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DAFTAR KUNJUNGAN PESERTA SAKIT

Kantor Cabang : BEKASI - 1011

FKTP : Klinik Mitra Medika - 0137U004

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

1 31-03-2018 0137U0040318Y003777 0000041128604 YB SUNARSA L PENERIMA PENSIUN Dental caries, unspecified Berobat Jalan
PNS
2 31-03-2018 0137U0040318Y003798 0000041516976 SRI JUMIATY P PNS DAERAH Myalgia Berobat Jalan

3 31-03-2018 0137U0040318Y003840 0000042101414 JULIANA ELLEN TEHUPEIORY P PENERIMA PENSIUN Acute upper respiratory Berobat Jalan
PNS infection, unspecified
4 31-03-2018 0137U0040318Y003835 0000043459266 RB BAMBANG SUDEWO L PENERIMA PENSIUN Myalgia Berobat Jalan
PNS
5 31-03-2018 0137U0040318Y003733 0000073252855 HELMAN SYACHRI L PENERIMA PENSIUN Respiratory tuberculosis Rujuk Lanjut
PNS unspecified, confirmed
bacteriologically and

6 31-03-2018 0137U0040318Y003838 0000073399937 TUTI RUKMIATI P PNS DAERAH Dyspepsia Berobat Jalan

7 31-03-2018 0137U0040318Y003743 0000073403559 YAYAH MARYAH P PNS DAERAH Acute upper respiratory Berobat Jalan
infection, unspecified
8 31-03-2018 0137U0040318Y003778 0000100561285 ANDRI PRABOWO L PNS PUSAT Impacted teeth Berobat Jalan

9 31-03-2018 0137U0040318Y003796 0000163597893 JIHAN ZAHIRAH P PNS DAERAH Other and unspecified Berobat Jalan
abdominal pain
10 31-03-2018 0137U0040318Y003822 0000165794681 PUTRI ADINDA LUTHFIYANI P PNS DAERAH Acute pharyngitis, Berobat Jalan
unspecified
11 31-03-2018 0137U0040318Y003740 0000204268072 MUGI LESTARI P PNS PUSAT Impacted teeth Rujuk Lanjut

12 31-03-2018 0137U0040318Y003759 0000274041112 RATNA SOVIA DEWI P PEGAWAI SWASTA Acute upper respiratory Berobat Jalan
infection, unspecified
13 31-03-2018 0137U0040318Y003762 0000977343333 JOVAN FAIREL ATHARIZZ L PNS PUSAT Dermatitis herpetiformis Berobat Jalan

14 31-03-2018 0137U0040318Y003767 0001013878394 LUTHFIAH P PBI (APBN) Acute upper respiratory Berobat Jalan
infection, unspecified
15 31-03-2018 0137U0040318Y003741 0001154691527 SUGENG HANDOYO L PEGAWAI SWASTA Disorder of refraction, Rujuk Lanjut
unspecified
16 31-03-2018 0137U0040318Y003805 0001193328573 Aqilla Putri Nurassyifa P PEGAWAI SWASTA Acute upper respiratory Berobat Jalan
infection, unspecified
17 31-03-2018 0137U0040318Y003810 0001200623038 AQILAALESHAPUTRI DEYANA L PEGAWAI SWASTA Abrasion of teeth Berobat Jalan

18 31-03-2018 0137U0040318Y003839 0001204199987 THALITA ALSHIRA P PEGAWAI SWASTA Irregular menstruation, Berobat Jalan
unspecified
19 31-03-2018 0137U0040318Y003821 0001256013145 SINTYA HANDAYANI P PEKERJA MANDIRI Other specified Rujuk Lanjut
noninflammatory disorders

20 31-03-2018 0137U0040318Y003789 0001256584871 FAJAR FEBRYAN L PEKERJA MANDIRI Impacted teeth Berobat Jalan

21 31-03-2018 0137U0040318Y003780 0001258952771 TUTWURI HANDAYANI P PEGAWAI SWASTA Necrosis of pulp Berobat Jalan
DAFTAR KUNJUNGAN PESERTA SAKIT

Kantor Cabang : BEKASI - 1011

FKTP : Klinik Mitra Medika - 0137U004

22 31-03-2018 0137U0040318Y003834 0001259114984 SAMUEL SIMANJUNTAK L PEKERJA MANDIRI Gastro-oesophageal reflux Berobat Jalan
disease without

23 31-03-2018 0137U0040318Y003808 0001259233839 BONG POSUN FRANSISKUS L PEKERJA MANDIRI Dental caries, unspecified Berobat Jalan

24 31-03-2018 0137U0040318Y003809 0001259238609 FLORENTINE PHOEI P PEKERJA MANDIRI Dental caries, unspecified Berobat Jalan

25 31-03-2018 0137U0040318Y003750 0001260175566 HARIS L PEKERJA MANDIRI Acute upper respiratory Berobat Jalan
infection, unspecified
26 31-03-2018 0137U0040318Y003801 0001286829112 ARI THIONI, AMD P PEGAWAI SWASTA Twin pregnancy Rujuk Lanjut

27 31-03-2018 0137U0040318Y003742 0001302918052 MUHAMMAD HASYIM L PEGAWAI SWASTA Pyothorax without fistula Berobat Jalan

28 31-03-2018 0137U0040318Y003766 0001312245843 LEONARDO SUBIANTO L PEKERJA MANDIRI Acute upper respiratory Berobat Jalan
infection, unspecified
29 31-03-2018 0137U0040318Y003783 0001313176173 SANIMAN L PEKERJA MANDIRI Dental caries, unspecified Berobat Jalan

30 31-03-2018 0137U0040318Y003755 0001320195756 MOH. SARDY L PEKERJA MANDIRI Acute upper respiratory Berobat Jalan
infection, unspecified
31 31-03-2018 0137U0040318Y003760 0001370363501 AMIRA SANIYYAH PUTRI P PEGAWAI BUMN Other and unspecified Berobat Jalan
abdominal pain
32 31-03-2018 0137U0040318Y003770 0001370634546 KARNIAH P PNS PUSAT Acute upper respiratory Berobat Jalan
infection, unspecified
33 31-03-2018 0137U0040318Y003828 0001385156147 MARI JULIANA P PEKERJA MANDIRI Other specified headache Berobat Jalan
syndromes
34 31-03-2018 0137U0040318Y003757 0001402633282 WINUR KASIH P PEGAWAI SWASTA Acute pharyngitis, Berobat Jalan
unspecified
35 31-03-2018 0137U0040318Y003781 0001407711644 RINI HASTUTI P PEGAWAI SWASTA Impacted teeth Berobat Jalan

36 31-03-2018 0137U0040318Y003764 0001424080945 EKA RIZKI LANTIKA SARI P PEGAWAI SWASTA Dyspepsia Berobat Jalan

37 31-03-2018 0137U0040318Y003765 0001430860612 rachel natalyne djahatela P PEKERJA MANDIRI Acute upper respiratory Berobat Jalan
infection, unspecified
38 31-03-2018 0137U0040318Y003753 0001435134273 PIPIT SOPIAH P PEKERJA MANDIRI Myalgia Berobat Jalan

39 31-03-2018 0137U0040318Y003817 0001435715954 RHEICA TANAH DJAYA P PEGAWAI SWASTA Impacted teeth Berobat Jalan

40 31-03-2018 0137U0040318Y003844 0001451048477 hilary kharisma nauli sitanggang P PNS PUSAT Acute upper respiratory Berobat Jalan
infection, unspecified
41 31-03-2018 0137U0040318Y003843 0001451049862 PUTRI CHARLENE MEISY P PNS PUSAT Acute upper respiratory Berobat Jalan
SITANGGANG infection, unspecified
42 31-03-2018 0137U0040318Y003788 0001452417311 AMIRUDDIN YUSUP L PEKERJA MANDIRI Impacted teeth Berobat Jalan

43 31-03-2018 0137U0040318Y003785 0001455057213 HENNIH P PEGAWAI SWASTA Dental caries, unspecified Berobat Jalan

44 31-03-2018 0137U0040318Y003782 0001455660156 JOKO SUGIANTO MANALU P PEGAWAI SWASTA Dental caries, unspecified Berobat Jalan
DAFTAR KUNJUNGAN PESERTA SAKIT

Kantor Cabang : BEKASI - 1011

FKTP : Klinik Mitra Medika - 0137U004

45 31-03-2018 0137U0040318Y003774 0001455707643 FABIAN MAHESA PRATAMA L PEKERJA MANDIRI Acute upper respiratory Berobat Jalan
infection, unspecified
46 31-03-2018 0137U0040318Y003729 0001459032153 JUJU P PEKERJA MANDIRI Benign lipomatous Rujuk Lanjut
neoplasm
47 31-03-2018 0137U0040318Y003748 0001460428255 SUPRIYATIN P PEKERJA MANDIRI Acute upper respiratory Berobat Jalan
infection, unspecified
48 31-03-2018 0137U0040318Y003786 0001461878469 KUSNA NINGSIH P PEKERJA MANDIRI Dental caries, unspecified Berobat Jalan

49 31-03-2018 0137U0040318Y003807 0001463024698 TJHIA MIE HWA P PEKERJA MANDIRI Impacted teeth Berobat Jalan

50 31-03-2018 0137U0040318Y003800 0001467832443 H.AININ SAPUTRA L PEKERJA MANDIRI Other secondary arthrosis Berobat Jalan

51 31-03-2018 0137U0040318Y003815 0001471883332 MAWAR ESTYNINGRUM P PEKERJA MANDIRI Dental caries, unspecified Berobat Jalan

52 31-03-2018 0137U0040318Y003768 0001473351456 ACHMAD CHAVIDH L PEKERJA MANDIRI Myalgia Berobat Jalan

53 31-03-2018 0137U0040318Y003804 0001480377802 EFI AFAROH P PEGAWAI SWASTA Gastro-oesophageal reflux Berobat Jalan
disease without

54 31-03-2018 0137U0040318Y003813 0001610263078 TUMINO L PEGAWAI SWASTA Impacted teeth Berobat Jalan

55 31-03-2018 0137U0040318Y003738 0001623342971 YOGA DWI WICAKSONO L PEGAWAI SWASTA Developmental disorder of Rujuk Lanjut
speech and language,

56 31-03-2018 0137U0040318Y003769 0001625620059 AIRELL KEITARO BAKTI L PEGAWAI SWASTA Acute upper respiratory Berobat Jalan
infection, unspecified
57 31-03-2018 0137U0040318Y003739 0001631493876 ALPHA MARTYANTA L PEGAWAI SWASTA Non-insulin-dependent Rujuk Lanjut
diabetes mellitus with

58 31-03-2018 0137U0040318Y003831 0001638838102 EDDY SARTONO L PEGAWAI BUMN Acute upper respiratory Berobat Jalan
infection, unspecified
59 31-03-2018 0137U0040318Y003814 0001639630304 FERDINATA KUSUMA L PEGAWAI SWASTA Dental caries, unspecified Berobat Jalan

60 31-03-2018 0137U0040318Y003833 0001639630315 HERMAYANTI P PEGAWAI SWASTA Acute pharyngitis, Berobat Jalan
unspecified
61 31-03-2018 0137U0040318Y003819 0001639803789 ROSITA P PEGAWAI SWASTA Dermatitis herpetiformis Berobat Jalan

62 31-03-2018 0137U0040318Y003842 0001643408831 Zoelfah TRI YUNI P PEKERJA MANDIRI Acute upper respiratory Berobat Jalan
infection, unspecified
63 31-03-2018 0137U0040318Y003736 0001647178874 DIAN KOESBANDONO L PEKERJA MANDIRI Low back pain, site Rujuk Lanjut
unspecified
64 31-03-2018 0137U0040318Y003816 0001648458538 DINDA HARIPRIANA L PEKERJA MANDIRI Impacted teeth Berobat Jalan

65 31-03-2018 0137U0040318Y003824 0001650864418 M ASIKIN ARDIYANTO L PEGAWAI SWASTA Acute upper respiratory Berobat Jalan
infection, unspecified
66 31-03-2018 0137U0040318Y003823 0001650864429 RENA FATIMAH LUBIS P PEGAWAI SWASTA Acute upper respiratory Berobat Jalan
infection, unspecified
DAFTAR KUNJUNGAN PESERTA SAKIT

Kantor Cabang : BEKASI - 1011

FKTP : Klinik Mitra Medika - 0137U004

67 31-03-2018 0137U0040318Y003732 0001655555253 MARVEL ARDINI PUTRA L PEKERJA MANDIRI Childhood autism Rujuk Lanjut

68 31-03-2018 0137U0040318Y003836 0001658992252 DRS.CECE HIDAYAT L PEGAWAI BUMD Dermatitis herpetiformis Berobat Jalan

69 31-03-2018 0137U0040318Y003735 0001716295285 SUSWANTARI P PEGAWAI SWASTA Benign paroxysmal vertigo Rujuk Lanjut

70 31-03-2018 0137U0040318Y003731 0001720454231 SUTIAH P PEKERJA MANDIRI Cataract, unspecified Rujuk Lanjut

71 31-03-2018 0137U0040318Y003752 0001722574258 FARREL ATTAYA RADITYA L PEKERJA MANDIRI Typhoid fever Berobat Jalan

72 31-03-2018 0137U0040318Y003776 0001722574822 LIZA SAKINAH P PEKERJA MANDIRI Acute upper respiratory Berobat Jalan
infection, unspecified
73 31-03-2018 0137U0040318Y003830 0001742296432 MOHAMMAD MUTAMAM L PEGAWAI SWASTA Myalgia Berobat Jalan

74 31-03-2018 0137U0040318Y003779 0001769446552 KONRISTA VIN YECIA P PEGAWAI SWASTA Impacted teeth Berobat Jalan

75 31-03-2018 0137U0040318Y003799 0001774477686 DAFFA RIZQY MAULANA L PEGAWAI SWASTA Acute upper respiratory Berobat Jalan
infection, unspecified
76 31-03-2018 0137U0040318Y003841 0001785239831 RUSHAYATI P PEKERJA MANDIRI Acute upper respiratory Berobat Jalan
infection, unspecified
77 31-03-2018 0137U0040318Y003818 0001792317396 ALEX APRIAN RAMADHAN L PEKERJA MANDIRI Necrosis of pulp Rujuk Lanjut

78 31-03-2018 0137U0040318Y003787 0001794844719 DADANG DARSONO L PEKERJA MANDIRI Loss of teeth due to Berobat Jalan
accident, extraction or

79 31-03-2018 0137U0040318Y003730 0001794933731 SUHARTIYAH P PEKERJA MANDIRI Soft tissue disorder, Rujuk Lanjut
unspecified
80 31-03-2018 0137U0040318Y003806 0001829579343 SULTAN MURIA S L PEKERJA MANDIRI Acute upper respiratory Berobat Jalan
infection, unspecified
81 31-03-2018 0137U0040318Y003734 0001831405138 VERONICA HARI SUDIBYORINI P PEKERJA MANDIRI Fever, unspecified Rujuk Lanjut

82 31-03-2018 0137U0040318Y003784 0001839566968 NENIH P PEGAWAI SWASTA Impacted teeth Berobat Jalan

83 31-03-2018 0137U0040318Y003758 0001860235751 ZAHRA JEHAN ERLANGGA P PEGAWAI SWASTA Acute upper respiratory Berobat Jalan
infection, unspecified
84 31-03-2018 0137U0040318Y003792 0001866374313 Daryl Athalla Khalif L PEGAWAI SWASTA Fracture of navicular Rujuk Lanjut
[scaphoid] bone of hand ,

85 31-03-2018 0137U0040318Y003791 0001866728046 ROMI ERA SETIAWAN L PEGAWAI SWASTA Dental caries, unspecified Berobat Jalan

86 31-03-2018 0137U0040318Y003737 0001876416489 GRACIA KINANTI HERAWATY P PEGAWAI SWASTA Other developmental Rujuk Lanjut
BASUKI disorders of speech and

87 31-03-2018 0137U0040318Y003747 0001895225242 achmad adya surya L PEKERJA MANDIRI Diarrhoea and Berobat Jalan
gastroenteritis of
presumed infectious origin
DAFTAR KUNJUNGAN PESERTA SAKIT

Kantor Cabang : BEKASI - 1011

FKTP : Klinik Mitra Medika - 0137U004

88 31-03-2018 0137U0040318Y003745 0001898812359 DAVID KARUNA GULDI L PEKERJA MANDIRI Dermatitis herpetiformis Berobat Jalan

89 31-03-2018 0137U0040318Y003744 0001898812438 KASSAvA GULDI L PEKERJA MANDIRI Pyothorax without fistula Berobat Jalan

90 31-03-2018 0137U0040318Y003827 0001962090549 AHMAD ZAFRAN ALFARIZI L PEGAWAI SWASTA Acute pharyngitis, Berobat Jalan
unspecified
91 31-03-2018 0137U0040318Y003826 0001968625315 aulia davina az'zahra P PEGAWAI SWASTA Acute pharyngitis, Berobat Jalan
unspecified
92 31-03-2018 0137U0040318Y003829 0002067565149 VIONA SHINTYA L PEKERJA MANDIRI Acute upper respiratory Berobat Jalan
infection, unspecified
93 31-03-2018 0137U0040318Y003790 0002077186252 LUKMAN L PEKERJA MANDIRI Impacted teeth Berobat Jalan

94 31-03-2018 0137U0040318Y003772 0002077186375 ARMAINI TATI P PEKERJA MANDIRI Other secondary arthrosis Berobat Jalan

95 31-03-2018 0137U0040318Y003837 0002078229251 el rafif shaka haryandi L PEKERJA MANDIRI Acute upper respiratory Berobat Jalan
infection, unspecified
96 31-03-2018 0137U0040318Y003773 0002081563986 khalil mumtaz lukmana L PEKERJA MANDIRI Acute upper respiratory Berobat Jalan
infection, unspecified
97 31-03-2018 0137U0040318Y003763 0002085654835 KAYLA APRILIA JASMIN P PEGAWAI SWASTA Gastro-oesophageal reflux Berobat Jalan
disease without

98 31-03-2018 0137U0040318Y003825 0002096151309 WIDJANARKO L PEGAWAI SWASTA Dermatitis herpetiformis Berobat Jalan

99 31-03-2018 0137U0040318Y003751 0002097932725 SUTARDI L PEGAWAI SWASTA Other specified headache Berobat Jalan
syndromes
100 31-03-2018 0137U0040318Y003754 0002136065163 ALVIES L PEGAWAI SWASTA Myalgia Berobat Jalan

101 31-03-2018 0137U0040318Y003749 0002137476126 AI NURHAYATI P PEGAWAI SWASTA Vertigo of central origin Berobat Jalan

102 31-03-2018 0137U0040318Y003775 0002203741686 MAULA ZIZOU JULIANDO S L PEGAWAI SWASTA Acute upper respiratory Berobat Jalan
infection, unspecified
103 31-03-2018 0137U0040318Y003795 0002208643479 CARSA WAHYUDI L PEGAWAI SWASTA Multiple superficial injuries, Rujuk Lanjut
unspecified
104 31-03-2018 0137U0040318Y003756 0002209911939 SUMIYATI P PEKERJA MANDIRI Other secondary arthrosis Berobat Jalan

105 31-03-2018 0137U0040318Y003820 0002217123257 DEDE SUANDI L PEGAWAI SWASTA Other specified headache Berobat Jalan
syndromes
106 31-03-2018 0137U0040318Y003797 0002229738142 FIKA KAMALIAH P PEKERJA MANDIRI Dyspepsia Berobat Jalan

107 31-03-2018 0137U0040318Y003746 0002230546544 HUSEN L PEKERJA MANDIRI Dyspepsia Berobat Jalan

108 31-03-2018 0137U0040318Y003794 0002232444295 TERIYANI ZAI P PEKERJA MANDIRI Acute pharyngitis, Berobat Jalan
unspecified
109 31-03-2018 0137U0040318Y003771 0002240385535 NADINE PUTRI KEISHA SAGALA P PNS PUSAT Acute upper respiratory Berobat Jalan
infection, unspecified
110 31-03-2018 0137U0040318Y003793 0002266504211 IWAN GUNAWAN L PEKERJA MANDIRI Non-insulin-dependent Rujuk Lanjut
diabetes mellitus
DAFTAR KUNJUNGAN PESERTA SAKIT

Kantor Cabang : BEKASI - 1011

FKTP : Klinik Mitra Medika - 0137U004

111 31-03-2018 0137U0040318Y003803 0002266504626 FARHAN MUHAMMAD L PEKERJA MANDIRI Acute pharyngitis, Berobat Jalan
GUNAWAN unspecified
112 31-03-2018 0137U0040318Y003802 0002268839632 ANWAR SUNARYO L PBI (APBD) Gastro-oesophageal reflux Berobat Jalan
disease without

113 31-03-2018 0137U0040318Y003761 0002283677673 BaYi NY NURHAYATI P PEKERJA MANDIRI Dyspepsia Berobat Jalan

114 31-03-2018 0137U0040318Y003832 0002292169151 SEPTI LIA PUSPITA SARI P PEGAWAI SWASTA Myalgia Berobat Jalan

115 31-03-2018 0137U0040318Y003811 0002312787565 jubaidah P PEKERJA MANDIRI Impacted teeth Berobat Jalan

116 31-03-2018 0137U0040318Y003812 0002312788432 novia rosmawaty P PEKERJA MANDIRI Necrosis of pulp Berobat Jalan

117 30-03-2018 0137U0040318Y003706 0000040554483 HANIYA FAYZA NABILA P PNS PUSAT Acute upper respiratory Berobat Jalan
infection, unspecified
118 30-03-2018 0137U0040318Y003686 0000172522451 JEREMY TRISTAN TIO L PNS PUSAT Acute upper respiratory Berobat Jalan
PANDIANGAN infection, unspecified
119 30-03-2018 0137U0040318Y003671 0000202416333 MOHAMAD S HAMDANI L PENERIMA PENSIUN Acute upper respiratory Berobat Jalan
PNS infection, unspecified
120 30-03-2018 0137U0040318Y003675 0000211234926 HERLIN NOVIANTI P PNS DAERAH Maternal care due to Rujuk Lanjut
uterine scar from previous

121 30-03-2018 0137U0040318Y003659 0000509123136 AI YETTI P PBI (APBN) Acute upper respiratory Berobat Jalan
infection, unspecified
122 30-03-2018 0137U0040318Y003677 0001032596087 DYAH MEI ASTUTI ARIYANTI P PBI (APBN) Maternal care for known or Rujuk Lanjut
suspected abnormality of

123 30-03-2018 0137U0040318Y003685 0001080573208 JONATHAN FELIX PANDIANGAN L PNS PUSAT Acute upper respiratory Berobat Jalan
infection, unspecified
124 30-03-2018 0137U0040318Y003725 0001123279424 YOPIE L PEGAWAI SWASTA Other and unspecified Berobat Jalan
infectious diseases
125 30-03-2018 0137U0040318Y003683 0001143044853 FENNY TRI POERWANTO L PEGAWAI SWASTA Acute upper respiratory Berobat Jalan
infection, unspecified
126 30-03-2018 0137U0040318Y003679 0001163711722 NADIANUR AURELLIA P PEGAWAI SWASTA Acute upper respiratory Berobat Jalan
ALAMSYAH infection, unspecified
127 30-03-2018 0137U0040318Y003654 0001190561668 EVA LISTIA INDRA SUGIARTI P PEGAWAI SWASTA Pain and other conditions Rujuk Lanjut
associated with female
genital organs and
menstrual cycle

128 30-03-2018 0137U0040318Y003673 0001197514326 TINTIN NOVTIANA P PEGAWAI SWASTA Cerebellar stroke Rujuk Lanjut
syndrome
129 30-03-2018 0137U0040318Y003726 0001260330467 BUNGA SUKMA ALDELLA P PEKERJA MANDIRI Other specified headache Berobat Jalan
syndromes
DAFTAR KUNJUNGAN PESERTA SAKIT

Kantor Cabang : BEKASI - 1011

FKTP : Klinik Mitra Medika - 0137U004

130 30-03-2018 0137U0040318Y003655 0001262927676 FIRMANSYAH SOEBANA L PEKERJA MANDIRI Non-insulin-dependent Berobat Jalan
ATMAJA diabetes mellitus with

131 30-03-2018 0137U0040318Y003680 0001263379239 HJ. MIMI SUHAEMI P PEKERJA MANDIRI Acute upper respiratory Berobat Jalan
infection, unspecified
132 30-03-2018 0137U0040318Y003717 0001278383422 YANTI SUNARTI P PEKERJA MANDIRI Dermatitis herpetiformis Berobat Jalan

133 30-03-2018 0137U0040318Y003716 0001278383758 RUMAISHA HASNAH SUFYAN P PEKERJA MANDIRI Acute upper respiratory Berobat Jalan
infection, unspecified
134 30-03-2018 0137U0040318Y003699 0001280259112 neneng suryanah P PEKERJA MANDIRI Dyspepsia Berobat Jalan

135 30-03-2018 0137U0040318Y003664 0001284230215 BASTIAN ROBINTANG SS L PEGAWAI SWASTA Acute upper respiratory Berobat Jalan
infection, unspecified
136 30-03-2018 0137U0040318Y003702 0001285603154 HENNY VERONICA P PEGAWAI SWASTA Acute upper respiratory Berobat Jalan
infection, unspecified
137 30-03-2018 0137U0040318Y003667 0001297586272 NURRANI SRI Maretiani P PENERIMA PENSIUN Acute upper respiratory Berobat Jalan
SWASTA infection, unspecified
138 30-03-2018 0137U0040318Y003689 0001305439255 Reni Oktora P PEGAWAI SWASTA Acute upper respiratory Berobat Jalan
infection, unspecified
139 30-03-2018 0137U0040318Y003682 0001306629742 PALGUNADI SATRIOPAMBUDI L PEKERJA MANDIRI Acute pharyngitis, Berobat Jalan
unspecified
140 30-03-2018 0137U0040318Y003691 0001315520919 ANIS SHOFWAN L PEKERJA MANDIRI Acute upper respiratory Berobat Jalan
infection, unspecified
141 30-03-2018 0137U0040318Y003662 0001327410584 MOHAMMAD TAHIR SALEH L PEGAWAI SWASTA Gastro-oesophageal reflux Berobat Jalan
disease without

142 30-03-2018 0137U0040318Y003687 0001336961362 EFENDI PANDIANGAN.SE L PEKERJA MANDIRI Myalgia Berobat Jalan

143 30-03-2018 0137U0040318Y003666 0001339467524 WIN NIO P PEKERJA MANDIRI Non-insulin-dependent Berobat Jalan
diabetes mellitus with

144 30-03-2018 0137U0040318Y003674 0001406389803 SUCI NURHAYATI P PEGAWAI SWASTA Maternal care for known or Rujuk Lanjut
suspected malpresentation

145 30-03-2018 0137U0040318Y003652 0001425043787 ENDI KARTUBI L PEKERJA MANDIRI Insulin-dependent Rujuk Lanjut
diabetes mellitus with

146 30-03-2018 0137U0040318Y003660 0001457701751 SYAHRUL RAMDANI L PEKERJA MANDIRI Stomatitis and related Berobat Jalan
lesions
147 30-03-2018 0137U0040318Y003703 0001459587137 NAYARA AFIFA L PEGAWAI SWASTA Acute upper respiratory Berobat Jalan
infection, unspecified
148 30-03-2018 0137U0040318Y003678 0001459737358 MASRUROH P PEKERJA MANDIRI Insulin-dependent Rujuk Lanjut
diabetes mellitus with

149 30-03-2018 0137U0040318Y003669 0001460024469 WIDI PUJA MOCH. RAMDHANI L PEGAWAI SWASTA Acute sinusitis Berobat Jalan
DAFTAR KUNJUNGAN PESERTA SAKIT

Kantor Cabang : BEKASI - 1011

FKTP : Klinik Mitra Medika - 0137U004

150 30-03-2018 0137U0040318Y003710 0001460954002 LIE CUN HAW L PEKERJA MANDIRI Other peripheral vertigo Rujuk Lanjut

151 30-03-2018 0137U0040318Y003719 0001460954158 EVY PURNAMASARI P PEKERJA MANDIRI Myalgia Berobat Jalan
SUTANDAR
152 30-03-2018 0137U0040318Y003694 0001462881431 PARIYAH P PEKERJA MANDIRI Hypermetropia Rujuk Lanjut

153 30-03-2018 0137U0040318Y003695 0001465869633 ATY WIDIARTI P PEGAWAI SWASTA Cataract, unspecified Rujuk Lanjut

154 30-03-2018 0137U0040318Y003701 0001467823307 ADE KARMINI P PEKERJA MANDIRI Other specified headache Berobat Jalan
syndromes
155 30-03-2018 0137U0040318Y003712 0001474330138 AJI PRAKOSO L PEKERJA MANDIRI Other miliary tuberculosis Rujuk Lanjut

156 30-03-2018 0137U0040318Y003661 0001624476453 FANDI OKMANTO L PEGAWAI SWASTA Acute upper respiratory Berobat Jalan
infection, unspecified
157 30-03-2018 0137U0040318Y003657 0001630345678 DIAN AYU SEKARTAJI P PEGAWAI SWASTA Acute upper respiratory Berobat Jalan
infection, unspecified
158 30-03-2018 0137U0040318Y003713 0001632040391 SUTARDI L PEGAWAI SWASTA Low back pain Rujuk Lanjut

159 30-03-2018 0137U0040318Y003658 0001632093737 MOCHAMMAD ADJIE L PEKERJA MANDIRI Nausea and vomiting Berobat Jalan
DHARMAWAN
160 30-03-2018 0137U0040318Y003718 0001632408917 PURNOMO L PEGAWAI SWASTA Acute upper respiratory Berobat Jalan
infection, unspecified
161 30-03-2018 0137U0040318Y003696 0001632408928 NENENG ROSANI P PEGAWAI SWASTA Myalgia Berobat Jalan

162 30-03-2018 0137U0040318Y003705 0001633962609 GINANJAR SANTOSO L PEGAWAI SWASTA Atopic dermatitis, Berobat Jalan
unspecified
163 30-03-2018 0137U0040318Y003707 0001634922033 CARINE KIELLA PONGOH P PEGAWAI SWASTA Acute upper respiratory Berobat Jalan
infection, unspecified
164 30-03-2018 0137U0040318Y003724 0001639107753 BIGI SERIDO L PEGAWAI SWASTA Acute upper respiratory Berobat Jalan
infection, unspecified
165 30-03-2018 0137U0040318Y003676 0001643914282 RAIHAAN FITRA L PEGAWAI SWASTA Developmental disorder of Rujuk Lanjut
speech and language,

166 30-03-2018 0137U0040318Y003690 0001651855555 HAMDANI L PEGAWAI SWASTA Dyspepsia Berobat Jalan

167 30-03-2018 0137U0040318Y003714 0001657146115 LIA APRIYANI P PEGAWAI SWASTA Myopia Rujuk Lanjut

168 30-03-2018 0137U0040318Y003681 0001718170323 NURIYAH P PEKERJA MANDIRI Acute upper respiratory Berobat Jalan
infection, unspecified
169 30-03-2018 0137U0040318Y003653 0001728278627 ROLIYAH P PENERIMA PENSIUN Unspecified viral infection Rujuk Lanjut
SWASTA characterized by skin and
mucous membrane lesions

170 30-03-2018 0137U0040318Y003663 0001728278638 ARDIYANSYAH,SH L PEKERJA MANDIRI Impacted cerumen Berobat Jalan

171 30-03-2018 0137U0040318Y003720 0001769601295 SACHIO IMTINAN L PEGAWAI SWASTA Acute upper respiratory Berobat Jalan
infection, unspecified
DAFTAR KUNJUNGAN PESERTA SAKIT

Kantor Cabang : BEKASI - 1011

FKTP : Klinik Mitra Medika - 0137U004

172 30-03-2018 0137U0040318Y003684 0001770078609 DESI NUR CAHAYANTI P PEGAWAI SWASTA Other and unspecified Berobat Jalan
abdominal pain
173 30-03-2018 0137U0040318Y003709 0001810704993 DWI DESSY BUDIYANTI P PEGAWAI SWASTA Acute upper respiratory Berobat Jalan
infection, unspecified
174 30-03-2018 0137U0040318Y003708 0001810708457 MUHAMMAD RIZKY GILANG L PEGAWAI SWASTA Acute upper respiratory Berobat Jalan
RAMADHAN infection, unspecified
175 30-03-2018 0137U0040318Y003722 0001820112309 SUJADI L PEGAWAI SWASTA Acute upper respiratory Berobat Jalan
infection, unspecified
176 30-03-2018 0137U0040318Y003728 0001845669407 NURUL KIKO YUANITA P PEKERJA MANDIRI Other antenatal screening Berobat Jalan

177 30-03-2018 0137U0040318Y003668 0001847201409 ARSHA PUJA MAHESA L PEGAWAI SWASTA Acute upper respiratory Berobat Jalan
infection, unspecified
178 30-03-2018 0137U0040318Y003670 0001860169105 JUFRAN L PEKERJA MANDIRI Acute upper respiratory Berobat Jalan
infection, unspecified
179 30-03-2018 0137U0040318Y003698 0001861598463 raihan rayi habibi L PEKERJA MANDIRI Acute upper respiratory Berobat Jalan
infection, unspecified
180 30-03-2018 0137U0040318Y003715 0001871888703 raisya kayla nurhasanah P PEKERJA MANDIRI Dermatitis herpetiformis Berobat Jalan

181 30-03-2018 0137U0040318Y003656 0001904173661 NURLIA MUHARI P PEKERJA MANDIRI Acute upper respiratory Berobat Jalan
infection, unspecified
182 30-03-2018 0137U0040318Y003727 0001962224144 NAURA NADHIFA ANNIDA P PEGAWAI SWASTA Myalgia Berobat Jalan

183 30-03-2018 0137U0040318Y003721 0001969544474 DANU RAMADAN L PEKERJA MANDIRI Other and unspecified Berobat Jalan
infectious diseases
184 30-03-2018 0137U0040318Y003672 0002070784697 IQBAL RIZKY RAFARDHAN L PEKERJA MANDIRI Other complications of Rujuk Lanjut
labour and delivery, not

185 30-03-2018 0137U0040318Y003700 0002078437296 QANITA FARANISA JANUAR P PEGAWAI SWASTA Dermatitis herpetiformis Berobat Jalan

186 30-03-2018 0137U0040318Y003693 0002084448014 MELI YULIANTI P PEKERJA MANDIRI Myopia Rujuk Lanjut

187 30-03-2018 0137U0040318Y003665 0002221982741 CORDELIA HAMIYAH P PEGAWAI SWASTA Acute upper respiratory Berobat Jalan
infection, unspecified
188 30-03-2018 0137U0040318Y003688 0002246038806 SOFIA P PEKERJA MANDIRI Dermatitis herpetiformis Berobat Jalan

189 30-03-2018 0137U0040318Y003723 0002248413592 NAUFAL HAKIM SUNIARAGA L PNS DAERAH Multiple superficial injuries, Berobat Jalan
unspecified
190 30-03-2018 0137U0040318Y003704 0002302254044 BRIGITTA YOVELLA JOCELYN P PEKERJA MANDIRI Acute upper respiratory Berobat Jalan
infection, unspecified
191 30-03-2018 0137U0040318Y003697 0002307128242 NAZRIEL SOLEH IBRAHIM L PEGAWAI SWASTA Acute upper respiratory Berobat Jalan
infection, unspecified
192 30-03-2018 0137U0040318Y003692 0002325122021 NURYANTI SIANIPAR, P PEKERJA MANDIRI Impacted teeth Berobat Jalan

193 30-03-2018 0137U0040318Y003711 0002432045092 ANNISA EKA PUTRI P PEKERJA MANDIRI Other antenatal screening Berobat Jalan
DAFTAR KUNJUNGAN PESERTA SAKIT

Kantor Cabang : BEKASI - 1011

FKTP : Klinik Mitra Medika - 0137U004

194 29-03-2018 0137U0040318Y003637 0000042120865 MAULIDDINA AMALIA P PEGAWAI SWASTA Acute upper respiratory Berobat Jalan
infection, unspecified
195 29-03-2018 0137U0040318Y003543 0000043735904 PHILIP A KANA L PNS PUSAT Disorder of refraction, Rujuk Lanjut
unspecified
196 29-03-2018 0137U0040318Y003621 0000072445735 ROBIATUL ADAWIYAH P PNS PUSAT Acute upper respiratory Berobat Jalan
infection, unspecified
197 29-03-2018 0137U0040318Y003565 0000073267648 RAMELAN L PENERIMA PENSIUN Dermatitis herpetiformis Berobat Jalan
PNS
198 29-03-2018 0137U0040318Y003563 0000073272003 TITIN SUPRAPTI P PENERIMA PENSIUN TNI Other specified headache Berobat Jalan
syndromes
199 29-03-2018 0137U0040318Y003557 0000073400591 CUCU ARIYANI P PNS DAERAH Acute upper respiratory Berobat Jalan
infection, unspecified
200 29-03-2018 0137U0040318Y003576 0000073570882 FARIDA PURWANTI HASSAN P PNS DAERAH Impacted teeth Berobat Jalan

201 29-03-2018 0137U0040318Y003617 0000149438845 TRIANI PUJI HASTUTI P PNS DAERAH Other and unspecified Berobat Jalan
abdominal pain
202 29-03-2018 0137U0040318Y003618 0000202416333 MOHAMAD S HAMDANI L PENERIMA PENSIUN Secondary hypertension, Berobat Jalan
PNS unspecified
203 29-03-2018 0137U0040318Y003578 0000204391449 NUR RAKHIM ARIF L PNS DAERAH Impacted teeth Berobat Jalan

204 29-03-2018 0137U0040318Y003622 0001081814106 ERINA ALIFIA RAZID P PNS PUSAT Dyspepsia Berobat Jalan

205 29-03-2018 0137U0040318Y003582 0001123259602 DEDI ISKANDAR L PEKERJA MANDIRI Dyspepsia Berobat Jalan

206 29-03-2018 0137U0040318Y003540 0001128642006 SAMAN SUHENDAR L PEGAWAI SWASTA Non-insulin-dependent Rujuk Lanjut
diabetes mellitus
207 29-03-2018 0137U0040318Y003615 0001135603102 HERMIN HERISMIANI P PEGAWAI SWASTA Acute upper respiratory Berobat Jalan
infection, unspecified
208 29-03-2018 0137U0040318Y003593 0001154809405 YULI YANTI LESTARI P PEGAWAI SWASTA Prolonged pregnancy Rujuk Lanjut

209 29-03-2018 0137U0040318Y003651 0001181971304 FEBRIANA TRULLY P PEGAWAI SWASTA Impacted teeth Berobat Jalan
TAKUMANSANG
210 29-03-2018 0137U0040318Y003596 0001257894821 ATJEP SUKARDI L PEKERJA MANDIRI Acute upper respiratory Berobat Jalan
infection, unspecified
211 29-03-2018 0137U0040318Y003601 0001259238609 FLORENTINE PHOEI P PEKERJA MANDIRI Acute upper respiratory Berobat Jalan
infection, unspecified
212 29-03-2018 0137U0040318Y003602 0001259264709 REINALDO CHRISTIAN BENA L PEKERJA MANDIRI Mixed asthma Berobat Jalan

213 29-03-2018 0137U0040318Y003589 0001259559371 ASNANI P PEKERJA MANDIRI Dermatitis herpetiformis Berobat Jalan

214 29-03-2018 0137U0040318Y003649 0001259852398 DEWI HERAWATI P PEKERJA MANDIRI Impacted teeth Berobat Jalan

215 29-03-2018 0137U0040318Y003603 0001275350073 MARKUS TIRTO DARMADI L PEKERJA MANDIRI Acute upper respiratory Berobat Jalan
infection, unspecified
216 29-03-2018 0137U0040318Y003594 0001284895405 NURAINI P PEKERJA MANDIRI Amenorrhoea, unspecified Rujuk Lanjut
DAFTAR KUNJUNGAN PESERTA SAKIT

Kantor Cabang : BEKASI - 1011

FKTP : Klinik Mitra Medika - 0137U004

217 29-03-2018 0137U0040318Y003537 0001287160571 RUDI NAPITULU L PEKERJA MANDIRI Benign paroxysmal vertigo Rujuk Lanjut

218 29-03-2018 0137U0040318Y003538 0001290608098 IWAN RIDWAN INDARI L PEKERJA MANDIRI Disorder of refraction, Rujuk Lanjut
unspecified
219 29-03-2018 0137U0040318Y003592 0001295516924 RANDY CHRISTIAN L PEKERJA MANDIRI Acute upper respiratory Berobat Jalan
infection, unspecified
220 29-03-2018 0137U0040318Y003636 0001297924446 F.ERNA SUSWIYANDANI P PEKERJA MANDIRI Dyspepsia Berobat Jalan

221 29-03-2018 0137U0040318Y003632 0001298634704 SARNIiN KURNIAWAN L PEKERJA MANDIRI Acute upper respiratory Berobat Jalan
infection, unspecified
222 29-03-2018 0137U0040318Y003607 0001313176959 SUPARMI P PEKERJA MANDIRI Hypothyroidism, Rujuk Lanjut
unspecified
223 29-03-2018 0137U0040318Y003575 0001323570846 LIM SIN HOA P PEKERJA MANDIRI Impacted teeth Berobat Jalan

224 29-03-2018 0137U0040318Y003535 0001325452465 TJOA PON NIO P PEKERJA MANDIRI Non-insulin-dependent Rujuk Lanjut
diabetes mellitus
225 29-03-2018 0137U0040318Y003630 0001335502304 PUTRI HOLONG LEONITA P PEKERJA MANDIRI Oedema, unspecified Berobat Jalan

226 29-03-2018 0137U0040318Y003555 0001336569445 UUM UNARSIH P PEKERJA MANDIRI Dermatitis herpetiformis Berobat Jalan

227 29-03-2018 0137U0040318Y003611 0001337084875 YOHANES DJONO SUWITO L PEKERJA MANDIRI Myalgia Berobat Jalan

228 29-03-2018 0137U0040318Y003553 0001340014847 BASUNI L PEKERJA MANDIRI Acute upper respiratory Berobat Jalan
infection, unspecified
229 29-03-2018 0137U0040318Y003542 0001340069354 YENNI P PEKERJA MANDIRI Non-insulin-dependent Rujuk Lanjut
diabetes mellitus
230 29-03-2018 0137U0040318Y003595 0001340075395 YANI KUMALAWATI P PEGAWAI SWASTA Disorders of lacrimal Rujuk Lanjut
system
231 29-03-2018 0137U0040318Y003558 0001379790325 MARLON PAMO L PEKERJA MANDIRI Gastritis, unspecified Rujuk Lanjut

232 29-03-2018 0137U0040318Y003624 0001381643706 LINDA ROSE ISKANDAR P PEKERJA MANDIRI Acute upper respiratory Berobat Jalan
infection, unspecified
233 29-03-2018 0137U0040318Y003626 0001404071032 LIMANTOKO L PEGAWAI SWASTA Acute upper respiratory Berobat Jalan
infection, unspecified
234 29-03-2018 0137U0040318Y003627 0001404071054 RAAFAT A'ZAM LIMANSYAH L PEGAWAI SWASTA Acute upper respiratory Berobat Jalan
infection, unspecified
235 29-03-2018 0137U0040318Y003584 0001442452285 YO TJIN LAN P PEKERJA MANDIRI Acute upper respiratory Berobat Jalan
infection, unspecified
236 29-03-2018 0137U0040318Y003588 0001447397897 SOEJIEM HADI SUDARSONO P PEKERJA MANDIRI Acute upper respiratory Berobat Jalan
infection, unspecified
237 29-03-2018 0137U0040318Y003590 0001452684317 SITI HAWA P PENERIMA PENSIUN Acute upper respiratory Berobat Jalan
SWASTA infection, unspecified
238 29-03-2018 0137U0040318Y003580 0001454593757 MIMI SUMIATI P PEKERJA MANDIRI Dental caries, unspecified Berobat Jalan

239 29-03-2018 0137U0040318Y003548 0001455655667 WINARTI P PNS PUSAT Disorder of refraction, Rujuk Lanjut
unspecified
DAFTAR KUNJUNGAN PESERTA SAKIT

Kantor Cabang : BEKASI - 1011

FKTP : Klinik Mitra Medika - 0137U004

240 29-03-2018 0137U0040318Y003613 0001455707643 FABIAN MAHESA PRATAMA L PEKERJA MANDIRI Acute upper respiratory Berobat Jalan
infection, unspecified
241 29-03-2018 0137U0040318Y003612 0001457611863 IKA PUJAWATI L PEKERJA MANDIRI Acute upper respiratory Berobat Jalan
infection, unspecified
242 29-03-2018 0137U0040318Y003619 0001457611918 ANINDITA NURJANATI L PEKERJA MANDIRI Other and unspecified Berobat Jalan
YULIANINGSIH infectious diseases
243 29-03-2018 0137U0040318Y003554 0001459032153 JUJU P PEKERJA MANDIRI Benign lipomatous Berobat Jalan
neoplasm, unspecified
244 29-03-2018 0137U0040318Y003608 0001460183141 CALVENT JE E.V.S EGETEN,SH L PEKERJA MANDIRI Myalgia Berobat Jalan

245 29-03-2018 0137U0040318Y003570 0001462823605 SUNARTI P PEKERJA MANDIRI Other secondary arthrosis Berobat Jalan

246 29-03-2018 0137U0040318Y003604 0001463634415 SULASTRI P PEKERJA MANDIRI Acute upper respiratory Berobat Jalan
infection, unspecified
247 29-03-2018 0137U0040318Y003605 0001463634426 FAUZIE FIRMANSYAH L PEGAWAI SWASTA Foreign body in colon Berobat Jalan
SETIAWAN
248 29-03-2018 0137U0040318Y003564 0001467833883 NINDYA NUR AVRILIA FAJRI P PEKERJA MANDIRI Acute upper respiratory Berobat Jalan
infection, unspecified
249 29-03-2018 0137U0040318Y003568 0001477134909 SUHENDI L PEKERJA MANDIRI Acute upper respiratory Berobat Jalan
infection, unspecified
250 29-03-2018 0137U0040318Y003635 0001516154804 ROBBY JULIUS L PEGAWAI SWASTA Acute upper respiratory Berobat Jalan
infection, unspecified
251 29-03-2018 0137U0040318Y003641 0001623892983 KATHERYN DJONSON P PEGAWAI SWASTA Chronic gingivitis Berobat Jalan

252 29-03-2018 0137U0040318Y003642 0001623892994 KEVIN DJONSON L PEGAWAI SWASTA Abrasion of teeth Berobat Jalan

253 29-03-2018 0137U0040318Y003614 0001629386008 MUHAMMAD IBNU L PEGAWAI SWASTA Other and unspecified Berobat Jalan
ADRIANSYAH infectious diseases
254 29-03-2018 0137U0040318Y003560 0001629861265 KUSTIAH PUJILESTARI P PEGAWAI SWASTA Other specified headache Berobat Jalan
syndromes
255 29-03-2018 0137U0040318Y003559 0001629861478 TREE PUTRI UTAMI PUJIYONO P PEGAWAI SWASTA Acute upper respiratory Berobat Jalan
infection, unspecified
256 29-03-2018 0137U0040318Y003598 0001635318336 WARTO L PEGAWAI SWASTA Dyspepsia Berobat Jalan

257 29-03-2018 0137U0040318Y003591 0001640343666 MUHAMMAD RAMADHANI L PEGAWAI SWASTA Typhoid fever Berobat Jalan

258 29-03-2018 0137U0040318Y003610 0001641901871 KEYSIAH ANANDA PUTRI P PEGAWAI SWASTA Acute upper respiratory Berobat Jalan
PRATAMA infection, unspecified
259 29-03-2018 0137U0040318Y003544 0001642751919 BUDIANTO SOETIKNO L PEKERJA MANDIRI Insulin-dependent Rujuk Lanjut
diabetes mellitus with

260 29-03-2018 0137U0040318Y003581 0001648009811 NICHOLAS ALEXANDRE L PEGAWAI SWASTA Varicella meningitis Berobat Jalan

261 29-03-2018 0137U0040318Y003587 0001648188268 ILMIRA ADHWA P PEGAWAI SWASTA Disorder of refraction, Rujuk Lanjut
unspecified
DAFTAR KUNJUNGAN PESERTA SAKIT

Kantor Cabang : BEKASI - 1011

FKTP : Klinik Mitra Medika - 0137U004

262 29-03-2018 0137U0040318Y003579 0001648458538 DINDA HARIPRIANA L PEKERJA MANDIRI Impacted teeth Berobat Jalan

263 29-03-2018 0137U0040318Y003606 0001648776251 SAGHIETA MAHADIRGA P PEGAWAI SWASTA Other and unspecified Berobat Jalan
HUTAMA infectious diseases
264 29-03-2018 0137U0040318Y003644 0001650270598 MAHPUDIN L PEGAWAI SWASTA Necrosis of pulp Berobat Jalan

265 29-03-2018 0137U0040318Y003639 0001656755559 ADE EKA APRIYANI P PEGAWAI SWASTA Myalgia Berobat Jalan

266 29-03-2018 0137U0040318Y003566 0001662571708 Khoirul Hakim Syahputra L PEGAWAI SWASTA Acute upper respiratory Berobat Jalan
infection, unspecified
267 29-03-2018 0137U0040318Y003573 0001716312363 ANG BOEN HIAN HANDRI L PEKERJA MANDIRI Other specified headache Berobat Jalan
syndromes
268 29-03-2018 0137U0040318Y003549 0001718270291 YUYUN P PEKERJA MANDIRI Chronic ischaemic heart Rujuk Lanjut
disease
269 29-03-2018 0137U0040318Y003545 0001718628974 TITIN SUMARNI P PEKERJA MANDIRI Congestive heart failure Rujuk Lanjut

270 29-03-2018 0137U0040318Y003551 0001720706938 RAHARJO L PEKERJA MANDIRI Heart failure Rujuk Lanjut

271 29-03-2018 0137U0040318Y003647 0001722807325 NAVESYA MURIZ P PEKERJA MANDIRI Necrosis of pulp Berobat Jalan

272 29-03-2018 0137U0040318Y003577 0001722818608 NURDIANAH P PEKERJA MANDIRI Impacted teeth Berobat Jalan

273 29-03-2018 0137U0040318Y003650 0001723912018 NURUL SASONO L PEGAWAI SWASTA Dental caries, unspecified Berobat Jalan

274 29-03-2018 0137U0040318Y003586 0001724796527 HELMON SIAHAAN L PEKERJA MANDIRI Acute upper respiratory Berobat Jalan
infection, unspecified
275 29-03-2018 0137U0040318Y003585 0001729899775 WANIH P PEKERJA MANDIRI Acute upper respiratory Berobat Jalan
infection, unspecified
276 29-03-2018 0137U0040318Y003539 0001741859256 DHITA PRAMUDYA WARDHANI P PEGAWAI SWASTA Missed abortion Rujuk Lanjut

277 29-03-2018 0137U0040318Y003648 0001766344329 LISNI P PEGAWAI BUMN Impacted teeth Berobat Jalan

278 29-03-2018 0137U0040318Y003572 0001766489872 HENDRYAN AQSHAL EL- L PEGAWAI SWASTA Stomatitis and related Berobat Jalan
GHIYATSA lesions
279 29-03-2018 0137U0040318Y003541 0001784874971 ROBERT CHANDRA L PEKERJA MANDIRI Non-insulin-dependent Rujuk Lanjut
diabetes mellitus
280 29-03-2018 0137U0040318Y003640 0001792264026 MARIA FERNANDES P PEGAWAI SWASTA Other antenatal screening Berobat Jalan

281 29-03-2018 0137U0040318Y003571 0001794933731 SUHARTIYAH P PEKERJA MANDIRI Acute upper respiratory Berobat Jalan
infection, unspecified
282 29-03-2018 0137U0040318Y003569 0001798798814 sumariah P PEKERJA MANDIRI Dermatitis herpetiformis Berobat Jalan

283 29-03-2018 0137U0040318Y003536 0001806033813 YUSTINA P PEKERJA MANDIRI Acute sinusitis Rujuk Lanjut

284 29-03-2018 0137U0040318Y003631 0001829579005 SULTAN GIRI L PEKERJA MANDIRI Other and unspecified Berobat Jalan
infectious diseases
285 29-03-2018 0137U0040318Y003561 0001843622493 DIAH SETIAWATI P PEKERJA MANDIRI Other specified headache Berobat Jalan
syndromes
DAFTAR KUNJUNGAN PESERTA SAKIT

Kantor Cabang : BEKASI - 1011

FKTP : Klinik Mitra Medika - 0137U004

286 29-03-2018 0137U0040318Y003645 0001845154337 RIEN WULANDARI, SP P PEGAWAI SWASTA Dental caries, unspecified Berobat Jalan

287 29-03-2018 0137U0040318Y003646 0001845155204 KHANSA MAZAYA FAIRUS P PEGAWAI SWASTA Chronic gingivitis Berobat Jalan

288 29-03-2018 0137U0040318Y003562 0001850688191 ANTON L PEKERJA MANDIRI Disorder of refraction, Rujuk Lanjut
unspecified
289 29-03-2018 0137U0040318Y003556 0001852548669 PRISTIKA DEWI P PEKERJA MANDIRI Nausea and vomiting Berobat Jalan

290 29-03-2018 0137U0040318Y003623 0001858884737 sirih P PEKERJA MANDIRI Dermatitis herpetiformis Berobat Jalan

291 29-03-2018 0137U0040318Y003629 0001865791866 NIGITA FRAYA ANDARESTA P PEGAWAI SWASTA Acute upper respiratory Berobat Jalan
infection, unspecified
292 29-03-2018 0137U0040318Y003643 0001880746492 sukarti P PEKERJA MANDIRI Impacted teeth Berobat Jalan

293 29-03-2018 0137U0040318Y003625 0001959661089 petrus marthin luther tahapary L PEKERJA MANDIRI Acute upper respiratory Berobat Jalan
infection, unspecified
294 29-03-2018 0137U0040318Y003574 0001964164926 rumardi bin kaspon L PEKERJA MANDIRI Impacted teeth Berobat Jalan

295 29-03-2018 0137U0040318Y003567 0002040167474 arif nur widianto P PNS PUSAT Typhoid fever Berobat Jalan

296 29-03-2018 0137U0040318Y003546 0002040168295 arsya nuuruddin L PNS PUSAT Disorder of refraction, Rujuk Lanjut
unspecified
297 29-03-2018 0137U0040318Y003616 0002047311459 ALISYA SHIVA ITJERENNI P PEKERJA MANDIRI Acute upper respiratory Berobat Jalan
infection, unspecified
298 29-03-2018 0137U0040318Y003609 0002067564857 PHANG LIE NAI P PEKERJA MANDIRI Dyspepsia Berobat Jalan

299 29-03-2018 0137U0040318Y003599 0002074564157 YANSEN L PEKERJA MANDIRI Acute upper respiratory Berobat Jalan
infection, unspecified
300 29-03-2018 0137U0040318Y003634 0002080903061 HEAVENLY GRACE WIDJAYA P PEGAWAI SWASTA Other and unspecified Berobat Jalan
ANWAR infectious diseases
301 29-03-2018 0137U0040318Y003633 0002097940037 ICHA UTAMI P PEGAWAI SWASTA Acute upper respiratory Berobat Jalan
infection, unspecified
302 29-03-2018 0137U0040318Y003638 0002098032996 HERU TRI WALUYO L PEGAWAI SWASTA Acute upper respiratory Berobat Jalan
infection, unspecified
303 29-03-2018 0137U0040318Y003552 0002195999627 MUTMAINAH P PEKERJA MANDIRI Acute upper respiratory Berobat Jalan
infection, unspecified
304 29-03-2018 0137U0040318Y003550 0002202825609 NUR HAYATI P PEKERJA MANDIRI Fever, unspecified Rujuk Lanjut

305 29-03-2018 0137U0040318Y003583 0002205086938 lim jam hie L PEKERJA MANDIRI Other secondary arthrosis Berobat Jalan

306 29-03-2018 0137U0040318Y003547 0002217025563 LAILA KADARNI P PEGAWAI SWASTA Other specified headache Rujuk Lanjut
syndromes
307 29-03-2018 0137U0040318Y003628 0002226280307 TITIN HARTINI P PEKERJA MANDIRI Myalgia Berobat Jalan

308 29-03-2018 0137U0040318Y003620 0002281868763 FERELLISYA HERAWAN P PNS DAERAH Acute upper respiratory Berobat Jalan
infection, unspecified
DAFTAR KUNJUNGAN PESERTA SAKIT

Kantor Cabang : BEKASI - 1011

FKTP : Klinik Mitra Medika - 0137U004

309 29-03-2018 0137U0040318Y003597 0002286551878 SANTI YUNIARTININGSIH P PEGAWAI SWASTA Gastro-oesophageal reflux Berobat Jalan
disease without

310 29-03-2018 0137U0040318Y003600 0002313776182 ANINDYA HANDAYANI PUTRI P PEGAWAI SWASTA Acute upper respiratory Berobat Jalan
infection, unspecified
311 28-03-2018 0137U0040318Y003530 0000035943074 SUKARSIH P PENERIMA PENSIUN Dental caries, unspecified Berobat Jalan
PNS
312 28-03-2018 0137U0040318Y003515 0000038026765 TITIN ZELVINA P PNS PUSAT Disorder of thyroid, Berobat Jalan
unspecified
313 28-03-2018 0137U0040318Y003495 0000045804723 A. SUDJIT RIYANTO L PENERIMA PENSIUN Other secondary arthrosis Rujuk Lanjut
PNS
314 28-03-2018 0137U0040318Y003433 0000073399667 HJ.HERNAWATI P PNS DAERAH Dermatitis herpetiformis Berobat Jalan

315 28-03-2018 0137U0040318Y003427 0000073402841 SUDASMI P PNS DAERAH Other secondary arthrosis Berobat Jalan

316 28-03-2018 0137U0040318Y003475 0000073403842 RIFDA SAFIRAH P PNS DAERAH Acute upper respiratory Berobat Jalan
infection, unspecified
317 28-03-2018 0137U0040318Y003463 0000202416333 MOHAMAD S HAMDANI L PENERIMA PENSIUN Acute upper respiratory Berobat Jalan
PNS infection, unspecified
318 28-03-2018 0137U0040318Y003435 0000508828792 INTAN SOLEHA P PEGAWAI SWASTA Varicella meningitis Berobat Jalan

319 28-03-2018 0137U0040318Y003430 0000508951181 MUHAMMAD SULTHON AULIA L PBI (APBN) Dermatitis herpetiformis Berobat Jalan

320 28-03-2018 0137U0040318Y003520 0001100629247 AJENG LUPITA HANDAYANI P PEKERJA MANDIRI Bullous disorder, Berobat Jalan
unspecified
321 28-03-2018 0137U0040318Y003505 0001211581012 ASEP SANJAYA L PEGAWAI SWASTA Acute upper respiratory Berobat Jalan
infection, unspecified
322 28-03-2018 0137U0040318Y003412 0001256013178 MARIANA THALIB P PEKERJA MANDIRI Hypertensive heart Rujuk Lanjut
disease
323 28-03-2018 0137U0040318Y003499 0001257232061 RAKA HABIBI RAMADHAN L PEKERJA MANDIRI Gastro-oesophageal reflux Berobat Jalan
disease without

324 28-03-2018 0137U0040318Y003466 0001259429646 HJ.LILIS HOLISOH P PEKERJA MANDIRI Acute upper respiratory Berobat Jalan
infection, unspecified
325 28-03-2018 0137U0040318Y003490 0001261573468 NUR YUNIAR P PNS DAERAH Dyspepsia Berobat Jalan

326 28-03-2018 0137U0040318Y003452 0001263868187 SUHARYONO L PEKERJA MANDIRI Impacted teeth Berobat Jalan

327 28-03-2018 0137U0040318Y003437 0001272324677 WAGIYAH P PEKERJA MANDIRI Dermatitis herpetiformis Rujuk Lanjut

328 28-03-2018 0137U0040318Y003440 0001275051971 SRI SULASTRI P PEKERJA MANDIRI Insulin-dependent Rujuk Lanjut
diabetes mellitus without

329 28-03-2018 0137U0040318Y003456 0001290608098 IWAN RIDWAN INDARI L PEKERJA MANDIRI Impacted teeth Berobat Jalan

330 28-03-2018 0137U0040318Y003496 0001290712814 MIDE P PEKERJA MANDIRI Acute upper respiratory Berobat Jalan
infection, unspecified
DAFTAR KUNJUNGAN PESERTA SAKIT

Kantor Cabang : BEKASI - 1011

FKTP : Klinik Mitra Medika - 0137U004

331 28-03-2018 0137U0040318Y003488 0001295875067 SOFYAN PUDJADI L PEGAWAI SWASTA Acute upper respiratory Berobat Jalan
infection, unspecified
332 28-03-2018 0137U0040318Y003458 0001297950996 SOLITA. A. SEUBELAN P PEKERJA MANDIRI Impacted teeth Berobat Jalan

333 28-03-2018 0137U0040318Y003445 0001308117903 SHERLY HERNIYANTI P PEGAWAI SWASTA Acute upper respiratory Berobat Jalan
infection, unspecified
334 28-03-2018 0137U0040318Y003415 0001323570161 SUHENDRA L PEKERJA MANDIRI Other specified headache Berobat Jalan
syndromes
335 28-03-2018 0137U0040318Y003453 0001323570846 LIM SIN HOA P PEKERJA MANDIRI Impacted teeth Berobat Jalan

336 28-03-2018 0137U0040318Y003414 0001328611937 dedeh kurniasih P PEKERJA MANDIRI Typhoid fever Berobat Jalan

337 28-03-2018 0137U0040318Y003471 0001335501639 OSMAN SITORUS L PEKERJA MANDIRI Mixed asthma Rujuk Lanjut

338 28-03-2018 0137U0040318Y003421 0001339567121 ENDANG L PEKERJA MANDIRI Atopic dermatitis, Berobat Jalan
unspecified
339 28-03-2018 0137U0040318Y003482 0001370634546 KARNIAH P PNS PUSAT Acute upper respiratory Berobat Jalan
infection, unspecified
340 28-03-2018 0137U0040318Y003424 0001372272579 SUGENG L PEKERJA MANDIRI Other specified headache Berobat Jalan
syndromes
341 28-03-2018 0137U0040318Y003457 0001383225625 HERIANTO L PEKERJA MANDIRI Dental caries, unspecified Berobat Jalan

342 28-03-2018 0137U0040318Y003519 0001384388291 DWI HANDAYANI P PEGAWAI SWASTA Acute upper respiratory Berobat Jalan
infection, unspecified
343 28-03-2018 0137U0040318Y003518 0001384458153 FAZRYA RACHMAN L PEGAWAI SWASTA Acute upper respiratory Berobat Jalan
infection, unspecified
344 28-03-2018 0137U0040318Y003470 0001385598464 Namih P PEGAWAI SWASTA Congestive heart failure Rujuk Lanjut

345 28-03-2018 0137U0040318Y003450 0001387116123 RINA WATI P PEGAWAI SWASTA Placenta praevia Rujuk Lanjut

346 28-03-2018 0137U0040318Y003514 0001421094249 FARADILAH WITANTI P PEKERJA MANDIRI Myopia Rujuk Lanjut

347 28-03-2018 0137U0040318Y003419 0001424080945 EKA RIZKI LANTIKA SARI P PEGAWAI SWASTA Acute upper respiratory Berobat Jalan
infection, unspecified
348 28-03-2018 0137U0040318Y003425 0001450658204 DYAN ANGGRAENI P PEKERJA MANDIRI Acute upper respiratory Berobat Jalan
infection, unspecified
349 28-03-2018 0137U0040318Y003426 0001450659813 felicia suryadi P PEKERJA MANDIRI Acute upper respiratory Berobat Jalan
infection, unspecified
350 28-03-2018 0137U0040318Y003461 0001452417311 AMIRUDDIN YUSUP L PEKERJA MANDIRI Impacted teeth Berobat Jalan

351 28-03-2018 0137U0040318Y003439 0001452576014 E. SRIWATUTI P PEKERJA MANDIRI Atopic dermatitis, Berobat Jalan
unspecified
352 28-03-2018 0137U0040318Y003432 0001459068568 ASNIMAR P PEKERJA MANDIRI Acute upper respiratory Berobat Jalan
infection, unspecified
353 28-03-2018 0137U0040318Y003420 0001459226867 ELY P PEKERJA MANDIRI Acute upper respiratory Berobat Jalan
infection, unspecified
DAFTAR KUNJUNGAN PESERTA SAKIT

Kantor Cabang : BEKASI - 1011

FKTP : Klinik Mitra Medika - 0137U004

354 28-03-2018 0137U0040318Y003465 0001459773257 AL SUWARJONO L PEKERJA MANDIRI Dermatitis herpetiformis Berobat Jalan

355 28-03-2018 0137U0040318Y003464 0001459790998 V SUMIATI P PEKERJA MANDIRI Acute upper respiratory Berobat Jalan
infection, unspecified
356 28-03-2018 0137U0040318Y003451 0001461068842 BAMBANG SATYA BUDHI L PEKERJA MANDIRI Hypertensive heart Rujuk Lanjut
DHARMA disease
357 28-03-2018 0137U0040318Y003512 0001461091274 WATI WARYATI P PEGAWAI PEMERINTAH Gastro-oesophageal reflux Berobat Jalan
NON PNS disease without

358 28-03-2018 0137U0040318Y003531 0001468594113 CHRISTINE ADELEIDA G.S.P. P PEKERJA MANDIRI Impacted teeth Berobat Jalan

359 28-03-2018 0137U0040318Y003455 0001470757555 NAWANG TUNINGSIH P PEKERJA MANDIRI Dental caries, unspecified Berobat Jalan

360 28-03-2018 0137U0040318Y003517 0001483407459 ai rodiah awalyah P PEGAWAI SWASTA Gastro-oesophageal reflux Berobat Jalan
disease without

361 28-03-2018 0137U0040318Y003476 0001555757864 MARIA MAHARANI P PEGAWAI SWASTA Vertigo of central origin Berobat Jalan

362 28-03-2018 0137U0040318Y003506 0001618174967 HARI SANYOTO L PEGAWAI SWASTA Acute upper respiratory Berobat Jalan
infection, unspecified
363 28-03-2018 0137U0040318Y003411 0001620623068 L. WARSIATUN P PEGAWAI SWASTA Contraceptive Rujuk Lanjut
management
364 28-03-2018 0137U0040318Y003510 0001627739054 R. ACHMAD ZAINAL ARDI L PEGAWAI SWASTA Other and unspecified Berobat Jalan
infectious diseases
365 28-03-2018 0137U0040318Y003413 0001629369832 NAUFAL NABIL RIDWANSYAH L PEKERJA MANDIRI Typhoid fever Berobat Jalan

366 28-03-2018 0137U0040318Y003468 0001629388181 EKA OKTAVIANTO L PEGAWAI SWASTA Myalgia Berobat Jalan

367 28-03-2018 0137U0040318Y003532 0001631467203 NURAINI RAHAYU P PEKERJA MANDIRI Necrosis of pulp Berobat Jalan

368 28-03-2018 0137U0040318Y003486 0001631742063 HENDARTO EKO PUTRO L PEGAWAI SWASTA Acute upper respiratory Berobat Jalan
infection, unspecified
369 28-03-2018 0137U0040318Y003522 0001631742074 NOVIRA OCTAVIA MS P PEGAWAI SWASTA Other contraceptive Berobat Jalan
management
370 28-03-2018 0137U0040318Y003460 0001633873994 BAROMEUS SINA L PEGAWAI SWASTA Dental caries, unspecified Berobat Jalan

371 28-03-2018 0137U0040318Y003511 0001642845429 IRWAN M.R. RUSTAM L PEGAWAI SWASTA Acute pharyngitis, Berobat Jalan
unspecified
372 28-03-2018 0137U0040318Y003477 0001643505355 EDDY KUSNADI L PEGAWAI SWASTA Acute upper respiratory Berobat Jalan
infection, unspecified
373 28-03-2018 0137U0040318Y003527 0001646271922 SLAMET SUHENDRA L PEGAWAI SWASTA Impacted teeth Berobat Jalan

374 28-03-2018 0137U0040318Y003526 0001646271933 RITA SAYOETI,SH P PEGAWAI SWASTA Caries of dentine Berobat Jalan

375 28-03-2018 0137U0040318Y003524 0001646271944 CITRA AMALIA SUHENDRA P PEKERJA MANDIRI Necrosis of pulp Berobat Jalan

376 28-03-2018 0137U0040318Y003525 0001646271955 IZZATI AURA SUHENDRA P PEGAWAI SWASTA Necrosis of pulp Berobat Jalan
DAFTAR KUNJUNGAN PESERTA SAKIT

Kantor Cabang : BEKASI - 1011

FKTP : Klinik Mitra Medika - 0137U004

377 28-03-2018 0137U0040318Y003521 0001647817661 PIPIN PRIYANTI P PEGAWAI SWASTA Foreign body in colon Berobat Jalan

378 28-03-2018 0137U0040318Y003480 0001649835742 ALAFASY ARSY L PEGAWAI SWASTA Acute upper respiratory Berobat Jalan
DHANURENDRA infection, unspecified
379 28-03-2018 0137U0040318Y003485 0001652980252 INDRI GILVA ELVERIA P PEGAWAI SWASTA Acute upper respiratory Berobat Jalan
infection, unspecified
380 28-03-2018 0137U0040318Y003501 0001655606834 PANJI NUGRAHA SETIAWAN L PEGAWAI SWASTA Acute upper respiratory Berobat Jalan
infection, unspecified
381 28-03-2018 0137U0040318Y003478 0001656027685 MARIA CELLY JACINDA P PEGAWAI SWASTA Acute upper respiratory Berobat Jalan
infection, unspecified
382 28-03-2018 0137U0040318Y003473 0001657482849 AHMAD PAUZI L PEGAWAI SWASTA Necrosis of pulp Rujuk Lanjut

383 28-03-2018 0137U0040318Y003534 0001658850164 MUHAMMAD NAUFAL AL L PEGAWAI SWASTA Necrosis of pulp Berobat Jalan
GHAZALI
384 28-03-2018 0137U0040318Y003523 0001658850175 ALVARO AURELIO RAMADHAN L PEGAWAI SWASTA Abrasion of teeth Berobat Jalan

385 28-03-2018 0137U0040318Y003434 0001724149315 RUSMARDINI P PEKERJA MANDIRI Other secondary arthrosis Rujuk Lanjut

386 28-03-2018 0137U0040318Y003467 0001732254219 ANA MARIANA P PEKERJA MANDIRI Other antenatal screening Berobat Jalan

387 28-03-2018 0137U0040318Y003447 0001737048159 SITI CHURIYAH P PEGAWAI SWASTA Acute upper respiratory Berobat Jalan
infection, unspecified
388 28-03-2018 0137U0040318Y003500 0001738627435 FUADY KURNIAWAN L PEGAWAI SWASTA Acute upper respiratory Berobat Jalan
infection, unspecified
389 28-03-2018 0137U0040318Y003454 0001740754776 BARLIANTA.P L PEKERJA MANDIRI Dental caries, unspecified Berobat Jalan

390 28-03-2018 0137U0040318Y003446 0001742419405 AMIRA MARSYAFA L PEGAWAI SWASTA Acute upper respiratory Berobat Jalan
infection, unspecified
391 28-03-2018 0137U0040318Y003498 0001744284936 FIRMANSYAH L PEKERJA MANDIRI Acute upper respiratory Berobat Jalan
infection, unspecified
392 28-03-2018 0137U0040318Y003459 0001768178946 SITI NURBAITI P PEGAWAI SWASTA Dental caries, unspecified Berobat Jalan

393 28-03-2018 0137U0040318Y003438 0001769677029 NOORCE ANGELINA TAHALELE P PEGAWAI SWASTA Acute upper respiratory Rujuk Lanjut
infection, unspecified
394 28-03-2018 0137U0040318Y003479 0001774490185 TATI HARTATI P PEGAWAI SWASTA Other specified headache Berobat Jalan
syndromes
395 28-03-2018 0137U0040318Y003469 0001793638034 SRITANTI P PEKERJA MANDIRI Chronic kidney disease Rujuk Lanjut

396 28-03-2018 0137U0040318Y003502 0001802609493 nur anisa P PEKERJA MANDIRI Acute upper respiratory Berobat Jalan
infection, unspecified
397 28-03-2018 0137U0040318Y003494 0001805232262 SYARIFAH NUR FALIHA L PEGAWAI SWASTA Acute upper respiratory Berobat Jalan
infection, unspecified
398 28-03-2018 0137U0040318Y003513 0001810007403 DINI KOMALASARI P PEKERJA MANDIRI Other specified headache Berobat Jalan
syndromes
399 28-03-2018 0137U0040318Y003448 0001817399441 GABRIEL MERVIN GUNAWAN L PEGAWAI SWASTA Acute upper respiratory Berobat Jalan
infection, unspecified
DAFTAR KUNJUNGAN PESERTA SAKIT

Kantor Cabang : BEKASI - 1011

FKTP : Klinik Mitra Medika - 0137U004

400 28-03-2018 0137U0040318Y003423 0001831404396 THOMAS BUDI WIBOWO L PEKERJA MANDIRI Typhoid fever Berobat Jalan

401 28-03-2018 0137U0040318Y003422 0001831405138 VERONICA HARI SUDIBYORINI P PEKERJA MANDIRI Typhoid fever Berobat Jalan

402 28-03-2018 0137U0040318Y003431 0001832444605 DJUBAEDAH P PEKERJA MANDIRI Dermatitis herpetiformis Berobat Jalan

403 28-03-2018 0137U0040318Y003487 0001837596791 NIA NOERANI P PEGAWAI BUMD Acute upper respiratory Berobat Jalan
infection, unspecified
404 28-03-2018 0137U0040318Y003491 0001845363431 CARLO SEPVENCO L PEKERJA MANDIRI Acute upper respiratory Berobat Jalan
infection, unspecified
405 28-03-2018 0137U0040318Y003474 0001848244882 CAHYO SETIAWAN L PEGAWAI SWASTA Nausea and vomiting Berobat Jalan

406 28-03-2018 0137U0040318Y003429 0001875764294 AGENG PRIHATIN L PEGAWAI BUMD Acute upper respiratory Berobat Jalan
infection, unspecified
407 28-03-2018 0137U0040318Y003503 0001877516267 NURAENI P PEGAWAI SWASTA Dyspepsia Berobat Jalan

408 28-03-2018 0137U0040318Y003493 0001890074744 RANTI P PEKERJA MANDIRI Gastro-oesophageal reflux Berobat Jalan
disease without

409 28-03-2018 0137U0040318Y003492 0001890075835 FRISKA AMALIA LARASATI P PEKERJA MANDIRI Acute upper respiratory Berobat Jalan
infection, unspecified
410 28-03-2018 0137U0040318Y003509 0001890667765 KUSMAYADI L PEKERJA MANDIRI Acute sinusitis Berobat Jalan

411 28-03-2018 0137U0040318Y003508 0001890667776 MIMIN KARMINI P PEKERJA MANDIRI Other specified headache Berobat Jalan
syndromes
412 28-03-2018 0137U0040318Y003428 0001895083841 EDISON SIMORANGKIR L PEKERJA MANDIRI Dermatitis herpetiformis Berobat Jalan

413 28-03-2018 0137U0040318Y003441 0001902962935 AZMI MAULANA L PEGAWAI SWASTA Typhoid fever Berobat Jalan

414 28-03-2018 0137U0040318Y003436 0001903044341 rumih L PEKERJA MANDIRI Typhoid fever Berobat Jalan

415 28-03-2018 0137U0040318Y003497 0001963178695 RINA MARYANA P PEGAWAI SWASTA Acute upper respiratory Berobat Jalan
infection, unspecified
416 28-03-2018 0137U0040318Y003533 0001963185221 sulastri herlina P PEKERJA MANDIRI Impacted teeth Berobat Jalan

417 28-03-2018 0137U0040318Y003416 0001963402604 hj. rohaya P PENERIMA PENSIUN Other specified headache Berobat Jalan
PNS syndromes
418 28-03-2018 0137U0040318Y003462 0001964671233 BONDAN DEWANTO L PEKERJA MANDIRI Acute upper respiratory Berobat Jalan
infection, unspecified
419 28-03-2018 0137U0040318Y003418 0001969692917 WINARTIE P PEKERJA MANDIRI Other specified headache Berobat Jalan
syndromes
420 28-03-2018 0137U0040318Y003449 0002043513145 HERMAN,BSC L PEKERJA MANDIRI Acute upper respiratory Berobat Jalan
infection, unspecified
421 28-03-2018 0137U0040318Y003417 0002050670766 IBTISAM P PEKERJA MANDIRI Myalgia Berobat Jalan

422 28-03-2018 0137U0040318Y003528 0002055540339 Khansa Syam Malihah P PEGAWAI SWASTA Abrasion of teeth Berobat Jalan
DAFTAR KUNJUNGAN PESERTA SAKIT

Kantor Cabang : BEKASI - 1011

FKTP : Klinik Mitra Medika - 0137U004

423 28-03-2018 0137U0040318Y003489 0002055783791 IWAN TARGO L PEGAWAI SWASTA Acute upper respiratory Berobat Jalan
infection, unspecified
424 28-03-2018 0137U0040318Y003444 0002077186375 ARMAINI TATI P PEKERJA MANDIRI Acute upper respiratory Berobat Jalan
infection, unspecified
425 28-03-2018 0137U0040318Y003443 0002081563986 khalil mumtaz lukmana L PEKERJA MANDIRI Nausea and vomiting Berobat Jalan

426 28-03-2018 0137U0040318Y003481 0002137476126 AI NURHAYATI P PEGAWAI SWASTA Varicella encephalitis Berobat Jalan

427 28-03-2018 0137U0040318Y003507 0002199506365 ANDRI DWI PURWANTO L PEGAWAI SWASTA Dyspepsia Berobat Jalan

428 28-03-2018 0137U0040318Y003504 0002206882225 NAYLA KHAIRUN NISSA P PEGAWAI PEMERINTAH Acute upper respiratory Berobat Jalan
NON PNS infection, unspecified
429 28-03-2018 0137U0040318Y003442 0002217025563 LAILA KADARNI P PEGAWAI SWASTA Traumatic shock Berobat Jalan

430 28-03-2018 0137U0040318Y003484 0002220037907 ratu kirana hasian sagala L PNS PUSAT Acute upper respiratory Berobat Jalan
infection, unspecified
431 28-03-2018 0137U0040318Y003516 0002229792772 HARSRIYATI P PEGAWAI SWASTA Myalgia Berobat Jalan

432 28-03-2018 0137U0040318Y003529 0002231629975 NANY MINTARNI P PEKERJA MANDIRI Impacted teeth Berobat Jalan

433 28-03-2018 0137U0040318Y003483 0002240385535 NADINE PUTRI KEISHA SAGALA P PNS PUSAT Acute upper respiratory Berobat Jalan
infection, unspecified
434 27-03-2018 0137U0040318Y003343 0000017575874 DILLA WAHYUNI P PEGAWAI SWASTA Other specified headache Berobat Jalan
syndromes
435 27-03-2018 0137U0040318Y003333 0000039621341 RIAMAULI SIMATUPANG P PNS DAERAH Insulin-dependent Rujuk Lanjut
diabetes mellitus with

436 27-03-2018 0137U0040318Y003325 0000073018394 SUDIRMAN GULTOM L PENERIMA PENSIUN TNI Dyspepsia Berobat Jalan

437 27-03-2018 0137U0040318Y003362 0000073400466 SUYATNO KADMIRA L PNS DAERAH Acute upper respiratory Berobat Jalan
infection, unspecified
438 27-03-2018 0137U0040318Y003293 0000073517567 DEDY HIDAYAT L PNS DAERAH Staphylococcal arthritis Rujuk Lanjut
and polyarthritis
439 27-03-2018 0137U0040318Y003334 0000073518052 DRA.TATI HAYATI BASUKI P PNS DAERAH Myalgia Berobat Jalan

440 27-03-2018 0137U0040318Y003395 0000073531394 PUJI LESTARI P PNS DAERAH Other secondary arthrosis Berobat Jalan

441 27-03-2018 0137U0040318Y003386 0000211234926 HERLIN NOVIANTI P PNS DAERAH Impacted teeth Berobat Jalan

442 27-03-2018 0137U0040318Y003380 0001013875007 MIFTAHUL ROHMAH L PEKERJA MANDIRI Necrosis of pulp Berobat Jalan

443 27-03-2018 0137U0040318Y003379 0001013875018 MUHARAM HABIBILAH L PEKERJA MANDIRI Chronic gingivitis Berobat Jalan

444 27-03-2018 0137U0040318Y003292 0001138063983 WINALDI HARITS PRIMAYUDHA L PEGAWAI SWASTA Acute upper respiratory Berobat Jalan
infection, unspecified
445 27-03-2018 0137U0040318Y003388 0001140542537 ELVI SANDRI P PEGAWAI SWASTA Impacted teeth Berobat Jalan
DAFTAR KUNJUNGAN PESERTA SAKIT

Kantor Cabang : BEKASI - 1011

FKTP : Klinik Mitra Medika - 0137U004

446 27-03-2018 0137U0040318Y003360 0001143248231 GUNTUR SAMODRO L PEKERJA MANDIRI Acute upper respiratory Berobat Jalan
infection, unspecified
447 27-03-2018 0137U0040318Y003369 0001159376916 DESY WIWITRI P PEGAWAI SWASTA Other contraceptive Berobat Jalan
management
448 27-03-2018 0137U0040318Y003393 0001198030408 FUNKI FAUZIA ASTUTI P PEGAWAI SWASTA Myalgia Berobat Jalan

449 27-03-2018 0137U0040318Y003345 0001256143869 IKA JUWITA MARSAH P PEGAWAI SWASTA Pre-eclampsia, Rujuk Lanjut
unspecified
450 27-03-2018 0137U0040318Y003326 0001256690474 SANDRA P PEKERJA MANDIRI Dyspepsia Berobat Jalan

451 27-03-2018 0137U0040318Y003337 0001257743013 YOSEPH DHASA L PEGAWAI SWASTA Dermatitis herpetiformis Berobat Jalan

452 27-03-2018 0137U0040318Y003348 0001257961432 SALMAN L PEKERJA MANDIRI Tinnitus Rujuk Lanjut

453 27-03-2018 0137U0040318Y003297 0001258532673 MOHAMAD NASRIL DAENG L PEKERJA MANDIRI Hyperplasia of prostate Rujuk Lanjut

454 27-03-2018 0137U0040318Y003401 0001259114951 SEPTIANI SIMANJUNTAK P PEGAWAI SWASTA Vertigo of central origin Berobat Jalan

455 27-03-2018 0137U0040318Y003318 0001260324516 SUKAMTO L PEKERJA MANDIRI Foreign body in alimentary Rujuk Lanjut
tract, part unspecified

456 27-03-2018 0137U0040318Y003301 0001267300934 SOENARYO KEMPES H L PEKERJA MANDIRI Insulin-dependent Rujuk Lanjut
diabetes mellitus
457 27-03-2018 0137U0040318Y003290 0001269669339 RR. NURNAWANINGSIH P PEKERJA MANDIRI Other secondary arthrosis Berobat Jalan

458 27-03-2018 0137U0040318Y003400 0001278383422 YANTI SUNARTI P PEKERJA MANDIRI Foreign body in colon Berobat Jalan

459 27-03-2018 0137U0040318Y003310 0001280259112 neneng suryanah P PEKERJA MANDIRI Other specified headache Berobat Jalan
syndromes
460 27-03-2018 0137U0040318Y003352 0001281380747 H WALUYO L PEKERJA MANDIRI Yellow fever Rujuk Lanjut

461 27-03-2018 0137U0040318Y003316 0001287160571 RUDI NAPITULU L PEKERJA MANDIRI Other specified headache Berobat Jalan
syndromes
462 27-03-2018 0137U0040318Y003392 0001291332025 R.WIDYATMOKO L PEKERJA MANDIRI Acute upper respiratory Berobat Jalan
infection, unspecified
463 27-03-2018 0137U0040318Y003382 0001294419958 OPI NUGRAHA L PEKERJA MANDIRI Impacted teeth Berobat Jalan

464 27-03-2018 0137U0040318Y003357 0001295516924 RANDY CHRISTIAN L PEKERJA MANDIRI Other and unspecified Berobat Jalan
infectious diseases
465 27-03-2018 0137U0040318Y003344 0001295858496 NOVI MEDIYANTI P PEKERJA MANDIRI Acute upper respiratory Berobat Jalan
infection, unspecified
466 27-03-2018 0137U0040318Y003389 0001297729214 AISYAH AURELIA L PEGAWAI SWASTA Chronic gingivitis Berobat Jalan

467 27-03-2018 0137U0040318Y003377 0001308909205 SUCI DEASY AFIANI, SE P PEGAWAI SWASTA Dental caries, unspecified Berobat Jalan

468 27-03-2018 0137U0040318Y003397 0001320195756 MOH. SARDY L PEKERJA MANDIRI Acute upper respiratory Berobat Jalan
infection, unspecified
DAFTAR KUNJUNGAN PESERTA SAKIT

Kantor Cabang : BEKASI - 1011

FKTP : Klinik Mitra Medika - 0137U004

469 27-03-2018 0137U0040318Y003366 0001337460952 ROKHMAN L PEKERJA MANDIRI Acute upper respiratory Berobat Jalan
infection, unspecified
470 27-03-2018 0137U0040318Y003288 0001337747578 SUKIMAN SAPUTRA L PEKERJA MANDIRI Other secondary arthrosis Rujuk Lanjut

471 27-03-2018 0137U0040318Y003358 0001379790325 MARLON PAMO L PEKERJA MANDIRI Gastro-oesophageal reflux Berobat Jalan
disease without

472 27-03-2018 0137U0040318Y003376 0001380212199 YANTI BINTI TARDI P PEKERJA MANDIRI Impacted teeth Berobat Jalan

473 27-03-2018 0137U0040318Y003363 0001381405241 MUHAMAD IBRAHIM RABBANI L PEGAWAI SWASTA Acute upper respiratory Berobat Jalan
infection, unspecified
474 27-03-2018 0137U0040318Y003390 0001385156147 MARI JULIANA P PEKERJA MANDIRI Vertigo of central origin Berobat Jalan

475 27-03-2018 0137U0040318Y003374 0001387894871 LINAH KARNA P PEKERJA MANDIRI Dental caries, unspecified Berobat Jalan

476 27-03-2018 0137U0040318Y003365 0001406683888 SANDRA NADIA P PEGAWAI SWASTA Cutaneous abscess, Berobat Jalan
furuncle and carbuncle
477 27-03-2018 0137U0040318Y003405 0001439511851 muhammad rifqi fadillah yusuf L PEGAWAI SWASTA Acute upper respiratory Berobat Jalan
infection, unspecified
478 27-03-2018 0137U0040318Y003322 0001440682672 HJ. SURYATI L PEKERJA MANDIRI Acute upper respiratory Berobat Jalan
infection, unspecified
479 27-03-2018 0137U0040318Y003299 0001447397897 SOEJIEM HADI SUDARSONO P PEKERJA MANDIRI Atopic dermatitis Rujuk Lanjut

480 27-03-2018 0137U0040318Y003320 0001451099632 BUDI SUTARNO L PEKERJA MANDIRI Coronary artery aneurysm Rujuk Lanjut

481 27-03-2018 0137U0040318Y003384 0001454921583 GWEN CALLISTA PANGAJOW P PEKERJA MANDIRI Abrasion of teeth Berobat Jalan

482 27-03-2018 0137U0040318Y003304 0001455955435 SUGENG PRAPTOLO L PEKERJA MANDIRI Other specified headache Berobat Jalan
syndromes
483 27-03-2018 0137U0040318Y003307 0001455956482 SITI HARTINI P PEKERJA MANDIRI Acute upper respiratory Berobat Jalan
infection, unspecified
484 27-03-2018 0137U0040318Y003319 0001456241062 TRISNAWATI GIYANTO P PEKERJA MANDIRI Insulin-dependent Rujuk Lanjut
diabetes mellitus with

485 27-03-2018 0137U0040318Y003359 0001456418597 HASANAH P PEKERJA MANDIRI Other specified headache Berobat Jalan
syndromes
486 27-03-2018 0137U0040318Y003381 0001458466751 YULI VERAWATI P PEKERJA MANDIRI Impacted teeth Berobat Jalan

487 27-03-2018 0137U0040318Y003306 0001460428255 SUPRIYATIN P PEKERJA MANDIRI Acute pharyngitis, Berobat Jalan
unspecified
488 27-03-2018 0137U0040318Y003336 0001460953405 LINNA SALIMIN L PEKERJA MANDIRI Other specified headache Berobat Jalan
syndromes
489 27-03-2018 0137U0040318Y003305 0001469702812 DESY ARYANI P PEKERJA MANDIRI Bronchopneumonia, Rujuk Lanjut
unspecified
490 27-03-2018 0137U0040318Y003332 0001475818402 WAKIDIYONO L PEKERJA MANDIRI Other specified dermatitis Rujuk Lanjut
DAFTAR KUNJUNGAN PESERTA SAKIT

Kantor Cabang : BEKASI - 1011

FKTP : Klinik Mitra Medika - 0137U004

491 27-03-2018 0137U0040318Y003349 0001478397238 ROSMALA P PEKERJA MANDIRI Insulin-dependent Rujuk Lanjut
diabetes mellitus with

492 27-03-2018 0137U0040318Y003289 0001480380647 RISTAM HARY SADEWO L PEGAWAI SWASTA Acute upper respiratory Berobat Jalan
infection, unspecified
493 27-03-2018 0137U0040318Y003375 0001480667883 tje we shiang P PEKERJA MANDIRI Impacted teeth Berobat Jalan

494 27-03-2018 0137U0040318Y003354 0001516282817 NENG FADLIAS NINGSIH P PEGAWAI SWASTA Other antenatal screening Berobat Jalan

495 27-03-2018 0137U0040318Y003341 0001617667334 WITA MAGDALENA P PEKERJA MANDIRI Acute upper respiratory Berobat Jalan
infection, unspecified
496 27-03-2018 0137U0040318Y003347 0001621380431 ADI PURANA L PENERIMA PENSIUN Insulin-dependent Rujuk Lanjut
SWASTA diabetes mellitus
497 27-03-2018 0137U0040318Y003327 0001624408571 BASRI SUSA L PENERIMA PENSIUN Secondary hypertension, Berobat Jalan
SWASTA unspecified
498 27-03-2018 0137U0040318Y003346 0001625364279 ERLANGGA SETIYAWAN L PEGAWAI SWASTA Respiratory tuberculosis, Rujuk Lanjut
bacteriologically and

499 27-03-2018 0137U0040318Y003372 0001629187716 NEZIRA P PEGAWAI SWASTA Dental caries, unspecified Berobat Jalan

500 27-03-2018 0137U0040318Y003402 0001631749061 EDI KUSNADI L PEGAWAI SWASTA Acute upper respiratory Berobat Jalan
infection, unspecified
501 27-03-2018 0137U0040318Y003398 0001635316571 SALAMAH P PEGAWAI SWASTA Dyspepsia Berobat Jalan

502 27-03-2018 0137U0040318Y003387 0001635640907 SRI HANDHINA YUSTIANTI P PEGAWAI BUMN Necrosis of pulp Berobat Jalan

503 27-03-2018 0137U0040318Y003378 0001637023443 M NAUFAL ALWAH L PEGAWAI SWASTA Impacted teeth Berobat Jalan

504 27-03-2018 0137U0040318Y003340 0001639553411 YUANA FEBRIANI SOKOWATI P PEGAWAI SWASTA Acute upper respiratory Berobat Jalan
infection, unspecified
505 27-03-2018 0137U0040318Y003296 0001645924645 MUHAMMAD ASYRAF ALWINI L PEGAWAI SWASTA Acute upper respiratory Berobat Jalan
infection, unspecified
506 27-03-2018 0137U0040318Y003311 0001646566119 HENDRA CITRA R L PEKERJA MANDIRI Other specified headache Berobat Jalan
syndromes
507 27-03-2018 0137U0040318Y003364 0001647817661 PIPIN PRIYANTI P PEGAWAI SWASTA Foreign body in colon Berobat Jalan

508 27-03-2018 0137U0040318Y003309 0001650315104 M REVANZA ALMER PUTRA H L PEGAWAI SWASTA Fever, unspecified Rujuk Lanjut

509 27-03-2018 0137U0040318Y003321 0001651851009 IRMAWATI P PEGAWAI SWASTA Disorder of refraction, Rujuk Lanjut
unspecified
510 27-03-2018 0137U0040318Y003383 0001653429036 MAYA MAESAROH P PEGAWAI SWASTA Impacted teeth Berobat Jalan

511 27-03-2018 0137U0040318Y003350 0001655889423 Mardian Yulianto L PEGAWAI SWASTA Acute sinusitis, Rujuk Lanjut
unspecified
512 27-03-2018 0137U0040318Y003353 0001656703697 NADIA YUSTIN HALIM P PEGAWAI SWASTA Other antenatal screening Berobat Jalan
DAFTAR KUNJUNGAN PESERTA SAKIT

Kantor Cabang : BEKASI - 1011

FKTP : Klinik Mitra Medika - 0137U004

513 27-03-2018 0137U0040318Y003302 0001658830386 YENI KURNIAWATI ASMARA P PEKERJA MANDIRI Cardiac arrhythmia, Rujuk Lanjut
unspecified
514 27-03-2018 0137U0040318Y003335 0001719423707 IMROATUL AZIZAH P PEKERJA MANDIRI Myalgia Berobat Jalan

515 27-03-2018 0137U0040318Y003406 0001721684226 DIAS DYAHRATRI AYU P PEKERJA MANDIRI Acute upper respiratory Berobat Jalan
PRASASTI infection, unspecified
516 27-03-2018 0137U0040318Y003391 0001721734795 HJ R DARMAH P PEKERJA MANDIRI Other secondary arthrosis Berobat Jalan

517 27-03-2018 0137U0040318Y003308 0001721987897 MUHAMMAD RIZKY KUSUMA L PEKERJA MANDIRI Atopic dermatitis, Berobat Jalan
unspecified
518 27-03-2018 0137U0040318Y003298 0001722818608 NURDIANAH P PEKERJA MANDIRI Acute upper respiratory Berobat Jalan
infection, unspecified
519 27-03-2018 0137U0040318Y003408 0001728278627 ROLIYAH P PENERIMA PENSIUN Myalgia Berobat Jalan
SWASTA
520 27-03-2018 0137U0040318Y003291 0001734575231 ELA NURMALASARI P PEGAWAI SWASTA Acute upper respiratory Berobat Jalan
infection, unspecified
521 27-03-2018 0137U0040318Y003294 0001736266195 Elisabeth Christiaan P PEKERJA MANDIRI Disorders of refraction and Rujuk Lanjut
accommodation
522 27-03-2018 0137U0040318Y003295 0001736266217 Gabriella Stefani Tua P PEKERJA MANDIRI Suppurative and Rujuk Lanjut
unspecified otitis media
523 27-03-2018 0137U0040318Y003385 0001738735435 ZAKY ACHMAD ALFARIZI L PEGAWAI SWASTA Necrosis of pulp Berobat Jalan

524 27-03-2018 0137U0040318Y003407 0001743913776 FERRY PRAMONO L PEGAWAI SWASTA Dyspepsia Berobat Jalan

525 27-03-2018 0137U0040318Y003314 0001775555717 ANDRI ANSYAH L PEGAWAI SWASTA Acute upper respiratory Berobat Jalan
infection, unspecified
526 27-03-2018 0137U0040318Y003313 0001775555739 AFIKAH RASTY DIANSYAH P PEGAWAI SWASTA Acute upper respiratory Berobat Jalan
infection, unspecified
527 27-03-2018 0137U0040318Y003328 0001785741748 NOVIETA P PEGAWAI SWASTA Acute upper respiratory Berobat Jalan
infection, unspecified
528 27-03-2018 0137U0040318Y003317 0001803034585 MUHAMAD ALBI FATUR RIZQI L PEGAWAI SWASTA Oedema, unspecified Berobat Jalan

529 27-03-2018 0137U0040318Y003371 0001809627658 SULASTRI P PEKERJA MANDIRI Impacted teeth Berobat Jalan

530 27-03-2018 0137U0040318Y003312 0001842721402 NIA KURNIASIH P PNS DAERAH Other specified headache Berobat Jalan
syndromes
531 27-03-2018 0137U0040318Y003339 0001847715175 RESTI YANI FAUZI P PEGAWAI SWASTA Other specified headache Berobat Jalan
syndromes
532 27-03-2018 0137U0040318Y003300 0001853195523 nazanin azra azeeza achmad P PEKERJA MANDIRI Acute upper respiratory Berobat Jalan
infection, unspecified
533 27-03-2018 0137U0040318Y003399 0001871888703 raisya kayla nurhasanah P PEKERJA MANDIRI Other and unspecified Berobat Jalan
infectious diseases
534 27-03-2018 0137U0040318Y003403 0001892535682 SANTI NURLAELA P PEKERJA MANDIRI Myalgia Berobat Jalan

535 27-03-2018 0137U0040318Y003338 0001899501006 G. STEFANUS KARO L PEKERJA MANDIRI Dermatitis herpetiformis Berobat Jalan
DAFTAR KUNJUNGAN PESERTA SAKIT

Kantor Cabang : BEKASI - 1011

FKTP : Klinik Mitra Medika - 0137U004

536 27-03-2018 0137U0040318Y003330 0001958913404 musrifah P PENERIMA PENSIUN Mixed asthma Rujuk Lanjut
PNS
537 27-03-2018 0137U0040318Y003331 0001963733771 PRITA KEMALASARI P PEKERJA MANDIRI Gastro-oesophageal reflux Rujuk Lanjut
disease without

538 27-03-2018 0137U0040318Y003355 0001965583901 nurhayati P PEKERJA MANDIRI Acute sinusitis Rujuk Lanjut

539 27-03-2018 0137U0040318Y003367 0001969183416 MUHAMMAD IZZAN L PEGAWAI SWASTA Specific developmental Rujuk Lanjut
disorders of speech and

540 27-03-2018 0137U0040318Y003356 0002044159233 luis andrew thiodorus L PEKERJA MANDIRI Anaemia, unspecified Berobat Jalan

541 27-03-2018 0137U0040318Y003315 0002057393542 LIU NAM / SUNARTO L PEKERJA MANDIRI Other specified headache Berobat Jalan
syndromes
542 27-03-2018 0137U0040318Y003323 0002068127853 MUHAMMAD RABBANI L PEGAWAI BUMN Acute upper respiratory Berobat Jalan
infection, unspecified
543 27-03-2018 0137U0040318Y003324 0002081801351 SAFEEA SHAUMY ZULKARNAIN P PEKERJA MANDIRI Acute upper respiratory Berobat Jalan
infection, unspecified
544 27-03-2018 0137U0040318Y003342 0002096305637 ANTONIUS MARIO C. L PEGAWAI SWASTA Acute upper respiratory Berobat Jalan
KODOATIE infection, unspecified
545 27-03-2018 0137U0040318Y003361 0002103709307 NURUL ICHSANI P PEGAWAI SWASTA Myalgia Berobat Jalan

546 27-03-2018 0137U0040318Y003373 0002136404474 YUDHO PRATOMO L PEGAWAI SWASTA Caries of dentine Berobat Jalan

547 27-03-2018 0137U0040318Y003368 0002195524495 KARNADI TARSA L PEKERJA MANDIRI Bell's palsy Rujuk Lanjut

548 27-03-2018 0137U0040318Y003329 0002209909904 EDY SUYATMIN L PEKERJA MANDIRI Myalgia Berobat Jalan

549 27-03-2018 0137U0040318Y003351 0002221517698 maritza avara nella P PNS PUSAT Specific developmental Rujuk Lanjut
disorder of motor function
550 27-03-2018 0137U0040318Y003303 0002221982741 CORDELIA HAMIYAH P PEGAWAI SWASTA Acute upper respiratory Berobat Jalan
infection, unspecified
551 27-03-2018 0137U0040318Y003396 0002222509983 ARDISON L PEKERJA MANDIRI Acute upper respiratory Berobat Jalan
infection, unspecified
552 27-03-2018 0137U0040318Y003404 0002306789627 DINI RESTINASARI P PEKERJA MANDIRI Other secondary arthrosis Berobat Jalan

553 27-03-2018 0137U0040318Y003394 0002430850893 BAYI NY DEWI YANTI P PEKERJA MANDIRI Other disorders of bilirubin Berobat Jalan
metabolism
554 27-03-2018 0137U0040318Y003370 0002432045092 ANNISA EKA PUTRI P PEKERJA MANDIRI Other antenatal screening Berobat Jalan

555 26-03-2018 0137U0040318Y003171 0000016041791 ARMEND L PENERIMA PENSIUN Abrasion of teeth Berobat Jalan
PNS
556 26-03-2018 0137U0040318Y003130 0000040904739 OOP KOMARUDDIN L PNS DAERAH Acute pharyngitis, Berobat Jalan
unspecified
557 26-03-2018 0137U0040318Y003214 0000041156831 SUKIRNO L PNS DAERAH Other specified headache Berobat Jalan
syndromes
DAFTAR KUNJUNGAN PESERTA SAKIT

Kantor Cabang : BEKASI - 1011

FKTP : Klinik Mitra Medika - 0137U004

558 26-03-2018 0137U0040318Y003228 0000042123262 SULISTRIYATI P PENERIMA PENSIUN Acute upper respiratory Berobat Jalan
PNS infection, unspecified
559 26-03-2018 0137U0040318Y003281 0000072846764 SUNARDI L PNS DAERAH Dental caries, unspecified Berobat Jalan

560 26-03-2018 0137U0040318Y003141 0000073248895 ENDANG RAHARDJININGSIH P PENERIMA PENSIUN Acute upper respiratory Berobat Jalan
PNS infection, unspecified
561 26-03-2018 0137U0040318Y003137 0000073269055 RURY ENDARWATI P PENERIMA PENSIUN Acute upper respiratory Berobat Jalan
PNS infection, unspecified
562 26-03-2018 0137U0040318Y003119 0000073382624 YANI AHYANI L PENERIMA PENSIUN Coronary artery aneurysm Rujuk Lanjut
PNS
563 26-03-2018 0137U0040318Y003218 0000073399937 TUTI RUKMIATI P PNS DAERAH Other specified headache Berobat Jalan
syndromes
564 26-03-2018 0137U0040318Y003222 0000073400141 NURLAELA P PNS DAERAH Unspecified haemorrhoids Berobat Jalan
without complication

565 26-03-2018 0137U0040318Y003135 0000073517128 ENONG HERYATI P PNS DAERAH Dyspepsia Berobat Jalan

566 26-03-2018 0137U0040318Y003231 0000149438845 TRIANI PUJI HASTUTI P PNS DAERAH Other and unspecified Berobat Jalan
infectious diseases
567 26-03-2018 0137U0040318Y003201 0000163977197 SURYATI SIDIK P PENERIMA PENSIUN TNI Myalgia Rujuk Lanjut

568 26-03-2018 0137U0040318Y003161 0000200540103 PAYAMAN PANGARIBUAN L PENERIMA PENSIUN TNI Other soft tissue disorders, Rujuk Lanjut
not elsewhere classified

569 26-03-2018 0137U0040318Y003129 0000205071759 ANNISA AGHNIA RAHIM L PEKERJA MANDIRI Acute upper respiratory Berobat Jalan
infection, unspecified
570 26-03-2018 0137U0040318Y003150 0000208704295 ARIQAH GHINA QONITA P PNS DAERAH Traumatic shock Berobat Jalan

571 26-03-2018 0137U0040318Y003211 0000508742627 DWIKY ADI KARA L PEGAWAI SWASTA Acute upper respiratory Berobat Jalan
infection, unspecified
572 26-03-2018 0137U0040318Y003127 0000508828792 INTAN SOLEHA P PEGAWAI SWASTA Varicella meningitis Berobat Jalan

573 26-03-2018 0137U0040318Y003149 0001124718682 MUIS WIJAYA L PEGAWAI SWASTA Typhoid fever Berobat Jalan

574 26-03-2018 0137U0040318Y003259 0001126446535 ABDUL MUKHLIS L PEGAWAI SWASTA Dyspepsia Berobat Jalan

575 26-03-2018 0137U0040318Y003276 0001143810628 RUSDI FLORA NAINGGOLAN P PEKERJA MANDIRI Impacted teeth Berobat Jalan

576 26-03-2018 0137U0040318Y003284 0001145593056 HENDRA SOFINDO L PEGAWAI SWASTA Impacted teeth Berobat Jalan

577 26-03-2018 0137U0040318Y003249 0001150338969 YUDHI AMOR L PEGAWAI SWASTA Acute upper respiratory Berobat Jalan
infection, unspecified
578 26-03-2018 0137U0040318Y003193 0001154809394 SITI HOLIFAH P PEGAWAI SWASTA Other antenatal screening Berobat Jalan

579 26-03-2018 0137U0040318Y003270 0001154955521 RISKA MUJI RAHAYU P PEGAWAI SWASTA Myalgia Berobat Jalan

580 26-03-2018 0137U0040318Y003170 0001158163424 HERAWATI P PEGAWAI SWASTA Impacted teeth Berobat Jalan
DAFTAR KUNJUNGAN PESERTA SAKIT

Kantor Cabang : BEKASI - 1011

FKTP : Klinik Mitra Medika - 0137U004

581 26-03-2018 0137U0040318Y003169 0001174099959 JESSIE NAYSHILA P PEGAWAI SWASTA Impacted teeth Berobat Jalan

582 26-03-2018 0137U0040318Y003223 0001183342498 ATHAILLAH RAFI ALAMSYAH L PEGAWAI SWASTA Acute upper respiratory Berobat Jalan
infection, unspecified
583 26-03-2018 0137U0040318Y003277 0001186237596 GRACE ANGEL NATALIA P PEKERJA MANDIRI Chronic gingivitis Berobat Jalan
HUTAURUK
584 26-03-2018 0137U0040318Y003230 0001189937619 YURHAM REZA HERMAWAN L PEGAWAI SWASTA Acute upper respiratory Berobat Jalan
infection, unspecified
585 26-03-2018 0137U0040318Y003155 0001196819381 AFIKA SAFA KHAIRUNISA P PEGAWAI SWASTA Typhoid fever Berobat Jalan

586 26-03-2018 0137U0040318Y003163 0001204760261 RUSLANSUASANA L PEGAWAI SWASTA Other cataract Rujuk Lanjut

587 26-03-2018 0137U0040318Y003251 0001221490517 LUCKY SUGANDA L PEGAWAI SWASTA Acute upper respiratory Berobat Jalan
infection, unspecified
588 26-03-2018 0137U0040318Y003252 0001221497403 ULANDARI P PEGAWAI SWASTA Other specified headache Berobat Jalan
syndromes
589 26-03-2018 0137U0040318Y003177 0001224028383 ADI AMIEN L PEKERJA MANDIRI Acute upper respiratory Berobat Jalan
infection, unspecified
590 26-03-2018 0137U0040318Y003124 0001257471371 SRI ARYATI P PEKERJA MANDIRI Dependence on renal Rujuk Lanjut
dialysis
591 26-03-2018 0137U0040318Y003116 0001257714224 AYLANI ISTANTI P PEKERJA MANDIRI Insulin-dependent Rujuk Lanjut
diabetes mellitus with

592 26-03-2018 0137U0040318Y003138 0001257859045 YAYAH R P PEKERJA MANDIRI Other specified headache Berobat Jalan
syndromes
593 26-03-2018 0137U0040318Y003219 0001257872905 RIA ANGGREANI SUGENG P PEKERJA MANDIRI Anaemia, unspecified Berobat Jalan

594 26-03-2018 0137U0040318Y003278 0001258150239 INDAH RAHAYU NINGSIH P PEKERJA MANDIRI Impacted teeth Berobat Jalan

595 26-03-2018 0137U0040318Y003147 0001259112982 SUCI VRAMAWATI P PEKERJA MANDIRI Other secondary arthrosis Berobat Jalan

596 26-03-2018 0137U0040318Y003216 0001259116209 SUJARWO L PEKERJA MANDIRI Myalgia Berobat Jalan

597 26-03-2018 0137U0040318Y003198 0001259116244 SAODA P PEKERJA MANDIRI Dyspepsia Rujuk Lanjut

598 26-03-2018 0137U0040318Y003183 0001259197648 ELIAS SILOOY L PEKERJA MANDIRI Acute upper respiratory Berobat Jalan
infection, unspecified
599 26-03-2018 0137U0040318Y003167 0001259520309 IR. EKO TJONDRO DJANUARSO L PEKERJA MANDIRI Hypertensive heart Rujuk Lanjut
disease
600 26-03-2018 0137U0040318Y003131 0001260389294 ARIYA KENZIEE LEE L PEGAWAI SWASTA Acute upper respiratory Berobat Jalan
infection, unspecified
601 26-03-2018 0137U0040318Y003194 0001269879669 NANANG MARTINI P PEKERJA MANDIRI Dislocation of ankle joint Rujuk Lanjut

602 26-03-2018 0137U0040318Y003189 0001271410839 NURBAETI RONY P PEKERJA MANDIRI Acute bronchitis, Rujuk Lanjut
unspecified
603 26-03-2018 0137U0040318Y003186 0001271912038 METHA K.MAKAMINAN P PENERIMA PENSIUN Non-insulin-dependent Rujuk Lanjut
SWASTA diabetes mellitus
DAFTAR KUNJUNGAN PESERTA SAKIT

Kantor Cabang : BEKASI - 1011

FKTP : Klinik Mitra Medika - 0137U004

604 26-03-2018 0137U0040318Y003125 0001272007708 SALMUNINGSIH P PEKERJA MANDIRI Hypertensive heart Rujuk Lanjut
disease
605 26-03-2018 0137U0040318Y003272 0001273051888 NAUFAL DANENDRA PASHA L ANGGOTA POLRI Acute upper respiratory Berobat Jalan
infection, unspecified
606 26-03-2018 0137U0040318Y003176 0001277202756 TARI SAVRINA P PEGAWAI SWASTA Acute upper respiratory Berobat Jalan
infection, unspecified
607 26-03-2018 0137U0040318Y003208 0001278575043 AINIYAH FAIDAH AZMI P PEGAWAI SWASTA Acute upper respiratory Berobat Jalan
infection, unspecified
608 26-03-2018 0137U0040318Y003243 0001280007088 PERCY P PEKERJA MANDIRI Acute upper respiratory Berobat Jalan
infection, unspecified
609 26-03-2018 0137U0040318Y003269 0001281529438 maryamah P PEGAWAI SWASTA Dyspepsia Berobat Jalan

610 26-03-2018 0137U0040318Y003268 0001281531036 dhika ramadhan L PEGAWAI SWASTA Acute upper respiratory Berobat Jalan
infection, unspecified
611 26-03-2018 0137U0040318Y003285 0001282682924 SUPARJO L PEKERJA MANDIRI Dental caries, unspecified Berobat Jalan

612 26-03-2018 0137U0040318Y003215 0001283940066 marfuah P PEKERJA MANDIRI Other secondary arthrosis Rujuk Lanjut

613 26-03-2018 0137U0040318Y003166 0001290608098 IWAN RIDWAN INDARI L PEKERJA MANDIRI Dental caries, unspecified Berobat Jalan

614 26-03-2018 0137U0040318Y003227 0001292513332 NAZWA RAHMAH WIDJAYA P PEGAWAI SWASTA Acute upper respiratory Berobat Jalan
infection, unspecified
615 26-03-2018 0137U0040318Y003226 0001292513354 DEFAIZ ARDIANSYAH WIDJAYA L PEGAWAI SWASTA Acute upper respiratory Berobat Jalan
infection, unspecified
616 26-03-2018 0137U0040318Y003118 0001293305668 LUKAS TANDIO TRIATMODJO L PEKERJA MANDIRI Chronic ischaemic heart Rujuk Lanjut
disease
617 26-03-2018 0137U0040318Y003128 0001293307132 TITIEK SURATI P PEKERJA MANDIRI Dermatitis herpetiformis Berobat Jalan

618 26-03-2018 0137U0040318Y003164 0001306536298 UMAY P PEGAWAI SWASTA Zoster [herpes zoster] Rujuk Lanjut

619 26-03-2018 0137U0040318Y003237 0001312198413 SANDY PRAYOGI L PEKERJA MANDIRI Acute upper respiratory Berobat Jalan
infection, unspecified
620 26-03-2018 0137U0040318Y003140 0001315567811 MARGARETHA P PEGAWAI SWASTA Acute upper respiratory Berobat Jalan
infection, unspecified
621 26-03-2018 0137U0040318Y003160 0001317011332 YANNYATI ISKANDAR L PEKERJA MANDIRI Abnormalities of breathing Rujuk Lanjut

622 26-03-2018 0137U0040318Y003144 0001323570161 SUHENDRA L PEKERJA MANDIRI Acute upper respiratory Berobat Jalan
infection, unspecified
623 26-03-2018 0137U0040318Y003142 0001323570846 LIM SIN HOA P PEKERJA MANDIRI Other specified headache Berobat Jalan
syndromes
624 26-03-2018 0137U0040318Y003273 0001327630094 abidal persada anugrah P PNS DAERAH Necrosis of pulp Berobat Jalan

625 26-03-2018 0137U0040318Y003197 0001337244658 MOCHAMMAD KOMARA L PEKERJA MANDIRI Haemorrhoids Rujuk Lanjut
WINATA
626 26-03-2018 0137U0040318Y003152 0001340069354 YENNI P PEKERJA MANDIRI Dermatitis herpetiformis Berobat Jalan
DAFTAR KUNJUNGAN PESERTA SAKIT

Kantor Cabang : BEKASI - 1011

FKTP : Klinik Mitra Medika - 0137U004

627 26-03-2018 0137U0040318Y003174 0001373858638 RENNY SULISTYANI P PEKERJA MANDIRI Diarrhoea and Berobat Jalan
gastroenteritis of
presumed infectious origin

628 26-03-2018 0137U0040318Y003181 0001379790325 MARLON PAMO L PEKERJA MANDIRI Myalgia Berobat Jalan

629 26-03-2018 0137U0040318Y003180 0001379791449 JEFFREY VANOV IRAWAN L PEKERJA MANDIRI Acute upper respiratory Berobat Jalan
PAMO infection, unspecified
630 26-03-2018 0137U0040318Y003132 0001385529456 KANAYA AYUNDITHA L PEGAWAI SWASTA Typhoid fever Berobat Jalan
RACHMANTYO
631 26-03-2018 0137U0040318Y003221 0001386043334 edy suhendi L PEKERJA MANDIRI Stroke, not specified as Rujuk Lanjut
haemorrhage or infarction
632 26-03-2018 0137U0040318Y003225 0001387893554 KOMALA P PEKERJA MANDIRI Myalgia Berobat Jalan

633 26-03-2018 0137U0040318Y003143 0001389518368 puji lestari L PEKERJA MANDIRI Atherosclerotic heart Rujuk Lanjut
disease
634 26-03-2018 0137U0040318Y003207 0001420967147 LASSY P PEKERJA MANDIRI Myalgia Berobat Jalan

635 26-03-2018 0137U0040318Y003120 0001422706375 indung irianingsih P PEKERJA MANDIRI Other peripheral vertigo Rujuk Lanjut

636 26-03-2018 0137U0040318Y003123 0001424147038 ENY SUHAENAWATI P PEKERJA MANDIRI Cerebral infarction, Rujuk Lanjut
unspecified
637 26-03-2018 0137U0040318Y003263 0001425400773 nayla annisa septiani L PEKERJA MANDIRI Dermatitis herpetiformis Berobat Jalan

638 26-03-2018 0137U0040318Y003122 0001430947304 MEIRA ESTRIYATI. L PEGAWAI SWASTA Sciatica, site unspecified Rujuk Lanjut

639 26-03-2018 0137U0040318Y003192 0001435712128 DWI TUNGGAL SARI P PEGAWAI SWASTA Other antenatal screening Berobat Jalan

640 26-03-2018 0137U0040318Y003196 0001444497107 IN ROCHMANAWATI P PEGAWAI SWASTA Disorders of refraction and Rujuk Lanjut
accommodation
641 26-03-2018 0137U0040318Y003199 0001447098322 RAIHAN GHIFARI WINATA L PEKERJA MANDIRI Disorders of refraction and Rujuk Lanjut
accommodation
642 26-03-2018 0137U0040318Y003271 0001452576014 E. SRIWATUTI P PEKERJA MANDIRI Myalgia Berobat Jalan

643 26-03-2018 0137U0040318Y003233 0001455688754 SRI HARTATI P PEKERJA MANDIRI Myalgia Berobat Jalan

644 26-03-2018 0137U0040318Y003283 0001455705808 CHELSEA FATIHAH SURONO P PEKERJA MANDIRI Abrasion of teeth Berobat Jalan

645 26-03-2018 0137U0040318Y003188 0001460770255 HENDRY JULIANSYAH L PEKERJA MANDIRI Calculus of kidney and Rujuk Lanjut
ureter
646 26-03-2018 0137U0040318Y003126 0001461476474 DANANG HARIYANTO L PEKERJA MANDIRI Acute upper respiratory Berobat Jalan
infection, unspecified
647 26-03-2018 0137U0040318Y003134 0001462191502 TJUK BUDIMAN L PEKERJA MANDIRI Congestive heart failure Rujuk Lanjut

648 26-03-2018 0137U0040318Y003173 0001462335074 IRWAN MULIAWAN L PEKERJA MANDIRI Impacted teeth Berobat Jalan

649 26-03-2018 0137U0040318Y003182 0001462819184 EVI SUSANTI P PEKERJA MANDIRI Acute upper respiratory Berobat Jalan
infection, unspecified
DAFTAR KUNJUNGAN PESERTA SAKIT

Kantor Cabang : BEKASI - 1011

FKTP : Klinik Mitra Medika - 0137U004

650 26-03-2018 0137U0040318Y003121 0001468594113 CHRISTINE ADELEIDA G.S.P. P PEKERJA MANDIRI Disorder of refraction, Rujuk Lanjut
unspecified
651 26-03-2018 0137U0040318Y003185 0001516666847 DEA LARASATI P PEGAWAI SWASTA Acute upper respiratory Berobat Jalan
infection, unspecified
652 26-03-2018 0137U0040318Y003178 0001622468351 MOCH. FACHRI L PEGAWAI SWASTA Acute upper respiratory Berobat Jalan
infection, unspecified
653 26-03-2018 0137U0040318Y003240 0001625364371 ZAHRA QUL SITHA P PEGAWAI SWASTA Acute upper respiratory Berobat Jalan
infection, unspecified
654 26-03-2018 0137U0040318Y003213 0001628559382 ASRIYANTI SYARIFAH P PEGAWAI SWASTA Acute upper respiratory Berobat Jalan
infection, unspecified
655 26-03-2018 0137U0040318Y003172 0001629385986 ATISAH P PEGAWAI SWASTA Impacted teeth Berobat Jalan

656 26-03-2018 0137U0040318Y003262 0001630835223 PRASKA ANGGIANTORO L PEKERJA MANDIRI Other specified headache Berobat Jalan
syndromes
657 26-03-2018 0137U0040318Y003145 0001635210382 ALVINO NATHANIEL S L PEGAWAI SWASTA Typhoid fever Berobat Jalan

658 26-03-2018 0137U0040318Y003260 0001644682307 TIARA FITRIANA DEWI P PEGAWAI SWASTA Other specified headache Berobat Jalan
syndromes
659 26-03-2018 0137U0040318Y003242 0001649824312 CHRISTOPHORUS JOKO L PEGAWAI SWASTA Other secondary arthrosis Berobat Jalan
TRIONO
660 26-03-2018 0137U0040318Y003202 0001654854208 ALI PARNOTO L PEGAWAI SWASTA Atherosclerotic Rujuk Lanjut
cardiovascular disease, so

661 26-03-2018 0137U0040318Y003261 0001656802631 DAYUN KHARIRI P PEGAWAI BUMD Dyspepsia Berobat Jalan

662 26-03-2018 0137U0040318Y003265 0001656802642 ZAID ARRASYID L PEGAWAI BUMD Acute upper respiratory Berobat Jalan
infection, unspecified
663 26-03-2018 0137U0040318Y003266 0001657609582 KURNIA MAYAHEXA L PEGAWAI SWASTA Acute upper respiratory Berobat Jalan
infection, unspecified
664 26-03-2018 0137U0040318Y003241 0001657615206 THERESIA NATHANIA PUTRI P PEGAWAI SWASTA Acute upper respiratory Berobat Jalan
RANUPANI infection, unspecified
665 26-03-2018 0137U0040318Y003244 0001657635535 ADINDA VISCA APRILLIA P PEGAWAI SWASTA Acute upper respiratory Berobat Jalan
infection, unspecified
666 26-03-2018 0137U0040318Y003236 0001659114415 LILIS SURIANI P PEGAWAI SWASTA Gastro-oesophageal reflux Berobat Jalan
disease without

667 26-03-2018 0137U0040318Y003235 0001718170334 DEFI MAHFUDHO P PEGAWAI SWASTA Acute upper respiratory Berobat Jalan
infection, unspecified
668 26-03-2018 0137U0040318Y003184 0001719914984 MUHAMMAD YUSUF MANNAGA L PEKERJA MANDIRI Other specified headache Berobat Jalan
syndromes
669 26-03-2018 0137U0040318Y003286 0001722039355 ENDANG MARULYATI P PEKERJA MANDIRI Impacted teeth Berobat Jalan

670 26-03-2018 0137U0040318Y003217 0001724274009 ASIH SULASIH P PEKERJA MANDIRI Myalgia Berobat Jalan

671 26-03-2018 0137U0040318Y003165 0001725456609 LIE HOA LIANA P PEKERJA MANDIRI Impacted teeth Berobat Jalan
DAFTAR KUNJUNGAN PESERTA SAKIT

Kantor Cabang : BEKASI - 1011

FKTP : Klinik Mitra Medika - 0137U004

672 26-03-2018 0137U0040318Y003279 0001726602715 DARTO L PEGAWAI SWASTA Impacted teeth Berobat Jalan

673 26-03-2018 0137U0040318Y003282 0001726708882 ANI SUHAENI P PEKERJA MANDIRI Impacted teeth Berobat Jalan

674 26-03-2018 0137U0040318Y003248 0001728150309 VINCENT WILLIAM L PEKERJA MANDIRI Atopic dermatitis Rujuk Lanjut

675 26-03-2018 0137U0040318Y003255 0001734260051 SYAHRUL SETYAWAN L PEKERJA MANDIRI Other acute gastritis Berobat Jalan

676 26-03-2018 0137U0040318Y003234 0001735242096 INTAN KUSUMA WARDANI P PEKERJA MANDIRI Gastritis, unspecified Berobat Jalan

677 26-03-2018 0137U0040318Y003205 0001736456084 RAFAEL PRINCE TANUWIDJAJA L PEGAWAI SWASTA Acute upper respiratory Berobat Jalan
infection, unspecified
678 26-03-2018 0137U0040318Y003250 0001737913476 FV EVI SETYOWATI P PEGAWAI SWASTA Gastro-oesophageal reflux Berobat Jalan
disease without

679 26-03-2018 0137U0040318Y003191 0001742518574 DEWI ISTIAWATY P PEGAWAI SWASTA Other antenatal screening Berobat Jalan

680 26-03-2018 0137U0040318Y003253 0001744573239 RAJENDRA ALVIANSYAH L PEGAWAI SWASTA Acute upper respiratory Berobat Jalan
infection, unspecified
681 26-03-2018 0137U0040318Y003280 0001766344329 LISNI P PEGAWAI BUMN Impacted teeth Berobat Jalan

682 26-03-2018 0137U0040318Y003287 0001767001059 RAKA PRAYOGA RAMADHAN L PEGAWAI SWASTA Necrosis of pulp Berobat Jalan

683 26-03-2018 0137U0040318Y003212 0001774954642 PUPUNG IVAN HS L PEGAWAI SWASTA Other specified headache Berobat Jalan
syndromes
684 26-03-2018 0137U0040318Y003139 0001787057739 RIDHO AKBAR KH L PENERIMA PENSIUN Acute upper respiratory Berobat Jalan
PNS infection, unspecified
685 26-03-2018 0137U0040318Y003220 0001791535645 aliza mahdian azzahro P PNS DAERAH Acute upper respiratory Berobat Jalan
infection, unspecified
686 26-03-2018 0137U0040318Y003154 0001814165278 SANDJAJA L PEKERJA MANDIRI Acute upper respiratory Berobat Jalan
infection, unspecified
687 26-03-2018 0137U0040318Y003153 0001814167877 HERLINA P PEKERJA MANDIRI Acute upper respiratory Berobat Jalan
infection, unspecified
688 26-03-2018 0137U0040318Y003117 0001816457668 YULITA MARTHA PALAN B. P PEGAWAI SWASTA Follicular cyst of ovary Rujuk Lanjut

689 26-03-2018 0137U0040318Y003148 0001834865976 ARIZA KURNIA P PEGAWAI SWASTA Typhoid fever Berobat Jalan

690 26-03-2018 0137U0040318Y003275 0001853943557 yudistira putra utama L PEKERJA MANDIRI Dental caries, unspecified Berobat Jalan

691 26-03-2018 0137U0040318Y003200 0001867542434 TASNIAH P PEKERJA MANDIRI Mixed asthma Rujuk Lanjut

692 26-03-2018 0137U0040318Y003210 0001887149891 EKA NURHAYATI P PEGAWAI SWASTA Acute upper respiratory Berobat Jalan
infection, unspecified
693 26-03-2018 0137U0040318Y003209 0001887150429 LUTHFI SAKHI ZAIDAN L PEGAWAI SWASTA Acute upper respiratory Berobat Jalan
infection, unspecified
694 26-03-2018 0137U0040318Y003151 0001890076836 AISYAH FEASY NURAINI P PEKERJA MANDIRI Acute upper respiratory Berobat Jalan
infection, unspecified
DAFTAR KUNJUNGAN PESERTA SAKIT

Kantor Cabang : BEKASI - 1011

FKTP : Klinik Mitra Medika - 0137U004

695 26-03-2018 0137U0040318Y003133 0001900789727 DASITI A P PEKERJA MANDIRI Acute upper respiratory Berobat Jalan
infection, unspecified
696 26-03-2018 0137U0040318Y003136 0001904345897 yayu dermayanti P PEGAWAI SWASTA Myalgia Berobat Jalan

697 26-03-2018 0137U0040318Y003274 0001963185221 sulastri herlina P PEKERJA MANDIRI Impacted teeth Berobat Jalan

698 26-03-2018 0137U0040318Y003190 0001964164926 rumardi bin kaspon L PEKERJA MANDIRI Impacted teeth Berobat Jalan

699 26-03-2018 0137U0040318Y003204 0001965533308 DEWI RATNA KOMALA P PEKERJA MANDIRI Other specified headache Berobat Jalan
syndromes
700 26-03-2018 0137U0040318Y003232 0002033124816 sri sutinah P PEKERJA MANDIRI Acute upper respiratory Berobat Jalan
infection, unspecified
701 26-03-2018 0137U0040318Y003257 0002035255252 PUTRI AISYAH P PEGAWAI SWASTA Varicella meningitis Berobat Jalan

702 26-03-2018 0137U0040318Y003258 0002035255858 ZAHRA TUSYIFA P PEGAWAI SWASTA Varicella meningitis Berobat Jalan

703 26-03-2018 0137U0040318Y003247 0002047311459 ALISYA SHIVA ITJERENNI P PEKERJA MANDIRI Acute upper respiratory Berobat Jalan
infection, unspecified
704 26-03-2018 0137U0040318Y003158 0002056723907 CARL JM.KODOATIE L PEKERJA MANDIRI Insulin-dependent Rujuk Lanjut
diabetes mellitus without

705 26-03-2018 0137U0040318Y003246 0002070111857 FAIRUZ ARDITO W. SUKMANA L PEKERJA MANDIRI Acute upper respiratory Berobat Jalan
infection, unspecified
706 26-03-2018 0137U0040318Y003179 0002099689334 MAGGIE NUANSA M. P PEGAWAI SWASTA Other specified headache Berobat Jalan
syndromes
707 26-03-2018 0137U0040318Y003238 0002136404507 MUHAMMAD FAISHAL GIBRAN L PEGAWAI SWASTA Acute tracheitis Berobat Jalan

708 26-03-2018 0137U0040318Y003203 0002137892444 HAKIM AKHTAR ALFARISY L PEGAWAI SWASTA Acute upper respiratory Berobat Jalan
infection, unspecified
709 26-03-2018 0137U0040318Y003256 0002202825609 NUR HAYATI P PEKERJA MANDIRI Acute upper respiratory Berobat Jalan
infection, unspecified
710 26-03-2018 0137U0040318Y003206 0002208680526 KHAYLA ALMIRA HARYANTO P PEGAWAI SWASTA Acute upper respiratory Berobat Jalan
infection, unspecified
711 26-03-2018 0137U0040318Y003175 0002217321898 YAYUK RAHAYU P PEKERJA MANDIRI Dyspepsia Berobat Jalan

712 26-03-2018 0137U0040318Y003245 0002220666928 DAREEN IMMANUEL L PEGAWAI SWASTA Acute upper respiratory Berobat Jalan
KURNIAWAN infection, unspecified
713 26-03-2018 0137U0040318Y003267 0002229904258 MUHAMMAD ARKANA KURNIA L PEGAWAI SWASTA Acute upper respiratory Berobat Jalan
MAKSUM infection, unspecified
714 26-03-2018 0137U0040318Y003224 0002247462551 naira azwa fakhira P PEKERJA MANDIRI Dermatitis herpetiformis Berobat Jalan

715 26-03-2018 0137U0040318Y003157 0002248692693 MOHAMAD FAISYAL L PEGAWAI SWASTA Traumatic shock Berobat Jalan
HARDYANSYAH
716 26-03-2018 0137U0040318Y003264 0002252872023 DARSIH P PEKERJA MANDIRI Dyspepsia Berobat Jalan

717 26-03-2018 0137U0040318Y003239 0002253310615 MUHAMAD DAFFA AL - L PEKERJA MANDIRI Acute upper respiratory Berobat Jalan
GHIBRAN infection, unspecified
DAFTAR KUNJUNGAN PESERTA SAKIT

Kantor Cabang : BEKASI - 1011

FKTP : Klinik Mitra Medika - 0137U004

718 26-03-2018 0137U0040318Y003168 0002256760135 ARRAZKA AHZAN PRAYOSO L PEGAWAI SWASTA Diarrhoea and Rujuk Lanjut
gastroenteritis of
presumed infectious origin

719 26-03-2018 0137U0040318Y003146 0002262956051 MUHAMMAD ZUFAR KHAAZIN L PEKERJA MANDIRI Typhoid fever Berobat Jalan

720 26-03-2018 0137U0040318Y003254 0002268532034 ATHALLA ALMIRAZ YUSUF L PEGAWAI SWASTA Acute upper respiratory Berobat Jalan
infection, unspecified
721 26-03-2018 0137U0040318Y003156 0002270490164 MUHAMMAD WILDAN L PNS PUSAT Acute upper respiratory Berobat Jalan
ARRASYID infection, unspecified
722 26-03-2018 0137U0040318Y003195 0002292526203 YAHDIAN DWI FADHLAN SANDI L PEKERJA MANDIRI Other headache Rujuk Lanjut
syndromes
723 26-03-2018 0137U0040318Y003229 0002432320773 NIZAM PRADIPTA ADYATMA L PEGAWAI SWASTA Other and unspecified Rujuk Lanjut
convulsions
724 25-03-2018 0137U0040318Y003050 0000036303783 SIRAT L PENERIMA PENSIUN Cataract, unspecified Rujuk Lanjut
PNS
725 25-03-2018 0137U0040318Y003085 0000038026765 TITIN ZELVINA P PNS PUSAT Acute upper respiratory Berobat Jalan
infection, unspecified
726 25-03-2018 0137U0040318Y003112 0000055589332 ETI PURWANDARI P PNS DAERAH Dyspepsia Berobat Jalan

727 25-03-2018 0137U0040318Y003111 0000072929891 SUBUR SUNIARAGA L PNS DAERAH Other specified headache Berobat Jalan
syndromes
728 25-03-2018 0137U0040318Y003084 0000163682381 MUHAMMAD AKHDAN L PNS PUSAT Acute upper respiratory Berobat Jalan
ARFADHIA infection, unspecified
729 25-03-2018 0137U0040318Y003093 0001143248231 GUNTUR SAMODRO L PEKERJA MANDIRI Acute upper respiratory Berobat Jalan
infection, unspecified
730 25-03-2018 0137U0040318Y003086 0001171215448 ANDRIAN PRAMUDIANSYAH L PEGAWAI SWASTA Other and unspecified Berobat Jalan
abdominal pain
731 25-03-2018 0137U0040318Y003103 0001179924388 TITIN WAHYU NINGSIH P PEKERJA MANDIRI Heart failure Rujuk Lanjut

732 25-03-2018 0137U0040318Y003074 0001203182381 AINA FaRHA P PEGAWAI SWASTA Acute upper respiratory Berobat Jalan
infections of multiple and

733 25-03-2018 0137U0040318Y003059 0001204114241 DANISH RAJABANI L PEGAWAI SWASTA Acute upper respiratory Berobat Jalan
infections of multiple and

734 25-03-2018 0137U0040318Y003114 0001204199987 THALITA ALSHIRA P PEGAWAI SWASTA Acute upper respiratory Berobat Jalan
infection, unspecified
735 25-03-2018 0137U0040318Y003048 0001256223802 ARIFIN L PEKERJA MANDIRI Cataract, unspecified Rujuk Lanjut

736 25-03-2018 0137U0040318Y003049 0001256224026 SISHI ARINE AISYAH P PEKERJA MANDIRI Acute bronchitis due to Rujuk Lanjut
other specified organisms
737 25-03-2018 0137U0040318Y003094 0001257602703 SRI LESTARI P PEKERJA MANDIRI Non-insulin-dependent Rujuk Lanjut
diabetes mellitus with
DAFTAR KUNJUNGAN PESERTA SAKIT

Kantor Cabang : BEKASI - 1011

FKTP : Klinik Mitra Medika - 0137U004

738 25-03-2018 0137U0040318Y003078 0001257894821 ATJEP SUKARDI L PEKERJA MANDIRI Acute upper respiratory Berobat Jalan
infections of multiple and

739 25-03-2018 0137U0040318Y003101 0001260700727 DINA KHRISTINA K P PEKERJA MANDIRI Myalgia Berobat Jalan

740 25-03-2018 0137U0040318Y003082 0001267268139 ENGGAR ACHMAD PRASETYO L PEGAWAI SWASTA Corns and callosities Rujuk Lanjut

741 25-03-2018 0137U0040318Y003104 0001287160571 RUDI NAPITULU L PEKERJA MANDIRI Other specified headache Berobat Jalan
syndromes
742 25-03-2018 0137U0040318Y003038 0001291253038 KREDO YASA ADHIANTORO L PEGAWAI SWASTA Acute upper respiratory Berobat Jalan
infections of multiple and

743 25-03-2018 0137U0040318Y003055 0001292820838 AHMAD FATHAN AL FALIH L PEGAWAI SWASTA Acute upper respiratory Berobat Jalan
infections of multiple and

744 25-03-2018 0137U0040318Y003088 0001381440047 BACHTIAR L PEKERJA MANDIRI Acute pharyngitis, Berobat Jalan
unspecified
745 25-03-2018 0137U0040318Y003087 0001400098544 WAHYUNI RISNAWATI P PEGAWAI SWASTA Other specified headache Berobat Jalan
syndromes
746 25-03-2018 0137U0040318Y003079 0001408435119 Muhammad Ghaisan Al Ghifari L PEGAWAI SWASTA Acute upper respiratory Berobat Jalan
infections of multiple and

747 25-03-2018 0137U0040318Y003187 0001429020832 YULIANA P PEGAWAI SWASTA Other antenatal screening Berobat Jalan

748 25-03-2018 0137U0040318Y003060 0001432808976 sumi P PEKERJA MANDIRI Other soft tissue disorders, Berobat Jalan
not elsewhere classified

749 25-03-2018 0137U0040318Y003053 0001439138507 ENTIN SUPRIATIN P PEGAWAI SWASTA Other soft tissue disorders, Berobat Jalan
not elsewhere classified

750 25-03-2018 0137U0040318Y003077 0001455132464 ADY CAHYADI L PEKERJA MANDIRI Dyspepsia Berobat Jalan

751 25-03-2018 0137U0040318Y003109 0001457701751 SYAHRUL RAMDANI L PEKERJA MANDIRI Typhoid fever Berobat Jalan

752 25-03-2018 0137U0040318Y003106 0001462624378 TUBAGUS RONNY NOUR L PEKERJA MANDIRI Dyspepsia Berobat Jalan
RONNI
753 25-03-2018 0137U0040318Y003095 0001602455962 Erlin Farliana Nila Hanjayani P PEGAWAI SWASTA Calculus of kidney and Rujuk Lanjut
ureter
754 25-03-2018 0137U0040318Y003052 0001624477623 RUDI WINARSO L PEGAWAI SWASTA Acute upper respiratory Berobat Jalan
infections of multiple and

755 25-03-2018 0137U0040318Y003080 0001625364257 USMAN EFFENDI L PEGAWAI SWASTA Other bullous disorders Berobat Jalan

756 25-03-2018 0137U0040318Y003061 0001627833868 RATNA DEWI P PEGAWAI SWASTA Other headache Berobat Jalan
syndromes
757 25-03-2018 0137U0040318Y003097 0001629387167 SUSCHADI SUDIYONO L PEGAWAI SWASTA Acute upper respiratory Berobat Jalan
infection, unspecified
DAFTAR KUNJUNGAN PESERTA SAKIT

Kantor Cabang : BEKASI - 1011

FKTP : Klinik Mitra Medika - 0137U004

758 25-03-2018 0137U0040318Y003091 0001631030883 ANANDA KUMAR L PEGAWAI SWASTA Dyspepsia Berobat Jalan

759 25-03-2018 0137U0040318Y003098 0001631776329 ALDINO L PEGAWAI SWASTA Other and unspecified Berobat Jalan
abdominal pain
760 25-03-2018 0137U0040318Y003100 0001633873994 BAROMEUS SINA L PEGAWAI SWASTA Acute upper respiratory Berobat Jalan
infection, unspecified
761 25-03-2018 0137U0040318Y003026 0001637621335 MUHAMMAD ALDYNA AZZAM L PEGAWAI SWASTA Acute upper respiratory Berobat Jalan
ASHARY infections of multiple and

762 25-03-2018 0137U0040318Y003073 0001639107753 BIGI SERIDO L PEGAWAI SWASTA Other soft tissue disorders, Berobat Jalan
not elsewhere classified

763 25-03-2018 0137U0040318Y003029 0001643913639 DENI IRAWAN L PEGAWAI SWASTA Acute upper respiratory Berobat Jalan
infections of multiple and

764 25-03-2018 0137U0040318Y003083 0001649969752 SOEPRIYADI RUSDIANTO P PEGAWAI SWASTA Chronic ischaemic heart Rujuk Lanjut
disease
765 25-03-2018 0137U0040318Y003037 0001658328614 RIKA AKANA P PEGAWAI SWASTA Contraceptive Berobat Jalan
management
766 25-03-2018 0137U0040318Y003054 0001718261706 WIDIASIH AMINATUN P PEKERJA MANDIRI Dyspepsia Berobat Jalan

767 25-03-2018 0137U0040318Y003092 0001721987897 MUHAMMAD RIZKY KUSUMA L PEKERJA MANDIRI Acute upper respiratory Berobat Jalan
infection, unspecified
768 25-03-2018 0137U0040318Y003108 0001768120457 KARTIKA AGUSTIANI P PEGAWAI SWASTA Varicella [chickenpox] Berobat Jalan

769 25-03-2018 0137U0040318Y003076 0001769446552 KONRISTA VIN YECIA P PEGAWAI SWASTA Disorders of vestibular Rujuk Lanjut
function
770 25-03-2018 0137U0040318Y003102 0001829578454 SYAFRUDDIN KATUTU L PEKERJA MANDIRI Myalgia Berobat Jalan

771 25-03-2018 0137U0040318Y003099 0001829982947 MUCHYATI P PEKERJA MANDIRI Unspecified viral hepatitis Rujuk Lanjut
without hepatic coma

772 25-03-2018 0137U0040318Y003051 0001834382373 TASLIMAH P PEKERJA MANDIRI Contraceptive Berobat Jalan
management
773 25-03-2018 0137U0040318Y003040 0001843571801 SYA'RONI L PEGAWAI SWASTA Other soft tissue disorders, Berobat Jalan
not elsewhere classified

774 25-03-2018 0137U0040318Y003113 0001847228512 nurkhayati P PEKERJA MANDIRI Dyspepsia Berobat Jalan

775 25-03-2018 0137U0040318Y003090 0001852766021 HARTONO L PEKERJA MANDIRI Acute upper respiratory Berobat Jalan
infection, unspecified
776 25-03-2018 0137U0040318Y003066 0001874697142 ALEXI HAMONANGAN SIANIPAR L PEKERJA MANDIRI Acute upper respiratory Berobat Jalan
infections of multiple and

777 25-03-2018 0137U0040318Y003846 0001878405456 SITI cHOLIPAH P PEKERJA MANDIRI Other contraceptive Berobat Jalan
management
DAFTAR KUNJUNGAN PESERTA SAKIT

Kantor Cabang : BEKASI - 1011

FKTP : Klinik Mitra Medika - 0137U004

778 25-03-2018 0137U0040318Y003115 0001878406154 rafael arinski L PEKERJA MANDIRI Typhoid fever Berobat Jalan

779 25-03-2018 0137U0040318Y003107 0001878406716 muhammad zibran ariansyah L PEKERJA MANDIRI Respiratory tuberculosis Rujuk Lanjut
unspecified, confirmed
bacteriologically and

780 25-03-2018 0137U0040318Y003089 0001962149635 ERNY SISWANTI P PEGAWAI SWASTA Senile cataract, Rujuk Lanjut
unspecified
781 25-03-2018 0137U0040318Y003105 0002054764269 HENDRO WICAKSONO L PEKERJA MANDIRI Other specified headache Berobat Jalan
syndromes
782 25-03-2018 0137U0040318Y003027 0002056723907 CARL JM.KODOATIE L PEKERJA MANDIRI Presbyopia Rujuk Lanjut

783 25-03-2018 0137U0040318Y003096 0002070784697 IQBAL RIZKY RAFARDHAN L PEKERJA MANDIRI Other complications of Rujuk Lanjut
labour and delivery, not

784 25-03-2018 0137U0040318Y003075 0002072338424 IR.TUTANG WIJAYA WACHID L PEGAWAI SWASTA Cholelithiasis Rujuk Lanjut

785 25-03-2018 0137U0040318Y003028 0002085425166 SITI JAENAH P PEGAWAI SWASTA Acute upper respiratory Berobat Jalan
infections of multiple and

786 25-03-2018 0137U0040318Y003072 0002087719762 RIANA HERYANI P PEGAWAI SWASTA Other soft tissue disorders, Berobat Jalan
not elsewhere classified

787 25-03-2018 0137U0040318Y003068 0002087720324 MUHAMMAD L PEGAWAI SWASTA Acute upper respiratory Berobat Jalan
infections of multiple and

788 25-03-2018 0137U0040318Y003064 0002206311581 kayla riezki amalia prabowo P KEPOLISIAN RI Acute upper respiratory Berobat Jalan
infections of multiple and

789 25-03-2018 0137U0040318Y003030 0002218016856 PURWANINGTIAS WULANDARI P PEKERJA MANDIRI Acute upper respiratory Berobat Jalan
infections of multiple and

790 25-03-2018 0137U0040318Y003036 0002230809456 PRISCILLA KINARA YULIANTO P PEGAWAI SWASTA Bronchopneumonia, Rujuk Lanjut
unspecified
791 25-03-2018 0137U0040318Y003110 0002248413592 NAUFAL HAKIM SUNIARAGA L PNS DAERAH Acute upper respiratory Berobat Jalan
infection, unspecified
792 25-03-2018 0137U0040318Y003031 0002266545396 yusuf hidayatuloh L PEGAWAI SWASTA Suppurative otitis media, Rujuk Lanjut
unspecified
793 25-03-2018 0137U0040318Y003081 0002306789627 DINI RESTINASARI P PEKERJA MANDIRI Acute upper respiratory Berobat Jalan
infections of multiple and

794 24-03-2018 0137U0040318Y002936 0000036303783 SIRAT L PENERIMA PENSIUN Myalgia Berobat Jalan
PNS
795 24-03-2018 0137U0040318Y002940 0000040904728 SRI SURASIH P PNS DAERAH Other specified headache Berobat Jalan
syndromes
DAFTAR KUNJUNGAN PESERTA SAKIT

Kantor Cabang : BEKASI - 1011

FKTP : Klinik Mitra Medika - 0137U004

796 24-03-2018 0137U0040318Y002937 0000040904739 OOP KOMARUDDIN L PNS DAERAH Acute upper respiratory Berobat Jalan
infection, unspecified
797 24-03-2018 0137U0040318Y002939 0000040904752 DINNA SUCI RAHMAH P PEKERJA MANDIRI Other secondary arthrosis Berobat Jalan

798 24-03-2018 0137U0040318Y003016 0000042101414 JULIANA ELLEN TEHUPEIORY P PENERIMA PENSIUN Acute upper respiratory Berobat Jalan
PNS infection, unspecified
799 24-03-2018 0137U0040318Y002994 0000042128504 ROSANDI L PENERIMA PENSIUN Myopia Berobat Jalan
PNS
800 24-03-2018 0137U0040318Y002978 0000042128515 DJUMIRAH P PENERIMA PENSIUN Other bullous disorders Berobat Jalan
PNS
801 24-03-2018 0137U0040318Y002921 0000063306336 HENI P PENERIMA PENSIUN Unspecified renal colic Rujuk Lanjut
PNS
802 24-03-2018 0137U0040318Y002928 0000072836291 HASTI ROHNURHAETY P PNS DAERAH Dental caries, unspecified Berobat Jalan

803 24-03-2018 0137U0040318Y002947 0000073517567 DEDY HIDAYAT L PNS DAERAH Other secondary arthrosis Berobat Jalan

804 24-03-2018 0137U0040318Y002959 0000073539044 MUH.RAFI ADHIPRAMANA L PNS DAERAH Acute upper respiratory Berobat Jalan
infection, unspecified
805 24-03-2018 0137U0040318Y002982 0000073570882 FARIDA PURWANTI HASSAN P PNS DAERAH Embedded and impacted Berobat Jalan
teeth
806 24-03-2018 0137U0040318Y002898 0000100561285 ANDRI PRABOWO L PNS PUSAT Disorder of refraction, Rujuk Lanjut
unspecified
807 24-03-2018 0137U0040318Y002933 0000149438845 TRIANI PUJI HASTUTI P PNS DAERAH Myalgia Berobat Jalan

808 24-03-2018 0137U0040318Y003017 0000165837565 JOHANIS SURIPATTY L PENERIMA PENSIUN Acute upper respiratory Berobat Jalan
PNS infection, unspecified
809 24-03-2018 0137U0040318Y003013 0000202416333 MOHAMAD S HAMDANI L PENERIMA PENSIUN Myalgia Berobat Jalan
PNS
810 24-03-2018 0137U0040318Y002980 0000202588975 LUTHFIYAH ZAHRA P PEKERJA MANDIRI Embedded and impacted Berobat Jalan
teeth
811 24-03-2018 0137U0040318Y003020 0000204985473 INNA FEBRIANTIE P PNS PUSAT Acute upper respiratory Berobat Jalan
infection, unspecified
812 24-03-2018 0137U0040318Y002938 0000205071759 ANNISA AGHNIA RAHIM L PEKERJA MANDIRI Acute upper respiratory Berobat Jalan
infection, unspecified
813 24-03-2018 0137U0040318Y002913 0000205247158 BAY MURNI P PENERIMA PENSIUN Gastro-oesophageal reflux Rujuk Lanjut
PNS disease
814 24-03-2018 0137U0040318Y002946 0000508828792 INTAN SOLEHA P PEGAWAI SWASTA Acute pharyngitis, Berobat Jalan
unspecified
815 24-03-2018 0137U0040318Y002960 0001100629247 AJENG LUPITA HANDAYANI P PEKERJA MANDIRI Hypermetropia Berobat Jalan

816 24-03-2018 0137U0040318Y002983 0001146846745 SUSANTI SE P PEGAWAI SWASTA Embedded and impacted Berobat Jalan
teeth
817 24-03-2018 0137U0040318Y002929 0001159527071 FITRI INDAH SARI P PEGAWAI SWASTA Impacted teeth Berobat Jalan

818 24-03-2018 0137U0040318Y002997 0001179924388 TITIN WAHYU NINGSIH P PEKERJA MANDIRI Pyothorax without fistula Berobat Jalan
DAFTAR KUNJUNGAN PESERTA SAKIT

Kantor Cabang : BEKASI - 1011

FKTP : Klinik Mitra Medika - 0137U004

819 24-03-2018 0137U0040318Y002962 0001180334711 RAIHANSYAH LUTFHI L PEGAWAI SWASTA Paratyphoid fever A Berobat Jalan

820 24-03-2018 0137U0040318Y002944 0001187675199 MIMIN MINTARSIH P PEGAWAI SWASTA Acute upper respiratory Berobat Jalan
infection, unspecified
821 24-03-2018 0137U0040318Y002924 0001243809696 TEGUH WIDODO L PEGAWAI SWASTA Caries of dentine Berobat Jalan

822 24-03-2018 0137U0040318Y002907 0001243809707 RODIATI P PEGAWAI SWASTA Other endometriosis Rujuk Lanjut

823 24-03-2018 0137U0040318Y003019 0001243809764 NURHAYATI P PEGAWAI SWASTA Acute upper respiratory Berobat Jalan
infection, unspecified
824 24-03-2018 0137U0040318Y003014 0001243809786 MUHAMMAD HAMID IBRAHIM L PEGAWAI SWASTA Other and unspecified Berobat Jalan
abdominal pain
825 24-03-2018 0137U0040318Y002975 0001256148944 ERNES DARIANSYAH L PEGAWAI SWASTA Acute upper respiratory Berobat Jalan
infections of multiple and

826 24-03-2018 0137U0040318Y002941 0001257582082 TITIEK LATIFAH P PEKERJA MANDIRI Other specified headache Berobat Jalan
syndromes
827 24-03-2018 0137U0040318Y002930 0001258952771 TUTWURI HANDAYANI P PEGAWAI SWASTA Impacted teeth Berobat Jalan

828 24-03-2018 0137U0040318Y002986 0001259233839 BONG POSUN FRANSISKUS L PEKERJA MANDIRI Dental caries Berobat Jalan

829 24-03-2018 0137U0040318Y002953 0001260105671 LISDA P PEKERJA MANDIRI Paratyphoid fever A Berobat Jalan

830 24-03-2018 0137U0040318Y002963 0001266185968 WAGITO L PEKERJA MANDIRI Acute upper respiratory Berobat Jalan
infection, unspecified
831 24-03-2018 0137U0040318Y003010 0001267506639 ARDI KUNCORO L PEKERJA MANDIRI Acute upper respiratory Berobat Jalan
infection, unspecified
832 24-03-2018 0137U0040318Y002949 0001279264072 JOHAN BENTO L PEKERJA MANDIRI Non-insulin-dependent Rujuk Lanjut
diabetes mellitus without

833 24-03-2018 0137U0040318Y002965 0001287861456 NANURU ALEXANDER L PEKERJA MANDIRI Insulin-dependent Rujuk Lanjut
ARTANAN diabetes mellitus with

834 24-03-2018 0137U0040318Y002964 0001287861906 N KANNAH P PEKERJA MANDIRI Insulin-dependent Rujuk Lanjut
diabetes mellitus with

835 24-03-2018 0137U0040318Y002927 0001290608098 IWAN RIDWAN INDARI L PEKERJA MANDIRI Impacted teeth Berobat Jalan

836 24-03-2018 0137U0040318Y002945 0001305439299 REZA ARDHA PRAMUDIYA L PEGAWAI SWASTA Dermatitis herpetiformis Berobat Jalan

837 24-03-2018 0137U0040318Y002934 0001305749349 NURIMAH P PEKERJA MANDIRI Secondary hypertension, Berobat Jalan
unspecified
838 24-03-2018 0137U0040318Y003003 0001306536298 UMAY P PEGAWAI SWASTA Varicella encephalitis Berobat Jalan

839 24-03-2018 0137U0040318Y002935 0001314077681 NYI RESA P PEKERJA MANDIRI Other secondary arthrosis Berobat Jalan

840 24-03-2018 0137U0040318Y003002 0001315568035 RACHEL FEBRIANI KOMARA P. P PEGAWAI SWASTA Acute upper respiratory Berobat Jalan
infection, unspecified
DAFTAR KUNJUNGAN PESERTA SAKIT

Kantor Cabang : BEKASI - 1011

FKTP : Klinik Mitra Medika - 0137U004

841 24-03-2018 0137U0040318Y003025 0001319808802 oey beng tiong L PEKERJA MANDIRI Impacted teeth Berobat Jalan

842 24-03-2018 0137U0040318Y002952 0001339885034 SUGENG SURIPTO L PEKERJA MANDIRI Typhoid fever Berobat Jalan

843 24-03-2018 0137U0040318Y002974 0001340087725 LESLYKA JANNATA L PEGAWAI SWASTA Acute upper respiratory Berobat Jalan
DARIANSYAH infections of multiple and

844 24-03-2018 0137U0040318Y002956 0001370634546 KARNIAH P PNS PUSAT Acute upper respiratory Berobat Jalan
infection, unspecified
845 24-03-2018 0137U0040318Y002909 0001387160739 DESTI PUSPITA P PEKERJA MANDIRI Acute upper respiratory Berobat Jalan
infection, unspecified
846 24-03-2018 0137U0040318Y002981 0001407711644 RINI HASTUTI P PEGAWAI SWASTA Dental caries Berobat Jalan

847 24-03-2018 0137U0040318Y002971 0001428180074 Safaraz Aufa Azalia P PEKERJA MANDIRI Acute upper respiratory Berobat Jalan
infection, unspecified
848 24-03-2018 0137U0040318Y002926 0001428262727 ANI P PEKERJA MANDIRI Necrosis of pulp Berobat Jalan

849 24-03-2018 0137U0040318Y002902 0001438079859 MAMAH NURMAIDAH P PEKERJA MANDIRI Other secondary arthrosis Berobat Jalan

850 24-03-2018 0137U0040318Y002920 0001440774268 JARIAMAN SARAGIH L PEKERJA MANDIRI Acute upper respiratory Berobat Jalan
infection, unspecified
851 24-03-2018 0137U0040318Y002948 0001445711962 LIA YULIASARI DEWI P PEKERJA MANDIRI Irregular menstruation, Rujuk Lanjut
unspecified
852 24-03-2018 0137U0040318Y002919 0001452576014 E. SRIWATUTI P PEKERJA MANDIRI Other specified headache Berobat Jalan
syndromes
853 24-03-2018 0137U0040318Y002943 0001454566228 SRI REJEKI INDARTINI P PEKERJA MANDIRI Other secondary arthrosis Berobat Jalan

854 24-03-2018 0137U0040318Y002967 0001455015069 HAMID L PEKERJA MANDIRI Insulin-dependent Rujuk Lanjut
diabetes mellitus
855 24-03-2018 0137U0040318Y002968 0001457891008 KUILIAN YAYA TINA P PEKERJA MANDIRI Other seropositive Rujuk Lanjut
rheumatoid arthritis, lower

856 24-03-2018 0137U0040318Y003023 0001458525723 SITI ROHIMAH P PEKERJA MANDIRI Paratyphoid fever A Berobat Jalan

857 24-03-2018 0137U0040318Y003021 0001463106363 NURUL KOMARIAH P PEKERJA MANDIRI Myalgia Berobat Jalan

858 24-03-2018 0137U0040318Y002973 0001465869644 YUNIARTY PUTRI P PEKERJA MANDIRI Necrosis of pulp Rujuk Lanjut

859 24-03-2018 0137U0040318Y002951 0001467832443 H.AININ SAPUTRA L PEKERJA MANDIRI Other specified headache Berobat Jalan
syndromes
860 24-03-2018 0137U0040318Y002987 0001469630248 SUMIYATI P PEKERJA MANDIRI Contraceptive Berobat Jalan
management
861 24-03-2018 0137U0040318Y003001 0001474330138 AJI PRAKOSO L PEKERJA MANDIRI Acute upper respiratory Berobat Jalan
infection, unspecified
862 24-03-2018 0137U0040318Y002942 0001475818402 WAKIDIYONO L PEKERJA MANDIRI Dermatitis herpetiformis Berobat Jalan
DAFTAR KUNJUNGAN PESERTA SAKIT

Kantor Cabang : BEKASI - 1011

FKTP : Klinik Mitra Medika - 0137U004

863 24-03-2018 0137U0040318Y003472 0001477625444 FITRI YULIA PRIHATINI P PEGAWAI SWASTA Other contraceptive Berobat Jalan
management
864 24-03-2018 0137U0040318Y003008 0001480605085 DEDI SUPRIADI L PEGAWAI SWASTA Acute upper respiratory Berobat Jalan
infection, unspecified
865 24-03-2018 0137U0040318Y002914 0001514788389 WAHYUNINGSIH P PEGAWAI SWASTA Necrosis of pulp Rujuk Lanjut

866 24-03-2018 0137U0040318Y002903 0001517751281 SYOFYAN HADI L PEGAWAI SWASTA Other specified headache Berobat Jalan
syndromes
867 24-03-2018 0137U0040318Y002899 0001517751292 INE NURUL HAYAH P PEGAWAI SWASTA Disorder of refraction, Rujuk Lanjut
unspecified
868 24-03-2018 0137U0040318Y002908 0001608760719 RIRIH MARTIANA P PEGAWAI SWASTA Other secondary arthrosis Berobat Jalan

869 24-03-2018 0137U0040318Y002911 0001625340284 JULIANA LE KINDANGAN P PEGAWAI SWASTA Acute upper respiratory Berobat Jalan
infection, unspecified
870 24-03-2018 0137U0040318Y002910 0001625340306 SAMUEL CHRISTOPER L PEGAWAI SWASTA Acute upper respiratory Berobat Jalan
infection, unspecified
871 24-03-2018 0137U0040318Y003022 0001625714087 DIMAS GUNTUR HERLAMBANG L PEGAWAI SWASTA Diarrhoea and Berobat Jalan
gastroenteritis of
presumed infectious origin

872 24-03-2018 0137U0040318Y002922 0001632068741 YOHNNY HONATA MODODAHI L PEKERJA MANDIRI Impacted teeth Berobat Jalan

873 24-03-2018 0137U0040318Y002923 0001632068752 VERONICA TITIK LISTYORINI P PEKERJA MANDIRI Dental caries, unspecified Berobat Jalan

874 24-03-2018 0137U0040318Y002985 0001639630304 FERDINATA KUSUMA L PEGAWAI SWASTA Embedded and impacted Berobat Jalan
teeth
875 24-03-2018 0137U0040318Y003024 0001648009811 NICHOLAS ALEXANDRE L PEGAWAI SWASTA Varicella encephalitis Berobat Jalan

876 24-03-2018 0137U0040318Y002918 0001650245106 Bernadien Pramudita Tantya P PEGAWAI SWASTA Disorder of refraction, Rujuk Lanjut
Kirana unspecified
877 24-03-2018 0137U0040318Y002999 0001652893053 Abdurrohim Salim L PEGAWAI SWASTA Paratyphoid fever A Berobat Jalan

878 24-03-2018 0137U0040318Y002955 0001655889423 Mardian Yulianto L PEGAWAI SWASTA Acute upper respiratory Berobat Jalan
infection, unspecified
879 24-03-2018 0137U0040318Y003000 0001657609593 SRI UTAMI DEWI P PEGAWAI SWASTA Acute upper respiratory Berobat Jalan
infection, unspecified
880 24-03-2018 0137U0040318Y002931 0001720357626 SUBAEDAH P PEKERJA MANDIRI Impacted teeth Berobat Jalan

881 24-03-2018 0137U0040318Y002990 0001722045262 NOVA HERLINA P PEGAWAI SWASTA Dental caries Berobat Jalan

882 24-03-2018 0137U0040318Y002969 0001723912018 NURUL SASONO L PEGAWAI SWASTA Foreign body in alimentary Rujuk Lanjut
tract
883 24-03-2018 0137U0040318Y002972 0001727929743 VALENTINO KHUNARA L PEGAWAI SWASTA Acute upper respiratory Berobat Jalan
DHARMA infection, unspecified
DAFTAR KUNJUNGAN PESERTA SAKIT

Kantor Cabang : BEKASI - 1011

FKTP : Klinik Mitra Medika - 0137U004

884 24-03-2018 0137U0040318Y002966 0001728769757 SUBANDI JOSOPRAWIRO L PEGAWAI SWASTA Respiratory tuberculosis Rujuk Lanjut
unspecified, confirmed
bacteriologically and

885 24-03-2018 0137U0040318Y002912 0001736904295 AFIQAH ZHAFIRAH L PEGAWAI SWASTA Dermatitis herpetiformis Berobat Jalan

886 24-03-2018 0137U0040318Y002998 0001738228397 RAHMASARI P PEGAWAI SWASTA Pyothorax without fistula Berobat Jalan

887 24-03-2018 0137U0040318Y002932 0001742490404 VERNY MIRANINGSIH P PEGAWAI SWASTA Dental caries, unspecified Berobat Jalan

888 24-03-2018 0137U0040318Y002976 0001785741748 NOVIETA P PEGAWAI SWASTA Acute upper respiratory Berobat Jalan
infections of multiple and

889 24-03-2018 0137U0040318Y002977 0001785742637 ARETA NATHANIA HARTANTO P PEGAWAI SWASTA Acute upper respiratory Berobat Jalan
infections of multiple and

890 24-03-2018 0137U0040318Y003006 0001797695908 Sephia Difa Adilla P PEGAWAI SWASTA Dental caries Berobat Jalan

891 24-03-2018 0137U0040318Y002916 0001799424944 MUKI L PEKERJA MANDIRI Myalgia Berobat Jalan

892 24-03-2018 0137U0040318Y003009 0001819750893 RISMA SINAGA P PEGAWAI SWASTA Dermatitis herpetiformis Berobat Jalan

893 24-03-2018 0137U0040318Y002915 0001845270112 TINI HARTINI P PEGAWAI SWASTA Dermatitis herpetiformis Berobat Jalan

894 24-03-2018 0137U0040318Y002905 0001856949456 HENDRIK JULIANUS TAHALELE L PENERIMA PENSIUN Hyperplasia of prostate Rujuk Lanjut
SWASTA
895 24-03-2018 0137U0040318Y002901 0001861042318 RUDI HARTONO L PEGAWAI SWASTA Cervical disc disorder, Rujuk Lanjut
unspecified
896 24-03-2018 0137U0040318Y003007 0001884441453 AKSENOWATI P PEKERJA MANDIRI Acute upper respiratory Berobat Jalan
infections of multiple and

897 24-03-2018 0137U0040318Y003005 0001959434853 PURYANTI P PEKERJA MANDIRI Other specified headache Berobat Jalan
syndromes
898 24-03-2018 0137U0040318Y003015 0001963851884 siwi aisyahrani P PEKERJA MANDIRI Gastro-oesophageal reflux Berobat Jalan
disease without

899 24-03-2018 0137U0040318Y002988 0002042838775 athallah tsaqib hartanto L PEGAWAI SWASTA Acute upper respiratory Berobat Jalan
infections of multiple and

900 24-03-2018 0137U0040318Y002904 0002056723907 CARL JM.KODOATIE L PEKERJA MANDIRI Myopia Berobat Jalan

901 24-03-2018 0137U0040318Y002954 0002057393542 LIU NAM / SUNARTO L PEKERJA MANDIRI Other specified headache Berobat Jalan
syndromes
902 24-03-2018 0137U0040318Y002991 0002067262108 AMEERA NAJMA ZAFIRA L PEKERJA MANDIRI Dental caries Berobat Jalan

903 24-03-2018 0137U0040318Y002979 0002076001885 ERDJULIS L PEKERJA MANDIRI Embedded and impacted Berobat Jalan
teeth
DAFTAR KUNJUNGAN PESERTA SAKIT

Kantor Cabang : BEKASI - 1011

FKTP : Klinik Mitra Medika - 0137U004

904 24-03-2018 0137U0040318Y002925 0002077186375 ARMAINI TATI P PEKERJA MANDIRI Impacted teeth Berobat Jalan

905 24-03-2018 0137U0040318Y002993 0002203033623 IRRINE AYU LUTHFIATI P PEGAWAI SWASTA Acute upper respiratory Berobat Jalan
infection, unspecified
906 24-03-2018 0137U0040318Y002917 0002209909904 EDY SUYATMIN L PEKERJA MANDIRI Myopia Berobat Jalan

907 24-03-2018 0137U0040318Y002958 0002220037907 ratu kirana hasian sagala L PNS PUSAT Acute upper respiratory Berobat Jalan
infection, unspecified
908 24-03-2018 0137U0040318Y002950 0002221517698 maritza avara nella P PNS PUSAT Acute upper respiratory Berobat Jalan
infection, unspecified
909 24-03-2018 0137U0040318Y002906 0002237844543 RIKA TERESNA ASIH P PEKERJA MANDIRI Endometriosis, unspecified Rujuk Lanjut

910 24-03-2018 0137U0040318Y002957 0002240385535 NADINE PUTRI KEISHA SAGALA P PNS PUSAT Acute upper respiratory Berobat Jalan
infection, unspecified
911 24-03-2018 0137U0040318Y002900 0002255929029 SUTIO L PEKERJA MANDIRI Chronic obstructive Rujuk Lanjut
pulmonary disease,

912 24-03-2018 0137U0040318Y003018 0002262841997 MUHAMMAD DZAKY L PNS PUSAT Dermatitis herpetiformis Berobat Jalan
RAMADHAN
913 24-03-2018 0137U0040318Y002984 0002262956051 MUHAMMAD ZUFAR KHAAZIN L PEKERJA MANDIRI Embedded and impacted Berobat Jalan
teeth
914 24-03-2018 0137U0040318Y002970 0002262956501 MUHAMMAD ABDAN L PEKERJA MANDIRI Infective dermatitis Rujuk Lanjut
SYAKURON
915 24-03-2018 0137U0040318Y002961 0002265694176 MUHAMMAD MUHYIDDIN L PEKERJA MANDIRI Myalgia Berobat Jalan

916 24-03-2018 0137U0040318Y002995 0002265694997 FATIMAH AZ ZAHRA P PEKERJA MANDIRI Paratyphoid fever A Berobat Jalan

917 24-03-2018 0137U0040318Y002874 0002278263655 DINA HANIVA P PEKERJA MANDIRI Prolonged pregnancy Rujuk Lanjut

918 24-03-2018 0137U0040318Y002996 0002292169667 IRFA AMALIA PUTRI L PEGAWAI SWASTA Dermatitis herpetiformis Berobat Jalan

919 24-03-2018 0137U0040318Y003011 0002296034807 herry kisriyanto L PEKERJA MANDIRI Acute upper respiratory Berobat Jalan
infection, unspecified
920 24-03-2018 0137U0040318Y003012 0002296034943 maharani surya P PEKERJA MANDIRI Acute upper respiratory Berobat Jalan
infection, unspecified
921 24-03-2018 0137U0040318Y003004 0002312787565 jubaidah P PEKERJA MANDIRI Embedded and impacted Berobat Jalan
teeth
922 24-03-2018 0137U0040318Y002992 0002312788432 novia rosmawaty P PEKERJA MANDIRI Embedded and impacted Berobat Jalan
teeth
923 24-03-2018 0137U0040318Y002989 0002312828728 ADI SUPRANOTO L PEGAWAI SWASTA Embedded and impacted Berobat Jalan
teeth
924 23-03-2018 0137U0040318Y002850 0000055592493 MARNI SUMARTINI P PNS DAERAH Special screening Berobat Jalan
examination for neoplasm

925 23-03-2018 0137U0040318Y002854 0000072831159 SILVYA OKTAVIA P PNS DAERAH Acute upper respiratory Berobat Jalan
KUSUMAWARDANI infection, unspecified
DAFTAR KUNJUNGAN PESERTA SAKIT

Kantor Cabang : BEKASI - 1011

FKTP : Klinik Mitra Medika - 0137U004

926 23-03-2018 0137U0040318Y002857 0000073271992 SINGAT RYADY F L PENERIMA PENSIUN TNI Acute upper respiratory Berobat Jalan
infection, unspecified
927 23-03-2018 0137U0040318Y002851 0000073396113 OCE PERMANA L PNS DAERAH Heart failure, unspecified Rujuk Lanjut

928 23-03-2018 0137U0040318Y002870 0000131129335 RAFEYFA ASYLA PUTRI A P PNS PUSAT Abrasion of teeth Berobat Jalan

929 23-03-2018 0137U0040318Y002825 0000162761758 MAROAN MANGATUR L PNS PUSAT Impacted teeth Berobat Jalan
MARPAUNG
930 23-03-2018 0137U0040318Y002836 0001123305726 SITI NURAISAH P PEGAWAI SWASTA Acute upper respiratory Berobat Jalan
infection, unspecified
931 23-03-2018 0137U0040318Y002873 0001159527071 FITRI INDAH SARI P PEGAWAI SWASTA Impacted teeth Berobat Jalan

932 23-03-2018 0137U0040318Y002790 0001170226574 YANNI P PEGAWAI SWASTA Acute upper respiratory Berobat Jalan
infection, unspecified
933 23-03-2018 0137U0040318Y002789 0001170947226 CARISSA AURELIA P PEGAWAI SWASTA Typhoid fever Berobat Jalan

934 23-03-2018 0137U0040318Y002844 0001175333747 NURLIS P PEKERJA MANDIRI Myalgia Berobat Jalan

935 23-03-2018 0137U0040318Y002777 0001194170938 SALMAH P PEGAWAI SWASTA Necrosis of pulp Rujuk Lanjut

936 23-03-2018 0137U0040318Y002823 0001197252257 KOK LIE TJIU P PEGAWAI SWASTA Impacted teeth Berobat Jalan

937 23-03-2018 0137U0040318Y002805 0001204199976 RINI JUWITA P PEGAWAI SWASTA Other specified headache Berobat Jalan
syndromes
938 23-03-2018 0137U0040318Y002803 0001204199987 THALITA ALSHIRA P PEGAWAI SWASTA Dyspepsia Berobat Jalan

939 23-03-2018 0137U0040318Y002887 0001225256139 KALIRI L PEGAWAI SWASTA Acute upper respiratory Berobat Jalan
infection, unspecified
940 23-03-2018 0137U0040318Y002824 0001259238609 FLORENTINE PHOEI P PEKERJA MANDIRI Dental caries, unspecified Berobat Jalan

941 23-03-2018 0137U0040318Y002889 0001259823227 ALY KURNIAWAN L PEKERJA MANDIRI Impacted teeth Berobat Jalan

942 23-03-2018 0137U0040318Y002890 0001259823633 christine P PEKERJA MANDIRI Dental caries, unspecified Berobat Jalan

943 23-03-2018 0137U0040318Y002835 0001260330467 BUNGA SUKMA ALDELLA P PEKERJA MANDIRI Acute upper respiratory Berobat Jalan
infection, unspecified
944 23-03-2018 0137U0040318Y002845 0001263986919 BISMAN SINUKABAN L PEKERJA MANDIRI Acute upper respiratory Berobat Jalan
infection, unspecified
945 23-03-2018 0137U0040318Y002762 0001266349781 tuti mahera P PEKERJA MANDIRI Vertigo of central origin Rujuk Lanjut

946 23-03-2018 0137U0040318Y002837 0001267988084 SRI LESTARI P PEKERJA MANDIRI Irregular menstruation, Berobat Jalan
unspecified
947 23-03-2018 0137U0040318Y002846 0001276442673 abimany'u idlan prabowo L PEKERJA MANDIRI Other and unspecified Berobat Jalan
infectious diseases
948 23-03-2018 0137U0040318Y002808 0001276535777 SUKARTO L PEKERJA MANDIRI Acute upper respiratory Berobat Jalan
infection, unspecified
949 23-03-2018 0137U0040318Y002768 0001277936201 AGUS SUHERLIM L PEKERJA MANDIRI Chronic ischaemic heart Rujuk Lanjut
disease, unspecified
DAFTAR KUNJUNGAN PESERTA SAKIT

Kantor Cabang : BEKASI - 1011

FKTP : Klinik Mitra Medika - 0137U004

950 23-03-2018 0137U0040318Y002868 0001280270643 RINDU FADILAH P PEKERJA MANDIRI Acute upper respiratory Berobat Jalan
infection, unspecified
951 23-03-2018 0137U0040318Y002794 0001292720128 SUTIYONO L PEKERJA MANDIRI Other specified Rujuk Lanjut
noninfective gastroenteritis

952 23-03-2018 0137U0040318Y002829 0001295516259 YOHANES SUHERMAN L PEKERJA MANDIRI Dental caries, unspecified Berobat Jalan

953 23-03-2018 0137U0040318Y002804 0001298615793 RATNA JUWITA P PEKERJA MANDIRI Acute upper respiratory Berobat Jalan
infection, unspecified
954 23-03-2018 0137U0040318Y002765 0001299225813 SAFIRA TANJUNG P PEKERJA MANDIRI Chronic sinusitis, Rujuk Lanjut
unspecified
955 23-03-2018 0137U0040318Y002811 0001302507854 CICIH KARNASIH P PEKERJA MANDIRI Myalgia Berobat Jalan

956 23-03-2018 0137U0040318Y002783 0001306884148 sri yuliati P PEKERJA MANDIRI Acute upper respiratory Berobat Jalan
infection, unspecified
957 23-03-2018 0137U0040318Y002795 0001307960774 TJU ATANG ETI P PEKERJA MANDIRI Myalgia Berobat Jalan

958 23-03-2018 0137U0040318Y002865 0001314942693 REHUELLAH ZIPORA P PEGAWAI SWASTA Acute upper respiratory Berobat Jalan
KALUMATA infection, unspecified
959 23-03-2018 0137U0040318Y002866 0001314942838 EUNIKE KIMBERLY CHRISTY P PEGAWAI SWASTA Acute upper respiratory Berobat Jalan
SUGIARTO infection, unspecified
960 23-03-2018 0137U0040318Y002830 0001316649352 RINA HARLINA P PEKERJA MANDIRI Benign neoplasm of Rujuk Lanjut
meninges, unspecified
961 23-03-2018 0137U0040318Y002793 0001319509113 MUCHTIAR THIO L PEKERJA MANDIRI Chronic ischaemic heart Rujuk Lanjut
disease
962 23-03-2018 0137U0040318Y002876 0001337107757 FITRIYANI APRILIA LESTARI L PEKERJA MANDIRI Acute pharyngitis, Berobat Jalan
unspecified
963 23-03-2018 0137U0040318Y002840 0001375550087 DARMINAH P PEKERJA MANDIRI Presbyopia Rujuk Lanjut

964 23-03-2018 0137U0040318Y002860 0001376337363 MIEKEWIANITA SUMADI P PEGAWAI SWASTA Acute pharyngitis, Berobat Jalan
unspecified
965 23-03-2018 0137U0040318Y002862 0001385988298 salsa puspa aghnia P PEKERJA MANDIRI Acute pharyngitis, Berobat Jalan
unspecified
966 23-03-2018 0137U0040318Y002848 0001403613448 Suci Irawati P PEGAWAI SWASTA Other antenatal screening Berobat Jalan

967 23-03-2018 0137U0040318Y002820 0001407711644 RINI HASTUTI P PEGAWAI SWASTA Dental caries, unspecified Berobat Jalan

968 23-03-2018 0137U0040318Y002821 0001421095015 AULIA SAFIRA WITANTI P PEKERJA MANDIRI Dental caries, unspecified Berobat Jalan

969 23-03-2018 0137U0040318Y002878 0001421650754 DANIEL GLENN MAMAHANI L PEKERJA MANDIRI Dyspepsia Berobat Jalan

970 23-03-2018 0137U0040318Y002877 0001421651845 YUSWATI P PEKERJA MANDIRI Dermatitis herpetiformis Berobat Jalan

971 23-03-2018 0137U0040318Y002766 0001422706375 indung irianingsih P PEKERJA MANDIRI Respiratory tuberculosis, Rujuk Lanjut
bacteriologically and
DAFTAR KUNJUNGAN PESERTA SAKIT

Kantor Cabang : BEKASI - 1011

FKTP : Klinik Mitra Medika - 0137U004

972 23-03-2018 0137U0040318Y002849 0001429615697 SISCA KELANA P PBI (APBD) Special screening Berobat Jalan
examination for neoplasm

973 23-03-2018 0137U0040318Y002816 0001431681895 ROS INTAN TOBING P PEKERJA MANDIRI Acute upper respiratory Berobat Jalan
infection, unspecified
974 23-03-2018 0137U0040318Y002875 0001432220995 WILLY FEBRIAN TANURI L PEGAWAI SWASTA Other specified headache Berobat Jalan
syndromes
975 23-03-2018 0137U0040318Y002853 0001440664536 EFENDY TARIGAN L PEKERJA MANDIRI Other and unspecified Berobat Jalan
infectious diseases
976 23-03-2018 0137U0040318Y002852 0001456418597 HASANAH P PEKERJA MANDIRI Other specified headache Berobat Jalan
syndromes
977 23-03-2018 0137U0040318Y002800 0001456732574 DANI SURATMAN L PEKERJA MANDIRI Dermatitis herpetiformis Berobat Jalan

978 23-03-2018 0137U0040318Y002802 0001458698758 SUNTIAH P PENERIMA PENSIUN Other specified headache Berobat Jalan
SWASTA syndromes
979 23-03-2018 0137U0040318Y002813 0001459570149 MEYLITA DELLA HERNINDA P PEGAWAI SWASTA Acute upper respiratory Berobat Jalan
infection, unspecified
980 23-03-2018 0137U0040318Y002855 0001460084769 NURHAYATI P PEKERJA MANDIRI Other secondary arthrosis Berobat Jalan

981 23-03-2018 0137U0040318Y002888 0001463060654 EMAN KARMAN L PEGAWAI SWASTA Myalgia Berobat Jalan

982 23-03-2018 0137U0040318Y002871 0001463839255 R ARI BINTORO L PEKERJA MANDIRI Dental caries, unspecified Berobat Jalan

983 23-03-2018 0137U0040318Y002771 0001464377398 TUTY SUPRIATY P PEKERJA MANDIRI Non-insulin-dependent Rujuk Lanjut
diabetes mellitus
984 23-03-2018 0137U0040318Y002879 0001468594113 CHRISTINE ADELEIDA G.S.P. P PEKERJA MANDIRI Other specified headache Berobat Jalan
syndromes
985 23-03-2018 0137U0040318Y002809 0001469153518 TJHAY SIU YOENG P PEKERJA MANDIRI Acute upper respiratory Berobat Jalan
infection, unspecified
986 23-03-2018 0137U0040318Y002817 0001474330105 SUGITO L PEKERJA MANDIRI Insulin-dependent Rujuk Lanjut
diabetes mellitus with

987 23-03-2018 0137U0040318Y002859 0001610147654 RIDOLOF BETAWI L PEGAWAI SWASTA Other specified headache Berobat Jalan
syndromes
988 23-03-2018 0137U0040318Y002834 0001622015111 ERLIENA SULISTIO P PEGAWAI SWASTA Other specified headache Berobat Jalan
syndromes
989 23-03-2018 0137U0040318Y002847 0001622491424 MUHAMMAD FADLI L PEGAWAI SWASTA Acute upper respiratory Berobat Jalan
infection, unspecified
990 23-03-2018 0137U0040318Y002769 0001622771482 SUHARTATI P PEGAWAI SWASTA Non-insulin-dependent Rujuk Lanjut
diabetes mellitus
991 23-03-2018 0137U0040318Y002788 0001625364279 ERLANGGA SETIYAWAN L PEGAWAI SWASTA Acute upper respiratory Berobat Jalan
infection, unspecified
992 23-03-2018 0137U0040318Y002796 0001625364371 ZAHRA QUL SITHA P PEGAWAI SWASTA Acute upper respiratory Berobat Jalan
infection, unspecified
DAFTAR KUNJUNGAN PESERTA SAKIT

Kantor Cabang : BEKASI - 1011

FKTP : Klinik Mitra Medika - 0137U004

993 23-03-2018 0137U0040318Y002885 0001631756676 TAUDI L PEGAWAI SWASTA Myopia Berobat Jalan

994 23-03-2018 0137U0040318Y002772 0001634367936 NUR SOIMAH P PEGAWAI SWASTA Necrosis of pulp Rujuk Lanjut

995 23-03-2018 0137U0040318Y002801 0001636027839 ARDY WINATA L PEGAWAI SWASTA Acute upper respiratory Berobat Jalan
infection, unspecified
996 23-03-2018 0137U0040318Y002856 0001641989226 IKAWATI P PEGAWAI SWASTA Gastro-oesophageal reflux Berobat Jalan
disease without

997 23-03-2018 0137U0040318Y002861 0001644978701 SITI RUKAYAH P PEGAWAI SWASTA Other and unspecified Berobat Jalan
infectious diseases
998 23-03-2018 0137U0040318Y002818 0001646135763 TOTOK WAHONO L PEKERJA MANDIRI Myalgia Berobat Jalan

999 23-03-2018 0137U0040318Y002872 0001647990909 WAHYU MAHENDRA L PEGAWAI SWASTA Impacted teeth Berobat Jalan

1000 23-03-2018 0137U0040318Y002867 0001648023142 DESMITA P PEGAWAI SWASTA Acute pharyngitis, Berobat Jalan
unspecified
1001 23-03-2018 0137U0040318Y002774 0001648299699 Vincent Hagen L PEGAWAI SWASTA Acute upper respiratory Berobat Jalan
infection, unspecified
1002 23-03-2018 0137U0040318Y002775 0001648299701 Callista Diadema P PEGAWAI SWASTA Acute upper respiratory Berobat Jalan
infection, unspecified
1003 23-03-2018 0137U0040318Y002858 0001657609593 SRI UTAMI DEWI P PEGAWAI SWASTA Acute upper respiratory Berobat Jalan
infection, unspecified
1004 23-03-2018 0137U0040318Y002896 0001719173169 KURNIA WIJAYA L PEKERJA MANDIRI Impacted teeth Berobat Jalan

1005 23-03-2018 0137U0040318Y002826 0001722045262 NOVA HERLINA P PEGAWAI SWASTA Impacted teeth Berobat Jalan

1006 23-03-2018 0137U0040318Y002786 0001724682521 RUSYADI L PEGAWAI SWASTA Acute upper respiratory Berobat Jalan
infection, unspecified
1007 23-03-2018 0137U0040318Y002881 0001725010604 DESSY SAGITA P PEKERJA MANDIRI Acute pharyngitis, Berobat Jalan
unspecified
1008 23-03-2018 0137U0040318Y002863 0001728287649 FAUZIAH P PEKERJA MANDIRI Acute upper respiratory Berobat Jalan
infection, unspecified
1009 23-03-2018 0137U0040318Y002799 0001729888762 AHMAD FAISAL L PEKERJA MANDIRI Acute upper respiratory Berobat Jalan
infection, unspecified
1010 23-03-2018 0137U0040318Y002770 0001738228364 MADSARI L PEGAWAI SWASTA Necrosis of pulp Rujuk Lanjut

1011 23-03-2018 0137U0040318Y002815 0001741601349 Endang L PEGAWAI SWASTA Acute upper respiratory Berobat Jalan
infection, unspecified
1012 23-03-2018 0137U0040318Y002781 0001741601777 Nusan Leo L PEGAWAI SWASTA Acute upper respiratory Berobat Jalan
infection, unspecified
1013 23-03-2018 0137U0040318Y002819 0001769601115 KURNIASIH P PEGAWAI SWASTA Impacted teeth Berobat Jalan

1014 23-03-2018 0137U0040318Y002895 0001773406269 NAFISA ALIYATUNNISA P PEGAWAI SWASTA Abrasion of teeth Berobat Jalan

1015 23-03-2018 0137U0040318Y002883 0001785793408 HERMAN CHANLEGO L PEKERJA MANDIRI Acute upper respiratory Berobat Jalan
infection, unspecified
DAFTAR KUNJUNGAN PESERTA SAKIT

Kantor Cabang : BEKASI - 1011

FKTP : Klinik Mitra Medika - 0137U004

1016 23-03-2018 0137U0040318Y002763 0001786984593 ANDIKA MULYA WIBISONO L PEGAWAI SWASTA Chest pain, unspecified Rujuk Lanjut

1017 23-03-2018 0137U0040318Y002776 0001808688734 LIE HENG BUN SUDARNO L PEKERJA MANDIRI Acute upper respiratory Berobat Jalan
infection, unspecified
1018 23-03-2018 0137U0040318Y002764 0001817399441 GABRIEL MERVIN GUNAWAN L PEGAWAI SWASTA Specific speech Rujuk Lanjut
articulation disorder
1019 23-03-2018 0137U0040318Y002779 0001831208499 RACHMAT KATILI BASARAH L PEGAWAI PEMERINTAH Dyspepsia Berobat Jalan
DENGAN PERJANJIAN

1020 23-03-2018 0137U0040318Y002843 0001832872509 JEFFRY RIGA SIMAMORA L PEGAWAI SWASTA Acute sinusitis Berobat Jalan

1021 23-03-2018 0137U0040318Y002886 0001842435729 RAIJA AGDERO PAWOLE L PEKERJA MANDIRI Acute upper respiratory Berobat Jalan
infection, unspecified
1022 23-03-2018 0137U0040318Y002787 0001845362531 JESICA FLORENSIA P PEKERJA MANDIRI Acute upper respiratory Berobat Jalan
infection, unspecified
1023 23-03-2018 0137U0040318Y002882 0001850843441 RISNA WULANSARI P PEGAWAI SWASTA Acute upper respiratory Berobat Jalan
infection, unspecified
1024 23-03-2018 0137U0040318Y002838 0001860171355 azzamy aufa juandra L PEKERJA MANDIRI Acute upper respiratory Berobat Jalan
infection, unspecified
1025 23-03-2018 0137U0040318Y002839 0001860172143 HAYFA TALITA JUANDRA P PEKERJA MANDIRI Acute upper respiratory Berobat Jalan
infection, unspecified
1026 23-03-2018 0137U0040318Y002831 0001872833231 ADRIEL FREDERICA BUTAR P PEGAWAI SWASTA Chronic gingivitis Berobat Jalan
BUTAR
1027 23-03-2018 0137U0040318Y002780 0001876499076 MOIIH P PEKERJA MANDIRI Myalgia Berobat Jalan

1028 23-03-2018 0137U0040318Y002864 0001884012737 MUFFAZAL MIRZA HARAHAP L PEGAWAI SWASTA Other and unspecified Berobat Jalan
infectious diseases
1029 23-03-2018 0137U0040318Y002784 0001884441442 ANDI BAMBANG HERINDRO L PEKERJA MANDIRI Acute upper respiratory Berobat Jalan
infection, unspecified
1030 23-03-2018 0137U0040318Y002797 0001895083841 EDISON SIMORANGKIR L PEKERJA MANDIRI Acute upper respiratory Berobat Jalan
infection, unspecified
1031 23-03-2018 0137U0040318Y002798 0001895085156 andika markus simorangkir L PEKERJA MANDIRI Acute upper respiratory Berobat Jalan
infection, unspecified
1032 23-03-2018 0137U0040318Y002773 0001903760774 NAPSIAH P PEKERJA MANDIRI Sequelae of stroke, not Rujuk Lanjut
specified as haemorrhage

1033 23-03-2018 0137U0040318Y002828 0001963394076 khansa jauzaa aqiilah P PNS DAERAH Abrasion of teeth Berobat Jalan

1034 23-03-2018 0137U0040318Y002892 0002045001036 ROHMADI L PEGAWAI SWASTA Impacted teeth Berobat Jalan

1035 23-03-2018 0137U0040318Y002891 0002045023863 ASJAD TSALASA KHAIRUNNISA P PEGAWAI SWASTA Chronic gingivitis Berobat Jalan

1036 23-03-2018 0137U0040318Y002880 0002056723907 CARL JM.KODOATIE L PEKERJA MANDIRI Myopia Berobat Jalan

1037 23-03-2018 0137U0040318Y002893 0002059432503 CANTIKA PUTRI MUTIAH P PEKERJA MANDIRI Bilateral femoral hernia, Berobat Jalan
with gangrene
DAFTAR KUNJUNGAN PESERTA SAKIT

Kantor Cabang : BEKASI - 1011

FKTP : Klinik Mitra Medika - 0137U004

1038 23-03-2018 0137U0040318Y002832 0002061235056 AZIL OGAN,H L PEGAWAI SWASTA Dyspepsia Berobat Jalan

1039 23-03-2018 0137U0040318Y002827 0002067262108 AMEERA NAJMA ZAFIRA L PEKERJA MANDIRI Chronic gingivitis Berobat Jalan

1040 23-03-2018 0137U0040318Y002884 0002076879892 IMANUEL MARTONA L PEKERJA MANDIRI Acute upper respiratory Berobat Jalan
infection, unspecified
1041 23-03-2018 0137U0040318Y002792 0002083542298 AGUS SUTARNO L PEKERJA MANDIRI Acute upper respiratory Berobat Jalan
infection, unspecified
1042 23-03-2018 0137U0040318Y002869 0002103998635 SUSAN MARGARETA CHANDRA P PEGAWAI SWASTA Impacted teeth Berobat Jalan

1043 23-03-2018 0137U0040318Y002807 0002142265871 ASNIATI P PEGAWAI SWASTA Acute upper respiratory Berobat Jalan
infection, unspecified
1044 23-03-2018 0137U0040318Y002897 0002204071874 MARCELLA YO P PEKERJA MANDIRI Abrasion of teeth Berobat Jalan

1045 23-03-2018 0137U0040318Y002767 0002206184859 SAMINO SURATNO L PEKERJA MANDIRI Other arthrosis Rujuk Lanjut

1046 23-03-2018 0137U0040318Y002812 0002207100363 fauzan khaerel firdaus L PEKERJA MANDIRI Myalgia Berobat Jalan

1047 23-03-2018 0137U0040318Y002814 0002226057243 MAULANA TRI WIBOWO L PNS DAERAH Spinal muscular atrophy, Rujuk Lanjut
unspecified
1048 23-03-2018 0137U0040318Y002782 0002227393181 NADHIRA NOVITA PUTRI P PEGAWAI SWASTA Acute upper respiratory Berobat Jalan
infection, unspecified
1049 23-03-2018 0137U0040318Y002778 0002230809456 PRISCILLA KINARA YULIANTO P PEGAWAI SWASTA Other specified headache Berobat Jalan
syndromes
1050 23-03-2018 0137U0040318Y002810 0002239733733 ARKHAN SAID RAMADHAN L PEGAWAI SWASTA Acute upper respiratory Berobat Jalan
infection, unspecified
1051 23-03-2018 0137U0040318Y002791 0002247887316 SUMARA L PEKERJA MANDIRI Acute upper respiratory Berobat Jalan
infection, unspecified
1052 23-03-2018 0137U0040318Y002806 0002275138934 INGE ROSALINA CHANDRA P PEGAWAI SWASTA Acute upper respiratory Berobat Jalan
infection, unspecified
1053 23-03-2018 0137U0040318Y002822 0002291780384 RUSYDINA DWI AMALIA P PEGAWAI SWASTA Impacted teeth Berobat Jalan

1054 23-03-2018 0137U0040318Y002842 0002297783147 NUR ACHMADI L PEKERJA MANDIRI Other secondary arthrosis Rujuk Lanjut

1055 23-03-2018 0137U0040318Y002833 0002299844114 NURMAINI P PEKERJA MANDIRI Myalgia Berobat Jalan

1056 23-03-2018 0137U0040318Y002841 0002308809295 BAYI NY HENDRAWATI L PEKERJA MANDIRI Acute upper respiratory Berobat Jalan
YULIANA infection, unspecified
1057 23-03-2018 0137U0040318Y002785 0002327194596 FISABILILLAH L PEGAWAI SWASTA Acute upper respiratory Berobat Jalan
infection, unspecified
1058 22-03-2018 0137U0040318Y002726 0000016041791 ARMEND L PENERIMA PENSIUN Other secondary arthrosis Berobat Jalan
PNS
1059 22-03-2018 0137U0040318Y002727 0000016041802 MASIDAH P PENERIMA PENSIUN Dyspepsia Berobat Jalan
PNS
1060 22-03-2018 0137U0040318Y002700 0000043459277 ERNAWATI P PENERIMA PENSIUN Dermatitis herpetiformis Berobat Jalan
PNS
DAFTAR KUNJUNGAN PESERTA SAKIT

Kantor Cabang : BEKASI - 1011

FKTP : Klinik Mitra Medika - 0137U004

1061 22-03-2018 0137U0040318Y002744 0000072762873 DATIH HANANINGSIH P PNS DAERAH Dental caries, unspecified Berobat Jalan

1062 22-03-2018 0137U0040318Y002693 0000072850083 ACHMAD SOLEH L PNS PUSAT Chronic obstructive Rujuk Lanjut
pulmonary disease with
acute exacerbation,

1063 22-03-2018 0137U0040318Y002662 0000073401838 PANDI L PENERIMA PENSIUN Other specified headache Berobat Jalan
PNS syndromes
1064 22-03-2018 0137U0040318Y002657 0000073402773 MOCHAMAD RIZAL ABDUL AZIS L PNS DAERAH Syncope and collapse Rujuk Lanjut

1065 22-03-2018 0137U0040318Y002702 0000148688212 LAILI SHAFIRA P PNS DAERAH Myalgia Berobat Jalan

1066 22-03-2018 0137U0040318Y003071 0000162761758 MAROAN MANGATUR L PNS PUSAT Diseases of pulp and Berobat Jalan
MARPAUNG periapical tissues
1067 22-03-2018 0137U0040318Y002673 0000163666708 ALYA MAAJID RAMADITA P PNS DAERAH Acute upper respiratory Berobat Jalan
infection, unspecified
1068 22-03-2018 0137U0040318Y002650 0000193992794 ISA YUSTIANTO L PNS DAERAH Respiratory tuberculosis, Rujuk Lanjut
bacteriologically and

1069 22-03-2018 0137U0040318Y002745 0000202925654 HAYAA NURQYREENNISYA P PNS DAERAH Chronic gingivitis Berobat Jalan
JUNIAR
1070 22-03-2018 0137U0040318Y002653 0000508933304 SIS SUNARYO L PBI (APBN) Polyneuropathy, Rujuk Lanjut
unspecified
1071 22-03-2018 0137U0040318Y002734 0001013874693 ANNISA BAHRUDIN P PEGAWAI SWASTA Dermatitis herpetiformis Berobat Jalan

1072 22-03-2018 0137U0040318Y002757 0001013875007 MIFTAHUL ROHMAH L PEKERJA MANDIRI Chronic gingivitis Berobat Jalan

1073 22-03-2018 0137U0040318Y002707 0001135603102 HERMIN HERISMIANI P PEGAWAI SWASTA Other secondary arthrosis Berobat Jalan

1074 22-03-2018 0137U0040318Y003033 0001170226574 YANNI P PEGAWAI SWASTA Other soft tissue disorders, Berobat Jalan
not elsewhere classified

1075 22-03-2018 0137U0040318Y003034 0001170947226 CARISSA AURELIA P PEGAWAI SWASTA Other soft tissue disorders, Berobat Jalan
not elsewhere classified

1076 22-03-2018 0137U0040318Y003065 0001197252257 KOK LIE TJIU P PEGAWAI SWASTA Dental caries Berobat Jalan

1077 22-03-2018 0137U0040318Y003058 0001204199987 THALITA ALSHIRA P PEGAWAI SWASTA Amoebiasis Berobat Jalan

1078 22-03-2018 0137U0040318Y002696 0001207944494 FATIMAH P PEKERJA MANDIRI Endometriosis, unspecified Rujuk Lanjut

1079 22-03-2018 0137U0040318Y002667 0001228124812 R PRIYATNO SUDIHARDJO L PEKERJA MANDIRI Cardiomegaly Rujuk Lanjut

1080 22-03-2018 0137U0040318Y002681 0001258893358 HJ. ETI KUSNIATI P PEKERJA MANDIRI Myalgia Berobat Jalan

1081 22-03-2018 0137U0040318Y002710 0001259114804 ROSMARIA CHANDRA P PBI (APBD) Dyspepsia Berobat Jalan
DAFTAR KUNJUNGAN PESERTA SAKIT

Kantor Cabang : BEKASI - 1011

FKTP : Klinik Mitra Medika - 0137U004

1082 22-03-2018 0137U0040318Y003070 0001259238609 FLORENTINE PHOEI P PEKERJA MANDIRI Dental caries Berobat Jalan

1083 22-03-2018 0137U0040318Y002703 0001260105671 LISDA P PEKERJA MANDIRI Dyspepsia Berobat Jalan

1084 22-03-2018 0137U0040318Y002760 0001260176747 ANAH SETIAWATI P PEKERJA MANDIRI Embedded teeth Berobat Jalan

1085 22-03-2018 0137U0040318Y002721 0001269622901 DADANG FRIATNA L PEKERJA MANDIRI Acute upper respiratory Berobat Jalan
infection, unspecified
1086 22-03-2018 0137U0040318Y003035 0001277936201 AGUS SUHERLIM L PEKERJA MANDIRI Other soft tissue disorders, Berobat Jalan
not elsewhere classified

1087 22-03-2018 0137U0040318Y002708 0001281874937 MARIAM P PEKERJA MANDIRI Vertigo of central origin Berobat Jalan

1088 22-03-2018 0137U0040318Y002686 0001290608098 IWAN RIDWAN INDARI L PEKERJA MANDIRI Necrosis of pulp Berobat Jalan

1089 22-03-2018 0137U0040318Y002651 0001297924007 G.I.KETUT.T.DHARMAWAN L PEKERJA MANDIRI Insulin-dependent Rujuk Lanjut
diabetes mellitus with

1090 22-03-2018 0137U0040318Y002661 0001304897365 oktin hartanti P PEKERJA MANDIRI Myalgia Berobat Jalan

1091 22-03-2018 0137U0040318Y003043 0001307960774 TJU ATANG ETI P PEKERJA MANDIRI Stomatitis and related Berobat Jalan
lesions
1092 22-03-2018 0137U0040318Y002737 0001322579114 SEAN PRAYITNO L PEKERJA MANDIRI Dyspepsia Berobat Jalan

1093 22-03-2018 0137U0040318Y002750 0001326811836 SUCI ATININGSIH P PEKERJA MANDIRI Impacted teeth Berobat Jalan

1094 22-03-2018 0137U0040318Y002749 0001326811871 YONATAN NOVIANTO L PEKERJA MANDIRI Chronic gingivitis Berobat Jalan

1095 22-03-2018 0137U0040318Y002753 0001327414713 AGUNG SAPUTRO L PEGAWAI PEMERINTAH Dental caries, unspecified Berobat Jalan
DENGAN PERJANJIAN

1096 22-03-2018 0137U0040318Y002680 0001335637034 RETNO MURNIANINGRUM P PEGAWAI SWASTA Other specified headache Berobat Jalan
syndromes
1097 22-03-2018 0137U0040318Y002756 0001376466772 ELSA PRASTIKA P PEGAWAI BUMN Chronic gingivitis Berobat Jalan

1098 22-03-2018 0137U0040318Y002748 0001380212199 YANTI BINTI TARDI P PEKERJA MANDIRI Impacted teeth Berobat Jalan

1099 22-03-2018 0137U0040318Y002677 0001381407186 RIZQI AKBAR ABDURRAHMAN L PEGAWAI SWASTA Acute upper respiratory Berobat Jalan
infection, unspecified
1100 22-03-2018 0137U0040318Y002712 0001381643706 LINDA ROSE ISKANDAR P PEKERJA MANDIRI Acute upper respiratory Berobat Jalan
infection, unspecified
1101 22-03-2018 0137U0040318Y002714 0001384342457 FRANCISCA EVI SUSANTI P PEKERJA MANDIRI Other antenatal screening Berobat Jalan

1102 22-03-2018 0137U0040318Y002682 0001384844894 IDA MISRIYANI P PEGAWAI PEMERINTAH Acute upper respiratory Berobat Jalan
DENGAN PERJANJIAN infection, unspecified

1103 22-03-2018 0137U0040318Y002751 0001387894871 LINAH KARNA P PEKERJA MANDIRI Loss of teeth due to Berobat Jalan
accident, extraction or
DAFTAR KUNJUNGAN PESERTA SAKIT

Kantor Cabang : BEKASI - 1011

FKTP : Klinik Mitra Medika - 0137U004

1104 22-03-2018 0137U0040318Y002738 0001388011948 UNANG L PEGAWAI SWASTA Acute upper respiratory Berobat Jalan
infection, unspecified
1105 22-03-2018 0137U0040318Y003063 0001407711644 RINI HASTUTI P PEGAWAI SWASTA Diseases of pulp and Berobat Jalan
periapical tissues
1106 22-03-2018 0137U0040318Y003062 0001421095015 AULIA SAFIRA WITANTI P PEKERJA MANDIRI Diseases of pulp and Berobat Jalan
periapical tissues
1107 22-03-2018 0137U0040318Y002664 0001432784867 RIYANTI URIP P PEKERJA MANDIRI Dermatitis, unspecified Rujuk Lanjut

1108 22-03-2018 0137U0040318Y002687 0001433390005 bambang guntoro L PEKERJA MANDIRI Necrosis of pulp Berobat Jalan

1109 22-03-2018 0137U0040318Y002735 0001434569174 INTAN SUPRIANTI P PEGAWAI SWASTA Dyspepsia Berobat Jalan

1110 22-03-2018 0137U0040318Y002683 0001445711962 LIA YULIASARI DEWI P PEKERJA MANDIRI Dysmenorrhoea, Berobat Jalan
unspecified
1111 22-03-2018 0137U0040318Y002678 0001455705821 DEWI AGUSTIARTAWATI P PEKERJA MANDIRI Other specified headache Berobat Jalan
syndromes
1112 22-03-2018 0137U0040318Y002720 0001456534653 DRS.H.HARSONO SONI.MM L PEGAWAI SWASTA Acute upper respiratory Berobat Jalan
infection, unspecified
1113 22-03-2018 0137U0040318Y003056 0001456732574 DANI SURATMAN L PEKERJA MANDIRI Other soft tissue disorders, Berobat Jalan
not elsewhere classified

1114 22-03-2018 0137U0040318Y002676 0001457205884 PAULA SUPRIATIN P PEKERJA MANDIRI Acute upper respiratory Berobat Jalan
infection, unspecified
1115 22-03-2018 0137U0040318Y002740 0001459227249 YONATAN SUTANDAR L PEKERJA MANDIRI Other and unspecified Berobat Jalan
infectious diseases
1116 22-03-2018 0137U0040318Y002660 0001461476474 DANANG HARIYANTO L PEKERJA MANDIRI Acute upper respiratory Berobat Jalan
infection, unspecified
1117 22-03-2018 0137U0040318Y002725 0001463030864 RINI P PEKERJA MANDIRI Acute upper respiratory Berobat Jalan
infection, unspecified
1118 22-03-2018 0137U0040318Y002652 0001463133914 IKAH SUTINAH HJ P PENERIMA PENSIUN Other arthrosis Rujuk Lanjut
PNS
1119 22-03-2018 0137U0040318Y003041 0001464377398 TUTY SUPRIATY P PEKERJA MANDIRI Diarrhoea and Berobat Jalan
gastroenteritis of
presumed infectious origin

1120 22-03-2018 0137U0040318Y002718 0001465761857 ASILAH SAUSAN RAIHANA P PEGAWAI SWASTA Varicella meningitis Berobat Jalan

1121 22-03-2018 0137U0040318Y002761 0001466140623 TAN TIAN NIO P PEKERJA MANDIRI Impacted teeth Berobat Jalan

1122 22-03-2018 0137U0040318Y002670 0001467191114 SAMSUDIN L PEGAWAI SWASTA Acute upper respiratory Berobat Jalan
infection, unspecified
1123 22-03-2018 0137U0040318Y002715 0001473924374 PUPAH P PEKERJA MANDIRI Other contraceptive Berobat Jalan
management
1124 22-03-2018 0137U0040318Y002666 0001475102777 SUPRAPTI P PEKERJA MANDIRI Chronic ischaemic heart Rujuk Lanjut
disease, unspecified
DAFTAR KUNJUNGAN PESERTA SAKIT

Kantor Cabang : BEKASI - 1011

FKTP : Klinik Mitra Medika - 0137U004

1125 22-03-2018 0137U0040318Y002754 0001480667883 tje we shiang P PEKERJA MANDIRI Impacted teeth Berobat Jalan

1126 22-03-2018 0137U0040318Y003042 0001622771482 SUHARTATI P PEGAWAI SWASTA Other bullous disorders Berobat Jalan

1127 22-03-2018 0137U0040318Y002742 0001623342936 YULIANTO L PEGAWAI SWASTA Myalgia Berobat Jalan

1128 22-03-2018 0137U0040318Y003039 0001625364279 ERLANGGA SETIYAWAN L PEGAWAI SWASTA Acute upper respiratory Berobat Jalan
infections of multiple and

1129 22-03-2018 0137U0040318Y003044 0001625364371 ZAHRA QUL SITHA P PEGAWAI SWASTA Acute upper respiratory Berobat Jalan
infections of multiple and

1130 22-03-2018 0137U0040318Y002701 0001627041071 MUHAMMAD PRIYO SADJAD L PEGAWAI SWASTA Acute upper respiratory Berobat Jalan
infection, unspecified
1131 22-03-2018 0137U0040318Y002722 0001627833868 RATNA DEWI P PEGAWAI SWASTA Other secondary arthrosis Berobat Jalan

1132 22-03-2018 0137U0040318Y002698 0001627891209 SUKARDI L PNS PUSAT Cataract, unspecified Rujuk Lanjut

1133 22-03-2018 0137U0040318Y002747 0001629187716 NEZIRA P PEGAWAI SWASTA Impacted teeth Berobat Jalan

1134 22-03-2018 0137U0040318Y002685 0001629387167 SUSCHADI SUDIYONO L PEGAWAI SWASTA Myalgia Berobat Jalan

1135 22-03-2018 0137U0040318Y002655 0001629941242 ANSAR L PEKERJA MANDIRI Other vitreous opacities Rujuk Lanjut

1136 22-03-2018 0137U0040318Y002679 0001631030883 ANANDA KUMAR L PEGAWAI SWASTA Acute upper respiratory Berobat Jalan
infection, unspecified
1137 22-03-2018 0137U0040318Y002691 0001633873994 BAROMEUS SINA L PEGAWAI SWASTA Necrosis of pulp Berobat Jalan

1138 22-03-2018 0137U0040318Y003069 0001634367936 NUR SOIMAH P PEGAWAI SWASTA Diseases of pulp and Berobat Jalan
periapical tissues
1139 22-03-2018 0137U0040318Y003057 0001636027839 ARDY WINATA L PEGAWAI SWASTA Acute upper respiratory Berobat Jalan
infections of multiple and

1140 22-03-2018 0137U0040318Y002711 0001637621324 NAGITA RIEZQIA ASHARY L PEGAWAI SWASTA Acute upper respiratory Berobat Jalan
infection, unspecified
1141 22-03-2018 0137U0040318Y002713 0001637893012 SYARIFAH P PEGAWAI SWASTA Other contraceptive Berobat Jalan
management
1142 22-03-2018 0137U0040318Y002736 0001640067816 SRI MULYANI P PEGAWAI SWASTA Other specified headache Berobat Jalan
syndromes
1143 22-03-2018 0137U0040318Y002705 0001643505355 EDDY KUSNADI L PEGAWAI SWASTA Acute upper respiratory Berobat Jalan
infection, unspecified
1144 22-03-2018 0137U0040318Y002758 0001645474342 FIRDAUS L PEGAWAI SWASTA Impacted teeth Berobat Jalan

1145 22-03-2018 0137U0040318Y002669 0001648009809 Tjong Kwie Liang L PEGAWAI SWASTA Other and unspecified Berobat Jalan
abdominal pain
1146 22-03-2018 0137U0040318Y002668 0001648009811 NICHOLAS ALEXANDRE L PEGAWAI SWASTA Varicella meningitis Berobat Jalan
DAFTAR KUNJUNGAN PESERTA SAKIT

Kantor Cabang : BEKASI - 1011

FKTP : Klinik Mitra Medika - 0137U004

1147 22-03-2018 0137U0040318Y002730 0001650270598 MAHPUDIN L PEGAWAI SWASTA Impacted teeth Rujuk Lanjut

1148 22-03-2018 0137U0040318Y002709 0001656027685 MARIA CELLY JACINDA P PEGAWAI SWASTA Acute upper respiratory Berobat Jalan
infection, unspecified
1149 22-03-2018 0137U0040318Y002697 0001657636659 MELIA WULAN DARI P PEGAWAI SWASTA Other antenatal screening Berobat Jalan

1150 22-03-2018 0137U0040318Y002654 0001716041621 DR. PALUPI LINDIASARI P PEKERJA MANDIRI Chronic periodontitis Rujuk Lanjut
S,S.PI,MM
1151 22-03-2018 0137U0040318Y002658 0001720124796 DJAENUDIN L PEKERJA MANDIRI Chronic ischaemic heart Rujuk Lanjut
disease, unspecified
1152 22-03-2018 0137U0040318Y002675 0001726078397 QATRUNNADA SALSABILA P PEKERJA MANDIRI Dyspepsia Berobat Jalan
DELFI
1153 22-03-2018 0137U0040318Y003045 0001729888762 AHMAD FAISAL L PEKERJA MANDIRI Acute upper respiratory Berobat Jalan
infections of multiple and

1154 22-03-2018 0137U0040318Y002694 0001729987536 RACHMADANI SETIAWAN L PEKERJA MANDIRI Other soft tissue disorders, Rujuk Lanjut
not elsewhere classified

1155 22-03-2018 0137U0040318Y002695 0001730216237 FITRI MEGAWATI P PEKERJA MANDIRI Polyneuropathy, Rujuk Lanjut
unspecified
1156 22-03-2018 0137U0040318Y002752 0001738228364 MADSARI L PEGAWAI SWASTA Impacted teeth Berobat Jalan

1157 22-03-2018 0137U0040318Y002704 0001740754776 BARLIANTA.P L PEKERJA MANDIRI Acute upper respiratory Berobat Jalan
infection, unspecified
1158 22-03-2018 0137U0040318Y002688 0001741243239 FRIAN FACHRIZA HUTOMO L PEKERJA MANDIRI Dental caries, unspecified Berobat Jalan

1159 22-03-2018 0137U0040318Y002706 0001743292901 KOKOM KOMARIAH TONGE P PEGAWAI SWASTA Dermatitis herpetiformis Berobat Jalan

1160 22-03-2018 0137U0040318Y002759 0001766344329 LISNI P PEGAWAI BUMN Embedded teeth Berobat Jalan

1161 22-03-2018 0137U0040318Y002717 0001775087482 SUHENDRA GUNAWAN L PEGAWAI SWASTA Diarrhoea and Berobat Jalan
gastroenteritis of
presumed infectious origin

1162 22-03-2018 0137U0040318Y002674 0001788372044 RATIH PUSPITA MUHARANI P PEGAWAI SWASTA Acute upper respiratory Berobat Jalan
infection, unspecified
1163 22-03-2018 0137U0040318Y002719 0001788604931 ENDANG MARTINNINGSIH SE P PEGAWAI SWASTA Other secondary arthrosis Berobat Jalan

1164 22-03-2018 0137U0040318Y002728 0001796872645 RIZA RACHMA KARTADIRJA P PEKERJA MANDIRI Acute upper respiratory Berobat Jalan
infection, unspecified
1165 22-03-2018 0137U0040318Y002746 0001809627658 SULASTRI P PEKERJA MANDIRI Impacted teeth Berobat Jalan

1166 22-03-2018 0137U0040318Y002743 0001811235789 BANGUN MULYANTORO L PENERIMA PENSIUN Impacted teeth Berobat Jalan
SWASTA
1167 22-03-2018 0137U0040318Y002732 0001833440861 JANETTIO ARGAND SYAPUTRA L PEKERJA MANDIRI Acute upper respiratory Berobat Jalan
infection, unspecified
DAFTAR KUNJUNGAN PESERTA SAKIT

Kantor Cabang : BEKASI - 1011

FKTP : Klinik Mitra Medika - 0137U004

1168 22-03-2018 0137U0040318Y002699 0001835527972 R. WISNU MAHENDRA L PENERIMA PENSIUN Acute upper respiratory Berobat Jalan
PNS infection, unspecified
1169 22-03-2018 0137U0040318Y002665 0001839005278 zainal azkia P PEGAWAI SWASTA Typhoid fever Berobat Jalan

1170 22-03-2018 0137U0040318Y003032 0001845362531 JESICA FLORENSIA P PEKERJA MANDIRI Acute upper respiratory Berobat Jalan
infections of multiple and

1171 22-03-2018 0137U0040318Y002659 0001849342105 M. ERDI SETIAWAN L PEKERJA MANDIRI Acute upper respiratory Berobat Jalan
infection, unspecified
1172 22-03-2018 0137U0040318Y002656 0001853127448 M.AFRIZAN HAKIM L PEGAWAI SWASTA Disorder of refraction, Rujuk Lanjut
unspecified
1173 22-03-2018 0137U0040318Y002733 0001888068993 SEAN KRISTIANTO L PEKERJA MANDIRI Acute upper respiratory Berobat Jalan
infection, unspecified
1174 22-03-2018 0137U0040318Y003046 0001895083841 EDISON SIMORANGKIR L PEKERJA MANDIRI Other soft tissue disorders, Berobat Jalan
not elsewhere classified

1175 22-03-2018 0137U0040318Y003047 0001895085156 andika markus simorangkir L PEKERJA MANDIRI Dyspepsia Berobat Jalan

1176 22-03-2018 0137U0040318Y002741 0001963918271 KUMORO SANTI SAPTA PUTRI P PEGAWAI SWASTA Acute upper respiratory Berobat Jalan
infection, unspecified
1177 22-03-2018 0137U0040318Y002729 0002061389428 ALYA RISFIKA YUSUF L PEGAWAI SWASTA Acute upper respiratory Berobat Jalan
infection, unspecified
1178 22-03-2018 0137U0040318Y002692 0002064684611 SITI SAMSIYAH P PEKERJA MANDIRI Neuralgia and neuritis, Rujuk Lanjut
unspecified
1179 22-03-2018 0137U0040318Y002739 0002085654835 KAYLA APRILIA JASMIN P PEGAWAI SWASTA Acute upper respiratory Berobat Jalan
infection, unspecified
1180 22-03-2018 0137U0040318Y002755 0002138681619 FEDRO RAYHAN MAULANA L PEGAWAI SWASTA Abrasion of teeth Berobat Jalan

1181 22-03-2018 0137U0040318Y002724 0002138681632 MUTIARA NOER MUCHLIS P PEGAWAI SWASTA Gastritis, unspecified Berobat Jalan

1182 22-03-2018 0137U0040318Y002689 0002204922339 NOVI SUGIARTI P PEGAWAI SWASTA Necrosis of pulp Berobat Jalan

1183 22-03-2018 0137U0040318Y002690 0002204922611 AISYAH PUTRI HANDOKO P PEGAWAI SWASTA Dental caries, unspecified Berobat Jalan

1184 22-03-2018 0137U0040318Y002663 0002207517243 ahmad mikail anaki L PEGAWAI SWASTA Acute upper respiratory Berobat Jalan
infection, unspecified
1185 22-03-2018 0137U0040318Y002672 0002221273168 NUR INDAH SARI P PEGAWAI SWASTA Other specified headache Berobat Jalan
syndromes
1186 22-03-2018 0137U0040318Y002671 0002221273631 AZMI CALISTA PUTRI P PEGAWAI SWASTA Acute upper respiratory Berobat Jalan
infection, unspecified
1187 22-03-2018 0137U0040318Y002723 0002271059706 CHINDY FELICIA P PEGAWAI SWASTA Acute upper respiratory Berobat Jalan
infection, unspecified
1188 22-03-2018 0137U0040318Y003067 0002291780384 RUSYDINA DWI AMALIA P PEGAWAI SWASTA Dental caries Berobat Jalan
DAFTAR KUNJUNGAN PESERTA SAKIT

Kantor Cabang : BEKASI - 1011

FKTP : Klinik Mitra Medika - 0137U004

1189 22-03-2018 0137U0040318Y002731 0002302254044 BRIGITTA YOVELLA JOCELYN P PEKERJA MANDIRI Other benign neoplasm of Rujuk Lanjut
connective and other soft

1190 22-03-2018 0137U0040318Y002684 0002427465688 NIZAZKA PUTRI SYAKAYLA P PEKERJA MANDIRI Acute upper respiratory Berobat Jalan
infection, unspecified
1191 22-03-2018 0137U0040318Y002716 0002435077642 MARYON AKYWEN P PEKERJA MANDIRI Hypertensive renal Rujuk Lanjut
disease without renal

1192 21-03-2018 0137U0040318Y002555 0000038167064 PONIDAH P PENERIMA PENSIUN Myalgia Berobat Jalan
PNS
1193 21-03-2018 0137U0040318Y002612 0000039202323 SRI HENIANTI P PBI (APBD) Other contraceptive Berobat Jalan
management
1194 21-03-2018 0137U0040318Y002647 0000041840368 MOCHAMAD IMAN SYAFRIL L PNS DAERAH Impacted teeth Berobat Jalan

1195 21-03-2018 0137U0040318Y002591 0000072762895 M. RAMADHAN JUNIAR L PNS DAERAH Myalgia Berobat Jalan

1196 21-03-2018 0137U0040318Y002571 0000073517567 DEDY HIDAYAT L PNS DAERAH Acute pharyngitis, Berobat Jalan
unspecified
1197 21-03-2018 0137U0040318Y002582 0000073531271 LISMAN SETIAWAN L PNS PUSAT Multiple superficial injuries, Berobat Jalan
TANJUNG,ST. unspecified
1198 21-03-2018 0137U0040318Y002600 0000200111321 LIES MARTI P PNS PUSAT Acute upper respiratory Berobat Jalan
infection, unspecified
1199 21-03-2018 0137U0040318Y002556 0000210032043 NAURA DURRATUL HIKMAH P PNS DAERAH Acute upper respiratory Berobat Jalan
infection, unspecified
1200 21-03-2018 0137U0040318Y002534 0000210240191 SRI DWIKURNIASIH P PENERIMA PENSIUN Acute upper respiratory Berobat Jalan
PNS infection, unspecified
1201 21-03-2018 0137U0040318Y002566 0000508808035 RIMA AMELIA P PBI (APBN) Other antenatal screening Berobat Jalan

1202 21-03-2018 0137U0040318Y002537 0000552139391 WAHYU SETYOWATI P PEGAWAI SWASTA Disorders of refraction and Berobat Jalan
accommodation
1203 21-03-2018 0137U0040318Y002601 0001079607835 HANNA FARADISA P PNS PUSAT Acute upper respiratory Berobat Jalan
infection, unspecified
1204 21-03-2018 0137U0040318Y002620 0001130990095 FIRMAN MUCHLISIN L PEGAWAI SWASTA Traumatic shock Berobat Jalan

1205 21-03-2018 0137U0040318Y002636 0001137936767 SAPRIYADI L PEGAWAI SWASTA Acute upper respiratory Berobat Jalan
infection, unspecified
1206 21-03-2018 0137U0040318Y002609 0001181971304 FEBRIANA TRULLY P PEGAWAI SWASTA Other secondary arthrosis Berobat Jalan
TAKUMANSANG
1207 21-03-2018 0137U0040318Y002588 0001201150157 RIZKY MAULANA CAHYADI L PEKERJA MANDIRI Foreign body in colon Berobat Jalan

1208 21-03-2018 0137U0040318Y002564 0001202766772 ZAHWAH ALIYAH P PEGAWAI SWASTA Dental caries, unspecified Berobat Jalan

1209 21-03-2018 0137U0040318Y002640 0001218236861 ZIHAN SHABRINA FIRMANSYAH P PEGAWAI SWASTA Necrosis of pulp Berobat Jalan

1210 21-03-2018 0137U0040318Y002575 0001238267406 LAKSAMANA FADILLAH LUBIS L PEGAWAI SWASTA Myalgia Berobat Jalan
DAFTAR KUNJUNGAN PESERTA SAKIT

Kantor Cabang : BEKASI - 1011

FKTP : Klinik Mitra Medika - 0137U004

1211 21-03-2018 0137U0040318Y002512 0001256013178 MARIANA THALIB P PEKERJA MANDIRI Other secondary arthrosis Rujuk Lanjut

1212 21-03-2018 0137U0040318Y002624 0001257907509 ROSNAINI MARDHIYYAH P PEGAWAI SWASTA Acute upper respiratory Berobat Jalan
infection, unspecified
1213 21-03-2018 0137U0040318Y002522 0001260324167 BASRI L PEKERJA MANDIRI Myalgia Berobat Jalan

1214 21-03-2018 0137U0040318Y002542 0001261266816 FITRI HERMAWATI P PEGAWAI SWASTA Multiple superficial injuries, Berobat Jalan
unspecified
1215 21-03-2018 0137U0040318Y002606 0001264934889 TUTI KRISNAMURTI HJ P PEKERJA MANDIRI Other specified headache Berobat Jalan
syndromes
1216 21-03-2018 0137U0040318Y002639 0001264935341 TESSA MEITANIA NURHAMZAH, P PEGAWAI SWASTA Other antenatal screening Berobat Jalan
ST
1217 21-03-2018 0137U0040318Y002614 0001267506887 RINI ANGGRAINI P PEKERJA MANDIRI Other antenatal screening Berobat Jalan

1218 21-03-2018 0137U0040318Y002610 0001275348036 EUBESIUS AGUS DARMADI L PEKERJA MANDIRI Acute upper respiratory Berobat Jalan
infection, unspecified
1219 21-03-2018 0137U0040318Y002538 0001277936201 AGUS SUHERLIM L PEKERJA MANDIRI Myalgia Berobat Jalan

1220 21-03-2018 0137U0040318Y002581 0001280869323 DAENG MANGATTA HM.NUR L PEKERJA MANDIRI Low back pain Rujuk Lanjut

1221 21-03-2018 0137U0040318Y002583 0001287901822 JOHANNES SUMADI L PEKERJA MANDIRI Cerebral infarction, Rujuk Lanjut
unspecified
1222 21-03-2018 0137U0040318Y002562 0001294212813 DHIAZ RINALDI,SH L PEGAWAI SWASTA Dental caries, unspecified Berobat Jalan

1223 21-03-2018 0137U0040318Y002517 0001301992029 ZAINALIS P PEKERJA MANDIRI Chronic renal failure, Rujuk Lanjut
unspecified
1224 21-03-2018 0137U0040318Y002590 0001305292983 LANNY ASRININGSIH P PEKERJA MANDIRI Exfoliation of teeth due to Rujuk Lanjut
systemic causes
1225 21-03-2018 0137U0040318Y002593 0001338486939 MUZAINAH P PEKERJA MANDIRI Low back pain Rujuk Lanjut

1226 21-03-2018 0137U0040318Y002642 0001338487569 MIYOSHI NARULSA P PEKERJA MANDIRI Impacted teeth Berobat Jalan

1227 21-03-2018 0137U0040318Y002607 0001384701884 m naufal aditya perdana L PEKERJA MANDIRI Acute upper respiratory Berobat Jalan
infection, unspecified
1228 21-03-2018 0137U0040318Y002530 0001405018506 RAHMAT HIDAYAT L PEGAWAI SWASTA Disorders of refraction and Berobat Jalan
accommodation
1229 21-03-2018 0137U0040318Y002598 0001421092967 SRI HANDAYANI P PEKERJA MANDIRI Disorders of refraction and Rujuk Lanjut
accommodation
1230 21-03-2018 0137U0040318Y002619 0001421094249 FARADILAH WITANTI P PEKERJA MANDIRI Myopia Berobat Jalan

1231 21-03-2018 0137U0040318Y002570 0001421495087 ELIAH DJUITA P PEKERJA MANDIRI Other secondary arthrosis Rujuk Lanjut

1232 21-03-2018 0137U0040318Y002615 0001428501161 desi noviningsih P PEKERJA MANDIRI Acute upper respiratory Berobat Jalan
infection, unspecified
1233 21-03-2018 0137U0040318Y002594 0001431586517 KANAKHA PHUTRO WIJAYA L PEKERJA MANDIRI Hyperkinetic disorder, Rujuk Lanjut
unspecified
DAFTAR KUNJUNGAN PESERTA SAKIT

Kantor Cabang : BEKASI - 1011

FKTP : Klinik Mitra Medika - 0137U004

1234 21-03-2018 0137U0040318Y002559 0001432103949 ASTUTI RINI SUSILOWATI P PEKERJA MANDIRI Necrosis of pulp Berobat Jalan

1235 21-03-2018 0137U0040318Y002511 0001435571897 syuryati P PEKERJA MANDIRI Insulin-dependent Rujuk Lanjut
diabetes mellitus
1236 21-03-2018 0137U0040318Y002553 0001436526303 NURSANTI P PEGAWAI SWASTA Dyspepsia Berobat Jalan

1237 21-03-2018 0137U0040318Y002546 0001438367218 TENA P PEKERJA MANDIRI Acute upper respiratory Berobat Jalan
infection, unspecified
1238 21-03-2018 0137U0040318Y002525 0001451663548 YULIANTO L PEGAWAI SWASTA Other specified headache Berobat Jalan
syndromes
1239 21-03-2018 0137U0040318Y002561 0001455705808 CHELSEA FATIHAH SURONO P PEKERJA MANDIRI Dental caries, unspecified Berobat Jalan

1240 21-03-2018 0137U0040318Y002519 0001457923061 ARY KEFANTO L PEKERJA MANDIRI Cerebral infarction, Rujuk Lanjut
unspecified
1241 21-03-2018 0137U0040318Y002560 0001458466751 YULI VERAWATI P PEKERJA MANDIRI Dental caries, unspecified Berobat Jalan

1242 21-03-2018 0137U0040318Y002629 0001458525723 SITI ROHIMAH P PEKERJA MANDIRI Myalgia Berobat Jalan

1243 21-03-2018 0137U0040318Y002574 0001459176478 ALFENTINO BLONDINO L PEGAWAI SWASTA Other specified headache Berobat Jalan
RISAKOTTA syndromes
1244 21-03-2018 0137U0040318Y002521 0001459865081 EDY L PEKERJA MANDIRI Cerebral infarction, Rujuk Lanjut
unspecified
1245 21-03-2018 0137U0040318Y002540 0001464383485 HERMIN P PEKERJA MANDIRI Myalgia Berobat Jalan

1246 21-03-2018 0137U0040318Y002551 0001465761857 ASILAH SAUSAN RAIHANA P PEGAWAI SWASTA Varicella meningitis Berobat Jalan

1247 21-03-2018 0137U0040318Y002631 0001466956451 DEVANYA ANANTASYA P PEGAWAI SWASTA Acute upper respiratory Berobat Jalan
SHOLTAN infection, unspecified
1248 21-03-2018 0137U0040318Y002557 0001467566289 ZUROTUL UMROH P PEKERJA MANDIRI Vertigo of central origin Berobat Jalan

1249 21-03-2018 0137U0040318Y002563 0001470757555 NAWANG TUNINGSIH P PEKERJA MANDIRI Necrosis of pulp Berobat Jalan

1250 21-03-2018 0137U0040318Y002622 0001477625444 FITRI YULIA PRIHATINI P PEGAWAI SWASTA Acute upper respiratory Berobat Jalan
infection, unspecified
1251 21-03-2018 0137U0040318Y002510 0001478399725 SUMIYATI P PEKERJA MANDIRI Insulin-dependent Rujuk Lanjut
diabetes mellitus with

1252 21-03-2018 0137U0040318Y002523 0001516291852 ABDUL MAJID L PEGAWAI SWASTA Unspecified haemorrhoids Berobat Jalan
without complication

1253 21-03-2018 0137U0040318Y002533 0001516647688 WINDI UTAMI P PEGAWAI SWASTA Gingivitis and periodontal Berobat Jalan
diseases
1254 21-03-2018 0137U0040318Y002529 0001517286306 NOVI NARYATI P PEGAWAI SWASTA Acute upper respiratory Berobat Jalan
infection, unspecified
1255 21-03-2018 0137U0040318Y002592 0001517868696 ALVIN RHENALDY L PEGAWAI SWASTA Acute upper respiratory Berobat Jalan
infection, unspecified
DAFTAR KUNJUNGAN PESERTA SAKIT

Kantor Cabang : BEKASI - 1011

FKTP : Klinik Mitra Medika - 0137U004

1256 21-03-2018 0137U0040318Y002611 0001548819426 GINANJAR BAYU KUSUMA L PEGAWAI SWASTA Other specified headache Berobat Jalan
syndromes
1257 21-03-2018 0137U0040318Y002649 0001621830778 DELFHII AMELIA ZAKINAH P PEKERJA MANDIRI Other antenatal screening Berobat Jalan

1258 21-03-2018 0137U0040318Y002623 0001622495362 BAMBANG WIDODO L PEGAWAI SWASTA Acute upper respiratory Berobat Jalan
infection, unspecified
1259 21-03-2018 0137U0040318Y002528 0001625364347 FITRIA SHIFA P PEGAWAI SWASTA Typhoid fever Berobat Jalan

1260 21-03-2018 0137U0040318Y002550 0001629388181 EKA OKTAVIANTO L PEGAWAI SWASTA Acute upper respiratory Berobat Jalan
infection, unspecified
1261 21-03-2018 0137U0040318Y002548 0001629388214 RAYYA FATIMAH AZZAHRA P PEGAWAI SWASTA Acute upper respiratory Berobat Jalan
infection, unspecified
1262 21-03-2018 0137U0040318Y002549 0001629388225 RIZKA NAJIA ALMERA P PEGAWAI SWASTA Acute upper respiratory Berobat Jalan
infection, unspecified
1263 21-03-2018 0137U0040318Y002514 0001629941242 ANSAR L PEKERJA MANDIRI Chronic ischaemic heart Rujuk Lanjut
disease, unspecified
1264 21-03-2018 0137U0040318Y002515 0001629941253 SUPRIATININGSIH P PEKERJA MANDIRI Insulin-dependent Rujuk Lanjut
diabetes mellitus with

1265 21-03-2018 0137U0040318Y002554 0001632334735 WIDIASTUTI HARIYANTO P PEGAWAI SWASTA Acute upper respiratory Berobat Jalan
infection, unspecified
1266 21-03-2018 0137U0040318Y002625 0001635145481 MUSTIKA ANHAR P PEGAWAI SWASTA Acute upper respiratory Berobat Jalan
infection, unspecified
1267 21-03-2018 0137U0040318Y002605 0001639990552 DAVIANSYAH TIAZ ALVARO L PEGAWAI BUMN Acute upper respiratory Berobat Jalan
NASUTION infection, unspecified
1268 21-03-2018 0137U0040318Y002568 0001641423464 AMAN SANTOSO L PEKERJA MANDIRI Chronic renal failure, Rujuk Lanjut
unspecified
1269 21-03-2018 0137U0040318Y002587 0001641984906 ANDIKA SEPTILIYANTO L PEGAWAI SWASTA Diarrhoea and Berobat Jalan
gastroenteritis of
presumed infectious origin

1270 21-03-2018 0137U0040318Y002630 0001646135774 A. SRI HARTANTI MUTININGSIH P PEKERJA MANDIRI Acute upper respiratory Berobat Jalan
infection, unspecified
1271 21-03-2018 0137U0040318Y002547 0001647053908 IMANIAR PRATIWI P PEGAWAI SWASTA Other specified headache Berobat Jalan
syndromes
1272 21-03-2018 0137U0040318Y002541 0001648148657 TATI ROHAYATI P PEGAWAI SWASTA Other specified headache Berobat Jalan
syndromes
1273 21-03-2018 0137U0040318Y002645 0001657482849 AHMAD PAUZI L PEGAWAI SWASTA Impacted teeth Berobat Jalan

1274 21-03-2018 0137U0040318Y002602 0001657697962 MUHAMMAD FATIH FADHILLA L PEGAWAI SWASTA Vertigo of central origin Berobat Jalan

1275 21-03-2018 0137U0040318Y002634 0001658757374 GUSTIN APDI L PEGAWAI SWASTA Acute upper respiratory Berobat Jalan
infection, unspecified
1276 21-03-2018 0137U0040318Y002635 0001658757396 KHANSA DISA PUTRI P PEGAWAI SWASTA Acute upper respiratory Berobat Jalan
infection, unspecified
DAFTAR KUNJUNGAN PESERTA SAKIT

Kantor Cabang : BEKASI - 1011

FKTP : Klinik Mitra Medika - 0137U004

1277 21-03-2018 0137U0040318Y002644 0001658850164 MUHAMMAD NAUFAL AL L PEGAWAI SWASTA Chronic gingivitis Berobat Jalan
GHAZALI
1278 21-03-2018 0137U0040318Y002643 0001658850175 ALVARO AURELIO RAMADHAN L PEGAWAI SWASTA Abrasion of teeth Berobat Jalan

1279 21-03-2018 0137U0040318Y002577 0001720500401 SINTONG SIAHAAN L PEGAWAI SWASTA Dermatitis herpetiformis Berobat Jalan

1280 21-03-2018 0137U0040318Y002544 0001720846978 MUHAMMAD ZHOLA L PEKERJA MANDIRI Dermatitis herpetiformis Berobat Jalan
ROMADHON AL MALIKI
1281 21-03-2018 0137U0040318Y002531 0001723328021 H.MUHAMADA L PEKERJA MANDIRI Constipation Berobat Jalan

1282 21-03-2018 0137U0040318Y002573 0001723962295 BAMBANG SOETOMO L PEKERJA MANDIRI Cerebral infarction, Rujuk Lanjut
unspecified
1283 21-03-2018 0137U0040318Y002567 0001732598436 HERAWATI P PEKERJA MANDIRI Single spontaneous Sembuh
delivery, unspecified
1284 21-03-2018 0137U0040318Y002638 0001739462444 NETY ERKAH MEHWA P PEGAWAI SWASTA Other antenatal screening Berobat Jalan

1285 21-03-2018 0137U0040318Y002535 0001742518574 DEWI ISTIAWATY P PEGAWAI SWASTA Acute upper respiratory Berobat Jalan
infection, unspecified
1286 21-03-2018 0137U0040318Y002539 0001765987121 HARMANTO L PEKERJA MANDIRI Tuberculosis of lung, Berobat Jalan
confirmed by sputum
microscopy with or without

1287 21-03-2018 0137U0040318Y002516 0001766422653 Santi Arisusanti P PEGAWAI BUMN Secondary hypertension, Rujuk Lanjut
unspecified
1288 21-03-2018 0137U0040318Y002646 0001767001059 RAKA PRAYOGA RAMADHAN L PEGAWAI SWASTA Abrasion of teeth Berobat Jalan

1289 21-03-2018 0137U0040318Y002626 0001788409146 WILLY ANDREA HALIM L PEGAWAI SWASTA Myalgia Berobat Jalan

1290 21-03-2018 0137U0040318Y002524 0001793138242 R HARRY TRIANTO L PEKERJA MANDIRI Disorders of refraction and Berobat Jalan
accommodation
1291 21-03-2018 0137U0040318Y002627 0001797691601 DEWI ANISHA P PEGAWAI SWASTA Myalgia Berobat Jalan

1292 21-03-2018 0137U0040318Y002628 0001797694402 Agnies Sheilla Nada P PEGAWAI SWASTA Other and unspecified Berobat Jalan
infectious diseases
1293 21-03-2018 0137U0040318Y002584 0001802603349 TITI RETIASIH P PEKERJA MANDIRI Acute upper respiratory Berobat Jalan
infection, unspecified
1294 21-03-2018 0137U0040318Y002617 0001834865976 ARIZA KURNIA P PEGAWAI SWASTA Acute upper respiratory Berobat Jalan
infection, unspecified
1295 21-03-2018 0137U0040318Y002616 0001834866887 ALMIRA FARICA LISHAN P PEGAWAI SWASTA Acute upper respiratory Berobat Jalan
infection, unspecified
1296 21-03-2018 0137U0040318Y002608 0001840021209 laode rayhan amin L PEKERJA MANDIRI Acute upper respiratory Berobat Jalan
infection, unspecified
1297 21-03-2018 0137U0040318Y002578 0001849343163 M. ERVIANSYAH L PEKERJA MANDIRI Acute upper respiratory Berobat Jalan
infection, unspecified
1298 21-03-2018 0137U0040318Y002580 0001859474981 JESSICA SANTOSO P PEGAWAI SWASTA Acute upper respiratory Berobat Jalan
infection, unspecified
DAFTAR KUNJUNGAN PESERTA SAKIT

Kantor Cabang : BEKASI - 1011

FKTP : Klinik Mitra Medika - 0137U004

1299 21-03-2018 0137U0040318Y002518 0001860242578 SITI SUPRIYANI P PNS PUSAT Thyrotoxicosis, Rujuk Lanjut
unspecified
1300 21-03-2018 0137U0040318Y002579 0001872731878 darrell alfian budiman L PEGAWAI SWASTA Dermatitis herpetiformis Berobat Jalan

1301 21-03-2018 0137U0040318Y002520 0001876501361 ENNY P PEKERJA MANDIRI Acute sinusitis Rujuk Lanjut

1302 21-03-2018 0137U0040318Y002532 0001878723382 EMI MARIANA LAKAFIN P PEKERJA MANDIRI Neuralgia and neuritis, Berobat Jalan
unspecified
1303 21-03-2018 0137U0040318Y002572 0001886512994 VETTY P PEGAWAI SWASTA Other secondary arthrosis Berobat Jalan

1304 21-03-2018 0137U0040318Y002632 0001901483291 HAFIZA SAFFA ALYA P PEKERJA MANDIRI Acute upper respiratory Berobat Jalan
infection, unspecified
1305 21-03-2018 0137U0040318Y002558 0001902637607 noer aini P PEKERJA MANDIRI Acute upper respiratory Berobat Jalan
infection, unspecified
1306 21-03-2018 0137U0040318Y002648 0001902962913 ROBI BUDIMAN L PEKERJA MANDIRI Caries of dentine Berobat Jalan

1307 21-03-2018 0137U0040318Y002552 0001906501037 MUHAMAD IQBAL L PEGAWAI BUMD Other tetanus Berobat Jalan

1308 21-03-2018 0137U0040318Y002576 0001958804234 michell heryanto L PEKERJA MANDIRI Other and unspecified Berobat Jalan
infectious diseases
1309 21-03-2018 0137U0040318Y002641 0001963185221 sulastri herlina P PEKERJA MANDIRI Dental caries, unspecified Berobat Jalan

1310 21-03-2018 0137U0040318Y002565 0001963394076 khansa jauzaa aqiilah P PNS DAERAH Dental caries, unspecified Berobat Jalan

1311 21-03-2018 0137U0040318Y002633 0001968613648 TATANG KAMALUDIN, SE L PEKERJA MANDIRI Dyspepsia Berobat Jalan

1312 21-03-2018 0137U0040318Y002586 0001970615676 muhammad kafie el azzam L PNS DAERAH Other and unspecified Berobat Jalan
yustianto infectious diseases
1313 21-03-2018 0137U0040318Y002513 0002048490088 MUARNIS ST SINARO L PEKERJA MANDIRI Other rheumatoid arthritis Rujuk Lanjut

1314 21-03-2018 0137U0040318Y002569 0002056197442 PUTRA NUR AMIN L PEKERJA MANDIRI Other respiratory Rujuk Lanjut
tuberculosis, confirmed
bacteriologically and

1315 21-03-2018 0137U0040318Y002526 0002066337077 HODIJAH HARAHAP P PNS DAERAH Myalgia Berobat Jalan

1316 21-03-2018 0137U0040318Y002527 0002066347427 ANGGIE NURAINI L PEKERJA MANDIRI Acute upper respiratory Berobat Jalan
infection, unspecified
1317 21-03-2018 0137U0040318Y002604 0002093826251 MUHAMMAD HAFIZ AL ISRO L PEGAWAI SWASTA Acute bronchitis, Rujuk Lanjut
RIYANTO unspecified
1318 21-03-2018 0137U0040318Y002621 0002210981501 AZKIYA ARIFATUL ISNAINI P PEGAWAI SWASTA Acute upper respiratory Berobat Jalan
infection, unspecified
1319 21-03-2018 0137U0040318Y002618 0002217123257 DEDE SUANDI L PEGAWAI SWASTA Vertigo of central origin Berobat Jalan

1320 21-03-2018 0137U0040318Y002596 0002241550034 ADIFA MYSHA ISMANTYAS P PEGAWAI SWASTA Traumatic shock Berobat Jalan

1321 21-03-2018 0137U0040318Y002543 0002252882597 NYANYU SITI GERILYAWATI P PEKERJA MANDIRI Acute upper respiratory Berobat Jalan
infection, unspecified
DAFTAR KUNJUNGAN PESERTA SAKIT

Kantor Cabang : BEKASI - 1011

FKTP : Klinik Mitra Medika - 0137U004

1322 21-03-2018 0137U0040318Y002599 0002270490164 MUHAMMAD WILDAN L PNS PUSAT Acute upper respiratory Berobat Jalan
ARRASYID infection, unspecified
1323 21-03-2018 0137U0040318Y002595 0002283454102 ANUGRAH DICKA L PEKERJA MANDIRI Acute upper respiratory Berobat Jalan
ARSATIASYAH infection, unspecified
1324 21-03-2018 0137U0040318Y002637 0002285577584 ISMAIL L PEKERJA MANDIRI Myalgia Berobat Jalan

1325 21-03-2018 0137U0040318Y002603 0002292526203 YAHDIAN DWI FADHLAN SANDI L PEKERJA MANDIRI Vertigo of central origin Berobat Jalan

1326 21-03-2018 0137U0040318Y002536 0002293035017 M SYAWAL LUFIWIJAHYA L PEKERJA MANDIRI Acute upper respiratory Berobat Jalan
infection, unspecified
1327 21-03-2018 0137U0040318Y002597 0002294508598 KATHRE KANTI LESTARI P PEKERJA MANDIRI Acute upper respiratory Berobat Jalan
infection, unspecified
1328 21-03-2018 0137U0040318Y002585 0002312166846 habibie raffasya ammar L PEKERJA MANDIRI Acute upper respiratory Berobat Jalan
infection, unspecified
1329 21-03-2018 0137U0040318Y002545 0002321172156 ARSEN ANDREW HANSEL L PEKERJA MANDIRI Acute upper respiratory Berobat Jalan
infection, unspecified
1330 21-03-2018 0137U0040318Y002589 0002426470997 AGUS DWINANTO L PEKERJA MANDIRI Foreign body in colon Berobat Jalan

1331 21-03-2018 0137U0040318Y002613 0002432045092 ANNISA EKA PUTRI P PEKERJA MANDIRI Other antenatal screening Berobat Jalan

1332 20-03-2018 0137U0040318Y002412 0000038786962 RENSI MANURUNG P PENERIMA PENSIUN Acute upper respiratory Berobat Jalan
PNS infection, unspecified
1333 20-03-2018 0137U0040318Y002457 0000039952574 HANS GURUH PANJAITAN L PEKERJA MANDIRI Schizophrenia, unspecified Rujuk Lanjut

1334 20-03-2018 0137U0040318Y002473 0000042210167 GRESNAWATI DARJANTO P PNS PUSAT Acute upper respiratory Berobat Jalan
infection, unspecified
1335 20-03-2018 0137U0040318Y002479 0000072303153 RINA SOFYANTINA P PNS DAERAH Myalgia Berobat Jalan

1336 20-03-2018 0137U0040318Y002453 0000072850083 ACHMAD SOLEH L PNS PUSAT Acute upper respiratory Berobat Jalan
infection, unspecified
1337 20-03-2018 0137U0040318Y002480 0000073538605 LALA NURMALA SUBAYA, S.PD P PNS DAERAH Low back pain Rujuk Lanjut

1338 20-03-2018 0137U0040318Y002408 0000073558618 DRS RUKMAN L PNS DAERAH Acute upper respiratory Berobat Jalan
infection, unspecified
1339 20-03-2018 0137U0040318Y002407 0000073558923 SURIP P PNS DAERAH Acute upper respiratory Berobat Jalan
infection, unspecified
1340 20-03-2018 0137U0040318Y002446 0000198112419 SOPHIAN FANANY, DRS L PENERIMA PENSIUN Heart failure Rujuk Lanjut
PNS
1341 20-03-2018 0137U0040318Y002508 0000211234926 HERLIN NOVIANTI P PNS DAERAH Impacted teeth Berobat Jalan

1342 20-03-2018 0137U0040318Y002474 0000977680091 MARGIE TAMPUBOLON P PNS PUSAT Acute upper respiratory Berobat Jalan
infection, unspecified
1343 20-03-2018 0137U0040318Y002469 0001013622311 SITI AENA P PBI (APBN) Dyspepsia Berobat Jalan

1344 20-03-2018 0137U0040318Y002506 0001013875007 MIFTAHUL ROHMAH L PEKERJA MANDIRI Necrosis of pulp Berobat Jalan
DAFTAR KUNJUNGAN PESERTA SAKIT

Kantor Cabang : BEKASI - 1011

FKTP : Klinik Mitra Medika - 0137U004

1345 20-03-2018 0137U0040318Y002448 0001094864343 DWI SULISTIYO L KEPOLISIAN RI Other specified headache Berobat Jalan
syndromes
1346 20-03-2018 0137U0040318Y002447 0001100490985 LENNY SORTA SINAGA P ANGGOTA POLRI Acute upper respiratory Berobat Jalan
infection, unspecified
1347 20-03-2018 0137U0040318Y002462 0001100491007 ANDREAS JUSTIN WIRYA L ANGGOTA POLRI Acute upper respiratory Berobat Jalan
KEEFA infection, unspecified
1348 20-03-2018 0137U0040318Y002483 0001125169784 MOHAMAD TAUFIK L PNS PUSAT Dermatitis herpetiformis Berobat Jalan

1349 20-03-2018 0137U0040318Y002440 0001126552724 JAUHARI L PEGAWAI SWASTA Dyspepsia Berobat Jalan

1350 20-03-2018 0137U0040318Y002484 0001137250618 WIWIN TRIHIYASTINI P PEGAWAI SWASTA Acute upper respiratory Berobat Jalan
infection, unspecified
1351 20-03-2018 0137U0040318Y002443 0001172964756 SETIA MIHESTI P PEKERJA MANDIRI Acute upper respiratory Berobat Jalan
infection, unspecified
1352 20-03-2018 0137U0040318Y002486 0001195261762 MUHAMAD ALWI DRAJAT L PEGAWAI SWASTA Other and unspecified Berobat Jalan
infectious diseases
1353 20-03-2018 0137U0040318Y002445 0001205006163 KHALILA FATMA RUKMANA P PEGAWAI SWASTA Acute upper respiratory Berobat Jalan
infection, unspecified
1354 20-03-2018 0137U0040318Y002468 0001207944494 FATIMAH P PEKERJA MANDIRI Irregular menstruation, Berobat Jalan
unspecified
1355 20-03-2018 0137U0040318Y002489 0001257894911 JARVIS FEBRIAN SAPUTRO L PEKERJA MANDIRI Acute upper respiratory Berobat Jalan
infection, unspecified
1356 20-03-2018 0137U0040318Y002477 0001275766468 RITA ANGELA SIMATUPANG P ANGGOTA POLRI Foreign body in colon Berobat Jalan

1357 20-03-2018 0137U0040318Y002395 0001283805909 DUMARITA CAROLINA P PEKERJA MANDIRI Multiple fractures, Rujuk Lanjut
unspecified
1358 20-03-2018 0137U0040318Y002392 0001287652871 FRANS HARYANTO L PEKERJA MANDIRI Acute ischaemic heart Rujuk Lanjut
disease, unspecified
1359 20-03-2018 0137U0040318Y002418 0001288515047 SILVIA RATNA WIJAYA P PEKERJA MANDIRI Acute upper respiratory Berobat Jalan
infections of multiple and

1360 20-03-2018 0137U0040318Y002405 0001291293663 ERLINA P PEKERJA MANDIRI Myalgia Berobat Jalan

1361 20-03-2018 0137U0040318Y002417 0001292180523 AFRILLIA RATNA FERENITHA P PEKERJA MANDIRI Acute upper respiratory Berobat Jalan
infections of multiple and

1362 20-03-2018 0137U0040318Y002428 0001300176731 MUHAMMAD RIZKY L PEGAWAI SWASTA Acute upper respiratory Berobat Jalan
infection, unspecified
1363 20-03-2018 0137U0040318Y002504 0001308909205 SUCI DEASY AFIANI, SE P PEGAWAI SWASTA Impacted teeth Berobat Jalan

1364 20-03-2018 0137U0040318Y002401 0001313690578 sri handarini P PEKERJA MANDIRI Other specified arthritis Rujuk Lanjut

1365 20-03-2018 0137U0040318Y002502 0001326811836 SUCI ATININGSIH P PEKERJA MANDIRI Dental caries, unspecified Berobat Jalan
DAFTAR KUNJUNGAN PESERTA SAKIT

Kantor Cabang : BEKASI - 1011

FKTP : Klinik Mitra Medika - 0137U004

1366 20-03-2018 0137U0040318Y002499 0001327414713 AGUNG SAPUTRO L PEGAWAI PEMERINTAH Impacted teeth Berobat Jalan
DENGAN PERJANJIAN

1367 20-03-2018 0137U0040318Y002403 0001335579568 ALRIYATMI P PEKERJA MANDIRI Other specified headache Berobat Jalan
syndromes
1368 20-03-2018 0137U0040318Y002432 0001340074078 AGUS SUKINDAR L PEGAWAI SWASTA Disorder of refraction, Rujuk Lanjut
unspecified
1369 20-03-2018 0137U0040318Y002461 0001370911691 AHMAD FARREL MULIA SANDI L PEKERJA MANDIRI Oedema, unspecified Berobat Jalan

1370 20-03-2018 0137U0040318Y002454 0001373800871 HAFIZA NANDITA P PEGAWAI SWASTA Dermatitis herpetiformis Berobat Jalan

1371 20-03-2018 0137U0040318Y002391 0001381109106 sri indrawati P PEKERJA MANDIRI Heart failure Rujuk Lanjut

1372 20-03-2018 0137U0040318Y002397 0001387808728 S.TATANG L PEKERJA MANDIRI Cerebrovascular disease, Rujuk Lanjut
unspecified
1373 20-03-2018 0137U0040318Y002427 0001387817403 NURYATI P PEKERJA MANDIRI Acute upper respiratory Berobat Jalan
infection, unspecified
1374 20-03-2018 0137U0040318Y002393 0001424091194 SITI MARYATUN P PEKERJA MANDIRI Other arthrosis Rujuk Lanjut

1375 20-03-2018 0137U0040318Y002441 0001426175346 SITI FARIDA P PEKERJA MANDIRI Other specified headache Berobat Jalan
syndromes
1376 20-03-2018 0137U0040318Y002455 0001426516749 MARYANI PURNOMO P PEKERJA MANDIRI Disorder of refraction, Rujuk Lanjut
unspecified
1377 20-03-2018 0137U0040318Y002406 0001432322919 HJ.NURHAYATI P PEKERJA MANDIRI Acute upper respiratory Berobat Jalan
infection, unspecified
1378 20-03-2018 0137U0040318Y002400 0001437996251 ERNA RUSTINA P PEKERJA MANDIRI Chronic obstructive Rujuk Lanjut
pulmonary disease,

1379 20-03-2018 0137U0040318Y002387 0001445355911 FATONAH P PEKERJA MANDIRI Congestive heart failure Rujuk Lanjut

1380 20-03-2018 0137U0040318Y002459 0001451538202 SHINTA DEWI P PEKERJA MANDIRI Other secondary arthrosis Rujuk Lanjut

1381 20-03-2018 0137U0040318Y002465 0001454487107 NUR AFIKA RIYANTHY K L PEKERJA MANDIRI Diarrhoea and Berobat Jalan
gastroenteritis of
presumed infectious origin

1382 20-03-2018 0137U0040318Y002449 0001456942206 ANTONIUS CHANDRA L PEKERJA MANDIRI Acute upper respiratory Berobat Jalan
infection, unspecified
1383 20-03-2018 0137U0040318Y002399 0001458098256 HANNI MAHARANI KOTO P PEKERJA MANDIRI Cervical disc disorders Rujuk Lanjut

1384 20-03-2018 0137U0040318Y002416 0001459213839 TAN LUCYAWATI AFERA P PEKERJA MANDIRI Embedded and impacted Berobat Jalan
teeth
1385 20-03-2018 0137U0040318Y002438 0001459773257 AL SUWARJONO L PEKERJA MANDIRI Acute upper respiratory Berobat Jalan
infections of multiple and

1386 20-03-2018 0137U0040318Y002388 0001460427996 NURHADY ANWAR L PEKERJA MANDIRI Acute and subacute Rujuk Lanjut
hepatic failure
DAFTAR KUNJUNGAN PESERTA SAKIT

Kantor Cabang : BEKASI - 1011

FKTP : Klinik Mitra Medika - 0137U004

1387 20-03-2018 0137U0040318Y002497 0001460771381 DESY INDAH MARLINA P PEKERJA MANDIRI Other antenatal screening Berobat Jalan

1388 20-03-2018 0137U0040318Y002437 0001461476474 DANANG HARIYANTO L PEKERJA MANDIRI Acute upper respiratory Berobat Jalan
infections of multiple and

1389 20-03-2018 0137U0040318Y002475 0001462819184 EVI SUSANTI P PEKERJA MANDIRI Other secondary arthrosis Berobat Jalan

1390 20-03-2018 0137U0040318Y002463 0001465134581 UMAYAH,HJ P PEKERJA MANDIRI Other specified headache Berobat Jalan
syndromes
1391 20-03-2018 0137U0040318Y002490 0001472273526 SUPARTO L PEKERJA MANDIRI Otalgia Berobat Jalan

1392 20-03-2018 0137U0040318Y002402 0001479303685 ALDI YUNUS L PEKERJA MANDIRI Acute upper respiratory Berobat Jalan
infection, unspecified
1393 20-03-2018 0137U0040318Y002503 0001480667883 tje we shiang P PEKERJA MANDIRI Impacted teeth Berobat Jalan

1394 20-03-2018 0137U0040318Y002415 0001483893292 TJOA TJONG SEN L PEKERJA MANDIRI Embedded and impacted Berobat Jalan
teeth
1395 20-03-2018 0137U0040318Y002425 0001516291852 ABDUL MAJID L PEGAWAI SWASTA Unspecified haemorrhoids Berobat Jalan
without complication

1396 20-03-2018 0137U0040318Y002444 0001603622755 ASTRID AZ ZAHRA P PEGAWAI SWASTA Acute upper respiratory Berobat Jalan
infection, unspecified
1397 20-03-2018 0137U0040318Y002466 0001620790975 MARTHIN YESANOV L PEGAWAI SWASTA Acute upper respiratory Berobat Jalan
KRISNAPURA KANA infection, unspecified
1398 20-03-2018 0137U0040318Y002389 0001623148064 TRI SARASWATI P PEGAWAI SWASTA Dental caries Berobat Jalan

1399 20-03-2018 0137U0040318Y002413 0001623148086 MAHESWARI RAMADINA P PEGAWAI SWASTA Disorders of refraction and Berobat Jalan
accommodation
1400 20-03-2018 0137U0040318Y002472 0001625364268 MEILANI P PEGAWAI SWASTA Myalgia Berobat Jalan

1401 20-03-2018 0137U0040318Y002470 0001625364279 ERLANGGA SETIYAWAN L PEGAWAI SWASTA Other specified headache Berobat Jalan
syndromes
1402 20-03-2018 0137U0040318Y002414 0001628007895 MINI SULASNI P PEGAWAI SWASTA Acute upper respiratory Berobat Jalan
infection, unspecified
1403 20-03-2018 0137U0040318Y002409 0001628468561 LIA KUMALA CHANDRA P PEGAWAI SWASTA Dyspepsia Berobat Jalan

1404 20-03-2018 0137U0040318Y002430 0001629910091 NAURA JAZIYAH SALSABILA L PNS DAERAH Typhoid fever Berobat Jalan

1405 20-03-2018 0137U0040318Y002505 0001634541726 YURESTINI IRBARANI P PEGAWAI SWASTA Impacted teeth Berobat Jalan

1406 20-03-2018 0137U0040318Y002488 0001638769634 YANTI P PEKERJA MANDIRI Other secondary arthrosis Berobat Jalan

1407 20-03-2018 0137U0040318Y002498 0001650005019 Suryanah P PEGAWAI SWASTA Special screening Berobat Jalan
examination for neoplasm

1408 20-03-2018 0137U0040318Y002464 0001650111884 HELEN BUNTAR P PEGAWAI SWASTA Acute upper respiratory Berobat Jalan
infection, unspecified
DAFTAR KUNJUNGAN PESERTA SAKIT

Kantor Cabang : BEKASI - 1011

FKTP : Klinik Mitra Medika - 0137U004

1409 20-03-2018 0137U0040318Y002456 0001654584028 GRIFFIN KENSHEE RIFKY L PEGAWAI SWASTA Acute upper respiratory Berobat Jalan
infection, unspecified
1410 20-03-2018 0137U0040318Y002424 0001658100216 Daniel Lutfi L PEGAWAI SWASTA Other specified headache Berobat Jalan
syndromes
1411 20-03-2018 0137U0040318Y002396 0001659190577 IRMA NOPIANI P PEGAWAI SWASTA Otalgia Rujuk Lanjut

1412 20-03-2018 0137U0040318Y002458 0001725431297 DAWUD RIFANGI SAKDUN L PEKERJA MANDIRI Calculus of ureter Rujuk Lanjut

1413 20-03-2018 0137U0040318Y002434 0001729987536 RACHMADANI SETIAWAN L PEKERJA MANDIRI Dyspepsia Berobat Jalan

1414 20-03-2018 0137U0040318Y002390 0001736266195 Elisabeth Christiaan P PEKERJA MANDIRI Dental caries Berobat Jalan

1415 20-03-2018 0137U0040318Y002410 0001736266217 Gabriella Stefani Tua P PEKERJA MANDIRI Suppurative and Berobat Jalan
unspecified otitis media
1416 20-03-2018 0137U0040318Y002500 0001737606745 ANI EKA WINDYASTUTI P PEGAWAI SWASTA Necrosis of pulp Berobat Jalan

1417 20-03-2018 0137U0040318Y002411 0001741601349 Endang L PEGAWAI SWASTA Pain in throat and chest Berobat Jalan

1418 20-03-2018 0137U0040318Y002493 0001742970385 LINA SETIAWATI P PEGAWAI SWASTA Dyspepsia Berobat Jalan

1419 20-03-2018 0137U0040318Y002494 0001742970429 KESIA MELIANI HARTOLO P PEGAWAI SWASTA Acute upper respiratory Berobat Jalan
infection, unspecified
1420 20-03-2018 0137U0040318Y002509 0001769509157 NEYSHA ADELIA ATHIFA P PEGAWAI SWASTA Necrosis of pulp Berobat Jalan

1421 20-03-2018 0137U0040318Y002487 0001769520868 DETRI YUNANI P PEGAWAI SWASTA Myalgia Berobat Jalan

1422 20-03-2018 0137U0040318Y002436 0001796873591 NABIILAH DHIYA ULHAQ P PEKERJA MANDIRI Acute upper respiratory Berobat Jalan
infections of multiple and

1423 20-03-2018 0137U0040318Y002467 0001798974404 MUHAMMAD RIDWAN L PEKERJA MANDIRI Diarrhoea and Berobat Jalan
gastroenteritis of
presumed infectious origin

1424 20-03-2018 0137U0040318Y002419 0001802467304 GUNARSO L PEGAWAI SWASTA Acute upper respiratory Berobat Jalan
infections of multiple and

1425 20-03-2018 0137U0040318Y002452 0001807480631 H. IWAN RIDWAN L PEKERJA MANDIRI Cerebrovascular disease, Rujuk Lanjut
unspecified
1426 20-03-2018 0137U0040318Y002476 0001841078507 MAULANA ABDILLAH L PEGAWAI SWASTA Acute upper respiratory Berobat Jalan
infection, unspecified
1427 20-03-2018 0137U0040318Y002421 0001847229164 salsa bila rohayati P PEKERJA MANDIRI Acute upper respiratory Berobat Jalan
infection, unspecified
1428 20-03-2018 0137U0040318Y002478 0001850688191 ANTON L PEKERJA MANDIRI Myopia Berobat Jalan

1429 20-03-2018 0137U0040318Y002507 0001866468971 SITI MARIAM P PEGAWAI SWASTA Impacted teeth Berobat Jalan
DAFTAR KUNJUNGAN PESERTA SAKIT

Kantor Cabang : BEKASI - 1011

FKTP : Klinik Mitra Medika - 0137U004

1430 20-03-2018 0137U0040318Y002435 0001868551468 HONEY WISNU RINI P PEGAWAI SWASTA Non-insulin-dependent Rujuk Lanjut
diabetes mellitus with
other specified

1431 20-03-2018 0137U0040318Y002431 0001902962889 RUSMIYAH P PEKERJA MANDIRI Other specified headache Berobat Jalan
syndromes
1432 20-03-2018 0137U0040318Y002398 0001902962935 AZMI MAULANA L PEGAWAI SWASTA Hordeolum and chalazion Rujuk Lanjut

1433 20-03-2018 0137U0040318Y002485 0001958802412 MARIO HERYANTO L PEGAWAI SWASTA Other specified headache Berobat Jalan
syndromes
1434 20-03-2018 0137U0040318Y002423 0001963918271 KUMORO SANTI SAPTA PUTRI P PEGAWAI SWASTA Disorders of refraction and Berobat Jalan
accommodation
1435 20-03-2018 0137U0040318Y002433 0001965534028 NOVILA INGGRID RELANI P PEKERJA MANDIRI Acute upper respiratory Berobat Jalan
infections of multiple and

1436 20-03-2018 0137U0040318Y002495 0002034545286 ELLY PUSPITA SARI P PEGAWAI SWASTA Dermatitis herpetiformis Berobat Jalan

1437 20-03-2018 0137U0040318Y002420 0002041693244 MUHAMAD FARHAN MAULANA L PEKERJA MANDIRI Acute upper respiratory Berobat Jalan
infection, unspecified
1438 20-03-2018 0137U0040318Y002442 0002069486526 AGUS PURWANTO L PEKERJA MANDIRI Chronic kidney disease Rujuk Lanjut

1439 20-03-2018 0137U0040318Y002394 0002090940783 AHMAD FADLAN SAKHA L PEGAWAI SWASTA Developmental disorder of Rujuk Lanjut
MUSHBIHIN speech and language,

1440 20-03-2018 0137U0040318Y002426 0002197152832 MUHAMMAD RIZKIA L PEGAWAI SWASTA Dermatitis herpetiformis Berobat Jalan

1441 20-03-2018 0137U0040318Y002429 0002221500251 ADDIN MUHAMMAD AMIN L PNS DAERAH Acute upper respiratory Berobat Jalan
infection, unspecified
1442 20-03-2018 0137U0040318Y002482 0002221517698 maritza avara nella P PNS PUSAT Acute upper respiratory Berobat Jalan
infection, unspecified
1443 20-03-2018 0137U0040318Y002422 0002228774927 SUTIRAH P PEKERJA MANDIRI Dermatitis herpetiformis Berobat Jalan

1444 20-03-2018 0137U0040318Y002471 0002235902556 RISMAWATI P PEGAWAI SWASTA Chronic ischaemic heart Rujuk Lanjut
disease, unspecified
1445 20-03-2018 0137U0040318Y002450 0002253380782 rifai fitra iskandar L PEKERJA MANDIRI Acute upper respiratory Berobat Jalan
infection, unspecified
1446 20-03-2018 0137U0040318Y002491 0002253666565 BAYI NY ANISA PURTIWI P PEGAWAI SWASTA Acute upper respiratory Berobat Jalan
infection, unspecified
1447 20-03-2018 0137U0040318Y002404 0002283454102 ANUGRAH DICKA L PEKERJA MANDIRI Acute upper respiratory Berobat Jalan
ARSATIASYAH infection, unspecified
1448 20-03-2018 0137U0040318Y002496 0002284426023 GHAZLAN DWITRA LAMPARD L PEGAWAI SWASTA Acute upper respiratory Berobat Jalan
infection, unspecified
1449 20-03-2018 0137U0040318Y002501 0002287845584 APRENI ERLINA P PEGAWAI SWASTA Necrosis of pulp Berobat Jalan

1450 20-03-2018 0137U0040318Y002481 0002302114487 SAHRUL FAHMI L PEKERJA MANDIRI Acute upper respiratory Berobat Jalan
infection, unspecified
DAFTAR KUNJUNGAN PESERTA SAKIT

Kantor Cabang : BEKASI - 1011

FKTP : Klinik Mitra Medika - 0137U004

1451 20-03-2018 0137U0040318Y002451 0002428869251 WAHYU MEGAWATI P PEKERJA MANDIRI Maternal care for other Rujuk Lanjut
known or suspected fetal

1452 20-03-2018 0137U0040318Y002439 0002433918418 TITUS FAEYZA ATHAYA L PEKERJA MANDIRI Acute upper respiratory Berobat Jalan
infection, unspecified
1453 20-03-2018 0137U0040318Y002492 0002435077642 MARYON AKYWEN P PEKERJA MANDIRI Vertigo of central origin Berobat Jalan

1454 19-03-2018 0137U0040318Y002317 0000038881888 DRS.WILLEM NIKSON L PNS PUSAT Vertigo of central origin Rujuk Lanjut
SITOMPUL, MM.
1455 19-03-2018 0137U0040318Y002195 0000040909342 SRI SUBEKTI P PNS DAERAH Insulin-dependent Rujuk Lanjut
diabetes mellitus
1456 19-03-2018 0137U0040318Y002300 0000042101414 JULIANA ELLEN TEHUPEIORY P PENERIMA PENSIUN Myalgia Berobat Jalan
PNS
1457 19-03-2018 0137U0040318Y002356 0000042123251 TAKWIM QUMARUN L PENERIMA PENSIUN Acute upper respiratory Berobat Jalan
PNS infection, unspecified
1458 19-03-2018 0137U0040318Y002250 0000048533332 MUCHTADI GOZALI, SH L PENERIMA PENSIUN Acute upper respiratory Berobat Jalan
PNS infections of multiple and

1459 19-03-2018 0137U0040318Y002286 0000055592493 MARNI SUMARTINI P PNS DAERAH Acute upper respiratory Berobat Jalan
infections of multiple and

1460 19-03-2018 0137U0040318Y002316 0000072735682 ENTAR KURNAESIH P PNS DAERAH Excessive, frequent and Rujuk Lanjut
irregular menstruation
1461 19-03-2018 0137U0040318Y002224 0000072774167 ADRIAN ATMAJI P S, KOM L PNS DAERAH Acute upper respiratory Berobat Jalan
infections of multiple and

1462 19-03-2018 0137U0040318Y002323 0000073383715 MUHAMMAD FAZRIN L PEGAWAI SWASTA Myopia Rujuk Lanjut
DERIAWAN
1463 19-03-2018 0137U0040318Y002232 0000073402918 ACHMAD BUNJAMIN L PENERIMA PENSIUN Insulin-dependent Rujuk Lanjut
PNS diabetes mellitus with

1464 19-03-2018 0137U0040318Y002235 0000073531271 LISMAN SETIAWAN L PNS PUSAT Dyspepsia Berobat Jalan
TANJUNG,ST.
1465 19-03-2018 0137U0040318Y002382 0000131129335 RAFEYFA ASYLA PUTRI A P PNS PUSAT Chronic gingivitis Berobat Jalan

1466 19-03-2018 0137U0040318Y002200 0000162761758 MAROAN MANGATUR L PNS PUSAT Dental caries Berobat Jalan
MARPAUNG
1467 19-03-2018 0137U0040318Y002233 0000164504294 SUTRISNO L PENERIMA PENSIUN TNI Insulin-dependent Rujuk Lanjut
diabetes mellitus with

1468 19-03-2018 0137U0040318Y002299 0000165837565 JOHANIS SURIPATTY L PENERIMA PENSIUN Acute upper respiratory Berobat Jalan
PNS infection, unspecified
1469 19-03-2018 0137U0040318Y002216 0000193992794 ISA YUSTIANTO L PNS DAERAH Acute upper respiratory Berobat Jalan
infections of multiple and
DAFTAR KUNJUNGAN PESERTA SAKIT

Kantor Cabang : BEKASI - 1011

FKTP : Klinik Mitra Medika - 0137U004

1470 19-03-2018 0137U0040318Y002201 0000198094059 AMABELA YOHANA ARTATI P PNS PUSAT Dental caries Berobat Jalan
MARPAUNG
1471 19-03-2018 0137U0040318Y002341 0000200111321 LIES MARTI P PNS PUSAT Acute upper respiratory Berobat Jalan
infection, unspecified
1472 19-03-2018 0137U0040318Y002217 0000202206036 M KHADAFI AZKA YUSTIANTO L PNS DAERAH Acute upper respiratory Berobat Jalan
infections of multiple and

1473 19-03-2018 0137U0040318Y002340 0001079607835 HANNA FARADISA P PNS PUSAT Foreign body in colon Berobat Jalan

1474 19-03-2018 0137U0040318Y002377 0001123279424 YOPIE L PEGAWAI SWASTA Impacted teeth Berobat Jalan

1475 19-03-2018 0137U0040318Y002302 0001123808501 FIRMAN L PEGAWAI SWASTA Other specified headache Berobat Jalan
syndromes
1476 19-03-2018 0137U0040318Y002325 0001144291724 UKARTA L PEGAWAI SWASTA Acute upper respiratory Berobat Jalan
infection, unspecified
1477 19-03-2018 0137U0040318Y002242 0001145660016 HENI HAFSYAH P PEGAWAI SWASTA Acute upper respiratory Berobat Jalan
infections of multiple and

1478 19-03-2018 0137U0040318Y002338 0001155852707 CUT DARA NOVITASARI P PEGAWAI SWASTA Dermatitis herpetiformis Berobat Jalan

1479 19-03-2018 0137U0040318Y002203 0001166474507 ERNY P PEGAWAI SWASTA Embedded and impacted Berobat Jalan
teeth
1480 19-03-2018 0137U0040318Y002260 0001194170938 SALMAH P PEGAWAI SWASTA Embedded and impacted Berobat Jalan
teeth
1481 19-03-2018 0137U0040318Y002204 0001202766772 ZAHWAH ALIYAH P PEGAWAI SWASTA Embedded and impacted Berobat Jalan
teeth
1482 19-03-2018 0137U0040318Y002209 0001213128101 GEMI SUKARSIH P PEKERJA MANDIRI Other specified headache Rujuk Lanjut
syndromes
1483 19-03-2018 0137U0040318Y002282 0001238267417 GINA ANDRIYANA P PEGAWAI SWASTA Acute upper respiratory Berobat Jalan
infections of multiple and

1484 19-03-2018 0137U0040318Y002272 0001255993874 RATNA DEWI P PEKERJA MANDIRI Acute upper respiratory Berobat Jalan
infections of multiple and

1485 19-03-2018 0137U0040318Y002273 0001255994021 PARAMITHA RAMADHANTY P PEKERJA MANDIRI Acute upper respiratory Berobat Jalan
infections of multiple and

1486 19-03-2018 0137U0040318Y002354 0001257773466 HERMIEN OKTAVIANTI P PEKERJA MANDIRI Vertigo of central origin Berobat Jalan

1487 19-03-2018 0137U0040318Y002227 0001258023385 ANTONIO ALFONSO CORUA L PENERIMA PENSIUN Acute upper respiratory Berobat Jalan
SWASTA infections of multiple and

1488 19-03-2018 0137U0040318Y002226 0001258023407 SUZANE JULIET ESTHER P PENERIMA PENSIUN Acute upper respiratory Berobat Jalan
SWASTA infections of multiple and
DAFTAR KUNJUNGAN PESERTA SAKIT

Kantor Cabang : BEKASI - 1011

FKTP : Klinik Mitra Medika - 0137U004

1489 19-03-2018 0137U0040318Y002361 0001258542909 SALWATI P PEKERJA MANDIRI Other specified headache Berobat Jalan
syndromes
1490 19-03-2018 0137U0040318Y002278 0001259559371 ASNANI P PEKERJA MANDIRI Acute upper respiratory Berobat Jalan
infections of multiple and

1491 19-03-2018 0137U0040318Y002339 0001259997625 NURHASANAH P PEKERJA MANDIRI Other specified headache Berobat Jalan
syndromes
1492 19-03-2018 0137U0040318Y002219 0001263343149 ROHIMIN L PEKERJA MANDIRI Dyspepsia Berobat Jalan

1493 19-03-2018 0137U0040318Y002210 0001263543028 TOMMY SAMUDRA AL-RASYID L PEKERJA MANDIRI Dental caries Berobat Jalan

1494 19-03-2018 0137U0040318Y002270 0001266349781 tuti mahera P PEKERJA MANDIRI Other soft tissue disorders, Berobat Jalan
not elsewhere classified

1495 19-03-2018 0137U0040318Y002212 0001267299246 FIKRI SAPUTRA L PEKERJA MANDIRI Acute upper respiratory Berobat Jalan
infections of multiple and

1496 19-03-2018 0137U0040318Y002218 0001272978112 stella bob lilianty P PEKERJA MANDIRI Acute upper respiratory Berobat Jalan
infections of multiple and

1497 19-03-2018 0137U0040318Y002264 0001279133403 LEGIMAN L PEKERJA MANDIRI Chronic ischaemic heart Rujuk Lanjut
disease, unspecified
1498 19-03-2018 0137U0040318Y002384 0001282682924 SUPARJO L PEKERJA MANDIRI Impacted teeth Berobat Jalan

1499 19-03-2018 0137U0040318Y002343 0001282683374 ADITYA DWI PRASETYO L PEKERJA MANDIRI Acute upper respiratory Berobat Jalan
infection, unspecified
1500 19-03-2018 0137U0040318Y002197 0001286769508 NOVI YANTI P PEKERJA MANDIRI Typhoid and paratyphoid Rujuk Lanjut
fevers
1501 19-03-2018 0137U0040318Y002193 0001291450241 EPON KOMALA SARI P PEKERJA MANDIRI Low back pain Rujuk Lanjut

1502 19-03-2018 0137U0040318Y002283 0001304268377 UTIN ERNA MARINI P PEGAWAI SWASTA Acute upper respiratory Berobat Jalan
infections of multiple and

1503 19-03-2018 0137U0040318Y002370 0001308037037 FARID WAJDI L PEKERJA MANDIRI Acute upper respiratory Berobat Jalan
infection, unspecified
1504 19-03-2018 0137U0040318Y002295 0001310238178 LIM ENGNI P PEKERJA MANDIRI Other secondary arthrosis Rujuk Lanjut

1505 19-03-2018 0137U0040318Y002287 0001315568035 RACHEL FEBRIANI KOMARA P. P PEGAWAI SWASTA Acute upper respiratory Berobat Jalan
infections of multiple and

1506 19-03-2018 0137U0040318Y002207 0001326324789 SYIFA RIZKY AMANDA P PEGAWAI SWASTA Dental caries Berobat Jalan

1507 19-03-2018 0137U0040318Y002386 0001326811836 SUCI ATININGSIH P PEKERJA MANDIRI Special screening Berobat Jalan
examination for neoplasm
DAFTAR KUNJUNGAN PESERTA SAKIT

Kantor Cabang : BEKASI - 1011

FKTP : Klinik Mitra Medika - 0137U004

1508 19-03-2018 0137U0040318Y002274 0001335976312 PRISWATI P PEGAWAI SWASTA Acute upper respiratory Berobat Jalan
infections of multiple and

1509 19-03-2018 0137U0040318Y002237 0001336725191 LANNY VERONICA LAIJ P PEKERJA MANDIRI Candidiasis, unspecified Rujuk Lanjut

1510 19-03-2018 0137U0040318Y002236 0001336725257 VINCE MAGDALENA LAY P PEKERJA MANDIRI Pityriasis alba Rujuk Lanjut

1511 19-03-2018 0137U0040318Y002255 0001339422816 DANA MAULANA L PEKERJA MANDIRI Embedded and impacted Berobat Jalan
teeth
1512 19-03-2018 0137U0040318Y002249 0001339506426 SHULTHON ROHMAN ABDILLAH L PEKERJA MANDIRI Acute upper respiratory Berobat Jalan
infections of multiple and

1513 19-03-2018 0137U0040318Y002247 0001339711211 INDIRA PUSPARINI P PEKERJA MANDIRI Acute upper respiratory Berobat Jalan
infections of multiple and

1514 19-03-2018 0137U0040318Y002333 0001375550087 DARMINAH P PEKERJA MANDIRI Hypermetropia Berobat Jalan

1515 19-03-2018 0137U0040318Y002296 0001376563814 SUCI WULANDARI P PEGAWAI SWASTA Other specified headache Berobat Jalan
syndromes
1516 19-03-2018 0137U0040318Y002288 0001379787254 vallerian evan ferenzhe L PEGAWAI SWASTA Injury of eye and orbit Rujuk Lanjut

1517 19-03-2018 0137U0040318Y002208 0001380507636 DESCYLIAWATI KOSIM P PEKERJA MANDIRI Irritable bowel syndrome Rujuk Lanjut
with diarrhoea
1518 19-03-2018 0137U0040318Y002261 0001421356274 LIS PERMANASARI P PEKERJA MANDIRI Insulin-dependent Rujuk Lanjut
diabetes mellitus with

1519 19-03-2018 0137U0040318Y002205 0001433390005 bambang guntoro L PEKERJA MANDIRI Dental caries Berobat Jalan

1520 19-03-2018 0137U0040318Y002206 0001433390758 sian hoa hazjar P PEKERJA MANDIRI Embedded and impacted Berobat Jalan
teeth
1521 19-03-2018 0137U0040318Y002234 0001435134273 PIPIT SOPIAH P PEKERJA MANDIRI Acute upper respiratory Berobat Jalan
infections of multiple and

1522 19-03-2018 0137U0040318Y002342 0001439199606 TATANG SUBEKTI L PEKERJA MANDIRI Stomatitis and related Berobat Jalan
lesions
1523 19-03-2018 0137U0040318Y002257 0001448280742 ROHANI P PEKERJA MANDIRI Dental caries Berobat Jalan

1524 19-03-2018 0137U0040318Y002198 0001448592647 REANDY FEBRIAND L PEGAWAI SWASTA Dental caries Berobat Jalan

1525 19-03-2018 0137U0040318Y002231 0001452481569 KHAIRANI AZMI SUBAGJA P PEKERJA MANDIRI Mixed simple and Rujuk Lanjut
mucopurulent chronic

1526 19-03-2018 0137U0040318Y002336 0001454289941 LIM AI TJU P PEKERJA MANDIRI Acute upper respiratory Berobat Jalan
infection, unspecified
1527 19-03-2018 0137U0040318Y002263 0001455315467 AINUN P PEKERJA MANDIRI Chronic obstructive Rujuk Lanjut
pulmonary disease,
DAFTAR KUNJUNGAN PESERTA SAKIT

Kantor Cabang : BEKASI - 1011

FKTP : Klinik Mitra Medika - 0137U004

1528 19-03-2018 0137U0040318Y002353 0001456680464 TITI FATIMAH P PEKERJA MANDIRI Stomatitis and related Berobat Jalan
lesions
1529 19-03-2018 0137U0040318Y002262 0001459177389 SONNY TJAHJADI L PEKERJA MANDIRI Schizophrenia, unspecified Rujuk Lanjut

1530 19-03-2018 0137U0040318Y002310 0001459324629 ENY P PEKERJA MANDIRI Chronic ischaemic heart Rujuk Lanjut
disease
1531 19-03-2018 0137U0040318Y002290 0001460953405 LINNA SALIMIN L PEKERJA MANDIRI Anaemia, unspecified Berobat Jalan

1532 19-03-2018 0137U0040318Y002289 0001460954158 EVY PURNAMASARI P PEKERJA MANDIRI Myalgia Berobat Jalan
SUTANDAR
1533 19-03-2018 0137U0040318Y002335 0001462778245 H.MOHAMAD AJIN L PBI (APBD) Myalgia Berobat Jalan

1534 19-03-2018 0137U0040318Y002304 0001464368501 ZAIDAH NADA RUHILLAH P PEKERJA MANDIRI Gastro-oesophageal reflux Berobat Jalan
disease without

1535 19-03-2018 0137U0040318Y002373 0001465869644 YUNIARTY PUTRI P PEKERJA MANDIRI Necrosis of pulp Berobat Jalan

1536 19-03-2018 0137U0040318Y002298 0001467833861 ROBERT HANDIYANTO L PEKERJA MANDIRI Other and unspecified Berobat Jalan
infectious diseases
1537 19-03-2018 0137U0040318Y002269 0001471812671 YANTO SETIAWAN L PEGAWAI SWASTA Acute upper respiratory Berobat Jalan
infections of multiple and

1538 19-03-2018 0137U0040318Y002265 0001474330116 SUHATI P PEKERJA MANDIRI Chronic ischaemic heart Rujuk Lanjut
disease, unspecified
1539 19-03-2018 0137U0040318Y002223 0001477134909 SUHENDI L PEKERJA MANDIRI Other soft tissue disorders, Berobat Jalan
not elsewhere classified

1540 19-03-2018 0137U0040318Y002245 0001479663562 SITI AISYAH P PEKERJA MANDIRI Acute upper respiratory Berobat Jalan
infections of multiple and

1541 19-03-2018 0137U0040318Y002243 0001479666778 ULIMA AZMI P PEKERJA MANDIRI Acute upper respiratory Berobat Jalan
infections of multiple and

1542 19-03-2018 0137U0040318Y002244 0001479911286 WARSIH P PEKERJA MANDIRI Gonarthrosis [arthrosis of Berobat Jalan
knee]
1543 19-03-2018 0137U0040318Y002327 0001517655284 JENAL ABIDIN L PEGAWAI SWASTA Acute upper respiratory Berobat Jalan
infection, unspecified
1544 19-03-2018 0137U0040318Y002378 0001623148064 TRI SARASWATI P PEGAWAI SWASTA Impacted teeth Berobat Jalan

1545 19-03-2018 0137U0040318Y002364 0001626369107 ADAM AFRIANSYAH L PEGAWAI SWASTA Acute upper respiratory Berobat Jalan
infection, unspecified
1546 19-03-2018 0137U0040318Y002372 0001627201203 ADNAN ANFASA KARTAWIJAYA L PEGAWAI SWASTA Necrosis of pulp Berobat Jalan

1547 19-03-2018 0137U0040318Y002326 0001627367567 RAHMI HERNAWATI P PEGAWAI SWASTA Other specified headache Berobat Jalan
syndromes
DAFTAR KUNJUNGAN PESERTA SAKIT

Kantor Cabang : BEKASI - 1011

FKTP : Klinik Mitra Medika - 0137U004

1548 19-03-2018 0137U0040318Y002379 0001628527498 IIN RUYANA P PEGAWAI BUMN Impacted teeth Berobat Jalan

1549 19-03-2018 0137U0040318Y002383 0001628527509 MUHAMMAD ALFATHUR RIZKY L PEGAWAI BUMN Chronic gingivitis Berobat Jalan

1550 19-03-2018 0137U0040318Y002355 0001628527522 DEWINTA PUTRI MAHARANI P PEGAWAI BUMN Other and unspecified Berobat Jalan
infectious diseases
1551 19-03-2018 0137U0040318Y002258 0001629387112 RUSMINI P PEGAWAI SWASTA Other contraceptive Berobat Jalan
management
1552 19-03-2018 0137U0040318Y002307 0001631467203 NURAINI RAHAYU P PEKERJA MANDIRI Other specified headache Berobat Jalan
syndromes
1553 19-03-2018 0137U0040318Y002238 0001632334735 WIDIASTUTI HARIYANTO P PEGAWAI SWASTA Acute upper respiratory Berobat Jalan
infections of multiple and

1554 19-03-2018 0137U0040318Y002228 0001632954532 ROHIDIN SURYA L PEGAWAI SWASTA Acute upper respiratory Berobat Jalan
infections of multiple and

1555 19-03-2018 0137U0040318Y002259 0001635210369 RUDI SIHOMBING L PEGAWAI SWASTA Embedded and impacted Berobat Jalan
teeth
1556 19-03-2018 0137U0040318Y002256 0001635210371 FRANSISCUS FERDINAND S L PEGAWAI SWASTA Embedded and impacted Berobat Jalan
teeth
1557 19-03-2018 0137U0040318Y002213 0001641423464 AMAN SANTOSO L PEKERJA MANDIRI Chronic ischaemic heart Rujuk Lanjut
disease, unspecified
1558 19-03-2018 0137U0040318Y002305 0001641651041 MADROBIH L PEGAWAI SWASTA Anaemia, unspecified Berobat Jalan

1559 19-03-2018 0137U0040318Y002292 0001642173006 IGNATIUS DANDI SAKTI L PEGAWAI SWASTA Acute upper respiratory Berobat Jalan
PURNOMO infection, unspecified
1560 19-03-2018 0137U0040318Y002291 0001642173028 MIKAEL CRESPO BALO DANTA L PEGAWAI SWASTA Acute upper respiratory Berobat Jalan
infection, unspecified
1561 19-03-2018 0137U0040318Y002303 0001642204844 SYAHWARRUDIN L PEGAWAI SWASTA Anaemia, unspecified Berobat Jalan

1562 19-03-2018 0137U0040318Y002251 0001647171483 LILY FRANCISCA P PEGAWAI SWASTA Acute upper respiratory Berobat Jalan
infections of multiple and

1563 19-03-2018 0137U0040318Y002280 0001650005019 Suryanah P PEGAWAI SWASTA Acute upper respiratory Berobat Jalan
infections of multiple and

1564 19-03-2018 0137U0040318Y002346 0001654584006 RIFKY L PEGAWAI SWASTA Acute upper respiratory Berobat Jalan
infection, unspecified
1565 19-03-2018 0137U0040318Y002252 0001654584017 JUSTIN ARDELL RIFKY L PEGAWAI SWASTA Acute upper respiratory Berobat Jalan
infections of multiple and

1566 19-03-2018 0137U0040318Y002202 0001656282767 Annisa Humaira Q P PEGAWAI SWASTA Embedded and impacted Berobat Jalan
teeth
1567 19-03-2018 0137U0040318Y002330 0001657338175 ANAH KARNASIH P PEGAWAI SWASTA Dermatitis herpetiformis Berobat Jalan
DAFTAR KUNJUNGAN PESERTA SAKIT

Kantor Cabang : BEKASI - 1011

FKTP : Klinik Mitra Medika - 0137U004

1568 19-03-2018 0137U0040318Y002381 0001657482849 AHMAD PAUZI L PEGAWAI SWASTA Dental caries, unspecified Berobat Jalan

1569 19-03-2018 0137U0040318Y002194 0001657635535 ADINDA VISCA APRILLIA P PEGAWAI SWASTA Other and unspecified Rujuk Lanjut
diseases of pulp and

1570 19-03-2018 0137U0040318Y002230 0001658328603 RICKY YULIANTO L PEGAWAI SWASTA Acute upper respiratory Berobat Jalan
infections of multiple and

1571 19-03-2018 0137U0040318Y002374 0001658850164 MUHAMMAD NAUFAL AL L PEGAWAI SWASTA Abrasion of teeth Berobat Jalan
GHAZALI
1572 19-03-2018 0137U0040318Y002344 0001658850175 ALVARO AURELIO RAMADHAN L PEGAWAI SWASTA Acute upper respiratory Berobat Jalan
infection, unspecified
1573 19-03-2018 0137U0040318Y002240 0001707228887 ANDRIANI P PEKERJA MANDIRI Acute upper respiratory Berobat Jalan
infections of multiple and

1574 19-03-2018 0137U0040318Y002196 0001716041621 DR. PALUPI LINDIASARI P PEKERJA MANDIRI Dental caries Berobat Jalan
S,S.PI,MM
1575 19-03-2018 0137U0040318Y002337 0001716589866 ANNATASYA ALVINA YULIYANTI P PEKERJA MANDIRI Oedema, unspecified Berobat Jalan

1576 19-03-2018 0137U0040318Y002334 0001716814552 MUHAMAD RIZKY L PEGAWAI SWASTA Acute upper respiratory Berobat Jalan
infection, unspecified
1577 19-03-2018 0137U0040318Y002225 0001721400906 ABDULLAH FAUZY L PEKERJA MANDIRI Acute upper respiratory Berobat Jalan
infections of multiple and

1578 19-03-2018 0137U0040318Y002241 0001722528246 SUMARSILAH P PEKERJA MANDIRI Other headache Berobat Jalan
syndromes
1579 19-03-2018 0137U0040318Y002199 0001728278638 ARDIYANSYAH,SH L PEKERJA MANDIRI Dental caries Berobat Jalan

1580 19-03-2018 0137U0040318Y002350 0001728287673 MARWAH SAFITRI SEPTIANI P PEKERJA MANDIRI Acute upper respiratory Berobat Jalan
infection, unspecified
1581 19-03-2018 0137U0040318Y002246 0001730216237 FITRI MEGAWATI P PEKERJA MANDIRI Acute upper respiratory Berobat Jalan
infections of multiple and

1582 19-03-2018 0137U0040318Y002221 0001738584202 SUMARDIYATI P PEKERJA MANDIRI Other soft tissue disorders, Berobat Jalan
not elsewhere classified

1583 19-03-2018 0137U0040318Y002329 0001738990135 MUHAMMAD FAREL L PEGAWAI SWASTA Cutaneous abscess, Berobat Jalan
furuncle and carbuncle
1584 19-03-2018 0137U0040318Y002301 0001740754776 BARLIANTA.P L PEKERJA MANDIRI Acute upper respiratory Berobat Jalan
infection, unspecified
1585 19-03-2018 0137U0040318Y002363 0001744826769 Reza Kharisma Putra L PEGAWAI SWASTA Other specified headache Berobat Jalan
syndromes
1586 19-03-2018 0137U0040318Y002266 0001769428124 RANTISI ABDILLAH SIDQI P PEGAWAI SWASTA Disorder of refraction, Rujuk Lanjut
SATYANANDA unspecified
DAFTAR KUNJUNGAN PESERTA SAKIT

Kantor Cabang : BEKASI - 1011

FKTP : Klinik Mitra Medika - 0137U004

1587 19-03-2018 0137U0040318Y002306 0001773056643 RULLY ADI RAMDAN L PEGAWAI SWASTA Acute upper respiratory Berobat Jalan
infection, unspecified
1588 19-03-2018 0137U0040318Y002357 0001795586545 YULIA ALUIE P PEKERJA MANDIRI Acute upper respiratory Berobat Jalan
infection, unspecified
1589 19-03-2018 0137U0040318Y002318 0001810924828 WIDYATI P PEKERJA MANDIRI Congestive heart failure Rujuk Lanjut

1590 19-03-2018 0137U0040318Y002351 0001810924852 CHRISTIAN YUNIARTO L PEKERJA MANDIRI Other secondary arthrosis Berobat Jalan

1591 19-03-2018 0137U0040318Y002211 0001811235789 BANGUN MULYANTORO L PENERIMA PENSIUN Dental caries Berobat Jalan
SWASTA
1592 19-03-2018 0137U0040318Y002311 0001813500369 RATIH INDRIATI P PEGAWAI SWASTA Insulin-dependent Rujuk Lanjut
diabetes mellitus with

1593 19-03-2018 0137U0040318Y002239 0001818045246 PRATIWI KUSUMASTUTI P PEGAWAI SWASTA Dyspepsia Berobat Jalan

1594 19-03-2018 0137U0040318Y002294 0001834507258 ANINDHITA KANAYA PUTRI P PEGAWAI SWASTA Dermatitis herpetiformis Berobat Jalan

1595 19-03-2018 0137U0040318Y002324 0001844099458 RADITYA WILDAN MAULANA L PEGAWAI SWASTA Acute upper respiratory Berobat Jalan
infection, unspecified
1596 19-03-2018 0137U0040318Y002385 0001849827442 HADI PURNOMO L PEGAWAI SWASTA Impacted teeth Berobat Jalan

1597 19-03-2018 0137U0040318Y002331 0001849834337 YAUZAA SYIFA KIKEINA P PEGAWAI SWASTA Acute upper respiratory Berobat Jalan
infection, unspecified
1598 19-03-2018 0137U0040318Y002371 0001849835261 HASNA GHANI AQILAH P PEGAWAI SWASTA Chronic gingivitis Berobat Jalan

1599 19-03-2018 0137U0040318Y002222 0001850888002 MUHAMMAD HARYANTO L PEGAWAI SWASTA Acute upper respiratory Berobat Jalan
PRABOWO infections of multiple and

1600 19-03-2018 0137U0040318Y002214 0001859950361 HAFIDAH IJAYANTI P PEKERJA MANDIRI Primary arthrosis of other Rujuk Lanjut
joints, multiple sites
1601 19-03-2018 0137U0040318Y002368 0001866360756 ELISABETH SEPTIANI ARINAN P PEGAWAI SWASTA Acute upper respiratory Berobat Jalan
infection, unspecified
1602 19-03-2018 0137U0040318Y002366 0001878405456 SITI cHOLIPAH P PEKERJA MANDIRI Myalgia Berobat Jalan

1603 19-03-2018 0137U0040318Y002365 0001878406154 rafael arinski L PEKERJA MANDIRI Other and unspecified Berobat Jalan
infectious diseases
1604 19-03-2018 0137U0040318Y002376 0001884012737 MUFFAZAL MIRZA HARAHAP L PEGAWAI SWASTA Abrasion of teeth Berobat Jalan

1605 19-03-2018 0137U0040318Y002279 0001884441442 ANDI BAMBANG HERINDRO L PEKERJA MANDIRI Asthma Rujuk Lanjut

1606 19-03-2018 0137U0040318Y002267 0001895083841 EDISON SIMORANGKIR L PEKERJA MANDIRI Acute upper respiratory Berobat Jalan
infections of multiple and

1607 19-03-2018 0137U0040318Y002268 0001895084133 megawati P PEKERJA MANDIRI Other soft tissue disorders, Berobat Jalan
not elsewhere classified
DAFTAR KUNJUNGAN PESERTA SAKIT

Kantor Cabang : BEKASI - 1011

FKTP : Klinik Mitra Medika - 0137U004

1608 19-03-2018 0137U0040318Y002271 0001899715138 ETI HAYATI P PEKERJA MANDIRI Other headache Berobat Jalan
syndromes
1609 19-03-2018 0137U0040318Y002229 0001908169593 ANTONIA TUTI IRAWATI P PEKERJA MANDIRI Acute upper respiratory Berobat Jalan
infections of multiple and

1610 19-03-2018 0137U0040318Y002254 0001963394076 khansa jauzaa aqiilah P PNS DAERAH Acute upper respiratory Berobat Jalan
infections of multiple and

1611 19-03-2018 0137U0040318Y002285 0001963851884 siwi aisyahrani P PEKERJA MANDIRI Acute upper respiratory Berobat Jalan
infections of multiple and

1612 19-03-2018 0137U0040318Y002253 0001971743499 SAUKAT BASHIR L PEKERJA MANDIRI Acute upper respiratory Berobat Jalan
infections of multiple and

1613 19-03-2018 0137U0040318Y002362 0001971930161 NUNUK MULYANINGRUM P PEGAWAI SWASTA Acute upper respiratory Berobat Jalan
infection, unspecified
1614 19-03-2018 0137U0040318Y002349 0002052835975 NUR AYNI HIJRIAH P PEGAWAI SWASTA Dysmenorrhoea, Berobat Jalan
unspecified
1615 19-03-2018 0137U0040318Y002248 0002059041429 LATHIFA BALQIS SALSABILLAH P PEKERJA MANDIRI Acute upper respiratory Berobat Jalan
infections of multiple and

1616 19-03-2018 0137U0040318Y002347 0002061376604 MOCHMMAD YUSUF L PEGAWAI SWASTA Acute upper respiratory Berobat Jalan
infection, unspecified
1617 19-03-2018 0137U0040318Y002348 0002061389248 AYU DWI OKTAVIANI P PEGAWAI SWASTA Irregular menstruation, Berobat Jalan
unspecified
1618 19-03-2018 0137U0040318Y002328 0002062226687 MAULIDIANI RIFAYA ZAIDA P PNS PUSAT Acute upper respiratory Berobat Jalan
infection, unspecified
1619 19-03-2018 0137U0040318Y002275 0002075026138 LC DIAN PERTIWI P PEKERJA MANDIRI Diarrhoea and Berobat Jalan
gastroenteritis of
presumed infectious origin

1620 19-03-2018 0137U0040318Y002284 0002076002256 ERVANNA L PEKERJA MANDIRI Acute upper respiratory Berobat Jalan
infections of multiple and

1621 19-03-2018 0137U0040318Y002360 0002088212567 SADIAH P PEKERJA MANDIRI Acute upper respiratory Berobat Jalan
infection, unspecified
1622 19-03-2018 0137U0040318Y002369 0002096324908 VIKA SAPUTRA P PEKERJA MANDIRI Dyspepsia Berobat Jalan

1623 19-03-2018 0137U0040318Y002297 0002202825609 NUR HAYATI P PEKERJA MANDIRI Acute upper respiratory Berobat Jalan
infection, unspecified
1624 19-03-2018 0137U0040318Y002345 0002217322236 MUHAMMAD ABDUL DHAPA L PEKERJA MANDIRI Dyspepsia Berobat Jalan

1625 19-03-2018 0137U0040318Y002359 0002223037304 IWAN L PEGAWAI SWASTA Other specified headache Berobat Jalan
syndromes
DAFTAR KUNJUNGAN PESERTA SAKIT

Kantor Cabang : BEKASI - 1011

FKTP : Klinik Mitra Medika - 0137U004

1626 19-03-2018 0137U0040318Y002276 0002231539075 HENI SULISTIYOWATI P PEKERJA MANDIRI Suppurative and Berobat Jalan
unspecified otitis media
1627 19-03-2018 0137U0040318Y002220 0002232304841 SITI WAFIRO P PEGAWAI SWASTA Other arthrosis Berobat Jalan

1628 19-03-2018 0137U0040318Y002352 0002242541891 FADHLI LUTFI DWIYOTO L PEKERJA MANDIRI Other and unspecified Berobat Jalan
infectious diseases
1629 19-03-2018 0137U0040318Y002293 0002285115682 ALI AHMAD ALTHA FARIZQI L PEGAWAI SWASTA Acute upper respiratory Berobat Jalan
infection, unspecified
1630 19-03-2018 0137U0040318Y002281 0002292170848 BELLA SYIFA AZALEA L PEGAWAI SWASTA Acute upper respiratory Berobat Jalan
infections of multiple and

1631 19-03-2018 0137U0040318Y002332 0002297783147 NUR ACHMADI L PEKERJA MANDIRI Myopia Berobat Jalan

1632 19-03-2018 0137U0040318Y002380 0002302253739 RAFAEL LOUIS HERNANDEZ L PEKERJA MANDIRI Abrasion of teeth Berobat Jalan

1633 19-03-2018 0137U0040318Y002358 0002302254044 BRIGITTA YOVELLA JOCELYN P PEKERJA MANDIRI Acute upper respiratory Berobat Jalan
infection, unspecified
1634 19-03-2018 0137U0040318Y002277 0002316637293 ANDHANU RIFKY NARESWARA L PEGAWAI SWASTA Acute upper respiratory Berobat Jalan
infections of multiple and

1635 19-03-2018 0137U0040318Y002367 0002328166067 ANNISA P PEKERJA MANDIRI Acute upper respiratory Berobat Jalan
infection, unspecified
1636 19-03-2018 0137U0040318Y002215 0002328488774 i gede keenan pranaja resana L PEGAWAI SWASTA Acute upper respiratory Berobat Jalan
infections of multiple and

1637 19-03-2018 0137U0040318Y002375 0002428018852 DARNADI L PEKERJA MANDIRI Impacted teeth Berobat Jalan

1638 18-03-2018 0137U0040318Y002113 0000035943063 WAGIYO L PENERIMA PENSIUN Chronic ischaemic heart Rujuk Lanjut
PNS disease
1639 18-03-2018 0137U0040318Y002111 0000035943074 SUKARSIH P PENERIMA PENSIUN Chronic ischaemic heart Rujuk Lanjut
PNS disease
1640 18-03-2018 0137U0040318Y002134 0000036190866 YATI JUHANAH P PNS PUSAT Acute upper respiratory Berobat Jalan
infection, unspecified
1641 18-03-2018 0137U0040318Y002309 0000039662943 SEBA SIREGAR P PENERIMA PENSIUN Unspecified diabetes Sembuh
PNS mellitus with other

1642 18-03-2018 0137U0040318Y002144 0000072309554 INDAH WAHYUNI BUDIASTUTI P PEKERJA MANDIRI Antenatal screening Berobat Jalan

1643 18-03-2018 0137U0040318Y002064 0000072891909 CITRA MAYA P PNS DAERAH Acute lymphadenitis, Rujuk Lanjut
unspecified
1644 18-03-2018 0137U0040318Y002312 0000073248895 ENDANG RAHARDJININGSIH P PENERIMA PENSIUN Unspecified diabetes Sembuh
PNS mellitus with other

1645 18-03-2018 0137U0040318Y002179 0000093185122 anik, st P PNS PUSAT Acute upper respiratory Berobat Jalan
infections of multiple and
DAFTAR KUNJUNGAN PESERTA SAKIT

Kantor Cabang : BEKASI - 1011

FKTP : Klinik Mitra Medika - 0137U004

1646 18-03-2018 0137U0040318Y002102 0000172522348 LASTRI TETY P PNS PUSAT Acute pharyngitis, Berobat Jalan
unspecified
1647 18-03-2018 0137U0040318Y002103 0000172522451 JEREMY TRISTAN TIO L PNS PUSAT Acute pharyngitis, Berobat Jalan
PANDIANGAN unspecified
1648 18-03-2018 0137U0040318Y002315 0000198112419 SOPHIAN FANANY, DRS L PENERIMA PENSIUN Unspecified diabetes Sembuh
PNS mellitus with other

1649 18-03-2018 0137U0040318Y002104 0001080573208 JONATHAN FELIX PANDIANGAN L PNS PUSAT Acute pharyngitis, Berobat Jalan
unspecified
1650 18-03-2018 0137U0040318Y002164 0001140259871 HERU PUJIANTO L PEGAWAI SWASTA Gonarthrosis [arthrosis of Berobat Jalan
knee]
1651 18-03-2018 0137U0040318Y002119 0001150539862 NOVIA INDRAWATI P PEGAWAI SWASTA Other maternal diseases Rujuk Lanjut
classifiable elsewhere but
complicating pregnancy,
childbirth and the
puerperium
1652 18-03-2018 0137U0040318Y002094 0001181971304 FEBRIANA TRULLY P PEGAWAI SWASTA Myalgia Berobat Jalan
TAKUMANSANG
1653 18-03-2018 0137U0040318Y002086 0001183342498 ATHAILLAH RAFI ALAMSYAH L PEGAWAI SWASTA Acute upper respiratory Berobat Jalan
infection, unspecified
1654 18-03-2018 0137U0040318Y002138 0001189937619 YURHAM REZA HERMAWAN L PEGAWAI SWASTA Specific developmental Rujuk Lanjut
disorders of speech and

1655 18-03-2018 0137U0040318Y002182 0001190743211 VERA DWI KURNIASARI P PEGAWAI SWASTA Acute upper respiratory Berobat Jalan
infections of multiple and

1656 18-03-2018 0137U0040318Y002181 0001192794309 ARKA REZKI RAFASYA L PEGAWAI SWASTA Acute upper respiratory Berobat Jalan
infections of multiple and

1657 18-03-2018 0137U0040318Y002123 0001208277707 KUNTO SULISTYO BUDI L PEKERJA MANDIRI Acute upper respiratory Berobat Jalan
infections of multiple and

1658 18-03-2018 0137U0040318Y002130 0001225256139 KALIRI L PEGAWAI SWASTA Acute upper respiratory Berobat Jalan
infections of multiple and

1659 18-03-2018 0137U0040318Y002121 0001255993874 RATNA DEWI P PEKERJA MANDIRI Acute upper respiratory Berobat Jalan
infections of multiple and

1660 18-03-2018 0137U0040318Y002120 0001255994021 PARAMITHA RAMADHANTY P PEKERJA MANDIRI Acute upper respiratory Berobat Jalan
infections of multiple and

1661 18-03-2018 0137U0040318Y002149 0001256584757 SUROSO L PEKERJA MANDIRI Other bullous disorders Berobat Jalan

1662 18-03-2018 0137U0040318Y002133 0001257743013 YOSEPH DHASA L PEGAWAI SWASTA Gout Berobat Jalan
DAFTAR KUNJUNGAN PESERTA SAKIT

Kantor Cabang : BEKASI - 1011

FKTP : Klinik Mitra Medika - 0137U004

1663 18-03-2018 0137U0040318Y002135 0001260204682 MIKAELA PAMELA SUNG P PEKERJA MANDIRI Developmental disorder of Rujuk Lanjut
speech and language,

1664 18-03-2018 0137U0040318Y002191 0001260781345 YOGO UTOMO L PEKERJA MANDIRI Other arthrosis Berobat Jalan

1665 18-03-2018 0137U0040318Y003159 0001270782505 HARYANTO L PEKERJA MANDIRI Unspecified diabetes Sembuh
mellitus with other

1666 18-03-2018 0137U0040318Y003162 0001270783012 MIYATI SRI MARDININGSIH P PEKERJA MANDIRI Unspecified diabetes Sembuh
mellitus with other

1667 18-03-2018 0137U0040318Y002096 0001280958265 RUKIA DALLY P PEKERJA MANDIRI Myalgia Berobat Jalan

1668 18-03-2018 0137U0040318Y002101 0001282392966 TIA HERMAWATI P PEKERJA MANDIRI Acute upper respiratory Berobat Jalan
infection, unspecified
1669 18-03-2018 0137U0040318Y002320 0001287652871 FRANS HARYANTO L PEKERJA MANDIRI Unspecified diabetes Sembuh
mellitus with other

1670 18-03-2018 0137U0040318Y002071 0001287652871 FRANS HARYANTO L PEKERJA MANDIRI Pyothorax without fistula Berobat Jalan

1671 18-03-2018 0137U0040318Y002069 0001287653308 RATIH KUSUMAHARTIN P PEKERJA MANDIRI Myalgia Berobat Jalan

1672 18-03-2018 0137U0040318Y002321 0001287653308 RATIH KUSUMAHARTIN P PEKERJA MANDIRI Unspecified diabetes Sembuh
mellitus with other

1673 18-03-2018 0137U0040318Y002142 0001291332025 R.WIDYATMOKO L PEKERJA MANDIRI Disorders of vestibular Berobat Jalan
function
1674 18-03-2018 0137U0040318Y002185 0001297729214 AISYAH AURELIA L PEGAWAI SWASTA Acute upper respiratory Berobat Jalan
infections of multiple and

1675 18-03-2018 0137U0040318Y002313 0001298615793 RATNA JUWITA P PEKERJA MANDIRI Unspecified diabetes Sembuh
mellitus with other

1676 18-03-2018 0137U0040318Y002189 0001302927568 ABDUL KADIR JAELANI L PEKERJA MANDIRI Dyspepsia Berobat Jalan

1677 18-03-2018 0137U0040318Y002084 0001302928176 H. DODDY MULYAWAN L PEKERJA MANDIRI Acute upper respiratory Berobat Jalan
infection, unspecified
1678 18-03-2018 0137U0040318Y002109 0001303039247 FATIMAH AZ-ZAHRA RIZKA P PEGAWAI SWASTA Typhoid fever Berobat Jalan
FAUZI
1679 18-03-2018 0137U0040318Y002125 0001304792346 YAN KURNIAWAN L PEKERJA MANDIRI Atherosclerotic Rujuk Lanjut
cardiovascular disease, so

1680 18-03-2018 0137U0040318Y002126 0001304792998 SURINI DARMANI P PEKERJA MANDIRI Stroke, not specified as Rujuk Lanjut
haemorrhage or infarction
1681 18-03-2018 0137U0040318Y002314 0001305749349 NURIMAH P PEKERJA MANDIRI Unspecified diabetes Sembuh
mellitus with other
DAFTAR KUNJUNGAN PESERTA SAKIT

Kantor Cabang : BEKASI - 1011

FKTP : Klinik Mitra Medika - 0137U004

1682 18-03-2018 0137U0040318Y002156 0001324295638 ROSHY GRACE SINAGA P KEPOLISIAN RI Acute upper respiratory Berobat Jalan
infections of multiple and

1683 18-03-2018 0137U0040318Y002167 0001336962363 JOSUA ARMANDO L PEKERJA MANDIRI Other malignant Rujuk Lanjut
neoplasms of skin
1684 18-03-2018 0137U0040318Y002141 0001338236943 NADIA NURAENI P PEKERJA MANDIRI Other malignant Berobat Jalan
neoplasms of skin
1685 18-03-2018 0137U0040318Y002072 0001339609397 TITIEN AULIATIN P PEKERJA MANDIRI Other specified headache Berobat Jalan
syndromes
1686 18-03-2018 0137U0040318Y002171 0001370644468 NURJANAH P PEGAWAI SWASTA Transient cerebral Rujuk Lanjut
ischaemic attack,

1687 18-03-2018 0137U0040318Y002319 0001372342871 SUNARI P PENERIMA PENSIUN Unspecified diabetes Sembuh
SWASTA mellitus with other

1688 18-03-2018 0137U0040318Y002187 0001375467726 JUPRI ATMONO L PEGAWAI SWASTA Other soft tissue disorders, Berobat Jalan
not elsewhere classified

1689 18-03-2018 0137U0040318Y002079 0001381407186 RIZQI AKBAR ABDURRAHMAN L PEGAWAI SWASTA Acute upper respiratory Berobat Jalan
infection, unspecified
1690 18-03-2018 0137U0040318Y002140 0001388010442 AHMAD NURJAMAN L PEGAWAI SWASTA Acute upper respiratory Berobat Jalan
infections of multiple and

1691 18-03-2018 0137U0040318Y002088 0001393279795 TRIARI RUKI HANDAYANI P PEKERJA MANDIRI Vertigo of central origin Berobat Jalan

1692 18-03-2018 0137U0040318Y002147 0001406683899 MUH ALFARIDZI L PEGAWAI SWASTA Acute upper respiratory Berobat Jalan
NURDIANSYACH infections of multiple and

1693 18-03-2018 0137U0040318Y002148 0001428177971 SANALI L PEKERJA MANDIRI Acute upper respiratory Berobat Jalan
infections of multiple and

1694 18-03-2018 0137U0040318Y002170 0001428640907 m hatta lubis L PEKERJA MANDIRI Chronic obstructive Rujuk Lanjut
pulmonary disease with
acute lower respiratory

1695 18-03-2018 0137U0040318Y002169 0001428641796 rosmiaty pane P PEKERJA MANDIRI Transient cerebral Rujuk Lanjut
ischaemic attack,

1696 18-03-2018 0137U0040318Y002154 0001429020832 YULIANA P PEGAWAI SWASTA Antenatal screening Berobat Jalan

1697 18-03-2018 0137U0040318Y002153 0001430438444 ANI BUDI PURWANI P PEKERJA MANDIRI Acute upper respiratory Berobat Jalan
infections of multiple and

1698 18-03-2018 0137U0040318Y002152 0001433391491 ERICK PRANAGA L PEGAWAI SWASTA Acute upper respiratory Berobat Jalan
infections of multiple and
DAFTAR KUNJUNGAN PESERTA SAKIT

Kantor Cabang : BEKASI - 1011

FKTP : Klinik Mitra Medika - 0137U004

1699 18-03-2018 0137U0040318Y002073 0001437996251 ERNA RUSTINA P PEKERJA MANDIRI Acute upper respiratory Berobat Jalan
infection, unspecified
1700 18-03-2018 0137U0040318Y002322 0001437996251 ERNA RUSTINA P PEKERJA MANDIRI Unspecified diabetes Sembuh
mellitus with other

1701 18-03-2018 0137U0040318Y002063 0001441771481 DEDE L PEKERJA MANDIRI Bell's palsy Rujuk Lanjut

1702 18-03-2018 0137U0040318Y002062 0001441771806 YENSI HARTATI P PEKERJA MANDIRI Cerebral infarction, Rujuk Lanjut
unspecified
1703 18-03-2018 0137U0040318Y002108 0001449827638 SARI HASTUNING PUTRI P PEGAWAI SWASTA Dyspepsia Berobat Jalan

1704 18-03-2018 0137U0040318Y002077 0001455379479 ADI ROCHMATUN L PEKERJA MANDIRI Other specified headache Berobat Jalan
syndromes
1705 18-03-2018 0137U0040318Y002078 0001455379547 WAGIYARTI P PEKERJA MANDIRI Myalgia Berobat Jalan

1706 18-03-2018 0137U0040318Y002159 0001461476474 DANANG HARIYANTO L PEKERJA MANDIRI Acute upper respiratory Berobat Jalan
infections of multiple and

1707 18-03-2018 0137U0040318Y002118 0001471856343 AM. SRI LESTARI P PEKERJA MANDIRI Acute upper respiratory Berobat Jalan
infection, unspecified
1708 18-03-2018 0137U0040318Y002067 0001477625444 FITRI YULIA PRIHATINI P PEGAWAI SWASTA Disorder of refraction, Rujuk Lanjut
unspecified
1709 18-03-2018 0137U0040318Y002114 0001608981489 ANDRI L PEGAWAI SWASTA Attention to surgical Berobat Jalan
dressings and sutures
1710 18-03-2018 0137U0040318Y002090 0001616546564 DINDA ORITINA P PEGAWAI SWASTA Acute upper respiratory Berobat Jalan
YUWANINGTYAS infection, unspecified
1711 18-03-2018 0137U0040318Y002122 0001621380519 AGUS SUBAGYO L PENERIMA PENSIUN Other arthrosis Berobat Jalan
SWASTA
1712 18-03-2018 0137U0040318Y002089 0001624486825 WARJIONO L PEGAWAI SWASTA Acute upper respiratory Berobat Jalan
infection, unspecified
1713 18-03-2018 0137U0040318Y002132 0001629388855 TAUFIQ LUTHFI HENDARTO L PEGAWAI SWASTA Dyspepsia Berobat Jalan

1714 18-03-2018 0137U0040318Y002115 0001637621335 MUHAMMAD ALDYNA AZZAM L PEGAWAI SWASTA Typhoid fever Berobat Jalan
ASHARY
1715 18-03-2018 0137U0040318Y002068 0001638769511 ENDANG P PEGAWAI SWASTA Malignant neoplasm of Rujuk Lanjut
breast
1716 18-03-2018 0137U0040318Y002176 0001639982439 TRI SULISTIYAWATI P PEGAWAI SWASTA Dyspepsia Berobat Jalan

1717 18-03-2018 0137U0040318Y002155 0001640514677 INTAN NUR PRATAMA P PEGAWAI SWASTA Other contraceptive Berobat Jalan
management
1718 18-03-2018 0137U0040318Y002105 0001647300633 Eka Sosilowati P PEGAWAI SWASTA Acute upper respiratory Berobat Jalan
infection, unspecified
1719 18-03-2018 0137U0040318Y002107 0001647300655 Diffa Salsabila C. P PEGAWAI SWASTA Acute upper respiratory Berobat Jalan
infection, unspecified
DAFTAR KUNJUNGAN PESERTA SAKIT

Kantor Cabang : BEKASI - 1011

FKTP : Klinik Mitra Medika - 0137U004

1720 18-03-2018 0137U0040318Y002106 0001647300677 Disha Kafka Azzahra P PEGAWAI SWASTA Acute upper respiratory Berobat Jalan
infection, unspecified
1721 18-03-2018 0137U0040318Y002082 0001648009506 Hengki Limanto L PEGAWAI SWASTA Dermatitis herpetiformis Berobat Jalan

1722 18-03-2018 0137U0040318Y002083 0001648009539 Vanness Valentino L PEGAWAI SWASTA Acute upper respiratory Berobat Jalan
infection, unspecified
1723 18-03-2018 0137U0040318Y002183 0001651810375 GEAN FAJRI RAMADHAN L PEGAWAI SWASTA Acute upper respiratory Berobat Jalan
infections of multiple and

1724 18-03-2018 0137U0040318Y002139 0001655607126 MARLINA P PEGAWAI SWASTA Other bullous disorders Berobat Jalan

1725 18-03-2018 0137U0040318Y002174 0001668101793 DENDY MASYHURI L PEGAWAI BUMN Myopia Rujuk Lanjut

1726 18-03-2018 0137U0040318Y002178 0001668101815 DINDA YUSTIKA P PEGAWAI BUMN Myopia Rujuk Lanjut

1727 18-03-2018 0137U0040318Y002180 0001721781112 TRI MEILANI P PEKERJA MANDIRI Dyspepsia Berobat Jalan

1728 18-03-2018 0137U0040318Y002145 0001734260038 KHOIRUNNISA P PEKERJA MANDIRI Acute upper respiratory Berobat Jalan
infections of multiple and

1729 18-03-2018 0137U0040318Y002127 0001742744968 MUHAMMAD BECKSAL RIZA L PEGAWAI SWASTA Acute upper respiratory Berobat Jalan
infections of multiple and

1730 18-03-2018 0137U0040318Y002173 0001744281786 Stevani Vanesa Kusumo Wardani P PEGAWAI SWASTA Acute upper respiratory Berobat Jalan
infections of multiple and

1731 18-03-2018 0137U0040318Y002151 0001744531593 JULIO CAESAR SOPLANTILA L PEGAWAI SWASTA Acute upper respiratory Berobat Jalan
infections of multiple and

1732 18-03-2018 0137U0040318Y002093 0001767001037 RASMANI L PEGAWAI SWASTA Acute upper respiratory Berobat Jalan
infection, unspecified
1733 18-03-2018 0137U0040318Y002143 0001769446552 KONRISTA VIN YECIA P PEGAWAI SWASTA Other malignant Berobat Jalan
neoplasms of skin
1734 18-03-2018 0137U0040318Y002097 0001785742637 ARETA NATHANIA HARTANTO P PEGAWAI SWASTA Acute upper respiratory Berobat Jalan
infection, unspecified
1735 18-03-2018 0137U0040318Y002080 0001790282215 SUGIYANTO WIBOWO L PEKERJA MANDIRI Other and unspecified Berobat Jalan
abdominal pain
1736 18-03-2018 0137U0040318Y002110 0001792317396 ALEX APRIAN RAMADHAN L PEKERJA MANDIRI Acute upper respiratory Berobat Jalan
infection, unspecified
1737 18-03-2018 0137U0040318Y002092 0001799284184 jhon rabbi manuel saragih amd L PEKERJA MANDIRI Urinary tract infection, site Berobat Jalan
not specified
1738 18-03-2018 0137U0040318Y002066 0001800370552 dahlief dahrin L PEKERJA MANDIRI Chronic ischaemic heart Rujuk Lanjut
disease, unspecified
1739 18-03-2018 0137U0040318Y002308 0001803474966 NURSIMAH P PEKERJA MANDIRI Unspecified diabetes Sembuh
mellitus with other
DAFTAR KUNJUNGAN PESERTA SAKIT

Kantor Cabang : BEKASI - 1011

FKTP : Klinik Mitra Medika - 0137U004

1740 18-03-2018 0137U0040318Y002161 0001834866887 ALMIRA FARICA LISHAN P PEGAWAI SWASTA Acute upper respiratory Berobat Jalan
infections of multiple and

1741 18-03-2018 0137U0040318Y002150 0001841793682 ANIK SETYO WATI P PEKERJA MANDIRI Acute upper respiratory Berobat Jalan
infections of multiple and

1742 18-03-2018 0137U0040318Y002129 0001844248386 ANA LIA AGUSTINA P PEGAWAI SWASTA Acute upper respiratory Berobat Jalan
infections of multiple and

1743 18-03-2018 0137U0040318Y002136 0001844498564 rachmawati munawar P PEKERJA MANDIRI Other cataract Rujuk Lanjut

1744 18-03-2018 0137U0040318Y002117 0001846067297 MANAH P PEGAWAI SWASTA Other specified headache Berobat Jalan
syndromes
1745 18-03-2018 0137U0040318Y002065 0001870620129 ahmad fauzi ramadhan L PEGAWAI SWASTA Suppurative otitis media, Rujuk Lanjut
unspecified
1746 18-03-2018 0137U0040318Y002087 0001872731878 darrell alfian budiman L PEGAWAI SWASTA Diarrhoea and Berobat Jalan
gastroenteritis of
presumed infectious origin

1747 18-03-2018 0137U0040318Y002188 0001886403723 EDI TARSINA L PEKERJA MANDIRI Dyspepsia Berobat Jalan

1748 18-03-2018 0137U0040318Y002116 0001890074182 ACHMAD PRIDO L PEKERJA MANDIRI Acute upper respiratory Berobat Jalan
infection, unspecified
1749 18-03-2018 0137U0040318Y002076 0001902637607 noer aini P PEKERJA MANDIRI Acute upper respiratory Berobat Jalan
infection, unspecified
1750 18-03-2018 0137U0040318Y002075 0001902638676 bima lutfi raihan L PEKERJA MANDIRI Acute upper respiratory Berobat Jalan
infection, unspecified
1751 18-03-2018 0137U0040318Y002165 0001958639062 ASEP WAWAN L PEKERJA MANDIRI Stroke, not specified as Rujuk Lanjut
haemorrhage or infarction
1752 18-03-2018 0137U0040318Y002168 0001960585514 satiyem P PENERIMA PENSIUN Gonarthrosis [arthrosis of Berobat Jalan
PNS knee]
1753 18-03-2018 0137U0040318Y002085 0001963185221 sulastri herlina P PEKERJA MANDIRI Gingivitis and periodontal Berobat Jalan
diseases
1754 18-03-2018 0137U0040318Y002128 0001963918271 KUMORO SANTI SAPTA PUTRI P PEGAWAI SWASTA Acute upper respiratory Berobat Jalan
infections of multiple and

1755 18-03-2018 0137U0040318Y002091 0001965059212 ALINE ABELIKA RISAKOTTA P PEGAWAI SWASTA Acute pharyngitis, Berobat Jalan
unspecified
1756 18-03-2018 0137U0040318Y002098 0002042838775 athallah tsaqib hartanto L PEGAWAI SWASTA Acute upper respiratory Berobat Jalan
infection, unspecified
1757 18-03-2018 0137U0040318Y002131 0002044156397 ivonne m mamahani P PEKERJA MANDIRI Dyspepsia Berobat Jalan

1758 18-03-2018 0137U0040318Y002162 0002048144376 aneira friska lavani P PEGAWAI SWASTA Acute upper respiratory Berobat Jalan
infections of multiple and
DAFTAR KUNJUNGAN PESERTA SAKIT

Kantor Cabang : BEKASI - 1011

FKTP : Klinik Mitra Medika - 0137U004

1759 18-03-2018 0137U0040318Y002184 0002053013804 azzam hamiz khalaf L PNS DAERAH Acute upper respiratory Berobat Jalan
infections of multiple and

1760 18-03-2018 0137U0040318Y002177 0002068126997 ROBBY ANGGARA L PEGAWAI BUMN Acute upper respiratory Berobat Jalan
infections of multiple and

1761 18-03-2018 0137U0040318Y002163 0002068127638 YANI P PEGAWAI BUMN Acute upper respiratory Berobat Jalan
infections of multiple and

1762 18-03-2018 0137U0040318Y002081 0002068765209 AYRA SHAFIQA SETIAWAN L PEGAWAI SWASTA Diarrhoea and Berobat Jalan
gastroenteritis of
presumed infectious origin

1763 18-03-2018 0137U0040318Y002192 0002086694256 BAYI NY rany septianti P PEGAWAI SWASTA Acute upper respiratory Berobat Jalan
infections of multiple and

1764 18-03-2018 0137U0040318Y002099 0002093826251 MUHAMMAD HAFIZ AL ISRO L PEGAWAI SWASTA Acute upper respiratory Berobat Jalan
RIYANTO infection, unspecified
1765 18-03-2018 0137U0040318Y002158 0002097689995 ISKANDAR L PEGAWAI SWASTA Other malignant Berobat Jalan
neoplasms of skin
1766 18-03-2018 0137U0040318Y002124 0002138681621 NADRA NOER MUCHLIS L PEGAWAI SWASTA Acute upper respiratory Berobat Jalan
infections of multiple and

1767 18-03-2018 0137U0040318Y002190 0002196510568 BAMBANG ARI WIBOWO L PEGAWAI SWASTA Other arthrosis Berobat Jalan

1768 18-03-2018 0137U0040318Y002186 0002209861449 SOFIA ZAHIRA P PEGAWAI SWASTA Acute upper respiratory Berobat Jalan
infections of multiple and

1769 18-03-2018 0137U0040318Y002070 0002218016856 PURWANINGTIAS WULANDARI P PEKERJA MANDIRI Acute upper respiratory Berobat Jalan
infection, unspecified
1770 18-03-2018 0137U0040318Y002074 0002221982741 CORDELIA HAMIYAH P PEGAWAI SWASTA Acute upper respiratory Berobat Jalan
infection, unspecified
1771 18-03-2018 0137U0040318Y002175 0002242541891 FADHLI LUTFI DWIYOTO L PEKERJA MANDIRI Acute upper respiratory Berobat Jalan
infections of multiple and

1772 18-03-2018 0137U0040318Y002095 0002243904399 MIRZA ADLAN IBRAHIM L PEGAWAI SWASTA Acute upper respiratory Berobat Jalan
infection, unspecified
1773 18-03-2018 0137U0040318Y002100 0002260992104 RAFARDHAN ATHALLA L PEGAWAI SWASTA Typhoid fever Berobat Jalan
MUHAMMAD
1774 18-03-2018 0137U0040318Y002166 0002265986439 RAQILLAH NAUFAL AL-HAZIQ L PEKERJA MANDIRI Acute upper respiratory Berobat Jalan
infections of multiple and

1775 18-03-2018 0137U0040318Y002146 0002288631789 SAIDAH KRISTIANI P PEKERJA MANDIRI Acute upper respiratory Berobat Jalan
infections of multiple and
DAFTAR KUNJUNGAN PESERTA SAKIT

Kantor Cabang : BEKASI - 1011

FKTP : Klinik Mitra Medika - 0137U004

1776 18-03-2018 0137U0040318Y002112 0002291284056 nurazizah P PEKERJA MANDIRI Other specified headache Berobat Jalan
syndromes
1777 18-03-2018 0137U0040318Y002172 0002292572992 ANGELA WANGSA HARDJA P PEKERJA MANDIRI Acute sinusitis, Rujuk Lanjut
unspecified
1778 18-03-2018 0137U0040318Y002160 0002308826597 CIU MOI P PEKERJA MANDIRI Acute upper respiratory Berobat Jalan
infections of multiple and

1779 18-03-2018 0137U0040318Y002157 0002308826867 LIU JASHTIN L PEKERJA MANDIRI Acute upper respiratory Berobat Jalan
infections of multiple and

1780 18-03-2018 0137U0040318Y002137 0002424346942 POPPY MARIA ULFA P PEGAWAI SWASTA Leiomyoma of uterus Rujuk Lanjut

1781 17-03-2018 0137U0040318Y002040 0000040554483 HANIYA FAYZA NABILA P PNS PUSAT Acute upper respiratory Berobat Jalan
infections of multiple and

1782 17-03-2018 0137U0040318Y002039 0000042123688 USMAN EFENDI L PENERIMA PENSIUN Other soft tissue disorders, Berobat Jalan
PNS not elsewhere classified

1783 17-03-2018 0137U0040318Y002050 0000073531394 PUJI LESTARI P PNS DAERAH Acute upper respiratory Berobat Jalan
infections of multiple and

1784 17-03-2018 0137U0040318Y002031 0000073552116 HJ SUPARTI SPD P PNS DAERAH Other arthrosis Berobat Jalan

1785 17-03-2018 0137U0040318Y002009 0000073558629 YAYAH SA'DIYAH P PNS DAERAH Gastro-oesophageal reflux Rujuk Lanjut
disease without

1786 17-03-2018 0137U0040318Y002048 0000073558923 SURIP P PNS DAERAH Acute upper respiratory Berobat Jalan
infections of multiple and

1787 17-03-2018 0137U0040318Y002038 0000073581412 YANA TURYANA L PNS DAERAH Other soft tissue disorders, Berobat Jalan
not elsewhere classified

1788 17-03-2018 0137U0040318Y002015 0000106665996 SINTA AMINARTI KATIRAH P PENERIMA PENSIUN Dyspepsia Berobat Jalan
PNS
1789 17-03-2018 0137U0040318Y002033 0000168080207 HAYFA FORTUNA DZAKIYA P PNS PUSAT Acute upper respiratory Berobat Jalan
infections of multiple and

1790 17-03-2018 0137U0040318Y002017 0000508480029 RENGGANI P PBI (APBN) Single spontaneous Berobat Jalan
delivery, unspecified
1791 17-03-2018 0137U0040318Y003845 0000508480029 RENGGANI P PBI (APBN) Single spontaneous Sembuh
delivery, unspecified
1792 17-03-2018 0137U0040318Y001995 0001079607835 HANNA FARADISA P PNS PUSAT Other and unspecified Berobat Jalan
abdominal pain
1793 17-03-2018 0137U0040318Y002006 0001081401131 SRI KASMIATI P PENERIMA PENSIUN TNI Myalgia Berobat Jalan
DAFTAR KUNJUNGAN PESERTA SAKIT

Kantor Cabang : BEKASI - 1011

FKTP : Klinik Mitra Medika - 0137U004

1794 17-03-2018 0137U0040318Y002049 0001145199115 M.ABD. YADI L PEGAWAI SWASTA Gastritis and duodenitis Berobat Jalan

1795 17-03-2018 0137U0040318Y002007 0001159527071 FITRI INDAH SARI P PEGAWAI SWASTA Acute upper respiratory Berobat Jalan
infection, unspecified
1796 17-03-2018 0137U0040318Y001988 0001193750032 FARIDA UMAR ag P PEGAWAI SWASTA Other and unspecified Berobat Jalan
abdominal pain
1797 17-03-2018 0137U0040318Y002037 0001194170938 SALMAH P PEGAWAI SWASTA Acute upper respiratory Berobat Jalan
infections of multiple and

1798 17-03-2018 0137U0040318Y002051 0001257747647 SITI SUDIARTI P PEKERJA MANDIRI Gastritis and duodenitis Berobat Jalan

1799 17-03-2018 0137U0040318Y002052 0001258532717 MAYLANEY HANA TRICIA P PEGAWAI SWASTA Missed abortion Rujuk Lanjut

1800 17-03-2018 0137U0040318Y002061 0001265974154 ESTER MULIANI P PNS PUSAT Acute upper respiratory Berobat Jalan
infections of multiple and

1801 17-03-2018 0137U0040318Y002016 0001271546897 LUCIA MARGARETA P PEKERJA MANDIRI Vertigo of central origin Berobat Jalan

1802 17-03-2018 0137U0040318Y002026 0001287861906 N KANNAH P PEKERJA MANDIRI Fracture of femur Rujuk Lanjut

1803 17-03-2018 0137U0040318Y002042 0001289012376 FAYOLA GIOVANI P PEKERJA MANDIRI Disorders of refraction and Rujuk Lanjut
accommodation
1804 17-03-2018 0137U0040318Y002043 0001289012861 MARTHA YETTY L PEKERJA MANDIRI Disorders of refraction and Rujuk Lanjut
accommodation
1805 17-03-2018 0137U0040318Y002041 0001289013186 STROMIE GIVEN MUSTAKIM P PEKERJA MANDIRI Disorder of refraction, Rujuk Lanjut
unspecified
1806 17-03-2018 0137U0040318Y002055 0001304995421 encang L PEKERJA MANDIRI Acute upper respiratory Berobat Jalan
infections of multiple and

1807 17-03-2018 0137U0040318Y002058 0001304995915 yuli P PEKERJA MANDIRI Soft tissue disorders Berobat Jalan
related to use, overuse

1808 17-03-2018 0137U0040318Y002045 0001308034967 ASLINA WAHARTI P PEKERJA MANDIRI Acute upper respiratory Berobat Jalan
infections of multiple and

1809 17-03-2018 0137U0040318Y002044 0001308041109 HANIF HAWARI L PEKERJA MANDIRI Acute upper respiratory Berobat Jalan
infections of multiple and

1810 17-03-2018 0137U0040318Y002008 0001314077681 NYI RESA P PEKERJA MANDIRI Acute upper respiratory Berobat Jalan
infection, unspecified
1811 17-03-2018 0137U0040318Y002053 0001320195756 MOH. SARDY L PEKERJA MANDIRI Acute upper respiratory Berobat Jalan
infections of multiple and

1812 17-03-2018 0137U0040318Y002023 0001324808943 JOSHUA CELLO TANOYO L PEKERJA MANDIRI Other atopic dermatitis Rujuk Lanjut

1813 17-03-2018 0137U0040318Y002025 0001324809303 VANESSA CARLA TANOYO P PEKERJA MANDIRI Acute upper respiratory Berobat Jalan
infection, unspecified
DAFTAR KUNJUNGAN PESERTA SAKIT

Kantor Cabang : BEKASI - 1011

FKTP : Klinik Mitra Medika - 0137U004

1814 17-03-2018 0137U0040318Y001983 0001339193441 SUHARTI P PEKERJA MANDIRI Other cataract Rujuk Lanjut

1815 17-03-2018 0137U0040318Y001982 0001376802551 ATHALIA PUTRI TSONYA P PEGAWAI SWASTA Typhoid and paratyphoid Rujuk Lanjut
fevers
1816 17-03-2018 0137U0040318Y002060 0001445951733 HANDRA ALVIN ZAFUTRA L PEGAWAI SWASTA Acute upper respiratory Berobat Jalan
infections of multiple and

1817 17-03-2018 0137U0040318Y002000 0001452132134 SRIANAH.WD P PEKERJA MANDIRI Myalgia Berobat Jalan

1818 17-03-2018 0137U0040318Y002018 0001462153419 ACHMAD MARYONO L PEKERJA MANDIRI Seborrhoeic dermatitis, Rujuk Lanjut
unspecified
1819 17-03-2018 0137U0040318Y002019 0001462153724 TITI SUTIANTI P PEKERJA MANDIRI Other nonorganic sleep Rujuk Lanjut
disorders
1820 17-03-2018 0137U0040318Y002029 0001463149991 DWI ANUGRAH ASTUTI P PEKERJA MANDIRI Respiratory tuberculosis, Rujuk Lanjut
bacteriologically and

1821 17-03-2018 0137U0040318Y001992 0001463558354 RANGGA SHAHPUTRA L PEKERJA MANDIRI Acute upper respiratory Berobat Jalan
infection, unspecified
1822 17-03-2018 0137U0040318Y002030 0001469702812 DESY ARYANI P PEKERJA MANDIRI Antenatal screening Berobat Jalan

1823 17-03-2018 0137U0040318Y002003 0001474164641 MUNA NOPELIA BR SINURAYA P PEKERJA MANDIRI Gastro-oesophageal reflux Berobat Jalan
disease without

1824 17-03-2018 0137U0040318Y002028 0001477270157 SUGANDI, SE L PEGAWAI SWASTA Heart failure, unspecified Rujuk Lanjut

1825 17-03-2018 0137U0040318Y002002 0001483084056 BIMA IBRAHIM.P L PEKERJA MANDIRI Acute upper respiratory Berobat Jalan
infection, unspecified
1826 17-03-2018 0137U0040318Y002012 0001608760708 BEJO SUPRAPTO L PEGAWAI SWASTA Acute upper respiratory Berobat Jalan
infection, unspecified
1827 17-03-2018 0137U0040318Y002027 0001621793439 PURNAMA YANTI P PEGAWAI SWASTA Other antenatal screening Berobat Jalan

1828 17-03-2018 0137U0040318Y001996 0001627833868 RATNA DEWI P PEGAWAI SWASTA Myalgia Berobat Jalan

1829 17-03-2018 0137U0040318Y002011 0001629941242 ANSAR L PEKERJA MANDIRI Disorders of refraction and Berobat Jalan
accommodation
1830 17-03-2018 0137U0040318Y002036 0001638523034 PANDU PRASETO L PEGAWAI SWASTA Acute upper respiratory Berobat Jalan
infections of multiple and

1831 17-03-2018 0137U0040318Y002013 0001642173006 IGNATIUS DANDI SAKTI L PEGAWAI SWASTA Acute pharyngitis, Berobat Jalan
PURNOMO unspecified
1832 17-03-2018 0137U0040318Y002020 0001657338603 GHINA NABILLAH MAHARANI P PEGAWAI SWASTA Myalgia Berobat Jalan

1833 17-03-2018 0137U0040318Y002032 0001657635535 ADINDA VISCA APRILLIA P PEGAWAI SWASTA Acute upper respiratory Berobat Jalan
infections of multiple and

1834 17-03-2018 0137U0040318Y001998 0001658328614 RIKA AKANA P PEGAWAI SWASTA Acute upper respiratory Berobat Jalan
infection, unspecified
DAFTAR KUNJUNGAN PESERTA SAKIT

Kantor Cabang : BEKASI - 1011

FKTP : Klinik Mitra Medika - 0137U004

1835 17-03-2018 0137U0040318Y001987 0001718549346 IMELDA P PEKERJA MANDIRI Other disorders of Rujuk Lanjut
refraction
1836 17-03-2018 0137U0040318Y001986 0001718549357 ALINE FRANSISCA WIJAYA P PEKERJA MANDIRI Other disorders of Rujuk Lanjut
refraction
1837 17-03-2018 0137U0040318Y001985 0001718549368 JESSEN FRANS WIJAYA L PEKERJA MANDIRI Disorder of refraction, Rujuk Lanjut
unspecified
1838 17-03-2018 0137U0040318Y002005 0001725456633 MEIDY YUNIAR P PEKERJA MANDIRI Other specified headache Berobat Jalan
syndromes
1839 17-03-2018 0137U0040318Y001990 0001742296432 MOHAMMAD MUTAMAM L PEGAWAI SWASTA Myalgia Berobat Jalan

1840 17-03-2018 0137U0040318Y002010 0001796872645 RIZA RACHMA KARTADIRJA P PEKERJA MANDIRI Acute upper respiratory Berobat Jalan
infection, unspecified
1841 17-03-2018 0137U0040318Y001981 0001800370181 kun maryati P PEKERJA MANDIRI Chronic obstructive Rujuk Lanjut
pulmonary disease,

1842 17-03-2018 0137U0040318Y001980 0001800370552 dahlief dahrin L PEKERJA MANDIRI Insulin-dependent Rujuk Lanjut
diabetes mellitus with

1843 17-03-2018 0137U0040318Y001993 0001802603349 TITI RETIASIH P PEKERJA MANDIRI Acute upper respiratory Berobat Jalan
infection, unspecified
1844 17-03-2018 0137U0040318Y001994 0001802609493 nur anisa P PEKERJA MANDIRI Other specified headache Berobat Jalan
syndromes
1845 17-03-2018 0137U0040318Y002014 0001843571801 SYA'RONI L PEGAWAI SWASTA Other and unspecified Berobat Jalan
abdominal pain
1846 17-03-2018 0137U0040318Y001991 0001872257512 mulyati z P PEKERJA MANDIRI Myalgia Berobat Jalan

1847 17-03-2018 0137U0040318Y002024 0001886512994 VETTY P PEGAWAI SWASTA Myalgia Berobat Jalan

1848 17-03-2018 0137U0040318Y002046 0001965583901 nurhayati P PEKERJA MANDIRI Acute upper respiratory Berobat Jalan
infections of multiple and

1849 17-03-2018 0137U0040318Y002054 0002040542561 rina dewi P PEKERJA MANDIRI Polyhydramnios Rujuk Lanjut

1850 17-03-2018 0137U0040318Y002035 0002040982356 RINI FITRIANI P PEGAWAI BUMN Acute upper respiratory Berobat Jalan
infections of multiple and

1851 17-03-2018 0137U0040318Y001989 0002069486526 AGUS PURWANTO L PEKERJA MANDIRI Myalgia Berobat Jalan

1852 17-03-2018 0137U0040318Y002057 0002071713249 ZAHRA YASMIN NABILA P PEKERJA MANDIRI Acute upper respiratory Berobat Jalan
infections of multiple and

1853 17-03-2018 0137U0040318Y002056 0002071713677 NADIA 'IZZATIL KUBRA L PEKERJA MANDIRI Acute upper respiratory Berobat Jalan
infections of multiple and
DAFTAR KUNJUNGAN PESERTA SAKIT

Kantor Cabang : BEKASI - 1011

FKTP : Klinik Mitra Medika - 0137U004

1854 17-03-2018 0137U0040318Y002047 0002086747841 GILANG RAMADYA PRAKASA L PEKERJA MANDIRI Acute upper respiratory Berobat Jalan
infections of multiple and

1855 17-03-2018 0137U0040318Y001999 0002098906312 ENDANG SUPARLAN L PEGAWAI SWASTA Acute upper respiratory Berobat Jalan
infection, unspecified
1856 17-03-2018 0137U0040318Y002034 0002104341636 KURNIA FEBRIYANTI P PEGAWAI SWASTA Acute upper respiratory Berobat Jalan
infections of multiple and

1857 17-03-2018 0137U0040318Y002021 0002197279067 bEBY APRILIANO L PEKERJA MANDIRI Acute upper respiratory Berobat Jalan
infection, unspecified
1858 17-03-2018 0137U0040318Y002022 0002217838116 NUR MUHAROMAH P PEGAWAI SWASTA Missed abortion Rujuk Lanjut

1859 17-03-2018 0137U0040318Y001997 0002230809456 PRISCILLA KINARA YULIANTO P PEGAWAI SWASTA Acute upper respiratory Berobat Jalan
infection, unspecified
1860 17-03-2018 0137U0040318Y002059 0002240027976 HASTHRID PUTRI SAVANA L PEGAWAI SWASTA Acute upper respiratory Berobat Jalan
infections of multiple and

1861 17-03-2018 0137U0040318Y001984 0002245350587 EDDY POERNAWAN L PEKERJA MANDIRI Unspecified haemorrhoids Rujuk Lanjut
without complication

1862 17-03-2018 0137U0040318Y002004 0002283693546 HILYA MAULIDA SOPRIH P PNS DAERAH Acute upper respiratory Berobat Jalan
infection, unspecified
1863 17-03-2018 0137U0040318Y002001 0002427135175 ADINDA RAHMA.P P PEKERJA MANDIRI Typhoid fever Berobat Jalan

1864 16-03-2018 0137U0040318Y001896 0000040813874 SUBAGYO, S.Pd. L PNS DAERAH Acute upper respiratory Berobat Jalan
infection, unspecified
1865 16-03-2018 0137U0040318Y001927 0000044916344 ENNY MAWARTY P PENERIMA PENSIUN Dental caries, unspecified Berobat Jalan
PNS
1866 16-03-2018 0137U0040318Y001913 0000072819922 ELY SUTARSIH P PNS DAERAH Other secondary arthrosis Berobat Jalan

1867 16-03-2018 0137U0040318Y001929 0000073016548 RIKUN MARIKEN P PENERIMA PENSIUN TNI Other specified cataract Rujuk Lanjut

1868 16-03-2018 0137U0040318Y001905 0000073269066 ELIZABETH FARA P PEGAWAI BUMN Acute upper respiratory Berobat Jalan
infection, unspecified
1869 16-03-2018 0137U0040318Y001894 0000073272003 TITIN SUPRAPTI P PENERIMA PENSIUN TNI Acute upper respiratory Berobat Jalan
infection, unspecified
1870 16-03-2018 0137U0040318Y001887 0000502936659 SANTIKA P PBI (APBN) Gastro-oesophageal reflux Berobat Jalan
disease without

1871 16-03-2018 0137U0040318Y001897 0000976031111 TEMBER ARI EDIYANTI P PNS DAERAH Other secondary arthrosis Berobat Jalan

1872 16-03-2018 0137U0040318Y001953 0001123269748 FITRIA APRILIYANTI P PEGAWAI SWASTA Acute upper respiratory Berobat Jalan
infection, unspecified
1873 16-03-2018 0137U0040318Y001968 0001146617662 R IRMA DIYANTINI P PEGAWAI SWASTA Other specified headache Berobat Jalan
syndromes
DAFTAR KUNJUNGAN PESERTA SAKIT

Kantor Cabang : BEKASI - 1011

FKTP : Klinik Mitra Medika - 0137U004

1874 16-03-2018 0137U0040318Y001979 0001147196654 TARMUZI L PEGAWAI SWASTA Acute upper respiratory Berobat Jalan
infection, unspecified
1875 16-03-2018 0137U0040318Y001978 0001159527071 FITRI INDAH SARI P PEGAWAI SWASTA Necrosis of pulp Berobat Jalan

1876 16-03-2018 0137U0040318Y001971 0001175678425 CHELLA ALICIA RAMDHANI P PEGAWAI SWASTA Dental caries, unspecified Berobat Jalan

1877 16-03-2018 0137U0040318Y001877 0001228124812 R PRIYATNO SUDIHARDJO L PEKERJA MANDIRI Acute bronchitis, Rujuk Lanjut
unspecified
1878 16-03-2018 0137U0040318Y001920 0001257633652 ETTY ROCHAETI P PEKERJA MANDIRI Dental caries, unspecified Berobat Jalan

1879 16-03-2018 0137U0040318Y001925 0001259238609 FLORENTINE PHOEI P PEKERJA MANDIRI Impacted teeth Berobat Jalan

1880 16-03-2018 0137U0040318Y001923 0001259265835 MARCELINO CHRISTIAN BENA L PEKERJA MANDIRI Necrosis of pulp Berobat Jalan

1881 16-03-2018 0137U0040318Y001973 0001259823633 christine P PEKERJA MANDIRI Necrosis of pulp Berobat Jalan

1882 16-03-2018 0137U0040318Y001949 0001260324516 SUKAMTO L PEKERJA MANDIRI Acute upper respiratory Berobat Jalan
infection, unspecified
1883 16-03-2018 0137U0040318Y001944 0001263495734 ISNAENI SUHARWATI P PEKERJA MANDIRI Acute upper respiratory Berobat Jalan
infection, unspecified
1884 16-03-2018 0137U0040318Y001930 0001267018481 HANApI HANDOYO L PEKERJA MANDIRI Brain stem stroke Rujuk Lanjut
syndrome
1885 16-03-2018 0137U0040318Y001885 0001269669339 RR. NURNAWANINGSIH P PEKERJA MANDIRI Myalgia Berobat Jalan

1886 16-03-2018 0137U0040318Y001916 0001270970098 FARIDA P PEKERJA MANDIRI Other secondary arthrosis Berobat Jalan

1887 16-03-2018 0137U0040318Y001939 0001279423293 tenny lie giok sian P PEKERJA MANDIRI Acute bronchitis, Rujuk Lanjut
unspecified
1888 16-03-2018 0137U0040318Y001963 0001291114888 muhammad januar said L PRAJURIT AD Acute upper respiratory Berobat Jalan
infection, unspecified
1889 16-03-2018 0137U0040318Y001926 0001295516259 YOHANES SUHERMAN L PEKERJA MANDIRI Impacted teeth Berobat Jalan

1890 16-03-2018 0137U0040318Y001902 0001295782863 H.SODIING L PEKERJA MANDIRI Low back pain Rujuk Lanjut

1891 16-03-2018 0137U0040318Y001915 0001303039124 MUHAMMAD YUSUF JOOTJE L PEGAWAI SWASTA Acute upper respiratory Berobat Jalan
FAUZI infection, unspecified
1892 16-03-2018 0137U0040318Y001934 0001308037037 FARID WAJDI L PEKERJA MANDIRI Acute upper respiratory Berobat Jalan
infection, unspecified
1893 16-03-2018 0137U0040318Y001970 0001308909205 SUCI DEASY AFIANI, SE P PEGAWAI SWASTA Necrosis of pulp Berobat Jalan

1894 16-03-2018 0137U0040318Y001975 0001310239563 jelita septyan P PEKERJA MANDIRI Dental caries, unspecified Berobat Jalan

1895 16-03-2018 0137U0040318Y001922 0001312245461 DANNY SUBIANTO L PEKERJA MANDIRI Impacted teeth Berobat Jalan

1896 16-03-2018 0137U0040318Y001947 0001314942693 REHUELLAH ZIPORA P PEGAWAI SWASTA Acute upper respiratory Berobat Jalan
KALUMATA infection, unspecified
1897 16-03-2018 0137U0040318Y001935 0001320109975 KONAH SRI BUDIYANTI P PEKERJA MANDIRI Acute upper respiratory Berobat Jalan
infection, unspecified
DAFTAR KUNJUNGAN PESERTA SAKIT

Kantor Cabang : BEKASI - 1011

FKTP : Klinik Mitra Medika - 0137U004

1898 16-03-2018 0137U0040318Y001889 0001328773702 LINA SUHARLINA P PEKERJA MANDIRI Low back pain Rujuk Lanjut

1899 16-03-2018 0137U0040318Y001890 0001338943588 ANG LEN WIH, ERWIN L PEKERJA MANDIRI Other specified cataract Rujuk Lanjut
SUGANDA
1900 16-03-2018 0137U0040318Y001895 0001341244811 LISWATI P PENERIMA PENSIUN Low back pain Berobat Jalan
SWASTA
1901 16-03-2018 0137U0040318Y001901 0001370945441 SISKA MEILISA P PEGAWAI SWASTA Other specified dermatitis Rujuk Lanjut

1902 16-03-2018 0137U0040318Y001921 0001375909007 LISNA NURYANTI P PEGAWAI SWASTA Impacted teeth Berobat Jalan

1903 16-03-2018 0137U0040318Y001941 0001386043334 edy suhendi L PEKERJA MANDIRI Insulin-dependent Rujuk Lanjut
diabetes mellitus with

1904 16-03-2018 0137U0040318Y001957 0001386044548 fathimah azzahra L PEKERJA MANDIRI Acute upper respiratory Berobat Jalan
infection, unspecified
1905 16-03-2018 0137U0040318Y001874 0001425684576 tati uswati kamaluddin P PEKERJA MANDIRI Heart failure, unspecified Rujuk Lanjut

1906 16-03-2018 0137U0040318Y001932 0001431681895 ROS INTAN TOBING P PEKERJA MANDIRI Diseases of bronchus, not Rujuk Lanjut
elsewhere classified
1907 16-03-2018 0137U0040318Y001891 0001435047142 WINARNO ABDUL RACHim L PEKERJA MANDIRI Acute upper respiratory Berobat Jalan
infection, unspecified
1908 16-03-2018 0137U0040318Y001892 0001435047873 hadriyani abdullah P PEKERJA MANDIRI Acute upper respiratory Berobat Jalan
infection, unspecified
1909 16-03-2018 0137U0040318Y001928 0001441771806 YENSI HARTATI P PEKERJA MANDIRI Other and unspecified Rujuk Lanjut
injuries of shoulder and

1910 16-03-2018 0137U0040318Y001907 0001455655667 WINARTI P PNS PUSAT Acute upper respiratory Berobat Jalan
infection, unspecified
1911 16-03-2018 0137U0040318Y001919 0001458466751 YULI VERAWATI P PEKERJA MANDIRI Impacted teeth Berobat Jalan

1912 16-03-2018 0137U0040318Y001936 0001463619341 HERLINAH TANUDJAJA P PEKERJA MANDIRI Acute upper respiratory Berobat Jalan
infection, unspecified
1913 16-03-2018 0137U0040318Y001956 0001467566289 ZUROTUL UMROH P PEKERJA MANDIRI Acute upper respiratory Berobat Jalan
infection, unspecified
1914 16-03-2018 0137U0040318Y001955 0001467566414 ANITA ATMAJA P PEKERJA MANDIRI Acute upper respiratory Berobat Jalan
infection, unspecified
1915 16-03-2018 0137U0040318Y001977 0001468347682 GOLSAR MANAHAN SIAHAAN L PEKERJA MANDIRI Necrosis of pulp Berobat Jalan

1916 16-03-2018 0137U0040318Y001976 0001468347737 RINDU ROITANA SIAHAAN P PEKERJA MANDIRI Necrosis of pulp Berobat Jalan

1917 16-03-2018 0137U0040318Y001911 0001472723728 NY. AGUSTINA P PBI (APBD) Other secondary arthrosis Berobat Jalan

1918 16-03-2018 0137U0040318Y001940 0001474203587 SOPIAH GINARTI P PEKERJA MANDIRI Insulin-dependent Rujuk Lanjut
diabetes mellitus with

1919 16-03-2018 0137U0040318Y001909 0001480483023 ANI ROHAYANI P PEGAWAI SWASTA Dyspepsia Berobat Jalan
DAFTAR KUNJUNGAN PESERTA SAKIT

Kantor Cabang : BEKASI - 1011

FKTP : Klinik Mitra Medika - 0137U004

1920 16-03-2018 0137U0040318Y001908 0001480484081 NALA LAILATUL FADHILAH P PEGAWAI SWASTA Acute upper respiratory Berobat Jalan
infection, unspecified
1921 16-03-2018 0137U0040318Y001937 0001608981489 ANDRI L PEGAWAI SWASTA Myalgia Berobat Jalan

1922 16-03-2018 0137U0040318Y001972 0001623339393 ARRAZY WIJAYA A.SIREGAR L PEGAWAI SWASTA Dental caries, unspecified Berobat Jalan

1923 16-03-2018 0137U0040318Y001950 0001628922159 WIWIT DARMAYANTI P PEGAWAI SWASTA Acute upper respiratory Berobat Jalan
infection, unspecified
1924 16-03-2018 0137U0040318Y001924 0001632068741 YOHNNY HONATA MODODAHI L PEKERJA MANDIRI Other intervertebral disc Rujuk Lanjut
disorders
1925 16-03-2018 0137U0040318Y001900 0001635145481 MUSTIKA ANHAR P PEGAWAI SWASTA Gastro-oesophageal reflux Berobat Jalan
disease without

1926 16-03-2018 0137U0040318Y001886 0001639696814 WAHYUDI L PEGAWAI SWASTA Other specified headache Berobat Jalan
syndromes
1927 16-03-2018 0137U0040318Y001966 0001641901869 DIAN PURNAMASARI P PEGAWAI SWASTA Other specified headache Berobat Jalan
syndromes
1928 16-03-2018 0137U0040318Y001952 0001642461388 TIARA EKA PUSPITA P PEGAWAI SWASTA Dyspepsia Berobat Jalan

1929 16-03-2018 0137U0040318Y001938 0001647998098 ANNA AZIZAH NUR P PEGAWAI SWASTA Dyspepsia Rujuk Lanjut
QOMARIYAH
1930 16-03-2018 0137U0040318Y001967 0001655607126 MARLINA P PEGAWAI SWASTA Dermatitis herpetiformis Berobat Jalan

1931 16-03-2018 0137U0040318Y001954 0001658992274 GESYA ALMIRA YUNIZA P PEGAWAI BUMD Acute upper respiratory Berobat Jalan
infection, unspecified
1932 16-03-2018 0137U0040318Y001875 0001717211169 THOMAS RIBERU L PEKERJA MANDIRI Hypokalaemia Rujuk Lanjut

1933 16-03-2018 0137U0040318Y001962 0001717924149 MARDINA RAHAYU P PEKERJA MANDIRI Acute upper respiratory Berobat Jalan
infection, unspecified
1934 16-03-2018 0137U0040318Y001946 0001717924162 SEPTIAN ADI UTAMA L PEKERJA MANDIRI Viral infection, unspecified Rujuk Lanjut

1935 16-03-2018 0137U0040318Y001918 0001736571284 NANDA RIZKY AULIA P PEGAWAI SWASTA Abrasion of teeth Berobat Jalan

1936 16-03-2018 0137U0040318Y001898 0001741601744 Apang L PEGAWAI SWASTA Dyspepsia Berobat Jalan

1937 16-03-2018 0137U0040318Y001912 0001742779326 NAJWA NUR HUMAIRA P PEGAWAI SWASTA Other and unspecified Berobat Jalan
infectious diseases
1938 16-03-2018 0137U0040318Y001960 0001802565347 dini lince P PEKERJA MANDIRI Other specified headache Berobat Jalan
syndromes
1939 16-03-2018 0137U0040318Y001951 0001803034585 MUHAMAD ALBI FATUR RIZQI L PEGAWAI SWASTA Gastritis, unspecified Berobat Jalan

1940 16-03-2018 0137U0040318Y001910 0001808688734 LIE HENG BUN SUDARNO L PEKERJA MANDIRI Myalgia Berobat Jalan

1941 16-03-2018 0137U0040318Y001933 0001869975641 H EFENDY DJARKASIH, ST L PEKERJA MANDIRI Insulin-dependent Rujuk Lanjut
diabetes mellitus
1942 16-03-2018 0137U0040318Y001942 0001870547444 RIRI KEMALA TARUNAWATI P PEGAWAI SWASTA Placenta praevia Rujuk Lanjut
DAFTAR KUNJUNGAN PESERTA SAKIT

Kantor Cabang : BEKASI - 1011

FKTP : Klinik Mitra Medika - 0137U004

1943 16-03-2018 0137U0040318Y001961 0001870549165 LATHIFAH AZ ZAHRA NOOR R P PEGAWAI SWASTA Acute upper respiratory Berobat Jalan
infection, unspecified
1944 16-03-2018 0137U0040318Y001943 0001900789716 TABON MAKIR L PEKERJA MANDIRI Insulin-dependent Rujuk Lanjut
diabetes mellitus with

1945 16-03-2018 0137U0040318Y001965 0001962224144 NAURA NADHIFA ANNIDA P PEGAWAI SWASTA Acute upper respiratory Berobat Jalan
infection, unspecified
1946 16-03-2018 0137U0040318Y001931 0001966432162 ELAH P PEKERJA MANDIRI Insulin-dependent Rujuk Lanjut
diabetes mellitus
1947 16-03-2018 0137U0040318Y001969 0002035736651 muhammad salman alfarizi abidin L PEKERJA MANDIRI Typhoid fever Berobat Jalan

1948 16-03-2018 0137U0040318Y001906 0002040168295 arsya nuuruddin L PNS PUSAT Acute upper respiratory Berobat Jalan
infection, unspecified
1949 16-03-2018 0137U0040318Y001917 0002050310755 MUHAMMAD IBRAHIM RIZKI L PEGAWAI SWASTA Other and unspecified Berobat Jalan
FAUZI infectious diseases
1950 16-03-2018 0137U0040318Y001903 0002201239214 SHAFIA CALLYSTA PUTRI P PEGAWAI PEMERINTAH Acute upper respiratory Berobat Jalan
DENGAN PERJANJIAN infection, unspecified

1951 16-03-2018 0137U0040318Y001899 0002217031558 RAFIYUDDIN H L PENERIMA PENSIUN Dermatitis herpetiformis Berobat Jalan
SWASTA
1952 16-03-2018 0137U0040318Y001893 0002228774927 SUTIRAH P PEKERJA MANDIRI Other secondary arthrosis Berobat Jalan

1953 16-03-2018 0137U0040318Y001959 0002238052656 ELRASYID PUTRA WALUYA L PEGAWAI SWASTA Acute upper respiratory Berobat Jalan
infection, unspecified
1954 16-03-2018 0137U0040318Y001876 0002242541485 SUTARNI P PEKERJA MANDIRI Chronic gastritis, Rujuk Lanjut
unspecified
1955 16-03-2018 0137U0040318Y001964 0002265871858 SITI FATIMAH P PEKERJA MANDIRI Disorders of refraction and Berobat Jalan
accommodation
1956 16-03-2018 0137U0040318Y001914 0002286176556 JOKO SUSILO L PEKERJA MANDIRI Foreign body in colon Berobat Jalan

1957 16-03-2018 0137U0040318Y001904 0002286775552 shaquille adhiasta putra L PEGAWAI SWASTA Acute upper respiratory Berobat Jalan
infection, unspecified
1958 16-03-2018 0137U0040318Y001958 0002292526203 YAHDIAN DWI FADHLAN SANDI L PEKERJA MANDIRI Myalgia Berobat Jalan

1959 16-03-2018 0137U0040318Y001974 0002302253739 RAFAEL LOUIS HERNANDEZ L PEKERJA MANDIRI Dental caries, unspecified Berobat Jalan

1960 16-03-2018 0137U0040318Y001945 0002309633324 RIFKI ABDUL MUHI L PEGAWAI SWASTA Acute upper respiratory Berobat Jalan
infection, unspecified
1961 16-03-2018 0137U0040318Y001948 0002318708125 EKI RAMADHAN.S L PEKERJA MANDIRI Acute upper respiratory Berobat Jalan
infection, unspecified
1962 16-03-2018 0137U0040318Y001888 0002426913573 ABRAHAM YUSUF AL MUTTAQI L PNS PUSAT Other and unspecified Berobat Jalan
infectious diseases
1963 15-03-2018 0137U0040318Y001818 0000037507509 RETNO DWIHASTUTI P PNS PUSAT Seropositive rheumatoid Rujuk Lanjut
arthritis
DAFTAR KUNJUNGAN PESERTA SAKIT

Kantor Cabang : BEKASI - 1011

FKTP : Klinik Mitra Medika - 0137U004

1964 15-03-2018 0137U0040318Y001855 0000043637747 ESTI SARI KASMADEWI P PNS PUSAT Other specified headache Berobat Jalan
syndromes
1965 15-03-2018 0137U0040318Y001792 0000072785981 IMAN HILMAN L PNS DAERAH Acute upper respiratory Berobat Jalan
infection, unspecified
1966 15-03-2018 0137U0040318Y001750 0000073016548 RIKUN MARIKEN P PENERIMA PENSIUN TNI Acute sinusitis Rujuk Lanjut

1967 15-03-2018 0137U0040318Y001784 0000073036923 SAHARUDIN L PENERIMA PENSIUN TNI Disorders of refraction and Berobat Jalan
accommodation
1968 15-03-2018 0137U0040318Y001751 0000073272407 SITI OMAS HUTASOIT P PENERIMA PENSIUN Insulin-dependent Rujuk Lanjut
PNS diabetes mellitus
1969 15-03-2018 0137U0040318Y001852 0000073383715 MUHAMMAD FAZRIN L PEGAWAI SWASTA Anaemia, unspecified Berobat Jalan
DERIAWAN
1970 15-03-2018 0137U0040318Y001785 0000073403829 PATMAH P PNS DAERAH Vertigo of central origin Rujuk Lanjut

1971 15-03-2018 0137U0040318Y001829 0000073531271 LISMAN SETIAWAN L PNS PUSAT Vertigo of central origin Berobat Jalan
TANJUNG,ST.
1972 15-03-2018 0137U0040318Y001824 0000073539011 SAPTARIANI P PNS DAERAH Diarrhoea and Berobat Jalan
gastroenteritis of
presumed infectious origin

1973 15-03-2018 0137U0040318Y001859 0000073558923 SURIP P PNS DAERAH Acute upper respiratory Berobat Jalan
infection, unspecified
1974 15-03-2018 0137U0040318Y001772 0000193992794 ISA YUSTIANTO L PNS DAERAH Acute upper respiratory Berobat Jalan
infection, unspecified
1975 15-03-2018 0137U0040318Y001801 0000200540103 PAYAMAN PANGARIBUAN L PENERIMA PENSIUN TNI Other specified headache Berobat Jalan
syndromes
1976 15-03-2018 0137U0040318Y001849 0001133277478 RACHMAT SURANTO L PEGAWAI SWASTA Other and unspecified Berobat Jalan
infectious diseases
1977 15-03-2018 0137U0040318Y001815 0001154809405 YULI YANTI LESTARI P PEGAWAI SWASTA Other antenatal screening Berobat Jalan

1978 15-03-2018 0137U0040318Y001764 0001159370638 GITA GEMPITA P PEKERJA MANDIRI Other specified headache Berobat Jalan
syndromes
1979 15-03-2018 0137U0040318Y001843 0001159371483 NUNUNG NURHAYATI P PEGAWAI SWASTA Vertigo of central origin Berobat Jalan

1980 15-03-2018 0137U0040318Y001809 0001188182845 FARIS RIZQI RABBANI L PEGAWAI SWASTA Impacted teeth Berobat Jalan

1981 15-03-2018 0137U0040318Y001762 0001193750032 FARIDA UMAR ag P PEGAWAI SWASTA Cutaneous abscess, Berobat Jalan
furuncle and carbuncle
1982 15-03-2018 0137U0040318Y001868 0001193750043 FARRA ILMIRA P PEGAWAI SWASTA Necrosis of pulp Berobat Jalan

1983 15-03-2018 0137U0040318Y002460 0001205205063 ALO MARIAM MAILASARI P PEGAWAI SWASTA Other antenatal screening Berobat Jalan

1984 15-03-2018 0137U0040318Y001780 0001238272784 BAINAH P PEGAWAI SWASTA Dyspepsia Berobat Jalan

1985 15-03-2018 0137U0040318Y001753 0001243809707 RODIATI P PEGAWAI SWASTA Acute appendicitis with Rujuk Lanjut
generalized peritonitis
DAFTAR KUNJUNGAN PESERTA SAKIT

Kantor Cabang : BEKASI - 1011

FKTP : Klinik Mitra Medika - 0137U004

1986 15-03-2018 0137U0040318Y001782 0001257554744 YUYUM RUMINI P PEKERJA MANDIRI Myalgia Berobat Jalan

1987 15-03-2018 0137U0040318Y001807 0001257714224 AYLANI ISTANTI P PEKERJA MANDIRI Necrosis of pulp Berobat Jalan

1988 15-03-2018 0137U0040318Y001851 0001259559371 ASNANI P PEKERJA MANDIRI Foreign body in colon Berobat Jalan

1989 15-03-2018 0137U0040318Y001833 0001260781345 YOGO UTOMO L PEKERJA MANDIRI Traumatic shock Berobat Jalan

1990 15-03-2018 0137U0040318Y001769 0001264020412 SUWARTO L PEKERJA MANDIRI Myalgia Berobat Jalan

1991 15-03-2018 0137U0040318Y001832 0001269796241 SUPARTINAH P PEKERJA MANDIRI Acute upper respiratory Berobat Jalan
infection, unspecified
1992 15-03-2018 0137U0040318Y001804 0001275766457 ORIETTA P ANGGOTA POLRI Dyspepsia Berobat Jalan

1993 15-03-2018 0137U0040318Y001812 0001277936201 AGUS SUHERLIM L PEKERJA MANDIRI Necrosis of pulp Berobat Jalan

1994 15-03-2018 0137U0040318Y001803 0001277937459 ANNA ROCHANA KUSNANDAR P PEKERJA MANDIRI Low back pain Berobat Jalan

1995 15-03-2018 0137U0040318Y001793 0001279799469 ISTIQOMAH P PEKERJA MANDIRI Acute upper respiratory Berobat Jalan
infection, unspecified
1996 15-03-2018 0137U0040318Y001842 0001291825664 SEMAN S L PEKERJA MANDIRI Acute upper respiratory Berobat Jalan
infection, unspecified
1997 15-03-2018 0137U0040318Y001872 0001305157059 HENNY ROSITA P PEKERJA MANDIRI Impacted teeth Berobat Jalan

1998 15-03-2018 0137U0040318Y001854 0001307966477 DEVI APRILIYANI P PEGAWAI SWASTA Dental caries, unspecified Berobat Jalan

1999 15-03-2018 0137U0040318Y001775 0001321835859 YETI SETYAWATI P PEKERJA MANDIRI Congestive heart failure Rujuk Lanjut

2000 15-03-2018 0137U0040318Y001873 0001326811836 SUCI ATININGSIH P PEKERJA MANDIRI Dental caries, unspecified Berobat Jalan

2001 15-03-2018 0137U0040318Y001845 0001337106993 SULIYAH P PEKERJA MANDIRI Traumatic shock Berobat Jalan

2002 15-03-2018 0137U0040318Y001789 0001337128222 MIMIN HERMINA P PEKERJA MANDIRI Cerebral infarction, Rujuk Lanjut
unspecified
2003 15-03-2018 0137U0040318Y001765 0001339984416 SABDIAT L PEKERJA MANDIRI Fracture of lower end of Rujuk Lanjut
tibia
2004 15-03-2018 0137U0040318Y001795 0001372135915 HERMAWAN L PEGAWAI SWASTA Mixed asthma Berobat Jalan

2005 15-03-2018 0137U0040318Y001754 0001375909007 LISNA NURYANTI P PEGAWAI SWASTA Acute maxillary sinusitis Rujuk Lanjut

2006 15-03-2018 0137U0040318Y001774 0001375909942 MUHAMMAD AFRAND L PEGAWAI SWASTA Acute upper respiratory Berobat Jalan
MUSLIMOVIC infection, unspecified
2007 15-03-2018 0137U0040318Y001881 0001376466772 ELSA PRASTIKA P PEGAWAI BUMN Necrosis of pulp Berobat Jalan

2008 15-03-2018 0137U0040318Y001837 0001377199653 WAHIDIN L PEGAWAI SWASTA Acute upper respiratory Berobat Jalan
infection, unspecified
2009 15-03-2018 0137U0040318Y001839 0001377199719 Ingga Wahmi Widjaya L PEGAWAI SWASTA Acute upper respiratory Berobat Jalan
infection, unspecified
DAFTAR KUNJUNGAN PESERTA SAKIT

Kantor Cabang : BEKASI - 1011

FKTP : Klinik Mitra Medika - 0137U004

2010 15-03-2018 0137U0040318Y001767 0001378225945 Bambang Siswanto L PEGAWAI SWASTA Acute upper respiratory Berobat Jalan
infection, unspecified
2011 15-03-2018 0137U0040318Y001788 0001380283187 TAN ANGGUR P PEKERJA MANDIRI Dyspepsia Berobat Jalan

2012 15-03-2018 0137U0040318Y001848 0001384701546 budi setyanto L PEKERJA MANDIRI Dyspepsia Berobat Jalan

2013 15-03-2018 0137U0040318Y001858 0001386338769 SITI HINDUN P PEKERJA MANDIRI Acute upper respiratory Berobat Jalan
infection, unspecified
2014 15-03-2018 0137U0040318Y001752 0001387894871 LINAH KARNA P PEKERJA MANDIRI Heart failure Rujuk Lanjut

2015 15-03-2018 0137U0040318Y001838 0001388235069 angeline lucianita maria P PEKERJA MANDIRI Maternal care for fetal Rujuk Lanjut
problem, unspecified
2016 15-03-2018 0137U0040318Y001853 0001405010259 MUNALINA P PEGAWAI SWASTA Vertigo of central origin Berobat Jalan

2017 15-03-2018 0137U0040318Y001758 0001432808572 suhandi L PEKERJA MANDIRI Chronic obstructive Rujuk Lanjut
pulmonary disease,

2018 15-03-2018 0137U0040318Y001823 0001439934107 AZIZ DESTA AMSORI L PEKERJA MANDIRI Dermatitis herpetiformis Berobat Jalan

2019 15-03-2018 0137U0040318Y001814 0001456304141 NY MT SETYANINGSIH P PEKERJA MANDIRI Dermatitis herpetiformis Berobat Jalan

2020 15-03-2018 0137U0040318Y001831 0001456626982 TIARA PUTRI OKTAVIANI P PEKERJA MANDIRI Acute upper respiratory Berobat Jalan
infection, unspecified
2021 15-03-2018 0137U0040318Y001771 0001457050735 MASRIYAH P PEKERJA MANDIRI Other secondary arthrosis Berobat Jalan

2022 15-03-2018 0137U0040318Y001776 0001457084428 RIA LESTARI P PEGAWAI SWASTA Dermatitis herpetiformis Berobat Jalan

2023 15-03-2018 0137U0040318Y001828 0001460770255 HENDRY JULIANSYAH L PEKERJA MANDIRI Acute upper respiratory Berobat Jalan
infection, unspecified
2024 15-03-2018 0137U0040318Y001773 0001470973678 ALFIANI RACHMAWATI P PEGAWAI SWASTA Acute lymphadenitis, Rujuk Lanjut
unspecified
2025 15-03-2018 0137U0040318Y001835 0001480482494 MAHMUD L PEGAWAI SWASTA Myalgia Berobat Jalan

2026 15-03-2018 0137U0040318Y001880 0001480667883 tje we shiang P PEKERJA MANDIRI Dental caries, unspecified Berobat Jalan

2027 15-03-2018 0137U0040318Y001830 0001515803321 TAUFIK JANUAR L PEGAWAI SWASTA Dyspepsia Berobat Jalan

2028 15-03-2018 0137U0040318Y001817 0001516291086 IDA METTY ARMIATY P PEGAWAI SWASTA Malignant neoplasm of Rujuk Lanjut
breast, unspecified
2029 15-03-2018 0137U0040318Y001867 0001516291097 ADITYA RIZKY MAULUDIN L PEGAWAI SWASTA Necrosis of pulp Berobat Jalan

2030 15-03-2018 0137U0040318Y001825 0001516291119 DINDA KIREINA MAULUDIN P PEGAWAI SWASTA Acute upper respiratory Berobat Jalan
infection, unspecified
2031 15-03-2018 0137U0040318Y001863 0001516380647 RIESTA AJENG KARTINI P PEKERJA MANDIRI Necrosis of pulp Rujuk Lanjut

2032 15-03-2018 0137U0040318Y001768 0001555773085 RICHARDO RINGKOT L PEKERJA MANDIRI Pure Berobat Jalan
SITUMORANG hypercholesterolaemia
DAFTAR KUNJUNGAN PESERTA SAKIT

Kantor Cabang : BEKASI - 1011

FKTP : Klinik Mitra Medika - 0137U004

2033 15-03-2018 0137U0040318Y001797 0001621380519 AGUS SUBAGYO L PENERIMA PENSIUN Acute upper respiratory Berobat Jalan
SWASTA infection, unspecified
2034 15-03-2018 0137U0040318Y001756 0001624813435 SUMARMAN L PEGAWAI SWASTA Non-insulin-dependent Rujuk Lanjut
diabetes mellitus
2035 15-03-2018 0137U0040318Y001870 0001629187716 NEZIRA P PEGAWAI SWASTA Impacted teeth Berobat Jalan

2036 15-03-2018 0137U0040318Y001865 0001629385301 ANIM H. L PEGAWAI SWASTA Acute upper respiratory Berobat Jalan
infection, unspecified
2037 15-03-2018 0137U0040318Y001763 0001629385896 REZKY DWI WAHYUDIANSYAH L PEGAWAI SWASTA Dyspepsia Berobat Jalan

2038 15-03-2018 0137U0040318Y001883 0001634541726 YURESTINI IRBARANI P PEGAWAI SWASTA Impacted teeth Berobat Jalan

2039 15-03-2018 0137U0040318Y001816 0001637557288 NUGRAHAENI PUTRI,SE P PEGAWAI SWASTA Other antenatal screening Berobat Jalan

2040 15-03-2018 0137U0040318Y001786 0001637893012 SYARIFAH P PEGAWAI SWASTA Typhoid fever Berobat Jalan

2041 15-03-2018 0137U0040318Y001791 0001644259667 RAINDINI CITRA HANDAYANI P PEGAWAI SWASTA Fracture of lower end of Rujuk Lanjut
tibia
2042 15-03-2018 0137U0040318Y001822 0001644682318 ADE RIZKI ARDI L PEGAWAI SWASTA Acute upper respiratory Berobat Jalan
infection, unspecified
2043 15-03-2018 0137U0040318Y001850 0001647998098 ANNA AZIZAH NUR P PEGAWAI SWASTA Myalgia Berobat Jalan
QOMARIYAH
2044 15-03-2018 0137U0040318Y001844 0001649969752 SOEPRIYADI RUSDIANTO P PEGAWAI SWASTA Other specified headache Berobat Jalan
syndromes
2045 15-03-2018 0137U0040318Y001882 0001650270598 MAHPUDIN L PEGAWAI SWASTA Necrosis of pulp Berobat Jalan

2046 15-03-2018 0137U0040318Y001794 0001652893378 Agus Linarti P PEGAWAI SWASTA Hyperlipidaemia, Berobat Jalan
unspecified
2047 15-03-2018 0137U0040318Y001862 0001655450954 HASAN BASRI L PEGAWAI SWASTA Myalgia Berobat Jalan

2048 15-03-2018 0137U0040318Y001878 0001655686754 KALISTA RIDWAN AZZAHRO P PEGAWAI SWASTA Chronic gingivitis Berobat Jalan

2049 15-03-2018 0137U0040318Y001847 0001657609582 KURNIA MAYAHEXA L PEGAWAI SWASTA Acute upper respiratory Berobat Jalan
infection, unspecified
2050 15-03-2018 0137U0040318Y001846 0001668101804 WARNIAH P PEGAWAI BUMN Foreign body in colon Berobat Jalan

2051 15-03-2018 0137U0040318Y001805 0001720500401 SINTONG SIAHAAN L PEGAWAI SWASTA Other secondary arthrosis Berobat Jalan

2052 15-03-2018 0137U0040318Y001755 0001720706938 RAHARJO L PEKERJA MANDIRI Chronic obstructive Rujuk Lanjut
pulmonary disease,

2053 15-03-2018 0137U0040318Y001808 0001720846967 MUHAMMAD ZAKHIR L PEKERJA MANDIRI Dental caries, unspecified Berobat Jalan
MUZHOFAR AL MALIKI
2054 15-03-2018 0137U0040318Y001811 0001722807325 NAVESYA MURIZ P PEKERJA MANDIRI Dental caries, unspecified Berobat Jalan

2055 15-03-2018 0137U0040318Y001884 0001723847196 ROSNIATI ARSYAD P PEKERJA MANDIRI Other antenatal screening Berobat Jalan
DAFTAR KUNJUNGAN PESERTA SAKIT

Kantor Cabang : BEKASI - 1011

FKTP : Klinik Mitra Medika - 0137U004

2056 15-03-2018 0137U0040318Y001802 0001723875366 TANIA PUTRI P PEGAWAI SWASTA Other specified headache Berobat Jalan
syndromes
2057 15-03-2018 0137U0040318Y001777 0001725875368 TJUNG YANTO L PEKERJA MANDIRI Myalgia Berobat Jalan

2058 15-03-2018 0137U0040318Y001820 0001729182262 ALA BIN MIIN L PEKERJA MANDIRI Congestive heart failure Rujuk Lanjut

2059 15-03-2018 0137U0040318Y001787 0001729888762 AHMAD FAISAL L PEKERJA MANDIRI Typhoid fever Berobat Jalan

2060 15-03-2018 0137U0040318Y001810 0001730216237 FITRI MEGAWATI P PEKERJA MANDIRI Necrosis of pulp Berobat Jalan

2061 15-03-2018 0137U0040318Y001766 0001786984593 ANDIKA MULYA WIBISONO L PEGAWAI SWASTA Acute upper respiratory Berobat Jalan
infection, unspecified
2062 15-03-2018 0137U0040318Y001871 0001821216521 dika L PEKERJA MANDIRI Abrasion of teeth Berobat Jalan

2063 15-03-2018 0137U0040318Y001840 0001841793682 ANIK SETYO WATI P PEKERJA MANDIRI Acute upper respiratory Berobat Jalan
infection, unspecified
2064 15-03-2018 0137U0040318Y001834 0001849589425 cindy wulan ratri P PEKERJA MANDIRI Vertigo of central origin Berobat Jalan

2065 15-03-2018 0137U0040318Y001879 0001862129237 UMI MUSLIKHATUN P PEGAWAI SWASTA Impacted teeth Berobat Jalan

2066 15-03-2018 0137U0040318Y001781 0001870620129 ahmad fauzi ramadhan L PEGAWAI SWASTA Typhoid fever Berobat Jalan

2067 15-03-2018 0137U0040318Y001841 0001873003667 NUR ASYIAH P PEKERJA MANDIRI Vertigo of central origin Berobat Jalan

2068 15-03-2018 0137U0040318Y001861 0001886570155 DATI P PEKERJA MANDIRI Other secondary arthrosis Berobat Jalan

2069 15-03-2018 0137U0040318Y001826 0001895083841 EDISON SIMORANGKIR L PEKERJA MANDIRI Acute upper respiratory Berobat Jalan
infection, unspecified
2070 15-03-2018 0137U0040318Y001799 0001898261752 AAN ARTININGSIH P PEKERJA MANDIRI Dyspepsia Berobat Jalan

2071 15-03-2018 0137U0040318Y001860 0001901881811 HJ.YUYUN SUMIATI P PEKERJA MANDIRI Acute upper respiratory Berobat Jalan
infection, unspecified
2072 15-03-2018 0137U0040318Y001869 0001906487864 MISRIYAH P PEGAWAI BUMD Necrosis of pulp Berobat Jalan

2073 15-03-2018 0137U0040318Y001827 0001960225176 JAENUDIN L PEGAWAI SWASTA Vertigo of central origin Berobat Jalan

2074 15-03-2018 0137U0040318Y001761 0001963175793 jolando surjadi L PEKERJA MANDIRI Acute upper respiratory Berobat Jalan
infection, unspecified
2075 15-03-2018 0137U0040318Y001813 0001963394076 khansa jauzaa aqiilah P PNS DAERAH Dental caries, unspecified Berobat Jalan

2076 15-03-2018 0137U0040318Y001757 0001967219346 MIKAILA NURUTAMI L PEGAWAI SWASTA Developmental disorder of Rujuk Lanjut
RAMADHANY speech and language,

2077 15-03-2018 0137U0040318Y001749 0002043513145 HERMAN,BSC L PEKERJA MANDIRI Insulin-dependent Rujuk Lanjut
diabetes mellitus with

2078 15-03-2018 0137U0040318Y001770 0002048638184 HENDRIYANA L PEKERJA MANDIRI Dermatitis herpetiformis Berobat Jalan

2079 15-03-2018 0137U0040318Y001806 0002059820324 RIS DIAN L PEGAWAI SWASTA Other secondary arthrosis Berobat Jalan
DAFTAR KUNJUNGAN PESERTA SAKIT

Kantor Cabang : BEKASI - 1011

FKTP : Klinik Mitra Medika - 0137U004

2080 15-03-2018 0137U0040318Y001790 0002061235056 AZIL OGAN,H L PEGAWAI SWASTA Acute upper respiratory Berobat Jalan
infection, unspecified
2081 15-03-2018 0137U0040318Y001819 0002070784697 IQBAL RIZKY RAFARDHAN L PEKERJA MANDIRI Hordeolum and chalazion Rujuk Lanjut

2082 15-03-2018 0137U0040318Y001856 0002086565602 RINI LESTARI P PEKERJA MANDIRI Dyspepsia Berobat Jalan

2083 15-03-2018 0137U0040318Y001836 0002096526576 SITI HODIJAH P PEGAWAI SWASTA Acute upper respiratory Berobat Jalan
infection, unspecified
2084 15-03-2018 0137U0040318Y001864 0002103776278 ISABELLE P PEGAWAI SWASTA Other and unspecified Berobat Jalan
infectious diseases
2085 15-03-2018 0137U0040318Y001779 0002213363733 RABBANI AHZA ALMUSYARY L PEGAWAI SWASTA Typhoid fever Berobat Jalan

2086 15-03-2018 0137U0040318Y001798 0002226057243 MAULANA TRI WIBOWO L PNS DAERAH Myalgia Berobat Jalan

2087 15-03-2018 0137U0040318Y001857 0002231627477 khairan umar ghazali L PEKERJA MANDIRI Nausea and vomiting Berobat Jalan

2088 15-03-2018 0137U0040318Y001783 0002234189338 ARI YUSMAN L PEKERJA MANDIRI Typhoid fever Berobat Jalan

2089 15-03-2018 0137U0040318Y001866 0002237844543 RIKA TERESNA ASIH P PEKERJA MANDIRI Impacted teeth Berobat Jalan

2090 15-03-2018 0137U0040318Y001778 0002244826811 ALEYSIA DISCA P PBI (APBN) Acute upper respiratory Berobat Jalan
infection, unspecified
2091 15-03-2018 0137U0040318Y001800 0002255310707 bayi ny. AAN ARTININGSIH L PEKERJA MANDIRI Acute upper respiratory Berobat Jalan
infection, unspecified
2092 15-03-2018 0137U0040318Y001759 0002302112529 SITI MARPUAH P PEKERJA MANDIRI Gastro-oesophageal reflux Berobat Jalan
disease without

2093 15-03-2018 0137U0040318Y001760 0002302113014 ROSSYANI WIJAYA P PEKERJA MANDIRI Gastro-oesophageal reflux Berobat Jalan
disease without

2094 15-03-2018 0137U0040318Y001796 0002318524929 MARYAM SALSABILA PUTRI P PEKERJA MANDIRI Disorders of refraction and Berobat Jalan
accommodation
2095 14-03-2018 0137U0040318Y001627 0000036909933 DARIUS YOHANES RUMPAK L PENERIMA PENSIUN Insulin-dependent Rujuk Lanjut
PNS diabetes mellitus with

2096 14-03-2018 0137U0040318Y001633 0000038167064 PONIDAH P PENERIMA PENSIUN Other secondary arthrosis Berobat Jalan
PNS
2097 14-03-2018 0137U0040318Y001730 0000072846044 MUH IRFAN ANWARI L PNS DAERAH Dental caries, unspecified Berobat Jalan

2098 14-03-2018 0137U0040318Y001653 0000073272003 TITIN SUPRAPTI P PENERIMA PENSIUN TNI Myalgia Berobat Jalan

2099 14-03-2018 0137U0040318Y001681 0000073401715 IDA ROSIDA P PNS DAERAH Non-insulin-dependent Rujuk Lanjut
diabetes mellitus with

2100 14-03-2018 0137U0040318Y001629 0000073531271 LISMAN SETIAWAN L PNS PUSAT Multiple superficial injuries, Berobat Jalan
TANJUNG,ST. unspecified
DAFTAR KUNJUNGAN PESERTA SAKIT

Kantor Cabang : BEKASI - 1011

FKTP : Klinik Mitra Medika - 0137U004

2101 14-03-2018 0137U0040318Y001658 0000073538649 MAMAN SUPARMAN L PNS DAERAH Other specified headache Berobat Jalan
syndromes
2102 14-03-2018 0137U0040318Y001737 0000164525027 JONI FAHAMSYAH L PNS DAERAH Other specified headache Berobat Jalan
syndromes
2103 14-03-2018 0137U0040318Y001645 0000206864278 DITA DIANING ASTUTI P PNS PUSAT Maternal care for known or Rujuk Lanjut
suspected malpresentation

2104 14-03-2018 0137U0040318Y001715 0001080865361 MALIKA ATHAYA AYUNINDYA P PNS DAERAH Dyspepsia Berobat Jalan

2105 14-03-2018 0137U0040318Y001657 0001125169784 MOHAMAD TAUFIK L PNS PUSAT Foreign body in colon Berobat Jalan

2106 14-03-2018 0137U0040318Y001647 0001132260906 GIYANTO L PEKERJA MANDIRI Suppurative and Rujuk Lanjut
unspecified otitis media
2107 14-03-2018 0137U0040318Y001721 0001140346214 M. FIRMANSYAH L PEGAWAI SWASTA Gingivitis and periodontal Berobat Jalan
diseases
2108 14-03-2018 0137U0040318Y001739 0001163711722 NADIANUR AURELLIA P PEGAWAI SWASTA Acute upper respiratory Berobat Jalan
ALAMSYAH infection, unspecified
2109 14-03-2018 0137U0040318Y001728 0001172354769 JIHAN APRILYUNANDA P PEGAWAI SWASTA Dental caries, unspecified Berobat Jalan

2110 14-03-2018 0137U0040318Y001626 0001190170269 FARIDILA ANING MUHARINI P PEGAWAI SWASTA Atopic dermatitis Berobat Jalan

2111 14-03-2018 0137U0040318Y001623 0001208515241 ERMI SAYEKTI ENDAHWATI P PEGAWAI SWASTA Other specified headache Berobat Jalan
syndromes
2112 14-03-2018 0137U0040318Y001624 0001208908179 ERMIYATI BT ABD MUKTI L PEGAWAI SWASTA Vertigo of central origin Berobat Jalan

2113 14-03-2018 0137U0040318Y001619 0001228124812 R PRIYATNO SUDIHARDJO L PEKERJA MANDIRI Acute upper respiratory Berobat Jalan
infection, unspecified
2114 14-03-2018 0137U0040318Y001632 0001258892706 H. KOSIM L PEKERJA MANDIRI Other secondary arthrosis Berobat Jalan

2115 14-03-2018 0137U0040318Y001744 0001259114804 ROSMARIA CHANDRA P PBI (APBD) Acute upper respiratory Berobat Jalan
infection, unspecified
2116 14-03-2018 0137U0040318Y001745 0001259114995 CALVIN JOSHUA L PBI (APBD) Acute upper respiratory Berobat Jalan
infection, unspecified
2117 14-03-2018 0137U0040318Y001636 0001260383163 FARIDA TAN P PEKERJA MANDIRI Other noninflammatory Berobat Jalan
disorders of vagina
2118 14-03-2018 0137U0040318Y001654 0001260726254 ASWANDI L PEKERJA MANDIRI Lead-induced gout Berobat Jalan

2119 14-03-2018 0137U0040318Y001648 0001266792309 MUHAMMAD RIZQY ANANDA L PEKERJA MANDIRI Dyspepsia Rujuk Lanjut

2120 14-03-2018 0137U0040318Y001706 0001281076446 TAOPIK L PEGAWAI SWASTA Myalgia Berobat Jalan

2121 14-03-2018 0137U0040318Y001720 0001281877749 SUYONO L PEKERJA MANDIRI Acute upper respiratory Berobat Jalan
infection, unspecified
2122 14-03-2018 0137U0040318Y001719 0001282683183 INTAN NOVITA SARI P PEKERJA MANDIRI Acute upper respiratory Berobat Jalan
infection, unspecified
DAFTAR KUNJUNGAN PESERTA SAKIT

Kantor Cabang : BEKASI - 1011

FKTP : Klinik Mitra Medika - 0137U004

2123 14-03-2018 0137U0040318Y001683 0001304270897 KADARACHMANTO L PEGAWAI SWASTA Insulin-dependent Rujuk Lanjut
diabetes mellitus with

2124 14-03-2018 0137U0040318Y001638 0001306536298 UMAY P PEGAWAI SWASTA Dyspepsia Berobat Jalan

2125 14-03-2018 0137U0040318Y001659 0001307963654 NOVI ANDIANI P PEGAWAI SWASTA Other and unspecified Berobat Jalan
infectious diseases
2126 14-03-2018 0137U0040318Y001688 0001310245571 LIM TJIOE HONG P PEKERJA MANDIRI Other benign neoplasm of Rujuk Lanjut
connective and other soft

2127 14-03-2018 0137U0040318Y001637 0001321418788 NATANAEL LISTYO HARTANTO L PEGAWAI SWASTA Myalgia Berobat Jalan

2128 14-03-2018 0137U0040318Y001668 0001326324789 SYIFA RIZKY AMANDA P PEGAWAI SWASTA Necrosis of pulp Berobat Jalan

2129 14-03-2018 0137U0040318Y001733 0001337751448 TJANIWATI P PEKERJA MANDIRI Acute upper respiratory Berobat Jalan
infection, unspecified
2130 14-03-2018 0137U0040318Y001697 0001342059118 SITI HASNISAH P PENERIMA PENSIUN Other specified headache Berobat Jalan
SWASTA syndromes
2131 14-03-2018 0137U0040318Y001696 0001342059129 RENDY SETIAWAN L PENERIMA PENSIUN Acute upper respiratory Berobat Jalan
SWASTA infection, unspecified
2132 14-03-2018 0137U0040318Y001718 0001370864878 NIKEN PRATIWI P PEKERJA MANDIRI Insulin-dependent Berobat Jalan
diabetes mellitus without

2133 14-03-2018 0137U0040318Y001709 0001371325263 KELSON PATTIASINA L PEKERJA MANDIRI Acute upper respiratory Berobat Jalan
infection, unspecified
2134 14-03-2018 0137U0040318Y001666 0001372480975 SUPIATUN P PENERIMA PENSIUN Impacted teeth Berobat Jalan
SWASTA
2135 14-03-2018 0137U0040318Y001736 0001381407186 RIZQI AKBAR ABDURRAHMAN L PEGAWAI SWASTA Acute upper respiratory Berobat Jalan
infection, unspecified
2136 14-03-2018 0137U0040318Y001660 0001384702727 fadhil halim pamungkas L PEKERJA MANDIRI Fever, unspecified Rujuk Lanjut

2137 14-03-2018 0137U0040318Y001695 0001385156171 STEVEN MARCELIUS cHEN L PEKERJA MANDIRI Acute upper respiratory Berobat Jalan
infection, unspecified
2138 14-03-2018 0137U0040318Y001699 0001385985576 SUDAMI GINTING L PEKERJA MANDIRI Other specified headache Berobat Jalan
syndromes
2139 14-03-2018 0137U0040318Y001655 0001386970536 MAI HENDRO L PEGAWAI SWASTA Acute upper respiratory Berobat Jalan
infection, unspecified
2140 14-03-2018 0137U0040318Y001669 0001388010464 AFIFAH KHAIRUNNISA L PEGAWAI SWASTA Necrosis of pulp Berobat Jalan

2141 14-03-2018 0137U0040318Y001667 0001390335063 NADIFA NADA RIZKIA P PEGAWAI SWASTA Abrasion of teeth Berobat Jalan

2142 14-03-2018 0137U0040318Y001694 0001422658833 MUHAMMAD FIKRI ASSIDIK L PEGAWAI SWASTA Acute upper respiratory Berobat Jalan
infection, unspecified
2143 14-03-2018 0137U0040318Y001634 0001424091194 SITI MARYATUN P PEKERJA MANDIRI Foreign body in colon Berobat Jalan

2144 14-03-2018 0137U0040318Y001725 0001427995315 ALI PURMONO L PEGAWAI SWASTA Dental caries, unspecified Berobat Jalan
DAFTAR KUNJUNGAN PESERTA SAKIT

Kantor Cabang : BEKASI - 1011

FKTP : Klinik Mitra Medika - 0137U004

2145 14-03-2018 0137U0040318Y001630 0001428262727 ANI P PEKERJA MANDIRI Foreign body in colon Berobat Jalan

2146 14-03-2018 0137U0040318Y001635 0001429649436 RASTI EKA PUTRI P PEKERJA MANDIRI Foreign body in colon Berobat Jalan

2147 14-03-2018 0137U0040318Y001698 0001431574751 MOCHAMMAD RIYAN L PEKERJA MANDIRI Acute upper respiratory Berobat Jalan
SURYANTO infection, unspecified
2148 14-03-2018 0137U0040318Y001618 0001442802734 TITIEK LESTARI P PEKERJA MANDIRI Mixed hyperlipidaemia Rujuk Lanjut

2149 14-03-2018 0137U0040318Y001740 0001444885187 RIZKI ANISA P PEKERJA MANDIRI Dyspepsia Berobat Jalan

2150 14-03-2018 0137U0040318Y001707 0001455434256 HALIMATUS SA'DIAH P PEKERJA MANDIRI Other benign neoplasm of Berobat Jalan
connective and other soft

2151 14-03-2018 0137U0040318Y001735 0001456381607 JUNAIDI SAPUTRA L PEKERJA MANDIRI Constipation Berobat Jalan

2152 14-03-2018 0137U0040318Y001684 0001456623437 ASEP SAEPULLOH HADIANA L PEKERJA MANDIRI Cataract, unspecified Rujuk Lanjut

2153 14-03-2018 0137U0040318Y001742 0001458098256 HANNI MAHARANI KOTO P PEKERJA MANDIRI Myalgia Berobat Jalan

2154 14-03-2018 0137U0040318Y001686 0001458466751 YULI VERAWATI P PEKERJA MANDIRI Necrosis of pulp Rujuk Lanjut

2155 14-03-2018 0137U0040318Y001671 0001458637424 SITI ZAINAB P PEKERJA MANDIRI Impacted teeth Berobat Jalan

2156 14-03-2018 0137U0040318Y001727 0001459550643 JUJU JURIAH P PEKERJA MANDIRI Dental caries, unspecified Berobat Jalan

2157 14-03-2018 0137U0040318Y001700 0001461078764 NAVIN AKMAL HAKIM L PEKERJA MANDIRI Myalgia Berobat Jalan

2158 14-03-2018 0137U0040318Y001670 0001462283403 NAYYARA SHAKIYA L PEKERJA MANDIRI Caries of dentine Berobat Jalan

2159 14-03-2018 0137U0040318Y001685 0001471064444 SOELISTIJOWATI P PEKERJA MANDIRI Other forms of chronic Rujuk Lanjut
ischaemic heart disease
2160 14-03-2018 0137U0040318Y001680 0001482317829 D SINAGA L PEKERJA MANDIRI Stroke, not specified as Rujuk Lanjut
haemorrhage or infarction
2161 14-03-2018 0137U0040318Y001679 0001482806755 MERRY PANJAITAN P PEKERJA MANDIRI Chronic ischaemic heart Rujuk Lanjut
disease, unspecified
2162 14-03-2018 0137U0040318Y001731 0001516453841 KEEFE KEI ALFIRDAUS L PEGAWAI SWASTA Dental caries, unspecified Berobat Jalan
WIBOWO
2163 14-03-2018 0137U0040318Y001675 0001602455995 Arlia Dhia Puspita Adji P PEGAWAI SWASTA Abrasion of teeth Berobat Jalan

2164 14-03-2018 0137U0040318Y001741 0001608981489 ANDRI L PEGAWAI SWASTA Other injuries of Berobat Jalan
unspecified body region
2165 14-03-2018 0137U0040318Y001748 0001619765717 RUSTAMAN L PEGAWAI SWASTA Acute upper respiratory Berobat Jalan
infection, unspecified
2166 14-03-2018 0137U0040318Y001724 0001623148064 TRI SARASWATI P PEGAWAI SWASTA Necrosis of pulp Berobat Jalan

2167 14-03-2018 0137U0040318Y001693 0001627848483 DONNY RUSLY L PEGAWAI SWASTA Dyspepsia Berobat Jalan

2168 14-03-2018 0137U0040318Y001738 0001630528907 LEYDRA DARIN P PEGAWAI SWASTA Acute upper respiratory Berobat Jalan
infection, unspecified
DAFTAR KUNJUNGAN PESERTA SAKIT

Kantor Cabang : BEKASI - 1011

FKTP : Klinik Mitra Medika - 0137U004

2169 14-03-2018 0137U0040318Y001729 0001634541726 YURESTINI IRBARANI P PEGAWAI SWASTA Necrosis of pulp Berobat Jalan

2170 14-03-2018 0137U0040318Y001711 0001637023454 DAFA AULIA RAMADAN L PEGAWAI SWASTA Acute upper respiratory Berobat Jalan
infection, unspecified
2171 14-03-2018 0137U0040318Y001678 0001637747954 YULISTIANA P PEGAWAI SWASTA Vertigo of central origin Rujuk Lanjut

2172 14-03-2018 0137U0040318Y001661 0001640284075 MUHAMAD IRWAN L PEGAWAI SWASTA Acute upper respiratory Berobat Jalan
infection, unspecified
2173 14-03-2018 0137U0040318Y001712 0001643431127 BILQIS FARHAH ATHAYA P PEGAWAI SWASTA Acute upper respiratory Berobat Jalan
infection, unspecified
2174 14-03-2018 0137U0040318Y001713 0001646272574 SOEGIONO WIJONO L PEGAWAI SWASTA Disorders of refraction and Berobat Jalan
accommodation
2175 14-03-2018 0137U0040318Y001650 0001648247231 SITI MARIYAM P PEGAWAI SWASTA Gastritis, unspecified Berobat Jalan

2176 14-03-2018 0137U0040318Y001714 0001652345649 MASYAGUS M. MUTAWADI L PEGAWAI SWASTA Acute upper respiratory Berobat Jalan
infection, unspecified
2177 14-03-2018 0137U0040318Y001665 0001653463506 MALIHAH SAYYIDAH NABILAH P PEGAWAI SWASTA Caries of dentine Berobat Jalan

2178 14-03-2018 0137U0040318Y001692 0001654267059 MUHAMMAD AKMAL ABISALI P PEGAWAI SWASTA Acute upper respiratory Berobat Jalan
infection, unspecified
2179 14-03-2018 0137U0040318Y001662 0001654702244 FEBBYANA ANGGRAINI P PEGAWAI SWASTA Acute upper respiratory Berobat Jalan
infection, unspecified
2180 14-03-2018 0137U0040318Y001640 0001655450965 NURKHOLILLAH P PEGAWAI SWASTA Necrosis of pulp Berobat Jalan

2181 14-03-2018 0137U0040318Y001621 0001655450976 FARID HASAN AL FAHREZI L PEGAWAI SWASTA Acute upper respiratory Berobat Jalan
infection, unspecified
2182 14-03-2018 0137U0040318Y001682 0001656168377 RETNO SITI ASIYAH P PEGAWAI SWASTA Vascular disorder of Rujuk Lanjut
intestine, unspecified
2183 14-03-2018 0137U0040318Y001652 0001716071613 BINTANG RAFLI ADRIAN L PEKERJA MANDIRI Other and unspecified Berobat Jalan
infectious diseases
2184 14-03-2018 0137U0040318Y001672 0001716071624 RARA SYIFA ZAHIERA P PEKERJA MANDIRI Caries of dentine Berobat Jalan

2185 14-03-2018 0137U0040318Y001689 0001717382608 NOFA ERI YANI P PEKERJA MANDIRI Epilepsy, unspecified Rujuk Lanjut

2186 14-03-2018 0137U0040318Y001631 0001718017806 WEI DEVI P PEKERJA MANDIRI Other diseases of stomach Berobat Jalan
and duodenum
2187 14-03-2018 0137U0040318Y001717 0001718829797 NENI SISWANTI P PEGAWAI SWASTA Acute upper respiratory Berobat Jalan
infection, unspecified
2188 14-03-2018 0137U0040318Y001732 0001720706951 DESI KUMALASARI P PEKERJA MANDIRI Dental caries, unspecified Berobat Jalan

2189 14-03-2018 0137U0040318Y001625 0001721910295 RICHARD LODWIK L PEKERJA MANDIRI Acute upper respiratory Berobat Jalan
infection, unspecified
2190 14-03-2018 0137U0040318Y001639 0001721910306 TRISNANINGSIH P PEKERJA MANDIRI Other multiple, unspecified Berobat Jalan
as to place of birth
DAFTAR KUNJUNGAN PESERTA SAKIT

Kantor Cabang : BEKASI - 1011

FKTP : Klinik Mitra Medika - 0137U004

2191 14-03-2018 0137U0040318Y001703 0001722574258 FARREL ATTAYA RADITYA L PEKERJA MANDIRI Acute upper respiratory Berobat Jalan
infection, unspecified
2192 14-03-2018 0137U0040318Y001674 0001728278638 ARDIYANSYAH,SH L PEKERJA MANDIRI Impacted teeth Berobat Jalan

2193 14-03-2018 0137U0040318Y001642 0001730216226 HARYONO L PEKERJA MANDIRI Impacted teeth Berobat Jalan

2194 14-03-2018 0137U0040318Y001641 0001730216237 FITRI MEGAWATI P PEKERJA MANDIRI Dental caries, unspecified Berobat Jalan

2195 14-03-2018 0137U0040318Y001664 0001731337593 DEWI SITI MARIAM P PEKERJA MANDIRI Other antenatal screening Berobat Jalan

2196 14-03-2018 0137U0040318Y001726 0001737606745 ANI EKA WINDYASTUTI P PEGAWAI SWASTA Necrosis of pulp Berobat Jalan

2197 14-03-2018 0137U0040318Y001701 0001738668824 GANANG KRISPIANDITO L PEGAWAI SWASTA Chronic gingivitis Berobat Jalan

2198 14-03-2018 0137U0040318Y001708 0001739253598 SEIJI ANTON SAPUTRA L PEGAWAI SWASTA Gastro-oesophageal reflux Berobat Jalan
disease without

2199 14-03-2018 0137U0040318Y001705 0001741601788 Nur Azizah P PEGAWAI SWASTA Acute upper respiratory Berobat Jalan
infection, unspecified
2200 14-03-2018 0137U0040318Y001673 0001742419405 AMIRA MARSYAFA L PEGAWAI SWASTA Necrosis of pulp Berobat Jalan

2201 14-03-2018 0137U0040318Y001643 0001745181066 LAURENSIA CHERYL P PEGAWAI SWASTA Other disorders of white Rujuk Lanjut
CHRISTABEL blood cells
2202 14-03-2018 0137U0040318Y001651 0001768316387 MUHAMAD AKBAR FAUZI L PEGAWAI BUMD Acute upper respiratory Berobat Jalan
infection, unspecified
2203 14-03-2018 0137U0040318Y001722 0001785742637 ARETA NATHANIA HARTANTO P PEGAWAI SWASTA Dental caries, unspecified Berobat Jalan

2204 14-03-2018 0137U0040318Y001710 0001798989456 OTI MAULIDA P PEGAWAI SWASTA Acute upper respiratory Berobat Jalan
infection, unspecified
2205 14-03-2018 0137U0040318Y001704 0001801893093 AGAM ABDILAH PRATAMA L PEGAWAI SWASTA Acute upper respiratory Berobat Jalan
infection, unspecified
2206 14-03-2018 0137U0040318Y001690 0001810924828 WIDYATI P PEKERJA MANDIRI Acute upper respiratory Berobat Jalan
infection, unspecified
2207 14-03-2018 0137U0040318Y001746 0001810924852 CHRISTIAN YUNIARTO L PEKERJA MANDIRI Myalgia Berobat Jalan

2208 14-03-2018 0137U0040318Y001622 0001844498564 rachmawati munawar P PEKERJA MANDIRI Myopia Berobat Jalan

2209 14-03-2018 0137U0040318Y001702 0001862585019 abian rahman ash-sidiq L PEGAWAI SWASTA Gingivitis and periodontal Berobat Jalan
diseases
2210 14-03-2018 0137U0040318Y001734 0001867575554 SITI HINDUN P PEKERJA MANDIRI Dyspepsia Berobat Jalan

2211 14-03-2018 0137U0040318Y001687 0001884128218 HABIBAH P PEKERJA MANDIRI Insulin-dependent Rujuk Lanjut
diabetes mellitus with

2212 14-03-2018 0137U0040318Y001644 0001963733771 PRITA KEMALASARI P PEKERJA MANDIRI Fracture at wrist and hand Rujuk Lanjut
level
2213 14-03-2018 0137U0040318Y001628 0001964508131 FITRIA S P PEKERJA MANDIRI Acute upper respiratory Berobat Jalan
infection, unspecified
DAFTAR KUNJUNGAN PESERTA SAKIT

Kantor Cabang : BEKASI - 1011

FKTP : Klinik Mitra Medika - 0137U004

2214 14-03-2018 0137U0040318Y001646 0001968171287 dwi retno pujiastuti P PEKERJA MANDIRI Malignant neoplasm of Rujuk Lanjut
breast, unspecified
2215 14-03-2018 0137U0040318Y001620 0002043513145 HERMAN,BSC L PEKERJA MANDIRI Other secondary arthrosis Berobat Jalan

2216 14-03-2018 0137U0040318Y001677 0002046806212 mahdalena P PEGAWAI SWASTA Care and examination Rujuk Lanjut
immediately after delivery
2217 14-03-2018 0137U0040318Y001743 0002048144376 aneira friska lavani P PEGAWAI SWASTA Acute upper respiratory Berobat Jalan
infection, unspecified
2218 14-03-2018 0137U0040318Y001716 0002071698388 FUAD ARBI SALEH L PEGAWAI SWASTA Acute upper respiratory Berobat Jalan
infection, unspecified
2219 14-03-2018 0137U0040318Y001821 0002073877402 SITI MAHMUDAH P PEGAWAI SWASTA Necrosis of pulp Berobat Jalan

2220 14-03-2018 0137U0040318Y001723 0002103998635 SUSAN MARGARETA CHANDRA P PEGAWAI SWASTA Necrosis of pulp Berobat Jalan

2221 14-03-2018 0137U0040318Y001691 0002198710359 MUHAMMAD ARSYA PRASETIO L PEGAWAI SWASTA Acute upper respiratory Berobat Jalan
infection, unspecified
2222 14-03-2018 0137U0040318Y001663 0002253380613 ade puryani hazmi P PEKERJA MANDIRI Other specified headache Berobat Jalan
syndromes
2223 14-03-2018 0137U0040318Y001649 0002255929029 SUTIO L PEKERJA MANDIRI Acute upper respiratory Berobat Jalan
infection, unspecified
2224 14-03-2018 0137U0040318Y001676 0002312787565 jubaidah P PEKERJA MANDIRI Impacted teeth Berobat Jalan

2225 14-03-2018 0137U0040318Y001656 0002312788432 novia rosmawaty P PEKERJA MANDIRI Myalgia Berobat Jalan

2226 14-03-2018 0137U0040318Y001747 0002312788972 riyan exsa mahendra L PEKERJA MANDIRI Acute upper respiratory Berobat Jalan
infection, unspecified
2227 13-03-2018 0137U0040318Y001570 0000009054909 WALBEN DAMANIK L PNS PUSAT Chronic ischaemic heart Rujuk Lanjut
disease, unspecified
2228 13-03-2018 0137U0040318Y001474 0000036203477 MARLINA ADISTY P PNS PUSAT Dental caries, unspecified Berobat Jalan

2229 13-03-2018 0137U0040318Y001484 0000040813874 SUBAGYO, S.Pd. L PNS DAERAH Other arthrosis Berobat Jalan

2230 13-03-2018 0137U0040318Y001591 0000043637747 ESTI SARI KASMADEWI P PNS PUSAT Myalgia Berobat Jalan

2231 13-03-2018 0137U0040318Y001573 0000073400231 SUHARNA L PNS DAERAH Other specified headache Berobat Jalan
syndromes
2232 13-03-2018 0137U0040318Y001490 0000073403829 PATMAH P PNS DAERAH Acute upper respiratory Berobat Jalan
infections of multiple and

2233 13-03-2018 0137U0040318Y001521 0000073538605 LALA NURMALA SUBAYA, S.PD P PNS DAERAH Acute upper respiratory Berobat Jalan
infections of multiple and

2234 13-03-2018 0137U0040318Y001560 0000073581412 YANA TURYANA L PNS DAERAH Acute upper respiratory Berobat Jalan
infection, unspecified
2235 13-03-2018 0137U0040318Y001557 0000120406274 NOVIANI P PNS PUSAT Acute upper respiratory Berobat Jalan
infection, unspecified
DAFTAR KUNJUNGAN PESERTA SAKIT

Kantor Cabang : BEKASI - 1011

FKTP : Klinik Mitra Medika - 0137U004

2236 13-03-2018 0137U0040318Y001569 0000121389614 MUNADI, SE L PNS DAERAH Chronic sinusitis, Rujuk Lanjut
unspecified
2237 13-03-2018 0137U0040318Y001593 0000194072736 SAANIH P PENERIMA PENSIUN Acute upper respiratory Berobat Jalan
PNS infection, unspecified
2238 13-03-2018 0137U0040318Y001612 0000202925654 HAYAA NURQYREENNISYA P PNS DAERAH Necrosis of pulp Berobat Jalan
JUNIAR
2239 13-03-2018 0137U0040318Y001522 0000204477794 BAMBANG ADHI HARTONO L PNS PUSAT Acute upper respiratory Berobat Jalan
infections of multiple and

2240 13-03-2018 0137U0040318Y001489 0000205185756 MUHAMMAD FATHI RAHMAN L PNS PUSAT Embedded and impacted Berobat Jalan
ADMAR teeth
2241 13-03-2018 0137U0040318Y001472 0000210084502 HUMAIRA PUTRI MAKESHA P PNS PUSAT Embedded and impacted Berobat Jalan
AMMAR teeth
2242 13-03-2018 0137U0040318Y001483 0000976031111 TEMBER ARI EDIYANTI P PNS DAERAH Disorders of vestibular Berobat Jalan
function
2243 13-03-2018 0137U0040318Y001505 0001093288342 JUANDA NATA ATMAJA, R L ANGGOTA POLRI Other soft tissue disorders, Berobat Jalan
not elsewhere classified

2244 13-03-2018 0137U0040318Y001601 0001124038956 FANNY HARLIADI P PEKERJA MANDIRI Other antenatal screening Berobat Jalan

2245 13-03-2018 0137U0040318Y001603 0001148349148 TRIO ATMAJA L PEGAWAI SWASTA Dental caries, unspecified Berobat Jalan

2246 13-03-2018 0137U0040318Y001530 0001148475971 MARYAMAN L PEGAWAI SWASTA Acute upper respiratory Berobat Jalan
infections of multiple and

2247 13-03-2018 0137U0040318Y001589 0001159453811 SRI PURWANINGSIH P PEGAWAI SWASTA Acute upper respiratory Berobat Jalan
infection, unspecified
2248 13-03-2018 0137U0040318Y001535 0001256223802 ARIFIN L PEKERJA MANDIRI Thyrotoxicosis, Rujuk Lanjut
unspecified
2249 13-03-2018 0137U0040318Y001477 0001256756747 SUPARDI RASYID L PEKERJA MANDIRI Cerebral infarction Rujuk Lanjut

2250 13-03-2018 0137U0040318Y001478 0001256756758 HASNAFIAH P PEKERJA MANDIRI Other arthritis Rujuk Lanjut

2251 13-03-2018 0137U0040318Y001606 0001258774672 ARJUNA TRAVIAN SAKHI L PEGAWAI PEMERINTAH Abrasion of teeth Berobat Jalan
DENGAN PERJANJIAN

2252 13-03-2018 0137U0040318Y001599 0001260781345 YOGO UTOMO L PEKERJA MANDIRI Acute upper respiratory Berobat Jalan
infection, unspecified
2253 13-03-2018 0137U0040318Y001501 0001262927676 FIRMANSYAH SOEBANA L PEKERJA MANDIRI Other arthrosis Berobat Jalan
ATMAJA
2254 13-03-2018 0137U0040318Y001520 0001266792309 MUHAMMAD RIZQY ANANDA L PEKERJA MANDIRI Acute upper respiratory Berobat Jalan
infections of multiple and

2255 13-03-2018 0137U0040318Y001615 0001269879669 NANANG MARTINI P PEKERJA MANDIRI Impacted teeth Berobat Jalan
DAFTAR KUNJUNGAN PESERTA SAKIT

Kantor Cabang : BEKASI - 1011

FKTP : Klinik Mitra Medika - 0137U004

2256 13-03-2018 0137U0040318Y001547 0001279117179 fandy pratama L PEKERJA MANDIRI HIV disease resulting in Rujuk Lanjut
unspecified infectious or

2257 13-03-2018 0137U0040318Y001554 0001281874893 UMAR ROHIM L PEKERJA MANDIRI Gastro-oesophageal reflux Berobat Jalan
disease without

2258 13-03-2018 0137U0040318Y001585 0001282682924 SUPARJO L PEKERJA MANDIRI Acute upper respiratory Berobat Jalan
infection, unspecified
2259 13-03-2018 0137U0040318Y001555 0001306599153 WINDA PUSPITA DEWI P PEGAWAI SWASTA Acute upper respiratory Berobat Jalan
infection, unspecified
2260 13-03-2018 0137U0040318Y001502 0001307960774 TJU ATANG ETI P PEKERJA MANDIRI Acute upper respiratory Berobat Jalan
infections of multiple and

2261 13-03-2018 0137U0040318Y001583 0001308034967 ASLINA WAHARTI P PEKERJA MANDIRI Acute upper respiratory Berobat Jalan
infection, unspecified
2262 13-03-2018 0137U0040318Y001544 0001310245571 LIM TJIOE HONG P PEKERJA MANDIRI Other specified headache Berobat Jalan
syndromes
2263 13-03-2018 0137U0040318Y001492 0001317338458 HERRY FERDIAN L PEKERJA MANDIRI Acute upper respiratory Berobat Jalan
infections of multiple and

2264 13-03-2018 0137U0040318Y001491 0001326204336 RIPAN SEPTIAN L PEKERJA MANDIRI Acute upper respiratory Berobat Jalan
infections of multiple and

2265 13-03-2018 0137U0040318Y001533 0001327444187 isminah P ANGGOTA POLRI Chronic ischaemic heart Rujuk Lanjut
disease
2266 13-03-2018 0137U0040318Y001575 0001336962363 JOSUA ARMANDO L PEKERJA MANDIRI Other specified headache Berobat Jalan
syndromes
2267 13-03-2018 0137U0040318Y001596 0001337973849 MUHAMMAD ALIF MIRZA L PEKERJA MANDIRI Acute upper respiratory Berobat Jalan
infection, unspecified
2268 13-03-2018 0137U0040318Y001495 0001338039213 PANG NIO P PEKERJA MANDIRI Other soft tissue disorders, Berobat Jalan
not elsewhere classified

2269 13-03-2018 0137U0040318Y001488 0001341358299 JUBAHAR L PENERIMA PENSIUN Heart failure Rujuk Lanjut
SWASTA
2270 13-03-2018 0137U0040318Y001519 0001370945441 SISKA MEILISA P PEGAWAI SWASTA Dermatitis herpetiformis Berobat Jalan

2271 13-03-2018 0137U0040318Y001553 0001376466298 Hanif Nur Muhammad Zahran L PEKERJA MANDIRI Other and unspecified Berobat Jalan
infectious diseases
2272 13-03-2018 0137U0040318Y001584 0001405010259 MUNALINA P PEGAWAI SWASTA Other specified headache Berobat Jalan
syndromes
2273 13-03-2018 0137U0040318Y001608 0001422212106 ROSA DESSIVITA P PEKERJA MANDIRI Impacted teeth Berobat Jalan

2274 13-03-2018 0137U0040318Y001607 0001422212343 syaikhah ameera zia hidayat L PEKERJA MANDIRI Caries of dentine Berobat Jalan
DAFTAR KUNJUNGAN PESERTA SAKIT

Kantor Cabang : BEKASI - 1011

FKTP : Klinik Mitra Medika - 0137U004

2275 13-03-2018 0137U0040318Y001480 0001424147038 ENY SUHAENAWATI P PEKERJA MANDIRI Insulin-dependent Rujuk Lanjut
diabetes mellitus
2276 13-03-2018 0137U0040318Y001588 0001425044283 MARSIDAH P PEKERJA MANDIRI Diarrhoea and Berobat Jalan
gastroenteritis of
presumed infectious origin

2277 13-03-2018 0137U0040318Y001513 0001428717093 onah haryanah P PEKERJA MANDIRI Other arthrosis Berobat Jalan

2278 13-03-2018 0137U0040318Y001516 0001428717475 DEWI PERMATA SARI P PEKERJA MANDIRI Antenatal screening Berobat Jalan

2279 13-03-2018 0137U0040318Y001538 0001431801797 TATI HASAN P PEKERJA MANDIRI Other arthritis Rujuk Lanjut

2280 13-03-2018 0137U0040318Y001562 0001443385721 POPIE OPERASISWANTY P PEGAWAI SWASTA Spondylosis Rujuk Lanjut

2281 13-03-2018 0137U0040318Y001498 0001453791374 CLAY ANDREW HANSEL L PEKERJA MANDIRI Acute upper respiratory Berobat Jalan
infections of multiple and

2282 13-03-2018 0137U0040318Y001564 0001456680464 TITI FATIMAH P PEKERJA MANDIRI Other and unspecified Berobat Jalan
abdominal pain
2283 13-03-2018 0137U0040318Y001602 0001457121688 LIANYWATI L PEKERJA MANDIRI Impacted teeth Berobat Jalan

2284 13-03-2018 0137U0040318Y001476 0001458637424 SITI ZAINAB P PEKERJA MANDIRI Disorders of refraction and Rujuk Lanjut
accommodation
2285 13-03-2018 0137U0040318Y001532 0001459307801 LAELIYAH P PEKERJA MANDIRI Acute upper respiratory Berobat Jalan
infections of multiple and

2286 13-03-2018 0137U0040318Y001594 0001459554862 NOVI INDRI RUSLIAWATI P PNS PUSAT Other specified headache Berobat Jalan
syndromes
2287 13-03-2018 0137U0040318Y001536 0001462023112 KRISNA BUDI SULISTIYANTO L PEGAWAI SWASTA Chronic ischaemic heart Rujuk Lanjut
disease, unspecified
2288 13-03-2018 0137U0040318Y001604 0001474551145 MUNDAFIR L PEKERJA MANDIRI Caries of dentine Berobat Jalan

2289 13-03-2018 0137U0040318Y001558 0001477270157 SUGANDI, SE L PEGAWAI SWASTA Chronic pharyngitis Rujuk Lanjut

2290 13-03-2018 0137U0040318Y001595 0001477625444 FITRI YULIA PRIHATINI P PEGAWAI SWASTA Myopia Berobat Jalan

2291 13-03-2018 0137U0040318Y001523 0001479666778 ULIMA AZMI P PEKERJA MANDIRI Acute upper respiratory Berobat Jalan
infections of multiple and

2292 13-03-2018 0137U0040318Y001546 0001480483023 ANI ROHAYANI P PEGAWAI SWASTA Other and unspecified Berobat Jalan
infectious diseases
2293 13-03-2018 0137U0040318Y003847 0001480493564 DELLY KURNIAWATI P PEGAWAI SWASTA Other antenatal screening Berobat Jalan

2294 13-03-2018 0137U0040318Y001567 0001481303283 FERRY A. BAHAR L PEKERJA MANDIRI Dyspepsia Berobat Jalan
DAFTAR KUNJUNGAN PESERTA SAKIT

Kantor Cabang : BEKASI - 1011

FKTP : Klinik Mitra Medika - 0137U004

2295 13-03-2018 0137U0040318Y001587 0001548835841 ATI SUGIHARTI P PEGAWAI SWASTA Diarrhoea and Berobat Jalan
gastroenteritis of
presumed infectious origin

2296 13-03-2018 0137U0040318Y001586 0001548835863 RAYHA AZURA P PEGAWAI SWASTA Dermatitis herpetiformis Berobat Jalan

2297 13-03-2018 0137U0040318Y001512 0001608981489 ANDRI L PEGAWAI SWASTA Acute upper respiratory Berobat Jalan
infections of multiple and

2298 13-03-2018 0137U0040318Y001508 0001624408571 BASRI SUSA L PENERIMA PENSIUN Other arthrosis Berobat Jalan
SWASTA
2299 13-03-2018 0137U0040318Y001576 0001626197095 SOLIHUDIN L PEGAWAI SWASTA Other specified headache Berobat Jalan
syndromes
2300 13-03-2018 0137U0040318Y001579 0001626197106 LINA FITRIAWATI P PEGAWAI SWASTA Other specified headache Berobat Jalan
syndromes
2301 13-03-2018 0137U0040318Y001578 0001626197117 NASYWA NABILA P PEGAWAI SWASTA Other and unspecified Berobat Jalan
infectious diseases
2302 13-03-2018 0137U0040318Y001577 0001626197128 LUTHFIA ALIFAH P PEGAWAI SWASTA Acute upper respiratory Berobat Jalan
infection, unspecified
2303 13-03-2018 0137U0040318Y001610 0001629187716 NEZIRA P PEGAWAI SWASTA Dental caries, unspecified Berobat Jalan

2304 13-03-2018 0137U0040318Y001509 0001630345678 DIAN AYU SEKARTAJI P PEGAWAI SWASTA Acute upper respiratory Berobat Jalan
infections of multiple and

2305 13-03-2018 0137U0040318Y001592 0001632016574 SANDRA BALQIA ADZRA P PEKERJA MANDIRI Acute upper respiratory Berobat Jalan
infection, unspecified
2306 13-03-2018 0137U0040318Y001517 0001634367936 NUR SOIMAH P PEGAWAI SWASTA Embedded and impacted Berobat Jalan
teeth
2307 13-03-2018 0137U0040318Y001580 0001637515956 MISRA DEWI P PEGAWAI SWASTA Myopia Berobat Jalan

2308 13-03-2018 0137U0040318Y001525 0001638856934 MANDY ALTHAFUNNISA P PEGAWAI BUMN Leukaemia of unspecified Rujuk Lanjut
HERMAWAN cell type
2309 13-03-2018 0137U0040318Y001551 0001640284075 MUHAMAD IRWAN L PEGAWAI SWASTA Acute upper respiratory Berobat Jalan
infection, unspecified
2310 13-03-2018 0137U0040318Y001510 0001645675097 H. LEGIYONO L PEKERJA MANDIRI Other arthrosis Berobat Jalan

2311 13-03-2018 0137U0040318Y001511 0001645675108 MAEMUNAH P PEKERJA MANDIRI Other arthrosis Berobat Jalan

2312 13-03-2018 0137U0040318Y001545 0001648188235 EKA NUR KOMARIAH P PEGAWAI SWASTA Acute upper respiratory Berobat Jalan
infection, unspecified
2313 13-03-2018 0137U0040318Y001540 0001652892906 Siti Khofifah Rahmi P PEGAWAI SWASTA Other antenatal screening Berobat Jalan

2314 13-03-2018 0137U0040318Y001514 0001653463506 MALIHAH SAYYIDAH NABILAH P PEGAWAI SWASTA Embedded and impacted Berobat Jalan
teeth
2315 13-03-2018 0137U0040318Y001534 0001655927752 PRASETYO BUDI SANTOSO L PEKERJA MANDIRI Presbyopia Rujuk Lanjut
DAFTAR KUNJUNGAN PESERTA SAKIT

Kantor Cabang : BEKASI - 1011

FKTP : Klinik Mitra Medika - 0137U004

2316 13-03-2018 0137U0040318Y001515 0001655927763 NUGROHO NINGRUM INDRIATI P PEKERJA MANDIRI Embedded and impacted Berobat Jalan
teeth
2317 13-03-2018 0137U0040318Y001539 0001725010604 DESSY SAGITA P PEKERJA MANDIRI Chronic renal failure, Rujuk Lanjut
unspecified
2318 13-03-2018 0137U0040318Y001556 0001725010615 CRISTIAN L PEKERJA MANDIRI Atopic dermatitis, Berobat Jalan
unspecified
2319 13-03-2018 0137U0040318Y001475 0001726730447 IE MARIA ANGELINA BLESSING P PEKERJA MANDIRI Other and unspecified Rujuk Lanjut
ovarian cysts
2320 13-03-2018 0137U0040318Y001486 0001728278998 SISHARIATY P PEKERJA MANDIRI Other arthrosis Berobat Jalan

2321 13-03-2018 0137U0040318Y001485 0001728279011 DAUD HASUDUNGAN SIAHAAN L PEKERJA MANDIRI Acute upper respiratory Berobat Jalan
infections of multiple and

2322 13-03-2018 0137U0040318Y001500 0001729412919 IMAS INA SURYANAH P PEKERJA MANDIRI Other arthrosis Berobat Jalan

2323 13-03-2018 0137U0040318Y001487 0001729412932 FAZRI SASMITA L PEKERJA MANDIRI Acute upper respiratory Berobat Jalan
infections of multiple and

2324 13-03-2018 0137U0040318Y001479 0001729699738 IRAWATI SIRINGO RINGO P PEKERJA MANDIRI Other miliary tuberculosis Rujuk Lanjut

2325 13-03-2018 0137U0040318Y001518 0001729888751 MUHAMAD FARIZ NAUFAL L PEKERJA MANDIRI Acute upper respiratory Berobat Jalan
infections of multiple and

2326 13-03-2018 0137U0040318Y001497 0001734260038 KHOIRUNNISA P PEKERJA MANDIRI Acute upper respiratory Berobat Jalan
infections of multiple and

2327 13-03-2018 0137U0040318Y001613 0001738228364 MADSARI L PEGAWAI SWASTA Impacted teeth Berobat Jalan

2328 13-03-2018 0137U0040318Y001531 0001740915821 Ade Yunita P PEGAWAI SWASTA Antenatal screening Berobat Jalan

2329 13-03-2018 0137U0040318Y001541 0001745436047 HARYANI P PEKERJA MANDIRI Other antenatal screening Berobat Jalan

2330 13-03-2018 0137U0040318Y001600 0001771178861 TIA SYNTIA DEWI P PEGAWAI SWASTA Other antenatal screening Berobat Jalan

2331 13-03-2018 0137U0040318Y001571 0001772752623 Anisa Purtiwi P PEGAWAI SWASTA Other specified headache Berobat Jalan
syndromes
2332 13-03-2018 0137U0040318Y001605 0001773406269 NAFISA ALIYATUNNISA P PEGAWAI SWASTA Necrosis of pulp Berobat Jalan

2333 13-03-2018 0137U0040318Y001563 0001785239831 RUSHAYATI P PEKERJA MANDIRI Insulin-dependent Rujuk Lanjut
diabetes mellitus with

2334 13-03-2018 0137U0040318Y001552 0001787017577 BIG RONALD L PEGAWAI SWASTA Gastro-oesophageal reflux Berobat Jalan
disease without

2335 13-03-2018 0137U0040318Y001542 0001787017599 RINI MEGAWATI P PEGAWAI SWASTA Impacted teeth Rujuk Lanjut

2336 13-03-2018 0137U0040318Y001616 0001788372044 RATIH PUSPITA MUHARANI P PEGAWAI SWASTA Necrosis of pulp Berobat Jalan
DAFTAR KUNJUNGAN PESERTA SAKIT

Kantor Cabang : BEKASI - 1011

FKTP : Klinik Mitra Medika - 0137U004

2337 13-03-2018 0137U0040318Y001507 0001801905851 RENY PRASTIWI P PEGAWAI SWASTA Disorders of vestibular Berobat Jalan
function
2338 13-03-2018 0137U0040318Y001559 0001803034585 MUHAMAD ALBI FATUR RIZQI L PEGAWAI SWASTA Other and unspecified Berobat Jalan
infectious diseases
2339 13-03-2018 0137U0040318Y001561 0001807186544 YANUAR DWI PUTRANTO L PEKERJA MANDIRI Non-insulin-dependent Rujuk Lanjut
diabetes mellitus
2340 13-03-2018 0137U0040318Y001609 0001809627658 SULASTRI P PEKERJA MANDIRI Necrosis of pulp Berobat Jalan

2341 13-03-2018 0137U0040318Y001504 0001811236116 nurtiti haryati P PENERIMA PENSIUN Other arthrosis Berobat Jalan
SWASTA
2342 13-03-2018 0137U0040318Y001611 0001821216521 dika L PEKERJA MANDIRI Chronic gingivitis Berobat Jalan

2343 13-03-2018 0137U0040318Y001526 0001860169105 JUFRAN L PEKERJA MANDIRI Diarrhoea and Rujuk Lanjut
gastroenteritis of
presumed infectious origin

2344 13-03-2018 0137U0040318Y001572 0001863017548 INTAN NOVITA T P PEKERJA MANDIRI Acute upper respiratory Berobat Jalan
infection, unspecified
2345 13-03-2018 0137U0040318Y001617 0001866468971 SITI MARIAM P PEGAWAI SWASTA Abrasion of teeth Berobat Jalan

2346 13-03-2018 0137U0040318Y001581 0001872927966 MUHAMMAD RIFQI HANIE L PEGAWAI SWASTA Cutaneous abscess, Berobat Jalan
furuncle and carbuncle
2347 13-03-2018 0137U0040318Y001503 0001875226498 MUHAMMAD FIKRY FADHILLAH L PEGAWAI SWASTA Acute upper respiratory Berobat Jalan
infections of multiple and

2348 13-03-2018 0137U0040318Y001597 0001876498874 MYECEL EFENDI L PEKERJA MANDIRI Acute upper respiratory Berobat Jalan
infection, unspecified
2349 13-03-2018 0137U0040318Y001549 0001882491862 dafina aulia oktafiani P PEKERJA MANDIRI Acute upper respiratory Berobat Jalan
infection, unspecified
2350 13-03-2018 0137U0040318Y001548 0001883209713 muhammad danish al raziq L PEKERJA MANDIRI Acute upper respiratory Berobat Jalan
infection, unspecified
2351 13-03-2018 0137U0040318Y001598 0001888104273 NAYLA PUTRI KHAIRINNISWAH P PEGAWAI SWASTA Acute upper respiratory Berobat Jalan
infection, unspecified
2352 13-03-2018 0137U0040318Y001566 0001889564984 TARUNA IMKA KARNAEN L PEKERJA MANDIRI Acute pharyngitis, Berobat Jalan
unspecified
2353 13-03-2018 0137U0040318Y001582 0001890074182 ACHMAD PRIDO L PEKERJA MANDIRI Myalgia Berobat Jalan

2354 13-03-2018 0137U0040318Y001494 0001963733771 PRITA KEMALASARI P PEKERJA MANDIRI Acute upper respiratory Berobat Jalan
infections of multiple and

2355 13-03-2018 0137U0040318Y001493 0001965387813 NUR IMAMAH P PEKERJA MANDIRI Acute upper respiratory Berobat Jalan
infections of multiple and

2356 13-03-2018 0137U0040318Y001496 0002070784697 IQBAL RIZKY RAFARDHAN L PEKERJA MANDIRI Acute upper respiratory Berobat Jalan
infections of multiple and
DAFTAR KUNJUNGAN PESERTA SAKIT

Kantor Cabang : BEKASI - 1011

FKTP : Klinik Mitra Medika - 0137U004

2357 13-03-2018 0137U0040318Y001524 0002080903061 HEAVENLY GRACE WIDJAYA P PEGAWAI SWASTA Acute upper respiratory Berobat Jalan
ANWAR infections of multiple and

2358 13-03-2018 0137U0040318Y001537 0002081631881 SEBASTIAN LEVI PRADANA L PEGAWAI SWASTA Developmental disorder of Rujuk Lanjut
speech and language,

2359 13-03-2018 0137U0040318Y001590 0002096315526 DODY ALWARDY L PEGAWAI SWASTA Gastro-oesophageal reflux Berobat Jalan
disease without

2360 13-03-2018 0137U0040318Y001574 0002206311581 kayla riezki amalia prabowo P KEPOLISIAN RI Acute upper respiratory Berobat Jalan
infection, unspecified
2361 13-03-2018 0137U0040318Y001568 0002208827406 assyfa putri zaskia P PEKERJA MANDIRI Acute upper respiratory Berobat Jalan
infection, unspecified
2362 13-03-2018 0137U0040318Y001499 0002229792772 HARSRIYATI P PEGAWAI SWASTA Other arthrosis Berobat Jalan

2363 13-03-2018 0137U0040318Y001543 0002230809456 PRISCILLA KINARA YULIANTO P PEGAWAI SWASTA Acute upper respiratory Berobat Jalan
infection, unspecified
2364 13-03-2018 0137U0040318Y001614 0002237844543 RIKA TERESNA ASIH P PEKERJA MANDIRI Dental caries, unspecified Berobat Jalan

2365 13-03-2018 0137U0040318Y001528 0002240028235 HAPSARI SUPRAPTI P PEKERJA MANDIRI Acute upper respiratory Berobat Jalan
infections of multiple and

2366 13-03-2018 0137U0040318Y001529 0002240028404 ERLYSA PURWANINGSIH P PEKERJA MANDIRI Acute upper respiratory Berobat Jalan
infections of multiple and

2367 13-03-2018 0137U0040318Y001550 0002240385535 NADINE PUTRI KEISHA SAGALA P PNS PUSAT Acute upper respiratory Berobat Jalan
infection, unspecified
2368 13-03-2018 0137U0040318Y001482 0002242541485 SUTARNI P PEKERJA MANDIRI Other arthrosis Berobat Jalan

2369 13-03-2018 0137U0040318Y001565 0002265549502 FADILLAH WARDANA L PEGAWAI SWASTA Acute upper respiratory Berobat Jalan
infection, unspecified
2370 13-03-2018 0137U0040318Y001506 0002268840036 ILHAM NUR FAJAR RAMADHAN L PBI (APBD) Acute upper respiratory Berobat Jalan
infections of multiple and

2371 13-03-2018 0137U0040318Y001481 0002304119507 SRISNA OKEN TINA P PEKERJA MANDIRI Other and unspecified Rujuk Lanjut
abdominal pain
2372 13-03-2018 0137U0040318Y001527 0002306789627 DINI RESTINASARI P PEKERJA MANDIRI Respiratory tuberculosis, Berobat Jalan
bacteriologically and

2373 13-03-2018 0137U0040318Y001473 0002421137608 HAFIDZAH PUTRI ZULWAQA P PEGAWAI PEMERINTAH Embedded and impacted Berobat Jalan
AMMAR NON PNS teeth
2374 12-03-2018 0137U0040318Y001373 0000020759409 PURWANTI ASIH RAHAYU P PNS PUSAT Benign neoplasm of breast Rujuk Lanjut

2375 12-03-2018 0137U0040318Y001325 0000026947427 DARLIS P PENERIMA PENSIUN Chronic renal failure, Rujuk Lanjut
PNS unspecified
DAFTAR KUNJUNGAN PESERTA SAKIT

Kantor Cabang : BEKASI - 1011

FKTP : Klinik Mitra Medika - 0137U004

2376 12-03-2018 0137U0040318Y001310 0000037507509 RETNO DWIHASTUTI P PNS PUSAT Other secondary arthrosis Berobat Jalan

2377 12-03-2018 0137U0040318Y001321 0000038881899 SUSY DAMAYANTI P PNS PUSAT Carpal tunnel syndrome Rujuk Lanjut

2378 12-03-2018 0137U0040318Y001387 0000041517101 YAYAT HIDAYAT L PENERIMA PENSIUN Acute upper respiratory Berobat Jalan
PNS infection, unspecified
2379 12-03-2018 0137U0040318Y001436 0000042120281 BAMBANG SETIA BUDI L PENERIMA PENSIUN Dyspepsia Berobat Jalan
PNS
2380 12-03-2018 0137U0040318Y001459 0000042123251 TAKWIM QUMARUN L PENERIMA PENSIUN Impacted teeth Berobat Jalan
PNS
2381 12-03-2018 0137U0040318Y001440 0000042123262 SULISTRIYATI P PENERIMA PENSIUN Acute upper respiratory Berobat Jalan
PNS infection, unspecified
2382 12-03-2018 0137U0040318Y001319 0000042836207 IR.SUKARDJI PARTODIHARDJO L PENERIMA PENSIUN Insulin-dependent Rujuk Lanjut
PNS diabetes mellitus with

2383 12-03-2018 0137U0040318Y001320 0000042844015 KARTINI P PENERIMA PENSIUN Non-insulin-dependent Rujuk Lanjut
HARDJOSUMARTO,MCH PNS diabetes mellitus with

2384 12-03-2018 0137U0040318Y001408 0000073004602 BAMBANG GUNAWAN,SE.MM L PENERIMA PENSIUN TNI Hyperplasia of prostate Rujuk Lanjut

2385 12-03-2018 0137U0040318Y001415 0000073004613 ENDANG SRI SUJIATI P PENERIMA PENSIUN TNI Low back pain Rujuk Lanjut

2386 12-03-2018 0137U0040318Y001402 0000164525231 RADINKA RIZKULLAH L PNS DAERAH Acute upper respiratory Berobat Jalan
FAHAMSYAH infection, unspecified
2387 12-03-2018 0137U0040318Y001303 0000507541836 ARIDIA PRASETYO L PBI (APBN) Epilepsy, unspecified Rujuk Lanjut

2388 12-03-2018 0137U0040318Y001326 0001093735629 ROHMAT TULOH L ANGGOTA POLRI Acute upper respiratory Berobat Jalan
infection, unspecified
2389 12-03-2018 0137U0040318Y001446 0001126274196 MAHFUD L PEGAWAI SWASTA Gastro-oesophageal reflux Berobat Jalan
disease without

2390 12-03-2018 0137U0040318Y001329 0001128856757 JULIANTO L PEKERJA MANDIRI Dyspepsia Berobat Jalan

2391 12-03-2018 0137U0040318Y001403 0001129464235 FATMAWATI P PEGAWAI SWASTA Acute upper respiratory Berobat Jalan
infection, unspecified
2392 12-03-2018 0137U0040318Y001355 0001132260906 GIYANTO L PEKERJA MANDIRI Impacted cerumen Berobat Jalan

2393 12-03-2018 0137U0040318Y001447 0001146214541 SELFI INDAH PRATIWI P PEGAWAI SWASTA Other and unspecified Berobat Jalan
infectious diseases
2394 12-03-2018 0137U0040318Y001362 0001153375907 ALDO JOUNANDa L PEGAWAI SWASTA Other specified headache Berobat Jalan
syndromes
2395 12-03-2018 0137U0040318Y001404 0001157543357 PANJI SASTRA JINGGA L PEGAWAI SWASTA Acute upper respiratory Berobat Jalan
infection, unspecified
2396 12-03-2018 0137U0040318Y001371 0001158205915 ROCHANI P PEGAWAI SWASTA Myalgia Berobat Jalan
DAFTAR KUNJUNGAN PESERTA SAKIT

Kantor Cabang : BEKASI - 1011

FKTP : Klinik Mitra Medika - 0137U004

2397 12-03-2018 0137U0040318Y001337 0001159310878 YUZANAH YUHARDIN P PEKERJA MANDIRI Acute upper respiratory Berobat Jalan
infection, unspecified
2398 12-03-2018 0137U0040318Y001343 0001166474507 ERNY P PEGAWAI SWASTA Dental caries, unspecified Berobat Jalan

2399 12-03-2018 0137U0040318Y001384 0001176304634 HARRY PRASETIYA L PEKERJA MANDIRI Other and unspecified Berobat Jalan
infectious diseases
2400 12-03-2018 0137U0040318Y001352 0001195312667 FILDZOH QONI'AH P PEKERJA MANDIRI Abrasion of teeth Berobat Jalan

2401 12-03-2018 0137U0040318Y001353 0001202766772 ZAHWAH ALIYAH P PEGAWAI SWASTA Necrosis of pulp Berobat Jalan

2402 12-03-2018 0137U0040318Y001348 0001257714224 AYLANI ISTANTI P PEKERJA MANDIRI Caries of dentine Berobat Jalan

2403 12-03-2018 0137U0040318Y001367 0001258212262 NURAINI P PEKERJA MANDIRI Dermatitis herpetiformis Berobat Jalan

2404 12-03-2018 0137U0040318Y001456 0001258532717 MAYLANEY HANA TRICIA P PEGAWAI SWASTA Other antenatal screening Berobat Jalan

2405 12-03-2018 0137U0040318Y001378 0001258644194 MUHAMMAD DIMYATI L PEKERJA MANDIRI Hyperplasia of prostate Rujuk Lanjut

2406 12-03-2018 0137U0040318Y001354 0001258952771 TUTWURI HANDAYANI P PEGAWAI SWASTA Impacted teeth Berobat Jalan

2407 12-03-2018 0137U0040318Y001342 0001259052164 RAY OKTAVIAN PRATAMA L PEGAWAI SWASTA Abrasion of teeth Berobat Jalan

2408 12-03-2018 0137U0040318Y001299 0001262837507 ADNAN SUHADA ABDULAH L PEKERJA MANDIRI Meningitis, unspecified Rujuk Lanjut

2409 12-03-2018 0137U0040318Y001405 0001263495734 ISNAENI SUHARWATI P PEKERJA MANDIRI Other specified headache Berobat Jalan
syndromes
2410 12-03-2018 0137U0040318Y001410 0001265953342 YUSUF SOHARDI L PEKERJA MANDIRI Acute upper respiratory Berobat Jalan
infection, unspecified
2411 12-03-2018 0137U0040318Y001331 0001266792309 MUHAMMAD RIZQY ANANDA L PEKERJA MANDIRI Dyspepsia Berobat Jalan

2412 12-03-2018 0137U0040318Y001385 0001267019447 RENDY SURYADI HANDOYO L PEGAWAI SWASTA Acute upper respiratory Berobat Jalan
infection, unspecified
2413 12-03-2018 0137U0040318Y001312 0001269155619 ELVIANI P PEKERJA MANDIRI Other specified headache Berobat Jalan
syndromes
2414 12-03-2018 0137U0040318Y001298 0001271006752 YOVI BUDIYONO TIRTO L PEKERJA MANDIRI Chronic ischaemic heart Rujuk Lanjut
SENTONO disease
2415 12-03-2018 0137U0040318Y001401 0001271410839 NURBAETI RONY P PEKERJA MANDIRI Acute upper respiratory Berobat Jalan
infection, unspecified
2416 12-03-2018 0137U0040318Y001414 0001278060366 LIM LIEN TJE P PEKERJA MANDIRI Cataract, unspecified Rujuk Lanjut

2417 12-03-2018 0137U0040318Y001390 0001278383422 YANTI SUNARTI P PEKERJA MANDIRI Dermatitis herpetiformis Berobat Jalan

2418 12-03-2018 0137U0040318Y001466 0001282682924 SUPARJO L PEKERJA MANDIRI Impacted teeth Berobat Jalan

2419 12-03-2018 0137U0040318Y001304 0001286001448 CASINI ASTRIANI P PEKERJA MANDIRI Acute upper respiratory Berobat Jalan
infection, unspecified
2420 12-03-2018 0137U0040318Y001324 0001287160571 RUDI NAPITULU L PEKERJA MANDIRI Other specified headache Berobat Jalan
syndromes
DAFTAR KUNJUNGAN PESERTA SAKIT

Kantor Cabang : BEKASI - 1011

FKTP : Klinik Mitra Medika - 0137U004

2421 12-03-2018 0137U0040318Y001351 0001287162494 RISMA JUHRIAH P PEKERJA MANDIRI Dental caries, unspecified Berobat Jalan

2422 12-03-2018 0137U0040318Y001461 0001288513258 ENDANG SUDRAJAT L PEKERJA MANDIRI Impacted teeth Berobat Jalan

2423 12-03-2018 0137U0040318Y001451 0001288515047 SILVIA RATNA WIJAYA P PEKERJA MANDIRI Acute upper respiratory Berobat Jalan
infection, unspecified
2424 12-03-2018 0137U0040318Y001425 0001289012376 FAYOLA GIOVANI P PEKERJA MANDIRI Myopia Berobat Jalan

2425 12-03-2018 0137U0040318Y001424 0001289012861 MARTHA YETTY L PEKERJA MANDIRI Myopia Berobat Jalan

2426 12-03-2018 0137U0040318Y001422 0001289013186 STROMIE GIVEN MUSTAKIM P PEKERJA MANDIRI Myalgia Berobat Jalan

2427 12-03-2018 0137U0040318Y001452 0001292181568 desvira cantika putri P PEKERJA MANDIRI Acute upper respiratory Berobat Jalan
infection, unspecified
2428 12-03-2018 0137U0040318Y001315 0001302177789 TASHYA PERMATA SARI P PEKERJA MANDIRI Acute upper respiratory Berobat Jalan
infection, unspecified
2429 12-03-2018 0137U0040318Y001464 0001305292983 LANNY ASRININGSIH P PEKERJA MANDIRI Dental caries, unspecified Berobat Jalan

2430 12-03-2018 0137U0040318Y001334 0001307558913 MAULANA AS L PEKERJA MANDIRI Myalgia Berobat Jalan

2431 12-03-2018 0137U0040318Y001333 0001307559576 NENENG LASMININGSIH P PEKERJA MANDIRI Other and unspecified Berobat Jalan
abdominal pain
2432 12-03-2018 0137U0040318Y001395 0001311613086 HJ. ANI ROHANI P PEKERJA MANDIRI Non-insulin-dependent Rujuk Lanjut
diabetes mellitus
2433 12-03-2018 0137U0040318Y001419 0001312245843 LEONARDO SUBIANTO L PEKERJA MANDIRI Acute upper respiratory Berobat Jalan
infection, unspecified
2434 12-03-2018 0137U0040318Y001376 0001313689408 ruslan L PEKERJA MANDIRI Chronic rhinitis Rujuk Lanjut

2435 12-03-2018 0137U0040318Y001382 0001313690578 sri handarini P PEKERJA MANDIRI Other secondary arthrosis Berobat Jalan

2436 12-03-2018 0137U0040318Y001457 0001323761949 ALBIDZAR FAIRUZAN L PEGAWAI SWASTA Chronic gingivitis Berobat Jalan
ALGHIFARI HANDARIES
2437 12-03-2018 0137U0040318Y001340 0001326324789 SYIFA RIZKY AMANDA P PEGAWAI SWASTA Necrosis of pulp Berobat Jalan

2438 12-03-2018 0137U0040318Y001462 0001327630094 abidal persada anugrah P PNS DAERAH Chronic gingivitis Berobat Jalan

2439 12-03-2018 0137U0040318Y001372 0001337501248 MUHAIDA TOFNI ROSMALI P PEKERJA MANDIRI Myalgia Berobat Jalan

2440 12-03-2018 0137U0040318Y001323 0001337972938 AISYAH PENTI OCTAVIANI P PEKERJA MANDIRI Acute upper respiratory Berobat Jalan
infection, unspecified
2441 12-03-2018 0137U0040318Y001322 0001338943803 LIAU ASIU, NURSIAH P PEKERJA MANDIRI Acute upper respiratory Berobat Jalan
infection, unspecified
2442 12-03-2018 0137U0040318Y001437 0001339723326 BIMA ARKANANTA FATIH L PEGAWAI SWASTA Acute upper respiratory Berobat Jalan
infection, unspecified
2443 12-03-2018 0137U0040318Y001386 0001340069354 YENNI P PEKERJA MANDIRI Nausea and vomiting Berobat Jalan

2444 12-03-2018 0137U0040318Y001370 0001341358299 JUBAHAR L PENERIMA PENSIUN Low back pain Rujuk Lanjut
SWASTA
DAFTAR KUNJUNGAN PESERTA SAKIT

Kantor Cabang : BEKASI - 1011

FKTP : Klinik Mitra Medika - 0137U004

2445 12-03-2018 0137U0040318Y001399 0001378197189 DWI LESTARI P PEGAWAI SWASTA Traumatic shock Berobat Jalan

2446 12-03-2018 0137U0040318Y001365 0001378225956 YENNI NASUTION P PEGAWAI SWASTA Other specified headache Berobat Jalan
syndromes
2447 12-03-2018 0137U0040318Y001438 0001386043694 siti munzayana P PEKERJA MANDIRI Acute upper respiratory Berobat Jalan
infection, unspecified
2448 12-03-2018 0137U0040318Y001450 0001402633282 WINUR KASIH P PEGAWAI SWASTA Acute upper respiratory Berobat Jalan
infection, unspecified
2449 12-03-2018 0137U0040318Y001468 0001420939991 soleha P PEKERJA MANDIRI Impacted teeth Berobat Jalan

2450 12-03-2018 0137U0040318Y001423 0001428717475 DEWI PERMATA SARI P PEKERJA MANDIRI Complications following Rujuk Lanjut
abortion and ectopic and

2451 12-03-2018 0137U0040318Y001397 0001429962197 TABIRUL HERIYANTO L PEKERJA MANDIRI Chronic ischaemic heart Rujuk Lanjut
disease, unspecified
2452 12-03-2018 0137U0040318Y001413 0001430994993 HAIKAL RIZKI ANUGRAH L PEKERJA MANDIRI Other and unspecified Berobat Jalan
infectious diseases
2453 12-03-2018 0137U0040318Y001318 0001432324844 GUNAWATI P PEKERJA MANDIRI Congestive heart failure Rujuk Lanjut

2454 12-03-2018 0137U0040318Y001332 0001432808572 suhandi L PEKERJA MANDIRI Acute upper respiratory Berobat Jalan
infection, unspecified
2455 12-03-2018 0137U0040318Y001308 0001435047142 WINARNO ABDUL RACHim L PEKERJA MANDIRI Other cataract Rujuk Lanjut

2456 12-03-2018 0137U0040318Y001380 0001436513321 DANU SALEH L PEKERJA MANDIRI Insulin-dependent Berobat Jalan
diabetes mellitus without

2457 12-03-2018 0137U0040318Y001383 0001438366599 ETTY SUSANTO P PEKERJA MANDIRI Other secondary arthrosis Berobat Jalan

2458 12-03-2018 0137U0040318Y001300 0001447246776 KUSHARYADI L PEKERJA MANDIRI Dermatitis herpetiformis Rujuk Lanjut

2459 12-03-2018 0137U0040318Y001361 0001448155899 BANYAK P PEKERJA MANDIRI Acute upper respiratory Berobat Jalan
infection, unspecified
2460 12-03-2018 0137U0040318Y001421 0001451048477 hilary kharisma nauli sitanggang P PNS PUSAT Varicella meningitis Berobat Jalan

2461 12-03-2018 0137U0040318Y001420 0001451049862 PUTRI CHARLENE MEISY P PNS PUSAT Varicella meningitis Berobat Jalan
SITANGGANG
2462 12-03-2018 0137U0040318Y001441 0001452132134 SRIANAH.WD P PEKERJA MANDIRI Gastro-oesophageal reflux Berobat Jalan
disease without

2463 12-03-2018 0137U0040318Y001317 0001455135219 RIFANNY YUANITA P PEKERJA MANDIRI Anaemia in other chronic Rujuk Lanjut
diseases classified

2464 12-03-2018 0137U0040318Y001381 0001455707643 FABIAN MAHESA PRATAMA L PEKERJA MANDIRI Acute upper respiratory Berobat Jalan
infection, unspecified
2465 12-03-2018 0137U0040318Y001375 0001457184475 REIHANUM ZHAFIRA P PEKERJA MANDIRI Acute bronchitis Rujuk Lanjut
INDRAWAN
DAFTAR KUNJUNGAN PESERTA SAKIT

Kantor Cabang : BEKASI - 1011

FKTP : Klinik Mitra Medika - 0137U004

2466 12-03-2018 0137U0040318Y001302 0001457923061 ARY KEFANTO L PEKERJA MANDIRI Disorders of refraction and Rujuk Lanjut
accommodation
2467 12-03-2018 0137U0040318Y001458 0001458466751 YULI VERAWATI P PEKERJA MANDIRI Impacted teeth Berobat Jalan

2468 12-03-2018 0137U0040318Y001393 0001458473591 EDWARD JUSUF L PEKERJA MANDIRI Low back pain Rujuk Lanjut

2469 12-03-2018 0137U0040318Y001417 0001458525644 RUSMAWANTO L PEKERJA MANDIRI Exfoliation of teeth due to Rujuk Lanjut
systemic causes
2470 12-03-2018 0137U0040318Y001469 0001458525723 SITI ROHIMAH P PEKERJA MANDIRI Dental caries, unspecified Berobat Jalan

2471 12-03-2018 0137U0040318Y001347 0001460098866 SARAH NOVIYANTI P PEKERJA MANDIRI Impacted teeth Berobat Jalan

2472 12-03-2018 0137U0040318Y001311 0001460098888 RAIHAN AREZKI KURNIAWAN L PEKERJA MANDIRI Acute upper respiratory Berobat Jalan
infection, unspecified
2473 12-03-2018 0137U0040318Y001346 0001460098899 KHANSA ASYA KURNIAWAN P PEKERJA MANDIRI Chronic gingivitis Berobat Jalan

2474 12-03-2018 0137U0040318Y001435 0001460430009 YOSIANA NATA WIJAYA P PEKERJA MANDIRI Other specified headache Berobat Jalan
syndromes
2475 12-03-2018 0137U0040318Y001406 0001460554929 BACHTIAR L PEKERJA MANDIRI Myalgia Berobat Jalan

2476 12-03-2018 0137U0040318Y001416 0001461072701 IWAN SUGIANTO L PEKERJA MANDIRI Presbyopia Rujuk Lanjut

2477 12-03-2018 0137U0040318Y001344 0001465857325 HUMAIRA InAYAH HUSNA P PEGAWAI SWASTA Necrosis of pulp Berobat Jalan

2478 12-03-2018 0137U0040318Y001364 0001466140623 TAN TIAN NIO P PEKERJA MANDIRI Other disorders of Rujuk Lanjut
Eustachian tube
2479 12-03-2018 0137U0040318Y001377 0001466809986 NANI SUWARNI P PENERIMA PENSIUN Chronic renal failure, Rujuk Lanjut
PNS unspecified
2480 12-03-2018 0137U0040318Y001470 0001468347682 GOLSAR MANAHAN SIAHAAN L PEKERJA MANDIRI Impacted teeth Berobat Jalan

2481 12-03-2018 0137U0040318Y001471 0001468347726 GRETTI PRIMINA SIAHAAN P PEKERJA MANDIRI Impacted teeth Berobat Jalan

2482 12-03-2018 0137U0040318Y001379 0001472263165 ILYAS L PEKERJA MANDIRI Congestive heart failure Rujuk Lanjut

2483 12-03-2018 0137U0040318Y001418 0001472914405 SHILLA AZZAHRA PERTIWI P ANGGOTA POLRI Acute upper respiratory Berobat Jalan
infection, unspecified
2484 12-03-2018 0137U0040318Y001398 0001474330116 SUHATI P PEKERJA MANDIRI Presbyopia Rujuk Lanjut

2485 12-03-2018 0137U0040318Y001400 0001474330151 FATURRAHMAN L PEKERJA MANDIRI Myopia Rujuk Lanjut

2486 12-03-2018 0137U0040318Y001314 0001477134909 SUHENDI L PEKERJA MANDIRI Myalgia Berobat Jalan

2487 12-03-2018 0137U0040318Y001388 0001481819747 DESRI GUNAWAN P PEGAWAI SWASTA Acute upper respiratory Berobat Jalan
infection, unspecified
2488 12-03-2018 0137U0040318Y001350 0001514788389 WAHYUNINGSIH P PEGAWAI SWASTA Caries of dentine Berobat Jalan

2489 12-03-2018 0137U0040318Y001305 0001519297198 ADE SUHERMAN L PEGAWAI SWASTA Oedema, unspecified Berobat Jalan
DAFTAR KUNJUNGAN PESERTA SAKIT

Kantor Cabang : BEKASI - 1011

FKTP : Klinik Mitra Medika - 0137U004

2490 12-03-2018 0137U0040318Y001306 0001624408593 FADILA SRI P PEKERJA MANDIRI Acute upper respiratory Berobat Jalan
infection, unspecified
2491 12-03-2018 0137U0040318Y001327 0001624813435 SUMARMAN L PEGAWAI SWASTA Non-insulin-dependent Berobat Jalan
diabetes mellitus with

2492 12-03-2018 0137U0040318Y001467 0001627878205 Mutiara Mega Pradhana P PEGAWAI SWASTA Necrosis of pulp Berobat Jalan

2493 12-03-2018 0137U0040318Y001429 0001628561226 IBRAHIM Z.W. P PEGAWAI SWASTA Acute upper respiratory Berobat Jalan
infection, unspecified
2494 12-03-2018 0137U0040318Y001411 0001629187738 DEWI SYAFA HARIANTI P PEGAWAI SWASTA Acute upper respiratory Berobat Jalan
infection, unspecified
2495 12-03-2018 0137U0040318Y001442 0001629386572 DIAN WIDYA PALUPI P PEGAWAI SWASTA Low back pain Berobat Jalan

2496 12-03-2018 0137U0040318Y001363 0001632933009 KEENAN EL-ZAKIR ANAQIE L PEKERJA MANDIRI Other and unspecified Berobat Jalan
infectious diseases
2497 12-03-2018 0137U0040318Y001366 0001635695111 HARI KURNIAWAN L PEGAWAI SWASTA Myalgia Berobat Jalan

2498 12-03-2018 0137U0040318Y001427 0001639990539 NONI TRIS ANANDITA. SIKOM P PEGAWAI BUMN Acute upper respiratory Berobat Jalan
infection, unspecified
2499 12-03-2018 0137U0040318Y001453 0001645682409 JOKO ADI SAPUTRO L PEGAWAI SWASTA Other and unspecified Berobat Jalan
infectious diseases
2500 12-03-2018 0137U0040318Y001368 0001646135763 TOTOK WAHONO L PEKERJA MANDIRI Myalgia Berobat Jalan

2501 12-03-2018 0137U0040318Y001328 0001655717714 ARIF DARMAWAN L PEGAWAI SWASTA Acute pharyngitis, Berobat Jalan
unspecified
2502 12-03-2018 0137U0040318Y001396 0001655927752 PRASETYO BUDI SANTOSO L PEKERJA MANDIRI Primary generalized Rujuk Lanjut
(osteo)arthrosis
2503 12-03-2018 0137U0040318Y001432 0001657087277 SUWITO L PEKERJA MANDIRI Acute upper respiratory Berobat Jalan
infection, unspecified
2504 12-03-2018 0137U0040318Y001349 0001658992252 DRS.CECE HIDAYAT L PEGAWAI BUMD Anaemia in neoplastic Rujuk Lanjut
disease
2505 12-03-2018 0137U0040318Y001426 0001659114448 ELZA ATIKA RAHMA P PEGAWAI SWASTA Acute upper respiratory Berobat Jalan
infection, unspecified
2506 12-03-2018 0137U0040318Y001428 0001668101771 THOLIB L PEGAWAI BUMN Dyspepsia Berobat Jalan

2507 12-03-2018 0137U0040318Y001409 0001719423696 HURIATUL AINI, SE P PEKERJA MANDIRI Myalgia Berobat Jalan

2508 12-03-2018 0137U0040318Y001335 0001720706938 RAHARJO L PEKERJA MANDIRI Bronchopneumonia, Berobat Jalan
unspecified
2509 12-03-2018 0137U0040318Y001301 0001725431319 IMAM AKBAR RAFSANJANI L PEKERJA MANDIRI Necrosis of pulp Rujuk Lanjut

2510 12-03-2018 0137U0040318Y001465 0001730125315 DAVID RICARDO L PEKERJA MANDIRI Chronic gingivitis Berobat Jalan

2511 12-03-2018 0137U0040318Y001338 0001732598436 HERAWATI P PEKERJA MANDIRI Other antenatal screening Berobat Jalan

2512 12-03-2018 0137U0040318Y001356 0001805189815 Jordi Kristanto L PEGAWAI SWASTA Other and unspecified Berobat Jalan
infectious diseases
DAFTAR KUNJUNGAN PESERTA SAKIT

Kantor Cabang : BEKASI - 1011

FKTP : Klinik Mitra Medika - 0137U004

2513 12-03-2018 0137U0040318Y001412 0001809627658 SULASTRI P PEKERJA MANDIRI Dermatitis herpetiformis Berobat Jalan

2514 12-03-2018 0137U0040318Y001407 0001810703992 SUHADI L PEGAWAI SWASTA Secondary hypertension, Berobat Jalan
unspecified
2515 12-03-2018 0137U0040318Y001345 0001830749499 ATHAILLAH WAFI EL RASYID L PEGAWAI SWASTA Chronic gingivitis Berobat Jalan
IRMANSYAH
2516 12-03-2018 0137U0040318Y001330 0001831208499 RACHMAT KATILI BASARAH L PEGAWAI PEMERINTAH Dyspepsia Rujuk Lanjut
DENGAN PERJANJIAN

2517 12-03-2018 0137U0040318Y001434 0001833440141 NORA PARDEDE P PEKERJA MANDIRI Myalgia Berobat Jalan

2518 12-03-2018 0137U0040318Y001297 0001834791063 SUSILO L PEKERJA MANDIRI Cataract, unspecified Rujuk Lanjut

2519 12-03-2018 0137U0040318Y001313 0001834791636 kusminah P PEKERJA MANDIRI Myalgia Berobat Jalan

2520 12-03-2018 0137U0040318Y001336 0001847201409 ARSHA PUJA MAHESA L PEGAWAI SWASTA Acute upper respiratory Berobat Jalan
infection, unspecified
2521 12-03-2018 0137U0040318Y001431 0001852548669 PRISTIKA DEWI P PEKERJA MANDIRI Myopia Berobat Jalan

2522 12-03-2018 0137U0040318Y001449 0001863607498 INDI ROHENDI L PEKERJA MANDIRI Acute upper respiratory Berobat Jalan
infection, unspecified
2523 12-03-2018 0137U0040318Y001443 0001871102092 susanti wulandari P PEKERJA MANDIRI Acute upper respiratory Berobat Jalan
infection, unspecified
2524 12-03-2018 0137U0040318Y001445 0001871102384 riviera manggala putri P PEKERJA MANDIRI Acute upper respiratory Berobat Jalan
infection, unspecified
2525 12-03-2018 0137U0040318Y001444 0001871102957 BAYI NY SUSANTI WULANDARI P PEKERJA MANDIRI Acute upper respiratory Berobat Jalan
infection, unspecified
2526 12-03-2018 0137U0040318Y001389 0001871888703 raisya kayla nurhasanah P PEKERJA MANDIRI Acute suppurative otitis Rujuk Lanjut
media
2527 12-03-2018 0137U0040318Y001359 0001882730259 RETI ROSTIATI P PEKERJA MANDIRI Coronary artery aneurysm Rujuk Lanjut

2528 12-03-2018 0137U0040318Y001433 0001888068993 SEAN KRISTIANTO L PEKERJA MANDIRI Acute upper respiratory Berobat Jalan
infection, unspecified
2529 12-03-2018 0137U0040318Y001309 0001895229876 PONIRIN L PEKERJA MANDIRI Myalgia Berobat Jalan

2530 12-03-2018 0137U0040318Y001463 0001898996185 OMO SINEN L PEKERJA MANDIRI Impacted teeth Berobat Jalan

2531 12-03-2018 0137U0040318Y001341 0001963394076 khansa jauzaa aqiilah P PNS DAERAH Chronic gingivitis Berobat Jalan

2532 12-03-2018 0137U0040318Y001307 0001969183416 MUHAMMAD IZZAN L PEGAWAI SWASTA Acute pharyngitis, Berobat Jalan
unspecified
2533 12-03-2018 0137U0040318Y001357 0002101282244 DAHLIA P PEGAWAI SWASTA Myalgia Berobat Jalan

2534 12-03-2018 0137U0040318Y001358 0002101282266 EVAN FADHLURRAHMAN L PEGAWAI SWASTA Acute upper respiratory Berobat Jalan
infection, unspecified
2535 12-03-2018 0137U0040318Y001316 0002196726478 muhammad rasyid al ghufran L PEKERJA MANDIRI Acute upper respiratory Berobat Jalan
infection, unspecified
DAFTAR KUNJUNGAN PESERTA SAKIT

Kantor Cabang : BEKASI - 1011

FKTP : Klinik Mitra Medika - 0137U004

2536 12-03-2018 0137U0040318Y001360 0002217322045 DHIKA YUSUF ARDIANSYAH L PEKERJA MANDIRI Other secondary arthrosis Berobat Jalan

2537 12-03-2018 0137U0040318Y001430 0002231004846 NURAINI P PEKERJA MANDIRI Acute upper respiratory Berobat Jalan
infection, unspecified
2538 12-03-2018 0137U0040318Y001339 0002238692106 TARA TANIA YASMIN P PEGAWAI SWASTA Other antenatal screening Berobat Jalan

2539 12-03-2018 0137U0040318Y001374 0002239262673 DEDY EFFENDY,SH L PEGAWAI SWASTA Disorder of refraction, Rujuk Lanjut
unspecified
2540 12-03-2018 0137U0040318Y001439 0002239439523 BAYI NY RIRIN INGGAR P PEGAWAI BUMN Dermatitis herpetiformis Berobat Jalan
HANDITYA
2541 12-03-2018 0137U0040318Y001392 0002258522019 AZZAM DAFFA PRATAMA L PEGAWAI SWASTA Acute upper respiratory Berobat Jalan
infection, unspecified
2542 12-03-2018 0137U0040318Y001460 0002263777571 HERMAN L PEKERJA MANDIRI Dental caries, unspecified Berobat Jalan

2543 12-03-2018 0137U0040318Y001455 0002263777659 SUMARNI JULAEHA P PEKERJA MANDIRI Myalgia Berobat Jalan

2544 12-03-2018 0137U0040318Y001454 0002263777773 MUHAMMAD SALMAN L PEKERJA MANDIRI Acute upper respiratory Berobat Jalan
SAPUTRA infection, unspecified
2545 12-03-2018 0137U0040318Y001391 0002285115682 ALI AHMAD ALTHA FARIZQI L PEGAWAI SWASTA Acute upper respiratory Berobat Jalan
infection, unspecified
2546 12-03-2018 0137U0040318Y001394 0002295124582 yuliana P PEKERJA MANDIRI Other antenatal screening Berobat Jalan

2547 12-03-2018 0137U0040318Y001448 0002315020735 AGUS SATRIA L PEGAWAI SWASTA Dermatitis herpetiformis Berobat Jalan

2548 12-03-2018 0137U0040318Y001369 0002430811888 SAPRI L PEKERJA MANDIRI Chronic ischaemic heart Rujuk Lanjut
disease
2549 11-03-2018 0137U0040318Y001227 0000038329097 YUSMAN AKBAR TURATEA L PNS PUSAT Other and unspecified Rujuk Lanjut
abdominal pain
2550 11-03-2018 0137U0040318Y001228 0000038329108 SITI MASITOH P PNS PUSAT Unspecified contact Rujuk Lanjut
dermatitis
2551 11-03-2018 0137U0040318Y001226 0000043459277 ERNAWATI P PENERIMA PENSIUN Psoriasis, unspecified Rujuk Lanjut
PNS
2552 11-03-2018 0137U0040318Y001236 0000072891909 CITRA MAYA P PNS DAERAH Other and unspecified Berobat Jalan
abdominal pain
2553 11-03-2018 0137U0040318Y001283 0000073280395 TATI HARYATI P PENERIMA PENSIUN Acute upper respiratory Berobat Jalan
PNS infection, unspecified
2554 11-03-2018 0137U0040318Y001265 0000073531269 ENDAH SUSANTI PUJIASTUTI, P PNS DAERAH Threatened abortion Rujuk Lanjut
S.Pd.
2555 11-03-2018 0137U0040318Y001274 0001126446535 ABDUL MUKHLIS L PEGAWAI SWASTA Dyspepsia Berobat Jalan

2556 11-03-2018 0137U0040318Y001247 0001154691527 SUGENG HANDOYO L PEGAWAI SWASTA Myalgia Berobat Jalan

2557 11-03-2018 0137U0040318Y001250 0001203921382 HAZEL HAURA FLAVIA P PEGAWAI SWASTA Varicella encephalitis Berobat Jalan

2558 11-03-2018 0137U0040318Y001248 0001204199987 THALITA ALSHIRA P PEGAWAI SWASTA Acute sinusitis Berobat Jalan
DAFTAR KUNJUNGAN PESERTA SAKIT

Kantor Cabang : BEKASI - 1011

FKTP : Klinik Mitra Medika - 0137U004

2559 11-03-2018 0137U0040318Y001266 0001257602703 SRI LESTARI P PEKERJA MANDIRI Other specified diabetes Rujuk Lanjut
mellitus with unspecified

2560 11-03-2018 0137U0040318Y001246 0001260726309 WINDA AGUSTIN P PEKERJA MANDIRI Typhoid fever Berobat Jalan

2561 11-03-2018 0137U0040318Y001237 0001260894385 MOHAMAD RACHMAN L PEKERJA MANDIRI Acute upper respiratory Berobat Jalan
infection, unspecified
2562 11-03-2018 0137U0040318Y001238 0001273204427 DEA ANDINI ANDRIANTI P PEGAWAI BUMN Acute upper respiratory Berobat Jalan
infection, unspecified
2563 11-03-2018 0137U0040318Y001232 0001276535777 SUKARTO L PEKERJA MANDIRI Other cataract Rujuk Lanjut

2564 11-03-2018 0137U0040318Y001239 0001276536014 SITI ZAENAB P PEKERJA MANDIRI Gastro-oesophageal reflux Berobat Jalan
disease without

2565 11-03-2018 0137U0040318Y001285 0001295875067 SOFYAN PUDJADI L PEGAWAI SWASTA Diarrhoea and Berobat Jalan
gastroenteritis of
presumed infectious origin

2566 11-03-2018 0137U0040318Y001268 0001304792346 YAN KURNIAWAN L PEKERJA MANDIRI Insulin-dependent Rujuk Lanjut
diabetes mellitus with

2567 11-03-2018 0137U0040318Y001269 0001304792998 SURINI DARMANI P PEKERJA MANDIRI Non-insulin-dependent Rujuk Lanjut
diabetes mellitus with

2568 11-03-2018 0137U0040318Y001296 0001311832743 minah P PEKERJA MANDIRI Dyspepsia Berobat Jalan

2569 11-03-2018 0137U0040318Y001253 0001336962363 JOSUA ARMANDO L PEKERJA MANDIRI Other specified headache Berobat Jalan
syndromes
2570 11-03-2018 0137U0040318Y001276 0001371216846 WAHYU ISMANTO L PEGAWAI SWASTA Diarrhoea and Berobat Jalan
gastroenteritis of
presumed infectious origin

2571 11-03-2018 0137U0040318Y001251 0001384482249 LIDYA KALINDA P PEKERJA MANDIRI Other and unspecified Berobat Jalan
abdominal pain
2572 11-03-2018 0137U0040318Y001252 0001428242433 TARYANA L PEKERJA MANDIRI Acute upper respiratory Berobat Jalan
infection, unspecified
2573 11-03-2018 0137U0040318Y001230 0001428244503 IKAH WARNIKAH P PEKERJA MANDIRI Non-insulin-dependent Rujuk Lanjut
diabetes mellitus without

2574 11-03-2018 0137U0040318Y001233 0001430434629 DESSY SUSANTY P PEKERJA MANDIRI Thyrotoxicosis, Rujuk Lanjut
unspecified
2575 11-03-2018 0137U0040318Y001293 0001462877932 HELDA MAMBU P PEKERJA MANDIRI Other specified headache Berobat Jalan
syndromes
2576 11-03-2018 0137U0040318Y001267 0001468292951 KWET KAUW P PEKERJA MANDIRI Other anxiety disorders Rujuk Lanjut
DAFTAR KUNJUNGAN PESERTA SAKIT

Kantor Cabang : BEKASI - 1011

FKTP : Klinik Mitra Medika - 0137U004

2577 11-03-2018 0137U0040318Y001271 0001476106064 RAHMAT FIRMANSYAH L PEKERJA MANDIRI Schizophrenia, unspecified Rujuk Lanjut

2578 11-03-2018 0137U0040318Y001284 0001483409709 alfarezcka faidillah muhammad L PEGAWAI SWASTA Acute upper respiratory Berobat Jalan
infection, unspecified
2579 11-03-2018 0137U0040318Y001231 0001516373199 DWI WAHYU SUDIATMOKO P PEGAWAI SWASTA Conjunctivitis, unspecified Rujuk Lanjut

2580 11-03-2018 0137U0040318Y001275 0001625364257 USMAN EFFENDI L PEGAWAI SWASTA Myalgia Berobat Jalan

2581 11-03-2018 0137U0040318Y001273 0001643431127 BILQIS FARHAH ATHAYA P PEGAWAI SWASTA Other and unspecified Berobat Jalan
infectious diseases
2582 11-03-2018 0137U0040318Y001242 0001644105677 H. DENNY RIDWAN L PEKERJA MANDIRI Acute upper respiratory Berobat Jalan
infection, unspecified
2583 11-03-2018 0137U0040318Y001272 0001648009495 HELEN MELIANA P PEGAWAI SWASTA Acute upper respiratory Berobat Jalan
infection, unspecified
2584 11-03-2018 0137U0040318Y001270 0001648009528 CHELLSY IVANA CALISTA P PEGAWAI SWASTA Other and unspecified Berobat Jalan
infectious diseases
2585 11-03-2018 0137U0040318Y001289 0001657482851 LUTFIYANTI P PEGAWAI SWASTA Dyspepsia Berobat Jalan

2586 11-03-2018 0137U0040318Y001291 0001657482862 ASYIFAH PUJIANTI P PEGAWAI SWASTA Other and unspecified Berobat Jalan
infectious diseases
2587 11-03-2018 0137U0040318Y001240 0001729412921 FIKA NUR FADILA P PEKERJA MANDIRI Acute upper respiratory Berobat Jalan
infection, unspecified
2588 11-03-2018 0137U0040318Y001280 0001742013191 TRI AGENG PRASETYO L PEGAWAI SWASTA Dyspepsia Berobat Jalan

2589 11-03-2018 0137U0040318Y001245 0001768317906 MUNADIH BIN NYAIN L PEGAWAI SWASTA Nummular dermatitis Berobat Jalan

2590 11-03-2018 0137U0040318Y001244 0001768317928 MUHAMMAD DENDI SAPUTRA L PEGAWAI SWASTA Dermatitis herpetiformis Berobat Jalan

2591 11-03-2018 0137U0040318Y001282 0001769446552 KONRISTA VIN YECIA P PEGAWAI SWASTA Diarrhoea and Berobat Jalan
gastroenteritis of
presumed infectious origin

2592 11-03-2018 0137U0040318Y001292 0001774477721 SALMA SALSABILA BACHRI P PEGAWAI SWASTA Acute upper respiratory Berobat Jalan
infection, unspecified
2593 11-03-2018 0137U0040318Y001288 0001797513298 SEFTY LAYLA AHDA FISHIYAM P PEGAWAI SWASTA Acute upper respiratory Berobat Jalan
infection, unspecified
2594 11-03-2018 0137U0040318Y001255 0001807039348 r handono L PEKERJA MANDIRI Disorder of kidney and Rujuk Lanjut
ureter, unspecified
2595 11-03-2018 0137U0040318Y001281 0001834654015 RAZKA AHMED MIDO L PEGAWAI SWASTA Acute upper respiratory Berobat Jalan
infection, unspecified
2596 11-03-2018 0137U0040318Y001294 0001844688914 APRIYANTO NATASANJAYA L PEKERJA MANDIRI Dermatitis herpetiformis Berobat Jalan
NAPITUPULU
2597 11-03-2018 0137U0040318Y001295 0001844689331 YOSEVINA METARAY P PEKERJA MANDIRI Other and unspecified Berobat Jalan
abdominal pain
2598 11-03-2018 0137U0040318Y001279 0001851077428 MUHAMMAD RAYA SYADEFA L PEGAWAI SWASTA Multiple superficial injuries, Berobat Jalan
unspecified
DAFTAR KUNJUNGAN PESERTA SAKIT

Kantor Cabang : BEKASI - 1011

FKTP : Klinik Mitra Medika - 0137U004

2599 11-03-2018 0137U0040318Y001287 0001874088911 WENING AYUNING TYAS P PEGAWAI SWASTA Other and unspecified Berobat Jalan
infectious diseases
2600 11-03-2018 0137U0040318Y001278 0001876129053 AMAMNDA SHABRINA P PEGAWAI SWASTA Acute upper respiratory Berobat Jalan
ALAWIYAH infection, unspecified
2601 11-03-2018 0137U0040318Y001277 0001906826229 eliza P PEKERJA MANDIRI Acute abdomen Berobat Jalan

2602 11-03-2018 0137U0040318Y001254 0001965583901 nurhayati P PEKERJA MANDIRI Acute sinusitis Berobat Jalan

2603 11-03-2018 0137U0040318Y001256 0002063315147 SONYA VILARINA P PEGAWAI SWASTA Mixed asthma Rujuk Lanjut

2604 11-03-2018 0137U0040318Y001249 0002070133233 JONI PAREMISA L PEKERJA MANDIRI Other secondary arthrosis Berobat Jalan

2605 11-03-2018 0137U0040318Y001235 0002195506102 FARUQ MALIK AKRAM L PEGAWAI SWASTA Typhoid fever Berobat Jalan

2606 11-03-2018 0137U0040318Y001290 0002208339246 FAJAR DWI SATRIO L PEGAWAI PEMERINTAH Multiple superficial injuries, Berobat Jalan
DENGAN PERJANJIAN unspecified

2607 11-03-2018 0137U0040318Y001286 0002209911939 SUMIYATI P PEKERJA MANDIRI Multiple superficial injuries, Berobat Jalan
unspecified
2608 11-03-2018 0137U0040318Y001243 0002245350587 EDDY POERNAWAN L PEKERJA MANDIRI Unspecified haemorrhoids Berobat Jalan
without complication

2609 11-03-2018 0137U0040318Y001234 0002245351239 DJUMINEM NARIYYAH L PEKERJA MANDIRI Other secondary arthrosis Rujuk Lanjut

2610 11-03-2018 0137U0040318Y001229 0002295735388 NAUFAL RIZKY ATHALLAH L PEGAWAI SWASTA Fever, unspecified Rujuk Lanjut

2611 11-03-2018 0137U0040318Y001241 0002297172341 FIRDA MAULIDYA P PEKERJA MANDIRI Acute upper respiratory Berobat Jalan
infection, unspecified
2612 10-03-2018 0137U0040318Y001122 0000016041791 ARMEND L PENERIMA PENSIUN Impacted teeth Berobat Jalan
PNS
2613 10-03-2018 0137U0040318Y001216 0000036725501 SYAIFUL ISKANDAR L PNS DAERAH Impacted teeth Berobat Jalan

2614 10-03-2018 0137U0040318Y001150 0000040975503 LISTIA AMBARWATI P PNS DAERAH Hypertensive heart Rujuk Lanjut
disease without

2615 10-03-2018 0137U0040318Y001175 0000041118254 MAMAT L PNS DAERAH Acute upper respiratory Berobat Jalan
infection, unspecified
2616 10-03-2018 0137U0040318Y001174 0000041118287 MUTIARA NOFIYANTI P PNS DAERAH Acute upper respiratory Berobat Jalan
infection, unspecified
2617 10-03-2018 0137U0040318Y001136 0000042210167 GRESNAWATI DARJANTO P PNS PUSAT Myalgia Berobat Jalan

2618 10-03-2018 0137U0040318Y001112 0000073276885 sardi sumadi al sumadi L PENERIMA PENSIUN Acute upper respiratory Berobat Jalan
PNS infection, unspecified
2619 10-03-2018 0137U0040318Y001177 0000073401715 IDA ROSIDA P PNS DAERAH Other and unspecified Berobat Jalan
abdominal pain
2620 10-03-2018 0137U0040318Y001164 0000157957446 BAMBANG SUGENG L PENERIMA PENSIUN TNI Other specified headache Berobat Jalan
syndromes
DAFTAR KUNJUNGAN PESERTA SAKIT

Kantor Cabang : BEKASI - 1011

FKTP : Klinik Mitra Medika - 0137U004

2621 10-03-2018 0137U0040318Y001213 0000209209702 MARWAN KHAIRAN L PNS DAERAH Gastro-oesophageal reflux Berobat Jalan
disease without

2622 10-03-2018 0137U0040318Y001114 0001101750041 BUDI ANTORO L TNI ANGKATAN DARAT Fracture of lower end of Rujuk Lanjut
radius
2623 10-03-2018 0137U0040318Y001187 0001128611351 KURNIADI L PEGAWAI SWASTA Typhoid fever Berobat Jalan

2624 10-03-2018 0137U0040318Y001172 0001147196654 TARMUZI L PEGAWAI SWASTA Myalgia Berobat Jalan

2625 10-03-2018 0137U0040318Y001206 0001154809394 SITI HOLIFAH P PEGAWAI SWASTA Acute pharyngitis, Berobat Jalan
unspecified
2626 10-03-2018 0137U0040318Y001218 0001166833473 KHALILA RYAN PUTRI P PEKERJA MANDIRI Impacted teeth Berobat Jalan

2627 10-03-2018 0137U0040318Y001201 0001172354771 REVAL L PEGAWAI SWASTA Acute upper respiratory Berobat Jalan
infection, unspecified
2628 10-03-2018 0137U0040318Y001212 0001195317033 FIRLI KARIMA RACHMA P PEGAWAI SWASTA Typhoid fever Berobat Jalan

2629 10-03-2018 0137U0040318Y001152 0001207944483 YON HENDRA A M, S.SI. L PEKERJA MANDIRI Other arthrosis Rujuk Lanjut

2630 10-03-2018 0137U0040318Y001220 0001257257261 RIZAL INDRA TJAHYA L PEKERJA MANDIRI Necrosis of pulp Berobat Jalan

2631 10-03-2018 0137U0040318Y001102 0001257633652 ETTY ROCHAETI P PEKERJA MANDIRI Acute upper respiratory Berobat Jalan
infection, unspecified
2632 10-03-2018 0137U0040318Y001194 0001258881873 SURYA WINARA BEY L PEKERJA MANDIRI Acute upper respiratory Berobat Jalan
infection, unspecified
2633 10-03-2018 0137U0040318Y001224 0001258952771 TUTWURI HANDAYANI P PEGAWAI SWASTA Impacted teeth Berobat Jalan

2634 10-03-2018 0137U0040318Y001171 0001259114984 SAMUEL SIMANJUNTAK L PEKERJA MANDIRI Gastro-oesophageal reflux Berobat Jalan
disease without

2635 10-03-2018 0137U0040318Y001263 0001259238609 FLORENTINE PHOEI P PEKERJA MANDIRI Impacted teeth Berobat Jalan

2636 10-03-2018 0137U0040318Y001264 0001259265835 MARCELINO CHRISTIAN BENA L PEKERJA MANDIRI Abrasion of teeth Berobat Jalan

2637 10-03-2018 0137U0040318Y001134 0001260354071 SUCIYANAH NABILLAH PUTRI P PEKERJA MANDIRI Hypermetropia Rujuk Lanjut

2638 10-03-2018 0137U0040318Y001159 0001265279927 SUMARNI P PEKERJA MANDIRI Other specified headache Berobat Jalan
syndromes
2639 10-03-2018 0137U0040318Y001157 0001271911498 FERDIE E.S.KIROH L PENERIMA PENSIUN Panic disorder [episodic Rujuk Lanjut
SWASTA paroxysmal anxiety]
2640 10-03-2018 0137U0040318Y001208 0001272010972 HAMZAH ARAFAH BACHTIAR L PEGAWAI SWASTA Acute upper respiratory Berobat Jalan
infection, unspecified
2641 10-03-2018 0137U0040318Y001118 0001273454649 MOCHAMAD HUSEN L PEGAWAI SWASTA Impacted teeth Berobat Jalan

2642 10-03-2018 0137U0040318Y001119 0001273454853 NURAENY P PEGAWAI SWASTA Impacted teeth Berobat Jalan

2643 10-03-2018 0137U0040318Y001137 0001275766457 ORIETTA P ANGGOTA POLRI Acute upper respiratory Berobat Jalan
infection, unspecified
DAFTAR KUNJUNGAN PESERTA SAKIT

Kantor Cabang : BEKASI - 1011

FKTP : Klinik Mitra Medika - 0137U004

2644 10-03-2018 0137U0040318Y001190 0001283172186 GORGARETTA PANJAITAN P PEKERJA MANDIRI Acute upper respiratory Berobat Jalan
infection, unspecified
2645 10-03-2018 0137U0040318Y001189 0001283174098 maudya PANJAITAN P PEKERJA MANDIRI Acute upper respiratory Berobat Jalan
infection, unspecified
2646 10-03-2018 0137U0040318Y001090 0001312829289 SUTARMIATI P PEKERJA MANDIRI Other arthrosis Rujuk Lanjut

2647 10-03-2018 0137U0040318Y001154 0001314474557 daddy suryadi L PEKERJA MANDIRI Stroke, not specified as Rujuk Lanjut
haemorrhage or infarction
2648 10-03-2018 0137U0040318Y001120 0001317110624 ADE CHRISTYAWATI P PEGAWAI SWASTA Disorder of refraction, Rujuk Lanjut
unspecified
2649 10-03-2018 0137U0040318Y001151 0001335844091 H.BAMBANG MUNGKASONO L PEKERJA MANDIRI Other specified abnormal Rujuk Lanjut
uterine and vaginal

2650 10-03-2018 0137U0040318Y001158 0001335846363 CHRISTINA R INDRIANINGRUM P PEKERJA MANDIRI Dermatitis herpetiformis Berobat Jalan

2651 10-03-2018 0137U0040318Y001131 0001338039235 PIANI YUNIAR P PEKERJA MANDIRI Acute upper respiratory Berobat Jalan
infection, unspecified
2652 10-03-2018 0137U0040318Y001110 0001370343374 CECILYA CINTHYA HANDAYANI P PEGAWAI SWASTA Acute upper respiratory Berobat Jalan
S infection, unspecified
2653 10-03-2018 0137U0040318Y001207 0001370945441 SISKA MEILISA P PEGAWAI SWASTA Acute upper respiratory Berobat Jalan
infection, unspecified
2654 10-03-2018 0137U0040318Y001219 0001374156279 ANDRA BHASKARA SYAZANI L PEGAWAI SWASTA Abrasion of teeth Berobat Jalan

2655 10-03-2018 0137U0040318Y001117 0001387894724 YEHEZKIEL KALUMATA L PEKERJA MANDIRI Dental caries, unspecified Berobat Jalan

2656 10-03-2018 0137U0040318Y001178 0001427195215 mariah P PEKERJA MANDIRI Other and unspecified Berobat Jalan
abdominal pain
2657 10-03-2018 0137U0040318Y001197 0001428123699 RETNO EDI SETIAWATI P PEKERJA MANDIRI Acute upper respiratory Berobat Jalan
infection, unspecified
2658 10-03-2018 0137U0040318Y001156 0001429962197 TABIRUL HERIYANTO L PEKERJA MANDIRI Chronic obstructive Rujuk Lanjut
pulmonary disease,

2659 10-03-2018 0137U0040318Y001128 0001430867766 suryaning ati P PEGAWAI SWASTA Other and unspecified Berobat Jalan
infectious diseases
2660 10-03-2018 0137U0040318Y001129 0001430870128 kirania azzahra putri antoni L PEGAWAI SWASTA Acute upper respiratory Berobat Jalan
infection, unspecified
2661 10-03-2018 0137U0040318Y001138 0001431681895 ROS INTAN TOBING P PEKERJA MANDIRI Acute upper respiratory Berobat Jalan
infection, unspecified
2662 10-03-2018 0137U0040318Y001200 0001435571897 syuryati P PEKERJA MANDIRI Typhoid fever Berobat Jalan

2663 10-03-2018 0137U0040318Y001094 0001439054291 HENNY MELIA P PEKERJA MANDIRI Other rheumatoid arthritis Rujuk Lanjut

2664 10-03-2018 0137U0040318Y001181 0001452132134 SRIANAH.WD P PEKERJA MANDIRI Other specified headache Berobat Jalan
syndromes
2665 10-03-2018 0137U0040318Y001167 0001454929064 DARMAWAN HALIM L PEKERJA MANDIRI Dyspepsia Berobat Jalan
DAFTAR KUNJUNGAN PESERTA SAKIT

Kantor Cabang : BEKASI - 1011

FKTP : Klinik Mitra Medika - 0137U004

2666 10-03-2018 0137U0040318Y001168 0001454932168 CHINTYA YUNITA P PEKERJA MANDIRI Stomatitis and related Berobat Jalan
lesions
2667 10-03-2018 0137U0040318Y001108 0001455057213 HENNIH P PEGAWAI SWASTA Acute upper respiratory Berobat Jalan
infection, unspecified
2668 10-03-2018 0137U0040318Y001101 0001455153759 HABIBI HADJAMI L PEKERJA MANDIRI Acute upper respiratory Berobat Jalan
infection, unspecified
2669 10-03-2018 0137U0040318Y001125 0001455955435 SUGENG PRAPTOLO L PEKERJA MANDIRI Vertigo of central origin Berobat Jalan

2670 10-03-2018 0137U0040318Y001113 0001455956482 SITI HARTINI P PEKERJA MANDIRI Hypertensive heart Rujuk Lanjut
disease
2671 10-03-2018 0137U0040318Y001257 0001456957449 CALISTAMA PUTRI ASMIN P PEKERJA MANDIRI Acute upper respiratory Berobat Jalan
infection, unspecified
2672 10-03-2018 0137U0040318Y001262 0001456957528 ULIYANTI HANNA NATALIA P PEKERJA MANDIRI Other antenatal screening Berobat Jalan

2673 10-03-2018 0137U0040318Y001258 0001466924433 SITI AISAH P PEGAWAI SWASTA Other contraceptive Berobat Jalan
management
2674 10-03-2018 0137U0040318Y001142 0001467131488 LESTY WIDIANINGSIH P PEGAWAI SWASTA Other specified headache Berobat Jalan
syndromes
2675 10-03-2018 0137U0040318Y001096 0001471812693 SUN LIN KURNIA P PEKERJA MANDIRI Fracture of lower end of Berobat Jalan
radius
2676 10-03-2018 0137U0040318Y001146 0001480605085 DEDI SUPRIADI L PEGAWAI SWASTA Other specified headache Berobat Jalan
syndromes
2677 10-03-2018 0137U0040318Y001165 0001482215499 CECILIA NATASYA P PEKERJA MANDIRI Meningitis, unspecified Rujuk Lanjut

2678 10-03-2018 0137U0040318Y001184 0001483084056 BIMA IBRAHIM.P L PEKERJA MANDIRI Nausea and vomiting Berobat Jalan

2679 10-03-2018 0137U0040318Y001223 0001516380647 RIESTA AJENG KARTINI P PEKERJA MANDIRI Abrasion of teeth Berobat Jalan

2680 10-03-2018 0137U0040318Y001193 0001517348204 KUSNADI L PEGAWAI SWASTA Other and unspecified Berobat Jalan
abdominal pain
2681 10-03-2018 0137U0040318Y001162 0001517348215 SITI SARAH HAZJAH P PEGAWAI SWASTA Disorders of refraction and Rujuk Lanjut
accommodation
2682 10-03-2018 0137U0040318Y001141 0001517707484 ZAHRUDIN L PEGAWAI SWASTA Myalgia Berobat Jalan

2683 10-03-2018 0137U0040318Y001160 0001522149039 YOHANES NELSEN C P PEGAWAI SWASTA Gastro-oesophageal reflux Berobat Jalan
disease without

2684 10-03-2018 0137U0040318Y001153 0001548819437 RISNA ANGGRAENI P PEGAWAI SWASTA Multiple delivery, all by Rujuk Lanjut
caesarean section
2685 10-03-2018 0137U0040318Y001155 0001610194386 KRISTIAN BANGUN KuaSAR L PEGAWAI SWASTA Chronic ischaemic heart Rujuk Lanjut
disease, unspecified
2686 10-03-2018 0137U0040318Y001103 0001628949317 RESTI ANGGRAINI P PEGAWAI SWASTA Acute upper respiratory Berobat Jalan
infection, unspecified
2687 10-03-2018 0137U0040318Y001140 0001637023454 DAFA AULIA RAMADAN L PEGAWAI SWASTA Acute upper respiratory Berobat Jalan
infection, unspecified
DAFTAR KUNJUNGAN PESERTA SAKIT

Kantor Cabang : BEKASI - 1011

FKTP : Klinik Mitra Medika - 0137U004

2688 10-03-2018 0137U0040318Y001147 0001641989215 ARIYANTO GUNAWAN L PEGAWAI SWASTA Acute pharyngitis, Berobat Jalan
unspecified
2689 10-03-2018 0137U0040318Y001180 0001643505355 EDDY KUSNADI L PEGAWAI SWASTA Acute upper respiratory Berobat Jalan
infection, unspecified
2690 10-03-2018 0137U0040318Y001179 0001643505377 VANNYA AURELIA P PEGAWAI SWASTA Acute upper respiratory Berobat Jalan
infection, unspecified
2691 10-03-2018 0137U0040318Y001124 0001644105699 FIRDHA SUCI LESTARI P PEKERJA MANDIRI Dyspepsia Berobat Jalan

2692 10-03-2018 0137U0040318Y001176 0001646135785 STEVANO TADEO L PEKERJA MANDIRI Acute upper respiratory Berobat Jalan
infection, unspecified
2693 10-03-2018 0137U0040318Y001195 0001646860937 MARLINA DAMAYANTI P PEGAWAI SWASTA Other secondary arthrosis Berobat Jalan

2694 10-03-2018 0137U0040318Y001163 0001646860959 IBRAHIM NURRASYID AKABAR L PEGAWAI SWASTA Acute bronchitis Rujuk Lanjut

2695 10-03-2018 0137U0040318Y001126 0001648009506 Hengki Limanto L PEGAWAI SWASTA Acute upper respiratory Berobat Jalan
infection, unspecified
2696 10-03-2018 0137U0040318Y001127 0001648009528 CHELLSY IVANA CALISTA P PEGAWAI SWASTA Acute upper respiratory Berobat Jalan
infection, unspecified
2697 10-03-2018 0137U0040318Y001210 0001650971913 FERI PURBASARI DINI P PEGAWAI SWASTA Acute upper respiratory Berobat Jalan
PRIMASTUTI infection, unspecified
2698 10-03-2018 0137U0040318Y001173 0001655606834 PANJI NUGRAHA SETIAWAN L PEGAWAI SWASTA Acute upper respiratory Berobat Jalan
infection, unspecified
2699 10-03-2018 0137U0040318Y001205 0001658992252 DRS.CECE HIDAYAT L PEGAWAI BUMD Acute pharyngitis, Berobat Jalan
unspecified
2700 10-03-2018 0137U0040318Y001095 0001717094081 EDDY EKO PRIYATNO L PEKERJA MANDIRI Sequelae of stroke, not Rujuk Lanjut
specified as haemorrhage

2701 10-03-2018 0137U0040318Y001148 0001717333547 BARIYAH P PEKERJA MANDIRI Acute upper respiratory Berobat Jalan
infection, unspecified
2702 10-03-2018 0137U0040318Y001198 0001721782067 INDUN NURYANINGSIH P PEKERJA MANDIRI Other secondary arthrosis Berobat Jalan

2703 10-03-2018 0137U0040318Y001202 0001721782089 TANTRI DWI P PEKERJA MANDIRI Acute upper respiratory Berobat Jalan
CAHYANINGWULAN infection, unspecified
2704 10-03-2018 0137U0040318Y001186 0001736338454 AFFAN WIBISONO L PEGAWAI SWASTA Acute upper respiratory Berobat Jalan
infection, unspecified
2705 10-03-2018 0137U0040318Y001192 0001737536027 FAYZA SALISA SYAHTIANI P PEGAWAI SWASTA Myalgia Berobat Jalan

2706 10-03-2018 0137U0040318Y001185 0001740754776 BARLIANTA.P L PEKERJA MANDIRI Other specified headache Berobat Jalan
syndromes
2707 10-03-2018 0137U0040318Y001170 0001769591092 TUKRAN L PEGAWAI SWASTA Nausea and vomiting Berobat Jalan

2708 10-03-2018 0137U0040318Y001100 0001769601238 ARI SUBEKTI P PEGAWAI SWASTA Acute upper respiratory Berobat Jalan
infection, unspecified
2709 10-03-2018 0137U0040318Y001149 0001772967295 IRWAN AFRIA KURNIAWAN L PEGAWAI SWASTA Impacted teeth Berobat Jalan
DAFTAR KUNJUNGAN PESERTA SAKIT

Kantor Cabang : BEKASI - 1011

FKTP : Klinik Mitra Medika - 0137U004

2710 10-03-2018 0137U0040318Y001259 0001779827973 IKA MULYASARI. AS P PEGAWAI SWASTA Other antenatal screening Berobat Jalan

2711 10-03-2018 0137U0040318Y001107 0001785742637 ARETA NATHANIA HARTANTO P PEGAWAI SWASTA Acute upper respiratory Berobat Jalan
infection, unspecified
2712 10-03-2018 0137U0040318Y001183 0001792208485 HENDHARTY W.H P PEKERJA MANDIRI Acute periodontitis Rujuk Lanjut

2713 10-03-2018 0137U0040318Y001222 0001826513965 ISNI WAHYUNINGTYAS P PEKERJA MANDIRI Abrasion of teeth Berobat Jalan

2714 10-03-2018 0137U0040318Y001169 0001831209063 PUTRA ADITYA PRATAMA L PEGAWAI PEMERINTAH Acute upper respiratory Berobat Jalan
NON PNS infection, unspecified
2715 10-03-2018 0137U0040318Y001196 0001833386376 maria sheila putri santoso P PEKERJA MANDIRI Typhoid fever Berobat Jalan

2716 10-03-2018 0137U0040318Y001115 0001839566968 NENIH P PEGAWAI SWASTA Impacted teeth Berobat Jalan

2717 10-03-2018 0137U0040318Y001217 0001854274015 DAFFA DHIYA ULHAQ L PEGAWAI SWASTA Dental caries, unspecified Berobat Jalan

2718 10-03-2018 0137U0040318Y001209 0001861514019 ARKAN RAMADHAN BACHTIAR L PEGAWAI SWASTA Typhoid fever Berobat Jalan

2719 10-03-2018 0137U0040318Y001109 0001872833231 ADRIEL FREDERICA BUTAR P PEGAWAI SWASTA Acute upper respiratory Berobat Jalan
BUTAR infection, unspecified
2720 10-03-2018 0137U0040318Y001097 0001882491311 arsiyati P PEKERJA MANDIRI Other specified headache Berobat Jalan
syndromes
2721 10-03-2018 0137U0040318Y001098 0001883209713 muhammad danish al raziq L PEKERJA MANDIRI Other and unspecified Berobat Jalan
infectious diseases
2722 10-03-2018 0137U0040318Y001199 0001893948783 MONICA cHARLOTTE KURNIADI P PEKERJA MANDIRI Acute upper respiratory Berobat Jalan
infection, unspecified
2723 10-03-2018 0137U0040318Y001130 0001902826798 Kimora Sachi Kayana P PEGAWAI SWASTA Acute upper respiratory Berobat Jalan
infection, unspecified
2724 10-03-2018 0137U0040318Y001203 0001968594006 NAESYLA MARTEN P PEKERJA MANDIRI Other chronic suppurative Rujuk Lanjut
otitis media
2725 10-03-2018 0137U0040318Y001139 0002032088095 INDRIANI P PEKERJA MANDIRI Other specified headache Berobat Jalan
syndromes
2726 10-03-2018 0137U0040318Y001145 0002036483561 MUHAMMAD HISYAM FERDIAN L PEKERJA MANDIRI Acute upper respiratory Berobat Jalan
infection, unspecified
2727 10-03-2018 0137U0040318Y001191 0002062815794 STEFANUS WINARTO L PEKERJA MANDIRI Acute upper respiratory Berobat Jalan
infection, unspecified
2728 10-03-2018 0137U0040318Y001133 0002070784697 IQBAL RIZKY RAFARDHAN L PEKERJA MANDIRI Conjunctivitis Berobat Jalan

2729 10-03-2018 0137U0040318Y001261 0002075805933 HERNI CAHAYANI SIDABUTAR P PEGAWAI SWASTA Other antenatal screening Berobat Jalan

2730 10-03-2018 0137U0040318Y001215 0002076001885 ERDJULIS L PEKERJA MANDIRI Dental caries, unspecified Berobat Jalan

2731 10-03-2018 0137U0040318Y001099 0002076229811 ANNISA SINTA WULANDARI P PEGAWAI SWASTA Acute upper respiratory Berobat Jalan
infection, unspecified
2732 10-03-2018 0137U0040318Y001121 0002077186375 ARMAINI TATI P PEKERJA MANDIRI Impacted teeth Berobat Jalan
DAFTAR KUNJUNGAN PESERTA SAKIT

Kantor Cabang : BEKASI - 1011

FKTP : Klinik Mitra Medika - 0137U004

2733 10-03-2018 0137U0040318Y001161 0002081631881 SEBASTIAN LEVI PRADANA L PEGAWAI SWASTA Other specified headache Berobat Jalan
syndromes
2734 10-03-2018 0137U0040318Y001116 0002083542513 AZAHARA KANAYA PUTRI P PEKERJA MANDIRI Chronic gingivitis Berobat Jalan

2735 10-03-2018 0137U0040318Y001105 0002103705909 AHMAD SUJAI L PEGAWAI SWASTA Other and unspecified Berobat Jalan
infectious diseases
2736 10-03-2018 0137U0040318Y001166 0002194829651 MUHAMAD WAHYUDI L PEGAWAI SWASTA Other specified headache Berobat Jalan
syndromes
2737 10-03-2018 0137U0040318Y001221 0002201919423 SENANDUNG BINAR EMBUN P PEKERJA MANDIRI Impacted teeth Berobat Jalan

2738 10-03-2018 0137U0040318Y001144 0002201986416 GARIS MUHAMMAD ZHAFRAN L PEGAWAI SWASTA Acute upper respiratory Berobat Jalan
infection, unspecified
2739 10-03-2018 0137U0040318Y001104 0002207515588 muhammad atthar anaki L PEGAWAI SWASTA Acute upper respiratory Berobat Jalan
infection, unspecified
2740 10-03-2018 0137U0040318Y001143 0002217031558 RAFIYUDDIN H L PENERIMA PENSIUN Other specified headache Berobat Jalan
SWASTA syndromes
2741 10-03-2018 0137U0040318Y001260 0002237291717 NURSITI HARIFAH P PEKERJA MANDIRI Other antenatal screening Berobat Jalan

2742 10-03-2018 0137U0040318Y001211 0002239439523 BAYI NY RIRIN INGGAR P PEGAWAI BUMN Acute upper respiratory Berobat Jalan
HANDITYA infection, unspecified
2743 10-03-2018 0137U0040318Y001132 0002242541485 SUTARNI P PEKERJA MANDIRI Myalgia Berobat Jalan

2744 10-03-2018 0137U0040318Y001214 0002242786353 BROTO PURWANTO WARSI P PEKERJA MANDIRI Irregular menstruation, Berobat Jalan
unspecified
2745 10-03-2018 0137U0040318Y001123 0002245324454 MUNI P PEKERJA MANDIRI Schizophrenia Rujuk Lanjut

2746 10-03-2018 0137U0040318Y001135 0002253310615 MUHAMAD DAFFA AL - L PEKERJA MANDIRI Acute upper respiratory Berobat Jalan
GHIBRAN infection, unspecified
2747 10-03-2018 0137U0040318Y001225 0002262956051 MUHAMMAD ZUFAR KHAAZIN L PEKERJA MANDIRI Impacted teeth Berobat Jalan

2748 10-03-2018 0137U0040318Y001204 0002262956501 MUHAMMAD ABDAN L PEKERJA MANDIRI Dermatitis herpetiformis Berobat Jalan
SYAKURON
2749 10-03-2018 0137U0040318Y001188 0002265694637 MARDIANA P PEKERJA MANDIRI Atopic dermatitis, Berobat Jalan
unspecified
2750 10-03-2018 0137U0040318Y001111 0002304119507 SRISNA OKEN TINA P PEKERJA MANDIRI Dyspepsia Berobat Jalan

2751 10-03-2018 0137U0040318Y001106 0002310968913 MUHAMMAD ARSENIO ATTAR L PEGAWAI SWASTA Acute upper respiratory Berobat Jalan
FIRMANSYAH infection, unspecified
2752 10-03-2018 0137U0040318Y001182 0002427135175 ADINDA RAHMA.P P PEKERJA MANDIRI Gastro-oesophageal reflux Berobat Jalan
disease without

2753 09-03-2018 0137U0040318Y000998 0000044916344 ENNY MAWARTY P PENERIMA PENSIUN Impacted teeth Berobat Jalan
PNS
2754 09-03-2018 0137U0040318Y000978 0000044916355 HENDRYSOND SMT, ARS L PENERIMA PENSIUN Acute sinusitis, Rujuk Lanjut
PNS unspecified
DAFTAR KUNJUNGAN PESERTA SAKIT

Kantor Cabang : BEKASI - 1011

FKTP : Klinik Mitra Medika - 0137U004

2755 09-03-2018 0137U0040318Y001014 0000073401401 DADANG PERMANA L PNS DAERAH Acute upper respiratory Berobat Jalan
infection, unspecified
2756 09-03-2018 0137U0040318Y001015 0000073401423 DITA ANINDIA UTAMI P PNS DAERAH Acute upper respiratory Berobat Jalan
infection, unspecified
2757 09-03-2018 0137U0040318Y001062 0000073470879 SARININGSIH P PNS DAERAH Other secondary arthrosis Berobat Jalan

2758 09-03-2018 0137U0040318Y000974 0000073570882 FARIDA PURWANTI HASSAN P PNS DAERAH Necrosis of pulp Rujuk Lanjut

2759 09-03-2018 0137U0040318Y001003 0000200255005 DJUANDA L PNS DAERAH Dyspepsia Berobat Jalan

2760 09-03-2018 0137U0040318Y000969 0000977322205 RIKA DELTI P PNS PUSAT Benign neoplasm of breast Rujuk Lanjut

2761 09-03-2018 0137U0040318Y000988 0001124634644 LIE TENG HUI L PEGAWAI SWASTA Acute upper respiratory Berobat Jalan
infection, unspecified
2762 09-03-2018 0137U0040318Y001027 0001133512986 SYAIFUL ROHMAN L PEGAWAI SWASTA Other specified headache Berobat Jalan
syndromes
2763 09-03-2018 0137U0040318Y000993 0001135995535 RIDWAN L PEGAWAI SWASTA Dental caries, unspecified Berobat Jalan

2764 09-03-2018 0137U0040318Y001047 0001138900959 ELI SUSANTI P PEGAWAI SWASTA Myopia Berobat Jalan

2765 09-03-2018 0137U0040318Y001029 0001143044853 FENNY TRI POERWANTO L PEGAWAI SWASTA Myalgia Berobat Jalan

2766 09-03-2018 0137U0040318Y001011 0001155385451 AMELLIA NATALIS P PEGAWAI SWASTA Acute upper respiratory Berobat Jalan
infection, unspecified
2767 09-03-2018 0137U0040318Y000982 0001173928735 IMAN FAUZIE HIDAYA L PEGAWAI SWASTA Hypermetropia Berobat Jalan

2768 09-03-2018 0137U0040318Y000981 0001190122391 BANYU V.SYANDA L PEGAWAI SWASTA Hypermetropia Berobat Jalan

2769 09-03-2018 0137U0040318Y000999 0001197252257 KOK LIE TJIU P PEGAWAI SWASTA Impacted teeth Berobat Jalan

2770 09-03-2018 0137U0040318Y001070 0001219025395 NENENG FARHANAH P PEGAWAI SWASTA Necrosis of pulp Rujuk Lanjut

2771 09-03-2018 0137U0040318Y000996 0001257714224 AYLANI ISTANTI P PEKERJA MANDIRI Impacted teeth Berobat Jalan

2772 09-03-2018 0137U0040318Y000979 0001258059971 DESI ARIYANTI P PEGAWAI SWASTA Other specified headache Berobat Jalan
syndromes
2773 09-03-2018 0137U0040318Y000995 0001259238609 FLORENTINE PHOEI P PEKERJA MANDIRI Dental caries, unspecified Berobat Jalan

2774 09-03-2018 0137U0040318Y001002 0001259264709 REINALDO CHRISTIAN BENA L PEKERJA MANDIRI Mixed asthma Berobat Jalan

2775 09-03-2018 0137U0040318Y001081 0001259823633 christine P PEKERJA MANDIRI Caries of dentine Berobat Jalan

2776 09-03-2018 0137U0040318Y000987 0001276552372 SITI ROCHMAH P PEKERJA MANDIRI Acute upper respiratory Berobat Jalan
infection, unspecified
2777 09-03-2018 0137U0040318Y001052 0001279097065 E.DWI.PRIYADI L PEKERJA MANDIRI Other secondary arthrosis Berobat Jalan

2778 09-03-2018 0137U0040318Y001051 0001279098101 y. sitie rochayah P PEKERJA MANDIRI Other specified headache Berobat Jalan
syndromes
DAFTAR KUNJUNGAN PESERTA SAKIT

Kantor Cabang : BEKASI - 1011

FKTP : Klinik Mitra Medika - 0137U004

2779 09-03-2018 0137U0040318Y001012 0001295875067 SOFYAN PUDJADI L PEGAWAI SWASTA Other specified headache Berobat Jalan
syndromes
2780 09-03-2018 0137U0040318Y001068 0001303038966 VONNY THERESIA LOLONG P PEGAWAI SWASTA Gastro-oesophageal reflux Berobat Jalan
disease without

2781 09-03-2018 0137U0040318Y001053 0001303039124 MUHAMMAD YUSUF JOOTJE L PEGAWAI SWASTA Hyperkinetic disorders Rujuk Lanjut
FAUZI
2782 09-03-2018 0137U0040318Y000994 0001312245461 DANNY SUBIANTO L PEKERJA MANDIRI Impacted teeth Berobat Jalan

2783 09-03-2018 0137U0040318Y001057 0001336962363 JOSUA ARMANDO L PEKERJA MANDIRI Other specified headache Berobat Jalan
syndromes
2784 09-03-2018 0137U0040318Y001069 0001370912152 METTI KUSMIATI P PEGAWAI SWASTA Myopia Berobat Jalan

2785 09-03-2018 0137U0040318Y001059 0001374582363 KINASIH HANDAYANI P PEKERJA MANDIRI Acute pharyngitis, Berobat Jalan
unspecified
2786 09-03-2018 0137U0040318Y001035 0001386031015 Aswani Gadang P PEGAWAI SWASTA Other arthrosis Rujuk Lanjut

2787 09-03-2018 0137U0040318Y001074 0001420939991 soleha P PEKERJA MANDIRI Caries of dentine Berobat Jalan

2788 09-03-2018 0137U0040318Y000971 0001423696702 NIHAYA P PEKERJA MANDIRI Heart failure Rujuk Lanjut

2789 09-03-2018 0137U0040318Y001019 0001424459327 SYAMSUDIN L PEKERJA MANDIRI Cerebral infarction, Rujuk Lanjut
unspecified
2790 09-03-2018 0137U0040318Y000968 0001437098218 KERI SUBIANTI RAHAYUDEWI P PEGAWAI SWASTA Primary arthrosis of other Rujuk Lanjut
joints, pelvic and thigh
2791 09-03-2018 0137U0040318Y001017 0001439918616 TRI RAHAYU BUDIATI P PEKERJA MANDIRI Irregular menstruation, Rujuk Lanjut
unspecified
2792 09-03-2018 0137U0040318Y001064 0001439934107 AZIZ DESTA AMSORI L PEKERJA MANDIRI Acute upper respiratory Berobat Jalan
infection, unspecified
2793 09-03-2018 0137U0040318Y000997 0001440682018 LISMAWATI P PEKERJA MANDIRI Dental caries, unspecified Berobat Jalan

2794 09-03-2018 0137U0040318Y000977 0001442452285 YO TJIN LAN P PEKERJA MANDIRI Acute upper respiratory Berobat Jalan
infection, unspecified
2795 09-03-2018 0137U0040318Y001023 0001451049862 PUTRI CHARLENE MEISY P PNS PUSAT Acute upper respiratory Berobat Jalan
SITANGGANG infection, unspecified
2796 09-03-2018 0137U0040318Y001005 0001455655667 WINARTI P PNS PUSAT Acute upper respiratory Berobat Jalan
infection, unspecified
2797 09-03-2018 0137U0040318Y001091 0001456417067 LIA ROOSMARTINI P PEKERJA MANDIRI Other antenatal screening Berobat Jalan

2798 09-03-2018 0137U0040318Y000973 0001458466751 YULI VERAWATI P PEKERJA MANDIRI Necrosis of pulp Rujuk Lanjut

2799 09-03-2018 0137U0040318Y001080 0001458525723 SITI ROHIMAH P PEKERJA MANDIRI Dental caries, unspecified Berobat Jalan

2800 09-03-2018 0137U0040318Y001039 0001461072701 IWAN SUGIANTO L PEKERJA MANDIRI Myopia Berobat Jalan

2801 09-03-2018 0137U0040318Y000975 0001461076198 HENDRAWATI NUGROHO P PEKERJA MANDIRI Acute bronchiolitis, Rujuk Lanjut
unspecified
DAFTAR KUNJUNGAN PESERTA SAKIT

Kantor Cabang : BEKASI - 1011

FKTP : Klinik Mitra Medika - 0137U004

2802 09-03-2018 0137U0040318Y001009 0001465941251 THIO HAN NIO P PEKERJA MANDIRI Acute upper respiratory Berobat Jalan
infection, unspecified
2803 09-03-2018 0137U0040318Y000986 0001469153518 TJHAY SIU YOENG P PEKERJA MANDIRI Acute upper respiratory Berobat Jalan
infection, unspecified
2804 09-03-2018 0137U0040318Y000989 0001470973678 ALFIANI RACHMAWATI P PEGAWAI SWASTA Benign neoplasm of breast Berobat Jalan

2805 09-03-2018 0137U0040318Y000980 0001472234949 HJ.ROCHMAH LILIS-SURYANI P PEKERJA MANDIRI Dyspepsia Berobat Jalan

2806 09-03-2018 0137U0040318Y001018 0001516282817 NENG FADLIAS NINGSIH P PEGAWAI SWASTA Single delivery by Rujuk Lanjut
caesarean section
2807 09-03-2018 0137U0040318Y001087 0001517868707 BRAIN RHENALDY L PEGAWAI SWASTA Necrosis of pulp Berobat Jalan

2808 09-03-2018 0137U0040318Y001055 0001539827807 RONA MENTARI P PEGAWAI SWASTA Nausea and vomiting Berobat Jalan

2809 09-03-2018 0137U0040318Y001010 0001602869872 PURWANTI P PEGAWAI SWASTA Acute upper respiratory Berobat Jalan
infection, unspecified
2810 09-03-2018 0137U0040318Y001008 0001602991078 SRI HARYANTI P PEGAWAI SWASTA Acute upper respiratory Berobat Jalan
infection, unspecified
2811 09-03-2018 0137U0040318Y001092 0001602991091 KIKY RISKY AMELIA P PEGAWAI SWASTA Other antenatal screening Berobat Jalan

2812 09-03-2018 0137U0040318Y001075 0001629187716 NEZIRA P PEGAWAI SWASTA Impacted teeth Berobat Jalan

2813 09-03-2018 0137U0040318Y001077 0001629187738 DEWI SYAFA HARIANTI P PEGAWAI SWASTA Caries of dentine Berobat Jalan

2814 09-03-2018 0137U0040318Y001076 0001629187749 AHMAD TRIANTO L PEGAWAI SWASTA Abrasion of teeth Berobat Jalan

2815 09-03-2018 0137U0040318Y001065 0001630433226 JEMMY YULIANUS RIRIMASSE L PEKERJA MANDIRI Other secondary arthrosis Berobat Jalan

2816 09-03-2018 0137U0040318Y001066 0001630433248 YORICO CHRISTY RIRIMASSE P PEKERJA MANDIRI Myopia Berobat Jalan

2817 09-03-2018 0137U0040318Y001006 0001631080056 TITIN KURNANI P PEKERJA MANDIRI Low back pain Berobat Jalan

2818 09-03-2018 0137U0040318Y001007 0001631080067 HANNA NAILIS SAADAH P PEKERJA MANDIRI Dyspepsia Berobat Jalan

2819 09-03-2018 0137U0040318Y001093 0001631756698 DIAN FAHDIANA P PEGAWAI SWASTA Other antenatal screening Berobat Jalan

2820 09-03-2018 0137U0040318Y001026 0001644702311 ELVIN ADRIANSYAH L PEGAWAI SWASTA Other specified headache Berobat Jalan
syndromes
2821 09-03-2018 0137U0040318Y001083 0001646271922 SLAMET SUHENDRA L PEGAWAI SWASTA Impacted teeth Berobat Jalan

2822 09-03-2018 0137U0040318Y001048 0001646271933 RITA SAYOETI,SH P PEGAWAI SWASTA Necrosis of pulp Rujuk Lanjut

2823 09-03-2018 0137U0040318Y001084 0001646271944 CITRA AMALIA SUHENDRA P PEKERJA MANDIRI Necrosis of pulp Berobat Jalan

2824 09-03-2018 0137U0040318Y001085 0001646271955 IZZATI AURA SUHENDRA P PEGAWAI SWASTA Abrasion of teeth Berobat Jalan

2825 09-03-2018 0137U0040318Y001040 0001646957687 Ponty Kathulistiandari P PEGAWAI SWASTA Acute upper respiratory Berobat Jalan
infection, unspecified
DAFTAR KUNJUNGAN PESERTA SAKIT

Kantor Cabang : BEKASI - 1011

FKTP : Klinik Mitra Medika - 0137U004

2826 09-03-2018 0137U0040318Y001041 0001646957698 Cliantha Zaida Lingga P PEGAWAI SWASTA Other and unspecified Berobat Jalan
infectious diseases
2827 09-03-2018 0137U0040318Y001038 0001649176435 FUDJI SUHERTI P PEGAWAI SWASTA Necrosis of pulp Rujuk Lanjut

2828 09-03-2018 0137U0040318Y001079 0001649176457 FADHIL ABDUL SUZAWAD L PEGAWAI SWASTA Abrasion of teeth Berobat Jalan

2829 09-03-2018 0137U0040318Y001036 0001654815791 IR MONANG H PASARIBU L PEKERJA MANDIRI Necrosis of pulp Rujuk Lanjut

2830 09-03-2018 0137U0040318Y001073 0001654815824 MEIDYANTO PARDAMEAN L PEKERJA MANDIRI Chronic gingivitis Berobat Jalan
PASARIBU
2831 09-03-2018 0137U0040318Y001086 0001657482849 AHMAD PAUZI L PEGAWAI SWASTA Impacted teeth Berobat Jalan

2832 09-03-2018 0137U0040318Y001016 0001657555154 DANIEL CHRISTOVELL L PEGAWAI SWASTA Acute upper respiratory Berobat Jalan
infection, unspecified
2833 09-03-2018 0137U0040318Y001054 0001716587201 WAWEN AVIANTIE P PEKERJA MANDIRI Other and unspecified Berobat Jalan
infectious diseases
2834 09-03-2018 0137U0040318Y001056 0001716587223 ANITA P PEKERJA MANDIRI Acute pharyngitis, Berobat Jalan
unspecified
2835 09-03-2018 0137U0040318Y001042 0001719653084 ALITA SYAHAMAH P PEGAWAI SWASTA Foreign body in colon Berobat Jalan

2836 09-03-2018 0137U0040318Y000992 0001720357626 SUBAEDAH P PEKERJA MANDIRI Dental caries, unspecified Berobat Jalan

2837 09-03-2018 0137U0040318Y001020 0001723962306 SRI HARTINI P PEKERJA MANDIRI Myalgia Berobat Jalan

2838 09-03-2018 0137U0040318Y001045 0001725010615 CRISTIAN L PEKERJA MANDIRI Atopic dermatitis, Berobat Jalan
unspecified
2839 09-03-2018 0137U0040318Y001024 0001730216226 HARYONO L PEKERJA MANDIRI Acute upper respiratory Berobat Jalan
infection, unspecified
2840 09-03-2018 0137U0040318Y001025 0001736456095 GRACIA PRINCES P PEGAWAI SWASTA Other and unspecified Berobat Jalan
TANUWIDJAJA infectious diseases
2841 09-03-2018 0137U0040318Y001082 0001737606745 ANI EKA WINDYASTUTI P PEGAWAI SWASTA Acute tracheitis Berobat Jalan

2842 09-03-2018 0137U0040318Y000972 0001742258992 Elisabeth Pong Masak P PENERIMA PENSIUN Insulin-dependent Rujuk Lanjut
SWASTA diabetes mellitus
2843 09-03-2018 0137U0040318Y001033 0001772850543 MUHRONI L PEGAWAI SWASTA Gastro-oesophageal reflux Berobat Jalan
disease without

2844 09-03-2018 0137U0040318Y001032 0001788910334 DHINI FIRGIANTIKA P PNS DAERAH Acute upper respiratory Berobat Jalan
infection, unspecified
2845 09-03-2018 0137U0040318Y001058 0001791535645 aliza mahdian azzahro P PNS DAERAH Other and unspecified Berobat Jalan
infectious diseases
2846 09-03-2018 0137U0040318Y001022 0001807040406 nery silvana P PEKERJA MANDIRI Acute upper respiratory Berobat Jalan
infection, unspecified
2847 09-03-2018 0137U0040318Y001060 0001821550465 ADELA PUTRI P PEKERJA MANDIRI Other and unspecified Berobat Jalan
infectious diseases
DAFTAR KUNJUNGAN PESERTA SAKIT

Kantor Cabang : BEKASI - 1011

FKTP : Klinik Mitra Medika - 0137U004

2848 09-03-2018 0137U0040318Y001044 0001828310477 EDWARD FREDERIK GENEWA L PEKERJA MANDIRI Chronic renal failure, Rujuk Lanjut
unspecified
2849 09-03-2018 0137U0040318Y000983 0001831208499 RACHMAT KATILI BASARAH L PEGAWAI PEMERINTAH Dyspepsia Berobat Jalan
DENGAN PERJANJIAN

2850 09-03-2018 0137U0040318Y000984 0001831208769 RISTA EKA OKTIANA P PEGAWAI PEMERINTAH Acute upper respiratory Berobat Jalan
DENGAN PERJANJIAN infection, unspecified

2851 09-03-2018 0137U0040318Y001000 0001834791636 kusminah P PEKERJA MANDIRI Hypermetropia Berobat Jalan

2852 09-03-2018 0137U0040318Y001001 0001834792683 wahyu hardiyanti P PEKERJA MANDIRI Acute upper respiratory Berobat Jalan
infection, unspecified
2853 09-03-2018 0137U0040318Y000991 0001836640214 MAHIRA KAMILA P PEGAWAI SWASTA Developmental disorder of Rujuk Lanjut
speech and language,

2854 09-03-2018 0137U0040318Y000976 0001860242578 SITI SUPRIYANI P PNS PUSAT Disorders of refraction and Rujuk Lanjut
accommodation
2855 09-03-2018 0137U0040318Y001071 0001867305161 TUBAGUS ALIFIANDRA L PEKERJA MANDIRI Myalgia Berobat Jalan
ARGANTHA
2856 09-03-2018 0137U0040318Y001013 0001875754146 AHMAD ROFIQ L PEKERJA MANDIRI Foreign body in colon Berobat Jalan

2857 09-03-2018 0137U0040318Y000985 0001876128985 NANI SRI YANI P PEGAWAI SWASTA Acute upper respiratory Berobat Jalan
infection, unspecified
2858 09-03-2018 0137U0040318Y001021 0001883683495 HUSNI ISKANDAR L PEKERJA MANDIRI Cutaneous abscess, Berobat Jalan
furuncle and carbuncle
2859 09-03-2018 0137U0040318Y001037 0001884441429 HETI K P PEKERJA MANDIRI Premature rupture of Rujuk Lanjut
membranes
2860 09-03-2018 0137U0040318Y001078 0001895083841 EDISON SIMORANGKIR L PEKERJA MANDIRI Dental caries, unspecified Berobat Jalan

2861 09-03-2018 0137U0040318Y000990 0001897996836 niken suci rahmawati P PEKERJA MANDIRI Hypermetropia Berobat Jalan

2862 09-03-2018 0137U0040318Y001034 0001902637607 noer aini P PEKERJA MANDIRI Primary respiratory Rujuk Lanjut
tuberculosis, confirmed
bacteriologically and

2863 09-03-2018 0137U0040318Y001046 0001902962867 SUMARSONO L PEKERJA MANDIRI Myalgia Berobat Jalan

2864 09-03-2018 0137U0040318Y001004 0002040168295 arsya nuuruddin L PNS PUSAT Acute upper respiratory Berobat Jalan
infection, unspecified
2865 09-03-2018 0137U0040318Y001067 0002050310755 MUHAMMAD IBRAHIM RIZKI L PEGAWAI SWASTA Myopia Berobat Jalan
FAUZI
2866 09-03-2018 0137U0040318Y001043 0002074179677 ANHAR RACHMAN L PEKERJA MANDIRI Dyspepsia Berobat Jalan

2867 09-03-2018 0137U0040318Y000970 0002076901018 LIEM KWANG MIEN L PEKERJA MANDIRI Senile cataract, Rujuk Lanjut
unspecified
DAFTAR KUNJUNGAN PESERTA SAKIT

Kantor Cabang : BEKASI - 1011

FKTP : Klinik Mitra Medika - 0137U004

2868 09-03-2018 0137U0040318Y001028 0002098906312 ENDANG SUPARLAN L PEGAWAI SWASTA Acute upper respiratory Berobat Jalan
infection, unspecified
2869 09-03-2018 0137U0040318Y001072 0002103998635 SUSAN MARGARETA CHANDRA P PEGAWAI SWASTA Impacted teeth Berobat Jalan

2870 09-03-2018 0137U0040318Y001049 0002229904258 MUHAMMAD ARKANA KURNIA L PEGAWAI SWASTA Other and unspecified Berobat Jalan
MAKSUM infectious diseases
2871 09-03-2018 0137U0040318Y001030 0002233637717 H. MUHAMMAD UMAR H. TAMIJI L PEKERJA MANDIRI Acute upper respiratory Berobat Jalan
infection, unspecified
2872 09-03-2018 0137U0040318Y001031 0002233638865 EVA FAUZIANA P PEKERJA MANDIRI Other secondary arthrosis Berobat Jalan

2873 09-03-2018 0137U0040318Y001061 0002266791243 ADITYA BRAHMANTA HADI L PEGAWAI SWASTA Other and unspecified Berobat Jalan
infectious diseases
2874 09-03-2018 0137U0040318Y001088 0002302251614 ANDRY L PEKERJA MANDIRI Impacted teeth Berobat Jalan

2875 09-03-2018 0137U0040318Y001089 0002302253739 RAFAEL LOUIS HERNANDEZ L PEKERJA MANDIRI Abrasion of teeth Berobat Jalan

2876 09-03-2018 0137U0040318Y001063 0002302254336 SUSANA TJIANG SUSAN P PEKERJA MANDIRI Other specified headache Berobat Jalan
syndromes
2877 09-03-2018 0137U0040318Y001050 0002305297034 QIBTYAH NASUHA PUTRI P PEKERJA MANDIRI Dermatitis herpetiformis Berobat Jalan

2878 08-03-2018 0137U0040318Y000944 0000016041802 MASIDAH P PENERIMA PENSIUN Dyspepsia Berobat Jalan
PNS
2879 08-03-2018 0137U0040318Y000963 0000045905062 RAMA ZAQY OKTAVIANTO L PNS PUSAT Oedema, unspecified Berobat Jalan

2880 08-03-2018 0137U0040318Y000866 0000048533332 MUCHTADI GOZALI, SH L PENERIMA PENSIUN Acute upper respiratory Berobat Jalan
PNS infection, unspecified
2881 08-03-2018 0137U0040318Y000931 0000055661769 TIROMLI TAMBUNAN P PNS DAERAH Dental caries, unspecified Berobat Jalan

2882 08-03-2018 0137U0040318Y000951 0000072824218 WIDAMURTIY P PNS DAERAH Myalgia Rujuk Lanjut

2883 08-03-2018 0137U0040318Y000932 0000072885161 FIRMAN FIRDAUS L PNS DAERAH Dental caries, unspecified Berobat Jalan

2884 08-03-2018 0137U0040318Y000904 0000073003285 ANNY HARIYATI P PENERIMA PENSIUN TNI Low back pain Rujuk Lanjut

2885 08-03-2018 0137U0040318Y000857 0000073241122 Drs.H.ARIS BUDIJONO L PENERIMA PENSIUN Acute upper respiratory Berobat Jalan
PNS infection, unspecified
2886 08-03-2018 0137U0040318Y000853 0000073570882 FARIDA PURWANTI HASSAN P PNS DAERAH Atopic dermatitis, Rujuk Lanjut
unspecified
2887 08-03-2018 0137U0040318Y000925 0000211234926 HERLIN NOVIANTI P PNS DAERAH Other antenatal screening Berobat Jalan

2888 08-03-2018 0137U0040318Y000875 0000408550601 DEDE YULIANI P PBI (APBN) Atopic dermatitis, Berobat Jalan
unspecified
2889 08-03-2018 0137U0040318Y000862 0001081963629 GALANG DIVA ERLANGGA L PNS DAERAH Acute upper respiratory Berobat Jalan
infection, unspecified
2890 08-03-2018 0137U0040318Y000966 0001082302582 ILA USWATUN HASANAH P PEKERJA MANDIRI Myalgia Berobat Jalan
DAFTAR KUNJUNGAN PESERTA SAKIT

Kantor Cabang : BEKASI - 1011

FKTP : Klinik Mitra Medika - 0137U004

2891 08-03-2018 0137U0040318Y000867 0001135472106 YULI WAHYU UTOMO L PEGAWAI SWASTA Dermatitis herpetiformis Berobat Jalan

2892 08-03-2018 0137U0040318Y000911 0001170703427 MEILINA PUTRI A P PEGAWAI SWASTA Dermatitis herpetiformis Berobat Jalan

2893 08-03-2018 0137U0040318Y000870 0001174099959 JESSIE NAYSHILA P PEGAWAI SWASTA Dyspepsia Berobat Jalan

2894 08-03-2018 0137U0040318Y000927 0001191284976 YENNI MUHTAR, SE P PEKERJA MANDIRI Caries of dentine Berobat Jalan

2895 08-03-2018 0137U0040318Y000952 0001193750043 FARRA ILMIRA P PEGAWAI SWASTA Chronic gingivitis Berobat Jalan

2896 08-03-2018 0137U0040318Y000892 0001211581012 ASEP SANJAYA L PEGAWAI SWASTA Acute upper respiratory Berobat Jalan
infection, unspecified
2897 08-03-2018 0137U0040318Y000850 0001256584757 SUROSO L PEKERJA MANDIRI Primary arthrosis of other Rujuk Lanjut
joints, shoulder region
2898 08-03-2018 0137U0040318Y000898 0001258599791 NA KIOE BENG L PEKERJA MANDIRI Acute upper respiratory Berobat Jalan
infection, unspecified
2899 08-03-2018 0137U0040318Y000954 0001258599903 ENDAWATI P PEKERJA MANDIRI Impacted teeth Berobat Jalan

2900 08-03-2018 0137U0040318Y000955 0001258774672 ARJUNA TRAVIAN SAKHI L PEGAWAI PEMERINTAH Abrasion of teeth Berobat Jalan
DENGAN PERJANJIAN

2901 08-03-2018 0137U0040318Y000956 0001258774997 FEDORA TALITA SAKHI P PEGAWAI PEMERINTAH Abrasion of teeth Berobat Jalan
DENGAN PERJANJIAN

2902 08-03-2018 0137U0040318Y000940 0001259119102 WIWIT SURYANTI P PEKERJA MANDIRI Myalgia Berobat Jalan

2903 08-03-2018 0137U0040318Y000883 0001260176747 ANAH SETIAWATI P PEKERJA MANDIRI Dental caries Berobat Jalan

2904 08-03-2018 0137U0040318Y000888 0001260177603 NUR KARIMAH P PEKERJA MANDIRI Acute upper respiratory Berobat Jalan
infection, unspecified
2905 08-03-2018 0137U0040318Y000912 0001261573266 PRAYITNO L PNS DAERAH Allergic contact dermatitis Rujuk Lanjut

2906 08-03-2018 0137U0040318Y000856 0001263343149 ROHIMIN L PEKERJA MANDIRI Dyspepsia Berobat Jalan

2907 08-03-2018 0137U0040318Y000918 0001264020412 SUWARTO L PEKERJA MANDIRI Gastro-oesophageal reflux Berobat Jalan
disease without

2908 08-03-2018 0137U0040318Y000895 0001267019447 RENDY SURYADI HANDOYO L PEGAWAI SWASTA Fever, unspecified Berobat Jalan

2909 08-03-2018 0137U0040318Y000894 0001269612911 SHELLY BEHTIAR P PEKERJA MANDIRI Malignant neoplasm of Rujuk Lanjut
cervix uteri, unspecified
2910 08-03-2018 0137U0040318Y000948 0001269625678 NURJANISAH P PEKERJA MANDIRI Other specified headache Berobat Jalan
syndromes
2911 08-03-2018 0137U0040318Y000950 0001269879737 DESY RATNASARI P PEKERJA MANDIRI Acute upper respiratory Berobat Jalan
infection, unspecified
2912 08-03-2018 0137U0040318Y000877 0001274573428 KODIM L PEKERJA MANDIRI Acute upper respiratory Berobat Jalan
infection, unspecified
DAFTAR KUNJUNGAN PESERTA SAKIT

Kantor Cabang : BEKASI - 1011

FKTP : Klinik Mitra Medika - 0137U004

2913 08-03-2018 0137U0040318Y000902 0001280006818 LIEM PICIS P PEKERJA MANDIRI Other arthrosis Berobat Jalan

2914 08-03-2018 0137U0040318Y000953 0001292469118 E.S BUDINA SIMATUPANG P PEGAWAI SWASTA Impacted teeth Berobat Jalan

2915 08-03-2018 0137U0040318Y000928 0001305157059 HENNY ROSITA P PEKERJA MANDIRI Dental caries, unspecified Berobat Jalan

2916 08-03-2018 0137U0040318Y000847 0001306536298 UMAY P PEGAWAI SWASTA Other arthrosis Rujuk Lanjut

2917 08-03-2018 0137U0040318Y000874 0001335167763 KUSNIDAH P PENERIMA PENSIUN Dermatitis herpetiformis Rujuk Lanjut
SWASTA
2918 08-03-2018 0137U0040318Y000878 0001335844091 H.BAMBANG MUNGKASONO L PEKERJA MANDIRI Congestive heart failure Rujuk Lanjut

2919 08-03-2018 0137U0040318Y000959 0001377199675 Mimi Mulyati P PEGAWAI SWASTA Low back pain Berobat Jalan

2920 08-03-2018 0137U0040318Y000960 0001377199719 Ingga Wahmi Widjaya L PEGAWAI SWASTA Acute upper respiratory Berobat Jalan
infection, unspecified
2921 08-03-2018 0137U0040318Y000946 0001386044188 iskandar putra L PEKERJA MANDIRI Acute upper respiratory Berobat Jalan
infection, unspecified
2922 08-03-2018 0137U0040318Y000899 0001427213924 TOYIBAH P PEKERJA MANDIRI Fever, unspecified Berobat Jalan

2923 08-03-2018 0137U0040318Y000921 0001432539303 JUWARNI P PEKERJA MANDIRI Other specified headache Berobat Jalan
syndromes
2924 08-03-2018 0137U0040318Y000941 0001449498284 YUMNA AMELIA L PEGAWAI SWASTA Dyspepsia Berobat Jalan

2925 08-03-2018 0137U0040318Y000852 0001455639232 YONG NYAT YUNG P PEKERJA MANDIRI Coronary artery aneurysm Rujuk Lanjut

2926 08-03-2018 0137U0040318Y000920 0001458637424 SITI ZAINAB P PEKERJA MANDIRI Anaemia, unspecified Berobat Jalan

2927 08-03-2018 0137U0040318Y000915 0001462880283 SAN MULYA RASIMAN L PEKERJA MANDIRI Myalgia Berobat Jalan

2928 08-03-2018 0137U0040318Y000922 0001464368477 DRA. OFI SOPIYATI P PEKERJA MANDIRI Other specified headache Berobat Jalan
syndromes
2929 08-03-2018 0137U0040318Y000923 0001464368499 MAULIDA ITSNI ZUMAIYJAH P PEKERJA MANDIRI Gastro-oesophageal reflux Berobat Jalan
disease without

2930 08-03-2018 0137U0040318Y000942 0001470475271 DANIL L PEKERJA MANDIRI Acute upper respiratory Berobat Jalan
infection, unspecified
2931 08-03-2018 0137U0040318Y000863 0001471812693 SUN LIN KURNIA P PEKERJA MANDIRI Traumatic shock Berobat Jalan

2932 08-03-2018 0137U0040318Y000891 0001482673836 ANGGI SEKAR LANGIT P PEKERJA MANDIRI Vertigo of central origin Berobat Jalan

2933 08-03-2018 0137U0040318Y000903 0001516291942 SRI HASTINI P PEGAWAI SWASTA Paratyphoid fever, Rujuk Lanjut
unspecified
2934 08-03-2018 0137U0040318Y000851 0001517710138 ANDIK SUPRIYADI L PEGAWAI SWASTA Inguinal hernia Rujuk Lanjut

2935 08-03-2018 0137U0040318Y000900 0001548819426 GINANJAR BAYU KUSUMA L PEGAWAI SWASTA Other specified headache Berobat Jalan
syndromes
2936 08-03-2018 0137U0040318Y000910 0001603587407 NURAENI P PEGAWAI SWASTA Acute upper respiratory Berobat Jalan
infection, unspecified
DAFTAR KUNJUNGAN PESERTA SAKIT

Kantor Cabang : BEKASI - 1011

FKTP : Klinik Mitra Medika - 0137U004

2937 08-03-2018 0137U0040318Y000884 0001611931689 BELVA PUTRI SALSABILA P PEGAWAI SWASTA Dental caries Berobat Jalan

2938 08-03-2018 0137U0040318Y000859 0001625364202 SUBUR L PEGAWAI SWASTA Other specified headache Berobat Jalan
syndromes
2939 08-03-2018 0137U0040318Y000860 0001631371037 GHAMAL RIYO JAGAD ALAM L PEGAWAI SWASTA Traumatic shock Berobat Jalan

2940 08-03-2018 0137U0040318Y000938 0001633481739 MURNI ANGRAINI P PEGAWAI SWASTA Other specified headache Berobat Jalan
syndromes
2941 08-03-2018 0137U0040318Y000906 0001639653153 RIA PRATIWI P PEGAWAI SWASTA Other benign neoplasm of Rujuk Lanjut
connective and other soft

2942 08-03-2018 0137U0040318Y000855 0001641968954 SUWARSIH P PEGAWAI SWASTA Disorder of thyroid, Rujuk Lanjut
unspecified
2943 08-03-2018 0137U0040318Y000937 0001643408741 EDy HERIYANTO L PEKERJA MANDIRI Acute upper respiratory Berobat Jalan
infection, unspecified
2944 08-03-2018 0137U0040318Y000936 0001643408831 Zoelfah TRI YUNI P PEKERJA MANDIRI Acute upper respiratory Berobat Jalan
infection, unspecified
2945 08-03-2018 0137U0040318Y000924 0001643505388 ROLLIS KUSNADI L PEGAWAI SWASTA Dyspepsia Berobat Jalan

2946 08-03-2018 0137U0040318Y000958 0001645674546 RENI SUSANTI P PEGAWAI SWASTA Other specified Berobat Jalan
predominantly sexually

2947 08-03-2018 0137U0040318Y000854 0001646901641 WIRANATA ADE SAPUTRA L PEGAWAI SWASTA Acute upper respiratory Berobat Jalan
infection, unspecified
2948 08-03-2018 0137U0040318Y000961 0001648022949 ZAILANI M L PEKERJA MANDIRI Other secondary arthrosis Berobat Jalan

2949 08-03-2018 0137U0040318Y000873 0001655730257 MILANO ABIMATA RIBALDI L PEGAWAI SWASTA Acute upper respiratory Berobat Jalan
infection, unspecified
2950 08-03-2018 0137U0040318Y000861 0001718270289 KARNAEN SUTEDJA L PEKERJA MANDIRI Acute upper respiratory Berobat Jalan
infection, unspecified
2951 08-03-2018 0137U0040318Y000885 0001721910306 TRISNANINGSIH P PEKERJA MANDIRI Antenatal screening Berobat Jalan

2952 08-03-2018 0137U0040318Y000886 0001722653831 HELEN TANDIYO P PEKERJA MANDIRI Myalgia Berobat Jalan

2953 08-03-2018 0137U0040318Y000930 0001723662562 ELKA JESIKA P PEKERJA MANDIRI Necrosis of pulp Berobat Jalan

2954 08-03-2018 0137U0040318Y000849 0001728381699 IR.SAFRUDIN LEO L PEKERJA MANDIRI Cerebral infarction, Rujuk Lanjut
unspecified
2955 08-03-2018 0137U0040318Y000848 0001729336882 SUKIMAN TAUFIK L PEKERJA MANDIRI Hyperplasia of prostate Rujuk Lanjut

2956 08-03-2018 0137U0040318Y000880 0001736571284 NANDA RIZKY AULIA P PEGAWAI SWASTA Diarrhoea and Berobat Jalan
gastroenteritis of
presumed infectious origin

2957 08-03-2018 0137U0040318Y000882 0001736571295 NAYLA RIZKY AMARA P PEGAWAI SWASTA Embedded and impacted Berobat Jalan
teeth
DAFTAR KUNJUNGAN PESERTA SAKIT

Kantor Cabang : BEKASI - 1011

FKTP : Klinik Mitra Medika - 0137U004

2958 08-03-2018 0137U0040318Y000858 0001736904295 AFIQAH ZHAFIRAH L PEGAWAI SWASTA Acute upper respiratory Berobat Jalan
infection, unspecified
2959 08-03-2018 0137U0040318Y000949 0001769601161 DEDI SURYADI L PEGAWAI SWASTA Dyspepsia Berobat Jalan

2960 08-03-2018 0137U0040318Y000947 0001772687316 FIRLY ANADITA HERLAMBANG L PEGAWAI SWASTA Acute upper respiratory Berobat Jalan
infection, unspecified
2961 08-03-2018 0137U0040318Y000879 0001773529953 IRENE EPHIFANIA SILAS P PEGAWAI BUMD Other specified headache Berobat Jalan
syndromes
2962 08-03-2018 0137U0040318Y000917 0001789925589 SRI DEWI ENDANG MURNI P PEKERJA MANDIRI Dyspepsia Berobat Jalan
RAHAYU
2963 08-03-2018 0137U0040318Y000871 0001790891651 wiryantini P PEKERJA MANDIRI Chronic kidney disease Rujuk Lanjut

2964 08-03-2018 0137U0040318Y000864 0001826513965 ISNI WAHYUNINGTYAS P PEKERJA MANDIRI Acute upper respiratory Berobat Jalan
infection, unspecified
2965 08-03-2018 0137U0040318Y000945 0001831269835 SUHAIMI L PEGAWAI SWASTA Congestive heart failure Rujuk Lanjut

2966 08-03-2018 0137U0040318Y000865 0001837523913 ESTHER RITA LUMBAN TOBING P PEGAWAI SWASTA Irregular menstruation, Berobat Jalan
unspecified
2967 08-03-2018 0137U0040318Y000967 0001844098389 DWI PRIYANTI P PEGAWAI SWASTA Myalgia Berobat Jalan

2968 08-03-2018 0137U0040318Y000929 0001845154337 RIEN WULANDARI, SP P PEGAWAI SWASTA Impacted teeth Berobat Jalan

2969 08-03-2018 0137U0040318Y000869 0001845776777 sabil abdillah L PEKERJA MANDIRI Foreign body in colon Berobat Jalan

2970 08-03-2018 0137U0040318Y000957 0001855644219 LOGOLA HARJAYA TJOENG L PEGAWAI SWASTA Chronic gingivitis Berobat Jalan

2971 08-03-2018 0137U0040318Y000965 0001863250806 safa nanda kasyafani P PBI (APBD) Dyspepsia Berobat Jalan

2972 08-03-2018 0137U0040318Y000943 0001866468971 SITI MARIAM P PEGAWAI SWASTA Other and unspecified Berobat Jalan
infectious diseases
2973 08-03-2018 0137U0040318Y000897 0001867542445 euis mujayanah P PEKERJA MANDIRI Tuberculosis of lung, Rujuk Lanjut
confirmed by sputum
microscopy with or without

2974 08-03-2018 0137U0040318Y000872 0001873696386 NAJWA ASYILAH PUTRI P PEGAWAI SWASTA Acute upper respiratory Berobat Jalan
infection, unspecified
2975 08-03-2018 0137U0040318Y000939 0001889564984 TARUNA IMKA KARNAEN L PEKERJA MANDIRI Acute upper respiratory Berobat Jalan
infection, unspecified
2976 08-03-2018 0137U0040318Y000935 0001893044867 helena vidianty P PNS PUSAT Dyspepsia Berobat Jalan

2977 08-03-2018 0137U0040318Y000905 0001900845898 Jihan Ainun Mahya L PEGAWAI SWASTA Developmental disorder of Rujuk Lanjut
speech and language,

2978 08-03-2018 0137U0040318Y000926 0001906487864 MISRIYAH P PEGAWAI BUMD Necrosis of pulp Berobat Jalan

2979 08-03-2018 0137U0040318Y000934 0001906651923 MISKAM L PENERIMA PENSIUN Dyspepsia Berobat Jalan
PNS
DAFTAR KUNJUNGAN PESERTA SAKIT

Kantor Cabang : BEKASI - 1011

FKTP : Klinik Mitra Medika - 0137U004

2980 08-03-2018 0137U0040318Y000964 0001959435549 azka rizqi ramadhan L PEKERJA MANDIRI Acute upper respiratory Berobat Jalan
infection, unspecified
2981 08-03-2018 0137U0040318Y000887 0001960753667 wijayanti P PEKERJA MANDIRI Contraceptive Berobat Jalan
management
2982 08-03-2018 0137U0040318Y000893 0001964508131 FITRIA S P PEKERJA MANDIRI Acute upper respiratory Berobat Jalan
infection, unspecified
2983 08-03-2018 0137U0040318Y000896 0002037965681 ZAFIRA HASNA NAFISAH P PEGAWAI SWASTA Acute upper respiratory Berobat Jalan
infection, unspecified
2984 08-03-2018 0137U0040318Y000919 0002054316374 MUHAMMAD ARDIYANTO L PEGAWAI BUMN Acute upper respiratory Berobat Jalan
UTOMO infection, unspecified
2985 08-03-2018 0137U0040318Y000868 0002060178917 LINA HERLINAWATI P PEGAWAI SWASTA Foreign body in colon Berobat Jalan

2986 08-03-2018 0137U0040318Y000916 0002061962188 JECONIA PRISCILLA SAMPE P PEGAWAI SWASTA Acute upper respiratory Berobat Jalan
infection, unspecified
2987 08-03-2018 0137U0040318Y000881 0002092014808 kim kathleen sanaky P PEKERJA MANDIRI Acute upper respiratory Berobat Jalan
infection, unspecified
2988 08-03-2018 0137U0040318Y000907 0002137892455 FIRLY AZZURA P PEGAWAI SWASTA Myalgia Berobat Jalan

2989 08-03-2018 0137U0040318Y000933 0002206165509 SIDIQ AHMMAD L ANGGOTA POLRI Acute upper respiratory Berobat Jalan
infection, unspecified
2990 08-03-2018 0137U0040318Y000908 0002217031558 RAFIYUDDIN H L PENERIMA PENSIUN Acute upper respiratory Berobat Jalan
SWASTA infection, unspecified
2991 08-03-2018 0137U0040318Y000913 0002275139327 VALERIANA NATALY P PEGAWAI SWASTA Acute upper respiratory Berobat Jalan
infection, unspecified
2992 08-03-2018 0137U0040318Y000914 0002275139924 VICKY CHANDRA L PEGAWAI SWASTA Other and unspecified Berobat Jalan
infectious diseases
2993 08-03-2018 0137U0040318Y000890 0002292169151 SEPTI LIA PUSPITA SARI P PEGAWAI SWASTA Non-Hodgkin's lymphoma, Berobat Jalan
unspecified type

2994 08-03-2018 0137U0040318Y000889 0002292169667 IRFA AMALIA PUTRI L PEGAWAI SWASTA Acute upper respiratory Berobat Jalan
infection, unspecified
2995 08-03-2018 0137U0040318Y000876 0002295735388 NAUFAL RIZKY ATHALLAH L PEGAWAI SWASTA Typhoid fever Berobat Jalan

2996 08-03-2018 0137U0040318Y000901 0002324294673 GIRINDRA TEANA AYESHA L PEGAWAI SWASTA Gastroenteritis and colitis Berobat Jalan
due to radiation
2997 08-03-2018 0137U0040318Y000962 0002420950994 ANDREAN L PEGAWAI SWASTA Acute upper respiratory Berobat Jalan
infection, unspecified
2998 08-03-2018 0137U0040318Y000909 0002432045092 ANNISA EKA PUTRI P PEKERJA MANDIRI Myopia Rujuk Lanjut

2999 07-03-2018 0137U0040318Y000795 0000016041791 ARMEND L PENERIMA PENSIUN Dental caries, unspecified Berobat Jalan
PNS
3000 07-03-2018 0137U0040318Y000797 0000017575874 DILLA WAHYUNI P PEGAWAI SWASTA Impacted teeth Berobat Jalan

3001 07-03-2018 0137U0040318Y000781 0000037299587 ACHMAD HILMAN SADIQIN L PEGAWAI SWASTA Acute upper respiratory Berobat Jalan
infection, unspecified
DAFTAR KUNJUNGAN PESERTA SAKIT

Kantor Cabang : BEKASI - 1011

FKTP : Klinik Mitra Medika - 0137U004

3002 07-03-2018 0137U0040318Y000807 0000041105608 MARIHOT HUTABARAT L PENERIMA PENSIUN Insulin-dependent Rujuk Lanjut
PNS diabetes mellitus with

3003 07-03-2018 0137U0040318Y000822 0000072735682 ENTAR KURNAESIH P PNS DAERAH Other specified headache Berobat Jalan
syndromes
3004 07-03-2018 0137U0040318Y000828 0000072829214 DEVIENA ANISA P PEGAWAI SWASTA Acute upper respiratory Berobat Jalan
infection, unspecified
3005 07-03-2018 0137U0040318Y000778 0000073243686 SITRUMIYATI P PENERIMA PENSIUN Insulin-dependent Rujuk Lanjut
PNS diabetes mellitus
3006 07-03-2018 0137U0040318Y000773 0000073531271 LISMAN SETIAWAN L PNS PUSAT Other surgical follow-up Berobat Jalan
TANJUNG,ST. care
3007 07-03-2018 0137U0040318Y000838 0001100629247 AJENG LUPITA HANDAYANI P PEKERJA MANDIRI Acute upper respiratory Berobat Jalan
infection, unspecified
3008 07-03-2018 0137U0040318Y000791 0001135995535 RIDWAN L PEGAWAI SWASTA Dental caries, unspecified Berobat Jalan

3009 07-03-2018 0137U0040318Y000809 0001143810628 RUSDI FLORA NAINGGOLAN P PEKERJA MANDIRI Dental caries, unspecified Berobat Jalan

3010 07-03-2018 0137U0040318Y000789 0001257743013 YOSEPH DHASA L PEGAWAI SWASTA Acute upper respiratory Berobat Jalan
infection, unspecified
3011 07-03-2018 0137U0040318Y000813 0001259233839 BONG POSUN FRANSISKUS L PEKERJA MANDIRI Other specified headache Berobat Jalan
syndromes
3012 07-03-2018 0137U0040318Y000750 0001260754727 CAECILIA INRIANI SUSANTI P PEKERJA MANDIRI Dyspepsia Rujuk Lanjut

3013 07-03-2018 0137U0040318Y000821 0001270448324 DWI ANTONO L PEGAWAI SWASTA Pyothorax without fistula Berobat Jalan

3014 07-03-2018 0137U0040318Y000819 0001271410593 IRAD JAHJA L PEKERJA MANDIRI Acute upper respiratory Berobat Jalan
infection, unspecified
3015 07-03-2018 0137U0040318Y000820 0001271411831 AZARINE NURATNA SHAFA P PEKERJA MANDIRI Acute upper respiratory Berobat Jalan
infection, unspecified
3016 07-03-2018 0137U0040318Y000788 0001272330459 susanti P PEGAWAI SWASTA Gastro-oesophageal reflux Berobat Jalan
disease without

3017 07-03-2018 0137U0040318Y000787 0001272331269 davin arkana masta L PEGAWAI SWASTA Gastro-oesophageal reflux Berobat Jalan
disease without

3018 07-03-2018 0137U0040318Y000834 0001284022552 ADE PUTI UNGU AL KHANSA P PNS PUSAT Dyspepsia Berobat Jalan

3019 07-03-2018 0137U0040318Y000815 0001284712075 YOHANES MIKHAELIS L PEKERJA MANDIRI Other and unspecified Berobat Jalan
BANYUTAWA infectious diseases
3020 07-03-2018 0137U0040318Y000814 0001284895405 NURAINI P PEKERJA MANDIRI Irregular menstruation, Berobat Jalan
unspecified
3021 07-03-2018 0137U0040318Y000755 0001286658551 LUHUT SIHOMBING NABABAN L PEKERJA MANDIRI Chronic ischaemic heart Rujuk Lanjut
disease, unspecified
3022 07-03-2018 0137U0040318Y000805 0001303205433 MUCHAMMAD DJAMZANI L PEGAWAI SWASTA Hyperplasia of prostate Rujuk Lanjut
DAFTAR KUNJUNGAN PESERTA SAKIT

Kantor Cabang : BEKASI - 1011

FKTP : Klinik Mitra Medika - 0137U004

3023 07-03-2018 0137U0040318Y000844 0001306536298 UMAY P PEGAWAI SWASTA Myalgia Berobat Jalan

3024 07-03-2018 0137U0040318Y000760 0001311832743 minah P PEKERJA MANDIRI Dyspepsia Berobat Jalan

3025 07-03-2018 0137U0040318Y000770 0001312829289 SUTARMIATI P PEKERJA MANDIRI Acute upper respiratory Berobat Jalan
infection, unspecified
3026 07-03-2018 0137U0040318Y000800 0001314543339 MURNIATI P PEGAWAI SWASTA Other antenatal screening Berobat Jalan

3027 07-03-2018 0137U0040318Y000824 0001314942625 ANDY SUGIARTO L PEGAWAI SWASTA Acute upper respiratory Berobat Jalan
infection, unspecified
3028 07-03-2018 0137U0040318Y000833 0001317110624 ADE CHRISTYAWATI P PEGAWAI SWASTA Myopia Berobat Jalan

3029 07-03-2018 0137U0040318Y000818 0001326205135 DINI NURYATI P PEKERJA MANDIRI Myalgia Berobat Jalan

3030 07-03-2018 0137U0040318Y000798 0001335473199 HUSNI TJANGGAH L PEKERJA MANDIRI Dental caries, unspecified Berobat Jalan

3031 07-03-2018 0137U0040318Y000757 0001335579568 ALRIYATMI P PEKERJA MANDIRI Other specified headache Berobat Jalan
syndromes
3032 07-03-2018 0137U0040318Y000840 0001337472191 MUHAMMAD EKO SANTOSO L PEGAWAI SWASTA Acute upper respiratory Berobat Jalan
infection, unspecified
3033 07-03-2018 0137U0040318Y000793 0001378463646 RATIH AGUSTINE AMBARWATY P PEGAWAI SWASTA Dental caries, unspecified Berobat Jalan

3034 07-03-2018 0137U0040318Y000792 0001378463861 NADIRA ZUHAYR JULYANA P PEGAWAI SWASTA Dental caries, unspecified Berobat Jalan
PUTRI
3035 07-03-2018 0137U0040318Y000769 0001400095394 MUHAMMAD DAFA AGUSTYAN L PEKERJA MANDIRI Acute upper respiratory Berobat Jalan
infection, unspecified
3036 07-03-2018 0137U0040318Y000794 0001409182378 ARIS SETIYAWAN L PEGAWAI SWASTA Dental caries, unspecified Berobat Jalan

3037 07-03-2018 0137U0040318Y000763 0001422432145 LIE FA TIN L PEKERJA MANDIRI Other cataract Rujuk Lanjut

3038 07-03-2018 0137U0040318Y000825 0001427995315 ALI PURMONO L PEGAWAI SWASTA Acute upper respiratory Berobat Jalan
infection, unspecified
3039 07-03-2018 0137U0040318Y000839 0001435571897 syuryati P PEKERJA MANDIRI Myalgia Berobat Jalan

3040 07-03-2018 0137U0040318Y000806 0001436367385 CUT MUTIA HANDAYANI P PEGAWAI SWASTA Dermatitis herpetiformis Rujuk Lanjut

3041 07-03-2018 0137U0040318Y000758 0001442802734 TITIEK LESTARI P PEKERJA MANDIRI Dyspepsia Berobat Jalan

3042 07-03-2018 0137U0040318Y000796 0001445592622 AMRI WASATRI IR L PEKERJA MANDIRI Impacted teeth Berobat Jalan

3043 07-03-2018 0137U0040318Y000826 0001446085045 SRI MULYANI P PEGAWAI SWASTA Otitis externa, unspecified Rujuk Lanjut

3044 07-03-2018 0137U0040318Y000765 0001453067662 THALIA CAREN GUNAWAN P PEKERJA MANDIRI Postprocedural disorder of Rujuk Lanjut
eye and adnexa,

3045 07-03-2018 0137U0040318Y000783 0001453791374 CLAY ANDREW HANSEL L PEKERJA MANDIRI Myopia Berobat Jalan
DAFTAR KUNJUNGAN PESERTA SAKIT

Kantor Cabang : BEKASI - 1011

FKTP : Klinik Mitra Medika - 0137U004

3046 07-03-2018 0137U0040318Y000761 0001453943362 VERY JULIAN L PEGAWAI SWASTA Unspecified haemorrhoids Berobat Jalan
without complication

3047 07-03-2018 0137U0040318Y000759 0001454958459 SRI HARTINI P PEKERJA MANDIRI Multiple superficial injuries, Rujuk Lanjut
unspecified
3048 07-03-2018 0137U0040318Y000762 0001455252827 VALERIAN HENDRI YONO L PEKERJA MANDIRI Acute upper respiratory Berobat Jalan
infection, unspecified
3049 07-03-2018 0137U0040318Y000846 0001458466751 YULI VERAWATI P PEKERJA MANDIRI Impacted teeth Berobat Jalan

3050 07-03-2018 0137U0040318Y000767 0001460427996 NURHADY ANWAR L PEKERJA MANDIRI Dyspepsia Berobat Jalan

3051 07-03-2018 0137U0040318Y000764 0001460437277 ABDUL MANAN L PEKERJA MANDIRI Multiple superficial injuries, Rujuk Lanjut
unspecified
3052 07-03-2018 0137U0040318Y000777 0001460685025 LANIH P PEKERJA MANDIRI Family history of asthma Rujuk Lanjut
and other chronic lower

3053 07-03-2018 0137U0040318Y000823 0001461000071 HERLINA P PEKERJA MANDIRI Other specified headache Berobat Jalan
syndromes
3054 07-03-2018 0137U0040318Y000784 0001462791565 AZILI ALI L PEKERJA MANDIRI Other specified headache Berobat Jalan
syndromes
3055 07-03-2018 0137U0040318Y000768 0001463634415 SULASTRI P PEKERJA MANDIRI Chronic ischaemic heart Berobat Jalan
disease
3056 07-03-2018 0137U0040318Y000817 0001466962132 URIP L PEKERJA MANDIRI Myalgia Berobat Jalan

3057 07-03-2018 0137U0040318Y000776 0001481694423 DJUMROH P PEKERJA MANDIRI Cerebral infarction Rujuk Lanjut

3058 07-03-2018 0137U0040318Y000837 0001517810624 DWI PAMBUDI L PEGAWAI SWASTA Acute upper respiratory Berobat Jalan
infection, unspecified
3059 07-03-2018 0137U0040318Y000831 0001608797553 LIDIA P PEGAWAI SWASTA Irregular menstruation, Berobat Jalan
unspecified
3060 07-03-2018 0137U0040318Y000835 0001629387134 HANA SHOFI RAHAYU P PEGAWAI SWASTA Acute upper respiratory Berobat Jalan
infection, unspecified
3061 07-03-2018 0137U0040318Y000829 0001631776329 ALDINO L PEGAWAI SWASTA Other specified headache Berobat Jalan
syndromes
3062 07-03-2018 0137U0040318Y000801 0001631904682 INDAH WIDIAWATI P PEGAWAI SWASTA Other antenatal screening Berobat Jalan

3063 07-03-2018 0137U0040318Y000779 0001631904693 ENDI L PEGAWAI SWASTA Hypermetropia Berobat Jalan

3064 07-03-2018 0137U0040318Y000841 0001637893012 SYARIFAH P PEGAWAI SWASTA Myalgia Berobat Jalan

3065 07-03-2018 0137U0040318Y000785 0001643508887 ASAN L PEGAWAI SWASTA Myalgia Berobat Jalan

3066 07-03-2018 0137U0040318Y000754 0001643838467 RINA EKASARI P PEKERJA MANDIRI Impacted teeth Rujuk Lanjut

3067 07-03-2018 0137U0040318Y000832 0001643838478 SARAH ALDRIANI L PEKERJA MANDIRI Acute upper respiratory Berobat Jalan
infection, unspecified
DAFTAR KUNJUNGAN PESERTA SAKIT

Kantor Cabang : BEKASI - 1011

FKTP : Klinik Mitra Medika - 0137U004

3068 07-03-2018 0137U0040318Y000827 0001644736419 PRIYA JATI L PEGAWAI SWASTA Acute upper respiratory Berobat Jalan
infection, unspecified
3069 07-03-2018 0137U0040318Y000756 0001649401514 IDA FITRI P PEGAWAI SWASTA Gastritis, unspecified Berobat Jalan

3070 07-03-2018 0137U0040318Y000845 0001657089527 IRFAN ARDHIANSYAH PUTRA L PEGAWAI SWASTA Necrosis of pulp Berobat Jalan

3071 07-03-2018 0137U0040318Y000772 0001658328614 RIKA AKANA P PEGAWAI SWASTA Diarrhoea and Berobat Jalan
gastroenteritis of
presumed infectious origin

3072 07-03-2018 0137U0040318Y000786 0001661875896 IDAH P PEGAWAI BUMN Myalgia Berobat Jalan

3073 07-03-2018 0137U0040318Y000749 0001710946462 NIKEN OCTAVIA S P PEGAWAI SWASTA Threatened abortion Rujuk Lanjut

3074 07-03-2018 0137U0040318Y000803 0001716589877 CHRISTINA ALVITA DAMAYANTI P PEKERJA MANDIRI Fracture of lower leg, part Rujuk Lanjut
unspecified , open
3075 07-03-2018 0137U0040318Y000804 0001716589899 ANNA M SUJATI P PEKERJA MANDIRI Hypertensive heart Rujuk Lanjut
disease with (congestive)

3076 07-03-2018 0137U0040318Y000842 0001725595086 SURIYANTI P PEKERJA MANDIRI Other secondary arthrosis Berobat Jalan

3077 07-03-2018 0137U0040318Y000752 0001730121445 IIN ISMALIYAH P PEKERJA MANDIRI Schizophrenia, unspecified Rujuk Lanjut

3078 07-03-2018 0137U0040318Y000780 0001736851566 EVA NURFAZRIAH P PEGAWAI SWASTA Acute upper respiratory Berobat Jalan
infection, unspecified
3079 07-03-2018 0137U0040318Y000799 0001742744957 AYU NILA WARDANI P PEGAWAI SWASTA Dental caries, unspecified Berobat Jalan

3080 07-03-2018 0137U0040318Y000751 0001785239831 RUSHAYATI P PEKERJA MANDIRI Primary generalized Rujuk Lanjut
(osteo)arthrosis
3081 07-03-2018 0137U0040318Y000774 0001819311513 I PUTU SUDARMA PUTRA L PEKERJA MANDIRI Typhoid and paratyphoid Rujuk Lanjut
fevers
3082 07-03-2018 0137U0040318Y000753 0001819750893 RISMA SINAGA P PEGAWAI SWASTA Dyspepsia Rujuk Lanjut

3083 07-03-2018 0137U0040318Y000812 0001836272799 JENNI DJILIANTI P PEKERJA MANDIRI Low back pain Rujuk Lanjut

3084 07-03-2018 0137U0040318Y000811 0001839252216 SUBADIYONO BE L PEKERJA MANDIRI Hyperplasia of prostate Rujuk Lanjut

3085 07-03-2018 0137U0040318Y000810 0001852548669 PRISTIKA DEWI P PEKERJA MANDIRI Acute upper respiratory Berobat Jalan
infection, unspecified
3086 07-03-2018 0137U0040318Y000836 0001870546397 MOEHAMMAD ARIEF RACHMAN L PEGAWAI SWASTA Other and unspecified Berobat Jalan
infectious diseases
3087 07-03-2018 0137U0040318Y000766 0001892021905 teddy rachmat riyadi L PEGAWAI SWASTA Chronic ischaemic heart Rujuk Lanjut
disease
3088 07-03-2018 0137U0040318Y000808 0002045210264 al farras langit antono L PEGAWAI SWASTA Chronic gingivitis Berobat Jalan

3089 07-03-2018 0137U0040318Y000771 0002053667204 TEGUH SISWADI L PEKERJA MANDIRI Other specified headache Berobat Jalan
syndromes
DAFTAR KUNJUNGAN PESERTA SAKIT

Kantor Cabang : BEKASI - 1011

FKTP : Klinik Mitra Medika - 0137U004

3090 07-03-2018 0137U0040318Y000830 0002091353049 DIPO SATRIO L PEGAWAI PEMERINTAH Other and unspecified Berobat Jalan
NON PNS infectious diseases
3091 07-03-2018 0137U0040318Y000790 0002196031285 SALIMAN L PEKERJA MANDIRI Impacted teeth Berobat Jalan

3092 07-03-2018 0137U0040318Y000816 0002208339246 FAJAR DWI SATRIO L PEGAWAI PEMERINTAH Acute upper respiratory Berobat Jalan
DENGAN PERJANJIAN infection, unspecified

3093 07-03-2018 0137U0040318Y000843 0002208690303 CINDY YULIANE KHANJAYA P PEGAWAI SWASTA Acute upper respiratory Berobat Jalan
infection, unspecified
3094 07-03-2018 0137U0040318Y000782 0002209911939 SUMIYATI P PEKERJA MANDIRI Multiple superficial injuries, Berobat Jalan
unspecified
3095 07-03-2018 0137U0040318Y000775 0002230809456 PRISCILLA KINARA YULIANTO P PEGAWAI SWASTA Stomatitis and related Berobat Jalan
lesions
3096 07-03-2018 0137U0040318Y000802 0002272538114 yuyun sari ayu wahyuni P PEKERJA MANDIRI Other contraceptive Berobat Jalan
management
3097 06-03-2018 0137U0040318Y000653 0000009054911 DRA SONDANG MARIA P PNS PUSAT Other specified headache Berobat Jalan
syndromes
3098 06-03-2018 0137U0040318Y000744 0000055661769 TIROMLI TAMBUNAN P PNS DAERAH Impacted teeth Berobat Jalan

3099 06-03-2018 0137U0040318Y000719 0000072303186 AZKA SHAFIRA P PNS DAERAH Dyspepsia Berobat Jalan

3100 06-03-2018 0137U0040318Y000586 0000073004602 BAMBANG GUNAWAN,SE.MM L PENERIMA PENSIUN TNI Insulin-dependent Rujuk Lanjut
diabetes mellitus with

3101 06-03-2018 0137U0040318Y000617 0000073266085 ANATYE AMELIA SITANALA L P PENERIMA PENSIUN Acute upper respiratory Berobat Jalan
PNS infection, unspecified
3102 06-03-2018 0137U0040318Y000629 0000073403829 PATMAH P PNS DAERAH Other specified headache Berobat Jalan
syndromes
3103 06-03-2018 0137U0040318Y000643 0000073415351 DWITA RESSA RIANA P PEGAWAI SWASTA Acute upper respiratory Berobat Jalan
infection, unspecified
3104 06-03-2018 0137U0040318Y000583 0000073570882 FARIDA PURWANTI HASSAN P PNS DAERAH Low back pain Rujuk Lanjut

3105 06-03-2018 0137U0040318Y000730 0000093185144 NADHIRA KOMALA HASTUTI P PNS PUSAT Acute upper respiratory Berobat Jalan
infection, unspecified
3106 06-03-2018 0137U0040318Y000593 0000195018759 AYUNINGTYAS CHAIRANI P PNS PUSAT Impacted teeth Rujuk Lanjut

3107 06-03-2018 0137U0040318Y000655 0000198112419 SOPHIAN FANANY, DRS L PENERIMA PENSIUN Dental caries, unspecified Berobat Jalan
PNS
3108 06-03-2018 0137U0040318Y000591 0000198112746 IMAM MUTTAQIN L PENERIMA PENSIUN Impacted teeth Rujuk Lanjut
PNS
3109 06-03-2018 0137U0040318Y000669 0000508618451 RUSMAN HADI L PBI (APBN) Unspecified haemorrhoids Berobat Jalan
without complication

3110 06-03-2018 0137U0040318Y000618 0000552139391 WAHYU SETYOWATI P PEGAWAI SWASTA Dyspepsia Berobat Jalan
DAFTAR KUNJUNGAN PESERTA SAKIT

Kantor Cabang : BEKASI - 1011

FKTP : Klinik Mitra Medika - 0137U004

3111 06-03-2018 0137U0040318Y000742 0001013875007 MIFTAHUL ROHMAH L PEKERJA MANDIRI Necrosis of pulp Berobat Jalan

3112 06-03-2018 0137U0040318Y000609 0001100629247 AJENG LUPITA HANDAYANI P PEKERJA MANDIRI Other specified headache Berobat Jalan
syndromes
3113 06-03-2018 0137U0040318Y000595 0001132551145 PENCE HARRIEYANTHO L PEKERJA MANDIRI Other specified nontoxic Rujuk Lanjut
SULISTIYO goitre
3114 06-03-2018 0137U0040318Y000720 0001136509266 NELLY SOELOE P PEGAWAI SWASTA Acute upper respiratory Berobat Jalan
infection, unspecified
3115 06-03-2018 0137U0040318Y000615 0001143044853 FENNY TRI POERWANTO L PEGAWAI SWASTA Acute upper respiratory Berobat Jalan
infection, unspecified
3116 06-03-2018 0137U0040318Y000731 0001159371483 NUNUNG NURHAYATI P PEGAWAI SWASTA Dyspepsia Berobat Jalan

3117 06-03-2018 0137U0040318Y000680 0001175636294 ASTRI NURMALAHAYATI P PEGAWAI SWASTA Other antenatal screening Berobat Jalan

3118 06-03-2018 0137U0040318Y000678 0001189133133 ERNA AGUS YUNITA P PEGAWAI SWASTA Other contraceptive Berobat Jalan
management
3119 06-03-2018 0137U0040318Y000614 0001197514326 TINTIN NOVTIANA P PEGAWAI SWASTA Acute pharyngitis, Berobat Jalan
unspecified
3120 06-03-2018 0137U0040318Y000627 0001200436424 RENDIKA ARLIYANSYAH L PEGAWAI SWASTA Acute upper respiratory Berobat Jalan
infection, unspecified
3121 06-03-2018 0137U0040318Y000667 0001238267417 GINA ANDRIYANA P PEGAWAI SWASTA Cutaneous abscess, Berobat Jalan
furuncle and carbuncle
3122 06-03-2018 0137U0040318Y000666 0001238267428 NANDA SYIFA AULIA LUBIS P PEGAWAI SWASTA Acute upper respiratory Berobat Jalan
infection, unspecified
3123 06-03-2018 0137U0040318Y000732 0001256584803 TATI ROCHAYATI P PEKERJA MANDIRI Dermatitis herpetiformis Berobat Jalan

3124 06-03-2018 0137U0040318Y000650 0001267506639 ARDI KUNCORO L PEKERJA MANDIRI Acute upper respiratory Berobat Jalan
infection, unspecified
3125 06-03-2018 0137U0040318Y000648 0001267506887 RINI ANGGRAINI P PEKERJA MANDIRI Acute upper respiratory Berobat Jalan
infection, unspecified
3126 06-03-2018 0137U0040318Y000649 0001267507023 RAIHAN RAMADAN L PEKERJA MANDIRI Acute upper respiratory Berobat Jalan
infection, unspecified
3127 06-03-2018 0137U0040318Y000673 0001271410839 NURBAETI RONY P PEKERJA MANDIRI Other specified headache Berobat Jalan
syndromes
3128 06-03-2018 0137U0040318Y000589 0001273083906 R. SOPIANI P PEKERJA MANDIRI Sciatica, multiple sites Rujuk Lanjut

3129 06-03-2018 0137U0040318Y000676 0001273138299 ALAWIYAH P PEKERJA MANDIRI Vertigo of central origin Berobat Jalan

3130 06-03-2018 0137U0040318Y000621 0001279133403 LEGIMAN L PEKERJA MANDIRI Myalgia Berobat Jalan

3131 06-03-2018 0137U0040318Y000652 0001290608098 IWAN RIDWAN INDARI L PEKERJA MANDIRI Dental caries, unspecified Berobat Jalan

3132 06-03-2018 0137U0040318Y000637 0001293307132 TITIEK SURATI P PEKERJA MANDIRI Dermatitis herpetiformis Berobat Jalan

3133 06-03-2018 0137U0040318Y000733 0001303748504 EGI PRAYOGO L PEKERJA MANDIRI Acute upper respiratory Berobat Jalan
infection, unspecified
DAFTAR KUNJUNGAN PESERTA SAKIT

Kantor Cabang : BEKASI - 1011

FKTP : Klinik Mitra Medika - 0137U004

3134 06-03-2018 0137U0040318Y000741 0001305157059 HENNY ROSITA P PEKERJA MANDIRI Dental caries, unspecified Berobat Jalan

3135 06-03-2018 0137U0040318Y000620 0001305687058 YENI MEILITA P PEKERJA MANDIRI Gastro-oesophageal reflux Berobat Jalan
disease without

3136 06-03-2018 0137U0040318Y000670 0001327630094 abidal persada anugrah P PNS DAERAH Acute upper respiratory Berobat Jalan
infection, unspecified
3137 06-03-2018 0137U0040318Y000665 0001376172505 OKSANTO L PEGAWAI SWASTA Other specified headache Berobat Jalan
syndromes
3138 06-03-2018 0137U0040318Y000664 0001389519202 SATRIO PINANDhITO L PEKERJA MANDIRI Dermatitis herpetiformis Berobat Jalan

3139 06-03-2018 0137U0040318Y000725 0001436783308 sofhya azmi safhira P PEKERJA MANDIRI Acute upper respiratory Berobat Jalan
infection, unspecified
3140 06-03-2018 0137U0040318Y000636 0001439933872 SRI LESTARI P PEKERJA MANDIRI Acute upper respiratory Berobat Jalan
infection, unspecified
3141 06-03-2018 0137U0040318Y000592 0001439934805 ALVITO KUSUMAH ADMAJA L PEKERJA MANDIRI Otalgia Rujuk Lanjut

3142 06-03-2018 0137U0040318Y000727 0001455750459 HARIS PUJIONO L PEKERJA MANDIRI Acute upper respiratory Berobat Jalan
infection, unspecified
3143 06-03-2018 0137U0040318Y000743 0001456351086 NANDITO ARYOSTYO L PEKERJA MANDIRI Abrasion of teeth Berobat Jalan
RADITHYA
3144 06-03-2018 0137U0040318Y000682 0001457179907 MUNDINGLAJA LUKMANTO L PEKERJA MANDIRI Insulin-dependent Rujuk Lanjut
diabetes mellitus with

3145 06-03-2018 0137U0040318Y000657 0001457611863 IKA PUJAWATI L PEKERJA MANDIRI Dental caries, unspecified Berobat Jalan

3146 06-03-2018 0137U0040318Y000748 0001457873469 MINARSIH P PEKERJA MANDIRI Dental caries, unspecified Berobat Jalan

3147 06-03-2018 0137U0040318Y000656 0001459030959 EEN L PEKERJA MANDIRI Other specified headache Berobat Jalan
syndromes
3148 06-03-2018 0137U0040318Y000724 0001459303075 ALFA RIZQI SUGIARTO L PNS DAERAH Acute upper respiratory Berobat Jalan
infection, unspecified
3149 06-03-2018 0137U0040318Y000651 0001463211922 LELYANI FRIDA P PEKERJA MANDIRI Dermatitis herpetiformis Berobat Jalan

3150 06-03-2018 0137U0040318Y000584 0001473082132 HAYATI SUSILO P PEKERJA MANDIRI Non-insulin-dependent Rujuk Lanjut
diabetes mellitus with
other specified

3151 06-03-2018 0137U0040318Y000672 0001482281807 MELANI MANSYUR SATIGI P PEKERJA MANDIRI Other specified headache Berobat Jalan
syndromes
3152 06-03-2018 0137U0040318Y000654 0001516291852 ABDUL MAJID L PEGAWAI SWASTA Necrosis of pulp Berobat Jalan

3153 06-03-2018 0137U0040318Y000596 0001516291942 SRI HASTINI P PEGAWAI SWASTA Vertigo of central origin Berobat Jalan

3154 06-03-2018 0137U0040318Y000606 0001517710138 ANDIK SUPRIYADI L PEGAWAI SWASTA Myalgia Berobat Jalan
DAFTAR KUNJUNGAN PESERTA SAKIT

Kantor Cabang : BEKASI - 1011

FKTP : Klinik Mitra Medika - 0137U004

3155 06-03-2018 0137U0040318Y000679 0001625364369 YANIH P PEGAWAI SWASTA Other contraceptive Berobat Jalan
management
3156 06-03-2018 0137U0040318Y000661 0001628986151 GILANG BRAMANDA L PEGAWAI SWASTA Other secondary arthrosis Rujuk Lanjut

3157 06-03-2018 0137U0040318Y000639 0001634367936 NUR SOIMAH P PEGAWAI SWASTA Acute upper respiratory Berobat Jalan
infection, unspecified
3158 06-03-2018 0137U0040318Y000612 0001634697268 SUMIATI P PEGAWAI BUMN Gastro-oesophageal reflux Berobat Jalan
disease without

3159 06-03-2018 0137U0040318Y000600 0001641989215 ARIYANTO GUNAWAN L PEGAWAI SWASTA Myalgia Berobat Jalan

3160 06-03-2018 0137U0040318Y000602 0001641989226 IKAWATI P PEGAWAI SWASTA Dyspepsia Berobat Jalan

3161 06-03-2018 0137U0040318Y000739 0001644259634 SUBAGYO L PEGAWAI SWASTA Impacted teeth Berobat Jalan

3162 06-03-2018 0137U0040318Y000663 0001647178874 DIAN KOESBANDONO L PEKERJA MANDIRI Calculus of kidney Rujuk Lanjut

3163 06-03-2018 0137U0040318Y000623 0001648806658 ABINAYA SAKHA PRADIPTA L PEGAWAI SWASTA Acute upper respiratory Berobat Jalan
infection, unspecified
3164 06-03-2018 0137U0040318Y000624 0001655439254 AJIS AMIN ANJASMARA L PEGAWAI SWASTA Acute upper respiratory Berobat Jalan
infection, unspecified
3165 06-03-2018 0137U0040318Y000709 0001655745208 FARHAN ADITYA PRATAMA L PEGAWAI SWASTA Encephalitis, myelitis and Rujuk Lanjut
encephalomyelitis,

3166 06-03-2018 0137U0040318Y000734 0001657482849 AHMAD PAUZI L PEGAWAI SWASTA Acute upper respiratory Berobat Jalan
infection, unspecified
3167 06-03-2018 0137U0040318Y000628 0001658328603 RICKY YULIANTO L PEGAWAI SWASTA Acute upper respiratory Berobat Jalan
infection, unspecified
3168 06-03-2018 0137U0040318Y000747 0001662571686 Herlina Endrayani P PEGAWAI SWASTA Impacted teeth Berobat Jalan

3169 06-03-2018 0137U0040318Y000681 0001710946462 NIKEN OCTAVIA S P PEGAWAI SWASTA Other antenatal screening Berobat Jalan

3170 06-03-2018 0137U0040318Y000721 0001717438779 DINA KOMALA P PEGAWAI SWASTA Pleural effusion, not Rujuk Lanjut
elsewhere classified
3171 06-03-2018 0137U0040318Y000671 0001719231287 TUMINAH P PEKERJA MANDIRI Dyspepsia Berobat Jalan

3172 06-03-2018 0137U0040318Y000659 0001724149304 MARYATI P PEKERJA MANDIRI Parkinson's disease Rujuk Lanjut

3173 06-03-2018 0137U0040318Y000646 0001725179308 AHMAD FATHAN ATHAYA L PEKERJA MANDIRI Typhoid fever Berobat Jalan

3174 06-03-2018 0137U0040318Y000616 0001727150275 ASEP NUGRAHA L PEKERJA MANDIRI Myalgia Berobat Jalan

3175 06-03-2018 0137U0040318Y000738 0001769438428 AHMAD AZZAM ABDILLAH L PEGAWAI SWASTA Acute upper respiratory Berobat Jalan
infection, unspecified
3176 06-03-2018 0137U0040318Y000603 0001769601238 ARI SUBEKTI P PEGAWAI SWASTA Acute upper respiratory Berobat Jalan
infection, unspecified
3177 06-03-2018 0137U0040318Y000736 0001790223682 RANDY TEGUH WIJATMIKO L PEKERJA MANDIRI Dermatitis herpetiformis Berobat Jalan
DAFTAR KUNJUNGAN PESERTA SAKIT

Kantor Cabang : BEKASI - 1011

FKTP : Klinik Mitra Medika - 0137U004

3178 06-03-2018 0137U0040318Y000729 0001801905838 Syachroni L PEGAWAI SWASTA Acute upper respiratory Berobat Jalan
infection, unspecified
3179 06-03-2018 0137U0040318Y000587 0001813025924 TS POERNOMO HADI L PEKERJA MANDIRI Secondary hypertension, Rujuk Lanjut
unspecified
3180 06-03-2018 0137U0040318Y000585 0001819443892 VICCY ANGELINE PURNAMA P PEGAWAI SWASTA Neuralgia and neuritis, Rujuk Lanjut
unspecified
3181 06-03-2018 0137U0040318Y000582 0001819750893 RISMA SINAGA P PEGAWAI SWASTA Mixed asthma Rujuk Lanjut

3182 06-03-2018 0137U0040318Y000662 0001829578454 SYAFRUDDIN KATUTU L PEKERJA MANDIRI Stroke, not specified as Rujuk Lanjut
haemorrhage or infarction
3183 06-03-2018 0137U0040318Y000626 0001837523913 ESTHER RITA LUMBAN TOBING P PEGAWAI SWASTA Acute upper respiratory Berobat Jalan
infection, unspecified
3184 06-03-2018 0137U0040318Y000723 0001838398241 DEDI HARYANTO L PEGAWAI SWASTA Myalgia Berobat Jalan

3185 06-03-2018 0137U0040318Y000718 0001852136289 ALIKA ZAHRA L PEGAWAI SWASTA Other specified bullous Berobat Jalan
disorders
3186 06-03-2018 0137U0040318Y000717 0001852136572 ARKAN RAMADAN HERI L PEGAWAI SWASTA Acute upper respiratory Berobat Jalan
infection, unspecified
3187 06-03-2018 0137U0040318Y000722 0001859482012 ANTONIUS SETIAWAN L PEKERJA MANDIRI Acute upper respiratory Berobat Jalan
CHANDRA infection, unspecified
3188 06-03-2018 0137U0040318Y000597 0001872833589 ADRIENNE FREIDA BUTAR P PEGAWAI SWASTA Typhoid fever Berobat Jalan
BUTAR
3189 06-03-2018 0137U0040318Y000590 0001874697142 ALEXI HAMONANGAN SIANIPAR L PEKERJA MANDIRI Respiratory tuberculosis, Rujuk Lanjut
bacteriologically and

3190 06-03-2018 0137U0040318Y000675 0001876128985 NANI SRI YANI P PEGAWAI SWASTA Acute upper respiratory Berobat Jalan
infection, unspecified
3191 06-03-2018 0137U0040318Y000588 0001876499717 ENI,HJ P PEKERJA MANDIRI Congestive heart failure Rujuk Lanjut

3192 06-03-2018 0137U0040318Y000594 0001882728797 PRASTA ALKHALIFI ZIKRI L PEKERJA MANDIRI Fever, unspecified Rujuk Lanjut
INDRAWAN
3193 06-03-2018 0137U0040318Y000728 0001902962867 SUMARSONO L PEKERJA MANDIRI Myalgia Berobat Jalan

3194 06-03-2018 0137U0040318Y000740 0001906487864 MISRIYAH P PEGAWAI BUMD Necrosis of pulp Berobat Jalan

3195 06-03-2018 0137U0040318Y000668 0001968594006 NAESYLA MARTEN P PEKERJA MANDIRI Acute upper respiratory Berobat Jalan
infection, unspecified
3196 06-03-2018 0137U0040318Y000613 0002040769877 nabil islami kassi L PEKERJA MANDIRI Gastro-oesophageal reflux Berobat Jalan
disease without

3197 06-03-2018 0137U0040318Y000737 0002059050993 ALVIAN RIZKY AZZAINI L PEKERJA MANDIRI Acute upper respiratory Berobat Jalan
infection, unspecified
3198 06-03-2018 0137U0040318Y000745 0002066073941 RIZKIA ALTHAFUNISSA P PEGAWAI SWASTA Acute tracheitis Berobat Jalan
NUGRAHA
DAFTAR KUNJUNGAN PESERTA SAKIT

Kantor Cabang : BEKASI - 1011

FKTP : Klinik Mitra Medika - 0137U004

3199 06-03-2018 0137U0040318Y000658 0002087695012 ALARIC AZZAHIDI L PEGAWAI SWASTA Diarrhoea and Berobat Jalan
gastroenteritis of
presumed infectious origin

3200 06-03-2018 0137U0040318Y000581 0002208339246 FAJAR DWI SATRIO L PEGAWAI PEMERINTAH Fracture of nasal bones Rujuk Lanjut
DENGAN PERJANJIAN

3201 06-03-2018 0137U0040318Y000638 0002210935252 R. RISNA WIDIANA P PEGAWAI SWASTA Acute pharyngitis, Berobat Jalan
unspecified
3202 06-03-2018 0137U0040318Y000726 0002211072941 salimah sari mumtazah P PEKERJA MANDIRI Acute upper respiratory Berobat Jalan
infection, unspecified
3203 06-03-2018 0137U0040318Y000716 0002211624123 BUNGA MAISA AKBAR P PEGAWAI SWASTA Acute upper respiratory Berobat Jalan
infection, unspecified
3204 06-03-2018 0137U0040318Y000715 0002235655067 FATHAN AZZAMI MASTA P PEGAWAI SWASTA Dyspepsia Rujuk Lanjut

3205 06-03-2018 0137U0040318Y000647 0002258513559 SYAHRIYANTO UTAMA L PEGAWAI SWASTA Other specified headache Berobat Jalan
syndromes
3206 06-03-2018 0137U0040318Y000746 0002260257311 AIRLANGGA SATURA WIBOWO L PEGAWAI SWASTA Chronic gingivitis Berobat Jalan

3207 06-03-2018 0137U0040318Y000660 0002265694997 FATIMAH AZ ZAHRA P PEKERJA MANDIRI Developmental disorder of Rujuk Lanjut
speech and language,

3208 06-03-2018 0137U0040318Y000674 0002275902764 michael hamrianto L PEKERJA MANDIRI Superficial injuries Berobat Jalan
involving other
combinations of body

3209 06-03-2018 0137U0040318Y000677 0002300276452 TOTO SUCIPTO L PEKERJA MANDIRI Myalgia Berobat Jalan

3210 06-03-2018 0137U0040318Y000735 0002419073594 BACHTIAR ARIFIN L PEKERJA MANDIRI Chronic renal failure, Rujuk Lanjut
unspecified
3211 05-03-2018 0137U0040318Y000690 0000035943063 WAGIYO L PENERIMA PENSIUN Impacted teeth Berobat Jalan
PNS
3212 05-03-2018 0137U0040318Y000691 0000035943074 SUKARSIH P PENERIMA PENSIUN Impacted teeth Berobat Jalan
PNS
3213 05-03-2018 0137U0040318Y000471 0000038881899 SUSY DAMAYANTI P PNS PUSAT Chronic ischaemic heart Rujuk Lanjut
disease
3214 05-03-2018 0137U0040318Y000508 0000042193484 DIDIT WASKITO L PNS PUSAT Other specified headache Berobat Jalan
syndromes
3215 05-03-2018 0137U0040318Y000550 0000042640367 DRS ALI PRAWOTO dipokusumo L PENERIMA PENSIUN TNI Tremor, unspecified Rujuk Lanjut

3216 05-03-2018 0137U0040318Y000512 0000072325091 FATIMAH P PNS DAERAH Acute upper respiratory Berobat Jalan
infection, unspecified
3217 05-03-2018 0137U0040318Y000532 0000072774167 ADRIAN ATMAJI P S, KOM L PNS DAERAH Acute pharyngitis, Berobat Jalan
unspecified
DAFTAR KUNJUNGAN PESERTA SAKIT

Kantor Cabang : BEKASI - 1011

FKTP : Klinik Mitra Medika - 0137U004

3218 05-03-2018 0137U0040318Y000469 0000073241908 AZWARDI AZIZ L PENERIMA PENSIUN Other and unspecified Rujuk Lanjut
PNS infectious diseases
3219 05-03-2018 0137U0040318Y000551 0000073281306 I'AH ROMDIYATI P PENERIMA PENSIUN Coronary artery aneurysm Rujuk Lanjut
PNS
3220 05-03-2018 0137U0040318Y000495 0000073517297 DESTIPUTRI ASIH P PNS DAERAH Embedded and impacted Berobat Jalan
MUNGGARAN teeth
3221 05-03-2018 0137U0040318Y000541 0000073531271 LISMAN SETIAWAN L PNS PUSAT Influenza due to identified Berobat Jalan
TANJUNG,ST. avian infliuenza virus

3222 05-03-2018 0137U0040318Y000632 0000196392238 HARYANI P PENERIMA PENSIUN Myalgia Berobat Jalan
PNS
3223 05-03-2018 0137U0040318Y000619 0000202416333 MOHAMAD S HAMDANI L PENERIMA PENSIUN Other specified headache Berobat Jalan
PNS syndromes
3224 05-03-2018 0137U0040318Y000490 0000977322205 RIKA DELTI P PNS PUSAT Benign neoplasm of breast Berobat Jalan

3225 05-03-2018 0137U0040318Y000708 0001123279424 YOPIE L PEGAWAI SWASTA Myalgia Berobat Jalan

3226 05-03-2018 0137U0040318Y000523 0001125169784 MOHAMAD TAUFIK L PNS PUSAT Acute upper respiratory Berobat Jalan
infection, unspecified
3227 05-03-2018 0137U0040318Y000625 0001130990095 FIRMAN MUCHLISIN L PEGAWAI SWASTA Gastro-oesophageal reflux Berobat Jalan
disease without

3228 05-03-2018 0137U0040318Y000607 0001132993866 SUPRIYATNA L PEGAWAI SWASTA Myalgia Berobat Jalan

3229 05-03-2018 0137U0040318Y000509 0001145160325 LAILAL FITRI HAMIDI SE P PEGAWAI BUMD Acute pharyngitis Berobat Jalan

3230 05-03-2018 0137U0040318Y000604 0001146846745 SUSANTI SE P PEGAWAI SWASTA Acute upper respiratory Berobat Jalan
infection, unspecified
3231 05-03-2018 0137U0040318Y000497 0001155385451 AMELLIA NATALIS P PEGAWAI SWASTA Single spontaneous Sembuh
delivery
3232 05-03-2018 0137U0040318Y000704 0001172327062 TINGGAL WAHYUNI P PEGAWAI SWASTA Other contraceptive Berobat Jalan
management
3233 05-03-2018 0137U0040318Y000686 0001172354769 JIHAN APRILYUNANDA P PEGAWAI SWASTA Chronic gingivitis Berobat Jalan

3234 05-03-2018 0137U0040318Y000461 0001177349703 BEATRIX ZACHAWERUS P PEGAWAI SWASTA Dyspepsia Rujuk Lanjut

3235 05-03-2018 0137U0040318Y000699 0001188876429 PANDU OKTA SEJATI L PEKERJA MANDIRI Abrasion of teeth Berobat Jalan

3236 05-03-2018 0137U0040318Y000693 0001219025395 NENENG FARHANAH P PEGAWAI SWASTA Impacted teeth Berobat Jalan

3237 05-03-2018 0137U0040318Y000630 0001221490484 DENDY SUGANDA L PEGAWAI SWASTA Dermatitis herpetiformis Berobat Jalan

3238 05-03-2018 0137U0040318Y000631 0001221497403 ULANDARI P PEGAWAI SWASTA Dyspepsia Berobat Jalan

3239 05-03-2018 0137U0040318Y000688 0001257554744 YUYUM RUMINI P PEKERJA MANDIRI Abrasion of teeth Berobat Jalan

3240 05-03-2018 0137U0040318Y000474 0001257602703 SRI LESTARI P PEKERJA MANDIRI Other arthritis Rujuk Lanjut
DAFTAR KUNJUNGAN PESERTA SAKIT

Kantor Cabang : BEKASI - 1011

FKTP : Klinik Mitra Medika - 0137U004

3241 05-03-2018 0137U0040318Y000455 0001257633652 ETTY ROCHAETI P PEKERJA MANDIRI Gastritis and duodenitis Rujuk Lanjut

3242 05-03-2018 0137U0040318Y000513 0001257747647 SITI SUDIARTI P PEKERJA MANDIRI Acute pharyngitis Berobat Jalan

3243 05-03-2018 0137U0040318Y000703 0001258150239 INDAH RAHAYU NINGSIH P PEKERJA MANDIRI Dental caries, unspecified Berobat Jalan

3244 05-03-2018 0137U0040318Y000525 0001258892706 H. KOSIM L PEKERJA MANDIRI Dental caries Berobat Jalan

3245 05-03-2018 0137U0040318Y000527 0001259200034 YEMIMA Y SILOOY SIPASULTA P PEKERJA MANDIRI Acute upper respiratory Berobat Jalan
infection, unspecified
3246 05-03-2018 0137U0040318Y000689 0001259823633 christine P PEKERJA MANDIRI Dental caries, unspecified Berobat Jalan

3247 05-03-2018 0137U0040318Y000465 0001260102756 KRISTIANA SATIO P PEKERJA MANDIRI Acute sinusitis Rujuk Lanjut

3248 05-03-2018 0137U0040318Y000484 0001260177603 NUR KARIMAH P PEKERJA MANDIRI Disorders of refraction and Rujuk Lanjut
accommodation
3249 05-03-2018 0137U0040318Y000534 0001260177761 HAFIZHA FITRI RAHMAWATI P PEKERJA MANDIRI Acute upper respiratory Berobat Jalan
infection, unspecified
3250 05-03-2018 0137U0040318Y000526 0001267018481 HANApI HANDOYO L PEKERJA MANDIRI Influenza due to identified Berobat Jalan
avian infliuenza virus

3251 05-03-2018 0137U0040318Y000554 0001267300934 SOENARYO KEMPES H L PEKERJA MANDIRI Coronary artery aneurysm Rujuk Lanjut

3252 05-03-2018 0137U0040318Y000702 0001267301081 HJ. TRI KASTIYANTI P PEKERJA MANDIRI Impacted teeth Berobat Jalan

3253 05-03-2018 0137U0040318Y000488 0001273454649 MOCHAMAD HUSEN L PEGAWAI SWASTA Embedded and impacted Berobat Jalan
teeth
3254 05-03-2018 0137U0040318Y000489 0001273454853 NURAENY P PEGAWAI SWASTA Dental caries Berobat Jalan

3255 05-03-2018 0137U0040318Y000577 0001277564016 YANI WIJAYA P PEKERJA MANDIRI Acute upper respiratory Berobat Jalan
infection, unspecified
3256 05-03-2018 0137U0040318Y000522 0001279712643 NURANDI L PEKERJA MANDIRI Acute upper respiratory Berobat Jalan
infection, unspecified
3257 05-03-2018 0137U0040318Y000548 0001282450522 LOLLY D WENAS WUNGKANA P PEKERJA MANDIRI Disorders of refraction and Rujuk Lanjut
accommodation
3258 05-03-2018 0137U0040318Y000706 0001282451038 FERLY JOHAN EDWARD W L PEGAWAI SWASTA Myalgia Berobat Jalan

3259 05-03-2018 0137U0040318Y000687 0001284895405 NURAINI P PEKERJA MANDIRI Impacted teeth Berobat Jalan

3260 05-03-2018 0137U0040318Y000473 0001292468635 BASARAJA SINURAT L PEGAWAI SWASTA Inguinal hernia Rujuk Lanjut

3261 05-03-2018 0137U0040318Y000456 0001295788228 AKLIMAH.HJ P PEKERJA MANDIRI Senile cataract, Rujuk Lanjut
unspecified
3262 05-03-2018 0137U0040318Y000610 0001299213977 JUSMAN TANJUNG L PEKERJA MANDIRI Acute upper respiratory Berobat Jalan
infection, unspecified
3263 05-03-2018 0137U0040318Y000558 0001304204095 A. PRASETYO L PEKERJA MANDIRI Atherosclerotic heart Rujuk Lanjut
disease
DAFTAR KUNJUNGAN PESERTA SAKIT

Kantor Cabang : BEKASI - 1011

FKTP : Klinik Mitra Medika - 0137U004

3264 05-03-2018 0137U0040318Y000560 0001304205197 F.SUPIYAH P PEKERJA MANDIRI Insulin-dependent Rujuk Lanjut
diabetes mellitus without

3265 05-03-2018 0137U0040318Y000552 0001307559576 NENENG LASMININGSIH P PEKERJA MANDIRI Chronic ischaemic heart Rujuk Lanjut
disease, unspecified
3266 05-03-2018 0137U0040318Y000695 0001327630094 abidal persada anugrah P PNS DAERAH Chronic gingivitis Berobat Jalan

3267 05-03-2018 0137U0040318Y000511 0001335371332 HENDRO SUYOTO L PEKERJA MANDIRI Acute sinusitis Berobat Jalan

3268 05-03-2018 0137U0040318Y000493 0001338487569 MIYOSHI NARULSA P PEKERJA MANDIRI Dental caries Berobat Jalan

3269 05-03-2018 0137U0040318Y000462 0001339467524 WIN NIO P PEKERJA MANDIRI Cataract, unspecified Rujuk Lanjut

3270 05-03-2018 0137U0040318Y000500 0001339650854 SUYATNI P PEKERJA MANDIRI Acute pharyngitis Berobat Jalan

3271 05-03-2018 0137U0040318Y000457 0001340206424 SUHARYATI P PEKERJA MANDIRI Bronchopneumonia, Rujuk Lanjut
unspecified
3272 05-03-2018 0137U0040318Y000570 0001381407186 RIZQI AKBAR ABDURRAHMAN L PEGAWAI SWASTA Disorder of refraction, Berobat Jalan
unspecified
3273 05-03-2018 0137U0040318Y000491 0001381643706 LINDA ROSE ISKANDAR P PEKERJA MANDIRI Acute pharyngitis, Berobat Jalan
unspecified
3274 05-03-2018 0137U0040318Y000642 0001386294939 RYAN ANDRE YANTO L PEGAWAI SWASTA Other specified headache Berobat Jalan
syndromes
3275 05-03-2018 0137U0040318Y000506 0001424091194 SITI MARYATUN P PEKERJA MANDIRI Acute pharyngitis Berobat Jalan

3276 05-03-2018 0137U0040318Y000567 0001430437443 TRI BUDI PURWANTI P PEGAWAI SWASTA Dysmenorrhoea, Berobat Jalan
unspecified
3277 05-03-2018 0137U0040318Y000458 0001432808572 suhandi L PEKERJA MANDIRI Cataract, unspecified Rujuk Lanjut

3278 05-03-2018 0137U0040318Y000464 0001436979183 PATRICIA ROSITA MARLINA P PEKERJA MANDIRI Other specified cataract Rujuk Lanjut

3279 05-03-2018 0137U0040318Y000470 0001439908479 INDAH WATI P PEKERJA MANDIRI Sequelae of stroke, not Rujuk Lanjut
specified as haemorrhage

3280 05-03-2018 0137U0040318Y000555 0001444209849 LIAN NIO P PEKERJA MANDIRI Other secondary arthrosis Rujuk Lanjut

3281 05-03-2018 0137U0040318Y000575 0001452132134 SRIANAH.WD P PEKERJA MANDIRI Dyspepsia Berobat Jalan

3282 05-03-2018 0137U0040318Y000635 0001453067662 THALIA CAREN GUNAWAN P PEKERJA MANDIRI Vertigo of central origin Berobat Jalan

3283 05-03-2018 0137U0040318Y000531 0001457454069 LILIK SUSWATI P PEKERJA MANDIRI Acute upper respiratory Berobat Jalan
infection, unspecified
3284 05-03-2018 0137U0040318Y000466 0001458606396 SUMARYADI L PEGAWAI SWASTA Radiculopathy Rujuk Lanjut

3285 05-03-2018 0137U0040318Y000533 0001460818293 NUR AINI L PENERIMA PENSIUN Other secondary arthrosis Rujuk Lanjut
SWASTA
DAFTAR KUNJUNGAN PESERTA SAKIT

Kantor Cabang : BEKASI - 1011

FKTP : Klinik Mitra Medika - 0137U004

3286 05-03-2018 0137U0040318Y000543 0001461053294 SUKARTI P PEKERJA MANDIRI Acute upper respiratory Berobat Jalan
infections of multiple and

3287 05-03-2018 0137U0040318Y000514 0001462195675 HJ WAHYUDIATI L PEGAWAI SWASTA Non-insulin-dependent Berobat Jalan
diabetes mellitus
3288 05-03-2018 0137U0040318Y000549 0001462312247 RISMAYANI P PEKERJA MANDIRI Uterovaginal prolapse, Rujuk Lanjut
unspecified
3289 05-03-2018 0137U0040318Y000463 0001462415253 ASUROH P PEKERJA MANDIRI Insulin-dependent Rujuk Lanjut
diabetes mellitus without

3290 05-03-2018 0137U0040318Y000538 0001463634415 SULASTRI P PEKERJA MANDIRI Disorder of refraction, Rujuk Lanjut
unspecified
3291 05-03-2018 0137U0040318Y000692 0001463839255 R ARI BINTORO L PEKERJA MANDIRI Impacted teeth Berobat Jalan

3292 05-03-2018 0137U0040318Y000580 0001466038056 RANY SEPTIANTI P PEGAWAI SWASTA Dyspepsia Berobat Jalan

3293 05-03-2018 0137U0040318Y000524 0001466140623 TAN TIAN NIO P PEKERJA MANDIRI Acute upper respiratory Berobat Jalan
infection, unspecified
3294 05-03-2018 0137U0040318Y000454 0001469702812 DESY ARYANI P PEKERJA MANDIRI Dyspepsia Rujuk Lanjut

3295 05-03-2018 0137U0040318Y000487 0001469702867 IBRAHIM ARYANDRI L PEKERJA MANDIRI Dental caries Berobat Jalan

3296 05-03-2018 0137U0040318Y000503 0001470973678 ALFIANI RACHMAWATI P PEGAWAI SWASTA Acute upper respiratory Berobat Jalan
infections of multiple and

3297 05-03-2018 0137U0040318Y000536 0001471812693 SUN LIN KURNIA P PEKERJA MANDIRI Pain in throat and chest Berobat Jalan

3298 05-03-2018 0137U0040318Y000520 0001472363741 RIYANTI P PEKERJA MANDIRI Myalgia Berobat Jalan

3299 05-03-2018 0137U0040318Y000579 0001479662739 AGUS SUPRIYADI L PEKERJA MANDIRI Typhoid fever Berobat Jalan

3300 05-03-2018 0137U0040318Y000492 0001480380039 RISNAN AJI FIRMANSYAH L PEGAWAI SWASTA Acute bronchitis, Rujuk Lanjut
unspecified
3301 05-03-2018 0137U0040318Y000561 0001482721301 OLDI OKTAviano PUTRA L PEKERJA MANDIRI Acute pharyngitis, Berobat Jalan
unspecified
3302 05-03-2018 0137U0040318Y000573 0001483084056 BIMA IBRAHIM.P L PEKERJA MANDIRI Acute upper respiratory Berobat Jalan
infection, unspecified
3303 05-03-2018 0137U0040318Y000502 0001516486443 DOHARA PARULIAN PURBA L PEGAWAI SWASTA Acute sinusitis Berobat Jalan

3304 05-03-2018 0137U0040318Y000498 0001608955514 DERIA FAUZIAH P PEGAWAI SWASTA Acute upper respiratory Berobat Jalan
infection, unspecified
3305 05-03-2018 0137U0040318Y000645 0001610147654 RIDOLOF BETAWI L PEGAWAI SWASTA Other specified headache Berobat Jalan
syndromes
3306 05-03-2018 0137U0040318Y000496 0001621463218 STEPHANIE P PEGAWAI SWASTA Antenatal screening Berobat Jalan

3307 05-03-2018 0137U0040318Y000634 0001621830464 Tazkia Hana Azzahra L PEGAWAI SWASTA Acute upper respiratory Berobat Jalan
infection, unspecified
DAFTAR KUNJUNGAN PESERTA SAKIT

Kantor Cabang : BEKASI - 1011

FKTP : Klinik Mitra Medika - 0137U004

3308 05-03-2018 0137U0040318Y000476 0001622771526 DODI WISONO L PEGAWAI SWASTA Other specified headache Berobat Jalan
syndromes
3309 05-03-2018 0137U0040318Y000707 0001625773015 NAUFAL HASTA AQVIANDRI L PEGAWAI SWASTA Acute upper respiratory Berobat Jalan
infection, unspecified
3310 05-03-2018 0137U0040318Y000697 0001629187716 NEZIRA P PEGAWAI SWASTA Impacted teeth Berobat Jalan

3311 05-03-2018 0137U0040318Y000696 0001629187738 DEWI SYAFA HARIANTI P PEGAWAI SWASTA Caries of dentine Berobat Jalan

3312 05-03-2018 0137U0040318Y000698 0001629187749 AHMAD TRIANTO L PEGAWAI SWASTA Impacted teeth Berobat Jalan

3313 05-03-2018 0137U0040318Y000553 0001629387191 SRI IRIANI P PEGAWAI SWASTA Other epilepsy Rujuk Lanjut

3314 05-03-2018 0137U0040318Y000640 0001632016563 AJENG KAILALUSI KHUMAIRA P PEKERJA MANDIRI Dermatitis herpetiformis Berobat Jalan

3315 05-03-2018 0137U0040318Y000641 0001632016574 SANDRA BALQIA ADZRA P PEKERJA MANDIRI Dermatitis herpetiformis Berobat Jalan

3316 05-03-2018 0137U0040318Y000521 0001633603858 SONNY PRIMADYAKSA L PEGAWAI SWASTA Other soft tissue disorders, Berobat Jalan
not elsewhere classified

3317 05-03-2018 0137U0040318Y000459 0001634297916 MUHAMMAD KAHFI ANAN L PEKERJA MANDIRI Overactive disorder Rujuk Lanjut
associated with mental
retardation and

3318 05-03-2018 0137U0040318Y000494 0001634367936 NUR SOIMAH P PEGAWAI SWASTA Dental caries Berobat Jalan

3319 05-03-2018 0137U0040318Y000711 0001639653153 RIA PRATIWI P PEGAWAI SWASTA Acute upper respiratory Berobat Jalan
infection, unspecified
3320 05-03-2018 0137U0040318Y000460 0001644105677 H. DENNY RIDWAN L PEKERJA MANDIRI Cataract, unspecified Rujuk Lanjut

3321 05-03-2018 0137U0040318Y000499 0001645617148 GALUH PITRAYANA L PEGAWAI SWASTA Acute pharyngitis Berobat Jalan

3322 05-03-2018 0137U0040318Y000559 0001648009811 NICHOLAS ALEXANDRE L PEGAWAI SWASTA Overactive disorder Rujuk Lanjut
associated with mental
retardation and

3323 05-03-2018 0137U0040318Y000601 0001650111884 HELEN BUNTAR P PEGAWAI SWASTA Dyspepsia Berobat Jalan

3324 05-03-2018 0137U0040318Y000633 0001650599458 SAENAL L PEGAWAI SWASTA Acute upper respiratory Berobat Jalan
infection, unspecified
3325 05-03-2018 0137U0040318Y000565 0001653463506 MALIHAH SAYYIDAH NABILAH P PEGAWAI SWASTA Typhoid fever Berobat Jalan

3326 05-03-2018 0137U0040318Y000701 0001654815791 IR MONANG H PASARIBU L PEKERJA MANDIRI Impacted teeth Berobat Jalan

3327 05-03-2018 0137U0040318Y000700 0001654815824 MEIDYANTO PARDAMEAN L PEKERJA MANDIRI Caries of dentine Berobat Jalan
PASARIBU
3328 05-03-2018 0137U0040318Y000539 0001655927752 PRASETYO BUDI SANTOSO L PEKERJA MANDIRI Acute upper respiratory Berobat Jalan
infection, unspecified
3329 05-03-2018 0137U0040318Y000684 0001657089527 IRFAN ARDHIANSYAH PUTRA L PEGAWAI SWASTA Necrosis of pulp Berobat Jalan
DAFTAR KUNJUNGAN PESERTA SAKIT

Kantor Cabang : BEKASI - 1011

FKTP : Klinik Mitra Medika - 0137U004

3330 05-03-2018 0137U0040318Y000544 0001671498371 TAN AN PIN L PEGAWAI SWASTA Gastritis and duodenitis Berobat Jalan

3331 05-03-2018 0137U0040318Y000546 0001671498382 PRILIYANI P PEGAWAI SWASTA Influenza due to identified Berobat Jalan
avian infliuenza virus

3332 05-03-2018 0137U0040318Y000545 0001671498393 EZRA TAN EMMANUEL L PEGAWAI SWASTA Influenza due to identified Berobat Jalan
avian infliuenza virus

3333 05-03-2018 0137U0040318Y000452 0001710897107 H. DEDI APRILANI L PENERIMA PENSIUN Disorder of refraction, Rujuk Lanjut
PNS unspecified
3334 05-03-2018 0137U0040318Y000501 0001718270289 KARNAEN SUTEDJA L PEKERJA MANDIRI Acute pharyngitis Berobat Jalan

3335 05-03-2018 0137U0040318Y000475 0001719914984 MUHAMMAD YUSUF MANNAGA L PEKERJA MANDIRI Chronic ischaemic heart Rujuk Lanjut
disease, unspecified
3336 05-03-2018 0137U0040318Y000478 0001722161889 IIN DARSINAH P PEKERJA MANDIRI Dermatitis herpetiformis Berobat Jalan

3337 05-03-2018 0137U0040318Y000557 0001722807303 VERAWATI SYAMSU P PEKERJA MANDIRI Necrosis of pulp Rujuk Lanjut

3338 05-03-2018 0137U0040318Y000482 0001724046636 A. SANUSI L PEKERJA MANDIRI Acute upper respiratory Berobat Jalan
infection, unspecified
3339 05-03-2018 0137U0040318Y000547 0001727150275 ASEP NUGRAHA L PEKERJA MANDIRI Influenza due to identified Berobat Jalan
avian infliuenza virus

3340 05-03-2018 0137U0040318Y000540 0001729550711 MARGRET ROMAULI SE P PEKERJA MANDIRI Myalgia Berobat Jalan

3341 05-03-2018 0137U0040318Y000486 0001731337593 DEWI SITI MARIAM P PEKERJA MANDIRI Pyothorax without fistula Berobat Jalan

3342 05-03-2018 0137U0040318Y000483 0001731337604 ZAHRAN KARUNIA PUTRA L PEKERJA MANDIRI Acute upper respiratory Berobat Jalan
infection, unspecified
3343 05-03-2018 0137U0040318Y000485 0001731337615 ANUGERAH PUTRA SOLIHIN L PEKERJA MANDIRI Acute upper respiratory Berobat Jalan
infection, unspecified
3344 05-03-2018 0137U0040318Y000529 0001737048273 HARINI P PEGAWAI SWASTA Acute upper respiratory Berobat Jalan
infection, unspecified
3345 05-03-2018 0137U0040318Y000569 0001738288967 Umar abdul Aziz L PEGAWAI SWASTA Gastro-oesophageal reflux Berobat Jalan
disease without

3346 05-03-2018 0137U0040318Y000574 0001740754776 BARLIANTA.P L PEKERJA MANDIRI Other specified headache Berobat Jalan
syndromes
3347 05-03-2018 0137U0040318Y000528 0001741171432 ONI SETIAWAN M NUGROHO L PEGAWAI SWASTA Myalgia Berobat Jalan

3348 05-03-2018 0137U0040318Y000599 0001741303361 YEMIMA QUEENZA KARANGAN P PEGAWAI SWASTA Acute upper respiratory Berobat Jalan
infection, unspecified
3349 05-03-2018 0137U0040318Y000505 0001741601744 Apang L PEGAWAI SWASTA Acute upper respiratory Berobat Jalan
infections of multiple and

3350 05-03-2018 0137U0040318Y000622 0001743354202 ANDRI L PEGAWAI SWASTA Acute upper respiratory Berobat Jalan
infection, unspecified
DAFTAR KUNJUNGAN PESERTA SAKIT

Kantor Cabang : BEKASI - 1011

FKTP : Klinik Mitra Medika - 0137U004

3351 05-03-2018 0137U0040318Y000683 0001767672066 NUKE PERMATA SARI P PEGAWAI SWASTA Necrosis of pulp Berobat Jalan

3352 05-03-2018 0137U0040318Y000516 0001773406247 EVA HASANAH P PEGAWAI SWASTA Influenza due to identified Berobat Jalan
avian infliuenza virus

3353 05-03-2018 0137U0040318Y000515 0001773406258 HALWA ALISHA SARAH P PEGAWAI SWASTA Disorders of vestibular Berobat Jalan
function
3354 05-03-2018 0137U0040318Y000517 0001773406269 NAFISA ALIYATUNNISA P PEGAWAI SWASTA Influenza due to identified Berobat Jalan
avian infliuenza virus

3355 05-03-2018 0137U0040318Y000644 0001779827973 IKA MULYASARI. AS P PEGAWAI SWASTA Other specified headache Berobat Jalan
syndromes
3356 05-03-2018 0137U0040318Y000537 0001804227524 YULIA METTA RATNASARI P PEGAWAI SWASTA Myalgia Berobat Jalan

3357 05-03-2018 0137U0040318Y000710 0001805215408 FITRIA RAMADHANI P PEGAWAI SWASTA Dyspepsia Berobat Jalan

3358 05-03-2018 0137U0040318Y000714 0001830907282 ANJAS PERWIRA NGAWARO L PEGAWAI SWASTA Myalgia Berobat Jalan

3359 05-03-2018 0137U0040318Y000578 0001831685231 SERVASIUS ASER L PEGAWAI SWASTA Myalgia Berobat Jalan

3360 05-03-2018 0137U0040318Y000571 0001841793636 PARDIYO L PEKERJA MANDIRI Myalgia Berobat Jalan

3361 05-03-2018 0137U0040318Y000467 0001849827442 HADI PURNOMO L PEGAWAI SWASTA Disorder of refraction, Rujuk Lanjut
unspecified
3362 05-03-2018 0137U0040318Y000518 0001859318638 AZAHRA SHAFA ANNISA P PEKERJA MANDIRI Influenza due to identified Berobat Jalan
avian infliuenza virus

3363 05-03-2018 0137U0040318Y000480 0001866736541 SAFANI AZZAHRA L PEGAWAI SWASTA Typhoid fever Berobat Jalan

3364 05-03-2018 0137U0040318Y000564 0001868242511 TRISTIANA L PEGAWAI BUMN Acute upper respiratory Berobat Jalan
infection, unspecified
3365 05-03-2018 0137U0040318Y000563 0001868242533 ADNINA ANJANI P PEKERJA MANDIRI Acute upper respiratory Berobat Jalan
infection, unspecified
3366 05-03-2018 0137U0040318Y000519 0001875754146 AHMAD ROFIQ L PEKERJA MANDIRI Stomatitis and related Berobat Jalan
lesions
3367 05-03-2018 0137U0040318Y000556 0001894742357 RAISYA HUMAIRA P PEGAWAI SWASTA Fever, unspecified Rujuk Lanjut

3368 05-03-2018 0137U0040318Y000685 0001895083841 EDISON SIMORANGKIR L PEKERJA MANDIRI Dental caries, unspecified Berobat Jalan

3369 05-03-2018 0137U0040318Y000605 0001968041507 EGA PUTRI RENATA P PEKERJA MANDIRI Acute upper respiratory Berobat Jalan
infection, unspecified
3370 05-03-2018 0137U0040318Y000713 0002036842964 kamsini L PEKERJA MANDIRI Myalgia Berobat Jalan

3371 05-03-2018 0137U0040318Y000481 0002043513167 HERLINA P PEKERJA MANDIRI Other cataract Rujuk Lanjut

3372 05-03-2018 0137U0040318Y000694 0002045023863 ASJAD TSALASA KHAIRUNNISA P PEGAWAI SWASTA Dental caries, unspecified Berobat Jalan
DAFTAR KUNJUNGAN PESERTA SAKIT

Kantor Cabang : BEKASI - 1011

FKTP : Klinik Mitra Medika - 0137U004

3373 05-03-2018 0137U0040318Y000468 0002057393542 LIU NAM / SUNARTO L PEKERJA MANDIRI Other cataract Rujuk Lanjut

3374 05-03-2018 0137U0040318Y000530 0002060178917 LINA HERLINAWATI P PEGAWAI SWASTA Myalgia Berobat Jalan

3375 05-03-2018 0137U0040318Y000705 0002061134234 DINA FEBRIYANTI P PEGAWAI SWASTA Other contraceptive Berobat Jalan
management
3376 05-03-2018 0137U0040318Y000572 0002062723217 DIMAS SETYO NUGROHO L PEGAWAI SWASTA Acute upper respiratory Berobat Jalan
infection, unspecified
3377 05-03-2018 0137U0040318Y000542 0002069486526 AGUS PURWANTO L PEKERJA MANDIRI Acute upper respiratory Berobat Jalan
infections of multiple and

3378 05-03-2018 0137U0040318Y000598 0002086694256 BAYI NY rany septianti P PEGAWAI SWASTA Typhoid fever Berobat Jalan

3379 05-03-2018 0137U0040318Y000568 0002098984994 TETI RACHMAWATI P PEGAWAI SWASTA Acute upper respiratory Berobat Jalan
infection, unspecified
3380 05-03-2018 0137U0040318Y000535 0002138508595 REZA REVANA AHADY L PEGAWAI SWASTA Acute upper respiratory Berobat Jalan
infection, unspecified
3381 05-03-2018 0137U0040318Y000504 0002197713429 SALTIANI DAMAYANTI P PEKERJA MANDIRI Acute upper respiratory Berobat Jalan
infections of multiple and

3382 05-03-2018 0137U0040318Y000611 0002209697864 FAJAR FAUZAN L PEGAWAI SWASTA Other specified headache Berobat Jalan
syndromes
3383 05-03-2018 0137U0040318Y000510 0002213362001 RAHAYUNI SUDIYANTI P PEGAWAI SWASTA Acute pharyngitis Berobat Jalan

3384 05-03-2018 0137U0040318Y000566 0002218988002 GERRY PRATAMA L PEKERJA MANDIRI Dyspepsia Berobat Jalan

3385 05-03-2018 0137U0040318Y000453 0002225461509 IRAWAN RIYANTO L PEGAWAI SWASTA Necrosis of pulp Rujuk Lanjut

3386 05-03-2018 0137U0040318Y000479 0002234434713 BRIGITTA NAVA FEODORA P PEGAWAI SWASTA Acute upper respiratory Berobat Jalan
infection, unspecified
3387 05-03-2018 0137U0040318Y000712 0002266352008 AINA SRI RAHAYU P PEKERJA MANDIRI Acute upper respiratory Berobat Jalan
infection, unspecified
3388 05-03-2018 0137U0040318Y000472 0002268158128 CYNTHIA MARIA SUNARJO P PEGAWAI SWASTA Mastoiditis, unspecified Rujuk Lanjut

3389 05-03-2018 0137U0040318Y000507 0002275501814 AINAYYA DIVA L PEGAWAI SWASTA Acute upper respiratory Berobat Jalan
FATHIATURROHMA infections of multiple and

3390 05-03-2018 0137U0040318Y000608 0002291430148 AUSHAF BILAL MUGHITS L PEGAWAI SWASTA Acute upper respiratory Berobat Jalan
infection, unspecified
3391 05-03-2018 0137U0040318Y000562 0002297537087 ZAENAL ABIDIN L PEKERJA MANDIRI Acute upper respiratory Berobat Jalan
infection, unspecified
3392 05-03-2018 0137U0040318Y000477 0002320206309 SUNARJO L PEKERJA MANDIRI Cataract, unspecified Rujuk Lanjut

3393 05-03-2018 0137U0040318Y000576 0002427135175 ADINDA RAHMA.P P PEKERJA MANDIRI Acute upper respiratory Berobat Jalan
infection, unspecified
3394 04-03-2018 0137U0040318Y000396 0000009054909 WALBEN DAMANIK L PNS PUSAT Other specified headache Berobat Jalan
syndromes
DAFTAR KUNJUNGAN PESERTA SAKIT

Kantor Cabang : BEKASI - 1011

FKTP : Klinik Mitra Medika - 0137U004

3395 04-03-2018 0137U0040318Y000371 0000033171265 SITI SUMARYANAH P PNS PUSAT Polyp of vagina Rujuk Lanjut

3396 04-03-2018 0137U0040318Y000405 0000046011475 SRI INDARYATI P PENERIMA PENSIUN TNI Acute upper respiratory Berobat Jalan
infection, unspecified
3397 04-03-2018 0137U0040318Y000363 0001127986334 RISALATUL MUAWANAH P PEGAWAI SWASTA Dysmenorrhoea, Berobat Jalan
unspecified
3398 04-03-2018 0137U0040318Y000406 0001129453931 BUDI ALAMSYAH L PEGAWAI SWASTA Acute upper respiratory Berobat Jalan
infection, unspecified
3399 04-03-2018 0137U0040318Y000445 0001135603102 HERMIN HERISMIANI P PEGAWAI SWASTA Myalgia Berobat Jalan

3400 04-03-2018 0137U0040318Y000365 0001187308991 CHOIRUL ERWANDA L PEGAWAI SWASTA Acute upper respiratory Berobat Jalan
infection, unspecified
3401 04-03-2018 0137U0040318Y000362 0001256456204 SUMARNI P PEKERJA MANDIRI Dyspepsia Berobat Jalan

3402 04-03-2018 0137U0040318Y000381 0001257582082 TITIEK LATIFAH P PEKERJA MANDIRI Other specified headache Berobat Jalan
syndromes
3403 04-03-2018 0137U0040318Y000404 0001260330344 NANA MAULANA L PEKERJA MANDIRI Other specified headache Berobat Jalan
syndromes
3404 04-03-2018 0137U0040318Y000402 0001260332829 NABIL ABDUN NASHIR L PEKERJA MANDIRI Acute upper respiratory Berobat Jalan
infection, unspecified
3405 04-03-2018 0137U0040318Y000403 0001260333167 SYAKY KHAIDAR AL HABSYI L PEKERJA MANDIRI Acute upper respiratory Berobat Jalan
infection, unspecified
3406 04-03-2018 0137U0040318Y000444 0001260781345 YOGO UTOMO L PEKERJA MANDIRI Other specified headache Berobat Jalan
syndromes
3407 04-03-2018 0137U0040318Y000442 0001267268139 ENGGAR ACHMAD PRASETYO L PEGAWAI SWASTA Myalgia Berobat Jalan

3408 04-03-2018 0137U0040318Y000364 0001267412229 SRI ROHYANI P PEKERJA MANDIRI Hepatomegaly with Rujuk Lanjut
splenomegaly, not

3409 04-03-2018 0137U0040318Y000429 0001288515047 SILVIA RATNA WIJAYA P PEKERJA MANDIRI Myalgia Berobat Jalan

3410 04-03-2018 0137U0040318Y000430 0001292181568 desvira cantika putri P PEKERJA MANDIRI Myalgia Berobat Jalan

3411 04-03-2018 0137U0040318Y000431 0001292182907 DIKA PUTRA WIBAWA L PEKERJA MANDIRI Acute upper respiratory Berobat Jalan
infection, unspecified
3412 04-03-2018 0137U0040318Y000356 0001307960774 TJU ATANG ETI P PEKERJA MANDIRI Unspecified haemorrhoids Berobat Jalan
without complication

3413 04-03-2018 0137U0040318Y000366 0001310459692 RINTO PRASETIO L PEGAWAI SWASTA Dyspepsia Berobat Jalan

3414 04-03-2018 0137U0040318Y000387 0001313693425 dewi sukmagitarini P PEKERJA MANDIRI Acute upper respiratory Berobat Jalan
infection, unspecified
3415 04-03-2018 0137U0040318Y000441 0001327628654 RIZAN ANUGRAH L PNS DAERAH Acute upper respiratory Berobat Jalan
infection, unspecified
DAFTAR KUNJUNGAN PESERTA SAKIT

Kantor Cabang : BEKASI - 1011

FKTP : Klinik Mitra Medika - 0137U004

3416 04-03-2018 0137U0040318Y000397 0001328611015 alih heryanto L PEKERJA MANDIRI Insulin-dependent Rujuk Lanjut
diabetes mellitus with

3417 04-03-2018 0137U0040318Y000411 0001328611937 dedeh kurniasih P PEKERJA MANDIRI Acute upper respiratory Berobat Jalan
infection, unspecified
3418 04-03-2018 0137U0040318Y000355 0001337751448 TJANIWATI P PEKERJA MANDIRI Acute upper respiratory Berobat Jalan
infection, unspecified
3419 04-03-2018 0137U0040318Y000417 0001341582873 BARNASZ ISWANTO L PENERIMA PENSIUN Chronic obstructive Rujuk Lanjut
SWASTA pulmonary disease,

3420 04-03-2018 0137U0040318Y000368 0001376384297 Melinda Rishayani P PEGAWAI SWASTA Acute upper respiratory Berobat Jalan
infection, unspecified
3421 04-03-2018 0137U0040318Y000357 0001378164881 BAGAS AQILA MAJID L PEGAWAI BUMN Acute upper respiratory Berobat Jalan
infection, unspecified
3422 04-03-2018 0137U0040318Y000418 0001384701546 budi setyanto L PEKERJA MANDIRI Pyothorax without fistula Berobat Jalan

3423 04-03-2018 0137U0040318Y000423 0001384702727 fadhil halim pamungkas L PEKERJA MANDIRI Acute upper respiratory Berobat Jalan
infection, unspecified
3424 04-03-2018 0137U0040318Y000420 0001402988422 BONI TABRONI L PEGAWAI SWASTA Other and unspecified Berobat Jalan
infectious diseases
3425 04-03-2018 0137U0040318Y000419 0001402988433 LINDA BAHARNIS P PEGAWAI SWASTA Myalgia Berobat Jalan

3426 04-03-2018 0137U0040318Y000422 0001405010248 IWAN SETIAWAN L PEGAWAI SWASTA Myalgia Berobat Jalan

3427 04-03-2018 0137U0040318Y000375 0001405907201 ROJALI L PEKERJA MANDIRI Disorders of refraction and Berobat Jalan
accommodation
3428 04-03-2018 0137U0040318Y000370 0001406389803 SUCI NURHAYATI P PEGAWAI SWASTA Other specified Berobat Jalan
pregnancy-related

3429 04-03-2018 0137U0040318Y000382 0001406683888 SANDRA NADIA P PEGAWAI SWASTA Disorders of refraction and Berobat Jalan
accommodation
3430 04-03-2018 0137U0040318Y000351 0001435570751 armon sirin L PEKERJA MANDIRI Acute upper respiratory Berobat Jalan
infection, unspecified
3431 04-03-2018 0137U0040318Y000424 0001443385721 POPIE OPERASISWANTY P PEGAWAI SWASTA Congestive heart failure Rujuk Lanjut

3432 04-03-2018 0137U0040318Y000354 0001451050266 VIOLIN GABRIEL ALINDRA P PNS PUSAT Varicella meningitis Berobat Jalan
SITANGGANG
3433 04-03-2018 0137U0040318Y000409 0001455153748 VERAWATY P PEKERJA MANDIRI Acute upper respiratory Berobat Jalan
infection, unspecified
3434 04-03-2018 0137U0040318Y000353 0001455379479 ADI ROCHMATUN L PEKERJA MANDIRI Acute upper respiratory Berobat Jalan
infection, unspecified
3435 04-03-2018 0137U0040318Y000416 0001456629232 NADINE PUTRI NOVIANTI P PEKERJA MANDIRI Diarrhoea and Berobat Jalan
gastroenteritis of
presumed infectious origin
DAFTAR KUNJUNGAN PESERTA SAKIT

Kantor Cabang : BEKASI - 1011

FKTP : Klinik Mitra Medika - 0137U004

3436 04-03-2018 0137U0040318Y000449 0001463634415 SULASTRI P PEKERJA MANDIRI Dyspepsia Berobat Jalan

3437 04-03-2018 0137U0040318Y000443 0001470873093 MUAY P PEKERJA MANDIRI Other specified headache Berobat Jalan
syndromes
3438 04-03-2018 0137U0040318Y000383 0001471265919 ARIFIN SIANIPAR ,S.SOS L PEKERJA MANDIRI Other disorders of external Berobat Jalan
ear
3439 04-03-2018 0137U0040318Y000446 0001516974849 SUTIAWAN L PEGAWAI SWASTA Acute upper respiratory Berobat Jalan
infection, unspecified
3440 04-03-2018 0137U0040318Y000391 0001516974862 DIZA RISKY PRAMUDYA L PEGAWAI SWASTA Acute conjunctivitis, Rujuk Lanjut
unspecified
3441 04-03-2018 0137U0040318Y000386 0001517348215 SITI SARAH HAZJAH P PEGAWAI SWASTA Disorders of refraction and Berobat Jalan
accommodation
3442 04-03-2018 0137U0040318Y000433 0001524438742 EDI JUNAEDI L PEGAWAI SWASTA Acute upper respiratory Berobat Jalan
infection, unspecified
3443 04-03-2018 0137U0040318Y000438 0001524438753 GUSTIANI FIRTIA P PEGAWAI SWASTA Other antenatal screening Berobat Jalan

3444 04-03-2018 0137U0040318Y000393 0001606346032 WULAN PRAMITASARI P PEGAWAI SWASTA Antenatal screening Berobat Jalan

3445 04-03-2018 0137U0040318Y000426 0001624329527 Warsono L PEGAWAI SWASTA Myalgia Berobat Jalan

3446 04-03-2018 0137U0040318Y000425 0001624329549 Yuli Wahyunita P PEGAWAI SWASTA Myalgia Berobat Jalan

3447 04-03-2018 0137U0040318Y000385 0001628032601 PUTRI LAYYINAH SAROFAH P PEGAWAI BUMN Chronic ischaemic heart Rujuk Lanjut
disease, unspecified
3448 04-03-2018 0137U0040318Y000437 0001629385986 ATISAH P PEGAWAI SWASTA Other antenatal screening Berobat Jalan

3449 04-03-2018 0137U0040318Y000399 0001631080056 TITIN KURNANI P PEKERJA MANDIRI Myalgia Berobat Jalan

3450 04-03-2018 0137U0040318Y000400 0001631080067 HANNA NAILIS SAADAH P PEKERJA MANDIRI Nausea and vomiting Berobat Jalan

3451 04-03-2018 0137U0040318Y000398 0001635307514 MURNI P PEGAWAI SWASTA Other specified headache Berobat Jalan
syndromes
3452 04-03-2018 0137U0040318Y000410 0001646135785 STEVANO TADEO L PEKERJA MANDIRI Dermatitis herpetiformis Berobat Jalan

3453 04-03-2018 0137U0040318Y000388 0001646860959 IBRAHIM NURRASYID AKABAR L PEGAWAI SWASTA Acute upper respiratory Berobat Jalan
infection, unspecified
3454 04-03-2018 0137U0040318Y000389 0001646860961 ALIDZAKI NURRASYID AKBAR L PEGAWAI SWASTA Acute upper respiratory Berobat Jalan
infection, unspecified
3455 04-03-2018 0137U0040318Y000401 0001648022949 ZAILANI M L PEKERJA MANDIRI Myalgia Berobat Jalan

3456 04-03-2018 0137U0040318Y000367 0001648097482 KRISTIANI LOVELY SIHITE P PEGAWAI SWASTA Acute upper respiratory Berobat Jalan
infection, unspecified
3457 04-03-2018 0137U0040318Y000448 0001648098044 DINA TRIWIYANTI P PEKERJA MANDIRI Unspecified haemorrhoids Rujuk Lanjut
without complication

3458 04-03-2018 0137U0040318Y000414 0001648387776 endri handayani P PEGAWAI SWASTA Other specified headache Berobat Jalan
syndromes
DAFTAR KUNJUNGAN PESERTA SAKIT

Kantor Cabang : BEKASI - 1011

FKTP : Klinik Mitra Medika - 0137U004

3459 04-03-2018 0137U0040318Y000372 0001653364034 KURNIAWAN WIDIATMOKO L PEKERJA MANDIRI Acute upper respiratory Berobat Jalan
infection, unspecified
3460 04-03-2018 0137U0040318Y000450 0001655717793 DARMANTO L PEGAWAI SWASTA Acute upper respiratory Berobat Jalan
infection, unspecified
3461 04-03-2018 0137U0040318Y000407 0001658830408 NAYLA HILMIYA ZAHRA P PEKERJA MANDIRI Dermatitis herpetiformis Berobat Jalan

3462 04-03-2018 0137U0040318Y000432 0001668101782 ABYAN INDRAWAN L PEGAWAI BUMN Acute upper respiratory Berobat Jalan
infection, unspecified
3463 04-03-2018 0137U0040318Y000440 0001769438406 AGUS DWI PUTRA L PEGAWAI SWASTA Acute pharyngitis, Berobat Jalan
unspecified
3464 04-03-2018 0137U0040318Y000373 0001785793408 HERMAN CHANLEGO L PEKERJA MANDIRI Acute upper respiratory Berobat Jalan
infection, unspecified
3465 04-03-2018 0137U0040318Y000390 0001785793421 DEWI ALAMSYAH P PEKERJA MANDIRI Dermatitis herpetiformis Berobat Jalan

3466 04-03-2018 0137U0040318Y000378 0001798974404 MUHAMMAD RIDWAN L PEKERJA MANDIRI Acute upper respiratory Berobat Jalan
infection, unspecified
3467 04-03-2018 0137U0040318Y000394 0001805558242 RINI MURYATI P PEGAWAI SWASTA Mixed asthma Rujuk Lanjut

3468 04-03-2018 0137U0040318Y000395 0001809628446 RUSMIATI P PEKERJA MANDIRI Myopia Rujuk Lanjut

3469 04-03-2018 0137U0040318Y000361 0001813768672 ANDIYANI FATIMAH P PEGAWAI SWASTA Myalgia Berobat Jalan

3470 04-03-2018 0137U0040318Y000376 0001838068885 NAYLA SAKHI ALI P PEKERJA MANDIRI Nausea and vomiting Berobat Jalan

3471 04-03-2018 0137U0040318Y000412 0001847229164 salsa bila rohayati P PEKERJA MANDIRI Dermatitis herpetiformis Berobat Jalan

3472 04-03-2018 0137U0040318Y000451 0001851077428 MUHAMMAD RAYA SYADEFA L PEGAWAI SWASTA Acute upper respiratory Berobat Jalan
infection, unspecified
3473 04-03-2018 0137U0040318Y000408 0001853535712 venki wibowo L PEKERJA MANDIRI Acute pharyngitis, Berobat Jalan
unspecified
3474 04-03-2018 0137U0040318Y000434 0001893042101 KHAYLA SALSABILA KAMALIA P PEKERJA MANDIRI Dermatitis herpetiformis Berobat Jalan

3475 04-03-2018 0137U0040318Y000380 0001893356357 HERI SUSANTO L PEKERJA MANDIRI Primary pulmonary Rujuk Lanjut
hypertension
3476 04-03-2018 0137U0040318Y000379 0001893356368 MARIANI SUNARJO P PEKERJA MANDIRI Low back pain Rujuk Lanjut

3477 04-03-2018 0137U0040318Y003410 0001897996836 niken suci rahmawati P PEKERJA MANDIRI Other antenatal screening Berobat Jalan

3478 04-03-2018 0137U0040318Y000436 0001898394805 warsito L PEKERJA MANDIRI Myalgia Berobat Jalan

3479 04-03-2018 0137U0040318Y000435 0001898395255 sutriyani P PEKERJA MANDIRI Myalgia Berobat Jalan

3480 04-03-2018 0137U0040318Y000374 0001902372614 m. arief fadhillah aziz L PEKERJA MANDIRI Multiple superficial injuries, Berobat Jalan
unspecified
3481 04-03-2018 0137U0040318Y000447 0001906771926 JESSLYN ANGELA DIOLOV P PEKERJA MANDIRI Atrial septal defect Rujuk Lanjut

3482 04-03-2018 0137U0040318Y000369 0001965210851 KHANSA AZKADINA P PEGAWAI SWASTA Nausea and vomiting Berobat Jalan
DAFTAR KUNJUNGAN PESERTA SAKIT

Kantor Cabang : BEKASI - 1011

FKTP : Klinik Mitra Medika - 0137U004

3483 04-03-2018 0137U0040318Y000352 0002041319439 ROSMENI P PEKERJA MANDIRI Acute upper respiratory Berobat Jalan
infection, unspecified
3484 04-03-2018 0137U0040318Y000428 0002050280482 jevin febriani isabella P PEKERJA MANDIRI Acute upper respiratory Berobat Jalan
infection, unspecified
3485 04-03-2018 0137U0040318Y000415 0002062794025 EUIS SAFITRI P PEKERJA MANDIRI Maternal care due to Rujuk Lanjut
uterine scar from previous

3486 04-03-2018 0137U0040318Y000421 0002069122836 AWAN GIBRAN KANAYA L PEKERJA MANDIRI Acute upper respiratory Berobat Jalan
infection, unspecified
3487 04-03-2018 0137U0040318Y000360 0002077186252 LUKMAN L PEKERJA MANDIRI Acute upper respiratory Berobat Jalan
infection, unspecified
3488 04-03-2018 0137U0040318Y000359 0002077188478 ABDUL FAQIH AL ARIF L PEKERJA MANDIRI Acute upper respiratory Berobat Jalan
LUKMANA infection, unspecified
3489 04-03-2018 0137U0040318Y000358 0002081563986 khalil mumtaz lukmana L PEKERJA MANDIRI Acute upper respiratory Berobat Jalan
infection, unspecified
3490 04-03-2018 0137U0040318Y000392 0002084762439 YAYUK NURAINI P PEKERJA MANDIRI Disorders of tooth Rujuk Lanjut
development and eruption
3491 04-03-2018 0137U0040318Y000413 0002199507197 RIZKY FADHLAN SYAHPUTRA L PEGAWAI BUMD Dermatitis herpetiformis Berobat Jalan

3492 04-03-2018 0137U0040318Y000384 0002255929029 SUTIO L PEKERJA MANDIRI Mixed asthma Berobat Jalan

3493 04-03-2018 0137U0040318Y000377 0002266643654 by ny MARDIANA L PEKERJA MANDIRI Gastro-oesophageal reflux Berobat Jalan
disease without

3494 04-03-2018 0137U0040318Y000439 0002278263655 DINA HANIVA P PEKERJA MANDIRI Other antenatal screening Berobat Jalan

3495 04-03-2018 0137U0040318Y000427 0002314882653 HAFIDHA ISNAN NUFUS P PEKERJA MANDIRI Acute upper respiratory Berobat Jalan
infection, unspecified
3496 03-03-2018 0137U0040318Y000300 0000033171265 SITI SUMARYANAH P PNS PUSAT Other contraceptive Berobat Jalan
management
3497 03-03-2018 0137U0040318Y000310 0000040988474 IRVAN CHRISDIAN L PEGAWAI SWASTA Acute upper respiratory Berobat Jalan
infection, unspecified
3498 03-03-2018 0137U0040318Y000275 0000045804723 A. SUDJIT RIYANTO L PENERIMA PENSIUN Dental caries, unspecified Berobat Jalan
PNS
3499 03-03-2018 0137U0040318Y000346 0000073402705 NURBAETI IRIANI P PNS DAERAH Non-insulin-dependent Berobat Jalan
diabetes mellitus with

3500 03-03-2018 0137U0040318Y000285 0000073517297 DESTIPUTRI ASIH P PNS DAERAH Necrosis of pulp Berobat Jalan
MUNGGARAN
3501 03-03-2018 0137U0040318Y000274 0000073570882 FARIDA PURWANTI HASSAN P PNS DAERAH Necrosis of pulp Berobat Jalan

3502 03-03-2018 0137U0040318Y000237 0000198112419 SOPHIAN FANANY, DRS L PENERIMA PENSIUN Congestive heart failure Rujuk Lanjut
PNS
3503 03-03-2018 0137U0040318Y000240 0000198112577 ROSYIDAH P PENERIMA PENSIUN Congestive heart failure Rujuk Lanjut
PNS
DAFTAR KUNJUNGAN PESERTA SAKIT

Kantor Cabang : BEKASI - 1011

FKTP : Klinik Mitra Medika - 0137U004

3504 03-03-2018 0137U0040318Y000280 0000198112746 IMAM MUTTAQIN L PENERIMA PENSIUN Dental caries, unspecified Berobat Jalan
PNS
3505 03-03-2018 0137U0040318Y000257 0000201618202 FERDY HERAWAN L PNS DAERAH Typhoid fever Berobat Jalan

3506 03-03-2018 0137U0040318Y000324 0000203185585 FATHAN KHAIRAN RAMADHAN L PNS PUSAT Caries of dentine Berobat Jalan

3507 03-03-2018 0137U0040318Y000332 0000976600045 RANIA RUBY AURELLIA P PNS PUSAT Abrasion of teeth Berobat Jalan

3508 03-03-2018 0137U0040318Y000327 0001125210734 EARLY NUROKHMAH P PEKERJA MANDIRI Impacted teeth Berobat Jalan

3509 03-03-2018 0137U0040318Y000318 0001133972921 HADI L PEGAWAI SWASTA Impacted teeth Berobat Jalan

3510 03-03-2018 0137U0040318Y000315 0001140542537 ELVI SANDRI P PEGAWAI SWASTA Gastritis, unspecified Berobat Jalan

3511 03-03-2018 0137U0040318Y000270 0001143044853 FENNY TRI POERWANTO L PEGAWAI SWASTA Other specified headache Berobat Jalan
syndromes
3512 03-03-2018 0137U0040318Y000328 0001153417678 RETNO YULIYANTI P PEKERJA MANDIRI Necrosis of pulp Berobat Jalan

3513 03-03-2018 0137U0040318Y000227 0001155385451 AMELLIA NATALIS P PEGAWAI SWASTA Prolonged pregnancy Rujuk Lanjut

3514 03-03-2018 0137U0040318Y000276 0001159527071 FITRI INDAH SARI P PEGAWAI SWASTA Dental caries, unspecified Berobat Jalan

3515 03-03-2018 0137U0040318Y000254 0001189937619 YURHAM REZA HERMAWAN L PEGAWAI SWASTA Acute upper respiratory Berobat Jalan
infection, unspecified
3516 03-03-2018 0137U0040318Y000271 0001197514326 TINTIN NOVTIANA P PEGAWAI SWASTA Acute upper respiratory Berobat Jalan
infection, unspecified
3517 03-03-2018 0137U0040318Y000323 0001259233839 BONG POSUN FRANSISKUS L PEKERJA MANDIRI Dental caries, unspecified Berobat Jalan

3518 03-03-2018 0137U0040318Y000320 0001259238609 FLORENTINE PHOEI P PEKERJA MANDIRI Caries of dentine Berobat Jalan

3519 03-03-2018 0137U0040318Y000321 0001259265835 MARCELINO CHRISTIAN BENA L PEKERJA MANDIRI Caries of dentine Berobat Jalan

3520 03-03-2018 0137U0040318Y000246 0001264020412 SUWARTO L PEKERJA MANDIRI Myalgia Berobat Jalan

3521 03-03-2018 0137U0040318Y000226 0001264219863 NGATI P PEKERJA MANDIRI Chronic ischaemic heart Rujuk Lanjut
disease, unspecified
3522 03-03-2018 0137U0040318Y000224 0001270782505 HARYANTO L PEKERJA MANDIRI Insulin-dependent Rujuk Lanjut
diabetes mellitus with
other specified

3523 03-03-2018 0137U0040318Y000225 0001270783012 MIYATI SRI MARDININGSIH P PEKERJA MANDIRI Insulin-dependent Rujuk Lanjut
diabetes mellitus with
other specified

3524 03-03-2018 0137U0040318Y000278 0001273138299 ALAWIYAH P PEKERJA MANDIRI Dental caries, unspecified Berobat Jalan

3525 03-03-2018 0137U0040318Y000233 0001290325151 SUNYATI P PEKERJA MANDIRI Chest pain on breathing Rujuk Lanjut

3526 03-03-2018 0137U0040318Y000264 0001292840122 TRISNA SUHARYADI L PEGAWAI SWASTA Gastritis, unspecified Berobat Jalan
DAFTAR KUNJUNGAN PESERTA SAKIT

Kantor Cabang : BEKASI - 1011

FKTP : Klinik Mitra Medika - 0137U004

3527 03-03-2018 0137U0040318Y000302 0001295406347 SUCIATI P PEKERJA MANDIRI Acute upper respiratory Berobat Jalan
infection, unspecified
3528 03-03-2018 0137U0040318Y000255 0001301988521 DWI HARMIYATI L PEKERJA MANDIRI Myalgia Berobat Jalan

3529 03-03-2018 0137U0040318Y000330 0001305933524 HAYEN MULYANA L PEKERJA MANDIRI Dental caries, unspecified Berobat Jalan

3530 03-03-2018 0137U0040318Y000295 0001306536298 UMAY P PEGAWAI SWASTA Other headache Berobat Jalan
syndromes
3531 03-03-2018 0137U0040318Y000232 0001306877319 WIWI DARWI P PEKERJA MANDIRI Fracture of lumbar spine Rujuk Lanjut
and pelvis
3532 03-03-2018 0137U0040318Y000316 0001311832743 minah P PEKERJA MANDIRI Myalgia Berobat Jalan

3533 03-03-2018 0137U0040318Y000268 0001312829289 SUTARMIATI P PEKERJA MANDIRI Other specified headache Berobat Jalan
syndromes
3534 03-03-2018 0137U0040318Y000250 0001314077681 NYI RESA P PEKERJA MANDIRI Stomatitis and related Berobat Jalan
lesions
3535 03-03-2018 0137U0040318Y000266 0001316017541 DEVI TANAH DJAYA P PEKERJA MANDIRI Other and unspecified Berobat Jalan
abdominal pain
3536 03-03-2018 0137U0040318Y000288 0001316021354 ERIC BRYAN TUMEWU L PEKERJA MANDIRI Necrosis of pulp Berobat Jalan

3537 03-03-2018 0137U0040318Y000289 0001316028036 CAROLINE QUEENSA TUMEWU P PEKERJA MANDIRI Dental caries, unspecified Berobat Jalan

3538 03-03-2018 0137U0040318Y000273 0001337190322 ILHAM HIDAYAT L PEKERJA MANDIRI Acute upper respiratory Berobat Jalan
infection, unspecified
3539 03-03-2018 0137U0040318Y000333 0001337472191 MUHAMMAD EKO SANTOSO L PEGAWAI SWASTA Dental caries, unspecified Berobat Jalan

3540 03-03-2018 0137U0040318Y000253 0001337925216 ONG SIN LIAN P PEKERJA MANDIRI Myalgia Berobat Jalan

3541 03-03-2018 0137U0040318Y000281 0001369091867 ATHAR MAHARANI P PEGAWAI BUMN Dental caries, unspecified Berobat Jalan

3542 03-03-2018 0137U0040318Y000282 0001369091878 GENTALA ARSYAD AWWABIN L PEGAWAI BUMN Dental caries, unspecified Berobat Jalan

3543 03-03-2018 0137U0040318Y000260 0001370650522 WIDYA ANGGRAINI P PEGAWAI SWASTA Other specified headache Berobat Jalan
syndromes
3544 03-03-2018 0137U0040318Y000294 0001370650533 ALIYA IZZATUNNISA P PEGAWAI SWASTA Acute upper respiratory Berobat Jalan
infection, unspecified
3545 03-03-2018 0137U0040318Y000306 0001377136596 RATNA SULASTRI P PEGAWAI SWASTA Abdominal and pelvic pain Berobat Jalan

3546 03-03-2018 0137U0040318Y000222 0001383225625 HERIANTO L PEKERJA MANDIRI Cerebellar stroke Rujuk Lanjut
syndrome
3547 03-03-2018 0137U0040318Y000345 0001386499239 RIO ARDA AL ISLAMI L PEGAWAI BUMD Acute upper respiratory Berobat Jalan
infection, unspecified
3548 03-03-2018 0137U0040318Y000326 0001407711655 DANENDRA ZEVANNO PUTRA L PEGAWAI SWASTA Abrasion of teeth Berobat Jalan
ANGGHIA
3549 03-03-2018 0137U0040318Y000249 0001430438106 KHANSA AMIRA PUTRI P PEGAWAI SWASTA Varicella meningitis Berobat Jalan
DAFTAR KUNJUNGAN PESERTA SAKIT

Kantor Cabang : BEKASI - 1011

FKTP : Klinik Mitra Medika - 0137U004

3550 03-03-2018 0137U0040318Y000293 0001432387462 SUKIYATI P PEKERJA MANDIRI Dental caries, unspecified Berobat Jalan

3551 03-03-2018 0137U0040318Y000314 0001432808572 suhandi L PEKERJA MANDIRI Myopia Berobat Jalan

3552 03-03-2018 0137U0040318Y000296 0001433390005 bambang guntoro L PEKERJA MANDIRI Calculus of kidney Rujuk Lanjut

3553 03-03-2018 0137U0040318Y000301 0001433390758 sian hoa hazjar P PEKERJA MANDIRI Acute upper respiratory Berobat Jalan
infection, unspecified
3554 03-03-2018 0137U0040318Y000247 0001439918155 IR.YUDI SETIAWAN L PEKERJA MANDIRI Hypertensive renal Rujuk Lanjut
disease with renal failure
3555 03-03-2018 0137U0040318Y000231 0001440682672 HJ. SURYATI L PEKERJA MANDIRI Trigger finger, multiple Rujuk Lanjut
sites
3556 03-03-2018 0137U0040318Y000341 0001442802699 INDRA SUDARMAN L PEKERJA MANDIRI Secondary hypertension, Berobat Jalan
unspecified
3557 03-03-2018 0137U0040318Y000342 0001442802734 TITIEK LESTARI P PEKERJA MANDIRI Myalgia Berobat Jalan

3558 03-03-2018 0137U0040318Y000287 0001445592622 AMRI WASATRI IR L PEKERJA MANDIRI Dental caries, unspecified Berobat Jalan

3559 03-03-2018 0137U0040318Y000299 0001447246776 KUSHARYADI L PEKERJA MANDIRI Insulin-dependent Rujuk Lanjut
diabetes mellitus
3560 03-03-2018 0137U0040318Y000248 0001452417311 AMIRUDDIN YUSUP L PEKERJA MANDIRI Other respiratory Rujuk Lanjut
tuberculosis, confirmed
bacteriologically and

3561 03-03-2018 0137U0040318Y000286 0001458637424 SITI ZAINAB P PEKERJA MANDIRI Dental caries, unspecified Berobat Jalan

3562 03-03-2018 0137U0040318Y000343 0001462791565 AZILI ALI L PEKERJA MANDIRI Vertigo of central origin Berobat Jalan

3563 03-03-2018 0137U0040318Y000241 0001468258018 HAMBALI L PEKERJA MANDIRI Myalgia Berobat Jalan

3564 03-03-2018 0137U0040318Y000334 0001472914405 SHILLA AZZAHRA PERTIWI P ANGGOTA POLRI Acute upper respiratory Berobat Jalan
infection, unspecified
3565 03-03-2018 0137U0040318Y000267 0001483409709 alfarezcka faidillah muhammad L PEGAWAI SWASTA Gastritis, unspecified Berobat Jalan

3566 03-03-2018 0137U0040318Y000251 0001517751292 INE NURUL HAYAH P PEGAWAI SWASTA Dermatitis herpetiformis Berobat Jalan

3567 03-03-2018 0137U0040318Y000229 0001523878705 BONY OCTAVIANO L PEGAWAI SWASTA Acute appendicitis, Rujuk Lanjut
unspecified
3568 03-03-2018 0137U0040318Y000269 0001548835841 ATI SUGIHARTI P PEGAWAI SWASTA Vertigo of central origin Berobat Jalan

3569 03-03-2018 0137U0040318Y000344 0001607592969 HILDA P PEGAWAI SWASTA Acute upper respiratory Berobat Jalan
infection, unspecified
3570 03-03-2018 0137U0040318Y000322 0001607592993 VINNIA SAMANTHA HALIM L PEGAWAI SWASTA Abrasion of teeth Berobat Jalan

3571 03-03-2018 0137U0040318Y000245 0001610263102 ERGI JUNIANTO PRASTIO P PEGAWAI SWASTA Typhoid fever Berobat Jalan

3572 03-03-2018 0137U0040318Y000263 0001624337752 DONI SAPUTRA L PEGAWAI SWASTA Acute upper respiratory Berobat Jalan
infection, unspecified
DAFTAR KUNJUNGAN PESERTA SAKIT

Kantor Cabang : BEKASI - 1011

FKTP : Klinik Mitra Medika - 0137U004

3573 03-03-2018 0137U0040318Y000234 0001624907362 SUKO HANDONO L PEGAWAI SWASTA Chronic ischaemic heart Rujuk Lanjut
disease, unspecified
3574 03-03-2018 0137U0040318Y000305 0001631467192 MUHIDAH P PEGAWAI SWASTA Diarrhoea and Berobat Jalan
gastroenteritis of
presumed infectious origin

3575 03-03-2018 0137U0040318Y000335 0001635190075 ASMAUL HUSNAH P PEGAWAI SWASTA Acute upper respiratory Berobat Jalan
infection, unspecified
3576 03-03-2018 0137U0040318Y000337 0001641827103 KARI USMAN L PEGAWAI SWASTA Foreign body in colon Berobat Jalan

3577 03-03-2018 0137U0040318Y000223 0001642845429 IRWAN M.R. RUSTAM L PEGAWAI SWASTA Presbyopia Rujuk Lanjut

3578 03-03-2018 0137U0040318Y000283 0001647998098 ANNA AZIZAH NUR P PEGAWAI SWASTA Necrosis of pulp Berobat Jalan
QOMARIYAH
3579 03-03-2018 0137U0040318Y000338 0001648936877 FIT TRIANTO L PEGAWAI SWASTA Acute upper respiratory Berobat Jalan
infection, unspecified
3580 03-03-2018 0137U0040318Y000336 0001653463506 MALIHAH SAYYIDAH NABILAH P PEGAWAI SWASTA Other and unspecified Berobat Jalan
infectious diseases
3581 03-03-2018 0137U0040318Y000258 0001654467017 ARYA HAIFANDIKA L PEGAWAI SWASTA Typhoid fever Berobat Jalan

3582 03-03-2018 0137U0040318Y000291 0001655730257 MILANO ABIMATA RIBALDI L PEGAWAI SWASTA Dental caries, unspecified Berobat Jalan

3583 03-03-2018 0137U0040318Y000243 0001666046586 EDAH JUBAEDAH P PEGAWAI SWASTA Other and unspecified Berobat Jalan
abdominal pain
3584 03-03-2018 0137U0040318Y000242 0001666046597 SALSABILAH P PEGAWAI SWASTA Acute upper respiratory Berobat Jalan
infection, unspecified
3585 03-03-2018 0137U0040318Y000265 0001719853244 IR.SUWARTO L PEKERJA MANDIRI Acute upper respiratory Berobat Jalan
infection, unspecified
3586 03-03-2018 0137U0040318Y000309 0001737913476 FV EVI SETYOWATI P PEGAWAI SWASTA Mixed asthma Berobat Jalan

3587 03-03-2018 0137U0040318Y000307 0001740767411 SYAHRULLAH L PEGAWAI SWASTA Acute upper respiratory Berobat Jalan
infection, unspecified
3588 03-03-2018 0137U0040318Y000319 0001740785499 GHAIDA JIHAN AULIA P PEGAWAI SWASTA Chronic gingivitis Berobat Jalan

3589 03-03-2018 0137U0040318Y000292 0001742970688 ALIANTO JAYADIHARJA,SE L PEGAWAI SWASTA Necrosis of pulp Berobat Jalan

3590 03-03-2018 0137U0040318Y000262 0001788910367 AMARA ALDIANRA AZZAHRANI L PNS DAERAH Acute upper respiratory Berobat Jalan
infection, unspecified
3591 03-03-2018 0137U0040318Y000244 0001796873591 NABIILAH DHIYA ULHAQ P PEKERJA MANDIRI Diarrhoea and Berobat Jalan
gastroenteritis of
presumed infectious origin

3592 03-03-2018 0137U0040318Y000303 0001807040406 nery silvana P PEKERJA MANDIRI Other specified headache Berobat Jalan
syndromes
3593 03-03-2018 0137U0040318Y000256 0001819443892 VICCY ANGELINE PURNAMA P PEGAWAI SWASTA Myalgia Berobat Jalan
DAFTAR KUNJUNGAN PESERTA SAKIT

Kantor Cabang : BEKASI - 1011

FKTP : Klinik Mitra Medika - 0137U004

3594 03-03-2018 0137U0040318Y000311 0001819750893 RISMA SINAGA P PEGAWAI SWASTA Mixed asthma Berobat Jalan

3595 03-03-2018 0137U0040318Y000304 0001828398047 ENTIN WARTINI P PEKERJA MANDIRI Malignant neoplasm of Rujuk Lanjut
breast, unspecified
3596 03-03-2018 0137U0040318Y000239 0001828651408 ATIN CHRISTIANTI L PEKERJA MANDIRI Dermatitis herpetiformis Berobat Jalan

3597 03-03-2018 0137U0040318Y000259 0001832018692 muhammad daffa al ghifari L PEGAWAI SWASTA Typhoid fever Berobat Jalan

3598 03-03-2018 0137U0040318Y000325 0001854274015 DAFFA DHIYA ULHAQ L PEGAWAI SWASTA Chronic gingivitis Berobat Jalan

3599 03-03-2018 0137U0040318Y000272 0001860040091 santy widia anggraeni P PEGAWAI SWASTA Acute pharyngitis, Berobat Jalan
unspecified
3600 03-03-2018 0137U0040318Y000230 0001880331017 fatimah P PEKERJA MANDIRI Congestive heart failure Rujuk Lanjut

3601 03-03-2018 0137U0040318Y000238 0001884012737 MUFFAZAL MIRZA HARAHAP L PEGAWAI SWASTA Acute upper respiratory Berobat Jalan
infection, unspecified
3602 03-03-2018 0137U0040318Y000261 0001889935424 ALRASYA RADIT PRATAMA L PEGAWAI SWASTA Acute upper respiratory Berobat Jalan
infection, unspecified
3603 03-03-2018 0137U0040318Y000297 0001905024172 NG HUI IM P PEKERJA MANDIRI Other cataract Rujuk Lanjut

3604 03-03-2018 0137U0040318Y000349 0001965814558 Fathan Arkana .R L PEGAWAI SWASTA Dermatitis herpetiformis Berobat Jalan

3605 03-03-2018 0137U0040318Y000298 0002048490088 MUARNIS ST SINARO L PEKERJA MANDIRI Other rheumatoid arthritis Rujuk Lanjut

3606 03-03-2018 0137U0040318Y000312 0002048490426 WARNIDA P PEKERJA MANDIRI Other secondary arthrosis Berobat Jalan

3607 03-03-2018 0137U0040318Y000329 0002056387307 dewi yanti P PEKERJA MANDIRI Maternal care due to Rujuk Lanjut
uterine scar from previous

3608 03-03-2018 0137U0040318Y000235 0002060077937 BINTANG PUSPASARI P PEKERJA MANDIRI Zoster [herpes zoster] Rujuk Lanjut

3609 03-03-2018 0137U0040318Y000236 0002060079118 senandung adiba alfatunnisa L PEKERJA MANDIRI Other miliary tuberculosis Rujuk Lanjut

3610 03-03-2018 0137U0040318Y000331 0002076001885 ERDJULIS L PEKERJA MANDIRI Impacted teeth Berobat Jalan

3611 03-03-2018 0137U0040318Y000348 0002082943091 VEBRINA P PEKERJA MANDIRI Otitis media, unspecified Berobat Jalan

3612 03-03-2018 0137U0040318Y000347 0002082943247 AQILLA RAMADHANI L PEGAWAI SWASTA Acute upper respiratory Berobat Jalan
infection, unspecified
3613 03-03-2018 0137U0040318Y000284 0002083542513 AZAHARA KANAYA PUTRI P PEKERJA MANDIRI Dental caries, unspecified Berobat Jalan

3614 03-03-2018 0137U0040318Y000277 0002196031285 SALIMAN L PEKERJA MANDIRI Necrosis of pulp Berobat Jalan

3615 03-03-2018 0137U0040318Y000317 0002206165509 SIDIQ AHMMAD L ANGGOTA POLRI Acute upper respiratory Berobat Jalan
infection, unspecified
3616 03-03-2018 0137U0040318Y000228 0002210941574 ir. indra madewa L PEKERJA MANDIRI Non-insulin-dependent Rujuk Lanjut
diabetes mellitus
3617 03-03-2018 0137U0040318Y000290 0002225461509 IRAWAN RIYANTO L PEGAWAI SWASTA Necrosis of pulp Berobat Jalan
DAFTAR KUNJUNGAN PESERTA SAKIT

Kantor Cabang : BEKASI - 1011

FKTP : Klinik Mitra Medika - 0137U004

3618 03-03-2018 0137U0040318Y000279 0002245351239 DJUMINEM NARIYYAH L PEKERJA MANDIRI Necrosis of pulp Berobat Jalan

3619 03-03-2018 0137U0040318Y000313 0002256322544 LANIKA ZOYA ALIFIA P PEKERJA MANDIRI Acute upper respiratory Berobat Jalan
infection, unspecified
3620 03-03-2018 0137U0040318Y000308 0002275901616 FERDYNAND HAMZAH L PEKERJA MANDIRI Myalgia Berobat Jalan

3621 03-03-2018 0137U0040318Y000340 0002296034807 herry kisriyanto L PEKERJA MANDIRI Other secondary arthrosis Berobat Jalan

3622 03-03-2018 0137U0040318Y000339 0002296034943 maharani surya P PEKERJA MANDIRI Acute upper respiratory Berobat Jalan
infection, unspecified
3623 03-03-2018 0137U0040318Y000350 0002306789627 DINI RESTINASARI P PEKERJA MANDIRI Myalgia Berobat Jalan

3624 03-03-2018 0137U0040318Y000252 0002427465295 HANIFAH AZZAHRAH P PEKERJA MANDIRI Irregular menstruation, Rujuk Lanjut
unspecified
3625 02-03-2018 0137U0040318Y000113 0000045804734 ELIZABETH PUDJIARTI P PENERIMA PENSIUN Insulin-dependent Rujuk Lanjut
PNS diabetes mellitus
3626 02-03-2018 0137U0040318Y000163 0000072886724 HERYANTO SUPARJAN L PNS DAERAH Other secondary arthrosis Berobat Jalan

3627 02-03-2018 0137U0040318Y000155 0000073531271 LISMAN SETIAWAN L PNS PUSAT Other specified headache Berobat Jalan
TANJUNG,ST. syndromes
3628 02-03-2018 0137U0040318Y000137 0000073570882 FARIDA PURWANTI HASSAN P PNS DAERAH Necrosis of pulp Berobat Jalan

3629 02-03-2018 0137U0040318Y000111 0000153744906 HERLINA FIBA MULYANI P PNS DAERAH Acute bronchitis Rujuk Lanjut

3630 02-03-2018 0137U0040318Y000177 0000167548612 ARYA IBRAHIM L PENERIMA PENSIUN Myopia Berobat Jalan
PNS
3631 02-03-2018 0137U0040318Y000202 0000170219463 YUNITA FLORENCE ANDRIES P PEGAWAI SWASTA Dyspepsia Berobat Jalan

3632 02-03-2018 0137U0040318Y000165 0000172550474 BINTANG CANTIKA ZAHRAH P PNS DAERAH Other and unspecified Berobat Jalan
infectious diseases
3633 02-03-2018 0137U0040318Y000214 0001095656905 SUBARJO L KEPOLISIAN RI Abrasion of teeth Berobat Jalan

3634 02-03-2018 0137U0040318Y000179 0001138972713 EFRYANTI P PEGAWAI SWASTA Acute upper respiratory Berobat Jalan
infection, unspecified
3635 02-03-2018 0137U0040318Y000174 0001190688557 RANTI SEKAR ANJANI P PEGAWAI SWASTA Acute upper respiratory Berobat Jalan
infection, unspecified
3636 02-03-2018 0137U0040318Y000136 0001202265156 MIZZARACHMAN ALGA L PEGAWAI SWASTA Acute periodontitis Berobat Jalan
IBRAHIM
3637 02-03-2018 0137U0040318Y000206 0001257254111 SRI JAYANTI P PBI (APBD) Necrosis of pulp Berobat Jalan

3638 02-03-2018 0137U0040318Y000138 0001257633652 ETTY ROCHAETI P PEKERJA MANDIRI Dental caries, unspecified Berobat Jalan

3639 02-03-2018 0137U0040318Y000205 0001257773466 HERMIEN OKTAVIANTI P PEKERJA MANDIRI Impacted teeth Berobat Jalan

3640 02-03-2018 0137U0040318Y000118 0001258212262 NURAINI P PEKERJA MANDIRI Atherosclerotic Rujuk Lanjut
cardiovascular disease, so
DAFTAR KUNJUNGAN PESERTA SAKIT

Kantor Cabang : BEKASI - 1011

FKTP : Klinik Mitra Medika - 0137U004

3641 02-03-2018 0137U0040318Y000139 0001259238609 FLORENTINE PHOEI P PEKERJA MANDIRI Necrosis of pulp Berobat Jalan

3642 02-03-2018 0137U0040318Y000112 0001262336624 IWAN L PEKERJA MANDIRI Acute bronchitis Rujuk Lanjut

3643 02-03-2018 0137U0040318Y000121 0001262927823 AGUSTIN ANASARI P PEKERJA MANDIRI Myalgia Berobat Jalan

3644 02-03-2018 0137U0040318Y000178 0001284712075 YOHANES MIKHAELIS L PEKERJA MANDIRI Acute upper respiratory Berobat Jalan
BANYUTAWA infection, unspecified
3645 02-03-2018 0137U0040318Y000158 0001288464849 YUNUS L PEKERJA MANDIRI Stroke, not specified as Rujuk Lanjut
haemorrhage or infarction
3646 02-03-2018 0137U0040318Y000160 0001288465479 ROSALINI MINTO P PEKERJA MANDIRI Presbyopia Rujuk Lanjut

3647 02-03-2018 0137U0040318Y000123 0001292468635 BASARAJA SINURAT L PEGAWAI SWASTA Unspecified abdominal Berobat Jalan
hernia with gangrene
3648 02-03-2018 0137U0040318Y000184 0001296134829 RINA MAYA P PEKERJA MANDIRI Acute upper respiratory Berobat Jalan
infection, unspecified
3649 02-03-2018 0137U0040318Y000185 0001296138857 KEVIN VIRIYA TANUWIJAYA L PEKERJA MANDIRI Acute upper respiratory Berobat Jalan
infection, unspecified
3650 02-03-2018 0137U0040318Y000216 0001306443802 rizky novriansyah L PEKERJA MANDIRI Dental caries, unspecified Berobat Jalan

3651 02-03-2018 0137U0040318Y000150 0001306536298 UMAY P PEGAWAI SWASTA Other specified headache Berobat Jalan
syndromes
3652 02-03-2018 0137U0040318Y000114 0001306920216 yuni nugraheni P PEGAWAI SWASTA Other arthritis Rujuk Lanjut

3653 02-03-2018 0137U0040318Y000195 0001310459692 RINTO PRASETIO L PEGAWAI SWASTA Acute upper respiratory Berobat Jalan
infection, unspecified
3654 02-03-2018 0137U0040318Y000131 0001312724643 SYAFRIL S.E L PEKERJA MANDIRI Acute upper respiratory Berobat Jalan
infection, unspecified
3655 02-03-2018 0137U0040318Y000130 0001312726904 NILA UTAMI,S.E P PEKERJA MANDIRI Myalgia Berobat Jalan

3656 02-03-2018 0137U0040318Y000181 0001314942693 REHUELLAH ZIPORA P PEGAWAI SWASTA Vertigo of central origin Berobat Jalan
KALUMATA
3657 02-03-2018 0137U0040318Y000180 0001314942838 EUNIKE KIMBERLY CHRISTY P PEGAWAI SWASTA Acute upper respiratory Berobat Jalan
SUGIARTO infection, unspecified
3658 02-03-2018 0137U0040318Y000188 0001322583693 PUTRA TRISETIA L PEKERJA MANDIRI Acute upper respiratory Berobat Jalan
infection, unspecified
3659 02-03-2018 0137U0040318Y000201 0001326962079 MIDAH P PEKERJA MANDIRI Other and unspecified Berobat Jalan
infectious diseases
3660 02-03-2018 0137U0040318Y000194 0001328053353 ABDUL ROHMAN L PEGAWAI SWASTA Acute upper respiratory Berobat Jalan
infection, unspecified
3661 02-03-2018 0137U0040318Y000193 0001337472191 MUHAMMAD EKO SANTOSO L PEGAWAI SWASTA Other secondary arthrosis Berobat Jalan

3662 02-03-2018 0137U0040318Y000196 0001339152579 JEJEN JAENI KAMAL L PBI (APBD) Other specified headache Berobat Jalan
syndromes
3663 02-03-2018 0137U0040318Y000133 0001340075395 YANI KUMALAWATI P PEGAWAI SWASTA Other secondary arthrosis Berobat Jalan
DAFTAR KUNJUNGAN PESERTA SAKIT

Kantor Cabang : BEKASI - 1011

FKTP : Klinik Mitra Medika - 0137U004

3664 02-03-2018 0137U0040318Y000215 0001370644468 NURJANAH P PEGAWAI SWASTA Impacted teeth Berobat Jalan

3665 02-03-2018 0137U0040318Y000107 0001383225625 HERIANTO L PEKERJA MANDIRI Hyperplasia of prostate Rujuk Lanjut

3666 02-03-2018 0137U0040318Y000173 0001385914612 Devi Aprianti P PEGAWAI SWASTA Acute upper respiratory Berobat Jalan
infection, unspecified
3667 02-03-2018 0137U0040318Y000135 0001407711644 RINI HASTUTI P PEGAWAI SWASTA Dental caries, unspecified Berobat Jalan

3668 02-03-2018 0137U0040318Y000122 0001425632635 HELDA MOFALINA SANUSI P PEKERJA MANDIRI Myalgia Berobat Jalan

3669 02-03-2018 0137U0040318Y000149 0001426338854 NENDEN SUPARTINI P PEKERJA MANDIRI Cerebral infarction, Rujuk Lanjut
unspecified
3670 02-03-2018 0137U0040318Y000127 0001428262727 ANI P PEKERJA MANDIRI Acute upper respiratory Berobat Jalan
infection, unspecified
3671 02-03-2018 0137U0040318Y000109 0001433829227 tjio sun nio P PEKERJA MANDIRI Disorders of refraction and Rujuk Lanjut
accommodation
3672 02-03-2018 0137U0040318Y000120 0001438368581 ALDO SUSANTO L PEKERJA MANDIRI Acute upper respiratory Berobat Jalan
infection, unspecified
3673 02-03-2018 0137U0040318Y000159 0001452417311 AMIRUDDIN YUSUP L PEKERJA MANDIRI Bronchopneumonia, Berobat Jalan
unspecified
3674 02-03-2018 0137U0040318Y000198 0001457184475 REIHANUM ZHAFIRA P PEKERJA MANDIRI Acute upper respiratory Berobat Jalan
INDRAWAN infection, unspecified
3675 02-03-2018 0137U0040318Y000134 0001463233724 PARTINI P PEKERJA MANDIRI Necrosis of pulp Berobat Jalan

3676 02-03-2018 0137U0040318Y000108 0001463366608 YANIH P PEGAWAI SWASTA Disorders of refraction and Rujuk Lanjut
accommodation
3677 02-03-2018 0137U0040318Y000115 0001464383485 HERMIN P PEKERJA MANDIRI Congestive heart failure Rujuk Lanjut

3678 02-03-2018 0137U0040318Y000154 0001468373319 DICKY PERMANA L PEKERJA MANDIRI Acute upper respiratory Berobat Jalan
infection, unspecified
3679 02-03-2018 0137U0040318Y000191 0001618174967 HARI SANYOTO L PEGAWAI SWASTA Other specified headache Berobat Jalan
syndromes
3680 02-03-2018 0137U0040318Y000221 0001623339393 ARRAZY WIJAYA A.SIREGAR L PEGAWAI SWASTA Impacted teeth Berobat Jalan

3681 02-03-2018 0137U0040318Y000168 0001625364268 MEILANI P PEGAWAI SWASTA Acute upper respiratory Berobat Jalan
infection, unspecified
3682 02-03-2018 0137U0040318Y000169 0001625364279 ERLANGGA SETIYAWAN L PEGAWAI SWASTA Acute upper respiratory Berobat Jalan
infection, unspecified
3683 02-03-2018 0137U0040318Y000199 0001625364292 PUTRI VERONICA P PEGAWAI SWASTA Acute upper respiratory Berobat Jalan
infection, unspecified
3684 02-03-2018 0137U0040318Y000142 0001629157713 BUDI MARESTIANTO L PEGAWAI SWASTA Acute upper respiratory Berobat Jalan
infection, unspecified
3685 02-03-2018 0137U0040318Y000210 0001629187738 DEWI SYAFA HARIANTI P PEGAWAI SWASTA Chronic gingivitis Berobat Jalan

3686 02-03-2018 0137U0040318Y000209 0001629187749 AHMAD TRIANTO L PEGAWAI SWASTA Chronic gingivitis Berobat Jalan
DAFTAR KUNJUNGAN PESERTA SAKIT

Kantor Cabang : BEKASI - 1011

FKTP : Klinik Mitra Medika - 0137U004

3687 02-03-2018 0137U0040318Y000157 0001630528929 RICKY FARDELI L PEGAWAI SWASTA Vertigo of central origin Berobat Jalan

3688 02-03-2018 0137U0040318Y000167 0001639990552 DAVIANSYAH TIAZ ALVARO L PEGAWAI BUMN Mixed asthma Berobat Jalan
NASUTION
3689 02-03-2018 0137U0040318Y000182 0001641651052 SUDARYANTI P PEGAWAI SWASTA Acute upper respiratory Berobat Jalan
infection, unspecified
3690 02-03-2018 0137U0040318Y000183 0001641651063 CAHAYA CANTIKA P PEGAWAI SWASTA Acute upper respiratory Berobat Jalan
infection, unspecified
3691 02-03-2018 0137U0040318Y000140 0001645674546 RENI SUSANTI P PEGAWAI SWASTA Single spontaneous Berobat Jalan
delivery, unspecified
3692 02-03-2018 0137U0040318Y000219 0001646271922 SLAMET SUHENDRA L PEGAWAI SWASTA Impacted teeth Berobat Jalan

3693 02-03-2018 0137U0040318Y000220 0001646271933 RITA SAYOETI,SH P PEGAWAI SWASTA Impacted teeth Berobat Jalan

3694 02-03-2018 0137U0040318Y000172 0001646271944 CITRA AMALIA SUHENDRA P PEKERJA MANDIRI Chronic frontal sinusitis Rujuk Lanjut

3695 02-03-2018 0137U0040318Y000218 0001646271955 IZZATI AURA SUHENDRA P PEGAWAI SWASTA Necrosis of pulp Berobat Jalan

3696 02-03-2018 0137U0040318Y000125 0001649401514 IDA FITRI P PEGAWAI SWASTA Myalgia Berobat Jalan

3697 02-03-2018 0137U0040318Y000148 0001655381081 KRISMANTO L PEGAWAI SWASTA Acute upper respiratory Berobat Jalan
infection, unspecified
3698 02-03-2018 0137U0040318Y000203 0001658328603 RICKY YULIANTO L PEGAWAI SWASTA Dyspepsia Berobat Jalan

3699 02-03-2018 0137U0040318Y000126 0001716719139 IKA KUSMARYANTI P PEKERJA MANDIRI Acute upper respiratory Berobat Jalan
infection, unspecified
3700 02-03-2018 0137U0040318Y000171 0001722807303 VERAWATI SYAMSU P PEKERJA MANDIRI Necrosis of pulp Berobat Jalan

3701 02-03-2018 0137U0040318Y000211 0001723606367 GABRIEL DERREL STEPHANUS L PEKERJA MANDIRI Necrosis of pulp Berobat Jalan

3702 02-03-2018 0137U0040318Y000152 0001724554719 LAMRIA P PEKERJA MANDIRI Acute upper respiratory Berobat Jalan
infection, unspecified
3703 02-03-2018 0137U0040318Y000151 0001724554721 KRISNA SAPUTRA L PEKERJA MANDIRI Acute upper respiratory Berobat Jalan
infection, unspecified
3704 02-03-2018 0137U0040318Y000146 0001733368509 ERNI ERAWATI P PEKERJA MANDIRI Other specified headache Berobat Jalan
syndromes
3705 02-03-2018 0137U0040318Y000147 0001733368511 YOLANDA P PEKERJA MANDIRI Other specified headache Berobat Jalan
syndromes
3706 02-03-2018 0137U0040318Y000119 0001736266184 STEFEN EDUARD TUA L PEKERJA MANDIRI Necrosis of pulp Rujuk Lanjut

3707 02-03-2018 0137U0040318Y000161 0001737048159 SITI CHURIYAH P PEGAWAI SWASTA Acute upper respiratory Berobat Jalan
infection, unspecified
3708 02-03-2018 0137U0040318Y000186 0001739009935 NAFIA NAZILA P PEGAWAI SWASTA Acute upper respiratory Berobat Jalan
infection, unspecified
3709 02-03-2018 0137U0040318Y000162 0001742419405 AMIRA MARSYAFA L PEGAWAI SWASTA Acute upper respiratory Berobat Jalan
infection, unspecified
DAFTAR KUNJUNGAN PESERTA SAKIT

Kantor Cabang : BEKASI - 1011

FKTP : Klinik Mitra Medika - 0137U004

3710 02-03-2018 0137U0040318Y000128 0001742518574 DEWI ISTIAWATY P PEGAWAI SWASTA Other specified headache Berobat Jalan
syndromes
3711 02-03-2018 0137U0040318Y000141 0001742518642 RALINE YUKIHELI ANDRIANI P PEGAWAI SWASTA Acute upper respiratory Berobat Jalan
infection, unspecified
3712 02-03-2018 0137U0040318Y000110 0001769638004 DIAH PERMATA SARI P PEGAWAI SWASTA Benign neoplasm of breast Rujuk Lanjut

3713 02-03-2018 0137U0040318Y000156 0001807400777 LENI RAHMAWATI KURNIA P PEGAWAI SWASTA Other antenatal screening Berobat Jalan

3714 02-03-2018 0137U0040318Y000124 0001813501348 SINTA KARTIKA CHANDRA P PEKERJA MANDIRI Insulin-dependent Rujuk Lanjut
diabetes mellitus with

3715 02-03-2018 0137U0040318Y000200 0001831404396 THOMAS BUDI WIBOWO L PEKERJA MANDIRI Traumatic shock Berobat Jalan

3716 02-03-2018 0137U0040318Y000116 0001839411303 CEN SOENG NAY P PEKERJA MANDIRI Insulin-dependent Rujuk Lanjut
diabetes mellitus with

3717 02-03-2018 0137U0040318Y000153 0001841532489 ari raka pradipta L PEGAWAI SWASTA Dermatitis herpetiformis Berobat Jalan

3718 02-03-2018 0137U0040318Y000117 0001842964391 mohammad adhwa gharibaldi L PEGAWAI SWASTA Leukaemia of unspecified Rujuk Lanjut
cell type
3719 02-03-2018 0137U0040318Y000176 0001863014444 MOHAMAD HARRIS L PEKERJA MANDIRI Foreign body in colon Berobat Jalan

3720 02-03-2018 0137U0040318Y000175 0001863017548 INTAN NOVITA T P PEKERJA MANDIRI Other secondary arthrosis Berobat Jalan

3721 02-03-2018 0137U0040318Y000197 0001882728797 PRASTA ALKHALIFI ZIKRI L PEKERJA MANDIRI Acute upper respiratory Berobat Jalan
INDRAWAN infection, unspecified
3722 02-03-2018 0137U0040318Y000170 0001884553435 RULY SUGIARTO L PEKERJA MANDIRI Necrosis of pulp Rujuk Lanjut

3723 02-03-2018 0137U0040318Y000217 0001884554616 damar krenali P PEKERJA MANDIRI Dental caries, unspecified Berobat Jalan

3724 02-03-2018 0137U0040318Y000166 0001887864827 SHABIYYAH ALESHA P PEGAWAI SWASTA Stomatitis and related Berobat Jalan
lesions
3725 02-03-2018 0137U0040318Y000208 0001895083841 EDISON SIMORANGKIR L PEKERJA MANDIRI Impacted teeth Berobat Jalan

3726 02-03-2018 0137U0040318Y000164 0001898812236 TONI L PEKERJA MANDIRI Stomatitis and related Berobat Jalan
lesions
3727 02-03-2018 0137U0040318Y000204 0001907163674 OMAN R L PEKERJA MANDIRI Acute upper respiratory Berobat Jalan
infection, unspecified
3728 02-03-2018 0137U0040318Y000192 0002035254475 ANDRI ALAMASYAH P L PEGAWAI SWASTA Acute upper respiratory Berobat Jalan
infection, unspecified
3729 02-03-2018 0137U0040318Y000207 0002045023863 ASJAD TSALASA KHAIRUNNISA P PEGAWAI SWASTA Abrasion of teeth Berobat Jalan

3730 02-03-2018 0137U0040318Y000143 0002057041629 ARIF WIDIANTO L PEKERJA MANDIRI Acute pharyngitis, Berobat Jalan
unspecified
3731 02-03-2018 0137U0040318Y000187 0002059432503 CANTIKA PUTRI MUTIAH P PEKERJA MANDIRI Cutaneous abscess, Berobat Jalan
furuncle and carbuncle
DAFTAR KUNJUNGAN PESERTA SAKIT

Kantor Cabang : BEKASI - 1011

FKTP : Klinik Mitra Medika - 0137U004

3732 02-03-2018 0137U0040318Y000189 0002071069852 FAJARIYAH DWI ASTUTI P PEKERJA MANDIRI Myalgia Berobat Jalan

3733 02-03-2018 0137U0040318Y000144 0002082374302 TAN KHIM JONG L PEKERJA MANDIRI Insulin-dependent Rujuk Lanjut
diabetes mellitus with

3734 02-03-2018 0137U0040318Y000129 0002201239214 SHAFIA CALLYSTA PUTRI P PEGAWAI PEMERINTAH Other and unspecified Berobat Jalan
DENGAN PERJANJIAN abdominal pain

3735 02-03-2018 0137U0040318Y000190 0002208165153 KHAIRUNNISA SALSABILA L PEGAWAI SWASTA Acute upper respiratory Berobat Jalan
infection, unspecified
3736 02-03-2018 0137U0040318Y000213 0002265931776 andrie hadi L PEKERJA MANDIRI Dental caries, unspecified Berobat Jalan

3737 02-03-2018 0137U0040318Y000212 0002265932856 adhesi nharian johansyah P PEKERJA MANDIRI Impacted teeth Berobat Jalan

3738 02-03-2018 0137U0040318Y000145 0002268158128 CYNTHIA MARIA SUNARJO P PEGAWAI SWASTA Other specified headache Berobat Jalan
syndromes
3739 02-03-2018 0137U0040318Y000132 0002270261079 EMAH SARTINI P PEKERJA MANDIRI Myalgia Berobat Jalan

3740 01-03-2018 0137U0040318Y000103 0000040876042 ANNISA RACHMI WULANDARI P PEKERJA MANDIRI Dermatitis herpetiformis Berobat Jalan

3741 01-03-2018 0137U0040318Y000101 0000073400466 SUYATNO KADMIRA L PNS DAERAH Acute upper respiratory Berobat Jalan
infection, unspecified
3742 01-03-2018 0137U0040318Y000040 0000073402705 NURBAETI IRIANI P PNS DAERAH Insulin-dependent Rujuk Lanjut
diabetes mellitus with

3743 01-03-2018 0137U0040318Y000041 0000073402716 MUSTOFA ACHMAD L PNS DAERAH Insulin-dependent Rujuk Lanjut
SOEDIRDJO diabetes mellitus with

3744 01-03-2018 0137U0040318Y000013 0000073570882 FARIDA PURWANTI HASSAN P PNS DAERAH Other disorders of lacrimal Rujuk Lanjut
gland
3745 01-03-2018 0137U0040318Y000029 0000097985136 ELYA NURKHAYATUN P PNS PUSAT Acute upper respiratory Berobat Jalan
infection, unspecified
3746 01-03-2018 0137U0040318Y000043 0000200111321 LIES MARTI P PNS PUSAT Acute pharyngitis, Berobat Jalan
unspecified
3747 01-03-2018 0137U0040318Y000083 0000200540103 PAYAMAN PANGARIBUAN L PENERIMA PENSIUN TNI Congestive heart failure Rujuk Lanjut

3748 01-03-2018 0137U0040318Y000009 0000210240191 SRI DWIKURNIASIH P PENERIMA PENSIUN Erosive (osteo)arthrosis Rujuk Lanjut
PNS
3749 01-03-2018 0137U0040318Y000044 0001079607835 HANNA FARADISA P PNS PUSAT Acute upper respiratory Berobat Jalan
infection, unspecified
3750 01-03-2018 0137U0040318Y000027 0001106392228 ERVIN NOVIANINGSIH SE P PRAJURIT AU Myalgia Berobat Jalan

3751 01-03-2018 0137U0040318Y000063 0001127974825 EMMY SRI REDJEKI P PEGAWAI SWASTA Dermatitis herpetiformis Berobat Jalan

3752 01-03-2018 0137U0040318Y000025 0001177349703 BEATRIX ZACHAWERUS P PEGAWAI SWASTA Acute abdomen Berobat Jalan
DAFTAR KUNJUNGAN PESERTA SAKIT

Kantor Cabang : BEKASI - 1011

FKTP : Klinik Mitra Medika - 0137U004

3753 01-03-2018 0137U0040318Y000075 0001193750043 FARRA ILMIRA P PEGAWAI SWASTA Chronic gingivitis Berobat Jalan

3754 01-03-2018 0137U0040318Y000023 0001258023407 SUZANE JULIET ESTHER P PENERIMA PENSIUN Dermatitis herpetiformis Berobat Jalan
SWASTA
3755 01-03-2018 0137U0040318Y000007 0001258645689 SITI HIKMAH P PEKERJA MANDIRI Chronic ischaemic heart Rujuk Lanjut
disease
3756 01-03-2018 0137U0040318Y000021 0001260102756 KRISTIANA SATIO P PEKERJA MANDIRI Acute upper respiratory Berobat Jalan
infection, unspecified
3757 01-03-2018 0137U0040318Y000055 0001260781345 YOGO UTOMO L PEKERJA MANDIRI Other specified headache Berobat Jalan
syndromes
3758 01-03-2018 0137U0040318Y000045 0001269379326 IRHAM MUSLIM L PEKERJA MANDIRI Acute pharyngitis, Berobat Jalan
unspecified
3759 01-03-2018 0137U0040318Y000037 0001270111724 RESTY ALIFIA FITRIANI P PEKERJA MANDIRI Systemic lupus Rujuk Lanjut
erythematosus
3760 01-03-2018 0137U0040318Y000082 0001275578583 FAMOI P PEKERJA MANDIRI Impacted teeth Berobat Jalan

3761 01-03-2018 0137U0040318Y000073 0001282265774 SUPRIYANTORO L PEKERJA MANDIRI Impacted teeth Berobat Jalan

3762 01-03-2018 0137U0040318Y000096 0001295760508 NARENDRA ADIYAKSA PUTRA L PEKERJA MANDIRI Acute upper respiratory Berobat Jalan
W infection, unspecified
3763 01-03-2018 0137U0040318Y000064 0001297924446 F.ERNA SUSWIYANDANI P PEKERJA MANDIRI Chronic ischaemic heart Rujuk Lanjut
disease
3764 01-03-2018 0137U0040318Y000036 0001298127161 RUYAWATy P PEKERJA MANDIRI Human immunodeficiency Rujuk Lanjut
virus [HIV] disease
resulting in infectious and
parasitic diseases

3765 01-03-2018 0137U0040318Y000059 0001310459692 RINTO PRASETIO L PEGAWAI SWASTA Dyspepsia Berobat Jalan

3766 01-03-2018 0137U0040318Y000034 0001314824567 ROSMIDA SIANIPAR P PEKERJA MANDIRI Insulin-dependent Rujuk Lanjut
diabetes mellitus
3767 01-03-2018 0137U0040318Y000014 0001335473199 HUSNI TJANGGAH L PEKERJA MANDIRI Dental caries, unspecified Berobat Jalan

3768 01-03-2018 0137U0040318Y000005 0001335756249 FEREDIE L PEKERJA MANDIRI Congestive heart failure Rujuk Lanjut

3769 01-03-2018 0137U0040318Y000094 0001340047451 MARIO PRASTYO L PEKERJA MANDIRI Dermatitis herpetiformis Berobat Jalan

3770 01-03-2018 0137U0040318Y000042 0001341252123 AVA YUANTI P PENERIMA PENSIUN Dermatitis herpetiformis Berobat Jalan
SWASTA
3771 01-03-2018 0137U0040318Y000066 0001376616802 IRSAL PRATAMA L PEGAWAI SWASTA Acute upper respiratory Berobat Jalan
infection, unspecified
3772 01-03-2018 0137U0040318Y000053 0001385987027 nindya adinda putri P PEKERJA MANDIRI Gastro-oesophageal reflux Berobat Jalan
disease without

3773 01-03-2018 0137U0040318Y000008 0001390259676 ERNA P PEKERJA MANDIRI Mixed asthma Rujuk Lanjut
DAFTAR KUNJUNGAN PESERTA SAKIT

Kantor Cabang : BEKASI - 1011

FKTP : Klinik Mitra Medika - 0137U004

3774 01-03-2018 0137U0040318Y000062 0001422212106 ROSA DESSIVITA P PEKERJA MANDIRI Anaemia, unspecified Berobat Jalan

3775 01-03-2018 0137U0040318Y000003 0001424324711 RUKIYEM P PEKERJA MANDIRI Dyspepsia Rujuk Lanjut

3776 01-03-2018 0137U0040318Y000058 0001429545723 HERLINAWATI P PEGAWAI SWASTA Acute upper respiratory Berobat Jalan
infection, unspecified
3777 01-03-2018 0137U0040318Y000057 0001429545734 MONICA DESTIYANTI P PEGAWAI SWASTA Gastro-oesophageal reflux Berobat Jalan
disease without

3778 01-03-2018 0137U0040318Y000015 0001445592622 AMRI WASATRI IR L PEKERJA MANDIRI Impacted teeth Berobat Jalan

3779 01-03-2018 0137U0040318Y000065 0001446524291 RIANTO L PEKERJA MANDIRI Epidermal cyst Rujuk Lanjut

3780 01-03-2018 0137U0040318Y000105 0001449707466 EDDY SUTRISNO H SE L PEGAWAI SWASTA Acute upper respiratory Berobat Jalan
infection, unspecified
3781 01-03-2018 0137U0040318Y000026 0001451050266 VIOLIN GABRIEL ALINDRA P PNS PUSAT Varicella meningitis Berobat Jalan
SITANGGANG
3782 01-03-2018 0137U0040318Y000097 0001455750459 HARIS PUJIONO L PEKERJA MANDIRI Myalgia Berobat Jalan

3783 01-03-2018 0137U0040318Y000080 0001458466751 YULI VERAWATI P PEKERJA MANDIRI Impacted teeth Berobat Jalan

3784 01-03-2018 0137U0040318Y000074 0001459032153 JUJU P PEKERJA MANDIRI Impacted teeth Berobat Jalan

3785 01-03-2018 0137U0040318Y000028 0001460099597 RISKIANI P PEKERJA MANDIRI Acute upper respiratory Berobat Jalan
infection, unspecified
3786 01-03-2018 0137U0040318Y000084 0001463460614 JESSLYN NAQUITA LESMANA P PEKERJA MANDIRI Abrasion of teeth Berobat Jalan

3787 01-03-2018 0137U0040318Y000068 0001466270504 AHMAD L PEGAWAI SWASTA Gastro-oesophageal reflux Berobat Jalan
disease without

3788 01-03-2018 0137U0040318Y000046 0001470973678 ALFIANI RACHMAWATI P PEGAWAI SWASTA Acute upper respiratory Berobat Jalan
infection, unspecified
3789 01-03-2018 0137U0040318Y000061 0001477380519 SITI PARIDA P PEKERJA MANDIRI Acute upper respiratory Berobat Jalan
infection, unspecified
3790 01-03-2018 0137U0040318Y000077 0001481488817 H. SIRAT HALINUAR RANI L PEKERJA MANDIRI Impacted teeth Berobat Jalan

3791 01-03-2018 0137U0040318Y000095 0001516385687 EVI LATHIFATUL MAGHFUROH P PEGAWAI SWASTA Gastro-oesophageal reflux Berobat Jalan
disease without

3792 01-03-2018 0137U0040318Y000104 0001516974862 DIZA RISKY PRAMUDYA L PEGAWAI SWASTA Anaemia, unspecified Berobat Jalan

3793 01-03-2018 0137U0040318Y000049 0001517710138 ANDIK SUPRIYADI L PEGAWAI SWASTA Vertigo of central origin Berobat Jalan

3794 01-03-2018 0137U0040318Y000100 0001517710173 RASYID PRAMUDITYA ADNAN L PEGAWAI SWASTA Acute upper respiratory Berobat Jalan
infection, unspecified
3795 01-03-2018 0137U0040318Y000010 0001625364347 FITRIA SHIFA P PEGAWAI SWASTA Abrasion of teeth Berobat Jalan

3796 01-03-2018 0137U0040318Y000081 0001629187716 NEZIRA P PEGAWAI SWASTA Impacted teeth Berobat Jalan
DAFTAR KUNJUNGAN PESERTA SAKIT

Kantor Cabang : BEKASI - 1011

FKTP : Klinik Mitra Medika - 0137U004

3797 01-03-2018 0137U0040318Y002894 0001629525238 WINDA GUSTIA WINDI P PEGAWAI SWASTA Other antenatal screening Berobat Jalan

3798 01-03-2018 0137U0040318Y000056 0001631196437 RAYA SYAMSI PRADIPTA L PEGAWAI SWASTA Acute upper respiratory Berobat Jalan
MULYA infection, unspecified
3799 01-03-2018 0137U0040318Y000012 0001632040402 LUJINAH P PEGAWAI SWASTA Sequelae of stroke, not Rujuk Lanjut
specified as haemorrhage

3800 01-03-2018 0137U0040318Y000102 0001637557187 ARIANTI NURFITRIYANI P PEGAWAI SWASTA Dyspepsia Berobat Jalan

3801 01-03-2018 0137U0040318Y000078 0001644259634 SUBAGYO L PEGAWAI SWASTA Dental caries, unspecified Berobat Jalan

3802 01-03-2018 0137U0040318Y000106 0001645674546 RENI SUSANTI P PEGAWAI SWASTA Single spontaneous Sembuh
delivery, unspecified
3803 01-03-2018 0137U0040318Y000067 0001649835742 ALAFASY ARSY L PEGAWAI SWASTA Acute upper respiratory Berobat Jalan
DHANURENDRA infection, unspecified
3804 01-03-2018 0137U0040318Y000030 0001658850129 phasa putratama L PEGAWAI SWASTA Acute upper respiratory Berobat Jalan
infection, unspecified
3805 01-03-2018 0137U0040318Y000098 0001660096517 EKO SESAR JULIANTO L PEGAWAI SWASTA Acute upper respiratory Berobat Jalan
infection, unspecified
3806 01-03-2018 0137U0040318Y000054 0001718270379 TJOAN LAN P PEKERJA MANDIRI Other specified headache Berobat Jalan
syndromes
3807 01-03-2018 0137U0040318Y000020 0001723670245 WENDY RUSLAN L PEKERJA MANDIRI Epilepsy, unspecified Rujuk Lanjut

3808 01-03-2018 0137U0040318Y000050 0001729550711 MARGRET ROMAULI SE P PEKERJA MANDIRI Irregular menstruation, Berobat Jalan
unspecified
3809 01-03-2018 0137U0040318Y000006 0001736266184 STEFEN EDUARD TUA L PEKERJA MANDIRI Necrosis of pulp Berobat Jalan

3810 01-03-2018 0137U0040318Y000018 0001736840384 ERWIN YUDA PRASETIA L PEGAWAI SWASTA Abrasion of teeth Berobat Jalan

3811 01-03-2018 0137U0040318Y000079 0001737606745 ANI EKA WINDYASTUTI P PEGAWAI SWASTA Necrosis of pulp Berobat Jalan

3812 01-03-2018 0137U0040318Y000087 0001741171432 ONI SETIAWAN M NUGROHO L PEGAWAI SWASTA Myalgia Berobat Jalan

3813 01-03-2018 0137U0040318Y000092 0001741601777 Nusan Leo L PEGAWAI SWASTA Myalgia Berobat Jalan

3814 01-03-2018 0137U0040318Y000016 0001742808925 Tata Suparyanto L PEGAWAI SWASTA Necrosis of pulp Berobat Jalan

3815 01-03-2018 0137U0040318Y000051 0001744542865 DEWI SUNINGSIH P PEGAWAI SWASTA Other specified headache Berobat Jalan
syndromes
3816 01-03-2018 0137U0040318Y000070 0001767662087 PAHALA SIALAGAN L PEGAWAI SWASTA Myalgia Berobat Jalan

3817 01-03-2018 0137U0040318Y000085 0001773406269 NAFISA ALIYATUNNISA P PEGAWAI SWASTA Cyst of oral region, Rujuk Lanjut
unspecified
3818 01-03-2018 0137U0040318Y000017 0001787017599 RINI MEGAWATI P PEGAWAI SWASTA Caries of dentine Berobat Jalan

3819 01-03-2018 0137U0040318Y000099 0001801905838 Syachroni L PEGAWAI SWASTA Dyspepsia Berobat Jalan
DAFTAR KUNJUNGAN PESERTA SAKIT

Kantor Cabang : BEKASI - 1011

FKTP : Klinik Mitra Medika - 0137U004

3820 01-03-2018 0137U0040318Y000032 0001821478421 YAKOBUS EKA PUTRA L PEGAWAI SWASTA Acute upper respiratory Berobat Jalan
ARYANTA infection, unspecified
3821 01-03-2018 0137U0040318Y000047 0001823608012 JONG DJU TSIN P PEKERJA MANDIRI Acute upper respiratory Berobat Jalan
infection, unspecified
3822 01-03-2018 0137U0040318Y000048 0001847201668 ANAYA PUJA MALIKA P PEGAWAI SWASTA Acute upper respiratory Berobat Jalan
infection, unspecified
3823 01-03-2018 0137U0040318Y000022 0001850888013 MUHAMMAD FARHAN RAQILLA L PEGAWAI SWASTA Other and unspecified Berobat Jalan
infectious diseases
3824 01-03-2018 0137U0040318Y000071 0001854991855 INDRAYATI P PEGAWAI SWASTA Acute upper respiratory Berobat Jalan
infection, unspecified
3825 01-03-2018 0137U0040318Y000093 0001864125022 NANANG HERMAWAN L PEGAWAI SWASTA Acute upper respiratory Berobat Jalan
infection, unspecified
3826 01-03-2018 0137U0040318Y000038 0001884441429 HETI K P PEKERJA MANDIRI Other antenatal screening Berobat Jalan

3827 01-03-2018 0137U0040318Y000088 0001884441453 AKSENOWATI P PEKERJA MANDIRI Anaemia, unspecified Berobat Jalan

3828 01-03-2018 0137U0040318Y000004 0001903044341 rumih L PEKERJA MANDIRI Secondary hypertension, Rujuk Lanjut
unspecified
3829 01-03-2018 0137U0040318Y000031 0001906633732 SUBAGYO L PENERIMA PENSIUN Unspecified haemorrhoids Berobat Jalan
PNS without complication

3830 01-03-2018 0137U0040318Y000011 0001906634259 INDRIWATI P PENERIMA PENSIUN Insulin-dependent Rujuk Lanjut
PNS diabetes mellitus with

3831 01-03-2018 0137U0040318Y000033 0001961200089 ZAHIRA AKHYAR PRAMUDITA P PRAJURIT AL Acute upper respiratory Berobat Jalan
infection, unspecified
3832 01-03-2018 0137U0040318Y000035 0001961334729 umar L PEKERJA MANDIRI Chronic ischaemic heart Rujuk Lanjut
disease, unspecified
3833 01-03-2018 0137U0040318Y000060 0002033752522 ahmad hanif widiantono L PEKERJA MANDIRI Acute upper respiratory Berobat Jalan
infection, unspecified
3834 01-03-2018 0137U0040318Y000002 0002046806212 mahdalena P PEGAWAI SWASTA Maternal care due to Rujuk Lanjut
uterine scar from previous

3835 01-03-2018 0137U0040318Y000086 0002066073941 RIZKIA ALTHAFUNISSA P PEGAWAI SWASTA Abrasion of teeth Berobat Jalan
NUGRAHA
3836 01-03-2018 0137U0040318Y000019 0002073206856 HERMAWATI P PEKERJA MANDIRI Other antenatal screening Berobat Jalan

3837 01-03-2018 0137U0040318Y000052 0002076879892 IMANUEL MARTONA L PEKERJA MANDIRI Acute upper respiratory Berobat Jalan
infection, unspecified
3838 01-03-2018 0137U0040318Y000001 0002082828993 ISNAWATI PUTRI P PEKERJA MANDIRI Single spontaneous Sembuh
delivery, unspecified
3839 01-03-2018 0137U0040318Y000039 0002084448014 MELI YULIANTI P PEKERJA MANDIRI Other contraceptive Berobat Jalan
management
3840 01-03-2018 0137U0040318Y000089 0002097689995 ISKANDAR L PEGAWAI SWASTA Other specified headache Berobat Jalan
syndromes
DAFTAR KUNJUNGAN PESERTA SAKIT

Kantor Cabang : BEKASI - 1011

FKTP : Klinik Mitra Medika - 0137U004

3841 01-03-2018 0137U0040318Y000072 0002138681619 FEDRO RAYHAN MAULANA L PEGAWAI SWASTA Chronic gingivitis Berobat Jalan

3842 01-03-2018 0137U0040318Y003409 0002198224179 devi andriani P PEGAWAI SWASTA Other antenatal screening Berobat Jalan

3843 01-03-2018 0137U0040318Y000090 0002209911939 SUMIYATI P PEKERJA MANDIRI Acute upper respiratory Berobat Jalan
infection, unspecified
3844 01-03-2018 0137U0040318Y000024 0002234060234 PERMANA AGUNG SEDAYU L PEGAWAI SWASTA Acute upper respiratory Berobat Jalan
infection, unspecified
3845 01-03-2018 0137U0040318Y000069 0002235655067 FATHAN AZZAMI MASTA P PEGAWAI SWASTA Acute upper respiratory Berobat Jalan
infection, unspecified
3846 01-03-2018 0137U0040318Y000091 0002269453026 sadrakh jericho willy keenan L ANGGOTA POLRI Dermatitis herpetiformis Berobat Jalan

3847 01-03-2018 0137U0040318Y000076 0002284116489 haifa nuraisya juniar P PNS DAERAH Caries of dentine Berobat Jalan

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