BPJS Tahun 2022

DAFTA
PROGRAM PELAYANAN KE
DINAS KES
PUSKESMAS : TALIWANG
UNIT PELAYANAN : LABORATORIUM
JENIS PELAYANAN : BPJS
BULAN : DESEMBER
TAHUN : 2022
Jenis Kunjungan URINE

UMUR No.ID/ NIK / DL HB
TGL NAMA PROT UL PPT
(THN) BPJS/ KIS
L P L P L P L P L P P
B L B L B L B L B L B L B L B L B L B L B
1 RAHEL 3 1 1
PUTRI 24 1 1
SULAIMAN 61 1 1
HJ. HADIATULLAH 58 1
MIALA 28 1 1
LUSIA 31 1 1 1
AISYAH PUTRI 18 1 1
RAIHA 45 1
ZAINAH 63 1
FAUZI AZIZ 54 1
CAHYA SENJA 9 1 1
SAHRIL SAMSUDIN 45 1
ENDANG SULASTRI 39 1
ASIA SALEH 57 1 1
ISWANTARI 30 1 1 1
M. MESA 1 1 1
MIRWA 32 1 1
ARABIAH 29 1 1
SITI AISYAH 50 1
ELI ERMAWATI 35 1 1
2 M. SALEH 61 1
M. JAFAR 52 1 1
ELI ERMAWATI 37 1 1
FAUZI AZIZ 54 1
SUWARNI 50 1
AMINILLAH 31 1
HURIATUSSADIAH 41 1 1 1
YENI 25 1 1 1
LITA F 37 1 1
BENI PUTRA 27 1
ALWIYAH 32 1 1
KASMANTO 55 1
ERNA 22 1 1
ARINI 50 1 1
3 ELY ERMAWATI 35 1 1
RISKI SABRIANSYAH 8 1 1
EMA RATNASARI 42 1 1
5 DEWI 39 1
HJ. HANA 72 1
UMI SURYATI 48 1 1 1
MADRID SATRIA R 38 1 1
SIKHAN ZAIN H 56 1
SAHERA 54 1 1
MASUJI 55 1
MURNIATI 42 1
ADELIA RAMADANI 19 1
ZAINUDDIN 52 1
NABASAR 49 1 1 1
FATI SUMARNI 53 1
RASAHURUDDIN 23 1 1
BQ. VINA 24 1 1 1
ATIKA 58 1 1
ZILIA HARTIKA 20 1 1 1
DARA DWI MAYANGSARI 33 1 1
SALMIRA 46 1 1 1
6 JAWARIAH 61 1
MASARI 71 1
NANIK 44 1
MAKARANI 44 1 1
AYU 30 1 1
SIATA 30 1 1
M.YAMIN 58 1
ENI 23 1 1
ZUHRIYAH 34 1 1 1
NURLAELA 57 1
MULYADI 20 1 1
INDRI 36 1 1 1
EKA M 25 1 1
ASMAWATI 17 1 1 1
FARIDA 23 1 1 1
MARIANI 34 1 1 1
SYARIFAH 31 1 1
7 NURHAYATI 54 1
ROY 39 1
JASWATI 44 1
FATIMAH 75 1
SARIFAH 48 1
RUDY 31 1 1
ZAENAP 67 1
HJ.MAMNUR 57 1
ROHANI 44 1
KUSNADI 35 1
LINDA 32 1 1 1
NURMA 29 1
MITA 62 1 1 1
TETI 42 1 1
ALFIRDAUS 6 1 1
RIDWAN 37 1
WARDAH 48 1 1
HJ.SITI AMINAH 76 1
qUENSHA 6.5 1 1
SALSA 11 1 1
ARI WAHYUNI 46 1
CELLA HS 74 1 1
ROHMI 52 1 1
REHANA 40 1
RISKA FATMALA 26 1 1
8 LAHAP 58 1 1 1
LILIS 36 1 1 1
FITRIAH 49 1
RUSTINI 46 1
SATRIAWAN 26 1
NAFILA G 26 1 1 1
JUMAIYAH 29 1 1 1
SRI NINI 40 1 1 1
SUKINA 57 1
DZIKRA S 11 1
YULIANA 22 1 1
SANAPIAH 71 1 1
ANDI RATNA 33 1 1
RISKA F 26 1 1
RISKA K 30 1 1
9 MARIYANAH 36 1 1
MUSMULYADI 45 1
RATU ATI 62 1 1
FIRYAL N.M 11 1 1
AMELIA N. 48 1
ROMANSYAH 30 1 1
EVIE NURFIDYA 29 1 1 1
ERNA IDAWATI 46 1
SUDIRMAN 38 1
FITRIAH 36 1 1
ALDHI R 26 1 1
RIAN ANDIKA 12 1 1
ZULFA 24 1 1
KARNA 22 1
M. SALEH 78 1 1
MARINI 16 1 1
HUSNUL FAIZAH 25 1 1
10 FIRYAL N.M 21 1 1
11 SUMIATUN 49 1 1
RAHNA 57 1 1 1
12 ADIDAH 58 1
INDRA 44 1
NURHAYATI 57 1
LINDARWATI 57 1
SUMARSUSANTI 58 1
USMAN 61 1
H.M. TAHIR 59 1 1
ZULBRILIANITA 24 1 1
SRI NURNANINGSIH 47 1 1
SANITA 40 1 1 1
MUH ADRIEL SYAIN 12 1
FAYAAD 13 1
MELANI 23 1 1 1
AWALUDDIN 46 1 1
SINTA 29 1 1 1
AMINAH 53 1 1
DESI 28 1 1 1
SUKMAWATI 22 1 1
NURHAYATI 58 1
SARIFAH 9 1
SITI RAUHAN 30 1 1
ETI ROSMAWATI 50 1 1
MASTARI 53 1
LINA ISLAMIA 27 1 1
M. FAHRI 7 1 1
HJ. FATIMAH 50 1
ATIKA 8 1 1
NURHASANAH 45 1
SURIANI 32 1 1 1
MARINI 16 1 1
SITI SARAH 32 1 1 1
ANDI P 33 1 1
THALIA 22 1 1
FATIMAH 36 1 1
NURHAYATI 54 1
DIAN A 39 1 1
DARMIANI 58 1
L. AHMAD L. T 77 1
SABARIAH 62 1
M. TAWSEN 27 1 1
MARDIAH 49 1 1
ALFAN DESWAN 7 1 1
USMAN 50 1
SILVIA SAHARA 26 1 1 1 1
EMILIA 38 1 1
MELANI 18 1 1
SANAPIAH 71 1 1
MINARTI 32 1 1 1 1
SIRHAN SAPUTRA 33 1 1
M. SADE 65 1 1
M. IKHSAN ISMAIL 56 1 1
IKLIMA 17 1 1
ANDI LALA 47 1
ARIS 23 1
HARIATI 37 1 1
14 RANA KATI 43 1 1
HARIYATI 37 1 1
ERNI 45 1
NANI 47 1
ROSMAWATI 40 1
UMI KALSUM 51 1
GIGIH 23 1 1
SUMIATI 49 1
NURHASANAH 45 1
RIDWAN 53 1
IBNU 51 1
HARLENA 40 1 1
MIHRIM 6 1
WARDAH 62 1
SUMARNI 41 1 1
RINA ANGGRAINI 26 1 1 1
DAFFA 8 1 1
DEVI AYU 21 1 1 1
KARMAN 50 1 1
LAELATI 5.8 1 1
AMINA 46 1 1
IRA 19 1
LENI 30 1 1 1
USMAN 14 1 1
INDAH P 22 1 1
M. NURDIN 50 1
ALFIN 11 1 1
IBRAHIM 74 1 1
DARMANSYAH 52 1 1
LINDAWATI 31 1 1 1
RISKA F 26 1 1
15 SYAHREN 55 1
MUSMULYADI 45 1
CEMPAU 61 1 1
HAMKA 34 1
SAMSUL RIZAL 47 1 1
ELYANA 49 1
SUSILAWATI 37 1 1
H.M YUSUF 77 1
MUSTIRAH 70 1 1 1
NURAINI 33 1
MASITA 38 1 1 1
SURIANTI KARIM 45 1
AGUNG 20 1
ZAINAL ARIFIN 48 1
HALIMAH 47 1 1
REZA 23 1 1 1
SITI NUR 82 1
SHARAH ARTIKA P 27 1 1 1
FAHRY 21 1
DIMAS 17 1
M. ROSSI 17 1
OON DEWI 33 1 1 1
M. RAFA 4 1 1
ADZANI 5 1 1
LILI SUSANTI 34 1 1 1
ISMAIL 38 1
SUMARTINA 59 1 1
FITRIANI 19 1 1
MARIYAM 63 1
M. ARKANENDRA 6 1 1
BENTARI BULAN R 17 1 1
M. RIZKY 17 1
ARIEL 17 1
M. ASWAR 18 1
PUTRI KHUSNAL K 13 1
MAHINI 28 1 1
16 EVA APRIANI 24 1 1
EVA APRIANI 24 1 1
MAHINI 25 1 1
SEKTA S 11 1 1
ENI NURAINI 23 1 1
EHAZA A 7 1 1
RIZKI AKBAR A 20 1
AHMAD YAIM 53 1 1 1
ROHANA 55 1
SAYATI 52 1
SHINTA S 31 1
SASMITA UTI 26 1 1
SABARIAH 44 1 1
ASNI R 51 1 1 1
AGUSTONO 33 1
ABDUL HADI 46 1
HASMIATI 40 1 1 1
CICI L 19 1 1 1
MUSTIKA 48 1 1
ANDI PUTRA 19 1
ULFA 29 1 1 1
PUTRI DAHAYU 19 1 1 1
DESI APRIANI 26 1 1 1
ANNI F 50 1 1
17 YARTA JAYA 61 1 1
AINURRAHM 48 1 1
IMAM 30 1
18 YODI ANDREA 12 1 1
19 M SALEH SYAM 72 1 1
ST ZUBAIDAH 58 1
MAHSUN 53 1 1
RUSLAN 49 1
HUSNUL FAIZAH 25 1 1 1
PATMATUN 31 1 1 1 1
HARTINI 22 1 1 1
MUTIASI 40 1
ATIKA 40 1
H. RIDWAN 94 1 1
ELI AMBAYANI 40 1 1
NURKEMAH 63 1
TENRIA BENG 65 1
AMBAYAH 75 1 1 1
MERZA PROLETA 22 1
SITI NUR 82 1
AISYAH 58 1
NANANG SAMUDRA 15 1
RINA ANGGRAINI 29 1 1
MUTMAINNAH 36 1 1 1
SIKRATUL 24 1
KHORIBUN 23 1
RAHMAWATI 60 1 1 1
DIAPURWATININGSIH 31 1 1
NURDIN 64 1
SABILA. M 13 1
RIRIN ARIANTI 21 1
SAPRIADI 33 1
WAHIDAH 15 1 1
HARIS ARIE 20 1
LUKMAN 42 1
M. SALEH 43 1
SURMA 41 1
WAWAN 23 1
20 JONI 28 1
RATNA 30 1 1 1
CEMPAU 61 1
SYAHRIL 53 1 1
MUSLIMIN 35 1
IWAN JAYADI 41 1
FATIMAH 57 1
A. BAKAR 68 1
BONITA 27 1
ISMAIL 33 1
SANIA 62 1 1
RONI PUTRA 27 1
FUJI ZAKIYAH 25 1
RINNY R 34 1 1
LINA KARLINA 24 1 1 1
SALMI 24 1 1 1
RONNY AQILA 15 1
MARIANI 19 1
IQRAM R 19 1
MITA FARIZAH 29 1 1 1
WIDYA ASTUTI 18 1
SURYANI 44 1 1
ALDI RIVALDI 19 1
IWAN 31 1 1
PUSPITA 26 1 1 1
YULI MARDIANA 25 1
KUSMARA 25 1
SRI DEVI 27 1
SAHODAH 36 1
ZAENA S 17 1
21 HERMI HARIAN 36 1 1
MARIANA 40 1 1
SAKIRA 6 1 1
ISMU RAHMAN 43 1
MUHAMMAD NUR 50 1 1
SRI HARTINI 56 1
YATI M 7.5 1 1
ARTIKA 72 1
MAHDIN 34 1 1
SYAMSUDDIN 73 1 1 1
ASTIKA 35 1 1 1
MANJA 77 1 1
RUDI 40 1
RINI ASTIKA 26 1
JANARIAH 63 1
NURJANAH 44 1
M. RADESTA 5.8 1 1
SULTAN R 4.2 1
SITI RAMLIA 53 1 1
NOVA ARIANI 34 1
FITRIANI 28 1 1 1
CENDIA GUNAWAN 23 1
FARSIH 67 1 1
PUTRI ALIFAH 13 1 1
SALIM R 17 1
SRI IDAWATI 50 1
NURJAMIN 35 1 1 1
SANATI 37 1 1 1
NURHAYATI 39 1 1
LASENDRANG 36 1
RUSLAN 29 1
YUNI ASTUTI 30 1 1
FITRI JAYANTI 27 1 1
DESI 26 1 1
HENGKI 20 1
DEVI 20 1 1 1
HERMI 36 1 1
NOVITASARI 33 1 1
RIFAI 65 1 1
22 HALIMAH 47 1 1 1
DEVI WAHYUNI 23 1
MARIAMAH 60 1
FITRIAH 43 1
NURDIN 59 1
H. JHONI 63 1
HERMI 36 1 1
SUKARDIN 36 1 1
JUMADIL 47 1 1
SATRIANI 33 1
IRWAN 38 1
SITI NOR 82 1
NAINI 32 1 1 1
MUSMULYADI 45 1
SRI WAHYUNI 39 1
ITA ROSITA 32 1 1
MELINDA 11 1
CANDRA 7 1
GAZA 30 1 1
ASTUTI 42 1 1
RITA 18 1 1
PRAWINDI 18 1
JULIA 21 1 1 1
DRUSTIN 32 1 1
YEYEN A 26 1
23 SRI ROHAYU 44 1
DONI KURNIAWAN 38 1
M. SALEH IDRIS 56 1
HAFSAH 25 1 1 1
LALU DANI 36 1
MASTAWAN 58 1 1
AMOLA 60 1
SARAH KHOIRAH 53 1
ELIYAH 31 1 1 1
ARDIANSYAH 26 1
ISTIQOMAH 24 1 1 1
SYAMSIAH 26 1
ABDUL HALIM 70 1
SYAMSUL HADI 31 1
HENDRA 42 1 1
DEVI 34 1 1 1
HERIANTO 32 1
IMBAK 54 1 1
H. SYAMSUL HADI 60 1 1 1
JAMALUDDIN 25 1
ABDUL AZIZ 39 1 1
AMINAH 48 1 1
HAMDI 45 1 1
MALNI 25 1
NURHASANAH 48 1 1
ULFADILAH 16 1
AHMAD 33 1
YULIA RAMDANI 15 1
HATIA 15 1
PUTRI 16 1
ISTANTO 51 1
ELICIA 3.11 1 1
25 NURHAYATI 4 1 1
RAHMAN HAUDER 29 1 1 1
26 ATIZAH 57 1
NURHAYATI 67 1
BANDRI 51 1
SUMIATI 44 1
dr. DEVI DAMAYANTI 28 1 1 1 1
DAWIYAH 63 1
JAYA H 34 1
UMAR 36 1 1 1
RAHMAWATI 60 1
WARNINGSIH 52 1
NILA JULIANTI 23 1
SYAFRUDDIN 45 1 1
H. SUDIRMAN 54 1 1
ADSIAH 30 1 1 1
JAFAR JALA 61 1
VITA 24 1
SAMSUDDIN 21 1
LEONI HAFIFA 17 1
RESTU PAMELA 15
RINTO HARAHAP 27 1
ZAINAB 42 1 1 1
SURYANINGSIH 26 1 1
HUSEN 58 1 1
TOMI K 17 1
SAMSUDDIN 33 1
DIAN FIRDAUS 30 1 1 1
ROFIUL MUHYI 17 1
RIA BUDIANA 33 1 1
27 AMRUL ARIANTO 34 1
EDI IRAWAN 19 1 1
RIZA DWI 24 1
ELY RAMDANI 56 1 1 1
ENI KENTITI 51 1 1 1
AN. BARAKA TSABIT 3.5 1 1
SALAMINA 62 1
LILY NURMALA 58 1
JUNAIDI 52 1 1
ERNA 32 1 1
ABU BAKAR 68 1
HJ. SUMMI ANIK 63 1
MUHAMMAD NUR 50 1
SUPRIADI 36 1
SANTIKA 22 1 1
JULIANTI 28 1 1
ELY AGUSTIN 20 1 1
H. RIDWAN 92 1 1
ABDUL KAPI 69 1 1 1
DAHYANI 35 1 1
RIA BUDIMAN 33 1 1 1
M. ALI 36 1 1
MARIATUN 51 1 1
TUFIAH BAGIS 48 1
RIZALDI 21 1
NURHASANAH 52 1
PUTU. AN 1 1 1
HADIJAH 72 1 1
HAMIDAH 33 1 1 1
28 DAENG SINARA 63 1 1
AAN YULIANI 33 1 1 1
FIDRI 31 1
NURJANNAH 53 1
RAHAN FAUZAN 11 1 1
M. ALI 70 1 1
EDI KUSNADI 42 1
AZKA HIDAYATULLAH 10 1
ASYRAF M. 7 1
MASTARI 37 1 1 1
MAULANA 30 1 1 1
MULYADI 51 1
DESI AYU 21 1 1 1
NIKITA 11 1 1
MARNAWATI 44 1 1
TOPAN RENATA 38 1 1
SRIYANI 43 1
RIVAL K 18 1
M. FATHIR 18 1
ANGGUN SRI W 35 1 1
29 HUSNUL KHOTIMAH 25 1
SURNAWATI 40 1
AZZAM 1 1 1
FAHRUL RHOSAN 17 1
HANI MIKAYLA 5 1 1
DONA HARDIANTO 38 1 1
BAYU NOVA 36 1
HENI ASTUTI 38 1 1
IQMAL IKRAM 16 1
AQMAL IRDAN 16 1
KAHARUDDIN 49 1 1
M. TAHIR 60 1
MARDIANA 29 1 1 1
IRMAWATI 43 1 1
ELY SUSANTI 35 1 1
ZULHAN R 33 1
MYESHA 12 1 1
NAKITA 11 1 1
SYAFRUDDIN 65 1
RAIDATURRAHMAN 27 1 1
NILA ZAKILA 18 1 1
ANITA 25 1
DENDA ANGGRAINI 29 1 1 1
FATIMAH 54 1
EVI TAMALA 29 1 1
H. A. HADI ZAFAR 61 1
ILHAM ANANDA 15 1
NABILA 17 1 1 1
30 SABARIAH 62 1
SURYA 43 1
SITI ASIYAH 53 1 1
NURHASANAH 45 1
ARIFIN AYUB 64 1 1 1
H. MUHAMMAD 77 1
HERI BUDIONO 45 1
ANDI ROSY 39 1
NURUL IHSAN 45 1
ETTY 32 1 1 1
ANWAR 25 1
DYAH AYU 31 1 1
RUSTINI 46 1 1 1
ANDIKA 15 1 1
NAKITA 11 1 1
SRI WAHYUNI 21 1
HADRIAH BILLA A 7.2 1 1
FAHRIANI 44 1
ROHMIATUL AIRI 25 1
HIDAYANI 25 1
DEWAYANG 18 1
31 EKA M 27 1 2
HARTINI 23 1 1
NAKITA 11 1 1
DELFI 20 1 1
154 52 249 119 49 17 133 43 0 0 20 11 0 0 27 29 18 9 25 11 21

DAFTAR TAGIHAN KLAIM LABORATORIUM
OGRAM PELAYANAN KESEHATAN GRATIS PADA PUSKESMAS DAN JARINGANNYA
DINAS KESEHATAN KABUPATEN SUMBAWA BARAT
JENIS PEMERIKSAAN
GD MAL WIDAL IgG/IgM/NS1 HBsAg ANTI HIV SIPILIS GULA CHOL

PPT
P L P L P L P L P L P L P L P L P L P
L B L B L B L B L B L B L B L B L B L B L B L B L B L B L B L B L B L B
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CHOL UA BTA TG FL
P L P L P L P L P
L B L B L B L B L B L B L B L B L
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44 40 21 53 40 1 0 0 0 0 1 0 0 0 0 0 0
DAFTAR T
PROGRAM PELAYANAN KESEH
DINAS KESEH
BULAN : NOVEMBER
TAHUN : 2022

(THN) BPJS/ KIS
B L B L B L B L B L B L B L B L B L B L B L
1 AMBAR SEPTARIA 26 1 1
SRIATI 44 1 1
FAISAL A. 25 1 1
MUSLIMIN 34 1
SAHEMAWATI 30 1 1 1
SAFI'I 47 1 1
SUGIANI 37 1 1 1
LITA MARIJUANA 19 1 1
DIKA SYAHRI 22 1 1
LILI KUSNATI 36 1 1 1
A. KARIM 69 1 1
M. ZAINK 64 1 1
HADIATULLAH 43 1 1
ISMIDANI 46 1 1 1
AISYAH 56 1
RISKA 16 1 1
BURHANUDDIN 42 1
FIHIRMAN 36 1 1
ZYAD AHMAD A 4 1 1
RISNAWATI 26 1 1 1
ROHYATI 32 1 1 1
DESI ARISANDI 31 1 1
YULIA 21 1 1 1
H. MAKASAU 77 1 1
INDRI FEBRIANTI 26 1 1
KIN LANGIT REVOLUSI 4 1 1
NURMAYANTI 21 1 1 1
KARIMUDDIN 52 1 1
2 NURMIATI 57 1
HJ. ZUBAIDAH 70 1
QEYLA P. 9.1 1 1
RENI ANGG 36 1 1
RIZAL MUHAMMMAD 31 1 1
HADIJAH 50 1
M. CORNYLIUS 10 1 1
SUPARMAWATI 42 1 1
INDAH LISTIANA 18 1 1 1
FITRIATUN 38 1 1 1
RITA RUSDIANA 39 1
HESI JUNAEMI 28 1 1
REHANI 35 1 1 1
BQ. SUMARNI 47 1
NOVISA 21 1 1 1
SUMARNI 52 1
NURKEMAH 63 1 1
ZAINAL ARIFIN 61 1 1
PADILAN 57 1 1
SALAMA 69 1 1 1
LUTFI AGUS 9 1 1
GITA FITRI 22 1
SITI HAJAR 67 1 1
NURAINI 36 1 1
MISNA 33 1 1 1
SHATIYAH 2.1 1 1
IKHSAN 6 1 1
AGUSTIAWAN 32 1
AN. AFRA CHAYRA 8 1 1
3 DIRGAHAYU 29 1
NURJANNAH 22 1 1
YANTI 31 1 1
H. ZAINUDDIN 52 1
ABDUL AZIS 66 1 1
NURAINUN 45 1 1 1
MASARI 71 1
MAEMUNAH 71 1 1
SULASTRI 19 1 1
SALMAWATI 34 1 1 1
YANTO 19 1
NAHRUL HAYAT 31 1 1
ENDANG ROSIDA 33 1 1
NENENG A 21 1 1 1
NURUL IKA N 24 1 1
DARMAWATI 51 1 1
ABDUL MANAF 64 1
NURUL AINI 26 1 1 1
NAHRUL H 31 1 1
RISKA 28 1 1
A.MAJID 37 1 1
4 TITIN 28 1
DEWI 33 1
HAMZAH 64 1
BELLA 21 1 1 1
AMBAIA 52 1 1
ROSDIANA 16 1 1 1
RIDHO ZULFIAH 29 1 1
SAHABUDDIN 52 1 1
TUTUN SURYANI 33 1 1 1
NOPITASARI 23 1 1
SAPTANINGSIH 58 1
TANTI 20 1 1 1
FIKRI 11 1 1
HERWIN 42 1 1
HIKMAH 35 1 1
NURKOMALASARI 25 1 1 1
YUYUN 30 1 1 1
NURHAYATI 44 1 1
NIZAR 33 1 1
ANIISA 29 1 1
TITIN 17 1 1 1 1
BAMBANG 42 1
AMIR AZMI 23 1 1
RAHMAH 45 1 1
5 AN. AQIL M 4.5 1 1
7 ELY 40 1 1
MERY 18 1 1 1
HADIJAH 41 1 1
INOK 65 1 1
M. AILAS 14 1 1
ANDI HAIDAR 9 1 1
AN. M. TAHIR 76 1 1
A. KADIR 70 1 1
M. FAHROZI 21 1 1
MASTIA 41 1
SYAMSUDDIN 45 1 1
SOPIAH 63 1
GALOEH PUTRI EKA 29 1 1 1
KUSNANDAR 46 1 1 1
RABIATUL 18 1 1 1
ZAINAL ARIFIN 47 1
AFHARIZ CHALIF N 5.8 1 1
AYU 29 1 1
HJ. GAMAR B 74 1
DRS. SAIFULLAH 53 1 1 1
SUPRI HARNINGSIH 41 1
NOVIA 20 1
LILIS INDASARI 28 1 1
ANGGUN 35 1 1 1
NURBASAN 44 1 1
SAIPUL YANI 45 1 1 1
SURYANTI 25 1 1
MARLIA 19 1
8 LINDAWATI 57 1
FATIMAH 67 1
FIZRA DIAH 13 1 1 1
DINA 25 1 1
L. AHMAD 77 1
ERNA 20 1 1 1
SAPAIYA 46 1
RIFA AH 72 1 1
NUSRUDDIN 47 1
HJ. ZUBAIDAH 70 1 1
AN. IRFAN SAPUTRA 10 1 1
SAHNIA 47 1
LENI 24 1 1 1
ELMA 34 1 1
SAHARA 27 1 1 1
NUR ALANG 39 1 1
USMAN BAHARUN 59 1
SARISA S.A 6 1 1
AN. NAJWA INANTA 11 1 1
SRI DARMAYANTI 16 1 1
MELI 37 1 1
IRWANSYAH 22 1
IRWANSYAH 48 1 1 1
9 SURNAWATI 40 1
NAUFAL 8 1 1
SITI AMINAH 65 1
M. SALEH 61 1
SAKIA 65 1 1 1
NURHASANAH 61 1 1
ERNI 45 1
MARUNI 56 1
ELY 34 1 1 1
FATURRHAMNAN 12 1 1
SINARANI 52 1
SRI SULASTRI 29 1 1 1
SAIFUL 33 1
GAMAR 58 1
JAFAR 67 1
RATNA 33 1 1 1
RAKA 13 1 1
SAMSUL 24 1
HENDRA 26 1
SYAFRUDDIN 61 1 1
AIDIL 21 1
AN. AHMAD SATRIA 4.5 1 1
10 NURHASANAH 43 1 1 1
FAHRI ANDANI 21 1 1
SIPAWATI 70 1
SEPIAH 56 1
FARIDA ANWAR 37 1
DESI HASNIATI 29 1 1 1
SAHARIAH 69 1
AMIRAH 12 1 1
IRFAN 46 1 1 1
HERNA 34 1 1 1
HAMIDA 33 1 1 1
NAUVAL 8 1 1
ARUMIKA 1 1 1
SRI WAHYUNI 31 1 1 1 1
ELI 37 1 1 1
MUNAH 46 1 1
YUNI 46 1
LENA 29 1 1
SYAFARUDDIN 33 1
RUSLIADIN 50 1 1
NANDINI 22 1 1
FATMAWATI 62 1
11 MARLIANA 38 1
SAMPUANG 53 1 1 1
MELANI 23 1 1 1
MASANGAN 71 1 1
WINDA 34 1
RETNO 47 1
MUHAMMAD 49 1
NABILA 11 1 1
NURJAYADI 52 1
RATIH 23 1 1 1
REZA 23 1 1
NURHAYATI 44 1 1
CITRA 45 1 1 1
SRI ARI 24 1
INDIRA 17 1 1
ALFA 8 1
RIZAL MUHAMMMAD 40 1
HUSNAWATI 47 1
ARINI 8 1 1
12 REHANI 36 1 1
ILHAM 25 1 1
DESI 25 1
13 ASTUTI 43 1 1
DEWI 34 1 1 1
TAZAN 19 1 1
14 JUMAIYAH 57 1
RATUIYAH 42 1
UMAR 57 1
UMI 65 1
FADILAH 40 1
MASITA 38 1 1 1
DEWI 34 1 1
AMNAH 42 1
DEDY 36 1 1
WARDA 62 1
RATNAWATI 52 1
HERANI 47 1
ERNA 32 1 1
HAIRANI 47 1
KHAFIJAH 23 1 1
FAYYAD 9 1 1 1
SYAIFUULAH 53 1
NURAINI 28 1 1
YUDI 37 1 1
SAHREN 54 1 1
HADIATULLAH 43 1 1
HAIRANI 36 1 1
SRI NUR 52 1 1
ALBY 9 1 1
WAHYU 20 1
FATMAWATI 62 1
SALWA 60 1
M. RAFFA 11 1 1
15 NURHASANAH 43 1
DONI 38 1
TINA 29 1 1
DAHLAN 54 1 1
ARDIANSYAH 13 1 1
ITA 42 1
NURADYA 15 1 1
MASTIAWAN 53 1
RINA 29 1 1 1
ROSDIANA 51 1 1
MARINI 16 1 1 1
JOHARIA 38 1 1 1
NILASARI 25 1 1
APRIAN 28 1
ANDEN 38 1 1
A.WAHAB 60 1 1
DINDA 17 1 1
ZIDNA 5 1 1
16 DEWI 38 1
SAHRATUNNUR 36 1 1 1
A.RAHMAN 57 1 1
AGUNG 49 1
ENI 36 1 1 1
RAHMAWATI 60 1 1
ANDI LALU 47 1
SYARIFUDDIN 52 1
DWI 27 1 1
SUMIATI 25 1 1 1
SALAMIA 32 1 1 1
RENU 22 1 1
MIRA 27 1 1
MARIHAN 28 1 1 1
ASIAH 57 1 1
NUR AZIZAH 21 1 1 1
FITRI 25 1 1
DEVISTA 31 1
RANDI 21 1
NURHAYATI 58 1 1
17 REHANA 40 1
SOLATIAH 28 1 1
SUTIKNO 36 1
RAHMAWATI 31 1 1
ANDRIANT1 26 1 1 1
SRI DEFI 16 1 1
SOLEKHAN 55 1
NURHAYATI 58 1
RUSLIANTO 50 1
ISNANINI 18 1 1 1
ANISAH 42 1 1
MANSYUR 63 1 1 1
ROHANA 53 1
NURHAYANI 40 1 1
HARIANTI 37 1 1 1
18 MAKARANI 45 1
FITRI KURNIA 25 1 1
H. RAMLI AHMAD 73 1 1
ERNAWATI 63 1 1
WISUDA WINDAH 41 1 1
ARIFIN 51 1 1
MUISYID 10 1 1
TANTI 20 1 1
MARJUANI 68 1 1
AN. FIRDAUS R 7.2 1 1
20 LILI 36 1 1 1
21 USMAN 61 1
KAHARUDDIN 69 1
LILI 37 1 1
AL ALFIZZI 3.8 1 1
ZAHRA 44 1
FARTIN 28 1 1
NURDILA 9 1 1
SUKARMAN 57 1
SRI LANGI 56 1
FAZIL 12 1 1
RUMININGSIH 35 1 1 1
MIMIN 32 1 1
ALFATULLAH 21 1
TEDI 27 1
ASMIRANA 78 1
CANDRA 43 1 1
NURHIKMAH 45 1
SAWIYAH 50 1
HENDRA 26 1 1
ZAENAP 67 1
WAHYUNI 35 1 1 1
SALEH BADO 50 1 1 1
ANDI BAHTIAR 33 1
FAIZAH 33 1 1 1
RENI ANGG 22 1 1 1
MUCHARANI 42 1
ZULKARNAEN 34 1 1 1
NIPA 42 1 1 1
TUKIMIN 62 1
ERDAWATI 30 1
ENDRIANI 24 1 1
HUSNIATI 31 1 1
SYARIFULLAH 32 1 1 1
IRFAN 29 1
ELSA 15 1 1
M. SALEH 63 1
SOPIAN 44 1 1 1
ALIF 7 1 1
22 DEWI 36 1 1
FATIMAH 67 1
KAHARUDDIN 49 1
LATIF 66 1
WAHIDA 27 1 1
ANITA 38 1 1 1
HARTINA 26 1
MYESA 7 1 1
ZULAIHA 50
HAJAR 30
FAHRUR 42
BADARIAH 63
MULYATI 32
FITRI 29
HADIJAH 42
23 AHMAD AMRULLAH 8 1 1
M. AMIN 56 1
DEDE HIKMAH 5.1 1 1
M. ZULKIFLI 28 1
DEVANDRA RADHITYA 10 1 1
NAUFAL 32 1
MARDIANA 29 1 1 1
A. LATIEF 66 1 1
RAHMAWATI 56 1
M. AKBAR 14 1
RIZKA SAFITRI 23 1 1
LINA KARLINA 25 1 1 1
WAHYU ADAMI 32 1 1
DENI MAS ADE 38 1
SLAMET 59 1
CAUGI 69 1 1
LASMI 39 1
WARDAH 46 1 1
NURSILA 19 1 1
24 SUDRIMAN 27 1 1
SUSIANA 26 1 1 1
AMNA 63 1
LINA KARLINA 25 1 1
RISTA 21 1 1
NANING 58 1
SAMSUDDIN 69 1 1
SUDIRMAN 27 1 1
RISTA AMRONI 30 1
ROHANA 50 1
BAHTIAR 55 1
25 SYAMSUDDIN 70 1
YARTA JAYA 61 1
SURYA 43 1
HALIMAH 42 1 1 1
ZAINAL ARIFIN 48 1
SAHARIAH 51 1
HARTAWAN 49 1 1
ANANASTYA 23 1 1 1
DESI APRIANI 25 1 1
YULIANA 50 1 1
SURYA MARIANA 25 1 1
MARDIANA 38 1 1
MAHDI 38 1
KUSTIM N 27 1
MAEMUN 30 1
ARMAYADI 34 1
26 HEN SASMITA 26 1 1 1 1
M. SAAD 1 1
27 NURHAYATI 55 1 1
28 TATA W 64 1
RUSTIATI 54 1
NURAINI 44 1
AN. AYA WASIATI 4.11 1 1
ERNI 57 1
ROHANA 35 1 1 1
RAHMIATUN 53 1
ADE CARMA 44 1
MASNIATI 46 1
SALMA 60 1 1
MARYAM 68 1 1
MULYADI 34 1
FIRDAUS 27 1 1 1
RENI KASIANI 28 1 1
MIMIT 70 1
DIRA SASMITA 29 1 1 1
ILHAM MAHYUDDIN 36 1 1
NUR ANISA 29 1 1 1
WAHYU CAHYO 27 1 1 1
HIFRIAH 48 1
YAZHAR. S.PD 37 1
NOVITA S 31 1
A AKBAR 26 1 1
SUPIANA 54 1 1
SAIDAH NURHAYATI 26 1
SRI SURYATI 45 1 1
DETA ENDAH 27 1 1 1
RABIATUL 18 1 1
29 ASSARIF 26 1
MUSLIMIN 35 1
RABIATUL 18 1 1
SABARIAH 62 1
ZOYA ZULKARNAIN 16 1 1
TANHAR 62 1 1
RIA AYU 27 1 1 1
FITRI WAHIDA 45 1 1
SRI WIWIN 30 1 1
ABDUL AZIZ 66 1
SUNARYATI 53 1
IRWANTO 30 1 1
HJ. MAMNURAISY 57 1
SOPIANINGSIH 19 1 1 1
SUSI ADE 22 1 1 1
RATNAINI 31 1 1 1
FATMAWATI 36 1 1 1
WULAN INDRIANTI 18 1
HIWANSYAH 38 1 1
SURNILANI 49 1
ISKANDAR 31 1
30 NURAINI 60 1
HULIYA LAFIFAH 28 1 1
M. IRZI 16 1
ROSMIATI 62 1 1
YESA HAERANI 17 1 1 1
RAEHANUN 19 1 1 1
AMANDA 49 1 1 1
SAIDA 30 1 1 1
AMRULLAH 48 1
DINI HARIANI 18 1 1 1
DEFI TASARI 30 1 1
FARIDA 50 1 1
NOVA SAFITRI 18 1 1 1 1
Ir. DJOKO AGOES 68 1
ALDA DINIAH 19 1 1
IRWAN 30 1 1
139 21 244 71 69 5 136 33 0 0 18 4 0 0 36 25 21 5 36 5 23 0
AM PELAYANAN KESEHATAN GRATIS PADA PUSKESMAS DAN JARINGANNYA
JENIS PEMERIKSAAN
GD MAL WIDAL IgG/IgM/NS1 HBsAg ANTI HIV SIPILIS GULA CHOL UA
L P L P L P L P L P L P L P L P L P L
B L B L B L B L B L B L B L B L B L B L B L B L B L B L B L B L B L B L B
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DAFTAR T
PROGRAM PELAYANAN KESEH
DINAS KESEH
BULAN : OKTOBER
TAHUN : 2022

(THN) BPJS/ KIS
B L B L B L B L B L B L B L B L B L B L B L
1 SAHNIM 52 1 1
HENI K 25 1 1
3 ROHANI 59 1
FATIMAH 67 1
MUTIASIH 42 1
ROMANSYAH 30 1 1
DINO 15 1 1
RABAIYAH 66 1 1
SAHERA 57 1
MARYANI 68 1 1
NURHAYATI 58 1
YETI G 42 1 1
EKA 10 1 1
SYAHRATUNNUR 40 1 1
ASTRI 25 1 1
ABDULLAH 66 1 1
SUMARNI 62 1
YEYEN F 23 1 1
HJ RAHMAWAN 68 1
DERI 28 1 1
ATHAR 4 1 1
SA'IDAH 20 1 1
ANDI NURNILA 9 1 1
ALUH A 23 1 1 1 1
TAZAH 18 1 1 1
4 H. AHMAD U 77 1
FATIMAH 59 1
AMNAH 42 1
JENAHARA 34 1 1
FITRIANA 39 1 1 1
SULHAENI 43 1
FITRIANTI 42 1 1 1
KHAIRUNNISA 13 1 1 1
IKA RAFIKA 26 1 1 1 1
YULI FITRIANI 25 1 1 1
AULIA S 25 1 1 1
YULI F 25 1 1 1
ABDULLAH 61 1 1
DESITASASARI 30 1 1
NILA WAHYUNI 27 1 1 1
5 FITRIAH 49 1
HASANAH 66 1
NILA WAHYUNI 27 1 1
HEN SASMITA 25 1 1 1
ZAINAL ABIDIN 69 1
M. NURDIN 73 1
KAMARIAH 65 1
FADILA MARDATULLAH 25 1
MASANGAN 71 1
SRI AYU 23 1 1 1
SOPAN 30 1 1
DIKA 21 1 1
YULLY 35 1 1 1
KAMARIAH 25 1
IRHAB 65 1 1
YULIANA 1 1 1
APRIYANTI 19 1 1 1
H. MAKASAU 22 1
SARTIKA AULIA 76 1
ROSI YULIANA 35 1 1 1
NURHAYATI 46 1
ROSDIANA 16 1 1 1
ERNI 31 1 1
LUH PUTU 34 1 1 1
SARA ASHARI 34 1 1
6 USMAN 64 1
AMIRULLAH 32 1 1
HARTAWAN 49 1 1
ADIDAH 58 1
NURHAYATI 58 1
MONAWIR 23 1 1
IKA HERAWATI 27 1 1 1
PAHRIA 34 1 1 1
SAFI"I 55 1
YUNIARTI 31 1 1 1
H.M.ZAIN 68 1 1
ABD. RAHMAN 63 1
HABIBAH 41 1 1 1
BADARIAH 46 1 1
7 SIT HAWA 38 1 1 1
ASEP MUHAMMAD 50 1
MASIH 59 1 1
RAJEMA 66 1 1
RAPIAH ABDULLAH 66 1
ROSNAWATI 40 1
ARINI 50 1 1
HERI S 48 1 1
NURHASANAH 45 1
MARNA ASNAINI 49 1
M. AMIN 56 1 1
Evi 31 1 1 1
JANARIAH 57 1 1
H. MASBOMA 49 1
A. WAHAB 82 1 1
SARAWAN 45 1
HALIMAH 47 1 1
NAFILA 26 1 1 1
SYAFARUDDIN 19 1
RISKI W 26 1 1
ZULFIANDI 21 1 1
NURUL 30 1 1
RISMA 36 1 1
MATENA 61 1 1 1
8 IBRAHIM 48 1 1 1
9 ANDRIANI 25 1 1
RESTU P 19 1 1
FIRMANSYAH 21 1 1
GAZIAH S 24 1 1
NILA A 30 1 1
SAIDAH 21 1 1
10 MARUNI 56 1
ERMAYANTI 32 1
RONI 1 1
RUSLAN 1
HASANAH 51 1
HJ. HALIMAH 54 1
FADILAH HAFSYAH 40 1
INDAH 19 1 1 1
RAODATUS SAADAH 20 1 1 1
SARA 34 1 1
DWI PUTRI 3 1 1
HERIANTO 33 1
SUMARNI 38 1 1
DINA ADE P 22 1 1
HENDRIYONO 28 1
SARA ASHARI 34 1 1
RAFIF 2.1 1 1
ZIDAN 12 1 1
M. IRFAN 19 1
WAHYUDI K 19
MAHANI 59 1 1
11 RUSMAN 57 1
ANDI LALA 47 1
DEWI SARTIKA 38 1
BQ APRI 33 1 1 1
FARLINA 25 1 1 1
MUHAMMAD 67 1 1 1
INNAH 25 1 1
HERLINAWATI 49 1
NURBANI 47 1
NURJANNAH 60 1
JASWATI 42 1 1
SARIANTI 28 1 1
FITRIANI 26 1 1
SARMILA 27 1 1
VIVIT 27 1 1
MELIANDANI 24 1 1 1
MARDIANA 32 1
ISNAINI 29 1 1
RAHMI B 22 1 1 1
MARYAM 66 1
NOVA S. 16 1 1
NOPI J. 23 1 1
12 DEVI M 49 1
HABIBAH 41 1 1
ASSHAUQI 12 1 1
HERLINAWATI 49 1
SAAIYAH 49 1
NOVITASARI 32 1 1 1
YUDI RISKY 12 1 1
UMI KALSUM 51 1
H.SALENGKE 71 1 1
ELYANA 49 1 1
SUKTISNO 36 1 1 1
ELLY S 38 1 1
NURDIN AYUB 59 1 1
IIS M 39 1 1
ANOM 83 1 1
IKRAR B 47 1 1 1
SOFIA M 27 1 1 1
TILA 27 1 1 1
LUH PUTU ADRI 34 1 1
LILI 36 1 1 1
13 SUMIATI 27 1 1 1
H.SALENGKE 71 1
HJ NURJANNAH 70 1 1
ALQADRUNNADA 7 1 1
NURJANNAH 44 1
DEKKATI 48 1
SUNARTI 40 1 1
NI WAYAN 39 1 1 1
DESI 39 1
RIA A 45 1
SURYA 28 1 1
NEVI ANGGRAINI 36 1 1
DEWI AYU 20 1 1 1
RAHMAN 44 1 1 1
SISKA 21 1 1 1
WAFA 1.1 1 1
HASNAH 51 1
CICI IRHANDA 18 1
DARA 19 1 1 1
TAUFIK 23 1 1 1
RISMA 27 1 1
ISTIQOMA 24 1 1 1
RISMA 27 1 1
ISTIQOMAH 24 1 1 1
DANDY 21 1
14 SAIPAH 54 1
YUNITA 43 1 1
ABD. HARIS 62 1 1
HERIANTO 60 1
NURWAHIDAH 46 1 1
MARIANI 52 1
NURAINI 46 1 1
MARIANA 41 1 1
YURAJA 4 1 1
SOPYAN P 24 1
15 RUSDIANTO 43 1 1
16 AMINAH 52 1 1
17 JAMILA 52 1
ADIMUDDIN 61 1
NILA W 27 1 1
EDI IRAWAN 19 1 1
ABD HARIS 62 1
AMALIA CLARA S 17 1 1
SAFIYAH 56 1
ELSA EDILA 5 1 1
IZA 14 1 1
NELA RIZKI 29 1
FAHRIA 33 1 1
NAWIRAH 46 1
NUMI H 28 1 1
ZAHRAH 44 1
MARTINA 39 1
BIAWAN 44 1 1 1
SUMIATI 36 1 1
M. IBNU SALEH 6.7 1 1
ROSDIANA 65 1
FARTIA 28 1 1
MAISA 30 1 1
HAMDANI TANAYAH 22 1
RAHMAT H 50 1 1
18 RAHMA ROMDAYANI 28 1 1
CANDRA 50 1
BURHAN 26 1 1
ATIJAH 56 1
IMAH 62 1
SOLIHIN 57 1 1
SAPRUDIN 47 1
SAHIR 79 1
HARFAN 51 1
SALMAH 57 1
M. ABDUL ROSYID 27 1 1
SUSANTI 23 1 1
PRATINA ROSDIANA 34 1 1
NURHAYATI 37 1 1 1
SRI SULASTRI 29 1 1 1
SALAMINA 62 1
MUFIDA 35 1
YAYU 19 1 1
AFDAL ADE PUTRA 18 1
NARIN 19 1
SYEKTH SOYAFI 64 1
A.RAHMAN 46 1
19 M. JAFAR ABIL 66 1
YUNITA HANDAYANI 22 1 1 1
RIZKI APTA M 6 1 1
HAMIDAH 33 1
NURDIN 57 1 1
SITI HAJAR 63 1
ISMAIL 47 1 1
AN. AFIKA NAZILA B 8 1 1
NURHAYATI 57 1
AGUS SUPRIADI 50 1 1
SUSILAWATI 31 1 1 1
FATIMAH 50 1
YUNI WULANDARI 22 1 1
RAHMAT RAMDANY 18 1
SUSANTI 25 1 1
HJ. FATMA 63 1 1
INDANA 24 1 1 1
NIRMALA 49 1
NURAINI 47 1
RAHMASARI 15 1
LILI ANDRIANI 15 1
HUMAINA 4.5 1 1
UWAIS 1.3 1
HERU W 38 1 1
IRIN 62 1 1
FAHRI 49 1
ASTUTI 36 1 1
20 SRI ROHANI 33 1 1 1
MARLINA 47 1
SALEHA 49 1 1 1
JULIA 21 1 1 1
SRI KANDI 19 1 1 1
MARDIANA 39 1 1
RINA ANGGRAINI 26 1 1
YATI YUWANDA 23 1 1
MARIAM 48 1 1 1
BURHAN 59 1 1
CHYUTHYA 24 1 1 1 1
NURSANTI 47 1 1
MUHAMMAD 55 1 1 1
ISMI T 20 1 1
21 ISARI TRI 26 1 1
SRI HARTINI 56 1
SUMIATI 35 1 1
KHOLIDA NAILAH 18 1 1
ASIAH S 57 1 1
BELLA 21 1 1 1
ZALZA TAHTA G 12 1 1
MAHNUN 54 1
A. MUHID 45 1
SYAMSIDAH 60 1 1
AMINAH 62 1 1
AN. FATHIA 1.8 1 1
SUSI SUSANTI 32 1 1
MAHDA N 25 1 1
22 LENA 25 1 1 1
23 SURIANTI 25 1 1
LEHA 25 1 1
RATNA 48 1 1
PURNAWANSYAH 36 1 1 1
24 SURIYANTI 25 1 1
MAHNUN 54 1
SYAHRATUNNUR 36 1 1 1
ZALIKHA DINI 10 1 1
SURYA 43 1
ASTRI PINASTI 25 1 1
ROSMINI 32 1 1 1
SILVIA ADE 33 1
FATIMAH 37 1 1
NURZAITUN 23 1 1 1
RIZKYA 1.2 1 1
M. IKHSAN 13 1 1
MISKIA 52 1 1
HADENAN SALEH 55 1 1
SYARIFA 6.5 1 1
YUNITA 33 1
SAHARUDDIN 57 1 1
FADIAH BAWAZIER 45 1
HENDRY KUSNANDI 48 1
IWAN HIDAYAT 26 1 1
SITI HADIJAH 28 1 1 1
ROHANA 31 1 1 1
AMRIANA 37 1
MUHAMMAD 52 1 1
KINIATI 23 1 1
INDRA KUSMADI 18 1
ENI NURAINI 37 1 1 1
NURUL AINI 43 1 1
RUDIANA 26 1 1 1
H SAYARAFUDDIN 74 1 1
MUHAMMAD ARIANTO 17 1
EVI AFRIANINGSIH 15 1
IIN OPIANTI 14 1
MAWADDA 16 1
SURYANTI 25 1 1
IRWANSYAH 37 1 1 1
HAMDAN 28 1 1
M IZZUL 14 1 1
RAMDANI 16 1
IRMA 17 1
KASIH PUTRI 17 1
SATRIA 16 1
AZMI 19 1
HAFIFA 17 1
SURIANTI 25 1 1
LIDIA 18 1
ESI 26 1 1
25 AMINAH 52 1 1 1
IRAWATI 35 1 1
LIDYAWATI 39 1 1
SURIYANTI 25 1 1
KARTINI 23 1 1 1
HERIANTO 29 1 1
ALIYAH 66 1
SUFYAN EFENDI 66 1 1
MILAH 48 1 1
IDA ZUBAIDAH 51 1
HALIMATUSSA'DIYAH 30 1 1 1
SAPAIYAH 30 1
RIZKA ADHI 1.3 1 1
YUYUN 36 1 1 1
NURUL JANNAH 26 1 1
A MUIS 49 1
FATMAWATI 55 1 1
HAERUDDIN 56 1 1 1
HESI 28 1 1 1
NUR HIJRIANNI 26 1 1
SURYA JAYA 43 1 1
SUHARNI 45 1 1 1
MARSONO 45 1
SOPIAH 20 1 1 1
ANGGAM 24 1
26 MAHSUN 52 1
IRFAN ISLAMI 46 1 1
AISYAH 62 1
M TAHIR 76 1 1
M. ZULFAN 10 1 1
H. SUPADMUN 72 1
MARDIANA 54 1
ZASKI MARDA 11 1 1
HARRY YUSUSF 7 1 1
RUSDA 46 1
SULAIMAN 61 1
M. FAHRI 5 1 1
NURAINI 38 1 1 1
TSABITA SHABINA 35 1
DESTI ANGGRAINI 14 1 1
M. ADRIAN NOVAL 8.9 1 1
M. IHSAN 1.5 1 1
RUSDI ARIEF 47 1 1
PUTRI 15 1 1
YUNI RAHMAWATI 42 1
EKA RIA SUSANTI 23 1 1 1
DEFI TASARI 30 1 1
FEBRIANTI 32 1
RAHAYU TARDANI 22 1 1 1
JAMILUDDIN 62 1
FIRA FEBRIANI 22 1 1
FAIRUZ 23 1 1 1
FITRI FEBIA 13 1 1 1 1
27 INDRA JAYA 28 1 1
SRI NURHAYATI 47 1 1
DESTRI 24 1 1 1
RUSTIATI 59 1
TATA WIDIANTO 64 1
NURAINI 44 1
ENI KUNTITI 51 1
A. LATIF 43 1
NURSIAH 52 1 1
MELY YUNITO 40 1 1 1
TATI HARTATI 52 1
MUSTAKIM 56 1
PATMAWATI 37 1 1
NURILAM 48 1
LISA FEBRIANI 18 1 1
MAHMUD M. SALEH 73 1
MARDIANA 35 1 1 1
SAHODA 47 1 1
DANNA 47 1 1
NURMA 57 1 1
ZULKARNAEN 42 1 1
DANDI 22 1
NURKEMAH 63 1 1
QAIREN 1.3 1 1
M. SALEH 61 1 1
SAHODA 68 1
FATHIA 33 1 1
ANGGUN 30 1 1
RAMDAN H 2 1 1 1
IIS FITRIANTI 37 1 1
FATIMAH 67 1 1
28 SAHARIAH 60 1
SABARIAH 62 1
SALMIAH 51 1 1
HJ. BAHYUN 74 1 1
NANIK R 44 1
BY RAZKA ADHI 1 1 1
DELLA NUR FADILAH 14 1 1
UMAR HASAN 60 1
A. LATIF 68 1
HADNAH 67 1
M. ZAHAINI 57 1
M. SYUKUR 45 1 1
SHOFIAH ATIKA 20 1
MAHINI 28 1 1 1
SALMAH 60 1 1
SALBIAH 58 1 1
RAMDAN HASNAPI 25 1 1
ANISAH 15 1 1 1
AN. ARETA 10 1 1
SADAH JUNA 8.4 1 1
SUPIANA 54 1 1
MAWIYAH 47 1
APRIANTO 6.9 1 1
ALANI AZZAHADI 7 1 1
M. REFKY A 8 1 1
NURLALY 22 1 1
AFIKA 3 1 1
NUR IFFAHUL R 22 1
RAFA 8 1 1
RAFI 8 1 1
29 RAMDANI 25 1 1
IKA 35 1 1
ELY 32 1 1
NURHAYATI 68 1 1
30 ELY SAKIAH 32 1 1
DESRIA YASMIN 24 1 1
AGUS 45 1 1
31 NINING 35 1 1 1
NURUL HUDA 66 1 1
SYAMSIAH 57 1 1
M. AMIN 53 1
RUSMAN 58 1
LENNI SASTRA 48 1 1
SRI NAWAN 24 1 1 1
FAUZI AZIS 54 1
MARIA 40 1 1 1
NURKHOLIFA 20 1 1 1
ASIAH SALEH 57 1 1
RAHMIATON 53 1
ENDANG SULASTRI 38 1
FITRIAH 42 1 1 1
SUMIATI 49 1
REHANUN 19 1 1 1
RENI KASIANI 28 1 1
INDAH PUTRIANI 24 1 1
RISKA 26 1 1 1
OKTMAN SURYADI 25 1
ERMA 53 1
TARAGA 8 1 1
YUNI 19 1
YULIA 27 1 1 1
ASMAWARNI 24 1 1 1
MUHAMMAD 52 1 1
AMRILLAH MAHENDRA 13 1 1
AMBAR S. 25 1 1
NITA SELFIANTI 31 1
EPI SAFINA 20 1
AN. KHAYRA 4.8 1 1
AN. RIFKY 4.2 1 1
122 34 250 108 62 16 83 30 0 2 76 26 1 0 38 20 22 2 32 13 18 3

AM PELAYANAN KESEHATAN GRATIS PADA PUSKESMAS DAN JARINGANNYA
JENIS PEMERIKSAAN
L P L P L P L P L P L P L P L P L P L
1
1 1
1
1
1 1 1
1
1 1
1
1
1 1 1
1
1 1
1 1 1 1 1
1 1
1 1 1 1 1
1
1 1 1 1 1 1
1
1 1 1 1 1 1
1 1 1
1 1
1
1 1
1
1
1
1 1 1 1
1 1 1 1
1
1 1 1 1
1 1
1
1 1 1
1 1
1 1
1 1
1 1
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1 1
1 1 1 1 1 1
1
1
1
1 1
1 1
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1 1
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1
1
1
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1
1
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1
1 1
1 1
1 1 1
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1 1 1 1
1
1 1 1 1 1
1
1
1 1 1 1 1 1
1 1 1 1
1 1
1
1
1 1
1 1
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1 1
1 1 1
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16 2 41 2 27 7 63 12 29 5 19 6 24 6 21 5 2 4 55 7 3 2 49 7 3 2 49 8 36 23 101 72 40 18 57 37 34
UA BTA TG FL
L P L P L P L P
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
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1
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1
1
1
1
1
1
1
1
1
1
1
1
1
1
15 49 29 1 0 0 0 0 0 0 1 0 0 0 0
DAFTAR TAG
PROGRAM PELAYANAN KESEHAT
DINAS KESEHATA
BULAN :SEPTEMBER
TAHUN : 2022

UMUR No.ID/ NIK / DL HB GD
(THN) BPJS/ KIS
L P L P L P L P L P P L
B L B L B L B L B L B L B L B L B L B L B L B L
1 KHALIFA 20 1 1
SARA 30 1 1
MIALA 28 1 1 1
SAHORA 57 1
ALKHALIFI 3.5 1 1
NURMA 54 1
DEA NAURA 11 1 1
DIANA 24 1 1
NOVITASARI 32 1 1 1
SATRIO 13 1 1
HAMDAN 35 1
HERANI 64 1
CANDRA 41 1 1
FARHAN 3.9 1
BAMBANG 53 1 1
NURMAWAN 37 1
NURHAYATI 68 1 1
FAHRI 33 1 1
KHALIFA 20 1 1
NUR 35 1 1
KICHI 7 1 1
2 RUDINI 36 1
NUR 35 1 1
ERNA 53 1
HASAN 38 1 1
FATMAH 50 1 1
ELY 44 1 1 1
RAMLAH 35 1 1 1
CANDRA 50 1
RUSMIN 40 1
JAYADI 39 1 1
ROMLAH 38 1 1 1
SAPARUDDIN 44 1 1
SRI REZEKI 46 1
SUCIAH 72 1
HERNI 40 1 1
SUMANTO 62 1 1
JUFRI 65 1 1
AMINAH 37 1 1 1
3 MUHAMMAD 43 1 1
RIA N 32 1 1
M ALEX 13 1 1 1
AGUSTINA 30 1 1
5 YUSNAWATI 26 1 1
M.NURDIN 74 1
IWAN J 53 1
SURYANI 45 1 1
LINDARWATI 46 1
ADIDAH 58 1
MURNIATI 55 1
RITA 46 1 1
KAHARUDDIIN 69 1 1
FITRIAH 49 1
M. KADRIL 78 1 1
NURIFA 34 1 1 1
ELI 31 1 1 1
FAHRIAH 28 1 1
NURHAYATI 52 1
FAKHIYATUL 21 1 1 1
HAMKIMAN 14 1 1 1
NURWAHIDAH 35 1 1 1
ZULFIKAR 51 1 1
MUSA EFENDI 50 1 1
ANA MARIANA 20 1 1 1
HJ. ARMIATI 55 1
RAIZZA 7 1 1
SURNAWATI 40 1
NURHAYATI 27 1
INTAN MURYANTI 21 1 1 1
MIKA 8 1 1
MARYAM 18 1 1
MASUJI 53 1
NAUTAN ARFALENO 7 1 1
HENDRY 47 1
SITI 64 1
M. NASIPUDDIN 47 1
MUKMINATULLAH 39 1 1
BIL HUSNA 34 1 1 1
6 YUSNAWATI 26 1 1
AMINOLLAH 29 1 1
FATHUL J 30 1 1
ST RAHMAH 64 1
HASANUDDIN 41 1
SUPRIADI 26 1 1
SRI YULIA 22 1 1
ABU SIFAUN 45 1
RAFIAH 46 1 1
MAEMUNA 66 1
UMAR AL QADRI 57 1 1
IBRAHIM 55 1
HARDIANTO 46 1 1
ADENIYA 28 1 1 1
RAENA 49 1 1
PATIMAH 19 1 1
AMINAH 48 1
SARTIKA 22 1 1
I GUSTI AYU 24 1 1 1
ERNA T 40 1
FATHUL JANNAH 30 1 1
NURJANNAH 53 1
INUL D 30 1 1
A RAHMAN 23 1 1
7 RAHMA 56 1
RAMLAH 35 1 1 1
FITRIANI 9 1 1
SITI KHADIJAH 70 1
ELI SULASTRI 37 1 1 1
ABDULLAH HS 65 1
SENI 32 1 1
SINTA 6.5 1 1
WARDIAN 25 1 1
INDAH M 19 1 1 1
ANDONG 64 1
GALANG 11 1 1
ARDIYAH 53 1
FATMAWATI 27 1 1 1
OON DEWI 33 1 1
SURYANI 29 1 1 1
ROSIDI 50 1 1
M RIUL 14 1 1
MENTARI 27 1 1
BENY R 15 1 1
8 FARIDA 41 1 1
ADRIAN 14 1 1
NURHAYATI 57 1
SAHRUL 40 1 1 1
NANI 47 1
YOGIE 27 1 1
SALAMA 68 1 1
SUMIATUN 46 1 1
SAPARUDDIN 46 1 1
RAMLI 39 1
APRIYANI 38 1
ST AISAH 90 1
MUHAMMAD 67 1 1
MARNA 49 1
ALFATIH 5 1 1 1
HADENA 53 1
FAIJAH 38 1 1
HJ. HAYATULLAH 68 1
DENDA 29 1 1 1
SUNDARI 56 1 1
AMINAH 44 1 1
TAMRIN 74 1 1
ABDIAYANSYAH 29 1 1
9 RUSLAN 49 1
RATNIYAH 41 1
EVI 47 1 1
INDANA 12 1 1
YANTI 38 1
SUMIATI 68 1 1 1
NURMIATI 42 1
RIDWAN 37 1
NOVITASARI 26 1 1
LISTI 16 1 2
HIKMAH 32 1 1
NURUL 36 1
HARDONI 28 1
NURMADI 38 1
DEWI 18 1 1
10 PATMA 31 1
SURIANI 24 1 1
YUSNAWATI 26 1 1 1
11 ANISA 22 1 1
ANISA 22 1 1
SURYANI 24 1 1
SAIFEUDDIN 50 1 1
SAPIAH 64 1 1
FITRI 26 1 1
12 MURNIATI 38 1 1
SALEHA 57 1
HJ HUDAYYAH 45 1 1 1
ETI 50 1 1 1
SUBAIDAH 45 1
ASTUTI 60 1 1
DENI 41 1 1
SUSANTI 39 1 1
13 M. AZRIL 11BLN 1 1
SUPIANA 54 1
SALBIYAH 51 1
LITA 19 1 1
ADELYA 6 1 1
ARIFIN 28 1 1
NURUL 23 1 1
ISMAWATI 24 1 1
MANCAWARI 78 1
SURYA 57 1 1
FATIMAH 64 1 1
RUSTATI 42 1
SAPAIYAH 14 1 1
KABER 30 1 1
14 NURSI 22 1 1 1
RINNY 34 1 1
NURIYAH 53 1
SARIFAH 12 1 1
BUNAIYAH 35 1 1 1
ANDI K 46 1 1
NURKEMAH 63 1
SITI 36 1 1
MARDIANTI 23 1 1
M. JAFAR 48 1 1
AWALIA 42 1 1 1
JAMIATUL 42 1 1
FEBY 19 1 1
NORMI 33 1 1
LAELY 44 1
ARSYA 3.11 1 1 1
INARAH 1.4 1 1
NURHAYATI 68 1 1
AWALUDDIN 27 1 1
NURDIN AYUB 59 1 1
RAJEMA 50 1 1 1
15 AWALIA 42 1 1
SAHRA SAID 48 1
BELLA S 48 1 1 1
SALMAM A 5 1 1
ENDANG S 38 1
CANDRA P 40 1 1 1
FAHRIAH 28 1 1 1
IBRAHIM TAGA 74 1 1
MURNIATI 32 1 1 1
ZAINAL A 47 1
SALWA 66 1
ANDRIANI 25 1 1 1
A.KADIR 53 1 1
MARIANI 32 1 1
NURUL H 42 1
NOTO K 55 1
16 ADY 35 1
HADIJAH 50 1
DHEDET 20 1
MAHSUN 53 1 1
TIARA 24 1 1
YANITIN 31 1 1 1
NAINI 32 1 1
IRAWATI 23 1 1
SIAH 71 1
M.BADRUN 25 1
YUNI 33 1 1
HAFSAH 25 1 1 1
BAKRAN 75 1
HASANAH 54 1 1
CEMPAU 61 1 1
SITI AISYAH 63 1
RENI 29 1 1
ERNAWATI 48 1
M. ADAN 2.5 1 1
SOLIHIN 57 1 1 1
17 SUHARTI 44 1 1 1
ABDUL MANAF 42 1 1
IRAWATI 23 1 1
18 MARDIATUL 35 1 1
19 ALIYAH 66 1
SYAMSIAH 40 1
MAHSUN 52 1
ANA 34 1 1 1
SITI 30 1 1 1
AMIRULLAH 32 1 1
FITRI 25 1 1 1
FITRIAH 36 1 1 1
AHMAD 53 1
RISKA 26 1 1 1
ROHANA 16 1 1
AB. MAJID 5.2 1 1
ASIA 42
FATIMAH 52 1 1
ST. HAZAR 63 1
RIANITA 35 1 1 1
FATIMAH 17 1 1 1
INAYAH 3 1 1
MAHMUD 73 1
AMAQ HARIS 79 1
MARWAN 46 1
NURUL 42 1
ROSDIANA 38 1
RIKAWATI 33 1 1 1
RAIHANIYAH 58 1
MUSTAFA 45 1
KUSNAYADI 56 1
LENA HARYATI 31 1 1
SISI 19 1
RINA 23 1
20 LENA HARYATI 31 1 1
SADARIAH 62 1
DARMIATUN 52 1
MURNI 40 1 1
MAEMUNAH 64 1
SABARIAH 62 1
NURMA 60 1
SRI 32 1 1 1
M. AMIN 53 1
NILA 27 1 1 1
LAWIYAH 42 1
PATIMAH 40 1 1
RUSKAMTO 66 1 1
IDA 38 1 1
DIKA 14 1 1
MANDARI 54 1 1
AHSYAH 6 1 1
ASRAF 9 1 1
USMIATI 40 1 1 1
ANDI K 12 1 1
SUTRIANA 19 1
DEFI 28 1 1 1
SRI ICA 58 1
ULFAH 34 1 1 1
LULU 25 1 1
SAKINAH 22 1 1
HASNI 57 1 1
21 M.NURDIN 73 1
SPASIAH 79 1
KINIATI 73 1 1
JUMATTINNUR 34 1 1 1
HADIJAH 59 1
RIKAWATI 33 1 1 1
FARTIN 28 1 1
JANARIAH 63 1 1
ARINI 50 1 1
SYAFRUDDIN 28 1 1 1
FATMAWATI 40 1 1
22 NILAWATI 63 1
VERA 50 1
WAGIRAN 51 1
ZAKIA 4 1 1
MAHMUD 72 1
FITRIANI 22 1 1 1
RAIHA 45 1
IDA 38 1 1 1
DEWI 23 1 1
SANDRANG 41 1 1 1
ACH TABRONI 40 1
HERMI 36 1 1 1
SAPUTRA 25 1
SAPIAH 47 1
23 DEWI 39 1
YUDI 34 1 1
MASAAT 65 1
MAHMUD 72 1
AMELIA 47 1
NURBAYA 75 1 1
FATHAN 17 1 1
HERIA 35 1 1 1
NILA 30 1 1 1
EKA 39 1 1 1
AISY 26 1 1
RUSDAN 64 1 1
ZUBAIDAH 45 1
GHIFARY 5.8 1 1
LOVITA 29 1 1
NOVI DEWI 34 1
ZAHIYA 6 1 1
WINDI 17 1 1
26 HASANUDDIN 60 1
HUSAIN 65 1
YULANDA 21 1 1 1
ZAHRAH 10 1 1
H ABDUL KADIR 72 1
MANDARA 63 1
CELA 77 1 1
JUMATI 59 1
NURKEMAH 63 1
H MUSTAMIN 54 1
SITI HAJAR 49 1 1
DANI 2.7 1 1
MUSLIMIN 34 1
NADIA 52 1 1
LISA 26 1 1 1
FARIDA 52 1 1
KARIMUDDIN 52 1 1 1
ANISA 21 1 1
PUTRI 9 1 1
M ZUHAIM 56 1
M YUNUS 65 1 1
AYUNI 54 1
ABDUL MANAF 45 1 1
CITRA YUNI 52 1 1
ARSYAD 52 1 1
RISTA DWI 21 1 1
NURDIN AYUB 59 1 1
27 MASUJI 58 1
LIDYAWATI 39 1 1 1
KISNA 36 1 1 1
SAPAIYAH 52 1
NUFAIL 2.3 1 1
NILAWATI 25 1 1
MINARTI 32 1 1 1
ISMAIL 32 1
RAMLAH 36 1 1
ADE KANTARI 36 1 1 1
MAHNIATI 30 1 1 1 1
ELVI SUSANTI 43 1
LARA IRAWATI 31 1 1
ANDI ABBAS 9 1 1
SUKRIN 20 1 1
28 SAEHUN 78 1 1
USMAN 38 1 1
SRIYANI 43 1
LILI 36 1
NUR SRIBATIN 22 1 1 1
ZERRA ANINDITA 26 1 1 1
NURAINI 59 1
MAHNEP 67 1
SAHEMA 55 1
SITI HADIJAH 70 1
CITRA YUNI 45 1 1 1
HAPSAH 61 1 1
JERA 32 1 1
MASARI 71 1
FITRI JAYANTI 27 1 1
SALBIYAH 57 1
WAZAHIRI 48 1 1
NABIL KHALID 16 1 1
NURUL H 39 1 1
WILDA 37 1
RAHMATULLAH 38 1
DAFFA ALVINO 1.4 1 1
NONI R 26 1 1
KIANO H 8.1 1 1
NIRMALA 25 1 1
ASSYIFA BILQIS 5.5 1 1
29 HERIAH 35 1 1
JUMATI 59 1
KAMARIAH 69 1
MASARI 71 1
ABDUL HAMID 52 1 1
UMAR ALQADRI 57 1 1
LEGIMAN 53 1
SALMAWATI 34 1 1 1
ARTHA PUTRA 6.7 1 1
ST MAISURI 67 1 1
ZUBAIDAH 70 1 1
AMBAYA 75 1 1
ELI ZAKIYAH 31 1 1 1
YULIA FITRIA 73 1
DOBI 36 1 1
HERIAH 35 1 1
SRI 35 1 1
YULIANTI 19 1 1
ALVENDINO 19 1 2 1
30 HASANAH 57 1 1 1
AISYAH 50 1
HERIAH 34 1 1
ANDI 7.8 1 1
SYAFRUDDIN 43 1 1
ST. ZUBAEDAH 58 1 1
RUSLAN 70 1 1
ASMAWATI 34 1 1 1
ADINDA 1 1 1
ABDULLAH HS 49 1
HALID BASMALAH 22 1 1
ISMI 25 1 1 1
DOBI 38 1 1
MARGA 4 1 1
KAHERUNNISA 41 1 1
AMILA 21 1 2
120 25 205 105 70 4 72 13 0 0 59 33 0 0 20 24 22 3 29 6 23 5 7 0
PELAYANAN KESEHATAN GRATIS PADA PUSKESMAS DAN JARINGANNYA
JENIS PEMERIKSAAN
P L P L P L P L P L P L P L P L P L P
1
1
1 1 1 1 1
1 1
1
1 1 1
1
1
1
1
1 1
1
1 1
1 1
1
1 1
1 1
1 1 1 1 1 1
1 1
1 1 1
1 1
1
1
1
1
1 1
1
1 1
1 1 1 1 1 1
1
1
1
1
1
1 1 1
1 1
1 1
1 1
1
1 1 1
1 1
1 1 1 1
1
1 1
1
1 1 1 1
1 1 1 1 1 1
1 1
1 1
1
1 1 1
1 1 1 1 1 1
1 1
1 1
1 1
1
1 1
1
1
1 1 1 1
1
1 1
1
1 1 1
1
1
1 1 1
1 1 1
1 1 1
1 1 1
1 1
1
1 1 1
1 1 1 1 1
1 1
1 1 1 1 1
1 1
1
1 1 1 1
1 1 1 1
1 1
1 1 1
1
1
1 1 1
1
1 1 1
1 1
1 1 1 1 1 1
1 1 1
1 1 1
1 1
1 1 1 1
1 1 1
1
1 1
1 1
1 1 1
1 1
1
1 1
1
1
1
1 1 1
1 1
1 1
1 1 1 1 1
1
1 1 1
1 1 1
1 1
1 1
1 1
1
1
1 1 1 1 1 1
1
1 1
1 1 1 1 1 1
1
1
1 1
1 1
1
1
1
1 1
1 1
1
1 1 1 1
1 1 1
1
1 1
1 1 1
1
1
1 1 1
1 1
1 1 1 1
1 1
1
1
1 1 1
1
1
1
1
1 1
1 1
1
1 1
1 1
1 1 1 1 1
1 1 1 1 1
1 1 1
1 1 1
1
1
1
1
1 1
1 1
1 1
1 1
1 1
1 1 1
1
1 1
1
1
1
1 1 1
1
1 1 1
1 1
1
1 1
1 1 1 1 1
1 1
1 1
1
1
1 1
1 1
1 1 1 1 1
1 1 1 1 1
1 1 1 1 1
1
1 1
1 1
1 1 1 1 1
1 1 1 1 1
1 1
1 1
1 1
1 1
1 1
1 1 1
1
1
1 1
1
1
1 1 1 1
1
1
1
1 1
1
1 1
1
1
1 1 1 1
1
1
1 1 1
1
1 1
1
1 1
1 1 1 1
1 1
1 1
1 1
1
1
1
1
1 1
1 1 1 1 1 1
1 1
1 1
1 1
1 1 1 1
1 1
1
1
1 1
1 1
1 1
1 1
1
1 1
1
1
1 1
1 1 1 1 1
1
1 1 1 1 1
1 1 1
1 1 1
1 1
1 1 1
1
1 1
1 1 1 1
1 1
1
1
1 1
1
1
1 1 1
1 1
1 1 1 1
1
1
1
1 1 1 1 1
1 1 1 1
1
1
1 1
1
2
1 1
1 1 1
1
1 1 1 1 1
1
1
1 1 1
1 1
1
1 1 1 1
1 1 1
1
1
1 1
1 1
1 1
1 1 1
1 1
1 1
1 1
1 1
1 1
1
1 1 1 1 1
1
1 1 1 1
1 1
1
1 1
1
1 1
1 1 1
1 1 1 1 1 1
1
1 1 1
1
1
1 1 1
1 1
1
1 1
1
1 1 1 1 1
1
1
1
1
1 1
1
1 1 1 1 1
1 1 1
1 1 1
1 1 1
1 1
1
1 1
1 1
1 1 1 1
1 1
1 1 1
1
1
1
1 1
1 1
1 1 1 1 1
1 1
1
1 1
1
1
1 1 1
1 1
1 1 1 1 1 1
1 1 1
1 1
1 1
1 1
1 1 1 1 1
1 1
1 1
1
1 1
1
1
1 1 1
1 1
1 1 1 1
1 1
1 1 1
1 1 1
1 1 1 1
22 2 25 0 51 9 11 0 4 2 18 0 12 1 3 1 47 6 3 1 43 5 1 2 43 5 32 20 94 78 38 16 61 47 29 13 50
UA BTA TG FL
P L P L P L P
L B L B L B L B L B L B L
1
1
1
1
1
1
1
1
1
1
1
1
1 1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
37 1 0 0 0 2 0 0 1 0 0 0 0
BULAN : AGUSTUS
TAHUN : 2022
UMUR No.ID/ NIK / Jenis Kunjungan

TGL NAMA DL HB
(THN) BPJS/ KIS
L P L P L P
1 NANI WIDYANTI 47 1
YULANDA 21 1
SABARIAH 41 1
SOFYAN 57 1 1
SAHRA 39 1
TINJUARYINI 27 1 1
ELY FITRIANI 19 1 1
ABDUL AZIZ 67 1 1
ROHIANA 34 1 1
MARYAM 68 1 1
NURSILA 18 1 1
HJ. RABAYAH 69 1
FITRI MEDIANA 33 1
KARIMUDDIN 52 1
SITI SUMARTINA 59 1
NURDIN 51 1 1
YULIANA OKTARIANA 18 1
ATAYA IBRAHIM 7 1 1
RAYAAD TULNAFSIAH 13 1
LUQYANA IMET 15 1
NORA RIZKINA 26 1 1
2 KAHARUDDIN 69 1
NURAINI 44 1
FARTINI 27 1 1
M. AFKAR 61 1 1
NURHAYATI 58 1
FITRI YUNIK 19 1 1
HANIFAH 22 1
ELYANA 53 1
SRI YULIANTI 52 1
PITRI WINDA 28 1
RIKI 36 1
3 ABDUL KADIR HAMID 75 1
DEVI MASNIWATI 49 1
ARDIANSYAH 40 1 1
ERNA 53 1
SANTI NOVRIANI 35 1
PUTRI MAYA 38 1 1
RIN IAPRIANI 38 1
MURTINI 33 1 1
M. ARIFTA 7 1 1
MISNAH 48 1
KALSUM 60 1
PUTRI MAESARI 29 1
HADIZAH 62 1
LALU KADRI 45 1 1
YULIA NARAMIKA 16 1 1
HEPI PITRIADI 34 1
INTAN 18 1 1
MASTIKA 26 1
HAWAIDA 38 1 1
YOGI SURYA 18 1
KARTIKA 17 1
DEKHA ADEKANTARI 19 1
4 YUN MASTIA 68 1
PUTRI MIFTAHUL 7 1 1
ISMI SALWA 20 1 1
ERNI NAMIRA 41 1
M. SALEH 78 1 1
HJ. KABNATIAH 56 1
HJ. SALMIAH 68 1 1
SITI HAJA 27 1
AISYAH 76 1
DEWI ISNAWATI 50 1
A.RAHMAN SURI 67 1
AQIFAH 9 1 1
H. UMAR 52 1
RAMLI 33 1
SUMIATI 26 1
ATIKA 26 1 1
LILIS 23
ELI 40 1
SUMAIYAH 62 1
RAIHAN 52 1
CITRA 45 1
FENI 19 1
ZULIANDA 29 1 1
RAMLI 39 1
MAEMUNAH 54 1 1
SYAMSUL 43 1
RIAN 21 1 1
5 LELI KARLINA 29 1
PUTRI ADELIA 19 1 1
MADIANI 38 1
MUSTINI 30 1 1
TENDRI ADENG 49 1
YENI ROSTILA 25 1 1
ASMIRANA 78 1
SITI 26 1
ZAHRA 57 1
MAHARANI 53 1
SRI WAHYUNINGSIH 23 1
HASNAINI 51 1
HJ. RAWE 70 1
SUPARDI 50 1
ERNIATI 32 1 1
ZUWANTO 38 1
SITI HAFSAH 48 1 1
NAPIL ARDIANSYAH 18 1
ZILFIYA 30 1
DANI 16 1
ARINI F 49 1 1
DYAMAS 18 1
AHMAD 18 1
ERI IRIANTI 31 1 1
6 RENU 21 1 1
HADIJA 68 1 1
7 ZAINUDDIN 58 1 1
HADIJA 61 1 1
TITIN AGUSTIN 28 1 2
NANI 21 1 1
8 SAIFULLAH 43 1 1
, AGUS 44 1
MAEMUNAH 67 1 1
AFIL HENI 20 1 1
NURUL 25 1
MARHAINI 44 1 1
ARDIANSYAH 52 1
ABDULLAH 67 1
NAWIRAH 46 1
FAHRUDDIN 61 1
AHMAD JUNAIDI 47 1 1
JAMALUDDIN 36 1 1
LILIKA 36 1 1
DODI 24 1
AYU 19 1 1
ZAHRA 57 1
SITI AISYAH 33 1 1
YUNITA 16 1
SHANY 36 1
AMRAH 39 1
RAMLAH 39 1
M.NAGA 2.3 1 1
PAULINA 30 1 1
HERU 38 1 1
SALWA 60 1 1
SUPIATI 24 1 1
HAZIZ 28 1
MINARTI 32 1 1
MUH DWI 31 1 1
HALIMATUSSADIAH 24 1 1
9 PAULINA GONO 30 1 1
HALIMATUSSADIAH 28 1 1
SIFAWATI 69 1
M. AMIN 50 1
SAENAP 53 1
WAHYUDI 42 1 1
SINTA ANDRIANI 30 1 1
MEHRAM 37 1 1
SYAHRIR 52 1 1
ST. AISYAH 37 1
SRI LANGI 56 1
FARTINI 29 1 1
PUTRI NABILA 15 1
ADINDA PUTRI 5 1 1
LASMI 26 1 1
MINATI 44 1
SRI YULIANI 42 1 1
SADARUDDIN 71 1
VIRDA Q 18 1
NURMAYANTI 20 1 1
ERNA H 39 1
RIZKI AMALIYAH 18 1
ANDRAWAN 41 1 1
TRI DASMAYANTI 24 1 1
10 A RAHMAN 48 1
ISNAWATI 44 1
ALI RAHMAT 48 1
ERNA 34 1 1
RINI 31 1 1
ROSTIKAWATI 33 1 1
TINA A. 20 1 1
11 YENI AFRIANI 20 1 1
KAROLINA B 50 1 1
HALIMA 21 1 1
AHMAD JUNAIDI 49 1
SYARAFUDDIN 74 1
DENI OKTA 22 1
DEVI MASNIWATI 49 1
MARISA 30 1 1
M. IKHSAN 9 1 1
BIAWAN 44 1 1
DIAN PEBRIANTI 24 1 1
MASJINI 38 1 1
SAHARIA 68 1
SUSIANI 30 1 1
MARDIANA 28 1 1
AAN 19 1
ROHATI 35 1 1
HAMDAN 72 1 1
RUDI SUSANTO 38 1
ELY FITRIANINGSIH 55 1
HAFSAH 71 1 1
HASNAWATI 48 1 1
RESTU SAPUTRA 20 1
SEPTI KURNIA 22 1
EMI 23 1
HALIMAH 27 1 1
NASARUDDIN 35 1
AMIR ZIAD 24 1
12 M. SALEH IDRIS 56 1
HALIMAH 27 1 1
WAZAHIRI 48 1
MUSTARAM 63 1
AMAL ZIKRULLAH 2 1 1
MIRSAH 52 1
HASANUDDIN 41 1 1
QONITA ADELIA F 8 1 1
MUHAMMAD ASYRAAF 8 1 1
HJ. SADARIAH 61 1
DESI 30 1 1
NURHAYATI 74 1
HALIM 41 1
FERI ERLENDA 22 1
HINDRAWATI 28 1 1
SHOPY M 26 1
SRI WAHYUNI 33 1 1
YUYUN 36 1 1
RISKA 22 1 1
13 RAFIAH 50 1 1
KARIMUDDIN 52 1
14 RITA ROSDIANA 39 1 1
15 FATIMAH 44 1 1
HADENA 52 1
DARMIATUN 52 1
SABARIAH 62 1
ZAINUDDIN 52 1
SUSILAWATI 59 1
BAHRI 18 1
AAN APRIANI 25 1 1
SAHARIA 68 1
MAESAROH 28 1
SANIA 67 1
FITRIANI 37 1
ZAINAL ARIFIN 47 1
A. MUIS 48 1 1
RITA 37 1 1
ANNISA 21 1
A RAHMAN 63 1
YUNDA T 36 1 1
AHMADI 62 1 1
NORASIAH 50 1 1
JUMIATI 49 1 1
AISYAH 71 1
PALA 60 1
ALMI 50 1
HALIMA 46 1
EKA 30 1
RAHMAWATI 60 1
MUHAMMAD SYAFII 47 1
KHAIRANI 39 1 1
M YUSUF 52 1 1
ERNI YUSNITA 41 1
DEVI ARISNAWATI 24 1 1
MOH ANHA 48 1
AZMAR KEMAL 26 1
ROSDIANA 45 1
IKA HERAWATI 27 1 1
DEDI HARTONO 25 1
LINDAWATI 36 1
OSCHAR JIHAD 20 1
16 FATMA 45 1 1
MEHRAM 37 1
INDRA SASTRIAWAN 14 1 1
SHARAH ARTIKA P 27 1 1
SYAHRIR 53 1
SRI RAHAYU 31 1
SRI HARTATI 48 1 1
AMIRIN 58 1
HADIJAH 49 1
RIZKI RIZALDI M 22 1
ZULKIFLI 32 1
FITRI ADEKAMTARI 25 1
SURIANI 46 1 1
YUYUN PRIHATIN 33 1
USMAN 48 1 1
MUSTIKA 48 1
HASMIATI 39 1 1
TIARA APRIANI 25 1
SAMSIA 47 1
MARNIATI 41 1
ARDIANSYAH 18 1
IWAN SUSANTO 45 1
SOMPAH 60 1
HERYANTO 66 1
CAHAYA PUTRI 2.8 1 1
AQILA 9 1
HASAN DEANG 60 1 1
17 MAHSUR S 53 1 1
18 MINARNI ELISA 36 1 1
MARS A 44 1 1
ARINI F 30 1 1
DEWI KOMALASARI 44 1
SRI YULIANTI 48 1
NURAIINI 51 1
SYAHRIL 23 1
HJ.LILY 58 1
M.AMIN 53 1
MATSUN 52 1
NURHASANAH 44 1 1 1
YULIANA 23 1 1
LENA 31 1
SABARIAH 62 1
MINARNI ELISA 36 1 3
HJ.LILY 58 1
AMINAH 52 1
HENDRA 27 1 1
PUTRI 40 1 1
LIANA 20 1 1
NURHAYATI 68 1 1
SYAFRUDDIN 26 1
NADIMAS 18 1
19 BURHANUDDIN 64 1 1
HAYATUNNUR 44 1
BIJE 28 1
TATA WIDIANTO 64 1
SUGIANI 37 1 1
M. JAFAR 1
SYAMSIAH 46 1
DAFA 2.5 1 1
ERNA 46 1
HIKMAH 46 1
RAMLAH 39 1
ROY 19 1
HASANAH 57 1
RUSMIANI 24 1
YUSIIHATUN 38 1 1
BAIQ SALIHIN 41 1
ELSA 16 1
NITA 15 1
ASMAWATI 35 1 2
20 JOHARI 52 1 1
SANAWIYAH 45 1 1
RAHMAN 45 1 1
22 HAMZAH 63 1
NILAWAN 63 1
SALMAH 54 1
M.YUSUF 59 1 1
OUTRI 24 1
EMILDA 35 1 1
KARLINA 26 1
ADAM 58 1
RUDI SUSANTO 44 1
HIKMAWATI 45 1
SAIKHA 56 1
RAIHAN 45 1
FAUZI 54 1
NANANG 42 1 1
AMELIA 47 1
AYU 20 1 1 1
ARFAN 29 1
SIYAS 65 1 1
NURSURIANI 37 1 1
SABARIAH 20 1 1
M. YUSUF 25 1 1
23 SANA'AH 44 1
NANIK 44 1
WAHYU ADITYA 13 1 1
MUKMINAH 59 1
M. NURDIN 73 1
ENDANG KASWATI 59 1 1
SULAIMAN 60 1
ASIA 53 1
NURJIHAD 27 1
NURAINI 24 1 1
YULIYARMAN 42 1
NURAINI 46 1
HELMI 53 1
M. ZULFIKAR 18 1
NURAINI 37 1
SOBA AL-QADRI 26 1 1
ZALALUDDIN 45 1
ABDUL GANI 20 1
24 HAFSAH 61 1 1
SITI ZUBAIDAH 58 1
SANAPIAH 58 1 1
NURDIN AYUB 59 1 1
RAHMAYANTI 15 1 1
RATNAWATI 52 1
HJ. MARYAM 83 1 1
ELI ANDRIANI 30 1
SAMSUL 52 1 1
SITI AISYAH 64 1
HAIRUL BARIYAH 26 1 1
MASITA 37 1
ARY WAHYUNI 46 1 1
INDAH 47 1 1
NURHAYATI 37 1
FANNY 19 1 1
HALIMAH 25 1 1
TIKFIAH BAGIS 48 1
HJ. JALINAH 95 1 1
SALMIAH 68 1
NASRUDDIN 33 1 1
25 HARTAWAN 49 1 1
NURDIN AYUB 59 1 1
FITRIYANI 34 1
FIDIATUL 29 1 1
SITI RAHMAH 55 1
IBRAHIM 63 1 1
NANING 37 1
NANSIADEKAYANTI 31 1 1
MURTIAH 56 1
MAEMUNAH 53 1
FATY 53 1
ELI 34 1
YULI ASTRIANI 38 1
FIRA 35 1 1
MINARNI ELISA 36 1 1
ETY AMBAYANI 42 1
RASAHUTIADIN 27 1 1
ERNAWATI 27 1 1
ASMA 33 1
MAULANA 20 1
HASNA 21 1
RANENDRA 31 1 1
NANDA 19 1
SUHARDI 28 1 1
26 MASNIATI 46 1
MAWARNI 50 1
ANISAH 43 1
NURSIAH 56 1
MASTARI 37 1 1
SITI KEIRA 13 1 1
A.RAHMAN 57 1
SANAPIAH 59 1
IBRAHIM 17 1 1
ELLENA 43 1 1
HADIATULLAH 50 1 1
SAHARIAH 5 1
ASMAWATI 23 1 1
YENI 15 1 1
27 SURYANINGSIH 30 1 1
28 I GEDE 60 1 1
RIRIN 19 1 1
RIA ADE KANTARI 46 1 1
ABDL MANAF 52 1 1
29 SURNANINGSIH 50 1 1
DEVI 39 1
DANI 40 1
H. MUSTAR 68 1
PUTRI AYU 23 1 1
AMNAH 42 1
ERNA 57 1
HERNA 34 1 1
FARTINI 28 1 1
KADAFI 5 1 1
SITI DURIAH 30 1 1
SYARHREM 55 1
ABDUL MANAF 51 1 1
KAMARIAH 70 1
LENI 30 1 1
NURUL HUDA 50 1
REZA 2 1 1
HASBI 35 1
SUPIATUN 75 1
RAHMIATUN 54 1
ERNIWATI 45 1
NURJANNAH 53 1
ASMAWATI 51 1
SAIPAH 54 1
KHAERANI 36 1
JOHNY 26 1 1
NURHASANAH 45 1
NORMA 68 1
SYARAFUDDIN 58 1
PUTRI 9 1 1
CELA 77 1 1
HUDAIDAH 61 1
DEA 11 1
SYARAFUDDIN 58 1
ERNA IDAWATI 46 1
ASEP 46 1 1
I MADE BUDI 49 1
ELY SUSANTI 43 1 1
30 AHMAD BIUN 58 1
H. AHMAD LI 77 1
M. TAHIR SAFI'I 68 1
IRMANSYAH 60 1
RAFI'AH 66 1
SUMIATI 30 1 1
RATUATY 64 1
NURHAYATI 58 1
NADIA 52 1
HJ. FATMAH 46 1
DEA NAURA ATIRA 11 1 1
NURZANAN 59 1 1
REVAN 3 1 1
MARDIANA 19 1 1
KARIMA ZULFIANI 18 1
ARDIANSYAH 42 1
SAFITRI A 34 1 1
SURYANINGSIH 30 1
31 SRI HANDAYANI 60 1 1
H. ISKANDAR 76 1
SAHRIL 19 1
ASMAWATI 33 1
DEVI 30 1
MURNIATI 42 1
INDRA SAMUDRA 45 1 1
ZAINAL ABIDIN 49 1 1
AFIZA 12 1 1
M. IKBAL 36 1
NURAINI 35 1
DEA NAURA 11 1 1
MURZALI 58 1
SITI AISYAH 37 1 1
BADARIAH 66 1 1
HAMIDA 19 1 1
DESI RATNASARI 23 1
SUUD 48 1 1
TIARA 16 1 1
120 48 209 135 55 11 63 29 1 1 68

PROGRAM PELAYANAN KESEHATAN GRATIS PADA PUSKESMAS DAN JARINGANNYA
JENIS PEM
URINE
HB GD MAL WIDAL IgG/IgM/NS1
PROT UL PPT
P L P L P P L P L P L P L
1 1
1 1
1
1 1
1 1 1
1 1 1
1
1 1
1 1
1
1
1
1
1 1
1
1
1
1 1
1 1
1 1 1 1
1
1 1 1
1
1 1
1
1
1
1
1
1 1
1 1 1
1 1
1 1
1 1
1 1 1
1
1
1 1
1
1
1 1 1
1
1 1
1
1
1
1
1 1
1
1 1
1
1
1 1 1
1 1
1 1
1 1
1
1 1
1
1
1
1
1
1 1 1 1
1
1
1 1
1 1
1
1
1 1
1
1
1
1
1
1
1
1
1 1
1
1
1
1
1
1
1 1
1 1 1
1
1 1
1
1
1
1 1
1
1
1
1
1
1 1
1
1
1
1 1
1 1
1 1 1
1
1
1
1
1
1
1 1 1
1
1
1
1 1
1
1
1
1
1
1 1
1 1
1
1 1
1 1
1 1
1
1 1
1
1
1
1 1
1 1
1 1
1 1 1
1
1 1
1
1 1
1 1
1
1
1 1
1
1
1
1 1
1
1
1
1
1
1
1
1
1 1
1 1
1
1
1
1
1
1 1
1
1
1 1
1
1
1
1 1 1 1
1 1
1
1 1
1
1
1 1
1
1 1 1
1
1 1
28 0 0 18 18 18 12 19 9 32 7 31 0 43 1 4 1 60 4 0 0 0 0 6 1
DAN JARINGANNYA
RAT
JENIS PEMERIKSAAN
IgG/IgM/NS1 HBsAg ANTI HIV SIPILIS GULA CHOL UA
P L P L P L P L P L P L
1 1
1
1
1
1 1 1 1
1 1 1 1
1 1 1
1
1 1 1 1
1 1
1
1
1 1 1 1
1
1 1
1
1
1 1
1
1 1 1 1 1 1
1 1
1 1
1
1 1 1
1 1 1
1
1 1 1 1
1 1 1 1 1
1 1 1
1
1
1 1
1 1 1 1
1 1 1 1
1 1
1 1
1 1
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1 1
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1 1 1 1 1
1 1
1
1 1
1
1 1 1 1 1
1 1 1 1
1
1
1 1
1 1 1
1
1 1 1 1
1
1
1 1 1
1 1
1 1 1 1
1 1
1
1 1
1
1
1
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1 1
1
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1
1
1
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1
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1
1 1
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1 1 1 1
1
1
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1
1
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1 1 1 1 1 1
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1
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1
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1
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1
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1
1
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1
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1
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1
1
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1
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1
1
1
1 1
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1
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1 1
1 1
1
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1
1
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1 1 1
1 1
1
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1 1
1 1
1
1 1
1 1
1 1 1 1
1 1 1 1 1 1
1
1 1 1
1 1 1
1 1
1
1 1 1
1 1 1
1
1 1
1
1 1 1
1 1
1 1 1 1 1
1
1
1
1 1
1 1 1 1
1
1
1 1
1
1 1 1
1
1 1 1
1 1
1 1
1
1 1 1
1
1
1 1
1
1 1
1 1
1
1 1 1 1
1 1 1 1
1
1 1
1 1
1 1
1
1
1
1 1 1
1 1
1 1 1
1 1 1
1 1
1 1
1 1 1
1 1 1
1 1 1
1 1 1
1 2
1 1
1
1 1
1 1
1
1
1 1
1
1 1
1 1
1
1 1
1 1
1 1 1
1 1
1 1 1 1
1 1 1 1 1 1
1 1 1
1 1 1 1
1
1
1 1
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1
1 1 1
1
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1
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1
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1
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1
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1 1
1
1 1
1 1
1
1
1 1
1 1 1
1 1
1 1
1 1 1
1
1 1 1
1
1 1
1 1 1 1
1 1
1
1 1
1 1 1
1
1 1
1 1
1 1
1 1
1 1
1 1
1 1
1 1
1
1 1
1
1
1 1
1 1
1 1
1 1
1 1
1 1
1 1
1
1 1
1
1 1
1 1
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1 1 1
1 1
1 1 1
1
1
1 1
1 1 1 1 1
1 1 1 1
1 1
1 1 1 1
1 1 1
8 1 7 2 60 8 5 2 56 7 6 2 58 7 38 31 91 111 36 32 53 73 34
UA BTA FL TG
L P L P L P L P
1
1
1
1
1
1
1
1 1
1
1
1
1
1 1
1
1
1 1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
27 40 48 2 0 0 3 0 0 0 0 0 1 0 0
BULAN :JULI
TAHUN : 2022
Jenis Kunjungan
TGL NAMA
(THN) BPJS/ KIS
L P L P L P
B L B L B L B L B L B
1 HASMIAH 31 1 1
M. ALI 60 1 1
MIA ASTUTI 34 1
ROSMAWATI 39 1
RAHMANUDDIN 54 1 1
RIDOAN AL-HAKIM 1 1 1
HANIPAH 46 1 1
ASIA 51 1 1
DIRA SASMITA 20 1 1
RISKA FATMAH 25 1
RIAN 25 1 1
FATRIATUN 38 1 1
RUSTIANTO 52 1 1
HAPSAH 28 1 1
DINA WARDA 17 1
2 YUNITA ERICA 21 1 1
YUNI FITRIANI 37 1 1
3 YUNI ERICA 21 1 1
4 A. RAHMAN 47 1
ATIJA 56 1
EGI PRAGOYI 25 1
TENRI ABENG 48 1
ENDANG 38 1
DANA SAPUTRA 38 1
ZAINUDDIN 64 1
RANI SUSANTI 42 1 1
NAIF PANGESTU 13 1 1
H. ZAINUDDIN 51 1
MASANGAN 71 1
HAMIDAH 51 1
FARADILA 24 1 1
HARIANTO 29 1
ROYANTO 38 1
DEILLA APRILIA 22 1
A.F. ALTRA 19 1
NURHAYATI 57 1
HADIJAH 28 1 1
HIDAYAT 20 1
MUSTIKA 27 1
RENU SAPUTRI 24 1 1
DESFYAN JAYANTO 18 1
DARAIYAH 63 1
SUSMITA SRI A 21 1 1
NINA SARTIKA P 24 1 1
SALMA 49 1
ROSDIANA 33 1 1
FILDZA A. F 17 1
ANDRIANI FEBRIAN 24 1 1
REHANUN 18 1 1
RUSDIANA 33 1 1
AMILIA B AULIA P 21 1 1
DELA ADELIA 23 1 1
5 HADENA 39 1 1
YUNI ASTRI 25 1 1
NILAWAN 41 1
MUDARTI 45 1 1
IMAM HIDAYAT 30 1
AMAR HARIS 24 1
RAMLAH 65 1
SAHIDUN ARSIM 37 1
SITI AISYAH 30 1 1
ESTI ERNAYANTI 27 1 1
LULU ANDI K 18 1
AYUN 59 1
LILY ANGGRAINI 40 1 1
SALMAH 59 1
MARLIA 39 1
JUWERIAH 41 1
RIKA APRIANA 25 1 1
RENI H 27 1 1
GITA P 18 1
AULIA S 2 1 1
SUPIANTO 38 1 1
6 SUPIANTO 38 1 1
BIDASARI 65 1
HADILA 63 1 1
SUKEMI 66 1 1
MARDIANA 47 1
TUTI HARYANI 56 1
ABDUL AZIS 43 1
FARIDA 44 1
ELIYAH 30 1 1
SULHAINI 37 1 1
ROZIAH 43 1 1
ASMILA 30 1
HJ FATIMAH 49 1
MASTIKA 26 1
IMA 5 1 1
YUNITA ANGGRAINI 32 1
NURHAYATI 55 1
HERU M 38 1
HERIKA D 21 1 1
7 SUPIANTO 38 1 1
ANDI LALA MANLAMA 47 1
AMINAH BT.M TAHIR 46 1 1
MARDIATUL 39 1 1
MASJINI 38 1 1
IIN MAESAPITA 27 1 1
ERIKA AGUSTINA 18 1
SYAHRULLAH 27 1 1
RITA ROSDIANA 39 1
MASITA 56 1
FEBBY YARA A 16 1 1
DEDEN PURNAWAN 39 1
NIYOOSHA 2 1 1
NURLAILI 26 1 1
SUHARDI 63 1
YUNI ANGGRAINY 38 1 1
ETI 41 1 1
MUKMIN 48 1 1
FAIZAH A 17 1
AHMAD PRAYOGI H 13 1
MARDIANA 37 1
8 JOHARIAH 37 1
SITI MINAH 1
AYUDIA AISYAH 1 1
EGA SETIA LESTARI 23 1
MARWAH HAMIDA 15 1 1
RAHMIATI 42 1
SARJANA IRFAN 58 1
MARISA 30 1 1
RAODA 42 1 1
FARIDA 57 1
INTAN P 30 1 1
FAHRIANI 48 1
HADENA 39 1 1
9 HJ. HAYATI 60 1 1
10 TITIN 23 1 1
VIVI 20 1 1
11 SURYA 42 1 1
ABDULLAH 65 1
INDRA 43 1
FEBBY YULIANDARI 25 1
SITI NURKIYAH 53 1 1
MAHMUD M SALEH 72 1
TURWANTO 44 1
LINA KARLINA 24 1 1
IBRA 6 1 1
ALIFDAWANKA 2 1 1
AREFUDDIN 49 1
SUSI SUSANTI 24 1 1
TITA MELIZA F 26 1 1
NURLAILA 38 1
PAULINA GONO 30 1 1
NURSILA J 6 1 1
NURIYA 23 1 1
12 JANARIAH 64 1
SARTINA 32 1 1
FERA FAZIRA 19 1 1
NI WYN SEKARDIAWATI 51 1
SINTA 26 1 1
RIKA 25 1 1
RUDIANA 26 1 1
WILDA 24 1 1
OLGA DWI RISKA 21 1
MADIANAH KHAIRONI 31 1 1
HADIYANI 73 1
HJ. RABAIYAH 59 1
DEWI 32 1 1
WINDA 31 1 1
BAMBANG PURWANTA 53 1 1
MAYTA 37 1 1
HERMIATI 49 1
SAHEMA 51 1
YEYEN A 26 1
DARUSSALAM 50 1
NAYTA SAFRITA 38 1 1
ISMAIL 28 1 1
CINDAWAN 41 1
DEWI SARTIKA 35 1
YENI ARDAYANTI 32 1 1
EPA RATNASARI 24 1 1
13 HASANUDDIN 41 1
RAJEMA 66 1 1
SULAIMAN 57 1
LIDYAWATI 38 1 1
BUDIR 58 1 1
HAFSA 62 1 1
DEDI IRAWAN 40 1
HARIATI 36 1 1
FATIMA 44 1
SABARIAH 42 1 1
LEASARI 15 1 1
WINDA APRIANI 22 1 1
NILA 30 1 1
ERNI YUSNITA 41 1
HENI RAHMAWATI 31 1
ABDURAHMAN 20 1 1
SALMAH 60 1
SUKEMI 66 1 1
JAYADI 28 1
PEFA NATILATA FILAULA 15 1
HERU MARDIANSYAH 38 1
JUMAIDI 19 1
TAUFIKURRAHMAN 19 1
NORA TAMASTI 18 1
INDRA WISANATA 19 1
14 NANI IDAYANTI 47 1
ZUMINAH 60 1
dr. FAIZAH 35 1 1
MAWARIA 50 1
RUKMINI 51 1
GUNAIYAH 56 1
DARTUTI 36 1 1
SYAMSIAH 48 1
HANISA 53 1
MASCIMBUAN 56 1
MIRSAH 52 1
ATHIYYAH 17 1
MARIANI 38 1
ENI PURWATI 43 1
INGKI F 17 1 1
SUMIANIK 60 1
RIZKI EWADIA 35 1
FIRYAL HASANAH 25 1
SANDI SANJAYA 35 1
LALU RIZAL AHDI S 40 1
SASKIA 31 1 1
15 USUP SUPRIATNA 53 1
RATNAWATI 25 1 1
RIYA 25 1 1
NURHAYATI 29 1 1
HERWANSYAH 46 1
NURAINI 27 1 1
FATTHUL JANNAH 30 1 1
LILI SUSANTI 34 1 1
USWATUN 22 1 1
ARINI FITRIANI 49 1 1
RISKA 30 1
SRI NURMALA 43 1 1
16 KARNILAWATI 32 1 1
ANDI TALLO 59 1
MARIA TRIANINGSIH 26 1
SITI MAIMUNAH 52 1
ERWIN WIJAYA 43 1
SATRIANI 33 1 1
ABDULLAH HS 62 1
HATMA 35 1
HARIANINGSIH 35 1
HJ. FATIMAH 67 1
AB. HADI 54 1
SITI NUR 82 1
MAWARIA 50 1
MASANGAN 51 1
WIDAN 22 1
M. SADE 64 1 1
SAPAIYAH 15 1
MARWAN 30 1
HERU SUMBAWANTO 21 1
M. HANDI 34 1
EMA WARDANI 1 1
GITA DINDA 23 1 1
ELZA MARDANA 15 1 1
ROMLAH 38 1 1
MAULANI DWI 22 1 1
NURAINI 46 1
ALBY ROZALVINO 19 1
DINA DITA NATASYA 19 1 1
CITRA SETIA 25 1 1
ILAN NURHAYATI 29 1 1
NENI SAFITRI 27 1 1
MARYAM 71 1
SANJUNG OKRIVINADI 19 1
AHMAD PIQRI 22 1
KARNILAWATI 32 1 1
NUR WAHIDAH 30 1 1
19 NANDA DATU 19 1
MUKMINAH 59 1
ZUMAIYAH 57 1
HADIATULLAH 58 1
ZILVIA 30 1
JESI H 19 1
DR MERTA 1 1
ZAHRAH 44 1
SURPIANTI 35 1 1
SRI WULAN 32 1 1
NURAINI 37 1 1
WIDHIE A 20 1
NURHAYATI 37 1 1
YULIANA 28 1 1
RIYAN ABI 27 1
SYARIDUDDIN 44 1
KASBULLAH 35 1
MAHDI 32 1
ERIN SARTINA 31 1 1
WARNI 41 1 1
ARNAS TIONA OZA 22 1
SANTY NOVRIANI 35 1 1
A.RAHMAN 25 1 1
NASRUDDIN 47 1
20 INAYAH 40 1
SUMARNI 1
HAMIDAH 50 1
NAZILA PUTRI 8 1 1
FARIDA 31 1
SULAIMAN 60 1 1
ZAINAL FUAD 51 1
MAKASAU 76 1 1
NURMIAWAN 61 1 1
DEFITA SARI 30 1 1
SRI RAFI'AH 44 1
NOVITA NUR HIDAYAH 13 1 1
21 HAMZAH HASAN 69 1
MASAAT UBUD 65 1
SALMAH 54 1
AZRUL ALI 21 1
ARI RAKASOMI 22 1
NURSIAN 24 1
NURSAMIN 76 1
LILI RABIATUL 33 1
MASANGAN 51 1
RAHMAWATI 50 1
PUTRI ADELLA 19 1 1
SUSULAWATI 31 1 1
ABU BAKAR 43 1
FAUZI AZIZ 54 1
YAYA 27 1
HEMI 44 1 1
SALMAH 43 1
SOLEKHAN 55 1
RAHMAD 20 1
SITI WIDAYANTI 1
ERNI SUPIYANTI 1
SITI AISYAH 1
AGUS SALIM 21 1
RIAN S 18 1
ANTO WIJAYA 20 1
22 KAPRI KARNI 25 1
WANDA IRAWAN 27 1 1
IRMA 27 1 1
HAIRUL 32 1 1
IRMA DAMAYANTI 18 1
JUHRIADI 50 1
23 DESI 30 1 1
RAHMAD 42 1
M. YASIN 46 1 1
24 DESI SUSAN 30 1 1
USNIATUN 22 1 1
SUBAIDAH 45 1 1
25 USNIATUN 22 1 1
ASTUTI 55 1
ZAINAL ABIDIN 69 1
NURFAIDAH 35 1
CANDRA 49 1
MARYAM 68 1 1
INTAN 23 1 1
SYARIFUDDIN 38 1 1
NURAINI 37 1
HADNAH 66 1 1
ABDUL LATIF 68 1
SAHYAM 58 1
RENI SAFITRI 21 1 1
ALEA ARIANI 16 1
PASYA ANUGRAH 10 1
RIYAN APRILIAN 28 1 1
SUMIATI 52 1
SALEHA 49 1
ZUBAIDAH 42 1
HAJAR SRIMULAN 30 1 1
MIMI 38 1
RENU 21 1
AQIL ALBI 4 1 1
PUTRI 7 1
YULIA 28 1 1
NURMIAWAN 61 1 1
UMAR YAHYA 46 1
ALFINA 18 1 1
SARTINI 27 1
ARDIANSYAH 40 1 1
HALIMA 27 1
26 NOVI 1 1
INDRA 43 1
LALA INTAN SAGINA 18 1
HERI SUPIANTO 47 1
CACA 11 1
SAHORA 57 1
TITIN AGUSTINA 27 1
HJ. SAPIAH 57 1
SYAMSU HADI 62 1
GAMAR 58 1
SAMSIAH 47 1
ISKANDAR 56 1
PAULINA GONO 28 1 1
AGUSTINUS 28 1 1
JUPRI 61 1
ANDI OKTARIADI 20 1
NURJANNAH FATAHOLA 53 1
SINARANI 52 1
RIDWAN 37 1
ARDIANSA 22 1
EGI 21 1
BQ. VINA 23 1 1
RUSMIN 40 1 1
27 NURIYAH 52 1
RUSMINISAH 31 1 1
SITI HADIJAH 69 1
BEATRIX PANGAU 77 1
AMRANSYAH 54 1
NURHASANAH 42 1
NIGNSIH 19 1 1
M AUFA 8 1 1
SAHORA 53 1
HIDAYAT IMBIK 52 1 1
HANDI J 27 1
SAHRA 50 1
NILA WAHYUNI 27 1 1
MASRI 61 1 1
MUHAMMAD SALEH 48 1 1
RIRIN HAIRUNNISA 19 1 1
ULANDARI 27 1 1
MAKAINTAN 42 1 1
M. AKBAR 19 1
DANASUPARJA 28 1 1
NALDI N 18 1
28 RESTI 23 1 1
MASURUNG 57 1
HALIMAH 53 1
NURHAYATI 32 1 1
BAHARUDDIN 71 1
RAHMA 61 1
SUMIANTI 25 1 1
ABDUL ASIZ 65 1 1
WIHARTI 39 1
SYAIFULLAH 41 1 1
MARIANA 41 1
BUNYAMIN 50 1
SITI AISYAH 63 1
RAHMIATUN 53 1
RENI NINGSIH 32 1 1
DR. FAIZAH 35 1 1
AGIL AMNESTA 7 1 1
MUNHAINI 56 1
TELLASARGHI 39 1
ARQIA ARILA 8 1 1
JAMAL 35 1
MARIHAN 28 1 1
NILAWATI 30 1 1
NORMALA 60 1 1
LILIS TARI 27 1 1
NOVA ALRIANTI 22 1 1
29 LILIS TARI 21 1 1
NOVA ALRIANTI 22 1 1
RESTI 22 1 1
HERLINA 35 1
WASNIATI 46 1
ROSDIANA 48 1
LALU RUSDIANTO 20 1
KALSUM 51 1
SRI HARTATI 54 1
MARYAM 70 1 1
JUSRI 61 1
HALIMAH 58 1
SYAFARUDDIN 65 1
NASRUDDIN 58 1
HARTAWAN 49 1 1
AMRIZAL 10 1 1
30 FITRI 13 1 1
TRIYAH 45 1 1
SITI NURLIS 57 1 1
31 YONA 15 1 1
NURSIAN 25 1 1
SURIATI 36 1 1
SAPARUDDIN 49 1 1
DWI RIZKI 30 1 1
FITRI 22 1 1
84 48 215 120 11 60 28 0 0 91
JENIS PEMERIKSAAN
URINE
PROT UL PPT
L B L B L B L B L B L B L B L B L B L B L B L B L
1 1
1
1 1 1
1
1 1
1
1
1
1 1
1
1
1
1 1
1
1 1
1 1
1
1
1
1 1 1
1 1
1
1
1
1
1
1
1
1
1
1
1 1
1 1
1
1
1 1
1
1 1 1
1
1 1
1
1
1
1
1
1 1 1
1 1
1
1 1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1 1
1 1
1
1
1
1 1 1
1
1 1
1 1 1
1
1
1 1
1 1
1
1
1
1
1 1 1
1 1 1
1
1
1
1
1 1
1
1
1 1 1
1 1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1 1 1
1 1
1
1
1 1
1 1
1 1 1
1 1
1 1 1 1
1
1
1
1
1
1
1
1 1
1
1
1
1
1
1
1
1
1
1
1
1 1
1 1
1 1 1
1
1 1 1
1
1
1
1
1 1
1
1
1
1
1
1 1
1
1
1 1
1 1
1
1 1
1
1
1
1
1 1
1
1
1 1
1
1 1
1
1 1
1
1
1
1
1 1
1 1
1 1
1
1
1 1
1
1 1
1
1 1
1 1
1
1
1
1
1
1
1 1
1 1
1 1
1 1 1
1
1
1
1
1
1
1 1
1 1
1
1
1
1 1
1 1
1 1
1 1
1
1 1 1
1 1 1
1
1
1
1 1
1 1
1
1
1
21 1 0 54 20 14 9 19 15 18 3 34 1 41 3 8 4 59 3 0 0 1 0 6 1
DAN JARINGANNYA
JENIS PEMERIKSAAN
B L B L B L B L B L B L B L B L B L B L B L B
1
1
1
1 1 1 1
1
1
1 1 1
1 1 1
1 1 1
1
1
1 1 1
1
1
1
1
1 1
1 1 1
1 1
1 1
1 1 1
1
1 1
1 1 1 1
1
1 1 1
1 1
1 1
1
1
1 1 1
1
1
1 1
1
1
1 1 1
1 1
1
1 1
1
1
1 1
1 1
1 1
1 1
1 1
1 1
1 1 1 1
1 1 1
1
1
1
1
1 1 1
1 1
1
1
1 1
1
1
1 1 1
1
1 1 1
1
1
1 1 1
1 1 1
1
1 1
1 1
1 1
1
1
1 1 1
1
1
1
1 1
1
1 1 1 1
1
1 1
1 1 1
1 1 1 1
1
1
1 1
1 1 1 1
1
1 1 1
1
1 1 1
1
1 1
1 1
1 1 1 1
1 1 1
1 1
1
1
1 1
1 1
1
1
1
1 1 1
1 1 1
1 1 1
1 1
1 1
1 1 1 1
1
1
1
1
1 1
1 1
1 1
1 1
1 1
1 1
1
1
1 1
1 1
1
1 1
1 1 1
1 1
1
1
1
1
1 1
1 1 1
1 1 1
1
1 1 1 1
1 1 1
1 1
1 1 1 1
1
1 1
1
1
1
1 1
1 1
1 1
1
1
1 1
1 1
1 1
1 1 1 1
1 1 1
1 1
1
1 1 1
1
1 1
1 1
1 1
1
1
1 1
1
1 1 1 1
1 1 1
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10 0 4 2 51 5 2 2 52 3 2 2 52 3 17 22 89 87 18 25 33 63 15
UA BTA FL
L P L P L P
L B L B L B L B L B L
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25 29 59 1 0 0 0 0 0 0 0
BULAN :JUNI
TAHUN : 2022
Jenis Kunjungan
TGL NAMA
(THN) BPJS/ KIS
L P L P L P
1 SAPIAHWATI 21 1
2 HIKMAH 29 1
MIFTAHUL HIDAYA 21 1 1
ABDULLAH 62 1
M. GIBRAN 4.2 1 1
DENY NOVIAN 35 1
ENDANG 38 1
BAMBANG BUDI YANTO 47 1
DARMIATUN 52 1
SISILAWATI 24 1 1
MUSA ENDEN 65 1 1
NURLIA 53 1 1
FITRI FAJRIANI 29 1 1
YULIANTI 36 1
HASMIATI 31 1 1
NUR NUGRAHENI 29 1 1
AMRULLAH 44 1
TITIN ANDRIANI 22 1 1
SUPIANA 54 1
MARDIAH 49 1
IMAM RAMDAN 22 1 1
NIZAR AHMAD 18 1 1
AFRIZAL ALI 35 1 1
KHAERUNNISA 39 1 1
3 BQ. SUNARTI 37 1 1
DEWI ISKANDARWATI 41 1 1
NIZAR AHMAD 18 1 1
FATRIANA 39 1 1
EMI SAHAEMI 51 1
HJ. AMINAH 55 1
RUSIDA 40 1
HJ. BAHYA 75 1 1
AWALIA 42 1
ENI NURAINI 36 1 1
RUSDIYANTO 51 1
SANIA 39 1
FATMA 62 1
IRAYANTI 22 1
YANTI 37 1 1
SALMAH 53 1
RANI SAPITRI 22 1 1
SYARIFUDDIN 43 1 1
M. GALANG 14 1
NORANI 57 1
ANITA PURWANTI 45 1
ANDRIANTI R 28 1 1
EVI APRIANTI 35 1
IRVAN ZULFAHMI 27 1
ROYANI 53 1
MUS MULYADI 30 1 1
4 MASITA 63 1 1
YUYLIANA 44 1 1
SITI NURKIYATI 54 1 1
5 YULIANA 43 1 1
NUR NANING 47 1 1
M. YUSUF 59 1 1
6 WIWIT SUPIANI 14 1 1
M. SALEH 56 1 1
FADIL 8 1 1
MAHMUD 72 1
FITRIANI 26 1 1
RYAN HIDAYAT 14 1 1
JUNASIH 52 1 1
AMINAH 41 1 1
RINI ERVIYANTI 21 1 1
NONI ARMLASI 37 1
EMI LIANA 19 1
SITI NURLIS 57 1
HJ. NURHASANAH 54 1
USMAN UDENG 60 1
ROSDAHLIA 47 1
M. SALEH SYAM 72 1
SYAMSIAH 40 1 1
SITI FATMAH 55 1 1
HIKMA YURISTI 33 1 1
ERNA WIRA K 22 1 1
MELA SANTIKA 36 1 1
RIKA APRIANA 25 1 1
7 DEKKATI 48 1
ULYA HANUMI 1.1 1 1
LILY ANGGRAINI 40 1
JEMASIH 52 1 1
AL HENDRA 68 1
SAHARIAH 47 1
SYAHRIL 52 1
IIN 37 1 1
HENY RAHMAWATI 31 1
AN. ZERRIN 3.6 1 1
M. JAFAR 48 1
RATNA 30 1 1
NURMA 62 1
AMINAH 51 1
M. TOLHAN 4 1 1
MASITA 55 1
LENI MARLINA 46 1 1
ELY AMBAYANI 41 1 1
ULFA DWI YANTI 24 1 1
DANENDRA 7 1 1
HAJIA 56 1 1
MIALA 28 1 1
MUSA 63 1 1
HADIJAH 51 1
8 SUBAIDAH 45 1 1
JEMASIH 52 1 1
NILAWAN 63 1
INDRA JAYADI SAPUTRA 25 1 1
SAKINA MAWADDAH 28 1 1
PAHRIAH 34 1 1
SAHRAH 57 1
ABDUL RIFAI 46 1 1
HENDRA SAPUTRA 38 1
NOVI SUSPITASARI 26 1 1
NUR AINI 42 1
MOH KADRUL 58 1
NURZAITUN S 22 1 1
HASMIATI 30 1
NAFILA 25 1 1
FITRI WULANDARI 21 1 1
RISKIKATUL A 26 1 1
NURAINI 51 1 1
LILI H 38 1
DEWI SARTIKA 35 1
ARlI 26 1 1
BAMBANG JAMAL 32 1 1
9 ASMAWATI 51 1
ASTUTIK 30 1
AMINA 59 1
TUTI 39 1
INDAH SETYPRINI 64 1
NURMA 17 1
BUDIMAN 59 1 1
RAMDI DWI 30 1
SARFAH 27 1
NANANG ISKANDAR 42 1 1
HIJJATULFITRIA 30 1 1
SUMIATI 62 1
JALIM 55 1 1
SRI NAWAN 23 1 1
ADIMUDDIN 19 1 1
10 ADIMUDDIN 61 1
SUMIATI 19 1 1
BAHARUDDIN 41 1 1
BUNYAMIN 49 1
RAIHA 45 1
ABDUL HAFIED 48 1
TITIN AGUSTINA 27 1 1
BAMBANG 32 1 1
INDRAWATI 35 1 1
HADIJAH 60 1 1
SUMIATI 30 1 1
EMI SUHAEMI 49 1
INDY MAGFIROH 11 1
HERLINA 31 1 1
MOH.KHOLID AL HANIF 6 1 1
FIKRI 10 1
BAMBANG 32 1
RESTI 1 1
SUMIATI 19 1 1
NANA J 13 1
FAKHRUDDIN 13 1
LUPITA SEPTIANI 14 1
YUNITA ADE PUTRI 17 1 1
IHSAN 13 1
ARIEL ADITYA 13 1
BAHARUDDIN 15 1
HUSNUL 13 1
RODIANSYAH 15 1
ALISYA SYAFITRI 13 1
SANJANI 12 1
AYU 13 1
SOFIA 10 1
M. ZAIWAR 11 1
ZABRI 62 1 1
SABRI 62 1 1
BAMBANG 32 1 1
11 BAMBANG 32 1 1
JEMASIH 52 1 1
SABRI 62 1 1
SABRI 62 1 1
SAHODAH 65 1 1
ABDURRAHMAN 22 1 1
12 SABRI 62 1 1
RAIYAN FADILAH 23 1 1
SAHODA 65 1 1
SRI AYU K 30 1 1
SITI NUR 72 1 1
13 RAIYAN FADILAH 23 1 1
JEMASIH 52 1 1
M. SALEH 61 1
HERMANTO 59 1
NURMIATI 57 1
NURHASANAH 43 1
SITI NUR 72 1
NURAINI 51 1
FAIZAH 45 1
AMENAH 60 1
NURKEMAH 56 1
BQ. SRI 32 1
BAHARUDDIN 41 1 1
ZAHRAH 63 1
AMRIN 55 1
NANDA SAFITRI 15 1
RINA ANGGRAINI 31 1
UJANG YANA 30 1 1
VERA 22 1
HERIA 44 1
GAZA IZUL 6 1 1
H. MALATALU 90 1 1
FARADILLAH R 25 1 1
ARLIA 25 1 1
IPONK 12 1 1
RAIYAN FADILAH 23 1 1
PANATI 21 1 1
ULFA DWI YANTI 24 1 1
M. NASAB 53 1
ANITA P 51 1 1
14 CANDRA KIRANA 41 1
DARIATI 21 1 1
dr. AVIVA 27 1 1
SITI ZUBAIDAH 58 1
AGUS SALIM 51 1
HIJRA SAPUTRA 37 1 1
AMINAH 63 1
INDAH 25 1 1
IMA LESTARI 22 1
HJ. NURJANA 68 1
ERI 29 1
A. RAZAK 30 1
AHMADI 52 1
AINUN 23 1 1
CHANDRA 49 1
FATIMAH 63 1
ARDINA 32 1 1
DUWI RATNASARI 24 1
LINDA 26 1
SUMIATI 49 1
ERMA 53 1
EKA TUZZAHRA 27 1
SUKMA 29 1 1
JEMASIH 52 1 1
ANITA PARWATASARI 51 1 1
MARDIANA 25 1 1
MASTIKA 18 1
ROHIYAH 35 1 1
M. NASIB 53 1
15 ARDINA SAPUTRI 32 1 1
RANDI PUTRA DINATA 30 1 1
A. KADIR HAMID 66 1
HJ. FATIMAH 67 1
ZAENATI 59 1
WAHIDA 52 1 1
NANIK RISWATI 43 1
JIHAN KAMILA 9 1 1
AHMAD JAYADI 36 1 1
A. MUIN ANDO 90 1 1
A. MAJID 74 1
MARIAM 69 1
RAHMAD 68 1
SRI SUKMA 41 1 1
SITI AISIAH 47 1
SYAMSIAH 46 1 1
MUHAMMAD 51 1
SINTA HASAN 62 1 1
HJ. KOMARIAH 55 1
JAWAHIR 69 1 1
MANCAWARI 78 1
ERDA SULASTRI 20 1 1
MARDIANA 22 1
16 SIPAWATI 69 1
H. AHMAD LI 77 1
HJ. SALMIAH 68 1 1
UMAR AL-QADRI 57 1
HAPSAH 61 1
HJ. MANGINDARA 69 1
GIO ILMI 17 1
H. AHMAD 68 1
SAHEMA 55 1
TITIN SURTINA 26 1 1
SAHORA 57 1
PUTRA MUTAKIR 19 1
YULLY ERLANDYA 35 1
M.O ROMANSYAH 64 1 1
ARI 38 1
FITRI KURNIATI 31 1 1
17 NIA ASTUTI 34 1
ANITA 7 1 1
BUNGA DAENG 61 1
HALIMAH 77 1
DINI HIRWANTI 28 1 1
SAHODA JASIM 65 1
PUTRI IBADAH 5 1 1
M. RIFAI 48 1
HERLINA SUSANTI 36 1
M. RAMDANI 57 1
ANITA ANJELINA 21 1 1
SRI ROHANI 33 1 1
SAPAIYAH 57 1
DARMAWATI 45 1
MARIATUL 42 1
WIWIK ARIYANTI 40 1 1
ASIAH 34 1 1
PUPUT ISMAWATI 16 1 1
19 HERNI H 36 1 1
HASAN M 72 1
20 HIJJATUL FITRIAH 28 1 1
AMINAH S 67 1
FAIZAH 23 1
HAMZAH 63 1
RAPIAH 66 1
BUNYAMIN 49 1
MASTARI 53 1 1
NORMA 68 1
RAI AGUSTIAN 25
M. NUR 65 1
RIZA FAGITA 23 1 1
IDA WARDANI 27 1 1
M. ALI 61 1
DARMANSYAH 29 1
DWI PUJA 19 1 1
NURHAYATI 55 1
VERA 22 1 1
SUMIATUN 39 1 1
SUSMAWATI 30 1 1
RENU 21 1 1
SITI ZURANI 40 1
M. SYAMSUL 40 1
YANG MA 57 1
SUHARYO 32 1 1
MARYAM 68 1 1
DESI 30 1 1
YAYU APRIANI 19 1 1
SYAMSUL BAHRI 40 1 1
LUSIANANTA 18 1 1
SRI ROHANI 23 1
SUPARDI 52 1 1
21 SAHEMA 52 1
BINTANG VANILA 4 1 1
ADIDAH 58 1
RINI DEKAYANTI 22 1 1
MASITA 58 1 1
HJ. SITI AISYAH 61 1
UMAR BAHWERES 57 1
KARNILAWATI 32 1 1
REZA ANGGAR 18 1
MARIANA 37 1 1
NURHAENI 48 1
MASAYANG 51 1
SISKA R 21 1 1
ROSITAWATI 41 1 1
AHMAD RIFKA 42 1
H. FATAWARI 67 1 1
ZILFIYA 35 1 1
AFRIANSYAH 26 1
SUSANTI 18 1 1
SAHRUL MUNIR 35 1
22 KAMARIAH 71 1
RAHMAWATI 55 1
MUTIARA 7 1 1
MUH. SALEH 41 1
NURHAYATI 41 1
SYAMSU HADI 62 1
ROHANA 45 1
ADENIYAH 27 1 1
DIAN FIRDAUS 30 1 1
RINDU 67 1
NURSIAH 23 1 1
SRI ANI 50 1
ELY LUBNA 44 1 1
BADARIAH 42 1
JALALUDDIN 45 1
JAWARIAH 37 1 1
SYAFRIADI 23 1
AWALUDDIN 25 1
ABDUL RAJAK 28 1
HALIMAH 24 1
SUSANTI 39 1
EVA 22 1 1
23 M. IKRAM 34 1
SAFI'I 55 1
SUMARNI 61 1
DEWI 30 1 1
SPASIAH 79 1
NURAINI 29 1 1
SANIAH 39 1 1
SURIATI 54 1
AMINAH 52 1
ENDANG 45 1 1
AISYAH 59 1
NURJANNAH 73 1
RATMINA 52 1
ERNA IDAWATI 46 1
ANDI RIFAI 39 1
SRI MOLA 42 1 1
AZAIIYAH 71 1
M. PUTRA 27 1 1
HERIANTO 29 1
24 FITRIAH 49 1
M SALEH IDRIS 56 1 1
AHSAN SIDIK 20 1
KAZEMA 66 1
FITRIA SOSILA 70 1 1
DRS. M SALEH 61 1
IDA FARIDA 31 1 1
ROHANA 45 1
SAMSUN 57 1 1
TONI HARIANTO 38 1
ANDI ELLY 31 1 1
TUTI ANGGRAENI L 32 1 1
RATNAH 59 1
GAZIAH 21 1 1
MUSA ENDEN 65 1
ELLY FITRIANINGSIH 55 1
GIBRAN P 1.4 1 1
SYAFARUDDIN 65 1 1
SRIANA 30 1 1
BADRIYA 17 1 1
25 RUSDIANTO 42 1 1
LINA K 35 1 1
RAGUAN 65 1 1
26 SANIAH 29 1 1
YAYA HIDAYAH 27 1 1
SANIAH 29 1 1
27 HAMDI 45 1 1
RUSLAN 49 1
YAYA HIDAYAH 27 1 1
SANIA 39 1 1
IBRAHIM 56 1 1
ALIYAH 66 1
SYAINUDDIN 64 1
RUSDA Z 46 1
RAHMAWATI 60 1
H. HUSAIN 76 1
LINDARWATI 56 1
M. TAYUP 71 1
HERIYATI 41 1
ERNI M. SALEH 56 1
MUJIANTO 5 1 1
SUPARDI 49 1
ILHAM 34 1
HUSNUL HATIMAH 50 1
H. ACHMAD A 75 1
NURHAYATI 57 1
RAJEMA 64 1
ISMUIDARI 46 1
NURUL WAHIDAH 26 1 1
TITI SURYANI 32 1 1
ERNI SUSANTI 26 1
SUURIATUN 48 1 1
M. KADAL 58 1
28 ASIAH SALEH 57 1 1
JAMILAH 51 1
SAHARIAH 48 1
HASRUN HERAWATI 37 1 1
MARLINA 39 1
RAHMIATUN 53 1
DEDI WIDODO 29 1 1
AWALIA 42 1
SUHADA 28 1
FITRI HAMDA 23 1 1
RIDWAN 53 1
SITI BUNAIYAH 69 1
MARIATUL 57 1
RAMLAH 74 1
LEGIMAN 53 1
MULIADI 41 1 1
SEPTI KURNIA 22 1
SURYATI 42 1
RITA HASTANTI 43 1 1
NAVALIA 17 1
SAMSIA TAL 21 1 1
ROSMIATI 61 1
ROFIQAH 27 1
HUSAIN 66 1
29 NURHAYATI 71 1
HJ. SITI AISYAH 61 1
DHAFA AHMAD 4.5 1 1
FATAMAWATI 54 1
SABARIAH 52 1 1
NITA 30 1
FITRI KURNIATI 25 1 1
SUDRYONO 58 1
KKARYADI 51 1
SALMI 24 1 1
RUDI ADEKA 29 1 1
AYUNI 27 1
RUKIAYAH 37 1 1
RAHAYU 22 1 1
RABIATUL 18 1 1
SARTYIN 27 1 1
30 SAPIATI 57 1
RIZA FAGITA 24 1 1
NURUL HUDA 66 1
MARYAM 68 1
ELYA SUSANTI 45 1
MUHAMMAD NUR 43 1
ANITA 38 1
LEYAN K 12 1
ALMAN PALUFI 20 1
NURHAYATI 36 1
MUHAMMAD IWAN 18 1
LUQMAN K 3.4 1
FATMA 50 1
AMINAH 42 1
NURHYATI 57 1 1
NIA ASTUTI 41 1
KETRIN 20 1
FITRIA MARCELINA 18 1 1
113 34 270 90 42 9 74 23 1 1 87
,
JENIS PEMERIKSAAN
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PROT UL PPT
1
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20 0 0 53 17 18 8 29 7 19 4 20 1 30 2 7 2 49 3 1 0 0 0 10 2
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72 61 59
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11 64 33 0 0 0 1 0 0 0 2
BULAN : MEI
TAHUN : 2022
Jenis Kunjungan
TGL NAMA
(THN) BPJS/ KIS
L P L P L
B L B L B L B L B L
1 RAMLI 39 1
2 RAFIAH 34 1 1
3 PATMAWATI 84 1 1
HUSNAINI 37 1 1
4 ENI ZANIAWATI 24 1 1
5 ROSITAWATI 41 1 1
6 ENI ZANIAWATI 24 1 1
ROSITAWATI 41 1 1
YULIANTI 35 1 1
7 NURLELA 29 1 1
DEFI TASARI 30 1 1
8 SRI DEFI 32 1 1
9 TINA 29 1 1
NURHASANAH 44 1
ROHANI 49 1
NURWASITA 41 1
SABARIAH 42 1
TATA WIDIYANTO 63 1
RUSTIATI 54 1
SITI NOR 82 1 1
HADIATULLAH 58 1
ASLIN 26 1
RATNA 44 1
SAIPAH 54 1
DENI PATRI 29 1
FAUZI ASIS 53 1
ZULFIAT SAEMIA 41 1
SAPARUDDIN 49 1
SALMA SAMAILAH 60 1
SUSI SUSILAWATI 31 1
HERLINA IBRAHIM 44 1
IGA MINDALIPA 24 1
MARYAM 68 1 1
MARIA MINDA 39 1
ASMIRANA 78 1
TANTAN WAHYUDI 25 1 1
H.ABDUL MAJID 73 1
SITI MAEMUNAH 27 1
HALIMAH 57 1 1
HUSAIN M.SALEH 66 1
NURYANI 37 1
SUKMAWATI 18 1
NORMA 23 1
SITI NURHADIZA 62 1
ADITYA NUR RAHMAH 19 1
H.M.RUBA' 65 1
SURTINI 31 1
EKA LESTARI 23 1
DEWI SARTIKA 35 1
AZKA MA'RU IKHSAN 4 1 1
MARDIANA 37 1
NURHAYATI 46 1 1
NOVIANTI 17 1 1
10 H.L. AHMAD LI 77 1
LENA HARTATI 31 1
SYAMSIAH 56 1
ENY SUSANTI 42 1
KADIR 67 1 1
ABDULL HAFID 48 1
YENI RUSTILA 25 1 1
ABDUL MAJID 73 1
NURAINI 57 1
ZAENATI 56 1
NURJAYANTI 45 1
HENDRA JUANDI 26 1 1
NURHAYATI 43 1
ALNIE Z 24 1
EDO R 22 1 1
RAHMAH 56 1
SOLEHA 29 1
SADIAH 65 1
RAHMAWATI 71 1
ROSITAWATI 41 1
FAIZAL 20 1 1
ABDUL RAHMAN 36 1
FAIZAL AZHAL 20 1 1
YUYUN APRIANI 27 1
FATIMAH AZZAHRA 17 1 1
RATNA M. AMIN 49 1
SUNTIATI 65 1
11 ENDANG LESTARI 46 1
MARYATUL 60 1
HJ. HALIMAH 53 1
DIKA SYAHRI 21 1 1
MARWAH 27 1 1
DAHLAN 53 1
BIDASARI 60 1
AMELIA 12 1 1
NOVITASARI 32 1
NURJANNAH 40 1
SRI LANGI 52 1
AHMAD JUANDI 43 1
ROHANIAWATI 36 1
SENDARI 54 1 1
MARIAM 53 1
PUTRI 23 1
NELI AGUSTINA 25 1
DESI RATNASARI 28 1
FITRIANINGSIH 37 1
TINA TRISNAWATI 26 1
RAHMA NOVIANTI 29 1
NURSEHA 48 1
YANTI H 36 1 1
SEPTI K 22 1
IWAN PARIAWAN 42 1
MUHAMMAD AFTA 2 1 1
EVI DIANA 35 1
MARWA 28 1 1
12 SYAHREM 54 1
BAIQ MARLINDA 24 1
DIKA 21 1 1
SERLY SURJAN EKAYANTI 25 1
SYAMSIA 46 1
YUN MASTIAH 67 1
RABAIYAH 68 1
HJ. FATIMAH 67 1
AISYAH H.A. MAJID 47 1
MINDARTI 47 1
FAJRIN 32 1
NURYANI 43 1
RISKA FATMALA 25 1
RASAHARUDDIN 26 1 1
FITRIATUN 36 1
ATIKA 26 1
SALMA 60 1
FARITA LINA 21 1
ERNAWATI 50 1
AMINAH 52 1
RISKA 29 1
BAMBANG 48 1 1
13 H. A. YANI 73 1 1
SITI AMINAH 62 1 1
GUNAIYAH 63 1 1
AHDIAT 45 1 1
MASTARI 60 1 1
LINA APRILAWATI 40 1 1
ARI SUPIYONO 52 1 1
RUSLAN 49 1
SALMAH 61 1 1
MUNHANI 56 1 1
M. SALEH 65 1 1
SUSILARANI 47 1 1
JHONI RAHMAN 61 1 1
SITI HASANA 59 1 1
SARIPAH 63 1 1
ZULKIFLI ISMAIL 51 1 1
SAWIYAH 57 1 1
NURAINI 36 1
ANISA KARINAH 19 1
AHMAD ABDULLAH 52 1 1
DIAWATI 49 1 1
MARWATI 34 1 1
BUNGA DAENG 61 1
RUSMA 57 1 1
SALAMUDDIN 66 1 1
ARIYANI FITRIYANTI 29 1
RAHMAWATI 63 1
RIRIN 32 1
GUNAWAN 50 1
ROHANA 59 1 1
BANRI 64 1 1
SAHABUDDIN 62 1 1
SRI NURAMI 21 1
AYU SURYA 23 1 1
JULIA DARAMIKA 19 1
SRI WELI 59 1
FITRAYANTI 50 1
NADYA S 7 1 1
DEVI AYU 21 1
14 M. AMIN 41 1 1
15 FARIDA ANDAYANI 48 1
LILIS SURYANI 36 1 1
16 ISMAIL 29 1 1
SRI NAWAN 23 1 1
KARMILA 29 1 1
NANI TRIANA 42 1
ISMAIL 29 1 1
17 BELLA SYAVIRA 20 1
ISMAIL 29 1 1
M. SALEH IDRIS 56 1
MUKMINAH 53 1
RINNY RAMDANY 34 1 1
LISTARI 40 1
SALMAH 53 1
NURYANI 38 1
KASIANTI 32 1 1
MASAYANG NUR 75 1
PIPIT ARUMDANI 20 1
FADLIKA MINALLAH 20 1
PUSPITAWATI 25 1
KARTINI 26 1
ELI SULASTRI 37 1
LILIKA ROSANDY 34 1
ELVIAH 22 1
MARYAM 1
SALMAH 47 1
WAHYUYNI 23 1
YUSRININGSIH 36 1
MA'RIFATUL FADILAT 29 1 1
SALMIYAH 51 1
YANTI FEBRIANTI 31 1
ABDUL RIFAI 46 1
AN. ADINDA 7 1 1
FITRIANI 38 1 1
HAMID BAHASOAN 47 1
ISMAIL 29 1 1
18 ISMAIL 29 1 1
KAFFA N 6 1 1
NURIYAH 52 1
SAHRA TINNUR 39 1
DEWI SARTIKA 37 1
MASHUNING 60 1 1
FITRIYAH 51 1
PANATI 21 1
MASITA 37 1
APRILAWATI 35 1
NINING JULIANINGSIH 21 1
TRI NOVITA 26 1
MUS MULYADI 39 1
ROHANA 49 1 1
AISYAH 57 1
NURUL AINI 36 1
FITRI JAYANTI 26 1
MUHAMMAD 58 1
FITRI JAYANTI 26 1
NURUL AINI 36 1
SAHMIN 32 1
19 KAHARUDDIN 68 1
MURNIATI 46 1
RAFIAH 66 1
MUSA ENDANG 62 1
BADARIAH 40 1 1
DARMA YUNI 37 1
ERMA 53 1
NURHAYATI 26 1
SITI HADIJAH 27 1
NURHAYATI 37 1
ELI SUGIANA 40 1
SURIYANI 23 1
ANDI RESI 32 1
ARSY 1.3 1 1
SUGIARTI 49 1
ROKTIAYAH 49 1
SAMSUDIN SARUNI 46 1
NOVI ARMINI 37 1
MUS MULIADI 41 1
M. TAHIR 67 1 1
DIAN ARININGSIH 45 1 1
NUR HALIMAH 30 1 1
20 SITI SUNDARI 28 1 1
NURAINI 59 1
ADIDAH 58 1
MARISA HARDIANTI 28 1
SITI ANISA 54 1
BAMBANG BUDI YANTO 45 1 1
ROKHAYAH 49 1
SOFIAH 27 1
INDER JAYA 41 1
MARTINA 59 1
ZILIA HARTIKA 19 1
IRMA 39 1
PALANTEI 62 1 1
GALIH 17 1 1
AMIRA ZAKIRA 24 1
RUSDAH 54 1
FITRIAH 42 1
AFRILYAN LESTARI 19 1
ALVIADATUL 4 1 1
HATIM AL-HAMZALI 1 1 1
ZHARA YULISA 29 1 1
KAMARUDDIN 76 1 1
ZAHRA YULISA 29 1
IRIN 62 1 1
LINDA SANTIANA 22 1
USMIATI 40 1
SNI 43 1
22 ELSA MAYORA 19 1 1
23 HENDRA 24 1 1
A. RAHMAN 47 1 1
TANTI 19 1 1
ALYAH 66 1
SURNAWATI 40 1
NURHIKMAH 25 1
SAFITRI A 34 1 1
MANSUR 22 1 1
MISROZAH 55 1
DIANA ISTIANUN 30 1
Ir. LALU MUH. AZHAR 58 1 1
FITRIAH 49 1
SURYANI 37 1
USMIATI 33 1
MISNAWATI 31 1
ATHIYYA 17 1 1
SANI YULIANTY 28 1
DIAN KURNIAWATI 36 1
NURFAJRIAH 33 1
SITI RADMA 42 1
DIANA ISTIANUN 30 1
SAHARIAH 60 1
NURHAYATI 57 1
SARINA 35 1
ROHMI 51 1
SEHON 47 1
NURVAIDA 35 1
TITIN SURTINA 26 1
ASMITA 21 1
HAMIDAH 30 1
SURIYANTI 25 1
MUHDAR 56 1
DEFI TASARI 30 1 1
ISTIKOWATI 51 1
MIMI HERAWATI 38 1
SYAHRAH 51 1
SYARIPUDDIN 62 1
FATIMATUL SURO 35 1 1
TULI PUTRI 23 1
ARIRUDDIN 60 1 1
MELAYANA 25 1
SURNIWATI 30 1
NURHAYATI 45 1 1
24 AHMAD NASIR 61 1
RIZKI APRIANSYAH 15 1 1
NURHAYATI 67 1
M. ZUHAINI 56 1
SARI DAENG 58 1
VERA SAFITRI ALQADRI 22 1
RINNY RAMDANY 34 1
IDAY ANTHI 41 1 1
TRI 39 1
INDRI YULIANI 37 1
SURIYAH 61 1 1
HJ. FATIMAH 52 1 1
HJ. AMNAH 57 1
M. JONI SAYU PUTRA 42 1
NADA GUDSIA 25 1
25 YANTI FEBRIANTI 31 1 1
SYARIFAH 55 1
LENI TRISTATANG 36 1
LINDARWATI 56 1
SULFIANI 38 1
LEGIMAN 59 1
AISYAH KADIR 56 1
SULASTRI 52 1
MURNIATI 42 1
H. SYAIFUDDIN 57 1 1
WAHYUNI 24 1 1
HABIBAH 45 1 1
MURAINI 45 1
ARINI 49 1 1
YUNI ASRI 24 1 1
26 NELI AGUSTINA 25 1 1
FATIMAH 44 1 1
GAZI BAWAZIR 62 1 1
FATIMAH 44 1
27 BADARIAH 50 1 1
FITRIANI 42 1 1
SABARIA 61 1
DENDRA 82 1 1
MUHAMMAD 49 1
ATIZA 56 1
ARDYAN 18 1 1
DARMAWATI 1 1
KEFIN 23 1 1
ERNI M. SALEH 56 1
LAILA MUFIDA 32 1
SONITA 40 1
SITI AISYAH 50 1
MULYANTO 26 1
NURLAILI 20 1 1
ASMAWATI 49 1
ERNAWATI 62 1
ANDRA 22 1 1
SANDORA 52 1
MARIATUL 25 1
A. RAHMAN 23 1
DEWI WAHYUNI 32 1
SITI NURFAI 57 1
RELVIA 23 1 1
28 SEPTI KURNIA 22 1 1
30 SAHMI 38 1 1
TIEN 51 1
ROSNAWATI 39 1
H. ABD. KADIR 72 1
NURMA 76 1
YUNITA 20 1
M. NURDIN 73 1
HERTINA 26 1 1
MAHREP 63 1
SRI NURAUMI 33 1
HALIMAH 46 1
SYAFFI 46 1
FAIZAH 41 1 1
M. THALIB 53 1 1
HASTIAWATI 28 1
RISKA 22 1
HERI SUSANTO 26 1 1
ANDRIANI 25 1
SELAMA ABDULLAH 74 1
ELI ERMAWATI 30 1
MARTINI 31 1
NURJIHAN NADIA 25 1
ERNAWATI 62 1
RAODA 42 1
SALWA FENIOLA 20 1 1
YANTI 37 1 1
SUUD 48 1
FENNY 25 1
HARTINA 26 1 1
BQ. SUSANTI 37 1 1
31 TENDRI ABENG 48 1
WAGIRAN 50 1
BQ. SUNARTI 37 1 1
SAHRA SAID 48 1
HAIRANI 47 1
SABARIAH 62 1
RIZKATUL ADIAN 24 1
SUTIYAH 66 1
ROSITAWATI 41 1 1
KHAIRULLAH 50 1
SOPYAN 55 1 1
JIANTI FITRIA 27 1
RAODATUS SAADAH 20 1
SITI AISYAH 43 1
AYU SAFITRI 23 1
34 54 195 142 22 21 49 45 2 0
337
PROGRAM PELAYANAN KESEHATAN GRATIS PADA PUSKESMAS DAN JARIN
JENIS PE
URINE
PROT UL PPT
B L B L B L B L B L B L B L B L B L B L B L B L B
1
1
1
1 1
1 1
1 1 1
1 1
1 1
1
1
1 1
1 1
1 1
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1 1
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1 1
1 1
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1 1
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1 1
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1 1
1 1
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1 1 1
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1 1 1
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1 1 1
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1 1 1
1 1
1 1
1 1 1
1 1 1
1 1 1
1 1 1
1 1
1 1 1
1 1
1 1
1 1 1
1 1 1
1 1
1 1
1
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1 1
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1 1 1
1 1
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1 1
1
1
1 1
1 1
1 1 1
1
1
1 1
1 1
1 1 1
1 1 1
1 1
1 1
1 1
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1 1 1 1
1 1
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1 1
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1
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1 1 1
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1
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93 25 0 0 59 16 8 15 12 19 23 9 1 5 3 8 6 2 48 11 8 2 6 1 5
RATORIUM
USKESMAS DAN JARINGANNYA
MBAWA BARAT
JENIS PEMERIKSAAN
IgG/IgM/NS1 HBsAg ANTI HIV SIPILIS GULA CHOL TG
L P L P L P L P L P L P L
L B L B L B L B L B L B L B L B L B L B L B L B
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3 3 1 3 2 53 11 3 1 42 8 3 1 44 9 11 31 111 99 12 30 41 64
TG UA BTA FL
L P L P L P L P
1
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8 22 30 42 0 0 0 0 0 0 0 0
BULAN :APRIL
TAHUN : 2022
Jenis Kunjungan
TGL NAMA
(THN) BPJS/ KIS
L P L P L P
1 JAYADIN 23 1
AMIRULLAH 32 1 1
SAMSIA 46 1
ASMAWATI 57 1
NILAWAN 63 1
HENDRA F 19 1
IKBAL FIRDAUS 26 1
NURWASIH 41 1
HENI KURNIAWATI 25 1 1
ADITYA NUR RAHMA 21 1 1
SYARIFUDDIN 38 1 1
2 IMAN 28 1 1
HILFIANTU 25 1 1
MARIANI 32 1 1
3 NURMIAWAN 61 1 1
RABAIYAH 67 1 1
4 DAENG UJUNG 68 1
M. SARJAN 39 1
ZULAIMI 18 1
JANARIAH 68 1
FAUZI AZIS 53 1
RATNAWATI 52 1
ERNAWATI 62 1
NANANG S 21 1
H. RAMLI AHMAD 72 1
MIMI ADE 26 1 1
RAHMIATI 41 1
ASMAWATI 17 1 1
WAHYUDI 51 1 1
NURKOMALASARI 23 1 1
NURUL 34 1
AISYAH 76 1
NURMIAWAN 61 1
ASIKA ARISANDI 35 1
MAINI 27 1 1
HARTATI 51 1
KURNIATY 41 1 1
MASTAWAN 59 1 1
RADIAH 48 1
5 M. IDRIS 77 1 1
HATIAH 36 1 1
YASSA NABILLA 1 1
SALBIAH 74 1 1
EVI YULIANI 31 1
ISKANDAR AHMAD 67 1
SAIKHAN 56 1
RITA NADAYANI 25 1 1
SAHORA 56 1 1
AULIYA SAFITRI 25 1 1
LILIS TARI 27 1 1
MUTHEA YARA M 14 1 1
BAIQ 16 1
USMAN 56 1
SYAFRUDDIN 44 1
NURAINI 46 1
NURMIAWARI 61 1 1
SUSMA 32 1 1
6 DJOKO 68 1
TATA WIDAY ANTI 63 1
SUSMA 32 1 1
CUT INTAN N 25 1 1
H. ZAINUDDIN 51 1
ADE IRMA YANI 30 1 1
INDAH MAYANGSARI 25 1 1
HADIJAH 60 1
RASAHURIADI 26 1 1
7 SABARIA 43 1 1
NURHALIMAH 30 1 1
RIZA 21 1 1
ERMA 53 1
SUSANTI 41 1
AL- 6 1 1
ANITA ANJELINA 21 1 1
WIDYA S 25 1 1
MAYA B 38 1 1
8 AHMAD HASAN 76 1 1
RATNAWATI 32 1 1
PUTRI ULANDARI 23 1 1
LUKMAN HAMDI 40 1 1
DARTATI 37 1
RATNAWATI 49 1
CICI 18 1
HERMANSYAH 45 1
SOFIAH MAWADDATI 27 1 1
SUDIRMAN 74 1 1
SAHRA 56 1
9 ARIFIN K 46 1 1
10 IIS DAHLIA 25 1 1
11 ZAINUDDIN SURKATI 64 1
DWI RIZQIA Y 29 1 1
DEWI ANDINI 21 1 1
ROYYAN 16 1
M. TAYUP P 21 1
HJ. HADIJAH 67 1
ARI SULI STIYO 26 1 1
HASANAH 38 1
DEKKATI 48 1
MERY MARDIANAH 18 1 1
MUSLIM 67 1
MIRWANSYAH 35 1 1
MAYANG 51 1
NURHIKMAH 24 1 1
WINDA SARI 25 1 1
KIANO 10 1 1
12 FAIZAH 45 1
RUSTINI 45 1
FAEADILAH 21 1 1
ASIYAH 71 1
SULAIMAN 60 1
M. AMIN 70 1
EDI CANIAGO 45 1
ISWANTARI 30 1 1
ZAENAP 25 1 1
NILA WAHYUNI 27 1 1
AMELIA 22 1 1
SYAFRUDDIN 44 1
AMERUDDIN 52 1
13 M. ALI 62 1 1
RIZKA KOMALA 31 1
SAHRUL YADI 39 1
HARTINA 25 1 1
SYAREFUDDIN 62 1
SRI HARTATI 25 1 1
HASANAH 42 1 1
AHMADI 52 1
14 AMINAH 44 1
FITRIAWATI 27 1 1
ROHANA 49 1
JAWIRAH 57 1
A. RAHMAN 60 1 1
M. KHAIRIL ADLI 11 1 1
ELMI ZIANDANI 37 1 1
BQ. SRI KARTINI 31 1 1
BACHRUM DJAYA 64 1 1
DESI APRILIANI 26 1 1
SYAFARUDIN 29 1 1
FATAHOLLAH 62 1 1
BIYANTO 65 1 1
MIRWANSYAH 35 1 1
DESTA 14 1 1
ARLIA A 25 1
YAYUK A 25 1 1
15 M. KHAIRIL 12 1 1
SRI SILFIA 22 1 1
M. KHAIRIL 12 1 1
16 M. KHAIRIL 12 1 1
SYAEHAN 51 1 1
M. KHAIRIL 12 1 1
17 SUMIAH 38 1 1
SUMIAH 39 1 1
RITA 41 1 1
SUMIAH 39 1 1
18 ENDANG SULASTRI 38 1
FITRIAH 42 1
KAHARUDDIN 68 1 1
SURMAWATI 64 1 1
NURMA 62 1 1
RITA WIDYA 37 1
RIZKIANA 19 1 1
MASTIKA 26 1 1
LIA KOMALASARI 32 1 1
SUKMAWATI 38 1
ROSIDA 43 1
MISNAWATI 31 1 1
ASMI NIRWANA 41 1 1
ELI ERMAWATI 34 1 1
LELI KARLINA 29 1 1
IKA KURNAWARDANI 24 1 1
AMEL YULIANI 24 1
NUR ALAMSYAH 36 1 1
HERMANSYAH 43 1
SITI SANIYAH 26 1 1
FARLINA 25 1 1
MINTEN 17 1 1
AMRANSYAH 56 1
M. ROYYAN 53 1
SYAIMA 25 1 1
19 RAHMAWATI 56 1
JONI IRAWAN 43 1 1
ROHANA HASAN 64 1
FAHRUDDIN YASIN 61 1
ERMA 53 1
SAHABUDDIN 53 1
NORKEMAH 64 1
SUSAN ELMIN Y 24 1
SITI AISYAH 39 1 1
AQILLA PUTRI H 4 1 1
20 DANI MAESTROT 39 1
KAFFA NAIYAH 6 1 1
MAULANI DWI N 23 1
ZAINAB 73 1
YANTI FEBRIANTI 31 1 1
RIA ANGGRAINI 37 1 1
AAS ARISKA 24 1
NADIA 37 1 1
21 HANISAH 45 1
ROHANA 49 1
LINDA SANTIANA 22 1 1
MAEMUNAH 66 1 1
SHINTA SALAHI 30 1
SANAIYAH 35 1 1
EJA MAYATI 27 1
SRI SILFIA 21 1 1
22 LIVIA AULIA 21 1 1
JUMARI SUSANTI 29 1 1
NURUL M 31 1 1
JAWARIAH 36 1 1
MARIYAWATI 32 1 1
MUTAHAR 58 1 1
FITRIAH 49 1
23 DIANA 39 1 1
SAMSIAH 41 1 1
24 H. SYARIFUDDIN 56 1 1
25 KUSNADI 35 1 1
SURYANI 37 1 1
YUNI ASRI 24 1 1
NURKHOLIFA 20 1 1
USMAN 47 1 1
SUSI SUSANTI 24 1 1
INAYA 39 1
CANDRA KIRANA 41 1
SAWIYAH 54 1
ALI RAHMAT 48 1
MUHAMMAD 56 1
TINI 11 1 1
NOVA ALPIANTI 26 1 1
PATAWARI 84 1 1
ETI AMBARYANI 41 1
NURSIAH 53 1
YUNI RAHMAWATI 41 1 1
CITRA HANDAYANI 21 1 1
26 RESKI A 31 1
BIDASARI 65 1
ANDI LALA 46 1
KARNILAWATI 32 1
MAHMUD 72 1
RIPAAH 65 1
M SAID 58 1
FAUZAN A 10 1 1
FATRIANTI 37 1
NAYA 32 1
H MAKASAU 76 1 1
YUYUN 25 1
NITA S. 30 1
NURJANNAH 40 1
IRMA DAMAYANTI 16 1 1
IBNU DWI 51 1
SITI NUR 32 1 1
ANDI ELI 31 1
ARINI FITRIANI 49 1
YUNI R 41 1 1
PANCA INDRAWATI 38 1 1
27 M. ALI MAJID 73 1 1
MUNARSIH 41 1 1
ABDULLAH 63 1
YUYUN WULANSARI 33 1 1
KUSNADI 35 1
ERMA 53 1
M. ZAKWAN 11 1 1
FASLI EKA 27 1
BADARIAH 42 1 1
SOLI DAENG 47 1
NURHAYATI 43 1 1
JUMIANI 34 1 1
M. ALI MAJID 73 1
SILVA 11 1 1
ROSIANA 31 1 1
KARIMUDDIN 52 1
MUNARSIH 41 1 1
MUNARSIH 41 1 1
28 NURDIN 61 1 1
SILVA SILSILIA 11 1 1
MERI M 18 1 1
MUNARSIH 41 1 1
TAZAH 18 1 1
SURIYATI 47 1
MARIAM 48 1
SARAH 39 1
DARMANSYAH 52 1
M. TAHIR 34 1
NELI AGUSTINA 25 1 1
RAEHAN 51 1
SRI SUSANTI 34 1 1
ALESHA 5 1 1
ZAINAL ARIFIN 47 1
SILVIA 11 1 1
29 FITRIAWATI 30 1 1
30 CAHYA SENJA 9 1
69 22 170 27 28 7 50 9 3 0 64
0 0
JENIS PEMERIKSAAN
URINE
PROT UL PPT
1
1
1 1 1
1 1
1 1
1
1
1
1
1 1
1
1
1
1
1 1
1
1 1 1
1 1
1
1
1
1
1
1 1 1
1
1
1 1
1
1 1
1
1
1
1
1 1
1
1
1
1
1 1
1
1 1
1 1
1 1 1
1
1 1
1
1
1 1 1
1
1
1
1
1 1 1
1
1
1
1
1
1 1
1 1
1
1
1 1
1
1
1 1
1 1
1
1
1 1
1 1
1
1
1 1
1 1 1
1 1
1
1
1
1 1
1
1 1
1
1
1
1
1
1
1 1
1
1 1
1 1 1
1
1 1 1
1 1 1
1 1 1
1 1 1
1 1 1
1 1
1 1
1
1 1
1 1
1
1
1 1
1
1 1
1 1
1
1
1
1
1
1 1
1 1
10 0 0 47 9 17 4 15 1 16 0 4 0 4 1 6 1 39 5 7 2 6 0 5 1
DAN JARINGANNYA
RAT
JENIS PEMERIKSAAN
1
1
1 1
1
1
1 1 1
1 1 1 1
1 1 1
1 1 1
1
1
1 1
1 1
1
1
1
1
1
1 1
1
1
1
1 1 1 1
1 1 1 1
1
1
1 1 1
1 1
1
1
1 1 1 1
1
1
1
1
1
1 1
1 1 1
1 1 1
1
1
1 1 1
1 1
1
1
1 1 1
1 1 1
1
1
1
1 1 1 1
1 1
1 1 1 1
1
1 1 1 1 1
1 1
1
1
1 1 1
1 1 1 1
1
1 1
1 1
1
1
1 1
1
1 1
1
1
1
1 1
1
1 1
1 1 1 1
1 1 1
1 1
1 1 1 1
1 1 1 1
1
1
1
1
1 1
1 1
1 1 1 1
1 1 1
1
1
1 1 1
1
1
1 1 1 1
1 1
1
1
1
1
1
1 1
1
1 1 1
1 1
1
1
1
1 1
1 1 1 1
1
1
1
1
1
1 1 1
1 1 1
1 1 1 1
1 1 1
1 1 1
1 1 1
1 1
1 1 1
1 1
1
1 1
1
1 1
1
1
1 1 1
1
1
1
1 1 1
1 1 1
1 1
1 1 1
1 1
1 1
1
1
1
1
1 1 1
1
1 1 1
1
1 1 1
1
1 1 1
1 1 1
1 1 1 1
1
1 1 1
1 1
1
1 1
1
1
1
1
1 1
1 1 1 1
1
1
1
1
1
1 1
1 1
1 1 1 1
1 1 1 1
1
1 1 1
1 1
1
1 1
1 1
1 1 1
1
1 1
1
1
1
1 1
1 1 1 1 1
1 1 1 1
1
1
1 1 1
1 1
1
1
1
1 1 1 1 1
1
1 1
1 1 1 1
1
1 1
1
2 0 4 0 38 6 4 0 37 4 0 0 36 4 32 14 84 14 24 11 46 5 20
UA BTA FL
L P L P L P
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
9 41 4 0 0 0 0 0 0 0 0
BULAN :MARET
TAHUN : 2022
Jenis Kunjungan
UMUR No.ID/ NIK /
TGL NAMA
(THN) BPJS/ KIS
DL HB
L P L P L
B L B L B L B L B L
1 HAMZAH H 63 1
SAHARIAH 60 1
SURNANINGSIH 49 1
SUPIANA 53 1
RAHMA 44 1
BURHANUDDIN 49 1
HENDRA 32 1 1
MASRI 41 1 1
SALMA 54 1 1
ELMI Z 37 1
JAELANI 42 1
MUNDARYANI 39 1
DEDI HUSRIADI 40 1
MARIANA 41 1
DWI RISQA 39 1
PAOLINA 29 1 1
SUMIATUN 47 1
YUSRININGSIH 36 1
WINARTI 38 1
NURHAYATI 26 1 1
MASTAWAN 58 1 1
SUPIATI 50 1
FARHADI 18 1
RABIAH 78 1 1
2 L. AHMAD 72 1
NAURA 11 1 1
ZAFRAN 5 1 1
HENDRA IRAWAN 36 1 1
EJA MAYANTI 27 1
FATMAWATI 54 1
NILA A 29 1
SUMIANTI 37 1
JAMALUDDIN 51 1
INAYAH 39 1
RABIAH 78 1 1
HJ. NURHAYATI 87 1
ROHAINIWATI 36 1
LILIS SURYANI 35 1
USMAN HADI 39 1
ROYYAN 16 1
AISYAH A 39 1
ICHA M. ZAIN 75 1 1
ISMAIL FAIZ 2.1 1
NURUL SAFITRI 21 1
NONI FITRIANI 31 1
LESIA ULFAH 30 1
3 WARDATUN HASANAH 2 1 1
4 SALMAH 54 1
ATIKA 36 1
NANIK SUPIATI 32 1
AMRUSSALAM 40 1
AHMAD HASAN 73 1
SAIPAH 54 1
SAPARUDIN 44 1 1
WAZAHIMI 47 1
ASIAH 76 1
AMIRULLAH 32 1 1
ANDIKA PUTRA 14 1 1
HJ. ARMIATI 55 1 1
SUPIATI 50 1
LISTARI 40 1
LUH PUTU ADRI 33 1
SAI KURNIA 18 1
HERLINAWATI 49 1
EKA LESTARI 22 1
HARTATI 48 1
MAKARIAH 67 1 1
ROSYASI 46 1
YAFI 12 1
ABIYU 6 1
RAFFA AKBAR 11 1
ARINI 49 1 1
WIWIN W 24 1
VIVI 27 1 1
ILYARI P 20 1
NURHOMAH 36 1 1
5 GEBI 6 1 1
IBRAHIM 49 1
M. FADHIL 11 1
FITRI 24 1 1
INDA 27 1 1
DINA MARIANA 32 1 1
6 SITI KHOMIDAH 50 1 1
7 ADIDAH 58 1
SYAMSIAH 56 1
NAPILA NURMALA S 14 1 1
HERMANTO 59 1 1
MAHMUD M. SALEH 72 1
NURMINAH 51 1
IDA R 32 1
NURJANNAH 54 1
KAHARUDDIN 31 1 1
CANDRA 49 1
NIZAR 32 1 1
RAFI A 7 1 1
NURHALIMAH 42 1 1
ITA ROSITA 31 1 1
HAIRANI 46 1
ANDI RANI 45 1
HUSNAINI 37 1
SAHORA 34 1
PERBATA 65 1
BAIQ M 25 1
RENU DIMA A 21 1
JUNAIDI 41 1
RISKA AMELIA 27 1
RITA B 41 1
NURYANI 37 1
JONI 38 1 1
MELINDA SARI 19 1
ANA TRI N 29 1
8 NAPILA NURMALA S 14 1 1
MUSLIMIN 34 1
DARYATMO 46 1
SITI KHOMIDAH 45 1
A. KADIR 75 1
RIANI 47 1
MASITA 37 1 1
WIWIN P 23 1 1
AFINA H 12 1
NOVITA HANDAYANI 26 1
M. FEBRIANSYAH 20 1
SITI KHOMIDAH 49 1
BQ. NUR ATIKA 30 1
ARIFIN 63 1
MULYADI 57 1
NOVI ARIYANTI 26 1 1
PATMA 81 1 1
DAHLIA 33 1
BURHANUDDIN 63 1
DARMA 53 1
9 DARMA 53 1
SAGUNI AHMAD 64 1
H. A. AZIS 56 1 1
NORMA 61 1
GUS 35 1
SAHARIA 46 1
IKHWANUL M 26 1
DESI RATNASARI 32 1
RIRIN DELVIA 21 1
NURHIDAYAH 27 1 1
DARMA 53 1
TELLA 29 1
M. TAHIR 60 1 1
10 H. USMAN 63 1 1
HJ. ERNA 56 1 1
DWI P 41 1 1
LILIS AGUSTINA 23 1
ROSILAWATI 41 1 1
ERA FAZIRA 23 1
HADIATULLAH 42 1
ELZA RAHAYU 18 1
SUPRI 41 1
HERNA G 34 1
SANARIAH 31 1
ARI W 32 1
NURLAILA 37 1
SUPIATUN 74 1
11 HASANUDDIN 47 1
WARDATUN HASANAH 31 1 1
ABDUL LATIF 68 1 1
NOVA P 34 1
KAPRI KARNI 25 1
RAHMAT 58 1 1
AHMAD SABIL 9 1 1
SYAINUDDIN 64 1
SURMILANI 49 1
ARIYANTI 31 1
JEZICA QUMALA 8 1
HAFSAH KAMILA 24 1
DARMATASYA 61 1 1
12 DAHLAN 54 1 1
H. RIZKY S 33 1 1
13 AISYAH 45 1
14 RATNA 56 1
NOUVAL K 27 1
RAHMIATUN 53 1
SYAMSUDDIN 45 1 1
NILA A 17 1 1
SALMAWATI 45 1
YENI A 29 1
YUNITA 20 1
NORA 26 1
RAHMA N 28 1
RATNA 26 1
NURHASANAH 39 1
ELSA MAYORA 19 1
RENI S 41 1 1
ASMAWATI 17 1 1
MUTIASIH 42 1 1
PUPUT 16 1
JASMIN S 8 1
CAHYO 30 1
RAGILTA 24 1
FITRIATULIAYLI 23 1 1
15 MASNIATI 46 1
ASWIN K 42 1
AMNAH 60 1
PILIN 42 1
AMBAIYAH 51 1 1
NURHAYAH 57 1
ERNI YUSNITA 40 1
DWI TIRTA K 34 1
KHAIRUL AMMAR 9 1 1
NANIK 43 1
MA'AH 55 1 1
ZAFILAH 13 1
DESTRI WANDARI 18 1 1
MAESARAH 53 1
FITRIATULIAYLI 23 1 1
SAHARUDDIN 57 1
M. SADIK RAHMA 66 1
M. JAFAR 8 1 1
NORMA 56 1 1
16 UMI KALSUM 65 1 1
ANA TRY N 29 1 1
CALVIN DESTA A 11 1
SANIAH 38 1
JUMERIAH 40 1
CINDAWAN 41 1
ELVIA 22 1
MARIANA 41 1 1
RIRIN FATONAH 32 1
NILA WAHYUNI 26 1
EGA MEILANI 18 1
17 MAYATI 25 1 1
NUR TAUFIK 46 1
HADIJAH 49 1
HJ. MUZNAH 52 1
SARINA 35 1
PINTAWAN 42 1
PAJRI SAPUTRA 20 1
IRWANSYAH 22 1
MARIZKA JULIA 10 1
SARA 30 1
MUHAMMAD 71 1 1
BADARIAH 76 1
MUS MULIADI 41 1
TILA DWI 26 1
H. HASAN 82 1 1
18 NURAINI 43 1
AMNAH 42 1
MAYAHARSINI 25 1
HERLINAWATI 49 1
HAFSAH 61 1
ALI K 32 1
NURSIAH 63 1
ANDI YUNI A 21 1
MARIA ULFA 18 1
ARINI 49 1 1
JUNAIDI 32 1
NORMA 57 1 1
H. SUDIRMAN 77 1
19 NURUL HIDAYATI 21 1 1
SAFA 30 1 1
SAFA 30 1 1
20 SAFA 30 1 1
RATMAWATI 31 1 1
ZAMIRAH 21 1 1
21 M. JIBRAN 10 1
ADIPATI 8 1 1
SAMIRA 21 1 1
SITI RAMLIA 53 1
RAHMAWATI 40 1
HJ. HALIMAH 53 1
SITI NURSINTARIANI 28 1
MASAYANG NUR 74 1
KADEK WIRA JUNIARTA 27 1 1
EIKO FIKHRIE 6 1 1
RISKY 10 1
HIDAYATININGSIH 49 1
FITRIAH 48 1
MUH. RIFA 48 1
YUYUN 37 1 1
22 FATMAWATI 34 1
TINA ERFIANA 29 1
ALISA S 5 1
IR. H. SYAHABUDDIN 57 1 1
SARI DAENG 58 1
MARSIDI 87 1
FITRIA SOSILA 20 1
ESTI ERNAYANTI 36 1
H. M YUSUF 77 1
HALIMAH 60 1
NANIN ROHANA 47 1
DWI SEPTIAWATI 26 1
HAPSAH 35 1
MELAYANA 25 1
SYARIFA SIHAB 11 1
ZACKY APRILIO 7.6 1
ARIL DARMAWANSYAH 13 1
EMI LIANA 19 1
SURYA GAZALI H 7 1
23 SRI RARA MINAMI 28 1 1
YUNI MASTIATI 67 1
SUDARJO 57 1
HJ. FATIMAH 71 1
ANDITA A 25 1
SUNDARI 47 1
SAGUNI AHMAD 64 1
SAPAYAH 45 1
SRI RARA MINAMI 28 1 1
DIYAH 24 1
SUBAIDAH 44 1
NUR SYIFA M 35 1 1
YUNI 27 1
ERNA 33 1 1
ZILFIYA 30 1
SELI HARTATI 29 1
FARRAS 9 1
MADEN 37 1
YULIA 36 1
24 ENDANG LESTARI 45 1
SYAMSIAH 54 1 1
AHMADI 19 1
SAHORA 35 1 1
YULIANTI 35 1 1
M. IDRIS 76 1 1
NURMAWASITA 41 1
NORA 29 1
HIDAYATI 45 1
SURYANI 37 1
MARDIATUN 39 1
M. NASIR 24 1
ARGA SAPUTRA 20 1
ROSIKA APRIANI 16 1
TETI 47 1
25 DEVI 30 1
AMINOLLAH 31 1
SAHRA 39 1
H. AHMAD S 58 1 1
NURHASANAH 44 1
ASEP 44 1
FITRIANI 37 1
ISKANDAR AHMAD 67 1
B. LINDAWATI 37 1
SANIA 61 1
HARYATI 28 1
ALAMSYAH 40 1 1
ROYANTO 38 1 1
M. ALI MAJID 73 1 1
ANDITA A 24 1 1
28 M. TAYUB 61 1 1
ROSNAWATI 36 1
NURHASANAH 44 1
SOFYAN 44 1
MUH. IDRIS 76 1 1
HJ. NURJANNAH 60 1
A. RAHIM 59 1
DESRIA YASMIN 24 1
JAMALUDDIN AHMAD 62 1 1
ASMAWATI 17 1
RAFIAH 33 1
YULIA ANGGRAINI 23 1 1
M. YASIN 61 1
SURYA 47 1 1
EKA NURPANSILA 30 1
HADIJAH 52 1
SUKMA LINDA 27 1
SURTINI 31 1
NURHAYATI 47 1
JULIANA 35 1
DESI SUSAN 28 1
MUH. ARYA 21 1
ALI AKBAR 20 1
YULIA 23 1 1
AN. DHIA 9 1 1
29 JAMAL 35 1
RADIAH 48 1
MARWA 27 1
AN. DHIA 9.1 1 1
YULIA A 23 1 1
NURAINI 51 1
ROSIDA 29 1
HALIMAH 61 1 1
INAYAH 11 1 1
HALIMAH 61 1 1
SITI JUMAENAH 17 1
RAHMA 66 1
M. KASUM 67 1 1
PUTRI N 19 1
PUTRI RIDA 19 1
ARYA L 18 1
ZULAHYAN 20 1
NURJANNAH 52 1
VINDI 21 1
YUNI 32 1 1
UMMI 48 1 1
30 DHIA ALIKA 9.1 1 1
LILI KUSNAWATI 36 1
ENDANG LESTARI 45 1
M. KASUM 67 1 1
ROBY SURYAWAN 40 1
HALIMAH 61 1
YUNI MASTIAH 67 1
ADI NOVA K 17 1
NENGSIH 23 1
H. UMAR 52 1
ANISA 21 1
HALIMAH 61 1
DEFI ANGGRAINI 28 1
HAUFANZA 3.5 1 1
31 SIPAWATI 69 1
LENI PUJIASTUTI 24 1
DEFITASURI 29 1 1
ABDUL HAFID 48 1
IKA RISMITA 34 1 1
JULIANA 35 1 1
MARYAM 68 1 1
FAJRIN SHOLIHAH 33 1
JANARIAH 72 1
NURMILAWAN 61 1
SITI 64 1
LINA 22 1
ERIKA 29 1
ANI WIRDA 33 1
MARIAM 53 1
ZAINAL ARIFIN 47 1
WIWIN SULASTRI 22 1
113 11 263 32 36 6 66 12 1 0
JENIS PEMERIKS
URINE
PROT UL PPT
1
1
1 1 1 1
1
1
1
1
1 1
1 1
1 1 1
1
1
1
1
1
1 1 1 1
1 1
1 1 1
1 1
1
1 1
1 1 1 1
1 1
1
1 1
1 1
1
1
1
1
1
1
1
1 1 1
1 1 1
1
1
1 1 1
1
1
1
1
1 1
1 1 1
1 1
1 1
1
1
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1
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1 1
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1
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1 1 1
1
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1 1
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1 1
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1
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1 1 1 1 1
1
1
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1 1
1
1 1 1
1 1
1
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1
1 1
1 1
1 1 1
1 1
1
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1 1 1 1
1 1
1
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1
1
1
1 1
1
1 1 1
1 1 1 1
1
1 1 1 1
1
1
1
1
1 1
1
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1 1 1 1
1 1 1
1
1
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1 1
1
1 1
1 1
1
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1 1
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1
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1 1
1
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1 1
1 1
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1 1
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1 1
1
1
1
1
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1 1
1 1 1
1 1 1
1
1
1
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1 1
1
1
1 1 1
1 1 1 1
1
1 1 1
1 1 1
1
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1
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1
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1 1 1 1
1 1 1
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1 1 1 1
1 1 1
1 1 1
1 1
1
1 1 1
1 1
1
1 1
1 1 1
91 7 0 0 55 7 25 0 36 0 24 2 28 0 32 0 10 0 64 1 10 0 8 1 5
M
AS DAN JARINGANNYA
BARAT
JENIS PEMERIKSAAN
IgG/IgM/NS1 HBsAg ANTI HIV SIPILIS GULA CHOL
L P L P L P L P L P L P
L B L B L B L B L B L B L B L B L B L B L B L
1 1
1
1 1
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1 1 1
1 1
1 1 1
1 1 1 1
1 1
1
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1 1
1 1
1
1 1 1 1
1
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1
1
1 1
1 1 1 1
1 1 1
1 1 1
1 1
1 1
1 1 1
1 1
1 1 1
1
1 1 1
1
1
1 1 1 1
1 1
1
1
1
1
1 1
1
1
1
1
1 1
1 1
1 1 1 1
0 5 0 4 0 65 2 2 0 57 0 0 0 57 0 40 10 126 20 33 5 61 11
UA BTA FL
L P L P L P
B L B L B L B L B L B L
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
29 3 63 10 0 0 0 0 0 0 0 0
BULAN : PEBRUARI
TAHUN : 2022
Jenis Kunjungan
TGL NAMA
(THN) BPJS/ KIS
L P L P L P
B L B L B L B L B L B L
1 ANDI FAISAL 7 1 1
ANDI FAISAL 7 1 1
SYAIFULLLAH 42 1 1
2 SAPAIYAH 42 1
ANITA 21 1 1
ELIZAH A 29 1 1
ASMAWATI 48 1
AHMAD M 20 1 1
SYAFARUDDIN 54 1
GUFRON M 20 1
RONI P 39 1
MUSNAH 58 1 1
SALMAH 53 1
SITI HAWA 50 1
YARTA JAYA 60 1
MASANGAN 53 1
HAMIDAH 50 1
HURIAH 39 1
HAERANI 56 1
SITI HAWA 50 1
M. TAHIR 60 1 1
ANDI TUANG 27 1 1
SAHARIA 48 1
ATIKA SE 39 1 1
DESI A 26 1 1
OVAN S 32 1 1
ZAKIMATUL AZMI 35 1
LINDA 26 1 1
SAIFUL BAHRI 13 1 1
AMENAH 60 1
MAHMUD 72 1
SULAIMAN 85 1
OKTAVIA 26 1
RAHYATUL JANNAH 34 1
HENDRY KUSNADI 47 1
KARMILA 28 1 1
HASMEJA 44 1 1
MIRA 5 1
MIRA 5 1
AHMAD M 20 1 1
FATIMAH 48 1
3 BQ. NURHIKMAH 44 1
MASNAH 58 1 1
MARYAMA 44 1
HJ. FATIMAH 82 1
SRI PURWATI 41 1 1
H. ABIDIN USMAN 71 1
AHMAD 20 1 1
DEVI AYU D 20 1 1
RAHMA 47 1 1
SRI WAHYUNI 29 1 1
AGUSTIAN 20 1
AKBAR ADI 22 1
NASRUDDIN 46 1
ELIZA 33 1 1
IFA AFIFA SHIHAB 5 1
RINI C 52 1
ANDI IDA 37 1 1
ROHANA 14 1 1
NURUL 34 1 1
YULIA P 26 1
AHMAD M 20 1 1
4 RIADA 26 1 1
ADIDAH 58 1
HJ. NURJANNAH 60 1
LUSIANA 30 1 1
HERIA 44 1
M. ZAIN 55 1
OPAN ARIANTO 31 1
ENI 23 1 1
SHAFFIYAH F 5 1 1
SUMARNI 61 1
ANDITA ARYA 24 1 1
INDAH P 24 1 1
SYUKRI 46 1
NORA 29 1 1
QILARA 2.5 1 1
ETY A 41 1 1
AHMAD 76 1 1
5 MAHRAH 50 1 1
MAHRAH 50 1
ANDI FIRMANSYAH 32 1 1
6 NURAINI 34 1 1
7 MARYAM 68 1 1
ZAINAL ABIDIN 68 1
SURYA 42 1
KHADIRAFUNNISA 16 1
RANI 20 1 1
MUHDAR 56 1
ISMAIL 50 1 1
ISHAQ 48 1 1
HUSAIN 30 1 1
NURJANNAH 39 1 1
RAHMA 47 1
SUNDUSIN 39 1
AGUSTINI 44 1 1
RINA S 25 1 1
MASARANG 56 1
FITRIANI 38 1 1
LENA HARIATI 30 1 1
GAZI 49 1 1
UMMUL HONI 29 1 1
SUPARMAN 52 1 1
SAMIRA 20 1 1
RATISA DWIPA A 17 1
AMIRA ZAKILLA 24 1 1
ZIDAN 12 1 1
8 YASE 15 1 1
M. SAID 49 1
DARMIATUN 52 1
LILI ANDRIANI 43 1 1
NANIK RISWATI 43 1
ASMIRANA 78 1
ALZENA A 9 1 1
ZAWIYA 57 1
M. SAAD 59 1 1
DAHLAN 53 1
HUSNA 8 1 1
MANSYUR 62 1 1
AMINA 54 1 1
M. TEGUH 14 1 1
HERMANTO 36 1
ALZENA A 9 1 1
JALALUDDIN 36 1 1
9 KHALIL GIBRAN 7 1 1
WINDA 31 1 1
NIZAR R 7 1
M. NURDIN 57 1 1
ALZENA A 9 1 1
AL HENDRA 68 1
DESI AYU K 30 1 1
RUSMININGSIH 31 1 1
SYAHDI 52 1 1
FITRIANI 29 1 1
NURMA 38 1
RIDLA R 25 1 1
YUSRIL 19 1 1
FITMI 24 1 1
AHMAD HASAN 59 1
SOFIAWATI 20 1 1
USMAN 70 1 1
FATIMAH 82 1 1
NUR S 11 1 1
APRIANI 49 1 1
ALZENA A 9 1 1
ALDI 5 1 1
10 SAPTO 29 1 1
ALZENA A 9 1 1
ALDI 5 1 1
BIKEN 56 1 1
MUADDIN 24 1 1
SAFRUDDIN 45 1 1
ARIYA MALINDA 19 1
NURHAYATI 57 1
ALAYA SHAFA S 17 1 1
JOHARIAH 36 1 1
M. SALEH 27 1
MUNARI 39 1 1
IDA FAHIRA 41 1
MAHNI 21 1 1
ROHANI 59 1 1
AN. ALZENA 9 1 1
11 SAIDUN 56 1
SINDA WATI 21 1 1
JUMINAH 60 1
VANY Z 32 1 1
TRINE W 44 1 1
ALZENA A 9 1 1
SAHIDA 36 1
M. NUERDIN 52 1
NURAINI 46 1
SUMI PARTI 33 1 1
YAN RAMDAYANI 47 1
NURLAELA 26 1 1
AN. ALDI 5 1 1
ALZENA A 9 1 1
HAMZAH 61 1 1
RIZA PEBRIANI 21 1 1
12 WATI S 23 1 1
IKA R 24 1 1
ALZENA A 9 1 1
NURHASANAH 55 1 1
TYAS 38 1 1
13 SRIANI 20 1 1
NOVA 17 1 1
HALIMAH 25 1 1
ZULKIFLI 11 1 1
HAMZAH 63 1 1
14 ROHANI 59 1
AMNAH 42 1
IKRAR BUDIMAN 44 1 1
SRI SUSANTI 33 1 1
ZAINUDDIN 63 1
AULIA Z 11 1 1
ADI IRAWAN 26 1 1
LILI FITRIA 34 1 1
IDAYATI 41 1
SUMARNI 53 1
SYAMSUDDIN 69 1 1
MUSTAFA 40 1
HADIJAH 68 1 1
HERIA 56 1 1
IRWANSYAH 31 1 1
ASMAWATI 17 1 1
SUSITA 32 1 1
AGIL H 50 1
SUBHAN 52 1
AHMAD MANCA 41 1
HADENA 53 1
YUNI 27 1 1
ZULKIFLI 11 1 1
DADE 12 1 1
TRI NURHIDAYAH 32 1 1
MINARMI ELIZA 35 1 1
JAMAL 34 1
ARDIANTO 21 1
FIKRI 29 1
NANDA 19 1
RIAWAN 24 1
FACRUL SUHAIRI 20 1
RIAN 23 1
YUDAH 21 1
15 TENRI ABENG 48 1
A. RAFIQ 42 1 1
SULAIMAN 76 1 1
WAGIRAN 1
RATNA DEWI 43 1
RAHMA 47 1
HAMZAH 63 1 1
ZULGAFAR 56 1
ZIDAN 13 1 1
TIPANI 25 1 1
LAELATUL 21 1 1
JESLIN 11 1 1
ABDUL MUIS 46 1 1
SALMIAH 46 1 1
DEDY K 35 1
ROSDIYANA 50 1
SYAMSUL 38 1 1
SRI N 25 1 1
16 ATIJA 56 1
DENTA BAYANG 38 1 1
FATIMAH 67 1
HADIJA 49 1
SAFINAH 61 1 1
SRI RARA M 29 1 1
DODI 29 1
SRI NAWAN 23 1 1
SURNAWATI 48 1
SAHARYAH 29 1 1
AGUSTINUS 27 1 1
M. IZUL ISLAM 15 1 1
BAIQ PARNIATI 41 1 1
IRMA WANTIKA 39 1 1
ZIKRA MAULIDA 18 1 1
AMINAH 17 1 1
BURHANUDDIN 38 1
SILATUR ROHMI 36 1 1
17 IRWAN BAFADAL 45 1
LENY T 36 1
NANIK S 50 1
H. MUSTAFA 68 1
SAFIYAH 57 1
ROSMAYANTI 24 1 1
ARLIA AGUSTIANINGSIH 25 1 1
ALAYA SHAFA S 17 1 1
TAKDIL 39 1 1
SAIKHAN 56 1
ERDA RITA 24 1 1
FITRIAH 48 1
MUIN HALIDI 50 1
ROSMAYANTI 24 1 1
A. RAFIQ 43 1 1
18 SURIYATI 1
RUSLAN 49 1
FITRIAH 48 1
ROSMAYANTI 24 1 1
SAMSUL ASARI 27 1 1
MUHAMMAD B 24 1
M. BADRUS 24 1
BURHANUDDIN 59 1
NURNANING 46 1 1
HADIATULLAH 49 1
SUHARLI 54 1 1
19 FAUZIAH 59 1 1
EMA RATNA PUTRI 41 1 1
NUR 27 1 1
20 SAFIRA 4.1 1
NURHAYATI 57 1 1
NORA FATIMATUZZAHRAH 29 1 1
21 YAYU JUNIARTI 48 1 1
SYACHON 50 1
WIDYA 14 1 1
SEMERIAH 32 1
FITRI 25 1 1
NURHAYANI 40 1
AISYAH PUTRI 17 1 1
PAULINA 29 1 1
MARIANI M 61 1 1
HABILLAH SALMIN 19 1
22 ALIYAH 66 1
SUSANTI 22 1 1
SUPIATI 50 1
MINARTI 21 1 1
NURVAIDA 35 1 1
NURHASANAH 44 1
FATI SUMARNI 53 1
SULIS A 22 1 1
HADIATULLAH 43 1
MIFTAHUL JANNAH 32 1 1
LUSIE NORA 20 1 1
WILIANI 26 1 1
A. RAFIQ B 42 1
DARMAWATI 34 1 1
AUFA RIJAL 7 1 1
JUMIATI 37 1
RATU A 6 1 1
SYARIFUDDIN 35 1 1
23 DEWI NITA 42 1
SAMSIA 46 1
NUR SRI BATIN 21 1 1
ANA APRIANA 35 1 1
DEDY H 40 1
TRI JUNIANTO 29 1
ELI NOVIANTI 36 1 1
DARA SINTA 19 1 1
DESINTA 25 1 1
AISYAH 6 1
24 HAMIDAH 63 1
HARTAWARI 48 1
HADIJAH 26 1 1
INDAH 27 1 1
ROSTAWATI 41 1
AGUS DWI 15 1 1
NOVITA 16 1 1
ABDUL AZIZ 22 1
M. SALEH 31 1
MITHA TRI M 17 1
IQBAL RIZKI 5 1 1
RITA ULFA S 24 1 1
SYILFI F 33 1 1
M. TAHIR 61 1 1
WIWIK A 34 1 1
25 YUNI NOVITASARI 26 1
MARHAINI 42 1 1
ISMAIL 37 1
FIKRI 57 1
JAELANI A. 42 1
NADIA MAGFIRA 18 1 1
BAHRUL AMRULLAH 23 1
FAHRI 46 1 1
HJ. AMNAH 48 1 1
26 SAPARUDDIN 42 1 1
ROMINISIH 31 1 1
SAOFA 36 1 1
99 16 218 21 50 8 73 10 0 0 68 2
JENIS PEMERIKSAAN
URINE
GD MAL WIDAL IgG/IgM/NS1
PROT UL PPT
L P L P P L P L P L P L P
1 1
1 1
1 1 1
1
1 1
1
1 1
1 1
1
1
1
1
1
1
1
1
1 1 1
1
1
1
1
1
1 1
1
1 1
1 1
1
1
1 1
1
1
1 1
1 1 1
1
1 1 1 1
1
1
1 1
1 1
1
1 1
1
1
1 1
1
1 1 1
1 1
1
1 1
1 1 1
1 1
1 1 1
1
1 1 1 1
1
1 1 1
1 1
1
1 1
1
1
1
1
1
1
1 1 1
1 1 1
1
1
1
1
1
1
1 1 1
1 1 1
1
1
1
1 1 1
1
1 1 1
1
1
1 1 1 1
1 1 1
1
1
1 1
1
1
1
1
1
1 1 1
1 1
1 1 1
1 1 1
1
1 1 1
1 1 1
1
1
1 1 1
1 1 1
1 1 1
1
1
1
1 1 1
1 1 1
1 1 1
1 1
1
1
1
1
1
1
1
1
1
1
1
1
1
1 1
1 1 1
1 1 1
1 1
1
1 1 1
1 1 1
1
1 1 1
1 1
1 1
1
1 1 1
1 1 1
1 1
1
1 1 1
1
1 1
1
1
1 1 1
1
1 1 1
1
1
1
1
1 1 1
1 1 1
1 1 1
1 1
1
1 1
1
1 1
1
1 1
1 1
1
1
1 1 1
1
1
1
1 1 1
1
1 1
1 1
1 1 1
1 1
1
1
1
1
1 1 1
1
1
1 1
1 1
1 1
1 1
1
1 1
1 1
1 1 1
1
1 1
1
1
1
1
1
1 1
1
0 0 40 2 25 3 29 1 17 0 14 0 23 0 25 3 68 1 26 2 22 1 18 3 24
AN JARINGANNYA
AT
JENIS PEMERIKSAAN
L B L B L B L B L B L B L B L B L B L B L B L
1
1 1 1 1
1 1 1 1
1 1
1 1
1 1
1
1 1
1 1
1 1
1
1 1
1
1 1
1 1 1 1
1 1 1 1
1 1 1 1
1 1
1 1 1
1 1
1
1 1 1
1 1
1
1
1 1
1
1 1 1
1 1
1 1 1
1
1 1
1 1 1 1
1 1 1
1
1 1
1 1
1 1 1 1
1
1 1 1
1 1
1
1 1 1
1 1 1 1
1
1 1 1
1
1 1
1 1 1
1
1
1 1
1 1 1
1 1
1
1 1 1 1
1 1
1 1 1 1
1 1 1
1 1 1 1
1 1 1 1
1 1 1
1 1
1
1 1
1 1 1
1 1 1
1 1 1
1 1
1 1 1 1
1 1 1
1
1 1
1 1 1 1
1 1 1 1
1
1 1 1 1
1
1 1
1 1
1 1
1 1
1
1 1
1
1 1 1 1
1 1
1 1
1
1
1 1 1
1
1 1 1
1
1
1
1 1
1 1
1
1
1 1
1 1
1
1
1 1 1 1
1 1 1 1
1 1
1 1
1
1
1 1 1
1 1 1
1 1 1
1 1 1
1
1
1 1 1 1 1
1
1
1 1 1 1
1 1 1
1 1
1 1
1 1
1
1
1 1
1 1
1
1 1 1
1 1 1
1 1
1
1 1 1
1
1 1 1
1
1 1 1
1 1
1 1
1 1 1
1
1
1 1 1
1
1 1 1
1 1 1
1 1 1
1 1 1 1 1
1 1 1
1
1 1
1
1
1 1 1 1
1
1 1
1 1
1 1 1
1 1 1
1
1 1 1 1
1
1 1
1 1
1 1 1
1 1
1 1 1
1 1 1
1
1 1
1 1 1
1
1 4 0 46 2 3 0 43 1 1 0 43 0 24 7 97 14 22 7 44 5 22 5
UA BTA FL
P L P L P
B L B L B L B L B L
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
40 2 0 0 0 0 0 0 0 0
BULAN : JANUARI
TAHUN : 2022
Jenis Kunjungan
TGL NAMA
(THN) BPJS/ KIS
L P L P L P
1 SARTIKA 31 1 1
AMRI 6 1 1
ALWAN 41 1 1
LULU S 34 1 1
DARMAWAN 12 1 1
2 DWI RIZKI 9 1 1
DESI R 26 1 1
MERI 32 1 1
ASIA 69 1 1
FITRIANI 37 1 1
3 ADIDAH 58 1
ANDRY JULIASTRI 19 1
ANTINI 27 1 1
MURHAINI 50 1
DENI NUGRAHA 36 1 1
SYAKILA 4.11 1 1
MASAAD UBUD 64 1
PUTU YUDIADI 32 1
DWI RIZKI 9 1 1
NURHANDAH 27 1 1
HARDONI 27 1 1
SYAHRIL 47 1
MARIAM 53 1
HERDIANTO 52 1
NADIER 14 1 1
BQ. USMATUN 22 1
FADILA AMANDA 23 1 1
M. ALWAN 40 1 1
MARIAM 53 1
EHSIA 16 1
SENIRIAH 40 1 1
LINA 38 1
AHMAD P 9 1 1
GHAZY ALFA 5 1 1
YUNA 27 1 1
ARI 22 1
ZAINAL ARIFIN 47 1
TEGUH 42 1 1
USNIATUN H 22 1 1
NURAENA 58 1
DARMANI 12 1 1
ASIA 68 1 1
MUH. SALIM 31 1 1
DENI NUGRAHA 36 1 1
NURHAYATI 43 1
DEWI N 36 1 1
DWI RIZKI 9 1 1
M. TAHIR 42 1 1
SALMAN JAYADI 33 1 1
4 DENI NUGRAHA 36 1 1
KAMARIAH 61 1 1
SULTAN RADITYA 3 1 1
HAFSAH 61 1
M. TAHIR 55 1
BUNAIYA 33 1 1
NORMA 56 1
SITI NURLIS 56 1 1
MASNI 43 1
MASITA 58 1 1
M. RIZKI 3 1 1
INTAN NURAINI 13 1 1
MINARTI 21 1 1
ABDULLAH 42 1
MARIA AMBU K 21 1 1
EKA M 15 1 1
NURLAILI AGUSTINA 26 1 1
DEWI NUGRAHA 36 1 1
INTAN 13 1 1
DEWI NUGRAHA 36 1 1
5 SUYOTO 60 1 1
MUKMINA 50 1
ARI APRIANI 34 1 1
DEWI NUGRAHA 36 1 1
SAHRUL YADI 39 1
FITRI R 13 1
MARIAM 68 1 1
SAINI 76 1 1
RISKA 27 1 1
KALSUM 63 1 1
H. ABDULLAH 72 1 1
FIRDAUS 26 1 1
DIKA 11 1 1
AHMAD P 56 1
SIRI MANDILA 25 1 1
NURAINI 45 1
RIZA FAGITA J 23 1 1
ERA S 36 1
WARDATUN 31 1 1
ERA SUSANTI 36 1 1
SUMIATI 43 1
NURJANNAH 76 1
DEWI INDRAWATI 1 1
RAGUAN 44 1 1
SUMIATI 43 1
SARMI 20 1 1
MIRGA P 13 1 1
YENI AULIA 15 1 1
ADI MAHROMAIN 34 1
M. ALVAN 9 1 1
DEWI NUGRAHA 13 1 1
INTAN NURAINI 13 1
AMIRUDDIN 62 1 1
DEWI N 36 1 1
MIRGA PUTRI R 13 1 1
6 ZULKIFLI MUHADLI 11 1 1
HAMIDAH 64 1
A. KADIR HAMID 75 1
HUSAIN M. SALEH 65 1
MASARAN 56 1
MIRGA PUTRI R 13 1 1
HUMAIDI ZAKI M 38 1 1
MARIA AMBU K 22
MUHDAR 56
MAYTA SAFITRI 37
INTAN NURAINI 13
NURUL SAFITRI 21
HARTINA 25
SEHON 46
SRIANI 42
HABIBAH 45 1
FITRA JAYA 48 1 1
SOVI 11 1 1
ADE MAULANA 36 1 1
BQ NINING 23 1 1
MARLINA 45 45 1
NURINTAN 38 1
BADARIAH 45 1
HASAN NURDIN 24 1 1
MULIATI 21 1 1
FATMAWATI 55 1 1
SUBAENA 34 1 1
PANJI MAULANA 29 1 1
7 SUBAENA 34 1 1
MARIA AMBU 22 1 1
YHUSRAN SALIM 42 1 1
M. ZAYYAN 3.11 1 1
SOVI 11 1 1
ANDITA ARYA 24 1
ALZA NURRAHMAN 14 1
AYU SAFITRI 25 1 1
VERI FEBRIYANTO 26 1
INDAH SAKIRA 20 1 1
SRI LANGI 55 1
AHMAD 56 1
HERMAN 35 1
M. SALEH 54
FATIMAH 46
YULIA 37 1
SYAFITRI 24 1
ROSMAYANTI 24 1
NURSIHA 60 1 1
RIZKI HIDAYATULLAH 17 1
MALAPUANG 32 1 1
8 SRI NURNANI 25 1 1
EMILIA 25 1 1
HADIJAH 51 1 1
RONA PURNAMI 21 1 1
YAYA HIDAYAH 26 1 1
9 ANI 30 1 1
10 ROSMINI 34 1 1
AMINAH 41 1
SIPAWATI 69 1
SAIPAH 53 1
M. AUFA 8 1
ABD. HAFID 48 1 1
ELINA FITRI 18 1
MUHAMMAD 66 1
ANI 30 1 1
HJ. NURJANNAH 57 1 1
NABILA 28 1 1
GALIH RIFKI K 11 1 1
NURYANTI 59 1
TIARA SULISTIA 7 1 1
ADINO PUTRA J 20 1 1
SESILIA TRI A 13 1
ARDINA S 32 1 1
MASTUR KALBIAH 30 1 1
SARIPAH 81 1
IDAYATI 30 1
ISTIKOMAH 51 1
NUR SEKA 60 1
MASTUR 54 1
SAODAH 56 1
HIDIANI 33 1
MUKHSIN 51 1
NURHIDAYAH 31 1
SITI HAWA 81 1 1
HUSAIN USMAN 76 1 1
ADE IRMA 30 1 1
MASTUR 30 1 1
TITIN A 22 1 1
ROSITA 35 1 1
RIA 34 1 1
11 H. A. HADI JAFAR SYIHAB 60 1
YAZAN ABDUL RAFIF 6 1 1
JHJ. FATIMAH 67 1
HJ. MIMI 26 1 1
MASTUR 30 1 1
SALEH 58 1
ADIZAH 36 1
IKBAL 13 1 1
HJ. RABAIYAH 56 1
ATIJAH 56 1
MARYAM 60 1
RANDI SAPUTRA 10 1 1
AMRIN 55 1
JUSMAWATI 36 1 1
HAUFANZA 3.2 1 1
MUH. DAHYAR 60 1
MUKHLIS 31 1
SALMAH 60 1
MARIA A 22 1 1
VENY MELINDA 24 1 1
YUNI FITRIANI 36 1 1
ETI A 41 1 1
NURAINI 48 1 1
WHENNAYU MILLA 24 1 1
DENITA SOLEHA 31 1 1
M. HAFIS 7 1 1
NURAINI 50 1 1
MARIA 22 1 1
MIMI 26 1 1
12 MARIA A 22 1 1
MIMI 26 1 1
IMRAN 49 1 1
RUKMINI 44 1
SAFRUDDIN 46 1
BY. MASTUR 1 1
YULIANTI 38 1 1
PADOTA PUTRA 19 1
USNA WATI 19 1 1
YULIANTI 24 1 1
RAINI 45 1
AMIRUDDIN 62 1 1
PUTRI LINDA L 28 1 1
JUWERIAH 41 1 1
HJ. CINDRA 80 1 1
SYARIFUDDIN 48 1 1
MIHRAM 52 1 1
13 ENNY ROJANI 39 1 1
MUNHAMI 56 1
SITI SUHADA 60 1
UMUL HANTI 26 1
MINADORISA 44 1 1
DEFITASARI 29 1 1
YULIA 66 1 1
KESI SAFITRI 22 1 1
HASMIATI 31 1 1
MARIANA 40 1
ERNAWATI 28 1 1
ELYAWATI 33 1
M. ALI MAJID 73 1 1
LINDA K 27 1
TATANG D 23 1 1
RINA MARIAM 30 1 1
MARDIANA 37 1
ALDA D 17 1
ALYAH 8 1 1
VIRA I 21 1 1
JULI A 36 1
DEFITASARI 29 1 1
14 A. KADIR 73 1
GHAISAN 3.8 1
NURHAYATI 46 1
YULIA 66 1 1
AFNI NETA Q 10.8 1 1
ZULKARNAEN 47 1
ASIAH 40 1 1
FAHRI 49 1
INDANA SULFA 23 1 1
ANISA 19 1 1
MAGHRIVIA PUTRI 22 1 1
YUISTEN E 7 1 1
IKE LIBRAYATI 47 1
ALIYAH 8 1 1
ENNY 39 1 1
15 ENNY 39 1
ALYAH 8 1 1
NISA NOVA A 13 1 1
M. FARDAN 8 1 1
RANI 27 1 1
16 GIBRAN 6 1 1
ALYAH 8 1 1
ERNI 43 1 1
ARIANI 40 1 1
NOVIANA SARI 26 1 1
17 HAMIDA 45 1 1
LAMYA 35 1 1
SRI LINDAWATI 38 1
FITRIAH 48 1
ILHAMUDDIN 11 1 1
ZAINUL A 38 1 1
ALYAH 8 1 1
GIBRAN 6 1 1
M. ARJUNA 12 1 1
MASNI 43 1 1
MINDARTI 33 1 1
SRIJAYANTI 19 1
AN. NATASHA ATTA 10 1 1
MUH. KHOLID 5.10 1 1
IZMUL NIZAM 25 1 1
NAVILLA 26 1 1
MARYATUN 39 1 1
RA'MAH 24 1 1
FARIDAH 45 1 1
M. DIVAN A 7 1 1
ARISHA 2.3 1 1
ALESHA 5 1 1
DYUSRAN ALIF F 6 1 1
HAFSAH 2 1 1
ALYVIA ANDA 31 1 1
M. THOLHAH A 4 1 1
EKI M 18 1 1
FITRIANI 32 1 1
18 ZIFIYA 29 1 1
YUSRAN 6 1 1
APRILIA 20 1 1
NALINDRA. E 13 1 1
KARIMUDDIN 51 1
RADJA DANI 15 1 1
NITA ROSITA 32 1 1
ADI PRATAMA 23 1
MASAYANG 70 1 1
H. SULAIMAN 73 1 1
DYUSRAN 6 1 1
SADIAWATI 25 1 1
EMI 52 1 1
ROSIDI 58 1 1
EKI MUSISI 18 1 1
19 HAIDAR 38 1 1
SYAFRUDIN 46 1
DYUSRAN 6 1 1
RINI A 31 1 1
LILI ANGRAINI 40 1 1
MARIANA 36 1 1
DEDY RAHMAD 35 1 1
MAULANI DWI N 22 1 1
RIZQI H 17 1 1
NURAINI 20 1 1
IRAYANTI 21 1 1
SULASTRI 40 1
CELA 76 1
KAHIRUN 38 1 1
SAMITA 21 1 1
SURIANI 47 1
HARYATI 28 1 1
ROSDIANA 32 1 1
RAMLI 48 1
EMHALIL 6.6 1 1
DARUSSALAM 50 1
ZAEDON 63 1 1
NURJANNAH 39 1 1
DYUSRAN 6 1 1
M. KHOLID 5.10 1 1
HUSAIN 32 1 1
20 RATIH K 23 1 1
SITI HADIJAH 69 1
IIN MAESUPITA 36 1 1
SRI LINDAWATI 38 1
SEMA 71 1
RAGUAN 44 1 1
ASMINI 31 1 1
KARDINA WANTI 23 1
DYUSRAN 6 1 1
MIFTAHUL H 21 1 1
DIAN R 41 1 1
RINNY RAMDANY 33 1 1
ULFA 23 1 1
ROSDIANA 37 1 1
CAHYA S 8 1
21 SAHRA 48 1
MARIA TRIANINGSIH 26 1 1
KARTINI 26 1 1
H. RAMLI A 72 1
AQILA F 7 1 1
ROSITAWATI 41 1 1
NURHALIMAH 29 1 1
HERY JAYADI 33 1
LARAS 12 1 1
HUSEIN 38 1
SITI MARYAM 42 1
H. HUSAIN 72 1
FIRDAUS 50 1 1
HERLINA 31 1
ABU SYIFA 44 1
LALU YEYET 45 1 1
ELLY 54 1
UUN NINGSIH 25 1 1
MUH. THOLHAH AZ-ZAKY 4 1
SUSMAWATI 37 1 1
22 FERA 25 1
FITRI 22 1 1
ZEULATI 2 1 1
FERA 25 1
23 FAHRIZAL 25 1 1
M. ADILYA 9 1 1
24 ASTUTI 21 1
ZIDAN 2.11 1 1
M. ADITYA 9 1 1
TIARA BHAZIA 18 1
ALDI PRATAMA 15 1 1
BAHAKING 45 1
LAELI ADIYANI 42 1
ZIKRIYAH 38 1
DAHLAN 53 1
IILMAN ADITIA 16 1 1
RATNAWATI 39 1
SURYANI 49 1
NURKEMAH 62 1
HAWADIAH 38 1 1
FENY EKA 22 1 1
TINA 25 1 1
RIANA 26 1 1
MUH. IKHSAN 32 1
AISYAH PUTRI M 17 1 1
SAMSUN 56 1 1
RAHMAWATI 54 1
SAMIRA 31 1 1
ALIA L 25 1 1
LALA 5 1 1
CAHYA SENJA 8 1
AN. ILMAN 13 1 1
ADITYA 9 1 1
JAWARIAH 76 1 1
25 KERTINA WATI 29 1 1
KHADIJAH 42 1 1
ILMAN 13 1 1
MARYAMA 44 1
M. AMIN 72 1 1
HJ. RABAYAH 65 1
MAHREP 63 1 1
RAHADIN RASAHU 26 1 1
SAKTI PUTRA 19 1 1
DESI R 23 1 1
ALEANO N 5.8 1 1
ARI AFRIAWAN 18 1
NURAINI 36 1
ABDUL LATIF 68 1 1
RATIH KUSUMA W 20 1 1
SEPRIADI 20 1
ILMAN 13 1 1
HALIMA 27 1 1
ANISA 49 1 1
SYANSIA 51 1 1
26 ASEP MUHAMMMAD 49 1
DEDY RAHMAD 36 1
ILMAN 13 1 1
ROSITAWATI 35 1 1
ELIN P 31 1 1
NOVA RISTIANI 6 1 1
SAFRI HASBULLAH 43 1 1
HALIMATUSSA'DIAH 45 1 1
NURUL WASTI 37 1
YAYUK 24 1 1
NURHAYATI 49 1
SYAMSUL K 33 1 1
QONITA A 6.5 1 1
INDRIYANI P 1.1 1 1
RUSTIANTI 45 1 1
M. SALEH 77 1 1
HADIJAH 68 1 1
NADIA 17 1
SUSMA 32 1 1
ILMAN 13 1 1
MARIFATUL F 28 1 1
ZAENAL A 41 1 1
MEGA 17 1 1
ILMAN 13 1 1
27 NUR ATIKA 30 1 1
MAEMUNAH 71 1
DINA MAYASARI 37 1 1
MEGA 17 1 1
ILMAN 13 1 1
HERY JAYADI 33 1
SAHORA 66 1 1
M. SARJAN 39 1
ALILA 7 1 1
H. A. YANI 72 1 1
DIVA 11 1 1
BOBBY ARIANTO 41 1
ROBIATUL ADAWIYAH 36 1 1
VIVI MAYTALIA 19 1 1
DANI LESTARI 31 1 1
M. ICHLAS RAYYAN 22 1
LENI PUJIASTUTI 24 1 1
ABDUL RIFAI 45 1 1
DINA 37 1
RISKA 30 1 1
FEBRI 14 1 1
SARIATUN 31 1 1
ILMAN 13 1 1
28 MASITA 58 1 1
ILMAN 13 1 1
DINA 37 1 1
DEDE TRI SAPRIANTY 10 1 1
SULAIMAN 60 1
ZUANDI 46 1
MEGA 17 1 1
RAHMAH 50 1
AINAYYA 5.6 1 1
APRIAN KUSUMA 23 1 1
RIZKA NOFIANTI 24 1
SABIB SAPII 20 1
RAEHAN SAPUTRA 20 1
H. DAYAD 66 1 1
TIKFIAH B 46
SAFA 30 1 1
ZIKRA MAULIDA 16 1 1
MARINA 18 1
RAMLAH 21 1
SAHNIM 36 1 1
M. NUR 25 1
FAHRI UMARA 16 1 1
29 VIVI 17 1 1
30 SUMIATI 26 1 1
MEGA 17 1 1
ANDI FAISAL 7 1 1
SUSI 26 1 1
31 FAJRIN 32 1 1
JAWARIAH 42 1
AYU 18 1 1
SUHAIMI 51 1 1
JIVA DWI 20 1
MAEMUNAH 65 1
NAUFAL R 19 1
NURTAUFIK IDRIS 46 1
MARYAMA 44 1
ANDI DAENG 21 1
NUR ALAMSYAH 36 1
NURDIN 59 1 1
MELI KUSMIATI 42 1 1
WIRASUSTIN 21 1
NURAINI 45 1
MARNI 46 1
KARDINA WANTI 23 1
HALIFAH 61 1 1
AZMAL HASAN 43 1 1
HASNA 39 1 1
LALU M. TAUFIK 21 1
RIFKI ISWANTO 19 1
WALDY SEPTI P 19 1
ROBY A 19 1
SAKTI PUTRA R 19 1
RIZKI AMANDA 20 1
MELI PUSPAWATI 19 1
RADIANSYAH 31 1
MEGA SILVIA 7 1 1
SAIFUDDIN 20 1
SYAHRUL ARGAM 20 1
MUL 1 1
HERU ARDIANSYAH 20 1 1
158 21 328 35 91 19 146 20 1 0 82

JENIS PEMERIKSAAN
URINE
PROT UL PPT
1 1 1
1 1
1 1 1
1 1
1
1
1 1 1
1
1
1 1
1
1 1
1
1
1
1 1
1
1
1
1
1 1
1 1
1 1 1
1 1
1
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1 1
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1 1 1
1
1 1
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1
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1
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1 1 1
1 1
1 1
1
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1 1
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1
1
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1
1
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1
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1 1
1
1
1 1
1
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1 1 1
1
1
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1 1
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1 1
1 1
1 1
1 1
1 1 1
1 1
1 1
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1 1
1
1
1
1
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1 1 1
1 1
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1 1 1
1
1
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1 1 1
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1 1
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1 1 1
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1 1 1
1 1
1
1
1 1 1
1 1
1
1 1
1
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1
1
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1 1
1
1 1
1
1
1 1
1
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1 1 1
1
1 1
1 1
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1 1 1
1
1 1
1
1 1
1 1 1
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1 1
1 1
1 1
1
1 1 1
1 1 1
1
1
1
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1 1 1
1
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1 1 1
1
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1 1
1
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1
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1 1 1 1
1
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1 1
1
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1
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1 1 1
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1 1 1
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1 1 1
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1
1
1
1 1 1
1
1 1 1
1
1
1 1 1
1
1 1 1
1 1 1
1 1 1
1
1
1
1
1
1
1
1
1
1
1 1 1
6 0 0 21 0 14 1 28 3 20 2 25 0 41 0 35 2 99 7 50 4 61 4 26 1
M
S DAN JARINGANNYA
ARAT
JENIS PEMERIKSAAN
1 1
1
1
1
1 1 1
1
1
1
1 1 1
1 1
1
1 1 1
1 1 1
1
1 1
1 1 1
1
1 1 1 1
1 1 1 1
1 1 1 1
1 1 1
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1 1
1 1 1
1 1 1 1
1
1
1 1 1
1 1 1 1
1 1 1 1
1 1 1 1
1
1
1
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1
1
1 1
1 1 1
1 1
1
1 1
1 1
1 1 1
1 1 1 1
1 1
1
1 1 1
1
1 1 1
1 1 1 1
1 1
1
1
1 1
1
1 1 1 1
1
1
1
1
1
1 1 1 1
1
1
1 1
1
1 1
1
1
1
1 1 1 1
1
1
1
1
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1 1
1
1
1
1
1 1
1 1 1
1 1 1 1
1 1 1 1
1 1 1 1
1
1
1
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1
1
1 1
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1 1 1 1
1 1 1
1 1
1
1 1 1 1
1
1
1
1
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1 1 1
1
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1 1 1 1
1
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1 1 1 1
1 1
1
1
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1 1 1
1
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1 1 1 1
1
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1 1 1
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1 1 1 1
1 1 1 1
1 1 1 1
1 1 1 1
1
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1 1 1
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1 1 1 1
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1 1 1 1
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1
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1 1 1
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1 1 1
1 1 1
1 1
1 1 1
1
1
1
1
1 1 1
1 1 1
1 1
1 1
1 1
1 1 1 1
1 1 1
27 1 3 2 58 4 0 0 54 3 0 0 52 3 41 1 132 13 35 1 43 6 37
UA BTA FL
L P L P L P
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
2 43 7 0 0 0 0 0 0 0 0

BPJS Tahun 2022

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DAFTA

Jenis Kunjungan URINE

154 52 249 119 49 17 133 43 0 0 20 11 0 0 27 29 18 9 25 11 21

GD MAL WIDAL IgG/IgM/NS1 HBsAg ANTI HIV SIPILIS GULA CHOL

Jenis Kunjungan URINE

GD MAL WIDAL IgG/IgM/NS1 HBsAg ANTI HIV SIPILIS GULA CHOL UA

Jenis Kunjungan URINE

122 34 250 108 62 16 83 30 0 2 76 26 1 0 38 20 22 2 32 13 18 3

GD MAL WIDAL IgG/IgM/NS1 HBsAg ANTI HIV SIPILIS GULA CHOL UA

Jenis Kunjungan URINE

GD MAL WIDAL IgG/IgM/NS1 HBsAg ANTI HIV SIPILIS GULA CHOL UA

UMUR No.ID/ NIK / Jenis Kunjungan

120 48 209 135 55 11 63 29 1 1 68

IgG/IgM/NS1 HBsAg ANTI HIV SIPILIS GULA CHOL UA

IgG/IgM/NS1 HBsAg ANTI HIV SIPILIS GULA CHOL UA

IgG/IgM/NS1 HBsAg ANTI HIV SIPILIS GULA CHOL UA

IgG/IgM/NS1 HBsAg ANTI HIV SIPILIS GULA CHOL TG

IgG/IgM/NS1 HBsAg ANTI HIV SIPILIS GULA CHOL UA

IgG/IgM/NS1 HBsAg ANTI HIV SIPILIS GULA CHOL

IgG/IgM/NS1 HBsAg ANTI HIV SIPILIS GULA CHOL UA

158 21 328 35 91 19 146 20 1 0 82

IgG/IgM/NS1 HBsAg ANTI HIV SIPILIS GULA CHOL UA

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