REGISTER RUJUKAN EKSTERNAL B

Tanggal No Tanggal Nama No. RM Tanggal Lahir

12/3/2021 1 12/3/2021 Elly Eliantana
2 JUNI KASIANI
3 LIE POH FENG
4 HERRY TERNOTO
5 NA SAUW TIN 1813/10 3/13/1953
12/7/2021 6 12/7/2021 DEDY KURNIAWAN 4597/15 6/20/1946
7 WISA 5224/15/GP 5/15/1940
8 HUTAMA TJAHJADI 2092/16 5/8/1936
9 WELIANA GUNAWAN 6657/20/GP 9/3/1952
10 SOEJONO 9111/21/GP 4/5/1957
11 LIM BUN HO 7099/15 GP 7/23/1960
12 TJEN ELLEN 7259/14 8/24/1956
12/13/2021 1 12/13/2021 LAI, KURNIAWAN 4497/18/GP 1952-06-18
2 LEGIMIN 3613/15 7/15/1957
3 JANI 3613/15 GP 5/30/1959
4 ASPAN KS 12614/12 12/28/1949
5 BONG A SAN 3008/21/GP 11/21/1951
6 NURHANI BUTAR BURTAR 9806/13/GP 3/24/1940
7 KHO TJIN HOA 12636/19 GP 9/11/1955
8 TAN HELEN 11593/21/GP 7/17/1953
9 FARIDAH 3394/15 7/30/1941
10 TITIEK HARIATI 10824/17 gp 7/12/1951
11 KHAYATUN 2857/18/GP 12/9/1960
12 BUN TJEN KHONG 8918/21/GP 4/20/1961
13 DARMAN 3130/21/gp 3/12/1956
14 IE KIANG HOEI 8994/10 3/23/1952
15 ASNAWATI 10655/13/GP 12/5/1948
16 HENDRO PRANOTO 7810/14 5/1/1946
17 CIN DJUK SAUW 625/15/GP 3/3/1952
18 LIE SE MOY 4696/14/GP 11/20/1948
19 TITIN 4453/18 12/31/1952
20 WISA 5224/15/GP 5/15/1940
21 NGADIMAN 5792/17/GP 6/9/1945
22 TITIK SUHARTI 4017/16/GP 10/12/1957
23 HERMIN _8427/21 10/26/1959
24 I GUSTI AYU KARNINA 2352/11/GP 5/16/1940
25 Suparmi 6100/14/GP 5/14/1952
12/15/2021 1 12/15/2021 UJANG MACHRUDIN 12295/18/GP 6/1/1961
2 WISA 5224/15/GP 5/15/1940
3 HUTAMA TJAHJADI 2092/16 5/8/1936
4 MARTA SADJIMAN 5368/18 5/15/1951
5 NA SAUW TIN 1813/10 GP 3/13/1953
6 DRS MAX MULYADI H 13056/19/GP 9/14/1940
7 MURTINAH 8807/13/GP 5/25/1955
8 HEFNAWATI 5494/14GP 11/1/1957
 9 TISWENING 315/15 GP 9/6/1956
12/16/2021 1 12/16/2021 LINGGAWATI SUSANTO 1340/15/gp 6/21/1956
2 hanny verlina wiryanata 3484/15/GP 3/6/1949
3 SUBAGDJA PANCA 8720/19/GP 11/18/1954
4 KWEE HOEI LAN 11997/18 GP 10/8/1946
12/17/2021 1 12/17/2021 ENDANG KADISIH 3222/8/gp 9/10/1955
2 KUSNADI KURNIAWAN 8172/21/GP 9/19/1959
3 BUDYONO 5030/14/UGD 10/10/1946
4 TAN MUI LANG 8464/17 6/25/1956
5 SULISTIYAWATI 3363/11 GP 2/16/1945
6 NELLY SENEWE 4003/14/GP 4/18/1948
7 JIOE PO AY 1570/16/GP 12/22/1953
8 SUDJONO SIMAN 1616/16 GP 3/3/1949
12/20/2021 1 12/20/2021 Lie Giok Du 3382/16
2 SLAMET BUDIANTO 878/21 1/27/1958
3 HIAP TJAN 807/15 4/1/1944
4 MIE MIE 3753/11 8/1/1952
5 SUYATI 292/17 3/14/1952
6 SITI JUARIAH 11735/21 1/9/1958
7 LILYANAH ADHI 11751/21/ 1/9/1958
8 TJOE YAN MOY 11754/21 12/27/1944
9 AMATUL HAFIZ SIDIQAH L. 12507/12/ 7/8/1955
10 SULAEMAN HERMAN 3731/11 4/28/1944
11 BUDI SANTOSO 8829/21 2/10/1947
12 TITIK SUHARTI 4017/16 10/12/1957
13 hanny verlina wiryanata 3484/15 3/6/1949
14 ARTINI 8325/17 27/12/197
15 JOSEPH HUTABARAT 11776/21 3/2/1960
16 JACUB AGUN TJIOMAS 8326/21 2/20/1961
12/21/2021 1 12/21/2021 linda aluwi 5707/18 1/30/1945
2 gouw soi weng 1044/15 4/29/1954
3 lim chai seng 10/29/1948
4 rika aryani 2489/18 12/19/1960
12/22/2021 1 12/22/2021 DENY HARTONO 40/21/TDU 10/20/1960
2 HAMBALI 5985/18/GP 2/16/1937
3 LITA KURNIAWAN 1602/15 GP 12/22/2021
4 MAIDE MANALU 2900/5/GP 5/10/1957
5 UDIN SYAFRUDIN 11769/19 GP 10/10/1957
6 HIOE MIE SIU 8168/16/GP 11/20/1955
7 MIAN TONDANG 5779/14/GP 2/20/1955
8 SURYANI 9237/19 GP 11/10/1947
9 HONG SIOE BIE 8952/14/GP 3/13/1954
10 SARWO EDDY WIDJAJA 3022/18/GP 10/2/1947
11 THE EDDY ISKANDAR 6004/14 7/15/1946
12 ZUHRIANAH 2156/2020 8/24/1952
13 CHO SUI TJU 3022/18/GP 3/23/1959
14 HADI PRATIKNO 9406/18 GP 11/11/1956
15 SUKAMTO 11841/21/GP 1/15/1959
 16 TJHAI KHI FAT 10763/17 5/21/1951
17 DARMO KATIMIN 4597/13/GP 9/16/1952
12/23/2021 1 12/23/2021 TJHIN PIANG NAM ALS BUDIANTO 5373/19/GP 9/3/1961
2 SUMIJATI 5614/16/GP 3/1/1956
3 RINA SENTOSA 8671/17/GP 3/11/1954
4 BEJO HARJONO 10598/18 GP 7/5/1956
5 TJEN HIAN HOA 5734/14 9/1/1953
6 SUGIONO 1330/18 6/30/1958
7 SITI AISYAH 11875/21/gp 12/20/1957
8 ALOYSIUS WURYATNO 8300/18 GP 5/27/1940
9 SARWO EDDY WIDJAJA 3022/18/GP 10/2/1947
10 NANDY ISKANDAR 9257/21/GP 4/1/1954
11 radjali josef 5376/14 1/20/1943
12/24/2021 1 12/24/2021 FRISNA BURHAN 4279/17/GP 2/21/1954
2 ATJANG 9932/18 GP 7/10/1954
3 LIE KIOEN LIN 5671/21/GP 12/24/1952
4 SUGIYO 9361/21/gp 5/17/1956
5 SARIYATI 4800/16 GP 7/27/1959
6 LOEI HENDRY 11906/21/gp 11/27/1958
7 TAN CHRISTINY 5888/18/GP 11/24/1956
8 LAUW MUI GUEK 6162/16 5/16/1959
9 TJOE DJOEN TJIN 8509/16/gp 6/5/1950
10 ARWI 6368/7/GP 4/13/1955
11 OEY WAN NIO 11911/21/GP 8/25/1956
12 INDRAWATI KUSUMA WARDANI 1837/17/GP 2/5/1946
13 HERLINA SUTARDJA 3095/16 GP 5/8/1953
14 BING SELAMAT 5669/18/GP 7/14/1957
15 INGE 7447/14/GP 7/23/1953
16 LIE SE MOY 4696/14/GP 11/20/1948
17 EDY YANTO TJHIN 1063/18/GP 2/12/1957
12/27/2021 1 12/27/2021 DARSANTO PRAJOGO 6264/21/GP 5/1/1943
2 VIRGINIA WIDJAJA 6263/21/GP 10/27/1945
3 HUSNIAH 2542/13 3/19/1957
4 TJHIE KHIUK LIAN 11924/21/gp 12/1/1953
5 GORETINA CANDRAWAN_ 11926/21/GP 9/12/1959
6 FAHRUDDIN 8938/21/GP 5/7/1944
7 SOEMIRAH,LIE 7670/13/GP 1/17/1957
8 LIANBRIL RUSLI 11778/21/gp 4/18/1954
9 BUNARTO 6593/18/GP 8/27/1950
10 CHAIRUL MALIUS 9962/20/GP 8/16/1961
11 FATIMAH 3376/13/GP 3/6/1960
12 TJENG KHIEUN JIN 4136/15/GP 3/18/1960
13 SUKARJI 12013/21/GP 3/1/1959
14 ROSMANI 375/18/GP 8/16/1938
15 hardijanto widjaja 2331/21/GP 5/15/1945
16 KURNIADI HIMAWAN 3655/21/GP 8/5/1943
17 SUKARJI 12013/21/GP 3/1/1959
12/28/2021 1 12/28/2021 CLEARESTA T TJIO FOEILAN 2336/16 5/18/1960
 2 HARTONO GUNAWAN 5029/17/GP 1/10/1964
3 SUGIANTO 889/20 jb 6/15/1960
4 JENIWATININGSIH 6475/16 GP 9/22/1959
5 LAY JIN HIE 6475/16_gp 11/22/1948
6 ARMILA 2331/15 GP 5/16/1957
7 TJHIN TJUN LIN 12046/21/gp 4/15/1947
8 LAIJ KHIM NIE 3529/8/GP 1/29/1950
9 DARMO KATIMIN 4597/13/GP 9/16/1952
10 SETIAWAN TIRTOWALUYO 6541/14/GP 7/23/1947
11 HERMAN SOESENO 6235/18/gp 2/23/1941
12 LILY YULIANTY SOESENO 6512/18/GP 4/15/1946
13 WATI MUKSIN 1451/16 7/24/1957
14 NYI ASWINAH 4060/12/GP 4/15/1961
12/29/2021 1 12/29/2021 TJIONG MAN HWA 4274/16 10/11/1952
2 HENG GEK KIM 2418/21/GP 4/4/1955
3 MARKUS 315/16/GP 11/11/1945
4 TJEN HIAN HOA 5734/14 9/1/1953
5 WOEN JAM SON 5734/14/GP 8/10/1959
6 THJIN KOEI FA 7788/14 5/20/1948
7 SUBAGDJA PANCA 8720/19/GP 11/18/1954
8 THE EDDY ISKANDAR 6004/14 7/15/1946
9 MUDJIYANTI 12007/13 12/15/1966
10 MARIMIN 12007/13/GP 4/30/1957
11 ANTON SEWONO WONG 12072/21/GP 12/20/1954
12 SYAMSUNAR_ 4813/14/GP 2/21/1951
13 HANDOYO KURNIAWAN 9730/12/GP 3/25/1948
14 TJENG KHIEUN JIN 4136/15/GP 3/18/1960
15 HELEN AFFANDIE 9197/20 4/1/1957
12/30/2021 1 12/30/2021 SENI WATI CHANDRA 2355/02/GP 1/7/1951
TAUFIK SYAIFULLAH 7408/14/GP 4/3/1959
BUDI IMAN RUSTANDI 1285/19/GP 5/21/1942
NURLIMAH 7809/15/GP 7/16/1957
LAI, KURNIAWAN 4497/18/GP 6/18/1952
DENY HARTONO 566/2021/gp 10/20/1960
ANNA LUSIWATI KARTIKA 7342/18/GP 6/25/1959
HENDRY TAN 12110/21/GP 11/28/1954
LINA 12110/21/GP 1/21/1948
NINIE 11921/21/GP 9/22/1949
NYI ASWINAH 4060/12/GP 4/15/1961
12/31/2021 1 12/31/2021 KOMSIAH 8119/15/gp 1/8/1962
LIM HOCK LAI/PEITHER S ./7767/21GP 1/8/1954
ARMILA 2331/15 GP 5/16/1957
SAHRONI 2458/16/GP 12/20/1957
FAM LAN SHONG 878/21 9/12/1957
JACUB AGUN TJIOMAS 8326/21 2/20/1961
REDJO B WONGSOKARMO 4017/16
R RUJUKAN EKSTERNAL BPJS DAN NON BPJS LANSIA

Diagnosis Kode ICD 10 Poli Tujuan Rumah Sakit

Myastenia Gravis Saraf RS Patria IKKT
DM
Disorder Accomodation H52.5 Mata RS Duta Indah
Spondilolithesi M43 Ortopedi RS Atma Jaya
GERD K29.7 Penyakit Dalam RS SW
CAD I25.9 Jantung RS Pelni
DM E11.6 PD RSSW
CRF N18.9 PD RSSW
AF I25 Jantung RSSW
Deviasi Septum Nasi J34 THT RS Bhakti Mulia
CAD I25.9 Jantung RS Pelni
CAD I25.9 Jantung RS Pelni
Neuroapti M79.1 Saraf RS Patria IKKT
Neopalsma buli Uro RSSW
STROKE I64.9 Saraf RSSW
OA genu M25.5 OT RSSW
Distonia G24.9 Distonia RSSW
STROKE I69 Saraf Patria
Katarak H25.5 Mata Patria
Gonarhrosis M25.5 Ortopedi BM
cts G56 Ortopedi BM
Trauma orbita S05 Mata DI
lbp m50 OT H DM
hemoroid k62 bedah di
stroke saraf di
CAD JP0 Pelni
dm, cad PD RSSW
cad JP0 rs pelni
CAD jp rssw
DM PD RSUD C
CAD jp pelni
Osteomyelitis femur ot rssw
HHD JP Pelni
Tumor pituitari saraf pelni
Degenerasi Makula Mata di
DM PD Pelni
CAD JP RSSW
CAD JP Pelni
neuritis saraf rssw
ppok paru rssw
CA Vulva sarana kemoterapi rs kanker dharmis
tb paru rssw
DKA kulit rssw
LBP Saraf pelni
LBP Saraf pelni
oesophagitis SPPD rssw
OA genu OT RSSW
LSK KK RSSW
Parkinson saraf Patria
Tirotoksikosis PD RSSW
Katarak Mata RSDI
Hernia bedah Hermina Daan mogot
Efusi pleura paru rssw
FAM Bedah RSDI
Bronkitis Paru Pelni
Mysathenia Gravis Saraf RSSW
Hearing loss THT Pelni
Post op katarak Mata Pelni
HHD Jantung Pelni
Senile Catarct Mata RSDI
Epilepsi post stroke Saraf RSSW
PPOK Paru RSSW
HT, CAD, Disaritmia Jantung RSSW
Katarak Mata RSDI
KATARAK Mata RSDI
Neoplasma breast Bedah RS Bakti mulia
Chronic Ischemic Heart disease Jantung Pelni
BPH Urologi RSSW
Malignant neoplasma liver IPD RS Atna
DM tipe 2, insulin IPD Pelni
DM tipe 2 IPD RSSW
CAD Jantung Pelni
Massa coli bedah RSDI
Hydrocephalus Bedah Saraf Pelni
Low Vision Both Eyes Mata RS Patria IKKT
Cataract, unspecified Mata RS Patria IKKT
Low Vision Both Eyes Mata RSDI
Tremor Saraf RS Patria IKKT
vertigo saraf rssw
tumor buli uro rsbm
ischialgia saraf pelni
hipertiroid pd pelni
Epilepsi saraf patria
Ca mamae b onk rssw
HHD JP RSSW
HHD JP RSDD C
Katarak Mata Patria
HEARING LOSS THT RS BM
HHD Jantung Hermina Daan mogot
kolelitiasis sppd rssw
Katarak mata RS duta Indah
CAD JP RSSW
Lipoma bedah rs di
Katarak Mata rs di
BPH Uro RSUD C
Ca paru paru rs kanker dharmais
Gg refraksi Mata rs duta indah
Tirotoksikosis PD RSSW
HHD JP RSSW
HHD JP RSSW
Frozen shoulder ot rssw
Gg akomodasi Mata rsdi
DM PD RS Patria IKKT
Katarak Mata Rs di
HHD Jantung RSSW
SYNCOPE Collapse PD Duta Indah
OA genu ot rssw
Ca paru paru rssw
Faringitis kronis THT Pelni
Post op katarak mata Patria
katarak Mata Patria
Ca paru paru dharmais
Post op katarak Mata Patria
Ca cervix B- onk dharmais
katarak mata Duta Indah
glaukoma Mata Duta Indah
Kardiomegali Jantung Patria
DM PD Patria
Katarak Mata Duta Indah
DM PD RSSW
hnp lumbak saraf Patria
dm pd RSUD C
DM PD Duta Indah
CAD Jantung pelni
CAD Jantung pelni
KATARAK Mata Duta Indah
mata Mata Duta Indah
Stroke saraf pelni
glaukoma Mata RSUD C
OA genu ot RS Bhakti Mulia
Melena pd Duta Indah
Post stroke saraf rssw
katarak Mata Duta Indah
crf pd Duta Indah
hipertiroid pf rssw
Lipoma bedah patra
cad jantung rssw
Stroke saraf Duta Indah
CRF PD Patria
Lipoma bedah patria
AF Jantung rssw
Katarak Mata Patria
CAD Jantung RSUD Cengkareng
HHD Jantung pelni
tbc paru pelni
CRF HD Pelni
Katarak Mata Duta Indah
CAD Jantung pelni
stroke saraf RSUD Cengkareng
neuropati saraf rssw
katarak Mata patria
katarak Mata patria
CRF PD RSSW
CAD Jantung RSUD C
Ca mamae bedah Duta Indah
Gg akomodasi mata Duta Indah
CAD Jantung Hermina Daan mogot
Post op katarak Mata Duta Indah
Gg akomodasi Mata Duta Indah
Gg akomodasi Mata Duta Indah
Post op katarak Mata Duta Indah
Gg akomodasi Mata patria
DM PD RSUD Cengkareng
HHD Jantung RSUD Cengkareng
CAD Jantung RSUD Cengkareng
Kalazion Mata Duta Indah
HHD Jantung RSSW
HHD Jantung RSSW
Gg akomodasi Mata patria
Post herpetic neuralgia Saraf Hermina Daan mogot
katarak mata patria
Parkinson saraf rssw
DM PD RSSW
Katarak Mata patria
PPOK Paru RSSW
HHD Jantung RSSW
Gg akomodasi Mata Duta Indah
Gg akomodasi Mata Duta Indah
Tirotoksikosis PD Duta Indah
Oesophagitis PD RSUD Cengkareng
abulia mata Duta Indah
Post op katarak Mata Duta Indah
CRF BTKV Pelni
Gg akomodasi Mata Duta Indah
Ca tiroid Bedah Onkologi Hermina Daan mogot
post vp shunt hydrocephalus Jantung RS Pelni
Dokter Perujuk

dr. Lina

dr. Lina

dr. Lina

dr. Lina
 dr. Lina

dr. Lina

dr.Lina
Daan mogot

dr.Natascha

dr. lina

dr. Lina

Daan mogot
dr. Lina

dr. lina

dr. lina

dr. lina
 dr. lina

Daan mogot

Daan mogot

dr. Lina

dr. Natascha
 REGISTER RUJUKAN EKSTERNAL BPJS DAN NO

Tanggal No Tanggal Nama No. RM Tanggal Lahir

1 1/3/2022 LIM FUI NEN 5605/14 2/10/1960
2 RIENA WIDYASTUTI 3663/21 10/16/1957
3 JO MI LI 154/17 5/4/1957
4 HIAP TJAN 3222/16 4/1/1944
5 REDJO B WONGSOKARMO 4017/16 4/5/1954
6 SUSANTO WIBOWO 2472/21 11/1/1952
7 NGOEI MIE HAN 305/18 1/20/1953
8 AGUSTINI 1464/14 8/1/1959
9 DR. MAX MULYADI 13056/19 9/14/1940
10 ANGELA IRYAWATI LUKMAN 7551/20 11/26/1955
11 LIM BIOE OEY 2271/16 3/4/1961
1 1/4/2022 SAHRONI 2458/16/GP 12/20/1957
2 ROSMANIDAR 7412/7 1/5/1956
3 MINANSI SJUKRI 2845/15 3/24/1954
4 HENDRO PRANOTO 7810/14/GP 5/1/1946
5 SUTINAH 8870/13/GP 12/19/1954
6 GO SOE TJENG 6267/14/GP 1/17/1952
7 MAEMUNAH 11426/13/GP 10/11/1958
8 RUDIYANTO MARGONO 2529/20/GP 7/6/1958
1 1/5/2022 BONG SUI LIONG 8316/20/GPQ 3/9/1957
2 KRISYANTO YONATHAN 9634/21 9/27/1959
3 LIOE FA PIN 8428/16/GP 8/15/1956
4 ASIMAH PANJAITAN 767/2020/GP 8/30/1960
5 EDDY HANDOKO 1106/18 7/10/1954
6 RUMIYATI RUMIYATI 7/12/1948
7 WONG KEI SEN 151/22/GP 7/5/1956
8 DIANTO NIRJANA 3854/19GP 6/29/1959
9 LIE MUI KHOI AL HENDRI R 8451/18 GP 8/22/1954
1 1/6/2022 LIM GIOK HIONG 12936/19/gp 4/19/1960
2 PUTUS HARYONO 9446/21/GP 6/13/1957
3 HENNY LIM 7456/16/gp 8/6/1955
4 BONG MIAU FUI 730/21 J1 10/16/1956
5 DRS. SETRIANTO TANDRA 7819/20/gp 7/9/1957
6 TJONG MIE NON 5484/13/GP 4/13/1958
7 AGUS 8652/14/GP 10/3/1961
8 LAY SUI TJHIANG 152/22/GP 7/10/1961
1 1/7/2022 NY AYU ROMLAH_ 11225/12 9/10/1960
2 ACHMAD BARUZI 9668/17 7/14/1947
3 RUSNIWATY.WY 6109/21 8/22/1953
4 SUDJONO SIMAN 1616/16 3/3/1959
5 ANING YUNINGSIH 7024/18/GP 3/16/1950
MUHAMAD 6461/15 1/31/1958
 NGADIRAH 3295/12 GP 6/17/1953
6 LAMBOK SITOMPUL 5062/16 10/1/1953
1 1/10/2022 WATIR 598/20/G1 12/1/1939
2 PHANG SUI LIAN 3807/15 GP 8/15/1949
3 LIE SIU MOI 1804/18_GP 6/9/1961
4 NA SAUW TIN 1813/10 GP 3/13/1953
HARIANTO LAURENS 5846/20/gp 12/19/1956
1 1/12/2022 TEO TJIE BENG 1867/19/GP 3/6/1951
2 LO HOK KIONG 4086/19/GP 5/14/1952
3 SUGIONO 1330/18 6/30/1958
4 TUGIMAN /338/22/GP 4/12/1950
5 IE LIONG TJU 6426/14/GP 2/16/1953
6 NY ROCHYATI JANSEN 8367/20/GP 5/31/1958
7 TISWENING 315/15 GP 9/6/1956
8 H. TOTONG SUWARDI 4273/19/GP 1/1/1960
9 IMAM TJAHJADI 3976/14/GP 10/19/1945
10 SARNO 8585/17/GP 1/1/1953
11 hanny verlina wiryanata 3484/15/GP 3/6/1949
1 1/13/2022 NOMAN ARIEF_4452/14/GP_4740/14UGD () TL: 1960-01-10
2 MARYATI MULYONO_5174/20/GP () TL: 1958-08-11
3 SUAIB BIN TOING-4001/19/gp, 980/15 JB () TL: 1949-11-25
4 SUANAH () TL: 1958-07-06
5 TJHIN SIAT TJUNG_328/21/GP () TL: 1957-01-06
6 MARHENI 13907/12 GP, 1722/14/UGD () TL: 1956-12-04
7 BUDIYONO-2693/13/GP () TL: 1960-11-11
8 TISWENING 315/15 GP () TL: 1956-09-06
9 WIWIEK W 3838/14 () TL: 1954-02-03
10 MARIANI 13982/13 () TL: 1946-07-17
11 HADI MULYONO 6957/14/gp () TL: 1954-12-28
12 SURYANA HASAN_8898/21/GP () TL: 1955-09-04
13 JOVITA FELIANTI BUDIHARJO 9916/16 GP () TL: 1953-04-06
14 USMAN MOCHTAR 1813/10 () TL: 1948-11-16
15 NA SAUW TIN 1813/10 GP () TL: 1953-03-13
1 1/14/2022 WILIANTO SULISTIO 9429/21/GP 3/6/1953
2 HJ. ANAH 7648/14/GP 4/12/1949
3 PAH SIU LAN 7608/21/gp 5/1/1950
4 SOPHIA GUNAWAN 3221/21/GP 12/24/1955
5 tanti herlina 1287/19/GP 7/15/1960
6 TUAH BUDIMAN TARIGAN 493/19/GP 6/19/1949
7 RD.RORO MARDIANA 493/19/GP 3/2/1956
8 SATIMAH BIN SALIM 5594/17_ 1/14/2022
9 DIMPEN 4131/13 12/27/1954
10 WANG KIM TIO 3470/18/GP 6/24/1960
11 ADMINI 7769/18/UGD 10/12/1961
12 NY ROCHYATI JANSEN 8367/20/GP 5/31/1958
13 YATIE SUGIARTI 134/16 1/2/1948
14 drs.irzal halim 6954/14/GP 6/16/1950
1 1/17/2022 TONY KARTONO 7086/14 10/25/1943
2 KHENG LILY KURNIAWATI 7086/14/GP 1/23/1946
3 H. MANSYUR TAJUDDIN 6825/9/GP 10/10/1945
4 TARMADI 3649/18 GP 12/1/1955
5 OEN TJIN GOAN 5415/14 1/9/1957
6 ZUHRIANAH 2156/2020 8/24/1952
7 TJEN FOEI KHIE 8417/20/GP 7/22/1957
8 LIM SOEI LAN 443/22/GP 12/23/1961
9 SUHARDI BIN KASARI 53/18/GP 4/15/1961
1 1/18/2022 SUPATMI 3850/14 GP 10/17/1958
2 SHINTA HANDAJANI w.s 5324/15 10/23/1950
3 BE KIM CU 454/22/gp 4/12/1936
4 NG SIOE HOA 9413/21/GP 8/16/1954
5 ASNAWATI 10655/13/GP 12/5/1948
6 TANTY YANIASTUTI 1653/11 2/6/1959
7 SODIRIN 8563/7/GP 10/20/1957
8 IWAN TIRTA ATMADJA 181/22GP 4/18/1941
1 1/19/2022 MURTINAH 8807/13/GP 5/25/1955
2 SUWARTI 3714/17UGD 11/29/1947
3 YUSAK SIHOMBING 1451/16 GP 11/1/1961
4 BASANI BUTAR BUTAR 9929/17 GP 11/25/1964
5 ARIFIN 1137/3/GP 12/23/1952
6 LIM GIOK HIONG 12936/19/gp 4/19/1960
7 ERLUWATI FONGDARSEN 9002/19/GP 12/28/1942
1 1/20/2022 AN 7218/18 6/4/1955
2 Candra Senjaya 457/18 8/15/1949
3 Ikimiyati 3391/5/ 1/24/1960
4 Kusmin 3840/15 7/22/1956
5 Muljadi 9158/13 8/3/1961
6 Suriati Salim 5547/14 3/20/1942
1 1/21/2022 NURMALA 12248/18 GP 8/8/1950
2 DRS. NGATMIN SINGOREJO 9642/13/GP 10/5/1952
3 LIAUW BUN LIN 604/22/GP TL: 1951-12-19
1 1/24/2022 SUWARNO 9991/19/GP 3/16/1948
2 LIM KING HWA 12930/19/GP 8/25/1945
3 HANNY KOSASIH 11807/18GP 5/28/1947
4 NY AYU ROMLAH 11225/12/gp, 9/10/1960
5 TEDDY TANUSAPUTRA 8046/14 GP 8/7/1954
6 RUMMY SETIAWATY 5/18/1954
7 JACOUB 2689/16 2/25/1939
8 NURDIN 11218/12/GP 12/2/1962
9 SURYANTO 8903/17 4/1/1961
10 DRG.ERWIN S 10/27/1953
11 THAMLISA 2698/20/GP 8/17/1959
12 YATIE SUGIARTI 134/16 1/2/1948
13 MELIANA HUSAIN 4034/14/GP 7/5/1943
1 1/25/2022 LEUNG LIZA LESMANA 3655/21 10/27/1951
2 P.SARDI 3760/19 7/7/1950
3 TAUFIK SYAIFULLAH 7408/14 4/3/1959
4 A.SALIM 8883/14 12/28/1949
5 DENY HARTONO 40/21 10/20/1960
1 1/26/2022 FARIDA 10230/21/GP 12/7/1957
BENNY MURTIDJAJA 705/21/ugd 6/22/1953
hanny verlina wiryanata 3484/15/GP 3/6/1949
TANTY YANIASTUTI 1653/11 2/6/1959
SETIAWAN TIRTOWALUYO 6541/14/GP 7/23/1947
NURMIYATI 1466/21/GP 7/11/1958
ELINA 981/15/GP 12/1/1956
1/27/2022 ANDRI 7215/13/GP 8/14/1964
LIM FUI NEN 5605/14 GP 2/10/1960
HUTAMA TJAHJADI 7057/18/UGD 5/8/1936
TAN KHIE KHOEN 9410/18/GP 5/5/1941
KASMINAH 641/14 GP 12/19/1949
UJUKAN EKSTERNAL BPJS DAN NON BPJS LANSIA

Diagnosis Kode ICD 10 Poli Tujuan Rumah Sakit Dokter Perujuk

HHD I11.0 Jantung RSUD Cengkareng dr. Anggun
NIDDM E11.6 Penyakit Dalam RS SW dr. Anggun
Schizophrenia F20.9 Jiwa RS SW dr. Anggun
CHF I50.0 Jantung RS SW dr. Anggun
BPH N40 Urologi RS PELNI dr. Anggun
CAD I25.9 Jantung RS PELNI dr. Anggun
Low Back Pain M54.57 Orthopedi RS SW dr. Anggun
Lipoma D21.9 Bedah RS Duta Indah dr. Anggun
Benign Neoplasm of Ski D23.9 Bedah RS SW dr. Anggun
Ca Paru C34.9 Paru RS Patria IKKT dr. Anggun
HHD I11.9 Jantung RS Patria IKKT dr. Anggun
katarak mata RS Duta Indah dr. Lina
HHD Jantung RS PELNI
LBP Saraf Duta indah
BPH Urologi RS PELNI
DM Penyakit Dalam RS Duta Indah
katarak mata RS Patria IKKT
OA GENU Orthopedi RSUD Cengkareng
Hepatitis B + ikterik Penyakit Dalam RS Duta Indah
Ca Rektum Bedah Duta indah
katarak mata Duta indah
Prurigo kulit RS SW
Stroke Saraf RS SW
BPH Urologi RS SW
Gg akomodasi mata RS Duta Indah
Gg akomodasi mata RS Duta Indah
katarak mata RS Patria IKKT
BPH Urologi RS PELNI
LBP Saraf RS Hermina Daan Mogot
Psudofakia mata RS Duta Indah
Anxietas Jiwa RS SW
Stroke Bedah Saraf RS SW
Neuritis Saraf RS Duta Indah
CAD Jantung RS PELNI
HHD Jantung RS PELNI
Inkontinensia uri Urologi RS SW
CAD Jantung RS SW
I25.9 PRB
Katarak Mata RS Duta Indah
DM Interna RS Pleni
Tic disorder Saraf RS Duta Indah
Spondiliits OT RS Bhakti Mulia
Stroke Saraf RS Duta Indah
CHF Jantung RS PELNI
CAD Jantung RS PELNI
CRF HD RS PELNI
OA GENU Orthopedi RS SW
CVD Saraf RS Sumber Waras
BPH Urologi RS Bhakti Mulia
HHD Jantung RS Pelni dr.Siska
Senile Cataract Mata RS Hermina Daan Mogot
Hemiplegia Saraf RS Bhakti Mulia
Presence of Intraoculer Mata RS Duta Indah
CAD Jantung RS Pelni
CKD stage V Sp.PD KGEH RS Pelni
Ischialgia Saraf RS Sumber Waras
Arthrosis Orthopedi RS Pelni
katarak Mata RS Hermina Daan Mogot
katarak Mata RS Duta Indah
CAD Jantung RS SW
Insulin DM Penyakit Dalam RS Pelni
Lung cancer Kemoterapi RS Dharmais
DM, HT, Stroke I69,3, E11,6, I1Saraf RS Duta Indah
HEARING LOSS H91.8 THT RS SUMBER WARAS dr.Eni
AUTOIMUN D89.8 SP.PD RS PATRIA IKKT dr.Eni
STROKE I64 SP.SARAF RSUD Cengkareng dr.Eni
CAD I21.9 SPJP RS BHAKTI MULYA dr.Eni
PPOK J44.9 SP.PARU RS SUMBER WARAS dr.Eni
CONTUSION OF HIP S70.0 SP.OT RS SUMBER WARAS dr.Eni
HHD I10.0 SP.JP RS SUMBER WARAS dr.Eni
POST OP Z48.9 SP.THT RS HERMINA DAAN MOGOT dr.Eni
POST OP KATARAK H52.5 mata RS Duta Indah dr.Eni
HHD I11.9 JANTUNG RS PELNI dr.Eni
FIBROSIS PARU J84.1 PARU RS SUMBER WARAS dr.Eni
HHD I11.9 JANTUNG RS SUMBER WARAS dr.Eni
CAD I25.9 Jantung RS BHAKTI MULYA
STROKE Saraf RS Duta Indah
Neuritis Saraf RS Duta Indah
CRF Penyakit Dalam RS Duta Indah
CAD Jantung RS Sumber Waras
HHD Penyakit Dalam RS Patria IKKT
DM Penyakit Dalam RS Patria IKKT
CAD Jantung RS Pelni
CAD Jantung RS SW
BPH Urologi RS SW
struma Bedah Duta indah
lock jaw Bedah RS PELNI
sirosis Penyakit Dalam RS SW
OA GENU Orthopedi RS PELNI
cad jantung RS Patria IKKT
OA GENU Orthopedi RS Patria IKKT
Gg urethra Urologi RS SW
CAD Jantung RS SW
CAD Jantung RS Patria IKKT
hhd Jantung RS SW
katarak Mata RS Patria IKKT
Gg akomodasi mata RS Duta Indah
katarak mata RS DUTA INDAH
dm Penyakit Dalam RS HERMINA DAAN MOGOT
OA Orthopedi RS Patria IKKT
katarak Mata RS Duta indah
alzehimer jiwa ra atmajaya
cad jantung RS SW
Prurigo Kulit RS SW
cad jantung RS Bhakti Mulia
CRF Penyakit Dalam RS Bhakti Mulia
CAD Jantung RS PELNI
stroke Saraf RSUD Cengkareng
Vertigo Saraf RS SW
tinitus THT RS SW
katarak Mata RS Hermina Daan Mogot
katarak Mata RS Duta Indah
dm Penyakit Dalam RS Duta Indah
katarak H25.8 Mata RS Duta Indah dr.Navaldi
Ca Colon C18.9 Penyakit Dalam RS Sumber Waras dr.Navaldi
CAD Jantung RS Sumber Waras dr.Navaldi
DM komplikasi E11.8 Penyakit Dalam RS Pelni dr.Navaldi
Gagal Ginjal N18.9 Penyakit Dalam RS Pelni dr.Navaldi
Katarak H25.8 Mata RS Atma Jaya dr.Navaldi
DM E11,8 Penyakit Dalam RS PELNI dr. Natascha
dm e11,8 Penyakit Dalam RS Sumber Waras dr. Natascha
latarak Mata RS Duta Indah dr. Natascha
BPH Urologi RS SW dr. Lina
Vertigo Saraf RS Hermina Daan mogot dr. Lina
OA genu Orthopedi RSUD Cengkareng dr. Lina
Neuritis Saraf RS SW dr. Lina
katarak Mata RS Duta Indah dr. Lina
Animal bite Bedah RS Patria IKKT dr. Lina
Ca Prostat Urologi RS Bhakti Mulia dr. Lina
BPH Urologi RS SW dr. Lina
CKD stage V Penyakit Dalam RS SW dr. Lina
ulkus gaster Penyakit Dalam RS PELNI dr. Lina
Retensi urin Urologi RS SW dr. Lina
HHD Jantung RS PELNI dr. Lina
Ca mammae Bedah Onkologi RS Hermina Daan Mogot dr. Lina
Ca Pancreas Penyakit Dalam RS PATRIA IKKT dr. Anggun
Hernia Inguinalis Bedah RS PATRIA IKKT dr. Anggun
Ischemic Heart Disease Jantung RS PELNI dr. Anggun
Cataract Mata RS Sumber Waras dr. Anggun
DM Penyakit Dalam RS Sumber Waras dr. Anggun
POST OP KATARAK mata RS PATRIA IKKT
CAD Jantung RS PELNI
CAD Jantung RS SW
LBP Saraf RS SW
Post op katarak mata RS PATRIA IKKT
Post op katarak mata RS Duta Indah
Tic disorder Saraf RS Duta Indah
katarak Mata RS PATRIA IKKT
Tinea korporis meluas Kulit RSUD Cengkareng
Deafness THT RS SW
CAD Jantung RS SW
dm Penyakit Dalam RS SW
 REGISTER RUJUKAN EKSTERNAL BPJS DAN N

Tanggal No Tanggal Nama No. RM Tanggal Lahir

1 2/4/2022 TJUN BOIJ 3837/21/gp 2/9/1951
2 ABUSANI 3005/17/GP 9/25/1945
3 AMINAH 11388/17 GP 12/3/1958
4 A.SALIM 8883/14 12/28/1949
5 RIHANA H 1056/22 11/17/1961
1 2/8/2022 RINA SENTOSA 8671/17/GP 3/11/1954
2 PE MER TJA 4737/14 GP 4/11/1950
3 TITIEN LIMIATI 1197/22/GP 11/26/1948
4 JO MI LI 154/17 5/4/1957
5 TJHAI LIE HON 1132/22/GP 11/10/1949
6 INDAH TJAHJADI 5224/15 GP 4/28/1966
7 HUTAMA TJAHJADI 7057/18/UGD 5/8/1936
8 HP YUSUP SAIM 842/22/GP 12/17/1956
9 TJAN PO SENG 3265/16 12/10/1950
10 BENNY BUDIMAN 10685/18/GP 10/6/1951
1 2/9/2022 MUSAROH 8674/14 11/26/1953
2 SUNANTO THAMIDA 5344/16 GP 3/19/1959
3 WIJI 5578/15 2/4/1959
1 2/10/2022 KAMINI 9937/21/GP 10/1/1961
2 JENIWATININGSIH 6475/16 GP 9/22/1959
3 BUNARTO 6593/18/GP 8/27/1950
4 HASAN 7182/11 GP 9/22/1950
5 aang sutinggal 2739/15/GP 11/21/1950
6 LAY MUK LAN 11002/21/gp 1/25/1954
7 CHAERANI 754/17/GP 12/23/1951
8 ANDY KOSASIH KHO 2487/19/GP 7/10/1958
9 TJENG KHIEUN JIN 4136/15/GP 3/18/1960
10 WIJI 188/18/J2 2/4/1959
1 2/11/2022 KUSMIN 3840/15/GP 7/22/1956
2 JENIWATININGSIH 6475/16 GP 9/22/1959
3 SUKINO 8456/16/GP 2/6/1959
4 TARSIH 2146/20UGD 11/12/1949
5 BUN KIM MI 1403/22 7/17/1956
6 SRI YONO 5335/17 4/1/1939
7 KARTINI 11719/19 gp 4/21/1950
8 MOCH.ABAS 1789/16/GP 12/25/1958
9 MOHAMAD NUH 4750/13/GP 7/7/1952
10 SATIMAH BIN SALIM 5594/17 12/12/1955
11 TANTY YANIASTUTI 1653/11 2/6/1959
12 ENDANG SULASIH 7010/15 9/29/1961
13 CHAERANI 754/17/GP 12/23/1951
14 ROSMANI 375/18/GP 8/16/1938
15 CHAERANI 754/17/GP 12/23/1951
1 2/14/2022 SURYATI 179/17 GP 12/12/1959
2 FANNY 6752/19 3/17/1949
3 LIE MUI KHOI AL HENDRI R 8451/18 GP 8/22/1954
4 ABDULLAH FATHONI 1074/14/GP 4/8/1955
5 JONAM HUTASOIT 8053/20/GP 11/11/1959
6 ASPAN KS 12614/12 12/28/1949
7 MASKUR ANKRI 10901/21/GP 4/24/1958
8 EDY SUWIGNO 1929/15/UGD 8/17/1955
9 TJEN ELLEN 7259/14 8/24/1956
10 A.SALIM 8883/14 12/28/1949
11 EDY JULIANI 12412/19 GP 3/28/1954
12 YUSAK SIHOMBING 1451/16 GP 11/1/1961
1 2/15/2022 DRS. NGATMIN SINGOREJO 9642/13/GP 10/5/1952
2 NOMAN ARIEF 4452/14/GP 1/10/1960
3 UNARIAH, S. PD 12960/19 GP 5/4/1954
4 JULIANA SUSANTO 2682/21 GP 1/11/1952
5 P. SINAGA 773/8/GP 9/6/1948
6 MURSID 5247/14 GP 4/24/1958
7 H.AHMAD WAHYONO 1380/16/GP 5/1/1933
8 ABDUL HAMID 5/30/1959
9 MERLIANA SIDIK 4982/18/gp 2/11/1957
10 SUHENDRA 1516/20/GP 1/1/1961
11 RIDWAN TEO 1763/15/GP 2/26/1948
12 OERIYAH 9703/17/GP 12/24/1945
1 2/16/2022 JAMINTER SINAGA 3805/13 GP 8/28/1954
2 ROSMANIDAR 5541/19/UGD 1/5/1956
3 NURDIN MARPAUNG 1488/21/GP 5/1/1952
4 SJAHRIL M.S.CHAN 7412/7 GP 12/30/1948
5 LITA KURNIAWAN 1602/15 GP 5/31/1945
6 SUPENDI 1542/22_GP 4/24/1953
7 H SITUMEANG 11657/13 6/24/1942
1 2/17/2022 LIE TING TING ALS.MARTINI 1623/22GP 12/10/1960
2 KWA EDDY WIDJAJA 6751/19 4/8/1950
1 2/21/2022 NOMAN ARIEF 4452/14/GP 1/10/1960
2 TAN TJOAN NIO 1091/18/GP 3/29/1958
3 LANDYAH 1766/17 GP 6/6/1946
4 LIOE KIT JOEN 1446/22_gp 9/10/1959
5 SUKARDI 2778/15 GP 4/12/1950
6 DARSANTO PRAJOGO 6264/21/GP 5/1/1943
7 ABD RAHMAN GULTOM 6544/14/GP 6/15/1956
8 SUKARSIH 1735/18 11/2/1956
9 JULIANA SUSANTO 1683/18/UGD 1/11/1952
10 EDDY SUTOPO 8524/18 11/6/1958
11 BUYUNG BUDIMAN 2489/18/GP 11/18/1958
12 SUKIMAN SURIA 8761/14 11/2/1949
13 YUN PURNAMAWATI 13270/19 GP 6/12/1957
14 DJIMIN 6000/19/GP 9/8/1959
2/22/2021 SURYA 12/30/1951
SRI SUTJIATI SUGENG 453/14 J1 11/26/1951
BENNY MURTIDJAJA 439/16 6/22/1953
HERMANTO 1369/17/GP 2/27/1956
NELIWATI 1702/22 4/8/1954
JUKAN EKSTERNAL BPJS DAN NON BPJS LANSIA

Diagnosis Kode ICD 10 Poli Tujuan Rumah Sakit Dokter Perujuk

Ca femur Ortopedi RS SW dr. Lina
BPH Urologi RS Bhakti Mulia
Faringitis kronis THT RS SW
CAD Jantung RS SW
Post angina Jantung RS Bhakti Mulia
Post op glaukoma Mata RS Duta Indah dr. Lina
lbp saraf RS Patria IKKT
Katarak Mata RS HERMINA
Katarak Mata RS Duta Indah
Katarak Mata RS Patria IKKT
Skizifrenia Jiwa RS soeharto heerdjan
Frozen shoulder Ortopedi RS SW
Stroke saraf RS Pelni
Stroke saraf RS Pelni
HHD Jantung RS Pelni
CAD Jantung ES SW
CAD Jantung RS Hermina Daan Mogot
DVT Bedah Vaskuler RS Pelni
CAD Jantung RS Pelni
CAD Jantung RS Pelni
Katarak Mata RS Duta Indah
Stroke saraf RS SW
chf Jantung RS SW
CAD Jantung RS Bhakti Mulia
Trigeminal neuralgia saraf RS Pelni
CAD Jantung RS SW
Resp disease Paru RS SW
DM Komplikasi Penyakit Dalam RS Pelni
Stroke saraf RS Pelni
CRF Penyakit Dalam RS Pelni
Hernia Bedah RS dUTA Indah
CHF Jantung RS Pelni
Katarak Mata RS Duta Indah
Gastroduodenal ulcer Penyakit Dalam RS Pelni
Katarak Mata RS Duta Indah
CHF Jantung RSUD Cengkareng
CAD Jantung RS SW
DM Komplikasi Penyakit Dalam RS Pelni
Dry Eye Mata RS Pelni
Katarak Mata RS Duta Indah
CHF Jantung RS Pelni
Stroke Saraf RS Duta Indah
CHF Jantung RS Pelni
OA Genu saraf RS SW
Katarak Mata RS Patria IKKT
cad Jantung RS Pelni
Skizifrenia Jiwa RS soeharto heerdjan
CAD Jantung RS SW
CAD Jantung RS SW
Gastroduodenal ulcer Penyakit Dalam RS SW
Katarak Mata RS Duta Indah
DM Komplikasi Penyakit Dalam RS Pelni
hhd Penyakit Dalam RS SW
Katarak mata RS Duta Indah
DM Komplikasi Penyakit Dalam rs sw
Glaukoma Mata RS Patria IKKT
chf Jantung RS Pelni
kolesistitis Penyakit Dalam RS Duta Indah
DM Komplikasi Penyakit Dalam RS Pelni
Katarak Mata RS Duta Indah
Katarak Mata RS Hermina Daan Mogot
Katarak Mata RS Patria IKKT
Katarak Mata RS Duta Indah
Katarak Mata RS Duta Indah
chf Jantung RS Pelni
BPH Urologi RSUD Cengkareng
Katarak Mata RS Duta Indah
Katarak Mata RS Duta Indah
OA Genu Ortopedi RS Pelni
Hernia Bedah digestif RS SW
Katarak Mata RS Duta Indah
CAD Jantung RS Pelni
Stroke Saraf RS Sumber Waras
Stroke Saraf RS SW
Gg akomodasi Mata RS Patria IKKT
Gg akomodasi Mata RS Patria IKKT
CAD Jantung RS Pelni
Katarak Mata RS Pelni
LBP Saraf RS Duta Indah
OA Genu Ortopedi RS Patria IKKT
CRF Penyakit Dalam RS Duta Indah
DKA Kulit Kelamin RS Pelni
CAD Jantung RS SW
Katarak Mata RS Patria IKKT
OA Genu Ortopedi RS Pelni
LBP Saraf RS Duta Indah
LBP Saraf RS Patria IKKT
Kista ginjal Urologi RS SW
OA Genu Ortopedi RS SW
CRF Penyakit Dalam RS Duta Indah
CHF Jantung RS SW
Hearing loss THT RS SW
BPH Urologi RS PELni
Ca rektum Penyakit Dalam RS Duta Indah
Retensi urin Urologi RS SW