Excel

<h2>DATA DIAGNOSIS PASIEN PUSKESMAS</h2>
Periode : 01-03-2019 s/d 31-03-2019<br>

<table class='grid' border='1'>
<tr>
<th>Kode Penyakit</th>
<th>Nama Diagnosis</th>
<th>ICDX</th>
<th>No.<br>Registrasi</th>
<th>No.Index</th>
<th>Tanggal</th>
<th>Nama</th>
<th>NamaKK</th>
<th>Pekerjaan</th>
<th>Alamat</th>
<th>Dusun</th>
<th>Desa</th>
<th>Tempat Periksa</th>
<th>Petugas Medis</th>
<th>Perawat Bidan</th>
<th>JK</th>
<th>Kelompok<br>Umur</th>
<th>Pengirim</th>
<th>Kunjungan</th>
<th>Jenis<br>Pasien</th>
<th>Tindak<br>Lanjut</th>
<th>Hari</th>
<th>Bulan</th>
<th>Tahun</th>
<th>Unit</th>
<th>Poli Rujuk</th>
<th>Rumah Sakit</th>
<th>Wilayah</th>
<th>Kartu Sehat</th>
<th>NIK</th>
<th>Systole</th>
<th>Diastole</th>
</tr><tr><td align='right'>S81.0</td><td>Open wound of
knee</td><td></td><td align='right'>289411</td><td
align='right'>52010107</td><td>01-03-2019</td><td>ANI TRI W</td><td>SURATMO 0201
S 14</td><td>PETANI/PEKEBUN</td><td>GEMBUK RT02
RW07</td><td>GEMBUK</td><td>TLOGOSARI</td><td>INDUK</td><td>dr. BUDI
ASHARI</td><td>SUWARTO,S.Kep.Nes</td><td>P</td><td>10-14 Thn.</td><td>Datang
Sendiri</td><td>Baru</td><td>BPJS PBI</td><td>Rajal</td><td
align='right'>14</td><td align='right'>6</td><td align='right'>13</td><td>BP.
Umum</td><td></td><td></td><td>Dalam
Wilayah</td><td>'0000565123926</td><td>'3312025808050001</td><td>100</td><td>60</td
></tr><tr><td align='right'>J11.8</td><td>Influenza with other manifestations,
virus not identified</td><td></td><td align='right'>289437</td><td
align='right'>57050367</td><td>01-03-2019</td><td>DANA ROKHANI</td><td>WARSIATUN
0705 W 05</td><td>KARYAWAN SWASTA</td><td>SUKOROYOM KULON RT02
RW03</td><td>SUKOROYOM KULON</td><td>PUCANGANOM</td><td>INDUK</td><td>dr. BUDI
ASHARI</td><td>SUGIYONO,S.Kep.Ns</td><td>P</td><td>20-44 Thn.</td><td>Datang
Sendiri</td><td>Baru</td><td>JAMKESDA</td><td>Rajal</td><td
Wilayah</td><td>'3312022210840001</td><td>'3312022210840001</td><td>120</td><td>80<
/td></tr><tr><td align='right'>F20.6</td><td>Simple schizophrenia</td><td></td><td
align='right'>289417</td><td align='right'>53040028</td><td>01-03-2019</td><td>DEDI
PRASETYO</td><td>SRIYANTO 0304 S 02</td><td>LAINNYA</td><td>PUREMBE
RT.02/02</td><td>PUREMBE</td><td>TLOGOHARJO</td><td>INDUK</td><td>dr. BUDI
ASHARI</td><td>SUWARTO,S.Kep.Nes</td><td>L</td><td>20-44 Thn.</td><td>Datang
Sendiri</td><td>Lama</td><td>UMUM WONOGIRI</td><td>Rajal</td><td
Wilayah</td><td>'</td><td>'3311112006960001</td><td>120</td><td>80</td></tr><tr><td
align='right'>R05</td><td>Cough</td><td></td><td align='right'>289426</td><td
align='right'>56050109</td><td>01-03-2019</td><td>FIKI</td><td>MEHRU/SUROTO 0605
S
18</td><td></td><td>NGUJUNG</td><td>NGUJUNG</td><td>GIRITONTRO</td><td>INDUK</td><t
d>dr. BUDI ASHARI</td><td>RISTINA Amd Keb</td><td>L</td><td>1-4 Thn.</td><td>Datang
Sendiri</td><td>Lama</td><td>Umum</td><td>Rajal</td><td align='right'>17</td><td
align='right'>10</td><td
align='right'>3</td><td>KIA</td><td></td><td></td><td>Dalam
Wilayah</td><td>'</td><td>'</td><td>70</td><td>40</td></tr><tr><td
align='right'>G43.8</td><td>Other migraine</td><td></td><td
align='right'>289431</td><td align='right'>55010122</td><td>01-03-
2019</td><td>HUDAYANI INDRAWATI</td><td>SUPARMAN 0501 S 12</td><td>BURUH HARIAN
LEPAS</td><td>GIRIBELAH</td><td>GIRIBELAH</td><td>JATIREJO</td><td>INDUK</td><td>dr
. BUDI ASHARI</td><td>SUWARTO,S.Kep.Nes</td><td>P</td><td>20-44 Thn.</td><td>Datang
align='right'>11</td><td align='right'>37</td><td>BP.
align='right'>J44.9</td><td>Chronic obstructive pulmonary disease,
unspecified</td><td></td><td align='right'>289423</td><td
align='right'>55060018</td><td>01-03-2019</td><td>KARMAN</td><td>KARMAN 05 06 K
05</td><td>PETANI/PEKEBUN</td><td>JATI RT03 RW
03</td><td>JATI</td><td>JATIREJO</td><td>INDUK</td><td>dr. BUDI
Sendiri</td><td>Lama</td><td>BPJS PBI</td><td>Rujuk</td><td
align='right'>57100045</td><td>01-03-2019</td><td>KARSI</td><td>KARSI 07 10 K
01</td><td>PETANI/PEKEBUN</td><td>JEPURUN RT
01RW10</td><td>JEPURUN</td><td>PUCANGANOM</td><td>INDUK</td><td>dr. BUDI
ASHARI</td><td>SUWARTO,S.Kep.Nes</td><td>P</td><td>>70 Thn.</td><td>Datang
Sendiri</td><td>Lama</td><td>BPJS PBI</td><td>Rajal</td><td
></tr><tr><td align='right'>T14.1</td><td>Open wound of unspecified body
region</td><td></td><td align='right'>290492</td><td
align='right'>52057004</td><td>01-03-
2019</td><td>KARTI</td><td></td><td>PETANI/PEKEBUN</td><td>GLAGAH</td><td>GLAGAH</t
d><td>TLOGOSARI</td><td>PUSTU TLOGOSARI</td><td>SULARNO,S.Kep.Ns</td><td> -
</td><td>P</td><td>>70 Thn.</td><td>Datang Sendiri</td><td>Lama</td><td>BPJS
PBI</td><td>Rajal</td><td align='right'>17</td><td align='right'>1</td><td
align='right'>79</td><td>BP. Umum</td><td></td><td></td><td>Dalam
></tr><tr><td align='right'>A15.2</td><td>Tuberculosis of lung, confirmed
histologically</td><td></td><td align='right'>289432</td><td
align='right'>53030064</td><td>01-03-2019</td><td>KARTOREJO
SOKIMIN</td><td>KARTOREJO SOKIMIN 03 03 K 05</td><td>PETANI/PEKEBUN</td><td>JAJAR
RT04 RW02</td><td>JAJAR</td><td>TLOGOHARJO</td><td>INDUK</td><td>dr. BUDI
ASHARI</td><td>SUWARTO,S.Kep.Nes</td><td>L</td><td>>70 Thn.</td><td>Datang
Sendiri</td><td>Lama</td><td>BPJS NON PBI</td><td>Rujuk</td><td
align='right'>56090044</td><td>01-03-2019</td><td>KASTO</td><td>KASTO 0609 K
01</td><td>PEDAGANG</td><td>DUNGKLEPU KULON</td><td>DUNG KLEPU
KULON</td><td>GIRITONTRO</td><td>INDUK</td><td>dr. BUDI
ASHARI</td><td>SUGIYONO,S.Kep.Ns</td><td>L</td><td>20-44 Thn.</td><td>Datang
Sendiri</td><td>Lama</td><td>BPJS PBI</td><td>Rajal</td><td align='right'>2</td><td
></tr><tr><td align='right'>H58.8</td><td>Other specified disorders of eye and
adnexa in diseases classified elsewhere</td><td></td><td
2019</td><td>MELANI NOVITASARI</td><td>SUGINO 06 07 G
01</td><td>PELAJAR/MAHASISWA</td><td>DUNGKANCIL RT01 RW09</td><td>DUNG
KANCIL</td><td>GIRITONTRO</td><td>INDUK</td><td>dr. BUDI
></tr><tr><td align='right'>S81.0</td><td>Open wound of knee</td><td></td><td
2019</td><td>MESIYEM</td><td>MESIYEM 0301 M
11</td><td>PETANI/PEKEBUN</td><td>TLOGO RT01
RW01</td><td>TLOGO</td><td>TLOGOHARJO</td><td>INDUK</td><td>dr. BUDI
></tr><tr><td align='right'>M79.1</td><td>Myalgia</td><td></td><td
2019</td><td>MISDI</td><td>MISDI 1313 M
01</td><td>PETANI/PEKEBUN</td><td>MOJOPURO,EROMOKO</td><td></td><td>WONOGIRI</td><t
d>INDUK</td><td>dr. BUDI ASHARI</td><td>SUGIYONO,S.Kep.Ns</td><td>L</td><td>>70
Thn.</td><td>Datang Sendiri</td><td>Lama</td><td>Umum</td><td>Rajal</td><td
Umum</td><td></td><td></td><td>Luar
align='right'>I11</td><td>Hypertensive heart disease</td><td></td><td
2019</td><td>MISINEM</td><td>MISINEM 0602 M
04</td><td>PETANI/PEKEBUN</td><td>GIRITONTRO KIDUL</td><td>GIRITONTRO
KIDUL</td><td>GIRITONTRO</td><td>INDUK</td><td>dr. BUDI
Sendiri</td><td>Lama</td><td>BPJS NON PBI</td><td>Rajal</td><td
></tr><tr><td align='right'>K29.9</td><td>Gastroduodenitis,
align='right'>54110041</td><td>01-03-2019</td><td>MISNO</td><td>MISNO 0411 M
03</td><td>PETANI/PEKEBUN</td><td>GUWO RT03
RW06</td><td>GUWO</td><td>BAYEMHARJO</td><td>INDUK</td><td>dr. BUDI
Sendiri</td><td>Lama</td><td>BPJS PBI</td><td>Rujuk</td><td align='right'>8</td><td
Wilayah</td><td>'0000565150162</td><td>'</td><td>140</td><td>80</td></tr><tr><td
align='right'>52057060</td><td>01-03-
2019</td><td>MIYEM</td><td></td><td>PETANI/PEKEBUN</td><td>GLAGAH</td><td>GLAGAH</t
d><td>TLOGOSARI</td><td>PUSTU
TLOGOSARI</td><td>SULARNO,S.Kep.Ns</td><td> - </td><td>P</td><td>45-54
Thn.</td><td>Datang Sendiri</td><td>Lama</td><td>BPJS PBI</td><td>Rajal</td><td
></tr><tr><td align='right'>H61.2</td><td>Impacted cerumen</td><td></td><td
2019</td><td>MURIFIKA ATMALYANA</td><td>SRIMULYONO 5605 S 01</td><td>BELUM/TIDAK
BEKERJA</td><td>NGUJUNG</td><td>NGUJUNG</td><td>GIRITONTRO</td><td>INDUK</td><td>dr
. BUDI ASHARI</td><td>RISTINA Amd Keb</td><td>P</td><td>1-4 Thn.</td><td>Datang
align='right'>14</td><td align='right'>11</td><td
align='right'>J11.8</td><td>Influenza with other manifestations, virus not
identified</td><td></td><td align='right'>289407</td><td
align='right'>56030006</td><td>01-03-2019</td><td>NGATIYEM</td><td>LEGIMAN 06 03 L
01</td><td>PETANI/PEKEBUN</td><td>GEBLUG RT03
RW07</td><td>GEBLUG</td><td>GIRITONTRO</td><td>INDUK</td><td>dr. BUDI
></tr><tr><td align='right'>K29.3</td><td>Chronic superficial
gastritis</td><td></td><td align='right'>289436</td><td
align='right'>56100129</td><td>01-03-2019</td><td>NYAMAN SUSANTO</td><td>NYAMAN
SUSANTO 0610 N
03</td><td>PEDAGANG</td><td>TANGGUNG</td><td>TANGGUNG</td><td>GIRITONTRO</td><td>IN
DUK</td><td>dr. BUDI ASHARI</td><td>SUWARTO,S.Kep.Nes</td><td>L</td><td>55-59
Thn.</td><td>Datang Sendiri</td><td>Lama</td><td>BPJS NON PBI</td><td>Rujuk</td><td
></tr><tr><td align='right'>M13.9</td><td>Arthritis, unspecified</td><td></td><td
2019</td><td>NYOTO</td><td>NYOTO</td><td>PETANI/PEKEBUN</td><td>GLAGAH</td><td>GLAG
AH</td><td>TLOGOSARI</td><td>PUSTU TLOGOSARI</td><td>SULARNO,S.Kep.Ns</td><td> -
</td><td>L</td><td>60-69 Thn.</td><td>Datang Sendiri</td><td>Lama</td><td>UMUM
WONOGIRI</td><td>Rajal</td><td align='right'>25</td><td align='right'>2</td><td
align='right'>L20.9</td><td>Atopic dermatitis, unspecified</td><td></td><td
2019</td><td>PARMIN</td><td>PARMIN 0701 P
06</td><td>PETANI/PEKEBUN</td><td>GROGOL RT03
RW02</td><td>GROGOL</td><td>PUCANGANOM</td><td>INDUK</td><td>dr. BUDI
Sendiri</td><td>Baru</td><td>BPJS PBI</td><td>Rajal</td><td align='right'>1</td><td
></tr><tr><td align='right'>R05</td><td>Cough</td><td></td><td
2019</td><td>PRAMUDINTYA</td><td>MUJI
WAHYONO</td><td>PELAJAR/MAHASISWA</td><td>SOKO</td><td>SOKO</td><td>TLOGOSARI</td><
td>PUSTU TLOGOSARI</td><td>SULARNO,S.Kep.Ns</td><td> - </td><td>P</td><td>10-14
Wilayah</td><td>'0000564191379</td><td>'3312025101050001</td><td>1</td><td>1</td></
tr><tr><td align='right'>F20.6</td><td>Simple schizophrenia</td><td></td><td
align='right'>289403</td><td align='right'>57100166</td><td>01-03-2019</td><td>RIAN
SETIAWAN</td><td>MARJAN 07 10 M 07</td><td>KARYAWAN SWASTA</td><td>JEPURUN RT 03
RW 10</td><td>JEPURUN</td><td>PUCANGANOM</td><td>INDUK</td><td>dr. BUDI
align='right'>F20.0</td><td>Paranoid schizophrenia</td><td></td><td
2019</td><td>RIYADI</td><td>SUKIRNO 02 05 S
06</td><td>PETANI/PEKEBUN</td><td>GLAGAH RT03
RW06</td><td>GLAGAH</td><td>TLOGOSARI</td><td>INDUK</td><td>dr. BUDI
></tr><tr><td align='right'>M79.0</td><td>Rheumatism, unspecified</td><td></td><td
2019</td><td>SAJIYEM</td><td>TUSIRAN</td><td>PETANI/PEKEBUN</td><td>NGUJUNG</td><td
>NGUJUNG</td><td>GIRITONTRO</td><td>INDUK</td><td>dr. BUDI
Sendiri</td><td>Lama</td><td>BPJS PBI</td><td>Rajal</td><td align='right'></td><td
align='right'>56070094</td><td>01-03-2019</td><td>SAKIYEM</td><td>KADIMIN 0607 K
08</td><td>PETANI/PEKEBUN</td><td>DUNGKANCIL RT01 RW09</td><td>DUNG
></tr><tr><td align='right'>N91.2</td><td>Amenorrhoea, unspecified</td><td></td><td
2019</td><td>SELVI LESTARI</td><td>JUMILAN 06 02 J 01</td><td>MENGURUS RUMAH
TANGGA</td><td>GIRITONTRO KIDUL RT 03 RW
03</td><td></td><td>GIRITONTRO</td><td>INDUK</td><td>dr. BUDI
ASHARI</td><td>RISTINA Amd Keb</td><td>P</td><td>20-44 Thn.</td><td>Datang
Sendiri</td><td>Baru</td><td>Umum</td><td>Rajal</td><td align='right'>12</td><td
align='right'>56055138</td><td>01-03-2019</td><td>SRI MULYONO</td><td>SRI MULYONO
0605 S
01</td><td>PELAJAR/MAHASISWA</td><td>NGUJUNG</td><td>NGUJUNG</td><td>GIRITONTRO</td
><td>INDUK</td><td>dr. BUDI ASHARI</td><td>SUGIYONO,S.Kep.Ns</td><td>L</td><td>45-
54 Thn.</td><td>Datang Sendiri</td><td>Lama</td><td>BPJS PBI</td><td>Rajal</td><td
></tr><tr><td align='right'>I11</td><td>Hypertensive heart disease</td><td></td><td
align='right'>289435</td><td align='right'>56055138</td><td>01-03-2019</td><td>SRI
MULYONO</td><td>SRI MULYONO 0605 S
><td>INDUK</td><td>dr. BUDI ASHARI</td><td>SUGIYONO,S.Kep.Ns</td><td>L</td><td>45-
align='right'>56020125</td><td>01-03-2019</td><td>SRI WAHYUNI</td><td>ARYO WIDODO
0602 A 02</td><td>PEDAGANG</td><td>GIRITONTRO KIDUL</td><td>GIRITONTRO
Wilayah</td><td>'0001849037534</td><td>'3312024107610002</td><td>160</td><td>100</t
d></tr><tr><td align='right'>H58.8</td><td>Other specified disorders of eye and
2019</td><td>SUGENG</td><td>SUPARNO 02 06 S
01</td><td>PETANI/PEKEBUN</td><td>BERGUNG RT01
RW04</td><td>BERGUNG</td><td>TLOGOSARI</td><td>INDUK</td><td>dr. BUDI
></tr><tr><td align='right'>F20.6</td><td>Simple schizophrenia</td><td></td><td
2019</td><td>SUKINI</td><td>KATMIN 03 07 K 02</td><td>PETANI/PEKEBUN</td><td>PAGER
GUNUNG RT04 RW05</td><td>PAGER GUNUNG</td><td>TLOGOHARJO</td><td>INDUK</td><td>dr.
BUDI ASHARI</td><td>SUWARTO,S.Kep.Nes</td><td>P</td><td>60-69 Thn.</td><td>Datang
align='right'>57050368</td><td>01-03-2019</td><td>SULAHUDIN</td><td>SULAHUDIN 0705
S 27</td><td>WIRASWASTA</td><td>SUKOROYOM KULON RT02 RW03</td><td>SUKOROYOM
KULON</td><td>PUCANGANOM</td><td>INDUK</td><td>dr. BUDI
align='right'>K29.1</td><td>Other acute gastritis</td><td></td><td
2019</td><td>SUMIATI</td><td>WAKIMAN 0112 W
01</td><td>PETANI/PEKEBUN</td><td>SELUR RT03
RW05</td><td>SELUR</td><td>NGARGOHARJO</td><td>INDUK</td><td>dr. BUDI
></tr><tr><td align='right'>L24.9</td><td>Irritant contact dermatitis, unspecified
cause</td><td></td><td align='right'>290493</td><td
align='right'>52077022</td><td>01-03-
2019</td><td>SUNARSI</td><td>PARWANTO</td><td>PETANI/PEKEBUN</td><td>SUMBERJO</td><
td>SUMBERJO</td><td>TLOGOSARI</td><td>PUSTU
Wilayah</td><td>'0002132627174</td><td>'3312026012810001</td><td>90</td><td>60</td>
</tr><tr><td align='right'>J11.8</td><td>Influenza with other manifestations, virus
not identified</td><td></td><td align='right'>289409</td><td
align='right'>52060013</td><td>01-03-2019</td><td>SUPARNO</td><td>SUPARNO 02 06 S
01
</td><td>PETANI/PEKEBUN</td><td>BERGUNG</td><td>BERGUNG</td><td>TLOGOSARI</td><td>I
NDUK</td><td>dr. BUDI ASHARI</td><td>SUWARTO,S.Kep.Nes</td><td>L</td><td>60-69
></tr><tr><td align='right'>H67</td><td>Otitis media in diseases classified
elsewhere</td><td></td><td align='right'>289408</td><td
align='right'>51120075</td><td>01-03-2019</td><td>SUPARTI</td><td>SUPRAPTO 01 12
S 05</td><td>PETANI/PEKEBUN</td><td>SELUR RT03
RW05</td><td>SELUR</td><td>NGARGOHARJO</td><td>INDUK</td><td>dr. BUDI
></tr><tr><td align='right'>S40.7</td><td>Multiple superficial injuries of shoulder
and upper arm</td><td></td><td align='right'>289422</td><td
align='right'>15151387</td><td>01-03-2019</td><td>SURATMAN</td><td>SURATMAN 1515 S
09</td><td>KARYAWAN
SWASTA</td><td>JAKARTA</td><td></td><td>JAKARTA</td><td>INDUK</td><td>dr. BUDI
align='right'>K29.6</td><td>Other gastritis</td><td></td><td
2019</td><td>SUTARMI</td><td>TUGINO 07 05 T 06</td><td>PEGAWAI NEGERI
SIPIL</td><td>SUKOROYOM KULON RT 02 RW
03</td><td></td><td>PUCANGANOM</td><td>INDUK</td><td>dr. BUDI
2019</td><td>SUTARNI</td><td></td><td>PETANI/PEKEBUN</td><td>SALAM</td><td>SALAM</t
</td><td>P</td><td>60-69 Thn.</td><td>Datang Sendiri</td><td>Lama</td><td>BPJS
align='right'>52087139</td><td>01-03-
2019</td><td>SUTINAH</td><td></td><td>PETANI/PEKEBUN</td><td>TLOGOSARI</td><td>TLOG
OSARI</td><td>TLOGOSARI</td><td>PUSTU TLOGOSARI</td><td>SULARNO,S.Kep.Ns</td><td> -
</td><td>P</td><td>45-54 Thn.</td><td>Datang Sendiri</td><td>Lama</td><td>BPJS NON
2019</td><td>SUTRISNI</td><td>MUJI
WAHYONO</td><td>PETANI/PEKEBUN</td><td>SOKO</td><td>SOKO</td><td>TLOGOSARI</td><td>
PUSTU TLOGOSARI</td><td>SULARNO,S.Kep.Ns</td><td> - </td><td>P</td><td>20-44
</tr><tr><td align='right'>F20.6</td><td>Simple schizophrenia</td><td></td><td
align='right'>289421</td><td align='right'>57040045</td><td>01-03-2019</td><td>TRI
WAHYUNINGSIH</td><td>SUKIRNO 07 04 S
06</td><td>PETANI/PEKEBUN</td><td>MANDEYAN</td><td></td><td>PUCANGANOM</td><td>INDU
K</td><td>dr. BUDI ASHARI</td><td> - </td><td>P</td><td>20-44 Thn.</td><td>Datang
></tr><tr><td align='right'>K29.5</td><td>Chronic gastritis,
align='right'>56010005</td><td>01-03-2019</td><td>TUGINAH</td><td>TUGINAH 06 01 T
02</td><td>PETANI/PEKEBUN</td><td>GIRITONTRO LOR RT01 RW 02</td><td>GIRITONTRO
LOR</td><td>GIRITONTRO</td><td>INDUK</td><td>dr. BUDI
2019</td><td>TUMIRAH</td><td></td><td>PETANI/PEKEBUN</td><td>KARANG
KULON</td><td></td><td>JAWA TIMUR</td><td>PUSTU
Thn.</td><td>Datang Sendiri</td><td>Baru</td><td>Umum</td><td>Rajal</td><td
align='right'>I11</td><td>Hypertensive heart disease</td><td></td><td
2019</td><td>TUSIRAN SISWO DARYONO</td><td>TUSIRAN SISWO DARYONO 0605 T
06</td><td>PETANI/PEKEBUN</td><td>NGUJUNG RT03
RW08</td><td>NGUJUNG</td><td>GIRITONTRO</td><td>INDUK</td><td>dr. BUDI
d></tr><tr><td align='right'>F20</td><td>Schizophrenia</td><td></td><td
2019</td><td>WAGIYEM</td><td>KATIYO 01 11 K
01</td><td>PETANI/PEKEBUN</td><td>BLEBER RT02
RW06</td><td>BLEBER</td><td>NGARGOHARJO</td><td>INDUK</td><td>dr. BUDI
2019</td><td>WIDATIN</td><td>BASUNI 0703 B 08</td><td>MENGURUS RUMAH
TANGGA</td><td>KUWANG RT03
RW06</td><td>KUWANG</td><td>PUCANGANOM</td><td>INDUK</td><td>dr. BUDI
2019</td><td>WIDATMI</td><td>HALDOKO 07 04 H 06</td><td>MENGURUS RUMAH
TANGGA</td><td>MANDEYAN RT01
RW01</td><td>MANDEYAN</td><td>PUCANGANOM</td><td>INDUK</td><td>dr. BUDI
></tr><tr><td align='right'>F20</td><td>Schizophrenia</td><td></td><td
2019</td><td>WIWIN</td><td>MESMIN 07 01 M
align='right'>D36.9</td><td>Benign neoplasm of unspecified site</td><td></td><td
2019</td><td>ABYAN ADI NANDANA</td><td>SUHADI 07 01 S 12</td><td>BELUM/TIDAK
BEKERJA</td><td>GROGOL RT01
ASHARI</td><td>SRI MURWATININGSIH</td><td>L</td><td>1-4 Thn.</td><td>Datang
align='right'>23</td><td align='right'></td><td
align='right'>56050199</td><td>02-03-2019</td><td>AHLE SYABANI
PUJIANDRA</td><td>WARDOYO 0605 W 05</td><td>BELUM/TIDAK BEKERJA</td><td>NGUJUNG
RT02 RW08</td><td>NGUJUNG</td><td>GIRITONTRO</td><td>INDUK</td><td>dr. BUDI
ASHARI</td><td>SRI MURWATININGSIH</td><td>P</td><td><1 Thn.</td><td>Datang
align='right'></td><td align='right'>9</td><td
align='right'></td><td>KIA</td><td></td><td></td><td>Dalam
align='right'>R50.8</td><td>Other specified fever</td><td></td><td
2019</td><td>AISYA SOFYA AL AWIYA</td><td>KISNO/SUTRISNO 07 03 K
12</td><td>BELUM/TIDAK BEKERJA</td><td>KUWANG RT 03 RW
06</td><td>KUWANG</td><td>PUCANGANOM</td><td>INDUK</td><td>dr. BUDI
ASHARI</td><td>SUHARNI</td><td>P</td><td>1-4 Thn.</td><td>Datang
align='right'>56010360</td><td>02-03-2019</td><td>BAMBANG SRI
HANANTO</td><td>BAMBANG SRI HANANTO 0601 B
02</td><td>PETANI/PEKEBUN</td><td>GIRITONTRO LOR RT02 RW1</td><td>GIRITONTRO
></tr><tr><td align='right'>J45.9</td><td>Asthma, unspecified</td><td></td><td
2019</td><td>DIMIN</td><td>DIMIN 07 07 D 03</td><td>PETANI/PEKEBUN</td><td>BANJAR
RT03 RW05</td><td>BANJAR</td><td>PUCANGANOM</td><td>INDUK</td><td>dr. BUDI
Sendiri</td><td>Lama</td><td>JAMKESDA</td><td>Rajal</td><td
/td></tr><tr><td align='right'>I11.9</td><td>Hypertensive heart disease without
(congestive) heart failure</td><td></td><td align='right'>289442</td><td
align='right'>57090012</td><td>02-03-2019</td><td>KARMI</td><td>SOMAN 0709 S
11</td><td>PETANI/PEKEBUN</td><td>P ANOM LOR </td><td>PUCANGANOM
LOR</td><td>PUCANGANOM</td><td>INDUK</td><td>dr. BUDI
></tr><tr><td align='right'>G62.9</td><td>Polyneuropathy,
align='right'>57050326</td><td>02-03-2019</td><td>KASINEM</td><td>KASINEM 07 05 K
09</td><td>MENGURUS RUMAH TANGGA</td><td>SUKOROYOM KULON RT02
ASHARI</td><td>SUGIYONO,S.Kep.Ns</td><td>P</td><td>>70 Thn.</td><td>Datang
2019</td><td>MARDI</td><td>MARDI 0505 M 04</td><td>PEDAGANG</td><td>PUNUNG RT 02
RW 02</td><td>PUNUNG</td><td>JATIREJO</td><td>INDUK</td><td>dr. BUDI
align='right'>57030164</td><td>02-03-2019</td><td>MUHAMMAD NUR HIDAYAH</td><td>ARI
SETIYANTO 0703 A 02</td><td>BELUM/TIDAK BEKERJA</td><td>KUWANG RT04
align='right'>3</td><td align='right'></td><td align='right'>5</td><td>BP.
></tr><tr><td align='right'>Z34.8</td><td>Supervision of other normal
pregnancy</td><td></td><td align='right'>289458</td><td
align='right'>57050313</td><td>02-03-2019</td><td>NANA ANIS
SETYOWATI</td><td>SOLIKIN 07 05 S 26</td><td>KARYAWAN SWASTA</td><td>SUKOROYOM
KULON RT02 RW03</td><td>SUKOROYOM
KULON</td><td>PUCANGANOM</td><td>INDUK</td><td>dr. BUDI ASHARI</td><td>RISTINA Amd
Keb</td><td>P</td><td>20-44 Thn.</td><td>Datang Sendiri</td><td>Lama</td><td>UMUM
align='right'>57130017</td><td>02-03-2019</td><td>OZORA HIMMATANA</td><td>TUGUR
ANJAR 0713 T 01</td><td>PELAJAR/MAHASISWA</td><td>KEPUH RT03
RW12</td><td>KEPUH</td><td>PUCANGANOM</td><td>INDUK</td><td>dr. BUDI
></tr><tr><td
align='right'>56055034</td><td>02-03-2019</td><td>PANDU</td><td>SURADI 06 05 S
03</td><td>PELAJAR/MAHASISWA</td><td>NGUJUNG RT 02
align='right'>57070246</td><td>02-03-2019</td><td>SAMIYEM</td><td>SURATNO 07 07 S
27</td><td>PETANI/PEKEBUN</td><td>BANJAR
03/05</td><td>BANJAR</td><td>PUCANGANOM</td><td>INDUK</td><td>dr. BUDI
d></tr><tr><td align='right'>Z34.8</td><td>Supervision of other normal
align='right'>57030007</td><td>02-03-2019</td><td>SAMSIYAH</td><td>PRIHANTO 0703 P
08</td><td>PETANI/PEKEBUN</td><td>KUWANG RT 02 RW
ASHARI</td><td>SRI MURWATININGSIH</td><td>P</td><td>20-44 Thn.</td><td>Datang
></tr><tr><td align='right'>K29.6</td><td>Other gastritis</td><td></td><td
2019</td><td>SOMAN</td><td>SOMAN 0709 S
11</td><td>PETANI/PEKEBUN</td><td>PUCANGANOM LOR</td><td>PUCANGANOM
align='right'>56100390</td><td>02-03-2019</td><td>SUKATMI</td><td>MARIDI 06 10 M
14</td><td>MENGURUS RUMAH TANGGA</td><td>TANGGUNG RT01
RW05</td><td>TANGGUNG</td><td>GIRITONTRO</td><td>INDUK</td><td>dr. BUDI
align='right'>56020117</td><td>02-03-2019</td><td>SUNARNO</td><td>MARIYO 0602 M
17</td><td>PEDAGANG</td><td>GIRITONTRO KIDUL</td><td>GIRITONTRO
align='right'>57030005</td><td>02-03-2019</td><td>SURATMI</td><td>ARI
SETIYANTO</td><td>PETANI/PEKEBUN</td><td>KUWANG</td><td>KUWANG</td><td>PUCANGANOM</
td><td>INDUK</td><td>dr. BUDI
align='right'>I11.9</td><td>Hypertensive heart disease without (congestive) heart
failure</td><td></td><td align='right'>289449</td><td
align='right'>56025018</td><td>02-03-2019</td><td>TUGIYEM</td><td>SUKADI 0602 S
37</td><td>PETANI/PEKEBUN</td><td>GIRITONTRO KIDUL RT01 RW03</td><td>GIRITONTRO
d></tr><tr><td align='right'>J11.8</td><td>Influenza with other manifestations,
align='right'>53015133</td><td>04-03-2019</td><td>ACHMADI</td><td></td><td>KARYAWAN
SWASTA</td><td>TLOGO</td><td>TLOGO</td><td>TLOGOHARJO</td><td>PKD
TLOGOHARJO</td><td>SRI SUPATMI</td><td> - </td><td>L</td><td>20-44
Thn.</td><td>Datang Sendiri</td><td>Baru</td><td>UMUM
align='right'>A09</td><td>Diarrhoea and gastroenteritis of presumed infectious
origin</td><td></td><td align='right'>289605</td><td
align='right'>51050039</td><td>04-03-2019</td><td>AULIAN BAZHIRA
FATANNA</td><td>WIDODO</td><td>BELUM/TIDAK
BEKERJA</td><td>GENTUNG</td><td>GENTUNG</td><td>NGARGOHARJO</td><td>PKD
NGARGOHARJO</td><td>HENI WIDIYASTUTI</td><td> - </td><td>L</td><td>1-4
tr><tr><td align='right'>D36.9</td><td>Benign neoplasm of unspecified
site</td><td></td><td align='right'>289486</td><td
align='right'>57050106</td><td>04-03-2019</td><td>CLAURANISA ZULFA ASIFA
RAMADANI</td><td>SUDARMAN ROHANI 0705 S 18</td><td>BELUM/TIDAK
BEKERJA</td><td>SUKOROYOM KULON RT03 RW03</td><td>SUKOROYOM
align='right'>53015103</td><td>04-03-2019</td><td>DEWANGGA
ARFAN</td><td>ACHMADI</td><td>BELUM/TIDAK
BEKERJA</td><td>TLOGO</td><td>TLOGO</td><td>TLOGOHARJO</td><td>PKD
align='right'>57090017</td><td>04-03-2019</td><td>ERMAWATI</td><td>YATNO 0709 Y
01</td><td>PETANI/PEKEBUN</td><td>PUCANGANOM LOR RT02 RW09</td><td>PUCANGANOM
align='right'></td><td align='right'>8</td><td align='right'>35</td><td>BP.
align='right'>K00.6</td><td>Disturbances in tooth eruption</td><td></td><td
2019</td><td>FAUZAL USNA</td><td>MUSLIM 0808 M
13</td><td>PELAJAR/MAHASISWA</td><td>PULOSARI</td><td></td><td>PRACIMANTORO</td><td
>INDUK</td><td>drg.DANAR WULANDARI</td><td>RIZKI ANISSA, AM.Kg</td><td>P</td><td>5-
9 Thn.</td><td>Datang Sendiri</td><td>Lama</td><td>UMUM
align='right'>6</td><td>BP. Gigi</td><td></td><td></td><td>Luar
align='right'>57090241</td><td>04-03-2019</td><td>FINA AL F </td><td>KATNO 07 09
K 02</td><td>PELAJAR/MAHASISWA</td><td>PUCANGANOM LOR RT 03 RW
09</td><td>PUCANGANOM LOR</td><td>PUCANGANOM</td><td>INDUK</td><td>dr. BUDI
></tr><tr><td
align='right'>T14.9</td><td>Injury, unspecified</td><td></td><td
2019</td><td>GIMAN</td><td>GIMAN</td><td>PETANI/PEKEBUN</td><td>GIRIROTO</td><td>GI
RIROTO</td><td>JATIREJO</td><td>PKD JATIREJO</td><td>SUHARNI</td><td> -
</td><td>L</td><td>>70 Thn.</td><td>Datang Sendiri</td><td>Lama</td><td>BPJS
align='right'>54065102</td><td>04-03-2019</td><td>HENDRA
ASTOPO</td><td>JUMADI</td><td>PELAJAR/MAHASISWA</td><td>BAYEM</td><td>BAYEM</td><td
>BAYEMHARJO</td><td>PUSTU BAYEMHARJO</td><td>RISTINA Amd Keb</td><td> -
align='right'>57130038</td><td>04-03-2019</td><td>HERYBERTUS
MISDI</td><td>HERYBERTUS MISDI 07 13 H 04</td><td>PETANI/PEKEBUN</td><td>KEPUH RT
3RW 13 P .ANOM</td><td>KEPUH</td><td>PUCANGANOM</td><td>INDUK</td><td>dr. BUDI
align='right'>55060074</td><td>04-03-2019</td><td>IKHSAN DWI YULIANTO</td><td>SARDI
05 06 S 05</td><td>BELUM/TIDAK BEKERJA</td><td>JATIREJO RT03
RW03</td><td>JATI</td><td>JATIREJO</td><td>INDUK</td><td>dr. BUDI
ASHARI</td><td>UMI NUR ISNIATI</td><td>L</td><td>1-4 Thn.</td><td>Datang
Sendiri</td><td>Lama</td><td>JAMKESDA</td><td>Rajal</td><td align='right'>4</td><td
Wilayah</td><td>'3312022803170001</td><td>'3312022803170001</td><td>80</td><td>60</
td></tr><tr><td align='right'>M79.11</td><td>Myalgia, shoulder
align='right'>56065025</td><td>04-03-2019</td><td>ISMINI</td><td>SUGIYARNO 0606 S
25</td><td>PETANI/PEKEBUN</td><td>GOBOH</td><td>GOBOH</td><td>GIRITONTRO</td><td>IN
DUK</td><td>dr. BUDI ASHARI</td><td>SUGIYONO,S.Kep.Ns</td><td>P</td><td>45-54
Thn.</td><td>Datang Sendiri</td><td>Lama</td><td>BPJS NON PBI</td><td>Rajal</td><td
align='right'>57030374</td><td>04-03-2019</td><td>ISTIANA SARWENDAH </td><td>KALIK
0703 K 07</td><td>KARYAWAN SWASTA</td><td>KUWANG RT03
align='right'>M79.1</td><td>Myalgia</td><td></td><td align='right'>289501</td><td
align='right'>55010121</td><td>04-03-2019</td><td>JUMINI</td><td>SULARNO 05 01 S
23</td><td>PEDAGANG</td><td>GIRIBELAH RT03
RW07</td><td>GIRIBELAH</td><td>JATIREJO</td><td>INDUK</td><td>dr. BUDI
></tr><tr><td align='right'>K00.6</td><td>Disturbances in tooth
eruption</td><td></td><td align='right'>289482</td><td
align='right'>10101063</td><td>04-03-2019</td><td>KALISA RAHMA
DESTIANI</td><td>WAHYU BUDI SANTOSO 10 10 W 06</td><td>BELUM/TIDAK
BEKERJA</td><td>WARU RT01
RW04,JOHUNUT,PARANGGUPITO</td><td></td><td>PARANGGUPITO</td><td>INDUK</td><td>drg.D
ANAR WULANDARI</td><td>RIZKI ANISSA, AM.Kg</td><td>P</td><td>5-9
Gigi</td><td></td><td></td><td>Luar
align='right'>K29.5</td><td>Chronic gastritis, unspecified</td><td></td><td
2019</td><td>KARNI</td><td>SUKATNO 0709 K
2019</td><td>KATINO</td><td>KATINO</td><td>PETANI/PEKEBUN</td><td>TLOGO</td><td>TLO
GO</td><td>TLOGOHARJO</td><td>PKD TLOGOHARJO</td><td>SRI SUPATMI</td><td> -
</td><td>L</td><td>45-54 Thn.</td><td>Datang Sendiri</td><td>Lama</td><td>BPJS
align='right'>55070046</td><td>04-03-2019</td><td>KATMAN</td><td>KATMAN 0501 K
04</td><td>PETANI/PEKEBUN</td><td>NGELOSARI RT01
RW03</td><td>NGELOSARI</td><td>JATIREJO</td><td>INDUK</td><td>dr. BUDI
align='right'>52110049</td><td>04-03-2019</td><td>LANGGA RAHADIAN
PUTRA</td><td>HARIYANTO 0211 H 01</td><td>PELAJAR/MAHASISWA</td><td>TAMBAK RT01
RW02</td><td>TAMBAK</td><td>TLOGOSARI</td><td>INDUK</td><td>drg.DANAR
WULANDARI</td><td>RIZKI ANISSA, AM.Kg</td><td>L</td><td>15-19 Thn.</td><td>Datang
Sendiri</td><td>Baru</td><td>UMUM WONOGIRI</td><td>Rajal</td><td
align='right'>S90.3</td><td>Contusion of other and unspecified parts of
foot</td><td></td><td align='right'>289505</td><td
align='right'>57040194</td><td>04-03-2019</td><td>MAHAMADOU AR RAZHAQ INOEH
PASMA</td><td>EDWIN</td><td>PELAJAR/MAHASISWA</td><td>MANDEYAN</td><td>MANDEYAN</td
><td>PUCANGANOM</td><td>INDUK</td><td>dr. BUDI
></tr><tr><td align='right'>I11.9</td><td>Hypertensive heart disease without
align='right'>57070056</td><td>04-03-2019</td><td>MARSIYEM</td><td>MARSIYEM 07 07
M 10 </td><td>PETANI/PEKEBUN</td><td>BANJAR RT 02 RW
05</td><td>BANJAR</td><td>PUCANGANOM</td><td>INDUK</td><td>dr. BUDI
Wilayah</td><td>'</td><td>'3312025307400001</td><td>180</td><td>100</td></tr><tr><t
d align='right'>J45.9</td><td>Asthma, unspecified</td><td></td><td
2019</td><td>MIJEM</td><td>RAHMANTO</td><td>PETANI/PEKEBUN</td><td>TLOGO</td><td>TL
OGO</td><td>TLOGOHARJO</td><td>PKD TLOGOHARJO</td><td>SRI SUPATMI</td><td> -
></tr><tr><td align='right'>J11.8</td><td>Influenza with other
manifestations, virus not identified</td><td></td><td align='right'>289491</td><td
align='right'>57040099</td><td>04-03-2019</td><td>MISIYAH</td><td>MARYONO 07 04 M
05</td><td>PETANI/PEKEBUN</td><td>MANDEYAN RT03
align='right'>51090008</td><td>04-03-2019</td><td>MISMI</td><td>SUKINO 01 09 S
09</td><td>PETANI/PEKEBUN</td><td>PULUNG RT04
RW04</td><td>PULUNG</td><td>NGARGOHARJO</td><td>INDUK</td><td>dr. BUDI
d></tr><tr><td align='right'>L20.8</td><td>Other atopic dermatitis</td><td></td><td
2019</td><td>MUHAMAD RIDWAN A</td><td>SRI DARYANTO 0709 S
04</td><td>PELAJAR/MAHASISWA</td><td>PUCANGANOM LOR</td><td>PUCANGANOM
></tr><tr><td align='right'>K05.1</td><td>Chronic gingivitis</td><td></td><td
2019</td><td>NOVIANA PUTRI UTAMI</td><td>PUJI UTOMO 0210 P 09</td><td>BELUM/TIDAK
BEKERJA</td><td>PORO RT01
RW01</td><td>PORO</td><td>TLOGOSARI</td><td>INDUK</td><td>drg.DANAR
WULANDARI</td><td>RIZKI ANISSA, AM.Kg</td><td>P</td><td>5-9 Thn.</td><td>Datang
Gigi</td><td></td><td></td><td>Dalam
tr><tr><td align='right'>H00.0</td><td>Hordeolum and other deep inflammation of
eyelid</td><td></td><td align='right'>289470</td><td
align='right'>57010260</td><td>04-03-2019</td><td>NUR AYIYAH</td><td>WARINO 0701 W
04</td><td>KARYAWAN
SWASTA</td><td>GROGOL</td><td>GROGOL</td><td>PUCANGANOM</td><td>INDUK</td><td>dr.
BUDI ASHARI</td><td>SUGIYONO,S.Kep.Ns</td><td>P</td><td>20-44 Thn.</td><td>Datang
align='right'>56040138</td><td>04-03-2019</td><td>PANGERAN ADI SURYA
NEGORO</td><td>HERU PRAYITNO 0604 H 04</td><td>BELUM/TIDAK
BEKERJA</td><td>KETONGGO RT02
RW07</td><td></td><td>GIRITONTRO</td><td>INDUK</td><td>dr. BUDI ASHARI</td><td>UMI
NUR ISNIATI</td><td>L</td><td><1 Thn.</td><td>Datang
align='right'>H82</td><td>Vertiginous syndromes in diseases classified
align='right'>51057007</td><td>04-03-
2019</td><td>PONEM</td><td>SARTU</td><td>PETANI/PEKEBUN</td><td>GENTUNG</td><td>GEN
TUNG</td><td>NGARGOHARJO</td><td>PKD NGARGOHARJO</td><td>HENI WIDIYASTUTI</td><td>
- </td><td>P</td><td>60-69 Thn.</td><td>Datang Sendiri</td><td>Lama</td><td>BPJS
align='right'>57020314</td><td>04-03-2019</td><td>PRABOWO</td><td>BOWO 07 02 B
04</td><td>PELAJAR/MAHASISWA</td><td>SUKOROYOM WETAN RT01 RW04</td><td>SUKOROYOM
WETAN</td><td>PUCANGANOM</td><td>INDUK</td><td>dr. BUDI
align='right'>56010231</td><td>04-03-2019</td><td>RADITA SANDI</td><td>HARSANTO
0601 H 05</td><td>BELUM/TIDAK BEKERJA</td><td>GRO LOR RT01 RW02</td><td>GIRITONTRO
LOR</td><td>GIRITONTRO</td><td>INDUK</td><td>dr. BUDI ASHARI</td><td>UMI NUR
ISNIATI</td><td>L</td><td>1-4 Thn.</td><td>Datang Sendiri</td><td>Lama</td><td>UMUM
align='right'>57020023</td><td>04-03-2019</td><td>RAKIYEM</td><td>SARMIDI 0702 S
24</td><td>PELAJAR/MAHASISWA</td><td>SUKOROYOM WETAN</td><td>SUKOROYOM
></tr><tr><td align='right'>B35.9</td><td>Dermatophytosis,
align='right'>10100464</td><td>04-03-2019</td><td>RAMDANI</td><td>RAMDANI 1010 R
01</td><td>PETANI/PEKEBUN</td><td>GEMULUNG</td><td></td><td>PARANGGUPITO</td><td>IN
DUK</td><td>drg.DANAR WULANDARI</td><td>RIZKI ANISSA, AM.Kg</td><td>L</td><td>20-44
2019</td><td>REGINA SAPTOSRI</td><td>JURI 0708 J 04</td><td>BURUH HARIAN
LEPAS</td><td>PUCANGANOM KIDUL</td><td>PUCANGANOM
KIDUL</td><td>PUCANGANOM</td><td>INDUK</td><td>dr. BUDI
></tr><tr><td align='right'>K03.1</td><td>Abrasion of teeth</td><td></td><td
align='right'>289472</td><td align='right'>10101388</td><td>04-03-2019</td><td>REJO
SUMARSO</td><td>REJO SUMARSO 1010 R 05</td><td>PETANI/PEKEBUN</td><td>BANGAMPEL
RT04 RW01</td><td></td><td>PARANGGUPITO</td><td>INDUK</td><td>drg.DANAR
align='right'>56040123</td><td>04-03-2019</td><td>RIA CAHYANI</td><td>HERU PRAYITNO
0604 H 04</td><td>MENGURUS RUMAH TANGGA</td><td>KETONGGO
RT.02/07</td><td>KETONGGO</td><td>GIRITONTRO</td><td>INDUK</td><td>dr. BUDI
ASHARI</td><td>UMI NUR ISNIATI</td><td>P</td><td>20-44 Thn.</td><td>Datang
align='right'>51047052</td><td>04-03-
2019</td><td>SALINO</td><td>SALINO</td><td>PETANI/PEKEBUN</td><td>KLEPU</td><td>KLE
PU</td><td>NGARGOHARJO</td><td>PKD NGARGOHARJO</td><td>HENI WIDIYASTUTI</td><td> -
></tr><tr><td align='right'>R51</td><td>Headache</td><td></td><td
2019</td><td>SAMINO</td><td>SAMINO</td><td>PENSIUNAN</td><td>DOLOGAN</td><td>DOLOGA
N</td><td>BAYEMHARJO</td><td>PUSTU BAYEMHARJO</td><td>RISTINA Amd Keb</td><td> -
align='right'>53010052</td><td>04-03-2019</td><td>SARIKEM</td><td>MISNO KUNCORO 03
01 M 04</td><td>PETANI/PEKEBUN</td><td>TLOGO RT 02 RW
01</td><td></td><td>TLOGOHARJO</td><td>INDUK</td><td>dr. BUDI
></tr><tr><td align='right'>Z34.9</td><td>Supervision of normal pregnancy,
align='right'>57140111</td><td>04-03-2019</td><td>SARNI</td><td>KATINO 0714 K
01</td><td>PETANI/PEKEBUN</td><td>PENDEM RT02
RW15</td><td>PENDEM</td><td>PUCANGANOM</td><td>INDUK</td><td>dr. BUDI
2019</td><td>SIYEM</td><td>SIYEM</td><td>PETANI/PEKEBUN</td><td>GIRIROTO</td><td>GI
2019</td><td>SLAMET</td><td>SLAMET</td><td>PETANI/PEKEBUN</td><td>TLOGO</td><td>TLO
align='right'>53015003</td><td>04-03-
2019</td><td>SOMAN</td><td>SOMAN</td><td>PETANI/PEKEBUN</td><td>TLGO</td><td>TLOGO<
/td><td>TLOGOHARJO</td><td>PKD TLOGOHARJO</td><td>SRI SUPATMI</td><td> -
2019</td><td>SONAH</td><td>MUSMULYADI 0702 M
02</td><td>PETANI/PEKEBUN</td><td>SUKOROYOM WETAN</td><td>SUKOROYOM
align='right'>55060021</td><td>04-03-2019</td><td>SUDATMI</td><td>SARDI 05 06 S
05</td><td>PETANI/PEKEBUN</td><td>JATI RT 03 RW
03</td><td>JATI</td><td>JATIREJO</td><td>INDUK</td><td>dr. BUDI ASHARI</td><td>UMI
NUR ISNIATI</td><td>P</td><td>20-44 Thn.</td><td>Datang
></tr><tr><td align='right'>I63.9</td><td>Cerebral infarction,
align='right'>55020051</td><td>04-03-2019</td><td>SULARNI</td><td>TUKINO 05 02 T
01</td><td>MENGURUS RUMAH TANGGA</td><td>GIRIROTO RT02 RW
06</td><td>GIRIROTO</td><td>JATIREJO</td><td>INDUK</td><td>dr. BUDI
></tr><tr><td align='right'>S51</td><td>Open wound of forearm</td><td></td><td
2019</td><td>SULARSI</td><td>MISWANTO 0601 M
10</td><td>PETANI/PEKEBUN</td><td>GIRITONTRO LOR RT.03 RW.01</td><td>GIRITONTRO
align='right'>51057024</td><td>04-03-
2019</td><td>SUMARNI</td><td>SUYANTO</td><td>PETANI/PEKEBUN</td><td>GENTUNG</td><td
>GENTUNG</td><td>NGARGOHARJO</td><td>PKD NGARGOHARJO</td><td>HENI
WIDIYASTUTI</td><td> - </td><td>P</td><td>45-54 Thn.</td><td>Datang
/td></tr><tr><td align='right'>S22.10</td><td>Multiple fractures of thoracic spine,
closed</td><td></td><td align='right'>289490</td><td
align='right'>57120093</td><td>04-03-2019</td><td>SUPARNO</td><td>SUPARNO 0712 S
16</td><td>PETANI/PEKEBUN</td><td>INGAK INGUK</td><td>INGAK -
INGUK</td><td>PUCANGANOM</td><td>INDUK</td><td>dr. BUDI
2019</td><td>SURATMAN</td><td>SURATMAN 1515 S 09</td><td>KARYAWAN
align='right'>M13.9</td><td>Arthritis, unspecified</td><td></td><td
2019</td><td>SUTINEM</td><td>KADIMIN</td><td>PETANI/PEKEBUN</td><td>NGRINGIN</td><t
d>NGRINGIN</td><td>NGARGOHARJO</td><td>PKD NGARGOHARJO</td><td>HENI
tr><tr><td align='right'>J45.9</td><td>Asthma, unspecified</td><td></td><td
2019</td><td>SUWARDI</td><td>SUWARDI 06 01 S
04</td><td>PETANI/PEKEBUN</td><td>GIRITONTRO LOR RT O1 RW O2</td><td>GIRITONTRO
LOR</td><td>GIRITONTRO</td><td>INDUK</td><td>dr.
BUDI ASHARI</td><td>SUGIYONO,S.Kep.Ns</td><td>L</td><td>60-69 Thn.</td><td>Datang
></tr><tr><td align='right'>M06.9</td><td>Rheumatoid arthritis,
align='right'>54025005</td><td>04-03-
2019</td><td>SUWARNI</td><td>SUWARNI</td><td>PETANI/PEKEBUN</td><td>NGUNDUK</td><td
>NGUNDUK</td><td>BAYEMHARJO</td><td>PUSTU BAYEMHARJO</td><td>RISTINA Amd
Keb</td><td> - </td><td>P</td><td>20-44 Thn.</td><td>Datang
></tr><tr><td align='right'>I10</td><td>Essential (primary)
hypertension</td><td></td><td align='right'>290372</td><td
align='right'>54025005</td><td>04-03-
></tr><tr><td align='right'>L20.9</td><td>Atopic dermatitis,
align='right'>57030091</td><td>04-03-2019</td><td>SUYATNO</td><td>SUYATNO 0703 S
39</td><td>PETANI/PEKEBUN</td><td>KUWANG RT04
2019</td><td>SUYOTO</td><td>SUYOTO 01 02 S
12</td><td>PETANI/PEKEBUN</td><td>NGRINGIN RT02
RW01</td><td>NGRINGIN</td><td>NGARGOHARJO</td><td>INDUK</td><td>dr. BUDI
align='right'>56010389</td><td>04-03-2019</td><td>TRI SURYANI</td><td>WARDI 0601 W
20</td><td>PETANI/PEKEBUN</td><td>GIRITONTRO LOR RT.03/01</td><td>GIRITONTRO
Wilayah</td><td>'0000564941406</td><td>'33120270071990</td><td>150</td><td>90</td><
/tr><tr><td align='right'>I10</td><td>Essential (primary)
align='right'>55025096</td><td>04-03-
2019</td><td>TUGI</td><td>TUGI</td><td>PETANI/PEKEBUN</td><td>GIRIROTO</td><td>GIRI
ROTO</td><td>JATIREJO</td><td>PKD JATIREJO</td><td>SUHARNI</td><td> -
2019</td><td>TUKIRAH</td><td>TUKIRAH</td><td>PETANI/PEKEBUN</td><td>GUPAKAN</td><td
>GUPAKAN</td><td>TLOGOSARI</td><td>PKD TLOGOSARI</td><td>RETNO AMBARWATI AMD
KEB</td><td> - </td><td>P</td><td>45-54 Thn.</td><td>Datang
align='right'>52105047</td><td>04-03-
2019</td><td>TUKIYEM</td><td>GIMUN</td><td>PETANI/PEKEBUN</td><td>PORO</td><td>PORO
</td><td>TLOGOSARI</td><td>PKD TLOGOSARI</td><td>RETNO AMBARWATI AMD KEB</td><td> -
></tr><tr><td align='right'>N18.8</td><td>Other chronic renal
align='right'>53065030</td><td>04-03-2019</td><td>TUMADI</td><td>YATMI 03 06 Y
01</td><td>KARYAWAN SWASTA</td><td>KLEPU RT 01 RW
05</td><td>KLEPU</td><td>TLOGOHARJO</td><td>INDUK</td><td>dr. BUDI
align='right'>53010040</td><td>04-03-2019</td><td>VANIA ZASKIA AZAHRA</td><td>TRI
WIDIYANTO 0301 T 03</td><td>BELUM/TIDAK
BEKERJA</td><td>TLOGO</td><td>TLOGO</td><td>TLOGOHARJO</td><td>INDUK</td><td>drg.DA
NAR WULANDARI</td><td>RIZKI ANISSA, AM.Kg</td><td>P</td><td>5-9 Thn.</td><td>Datang
align='right'>M06.9</td><td>Rheumatoid arthritis, unspecified</td><td></td><td
2019</td><td>WAGIYEM</td><td>WAGIYEM</td><td>PETANI/PEKEBUN</td><td>BAYEM</td><td>B
AYEM</td><td>BAYEMHARJO</td><td>PUSTU BAYEMHARJO</td><td>RISTINA Amd Keb</td><td> -
align='right'>57140112</td><td>04-03-2019</td><td>WAHYU R U</td><td>SURONO 0714 S
25</td><td>PELAJAR/MAHASISWA</td><td>PENDEM RT02
></tr><tr><td align='right'>K02.1</td><td>Caries of dentine</td><td></td><td
2019</td><td>WAHYU
SAYEKTI</td><td>SUPARMIN</td><td>PETANI/PEKEBUN</td><td>BAYEM</td><td>BAYEM</td><td
></tr><tr><td align='right'>H66.3</td><td>Other chronic suppurative otitis
media</td><td></td><td align='right'>289475</td><td
align='right'>57130139</td><td>04-03-2019</td><td>WALUYO</td><td>WALUYO 0713 W
06</td><td>PETANI/PEKEBUN</td><td>KEPUH RT02
Sendiri</td><td>Lama</td><td>JAMKESDA</td><td>Rujuk</td><td align='right'>2</td><td
align='right'></td><td align='right'>66</td><td>BP. Umum</td><td>Poli
THT</td><td>RSUD DR. SOEDIRAN
MS WONOGIRI</td><td>Dalam
/td></tr><tr><td align='right'>R51</td><td>Headache</td><td></td><td
2019</td><td>WARINO</td><td>WARINO 0407 W
02</td><td>PETANI/PEKEBUN</td><td>NGALURAN RT01
RW05</td><td>NGALURAN</td><td>BAYEMHARJO</td><td>PUSTU BAYEMHARJO</td><td>RISTINA
Amd Keb</td><td> - </td><td>L</td><td>60-69 Thn.</td><td>Datang
2019</td><td>WASIYEM</td><td>GITO</td><td>PETANI/PEKEBUN</td><td>TAMBAK</td><td>TAM
BAK</td><td>TLOGOSARI</td><td>PKD TLOGOSARI</td><td>RETNO AMBARWATI AMD
2019</td><td>WIDATMI</td><td>HALDOKO 07 04 H 06</td><td>MENGURUS RUMAH
TANGGA</td><td>MANDEYAN RT01
></tr><tr><td align='right'>S90.2</td><td>Contusion of toe(s) with damage to
nail</td><td></td><td align='right'>289492</td><td
align='right'>51010010</td><td>04-03-2019</td><td>WIYATI</td><td>WAKIJO 01 01 W
2</td><td>KARYAWAN SWASTA</td><td>PELET RT 01 RW
02</td><td>PELET</td><td>NGARGOHARJO</td><td>INDUK</td><td>dr. BUDI
></tr><tr><td align='right'>J41.8</td><td>Mixed simple and mucopurulent chronic
bronchitis</td><td></td><td align='right'>289498</td><td
align='right'>56010114</td><td>04-03-2019</td><td>ZAKIYA INEZ
KEYRILLA</td><td>MESGI 06 01 M 01</td><td>PELAJAR/MAHASISWA</td><td>GIRITONTRO
LOR RT03 RW01</td><td>GIRITONTRO LOR</td><td>GIRITONTRO</td><td>INDUK</td><td>dr.
align='right'>57130094</td><td>05-03-2019</td><td>AKHSITA HIMMATANA</td><td>TUGUR
ANJAR SETIAWAN 07 13 T 01</td><td>BELUM/TIDAK BEKERJA</td><td>KEPUH RRT 3RW 13 P
.ANOM</td><td>KEPUH</td><td>PUCANGANOM</td><td>INDUK</td><td>dr. BUDI
ASHARI</td><td>SRI SUPATMI</td><td>P</td><td>1-4 Thn.</td><td>Datang
align='right'>A02.9</td><td>Salmonella infection, unspecified</td><td></td><td
2019</td><td>ANDRIAN NUR CAHYO</td><td>TUKIMIN 0706 T 01</td><td>KARYAWAN
SWASTA</td><td>TAMBAHSARI RT02
RW07</td><td>TAMBAHSARI</td><td>PUCANGANOM</td><td>INDUK</td><td>dr. BUDI
Sendiri</td><td>Baru</td><td>BPJS PBI</td><td>Rujuk</td><td
align='right'>57030306</td><td>05-03-2019</td><td>ANITA FEBRIYANTI</td><td>NUGROHO
0703 N 01</td><td>BURUH HARIAN
LEPAS</td><td>KUWANG</td><td>KUWANG</td><td>PUCANGANOM</td><td>INDUK</td><td>dr.
align='right'></td><td align='right'>23</td><td>BP.
/td></tr><tr><td align='right'>K00.6</td><td>Disturbances in tooth
align='right'>57020151</td><td>05-03-2019</td><td>ARIF RAHMAN
NURDIANSYAH</td><td>RIYANTO 07 02 R 02</td><td>BELUM/TIDAK
BEKERJA</td><td>SUKOROYOM WETAN RT03 RW04</td><td>SUKOROYOM
WETAN</td><td>PUCANGANOM</td><td>INDUK</td><td>drg.DANAR WULANDARI</td><td>RIZKI
ANISSA, AM.Kg</td><td>P</td><td>5-9 Thn.</td><td>Datang
align='right'>56050018</td><td>05-03-2019</td><td>CINTIA OKTAVIANI</td><td>SULARDI
0605 S
d>dr. BUDI ASHARI</td><td>SUGIYONO,S.Kep.Ns</td><td>P</td><td>5-9
align='right'>57140095</td><td>05-03-2019</td><td>DENYSA NUR RISKY</td><td>MUSTAQIM
0714 M 02</td><td>PELAJAR/MAHASISWA</td><td>PENDEM RT01
></tr><tr><td align='right'>J45</td><td>Asthma</td><td></td><td
/td></tr><tr><td align='right'>Z34.8</td><td>Supervision of other normal
align='right'>55060090</td><td>05-03-2019</td><td>ELISA NOVITA SARI</td><td>SUNARLI
05 06 S 20</td><td>BELUM/TIDAK BEKERJA</td><td>JATI RT02
align='right'>57030223</td><td>05-03-2019</td><td>GABRIEL RASYA
SAPUTRA</td><td>NUGROHO 0703 N 01</td><td>BELUM/TIDAK BEKERJA</td><td>KUWANG
RT03 RW06</td><td>KUWANG</td><td>PUCANGANOM</td><td>INDUK</td><td>dr. BUDI
ASHARI</td><td>RETNO AMBARWATI AMD KEB</td><td>L</td><td>1-4 Thn.</td><td>Datang
td></tr><tr><td align='right'>K00.6</td><td>Disturbances in tooth
align='right'>56010314</td><td>05-03-2019</td><td>GISELA NUR HANIFA</td><td>AHMAD
RIDWAN 0601 A 04</td><td></td><td>GIRITONTRO LOR</td><td>GIRITONTRO
LOR</td><td>GIRITONTRO</td><td>INDUK</td><td>drg.DANAR WULANDARI</td><td>RIZKI
td></tr><tr><td align='right'>H25.9</td><td>Senile cataract,
align='right'>52130073</td><td>05-03-2019</td><td>GIYOREJO</td><td>GIYOREJO 0213
G 03</td><td>PETANI/PEKEBUN</td><td>KERJO RT03
RW03</td><td>KERJO</td><td>TLOGOSARI</td><td>INDUK</td><td>dr. BUDI
ASHARI</td><td>SUGIYONO,S.Kep.Ns</td><td>L</td><td>>70 Thn.</td><td>Datang
Sendiri</td><td>Baru</td><td>BPJS PBI</td><td>Rujuk</td><td align='right'>0</td><td
></tr><tr><td align='right'>R50.9</td><td>Fever, unspecified</td><td></td><td
2019</td><td>JUNIARKA ISCO RAMADHANSYAH</td><td>SUROSO 0211 S
19</td><td>BELUM/TIDAK BEKERJA</td><td>TAMBAK RT01
RW02</td><td>TAMBAK</td><td>TLOGOSARI</td><td>INDUK</td><td>dr. BUDI
ASHARI</td><td>RETNO AMBARWATI AMD KEB</td><td>L</td><td><1 Thn.</td><td>Datang
Sendiri</td><td>Lama</td><td>Umum</td><td>Rajal</td><td align='right'></td><td
align='right'>9</td><td align='right'></td><td>KIA</td><td></td><td></td><td>Dalam
2019</td><td>KATIRAN</td><td>KATIRAN</td><td>PETANI/PEKEBUN</td><td>PORO</td><td>PO
RO</td><td>TLOGOSARI</td><td>PKD TLOGOSARI</td><td>RETNO AMBARWATI AMD KEB</td><td>
- </td><td>L</td><td>45-54 Thn.</td><td>Datang Sendiri</td><td>Lama</td><td>BPJS
align='right'>57060006</td><td>05-03-2019</td><td>LAYEM</td><td>SUNARNO 0706 S
04</td><td>PELAJAR/MAHASISWA</td><td>TAMBAHSARI</td><td>TAMBAHSARI</td><td>PUCANGAN
OM</td><td>INDUK</td><td>dr. BUDI
align='right'>T20</td><td>Burn and corrosion of head and neck</td><td></td><td
2019</td><td>MARYONO</td><td>MARYONO 0602 M
15</td><td>PETANI/PEKEBUN</td><td>GIRITONTRO KIDUL RT02 RWE03</td><td>GIRITONTRO
align='right'>57010220</td><td>05-03-2019</td><td>MUH. ZAKI</td><td>PUJIONO 07 01
P 03</td><td>BELUM/TIDAK BEKERJA</td><td>GROGOL
RT.03/02</td><td>GROGOL</td><td>PUCANGANOM</td><td>INDUK</td><td>dr. BUDI
align='right'>57030164</td><td>05-03-2019</td><td>MUHAMMAD NUR HIDAYAH</td><td>ARI
SETIYANTO 0703 A 02</td><td>BELUM/TIDAK BEKERJA</td><td>KUWANG RT04
align='right'>52105018</td><td>05-03-2019</td><td>NOVIANA PUTRI UTAMI</td><td>PUJI
UTOMO</td><td>PELAJAR/MAHASISWA</td><td>PORO</td><td>PORO</td><td>TLOGOSARI</td><td
>PKD TLOGOSARI</td><td>RETNO AMBARWATI AMD KEB</td><td> - </td><td>P</td><td>5-9
align='right'>56010084</td><td>05-03-2019</td><td>PARINEM</td><td>PARINEM 0601 P
06</td><td>MENGURUS RUMAH TANGGA</td><td>GIRITONTRO LOR RT01
RW01</td><td>GIRITONTRO LOR</td><td>GIRITONTRO</td><td>INDUK</td><td>dr. BUDI
></tr><tr><td align='right'>E11.6</td><td>Non-insulin-dependent diabetes mellitus
with other specified complications</td><td></td><td align='right'>289537</td><td
align='right'>57090202</td><td>05-03-2019</td><td>PODO SANTONO</td><td>PODO SANTONO
0709 P 07</td><td>PETANI/PEKEBUN</td><td>PUCANGANOM LOR RT03
RW09</td><td>PUCANGANOM LOR</td><td>PUCANGANOM</td><td>INDUK</td><td>dr. BUDI
d align='right'>K29.7</td><td>Gastritis, unspecified</td><td></td><td
align='right'>289609</td><td align='right'>55100030</td><td>05-03-2019</td><td>PUJI
ASTUTI</td><td>SARJONO</td><td>PERANGKAT DESA</td><td>SENGON
RT02/04</td><td>SENGON</td><td>JATIREJO</td><td>PKD
JATIREJO</td><td>SUHARNI</td><td> - </td><td>P</td><td>20-44 Thn.</td><td>Datang
align='right'>56055113</td><td>05-03-2019</td><td>PURYANTI</td><td>SULARDI 0605 S
21</td><td>MENGURUS RUMAH
TANGGA</td><td>NGUJUNG</td><td>NGUJUNG</td><td>GIRITONTRO</td><td>INDUK</td><td>dr.
align='right'>56020558</td><td>05-03-2019</td><td>RAFA FAUZAN
KAMIL</td><td>HARYANTO 0602 H 08</td><td>PELAJAR/MAHASISWA</td><td>GIRITONTRO
KIDUL RT03 RW03</td><td>GIRITONTRO
align='right'>Z34.8</td><td>Supervision of other normal pregnancy</td><td></td><td
2019</td><td>RAHMINI</td><td>WIDODO 0401 W
04</td><td>PETANI/PEKEBUN</td><td>BELEH RT01
RW04</td><td>BELEH</td><td>BAYEMHARJO</td><td>INDUK</td><td>dr. BUDI
align='right'>55050012</td><td>05-03-2019</td><td>RETNO
KURNIAWATI</td><td>SEPDWIYANTO 05 05 S 20</td><td>MENGURUS RUMAH
TANGGA</td><td>PUNUNG RT01
RW02</td><td>PUNUNG</td><td>JATIREJO</td><td>INDUK</td><td>dr. BUDI
ASHARI</td><td>RETNO AMBARWATI AMD KEB</td><td>P</td><td>20-44 Thn.</td><td>Datang
align='right'>57100175</td><td>05-03-2019</td><td>RIONALDO ERIK KURNIAWAN
</td><td>YULIANTO 0710 Y 02</td><td>PELAJAR/MAHASISWA</td><td>JEPURUN RT03
RW10</td><td>JEPURUN</td><td>PUCANGANOM</td><td>INDUK</td><td>dr. BUDI
/td></tr><tr><td align='right'>M79.15</td><td>Myalgia, pelvic and
thigh</td><td></td><td align='right'>289523</td><td
align='right'>57135025</td><td>05-03-2019</td><td>SISRI</td><td>SISRI 0713 S
align='right'>57125022</td><td>05-03-2019</td><td>SITI KURNIATI</td><td>NGATIMIN
0712 N 04</td><td>PETANI/PEKEBUN</td><td>INGAK INGUK RT02 RW06</td><td>INGAK -
LESTARI</td><td>GIYANTO</td><td>PETANI/PEKEBUN</td><td>PORO</td><td>PORO</td><td>TL
OGOSARI</td><td>PKD TLOGOSARI</td><td>RETNO AMBARWATI AMD KEB</td><td> -
SULASMI</td><td>RIYANTO 07 02 R 02</td><td>PETANI/PEKEBUN</td><td>SUKOROYOM WETAN
RT03 RW04</td><td>SUKOROYOM WETAN</td><td>PUCANGANOM</td><td>INDUK</td><td>dr. BUDI
></tr><tr><td align='right'>N34.3</td><td>Urethral syndrome,
align='right'>56045072</td><td>05-03-2019</td><td>SULARMI</td><td>DARMIN 0604 D
TANGGA</td><td>KETONGGO</td><td>KETONGGO</td><td>GIRITONTRO</td><td>INDUK</td><td>d
r. BUDI ASHARI</td><td>SUGIYONO,S.Kep.Ns</td><td>P</td><td>45-54
align='right'>57130111</td><td>05-03-2019</td><td>SUMARNI</td><td>TUMIJAN 07013 T
d align='right'>M79.0</td><td>Rheumatism, unspecified</td><td></td><td
2019</td><td>TAMIYEM</td><td>TAMIYEM 0606 T
02</td><td>PETANI/PEKEBUN</td><td>GOBOH</td><td>GOBOH</td><td>GIRITONTRO</td><td>IN
DUK</td><td>dr. BUDI ASHARI</td><td>SUWARTO,S.Kep.Nes</td><td>P</td><td>>70
align='right'>57100065</td><td>05-03-2019</td><td>TARSISIUS
WIDODO</td><td>TARSISIUS WIDODO 0710 T 02</td><td>KARYAWAN
SWASTA</td><td>JEPURUN</td><td>JEPURUN</td><td>PUCANGANOM</td><td>INDUK</td><td>dr.
d></tr><tr><td align='right'>I11.9</td><td>Hypertensive heart disease without
align='right'>57100066</td><td>05-03-2019</td><td>THERESIA
SUMARTIN</td><td>TARSISIUS WIDODO 0710 T 02</td><td>MENGURUS RUMAH
TANGGA</td><td>JEPURUN</td><td>JEPURUN</td><td>PUCANGANOM</td><td>INDUK</td><td>dr.
Wilayah</td><td>'0002058845668</td><td>'331202540849</td><td>160</td><td>90</td></t
r><tr><td align='right'>J44.1</td><td>Chronic obstructive pulmonary disease with
acute exacerbation, unspecified</td><td></td><td align='right'>289512</td><td
align='right'>51010024</td><td>05-03-2019</td><td>UNTORO HERU
SAPUTRA</td><td>UNTORO HERU SAPUTRA 01 01 U 01</td><td>KARYAWAN
SWASTA</td><td>PELET, RT 01 RW
align='right'>57080193</td><td>05-03-2019</td><td>WARSINO</td><td>WARSINO 0708 W
02</td><td>KARYAWAN SWASTA</td><td>PUCANGANOM KIDUL RT07 RW08</td><td>PUCANGANOM
align='right'>57020354</td><td>05-03-2019</td><td>YUNITASARI</td><td>SENO/EKO
0702 S 39</td><td>MENGURUS RUMAH TANGGA</td><td>SUKOROYOM WETAN RT.04
RW.04</td><td>SUKOROYOM WETAN</td><td>PUCANGANOM</td><td>INDUK</td><td>dr. BUDI
/td></tr><tr><td align='right'>K05.2</td><td>Acute periodontitis</td><td></td><td
2019</td><td>AGUNG SUSENO</td><td>AGUNG SUSENO</td><td>PEGAWAI NEGERI
SIPIL</td><td>BATURETNO</td><td></td><td>WONOGIRI</td><td>INDUK</td><td>drg.DANAR
align='right'>L29</td><td>Pruritus</td><td></td><td align='right'>289553</td><td
align='right'>57140113</td><td>06-03-2019</td><td>ALFANI DWI
ALFARIZI</td><td>SUPARMAN 0714 S 27</td><td>BELUM/TIDAK BEKERJA</td><td>PENDEM
RT01 RW15</td><td>PENDEM</td><td>PUCANGANOM</td><td>INDUK</td><td>dr. BUDI
ASHARI</td><td>SUHARNI</td><td>L</td><td>1-4 Thn.</td><td>Datang
2019</td><td>ARDYAS ROSSI
ANANTO</td><td>SUWANTO</td><td>PELAJAR/MAHASISWA</td><td>PORO</td><td>PORO</td><td>
TLOGOSARI</td><td>PKD TLOGOSARI</td><td>RETNO AMBARWATI AMD KEB</td><td> -
></tr><tr><td align='right'>S52.80</td><td>Fracture of other parts of forearm ,
align='right'>56100072</td><td>06-03-2019</td><td>ASIH SETIYOWATI</td><td>WASIS
0610 W 15</td><td>MENGURUS RUMAH TANGGA</td><td>TANGGUNG RT03
></tr><tr><td align='right'>Z00.8</td><td>Other general
examinations</td><td></td><td align='right'>289548</td><td
align='right'>14140698</td><td>06-03-2019</td><td>ASSANI NUGROHO</td><td>ASSANI
NUGROHO 1414 A 01</td><td>PEGAWAI NEGERI
SIPIL</td><td>WONOGIRI</td><td></td><td>WONOGIRI</td><td>INDUK</td><td>dr. BUDI
align='right'>52105032</td><td>06-03-2019</td><td>ATIK
SURYANINGSIH</td><td>SUWANTO</td><td>PETANI/PEKEBUN</td><td>PORO</td><td>PORO</td><
td>TLOGOSARI</td><td>PKD TLOGOSARI</td><td>RETNO AMBARWATI AMD KEB</td><td> -
></tr><tr><td align='right'>Z00.6</td><td>Examination for normal comparison and
control in clinical research programme</td><td></td><td
align='right'>289547</td><td align='right'>57100133</td><td>06-03-2019</td><td>AYU
OKTAVIANINGSIH</td><td>LESTARI 07 10 L 02</td><td>BELUM/TIDAK
BEKERJA</td><td>JEPURUN RT 02 RW
align='right'>52087114</td><td>06-03-2019</td><td>GALANG EKO
PRASETYO</td><td></td><td>PELAJAR/MAHASISWA</td><td>TLOGOSARI</td><td>TLOGOSARI</td
><td>TLOGOSARI</td><td>PUSTU TLOGOSARI</td><td>SULARNO,S.Kep.Ns</td><td> -
tr><tr><td align='right'>R05</td><td>Cough</td><td></td><td
2019</td><td>GHAYDA ADZKIYA NAFIZ</td><td>WANTO 07 05 W 04</td><td>BELUM/TIDAK
BEKERJA</td><td>SUROYOM KULON RT 03 RW 03</td><td>SUKOROYOM
</tr><tr><td align='right'>C76.8</td><td>Malignant neoplasm overlapping other and
ill-defined sites</td><td></td><td align='right'>289561</td><td
align='right'>56100415</td><td>06-03-2019</td><td>HESTI
PARAMITARADYASTUTI</td><td>BUDIYONO 0610 B 04</td><td>WIRASWASTA</td><td>TANGGUNG
RT03 RW05</td><td>TANGGUNG</td><td>GIRITONTRO</td><td>INDUK</td><td>dr. BUDI
2019</td><td>KANIYEM</td><td></td><td>PETANI/PEKEBUN</td><td>BLEBER</td><td>BLEBER<
/td><td>NGARGOHARJO</td><td>PUSTU NGARGOHARJO</td><td>SUSI HERAWATI, AMK</td><td> -
2019</td><td>KANIYEM</td><td></td><td>PETANI/PEKEBUN</td><td>BLEBER</td><td>BLEBER<
/td><td>NGARGOHARJO</td><td>PUSTU NGARGOHARJO</td><td>SUSI HERAWATI, AMK</td><td> -
align='right'>52057004</td><td>06-03-
2019</td><td>KARTI</td><td></td><td>PETANI/PEKEBUN</td><td>GLAGAH</td><td>GLAGAH</t
align='right'>52057013</td><td>06-03-
2019</td><td>KATINEM</td><td>NYOTO</td><td>PETANI/PEKEBUN</td><td>GLAGAH</td><td>GL
AGAH</td><td>TLOGOSARI</td><td>PUSTU TLOGOSARI</td><td>SULARNO,S.Kep.Ns</td><td> -
</td><td>P</td><td>55-59 Thn.</td><td>Datang Sendiri</td><td>Lama</td><td>UMUM
2019</td><td>KATMIN</td><td>KATMIN 00405 K
01</td><td>PETANI/PEKEBUN</td><td>DOLOGAN RT01
RW02</td><td>DOLOGAN</td><td>BAYEMHARJO</td><td>INDUK</td><td>dr.
d></tr><tr><td align='right'>F20.6</td><td>Simple schizophrenia</td><td></td><td
2019</td><td>MARYANTI</td><td>MISDI 07 02 M 10</td><td>LAINNYA</td><td>SUKOROYOM
WETAN RT 02 RW 04</td><td>SUKOROYOM
></tr><tr><td align='right'>A15.4</td><td>Tuberculosis of intrathoracic lymph
nodes, confirmed bacteriologically and histologically</td><td></td><td
2019</td><td>MISNO</td><td>MISNO 0411 M 03</td><td>PETANI/PEKEBUN</td><td>GUWO
RT03 RW06</td><td>GUWO</td><td>BAYEMHARJO</td><td>INDUK</td><td>dr. BUDI
align='right'>57020088</td><td>06-03-2019</td><td>MUHAMMAD EVAN
RUSNADI</td><td>SUTRISNO 0702 S 04</td><td>PERANGKAT DESA</td><td>SUKOROYOM
WETAN</td><td>SUKOROYOM WETAN</td><td>PUCANGANOM</td><td>INDUK</td><td>dr. BUDI
2019</td><td>MULYANI</td><td>SIHONO 02 11 S 17</td><td>LAINNYA</td><td>TAMBAK
RT01 RW02</td><td>TAMBAK</td><td>TLOGOSARI</td><td>INDUK</td><td>dr. BUDI
align='right'>51137004</td><td>06-03-2019</td><td>NANDA ADITYA
SAPUTRA</td><td></td><td>PELAJAR/MAHASISWA</td><td>GEDANGAN</td><td>GEDANGAN</td><t
d>NGARGOHARJO</td><td>PUSTU NGARGOHARJO</td><td>SUSI HERAWATI, AMK</td><td> -
</tr><tr><td align='right'>R05</td><td>Cough</td><td></td><td
2019</td><td>PINSA</td><td></td><td>PELAJAR/MAHASISWA</td><td>KARANG
align='right'>H58.8</td><td>Other specified disorders of eye and adnexa in diseases
classified elsewhere</td><td></td><td align='right'>289559</td><td
align='right'>56060084</td><td>06-03-2019</td><td>PONIJAH</td><td>SULARDI 0606 S
23</td><td>PETANI/PEKEBUN</td><td>GOBOH RT01
RW06</td><td>GOBOH</td><td>GIRITONTRO</td><td>INDUK</td><td>dr. BUDI
align='right'>51010093</td><td>06-03-2019</td><td>RAFA WAHYU
RAMADHAN</td><td>UNTORO HERU SAPUTRO</td><td>PELAJAR/MAHASISWA</td><td>PELET RT01
RW02,NGARGOHARJO</td><td>PELET</td><td>NGARGOHARJO</td><td>PUSTU
NGARGOHARJO</td><td>SUSI HERAWATI, AMK</td><td> - </td><td>L</td><td>5-9
</tr><tr><td align='right'>Z34.8</td><td>Supervision of other normal
align='right'>52110045</td><td>06-03-2019</td><td>RANI NURANI</td><td>DENI SAPUTRA
0211 D 04</td><td>MENGURUS RUMAH TANGGA</td><td>TAMBAK RT01
align='right'>L23</td><td>Allergic contact dermatitis</td><td></td><td
2019</td><td>RAYYASIVA SRENGENGE NUGRAHA</td><td>WAHYU NUGROHO 06 01 W
06</td><td>PELAJAR/MAHASISWA</td><td>GIRITONTRO LOR RT02
RW02</td><td></td><td>GIRITONTRO</td><td>INDUK</td><td>dr. BUDI
align='right'>289555</td><td align='right'>57050139</td><td>06-03-2019</td><td>RINI
WIDI ASTUTI</td><td>SUGIYONO 0705 S 02</td><td>MENGURUS RUMAH
TANGGA</td><td>SUKOROYOM KULON</td><td>SUKOROYOM
align='right'>289555</td><td align='right'>57050139</td><td>06-03-2019</td><td>RINI
WIDI ASTUTI</td><td>SUGIYONO 0705 S 02</td><td>MENGURUS RUMAH
TANGGA</td><td>SUKOROYOM KULON</td><td>SUKOROYOM
align='right'>52080113</td><td>06-03-2019</td><td>RUSILAH</td><td>SOGIMIN 02 08 S
31</td><td>PETANI/PEKEBUN</td><td>TLOGOSARI 01
RW05</td><td>TLOGOSARI</td><td>TLOGOSARI</td><td>INDUK</td><td>dr. BUDI
align='right'>51035001</td><td>06-03-
2019</td><td>SARTINI</td><td>TEMIN</td><td>PETANI/PEKEBUN</td><td>PRINGKUKU</td><td
>PRINGKUKU</td><td>NGARGOHARJO</td><td>PUSTU NGARGOHARJO</td><td>SUSI HERAWATI,
AMK</td><td> - </td><td>P</td><td>55-59 Thn.</td><td>Datang
></tr><tr><td align='right'>L24.4</td><td>Irritant contact dermatitis due to drugs
in contact with skin</td><td></td><td align='right'>289544</td><td
align='right'>55010282</td><td>06-03-2019</td><td>SINO</td><td>SINO 05 01 S
09</td><td>PETANI/PEKEBUN</td><td>GIRIBELAH RT01
RW07</td><td>GIRIBELAH</td><td>JATIREJO</td><td>INDUK</td><td>dr.
BUDI ASHARI</td><td>SUGIYONO,S.Kep.Ns</td><td>L</td><td>>70 Thn.</td><td>Datang
/td></tr><tr><td align='right'>M79.04</td><td>Rheumatism, unspecified,
hand</td><td></td><td align='right'>289544</td><td
align='right'>55010282</td><td>06-03-2019</td><td>SINO</td><td>SINO 05 01 S
/td></tr><tr><td align='right'>J45.8</td><td>Mixed asthma</td><td></td><td
2019</td><td>SOGIYEM</td><td>SOGIYEM 0507 S
09</td><td>PETANI/PEKEBUN</td><td>NGELOSASRI RT.01
RW.03</td><td>NGELOSARI</td><td>JATIREJO</td><td>INDUK</td><td>dr. BUDI
></tr><tr><td align='right'>K12.1</td><td>Other forms of
stomatitis</td><td></td><td align='right'>289616</td><td
align='right'>51027079</td><td>06-03-2019</td><td>SRI
LESTARI</td><td>SUYATNO</td><td>PETANI/PEKEBUN</td><td>NGRINGIN</td><td>NGRINGIN</t
d><td>NGARGOHARJO</td><td>PUSTU NGARGOHARJO</td><td>SUSI HERAWATI, AMK</td><td> -
</tr><tr><td align='right'>I11.9</td><td>Hypertensive heart disease without
align='right'>56030116</td><td>06-03-2019</td><td>SUGIARTO</td><td>SUGIARTO 0603 S
32</td><td>PENSIUNAN</td><td>GEBLUG RT04
RW07</td><td></td><td>GIRITONTRO</td><td>INDUK</td><td>dr. BUDI
2019</td><td>SUKARMI</td><td>SUKARMI</td><td>PENSIUNAN</td><td>GENTUNG</td><td>GENT
UNG</td><td>NGARGOHARJO</td><td>PUSTU NGARGOHARJO</td><td>SUSI HERAWATI,
align='right'>51057020</td><td>06-03-
UNG</td><td>NGARGOHARJO</td><td>PUSTU NGARGOHARJO</td><td>SUSI HERAWATI,
2019</td><td>SUKATI</td><td>PARDI</td><td>PETANI/PEKEBUN</td><td>GENTUNG</td><td>GE
NTUNG</td><td>NGARGOHARJO</td><td>PUSTU NGARGOHARJO</td><td>SUSI HERAWATI,
></tr><tr><td align='right'>L24.8</td><td>Irritant contact dermatitis due to other
agents</td><td></td><td align='right'>289615</td><td
align='right'>51017035</td><td>06-03-2019</td><td>SUKIRAH</td><td>EKO WINARNO 0101
E 01</td><td>BURUH HARIAN LEPAS</td><td>PELET RT01 RW
02</td><td>PELET</td><td>NGARGOHARJO</td><td>PUSTU NGARGOHARJO</td><td>SUSI
HERAWATI, AMK</td><td> - </td><td>P</td><td>20-44 Thn.</td><td>Datang
agents</td><td></td><td align='right'>290369</td><td
align='right'>51017035</td><td>06-03-2019</td><td>SUKIRAH</td><td>EKO WINARNO 0101
E 01</td><td>BURUH HARIAN LEPAS</td><td>PELET RT01 RW
02</td><td>PELET</td><td>NGARGOHARJO</td><td>PUSTU NGARGOHARJO</td><td>SUSI
HERAWATI, AMK</td><td> - </td><td>P</td><td>20-44 Thn.</td><td>Datang
align='right'>55010244</td><td>06-03-2019</td><td>SULARNI</td><td>SRI HARDONO 05 01
S 52</td><td>MENGURUS RUMAH TANGGA</td><td>GIRIBELAH RT03
2019</td><td>SULARNO</td><td>SULARNO 0601 S
02</td><td>PETANI/PEKEBUN</td><td>GIRITONTRO LOR</td><td>GIRITONTRO
2019</td><td>SULARSI</td><td>MISWANTO 0601 M
></tr><tr><td align='right'>M79.15</td><td>Myalgia, pelvic and
align='right'>56020129</td><td>06-03-2019</td><td>SUPRIHATMINI</td><td>SUROTO 0602
S 46</td><td>PETANI/PEKEBUN</td><td>GIRITONTRO KIDUL</td><td>GIRITONTRO
></tr><tr><td align='right'>N20.2</td><td>Calculus of kidney with calculus of
ureter</td><td></td><td align='right'>289551</td><td
align='right'>54060104</td><td>06-03-2019</td><td>SURIP UTAMI</td><td>SURIP UTAMI
0406 S 22</td><td>PETANI/PEKEBUN</td><td>BAYEM RT01
RW01</td><td>BAYEM</td><td>BAYEMHARJO</td><td>INDUK</td><td>dr. BUDI
Sendiri</td><td>Baru</td><td>JAMKESDA</td><td>Rujuk</td><td align='right'>7</td><td
align='right'>3</td><td align='right'>45</td><td>BP. Umum</td><td>Poli
Dalam</td><td>RS MAGUAN HUSADA</td><td>Dalam
/td></tr><tr><td align='right'>K29.5</td><td>Chronic gastritis,
align='right'>57100136</td><td>06-03-2019</td><td>SUYARTI</td><td>BARNO 07 10 B
02</td><td>PETANI/PEKEBUN</td><td>JEPURUN RT02 RW
10</td><td>JEPURUN</td><td>PUCANGANOM</td><td>INDUK</td><td>dr. BUDI
ASHARI</td><td>SUGIYONO,S.Kep.Ns</td><td>P</td><td>20-44
align='right'>52105005</td><td>06-03-
2019</td><td>SUYATMI</td><td>SUPRIYONO</td><td>PETANI/PEKEBUN</td><td>PORO</td><td>
PORO</td><td>TLOGOSARI</td><td>PKD TLOGOSARI</td><td>RETNO AMBARWATI AMD
></tr><tr><td align='right'>L24</td><td>Irritant contact
dermatitis</td><td></td><td align='right'>289567</td><td
align='right'>56010086</td><td>06-03-2019</td><td>TITIEK MULYANI</td><td>SUKINO
0601 S 25</td><td>PETANI/PEKEBUN</td><td>GIRITONTRO LOR</td><td>GIRITONTRO
align='right'>51055035</td><td>06-03-
2019</td><td>TUKINO</td><td>TUKINO</td><td>PETANI/PEKEBUN</td><td>GENTUNG</td><td>G
ENTUNG</td><td>NGARGOHARJO</td><td>PUSTU NGARGOHARJO</td><td>SUSI HERAWATI,
AMK</td><td> - </td><td>L</td><td>>70 Thn.</td><td>Datang
align='right'>55020104</td><td>06-03-2019</td><td>TUKIYEM</td><td>TUKIYEM 0502 T
06</td><td>BELUM/TIDAK BEKERJA</td><td>GIRIROTO RT02
RW06</td><td>GIRIROTO</td><td>JATIREJO</td><td>INDUK</td><td>dr. BUDI
2019</td><td>WINARNO</td><td>WINARNO</td><td>PETANI/PEKEBUN</td><td>GENTUNG</td><td
WIDIYASTUTI</td><td> - </td><td>L</td><td>55-59 Thn.</td><td>Datang
align='right'>51055026</td><td>06-03-
2019</td><td>WINARNO</td><td>WINARNO</td><td>PETANI/PEKEBUN</td><td>GENTUNG</td><td
></tr><tr><td align='right'>S90.2</td><td>Contusion of toe(s) with damage to
></tr><tr><td align='right'>K29</td><td>Gastritis and duodenitis</td><td></td><td
align='right'>289566</td><td align='right'>56065024</td><td>06-03-2019</td><td>YUGO
LARE VITIANTO</td><td>HARMANTO 0604 H
04</td><td>PELAJAR/MAHASISWA</td><td>GOBOH</td><td>GOBOH</td><td>GIRITONTRO</td><td
>INDUK</td><td>dr. BUDI ASHARI</td><td>SUGIYONO,S.Kep.Ns</td><td>P</td><td>5-9
align='right'>57030054</td><td>08-03-2019</td><td>ABDUL ROSID</td><td> ROSID 07 03
R 04</td><td>PETANI/PEKEBUN</td><td>KUWANG RT03 RW
align='right'>55040008</td><td>08-03-2019</td><td>ANING PULUNGSARI</td><td>PEPRI
05 04 P 02</td><td>PETANI/PEKEBUN</td><td>KANIGORO RT02
RW01</td><td>KANIGORO</td><td>JATIREJO</td><td>INDUK</td><td>dr. BUDI
></tr><tr><td align='right'>Z23.5</td><td>Need for immunization against tetanus
alone</td><td></td><td align='right'>289574</td><td
align='right'>55040008</td><td>08-03-2019</td><td>ANING PULUNGSARI</td><td>PEPRI
05 04 P 02</td><td>PETANI/PEKEBUN</td><td>KANIGORO RT02
></tr><tr><td align='right'>H60.5</td><td>Acute otitis externa,
noninfective</td><td></td><td align='right'>289592</td><td
align='right'>57030102</td><td>08-03-2019</td><td>ASMANAH</td><td>SUGIHARTO 0703
S 04</td><td>MENGURUS RUMAH TANGGA</td><td>KUWANG RT 02 RW
align='right'>56080312</td><td>08-03-2019</td><td>DESI WAHYUNI</td><td>KATIMIN 0608
K 11</td><td>WIRASWASTA</td><td>DUNGKLEPU WETAN RT 01 RW 04</td><td>DUNG KLEPU
WETAN</td><td>GIRITONTRO</td><td>INDUK</td><td>dr. BUDI ASHARI</td><td>RISTINA Amd
Keb</td><td>P</td><td>20-44 Thn.</td><td>Datang Sendiri</td><td>Lama</td><td>UMUM
align='right'>J45.9</td><td>Asthma, unspecified</td><td></td><td
/td></tr><tr><td align='right'>E11.4</td><td>Non-insulin-dependent diabetes
mellitus with neurological complications</td><td></td><td
align='right'>289618</td><td align='right'>53080093</td><td>08-03-2019</td><td>ENOH
SAPUTRA</td><td>ENOH SAPUTRA 0308 E 02</td><td>SOPIR</td><td>GINADE KULON RT01
RW03</td><td>GINADE KULON</td><td>TLOGOHARJO</td><td>INDUK</td><td>dr. BUDI
Sendiri</td><td>Baru</td><td>BPJS
></tr><tr><td align='right'>J11.1</td><td>Influenza with other respiratory
manifestations, virus not identified</td><td></td><td align='right'>289618</td><td
align='right'>53080093</td><td>08-03-2019</td><td>ENOH SAPUTRA</td><td>ENOH SAPUTRA
0308 E 02</td><td>SOPIR</td><td>GINADE KULON RT01 RW03</td><td>GINADE
KULON</td><td>TLOGOHARJO</td><td>INDUK</td><td>dr. BUDI
></tr><tr><td align='right'>A09</td><td>Diarrhoea and gastroenteritis of presumed
infectious origin</td><td></td><td align='right'>289620</td><td
align='right'>57160018</td><td>08-03-2019</td><td>HARMADI</td><td>WAGIMAN 0716 W
02</td><td>PETANI/PEKEBUN</td><td>SAWIT LOR</td><td>SAWIT
align='right'>H25.9</td><td>Senile cataract, unspecified</td><td></td><td
2019</td><td>HARYANTO</td><td>HARYANTO 0705 H
08</td><td>WIRASWASTA</td><td>SUKOROYOM KULON RT01 RW03</td><td>SUKOROYOM
></tr><tr><td align='right'>Z96.1</td><td>Presence of intraocular
lens</td><td></td><td align='right'>289598</td><td
align='right'>52130071</td><td>08-03-2019</td><td>JAMI</td><td>MISRI 0213 M
04</td><td>PETANI/PEKEBUN</td><td>KERJO RT03 RW
03</td><td>KERJO</td><td>TLOGOSARI</td><td>INDUK</td><td>dr. BUDI
ASHARI</td><td>SUWARTO,S.Kep.Nes</td><td>P</td><td>0-7 hari</td><td>Datang
align='right'>52060006</td><td>08-03-2019</td><td>JUMI</td><td>SAIMIN 02 06 S
align='right'>289576</td><td align='right'>57020081</td><td>08-03-2019</td><td>LENI
WULANSARI</td><td>SUNARDI 0702 S 28</td><td>MENGURUS RUMAH
TANGGA</td><td>SUKOROYOM WETAN</td><td>SUKOROYOM
></tr><tr><td align='right'>A15</td><td>Respiratory tuberculosis, bacteriologically
and histologically confirmed</td><td></td><td align='right'>289585</td><td
ASHARI</td><td>SULARNO,S.Kep.Ns</td><td>L</td><td>60-69 Thn.</td><td>Datang
></tr><tr><td align='right'>Z02.8</td><td>Other examinations for administrative
purposes</td><td></td><td align='right'>289586</td><td
align='right'>57050369</td><td>08-03-2019</td><td>MUFIDA KURNIANINGSING
</td><td>MUFID ABI SUTRISNO 0705 M 18</td><td>PETANI/PEKEBUN</td><td>SUKOROYOM
KULON</td><td>PUCANGANOM</td><td>INDUK</td><td>dr. BUDI ASHARI</td><td>RISTINA Amd
Keb</td><td>P</td><td>45-54 Thn.</td><td>Datang Sendiri</td><td>Baru</td><td>UMUM
align='right'>N60.2</td><td>Fibroadenosis of breast</td><td></td><td
2019</td><td>NARISEM</td><td>WARSINO 0603 W 02</td><td>MENGURUS RUMAH
TANGGA</td><td>GEBLUG RT04
align='right'>K29.3</td><td>Chronic superficial gastritis</td><td></td><td
2019</td><td>PAINAH</td><td>PAINAH 07 04 P
></tr><tr><td align='right'>D36.9</td><td>Benign neoplasm of unspecified
align='right'>52060034</td><td>08-03-2019</td><td>PURNOMO</td><td>PURNOMO 0206 P
01</td><td>PERANGKAT DESA</td><td>BERGUNG RT01
Sendiri</td><td>Baru</td><td>BPJS NON PBI</td><td>Rujuk</td><td
align='right'>57050370</td><td>08-03-2019</td><td>PURWADI</td><td>MUFIDA ABI
SUTRISNO 0705 M 18</td><td>KARYAWAN SWASTA</td><td>SUKOROYOM KULON RT02
align='right'>289595</td><td align='right'>57070197</td><td>08-03-2019</td><td>RENI
DEVI NUR HIDAYATI</td><td>SEMAN 0707 S 38</td><td>PETANI/PEKEBUN</td><td>BANJAR
RT02/05</td><td>BANJAR</td><td>PUCANGANOM</td><td>INDUK</td><td>dr. BUDI
></tr><tr><td align='right'>M79.03</td><td>Rheumatism, unspecified,
forearm</td><td></td><td align='right'>289588</td><td
align='right'>56050108</td><td>08-03-2019</td><td>RIYADI</td><td>RIYADI 0605 R
01</td><td>PETANI/PEKEBUN</td><td>NGUJUNG</td><td>NGUJUNG</td><td>GIRITONTRO</td><t
d>INDUK</td><td>dr. BUDI ASHARI</td><td>SUGIYONO,S.Kep.Ns</td><td>L</td><td>45-54
align='right'>52115018</td><td>08-03-
2019</td><td>RUKON</td><td>RUKON</td><td>PETANI/PEKEBUN</td><td>TAMBAK</td><td>TAMB
AK</td><td>TLOGOSARI</td><td>PKD TLOGOSARI</td><td>RETNO AMBARWATI AMD KEB</td><td>
- </td><td>L</td><td>>70 Thn.</td><td>Datang Sendiri</td><td>Lama</td><td>BPJS
</tr><tr><td align='right'>R51</td><td>Headache</td><td></td><td
2019</td><td>RUKON</td><td>RUKON</td><td>PETANI/PEKEBUN</td><td>TAMBAK</td><td>TAMB
</tr><tr><td align='right'>I11</td><td>Hypertensive heart disease</td><td></td><td
2019</td><td>SAINEM</td><td>TAMAN 0610 T
05</td><td>PETANI/PEKEBUN</td><td>TANGGUNGRT02
align='right'>57050029</td><td>08-03-2019</td><td>SALAMUN</td><td>SALAMUN 07 05 S
36</td><td>PETANI/PEKEBUN</td><td>SUKOROYOM KULON RT 01 RW 03</td><td>SUKOROYOM
></tr><tr><td align='right'>S01.3</td><td>Open wound of ear</td><td></td><td
2019</td><td>SARJU</td><td>SARJU 0607 S 14</td><td>PETANI/PEKEBUN</td><td>DUNG
KANCIL</td><td>DUNG KANCIL</td><td>GIRITONTRO</td><td>INDUK</td><td>dr. BUDI
align='right'>56070117</td><td>08-03-2019</td><td>SARJU</td><td>SARJU 0607 S
14</td><td>PETANI/PEKEBUN</td><td>DUNG KANCIL</td><td>DUNG
align='right'>K29.3</td><td>Chronic superficial gastritis</td><td></td><td
2019</td><td>SARMI</td><td>MESRAN 5702 M
04</td><td>PELAJAR/MAHASISWA</td><td>SUKOROYOM KULON</td><td>SUKOROYOM
2019</td><td>SARMI</td><td>KEMIN</td><td>PETANI/PEKEBUN</td><td>PORO</td><td>PORO</
td><td>TLOGOSARI</td><td>PKD TLOGOSARI</td><td>RETNO AMBARWATI AMD KEB</td><td> -
align='right'>56010077</td><td>08-03-2019</td><td>SRI HARTINI</td><td>SUPARNO 06
01 S 13</td><td>MENGURUS RUMAH TANGGA</td><td>GIRITONTRO LORRT 03 RW
01</td><td>GIRITONTRO LOR</td><td>GIRITONTRO</td><td>INDUK</td><td>dr. BUDI
></tr><tr><td align='right'>M62.95</td><td>Disorder of muscle, unspecified, pelvic
region and thigh</td><td></td><td align='right'>289572</td><td
align='right'>55020036</td><td>08-03-2019</td><td>SUKATI</td><td>SUKIJO 05 02 S
06</td><td>PETANI/PEKEBUN</td><td>GIRIROTO RT 01 RW
align='right'>56055043</td><td>08-03-2019</td><td>SUNARSI</td><td>MUDJIYONO 0605
M 08</td><td>MENGURUS RUMAH
TANGGA</td><td>NGUJUNG</td><td></td><td>GIRITONTRO</td><td>INDUK</td><td>dr. BUDI
></tr><tr><td align='right'>S50</td><td>Superficial injury of
09</td><td>KARYAWAN
align='right'>M79.04</td><td>Rheumatism, unspecified, hand</td><td></td><td
2019</td><td>SURIP</td><td>SUDADI 01 08 S
6</td><td>PETANI/PEKEBUN</td><td>NGADIREJO RT 02 RW
04</td><td>NGADIREJO</td><td>NGARGOHARJO</td><td>INDUK</td><td>dr. BUDI
align='right'>57150059</td><td>08-03-2019</td><td>SUTARNO</td><td>SUTARNO 0715 S
18</td><td>PETANI/PEKEBUN</td><td>SAWIT KIDUL RT02 RW14</td><td>SAWIT
/td></tr><tr><td align='right'>J45</td><td>Asthma</td><td></td><td
align='right'>53030066</td><td>08-03-2019</td><td>TRI MARSINI</td><td>KATNO 03 03
K 06</td><td>PENSIUNAN</td><td>JAJAR RT03
RW01</td><td>JAJAR</td><td>TLOGOHARJO</td><td>INDUK</td><td>dr. BUDI
></tr><tr><td align='right'>H40.0</td><td>Glaucoma suspect</td><td></td><td
2019</td><td>TUINAH</td><td>MISNO 0511 M 05</td><td>PETANI/PEKEBUN</td><td>BUWENG
</td><td>BUWENG</td><td>JATIREJO</td><td>INDUK</td><td>dr. BUDI
with renal complications</td><td></td><td align='right'>289597</td><td
align='right'>57070005</td><td>08-03-2019</td><td>TUKINI</td><td>TURYANTO 0707 T
07</td><td>PEDAGANG</td><td>BANJAR RT 03
RW05</td><td>BANJAR</td><td>PUCANGANOM</td><td>INDUK</td><td>dr. BUDI
align='right'>54060057</td><td>08-03-2019</td><td>WAHYU SAYEKTI</td><td>SUPARMAN
0406 S 04</td><td>BURUH HARIAN LEPAS</td><td>BAYEM RT02
></tr><tr><td align='right'>K04.1</td><td>Necrosis of pulp</td><td></td><td
2019</td><td>WALTINI</td><td>YATNO 06 01 Y 01</td><td>MENGURUS RUMAH
TANGGA</td><td>GIRITONTRO LOR RT02 RW02</td><td>GIRITONTRO
align='right'>57060104</td><td>09-03-2019</td><td>AUFA ALTHAP ZAFIR</td><td>SUJONO
07 06 S 12</td><td>BELUM/TIDAK BEKERJA</td><td>TAMBAHSARI RT 02 RW
07</td><td>TAMBAHSARI</td><td>PUCANGANOM</td><td>INDUK</td><td>dr. BUDI
2019</td><td>AYESHA IFRA MIKYLA</td><td>SURATNO 07 06 S 23</td><td>BELUM/TIDAK
BEKERJA</td><td>TAMBAHSARI RT 02 RW
07</td><td></td><td>PUCANGANOM</td><td>INDUK</td><td>dr. BUDI ASHARI</td><td>SRI
MURWATININGSIH</td><td>P</td><td><1 Thn.</td><td>Datang
align='right'>R50.9</td><td>Fever, unspecified</td><td></td><td
align='right'>289634</td><td align='right'>57040277</td><td>09-03-2019</td><td>DEA
AYU MAHARANI</td><td>WASDI 07 04 W 08</td><td>BELUM/TIDAK BEKERJA</td><td>MANDEYAN
RT 04 RW 01</td><td>MANDEYAN</td><td>PUCANGANOM</td><td>INDUK</td><td>dr. BUDI
ASHARI</td><td>SRI SUPATMI</td><td>P</td><td><1 Thn.</td><td>Datang
align='right'>289623</td><td align='right'>54110054</td><td>09-03-2019</td><td>DEWI
HARTANTI</td><td>ARI INRAWANTO 0411 A 01</td><td>BURUH HARIAN
LEPAS</td><td>GUWO RT03
td></tr><tr><td align='right'>J11.8</td><td>Influenza with other manifestations,
align='right'>57020185</td><td>09-03-2019</td><td>EKA SELI</td><td>SUPANTO 0702 S
18</td><td></td><td>SUKOROYOM WETAN</td><td>SUKOROYOM
align='right'>M79.10</td><td>Myalgia, multiple sites</td><td></td><td
align='right'>289624</td><td align='right'>57030124</td><td>09-03-2019</td><td>ERNI
SULISTYANINGSIH</td><td>BUDI 07 03 B 07</td><td>BURUH HARIAN LEPAS</td><td>KUWANG
RT 04 RW 06</td><td>KUWANG</td><td>PUCANGANOM</td><td>INDUK</td><td>dr. BUDI
align='right'>57030238</td><td>09-03-2019</td><td>EXEL</td><td>BUDI SANTOSO 0703
B 07</td><td>BELUM/TIDAK BEKERJA</td><td>KUWANG RT 04 RW
align='right'>55080102</td><td>09-03-2019</td><td>KARIYAH</td><td>KASMAN 0508 K
07</td><td>PETANI/PEKEBUN</td><td>NGORODOWO RT04
RW03</td><td>NGORODOWO</td><td>JATIREJO</td><td>INDUK</td><td>dr. BUDI
align='right'>52095006</td><td>09-03-
2019</td><td>KATIYAH</td><td>KATIYAH</td><td>PETANI/PEKEBUN</td><td>KLEPU</td><td>K
LEPU</td><td>TLOGOSARI</td><td>PKD TLOGOSARI</td><td>RETNO AMBARWATI AMD
align='right'>57010282</td><td>09-03-2019</td><td>LUKI KANSA ALFAYAT</td><td>WASINO
0701 W 01</td><td>PELAJAR/MAHASISWA</td><td>GROGOL RT02
align='right'>57090168</td><td>09-03-2019</td><td>MUHAMMAD BAHTIAR AL
GHIFARI</td><td>SUKATNO 0709 S 02</td><td>BELUM/TIDAK BEKERJA</td><td>PUCANGANOM
LOR RT03 RW09</td><td>PUCANGANOM LOR</td><td>PUCANGANOM</td><td>INDUK</td><td>dr.
BUDI ASHARI</td><td>SRI MURWATININGSIH</td><td>L</td><td>1-4 Thn.</td><td>Datang
align='right'>15151306</td><td>09-03-2019</td><td>NOVI MAHDALENI</td><td>PARSINAH
15 15 P 03</td><td>LAINNYA</td><td>KUSAMBI RT04
RW13</td><td></td><td>JAKARTA</td><td>INDUK</td><td>dr. BUDI
align='right'>H65</td><td>Nonsuppurative otitis media</td><td></td><td
2019</td><td>PUJIYONO</td><td>PUJIYONO 07 01 P
03</td><td>PETANI/PEKEBUN</td><td>GROGOL RT 03 RW
02</td><td>GROGOL</td><td>PUCANGANOM</td><td>INDUK</td><td>dr. BUDI
align='right'>57100176</td><td>09-03-2019</td><td>RIA AMALIA
RAMADHANI</td><td>BARNO 07 10 B 02</td><td>PELAJAR/MAHASISWA</td><td>JEPURUN RT 01
RW 10</td><td></td><td>PUCANGANOM</td><td>INDUK</td><td>dr. BUDI
align='right'>54080007</td><td>09-03-2019</td><td>SAMIDJO</td><td>SAMIDJO 04 08 S
06</td><td>MENGURUS RUMAH TANGGA</td><td>NGANTAP RT 3 RW
5</td><td>NGANTAP</td><td>BAYEMHARJO</td><td>INDUK</td><td>dr. BUDI
align='right'>57060103</td><td>09-03-2019</td><td>SRI SULASTRI</td><td>SUJONO 0706
S
12</td><td>PEDAGANG</td><td>TAMBAHSARI</td><td>TAMBAHSARI</td><td>PUCANGANOM</td><t
d>INDUK</td><td>dr. BUDI ASHARI</td><td>SUGIYONO,S.Kep.Ns</td><td>P</td><td>20-44
Thn.</td><td>Datang Sendiri</td><td>Lama</td><td>UMUM
align='right'>S51</td><td>Open wound of forearm</td><td></td><td
2019</td><td>SULARSI</td><td>MISWANTO 06 01 M
align='right'>57040256</td><td>09-03-
2019</td><td>SULARSO</td><td>KARMIN/07/04/K/08</td><td>PETANI/PEKEBUN</td><td>MANDE
YAN</td><td></td><td>PUCANGANOM</td><td>INDUK</td><td>dr. BUDI
align='right'>S81</td><td>Open wound of lower leg</td><td></td><td
2019</td><td>WIYATI</td><td>WAKIJO 01 01 W 2</td><td>KARYAWAN
SWASTA</td><td>PELET RT 01 RW
></tr><tr><td align='right'>S81.8</td><td>Open wound of other parts of lower
leg</td><td></td><td align='right'>289694</td><td
align='right'>57010143</td><td>11-03-2019</td><td>ADI PRASETYO</td><td>SRIYANTO
57 01 S 10</td><td>PELAJAR/MAHASISWA</td><td>GROGOL RT01
RW02</td><td>GROGOL</td><td>PUCANGANOM</td><td>INDUK</td><td>drg.DANAR
></tr><tr><td align='right'>S60.0</td><td>Contusion of finger(s) without damage to
align='right'>57120108</td><td>11-03-2019</td><td>ADITYA</td><td>SARJONO 0712 S
09</td><td></td><td>NGAK INGUK</td><td>INGAK -
INGUK</td><td>PUCANGANOM</td><td>INDUK</td><td>dr. BUDI ASHARI</td><td>HENI
WIDIYASTUTI</td><td>L</td><td>1-4 Thn.</td><td>Datang
2019</td><td>AHMAD CHOLID PRASETYO</td><td>SRIYANTO 0701 S 10</td><td>BELUM/TIDAK
BEKERJA</td><td>GROGOL RT01
ASHARI</td><td>SRI SUPATMI</td><td>L</td><td><1 Thn.</td><td>Datang
align='right'>N34.1</td><td>Nonspecific urethritis</td><td></td><td
align='right'>289693</td><td align='right'>57090099</td><td>11-03-2019</td><td>ANA
KHUSNUL KOTIMAH</td><td>PARJIYO 0709 P 01</td><td>KARYAWAN
SWASTA</td><td>PUCANGANOM LOR</td><td>PUCANGANOM
align='right'>55040008</td><td>11-03-2019</td><td>ANING
PULUNGSARI</td><td>PEPRI</td><td>PETANI/PEKEBUN</td><td>KANIGORO</td><td>KANIGORO</
td><td>JATIREJO</td><td>PKD JATIREJO</td><td>SUHARNI</td><td> -
align='right'>K04.1</td><td>Necrosis of pulp</td><td></td><td
2019</td><td>APRILIA PUJI LESTARI</td><td>PUJI MULYANTO</td><td>PERANGKAT
DESA</td><td>JRPURUN</td><td>JEPURUN</td><td>PUCANGANOM</td><td>INDUK</td><td>drg.D
Thn.</td><td>Datang Sendiri</td><td>Lama</td><td>BPJS PBI</td><td>Rujuk</td><td
></tr><tr><td align='right'>H00.0</td><td>Hordeolum and other deep inflammation of
eyelid</td><td></td><td align='right'>289685</td><td
align='right'>56010361</td><td>11-03-
2019</td><td>AQILLA</td><td>TRIYONO</td><td></td><td>GIRITOINTRO
LOR</td><td>GIRITONTRO LOR</td><td>GIRITONTRO</td><td>INDUK</td><td>dr. BUDI
align='right'>7</td><td align='right'>2</td><td>KIA</td><td></td><td></td><td>Dalam
align='right'>290791</td><td align='right'>55020079</td><td>11-03-2019</td><td>AYU
FATMASARI</td><td>RIBUT WAHYUDI</td><td>PETANI/PEKEBUN</td><td>GIRIROTO,
JATIREJO</td><td>GIRIROTO</td><td>JATIREJO</td><td>PKD
></tr><tr><td align='right'>S42.20</td><td>Fracture of upper end of humerus,
align='right'>52080124</td><td>11-03-2019</td><td>BELLA S</td><td>SUTASNO 0208 S
35</td><td>PELAJAR/MAHASISWA</td><td>TLOGOSARI RT01
without complications</td><td></td><td align='right'>289659</td><td
align='right'>57040001</td><td>11-03-2019</td><td>BOINEM</td><td>SARINO 0704 S
23</td><td>PETANI/PEKEBUN</td><td>MANDEYAN</td><td>MANDEYAN</td><td>PUCANGANOM</td>
<td>INDUK</td><td>dr. BUDI ASHARI</td><td>SUGIYONO,S.Kep.Ns</td><td>P</td><td>55-59
2019</td><td>BOINEM</td><td>PONIJAN</td><td>PETANI/PEKEBUN</td><td>SUMBERJO</td><td
>SUMBERJO</td><td>TLOGOSARI</td><td>PUSTU
></tr><tr><td align='right'>K01.1</td><td>Impacted teeth</td><td></td><td
align='right'>289703</td><td align='right'>57120136</td><td>11-03-2019</td><td>BUDI
AGUNG NUGROHO</td><td>BUDI AGUNG NUGROHO 07 12 B
01</td><td>PETANI/PEKEBUN</td><td>INGAK INGUK RT 01 RW 16</td><td>INGAK -
INGUK</td><td>PUCANGANOM</td><td>INDUK</td><td>drg.DANAR WULANDARI</td><td>RIZKI
ANISSA, AM.Kg</td><td>L</td><td>20-44 Thn.</td><td>Datang
2019</td><td>CHRISTINA SRI PURWANTI</td><td>FR. SULARSO 07 10 F
01</td><td>PETANI/PEKEBUN</td><td>JEPURUN RT02
></tr><tr><td align='right'>J44.9</td><td>Chronic obstructive pulmonary disease,
align='right'>57070077</td><td>11-03-2019</td><td>DIMIN</td><td>DIMIN 07 07 D
03</td><td>PETANI/PEKEBUN</td><td>BANJAR RT03
/td></tr><tr><td align='right'>L50.9</td><td>Urticaria,
align='right'>52077018</td><td>11-03-2019</td><td>EDI PRIHANI</td><td>HERI
SUWANDI</td><td>PETANI/PEKEBUN</td><td>SUMBERJO</td><td>SUMBERJO</td><td>TLOGOSARI<
/td><td>PUSTU TLOGOSARI</td><td>SULARNO,S.Kep.Ns</td><td> - </td><td>P</td><td>55-
></tr><tr><td align='right'>I50</td><td>Heart failure</td><td></td><td
align='right'>289642</td><td align='right'>53110050</td><td>11-03-2019</td><td>EKO
ARDIANTO PUTRO</td><td>EKO ARDIANTO PUTRO 0311 E
03</td><td>PETANI/PEKEBUN</td><td>GINADE WETAN RT04 RW03</td><td>GINADE
ETAN</td><td>TLOGOHARJO</td><td>INDUK</td><td>dr. BUDI
align='right'>D36.7</td><td>Benign neoplasm of other specified
sites</td><td></td><td align='right'>289687</td><td
align='right'>57010283</td><td>11-03-2019</td><td>EKO PURWANTO</td><td>EKO PURWANTO
0701 E 01</td><td>PETANI/PEKEBUN</td><td>GROGOL RT01
align='right'>55050057</td><td>11-03-2019</td><td>FAJRINA ZAHWA NURILIA
PUTRI</td><td>ARYANTO 0505 A 01</td><td>BELUM/TIDAK
BEKERJA</td><td>PUNUNG</td><td>PUNUNG</td><td>JATIREJO</td><td>INDUK</td><td>drg.DA
NAR WULANDARI</td><td>RIZKI ANISSA, AM.Kg</td><td>P</td><td>5-9 Thn.</td><td>Datang
align='right'>Z34.8</td><td>Supervision
of other normal pregnancy</td><td></td><td align='right'>290797</td><td
align='right'>55030037</td><td>11-03-2019</td><td>FITRI AL HAYATI</td><td>SUTARNO
0503 S 04</td><td>KARYAWAN SWASTA</td><td>SONGGODULANG RT01
RW01</td><td>SONGGODULANG</td><td>JATIREJO</td><td>PKD
align='right'>56020378</td><td>11-03-2019</td><td>FITRIANI</td><td>HERU SULISTYO
0602 H 07</td><td>BURUH HARIAN LEPAS</td><td>GIRITONTRO KIDUL</td><td>GIRITONTRO
align='right'>57030223</td><td>11-03-2019</td><td>GABRIEL RASYA
SAPUTRA</td><td>NUGROHO 0703 N 01</td><td>BELUM/TIDAK BEKERJA</td><td>KUWANG
ASHARI</td><td>SRI SUPATMI</td><td>L</td><td>1-4 Thn.</td><td>Datang
td></tr><tr><td align='right'>M79.29</td><td>Neuralgia and neuritis, unspecified,
site unspecified</td><td></td><td align='right'>289645</td><td
align='right'>57090141</td><td>11-03-2019</td><td>HADI WIYONO</td><td>HADI WIYONO
0709 H 01</td><td>PETANI/PEKEBUN</td><td>PUCANGANOM LOR RT02
2019</td><td>HARTINI</td><td>SUPANTO 0107 S
09</td><td>PETANI/PEKEBUN</td><td>NGASEM RT 02 RW
4</td><td>NGASEM</td><td>NGARGOHARJO</td><td>INDUK</td><td>drg.DANAR
></tr><tr><td align='right'>H10.8</td><td>Other conjunctivitis</td><td></td><td
2019</td><td>JOVANDRA RAFIF RAHANDIKA</td><td>SEMANGUN/DHIKA PURNA
MANGGALA</td><td>BELUM/TIDAK BEKERJA</td><td>GIRITONTRO LOR RT02
ASHARI</td><td>RISTINA Amd Keb</td><td>L</td><td><1 Thn.</td><td>Datang
align='right'>55025014</td><td>11-03-
2019</td><td>JUMADI</td><td>JUMADI</td><td>PETANI/PEKEBUN</td><td>GIRIROTO</td><td>
GIRIROTO</td><td>JATIREJO</td><td>PKD JATIREJO</td><td>SUHARNI</td><td> -
</td><td>L</td><td>60-69 Thn.</td><td>Datang Sendiri</td><td>Lama</td><td>BPJS NON
align='right'>10101063</td><td>11-03-2019</td><td>KALISA RAHMA
DESTIANI</td><td>WAHYU BUDI SANTOSO 10 10 W 06</td><td>BELUM/TIDAK
BEKERJA</td><td>WARU RT01
RW04,JOHUNUT,PARANGGUPITO</td><td></td><td>PARANGGUPITO</td><td>INDUK</td><td>drg.D
align='right'>54080117</td><td>11-03-2019</td><td>KARTI</td><td>MISMAN 04 08 M
02</td><td>PETANI/PEKEBUN</td><td>NGANTAP RT 03 RW
05</td><td>NGANTAP</td><td>BAYEMHARJO</td><td>INDUK</td><td>dr. BUDI
2019</td><td>KATIJEM</td><td>KATIJEM</td><td>PETANI/PEKEBUN</td><td>GIRIROTO</td><t
d>GIRIROTO</td><td>JATIREJO</td><td>PKD JATIREJO</td><td>SUHARNI</td><td> -
align='right'>57100043</td><td>11-03-2019</td><td>KATIMAN</td><td>KATIMAN 0710 K
05</td><td>PETANI/PEKEBUN</td><td>JEPURUN</td><td>JEPURUN</td><td>PUCANGANOM</td><t
d>INDUK</td><td>dr. BUDI ASHARI</td><td>SUGIYONO,S.Kep.Ns</td><td>L</td><td>>70
d></tr><tr><td align='right'>D36.9</td><td>Benign neoplasm of unspecified
align='right'>52130002</td><td>11-03-2019</td><td>KATINAH</td><td>KATENI 0213 K
05</td><td>PETANI/PEKEBUN</td><td>KERJO</td><td>KERJO</td><td>TLOGOSARI</td><td>IND
UK</td><td>dr. BUDI ASHARI</td><td>SUGIYONO,S.Kep.Ns</td><td>P</td><td>55-59
></tr><tr><td align='right'>K29.7</td><td>Gastritis, unspecified</td><td></td><td
2019</td><td>KATINAH</td><td>KATINAH</td><td>PETANI/PEKEBUN</td><td>GLAGAH</td><td>
GLAGAH</td><td>TLOGOSARI</td><td>PUSTU TLOGOSARI</td><td>SULARNO,S.Kep.Ns</td><td>
- </td><td>P</td><td>>70 Thn.</td><td>Datang Sendiri</td><td>Lama</td><td>BPJS
tr><tr><td align='right'>M79.11</td><td>Myalgia, shoulder region</td><td></td><td
2019</td><td>KATINO</td><td>KATINO 04 11 K 03</td><td>PETANI/PEKEBUN</td><td>GUWO
RT03 RW06</td><td>GUWO</td><td>BAYEMHARJO</td><td>INDUK</td><td>dr. BUDI
align='right'>56060106</td><td>11-03-2019</td><td>LAIRE QURENAY
AVIANTI</td><td>HARMANTO 0606 H 04</td><td>BELUM/TIDAK BEKERJA</td><td>GOBOH RT03
RW06</td><td></td><td>GIRITONTRO</td><td>INDUK</td><td>dr. BUDI ASHARI</td><td>SRI
SUPATMI</td><td>P</td><td>1-4 Thn.</td><td>Datang
align='right'>M79.22</td><td>Neuralgia and neuritis, unspecified, upper
arm</td><td></td><td align='right'>289670</td><td
align='right'>57100042</td><td>11-03-2019</td><td>MARSI</td><td>KATIMAN
0710 K 05</td><td>PETANI/PEKEBUN</td><td>JEPURUN RT02
2019</td><td>MIJEM</td><td>SARDI</td><td>PETANI/PEKEBUN</td><td>NGRINGIN</td><td>NG
RINGIN</td><td>NGARGOHARJO</td><td>PUSTU NGARGOHARJO</td><td>SUSI HERAWATI,
/td></tr><tr><td align='right'>K29.6</td><td>Other gastritis</td><td></td><td
2019</td><td>MISIYEM</td><td>SARMO</td><td>PETANI/PEKEBUN</td><td>GENTUNG</td><td>G
ENTUNG</td><td>NGARGOHARJO</td><td>PUSTU NGARGOHARJO</td><td>SUSI HERAWATI,
></tr><tr><td align='right'>M54.50</td><td>Low back pain, multiple
align='right'>56080197</td><td>11-03-2019</td><td>MOHAMMAD SALEH
SUSALEH</td><td>MOHAMMAD SALEH SUSALEH 0608 M
01</td><td>PENSIUNAN</td><td>DUNGKLEPU WETAN RT 02 RW 04</td><td>DUNG KLEPU
WETAN</td><td>GIRITONTRO</td><td>INDUK</td><td>dr. BUDI
2019</td><td>MUKADI</td><td>MUKADI
</td><td>PETANI/PEKEBUN</td><td>PRINGKUKU</td><td>PRINGKUKU</td><td>NGARGOHARJO</td
><td>PUSTU NGARGOHARJO</td><td>SUSI HERAWATI, AMK</td><td> - </td><td>L</td><td>45-
54 Thn.</td><td>Datang Sendiri</td><td>Lama</td><td>BPJS NON
2019</td><td>MUKADI</td><td>MUKADI
</td><td>PETANI/PEKEBUN</td><td>PRINGKUKU</td><td>PRINGKUKU</td><td>NGARGOHARJO</td
><td>PUSTU NGARGOHARJO</td><td>SUSI HERAWATI, AMK</td><td> - </td><td>L</td><td>45-
align='right'>56020541</td><td>11-03-2019</td><td>MULAT
SUSILOWATI</td><td>SUPRIYADI 0602 S 69</td><td>MENGURUS RUMAH
TANGGA</td><td>GIRITONTRO KIDUL RT02 RW03</td><td>GIRITONTRO
align='right'></td><td align='right'></td><td align='right'>55</td><td>BP.
></tr><tr><td align='right'>H81.4</td><td>Verti of central origin</td><td></td><td
2019</td><td>MULYANI</td><td>MULYANI 0702 M
12</td><td>PETANI/PEKEBUN</td><td>SUKOROYOM WETAN RT01 RW04</td><td>SUKOROYOM
align='right'>56010039</td><td>11-03-2019</td><td>NANIK</td><td>TRIYONO 0601 T
align='right'>56010039</td><td>11-03-2019</td><td>NANIK</td><td>TRIYONO 0601 T
d></tr><tr><td align='right'>L20.9</td><td>Atopic dermatitis,
align='right'>56030056</td><td>11-03-2019</td><td>NATIFA ISNA HASIMAH</td><td>DWI
HARTANTO 06 03 D 01</td><td>BELUM/TIDAK BEKERJA</td><td>GEBLUG RT04
align='right'>57060105</td><td>11-03-2019</td><td>NAVINSHA AZARINE
NUGRAHA</td><td>NUGROHO 0703 N
01</td><td></td><td>TAMBAHSARI</td><td></td><td>PUCANGANOM</td><td>INDUK</td><td>dr
. BUDI ASHARI</td><td>SRI SUPATMI</td><td>P</td><td>1-4 Thn.</td><td>Datang
align='right'></td><td align='right'></td><td
align='right'>54080008</td><td>11-03-2019</td><td>NOVAL</td><td>WIYONO 0408 W
01</td><td></td><td>NGANTAP</td><td>NGANTAP</td><td>BAYEMHARJO</td><td>INDUK</td><t
d>dr. BUDI ASHARI</td><td>SUGIYONO,S.Kep.Ns</td><td>L</td><td>5-9
2019</td><td>NOVIANA PUTRI UTAMI</td><td>PUJI UTOMO 0210 P 09</td><td>BELUM/TIDAK
BEKERJA</td><td>PORO RT01
RW01</td><td>PORO</td><td>TLOGOSARI</td><td>INDUK</td><td>drg.DANAR
</tr><tr><td align='right'>Z30.4</td><td>Surveillance of contraceptive
drugs</td><td></td><td align='right'>289709</td><td
align='right'>56030037</td><td>11-03-2019</td><td>NURHAYATI</td><td>DWI HARTANTO
06 03 D 01</td><td>MENGURUS RUMAH TANGGA</td><td>GEBLUG RT04
></tr><tr><td align='right'>K05.3</td><td>Chronic periodontitis</td><td></td><td
2019</td><td>PAIMO</td><td>PAIMO 0511 P
06</td><td>PETANI/PEKEBUN</td><td>BUWENG</td><td>BUWENG</td><td>JATIREJO</td><td>IN
DUK</td><td>drg.DANAR
align='right'>M10.10</td><td>Lead-induced ut, multiple sites</td><td></td><td
2019</td><td>PAIMO</td><td>PAIMO 05 07 P
></tr><tr><td align='right'>I69.4</td><td>Sequelae of stroke, not specified as
haemorrhage or infarction</td><td></td><td align='right'>289702</td><td
align='right'>56050070</td><td>11-03-2019</td><td>PAINO</td><td>PAINO 0605 P
03</td><td>PENSIUNAN</td><td>NGUJUNG</td><td>NGUJUNG</td><td>GIRITONTRO</td><td>IND
UK</td><td>dr. BUDI ASHARI</td><td>SUGIYONO,S.Kep.Ns</td><td>L</td><td>>70
align='right'>53110044</td><td>11-03-2019</td><td>PARMI</td><td>EKO ARDIANTO 0311
E 03</td><td>PETANI/PEKEBUN</td><td>GINADE WETAN RT04 RW03</td><td>GINADE
ETAN</td><td>TLOGOHARJO</td><td>INDUK</td><td>dr. BUDI
2019</td><td>PONEM</td><td>PONEM</td><td>PETANI/PEKEBUN</td><td>PRINGKUKU</td><td>P
RINGKUKU</td><td>NGARGOHARJO</td><td>PUSTU NGARGOHARJO</td><td>SUSI HERAWATI,
AMK</td><td> - </td><td>P</td><td>>70 Thn.</td><td>Datang
align='right'>57020314</td><td>11-03-2019</td><td>PRABOWO SUJANA</td><td>BOWO 07
02 B 04</td><td>PETANI/PEKEBUN</td><td>SUKOROYOM WETAN RT01 RW04</td><td>SUKOROYOM
></tr><tr><td align='right'>J18.0</td><td>Bronchopneumonia,
align='right'>51010093</td><td>11-03-2019</td><td>RAFA WAHYU
RAMADHAN</td><td>UNTORO HERU SAPUTRO 0101 U 01</td><td>BELUM/TIDAK
BEKERJA</td><td>PELET RT01
RW02,NGARGOHARJO</td><td>PELET</td><td>NGARGOHARJO</td><td>INDUK</td><td>dr. BUDI
2019</td><td>RAFEYAN ARSYAD RAFISKY</td><td>MISMAN 0408 M 02</td><td>BELUM/TIDAK
BEKERJA</td><td>NGANTAP RT03
RW05</td><td>NGANTAP</td><td>BAYEMHARJO</td><td>INDUK</td><td>dr. BUDI
ASHARI</td><td>RISTINA Amd Keb</td><td>L</td><td>1-4 Thn.</td><td>Datang
2019</td><td>RIYANI</td><td>DWI HARTANTO</td><td>MENGURUS RUMAH
TANGGA</td><td>TAMBAK</td><td>TAMBAK</td><td>TLOGOSARI</td><td>PKD
TLOGOSARI</td><td>RETNO AMBARWATI AMD KEB</td><td> - </td><td>P</td><td>20-44
2019</td><td>RUKINEM</td><td></td><td>PETANI/PEKEBUN</td><td>GEDANGAN</td><td>GEDAN
GAN</td><td>NGARGOHARJO</td><td>PUSTU NGARGOHARJO</td><td>SUSI HERAWATI,
align='right'>51137010</td><td>11-03-
align='right'>52077003</td><td>11-03-
2019</td><td>SAMINAH</td><td>SUTARNO</td><td>PETANI/PEKEBUN</td><td>SUMBERJO</td><t
d>SUMBERJO</td><td>TLOGOSARI</td><td>PUSTU
align='right'>55020112</td><td>11-03-2019</td><td>SAMINEM</td><td>MISDI 0502 M
06</td><td>PETANI/PEKEBUN</td><td>GIRIROTO RT01
RW06</td><td>GIRIROTO</td><td>JATIREJO</td><td>PKD
2019</td><td>SAMIYEM</td><td>SUMARNO</td><td>PETANI/PEKEBUN</td><td>SUMBERJO</td><t
d>SUMBERJO</td><td>TLOGOSARI</td><td>PUSTU
align='right'>54070010</td><td>11-03-2019</td><td>SARSI</td><td>WARJI 04 07 W
03</td><td>PETANI/PEKEBUN</td><td>NGALURAN RT01 RW
05</td><td>NGALURAN</td><td>BAYEMHARJO</td><td>INDUK</td><td>dr. BUDI
d></tr><tr><td align='right'>K00.6</td><td>Disturbances in tooth
align='right'>56080323</td><td>11-03-2019</td><td>SIFA FAUZIAH</td><td>SEDIYANTO
0608 S 33</td><td>BELUM/TIDAK BEKERJA</td><td>DUNGKLEPU WETAN</td><td>DUNG KLEPU
WETAN</td><td>GIRITONTRO</td><td>INDUK</td><td>drg.DANAR WULANDARI</td><td>RIZKI
Sendiri</td><td>Lama</td><td>Umum</td><td>Rajal</td><td
d></tr><tr><td align='right'>Z34.8</td><td>Supervision of other normal
align='right'>0511</td><td>11-03-2019</td><td>SITI UMI
K</td><td>SUHADI</td><td>MENGURUS RUMAH
TANGGA</td><td>BUWENG</td><td>BUWENG</td><td>JATIREJO</td><td>PKD
align='right'>56100020</td><td>11-03-2019</td><td>SITIK</td><td>TUMIRAN 06 10 T
02</td><td>PETANI/PEKEBUN</td><td>TANGGUNG</td><td>TANGGUNG</td><td>GIRITONTRO</td>
align='right'>57090210</td><td>11-03-2019</td><td>SOLIKIN</td><td>SOLIKIN 07 09 S
39</td><td>PETANI/PEKEBUN</td><td>PUCANGANOM RT 01 RW 09</td><td>PUCANGANOM
MULYONO</td><td>SRI MULYONO 0605 S
></tr><tr><td align='right'>Z30.4</td><td>Surveillance of contraceptive
SURATMI</td><td>WAKIDI</td><td>PETANI/PEKEBUN</td><td>GIRIROTO</td><td>GIRIROTO</td
><td>JATIREJO</td><td>PKD JATIREJO</td><td>SUHARNI</td><td> -
align='right'>56010027</td><td>11-03-2019</td><td>SUKARNI</td><td>BAYU BUDI UTOMO
0601 B 01</td><td>MENGURUS RUMAH TANGGA</td><td>GIRITONTRO LOR RT03
align='right'>55010336</td><td>11-03-2019</td><td>SUKATI</td><td>TUGIMAN 0501 T
2019</td><td>SUKATI</td><td></td><td>PETANI/PEKEBUN</td><td>GEDANGAN</td><td>GEDANG
AN</td><td>NGARGOHARJO</td><td>PUSTU NGARGOHARJO</td><td>SUSI HERAWATI,
2019</td><td>SUKATMI</td><td>WIDODO 0113 W
02</td><td>PETANI/PEKEBUN</td><td>GEDANGAN</td><td>GEDANGAN</td><td>NGARGOHARJO</td
><td>PUSTU NGARGOHARJO</td><td>SUSI HERAWATI, AMK</td><td> - </td><td>P</td><td>45-
align='right'>51130006</td><td>11-03-2019</td><td>SUKATMI</td><td>WIDODO 0113 W
02</td><td>PETANI/PEKEBUN</td><td>GEDANGAN</td><td>GEDANGAN</td><td>NGARGOHARJO</td
><td>PUSTU NGARGOHARJO</td><td>SUSI HERAWATI, AMK</td><td> - </td><td>P</td><td>45-
2019</td><td>SUKIYEM</td><td>KATIM 0407 K
06</td><td>PETANI/PEKEBUN</td><td>NGALURAN</td><td>NGALURAN</td><td>BAYEMHARJO</td>
<td>INDUK</td><td>drg.DANAR WULANDARI</td><td>RIZKI ANISSA,
AM.Kg</td><td>P</td><td>>70 Thn.</td><td>Datang
Sendiri</td><td>Baru</td><td>Umum</td><td>internal rujukan</td><td
align='right'>54070090</td><td>11-03-2019</td><td>SUKIYEM</td><td>KATIM 0407 K
06</td><td>PETANI/PEKEBUN</td><td>NGALURAN</td><td>NGALURAN</td><td>BAYEMHARJO</td>
<td>INDUK</td><td>dr. BUDI ASHARI</td><td>SUGIYONO,S.Kep.Ns</td><td>P</td><td>>70
align='right'>E11.6</td><td>Non-insulin-dependent diabetes mellitus with other
specified complications</td><td></td><td align='right'>289713</td><td
align='right'>52080062</td><td>11-03-2019</td><td>SULARNO</td><td>SULARNO 0208 S
17</td><td>PEGAWAI NEGERI SIPIL</td><td>TLOGOSARI RT01
align='right'>56100225</td><td>11-03-2019</td><td>SULARTO</td><td>SULARTO 0610 S
<td>INDUK</td><td>dr. BUDI ASHARI</td><td>SUGIYONO,S.Kep.Ns</td><td>L</td><td>55-59
</tr><tr><td
align='right'>56010220</td><td>11-03-2019</td><td>SULASTRI</td><td>ASHARI 0601 A
02</td><td>BURUH HARIAN LEPAS</td><td>GIRITONTRO LOR RT.01/01</td><td>GIRITONTRO
align='right'>57095001</td><td>11-03-2019</td><td>SULIYEM</td><td>PARJIYO 0709 P
01</td><td>PETANI/PEKEBUN</td><td>PUCANGANOM LOR RT03 RW09</td><td>PUCANGANOM
2019</td><td>SUMINI</td><td></td><td>PETANI/PEKEBUN</td><td>GEDANGAN</td><td>GEDANG
AN</td><td>NGARGOHARJO</td><td>PUSTU NGARGOHARJO</td><td>SUSI HERAWATI,
align='right'>10101390</td><td>11-03-2019</td><td>SUNARTI</td><td>WAGIMAN 1010 W
07</td><td>PETANI/PEKEBUN</td><td>TLOGOKAJANG</td><td></td><td>PARANGGUPITO</td><td
2019</td><td>SUPARSI</td><td>JIMIN</td><td>PETANI/PEKEBUN</td><td>SUMBERJO</td><td>
SUMBERJO</td><td>TLOGOSARI</td><td>PUSTU
2019</td><td>SUPARTIN</td><td>WARTO
SANTOSO</td><td>PETANI/PEKEBUN</td><td>MULWOSARI</td><td>MULWOSARI</td><td>JATIREJO
</td><td>PKD JATIREJO</td><td>SUHARNI</td><td> - </td><td>P</td><td>45-54
align='right'>55080103</td><td>11-03-2019</td><td>SURAHMANTO</td><td>SURAHMANTO
0508 S 06</td><td>PETANI/PEKEBUN</td><td>NGORODOWO RT04
2019</td><td>SURATMI</td><td>SUTARDI 0102 S
03</td><td>PETANI/PEKEBUN</td><td>NGRINGIN RT 002 RW
01</td><td>NGRINGIN</td><td>NGARGOHARJO</td><td>INDUK</td><td>dr. BUDI
2019</td><td>SUTINEM</td><td></td><td>PETANI/PEKEBUN</td><td>PRINGKUKU</td><td>PRIN
GKUKU</td><td>NGARGOHARJO</td><td>PUSTU NGARGOHARJO</td><td>SUSI HERAWATI,
align='right'>I10</td><td>Essential (primary) hypertension</td><td></td><td
2019</td><td>SUTINI</td><td>PAIMAN</td><td>PETANI/PEKEBUN</td><td>PRINGKUKU</td><td
d></tr><tr><td align='right'>R05</td><td>Cough</td><td></td><td
2019</td><td>SUTINI</td><td>PAIMAN</td><td>PETANI/PEKEBUN</td><td>PRINGKUKU</td><td
align='right'>56070147</td><td>11-03-2019</td><td>SUYATMAN</td><td>SUYATMAN 06 07 S
23</td><td>PETANI/PEKEBUN</td><td>DUNGKANCIL RT02 RW09</td><td>DUNG
align='right'>59091391</td><td>11-03-2019</td><td>TARMIN</td><td>SUTARMIN 0909 S
21</td><td>PETANI/PEKEBUN</td><td>NAWANGAN
KIDUL</td><td></td><td>GIRIWOYO</td><td>INDUK</td><td>dr. BUDI
align='right'>S60.0</td><td>Contusion of finger(s) without damage to
align='right'>57140068</td><td>11-03-2019</td><td>TIARA PUTRI PRASTIA</td><td>ARIF
PRASETYO</td><td>BELUM/TIDAK
BEKERJA</td><td>PENDEM</td><td>PENDEM</td><td>PUCANGANOM</td><td>INDUK</td><td>dr.
BUDI ASHARI</td><td>SRI SUPATMI</td><td>P</td><td>1-4 Thn.</td><td>Datang
align='right'>H65.2</td><td>Chronic serous otitis media</td><td></td><td
SURYANI</td><td>WARDI 0601 W 20</td><td>PETANI/PEKEBUN</td><td>GIRITONTRO
LOR RT.03/01</td><td>GIRITONTRO LOR</td><td>GIRITONTRO</td><td>INDUK</td><td>dr.
/tr><tr><td align='right'>I20.9</td><td>Angina pectoris,
align='right'>55025080</td><td>11-03-2019</td><td>TUGIMAN</td><td>TUGIMAN 05 02
T07</td><td>PETANI/PEKEBUN</td><td>GIRIROTO RT02
2019</td><td>TUKIJO MARTOREJO</td><td>TUKIJO
MARTOREJO</td><td>PETANI/PEKEBUN</td><td>NGRINGIN</td><td>NGRINGIN</td><td>NGARGOHA
RJO</td><td>PUSTU NGARGOHARJO</td><td>SUSI HERAWATI, AMK</td><td> -
></tr><tr><td align='right'>H82</td><td>Vertiginous syndromes in diseases
align='right'>51027086</td><td>11-03-2019</td><td>TUKIJO MARTOREJO</td><td>TUKIJO
MARTOREJO</td><td>PETANI/PEKEBUN</td><td>NGRINGIN</td><td>NGRINGIN</td><td>NGARGOHA
RJO</td><td>PUSTU NGARGOHARJO</td><td>SUSI HERAWATI, AMK</td><td> -
align='right'>52095008</td><td>11-03-
2019</td><td>TUKIRAN</td><td>TUKIRAN</td><td>PETANI/PEKEBUN</td><td>KLEPU</td><td>K
LEPU</td><td>TLOGOSARI</td><td>PKD TLOGOSARI</td><td>RETNO AMBARWATI AMD
KEB</td><td> - </td><td>L</td><td>60-69 Thn.</td><td>Datang
d></tr><tr><td align='right'>E05.4</td><td>Thyrotoxicosis factitia</td><td></td><td
2019</td><td>TUMINI</td><td>KARDI 07 01 K 03</td><td>MENGURUS RUMAH
TANGGA</td><td>GROGOL RT 03 RW
></tr><tr><td align='right'>S50.9</td><td>Superficial injury of forearm,
align='right'>53010002</td><td>11-03-2019</td><td>TUMINO</td><td>TUMINO 03 01 T
01</td><td>PEGAWAI NEGERI SIPIL</td><td>TLOGOHARJO RT 01 RW
01</td><td>TLOGO</td><td>TLOGOHARJO</td><td>INDUK</td><td>dr. BUDI
2019</td><td>TUMIRAH</td><td>SUKAMTO</td><td>PETANI/PEKEBUN</td><td>SOKO</td><td>SO
KO</td><td>TLOGOSARI</td><td>PUSTU TLOGOSARI</td><td>SULARNO,S.Kep.Ns</td><td> -
align='right'>51100017</td><td>11-03-2019</td><td>TUMIYEM</td><td>BUDI SANTOSO
0110 B
01</td><td>PETANI/PEKEBUN</td><td>BALONG</td><td>BALONG</td><td>NGARGOHARJO</td><td
align='right'>57140094</td><td>11-03-2019</td><td>WAGINAH</td><td>SOMO 0 7 14 S
24</td><td>PETANI/PEKEBUN</td><td>PENDEM RT01
align='right'>54060057</td><td>11-03-2019</td><td>WAHYU SAYEKTI</td><td>SUPARMAN
0406 S 04</td><td>BURUH HARIAN LEPAS</td><td>BAYEM RT02
align='right'>57020031</td><td>11-03-2019</td><td>WAHYU SUGIH
KRISTIANI</td><td>YULIONO 0702 Y 02</td><td>PETANI/PEKEBUN</td><td>SUKOROYOM
WETAN RT01 RW04</td><td>SUKOROYOM
align='right'>E56.8</td><td>Deficiency of other vitamins</td><td></td><td
2019</td><td>WAHYU SUGIH KRISTIANI</td><td>YULIONO 0702 Y
align='right'>55020080</td><td>11-03-2019</td><td>WAHYU WISANG</td><td>DATO 0502
D 02</td><td>PETANI/PEKEBUN</td><td>GIRIROTO RT02
RW06,JATIREJO</td><td>GIRIROTO</td><td>JATIREJO</td><td>INDUK</td><td>dr. BUDI
></tr><tr><td align='right'>I47.1</td><td>Supraventricular
tachycardia</td><td></td><td align='right'>289650</td><td
align='right'>51080010</td><td>11-03-2019</td><td>WALUYO</td><td>WALUYO 01 08 W
2019</td><td>WIDATI</td><td>KASNO</td><td>PETANI/PEKEBUN</td><td>PULUNG</td><td>PUL
UNG</td><td>NGARGOHARJO</td><td>PUSTU
NGARGOHARJO</td><td>SUSI HERAWATI, AMK</td><td> - </td><td>P</td><td>55-59
2019</td><td>WIDODO</td><td>WIDODO</td><td>PETANI/PEKEBUN</td><td>GEDANGAN</td><td>
GEDANGAN</td><td>NGARGOHARJO</td><td>PUSTU NGARGOHARJO</td><td>SUSI HERAWATI,
AMK</td><td> - </td><td>L</td><td>55-59 Thn.</td><td>Datang
</tr><tr><td align='right'>K29.6</td><td>Other gastritis</td><td></td><td
2019</td><td>WIDODO</td><td>WIDODO</td><td>PETANI/PEKEBUN</td><td>GEDANGAN</td><td>
GEDANGAN</td><td>NGARGOHARJO</td><td>PUSTU NGARGOHARJO</td><td>SUSI HERAWATI,
</tr><tr><td align='right'>S81.0</td><td>Open wound of knee</td><td></td><td
2019</td><td>WIYATI</td><td>WAKIJO 01 01 W 2</td><td>KARYAWAN
SWASTA</td><td>PELET RT 01 RW
align='right'>54080085</td><td>11-03-2019</td><td>WIYONO</td><td>WIYONO 0408 W
01</td><td>PETANI/PEKEBUN</td><td>NGANTAP
RT.03/05</td><td>NGANTAP</td><td>BAYEMHARJO</td><td>INDUK</td><td>dr. BUDI
align='right'>57120165</td><td>11-03-2019</td><td>WURYANI</td><td>RAIL 0712 R
01</td><td>MENGURUS RUMAH TANGGA</td><td>INGAK INGUK RT02 RW16</td><td>INGAK -
></tr><tr><td align='right'>M79.28</td><td>Neuralgia and neuritis, unspecified,
other site</td><td></td><td align='right'>289683</td><td
align='right'>57110003</td><td>11-03-2019</td><td>YANTI </td><td>KATIMIN 0711 K
01</td><td>PETANI/PEKEBUN</td><td>PLOSO RT01
RW11</td><td>PLOSO</td><td>PUCANGANOM</td><td>INDUK</td><td>dr. BUDI
align='right'>53020015</td><td>12-03-2019</td><td>ADELIA SINDI</td><td>TUMADI 03
02 T
01</td><td></td><td>SAMBIREJO</td><td>SAMBIREJO</td><td>TLOGOHARJO</td><td>INDUK</t
d><td>dr. BUDI ASHARI</td><td>RETNO AMBARWATI AMD KEB</td><td>P</td><td>1-4
align='right'>K12.1</td><td>Other forms of stomatitis</td><td></td><td
2019</td><td>AISYAH AYU ANGGRAINI</td><td>SUHARDI 06 02 S 57</td><td>KARYAWAN
SWASTA</td><td>GIRITONTRO KIDUL RT05 RW03</td><td>GIRITONTRO
align='right'>57160011</td><td>12-03-2019</td><td>AIZSHA SUCI
MAHARANI</td><td>WAKIJAN 0716 W 03</td><td>BELUM/TIDAK BEKERJA</td><td>SAWIT
LOR</td><td>SAWIT LOR</td><td>PUCANGANOM</td><td>INDUK</td><td>dr. BUDI
align='right'>54100075</td><td>12-03-2019</td><td>AMELIA INGGRID
ARIANI</td><td>MISRI/AGUS 0410 M 02</td><td>BELUM/TIDAK BEKERJA</td><td>GUNUNG
BROMO</td><td>GUNUNG BROMO</td><td>BAYEMHARJO</td><td>INDUK</td><td>dr. BUDI
align='right'>I63.9</td><td>Cerebral infarction, unspecified</td><td></td><td
2019</td><td>BEJO</td><td>BEJO 0214 B 01</td><td>PETANI/PEKEBUN</td><td>GUPAKAN
RT02 RW03</td><td>GUPAKAN</td><td>TLOGOSARI</td><td>INDUK</td><td>dr. BUDI
align='right'>57090079</td><td>12-03-2019</td><td>DAMAN MUHAMMAD IMAN</td><td>DAMAN
MUHAMMAD IMAN 07 09 D 01</td><td>PETANI/PEKEBUN</td><td>PUCANGANOM LOR RT 01 RW
09</td><td>PUCANGANOM LOR</td><td>PUCANGANOM</td><td>INDUK</td><td>dr. BUDI
align='right'>54110116</td><td>12-03-2019</td><td>DANU DWI TIRTA</td><td>HENDRA
DODI 0411 H 03</td><td>BELUM/TIDAK BEKERJA</td><td>GUWO RT03
RW06</td><td></td><td>BAYEMHARJO</td><td>INDUK</td><td>dr. BUDI
align='right'>56040099</td><td>12-03-2019</td><td>DARMIN</td><td>DARMIN 06 04 D
02</td><td>PETANI/PEKEBUN</td><td>KETONGGO,RT 01 RW
07</td><td>KETONGGO</td><td>GIRITONTRO</td><td>INDUK</td><td>dr. BUDI
align='right'>55020078</td><td>12-03-2019</td><td>DATO</td><td>DATO
0502 D 02</td><td>PETANI/PEKEBUN</td><td>GIRIROTO RT02
RW06,JATIREJO</td><td>GIRIROTO</td><td>JATIREJO</td><td>INDUK</td><td>dr. BUDI
align='right'>289759</td><td align='right'>52110035</td><td>12-03-2019</td><td>DEWI
KUMALA SARI</td><td>SURONO 0211 S 05</td><td>KARYAWAN SWASTA</td><td>TAMBAK RT01
RW02</td><td></td><td>TLOGOSARI</td><td>INDUK</td><td>dr. BUDI
align='right'>289721</td><td align='right'>53050018</td><td>12-03-2019</td><td>DINA
SARTINI RIA PUTRININGSIH</td><td>SLAMET RIYADI 03 05 S 06</td><td>KARYAWAN
SWASTA</td><td>PLARENG RT 02 RW
05</td><td>PLARENG</td><td>TLOGOHARJO</td><td>INDUK</td><td>dr. BUDI
/td></tr><tr><td align='right'>D36.9</td><td>Benign neoplasm of unspecified
align='right'>56040143</td><td>12-03-2019</td><td>DJUKI</td><td>JUKI 0604 J
04</td><td>PENSIUNAN</td><td>KETONGGO RT02
RW07</td><td>KETONGGO</td><td>GIRITONTRO</td><td>INDUK</td><td>dr. BUDI
2019</td><td>HANIF AKMA M</td><td>LARDI 0703 L 01</td><td>BELUM/TIDAK
BEKERJA</td><td>KUWANG RT 04 RW
06</td><td></td><td>PUCANGANOM</td><td>INDUK</td><td>dr. BUDI ASHARI</td><td>RETNO
AMBARWATI AMD KEB</td><td>L</td><td><1 Thn.</td><td>Datang
align='right'>54060106</td><td>12-03-2019</td><td>IBNU EKA PRATAMA</td><td>KATIRAH
0406 K 04</td><td>KARYAWAN SWASTA</td><td>BAYEM RT02
align='right'>K05.3</td><td>Chronic periodontitis</td><td></td><td
2019</td><td>KARYATI R</td><td>SUPRAPTO 01 05 S
08</td><td>PETANI/PEKEBUN</td><td>GENTUNG</td><td>GENTUNG</td><td>NGARGOHARJO</td><
td>INDUK</td><td>drg.DANAR WULANDARI</td><td>RIZKI ANISSA,
AM.Kg</td><td>P</td><td>45-54 Thn.</td><td>Datang Sendiri</td><td>Lama</td><td>BPJS
align='right'>49</td><td>BP. Gigi</td><td></td><td></td><td>Dalam
></tr><tr><td align='right'>M79.79</td><td>Fibromyalgia, site
align='right'>56100019</td><td>12-03-2019</td><td>KASIRAH</td><td>SUMANTRI 0610 S
16</td><td>PETANI/PEKEBUN</td><td>TANGGUNG RT04
></tr><tr><td align='right'>K12.1</td><td>Other forms of
stomatitis</td><td></td><td align='right'>290378</td><td
align='right'>54065105</td><td>12-03-
2019</td><td>LASTRI</td><td>GIARSO</td><td>PETANI/PEKEBUN</td><td>BAYEM</td><td>BAY
EM</td><td>BAYEMHARJO</td><td>PUSTU BAYEMHARJO</td><td>RISTINA Amd Keb</td><td> -
align='right'>52030026</td><td>12-03-2019</td><td>LILIS TRIANI</td><td>SATIYO 02 03
S 08</td><td>KARYAWAN SWASTA</td><td>SALAM RT 01 RW
06</td><td></td><td>TLOGOSARI</td><td>INDUK</td><td>dr. BUDI ASHARI</td><td>RETNO
AMBARWATI AMD KEB</td><td>P</td><td>20-44 Thn.</td><td>Datang
</tr><tr><td align='right'>R51</td><td>Headache</td><td></td><td
2019</td><td>MURTI
ASIH</td><td>MULYONO</td><td>PETANI/PEKEBUN</td><td>BAYEM</td><td>BAYEM</td><td>BAY
EMHARJO</td><td>PUSTU BAYEMHARJO</td><td>RISTINA Amd Keb</td><td> -
align='right'>N61</td><td>Inflammatory disorders of breast</td><td></td><td
align='right'>57125025</td><td>12-03-2019</td><td>PARMI</td><td>RAIL 07 12 R
01</td><td>PETANI/PEKEBUN</td><td>INGAK INGUK RT 02 RW 16</td><td>INGAK -
align='right'>51100067</td><td>12-03-2019</td><td>PIPIT
KURNIAWATI</td><td>TUKIJO/HERNOWO 0110 T 05</td><td>MENGURUS RUMAH
TANGGA</td><td>BALONG RT 01 RW
06</td><td>BALONG</td><td>NGARGOHARJO</td><td>INDUK</td><td>dr. BUDI
align='right'>56060084</td><td>12-03-2019</td><td>PONIJAH</td><td>SULARDI 0606 S
align='right'>56090117</td><td>12-03-2019</td><td>PRADITA</td><td>SAGIMIN
06 09 S 22</td><td>BELUM/TIDAK BEKERJA</td><td>DUNGKLEPU KULON
RT04/04</td><td>DUNG KLEPU KULON</td><td>GIRITONTRO</td><td>INDUK</td><td>dr. BUDI
2019</td><td>REZTA FALITA AFARA</td><td>ALIP SAPARTO 0208 A
02</td><td>BELUM/TIDAK BEKERJA</td><td>TLOGOSARI 01
RW05</td><td>TLOGOSARI</td><td>TLOGOSARI</td><td>INDUK</td><td>drg.DANAR
align='right'>289746</td><td align='right'>51040058</td><td>12-03-2019</td><td>RIA
ADESTI KUSTYANI</td><td>KUSNO 01 04 K 03</td><td>KARYAWAN SWASTA</td><td>KLEPU RT
01 RW 03</td><td>KLEPU</td><td>NGARGOHARJO</td><td>INDUK</td><td>dr. BUDI
2019</td><td>RIANI</td><td>SARMO 0213 S 10</td><td>KARYAWAN SWASTA</td><td>KERJO
RT03 RW03</td><td>KERJO</td><td>TLOGOSARI</td><td>INDUK</td><td>dr. BUDI
align='right'>S50.9</td><td>Superficial injury of forearm,
align='right'>55060113</td><td>12-03-2019</td><td>SARMONO</td><td>SARMONO 0506 S
25</td><td>WIRASWASTA</td><td>JATI RT 03
2019</td><td>SLAMET WIYONO</td><td>WAGIMIN 1010 W 10</td><td>KARYAWAN
HONORER</td><td>MLOKO RT02
RW01</td><td></td><td>PARANGGUPITO</td><td>INDUK</td><td>dr. BUDI
align='right'>M79.03</td><td>Rheumatism, unspecified, forearm</td><td></td><td
RAHAYU</td><td>TUMADI 0302 T 01</td><td>PETANI/PEKEBUN</td><td>SAMBIREJO RT04
RW01</td><td>SAMBIREJO</td><td>TLOGOHARJO</td><td>INDUK</td><td>dr. BUDI
SULASTRI</td><td>SUPARMIN 0704 S 05</td><td>PETANI/PEKEBUN</td><td>MANDEYAN RT04
></tr><tr><td align='right'>B00.9</td><td>Herpesviral infection,
align='right'>57030066</td><td>12-03-2019</td><td>SUGIYANTI</td><td>BUDI SETYONO
0703 B 01</td><td>BURUH HARIAN
align='right'>55010102</td><td>12-03-2019</td><td>SUMINI</td><td>SURAHMAN 05 01 S
align='right'>B18</td><td>Chronic viral hepatitis</td><td></td><td
2019</td><td>SUMIYEM</td><td>SIRIN 0704 S
align='right'>54060105</td><td>12-03-2019</td><td>SUPARMAN</td><td>SUPARMAN 0406
S 04</td><td>PETANI/PEKEBUN</td><td>BAYEM RT02
align='right'>56020370</td><td>12-03-2019</td><td>SUTINI</td><td>SULARNO 0602 S
58</td><td>PENSIUNAN</td><td>GIRITONTRO KIDUL RT05 RW03</td><td>GIRITONTRO
></tr><tr><td align='right'>M79.05</td><td>Rheumatism, unspecified, pelvic region
and thigh</td><td></td><td align='right'>289717</td><td
align='right'>56060019</td><td>12-03-2019</td><td>SUWARDI</td><td>SUWARDI 06 06 S
02</td><td>PETANI/PEKEBUN</td><td>GOBOH RT 02
align='right'>56010174</td><td>12-03-2019</td><td>TAUFIQ ABDULLAH</td><td>WIDI
LISTIYONO 0601 W 03</td><td>BELUM/TIDAK BEKERJA</td><td>GIRITONTRO LOR RT01
align='right'>54025006</td><td>12-03-
2019</td><td>TINEM</td><td>SONOKARIYO</td><td>PETANI/PEKEBUN</td><td>NGUNDUK</td>
<td>NGUNDUK</td><td>BAYEMHARJO</td><td>PUSTU BAYEMHARJO</td><td>RISTINA Amd
Keb</td><td> - </td><td>P</td><td>>70 Thn.</td><td>Datang
align='right'>289728</td><td align='right'>54100074</td><td>12-03-2019</td><td>TONI
SANTOSO</td><td>MISRI 0410 M 02</td><td>BURUH HARIAN LEPAS</td><td>GUNUNG BROMO
RT02 RW07</td><td>GUNUNG BROMO</td><td>BAYEMHARJO</td><td>INDUK</td><td>dr. BUDI
align='right'>53065030</td><td>12-03-2019</td><td>TUMADI</td><td>YATMI 03 06 Y
01</td><td>KARYAWAN SWASTA</td><td>KLEPU RT 01 RW
align='right'>53090018</td><td>12-03-2019</td><td>WAGINO</td><td>WAGINO 0309 W
02</td><td>PETANI/PEKEBUN</td><td>KRANGGAN RT02
RW04</td><td>KRANGGAN</td><td>TLOGOHARJO</td><td>PUSTU BAYEMHARJO</td><td>RISTINA
Amd Keb</td><td> - </td><td>L</td><td>>70 Thn.</td><td>Datang
/td></tr><tr><td align='right'>L20.9</td><td>Atopic dermatitis,
align='right'>51010011</td><td>12-03-2019</td><td>WARTI</td><td>WIRATNO 0101 W
01</td><td>PETANI/PEKEBUN</td><td>PELET</td><td>PELET</td><td>NGARGOHARJO</td><td>I
NDUK</td><td>dr. BUDI ASHARI</td><td>SUWARTO,S.Kep.Nes</td><td>P</td><td>45-54
Wilayah</td><td>'0000565770317</td><td>'3312</td><td>130</td><td>80</td></tr><tr><t
d align='right'>K29.5</td><td>Chronic gastritis, unspecified</td><td></td><td
2019</td><td>WARTI</td><td>SUTIMAN 06 09 S 05</td><td>MENGURUS RUMAH
TANGGA</td><td>DUNGKLEPU KULON</td><td>DUNG KLEPU
KULON</td><td>GIRITONTRO</td><td>INDUK</td><td>dr. BUDI
></tr><tr><td align='right'>H60.9</td><td>Otitis externa,
align='right'>51130014</td><td>12-03-2019</td><td>WIDODO</td><td>WIDODO 01 13 W
02</td><td>PETANI/PEKEBUN</td><td>GEDANGAN RT 01 RW
05</td><td>GEDANGAN</td><td>NGARGOHARJO</td><td>INDUK</td><td>dr. BUDI
</tr><tr><td align='right'>E11.6</td><td>Non-insulin-dependent diabetes mellitus
align='right'>56100144</td><td>12-03-2019</td><td>YATI SUHAETI</td><td>WAKIMIN 06
10 W 05</td><td>MENGURUS RUMAH
TANGGA</td><td>TANGGUNG</td><td>TANGGUNG</td><td>GIRITONTRO</td><td>INDUK</td><td>d
r. BUDI ASHARI</td><td>SUWARTO,S.Kep.Nes</td><td>P</td><td>45-54
></tr><tr><td align='right'>K08.8</td><td>Other specified disorders of teeth and
supporting structures</td><td></td><td align='right'>289740</td><td
align='right'>57090258</td><td>12-03-2019</td><td>YETI</td><td>HARNO 0709 H
02</td><td>MENGURUS RUMAH TANGGA</td><td>PUCANGANOM LOR RT01
align='right'>Z00.6</td><td>Examination for normal comparison and control in
clinical research programme</td><td></td><td align='right'>289749</td><td
align='right'>58081393</td><td>12-03-2019</td><td>YUNI PASIATI</td><td>HARYANTO
0808 H 10</td><td>KARYAWAN
HONORER</td><td>PELEM</td><td></td><td>PRACIMANTORO</td><td>INDUK</td><td>dr. BUDI
align='right'>289751</td><td align='right'>57090256</td><td>12-03-2019</td><td>ZIAN
CANDRA MUSTOFA</td><td>YATNO / M. MUSTOFA 0709 Y 01</td><td>BELUM/TIDAK
BEKERJA</td><td>PUCANGANOM LOR</td><td>PUCANGANOM
LOR</td><td>PUCANGANOM</td><td>INDUK</td><td>dr. BUDI ASHARI</td><td>RETNO
align='right'>56010063</td><td>13-03-2019</td><td> JUMIYEM</td><td>SURIP JUMIYEM
0601 S 48</td><td>PETANI/PEKEBUN</td><td>GIRITONTRO LOR RT01
align='right'>53080076</td><td>13-03-2019</td><td>AL FIKRI CAHYATAMA</td><td>SLAMET
0308 S 02</td><td>PELAJAR/MAHASISWA</td><td>GINADE KULON RT01 RW03</td><td>GINADE
align='right'>N50.1</td><td>Vascular disorders of male genital
organs</td><td></td><td align='right'>289795</td><td
align='right'>51040026</td><td>13-03-2019</td><td>ANDITA</td><td>JOKO PURNOMO 0104
J 01</td><td>LAINNYA</td><td>KLEPU RT03
RW05,NGARGOHARJO</td><td>KLEPU</td><td>NGARGOHARJO</td><td>INDUK</td><td>dr. BUDI
Sendiri</td><td>Lama</td><td>JAMKESDA</td><td>Rujuk</td><td
align='right'>29</td><td>KIA</td><td>Poli Bedah</td><td>RSUD DR. SOEDIRAN MS
WONOGIRI</td><td>Dalam
/td></tr><tr><td align='right'>Z39.2</td><td>Routine postpartum follow-
up</td><td></td><td align='right'>289768</td><td align='right'>57010278</td><td>13-
03-2019</td><td>AZAM MAULANA</td><td>SUTARTO 0701 S 08</td><td>BELUM/TIDAK
BEKERJA</td><td>GROGOL</td><td>GROGOL</td><td>PUCANGANOM</td><td>INDUK</td><td>dr.
BUDI ASHARI</td><td>SUHARNI</td><td>L</td><td><1 Thn.</td><td>Datang
align='right'>K26.7</td><td>Duodenal ulcer, chronic without haemorrhage
or perforation</td><td></td><td align='right'>290788</td><td
align='right'>55125040</td><td>13-03-2019</td><td>BAYU
RAHMANTO</td><td>TUKINAH</td><td>PELAJAR/MAHASISWA</td><td>NGASEM</td><td>NGASEM</t
d><td>JATIREJO</td><td>PKD JATIREJO</td><td>SUHARNI</td><td> -
</td><td>L</td><td>15-19 Thn.</td><td>Datang Sendiri</td><td>Baru</td><td>UMUM
align='right'>53065010</td><td>13-03-2019</td><td>DAFFA
ADITYA</td><td>SUNARTI</td><td>PELAJAR/MAHASISWA</td><td>KLEPU</td><td>KLEPU</td><t
d>TLOGOHARJO</td><td>PKD TLOGOHARJO</td><td>SRI SUPATMI</td><td> -
tr><tr><td align='right'>J11.8</td><td>Influenza with other manifestations, virus
align='right'>53015049</td><td>13-03-2019</td><td>DENI DWI
PUTRA</td><td>PARINO</td><td>PELAJAR/MAHASISWA</td><td>TLOGO</td><td>TLOGO</td><td>
TLOGOHARJO</td><td>PKD TLOGOHARJO</td><td>SRI SUPATMI</td><td> -
/td></tr><tr><td align='right'>J45.9</td><td>Asthma, unspecified</td><td></td><td
align='right'>289787</td><td align='right'>57130001</td><td>13-03-2019</td><td>EKO
SUSANTO</td><td>SANEM 07 13 S 10</td><td>PETANI/PEKEBUN</td><td>KEPUH RT 02 RW
12</td><td>KEPUH</td><td>PUCANGANOM</td><td>INDUK</td><td>dr. BUDI
align='right'>11110171</td><td>13-03-
2019</td><td>ENI</td><td></td><td>PETANI/PEKEBUN</td><td>KARANG
align='right'>55040113</td><td>13-03-2019</td><td>ERAWATI</td><td>NAIMAN 0504 N
01</td><td>PETANI/PEKEBUN</td><td>KANIGORO RT02
2019</td><td>FHARISCA PUTRA ANGGORO</td><td>ARIF
WIDIYANTO</td><td>PELAJAR/MAHASISWA</td><td>TLOGO</td><td>TLOGO</td><td>TLOGOHARJO<
/td><td>PKD TLOGOHARJO</td><td>SRI SUPATMI</td><td> - </td><td>L</td><td>10-14
tr><tr><td align='right'>Z00.8</td><td>Other general examinations</td><td></td><td
align='right'>289765</td><td align='right'>57080228</td><td>13-03-2019</td><td>HERI
PRASETYO</td><td>PURWADI 0708 P 04</td><td>KARYAWAN SWASTA</td><td>PUCANGANOM
KIDUL RT02 RW08</td><td>PUCANGANOM
align='right'>53015116</td><td>13-03-2019</td><td>ILHAM DWI ARMAN LASTA</td><td>EKO
H D</td><td>BELUM/TIDAK
Thn.</td><td>Datang Sendiri</td><td>Lama</td><td>JAMKESDA</td><td>Rajal</td><td
></tr><tr><td align='right'>I50.9</td><td>Heart failure,
></tr><tr><td align='right'>A06.0</td><td>Acute amoebic dysentery</td><td></td><td
2019</td><td>KASEMI</td><td>MARYOTO 07 05 M
></tr><tr><td align='right'>G46.8</td><td>Other vascular syndromes of brain in
cerebrovascular diseases</td><td></td><td align='right'>289796</td><td
align='right'>55080041</td><td>13-03-2019</td><td>KASIYEM</td><td>KASIYEM 05 08 K
01</td><td>PETANI/PEKEBUN</td><td>NGORODOWO RT 04 RW
03</td><td>NGORODOWO</td><td>JATIREJO</td><td>INDUK</td><td>dr. BUDI
2019</td><td>KASMI</td><td>SAJIMAN</td><td>PETANI/PEKEBUN</td><td>KLEPU</td><td>KLE
PU</td><td>NGARGOHARJO</td><td>PKD NGARGOHARJO</td><td>HENI WIDIYASTUTI</td><td> -
tr><tr><td align='right'>M43.6</td><td>Torticollis</td><td></td><td
2019</td><td>KATIJEM</td><td>SUKIDI</td><td>PETANI/PEKEBUN</td><td>SAMBIREJO</td><t
d>SAMBIREJO</td><td>TLOGOHARJO</td><td>PKD TLOGOHARJO</td><td>SRI SUPATMI</td><td>
align='right'>53015027</td><td>13-03-
2019</td><td>KATIM</td><td>KATIM</td><td>PETANI/PEKEBUN</td><td>TLOGO</td><td>TLOGO
</td><td>TLOGOHARJO</td><td>PKD TLOGOHARJO</td><td>SRI SUPATMI</td><td> -
</td><td>L</td><td>55-59
align='right'>I50.9</td><td>Heart failure, unspecified</td><td></td><td
2019</td><td>KATINAH</td><td>MIDI 07 13 M
03</td><td>PETANI/PEKEBUN</td><td>KEPUH RT 01 RW
2019</td><td>KATIRAN</td><td>KATIRAN</td><td>PETANI/PEKEBUN</td><td>PORO</td><td>PO
RO</td><td>TLOGOSARI</td><td>PKD TLOGOSARI</td><td>RETNO AMBARWATI AMD KEB</td><td>
align='right'>54070034</td><td>13-03-2019</td><td>LESTARI</td><td>KADARUSMAN 0407
K 02</td><td>PEDAGANG</td><td>NGALURAN RT01
RW05</td><td>NGALURAN</td><td>BAYEMHARJO</td><td>INDUK</td><td>dr. BUDI
align='right'>57080075</td><td>13-03-2019</td><td>LIA MAHARANI</td><td>SUKATMO
0708 S 07</td><td>PERANGKAT DESA</td><td>PUCANGANOM KIDUL RT01
RW08</td><td>PUCANGANOM KIDUL</td><td>PUCANGANOM</td><td>INDUK</td><td>dr. BUDI
2019</td><td>MIYATUN</td><td>SUPRIYANTO 0610 S
/td></tr><tr><td align='right'>J11.8</td><td>Influenza with other manifestations,
align='right'>57060030</td><td>13-03-2019</td><td>MUHAMMAD IQBAL
PERMANA</td><td>SUTOPO 0706 S 02</td><td>BELUM/TIDAK
BEKERJA</td><td>TAMBAKSARI</td><td>TAMBAHSARI</td><td>PUCANGANOM</td><td>INDUK</td>
<td>dr. BUDI ASHARI</td><td>SUWARTO,S.Kep.Nes</td><td>L</td><td>5-9
/td></tr><tr><td align='right'>I10</td><td>Essential (primary)
align='right'>53025085</td><td>13-03-
2019</td><td>MUKIJEM</td><td>MUKIJEM</td><td>PETANI/PEKEBUN</td><td>SAMBIREJO</td><
td>SAMBIREJO</td><td>TLOGOHARJO</td><td>PKD TLOGOHARJO</td><td>SRI SUPATMI</td><td>
- </td><td>P</td><td>60-69 Thn.</td><td>Datang Sendiri</td><td>Lama</td><td>UMUM
Wilayah</td><td>'3312025109450001</td><td>'3312025109450001</td><td>190</td><td>100
</td></tr><tr><td align='right'>Z00.8</td><td>Other general
align='right'>57070287</td><td>13-03-2019</td><td>NAZDIAN GIRI RAHMAN
HAKIM</td><td>AHMAD SAFRUDIN 0707 S 25</td><td>BELUM/TIDAK BEKERJA</td><td>BANJAR
RT 01 RW05</td><td>BANJAR</td><td>PUCANGANOM</td><td>INDUK</td><td>dr. BUDI
align='right'>Z30.1</td><td>Insertion of (intrauterine) contraceptive
device</td><td></td><td align='right'>289776</td><td
align='right'>56010045</td><td>13-03-2019</td><td>NINING
WIDYATANTI</td><td>HARSANTO 0601 H 04</td><td>MENGURUS RUMAH
TANGGA</td><td>GIRITONTRO LOR RT 01 RW 02</td><td>GIRITONTRO
align='right'></td><td align='right'>34</td><td>KIA</td><td></td><td></td><td>Dalam
></tr><tr><td align='right'>Z30.8</td><td>Other contraceptive
management</td><td></td><td align='right'>289772</td><td
align='right'>56100031</td><td>13-03-2019</td><td>NUR HAYATI</td><td>SUTANTO 0610
S 52</td><td>MENGURUS RUMAH
TANGGA</td><td>TANGGUNG</td><td>TANGGUNG</td><td>GIRITONTRO</td><td>INDUK</td><td>d
r. BUDI ASHARI</td><td>SUHARNI</td><td>P</td><td>20-44 Thn.</td><td>Datang
2019</td><td>NURLITA</td><td>SUWARNO</td><td>BELUM/TIDAK
BEKERJA</td><td>SELUR</td><td>SELUR</td><td>NGARGOHARJO</td><td>PKD
NGARGOHARJO</td><td>HENI WIDIYASTUTI</td><td> - </td><td>P</td><td>1-4
align='right'>E11.5</td><td>Non-insulin-dependent diabetes mellitus with peripheral
circulatory complications</td><td></td><td align='right'>289788</td><td
align='right'>55120035</td><td>13-03-2019</td><td>PARNI</td><td>PAIDI 0512 P
01</td><td>PETANI/PEKEBUN</td><td>NGASEM RT 03
RW05,JATIREJO</td><td>NGASEM</td><td>JATIREJO</td><td>INDUK</td><td>dr. BUDI
2019</td><td>PONO</td><td>PONO 01 09 P 02</td><td>PETANI/PEKEBUN</td><td>PULUNG
RT04 RW04</td><td>PULUNG</td><td>NGARGOHARJO</td><td>INDUK</td><td>dr. BUDI
align='right'>0111</td><td>13-03-2019</td><td>RENI PUJI
UTAMI</td><td>SULISTYONO</td><td>PETANI/PEKEBUN</td><td>BLEBER</td><td>BLEBER</td><
td>NGARGOHARJO</td><td>PKD NGARGOHARJO</td><td>HENI WIDIYASTUTI</td><td> -
></tr><tr><td align='right'>A18.2</td><td>Tuberculous peripheral
lymphadenopathy</td><td></td><td align='right'>289791</td><td
align='right'>55010256</td><td>13-03-2019</td><td>REZA ADIPUTRA</td><td>BUDI
HARTANTO 05 01 B 01</td><td>BELUM/TIDAK BEKERJA</td><td>GIRIBELAH RT03
align='right'>6</td><td align='right'>1</td><td>KIA</td><td>Poli Anak</td><td>RSUD
DR. SOEDIRAN MS WONOGIRI</td><td>Dalam
td></tr><tr><td align='right'>I10</td><td>Essential (primary)
align='right'>57060143</td><td>13-03-2019</td><td>SARNI</td><td>NARIMO 0706 N
02</td><td>MENGURUS RUMAH TANGGA</td><td>TAMBAHSARI RT02
2019</td><td>SARWANTI</td><td>MUKADI</td><td>PETANI/PEKEBUN</td><td>PRINGKUKU</td><
td>PRINGKUKU</td><td>NGARGOHARJO</td><td>PKD NGARGOHARJO</td><td>HENI
d></tr><tr><td align='right'>J45.9</td><td>Asthma, unspecified</td><td></td><td
2019</td><td>SLAMET</td><td>SLAMET</td><td>PETANI/PEKEBUN</td><td>TLOGO</td><td>TLO
align='right'>53025091</td><td>13-03-
2019</td><td>SLAMET</td><td>SLAMET</td><td>PELAJAR/MAHASISWA</td><td>SAMBIREJO</td>
<td>SAMBIREJO</td><td>TLOGOHARJO</td><td>PKD TLOGOHARJO</td><td>SRI
SUPATMI</td><td> - </td><td>L</td><td>60-69 Thn.</td><td>Datang
align='right'>Z30.4</td><td>Surveillance of contraceptive drugs</td><td></td><td
SETIYATMI</td><td>KARBI</td><td>PETANI/PEKEBUN</td><td>GINADE KULON</td><td>GINADE
KULON</td><td>TLOGOHARJO</td><td>PKD TLOGOHARJO</td><td>SRI SUPATMI</td><td> -
align='right'>K02.1</td><td>Caries of dentine</td><td></td><td
2019</td><td>SUGENG</td><td>SUGENG</td><td>PETANI/PEKEBUN</td><td>TLOGO</td><td>TLO
align='right'>54110065</td><td>13-03-2019</td><td>SUKAMTO</td><td>SUKAMTO 0411 S
23</td><td>PEGAWAI NEGERI SIPIL</td><td>GUWO RT03
align='right'>53015073</td><td>13-03-2019</td><td>SULARSI</td><td>EKO
H</td><td>MENGURUS RUMAH
TANGGA</td><td>TLOGO</td><td>TLOGO</td><td>TLOGOHARJO</td><td>PKD
TLOGOHARJO</td><td>SRI SUPATMI</td><td> - </td><td>P</td><td>20-44
align='right'>M79.0</td><td>Rheumatism, unspecified</td><td></td><td
2019</td><td>SUMAMI</td><td>RIBUT RIYANTO 0407 R 02</td><td>BURUH HARIAN
LEPAS</td><td>NGALURAN</td><td>NGALURAN</td><td>BAYEMHARJO</td><td>INDUK</td><td>dr
. BUDI ASHARI</td><td>SUHARNI</td><td>P</td><td>20-44 Thn.</td><td>Datang
align='right'>55060036</td><td>13-03-2019</td><td>SUMINO</td><td>SUMINO 05 06 S
24</td><td>PETANI/PEKEBUN</td><td>JATI RT 02 RW
03</td><td>JATI</td><td>JATIREJO</td><td>INDUK</td><td>dr. BUDI
></tr><tr><td align='right'>H60.9</td><td>Otitis externa,
align='right'>56040005</td><td>13-03-2019</td><td>SUNARMI</td><td>SUWANDI 06 04 S
04</td><td>PETANI/PEKEBUN</td><td>KETONGGO RT01 RW
</tr><tr><td align='right'>Z30.8</td><td>Other contraceptive
align='right'>57060079</td><td>13-03-2019</td><td>SUNARNI</td><td>ARIE
PRASETYO 0706 A 01</td><td>BURUH HARIAN
LEPAS</td><td>TAMBAHSASRI</td><td>TAMBAHSARI</td><td>PUCANGANOM</td><td>INDUK</td><
td>dr. BUDI ASHARI</td><td>SUHARNI</td><td>P</td><td>20-44 Thn.</td><td>Datang
align='right'>53025090</td><td>13-03-
2019</td><td>SUPARTI</td><td>SLAMET</td><td>PETANI/PEKEBUN</td><td>TLOGO</td><td>TL
align='right'>R11</td><td>Nausea and vomiting</td><td></td><td
2019</td><td>SURATMI</td><td>SURYANTO</td><td>PETANI/PEKEBUN</td><td>GINADE
KULON</td><td>GINADE KULON</td><td>TLOGOHARJO</td><td>PKD TLOGOHARJO</td><td>SRI
SUPATMI</td><td> - </td><td>P</td><td>20-44 Thn.</td><td>Datang
></tr><tr><td align='right'>N18.5</td><td>Chronic kidney disease, stage
5</td><td></td><td align='right'>289762</td><td align='right'>55010119</td><td>13-
03-2019</td><td>SURIPTI</td><td>UNTUNG PRAYITNO 05 01 U 01</td><td>BURUH HARIAN
LEPAS</td><td>GIRIBELAH
RT01/07</td><td>GIRIBELAH</td><td>JATIREJO</td><td>INDUK</td><td>dr. BUDI
align='right'>53030026</td><td>13-03-2019</td><td>SUTARDI</td><td>SUTARDI 03 03 S
11</td><td>WIRASWASTA</td><td>JAJAR RT 05 RW
02</td><td>JAJAR</td><td>TLOGOHARJO</td><td>INDUK</td><td>dr. BUDI
d></tr><tr><td align='right'>F20.1</td><td>Hebephrenic
schizophrenia</td><td></td><td align='right'>289783</td><td
align='right'>53050024</td><td>13-03-2019</td><td>SUWARNI</td><td>SUKIJO 0305 S
08</td><td>MENGURUS RUMAH TANGGA</td><td>PLARENG RT 03 WR
align='right'>53095007</td><td>13-03-2019</td><td>TINI</td><td>SAIMAN 0309 S
RW04</td><td>KRANGGAN</td><td>TLOGOHARJO</td><td>INDUK</td><td>dr. BUDI
/td></tr><tr><td align='right'>H60.9</td><td>Otitis externa,
align='right'>51020102</td><td>13-03-2019</td><td>TUKINO</td><td>TUKINO 0102 T
06</td><td>PENSIUNAN</td><td>NGRINGIN RT02
03-2019</td><td>TUMADI</td><td>YATMI 03 06 Y 01</td><td>KARYAWAN
SWASTA</td><td>KLEPU RT 01 RW
align='right'>11110194</td><td>13-03-
2019</td><td>TUMINEM</td><td></td><td>PETANI/PEKEBUN</td><td>PUDAK</td><td></td><td
>JAWA TIMUR</td><td>PUSTU TLOGOSARI</td><td>SULARNO,S.Kep.Ns</td><td> -
</td><td>P</td><td>60-69 Thn.</td><td>Datang
align='right'>L24.5</td><td>Irritant contact dermatitis due to other chemical
products</td><td></td><td align='right'>289766</td><td
align='right'>56050005</td><td>13-03-2019</td><td>TUMINI</td><td>HARTOYO 06 05 H
d>INDUK</td><td>dr. BUDI ASHARI</td><td>SUGIYONO,S.Kep.Ns</td><td>P</td><td>45-54
></tr><tr><td align='right'>S60.2</td><td>Contusion of other parts of wrist and
align='right'>53010002</td><td>13-03-2019</td><td>TUMINO</td><td>TUMINO 03 01 T
01</td><td>PEGAWAI NEGERI SIPIL</td><td>TLOGOHARJO RT 01 RW
01</td><td>TLOGO</td><td>TLOGOHARJO</td><td>INDUK</td><td>dr. BUDI
align='right'>290744</td><td align='right'>53010005</td><td>13-03-2019</td><td>URIP
SETYORINI</td><td>ARIS
SETIANTO</td><td>PETANI/PEKEBUN</td><td>TLOGO</td><td>TLOGO</td><td>TLOGOHARJO</td>
<td>PKD TLOGOHARJO</td><td>SRI SUPATMI</td><td> - </td><td>P</td><td>20-44
></tr><tr><td align='right'>K29.1</td><td>Other acute gastritis</td><td></td><td
2019</td><td>VALENTINUS SUKADI</td><td>VALENTINUS SUKADI 0710 V
01</td><td>PETANI/PEKEBUN</td><td>JEPURUN RT01
</tr><tr><td align='right'>I84.9</td><td>Unspecified haemorrhoids without
complication</td><td></td><td align='right'>290749</td><td
align='right'>53010017</td><td>13-03-
2019</td><td>WAKINEM</td><td>ASTOMO</td><td>PETANI/PEKEBUN</td><td>TLOGO</td><td>TL
align='right'>51040005</td><td>13-03-2019</td><td>WAKIYEM</td><td>JOKO PURNOMO 01
04 J
01</td><td>PETANI/PEKEBUN</td><td>KLEPU</td><td>KLEPU</td><td>NGARGOHARJO</td><td>I
NDUK</td><td>dr. BUDI ASHARI</td><td>SUWARTO,S.Kep.Nes</td><td>P</td><td>45-54
Thn.</td><td>Datang
align='right'>M79.04</td><td>Rheumatism, unspecified, hand</td><td></td><td
2019</td><td>WASIYEM</td><td>SUGITO 0211 S
10</td><td>PETANI/PEKEBUN</td><td>TAMBAK RT01
align='right'>53015102</td><td>13-03-
2019</td><td>WINDAYANI</td><td>ACHMADI</td><td>PETANI/PEKEBUN</td><td>TLOGO</td><td
>TLOGO</td><td>TLOGOHARJO</td><td>PKD TLOGOHARJO</td><td>SRI SUPATMI</td><td> -
align='right'>S98.2</td><td>Traumatic amputation of two or more
toes</td><td></td><td align='right'>289801</td><td
align='right'>51010010</td><td>13-03-2019</td><td>WIYATI</td><td>WAKIJO 0101 W
2019</td><td>ADITYA</td><td>SARJONO 0712 S 09</td><td></td><td>NGAK
INGUK</td><td>INGAK - INGUK</td><td>PUCANGANOM</td><td>INDUK</td><td>dr. BUDI
2019</td><td>AGISHA</td><td>ANANG 06 05 A 07</td><td>BELUM/TIDAK
g.DANAR WULANDARI</td><td>RIZKI ANISSA, AM.Kg</td><td>L</td><td>5-9
align='right'>56100234</td><td>14-03-2019</td><td>ALFI ARROHMAH</td><td>SUPARMIN
0610 S 36</td><td>PETANI/PEKEBUN</td><td>TANGGUNG RT 04 RW
05</td><td>TANGGUNG</td><td>GIRITONTRO</td><td>INDUK</td><td>dr. BUDI
</tr><tr><td align='right'>A15</td><td>Respiratory tuberculosis, bacteriologically
align='right'>53020096</td><td>14-03-2019</td><td>ANISA YULIANA</td><td>SUNARSIH
0302 S 36</td><td>KARYAWAN SWASTA</td><td>SAMBIREJO RT03
2019</td><td>APRILIAN WIDYANTORO UTOMO</td><td>AGUS RAHARJO 0102 A
01</td><td>PELAJAR/MAHASISWA</td><td>NGRINGIN RT02
align='right'>15151381</td><td>14-03-2019</td><td>AULIA FAUZIAH</td><td>SUMARNO
1515 S 08</td><td>BELUM/TIDAK
BEKERJA</td><td>JAKARTA</td><td></td><td>JAKARTA</td><td>INDUK</td><td>dr. BUDI
2019</td><td>BEJO</td><td>BEJO 0601 B 06</td><td>PENSIUNAN</td><td>GIGRTONTRO
2019</td><td>BEJO</td><td>BEJO 0601 B 06</td><td>PENSIUNAN</td><td>GIGRTONTRO
2019</td><td>CUCUN TAHLINA</td><td>ANIK SYAHANIK</td><td>MENGURUS RUMAH
TANGGA</td><td>PANDEGLANG RT01
RW03</td><td></td><td>JAKARTA</td><td>INDUK</td><td>dr. BUDI ASHARI</td><td>RETNO
AMBARWATI AMD KEB</td><td>P</td><td>20-44 Thn.</td><td>Datang
align='right'>7</td><td align='right'>24</td><td>KIA</td><td></td><td></td><td>Luar
align='right'>Z00.3</td><td>Examination for adolescent development
state</td><td></td><td align='right'>289855</td><td
align='right'>52130074</td><td>14-03-2019</td><td>ELIS SETYOWATI</td><td>KATIYO
0213 K 08</td><td>PELAJAR/MAHASISWA</td><td>KERJO RT03
RW03</td><td>KERJO</td><td>TLOGOSARI</td><td>INDUK</td><td>dr. BUDI
align='right'>57050280</td><td>14-03-2019</td><td>FEPBINAFERON
MARGABUDI</td><td>HUTOMO/PURNOMO 0705 H
07</td><td>PETANI/PEKEBUN</td><td>SUKOROYOM KULON RT03M RW03</td><td>SUKOROYOM
align='right'>54010019</td><td>14-03-2019</td><td>INTAN TIARAWATI</td><td>SUMADI
0401 S 08</td><td>PELAJAR/MAHASISWA</td><td>BELEH RT01
align='right'>56020519</td><td>14-03-2019</td><td>JOKO MULYONO</td><td>JOKO MULYONO
06 02 J 07</td><td>PEGAWAI NEGERI SIPIL</td><td>GIRITONTRO KIDUL</td><td>GIRITONTRO
align='right'>15151394</td><td>14-03-2019</td><td>JUBAIDAH</td><td>SUMARNO 1515 S
TANGGA</td><td>JAKARTA</td><td></td><td>JAKARTA</td><td>INDUK</td><td>dr. BUDI
align='right'>57120146</td><td>14-03-2019</td><td>KARYONO SATINO</td><td>KARYONO
SATINO 0712 K 04</td><td>PETANI/PEKEBUN</td><td>INGAK INGUK RT02
RW16</td><td>INGAK - INGUK</td><td>PUCANGANOM</td><td>INDUK</td><td>dr. BUDI
d align='right'>H10.1</td><td>Acute atopic conjunctivitis</td><td></td><td
2019</td><td>KATIMIN</td><td>KATIMIN 0602 K
07</td><td>PETANI/PEKEBUN</td><td>GIRITONTRO KIDUL RT02 RW03</td><td>GIRITONTRO
align='right'>56080068</td><td>14-03-2019</td><td>KATIMIN</td><td>KATIMIN 0608 K
08</td><td>PETANI/PEKEBUN</td><td>DUNGKLEPU WETAN</td><td>DUNG KLEPU
align='right'>53015131</td><td>14-03-2019</td><td>KATMI</td><td>DANDUNG
R</td><td>PETANI/PEKEBUN</td><td>TLOGO</td><td>TLOGO</td><td>TLOGOHARJO</td><td>PKD
/td></tr><tr><td align='right'>J45.0</td><td>Predominantly allergic
asthma</td><td></td><td align='right'>289857</td><td
align='right'>51090003</td><td>14-03-2019</td><td>LARSI</td><td>KATINO 0109 K
01</td><td>PEGAWAI NEGERI SIPIL</td><td>PULUNG RT04
2019</td><td>MALOYO</td><td>MALOYO</td><td>PETANI/PEKEBUN</td><td>JAJAR</td><td>JAJ
AR</td><td>TLOGOHARJO</td><td>PKD TLOGOHARJO</td><td>SRI SUPATMI</td><td> -
align='right'>53015031</td><td>14-03-
2019</td><td>MARSI</td><td>PARINO</td><td>PETANI/PEKEBUN</td><td>TLOGO</td><td>TLOG
O</td><td>TLOGOHARJO</td><td>PKD TLOGOHARJO</td><td>SRI SUPATMI</td><td> -
2019</td><td>MAULANA DZIKRI RABBANI</td><td>M.ARYANTO</td><td>BELUM/TIDAK
BEKERJA</td><td>TLOGOSARI</td><td>TLOGOSARI</td><td>TLOGOSARI</td><td>PUSTU
TLOGOSARI</td><td>SULARNO,S.Kep.Ns</td><td> - </td><td>L</td><td><1
align='right'>A15</td><td>Respiratory tuberculosis, bacteriologically and
histologically confirmed</td><td></td><td align='right'>289841</td><td
></tr><tr><td align='right'>M79.10</td><td>Myalgia, multiple sites</td><td></td><td
2019</td><td>MULYONO</td><td>MULYONO 0308 M
03</td><td>PETANI/PEKEBUN</td><td>GINADE KULON RT01 RW03</td><td>GINADE
></tr><tr><td align='right'>N60.1</td><td>Diffuse cystic
mastopathy</td><td></td><td align='right'>289814</td><td
align='right'>56030127</td><td>14-03-2019</td><td>NARISEM</td><td>WARSINO 0603 W
02</td><td>MENGURUS RUMAH TANGGA</td><td>GEBLUG RT04
align='right'>57030055</td><td>14-03-2019</td><td>NUR FAHUDA</td><td>ISMANTO 07
03 I 01</td><td>PELAJAR/MAHASISWA</td><td>KUWANG RT 02 RW
align='right'>K08.3</td><td>Retained dental root</td><td></td><td
2019</td><td>NYAMAN SUSANTO</td><td>NYAMAN SUSANTO 0610 N
Thn.</td><td>Datang Sendiri</td><td>Lama</td><td>BPJS
NON PBI</td><td>Rajal</td><td align='right'>9</td><td align='right'>5</td><td
2019</td><td>PAIMO</td><td>PAIMO 0511 P
align='right'>K29.7</td><td>Gastritis, unspecified</td><td></td><td
2019</td><td>PARINO</td><td>PARINO</td><td>PETANI/PEKEBUN</td><td>TLOGO</td><td>TLO
2019</td><td>PARINO</td><td>PARINO</td><td>PETANI/PEKEBUN</td><td>TLOGO</td><td>TLO
></tr><tr><td align='right'>H10.4</td><td>Chronic conjunctivitis</td><td></td><td
2019</td><td>PONIJAH</td><td>SULARDI 0606 S
2019</td><td>PONIRAH</td><td>PONIRAH 07 04 P
RW01</td><td>MANDEYAN</td><td>PUCANGANOM</td><td>INDUK</td><td>drg.DANAR
align='right'>54010004</td><td>14-03-2019</td><td>PRIHATIN</td><td>SUMADI 0401 S
08</td><td>MENGURUS RUMAH TANGGA</td><td>BELEH RT01
</tr><tr><td align='right'>Z34.8</td><td>Supervision of other normal
align='right'>54010085</td><td>14-03-2019</td><td>RAHMINI</td><td>WIDODO 0401 W
04</td><td>PETANI/PEKEBUN</td><td>BELEH RT01
></tr><tr><td align='right'>H10.8</td><td>Other conjunctivitis</td><td></td><td
2019</td><td>REBIYEM</td><td>REBIYEM 07 09 R
align='right'>57090119</td><td>14-03-2019</td><td>REBIYEM</td><td>REBIYEM 07 09 R
align='right'>56010102</td><td>14-03-2019</td><td>RISTY
ZAIDAN</td><td>SUMARSO</td><td></td><td>GIRITONTRO LOR</td><td>GIRITONTRO
align='right'>57010094</td><td>14-03-2019</td><td>RIYATI</td><td>SULARNO 0701 S
01</td><td>MENGURUS RUMAH TANGGA</td><td>GROGOL RT03
align='right'>57030220</td><td>14-03-2019</td><td>RIZKY S R</td><td>SULISTYO 07 03
S 47</td><td>PELAJAR/MAHASISWA</td><td>KUWANG RT03
align='right'>56100172</td><td>14-03-2019</td><td>SAGIYEM</td><td>NYAMAN S 0610 N
03</td><td>WIRASWASTA</td><td>TANGGUNG</td><td>TANGGUNG</td><td>GIRITONTRO</td><td>
INDUK</td><td>dr. BUDI ASHARI</td><td>SUGIYONO,S.Kep.Ns</td><td>P</td><td>55-59
align='right'>15151395</td><td>14-03-2019</td><td>SITI RETNOWATI</td><td>DWI
HARYANTO
</td><td>PENSIUNAN</td><td>JAKARTA</td><td></td><td>JAKARTA</td><td>INDUK</td><td>d
r. BUDI ASHARI</td><td>SUGIYONO,S.Kep.Ns</td><td>P</td><td>60-69
RAHAYU</td><td>MISMAN 0602 M 16</td><td>BURUH HARIAN LEPAS</td><td>GIRITONTRO
KIDUL</td><td>GIRITONTRO KIDUL</td><td>GIRITONTRO</td><td>INDUK</td><td>dr. BUDI
align='right'>54080029</td><td>14-03-2019</td><td>SRI REJEKI</td><td>MISMAN 04 0 8
M 02</td><td>PELAJAR/MAHASISWA</td><td>NGANTAP RT03
RW05</td><td>NGANTAP</td><td>BAYEMHARJO</td><td>INDUK</td><td>dr. BUDI
align='right'>56020584</td><td>14-03-2019</td><td>SUGITO</td><td>SUGITO 0602 S
10</td><td>PETANI/PEKEBUN</td><td>GIRITONTRO KDUL 05/03I</td><td>GIRITONTRO
></tr><tr><td align='right'>M79.19</td><td>Myalgia, site
align='right'>51060012</td><td>14-03-2019</td><td>SUGIYO</td><td>SUGIYO 0106 S
05</td><td>PETANI/PEKEBUN</td><td>NGLARANGAN
01/04</td><td>NGLARANGAN</td><td>NGARGOHARJO</td><td>INDUK</td><td>dr. BUDI
2019</td><td>SUKADI</td><td>SUKADI 07 13 S
align='right'>51090012</td><td>14-03-2019</td><td>SUPARJO</td><td>SUPARJO 0109 S
10</td><td>PENSIUNAN</td><td>PULUNG RT04
align='right'>51050006</td><td>14-03-2019</td><td>SUPRAPTO</td><td>SUPRAPTO 0105 S
08</td><td>PETANI/PEKEBUN</td><td>GENTUNG RT02
RW03</td><td>GENTUNG</td><td>NGARGOHARJO</td><td>INDUK</td><td>dr. BUDI
></tr><tr><td align='right'>N34.3</td><td>Urethral syndrome,
align='right'>52110050</td><td>14-03-2019</td><td>SURANTO</td><td>SURANTO 0211 S
08</td><td>PETANI/PEKEBUN</td><td>TAMBAK RT01
></tr><tr><td align='right'>S51.9</td><td>Open wound of forearm, part
09</td><td>KARYAWAN
2019</td><td>SURATMI</td><td>SUTARDI 0102 S
03</td><td>PETANI/PEKEBUN</td><td>NGRINGIN RT 002 RW
></tr><tr><td align='right'>S10.7</td><td>Multiple superficial injuries of
neck</td><td></td><td align='right'>289806</td><td
align='right'>54020018</td><td>14-03-2019</td><td>TINEM</td><td>SONO KARYO 04 02
S 06</td><td>PETANI/PEKEBUN</td><td>NGUNDUK RT 01 RW
03</td><td>NGUNDUK</td><td>BAYEMHARJO</td><td>INDUK</td><td>dr. BUDI
align='right'>52037044</td><td>14-03-
2019</td><td>TRIYATI</td><td>SUWANTO</td><td>MENGURUS RUMAH
TANGGA</td><td>SALAM</td><td>SALAM</td><td>TLOGOSARI</td><td>PUSTU
align='right'>55025032</td><td>14-03-2019</td><td>TUKINO</td><td>TUKINO 05 02 T
01</td><td>PENSIUNAN</td><td>GIRIROTO RT 02 RW
d></tr><tr><td align='right'>K12</td><td>Stomatitis and related
lesions</td><td></td><td align='right'>289810</td><td
align='right'>57020002</td><td>14-03-2019</td><td>TUKIYEM</td><td>KASNO 0702 K
></tr><tr><td align='right'>S10.9</td><td>Superficial injury of neck, part
align='right'>57010066</td><td>14-03-2019</td><td>TUMINI</td><td>KARDI 07 01 K
03</td><td>MENGURUS RUMAH TANGGA</td><td>GROGOL RT 03 RW
></tr><tr><td align='right'>H25.9</td><td>Senile cataract,
align='right'>56055019</td><td>14-03-2019</td><td>TUMIYEM</td><td>YOSO TARWONO
0605 Y 01</td><td>PETANI/PEKEBUN</td><td>NGUJUNG, RT 03, RW
08</td><td>NGUJUNG</td><td>GIRITONTRO</td><td>INDUK</td><td>dr. BUDI
Sendiri</td><td>Lama</td><td>UMUM WONOGIRI</td><td>Rujuk</td><td
Umum</td><td>Poli Mata</td><td>RS MAGUAN HUSADA</td><td>Dalam
align='right'>54110027</td><td>14-03-2019</td><td>TUMIYEM</td><td>MISNO 0411 M
03</td><td>PETANI/PEKEBUN</td><td>GUWO</td><td>GUWO</td><td>BAYEMHARJO</td><td>INDU
K</td><td>dr. BUDI ASHARI</td><td>SUGIYONO,S.Kep.Ns</td><td>L</td><td>>70
align='right'>57070004</td><td>14-03-2019</td><td>UMAYAH</td><td>UMAYAH 07 07 U
01</td><td>PENSIUNAN</td><td>BANJAR RT01
align='right'>57120001</td><td>14-03-2019</td><td>WINDARI</td><td>SARJONO 0712 S
2019</td><td>ZIDNA ILMAN NAFI AN</td><td>SLAMET 0705
S37</td><td>PELAJAR/MAHASISWA</td><td>SIKOROYOM KULON</td><td>SUKOROYOM
KULON</td><td>PUCANGANOM</td><td>INDUK</td><td>drg.DANAR WULANDARI</td><td>RIZKI
</tr><tr><td align='right'>E56.8</td><td>Deficiency of other
vitamins</td><td></td><td align='right'>289873</td><td
align='right'>57100177</td><td>15-03-2019</td><td> SUKADI</td><td>VALENTINUS SUKADI
0710 V 01</td><td>PETANI/PEKEBUN</td><td>JEPURUN RT01
2019</td><td>ADITYA SAPUTRA</td><td>SUWANDI 0604 S
04</td><td>LAINNYA</td><td>KETONGGO</td><td>KETONGGO</td><td>GIRITONTRO</td><td>IND
UK</td><td>dr. BUDI ASHARI</td><td>SUWARTO,S.Kep.Nes</td><td>L</td><td>20-44
></tr><tr><td align='right'>Z23.2</td><td>Need for immunization against
tuberculosis [BCG]</td><td></td><td align='right'>289882</td><td
align='right'>55090086</td><td>15-03-2019</td><td>AKMAL AUFRAN
PURNOMO</td><td>BAMBANG</td><td>BELUM/TIDAK
BEKERJA</td><td>MULWOSARI</td><td></td><td>JATIREJO</td><td>INDUK</td><td>dr. BUDI
ASHARI</td><td>RISTINA Amd Keb</td><td>L</td><td>8-30 hari</td><td>Datang
Sendiri</td><td>Baru</td><td>Imunisasi</td><td>Rajal</td><td
align='right'>0</td><td>Imunisasi</td><td></td><td></td><td>Dalam
align='right'>Z24.0</td><td>Need for immunization against
poliomyelitis</td><td></td><td align='right'>289882</td><td
align='right'>55090086</td><td>15-03-2019</td><td>AKMAL AUFRAN
PURNOMO</td><td>BAMBANG</td><td>BELUM/TIDAK
BEKERJA</td><td>MULWOSARI</td><td></td><td>JATIREJO</td><td>INDUK</td><td>dr. BUDI
ASHARI</td><td>RISTINA Amd Keb</td><td>L</td><td>8-30 hari</td><td>Datang
align='right'>56020067</td><td>15-03-2019</td><td>ANINDA SALTSABILA</td><td>SUNARNO
0602 S 18</td><td>PELAJAR/MAHASISWA</td><td>GIRITONTRO KIDUL</td><td>GIRITONTRO
2019</td><td>ANINDA SALTSABILA</td><td>SUNARNO 0602 S
18</td><td>PELAJAR/MAHASISWA</td><td>GIRITONTRO KIDUL</td><td>GIRITONTRO
align='right'>57040309</td><td>15-03-2019</td><td>BELLA YVANA AUDIYA</td><td>M
ANSORI</td><td>BELUM/TIDAK
BEKERJA</td><td>MANDEYAN</td><td>MANDEYAN</td><td>PUCANGANOM</td><td>INDUK</td><td>
dr. BUDI ASHARI</td><td>RISTINA Amd Keb</td><td>P</td><td>8-30 hari</td><td>Datang
align='right'>57040309</td><td>15-03-2019</td><td>BELLA YVANA AUDIYA</td><td>M
ANSORI</td><td>BELUM/TIDAK
dr. BUDI ASHARI</td><td>RISTINA Amd Keb</td><td>P</td><td>8-30 hari</td><td>Datang
align='right'>F20.1</td><td>Hebephrenic schizophrenia</td><td></td><td
2019</td><td>DINAR WAHYUNIKA OKTA F</td><td>SRIYANTO 07 02 S
20</td><td>PELAJAR/MAHASISWA</td><td>SUKOROYOM WETAN RT 01 RW
ASHARI</td><td>SUWARTO,S.Kep.Nes</td><td>P</td><td>20-44
Thn.</td><td>Datang Sendiri</td><td>Lama</td><td>BPJS NON
></tr><tr><td align='right'>S01.7</td><td>Multiple open wounds of
head</td><td></td><td align='right'>289872</td><td
align='right'>56070099</td><td>15-03-2019</td><td>DWI PRASETYO</td><td>SARJU 0607
S 14</td><td>LAINNYA</td><td>DUNGKANCIL</td><td>DUNG
align='right'>57030445</td><td>15-03-2019</td><td>ELVANA ZAINUL
FAHLEFI</td><td>AGUS SARYONO</td><td>BELUM/TIDAK
BEKERJA</td><td>KUWANG</td><td>KUWANG</td><td>PUCANGANOM</td><td>INDUK</td><td>dr.
BUDI ASHARI</td><td>RISTINA Amd Keb</td><td>L</td><td><1 Thn.</td><td>Datang
align='right'>57030445</td><td>15-03-2019</td><td>ELVANA ZAINUL
FAHLEFI</td><td>AGUS SARYONO</td><td>BELUM/TIDAK
BUDI ASHARI</td><td>RISTINA Amd Keb</td><td>L</td><td><1 Thn.</td><td>Datang
align='right'>Z23.2</td><td>Need for immunization against tuberculosis
[BCG]</td><td></td><td align='right'>289885</td><td
align='right'>57030446</td><td>15-03-2019</td><td>FADLI
KURNIAWAN</td><td>KATIMIN</td><td>BELUM/TIDAK
BUDI ASHARI</td><td>RISTINA Amd Keb</td><td>L</td><td>8-30 hari</td><td>Datang
align='right'>57030446</td><td>15-03-2019</td><td>FADLI
KURNIAWAN</td><td>KATIMIN</td><td>BELUM/TIDAK
align='right'>S22.0</td><td>Fracture of thoracic vertebra</td><td></td><td
2019</td><td>JUMINI</td><td>SULARNO 05 01 S 23</td><td>PEDAGANG</td><td>GIRIBELAH
RT03 RW07</td><td>GIRIBELAH</td><td>JATIREJO</td><td>INDUK</td><td>dr. BUDI
align='right'>57030135</td><td>15-03-2019</td><td>KARTINI</td><td>SUROTO 0703 S
></tr><tr><td align='right'>I84.9</td><td>Unspecified haemorrhoids without
align='right'>57050088</td><td>15-03-2019</td><td>KASEMI</td><td>MARYOTO 07 05 M
align='right'>55110052</td><td>15-03-2019</td><td>LITA NOFIANTI</td><td>SUPRIYADI
0511 S 02</td><td>LAINNYA</td><td>BUWENG RT02
RW05</td><td>BUWENG</td><td>JATIREJO</td><td>INDUK</td><td>dr. BUDI
align='right'>57130140</td><td>15-03-2019</td><td>M.RASYID RIO
HARTANTO</td><td>HARTANTO</td><td>BELUM/TIDAK
BEKERJA</td><td>KEPUH</td><td>KEPUH</td><td>PUCANGANOM</td><td>INDUK</td><td>dr.
align='right'>57130140</td><td>15-03-2019</td><td>M.RASYID RIO
HARTANTO</td><td>HARTANTO</td><td>BELUM/TIDAK
BEKERJA</td><td>KEPUH</td><td>KEPUH</td><td>PUCANGANOM</td><td>INDUK</td><td>dr.
align='right'>I50.0</td><td>Congestive heart failure</td><td></td><td
2019</td><td>MARYOTO</td><td>MARYOTO 06 02 M
></tr><tr><td align='right'>K08.3</td><td>Retained dental root</td><td></td><td
2019</td><td>NYAMAN SUSANTO</td><td>NYAMAN SUSANTO 0610 N
with renal complications</td><td></td><td align='right'>289874</td><td
align='right'>51060009</td><td>15-03-2019</td><td>PANIYEM</td><td>SARPAN 01 06 S
02</td><td>PETANI/PEKEBUN</td><td>NGLARANGAN RT04
RW03</td><td>NGLARANGAN</td><td>NGARGOHARJO</td><td>INDUK</td><td>dr. BUDI
Dalam</td><td>RSUD DR. SOEDIRAN MS WONOGIRI</td><td>Dalam
/td></tr><tr><td align='right'>R50.9</td><td>Fever, unspecified</td><td></td><td
2019</td><td>REVINA NADIA KHALISTA</td><td>DEDI SUSANTO 0302 D
02</td><td>BELUM/TIDAK BEKERJA</td><td>SAMBIREJO RT01
align='right'>56010049</td><td>15-03-2019</td><td>RIDHO ARDIANTO</td><td>SUPRIYANTO
0601 S 15</td><td>PELAJAR/MAHASISWA</td><td>GIRITONTRO LOR RT 01 RW
02</td><td>GIRITONTRO LOR</td><td>GIRITONTRO</td><td>INDUK</td><td>dr. BUDI
align='right'>M79.02</td><td>Rheumatism, unspecified, upper arm</td><td></td><td
2019</td><td>SARMINI</td><td>SUNARMO 0506 S
17</td><td>PETANI/PEKEBUN</td><td>JATI
02/03</td><td>JATI</td><td>JATIREJO</td><td>INDUK</td><td>dr. BUDI
2019</td><td>SELVIA ANGGRAHENI</td><td>HERI PURWANTO 0601 H 06</td><td>MENGURUS
RUMAH TANGGA</td><td>GIRITONTRO LOR RT03 RW01</td><td>GIRITONTRO
align='right'>N34.3</td><td>Urethral syndrome, unspecified</td><td></td><td
2019</td><td>SUMINI</td><td>TARMUJI 0605 T
d>INDUK</td><td>dr. BUDI ASHARI</td><td>SUWARTO,S.Kep.Nes</td><td>P</td><td>45-54
align='right'>56020031</td><td>15-03-
2019</td><td>SURATMI</td><td>SUNARNO</td><td>MENGURUS RUMAH
TANGGA</td><td>GIRITONTRO KIDUL</td><td>GIRITONTRO
align='right'>51020035</td><td>15-03-2019</td><td>SUYOTO</td><td>SUYOTO 01 02 S
UTAMI</td><td>HARYANTO 0712 H 05</td><td>PELAJAR/MAHASISWA</td><td>NGAK INGUK RT01
RW16,PUCANGANOM</td><td>INGAK - INGUK</td><td>PUCANGANOM</td><td>INDUK</td><td>dr.
align='right'>56030084</td><td>15-03-2019</td><td>TRIAS KRISTIANI</td><td>SUKIDI
0603 S 18</td><td>BELUM/TIDAK BEKERJA</td><td>GEBLUG
RT.03/07</td><td>GEBLUG</td><td>GIRITONTRO</td><td>INDUK</td><td>dr. BUDI
align='right'>I84.9</td><td>Unspecified haemorrhoids without
align='right'>56045052</td><td>15-03-2019</td><td>TUKINEM</td><td>TUGIMAN 0604 T
04</td><td>PETANI/PEKEBUN</td><td>KETONGGO</td><td>KETONGGO</td><td>GIRITONTRO</td>
<td>INDUK</td><td>dr. BUDI ASHARI</td><td>SUWARTO,S.Kep.Nes</td><td>P</td><td>>70
></tr><tr><td align='right'>Z34.0</td><td>Supervision of normal first
align='right'>56060076</td><td>15-03-2019</td><td>WARSIYEM</td><td> SANTOSO 06 06
S 24</td><td>BURUH HARIAN LEPAS</td><td>GOBOH RT02
></tr><tr><td align='right'>H10.9</td><td>Conjunctivitis,
align='right'>57070288</td><td>16-03-2019</td><td>ADELIA INDI
ANGGRAENI</td><td>SUGIYANTO 0707 S 09</td><td>PELAJAR/MAHASISWA</td><td>BANJAR
></tr><tr><td align='right'>A00.9</td><td>Cholera, unspecified</td><td></td><td
2019</td><td>ANITASYA PUTRI NAJWA</td><td>SATINO 07 01 S 15</td><td>BELUM/TIDAK
BEKERJA</td><td>GROGOLRT 02 RW
align='right'>F44.5</td><td>Dissociative convulsions</td><td></td><td
align='right'>52080125</td><td>16-03-2019</td><td>JIKEM</td><td>MIJAN 0208 M
02</td><td>PETANI/PEKEBUN</td><td>TLOGOSARI RT01
ASHARI</td><td>SUWARTO,S.Kep.Nes</td><td>P</td><td>60-69
Thn.</td><td>Datang Sendiri</td><td>Lama</td><td>BPJS NON
PBI</td><td>Rujuk</td><td align='right'>15</td><td align='right'>3</td><td
></tr><tr><td align='right'>G43.9</td><td>Migraine, unspecified</td><td></td><td
2019</td><td>JUMINI</td><td>TUSIRAN 0202 T
08</td><td>PETANI/PEKEBUN</td><td>MANTHANG RT01
RW07</td><td>MANTHANG</td><td>TLOGOSARI</td><td>INDUK</td><td>dr. BUDI
align='right'>57050088</td><td>16-03-2019</td><td>KASEMI</td><td>MARYOTO 07 05 M
></tr><tr><td align='right'>S01.7</td><td>Multiple open wounds of
head</td><td></td><td align='right'>289900</td><td
align='right'>57020249</td><td>16-03-2019</td><td>KASNO</td><td>KASNO 07 02 K
06</td><td>PETANI/PEKEBUN</td><td>SUKOROYOM WETAN RT 02 RW 04</td><td>SUKOROYOM
</tr><tr><td align='right'>I50.1</td><td>Left ventricular failure</td><td></td><td
2019</td><td>KIYEM</td><td>POIMIN 0301 P 07</td><td>PETANI/PEKEBUN</td><td>TLOGO
RT02 RW01</td><td>TLOGO</td><td>TLOGOHARJO</td><td>INDUK</td><td>dr. BUDI
></tr><tr><td align='right'>S01.4</td><td>Open wound of cheek and temporomandibular
area</td><td></td><td align='right'>289896</td><td
align='right'>57020143</td><td>16-03-2019</td><td>LARNI</td><td>MARDI 0702 M
/td></tr><tr><td align='right'>S01.3</td><td>Open wound of ear</td><td></td><td
2019</td><td>MIYATUN</td><td>UNTUNG BASUKI 0703 U
01</td><td>PELAJAR/MAHASISWA</td><td>KUWANG</td><td>KUWANG</td><td>PUCANGANOM</td><
td>INDUK</td><td>dr. BUDI ASHARI</td><td>SUWARTO,S.Kep.Nes</td><td>P</td><td>20-44
align='right'>Z30.8</td><td>Other contraceptive management</td><td></td><td
align='right'>289899</td><td align='right'>56100297</td><td>16-03-2019</td><td>NUR
HAYATI</td><td>SUTANTO 0610 S 52</td><td>BURUH HARIAN LEPAS</td><td>TANGGUNG RT04
align='right'>H25.9</td><td>Senile cataract, unspecified</td><td></td><td
2019</td><td>SIJEM</td><td>TUYADI 0714 T 07</td><td>PETANI/PEKEBUN</td><td>PENDEM
align='right'>57040094</td><td>16-03-2019</td><td>SRI HARTINI</td><td>PURNOMO 0704
SP 06</td><td>MENGURUS RUMAH
TANGGA</td><td>MANDEYAN</td><td>MANDEYAN</td><td>PUCANGANOM</td><td>INDUK</td><td>d
r. BUDI ASHARI</td><td>SUWARTO,S.Kep.Nes</td><td>P</td><td>60-69
align='right'>56100390</td><td>16-03-2019</td><td>SUKATMI</td><td>MARIDI 06 10 M
14</td><td>MENGURUS RUMAH TANGGA</td><td>TANGGUNG RT01
2019</td><td>SUNARNI</td><td>ARIE PRASETYO 0706 A 01</td><td>BURUH HARIAN
LEPAS</td><td>TAMBAHSASRI</td><td>TAMBAHSARI</td><td>PUCANGANOM</td><td>INDUK</td><
td>dr. BUDI ASHARI</td><td>RISTINA Amd Keb</td><td>P</td><td>20-44
align='right'>S01.2</td><td>Open wound of nose</td><td></td><td
align='right'>57080110</td><td>18-03-2019</td><td>AFIFATUL MUNAWAROH</td><td>ANIS
SETIAWAN 07 08 A 04</td><td>PELAJAR/MAHASISWA</td><td>PUCANGANOM
KIDUL</td><td>PUCANGANOM KIDUL</td><td>PUCANGANOM</td><td>INDUK</td><td>dr. BUDI
align='right'>56050015</td><td>18-03-2019</td><td>AGISHA</td><td>ANANG 06 05 A
07</td><td>BELUM/TIDAK
g.DANAR WULANDARI</td><td>RIZKI ANISSA, AM.Kg</td><td>L</td><td>5-9
WONOGIRI</td><td>Rajal</td><td
align='right'>52145065</td><td>18-03-2019</td><td>ALYA NUR
AZAHRA</td><td>YALIMI</td><td>BELUM/TIDAK
BEKERJA</td><td>GUPAKAN</td><td>GUPAKAN</td><td>TLOGOSARI</td><td>PKD
align='right'>289938</td><td align='right'>55100032</td><td>18-03-2019</td><td>ANDI
ISHARYANTO</td><td>SARWO/05/10/S/07</td><td>PETANI/PEKEBUN</td><td>SENGON</td><td>S
ENGON</td><td>JATIREJO</td><td>INDUK</td><td>drg.DANAR WULANDARI</td><td>RIZKI
></tr><tr><td align='right'>K29.9</td><td>Gastroduodenitis,
align='right'>51040026</td><td>18-03-2019</td><td>ANDITA</td><td>JOKO PURNOMO 0104
J 01</td><td>LAINNYA</td><td>KLEPU RT03
RW05,NGARGOHARJO</td><td>KLEPU</td><td>NGARGOHARJO</td><td>INDUK</td><td>dr. BUDI
Umum</td><td>Poli Dalam</td><td>RSUD DR. SOEDIRAN MS WONOGIRI</td><td>Dalam
/td></tr><tr><td align='right'>K00.6</td><td>Disturbances in tooth
align='right'>57050040</td><td>18-03-2019</td><td>ANESTA</td><td>SUHEBI 07 05 S
08</td><td>PELAJAR/MAHASISWA</td><td>SUKOROYOM KULON RT 02 RW 03</td><td>SUKOROYOM
2019</td><td>ARDELIA</td><td>ALFALIAN 0605 A
03</td><td>PELAJAR/MAHASISWA</td><td>NGUJUNG RT03
RW08</td><td>NGUJUNG</td><td>GIRITONTRO</td><td>INDUK</td><td>drg.DANAR
align='right'>52057014</td><td>18-03-2019</td><td>ARISTA
DEA</td><td></td><td>PELAJAR/MAHASISWA</td><td>GLAGAH</td><td>GLAGAH</td><td>TLOGOS
ARI</td><td>PUSTU TLOGOSARI</td><td>SULARNO,S.Kep.Ns</td><td> -
</td><td>P</td><td>5-9 Thn.</td><td>Datang Sendiri</td><td>Baru</td><td>UMUM
align='right'>289926</td><td align='right'>56100381</td><td>18-03-2019</td><td>ARKA
NIZARUL MAULANA</td><td>MARIDI 06 10 M
14</td><td>PELAJAR/MAHASISWA</td><td>TANGGUNG</td><td>TANGGUNG</td><td>GIRITONTRO</
td><td>INDUK</td><td>drg.DANAR WULANDARI</td><td>RIZKI ANISSA,
AM.Kg</td><td>L</td><td>5-9 Thn.</td><td>Datang Sendiri</td><td>Lama</td><td>UMUM
align='right'>289950</td><td align='right'>56020684</td><td>18-03-2019</td><td>ASEP
SOEPUDIN</td><td>ASEP SOEPUDIN 06 02 A 15</td><td>KARYAWAN
SWASTA</td><td>GIRITONTRO KIDUL RT 04 RW 03</td><td>GIRITONTRO
KIDUL</td><td>GIRITONTRO</td><td>INDUK</td><td>drg.DANAR WULANDARI</td><td>RIZKI
align='right'>54065160</td><td>18-03-2019</td><td>AYUNINGDYA AILA
VARISHA</td><td>EDI </td><td>BELUM/TIDAK
BEKERJA</td><td>BAYEM</td><td>BAYEM</td><td>BAYEMHARJO</td><td>PUSTU
BAYEMHARJO</td><td>RISTINA Amd Keb</td><td> - </td><td>P</td><td>1-4
align='right'>55010255</td><td>18-03-2019</td><td>BUDI HARTANTO</td><td>BUDI
HARTANTO 0501 B 01</td><td>PETANI/PEKEBUN</td><td>GIRIBELAH
03/07</td><td>GIRIBELAH</td><td>JATIREJO</td><td>INDUK</td><td>dr. BUDI
align='right'>52087018</td><td>18-03-2019</td><td>BUDI WULANDARI</td><td>ZAENAL
ABIDIN</td><td>PETANI/PEKEBUN</td><td>TLOGOSARI</td><td>TLOGOSARI</td><td>TLOGOSARI
</td><td>PUSTU TLOGOSARI</td><td>SULARNO,S.Kep.Ns</td><td> - </td><td>P</td><td>20-
align='right'>54065110</td><td>18-03-
2019</td><td>CANDRA</td><td>GIARSO</td><td>BELUM/TIDAK
BAYEMHARJO</td><td>RISTINA Amd Keb</td><td> - </td><td>L</td><td>5-9
align='right'>289922</td><td align='right'>52110046</td><td>18-03-2019</td><td>DENI
SAPUTRA </td><td>DENI SAPUTRA 0211 D 04</td><td>KARYAWAN SWASTA</td><td>TAMBAK
RT01 RW02</td><td>TAMBAK</td><td>TLOGOSARI</td><td>INDUK</td><td>drg.DANAR
align='right'>56010442</td><td>18-03-2019</td><td>DEWI ERNAWATI</td><td>WAHYU
NUGROHO 06 01 W 06</td><td>PEDAGANG</td><td>GIRITONTRO LOR RT 02 RW
align='right'>H60.8</td><td>Other otitis externa</td><td></td><td
align='right'>289908</td><td align='right'>51070059</td><td>18-03-2019</td><td>DIAH
AULIA DEWI</td><td>SURADI 0107 S10</td><td>BELUM/TIDAK BEKERJA</td><td>NGASEM RT 02
RW 04</td><td>NGASEM</td><td>NGARGOHARJO</td><td>INDUK</td><td>dr. BUDI
Sendiri</td><td>Baru</td><td>BPJS NON PBI</td><td>Rajal</td><td
align='right'>57070077</td><td>18-03-2019</td><td>DIMIN</td><td>DIMIN 07 07 D
/td></tr><tr><td align='right'>F20.6</td><td>Simple schizophrenia</td><td></td><td
align='right'>14141395</td><td>18-03-2019</td><td>DWI ISTANTO</td><td>SUYOTO/
SARJONO</td><td>KARYAWAN SWASTA</td><td>WEDI RT 01 RW 05</td><td></td><td>JAWA
TENGAH</td><td>INDUK</td><td>dr. BUDI
2019</td><td>ENDRA PRATAMA PUTRA</td><td>SENO/EKO SETIAWAN 0702 S
39</td><td>PELAJAR/MAHASISWA</td><td>SUKOROYOM WETAN RT.04 RW.04</td><td>SUKOROYOM
td></tr><tr><td align='right'>J11.8</td><td>Influenza with other manifestations,
align='right'>54070024</td><td>18-03-2019</td><td>FEBIAN ASKA</td><td>SANTOSO 0407
S
10</td><td></td><td>NGALURAN</td><td>NGALURAN</td><td>BAYEMHARJO</td><td>INDUK</td>
<td>dr. BUDI ASHARI</td><td>SRI MURWATININGSIH</td><td>P</td><td>1-4
align='right'>L23.4</td><td>Allergic contact dermatitis due to
dyes</td><td></td><td align='right'>289930</td><td
align='right'>57030053</td><td>18-03-2019</td><td>FIRDATUN HASANAH</td><td>SADERI
07 03 S 03</td><td>PELAJAR/MAHASISWA</td><td>KUWANG RT01
2019</td><td>FITRI IRAWATI</td><td>BUDI HARTANTO 05 01 B 01</td><td>MENGURUS
RUMAH TANGGA</td><td>GIRIBELAH RT03
</tr><tr><td align='right'>K29.5</td><td>Chronic gastritis,
align='right'>57080229</td><td>18-03-2019</td><td>IPAH SUPRAPTI</td><td>TUKIMIN 07
08 T 08</td><td>PETANI/PEKEBUN</td><td>PUCANGANOM KIDUL RT 03 RW
08</td><td>PUCANGANOM KIDUL</td><td>PUCANGANOM</td><td>INDUK</td><td>dr. BUDI
></tr><tr><td align='right'>F20.0</td><td>Paranoid schizophrenia</td><td></td><td
align='right'>289943</td><td align='right'>57080125</td><td>18-03-2019</td><td>IWAN
SUSANTO</td><td>TUGIYO 0708 T 06</td><td>PETANI/PEKEBUN</td><td>PUCANGANOM KIDUL
RT01 RW08</td><td>PUCANGANOM KIDUL</td><td>PUCANGANOM</td><td>INDUK</td><td>dr.
BUDI ASHARI</td><td>SUWARTO,S.Kep.Nes</td><td>L</td><td>15-19 Thn.</td><td>Datang
2019</td><td>JIKEM</td><td></td><td>PETANI/PEKEBUN</td><td>NGRINGIN</td><td>NGRINGI
N</td><td>NGARGOHARJO</td><td>PUSTU NGARGOHARJO</td><td>SUSI HERAWATI, AMK</td><td>
- </td><td>P</td><td>>70 Thn.</td><td>Datang Sendiri</td><td>Lama</td><td>BPJS
2019</td><td>JURIYANI</td><td>SUKIMIN</td><td>PETANI/PEKEBUN</td><td>BAYEM</td><td>
BAYEM</td><td>BAYEMHARJO</td><td>PUSTU BAYEMHARJO</td><td>RISTINA Amd Keb</td><td>
2019</td><td>KALIYEM</td><td>MUSIMAN</td><td>PETANI/PEKEBUN</td><td>GEDANGAN</td><t
d>GEDANGAN</td><td>NGARGOHARJO</td><td>PUSTU NGARGOHARJO</td><td>SUSI HERAWATI,
2019</td><td>KARDIANTO</td><td>KARDIANTO 11 11 K
02</td><td>PETANI/PEKEBUN</td><td>GEDOMPOL RT 02 RW 07</td><td></td><td>JAWA
TIMUR</td><td>INDUK</td><td>drg.DANAR WULANDARI</td><td>RIZKI ANISSA,
AM.Kg</td><td>L</td><td>55-59 Thn.</td><td>Datang
2019</td><td>KARMI</td><td>TUKINO</td><td>PETANI/PEKEBUN</td><td>TLOGO</td><td>TLOG
d></tr><tr><td align='right'>I10</td><td>Essential (primary)
align='right'>53065043</td><td>18-03-
2019</td><td>KARTI</td><td>PARDI</td><td>PETANI/PEKEBUN</td><td>KLEPU</td><td>KLEPU
</td><td>TLOGOHARJO</td><td>PKD TLOGOHARJO</td><td>SRI SUPATMI</td><td> -
2019</td><td>KARYO SUMANTO</td><td>KARYO
SUMANTO</td><td>PETANI/PEKEBUN</td><td>TLOGOSARI</td><td>TLOGOSARI</td><td>TLOGOSAR
I</td><td>PUSTU TLOGOSARI</td><td>SULARNO,S.Kep.Ns</td><td> -
</td><td>L</td><td>>70 Thn.</td><td>Datang Sendiri</td><td>Lama</td><td>BPJS NON
2019</td><td>KATIJO</td><td>KATIJO</td><td>PETANI/PEKEBUN</td><td>PELET</td><td>PEL
ET</td><td>NGARGOHARJO</td><td>PUSTU NGARGOHARJO</td><td>SUSI HERAWATI,
align='right'>56100052</td><td>18-03-2019</td><td>KATINO</td><td>KATINO 0610 K
04</td><td>PELAJAR/MAHASISWA</td><td>TANGGUNG RT01
RW05,GIRITONTRO</td><td>TANGGUNG</td><td>GIRITONTRO</td><td>INDUK</td><td>dr. BUDI
align='right'>54060035</td><td>18-03-2019</td><td>KATIRAH</td><td>KATIRAH 0406 K
04</td><td>PETANI/PEKEBUN</td><td>BAYEM RT02
></tr><tr><td align='right'>M79.10</td><td>Myalgia, multiple sites</td><td></td><td
2019</td><td>KATIYEM</td><td>GIMIN 0604 G
02</td><td>PETANI/PEKEBUN</td><td>KETONGGO RT 01 RW
2019</td><td>KATNI</td><td>KATINO</td><td>PETANI/PEKEBUN</td><td>BAYEM</td><td>BAYE
M</td><td>BAYEMHARJO</td><td>PUSTU BAYEMHARJO</td><td>RISTINA Amd Keb</td><td> -
align='right'>54065163</td><td>18-03-2019</td><td>KRISTIYANI</td><td>EDI
HARTONO</td><td>MENGURUS RUMAH
TANGGA</td><td>BAYEM</td><td>BAYEM</td><td>BAYEMHARJO</td><td>PUSTU
align='right'>57030072</td><td>18-03-2019</td><td>LESTARI</td><td>YATINO 0703 Y
align='right'>57030199</td><td>18-03-2019</td><td>MA'RUF ABIDA</td><td>NGATMAN
0703 N 02</td><td>BELUM/TIDAK BEKERJA</td><td>KUWANG RT01
align='right'>51017037</td><td>18-03-
2019</td><td>MANIYEM</td><td>KATIJO</td><td>PETANI/PEKEBUN</td><td>PELET</td><td>PE
LET</td><td>NGARGOHARJO</td><td>PUSTU NGARGOHARJO</td><td>SUSI HERAWATI,
align='right'>56100198</td><td>18-03-2019</td><td>MARSIYEM</td><td>NASRUN 06 10 N
01</td><td>PETANI/PEKEBUN</td><td>TANGGUNG RT
02/05</td><td>TANGGUNG</td><td>GIRITONTRO</td><td>INDUK</td><td>dr. BUDI
align='right'>57030064</td><td>18-03-2019</td><td>MIFTAH SYAHUDA</td><td>DENAN 07
03 D 04</td><td>BELUM/TIDAK
/td></tr><tr><td align='right'>M13.9</td><td>Arthritis,
align='right'>51027018</td><td>18-03-
2019</td><td>MIKAYLA ZALINDRA DARMAWAN</td><td>ANGGA DARMAWAN 0101 A
BEKERJA</td><td>PELET</td><td>PELET</td><td>NGARGOHARJO</td><td>PUSTU
NGARGOHARJO</td><td>SUSI HERAWATI, AMK</td><td> - </td><td>L</td><td>5-9
align='right'>55100039</td><td>18-03-2019</td><td>MINAH</td><td>SARWO 0510 S
07</td><td>PETANI/PEKEBUN</td><td>SENGON RT02
RW04</td><td>SENGON</td><td>JATIREJO</td><td>INDUK</td><td>dr. BUDI
align='right'>57050114</td><td>18-03-2019</td><td>MISGINAH</td><td>SALAMUN 07 05
S 36</td><td>PETANI/PEKEBUN</td><td>SUKOROYOM KULON RT 01 RW 03</td><td>SUKOROYOM
align='right'>53020017</td><td>18-03-2019</td><td>MUH LINTANG</td><td>SUWARSO 03
02 S 05</td><td>BELUM/TIDAK BEKERJA</td><td>SAMBIREJO RT03
RW01</td><td></td><td>TLOGOHARJO</td><td>INDUK</td><td>dr. BUDI ASHARI</td><td>SRI
MURWATININGSIH</td><td>L</td><td>1-4 Thn.</td><td>Datang
td></tr><tr><td align='right'>M79.05</td><td>Rheumatism, unspecified, pelvic region
align='right'>57050371</td><td>18-03-2019</td><td>MULYADI</td><td>MULYADI 07 05 M
08</td><td>PERDAGANGAN</td><td>SUKOROYOM KULON RT 02 RW 03</td><td>SUKOROYOM
2019</td><td>MURIFIKA ATMALYANA</td><td>SRIMULYONO 5605 S 01</td><td>BELUM/TIDAK
align='right'>E84.9</td><td>Cystic fibrosis, unspecified</td><td></td><td
align='right'>57120133</td><td>18-03-2019</td><td>NGATIMIN</td><td>NGATIMIN 0712
N 04</td><td>PELAJAR/MAHASISWA</td><td>NGAK INGUK RT02 RW16</td><td>INGAK -
align='right'>55120050</td><td>18-03-
2019</td><td>NGATINEM</td><td>NGATINEM</td><td>PETANI/PEKEBUN</td><td>NGASEM
</td><td>NGASEM</td><td>JATIREJO</td><td>INDUK</td><td>dr. BUDI
align='right'>Z48.9</td><td>Surgical follow-up care, unspecified</td><td></td><td
2019</td><td>NINING WIDYATANTI</td><td>HARSANTO 0601 H 04</td><td>MENGURUS RUMAH
TANGGA</td><td>GIRITONTRO LOR RT 01 RW 02</td><td>GIRITONTRO
LOR</td><td>GIRITONTRO</td><td>INDUK</td><td>dr. BUDI ASHARI</td><td>SRI
MURWATININGSIH</td><td>P</td><td>20-44 Thn.</td><td>Datang
align='right'>55030046</td><td>18-03-
2019</td><td>PAIJEM</td><td>SULARNO</td><td>PETANI/PEKEBUN</td><td>SONGGODULANG RT
01 RW 01</td><td>SONGGODULANG</td><td>JATIREJO</td><td>INDUK</td><td>dr. BUDI
</tr><tr><td align='right'>K29.9</td><td>Gastroduodenitis,
align='right'>57040114</td><td>18-03-2019</td><td>PAINAH</td><td>PAINAH 07 04 P
align='right'>51030074</td><td>18-03-2019</td><td>PARMAN</td><td>SUPARMAN
0103 S 18</td><td>PETANI/PEKEBUN</td><td>PRINGKUKU RT 02 RW
02</td><td>PRINGKUKU</td><td>NGARGOHARJO</td><td>INDUK</td><td>dr. BUDI
d></tr><tr><td align='right'>M79.1</td><td>Myalgia</td><td></td><td
2019</td><td>PARMI</td><td>KADIMAN 0407 K
01</td><td>PETANI/PEKEBUN</td><td>NGALURAN RT 01 RW
</tr><tr><td align='right'>K05.2</td><td>Acute periodontitis</td><td></td><td
2019</td><td>PENTI ANGGONO</td><td>SUPRIYANTO 05 11 S
20</td><td>PELAJAR/MAHASISWA</td><td>BUWENG RT 01 RW
05</td><td>BUWENG</td><td>JATIREJO</td><td>INDUK</td><td>drg.DANAR
</tr><tr><td align='right'>J45.9</td><td>Asthma, unspecified</td><td></td><td
2019</td><td>PONIKEM</td><td></td><td>PETANI/PEKEBUN</td><td>NGRINGIN</td><td>NGRIN
GIN</td><td>NGARGOHARJO</td><td>PUSTU NGARGOHARJO</td><td>SUSI HERAWATI,
2019</td><td>PONO</td><td>PONO</td><td>PETANI/PEKEBUN</td><td>PULUNG</td><td>PULUNG
</td><td>NGARGOHARJO</td><td>PUSTU NGARGOHARJO</td><td>SUSI HERAWATI, AMK</td><td>
2019</td><td>RETNO KURNIAWATI</td><td>SEPDWIYANTO 05 05 S 20</td><td>MENGURUS
RUMAH TANGGA</td><td>PUNUNG RT01
align='right'>55120001</td><td>18-03-2019</td><td>REZA ARYA ADI
KUSUMA</td><td>SUPRIYANTO</td><td>PELAJAR/MAHASISWA</td><td>NGASEM RT02
RW05</td><td>NGASEM</td><td>JATIREJO</td><td>INDUK</td><td>dr. BUDI
align='right'>53015034</td><td>18-03-2019</td><td>RINA EKAWATI</td><td>EDI
</td><td>MENGURUS RUMAH
TANGGA</td><td>TLOGOHARJO</td><td>TLOGO</td><td>TLOGOHARJO</td><td>PKD
2019</td><td>RIZAL DWI
YULIANTO</td><td></td><td>PELAJAR/MAHASISWA</td><td>TLOGOSARI</td><td>TLOGOSARI</td
align='right'>56010102</td><td>18-03-2019</td><td>RIZKY ZAIDAN
AKMAL</td><td>SUMARSO</td><td>BELUM/TIDAK BEKERJA</td><td>GIRITONTRO
LOR</td><td>GIRITONTRO LOR</td><td>GIRITONTRO</td><td>INDUK</td><td>drg.DANAR
align='right'>57030050</td><td>18-03-2019</td><td>ROSA YULIA NINGSIH</td><td>YATINO
0703
Y01</td><td></td><td>KUWANG</td><td></td><td>PUCANGANOM</td><td>INDUK</td><td>dr.
2019</td><td>SAGIYO</td><td>SAGIYO 06 03 S
></tr><tr><td align='right'>G44.2</td><td>Tension-type headache</td><td></td><td
2019</td><td>SAINEM</td><td></td><td>PETANI/PEKEBUN</td><td>PELET</td><td>PELET</td
><td>NGARGOHARJO</td><td>PUSTU NGARGOHARJO</td><td>SUSI HERAWATI, AMK</td><td> -
PBI</td><td>Rajal</td><td
align='right'>51110008</td><td>18-03-2019</td><td>SAMINEM</td><td>SUMADI 01 11 S
02</td><td>PETANI/PEKEBUN</td><td>BLEBER RT 02 RW 06
NGARGOHARJO</td><td>BLEBER</td><td>NGARGOHARJO</td><td>INDUK</td><td>dr. BUDI
2019</td><td>SAMINEM</td><td>SUMADI 01 11 S
02</td><td>PETANI/PEKEBUN</td><td>BLEBER RT 02 RW 06
NGARGOHARJO</td><td>BLEBER</td><td>NGARGOHARJO</td><td>INDUK</td><td>dr. BUDI
></tr><tr><td align='right'>G40.1</td><td>Localization-related (focal) (partial)
symptomatic epilepsy and epileptic syndromes with simple partial
seizures</td><td></td><td align='right'>289947</td><td
align='right'>55050090</td><td>18-03-2019</td><td>SAMIYEM</td><td>SUPARTO 05 05 S
23</td><td>PETANI/PEKEBUN</td><td>PUNUNG RT01
align='right'>53015058</td><td>18-03-
2019</td><td>SAMIYEM</td><td>SAMIYEM</td><td>PETANI/PEKEBUN</td><td>TLOGO</td><td>T
LOGO</td><td>TLOGOHARJO</td><td>PKD TLOGOHARJO</td><td>SRI SUPATMI</td><td> -
align='right'>53015058</td><td>18-03-
2019</td><td>SAMIYEM</td><td>SAMIYEM</td><td>PETANI/PEKEBUN</td><td>TLOGO</td><td>T
align='right'>52100058</td><td>18-03-
2019</td><td>SANIYEM</td><td>MARDI</td><td>PETANI/PEKEBUN</td><td>PORO RT 01 RW 01
</td><td>PORO</td><td>TLOGOSARI</td><td>INDUK</td><td>dr. BUDI
align='right'>51027014</td><td>18-03-
2019</td><td>SARIYEM</td><td>KADIMAN</td><td>PETANI/PEKEBUN</td><td>NGRINGIN</td><t
d>NGRINGIN</td><td>NGARGOHARJO</td><td>PUSTU NGARGOHARJO</td><td>SUSI HERAWATI,
d></tr><tr><td align='right'>K29.6</td><td>Other gastritis</td><td></td><td
2019</td><td>SARIYEM</td><td>KADIMAN</td><td>PETANI/PEKEBUN</td><td>NGRINGIN</td><t
d>NGRINGIN</td><td>NGARGOHARJO</td><td>PUSTU NGARGOHARJO</td><td>SUSI HERAWATI,
d></tr><tr><td align='right'>M13.9</td><td>Arthritis, unspecified</td><td></td><td
2019</td><td>SARTIN</td><td>SUNARTO</td><td>PETANI/PEKEBUN</td><td>PRINGKUKU</td><t
d>PRINGKUKU</td><td>NGARGOHARJO</td><td>PUSTU NGARGOHARJO</td><td>SUSI HERAWATI,
</tr><tr><td align='right'>I10</td><td>Essential (primary)
align='right'>51035001</td><td>18-03-
2019</td><td>SARTINI</td><td>TEMIN</td><td>PETANI/PEKEBUN</td><td>PRINGKUKU</td><td
2019</td><td>SARYONO</td><td>SARYONO 0101 S
17</td><td>PETANI/PEKEBUN</td><td>PELET
01/02</td><td>PELET</td><td>NGARGOHARJO</td><td>PUSTU NGARGOHARJO</td><td>SUSI
HERAWATI, AMK</td><td> - </td><td>L</td><td>55-59 Thn.</td><td>Datang
align='right'>57010022</td><td>18-03-2019</td><td>SATIYEM</td><td>SARMAN 07 01 S
align='right'>Z02.8</td><td>Other examinations for administrative
align='right'>57050350</td><td>18-03-2019</td><td>SELFI PATMAWATI</td><td>SARJONO
0705 S 12</td><td>KARYAWAN SWASTA</td><td>SUKOROYOM KULON RT01
RW03</td><td></td><td>PUCANGANOM</td><td>INDUK</td><td>dr. BUDI ASHARI</td><td>UMI
NUR ISNIATI</td><td>P</td><td>20-44 Thn.</td><td>Datang
></tr><tr><td align='right'>K35</td><td>Acute appendicitis</td><td></td><td
2019</td><td>SELVIA ANGGRAHENI</td><td>HERI PURWANTO 0601 H 06</td><td>MENGURUS
RUMAH TANGGA</td><td>GIRITONTRO LOR RT03 RW01</td><td>GIRITONTRO
align='right'>M79.05</td><td>Rheumatism, unspecified, pelvic region and
align='right'>56020234</td><td>18-03-2019</td><td>SENEN</td><td>MOKARYO 06 02 M
21</td><td>PETANI/PEKEBUN</td><td>GIRITONTRO KIDUL RT 02 RW 03</td><td>GIRITONTRO
align='right'>55050115</td><td>18-03-2019</td><td>SHINDY WIDIYANTI</td><td>SUTIYONO
0505 S 29</td><td>BELUM/TIDAK BEKERJA</td><td>PUNUNG RT 02 RW
002</td><td>PUNUNG</td><td>JATIREJO</td><td>INDUK</td><td>drg.DANAR
td></tr><tr><td align='right'>I11.9</td><td>Hypertensive heart disease without
align='right'>57125022</td><td>18-03-2019</td><td>SITI KURNIATI</td><td>NGATIMIN
0712 N 04</td><td>PETANI/PEKEBUN</td><td>INGAK INGUK RT02 RW06</td><td>INGAK -
align='right'>I84.9</td><td>Unspecified haemorrhoids without
align='right'>57010031</td><td>18-03-2019</td><td>SITI NUR HASANAH</td><td>SUTARTO
07 01 S 08</td><td>KARYAWAN SWASTA</td><td>GROGOL RT02
align='right'>52110051</td><td>18-03-2019</td><td>SLAMET</td><td>SEMBIR 0211 S
20</td><td>PETANI/PEKEBUN</td><td>TAMBAK RT 01 RW
02</td><td>TAMBAK</td><td>TLOGOSARI</td><td>INDUK</td><td>dr. BUDI
align='right'>54065151</td><td>18-03-
2019</td><td>SOGINI</td><td>WAKINO</td><td>PETANI/PEKEBUN</td><td>BAYEM</td><td>BAY
</td></tr><tr><td align='right'>I10</td><td>Essential (primary)
align='right'>54065112</td><td>18-03-2019</td><td>SONIYEM</td><td>TOTO
P</td><td>PETANI/PEKEBUN</td><td>BAYEM</td><td>BAYEM</td><td>BAYEMHARJO</td><td>PUS
TU BAYEMHARJO</td><td>RISTINA Amd Keb</td><td> - </td><td>P</td><td>>70
d></tr><tr><td align='right'>S50.9</td><td>Superficial injury of forearm,
align='right'>56010131</td><td>18-03-2019</td><td>SUGIARTI</td><td>SUWARDI 06 01
S 04</td><td>PETANI/PEKEBUN</td><td>GIRITONTRO LOR RT01 RW2</td><td>GIRITONTRO
align='right'>55050037</td><td>18-03-2019</td><td>SUGINEM</td><td>KATIMAN 05 05 K
01</td><td>PETANI/PEKEBUN</td><td>PUNUNGRT 01 RW
02</td><td>PUNUNG</td><td>JATIREJO</td><td>INDUK</td><td>dr. BUDI
/td></tr><tr><td align='right'>M79.04</td><td>Rheumatism, unspecified,
align='right'>54070033</td><td>18-03-2019</td><td>SUKATMI</td><td>SUKATMI 04 07 S
15</td><td>PETANI/PEKEBUN</td><td>NGALURAN RT01 RW
align='right'>51037024</td><td>18-03-
2019</td><td>SUKINAH</td><td>PARDI</td><td>PETANI/PEKEBUN</td><td>PRINGKUKU</td><td
/td></tr><tr><td align='right'>M13.9</td><td>Arthritis,
align='right'>51037024</td><td>18-03-
2019</td><td>SUKINAH</td><td>PARDI</td><td>PETANI/PEKEBUN</td><td>PRINGKUKU</td><td
align='right'>51037046</td><td>18-03-
2019</td><td>SUMARNI</td><td></td><td>PETANI/PEKEBUN</td><td>PRINGKUKU</td><td>PRIN
GKUKU</td><td>NGARGOHARJO</td><td>PUSTU NGARGOHARJO</td><td>SUSI HERAWATI,
2019</td><td>SUMINI</td><td>WARIMIN</td><td>PETANI/PEKEBUN</td><td>KELOR</td><td>KE
LOR</td><td>TLOGOHARJO</td><td>PKD TLOGOHARJO</td><td>SRI SUPATMI</td><td> -
></tr><tr><td align='right'>S89.9</td><td>Unspecified injury of lower
align='right'>51080017</td><td>18-03-2019</td><td>SUNARMI</td><td>HANDOKO 0108 H
TANGGA</td><td>NGADIREJO</td><td></td><td>NGARGOHARJO</td><td>INDUK</td><td>dr.
Sendiri</td><td>Lama</td><td>BPJS PBI</td><td>Rujuk</td><td align='right'></td><td
align='right'>52067007</td><td>18-03-
2019</td><td>SUNARSI</td><td></td><td>PETANI/PEKEBUN</td><td>SUMBERJO</td><td>BERGU
NG</td><td>TLOGOSARI</td><td>PUSTU TLOGOSARI</td><td>SULARNO,S.Kep.Ns</td><td> -
2019</td><td>SUPATMI</td><td>SAIDI</td><td>PETANI/PEKEBUN</td><td>PRINGKUKU</td><td
d align='right'>K29.5</td><td>Chronic gastritis, unspecified</td><td></td><td
2019</td><td>SURATMAN</td><td>SURATMAN 0710 S
05</td><td>PENSIUNAN</td><td>JEPURUN RT.02
></tr><tr><td align='right'>S02.5</td><td>Fracture of tooth</td><td></td><td
03</td><td></td><td>PUCANGANOM</td><td>INDUK</td><td>drg.DANAR
2019</td><td>SUTINAH</td><td></td><td>PETANI/PEKEBUN</td><td>TLOGOSARI</td><td>TLOG
align='right'>51037075</td><td>18-03-
2019</td><td>SUTRIYATMI</td><td>WARSINO</td><td>MENGURUS RUMAH
TANGGA</td><td>PRINGKUKU</td><td>PRINGKUKU</td><td>NGARGOHARJO</td><td>PUSTU
NGARGOHARJO</td><td>SUSI HERAWATI, AMK</td><td> - </td><td>P</td><td>20-44
td></tr><tr><td align='right'>M13.9</td><td>Arthritis, unspecified</td><td></td><td
2019</td><td>SUYANTO</td><td>SUYANTO</td><td>PETANI/PEKEBUN</td><td>GENTUNG</td><td
>GENTUNG</td><td>NGARGOHARJO</td><td>PUSTU NGARGOHARJO</td><td>SUSI HERAWATI,
2019</td><td>SUYATI</td><td>SARYONO</td><td>PETANI/PEKEBUN</td><td>PELET</td><td>PE
LET</td><td>NGARGOHARJO</td><td>PUSTU NGARGOHARJO</td><td>SUSI HERAWATI,
2019</td><td>SUYATI</td><td></td><td>PETANI/PEKEBUN</td><td>NGRINGIN</td><td>NGRING
IN</td><td>NGARGOHARJO</td><td>PUSTU NGARGOHARJO</td><td>SUSI HERAWATI,
2019</td><td>SUYATMI</td><td>SUPRIYONO</td><td>PETANI/PEKEBUN</td><td>PORO</td><td>
PORO</td><td>TLOGOSARI</td><td>PKD TLOGOSARI</td><td>RETNO AMBARWATI AMD
2019</td><td>SUYATNO</td><td>SUYATNO 06 10 S
align='right'>53115015</td><td>18-03-
2019</td><td>TARNI</td><td>SUMARNO</td><td>PETANI/PEKEBUN</td><td>GINADE
WETAN</td><td>GINADE ETAN</td><td>TLOGOHARJO</td><td>PKD TLOGOHARJO</td><td>SRI
2019</td><td>TEMIN </td><td>TEMIN 0603 T 09</td><td>PETANI/PEKEBUN</td><td>GEBLUG
RT03 RW07</td><td>GEBLUG</td><td>GIRITONTRO</td><td>INDUK</td><td>drg.DANAR
align='right'>51050062</td><td>18-03-2019</td><td>TRIMANTO</td><td>TRIMANTO 0105 T
05</td><td>PETANI/PEKEBUN</td><td>GENTUNG RT 02 RW
03</td><td>GENTUNG</td><td>NGARGOHARJO</td><td>PUSTU NGARGOHARJO</td><td>SUSI
align='right'>51050062</td><td>18-03-2019</td><td>TRIMANTO</td><td>TRIMANTO 0105 T
03</td><td>GENTUNG</td><td>NGARGOHARJO</td><td>PUSTU NGARGOHARJO</td><td>SUSI
align='right'>56070093</td><td>18-03-2019</td><td>TUKIJEM</td><td>TUKIJEM 0607 T
02</td><td>MENGURUS RUMAH TANGGA</td><td>DUNG KANCIL RT01 RW09</td><td>DUNG
align='right'>51055035</td><td>18-03-
ENTUNG</td><td>NGARGOHARJO</td><td>PUSTU
NGARGOHARJO</td><td>SUSI HERAWATI, AMK</td><td> - </td><td>L</td><td>>70
></tr><tr><td align='right'>L20.8</td><td>Other atopic dermatitis</td><td></td><td
2019</td><td>TUKIYEM</td><td>GIMUN</td><td>PETANI/PEKEBUN</td><td>PORO</td><td>PORO
</td><td>TLOGOSARI</td><td>PKD TLOGOSARI</td><td>RETNO AMBARWATI AMD KEB</td><td> -
2019</td><td>TUMINEM</td><td>SUMARDI</td><td>PETANI/PEKEBUN</td><td>GENTUNG</td><td
>GENTUNG</td><td>NGARGOHARJO</td><td>PUSTU NGARGOHARJO</td><td>SUSI HERAWATI,
align='right'>54055022</td><td>18-03-
2019</td><td>TUMIYATI</td><td>WARNO</td><td>MENGURUS RUMAH
TANGGA</td><td>DOLOGAN</td><td>DOLOGAN</td><td>BAYEMHARJO</td><td>PUSTU
SETYORINI</td><td>ARIS SETIANTO 0301 A 03</td><td>MENGURUS RUMAH
TANGGA</td><td>TLOGO</td><td>TLOGO</td><td>TLOGOHARJO</td><td>INDUK</td><td>drg.DAN
AR WULANDARI</td><td>RIZKI ANISSA, AM.Kg</td><td>P</td><td>20-44
2019</td><td>WARDANI</td><td>SUKARDI</td><td>PETANI/PEKEBUN</td><td>GINADE
align='right'>54055021</td><td>18-03-
2019</td><td>WARNO</td><td>WARNO</td><td>PETANI/PEKEBUN</td><td>DOLOGAN</td><td>DOL
OGAN</td><td>BAYEMHARJO</td><td>PUSTU BAYEMHARJO</td><td>RISTINA Amd Keb</td><td> -
2019</td><td>ADE</td><td>H. RAFLI</td><td>KARYAWAN
SWASTA</td><td>SUKABUMI</td><td></td><td>JAKARTA</td><td>INDUK</td><td>dr. BUDI
align='right'>56010072</td><td>19-03-2019</td><td>AIN NAFA SATITI
DAMAYANTI</td><td>INDRI 0601 I 01</td><td>PELAJAR/MAHASISWA</td><td>GIRITONTRO
align='right'>56050012</td><td>19-03-2019</td><td>ALDO FIRMANSYAH</td><td>KARYATI
0605 K
><td>INDUK</td><td>dr. BUDI ASHARI</td><td>SUGIYONO,S.Kep.Ns</td><td>L</td><td>5-9
2019</td><td>ANNASYA DWI FAJRIANTI</td><td>TOSIM 06 04 T 03</td><td>BELUM/TIDAK
BEKERJA</td><td>KETONGGO RT 02 RW
2019</td><td>ARDYANSYAH ADHY PRASETYO</td><td>WASINO 0705 W
002</td><td></td><td>SUKOROYOM KULON</td><td>SUKOROYOM
align='right'>289994</td><td align='right'>57030425</td><td>19-03-2019</td><td>AZKA
ADITYA NUR ROHMAN</td><td>SULISTYO 0703 S 47</td><td>BELUM/TIDAK
BEKERJA</td><td>KUWANG RT 03 RW
align='right'>59091249</td><td>19-03-2019</td><td>BAYU FREDYANTO</td><td>BAYU
FREDYANTO 0909 B 01</td><td>KARYAWAN
HONORER</td><td>SIRNOBOYO</td><td></td><td>GIRIWOYO</td><td>INDUK</td><td>dr. BUDI
align='right'>S10.1</td><td>Other and unspecified superficial injuries of
throat</td><td></td><td align='right'>290023</td><td
align='right'>57090260</td><td>19-03-2019</td><td>BRIGITA VALENSIA RISQI
HUSADA</td><td>MARIO 0709 M 10</td><td>BELUM/TIDAK BEKERJA</td><td>PUCANGANOM
LOR</td><td>PUCANGANOM LOR</td><td>PUCANGANOM</td><td>INDUK</td><td>dr. BUDI
align='right'>56055016</td><td>19-03-2019</td><td>DARYATMI</td><td>SUMADI 06 05 S
17</td><td>PELAJAR/MAHASISWA</td><td>NGUJUNG RT 02 RW
2019</td><td>DEFFITA INDAH PERMATA SARI</td><td>SUSENO 0605 S
09</td><td>LAINNYA</td><td>GIRITONTRO</td><td>NGUJUNG</td><td>GIRITONTRO</td><td>IN
align='right'>53050018</td><td>19-03-2019</td><td>DINA SARTINI RIA
PUTRININGSIH</td><td>SLAMET RIYADI 03 05 S 06</td><td>KARYAWAN
align='right'>54090028</td><td>19-03-2019</td><td>ETIK</td><td>SUTRISNO 0409 S
04</td><td>BURUH HARIAN LEPAS</td><td>WATES RT01
RW06</td><td>WATES</td><td>BAYEMHARJO</td><td>INDUK</td><td>dr. BUDI
align='right'>57040003</td><td>19-03-2019</td><td>EVA AYU SAFIRA</td><td>HARYADI
07 04 H 02</td><td>PELAJAR/MAHASISWA</td><td>MANDEYAN RT 03 RW
01</td><td>MANDEYAN</td><td>PUCANGANOM</td><td>INDUK</td><td>dr. BUDI
align='right'>55020047</td><td>19-03-2019</td><td>GIMAN</td><td>GIMAN 0502 G
2019</td><td>IKA</td><td>MARJO</td><td>PERANGKAT DESA</td><td>GINADE KULON RT 01 RW
align='right'>56020120</td><td>19-03-2019</td><td>INAYAH</td><td>SUGIYARTO 06 02 S
51</td><td></td><td>GIRITONTRO KIDUL</td><td>GIRITONTRO
align='right'>57030013</td><td>19-03-2019</td><td>IQBAL ARDYAN
FIRNANDA</td><td>WARSITO 07 03 W 02</td><td>PELAJAR/MAHASISWA</td><td>KUWANG RT
02 RW 06</td><td>KUWANG</td><td>PUCANGANOM</td><td>INDUK</td><td>dr. BUDI
align='right'>57030254</td><td>19-03-2019</td><td>ISTIDIYAH
PRAMESTI</td><td>ISMANTO 0703 I 01</td><td>PELAJAR/MAHASISWA</td><td>KUWANG RT02
align='right'>57030447</td><td>19-03-2019</td><td>KADIYEM</td><td>KATIMIN 07 03 K
06</td><td>PETANI/PEKEBUN</td><td>KUWANG RT 01 RW
align='right'>L24.9</td><td>Irritant contact dermatitis, unspecified
align='right'>51115042</td><td>19-03-
2019</td><td>KATIJEM</td><td>PARNO</td><td>PETANI/PEKEBUN</td><td>BLEBER</td><td>BL
EBER</td><td>NGARGOHARJO</td><td>PUSKESLING NGARGOHARJO</td><td>dr. ZAENAL ARIFIN
HP</td><td>SUSI HERAWATI, AMK</td><td>P</td><td>60-69 Thn.</td><td>Datang
2019</td><td>KATINEM</td><td>KATIJO</td><td>PETANI/PEKEBUN</td><td>GENTUNG</td><td>
GENTUNG</td><td>NGARGOHARJO</td><td>PUSKESLING NGARGOHARJO</td><td>dr. ZAENAL
ARIFIN HP</td><td>SUSI HERAWATI, AMK</td><td>P</td><td>>70 Thn.</td><td>Datang
align='right'>54110225</td><td>19-03-2019</td><td>MELISA INDAH
FATIKASARI</td><td>WARNO/TUKINO 0711 W 04</td><td>LAINNYA</td><td>PLOSO RT02
></tr><tr><td align='right'>H10.0</td><td>Mucopurulent
conjunctivitis</td><td></td><td align='right'>290427</td><td
align='right'>51030045</td><td>19-03-
2019</td><td>MINATUN</td><td>SRIYONO</td><td>PETANI/PEKEBUN</td><td>PRINGKUKU</td><
td>PRINGKUKU</td><td>NGARGOHARJO</td><td>PUSKESLING NGARGOHARJO</td><td>dr. ZAENAL
ARIFIN HP</td><td>HENI WIDIYASTUTI</td><td>P</td><td>20-44 Thn.</td><td>Datang
2019</td><td>MINEM</td><td>MINEM</td><td>PETANI/PEKEBUN</td><td>BLEBER</td><td>BLEB
ER</td><td>NGARGOHARJO</td><td>PUSKESLING NGARGOHARJO</td><td>dr.
ZAENAL ARIFIN HP</td><td>SUSI HERAWATI, AMK</td><td>P</td><td>45-54
></tr><tr><td align='right'>S10</td><td>Superficial injury of neck</td><td></td><td
align='right'>290018</td><td align='right'>56020347</td><td>19-03-2019</td><td>MUH
COLIL</td><td>SURYANTO 0602 S 06</td><td>BELUM/TIDAK BEKERJA</td><td>GIRITONTRO
align='right'>H66.9</td><td>Otitis media, unspecified</td><td></td><td
2019</td><td>NAJWA HABIBAH</td><td>MUHAMAD ANWAR 0601 M 08</td><td>BELUM/TIDAK
BEKERJA</td><td>GIRITONTRO
LOR</td><td></td><td>GIRITONTRO</td><td>INDUK</td><td>dr. BUDI
Umum</td><td>Poli THT</td><td>RS MAGUAN HUSADA</td><td>Dalam
align='right'>H66.9</td><td>Otitis media, unspecified</td><td></td><td
2019</td><td>NAJWA HABIBAH</td><td>MUHAMAD ANWAR 0601 M 08</td><td>BELUM/TIDAK
LOR</td><td></td><td>GIRITONTRO</td><td>INDUK</td><td>dr. BUDI
Umum</td><td>Poli THT</td><td>RS MAGUAN HUSADA</td><td>Dalam
align='right'>51010120</td><td>19-03-
2019</td><td>NOVIANTI</td><td>SARWADI</td><td>PETANI/PEKEBUN</td><td>PELET</td><td>
PELET</td><td>NGARGOHARJO</td><td>PUSKESLING NGARGOHARJO</td><td>dr. ZAENAL ARIFIN
align='right'>289996</td><td align='right'>57030419</td><td>19-03-2019</td><td>NUR
FAIZAH MUFIDAH</td><td>PAIMAN 0703 P 15</td><td>KARYAWAN SWASTA</td><td>KUWANG
2019</td><td>PAIJEM</td><td>TUGINO</td><td>PETANI/PEKEBUN</td><td>BLEBER</td><td>BL
/td></tr><tr><td align='right'>M48.06</td><td>Spinal stenosis, lumbar
align='right'>55070010</td><td>19-03-2019</td><td>PAIJO</td><td>PAIJO 0507 P
d></tr><tr><td align='right'>K29.5</td><td>Chronic gastritis,
align='right'>54110026</td><td>19-03-2019</td><td>PAINEM</td><td>SUROREJO 0411 S
K</td><td>dr. BUDI ASHARI</td><td>SUGIYONO,S.Kep.Ns</td><td>P</td><td>>70
align='right'>51057007</td><td>19-03-
TUNG</td><td>NGARGOHARJO</td><td>PUSKESLING NGARGOHARJO</td><td>dr. ZAENAL ARIFIN
align='right'>51055039</td><td>19-03-
2019</td><td>PONIJEM</td><td>TUKIJAN</td><td>PETANI/PEKEBUN</td><td>GENTUNG</td><td
>GENTUNG</td><td>NGARGOHARJO</td><td>PUSKESLING NGARGOHARJO</td><td>dr. ZAENAL
ARIFIN HP</td><td>SUSI HERAWATI, AMK</td><td>P</td><td>45-54 Thn.</td><td>Datang
align='right'>51100070</td><td>19-03-2019</td><td>REJO</td><td>REJO 0110 R
02</td><td>PETANI/PEKEBUN</td><td>BALONG RT 01 RW
06</td><td>BALONG</td><td>NGARGOHARJO</td><td>PUSKESLING NGARGOHARJO</td><td>dr.
ZAENAL ARIFIN HP</td><td>SUSI HERAWATI, AMK</td><td>L</td><td>>70
2019</td><td>REVANGGA FARIS FERDIANSAH</td><td>BAMBANG 0703 B
04</td><td>BELUM/TIDAK BEKERJA</td><td>KUWANG RT01
RW06</td><td>KUWANG</td><td>PUCANGANOM</td><td>INDUK</td><td>drg.DANAR
td></tr><tr><td align='right'>Z34.8</td><td>Supervision of other normal
align='right'>51040058</td><td>19-03-2019</td><td>RIA ADESTI KUSTYANI</td><td>KUSNO
01 04 K 03</td><td>KARYAWAN SWASTA</td><td>KLEPU RT 01 RW
03</td><td>KLEPU</td><td>NGARGOHARJO</td><td>INDUK</td><td>dr. BUDI
></tr><tr><td align='right'>G40.1</td><td>Localization-related (focal) (partial)
symptomatic epilepsy and epileptic syndromes with simple partial
seizures</td><td></td><td align='right'>290012</td><td
align='right'>52040006</td><td>19-03-2019</td><td>RIA FITRIYANI</td><td>SUKIJAN
0204 S 01</td><td>PETANI/PEKEBUN</td><td>SOKO RT02
RW06</td><td>SOKO</td><td>TLOGOSARI</td><td>INDUK</td><td>dr. BUDI
align='right'>56010228</td><td>19-03-2019</td><td>RIZAL</td><td>RIBUT
0601 R 01</td><td>BELUM/TIDAK BEKERJA</td><td>GIRITONTRO LOR RT01
2019</td><td>SAMADI</td><td>SAMADI 06 10 S 12</td><td>PEGAWAI NEGERI
SIPIL</td><td>TANGGUNG RT04
align='right'>55110007</td><td>19-03-2019</td><td>SAMIYEM</td><td>KATIYEM 05 11 K
03</td><td>PETANI/PEKEBUN</td><td>BUWENG RT 01 RW
05</td><td>BUWENG</td><td>JATIREJO</td><td>INDUK</td><td>dr. BUDI
2019</td><td>SARINO</td><td>SARINO</td><td>PETANI/PEKEBUN</td><td>BLEBER</td><td>BL
HP</td><td>SUSI HERAWATI, AMK</td><td>L</td><td>55-59 Thn.</td><td>Datang
align='right'>56010185</td><td>19-03-2019</td><td>SARNO</td><td>SARNO 0601 S
</tr><tr><td align='right'>K29.7</td><td>Gastritis, unspecified</td><td></td><td
2019</td><td>SARTIN</td><td>SUNARTO</td><td>PETANI/PEKEBUN</td><td>PRINGKUKU</td><t
d>PRINGKUKU</td><td>NGARGOHARJO</td><td>PUSKESLING NGARGOHARJO</td><td>dr. ZAENAL
></tr><tr><td align='right'>K01.1</td><td>Impacted teeth</td><td></td><td
2019</td><td>SARWINI</td><td>BOWO P 06 02 B 01</td><td>PEGAWAI NEGERI
SIPIL</td><td>GIRITONTRO KIDUL RT02 RW03</td><td>GIRITONTRO
align='right'>0110</td><td>19-03-
2019</td><td>SATIYEM</td><td>SEMAN</td><td>PETANI/PEKEBUN</td><td>BALONG</td><td>BA
LONG</td><td>NGARGOHARJO</td><td>PUSKESLING NGARGOHARJO</td><td>dr. ZAENAL ARIFIN
2019</td><td>SINEM</td><td>SUKIYO</td><td>PETANI/PEKEBUN</td><td>GENTUNG</td><td>GE
NTUNG</td><td>NGARGOHARJO</td><td>PUSKESLING NGARGOHARJO</td><td>dr. ZAENAL ARIFIN
HP</td><td>SUSI HERAWATI, AMK</td><td>P</td><td>>70 Thn.</td><td>Datang
d></tr><tr><td align='right'>K29.7</td><td>Gastritis, unspecified</td><td></td><td
2019</td><td>SOGINEM</td><td></td><td>PETANI/PEKEBUN</td><td>KLEPU</td><td>KLEPU</t
d><td>NGARGOHARJO</td><td>PUSKESLING NGARGOHARJO</td><td>dr. ZAENAL ARIFIN
align='right'>R51</td><td>Headache</td><td></td><td align='right'>290434</td><td
PURWANTINI</td><td>LUWARNO</td><td>PETANI/PEKEBUN</td><td>GENTUNG</td><td>GENTUNG</
td><td>NGARGOHARJO</td><td>PUSKESLING NGARGOHARJO</td><td>dr. ZAENAL ARIFIN
align='right'>57040082</td><td>19-03-2019</td><td>SRI WAHYUNI</td><td>HARYADI 07
04 H 02</td><td>PETANI/PEKEBUN</td><td>MANDEYAN RT 03 RW
align='right'>51100024</td><td>19-03-
2019</td><td>SUDIYEM</td><td>SUDIYEM</td><td>PETANI/PEKEBUN</td><td>BALONG RT01
RW06,NGARGOHARJO</td><td>BALONG</td><td>NGARGOHARJO</td><td>PUSKESLING
NGARGOHARJO</td><td>dr. ZAENAL ARIFIN HP</td><td>SUSI HERAWATI,
AMK</td><td>L</td><td>45-54 Thn.</td><td>Datang Sendiri</td><td>Lama</td><td>BPJS
align='right'>51055034</td><td>19-03-
2019</td><td>SUKARMI</td><td>SUKARMI</td><td>PETANI/PEKEBUN</td><td>GENTUNG</td><td
d></tr><tr><td align='right'>K02.1</td><td>Caries of dentine</td><td></td><td
2019</td><td>SUKATI</td><td>SUYATNO 0703 S 39</td><td>BURUH HARIAN
LEPAS</td><td>KUWANG</td><td>KUWANG</td><td>PUCANGANOM</td><td>INDUK</td><td>drg.DA
NAR WULANDARI</td><td>RIZKI ANISSA, AM.Kg</td><td>P</td><td>55-59
Thn.</td><td>Datang Sendiri</td><td>Lama</td><td>UMUM WONOGIRI</td><td>internal
rujukan</td><td align='right'>14</td><td align='right'>5</td><td
d align='right'>I11.9</td><td>Hypertensive heart disease without (congestive) heart
align='right'>57030249</td><td>19-03-2019</td><td>SUKATI</td><td>SUYATNO
0703 S 39</td><td>BURUH HARIAN
align='right'>51037026</td><td>19-03-
2019</td><td>SUKINI</td><td>KASMO</td><td>PETANI/PEKEBUN</td><td>PRINGKUKU</td><td>
PRINGKUKU</td><td>NGARGOHARJO</td><td>PUSKESLING NGARGOHARJO</td><td>dr. ZAENAL
ARIFIN HP</td><td>HENI WIDIYASTUTI</td><td>P</td><td>45-54 Thn.</td><td>Datang
align='right'>51055019</td><td>19-03-
2019</td><td>SUMARNI</td><td>SUYATNO</td><td>PETANI/PEKEBUN</td><td>GENTUNG</td><td
2019</td><td>SUNARSI</td><td>SUNARSI</td><td>PETANI/PEKEBUN</td><td>GENTUNG</td><td
>GENTUNG</td><td>NGARGOHARJO</td><td>PUSKESLING NGARGOHARJO</td><td>HENI
align='right'>51115025</td><td>19-03-
2019</td><td>SUPIAH</td><td>WARSINO</td><td>PETANI/PEKEBUN</td><td>BLEBER</td><td>B
LEBER</td><td>NGARGOHARJO</td><td>PUSKESLING NGARGOHARJO</td><td>dr. ZAENAL ARIFIN
></tr><tr><td align='right'>S51.9</td><td>Open wound of forearm, part
09</td><td>KARYAWAN
align='right'>54110042</td><td>19-03-2019</td><td>SUROREJO</td><td>SUROREJO 0411
S
K</td><td>dr. BUDI ASHARI</td><td>SUGIYONO,S.Kep.Ns</td><td>L</td><td>>70
d></tr><tr><td align='right'>E10.9</td><td>Insulin-dependent diabetes mellitus
align='right'>51030013</td><td>19-03-
2019</td><td>SUTANTINI</td><td>MISNO</td><td>PEGAWAI NEGERI
SIPIL</td><td>PRINGKUKU</td><td>PRINGKUKU</td><td>NGARGOHARJO</td><td>PUSKESLING
NGARGOHARJO</td><td>dr. ZAENAL ARIFIN HP</td><td>SUSI HERAWATI,
AMK</td><td>L</td><td>55-59 Thn.</td><td>Datang Sendiri</td><td>Lama</td><td>BPJS
align='right'>57080118</td><td>19-03-2019</td><td>SUTARDI</td><td>SUTARDI 07080
S 26</td><td>PETANI/PEKEBUN</td><td>PUCANGANOM KIDUL RT02 RW08</td><td>SUKOROYOM
align='right'>55110014</td><td>19-03-2019</td><td>SUTARMI</td><td>SURIPTO 0511 S
></tr><tr><td align='right'>H65.0</td><td>Acute serous otitis
align='right'>58080306</td><td>19-03-2019</td><td>TARDI</td><td>TARDI 08 08 T
04</td><td>PETANI/PEKEBUN</td><td>PRACIMANTORO</td><td></td><td>PRACIMANTORO</td><t
align='right'>51100047</td><td>19-03-2019</td><td>TRI HARMINI</td><td>WARNO 0110 W
04</td><td>PELAJAR/MAHASISWA</td><td>BALONG
01/06</td><td>BALONG</td><td>NGARGOHARJO</td><td>PUSKESLING NGARGOHARJO</td><td>dr.
ZAENAL ARIFIN HP</td><td>HENI WIDIYASTUTI</td><td>P</td><td>20-44
2019</td><td>TUKINAH</td><td>SEMIN</td><td>PETANI/PEKEBUN</td><td>BLEBER</td><td>BL
align='right'>51055041</td><td>19-03-
2019</td><td>TUKINAH</td><td>SARTU</td><td>PETANI/PEKEBUN</td><td>GENTUNG</td><td>G
ENTUNG</td><td>NGARGOHARJO</td><td>PUSKESLING NGARGOHARJO</td><td>dr. ZAENAL ARIFIN
align='right'>51055035</td><td>19-03-
ENTUNG</td><td>NGARGOHARJO</td><td>PUSKESLING NGARGOHARJO</td><td>dr. ZAENAL ARIFIN
HP</td><td>HENI WIDIYASTUTI</td><td>L</td><td>>70 Thn.</td><td>Datang
2019</td><td>TUMINI</td><td>TUMINI 0808 T 06</td><td>PETANI/PEKEBUN</td><td>DAYU,
PRACIMANTORO</td><td></td><td>PRACIMANTORO</td><td>INDUK</td><td>dr.
align='right'>57010017</td><td>19-03-2019</td><td>TUMINI</td><td>TUMINI 07 01 T
03</td><td>PETANI/PEKEBUN</td><td>GROGOL RT 02 RW
2019</td><td>WAGIYEM</td><td>SIMIN</td><td>PETANI/PEKEBUN</td><td>BLEBER</td><td>BL
2019</td><td>WAHYU TRI RAMADANI</td><td>SEMIN 0602 S 33</td><td>BELUM/TIDAK
BEKERJA</td><td>GIRITONTRO KIDUL</td><td>GIRITONTRO
align='right'>57140114</td><td>19-03-2019</td><td>WAKINEM</td><td>SAMINO 07 14 S
17</td><td>PETANI/PEKEBUN</td><td>PENDEM RT 02 RW
015</td><td>PENDEM</td><td>PUCANGANOM</td><td>INDUK</td><td>dr. BUDI
</td></tr><tr><td align='right'>K05.3</td><td>Chronic
periodontitis</td><td></td><td align='right'>289988</td><td
align='right'>55050227</td><td>19-03-2019</td><td>WAKINO</td><td>WAKINO 05 05 W
10</td><td>PETANI/PEKEBUN</td><td>PUNUNG RT 01 RW
02</td><td>PUNUNG</td><td>JATIREJO</td><td>INDUK</td><td>drg.DANAR
/td></tr><tr><td align='right'>M79.15</td><td>Myalgia, pelvic and
align='right'>54110044</td><td>19-03-2019</td><td>WENING</td><td>SURYONO 0411 S
/td></tr><tr><td align='right'>M05</td><td>Seropositive rheumatoid
arthritis</td><td></td><td align='right'>290000</td><td
align='right'>57030237</td><td>19-03-2019</td><td>WESTRI NUR UTAMI</td><td>SARIMAN
07 03 S 27</td><td>MENGURUS RUMAH TANGGA</td><td>KUWANG RT02
RW06</td><td></td><td>PUCANGANOM</td><td>INDUK</td><td>dr. BUDI
2019</td><td>WIDHI KURNIA</td><td>WARDI 09 09 W 06</td><td>BELUM/TIDAK
BEKERJA</td><td>NGUDAL RT 01 RW
08</td><td></td><td>GIRIWOYO</td><td>INDUK</td><td>dr. BUDI
align='right'>56020168</td><td>19-03-2019</td><td>WIYATI</td><td>TULADI 0602 T
></tr><tr><td align='right'>S98.4</td><td>Traumatic amputation of foot, level
align='right'>56050080</td><td>19-03-2019</td><td>ZIMA</td><td>MARYANTO 0605 M
09</td><td>BELUM/TIDAK BEKERJA</td><td>NGUJUNG RT04
align='right'>56020449</td><td>20-03-2019</td><td>AHMAD ZAKI</td><td>UMAR ABIBI
0602 U 03</td><td></td><td>GIRITONTRO KIDUL</td><td>GIRITONTRO
KIDUL</td><td>GIRITONTRO</td><td>INDUK</td><td>dr. BUDI ASHARI</td><td>SRI
SUPATMI</td><td>L</td><td>1-4 Thn.</td><td>Datang
2019</td><td>ALIF</td><td>SULARTO 0308 S
07</td><td>PELAJAR/MAHASISWA</td><td>GINADE KULON RT02 RW03</td><td>GINADE
KULON</td><td>TLOGOHARJO</td><td>INDUK</td><td>drg.DANAR WULANDARI</td><td>RIZKI
align='right'>54065019</td><td>20-03-2019</td><td>ANDIKA PERDANA
SAPUTRA</td><td>JUMRI</td><td>PELAJAR/MAHASISWA</td><td>BAYEM</td><td>BAYEM</td><td
align='right'>53025031</td><td>20-03-
2019</td><td>ARIFKI</td><td>WALUYO</td><td>PELAJAR/MAHASISWA</td><td>SAMBIREJO</td>
<td>SAMBIREJO</td><td>TLOGOHARJO</td><td>PKD
tr><tr><td align='right'>Z30.8</td><td>Other contraceptive
align='right'>55110002</td><td>20-03-2019</td><td>ASRI ASMARANINGRUM</td><td>WIYONO
0511 W 06</td><td>KARYAWAN HONORER</td><td>BUWENG RT01
></tr><tr><td align='right'>K29</td><td>Gastritis and duodenitis</td><td></td><td
2019</td><td>CATUR NUGROHO</td><td>MISIYEM 0602 M 08</td><td>KARYAWAN
SWASTA</td><td>GIRITONTRO KIDUL RT03 RW03</td><td>GIRITONTRO
align='right'>S01.0</td><td>Open wound of scalp</td><td></td><td
2019</td><td>DJUKI</td><td>JUKI 0604 J 04</td><td>PENSIUNAN</td><td>KETONGGO RT02
align='right'>290412</td><td align='right'>54065157</td><td>20-03-2019</td><td>EDI
HARTONO</td><td>EDI
HARTONO</td><td>PETANI/PEKEBUN</td><td>BAYEM</td><td>BAYEM</td><td>BAYEMHARJO</td><
td>PUSTU BAYEMHARJO</td><td>RISTINA Amd Keb</td><td> - </td><td>L</td><td>45-54
align='right'>290771</td><td align='right'>53085043</td><td>20-03-2019</td><td>EDI
W</td><td>SAMINO</td><td>MENGURUS RUMAH TANGGA</td><td>GINADE KULON</td><td>GINADE
KULON</td><td>TLOGOHARJO</td><td>PKD TLOGOHARJO</td><td>SRI SUPATMI</td><td> -
align='right'>51020014</td><td>20-03-2019</td><td>EKA SETYOWATI</td><td>RUSTANTO
0102 R 01</td><td>KARYAWAN SWASTA</td><td>NGRINGIN RT02 RW
align='right'>54065118</td><td>20-03-2019</td><td>FAJAR NUR
OKTAVIANI</td><td>SARWADI</td><td>BELUM/TIDAK
2019</td><td>FARAH MAJIDAH</td><td>SURATMO 1010 S 43</td><td>BELUM/TIDAK
BEKERJA</td><td>SAMBI RT02
RW02,JOHUNUT</td><td></td><td>PARANGGUPITO</td><td>INDUK</td><td>drg.DANAR
2019</td><td>FREDERICA BALQISSA ARETHA</td><td>RUSTANTO 0102 R
RW01</td><td>NGRINGIN</td><td>NGARGOHARJO</td><td>INDUK</td><td>drg.DANAR
Sendiri</td><td>Baru</td><td>JAMKESDA</td><td>Rajal</td><td align='right'>5</td><td
2019</td><td>GUNEM</td><td>MARTO S 07 10 M 06</td><td>PENSIUNAN</td><td>JEPURUN
RT02 RW10</td><td>JEPURUN</td><td>PUCANGANOM</td><td>INDUK</td><td>drg.DANAR
align='right'>54065039</td><td>20-03-
2019</td><td>HANDAYANI</td><td>SARWADI</td><td>PETANI/PEKEBUN</td><td>BAYEM</td><td
>BAYEM</td><td>BAYEMHARJO</td><td>PUSTU BAYEMHARJO</td><td>RISTINA Amd Keb</td><td>
></tr><tr><td align='right'>E11</td><td>Non-insulin-dependent diabetes
mellitus</td><td></td><td align='right'>290051</td><td
align='right'>57040034</td><td>20-03-2019</td><td>HULIYAH YANI</td><td>WINARDI
0704 W 03</td><td>MENGURUS RUMAH TANGGA</td><td>MANDEYAN RT02
chemical products</td><td></td><td align='right'>290068</td><td
align='right'>56070017</td><td>20-03-2019</td><td>IRIYATI
TRISNOWATI</td><td>KATIRIN 0607 K 11</td><td>PELAJAR/MAHASISWA</td><td>DUNGKANCIL
RT01 RW09</td><td>DUNG KANCIL</td><td>GIRITONTRO</td><td>INDUK</td><td>dr. BUDI
</tr><tr><td align='right'>A09</td><td>Diarrhoea and gastroenteritis of presumed
align='right'>57030374</td><td>20-03-2019</td><td>ISTIANA SARWENDAH </td><td>KALIK
0703 K 07</td><td>KARYAWAN SWASTA</td><td>KUWANG RT03
align='right'>K29.1</td><td>Other acute gastritis</td><td></td><td
2019</td><td>JENAR TRIAS RAMADAN</td><td>SUSANTI 0505 S 30</td><td>BELUM/TIDAK
BEKERJA</td><td>PUNUNG RT01
align='right'>57010078</td><td>20-03-2019</td><td>KARMI</td><td>NGATIJO 0701 N
01</td><td>PETANI/PEKEBUN</td><td>GROGOL</td><td>GROGOL</td><td>PUCANGANOM</td><td>
INDUK</td><td>dr. BUDI ASHARI</td><td>SUWARTO,S.Kep.Nes</td><td>P</td><td>60-69
align='right'>M79.79</td><td>Fibromyalgia, site unspecified</td><td></td><td
2019</td><td>KARTIN</td><td>WIRYADI 0713 W
></tr><tr><td align='right'>S50.9</td><td>Superficial injury of forearm,
</tr><tr><td align='right'>M79.1</td><td>Myalgia</td><td></td><td
2019</td><td>KASTINI</td><td>WARDI</td><td>PETANI/PEKEBUN</td><td>NGASEM</td><td>NG
ASEM</td><td>JATIREJO</td><td>PKD JATIREJO</td><td>SUHARNI</td><td> -
align='right'>53015041</td><td>20-03-
2019</td><td>KATINEM</td><td>SOKARMO</td><td>PETANI/PEKEBUN</td><td>TLOGO</td><td>T
align='right'>53100009</td><td>20-03-2019</td><td>KURNIAWAN RICKO
HARYANTO</td><td>PATMIYANTO 03 10 P 01</td><td>PELAJAR/MAHASISWA</td><td>KELOR
RT01 RW04</td><td>KELOR</td><td>TLOGOHARJO</td><td>INDUK</td><td>dr. BUDI
align='right'>57020005</td><td>20-03-2019</td><td>MARYATI</td><td>KASNO 07 02 K
WETAN</td><td>PUCANGANOM</td><td>INDUK</td><td>dr. BUDI ASHARI</td><td>SRI
align='right'>54065058</td><td>20-03-
2019</td><td>MISNO</td><td>MISNO</td><td>PETANI/PEKEBUN</td><td>BAYEM</td><td>BAYEM
</td><td>BAYEMHARJO</td><td>PUSTU BAYEMHARJO</td><td>RISTINA Amd Keb</td><td> -
</tr><tr><td align='right'>R05</td><td>Cough</td><td></td><td
2019</td><td>MISNO</td><td>MISNO</td><td>PETANI/PEKEBUN</td><td>BAYEM</td><td>BAYEM
</td><td>BAYEMHARJO</td><td>PUSTU BAYEMHARJO</td><td>RISTINA Amd Keb</td><td> -
</tr><tr><td align='right'>Z00.6</td><td>Examination for normal comparison and
2019</td><td>MULYANI</td><td>SIHONO 02 11 S 17</td><td>LAINNYA</td><td>TAMBAK
RT01 RW02</td><td>TAMBAK</td><td>TLOGOSARI</td><td>INDUK</td><td>dr. BUDI
align='right'>56100188</td><td>20-03-2019</td><td>NITA JULIATI</td><td>CUSWINDYA
TIYANARTA 06 10 C 01</td><td>MENGURUS RUMAH TANGGA</td><td>TANGGUNG RT02
align='right'>53025015</td><td>20-03-
2019</td><td>PARIYEM</td><td>MISRAN</td><td>PETANI/PEKEBUN</td><td>SAMBIREJO</td><t
d>SAMBIREJO</td><td>TLOGOHARJO</td><td>PKD TLOGOHARJO</td><td>SRI SUPATMI</td><td>
align='right'>53025001</td><td>20-03-
2019</td><td>PARNI</td><td>TUKIRAN</td><td>PETANI/PEKEBUN</td><td>SAMBIREJO</td><td
>SAMBIREJO</td><td>TLOGOHARJO</td><td>PKD TLOGOHARJO</td><td>SRI SUPATMI</td><td> -
align='right'>56010110</td><td>20-03-2019</td><td>PINASIH</td><td> SULARNO 0601 S
02</td><td>PETANI/PEKEBUN</td><td>GIRITONTRO LOR RT03 RW01</td><td>GIRITONTRO
Sendiri</td><td>Lama</td><td>BPJS
align='right'>54010018</td><td>20-03-2019</td><td>QOIRUL RAHMA ADITIA</td><td>IMAM
PAHRATIN 0401 I 01</td><td>PELAJAR/MAHASISWA</td><td>BELEH RT02
align='right'>59091399</td><td>20-03-2019</td><td>RAHMAT
WIDIYANTO</td><td>WIDODO</td><td>KARYAWAN SWASTA</td><td>NGUDAL RT 03 RW
08</td><td></td><td>GIRIWOYO</td><td>INDUK</td><td>dr. BUDI
2019</td><td>RATIKA RIZKY MARDANI</td><td>SUMARDI 07 10 S 14</td><td>KARYAWAN
SWASTA</td><td>JEPURUN RT01 RW
align='right'>M79.10</td><td>Myalgia, multiple sites</td><td></td><td
align='right'>290034</td><td align='right'>56090005</td><td>20-03-2019</td><td>REBO
HARJONO</td><td>REBO HARJONO 06 09 R 05</td><td>PETANI/PEKEBUN</td><td>DUNGKLEPU
KULON</td><td>DUNG KLEPU KULON</td><td>GIRITONTRO</td><td>INDUK</td><td>dr. BUDI
</tr><tr><td align='right'>R50.9</td><td>Fever, unspecified</td><td></td><td
2019</td><td>REVA</td><td>KASIMIN</td><td>PELAJAR/MAHASISWA</td><td>GINADE</td><td>
GINADE KULON</td><td>TLOGOHARJO</td><td>PKD TLOGOHARJO</td><td>SRI SUPATMI</td><td>
tr><tr><td align='right'>F20.9</td><td>Schizophrenia, unspecified</td><td></td><td
2019</td><td>RIYADI</td><td>SUKIRNO 02 05 S
RW06</td><td>GLAGAH</td><td>TLOGOSARI</td><td>INDUK</td><td>drg.DANAR
></tr><tr><td align='right'>D25.0</td><td>Submucous leiomyoma of
uterus</td><td></td><td align='right'>290070</td><td
align='right'>52050017</td><td>20-03-2019</td><td>SANIYEM</td><td>SUKATNO 0205 S
RW06</td><td>GLAGAH</td><td>TLOGOSARI</td><td>INDUK</td><td>dr. BUDI
align='right'>55060071</td><td>20-03-2019</td><td>SARMINI</td><td>SUNARMO 0506 S
17</td><td>PETANI/PEKEBUN</td><td>JATI
02/03</td><td>JATI</td><td>JATIREJO</td><td>INDUK</td><td>dr. BUDI
align='right'>56010034</td><td>20-03-2019</td><td>SHOLEH PADMADI,
S.PD</td><td>SHOLEH PADMADI, S.PD 0601 S
23</td><td>PENSIUNAN</td><td>GIRITONTRO LOR</td><td>GIRITONTRO
></tr><tr><td align='right'>N30.9</td><td>Cystitis, unspecified</td><td></td><td
align='right'>290036</td><td align='right'>58080936</td><td>20-03-2019</td><td>SITI
AMALIA</td><td>GEMPUR ANGKORO PUTRO 08089 G 02</td><td>MENGURUS RUMAH
TANGGA</td><td>JOSARI RT02
RW03,JIMBAR</td><td></td><td>PRACIMANTORO</td><td>INDUK</td><td>dr. BUDI
align='right'>24</td><td>KIA</td><td></td><td></td><td>Luar
align='right'>F20.6</td><td>Simple schizophrenia</td><td></td><td
2019</td><td>SUGENG</td><td>SUPARNO 02 06 S
align='right'>56070011</td><td>20-03-2019</td><td>SUKIYO</td><td>SUKIYO 06 07 S
11</td><td>PETANI/PEKEBUN</td><td>D KANCIL</td><td>DUNG
</tr><tr><td align='right'>J45</td><td>Asthma</td><td></td><td
2019</td><td>SULASTRI</td><td>KASIMUN</td><td>PETANI/PEKEBUN</td><td>GINADE
align='right'>55080013</td><td>20-03-2019</td><td>SUPARSI</td><td>HARI WIDODO 05
08 H 01</td><td>PETANI/PEKEBUN</td><td>NGORODOWO RT 04
align='right'>54065003</td><td>20-03-
2019</td><td>SUSILOWATI</td><td>JUMRI</td><td>PETANI/PEKEBUN</td><td>BAYEM</td><td>
align='right'>53015045</td><td>20-03-
2019</td><td>TAMIYEM</td><td>TOREJO</td><td>PETANI/PEKEBUN</td><td>TLOGO</td><td>TL
2019</td><td>TAMIYEM</td><td>TOREJO</td><td>PETANI/PEKEBUN</td><td>TLOGO</td><td>TL
align='right'>55025095</td><td>20-03-2019</td><td>TITIK
PERMATASARI</td><td>SURONO</td><td>PETANI/PEKEBUN</td><td>GIRIROTO</td><td>GIRIROTO
</td><td>JATIREJO</td><td>PKD JATIREJO</td><td>SUHARNI</td><td> -
/td></tr><tr><td align='right'>Z00.8</td><td>Other general
align='right'>56020132</td><td>20-03-2019</td><td>TIVA SANDITA</td><td>SUKIMAN
0602 S 56</td><td>KARYAWAN SWASTA</td><td>GIRITONTRO KIDUL</td><td>GIRITONTRO
DARYANTI</td><td>ADI CAHYONO 0707 A 02</td><td>PETANI/PEKEBUN</td><td>BANJAR RT01
align='right'>57070035</td><td>20-03-2019</td><td>TRI DARYANTI</td><td>ADI CAHYONO
0707 A 02</td><td>PETANI/PEKEBUN</td><td>BANJAR RT01
RINI KRISTIANTI</td><td>SOLEH PADMADI 06 01 S 23</td><td>MENGURUS RUMAH
TANGGA</td><td>GIRITONTRO LOR 01/01 </td><td>GIRITONTRO
align='right'>56010096</td><td>20-03-2019</td><td>TRI RINI KRISTIANTI</td><td>SOLEH
PADMADI 06 01 S 23</td><td>MENGURUS RUMAH TANGGA</td><td>GIRITONTRO LOR 01/01
</td><td>GIRITONTRO LOR</td><td>GIRITONTRO</td><td>INDUK</td><td>dr. BUDI
align='right'>52115035</td><td>20-03-
2019</td><td>TUSIM</td><td>TUSIM</td><td>PETANI/PEKEBUN</td><td>TAMBAK</td><td>TAMB
align='right'>52135058</td><td>20-03-2019</td><td>YANUAR FITO
ARJUNA</td><td>SUHARNO</td><td>BELUM/TIDAK BEKERJA</td><td>KERJO
,TLOGOSARI</td><td>KERJO</td><td>TLOGOSARI</td><td>PKD TLOGOSARI</td><td>RETNO
AMBARWATI AMD KEB</td><td> - </td><td>L</td><td>1-4 Thn.</td><td>Datang
align='right'>M79.0</td><td>Rheumatism, unspecified</td><td></td><td
2019</td><td>YATMI</td><td>SARGINO 0808 S 57</td><td>MENGURUS RUMAH
TANGGA</td><td>NAILAN RT02
RW06</td><td></td><td>PRACIMANTORO</td><td>INDUK</td><td>dr. BUDI
align='right'>57050026</td><td>20-03-2019</td><td>YUNIDAR</td><td>DARMO SUWITO
0705 D 04</td><td>PETANI/PEKEBUN</td><td>SUKOROYOM KULON</td><td>SUKOROYOM
align='right'>53060051</td><td>21-03-2019</td><td>ADINDA AYU
PRATIWI</td><td>SUTARNO</td><td>BELUM/TIDAK
BEKERJA</td><td>KLEPU,TLOGOHARJO</td><td>KLEPU</td><td>TLOGOHARJO</td><td>INDUK</td
><td>dr. BUDI ASHARI</td><td>RISTINA Amd Keb</td><td>P</td><td><1
Thn.</td><td>Datang Sendiri</td><td>Lama</td><td>Imunisasi</td><td>Rajal</td><td
align='right'></td><td>Imunisasi</td><td></td><td></td><td>Dalam
align='right'>Z24.6</td><td>Need for immunization against viral
hepatitis</td><td></td><td align='right'>290135</td><td
align='right'>53060051</td><td>21-03-2019</td><td>ADINDA AYU
PRATIWI</td><td>SUTARNO</td><td>BELUM/TIDAK
align='right'>Z27.3</td><td>Need for immunization against diphtheria-tetanus-
pertussis with poliomyelitis [DTP + polio]</td><td></td><td
2019</td><td>ADINDA AYU PRATIWI</td><td>SUTARNO</td><td>BELUM/TIDAK
align='right'>53030059</td><td>21-03-2019</td><td>ANGGER
DEWANTARA</td><td>SULARSO</td><td>BELUM/TIDAK BEKERJA</td><td>JAJAR RT03
</tr><tr><td align='right'>Z24.5</td><td>Need for immunization against rubella
align='right'>57080197</td><td>21-03-2019</td><td>ANINDITA KEISYA
AZZAHRA</td><td>DARMAN 0708 D 01</td><td>BELUM/TIDAK BEKERJA</td><td>PUCANGANOM
KIDUL</td><td></td><td>PUCANGANOM</td><td>INDUK</td><td>dr. BUDI
ASHARI</td><td>RISTINA Amd Keb</td><td>P</td><td><1 Thn.</td><td>Datang
Sendiri</td><td>Lama</td><td>Imunisasi</td><td>Rajal</td><td align='right'></td><td
align='right'>59090744</td><td>21-03-2019</td><td>ANUGRAH GALIH
PRASETYO</td><td>AGUNG TARWANTO 09 09 A02</td><td></td><td>TIRTOSWORO RT02
RW05</td><td></td><td>GIRIWOYO</td><td>INDUK</td><td>dr. BUDI
/td></tr><tr><td align='right'>Z24.6</td><td>Need for immunization against viral
align='right'>51030071</td><td>21-03-2019</td><td>ARJUNA ABISKA</td><td>YUSUF
BAKTIAR</td><td>BELUM/TIDAK
BEKERJA</td><td>PRINGKUKU</td><td>PRINGKUKU</td><td>NGARGOHARJO</td><td>INDUK</td><
td>dr. BUDI ASHARI</td><td>HENI WIDIYASTUTI</td><td>L</td><td><1
2019</td><td>ARJUNA ABISKA</td><td>YUSUF BAKTIAR</td><td>BELUM/TIDAK
td>dr. BUDI ASHARI</td><td>HENI WIDIYASTUTI</td><td>L</td><td><1
align='right'>Z24.5</td><td>Need for immunization against rubella
align='right'>56060131</td><td>21-03-2019</td><td>ARZAQUNA
PURBAWASISESA</td><td>SIGIT SETYOKO</td><td>BELUM/TIDAK
BEKERJA</td><td>GOBOH</td><td>GOBOH</td><td>GIRITONTRO</td><td>INDUK</td><td>dr.
BUDI ASHARI</td><td>SRI SUPATMI</td><td>L</td><td><1 Thn.</td><td>Datang
align='right'>57040001</td><td>21-03-2019</td><td>BOINEM</td><td>SARINO 0704 S
23</td><td>PETANI/PEKEBUN</td><td>MANDEYAN</td><td>MANDEYAN</td><td>PUCANGANOM</td>
/td></tr><tr><td align='right'>Z00.6</td><td>Examination for normal comparison and
2019</td><td>EVITA YULIANTI</td><td>SUMAR 0401 S
13</td><td>PELAJAR/MAHASISWA</td><td>BELEH RT02
align='right'>56100378</td><td>21-03-2019</td><td>FAHDIL AQIDUN
HAKIM</td><td>JUMALI 0610 J 02</td><td>BELUM/TIDAK BEKERJA</td><td>TANGGUNG RT02
ASHARI</td><td>HENI WIDIYASTUTI</td><td>L</td><td><1 Thn.</td><td>Datang
align='right'>57090257</td><td>21-03-2019</td><td>FEBIANDRA SAKTI
ASA</td><td>GUNAWAN</td><td>BELUM/TIDAK BEKERJA</td><td>PUCANGANOM
KIDUL</td><td></td><td>PUCANGANOM</td><td>INDUK</td><td>dr. BUDI ASHARI</td><td>SRI
SUPATMI</td><td>L</td><td><1 Thn.</td><td>Datang
2019</td><td>FEBIANDRA SAKTI ASA</td><td>GUNAWAN</td><td>BELUM/TIDAK
BEKERJA</td><td>PUCANGANOM
KIDUL</td><td></td><td>PUCANGANOM</td><td>INDUK</td><td>dr. BUDI ASHARI</td><td>SRI
2019</td><td>GIMAN</td><td>GIMAN 0502 G
align='right'>57100032</td><td>21-03-2019</td><td>GUNEM</td><td>MARTO S 07 10 M
06</td><td>PENSIUNAN</td><td>JEPURUN RT02
></tr><tr><td align='right'>Z24.6</td><td>Need for immunization against viral
align='right'>56050214</td><td>21-03-
2019</td><td>HAFIDZAH</td><td>ERWIN</td><td>BELUM/TIDAK
. BUDI ASHARI</td><td>RETNO AMBARWATI AMD KEB</td><td>L</td><td><1
2019</td><td>HAFIDZAH</td><td>ERWIN</td><td>BELUM/TIDAK
. BUDI ASHARI</td><td>RETNO AMBARWATI AMD KEB</td><td>L</td><td><1
align='right'>56070162</td><td>21-03-2019</td><td>HANIFA AZAWA
F</td><td>SRIYANTO</td><td>BELUM/TIDAK BEKERJA</td><td>DUNGKANCIL</td><td>DUNG
KANCIL</td><td>GIRITONTRO</td><td>INDUK</td><td>dr. BUDI ASHARI</td><td>RETNO
AMBARWATI AMD KEB</td><td>P</td><td><1 Thn.</td><td>Datang
align='right'>L20.8</td><td>Other atopic dermatitis</td><td></td><td
2019</td><td>HASTUTIK</td><td>SUMADI 02 01 S
10</td><td>PETANI/PEKEBUN</td><td>GEMBUK RT 02 RW
07</td><td>GEMBUK</td><td>TLOGOSARI</td><td>INDUK</td><td>dr. BUDI
></tr><tr><td align='right'>K56.7</td><td>Ileus, unspecified</td><td></td><td
2019</td><td>INARA RATIFA</td><td>SANURI </td><td>BELUM/TIDAK
BEKERJA</td><td>BANJAR RT03
align='right'>2</td><td>KIA</td><td>Poli Anak</td><td>RSUD DR. SOEDIRAN MS
WONOGIRI</td><td>Dalam
align='right'>57030254</td><td>21-03-2019</td><td>ISTIDIYAH
PRAMESTI</td><td>ISMANTO 0703 I 01</td><td>PELAJAR/MAHASISWA</td><td>KUWANG RT02
2019</td><td>KARDIANTO</td><td>KARDIANTO 11 11 K
02</td><td>PETANI/PEKEBUN</td><td>GEDOMPOL RT 02 RW 07</td><td></td><td>JAWA
TIMUR</td><td>INDUK</td><td>drg.DANAR WULANDARI</td><td>RIZKI ANISSA,
AM.Kg</td><td>L</td><td>55-59 Thn.</td><td>Datang
align='right'>57020035</td><td>21-03-2019</td><td>KARMI</td><td>BOWO 07 02 B
></tr><tr><td align='right'>Z24.5</td><td>Need for immunization against rubella
align='right'>52130040</td><td>21-03-
2019</td><td>KEYNARA</td><td>TAUFIK</td><td>BELUM/TIDAK
BEKERJA</td><td>KERJO,TLOGOSARI</td><td>KERJO</td><td>TLOGOSARI</td><td>INDUK</td><
td>dr. BUDI ASHARI</td><td>RETNO AMBARWATI AMD KEB</td><td>P</td><td>1-4
align='right'>57050178</td><td>21-03-2019</td><td>KUMALA LUTFI HALIMAH</td><td>AMIR
CHALIMI 0705 A 08</td><td>PEDAGANG</td><td>SUKOROYOM KULON</td><td>SUKOROYOM
align='right'>55060056</td><td>21-03-2019</td><td>LAUDI SHAKIYA
ELEVINA</td><td>WINARSO 05 06 W
01</td><td></td><td>JATI</td><td>JATI</td><td>JATIREJO</td><td>INDUK</td><td>dr.
BUDI ASHARI</td><td>SUHARNI</td><td>P</td><td>1-4 Thn.</td><td>Datang
td></tr><tr><td align='right'>S01.0</td><td>Open wound of scalp</td><td></td><td
align='right'>290083</td><td align='right'>52030015</td><td>21-03-2019</td><td>M.
ARSELLO</td><td>AHMAD
SUDARTONO</td><td></td><td>SALAM</td><td></td><td>TLOGOSARI</td><td>INDUK</td><td>d
r. BUDI ASHARI</td><td>SUGIYONO,S.Kep.Ns</td><td>P</td><td>1-4 Thn.</td><td>Datang
align='right'>53080089</td><td>21-03-2019</td><td>M.RISKI
DEVANDO</td><td>WIDODO</td><td>BELUM/TIDAK BEKERJA</td><td>GINADE
KULON</td><td></td><td>TLOGOHARJO</td><td>INDUK</td><td>dr. BUDI
align='right'>53080089</td><td>21-03-2019</td><td>M.RISKI
DEVANDO</td><td>WIDODO</td><td>BELUM/TIDAK BEKERJA</td><td>GINADE
KULON</td><td></td><td>TLOGOHARJO</td><td>INDUK</td><td>dr. BUDI
align='right'>K04.7</td><td>Periapical abscess without sinus</td><td></td><td
2019</td><td>MARSIH</td><td>WAKIMIN 0408 W 01</td><td>PETANI/PEKEBUN</td><td>BAYEM
RT01 RW01</td><td>BAYEM</td><td>BAYEMHARJO</td><td>INDUK</td><td>drg.DANAR
align='right'>57070056</td><td>21-03-2019</td><td>MARSIYEM</td><td>MARSIYEM 07 07
M 10 </td><td>PETANI/PEKEBUN</td><td>BANJAR RT 02 RW
d align='right'>R05</td><td>Cough</td><td></td><td align='right'>290109</td><td
align='right'>54110078</td><td>21-03-2019</td><td>MARYATI</td><td>SISWOYO 0411 S
03
</td><td>PETANI/PEKEBUN</td><td>GUWO</td><td>GUWO</td><td>BAYEMHARJO</td><td>INDUK<
/td><td>dr. BUDI ASHARI</td><td>SUGIYONO,S.Kep.Ns</td><td>P</td><td>45-54
/td></tr><tr><td align='right'>Z24.5</td><td>Need for immunization against rubella
align='right'>52080103</td><td>21-03-2019</td><td>MELODY RAYA
RAMADAN</td><td>JARNO</td><td>BELUM/TIDAK
BEKERJA</td><td>TLOGOSARI</td><td></td><td>TLOGOSARI</td><td>INDUK</td><td>dr. BUDI
align='right'>A15</td><td>Respiratory tuberculosis, bacteriologically and
histologically confirmed</td><td></td><td align='right'>290108</td><td
align='right'>53010060</td><td>21-03-2019</td><td>MISNO KUNCORO</td><td>MISNO
KUNCORO 0301 M 04</td><td>PEDAGANG</td><td>TLOGO R02
RW01</td><td>TLOGO</td><td>TLOGOHARJO</td><td>INDUK</td><td>dr. BUDI
></tr><tr><td align='right'>S10.9</td><td>Superficial injury of neck, part
align='right'>56020347</td><td>21-03-2019</td><td>MUH COLIL</td><td>SURYANTO 0602
S 06</td><td>BELUM/TIDAK BEKERJA</td><td>GIRITONTRO KIDUL</td><td>GIRITONTRO
align='right'>51030070</td><td>21-03-2019</td><td>MUHAMMAD ILHAM</td><td>HERI
SETIAWAN 0103 H 01</td><td>BELUM/TIDAK
td>dr. BUDI ASHARI</td><td>HENI WIDIYASTUTI</td><td>P</td><td><1
align='right'>51030070</td><td>21-03-2019</td><td>MUHAMMAD ILHAM</td><td>HERI
SETIAWAN 0103 H 01</td><td>BELUM/TIDAK
2019</td><td>MUHAMMAD ILHAM</td><td>HERI SETIAWAN 0103 H 01</td><td>BELUM/TIDAK
align='right'>C50</td><td>Malignant neoplasm of breast</td><td></td><td
Umum</td><td>Poli Bedah</td><td>RSUD DR. SOEDIRAN MS WONOGIRI</td><td>Dalam
2019</td><td>NASIFATUL ZAHRA RAMADHANI</td><td>HARI SETYAWAN 0502 H
01</td><td>BELUM/TIDAK BEKERJA</td><td>GIRIROTO RT02
RW06</td><td>GIRIROTO</td><td>JATIREJO</td><td>INDUK</td><td>drg.DANAR
/tr><tr><td align='right'>B00.1</td><td>Herpesviral vesicular
align='right'>57070116</td><td>21-03-2019</td><td>NGATMINI</td><td>MARYOTO 0707 M
11</td><td>MENGURUS RUMAH TANGGA</td><td>BANJAR RT01
></tr><tr><td align='right'>S60</td><td>Superficial injury of wrist and
align='right'>57050299</td><td>21-03-2019</td><td>PANDU ALVIAN</td><td>SUKIDI 0705
S 11</td><td>BELUM/TIDAK BEKERJA</td><td>SUKOROYOM
KULON</td><td>SUKOROYOM KULON</td><td>PUCANGANOM</td><td>INDUK</td><td>dr. BUDI
align='right'>L24.4</td><td>Irritant contact dermatitis due to drugs in contact
with skin</td><td></td><td align='right'>290111</td><td
align='right'>56070174</td><td>21-03-2019</td><td>PARINEM</td><td>SARNO 07 06 S
24</td><td>PETANI/PEKEBUN</td><td>DUNG KANCIL RT 01 RW 09</td><td>DUNG
align='right'>57030234</td><td>21-03-
2019</td><td>PARTI</td><td>DASUKI</td><td>PELAJAR/MAHASISWA</td><td>KUWANG</td><td>
KUWANG</td><td>PUCANGANOM</td><td>INDUK</td><td>dr. BUDI
align='right'>M79.15</td><td>Myalgia, pelvic and thigh</td><td></td><td
2019</td><td>PAWITI</td><td>DARYONO 07 07 D
</td></tr><tr><td align='right'>K05.2</td><td>Acute periodontitis</td><td></td><td
2019</td><td>PENTI ANGGONO</td><td>SUPRIYANTO 05 11 S
20</td><td>PELAJAR/MAHASISWA</td><td>BUWENG RT 01 RW
align='right'>52057057</td><td>21-03-2019</td><td>PINDO CAESAR
LADUNNI</td><td></td><td>BELUM/TIDAK
BEKERJA</td><td>GLAGAH</td><td>GLAGAH</td><td>TLOGOSARI</td><td>PUSTU
tr><tr><td align='right'>I50</td><td>Heart failure</td><td></td><td
align='right'>53010083</td><td>21-03-2019</td><td>RAHMAT SURYA
PRATAMA</td><td>MULYADI</td><td>MENGURUS RUMAH
TANGGA</td><td>TLOGO</td><td></td><td>TLOGOHARJO</td><td>INDUK</td><td>dr. BUDI
align='right'>53010083</td><td>21-03-2019</td><td>RAHMAT SURYA
PRATAMA</td><td>MULYADI</td><td>MENGURUS RUMAH
2019</td><td>RAHMAT SURYA PRATAMA</td><td>MULYADI</td><td>MENGURUS RUMAH
2019</td><td>RAYSAGA ARTEZY IBRAHIM</td><td>NUGROHO SETIAWAN 07 04 N
dr. BUDI ASHARI</td><td>RETNO AMBARWATI AMD KEB</td><td>L</td><td><1
align='right'>57040298</td><td>21-03-2019</td><td>RAYSAGA ARTEZY
IBRAHIM</td><td>NUGROHO SETIAWAN 07 04 N 03</td><td>BELUM/TIDAK
dr. BUDI ASHARI</td><td>RETNO AMBARWATI AMD KEB</td><td>L</td><td><1
align='right'>56020676</td><td>21-03-2019</td><td>RENANDO GHAISAN
USTADI</td><td>DANI USTADI 0610 D 02</td><td>BELUM/TIDAK
BEKERJA</td><td>GIRITONTRO KIDUL</td><td>GIRITONTRO
KIDUL</td><td>GIRITONTRO</td><td>INDUK</td><td>dr. BUDI ASHARI</td><td>UMI NUR
ISNIATI</td><td>L</td><td><1 Thn.</td><td>Datang
2019</td><td>RENANDO GHAISAN USTADI</td><td>DANI USTADI 0610 D
02</td><td>BELUM/TIDAK BEKERJA</td><td>GIRITONTRO KIDUL</td><td>GIRITONTRO
align='right'>O12.2</td><td>Gestational oedema with proteinuria</td><td></td><td
2019</td><td>RETNO WULANDARI</td><td>FITRIANTO 07 11 F 01</td><td>MENGURUS RUMAH
TANGGA</td><td>PLOSO RT01
align='right'>290080</td><td align='right'>57100166</td><td>21-03-2019</td><td>RIAN
SETIAWAN</td><td>MARJAN 07 10 M 07</td><td>KARYAWAN SWASTA</td><td>JEPURUN RT 03
RW 10</td><td>JEPURUN</td><td>PUCANGANOM</td><td>INDUK</td><td>dr.
align='right'>52047038</td><td>21-03-
2019</td><td>SAMIDJAN</td><td></td><td>PETANI/PEKEBUN</td><td>SOKO</td><td>SOKO</td
2019</td><td>SAMIYEM</td><td>SUKIRNO 07 04 S
d></tr><tr><td align='right'>J44.9</td><td>Chronic obstructive pulmonary disease,
align='right'>53010052</td><td>21-03-2019</td><td>SARIKEM</td><td>MISNO KUNCORO 03
01 M 04</td><td>PETANI/PEKEBUN</td><td>TLOGO RT 02 RW
2019</td><td>SARMI</td><td>KEMIN</td><td>PETANI/PEKEBUN</td><td>PORO</td><td>PORO</
td><td>TLOGOSARI</td><td>PKD TLOGOSARI</td><td>RETNO AMBARWATI AMD KEB</td><td> -
align='right'>51020109</td><td>21-03-2019</td><td>SAVITRI</td><td>KARMOREJO 01 02 K
05</td><td>MENGURUS RUMAH TANGGA</td><td>NGRINGIN RT 02 RW
td></tr><tr><td align='right'>Z27.3</td><td>Need for immunization against
diphtheria-tetanus-pertussis with poliomyelitis [DTP + polio]</td><td></td><td
2019</td><td>SIFANI ALISIA SALSABILA</td><td>PONIJAN 0708 P
02</td><td>BELUM/TIDAK BEKERJA</td><td>PUCANGANOM KIDUL RT01
RW08</td><td>PUCANGANOM KIDUL</td><td>PUCANGANOM</td><td>INDUK</td><td>dr. BUDI
ASHARI</td><td>RETNO AMBARWATI AMD KEB</td><td>P</td><td><1 Thn.</td><td>Datang
align='right'>57080219</td><td>21-03-2019</td><td>SIFANI ALISIA
SALSABILA</td><td>PONIJAN 0708 P 02</td><td>BELUM/TIDAK
BEKERJA</td><td>PUCANGANOM KIDUL RT01 RW08</td><td>PUCANGANOM
KIDUL</td><td>PUCANGANOM</td><td>INDUK</td><td>dr. BUDI ASHARI</td><td>RETNO
align='right'>55010282</td><td>21-03-2019</td><td>SINO ATMO SUWITO</td><td>SINO 05
01 S 09</td><td>PETANI/PEKEBUN</td><td>GIRIBELAH RT01
align='right'>56070014</td><td>21-03-2019</td><td>SLAMET</td><td>SLAMET 0607 S
19</td><td>PETANI/PEKEBUN</td><td>DUNGKANCIL</td><td>DUNG
align='right'>56080108</td><td>21-03-2019</td><td>SRI HARTATI</td><td>SUPARNO 0606
S 05</td><td>MENGURUS RUMAH TANGGA</td><td>DUNGKLEPU WETAN</td><td>DUNG KLEPU
align='right'>57050256</td><td>21-03-2019</td><td>SUGINEM</td><td>SUKIRMAN 0705 S
09</td><td>PETANI/PEKEBUN</td><td>SUKOROYOM KULON RT03/03</td><td>SUKOROYOM
2019</td><td>SUKATMI</td><td></td><td>PETANI/PEKEBUN</td><td>TLOGOSARI</td><td>TLOG
d></tr><tr><td align='right'>H25.9</td><td>Senile cataract,
align='right'>57050150</td><td>21-03-
2019</td><td>SUKIRMAN</td><td>SUKIRMAN</td><td>PELAJAR/MAHASISWA</td><td>SUKOROYOM
2019</td><td>SUNARTO</td><td>SUNARTO 0707 S 49</td><td>WIRASWASTA</td><td>BANJAR
2019</td><td>SUPARMI</td><td>SUGIMIN</td><td>MENGURUS RUMAH
TANGGA</td><td>KLEPU</td><td>KLEPU</td><td>TLOGOSARI</td><td>PKD
Thn.</td><td>Datang Sendiri</td><td>Lama</td><td>BPJS
align='right'>56100149</td><td>21-03-2019</td><td>SURATMI</td><td>BUDIYONO 0610 B
TANGGA</td><td>TANGGUNG</td><td></td><td>GIRITONTRO</td><td>INDUK</td><td>dr. BUDI
align='right'>54110018</td><td>21-03-2019</td><td>SURYONO</td><td>SURYONO 0411 S
align='right'>56055021</td><td>21-03-2019</td><td>SUTARWI</td><td>SURAHMIN 06 05 S
12</td><td>PELAJAR/MAHASISWA</td><td>NGUJUNG RT 01 RW
></tr><tr><td align='right'>J11</td><td>Influenza, virus not
align='right'>55050110</td><td>21-03-2019</td><td>SUYANTO</td><td>SUYANTO 05 05 S
></tr><tr><td align='right'>H65.4</td><td>Other chronic nonsuppurative otitis
align='right'>55070004</td><td>21-03-2019</td><td>SUYATMI</td><td>PAIJO 0507
P05</td><td>PETANI/PEKEBUN</td><td>NGELOSARI</td><td>NGELOSARI</td><td>JATIREJO</td
><td>INDUK</td><td>dr. BUDI ASHARI</td><td>SUGIYONO,S.Kep.Ns</td><td>P</td><td>60-
PBI</td><td>Rujuk</td><td align='right'>4</td><td align='right'>6</td><td
align='right'>57020076</td><td>21-03-2019</td><td>TAJEM</td><td>TAJEM 07 02 T
03-2019</td><td>TUKIYEM</td><td>YOSO SUWITO 07 04 Y
01</td><td>PETANI/PEKEBUN</td><td>MANDEYAN RT 03 RQW
SETYORINI</td><td>ARIS SETIANTO 0301 A 03</td><td>MENGURUS RUMAH
TANGGA</td><td>TLOGO</td><td>TLOGO</td><td>TLOGOHARJO</td><td>INDUK</td><td>drg.DAN
AR WULANDARI</td><td>RIZKI ANISSA, AM.Kg</td><td>P</td><td>20-44
align='right'>51110024</td><td>21-03-2019</td><td>VIBRASIARIA
MUTIKA</td><td>SURIPTO 01 11 S 12</td><td>BELUM/TIDAK BEKERJA</td><td>BLEBER RT 02
RW 06 NGARGOHARJO</td><td>BLEBER</td><td>NGARGOHARJO</td><td>INDUK</td><td>dr. BUDI
></tr><tr><td align='right'>D33.0</td><td>Benign neoplasm of brain,
supratentorial</td><td></td><td align='right'>290089</td><td
align='right'>57030342</td><td>21-03-2019</td><td>WIDATIN</td><td>BASUNI 0703 B
08</td><td>MENGURUS RUMAH TANGGA</td><td>KUWANG RT03
align='right'>52130037</td><td>21-03-2019</td><td>YANUAR FITO
</td><td>SUHARNO</td><td>BELUM/TIDAK BEKERJA</td><td>KERJO
,TLOGOSARI</td><td>KERJO</td><td>TLOGOSARI</td><td>INDUK</td><td>dr. BUDI
Sendiri</td><td>Lama</td><td>Imunisasi</td><td>Rajal</td><td
align='right'>57115073</td><td>21-03-2019</td><td>YOSO SUKATNO</td><td>YOSO SUKATNO
0711 Y
01</td><td>PETANI/PEKEBUN</td><td>PLOSO</td><td>PLOSO</td><td>PUCANGANOM</td><td>IN
DUK</td><td>dr. BUDI ASHARI</td><td>SUGIYONO,S.Kep.Ns</td><td>L</td><td>>70
></tr><tr><td align='right'>S81.9</td><td>Open wound of lower leg, part
align='right'>15151398</td><td>22-03-2019</td><td>ADE</td><td>H.
RAFLI</td><td>KARYAWAN
SWASTA</td><td>SUKABUMI</td><td></td><td>JAKARTA</td><td>INDUK</td><td>dr. BUDI
align='right'>S10.9</td><td>Superficial injury of neck, part
align='right'>57090260</td><td>22-03-2019</td><td>BRIGITA VALENSIA RISQI
HUSADA</td><td>MARIO 0709 M 10</td><td>BELUM/TIDAK BEKERJA</td><td>PUCANGANOM
LOR</td><td>PUCANGANOM LOR</td><td>PUCANGANOM</td><td>INDUK</td><td>dr. BUDI
ASHARI</td><td>SUGIYONO,S.Kep.Ns</td><td>P</td><td>1-4
align='right'>57050332</td><td>22-03-2019</td><td>BUDI FAHMI ALI</td><td>HADI UTOMO
0705 H 03</td><td>KARYAWAN SWASTA</td><td>SUKOROYOM KULON RT01
align='right'>55010255</td><td>22-03-2019</td><td>BUDI HARTANTO</td><td>BUDI
HARTANTO 0501 B 01</td><td>PETANI/PEKEBUN</td><td>GIRIBELAH
03/07</td><td>GIRIBELAH</td><td>JATIREJO</td><td>INDUK</td><td>dr. BUDI
</tr><tr><td align='right'>L24.9</td><td>Irritant contact dermatitis, unspecified
align='right'>52077016</td><td>22-03-2019</td><td>DINA
WAHYUNI</td><td>PARMIN</td><td>PELAJAR/MAHASISWA</td><td>SUMBERJO</td><td>SUMBERJO<
/td><td>TLOGOSARI</td><td>PUSTU TLOGOSARI</td><td>SULARNO,S.Kep.Ns</td><td> -
align='right'>54110086</td><td>22-03-2019</td><td>DODY SETIAWAN</td><td>DODY
SETIAWAN 0411 D 01</td><td>PETANI/PEKEBUN</td><td>GUWO RT03
2019</td><td>GISELA NUR HANIFA</td><td>AHMAD RIDWAN 0601 A
04</td><td></td><td>GIRITONTRO LOR</td><td>GIRITONTRO
td></tr><tr><td align='right'>K29.5</td><td>Chronic gastritis,
align='right'>57080229</td><td>22-03-2019</td><td>IPAH SUPRAPTI</td><td>TUKIMIN 07
08 T 08</td><td>PETANI/PEKEBUN</td><td>PUCANGANOM KIDUL RT 03 RW
08</td><td>PUCANGANOM KIDUL</td><td>PUCANGANOM</td><td>INDUK</td><td>dr. BUDI
></tr><tr><td align='right'>S01.9</td><td>Open wound of head, part
align='right'>56020530</td><td>22-03-2019</td><td>JUMIYATI</td><td>SUPARDIMAN 0602
S 44</td><td>PEDAGANG</td><td>GIRITONTRO KIDUL
01/03</td><td></td><td>GIRITONTRO</td><td>INDUK</td><td>dr. BUDI
2019</td><td>KASNO</td><td>KASNO 07 02 K
</tr><tr><td align='right'>I10</td><td>Essential (primary)
align='right'>52037009</td><td>22-03-
2019</td><td>KATIYEM</td><td>DARMO</td><td>PETANI/PEKEBUN</td><td>SALAM</td><td>SAL
AM</td><td>TLOGOSARI</td><td>PUSTU TLOGOSARI</td><td>SULARNO,S.Kep.Ns</td><td> -
align='right'>H65.9</td><td>Nonsuppurative otitis media,
align='right'>56010057</td><td>22-03-2019</td><td>KIARA RIZQITA
NABILLA</td><td>TUKIMAN 0601 T 05</td><td>PELAJAR/MAHASISWA</td><td>GIRITONTRO
LOR RT03 RW01</td><td>GIRITONTRO LOR</td><td>GIRITONTRO</td><td>INDUK</td><td>dr.
align='right'>290169</td><td align='right'>57050228</td><td>22-03-2019</td><td>M.
ROFIQ NUR ALFAN</td><td>SOLAUDIN 07 05 S
align='right'>54065007</td><td>22-03-
2019</td><td>MINEM</td><td>PAIJAN</td><td>PETANI/PEKEBUN</td><td>BAYEM</td><td>BAYE
M</td><td>BAYEMHARJO</td><td>PKD TLOGOHARJO</td><td>SRI SUPATMI</td><td> -
align='right'>53070008</td><td>22-03-2019</td><td>MISDI</td><td>MISDI 03 07 M
01</td><td>PETANI/PEKEBUN</td><td>PAGER GUNUNGRT04 RW 05</td><td>PAGER
GUNUNG</td><td>TLOGOHARJO</td><td>INDUK</td><td>dr. BUDI
align='right'>57090218</td><td>22-03-2019</td><td>MURWITO</td><td>MURWITO 0709 M
03</td><td>PETANI/PEKEBUN</td><td>PUCANGANOM KIDUL RT03 RW08</td><td>PUCANGANOM
/td></tr><tr><td align='right'>K02.0</td><td>Caries limited to
enamel</td><td></td><td align='right'>290164</td><td
align='right'>55110065</td><td>22-03-2019</td><td>NABILA MIKAYLA A</td><td>SUTRISNO
05 11 S 24</td><td></td><td>BUWENG RT 02 RW
td></tr><tr><td align='right'>K29.6</td><td>Other gastritis</td><td></td><td
2019</td><td>NANANG BAKTI PAMUNGKAS</td><td>SUPRIYONO 01 11 S
16</td><td>BELUM/TIDAK BEKERJA</td><td>BLEBER RT 02 RW
06</td><td>BLEBER</td><td>NGARGOHARJO</td><td>INDUK</td><td>dr. BUDI
align='right'>54070016</td><td>22-03-2019</td><td>NELA A Y</td><td>SANTOSO 0407 S
10</td><td>MENGURUS RUMAH TANGGA</td><td>NGALURAN RT01
align='right'>56065002</td><td>22-03-2019</td><td>NGATIYEM</td><td>SUTIYO 06 06 S
04</td><td>PETANI/PEKEBUN</td><td>GOBOH RT 03 RW
06</td><td>GOBOH</td><td>GIRITONTRO</td><td>INDUK</td><td>dr. BUDI
d></tr><tr><td align='right'>T14.9</td><td>Injury, unspecified</td><td></td><td
2019</td><td>OLIVIERA NANDA
PRATAMA</td><td>MARMO</td><td>PELAJAR/MAHASISWA</td><td>TLOGO</td><td>TLOGO</td><td
>TLOGOHARJO</td><td>PKD TLOGOHARJO</td><td>SRI SUPATMI</td><td> -
tr><tr><td align='right'>M19.95</td><td>Arthrosis, unspecified, pelvic and
align='right'>51060005</td><td>22-03-2019</td><td>PAIYEM</td><td>TUKIYO 0106 T
01</td><td>PETANI/PEKEBUN</td><td>NGLARANGAN RT01
RW04</td><td>NGLARANGAN</td><td>NGARGOHARJO</td><td>INDUK</td><td>dr. BUDI
></tr><tr><td align='right'>I20.9</td><td>Angina pectoris,
align='right'>56100009</td><td>22-03-2019</td><td>RAHAYU NURYANTI</td><td>SRIYATNO
0610 S 08</td><td>MENGURUS RUMAH TANGGA</td><td>TANGGUNG RT04
/tr><tr><td align='right'>J11.8</td><td>Influenza with other manifestations, virus
align='right'>56065015</td><td>22-03-2019</td><td>SAMIJEM</td><td>SAMIJEM 0606 S
13</td><td></td><td>GOBOH</td><td>GOBOH</td><td>GIRITONTRO</td><td>INDUK</td><td>dr
. BUDI ASHARI</td><td>SUGIYONO,S.Kep.Ns</td><td>P</td><td>>70 Thn.</td><td>Datang
2019</td><td>SARNI</td><td>KATINO 0714 K 01</td><td>PETANI/PEKEBUN</td><td>PENDEM
</tr><tr><td align='right'>J31</td><td>Chronic rhinitis, nasopharyngitis and
pharyngitis</td><td></td><td align='right'>290158</td><td
align='right'>55020127</td><td>22-03-2019</td><td>SARWONO </td><td>SARWONO 05 02 S
24</td><td>WIRASWASTA</td><td>GIRIROTO RT 01 RW 06
</td><td>GIRIROTO</td><td>JATIREJO</td><td>INDUK</td><td>dr. BUDI
2019</td><td>SENEN</td><td>MOKARYO 06 02 M
></tr><tr><td align='right'>D53.9</td><td>Nutritional anaemia,
align='right'>56030059</td><td>22-03-2019</td><td>SUKARTI</td><td>SUTARJO 06 03 S
Umum</td><td>Poli Dalam</td><td>RS MAGUAN HUSADA</td><td>Dalam
2019</td><td>SULARMI</td><td></td><td>PETANI/PEKEBUN</td><td>SOKO</td><td>SALAM</td
2019</td><td>SUMARNI</td><td>TIMIN 10 10 T
12</td><td>PETANI/PEKEBUN</td><td>NGLEDOK RT 02 RW 02
GENDAYAKAN</td><td></td><td>PARANGGUPITO</td><td>INDUK</td><td>drg.DANAR
align='right'>54070091</td><td>22-03-2019</td><td>SURANTO </td><td>SURANTO 04 07 S
02</td><td>PETANI/PEKEBUN</td><td>NGALURAN RT 01 RW
2019</td><td>SUTRISNI</td><td>SUTRISNI</td><td>PETANI/PEKEBUN</td><td>SOKO</td><td>
SOKO</td><td>TLOGOSARI</td><td>PUSTU TLOGOSARI</td><td>SULARNO,S.Kep.Ns</td><td> -
align='right'>53015134</td><td>22-03-2019</td><td>TRI WIDIANTO</td><td>TRI
WIDIANTO</td><td>KARYAWAN
SWASTA</td><td>TLOGO</td><td>TLOGO</td><td>TLOGOHARJO</td><td>PKD
align='right'>56070156</td><td>22-03-2019</td><td>TUKINEM</td><td>MARTOYOSO 0607 M
06</td><td>PETANI/PEKEBUN</td><td>DUNG KANCIL RT01 RW09</td><td>DUNG
2019</td><td>WAKINO</td><td>WAKINO 05 05 W 10</td><td>PETANI/PEKEBUN</td><td>PUNUNG
RT 01 RW 02</td><td>PUNUNG</td><td>JATIREJO</td><td>INDUK</td><td>drg.DANAR
/td></tr><tr><td align='right'>K08.3</td><td>Retained dental root</td><td></td><td
align='right'>57080230</td><td>22-03-2019</td><td>ZAHFIA ANNASHATUL
AIRURI</td><td>SUTARDI 07 08 S 26</td><td>BELUM/TIDAK BEKERJA</td><td>PUCANGANOM
KIDUL RT 02 RW 08</td><td>PUCANGANOM
align='right'>55110109</td><td>23-03-2019</td><td>ABDILLAH ASHRAF
PRATAMA</td><td>SARYOKO</td><td>BELUM/TIDAK
BEKERJA</td><td>BUWENG</td><td></td><td>JATIREJO</td><td>INDUK</td><td>dr. BUDI
ASHARI</td><td>UMI NUR ISNIATI</td><td>L</td><td><1 Thn.</td><td>Datang
2019</td><td>ABDILLAH ASHRAF PRATAMA</td><td>SARYOKO</td><td>BELUM/TIDAK
BEKERJA</td><td>BUWENG</td><td></td><td>JATIREJO</td><td>INDUK</td><td>dr. BUDI
align='right'>53030048</td><td>23-03-2019</td><td>ABRIZAM AULIAN
FAIZ</td><td>SUNARTO</td><td></td><td>JAJAR,
TLOGOHARJO</td><td></td><td>TLOGOHARJO</td><td>INDUK</td><td>dr. BUDI
align='right'>52080120</td><td>23-03-2019</td><td>ADZRIEL RAFID
SYAHPUTRA</td><td>SUPRIYANTO</td><td>BELUM/TIDAK
2019</td><td>ADZRIEL RAFID SYAHPUTRA</td><td>SUPRIYANTO</td><td>BELUM/TIDAK
align='right'>A01</td><td>Typhoid and paratyphoid fevers</td><td></td><td
2019</td><td>AHMAD KHAFI</td><td>SULARNO 0701
S01</td><td>PELAJAR/MAHASISWA</td><td>GROGOL RT03
align='right'>55060107</td><td>23-03-2019</td><td>AKIO AL
AYYUBI</td><td>TUGIRAN</td><td>BELUM/TIDAK BEKERJA</td><td>JATI
</td><td></td><td>JATIREJO</td><td>INDUK</td><td>dr. BUDI ASHARI</td><td>RETNO
align='right'>55060107</td><td>23-03-2019</td><td>AKIO AL
AYYUBI</td><td>TUGIRAN</td><td>BELUM/TIDAK BEKERJA</td><td>JATI
align='right'>290229</td><td align='right'>55060107</td><td>23-03-2019</td><td>AKIO
AL AYYUBI</td><td>TUGIRAN</td><td>BELUM/TIDAK BEKERJA</td><td>JATI
align='right'>58080641</td><td>23-03-2019</td><td>ALFA MAHARDIKA
QALAMI</td><td>SUGENG HARIADI 0808 S
44</td><td>PELAJAR/MAHASISWA</td><td>SIRNOBOYO,GIRIWOYO</td><td></td><td>GIRIWOYO</
td><td>INDUK</td><td>dr. BUDI
align='right'>55040112</td><td>23-03-2019</td><td>ALVIAN RAMADHANI</td><td>EDI
GURITNO</td><td>BELUM/TIDAK
BEKERJA</td><td>KANIGORO</td><td></td><td>JATIREJO</td><td>INDUK</td><td>dr. BUDI
2019</td><td>ALVIAN RAMADHANI</td><td>EDI GURITNO</td><td>BELUM/TIDAK
align='right'>55070059</td><td>23-03-
2019</td><td>ALVINO</td><td>SUYATNO</td><td>BELUM/TIDAK
BEKERJA</td><td>NGELOSARI</td><td></td><td>JATIREJO</td><td>INDUK</td><td>dr. BUDI
align='right'>55070059</td><td>23-03-
align='right'>56070164</td><td>23-03-2019</td><td>ARSYAD
GESIT</td><td>MURDIYANTO</td><td>BELUM/TIDAK
BEKERJA</td><td>DUNGKANCIL</td><td>DUNG
KANCIL</td><td>GIRITONTRO</td><td>INDUK</td><td>dr. BUDI ASHARI</td><td>UMI NUR
align='right'>290174</td><td align='right'>55110002</td><td>23-03-2019</td><td>ASRI
ASMARANINGRUM</td><td>WIYONO 0511 W 06</td><td>KARYAWAN HONORER</td><td>BUWENG
RT01 RW05</td><td>BUWENG</td><td>JATIREJO</td><td>INDUK</td><td>dr. BUDI
align='right'>56080001</td><td>23-03-2019</td><td>AZAH RANIFAH</td><td>SUGIRAN 06
08 S 04</td><td>PELAJAR/MAHASISWA</td><td>DUNGKLEPU WETAN</td><td>DUNG KLEPU
align='right'>57100165</td><td>23-03-2019</td><td>AZAHWA AQILA
ANGGRAINI</td><td>DIYONO</td><td>BELUM/TIDAK
BEKERJA</td><td>JEPURUN</td><td></td><td>PUCANGANOM</td><td>INDUK</td><td>dr. BUDI
align='right'>57100165</td><td>23-03-2019</td><td>AZAHWA AQILA
ANGGRAINI</td><td>DIYONO</td><td>BELUM/TIDAK
2019</td><td>AZAHWA AQILA ANGGRAINI</td><td>DIYONO</td><td>BELUM/TIDAK
align='right'>51110042</td><td>23-03-2019</td><td>AZIZAH NATALIA N</td><td>AGUS P
</td><td>BELUM/TIDAK
BEKERJA</td><td>BLEBER</td><td></td><td>NGARGOHARJO</td><td>INDUK</td><td>dr. BUDI
align='right'>51110042</td><td>23-03-2019</td><td>AZIZAH NATALIA N</td><td>AGUS P
</td><td>BELUM/TIDAK
2019</td><td>AZIZAH NATALIA N</td><td>AGUS P </td><td>BELUM/TIDAK
align='right'>56080298</td><td>23-03-2019</td><td>AZKIA AYUNINA
RAMADHANI</td><td>SEDIYANTO/KHAIRULLOH 06 08 S 33</td><td>BELUM/TIDAK
BEKERJA</td><td>DUNG KLEPU
WETAN</td><td></td><td>GIRITONTRO</td><td>INDUK</td><td>dr. BUDI
ASHARI</td><td>SUHARNI</td><td>P</td><td><1 Thn.</td><td>Datang
align='right'>56010482</td><td>23-03-2019</td><td>AZRIL
RAFIQ SYAHPUTRA</td><td>WINARNO</td><td>BELUM/TIDAK BEKERJA</td><td>GIRITONTRO
LOR</td><td></td><td>GIRITONTRO</td><td>INDUK</td><td>dr. BUDI ASHARI</td><td>UMI
align='right'>56010482</td><td>23-03-2019</td><td>AZRIL RAFIQ
SYAHPUTRA</td><td>WINARNO</td><td>BELUM/TIDAK BEKERJA</td><td>GIRITONTRO
2019</td><td>AZRIL RAFIQ SYAHPUTRA</td><td>WINARNO</td><td>BELUM/TIDAK
align='right'>51020084</td><td>23-03-2019</td><td>BANU
RAHARJO</td><td>SARWANTO</td><td>BELUM/TIDAK
BEKERJA</td><td>NGRINGIN</td><td></td><td>NGARGOHARJO</td><td>INDUK</td><td>dr.
BUDI ASHARI</td><td>RISTINA Amd Keb</td><td>L</td><td>1-4 Thn.</td><td>Datang
align='right'>55100050</td><td>23-03-2019</td><td>BRLYAN PRADIPTA AL
FATIH</td><td>WITRIATNO</td><td>BELUM/TIDAK BEKERJA</td><td>SENGON
</td><td>SENGON</td><td>JATIREJO</td><td>INDUK</td><td>dr. BUDI
2019</td><td>BRLYAN PRADIPTA AL FATIH</td><td>WITRIATNO</td><td>BELUM/TIDAK
BEKERJA</td><td>SENGON </td><td>SENGON</td><td>JATIREJO</td><td>INDUK</td><td>dr.
BUDI ASHARI</td><td>RETNO AMBARWATI AMD KEB</td><td>L</td><td><1
align='right'>55050125</td><td>23-03-2019</td><td>DEVANO IQBAL
SAPUTRA</td><td>ANTO</td><td>BELUM/TIDAK
BEKERJA</td><td>PUNUNG</td><td></td><td>JATIREJO</td><td>INDUK</td><td>dr. BUDI
2019</td><td>DEVANO IQBAL SAPUTRA</td><td>ANTO</td><td>BELUM/TIDAK
BEKERJA</td><td>PUNUNG</td><td></td><td>JATIREJO</td><td>INDUK</td><td>dr. BUDI
align='right'>S61.8</td><td>Open wound of other parts of wrist and
align='right'>56080318</td><td>23-03-2019</td><td>FADHIL
SYABANI</td><td>MIYANTO</td><td>BELUM/TIDAK BEKERJA</td><td>DUNGKLEPU
ASHARI</td><td>SUHARNI</td><td>L</td><td><1 Thn.</td><td>Datang
align='right'>56080318</td><td>23-03-2019</td><td>FADHIL
SYABANI</td><td>MIYANTO</td><td>BELUM/TIDAK BEKERJA</td><td>DUNGKLEPU
2019</td><td>FADHIL SYABANI</td><td>MIYANTO</td><td>BELUM/TIDAK
BEKERJA</td><td>DUNGKLEPU
align='right'>57035005</td><td>23-03-2019</td><td>FEBRIANA ANDINI</td><td>BUDI
SANTOSO 07 03 B 07</td><td>PELAJAR/MAHASISWA</td><td>KUWANG RT04
></tr><tr><td align='right'>Z00.5</td><td>Examination of potential donor of organ
and tissue</td><td></td><td align='right'>290183</td><td
align='right'>57120181</td><td>23-03-2019</td><td>FITRI NURJANAH</td><td>SARJONO 07
12 S 09</td><td>BELUM/TIDAK BEKERJA</td><td>INGAK INGUK RT 02 RW 16</td><td>INGAK -
INGUK</td><td>PUCANGANOM</td><td>INDUK</td><td>dr. BUDI ASHARI</td><td>SRI
MURWATININGSIH</td><td>P</td><td>15-19 Thn.</td><td>Datang
align='right'>570283</td><td>23-03-2019</td><td>GANI PUTRA
RAMADHANI</td><td>SARDIANTO</td><td>BELUM/TIDAK
BEKERJA</td><td>MANDEYAN</td><td></td><td>PUCANGANOM</td><td>INDUK</td><td>dr. BUDI
align='right'>55060085</td><td>23-03-2019</td><td>JONATHAN
ATHAFARIZ</td><td>WINARSO</td><td>BELUM/TIDAK
BEKERJA</td><td>JATI</td><td></td><td>JATIREJO</td><td>INDUK</td><td>dr. BUDI
ASHARI</td><td>HENI WIDIYASTUTI</td><td>L</td><td>1-4
align='right'>52110038</td><td>23-03-2019</td><td>JUNIARKA ISCO
RAMADHANSYAH</td><td>SUROSO 0211 S 19</td><td>BELUM/TIDAK BEKERJA</td><td>TAMBAK
RT01 RW02</td><td></td><td>TLOGOSARI</td><td>INDUK</td><td>dr. BUDI
align='right'>53030053</td><td>23-03-2019</td><td>KHALISA SYARIFATUN
NISA</td><td>SLAMET HARTONO 0303 S 02</td><td>BELUM/TIDAK BEKERJA</td><td>JAJAR
RT04 RW02</td><td></td><td>TLOGOHARJO</td><td>INDUK</td><td>dr. BUDI
ASHARI</td><td>HENI WIDIYASTUTI</td><td>P</td><td>1-4 Thn.</td><td>Datang
align='right'>55060099</td><td>23-03-2019</td><td>M. ARYA PRASETYA</td><td>ANDI
P</td><td>BELUM/TIDAK
BEKERJA</td><td>JATIREJO</td><td></td><td>JATIREJO</td><td>INDUK</td><td>dr. BUDI
align='right'>54110121</td><td>23-03-2019</td><td>M. AZKA
ALDRIC</td><td>KUSPRIADI</td><td>BELUM/TIDAK
BEKERJA</td><td>GUWO</td><td></td><td>BAYEMHARJO</td><td>INDUK</td><td>dr. BUDI
align='right'>55060111</td><td>23-03-2019</td><td>M.MARVEL
FADILAH</td><td>SULIYANTO</td><td>BELUM/TIDAK
2019</td><td>M.MARVEL FADILAH</td><td>SULIYANTO</td><td>BELUM/TIDAK
align='right'>51020103</td><td>23-03-2019</td><td>MARCELINO MUHAMMAD
SALIM</td><td>TANTO</td><td>BELUM/TIDAK
BEKERJA</td><td>NGRINGIN</td><td>NGRINGIN</td><td>NGARGOHARJO</td><td>INDUK</td><td
>dr. BUDI ASHARI</td><td>SUHARNI</td><td>L</td><td><1 Thn.</td><td>Datang
2019</td><td>MARCELINO MUHAMMAD SALIM</td><td>TANTO</td><td>BELUM/TIDAK
BEKERJA</td><td>NGRINGIN</td><td>NGRINGIN</td><td>NGARGOHARJO</td><td>INDUK</td><td
>dr. BUDI ASHARI</td><td>SUHARNI</td><td>L</td><td><1 Thn.</td><td>Datang
align='right'>K05.2</td><td>Acute periodontitis</td><td></td><td
align='right'>290196</td><td align='right'>56050027</td><td>23-03-2019</td><td>MEGA
OKTAVIA KARNAS</td><td>KARYATI 06 05 K 04</td><td>MENGURUS RUMAH
TANGGA</td><td>NGUJUNG RT02
RW08</td><td>NGUJUNG</td><td>GIRITONTRO</td><td>INDUK</td><td>drg.DANAR
align='right'>55040109</td><td>23-03-2019</td><td>MORGAN ARDHANA
PUTRA</td><td>SARINGAT 0504 S 20</td><td>BELUM/TIDAK BEKERJA</td><td>KANIGORO
RT02 RW01</td><td></td><td>JATIREJO</td><td>INDUK</td><td>dr. BUDI
2019</td><td>MORGAN ARDHANA PUTRA</td><td>SARINGAT 0504 S 20</td><td>BELUM/TIDAK
BEKERJA</td><td>KANIGORO RT02
RW01</td><td></td><td>JATIREJO</td><td>INDUK</td><td>dr. BUDI ASHARI</td><td>UMI
align='right'>53030055</td><td>23-03-2019</td><td>MUHAMAD BINTANG
PRATAMA</td><td>TRI EDI SETAWAN 0303 T 03</td><td>BELUM/TIDAK BEKERJA</td><td>JAJAR
03/02</td><td></td><td>TLOGOHARJO</td><td>INDUK</td><td>dr. BUDI
align='right'>52110044</td><td>23-03-2019</td><td>MUTIA
ALKAYRA</td><td>SLAMET</td><td>BELUM/TIDAK
BEKERJA</td><td>TAMBAK</td><td></td><td>TLOGOSARI</td><td>INDUK</td><td>dr. BUDI
ASHARI</td><td>UMI NUR ISNIATI</td><td>P</td><td><1 Thn.</td><td>Datang
2019</td><td>MUTIA ALKAYRA</td><td>SLAMET</td><td>BELUM/TIDAK
BEKERJA</td><td>TAMBAK</td><td></td><td>TLOGOSARI</td><td>INDUK</td><td>dr. BUDI
ASHARI</td><td>UMI NUR ISNIATI</td><td>P</td><td><1 Thn.</td><td>Datang
align='right'>56070027</td><td>23-03-2019</td><td>NANANG IGUH
SANTOSO</td><td>NANANG IGUH SANTOSO 0607 N
align='right'>57030435</td><td>23-03-2019</td><td>NAYLA AL MAHIRA
HARTONO</td><td>KALIK/HARTONO 0703 K 07</td><td>BELUM/TIDAK BEKERJA</td><td>KUWANG
align='right'>57030435</td><td>23-03-2019</td><td>NAYLA AL MAHIRA
HARTONO</td><td>KALIK/HARTONO 0703 K 07</td><td>BELUM/TIDAK BEKERJA</td><td>KUWANG
2019</td><td>NAYLA AL MAHIRA HARTONO</td><td>KALIK/HARTONO 0703 K
align='right'>57030299</td><td>23-03-2019</td><td>NGATINEM</td><td>KASMIN 0703 K
></tr><tr><td align='right'>M62.09</td><td>Diastasis of muscle, site
align='right'>56100148</td><td>23-03-2019</td><td>NGATIYEM</td><td>TUMIN 06 10 T
align='right'>56020656</td><td>23-03-2019</td><td>PRAMUTIA
ASHILA</td><td>WARSINO/TRIYANTO</td><td>BELUM/TIDAK BEKERJA</td><td>GIRITONTRO
KIDUL RT 02 RW 03</td><td>GIRITONTRO
KIDUL</td><td>GIRITONTRO</td><td>INDUK</td><td>dr. BUDI ASHARI</td><td>RETNO
align='right'>56020656</td><td>23-03-2019</td><td>PRAMUTIA
ASHILA</td><td>WARSINO/TRIYANTO</td><td>BELUM/TIDAK BEKERJA</td><td>GIRITONTRO
KIDUL RT 02 RW 03</td><td>GIRITONTRO
2019</td><td>PRAMUTIA ASHILA</td><td>WARSINO/TRIYANTO</td><td>BELUM/TIDAK
BEKERJA</td><td>GIRITONTRO KIDUL RT 02 RW 03</td><td>GIRITONTRO
></tr><tr><td align='right'>J11.0</td><td>Influenza with pneumonia, virus not
align='right'>55040108</td><td>23-03-2019</td><td>REVAN
ADIKA</td><td>SULARNO</td><td>BELUM/TIDAK
align='right'>55040108</td><td>23-03-2019</td><td>REVAN
ADIKA</td><td>SULARNO</td><td>BELUM/TIDAK
2019</td><td>REVAN ADIKA</td><td>SULARNO</td><td>BELUM/TIDAK
align='right'>57150071</td><td>23-03-2019</td><td>SAIMO</td><td>SAIMO 0715 S
21</td><td>PETANI/PEKEBUN</td><td>SAWIT KIDUL RT02 RW14</td><td>SAWIT
align='right'>57040258</td><td>23-03-2019</td><td>SALSABILA MIRA
CANTIKA</td><td>SUKIRNO 0704 S 06</td><td>PELAJAR/MAHASISWA</td><td>MANDEYAN
03/01</td><td>MANDEYAN</td><td>PUCANGANOM</td><td>INDUK</td><td>dr. BUDI
align='right'>E56.9</td><td>Vitamin deficiency, unspecified</td><td></td><td
2019</td><td>SARINEM</td><td>SOYO 0712 S 07</td><td>PETANI/PEKEBUN</td><td>INGAK
INGUK RT02 RW16</td><td>INGAK - INGUK</td><td>PUCANGANOM</td><td>INDUK</td><td>dr.
</tr><tr><td align='right'>G40.9</td><td>Epilepsy, unspecified</td><td></td><td
2019</td><td>SATINO SISWO PRIYANTO</td><td>SATINO SISWO PRIYANTO 0511 S
08</td><td>PETANI/PEKEBUN</td><td>BUWENG RT01
></tr><tr><td align='right'>H93.9</td><td>Disorder of ear,
align='right'>56070048</td><td>23-03-2019</td><td>SIGIT</td><td>NANANG 0607 N
01</td><td>PELAJAR/MAHASISWA</td><td>DUNGKANCIL</td><td>DUNG
THT</td><td>RSUD DR. SOEDIRAN MS WONOGIRI</td><td>Dalam
align='right'>53080090</td><td>23-03-2019</td><td>SIGNI
TIAN</td><td>KRISTIANTO</td><td>BELUM/TIDAK BEKERJA</td><td>GINADE
KULON</td><td></td><td>TLOGOHARJO</td><td>INDUK</td><td>dr. BUDI ASHARI</td><td>SRI
2019</td><td>SIGNI TIAN</td><td>KRISTIANTO</td><td>BELUM/TIDAK
BEKERJA</td><td>GINADE KULON</td><td></td><td>TLOGOHARJO</td><td>INDUK</td><td>dr.
align='right'>51010159</td><td>23-03-2019</td><td>SOFIA
AZAHRA</td><td>TRIYANTO</td><td>BELUM/TIDAK
BEKERJA</td><td>PELET</td><td>PELET</td><td>NGARGOHARJO</td><td>INDUK</td><td>dr.
BUDI ASHARI</td><td>RETNO AMBARWATI AMD KEB</td><td>P</td><td><1
2019</td><td>SOFIA AZAHRA</td><td>TRIYANTO</td><td>BELUM/TIDAK
BUDI ASHARI</td><td>RETNO AMBARWATI AMD KEB</td><td>P</td><td><1
align='right'>56050066</td><td>23-03-2019</td><td>SONIA AJENG
PAMUNGKAS</td><td>KARYATI 0605 K
><td>INDUK</td><td>dr. BUDI ASHARI</td><td>SUWARTO,S.Kep.Nes</td><td>P</td><td>15-
2019</td><td>SONIA AJENG PAMUNGKAS</td><td>KARYATI 0605 K
><td>INDUK</td><td>dr. BUDI ASHARI</td><td>SUWARTO,S.Kep.Nes</td><td>P</td><td>15-
></tr><tr><td align='right'>F20.2</td><td>Catatonic schizophrenia</td><td></td><td
2019</td><td>SUGENG HARIADI</td><td>SUGENG HARIADI</td><td>PEGAWAI NEGERI
SIPIL</td><td>GIRIWOYO</td><td></td><td>GIRIWOYO</td><td>INDUK</td><td>dr. BUDI
align='right'>E56.8</td><td>Deficiency of other vitamins</td><td></td><td
2019</td><td>SUGIYO SUDARMO</td><td>SUGIYO SUDARMO 0607 S
2019</td><td>SULASTRI</td><td>KATNO 07 13 K
03</td><td>PETANI/PEKEBUN</td><td>KEPUH RT02 RW
></tr><tr><td align='right'>S20.3</td><td>Other superficial injuries of front wall
of thorax</td><td></td><td align='right'>290180</td><td
09</td><td>KARYAWAN
2019</td><td>SUTARNI</td><td></td><td>PETANI/PEKEBUN</td><td>SALAM</td><td>SALAM</t
></tr><tr><td align='right'>L24.2</td><td>Irritant contact dermatitis due to
solvents</td><td></td><td align='right'>290185</td><td
align='right'>53030054</td><td>23-03-2019</td><td>SYAFIYA
AZIZAH</td><td>MULYANTO</td><td></td><td>JAJAR</td><td></td><td>TLOGOHARJO</td><td>
INDUK</td><td>dr. BUDI ASHARI</td><td>RISTINA Amd Keb</td><td>P</td><td>1-4
align='right'>57120151</td><td>23-03-2019</td><td>TAUFIK LOGMAN
MAULANA</td><td>RA'IL 0712 R 01</td><td>PETANI/PEKEBUN</td><td>INGAK INGUK RT02
RW16</td><td>INGAK - INGUK</td><td>PUCANGANOM</td><td>INDUK</td><td>dr. BUDI
align='right'>52130042</td><td>23-03-
2019</td><td>VANIA</td><td>RIKI</td><td></td><td>KERJO
TLOGOSARI</td><td></td><td>TLOGOSARI</td><td>INDUK</td><td>dr. BUDI
align='right'>52057034</td><td>25-03-
2019</td><td>ALDO</td><td></td><td>PELAJAR/MAHASISWA</td><td>GLAGAH</td><td>GLAGAH<
</td><td>L</td><td>5-9 Thn.</td><td>Datang
align='right'>290296</td><td align='right'>56090027</td><td>25-03-2019</td><td>ALDO
TEGAR PRAKOSO</td><td>HANAFI 0609 H
01</td><td>PELAJAR/MAHASISWA</td><td>DUNGKLEPU KULON</td><td>DUNG KLEPU
KULON</td><td>GIRITONTRO</td><td>INDUK</td><td>drg.DANAR WULANDARI</td><td>RIZKI
tr><tr><td align='right'>K04.7</td><td>Periapical abscess without
sinus</td><td></td><td align='right'>290273</td><td
align='right'>56010489</td><td>25-03-2019</td><td>ALVAN ALVINO VENDYA
PUTRA</td><td>YATNO 06 01 Y 01</td><td>PELAJAR/MAHASISWA</td><td>GIRITONTRO LOR RT
02 RW 02</td><td></td><td>GIRITONTRO</td><td>INDUK</td><td>drg.DANAR
align='right'>57100123</td><td>25-03-2019</td><td>ALVINA </td><td>TRI MURWANTO
0710 T 03</td><td>BELUM/TIDAK BEKERJA</td><td>JEPURUN RT 03 RW
2019</td><td>ALVINAWAUFIQ A' SYIFA</td><td>ALIB MUSTOFA 0212 A
01</td><td></td><td>NGELO RT02
RW05</td><td>NGELO</td><td>TLOGOSARI</td><td>INDUK</td><td>drg.DANAR
tr><tr><td align='right'>I10</td><td>Essential (primary)
align='right'>55115014</td><td>25-03-2019</td><td>ANIK
WIDOWATI</td><td>SAMINO</td><td>PETANI/PEKEBUN</td><td>BUWENG</td><td>BUWENG</td><t
d>JATIREJO</td><td>PKD JATIREJO</td><td>SUHARNI</td><td> - </td><td>P</td><td>45-54
align='right'>53115035</td><td>25-03-2019</td><td>AQILA WAHYU
WULANDARI</td><td>SUMARNO</td><td>BELUM/TIDAK BEKERJA</td><td>GINADE WETAN RT05
RW03</td><td>GINADE ETAN</td><td>TLOGOHARJO</td><td>PKD TLOGOHARJO</td><td>SRI
align='right'>56070012</td><td>25-03-2019</td><td>ARDYNA REVI
WIDIASTUTI</td><td>WALUYO 06 07 W 03</td><td>KARYAWAN SWASTA</td><td>DUNGKANCIL
RT02 RW09</td><td>DUNG KANCIL</td><td>GIRITONTRO</td><td>INDUK</td><td>dr. BUDI
align='right'>56020609</td><td>25-03-2019</td><td>ARSYA</td><td>JUMALI / HERI S
</td><td>BELUM/TIDAK BEKERJA</td><td>GIRITONTRO KIDUL RT 02 RW
03</td><td>GIRITONTRO KIDUL</td><td>GIRITONTRO</td><td>INDUK</td><td>dr. BUDI
align='right'>L24</td><td>Irritant contact dermatitis</td><td></td><td
2019</td><td>AZRIL RAFIQ SYAHPUTRA</td><td>WINARNO 0601 W 22</td><td>BELUM/TIDAK
BEKERJA</td><td>GIRITONTRO LOR</td><td>GIRITONTRO
LOR</td><td>GIRITONTRO</td><td>INDUK</td><td>dr. BUDI ASHARI</td><td>UMI NUR
ISNIATI</td><td>L</td><td><1 Thn.</td><td>Datang Sendiri</td><td>Lama</td><td>UMUM
WONOGIRI</td><td>Rajal</td><td align='right'></td><td align='right'>6</td><td
align='right'>53015121</td><td>25-03-2019</td><td>BILQIS</td><td>RIFI
AFANDI</td><td>BELUM/TIDAK
align='right'>S01.0</td><td>Open wound of scalp</td><td></td><td
2019</td><td>BRIGITA VALENSIA RISQI HUSADA</td><td>MARIO 0709 M
10</td><td>BELUM/TIDAK BEKERJA</td><td>PUCANGANOM LOR</td><td>PUCANGANOM
WULANDARI</td><td>ZAENAL
</tr><tr><td align='right'>M13.9</td><td>Arthritis, unspecified</td><td></td><td
WULANDARI</td><td>ZAENAL
</tr><tr><td align='right'>F20.6</td><td>Simple schizophrenia</td><td></td><td
align='right'>290259</td><td align='right'>53040028</td><td>25-03-2019</td><td>DEDI
PRASETYO</td><td>SRIYANTO 0304 S 02</td><td>LAINNYA</td><td>PUREMBE
RT.02/02</td><td>PUREMBE</td><td>TLOGOHARJO</td><td>INDUK</td><td>dr. BUDI
align='right'>Z00.8</td><td>Other general examinations</td><td></td><td
2019</td><td>DICKI PUTRA OKTAVIANDO</td><td>TRIYONO 0710 T
04</td><td>LAINNYA</td><td>INGAK INGUK RT01 RW16</td><td>INGAK -
2019</td><td>DIMAS BUDI SANTOSO</td><td>SURATMAN 0602 S
20</td><td>PELAJAR/MAHASISWA</td><td>GIRITONTRO KIDUL RT02 RW03</td><td>GIRITONTRO
/td></tr><tr><td align='right'>S51.9</td><td>Open wound of forearm, part
align='right'>290289</td><td align='right'>56040144</td><td>25-03-2019</td><td>EMI
NURYA DEWI</td><td>SONIYEM 0604 S 20</td><td>MENGURUS RUMAH
TANGGA</td><td>KETONGGO
</td><td>KETONGGO</td><td>GIRITONTRO</td><td>INDUK</td><td>drg.DANAR
align='right'>290283</td><td align='right'>51110039</td><td>25-03-2019</td><td>ERMA
AYU FITRIYANI</td><td>NGATMO 0111 N 01</td><td>PELAJAR/MAHASISWA</td><td>BLEBER
RT02 RW06</td><td>BLEBER</td><td>NGARGOHARJO</td><td>INDUK</td><td>drg.DANAR
align='right'>Z00.8</td><td>Other general examinations</td><td></td><td
align='right'>290286</td><td align='right'>52140048</td><td>25-03-2019</td><td>EVA
SURYANI</td><td>TUMI 0214 T 03</td><td>PELAJAR/MAHASISWA</td><td>GUPAKAN RT03
RW02</td><td>GUPAKAN</td><td>TLOGOSARI</td><td>INDUK</td><td>dr. BUDI
align='right'>55050017</td><td>25-03-2019</td><td>GALANG ANUGRAH
PRATAMA</td><td>SUPARDI TUGINO 05 05 S 06</td><td>PELAJAR/MAHASISWA</td><td>PUNUNG
RT 02 RW 02</td><td>PUNUNG</td><td>JATIREJO</td><td>INDUK</td><td>dr. BUDI
tr><tr><td align='right'>S81.8</td><td>Open wound of other parts of lower
align='right'>57050023</td><td>25-03-2019</td><td>HADI UTOMO</td><td>HADI UTOMO
0705 H 03</td><td>PETANI/PEKEBUN</td><td>SUKOROYOM KULON RT01
2019</td><td>HARMINI</td><td>SUPARDI 0505 S 06</td><td>MENGURUS RUMAH
TANGGA</td><td>PUNUNG RT02
thigh</td><td></td><td
2019</td><td>HARTIWI</td><td>MARGONO 0508 M
04</td><td>PETANI/PEKEBUN</td><td>NGORODOWO RT04 RW
03</td><td>NGORODOWO</td><td>JATIREJO</td><td>INDUK</td><td>dr. BUDI
align='right'>57030416</td><td>25-03-2019</td><td>IBRA ADELIO</td><td>MARIJEM /
EKSAN 0703 M 08</td><td>BELUM/TIDAK BEKERJA</td><td>KUWANG RT04
ASHARI</td><td>SUGIYONO,S.Kep.Ns</td><td>P</td><td><1 Thn.</td><td>Datang
align='right'></td><td align='right'>11</td><td align='right'></td><td>BP.
d align='right'>J11.8</td><td>Influenza with other manifestations, virus not
align='right'>52020071</td><td>25-03-2019</td><td>IKA SRIANI</td><td>MULYONO 02 02
M 02</td><td>MENGURUS RUMAH TANGGA</td><td>MANTHANG RT 01 RW
07</td><td>MANTHANG</td><td>TLOGOSARI</td><td>INDUK</td><td>dr. BUDI
align='right'>55070064</td><td>25-03-2019</td><td>INTA ANDRIYANTI</td><td>SUKATNO
0507 S 10</td><td>KARYAWAN SWASTA</td><td>NGELOSARI RT01
</tr><tr><td align='right'>K00.6</td><td>Disturbances in tooth
align='right'>52040015</td><td>25-03-2019</td><td>IRVANDA GALANG
SETYAWAN</td><td>WITO 0204 W 01</td><td>PELAJAR/MAHASISWA</td><td>SOKO RT02
RW06</td><td>SOKO</td><td>TLOGOSARI</td><td>INDUK</td><td>dr. BUDI
tr><tr><td align='right'>S01</td><td>Open wound of head</td><td></td><td
2019</td><td>JUMIYATI</td><td>SUPARDIMAN 0602 S
44</td><td>PEDAGANG</td><td>GIRITONTRO KIDUL
01/03</td><td></td><td>GIRITONTRO</td><td>INDUK</td><td>dr. BUDI
2019</td><td>JURIYANI</td><td>SUKIMIN</td><td>PETANI/PEKEBUN</td><td>BAYEM</td><td>
align='right'>51075019</td><td>25-03-
2019</td><td>KARTIRAN</td><td>KARTIRAN</td><td>PETANI/PEKEBUN</td><td>NGASEM</td><t
d>NGASEM</td><td>NGARGOHARJO</td><td>PKD NGARGOHARJO</td><td>HENI
align='right'>53015128</td><td>25-03-
2019</td><td>KASIMAH</td><td>MINO</td><td>PETANI/PEKEBUN</td><td>TLOGO</td><td>TLOG
></tr><tr><td align='right'>S61.8</td><td>Open wound of other parts of wrist and
</tr><tr><td align='right'>M13.9</td><td>Arthritis, unspecified</td><td></td><td
2019</td><td>KATEMI</td><td></td><td>PETANI/PEKEBUN</td><td>GEDOMPOL</td><td></td><
td>JAWA TIMUR</td><td>PUSTU TLOGOSARI</td><td>SULARNO,S.Kep.Ns</td><td> -
align='right'>52057013</td><td>25-03-
align='right'>53015079</td><td>25-03-
2019</td><td>KATINI</td><td>SUGENG</td><td>PETANI/PEKEBUN</td><td>TLOGO</td><td>TLO
2019</td><td>KATIRAH</td><td>KATIRAH</td><td>PETANI/PEKEBUN</td><td>BAYEM</td><td>B
AYEM</td><td>BAYEMHARJO</td><td>PUSTU BAYEMHARJO</td><td>RISTINA Amd Keb</td><td> -
2019</td><td>KATIYEM</td><td></td><td>PETANI/PEKEBUN</td><td>GLAGAH</td><td>GLAGAH<
PBI</td><td>Rajal</td><td
align='right'>57135008</td><td>25-03-2019</td><td>KEVIN APRILIO</td><td>AGUS
PUJIATMOKO 07 13 A 01</td><td>BELUM/TIDAK BEKERJA</td><td>KEPUH RT01
RW12</td><td>KEPUH</td><td>PUCANGANOM</td><td>INDUK</td><td>drg.DANAR
2019</td><td>LINDA FATMAWATI</td><td>JUMIN 0715 J 01</td><td>LAINNYA</td><td>SAWIT
KIDUL RT02 RW14</td><td>PUCANGANOM
KIDUL</td><td>PUCANGANOM</td><td>INDUK</td><td>dr. BUDI ASHARI</td><td>UMI NUR
ISNIATI</td><td>P</td><td>20-44 Thn.</td><td>Datang
align='right'>56070049</td><td>25-03-2019</td><td>M. LUTFI JIHADUL</td><td>HERU
LUTFI 0607 H 01</td><td>PELAJAR/MAHASISWA</td><td>DUNGKANCIL</td><td>DUNG
align='right'>57080020</td><td>25-03-2019</td><td>MAMIK</td><td>MURWITO 07 08 M
/td></tr><tr><td align='right'>M79.1</td><td>Myalgia</td><td></td><td
2019</td><td>MARGONO</td><td>MARGONO</td><td>PETANI/PEKEBUN</td><td>NGELOSARI</td><
td>NGELOSARI</td><td>JATIREJO</td><td>PKD JATIREJO</td><td>SUHARNI</td><td> -
align='right'>57090127</td><td>25-03-2019</td><td>MEILIMA
SETYADIN</td><td>SUPARYATMO 0709 S 13</td><td>WIRASWASTA</td><td>PUCANGANOM LOR
RT01 RW09</td><td>PUCANGANOM LOR</td><td>PUCANGANOM</td><td>INDUK</td><td>dr. BUDI
align='right'>11110167</td><td>25-03-
2019</td><td>MENUR</td><td></td><td>PELAJAR/MAHASISWA</td><td>PUDAK</td><td></td><t
d>JAWA TIMUR</td><td>PUSTU TLOGOSARI</td><td>SULARNO,S.Kep.Ns</td><td> -
2019</td><td>MENUR</td><td></td><td>PELAJAR/MAHASISWA</td><td>PUDAK</td><td></td><t
align='right'>55015065</td><td>25-03-
2019</td><td>MISIYEM</td><td>MISIYEM</td><td>PETANI/PEKEBUN</td><td>GIRIROTO</td><t
d>GIRIROTO</td><td>JATIREJO</td><td>PKD JATIREJO</td><td>SUHARNI</td><td> -
</td><td>P</td><td>>70 Thn.</td><td>Datang Sendiri</td><td>Lama</td><td>UMUM
05</td><td>PETANI/PEKEBUN</td><td>WATES RT01
RW17</td><td>WATES</td><td>PUCANGANOM</td><td>INDUK</td><td>dr. BUDI
align='right'>53020017</td><td>25-03-2019</td><td>MUH LINTANG</td><td>SUWARSO 03
02 S 05</td><td>BELUM/TIDAK BEKERJA</td><td>SAMBIREJO RT03
RW01</td><td></td><td>TLOGOHARJO</td><td>INDUK</td><td>dr. BUDI ASHARI</td><td>UMI
NUR ISNIATI</td><td>L</td><td>1-4 Thn.</td><td>Datang
td></tr><tr><td align='right'>S01</td><td>Open wound of head</td><td></td><td
align='right'>290279</td><td align='right'>56020347</td><td>25-03-2019</td><td>MUH
COLIL</td><td>SURYANTO 0602 S 06</td><td>BELUM/TIDAK BEKERJA</td><td>GIRITONTRO
KIDUL</td><td>GIRITONTRO KIDUL</td><td>GIRITONTRO</td><td>INDUK</td><td>drg.DANAR
2019</td><td>MUJIYEM </td><td>PAIMIN 0310 P
04</td><td>PETANI/PEKEBUN</td><td>KELOR RT01
RW04</td><td>KELOR</td><td>TLOGOHARJO</td><td>INDUK</td><td>dr. BUDI
align='right'>55010075</td><td>25-03-2019</td><td>NADIFA</td><td>LUKMAN SANTOSO
0501 L 02</td><td>BELUM/TIDAK
BEKERJA</td><td>GIRIBELAH</td><td>GIRIBELAH</td><td>JATIREJO</td><td>INDUK</td><td>
dr. BUDI ASHARI</td><td>UMI NUR ISNIATI</td><td>P</td><td>1-4 Thn.</td><td>Datang
td></tr><tr><td align='right'>Z34.8</td><td>Supervision of other normal
align='right'>57020269</td><td>25-03-
2019</td><td>NARIH</td><td>IKHSANUDIN</td><td>BURUH HARIAN LEPAS</td><td>SUKOROYOM
WETAN</td><td>PUCANGANOM</td><td>INDUK</td><td>dr. BUDI ASHARI</td><td>UMI NUR
/td></tr><tr><td
align='right'>55050002</td><td>25-03-2019</td><td>NAYSILLA RAMADHANI
OKTAVIYANA</td><td>SUJARNO 0505 S
18</td><td>PELAJAR/MAHASISWA</td><td>PUNUNG</td><td>PUNUNG</td><td>JATIREJO</td><td
align='right'>57020343</td><td>25-03-2019</td><td>NIKE ASTUTI</td><td>WIDODO 0702
W 14</td><td>PETANI/PEKEBUN</td><td>SUKOROYOM WETAN RT03 RW04</td><td>SUKOROYOM
/td></tr><tr><td align='right'>R05</td><td>Cough</td><td></td><td
2019</td><td>PAIJAH</td><td></td><td>PETANI/PEKEBUN</td><td>NGORODOWO</td><td>NGORO
DOWO</td><td>JATIREJO</td><td>PKD JATIREJO</td><td>SUHARNI</td><td> -
align='right'>51055024</td><td>25-03-2019</td><td>PALIMIN
MARTOSUYATNO</td><td>PALIMIN
MARTOSUYATNO</td><td>PETANI/PEKEBUN</td><td>GENTUNG</td><td>GENTUNG</td><td>NGARGOH
ARJO</td><td>PKD NGARGOHARJO</td><td>HENI WIDIYASTUTI</td><td> -
align='right'>56020668</td><td>25-03-2019</td><td>PARAMITA WULAN
SEPTYANA</td><td>MAHARJONO 0602 M 18</td><td>KARYAWAN HONORER</td><td>GIRITONTRO
KIDUL RT04 RW03</td><td>GIRITONTRO
2019</td><td>PARTIN</td><td>EDI
SUMARNO</td><td>PETANI/PEKEBUN</td><td>GIRIROTO</td><td>GIRIROTO</td><td>JATIREJO</
td><td>PKD JATIREJO</td><td>SUHARNI</td><td> - </td><td>P</td><td>20-44
align='right'>51057007</td><td>25-03-
TUNG</td><td>NGARGOHARJO</td><td>PKD NGARGOHARJO</td><td>HENI WIDIYASTUTI</td><td>
align='right'>55100030</td><td>25-03-2019</td><td>PUJI
ASTUTI</td><td>SARJONO</td><td>PERANGKAT DESA</td><td>SENGON
RT02/04</td><td>SENGON</td><td>JATIREJO</td><td>PKD
align='right'>57080033</td><td>25-03-2019</td><td>REGINA SAPTOSRI</td><td>JURI
0708 J 04</td><td>BURUH HARIAN LEPAS</td><td>PUCANGANOM KIDUL</td><td>PUCANGANOM
align='right'>57080033</td><td>25-03-2019</td><td>REGINA SAPTOSRI</td><td>JURI
0708 J 04</td><td>BURUH HARIAN LEPAS</td><td>PUCANGANOM KIDUL</td><td>PUCANGANOM
></tr><tr><td align='right'>O30.0</td><td>Twin pregnancy</td><td></td><td
2019</td><td>RETNO KURNIAWATI</td><td>SEPDWIYANTO 05 05 S 20</td><td>MENGURUS
RUMAH TANGGA</td><td>PUNUNG RT01
</tr><tr><td align='right'>L24.9</td><td>Irritant contact dermatitis, unspecified
align='right'>52087191</td><td>25-03-
2019</td><td>RIFQIAANISAH</td><td></td><td>PELAJAR/MAHASISWA</td><td>TLOGOSARI</td>
<td>TLOGOSARI</td><td>TLOGOSARI</td><td>PUSTU
Thn.</td><td>Datang Sendiri</td><td>Baru</td><td>BPJS PBI</td><td>Rajal</td><td
align='right'>11110168</td><td>25-03-
2019</td><td>RIVANO</td><td></td><td>PELAJAR/MAHASISWA</td><td>GEDOMPOL</td><td></t
d><td>JAWA TIMUR</td><td>PUSTU TLOGOSARI</td><td>SULARNO,S.Kep.Ns</td><td> -
2019</td><td>SAMANI</td><td></td><td>PETANI/PEKEBUN</td><td>BOTO</td><td></td><td>J
AWA TIMUR</td><td>PUSTU TLOGOSARI</td><td>SULARNO,S.Kep.Ns</td><td> -
2019</td><td>SAMINEM</td><td>SAYUTI 0709 S
14</td><td>PETANI/PEKEBUN</td><td>PUCANGANOM LOR RT03 RW 09</td><td>PUCANGANOM
align='right'>57010014</td><td>25-03-2019</td><td>SANTIYEM</td><td>BOIMIN
07 01 B 01</td><td>PETANI/PEKEBUN</td><td>GROGOL RT 03 RW
align='right'>54070092</td><td>25-03-2019</td><td>SARDI</td><td>SARDI 0407 S S
align='right'>57170036</td><td>25-03-2019</td><td>SARTIYAH</td><td>MISNO 07 17 M
05</td><td>PETANI/PEKEBUN</td><td>WATES RT01
RW17</td><td>WATES</td><td>PUCANGANOM</td><td>INDUK</td><td>dr. BUDI
align='right'>57110001</td><td>25-03-2019</td><td>SARTUMI</td><td>MUJIONO 07 11 M
04</td><td>PETANI/PEKEBUN</td><td>PLOSO RT 01 RW
11</td><td>PLOSO</td><td>PUCANGANOM</td><td>INDUK</td><td>dr. BUDI
></tr><tr><td align='right'>Z34.9</td><td>Supervision of normal pregnancy,
align='right'>57020360</td><td>25-03-2019</td><td>SITI NURUL
KHOTIMAH</td><td>BASUKI 0702 B01</td><td>MENGURUS RUMAH TANGGA</td><td>SUKOROYOM
align='right'>55110030</td><td>25-03-2019</td><td>SONIYEM</td><td>SUKADI 0511 S
12</td><td>PETANI/PEKEBUN</td><td>BUWENG RT01
d></tr><tr><td align='right'>R51</td><td>Headache</td><td></td><td
SURATMI</td><td>WAKIDI</td><td>PETANI/PEKEBUN</td><td>GIRIROTO</td><td>GIRIROTO</td
><td>JATIREJO</td><td>PKD JATIREJO</td><td>SUHARNI</td><td> -
UPAMI</td><td>SURADI</td><td>PETANI/PEKEBUN</td><td>GEDANGAN</td><td>GEDANGAN</td><
td>NGARGOHARJO</td><td>PKD NGARGOHARJO</td><td>HENI WIDIYASTUTI</td><td> -
align='right'>53020075</td><td>25-03-2019</td><td>SRI WATI</td><td>SARINO 03 02 S
09</td><td>PETANI/PEKEBUN</td><td>SAMBIREJO RT 04 RW
01</td><td>SAMBIREJO</td><td>TLOGOHARJO</td><td>INDUK</td><td>dr. BUDI
Umum</td><td>Poli Bedah</td><td>RSUD DR. SOEDIRAN MS WONOGIRI</td><td>Dalam
/td></tr><tr><td align='right'>K02.1</td><td>Caries of dentine</td><td></td><td
2019</td><td>SRIYATI </td><td>LOSO 0909 L
01</td><td>PETANI/PEKEBUN</td><td>NGUDAL</td><td></td><td>GIRIWOYO</td><td>INDUK</t
d><td>drg.DANAR WULANDARI</td><td>RIZKI ANISSA, AM.Kg</td><td>P</td><td>20-44
UNG</td><td>NGARGOHARJO</td><td>PKD NGARGOHARJO</td><td>HENI WIDIYASTUTI</td><td> -
align='right'>56020062</td><td>25-03-2019</td><td>SUMARNO</td><td>SUMARNO 0602 S
></tr><tr><td align='right'>J01.8</td><td>Other acute sinusitis</td><td></td><td
2019</td><td>SUMIYATUN</td><td>TUKIJO 0308 T
08</td><td>PETANI/PEKEBUN</td><td>GINADE KULON RT02 RW03</td><td>GINADE
2019</td><td>SUMIYEM</td><td>PAINO</td><td>PETANI/PEKEBUN</td><td>SONGGODULANG</td>
<td>SONGGODULANG</td><td>JATIREJO</td><td>PKD JATIREJO</td><td>SUHARNI</td><td> -
align='right'>T14.9</td><td>Injury, unspecified</td><td></td><td
2019</td><td>SUPARSI</td><td>HARI
WIDODO</td><td>PETANI/PEKEBUN</td><td>NGORODOWO</td><td>NGORODOWO</td><td>JATIREJO<
/td><td>PKD JATIREJO</td><td>SUHARNI</td><td> - </td><td>P</td><td>20-44
2019</td><td>SUTARNI</td><td>JAMAL</td><td>PETANI/PEKEBUN</td><td>KANIGORO</td><td>
KANIGORO</td><td>JATIREJO</td><td>PKD JATIREJO</td><td>SUHARNI</td><td> -
</td><td>L</td><td>45-54
align='right'>54025005</td><td>25-03-
align='right'>55070004</td><td>25-03-
2019</td><td>SUYATMI</td><td>PAIJO</td><td>PETANI/PEKEBUN</td><td>NGELOSARI</td><td
>NGELOSARI</td><td>JATIREJO</td><td>PKD JATIREJO</td><td>SUHARNI</td><td> -
align='right'>57030109</td><td>25-03-2019</td><td>SYIFA NUR AINI</td><td>EDI WIDODO
07 03 E 01</td><td>PELAJAR/MAHASISWA</td><td>KUWANG RT 04 RW
06</td><td>KUWANG</td><td>PUCANGANOM</td><td>INDUK</td><td>drg.DANAR
align='right'>54070093</td><td>25-03-2019</td><td>TAMPIYEM </td><td>SARDI 0407 S
align='right'>57160030</td><td>25-03-2019</td><td>TARTI</td><td>NUR AHMAD 0716 N
01</td><td>BURUH HARIAN LEPAS</td><td>SAWIT LOR</td><td>SAWIT
align='right'>54085006</td><td>25-03-2019</td><td>THOMAS DWI
NUGROHO</td><td>SUTRISNO</td><td>PELAJAR/MAHASISWA</td><td>NGANTAP</td><td>NGANTAP<
/td><td>BAYEMHARJO</td><td>PUSTU BAYEMHARJO</td><td>RISTINA Amd Keb</td><td> -
</tr><tr><td align='right'>K29.7</td><td>Gastritis, unspecified</td><td></td><td
2019</td><td>TIJAH</td><td></td><td>PETANI/PEKEBUN</td><td>GEDOMPOL</td><td></td><t
align='right'>54025006</td><td>25-03-
2019</td><td>TINEM</td><td>SONOKARIYO</td><td>PETANI/PEKEBUN</td><td>NGUNDUK</td><t
d>NGUNDUK</td><td>BAYEMHARJO</td><td>PUSTU BAYEMHARJO</td><td>RISTINA Amd
Keb</td><td> - </td><td>P</td><td>>70 Thn.</td><td>Datang
LESTARI</td><td>SARWOTO</td><td>PETANI/PEKEBUN</td><td>NGELOSARI</td><td>NGELOSARI<
/td><td>JATIREJO</td><td>PKD JATIREJO</td><td>SUHARNI</td><td> -
2019</td><td>TUGI</td><td>TUGI</td><td>PETANI/PEKEBUN</td><td>GIRIROTO</td><td>GIRI
ROTO</td><td>JATIREJO</td><td>PKD JATIREJO</td><td>SUHARNI</td><td> -
align='right'>57120009</td><td>25-03-2019</td><td>TUKINI</td><td>SURIPTO 0712 S
20</td><td>PETANI/PEKEBUN</td><td>NGAK- NGUK RT01 RW16</td><td>INGAK -
align='right'>51055035</td><td>25-03-
ENTUNG</td><td>NGARGOHARJO</td><td>PKD NGARGOHARJO</td><td>HENI
WIDIYASTUTI</td><td> - </td><td>L</td><td>>70 Thn.</td><td>Datang
align='right'>290265</td><td align='right'>14141402</td><td>25-03-2019</td><td>UUD
CAHYADI</td><td>SUKATNO/PUJIANTO 0705 S 10</td><td>KARYAWAN
SWASTA</td><td>KARANGANYAR</td><td></td><td>JAWA TENGAH</td><td>INDUK</td><td>dr.
2019</td><td>WAGINARSIH</td><td>SULARNA</td><td>PETANI/PEKEBUN</td><td>KANIGORO
RT02 RW01</td><td>KANIGORO</td><td>JATIREJO</td><td>PKD
align='right'>57030297</td><td>25-03-2019</td><td>WIAM</td><td>DEDI YULIANTO 0703
D 01</td><td>BELUM/TIDAK
BUDI ASHARI</td><td>UMI NUR ISNIATI</td><td>L</td><td>1-4 Thn.</td><td>Datang
align='right'>58081051</td><td>25-03-2019</td><td>WIDIHARSO</td><td>WIDIHARSO 08
08 W 01</td><td>PEGAWAI NEGERI SIPIL</td><td>NUJO RT02
RW12,PRACIMANTORO</td><td></td><td>PRACIMANTORO</td><td>INDUK</td><td>dr. BUDI
></tr><tr><td align='right'>K04.7</td><td>Periapical abscess without
sinus</td><td></td><td align='right'>290244</td><td
align='right'>53015040</td><td>25-03-2019</td><td>WIJI LESTARI</td><td>SUWARTO
0301 S 01</td><td>PETANI/PEKEBUN</td><td>TLOGO RT02
RW01</td><td></td><td>TLOGOHARJO</td><td>INDUK</td><td>drg.DANAR
Sendiri</td><td>Lama</td><td>JAMKESDA</td><td>Rajal</td><td align='right'></td><td
align='right'>57120001</td><td>25-03-2019</td><td>WINDARI</td><td>SARJONO 0712 S
</tr><tr><td align='right'>F20</td><td>Schizophrenia</td><td></td><td
2019</td><td>WIWIN</td><td>MESMIN 07 01 M
align='right'></td><td align='right'></td><td align='right'>37</td><td>BP.
align='right'>57010164</td><td>26-03-2019</td><td>ADLI AHSANUL HAKIM</td><td>ALI
ABAS 07 01 A </td><td>BELUM/TIDAK
BUDI ASHARI</td><td>SRI SUPATMI</td><td>L</td><td>1-4 Thn.</td><td>Datang
2019</td><td>AHMAD ANDRIANSYAH </td><td>SUBANDI 0409 S
01</td><td>PELAJAR/MAHASISWA</td><td>WATES RT02
RW06</td><td>WATES</td><td>BAYEMHARJO</td><td>INDUK</td><td>dr. BUDI
align='right'>52130036</td><td>26-03-2019</td><td>AIRA FAHYADHI</td><td>SURYADI
/GIJEM 0213 G
02</td><td></td><td>KERJO</td><td></td><td>TLOGOSARI</td><td>INDUK</td><td>dr. BUDI
align='right'>57120055</td><td>26-03-2019</td><td>AMELIA</td><td>WARSIMAN 0712 W
04</td><td>PELAJAR/MAHASISWA</td><td>INGAK-INGUK RT 01 RW 16</td><td>INGAK -
2019</td><td>AMELIA INGGRID ARIANI</td><td>MISRI/AGUS 0410 M
02</td><td>BELUM/TIDAK BEKERJA</td><td>GUNUNG BROMO</td><td>GUNUNG
BROMO</td><td>BAYEMHARJO</td><td>INDUK</td><td>dr. BUDI ASHARI</td><td>SRI
align='right'>56010338</td><td>26-03-2019</td><td>ANDIKA PUTRA
PRATAMA</td><td>MARSO 0601 S 06 </td><td>KARYAWAN SWASTA</td><td>GIRITONTRO
align='right'>57010247</td><td>26-03-2019</td><td>ANITASYA PUTRI
NAJWA</td><td>SATINO 07 01 S 15</td><td>BELUM/TIDAK BEKERJA</td><td>GROGOLRT 02 RW
align='right'>56040081</td><td>26-03-2019</td><td>ANNASYA DWI
FAJRIANTI</td><td>TOSIM 06 04 T 03</td><td>BELUM/TIDAK BEKERJA</td><td>KETONGGO RT
02 RW 07</td><td>KETONGGO</td><td>GIRITONTRO</td><td>INDUK</td><td>dr. BUDI
align='right'>51010162</td><td>26-03-2019</td><td>ARDIAN DHANI
PRATAMA</td><td>SUNARDI</td><td>BELUM/TIDAK
align='right'>Z27.3</td><td>Need
for immunization against diphtheria-tetanus-pertussis with poliomyelitis [DTP +
polio]</td><td></td><td align='right'>290345</td><td
align='right'>51010162</td><td>26-03-2019</td><td>ARDIAN DHANI
PRATAMA</td><td>SUNARDI</td><td>BELUM/TIDAK
align='right'>57010279</td><td>26-03-2019</td><td>ASSIFA PUTU AURA
ZASKIA</td><td>ANJAR ARDIYANTO</td><td>BELUM/TIDAK
BUDI ASHARI</td><td>UMI NUR ISNIATI</td><td>P</td><td><1 Thn.</td><td>Datang
2019</td><td>ASSIFA PUTU AURA ZASKIA</td><td>ANJAR ARDIYANTO</td><td>BELUM/TIDAK
align='right'>55090085</td><td>26-03-2019</td><td>ATAYA FILZA
EILIA</td><td>RAHMAD</td><td>BELUM/TIDAK
BEKERJA</td><td>MULWOSARI</td><td>MULWOSARI</td><td>JATIREJO</td><td>INDUK</td><td>
dr. BUDI ASHARI</td><td>HENI WIDIYASTUTI</td><td>P</td><td><1 Thn.</td><td>Datang
2019</td><td>ATAYA FILZA EILIA</td><td>RAHMAD</td><td>BELUM/TIDAK
BEKERJA</td><td>MULWOSARI</td><td>MULWOSARI</td><td>JATIREJO</td><td>INDUK</td><td>
dr. BUDI ASHARI</td><td>HENI WIDIYASTUTI</td><td>P</td><td><1 Thn.</td><td>Datang
align='right'>57130183</td><td>26-03-2019</td><td>AZAM
KHOLID</td><td>WIDODO/RETNONINGSIH</td><td>MENGURUS RUMAH
TANGGA</td><td>KEPUH</td><td>KEPUH</td><td>PUCANGANOM</td><td>INDUK</td><td>dr.
2019</td><td>BENING ARUM KHOIRUNISA</td><td>TRIYANTO 0311 T
03</td><td>BELUM/TIDAK BEKERJA</td><td>GINADE WETAN RT03
RW03</td><td></td><td>TLOGOHARJO</td><td>INDUK</td><td>drg.DANAR
align='right'>H67.1</td><td>Otitis media in viral diseases classified
align='right'>56070153</td><td>26-03-2019</td><td>BETA ANJASMARA </td><td>MITRO
SARONO 0607 M 05</td><td>KARYAWAN SWASTA</td><td>DUNGKANCIL RT01 RW09</td><td>DUNG
KANCIL</td><td>GIRITONTRO</td><td>INDUK</td><td>dr. BUDI ASHARI</td><td>SRI
align='right'>52140047</td><td>26-03-2019</td><td>BINAR LANGIT
QALESYA</td><td>GUNANTO</td><td>BELUM/TIDAK BEKERJA</td><td>GUPAKAN
</td><td>GUPAKAN</td><td>TLOGOSARI</td><td>INDUK</td><td>dr. BUDI
ASHARI</td><td>UMI NUR ISNIATI</td><td>P</td><td>8-30 hari</td><td>Datang
align='right'>56060142</td><td>26-03-2019</td><td>CARRISA ULFA
NADHIFA</td><td>WIYONO</td><td>BELUM/TIDAK
2019</td><td>CARRISA ULFA NADHIFA</td><td>WIYONO</td><td>BELUM/TIDAK
align='right'>290313</td><td align='right'>53050018</td><td>26-03-2019</td><td>DINA
SARTINI RIA PUTRININGSIH</td><td>SLAMET RIYADI 03 05 S 06</td><td>KARYAWAN
align='right'>54060097</td><td>26-03-2019</td><td>ELFANA ARDANA
PUTRA</td><td>TUMINO/FERI NIRA U</td><td>BELUM/TIDAK
BEKERJA</td><td>BAYEM</td><td></td><td>BAYEMHARJO</td><td>INDUK</td><td>dr. BUDI
align='right'>53040061</td><td>26-03-2019</td><td>FAIQ GANDUNG
PAMUNGKAS</td><td>TOREJO</td><td>BELUM/TIDAK
BEKERJA</td><td>PUREMBE</td><td>PUREMBE</td><td>TLOGOHARJO</td><td>INDUK</td><td>dr
. BUDI ASHARI</td><td>RETNO AMBARWATI AMD KEB</td><td>L</td><td>1-4
Thn.</td><td>Datang Sendiri</td><td>Baru</td><td>Imunisasi</td><td>Rajal</td><td
align='right'>53040061</td><td>26-03-2019</td><td>FAIQ GANDUNG
PAMUNGKAS</td><td>TOREJO</td><td>BELUM/TIDAK
BEKERJA</td><td>PUREMBE</td><td>PUREMBE</td><td>TLOGOHARJO</td><td>INDUK</td><td>dr
. BUDI ASHARI</td><td>RETNO AMBARWATI AMD KEB</td><td>L</td><td>1-4
Thn.</td><td>Datang Sendiri</td><td>Baru</td><td>Imunisasi</td><td>Rajal</td><td
align='right'>K29.9</td><td>Gastroduodenitis, unspecified</td><td></td><td
2019</td><td>FAULANA ARIFIN</td><td>WAKIJA
07 16 W 03</td><td></td><td>SAWIT LOR RT01 RW 13</td><td>SAWIT
align='right'>54065158</td><td>26-03-2019</td><td>FERA
FITRISARI</td><td>SARYANTO</td><td>PELAJAR/MAHASISWA</td><td>BAYEM</td><td>BAYEM</t
d><td>BAYEMHARJO</td><td>PUSTU BAYEMHARJO</td><td>RISTINA Amd Keb</td><td> -
align='right'>54035004</td><td>26-03-
2019</td><td>GINAH</td><td>WARTO</td><td>PETANI/PEKEBUN</td><td>KLAPEYAN</td><td>KL
AMPEYAN</td><td>BAYEMHARJO</td><td>PUSTU BAYEMHARJO</td><td>RISTINA Amd
2019</td><td>GINAH</td><td>WARTO</td><td>PETANI/PEKEBUN</td><td>KLAPEYAN</td><td>KL
AMPEYAN</td><td>BAYEMHARJO</td><td>PUSTU BAYEMHARJO</td><td>RISTINA Amd
align='right'>56020637</td><td>26-03-2019</td><td>JOSHEVIRA SHAKIYA</td><td>JONY
FERIYANTO</td><td>BELUM/TIDAK BEKERJA</td><td>GIRITONTRO
KIDUL</td><td></td><td>GIRITONTRO</td><td>INDUK</td><td>dr. BUDI ASHARI</td><td>UMI
NUR ISNIATI</td><td>P</td><td><1 Thn.</td><td>Datang
2019</td><td>KARIYEM</td><td>DARNO</td><td>PETANI/PEKEBUN</td><td>BAYEM</td><td>BAY
2019</td><td>KARIYEM</td><td>DARNO</td><td>PETANI/PEKEBUN</td><td>BAYEM</td><td>BAY
2019</td><td>KATNI</td><td>PARMIN 05 02 P
02</td><td>PETANI/PEKEBUN</td><td>GIRIROTO RT 01 RW
align='right'>54065022</td><td>26-03-
</td></tr><tr><td align='right'>J11.8</td><td>Influenza with other manifestations,
align='right'>54065105</td><td>26-03-
</td></tr><tr><td align='right'>K04.0</td><td>Pulpitis</td><td></td><td
align='right'>290336</td><td align='right'>57030406</td><td>26-03-2019</td><td>LIVE
VIA SEKARWATI</td><td>SITI 0703 S 11</td><td>PELAJAR/MAHASISWA</td><td>KUWANG RT02
align='right'>55090084</td><td>26-03-2019</td><td>LUBNA NUR ATALA M</td><td>DENI P
</td><td>MENGURUS RUMAH
TANGGA</td><td>GIRIROTO</td><td>GIRIROTO</td><td>JATIREJO</td><td>INDUK</td><td>dr.
BUDI ASHARI</td><td>HENI WIDIYASTUTI</td><td>P</td><td><1 Thn.</td><td>Datang
2019</td><td>LUBNA NUR ATALA M</td><td>DENI P </td><td>MENGURUS RUMAH
TANGGA</td><td>GIRIROTO</td><td>GIRIROTO</td><td>JATIREJO</td><td>INDUK</td><td>dr.
BUDI ASHARI</td><td>HENI WIDIYASTUTI</td><td>P</td><td><1 Thn.</td><td>Datang
align='right'>56100413</td><td>26-03-2019</td><td>MARCEL ATHARIQ PUTRA
DENADA</td><td>RINDO FERNANDO</td><td>BELUM/TIDAK
BEKERJA</td><td>TANGGUNG</td><td>TANGGUNG</td><td>GIRITONTRO</td><td>INDUK</td><td>
dr. BUDI ASHARI</td><td>UMI NUR ISNIATI</td><td>L</td><td><1 Thn.</td><td>Datang
2019</td><td>MARCEL ATHARIQ PUTRA DENADA</td><td>RINDO FERNANDO</td><td>BELUM/TIDAK
BEKERJA</td><td>TANGGUNG</td><td>TANGGUNG</td><td>GIRITONTRO</td><td>INDUK</td><td>
dr. BUDI ASHARI</td><td>UMI NUR ISNIATI</td><td>L</td><td><1 Thn.</td><td>Datang
align='right'>53090008</td><td>26-03-2019</td><td>MARDIHANTO</td><td>TAMINO 03 09 T
RW04</td><td>KRANGGAN</td><td>TLOGOHARJO</td><td>INDUK</td><td>dr. BUDI
ASHARI</td><td>SRI SUPATMI</td><td>L</td><td>20-44 Thn.</td><td>Datang
2019</td><td>MARSINI</td><td>DUKUT 06 05 D
01</td><td>PETANI/PEKEBUN</td><td>NGUJUNG RT 03 RW
align='right'>56040130</td><td>26-03-2019</td><td>MASHEL ASKA BIMA</td><td>DARMIN
0604 D 02</td><td>BELUM/TIDAK BEKERJA</td><td>KETONGGO RT01
2019</td><td>MINARTI</td><td>SUTIYOKO 0311 S
02</td><td>PETANI/PEKEBUN</td><td>GINADE ETANRT05 RW03</td><td>GINADE
ETAN</td><td>TLOGOHARJO</td><td>INDUK</td><td>dr. BUDI ASHARI</td><td>SRI
align='right'>54065007</td><td>26-03-
2019</td><td>MINEM</td><td>PAIJAN</td><td>PETANI/PEKEBUN</td><td>BAYEM</td><td>BAYE
align='right'>55030023</td><td>26-03-2019</td><td>MOH.ALFATIH</td><td>EKO / HERI
SAMSUDIN 0503 H
03</td><td></td><td>SONGGODULANG</td><td>SONGGODULANG</td><td>JATIREJO</td><td>INDU
K</td><td>dr. BUDI ASHARI</td><td>HENI WIDIYASTUTI</td><td>L</td><td>1-4
align='right'>56050048</td><td>26-03-2019</td><td>MUGIYATI</td><td>SULISTYO 06 05
S 39</td><td>MENGURUS RUMAH TANGGA</td><td>NGUJUNG RT 03 RW
</tr><tr><td align='right'>Z23.2</td><td>Need for immunization against tuberculosis
align='right'>57040310</td><td>26-03-2019</td><td>MUHAMMAD EL RAFATHAR
</td><td>HERI MARSANTO</td><td>BELUM/TIDAK
dr. BUDI ASHARI</td><td>RETNO AMBARWATI AMD KEB</td><td>L</td><td>8-30
hari</td><td>Datang Sendiri</td><td>Baru</td><td>Imunisasi</td><td>Rajal</td><td
align='right'>57040310</td><td>26-03-2019</td><td>MUHAMMAD EL RAFATHAR
</td><td>HERI MARSANTO</td><td>BELUM/TIDAK
dr. BUDI ASHARI</td><td>RETNO AMBARWATI AMD KEB</td><td>L</td><td>8-30
hari</td><td>Datang Sendiri</td><td>Baru</td><td>Imunisasi</td><td>Rajal</td><td
2019</td><td>MURTI
ASIH</td><td>MULYONO</td><td>PETANI/PEKEBUN</td><td>BAYEM</td><td>BAYEM</td><td>BAY
EMHARJO</td><td>PUSTU BAYEMHARJO</td><td>RISTINA Amd Keb</td><td> -
align='right'>56050051</td><td>26-03-2019</td><td>NAFAS IHTIYA BEKTI</td><td>ERI
KUSUMO BEKTI 0605 E
d>dr. BUDI ASHARI</td><td>SUGIYONO,S.Kep.Ns</td><td>P</td><td>5-9
align='right'>57060105</td><td>26-03-2019</td><td>NAVINSHA AZARINE
NUGRAHA</td><td>NUGROHO 0703 N
01</td><td></td><td>TAMBAHSARI</td><td></td><td>PUCANGANOM</td><td>INDUK</td><td>dr
. BUDI ASHARI</td><td>UMI NUR ISNIATI</td><td>P</td><td>1-4 Thn.</td><td>Datang
align='right'>57010169</td><td>26-03-2019</td><td>NURANI</td><td>DRAJAT 0701 D
align='right'>53060052</td><td>26-03-2019</td><td>PAIJEM</td><td>SUMIN 0306 S
16</td><td>PETANI/PEKEBUN</td><td>KLEPU RT01
RW05,TLOGOHARJO</td><td>KLEPU</td><td>TLOGOHARJO</td><td>INDUK</td><td>dr. BUDI
d></tr><tr><td align='right'>L02.9</td><td>Cutaneous abscess, furuncle and
carbuncle, unspecified</td><td></td><td align='right'>290318</td><td
align='right'>57030226</td><td>26-03-2019</td><td>PARWATI </td><td>KASMIN 0703 K
10</td><td>PETANI/PEKEBUN</td><td>KUWANG</td><td>KUWANG</td><td>PUCANGANOM</td><td>
INDUK</td><td>dr. BUDI ASHARI</td><td>SUGIYONO,S.Kep.Ns</td><td>P</td><td>20-44
></tr><tr><td align='right'>J11.8</td><td>Influenza
with other manifestations, virus not identified</td><td></td><td
2019</td><td>PONIYEM</td><td>PONIYEM 0710 P
01</td><td>PELAJAR/MAHASISWA</td><td>JEPURUN</td><td>JEPURUN</td><td>PUCANGANOM</td
><td>INDUK</td><td>dr. BUDI ASHARI</td><td>SUGIYONO,S.Kep.Ns</td><td>P</td><td>>70
d align='right'>I11.9</td><td>Hypertensive heart disease without (congestive) heart
align='right'>57100011</td><td>26-03-2019</td><td>PONIYEM</td><td>PONIYEM 0710 P
01</td><td>PELAJAR/MAHASISWA</td><td>JEPURUN</td><td>JEPURUN</td><td>PUCANGANOM</td
><td>INDUK</td><td>dr. BUDI ASHARI</td><td>SUGIYONO,S.Kep.Ns</td><td>P</td><td>>70
d align='right'>J11.8</td><td>Influenza with other manifestations, virus not
align='right'>56080100</td><td>26-03-2019</td><td>QONITA NADIA LUTHFI NOVITRI
SALEH</td><td>M.SALEH SUSALEH 0608 M
01</td><td>PELAJAR/MAHASISWA</td><td>DUNGKLEPU WETAN</td><td>DUNG KLEPU
></tr><tr><td align='right'>C50.8</td><td>Malignant neoplasm overlapping breast
align='right'>56100009</td><td>26-03-2019</td><td>RAHAYU NURYANTI</td><td>SRIYATNO
0610 S 08</td><td>MENGURUS RUMAH TANGGA</td><td>TANGGUNG RT04
/tr><tr><td align='right'>A09</td><td>Diarrhoea and gastroenteritis of presumed
align='right'>56065021</td><td>26-03-2019</td><td>RANDY FIDAYANTO</td><td>SUTIYO
0606 04</td><td>PERANGKAT DESA</td><td>GOBOH RT03
align='right'>51010161</td><td>26-03-2019</td><td>REVIONA PUTRI
ZESYA</td><td>SISWANTO</td><td>BELUM/TIDAK
BUDI ASHARI</td><td>RISTINA Amd Keb</td><td>P</td><td><1 Thn.</td><td>Datang
2019</td><td>REVIONA PUTRI ZESYA</td><td>SISWANTO</td><td>BELUM/TIDAK
BUDI ASHARI</td><td>RISTINA Amd Keb</td><td>P</td><td><1 Thn.</td><td>Datang
align='right'>56100344</td><td>26-03-2019</td><td>REYFAN ALBY
PRADIPTA</td><td>SUNYONO 0610 S 01</td><td>BELUM/TIDAK BEKERJA</td><td>TANGGUNG,
GIRITONTRO</td><td></td><td>GIRITONTRO</td><td>INDUK</td><td>dr. BUDI
ASHARI</td><td>HENI WIDIYASTUTI</td><td>L</td><td>1-4 Thn.</td><td>Datang
align='right'>L21.8</td><td>Other seborrhoeic dermatitis</td><td></td><td
align='right'>290305</td><td align='right'>10101403</td><td>26-03-2019</td><td>RIKA
WULANDARI</td><td>PAIMO 1010 P 05</td><td>KARYAWAN SWASTA</td><td>BOGOR RT02
RW02,PARANGGUPITO</td><td></td><td>PARANGGUPITO</td><td>INDUK</td><td>dr. BUDI
2019</td><td>RIZKI ADITYA PRATAMA</td><td>ANTON 0505 A
05</td><td>PELAJAR/MAHASISWA</td><td>PUNUNG RT01
RW02</td><td>PUNUNG</td><td>JATIREJO</td><td>INDUK</td><td>drg.DANAR
align='right'>54065130</td><td>26-03-2019</td><td>RIZKY DWI
YULIANTO</td><td>SUPARMAN</td><td>BELUM/TIDAK
BAYEMHARJO</td><td>RISTINA Amd Keb</td><td> - </td><td>L</td><td>1-4
</tr><tr><td align='right'>Z24.0</td><td>Need for immunization against
align='right'>52050037</td><td>26-03-2019</td><td>SABIAN AZMI
ARDIANO</td><td>SULARDI</td><td>BELUM/TIDAK
BEKERJA</td><td>GLAGAH</td><td></td><td>TLOGOSARI</td><td>INDUK</td><td>dr. BUDI
align='right'>52050037</td><td>26-03-2019</td><td>SABIAN AZMI
ARDIANO</td><td>SULARDI</td><td>BELUM/TIDAK
2019</td><td>SABIAN AZMI ARDIANO</td><td>SULARDI</td><td>BELUM/TIDAK
align='right'>56020393</td><td>26-03-2019</td><td>SAFANA</td><td>WAHYUDI 0602 W
13</td><td>BELUM/TIDAK BEKERJA</td><td>GIRITONTRO KIDUL</td><td>GIRITONTRO
KIDUL</td><td>GIRITONTRO</td><td>INDUK</td><td>dr. BUDI ASHARI</td><td>SRI
align='right'>J11.8</td><td>Influenza with
other manifestations, virus not identified</td><td></td><td
2019</td><td>SATIYEM</td><td>MISMAN</td><td>PETANI/PEKEBUN</td><td>BAYEM</td><td>BA
YEM</td><td>BAYEMHARJO</td><td>PUSTU BAYEMHARJO</td><td>RISTINA Amd Keb</td><td> -
tr><tr><td align='right'>R79.9</td><td>Abnormal finding of blood chemistry,
align='right'>55050088</td><td>26-03-2019</td><td>SEP DWIANTO</td><td>SEP DWIANTO
05 05 S 20</td><td>PEDAGANG</td><td>PUNUNG
01/02</td><td>PUNUNG</td><td>JATIREJO</td><td>INDUK</td><td>dr. BUDI
align='right'>57090143</td><td>26-03-2019</td><td>SINDI ROHMATUN</td><td>ASTRIYONO
0709 A 05</td><td>PERANGKAT DESA</td><td>PUCANGANOM LOR</td><td>PUCANGANOM
LOR</td><td>PUCANGANOM</td><td>INDUK</td><td>drg.DANAR WULANDARI</td><td>RIZKI
align='right'>290347</td><td align='right'>56010030</td><td>26-03-2019</td><td>SITI
HARTANTI BADRIYAH</td><td>FUAD HELMI EFFENDI 06 01 F 01</td><td>MENGURUS RUMAH
TANGGA</td><td>GIRITONTRO LOR RT 02 RW01</td><td>GIRITONTRO
align='right'>57080151</td><td>26-03-2019</td><td>SITI MARYAM</td><td>SUPARNO 0708
S 01</td><td>PETANI/PEKEBUN</td><td>PUCANGANOM KIDUL RT03 RW08</td><td>PUCANGANOM
align='right'>57050165</td><td>26-03-2019</td><td>SLAFIRA</td><td>KHOIRI 07 05 K
01</td><td>PERANGKAT DESA</td><td>SUKOROYOM KULON RT 03 RW 03</td><td>SUKOROYOM
2019</td><td>SOGINI</td><td>WAKINO</td><td>PETANI/PEKEBUN</td><td>BAYEM</td><td>BAY
</td></tr><tr><td align='right'>A09</td><td>Diarrhoea and gastroenteritis of
presumed infectious origin</td><td></td><td align='right'>290352</td><td
align='right'>56100262</td><td>26-03-2019</td><td>SRI LESTARI</td><td>SUWONDO 0610
S 11</td><td>MENGURUS RUMAH TANGGA</td><td>TANGGUNG RT03
2019</td><td>SUKINI</td><td>KATMIN 03 07 K 02</td><td>PETANI/PEKEBUN</td><td>PAGER
GUNUNG RT04 RW05</td><td>PAGER GUNUNG</td><td>TLOGOHARJO</td><td>INDUK</td><td>dr.
align='right'>56080046</td><td>26-03-2019</td><td>SUPIYATI</td><td>DEDI 0608 D
02</td><td>MENGURUS RUMAH TANGGA</td><td>DUNGKLEPU WETAN</td><td>DUNG KLEPU
2019</td><td>SURATMI</td><td>IWAN 0303 I 01</td><td>MENGURUS RUMAH
TANGGA</td><td>JAJAR RT04
align='right'>N18.9</td><td>Chronic renal failure, unspecified</td><td></td><td
2019</td><td>SUTINEM</td><td>MISRAN 0702 M
</tr><tr><td align='right'>M79.10</td><td>Myalgia, multiple sites</td><td></td><td
2019</td><td>TANEM</td><td>TUKIYO 0701 T06</td><td>PETANI/PEKEBUN</td><td>GROGOL
RT02 RW02</td><td>GROGOL</td><td>PUCANGANOM</td><td>INDUK</td><td>dr. BUDI
align='right'>53060056</td><td>26-03-2019</td><td>TICKANIA MEGGA</td><td>BIBIT
MURYANTO</td><td>BELUM/TIDAK BEKERJA</td><td>KLEPU
TLOGOHARJO,</td><td>KLEPU</td><td>TLOGOHARJO</td><td>INDUK</td><td>dr. BUDI
ASHARI</td><td>RETNO AMBARWATI AMD KEB</td><td>P</td><td>8-30 hari</td><td>Datang
poliomyelitis</td><td></td><td
2019</td><td>TICKANIA MEGGA</td><td>BIBIT MURYANTO</td><td>BELUM/TIDAK
BEKERJA</td><td>KLEPU
TLOGOHARJO,</td><td>KLEPU</td><td>TLOGOHARJO</td><td>INDUK</td><td>dr. BUDI
ASHARI</td><td>RETNO AMBARWATI AMD KEB</td><td>P</td><td>8-30 hari</td><td>Datang
align='right'>57150040</td><td>26-03-2019</td><td>TRI WINARNI</td><td>ROHMAD 0715 R
01</td><td>MENGURUS RUMAH TANGGA</td><td>SAWIT KIDUL RT02 RW14</td><td>SAWIT
align='right'>56030069</td><td>26-03-2019</td><td>TRISKA NUR OKTAVIA</td><td>EKO
HARYANTO 0603 E 01</td><td>PELAJAR/MAHASISWA</td><td>GEBLUK RT04
align='right'>57010048</td><td>26-03-2019</td><td>TUKINEM </td><td>TUKINEM 0701
T 05</td><td>PETANI/PEKEBUN</td><td>GROGOL RT01
d></tr><tr><td align='right'>M13.9</td><td>Arthritis, unspecified</td><td></td><td
2019</td><td>TUMI</td><td></td><td>PETANI/PEKEBUN</td><td>NGELO</td><td>NGELO</td><
td>TLOGOSARI</td><td>PUSTU TLOGOSARI</td><td>SULARNO,S.Kep.Ns</td><td> -
</td><td>P</td><td>>70 Thn.</td><td>Datang Sendiri</td><td>Lama</td><td>UMUM
align='right'>55110045</td><td>26-03-2019</td><td>TUMINEM</td><td>TUMINEM 05 11 T
></tr><tr><td align='right'>W58</td><td>Bitten or struck by crocodile or
alligator</td><td></td><td align='right'>290368</td><td
align='right'>51050063</td><td>26-03-2019</td><td>TUMIYEM</td><td>SARMO 01 05 S
03</td><td></td><td>NGARGOHARJO</td><td>INDUK</td><td>dr. BUDI ASHARI</td><td>SRI
SUPATMI</td><td>P</td><td>>70 Thn.</td><td>Datang Sendiri</td><td>Baru</td><td>UMUM
align='right'>56020601</td><td>26-03-2019</td><td>UMAR NAYIRI</td><td>UMAR NAYIRI
0602 U 01</td><td>PEGAWAI NEGERI SIPIL</td><td>GIRITONTRO KIDUL RT04
RW03</td><td>GIRITONTRO KIDUL</td><td>GIRITONTRO</td><td>INDUK</td><td>dr. BUDI
with peripheral circulatory complications</td><td></td><td
align='right'>290363</td><td align='right'>56020601</td><td>26-03-2019</td><td>UMAR
NAYIRI</td><td>UMAR NAYIRI 0602 U 01</td><td>PEGAWAI NEGERI
SIPIL</td><td>GIRITONTRO KIDUL RT04 RW03</td><td>GIRITONTRO
align='right'>55010337</td><td>26-03-2019</td><td>VIONA OZZIE JULIAN</td><td>YUNUS
YULIANTO</td><td>BELUM/TIDAK
BEKERJA</td><td>GIRIBELAH</td><td>GIRIBELAH</td><td>JATIREJO</td><td>INDUK</td><td>
dr. BUDI ASHARI</td><td>SRI SUPATMI</td><td>P</td><td><1 Thn.</td><td>Datang
2019</td><td>WAGINO</td><td>WAGINO 0309 W
RW04</td><td>KRANGGAN</td><td>TLOGOHARJO</td><td>PUSTU BAYEMHARJO</td><td>RISTINA
Amd Keb</td><td> - </td><td>L</td><td>>70 Thn.</td><td>Datang
/td></tr><tr><td align='right'>J44.9</td><td>Chronic obstructive pulmonary disease,
align='right'>56070090</td><td>26-03-2019</td><td>WALUYO</td><td>WALUYO 0607 W
02</td><td>WIRASWASTA</td><td>DUNG KANCIL</td><td>DUNG
align='right'>53015102</td><td>26-03-2019</td><td>WINDAYANI</td><td>AHMADI 0301 A
06</td><td>MENGURUS RUMAH TANGGA</td><td>TLOGO
01/01</td><td>TLOGO</td><td>TLOGOHARJO</td><td>INDUK</td><td>dr. BUDI
align='right'>57080069</td><td>26-03-2019</td><td>YUSUP ABDUL AZIZ</td><td>ASWADI
0708 A 03</td><td>PELAJAR/MAHASISWA</td><td>PUCANGANOM KIDUL
RT03/08</td><td>PUCANGANOM KIDUL</td><td>PUCANGANOM</td><td>INDUK</td><td>dr. BUDI
align='right'>57090131</td><td>26-03-2019</td><td>ZULFA UZI
AQUARIZTA</td><td>KASINO 0709 K 03</td><td>LAINNYA</td><td>PUCANGANOM LOR
03/09</td><td>PUCANGANOM LOR</td><td>PUCANGANOM</td><td>INDUK</td><td>dr. BUDI
2019</td><td>ABDUR ROZAK PUTERA ROHMANI</td><td>RIPTO BUDOYO 06 01 R
04</td><td>BELUM/TIDAK BEKERJA</td><td>GIRITONTRO LOR RT03 RW02</td><td>GIRITONTRO
align='right'>53085047</td><td>27-03-2019</td><td>AFIF
KHOIRUL</td><td>SULARTO</td><td>BELUM/TIDAK BEKERJA</td><td>GINADE
SUPATMI</td><td> - </td><td>L</td><td>5-9 Thn.</td><td>Datang
align='right'>57160011</td><td>27-03-2019</td><td>AIZSHA SUCI
MAHARANI</td><td>WAKIJAN 0716 W 03</td><td>BELUM/TIDAK BEKERJA</td><td>SAWIT
LOR</td><td>SAWIT LOR</td><td>PUCANGANOM</td><td>INDUK</td><td>dr. BUDI
></tr><tr><td align='right'>S29.9</td><td>Unspecified injury of
thorax</td><td></td><td align='right'>290540</td><td
align='right'>57010280</td><td>27-03-2019</td><td>ALI ABAS</td><td>ALI ABAS 07
01 A 01</td><td>KARYAWAN SWASTA</td><td>GROGOL RT01
align='right'>290538</td><td align='right'>54010088</td><td>27-03-2019</td><td>ARIA
MAJIT</td><td>PAIMAN 04 01 P 01</td><td>BELUM/TIDAK BEKERJA</td><td>BELEH RT 01 RW
04</td><td>BELEH</td><td>BAYEMHARJO</td><td>INDUK</td><td>dr. BUDI
2019</td><td>BASYIROH</td><td>SUWARNO 06 04 S 07</td><td>MENGURUS RUMAH
TANGGA</td><td>KETONGGO RT02
align='right'>52027040</td><td>27-03-
2019</td><td>BUNGA</td><td></td><td>BELUM/TIDAK
BEKERJA</td><td>MANTANG</td><td>MANTHANG</td><td>TLOGOSARI</td><td>PUSTU
align='right'>55040114</td><td>27-03-2019</td><td>CHOLIFAH AFRILA</td><td>SUPRIYONO
05 04 S 23</td><td>BELUM/TIDAK BEKERJA</td><td>KANIGORO RT 02 RW
01</td><td>KANIGORO</td><td>JATIREJO</td><td>INDUK</td><td>dr. BUDI
align='right'>D36.9</td><td>Benign neoplasm of unspecified site</td><td></td><td
2019</td><td>DJUKI</td><td>JUKI 0604 J 04</td><td>PENSIUNAN</td><td>KETONGGO RT02
align='right'>290682</td><td align='right'>52037010</td><td>27-03-2019</td><td>DWI
ROHANI</td><td>SULARSO</td><td>PETANI/PEKEBUN</td><td>SALAM</td><td>SALAM</td><td>T
LOGOSARI</td><td>PUSTU TLOGOSARI</td><td>SULARNO,S.Kep.Ns</td><td> -
align='right'>55030007</td><td>27-03-2019</td><td>DWI WINARTI</td><td>SULARNO 05 03
S
07</td><td>PELAJAR/MAHASISWA</td><td>SONGGODULANG</td><td></td><td>JATIREJO</td><td
></tr><tr><td align='right'>D36.7</td><td>Benign neoplasm of other specified
align='right'>57030124</td><td>27-03-2019</td><td>ERNI SULISTYANINGSIH</td><td>BUDI
07 03 B 07</td><td>BURUH HARIAN LEPAS</td><td>KUWANG RT 04 RW
align='right'>57030238</td><td>27-03-2019</td><td>EXEL</td><td>BUDI SANTOSO 0703
B 07</td><td>BELUM/TIDAK BEKERJA</td><td>KUWANG RT 04 RW
ASHARI</td><td>HENI WIDIYASTUTI</td><td>L</td><td>1-4 Thn.</td><td>Datang
align='right'>51020060</td><td>27-03-2019</td><td>FEBRIYANTI UTAMI</td><td>WAHYU
HUTOMO 01 02 H 01</td><td>KARYAWAN SWASTA</td><td>NGRINGIN RT 02 RW
</tr><tr><td align='right'>H54.7</td><td>Unspecified visual loss</td><td></td><td
2019</td><td>GINO</td><td>GINO 06 02 G 02</td><td>PEGAWAI NEGERI
SIPIL</td><td>GIRITONTRO KIDUL RT 02 RW 03</td><td>GIRITONTRO
align='right'>57070187</td><td>27-03-2019</td><td>HAFIE YAHYA AGUSTIAN</td><td>DWI
MARDIYANTO 07 07 D 04</td><td>BELUM/TIDAK BEKERJA</td><td>BANJAR RT03
RW05</td><td></td><td>PUCANGANOM</td><td>INDUK</td><td>dr. BUDI ASHARI</td><td>HENI
WIDIYASTUTI</td><td>L</td><td>1-4 Thn.</td><td>Datang
align='right'>G62.9</td><td>Polyneuropathy, unspecified</td><td></td><td
align='right'>290498</td><td align='right'>52020071</td><td>27-03-2019</td><td>IKA
SRIANI</td><td>MULYONO 02 02 M 02</td><td>MENGURUS RUMAH TANGGA</td><td>MANTHANG RT
01 RW 07</td><td>MANTHANG</td><td>TLOGOSARI</td><td>INDUK</td><td>dr. BUDI
align='right'>57030448</td><td>27-03-2019</td><td>ILHAM SUKARSA</td><td>TUKIJO 07
03 T 19</td><td>BELUM/TIDAK BEKERJA</td><td>KUWANG RT 01 RW
/td></tr><tr><td align='right'>R05</td><td>Cough</td><td></td><td
2019</td><td>IRFANDA GALANG SETIAWAN</td><td>SUWITO</td><td>BELUM/TIDAK
BEKERJA</td><td>SOKO</td><td>SOKO</td><td>TLOGOSARI</td><td>PUSTU
TLOGOSARI</td><td>SULARNO,S.Kep.Ns</td><td> - </td><td>L</td><td>5-9
align='right'>54035022</td><td>27-03-2019</td><td>JUMINI</td><td>KALIMIN
</td><td>PETANI/PEKEBUN</td><td>KLAMPEYAN</td><td>KLAMPEYAN</td><td>BAYEMHARJO</td>
<td>PUSTU BAYEMHARJO</td><td>RISTINA Amd Keb</td><td> - </td><td>P</td><td>45-54
align='right'>53050007</td><td>27-03-2019</td><td>KADIYO</td><td>KADIYO 0305 K
04</td><td>PETANI/PEKEBUN</td><td>PLARENG RT02
RW05</td><td>PLARENG</td><td>TLOGOHARJO</td><td>INDUK</td><td>dr. BUDI
2019</td><td>KASIWEN</td><td>JAENI 0705 J 03</td><td>MENGURUS RUMAH
TANGGA</td><td>SUKOROYOM KULON RT01 RW03</td><td>SUKOROYOM
2019</td><td>KASIYEM</td><td>SUTIYEM</td><td>PELAJAR/MAHASISWA</td><td>JATI</td><td
>JATI</td><td>JATIREJO</td><td>INDUK</td><td>dr. BUDI
align='right'>55060025</td><td>27-03-
2019</td><td>KASIYEM</td><td>SUTIYEM</td><td>PELAJAR/MAHASISWA</td><td>JATI</td><td
>JATI</td><td>JATIREJO</td><td>INDUK</td><td>dr. BUDI
align='right'>55125007</td><td>27-03-2019</td><td>KASTINI</td><td>WARDI PAMUNGKAS
0512 W 02</td><td>PETANI/PEKEBUN</td><td>NGASEM RT03
RW05</td><td>NGASEM</td><td>JATIREJO</td><td>INDUK</td><td>dr. BUDI
></tr><tr><td align='right'>N30.9</td><td>Cystitis, unspecified</td><td></td><td
2019</td><td>KATIBIN</td><td>KATIBIN 07 15 K
03</td><td>PETANI/PEKEBUN</td><td>PENDEM RT 01 RW 15
</td><td>PENDEM</td><td>PUCANGANOM</td><td>INDUK</td><td>dr. BUDI
Sendiri</td><td>Baru</td><td>JAMKESDA</td><td>Rujuk</td><td
Umum</td><td>Poli Urology</td><td>RSUD DR. SOEDIRAN MS WONOGIRI</td><td>Dalam
/td></tr><tr><td align='right'>M06.9</td><td>Rheumatoid arthritis,
align='right'>54035014</td><td>27-03-
2019</td><td>KATMI</td><td>PAIJEM</td><td>PETANI/PEKEBUN</td><td>KLAMPEYAN</td><td>
KLAMPEYAN</td><td>BAYEMHARJO</td><td>PUSTU BAYEMHARJO</td><td>RISTINA Amd
align='right'>54050024</td><td>27-03-2019</td><td>LATHIFA ARSY
BILQISTHI</td><td>WARNO 04 05 W 01</td><td>PELAJAR/MAHASISWA</td><td>DOLOGAN
RT01 RW02</td><td>DOLOGAN</td><td>BAYEMHARJO</td><td>INDUK</td><td>dr. BUDI
align='right'>290504</td><td align='right'>57020081</td><td>27-03-2019</td><td>LENI
WULANSARI</td><td>SUNARDI 0702 S 28</td><td>MENGURUS RUMAH
TANGGA</td><td>SUKOROYOM WETAN</td><td>SUKOROYOM
></tr><tr><td align='right'>Z00.2</td><td>Examination for period of rapid growth in
childhood</td><td></td><td align='right'>290511</td><td
align='right'>55030040</td><td>27-03-2019</td><td>M RIZA D SALAM</td><td>WAGIYO /
BADRUS S 05 03 W 01</td><td>BELUM/TIDAK BEKERJA</td><td>SONGGODULANG RT 01 RW
01</td><td></td><td>JATIREJO</td><td>INDUK</td><td>dr. BUDI ASHARI</td><td>HENI
WIDIYASTUTI</td><td>L</td><td><1 Thn.</td><td>Datang
align='right'>53025069</td><td>27-03-
2019</td><td>MARGONO</td><td>MARGONO</td><td>PETANI/PEKEBUN</td><td>SAMBIREJO</td><
2019</td><td>MARGONO</td><td>MARGONO</td><td>PETANI/PEKEBUN</td><td>SAMBIREJO</td><
align='right'>54110078</td><td>27-03-2019</td><td>MARYATI</td><td>SISWOYO 0411 S
03
</td><td>PETANI/PEKEBUN</td><td>GUWO</td><td>GUWO</td><td>BAYEMHARJO</td><td>INDUK<
Thn.</td><td>Datang Sendiri</td><td>Lama</td><td>JAMKESDA</td><td>Rujuk</td><td
Umum</td><td>Poli Dalam</td><td>RSUD DR. SOEDIRAN MS WONOGIRI</td><td>Dalam
/td></tr><tr><td align='right'>E11.6</td><td>Non-insulin-dependent diabetes
mellitus with other specified complications</td><td></td><td
2019</td><td>MESIYEM</td><td>MESIYEM 0506 M
01</td><td>PETANI/PEKEBUN</td><td>JATI</td><td>JATI</td><td>JATIREJO</td><td>INDUK<
></tr><tr><td align='right'>C50</td><td>Malignant neoplasm of
breast</td><td></td><td align='right'>290497</td><td
align='right'>55110021</td><td>27-03-2019</td><td>PAIKEM</td><td>KASIDI 05 11 K
2019</td><td>PARIYEM</td><td>NGATMAN</td><td>PETANI/PEKEBUN</td><td>KLAMPEYAN</td><
td>KLAMPEYAN</td><td>BAYEMHARJO</td><td>PUSTU BAYEMHARJO</td><td>RISTINA Amd
align='right'>57030414</td><td>27-03-2019</td><td>PARNI</td><td>TUKIJO 07 03 T
/td></tr><tr><td align='right'>R11</td><td>Nausea and vomiting</td><td></td><td
2019</td><td>PAWITI</td><td>GIYANTO</td><td>PETANI/PEKEBUN</td><td>TLOGO</td><td>TL
align='right'>56070139</td><td>27-03-2019</td><td>PIPIN OKTA PIANI</td><td>HARYANTO
06 07 H 03</td><td>KARYAWAN SWASTA</td><td>DUNGKANCIL RT01 RW09</td><td>DUNG
KANCIL</td><td>GIRITONTRO</td><td>INDUK</td><td>dr. BUDI ASHARI</td><td>HENI
WIDIYASTUTI</td><td>P</td><td>20-44 Thn.</td><td>Datang
align='right'>57170046</td><td>27-03-2019</td><td>PONIYEM</td><td>SARNO 07 17 S
06</td><td>PETANI/PEKEBUN</td><td>WATES RT 01 RW
17</td><td>WATES</td><td>PUCANGANOM</td><td>INDUK</td><td>dr. BUDI
align='right'>57160057</td><td>27-03-2019</td><td>RARA ULFAIRAH FAJARIA</td><td>NUR
AHMAD 07 16 N 01</td><td>BELUM/TIDAK BEKERJA</td><td>SAWIT LOR RT 02 RW
03</td><td>SAWIT LOR</td><td>PUCANGANOM</td><td>INDUK</td><td>dr. BUDI
ASHARI</td><td>HENI WIDIYASTUTI</td><td>P</td><td>1-4 Thn.</td><td>Datang
2019</td><td>RATRI RAHMAWATI</td><td>SUHONO 07 10 S
15</td><td>PELAJAR/MAHASISWA</td><td>JEPURU RT02
RW10</td><td>JEPURUN</td><td>PUCANGANOM</td><td>INDUK</td><td>drg.DANAR
align='right'>57030186</td><td>27-03-2019</td><td>REVANGGA FARIS
FERDIANSAH</td><td>BAMBANG 0703 B 04</td><td>BELUM/TIDAK BEKERJA</td><td>KUWANG
RT01 RW06</td><td>KUWANG</td><td>PUCANGANOM</td><td>INDUK</td><td>drg.DANAR
td></tr><tr><td align='right'>R05</td><td>Cough</td><td></td><td
2019</td><td>RIZKY DWI YULIANTO</td><td>SUPARMAN 0406 S 04</td><td>BELUM/TIDAK
BEKERJA</td><td>BAYEMHARJO RT02
</tr><tr><td align='right'>Z30.8</td><td>Other contraceptive
align='right'>54060008</td><td>27-03-2019</td><td>ROHKAYATI</td><td>SUKRISTIANTO
04 06 S 02</td><td>MENGURUS RUMAH TANGGA</td><td>BAYEM RT01
2019</td><td>SAMINO</td><td>SAMINO</td><td>PETANI/PEKEBUN</td><td>PUNUNG</td><td>PU
NUNG</td><td>JATIREJO</td><td>PUSTU BAYEMHARJO</td><td>RISTINA Amd Keb</td><td> -
</tr><tr><td align='right'>M79.0</td><td>Rheumatism, unspecified</td><td></td><td
2019</td><td>SARINEM </td><td>SARINEM 04 01 S
14</td><td>PETANI/PEKEBUN</td><td>BELEH RT 02 RW
align='right'>M79.05</td><td>Rheumatism, unspecified, pelvic region and
align='right'>57100171</td><td>27-03-2019</td><td>SARNI</td><td>WIJIONO 0710 W
03</td><td>PETANI/PEKEBUN</td><td>JEPURUN RT 01 RW
align='right'>55060042</td><td>27-03-2019</td><td>SATIMIN</td><td>SATIMIN 0506 S
10</td><td>PETANI/PEKEBUN</td><td>JATI RT03
2019</td><td>SILVI AMELIA WULANDARI</td><td>GIYATNO 07 14 G
RW05,PUCANGANOM</td><td>PENDEM</td><td>PUCANGANOM</td><td>INDUK</td><td>drg.DANAR
</tr><tr><td align='right'>H58.8</td><td>Other specified disorders of eye and
align='right'>290496</td><td align='right'>55010282</td><td>27-03-2019</td><td>SINO
ATMO SUWITO</td><td>SINO 05 01 S 09</td><td>PETANI/PEKEBUN</td><td>GIRIBELAH RT01
/td></tr><tr><td align='right'>I84.9</td><td>Unspecified haemorrhoids without
align='right'>53020075</td><td>27-03-2019</td><td>SRI WATI</td><td>SARINO 03 02 S
09</td><td>PETANI/PEKEBUN</td><td>SAMBIREJO RT 04 RW
01</td><td>SAMBIREJO</td><td>TLOGOHARJO</td><td>INDUK</td><td>dr. BUDI
align='right'>56010027</td><td>27-03-2019</td><td>SUKARNI</td><td>BAYU BUDI UTOMO
0601 B 01</td><td>MENGURUS RUMAH TANGGA</td><td>GIRITONTRO LOR RT03
/tr><tr><td align='right'>F20.4</td><td>Post-schizophrenic
depression</td><td></td><td align='right'>290503</td><td
align='right'>51040004</td><td>27-03-2019</td><td>SUKIJEM</td><td>KADI 0104 K
02</td><td>PETANI/PEKEBUN</td><td>KLEPU RT01
RW03</td><td>KLEPU</td><td>NGARGOHARJO</td><td>INDUK</td><td>dr. BUDI
align='right'>54035023</td><td>27-03-
2019</td><td>SUWARTI</td><td>WARTO</td><td>PETANI/PEKEBUN</td><td>KLAMPEYAN</td><td
>KLAMPEYAN</td><td>BAYEMHARJO</td><td>PUSTU BAYEMHARJO</td><td>RISTINA Amd
2019</td><td>WARIYEM</td><td>MARMAN</td><td>PETANI/PEKEBUN</td><td>TLOGO</td><td>TL
align='right'>54060107</td><td>27-03-2019</td><td>WARYANTI </td><td>EKO HARIYANTO
04 06 E 01</td><td>MENGURUS RUMAH TANGGA</td><td>BAYEM RT 01 RW
01</td><td>BAYEM</td><td>BAYEMHARJO</td><td>INDUK</td><td>dr. BUDI
2019</td><td>WARYANTI </td><td>EKO HARIYANTO 04 06 E 01</td><td>MENGURUS RUMAH
TANGGA</td><td>BAYEM RT 01 RW
01</td><td>BAYEM</td><td>BAYEMHARJO</td><td>INDUK</td><td>dr. BUDI
align='right'>H65.0</td><td>Acute
serous otitis media</td><td></td><td align='right'>290533</td><td
align='right'>57140086</td><td>27-03-2019</td><td>WIDODO</td><td>WIDODO 0714 W
04</td><td>KARYAWAN SWASTA</td><td>PENDEM RT01
align='right'>S50.9</td><td>Superficial injury of forearm,
align='right'>57100178</td><td>27-03-2019</td><td>WIJIYONO</td><td>WIJIYONO 07 10 W
04</td><td>PETANI/PEKEBUN</td><td>JEPURUN RT 01 RW
></tr><tr><td align='right'>K03.6</td><td>Deposits [accretions] on
teeth</td><td></td><td align='right'>290537</td><td
align='right'>57050142</td><td>27-03-2019</td><td>ZIDNA ILMAN NAFI
AN</td><td>SLAMET 0705 S37</td><td>PELAJAR/MAHASISWA</td><td>SIKOROYOM
KULON</td><td>SUKOROYOM KULON</td><td>PUCANGANOM</td><td>INDUK</td><td>drg.DANAR
</tr><tr><td align='right'>R50.9</td><td>Fever, unspecified</td><td></td><td
2019</td><td>ZULAIHAH AISYANA PUTRI AZ ZAHWA</td><td>SADERI 0703 S
</tr><tr><td align='right'>K02.1</td><td>Caries of dentine</td><td></td><td
2019</td><td>ABDUR ROZAK PUTERA ROHMANI</td><td>RIPTO BUDOYO 06 01 R
04</td><td>BELUM/TIDAK BEKERJA</td><td>GIRITONTRO LOR RT03 RW02</td><td>GIRITONTRO
tr><tr><td align='right'>K29.5</td><td>Chronic gastritis,
align='right'>51027008</td><td>28-03-2019</td><td>AGUS DWI RAHARDJO</td><td>AGUS
DWI RAHARDJO 0102 A
01</td><td>PETANI/PEKEBUN</td><td>NGRINGIN</td><td>NGRINGIN</td><td>NGARGOHARJO</td
><td>INDUK</td><td>dr. BUDI ASHARI</td><td>SUWARTO,S.Kep.Nes</td><td>L</td><td>45-
54 Thn.</td><td>Datang Sendiri</td><td>Lama</td><td>BPJS PBI</td><td>Rujuk</td><td
align='right'>10101404</td><td>28-03-2019</td><td>ALKA CHALLISTA</td><td>TUIMIN
1010 07</td><td>PELAJAR/MAHASISWA</td><td>BANGAMPEL RT04
RW01</td><td></td><td>PARANGGUPITO</td><td>INDUK</td><td>dr. BUDI
align='right'>51145061</td><td>28-03-
2019</td><td>AMEL</td><td>RAFIK</td><td>BELUM/TIDAK
BEKERJA</td><td>BOGOR</td><td>TLOGOMATI</td><td>NGARGOHARJO</td><td>PKD
NGARGOHARJO</td><td>HENI WIDIYASTUTI</td><td> - </td><td>P</td><td>5-9
2019</td><td>ANDRIYANTI</td><td>SUKIMAN 01 10 S 18</td><td>KARYAWAN
SWASTA</td><td>BALONG RT 01 RW
06</td><td>BALONG</td><td>NGARGOHARJO</td><td>INDUK</td><td>dr. BUDI
/td></tr><tr><td align='right'>A15</td><td>Respiratory tuberculosis,
bacteriologically and histologically confirmed</td><td></td><td
2019</td><td>ANISA YULIANA</td><td>SUNARSIH 0302 S 36</td><td>KARYAWAN
SWASTA</td><td>SAMBIREJO RT03
align='right'>55015064</td><td>28-03-
2019</td><td>ARTUR</td><td>ARIS</td><td>PELAJAR/MAHASISWA</td><td>GIRIROTO</td><td>
GIRIBELAH</td><td>JATIREJO</td><td>PKD JATIREJO</td><td>SUHARNI</td><td> -
align='right'>K05.1</td><td>Chronic gingivitis</td><td></td><td
align='right'>290575</td><td align='right'>56020684</td><td>28-03-2019</td><td>ASEP
SOEPUDIN</td><td>ASEP SOEPUDIN 06 02 A 15</td><td>KARYAWAN
SWASTA</td><td>GIRITONTRO KIDUL RT 04 RW 03</td><td>GIRITONTRO
align='right'>57060052</td><td>28-03-2019</td><td>AZZAM SABARUDIN</td><td>DWI
FEBRIANI 0706 D 02</td><td></td><td>TAMBAHSARI RT02
2019</td><td>BAGAS</td><td>SURAHMANTO</td><td>PELAJAR/MAHASISWA</td><td>NGORODOWO</
td><td>NGORODOWO</td><td>JATIREJO</td><td>PKD JATIREJO</td><td>SUHARNI</td><td> -
align='right'>56080243</td><td>28-03-2019</td><td>BASUKI</td><td>BASUKI 0608 B
01</td><td>TENTARA NASIONAL INDONESIA</td><td>DUNGKLEPU WETAN RT01
RW04</td><td>DUNG KLEPU WETAN</td><td>GIRITONTRO</td><td>INDUK</td><td>dr. BUDI
></tr><tr><td align='right'>S01</td><td>Open wound of head</td><td></td><td
2019</td><td>BRIGITA VALENSIA RISQI HUSADA</td><td>MARIO 0709 M
10</td><td>BELUM/TIDAK BEKERJA</td><td>PUCANGANOM
LOR</td><td></td><td>PUCANGANOM</td><td>INDUK</td><td>dr. BUDI
align='right'>N18.5</td><td>Chronic kidney disease, stage 5</td><td></td><td
2019</td><td>DAHLAN ROSIDI</td><td>DAHLAN ROSIDI 07 07 D
align='right'>51020098</td><td>28-03-2019</td><td>DAMAR</td><td>TULATNO 01 02 T
align='right'>57040277</td><td>28-03-2019</td><td>DEA AYU MAHARANI</td><td>WASDI
07 04 W 08</td><td>BELUM/TIDAK BEKERJA</td><td>MANDEYAN RT 04 RW
ASHARI</td><td>RETNO AMBARWATI AMD KEB</td><td>P</td><td><1 Thn.</td><td>Datang
/td></tr><tr><td align='right'>D36.9</td><td>Benign neoplasm of unspecified
align='right'>55030007</td><td>28-03-2019</td><td>DWI WINARTI</td><td>SULARNO 05 03
S
07</td><td>PETANI/PEKEBUN</td><td>SONGGODULANG</td><td>SONGGODULANG</td><td>JATIREJ
O</td><td>INDUK</td><td>dr. BUDI
align='right'>57130141</td><td>28-03-2019</td><td>ELISA WATI</td><td>SUTIYO 0713
S 22</td><td>MENGURUS RUMAH TANGGA</td><td>KEPUH RT03
RTW12</td><td>KEPUH</td><td>PUCANGANOM</td><td>INDUK</td><td>dr. BUDI
td></tr><tr><td align='right'>E56.8</td><td>Deficiency of other
vitamins</td><td></td><td align='right'>290588</td><td
align='right'>57130141</td><td>28-03-2019</td><td>ELISA WATI</td><td>SUTIYO 0713
S 22</td><td>MENGURUS RUMAH TANGGA</td><td>KEPUH RT03
RTW12</td><td>KEPUH</td><td>PUCANGANOM</td><td>INDUK</td><td>dr. BUDI
td></tr><tr><td align='right'>L02</td><td>Cutaneous abscess, furuncle and
carbuncle</td><td></td><td align='right'>290584</td><td
align='right'>55090053</td><td>28-03-2019</td><td>EMI WIDYASTUTI</td><td>NANDA
RISKI AJI WIBOWO</td><td>BURUH HARIAN LEPAS</td><td>MULWOSARI RT01
RW04</td><td>MULWOSARI</td><td>JATIREJO</td><td>INDUK</td><td>dr. BUDI
2019</td><td>FAJAR WAHYUDI</td><td>SURIPTO 0712 S 20</td><td>PERANGKAT
DESA</td><td>INGAK INGUK</td><td>INGAK -
align='right'>57080045</td><td>28-03-2019</td><td>GILANG</td><td>PONIJAN 0708 P
02</td><td></td><td>PUCANG ANOM KIDUL</td><td>PUCANGANOM
2019</td><td>GIMAN</td><td>GIMAN</td><td>PETANI/PEKEBUN</td><td>GIRIROTO</td><td>GI
2019</td><td>GINEN</td><td>GINEN 0210 G 05</td><td>PETANI/PEKEBUN</td><td>PORO
RT02 RW03</td><td>PORO</td><td>TLOGOSARI</td><td>INDUK</td><td>drg.DANAR
align='right'>C76.8</td><td>Malignant neoplasm overlapping other and ill-defined
align='right'>56100415</td><td>28-03-2019</td><td>HESTI
PARAMITARADYASTUTI</td><td>BUDIYONO 0610 B 04</td><td>WIRASWASTA</td><td>TANGGUNG
RT03 RW05</td><td>TANGGUNG</td><td>GIRITONTRO</td><td>INDUK</td><td>dr. BUDI
></tr><tr><td align='right'>S49.9</td><td>Unspecified injury of shoulder and upper
arm</td><td></td><td align='right'>290557</td><td
align='right'>52020071</td><td>28-03-2019</td><td>IKA SRIANI</td><td>MULYONO 02 02
M 02</td><td>MENGURUS RUMAH TANGGA</td><td>MANTHANG RT 01 RW
07</td><td>MANTHANG</td><td>TLOGOSARI</td><td>INDUK</td><td>dr. BUDI
align='right'>57080158</td><td>28-03-2019</td><td>KHUSNI BAIATUN</td><td>SAYADI
0708 S 23</td><td>MENGURUS RUMAH TANGGA</td><td>PUCANGANOM KIDUL
RT01/08</td><td>PUCANGANOM KIDUL</td><td>PUCANGANOM</td><td>INDUK</td><td>dr. BUDI
align='right'>55050128</td><td>28-03-2019</td><td>LESTARI</td><td>LESTARI 0505 L
align='right'>55050128</td><td>28-03-2019</td><td>LESTARI</td><td>LESTARI 0505 L
align='right'>57030172</td><td>28-03-2019</td><td>LINA ANDARWATI</td><td>PAIMIN 07
03 P 13</td><td>MENGURUS RUMAH TANGGA</td><td>KUWANG RT 04 RW
2019</td><td>MALOYO</td><td>MALOYO</td><td>PETANI/PEKEBUN</td><td>JAJAR</td><td>JAJ
align='right'>57010284</td><td>28-03-2019</td><td>MARNI</td><td>MARNI 0701 M
d align='right'>J45.9</td><td>Asthma, unspecified</td><td></td><td
2019</td><td>MISGINAH</td><td>SALAMUN 07 05 S
align='right'>57050114</td><td>28-03-2019</td><td>MISGINAH</td><td>SALAMUN 07 05
S 36</td><td>PETANI/PEKEBUN</td><td>SUKOROYOM KULON RT 01 RW 03</td><td>SUKOROYOM
align='right'>51090008</td><td>28-03-2019</td><td>MISMI</td><td>SUKINO 01 09 S
09</td><td>PETANI/PEKEBUN</td><td>PULUNG RT04
></tr><tr><td align='right'>F20.3</td><td>Undifferentiated
schizophrenia</td><td></td><td align='right'>290582</td><td
align='right'>58081405</td><td>28-03-2019</td><td>MUJIATUN</td><td>FARKAN 0808 F
02</td><td>PETANI/PEKEBUN</td><td>PULOSARI RT03
2019</td><td>MUJIATUN</td><td>FARKAN 0808 F
02</td><td>PETANI/PEKEBUN</td><td>PULOSARI RT03
2019</td><td>MUKIJEM</td><td>MUKIJEM</td><td>PETANI/PEKEBUN</td><td>SAMBIREJO</td><
- </td><td>P</td><td>60-69 Thn.</td><td>Datang Sendiri</td><td>Lama</td><td>UMUM
/td></tr><tr><td align='right'>R50.9</td><td>Fever, unspecified</td><td></td><td
2019</td><td>NAJWA</td><td>MARSITO</td><td>BELUM/TIDAK BEKERJA</td><td>GINADE
KLN</td><td>GINADE KULON</td><td>TLOGOHARJO</td><td>PKD TLOGOHARJO</td><td>SRI
align='right'>57030410</td><td>28-03-2019</td><td>NAUFAL ARIF</td><td>PAIMIN 07
03 P 13</td><td>BELUM/TIDAK BEKERJA</td><td>KUWANG RT04
align='right'>57130005</td><td>28-03-2019</td><td>NAURA SYAFA AULIOA</td><td>SUTIYO
07 13 S
22</td><td></td><td>KEPUH</td><td>KEPUH</td><td>PUCANGANOM</td><td>INDUK</td><td>dr
align='right'>57145008</td><td>28-03-2019</td><td>NAYLA OKTAVIAN
SARI</td><td>MUSTAQIM 0714 M 02</td><td>BELUM/TIDAK BEKERJA</td><td>PENDEM RT01
align='right'>56100148</td><td>28-03-2019</td><td>NGATIYEM</td><td>TUMIN 06 10 T
2019</td><td>NGATNO</td><td></td><td>PETANI/PEKEBUN</td><td>TLOGOSARI</td><td>TLOGO
SARI</td><td>TLOGOSARI</td><td>PUSTU TLOGOSARI</td><td>SULARNO,S.Kep.Ns</td><td> -
2019</td><td>PAIJEM</td><td>WARIMO</td><td>PETANI/PEKEBUN</td><td>JAJAR</td><td>JAJ
align='right'>53055047</td><td>28-03-
2019</td><td>PARMI</td><td>PARMI</td><td>PETANI/PEKEBUN</td><td>PLARENG</td><td>PLA
RENG</td><td>TLOGOHARJO</td><td>PKD TLOGOHARJO</td><td>SRI SUPATMI</td><td> -
></tr><tr><td align='right'>M79.19</td><td>Myalgia, site
align='right'>56070160</td><td>28-03-2019</td><td>PARTINI</td><td>NANANG 0607 N
01</td><td>MENGURUS RUMAH TANGGA</td><td>DUNGKANCIL RT 01 RW 09</td><td>DUNG
></tr><tr><td align='right'>H54.7</td><td>Unspecified visual loss</td><td></td><td
2019</td><td>PARTIYEM</td><td>WARINO 0602 W
02</td><td>PENSIUNAN</td><td>GIRITONTRO KIDUL RT01 RW03</td><td>GIRITONTRO
align='right'>57030226</td><td>28-03-2019</td><td>PARWATI </td><td>KASMIN 0703 K
10</td><td>PETANI/PEKEBUN</td><td>KUWANG</td><td>KUWANG</td><td>PUCANGANOM</td><td>
INDUK</td><td>dr. BUDI ASHARI</td><td>SUWARTO,S.Kep.Nes</td><td>P</td><td>20-44
align='right'>52087059</td><td>28-03-
2019</td><td>PAYEM</td><td>SULARTO</td><td>PETANI/PEKEBUN</td><td>TLOGOSARI</td><td
>TLOGOSARI</td><td>TLOGOSARI</td><td>PUSTU
2019</td><td>SAKIYO</td><td>SAKIYO</td><td>PETANI/PEKEBUN</td><td>GIRIROTO</td><td>
GIRIROTO</td><td>JATIREJO</td><td>PKD JATIREJO</td><td>SUHARNI</td><td> -
align='right'>55110007</td><td>28-03-2019</td><td>SAMIYEM</td><td>KATIYEM 05 11 K
d></tr><tr><td align='right'>H58.8</td><td>Other specified disorders of eye and
2019</td><td>SARINO</td><td>SARINO 0708 S
2019</td><td>SARIYEM</td><td>SATIMO</td><td>PETANI/PEKEBUN</td><td>TLOGO</td><td>TL
OGO</td><td>TLOGOHARJO</td><td>PKD
align='right'>56080009</td><td>28-03-2019</td><td>SARMI</td><td>SULIMIN 0608 S
48</td><td>PETANI/PEKEBUN</td><td>DUNGKLEPU WETAN RT 02 RW 04</td><td>DUNG KLEPU
align='right'>55090076</td><td>28-03-2019</td><td>SARMI</td><td>PUJI 0509 P
08</td><td>MENGURUS RUMAH TANGGA</td><td>MULWOSARI,
JATIREJO</td><td>MULWOSARI</td><td>JATIREJO</td><td>INDUK</td><td>dr. BUDI
2019</td><td>SARNI</td><td>PAIMIN</td><td>PETANI/PEKEBUN</td><td>JAJAR</td><td>JAJA
R</td><td>TLOGOHARJO</td><td>PKD TLOGOHARJO</td><td>SRI SUPATMI</td><td> -
2019</td><td>SARWONO</td><td>SARWONO</td><td>PETANI/PEKEBUN</td><td>GUWO</td><td>GU
WO</td><td>BAYEMHARJO</td><td>PUSTU BAYEMHARJO</td><td>RISTINA Amd Keb</td><td> -
2019</td><td>SENEN</td><td>MOKARYO 06 02 M
align='right'>55010153</td><td>28-03-2019</td><td>SEPTI FITRIASTUTI</td><td>ALI
SAPUR 0501 A 07</td><td>BELUM/TIDAK BEKERJA</td><td>GIRIBELAH RT03
2019</td><td>SEPTI FITRIASTUTI</td><td>ALI SAPUR 0501 A 07</td><td>BELUM/TIDAK
BEKERJA</td><td>GIRIBELAH RT03
align='right'>51145060</td><td>28-03-
2019</td><td>SILFA</td><td>RAFIK</td><td>PELAJAR/MAHASISWA</td><td>BOGOR</td><td>TL
OGOMATI</td><td>NGARGOHARJO</td><td>PKD NGARGOHARJO</td><td>HENI
align='right'>K41.0</td><td>Bilateral femoral hernia, with obstruction, without
gangrene</td><td></td><td align='right'>290551</td><td
align='right'>55010338</td><td>28-03-2019</td><td>SITI WURYATI</td><td>SUROTO 0501
align='right'>57070158</td><td>28-03-2019</td><td>SRI HARTANTO</td><td> HARTANTO 07
07 H 03</td><td>PETANI/PEKEBUN</td><td>BANJAR RT 03 RW
RAHAYU</td><td>MISMAN 0602 M 16</td><td>BURUH HARIAN LEPAS</td><td>GIRITONTRO
align='right'>56020584</td><td>28-03-2019</td><td>SUGITO</td><td>SUGITO 0602 S
10</td><td>PETANI/PEKEBUN</td><td>GIRITONTRO KDUL 05/03I</td><td>GIRITONTRO
align='right'>56035056</td><td>28-03-
2019</td><td>SUGIYANTI</td><td>WAGINO</td><td>PELAJAR/MAHASISWA</td><td>GEBLUG</td>
<td>GEBLUG</td><td>GIRITONTRO</td><td>INDUK</td><td>dr. BUDI
2019</td><td>SUKARNO</td><td>SUKARNO 0707 S
align='right'>51050006</td><td>28-03-2019</td><td>SUPRAPTO</td><td>SUPRAPTO 0105 S
08</td><td>PETANI/PEKEBUN</td><td>GENTUNG RT02
RW03</td><td>GENTUNG</td><td>NGARGOHARJO</td><td>INDUK</td><td>dr. BUDI
ASHARI</td><td>SUWARTO,S.Kep.Nes</td><td>L</td><td>55-59
></tr><tr><td align='right'>H81.4</td><td>Verti of central origin</td><td></td><td
2019</td><td>SUPRIHATIN</td><td>SUGITO 06 02 S 10</td><td>BURUH HARIAN
LEPAS</td><td>GIRITONTRO KIDUL</td><td>GIRITONTRO
2019</td><td>SURATI</td><td>SUROTO 07 16 S 11</td><td>PETANI/PEKEBUN</td><td>SAWIT
LOR RT03 RW13</td><td>SAWIT LOR</td><td>PUCANGANOM</td><td>INDUK</td><td>dr. BUDI
align='right'>54110024</td><td>28-03-2019</td><td>SUSILO UTAMI</td><td>HERI
PRAYITNO 04 11 H 01</td><td>PETANI/PEKEBUN</td><td>GUWO RT 03 RW
06</td><td>GUWO</td><td>BAYEMHARJO</td><td>INDUK</td><td>dr. BUDI
></tr><tr><td align='right'>K30</td><td>Dyspepsia</td><td></td><td
03</td><td>GENTUNG</td><td>NGARGOHARJO</td><td>INDUK</td><td>dr. BUDI
></tr><tr><td align='right'>J11</td><td>Influenza, virus not
align='right'>55050110</td><td>28-03-2019</td><td>SUYANTO</td><td>SUYANTO 05 05 S
2019</td><td>TUKIMIN</td><td>LESTARI 0505 L 03</td><td>WIRASWASTA</td><td>PUNUNG
RT01 RW02</td><td>PUNUNG</td><td>JATIREJO</td><td>INDUK</td><td>dr. BUDI
align='right'>52087077</td><td>28-03-
2019</td><td>TUKIYEM</td><td></td><td>PETANI/PEKEBUN</td><td>TLOGOSARI</td><td>TLOG
2019</td><td>TUMINI</td><td>SUGENG</td><td>PETANI/PEKEBUN</td><td>NGELO</td><td>NGE
LO</td><td>TLOGOSARI</td><td>PUSTU TLOGOSARI</td><td>SULARNO,S.Kep.Ns</td><td> -
2019</td><td>TUNEM</td><td>SOMOREJO 0610 S
<td>INDUK</td><td>drg.DANAR WULANDARI</td><td>RIZKI ANISSA,
AM.Kg</td><td>P</td><td>>70 Thn.</td><td>Datang Sendiri</td><td>Lama</td><td>BPJS
PBI</td><td>internal rujukan</td><td align='right'>27</td><td
align='right'>56100111</td><td>28-03-2019</td><td>TUNEM</td><td>SOMOREJO 0610 S
<td>INDUK</td><td>dr. BUDI ASHARI</td><td>SUWARTO,S.Kep.Nes</td><td>P</td><td>>70
align='right'>55080073</td><td>28-03-2019</td><td>TUSIYEM</td><td>WAGIMIN 0508 W
03</td><td>PETANI/PEKEBUN</td><td>NGORODOWO RT04
d></tr><tr><td align='right'>R05</td><td>Cough</td><td></td><td
2019</td><td>WARINO</td><td>WARINO 0407 W
RW05</td><td>NGALURAN</td><td>BAYEMHARJO</td><td>PUSTU BAYEMHARJO</td><td>RISTINA
Amd Keb</td><td> - </td><td>L</td><td>60-69 Thn.</td><td>Datang
align='right'>290698</td><td align='right'>53015040</td><td>28-03-2019</td><td>WIJI
L</td><td>SUWARTO</td><td>PETANI/PEKEBUN</td><td>TLOGO</td><td>TLOGO</td><td>TLOGOH
ARJO</td><td>PKD TLOGOHARJO</td><td>SRI SUPATMI</td><td> - </td><td>P</td><td>45-54
align='right'>N94.6</td><td>Dysmenorrhoea, unspecified</td><td></td><td
2019</td><td>YENI</td><td>BUDIAGUNG</td><td>MENGURUS RUMAH
TANGGA</td><td>KLEPU</td><td>KLEPU</td><td>TLOGOHARJO</td><td>PKD
align='right'>54110009</td><td>28-03-2019</td><td>YULIA B</td><td>KATINO 0411 K
03</td><td>PEDAGANG</td><td>GUWO</td><td>GUWO</td><td>BAYEMHARJO</td><td>INDUK</td>
<td>dr. BUDI ASHARI</td><td>SUWARTO,S.Kep.Nes</td><td>P</td><td>20-44
></tr><tr><td align='right'>M32.9</td><td>Systemic lupus erythematosus,
align='right'>53100005</td><td>29-03-2019</td><td>IIN SUHARNI</td><td>PATMIYANTO 03
10 P 01</td><td>MENGURUS RUMAH TANGGA</td><td>KELOR RT 01 RW
04</td><td>KELOR</td><td>TLOGOHARJO</td><td>INDUK</td><td>dr. BUDI
align='right'>57060076</td><td>29-03-2019</td><td>KASIRAN</td><td>KASIRAN 0706 K
03</td><td>PENSIUNAN</td><td>TAMBAHSARI</td><td>TAMBAHSARI</td><td>PUCANGANOM</td><
td>INDUK</td><td>dr. BUDI ASHARI</td><td>SUGIYONO,S.Kep.Ns</td><td>L</td><td>>70
d></tr><tr><td align='right'>M79.05</td><td>Rheumatism, unspecified, pelvic region
align='right'>55030011</td><td>29-03-2019</td><td>KATIJEM</td><td>SUTONO 05 03 S
08</td><td>PETANI/PEKEBUN</td><td>SONGGODULANG</td><td>SONGGODULANG</td><td>JATIREJ
O</td><td>INDUK</td><td>dr. BUDI
2019</td><td>KATIJEM</td><td>KATIJEM 0406 K
08</td><td>PETANI/PEKEBUN</td><td>BAYEM RT02
></tr><tr><td align='right'>K04.0</td><td>Pulpitis</td><td></td><td
align='right'>290623</td><td align='right'>57030406</td><td>29-03-2019</td><td>LIVE
VIA SEKARWATI</td><td>SITI 0703 S 11</td><td>PELAJAR/MAHASISWA</td><td>KUWANG RT02
2019</td><td>LUTHFIYYAH SAJA YUMNA</td><td>GINEN 0712 G
02</td><td>PELAJAR/MAHASISWA</td><td>INGAK INGUK</td><td>INGAK -
align='right'>52010102</td><td>29-03-2019</td><td>MISKIYEM</td><td>TEGUH 0201 T
07</td><td>PETANI/PEKEBUN</td><td>GEMBUK RT02
RW07</td><td>GEMBUK</td><td>TLOGOSARI</td><td>INDUK</td><td>dr. BUDI
2019</td><td>MIYATUN</td><td>SUPRIYANTO 0610 S
RW05</td><td>TANGGUNG</td><td>GIRITONTRO</td><td>INDUK</td><td>drg.DANAR
align='right'>57030089</td><td>29-03-2019</td><td>MUHAMAD FAJAR
BUDIATMA</td><td>BUDI SETIYONO 0703 B 01</td><td>PELAJAR/MAHASISWA</td><td>KUWANG
align='right'>57020048</td><td>29-03-2019</td><td>MUTIYA GIRI
SAFITRI</td><td>SUTRISNO 0702 S 04</td><td></td><td>SUKOROYOM
WETAN</td><td>SUKOROYOM WETAN</td><td>PUCANGANOM</td><td>INDUK</td><td>dr. BUDI
></tr><tr><td align='right'>N60.1</td><td>Diffuse cystic
mastopathy</td><td></td><td align='right'>290618</td><td
align='right'>56030127</td><td>29-03-2019</td><td>NARISEM</td><td>WARSINO 0603 W
02</td><td>MENGURUS RUMAH TANGGA</td><td>GEBLUG RT04
align='right'>55050002</td><td>29-03-2019</td><td>NAYSILLA RAMADHANI
OKTAVIYANA</td><td>SUJARNO 0505 S
18</td><td>PELAJAR/MAHASISWA</td><td>PUNUNG</td><td>PUNUNG</td><td>JATIREJO</td><td
align='right'>56065002</td><td>29-03-2019</td><td>NGATIYEM</td><td>SUTIYO 06 06 S
04</td><td>PETANI/PEKEBUN</td><td>GOBOH RT 03 RW
06</td><td>GOBOH</td><td>GIRITONTRO</td><td>INDUK</td><td>dr. BUDI
d></tr><tr><td align='right'>K00.6</td><td>Disturbances in tooth
align='right'>51020110</td><td>29-03-2019</td><td>NOVAL ARYA PUTRA</td><td>TRIMANTO
0102 T 01</td><td>PELAJAR/MAHASISWA</td><td>NGRINGIN RT02
RW01</td><td>NGRINGIN</td><td>NGARGOHARJO</td><td>INDUK</td><td>drg.DANAR
align='right'>S52.80</td><td>Fracture of other parts of forearm ,
align='right'>57130135</td><td>29-03-2019</td><td>PAIJEM</td><td>SUMARDI 0713
S30</td><td>MENGURUS RUMAH TANGGA</td><td>KEPUH RT 02 RW
align='right'>57120016</td><td>29-03-2019</td><td>PARYANTI</td><td>GINEN 07 12 G
02</td><td>PETANI/PEKEBUN</td><td>INGAK INGUK RT02 RW 16</td><td>INGAK -
align='right'>55100030</td><td>29-03-2019</td><td>PUJI ASTUTI</td><td>SARJONO 05 10
S 06</td><td>BURUH HARIAN LEPAS</td><td>SENGON
RT02/04</td><td>SENGON</td><td>JATIREJO</td><td>INDUK</td><td>dr. BUDI
2019</td><td>SARINO</td><td>SARINO 0708 S
></tr><tr><td align='right'>I25.9</td><td>Chronic ischaemic heart disease,
align='right'>55120016</td><td>29-03-2019</td><td>SARTINI</td><td>MISNO 05 12 M
02</td><td>MENGURUS RUMAH TANGGA</td><td>NGASEM
</td><td>NGASEM</td><td>JATIREJO</td><td>INDUK</td><td>dr. BUDI
></tr><tr><td align='right'>G40.9</td><td>Epilepsy, unspecified</td><td></td><td
align='right'>290614</td><td align='right'>55050088</td><td>29-03-2019</td><td>SEP
DWIANTO</td><td>SEP DWIANTO 05 05 S 20</td><td>PEDAGANG</td><td>PUNUNG
01/02</td><td>PUNUNG</td><td>JATIREJO</td><td>INDUK</td><td>dr. BUDI
2019</td><td>SILVI AMELIA WULANDARI</td><td>GIYATNO 07 14 G
RW05,PUCANGANOM</td><td>PENDEM</td><td>PUCANGANOM</td><td>INDUK</td><td>drg.DANAR
align='right'>55010244</td><td>29-03-2019</td><td>SULARNI</td><td>SRI HARDONO 05 01
</tr><tr><td align='right'>I50.9</td><td>Heart failure,
align='right'>54070078</td><td>29-03-2019</td><td>SULASTRI</td><td>SULASTRI 0407
S 20</td><td>PETANI/PEKEBUN</td><td>NGALURAN RT01
2019</td><td>SULASTRI</td><td>KASIMUN</td><td>PETANI/PEKEBUN</td><td>GINADE
align='right'>57050132</td><td>29-03-2019</td><td>SULIMAH</td><td>MAKNO 0705 M
03</td><td>PETANI/PEKEBUN</td><td>SUKOROYOM KULON RT03 RW03</td><td>SUKOROYOM
d></tr><tr><td align='right'>L20.8</td><td>Other atopic dermatitis</td><td></td><td
2019</td><td>SUPRIHATMINI</td><td>SUROTO 0602 S
KIDUL</td><td>GIRITONTRO</td><td>INDUK</td><td>dr. BUDI ASHARI</td><td>RISTINA Amd
Keb</td><td>P</td><td>20-44 Thn.</td><td>Datang Sendiri</td><td>Lama</td><td>BPJS
align='right'>51080025</td><td>29-03-2019</td><td>SURIP</td><td>SUDADI 01 08 S
SIPIL</td><td>SUKOROYOM KULON RT 02 RW 03</td><td>SUKOROYOM
align='right'>54020008</td><td>29-03-2019</td><td>SUWARTI</td><td>MIRANTO 04 02 M
01</td><td>MENGURUS RUMAH TANGGA</td><td>NGUNDUK RRT01
RW03</td><td>NGUNDUK</td><td>BAYEMHARJO</td><td>INDUK</td><td>dr. BUDI
2019</td><td>WASINI</td><td>KATIMAN 0713 K 02</td><td>PETANI/PEKEBUN</td><td>KEPUH
RT02 RW12</td><td>KEPUH</td><td>PUCANGANOM</td><td>INDUK</td><td>dr. BUDI
align='right'>56010063</td><td>30-03-2019</td><td> JUMIYEM</td><td>SURIP JUMIYEM
0601 S 48</td><td>PETANI/PEKEBUN</td><td>GIRITONTRO LOR RT01
2019</td><td>AFNAN NAZRIL</td><td>SUGIYARSO 0705 S 10</td><td>BELUM/TIDAK
BEKERJA</td><td>SUKOROYOM KULON</td><td>SUKOROYOM
KULON</td><td>PUCANGANOM</td><td>INDUK</td><td>dr. BUDI ASHARI</td><td>SRI
MURWATININGSIH</td><td>L</td><td>1-4 Thn.</td><td>Datang
align='right'>290821</td><td align='right'>51110027</td><td>30-03-2019</td><td>ALIF
ROHANANSYA</td><td>SULIS SETIYONO 01 11 S
14</td><td>PELAJAR/MAHASISWA</td><td>BLEBER RT 02 RW
06</td><td>BLEBER</td><td>NGARGOHARJO</td><td>INDUK</td><td>drg.DANAR
</tr><tr><td align='right'>K02.1</td><td>Caries of dentine</td><td></td><td
align='right'>290821</td><td align='right'>51110027</td><td>30-03-2019</td><td>ALIF
ROHANANSYA</td><td>SULIS SETIYONO 01 11 S
14</td><td>PELAJAR/MAHASISWA</td><td>BLEBER RT 02 RW
06</td><td>BLEBER</td><td>NGARGOHARJO</td><td>INDUK</td><td>drg.DANAR
align='right'>57020151</td><td>30-03-2019</td><td>ARIF RAHMAN
NURDIANSYAH</td><td>RIYANTO 07 02 R 02</td><td>BELUM/TIDAK
BEKERJA</td><td>SUKOROYOM WETAN RT03 RW04</td><td>SUKOROYOM
align='right'>57050097</td><td>30-03-2019</td><td>ASIH SRI
LESTARI</td><td>SUGIYARSO 07 05 S 10</td><td>PELAJAR/MAHASISWA</td><td>SUKOROYOM
align='right'>57050372</td><td>30-03-2019</td><td>AYU LARASANTI</td><td>MULYADI
0705 M 08</td><td>PELAJAR/MAHASISWA</td><td>SUKOROYOM KULON RT02
align='right'>55040088</td><td>30-03-2019</td><td>DARIYEM</td><td>DUL KASPAN 05 04
D 02</td><td>MENGURUS RUMAH
TANGGA</td><td>KANIGORO</td><td>KANIGORO</td><td>JATIREJO</td><td>INDUK</td><td>dr.
BUDI ASHARI</td><td>SUGIYONO,S.Kep.Ns</td><td>P</td><td>>70 Thn.</td><td>Datang
></tr><tr><td align='right'>I21.3</td><td>Acute transmural myocardial infarction of
unspecified site</td><td></td><td align='right'>290810</td><td
align='right'>56100132</td><td>30-03-2019</td><td>DARMO SUWITO</td><td>DARMO SUWITO
0610 D 04</td><td>PETANI/PEKEBUN</td><td>TANGGUNG RT02
RW05</td><td>TANGGUNG</td><td>GIRITONTRO</td><td>INDUK</td><td>dr.
BUDI ASHARI</td><td>SUGIYONO,S.Kep.Ns</td><td>L</td><td>>70 Thn.</td><td>Datang
></tr><tr><td align='right'>S01.1</td><td>Open wound of eyelid and periocular
area</td><td></td><td align='right'>290812</td><td
></tr><tr><td align='right'>S06.0</td><td>Concussion</td><td></td><td
align='right'>290822</td><td align='right'>57050170</td><td>30-03-2019</td><td>HARI
SURIPTO</td><td>HARI SURIPTO 0705 H 04</td><td>PEGAWAI NEGERI
SIPIL</td><td>SUKOROYOM KULON</td><td>SUKOROYOM
2019</td><td>KARTI</td><td>MISMAN 04 08 M 02</td><td>PETANI/PEKEBUN</td><td>NGANTAP
RT 03 RW 05</td><td>NGANTAP</td><td>BAYEMHARJO</td><td>INDUK</td><td>drg.DANAR
align='right'>56030023</td><td>30-03-2019</td><td>KASIRIN</td><td>KASIRIN 0603 K
align='right'>F20.5</td><td>Residual schizophrenia</td><td></td><td
2019</td><td>MARYANTI</td><td>MISDI 07 02 M 10</td><td>LAINNYA</td><td>SUKOROYOM
ASHARI</td><td>SRI MURWATININGSIH</td><td>L</td><td><1 Thn.</td><td>Datang
align='right'>56020433</td><td>30-03-2019</td><td>NABILA ADINDA</td><td>PAIMAN
0602 P 06</td><td>PERANGKAT DESA</td><td>GIRITONTRO KIDUL</td><td>GIRITONTRO
align='right'>57130142</td><td>30-03-2019</td><td>PARNI</td><td>TIREJO SOMIN 0713
T 03</td><td>PETANI/PEKEBUN</td><td>KEPUH RT03
d></tr><tr><td align='right'>J44.9</td><td>Chronic obstructive pulmonary disease,
align='right'>52070005</td><td>30-03-2019</td><td>PONIJAN</td><td>PONIJAN 0207 P
02</td><td>PELAJAR/MAHASISWA</td><td>SUMBERJO
RT02/04</td><td>SUMBERJO</td><td>TLOGOSARI</td><td>INDUK</td><td>dr. BUDI
align='right'>54060008</td><td>30-03-2019</td><td>ROHKAYATI</td><td>SUKRISTIANTO
04 06 S 02</td><td>MENGURUS RUMAH TANGGA</td><td>BAYEM RT01
align='right'>56050031</td><td>30-03-2019</td><td>SAKIDI</td><td>SAKIDI 06 05 S
13</td><td>PETANI/PEKEBUN</td><td>NGUJUNG RT04
align='right'>53080029</td><td>30-03-2019</td><td>SALSABILA</td><td>BEJO 0308 B
01</td><td>PELAJAR/MAHASISWA</td><td>GINADE KULON RT01 RW03</td><td>GINADE
KULON</td><td>TLOGOHARJO</td><td>INDUK</td><td>drg.DANAR WULANDARI</td><td>RIZKI
/td></tr><tr><td align='right'>L20.8</td><td>Other atopic
align='right'>56080128</td><td>30-03-2019</td><td>SUNARSI</td><td>SUWANDI 06 08
S17</td><td>PETANI/PEKEBUN</td><td>DUNGKLEPU WETAN</td><td>DUNG KLEPU
align='right'>M79.16</td><td>Myalgia, lower leg</td><td></td><td
2019</td><td>SUPARSI</td><td>IMAM PAHRUDIN 0401 I
01</td><td>PETANI/PEKEBUN</td><td>BELEH RT 02 RW
align='right'>56080300</td><td>30-03-2019</td><td>YASMINE
NAURALIA</td><td>SUKATMIN/IBRAHIM 0608 S 10</td><td>BELUM/TIDAK
BEKERJA</td><td>DUNGKLEPU
WETAN </td><td>DUNG KLEPU WETAN</td><td>GIRITONTRO</td><td>INDUK</td><td>dr. BUDI
ASHARI</td><td>SRI MURWATININGSIH</td><td>P</td><td><1 Thn.</td><td>Datang
Wilayah</td><td>'</td><td>'</td><td>70</td><td>50</td></tr></table>

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<h2>DATA DIAGNOSIS PASIEN PUSKESMAS</h2>

Periode : 01-03-2019 s/d 31-03-2019<br>

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