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    Laporan Universal

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    Parid Kasdiantoro
    This document is a monthly report from Tugu Public Health Center in Trenggalek, East Java, Indonesia for the period of April 1-30, 2023. It details 4 patient cases seen at the general outpatient clinic. Each case lists the patient's name, ID number, address, date of birth, age, gender, occupation, treating doctor, status (new or existing patient), payment method, diagnosis and ICD-10 code. All 4 patients were diagnosed with superficial injury of unspecified body region.

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    © All Rights Reserved
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    Laporan Universal

    Uploaded by

    Parid Kasdiantoro
    8 views3 pages
    This document is a monthly report from Tugu Public Health Center in Trenggalek, East Java, Indonesia for the period of April 1-30, 2023. It details 4 patient cases seen at the general outpatient clinic. Each case lists the patient's name, ID number, address, date of birth, age, gender, occupation, treating doctor, status (new or existing patient), payment method, diagnosis and ICD-10 code. All 4 patients were diagnosed with superficial injury of unspecified body region.

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    laporan_universal (2).xls

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    This document is a monthly report from Tugu Public Health Center in Trenggalek, East Java, Indonesia for the period of April 1-30, 2023. It details 4 patient cases seen at the general outpatient clinic. Each case lists the patient's name, ID number, address, date of birth, age, gender, occupation, treating doctor, status (new or existing patient), payment method, diagnosis and ICD-10 code. All 4 patients were diagnosed with superficial injury of unspecified body region.

    Copyright:

    © All Rights Reserved
    Download as TXT, PDF, TXT or read online from Scribd
    Download as txt, pdf, or txt
    8 views3 pages

    Laporan Universal

    Uploaded by

    Parid Kasdiantoro
    This document is a monthly report from Tugu Public Health Center in Trenggalek, East Java, Indonesia for the period of April 1-30, 2023. It details 4 patient cases seen at the general outpatient clinic. Each case lists the patient's name, ID number, address, date of birth, age, gender, occupation, treating doctor, status (new or existing patient), payment method, diagnosis and ICD-10 code. All 4 patients were diagnosed with superficial injury of unspecified body region.

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    © All Rights Reserved
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    <table class='tabel' width='90%'>

    <tr class="form">
    <td align="center" colspan="9">
    <big><big><span style="font-weight: bold;">
    LAPORAN UNIVERSAL POLI UMUM<br>
    BULAN 01-04-2023 - 30-04-2023 </span></big></big>
    </td>
    </tr>
    </table>
    <table align='center'>
    <tr>
    <td>Total</td>
    <td>:</td>
    <td>4</td>
    </tr>
    </table>
    <table align="center" width="98%" border="1">
    <tr class="row1">
    <td width='3%'>No</td>
    <td width='6%'>Tanggal</td>
    <td width='6%'>PKM</td>
    <td width='6%'>No RM</td>
    <td width='10%'>Nama</td>
    <td width='10%'>NIK</td>
    <td width='10%'>Alamat</td>
    <td width='6%'>Desa</td>
    <td width='5%'>Kecamatan</td>
    <td width='5%'>Kabupaten</td>
    <td width='6%'>Tgl Lahir</td>
    <td width='6%'>Umur<br>Th</td>
    <td width='2%'>L/P</td>
    <td width='7%'>Pekerjaan</td>
    <td width='7%'>Ruangan</td>
    <td width='7%'>Petugas</td>
    <td width='4%'>Status</td>
    <td>Kasus</td>
    <td>Cara Bayar</td>
    <td>Jenis BPJS</td>
    <td>No BPJS</td>
    <td>Kode Bridging</td>
    <td>ICD-10</td>
    <td>Diagnosa</td>

    </tr>

    <tr align="left" valign="top">


    <td>1</td>
    <td>05-04-2023</td>
    <td>PUSKESMAS TUGU</td>
    <td>000421</td>
    <td>USWATUN KASANAH</td>
    <td>'3503056012910005</td>
    <td>DUSUN KEBON, RT : 020,RW :005 </td>
    <td>GONDANG</td>
    <td>TUGU</td>
    <td>TRENGGALEK</td>
    <td>20-12-1991</td>
    <td>31</td>
    <td>P</td>
    <td>Belum / Tidak Bekerja</td>
    <td>POLI UMUM</td>
    <td>dr. Reza Suzana</td>
    <td>LAMA</td>
    <td>KASUS BARU</td>
    <td>BPJS</td>
    <td>PEKERJA MANDIRI</td>
    <td>'0003070710134</td>
    <td>131506010423Y000158</td>
    <td align='center'>
    T14.0 </td>
    <td align='center'>
    <font color='red'>Superficial injury of unspecified body region</font>
    </td>

    </tr>

    <tr align="left" valign="top">


    <td>2</td>
    <td>05-04-2023</td>
    <td>PUSKESMAS TUGU</td>
    <td>020216</td>
    <td>DEVITA NURFADILA</td>
    <td>'3503056612130003</td>
    <td>RT 26 RW 06</td>
    <td>GONDANG</td>
    <td>TUGU</td>
    <td>TRENGGALEK</td>
    <td>26-12-2013</td>
    <td>9</td>
    <td>P</td>
    <td>Pelajar / Mahasiswa</td>
    <td>POLI UMUM</td>
    <td>dr. Nonong Puspowicahyo</td>
    <td>LAMA</td>
    <td>KASUS BARU</td>
    <td>UMUM</td>
    <td></td>
    <td>'</td>
    <td></td>
    <td align='center'>
    T14.0 </td>
    <td align='center'>
    <font color='red'>Superficial injury of unspecified body region</font>
    </td>

    </tr>

    <tr align="left" valign="top">


    <td>3</td>
    <td>06-04-2023</td>
    <td>PUSKESMAS TUGU</td>
    <td>026277</td>
    <td>MUNTAMAH</td>
    <td>'3503056001770002</td>
    <td>RT 008 RW 003</td>
    <td>NGEPEH</td>
    <td>TUGU</td>
    <td>TRENGGALEK</td>
    <td>20-01-1979</td>
    <td>44</td>
    <td>P</td>
    <td>Petani / Pekebun</td>
    <td>POLI UMUM</td>
    <td>dr. Reza Suzana</td>
    <td>BARU</td>
    <td>KASUS BARU</td>
    <td>UMUM</td>
    <td></td>
    <td>'</td>
    <td></td>
    <td align='center'>
    T14.0 </td>
    <td align='center'>
    <font color='red'>Superficial injury of unspecified body region</font>
    </td>

    </tr>

    <tr align="left" valign="top">


    <td>4</td>
    <td>13-04-2023</td>
    <td>PUSKESMAS TUGU</td>
    <td>026391</td>
    <td>AISYA FEBRIANI DWI NURCAHYANI</td>
    <td>'</td>
    <td>RT 006 RW 003</td>
    <td>BANARAN</td>
    <td>TUGU</td>
    <td>TRENGGALEK</td>
    <td>28-02-2014</td>
    <td>9</td>
    <td>P</td>
    <td>Pelajar / Mahasiswa</td>
    <td>POLI UMUM</td>
    <td>dr. Reza Suzana</td>
    <td>BARU</td>
    <td>KASUS BARU</td>
    <td>UMUM</td>
    <td></td>
    <td>'</td>
    <td></td>
    <td align='center'>
    T14.0 </td>
    <td align='center'>
    <font color='red'>Superficial injury of unspecified body region</font>
    </td>

    </tr>
    </table>

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