Ket Daftar Pasien 14 Mei 2018.docx

PEMERINTAH PROVINSI DAERAH KHUSUS IBU KOTA JAKARTA DINAS KESEHATAN SUKU DINAS KESEHATAN KOTA ADMINISTRASI JAKARTA SELATAN

PUSKESMAS KELURAHAN SRENGSENG SAWAH J

Jl. Batu No. 1, RT. 13/RW.09, Kel. Srengseng Sawah, Jagakarsa - Jakarta Selatan Telp. (021) 7864707, 021-7874051, 021-78891806, Fax. (021) 7864707 Kode Pos 12640

SURAT KETERANGAN DAFTAR PASIEN

Yang bertanda tangan di bawah ini, Kepala Puskesmas Kelurahan Srengseng Sawah menugaskan kepada:

Petugas

: dr. Hernita Perliyani

Poli

: Poli Umum Puskesmas Kelurahan Srengseng Sawah

Tanggal

: Senin, 14 Mei 2018

Telah melaksanakan tugas melakukan pemeriksaan pasien rawat jalan dengan daftar sebagai berikut: No 1

2

3

4

5

6

7

8

Nama

Usia

Kelamin

Penyakit

ASNI ARIDA

42Th 9 Bln

P

Essential (primary) hypertension

ASNI ARIDA

42Th 9 Bln

P

Other peripheral vertigo

ASNI ARIDA

42Th 9 Bln

P

Neuralgia and neuritis, unspecified

BAMBANG SUPARDI#

74Th 4 Bln

L

Cough

BAMBANG SUPARDI#

74Th 4 Bln

L

Essential (primary) hypertension

PURWIDIANINGSIH #

42Th 4 Bln

P

Thyrotoxicosis, unspecified

PARTINI #

60Th 2 Bln

P

Tinea corporis

PARTINI #

60Th 2 Bln

P

Essential (primary) hypertension

PEMERINTAH PROVINSI DAERAH KHUSUS IBU KOTA JAKARTA DINAS KESEHATAN SUKU DINAS KESEHATAN KOTA ADMINISTRASI JAKARTA SELATAN

PUSKESMAS KELURAHAN SRENGSENG SAWAH J

Jl. Batu No. 1, RT. 13/RW.09, Kel. Srengseng Sawah, Jagakarsa - Jakarta Selatan Telp. (021) 7864707, 021-7874051, 021-78891806, Fax. (021) 7864707 Kode Pos 12640

9

10

11

12

13

14

15

16

17

18

19

20

21

22

23

ADHELIA MEISY

14Th 10 Bln

P

Acute upper respiratory infection, unspecified

RANTINEM

60Th 4 Bln

L

Essential (primary) hypertension

HOLID

58Th 1 Bln

L

Cataract, unspecified

AZIZAH

56Th 11 Bln

P

Status asthmaticus

DARWIASIH

52Th 9 Bln

P

Primary gonarthrosis, bilateral

TATIK MAHYUNINGSIH #

59Th 1 Bln

L

Essential (primary) hypertension

TATIK MAHYUNINGSIH #

59Th 1 Bln

L

Acute pharyngitis, unspecified

Ny Mulyihatun #

61Th 10 Bln

P

Cardiomegaly

RIDWAN

58Th 7 Bln

L

Cough

SAKIYEM #

61Th 11 Bln

P

Other peripheral vertigo

Warsidi #

56Th 4 Bln

L

Sequelae of stroke, not specified as haemorrhage or infarction

NAPSIAH#

73Th 2 Bln

P

Essential (primary) hypertension

N.A.KOMALANINGSIH

69Th 10 Bln

P

Hypertensive heart disease with (congestive) heart failure

TRI PERWANGSIH #

64Th 3 Bln

P

Tension-type headache

SUKAESIH

44Th 6

P

Tinea corporis

PEMERINTAH PROVINSI DAERAH KHUSUS IBU KOTA JAKARTA DINAS KESEHATAN SUKU DINAS KESEHATAN KOTA ADMINISTRASI JAKARTA SELATAN

PUSKESMAS KELURAHAN SRENGSENG SAWAH J

Jl. Batu No. 1, RT. 13/RW.09, Kel. Srengseng Sawah, Jagakarsa - Jakarta Selatan Telp. (021) 7864707, 021-7874051, 021-78891806, Fax. (021) 7864707 Kode Pos 12640

Bln 24

25

26

27

28

29

30

31

32

33

34

35

36

37

JILSA QIFAYA

3Th 3 Bln

P

Atopic dermatitis, unspecified

YULIANA

66Th 8 Bln

P

Hypertensive heart disease with (congestive) heart failure

NUNUNG#

46Th 4 Bln

P

Polyarthritis, unspecified

KABUL SUBIYANTORO

35Th 8 Bln

L

Follow-up examination after surgery for other conditions

Ilham Maulana

22Th 11 Bln

L

Follow-up examination after other treatment for other conditions

SRIYANTO

58Th 7 Bln

L

Hypertensive heart disease with (congestive) heart failure

SUPRIATI #

38Th 5 Bln

P

Acute upper respiratory infection, unspecified

ARKAN KRISMAYANTO

1Th 6 Bln

L

Acute nasopharyngitis [common cold]

IMAM JAFAR SODIK

9Th 6 Bln

L

Person injured in unspecified vehicle accident

TONIH

64Th 2 Bln

P

Myalgia

Bachtiar Affandi #

50Th 1 Bln

L

Urinary tract infection, site not specified

Bachtiar Affandi #

50Th 1 Bln

L

Essential (primary) hypertension

RENITA

38Th 5 Bln

P

Acute upper respiratory infection, unspecified

SAIYAH

68Th 2 Bln

P

Other specified postsurgical states

PEMERINTAH PROVINSI DAERAH KHUSUS IBU KOTA JAKARTA DINAS KESEHATAN SUKU DINAS KESEHATAN KOTA ADMINISTRASI JAKARTA SELATAN

PUSKESMAS KELURAHAN SRENGSENG SAWAH J

Jl. Batu No. 1, RT. 13/RW.09, Kel. Srengseng Sawah, Jagakarsa - Jakarta Selatan Telp. (021) 7864707, 021-7874051, 021-78891806, Fax. (021) 7864707 Kode Pos 12640

38

39

40

41

42

TUTI HERAWATI #

47Th 8 Bln

P

Essential (primary) hypertension

RATIH PURWANINGSIH

32Th 2 Bln

P

Acute pharyngitis, unspecified

YULI ANGGRAINI #

35Th 8 Bln

P

Essential (primary) hypertension

MUHAMMAD FAHMI

5Th 11 Bln

L

Impetigo [any organism] [any site]

MIFTHA KHAIRANI TANJUNG

24Th 10 Bln

P

Fibroadenosis of breast

FRANSISCUS IRIANTO

60Th 10 Bln

L

Non-insulin-dependent diabetes mellitus with unspecified complications

NADIA ALFITASARI

24Th 10 Bln

P

Diarrhoea and gastroenteritis of presumed infectious origin

nilam cahya

18Th 11 Bln

L

General medical examination

ASMAN, H. #

74Th 7 Bln

L

Congestive heart failure

NURHAYATI.

45Th 6 Bln

P

Headache

ILHAM SAPUTRA

17Th 2 Bln

L

Person injured in collision between car and two- or three-wheeled motor vehicle (traffic)

WISNU MURTI ANGGORO

42Th 11 Bln

L

Acute pharyngitis, unspecified

WISNU MURTI ANGGORO

42Th 11 Bln

L

Essential (primary) hypertension

ariyanthi miranda

66Th 2 Bln

P

Congestive heart failure

43

44

45

46

47

48

49

50

51

PEMERINTAH PROVINSI DAERAH KHUSUS IBU KOTA JAKARTA DINAS KESEHATAN SUKU DINAS KESEHATAN KOTA ADMINISTRASI JAKARTA SELATAN

PUSKESMAS KELURAHAN SRENGSENG SAWAH J

Jl. Batu No. 1, RT. 13/RW.09, Kel. Srengseng Sawah, Jagakarsa - Jakarta Selatan Telp. (021) 7864707, 021-7874051, 021-78891806, Fax. (021) 7864707 Kode Pos 12640

52

53

54

55

DJIAH #

57Th 2 Bln

P

Essential (primary) hypertension

DJUMSIAH #

71Th 3 Bln

P

Primary gonarthrosis, bilateral

DJUMSIAH #

71Th 3 Bln

P

Essential (primary) hypertension

SHAKILA RIZKIA RAMADHANI

1Th 9 Bln

P

Atopic dermatitis, unspecified

NANANG RUSMANA

63Th 10 Bln

L

Chronic obstructive pulmonary disease with acute lower respiratory infection

CUT ASYA PRAMANDASARI

16Th 1 Bln

P

General medical examination

KHALISAH

33Th 0 Bln

P

Viral conjunctivitis, unspecified

RIZKY ADE DHARMAWAN

19Th 11 Bln

L

General medical examination

PUTRI RAHMAWATI

9Th 0 Bln

P

Acute tonsillitis, unspecified

ASHIKLLA ANGGRAINI

16Th 8 Bln

P

General medical examination

EMELIA SARI

16Th 6 Bln

P

General medical examination

SOPIYAH

56Th 2 Bln

P

Essential (primary) hypertension

MUHAMMAD IQBAL JAILANI

11Th 7 Bln

L

Atopic dermatitis, unspecified

NG HO KIAT #

84Th 5 Bln

L

Congestive heart failure

56

57

58

59

60

61

62

63

64

65

PEMERINTAH PROVINSI DAERAH KHUSUS IBU KOTA JAKARTA DINAS KESEHATAN SUKU DINAS KESEHATAN KOTA ADMINISTRASI JAKARTA SELATAN

PUSKESMAS KELURAHAN SRENGSENG SAWAH J

Jl. Batu No. 1, RT. 13/RW.09, Kel. Srengseng Sawah, Jagakarsa - Jakarta Selatan Telp. (021) 7864707, 021-7874051, 021-78891806, Fax. (021) 7864707 Kode Pos 12640

66

67

68

69

70

71

72

73

74

75

76

77

78

79

80

Sebastian Wijaya

15Th 5 Bln

L

Acute pharyngitis, unspecified

IRA AGUSTINA

52Th 9 Bln

P

Essential (primary) hypertension

AULIA VERONANDA WIDYASTUTI

20Th 10 Bln

P

Enlarged lymph nodes, unspecified

AMALDO

36Th 4 Bln

L

Tension-type headache

YULITA MAHARDINI POYSANCIN

22Th 8 Bln

P

Other atopic dermatitis

SUSANTI

53Th 4 Bln

P

Atopic dermatitis, unspecified

MEGA PUJI ASTUTI#

22Th 6 Bln

P

Primary dysmenorrhoea

ABDUL MUFTI

46Th 10 Bln

L

Atopic dermatitis, unspecified

HASMUNI

56Th 4 Bln

L

Essential (primary) hypertension

HASMUNI

56Th 4 Bln

L

Neuralgia and neuritis, unspecified, forearm

TRI HARDIANTI

24Th 6 Bln

P

General medical examination

IDA ROSDIANA

38Th 1 Bln

P

Cough

USLAN HARYANTO

46Th 5 Bln

L

Impetigo [any organism] [any site]

PRIHANDONO

36Th 1 Bln

L

Acute upper respiratory infection, unspecified

AMI ZAMZAMI

20Th 4

L

Follow-up examination after surgery

PEMERINTAH PROVINSI DAERAH KHUSUS IBU KOTA JAKARTA DINAS KESEHATAN SUKU DINAS KESEHATAN KOTA ADMINISTRASI JAKARTA SELATAN

PUSKESMAS KELURAHAN SRENGSENG SAWAH J

Jl. Batu No. 1, RT. 13/RW.09, Kel. Srengseng Sawah, Jagakarsa - Jakarta Selatan Telp. (021) 7864707, 021-7874051, 021-78891806, Fax. (021) 7864707 Kode Pos 12640

Bln 81

82

83

84

85

86

bayi panji newton

1Th 8 Bln

L

Epilepsy, unspecified

bayi panji newton

1Th 8 Bln

L

Acute upper respiratory infection, unspecified

Mochamad faqih prayoga

11Th 7 Bln

L

Other gastritis

indiah purnamasari

48Th 9 Bln

P

Excessive and frequent menstruation with regular cycle

SLAMET JUDOPRAYITNO,BE#

73Th 0 Bln

L

Hypertensive heart disease with (congestive) heart failure

RIO ELBANOSA PURBA

26Th 11 Bln

L

Diarrhoea and gastroenteritis of presumed infectious origin

THOHA#

59Th 0 Bln

L

Non-insulin-dependent diabetes mellitus with unspecified complications

MUHAMMAD ALFI FADHOLLI

25Th 6 Bln

L

General medical examination

IREN AYU SAPUTRA

22Th 9 Bln

P

General medical examination

NIMIH DAMAYANTI #

55Th 5 Bln

P

Myasthenia gravis

TANTRI

1Th 0 Bln

P

Acute nasopharyngitis [common cold]

AGUS.

44Th 7 Bln

L

Cough

Desata eka rikanty

32Th 2 Bln

P

Mumps without complication

CUCU SUDARYAH

75Th 0

P

Follow-up examination after other

87

88

89

90

91

92

93

94

for other conditions

PEMERINTAH PROVINSI DAERAH KHUSUS IBU KOTA JAKARTA DINAS KESEHATAN SUKU DINAS KESEHATAN KOTA ADMINISTRASI JAKARTA SELATAN

PUSKESMAS KELURAHAN SRENGSENG SAWAH J

Jl. Batu No. 1, RT. 13/RW.09, Kel. Srengseng Sawah, Jagakarsa - Jakarta Selatan Telp. (021) 7864707, 021-7874051, 021-78891806, Fax. (021) 7864707 Kode Pos 12640

Bln 95

96

97

98

99

100

101

102

103

104

105

106

107

108

treatment for other conditions

NABILA HAURA KHANZA

13Th 8 Bln

P

General medical examination

ALDI FARHANDIKA

18Th 7 Bln

L

General medical examination

ARBAIN

35Th 5 Bln

L

Non-insulin-dependent diabetes mellitus with renal complications

GIBRAN HAIDAR RASYID

1Th 10 Bln

L

Other atopic dermatitis

SUMIYATI

54Th 1 Bln

P

Myalgia

SUMIYATI

54Th 1 Bln

P

Hypertensive heart disease with (congestive) heart failure

MUHAMMAD JUNDI ASKARI

9Th 0 Bln

L

Varicella without complication

NAZHIRA ZALFA RADINIA

12Th 6 Bln

P

General medical examination

MUS ANDRY #

66Th 5 Bln

L

Hypertensive heart disease with (congestive) heart failure

DINY EKA SAPUTRI

23Th 8 Bln

P

Other specified fever

TATI

45Th 8 Bln

P

Fibroadenosis of breast

MEROH #

68Th 11 Bln

P

Essential (primary) hypertension

MOESOFFAH #

51Th 7 Bln

P

Essential (primary) hypertension

UMAIR

9Th 11 Bln

L

General medical examination

PEMERINTAH PROVINSI DAERAH KHUSUS IBU KOTA JAKARTA DINAS KESEHATAN SUKU DINAS KESEHATAN KOTA ADMINISTRASI JAKARTA SELATAN

PUSKESMAS KELURAHAN SRENGSENG SAWAH J

Jl. Batu No. 1, RT. 13/RW.09, Kel. Srengseng Sawah, Jagakarsa - Jakarta Selatan Telp. (021) 7864707, 021-7874051, 021-78891806, Fax. (021) 7864707 Kode Pos 12640

SUDINI**

43Th 7 Bln

P

Myalgia

RERE YUNISA

18Th 8 Bln

P

Acute nasopharyngitis [common cold]

YOSEFARUNA DINAR

48Th 7 Bln

L

Cutaneous abscess, furuncle and carbuncle, unspecified

AIRA NAFISAH GUNAWAN

2Th 9 Bln

P

Acute pharyngitis, unspecified

Rizki Damayanti

18Th 9 Bln

P

General medical examination

YULI YANIH

18Th 8 Bln

P

General medical examination

EKO ERIYANTO

19Th 2 Bln

L

General medical examination

HARIS PRATOMO

19Th 2 Bln

L

General medical examination

SANAH

46Th 5 Bln

P

Acute upper respiratory infection, unspecified

ANNISA PUTRI RAMADHANI

1Th 9 Bln

P

Acute nasopharyngitis [common cold]

ROHMAN

39Th 8 Bln

L

General medical examination

WATI KARTINI

31Th 10 Bln

P

Dyspepsia

MOHERIK SANJAYA

36Th 9 Bln

L

Acute nasopharyngitis [common cold]

122

FEBRIYANTO NURULHUDA W

18Th 1 Bln

L

Cutaneous abscess, furuncle and carbuncle, unspecified

123

SAMANI

63Th 2

P

Acute pharyngitis, unspecified

109

110

111

112

113

114

115

116

117

118

119

120

121

PEMERINTAH PROVINSI DAERAH KHUSUS IBU KOTA JAKARTA DINAS KESEHATAN SUKU DINAS KESEHATAN KOTA ADMINISTRASI JAKARTA SELATAN

PUSKESMAS KELURAHAN SRENGSENG SAWAH J

Jl. Batu No. 1, RT. 13/RW.09, Kel. Srengseng Sawah, Jagakarsa - Jakarta Selatan Telp. (021) 7864707, 021-7874051, 021-78891806, Fax. (021) 7864707 Kode Pos 12640

Bln 124

125

126

127

128

129

130

131

132

133

134

135

136

137

KHUNAENI

31Th 4 Bln

P

Dyspepsia

JEREMY MARIO WIBOWO

8Th 0 Bln

L

Cutaneous abscess, furuncle and carbuncle, unspecified

IRYANI KAMAL

66Th 6 Bln

P

Atherosclerotic cardiovascular disease, so described

GALANG DIKA M

21Th 1 Bln

L

Other acute upper respiratory infections of multiple sites

CHANDRA W

64Th 11 Bln

L

Insulin-dependent diabetes mellitus without complications

MURDIYATI #

57Th 5 Bln

P

Dyspepsia

MURDIYATI #

57Th 5 Bln

P

Essential (primary) hypertension

ULFAH KHAIRUNNISA

7Th 9 Bln

P

Acute pharyngitis, unspecified

RAFIF MAHAWIRA AYDIN

13Th 6 Bln

L

General medical examination

MUDJIANTO

62Th 11 Bln

L

Sequelae of stroke, not specified as haemorrhage or infarction

EKA YUDASMARA

36Th 3 Bln

L

Acute upper respiratory infection, unspecified

FATIMAH AZZAHRA

18Th 9 Bln

P

General medical examination

AZKIA MAHARYANI

12Th 4 Bln

P

General medical examination

TIVANY KONITA ALYA PUTRI

7Th 3 Bln

P

Other acute upper respiratory infections of multiple sites

PEMERINTAH PROVINSI DAERAH KHUSUS IBU KOTA JAKARTA DINAS KESEHATAN SUKU DINAS KESEHATAN KOTA ADMINISTRASI JAKARTA SELATAN

PUSKESMAS KELURAHAN SRENGSENG SAWAH J

Jl. Batu No. 1, RT. 13/RW.09, Kel. Srengseng Sawah, Jagakarsa - Jakarta Selatan Telp. (021) 7864707, 021-7874051, 021-78891806, Fax. (021) 7864707 Kode Pos 12640

INTAN MAULANI

13Th 10 Bln

P

Cutaneous abscess, furuncle and carbuncle, unspecified

YULIANTI

50Th 0 Bln

P

Angina pectoris, unspecified

IKA LESTARI

42Th 10 Bln

P

Essential (primary) hypertension

141 NAUFAL SYAM ADITYA DARMAWAN

3Th 3 Bln

L

Acute upper respiratory infection, unspecified

142

AGUS DARMAWAN

31Th 7 Bln

L

Myalgia

FEBRI PURNAMA SARI

29Th 1 Bln

P

Other gastritis

138

139

140

143

Mengetahui, Kepala Puskesmas Kelurahan Srengseng Sawah

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