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This document contains a list of 39 patient visits to a health center branch in Samarinda on September 29, 2018. It includes information such as patient name, sex, type of insurance, diagnosis, and whether they were referred for further treatment or seen on an outpatient basis. The majority of visits were for issues like hypertension, dental problems, and respiratory infections. Several patients were referred to other facilities for specialist care.

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0% found this document useful (0 votes)
171 views66 pages

CreatePDF 3

This document contains a list of 39 patient visits to a health center branch in Samarinda on September 29, 2018. It includes information such as patient name, sex, type of insurance, diagnosis, and whether they were referred for further treatment or seen on an outpatient basis. The majority of visits were for issues like hypertension, dental problems, and respiratory infections. Several patients were referred to other facilities for specialist care.

Uploaded by

Re GL
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as PDF, TXT or read online on Scribd
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DAFTAR KUNJUNGAN PESERTA SAKIT

Kantor Cabang : SAMARINDA - 1601

FKTP : SEGIRI - 16010205

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

1 29-09-2018 160102050918Y001286 0000120281398 SjAMSUL HADI L PENERIMA PENSIUN Glaucoma, unspecified Rujuk Lanjut
PNS
2 29-09-2018 160102050918Y001308 0000120571154 ARBAINAH P PENERIMA PENSIUN Superficial injury of lower Berobat Jalan
PNS leg, unspecified
3 29-09-2018 160102050918Y001312 0000120614444 PAYAMAN SINAMBELA, DRS L PENERIMA PENSIUN Vertigo of central origin Berobat Jalan
PNS
4 29-09-2018 160102050918Y001307 0000120655743 Mery Diana SIMANUNGKALIT P PENERIMA PENSIUN Surgical follow-up care, Berobat Jalan
PNS unspecified
5 29-09-2018 160102050918Y001284 0000120668049 MUHAMMAD ANDRIANUR L PENERIMA PENSIUN Acute nasopharyngitis Berobat Jalan
SAPUTRA PNS [common cold]
6 29-09-2018 160102050918Y001316 0000120686848 MUKANI L PENERIMA PENSIUN Essential (primary) Berobat Jalan
PNS hypertension
7 29-09-2018 160102050918Y001302 0000120686859 ANI HAIRIAH P PENERIMA PENSIUN Essential (primary) Berobat Jalan
PNS hypertension
8 29-09-2018 160102050918Y001301 0000120841288 WIDYA EKA AGUSTINA WULAN P PNS DAERAH Impacted cerumen Berobat Jalan

9 29-09-2018 160102050918Y001289 0000121098464 ACHMAD BASRUN L PENERIMA PENSIUN Chronic ischaemic heart Rujuk Lanjut
PNS disease, unspecified
10 29-09-2018 160102050918Y001299 0000123030505 NOOR FATHONI L PNS DAERAH Viral warts Rujuk Lanjut

11 29-09-2018 160102050918Y001288 0000123118828 HUMAIRA PERMATA P PNS DAERAH Pulpitis Rujuk Lanjut

12 29-09-2018 160102050918Y001282 0000123257485 M.YELIANA P PNS DAERAH Essential (primary) Rujuk Lanjut
hypertension
13 29-09-2018 160102050918Y001297 0000123680878 HALIPAH P PNS DAERAH Low back pain Rujuk Lanjut

14 29-09-2018 160102050918Y001300 0000123688991 ANISA PURNAMA P PNS DAERAH Pulpitis Rujuk Lanjut

15 29-09-2018 160102050918Y001325 0000123726341 TUKIMIN L PNS DAERAH Non-insulin-dependent Berobat Jalan


diabetes mellitus without

16 29-09-2018 160102050918Y001311 0000165586206 DEMSI SIREGAR P PNS PUSAT Essential (primary) Berobat Jalan
hypertension
17 29-09-2018 160102050918Y001276 0000166051495 PALAS TUMPAL DOLY LUMBAN L PNS DAERAH Disorders of refraction and Rujuk Lanjut
TOBING accommodation
18 29-09-2018 160102050918Y001292 0000174098193 KURNIAH P PNS DAERAH Conjunctivitis, unspecified Berobat Jalan

19 29-09-2018 160102050918Y001294 0000900598544 FITRI RIYANTI P PBI (APBN) Acute nasopharyngitis Berobat Jalan
[common cold]
20 29-09-2018 160102050918Y001303 0000902019251 GALANG L PBI (APBN) Cutaneous mycobacterial Berobat Jalan
infection
21 29-09-2018 160102050918Y001281 0000902131356 ANDI MISDAR L PBI (APBN) Schizophrenia, unspecified Rujuk Lanjut
DAFTAR KUNJUNGAN PESERTA SAKIT

Kantor Cabang : SAMARINDA - 1601

FKTP : SEGIRI - 16010205

22 29-09-2018 160102050918Y001310 0000902531305 MANSYAH L PBI (APBN) Pain localized to other Berobat Jalan
parts of lower abdomen
23 29-09-2018 160102050918Y001291 0000902738351 AINI ASTUTI P PBI (APBN) Cervical root disorders, not Rujuk Lanjut
elsewhere classified
24 29-09-2018 160102050918Y001280 0000903544558 NIAM ZAINUR ROMADHON L PBI (APBN) Epilepsy Rujuk Lanjut

25 29-09-2018 160102050918Y001319 0000903941818 DARIYAH P PBI (APBN) Dyspepsia Berobat Jalan

26 29-09-2018 160102050918Y001320 0000903943383 AZIZAH NOR OCTAVIA P PBI (APBN) General examination and Berobat Jalan
investigation of persons
without complaint and

27 29-09-2018 160102050918Y001318 0001066473685 SITI NOVIA SARI P PBI (APBN) Dyspepsia Berobat Jalan

28 29-09-2018 160102050918Y001313 0001066478578 DAHLIANA P PBI (APBN) Cystitis, unspecified Berobat Jalan

29 29-09-2018 160102050918Y001322 0001066479873 NURDIN BARUS L PBI (APBN) Allergic contact dermatitis, Berobat Jalan
unspecified cause

30 29-09-2018 160102050918Y001277 0001066479884 RIATUN P PBI (APBN) Essential (primary) Berobat Jalan
hypertension
31 29-09-2018 160102050918Y001298 0001323588936 fatmawati P PNS DAERAH Disorders of refraction and Rujuk Lanjut
accommodation
32 29-09-2018 160102050918Y001287 0001382175246 A. SYAFI'I L PEKERJA MANDIRI Gastritis, unspecified Berobat Jalan

33 29-09-2018 160102050918Y001328 0001445400821 ABDUL MANAF L PEKERJA MANDIRI Chronic ischaemic heart Berobat Jalan
disease, unspecified
34 29-09-2018 160102050918Y001315 0001666630247 SYAIFUL HAYADI L PEGAWAI BUMN Cellulitis, unspecified Berobat Jalan

35 29-09-2018 160102050918Y001323 0001706141272 MUKHAMAD YUNUS L PEGAWAI SWASTA Dental caries, unspecified Rujuk Lanjut

36 29-09-2018 160102050918Y001314 0001851493735 diana kartikawati P PNS PUSAT Other and unspecified Berobat Jalan
abdominal pain
37 29-09-2018 160102050918Y001305 0001877096586 RAKHA FATHAN ATALLAH L PNS DAERAH Allergic contact dermatitis, Berobat Jalan
unspecified cause

38 29-09-2018 160102050918Y001279 0001925212994 USMAN L PBI (APBD) Chronic ischaemic heart Berobat Jalan
disease, unspecified
39 29-09-2018 160102050918Y001296 0001925232568 DINDA AZZAHRA P PBI (APBD) Acute tonsillitis, Berobat Jalan
unspecified
40 29-09-2018 160102050918Y001295 0001928652939 SAMIRAN L PBI (APBD) Cataract, unspecified Rujuk Lanjut

41 29-09-2018 160102050918Y001306 0001929263962 SITI YULAINAH P PBI (APBD) Hyperlipidaemia, Berobat Jalan
unspecified
42 29-09-2018 160102050918Y001278 0001929264129 SANIAH P PBI (APBD) Senile cataract, Rujuk Lanjut
unspecified
DAFTAR KUNJUNGAN PESERTA SAKIT

Kantor Cabang : SAMARINDA - 1601

FKTP : SEGIRI - 16010205

43 29-09-2018 160102050918Y001285 0002039632391 fitriah P PNS PUSAT Asthma Berobat Jalan

44 29-09-2018 160102050918Y001326 0002060451191 SAMSIAH P PEKERJA MANDIRI Non-insulin-dependent Berobat Jalan


diabetes mellitus without

45 29-09-2018 160102050918Y001324 0002073949255 MUJIATEN P PEKERJA MANDIRI Essential (primary) Berobat Jalan
hypertension
46 29-09-2018 160102050918Y001290 0002092377993 YULIANA PALIN P PEKERJA MANDIRI Blighted ovum and Rujuk Lanjut
nonhydatidiform mole
47 29-09-2018 160102050918Y001283 0002213496966 SHELA NOVIANI NUR AZIZAH P PEKERJA MANDIRI Cutaneous mycobacterial Berobat Jalan
infection
48 29-09-2018 160102050918Y001321 0002245028613 ANDI AZIS L PEKERJA MANDIRI Non-insulin-dependent Berobat Jalan
diabetes mellitus without

49 29-09-2018 160102050918Y001327 0002262899698 DUDY RAHMAN L PEKERJA MANDIRI Essential (primary) Berobat Jalan
hypertension
50 29-09-2018 160102050918Y001317 0002279199633 SRI SUPARMIATI P PEKERJA MANDIRI Essential (primary) Berobat Jalan
hypertension
51 29-09-2018 160102050918Y001293 0002309323206 SIRAMIATI P PEKERJA MANDIRI Chronic gingivitis Rujuk Lanjut

52 29-09-2018 160102050918Y001309 0002322632553 HASANAH P PEKERJA MANDIRI Surgical follow-up care, Berobat Jalan
unspecified
53 29-09-2018 160102050918Y001304 0002438745974 MUHAMMAD AL-FATIH L PEKERJA MANDIRI Acute nasopharyngitis Berobat Jalan
[common cold]
54 28-09-2018 160102050918Y001268 0000120013132 SALAFUDDIN S.PD L PNS DAERAH Acute pharyngitis, Berobat Jalan
unspecified
55 28-09-2018 160102050918Y001264 0000120042595 JAMIRAH P PNS DAERAH Other chest pain Berobat Jalan

56 28-09-2018 160102050918Y001227 0000120528314 BAHARUDDIN L PEGAWAI SWASTA Other disorders of urinary Rujuk Lanjut
system
57 28-09-2018 160102050918Y001245 0000120549317 MAS`UD L PNS DAERAH Myalgia Berobat Jalan

58 28-09-2018 160102050918Y001232 0000120636213 ARIAH P PENERIMA PENSIUN Non-insulin-dependent Berobat Jalan


PNS diabetes mellitus without

59 28-09-2018 160102050918Y001228 0000120652907 THAMRIN RAHMAN L PENERIMA PENSIUN Non-insulin-dependent Berobat Jalan
PNS diabetes mellitus without

60 28-09-2018 160102050918Y001249 0000120670323 NUKMAN.SJ, DRS L PENERIMA PENSIUN Headache Berobat Jalan
PNS
61 28-09-2018 160102050918Y001242 0000120684971 H. MUSTAFA L PENERIMA PENSIUN TNI Hyperplasia of prostate Rujuk Lanjut

62 28-09-2018 160102050918Y001238 0000120721803 DRS.E.DING JIU HONG L PNS DAERAH Chronic ischaemic heart Rujuk Lanjut
disease, unspecified
63 28-09-2018 160102050918Y001237 0000120818654 DIAN ANGGRENI P PNS DAERAH Paroxysmal tachycardia Rujuk Lanjut
DAFTAR KUNJUNGAN PESERTA SAKIT

Kantor Cabang : SAMARINDA - 1601

FKTP : SEGIRI - 16010205

64 28-09-2018 160102050918Y001251 0000120887289 ERNAWATY P PNS PUSAT Non-insulin-dependent Berobat Jalan


diabetes mellitus without

65 28-09-2018 160102050918Y001244 0000123032035 EMMELLYA NURTININGSIH P PNS DAERAH Schizophrenia, unspecified Rujuk Lanjut

66 28-09-2018 160102050918Y001272 0000123062804 KLAWU ELING WASPODO L PNS DAERAH Essential (primary) Berobat Jalan
hypertension
67 28-09-2018 160102050918Y001231 0000123110379 EMI YUSNITA P PNS DAERAH Excessive, frequent and Rujuk Lanjut
irregular menstruation
68 28-09-2018 160102050918Y001234 0000123111191 RAHAYU MULYANINGSIH P PENERIMA PENSIUN Essential (primary) Berobat Jalan
PNS hypertension
69 28-09-2018 160102050918Y001275 0000201887289 MUHAMMAD ZABDAN ZAHIR L PNS DAERAH Disturbances in tooth Berobat Jalan
eruption
70 28-09-2018 160102050918Y001233 0000897727241 LUKAS MUYA L PBI (APBN) Surgical follow-up care, Rujuk Lanjut
unspecified
71 28-09-2018 160102050918Y001243 0000902077773 NASIAH P PBI (APBN) Schizophrenia, unspecified Rujuk Lanjut

72 28-09-2018 160102050918Y001261 0000902346355 SUBUHAN L PBI (APBN) Fever of other and Berobat Jalan
unknown origin
73 28-09-2018 160102050918Y001258 0000902346535 ROHAYAH P PBI (APBN) Dyspepsia Berobat Jalan

74 28-09-2018 160102050918Y001253 0000902458574 HERLINA SUSANTI P PBI (APBN) Acute pharyngitis, Berobat Jalan
unspecified
75 28-09-2018 160102050918Y001265 0000902703993 WAHYU ARBAININGSIH P PBI (APBN) Burns classified according Berobat Jalan
to extent of body surface

76 28-09-2018 160102050918Y001247 0000903221763 AJI ISKANDAR L PBI (APBN) Acute pharyngitis, Berobat Jalan
unspecified
77 28-09-2018 160102050918Y001260 0000903247929 SAMINTEN P PBI (APBN) Headache Berobat Jalan

78 28-09-2018 160102050918Y001255 0000903645101 MISIYAH P PBI (APBN) Non-insulin-dependent Berobat Jalan


diabetes mellitus without

79 28-09-2018 160102050918Y001248 0000937472613 SISKA P PBI (APBN) Acute pharyngitis, Berobat Jalan
unspecified
80 28-09-2018 160102050918Y001267 0000937474143 NUR AINI P PBI (APBN) Acute nasopharyngitis Berobat Jalan
[common cold]
81 28-09-2018 160102050918Y001246 0001066481739 SUPRAPTI P PBI (APBN) Disorders of refraction and Rujuk Lanjut
accommodation
82 28-09-2018 160102050918Y001259 0001134464174 LA MENTE L PEKERJA MANDIRI Non-insulin-dependent Berobat Jalan
diabetes mellitus without

83 28-09-2018 160102050918Y001271 0001313805521 wahamu P PEKERJA MANDIRI Chest pain, unspecified Berobat Jalan
DAFTAR KUNJUNGAN PESERTA SAKIT

Kantor Cabang : SAMARINDA - 1601

FKTP : SEGIRI - 16010205

84 28-09-2018 160102050918Y001256 0001434211277 longsat L PEKERJA MANDIRI Non-insulin-dependent Berobat Jalan


diabetes mellitus without

85 28-09-2018 160102050918Y001270 0001436135027 ATI TOPANG P PNS DAERAH Acute nasopharyngitis Berobat Jalan
[common cold]
86 28-09-2018 160102050918Y001266 0001478196292 SITI FAJARIAH P PEGAWAI SWASTA Acute nasopharyngitis Berobat Jalan
[common cold]
87 28-09-2018 160102050918Y001241 0001550686037 ROBET AJANG L PBI (APBD) Other benign neoplasms Rujuk Lanjut
of connective and other

88 28-09-2018 160102050918Y001235 0001551188777 WILIAM NENSEN L PEKERJA MANDIRI Benign neoplasm of bone Rujuk Lanjut
and articular cartilage,

89 28-09-2018 160102050918Y001250 0001644858729 DAUD SRI SEMBILAN L PEGAWAI SWASTA Other arthrosis Berobat Jalan
BUMBUNGAN
90 28-09-2018 160102050918Y001230 0001723636765 DELIA HASANAH PUTRI L PBI (APBD) Asthma Rujuk Lanjut

91 28-09-2018 160102050918Y001254 0001924779925 AHMAD FAJRI L PEKERJA MANDIRI Hordeolum and other deep Berobat Jalan
inflammation of eyelid

92 28-09-2018 160102050918Y001236 0002064018756 NAMIRAH P PEKERJA MANDIRI Other arthrosis Rujuk Lanjut

93 28-09-2018 160102050918Y001229 0002069303556 AIDA RUSLIAH P PEKERJA MANDIRI Chronic ischaemic heart Rujuk Lanjut
disease, unspecified
94 28-09-2018 160102050918Y001273 0002075918793 NOERMA FITRIANI P PEKERJA MANDIRI Necrosis of pulp Berobat Jalan

95 28-09-2018 160102050918Y001274 0002079071921 MUINAH P PEKERJA MANDIRI Acute periodontitis Berobat Jalan

96 28-09-2018 160102050918Y001252 0002215302996 MUHAMMAD DAFFA ZUHDI L PEKERJA MANDIRI Dyspepsia Berobat Jalan

97 28-09-2018 160102050918Y001263 0002219930583 WA HARI P PEKERJA MANDIRI Non-insulin-dependent Berobat Jalan


diabetes mellitus without

98 28-09-2018 160102050918Y001257 0002238223241 TOMMY MASHOER L PEKERJA MANDIRI Essential (primary) Berobat Jalan
hypertension
99 28-09-2018 160102050918Y001262 0002269904499 abraham saputra L PEGAWAI SWASTA Acute nasopharyngitis Berobat Jalan
[common cold]
100 28-09-2018 160102050918Y001240 0002317792937 RIFKI ALMUHARRAM L PEKERJA MANDIRI Superficial injury of hip Rujuk Lanjut
and thigh
101 28-09-2018 160102050918Y001269 0002435890509 HAMKA L PEKERJA MANDIRI Otitis media, unspecified Berobat Jalan

102 28-09-2018 160102050918Y001239 0002477101443 RIDHO SAPUTRA L PEKERJA MANDIRI Bronchopneumonia, Rujuk Lanjut
unspecified
103 27-09-2018 160102050918Y001209 0000120263499 LILISTIATI P PNS DAERAH Surgical follow-up care, Rujuk Lanjut
unspecified
DAFTAR KUNJUNGAN PESERTA SAKIT

Kantor Cabang : SAMARINDA - 1601

FKTP : SEGIRI - 16010205

104 27-09-2018 160102050918Y001194 0000120317466 JUMANI L PNS DAERAH Stroke, not specified as Rujuk Lanjut
haemorrhage or infarction
105 27-09-2018 160102050918Y001205 0000120361713 MOHAMAD ABDUL SODEK L PENERIMA PENSIUN Non-insulin-dependent Berobat Jalan
PNS diabetes mellitus without

106 27-09-2018 160102050918Y001216 0000120445773 INDRIANI NURDIN P PNS DAERAH Low back pain Rujuk Lanjut

107 27-09-2018 160102050918Y001198 0000120513914 RIBUT SUKIDJO L PENERIMA PENSIUN TNI After-cataract Rujuk Lanjut

108 27-09-2018 160102050918Y001226 0000120549352 MERY TANDIARANG P PNS DAERAH Low back pain Rujuk Lanjut

109 27-09-2018 160102050918Y001200 0000120655056 ASKAMAN MASDAR L PENERIMA PENSIUN Senile cataract Rujuk Lanjut
PNS
110 27-09-2018 160102050918Y001196 0000120656237 DANTES HUTAHAEAN SH. L PENERIMA PENSIUN Hyperplasia of prostate Rujuk Lanjut
PNS
111 27-09-2018 160102050918Y001215 0000120670064 NANANG HASAN L PENERIMA PENSIUN Hyperplasia of prostate Rujuk Lanjut
PNS
112 27-09-2018 160102050918Y001221 0000120678131 ABIDINSYAH L PENERIMA PENSIUN Zoster without Berobat Jalan
PNS complication
113 27-09-2018 160102050918Y001210 0000120684971 H. MUSTAFA L PENERIMA PENSIUN TNI Chronic ischaemic heart Berobat Jalan
disease, unspecified
114 27-09-2018 160102050918Y001201 0000120704095 RAMIN REDJO L PENERIMA PENSIUN Insulin-dependent Berobat Jalan
PNS diabetes mellitus
115 27-09-2018 160102050918Y001224 0000120903783 DARIYAH P PENERIMA PENSIUN Essential (primary) Berobat Jalan
PNS hypertension
116 27-09-2018 160102050918Y001225 0000122036635 NAVA SHEILASIA FASYA P PNS DAERAH Acute pharyngitis, Berobat Jalan
unspecified
117 27-09-2018 160102050918Y001203 0000123677919 BERLIANA P PNS DAERAH Essential (primary) Berobat Jalan
hypertension
118 27-09-2018 160102050918Y001202 0000123677921 PARLINDUNGAN PASARIBU, SH L PNS DAERAH Essential (primary) Berobat Jalan
hypertension
119 27-09-2018 160102050918Y001199 0000123680564 DEYMANTER SIANTURI L PNS DAERAH Senile cataract Rujuk Lanjut

120 27-09-2018 160102050918Y001193 0000123680913 HAMDAN L PNS DAERAH Essential (primary) Berobat Jalan
hypertension
121 27-09-2018 160102050918Y001214 0000123682959 JEMMI ANGGRAINI P PNS DAERAH Thyrotoxicosis Rujuk Lanjut
[hyperthyroidism]
122 27-09-2018 160102050918Y001217 0000902443443 SIDAR P PBI (APBN) Pulpitis Berobat Jalan

123 27-09-2018 160102050918Y001218 0000902464942 KURNIAWATI P PBI (APBN) Spontaneous abortion, Rujuk Lanjut
complete or unspecified,

124 27-09-2018 160102050918Y001223 0000902744177 NURHAYATI P PBI (APBN) Non-insulin-dependent Berobat Jalan
diabetes mellitus without
DAFTAR KUNJUNGAN PESERTA SAKIT

Kantor Cabang : SAMARINDA - 1601

FKTP : SEGIRI - 16010205

125 27-09-2018 160102050918Y001222 0000902766418 MUJIATI P PBI (APBN) Dyspepsia Berobat Jalan

126 27-09-2018 160102050918Y001213 0001066482189 TUKINEM P PBI (APBN) Essential (primary) Berobat Jalan
hypertension
127 27-09-2018 160102050918Y001207 0001066483945 RUSBIYANTI P PBI (APBN) Chronic periodontitis Berobat Jalan

128 27-09-2018 160102050918Y001211 0001264941022 APRIADINATA L PEKERJA MANDIRI Retinal detachments and Rujuk Lanjut
breaks
129 27-09-2018 160102050918Y001197 0001270801629 NURUL AINI P PEKERJA MANDIRI Chronic ischaemic heart Rujuk Lanjut
disease, unspecified
130 27-09-2018 160102050918Y001212 0001428508258 ELIS YULISA P PEKERJA MANDIRI Other specified Rujuk Lanjut
orthopaedic follow-up care

131 27-09-2018 160102050918Y001204 0001832431026 PONCO HEKSA SKIDATINI P PEKERJA MANDIRI Haemorrhage in early Rujuk Lanjut
pregnancy, unspecified
132 27-09-2018 160102050918Y001206 0001925233211 SUWATI P PBI (APBD) Cystitis, unspecified Rujuk Lanjut

133 27-09-2018 160102050918Y001220 0001928661671 MULYANIANTO L PBI (APBD) Disorders of refraction and Rujuk Lanjut
accommodation
134 27-09-2018 160102050918Y001195 0001930552828 AHMAD M L PBI (APBD) Essential (primary) Berobat Jalan
hypertension
135 27-09-2018 160102050918Y001219 0002093483676 J SUTRA P PEKERJA MANDIRI Thyrotoxicosis Rujuk Lanjut
[hyperthyroidism]
136 27-09-2018 160102050918Y001208 0002245943272 SUHARTIK P PEKERJA MANDIRI Benign neoplasm of Rujuk Lanjut
unspecified site
137 26-09-2018 160102050918Y001164 0000120655956 SITI SYAMSIAH P PENERIMA PENSIUN Non-insulin-dependent Berobat Jalan
PNS diabetes mellitus without

138 26-09-2018 160102050918Y001157 0000120658061 MURDJANI PATHUR L PENERIMA PENSIUN Pulpitis Berobat Jalan
PNS
139 26-09-2018 160102050918Y001156 0000120659398 EDDY MOHJID L PENERIMA PENSIUN Hypertensive heart Berobat Jalan
PNS disease with (congestive)

140 26-09-2018 160102050918Y001180 0000120661839 H.AWANG JOENANI, DR L PENERIMA PENSIUN Chronic ischaemic heart Rujuk Lanjut
PNS disease, unspecified
141 26-09-2018 160102050918Y001181 0000120661841 TJANDRA KIRANA YUdHA P PENERIMA PENSIUN Cardiac arrhythmia, Rujuk Lanjut
SUBRATA PNS unspecified
142 26-09-2018 160102050918Y001191 0000120674081 SUHADI L PENERIMA PENSIUN Nonorganic insomnia Berobat Jalan
PNS
143 26-09-2018 160102050918Y001150 0000120685893 IR TL TOBING L PENERIMA PENSIUN Hyperplasia of prostate Rujuk Lanjut
PNS
144 26-09-2018 160102050918Y001154 0000120719924 RIZALY L PNS DAERAH Chronic renal failure, Rujuk Lanjut
unspecified
DAFTAR KUNJUNGAN PESERTA SAKIT

Kantor Cabang : SAMARINDA - 1601

FKTP : SEGIRI - 16010205

145 26-09-2018 160102050918Y001178 0000120913615 RATRI SUNDARI P PNS PUSAT Tuberculosis of lung, Rujuk Lanjut
confirmed by sputum
microscopy with or without

146 26-09-2018 160102050918Y001184 0000123084988 FARID WAJDI RAHIM L PNS DAERAH Chronic obstructive Berobat Jalan
pulmonary disease,

147 26-09-2018 160102050918Y001162 0000123692049 SUMARNI MARIMAN P PNS DAERAH Chronic ischaemic heart Berobat Jalan
disease, unspecified
148 26-09-2018 160102050918Y001166 0000123692051 MUHAMMAD YUNUS L PNS DAERAH Chronic ischaemic heart Berobat Jalan
disease, unspecified
149 26-09-2018 160102050918Y001174 0000123719343 M RUSLIAN NOOR L PENERIMA PENSIUN Chronic lymphocytic Berobat Jalan
PNS leukaemia
150 26-09-2018 160102050918Y001176 0000158053386 SUMARDI L PNS PUSAT Chronic ischaemic heart Rujuk Lanjut
disease, unspecified
151 26-09-2018 160102050918Y001160 0000158694399 ARMANIYAH SY P PENERIMA PENSIUN Hypertensive heart Rujuk Lanjut
PNS disease
152 26-09-2018 160102050918Y001163 0000195003819 MASOLA BALISA L PNS DAERAH Hyperplasia of prostate Rujuk Lanjut

153 26-09-2018 160102050918Y001179 0000735425032 LISNOWATI P PBI (APBN) Other specified Rujuk Lanjut
noninflammatory disorders

154 26-09-2018 160102050918Y001172 0000896963477 YOHANA HIROH P PBI (APBN) Follicular cyst of ovary Rujuk Lanjut

155 26-09-2018 160102050918Y001188 0000902015717 ADE RIZKI FADILAH L PBI (APBN) Headache Berobat Jalan

156 26-09-2018 160102050918Y001167 0000902461522 AHMAD SAUKANI L PBI (APBN) Dental caries, unspecified Berobat Jalan

157 26-09-2018 160102050918Y001159 0000902593923 DIAN TANIAR P PBI (APBN) Acute nasopharyngitis Berobat Jalan
[common cold]
158 26-09-2018 160102050918Y001158 0000902610393 DARWADI L PBI (APBN) Insulin-dependent Rujuk Lanjut
diabetes mellitus with

159 26-09-2018 160102050918Y001190 0000902691257 TOLE P PBI (APBN) Diarrhoea and Berobat Jalan
gastroenteritis of
presumed infectious origin

160 26-09-2018 160102050918Y001169 0000903124708 ZAINAL ABIDIN L PBI (APBN) Chronic obstructive Rujuk Lanjut
pulmonary disease,

161 26-09-2018 160102050918Y001173 0001263559241 MUHAMMAD RAMADHAN L PEGAWAI SWASTA Other and unspecified Rujuk Lanjut
KRISNA ANANDA abdominal pain
162 26-09-2018 160102050918Y001182 0001325266637 muhammad abraham indrawan L PEKERJA MANDIRI Asthma, unspecified Berobat Jalan
DAFTAR KUNJUNGAN PESERTA SAKIT

Kantor Cabang : SAMARINDA - 1601

FKTP : SEGIRI - 16010205

163 26-09-2018 160102050918Y001187 0001434211277 longsat L PEKERJA MANDIRI Non-insulin-dependent Berobat Jalan
diabetes mellitus with
peripheral circulatory

164 26-09-2018 160102050918Y001183 0001775281779 HERLINA L. SITUMORANG P PEGAWAI SWASTA Myalgia, hand Berobat Jalan

165 26-09-2018 160102050918Y001165 0001844843455 OTONG SUKARNA L PEKERJA MANDIRI Acute periodontitis Berobat Jalan

166 26-09-2018 160102050918Y001170 0001871929517 ARIFIN L PEKERJA MANDIRI Chronic ischaemic heart Rujuk Lanjut
disease, unspecified
167 26-09-2018 160102050918Y001155 0001923899837 MUHAMAD DERLY L PBI (APBD) Other orthopaedic Rujuk Lanjut
follow-up care
168 26-09-2018 160102050918Y001168 0001925214232 SABINAH P PBI (APBD) After-cataract Rujuk Lanjut

169 26-09-2018 160102050918Y001171 0001925222769 NENENG TRIANA P PBI (APBD) Other specified headache Rujuk Lanjut
syndromes
170 26-09-2018 160102050918Y001189 0001925271551 MULYATI P PBI (APBD) Essential (primary) Berobat Jalan
hypertension
171 26-09-2018 160102050918Y001177 0001931885559 JIUL L PBI (APBD) Bronchitis, not specified as Rujuk Lanjut
acute or chronic
172 26-09-2018 160102050918Y001192 0002082332147 SUTATIK P PBI (APBD) Diarrhoea and Berobat Jalan
gastroenteritis of
presumed infectious origin

173 26-09-2018 160102050918Y001186 0002211560662 SUSANTI P PEKERJA MANDIRI Supervision of normal first Berobat Jalan
pregnancy
174 26-09-2018 160102050918Y001185 0002328216671 SUKADI L PEKERJA MANDIRI Myalgia, shoulder region Berobat Jalan

175 26-09-2018 160102050918Y001161 0002421838653 ACHMAD BASRI L PEGAWAI BUMD Hyperplasia of prostate Rujuk Lanjut

176 26-09-2018 160102050918Y001175 0002485912421 MUHAMMAD RIDWAN KAMIL L PEGAWAI SWASTA Tetralogy of Fallot Rujuk Lanjut

177 25-09-2018 160102050918Y001126 0000119701596 SUKAPTI P PNS DAERAH Malignant neoplasm of Rujuk Lanjut
cervix uteri, unspecified
178 25-09-2018 160102050918Y001151 0000119982508 AYUB L PNS DAERAH Unspecified injury of wrist Berobat Jalan
and hand
179 25-09-2018 160102050918Y001137 0000120413518 NURDA AGUSTINI P PNS PUSAT Excessive and frequent Rujuk Lanjut
menstruation with irregular

180 25-09-2018 160102050918Y001116 0000120427064 HAMISYAH P PENERIMA PENSIUN Asthma Berobat Jalan
PNS
181 25-09-2018 160102050918Y001148 0000120433961 ADITYA KOESPRAYOGI L PNS DAERAH Acute pharyngitis, Berobat Jalan
unspecified
182 25-09-2018 160102050918Y001127 0000120490975 hm AGUS SUTOPO, mba L PENERIMA PENSIUN TNI Chronic ischaemic heart Berobat Jalan
disease, unspecified
DAFTAR KUNJUNGAN PESERTA SAKIT

Kantor Cabang : SAMARINDA - 1601

FKTP : SEGIRI - 16010205

183 25-09-2018 160102050918Y001125 0000120532948 TOMMY BUSTOMI, S.KOM L PNS PUSAT Non-insulin-dependent Berobat Jalan
diabetes mellitus without

184 25-09-2018 160102050918Y001101 0000120603137 MASRAH P PENERIMA PENSIUN Chronic ischaemic heart Rujuk Lanjut
PNS disease, unspecified
185 25-09-2018 160102050918Y001096 0000120604386 MISRANSYAH L PENERIMA PENSIUN Non-insulin-dependent Berobat Jalan
PNS diabetes mellitus without

186 25-09-2018 160102050918Y001097 0000120604397 ASNAH P PENERIMA PENSIUN Non-insulin-dependent Berobat Jalan
PNS diabetes mellitus without

187 25-09-2018 160102050918Y001140 0000120615208 RACHMINAWATI P PENERIMA PENSIUN Disorders of refraction and Rujuk Lanjut
PNS accommodation
188 25-09-2018 160102050918Y001111 0000120616143 RIDWAN SYAHRANI L PENERIMA PENSIUN Hyperplasia of prostate Rujuk Lanjut
PNS
189 25-09-2018 160102050918Y001114 0000120658072 HENNY P PENERIMA PENSIUN Chronic ischaemic heart Rujuk Lanjut
PNS disease, unspecified
190 25-09-2018 160102050918Y001112 0000120664056 MISRIATY P PENERIMA PENSIUN Chronic ischaemic heart Rujuk Lanjut
PNS disease, unspecified
191 25-09-2018 160102050918Y001110 0000120671032 SITI SUTIJANTI P PENERIMA PENSIUN Chronic ischaemic heart Berobat Jalan
PNS disease, unspecified
192 25-09-2018 160102050918Y001117 0000120674733 SUPANTO.H.DRS L PENERIMA PENSIUN Hyperplasia of prostate Rujuk Lanjut
PNS
193 25-09-2018 160102050918Y001095 0000120689425 NURACHMAN, BSC L PENERIMA PENSIUN Essential (primary) Berobat Jalan
PNS hypertension
194 25-09-2018 160102050918Y001152 0000120775105 PUSPAWATI P PNS DAERAH Dental caries, unspecified Berobat Jalan

195 25-09-2018 160102050918Y001104 0000120882868 MARDIONo L PNS DAERAH Chronic renal failure, Rujuk Lanjut
unspecified
196 25-09-2018 160102050918Y001136 0000123676953 RESSA SALSSA AULIA P PNS DAERAH Mucocele of salivary gland Rujuk Lanjut

197 25-09-2018 160102050918Y001138 0000123682037 BASYARIAH P PENERIMA PENSIUN Non-insulin-dependent Rujuk Lanjut
PNS diabetes mellitus without

198 25-09-2018 160102050918Y001094 0000123692523 SUPRIYATI P PNS DAERAH Essential (primary) Berobat Jalan
hypertension
199 25-09-2018 160102050918Y001124 0000123693873 WAHYU ADHIANTO L PNS DAERAH Hypertensive heart Rujuk Lanjut
disease
200 25-09-2018 160102050918Y001141 0000133256698 GUSTI SRI ANDARNI P PNS DAERAH Myalgia, shoulder region Berobat Jalan

201 25-09-2018 160102050918Y001128 0000162954843 BAKERI L PNS DAERAH Malignant neoplasm of Rujuk Lanjut
nasopharynx, unspecified
DAFTAR KUNJUNGAN PESERTA SAKIT

Kantor Cabang : SAMARINDA - 1601

FKTP : SEGIRI - 16010205

202 25-09-2018 160102050918Y001099 0000195003819 MASOLA BALISA L PNS DAERAH Non-insulin-dependent Rujuk Lanjut
diabetes mellitus with
neurological complications

203 25-09-2018 160102050918Y001149 0000902026067 KHALIF OKTIFAN YANI L PBI (APBN) Dental caries, unspecified Berobat Jalan

204 25-09-2018 160102050918Y001143 0000902382794 MURNIFAH P PBI (APBN) Acute nasopharyngitis Berobat Jalan
[common cold]
205 25-09-2018 160102050918Y001144 0000902463917 WA RASA P PBI (APBN) Myalgia, shoulder region Berobat Jalan

206 25-09-2018 160102050918Y001102 0000903222854 SAID UMAR UMAYAH L PBI (APBN) Essential (primary) Berobat Jalan
hypertension
207 25-09-2018 160102050918Y001129 0000903768513 MUT MAINAH P PBI (APBN) Fever, unspecified Berobat Jalan

208 25-09-2018 160102050918Y001107 0001066474822 DESI MARYATI P PBI (APBN) Foreign body in ear Rujuk Lanjut

209 25-09-2018 160102050918Y001122 0001066474901 ACHMAD YANI L PBI (APBN) Ascites Rujuk Lanjut

210 25-09-2018 160102050918Y001121 0001066480536 ENDANG SUPRIATI P PBI (APBN) Tinnitus Rujuk Lanjut

211 25-09-2018 160102050918Y001118 0001384795056 AQILA RAISA RAMADHANI P PEGAWAI SWASTA Zoster without Berobat Jalan
complication
212 25-09-2018 160102050918Y001098 0001426694253 ARYA ARDHIKA L PEGAWAI SWASTA Acute pharyngitis, Berobat Jalan
unspecified
213 25-09-2018 160102050918Y001135 0001546817736 ROBIYANTO L PEGAWAI SWASTA Thyrotoxicosis, Rujuk Lanjut
unspecified
214 25-09-2018 160102050918Y001132 0001775281779 HERLINA L. SITUMORANG P PEGAWAI SWASTA Essential (primary) Berobat Jalan
hypertension
215 25-09-2018 160102050918Y001134 0001923457004 MARTA SUE JALUNG P PEKERJA MANDIRI Malignant neoplasm of Rujuk Lanjut
nasopharynx
216 25-09-2018 160102050918Y001145 0001970066226 SUPARMI P PEKERJA MANDIRI Acute nasopharyngitis Berobat Jalan
[common cold]
217 25-09-2018 160102050918Y001131 0002037708099 JULIANUS HERU L PNS DAERAH Epilepsy, unspecified Rujuk Lanjut

218 25-09-2018 160102050918Y001120 0002061384153 ZAINAB P PEKERJA MANDIRI Non-insulin-dependent Rujuk Lanjut
diabetes mellitus without

219 25-09-2018 160102050818Y001003 0002062940163 ROSIDAH P PEKERJA MANDIRI Non-insulin-dependent Berobat Jalan
diabetes mellitus without

220 25-09-2018 160102050918Y001093 0002077217504 BAMBANG SUHARTONO L PEKERJA MANDIRI Myalgia, ankle and foot Berobat Jalan

221 25-09-2018 160102050918Y001147 0002085477963 ANISSA PATRICIA WAHAB P PEKERJA MANDIRI Fever, unspecified Berobat Jalan

222 25-09-2018 160102050918Y001139 0002088110171 ARSIFAH P PEKERJA MANDIRI Sequelae of stroke, not Rujuk Lanjut
specified as haemorrhage
DAFTAR KUNJUNGAN PESERTA SAKIT

Kantor Cabang : SAMARINDA - 1601

FKTP : SEGIRI - 16010205

223 25-09-2018 160102050918Y001123 0002197540866 SUMARDI HARTOYO L PEKERJA MANDIRI Sequelae of stroke, not Berobat Jalan
specified as haemorrhage

224 25-09-2018 160102050918Y001133 0002201374225 WINDARI P PEKERJA MANDIRI Malignant neoplasm of Rujuk Lanjut
cervix uteri, unspecified
225 25-09-2018 160102050918Y001113 0002203276037 SUPRAPTO L PEKERJA MANDIRI Cervical root disorders, not Rujuk Lanjut
elsewhere classified
226 25-09-2018 160102050918Y001100 0002204132962 DWI RETNO WULANDARI P PEKERJA MANDIRI Myopia Rujuk Lanjut

227 25-09-2018 160102050918Y001142 0002244498039 FAYYADH ABIMANYU SYAWAL L PEKERJA MANDIRI Acute nasopharyngitis Berobat Jalan
[common cold]
228 25-09-2018 160102050918Y001153 0002254960642 AGUSTAN L PEKERJA MANDIRI Necrosis of pulp Berobat Jalan

229 25-09-2018 160102050918Y001130 0002323805117 HENDRIKUS GANING L PBI (APBD) Other specified headache Rujuk Lanjut
syndromes
230 25-09-2018 160102050918Y001119 0002469421315 DESI NURYATI P PEKERJA MANDIRI Acute pharyngitis, Berobat Jalan
unspecified
231 25-09-2018 160102050918Y001146 0002479997417 NUR HASNAINI P PEKERJA MANDIRI Malignant neoplasm of Berobat Jalan
breast, unspecified
232 24-09-2018 160102050918Y001067 0000119718911 DWI TUGAS IRIANTO UTOMO L PNS DAERAH Chronic renal failure, Rujuk Lanjut
unspecified
233 24-09-2018 160102050918Y001058 0000120615208 RACHMINAWATI P PENERIMA PENSIUN Other disorders of ear, not Rujuk Lanjut
PNS elsewhere classified
234 24-09-2018 160102050918Y001062 0000120634402 ULZULKIPLI L PENERIMA PENSIUN Low back pain Rujuk Lanjut
PNS
235 24-09-2018 160102050918Y001044 0000120640599 THABRANIE NAWAWI L PENERIMA PENSIUN Chronic ischaemic heart Rujuk Lanjut
PNS disease, unspecified
236 24-09-2018 160102050918Y001075 0000120672674 SAMLAN,DRS, BCHK, H L PENERIMA PENSIUN Gastritis, unspecified Berobat Jalan
PNS
237 24-09-2018 160102050918Y001036 0000120704095 RAMIN REDJO L PENERIMA PENSIUN Hyperplasia of prostate Rujuk Lanjut
PNS
238 24-09-2018 160102050918Y001082 0000120800744 NANING ASMINAWATY P PNS DAERAH Essential (primary) Berobat Jalan
hypertension
239 24-09-2018 160102050918Y001038 0000120897426 PIRAWATI P PNS DAERAH Schizophrenia, unspecified Rujuk Lanjut

240 24-09-2018 160102050918Y001065 0000120927958 SYARIFUDDIN L PNS PUSAT Chronic ischaemic heart Rujuk Lanjut
disease, unspecified
241 24-09-2018 160102050918Y001064 0000120950008 TAPPE PIETER SUNDUN L PENERIMA PENSIUN Chronic ischaemic heart Rujuk Lanjut
PNS disease, unspecified
242 24-09-2018 160102050918Y001086 0000123111617 SIMON SAUNG L PENERIMA PENSIUN Dysphagia Berobat Jalan
PNS
243 24-09-2018 160102050918Y001105 0000123241893 PARTINEM P PENERIMA PENSIUN Necrosis of pulp Berobat Jalan
PNS
DAFTAR KUNJUNGAN PESERTA SAKIT

Kantor Cabang : SAMARINDA - 1601

FKTP : SEGIRI - 16010205

244 24-09-2018 160102050918Y001040 0000123285778 ERAWATY P PNS DAERAH Non-insulin-dependent Berobat Jalan
diabetes mellitus with
neurological complications

245 24-09-2018 160102050918Y001048 0000123676773 ANI MURDIANI P PNS DAERAH Low back pain Rujuk Lanjut

246 24-09-2018 160102050918Y001051 0000123677133 hj. ARPAH MASDALI, s.sos. P PNS DAERAH Necrosis of pulp Rujuk Lanjut
m.,kes
247 24-09-2018 160102050918Y001041 0000123678933 SYLVANA YOEDYANTO P PENERIMA PENSIUN Hemiplegia, unspecified Rujuk Lanjut
PNS
248 24-09-2018 160102050918Y001066 0000123679629 ELISABETH P PENERIMA PENSIUN Essential (primary) Berobat Jalan
PNS hypertension
249 24-09-2018 160102050918Y001061 0000210397206 NADYA ELIZABETH NAULI P PNS DAERAH Disorder of refraction, Rujuk Lanjut
LUMBAN TOBING unspecified
250 24-09-2018 160102050918Y001046 0000896846736 RINTAK L PBI (APBN) Chronic ischaemic heart Rujuk Lanjut
disease, unspecified
251 24-09-2018 160102050918Y001056 0000897730255 MARIMA ROSALIA DAHAI P PBI (APBN) Benign neoplasm of other Rujuk Lanjut
and unspecified sites

252 24-09-2018 160102050918Y001070 0000898416617 WARDANIAH P PBI (APBN) Malignant neoplasm of Rujuk Lanjut
endometrium
253 24-09-2018 160102050918Y001054 0000900398439 PASINAH P PBI (APBN) Malignant neoplasm of Rujuk Lanjut
cervix uteri, unspecified
254 24-09-2018 160102050918Y001080 0000902006559 NURUL IDAYANTI P PBI (APBN) Non-insulin-dependent Berobat Jalan
diabetes mellitus without

255 24-09-2018 160102050918Y001076 0000902128476 RATNA P PBI (APBN) Myalgia, shoulder region Berobat Jalan

256 24-09-2018 160102050918Y001103 0000902332956 NOOR INDAH MEI RIRIN .M P PBI (APBN) Necrosis of pulp Berobat Jalan

257 24-09-2018 160102050918Y001037 0000902626299 MARLIN CHRSITINA P PBI (APBN) Other specified headache Rujuk Lanjut
syndromes
258 24-09-2018 160102050918Y001092 0000902716391 ALIANSYAH ZULKARNAEN L PBI (APBN) Chronic ischaemic heart Berobat Jalan
disease, unspecified
259 24-09-2018 160102050918Y001083 0000903258819 FITRI P PBI (APBN) Acute nasopharyngitis Berobat Jalan
[common cold]
260 24-09-2018 160102050918Y001060 0000903436964 YATI MINATI P PBI (APBN) Asthma, unspecified Rujuk Lanjut

261 24-09-2018 160102050918Y001073 0000903450611 ADAM SAPUTRA L PBI (APBN) Superficial injury of lower Berobat Jalan
leg, unspecified
262 24-09-2018 160102050918Y001090 0000903924911 SAMIDE P PBI (APBN) Acute nasopharyngitis Berobat Jalan
[common cold]
263 24-09-2018 160102050918Y001042 0001066125802 HAMIYAH P PBI (APBN) Disorders of refraction and Rujuk Lanjut
accommodation
DAFTAR KUNJUNGAN PESERTA SAKIT

Kantor Cabang : SAMARINDA - 1601

FKTP : SEGIRI - 16010205

264 24-09-2018 160102050918Y001077 0001066474135 ADELIA ADINDA P PBI (APBN) Pain localized to other Berobat Jalan
parts of lower abdomen
265 24-09-2018 160102050918Y001088 0001066479873 NURDIN BARUS L PBI (APBN) Dermatophytosis, Berobat Jalan
unspecified
266 24-09-2018 160102050918Y001081 0001098172179 Muhammad RIZq MUHTAROM L ANGGOTA POLRI Acute nasopharyngitis Berobat Jalan
[common cold]
267 24-09-2018 160102050918Y001072 0001148628701 RONY TANDIARRANG L PEGAWAI BUMN Fever, unspecified Berobat Jalan

268 24-09-2018 160102050918Y001087 0001268373688 NASAN JONY SILALAHI raja L PEKERJA MANDIRI Non-insulin-dependent Berobat Jalan
diabetes mellitus without

269 24-09-2018 160102050918Y001043 0001283120008 NUR HANA P PEKERJA MANDIRI Spondylolysis, lumbar Rujuk Lanjut
region
270 24-09-2018 160102050918Y001049 0001445013977 SAIMAH P PEKERJA MANDIRI Malignant neoplasm of Rujuk Lanjut
cervix uteri, unspecified
271 24-09-2018 160102050918Y001089 0001549966623 SURIYATI P PEGAWAI SWASTA Essential (primary) Berobat Jalan
hypertension
272 24-09-2018 160102050918Y001053 0001553544832 BALE NJUK L PBI (APBD) Hodgkin lymphoma Rujuk Lanjut

273 24-09-2018 160102050918Y001106 0001925221779 SISWANTI P PBI (APBD) Necrosis of pulp Berobat Jalan

274 24-09-2018 160102050918Y001039 0001925223107 LUDIA PIRADE P PBI (APBD) Essential (primary) Rujuk Lanjut
hypertension
275 24-09-2018 160102050918Y001074 0001927055981 SITI RAMLAH P PEKERJA MANDIRI Low back pain Rujuk Lanjut

276 24-09-2018 160102050918Y001091 0001927205278 SRI PRAPTI P PEKERJA MANDIRI Myalgia, ankle and foot Berobat Jalan

277 24-09-2018 160102050918Y001079 0001972019362 NUR ASNI ASYARI P PEKERJA MANDIRI Headache Berobat Jalan

278 24-09-2018 160102050918Y001063 0002044194884 ALEXANDER PITER LUMBAN L PNS DAERAH Disorder of refraction, Rujuk Lanjut
TOBING unspecified
279 24-09-2018 160102050918Y001057 0002065034711 ROSITAH P PEKERJA MANDIRI Insulin-dependent Rujuk Lanjut
diabetes mellitus without

280 24-09-2018 160102050918Y001078 0002071329355 MUHAMMAD ARIS L PEKERJA MANDIRI Acute tonsillitis, Berobat Jalan
unspecified
281 24-09-2018 160102050918Y001059 0002073378622 GUNAWAN L PEKERJA MANDIRI Chronic ischaemic heart Rujuk Lanjut
disease, unspecified
282 24-09-2018 160102050918Y001055 0002081639092 WAHYU DIANA WATI P PEKERJA MANDIRI Supervision of high-risk Rujuk Lanjut
pregnancy
283 24-09-2018 160102050918Y001045 0002083965434 M. SYAIFUDIN ANWAR L PEKERJA MANDIRI Thalassaemia Rujuk Lanjut

284 24-09-2018 160102050918Y001109 0002194063749 RINA ASTUTI P PBI (APBD) Dental caries, unspecified Berobat Jalan

285 24-09-2018 160102050918Y001084 0002196404684 PANTI ASTUTI P PEKERJA MANDIRI Myalgia, shoulder region Berobat Jalan
DAFTAR KUNJUNGAN PESERTA SAKIT

Kantor Cabang : SAMARINDA - 1601

FKTP : SEGIRI - 16010205

286 24-09-2018 160102050918Y001069 0002229870071 YOHANI MATIAS P PEKERJA MANDIRI Malignant neoplasm of Rujuk Lanjut
cervix uteri, unspecified
287 24-09-2018 160102050918Y001052 0002231754311 NANI MISNAWATI P PEKERJA MANDIRI Primary arthrosis of other Rujuk Lanjut
joints, lower leg
288 24-09-2018 160102050918Y001108 0002245419191 SUGENG L PBI (APBD) Dental caries, unspecified Berobat Jalan

289 24-09-2018 160102050918Y001085 0002270330346 SUKARNI L PEKERJA MANDIRI Myalgia, shoulder region Berobat Jalan

290 24-09-2018 160102050918Y001068 0002290488276 DEVUNG P PBI (APBD) Abdominal and pelvic pain Rujuk Lanjut

291 24-09-2018 160102050918Y001047 0002299507367 WA INI P PBI (APBD) Spondylolysis, lumbar Rujuk Lanjut
region
292 24-09-2018 160102050918Y001050 0002325081835 NITA OKTAVIA L PEKERJA MANDIRI Psoriasis Rujuk Lanjut

293 24-09-2018 160102050918Y001071 0002446635161 PURWATI NINGSIH P PEKERJA MANDIRI Malignant neoplasm of Rujuk Lanjut
cervix uteri, unspecified
294 22-09-2018 160102050918Y001000 0000005421712 ARIFIN WAGIMAN L PENERIMA PENSIUN Other chronic renal failure Rujuk Lanjut
PNS
295 22-09-2018 160102050918Y001001 0000006198996 WINARTI MUKIYAT P PENERIMA PENSIUN Non-insulin-dependent Rujuk Lanjut
PNS diabetes mellitus without

296 22-09-2018 160102050918Y001014 0000120292637 MATOYAH P PNS PUSAT Non-insulin-dependent Berobat Jalan
diabetes mellitus with
neurological complications

297 22-09-2018 160102050918Y001012 0000120346211 D.TITO YOUMINARTO L PENERIMA PENSIUN Hyperplasia of prostate Rujuk Lanjut
PNS
298 22-09-2018 160102050918Y001027 0000120383965 RUSMINAH P PENERIMA PENSIUN Hypertensive heart Berobat Jalan
PNS disease
299 22-09-2018 160102050918Y001025 0000120590649 LAILIDA MOCHDAR P PENERIMA PENSIUN Chronic ischaemic heart Rujuk Lanjut
PNS disease, unspecified
300 22-09-2018 160102050918Y001004 0000120661121 SUDARMI P PENERIMA PENSIUN Chronic ischaemic heart Berobat Jalan
PNS disease, unspecified
301 22-09-2018 160102050918Y001020 0000120913604 KUKUH L PNS PUSAT Essential (primary) Rujuk Lanjut
hypertension
302 22-09-2018 160102050918Y001023 0000120914199 LA LORE L PNS PUSAT Essential (primary) Berobat Jalan
hypertension
303 22-09-2018 160102050918Y001018 0000121653573 AKMAL AJI RAHMADIN L PNS DAERAH Acute nasopharyngitis Berobat Jalan
[common cold]
304 22-09-2018 160102050918Y001022 0000126801898 SYAFINAR MUCHTARUDIN P PENERIMA PENSIUN TNI Other anxiety disorders Rujuk Lanjut

305 22-09-2018 160102050918Y001029 0000147877929 HAIRUNNISYAH WATI P PNS DAERAH Disorders of refraction and Rujuk Lanjut
accommodation
DAFTAR KUNJUNGAN PESERTA SAKIT

Kantor Cabang : SAMARINDA - 1601

FKTP : SEGIRI - 16010205

306 22-09-2018 160102050918Y001028 0000901934673 BAMBANG L PBI (APBN) Non-insulin-dependent Berobat Jalan
diabetes mellitus without

307 22-09-2018 160102050918Y001003 0000902036665 BARLIANG P PBI (APBN) Sequelae of stroke, not Berobat Jalan
specified as haemorrhage

308 22-09-2018 160102050918Y001011 0000902500402 MISNIADI L PBI (APBN) Other disorders of lens Rujuk Lanjut

309 22-09-2018 160102050918Y001016 0000902679041 ERYANI P PBI (APBN) Abdominal and pelvic pain Rujuk Lanjut

310 22-09-2018 160102050918Y001034 0000902795185 EKO HANDOYO L PBI (APBN) Fever, unspecified Berobat Jalan

311 22-09-2018 160102050918Y001015 0000903213584 SUKMA P PBI (APBN) Other spondylosis with Rujuk Lanjut
myelopathy, lumbar region

312 22-09-2018 160102050918Y001017 0000903230864 RASMADI L PBI (APBN) Chronic ischaemic heart Berobat Jalan
disease, unspecified
313 22-09-2018 160102050918Y001002 0000903544558 NIAM ZAINUR ROMADHON L PBI (APBN) Epilepsy Berobat Jalan

314 22-09-2018 160102050918Y001013 0000948459914 KAMSUDIN L PBI (APBN) Cough Rujuk Lanjut

315 22-09-2018 160102050918Y001006 0000976689257 SOFIE FARISTINA P PNS PUSAT Supervision of high-risk Rujuk Lanjut
pregnancy
316 22-09-2018 160102050918Y001033 0001925222534 SUMARI L PBI (APBD) Acute nasopharyngitis Berobat Jalan
[common cold]
317 22-09-2018 160102050918Y001019 0001929375641 PUTRI APRILLIANIK P PBI (APBD) Impacted cerumen Rujuk Lanjut

318 22-09-2018 160102050918Y001024 0002054914615 YULIANI P PEKERJA MANDIRI Abrasion of teeth Rujuk Lanjut

319 22-09-2018 160102050918Y001035 0002060451191 SAMSIAH P PEKERJA MANDIRI Allergic contact dermatitis, Berobat Jalan
unspecified cause

320 22-09-2018 160102050918Y001008 0002060903079 HAPSYAH P PEKERJA MANDIRI Non-insulin-dependent Rujuk Lanjut
diabetes mellitus with

321 22-09-2018 160102050918Y001026 0002072851018 M. MARSILAN L PEKERJA MANDIRI Diarrhoea and Berobat Jalan
gastroenteritis of
presumed infectious origin

322 22-09-2018 160102050918Y001030 0002079162123 MUHAMMAD KENZHI AL MAJID L PEKERJA MANDIRI Surgical follow-up care, Berobat Jalan
unspecified
323 22-09-2018 160102050918Y001032 0002194783659 JIHAN RAYYA ZULFA L PEGAWAI SWASTA Pain localized to other Berobat Jalan
parts of lower abdomen
324 22-09-2018 160102050918Y001009 0002201822313 MARIAM P PEKERJA MANDIRI Low back pain Rujuk Lanjut

325 22-09-2018 160102050918Y001005 0002203276037 SUPRAPTO L PEKERJA MANDIRI Hypertensive heart Berobat Jalan
disease
DAFTAR KUNJUNGAN PESERTA SAKIT

Kantor Cabang : SAMARINDA - 1601

FKTP : SEGIRI - 16010205

326 22-09-2018 160102050918Y001007 0002203276307 MUSINAH P PEKERJA MANDIRI Stroke, not specified as Rujuk Lanjut
haemorrhage or infarction
327 22-09-2018 160102050918Y001021 0002225691505 JUNAEDI L PEKERJA MANDIRI Surgical follow-up care, Rujuk Lanjut
unspecified
328 22-09-2018 160102050918Y001115 0002229796721 AULIA NAFISAH P PEKERJA MANDIRI Acute nasopharyngitis Berobat Jalan
[common cold]
329 22-09-2018 160102050918Y001031 0002443456765 ELO LINAWATI P PEKERJA MANDIRI Hyperlipidaemia, Berobat Jalan
unspecified
330 22-09-2018 160102050918Y001010 0002464327901 raFITRI L PEKERJA MANDIRI Low vision, both eyes Rujuk Lanjut

331 21-09-2018 160102050918Y000963 0000106578099 NAJAMUDDIN L PNS PUSAT Essential (primary) Berobat Jalan
hypertension
332 21-09-2018 160102050918Y000993 0000120549159 ASTINI P PNS DAERAH Chronic ischaemic heart Berobat Jalan
disease, unspecified
333 21-09-2018 160102050918Y000935 0000120612813 RUSMINI P PENERIMA PENSIUN Chronic ischaemic heart Rujuk Lanjut
PNS disease, unspecified
334 21-09-2018 160102050918Y000945 0000123681813 BASO TURUN BUA L PENERIMA PENSIUN Hyperplasia of prostate Rujuk Lanjut
PNS
335 21-09-2018 160102050918Y000988 0000123682307 IDA RUSMI P PNS DAERAH Non-insulin-dependent Berobat Jalan
diabetes mellitus without

336 21-09-2018 160102050918Y000990 0000123682318 RUSTAM L PNS DAERAH Sequelae of stroke, not Berobat Jalan
specified as haemorrhage

337 21-09-2018 160102050918Y000994 0000123684658 MARSONO L PNS DAERAH Sequelae of stroke, not Berobat Jalan
specified as haemorrhage

338 21-09-2018 160102050918Y000967 0000123693399 THERESIA SRI LESTARI P PNS DAERAH Low back pain Rujuk Lanjut

339 21-09-2018 160102050918Y000949 0000518648995 RUSIMIN L PBI (APBN) Convulsions, not Rujuk Lanjut
elsewhere classified
340 21-09-2018 160102050918Y000978 0000898770082 FETTY FAJRIANTI P PBI (APBN) Fracture of femur, part Rujuk Lanjut
unspecified
341 21-09-2018 160102050918Y000932 0000901899369 FEBRI LAILATUL HUSNA P PBI (APBN) Mucocele of salivary gland Rujuk Lanjut

342 21-09-2018 160102050918Y000936 0000902035269 MASNIAH P PBI (APBN) Essential (primary) Berobat Jalan
hypertension
343 21-09-2018 160102050918Y000928 0000902502516 FAUZI L PBI (APBN) Decubitus ulcer Berobat Jalan

344 21-09-2018 160102050918Y000997 0000902739723 MUHAMMAD ABDUL AZIS L PBI (APBN) Acute nasopharyngitis Berobat Jalan
[common cold]
345 21-09-2018 160102050918Y000933 0000903360857 MASMINAH P PBI (APBN) Senile cataract Rujuk Lanjut

346 21-09-2018 160102050918Y000956 0000903395294 SALEH L PBI (APBN) Acute nasopharyngitis Berobat Jalan
[common cold]
DAFTAR KUNJUNGAN PESERTA SAKIT

Kantor Cabang : SAMARINDA - 1601

FKTP : SEGIRI - 16010205

347 21-09-2018 160102050918Y000943 0001066476396 KAMISAH P PBI (APBN) Myalgia, shoulder region Berobat Jalan

348 21-09-2018 160102050918Y000938 0001066476914 SUNARSIH P PBI (APBN) Essential (primary) Berobat Jalan
hypertension
349 21-09-2018 160102050918Y000989 0001066478804 WARSINI P PBI (APBN) Myalgia, ankle and foot Rujuk Lanjut

350 21-09-2018 160102050918Y000964 0001066479873 NURDIN BARUS L PBI (APBN) Low back pain Rujuk Lanjut

351 21-09-2018 160102050918Y000985 0001203050283 FARIDA P PEGAWAI SWASTA Other benign neoplasm of Rujuk Lanjut
connective and other soft

352 21-09-2018 160102050918Y000980 0001445777864 NOOR AISYAH P PEKERJA MANDIRI Chronic ischaemic heart Rujuk Lanjut
disease, unspecified
353 21-09-2018 160102050918Y000999 0001484377582 AHMAD AFFANTIAN L PEGAWAI SWASTA Impacted cerumen Berobat Jalan

354 21-09-2018 160102050918Y000984 0001611811192 PETRUS HIBAU LIAH L PBI (APBD) Chronic ischaemic heart Rujuk Lanjut
disease, unspecified
355 21-09-2018 160102050918Y000996 0001725146717 MELI ANDRI YANI P PEGAWAI SWASTA Diarrhoea and Berobat Jalan
gastroenteritis of
presumed infectious origin

356 21-09-2018 160102050918Y000998 0001742977361 LUSLI YANDI L PEGAWAI SWASTA Diarrhoea and Berobat Jalan
gastroenteritis of
presumed infectious origin

357 21-09-2018 160102050918Y000937 0001925224896 NURAENI P PBI (APBD) Dyspepsia Rujuk Lanjut

358 21-09-2018 160102050918Y000952 0001925230454 ZAINAL ABIDIN L PBI (APBD) Schizophrenia, unspecified Rujuk Lanjut

359 21-09-2018 160102050918Y000962 0001963314112 RA.IRIANDI WARGANEGARA L PEKERJA MANDIRI Hyperplasia of prostate Rujuk Lanjut

360 21-09-2018 160102050918Y000955 0002203276037 SUPRAPTO L PEKERJA MANDIRI Chronic obstructive Rujuk Lanjut
pulmonary disease with
acute exacerbation,

361 21-09-2018 160102050918Y000951 0002203276307 MUSINAH P PEKERJA MANDIRI Stroke, not specified as Berobat Jalan
haemorrhage or infarction
362 21-09-2018 160102050918Y000965 0002270330346 SUKARNI L PEKERJA MANDIRI Myalgia, ankle and foot Berobat Jalan

363 21-09-2018 160102050918Y000973 0002290488175 AMIR L PBI (APBD) Psoriasis, unspecified Rujuk Lanjut

364 21-09-2018 160102050918Y000987 0002305389835 ELSA SYAVINA KUSUMAWARDI P PEKERJA MANDIRI Disorders of refraction and Rujuk Lanjut
accommodation
365 21-09-2018 160102050918Y000966 0002319876191 SLAMET L PEKERJA MANDIRI Dyspepsia Berobat Jalan

366 21-09-2018 160102050918Y000941 0002419593489 KARSINI P PEKERJA MANDIRI Non-insulin-dependent Berobat Jalan
diabetes mellitus without
DAFTAR KUNJUNGAN PESERTA SAKIT

Kantor Cabang : SAMARINDA - 1601

FKTP : SEGIRI - 16010205

367 21-09-2018 160102050918Y000992 0002425544076 ADULLAH L PEKERJA MANDIRI Acute nasopharyngitis Berobat Jalan
[common cold]
368 21-09-2018 160102050918Y000991 0002425544469 SITI AISYAH P PEKERJA MANDIRI Oedema, unspecified Berobat Jalan

369 21-09-2018 160102050918Y000995 0002438204545 KANZANA AHMAD P PEKERJA MANDIRI Allergic contact dermatitis, Berobat Jalan
unspecified cause

370 20-09-2018 160102050918Y000912 0000120658061 MURDJANI PATHUR L PENERIMA PENSIUN Non-insulin-dependent Berobat Jalan
PNS diabetes mellitus without

371 20-09-2018 160102050918Y000895 0000120672674 SAMLAN,DRS, BCHK, H L PENERIMA PENSIUN Chronic ischaemic heart Berobat Jalan
PNS disease, unspecified
372 20-09-2018 160102050918Y000901 0000120739961 SOFIANSYAH L PNS DAERAH Chronic ischaemic heart Rujuk Lanjut
disease, unspecified
373 20-09-2018 160102050918Y000896 0000121111727 ZAINAL ARIFIN. BE L PENERIMA PENSIUN Hyperplasia of prostate Rujuk Lanjut
PNS
374 20-09-2018 160102050918Y000894 0000123692523 SUPRIYATI P PNS DAERAH Gonarthrosis [arthrosis of Rujuk Lanjut
knee]
375 20-09-2018 160102050918Y000909 0000898414255 SENATI P PBI (APBN) Intracranial Rujuk Lanjut
space-occupying lesion
376 20-09-2018 160102050918Y000918 0000899277491 HENNI WATI P PBI (APBN) Low back pain Rujuk Lanjut

377 20-09-2018 160102050918Y000905 0000902015245 SUDARMI P PBI (APBN) Presbyopia Rujuk Lanjut

378 20-09-2018 160102050918Y000913 0000902744627 RAUDAH P PBI (APBN) Cough Rujuk Lanjut

379 20-09-2018 160102050918Y000924 0000902870021 NORMA SARI P PBI (APBN) Essential (primary) Berobat Jalan
hypertension
380 20-09-2018 160102050918Y000904 0000903837644 SUPATIAH P PBI (APBN) Chronic ischaemic heart Rujuk Lanjut
disease, unspecified
381 20-09-2018 160102050918Y000902 0001100521967 YEtTI SUSANTI P ANGGOTA POLRI Chronic ischaemic heart Berobat Jalan
disease, unspecified
382 20-09-2018 160102050918Y000917 0001473974166 HAMSAH L PEKERJA MANDIRI Chronic kidney disease Rujuk Lanjut

383 20-09-2018 160102050918Y000899 0001923352446 MERKURIUS L PNS DAERAH Epilepsy Rujuk Lanjut

384 20-09-2018 160102050918Y000923 0001925222286 ABDUL RAZAK MUSTAFA L PBI (APBD) Essential (primary) Berobat Jalan
hypertension
385 20-09-2018 160102050918Y000908 0001925232579 YULI SUPIANI P PBI (APBD) Submucous leiomyoma of Rujuk Lanjut
uterus
386 20-09-2018 160102050918Y000925 0002035524846 NAURA ZERLITA ADIBA P PNS DAERAH Allergic contact dermatitis, Berobat Jalan
unspecified cause

387 20-09-2018 160102050918Y000900 0002063784701 SAHRUL TAJUDIN L PEKERJA MANDIRI Chronic ischaemic heart Rujuk Lanjut
disease, unspecified
DAFTAR KUNJUNGAN PESERTA SAKIT

Kantor Cabang : SAMARINDA - 1601

FKTP : SEGIRI - 16010205

388 20-09-2018 160102050918Y000914 0002086109976 NOR RAHMAWATI P PEKERJA MANDIRI Deposits [accretions] on Rujuk Lanjut
teeth
389 20-09-2018 160102050918Y000915 0002196395572 DWI ROSO PRASETYO L PEKERJA MANDIRI Other orthopaedic Rujuk Lanjut
follow-up care
390 20-09-2018 160102050918Y000897 0002201822313 MARIAM P PEKERJA MANDIRI Myalgia, multiple sites Berobat Jalan

391 20-09-2018 160102050918Y000916 0002215302546 GADIS RISMA SEPTIANANDA P PEKERJA MANDIRI Superficial injury of lower Rujuk Lanjut
leg, unspecified
392 20-09-2018 160102050918Y000910 0002269904499 abraham saputra L PEGAWAI SWASTA Diarrhoea and Berobat Jalan
gastroenteritis of
presumed infectious origin

393 20-09-2018 160102050918Y000919 0002284818647 NORSIAH P PEKERJA MANDIRI Dental caries, unspecified Berobat Jalan

394 20-09-2018 160102050918Y000921 0002299531285 FITA DWI RATNAWATI P PEKERJA MANDIRI Delivery by caesarean Rujuk Lanjut
section, unspecified
395 20-09-2018 160102050918Y000907 0002317500821 JUWITA HB P PEKERJA MANDIRI Non-insulin-dependent Berobat Jalan
diabetes mellitus without

396 20-09-2018 160102050918Y000898 0002327931718 KEMAL AHMAD L PEKERJA MANDIRI Periapical abscess without Rujuk Lanjut
sinus
397 20-09-2018 160102050918Y000920 0002378081452 ANDRIANE M SAKUDU P PEKERJA MANDIRI Benign paroxysmal vertigo Rujuk Lanjut

398 20-09-2018 160102050918Y000906 0002430191766 DJAMAH P PEKERJA MANDIRI Non-insulin-dependent Berobat Jalan
diabetes mellitus without

399 20-09-2018 160102050918Y000911 0002443579031 SUMARI L PEKERJA MANDIRI Heart failure, unspecified Rujuk Lanjut

400 20-09-2018 160102050918Y000903 0002456631347 MUHAMMAD RASKA MAHESYA L PEKERJA MANDIRI Acute nasopharyngitis Berobat Jalan
PRATAMA [common cold]
401 20-09-2018 160102050918Y000922 0002465755446 BADARUDDIN L PEKERJA MANDIRI Tuberculosis of other Rujuk Lanjut
specified organs
402 19-09-2018 160102050918Y000878 0000119672572 AMNAH.B P PENERIMA PENSIUN Chronic ischaemic heart Rujuk Lanjut
PNS disease, unspecified
403 19-09-2018 160102050918Y000856 0000119934955 PERIDA P PENERIMA PENSIUN After-cataract Rujuk Lanjut
PNS
404 19-09-2018 160102050918Y000888 0000120066941 MAULANA RIQI RIZQI L PEKERJA MANDIRI Unspecified haemorrhoids Berobat Jalan
without complication

405 19-09-2018 160102050918Y000848 0000120366088 JAWAKIN SIMANJUNTAK L PENERIMA PENSIUN Non-insulin-dependent Rujuk Lanjut
PNS diabetes mellitus without

406 19-09-2018 160102050918Y000855 0000120513251 RUSMINI P PENERIMA PENSIUN TNI Essential (primary) Berobat Jalan
hypertension
DAFTAR KUNJUNGAN PESERTA SAKIT

Kantor Cabang : SAMARINDA - 1601

FKTP : SEGIRI - 16010205

407 19-09-2018 160102050918Y000851 0000120656698 TUKIRAH P PENERIMA PENSIUN Essential (primary) Berobat Jalan
PNS hypertension
408 19-09-2018 160102050918Y000877 0000120659343 E.A. SYARWANI BBA L PENERIMA PENSIUN Acute nasopharyngitis Berobat Jalan
PNS [common cold]
409 19-09-2018 160102050918Y000864 0000120666611 KASPOEL BASRAN L PENERIMA PENSIUN Non-insulin-dependent Rujuk Lanjut
PNS diabetes mellitus without

410 19-09-2018 160102050918Y000845 0000120666868 LEGIMAN L PENERIMA PENSIUN Cough Berobat Jalan
PNS
411 19-09-2018 160102050918Y000843 0000120674542 SUMARDJI L PENERIMA PENSIUN Polycythaemia vera Rujuk Lanjut
PNS
412 19-09-2018 160102050918Y000850 0000120678131 ABIDINSYAH L PENERIMA PENSIUN Zoster without Berobat Jalan
PNS complication
413 19-09-2018 160102050918Y000871 0000121789427 SUHERaWATI P PNS DAERAH Malignant neoplasm of Rujuk Lanjut
breast, unspecified
414 19-09-2018 160102050918Y000883 0000123039933 ROLAM SIMANULLANG L PNS DAERAH Non-insulin-dependent Berobat Jalan
diabetes mellitus without

415 19-09-2018 160102050918Y000891 0000198560799 DARMAWATI P PNS PUSAT Acute nasopharyngitis Berobat Jalan
[common cold]
416 19-09-2018 160102050918Y000868 0000897391113 YULI KARMILA P PBI (APBN) Dyspepsia Berobat Jalan

417 19-09-2018 160102050918Y000857 0000902035269 MASNIAH P PBI (APBN) Essential (primary) Berobat Jalan
hypertension
418 19-09-2018 160102050918Y000890 0000902481456 WA NDEPA P PBI (APBN) Myalgia, shoulder region Berobat Jalan

419 19-09-2018 160102050918Y000863 0000902566776 YUSRANSYAH L PBI (APBN) Other disorders of urinary Rujuk Lanjut
system
420 19-09-2018 160102050918Y000882 0000902601595 YUSNANIK P PBI (APBN) Benign paroxysmal vertigo Berobat Jalan

421 19-09-2018 160102050918Y000881 0000902676947 SANTI HIDIANTI P PBI (APBN) Dyspepsia Berobat Jalan

422 19-09-2018 160102050918Y000847 0000902927215 FASTABIQUL KHAIRAT L PBI (APBN) Acute nasopharyngitis Berobat Jalan
[common cold]
423 19-09-2018 160102050918Y000884 0000903894467 MAIMUNAH P PBI (APBN) Vertiginous syndromes in Berobat Jalan
diseases classified

424 19-09-2018 160102050918Y000880 0001066477983 ISMAIL L PBI (APBN) Other peripheral vertigo Berobat Jalan

425 19-09-2018 160102050918Y000886 0001066478916 SITI AMINAH P PBI (APBN) Essential (primary) Berobat Jalan
hypertension
426 19-09-2018 160102050918Y000861 0001066483315 MASRANI L PBI (APBN) Chronic ischaemic heart Rujuk Lanjut
disease, unspecified
427 19-09-2018 160102050918Y000858 0001100351384 DJAFAR PRASMONO L ANGGOTA POLRI Chronic viral hepatitis B Rujuk Lanjut
without delta-agent
DAFTAR KUNJUNGAN PESERTA SAKIT

Kantor Cabang : SAMARINDA - 1601

FKTP : SEGIRI - 16010205

428 19-09-2018 160102050918Y000893 0001150843454 BELLA RAHMA DWI PUTRI L PEGAWAI SWASTA Acute nasopharyngitis Berobat Jalan
[common cold]
429 19-09-2018 160102050918Y000867 0001177237991 YASINTA P PEGAWAI SWASTA Headache Berobat Jalan

430 19-09-2018 160102050918Y000865 0001177238002 GILANG EKA RENDRA GRAHA L PEGAWAI SWASTA Superficial injury of head, Rujuk Lanjut
part unspecified
431 19-09-2018 160102050918Y000873 0001619875765 SULISTYOWATI P PEKERJA MANDIRI Hypertensive heart Rujuk Lanjut
disease
432 19-09-2018 160102050918Y000879 0001725420216 RAHEL MARIA SAPUTRI P PEKERJA MANDIRI Dyspepsia Berobat Jalan

433 19-09-2018 160102050918Y000844 0001925222995 USNEIDI L PBI (APBD) Chronic ischaemic heart Rujuk Lanjut
disease, unspecified
434 19-09-2018 160102050918Y000866 0001925232557 RUSDIANSYAH L PBI (APBD) Cough Berobat Jalan

435 19-09-2018 160102050918Y000862 0001925232579 YULI SUPIANI P PBI (APBD) Secondary amenorrhoea Rujuk Lanjut

436 19-09-2018 160102050918Y000887 0001926723868 SUKINAH P PEKERJA MANDIRI Benign neoplasm of Berobat Jalan
unspecified site
437 19-09-2018 160102050918Y000869 0001928653255 SRI WIDIASTUTI P PBI (APBD) Pain localized to other Berobat Jalan
parts of lower abdomen
438 19-09-2018 160102050918Y000846 0001970066226 SUPARMI P PEKERJA MANDIRI Chronic ischaemic heart Rujuk Lanjut
disease, unspecified
439 19-09-2018 160102050918Y000854 0002001383616 SITI MASNAH P PBI (APBN) Essential (primary) Berobat Jalan
hypertension
440 19-09-2018 160102050918Y000874 0002061302084 SAMAIYAH P PEKERJA MANDIRI Hyperlipidaemia, Berobat Jalan
unspecified
441 19-09-2018 160102050918Y000849 0002077217504 BAMBANG SUHARTONO L PEKERJA MANDIRI Hyperplasia of prostate Rujuk Lanjut

442 19-09-2018 160102050918Y000889 0002083722489 RUBIYANTI P PEKERJA MANDIRI Essential (primary) Berobat Jalan
hypertension
443 19-09-2018 160102050918Y000872 0002203276037 SUPRAPTO L PEKERJA MANDIRI Cervical root disorders, not Rujuk Lanjut
elsewhere classified
444 19-09-2018 160102050918Y000885 0002210925677 MUHAMMAD TIRTA HASAN L PEGAWAI BUMD Acute nasopharyngitis Berobat Jalan
RIFA'I [common cold]
445 19-09-2018 160102050918Y000892 0002211599755 WA NIA P PEKERJA MANDIRI Myalgia, shoulder region Berobat Jalan

446 19-09-2018 160102050918Y000860 0002217136735 MOH NURYADIN L PEKERJA MANDIRI Myalgia, ankle and foot Berobat Jalan

447 19-09-2018 160102050918Y000876 0002222776427 RESKI UTAMI P PEKERJA MANDIRI Impacted teeth Rujuk Lanjut

448 19-09-2018 160102050918Y000875 0002233101756 JUMAIDAH P PBI (APBD) Acute nasopharyngitis Berobat Jalan
[common cold]
449 19-09-2018 160102050918Y000870 0002235819126 ARKANA PUTRA RAIHAN L PEKERJA MANDIRI Fever, unspecified Berobat Jalan

450 19-09-2018 160102050918Y000859 0002294990122 YATIM P PEKERJA MANDIRI Benign neoplasm of Rujuk Lanjut
unspecified site
DAFTAR KUNJUNGAN PESERTA SAKIT

Kantor Cabang : SAMARINDA - 1601

FKTP : SEGIRI - 16010205

451 19-09-2018 160102050918Y000852 0002327464517 NOR HAMALAH P PEKERJA MANDIRI Acute nasopharyngitis Berobat Jalan
[common cold]
452 19-09-2018 160102050918Y000853 0002327470806 NURUS SYIFA INAYAH P PEKERJA MANDIRI Mumps without Berobat Jalan
complication
453 18-09-2018 160102050918Y000820 0000120040345 HERMIN TATTO P PNS DAERAH Chronic ischaemic heart Rujuk Lanjut
disease, unspecified
454 18-09-2018 160102050918Y000815 0000120109948 PAYA PANGKUNG P PNS DAERAH Loss of teeth due to Rujuk Lanjut
accident, extraction or

455 18-09-2018 160102050918Y000823 0000120277686 SUSILAWATI P PNS PUSAT Disorder of refraction, Rujuk Lanjut
unspecified
456 18-09-2018 160102050918Y000822 0000120427053 MATNOH ASRA L PENERIMA PENSIUN Disorder of refraction, Rujuk Lanjut
PNS unspecified
457 18-09-2018 160102050918Y000835 0000120554559 ABDILLAH L PENERIMA PENSIUN Chronic ischaemic heart Rujuk Lanjut
PNS disease, unspecified
458 18-09-2018 160102050918Y000817 0000120561322 BURING P PENERIMA PENSIUN After-cataract Rujuk Lanjut
PNS
459 18-09-2018 160102050918Y000806 0000120671662 RUSLI L PENERIMA PENSIUN Non-insulin-dependent Berobat Jalan
PNS diabetes mellitus without

460 18-09-2018 160102050918Y000841 0000120674081 SUHADI L PENERIMA PENSIUN Acute nasopharyngitis Berobat Jalan
PNS [common cold]
461 18-09-2018 160102050918Y000805 0000120674362 SUKIRNO L PENERIMA PENSIUN Essential (primary) Berobat Jalan
PNS hypertension
462 18-09-2018 160102050918Y000818 0000120684971 H. MUSTAFA L PENERIMA PENSIUN TNI Chronic ischaemic heart Rujuk Lanjut
disease, unspecified
463 18-09-2018 160102050918Y000808 0000120685893 IR TL TOBING L PENERIMA PENSIUN Non-insulin-dependent Berobat Jalan
PNS diabetes mellitus without

464 18-09-2018 160102050918Y000836 0000120907945 FADJAR PAMBUDHI L PNS PUSAT Non-insulin-dependent Rujuk Lanjut
diabetes mellitus without

465 18-09-2018 160102050918Y000831 0000123682487 INDRA JAYA L PENERIMA PENSIUN Acute pharyngitis, Berobat Jalan
PNS unspecified
466 18-09-2018 160102050918Y000809 0000123726341 TUKIMIN L PNS DAERAH Unstable angina Rujuk Lanjut

467 18-09-2018 160102050918Y000842 0000147818351 ACHMAD ZAKKI MUBARROK L PNS DAERAH Surgical follow-up care, Berobat Jalan
unspecified
468 18-09-2018 160102050918Y000839 0000204966268 PENSIUS L PNS DAERAH Chronic ischaemic heart Rujuk Lanjut
disease, unspecified
469 18-09-2018 160102050918Y000807 0000211198127 SURATMI P PNS DAERAH Non-insulin-dependent Berobat Jalan
diabetes mellitus without
DAFTAR KUNJUNGAN PESERTA SAKIT

Kantor Cabang : SAMARINDA - 1601

FKTP : SEGIRI - 16010205

470 18-09-2018 160102050918Y000828 0000735425032 LISNOWATI P PBI (APBN) Supervision of normal Rujuk Lanjut
pregnancy, unspecified
471 18-09-2018 160102050918Y000840 0000895896235 RUDI PURNOMO L PBI (APBN) Acute pharyngitis, Berobat Jalan
unspecified
472 18-09-2018 160102050918Y000827 0000896453943 YULIA WATI P PBI (APBN) Malignant neoplasm of Rujuk Lanjut
cervix uteri, unspecified
473 18-09-2018 160102050918Y000821 0000896776852 SITI RAHMAH P PBI (APBN) Thyrotoxicosis, Rujuk Lanjut
unspecified
474 18-09-2018 160102050918Y000804 0000901882923 SUGENG HARYANTO L PBI (APBN) Non-insulin-dependent Berobat Jalan
diabetes mellitus without

475 18-09-2018 160102050918Y000819 0000902137825 SUKAMTO L PBI (APBN) Surgical follow-up care, Rujuk Lanjut
unspecified
476 18-09-2018 160102050918Y000801 0000902621507 WA SETI P PBI (APBN) Acute pharyngitis, Berobat Jalan
unspecified
477 18-09-2018 160102050918Y000816 0001066475496 WA TUI P PBI (APBN) Disorder of refraction, Rujuk Lanjut
unspecified
478 18-09-2018 160102050918Y000825 0001071602728 MAHMUD L PBI (APBN) Chest pain, unspecified Rujuk Lanjut

479 18-09-2018 160102050918Y000802 0001725503073 ANIP SUSANTO L PEKERJA MANDIRI Superficial frostbite of Berobat Jalan
other and unspecified sites

480 18-09-2018 160102050918Y000813 0001734278106 BEN AHMAD HAFIZ L PEKERJA MANDIRI Acute nasopharyngitis Berobat Jalan
PANOTOGOMO [common cold]
481 18-09-2018 160102050918Y000811 0001925221825 PAINO L PBI (APBD) Other headache Rujuk Lanjut
syndromes
482 18-09-2018 160102050918Y000812 0001925240038 BAMBANG SURYONO L PBI (APBD) Chronic ischaemic heart Berobat Jalan
disease, unspecified
483 18-09-2018 160102050918Y000826 0002054914615 YULIANI P PEKERJA MANDIRI Spinal enthesopathy, Rujuk Lanjut
cervicothoracic region
484 18-09-2018 160102050918Y000838 0002064033606 GT. SAIBATUL ASLAMIAH P PEKERJA MANDIRI Essential (primary) Berobat Jalan
hypertension
485 18-09-2018 160102050918Y000803 0002069303556 AIDA RUSLIAH P PEKERJA MANDIRI Chronic ischaemic heart Rujuk Lanjut
disease, unspecified
486 18-09-2018 160102050918Y000837 0002071328973 SADDIAH P PEKERJA MANDIRI Essential (primary) Berobat Jalan
hypertension
487 18-09-2018 160102050918Y000830 0002086109976 NOR RAHMAWATI P PEKERJA MANDIRI Chronic post-traumatic Rujuk Lanjut
headache
488 18-09-2018 160102050918Y000824 0002236646575 AZRINA RAZIYA SHAZFA P PEGAWAI SWASTA Cytomegaloviral Rujuk Lanjut
mononucleosis
489 18-09-2018 160102050918Y000814 0002260057645 ABD. LATIF L PEKERJA MANDIRI Hyperplasia of prostate Rujuk Lanjut

490 18-09-2018 160102050918Y000833 0002261547314 ZAKIYA P PEGAWAI SWASTA Other acute sinusitis Rujuk Lanjut
DAFTAR KUNJUNGAN PESERTA SAKIT

Kantor Cabang : SAMARINDA - 1601

FKTP : SEGIRI - 16010205

491 18-09-2018 160102050918Y000810 0002317500573 HAMRAN AB L PEKERJA MANDIRI Non-insulin-dependent Rujuk Lanjut
diabetes mellitus with

492 18-09-2018 160102050918Y000834 0002433696366 YUWANDI YUNUS L PEGAWAI SWASTA Tuberculosis of lung, Rujuk Lanjut
without mention of
bacteriological or

493 18-09-2018 160102050918Y000829 0002437496831 USMAN L PEKERJA MANDIRI Chronic renal failure, Rujuk Lanjut
unspecified
494 18-09-2018 160102050918Y000832 0002476597566 YUNITA EKA SRI MULYANTI P PEKERJA MANDIRI Headache Berobat Jalan

495 17-09-2018 160102050918Y000717 0000120217397 E.A. SURYANTO, DRS L PENERIMA PENSIUN Essential (primary) Berobat Jalan
PNS hypertension
496 17-09-2018 160102050918Y000755 0000120281398 SjAMSUL HADI L PENERIMA PENSIUN Non-insulin-dependent Berobat Jalan
PNS diabetes mellitus without

497 17-09-2018 160102050918Y000739 0000120292839 NURKHOIRIAH HARAHAP P PNS PUSAT Adhesive capsulitis of Rujuk Lanjut
shoulder
498 17-09-2018 160102050918Y000699 0000120442487 WISBAR ALDAR L PNS DAERAH Chronic ischaemic heart Berobat Jalan
disease, unspecified
499 17-09-2018 160102050918Y000730 0000120488984 SYAPRUDDIN L PEGAWAI PEMERINTAH Chronic ischaemic heart Rujuk Lanjut
DENGAN PERJANJIAN disease, unspecified

500 17-09-2018 160102050918Y000781 0000120549172 ERNAWATI P PNS DAERAH Other disorders of urinary Berobat Jalan
system
501 17-09-2018 160102050918Y000723 0000120659343 E.A. SYARWANI BBA L PENERIMA PENSIUN Chronic ischaemic heart Rujuk Lanjut
PNS disease, unspecified
502 17-09-2018 160102050918Y000735 0000120666701 RUSNIAH P PENERIMA PENSIUN Cardiac arrhythmia, Rujuk Lanjut
PNS unspecified
503 17-09-2018 160102050918Y000757 0000120674057 SUGIARTO L PENERIMA PENSIUN Acute nasopharyngitis Berobat Jalan
PNS [common cold]
504 17-09-2018 160102050918Y000714 0000120705006 SITI FATIMAH P PENERIMA PENSIUN Asthma, unspecified Rujuk Lanjut
PNS
505 17-09-2018 160102050918Y000700 0000120905289 padjriansyah L PENERIMA PENSIUN Hyperplasia of prostate Rujuk Lanjut
PNS
506 17-09-2018 160102050918Y000799 0000120905291 TINI KARTINI P PENERIMA PENSIUN Myalgia, shoulder region Berobat Jalan
PNS
507 17-09-2018 160102050918Y000740 0000123297344 SULISTYOWATI P PENERIMA PENSIUN Low back pain Rujuk Lanjut
PNS
508 17-09-2018 160102050918Y000724 0000169343583 HERMAWATI P PNS PUSAT Non-insulin-dependent Berobat Jalan
diabetes mellitus without

509 17-09-2018 160102050918Y000773 0000518648995 RUSIMIN L PBI (APBN) Fever, unspecified Berobat Jalan
DAFTAR KUNJUNGAN PESERTA SAKIT

Kantor Cabang : SAMARINDA - 1601

FKTP : SEGIRI - 16010205

510 17-09-2018 160102050918Y000783 0000755596495 M AGUS RIZKY L PBI (APBN) Surgical follow-up care, Berobat Jalan
unspecified
511 17-09-2018 160102050918Y000764 0000897730255 MARIMA ROSALIA DAHAI P PBI (APBN) Acute lymphadenitis of Berobat Jalan
upper limb
512 17-09-2018 160102050918Y000762 0000899277491 HENNI WATI P PBI (APBN) Myalgia Berobat Jalan

513 17-09-2018 160102050918Y000778 0000902249886 AYU NURJANAH P PBI (APBN) Acute nasopharyngitis Berobat Jalan
[common cold]
514 17-09-2018 160102050918Y000791 0000902338097 UMAMI P PBI (APBN) Myalgia, shoulder region Berobat Jalan

515 17-09-2018 160102050918Y000754 0000902499491 MUNTIWA P PBI (APBN) Essential (primary) Berobat Jalan
hypertension
516 17-09-2018 160102050918Y000794 0000902502055 JARIYATIN P PBI (APBN) Essential (primary) Berobat Jalan
hypertension
517 17-09-2018 160102050918Y000796 0000902502516 FAUZI L PBI (APBN) Decubitus ulcer Berobat Jalan

518 17-09-2018 160102050918Y000759 0000902751456 AHMAD MISRANSYAH L PBI (APBN) Essential (primary) Berobat Jalan
hypertension
519 17-09-2018 160102050918Y000709 0000902751827 YUNITA AMELIA PUTRI P PBI (APBN) Schizophrenia, unspecified Rujuk Lanjut

520 17-09-2018 160102050918Y000704 0000903226432 SASTRO SAIDI L PBI (APBN) Non-insulin-dependent Berobat Jalan
diabetes mellitus without

521 17-09-2018 160102050918Y000792 0000903360104 HAERATI DAENG SIMBA P PBI (APBN) Asthma, unspecified Berobat Jalan

522 17-09-2018 160102050918Y000776 0000903427975 SITI SUPARTI P PBI (APBN) Non-insulin-dependent Berobat Jalan
diabetes mellitus without

523 17-09-2018 160102050918Y000769 0000903453219 BAYAH. S P PBI (APBN) Surgical follow-up care, Berobat Jalan
unspecified
524 17-09-2018 160102050918Y000753 0001066471828 SITI NURAINI P PBI (APBN) Essential (primary) Berobat Jalan
hypertension
525 17-09-2018 160102050918Y000696 0001066483113 SYAHRUDDIN L PBI (APBN) Other chest pain Rujuk Lanjut

526 17-09-2018 160102050918Y000772 0001066483282 WATINI P PEKERJA MANDIRI Superficial injury of lower Berobat Jalan
leg, unspecified
527 17-09-2018 160102050918Y000733 0001095294576 NATALIS TUSIN L ANGGOTA POLRI Hyperplasia of prostate Rujuk Lanjut

528 17-09-2018 160102050918Y000750 0001169151164 AHMAD BINSAR PARSAOROAN L PEGAWAI SWASTA Varicella without Berobat Jalan
BATUBARA complication
529 17-09-2018 160102050918Y000756 0001202626102 RAFIAH P PEGAWAI PEMERINTAH Malignant neoplasm of Rujuk Lanjut
DENGAN PERJANJIAN cervix uteri, unspecified

530 17-09-2018 160102050918Y000785 0001226521271 DWI SANDI ARIFIANTO L PEGAWAI SWASTA Acute pharyngitis, Berobat Jalan
unspecified
DAFTAR KUNJUNGAN PESERTA SAKIT

Kantor Cabang : SAMARINDA - 1601

FKTP : SEGIRI - 16010205

531 17-09-2018 160102050918Y000706 0001261838597 MAULIDA ALYA NISA P PEKERJA MANDIRI Low vision, both eyes Rujuk Lanjut

532 17-09-2018 160102050918Y000702 0001268373688 NASAN JONY SILALAHI raja L PEKERJA MANDIRI Hyperplasia of prostate Rujuk Lanjut

533 17-09-2018 160102050918Y000768 0001480770279 HOTIMAH P PEKERJA MANDIRI Malignant neoplasm of Rujuk Lanjut
cervix uteri, unspecified
534 17-09-2018 160102050918Y000767 0001550022221 AHMAD SAHRUL L PEGAWAI SWASTA Gonococcal infection, Berobat Jalan
unspecified
535 17-09-2018 160102050918Y000765 0001551827485 ADE JULIA P PBI (APBD) Other injuries of lower Berobat Jalan
limb, level unspecified
536 17-09-2018 160102050918Y000795 0001649069853 NABILA EKA PUTRI P PEGAWAI SWASTA Acute nasopharyngitis Berobat Jalan
[common cold]
537 17-09-2018 160102050918Y000758 0001743886528 LANGGENG BRAMANTYO L PEGAWAI SWASTA Acute nasopharyngitis Berobat Jalan
[common cold]
538 17-09-2018 160102050918Y000707 0001812958323 JAMILAH P PEKERJA MANDIRI Non-insulin-dependent Berobat Jalan
diabetes mellitus without

539 17-09-2018 160102050918Y000741 0001820224664 YOANNITA RINI P PEKERJA MANDIRI Malignant neoplasm of Rujuk Lanjut
cervix uteri, unspecified
540 17-09-2018 160102050918Y000793 0001881581646 TIMBUL WAHYUDI L PEKERJA MANDIRI Sequelae of stroke, not Berobat Jalan
specified as haemorrhage

541 17-09-2018 160102050918Y000800 0001924843421 ANITA RAHMAH P PEKERJA MANDIRI Myalgia, shoulder region Berobat Jalan

542 17-09-2018 160102050918Y000770 0001925047225 NUR TINA SARI HARTATI P PEKERJA MANDIRI Dyspepsia Berobat Jalan

543 17-09-2018 160102050918Y000788 0001925214309 PAIMAN L PBI (APBD) Epilepsy, unspecified Berobat Jalan

544 17-09-2018 160102050918Y000705 0001925217955 YULIONO L PBI (APBD) Schizophrenia, unspecified Rujuk Lanjut

545 17-09-2018 160102050918Y000775 0001925253753 ADI FADLI L PBI (APBD) Acute nasopharyngitis Berobat Jalan
[common cold]
546 17-09-2018 160102050918Y000780 0001929375685 RANI KUSUMA P PBI (APBD) Non-insulin-dependent Berobat Jalan
diabetes mellitus with

547 17-09-2018 160102050918Y000751 0001963314112 RA.IRIANDI WARGANEGARA L PEKERJA MANDIRI Chronic viral hepatitis, Rujuk Lanjut
unspecified
548 17-09-2018 160102050918Y000738 0002060447646 SUKANTI P PEKERJA MANDIRI Chronic ischaemic heart Rujuk Lanjut
disease, unspecified
549 17-09-2018 160102050918Y000710 0002062414517 DWI ATMODJO L PEKERJA MANDIRI Essential (primary) Berobat Jalan
hypertension
550 17-09-2018 160102050918Y000797 0002062414809 SRI ASIH P PEKERJA MANDIRI Myalgia, shoulder region Berobat Jalan

551 17-09-2018 160102050918Y000698 0002062453689 ABDUL HAKIM L PEKERJA MANDIRI Essential (primary) Rujuk Lanjut
hypertension
DAFTAR KUNJUNGAN PESERTA SAKIT

Kantor Cabang : SAMARINDA - 1601

FKTP : SEGIRI - 16010205

552 17-09-2018 160102050918Y000789 0002064033606 GT. SAIBATUL ASLAMIAH P PEKERJA MANDIRI Essential (primary) Berobat Jalan
hypertension
553 17-09-2018 160102050918Y000736 0002064043181 ENDANG SRI ASTUTIK P PEKERJA MANDIRI Other specified Rujuk Lanjut
orthopaedic follow-up care

554 17-09-2018 160102050918Y000779 0002065980126 RUSLI SIREGAR L PEKERJA MANDIRI Cough Rujuk Lanjut

555 17-09-2018 160102050918Y000701 0002070585235 SULAIKAH P PEKERJA MANDIRI Non-insulin-dependent Berobat Jalan
diabetes mellitus without

556 17-09-2018 160102050918Y000749 0002073187282 EDY PURWANTO L PEKERJA MANDIRI Congestive heart failure Rujuk Lanjut

557 17-09-2018 160102050918Y000748 0002075717474 ABDUL SAMAD L PEKERJA MANDIRI Chronic ischaemic heart Rujuk Lanjut
disease, unspecified
558 17-09-2018 160102050918Y000703 0002076778293 SYAEPIDIN L PEKERJA MANDIRI Unspecified injury of lower Rujuk Lanjut
leg
559 17-09-2018 160102050918Y000766 0002082322642 HARIONO L PEKERJA MANDIRI Acute pharyngitis, Berobat Jalan
unspecified
560 17-09-2018 160102050918Y000771 0002082323417 PUTRIASA EWIN P PEKERJA MANDIRI Acute pharyngitis, Berobat Jalan
unspecified
561 17-09-2018 160102050918Y000787 0002082929499 ADHE SAFITRI PURBA P PEGAWAI PEMERINTAH Acute nasopharyngitis Berobat Jalan
DENGAN PERJANJIAN [common cold]

562 17-09-2018 160102050918Y000782 0002085477434 SANTARI WAHAB L PEKERJA MANDIRI Headache Berobat Jalan

563 17-09-2018 160102050918Y000742 0002085477963 ANISSA PATRICIA WAHAB P PEKERJA MANDIRI Fever, unspecified Rujuk Lanjut

564 17-09-2018 160102050918Y000697 0002203130924 SADEMI P PEKERJA MANDIRI Senile cataract, Rujuk Lanjut
unspecified
565 17-09-2018 160102050918Y000777 0002203870127 ABDUL SAKIL L PEKERJA MANDIRI Non-insulin-dependent Berobat Jalan
diabetes mellitus without

566 17-09-2018 160102050918Y000761 0002205473073 RAHWONO L PEKERJA MANDIRI Essential (primary) Berobat Jalan
hypertension
567 17-09-2018 160102050918Y000763 0002205473859 JAINAB MISNAWATI P PEKERJA MANDIRI Acute nasopharyngitis Berobat Jalan
[common cold]
568 17-09-2018 160102050918Y000760 0002205474581 JAIRA ALMIRA DEVI ILONA P PEKERJA MANDIRI Acute nasopharyngitis Berobat Jalan
[common cold]
569 17-09-2018 160102050918Y000752 0002245028613 ANDI AZIS L PEKERJA MANDIRI Non-insulin-dependent Berobat Jalan
diabetes mellitus without

570 17-09-2018 160102050918Y000774 0002290730477 MASDUKI L PEKERJA MANDIRI Essential (primary) Berobat Jalan
hypertension
571 17-09-2018 160102050918Y000798 0002317061575 NURUL KHUMAIROH L PEKERJA MANDIRI Dyspepsia Berobat Jalan
DAFTAR KUNJUNGAN PESERTA SAKIT

Kantor Cabang : SAMARINDA - 1601

FKTP : SEGIRI - 16010205

572 17-09-2018 160102050918Y000786 0002317500573 HAMRAN AB L PEKERJA MANDIRI Fever, unspecified Berobat Jalan

573 17-09-2018 160102050918Y000784 0002326067548 MUHAMMAD SENDY PRASETYA L PEGAWAI SWASTA Fever, unspecified Berobat Jalan

574 17-09-2018 160102050918Y000986 0002327980015 RHEVA WILDA MAHESTRI P PEKERJA MANDIRI Fever, unspecified Berobat Jalan

575 17-09-2018 160102050918Y000725 0002378081452 ANDRIANE M SAKUDU P PEKERJA MANDIRI Xanthelasma of eyelid Rujuk Lanjut

576 17-09-2018 160102050918Y000790 0002422731183 KISWATI P PEKERJA MANDIRI Acute nasopharyngitis Berobat Jalan
[common cold]
577 17-09-2018 160102050918Y000734 0002479997417 NUR HASNAINI P PEKERJA MANDIRI Malignant neoplasm of Rujuk Lanjut
breast, unspecified
578 15-09-2018 160102050918Y000648 0000120292694 drs. MOHD FAIZAL., apt.,mppm L PNS PUSAT Non-insulin-dependent Berobat Jalan
diabetes mellitus without

579 15-09-2018 160102050918Y000641 0000120452567 SUGIJONO L PENERIMA PENSIUN Non-insulin-dependent Berobat Jalan
PNS diabetes mellitus without

580 15-09-2018 160102050918Y000668 0000120488973 SALMAH TIMA P PENERIMA PENSIUN Non-insulin-dependent Berobat Jalan
PNS diabetes mellitus without

581 15-09-2018 160102050918Y000679 0000120528191 LA BESA L PNS PUSAT Acute nasopharyngitis Berobat Jalan
[common cold]
582 15-09-2018 160102050918Y000670 0000120549317 MAS`UD L PNS DAERAH Myalgia Berobat Jalan

583 15-09-2018 160102050918Y000666 0000120559779 SJAHRIL AIDA P PENERIMA PENSIUN Non-insulin-dependent Berobat Jalan
PNS diabetes mellitus without

584 15-09-2018 160102050918Y000671 0000120560883 SITI AMANAH P PENERIMA PENSIUN Hyperlipidaemia, Berobat Jalan
PNS unspecified
585 15-09-2018 160102050918Y000643 0000120584788 RONIAH, HJ P PENERIMA PENSIUN Superficial injury of lower Rujuk Lanjut
PNS leg, unspecified
586 15-09-2018 160102050918Y000640 0000120634277 DJALEHA P PENERIMA PENSIUN Superficial injury of Rujuk Lanjut
PNS forearm, unspecified
587 15-09-2018 160102050918Y000680 0000120666295 JUMIATY P PENERIMA PENSIUN Essential (primary) Berobat Jalan
PNS hypertension
588 15-09-2018 160102050918Y000642 0000120671032 SITI SUTIJANTI P PENERIMA PENSIUN Chronic ischaemic heart Rujuk Lanjut
PNS disease, unspecified
589 15-09-2018 160102050918Y000651 0000120756688 SURYANIWATI P PENERIMA PENSIUN Naevus, non-neoplastic Rujuk Lanjut
PNS
590 15-09-2018 160102050918Y000669 0000120776376 SAKILA P PNS DAERAH Cystitis, unspecified Berobat Jalan

591 15-09-2018 160102050918Y000639 0000120791158 HALIMATUSAKDIAH P PNS DAERAH Essential (primary) Berobat Jalan
hypertension
592 15-09-2018 160102050918Y000688 0000120826089 MARJONO L PNS DAERAH Otitis externa, unspecified Berobat Jalan
DAFTAR KUNJUNGAN PESERTA SAKIT

Kantor Cabang : SAMARINDA - 1601

FKTP : SEGIRI - 16010205

593 15-09-2018 160102050918Y000665 0000121050393 MARGIRISWANTO L PNS PUSAT Essential (primary) Berobat Jalan
hypertension
594 15-09-2018 160102050918Y000675 0000123126142 SUKANTI P PENERIMA PENSIUN Non-insulin-dependent Berobat Jalan
PNS diabetes mellitus without

595 15-09-2018 160102050918Y000658 0000199546176 SALMARIAH P PNS DAERAH Acute nasopharyngitis Berobat Jalan
[common cold]
596 15-09-2018 160102050918Y000655 0000728261256 MUTMAINAH P PBI (APBN) Dyspepsia Berobat Jalan

597 15-09-2018 160102050918Y000667 0000759640296 TITIN SULIAWATI P PBI (APBN) Cough Rujuk Lanjut

598 15-09-2018 160102050918Y000681 0000899171515 ODA DEA P PBI (APBN) Surgical follow-up care, Berobat Jalan
unspecified
599 15-09-2018 160102050918Y000674 0000902546482 MUHAMMAD RIZKY L PBI (APBN) Dyspepsia Berobat Jalan

600 15-09-2018 160102050918Y000676 0000902655494 SUCI MAYA RANTI P PBI (APBN) Superficial injury of lower Berobat Jalan
leg, unspecified
601 15-09-2018 160102050918Y000684 0000902738351 AINI ASTUTI P PBI (APBN) Fever, unspecified Berobat Jalan

602 15-09-2018 160102050918Y000654 0000902922557 NUR ZAKIAH P PBI (APBN) Non-insulin-dependent Berobat Jalan
diabetes mellitus without

603 15-09-2018 160102050918Y000689 0000903192693 TINA P PBI (APBN) Haemoptysis Berobat Jalan

604 15-09-2018 160102050918Y000653 0000903394809 DARSILAN L PBI (APBN) Presbyopia Rujuk Lanjut

605 15-09-2018 160102050918Y000686 0000903458902 TIROHMAH P PBI (APBN) Other disorders of urinary Berobat Jalan
system
606 15-09-2018 160102050918Y000646 0000976689257 SOFIE FARISTINA P PNS PUSAT Supervision of high-risk Rujuk Lanjut
pregnancy
607 15-09-2018 160102050918Y000690 0001066519181 NURUL SUSANTI P PBI (APBN) General medical Berobat Jalan
examination
608 15-09-2018 160102050918Y000687 0001132080592 NURUL INDAH P PEKERJA MANDIRI Acute nasopharyngitis Berobat Jalan
[common cold]
609 15-09-2018 160102050918Y000673 0001267206873 KASTIAH P ANGGOTA POLRI Non-insulin-dependent Berobat Jalan
diabetes mellitus without

610 15-09-2018 160102050918Y000649 0001445777447 ACHMAD ZUHRI L PEKERJA MANDIRI Benign neoplasm of Rujuk Lanjut
unspecified site
611 15-09-2018 160102050918Y000652 0001545195835 AJENG KHALISA MAHARANI P PEGAWAI SWASTA Impacted cerumen Berobat Jalan

612 15-09-2018 160102050918Y000656 0001734272662 RATNA SARI P PEKERJA MANDIRI Essential (primary) Berobat Jalan
hypertension
613 15-09-2018 160102050918Y000677 0001880611953 rezky nur hidayat L PNS PUSAT Acute tonsillitis, Berobat Jalan
unspecified
DAFTAR KUNJUNGAN PESERTA SAKIT

Kantor Cabang : SAMARINDA - 1601

FKTP : SEGIRI - 16010205

614 15-09-2018 160102050918Y000659 0001923462303 MARLEN UDAU P PEKERJA MANDIRI Somatoform disorder, Rujuk Lanjut
unspecified
615 15-09-2018 160102050918Y000647 0001925222139 SURATMI P PBI (APBD) Hydronephrosis with renal Rujuk Lanjut
and ureteral calculous

616 15-09-2018 160102050918Y000644 0001925234785 KOLETA SAIMAN P PBI (APBD) Other and unspecified Rujuk Lanjut
ovarian cysts
617 15-09-2018 160102050918Y000664 0001928653042 JAMILAH P PBI (APBD) Essential (primary) Berobat Jalan
hypertension
618 15-09-2018 160102050918Y000672 0002060451191 SAMSIAH P PEKERJA MANDIRI Non-insulin-dependent Berobat Jalan
diabetes mellitus without

619 15-09-2018 160102050918Y000661 0002081219185 MUHAMMAD REZKI SANTOS L PEKERJA MANDIRI Cutaneous mycobacterial Berobat Jalan
infection
620 15-09-2018 160102050918Y000645 0002084625134 PARIDA P PEKERJA MANDIRI Thyroiditis, unspecified Rujuk Lanjut

621 15-09-2018 160102050918Y000663 0002194783064 MUHAMMAD HAFIZH L PEGAWAI SWASTA Acute nasopharyngitis Berobat Jalan
RAMADHANI [common cold]
622 15-09-2018 160102050918Y000685 0002204132962 DWI RETNO WULANDARI P PEKERJA MANDIRI Hordeolum and other deep Berobat Jalan
inflammation of eyelid

623 15-09-2018 160102050918Y000657 0002205357851 fazli nur parisi L PNS DAERAH Acute nasopharyngitis Berobat Jalan
[common cold]
624 15-09-2018 160102050918Y000692 0002209714514 MELANI P PEKERJA MANDIRI Supervision of pregnancy Berobat Jalan
with history of infertility
625 15-09-2018 160102050918Y000683 0002219945084 KADINEM P PEKERJA MANDIRI Essential (primary) Berobat Jalan
hypertension
626 15-09-2018 160102050918Y000682 0002230285678 MIKAILA P PEKERJA MANDIRI Diarrhoea and Berobat Jalan
gastroenteritis of
presumed infectious origin

627 15-09-2018 160102050918Y000650 0002296627446 IKE YUWAN AFRIDAY APRILIA P PEKERJA MANDIRI Bell's palsy Rujuk Lanjut

628 15-09-2018 160102050918Y000678 0002322632553 HASANAH P PEKERJA MANDIRI Surgical follow-up care, Berobat Jalan
unspecified
629 15-09-2018 160102050918Y000660 0002477485686 MUHAMMAD JUSTVIN FEBRIAN L PNS DAERAH Disorder of refraction, Rujuk Lanjut
ARHAM unspecified
630 15-09-2018 160102050918Y000662 0002477876049 ARIFA NUR FATIMAH P PBI (APBN) Routine child health Berobat Jalan
examination
631 14-09-2018 160102050918Y000584 0000120509526 ZUBAIDAH P PENERIMA PENSIUN TNI Senile cataract Rujuk Lanjut

632 14-09-2018 160102050918Y000564 0000120522813 HJ.NOORHIDAYAH, SE, M.KES P PNS PUSAT Congestive heart failure Rujuk Lanjut
DAFTAR KUNJUNGAN PESERTA SAKIT

Kantor Cabang : SAMARINDA - 1601

FKTP : SEGIRI - 16010205

633 14-09-2018 160102050918Y000600 0000120549453 SAIDAH P PNS DAERAH Non-insulin-dependent Berobat Jalan
diabetes mellitus without

634 14-09-2018 160102050918Y000599 0000120549464 NANANG RIDUAN L PNS DAERAH Non-insulin-dependent Berobat Jalan
diabetes mellitus without

635 14-09-2018 160102050918Y000560 0000120561311 APUK BILUNG L PENERIMA PENSIUN Hyperplasia of prostate Rujuk Lanjut
PNS
636 14-09-2018 160102050918Y000612 0000120561322 BURING P PENERIMA PENSIUN Conjunctivitis, unspecified Berobat Jalan
PNS
637 14-09-2018 160102050918Y000568 0000120590177 DJOEAIRIYAH, HJ P PENERIMA PENSIUN Non-insulin-dependent Rujuk Lanjut
PNS diabetes mellitus without

638 14-09-2018 160102050918Y000569 0000120614444 PAYAMAN SINAMBELA, DRS L PENERIMA PENSIUN Hyperplasia of prostate Rujuk Lanjut
PNS
639 14-09-2018 160102050918Y000566 0000120655361 ASNIAH P PENERIMA PENSIUN Non-insulin-dependent Rujuk Lanjut
PNS diabetes mellitus with

640 14-09-2018 160102050918Y000559 0000120657464 DRS. ENCIK ACHMAD FAIZAL L PENERIMA PENSIUN Hyperplasia of prostate Rujuk Lanjut
PNS
641 14-09-2018 160102050918Y000577 0000120660478 ROCHANA P PENERIMA PENSIUN Hypertensive heart Rujuk Lanjut
PNS disease with (congestive)

642 14-09-2018 160102050918Y000556 0000120666947 LUDIA PUDI P PENERIMA PENSIUN Tinnitus Rujuk Lanjut
PNS
643 14-09-2018 160102050918Y000563 0000120666958 MARKUS ROMBE L PENERIMA PENSIUN Chronic ischaemic heart Berobat Jalan
PNS disease, unspecified
644 14-09-2018 160102050918Y000555 0000120672066 SUKARSIH P PENERIMA PENSIUN Epilepsy, unspecified Rujuk Lanjut
PNS
645 14-09-2018 160102050918Y000583 0000120756688 SURYANIWATI P PENERIMA PENSIUN Senile incipient cataract Rujuk Lanjut
PNS
646 14-09-2018 160102050918Y000572 0000120913479 KHEMASILI KOSALA P PNS DAERAH Essential (primary) Berobat Jalan
hypertension
647 14-09-2018 160102050918Y000574 0000120913481 JOHANES NONO JUWONO,IR L PNS DAERAH Chronic ischaemic heart Berobat Jalan
disease, unspecified
648 14-09-2018 160102050918Y000592 0000123132396 AJI DESI INDRAWATI P PNS DAERAH Presbyopia Rujuk Lanjut

649 14-09-2018 160102050918Y000565 0000123238168 SAMSIYAH P PENERIMA PENSIUN Congestive heart failure Rujuk Lanjut
PNS
650 14-09-2018 160102050918Y000558 0000123684851 MASITAH P PNS DAERAH Chronic ischaemic heart Rujuk Lanjut
disease, unspecified
651 14-09-2018 160102050918Y000573 0000164273804 MEUTIA FARIDA P PENERIMA PENSIUN TNI Thyroiditis, unspecified Rujuk Lanjut
DAFTAR KUNJUNGAN PESERTA SAKIT

Kantor Cabang : SAMARINDA - 1601

FKTP : SEGIRI - 16010205

652 14-09-2018 160102050918Y000594 0000897476679 MULYANI P PBI (APBN) Cardiomyopathy, Rujuk Lanjut
unspecified
653 14-09-2018 160102050918Y000579 0000897727241 LUKAS MUYA L PBI (APBN) Benign neoplasm of other Rujuk Lanjut
specified sites
654 14-09-2018 160102050918Y000590 0000898165427 NUR SANIAH P PBI (APBN) Injury of conjunctiva and Rujuk Lanjut
corneal abrasion without

655 14-09-2018 160102050918Y000586 0000899127101 HJ JAMIAH P PBI (APBN) Blindness, one eye, low Rujuk Lanjut
vision other eye
656 14-09-2018 160102050918Y000610 0000899218102 RAHMAWATI P PBI (APBN) Acute nasopharyngitis Berobat Jalan
[common cold]
657 14-09-2018 160102050918Y000596 0000899356083 DIKIE CANDRA L PBI (APBN) Epilepsy, unspecified Rujuk Lanjut

658 14-09-2018 160102050918Y000605 0000902001835 NURHAYATI P PBI (APBN) Essential (primary) Berobat Jalan
hypertension
659 14-09-2018 160102050918Y000607 0000902393561 FIKRIANSA L PBI (APBN) Dysphagia Berobat Jalan

660 14-09-2018 160102050918Y000582 0000902546752 IIN NOVI YANI P PBI (APBN) Supervision of high-risk Rujuk Lanjut
pregnancy
661 14-09-2018 160102050918Y000693 0000902593923 DIAN TANIAR P PBI (APBN) Supervision of normal first Berobat Jalan
pregnancy
662 14-09-2018 160102050918Y000608 0000902703475 NUR ROHMANI P PBI (APBN) Non-insulin-dependent Berobat Jalan
diabetes mellitus without

663 14-09-2018 160102050918Y000578 0000903213584 SUKMA P PBI (APBN) Systemic lupus Rujuk Lanjut
erythematosus,

664 14-09-2018 160102050918Y000609 0001066471503 ENDANG SULASTRI P PEKERJA MANDIRI Essential (primary) Berobat Jalan
hypertension
665 14-09-2018 160102050918Y000585 0001066472245 M. SAIRI L PBI (APBN) Chronic ischaemic heart Berobat Jalan
disease, unspecified
666 14-09-2018 160102050918Y000580 0001323587261 baharuddin L PNS DAERAH Other and unspecified Rujuk Lanjut
cirrhosis of liver
667 14-09-2018 160102050918Y000576 0001545884651 NURHAYATI P PEGAWAI SWASTA Malignant neoplasm of Rujuk Lanjut
sigmoid colon
668 14-09-2018 160102050918Y000589 0001548746133 HARLIATI P PEKERJA MANDIRI Chronic viral hepatitis, Rujuk Lanjut
unspecified
669 14-09-2018 160102050918Y000593 0001553675973 DEVIONA CAROLENSA P PBI (APBD) Allergic contact dermatitis, Berobat Jalan
unspecified cause

670 14-09-2018 160102050918Y000613 0001725503073 ANIP SUSANTO L PEKERJA MANDIRI Superficial frostbite of Berobat Jalan
other and unspecified sites

671 14-09-2018 160102050918Y000601 0001734278051 MOHAMMAD IRHAM L PEKERJA MANDIRI Chronic ischaemic heart Rujuk Lanjut
HIDAYANTO disease, unspecified
DAFTAR KUNJUNGAN PESERTA SAKIT

Kantor Cabang : SAMARINDA - 1601

FKTP : SEGIRI - 16010205

672 14-09-2018 160102050918Y000602 0001844845481 SUMIATI P PEKERJA MANDIRI Acute nasopharyngitis Berobat Jalan
[common cold]
673 14-09-2018 160102050918Y000570 0001923266046 ASENG L PEKERJA MANDIRI Sequelae of stroke, not Rujuk Lanjut
specified as haemorrhage

674 14-09-2018 160102050918Y000557 0001925217336 MOCHAMAD ARYA YUDISTIRA L PBI (APBD) Acute tonsillitis, Rujuk Lanjut
unspecified
675 14-09-2018 160102050918Y000554 0001925222995 USNEIDI L PBI (APBD) After-cataract Rujuk Lanjut

676 14-09-2018 160102050918Y000567 0001925231837 MUHAMMAD ZEINULLOH L PEKERJA MANDIRI Nephrotic syndrome, Rujuk Lanjut
unspecified
677 14-09-2018 160102050918Y000604 0001929263962 SITI YULAINAH P PBI (APBD) Hyperlipidaemia, Berobat Jalan
unspecified
678 14-09-2018 160102050918Y000587 0002060756177 JUSRIADI L PEGAWAI SWASTA Chronic viral hepatitis, Rujuk Lanjut
unspecified
679 14-09-2018 160102050918Y000553 0002061008267 ARDIANSYAH L PEKERJA MANDIRI Schizophrenia, unspecified Rujuk Lanjut

680 14-09-2018 160102050918Y000588 0002077780421 SUSI P PEKERJA MANDIRI Excessive and frequent Rujuk Lanjut
menstruation with irregular

681 14-09-2018 160102050918Y000591 0002227046275 FERRY IRAWAN L PEGAWAI SWASTA Tuberculosis of lung, Berobat Jalan
without mention of
bacteriological or

682 14-09-2018 160102050918Y000597 0002232638087 RIZKA NURYANTI TANJUNG P PBI (APBD) Asthma, unspecified Berobat Jalan

683 14-09-2018 160102050918Y000611 0002238223241 TOMMY MASHOER L PEKERJA MANDIRI Essential (primary) Berobat Jalan
hypertension
684 14-09-2018 160102050918Y000606 0002238907599 NAURAH NABILAH P PNS DAERAH Acute tonsillitis, Berobat Jalan
unspecified
685 14-09-2018 160102050918Y000691 0002249201147 ROSHITA SARI P PEKERJA MANDIRI Supervision of normal Berobat Jalan
pregnancy, unspecified
686 14-09-2018 160102050918Y000562 0002281711274 aurellia azzahra putri P PEKERJA MANDIRI Acute nasopharyngitis Berobat Jalan
[common cold]
687 14-09-2018 160102050918Y000603 0002285234054 NAURA ANINDYA SUSANTO P PEKERJA MANDIRI Acute nasopharyngitis Berobat Jalan
[common cold]
688 14-09-2018 160102050918Y000595 0002308662753 SITI HANIFAH L PBI (APBD) Disorder of refraction, Rujuk Lanjut
unspecified
689 14-09-2018 160102050918Y000561 0002317792937 RIFKI ALMUHARRAM L PEKERJA MANDIRI Superficial injury of lower Rujuk Lanjut
leg, unspecified
690 14-09-2018 160102050918Y000571 0002451658037 ALVINO KENZO RAFAEL L PBI (APBN) Acute bronchiolitis, Rujuk Lanjut
unspecified
691 14-09-2018 160102050918Y000575 0002456074629 NATHANAEL MICHAEL GILBERT L PEKERJA MANDIRI Disorder of refraction, Rujuk Lanjut
unspecified
DAFTAR KUNJUNGAN PESERTA SAKIT

Kantor Cabang : SAMARINDA - 1601

FKTP : SEGIRI - 16010205

692 14-09-2018 160102050918Y000598 0002482165135 SURYADI L PEKERJA MANDIRI Sequelae of stroke, not Rujuk Lanjut
specified as haemorrhage

693 13-09-2018 160102050918Y000507 0000119645133 YOGI HADIPUTRA L PNS DAERAH Benign neoplasm of Rujuk Lanjut
unspecified site
694 13-09-2018 160102050918Y000529 0000120067479 GINA ATIKA P PNS DAERAH Presbyopia Rujuk Lanjut

695 13-09-2018 160102050918Y000489 0000120512013 ACHMAD FADLY L PENERIMA PENSIUN TNI Non-insulin-dependent Rujuk Lanjut
diabetes mellitus with

696 13-09-2018 160102050918Y000497 0000120528314 BAHARUDDIN L PEGAWAI SWASTA Other forms of stomatitis Rujuk Lanjut

697 13-09-2018 160102050918Y000536 0000120549025 ACHMAD FAIZIN L PNS DAERAH Acute nasopharyngitis Berobat Jalan
[common cold]
698 13-09-2018 160102050918Y000537 0000120549172 ERNAWATI P PNS DAERAH Non-insulin-dependent Berobat Jalan
diabetes mellitus without

699 13-09-2018 160102050918Y000540 0000120549396 MUS'IFAH P PNS DAERAH Dyspepsia Berobat Jalan

700 13-09-2018 160102050918Y000541 0000120549475 SUGENG WAHONO L PNS DAERAH Essential (primary) Berobat Jalan
hypertension
701 13-09-2018 160102050918Y000495 0000120629136 BADARIAH P PENERIMA PENSIUN Chronic ischaemic heart Rujuk Lanjut
PNS disease, unspecified
702 13-09-2018 160102050918Y000502 0000120652863 RACHMATIAH P PENERIMA PENSIUN Essential (primary) Berobat Jalan
PNS hypertension
703 13-09-2018 160102050918Y000488 0000120655056 ASKAMAN MASDAR L PENERIMA PENSIUN Essential (primary) Berobat Jalan
PNS hypertension
704 13-09-2018 160102050918Y000485 0000120672674 SAMLAN,DRS, BCHK, H L PENERIMA PENSIUN Chronic ischaemic heart Rujuk Lanjut
PNS disease, unspecified
705 13-09-2018 160102050918Y000513 0000120756295 SAWUDI L PNS DAERAH Superficial injury of lower Berobat Jalan
leg, unspecified
706 13-09-2018 160102050918Y000528 0000122089735 NANI PURWATI P PNS PUSAT Hyperlipidaemia, Berobat Jalan
unspecified
707 13-09-2018 160102050918Y000510 0000123120099 ASMUNI SABRAN L PENERIMA PENSIUN Sequelae of stroke, not Rujuk Lanjut
PNS specified as haemorrhage

708 13-09-2018 160102050918Y000516 0000123285295 NURDIN THAYIB L PENERIMA PENSIUN Non-insulin-dependent Rujuk Lanjut
PNS diabetes mellitus with
other specified

709 13-09-2018 160102050918Y000487 0000123677098 AROME BERNADETTA SILALAHI P PNS DAERAH Leiomyoma of uterus, Rujuk Lanjut
unspecified
710 13-09-2018 160102050918Y000524 0000123686638 NILA ROSANAH P PNS DAERAH Acute nasopharyngitis Berobat Jalan
[common cold]
DAFTAR KUNJUNGAN PESERTA SAKIT

Kantor Cabang : SAMARINDA - 1601

FKTP : SEGIRI - 16010205

711 13-09-2018 160102050918Y000486 0000123729827 MUZAIYID L PNS DAERAH Hordeolum and other deep Berobat Jalan
inflammation of eyelid

712 13-09-2018 160102050918Y000491 0000123729838 DALIAH P PNS DAERAH Cellulitis of other sites Rujuk Lanjut

713 13-09-2018 160102050918Y000500 0000158221001 HJ. MUSLICHAH P PENERIMA PENSIUN Non-insulin-dependent Berobat Jalan
PNS diabetes mellitus without

714 13-09-2018 160102050918Y000519 0000159257733 JEANNE CORNELIA BURKENS P PENERIMA PENSIUN Myalgia Berobat Jalan
PNS
715 13-09-2018 160102050918Y000522 0000727598417 IQBAL AFIN HIDAYATULLAH L PBI (APBN) Fracture of lower end of Rujuk Lanjut
both ulna and radius
716 13-09-2018 160102050918Y000531 0000759640296 TITIN SULIAWATI P PBI (APBN) Acute nasopharyngitis Berobat Jalan
[common cold]
717 13-09-2018 160102050918Y000496 0000898429331 AMRI L PBI (APBN) Chronic ischaemic heart Rujuk Lanjut
disease, unspecified
718 13-09-2018 160102050918Y000512 0000898929999 MUKRANSYAH L PBI (APBN) Hyperplasia of prostate Rujuk Lanjut

719 13-09-2018 160102050918Y000538 0000902547742 WAAJID VAHREZA L PBI (APBN) Allergic contact dermatitis, Berobat Jalan
unspecified cause

720 13-09-2018 160102050918Y000530 0000902601595 YUSNANIK P PBI (APBN) Benign paroxysmal vertigo Rujuk Lanjut

721 13-09-2018 160102050918Y000532 0000902748115 NORAIDAH P PBI (APBN) Myalgia, shoulder region Berobat Jalan

722 13-09-2018 160102050918Y000508 0001066478916 SITI AMINAH P PBI (APBN) Essential (primary) Berobat Jalan
hypertension
723 13-09-2018 160102050918Y000501 0001081898155 SUPRIATI DWI LESTARI P PNS DAERAH Atopic dermatitis, Rujuk Lanjut
unspecified
724 13-09-2018 160102050918Y000521 0001263188856 FARISTIA FATIMAH L PEGAWAI SWASTA Acute tonsillitis, Berobat Jalan
unspecified
725 13-09-2018 160102050918Y000534 0001296661239 RUSTAM SYAH L PNS DAERAH Acute nasopharyngitis Berobat Jalan
[common cold]
726 13-09-2018 160102050918Y000494 0001446895697 GUNAWAN WIBISONO L PEGAWAI SWASTA Blindness, one eye, low Rujuk Lanjut
vision other eye
727 13-09-2018 160102050918Y000517 0001611786576 AGUSTINUS LIAH SONG L PBI (APBD) Malignant neoplasm of Rujuk Lanjut
oesophagus, unspecified
728 13-09-2018 160102050918Y000506 0001724606458 UMI KULSUM AS P PBI (APBD) Superficial injury of lower Berobat Jalan
leg, unspecified
729 13-09-2018 160102050918Y000484 0001795315667 SOVIAWATY P PEKERJA MANDIRI Non-insulin-dependent Rujuk Lanjut
diabetes mellitus with

730 13-09-2018 160102050918Y000509 0001822062813 isnayati P PEKERJA MANDIRI Surgical follow-up care, Rujuk Lanjut
unspecified
DAFTAR KUNJUNGAN PESERTA SAKIT

Kantor Cabang : SAMARINDA - 1601

FKTP : SEGIRI - 16010205

731 13-09-2018 160102050918Y000493 0001925232017 LIA AYU RACHMAWATI P PNS DAERAH Disorder of refraction, Rujuk Lanjut
unspecified
732 13-09-2018 160102050918Y000511 0001925238407 IMAM TURHADI L PBI (APBD) Dyspepsia Berobat Jalan

733 13-09-2018 160102050918Y000525 0001926701155 RUSNA WATI P PEKERJA MANDIRI Other endometriosis Rujuk Lanjut

734 13-09-2018 160102050918Y000515 0001968769045 SUMIATI. A P PEKERJA MANDIRI Surgical follow-up care, Rujuk Lanjut
unspecified
735 13-09-2018 160102050918Y000514 0002001421596 AMBARYATUN P PBI (APBN) Essential (primary) Berobat Jalan
hypertension
736 13-09-2018 160102050918Y000498 0002077217504 BAMBANG SUHARTONO L PEKERJA MANDIRI Myalgia Berobat Jalan

737 13-09-2018 160102050918Y000533 0002083502553 SUHAEMA P PBI (APBD) Tuberculosis of bones and Rujuk Lanjut
joints
738 13-09-2018 160102050918Y000518 0002196457727 rafa putra mering hanafi L PEKERJA MANDIRI Epilepsy, unspecified Rujuk Lanjut

739 13-09-2018 160102050918Y000504 0002219585894 MUHAMMAD EFFENDI L PEKERJA MANDIRI Schizophrenia, unspecified Rujuk Lanjut

740 13-09-2018 160102050918Y000503 0002223960333 CHERRY SUNDARI L PBI (APBD) Cutaneous abscess, Berobat Jalan
furuncle and carbuncle of

741 13-09-2018 160102050918Y000527 0002231971536 CAHYO PRASETYO L PEKERJA MANDIRI Acute nasopharyngitis Berobat Jalan
[common cold]
742 13-09-2018 160102050918Y000520 0002231971942 RUDI SETIAWAN L PEKERJA MANDIRI Acute pharyngitis, Berobat Jalan
unspecified
743 13-09-2018 160102050918Y000499 0002254563595 RINA ARIANI P PEKERJA MANDIRI Schizophrenia, unspecified Rujuk Lanjut

744 13-09-2018 160102050918Y000492 0002294662533 JAINAH P PEKERJA MANDIRI Stroke, not specified as Rujuk Lanjut
haemorrhage or infarction
745 13-09-2018 160102050918Y000505 0002310387625 nusuk L PEKERJA MANDIRI Hyperplasia of prostate Rujuk Lanjut

746 13-09-2018 160102050918Y000523 0002442203379 MASROKAN L PEKERJA MANDIRI Non-insulin-dependent Berobat Jalan
diabetes mellitus without

747 13-09-2018 160102050918Y000526 0002471537024 MUH WILDAN ZAKIYA DARAJAT L PEKERJA MANDIRI Benign neoplasm of other Rujuk Lanjut
specified sites
748 13-09-2018 160102050918Y000535 0002474488866 REHANDIKA ADE SAPUTRA L PBI (APBD) Surgical follow-up care, Berobat Jalan
unspecified
749 12-09-2018 160102050918Y000433 0000120054328 DENI DULNAMUS L PNS DAERAH Otitis media, unspecified Berobat Jalan

750 12-09-2018 160102050918Y000418 0000120059853 AMALIA ASWIN P PNS DAERAH Impacted teeth Rujuk Lanjut

751 12-09-2018 160102050918Y000396 0000120100173 AGUSTINA ARRUAN P PNS DAERAH Essential (primary) Berobat Jalan
hypertension
DAFTAR KUNJUNGAN PESERTA SAKIT

Kantor Cabang : SAMARINDA - 1601

FKTP : SEGIRI - 16010205

752 12-09-2018 160102050918Y000391 0000120352443 SRI HASTUTI P PNS DAERAH Non-insulin-dependent Rujuk Lanjut
diabetes mellitus without

753 12-09-2018 160102050918Y000430 0000120428684 RIZALI NOOR L PNS PUSAT Headache Berobat Jalan

754 12-09-2018 160102050918Y000406 0000120492279 BACHRUN L PENERIMA PENSIUN TNI Hyperplasia of prostate Rujuk Lanjut

755 12-09-2018 160102050918Y000417 0000120492281 SALMIAH P PENERIMA PENSIUN TNI Crystal arthropathy, Rujuk Lanjut
unspecified
756 12-09-2018 160102050918Y000377 0000120513014 SALAMAH P PENERIMA PENSIUN TNI Non-insulin-dependent Berobat Jalan
diabetes mellitus without

757 12-09-2018 160102050918Y000376 0000120513172 SITTI ROHANI P VETERAN Senile cataract, Rujuk Lanjut
unspecified
758 12-09-2018 160102050918Y000375 0000120513914 RIBUT SUKIDJO L PENERIMA PENSIUN TNI Non-insulin-dependent Rujuk Lanjut
diabetes mellitus with
neurological complications

759 12-09-2018 160102050918Y000373 0000120513925 SURATMI P PENERIMA PENSIUN TNI Non-insulin-dependent Rujuk Lanjut
diabetes mellitus with
neurological complications

760 12-09-2018 160102050918Y000370 0000120549071 TRI URBA NURYANTO L PNS DAERAH Intrahepatic bile duct Rujuk Lanjut
carcinoma
761 12-09-2018 160102050918Y000404 0000120571143 DRS. HADRANSYAH SALMAN L PENERIMA PENSIUN Chronic ischaemic heart Rujuk Lanjut
PNS disease, unspecified
762 12-09-2018 160102050918Y000414 0000120571154 ARBAINAH P PENERIMA PENSIUN Non-insulin-dependent Rujuk Lanjut
PNS diabetes mellitus with
other specified

763 12-09-2018 160102050918Y000393 0000120588164 HELMY SULAIMAN, BA L PENERIMA PENSIUN Chronic obstructive Rujuk Lanjut
PNS pulmonary disease with
acute exacerbation,

764 12-09-2018 160102050918Y000381 0000120615985 SINTA DIANA SIAHAAN P PENERIMA PENSIUN Non-insulin-dependent Berobat Jalan
PNS diabetes mellitus without

765 12-09-2018 160102050918Y000412 0000120659343 E.A. SYARWANI BBA L PENERIMA PENSIUN Hyperplasia of prostate Rujuk Lanjut
PNS
766 12-09-2018 160102050918Y000402 0000120672066 SUKARSIH P PENERIMA PENSIUN After-cataract Rujuk Lanjut
PNS
767 12-09-2018 160102050918Y000379 0000123279568 HERMIATI M P PNS DAERAH Dyspepsia Berobat Jalan

768 12-09-2018 160102050918Y000419 0000123677954 BERTHA P PNS DAERAH Malignant neoplasm of Rujuk Lanjut
breast, unspecified
DAFTAR KUNJUNGAN PESERTA SAKIT

Kantor Cabang : SAMARINDA - 1601

FKTP : SEGIRI - 16010205

769 12-09-2018 160102050918Y000371 0000123681295 SUYANTO L PNS DAERAH Essential (primary) Berobat Jalan
hypertension
770 12-09-2018 160102050918Y000413 0000123726341 TUKIMIN L PNS DAERAH Non-insulin-dependent Berobat Jalan
diabetes mellitus without

771 12-09-2018 160102050918Y000384 0000158009253 MUKMINAH P PENERIMA PENSIUN Non-insulin-dependent Berobat Jalan
PNS diabetes mellitus without

772 12-09-2018 160102050918Y000427 0000896467904 MARYANI P PBI (APBN) Acute nasopharyngitis Berobat Jalan
[common cold]
773 12-09-2018 160102050918Y000383 0000898668235 DINAH P PBI (APBN) Tuberculous peripheral Rujuk Lanjut
lymphadenopathy
774 12-09-2018 160102050918Y000407 0000901935044 LENAH P PBI (APBN) Myalgia Berobat Jalan

775 12-09-2018 160102050918Y000401 0000902438662 SAFRI YADI L PBI (APBN) Dental caries Rujuk Lanjut

776 12-09-2018 160102050918Y000372 0000902650307 RUSMINI P PBI (APBN) Other and unspecified Rujuk Lanjut
abdominal pain
777 12-09-2018 160102050918Y000445 0000902703475 NUR ROHMANI P PBI (APBN) Headache Berobat Jalan

778 12-09-2018 160102050918Y000395 0000903229885 DAROJI L PBI (APBN) Insulin-dependent Rujuk Lanjut
diabetes mellitus with
peripheral circulatory

779 12-09-2018 160102050918Y000385 0000903442634 NANANG L PBI (APBN) Essential (primary) Berobat Jalan
hypertension
780 12-09-2018 160102050918Y000374 0001066481627 SUKATLIN P PBI (APBN) Chronic ischaemic heart Rujuk Lanjut
disease, unspecified
781 12-09-2018 160102050918Y000415 0001152600884 SHOLEH ANGGORO L PEKERJA MANDIRI Surgical follow-up care, Rujuk Lanjut
unspecified
782 12-09-2018 160102050918Y000388 0001268373688 NASAN JONY SILALAHI raja L PEKERJA MANDIRI Chronic ischaemic heart Rujuk Lanjut
disease, unspecified
783 12-09-2018 160102050918Y000389 0001268375229 HERBINA SIMANJUNTAK P PEKERJA MANDIRI Chronic ischaemic heart Rujuk Lanjut
disease, unspecified
784 12-09-2018 160102050918Y000411 0001296661239 RUSTAM SYAH L PNS DAERAH Cough Berobat Jalan

785 12-09-2018 160102050918Y000394 0001445778369 FERDI IBRAHIM L PEKERJA MANDIRI Chronic viral hepatitis B Rujuk Lanjut
with delta-agent
786 12-09-2018 160102050918Y000400 0001548686801 HERNI P PEGAWAI SWASTA Malignant neoplasm of Rujuk Lanjut
breast
787 12-09-2018 160102050918Y000369 0001795314374 MUSA ALWIE L PEKERJA MANDIRI Non-insulin-dependent Rujuk Lanjut
diabetes mellitus with

788 12-09-2018 160102050918Y000480 0001795315667 SOVIAWATY P PEKERJA MANDIRI Non-insulin-dependent Berobat Jalan
diabetes mellitus without
DAFTAR KUNJUNGAN PESERTA SAKIT

Kantor Cabang : SAMARINDA - 1601

FKTP : SEGIRI - 16010205

789 12-09-2018 160102050918Y000386 0001895690981 ACHMAD GAZALI L PEGAWAI SWASTA Chronic ischaemic heart Rujuk Lanjut
disease, unspecified
790 12-09-2018 160102050918Y000409 0001924827445 MINA P PEKERJA MANDIRI Psoriasis vulgaris Rujuk Lanjut

791 12-09-2018 160102050918Y000423 0001925214309 PAIMAN L PBI (APBD) Epilepsy, unspecified Rujuk Lanjut

792 12-09-2018 160102050918Y000390 0001925224997 MULYANTORO L PBI (APBD) Schizophrenia, unspecified Rujuk Lanjut

793 12-09-2018 160102050918Y000387 0001925231253 SLAMET RIDUAN L PBI (APBD) Schizophrenia, unspecified Rujuk Lanjut

794 12-09-2018 160102050918Y000446 0001925232107 MARTIYEM P PBI (APBD) Myalgia, hand Berobat Jalan

795 12-09-2018 160102050918Y000378 0001925232658 DIRMAN MUHAMMAD L PBI (APBD) Other disorders of Rujuk Lanjut
conjunctiva
796 12-09-2018 160102050918Y000539 0001928653154 FITRI YANTI P PBI (APBD) Supervision of normal first Berobat Jalan
pregnancy
797 12-09-2018 160102050918Y000399 0002001403574 SAMURI L PBI (APBN) Myalgia, shoulder region Berobat Jalan

798 12-09-2018 160102050918Y000422 0002065980126 RUSLI SIREGAR L PEKERJA MANDIRI Chronic ischaemic heart Rujuk Lanjut
disease, unspecified
799 12-09-2018 160102050918Y000425 0002066742167 AJI SYARIFAH BAIDURI P PEKERJA MANDIRI Dyspepsia Berobat Jalan
PERTIWI
800 12-09-2018 160102050918Y000398 0002075293427 TAMRIN L PBI (APBD) Chronic ischaemic heart Rujuk Lanjut
disease, unspecified
801 12-09-2018 160102050918Y000454 0002085477434 SANTARI WAHAB L PEKERJA MANDIRI Non-insulin-dependent Berobat Jalan
diabetes mellitus without

802 12-09-2018 160102050918Y000392 0002087629266 sanusi L PEKERJA MANDIRI Acute nasopharyngitis Berobat Jalan
[common cold]
803 12-09-2018 160102050918Y000403 0002194235289 ANNISA DWI RAMADHANI P PBI (APBD) Convulsions, not Rujuk Lanjut
elsewhere classified
804 12-09-2018 160102050918Y000382 0002219929301 RAHMANSYAH L PEKERJA MANDIRI Fever, unspecified Berobat Jalan

805 12-09-2018 160102050918Y000420 0002254958144 UPE ANI SODDIN P PEKERJA MANDIRI Benign neoplasm of Rujuk Lanjut
unspecified site
806 12-09-2018 160102050918Y000424 0002254960642 AGUSTAN L PEKERJA MANDIRI Chronic apical Berobat Jalan
periodontitis
807 12-09-2018 160102050918Y000416 0002268754018 SYAMSUDIN L PEKERJA MANDIRI Parkinson's disease Rujuk Lanjut

808 12-09-2018 160102050918Y000408 0002290270882 AURA MISYA RAHMADANI P PBI (APBD) Epilepsy, unspecified Rujuk Lanjut

809 12-09-2018 160102050918Y000410 0002322632553 HASANAH P PEKERJA MANDIRI Infection following a Berobat Jalan
procedure, not elsewhere

810 12-09-2018 160102050918Y000405 0002421836526 TI'AMAH P PEKERJA MANDIRI Headache Berobat Jalan
DAFTAR KUNJUNGAN PESERTA SAKIT

Kantor Cabang : SAMARINDA - 1601

FKTP : SEGIRI - 16010205

811 12-09-2018 160102050918Y000397 0002438204545 KANZANA AHMAD P PEKERJA MANDIRI Lack of expected normal Rujuk Lanjut
physiological

812 12-09-2018 160102050918Y000380 0002453842901 NURSAM P PEKERJA MANDIRI Essential (primary) Berobat Jalan
hypertension
813 10-09-2018 160102050918Y000334 0000119775644 NURJALI L PNS DAERAH Chronic ischaemic heart Rujuk Lanjut
disease, unspecified
814 10-09-2018 160102050918Y000320 0000119934955 PERIDA P PENERIMA PENSIUN After-cataract Rujuk Lanjut
PNS
815 10-09-2018 160102050918Y000337 0000119991262 PARJIEM,A.MA.PD P PENERIMA PENSIUN Benign neoplasm of Rujuk Lanjut
PNS unspecified site
816 10-09-2018 160102050918Y000331 0000120215373 SILVIAWAN P PENERIMA PENSIUN Presbyopia Rujuk Lanjut
PNS
817 10-09-2018 160102050918Y000336 0000120287755 SYARIFUL L PENERIMA PENSIUN Chronic ischaemic heart Rujuk Lanjut
PNS disease, unspecified
818 10-09-2018 160102050918Y000363 0000120313247 SAJIAH P PNS DAERAH Acute pharyngitis, Berobat Jalan
unspecified
819 10-09-2018 160102050918Y000976 0000120342936 ZULKIPLI L PENERIMA PENSIUN Chronic ischaemic heart Berobat Jalan
PNS disease, unspecified
820 10-09-2018 160102050918Y000354 0000120419921 HERRY MULYANI P PNS PUSAT Myalgia, shoulder region Berobat Jalan

821 10-09-2018 160102050918Y000316 0000120431924 SUPONO L PENERIMA PENSIUN Chronic renal failure, Rujuk Lanjut
PNS unspecified
822 10-09-2018 160102050918Y000325 0000120500943 RUKIYAH P PENERIMA PENSIUN TNI Noninflammatory disorders Rujuk Lanjut
of ovary, fallopian tube
and broad ligament

823 10-09-2018 160102050918Y000318 0000120512698 I WAYAN NASA ADHI,BA L PENERIMA PENSIUN TNI After-cataract Rujuk Lanjut

824 10-09-2018 160102050918Y000315 0000120572537 NORSIAH YUSRAN P PENERIMA PENSIUN Chronic ischaemic heart Rujuk Lanjut
PNS disease, unspecified
825 10-09-2018 160102050918Y000324 0000120578848 M.ARPAN L PENERIMA PENSIUN After-cataract Rujuk Lanjut
PNS
826 10-09-2018 160102050918Y000323 0000120578859 MARGARETHA THERESIA P PENERIMA PENSIUN Asthma, unspecified Rujuk Lanjut
SARAUN PNS
827 10-09-2018 160102050918Y000333 0000120614444 PAYAMAN SINAMBELA, DRS L PENERIMA PENSIUN Glaucoma, unspecified Rujuk Lanjut
PNS
828 10-09-2018 160102050918Y000979 0000120629665 NENENG KRISTIANI ROCHJIATI P PENERIMA PENSIUN Chronic ischaemic heart Berobat Jalan
PNS disease, unspecified
829 10-09-2018 160102050918Y000440 0000120656237 DANTES HUTAHAEAN SH. L PENERIMA PENSIUN Acute nasopharyngitis Berobat Jalan
PNS [common cold]
830 10-09-2018 160102050918Y000327 0000120660287 HJ. AJI DJUWITA KIRANA P PENERIMA PENSIUN Non-insulin-dependent Rujuk Lanjut
PNS diabetes mellitus without
DAFTAR KUNJUNGAN PESERTA SAKIT

Kantor Cabang : SAMARINDA - 1601

FKTP : SEGIRI - 16010205

831 10-09-2018 160102050918Y000330 0000120673225 SITI SYARAH P PENERIMA PENSIUN Chronic ischaemic heart Rujuk Lanjut
PNS disease, unspecified
832 10-09-2018 160102050918Y000366 0000120739972 RAHMANIAH P PNS DAERAH Acute nasopharyngitis Berobat Jalan
[common cold]
833 10-09-2018 160102050918Y000351 0000120756295 SAWUDI L PNS DAERAH Superficial injury of lower Berobat Jalan
leg, unspecified
834 10-09-2018 160102050918Y000971 0000120917564 MONIKA FEBRI PAEMBONAN P PNS PUSAT Acute pharyngitis, Berobat Jalan
unspecified
835 10-09-2018 160102050918Y000342 0000123084347 WA INDU P PNS DAERAH Other and unspecified Rujuk Lanjut
abdominal pain
836 10-09-2018 160102050918Y000352 0000123677133 hj. ARPAH MASDALI, s.sos. P PNS DAERAH Chronic ischaemic heart Berobat Jalan
m.,kes disease, unspecified
837 10-09-2018 160102050918Y000358 0000123684041 HELDA SUSANTI P PENERIMA PENSIUN Acute nasopharyngitis Berobat Jalan
PNS [common cold]
838 10-09-2018 160102050918Y000362 0000123686223 MARTIN JUANDA L PNS DAERAH Essential (primary) Berobat Jalan
hypertension
839 10-09-2018 160102050918Y000326 0000123691408 SRI UTAMININGSIH P PNS DAERAH Low back pain Rujuk Lanjut

840 10-09-2018 160102050918Y000332 0000123693399 THERESIA SRI LESTARI P PNS DAERAH Amenorrhoea, unspecified Rujuk Lanjut

841 10-09-2018 160102050918Y000347 0000159027333 HAMDANAH P PNS DAERAH Non-insulin-dependent Rujuk Lanjut
diabetes mellitus with
neurological complications

842 10-09-2018 160102050918Y000350 0000194227931 DR.IRA PUSPA RACHMAWATI P PNS DAERAH Asthma, unspecified Berobat Jalan

843 10-09-2018 160102050918Y000348 0000901926213 TAJUDDIN NOOR L PBI (APBN) Essential (primary) Berobat Jalan
hypertension
844 10-09-2018 160102050918Y000359 0000902076693 HANI RAHMAWATI P PBI (APBN) Headache Berobat Jalan

845 10-09-2018 160102050918Y000338 0000902379339 M RIZKY A L PBI (APBN) Dyslexia and other Rujuk Lanjut
symbolic dysfunctions, not

846 10-09-2018 160102050918Y000983 0000902504744 RUGAIYAH P PBI (APBN) Essential (primary) Berobat Jalan
hypertension
847 10-09-2018 160102050918Y000367 0000902613609 YUNIATI P PBI (APBN) Headache Berobat Jalan

848 10-09-2018 160102050918Y000357 0000902628922 WA SUNTI P PBI (APBN) Essential (primary) Berobat Jalan
hypertension
849 10-09-2018 160102050918Y000981 0000902794893 SLAMET RUDIANTO L PBI (APBN) Chronic obstructive Rujuk Lanjut
pulmonary disease,

850 10-09-2018 160102050918Y000970 0000903254196 RUDIANSYAH BJ L PBI (APBN) Allergic contact dermatitis, Berobat Jalan
unspecified cause
DAFTAR KUNJUNGAN PESERTA SAKIT

Kantor Cabang : SAMARINDA - 1601

FKTP : SEGIRI - 16010205

851 10-09-2018 160102050918Y000968 0000903275379 PAITUN P PBI (APBN) Non-insulin-dependent Berobat Jalan
diabetes mellitus without

852 10-09-2018 160102050918Y000969 0000903427503 RAFKA AVRIAN FAUZI L PBI (APBN) Fever, unspecified Berobat Jalan

853 10-09-2018 160102050918Y000340 0001066449835 MARDIANA P PBI (APBN) Hypertensive renal Rujuk Lanjut
disease
854 10-09-2018 160102050918Y000322 0001066476971 MULYANTI P PBI (APBN) Adjustment disorders Rujuk Lanjut

855 10-09-2018 160102050918Y000339 0001314102003 RUSDIANA P PEGAWAI SWASTA Hypertensive renal Rujuk Lanjut
disease
856 10-09-2018 160102050918Y000975 0001408515129 DWI KASIYATI P PEGAWAI SWASTA Dermatophytosis, Berobat Jalan
unspecified
857 10-09-2018 160102050918Y000321 0001433246916 ISKANDAR L PEKERJA MANDIRI Haemoptysis Rujuk Lanjut

858 10-09-2018 160102050918Y000364 0001611847765 IGIT ALUNG P PBI (APBD) Dyspepsia Berobat Jalan

859 10-09-2018 160102050918Y000441 0001649089798 FATHIR AZKA JIBRANI L PEGAWAI SWASTA Allergic contact dermatitis, Berobat Jalan
unspecified cause

860 10-09-2018 160102050918Y000343 0001724627935 RINA ASTUTI P PEKERJA MANDIRI Malignant neoplasm of Rujuk Lanjut
breast
861 10-09-2018 160102050918Y000365 0001775281779 HERLINA L. SITUMORANG P PEGAWAI SWASTA Essential (primary) Berobat Jalan
hypertension
862 10-09-2018 160102050918Y000328 0001823509416 ROBBY VADILLAH ZURIN L PEGAWAI SWASTA Benign neoplasm of Rujuk Lanjut
unspecified site
863 10-09-2018 160102050918Y000317 0001923462303 MARLEN UDAU P PEKERJA MANDIRI Tinnitus Rujuk Lanjut

864 10-09-2018 160102050918Y000335 0001924996847 AJI SETIAWAN L PEKERJA MANDIRI Benign neoplasm of Rujuk Lanjut
unspecified site
865 10-09-2018 160102050918Y000341 0001925217358 CHERLY AGUSTIN P PBI (APBD) Benign neoplasm of Rujuk Lanjut
unspecified site
866 10-09-2018 160102050918Y000360 0001925235977 KHUSNUL KHOTIMAH P PEGAWAI SWASTA Conjunctivitis, unspecified Berobat Jalan

867 10-09-2018 160102050918Y000349 0001929264096 ERNA DWI ASTUTIK P PBI (APBD) Supervision of normal Rujuk Lanjut
pregnancy, unspecified
868 10-09-2018 160102050918Y000974 0002049810726 rahardi L PEKERJA MANDIRI Sequelae of stroke, not Berobat Jalan
specified as haemorrhage

869 10-09-2018 160102050918Y000319 0002063145666 NURHAIDAH P PEKERJA MANDIRI Chronic ischaemic heart Rujuk Lanjut
disease, unspecified
870 10-09-2018 160102050918Y000977 0002073949255 MUJIATEN P PEKERJA MANDIRI Essential (primary) Berobat Jalan
hypertension
871 10-09-2018 160102050918Y000346 0002083722489 RUBIYANTI P PEKERJA MANDIRI Fracture of other parts of Rujuk Lanjut
forearm , closed
DAFTAR KUNJUNGAN PESERTA SAKIT

Kantor Cabang : SAMARINDA - 1601

FKTP : SEGIRI - 16010205

872 10-09-2018 160102050918Y000982 0002087826581 MASITAH P PEKERJA MANDIRI Non-insulin-dependent Berobat Jalan
diabetes mellitus without

873 10-09-2018 160102050918Y000344 0002194372877 ARNOLDUS TONI L PBI (APBD) Leukaemia of unspecified Rujuk Lanjut
cell type
874 10-09-2018 160102050918Y000972 0002226755845 DAVA DYLOVA PRAMONO L PEKERJA MANDIRI Superficial injury of lower Berobat Jalan
leg, unspecified
875 10-09-2018 160102050918Y000356 0002231971942 RUDI SETIAWAN L PEKERJA MANDIRI Acute nasopharyngitis Berobat Jalan
[common cold]
876 10-09-2018 160102050918Y000345 0002241872122 ARIYONO L PEKERJA MANDIRI Hyperplasia of prostate Rujuk Lanjut

877 10-09-2018 160102050918Y000443 0002253033314 SAPTIKA MAHARANI P PNS DAERAH Acute nasopharyngitis Berobat Jalan
[common cold]
878 10-09-2018 160102050918Y000361 0002290183097 LINdA SUSANTI P PEKERJA MANDIRI Dyspepsia Berobat Jalan

879 10-09-2018 160102050918Y000447 0002290189634 devan arcadia L PEKERJA MANDIRI Varicella without Berobat Jalan
complication
880 10-09-2018 160102050918Y000353 0002290730477 MASDUKI L PEKERJA MANDIRI Essential (primary) Berobat Jalan
hypertension
881 10-09-2018 160102050918Y000442 0002293592152 MUHAMMAD AZKA RAMADHAN L PEKERJA MANDIRI Acute nasopharyngitis Berobat Jalan
[common cold]
882 10-09-2018 160102050918Y000355 0002376998122 RINDU ANINDHIKA HASIBUAN P PEKERJA MANDIRI Supervision of normal Rujuk Lanjut
pregnancy, unspecified
883 10-09-2018 160102050918Y000444 0002456467097 KHAYRA FATIMAH IZMI P PEGAWAI PEMERINTAH Acute nasopharyngitis Berobat Jalan
DENGAN PERJANJIAN [common cold]

884 10-09-2018 160102050918Y000329 0002477485337 SUSI AGUS SUSANTI P PNS DAERAH Low vision, both eyes Rujuk Lanjut

885 08-09-2018 160102050918Y000459 0000102364266 EYVAMIA VERIKA VASHTI P PNS DAERAH Acute pharyngitis, Berobat Jalan
unspecified
886 08-09-2018 160102050918Y000473 0000119868816 SRI WAHYUNI,SP P PNS DAERAH Low vision, both eyes Rujuk Lanjut

887 08-09-2018 160102050918Y000456 0000120419921 HERRY MULYANI P PNS PUSAT Myalgia Berobat Jalan

888 08-09-2018 160102050918Y000960 0000120431913 WAGIYEM P PENERIMA PENSIUN Acute nasopharyngitis Berobat Jalan
PNS [common cold]
889 08-09-2018 160102050918Y000469 0000120488973 SALMAH TIMA P PENERIMA PENSIUN Non-insulin-dependent Berobat Jalan
PNS diabetes mellitus without

890 08-09-2018 160102050918Y000467 0000120549352 MERY TANDIARANG P PNS DAERAH Non-insulin-dependent Berobat Jalan
diabetes mellitus without

891 08-09-2018 160102050918Y000465 0000120550601 B. MUSA UNYA L PNS DAERAH Acute nasopharyngitis Berobat Jalan
[common cold]
892 08-09-2018 160102050918Y000958 0000120658061 MURDJANI PATHUR L PENERIMA PENSIUN Chronic ischaemic heart Berobat Jalan
PNS disease, unspecified
DAFTAR KUNJUNGAN PESERTA SAKIT

Kantor Cabang : SAMARINDA - 1601

FKTP : SEGIRI - 16010205

893 08-09-2018 160102050918Y000472 0000120664866 HP. SIREGAR L PENERIMA PENSIUN Chronic ischaemic heart Rujuk Lanjut
PNS disease, unspecified
894 08-09-2018 160102050918Y000421 0000120672066 SUKARSIH P PENERIMA PENSIUN Senile cataract, Rujuk Lanjut
PNS unspecified
895 08-09-2018 160102050918Y000954 0000120674057 SUGIARTO L PENERIMA PENSIUN Essential (primary) Berobat Jalan
PNS hypertension
896 08-09-2018 160102050918Y000961 0000120674081 SUHADI L PENERIMA PENSIUN Acute pharyngitis, Berobat Jalan
PNS unspecified
897 08-09-2018 160102050918Y000959 0000120686848 MUKANI L PENERIMA PENSIUN Essential (primary) Berobat Jalan
PNS hypertension
898 08-09-2018 160102050918Y000947 0000120686859 ANI HAIRIAH P PENERIMA PENSIUN Essential (primary) Berobat Jalan
PNS hypertension
899 08-09-2018 160102050918Y000934 0000120926204 SUMARDI L PNS PUSAT Essential (primary) Berobat Jalan
hypertension
900 08-09-2018 160102050918Y000453 0000123024082 DARTI P PENERIMA PENSIUN Non-insulin-dependent Berobat Jalan
PNS diabetes mellitus without

901 08-09-2018 160102050918Y000451 0000123297625 MARLINA AIDHA P PENERIMA PENSIUN Chronic ischaemic heart Berobat Jalan
PNS disease, unspecified
902 08-09-2018 160102050918Y000471 0000123711041 SRI NGATIN P PNS DAERAH Hyperlipidaemia, Berobat Jalan
unspecified
903 08-09-2018 160102050918Y000942 0000165586206 DEMSI SIREGAR P PNS PUSAT Essential (primary) Rujuk Lanjut
hypertension
904 08-09-2018 160102050918Y000946 0000170565669 IRWAN HERMAWAN L PEKERJA MANDIRI Chronic ischaemic heart Rujuk Lanjut
disease, unspecified
905 08-09-2018 160102050918Y000950 0000171613271 HJ.UMMU AIMANUL P PNS PUSAT Chronic ischaemic heart Berobat Jalan
KHOBASYIAH disease, unspecified
906 08-09-2018 160102050918Y000939 0000206978141 CHIKA SYIFANA PUTRI P PNS PUSAT Acute tonsillitis, Berobat Jalan
unspecified
907 08-09-2018 160102050918Y000476 0000902524397 OLIVIA BAYU FEBRIANTI P PBI (APBN) Acute tonsillitis, Berobat Jalan
unspecified
908 08-09-2018 160102050918Y000461 0000902592371 ROHATI P PBI (APBN) Cystitis, unspecified Berobat Jalan

909 08-09-2018 160102050918Y000944 0000903222854 SAID UMAR UMAYAH L PBI (APBN) Essential (primary) Berobat Jalan
hypertension
910 08-09-2018 160102050918Y000450 0000903275379 PAITUN P PBI (APBN) Non-insulin-dependent Berobat Jalan
diabetes mellitus without

911 08-09-2018 160102050918Y000746 0001066476025 FENI NOVITASARI P PBI (APBN) Urticaria, unspecified Berobat Jalan

912 08-09-2018 160102050918Y000957 0001066477408 DWI BAMBANG PURNAMA L PBI (APBN) Chronic obstructive Rujuk Lanjut
pulmonary disease,
DAFTAR KUNJUNGAN PESERTA SAKIT

Kantor Cabang : SAMARINDA - 1601

FKTP : SEGIRI - 16010205

913 08-09-2018 160102050918Y000745 0001066477836 RUSMINI P PBI (APBN) Dermatophytosis, Berobat Jalan
unspecified
914 08-09-2018 160102050918Y000463 0001066479917 ARBAIN L PBI (APBN) Surgical follow-up care, Rujuk Lanjut
unspecified
915 08-09-2018 160102050918Y000449 0001066483383 NUR RIPANI L PBI (APBN) Dyspepsia Berobat Jalan

916 08-09-2018 160102050918Y000470 0001066484507 SUHAIMI L PBI (APBN) Essential (primary) Berobat Jalan
hypertension
917 08-09-2018 160102050918Y000744 0001066484531 DHAFA RISKY MAULANA L PBI (APBN) Acute pharyngitis, Berobat Jalan
unspecified
918 08-09-2018 160102050918Y000930 0001150843454 BELLA RAHMA DWI PUTRI L PEGAWAI SWASTA Headache Berobat Jalan

919 08-09-2018 160102050918Y000452 0001283120008 NUR HANA P PEKERJA MANDIRI Chronic ischaemic heart Berobat Jalan
disease, unspecified
920 08-09-2018 160102050918Y000737 0001378350257 AFIFAH NUR SYAHRAJANI P PEGAWAI SWASTA Glaucoma, unspecified Rujuk Lanjut

921 08-09-2018 160102050918Y000931 0001546230352 TAMYES L PEGAWAI SWASTA Benign neoplasm of Rujuk Lanjut
unspecified site
922 08-09-2018 160102050918Y000747 0001725146706 SALMA DJEJA P PEKERJA MANDIRI Myalgia Berobat Jalan

923 08-09-2018 160102050918Y000474 0001802796131 AFIF OMAR AHMAD L PNS DAERAH Hiccough Berobat Jalan

924 08-09-2018 160102050918Y000953 0001819917437 DIAN WAHYUNING FITRI P PEGAWAI SWASTA Acute pharyngitis, Berobat Jalan
unspecified
925 08-09-2018 160102050918Y000468 0001826839315 ELLISA P PEKERJA MANDIRI Non-insulin-dependent Berobat Jalan
diabetes mellitus without

926 08-09-2018 160102050918Y000927 0001865580939 helen sintice silaban L PEKERJA MANDIRI Acute pharyngitis, Berobat Jalan
unspecified
927 08-09-2018 160102050918Y000926 0001925214309 PAIMAN L PBI (APBD) Localization-related (focal) Rujuk Lanjut
(partial) idiopathic epilepsy
and epileptic syndromes
with seizures of localized
onset
928 08-09-2018 160102050918Y000929 0001925232311 MUHAMMAD ZAKKY ZAMANY L PBI (APBD) Acute pharyngitis, Berobat Jalan
unspecified
929 08-09-2018 160102050918Y000455 0001925232592 ZAINUL SHOLIKHIN L PBI (APBD) Constipation Berobat Jalan

930 08-09-2018 160102050918Y000457 0001926835885 NASUHA P PEKERJA MANDIRI Myalgia Berobat Jalan

931 08-09-2018 160102050918Y000464 0002072381916 SIE MOIJ P PEKERJA MANDIRI Chronic renal failure, Rujuk Lanjut
unspecified
932 08-09-2018 160102050918Y000466 0002091668589 HASNAH P PEKERJA MANDIRI Non-insulin-dependent Berobat Jalan
diabetes mellitus without
DAFTAR KUNJUNGAN PESERTA SAKIT

Kantor Cabang : SAMARINDA - 1601

FKTP : SEGIRI - 16010205

933 08-09-2018 160102050918Y000743 0002225133909 SUMIATI P PEKERJA MANDIRI Non-insulin-dependent Berobat Jalan
diabetes mellitus without

934 08-09-2018 160102050918Y000462 0002226982746 AHMAD MAULANA L PNS DAERAH Dyspepsia Berobat Jalan

935 08-09-2018 160102050918Y000940 0002257862229 LA PITIHA L PEKERJA MANDIRI Acute nasopharyngitis Berobat Jalan
[common cold]
936 08-09-2018 160102050918Y000458 0002299507367 WA INI P PBI (APBD) Sciatica Rujuk Lanjut

937 08-09-2018 160102050918Y000948 0002322632553 HASANAH P PEKERJA MANDIRI Infection following a Berobat Jalan
procedure, not elsewhere

938 08-09-2018 160102050918Y000695 0002442633557 FAR SUMIATI P PEKERJA MANDIRI Benign neoplasm of Rujuk Lanjut
unspecified site
939 07-09-2018 160102050918Y000548 0000037445657 SITI ALBAROROH P PNS PUSAT Non-insulin-dependent Berobat Jalan
diabetes mellitus without

940 07-09-2018 160102050918Y000619 0000120470005 MOEDJIONO L PNS PUSAT Hyperplasia of prostate Rujuk Lanjut

941 07-09-2018 160102050918Y000694 0000120545199 EDWARD SURYATMANTO L PNS DAERAH Non-insulin-dependent Berobat Jalan
diabetes mellitus without

942 07-09-2018 160102050918Y000475 0000120549352 MERY TANDIARANG P PNS DAERAH Presbyopia Rujuk Lanjut

943 07-09-2018 160102050918Y000625 0000120561311 APUK BILUNG L PENERIMA PENSIUN Presbyopia Rujuk Lanjut
PNS
944 07-09-2018 160102050918Y000624 0000120561322 BURING P PENERIMA PENSIUN Essential (primary) Berobat Jalan
PNS hypertension
945 07-09-2018 160102050918Y000718 0000120629654 SYAHRUDDIN TARMIDZI L PENERIMA PENSIUN Chronic ischaemic heart Rujuk Lanjut
PNS disease, unspecified
946 07-09-2018 160102050918Y000626 0000120636415 LAILIYAH P PENERIMA PENSIUN Stroke, not specified as Rujuk Lanjut
PNS haemorrhage or infarction
947 07-09-2018 160102050918Y000617 0000120641073 HATTA SIDIK L PENERIMA PENSIUN Chronic ischaemic heart Rujuk Lanjut
PNS disease, unspecified
948 07-09-2018 160102050918Y000549 0000120642063 ILHAMSYAH L PENERIMA PENSIUN Headache Rujuk Lanjut
PNS
949 07-09-2018 160102050918Y000479 0000120657014 WIJANA MULJOWIDODO L PENERIMA PENSIUN Sequelae of stroke, not Rujuk Lanjut
PNS specified as haemorrhage

950 07-09-2018 160102050918Y000623 0000120661119 SISWOJO L PENERIMA PENSIUN Chronic ischaemic heart Berobat Jalan
PNS disease, unspecified
951 07-09-2018 160102050918Y000728 0000120668782 HATIPAH P PENERIMA PENSIUN Non-insulin-dependent Rujuk Lanjut
PNS diabetes mellitus without

952 07-09-2018 160102050918Y000630 0000120782147 NOR HASANAH P PENERIMA PENSIUN Pleural condition, Rujuk Lanjut
PNS unspecified
DAFTAR KUNJUNGAN PESERTA SAKIT

Kantor Cabang : SAMARINDA - 1601

FKTP : SEGIRI - 16010205

953 07-09-2018 160102050918Y000636 0000123079149 ALFARET DAPEN SIMBOLON L PNS DAERAH Essential (primary) Berobat Jalan
hypertension
954 07-09-2018 160102050918Y000620 0000123678922 DR.FREDDY YOEDYANTO L PENERIMA PENSIUN Non-insulin-dependent Berobat Jalan
PNS diabetes mellitus without

955 07-09-2018 160102050918Y000622 0000123687167 FATIMAH P PNS DAERAH Epilepsy, unspecified Rujuk Lanjut

956 07-09-2018 160102050918Y000618 0000170565669 IRWAN HERMAWAN L PEKERJA MANDIRI Tension-type headache Rujuk Lanjut

957 07-09-2018 160102050918Y000368 0000893878705 noorsehan P PBI (APBN) Hodgkin lymphoma Rujuk Lanjut

958 07-09-2018 160102050918Y000637 0000897253784 ABDUL HAMID L PBI (APBN) Other and unspecified Rujuk Lanjut
cirrhosis of liver
959 07-09-2018 160102050918Y000715 0000897270682 MIHAI P PBI (APBN) Surgical follow-up care, Rujuk Lanjut
unspecified
960 07-09-2018 160102050918Y000638 0000898629096 YUDA PRAWIJAYA L PBI (APBN) Tuberculous peripheral Berobat Jalan
lymphadenopathy
961 07-09-2018 160102050918Y000720 0000901935213 TINA HASISEH P PBI (APBN) Essential (primary) Berobat Jalan
hypertension
962 07-09-2018 160102050918Y000713 0000902377495 TOTO AGUS PURWANTO L PBI (APBN) Hyperlipidaemia, Berobat Jalan
unspecified
963 07-09-2018 160102050918Y000628 0000902379339 M RIZKY A L PBI (APBN) Dyslexia and other Rujuk Lanjut
symbolic dysfunctions, not

964 07-09-2018 160102050918Y000719 0000902411921 HASAN L PBI (APBN) Essential (primary) Berobat Jalan
hypertension
965 07-09-2018 160102050918Y000721 0000902586969 ERIFADIN SABUR L PBI (APBN) Essential (primary) Berobat Jalan
hypertension
966 07-09-2018 160102050918Y000448 0000902626299 MARLIN CHRSITINA P PBI (APBN) Other specified headache Rujuk Lanjut
syndromes
967 07-09-2018 160102050918Y000629 0000902629809 ELISABETH DEBORA P PBI (APBN) Pain localized to other Rujuk Lanjut
parts of lower abdomen
968 07-09-2018 160102050918Y000731 0000902926743 ARDIA NUR CAHYANI P PBI (APBN) Diarrhoea and Berobat Jalan
gastroenteritis of
presumed infectious origin

969 07-09-2018 160102050918Y000550 0000903427503 RAFKA AVRIAN FAUZI L PBI (APBN) Fever, unspecified Berobat Jalan

970 07-09-2018 160102050918Y000631 0001281680741 DANIEL SANG NYUK L PEKERJA MANDIRI Chronic ischaemic heart Rujuk Lanjut
disease, unspecified
971 07-09-2018 160102050918Y000711 0001291124305 KHUSNAINI P PBI (APBD) Benign neoplasm of Rujuk Lanjut
unspecified site
972 07-09-2018 160102050918Y000481 0001445777447 ACHMAD ZUHRI L PEKERJA MANDIRI Chronic ischaemic heart Rujuk Lanjut
disease, unspecified
DAFTAR KUNJUNGAN PESERTA SAKIT

Kantor Cabang : SAMARINDA - 1601

FKTP : SEGIRI - 16010205

973 07-09-2018 160102050918Y000581 0001445780103 WAHYU DRAJAT L PEKERJA MANDIRI Chronic viral hepatitis, Rujuk Lanjut
unspecified
974 07-09-2018 160102050918Y001329 0001477357852 MUHAMMAD RIZAL KURNIA L PEGAWAI SWASTA Epilepsy, unspecified Rujuk Lanjut

975 07-09-2018 160102050918Y000616 0001553441534 YEHEZKIEL UNCAN L PBI (APBD) Epilepsy, unspecified Rujuk Lanjut

976 07-09-2018 160102050918Y000634 0001611802574 JUNAIDI L PBI (APBD) Calculus of gallbladder Rujuk Lanjut
with other cholecystitis
977 07-09-2018 160102050918Y000632 0001796465496 MARIA ULFAH P PEGAWAI SWASTA Chronic viral hepatitis, Rujuk Lanjut
unspecified
978 07-09-2018 160102050918Y000729 0001924514796 WIGIARTI P PEKERJA MANDIRI Benign neoplasm of Rujuk Lanjut
unspecified site
979 07-09-2018 160102050918Y000490 0001924931766 SUNARTIN P PEKERJA MANDIRI Unspecified viral hepatitis Rujuk Lanjut
without hepatic coma

980 07-09-2018 160102050918Y000708 0001925217336 MOCHAMAD ARYA YUDISTIRA L PBI (APBD) Acute tonsillitis, Berobat Jalan
unspecified
981 07-09-2018 160102050918Y000712 0001925217358 CHERLY AGUSTIN P PBI (APBD) Benign neoplasm of Rujuk Lanjut
unspecified site
982 07-09-2018 160102050918Y000726 0001925221915 HERI MULYONO L PBI (APBD) Essential (primary) Berobat Jalan
hypertension
983 07-09-2018 160102050918Y000483 0001925222095 MUJIATI P PBI (APBD) Heart failure, unspecified Rujuk Lanjut

984 07-09-2018 160102050918Y000614 0001925224806 MULYONO L PBI (APBD) Hyperplasia of prostate Rujuk Lanjut

985 07-09-2018 160102050918Y000722 0002059620434 FADJRI L PEKERJA MANDIRI Chronic ischaemic heart Rujuk Lanjut
disease, unspecified
986 07-09-2018 160102050918Y000621 0002059621334 FIRDA P PEKERJA MANDIRI Chronic ischaemic heart Rujuk Lanjut
disease, unspecified
987 07-09-2018 160102050918Y000635 0002068061927 LASI L PEKERJA MANDIRI Chronic viral hepatitis, Rujuk Lanjut
unspecified
988 07-09-2018 160102050918Y000551 0002075293686 RISKI HARDIYANTI P PBI (APBD) Dyspepsia Berobat Jalan

989 07-09-2018 160102050918Y000627 0002083722489 RUBIYANTI P PEKERJA MANDIRI Fracture of other parts of Berobat Jalan
forearm , closed
990 07-09-2018 160102050918Y000552 0002200275224 PANIYEM P PEKERJA MANDIRI Acute nasopharyngitis Berobat Jalan
[common cold]
991 07-09-2018 160102050918Y000727 0002230354157 KIPANG P PBI (APBD) Malignant neoplasm of Rujuk Lanjut
cervix uteri, unspecified
992 07-09-2018 160102050918Y000460 0002236646575 AZRINA RAZIYA SHAZFA P PEGAWAI SWASTA Paraplegia, unspecified Rujuk Lanjut

993 07-09-2018 160102050918Y000615 0002268754211 MARIAMA P PEKERJA MANDIRI Chronic ischaemic heart Rujuk Lanjut
disease, unspecified
994 07-09-2018 160102050918Y000633 0002287018462 PAINO L PEKERJA MANDIRI Other and unspecified Berobat Jalan
cirrhosis of liver
DAFTAR KUNJUNGAN PESERTA SAKIT

Kantor Cabang : SAMARINDA - 1601

FKTP : SEGIRI - 16010205

995 07-09-2018 160102050918Y000716 0002317500821 JUWITA HB P PEKERJA MANDIRI Essential (primary) Berobat Jalan
hypertension
996 07-09-2018 160102050918Y000732 0002463561336 LA TEPU L PEKERJA MANDIRI Superficial injury of lower Rujuk Lanjut
leg, unspecified
997 06-09-2018 160102050918Y000311 0000119705286 WILSON NIAS LENSUIT L PNS DAERAH Senile cataract, Rujuk Lanjut
unspecified
998 06-09-2018 160102050918Y000307 0000120317466 JUMANI L PNS DAERAH Chronic periodontitis Berobat Jalan

999 06-09-2018 160102050918Y000308 0000120381039 NORHASANAH P PNS PUSAT Low back pain Rujuk Lanjut

1000 06-09-2018 160102050918Y000314 0000120495429 MUYASSAROH P VETERAN Chronic ischaemic heart Berobat Jalan
disease, unspecified
1001 06-09-2018 160102050918Y000266 0000120549352 MERY TANDIARANG P PNS DAERAH Presbyopia Rujuk Lanjut

1002 06-09-2018 160102050918Y000309 0000120549453 SAIDAH P PNS DAERAH Caries of dentine Berobat Jalan

1003 06-09-2018 160102050918Y000478 0000120598762 M. NUR ARTHA, BC.HK L PENERIMA PENSIUN Non-insulin-dependent Rujuk Lanjut
PNS diabetes mellitus with

1004 06-09-2018 160102050918Y000313 0000120601809 MARIJATI P PENERIMA PENSIUN Dyspnoea Rujuk Lanjut
PNS
1005 06-09-2018 160102050918Y000276 0000120607863 MUHAMMAD YUSUF. A L PENERIMA PENSIUN Sequelae of stroke, not Berobat Jalan
PNS specified as haemorrhage

1006 06-09-2018 160102050918Y000299 0000120629193 SYAHRAN L PENERIMA PENSIUN Non-insulin-dependent Rujuk Lanjut
PNS diabetes mellitus with
neurological complications

1007 06-09-2018 160102050918Y000300 0000120629248 JAMRUD P PENERIMA PENSIUN Sequelae of stroke, not Rujuk Lanjut
PNS specified as haemorrhage

1008 06-09-2018 160102050918Y000428 0000120636415 LAILIYAH P PENERIMA PENSIUN Sequelae of stroke, not Rujuk Lanjut
PNS specified as haemorrhage

1009 06-09-2018 160102050918Y000542 0000120672055 SABAN L PENERIMA PENSIUN Non-insulin-dependent Berobat Jalan
PNS diabetes mellitus without

1010 06-09-2018 160102050918Y000278 0000120672674 SAMLAN,DRS, BCHK, H L PENERIMA PENSIUN Hyperplasia of prostate Rujuk Lanjut
PNS
1011 06-09-2018 160102050918Y000301 0000120684969 HJ.HADIDJAH muhidin P PENERIMA PENSIUN Sequelae of stroke, not Rujuk Lanjut
PNS specified as haemorrhage

1012 06-09-2018 160102050918Y000281 0000120727506 KAMSIAH P PENERIMA PENSIUN Chronic ischaemic heart Berobat Jalan
PNS disease, unspecified
1013 06-09-2018 160102050918Y000297 0000120756295 SAWUDI L PNS DAERAH Superficial injury of lower Berobat Jalan
leg, unspecified
DAFTAR KUNJUNGAN PESERTA SAKIT

Kantor Cabang : SAMARINDA - 1601

FKTP : SEGIRI - 16010205

1014 06-09-2018 160102050918Y000432 0000121926712 KRISTIAN PILIPUS L PNS PUSAT Malignant neoplasm of Rujuk Lanjut
nasopharynx, unspecified
1015 06-09-2018 160102050918Y000305 0000123118828 HUMAIRA PERMATA P PNS DAERAH Pulpitis Berobat Jalan

1016 06-09-2018 160102050918Y000280 0000123693423 THOMAS ALVA EDISON L PNS DAERAH Acute hepatitis B without Rujuk Lanjut
delta-agent and without

1017 06-09-2018 160102050918Y000275 0000211198127 SURATMI P PNS DAERAH Non-insulin-dependent Rujuk Lanjut
diabetes mellitus without

1018 06-09-2018 160102050918Y000547 0000902006559 NURUL IDAYANTI P PBI (APBN) Non-insulin-dependent Berobat Jalan
diabetes mellitus without

1019 06-09-2018 160102050918Y000310 0000902363567 JOKO SUKISNO L PBI (APBN) Other soft tissue disorders Rujuk Lanjut
related to use, overuse

1020 06-09-2018 160102050918Y000304 0000902501379 SAUDJI L PBI (APBN) Hyperplasia of prostate Rujuk Lanjut

1021 06-09-2018 160102050918Y000439 0000902684215 SUTRISNO L PBI (APBN) Acute nasopharyngitis Berobat Jalan
[common cold]
1022 06-09-2018 160102050918Y000431 0000903218084 KUSRINI P PBI (APBN) Chronic ischaemic heart Berobat Jalan
disease, unspecified
1023 06-09-2018 160102050918Y000312 0000903399816 WARSINAH P PBI (APBN) Benign neoplasm of Rujuk Lanjut
unspecified site
1024 06-09-2018 160102050918Y000545 0001066476993 WA UHA P PBI (APBN) Haemoptysis Berobat Jalan

1025 06-09-2018 160102050918Y000436 0001066478499 RUSFASIYAH P PBI (APBN) Hyperlipidaemia, Berobat Jalan
unspecified
1026 06-09-2018 160102050918Y000426 0001143771232 LAWAI LEJIU L PEGAWAI SWASTA Malignant neoplasm of Rujuk Lanjut
nasopharynx, unspecified
1027 06-09-2018 160102050918Y000435 0001303268499 BUDI SANTOSO L PEKERJA MANDIRI Malignant neoplasm of Rujuk Lanjut
larynx, unspecified
1028 06-09-2018 160102050918Y000477 0001433246916 ISKANDAR L PEKERJA MANDIRI Haemoptysis Berobat Jalan

1029 06-09-2018 160102050918Y000429 0001444650096 HERIBERTUS BELAWA OPEN L PEGAWAI SWASTA Diarrhoea and Berobat Jalan
gastroenteritis of
presumed infectious origin

1030 06-09-2018 160102050918Y000303 0001611571678 RUSLI L PBI (APBD) Calculus of kidney with Rujuk Lanjut
calculus of ureter
1031 06-09-2018 160102050918Y000293 0001925224896 NURAENI P PBI (APBD) Dyspnoea Rujuk Lanjut

1032 06-09-2018 160102050918Y000434 0001926347163 MUHAMMAD SYAMSURIADI L PEKERJA MANDIRI External haemorrhoids Rujuk Lanjut
without complication
1033 06-09-2018 160102050918Y000279 0001928654919 AISYAH P PBI (APBD) Asthma, unspecified Berobat Jalan
DAFTAR KUNJUNGAN PESERTA SAKIT

Kantor Cabang : SAMARINDA - 1601

FKTP : SEGIRI - 16010205

1034 06-09-2018 160102050918Y000438 0001929263962 SITI YULAINAH P PBI (APBD) Hyperlipidaemia, Berobat Jalan
unspecified
1035 06-09-2018 160102050918Y000298 0001930552828 AHMAD M L PBI (APBD) Myalgia, other site Berobat Jalan

1036 06-09-2018 160102050918Y000282 0002024612381 SUHARTI P PBI (APBN) Uterovaginal prolapse, Rujuk Lanjut
unspecified
1037 06-09-2018 160102050918Y000306 0002075293541 SUBAIDAH P PBI (APBD) Myalgia, multiple sites Berobat Jalan

1038 06-09-2018 160102050918Y000543 0002075293686 RISKI HARDIYANTI P PBI (APBD) Dyspepsia Berobat Jalan

1039 06-09-2018 160102050918Y000284 0002075293798 MUHAMMAD SURYA HAJAR L PBI (APBD) Dyspepsia Berobat Jalan
HASWAD
1040 06-09-2018 160102050918Y000546 0002196404684 PANTI ASTUTI P PEKERJA MANDIRI Non-insulin-dependent Berobat Jalan
diabetes mellitus without

1041 06-09-2018 160102050918Y000285 0002201822313 MARIAM P PEKERJA MANDIRI Hypokalaemia Rujuk Lanjut

1042 06-09-2018 160102050918Y000302 0002203276037 SUPRAPTO L PEKERJA MANDIRI Dyspnoea Rujuk Lanjut

1043 06-09-2018 160102050918Y000283 0002225691505 JUNAEDI L PEKERJA MANDIRI Acute pharyngitis, Berobat Jalan
unspecified
1044 06-09-2018 160102050918Y000296 0002243350631 MERE ULENG P PEKERJA MANDIRI Myalgia, ankle and foot Berobat Jalan

1045 06-09-2018 160102050918Y000544 0002243364322 ANGGA L PEKERJA MANDIRI Acute pharyngitis, Berobat Jalan
unspecified
1046 06-09-2018 160102050918Y000277 0002262899698 DUDY RAHMAN L PEKERJA MANDIRI Diarrhoea and Berobat Jalan
gastroenteritis of
presumed infectious origin

1047 06-09-2018 160102050918Y000482 0002268754211 MARIAMA P PEKERJA MANDIRI Chronic ischaemic heart Rujuk Lanjut
disease, unspecified
1048 06-09-2018 160102050918Y000295 0002275127493 SITI SA'IMAH L PBI (APBD) Epilepsy, unspecified Rujuk Lanjut

1049 06-09-2018 160102050918Y000437 0002304223389 ANDI HERY WIJAYA AS L PEKERJA MANDIRI Surgical follow-up care, Berobat Jalan
unspecified
1050 05-09-2018 160102050918Y000263 0000058656868 ULYANA PURI P PNS PUSAT Dental caries, unspecified Berobat Jalan

1051 05-09-2018 160102050918Y000260 0000120132832 WINARTI P PNS DAERAH Chronic periodontitis Berobat Jalan

1052 05-09-2018 160102050918Y000205 0000120421012 SUDJATMIKO L PENERIMA PENSIUN Essential (primary) Rujuk Lanjut
PNS hypertension
1053 05-09-2018 160102050918Y000290 0000120431924 SUPONO L PENERIMA PENSIUN Hyperlipidaemia, Berobat Jalan
PNS unspecified
1054 05-09-2018 160102050918Y000251 0000120459363 SA'AMAH P VETERAN Sequelae of stroke, not Rujuk Lanjut
specified as haemorrhage
DAFTAR KUNJUNGAN PESERTA SAKIT

Kantor Cabang : SAMARINDA - 1601

FKTP : SEGIRI - 16010205

1055 05-09-2018 160102050918Y000288 0000120549069 AGUSTIN RAHMAWATI P PNS DAERAH Acute pharyngitis, Berobat Jalan
unspecified
1056 05-09-2018 160102050918Y000292 0000120549104 ANI ENDANG SRI SUMARNI P PNS DAERAH Essential (primary) Berobat Jalan
hypertension
1057 05-09-2018 160102050918Y000206 0000120549172 ERNAWATI P PNS DAERAH Non-insulin-dependent Rujuk Lanjut
diabetes mellitus without

1058 05-09-2018 160102050918Y000232 0000120549227 HAIRINI P PNS DAERAH Non-insulin-dependent Berobat Jalan
diabetes mellitus without

1059 05-09-2018 160102050918Y000200 0000120549352 MERY TANDIARANG P PNS DAERAH Presbyopia Rujuk Lanjut

1060 05-09-2018 160102050918Y000286 0000120569139 DR. ROBBY CAHYA BK L PENERIMA PENSIUN Insulin-dependent Berobat Jalan
PNS diabetes mellitus without

1061 05-09-2018 160102050918Y000218 0000120570513 ROHANA P PENERIMA PENSIUN Senile incipient cataract Rujuk Lanjut
PNS
1062 05-09-2018 160102050918Y000244 0000120666958 MARKUS ROMBE L PENERIMA PENSIUN Chronic ischaemic heart Rujuk Lanjut
PNS disease, unspecified
1063 05-09-2018 160102050918Y000221 0000120668602 MASTORA P PENERIMA PENSIUN Myalgia, ankle and foot Berobat Jalan
PNS
1064 05-09-2018 160102050918Y000254 0000120672066 SUKARSIH P PENERIMA PENSIUN Non-insulin-dependent Rujuk Lanjut
PNS diabetes mellitus with
neurological complications

1065 05-09-2018 160102050918Y000201 0000120674362 SUKIRNO L PENERIMA PENSIUN Hyperplasia of prostate Rujuk Lanjut
PNS
1066 05-09-2018 160102050918Y000289 0000120777377 SITI WAHIDAH P PNS DAERAH Allergic contact dermatitis, Berobat Jalan
unspecified cause

1067 05-09-2018 160102050918Y000219 0000120847634 UMAR AZZAM ABDURRAHMAN L PNS DAERAH Acute nasopharyngitis Berobat Jalan
[common cold]
1068 05-09-2018 160102050918Y000245 0000123038908 DJURIANTI P PENERIMA PENSIUN Chronic ischaemic heart Rujuk Lanjut
PNS disease, unspecified
1069 05-09-2018 160102050918Y000240 0000123039933 ROLAM SIMANULLANG L PNS DAERAH Non-insulin-dependent Rujuk Lanjut
diabetes mellitus with
neurological complications

1070 05-09-2018 160102050918Y000258 0000123108445 FADHILLA PUTRI SOFIANITA P PNS DAERAH Dental caries, unspecified Berobat Jalan

1071 05-09-2018 160102050918Y000231 0000123258082 AHMAD HERWANSYAH L PNS DAERAH Low vision, both eyes Rujuk Lanjut

1072 05-09-2018 160102050918Y000249 0000123272864 ILMANSYAH L PNS DAERAH Retention of urine Rujuk Lanjut

1073 05-09-2018 160102050918Y000236 0000123676064 AKHMAD TAUFIK L PNS DAERAH Orthostatic proteinuria, Rujuk Lanjut
unspecified
DAFTAR KUNJUNGAN PESERTA SAKIT

Kantor Cabang : SAMARINDA - 1601

FKTP : SEGIRI - 16010205

1074 05-09-2018 160102050918Y000237 0000123676558 ANA HIVUI P PENERIMA PENSIUN After-cataract Rujuk Lanjut
PNS
1075 05-09-2018 160102050918Y000253 0000123685762 MUHAMMAD LUTFHI L PNS DAERAH Sequelae of stroke, not Rujuk Lanjut
WIDYASTONO specified as haemorrhage

1076 05-09-2018 160102050918Y000242 0000123687742 RADIANAH RAGA P PENERIMA PENSIUN Essential (primary) Berobat Jalan
PNS hypertension
1077 05-09-2018 160102050918Y000211 0000123726374 DEWI RIZKI RAMADHANI P PEGAWAI SWASTA Supervision of other Berobat Jalan
normal pregnancy
1078 05-09-2018 160102050918Y000241 0000159257733 JEANNE CORNELIA BURKENS P PENERIMA PENSIUN Chronic ischaemic heart Rujuk Lanjut
PNS disease, unspecified
1079 05-09-2018 160102050918Y000287 0000164796816 SRI AFTARI PUJI ASTUTI P PENERIMA PENSIUN Acute nasopharyngitis Berobat Jalan
PNS [common cold]
1080 05-09-2018 160102050918Y000259 0000196170614 EVANSYAH, SE L PEGAWAI SWASTA Chronic apical Berobat Jalan
periodontitis
1081 05-09-2018 160102050918Y000223 0000207821215 KARSUMI P PENERIMA PENSIUN TNI Non-insulin-dependent Berobat Jalan
diabetes mellitus with
neurological complications

1082 05-09-2018 160102050918Y000247 0000735425032 LISNOWATI P PBI (APBN) Abdominal pregnancy Rujuk Lanjut

1083 05-09-2018 160102050918Y000235 0000901935382 DEVILIA ANGRAINI P PBI (APBN) Nephrotic syndrome, Rujuk Lanjut
unspecified
1084 05-09-2018 160102050918Y000272 0000902393561 FIKRIANSA L PBI (APBN) Acute pharyngitis, Berobat Jalan
unspecified
1085 05-09-2018 160102050918Y000207 0000902464773 JUHAIDA P PBI (APBN) Sequelae of stroke, not Berobat Jalan
specified as haemorrhage

1086 05-09-2018 160102050918Y000227 0000902511516 SAIYAH P PEKERJA MANDIRI Non-insulin-dependent Rujuk Lanjut
diabetes mellitus without

1087 05-09-2018 160102050918Y000261 0000902733467 ADAM BACHTIAR L PBI (APBN) Chronic apical Berobat Jalan
periodontitis
1088 05-09-2018 160102050918Y000270 0000902933515 FANI FAHRIZAL L PBI (APBN) Acute pharyngitis, Berobat Jalan
unspecified
1089 05-09-2018 160102050918Y000225 0000902934911 RACHMAWATI P PBI (APBN) Other and unspecified Rujuk Lanjut
abnormalities of breathing
1090 05-09-2018 160102050918Y000239 0000903213584 SUKMA P PBI (APBN) Epilepsy, unspecified Rujuk Lanjut

1091 05-09-2018 160102050918Y000217 0000903229885 DAROJI L PBI (APBN) Myalgia, multiple sites Berobat Jalan

1092 05-09-2018 160102050918Y000212 0000903241282 LA HASI L PBI (APBN) Essential (primary) Berobat Jalan
hypertension
1093 05-09-2018 160102050918Y000209 0000903243273 WA KACI P PBI (APBN) Chronic ischaemic heart Berobat Jalan
disease, unspecified
DAFTAR KUNJUNGAN PESERTA SAKIT

Kantor Cabang : SAMARINDA - 1601

FKTP : SEGIRI - 16010205

1094 05-09-2018 160102050918Y000202 0000936794373 AMBO TANG L PBI (APBN) Unilateral or unspecified Rujuk Lanjut
femoral hernia, without

1095 05-09-2018 160102050918Y000274 0001066476407 HADI NUGROHO L PBI (APBN) Diarrhoea and Berobat Jalan
gastroenteritis of
presumed infectious origin

1096 05-09-2018 160102050918Y000226 0001723581617 MAIJO L PEKERJA MANDIRI Chronic periodontitis Berobat Jalan

1097 05-09-2018 160102050918Y000256 0001816395513 KETUT EVI TRISNAWATI P PEGAWAI SWASTA Ascites Rujuk Lanjut

1098 05-09-2018 160102050918Y000243 0001833651483 H.RISAL PRATAMA L PEKERJA MANDIRI Orthopaedic follow-up Rujuk Lanjut
care, unspecified
1099 05-09-2018 160102050918Y000250 0001840891331 FILIPE'E YODLIN NAINGGOLAN L PEKERJA MANDIRI Impacted teeth Rujuk Lanjut

1100 05-09-2018 160102050918Y000291 0001925222286 ABDUL RAZAK MUSTAFA L PBI (APBD) Essential (primary) Berobat Jalan
hypertension
1101 05-09-2018 160102050918Y000269 0001925222973 SUPARTI P PBI (APBD) Myalgia, ankle and foot Berobat Jalan

1102 05-09-2018 160102050918Y000224 0001925232535 NGATEMAN L PBI (APBD) Hyperplasia of prostate Rujuk Lanjut

1103 05-09-2018 160102050918Y000246 0001925235415 LUKMAN L PBI (APBD) Benign neoplasm of Rujuk Lanjut
unspecified site
1104 05-09-2018 160102050918Y000264 0001925236203 RAHMAWATI P PBI (APBD) Chronic apical Berobat Jalan
periodontitis
1105 05-09-2018 160102050918Y000230 0001925240152 UMI MUALIFAH MASYHURI P PBI (APBD) Fever, unspecified Berobat Jalan

1106 05-09-2018 160102050918Y000268 0001928666452 MUHAMMAD AQASYAH L PBI (APBD) Allergic contact dermatitis, Berobat Jalan
SAPUTRA unspecified cause

1107 05-09-2018 160102050918Y000267 0001933754837 M.YUSUF L PEKERJA MANDIRI Acute nasopharyngitis Berobat Jalan
[common cold]
1108 05-09-2018 160102050918Y000228 0002039632391 fitriah P PNS PUSAT Low vision, both eyes Rujuk Lanjut

1109 05-09-2018 160102050918Y000220 0002061586517 MUHAMMAD KOSIM L PEKERJA MANDIRI Non-insulin-dependent Berobat Jalan
diabetes mellitus with
neurological complications

1110 05-09-2018 160102050918Y000265 0002066741695 AJI SYARIFAH MALAHAYATI L PEKERJA MANDIRI Low vision, both eyes Rujuk Lanjut
PERWITA
1111 05-09-2018 160102050918Y000234 0002069102698 ADIBA NUR AZ ZAHRA P PEGAWAI SWASTA Acute nasopharyngitis Berobat Jalan
[common cold]
1112 05-09-2018 160102050918Y000255 0002072851132 ALIYAH P PEKERJA MANDIRI Myalgia, multiple sites Berobat Jalan

1113 05-09-2018 160102050918Y000252 0002083722489 RUBIYANTI P PEKERJA MANDIRI Fracture of upper end of Rujuk Lanjut
radius, closed
1114 05-09-2018 160102050918Y000208 0002208847858 SRI GANTINI P PEKERJA MANDIRI Gastritis, unspecified Rujuk Lanjut
DAFTAR KUNJUNGAN PESERTA SAKIT

Kantor Cabang : SAMARINDA - 1601

FKTP : SEGIRI - 16010205

1115 05-09-2018 160102050918Y000262 0002214196356 PRIYO AGUNG WICAKSONO L PEKERJA MANDIRI Dental caries, unspecified Berobat Jalan

1116 05-09-2018 160102050918Y000271 0002226789371 MELYA SHAVIRA P PEKERJA MANDIRI Acute nasopharyngitis Berobat Jalan
[common cold]
1117 05-09-2018 160102050918Y000233 0002230048337 WIWIK P PEKERJA MANDIRI Non-insulin-dependent Berobat Jalan
diabetes mellitus with
neurological complications

1118 05-09-2018 160102050918Y000294 0002233102522 MUHAMMAD ADJI ISMOE L PBI (APBD) Acute pharyngitis, Berobat Jalan
YAHYA unspecified
1119 05-09-2018 160102050918Y000248 0002233102779 MUHAMMAD HAFIDZ L PBI (APBD) Acute nasopharyngitis Berobat Jalan
RAMADHAN [common cold]
1120 05-09-2018 160102050918Y000273 0002240230048 MOCH. MUWAFFAQ L PEKERJA MANDIRI Non-insulin-dependent Berobat Jalan
diabetes mellitus without

1121 05-09-2018 160102050918Y000222 0002251424237 SITI AISAH P PEKERJA MANDIRI Headache Rujuk Lanjut

1122 05-09-2018 160102050918Y000216 0002263910049 MUHAMMAD RIYAN FACHRIZAL L PEKERJA MANDIRI Surgical follow-up care, Berobat Jalan
unspecified
1123 05-09-2018 160102050918Y000213 0002267040767 SISKA APRIL JURU P PEKERJA MANDIRI Leprosy, unspecified Berobat Jalan

1124 05-09-2018 160102050918Y000229 0002315048051 ANINDYA FAUZIAH P PBI (APBN) Diarrhoea and Berobat Jalan
gastroenteritis of
presumed infectious origin

1125 05-09-2018 160102050918Y000238 0002320642372 ERICHA OZHAWA ZHILFA P PEGAWAI SWASTA Allergic contact dermatitis, Berobat Jalan
unspecified cause

1126 05-09-2018 160102050918Y000257 0002454844544 AJI ILYAS AL HANAN L PBI (APBN) Surgical follow-up care, Rujuk Lanjut
unspecified
1127 05-09-2018 160102050918Y000214 0002480515029 ABDUL MUIN L PEKERJA MANDIRI Acute nasopharyngitis Berobat Jalan
[common cold]
1128 05-09-2018 160102050918Y000215 0002480523928 KEYLA ADHIRA RASHA P PEKERJA MANDIRI Diseases of lips Berobat Jalan

1129 04-09-2018 160102050918Y000128 0000006198996 WINARTI MUKIYAT P PENERIMA PENSIUN Chronic ischaemic heart Rujuk Lanjut
PNS disease, unspecified
1130 04-09-2018 160102050918Y000183 0000037445657 SITI ALBAROROH P PNS PUSAT Surgical follow-up care, Berobat Jalan
unspecified
1131 04-09-2018 160102050918Y000184 0000119811633 AGUS SALIM L PEKERJA MANDIRI Schizophrenia, unspecified Rujuk Lanjut

1132 04-09-2018 160102050918Y000132 0000120248008 MISYE ARSITA LESTARI P PNS DAERAH Low vision, both eyes Rujuk Lanjut

1133 04-09-2018 160102050918Y000130 0000120352432 SUNARSO L PNS DAERAH Chronic ischaemic heart Rujuk Lanjut
disease, unspecified
1134 04-09-2018 160102050918Y000197 0000120383807 SARBEN PURBA L PNS PUSAT Essential (primary) Berobat Jalan
hypertension
DAFTAR KUNJUNGAN PESERTA SAKIT

Kantor Cabang : SAMARINDA - 1601

FKTP : SEGIRI - 16010205

1135 04-09-2018 160102050918Y000168 0000120490975 hm AGUS SUTOPO, mba L PENERIMA PENSIUN TNI Hyperplasia of prostate Rujuk Lanjut

1136 04-09-2018 160102050918Y000145 0000120528314 BAHARUDDIN L PEGAWAI SWASTA Dental caries, unspecified Berobat Jalan

1137 04-09-2018 160102050918Y000144 0000120549115 SLAMET SUMEDI L PNS DAERAH Chronic apical Berobat Jalan
periodontitis
1138 04-09-2018 160102050918Y000156 0000120585161 H.SYACHDAN ILHAM L PENERIMA PENSIUN Essential (primary) Berobat Jalan
PNS hypertension
1139 04-09-2018 160102050918Y000117 0000120605141 MOHAMMAD FARIED. SA,BSC L PENERIMA PENSIUN Insulin-dependent Rujuk Lanjut
PNS diabetes mellitus with

1140 04-09-2018 160102050918Y000199 0000120655743 Mery Diana SIMANUNGKALIT P PENERIMA PENSIUN Hyperlipidaemia, Berobat Jalan
PNS unspecified
1141 04-09-2018 160102050918Y000196 0000120656316 MUNTIYANAH P PENERIMA PENSIUN Non-insulin-dependent Berobat Jalan
PNS diabetes mellitus without

1142 04-09-2018 160102050918Y000114 0000120666947 LUDIA PUDI P PENERIMA PENSIUN Non-insulin-dependent Rujuk Lanjut
PNS diabetes mellitus with

1143 04-09-2018 160102050918Y000152 0000120668433 MASMAR P PENERIMA PENSIUN Essential (primary) Berobat Jalan
PNS hypertension
1144 04-09-2018 160102050918Y000137 0000120668771 MIMI ROSMIDI AKIS L PENERIMA PENSIUN Hyperplasia of prostate Rujuk Lanjut
PNS
1145 04-09-2018 160102050918Y000147 0000120670817 DINAR SITORUS P PENERIMA PENSIUN Non-insulin-dependent Berobat Jalan
PNS diabetes mellitus without

1146 04-09-2018 160102050918Y000133 0000121098464 ACHMAD BASRUN L PENERIMA PENSIUN Hyperplasia of prostate Rujuk Lanjut
PNS
1147 04-09-2018 160102050918Y000195 0000121111727 ZAINAL ARIFIN. BE L PENERIMA PENSIUN Acute nasopharyngitis Berobat Jalan
PNS [common cold]
1148 04-09-2018 160102050918Y000163 0000123039933 ROLAM SIMANULLANG L PNS DAERAH Unstable angina Rujuk Lanjut

1149 04-09-2018 160102050918Y000157 0000123087194 GHOZALI SAPUTRA L PEKERJA MANDIRI Schizophrenia, unspecified Rujuk Lanjut

1150 04-09-2018 160102050918Y000194 0000123118839 ABDUL KADIR L PENERIMA PENSIUN Myalgia, other site Berobat Jalan
PNS
1151 04-09-2018 160102050918Y000180 0000123677109 JUPENSIUS SINAGA L PNS DAERAH Hyperplasia of prostate Rujuk Lanjut

1152 04-09-2018 160102050918Y000138 0000123677133 hj. ARPAH MASDALI, s.sos. P PNS DAERAH Asthma, unspecified Berobat Jalan
m.,kes
1153 04-09-2018 160102050918Y000164 0000123678437 DERMAWAN MINAULI PURBA P PNS DAERAH Sciatica Rujuk Lanjut

1154 04-09-2018 160102050918Y000170 0000123681813 BASO TURUN BUA L PENERIMA PENSIUN Non-insulin-dependent Rujuk Lanjut
PNS diabetes mellitus with
neurological complications
DAFTAR KUNJUNGAN PESERTA SAKIT

Kantor Cabang : SAMARINDA - 1601

FKTP : SEGIRI - 16010205

1155 04-09-2018 160102050918Y000154 0000123684039 MUHAMMAD KURNIADI L PENERIMA PENSIUN Sequelae of stroke, not Berobat Jalan
PNS specified as haemorrhage

1156 04-09-2018 160102050918Y000172 0000123685727 MUHAMMAD JUHDI L PNS DAERAH Chronic ischaemic heart Rujuk Lanjut
disease, unspecified
1157 04-09-2018 160102050918Y000160 0000123866199 TAUFIKURRAHIM L PENERIMA PENSIUN Essential (primary) Berobat Jalan
PNS hypertension
1158 04-09-2018 160102050918Y000123 0000202840896 DIAF DJAFAR L PNS DAERAH Hyperplasia of prostate Rujuk Lanjut

1159 04-09-2018 160102050918Y000198 0000211028229 ARDINA CLARISSA RUMENGAN P PNS DAERAH Cutaneous abscess, Berobat Jalan
PONGMAKAMBA furuncle and carbuncle of

1160 04-09-2018 160102050918Y000143 0000893260214 HAPIJAH P PBI (APBN) Supervision of high-risk Rujuk Lanjut
pregnancy, unspecified
1161 04-09-2018 160102050918Y000161 0000899480665 ASMIN SYURYANTO L PBI (APBN) Orthopaedic follow-up Rujuk Lanjut
care, unspecified
1162 04-09-2018 160102050918Y000173 0000902592382 HANIAH P PBI (APBN) Myalgia, multiple sites Berobat Jalan

1163 04-09-2018 160102050918Y000174 0000902592797 KHORI ATUL AZIZAH P PBI (APBN) Dyspepsia Berobat Jalan

1164 04-09-2018 160102050918Y000131 0000902610639 MUTINI P PBI (APBN) Fever, unspecified Berobat Jalan

1165 04-09-2018 160102050918Y000177 0000902674192 AULIA KHUSNUL KHOTIMAH P PBI (APBN) Allergic contact dermatitis, Berobat Jalan
unspecified cause

1166 04-09-2018 160102050918Y000159 0000903343037 KAMSIDA P PBI (APBN) Cystitis, unspecified Berobat Jalan

1167 04-09-2018 160102050918Y000191 0000903427975 SITI SUPARTI P PBI (APBN) Non-insulin-dependent Berobat Jalan
diabetes mellitus without

1168 04-09-2018 160102050918Y000121 0000903827114 TONI KAHAR L PBI (APBN) Non-insulin-dependent Rujuk Lanjut
diabetes mellitus with
neurological complications

1169 04-09-2018 160102050918Y000140 0000903832424 INDY HARIYANTI P PBI (APBN) Acute apical periodontitis Berobat Jalan
of pulpal origin
1170 04-09-2018 160102050918Y000179 0000903941458 SUCI LESTARI P PBI (APBN) Dental caries, unspecified Berobat Jalan

1171 04-09-2018 160102050918Y000162 0001066474809 ENDANG SULASTRI P PBI (APBN) Chronic ischaemic heart Rujuk Lanjut
disease, unspecified
1172 04-09-2018 160102050918Y000129 0001066476115 TUNIK P PBI (APBN) Adhesive capsulitis of Rujuk Lanjut
shoulder
1173 04-09-2018 160102050918Y000192 0001066477904 FEBRIANA DWI JULIANTI P PBI (APBN) Acute pharyngitis, Berobat Jalan
unspecified
1174 04-09-2018 160102050918Y000139 0001066478005 MUHAMMAD SHOLAHUDDIN L PBI (APBN) Disorder of external ear, Berobat Jalan
SANJAYA unspecified
DAFTAR KUNJUNGAN PESERTA SAKIT

Kantor Cabang : SAMARINDA - 1601

FKTP : SEGIRI - 16010205

1175 04-09-2018 160102050918Y000116 0001071313391 laSIGA L PBI (APBN) Chronic renal failure, Rujuk Lanjut
unspecified
1176 04-09-2018 160102050918Y000151 0001262605329 PUTRI WAHYUNI P PEKERJA MANDIRI Supervision of high-risk Rujuk Lanjut
pregnancy, unspecified
1177 04-09-2018 160102050918Y000204 0001445954354 AZIDAH P PEKERJA MANDIRI Supervision of other Berobat Jalan
normal pregnancy
1178 04-09-2018 160102050918Y000142 0001551621701 RIFKI ADITYA L PEGAWAI SWASTA Fracture of shaft of femur, Rujuk Lanjut
closed
1179 04-09-2018 160102050918Y000193 0001673341222 MAWAR R.Z. ERSATI EKA P. P PBI (APBD) Varicella without Berobat Jalan
complication
1180 04-09-2018 160102050918Y000178 0001802154677 DESY LINTIN P PEGAWAI SWASTA Acute apical periodontitis Berobat Jalan
of pulpal origin
1181 04-09-2018 160102050918Y000203 0001866984873 MUSDALIFAH.Z P PEGAWAI PEMERINTAH Supervision of other Berobat Jalan
NON PNS normal pregnancy
1182 04-09-2018 160102050918Y000134 0001875933167 GAFAR KASIM L PEKERJA MANDIRI Chronic ischaemic heart Rujuk Lanjut
disease, unspecified
1183 04-09-2018 160102050918Y000136 0001925221836 REZA KURNIAWAN L PBI (APBD) Epilepsy, unspecified Rujuk Lanjut

1184 04-09-2018 160102050918Y000135 0001925222512 SRI SURYA NINGSIH P PBI (APBD) Schizophrenia, unspecified Rujuk Lanjut

1185 04-09-2018 160102050918Y000166 0001925263934 SUWANDI L PBI (APBD) Essential (primary) Berobat Jalan
hypertension
1186 04-09-2018 160102050918Y000153 0001925264935 ADITYA RIZQI L PBI (APBD) Acute nasopharyngitis Berobat Jalan
[common cold]
1187 04-09-2018 160102050918Y000181 0001928649115 ASMA P PBI (APBD) Headache Berobat Jalan

1188 04-09-2018 160102050918Y000169 0001928653255 SRI WIDIASTUTI P PBI (APBD) Non-insulin-dependent Rujuk Lanjut
diabetes mellitus without

1189 04-09-2018 160102050918Y000187 0001978924151 SITI NUR HALIZAH P PBI (APBN) General medical Berobat Jalan
examination
1190 04-09-2018 160102050918Y000120 0002059621334 FIRDA P PEKERJA MANDIRI Acute apical periodontitis Rujuk Lanjut
of pulpal origin
1191 04-09-2018 160102050918Y000158 0002071328973 SADDIAH P PEKERJA MANDIRI Essential (primary) Berobat Jalan
hypertension
1192 04-09-2018 160102050918Y000115 0002074805425 LA SALIPA L PEKERJA MANDIRI Chronic ischaemic heart Rujuk Lanjut
disease, unspecified
1193 04-09-2018 160102050918Y000141 0002083115226 ABDUL HAMID L PEKERJA MANDIRI Soft tissue disorder, Rujuk Lanjut
unspecified, ankle and foot

1194 04-09-2018 160102050918Y000146 0002087825501 PURNAMAWATI P PEKERJA MANDIRI Acute apical periodontitis Berobat Jalan
of pulpal origin
1195 04-09-2018 160102050918Y000150 0002253429821 FAISAL ADITIYA PRATAMA L PEKERJA MANDIRI Acute nasopharyngitis Berobat Jalan
[common cold]
DAFTAR KUNJUNGAN PESERTA SAKIT

Kantor Cabang : SAMARINDA - 1601

FKTP : SEGIRI - 16010205

1196 04-09-2018 160102050918Y000189 0002261547314 ZAKIYA P PEGAWAI SWASTA Bronchitis, not specified as Rujuk Lanjut
acute or chronic
1197 04-09-2018 160102050918Y000167 0002271822074 SANIAH P PENERIMA PENSIUN Sequelae of stroke, not Rujuk Lanjut
PNS specified as haemorrhage

1198 04-09-2018 160102050918Y000190 0002282551198 WANCEHI P PEKERJA MANDIRI Chronic obstructive Rujuk Lanjut
pulmonary disease,

1199 04-09-2018 160102050918Y000149 0002284916231 YASINTHA DIVYANA ZAHRA P PBI (APBN) Acute nasopharyngitis Berobat Jalan
[common cold]
1200 04-09-2018 160102050918Y000155 0002304446027 DEA ANANDA P PEKERJA MANDIRI Impacted teeth Rujuk Lanjut

1201 04-09-2018 160102050918Y000182 0002314120151 HEDNIYATI MANULLANG P PEGAWAI SWASTA Dental caries, unspecified Berobat Jalan

1202 04-09-2018 160102050918Y000186 0002318226917 SLAMET RIYADI L PEKERJA MANDIRI Fever, unspecified Berobat Jalan

1203 04-09-2018 160102050918Y000185 0002322632553 HASANAH P PEKERJA MANDIRI Foreign body in colon Berobat Jalan

1204 04-09-2018 160102050918Y000148 0002422135899 MUHAMMAD ZAYAAN SAPUTRA L PEKERJA MANDIRI Acute nasopharyngitis Berobat Jalan
[common cold]
1205 04-09-2018 160102050918Y000188 0002430133367 RONA DEWI FAYANI P PEGAWAI SWASTA Surgical follow-up care, Berobat Jalan
unspecified
1206 04-09-2018 160102050918Y000171 0002435064153 SYAHRIL L PEKERJA MANDIRI Hyperplasia of prostate Rujuk Lanjut

1207 04-09-2018 160102050918Y000176 0002463562236 LA JODI L PEKERJA MANDIRI Surgical follow-up care, Rujuk Lanjut
unspecified
1208 04-09-2018 160102050918Y000175 0002475832151 SUGIANTO L PEKERJA MANDIRI Sequelae of stroke, not Rujuk Lanjut
specified as haemorrhage

1209 03-09-2018 160102050918Y000112 0000119642534 TIUR SIAHAAN P PNS DAERAH Other and unspecified Rujuk Lanjut
abdominal pain
1210 03-09-2018 160102050918Y000074 0000119645133 YOGI HADIPUTRA L PNS DAERAH Benign neoplasm of Rujuk Lanjut
unspecified site
1211 03-09-2018 160102050918Y000043 0000120268089 AMIRULLAH SIAHAAN L PNS DAERAH Non-insulin-dependent Berobat Jalan
diabetes mellitus without

1212 03-09-2018 160102050918Y000054 0000120292648 AMIR MARYONO L PNS PUSAT Essential (primary) Berobat Jalan
hypertension
1213 03-09-2018 160102050918Y000119 0000120293087 SITTI RUSDIANA H P PNS PUSAT Essential (primary) Berobat Jalan
hypertension
1214 03-09-2018 160102050918Y000050 0000120352432 SUNARSO L PNS DAERAH Hyperplasia of prostate Rujuk Lanjut

1215 03-09-2018 160102050918Y000210 0000120371949 ENI HERAWATI P PNS DAERAH Supervision of other Berobat Jalan
normal pregnancy
1216 03-09-2018 160102050918Y000070 0000120417502 ARIF RAKHMANTO L PNS PUSAT Malignant neoplasm of Rujuk Lanjut
brain, unspecified
DAFTAR KUNJUNGAN PESERTA SAKIT

Kantor Cabang : SAMARINDA - 1601

FKTP : SEGIRI - 16010205

1217 03-09-2018 160102050918Y000059 0000120471276 KHOIRUL SOLIKHIN L PNS PUSAT Chronic ischaemic heart Rujuk Lanjut
disease, unspecified
1218 03-09-2018 160102050918Y000126 0000120533861 NETANIELLA NOVRIN P PNS PUSAT Tuberculosis of lung, Berobat Jalan
PANGNGAROAN without mention of
bacteriological or

1219 03-09-2018 160102050918Y000124 0000120549069 AGUSTIN RAHMAWATI P PNS DAERAH Acute nasopharyngitis Berobat Jalan
[common cold]
1220 03-09-2018 160102050918Y000125 0000120549071 TRI URBA NURYANTO L PNS DAERAH Cough Berobat Jalan

1221 03-09-2018 160102050918Y000086 0000120554864 SITI ARBAYAH P PENERIMA PENSIUN Chronic ischaemic heart Rujuk Lanjut
PNS disease, unspecified
1222 03-09-2018 160102050918Y000094 0000120559779 SJAHRIL AIDA P PENERIMA PENSIUN Essential (primary) Berobat Jalan
PNS hypertension
1223 03-09-2018 160102050918Y000075 0000120581188 YUSRAN MAWAN L PENERIMA PENSIUN Chronic ischaemic heart Berobat Jalan
PNS disease, unspecified
1224 03-09-2018 160102050918Y000076 0000120581199 BAHARIAH ZAILANI P PENERIMA PENSIUN Hypertensive heart Berobat Jalan
PNS disease with (congestive)

1225 03-09-2018 160102050918Y000040 0000120629654 SYAHRUDDIN TARMIDZI L PENERIMA PENSIUN Non-insulin-dependent Berobat Jalan
PNS diabetes mellitus without

1226 03-09-2018 160102050918Y000109 0000120657161 SOEMIJATI P PENERIMA PENSIUN Other and unspecified Berobat Jalan
PNS abdominal pain
1227 03-09-2018 160102050918Y000069 0000120659139 SjARIFULLAH L PENERIMA PENSIUN Chronic ischaemic heart Rujuk Lanjut
PNS disease, unspecified
1228 03-09-2018 160102050918Y000078 0000120664844 MUHAMMAD SYARWANI L PENERIMA PENSIUN Hyperplasia of prostate Rujuk Lanjut
RAMLIE PNS
1229 03-09-2018 160102050918Y000067 0000120666339 JUSUF ATJIL, H. L PENERIMA PENSIUN Allergic contact dermatitis, Berobat Jalan
PNS unspecified cause

1230 03-09-2018 160102050918Y000068 0000120677196 ZAINAL ABIDIN,SH L PENERIMA PENSIUN Chronic ischaemic heart Rujuk Lanjut
PNS disease, unspecified
1231 03-09-2018 160102050918Y000046 0000120689302 NOOR ALIAH P PENERIMA PENSIUN After-cataract Rujuk Lanjut
PNS
1232 03-09-2018 160102050918Y000099 0000120714669 MURDIANSYAH L PENERIMA PENSIUN Chronic ischaemic heart Rujuk Lanjut
PNS disease, unspecified
1233 03-09-2018 160102050918Y000101 0000120714671 NURDIANA P PENERIMA PENSIUN Chronic ischaemic heart Rujuk Lanjut
PNS disease, unspecified
1234 03-09-2018 160102050918Y000063 0000120756295 SAWUDI L PNS DAERAH Superficial injury of lower Berobat Jalan
leg, unspecified
1235 03-09-2018 160102050918Y000085 0000123085541 MUHAMAD REZA ADHA L PNS DAERAH Follow-up care involving Rujuk Lanjut
removal of fracture plate
and other internal fixation
DAFTAR KUNJUNGAN PESERTA SAKIT

Kantor Cabang : SAMARINDA - 1601

FKTP : SEGIRI - 16010205

1236 03-09-2018 160102050918Y000065 0000123678729 DARMA GEDOAN L PNS DAERAH Essential (primary) Berobat Jalan
hypertension
1237 03-09-2018 160102050918Y000087 0000123682498 INDRA TAMBOEN L PENERIMA PENSIUN Non-insulin-dependent Rujuk Lanjut
PNS diabetes mellitus without

1238 03-09-2018 160102050918Y000090 0000123682509 RENOKASIH P PENERIMA PENSIUN Non-insulin-dependent Rujuk Lanjut
PNS diabetes mellitus without

1239 03-09-2018 160102050918Y000102 0000123694075 WENDA ELVIANA P PNS DAERAH Essential (primary) Berobat Jalan
hypertension
1240 03-09-2018 160102050918Y000108 0000897069969 USWATUN P PBI (APBN) Acute nasopharyngitis Berobat Jalan
[common cold]
1241 03-09-2018 160102050918Y000106 0000899651002 MOHSARIF L PBI (APBN) Epilepsy, unspecified Rujuk Lanjut

1242 03-09-2018 160102050918Y000095 0000902442734 ALVIANO ALBIANSAH L PBI (APBN) Dental caries, unspecified Berobat Jalan

1243 03-09-2018 160102050918Y000062 0000902452307 ANNISA RAMADHINI SAMSURI P PBI (APBN) Disorder of ear, Berobat Jalan
unspecified
1244 03-09-2018 160102050918Y000105 0000902527773 SUMINI P PBI (APBN) Superficial injury of lower Rujuk Lanjut
leg, unspecified
1245 03-09-2018 160102050918Y000088 0000902528199 ASTUTIK P PBI (APBN) Essential (primary) Berobat Jalan
hypertension
1246 03-09-2018 160102050918Y000103 0000902529123 FRISCA RIRIS APRILIA WATI P PBI (APBN) Acute pharyngitis, Berobat Jalan
unspecified
1247 03-09-2018 160102050918Y000096 0000902718911 MUHAMMAD ANDI L PBI (APBN) Dental caries, unspecified Berobat Jalan

1248 03-09-2018 160102050918Y000057 0000902766565 HAMSYAH L PBI (APBN) Disorder of lens, Rujuk Lanjut
unspecified
1249 03-09-2018 160102050918Y000083 0000903377597 TRANINGSIH P PBI (APBN) Myalgia, multiple sites Berobat Jalan

1250 03-09-2018 160102050918Y000056 0000903453219 BAYAH. S P PBI (APBN) Other cholelithiasis Rujuk Lanjut

1251 03-09-2018 160102050918Y000118 0000903866016 SUNARSIH P PBI (APBN) Essential (primary) Berobat Jalan
hypertension
1252 03-09-2018 160102050918Y000051 0001313797487 WA LICE P PEKERJA MANDIRI Non-insulin-dependent Rujuk Lanjut
diabetes mellitus with
neurological complications

1253 03-09-2018 160102050918Y000107 0001387982046 LIATI P PEKERJA MANDIRI Allergic contact dermatitis, Berobat Jalan
unspecified cause

1254 03-09-2018 160102050918Y000110 0001462723345 MARIA MARLIANI P PENERIMA PENSIUN TNI Hordeolum and other deep Berobat Jalan
inflammation of eyelid

1255 03-09-2018 160102050918Y000113 0001470309208 HELDIYANI P PEKERJA MANDIRI Impacted teeth Rujuk Lanjut
DAFTAR KUNJUNGAN PESERTA SAKIT

Kantor Cabang : SAMARINDA - 1601

FKTP : SEGIRI - 16010205

1256 03-09-2018 160102050918Y000049 0001549150694 SALSABILA RAHMADANI P PEGAWAI SWASTA Fever, unspecified Berobat Jalan

1257 03-09-2018 160102050918Y000071 0001609489168 SIA SAVANG P PBI (APBD) Non-insulin-dependent Rujuk Lanjut
diabetes mellitus with
neurological complications

1258 03-09-2018 160102050918Y000093 0001614490615 M. HAFID ANNADORI L PBI (APBD) Allergic contact dermatitis, Rujuk Lanjut
unspecified cause

1259 03-09-2018 160102050918Y000092 0001614490648 MUHAMMAD RIDWAN KAMIL L PBI (APBD) Allergic contact dermatitis, Rujuk Lanjut
unspecified cause

1260 03-09-2018 160102050918Y000111 0001923462303 MARLEN UDAU P PEKERJA MANDIRI Dyspepsia Berobat Jalan

1261 03-09-2018 160102050918Y000104 0001924986058 BAYU SETIAWAN L PEKERJA MANDIRI Headache Berobat Jalan

1262 03-09-2018 160102050918Y000055 0001925212994 USMAN L PBI (APBD) Chronic ischaemic heart Berobat Jalan
disease, unspecified
1263 03-09-2018 160102050918Y000082 0001925223131 RADIYANTO L PBI (APBD) Thyrotoxicosis, Rujuk Lanjut
unspecified
1264 03-09-2018 160102050918Y000084 0001925223153 BESTINA B TURNIP P PBI (APBD) Myalgia, ankle and foot Rujuk Lanjut

1265 03-09-2018 160102050918Y000044 0001925232118 SITI AMINURYATI P PBI (APBD) Schizophrenia, unspecified Rujuk Lanjut

1266 03-09-2018 160102050918Y000165 0002038642637 MASTIANI P PEKERJA MANDIRI Non-insulin-dependent Rujuk Lanjut
diabetes mellitus without

1267 03-09-2018 160102050918Y000060 0002047729397 dinda ayu hariyanti L PNS DAERAH Myalgia, multiple sites Berobat Jalan

1268 03-09-2018 160102050918Y000098 0002059561642 PUTRI AZZAHRA P PEGAWAI SWASTA Constipation Rujuk Lanjut

1269 03-09-2018 160102050918Y000045 0002065176099 MURIYATI P PEKERJA MANDIRI Chronic ischaemic heart Berobat Jalan
disease, unspecified
1270 03-09-2018 160102050918Y000064 0002066504837 MASTORA P PEKERJA MANDIRI Non-insulin-dependent Berobat Jalan
diabetes mellitus without

1271 03-09-2018 160102050918Y000047 0002066679641 SULIS SETIOWATI P PEKERJA MANDIRI Chronic ischaemic heart Rujuk Lanjut
disease, unspecified
1272 03-09-2018 160102050918Y000122 0002197540866 SUMARDI HARTOYO L PEKERJA MANDIRI Sequelae of stroke, not Berobat Jalan
specified as haemorrhage

1273 03-09-2018 160102050918Y000042 0002204041454 SUTRISNO L PBI (APBD) Acute nasopharyngitis Berobat Jalan
[common cold]
1274 03-09-2018 160102050918Y000097 0002222931835 MULYADI L PEKERJA MANDIRI Chronic viral hepatitis B Rujuk Lanjut
without delta-agent
DAFTAR KUNJUNGAN PESERTA SAKIT

Kantor Cabang : SAMARINDA - 1601

FKTP : SEGIRI - 16010205

1275 03-09-2018 160102050918Y000053 0002226123371 TUNI P PEKERJA MANDIRI Non-insulin-dependent Berobat Jalan
diabetes mellitus without

1276 03-09-2018 160102050918Y000077 0002232069377 SAMINYO L PEKERJA MANDIRI Non-insulin-dependent Berobat Jalan
diabetes mellitus with
neurological complications

1277 03-09-2018 160102050918Y000100 0002232489802 HASRIANTI P PEKERJA MANDIRI Primary generalized Rujuk Lanjut
(osteo)arthrosis
1278 03-09-2018 160102050918Y000091 0002244558701 HARITS UWAIS TSARWAN L PNS DAERAH Fever, unspecified Berobat Jalan

1279 03-09-2018 160102050918Y000066 0002245028613 ANDI AZIS L PEKERJA MANDIRI Non-insulin-dependent Berobat Jalan
diabetes mellitus without

1280 03-09-2018 160102050918Y000041 0002246200997 LA UNE L PEKERJA MANDIRI Non-insulin-dependent Rujuk Lanjut
diabetes mellitus with
neurological complications

1281 03-09-2018 160102050918Y000073 0002247516549 JAMALUDIN L PEKERJA MANDIRI Superficial injury of lower Rujuk Lanjut
leg, unspecified
1282 03-09-2018 160102050918Y000061 0002253670582 MARLIN NATTY P PEKERJA MANDIRI Other and unspecified Rujuk Lanjut
ovarian cysts
1283 03-09-2018 160102050918Y000089 0002260999383 AMINA P PEKERJA MANDIRI Acute nasopharyngitis Berobat Jalan
[common cold]
1284 03-09-2018 160102050918Y000080 0002263910049 MUHAMMAD RIYAN FACHRIZAL L PEKERJA MANDIRI Surgical follow-up care, Berobat Jalan
unspecified
1285 03-09-2018 160102050918Y000058 0002317500821 JUWITA HB P PEKERJA MANDIRI Senile cataract, Rujuk Lanjut
unspecified
1286 03-09-2018 160102050918Y000072 0002426405139 M. ZAINUDIN L PEKERJA MANDIRI Angina pectoris, Rujuk Lanjut
unspecified
1287 03-09-2018 160102050918Y000048 0002436961768 ATHABINA RAMADHANI VANIA P PEGAWAI SWASTA Ptosis of eyelid Rujuk Lanjut
ANDRIANSYAH
1288 03-09-2018 160102050918Y000052 0002469231944 SAVIERA NURUL LAYLI P PEKERJA MANDIRI Constipation Berobat Jalan

1289 03-09-2018 160102050918Y000079 0002477485337 SUSI AGUS SUSANTI P PNS DAERAH Headache Berobat Jalan

1290 03-09-2018 160102050918Y000081 0002481241937 ABDUSSALAM L PEKERJA MANDIRI Keratitis, unspecified Rujuk Lanjut

1291 01-09-2018 160102050918Y000034 0000120403708 YANUAR RAMDANI L PNS PUSAT Adhesive capsulitis of Rujuk Lanjut
shoulder
1292 01-09-2018 160102050918Y000021 0000120490975 hm AGUS SUTOPO, mba L PENERIMA PENSIUN TNI Chronic ischaemic heart Rujuk Lanjut
disease, unspecified
1293 01-09-2018 160102050918Y000004 0000120513014 SALAMAH P PENERIMA PENSIUN TNI Non-insulin-dependent Rujuk Lanjut
diabetes mellitus without
DAFTAR KUNJUNGAN PESERTA SAKIT

Kantor Cabang : SAMARINDA - 1601

FKTP : SEGIRI - 16010205

1294 01-09-2018 160102050918Y000029 0000120533861 NETANIELLA NOVRIN P PNS PUSAT Tuberculosis of lung, Berobat Jalan
PANGNGAROAN without mention of
bacteriological or

1295 01-09-2018 160102050918Y000025 0000120549453 SAIDAH P PNS DAERAH Nausea and vomiting Berobat Jalan

1296 01-09-2018 160102050918Y000019 0000120659354 AJI AGUSTINA P PENERIMA PENSIUN Essential (primary) Berobat Jalan
PNS hypertension
1297 01-09-2018 160102050918Y000010 0000120674081 SUHADI L PENERIMA PENSIUN Acute nasopharyngitis Berobat Jalan
PNS [common cold]
1298 01-09-2018 160102050918Y000023 0000120756295 SAWUDI L PNS DAERAH Chronic ischaemic heart Berobat Jalan
disease, unspecified
1299 01-09-2018 160102050918Y000016 0000120837115 DRA. SRI SUTANTI P PNS DAERAH Myalgia, ankle and foot Rujuk Lanjut

1300 01-09-2018 160102050918Y000001 0000120850896 SUHARJI L PNS DAERAH Non-insulin-dependent Rujuk Lanjut
diabetes mellitus without

1301 01-09-2018 160102050918Y000037 0000123018772 NIKEN RAIHANA KUSUMA P PNS DAERAH Headache Berobat Jalan
NINGRUM
1302 01-09-2018 160102050918Y000009 0000123030505 NOOR FATHONI L PNS DAERAH Allergic contact dermatitis, Berobat Jalan
unspecified cause

1303 01-09-2018 160102050918Y000017 0000123679326 EDI IWAKUSUMA L PENERIMA PENSIUN Atrial fibrillation and flutter Rujuk Lanjut
PNS
1304 01-09-2018 160102050918Y000002 0000123726341 TUKIMIN L PNS DAERAH Pterygium Rujuk Lanjut

1305 01-09-2018 160102050918Y000006 0000902114414 SUGIYAH P PBI (APBN) Essential (primary) Berobat Jalan
hypertension
1306 01-09-2018 160102050918Y000012 0000902249886 AYU NURJANAH P PBI (APBN) Dysmenorrhoea, Berobat Jalan
unspecified
1307 01-09-2018 160102050918Y000014 0000902501379 SAUDJI L PBI (APBN) Congestive heart failure Rujuk Lanjut

1308 01-09-2018 160102050918Y000039 0000902794983 YAYUK SRININGSIH P PBI (APBN) Essential (primary) Berobat Jalan
hypertension
1309 01-09-2018 160102050918Y000013 0000903213584 SUKMA P PBI (APBN) Otitis media, unspecified Rujuk Lanjut

1310 01-09-2018 160102050918Y000008 0000903229885 DAROJI L PBI (APBN) Diarrhoea and Berobat Jalan
gastroenteritis of
presumed infectious origin

1311 01-09-2018 160102050918Y000028 0000903873104 TUGINAH P PBI (APBN) Acute nasopharyngitis Berobat Jalan
[common cold]
1312 01-09-2018 160102050918Y000033 0001066472245 M. SAIRI L PBI (APBN) Tinnitus Rujuk Lanjut

1313 01-09-2018 160102050918Y000026 0001551778683 ADE L PEGAWAI SWASTA Cough Berobat Jalan
DAFTAR KUNJUNGAN PESERTA SAKIT

Kantor Cabang : SAMARINDA - 1601

FKTP : SEGIRI - 16010205

1314 01-09-2018 160102050918Y000020 0001723636787 FAISAL HISYAM TRIYADI L PBI (APBD) Impacted cerumen Berobat Jalan

1315 01-09-2018 160102050918Y000032 0001736725544 Yuliana Andayani Rinding P PEGAWAI SWASTA Essential (primary) Rujuk Lanjut
hypertension
1316 01-09-2018 160102050918Y000030 0001742888024 RANO L PEGAWAI SWASTA Lepromatous leprosy Berobat Jalan

1317 01-09-2018 160102050918Y000035 0001925307551 MUHAMMAD ALZAHRAN ALHAM L PBI (APBD) Acute nasopharyngitis Berobat Jalan
[common cold]
1318 01-09-2018 160102050918Y000007 0002060451191 SAMSIAH P PEKERJA MANDIRI Non-insulin-dependent Berobat Jalan
diabetes mellitus without

1319 01-09-2018 160102050918Y000015 0002061587035 SUWATI P PEKERJA MANDIRI Hypertensive renal Rujuk Lanjut
disease with renal failure
1320 01-09-2018 160102050918Y000003 0002062122221 DJUMANSYAH L PEKERJA MANDIRI Chronic ischaemic heart Rujuk Lanjut
disease, unspecified
1321 01-09-2018 160102050918Y000018 0002203276037 SUPRAPTO L PEKERJA MANDIRI After-cataract Rujuk Lanjut

1322 01-09-2018 160102050918Y000024 0002203276948 SAHLAN L PEKERJA MANDIRI Bronchitis, not specified as Rujuk Lanjut
acute or chronic
1323 01-09-2018 160102050918Y000036 0002219945084 KADINEM P PEKERJA MANDIRI Essential (primary) Berobat Jalan
hypertension
1324 01-09-2018 160102050918Y000027 0002290006326 NAZHIERA SHYAQILA CARISSA P PEGAWAI SWASTA Acute tonsillitis, Berobat Jalan
unspecified
1325 01-09-2018 160102050918Y000031 0002304223389 ANDI HERY WIJAYA AS L PEKERJA MANDIRI Surgical follow-up care, Berobat Jalan
unspecified
1326 01-09-2018 160102050918Y000011 0002375417125 TOWIYAH P PEKERJA MANDIRI Acute nasopharyngitis Berobat Jalan
[common cold]
1327 01-09-2018 160102050918Y000127 0002375417147 FITRI RAMADHANI P PEKERJA MANDIRI Diarrhoea and Berobat Jalan
gastroenteritis of
presumed infectious origin

1328 01-09-2018 160102050918Y000038 0002430191766 DJAMAH P PEKERJA MANDIRI Non-insulin-dependent Berobat Jalan
diabetes mellitus without

1329 01-09-2018 160102050918Y000022 0002436961768 ATHABINA RAMADHANI VANIA P PEGAWAI SWASTA Hordeolum and other deep Rujuk Lanjut
ANDRIANSYAH inflammation of eyelid

1330 01-09-2018 160102050918Y000005 0002451167717 SUKARTI P PEKERJA MANDIRI Dyspepsia Berobat Jalan

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