>Baru</td><td>BPJS NON
PBI</td><td>Rujuk</td><td align='right'>9</td><td align='right'></td><td
align='right'>63</td><td>BP. Gigi</td><td>GIGI BEDAH MULUT</td><td>RS KEN
SARAS</td><td>Luar
Wilayah</td><td>'0002252317691</td><td>'3322015305600001</td><td>130</td><td>105</
td><td>119</td><td>36</td><td>22</td><td>156</td><td>52</td><td></td><td></
td><td></td></tr><tr><td align='right'>K08.3</td><td>Retained dental
root</td><td></td><td>pasien datang dengan keluhan mau cabut gigi </td><td
align='right'>2768</td><td align='right'>1004862</td><td>22-05-2023</td><td>WAHYU
DIONO</td><td></td><td></td><td>'</td><td>22-09-1980</td><td>SENDEN RT
01/01</td><td>SENDEN</td><td>BATUR</td><td>PUSKESMAS INDUK</td><td>drg.Ade
Indranila</td><td> - </td><td>L</td><td>20-44
Thn.</td><td>Keluarga</td><td>Lama</td><td>Umum</td><td>Rajal</td><td
align='right'></td><td align='right'>8</td><td align='right'>42</td><td>BP.
Gigi</td><td></td><td></td><td>Dalam
Wilayah</td><td>'0000602246452</td><td>'3322012209800000</td><td>114</td><td>66</
td><td>94</td><td>36</td><td>24</td><td>162</td><td>52</td><td></td><td>exo gigi
1.3 </td><td>exo dengan lidocain </td></tr><tr><td align='right'>T14.1</td><td>Open
wound of unspecified body region</td><td></td><td></td><td
align='right'>2783</td><td align='right'>1004850</td><td>22-05-2023</td><td>WAHYU
RIWIDIGDO</td><td>WAHYU RIWIDIGDO</td><td></td><td>'085640009972</td><td>09-08-
1980</td><td>GETASAN RT 2 RW 1</td><td>GETASAN</td><td>GETASAN</td><td>PUSKESMAS
INDUK</td><td>dr.Arninta Rahma
Khoirunnisa</td><td>Supomo,A.Md.Kep</td><td>L</td><td>20-44
Thn.</td><td>Keluarga</td><td>Lama</td><td>BPJS NON PBI</td><td>Rajal</td><td
align='right'>13</td><td align='right'>9</td><td align='right'>42</td><td>BP.
Umum</td><td></td><td></td><td>Dalam
Wilayah</td><td>'0001526922617</td><td>'3322010908800002</td><td>170</td><td>75</
td><td>87</td><td>36.5</td><td>20</td><td>170</td><td>75</td><td></td><td></
td><td></td></tr><tr><td align='right'>J06.9</td><td>Acute upper respiratory
infection, unspecified</td><td></td><td></td><td align='right'>2798</td><td
align='right'>1001281</td><td>22-05-2023</td><td>WANTONO
WARDI</td><td></td><td></td><td>'</td><td>12-05-1957</td><td>WATULAWANG RT 12 RW
03</td><td></td><td>Luar Wilayah</td><td>PUSKESMAS INDUK</td><td>dr.Arninta Rahma
Khoirunnisa</td><td>Supomo,A.Md.Kep</td><td>L</td><td>60-69
Thn.</td><td>Keluarga</td><td>Baru</td><td>Umum</td><td>Rajal</td><td
align='right'>10</td><td align='right'></td><td align='right'>66</td><td>BP.
Umum</td><td></td><td></td><td>Luar
Wilayah</td><td>'0001797912044</td><td>'3322011205570001</td><td>120</td><td>80</
td><td>87</td><td>36.5</td><td>20</td><td>146</td><td>54</td><td></td><td></
td><td></td></tr><tr><td align='right'>J06.9</td><td>Acute upper respiratory
infection, unspecified</td><td></td><td></td><td align='right'>2816</td><td
align='right'>1018773</td><td>22-05-2023</td><td>WIRA UTTAMA
UMBU</td><td></td><td></td><td>'</td><td>04-12-2017</td><td>BUMIAYU RT
02/04</td><td></td><td>Luar Wilayah</td><td>PUSKESMAS INDUK</td><td>dr.Arninta
Rahma Khoirunnisa</td><td>Supomo,A.Md.Kep</td><td>L</td><td>5-9
Thn.</td><td>Keluarga</td><td>Lama</td><td>BPJS PBI</td><td>Rajal</td><td
align='right'>18</td><td align='right'>5</td><td align='right'>5</td><td>BP.
Umum</td><td></td><td></td><td>Luar
Wilayah</td><td>'0002907563951</td><td>'3322010412170001</td><td>80</td><td>60</
td><td>87</td><td>36.5</td><td>20</td><td>131</td><td>17</td><td></td><td></
td><td></td></tr></table>