<div><p><center><strong>REGISTER PELAYANAN KB<br>PUSKESMAS PUCANGSAWIT<br>11 -

2023</strong></center></p></div>
<table class="tabler w3-table w3-bordered w3-striped w3-border test w3-hoverable">
<tr align="center" style="background-color:#b5381c;color:white;">
<th>No</th>
<th width="120px">Tanggal</th>
<th>NAMA SUAMI</th>
<th>NIK ISTRI</th>
<th>NAMA ISTRI</th>
<th>TANGGAL LAHIR ISTRI</th>
<th>ALAMAT</th>
<th>NO HP</th>
<th>INFORMED CONSENT</th>
<th>STATUS PESERTA KB</th>
<th>PELAYANAN KB</th>
<th>JENIS TINDAKAN</th>
<th>KASUS</th>
<th>JENIS ALKON</th>
<th>PENGGUNAAN ASURANSI</th>
</tr>

<tr align="right">
<td align="center">1</td>
<td align="left">03 November 2023</td>
<td align="left">DWI PRIYANTO</td>
<td align="left">'3372046711970007</td>
<td align="left">GILDA INDIRAWATI</td>
<td align="left">27 November 1997</td>
<td align="left">RT 05 RW 08 PUCANGSAWIT</td>
<td align="left">'089649453676</td>
<td align="left">YA</td>
<td align="left">
PESERTA KB BARU</td>
<td align="left">
PASCA SALIN</td>
<td align="left"></td>
<td align="left"></td>
<td align="left">SUNTIK</td>
<td align="left">
BPJS KESEHATAN</td>
</tr>

<tr align="right">
<td align="center">2</td>
<td align="left">14 November 2023</td>
<td align="left">ANGGORO</td>
<td align="left">'3372046904730004</td>
<td align="left">ROCHAYAH IRNAWATI</td>
<td align="left">29 April 1973</td>
<td align="left">RT 01 RW 05 SEWU</td>
<td align="left">'</td>
<td align="left">YA</td>
<td align="left">
PESERTA KB BARU</td>
<td align="left">
</td>
<td align="left"></td>
<td align="left"></td>
<td align="left">KONDOM</td>
 <td align="left">
BPJS KESEHATAN</td>
</tr>

<tr align="right">
<td align="center">3</td>
<td align="left">17 November 2023</td>
<td align="left">WIDYA KUSTOWO</td>
<td align="left">'3309175102920002</td>
<td align="left">TASMI</td>
<td align="left">11 Februari 1992</td>
<td align="left">3/7 PUCANGSAWIT</td>
<td align="left">'081915681917</td>
<td align="left">YA</td>
<td align="left">
PESERTA KB BARU</td>
<td align="left">
</td>
<td align="left"></td>
<td align="left"></td>
<td align="left">SUNTIK</td>
<td align="left">
BPJS KESEHATAN</td>
</tr>

<tr align="right">
<td align="center">4</td>
<td align="left">17 November 2023</td>
<td align="left">MARIONO</td>
<td align="left">'3311094107970014</td>
<td align="left">FITRIANI</td>
<td align="left">01 Januari 1997</td>
<td align="left">RT 01 RW 07 SEWU</td>
<td align="left">'089518365863</td>
<td align="left">YA</td>
<td align="left">
PESERTA KB BARU</td>
<td align="left">
</td>
<td align="left"></td>
<td align="left"></td>
<td align="left">SUNTIK</td>
<td align="left">
BPJS KESEHATAN</td>
</tr>

<tr align="right">
<td align="center">5</td>
<td align="left">17 November 2023</td>
<td align="left">DODIK KURNIAWAN</td>
<td align="left">'3372044105830002</td>
<td align="left">TRI SETYANINGSIH</td>
<td align="left">01 Mei 1983</td>
<td align="left">RT 01 RW VIII PUCANGSAWIT</td>
<td align="left">'-</td>
<td align="left">YA</td>
<td align="left">
PESERTA KB BARU</td>
<td align="left">
</td>
<td align="left"></td>
<td align="left"></td>
<td align="left">PIL</td>
<td align="left">
BPJS KESEHATAN</td>
</tr>

<tr align="right">
<td align="center">6</td>
<td align="left">21 November 2023</td>
<td align="left">MUH DIEGA PRAMUDYA</td>
<td align="left">'3372046201980002</td>
<td align="left">ANGGITA MILA SARI</td>
<td align="left">22 Januari 1998</td>
<td align="left">RT 01 RW 09 PUCANGSAWIT</td>
<td align="left">'085801221998</td>
<td align="left">YA</td>
<td align="left">
PESERTA KB BARU</td>
<td align="left">
</td>
<td align="left"></td>
<td align="left"></td>
<td align="left">KONDOM</td>
<td align="left">
BPJS KESEHATAN</td>
</tr>

<tr align="right">
<td align="center">7</td>
<td align="left">28 November 2023</td>
<td align="left">SRI HARTATIK</td>
<td align="left">'332044312750005</td>
<td align="left">SRI HARTATIK</td>
<td align="left">03 Desember 1975</td>
<td align="left">RT 04 RW 6 SEWU</td>
<td align="left">'</td>
<td align="left">YA</td>
<td align="left">
PESERTA KB BARU</td>
<td align="left">
PASCA SALIN</td>
<td align="left"></td>
<td align="left"></td>
<td align="left">KONDOM</td>
<td align="left">
BPJS KESEHATAN</td>
</tr>

<tr align="right">
<td align="center">8</td>
<td align="left">28 November 2023</td>
<td align="left">SUJIYANTO</td>
<td align="left">'3372045904950002</td>
<td align="left">NUR RIZKI HANDAYANI</td>
<td align="left">19 April 1995</td>
<td align="left">SEWU 01/IV SEWU</td>
<td align="left">'081959272628</td>
 <td align="left">YA</td>
<td align="left">
PESERTA KB BARU</td>
<td align="left">
PASCA SALIN</td>
<td align="left"></td>
<td align="left"></td>
<td align="left">KONDOM</td>
<td align="left">
BPJS KESEHATAN</td>
</tr>

<tr align="right">
<td align="center">1</td>
<td align="left">03 November 2023</td>
<td align="left">SUDIYANTO</td>
<td align="left">'3372046711990004</td>
<td align="left">ANISA PUTRI</td>
<td align="left">27 November 1999</td>
<td align="left">RT 01 RW V JAGALAN</td>
<td align="left">'081699470092</td>
<td align="left">YA</td>
<td align="left">
PESERTA KB ULANGAN</td>
<td align="left">
</td>
<td align="left"></td>
<td align="left"></td>
<td align="left">
|
Suntik |
|
Z30.8|Other contraceptive management</td>
<td align="left">
BPJS KESEHATAN</td>
</tr>

<tr align="right">
<td align="center">2</td>
<td align="left">03 November 2023</td>
<td align="left">SARWO EDI</td>
<td align="left">'3372045907840003</td>
<td align="left">SRI LESTARI</td>
<td align="left">19 Juli 1984</td>
<td align="left">RT 02 RW II SEWU</td>
<td align="left">'0</td>
<td align="left">YA</td>
<td align="left">
PESERTA KB ULANGAN</td>
<td align="left">
</td>
<td align="left"></td>
<td align="left"></td>
<td align="left">
SuntikSuntik |
Suntik |
|
Z30.8|Other contraceptive management</td>
 <td align="left">
BPJS KESEHATAN</td>
</tr>

<tr align="right">
<td align="center">3</td>
<td align="left">03 November 2023</td>
<td align="left">AGUS BUDI PRASETYO</td>
<td align="left">'3372045708930021</td>
<td align="left">ERNI KRISTIANTI</td>
<td align="left">17 Agustus 1992</td>
<td align="left">RT 01 RW XIII PUCANGSAWIT</td>
<td align="left">'</td>
<td align="left">YA</td>
<td align="left">
PESERTA KB ULANGAN</td>
<td align="left">
</td>
<td align="left"></td>
<td align="left"></td>
<td align="left">
|
SuntikKondom |
|
Z30.8|Other contraceptive management</td>
<td align="left">
BPJS KESEHATAN</td>
</tr>

<tr align="right">
<td align="center">4</td>
<td align="left">06 November 2023</td>
<td align="left">ADIK CAHYANTI</td>
<td align="left">'3372034612970008</td>
<td align="left">ADIK CAHYANTI</td>
<td align="left">06 Desember 1997</td>
<td align="left">RT 05 RW 08 SEWU</td>
<td align="left">'082335831014</td>
<td align="left">YA</td>
<td align="left">
PESERTA KB ULANGAN</td>
<td align="left">
</td>
<td align="left"></td>
<td align="left"></td>
<td align="left">
SuntikSuntik |
Suntik |
|
Z30.8|Other contraceptive management</td>
<td align="left">
BPJS KESEHATAN</td>
</tr>

<tr align="right">
<td align="center">5</td>
<td align="left">06 November 2023</td>
<td align="left">WAHONO</td>
<td align="left">'3372045208760002</td>
 <td align="left">SIYAMTI NINGSIH</td>
<td align="left">12 Agustus 1976</td>
<td align="left">03/VII SEWU</td>
<td align="left">'</td>
<td align="left">YA</td>
<td align="left">
PESERTA KB ULANGAN</td>
<td align="left">
</td>
<td align="left"></td>
<td align="left"></td>
<td align="left">
SuntikSuntik |
Suntik |
|
Z30.8|Other contraceptive management</td>
<td align="left">
BPJS KESEHATAN</td>
</tr>

<tr align="right">
<td align="center">6</td>
<td align="left">07 November 2023</td>
<td align="left">YOHANES DANY KRISTIAN</td>
<td align="left">'3372044404760002</td>
<td align="left">EVI APRIYANTI</td>
<td align="left">04 April 1976</td>
<td align="left">JAGALAN RT 2 RW 9 JAGALAN</td>
<td align="left">'085728510556</td>
<td align="left">YA</td>
<td align="left">
PESERTA KB ULANGAN</td>
<td align="left">
</td>
<td align="left"></td>
<td align="left"></td>
<td align="left">
Suntik |
|
|
Z30.8|Other contraceptive management</td>
<td align="left">
BPJS KESEHATAN</td>
</tr>

<tr align="right">
<td align="center">7</td>
<td align="left">07 November 2023</td>
<td align="left">SUHARNO TN</td>
<td align="left">'3372045104840001</td>
<td align="left">WARTINI NY</td>
<td align="left">04 November 1984</td>
<td align="left">JAGALAN 04/IV JAGALAN</td>
<td align="left">'</td>
<td align="left">YA</td>
<td align="left">
PESERTA KB ULANGAN</td>
<td align="left">
</td>
 <td align="left"></td>
<td align="left"></td>
<td align="left">
PIL |
|
|
Z30.4|Surveillance of contraceptive drugs</td>
<td align="left">
BPJS KESEHATAN</td>
</tr>

<tr align="right">
<td align="center">8</td>
<td align="left">07 November 2023</td>
<td align="left">KELVIN WIJAYA</td>
<td align="left">'3314195702850001</td>
<td align="left">SRI RAHAYU NINGSIH</td>
<td align="left">17 Februari 1985</td>
<td align="left">JAGALAN 3/13 JAGALAN</td>
<td align="left">'085816787873</td>
<td align="left">YA</td>
<td align="left">
PESERTA KB ULANGAN</td>
<td align="left">
</td>
<td align="left"></td>
<td align="left"></td>
<td align="left">
Suntik |
|
|
Z30.8|Other contraceptive management</td>
<td align="left">
BPJS KESEHATAN</td>
</tr>

<tr align="right">
<td align="center">9</td>
<td align="left">07 November 2023</td>
<td align="left">AGUS IRMAS NUR CAHYO</td>
<td align="left">'3372046403940004</td>
<td align="left">PUTRI ARIESTA AYUNINGTYAS.NY </td>
<td align="left">24 Maret 1994</td>
<td align="left">RT 03 RW 9 SEWU</td>
<td align="left">'088226340226</td>
<td align="left">YA</td>
<td align="left">
PESERTA KB ULANGAN</td>
<td align="left">
</td>
<td align="left"></td>
<td align="left"></td>
<td align="left">
Kondom |
|
|
Z30.8|Other contraceptive management</td>
<td align="left">
BPJS KESEHATAN</td>
 </tr>

<tr align="right">
<td align="center">10</td>
<td align="left">10 November 2023</td>
<td align="left">DEWI HASTUTI</td>
<td align="left">'3311114801010001</td>
<td align="left">DEWI HASTUTI</td>
<td align="left">08 Januari 2001</td>
<td align="left">RT 04 RW 07 PUCANGSAWIT</td>
<td align="left">'085705536191</td>
<td align="left">YA</td>
<td align="left">
PESERTA KB ULANGAN</td>
<td align="left">
</td>
<td align="left"></td>
<td align="left"></td>
<td align="left">
|
Suntik |
|
N90|Other noninflammatory disorders of vulva and...</td>
<td align="left">
BPJS KESEHATAN</td>
</tr>

<tr align="right">
<td align="center">11</td>
<td align="left">10 November 2023</td>
<td align="left">WATONO</td>
<td align="left">'3372046606720005</td>
<td align="left">SULIARTI</td>
<td align="left">26 Juni 1972</td>
<td align="left">RT 5 RW VIII PUCANGSAWIT</td>
<td align="left">'08121503469</td>
<td align="left">YA</td>
<td align="left">
PESERTA KB ULANGAN</td>
<td align="left">
</td>
<td align="left"></td>
<td align="left"></td>
<td align="left">
PIL |
PIL |
|
Z30.4|Surveillance of contraceptive drugs</td>
<td align="left">
BPJS KESEHATAN</td>
</tr>

<tr align="right">
<td align="center">12</td>
<td align="left">10 November 2023</td>
<td align="left">KRISYONO</td>
<td align="left">'3312016703830003</td>
<td align="left">SRI LESTARI</td>
<td align="left">27 Maret 1983</td>
 <td align="left">RT 03 RW XI PUCANGSAWIT</td>
<td align="left">'085728854211</td>
<td align="left">YA</td>
<td align="left">
PESERTA KB ULANGAN</td>
<td align="left">
</td>
<td align="left"></td>
<td align="left"></td>
<td align="left">
Suntik |
Suntik |
|
Z30.8|Other contraceptive management</td>
<td align="left">
BPJS KESEHATAN</td>
</tr>

<tr align="right">
<td align="center">13</td>
<td align="left">10 November 2023</td>
<td align="left">EKO BUDIONO</td>
<td align="left">'3372045708740007</td>
<td align="left">ILA KUMARA DEWI</td>
<td align="left">17 Agustus 1974</td>
<td align="left">RT 04 RW VIII PUCANGSAWIT</td>
<td align="left">'083869757043</td>
<td align="left">YA</td>
<td align="left">
PESERTA KB ULANGAN</td>
<td align="left">
</td>
<td align="left"></td>
<td align="left"></td>
<td align="left">
Kondom |
Kondom |
|
Z30.8|Other contraceptive management</td>
<td align="left">
BPJS KESEHATAN</td>
</tr>

<tr align="right">
<td align="center">14</td>
<td align="left">10 November 2023</td>
<td align="left">MARGONO</td>
<td align="left">'3372046503840004</td>
<td align="left">ANI MARISA</td>
<td align="left">25 Maret 1984</td>
<td align="left">PUCANGSAWIT RT 02 RW XI PUCANGSAWIT</td>
<td align="left">'085725026318</td>
<td align="left">YA</td>
<td align="left">
PESERTA KB ULANGAN</td>
<td align="left">
</td>
<td align="left"></td>
<td align="left"></td>
 <td align="left">
|
|
|
Z00|General examination and investigation of persons...</td>
<td align="left">
BPJS KESEHATAN</td>
</tr>

<tr align="right">
<td align="center">15</td>
<td align="left">10 November 2023</td>
<td align="left">BINTORO</td>
<td align="left">'3372044206830008</td>
<td align="left">NITA SETIAWATI</td>
<td align="left">02 Juni 1983</td>
<td align="left">RT 03 RW IV PUCANGSAWIT</td>
<td align="left">'085865702773</td>
<td align="left">YA</td>
<td align="left">
PESERTA KB ULANGAN</td>
<td align="left">
</td>
<td align="left"></td>
<td align="left"></td>
<td align="left">
Suntik |
Suntik |
|
Z30.8|Other contraceptive management</td>
<td align="left">
BPJS KESEHATAN</td>
</tr>

<tr align="right">
<td align="center">16</td>
<td align="left">10 November 2023</td>
<td align="left">SRIYANTO</td>
<td align="left">'3372046412860002</td>
<td align="left">HARMINI</td>
<td align="left">24 Desember 1986</td>
<td align="left">RT 2/14 PUCANGSAWIT</td>
<td align="left">'081328900825</td>
<td align="left">YA</td>
<td align="left">
PESERTA KB ULANGAN</td>
<td align="left">
</td>
<td align="left"></td>
<td align="left"></td>
<td align="left">
Suntik |
Suntik |
|
Z30.8|Other contraceptive management</td>
<td align="left">
BPJS KESEHATAN</td>
</tr>
 <tr align="right">
<td align="center">17</td>
<td align="left">10 November 2023</td>
<td align="left">TEGUH W </td>
<td align="left">'3372045211780001</td>
<td align="left">TRIWIK REJEKI</td>
<td align="left">12 November 1978</td>
<td align="left">JAGALAN TRT 03 RW III JAGALAN</td>
<td align="left">'087836251543</td>
<td align="left">YA</td>
<td align="left">
PESERTA KB ULANGAN</td>
<td align="left">
</td>
<td align="left"></td>
<td align="left"></td>
<td align="left">
Kondom |
Suntik |
Kondom |
Z34.8|Supervision of other normal pregnancy</td>
<td align="left">
BPJS KESEHATAN</td>
</tr>

<tr align="right">
<td align="center">18</td>
<td align="left">13 November 2023</td>
<td align="left">SUNARDI</td>
<td align="left">'3372045310860003</td>
<td align="left">SULASTRI</td>
<td align="left">13 Oktober 1986</td>
<td align="left">RT 3 RW VII SEWU</td>
<td align="left">'</td>
<td align="left">YA</td>
<td align="left">
PESERTA KB ULANGAN</td>
<td align="left">
</td>
<td align="left"></td>
<td align="left"></td>
<td align="left">
Suntik |
Suntik |
|
Z30.8|Other contraceptive management</td>
<td align="left">
BPJS KESEHATAN</td>
</tr>

<tr align="right">
<td align="center">19</td>
<td align="left">14 November 2023</td>
<td align="left">DONI HARYADI</td>
<td align="left">'3372045406890024</td>
<td align="left">PUJI RAHAYU </td>
<td align="left">14 Juni 1989</td>
<td align="left">JAGALAN 04/VI JAGALAN</td>
<td align="left">'</td>
 <td align="left">YA</td>
<td align="left">
PESERTA KB ULANGAN</td>
<td align="left">
</td>
<td align="left"></td>
<td align="left"></td>
<td align="left">
Suntik |
|
|
Z30.8|Other contraceptive management</td>
<td align="left">
BPJS KESEHATAN</td>
</tr>

<tr align="right">
<td align="center">20</td>
<td align="left">14 November 2023</td>
<td align="left">FREDDY KOESWIYANTO</td>
<td align="left">'3372044505920001</td>
<td align="left">NINING DWI ASTUTIK</td>
<td align="left">05 Mei 1992</td>
<td align="left">JAGALAN 3/15 JAGALAN</td>
<td align="left">'085725286005</td>
<td align="left">YA</td>
<td align="left">
PESERTA KB ULANGAN</td>
<td align="left">
</td>
<td align="left"></td>
<td align="left"></td>
<td align="left">
Suntik |
|
|
Z30.8|Other contraceptive management</td>
<td align="left">
BPJS KESEHATAN</td>
</tr>

<tr align="right">
<td align="center">21</td>
<td align="left">17 November 2023</td>
<td align="left">AGUS</td>
<td align="left">'3372044501840004</td>
<td align="left">WAGINEM</td>
<td align="left">05 Januari 1983</td>
<td align="left">RT 02 RW XIII PUCANGSAWIT</td>
<td align="left">'-</td>
<td align="left">YA</td>
<td align="left">
PESERTA KB ULANGAN</td>
<td align="left">
</td>
<td align="left"></td>
<td align="left"></td>
<td align="left">
Suntik |
Suntik |
|
Z30.8|Other contraceptive management</td>
<td align="left">
BPJS KESEHATAN</td>
</tr>

<tr align="right">
<td align="center">22</td>
<td align="left">17 November 2023</td>
<td align="left">BUDI SANTOSO</td>
<td align="left">'3372046908870001</td>
<td align="left">WIWIK ASTUTI NINGSIH</td>
<td align="left">29 Agustus 1987</td>
<td align="left">RT 02 RW 08 PUCANGSAWIT</td>
<td align="left">'0895329052030</td>
<td align="left">YA</td>
<td align="left">
PESERTA KB ULANGAN</td>
<td align="left">
</td>
<td align="left"></td>
<td align="left"></td>
<td align="left">
Suntik |
Suntik |
|
Z30.8|Other contraceptive management</td>
<td align="left">
BPJS KESEHATAN</td>
</tr>

<tr align="right">
<td align="center">23</td>
<td align="left">17 November 2023</td>
<td align="left">MARGONO</td>
<td align="left">'3372046503840004</td>
<td align="left">ANI MARISA</td>
<td align="left">25 Maret 1984</td>
<td align="left">PUCANGSAWIT RT 02 RW XI PUCANGSAWIT</td>
<td align="left">'085725026318</td>
<td align="left">YA</td>
<td align="left">
PESERTA KB ULANGAN</td>
<td align="left">
</td>
<td align="left"></td>
<td align="left"></td>
<td align="left">
Suntik |
Suntik |
|
Z30.8|Other contraceptive management</td>
<td align="left">
BPJS KESEHATAN</td>
</tr>

<tr align="right">
<td align="center">24</td>
 <td align="left">17 November 2023</td>
<td align="left">SRIYONO</td>
<td align="left">'3312014112970002</td>
<td align="left">RIZKI FIDHI ASTUTI</td>
<td align="left">01 Desember 1997</td>
<td align="left">RT 04 RW 08 PUCANGSAWIT</td>
<td align="left">'087812570383</td>
<td align="left">YA</td>
<td align="left">
PESERTA KB ULANGAN</td>
<td align="left">
</td>
<td align="left"></td>
<td align="left"></td>
<td align="left">
Suntik |
Suntik |
|
Z30.8|Other contraceptive management</td>
<td align="left">
TIDAK</td>
</tr>

<tr align="right">
<td align="center">25</td>
<td align="left">17 November 2023</td>
<td align="left">RYAN AHMAD BRILLIANT</td>
<td align="left">'3372044408960024</td>
<td align="left">AGUSTINA TANJUNG PUTRI</td>
<td align="left">04 Agustus 1996</td>
<td align="left">RT 2 RW 4 SEWU</td>
<td align="left">'085704190149</td>
<td align="left">YA</td>
<td align="left">
PESERTA KB ULANGAN</td>
<td align="left">
</td>
<td align="left"></td>
<td align="left"></td>
<td align="left">
Suntik |
Suntik |
|
Z30.8|Other contraceptive management</td>
<td align="left">
BPJS KESEHATAN</td>
</tr>

<tr align="right">
<td align="center">26</td>
<td align="left">17 November 2023</td>
<td align="left">AGUS BUDI PRASETYO</td>
<td align="left">'3372045708930021</td>
<td align="left">ERNI KRISTIANTI</td>
<td align="left">17 Agustus 1992</td>
<td align="left">RT 01 RW XIII PUCANGSAWIT</td>
<td align="left">'</td>
<td align="left">YA</td>
<td align="left">
PESERTA KB ULANGAN</td>
<td align="left">
</td>
<td align="left"></td>
<td align="left"></td>
<td align="left">
|
Suntik |
|
Z30|Contraceptive management</td>
<td align="left">
BPJS KESEHATAN</td>
</tr>

<tr align="right">
<td align="center">27</td>
<td align="left">20 November 2023</td>
<td align="left">WAHYONO</td>
<td align="left">'3372015409020003</td>
<td align="left">WIHELMIA AYU VANIA PUTRI </td>
<td align="left">14 September 2002</td>
<td align="left">RT 06 RW 08 SEWU</td>
<td align="left">'</td>
<td align="left">YA</td>
<td align="left">
PESERTA KB ULANGAN</td>
<td align="left">
</td>
<td align="left"></td>
<td align="left"></td>
<td align="left">
Suntik |
Suntik |
|
Z30.8|Other contraceptive management</td>
<td align="left">
BPJS KESEHATAN</td>
</tr>

<tr align="right">
<td align="center">28</td>
<td align="left">21 November 2023</td>
<td align="left">SUDARSONO</td>
<td align="left">'3372045712930001</td>
<td align="left">DESY TRI RAHMAWATI</td>
<td align="left">17 Desember 1993</td>
<td align="left">RT02/VII SEWU</td>
<td align="left">'0895363025340</td>
<td align="left">YA</td>
<td align="left">
PESERTA KB ULANGAN</td>
<td align="left">
</td>
<td align="left"></td>
<td align="left"></td>
<td align="left">
|
|
|
Z30.0|General counselling and advice on contraception</td>
<td align="left">
BPJS KESEHATAN</td>
</tr>

<tr align="right">
<td align="center">29</td>
<td align="left">21 November 2023</td>
<td align="left">OKKY RYAN PUTRA</td>
<td align="left">'3314076811970002</td>
<td align="left">EKA NOVITA SULISTYO RINI</td>
<td align="left">26 November 1997</td>
<td align="left">PUCANGSAWIT RT 02 RW 11 JEBRES SURAKARTA PUCANGSAWIT</td>
<td align="left">'081329617100</td>
<td align="left">YA</td>
<td align="left">
PESERTA KB ULANGAN</td>
<td align="left">
</td>
<td align="left"></td>
<td align="left"></td>
<td align="left">
|
|
|
Z30.0|General counselling and advice on contraception</td>
<td align="left">
BPJS KESEHATAN</td>
</tr>

<tr align="right">
<td align="center">30</td>
<td align="left">21 November 2023</td>
<td align="left">EKO SUSILO </td>
<td align="left">'3372044111020003</td>
<td align="left">NADIA 0ENTARI SUSILOWATI</td>
<td align="left">01 November 2002</td>
<td align="left">RT 02 RW XV PUCANGSAWIT</td>
<td align="left">'0881023985211</td>
<td align="left">YA</td>
<td align="left">
PESERTA KB ULANGAN</td>
<td align="left">
</td>
<td align="left"></td>
<td align="left"></td>
<td align="left">
Suntik |
Suntik |
|
Z30.8|Other contraceptive management</td>
<td align="left">
BPJS KESEHATAN</td>
</tr>

<tr align="right">
<td align="center">31</td>
<td align="left">21 November 2023</td>
<td align="left">SETU WAHYONO</td>
 <td align="left">'3372046501740002</td>
<td align="left">SURAMI</td>
<td align="left">25 Januari 1974</td>
<td align="left">RT 02 RW VII JAGALAN</td>
<td align="left">'-</td>
<td align="left">YA</td>
<td align="left">
PESERTA KB ULANGAN</td>
<td align="left">
</td>
<td align="left"></td>
<td align="left"></td>
<td align="left">
PIL |
PIL |
|
Z30.4|Surveillance of contraceptive drugs</td>
<td align="left">
BPJS KESEHATAN</td>
</tr>

<tr align="right">
<td align="center">32</td>
<td align="left">21 November 2023</td>
<td align="left">RAHAYU</td>
<td align="left">'3372045111870004</td>
<td align="left">RAHAYU</td>
<td align="left">11 November 1987</td>
<td align="left">RT 03 RW 03 JAGALAN</td>
<td align="left">'</td>
<td align="left">YA</td>
<td align="left">
PESERTA KB ULANGAN</td>
<td align="left">
</td>
<td align="left"></td>
<td align="left"></td>
<td align="left">
|
|
|
Z30.0|General counselling and advice on contraception</td>
<td align="left">
BPJS KESEHATAN</td>
</tr>

<tr align="right">
<td align="center">33</td>
<td align="left">21 November 2023</td>
<td align="left">TEGUH W </td>
<td align="left">'3372045211780001</td>
<td align="left">TRIWIK REJEKI</td>
<td align="left">12 November 1978</td>
<td align="left">JAGALAN TRT 03 RW III JAGALAN</td>
<td align="left">'087836251543</td>
<td align="left">YA</td>
<td align="left">
PESERTA KB ULANGAN</td>
<td align="left">
</td>
<td align="left"></td>
<td align="left"></td>
<td align="left">
|
|
|
Z30.0|General counselling and advice on contraception</td>
<td align="left">
BPJS KESEHATAN</td>
</tr>

<tr align="right">
<td align="center">34</td>
<td align="left">21 November 2023</td>
<td align="left">EKO YULIANTO, TN</td>
<td align="left">'3372044111910003</td>
<td align="left">YOPI CARLINA</td>
<td align="left">01 November 1991</td>
<td align="left">RT 01 RW XII PUCANGSAWIT</td>
<td align="left">'</td>
<td align="left">YA</td>
<td align="left">
PESERTA KB ULANGAN</td>
<td align="left">
</td>
<td align="left"></td>
<td align="left"></td>
<td align="left">
Suntik |
Suntik |
|
Z30.8|Other contraceptive management</td>
<td align="left">
BPJS KESEHATAN</td>
</tr>

<tr align="right">
<td align="center">35</td>
<td align="left">21 November 2023</td>
<td align="left">AHMAD FAJAR</td>
<td align="left">'3372046408000003</td>
<td align="left">MILA WULANDARI</td>
<td align="left">24 Agustus 2000</td>
<td align="left">RT 02 RW 1V PUCANGSAWIT</td>
<td align="left">'081327747502</td>
<td align="left">YA</td>
<td align="left">
PESERTA KB ULANGAN</td>
<td align="left">
</td>
<td align="left"></td>
<td align="left"></td>
<td align="left">
Suntik |
Suntik |
|
Z30.8|Other contraceptive management</td>
<td align="left">
BPJS KESEHATAN</td>
</tr>

<tr align="right">
<td align="center">36</td>
<td align="left">21 November 2023</td>
<td align="left">TOPAN HARYANTO</td>
<td align="left">'3372047012790002</td>
<td align="left">LESTARI</td>
<td align="left">30 Desember 1979</td>
<td align="left">PC SAWIT RT 02 RW 1V PUCANGSAWIT</td>
<td align="left">'-</td>
<td align="left">YA</td>
<td align="left">
PESERTA KB ULANGAN</td>
<td align="left">
</td>
<td align="left"></td>
<td align="left"></td>
<td align="left">
Suntik |
Suntik |
|
Z30.8|Other contraceptive management</td>
<td align="left">
BPJS KESEHATAN</td>
</tr>

<tr align="right">
<td align="center">37</td>
<td align="left">21 November 2023</td>
<td align="left">ARIEF VREDI</td>
<td align="left">'3372045010910002</td>
<td align="left">SRI HASTUTI</td>
<td align="left">10 Oktober 1991</td>
<td align="left">RT 1 RW X1 PUCANGSAWIT</td>
<td align="left">'082242311710</td>
<td align="left">YA</td>
<td align="left">
PESERTA KB ULANGAN</td>
<td align="left">
</td>
<td align="left"></td>
<td align="left"></td>
<td align="left">
IMPLANT |
IMPLANT |
|
Z30.8|Other contraceptive management</td>
<td align="left">
BPJS KESEHATAN</td>
</tr>

<tr align="right">
<td align="center">38</td>
<td align="left">21 November 2023</td>
<td align="left">SUGENG TN</td>
<td align="left">'3372045912850002</td>
<td align="left">DIAN PRIHANTINI</td>
 <td align="left">19 Desember 1985</td>
<td align="left">JAGALAN 04/04 JAGALAN</td>
<td align="left">'085728751240</td>
<td align="left">YA</td>
<td align="left">
PESERTA KB ULANGAN</td>
<td align="left">
</td>
<td align="left"></td>
<td align="left"></td>
<td align="left">
|
|
|
Z30.0|General counselling and advice on contraception</td>
<td align="left">
BPJS KESEHATAN</td>
</tr>

<tr align="right">
<td align="center">39</td>
<td align="left">24 November 2023</td>
<td align="left">BOBY WIRA UTAMA</td>
<td align="left">'317510695000009</td>
<td align="left">WINDYANI KUSANDARI</td>
<td align="left">29 Mei 2000</td>
<td align="left">RT 1 RW 14 PUCANGSAWIT</td>
<td align="left">'089549251004</td>
<td align="left">YA</td>
<td align="left">
PESERTA KB ULANGAN</td>
<td align="left">
</td>
<td align="left"></td>
<td align="left"></td>
<td align="left">
Suntik |
Suntik |
|
Z30.8|Other contraceptive management</td>
<td align="left">
BPJS KESEHATAN</td>
</tr>

<tr align="right">
<td align="center">40</td>
<td align="left">24 November 2023</td>
<td align="left">SUDARSONO</td>
<td align="left">'3372045712930001</td>
<td align="left">DESY TRI RAHMAWATI</td>
<td align="left">17 Desember 1993</td>
<td align="left">RT02/VII SEWU</td>
<td align="left">'0895363025340</td>
<td align="left">YA</td>
<td align="left">
PESERTA KB ULANGAN</td>
<td align="left">
</td>
<td align="left"></td>
 <td align="left"></td>
<td align="left">
|
IUD |
|
Z30.8|Other contraceptive management</td>
<td align="left">
BPJS KESEHATAN</td>
</tr>

<tr align="right">
<td align="center">41</td>
<td align="left">24 November 2023</td>
<td align="left">ARIEF VREDI</td>
<td align="left">'3372045010910002</td>
<td align="left">SRI HASTUTI</td>
<td align="left">10 Oktober 1991</td>
<td align="left">RT 1 RW X1 PUCANGSAWIT</td>
<td align="left">'082242311710</td>
<td align="left">YA</td>
<td align="left">
PESERTA KB ULANGAN</td>
<td align="left">
</td>
<td align="left"></td>
<td align="left"></td>
<td align="left">
IMPLANT |
IMPLANT |
|
Z00.0|General medical examination</td>
<td align="left">
BPJS KESEHATAN</td>
</tr>

<tr align="right">
<td align="center">42</td>
<td align="left">27 November 2023</td>
<td align="left">ARIYANTO</td>
<td align="left">'3372046203870004</td>
<td align="left">TRI FACHRUDI'ANI</td>
<td align="left">22 Maret 1987</td>
<td align="left">RT 6 RW 8 SEWU</td>
<td align="left">'</td>
<td align="left">YA</td>
<td align="left">
PESERTA KB ULANGAN</td>
<td align="left">
</td>
<td align="left"></td>
<td align="left"></td>
<td align="left">
|
Suntik |
|
Z30.8|Other contraceptive management</td>
<td align="left">
BPJS KESEHATAN</td>
</tr>
 <tr align="right">
<td align="center">43</td>
<td align="left">28 November 2023</td>
<td align="left">SARDI</td>
<td align="left">'3308156810770002</td>
<td align="left">SUDARMI</td>
<td align="left">28 Oktober 1977</td>
<td align="left">RT 02 RW VII PUCANGSAWIT</td>
<td align="left">'0</td>
<td align="left">YA</td>
<td align="left">
PESERTA KB ULANGAN</td>
<td align="left">
</td>
<td align="left"></td>
<td align="left"></td>
<td align="left">
|
Suntik |
|
Z30.8|Other contraceptive management</td>
<td align="left">
BPJS KESEHATAN</td>
</tr>

<tr align="right">
<td align="center">44</td>
<td align="left">28 November 2023</td>
<td align="left">SUHARNO</td>
<td align="left">'3372046611760001</td>
<td align="left">YANI</td>
<td align="left">01 Juni 1976</td>
<td align="left">JAGALAN 03/XII JAGALAN</td>
<td align="left">'085100952398</td>
<td align="left">YA</td>
<td align="left">
PESERTA KB ULANGAN</td>
<td align="left">
</td>
<td align="left"></td>
<td align="left"></td>
<td align="left">
SuntikSuntik |
Suntik |
|
Z30.8|Other contraceptive management</td>
<td align="left">
BPJS KESEHATAN</td>
</tr>

<tr align="right">
<td align="center">45</td>
<td align="left">28 November 2023</td>
<td align="left">OKKY RYAN PUTRA</td>
<td align="left">'3314076811970002</td>
<td align="left">EKA NOVITA SULISTYO RINI</td>
<td align="left">26 November 1997</td>
<td align="left">PUCANGSAWIT RT 02 RW 11 JEBRES SURAKARTA PUCANGSAWIT</td>
 <td align="left">'081329617100</td>
<td align="left">YA</td>
<td align="left">
PESERTA KB ULANGAN</td>
<td align="left">
</td>
<td align="left"></td>
<td align="left"></td>
<td align="left">
IUD |
IUD |
|
Z30.8|Other contraceptive management</td>
<td align="left">
BPJS KESEHATAN</td>
</tr>

<tr align="right">
<td align="center">46</td>
<td align="left">28 November 2023</td>
<td align="left">UUN PUJI PRASETYO</td>
<td align="left">'3313104507960004</td>
<td align="left">ERNI DYAH WINURYANTI</td>
<td align="left">05 Juli 1996</td>
<td align="left">PUCANGSAWIT RT 2 RW 2 PUCANGSAWIT</td>
<td align="left">'081935310159</td>
<td align="left">YA</td>
<td align="left">
PESERTA KB ULANGAN</td>
<td align="left">
</td>
<td align="left"></td>
<td align="left"></td>
<td align="left">
|
Kondom |
Suntik |
Z30.8|Other contraceptive management</td>
<td align="left">
BPJS KESEHATAN</td>
</tr>

<tr align="right">
<td align="center">47</td>
<td align="left">28 November 2023</td>
<td align="left">ANGGORO</td>
<td align="left">'3372046904730004</td>
<td align="left">ROCHAYAH IRNAWATI</td>
<td align="left">29 April 1973</td>
<td align="left">RT 01 RW 05 SEWU</td>
<td align="left">'</td>
<td align="left">YA</td>
<td align="left">
PESERTA KB ULANGAN</td>
<td align="left">
</td>
<td align="left"></td>
<td align="left"></td>
<td align="left">
 |
IMPLANT |
Kondom |
Z30.8|Other contraceptive management</td>
<td align="left">
BPJS KESEHATAN</td>
</tr>

<tr align="right">
<td align="center">48</td>
<td align="left">28 November 2023</td>
<td align="left">RAHAYU</td>
<td align="left">'3372045111870004</td>
<td align="left">RAHAYU</td>
<td align="left">11 November 1987</td>
<td align="left">RT 03 RW 03 JAGALAN</td>
<td align="left">'</td>
<td align="left">YA</td>
<td align="left">
PESERTA KB ULANGAN</td>
<td align="left">
</td>
<td align="left"></td>
<td align="left"></td>
<td align="left">
Suntik |
Suntik |
|
Z30.8|Other contraceptive management</td>
<td align="left">
BPJS KESEHATAN</td>
</tr>

<tr align="right">
<td align="center">49</td>
<td align="left">28 November 2023</td>
<td align="left">TEGUH W </td>
<td align="left">'3372045211780001</td>
<td align="left">TRIWIK REJEKI</td>
<td align="left">12 November 1978</td>
<td align="left">JAGALAN TRT 03 RW III JAGALAN</td>
<td align="left">'087836251543</td>
<td align="left">YA</td>
<td align="left">
PESERTA KB ULANGAN</td>
<td align="left">
</td>
<td align="left"></td>
<td align="left"></td>
<td align="left">
Kondom |
Kondom |
|
Z30.8|Other contraceptive management</td>
<td align="left">
BPJS KESEHATAN</td>
</tr>

<tr align="right">
 <td align="center">50</td>
<td align="left">28 November 2023</td>
<td align="left">SRI HARTATIK</td>
<td align="left">'332044312750005</td>
<td align="left">SRI HARTATIK</td>
<td align="left">03 Desember 1975</td>
<td align="left">RT 04 RW 6 SEWU</td>
<td align="left">'</td>
<td align="left">YA</td>
<td align="left">
PESERTA KB ULANGAN</td>
<td align="left">
</td>
<td align="left"></td>
<td align="left"></td>
<td align="left">
PIL |
PIL |
PIL |
Z30.8|Other contraceptive management</td>
<td align="left">
BPJS KESEHATAN</td>
</tr>
</table>