<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">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>
</table>