Mandatory Cleaning RSUD Simo

TGL DAFTAR/ TGL
NO. REKAM JENIS KATEGO

NO NAMA PASIEN TGL LAHIR ALAMAT PASIEN MULAI KETERANGAN UNIT
MEDIS KELAMIN RI ICD X
PENGOBATAN
1 1612106796 ADI SETYOBUDI 12/19/94 L PONCOL WETAN 4/1 PULUTAN NOGOSARI 02/23/17 A15.0 Tb lung confirm sputum microscopy with or without culture PENYAKIT DALAM (POLI)
2 1708112479 AHMAD ARIS SETIYANTO 08/29/94 L KEDUNGDOWO 3/1 BENDUNGAN SIMO 08/29/17 A16.2 Tb lung without mention of bact or histological confirm UMUM (POLI)
3 1708112336 ALISA NUR SAIDAH ARYANTI 11/29/15 P LEMAHIRENG 1/1 LEMAHIRENG KEMUSU 08/21/17 A16.2 Tb lung without mention of bact or histological confirm ANAK (POLI)
4 0910034521 AMALIA NURAINI 12/17/08 P NGROTO 19/ PENTUR SIMO 01/09/18 A16.2 Tb lung without mention of bact or histological confirm ANAK (POLI)
5 1504091025 ANANG SAPUTRA 04/17/97 L TITANG SIMO 09/11/17 A16.2 Tb lung without mention of bact or histological confirm PENYAKIT DALAM (POLI)
6 1801115253 ANIN NABILA 02/21/16 P MOJOREJO KEYONGAN NOGOSARI 02/05/18 A16.2 Tb lung without mention of bact or histological confirm ANAK (POLI)
7 1708112004 ARI HENI MARLINA 09/21/71 P BEGAH 14/3 BLAGUNG SIMO 01/03/18 A16.2 Tb lung without mention of bact or histological confirm PENYAKIT DALAM (POLI)
8 1702108148 ARI WINARNO 02/08/89 L GROMPOL 17/3 TROSOBO SAMBI 02/08/17 A16.2 Tb lung without mention of bact or histological confirm PENYAKIT DALAM (POLI)
9 arif budiyanto 27 L turunan Teter Simo 11/14/2017
10 1504090640 ARIFIN 10/05/78 L KRAMBIL SAWIT 13/4 TALAKBROTO 10/16/17 A16.2 Tb lung without mention of bact or histological confirm PENYAKIT DALAM (POLI)
11 1705110349 ASMO SEMITO 07/01/55 L NGEMBAT 38/ 11 SEMPU ANDONG 05/15/17 A16.2 Tb lung without mention of bact or histological confirm PENYAKIT DALAM (POLI)
12 1804117156 ASTRI SETYA DEVITASARI 04/04/07 P SIDOMULYO 1/4 NGLEMBU SAMBI 04/04/18 A16.2 Tb lung without mention of bact or histological confirm ANAK (POLI)
13 1506092605 ATHA CYNARA FELITA 06/08/14 P TITANG SIMO SIMO 03/16/18 A16.2 Tb lung without mention of bact or histological confirm ANAK (POLI)
14 1806118783 ATIK PUJI LESTARI 02/03/79 P JEGORAN 8/1 MANYARAN KARANGGEDE 06/26/18 A16.9 Resp tb unspec without mention of bact or hist confirm PENYAKIT DALAM (POLI)
15 1408083536 ATMO WIJOYO W 08/22/42 L KRANGGAN TASIKMADU KARANGANYAR 03/29/17 A16.2 Tb lung without mention of bact or histological confirm PENYAKIT DALAM (POLI)
16 1803116526 AZAM FATA MAULANA 10/02/14 L TEGALSARI 13/3 TANJUNG KLEGO 03/26/18 A16.2 Tb lung without mention of bact or histological confirm ANAK (POLI)
17 1206059417 DARMIN 02/22/44 L TARI WETAN SIMO 08/15/17 A16.2 Tb lung without mention of bact or histological confirm PENYAKIT DALAM (POLI)
18 1610105458 DARMINI 10/21/65 P KACANGAN 4/1 KACANGAN ANDONG 01/11/17 A15.9 Respiratory tb unspec confirm bact and histologically CENDANA
19 1706110729 DARMO SUWITO 12/11/35 L SENDANGREJO 17/4 SENDANGREJO KLEGO 08/21/17 A16.2 Tb lung without mention of bact or histological confirm PENYAKIT DALAM (POLI)
20 1304069172 DEWI SARTIKA 10/23/88 P KRAMBILSAWIT 13/4 TALAKBROTO SIMO 04/30/18 A16.2 Tb lung without mention of bact or histological confirm PENYAKIT DALAM (POLI)
21 1802116095 DWI ARDIANA LESTARI 07/15/86 P TEGALSARI 13/3 TANJUNG KLEGO 02/22/18 A16.2 Tb lung without mention of bact or histological confirm UMUM (POLI)
22 1708111996 DWI AYU PRATIWI 08/04/14 P TRAYON 4/2 KEBONAN KARANGGEDE 08/04/17 A16.2 Tb lung without mention of bact or histological confirm ANAK (POLI)
23 1801115140 DWI ENDANG HANDAYANI 01/06/76 P SOKO 01/02 SANGGE KLEGO 01/18/18 A16.2 Tb lung without mention of bact or histological confirm UMUM (POLI)
24 1806118325 DWIANTO 04/23/94 L KARANG 14/04 PENTUR SIMO 06/11/18 A16.2 Tb lung without mention of bact or histological confirm UMUM (POLI)
25 0903029831 ENIK SUMIYATI 03/14/74 P BANARAN 10/3 SEMPU 01/26/17 A15.0 Tb lung confirm sputum microscopy with or without culture PENYAKIT DALAM (POLI)
26 0802022779 FADILA GITA 12/04/07 P TITANG 05/26/17 A16.2 Tb lung without mention of bact or histological confirm ANAK (POLI)
27 1803116623 FARSYA JUNETA AZZAHWA 06/24/14 P KADIREJO 2/2 SEMPULUR KARANGGEDE BOYOLALI 03/12/18 A16.2 Tb lung without mention of bact or histological confirm ANAK (POLI)
28 1011043490 GINEM 11/16/73 P KEDUNG WULUH 12/3 TEMON SIMO 05/23/17 A16.9 Resp tb unspec without mention of bact or hist confirm PENYAKIT DALAM (POLI)
29 1802115762 HADI SISWANTO 02/05/34 L PULUTAN 12/02 PULUTAN NOGOSARI 02/05/18 A16.7 Prim respiratory tb without mention of bact or hist confirm CENDANA
30 1301065125 HAIKAL 07/14/14 L BANJAREJO SEMPU ANDONG 02/15/18 A16.2 Tb lung without mention of bact or histological confirm ANAK (POLI)
31 1706110741 HANIFA PUTRI ARDIAN 06/05/11 P PERENG 1/1 PAKEL ANDONG 06/05/17 A16.2 Tb lung without mention of bact or histological confirm ANAK (POLI)
32 1612106730 HARNI 05/25/91 P NGASINAN 14/3 MUNGGUR ANDONG 01/20/17 A15.0 Tb lung confirm sputum microscopy with or without culture PENYAKIT DALAM (POLI)
33 1103046525 HARTATIK 02/27/79 P NAYAN 5/7 PELEM SIMO 03/19/18 A16.2 Tb lung without mention of bact or histological confirm PENYAKIT DALAM (POLI)
34 1609104840 HENI SETYOWATI 06/20/94 P PAGERJURANG PASEBAN BAYAT KLATEN 02/28/17 A15.0 Tb lung confirm sputum microscopy with or without culture PENYAKIT DALAM (POLI)
35 1705110655 HILYA HUSNA MALIKA 05/10/12 P PENGKOL 2/4 PENGKOL KARANGGEDE 05/31/17 A16.9 Resp tb unspec without mention of bact or hist confirm ANAK (POLI)
36 1803116529 IFRA LUTFIANA PUTRI SHARLIZ 04/24/09 P TEGALSARI 13/03 TANJUNG KLEGO 03/31/18 A16.2 Tb lung without mention of bact or histological confirm UMUM (POLI)
37 1710113207 IMAM MUCHSIN 05/31/83 L GONDANGREJO 04/01 KEYONGAN NOGOSARI 10/04/17 A16.2 Tb lung without mention of bact or histological confirm PENYAKIT DALAM (POLI)
38 1707111436 INDAH SEPTI 07/09/86 P BAKALAN 07/09/17 A16.2 Tb lung without mention of bact or histological confirm CENDANA
39 1704109538 INDAH SETYOWATI 11/02/16 P POKO KRAJAN PULUTAN NOGOSARI 04/10/17 A16.2 Tb lung without mention of bact or histological confirm ANAK (POLI)
40 1704109626 IRFAN NUR TAUFIQ 06/26/95 L GULON 3/1 TANJUNG KLEGO 04/17/17 A15.0 Tb lung confirm sputum microscopy with or without culture PENYAKIT DALAM (POLI)
41 1803116665 ISTIQOMAH 10/07/14 P MOJO 1/1 WATES SIMO 03/20/18 A16.2 Tb lung without mention of bact or histological confirm ANAK (POLI)
42 1703108677 ISTIYAWATI 03/02/75 P RINGINWOK 04/11/17 A16.2 Tb lung without mention of bact or histological confirm PENYAKIT DALAM (POLI)
43 jakimin 70 L gablok 11/3 Teter Simo 1/10/2018
44 1611106433 JAMARI 12/31/30 L BANJAREJO SEMPU ANDONG 05/31/18 A16.2 Tb lung without mention of bact or histological confirm PENYAKIT DALAM (POLI)
45 1701107682 JAMIATUN 02/15/49 P SOKOREJO 3/3 MANYARAN KARANGGEDE 02/22/17 A15.0 Tb lung confirm sputum microscopy with or without culture PENYAKIT DALAM (POLI)
46 1405080315 JAMJURI 07/01/29 L PENGKOL 5/2 KARANGGEDE 01/10/18 A16.7 Prim respiratory tb without mention of bact or hist confirm EDELWEIS
47 1703108729 JANATIN 03/04/52 P SOKO 10/2 SENDANGREJO 03/04/17 A16.2 Tb lung without mention of bact or histological confirm CENDANA
48 1403078577 JARIYATUN 03/13/60 P JERING WATES SIMO 05/29/17 A16.2 Tb lung without mention of bact or histological confirm PENYAKIT DALAM (POLI)
49 1804117110 JOKO SANTOSO 05/25/69 L PERMATA BANJAR ASRI BLOK A3 RTO4 /09 CIPOCOK JAYA 04/11/18 A16.2 Tb lung without mention of bact or histological confirm PENYAKIT DALAM (POLI)
50 1707111296 JUANA AGUS PRASETYO 01/01/87 L TEPURSARI RT 01/03 SAMBI 07/04/17 A16.2 Tb lung without mention of bact or histological confirm PENYAKIT DALAM (POLI)
51 1702108147 JUMANI 02/08/62 L NGUMBUL GLONGGONG 02/13/17 A16.2 Tb lung without mention of bact or histological confirm PENYAKIT DALAM (POLI)
52 jumari 55 L widoro Glonggong Nogosari 2/22/2017
53 Jumeri 73 L kwangsan Simo 1/12/2018
54 1703109051 JUMIYEM 03/18/77 P GONDANGREJO 1/5 KEYONGAN NOGOSARI 04/27/17 A18.2 Tuberculous peripheral lymphadenopathy BEDAH (POLI)
55 1808119473 KAMTI 03/30/89 P WALEN 7/2 WALEN SIMO 08/01/18 A16.2 Tb lung without mention of bact or histological confirm UMUM (POLI)
56 1706110837 KANIFA INDRI AZAHRA 08/25/15 P KLEBEN 20/7 SIMO SIMO 06/10/17 A16.2 Tb lung without mention of bact or histological confirm ANAK (POLI)
57 1801115122 KARSI 01/13/45 P TROSOBO 1/3 TROSOBO SAMBI 04/02/18 A16.2 Tb lung without mention of bact or histological confirm PENYAKIT DALAM (POLI)
58 1701107455 KASIYEM 12/06/55 P SANGGRAHAN RT 15/04 PELEM SIMO 07/03/17 A16.2 Tb lung without mention of bact or histological confirm EDELWEIS
59 1702108284 KHOIRI 08/10/91 L REJOSARI 6/2 PENTUR SIMO 02/13/17 A16.2 Tb lung without mention of bact or histological confirm CENDANA
60 1712114858 KOSIDI 12/31/51 L KARANGKEPOH RT 24/08 BAKALREJO SUSUKAN 06/07/18 A16.2 Tb lung without mention of bact or histological confirm PENYAKIT DALAM (POLI)
61 1502089321 LOSO HADI ATMOJO 09/01/55 L ANDONG 2/1 ANDONG 03/22/17 A16.2 Tb lung without mention of bact or histological confirm PENYAKIT DALAM (POLI)
62 1010042382 MARWAN 10/04/60 L KALANGAN 1/1 03/29/17 A16.2 Tb lung without mention of bact or histological confirm PENYAKIT DALAM (POLI)
63 1701107480 MEIRENA SAFIRTI 05/31/89 P JERINGAN 21/7 WALEN SIMO 02/14/17 A16.2 Tb lung without mention of bact or histological confirm PENYAKIT DALAM (POLI)
64 1806118859 MITRO SLAMET 06/29/55 L TIMPIK 01/09 TIMPIK SUSUKAN 07/10/18 A16.9 Resp tb unspec without mention of bact or hist confirm PENYAKIT DALAM (POLI)
65 1803116386 MUCHAMMAD DIMAS SAPTA DEWA 12/02/96 L GEDANGAN 11/2 SENGGRONG ANDONG 05/11/18 A16.2 Tb lung without mention of bact or histological confirm PENYAKIT DALAM (POLI)
66 1802116174 MUFIDA FAIHA SALSABILA 07/25/17 P BANJARJO 7/3 SEMPU ANDONG 02/23/18 A16.2 Tb lung without mention of bact or histological confirm ANAK (POLI)
67 muh abdul mujib 44 L blagung Simo 4/2/2017
68 1807119068 MUHAMMAD ABDUL GHOFUR 03/14/99 L NGEBUK 01/10 TAWANG SUSUKAN 07/14/18 A16.9 Resp tb unspec without mention of bact or hist confirm UMUM (POLI)
69 1203057070 MUHAMMAD HAMAMI 03/20/71 L SIMO 1/1 SIMO 01/27/17 A16.2 Tb lung without mention of bact or histological confirm PENYAKIT DALAM (POLI)
70 1704109559 MUHAMMAD NASIR 05/05/90 L SALAMREJO 4/6 POJOK NOGOSARI 04/10/17 A16.2 Tb lung without mention of bact or histological confirm UMUM (POLI)
71 1709112678 MUHAMMAD WINARTO 05/04/73 L BLAGUNG 05/01 SIMO 09/22/17 A16.2 Tb lung without mention of bact or histological confirm PENYAKIT DALAM (POLI)
72 1411085702 MUJIANTO 038944 08/06/66 L GUMUKREJO 4/3 KEYONGAN NOGOSARI 02/27/18 A16.2 Tb lung without mention of bact or histological confirm PENYAKIT DALAM (POLI)
73 1005038944 MUJIYANTO 08/06/66 L GUMUKREJO 4/3 KEYONGAN NOGOSARI 01/25/18 A16.2 Tb lung without mention of bact or histological confirm PENYAKIT DALAM (POLI)
74 1707111276 MUJIYEM 07/03/57 P JENALAS 3/2 BENDO NOGOSARI 07/03/17 A16.2 Tb lung without mention of bact or histological confirm CENDANA
75 1211063403 MULYANI 05/22/66 P BANARAN TROSOBO SAMBI 05/22/17 A16.9 Resp tb unspec without mention of bact or hist confirm PENYAKIT DALAM (POLI)
76 1104047247 MULYONO 04/12/59 L GRINTINGAN 14/3 BABADAN 03/07/17 A16.2 Tb lung without mention of bact or histological confirm PENYAKIT DALAM (POLI)
77 1708111970 MURDOWO 08/01/92 L DERASAN 4/2 SEMPU ANDONG 08/11/17 A16.2 Tb lung without mention of bact or histological confirm PENYAKIT DALAM (POLI)
78 1805118247 MUSERI 12/31/48 L PRINGAPUS 04/02 MANYARAN KARANGGEDE 05/29/18 A16.2 Tb lung without mention of bact or histological confirm CENDANA
79 1701107730 NABILA PUTRI RAIS 03/31/16 P GEBANG 5/5 MANYARAN KARANGGEDE 01/24/17 A15.0 Tb lung confirm sputum microscopy with or without culture ANAK (POLI)
80 0903029800 NGATIRI 03/12/67 L GRENJENG 02/05 01/17/17 A15.0 Tb lung confirm sputum microscopy with or without culture PENYAKIT DALAM (POLI)
81 1703108815 NGATIYANI 03/08/69 P PANTARAN 03/15/17 A16.2 Tb lung without mention of bact or histological confirm PENYAKIT DALAM (POLI)
82 1711113897 NGUDIYONO 11/05/67 L NGAMPON 24/8 WALEN SIMO 01/04/18 A16.2 Tb lung without mention of bact or histological confirm CENDANA
83 1404079200 NIRYAWATI 04/01/90 P KRAJAN GLONGGONG NOGOSARI 01/27/17 A15.0 Tb lung confirm sputum microscopy with or without culture PENYAKIT DALAM (POLI)
84 0906031331 NUR HIDAYATI 06/01/73 P PACINGAN 28/06 09/04/17 A16.9 Resp tb unspec without mention of bact or hist confirm PENYAKIT DALAM (POLI)
85 1803117021 NURUL FADILAH 03/29/97 P PANCURAN 21/5 PENTUR SIMO 04/16/18 A16.2 Tb lung without mention of bact or histological confirm UMUM (POLI)
86 1112053850 PARMUJI 12/13/81 L GUMUK REJO 2/4 SAMBI 01/04/18 A16.2 Tb lung without mention of bact or histological confirm CENDANA
87 parmuji 36 L pulung Gunung Simo 12/22/2017
88 1009042171 PARSINEM 01/01/58 P GABLOG RT 11/03 TETER SIMO 01/11/18 A16.2 Tb lung without mention of bact or histological confirm PENYAKIT DALAM (POLI)
89 1704109891 PARTINAH 12/31/60 P BLAGUNG 5/1 SIMO 07/25/17 A16.2 Tb lung without mention of bact or histological confirm PENYAKIT DALAM (POLI)
90 0906031319 PATONAH 06/01/68 P MANGGAL 17/06 SIMO SIMO 01/25/18 A16.2 Tb lung without mention of bact or histological confirm PENYAKIT DALAM (POLI)
91 1611105965 PUJIYATI 11/10/59 P PENGGUNG 4/1 KEDUNGLENGKONG SIMO 01/10/17 A16.2 Tb lung without mention of bact or histological confirm PENYAKIT DALAM (POLI)
92 1707111911 PUTRO ADY HIKMAWAN 06/27/98 L PACINGAN 28/5 WALEN SIMO 08/10/17 A16.2 Tb lung without mention of bact or histological confirm PENYAKIT DALAM (POLI)
93 1801115410 QOSIDAH 12/31/63 P GLAGAHOMBO RT 01/09 TAWANG SUSUKAN 01/24/18 A16.2 Tb lung without mention of bact or histological confirm UMUM (POLI)
94 1803116527 QUANEISHA SAHLA EL ZAHEER 06/18/17 P TEGALSARI 13/3 TANJUNG KLEGO 03/12/18 A16.2 Tb lung without mention of bact or histological confirm ANAK (POLI)
95 1705110344 RIDHO WIBOWO SRI MULYANINGTYAS 01/29/87 P LEMAH IRENG 1/3 KETITANG NOGOSARI 05/22/17 A16.2 Tb lung without mention of bact or histological confirm PENYAKIT DALAM (POLI)
96 1708112166 RIZKA SAKINATUL BADRIYAH 11/05/09 P SUMBERSARI DOLOG 12/4 BAKALREJO SUSUKAN 09/05/17 A16.2 Tb lung without mention of bact or histological confirm ANAK (POLI)
97 Rizki Fendriano 20 L Gulon 1/1 Tanjung Klego 4/28/2018
98 0904030258 RUKAYAH 04/06/59 P KLALINGAN 01/04/17 A15.0 Tb lung confirm sputum microscopy with or without culture PENYAKIT DALAM (POLI)
99 1606102870 SAKIRIN 06/29/60 L BEJEN 04/07/17 A16.2 Tb lung without mention of bact or histological confirm FLAMBOYAN
100 1805117787 SAMI RAHAYU 05/03/72 P ALAS MALANG GONDANGRAWE 05/03/18 A16.2 Tb lung without mention of bact or histological confirm CENDANA
101 1708112418 SARI RAKHMAWATI 09/28/88 P JL. KAMPUNG SAWAH 9/11 SEMPER TIMUR CILINCUNG 08/25/17 A16.2 Tb lung without mention of bact or histological confirm PENYAKIT DALAM (POLI)
102 1302066918 SARMIYATI 12/01/50 P PULUNG 2/1 GUNUNG SIMO 02/01/18 A16.2 Tb lung without mention of bact or histological confirm PENYAKIT DALAM (POLI)
103 1712114765 SISWANTO 12/15/50 L JEMONO 023/04 WATES SIMO 01/04/18 A16.2 Tb lung without mention of bact or histological confirm PENYAKIT DALAM (POLI)
104 1704109418 SITI 04/04/31 P MOJO 04/17/17 A16.2 Tb lung without mention of bact or histological confirm PENYAKIT DALAM (POLI)
105 1707111863 SITI AMINAH 02/28/66 P NGRENI RT 05/02 SIMO SIMO 07/28/17 A16.2 Tb lung without mention of bact or histological confirm CENDANA
106 1807119211 SITI KARIMAH 07/18/83 P KARANGSARI 14/5 BAKALREJO SUSUKAN 07/18/18 A16.9 Resp tb unspec without mention of bact or hist confirm PENYAKIT DALAM (POLI)
107 1802116147 SITI MARYAMAH 12/31/37 P KARANGGAYAM 3/1 SUMBER SIMO 02/23/18 A16.2 Tb lung without mention of bact or histological confirm CENDANA
108 0912035642 SITI ROBINGATUN 12/15/69 P KARANG 9/02 04/18/17 A16.2 Tb lung without mention of bact or histological confirm CENDANA
109 1612107050 SITI ROHMATUN 01/09/69 P PENGKOL 1/4 PENGKOL KARANGGEDE 04/27/17 A16.2 Tb lung without mention of bact or histological confirm PENYAKIT DALAM (POLI)
110 1804117719 SITI SOFIATUN 08/21/99 P SUMBERAN 10/2 BEJI ANDONG 05/16/18 A16.2 Tb lung without mention of bact or histological confirm PENYAKIT DALAM (POLI)
111 1103046317 SLAMET 03/10/61 L GEMPOLSARI 18/4 WATES SIMO 04/16/18 A16.0 Tuberculosis of lung, bacteriologically & histolog'y negative PENYAKIT DALAM (POLI)
112 1707111928 SOFIYA NIKEN 11/15/13 P KARANGSARI 14/5 BAKALREJO SUSUKAN 08/08/17 A16.2 Tb lung without mention of bact or histological confirm ANAK (POLI)
113 1608104058 SRI SUMIYATI 08/16/67 P WONOKERTI 03/24/17 A15.0 Tb lung confirm sputum microscopy with or without culture PENYAKIT DALAM (POLI)
114 1804117670 SUCEPTO 12/09/50 L SIDOMULYO 17/05 PELEM SIMO 04/27/18 A16.2 Tb lung without mention of bact or histological confirm CENDANA
115 0912035501 SUDARMAN 10/08/41 L SERETAN 15/3 07/10/17 A16.2 Tb lung without mention of bact or histological confirm PENYAKIT DALAM (POLI)
116 1608103942 SUDIYARTI AGUSTINA 08/11/68 P BOGO 1/15 TIMPIK SUSUKAN 01/25/17 A15.0 Tb lung confirm sputum microscopy with or without culture PENYAKIT DALAM (POLI)
117 1308072449 SUGIYONO 02/02/77 L KEMEL 9/3 KEDUNGLENGKONG SIMO 04/04/17 A16.2 Tb lung without mention of bact or histological confirm PENYAKIT DALAM (POLI)
118 1702108228 SUHANTO 02/10/87 L DILEM 1/3 TAWANG SUSUKAN SEMARANG 02/27/17 A15.0 Tb lung confirm sputum microscopy with or without culture PENYAKIT DALAM (POLI)
119 1108050481 SUJITO 08/19/35 L NGAMPON 25/8 WALEN SIMO 02/21/18 A16.2 Tb lung without mention of bact or histological confirm PENYAKIT DALAM (POLI)
120 1704110043 SUKARTI 07/27/68 P RANDUKUNING 9/1 GLINTANG SAMBI 05/10/17 A16.2 Tb lung without mention of bact or histological confirm CENDANA
121 1706110725 SUKIMIN 02/10/43 L TEGALSARI 1/3 TANJUNG 06/05/17 A16.1 Tuberculosis lung bact and histological examin not done CENDANA
122 1701107481 SULAMAH 01/11/47 P JENGGLONG RT 31 RW 09 SEMPU ANDONG 01/11/17 A16.2 Tb lung without mention of bact or histological confirm CENDANA
123 1801115161 SUMEDI 09/27/64 L JEMBATAN PARI 1/3 CIJUJUNG SUKARAJA 01/08/18 A16.2 Tb lung without mention of bact or histological confirm PENYAKIT DALAM (POLI)
124 1006040067 SUMERI 06/30/32 L SAMBENGAN 17/6 GUNUNG SIMO 05/03/17 A15.0 Tb lung confirm sputum microscopy with or without culture PENYAKIT DALAM (POLI)
125 1008040882 SUMINAH 08/07/60 P SERETAN 14/3 SENDANGREJO KLEGO 01/20/17 A15.0 Tb lung confirm sputum microscopy with or without culture PENYAKIT DALAM (POLI)
126 1605102069 SUNARYO 05/16/73 L NGOYOG 13/2 BEJI ANDONG 01/23/17 A16.2 Tb lung without mention of bact or histological confirm PENYAKIT DALAM (POLI)
127 1205058505 SUPARTI 05/08/67 P GULON TANJUNG KLEGO 02/23/17 A15.0 Tb lung confirm sputum microscopy with or without culture PENYAKIT DALAM (POLI)
128 1702108121 SUPARTI 02/07/57 P KARANGSARI 16/5 BAKALREJO SUSUKAN 02/07/17 A16.2 Tb lung without mention of bact or histological confirm PENYAKIT DALAM (POLI)
129 suparti 52 P karang anyar 2/3 Pojok Nogosari 2/25/2017
130 1806118324 SUPENI 12/11/69 P SERETAN 11/03 SENDANGREJO KLEGO 06/04/18 A16.2 Tb lung without mention of bact or histological confirm UMUM (POLI)
131 1803116950 SUPI 11/10/43 P BANYUURIP 7/1 KEDUNGDOWO ANDONG 03/27/18 A16.2 Tb lung without mention of bact or histological confirm PENYAKIT DALAM (POLI)
132 1612106663 SUPRAPTI 07/09/82 P SELANEGARA 4/3 SUMPIUH BANYUMAS 01/25/17 A15.0 Tb lung confirm sputum microscopy with or without culture PENYAKIT DALAM (POLI)
133 1706110705 SURDI 06/03/52 L MANGGAL SIMO 08/09/17 A16.2 Tb lung without mention of bact or histological confirm PENYAKIT DALAM (POLI)
134 1801115070 SURIPTO 01/03/58 L DERASAN 04/02 SEMPU ANDONG 01/03/18 A16.2 Tb lung without mention of bact or histological confirm CENDANA
135 susanti 32 P terangan Kedunglengkong Simo 2/18/2017
136 1603100137 SUTINEM 11/10/50 P JEGORAN 7/1 MANYARAN KARANGGEDE 01/09/17 A16.2 Tb lung without mention of bact or histological confirm PENYAKIT DALAM (POLI)
137 1806118299 SUTINI 03/01/58 P KARANGGAYAM 5/1 SUMBER SIMO 06/18/18 A16.2 Tb lung without mention of bact or histological confirm CENDANA
138 1802116022 SUYOTO 02/14/73 L JAMBON BABADAN SAMBI 02/14/18 A16.2 Tb lung without mention of bact or histological confirm CENDANA
139 1002036901 SUYOTO 12/14/45 L GROJOGAN 3/6 POJOK 01/09/17 A16.2 Tb lung without mention of bact or histological confirm PENYAKIT DALAM (POLI)
140 suyoto 56 L jambon Babadan Sambi 8/16/2017
141 1604101401 TASLIM 09/13/85 L BANJARSARI 18/3 TEMON SIMO 07/26/17 A16.2 Tb lung without mention of bact or histological confirm PENYAKIT DALAM (POLI)
142 towirejo 85 L kalangan 1/1 Nglembu Sambi 2/27/2017
143 1604101013 TUJIRAN 04/14/66 L SOKO 10/2 SENDANGREJO KLEGO 03/29/17 A16.2 Tb lung without mention of bact or histological confirm PENYAKIT DALAM (POLI)
144 1808119492 TUKIMAH 11/14/70 P SIDOMULYO 20/7 GUNUNG 08/02/18 A16.9 Resp tb unspec without mention of bact or hist confirm PENYAKIT DALAM (POLI)
145 1802115969 TUKINO 02/12/87 L BONGKOL 2/1 PENGKOL KARANGGEDE 02/12/18 A16.2 Tb lung without mention of bact or histological confirm PENYAKIT DALAM (POLI)
146 1009041726 TUKIRIN 09/13/82 L KRIKILAN 20/04 BLAGUNG 03/24/17 A15.0 Tb lung confirm sputum microscopy with or without culture PENYAKIT DALAM (POLI)
147 1610105218 WAKIDIN 05/28/47 L GEJUGAN GLONGGONG NOGOSARI 07/27/18 A16.9 Resp tb unspec without mention of bact or hist confirm PENYAKIT DALAM (POLI)
148 0906031659 WAKIYEM 06/19/49 P MARGOREJO 5/4, GLONGGONG, NOGOSARI 08/14/17 A16.2 Tb lung without mention of bact or histological confirm PENYAKIT DALAM (POLI)
149 1801115226 WARSONO 05/26/58 L KADIPATEN 16/3 KADIPATEN ANDONG 01/12/18 A16.2 Tb lung without mention of bact or histological confirm PENYAKIT DALAM (POLI)
150 1202056308 WASITO 02/25/73 L SAMBIREJO 19/3 TROSOBO SAMBI 07/19/17 A16.9 Resp tb unspec without mention of bact or hist confirm PENYAKIT DALAM (POLI)
151 watik 36 P ngelo Mojo Andong 1/13/2017
152 1404079901 WIJI 04/23/49 L PULOREJO RT 02/03 PULUTAN NOGOSARI 06/28/17 A16.2 Tb lung without mention of bact or histological confirm CENDANA
153 winarto 44 L blagung 5/1 Simo 9/16/2017
154 1704109798 WIRYO REJO 12/06/39 L JANGKUNGAN RT 07/02 GLONGONG NOGOSARI 04/20/17 A16.2 Tb lung without mention of bact or histological confirm CENDANA
155 1701107781 WISNU ARYA NUGROHO 08/01/08 L GREMBYUK RT 29/08 TANJUNG KLEGO 02/13/17 A15.0 Tb lung confirm sputum microscopy with or without culture ANAK (POLI)
156 0907031996 YAHMAN 07/06/54 L KEMEL 9/3 KEDUNGLENGKONG SIMO 01/08/18 A16.2 Tb lung without mention of bact or histological confirm PENYAKIT DALAM (POLI)
157 1511096291 YOGA ARYA WAHANA 11/03/06 L PAKEL 6/2 TETER SIMO 04/03/18 A16.2 Tb lung without mention of bact or histological confirm ANAK (POLI)
158 1804117519 YOSSA HERDIAN PRATAMA 04/21/18 L KARANGPILANG 06/01 JAGOAN SAMBI 07/06/18 A16.2 Tb lung without mention of bact or histological confirm ANAK (POLI)
159 1610105547 ZIL VIANA RAHMAWATI 10/15/83 P SUCEN TIMUR RT 11/04 KEDUNG LENGKONG SIMO 01/18/17 A16.2 Tb lung without mention of bact or histological confirm PENYAKIT DALAM (POLI)
TGL DAFTAR/ TGL
PENGOBATAN
61 1802116022 MR. X / SUYOTO 02/14/73 L JAMBON BABADAN SAMBI 02/14/18 A16.2 Tb lung without mention of bact or histological confirm CENDANA
146 jumari 55 L widoro 2/22/2017
147 meirena safitri 28 P jeringan 21/7 2/20/2017
148 muh hamami 46 L simo 1/1 1/30/2017
149 ngatiyani 48 P pantaran 3/16/2017
150 sri sumiyati 50 P wonokerti 3/31/2017
151 suhanto 30 L tawang 2/27/2017
152 suparti 52 P karang anyar 2/3 2/25/2017
153 susanti 32 P terangan 2/18/2017
154 towirejo 85 L kalangan 1/1 2/27/2017
155 watik 36 P ngelo 1/13/2017
156 muh abdul mujib 44 L blagung 4/2/2017
157 ridho wibowo 30 P lemah ireng 1/3 5/23/2017
158 sakirin 57 L bejen 1/3 4/12/2017
159 siti 86 P mojo 1/6 4/13/2017
160 darmin T 73 L tari wetan 7/9/2017
161 kasiyem 62 P sanggrahan 7/7/2017
162 putro adi 19 L pacingan 8/3/2017
163 sudarman 76 L klego 7/14/2017
164 suyoto 56 L jambon 8/16/2017
165 Tukirin 35 L Jl. Blagung - Simo 9/24/2017
166 winarto 44 L blagung 5/1 9/16/2017
167 arif budiyanto 27 L turunan 11/14/2017
168 jamjuri 88 L pengkol 11/29/2017
169 parmuji 36 L pulung 12/22/2017
170 siswanto 67 L wates 12/28/2017
171 Dwi Ardiana 32 P Tegal Sari 2/22/2018
172 Dwi Endang 42 P Soko Sangge 2/22/2018
173 Hartatik 40 P Mayar 3/20/2018
174 jakimin 70 L gablok 11/3 1/10/2018
175 Jumeri 73 L kwangsan 1/12/2018
176 Karsi 70 L Sambirejo 1/15/2018
177 Muchamad Dimas 21 L Gedongan 11/2 3/27/2018
178 Patonah 47 P Manggal 1/25/2018
179 Sarmiyati 56 P pulung 2/1 1/3/2018
180 Slamet 57 L Wates 3/7/2018
181 Sumedi 54 L Jembatan Pari 1/12/2018
182 suripto 60 L derasan 4/3 1/7/2018
183 Suyoto 45 L Jambon 2/26/2018
184 Tukino 31 L Pengkol 2/19/2018
185 Azzam 3 L tegalsari 13/3 4/11/2018
186 dwianto 24 L Karang 14/4 6/11/2018
187 Haikal 5 L Banjarjo 7/3 5/7/2018
188 Ifra Lutfiana P 8 P Tegal Sari 5/12/2018
189 Rizki Fendriano 20 L Gulon 1/1 4/28/2018
190 Siti Sofiatun 18 P Sumberan 010/002 5/17/2018
191 Sutini 60 P Karanggayam 6/22/2018
TGL DAFTAR/ TGL
PENGOBATAN
61 1802116022 SUYOTO 02/14/73 L JAMBON BABADAN SAMBI 02/14/18 A16.2 Tb lung without mention of bact or histological confirm CENDANA
LAPORAN TB 03 RSUD SIMO 2017
No Nomor
No Registrasi Status Pengobatan Register Nama Pasien NIK Umur Jenis Kelamin
Faskes Kab/Kota
1 39 Sesuai Standar 0 jumari 0 55 Laki-Laki

2 27 Sesuai Standar 0 meirena safitri 0 28 Perempuan
3 16 Sesuai Standar 0 muh hamami 0 46 Laki-Laki
4 43 Sesuai Standar 0 ngatiyani 0 48 Perempuan
5 52 Sesuai Standar 0 sri sumiyati 0 50 Perempuan
6 28 Sesuai Standar 0 suhanto 0 30 Laki-Laki
7 0 Sesuai Standar 0 suparti 0 52 Perempuan
8 31 Sesuai Standar 0 susanti 0 32 Perempuan
9 0 Sesuai Standar 0 towirejo 0 85 Laki-Laki
10 5 Sesuai Standar 0 watik 0 36 Perempuan
11 60 Sesuai Standar 0 muh abdul mujib 0 44 Laki-Laki
12 91 Sesuai Standar 0 ridho wibowo 0 30 Perempuan
13 63 Sesuai Standar 0 sakirin 0 57 Laki-Laki
14 66 Sesuai Standar 0 siti 0 86 Perempuan
15 104 Sesuai Standar 0 darmin T 0 73 Laki-Laki
16 107 Sesuai Standar 0 kasiyem 0 62 Perempuan
17 116 Sesuai Standar 0 putro adi 0 19 Laki-Laki
18 111 Sesuai Standar 0 sudarman 0 76 Laki-Laki
19 120 Sesuai Standar 0 suyoto 0 56 Laki-Laki
20 9 Sesuai Standar 0 Tukirin 0 35 Laki-Laki
21 138 Sesuai Standar 0 winarto 3309130485730000 44 Laki-Laki
22 163 Sesuai Standar 0 arif budiyanto 0 27 Laki-Laki
23 165 Sesuai Standar 0 jamjuri 0 88 Laki-Laki
24 176 Sesuai Standar 0 parmuji 0 36 Laki-Laki
25 185 Sesuai Standar 0 siswanto 3309315125100000 67 Laki-Laki
26 30 Sesuai Standar 0 Dwi Ardiana 3276025507860010 32 Perempuan
27 9 Sesuai Standar 0 Dwi Endang 0 42 Perempuan
28 47 Sesuai Standar 0 Hartatik 3309136702799000 40 Perempuan
29 7 Sesuai Standar 0 jakimin 0 70 Laki-Laki
30 4 Sesuai Standar 0 Jumeri 3309130912450000 73 Laki-Laki
31 10 Sesuai Standar 0 Karsi 3309105301450000 70 Laki-Laki
32 48 Sesuai Standar 0 Muchamad Dimas 3271050212960000 21 Laki-Laki
33 14 Sesuai Standar 0 Patonah 3309135303689000 47 Perempuan
34 2 Sesuai Standar 0 Sarmiyati 3309134112509000 56 Perempuan
35 33 Sesuai Standar 0 Slamet 3309130108610000 57 Laki-Laki
36 8 Sesuai Standar 0 Sumedi 0 54 Laki-Laki
37 5 Sesuai Standar 0 suripto 0 60 Laki-Laki
38 27 Sesuai Standar 0 Suyoto 0 45 Laki-Laki
39 26 Sesuai Standar 0 Tukino 3309142508850000 31 Laki-Laki
40 1803116526 Sesuai Standar 0 Azzam 0 3 Laki-Laki
41 180611825 Sesuai Standar 0 dwianto 3309132304940000 24 Laki-Laki
42 180311000 Sesuai Standar 0 Haikal 0 5 Laki-Laki
43 1803116529 Sesuai Standar 0 Ifra Lutfiana P 0 8 Perempuan
44 1606102790 Sesuai Standar 0 Rizki Fendriano 3309152110989000 20 Laki-Laki
45 18047719 Sesuai Standar 0 Siti Sofiatun 3309166108999000 18 Perempuan
46 1806118299 Sesuai Standar 0 Sutini 3309134103590000 60 Perempuan
IMO 2017
Propinsi Kabupaten Kecamatan Keluarahan Nama Jalan Nama Fasyankes
JAWA TENGAH BOYOLALI NOGOSARI GLONGGONG widoro RSUD SIMO

JAWA TENGAH BOYOLALI SIMO WALEN jeringan 21/7 RSUD SIMO
JAWA TENGAH BOYOLALI SIMO SIMO simo 1/1 RSUD SIMO
JAWA TENGAH BOYOLALI SIMO TALAKBROTO pantaran RSUD SIMO
JAWA TENGAH BOYOLALI SIMO PELEM wonokerti RSUD SIMO
JAWA TENGAH SEMARANG SUSUKAN TAWANG tawang RSUD SIMO
JAWA TENGAH BOYOLALI NOGOSARI POJOK karang anyar 2/3 RSUD SIMO
JAWA TENGAH BOYOLALI SIMO KEDUNGLENGKONG terangan RSUD SIMO
JAWA TENGAH BOYOLALI SAMBI NGLEMBU kalangan 1/1 RSUD SIMO
JAWA TENGAH BOYOLALI ANDONG MOJO ngelo RSUD SIMO
JAWA TENGAH BOYOLALI SIMO BLAGUNG blagung RSUD SIMO
JAWA TENGAH BOYOLALI NOGOSARI KETITANG lemah ireng 1/3 RSUD SIMO
JAWA TENGAH BOYOLALI KARANGGEDE KARANGGEDE bejen 1/3 RSUD SIMO
JAWA TENGAH BOYOLALI KARANGGEDE MANYARAN mojo 1/6 RSUD SIMO
JAWA TENGAH BOYOLALI SIMO SUMBER tari wetan RSUD SIMO
JAWA TENGAH BOYOLALI SIMO PELEM sanggrahan RSUD SIMO
JAWA TENGAH BOYOLALI SIMO WALEN pacingan RSUD SIMO
JAWA TENGAH BOYOLALI KLEGO KLEGO klego RSUD SIMO
JAWA TENGAH BOYOLALI SAMBI BABADAN jambon RSUD SIMO
JAWA TENGAH BOYOLALI SIMO BLAGUNG Jl. Blagung - Simo RSUD SIMO
JAWA TENGAH BOYOLALI SIMO SIMO blagung 5/1 RSUD SIMO
JAWA TENGAH BOYOLALI SIMO TETER turunan RSUD SIMO
JAWA TENGAH BOYOLALI SIMO TALAKBROTO pengkol RSUD SIMO
JAWA TENGAH BOYOLALI SIMO GUNUNG pulung RSUD SIMO
JAWA TENGAH BOYOLALI SIMO WATES wates RSUD SIMO
JAWA TENGAH BOYOLALI KLEGO TANJUNG Tegal Sari RSUD SIMO
JAWA TENGAH BOYOLALI KLEGO KLEGO Soko Sangge RSUD SIMO
JAWA TENGAH BOYOLALI SIMO PELEM Mayar RSUD SIMO
JAWA TENGAH BOYOLALI SIMO TETER gablok 11/3 RSUD SIMO
JAWA TENGAH BOYOLALI SIMO SIMO kwangsan RSUD SIMO
JAWA TENGAH BOYOLALI SAMBI TROSOBO Sambirejo RSUD SIMO
JAWA TENGAH BOYOLALI ANDONG SENGGRONG Gedongan 11/2 RSUD SIMO
JAWA TENGAH BOYOLALI SIMO SIMO Manggal RSUD SIMO
JAWA TENGAH BOYOLALI SIMO GUNUNG pulung 2/1 RSUD SIMO
JAWA TENGAH BOYOLALI SIMO WATES Wates RSUD SIMO
JAWA BARAT BOGOR SUKARAJA CIJUJUNG Jembatan Pari RSUD SIMO
JAWA TENGAH BOYOLALI ANDONG SEMPU derasan 4/3 RSUD SIMO
JAWA TENGAH BOYOLALI SAMBI BABADAN Jambon RSUD SIMO
JAWA TENGAH BOYOLALI KARANGGEDE KARANGGEDE Pengkol RSUD SIMO
JAWA TENGAH BOYOLALI KLEGO TANJUNG tegalsari 13/3 RSUD SIMO
JAWA TENGAH BOYOLALI SIMO PENTUR Karang 14/4 RSUD SIMO
JAWA TENGAH BOYOLALI ANDONG SEMPU Banjarjo 7/3 RSUD SIMO
JAWA TENGAH BOYOLALI KLEGO TANJUNG Tegal Sari RSUD SIMO
JAWA TENGAH BOYOLALI KLEGO TANJUNG Gulon 1/1 RSUD SIMO
JAWA TENGAH BOYOLALI ANDONG BEJI Sumberan 010/002 RSUD SIMO
JAWA TENGAH BOYOLALI SIMO SUMBER Karanggayam RSUD SIMO
Klasifikasi Klasifikasi Berdasarkan
Dirujuk Oleh Tipe Diagnosis TB Berdasarkan Lokasi Riwayat Pengobatan
Anatomi Sebelumnya
Faskes Terdiagnosis klinis Paru Baru

Anggota Masyarakat / Kader Terdiagnosis klinis Paru Baru
Inisiatif Pasien / Keluarga Terdiagnosis klinis Paru Baru
Faskes Terkonfirmasi bakteriologis Paru Baru
Inisiatif Pasien / Keluarga Terkonfirmasi bakteriologis Paru Baru
Klasifikasi Berdasarkan Skoring TB Hasil Pemeriksaan Tanggal Mulai
Status HIV pada Saat Paduan OAT Sumber Obat Nomor BPJS
Anak Foto Toraks Pengobatan
Didiagnosis
Negatif Positif 2/22/2017 Kategori 1 Program TB 0

Tidak diketahui Positif 2/20/2017 Kategori 1 Program TB 0
Negatif Tidak dilakukan 1/13/2017 Kategori 1 Program TB 0
Positif Positif 5/23/2017 Kategori 1 Program TB 0
Tidak diketahui Tidak dilakukan 8/3/2017 Kategori 1 Program TB 0
Positif Positif 11/14/2017 Kategori 1 Program TB 0
Kategori
Tidak diketahui 7 Positif 4/11/2018 Anak Program TB 0
Negatif Tidak dilakukan 6/11/2018 Kategori 1 Program TB 0
Kategori
Tidak diketahui 8 Negatif 5/7/2018 Anak Program TB 0
Kategori
Tidak diketahui 7 Tidak dilakukan 5/12/2018 Anak Program TB 0
Pemeriksaan Contoh Uji
Sebelum Pengobatan Akhir Bulan ke 2/bulan ke 3 Bulan ke 3
Mikroskopis/ PA (untuk TCM Biakan No reg lab Hasil Mikroskopis No reg lab Hasil Mikroskopis
Ekstra Paru)
Negatif Tidak dilakukan Tidak dilakukan 59 Negatif

Negatif Tidak dilakukan Tidak dilakukan Putus Berobat Putus Berobat
Negatif Tidak dilakukan Tidak dilakukan Tidak dilakukan
Positif Tidak dilakukan Tidak dilakukan 54 Negatif
Positif Tidak dilakukan Tidak dilakukan Putus Berobat Putus Berobat
Negatif Tidak dilakukan Tidak dilakukan Meninggal Meninggal
Positif Tidak dilakukan Tidak dilakukan
Negatif Tidak dilakukan Tidak dilakukan
Tidak dilakukan Tidak dilakukan Tidak dilakukan
Tidak dilakukan Tidak dilakukan Tidak dilakukan
Uji Kolabotasi Kegia
Bulan ke 5 Akhir Pengobatan Hasil Akhir Pengobatan Layanan Tes dan Konselin
No reg lab Hasil Mikroskopis No reg lab Hasil Mikroskopis Tanggal Hasil Tanggal Dianjurkan
Putus Berobat Putus Berobat 5/5/2017 Putus berobat 2/22/2017

Tidak dilakukan Tidak dilakukan 2/24/2017 Pengobatan lengkap 1/30/2017
Tidak dilakukan Tidak dilakukan 9/2/2017 Pengobatan lengkap 0000-00-00
Tidak dilakukan 134 Negatif 9/20/2017 Pengobatan lengkap 0000-00-00
Tidak dilakukan 98 Negatif 7/29/2017 Sembuh 1/13/2017
Putus Berobat Putus Berobat 6/19/2017 Putus berobat 0000-00-00
Tidak dilakukan 133 Negatif 9/11/2017 Pengobatan lengkap 0000-00-00
Tidak dilakukan 367 Negatif 1/15/2018 Sembuh 0000-00-00
Tidak dilakukan 254 Negatif 2/28/2018 Sembuh 9/21/2017
Meninggal Meninggal 2/17/2018 Meninggal 0000-00-00
Meninggal Meninggal 12/14/2017 Meninggal 0000-00-00
0000-00-00 0000-00-00
0000-00-00 0000-00-00
0000-00-00 0000-00-00
0000-00-00 0000-00-00
0000-00-00 0000-00-00
0000-00-00 0000-00-00
0000-00-00 0000-00-00
0000-00-00 0000-00-00
0000-00-00 0000-00-00
0000-00-00 0000-00-00
0000-00-00 0000-00-00
0000-00-00 0000-00-00
0000-00-00 0000-00-00
0000-00-00 0000-00-00
0000-00-00 0000-00-00
0000-00-00 0000-00-00
0000-00-00 0000-00-00
0000-00-00 0000-00-00
Kolabotasi Kegiatan TB - HIV Kegiatan TB-
Tes dan Konseling HIV Layanan PDP DM Dipindah
ke TB.03 Ket
Tanggal Tes Terapi RO
Hasil Tes PPK ART DM
HIV DM
0000-00-00 Tidak
0000-00-00 Tidak Ya
0000-00-00 Tidak
0000-00-00 Ya
0000-00-00 Tidak
2/28/2017 Non Reaktif Tidak
0000-00-00 Tidak
0000-00-00 Tidak
0000-00-00 Tidak
0000-00-00 Tidak Tidak
0000-00-00 Tidak
0000-00-00 Tidak
0000-00-00 Tidak
0000-00-00 Tidak
0000-00-00 Tidak
0000-00-00 Tidak
0000-00-00 Tidak Ya
0000-00-00 Tidak
0000-00-00 Tidak
0000-00-00 Tidak
0000-00-00 Tidak
0000-00-00 Tidak
0000-00-00 Ya
0000-00-00 Tidak
0000-00-00 Tidak
0000-00-00 Tidak
0000-00-00 Ya
0000-00-00 Tidak
0000-00-00 Tidak
0000-00-00 Ya
0000-00-00 Ya
0000-00-00 Tidak
0000-00-00 Tidak
0000-00-00 Tidak
0000-00-00 Tidak
0000-00-00 Tidak
0000-00-00 Tidak
0000-00-00 Tidak
0000-00-00 Tidak
0000-00-00 Tidak
0000-00-00 Tidak
LAPORAN DATA PASIEN RAWAT JALAN & RAWAT INAP DENGAN PENYAKIT TUBERCULOSIS
RSUD SIMO
TAHUN 2017 - 2018
NO. REKAM JENIS TGL DAFTAR/ TGL KATEGORI

NO NAMA PASIEN TGL LAHIR ALAMAT PASIEN KETERANGAN UNIT
MEDIS KELAMIN MULAI PENGOBATAN ICD X
1 0904030258 RUKAYAH 4/6/1959 P KLALINGAN 1/4/2017 8:41 A15.0 Tb lung confirm sputum microscopy with or without culture PENYAKIT DALAM (POLI)
2 0903029800 NGATIRI 3/12/1967 L GRENJENG 02/05 1/17/2017 7:22 A15.0 Tb lung confirm sputum microscopy with or without culture PENYAKIT DALAM (POLI)
3 1612106730 HARNI 5/25/1991 P NGASINAN 14/3 MUNGGUR ANDONG 1/20/2017 7:39 A15.0 Tb lung confirm sputum microscopy with or without culture PENYAKIT DALAM (POLI)
4 1008040882 SUMINAH 8/7/1960 P SERETAN 14/3 SENDANGREJO KLEGO 1/20/2017 8:03 A15.0 Tb lung confirm sputum microscopy with or without culture PENYAKIT DALAM (POLI)
5 1701107730 NABILA PUTRI RAIS 3/31/2016 P GEBANG 5/5 MANYARAN KARANGGEDE 1/24/2017 8:12 A15.0 Tb lung confirm sputum microscopy with or without culture ANAK (POLI)
6 1612106663 SUPRAPTI 7/9/1982 P SELANEGARA 4/3 SUMPIUH BANYUMAS 1/25/2017 8:26 A15.0 Tb lung confirm sputum microscopy with or without culture PENYAKIT DALAM (POLI)
7 1608103942 SUDIYARTI AGUSTINA 8/11/1968 P BOGO 1/15 TIMPIK SUSUKAN 1/25/2017 9:35 A15.0 Tb lung confirm sputum microscopy with or without culture PENYAKIT DALAM (POLI)
8 0903029831 ENIK SUMIYATI 3/14/1974 P BANARAN 10/3 SEMPU 1/26/2017 9:24 A15.0 Tb lung confirm sputum microscopy with or without culture PENYAKIT DALAM (POLI)
9 1404079200 NIRYAWATI 4/1/1990 P KRAJAN GLONGGONG NOGOSARI 1/27/2017 8:05 A15.0 Tb lung confirm sputum microscopy with or without culture PENYAKIT DALAM (POLI)
10 1701107781 WISNU ARYA NUGROHO 8/1/2008 L GREMBYUK RT 29/08 TANJUNG KLEGO 2/13/2017 10:59 A15.0 Tb lung confirm sputum microscopy with or without culture ANAK (POLI)
11 1404079200 NIRYAWATI 4/1/1990 P KRAJAN GLONGGONG NOGOSARI 2/22/2017 8:11 A15.0 Tb lung confirm sputum microscopy with or without culture PENYAKIT DALAM (POLI)
12 1701107682 JAMIATUN 2/15/1949 P SOKOREJO 3/3 MANYARAN KARANGGEDE 2/22/2017 8:18 A15.0 Tb lung confirm sputum microscopy with or without culture PENYAKIT DALAM (POLI)
13 1205058505 SUPARTI 5/8/1967 P GULON TANJUNG KLEGO 2/23/2017 8:15 A15.0 Tb lung confirm sputum microscopy with or without culture PENYAKIT DALAM (POLI)
14 1612106796 ADI SETYOBUDI 12/19/1994 L PONCOL WETAN 4/1 PULUTAN NOGOSARI 2/23/2017 8:43 A15.0 Tb lung confirm sputum microscopy with or without culture PENYAKIT DALAM (POLI)
15 1702108228 SUHANTO 2/10/1987 L DILEM 1/3 TAWANG SUSUKAN SEMARANG 2/27/2017 8:07 A15.0 Tb lung confirm sputum microscopy with or without culture PENYAKIT DALAM (POLI)
16 1609104840 HENI SETYOWATI 6/20/1994 P PAGERJURANG PASEBAN BAYAT KLATEN 2/28/2017 9:34 A15.0 Tb lung confirm sputum microscopy with or without culture PENYAKIT DALAM (POLI)
17 1608104058 SRI SUMIYATI 8/16/1967 P WONOKERTI 3/24/2017 8:16 A15.0 Tb lung confirm sputum microscopy with or without culture PENYAKIT DALAM (POLI)
18 1009041726 TUKIRIN 9/13/1982 L KRIKILAN 20/04 BLAGUNG 3/24/2017 8:27 A15.0 Tb lung confirm sputum microscopy with or without culture PENYAKIT DALAM (POLI)
19 1704109626 IRFAN NUR TAUFIQ 6/26/1995 L GULON 3/1 TANJUNG KLEGO 4/17/2017 8:59 A15.0 Tb lung confirm sputum microscopy with or without culture PENYAKIT DALAM (POLI)
20 1006040067 SUMERI 6/30/1932 L SAMBENGAN 17/6 GUNUNG SIMO 5/3/2017 9:48 A15.0 Tb lung confirm sputum microscopy with or without culture PENYAKIT DALAM (POLI)
21 1006040067 SUMERI 6/30/1932 L SAMBENGAN 17/6 GUNUNG SIMO 7/3/2017 8:16 A15.0 Tb lung confirm sputum microscopy with or without culture PENYAKIT DALAM (POLI)
22 1002036901 SUYOTO 12/14/1945 L GROJOGAN 3/6 POJOK 1/9/2017 7:08 A16.2 Tb lung without mention of bact or histological confirm PENYAKIT DALAM (POLI)
23 1603100137 SUTINEM 11/10/1950 P JEGORAN 7/1 MANYARAN KARANGGEDE 1/9/2017 7:44 A16.2 Tb lung without mention of bact or histological confirm PENYAKIT DALAM (POLI)
24 1611105965 PUJIYATI 11/10/1959 P PENGGUNG 4/1 KEDUNGLENGKONG SIMO 1/10/2017 8:02 A16.2 Tb lung without mention of bact or histological confirm PENYAKIT DALAM (POLI)
25 1612106663 SUPRAPTI 7/9/1982 P SELANEGARA 4/3 SUMPIUH BANYUMAS 1/10/2017 8:47 A16.2 Tb lung without mention of bact or histological confirm PENYAKIT DALAM (POLI)
26 1608103942 SUDIYARTI AGUSTINA 8/11/1968 P BOGO 1/15 TIMPIK SUSUKAN 1/11/2017 10:00 A16.2 Tb lung without mention of bact or histological confirm PENYAKIT DALAM (POLI)
27 1610105547 ZIL VIANA RAHMAWATI 10/15/1983 P SUCEN TIMUR RT 11/04 KEDUNG LENGKONG SIMO 1/18/2017 8:41 A16.2 Tb lung without mention of bact or histological confirm PENYAKIT DALAM (POLI)
28 1605102069 SUNARYO 5/16/1973 L NGOYOG 13/2 BEJI ANDONG 1/23/2017 7:49 A16.2 Tb lung without mention of bact or histological confirm PENYAKIT DALAM (POLI)
29 1205058505 SUPARTI 5/8/1967 P GULON TANJUNG KLEGO 1/24/2017 8:38 A16.2 Tb lung without mention of bact or histological confirm PENYAKIT DALAM (POLI)
30 1608103942 SUDIYARTI AGUSTINA 8/11/1968 P BOGO 1/15 TIMPIK SUSUKAN 1/26/2017 9:42 A16.2 Tb lung without mention of bact or histological confirm PENYAKIT DALAM (POLI)
31 1203057070 MUHAMMAD HAMAMI 3/20/1971 L SIMO 1/1 SIMO 1/27/2017 8:53 A16.2 Tb lung without mention of bact or histological confirm PENYAKIT DALAM (POLI)
32 1701107730 NABILA PUTRI RAIS 3/31/2016 P GEBANG 5/5 MANYARAN KARANGGEDE 1/30/2017 8:07 A16.2 Tb lung without mention of bact or histological confirm ANAK (POLI)
33 1609104840 HENI SETYOWATI 6/20/1994 P PAGERJURANG PASEBAN BAYAT KLATEN 1/30/2017 8:54 A16.2 Tb lung without mention of bact or histological confirm PENYAKIT DALAM (POLI)
34 1702108121 SUPARTI 2/7/1957 P KARANGSARI 16/5 BAKALREJO SUSUKAN 2/7/2017 9:05 A16.2 Tb lung without mention of bact or histological confirm PENYAKIT DALAM (POLI)
35 1702108148 ARI WINARNO 2/8/1989 L GROMPOL 17/3 TROSOBO SAMBI 2/8/2017 8:05 A16.2 Tb lung without mention of bact or histological confirm PENYAKIT DALAM (POLI)
36 1702108147 JUMANI 2/8/1962 L NGUMBUL GLONGGONG 2/13/2017 8:19 A16.2 Tb lung without mention of bact or histological confirm PENYAKIT DALAM (POLI)
37 1701107480 MEIRENA SAFIRTI 5/31/1989 P JERINGAN 21/7 WALEN SIMO 2/14/2017 10:49 A16.2 Tb lung without mention of bact or histological confirm PENYAKIT DALAM (POLI)
38 1612106730 HARNI 5/25/1991 P NGASINAN 14/3 MUNGGUR ANDONG 2/20/2017 8:04 A16.2 Tb lung without mention of bact or histological confirm PENYAKIT DALAM (POLI)
39 1701107480 MEIRENA SAFIRTI 5/31/1989 P JERINGAN 21/7 WALEN SIMO 2/20/2017 9:31 A16.2 Tb lung without mention of bact or histological confirm PENYAKIT DALAM (POLI)
43 1104047247 MULYONO 4/12/1959 L GRINTINGAN 14/3 BABADAN 3/7/2017 8:12 A16.2 Tb lung without mention of bact or histological confirm PENYAKIT DALAM (POLI)
44 1703108815 NGATIYANI 3/8/1969 P PANTARAN 3/15/2017 8:34 A16.2 Tb lung without mention of bact or histological confirm PENYAKIT DALAM (POLI)
46 1502089321 LOSO HADI ATMOJO 9/1/1955 L ANDONG 2/1 ANDONG 3/22/2017 8:10 A16.2 Tb lung without mention of bact or histological confirm PENYAKIT DALAM (POLI)
49 1010042382 MARWAN 10/4/1960 L KALANGAN 1/1 3/29/2017 7:52 A16.2 Tb lung without mention of bact or histological confirm PENYAKIT DALAM (POLI)
50 1604101013 TUJIRAN 4/14/1966 L SOKO 10/2 SENDANGREJO KLEGO 3/29/2017 8:59 A16.2 Tb lung without mention of bact or histological confirm PENYAKIT DALAM (POLI)
51 1408083536 ATMO WIJOYO W 8/22/1942 L KRANGGAN TASIKMADU KARANGANYAR 3/29/2017 11:06 A16.2 Tb lung without mention of bact or histological confirm PENYAKIT DALAM (POLI)
52 1009041726 TUKIRIN 9/13/1982 L KRIKILAN 20/04 BLAGUNG 4/3/2017 8:15 A16.2 Tb lung without mention of bact or histological confirm PENYAKIT DALAM (POLI)
53 1308072449 SUGIYONO 2/2/1977 L KEMEL 9/3 KEDUNGLENGKONG SIMO 4/4/2017 9:16 A16.2 Tb lung without mention of bact or histological confirm PENYAKIT DALAM (POLI)
55 1404079200 NIRYAWATI 4/1/1990 P KRAJAN GLONGGONG NOGOSARI 4/10/2017 7:56 A16.2 Tb lung without mention of bact or histological confirm PENYAKIT DALAM (POLI)
56 1702108147 JUMANI 2/8/1962 L NGUMBUL GLONGGONG 4/10/2017 8:23 A16.2 Tb lung without mention of bact or histological confirm PENYAKIT DALAM (POLI)
58 1704109559 MUHAMMAD NASIR 5/5/1990 L SALAMREJO 4/6 POJOK NOGOSARI 4/10/2017 9:05 A16.2 Tb lung without mention of bact or histological confirm UMUM (POLI)
59 1704109538 INDAH SETYOWATI 11/2/2016 P POKO KRAJAN PULUTAN NOGOSARI 4/10/2017 10:13 A16.2 Tb lung without mention of bact or histological confirm ANAK (POLI)
60 1701107781 WISNU ARYA NUGROHO 8/1/2008 L GREMBYUK RT 29/08 TANJUNG KLEGO 4/10/2017 11:14 A16.2 Tb lung without mention of bact or histological confirm ANAK (POLI)
62 1703108677 ISTIYAWATI 3/2/1975 P RINGINWOK 4/11/2017 9:09 A16.2 Tb lung without mention of bact or histological confirm PENYAKIT DALAM (POLI)
63 1704109626 IRFAN NUR TAUFIQ 6/26/1995 L GULON 3/1 TANJUNG KLEGO 4/13/2017 8:15 A16.2 Tb lung without mention of bact or histological confirm PENYAKIT DALAM (POLI)
64 1704109418 SITI 4/4/1931 P MOJO 4/17/2017 8:47 A16.2 Tb lung without mention of bact or histological confirm PENYAKIT DALAM (POLI)
65 1205058505 SUPARTI 5/8/1967 P GULON TANJUNG KLEGO 4/19/2017 7:52 A16.2 Tb lung without mention of bact or histological confirm PENYAKIT DALAM (POLI)
67 1702108228 SUHANTO 2/10/1987 L DILEM 1/3 TAWANG SUSUKAN SEMARANG 4/27/2017 7:54 A16.2 Tb lung without mention of bact or histological confirm PENYAKIT DALAM (POLI)
68 1612107050 SITI ROHMATUN 1/9/1969 P PENGKOL 1/4 PENGKOL KARANGGEDE 4/27/2017 8:01 A16.2 Tb lung without mention of bact or histological confirm PENYAKIT DALAM (POLI)
71 1611105965 PUJIYATI 11/10/1959 P PENGGUNG 4/1 KEDUNGLENGKONG SIMO 5/4/2017 8:08 A16.2 Tb lung without mention of bact or histological confirm PENYAKIT DALAM (POLI)
74 1703108815 NGATIYANI 3/8/1969 P PANTARAN 5/12/2017 8:45 A16.2 Tb lung without mention of bact or histological confirm PENYAKIT DALAM (POLI)
75 1705110349 ASMO SEMITO 7/1/1955 L NGEMBAT 38/ 11 SEMPU ANDONG 5/15/2017 9:48 A16.2 Tb lung without mention of bact or histological confirm PENYAKIT DALAM (POLI)
77 1604101013 TUJIRAN 4/14/1966 L SOKO 10/2 SENDANGREJO KLEGO 5/22/2017 7:48 A16.2 Tb lung without mention of bact or histological confirm PENYAKIT DALAM (POLI)
78 1705110344 RIDHO WIBOWO SRI MULYANINGTYAS 1/29/1987 P LEMAH IRENG 1/3 KETITANG NOGOSARI 5/22/2017 8:11 A16.2 Tb lung without mention of bact or histological confirm PENYAKIT DALAM (POLI)
79 1502089321 LOSO HADI ATMOJO 9/1/1955 L ANDONG 2/1 ANDONG 5/24/2017 7:58 A16.2 Tb lung without mention of bact or histological confirm PENYAKIT DALAM (POLI)
81 0802022779 FADILA GITA 12/4/2007 P TITANG 5/26/2017 8:41 A16.2 Tb lung without mention of bact or histological confirm ANAK (POLI)
82 1403078577 JARIYATUN 3/13/1960 P JERING WATES SIMO 5/29/2017 8:11 A16.2 Tb lung without mention of bact or histological confirm PENYAKIT DALAM (POLI)
84 1608104058 SRI SUMIYATI 8/16/1967 P WONOKERTI 5/31/2017 7:45 A16.2 Tb lung without mention of bact or histological confirm PENYAKIT DALAM (POLI)
85 1706110741 HANIFA PUTRI ARDIAN 6/5/2011 P PERENG 1/1 PAKEL ANDONG 6/5/2017 10:38 A16.2 Tb lung without mention of bact or histological confirm ANAK (POLI)
87 1706110837 KANIFA INDRI AZAHRA 8/25/2015 P KLEBEN 20/7 SIMO SIMO 6/10/2017 13:10 A16.2 Tb lung without mention of bact or histological confirm ANAK (POLI)
90 1707111296 JUANA AGUS PRASETYO 1/1/1987 L TEPURSARI RT 01/03 SAMBI 7/4/2017 10:38 A16.2 Tb lung without mention of bact or histological confirm PENYAKIT DALAM (POLI)
92 0912035501 SUDARMAN 10/8/1941 L SERETAN 15/3 7/10/2017 8:22 A16.2 Tb lung without mention of bact or histological confirm PENYAKIT DALAM (POLI)
93 1008040882 SUMINAH 8/7/1960 P SERETAN 14/3 SENDANGREJO KLEGO 7/12/2017 8:25 A16.2 Tb lung without mention of bact or histological confirm PENYAKIT DALAM (POLI)
97 1704109891 PARTINAH 12/31/1960 P BLAGUNG 5/1 SIMO 7/25/2017 9:55 A16.2 Tb lung without mention of bact or histological confirm PENYAKIT DALAM (POLI)
98 1604101401 TASLIM 9/13/1985 L BANJARSARI 18/3 TEMON SIMO 7/26/2017 8:07 A16.2 Tb lung without mention of bact or histological confirm PENYAKIT DALAM (POLI)
100 1708111996 DWI AYU PRATIWI 8/4/2014 P TRAYON 4/2 KEBONAN KARANGGEDE 8/4/2017 8:33 A16.2 Tb lung without mention of bact or histological confirm ANAK (POLI)
101 1707111928 SOFIYA NIKEN 11/15/2013 P KARANGSARI 14/5 BAKALREJO SUSUKAN 8/8/2017 13:06 A16.2 Tb lung without mention of bact or histological confirm ANAK (POLI)
102 1706110705 SURDI 6/3/1952 L MANGGAL SIMO 8/9/2017 8:58 A16.2 Tb lung without mention of bact or histological confirm PENYAKIT DALAM (POLI)
103 1707111911 PUTRO ADY HIKMAWAN 6/27/1998 L PACINGAN 28/5 WALEN SIMO 8/10/2017 8:06 A16.2 Tb lung without mention of bact or histological confirm PENYAKIT DALAM (POLI)
104 1708111970 MURDOWO 8/1/1992 L DERASAN 4/2 SEMPU ANDONG 8/11/2017 8:17 A16.2 Tb lung without mention of bact or histological confirm PENYAKIT DALAM (POLI)
105 0906031659 WAKIYEM 6/19/1949 P MARGOREJO 5/4, GLONGGONG, NOGOSARI 8/14/2017 8:43 A16.2 Tb lung without mention of bact or histological confirm PENYAKIT DALAM (POLI)
107 1206059417 DARMIN 2/22/1944 L TARI WETAN SIMO 8/15/2017 7:40 A16.2 Tb lung without mention of bact or histological confirm PENYAKIT DALAM (POLI)
110 1708112336 ALISA NUR SAIDAH ARYANTI 11/29/2015 P LEMAHIRENG 1/1 LEMAHIRENG KEMUSU 8/21/2017 8:38 A16.2 Tb lung without mention of bact or histological confirm ANAK (POLI)
111 1706110729 DARMO SUWITO 12/11/1935 L SENDANGREJO 17/4 SENDANGREJO KLEGO 8/21/2017 10:48 A16.2 Tb lung without mention of bact or histological confirm PENYAKIT DALAM (POLI)
113 1708112418 SARI RAKHMAWATI 9/28/1988 P JL. KAMPUNG SAWAH 9/11 SEMPER TIMUR CILINCUNG 8/25/2017 9:51 A16.2 Tb lung without mention of bact or histological confirm PENYAKIT DALAM (POLI)
115 1708112479 AHMAD ARIS SETIYANTO 8/29/1994 L KEDUNGDOWO 3/1 BENDUNGAN SIMO 8/29/2017 8:16 A16.2 Tb lung without mention of bact or histological confirm UMUM (POLI)
116 1708112166 RIZKA SAKINATUL BADRIYAH 11/5/2009 P SUMBERSARI DOLOG 12/4 BAKALREJO SUSUKAN 9/5/2017 13:06 A16.2 Tb lung without mention of bact or histological confirm ANAK (POLI)
117 1504091025 ANANG SAPUTRA 4/17/1997 L TITANG SIMO 9/11/2017 7:17 A16.2 Tb lung without mention of bact or histological confirm PENYAKIT DALAM (POLI)
119 1706110729 DARMO SUWITO 12/11/1935 L SENDANGREJO 17/4 SENDANGREJO KLEGO 9/20/2017 9:39 A16.2 Tb lung without mention of bact or histological confirm PENYAKIT DALAM (POLI)
120 1709112678 MUHAMMAD WINARTO 5/4/1973 L BLAGUNG 05/01 SIMO 9/22/2017 9:00 A16.2 Tb lung without mention of bact or histological confirm PENYAKIT DALAM (POLI)
122 1707111911 PUTRO ADY HIKMAWAN 6/27/1998 L PACINGAN 28/5 WALEN SIMO 9/26/2017 8:11 A16.2 Tb lung without mention of bact or histological confirm PENYAKIT DALAM (POLI)
123 1604101401 TASLIM 9/13/1985 L BANJARSARI 18/3 TEMON SIMO 9/28/2017 8:01 A16.2 Tb lung without mention of bact or histological confirm PENYAKIT DALAM (POLI)
125 1710113207 IMAM MUCHSIN 5/31/1983 L GONDANGREJO 04/01 KEYONGAN NOGOSARI 10/4/2017 8:32 A16.2 Tb lung without mention of bact or histological confirm PENYAKIT DALAM (POLI)
126 1008040882 SUMINAH 8/7/1960 P SERETAN 14/3 SENDANGREJO KLEGO 10/10/2017 9:37 A16.2 Tb lung without mention of bact or histological confirm PENYAKIT DALAM (POLI)
127 0912035501 SUDARMAN 10/8/1941 L SERETAN 15/3 10/11/2017 8:56 A16.2 Tb lung without mention of bact or histological confirm PENYAKIT DALAM (POLI)
129 1504090640 ARIFIN 10/5/1978 L KRAMBIL SAWIT 13/4 TALAKBROTO 10/16/2017 8:08 A16.2 Tb lung without mention of bact or histological confirm PENYAKIT DALAM (POLI)
130 1710113207 IMAM MUCHSIN 5/31/1983 L GONDANGREJO 04/01 KEYONGAN NOGOSARI 10/16/2017 9:24 A16.2 Tb lung without mention of bact or histological confirm PENYAKIT DALAM (POLI)
132 1205058505 SUPARTI 5/8/1967 P GULON TANJUNG KLEGO 5/17/2017 7:49 A16.9 Resp tb unspec without mention of bact or hist confirm PENYAKIT DALAM (POLI)
133 1211063403 MULYANI 5/22/1966 P BANARAN TROSOBO SAMBI 5/22/2017 7:41 A16.9 Resp tb unspec without mention of bact or hist confirm PENYAKIT DALAM (POLI)
134 1011043490 GINEM 11/16/1973 P KEDUNG WULUH 12/3 TEMON SIMO 5/23/2017 8:12 A16.9 Resp tb unspec without mention of bact or hist confirm PENYAKIT DALAM (POLI)
135 1705110655 HILYA HUSNA MALIKA 5/10/2012 P PENGKOL 2/4 PENGKOL KARANGGEDE 5/31/2017 8:35 A16.9 Resp tb unspec without mention of bact or hist confirm ANAK (POLI)
136 1202056308 WASITO 2/25/1973 L SAMBIREJO 19/3 TROSOBO SAMBI 7/19/2017 7:56 A16.9 Resp tb unspec without mention of bact or hist confirm PENYAKIT DALAM (POLI)
137 0906031331 NUR HIDAYATI 6/1/1973 P PACINGAN 28/06 9/4/2017 9:06 A16.9 Resp tb unspec without mention of bact or hist confirm PENYAKIT DALAM (POLI)
138 1206059417 DARMIN 2/22/1944 L TARI WETAN SIMO 9/7/2017 8:03 A16.9 Resp tb unspec without mention of bact or hist confirm PENYAKIT DALAM (POLI)
139 1604101401 TASLIM 9/13/1985 L BANJARSARI 18/3 TEMON SIMO 3/29/2017 11:24 A18.2 Tuberculous peripheral lymphadenopathy PENYAKIT DALAM (POLI)
140 1703109051 JUMIYEM 3/18/1977 P GONDANGREJO 1/5 KEYONGAN NOGOSARI 4/27/2017 9:10 A18.2 Tuberculous peripheral lymphadenopathy BEDAH (POLI)
149 1203057070 MUHAMMAD HAMAMI 3/20/1971 L SIMO 1/1 SIMO SIMO 1/15/2018 A16.2 Tb lung without mention of bact or histological confirm PENYAKIT DALAM (POLI)
150 1704109418 SITI 11/30/1931 P MOJO RT 01/05 MANYARAN KARANGGEDE 1/18/2018 A16.2 Tb lung without mention of bact or histological confirm PENYAKIT DALAM (POLI)
169 1704109891 PARTINAH 12/31/1960 P BLAGUNG 5/1 SIMO SIMO 2/27/2018 A16.2 Tb lung without mention of bact or histological confirm PENYAKIT DALAM (POLI)
170 1411085702 MUJIANTO 038944 8/6/1966 L GUMUKREJO 4/3 KEYONGAN NOGOSARI 2/27/2018 A16.2 Tb lung without mention of bact or histological confirm PENYAKIT DALAM (POLI)
189 1803116526 AZAM FATA MAULANA 10/2/2014 L TEGALSARI 13/3 TANJUNG KLEGO 3/31/2018 A16.2 Tb lung without mention of bact or histological confirm UMUM (POLI)
197 1804117110 JOKO SANTOSO 5/25/1969 L PERMATA BANJAR ASRI BLOK A3 RTO4 /09 CIPOCOK JA 4/11/2018 A16.2 Tb lung without mention of bact or histological confirm PENYAKIT DALAM (POLI)
200 1802116095 DWI ARDIANA LESTARI 7/15/1986 P TEGALSARI 13/3 TANJUNG KLEGO 4/19/2018 A16.2 Tb lung without mention of bact or histological confirm PENYAKIT DALAM (POLI)
201 1704109418 SITI 11/30/1931 P MOJO RT 01/05 MANYARAN KARANGGEDE 4/19/2018 A16.2 Tb lung without mention of bact or histological confirm PENYAKIT DALAM (POLI)
209 1803116529 IFRA LUTFIANA PUTRI SHARLIZ 4/24/2009 P TEGALSARI 13/03 TANJUNG KLEGO 5/11/2018 A16.2 Tb lung without mention of bact or histological confirm ANAK (POLI)
213 1704109418 SITI 11/30/1931 P MOJO RT 01/05 MANYARAN KARANGGEDE 5/24/2018 A16.9 Resp tb unspec without mention of bact or hist confirm PENYAKIT DALAM (POLI)
218 1008040882 SUMINAH 8/7/1960 P SERETAN 14/3 SENDANGREJO KLEGO 6/4/2018 A16.2 Tb lung without mention of bact or histological confirm PENYAKIT DALAM (POLI)
225 1301065125 HAIKAL 7/14/2014 L BANJAREJO SEMPU ANDONG 6/25/2018 A15.0 Tb lung confirm sputum microscopy with or without culture ANAK (POLI)
227 1608104058 SRI SUMIYATI 8/16/1967 P WONOKERTI PELEM SIMO 6/25/2018 A16.2 Tb lung without mention of bact or histological confirm PENYAKIT DALAM (POLI)
229 1103046317 SLAMET 3/10/1961 L GEMPOLSARI 18/4 WATES SIMO 6/28/2018 A16.9 Resp tb unspec without mention of bact or hist confirm PENYAKIT DALAM (POLI)
230 1804117719 SITI SOFIATUN 8/21/1999 P SUMBERAN 10/2 BEJI ANDONG 6/28/2018 A16.9 Resp tb unspec without mention of bact or hist confirm PENYAKIT DALAM (POLI)
231 0906031319 PATONAH 6/1/1968 P MANGGAL 17/06 SIMO SIMO 7/3/2018 A16.9 Resp tb unspec without mention of bact or hist confirm PENYAKIT DALAM (POLI)
234 1803116529 IFRA LUTFIANA PUTRI SHARLIZ 4/24/2009 P TEGALSARI 13/03 TANJUNG KLEGO 7/9/2018 A16.9 Resp tb unspec without mention of bact or hist confirm ANAK (POLI)
235 1803116527 QUANEISHA SAHLA EL ZAHEER 6/18/2017 P TEGALSARI 13/3 TANJUNG KLEGO 7/9/2018 A16.9 Resp tb unspec without mention of bact or hist confirm ANAK (POLI)
240 1803116526 AZAM FATA MAULANA 10/2/2014 L TEGALSARI 13/3 TANJUNG KLEGO 7/20/2018 A16.9 Resp tb unspec without mention of bact or hist confirm ANAK (POLI)
243 1807119211 SITI KARIMAH 7/18/1983 P KARANGSARI 14/5 BAKALREJO SUSUKAN 7/24/2018 A16.2 Tb lung without mention of bact or histological confirm PENYAKIT DALAM (POLI)
244 1103046317 SLAMET 3/10/1961 L GEMPOLSARI 18/4 WATES SIMO 7/25/2018 A16.9 Resp tb unspec without mention of bact or hist confirm PENYAKIT DALAM (POLI)
245 1103046525 HARTATIK 2/27/1979 P NAYAN 5/7 PELEM SIMO 7/27/2018 A16.9 Resp tb unspec without mention of bact or hist confirm PENYAKIT DALAM (POLI)
249 1610105458 DARMINI 10/21/1965 P KACANGAN 4/1 KACANGAN ANDONG 1/11/2017 13:08 A15.9 Respiratory tb unspec confirm bact and histologically CENDANA
250 1202056308 WASITO 2/25/1973 L SAMBIREJO 19/3 TROSOBO SAMBI 7/11/2017 11:12 A16.0 Tuberculosis of lung, bacteriologically & histolog'y neg CENDANA
251 1706110725 SUKIMIN 2/10/1943 L TEGALSARI 1/3 TANJUNG 6/5/2017 7:17 A16.1 Tuberculosis lung bact and histological examin not done CENDANA
252 1701107481 SULAMAH 1/11/1947 P JENGGLONG RT 31 RW 09 SEMPU ANDONG 1/11/2017 11:25 A16.2 Tb lung without mention of bact or histological confirm CENDANA
253 1702108284 KHOIRI 8/10/1991 L REJOSARI 6/2 PENTUR SIMO 2/13/2017 13:08 A16.2 Tb lung without mention of bact or histological confirm CENDANA
254 1707111436 INDAH SEPTI 7/9/1986 P BAKALAN 7/9/2017 3:51 A16.2 Tb lung without mention of bact or histological confirm CENDANA
255 1707111863 SITI AMINAH 2/28/1966 P NGRENI RT 05/02 SIMO SIMO 7/28/2017 11:21 A16.2 Tb lung without mention of bact or histological confirm CENDANA
256 1708111970 MURDOWO 8/1/1992 L DERASAN 4/2 SEMPU ANDONG 8/2/2017 17:27 A16.2 Tb lung without mention of bact or histological confirm CENDANA
257 1205058505 SUPARTI 5/8/1967 P GULON TANJUNG KLEGO 1/30/2017 6:17 A16.2 Tb lung without mention of bact or histological confirm CENDANA
258 1702108147 JUMANI 2/8/1962 L NGUMBUL GLONGGONG 2/8/2017 7:21 A16.2 Tb lung without mention of bact or histological confirm CENDANA
259 1703108729 JANATIN 3/4/1952 P SOKO 10/2 SENDANGREJO 3/4/2017 19:00 A16.2 Tb lung without mention of bact or histological confirm CENDANA
260 1703108815 NGATIYANI 3/8/1969 P PANTARAN 3/8/2017 15:51 A16.2 Tb lung without mention of bact or histological confirm CENDANA
261 1704109418 SITI 4/4/1931 P MOJO 4/4/2017 15:49 A16.2 Tb lung without mention of bact or histological confirm FLAMBOYAN
262 1606102870 SAKIRIN 6/29/1960 L BEJEN 4/7/2017 11:46 A16.2 Tb lung without mention of bact or histological confirm FLAMBOYAN
263 0912035642 SITI ROBINGATUN 12/15/1969 P KARANG 9/02 4/18/2017 9:25 A16.2 Tb lung without mention of bact or histological confirm CENDANA
264 1704109798 WIRYO REJO 12/6/1939 L JANGKUNGAN RT 07/02 GLONGONG NOGOSARI 4/20/2017 14:47 A16.2 Tb lung without mention of bact or histological confirm CENDANA
265 1704110043 SUKARTI 7/27/1968 P RANDUKUNING 9/1 GLINTANG SAMBI 5/10/2017 1:47 A16.2 Tb lung without mention of bact or histological confirm CENDANA
266 1404079901 WIJI 4/23/1949 L PULOREJO RT 02/03 PULUTAN NOGOSARI 6/28/2017 6:50 A16.2 Tb lung without mention of bact or histological confirm CENDANA
267 1206059417 DARMIN 2/22/1944 L TARI WETAN SIMO 7/1/2017 13:01 A16.2 Tb lung without mention of bact or histological confirm CENDANA
268 1707111276 MUJIYEM 7/3/1957 P JENALAS 3/2 BENDO NOGOSARI 7/3/2017 11:04 A16.2 Tb lung without mention of bact or histological confirm CENDANA
269 1701107455 KASIYEM 12/6/1955 P SANGGRAHAN RT 15/04 PELEM SIMO 7/3/2017 15:11 A16.2 Tb lung without mention of bact or histological confirm EDELWEIS
270 1707111911 PUTRO ADY HIKMAWAN 6/27/1998 L PACINGAN 28/5 WALEN SIMO 7/31/2017 11:15 A16.2 Tb lung without mention of bact or histological confirm CENDANA
271 1704109798 WIRYO REJO 12/6/1939 L JANGKUNGAN RT 07/02 GLONGONG NOGOSARI 8/29/2017 13:56 A16.2 Tb lung without mention of bact or histological confirm CENDANA
272 1709112678 MUHAMMAD WINARTO 5/4/1973 L BLAGUNG 05/01 SIMO 9/9/2017 18:17 A16.2 Tb lung without mention of bact or histological confirm CENDANA
273 1009041726 TUKIRIN 9/13/1982 L KRIKILAN 20/04 BLAGUNG 9/22/2017 16:29 A16.2 Tb lung without mention of bact or histological confirm CENDANA
274 1104047247 MULYONO 4/12/1959 L GRINTINGAN 14/3 BABADAN 1/23/2017 12:23 A16.9 Resp tb unspec without mention of bact or hist confirm CENDANA
275 1801115070 SURIPTO 1/3/1958 L DERASAN 04/02 SEMPU ANDONG 1/3/2018 6:53 A16.2 Tb lung without mention of bact or histological confirm CENDANA
276 1009042171 PARSINEM 1/1/1958 P GABLOG RT 11/03 TETER SIMO 1/3/2018 12:15 A16.5 Tb pleurisy without mention of bact or histological confirm CENDANA
277 1711113897 NGUDIYONO 11/5/1967 L NGAMPON 24/8 WALEN SIMO 1/4/2018 5:29 A16.2 Tb lung without mention of bact or histological confirm CENDANA
278 1112053850 PARMUJI 12/13/1981 L GUMUK REJO 2/4 SAMBI 1/4/2018 13:54 A16.2 Tb lung without mention of bact or histological confirm CENDANA
279 1801115122 KARSI 1/13/1945 P TROSOBO 1/3 TROSOBO SAMBI 1/5/2018 7:55 A16.2 Tb lung without mention of bact or histological confirm CENDANA
280 1801115140 DWI ENDANG HANDAYANI 1/6/1976 P SOKO 01/02 SANGGE KLEGO 1/6/2018 11:23 A16.2 Tb lung without mention of bact or histological confirm EDELWEIS
281 1405080315 JAMJURI 7/1/1929 L PENGKOL 5/2 KARANGGEDE 1/10/2018 19:42 A16.7 Prim respiratory tb without mention of bact or hist confirm EDELWEIS
282 1801115070 SURIPTO 1/3/1958 L DERASAN 04/02 SEMPU ANDONG 1/10/2018 20:30 A16.2 Tb lung without mention of bact or histological confirm CENDANA
283 1802115762 HADI SISWANTO 2/5/1934 L PULUTAN 12/02 PULUTAN NOGOSARI 2/5/2018 0:38 A16.7 Prim respiratory tb without mention of bact or hist confirm CENDANA
284 1802116022 MR. X / SUYOTO 2/14/1973 L JAMBON BABADAN SAMBI 2/14/2018 8:52 A16.2 Tb lung without mention of bact or histological confirm CENDANA
285 1103046317 SLAMET 3/10/1961 L GEMPOLSARI 18/4 WATES SIMO 2/19/2018 13:25 A16.7 Prim respiratory tb without mention of bact or hist confirm CENDANA
286 1802116147 SITI MARYAMAH 12/31/1937 P KARANGGAYAM 3/1 SUMBER SIMO 2/23/2018 14:26 A16.2 Tb lung without mention of bact or histological confirm CENDANA
287 1803116386 MUCHAMMAD DIMAS SAPTA DEWA 12/2/1996 L GEDANGAN 11/2 SENGGRONG ANDONG 3/2/2018 10:34 A16.7 Prim respiratory tb without mention of bact or hist confirm CENDANA
288 1804117110 JOKO SANTOSO 5/25/1969 L PERMATA BANJAR ASRI BLOK A3 RTO4 /09 CIPOCOK JA 4/3/2018 18:29 A16.2 Tb lung without mention of bact or histological confirm EDELWEIS
289 1002036901 SUYOTO 12/14/1945 L GROJOGAN 3/6 POJOK NOGOSARI 4/10/2018 16:17 A16.2 Tb lung without mention of bact or histological confirm CENDANA
290 1804117670 SUCEPTO 12/9/1950 L SIDOMULYO 17/05 PELEM SIMO 4/27/2018 19:28 A16.2 Tb lung without mention of bact or histological confirm CENDANA
291 1805117787 SAMI RAHAYU 5/3/1972 P ALAS MALANG GONDANGRAWE 5/3/2018 10:58 A16.2 Tb lung without mention of bact or histological confirm CENDANA
292 1703108677 ISTIYAWATI 3/2/1975 P RINGINWOK JAGOAN SAMBI 5/25/2018 10:47 A16.2 Tb lung without mention of bact or histological confirm BOUGENVILLE
293 1805118247 MUSERI 12/31/1948 L PRINGAPUS 04/02 MANYARAN KARANGGEDE 5/29/2018 15:25 A16.2 Tb lung without mention of bact or histological confirm CENDANA
294 1806118299 SUTINI 3/1/1958 P KARANGGAYAM 5/1 SUMBER SIMO 6/18/2018 19:36 A16.2 Tb lung without mention of bact or histological confirm CENDANA
NO. REKAM JENIS
NO NAMA PASIEN TGL LAHIR KELAMIN
MEDIS
1 0904030258 RUKAYAH 4/6/1959 P
2 1002036901 SUYOTO 12/14/1945 L
3 1603100137 SUTINEM 11/10/1950 P
4 1611105965 PUJIYATI 11/10/1959 P
5 1612106663 SUPRAPTI 7/9/1982 P
6 1608103942 SUDIYARTI AGUSTINA 8/11/1968 P
7 1701107481 SULAMAH 1/11/1947 P
8 1610105458 DARMINI 10/21/1965 P
9 0903029800 NGATIRI 3/12/1967 L
10 1610105547 ZIL VIANA RAHMAWATI 10/15/1983 P
11 1612106730 HARNI 5/25/1991 P
12 1008040882 SUMINAH 8/7/1960 P
13 1605102069 SUNARYO 5/16/1973 L
14 1104047247 MULYONO 4/12/1959 L
15 1701107730 NABILA PUTRI RAIS 3/31/2016 P
16 1205058505 SUPARTI 5/8/1967 P
17 0903029831 ENIK SUMIYATI 3/14/1974 P
18 1404079200 NIRYAWATI 4/1/1990 P
19 1203057070 MUHAMMAD HAMAMI 3/20/1971 L
20 1609104840 HENI SETYOWATI 6/20/1994 P
21 1702108121 SUPARTI 2/7/1957 P
22 1702108148 ARI WINARNO 2/8/1989 L
23 1702108147 JUMANI 2/8/1962 L
24 1701107781 WISNU ARYA NUGROHO 8/1/2008 L
25 1702108284 KHOIRI 8/10/1991 L
26 1701107480 MEIRENA SAFIRTI 5/31/1989 P
27 1701107682 JAMIATUN 2/15/1949 P
28 1612106796 ADI SETYOBUDI 12/19/1994 L
29 1702108228 SUHANTO 2/10/1987 L
30 1703108729 JANATIN 3/4/1952 P
31 1703108815 NGATIYANI 3/8/1969 P
32 1502089321 LOSO HADI ATMOJO 9/1/1955 L
33 1608104058 SRI SUMIYATI 8/16/1967 P
34 1009041726 TUKIRIN 9/13/1982 L
35 1010042382 MARWAN 10/4/1960 L
36 1604101013 TUJIRAN 4/14/1966 L
37 1408083536 ATMO WIJOYO W 8/22/1942 L
38 1604101401 TASLIM 9/13/1985 L
39 1308072449 SUGIYONO 2/2/1977 L
40 1606102870 SAKIRIN 6/29/1960 L
41 1704109559 MUHAMMAD NASIR 5/5/1990 L
42 1704109538 INDAH SETYOWATI 11/2/2016 P
43 1703108677 ISTIYAWATI 3/2/1975 P
44 1704109626 IRFAN NUR TAUFIQ 6/26/1995 L
45 1704109418 SITI 4/4/1931 P
46 0912035642 SITI ROBINGATUN 12/15/1969 P
47 1704109798 WIRYO REJO 12/6/1939 L
48 1612107050 SITI ROHMATUN 1/9/1969 P
49 1703109051 JUMIYEM 3/18/1977 P
50 1006040067 SUMERI 6/30/1932 L
51 1704110043 SUKARTI 7/27/1968 P
52 1705110349 ASMO SEMITO 7/1/1955 L
53 1211063403 MULYANI 5/22/1966 P
54 1705110344 RIDHO WIBOWO SRI MULYANINGTYAS 1/29/1987 P
55 1011043490 GINEM 11/16/1973 P
56 0802022779 FADILA GITA 12/4/2007 P
57 1403078577 JARIYATUN 3/13/1960 P
58 1705110655 HILYA HUSNA MALIKA 5/10/2012 P
59 1706110725 SUKIMIN 2/10/1943 L
60 1706110741 HANIFA PUTRI ARDIAN 6/5/2011 P
61 1706110837 KANIFA INDRI AZAHRA 8/25/2015 P
62 1404079901 WIJI 4/23/1949 L
63 1206059417 DARMIN 2/22/1944 L
64 1707111276 MUJIYEM 7/3/1957 P
65 1701107455 KASIYEM 12/6/1955 P
66 1707111296 JUANA AGUS PRASETYO 1/1/1987 L
67 1707111436 INDAH SEPTI 7/9/1986 P
68 0912035501 SUDARMAN 10/8/1941 L
69 1202056308 WASITO 2/25/1973 L
70 1704109891 PARTINAH 12/31/1960 P
71 1707111863 SITI AMINAH 2/28/1966 P
72 1707111911 PUTRO ADY HIKMAWAN 6/27/1998 L
73 1708111970 MURDOWO 8/1/1992 L
74 1708111996 DWI AYU PRATIWI 8/4/2014 P
75 1707111928 SOFIYA NIKEN 11/15/2013 P
76 1706110705 SURDI 6/3/1952 L
77 0906031659 WAKIYEM 6/19/1949 P
78 1708112336 ALISA NUR SAIDAH ARYANTI 11/29/2015 P
79 1706110729 DARMO SUWITO 12/11/1935 L
80 1708112418 SARI RAKHMAWATI 9/28/1988 P
81 1708112479 AHMAD ARIS SETIYANTO 8/29/1994 L
82 0906031331 NUR HIDAYATI 6/1/1973 P
83 1708112166 RIZKA SAKINATUL BADRIYAH 11/5/2009 P
84 1709112678 MUHAMMAD WINARTO 5/4/1973 L
85 1504091025 ANANG SAPUTRA 4/17/1997 L
86 1710113207 IMAM MUCHSIN 5/31/1983 L
87 1504090640 ARIFIN 10/5/1978 L
88 1801115070 SURIPTO 1/3/1958 60
89 1708112004 ARI HENI MARLINA 9/21/1971 46
90 1009042171 PARSINEM 1/1/1958 60
91 1711113897 NGUDIYONO 11/5/1967 50
92 1712114765 SISWANTO 12/15/1950 67
93 1112053850 PARMUJI 12/13/1981 36
94 1801115122 KARSI 1/13/1945 73
95 1801115140 DWI ENDANG HANDAYANI 1/6/1976 42
96 1801115161 SUMEDI 9/27/1964 53
97 0907031996 YAHMAN 7/6/1954 63
98 0910034521 AMALIA NURAINI 12/17/2008 9
99 1405080315 JAMJURI 7/1/1929 88
100 1801115226 WARSONO 5/26/1958 59
101 1801115410 QOSIDAH 12/31/1963 54
102 0906031319 PATONAH 6/1/1968 49
103 1005038944 MUJIYANTO 8/6/1966 51
104 1302066918 SARMIYATI 12/1/1950 67
105 1802115762 HADI SISWANTO 2/5/1934 84
106 1801115253 ANIN NABILA 2/21/2016 2
107 1802115969 TUKINO 2/12/1987 31
108 1802116022 MR. X / SUYOTO 2/14/1973 45
109 1301065125 HAIKAL 7/14/2014 3
110 1103046317 SLAMET 3/10/1961 56
111 1108050481 SUJITO 8/19/1935 82
112 1802116095 DWI ARDIANA LESTARI 7/15/1986 31
113 1802116174 MUFIDA FAIHA SALSABILA 7/25/2017 0
114 1802116147 SITI MARYAMAH 12/31/1937 80
115 1803116386 MUCHAMMAD DIMAS SAPTA DEWA 12/2/1996 21
116 1803116527 QUANEISHA SAHLA EL ZAHEER 6/18/2017 0
117 1803116623 FARSYA JUNETA AZZAHWA 6/24/2014 3
118 1506092605 ATHA CYNARA FELITA 6/8/2014 3
119 1103046525 HARTATIK 2/27/1979 39
120 1803116665 ISTIQOMAH 10/7/2014 3
121 1803116526 AZAM FATA MAULANA 10/2/2014 3
122 1803116950 SUPI 11/10/1943 74
123 1803116529 IFRA LUTFIANA PUTRI SHARLIZ 4/24/2009 8
124 1511096291 YOGA ARYA WAHANA 11/3/2006 11
125 1804117110 JOKO SANTOSO 5/25/1969 48
126 1804117156 ASTRI SETYA DEVITASARI 4/4/2007 11
127 1803117021 NURUL FADILAH 3/29/1997 21
128 1804117670 SUCEPTO 12/9/1950 67
129 1304069172 DEWI SARTIKA 10/23/1988 29
130 1805117787 SAMI RAHAYU 5/3/1972 46
131 1804117719 SITI SOFIATUN 8/21/1999 18
132 1805118247 MUSERI 12/31/1948 69
133 1611106433 JAMARI 12/31/1930 87
134 1806118324 SUPENI 12/11/1969 48
135 1712114858 KOSIDI 12/31/1951 66
136 1806118325 DWIANTO 4/23/1994 24
137 1806118299 SUTINI 3/1/1958 60
138 1806118783 ATIK PUJI LESTARI 2/3/1979 39
139 1804117519 YOSSA HERDIAN PRATAMA 4/21/2018 0
140 1806118859 MITRO SLAMET 6/29/1955 63
141 1807119068 MUHAMMAD ABDUL GHOFUR 3/14/1999 19
142 1807119211 SITI KARIMAH 7/18/1983 35
143 1610105218 WAKIDIN 5/28/1947 71
144 1808119473 KAMTI 3/30/1989 29
145 1808119492 TUKIMAH 11/14/1970 47
TGL DAFTAR/ TGL KATEGOR
ALAMAT PASIEN MULAI PENGOBATAN I ICD X
KLALINGAN 1/4/2017 8:41 A15.0
GROJOGAN 3/6 POJOK NOGOSARI 1/9/2017 7:08 A16.2
JEGORAN 7/1 MANYARAN KARANGGEDE 1/9/2017 7:44 A16.2
PENGGUNG 4/1 KEDUNGLENGKONG SIMO 1/10/2017 8:02 A16.2
SELANEGARA 4/3 SUMPIUH BANYUMAS 1/10/2017 8:47 A16.2
BOGO 1/15 TIMPIK SUSUKAN 1/11/2017 10:00 A16.2
JENGGLONG RT 31 RW 09 SEMPU ANDONG 1/11/2017 11:25 A16.2
KACANGAN 4/1 KACANGAN ANDONG 1/11/2017 13:08 A15.9
GRENJENG 02/05 1/17/2017 7:22 A15.0
SUCEN TIMUR RT 11/04 KEDUNG LENGKONG SIMO 1/18/2017 8:41 A16.2
NGASINAN 14/3 MUNGGUR ANDONG 1/20/2017 7:39 A15.0
SERETAN 14/3 SENDANGREJO KLEGO 1/20/2017 8:03 A15.0
NGOYOG 13/2 BEJI ANDONG 1/23/2017 7:49 A16.2
GRINTINGAN 14/3 BABADAN 1/23/2017 12:23 A16.9
GEBANG 5/5 MANYARAN KARANGGEDE 1/24/2017 8:12 A15.0
GULON TANJUNG KLEGO 1/24/2017 8:38 A16.2
BANARAN 10/3 SEMPU 1/26/2017 9:24 A15.0
KRAJAN GLONGGONG NOGOSARI 1/27/2017 8:05 A15.0
SIMO 1/1 SIMO 1/27/2017 8:53 A16.2
PAGERJURANG PASEBAN BAYAT KLATEN 1/30/2017 8:54 A16.2
KARANGSARI 16/5 BAKALREJO SUSUKAN 2/7/2017 9:05 A16.2
GROMPOL 17/3 TROSOBO SAMBI 2/8/2017 8:05 A16.2
NGUMBUL GLONGGONG 2/13/2017 8:19 A16.2
GREMBYUK RT 29/08 TANJUNG KLEGO 2/13/2017 10:59 A15.0
REJOSARI 6/2 PENTUR SIMO 2/13/2017 13:08 A16.2
JERINGAN 21/7 WALEN SIMO 2/14/2017 10:49 A16.2
SOKOREJO 3/3 MANYARAN KARANGGEDE 2/22/2017 8:18 A15.0
PONCOL WETAN 4/1 PULUTAN NOGOSARI 2/23/2017 8:43 A15.0
DILEM 1/3 TAWANG SUSUKAN SEMARANG 2/27/2017 8:07 A15.0
SOKO 10/2 SENDANGREJO 3/4/2017 19:00 A16.2
PANTARAN 3/8/2017 15:51 A16.2
ANDONG 2/1 ANDONG 3/22/2017 8:10 A16.2
WONOKERTI 3/24/2017 8:16 A15.0
KRIKILAN 20/04 BLAGUNG 3/24/2017 8:27 A15.0
KALANGAN 1/1 3/29/2017 7:52 A16.2
SOKO 10/2 SENDANGREJO KLEGO 3/29/2017 8:59 A16.2
KRANGGAN TASIKMADU KARANGANYAR 3/29/2017 11:06 A16.2
BANJARSARI 18/3 TEMON SIMO 3/29/2017 11:24 A18.2
KEMEL 9/3 KEDUNGLENGKONG SIMO 4/4/2017 9:16 A16.2
BEJEN 4/7/2017 11:46 A16.2
SALAMREJO 4/6 POJOK NOGOSARI 4/10/2017 9:05 A16.2
POKO KRAJAN PULUTAN NOGOSARI 4/10/2017 10:13 A16.2
RINGINWOK JAGOAN SAMBI 4/11/2017 9:09 A16.2
GULON 3/1 TANJUNG KLEGO 4/13/2017 8:15 A16.2
MOJO RT 01/05 MANYARAN KARANGGEDE 4/17/2017 8:47 A16.2
KARANG 9/02 4/18/2017 9:25 A16.2
JANGKUNGAN RT 07/02 GLONGONG NOGOSARI 4/20/2017 14:47 A16.2
PENGKOL 1/4 PENGKOL KARANGGEDE 4/27/2017 8:01 A16.2
GONDANGREJO 1/5 KEYONGAN NOGOSARI 4/27/2017 9:10 A18.2
SAMBENGAN 17/6 GUNUNG SIMO 5/3/2017 9:48 A15.0
RANDUKUNING 9/1 GLINTANG SAMBI 5/10/2017 1:47 A16.2
NGEMBAT 38/ 11 SEMPU ANDONG 5/15/2017 9:48 A16.2
BANARAN TROSOBO SAMBI 5/22/2017 7:41 A16.9
LEMAH IRENG 1/3 KETITANG NOGOSARI 5/22/2017 8:11 A16.2
KEDUNG WULUH 12/3 TEMON SIMO 5/23/2017 8:12 A16.9
TITANG 5/26/2017 8:41 A16.2
JERING WATES SIMO 5/29/2017 8:11 A16.2
PENGKOL 2/4 PENGKOL KARANGGEDE 5/31/2017 8:35 A16.9
TEGALSARI 1/3 TANJUNG 6/5/2017 7:17 A16.1
PERENG 1/1 PAKEL ANDONG 6/5/2017 10:38 A16.2
KLEBEN 20/7 SIMO SIMO 6/10/2017 13:10 A16.2
PULOREJO RT 02/03 PULUTAN NOGOSARI 6/28/2017 6:50 A16.2
TARI WETAN SIMO 7/1/2017 13:01 A16.2
JENALAS 3/2 BENDO NOGOSARI 7/3/2017 11:04 A16.2
SANGGRAHAN RT 15/04 PELEM SIMO 7/3/2017 15:11 A16.2
TEPURSARI RT 01/03 SAMBI 7/4/2017 10:38 A16.2
BAKALAN 7/9/2017 3:51 A16.2
SAMBIREJO 19/3 TROSOBO SAMBI 7/11/2017 11:12 A16.0
BLAGUNG 5/1 SIMO 7/25/2017 9:55 A16.2
NGRENI RT 05/02 SIMO SIMO 7/28/2017 11:21 A16.2
PACINGAN 28/5 WALEN SIMO 7/31/2017 11:15 A16.2
DERASAN 4/2 SEMPU ANDONG 8/2/2017 17:27 A16.2
TRAYON 4/2 KEBONAN KARANGGEDE 8/4/2017 8:33 A16.2
MANGGAL SIMO 8/9/2017 8:58 A16.2
MARGOREJO 5/4, GLONGGONG, NOGOSARI 8/14/2017 8:43 A16.2
LEMAHIRENG 1/1 LEMAHIRENG KEMUSU 8/21/2017 8:38 A16.2
SENDANGREJO 17/4 SENDANGREJO KLEGO 8/21/2017 10:48 A16.2
JL. KAMPUNG SAWAH 9/11 SEMPER TIMUR CILINCUNG 8/25/2017 9:51 A16.2
KEDUNGDOWO 3/1 BENDUNGAN SIMO 8/29/2017 8:16 A16.2
PACINGAN 28/06 9/4/2017 9:06 A16.9
SUMBERSARI DOLOG 12/4 BAKALREJO SUSUKAN 9/5/2017 13:06 A16.2
BLAGUNG 05/01 SIMO 9/9/2017 18:17 A16.2
TITANG SIMO 9/11/2017 7:17 A16.2
GONDANGREJO 04/01 KEYONGAN NOGOSARI 10/4/2017 8:32 A16.2
KRAMBIL SAWIT 13/4 TALAKBROTO 10/16/2017 8:08 A16.2
DERASAN 04/02 SEMPU ANDONG 1/3/2018 6:53 A16.2
BEGAH 14/3 BLAGUNG SIMO 1/3/2018 9:55 A16.2
GABLOG RT 11/03 TETER SIMO 1/3/2018 12:15 A16.5
NGAMPON 24/8 WALEN SIMO 1/4/2018 5:29 A16.2
JEMONO 023/04 WATES SIMO 1/4/2018 7:42 A16.2
GUMUK REJO 2/4 SAMBI 1/4/2018 13:54 A16.2
TROSOBO 1/3 TROSOBO SAMBI 1/5/2018 7:55 A16.2
SOKO 01/02 SANGGE KLEGO 1/6/2018 11:23 A16.2
JEMBATAN PARI 1/3 CIJUJUNG SUKARAJA 1/8/2018 7:42 A16.2
KEMEL 9/3 KEDUNGLENGKONG SIMO 1/8/2018 8:11 A16.2
NGROTO 19/ PENTUR SIMO 1/9/2018 13:21 A16.2
PENGKOL 5/2 KARANGGEDE 1/10/2018 19:42 A16.7
KADIPATEN 16/3 KADIPATEN ANDONG 1/12/2018 8:35 A16.2
GLAGAHOMBO RT 01/09 TAWANG SUSUKAN 1/24/2018 8:19 A16.2
MANGGAL 17/06 SIMO SIMO 1/25/2018 8:17 A16.2
GUMUKREJO 4/3 KEYONGAN NOGOSARI 1/25/2018 8:20 A16.2
PULUNG 2/1 GUNUNG SIMO 2/1/2018 7:35 A16.2
PULUTAN 12/02 PULUTAN NOGOSARI 2/5/2018 0:38 A16.7
MOJOREJO KEYONGAN NOGOSARI 2/5/2018 12:59 A16.2
BONGKOL 2/1 PENGKOL KARANGGEDE 2/12/2018 9:00 A16.2
JAMBON BABADAN SAMBI 2/14/2018 8:52 A16.2
BANJAREJO SEMPU ANDONG 2/15/2018 13:37 A16.2
GEMPOLSARI 18/4 WATES SIMO 2/19/2018 13:25 A16.7
NGAMPON 25/8 WALEN SIMO 2/21/2018 7:55 A16.2
TEGALSARI 13/3 TANJUNG KLEGO 2/22/2018 10:50 A16.2
BANJARJO 7/3 SEMPU ANDONG 2/23/2018 14:09 A16.2
KARANGGAYAM 3/1 SUMBER SIMO 2/23/2018 14:26 A16.2
GEDANGAN 11/2 SENGGRONG ANDONG 3/2/2018 10:34 A16.7
KADIREJO 2/2 SEMPULUR KARANGGEDE BOYOLALI 3/12/2018 11:28 A16.2
TITANG SIMO SIMO 3/16/2018 9:23 A16.2
NAYAN 5/7 PELEM SIMO 3/19/2018 9:22 A16.2
MOJO 1/1 WATES SIMO 3/20/2018 8:57 A16.2
BANYUURIP 7/1 KEDUNGDOWO ANDONG 3/27/2018 8:05 A16.2
PAKEL 6/2 TETER SIMO 4/3/2018 8:16 A16.2
PERMATA BANJAR ASRI BLOK A3 RTO4 /09 CIPOCOK JAYA 4/3/2018 18:29 A16.2
SIDOMULYO 1/4 NGLEMBU SAMBI 4/4/2018 9:23 A16.2
PANCURAN 21/5 PENTUR SIMO 4/16/2018 10:10 A16.2
SIDOMULYO 17/05 PELEM SIMO 4/27/2018 19:28 A16.2
KRAMBILSAWIT 13/4 TALAKBROTO SIMO 4/30/2018 10:56 A16.2
ALAS MALANG GONDANGRAWE 5/3/2018 10:58 A16.2
SUMBERAN 10/2 BEJI ANDONG 5/16/2018 8:13 A16.2
PRINGAPUS 04/02 MANYARAN KARANGGEDE 5/29/2018 15:25 A16.2
BANJAREJO SEMPU ANDONG 5/31/2018 7:48 A16.2
KARANGKEPOH RT 24/08 BAKALREJO SUSUKAN 6/7/2018 8:29 A16.2
KARANG 14/04 PENTUR SIMO 6/11/2018 8:07 A16.2
KARANGGAYAM 5/1 SUMBER SIMO 6/18/2018 19:36 A16.2
JEGORAN 8/1 MANYARAN KARANGGEDE 6/26/2018 7:55 A16.9
KARANGPILANG 06/01 JAGOAN SAMBI 7/6/2018 9:21 A16.2
TIMPIK 01/09 TIMPIK SUSUKAN 7/10/2018 8:36 A16.9
NGEBUK 01/10 TAWANG SUSUKAN 7/14/2018 9:08 A16.9
GEJUGAN GLONGGONG NOGOSARI 7/27/2018 8:41 A16.9
WALEN 7/2 WALEN SIMO 8/1/2018 8:24 A16.2
SIDOMULYO 20/7 GUNUNG 8/2/2018 10:35 A16.9
KETERANGAN
Tb lung confirm sputum microscopy with or without culture

Tb lung without mention of bact or histological confirm
Respiratory tb unspec confirm bact and histologically
Resp tb unspec without mention of bact or hist confirm
Tuberculous peripheral lymphadenopathy
Tuberculous peripheral lymphadenopathy
Tuberculosis lung bact and histological examin not done
Tuberculosis of lung, bacteriologically & histolog'y neg
Tb pleurisy without mention of bact or histological confirm
Prim respiratory tb without mention of bact or hist confirm
UNIT
PENYAKIT DALAM (POLI)

CENDANA
CENDANA
CENDANA
ANAK (POLI)
ANAK (POLI)
CENDANA
CENDANA
CENDANA
FLAMBOYAN
UMUM (POLI)
ANAK (POLI)
CENDANA
CENDANA
BEDAH (POLI)
CENDANA
ANAK (POLI)
ANAK (POLI)
CENDANA
ANAK (POLI)
ANAK (POLI)
CENDANA
CENDANA
CENDANA
EDELWEIS
CENDANA
CENDANA
CENDANA
CENDANA
CENDANA
ANAK (POLI)
ANAK (POLI)
ANAK (POLI)
UMUM (POLI)
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UMUM (POLI)
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ANAK (POLI)
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ANAK (POLI)
ANAK (POLI)
ANAK (POLI)
ANAK (POLI)
ANAK (POLI)
UMUM (POLI)
ANAK (POLI)
EDELWEIS
ANAK (POLI)
UMUM (POLI)
CENDANA
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UMUM (POLI)
UMUM (POLI)
CENDANA
ANAK (POLI)
UMUM (POLI)
UMUM (POLI)

Mandatory Cleaning RSUD Simo

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Mandatory Cleaning RSUD Simo

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TGL DAFTAR/ TGL

NO. REKAM JENIS KATEGO

1 39 Sesuai Standar 0 jumari 0 55 Laki-Laki

Propinsi Kabupaten Kecamatan Keluarahan Nama Jalan Nama Fasyankes

JAWA TENGAH BOYOLALI NOGOSARI GLONGGONG widoro RSUD SIMO

Faskes Terdiagnosis klinis Paru Baru

Negatif Positif 2/22/2017 Kategori 1 Program TB 0

Negatif Tidak dilakukan Tidak dilakukan 59 Negatif

Putus Berobat Putus Berobat 5/5/2017 Putus berobat 2/22/2017

NO. REKAM JENIS TGL DAFTAR/ TGL KATEGORI

Tb lung confirm sputum microscopy with or without culture

PENYAKIT DALAM (POLI)

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