Gigi 2023 06 01 2023 06 30

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style='width:1457.25pt;border-collapse:collapse;table-layout:fixed;'>
<tr height="17" style='height:12.75pt;'>
<td height="34" width="38" rowspan="2"
style='height:25.50pt;width:28.50pt;'>No.</td>
<td align="center" width="93" rowspan="2"
style='width:69.75pt;'>Tangal</td>
<td align="center" width="305" rowspan="2" style='width:228.75pt;'>Nama</td>
<td align="center" rowspan="2">JK</td>
<td align="center" width="305" rowspan="2" style='width:228.75pt;'>Alamat</td>
<td align="center" width="150" rowspan="2" style='width:112.50pt;'>NO
RM</td>
<td align="center" width="150" rowspan="2" style='width:112.50pt;'>NIK</td>
<td align="center" width="150" rowspan="2" style='width:112.50pt;'>No.
BPJS</td>
<td align="center" width="565" colspan="9"
style='width:423.75pt;'>Pelayanan</td>
<td align="center" width="88" rowspan="2" style='width:66.00pt;'>Diagnosa</td>
<td align="center" width="200" rowspan="2" style='width:200.00pt;'>Terapi</td>
<td align="center" width="88" rowspan="2" style='width:66.00pt;'>BB/TB</td>
<td align="center" width="88" rowspan="2" style='width:66.00pt;'>TD</td>
<td align="center" width="88" rowspan="2" style='width:66.00pt;'>HR</td>
<td align="center" width="88" rowspan="2" style='width:66.00pt;'>RR</td>
<td align="center" width="88" rowspan="2" style='width:66.00pt;'>CARA
BAYAR</td>
<td align="center" width="88" rowspan="2"
style='width:66.00pt;'>STATUS</td>
</tr>
<td align="center">Umum (BP)</td>
<td align="center">Gigi</td>
<td align="center">KIA</td>
<td align="center">Kebid.</td>
<td align="center">KB</td>
<td align="center">UGD</td>
<td align="center">Jiwa</td>
<td align="center">Rujukan</td>
<td align="center">Kunj. Sehat</td>
</tr>
<td height="17" align="right">1.</td>
<td class="xl67" align="center" > 03/06/2023</td>
<td>USWATUN HASANAH</td>
<td>P</td>
<td>CURAH TEMU 03/01</td>
<td align="center"> 0067406</td>
<td align="center"> </td>
<td align="center"></td>
<td align="center">✔</td>
<td>K01</td>
<td>medikasi</td>
<td align="center">25/125</td>
<td align="center">80</td>
<td align="center">TUNAI</td>
<td align="center">DILAYANI</td>
</tr>
<td>RURI AYU PUSPITA</td>
<td>P</td>
<td>KP. MIMBO 01/02</td>
<td>K04</td>
<td>MEDIKASI AMOX ASMEF</td>
</tr>
<td>SHAQEENA AYU NUFRELIYA</td>
<td>P</td>
<td>KRAJAN 01/07 SUMBEREJO</td>
<td>K00</td>
<td>EVALUASI</td>
</tr>
<td>MARFUAH</td>
<td>P</td>
<td>MUNCAR</td>
<td>Z48</td>
<td>Amoxcillin, asmef </td>
</tr>
<td>MUHAMMAD ANDIK</td>
<td>L</td>
<td>MERAK</td>
<td>K04</td>
<td>amox, asmef</td>
</tr>
<td>MANI</td>
<td>P</td>
<td>COTEK SIDODADI 002/003</td>
<td>K04</td>
<td></td>
<td align="center">BPJS</td>
</tr>
<td>GHUFRON EFENDI</td>
<td>L</td>
<td>CURAHTEMU 02/02</td>
<td>K04</td>
<td>tumpat dengan 3 m</td>
</tr>
<td>AWAN HARIYANTO</td>
<td>L</td>
<td>BLANGGUAN 02/07</td>
<td>K04</td>
<td>medikasi</td>
</tr>
<td>MASUDI</td>
<td>L</td>
<td>KP. MIMBO, RT/RW : 3/2</td>
<td>K02</td>
<td>medikasi</td>
</tr>
<td>MUHAMMAD ANDIK</td>
<td>L</td>
<td>MERAK</td>
<td>K04</td>
<td></td>
</tr>
<td>RUMLAILY PRANANDARI</td>
<td>P</td>
<td>RT/RW : 010/002, SIDOMULYO</td>
<td>K04</td>
<td>medikasi</td>
</tr>
<td>MUHAMMAD ROFIQIL WAFA</td>
<td>L</td>
<td>SUKOREJO</td>
<td>K05</td>
<td>evaluasi</td>
</tr>
<td>AZKYA SANAZ FALISHA</td>
<td>P</td>
<td>NYAMPLUNG 01/01</td>
<td>K00</td>
<td>ekstraksi</td>
</tr>
<td>ALISHA ALI WAFA</td>
<td>P</td>
<td>MIMBO RT 2 RW 1</td>
<td>K04</td>
<td>asmef</td>
</tr>
<td>ARBIDIN</td>
<td>L</td>
<td>MIMBO 02/03</td>
<td>E11.7</td>
<td>konsul poli bp</td>
</tr>
<td>bella kartika sari</td>
<td>P</td>
<td>sidomulyo 1/8</td>
<td>K05</td>
<td>SCALLING</td>
</tr>
<td>SUNADI</td>
<td>P</td>
<td>cotek 01/01</td>
<td>K05</td>
<td>EKTRAKSI GIGI</td>
</tr>
<td>SUTIYANI</td>
<td>P</td>
<td>SIDODADI 2/3 SUMBERWARU</td>
<td>K05</td>
<td>SCALLING </td>
</tr>
<td>ENDANG KUMALASARI</td>
<td>L</td>
<td>cotek sidodadi 02/03</td>
<td>K05</td>
<td>SCALLING </td>
</tr>
<td>TOTOK SUHAIDI</td>
<td>L</td>
<td>sodung 02/09</td>
<td>K04</td>
<td></td>
</tr>
<td>AWAR</td>
<td>L</td>
<td>curahtemu 01/01</td>
<td>K05</td>
<td>amox asmef</td>
</tr>
<td>RUDI ISMAIL</td>
<td>L</td>
<td>BINDUNG 003/001</td>
<td>K02</td>
<td>tumpat dengan 3 m</td>
</tr>
<td>MOH. SAHRUL RAMADANI</td>
<td>L</td>
<td>K05</td>
<td>scalling</td>
</tr>
<td>NUR IDAYATI</td>
<td>P</td>
<td>K05</td>
<td>medikasi</td>
</tr>
<td>MOH.FIKRI AL AMIN</td>
<td>L</td>
<td>K02</td>
<td>medikasi</td>
</tr>
<td>ahmad zydan khoiril khuluq</td>
<td>L</td>
<td>nyamplung 02/01</td>
<td>K00</td>
<td>ekstraksi gigi</td>
</tr>
<td>Matsuri</td>
<td>L</td>
<td>Mimbo 002/002</td>
<td>K04</td>
<td>MEDIKASI</td>
</tr>
<td>AYU NUR ARIFATUS SA'DIYAH</td>
<td>P</td>
<td>K04</td>
<td>medikasi</td>
</tr>
<td>TIARA NOVITA INTANIA PUTRI</td>
<td>P</td>
<td>K00</td>
<td>EKJSTRAKSI</td>
</tr>
<td>HALIMA</td>
<td>P</td>
<td>sumberwaru 01/12</td>
<td>K05</td>
<td>kontrol metformin</td>
</tr>
<td>IRMA</td>
<td>P</td>
<td>SEKARPUTIH 3/1</td>
<td>K04</td>
<td>medikasi amo asmef</td>
</tr>
<td>DRI WIARSO</td>
<td>L</td>
<td>COTEK 01/01</td>
<td>I10,K05</td>
<td>medikasi </td>
</tr>
<td>CARRISA ARIFIN PUTRI</td>
<td>P</td>
<td>K04</td>
<td></td>
</tr>
<td>SUPATMI</td>
<td>P</td>
<td>SIDOMULYO 02/08</td>
<td>K05</td>
<td></td>
</tr>
<td>SOFIATUL FEBRI AULIA</td>
<td>P</td>
<td>K04</td>
<td>IBUPROFEN, AMOX</td>
</tr>
<td>ALFIAN ZAKARIYAH</td>
<td>L</td>
<td>K01</td>
<td>medikasi</td>
</tr>
<td>ADITYA TRI ARDI RAHARJO</td>
<td>L</td>
<td>DUSUN MARON 01/02 GENTENG KULON</td>
<td>K04</td>
<td>MEDIKASI</td>
</tr>
<td>EKA SAFIRA PURNAMASARI</td>
<td>P</td>
<td>K00</td>
<td></td>
</tr>
<td>miyatik</td>
<td>P</td>
<td>BANTEN - SEMPU KELAPA ENDEP 03/10</td>
<td>K05</td>
<td>MEDIKASI</td>
</tr>
<td>HANDAYANI</td>
<td>P</td>
<td>SIDODADI 01/03</td>
<td>K05</td>
<td>MEDIKASI</td>
</tr>
<td>SAMSUL ARIFIN</td>
<td>L</td>
<td>KP. CURAH LACI 01/02</td>
<td>K05</td>
<td>scalling </td>
</tr>
<td>TOTOK SUHAIDI</td>
<td>L</td>
<td>sodung 02/09</td>
<td>Z00</td>
<td>medikaso</td>
</tr>
<td>ARSY ANDARA NUR ISMAWATI</td>
<td>P</td>
<td>SIDOMULYO 03/010</td>
<td>K00</td>
<td>ektaksi gigi</td>
</tr>
<td>ALFIYA NUR ZAINIYAH</td>
<td>P</td>
<td>RANUREJO 02/03</td>
<td>K00</td>
<td>pamol</td>
</tr>
<td>ROYHAN ALI ZAKI</td>
<td>L</td>
<td>SUMBEREJO 03/06</td>
<td>K00</td>
<td>ektraksi gigi</td>
</tr>
<td>ASMANI</td>
<td>P</td>
<td>MIMBO</td>
<td>K04</td>
<td>medikasi</td>
</tr>
<td>INDAH YUNIAR MEGAWATI</td>
<td>P</td>
<td>K05</td>
<td>medikaso</td>
</tr>
<td>HANDAYANI</td>
<td>P</td>
<td>SIDODADI 01/03</td>
<td>K05</td>
<td>ektraksi asmef</td>
</tr>
<td>P</td>
<td>K04</td>
<td></td>
</tr>
<td>SUMARWA</td>
<td>L</td>
<td>K02</td>
<td>medikasi</td>
</tr>
<td>LAILATUL MUKARROMAH</td>
<td>P</td>
<td>KEDUNGDOWO</td>
<td>K00</td>
<td>evaluasi</td>
</tr>
<td>AHMAD ALFAN FIRDAUS</td>
<td>L</td>
<td>K05</td>
</tr>
<td>ARDAVA AYAS HIDAYATULLAH</td>
<td>L</td>
<td>SUKOREJO 03/04</td>
<td>Z00</td>
<td>ibuprofen </td>
</tr>
<td>SITI ISTIQOMAH</td>
<td>P</td>
<td>BANYUPUTIH 03/02</td>
<td>Z00</td>
<td>amox, asam</td>
</tr>
<td>yuliyati</td>
<td>P</td>
<td>krajan rt.01 rw.07 SUMBEREJO</td>
<td>Z00</td>
<td>scalling </td>
</tr>
<td>AURELLIO RAFAEL ADITYA</td>
<td>P</td>
<td>K00</td>
</tr>
<td>YULIARSIH</td>
<td>P</td>
<td>KP MIMBO 02/01</td>
<td>K04</td>
<td>MEDIKASI</td>
</tr>
<td>PARINI</td>
<td>P</td>
<td>K05</td>
<td>medikasi</td>
</tr>
<td>HARTINI SAMAD</td>
<td>P</td>
<td>SUMBERWARU 01/05</td>
<td>K05</td>
</tr>
<td>ricky achmad alfian hartono</td>
<td>L</td>
<td>sukorejo 05/05</td>
<td>K00</td>
</tr>
<td>P</td>
<td>K04</td>
<td></td>
</tr>
</table>
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Gigi 2023 06 01 2023 06 30

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