CAKUPAN PELAYANAN KESEHATAN RUJUKAN

PUSKESMAS PARUNGSARI
TAHUN 2019

STATUS KEPESERTAAN
TOTAL
NO BULAN
KASUS
UMUM JKN

1 JANUARI 0 0
2 FEBRUARI 0 0
3 MARET 0 0
4 APRIL 0 0
5 MEI 0 0
6 JUNI 0 0
7 JULI 0 0
8 AGUSTUS 0 0
9 SEPTEMBER 0 0
10 OKTOBER 0 0
11 NOVEMBER 0 0
12 DESEMBER 0 0
TOTAL 0 0 0

Parungsari, 28 Februari 2019

Pengelola Rujukan Kepala Puskesmas Parungsari

Dr. Asep Suryatna Hj. Halimatu Saadiah,S.ST

NIP. NIP.196808211988032005
JUKAN

RINGKASAN
KASUS
RUJUKAN

ungsari, 28 Februari 2019

ala Puskesmas Parungsari

Halimatu Saadiah,S.ST
.196808211988032005
 RINGKASAN KASUS RUJUKAN
PUSKESMAS PARUNGSARI
TAHUN 2018

NO JANUARI FEBRUARI MARET APRIL MEI JUNI JULI

1 Nasal polyp Parkinson's disease Parkinson's disease Other pneumonia, Anxiety disorder, Myopia Other benign neoplasm of
organism unspecified unspecified connective and other soft
Twin pregnancy Other senile cataract Unspecified appendicitis Other benign neoplasm Other and unspecified Non-insulin-dependent
tissue of head, face and neck
of skin of scalp and neck cirrhosis of liver diabetes mellitus without
complications
2 Thalassaemia, unspecified
Hydatidiform mole Hyperplasia of prostate Other specified surgical Pre-eclampsia, Respiratory tuberculosis, Congestive heart failure
follow-up care unspecified bacteriologically and
histologically confirmed Unilateral or unspecified femoral hernia,
3 without obstruction or gangrene
Urinary calculus, Other specified surgical Unspecified appendicitis Other surgical follow-up Contact with and exposure Congestive heart failure
unspecified follow-up care care to tuberculosis Cataract, unspecified
4
Twin pregnancy Mixed anxiety and Unspecified appendicitis Hyperplasia of prostate Other surgical follow-up care
depressive disorder Sequelae of stroke, not
specified as haemorrhage Congestive heart failure
or infarction
5
Nasal polyp Brachial plexus disorders Other specified surgical Exophthalmic conditions Other benign neoplasms of Personal history of
follow-up care connective and other soft leukaemia
tissue

6 Cataract, unspecified
Pre-eclampsia, Cyanosis Fasciitis, not elsewhere Glaucoma, unspecified Other specified surgical Acute sinusitis, unspecified
unspecified classified, ankle and foot follow-up care Tuberculosis of lung, confirmed by
sputum microscopy with or without
7 culture (TACC)
8 Other surgical follow-up Acute bronchiolitis, Tuberculous pleurisy, Other senile cataract Retention of urine Peptic ulcer, unspecified as
care unspecified without mention of acute or chronic, without
Hyperplasia of prostate Blindness, one eye, low Supervision of normal
bacteriological or Congestive heart
haemorrhage failure
or perforation
Respiratory tuberculosis,
vision other eye pregnancy,
histological unspecified
confirmation bacteriologically and Melaena
histologically confirmed
9
 Exophthalmic conditions Other specified surgical Exophthalmic conditions Cutaneous abscess, Unspecified dementia
follow-up care furuncle and carbuncle of
other sites
10 Other senile cataract
11 Glaucoma, unspecified Congestive heart failure Supervision of normal Placenta praevia Thalassaemia, unspecified Benign lipomatous neoplasm
pregnancy, unspecified
12 Hyperplasia of prostate Bullous erythema Other senile cataract Chronic tonsillitis Hyperplasia of prostate
multiforme
Tuberculosis of lung, Other specified surgical Non-insulin-dependent Other specified surgical
confirmed by sputum follow-up care diabetes mellitus with other follow-up care
13 microscopy with or specified complications Other surgical follow-up care
without culture
14 Vertigo of central origin Supervision of normal Other cardiac arrhythmias Parkinson's disease Mixed anxiety and
pregnancy, unspecified depressive disorder
Angina pectoris, Obstructed labour due to Gestational [pregnancy- Brachial plexus disorders
unspecified breech presentation induced] oedema and
proteinuria without
hypertension
15 Cerebral palsy
16 Thyrotoxicosis, unspecified Brachial plexus disorders Cyanosis
Prolonged pregnancy Parkinson's disease
17 Cyanosis
Gastritis and duodenitis Tuberculous pleurisy, without
mention of bacteriological or
histological confirmation
18 Other senile cataract
Peptic ulcer, site Chronic tonsillitis
19 unspecified
Placenta praevia Other surgical follow-up care

20
Atrial septal defect Other senile cataract
21
Personal history of
22 leukaemia
Tuberculosis of lung,
confirmed by sputum
microscopy with or without
culture

23
Retention of urine

24
 Melaena

25
Congestive heart failure
26
Cataract, unspecified

27
Myopia

28
Thalassaemia, unspecified

29
Unilateral or unspecified
femoral hernia, without
30 obstruction or gangrene
Cataract, unspecified
31

32

33

34

35

36
37

38

39
 AGUSTUS
Personal history of endocrine, Superficial injury of
nutritional and metabolic
Prolonged
diseases pregnancy
Unilateral or unspecified
inguinal hernia, without
obstruction or gangrene
Maternal care for breech
presentation
Personal history of infectious
and parasitic diseases
Personal history of infectious
and parasitic diseases
Other specified surgical follow- Unilateral or unspecified Hearing loss, unspecified Cutaneous abscess,
up care
Personal history of infectious
and parasitic diseases
Typhoid fever
SEPTEMBER OKTOBER NOVEMBER DESEMBER
Respiratory tuberculosis Unspecified cleft palate Diseases of tongue
thorax unspecified, without with unilateral cleft lip
Bilateral inguinal hernia, Other
mentionspecified
of surgical Asthma Other abnormal products
with obstruction, without follow-up care or
bacteriological of conception
gangrene histological confirmation
Congestive heart failure Diseases of tongue Low back pain Other specified abnormal
products of conception
Benign neoplasm of Cataract, unspecified Benign neoplasm of Maternal care due to
breast breast uterine scar from
previous surgery
Varicose veins of other Other specified surgical Prolonged pregnancy Senile cataract
sites follow-up care
Other specified surgical Bilateral inguinal hernia, Unspecified injury of Parkinson's disease
follow-up care with obstruction, without abdomen, lower back
gangrene and pelvis
Benign neoplasm of
inguinal hernia, without furuncle and carbuncle thyroid gland
obstruction or gangrene
Nasal polyp, unspecified Disorder of thyroid, Abdominal and pelvic Senile cataract,
unspecified pain unspecified
Congestive heart failure Senile cataract Cerebral infarction, Hyperplasia of prostate
unspecified
Leptospirosis
Other benign neoplasm of
connective and other soft
Other
tissue benign
of head,neoplasm
face and of
neck
connective and other soft
Cerebral palsy
tissue of thorax Axilla
Congestive heart failure
Congestive heart failure
Other specified surgical follow- Other surgical follow-up
up care
Adherent leukoma
Follow-up examination after
other treatment for other
conditions
Primary generalized
(osteo)arthrosis
Personal history of infectious
and parasitic diseases
Congestive heart failure
Unspecified jaundice
Fistula of stomach and
duodenum
Other benign neoplasm of
connective and other soft
tissue of thorax Axilla
Epilepsy, unspecified Other cataract Persistent fever Other headache
syndromes
Prolonged first stage (of Diseases of tongue Fever, unspecified Nontoxic goitre,
labour) unspecified
Other specified surgical Other keratitis Thyrotoxicosis, Glaucoma, unspecified
follow-up care unspecified
Congestive heart failure Anaemia, unspecified Bacterial foodborne Other cataract
intoxication, unspecified
Respiratory tuberculosis Nonsuppurative otitis Congestive heart failure Other chronic
unspecified, without media suppurative otitis media
Congestive
mention of heart failure Haemorrhage in early Leptospirosis Irritable bowel syndrome
bacteriological or pregnancy without diarrhoea
histological confirmation
Abdominal and pelvic Malignant neoplasm of Other chronic obstructive
care pain abdomen pulmonary disease
Inguinal hernia Systemic lupus Other specified surgical Radiculopathy
erythematosus follow-up care
Acute appendicitis, Other injury of lumbar Melaena Other benign neoplasm
unspecified spinal cord of connective and other
soft tissue of abdomen
Parkinson's disease Congestive heart failure Pneumonia, unspecified Bronchiectasis
Congestive heart failure Abdominal and pelvic Nephrotic syndrome Gastro-oesophageal
pain reflux disease without
oesophagitis
Spina bifida, unspecified Foreign body in ear Prolonged second stage Anxiety disorder,
(of labour) unspecified
Localized enlarged Congestive heart failure Other senile cataract Myopia
lymph nodes
Cataract, unspecified Respiratory tuberculosis Malignant neoplasm of Polyneuropathy,
unspecified, without abdomen unspecified
mention of
bacteriological or
histological confirmation
Adherent leukoma Nontoxic goitre, Other specified surgical Suppurative and
unspecified follow-up care unspecified otitis media
Melaena Personal history of Primary generalized Abdominal and pelvic Heart failure
infectious and parasitic (osteo)arthrosis pain
diseases
Malignant neoplasm of bladder, Malignant neoplasm of Asthma, unspecified Pneumonia, unspecified Injury of eye and orbit
unspecified breast
Angina pectoris Glaucoma, unspecified Non-insulin-dependent Hypertrophy of tonsils
diabetes mellitus with
unspecified
complications

Non-insulin-dependent Other and unspecified Other senile cataract Abdominal and pelvic
diabetes mellitus with cirrhosis of liver pain
unspecified
complications

Other specified surgical Asthma, unspecified Other surgical follow-up

follow-up care care

Vasomotor rhinitis Leiomyoma of uterus Retrobulbar neuritis in

diseases classified
elsewhere
Congestive heart failure Congestive heart failure Low back pain

Chronic viral hepatitis B Cerebral palsy

with delta-agent

Peptic ulcer, acute with Other specified surgical

haemorrhage follow-up care

Tuberculosis of lung, Other chronic

confirmed by sputum suppurative otitis media
microscopy with or
without culture

Prolonged pregnancy Mucocele of salivary

gland
Other chronic Fever, unspecified
suppurative otitis media
Peptic ulcer, unspecified Parkinson's disease
as acute or chronic,
without haemorrhage or
perforation

Personal history of Cerebral infarction,

infectious and parasitic unspecified
diseases
Congestive heart failure Vasomotor rhinitis
 DATA RUJUKAN POLIKLINIK
PUSKESMAS PARUNGSARI BULAN JULI 2018
JANUARI

1/27/2018 796832572 ACENG MURTADO L PBI Nasal polyp YA

No Nama No.BPJS L/P Diagnosa 1 (APBN)
1/25/2018 796842549 NURAISAH P PBI Twin pregnancy
1 RIPA AL PARIJI 796263963 L Myopia 2 (APBN)
1/3/2018 798216041 ENENG P PBI Hydatidiform mole YA
2 ARUL 797347394 L Thalassaemia, unspecified 3 (APBN)
3 RUNAH 798138189 P Unilateral or unspecified femoral hernia, without obstruction or gangrene 4 1/15/2018 797623288 ASTAMI L PBI Urinary calculus, YA
(APBN) unspecified
1/25/2018 796842549 NURAISAH P PBI Twin pregnancy YA
4 KENENG 1989747191 P Cataract, unspecified 5 (APBN)
1/27/2018 796832572 ACENG MURTADO L PBI Nasal polyp YA
5 KARTI 47043404 P Congestive heart failure 6 (APBN)
796759097 YULIYAWATUL P PBI Pre-eclampsia,
6 SUMINAH 796807372 P Cataract, unspecified 7 FADILAH (APBN) unspecified
797055243 SITI HASANAH P PBI Other surgical follow-
7 YUNUS 797962871 L Tuberculosis of lung, confirmed by sputum microscopy with or without culture (TACC) 8 (APBN) up care
797100794 JABENG L PBI Hyperplasia of
8 HERNI 799142938 P Retention of urine 9 (APBN) prostate
796833988 MANSUR L PBI Exophthalmic
9 SAHAM 1989872739 P Melaena 10 (APBN) conditions
796815832 HERI HASANAH P PBI Glaucoma,
10 NENGSIH 796757163 P Other senile cataract 11 (APBN) unspecified
11 ARUL 797347394 L Thalassaemia, unspecified
12 APIAH 795837936 P Chronic tonsillitis
13 MURNI 797711758 P Other surgical follow-up care FEB
2/27/2018 47034832 SUMAH P PENERIM Parkinson's disease YA
A
PENSIUN
PNS
14 SUMAH 47034832 P Parkinson's disease 1
2/19/2018 796165762 BAHRUDIN L PBI Other senile cataract YA
15 DEDE AMIN 796837713 P Cerebral palsy 2 (APBN)
2450193017 SAYAMIN L PEKERJA Hyperplasia of
MANDIRI prostate

16 SUGIARSIH 796817957 P Brachial plexus disorders 3

796757163 NENGSIH P PBI Other specified
(APBN) surgical follow-up
17 BAGAS ADI DARMAWAN 796818745 L Cyanosis 4 care
798023204 TITIN MURTINI P PBI Mixed anxiety and
(APBN) depressive disorder
18 NENGSIH 796757163 P Other senile cataract 5
796817957 SUGIARSIH P PBI Brachial plexus
6 (APBN) disorders
796818745 BAGUS ADI L PBI Cyanosis
7 DARMAWAN (APBN)

MARET
3/31/2018 47034832 SUMAH P PENERIM Parkinson's disease YA
A
PENSIUN
PNS
1
3/27/2018 797424129 LAMRI L PBI Unspecified YA
2 (APBN) appendicitis
3/27/2018 797778843 SUHA P PBI Other specified YA
(APBN) surgical follow-up
3 care
3/27/2018 802472578 SITI FITRIYANI P PBI Unspecified YA
4 (APBN) appendicitis
3/26/2018 797038233 IPUL HAETAMI L PBI Unspecified YA
5 (APBN) appendicitis
3/26/2018 798069251 HAJARUDIN L PBI Other specified YA
(APBN) surgical follow-up
6 care
3/26/2018 2123202644 URSIN L PBI Fasciitis, not YA
(APBN) elsewhere classified,
ankle and foot
7
3/22/2018 2085082143 naufal ariqin L PEKERJA Acute bronchiolitis, YA
ramadhani MANDIRI unspecified

8
3/20/2018 796925529 ROHIDIN L PBI Blindness, one eye, YA
(APBN) low vision other eye
9
3/20/2018 797778843 SUHA P PBI Other specified Y
(APBN) surgical follow-up
10 care
3/20/2018 798186598 HARMADI L PBI Congestive heart YA
11 (APBN) failure
3/19/2018 796258697 KEMAD L PBI Hyperplasia of YA
12 (APBN) prostate
3/19/2018 797424221 YATI P PBI Tuberculosis of lung, YA
(APBN) confirmed by sputum
microscopy with or
without culture
13
3/15/2018 1051080107 NITA P PBI Vertigo of central YA
14 (APBN) origin
3/14/2018 1051075539 HASIM L PBI Angina pectoris, YA
15 (APBN) unspecified

APRIL
4/30/2018 2453416299 MUHAMAD L PBI Other pneumonia, YA
HIDAYATULLAH (APBD) organism unspecified

1
4/28/2018 797544808 JUMAN L PBI Other benign YA
(APBN) neoplasm of skin of
2 scalp and neck
4/24/2018 796759097 YULIYAWATUL P PBI Pre-eclampsia, YA
3 FADILAH (APBN) unspecified
4/23/2018 797055243 SITI HASANAH P PBI Other surgical follow- YA
4 (APBN) up care
4/21/2018 797100794 JABENG L PBI Hyperplasia of YA
5 (APBN) prostate
4/19/2018 796833988 MANSUR L PBI Exophthalmic YA
6 (APBN) conditions
4/18/2018 796815832 HERI HASANAH P PBI Glaucoma, YA
7 (APBN) unspecified
4/18/2018 797424221 YATI P PBI Tuberculous pleurisy, YA
(APBN) without mention of
bacteriological or
histological
confirmation

8
4/17/2018 795852551 SURNI P PBI Supervision of normal YA
(APBN) pregnancy,
unspecified
9
4/17/2018 796833988 MANSUR L PBI Exophthalmic YA
10 (APBN) conditions
4/17/2018 798199749 siti mastoah P PBI Supervision of normal YA
(APBN) pregnancy,
unspecified
11
4/16/2018 797885651 ASMAH P PBI Bullous erythema YA
12 (APBN) multiforme
4/12/2018 796960484 ENOK P PBI Other specified YA
(APBN) surgical follow-up
13 care
4/11/2018 798656466 YUYUM RUMANAH P PBI Supervision of normal YA
(APBN) pregnancy,
unspecified
14
 4/11/2018 2438703977 EMIN MAULANI P PEKERJA Obstructed labour YA
PUTRI MANDIRI due to breech
presentation
15

MEI
5/31/2018 796338821 ENO P PBI Anxiety disorder, YA
1 (APBN) unspecified
5/30/2018 796248742 RADI L PBI Other and YA
(APBN) unspecified cirrhosis
2 of liver
5/28/2018 797962871 YUYUS L PBI Respiratory YA
(APBN) tuberculosis,
bacteriologically and
histologically
confirmed
3
5/28/2018 798364293 RASTA L PBI Contact with and YA
(APBN) exposure to
4 tuberculosis
5/24/2018 797446844 SITI P PBI Sequelae of stroke, YA
(APBN) not specified as
haemorrhage or
infarction
5
5/21/2018 796660211 ASWINAH P PBI Other benign YA
(APBN) neoplasms of
connective and other
soft tissue
6
5/21/2018 797544808 JUMAN L PBI Other specified YA
(APBN) surgical follow-up
7 care
5/21/2018 797694963 ASLA L PBI Other senile cataract YA
8 (APBN)
5/21/2018 797948515 ARSA L PBI Respiratory YA
(APBN) tuberculosis,
bacteriologically and
histologically
confirmed
9
5/21/2018 1282279713 KAMILAH mardiah P KEPOLISI Cutaneous abscess, YA
mutmainah AN RI furuncle and
carbuncle of other
sites
10
5/21/2018 1422213748 yani handayani P PEKERJA Placenta praevia YA
MANDIRI

11
5/9/2018 797694963 ASLA L PBI Other senile cataract YA
12 (APBN)
5/17/2018 797488187 MARJONO L PBI Non-insulin- YA
(APBN) dependent diabetes
mellitus with other
specified
complications

13
5/16/2018 797418988 ARWITI P PBI Other cardiac YA
14 (APBN) arrhythmias
5/16/2018 798656466 YUYUM RUMANAH P PBI Gestational YA
(APBN) [pregnancy-induced]
oedema and
proteinuria without
hypertension

15
5/15/2018 795831693 M JAENUDIN L PBI Thyrotoxicosis, YA
16 (APBN) unspecified
5/15/2018 797092694 UMSINAH P PBI Prolonged pregnancy YA
17 (APBN)
5/15/2018 797283099 SANACI P PBI Gastritis and YA
18 (APBN) duodenitis
5/15/2018 797571371 RAINAH P PBI Peptic ulcer, site YA
19 (APBN) unspecified
5/15/2018 1422213748 yani handayani P PEKERJA Placenta praevia YA
MANDIRI

20
5/15/2018 2438704596 nata sabila L PEKERJA Atrial septal defect YA
MANDIRI

21

JULI
7/31/2018 797447856 JUBADRAH P PBI Other benign YA
(APBN) neoplasm of
connective and other
soft tissue of head,
face and neck

1
7/31/2018 797488187 MARJONO L PBI Non-insulin- YA
(APBN) dependent diabetes
mellitus without
complications

2
7/31/2018 797571371 RAINAH P PBI Congestive heart YA
3 (APBN) failure
7/30/2018 797418988 ARWITI P PBI Congestive heart YA
4 (APBN) failure
7/28/2018 797001535 SUMI P PBI Other surgical follow- YA
5 (APBN) up care
7/24/2018 797347394 ARUL L PBI Personal history of YA
6 (APBN) leukaemia
7/18/2018 796787447 SITI ATIAH P PBI Acute sinusitis, YA
7 (APBN) unspecified
7/18/2018 797033529 MAHMUD L PBI Peptic ulcer, YA
(APBN) unspecified as acute
or chronic, without
haemorrhage or
perforation

8
7/16/2018 797571371 RAINAH P PBI Congestive heart YA
9 (APBN) failure
7/16/2018 797254874 IPAH P PBI Unspecified dementia YA
10 (APBN)
7/16/2018 798199716 DEDEN L PBI Benign lipomatous YA
(APBN) neoplasm
11
7/16/2018 2450193017 SAYAMIN L PEKERJA Hyperplasia of YA
MANDIRI prostate

12
7/13/2018 796757163 NENGSIH P PBI Other specified YA
(APBN) surgical follow-up
13 care
7/13/2018 798023204 TITIN MURTINI P PBI Mixed anxiety and YA
(APBN) depressive disorder
14
7/12/2018 796817957 SUGIARSIH P PBI Brachial plexus YA
15 (APBN) disorders
7/12/2018 796818745 BAGUS ADI L PBI Cyanosis YA
16 DARMAWAN (APBN)
7/10/2018 47034832 SUMAH P PENERIM Parkinson's disease YA
A
PENSIUN
PNS
17
7/10/2018 797962871 YUYUS L PBI Tuberculous pleurisy, YA
(APBN) without mention of
bacteriological or
histological
confirmation

18
7/9/2018 795837936 APIAH P PBI Chronic tonsillitis YA
19 (APBN)
7/9/2018 797711758 MURNI P PBI Other surgical follow- YA
20 (APBN) up care
7/6/2018 796757163 NENGSIH P PBI Other senile cataract YA
21 (APBN)
7/6/2018 797347394 ARUL L PBI Personal history of YA
22 (APBN) leukaemia
 7/4/2018 797962871 YUYUS L PBI Tuberculosis of lung, YA
(APBN) confirmed by sputum
microscopy with or
without culture
23
7/4/2018 799142938 HERNI P PBI Retention of urine YA
24 (APBN)
7/4/2018 1989872739 SAHAMI P PBI Melaena YA
25 (APBN)
7/3/2018 47043404 NARTI P PENERIM Congestive heart YA
A failure
PENSIUN
PNS
26
7/3/2018 796807372 SUMINAH P PBI Cataract, unspecified YA
27 (APBN)
7/2/2018 796263963 RIPA AL PARIJI L PBI Myopia YA
28 (APBN)
7/2/2018 797347394 ARUL L PBI Thalassaemia, YA
29 (APBN) unspecified
7/2/2018 798138189 RUNAH P PBI Unilateral or YA
(APBN) unspecified femoral
hernia, without
obstruction or
gangrene

30
7/2/2018 1989747191 KENENG P PBI Cataract, unspecified YA
31 (APBN)
32

AGUSTUS
8/30/2018 796903108 TASIM L PBI Personal history of YA
(APBN) endocrine, nutritional
and metabolic
diseases
1
8/30/2018 797235298 SUHARTINI P PBI Prolonged pregnancy YA
2 (APBN)
8/29/2018 797013707 BISRIN L PBI Unilateral or YA
(APBN) unspecified inguinal
hernia, without
obstruction or
gangrene

3
8/27/2018 797135883 SUMANAH P PBI Maternal care for YA
(APBN) breech presentation
4
8/25/2018 797962871 YUYUS L PBI Personal history of YA
(APBN) infectious and
parasitic diseases
5
8/23/2018 797962871 YUYUS L PBI Personal history of YA
(APBN) infectious and
parasitic diseases
6
8/20/2018 797935432 IPAL LAKSANA L PBI Other specified YA
(APBN) surgical follow-up
7 care
8/16/2018 797962871 YUYUS L PBI Personal history of YA
(APBN) infectious and
parasitic diseases
8
8/14/2018 796985155 SRI P PBI Typhoid fever YA
9 (APBN)
8/14/2018 797001535 SUMI P PBI Leptospirosis YA
10 (APBN)
8/14/2018 797447856 JUBADRAH P PBI Other benign YA
(APBN) neoplasm of
connective and other
soft tissue of head,
face and neck

11
8/14/2018 798075437 SUKARMA L PBI Other benign YA
(APBN) neoplasm of
connective and other
soft tissue of thorax
Axilla
12
8/13/2018 796837713 DEDE AMIN L PBI Cerebral palsy YA
13 (APBN)
8/13/2018 797571371 RAINAH P PBI Congestive heart YA
14 (APBN) failure
8/8/2018 797571371 RAINAH P PBI Congestive heart YA
15 (APBN) failure
8/7/2018 796391223 KARSIAH P PBI Other specified YA
(APBN) surgical follow-up
16 care
8/7/2018 796897822 RAMAN L PBI Adherent leukoma YA
17 (APBN)
8/7/2018 797400854 SURTINI P PBI Follow-up YA
(APBN) examination after
other treatment for
other conditions
18
8/6/2018 1051075359 JUNENGSIH P PBI Primary generalized YA
(APBN) (osteo)arthrosis
19
8/3/2018 797962871 YUYUS L PBI Personal history of YA
(APBN) infectious and
parasitic diseases
20
8/2/2018 47043404 NARTI P PENERIM Congestive heart YA
A failure
PENSIUN
PNS
21
8/1/2018 797001535 SUMI P PBI Unspecified jaundice YA
22 (APBN)
8/1/2018 797935432 IPAL LAKSANA L PBI Fistula of stomach YA
(APBN) and duodenum
23
8/1/2018 798075437 SUKARMA L PBI Other benign YA
(APBN) neoplasm of
connective and other
soft tissue of thorax
Axilla
24
8/1/2018 1989872739 SAHAMI P PBI Melaena YA
25 (APBN)
8/1/2018 2450193017 SAYAMIN L PEKERJA Malignant neoplasm YA
MANDIRI of bladder,
unspecified
26
27

SEPTEMBER
9/27/2018 47226115 MANSYUR L PNS Superficial injury of YA
DAERAH thorax
1
9/25/2018 796816732 HASAN GANI L PBI Bilateral inguinal YA
(APBN) hernia, with
obstruction, without
gangrene
2
9/25/2018 796831907 MAHIM L PBI Congestive heart YA
3 (APBN) failure
9/25/2018 797033158 SARIKAH P PBI Benign neoplasm of YA
4 (APBN) breast
9/25/2018 798028402 SAENAH P PBI Varicose veins of YA
5 (APBN) other sites
9/25/2018 1451073025 ARSAH P PEKERJA Other specified YA
MANDIRI surgical follow-up
care
6
9/25/2018 1989814048 SAPE'I L PBI Unilateral or YA
(APBN) unspecified inguinal
hernia, without
obstruction or
gangrene

7
9/25/2018 2032314085 aska sudirman L PEKERJA Nasal polyp, YA
MANDIRI unspecified

8
 9/25/2018 2284074573 E. HABSAH P PENERIM Congestive heart YA
A failure
PENSIUN
PNS
9
9/24/2018 2223148443 SOPIYAH P PEKERJA Epilepsy, unspecified YA
MANDIRI

10
9/22/2018 796765241 NERI P PBI Prolonged first stage YA
11 (APBN) (of labour)
9/21/2018 1451073025 ARSAH P PEKERJA Other specified YA
MANDIRI surgical follow-up
care
12
9/20/2018 47043404 NARTI P PENERIM Congestive heart YA
A failure
PENSIUN
PNS
13
9/19/2018 797791217 ILMI L PBI Respiratory YA
(APBN) tuberculosis
unspecified, without
mention of
bacteriological or
histological
confirmation
14
9/18/2018 796765072 SANECA P PBI Congestive heart YA
15 (APBN) failure
9/8/2018 797161342 LINA HERTINA P PBI Other surgical follow- YA
16 (APBN) up care
9/18/2018 797162049 YOGI ISKANDAR L PBI Inguinal hernia YA
17 (APBN)
9/18/2018 797879981 SANIM L PBI Acute appendicitis, YA
(APBN) unspecified
18
9/8/2018 1051076676 OMBOY P PBI Parkinson's disease YA
19 (APBN)
9/18/2018 2302413085 ERUM P PEKERJA Congestive heart YA
MANDIRI failure

20
9/18/2018 2490825396 taufiq hidayah L PBI Spina bifida, YA
21 (APBN) unspecified
9/17/2018 47290048 SITI PARMI APRILIA P PNS Localized enlarged YA
DAERAH lymph nodes
22
9/17/2018 796822345 MUSTOPA L PBI Cataract, unspecified YA
23 (APBN)
9/14/2018 796897822 RAMAN L PBI Adherent leukoma YA
24 (APBN)
9/4/2018 797962871 YUYUS L PBI Personal history of YA
(APBN) infectious and
parasitic diseases
25
9/12/2018 796593047 hayati P PBI Malignant neoplasm YA
(APBN) of breast
26
9/12/2018 796924495 ANIS P PBI Angina pectoris YA
27 (APBN)
9/12/2018 1051076013 DARSIH P PBI Non-insulin- YA
(APBN) dependent diabetes
mellitus with
unspecified
complications
28
9/10/2018 797135883 SUMANAH P PBI Other specified YA
(APBN) surgical follow-up
29 care
9/10/2018 797326514 SUANDI L PBI Vasomotor rhinitis YA
30 (APBN)
9/8/2018 797057447 HABUDIN L PBI Congestive heart YA
31 (APBN) failure
9/8/2018 797135883 SUMANAH P PBI Chronic viral hepatitis YA
(APBN) B with delta-agent
32
9/7/2018 797571371 RAINAH P PBI Peptic ulcer, acute YA
(APBN) with haemorrhage
33
9/5/2018 797791217 ILMI L PBI Tuberculosis of lung, YA
(APBN) confirmed by sputum
microscopy with or
without culture

34
9/4/2018 796239088 UMSINAH P PBI Prolonged pregnancy YA
35 (APBN)
9/4/2018 797991243 BAHRUDIN L PBI Other chronic YA
(APBN) suppurative otitis
36 media
9/3/2018 797033529 MAHMUD L PBI Peptic ulcer, YA
(APBN) unspecified as acute
or chronic, without
haemorrhage or
perforation

37
9/1/2018 797962871 YUYUS L PBI Personal history of YA
(APBN) infectious and
parasitic diseases
38
2302413085 ERUM P PEKERJA Congestive heart
MANDIRI failure

39

OKTOBER
10/31/2018 796818745 BAGUS ADI L PBI Respiratory YA
DARMAWAN (APBN) tuberculosis
unspecified, without
mention of
bacteriological or
histological
confirmation
1
10/31/2018 797182391 SITI MASITOH P PBI Other specified YA
(APBN) surgical follow-up
2 care
10/30/2018 209243351 PUSPITA RIYANTI P PNS Diseases of tongue YA
DAERAH
3
10/30/2018 796662797 SAMAIN L PBI Cataract, unspecified YA
4 (APBN)
10/30/2018 796801656 RUMI P PBI Other specified YA
(APBN) surgical follow-up
5 care
10/30/2018 796816732 HASAN GANI L PBI Bilateral inguinal YA
(APBN) hernia, with
obstruction, without
gangrene
6
10/30/2018 1051079027 SANI P PBI Hearing loss, YA
7 (APBN) unspecified
10/29/2018 795831693 M JAENUDIN L PBI Disorder of thyroid, YA
(APBN) unspecified
8
10/29/2018 798199255 JAMI P PBI Senile cataract YA
9 (APBN)
10/29/2018 1989791807 SALA L PBI Other cataract YA
10 (APBN)
10/27/2018 209243351 PUSPITA RIYANTI P PNS Diseases of tongue YA
DAERAH
11
10/25/2018 797301371 SANDI L PBI Other keratitis YA
12 (APBN)
10/24/2018 796814763 KARMAH P PBI Anaemia, unspecified YA
13 (APBN)
10/24/2018 796985155 SRI P PBI Nonsuppurative otitis YA
14 (APBN) media
10/24/2018 797182391 SITI MASITOH P PBI Haemorrhage in early YA
15 (APBN) pregnancy
10/24/2018 798063208 SUHENAH P PBI Abdominal and pelvic YA
16 (APBN) pain
10/23/2018 796279443 DEDE P PBI Systemic lupus YA
17 (APBN) erythematosus
10/23/2018 796588852 SARHAN L PBI Other injury of lumbar YA
(APBN) spinal cord
18
 10/22/2018 796831907 MAHIM L PBI Congestive heart YA
19 (APBN) failure
10/22/2018 797258349 RENI P PBI Abdominal and pelvic YA
20 (APBN) pain
10/22/2018 797568107 SAJARIL L PBI Foreign body in ear YA
21 (APBN)
10/7/2018 1051076002 SAHRI L PBI Congestive heart YA
22 (APBN) failure
10/16/2018 796790237 ADUL L PBI Respiratory YA
(APBN) tuberculosis
unspecified, without
mention of
bacteriological or
histological
confirmation
23
10/15/2018 1051067147 NURPIAH P PBI Nontoxic goitre, YA
24 (APBN) unspecified
10/15/2018 1051075359 JUNENGSIH P PBI Primary generalized YA
(APBN) (osteo)arthrosis
25
10/12/2018 797919399 ENENG P PBI Asthma, unspecified YA
26 (APBN)
10/10/2018 1051067035 ARJA L PBI Glaucoma, YA
27 (APBN) unspecified
10/10/2018 1989814048 SAPE'I L PBI Other and YA
(APBN) unspecified cirrhosis
28 of liver
10/9/2018 796026508 MASROH P PBI Asthma, unspecified YA
29 MELAWATI (APBN)
10/9/2018 2284074573 E. HABSAH P PENERIM Leiomyoma of uterus YA
A
PENSIUN
PNS
30
10/9/2018 2302413085 ERUM P PEKERJA Congestive heart YA
MANDIRI failure

31
10/8/2018 796837713 DEDE AMIN L PBI Cerebral palsy YA
32 (APBN)
10/8/2018 797135883 SUMANAH P PBI Other specified YA
(APBN) surgical follow-up
33 care
10/2/2018 796466711 ALI L PBI Other chronic YA
(APBN) suppurative otitis
34 media
10/2/2018 796824538 HILMAN L PBI Mucocele of salivary YA
35 (APBN) gland
10/2/2018 2483426935 M. NABHAN L PBI Fever, unspecified YA
RASYIQUL (APBN)
36 MUBAROK
10/1/2018 47034832 SUMAH P PENERIM Parkinson's disease YA
A
PENSIUN
PNS
37
10/1/2018 796748613 UDING SAMSUDIN L PBI Cerebral infarction, YA
(APBN) unspecified
38
10/1/2018 797326514 SUANDI L PBI Vasomotor rhinitis YA
39 (APBN)

NOVEMBER
11/29/2018 2483426935 M. NABHAN L PBI Unspecified cleft YA
RASYIQUL (APBN) palate with unilateral
1 MUBAROK cleft lip
11/27/2018 795974376 ENENG KARNIAH P PBI Asthma YA
2 (APBN)
11/27/2018 796719712 SAMAH P PBI Low back pain YA
3 (APBN)
11/27/2018 797424052 KHOLIPAH P PBI Benign neoplasm of YA
4 (APBN) breast
11/22/2018 797269149 KAYAH ROKAYAH P PBI Prolonged pregnancy YA
5 (APBN)
11/21/2018 1051075495 DURI L PBI Unspecified injury of YA
(APBN) abdomen, lower back
and pelvis
6
11/19/2018 797370039 UDING L PBI Cutaneous abscess, YA
(APBN) furuncle and
7 carbuncle
11/19/2018 797571371 RAINAH P PBI Abdominal and pelvic YA
8 (APBN) pain
11/19/2018 1989704597 SAHAL L PBI Cerebral infarction, YA
(APBN) unspecified
9
11/15/2018 1051066956 ASNAPI L PBI Persistent fever YA
10 (APBN)
11/14/2018 797927275 UDING L PBI Fever, unspecified YA
11 (APBN)
11/14/2018 798350861 JUMARI L PBI Thyrotoxicosis, YA
12 (APBN) unspecified
11/14/2018 2483426935 M. NABHAN L PBI Bacterial foodborne YA
RASYIQUL (APBN) intoxication,
MUBAROK unspecified
13
11/13/2018 796868199 TEME P PBI Congestive heart YA
14 (APBN) failure
11/12/2018 797001535 SUMI P PBI Leptospirosis YA
15 (APBN)
11/12/2018 797062072 AMJUL WIJAYA L PBI Malignant neoplasm YA
(APBN) of abdomen
16
11/12/2018 797935432 IPAL LAKSANA L PBI Other specified YA
(APBN) surgical follow-up
17 care
11/12/2018 1989872739 SAHAMI P PBI Melaena YA
18 (APBN)
11/8/2018 1999596598 IRAM L PBI Pneumonia, YA
19 (APBN) unspecified
11/7/2018 797451423 SARINDA L PBI Nephrotic syndrome YA
20 (APBN)
11/6/2018 798028402 SAENAH P PBI Prolonged second YA
(APBN) stage (of labour)
21
11/6/2018 798199086 SALA L PBI Other senile cataract YA
22 (APBN)
11/5/2018 797062072 AMJUL WIJAYA L PBI Malignant neoplasm YA
(APBN) of abdomen
23
11/5/2018 797935432 IPAL LAKSANA L PBI Other specified YA
(APBN) surgical follow-up
24 care
11/5/2018 798017095 SUPARMAN L PBI Abdominal and pelvic YA
25 (APBN) pain
11/5/2018 1051067305 NARPAH P PBI Pneumonia, YA
26 (APBN) unspecified
11/5/2018 1051076013 DARSIH P PBI Non-insulin- YA
(APBN) dependent diabetes
mellitus with
unspecified
complications
27
11/5/2018 1989791807 SALA L PBI Other senile cataract YA
28 (APBN)
11/5/2018 2284074573 E. HABSAH P PENERIM Other surgical follow- YA
A up care
PENSIUN
PNS
29
11/1/2018 796673946 AJAT L PBI Retrobulbar neuritis YA
(APBN) in diseases classified
elsewhere

30
11/27/2018 796719712 SAMAH P PBI Low back pain
31 (APBN)

DESEMBER
12/1/2018 209243351 PUSPITA RIYANTI P PNS Diseases of tongue YA
DAERAH
1
 12/26/2018 795961956 SANI P PBI Other abnormal YA
(APBN) products of
2 conception
12/26/2018 1051075798 NENI P PBI Other specified YA
(APBN) abnormal products of
conception
3
12/26/2018 1434973871 siti rohayati P PEKERJA Maternal care due to YA
MANDIRI uterine scar from
previous surgery
4
12/24/2018 797875942 ARNAMIN L PBI Senile cataract YA
5 (APBN)
12/22/2018 47034832 SUMAH P PENERIM Parkinson's disease YA
A
PENSIUN
PNS
6
12/22/2018 2481682443 NAWIAH P PEKERJA Benign neoplasm of YA
MANDIRI thyroid gland

7
12/18/2018 47039062 NY. HUSNAH E. P PENERIM Senile cataract, YA
A unspecified
PENSIUN
PNS
8
12/17/2018 797669032 SARIP L PBI Hyperplasia of YA
9 (APBN) prostate
12/16/2018 796700823 AGUS L PBI Other headache YA
10 (APBN) syndromes
12/13/2018 796814267 MASNI P PBI Nontoxic goitre, YA
11 (APBN) unspecified
12/12/2018 796860516 USWATUN P PBI Glaucoma, YA
12 HASANAH (APBN) unspecified
12/11/2018 796794761 SADAR L PBI Other cataract YA
13 (APBN)
12/11/2018 796860516 USWATUN P PBI Other chronic YA
HASANAH (APBN) suppurative otitis
14 media
12/11/2018 796973218 NURMALASARI P PBI Irritable bowel YA
(APBN) syndrome without
15 diarrhoea
12/11/2018 797193685 NAHROWI L PBI Other chronic YA
(APBN) obstructive
pulmonary disease
16
12/11/2018 1051079253 NASIR L PBI Radiculopathy YA
17 (APBN)
12/10/2018 796299928 SARWANAH P PBI Other benign YA
(APBN) neoplasm of
connective and other
soft tissue of
abdomen
18
12/10/2018 797391461 SURNATI P PBI Bronchiectasis YA
19 (APBN)
12/10/2018 797441534 PEPEN L PBI Gastro-oesophageal YA
(APBN) reflux disease without
oesophagitis

20
12/7/2018 798104867 ROHMAH P PBI Anxiety disorder, YA
21 (APBN) unspecified
12/4/2018 796379927 KONA L PBI Myopia YA
22 (APBN)
12/4/2018 796820725 ETI P PBI Polyneuropathy, YA
23 (APBN) unspecified
12/4/2018 797991243 BAHRUDIN L PBI Suppurative and YA
(APBN) unspecified otitis
24 media
12/3/2018 47043404 NARTI P PENERIM Heart failure YA
A
PENSIUN
PNS
25
12/3/2018 796467216 SITI ADHIAH P PBI Injury of eye and orbit YA
26 (APBN)
12/3/2018 797099128 NAYLA ANASTARA P PBI Hypertrophy of tonsils YA
27 (APBN)
12/3/2018 797713593 AKBAR L PBI Abdominal and pelvic YA
28 (APBN) pain
 DATA RUJUKAN PERSALINAN
PUSKESMAS PARUNGSARI BULAN JULI 2018

No. Tanggal Nama Diagnosa BPJS/KIS Umum Jampersal

1
2
3
4
5
6
7
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