DAFTAR KUNJUNGAN PESERTA SAKIT

Kantor Cabang : PALEMBANG - 0601

FKTP : PALEM RAYA - 04290003

NO TANGGAL NO KUNJUNGAN NO KARTU NAMA PESERTA SEX JENIS PESERTA DIAGNOSA DIRUJUK

1 31-01-2019 042900030119P000121 0000027612426 DARMASHILA. MS L PENERIMA PENSIUN Low back pain Berobat Jalan
PNS
2 31-01-2019 042900030119P000120 0000321425583 PAHRUDIN L PBI (APBN) Low back pain Berobat Jalan

3 31-01-2019 042900030119P000127 0001176088983 MIRAWATI P PEGAWAI SWASTA Single spontaneous Sembuh

delivery, unspecified
4 31-01-2019 042900030119P000027 0001883462073 HASTUTI WAHYUNI P PEGAWAI SWASTA Presence of other Rujuk Lanjut
functional implants
5 31-01-2019 042900030119P000028 0002481948639 AIRIN APRILIA NAJWA P PEGAWAI SWASTA Follow-up examination Rujuk Lanjut
after unspecified treatment
for other conditions

6 30-01-2019 042900030119P000118 0000321389504 VIKAN CAHAYA WULANDARI P PBI (APBN) Acute upper respiratory Berobat Jalan
infection, unspecified
7 30-01-2019 042900030119P000117 0002064856915 chintia azzahra P PEGAWAI SWASTA Acute upper respiratory Berobat Jalan
infection, unspecified
8 30-01-2019 042900030119P000119 0002610657988 RASYA MUHAMMAD ATHAYA L PEGAWAI SWASTA Acute upper respiratory Berobat Jalan
infection, unspecified
9 29-01-2019 042900030119P000025 0000027775811 DAVID INDRIADI L PEKERJA MANDIRI Migraine Rujuk Lanjut

10 29-01-2019 042900030119P000116 0000321356766 SOFYAN IRAWAN L PBI (APBN) Gastritis, unspecified Berobat Jalan

11 29-01-2019 042900030119P000026 0001326029782 delia putri ramadhani P PEGAWAI SWASTA Suppurative and Rujuk Lanjut
unspecified otitis media
12 28-01-2019 042900030119P000113 0000026875528 IRSAN BAHRI L PENERIMA PENSIUN Allergy, unspecified Berobat Jalan
PNS
13 28-01-2019 042900030119P000114 0000321565465 SUMARNI P PBI (APBN) Allergy, unspecified Berobat Jalan

14 28-01-2019 042900030119P000022 0000992109082 SANAWIYAH P PBI (APBN) Degenerated conditions of Rujuk Lanjut
globe
15 28-01-2019 042900030119P000112 0000992115382 YATINEM P PBI (APBN) Low back pain Berobat Jalan

16 28-01-2019 042900030119P000115 0001509524043 FUADI L PBI (APBD) Gastritis, unspecified Berobat Jalan

17 28-01-2019 042900030119P000111 0001509796866 NASLENI L PBI (APBD) Non-insulin-dependent Berobat Jalan

diabetes mellitus without

18 28-01-2019 042900030119P000024 0001883462073 HASTUTI WAHYUNI P PEGAWAI SWASTA Presence of other Rujuk Lanjut
functional implants
19 28-01-2019 042900030119P000023 0002499808893 UJANG ZAINI L PEKERJA MANDIRI Chronic ischaemic heart Rujuk Lanjut
disease
20 27-01-2019 042900030119P000110 0000321386602 MELATI ZAHRA P PBI (APBN) Acute upper respiratory Berobat Jalan
infection, unspecified
 DAFTAR KUNJUNGAN PESERTA SAKIT

Kantor Cabang : PALEMBANG - 0601

FKTP : PALEM RAYA - 04290003

21 26-01-2019 042900030119P000109 0000321445675 ADE SENIA P PBI (APBN) Acute upper respiratory Berobat Jalan
infection, unspecified
22 24-01-2019 042900030119P000021 0000026103879 SAPARUDIN L PNS DAERAH Atherosclerotic heart Rujuk Lanjut
disease
23 24-01-2019 042900030119P000108 0001326029782 delia putri ramadhani P PEGAWAI SWASTA Acute upper respiratory Berobat Jalan
infection, unspecified
24 23-01-2019 042900030119P000020 0000026485705 RUSNAH P PENERIMA PENSIUN TNI Low back pain Rujuk Lanjut

25 23-01-2019 042900030119P000105 0000321439318 SURYANA P PBI (APBN) Low back pain Berobat Jalan

26 23-01-2019 042900030119P000106 0001189331469 Salsabila Ramadani P PEGAWAI SWASTA Disturbances in tooth Berobat Jalan
eruption
27 23-01-2019 042900030119P000107 0001509524008 ADRIAN FERNANDES L PBI (APBD) Disturbances in tooth Berobat Jalan
eruption
28 23-01-2019 042900030119P000019 0002567554187 ANISA SHABIYA P PBI (APBD) Fever, unspecified Rujuk Lanjut

29 22-01-2019 042900030119P000104 0000027595653 SUPARITO L PNS DAERAH Gastritis, unspecified Berobat Jalan

30 22-01-2019 042900030119P000102 0000159690677 SYORI b. HARUN L PENERIMA PENSIUN Gastritis, unspecified Berobat Jalan
PNS
31 22-01-2019 042900030119P000101 0000321412307 TEGAR OKTA TRIANSA L PBI (APBN) Acute upper respiratory Berobat Jalan
infection, unspecified
32 22-01-2019 042900030119P000018 0000322136886 NASIR L PBI (APBN) Respiratory tuberculosis Rujuk Lanjut
unspecified, confirmed
bacteriologically and

33 22-01-2019 042900030119P000103 0001080249592 SADIYAH P PENERIMA PENSIUN Low back pain Berobat Jalan
PNS
34 21-01-2019 042900030119P000017 0000027610121 HAMIMA P PNS DAERAH Non-insulin-dependent Rujuk Lanjut
diabetes mellitus without

35 21-01-2019 042900030119P000093 0000027610121 HAMIMA P PNS DAERAH Low back pain Berobat Jalan

36 21-01-2019 042900030119P000091 0000321356766 SOFYAN IRAWAN L PBI (APBN) Gastritis, unspecified Berobat Jalan

37 21-01-2019 042900030119P000099 0000321375644 RITA HARYANI P PBI (APBN) Acute upper respiratory Berobat Jalan
infection, unspecified
38 21-01-2019 042900030119P000092 0000321413703 WITOYO L PBI (APBN) Diseases of pulp and Berobat Jalan
periapical tissues
39 21-01-2019 042900030119P000097 0000322448589 SOPUAN L PBI (APBN) Low back pain Berobat Jalan

40 21-01-2019 042900030119P000098 0000322448826 YULIATI P PBI (APBN) Gastritis, unspecified Berobat Jalan

41 21-01-2019 042900030119P000100 0001307846687 FITRIA SUSANTI P PEKERJA MANDIRI Low back pain Berobat Jalan

42 21-01-2019 042900030119P000016 0001883462073 HASTUTI WAHYUNI P PEGAWAI SWASTA Benign neoplasm of breast Rujuk Lanjut
 DAFTAR KUNJUNGAN PESERTA SAKIT

Kantor Cabang : PALEMBANG - 0601

FKTP : PALEM RAYA - 04290003

43 21-01-2019 042900030119P000096 0001883463063 KEILA LAHIRA FITRI P PEGAWAI SWASTA Acute upper respiratory Berobat Jalan
infection, unspecified
44 21-01-2019 042900030119P000095 0002199668005 MURDIYAH P PEKERJA MANDIRI Gastritis, unspecified Berobat Jalan

45 21-01-2019 042900030119P000094 0002610657988 RASYA MUHAMMAD ATHAYA L PEGAWAI SWASTA Acute upper respiratory Berobat Jalan
infection, unspecified
46 20-01-2019 042900030119P000089 0000321374632 WIJI P PBI (APBN) Low back pain Berobat Jalan

47 20-01-2019 042900030119P000090 0000321391293 WAKIMIN L PBI (APBN) Acute upper respiratory Berobat Jalan
infection, unspecified
48 19-01-2019 042900030119P000087 0000321412779 SUMIYATI P PBI (APBN) Diseases of pulp and Berobat Jalan
periapical tissues
49 19-01-2019 042900030119P000088 0001509796866 NASLENI L PBI (APBD) Low back pain Berobat Jalan

50 18-01-2019 042900030119P000086 0000321462731 NURHAYATI P PBI (APBN) Low back pain Berobat Jalan

51 17-01-2019 042900030119P000029 0000027720764 AMRULLAH L PNS DAERAH Schizophrenia, unspecified Berobat Jalan

52 17-01-2019 042900030119P000014 0000168844138 DIS P PENERIMA PENSIUN Disorder of refraction, Rujuk Lanjut
PNS unspecified
53 17-01-2019 042900030119P000084 0000321406119 RIZKI DARMAWAN L PBI (APBN) Acute upper respiratory Berobat Jalan
infection, unspecified
54 17-01-2019 042900030119P000085 0000321421566 DESI APRITA P PBI (APBN) Low back pain Berobat Jalan

55 17-01-2019 042900030119P000015 0001307846687 FITRIA SUSANTI P PEKERJA MANDIRI Supervision of normal Rujuk Lanjut
pregnancy, unspecified
56 16-01-2019 042900030119P000082 0000321400629 LINGGAWATI P PBI (APBN) Acute upper respiratory Berobat Jalan
infection, unspecified
57 16-01-2019 042900030119P000083 0000321507606 YAM P PBI (APBN) Gastritis, unspecified Berobat Jalan

58 16-01-2019 042900030119P000013 0002199668005 MURDIYAH P PEKERJA MANDIRI Lumbar and other Rujuk Lanjut
intervertebral disc

59 15-01-2019 042900030119P000012 0000027612426 DARMASHILA. MS L PENERIMA PENSIUN Acute bronchitis Rujuk Lanjut
PNS
60 15-01-2019 042900030119P000080 0001509526067 YULIAWATI P PBI (APBD) Acute upper respiratory Berobat Jalan
infection, unspecified
61 15-01-2019 042900030119P000081 0002281167753 SUKARMAN L PEKERJA MANDIRI Acute upper respiratory Berobat Jalan
infection, unspecified
62 14-01-2019 042900030119P000078 0000122181546 HAMDAN L PENERIMA PENSIUN Gastritis, unspecified Berobat Jalan
PNS
63 14-01-2019 042900030119P000079 0001272129085 NAILAH HASANA P PEGAWAI SWASTA Low back pain Berobat Jalan

64 13-01-2019 042900030119P000077 0000321386771 M HERU SEPTIANTO L PBI (APBN) Acute upper respiratory Berobat Jalan
infection, unspecified
 DAFTAR KUNJUNGAN PESERTA SAKIT

Kantor Cabang : PALEMBANG - 0601

FKTP : PALEM RAYA - 04290003

65 12-01-2019 042900030119P000073 0000321356766 SOFYAN IRAWAN L PBI (APBN) Low back pain Berobat Jalan

66 12-01-2019 042900030119P000074 0000321364596 JESI P PBI (APBN) Acute upper respiratory Berobat Jalan
infection, unspecified
67 12-01-2019 042900030119P000076 0001307846687 FITRIA SUSANTI P PEKERJA MANDIRI Acute upper respiratory Berobat Jalan
infection, unspecified
68 12-01-2019 042900030119P000075 0001509524109 MARYANI P PBI (APBD) Gastritis, unspecified Berobat Jalan

69 11-01-2019 042900030119P000072 0000322434437 BAMBANG IRAWAN L PBI (APBN) Essential (primary) Berobat Jalan
hypertension
70 11-01-2019 042900030119Y000011 0000322594885 WAHID MOTOHARI L PBI (APBN) Gastric ulcer Rujuk Lanjut

71 10-01-2019 042900030119Y000009 0000026875539 MUSNAI P PENERIMA PENSIUN Osteoporosis of disuse Rujuk Lanjut
PNS
72 10-01-2019 042900030119P000071 0000323944132 RUKIYAH P PBI (APBN) Gastritis, unspecified Berobat Jalan

73 10-01-2019 042900030119Y000010 0001859044432 KAMELIA SARI P PEKERJA MANDIRI Follow-up examination Rujuk Lanjut
after unspecified treatment
for other conditions

74 09-01-2019 042900030119P000069 0000027237137 BASTIUN L PNS DAERAH Acute upper respiratory Berobat Jalan
infection, unspecified
75 09-01-2019 042900030119P000067 0000321384958 M AGUS JULYANTO L PBI (APBN) Acute upper respiratory Berobat Jalan
infection, unspecified
76 09-01-2019 042900030119P000070 0000321397389 PUTRI WIRANI P PBI (APBN) Acute upper respiratory Berobat Jalan
infection, unspecified
77 09-01-2019 042900030119P000063 0000321447881 RIO STEVEN L PBI (APBN) Schizophrenia, unspecified Berobat Jalan

78 09-01-2019 042900030119P000064 0001427920661 SUHERNI BINTI JUMRI P PBI (APBD) Acute upper respiratory Berobat Jalan
infection, unspecified
79 09-01-2019 042900030119P000065 0001509523953 EKO WAHYU SURYANINGSIH P PBI (APBD) Other forms of stomatitis Berobat Jalan

80 09-01-2019 042900030119P000068 0001509524109 MARYANI P PBI (APBD) Migraine, unspecified Berobat Jalan

81 09-01-2019 042900030119P000066 0002264557779 ASTUTI ALAWIYA P PEKERJA MANDIRI Acute upper respiratory Berobat Jalan
infection, unspecified
82 08-01-2019 042900030119P000053 0000026875528 IRSAN BAHRI L PENERIMA PENSIUN Allergy, unspecified Berobat Jalan
PNS
83 08-01-2019 042900030119P000056 0000027775642 HERYANI P PNS DAERAH Non-insulin-dependent Berobat Jalan
diabetes mellitus without

84 08-01-2019 042900030119P000050 0000321425583 PAHRUDIN L PBI (APBN) Schizophrenia, unspecified Berobat Jalan

85 08-01-2019 042900030119P000062 0000321465429 JUREMI L PBI (APBN) Acute upper respiratory Berobat Jalan
infection, unspecified
 DAFTAR KUNJUNGAN PESERTA SAKIT

Kantor Cabang : PALEMBANG - 0601

FKTP : PALEM RAYA - 04290003

86 08-01-2019 042900030119P000058 0000321551471 ALADIN MADIN L PBI (APBN) Gastritis, unspecified Berobat Jalan

87 08-01-2019 042900030119P000057 0000322136886 NASIR L PBI (APBN) Migraine Berobat Jalan

88 08-01-2019 042900030119P000051 0000322448826 YULIATI P PBI (APBN) Gastritis, unspecified Berobat Jalan

89 08-01-2019 042900030119P000060 0000322535316 M UMAR L PBI (APBN) Low back pain Berobat Jalan

90 08-01-2019 042900030119P000061 0000992115663 YAMANI P PBI (APBN) Migraine Berobat Jalan

91 08-01-2019 042900030119P000059 0000992115977 MUHTAR SALEH L PBI (APBN) Low back pain Berobat Jalan

92 08-01-2019 042900030119P000055 0001509523784 MARDIYANA P PBI (APBD) Gastritis, unspecified Berobat Jalan

93 08-01-2019 042900030119P000054 0001509523795 ARI MARWANSAH L PBI (APBD) Allergy, unspecified Berobat Jalan

94 08-01-2019 042900030119P000052 0001607026149 ACHMAD JAIS L PEGAWAI SWASTA Acute upper respiratory Berobat Jalan
infection, unspecified
95 08-01-2019 042900030119Y000007 0001725877247 AHMAD TARMIZI L PEKERJA MANDIRI Hypertensive heart Rujuk Lanjut
disease
96 08-01-2019 042900030119Y000006 0001725877258 RUSMINI P PEKERJA MANDIRI Systemic lupus Rujuk Lanjut
erythematosus,

97 08-01-2019 042900030119Y000005 0001969328531 ROMIDAH P PEKERJA MANDIRI Thyrotoxicosis, Rujuk Lanjut

unspecified
98 07-01-2019 042900030119Y000004 0000025373193 DELLY MASITOH P PENERIMA PENSIUN Essential (primary) Rujuk Lanjut
PNS hypertension
99 07-01-2019 042900030119P000049 0000027237137 BASTIUN L PNS DAERAH Acute upper respiratory Berobat Jalan
infection, unspecified
100 07-01-2019 042900030119P000048 0000320656961 HERIANTO L PBI (APBN) Acute upper respiratory Berobat Jalan
infection, unspecified
101 07-01-2019 042900030119P000047 0000321374125 TOIMON L PBI (APBN) Gastritis, unspecified Berobat Jalan

102 07-01-2019 042900030119P000046 0000321414682 SUPRIHATIN L PBI (APBN) Influenza due to other Berobat Jalan
identified influenza virus
103 06-01-2019 042900030119P000045 0000321414636 NURAINI P PBI (APBN) Chronic gingivitis Berobat Jalan

104 06-01-2019 042900030119P000044 0000322309203 RAPITA P PBI (APBN) Cutaneous abscess, Berobat Jalan
furuncle and carbuncle,

105 05-01-2019 042900030119P000041 0000321386038 RISKA DAMAYANTI P PBI (APBN) Acute upper respiratory Berobat Jalan
infection, unspecified
106 05-01-2019 042900030119P000043 0000323944132 RUKIYAH P PBI (APBN) Low back pain Berobat Jalan

107 05-01-2019 042900030119P000040 0000323945831 SINDI AULIA P PBI (APBN) Acute upper respiratory Berobat Jalan
infection, unspecified
108 05-01-2019 042900030119P000042 0001509796866 NASLENI L PBI (APBD) Gastritis, unspecified Berobat Jalan
 DAFTAR KUNJUNGAN PESERTA SAKIT

Kantor Cabang : PALEMBANG - 0601

FKTP : PALEM RAYA - 04290003

109 04-01-2019 042900030119P000038 0000321414456 SUCIPTO L PBI (APBN) Acute upper respiratory Berobat Jalan
infection, unspecified
110 04-01-2019 042900030119P000039 0002264557454 ABDUL HARIS L PEKERJA MANDIRI Gangrene, not elsewhere Berobat Jalan
classified
111 03-01-2019 042900030119P000036 0000321405276 YUSNANI P PBI (APBN) Non-insulin-dependent Berobat Jalan
diabetes mellitus without

112 03-01-2019 042900030119P000035 0000992116798 NURAINI P PBI (APBN) Pneumonia, unspecified Berobat Jalan

113 03-01-2019 042900030119Y000003 0001426290603 masnoni L PEKERJA MANDIRI Essential (primary) Rujuk Lanjut
hypertension
114 03-01-2019 042900030119P000037 0001509796888 AZIZAH P PBI (APBD) Influenza, virus not Berobat Jalan
identified
115 03-01-2019 042900030119P000123 0001832209468 HANAFI L PEKERJA MANDIRI Essential (primary) Rujuk Lanjut
hypertension
116 02-01-2019 042900030119Y000001 0000025243751 FAHRURROZI L PNS DAERAH Cerebral infarction, Rujuk Lanjut
unspecified
117 02-01-2019 042900030119P000125 0000026485705 RUSNAH P PENERIMA PENSIUN TNI Hypertensive heart Rujuk Lanjut
disease with (congestive)

118 02-01-2019 042900030119Y000002 0000027143717 YUSMAYANI P PNS DAERAH Conductive hearing loss, Rujuk Lanjut
bilateral
119 02-01-2019 042900030119P000034 0000027775642 HERYANI P PNS DAERAH Gastritis and duodenitis Berobat Jalan

120 02-01-2019 042900030119P000124 0000070195612 E. KOMSALI L PNS PUSAT Non-insulin-dependent Rujuk Lanjut
diabetes mellitus
121 02-01-2019 042900030119P000033 0000320612466 TIARA P PBI (APBN) Gastritis, unspecified Berobat Jalan

122 02-01-2019 042900030119P000031 0000321408292 MUKAYAT L PBI (APBN) Other diseases of upper Berobat Jalan
respiratory tract
123 02-01-2019 042900030119P000032 0000321472089 SAWILA P PBI (APBN) Essential (primary) Berobat Jalan
hypertension
124 02-01-2019 042900030119Y000008 0001189331469 Salsabila Ramadani P PEGAWAI SWASTA Fever, unspecified Berobat Jalan

125 02-01-2019 042900030119P000126 0002199668005 MURDIYAH P PEKERJA MANDIRI Other intervertebral disc Rujuk Lanjut
disorders
126 02-01-2019 042900030119P000122 0002239251581 FAUZI L PEKERJA MANDIRI Essential (primary) Rujuk Lanjut
hypertension
127 01-01-2019 042900030119P000030 0000321461897 KARNO L PBI (APBN) Essential (primary) Berobat Jalan
hypertension