REGISTER KUNJUNGAN PENDERITA RAWAT JALAN JAMKESDA

UPT PUSKESMAS SARONGGI TAHUN 2016

BULAN
UNIT LAYANAN

: JANUARI
: PONKESDES KAMBINGAN TIMUR
KODE

NO
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22

TGL
29/12/2015
29/12/2015
30/12/2015
30/12/2015
31/12/2015
02/01/2016
02/01/2016
04/01/2016
04/01/2016
04/01/2016
05/01/2016
05/01/2016
05/01/2016
06/01/2016
06/01/2016
06/01/2016
07/01/2016
07/01/2016
07/01/2016
08/01/2016
08/01/2016
09/01/2016

NO.NIK / SPM
3529065006560001
3529061111740003
3529065509800005
3529066304800002
3529060107300081
3529060805090005
3529065706820003
3529066705960002
3529061605510001
3529060705780001
3509194107920122
3529064908960003
3529064107630243
3529061208400001
3529060402651154
3529065905610001
3529062707890002
3529090404800003
3529064606750007
3529061212920002
3529065606390002
3529065610460001

NAMA PENDERITA
Ummina
Heri
Hozaimah
Zainatul M
Musiya
Fahrur Rosi
Subaida
Jumaena
M Sale
Imam Muhlis
Siti Oktavia
Ira Widyaningrum
Suprihatin
H Zakariya
Masturi
Su'iya
Sundari
Ahmad Yani
Siti Nurhasanah
Arifin
Sanira
Amna

UMUR
(TH)

65
30
31
16
60
7
30
19
63
38
23
21
50
70
51
51
47
36
41
24
60
65

ALAMAT
Kambingan Timur
Kambingan Timur
Kambingan Timur
Kambingan Timur
Juluk
Kambingan Timur
Kambingan Timur
Kambingan Timur
Kambingan Timur
Kambingan Timur
Kambingan Timur
Kambingan Timur
Kambingan Timur
Kambingan Timur
Talang
Kambingan Timur
Kambingan Timur
Kambingan Timur
Kambingan Timur
Kambingan Timur
Kambingan Timur
Kambingan Timur

DIAGNOSA
GEA
Febris
ISPA
ISPA
Alergi
ISPA
ISPA
Febris
Alergi
ISPA
Febris
Febris
ISPA
HT
Febris
DM
DM
ISPA
Gastritis
Gastritis
GEA
HT

ICD X
A09
R50
J06
J06
L23
J06
J06
R50
L23
J06
R50
R50
J06
I10
R50
E11
E11
J06
K29
K29
A09
I10

KARCIS
MASUK
Rp. 7500
Rp7,500
Rp7,500
Rp7,500
Rp7,500
Rp7,500
Rp7,500
Rp7,500
Rp7,500
Rp7,500
Rp7,500
Rp7,500
Rp7,500
Rp7,500
Rp7,500
Rp7,500
Rp7,500
Rp7,500
Rp7,500
Rp7,500
Rp7,500
Rp7,500
Rp7,500

TINDAKAN
INJEKSI

Rp1,000
Rp1,000
Rp1,000
Rp1,000
Rp1,000
Rp1,000
Rp1,000
Rp1,000
Rp1,000
Rp1,000
Rp1,000
Rp1,000
Rp1,000
Rp1,000
Rp1,000
Rp1,000
Rp1,000
Rp1,000
Rp1,000
Rp1,000

KB

23
24
25
26
27
28
29
30
31
32
33
34
35
36
37
38
39
40
41
42
43
44
45
46
47
48
49
50
51
52
53
54
55

09/01/2016
11/01/2016
11/01/2016
11/01/2016
11/01/2016
12/01/2016
12/01/2016
12/01/2016
13/01/2016
13/01/2016
14/01/2016
14/01/2016
14/01/2016
14/01/2016
15/01/2016
15/01/2016
15/01/2016
16/01/2015
16/01/2016
18/01/2016
18/01/2016
18/01/2016
19/01/2016
19/01/2016
19/01/2016
20/01/2016
20/01/2016
21/01/2016
1/21/2016
1/21/2016
22/01/2016
1/22/2016
1/22/2016

3529062309420001
3529061712450001
3529065603380001
3529064710430003
3529064107540084
3529061208400001
3529064406760002
3529066010880002
3529064105950001
3529066007840001
3529064207720000
3529060107460077
3529065002770002
3529064410430001
3529066705960002
3529063012810007
3529065706820003
3529064410690001
3529066005130001
3529065011880002
3529066011130001
3529060111550001
3529065205890003
3529062712720001
3529061802030005
3529060302770003
3529061206940003
3529061211860002
3529062512680001
3529111303690001
3529064107520099
3529065006560000
3529064212600004

Tikno
Sappa
Minanti
Marsuni
Sulami
H Zakariya
Suhartatik
Rifatul
Maesaratul
Subaini
Horriyah
B Asmawi
Yuliatin
Fatima
Jumaena
Masturiyanto
Subaida
Buniya
Hellen
Siti Amsah
Ayu Wulandari
Sudra
Juhainiyati
Supat
M. Arik Fahrudin
Saturi
Firdaus
Juwardi
Buridin
Sudahri
Ruhani
Ummina
Saliha

60
71
70
61
60
65
30
26
20
32
42
66
37
72
19
31
28
55
2
28
2
70
26
65
13
39
22
30
48
47
65
66
56

Kambingan Timur
Kambingan Timur
Kambingan Timur
Kambingan Timur
Kambingan Timur
Kambingan Timur
Kambingan Timur
Kambingan Timur
Kambingan Timur
Kambingan Timur
Kambingan Timur
Kambingan Timur
Kambingan Timur
Kambingan Timur
Kambingan Timur
Talang
Kambingan Timur
Talang
Juluk
Kambingan Timur
Kambingan Timur
Talang
Kambingan Timur
Kambingan Timur
Kambingan Timur
Kambingan Timur
Kambingan Timur
Kambingan Timur
Kambingan Timur
Kambingan Timur
Kambingan Timur
Kambingan Timur
Kambingan Timur

HT
HT
HT
Alergi
GOUT
Febris
Caries Gigi
Alergi
ISPA
Febris
GOUT
Caries Gigi
GEA
HT
Gastritis
Febris
Hamil
Skabies
Faringitis
Hamil
GEA
GEA
Febris
ISPA
Febris
Faringitis
Faringitis
Gastritis
Febris
ISPA
HT
HT
Myalgia

I10
I10
I10
L23
M10
R50
K02
L23
J06
R50
M10
K02
A09
I10
K29
R50
B86
J31
J31
A09
A09
R50
J06
R50
J31
J31
K29
R50
J06
I10
I10
G44

Rp7,500
Rp7,500
Rp7,500
Rp7,500
Rp7,500
Rp7,500
Rp7,500
Rp7,500
Rp7,500
Rp7,500
Rp7,500
Rp7,500
Rp7,500
Rp7,500
Rp7,500
Rp7,500
Rp7,500
Rp7,500
Rp7,500
Rp7,500
Rp7,500
Rp7,500
Rp7,500
Rp7,500
Rp7,500
Rp7,500
Rp7,500
Rp7,500
Rp7,500
Rp7,500
Rp7,500
Rp7,500
Rp7,500

Rp1,000
Rp1,000
Rp1,000
Rp1,000
Rp1,000
Rp1,000
Rp1,000
Rp1,000
Rp1,000
Rp1,000
Rp1,000
Rp1,000
Rp1,000
Rp1,000
Rp1,000
Rp1,000
Rp1,000
Rp1,000
Rp1,000
Rp1,000
Rp1,000
Rp1,000
Rp1,000
Rp1,000

Rp1,000

56
57
58
59
60
61
62
63
64

23/01/2016
1/23/2016
1/23/2016
1/23/2016
1/23/2016
1/23/2016
25/01/2016
1/25/2016
1/25/2016

3529065707450001
3529065211600003
3529065509800005
3529065210810000
3529116707790001
3529062506830003
3529061701830002
3529066007840001
3529062705940002

Santami
Rukiye
Hozaimah
Rohani
Hamni
Salhaniyah
Malika
Aulia wildiana
Desi ana lutfianti

JUMLAH

71
47
37
35
39
22
4
15bln
3

Kambingan
Kambingan
Kambingan
Kambingan
Kambingan
Kambingan
Kambingan
Kambingan
Kambingan

Timur
Timur
Timur
Timur
Timur
Timur
Timur
Timur
Timur

Myalgia
Myalgia
ISPA
ISPA
Myalgia
Hamil
Febris
Skabies
Febris

G44
G44
J06
J06
G44
R50
B86
R50

Rp7,500 Rp1,000
Rp7,500 Rp1,000
Rp7,500 Rp1,000
Rp7,500 Rp1,000
Rp7,500 Rp1,000
Rp7,500 Rp1,000
Rp7,500
Rp7,500
Rp7,500
Rp480,000 Rp50,000

TINDAKAN
Rawat Luka

total

lain2

Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp

8,500.00
8,500.00
8,500.00
8,500.00
8,500.00
7,500.00
8,500.00
8,500.00
8,500.00
8,500.00
8,500.00
8,500.00
8,500.00
7,500.00
8,500.00
8,500.00
8,500.00
8,500.00
8,500.00
8,500.00
8,500.00
7,500.00

KET

Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp

7,500.00
7,500.00
7,500.00
8,500.00
8,500.00
8,500.00
8,500.00
8,500.00
8,500.00
8,500.00
8,500.00
8,500.00
8,500.00
7,500.00
8,500.00
8,500.00
8,500.00
8,500.00
7,500.00
8,500.00
7,500.00
8,500.00
8,500.00
8,500.00
8,500.00
8,500.00
8,500.00
8,500.00
8,500.00
8,500.00
7,500.00
7,500.00
8,500.00

Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp

8,500.00
8,500.00
8,500.00
8,500.00
8,500.00
8,500.00
7,500.00
7,500.00
7,500.00
530,000.00

REGISTER KUNJUNGAN PEND

UPT PUSKESMAS SA
BULAN
UNIT LAYANAN

: FEBRUARI
: PONKESDES KAMBINGAN TIMUR

UMUR
(TH)

3529065004040001 Aulia

10

28/01/2016

3529060308080001 Maulidiya

29/01/2016

3529065607940003 Laelatul Badriyah

29/01/2016

3529066011130001 Ayu Wulandari

30/01/2016

3529066310070001 Nelly

01/02/2016

3529064106780001 Sahweni

32

01/02/2016

3529066606130001 Nurul Uyuni

02/02/2016

03/02/2016

3529066908660001 Asnati

10

05/02/2016

3529062511110002 Ilham Maulana

11

05/02/2016

3529064411050004 Nurul Fadilah

12

06/02/2016

3529065807070002 Erlita Asafa

13

06/02/2016

3529066007790001 Rico

14
15

08/02/2016

3529066410120002 Nuril Arofah

09/02/2016

3529062607140003 Asmil

16

09/02/2016

3529063012130001 Ach Bahtiar

17

10/02/2016

3529066405880002 Ach Fahrillah

18

10/02/2016

3529066512700003 Putri Masya

19

11/02/2016

3529066910880001 Afif Alafgan

20

11/02/2016

3529066007840001 Aulia Wildiyana

21

12/02/2016

3529063012130001 Ifan

22

13/02/2016

3529066405880002 Moh Zatran

23

13/02/2016

3529060612700001 Ayu Citra Almania

24

15/02/2016

3529062101830001 Ach Jibran

5bln

25

15/02/2016

3529065508750006 Salmankan

26

16/02/2016

3529111007120003 Malika

27

16/02/2016

3529066904910004 Aidil Kurtubi

NO

TGL

27/01/2016

NO.NIK / SPM

NAMA PENDERITA

35290604303040001 Syaeful Rahman

14

2
2

1
1

60

7bln

4
3bln

28

17/02/2026

3529064505600006 Maryama

29

17/02/2026

3529066603030002 Nova Binti S

11

30

18/02/2016

3529062011090001 M Syarifuddin

31

18/02/2016

3529060911740002 Farah Ramadhani

32
33

19/02/2016

3529061812070001 Ananta Reza

19/02/2016

3529064107470087 Siti Fatimah

34

20/02/2016

3529061704110003 Panji Kusuma

35

22/02/2016

36

23/02/2016

3529066010320001 Binek

37

24/02/2016

3529061208610003 Abd Hadi

13

38

24/02/2016

3529061812090002 Ahmad Roni

39

25/02/2016

3529064903390001 Milasi

352901803100003

Ribut Hariyanto

56

5
9

66

49

71

70

REGISTER KUNJUNGAN PENDERITA RAWAT JALAN JAMKESDA

UPT PUSKESMAS SARONGGI TAHUN 2016

KODE
ALAMAT

DIAGNOSA

ICD X

KARCIS
MASUK
Rp. 7500

TINDAKAN
INJEKSI

Rp1,000

Kambingan Timur

Febris

R50

Rp7,500

Kambingan Timur

Febris

R50

Rp7,500

Kambingan Timur

Febris

R50

Rp7,500

Kambingan Timur

Febris

R50

Rp7,500

Kambingan Timur

ISPA

J06

Rp7,500

Kambingan Timur

Gastritis

K29

Rp7,500

Kambingan Timur

Febris

R50

Rp7,500

Talang

Febris

R50

Rp7,500

Rp1,000

Talang

G3 Sendi

M10

Rp7,500

Rp1,000

Talang

Febris

R50

Rp7,500

Kambingan Timur

ISPA

J06

Rp7,500

Kambingan Timur

Alergi

L23

Rp7,500

Kambingan Timur

ISPA

J06

Rp7,500

Kambingan Timur

ISPA

J06

Rp7,500

Kambingan Timur

ISPA

J06

Rp7,500

Kambingan Timur

ISPA

J06

Rp7,500

Kambingan Timur

GEA

A09

Rp7,500

Kambingan Timur

Alergi

L23

Rp7,500

Kambingan Timur

Febris

R50

Rp7,500

Kambingan Timur

Skabies

B86

Rp7,500

Kambingan Timur

ISPA

J06

Rp7,500

Kambingan Timur

Febris

R50

Rp7,500

Kambingan Timur

ISPA

J06

Rp7,500

Kambingan Timur

ISPA

J06

Rp7,500

Kambingan Timur

ISPA

J06

Rp7,500

Kambingan Timur

Febris

R50

Rp7,500

Kambingan Timur

ISPA

J06

Rp7,500

Rp1,000

KB

Rawat Luka

Kambingan Timur

HT

I10

Rp7,500

Kambingan Timur

Febris

R50

Rp7,500

Kambingan Timur

GEA

A09

Rp7,500

Kambingan Timur

Alergi

L23

Rp7,500

Kambingan Timur

Alergi

L23

Rp7,500

Kambingan Timur

G3 Sendi

M10

Rp7,500

Kambingan Timur

ISPA

J06

Rp7,500

Kambingan Timur

DM

E11

Rp7,500

Rp1,000

Kambingan Timur

G3 Sendi

M10

Rp7,500

Rp1,000

Kambingan Timur

Febris

R50

Rp7,500

Rp1,000

Kambingan Timur

Skabies

B86

Rp7,500

Kambingan Timur

HT

I10

Rp7,500
Rp292,500

Rp1,000

Rp7,000

AKAN
total

lain2

Rp

7,500.00

Rp

7,500.00

Rp

7,500.00

Rp

7,500.00

Rp

7,500.00

Rp

8,500.00

Rp

7,500.00

Rp

8,500.00

Rp

8,500.00

Rp

7,500.00

Rp

7,500.00

Rp

7,500.00

Rp

7,500.00

Rp

7,500.00

Rp

7,500.00

Rp

7,500.00

Rp

7,500.00

Rp

7,500.00

Rp

7,500.00

Rp

7,500.00

Rp

7,500.00

Rp

7,500.00

Rp

7,500.00

Rp

7,500.00

Rp

7,500.00

Rp

7,500.00

Rp

7,500.00

KET

Rp

7,500.00

Rp

7,500.00

Rp

7,500.00

Rp

7,500.00

Rp

7,500.00

Rp

8,500.00

Rp

7,500.00

Rp

8,500.00

Rp

8,500.00

Rp

8,500.00

Rp

7,500.00

Rp

7,500.00

Rp

299,500.00

REGISTER KUNJUNGAN PENDERITA RAWAT JALAN JAMKESDA

UPT PUSKESMAS SARONGGI TAHUN 2016
BULAN
UNIT LAYANAN

: MARET
: PONKESDES KAMBINGAN TIMUR
KODE

NO

TGL

NO.NIK / SPM

NAMA PENDERITA

UMUR
(TH)

ALAMAT

DIAGNOSA

ICD X

KARCIS
MASUK
Rp. 7500

26/02/2016

3529090404800003 Moh Zafran

27/02/2016

3529064105950001 Maesatul

27/02/2016

3529062901010002 Andre

29/02/2016

3529065801130001 Ratnawita

01/03/2016

3529060705640004 Rabe'i

01/03/2016

02/03/2016

02/03/2016

3529062910880003

03/03/2016

10

21Bln

Kambingan Timur

Febris

R50

Rp7,500

19

Kambingan Timur

ISPA

J06

Rp7,500

24Bln

Kambingan Timur

Febris

R50

Rp7,500

Kambingan Timur

Febris

R50

Rp7,500

46

Kambingan Timur

Febris

R50

Rp7,500

3529061502090002 Wildan

10

Kambingan Timur

Febris

R50

Rp7,500

3529111007120003 Zainal

Kambingan Timur

ISPA

J06

Rp7,500

Ahmad Walid

28

Kambingan Timur

Gastritis

K29

Rp7,500

3529066107900002

Ach Gibran

Kambingan Timur

ISPA

J06

Rp7,500

03/03/2016

3529060404840003

Ach Bahtiar M

18Bln

Kambingan Timur

Febris

R50

Rp7,500

11

04/03/2016

3529051006870002

Tasa Kamila

4Bln

Kambingan Timur

ISPA

J06

Rp7,500

12

04/03/2016

3529062906840003

Afif Al Afgan

13Bln

Kambingan Timur

ISPA

J06

Rp7,500

13

05/03/2016

3529061805810001

Aulia Wildiana

17Bln

Kambingan Timur

Febris

R50

Rp7,500

14
15

05/03/2016

3529066208920002

Ach Ifan Bahtiar

25Bln

Kambingan Timur

Dermatitis

L23

Rp7,500

07/03/2016

3529060908680004

Moh Zafran

26Bln

Kambingan Timur

Dermatitis

L23

Rp7,500

16

07/03/2016

3529062512680001

Putri Masa

14Bln

Kambingan Timur

ISPA

J06

Rp7,500

17

08/03/2016

3529060612700001

Ayu Citra

9Bln

Kambingan Timur

ISPA

J06

Rp7,500

18

08/03/2016

3529066405880002

Ach Fahrillah

17Bln

Kambingan Timur

Febris

R50

Rp7,500

19

10/03/2016

Kambingan Timur

Febris

R50

Rp7,500

3529062910850003 Moh Fadil Alih

TINDAKAN
INJEKSI

Rp1,000
Rp1,000

Rp1,000

Rp1,000

KB

20

10/03/2016

3529061701830002

Malika Arifatul

21

11/03/2016

3529066904910004

Moh Adil

22

11/03/2016

3529065205890003

Naila

23

12/03/2016

3529064505600006

24

12/03/2016

25

6Bln

Kambingan Timur

Febris

R50

Rp7,500

4Bln

Kambingan Timur

ISPA

J06

Rp7,500

4Bln

Kambingan Timur

Dermatitis

L23

Rp7,500

Maryama

Kambingan Timur

Karies Gigi

K02

Rp7,500

3529065702770001

Nur Indah

39

Kambingan Timur

GEA

A09

Rp7,500

14/03/2016

3529061507580002

Adi Subirto

58

Kambingan Timur

HT

I10

Rp7,500

26

14/03/2016

35290911740002

Matrawi

40

Kambingan Timur

GOUT

M10

Rp7,500

Rp1,000

27

15/03/2016

3529062106980001

Agus Salim

18

Kambingan Timur

GEA

I10

Rp7,500

Rp1,000

28

15/03/2016

3529031201610001

Sirojul Munir

60

Kambingan Timur

HT

I10

Rp7,500

29

16/03/2016

3529065208930002

Jamilatul H

25

Kambingan Timur

Dermatitis

L23

Rp7,500

Rp1,000

30

16/03/2016

3529063112300012

Abd Kawir

60

Kambingan Timur

GOUT

M10

Rp7,500

Rp1,000

31

17/03/2016

3529064912550004

HJ. Siti Nur Asiseh

61

Kambingan Timur

GOUT

M10

Rp7,500

Rp1,000

32
33

17/03/2016

3529061001920003

Jamaluddin

24

Kambingan Timur

Gastritis

K29

Rp7,500

Rp1,000

18/03/2016

3529064207720003

Horriyah

44

Kambingan Timur

Gastritis

K29

Rp7,500

Rp1,000

34

19/03/2016

3529066809060003

Farah Rahma

10

Kambingan Timur

Karies Gigi

K02

Rp7,500

Rp1,000

35

21/03/2016

3529064107400191

Suwam

70

Kambingan Timur

HT

I10

Rp7,500

36

3/21/2016

3529062503640002

Bahrawi

52

Kambingan Timur

GOUT

M10

Rp7,500

37

22/03/2016

3529066010350002

Fatimah

81

Kambingan Timur

HT

I10

Rp7,500

38

22/03/2016

3529067006580014

Juma'i

58

Kambingan Timur

GOUT

M10

Rp7,500

Rp1,000

39

23/03/2016

3529060905520002

Mathuri

64

Kambingan Timur

GOUT

M10

Rp7,500

Rp1,000

40

23/03/2016

3529065510100001

Nahdatul U

Kambingan Timur

Dermatitis

L23

Rp7,500

41

24/03/2016

3529064107530159

Siti Zaitunah

65

Kambingan Timur

GOUT

M10

Rp7,500

Rp1,000

42

24/03/2016

3529064907940005

Siti Asofah

46

Kambingan Timur

GOUT

M10

Rp7,500
Rp315,000

Rp1,000

J U M LAH

Rp1,000

Rp1,000

Rp17,000

TINDAKAN
Rawat Luka

TOTAL

lain2

Rp

7,500.00

Rp

8,500.00

Rp

7,500.00

Rp

7,500.00

Rp

8,500.00

Rp

7,500.00

Rp

7,500.00

Rp

8,500.00

Rp

7,500.00

Rp

7,500.00

Rp

7,500.00

Rp

7,500.00

Rp

7,500.00

Rp

7,500.00

Rp

7,500.00

Rp

7,500.00

Rp

7,500.00

Rp

7,500.00

Rp

7,500.00

KET

Rp

7,500.00

Rp

7,500.00

Rp

7,500.00

Rp

7,500.00

Rp

8,500.00

Rp

7,500.00

Rp

8,500.00

Rp

8,500.00

Rp

7,500.00

Rp

8,500.00

Rp

8,500.00

Rp

8,500.00

Rp

8,500.00

Rp

8,500.00

Rp

8,500.00

Rp

7,500.00

Rp

8,500.00

Rp

7,500.00

Rp

8,500.00

Rp

8,500.00

Rp

7,500.00

Rp

8,500.00

Rp

8,500.00

Rp

332,000.00

REGISTER KUNJUNGAN PENDERITA RAWAT JALAN JAMKESDA

UPT PUSKESMAS SARONGGI TAHUN 2016
BULAN
UNIT LAYANAN
NO
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24

TGL
26/03/2016
26/03/2016
28/03/2016
28/03/2016
29/03/2016
01/04/2016
04/04/2016
05/04/2016
06/04/2016
07/04/2016
08/04/2016
08/04/2016
09/04/2016
11/04/2016
12/04/2016
13/04/2016
15/04/2016
15/04/2016
16/04/2016
16/04/2016
18/04/2016
18/04/2016
19/04/2016
19/04/2016

: APRIL
: PONKESDES KAMBINGAN TIMUR
NO.NIK / SPM
3529066011130001
3529114305940001
3529052510630001
3529056003830002
3529065605460001
3529066107810002
3529061206680005
3529066208920002
3529065110120001
3529060908680004
3529062906840003
3529066911100001
3529066904910004
3529060612700001
3529066405880002
3529062010600003
3529062512680001
3529064102030003
3529065205890003
3529061701830002
3529061805810001
3529064806810008
3529061507580002
3529064410430001

NAMA PENDERITA
Ayu Wulandari
Salhaniyah
Sardeno
Suniati
Rupami
Suhatimah
Sucipno
Ach. Ifan Bahtiar
Nandia Asahro
Moh. Zafran F.A
Afif Alafgan
Adila Nisa Ardani
Ach. Askal Akil
Ayu Citra
Ach Fachrilah
Fasa Kamila
Masya Adifa
Moh. Fadil Alhikam
Kaila
Malika. A
Aulia Wildiayana
Alifiandra
Adi Subirto
Hj. Fatimah

KODE

UMUR
(TH)

ALAMAT

26 bl
22 th
46 th
43 th
55 th
65 th
50 th
26 th
29 bl
26 th
4 bln
2 bln
5 bln
10 bln
18 bln
5 bln
15 bln
40 bln
5 bln
7 bln
18 bln
18 bln
58 th
65 th

Kambingan Timur
Kambingan Timur
Kambingan Timur
Kambingan Timur
Kambingan Timur
Kambingan Timur
Kambingan Timur
Kambingan Timur
Kambingan Timur
Kambingan Timur
Kambingan Timur
Kambingan Timur
Kambingan Timur
Kambingan Timur
Kambingan Timur
Kambingan Timur
Kambingan Timur
Kambingan Timur
Kambingan Timur
Kambingan Timur
Kambingan Timur
Kambingan Timur
Kambingan Timur
Kambingan Timur

DIAGNOSA
ISPA
HAMIL
ISPA
ISPA
Gastritis
gg otot
HT
ISPA
ISPA
ISPA
ISPA
gatal-gatal
panas
ISPA
ISPA
diare
dermatitis
ISPA
panas
sakit mata
gatal-gatal
ISPA
HT
HT

ICD X
J06
J06
J06
K29
M10
I10
J06
J06
J06
J06
L23
R50
J06
J06
A09
L23
J06
R50
L23
J06
I10
I10

KARCIS
MASUK
Rp. 7500
Rp7,500
Rp7,500
Rp7,500
Rp7,500
Rp7,500
Rp7,500
Rp7,500
Rp7,500
Rp7,500
Rp7,500
Rp7,500
Rp7,500
Rp7,500
Rp7,500
Rp7,500
Rp7,500
Rp7,500
Rp7,500
Rp7,500
Rp7,500
Rp7,500
Rp7,500
Rp7,500
Rp7,500

TINDAKAN
INJEKSI

Rp1,000
Rp1,000
Rp1,000
Rp1,000
Rp1,000
Rp1,000
Rp1,000
Rp1,000

KB

Rawat Luka

25
26
27
28
29
30
31
32
33

20/04/2016
20/04/2016
21/04/2016
21/04/2016
21/04/2016
22/04/2016
23/04/2016
25/04/2016
25/04/2016

3529061506630001
3529065107670003
3529066005360001
3529065006560001
3529061712450001
3529064510690004
3529064912550002
3529064107400091
3529062503640002

Bustami
supiyati
bini'
Ummira
M. Saleh
Suhaini
Arwa'ie
Suwam
Bahrawi

J U M LAH

50 th
50 th
71 th
65 th
66 th
61 th
61 th
70 th
52 th

Kambingan Timur
Kambingan Timur
Kambingan Timur
Kambingan Timur
Kambingan Timur
Kambingan Timur
Kambingan Timur
Kambingan Timur
Kambingan Timur

GOUT
ISPA
HT
GOUT
GOUT
Gastritis
Gastritis
ISPA
GOUT

M10
J06
I10
M10
M10
L23
L23
J06
M10

Rp7,500
Rp7,500
Rp7,500
Rp7,500
Rp7,500
Rp7,500
Rp7,500
Rp7,500
Rp7,500
Rp247,500

Rp1,000
Rp1,000
Rp1,000
Rp1,000
Rp1,000
Rp1,000
Rp1,000
Rp1,000
Rp15,000

KAN
TOTAL

lain2

Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp

7,500.00
8,500.00
8,500.00
8,500.00
8,500.00
8,500.00
7,500.00
8,500.00
7,500.00
8,500.00
7,500.00
7,500.00
7,500.00
7,500.00
7,500.00
7,500.00
7,500.00
7,500.00
7,500.00
7,500.00
7,500.00
7,500.00
7,500.00
7,500.00

KET

Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp

8,500.00
8,500.00
7,500.00
8,500.00
8,500.00
8,500.00
8,500.00
8,500.00
8,500.00
262,500.00

REGISTER KUNJUNGAN PENDERITA RAWAT JALAN JAMKESDA

UPT PUSKESMAS SARONGGI TAHUN 2016
BULAN
UNIT LAYANAN
NO
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24

TGL
27/04/2016
28/04/2016
29/04/2016
29/04/2016
30/04/2016
30/04/2016
02/05/2016
02/05/2016
02/05/2016
03/05/2016
03/05/2016
03/05/2016
04/05/2016
04/05/2016
04/05/2016
05/05/2016
06/05/2016
06/05/2016
07/05/2016
07/05/2016
09/05/2016
09/05/2016
10/05/2016
11/05/2016

: MEI
: PONKESDES KAMBINGAN TIMUR
NO.NIK / SPM
3529066606130001
3529060406120001
3529065801130001
3529060503060002
3529060503060002
3529062507920001
3529064603010004
3529066007840001
3529064207720003
3529064505600006
3529064311030001
3529060503060002
3529065002770002
3529061512640002
3529061004680002
3529064306960002
3529061205620001
3529061111740003
3529064207720003
3529062711760002
3529064403390001
3529064806810008
3529061910750002
3529061510680006

NAMA PENDERITA
Nurul Wahyuni
Kosiful Anwar
Ratnawita
Riko
Salhaniyah
RukaryaNingsih
Rosidatul Hasanah
Subirto
Horiyah
Maryama
Nurdiana Putri
Riko
Yuliantin
Alifiandra
Nurul Wahyuni
Hafiyatus Sholihah
Sadi
Heri
Horiyah
Kusnaini
Milasi
Alifiandra
Sudarsono
Mat Sahit

KODE

UMUR
(TH)

ALAMAT

2
4
3.5
2
21
20
15
55
43
50
8
2
32
1.5
2
1.5
45
23
43
60
66
2
46
48

Kambingan Timur
Kambingan Timur
Kambingan Timur
Kambingan Timur
Kambingan Timur
Kambingan Timur
Kambingan Timur
Kambingan Timur
Kambingan Timur
Kambingan Timur
Kambingan Timur
Kambingan Timur
Kambingan Timur
Kambingan Timur
Kambingan Timur
Kambingan Timur
Kambingan Timur
Kambingan Timur
Kambingan Timur
Kambingan Timur
Kambingan Timur
Kambingan Timur
Kambingan Timur
Kambingan Timur

DIAGNOSA
ISPA
Febris
Febris
ISPA
Febris
Hamil
Febris
Febris
Febris
Karies Gigi
Alergi
Febris
Karies Gigi
ISPA
Febris
Skabies
Skabies
Febris
Febris
Febris
HT
ISPA
G3 Otot
G3 Otot

ICD X
J06
R50
R50
J06
R50
R50
R50
R50
K02
L23
R50
K02
J06
R50
B86
B86
R50
R50
R50
I10
J06
M10
M10

KARCIS
MASUK
Rp. 7500
Rp7,500
Rp7,500
Rp7,500
Rp7,500
Rp7,500
Rp7,500
Rp7,500
Rp7,500
Rp7,500
Rp7,500
Rp7,500
Rp7,500
Rp7,500
Rp7,500
Rp7,500
Rp7,500
Rp7,500
Rp7,500
Rp7,500
Rp7,500
Rp7,500
Rp7,500
Rp7,500
Rp7,500

TINDAKAN
INJEKSI

Rp1,000

Rp1,000
Rp1,000
Rp1,000
Rp1,000
Rp1,000

Rp1,000

Rp1,000
Rp1,000
Rp1,000
Rp1,000
Rp1,000
Rp1,000
Rp1,000

KB

25
26
27
28
29
30
31
32

12/05/2016
13/05/2016
14/05/2016
16/05/2016
17/05/2016
18/05/2016
19/05/2016
21/05/2016

3529060709540003
3529061307660001
3529065706620002
3529062503640002
3529066206720001
3529064511650007
3529063012560006
3529064107450172

Moh. Tahir
Almuni
Rukiyah
Bahrawi
Sumina
Salama
Matrasid
Astina
J U M LAH

62
50
54
52
48
51
61
71

Kambingan Timur
Kambingan Timur
Kambingan Timur
Kambingan Timur
Kambingan Timur
Kambingan Timur
Kambingan Timur
Kambingan Timur

G3 Otot
G3 Otot
HT
Gastritis
GEA
G3 Otot
G3 Otot
HT

M10
M10
I10
K29
A09
M10
M10
I10

Rp7,500
Rp7,500
Rp7,500
Rp7,500
Rp7,500
Rp7,500
Rp7,500
Rp7,500
Rp240,000

Rp1,000
Rp1,000
Rp1,000
Rp1,000
Rp1,000
Rp1,000
Rp19,000

TINDAKAN
Rawat Luka

TOTAL

lain2

Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp

7,500.00
7,500.00
7,500.00
7,500.00
8,500.00
8,500.00
7,500.00
8,500.00
8,500.00
8,500.00
7,500.00
7,500.00
8,500.00
7,500.00
7,500.00
7,500.00
8,500.00
8,500.00
8,500.00
8,500.00
7,500.00
8,500.00
8,500.00
8,500.00

KET

Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp

8,500.00
8,500.00
7,500.00
8,500.00
8,500.00
8,500.00
8,500.00
7,500.00
259,000.00

REGISTER KUNJUNGAN PENDERITA RAWAT JALAN JAMKESDA

UPT PUSKESMAS SARONGGI TAHUN 2016
BULAN
UNIT LAYANAN
NO
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24

TGL
5/25/2016
5/25/2016
26-05-2016
26-05-2016
27-05-2016
27-05-2016
28-05-2016
28-05-2016
30-05-2016
30-05-2016
31-05-2016
31-05-2016
02-06-2016
02-06-2016
04-06-2016
04-06-2016
06-06-2016
06-06-2016
07-06-2016
07-06-2016
08-06-2016
09-06-2016
13-06-2016
13-06-2016

: JUNI
: PONKESDES KAMBINGAN TIMUR
NO.NIK / SPM
3529111007120003
3529065801130001
3529066111100001
3529066410120002
3529060406120001
3529064207720003
3529066010880002
3529061505810002
3529062906840003
3529061512700003
3529064411050004
3529062512680001
3529066310070001
3529066905100002
3529061701830002
3529063012130001
3529060811130002
3529062101830001
3529066410130002
3529066911100001
3529066107900002
3529066010880002
3529067011120001
3529066011130001

NAMA PENDERITA
Zainal Arifin
Ratnawita
Nuri
Nuril Arofah
Moh Kasiful A.
Horriyah
Rifatul Hasanah
Erlita Asafa
Siti Hoirotun
Salman
Adila Nisa Ardoni
Putri Masya Adifa
Afif Al Argan
Devita Anisa
Malika
ACH Ifan Bahtiar
M Zafran
Ach Gibran
Nadia Azzahrah
Maghfiroh
Ike Putri Wulandari
Nizatul
Warda
Ayu Wulandari

KODE

UMUR
(TH)

ALAMAT

4
4
6
3
3
42
28
20Bln
4Bln
3
4
2
2
6
9Bln
3
3
10Bln
3
23
26
6
4
3

Kambingan Timur
Kambingan Timur
Kambingan Timur
Kambingan Timur
Kambingan Timur
Kambingan Timur
Kambingan Timur
Kambingan Timur
Kambingan Timur
Kambingan Timur
Kambingan Timur
Kambingan Timur
Kambingan Timur
Kambingan Timur
Kambingan Timur
Kambingan Timur
Kambingan Timur
Kambingan Timur
Kambingan Timur
Kambingan Timur
Kambingan Timur
Kambingan Timur
Kambingan Timur
Kambingan Timur

DIAGNOSA
ISPA
ISPA
Febris
ISPA
Febris
GEA
Gastritis
Dermatitis
Dermatitis
Febris
Febris
ISPA
ISPA
Dermatitis
ISPA
GEA
ISPA
ISPA
GEA
Gastritis
ISPA
Dermatitis
GEA
ISPA

ICD X
J06
J06
R50
J06
R50
A09
K29
L23
L23
R50
R50
J06
J06
L23
J06
A09
J06
J06
A09
K29
J06
L23
A09
J06

KARCIS
MASUK
Rp. 7500
Rp7,500
Rp7,500
Rp7,500
Rp7,500
Rp7,500
Rp7,500
Rp7,500
Rp7,500
Rp7,500
Rp7,500
Rp7,500
Rp7,500
Rp7,500
Rp7,500
Rp7,500
Rp7,500
Rp7,500
Rp7,500
Rp7,500
Rp7,500
Rp7,500
Rp7,500
Rp7,500
Rp7,500

TINDAKAN
INJEKSI

Rp1,000

Rp1,000
Rp1,000

Rp1,000
Rp1,000

KB

25
26
27
28
29
30
31

14-06-2016
14-06-2016
15-06-2016
18-06-2016
18-06-2016
21-06-2016
22-06-2016

3529060612630001
3529060702090001
3529111007120003
3529062607140003
3529060503060002
3529066410120002
3529064505600006

Mulyono
Andri
Zainal Arifin
Asmil
Riko
Nuril Arofah
Maryama
J U M LAH

65
3
4
2
2
3
56

Kambingan Timur
Kambingan Timur
Kambingan Timur
Kambingan Timur
Kambingan Timur
Kambingan Timur
Kambingan Timur

Dermatitis
Febris
Dermatitis
Febris
Febris
ISPA
Caries Gigi

L23
R50
L23
R50
R50
J06
K02

Rp7,500
Rp7,500
Rp7,500
Rp7,500
Rp7,500
Rp7,500
Rp7,500
Rp232,500

Rp1,000

Rp1,000
Rp6,000

TINDAKAN
Rawat Luka

TOTAL

lain2

Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp

7,500.00
7,500.00
7,500.00
7,500.00
7,500.00
8,500.00
8,500.00
7,500.00
7,500.00
7,500.00
7,500.00
7,500.00
7,500.00
7,500.00
7,500.00
7,500.00
7,500.00
7,500.00
7,500.00
8,500.00
8,500.00
7,500.00
7,500.00
7,500.00

KET

Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp

8,500.00
7,500.00
7,500.00
7,500.00
7,500.00
7,500.00
8,500.00
238,500.00

REGISTER KUNJUNGAN P
UPT PUSKESM
BULAN
UNIT LAYANAN

: JULI
: PONKESDES KAMBINGAN TIMUR

NO

TGL

NO.NIK / SPM

NAMA PENDERITA

1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30

24-06-16
24-6-16
25-06-16
25-06-16
27-06-16
27-06-16
28-06-16
29-06-16
30-06-16
30-06-16
02-07-16
02-07-16
12-07-16
12-07-16
14-07-16
14-07-16
16-07-16
16-07-16
19-07-16
19-07-16
19-07-16
20-07-16
20-07-16
20-07-16
21-07-16
21-07-16
22-07-16
22-07-16
24-07-16
24-07-16

3529062603100001
3529062010600003
3529062211880001
3529061701830002
3529065603810002
3529062512680001
3529060908680004
3529066512700003
3529061704830004
3529060612700001
3529061507580002
3529061805810001
3529066410130002
3529061012880001
3529066405880002
3529066904910004
3529062906840003
3529066107900002
3529064102030003
3529060404840003
3509194107920122
3529066104700002
3529061011450001
3529065205890003
3529064806810008
3529061507580002
3529064603010004
3529061803100003
3529052510630001
3529061505810002

Ach. Ardana Riski

Tasa Kamila
Dzul Hilmi Gozali
Malika Arifatul
Aprilia Cantika P
Putri Masa A
Moh. Fatian A
Naura Z.A
Moh. Abdillah
Ayu Citra
Maryama
Aulia Wildiana
Nadia Assahmah
Adila Nisa A
A. Fahrillah
Ach. Askal
Afif Alafgan
Ach. Gibran
Moh. Fadit A
A. Bahtiar M
Desiana L
Siti Asofa
Salhadiah
Kaila
Alfiandra
Adi Subirto
Rosidah
Ribut Harianto
Sardeno
Erlita Azafa
J U M LAH

UMUR
(TH)

8 Bl
7 Bl
3 Bl
10 Bl
2 Bl
2 Bl
30 Bl
2 Bl
3 Bl
13 Bl
52 Th
21 Bl
32 Bl
7 Bl
21 Bl
8 Bl
17 Bl
10 Bl
44 Bl
22 Bl
35 Bl
48 Th
22 Th
8 Bl
21 Bl
60 Th
41 Th
53 Th
47 Th
22 Bl

GISTER KUNJUNGAN PENDERITA RAWAT JALAN JAMKESDA

UPT PUSKESMAS SARONGGI TAHUN 2016

KODE
ALAMAT
KAMBINGAN TIMUR
KAMBINGAN TIMUR
KAMBINGAN TIMUR
KAMBINGAN TIMUR
KAMBINGAN TIMUR
KAMBINGAN TIMUR
KAMBINGAN TIMUR
KAMBINGAN TIMUR
KAMBINGAN TIMUR
KAMBINGAN TIMUR
KAMBINGAN TIMUR
KAMBINGAN TIMUR
KAMBINGAN TIMUR
KAMBINGAN TIMUR
KAMBINGAN TIMUR
KAMBINGAN TIMUR
KAMBINGAN TIMUR
KAMBINGAN TIMUR
KAMBINGAN TIMUR
KAMBINGAN TIMUR
KAMBINGAN TIMUR
KAMBINGAN TIMUR
KAMBINGAN TIMUR
KAMBINGAN TIMUR
KAMBINGAN TIMUR
KAMBINGAN TIMUR
KAMBINGAN TIMUR
KAMBINGAN TIMUR
KAMBINGAN TIMUR
KAMBINGAN TIMUR

DIAGNOSA
ISPA
ISPA
ISPA
ISPA
ISPA
GEA
ALERGI
ALERGI
ISPA
GEA
GOUT
ALERGI
ISPA
FEBRIS
GEA
ISPA
FEBRIS
FEBRIS
FEBRIS
ALERGI
ISPA
Sakit Telinga
FEBRIS
ALERGI
ISPA
ISPA
GOUT
GOUT
ASMA
ISPA

ICD X
J06
J06
J06
J06
J06
A09
L23
L23
J06
A09
M10
A09
J06
R50
A09
J06
R50
R50
R50
L23
J06
R50
L23
J06
J06
M10
M10
J45
J06

KARCIS
MASUK
Rp. 7500
Rp7,500
Rp7,500
Rp7,500
Rp7,500
Rp7,500
Rp7,500
Rp7,500
Rp7,500
Rp7,500
Rp7,500
Rp7,500
Rp7,500
Rp7,500
Rp7,500
Rp7,500
Rp7,500
Rp7,500
Rp7,500
Rp7,500
Rp7,500
Rp7,500
Rp7,500
Rp7,500
Rp7,500
Rp7,500
Rp7,500
Rp7,500
Rp7,500
Rp7,500
Rp7,500
Rp225,000

TINDAKAN
INJEKSI

Rp1,000

Rp1,000

Rp1,000
Rp1,000

Rp1,000
Rp1,000
Rp1,000
Rp1,000
Rp7,000

KB

Rawat
Luka

lain2

TOTAL
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp

7,500.00
7,500.00
7,500.00
7,500.00
7,500.00
7,500.00
7,500.00
7,500.00
7,500.00
7,500.00
8,500.00
7,500.00
7,500.00
7,500.00
7,500.00
7,500.00
7,500.00
7,500.00
7,500.00
7,500.00
7,500.00
8,500.00
8,500.00
7,500.00
7,500.00
8,500.00
8,500.00
8,500.00
8,500.00
7,500.00
232,000.00

KET

REGISTER KUNJUNGAN PENDERITA RAWAT JALAN JAMKESDA

UPT PUSKESMAS SARONGGI TAHUN 2016
BULAN
UNIT LAYANAN

NO
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23

TGL
27/07/'16
28/07/'16
29/07/'16
30/07/'16
30/07/'16
02/08/'16
02/08/'16
03/08/'16
04/08/'16
05/08/'16
05/08/'16
06/08/'16
08/08/'16
09/08/'16
09/08/'16
11/08/'16
11/08/'16
13/08/'16
15/08/'16
15/08/'16
16/08/'16
18/08/'16
19/08/'16

: AGUSTUS
: PONKESDES KAMBINGAN TIMUR

NO.NIK / SPM
3529065011840003
3529061704830004
3529065801130001
3529064906770002
3529064811630004
3529061507580002
3529061908090001
3529060705780001
3529060910720003
3529066405880002
3529066512700003
3529064606750007
3529066406880001
3529066103780004
3529066104700002
3529061206940003
3529060503060002
3529066010880002
3529060711810004
3529066810890003
3529064102720001
3529066705960002
3529065801130001

NAMA PENDERITA
Ayu Wulandari
Moh. Abdillah
Ratnawita
Farida
Atun
Adi Subirto
Gufron
Zidan
Hamdani
Tian
Difa
Malika
Hilmi
Robiatul
Siti Asofa
Ayu Wulandari
Moh. Riko
Niza
Dana
Ayu Citra
Bunawi
Jumainna
Ratnawita

KODE

UMUR
(TH)

ALAMAT

32 Bl
3 Bl
38 Bln
4 Th
45 Th
60 TH
72 Th
3 Th
42 Th
3 Th
2 Th
11 Bl
4 Bl
11 Th
41Th
26 Bl
28 Bl
5 Th
8 Bl
13 Bl
65 Th
21 Th
3 Th

KAMBINGAN TIMUR
KAMBINGAN TIMUR
KAMBINGAN TIMUR
KAMBINGAN TIMUR
KAMBINGAN TIMUR
KAMBINGAN TIMUR
KAMBINGAN TIMUR
KAMBINGAN TIMUR
KAMBINGAN TIMUR
KAMBINGAN TIMUR
KAMBINGAN TIMUR
KAMBINGAN TIMUR
KAMBINGAN TIMUR
KAMBINGAN TIMUR
KAMBINGAN TIMUR
KAMBINGAN TIMUR
KAMBINGAN TIMUR
KAMBINGAN TIMUR
KAMBINGAN TIMUR
KAMBINGAN TIMUR
KAMBINGAN TIMUR
KAMBINGAN TIMUR
KAMBINGAN TIMUR

DIAGNOSA
ISPA
FEBRIS
GEA
FEBRIS
FEBRIS
ISPA
Caries
ALERGI
DM
FEBRIS
ISPA
ISPA
FEBRIS
ISPA
Caries
ISPA
ISPA
ALERGI
ISPA
ISPA
FEBRIS
FEBRIS
ISPA

ICD X
J06
R50
A.09
R50
R50
J06
K.02
L.23
E.11
R50
J06
J06
R50
J06
K.02
J06
J06
L.23
J06
J06
R50
R50
J06

KARCIS
MASUK
Rp. 7500
Rp7,500
Rp7,500
Rp7,500
Rp7,500
Rp7,500
Rp7,500
Rp7,500
Rp7,500
Rp7,500
Rp7,500
Rp7,500
Rp7,500
Rp7,500
Rp7,500
Rp7,500
Rp7,500
Rp7,500
Rp7,500
Rp7,500
Rp7,500
Rp7,500
Rp7,500
Rp7,500

TINDAKAN
INJEKSI

Rp1,000

Rp1,000
Rp1,000
Rp1,000
Rp1,000

Rp1,000

Rp1,000
Rp1,000

24
25
26
27
28

22/08/'16
22/08/'16
23/08/'16
24/08/'16
24/08/'16

3529062603100001
3529060302770003
3529064505600006
3529066104700002
3529061206940003

M. Riski ardana

Nuril
Maryama
Siti Asofa
Ayu Wulandari
J U M LAH

9 Bl
3 Th
55 Th
40 Th
26 Bl

KAMBINGAN TIMUR
KAMBINGAN TIMUR
KAMBINGAN TIMUR
KAMBINGAN TIMUR
KAMBINGAN TIMUR

ISPA
ISPA
FEBRIS
Caries
FEBRIS

J06
J06
R50
K.02
R50

Rp7,500
Rp7,500
Rp7,500
Rp7,500
Rp7,500
Rp210,000

Rp1,000
Rp1,000
Rp9,000

TINDAKAN
KB

Rawat
Luka

TOTAL

lain2

Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp

7,500.00
7,500.00
7,500.00
7,500.00
8,500.00
8,500.00
8,500.00
7,500.00
8,500.00
7,500.00
7,500.00
7,500.00
7,500.00
7,500.00
8,500.00
7,500.00
7,500.00
7,500.00
7,500.00
7,500.00
8,500.00
8,500.00
7,500.00

KET

Rp
Rp
Rp
Rp
Rp
Rp

7,500.00
7,500.00
8,500.00
8,500.00
7,500.00
219,000.00

REGISTER KUNJUNGAN PENDERITA RAWAT JALAN JAMKESDA

UPT PUSKESMAS SARONGGI TAHUN 2016
BULAN
UNIT LAYANAN

: SEPTEMBER
: PONKESDES KAMBINGAN TIMUR

NO

TGL

NO.NIK / SPM

NAMA PENDERITA

1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17

8/25/2016
8/27/2016
8/29/2016
8/29/2016
8/30/2016
01/09/2016
03/09/2016
05/09/2016
06/09/2016
13/09/2016
13/09/2016
13/09/2016
15/09/2016
17/09/2016
19/09//2016
22/09/2016
23/09/2016

3529062506830003
3529111007120003
3529066405880002
3529064505600006
3529061206940003
3529061505600011
3529064508680001
3529060711810004
3529065510810007
3529065910080001
3529065706820003
3529063105020002
3529065311880002
3529061512570001
3529064606750007
3529065407880002
3529066410120002

Sudirman
Zainal Arifin
Maesaroh
Maryama
Ayu Wulandari
Sardeno
Buwama
M. Riski Ardana
Nuril Qomariyah
Nabila Suci
Subaida
Alimad Askal
Halimatus
Malika
Siti Nurhasanah
Siti Qomariyah
Nurillah
J U M LA H

KODE

UMUR
(TH)

ALAMAT

DIAGNOSA

23
11Bln
2
53
3
55
49
9Bln
35
3Bln
2Bln
10Bln
25
7Bln
25
28
10Bln

KAMBINGAN TIMUR
KAMBINGAN TIMUR
KAMBINGAN TIMUR
KAMBINGAN TIMUR
KAMBINGAN TIMUR
KAMBINGAN TIMUR
KAMBINGAN TIMUR
KAMBINGAN TIMUR
KAMBINGAN TIMUR
KAMBINGAN TIMUR
KAMBINGAN TIMUR
KAMBINGAN TIMUR
KAMBINGAN TIMUR
KAMBINGAN TIMUR
KAMBINGAN TIMUR
KAMBINGAN TIMUR
KAMBINGAN TIMUR

ISPA
ISPA
Alergi
GOUT
ISPA
ASMA
HT
ISPA
Gastritis
Obs Febris
ISPA
ISPA
ISPA
ISPA
Konseling
Konseling
Obs Febris

ICD X
J06
J06
L23
M10
J06
J45
I10
J06
K29
R50
J06
J06
J06
J06
R50

KARCIS
MASUK
Rp. 7500
Rp7,500
Rp7,500
Rp7,500
Rp7,500
Rp7,500
Rp7,500
Rp7,500
Rp7,500
Rp7,500
Rp7,500
Rp7,500
Rp7,500
Rp7,500
Rp7,500
Rp7,500
Rp7,500
Rp7,500
Rp127,500

TINDAKAN
INJEKSI
Rawat
KB
Luka
Rp1,000
Rp1,000

Rp1,000
Rp1,000

Rp1,000

Rp1,000
Rp1,000
Rp1,000
Rp1,000
Rp8,000

TOTAL

lain2
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp
Rp

8,500.00
7,500.00
7,500.00
8,500.00
7,500.00
8,500.00
7,500.00
7,500.00
8,500.00
7,500.00
7,500.00
7,500.00
8,500.00
7,500.00
8,500.00
8,500.00
8,500.00
135,500.00

KET