RUMAH SAKIT UMUM DAERAH MAMPANG PRAPATAN

Jl. Kapten P. Tendean No. 9A, Mampang Prapatan, Jakarta Selatan, DKI Jakarta
021-7971115
E-mail : rsudmampangprapatan@jakarta.go.id

DAFTAR PASIEN RAWAT INAP

NO.RAWAT NO.R.M. NAMA PASIEN NO.KAMAR NAMA KAMAR DIAGNOSA AWAL DIAGN.AKHIR TGL.MASUK TGL.KELUAR BIAYA KAMAR
2024/04/01/000286 045194 PANGI LESTARI CA002 P CEMPAKA A TUMOR LEHER POST EKSISI 01/04/2024 12:51:35 03/04/2024 10:57:07 Rp 300,000.00
MASSA
2024/04/01/000356 027892 SITI AISYAH CA003 P CEMPAKA A BACTERIAL BACTERIAL 01/04/2024 22:47:16 03/04/2024 17:34:55 Rp 300,000.00
INFECTION INFECTION
2024/04/02/000373 121568 HERMIN MARDIANA CA002 P CEMPAKA A HIPOKALEMIA HIPOKALEMIA 02/04/2024 04:30:57 03/04/2024 10:03:06 Rp 200,000.00
BERAT
2024/04/02/000501 121605 SADIYAH CA003 P CEMPAKA A SUSP TB SUSP TB 02/04/2024 23:13:25 06/04/2024 18:12:24 Rp 500,000.00
2024/04/03/000614 121612 CATUR CICIN CA002 P CEMPAKA A DENGUE FEVER DENGUE FEVER 03/04/2024 11:41:29 05/04/2024 16:36:45 Rp 300,000.00
KUSUMAWATI
2024/04/04/000464 101153 FIRDA NURUL CA003 P CEMPAKA A VOMITUS VOMITUS 04/04/2024 00:51:50 06/04/2024 12:13:07 Rp 300,000.00
PERSISTEN
2024/04/04/000467 115072 FITRI NURHAYATI CA004 P CEMPAKA A DHF, G1P0A0 DHF 04/04/2024 02:51:25 06/04/2024 11:32:11 Rp 300,000.00
2024/04/04/000542 023354 ANITJE DALMO CA001 P CEMPAKA A ULCUS PEDIS POST OP 04/04/2024 12:44:41 06/04/2024 10:07:41 Rp 300,000.00
BOGAR SINISTRA DEBRIDEMENT
2024/04/05/000223 120228 WINDA SARI CA001 P CEMPAKA A VIRAL INFECTION VIRAL 05/04/2024 03:30:28 08/04/2024 11:22:16 Rp 400,000.00
2024/04/05/000411 121733 DEWI NOVITASARY CA002 P CEMPAKA A DHF GRADE I DHF GRADE I 05/04/2024 17:16:40 07/04/2024 11:15:30 Rp 300,000.00
2024/04/06/000520 119103 HASANAH CA001 P CEMPAKA A ULKUS DIGITI ULKUS DIGITI 06/04/2024 11:27:41 08/04/2024 13:19:30 Rp 300,000.00
MANUS SINISTRA MANUS
2024/04/06/000545 049232 YUNANI CA003 P CEMPAKA A SUSP TB DD CAP SUSP TB DD CAP 06/04/2024 19:14:37 08/04/2024 11:26:20 Rp 300,000.00
DM
2024/04/07/000024 121766 ISA MEIDELLA CA002 P CEMPAKA A DHF DHF 07/04/2024 11:53:07 08/04/2024 09:00:17 Rp 200,000.00
2024/04/08/000294 013047 TRI ASTUTI CA001 P CEMPAKA A ASMA, SUSP TB ASMA, SUSP TB 08/04/2024 14:46:35 12/04/2024 20:06:04 Rp 500,000.00
PARU
2024/04/08/000267 121525 SRI SUPARNI CA004 P CEMPAKA A KRISIS HIPERTENSI KRISIS 08/04/2024 16:44:21 09/04/2024 17:43:07 Rp 200,000.00
+ KRISIS HIPERTENSI +
HIPERGLIKEMI + KRISIS
HIPERGLIKEMI +
VES
2024/04/08/000300 001606 SITI MAYSAROH CA001 P CEMPAKA A HIPERTENSI HIPERTENSI 08/04/2024 23:23:49 09/04/2024 10:07:36 Rp 200,000.00
URGENSI
2024/04/09/000154 054651 INDAH AYU CA003 P CEMPAKA A DEMAM THYPOID DEMAM THYPOID 09/04/2024 16:35:22 11/04/2024 12:02:17 Rp 300,000.00
PERMATA SARI
2024/04/11/000290 121892 ASMAWYN CA002 P CEMPAKA A HIPERGLIKEMIA, DM HIPERGLIKEMIA, 11/04/2024 18:39:03 17/04/2024 20:00:05 Rp 700,000.00
TP2, KAD, BI, AKI DD DM TP2, KAD, BI,
AKUT ON CKD AKI DD AKUT ON
CKD
2024/04/11/000309 010850 DINA CA001 P CEMPAKA A DYSPNEU DYSPNEU 11/04/2024 23:17:28 15/04/2024 11:39:54 Rp 500,000.00
SOFIATUDDINSYAH
2024/04/12/000371 044440 NUR KHANIFAH CA002 P CEMPAKA A DENGUE FEVER DENGUE FEVER 12/04/2024 10:16:27 15/04/2024 10:44:59 Rp 400,000.00
2024/04/12/000407 046900 IKA KUMALA SARI CA003 P CEMPAKA A DHF GR I DHF GR I 12/04/2024 14:51:57 16/04/2024 12:35:32 Rp 500,000.00
2024/04/13/000037 121929 ARNI BT ARSYAD CA002 P CEMPAKA A HYPOKALEMIA HYPOKALEMIA 13/04/2024 06:36:34 15/04/2024 10:08:26 Rp 300,000.00
2024/04/13/000078 119103 HASANAH CA002 P CEMPAKA A HIPERGLIKEMIA DM HIPERGLIKEMIA 13/04/2024 12:39:19 17/04/2024 11:13:22 Rp 500,000.00

7/19/24, 8:39 PM Page 1 of 17

NO.RAWAT NO.R.M. NAMA PASIEN NO.KAMAR NAMA KAMAR DIAGNOSA AWAL DIAGN.AKHIR TGL.MASUK TGL.KELUAR BIAYA KAMAR
TYPE 2 AKI DD DM TYPE 2 AKI
AKUT ON CKD DD AKUT ON
2024/04/15/000401 121990 TUTI ASTUTI CA001 P CEMPAKA A DENGUE FEVER + DENGUE FEVER 15/04/2024 12:30:23 21/04/2024 11:35:45 Rp 700,000.00
HIPOKALEMIA + HIPOKALEMIA
2024/04/15/000463 040988 SHERANIA DIVA CA002 P CEMPAKA A DHF DHF 15/04/2024 22:04:58 17/04/2024 11:29:54 Rp 300,000.00
ANAZTASYA
FARADILLA
2024/04/16/000361 029848 NADA SELVIANA CA003 P CEMPAKA A ASTHMA ASTHMA 16/04/2024 06:00:49 18/04/2024 11:19:41 Rp 300,000.00
2024/04/16/000512 005496 NANY SAKINEM CA004 P CEMPAKA A GEA GEA 16/04/2024 21:39:51 19/04/2024 10:46:39 Rp 400,000.00
2024/04/17/000128 092597 MARNI CA002 P CEMPAKA A BACTERIAL BACTERIAL 17/04/2024 04:57:18 19/04/2024 10:49:02 Rp 300,000.00
INFECTION+ INFECTION+
VOMITUS VOMITUS
PERSISTEN+HIPER PERSISTEN+HIP
GLIKMIA ERGLIKMIA
2024/04/17/000296 014327 SUMINEM CA002 P CEMPAKA A GEA GEA + CKD 17/04/2024 13:52:02 19/04/2024 10:58:43 Rp 300,000.00
STAGE IV +
2024/04/17/000328 122110 ELI SOPIAH CA003 P CEMPAKA A ANEMIA ANEMIA 17/04/2024 18:26:43 20/04/2024 10:41:32 Rp 400,000.00
2024/04/17/000347 119342 RAHMAWATI CA003 P CEMPAKA A DEMAM TYPHOID DEMAM TYPHOID 17/04/2024 21:18:52 18/04/2024 15:17:44 Rp 200,000.00
2024/04/18/000209 046005 ENDANG ASTUTI CA003 P CEMPAKA A ASTHMA ASTHMA 18/04/2024 12:52:17 20/04/2024 15:25:53 Rp 300,000.00
EKSERBASI AKUT EKSERBASI
2024/04/18/000267 122165 OCDELIANY CA004 P CEMPAKA A DYSPEPSIA DYSPEPSIA 18/04/2024 20:54:43 20/04/2024 20:10:38 Rp 300,000.00
2024/04/18/000268 122163 NURHIDAYATUN CA003 P CEMPAKA A VERTIGO VERTIGO 18/04/2024 21:10:22 26/04/2024 14:09:54 Rp 900,000.00
2024/04/19/000377 032890 KHAERONAH CA002 P CEMPAKA A GEA GEA 19/04/2024 14:57:17 22/04/2024 11:25:58 Rp 400,000.00
2024/04/19/000397 058667 ELFITA CA001 P CEMPAKA A TUMOR DINDING TUMOR DINDING 19/04/2024 15:56:28 21/04/2024 15:06:48 Rp 200,000.00
CAHYANINGSIH ABDOMEN ABDOMEN
2024/04/19/000436 008728 DEVITA SARI CA004 P CEMPAKA A VOMITUS VOMITUS 19/04/2024 20:20:51 20/04/2024 00:56:37 Rp 200,000.00
2024/04/20/000064 089330 HAWILAH CA004 P CEMPAKA A HIPERGLIKEMIA, DM HIPERGLIKEMIA, 20/04/2024 02:56:06 23/04/2024 11:11:30 Rp 400,000.00
DM
2024/04/21/000048 038469 AMSAH CA001 P CEMPAKA A TUMOR GLUTEAL TUMOR 21/04/2024 15:41:36 23/04/2024 10:46:26 Rp 300,000.00
SINISTRA GLUTEAL
2024/04/21/000056 020371 WATI HERAWATI CA003 P CEMPAKA A DHF DHF 21/04/2024 21:08:18 24/04/2024 12:28:36 Rp 400,000.00
2024/04/22/000155 072511 YESSI RUT MARIA CA004 P CEMPAKA A DHF GR II DHF GR II 22/04/2024 00:45:57 25/04/2024 09:40:34 Rp 400,000.00
2024/04/22/000357 091042 HILMIYAH CA002 P CEMPAKA A DHF DHF 22/04/2024 16:46:41 27/04/2024 10:52:35 Rp 600,000.00
2024/04/22/000389 093336 INDAH UTRIYANA CA001 P CEMPAKA A DEMAM THYPOID DEMAM THYPOID 22/04/2024 23:08:38 24/04/2024 17:53:25 Rp 300,000.00
2024/04/24/000316 122475 HOIRIYAH CA001 P CEMPAKA A DYSPEPSIA ET DYSPEPSIA ET 24/04/2024 19:47:37 27/04/2024 14:38:01 Rp 400,000.00
VOMITUS VOMITUS
2024/04/24/000333 083658 SILVIA WIDIANTI CA004 P CEMPAKA A DENGUE FEVER DENGUE FEVER 24/04/2024 23:13:37 27/04/2024 10:48:32 Rp 400,000.00
2024/04/24/000332 063033 FARIDA CA001 P CEMPAKA A ANAEMIA ANAEMIA 24/04/2024 23:41:12 25/04/2024 18:14:47 Rp 200,000.00
2024/04/25/000234 122504 ZAINAL ARIFIN CA002 P CEMPAKA A ULKUS PEDIS ULKUS PEDIS 25/04/2024 12:29:12 27/04/2024 10:58:49 Rp 300,000.00
DEXTRA
2024/04/25/000298 075412 DEWI SAFITRI CA002 P CEMPAKA A DHF GR 1 DHF GR 1 25/04/2024 20:13:58 28/04/2024 14:10:31 Rp 400,000.00
2024/04/26/000477 122560 NADINE KEISHA CA004 P CEMPAKA A DEMAM DENGUE DEMAM DENGUE 26/04/2024 15:32:17 30/04/2024 11:17:24 Rp 500,000.00
SHAFIRA
2024/04/27/000532 122591 RINA ARI SETIANI CA003 P CEMPAKA A THYPOID FEVER THYPOID FEVER 27/04/2024 00:25:53 29/04/2024 10:59:27 Rp 300,000.00
2024/04/27/000650 122505 VIONITA OKTAVIANI CA001 P CEMPAKA A DHF DHF 27/04/2024 19:50:56 01/05/2024 10:52:38 Rp 500,000.00
2024/04/28/000035 081237 FILZA RIANY CA002 P CEMPAKA A VERTIGO PERIFER VERTIGO 28/04/2024 14:34:33 01/05/2024 12:58:42 Rp 400,000.00
2024/04/28/000078 075219 MARJANAH CA001 P CEMPAKA A PNEUMONIA PNEUMONIA 28/04/2024 21:15:48 02/05/2024 11:47:00 Rp 500,000.00
2024/04/28/000077 057052 SUMARTI CA004 P CEMPAKA A HIPOKALEMIA HIPOKALEMIA 28/04/2024 22:53:21 30/04/2024 13:07:13 Rp 300,000.00
2024/04/29/000640 002157 SONAK SOSIAWANI CA003 P CEMPAKA A STT STT 29/04/2024 15:41:14 01/05/2024 09:46:47 Rp 300,000.00

7/19/24, 8:39 PM Page 2 of 17

NO.RAWAT NO.R.M. NAMA PASIEN NO.KAMAR NAMA KAMAR DIAGNOSA AWAL DIAGN.AKHIR TGL.MASUK TGL.KELUAR BIAYA KAMAR
HUTAPEA
2024/04/01/000267 121527 AHMAD FAUZI CB002 L CEMPAKA B DEMAM DENGUE DEMAM DENGUE 01/04/2024 11:31:57 05/04/2024 11:25:37 Rp 500,000.00
2024/04/02/000498 121593 JAYADI CB003 L CEMPAKA B COLIC ABDOMEN COLIC ABDOMEN 02/04/2024 22:02:02 04/04/2024 10:28:09 Rp 300,000.00
2024/04/04/000502 121654 PULUNG ANJI CB001 L CEMPAKA B DHF dhf 04/04/2024 08:14:16 07/04/2024 09:12:02 Rp 400,000.00
SANTOSA
2024/04/04/000575 121598 MOCHAMAD RAFLI CB003 L CEMPAKA B VERTIGO VERTIGO 04/04/2024 16:55:02 06/04/2024 10:57:47 Rp 300,000.00
SABILI HARUN
2024/04/05/000224 114081 AHMAD SEINI CB004 L CEMPAKA B VERTIGO VERTIGO 05/04/2024 03:37:06 06/04/2024 10:32:04 Rp 200,000.00
2024/04/05/000225 121693 DONY LESMANA CB002 L CEMPAKA B FEBRIS H6 EC SUSP FEBRIS H6 EC 05/04/2024 03:43:36 07/04/2024 09:32:48 Rp 300,000.00
DENGUE FEVER, SUSP DENGUE
FEVER, ISK
2024/04/04/000601 017913 SATOTO CB002 L CEMPAKA B penurunan kesadaran penurunan 05/04/2024 16:08:11 07/04/2024 10:55:25 Rp 300,000.00
ec hipoglikemia kesadaran ec
riwayat cvd hipoglikemia
riwayat cvd
2024/04/05/000405 121720 MUHAMMAD SYAHID CB004 L CEMPAKA B DHF DHF 05/04/2024 16:50:56 08/04/2024 11:31:58 Rp 400,000.00
AL AZIZ
2024/04/05/000427 121736 TEGUH CB003 L CEMPAKA B SUSP TB SUSP TB 05/04/2024 20:02:51 08/04/2024 10:30:49 Rp 400,000.00
2024/04/05/000431 121734 IDHAM CHOLID CB003 L CEMPAKA B DYSPNOE + DYSPNOE 05/04/2024 21:10:47 06/04/2024 16:15:20 Rp 200,000.00
INTOLEKTASI
2024/04/07/000022 081315 NURALINT GUNTUR CB001 L CEMPAKA B TUMOR COLLI PPOST EKSISI 07/04/2024 11:42:35 08/04/2024 13:26:34 Rp 200,000.00
WICAKSONO SINISTRA TUMOR COLLI
SINISTRA
2024/04/08/000271 121810 SAADI CB001 L CEMPAKA B ASMA ASMA 08/04/2024 17:55:57 12/04/2024 18:58:51 Rp 500,000.00
2024/04/09/000121 041509 ISHAK CB002 L CEMPAKA B LBP DD HNP LBP 09/04/2024 09:31:44 10/04/2024 18:56:45 Rp 300,000.00
2024/04/09/000141 121837 SIGIT RIYADI CB002 L CEMPAKA B disfagia susp disfagia susp 09/04/2024 09:52:12 11/04/2024 12:00:03 Rp 300,000.00
kandidiasis oral kandidiasis oral
2024/04/09/000134 121838 AGHATAN CB003 L CEMPAKA B DENGUE FEVER + DENGUE FEVER 09/04/2024 11:17:02 12/04/2024 18:17:07 Rp 400,000.00
FAWAZZILAH ATHA INTAKE SULIT + INTAKE SULIT
2024/04/09/000148 121840 HERMANTO CB004 L CEMPAKA B Vertigo Perifer, Vertigo Perifer, 09/04/2024 14:22:44 11/04/2024 11:58:03 Rp 300,000.00
Dyspepsia, Hipertensi Dyspepsia,
Hipertensi
2024/04/10/000221 121866 ENDRO CB004 L CEMPAKA B CAP DD TB CAP DD TB 10/04/2024 19:46:57 13/04/2024 12:25:13 Rp 400,000.00
2024/04/11/000013 077209 AGUS CB002 L CEMPAKA B KOLIK ABDOMEN EC KOLIK ABDOMEN 11/04/2024 00:56:41 13/04/2024 10:30:05 Rp 300,000.00
DISPEPSIA SUSP EC DISPEPSIA
CHOLESITIS SUSP SUSP
TB PARU CHOLESITIS
2024/04/11/000256 121882 NGADIYONO CB001 L CEMPAKA B DEMAM DENGUE, DEMAM 11/04/2024 11:05:16 14/04/2024 18:58:41 Rp 400,000.00
HIPOKALEMIA DENGUE,
2024/04/11/000307 107602 PUTRA CB004 L CEMPAKA B VERTIGO PERIFER VERTIGO 11/04/2024 23:04:27 13/04/2024 09:58:26 Rp 300,000.00
2024/04/12/000326 121903 DJAMALULLAIL CB003 L CEMPAKA B PNEUMONIA DD TB PNEUMONIA DD 12/04/2024 07:57:15 16/04/2024 09:14:29 Rp 500,000.00
TB
2024/04/12/000400 116532 MARDJUKI CB003 L CEMPAKA B ANEMIA ANEMIA 12/04/2024 13:30:08 13/04/2024 09:42:42 Rp 200,000.00
2024/04/12/000424 121920 WAWAN CB001 L CEMPAKA B HIPOENATREMI HIPOENATREMI 12/04/2024 19:11:20 15/04/2024 10:06:40 Rp 400,000.00
2024/04/13/000062 121935 HAYAT KAMAL CB004 L CEMPAKA B DENGUE FEVER DENGUE FEVER 13/04/2024 09:16:50 16/04/2024 12:41:09 Rp 400,000.00
2024/04/13/000064 110199 DARYADI CB003 L CEMPAKA B CVD SNH DD SH CVD SNH DD SH 13/04/2024 11:08:01 15/04/2024 18:00:57 Rp 300,000.00
2024/04/14/000008 110057 NGADRIS CB002 L CEMPAKA B HIPOGLIKEMIA HIPOGLIKEMIA 14/04/2024 07:07:12 16/04/2024 13:13:56 Rp 300,000.00
2024/04/14/000046 121975 MUHAMMAD RAFFLY CB001 L CEMPAKA B HIPOKALEMIA HIPOKALEMIA 14/04/2024 20:11:41 17/04/2024 11:59:16 Rp 400,000.00
FADHLURRAHMAN
2024/04/15/000276 121973 KELVIN PRATAMA CB003 L CEMPAKA B DHF GRADE I DHF GRADE I 15/04/2024 03:10:42 19/04/2024 13:01:02 Rp 500,000.00

7/19/24, 8:39 PM Page 3 of 17

NO.RAWAT NO.R.M. NAMA PASIEN NO.KAMAR NAMA KAMAR DIAGNOSA AWAL DIAGN.AKHIR TGL.MASUK TGL.KELUAR BIAYA KAMAR
SATHI
2024/04/15/000426 121991 PERY CB004 L CEMPAKA B DIARE AKUT DIARE AKUT 15/04/2024 15:09:33 16/04/2024 17:53:05 Rp 300,000.00
2024/04/15/000427 116102 DAHRUN NUHUNG CB004 L CEMPAKA B DYSPEPSIA DYSPEPSIA 15/04/2024 15:10:26 16/04/2024 13:07:37 Rp 200,000.00
2024/04/15/000455 016804 H. BUNYAMIN CB002 L CEMPAKA B CAP DD TB CAP DD TB 15/04/2024 19:45:44 18/04/2024 14:02:35 Rp 400,000.00
2024/04/15/000470 122021 AHMAD TAUFIK CB002 L CEMPAKA B EFFUSION PLEURAL EFFUSION 15/04/2024 22:52:02 18/04/2024 14:59:22 Rp 400,000.00
PLEURAL
2024/04/16/000360 098473 HAFIZ KUSUMAH CB002 L CEMPAKA B VOMITUS VOMITUS 16/04/2024 05:49:27 18/04/2024 15:08:42 Rp 300,000.00
2024/04/16/000495 122017 ARIYANTO CB004 L CEMPAKA B ILEUS OBSTRUKSI ILEUS 16/04/2024 17:23:55 18/04/2024 10:45:38 Rp 300,000.00
2024/04/17/000129 122071 ROIDIN PANJAITAN CB004 L CEMPAKA B HIPOKALEMIA HIPOKALEMIA 17/04/2024 05:17:07 19/04/2024 12:16:59 Rp 200,000.00
BERAT + BERAT +
RIWRADIKULOPA
TI
2024/04/17/000288 121985 NUR SOPIAN CB001 L CEMPAKA B DHF GRADE 2 + DHF GRADE 2 + 17/04/2024 13:01:30 20/04/2024 09:44:44 Rp 400,000.00
HIPERGLIKEMIA HIPERGLIKEMIA
REAKTIF REAKTIF
2024/04/17/000346 121736 TEGUH CB002 L CEMPAKA B ARDS ARDS 17/04/2024 21:20:37 27/04/2024 16:08:07 Rp 1,100,000.00
2024/04/18/000113 122134 ASYURO H ASENI CB002 L CEMPAKA B BACTERIAL BACTERIAL 18/04/2024 07:03:56 20/04/2024 14:43:12 Rp 300,000.00
INFECTION, SUSP INFECTION,
SUSP TB
2024/04/18/000205 122138 RATIMAN CB003 L CEMPAKA B DYPSNEU SUSP TB DYPSNEU SUSP 18/04/2024 12:30:02 20/04/2024 20:08:52 Rp 300,000.00
PARU + TB PARU +
HIPOKALEMIA + HT HIPOKALEMIA +
HT
2024/04/18/000216 098764 MUHAMAD NASIR CB004 L CEMPAKA B BP DD TB , BP DD TB , 18/04/2024 13:51:16 20/04/2024 13:28:32 Rp 300,000.00
BACTERIAL BACTERIAL
INFECTION INFECTION
2024/04/19/000158 109268 YOHANES BASTIAN CB004 L CEMPAKA B BURN INJURY BURN INJURY 19/04/2024 02:12:40 20/04/2024 14:34:56 Rp 200,000.00
NALELE
2024/04/20/000065 089523 RANDY NOBEL CB001 L CEMPAKA B DHF, GEA, DHF GRADE I + 20/04/2024 03:09:25 25/04/2024 09:29:44 Rp 600,000.00
LOLONG PNEUMONIA DD TB PNEUMONIA DD
TB
2024/04/20/000148 056482 TUTUT SUYATNO CB003 L CEMPAKA B CA PARU CA PARU 20/04/2024 11:51:47 24/04/2024 09:35:53 Rp 500,000.00
2024/04/22/000156 122310 CACA MUNANDAR CB002 L CEMPAKA B DEMAM TIFOID DEMAM TIFOID 22/04/2024 00:50:33 24/04/2024 11:30:21 Rp 300,000.00
2024/04/23/000394 105225 ABDUL RAHMAN CB003 L CEMPAKA B DHF DHF 23/04/2024 00:11:04 24/04/2024 17:16:10 Rp 200,000.00
SOLEH
2024/04/23/000400 122314 ABYAN SURYO CB004 L CEMPAKA B DHF GR I DHF GR I 23/04/2024 02:19:44 25/04/2024 10:07:29 Rp 300,000.00
2024/04/24/000307 122279 MUHAMAD ZULKIFLI CB003 L CEMPAKA B DHF DHF 24/04/2024 17:32:06 25/04/2024 17:04:55 Rp 200,000.00
MALIK
2024/04/24/000306 086057 AMMARZAKY CB001 L CEMPAKA B DHF GRADE I DHF GRADE I 24/04/2024 17:59:30 26/04/2024 09:48:11 Rp 300,000.00
2024/04/25/000126 098679 SUDARDI CB003 L CEMPAKA B ANEMIA ANEMIA 25/04/2024 00:54:11 25/04/2024 18:30:41 Rp 200,000.00
2024/04/25/000229 122496 EDI SUSANTO CB004 L CEMPAKA B DHF GRADE I DHF GRADE I 25/04/2024 11:41:54 29/04/2024 16:16:31 Rp 500,000.00
2024/04/25/000263 073522 ARBAWIJAYA CB003 L CEMPAKA B GEA GEA 25/04/2024 16:46:51 28/04/2024 14:13:57 Rp 400,000.00
2024/04/25/000312 122532 AAN WINARNO CB003 L CEMPAKA B DEMAM DENGUE DEMAM DENGUE 25/04/2024 23:32:40 30/04/2024 10:39:08 Rp 600,000.00
2024/04/26/000460 047621 MIRDJO CB001 L CEMPAKA B STROKE CVD, HT STROKE CVD, HT 26/04/2024 12:26:32 28/04/2024 16:19:58 Rp 300,000.00
2024/04/26/000509 104596 MIKY TRISNOFA CB004 L CEMPAKA B DYSPEPSIA DYSPEPSIA 26/04/2024 19:33:09 30/04/2024 10:59:43 Rp 500,000.00
2024/04/27/000542 122603 WAHYUDI CB002 L CEMPAKA B SUSP TB DD CAP + SUSP TB DD CAP 27/04/2024 04:04:31 30/04/2024 10:45:11 Rp 400,000.00
HIPOKALEMI + HIPOKALEMI
2024/04/29/000464 122167 MAMURI B MUKTAR CB002 L CEMPAKA B TH + DISCHARGE TB TH + DISCHARGE 29/04/2024 04:01:15 01/05/2024 12:38:58 Rp 300,000.00
USMAN TB

7/19/24, 8:39 PM Page 4 of 17

NO.RAWAT NO.R.M. NAMA PASIEN NO.KAMAR NAMA KAMAR DIAGNOSA AWAL DIAGN.AKHIR TGL.MASUK TGL.KELUAR BIAYA KAMAR
2024/04/29/000611 122669 SAMUEL ADI CB001 L CEMPAKA B DHF GRADE II DHF GRADE II 29/04/2024 13:27:04 02/05/2024 12:27:51 Rp 400,000.00
SAPUTRA BUTAR
2024/04/17/000350 122121 ATIN ANGGRAENI CC001P CEMPAKA C DHF DHF 17/04/2024 17:56:07 20/04/2024 09:51:20 Rp 400,000.00
2024/04/19/000153 018233 SUMIYATI CC004P CEMPAKA C CKD + LBP CKD + LBP 19/04/2024 00:57:55 21/04/2024 22:15:52 Rp 300,000.00
2024/04/19/000371 085528 MAHMUDAH CC002P CEMPAKA C CHF + ANEMIA CHF + ANEMIA 19/04/2024 12:57:31 23/04/2024 12:23:54 Rp 500,000.00
2024/04/19/000415 092808 NAJLA HAFIDZAH CC003P CEMPAKA C DHF GR II DHF GR II 19/04/2024 16:21:06 21/04/2024 20:03:50 Rp 200,000.00
IMANINA
2024/04/19/000417 122168 LIFTA WIRA CC001P CEMPAKA C DEMAM DENGUE DEMAM DENGUE 19/04/2024 17:57:31 25/04/2024 10:04:51 Rp 700,000.00
ANGRAHENI
2024/04/19/000447 049431 HUSNAWATI CC003P CEMPAKA C HEMOPTISIS SUSP HEMOPTISIS 19/04/2024 23:38:08 23/04/2024 11:27:36 Rp 500,000.00
TB, DM SUSP TB, DM
2024/04/21/000049 122281 SIBENG SUSANTI CC004P CEMPAKA C DHF GRADE I DHF GRADE I 21/04/2024 15:43:22 26/04/2024 11:55:17 Rp 600,000.00
2024/04/22/000332 089002 NURSEHA CC001P CEMPAKA C ULKUS PEDIS ULKUS PEDIS 22/04/2024 13:20:04 25/04/2024 14:37:18 Rp 400,000.00
DEKSTRA DEKSTRA
2024/04/23/000402 122382 YAYAH MARDIAH CC002P CEMPAKA C VOMITUS VOMITUS 23/04/2024 02:40:05 23/04/2024 16:54:16 Rp 200,000.00
2024/04/23/000403 072852 PITERIA CC003P CEMPAKA C VOMITUS VOMITUS 23/04/2024 02:43:01 23/04/2024 15:05:22 Rp 200,000.00
2024/04/24/000128 112028 ISTIYANA CC003P CEMPAKA C HYPOGLYCAEMIA HYPOGLYCAEMI 24/04/2024 03:04:53 24/04/2024 17:25:18 Rp 200,000.00
2024/04/24/000304 122457 NAPISAH CC003P CEMPAKA C VOMITUS VOMITUS 24/04/2024 17:58:10 27/04/2024 11:47:29 Rp 400,000.00
2024/04/24/000305 122471 PRIYANKA WANDA CC002P CEMPAKA C DHF GRADE I DHF GRADE I 24/04/2024 17:58:58 26/04/2024 10:28:35 Rp 300,000.00
RAHAYU
2024/04/26/000498 044202 PURWANTORO CC002P CEMPAKA C CAD, VERTIGO, GEA CAD, VERTIGO, 26/04/2024 17:32:57 29/04/2024 12:12:17 Rp 400,000.00
GEA
2024/04/26/000504 007448 VITA SARI CC002P CEMPAKA C HT URGENSI HT URGENSI 26/04/2024 18:32:25 27/04/2024 13:12:53 Rp 200,000.00
2024/04/27/000647 122616 EKA DIAN PERTIWI CC001P CEMPAKA C DHF GRADE I DHF GRADE I 27/04/2024 19:35:35 30/04/2024 10:55:17 Rp 400,000.00
2024/04/28/000041 084443 KHOMSIYAH CC002P CEMPAKA C TUMOR PEDIS TUMOR PEDIS 28/04/2024 15:17:35 30/04/2024 11:12:19 Rp 300,000.00
BILATERAL BILATERAL
2024/04/28/000061 030711 AISAH CC004P CEMPAKA C GEA, HIPOKALEMIA, GEA, 28/04/2024 19:16:42 30/04/2024 10:50:18 Rp 300,000.00
INTAKE SULIT HIPOKALEMIA,
INTAKE SULIT
2024/04/28/000070 075342 BARIAH CC003P CEMPAKA C VERTIGO PERIFER + VERTIGO 28/04/2024 21:07:50 30/04/2024 12:47:13 Rp 300,000.00
DYSPEPSIA PERIFER +
2024/04/29/000647 122687 SUTARMI CC002P CEMPAKA C SUSP TB susp tb 29/04/2024 17:58:55 01/05/2024 10:46:39 Rp 300,000.00
2024/04/30/000129 022559 TITIN SURTINI CC003P CEMPAKA C DM DM 30/04/2024 00:43:07 11/05/2024 13:34:05 Rp 1,200,000.00
2024/04/30/000280 031145 SITI KHOSIAH CC001P CEMPAKA C VERTIGO VERTIGO 30/04/2024 19:29:20 03/05/2024 10:40:13 Rp 400,000.00
2024/04/04/000582 121173 YASRIL ICU2 ICU obs dyspneu ec afrr obs dyspneu ec 04/04/2024 17:46:44 05/04/2024 02:12:31 Rp 2,000,000.00
acs stemi anterior afrr acs stemi
susp tb paru anterior susp tb
paru
2024/04/04/000601 017913 SATOTO ICU3 ICU penurunan kesadaran - 04/04/2024 20:08:29 05/04/2024 16:08:11 Rp 2,000,000.00
ec hipoglikemia
riwayat cvd
2024/04/05/000356 121702 LESTIYONO ADI ICU2 ICU CHF + DYSPEPSIA CHF + 05/04/2024 13:12:23 07/04/2024 00:44:17 Rp 3,000,000.00
WIRYONO
2024/04/08/000255 047865 MAEMUNAH ICU2 ICU CVD SNH DD SH CVD SNH DD SH 08/04/2024 16:44:17 09/04/2024 14:01:53 Rp 2,000,000.00
2024/04/09/000152 121842 SYATIROH ICU2 ICU Syok Hipovolemik e.c. Syok Hipovolemik 09/04/2024 15:53:50 10/04/2024 07:29:46 Rp 2,000,000.00
Vomitus Persisten e.c. Vomitus
Intake Sulit Persisten Intake
Sulit
2024/04/10/000208 086959 MURWADI ICU1 ICU ALO ALO 10/04/2024 17:00:33 10/04/2024 22:09:07 Rp 2,000,000.00

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NO.RAWAT NO.R.M. NAMA PASIEN NO.KAMAR NAMA KAMAR DIAGNOSA AWAL DIAGN.AKHIR TGL.MASUK TGL.KELUAR BIAYA KAMAR
2024/04/14/000031 109643 SITI AMINAH ICU1 ICU SISA KONSEPSI SISA KONSEPSI 14/04/2024 14:00:41 16/04/2024 13:30:19 Rp 3,000,000.00
PRO KURETASE PRO KURETASE
2024/04/19/000425 122209 YANTI ICU1 ICU STROKE CVD SNH STROKE CVD 19/04/2024 18:24:17 20/04/2024 19:44:09 Rp 2,000,000.00
DD SH SNH DD SH
2024/04/04/000465 116430 MAESAROH ISO3 P ISOLASI A KRISIS HT, ANEMIA
KRISIS HT, 04/04/2024 00:49:43 06/04/2024 10:58:58 Rp 600,000.00
ANEMIA
2024/04/05/000273 035559 SOPIYAH ISO5 P ISOLASI A SUSP TB SUSP TB 05/04/2024 07:47:21 06/04/2024 16:04:35 Rp 400,000.00
2024/04/05/000362 016365 SUYATI ISO1 P ISOLASI A DYSPNEU SUSP TB SUSP TB 05/04/2024 13:01:51 06/04/2024 16:10:09 Rp 400,000.00
PARU
2024/04/05/000438 121740 ENDANG PUTRI ISO3 P ISOLASI A SUSP TB SUSP TB 05/04/2024 23:14:46 08/04/2024 15:34:22 Rp 800,000.00
HANDAYANI
2024/04/14/000013 121964 SUPRIYATNI ISO3 P ISOLASI A PNEUMONIA DD TB PNEUMONIA DD 14/04/2024 09:17:19 18/04/2024 11:09:13 Rp 1,000,000.00
+ HIPOKALEMIA TB +
HIPOKALEMIA
2024/04/14/000037 039880 TITIN SUMARNI ISO4 P ISOLASI A HIPOKALEMIA HIPOKALEMIA 14/04/2024 16:17:15 16/04/2024 14:54:14 Rp 600,000.00
2024/04/17/000316 122115 YULIANA ISO1 P ISOLASI A PROLONGED PROLONGED 17/04/2024 16:33:11 21/04/2024 20:58:12 Rp 1,000,000.00
FEVER
2024/04/18/000212 121941 MUNISAH ISO3 P ISOLASI A EFUSI PLEURA SIN EFUSI PLEURA 18/04/2024 13:14:13 20/04/2024 16:23:02 Rp 600,000.00
EC SUSP TB PARU SIN EC SUSP TB
2024/04/22/000386 045945 ZUBAEDAH ISO4 P ISOLASI A CAP DD TB PARU CAP DD TB PARU 22/04/2024 22:02:14 24/04/2024 20:42:53 Rp 600,000.00
2024/04/23/000508 005170 SUKMAWATI ISO3 P ISOLASI A ULKUS PEDIS ULKUS PEDIS 23/04/2024 13:46:14 24/04/2024 12:23:19 Rp 400,000.00
DEKSTRA + DM DEKSTRA + DM
2024/04/02/000450 120288 NIMAN ISO10 L ISOLASI B ABSES SKROTUM ABSES 02/04/2024 13:01:45 04/04/2024 11:17:11 Rp 600,000.00
2024/04/05/000383 116373 SITI CHAERANI ISO10 L ISOLASI B VOMITUS VOMITUS 05/04/2024 15:43:22 05/04/2024 22:10:48 Rp 200,000.00
2024/04/10/000177 121849 MOHAMAD ISO10 L ISOLASI B DYSPNEU DYSPNEU 09/04/2024 23:33:47 11/04/2024 16:57:14 Rp 600,000.00
2024/04/28/000080 122641 ASIH ISO2 L ISOLASI B VERTIGO VERTIGO 28/04/2024 23:13:42 29/04/2024 15:15:35 Rp 400,000.00
2024/04/02/000500 110896 DELLI ISO11 ISOLASI C COLIC ABDOMEN COLIC ABDOMEN 02/04/2024 23:01:36 06/04/2024 17:00:25 Rp 1,000,000.00
2024/04/11/000308 089744 SOLEHA ISO11 ISOLASI C PNEUMONIA DD TB PNEUMONIA DD 11/04/2024 23:18:46 13/04/2024 10:37:59 Rp 600,000.00
PARU TB PARU
2024/04/14/000004 121961 HARTONO ISO11 ISOLASI C Vertigo perifer CAP Vertigo perifer 14/04/2024 02:44:07 15/04/2024 14:49:58 Rp 400,000.00
dd TB CAP dd TB
2024/04/20/000063 121981 DEDDY SAPUTRA ISO11 ISOLASI C ANEMIA, SUSP TB ANEMIA, SUSP 20/04/2024 02:46:49 23/04/2024 12:16:02 Rp 800,000.00
2024/04/21/000081 104295 TIURLINA SIMARE ISO11 ISOLASI C SUSP TB SUSP TB 21/04/2024 23:18:50 26/04/2024 13:11:02 Rp 1,200,000.00
2024/04/26/000529 121714 MOHAMAD ALWI ISO11 ISOLASI C VERTIGO + TB VERTIGO + TB 26/04/2024 22:53:42 02/05/2024 18:55:24 Rp 1,400,000.00
2024/04/04/000594 121534 SARMIN ISO7 ISOLASI D efusion pleural EFUSION 04/04/2024 19:57:10 06/04/2024 17:45:26 Rp 600,000.00
2024/04/15/000474 122024 NURJANAH ISO7 ISOLASI D PENURUNAN PENURUNAN 15/04/2024 23:55:22 16/04/2024 02:24:56 Rp 400,000.00
KESADARAN KESADARAN
2024/04/16/000354 058327 SUYONO ISO7 ISOLASI D SUSP TB PARU SUSP TB PARU 16/04/2024 00:26:06 17/04/2024 20:01:22 Rp 400,000.00
2024/04/24/000126 122444 TUNGGUL RAHMAT ISO7 ISOLASI D TB PARU TB PARU 24/04/2024 02:47:56 27/04/2024 16:47:14 Rp 800,000.00
KUNCORO
2024/04/27/000661 122621 NAYLA SAFIRA ISO7 ISOLASI D obs dyspneu ec TB obs dyspneu ec 27/04/2024 23:21:01 28/04/2024 22:12:24 Rp 400,000.00
paru TB paru
2024/04/13/000128 022154 DARA AYUDIA ISO5 ISOLASI E DENGUE FEVER DENGUE FEVER 13/04/2024 23:42:49 16/04/2024 11:42:46 Rp 800,000.00
WITH WARNING WITH WARNING
SIGN B20 ON ARV SIGN B20 ON
2024/04/16/000507 063828 BAIDOWI ISO5 ISOLASI E ANEMIA + SUSP TB ANEMIA + SUSP 16/04/2024 20:11:58 21/04/2024 21:10:52 Rp 1,200,000.00
+ B20 TB + B20
2024/04/25/000252 045688 SLAMET RIYADI ISO5 ISOLASI E SUSP TB PARU SUSP TB PARU 25/04/2024 15:47:48 28/04/2024 21:15:43 Rp 800,000.00
2024/04/28/000075 028182 SUGIRI ISO5 ISOLASI E TB PARU TB PARU 28/04/2024 21:31:49 30/04/2024 15:58:48 Rp 600,000.00

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NO.RAWAT NO.R.M. NAMA PASIEN NO.KAMAR NAMA KAMAR DIAGNOSA AWAL DIAGN.AKHIR TGL.MASUK TGL.KELUAR BIAYA KAMAR
2024/04/02/000367 096483 ANDISKA FEBRIANA ISO6 ISOLASI F DHF GRADE I + B20 DHF GRADE I + 02/04/2024 00:56:11 06/04/2024 13:06:21 Rp 1,000,000.00
IMUNOKOMPROMA B20
IS
2024/04/08/000297 092490 JAENUDIN ISO6 ISOLASI F ASPERGILOSIS ASPERGILOSIS 08/04/2024 22:12:49 12/04/2024 20:06:04 Rp 1,000,000.00
IMUNOKOMPROMA PARU
IS
2024/04/14/000025 121965 OKI GUNAWAN ISO6 ISOLASI F REAKSI ALERGI REAKSI ALERGI 14/04/2024 16:43:25 15/04/2024 16:36:48 Rp 400,000.00
IMUNOKOMPROMA SYNDROM STEVEN SYNDROM
IS JOHNSON STEVEN
2024/04/20/000067 114531 RAVANIA HANUM ISO6 ISOLASI F KDS, SUSP HFMD KDS, SUSP 20/04/2024 04:59:42 22/04/2024 13:08:09 Rp 600,000.00
HUSAIN IMUNOKOMPROMA
IS
2024/04/22/000363 122355 KEENARA AYESHA ISO6 ISOLASI F COMBUSTIO GRADE COMBUSTIO 22/04/2024 17:55:42 23/04/2024 12:11:46 Rp 400,000.00
AULIA IMUNOKOMPROMA II GRADE II
IS
2024/04/25/000225 122498 IBNU AL FATIH ISO6 ISOLASI F VOMITUS, VOMITUS, 25/04/2024 11:54:12 27/04/2024 14:14:51 Rp 600,000.00
RAMADHAN IMUNOKOMPROMA BACTERIAL BACTERIAL
IS INFECTION
2024/04/01/000304 121547 DAVID RAKA LL010 LILLY A THYPOID FEVER THYPOID FEVER 01/04/2024 13:27:13 04/04/2024 12:43:02 Rp 400,000.00
2024/04/01/000349 121561 MUHAMMAD LL008 LILLY A DHF DHF 01/04/2024 20:05:21 03/04/2024 13:46:14 Rp 300,000.00
FARZHA SITOPU
2024/04/02/000475 121538 MUHAMMAD DAVIN LL003 LILLY A DHF GR I DHF 02/04/2024 18:04:45 05/04/2024 19:48:32 Rp 400,000.00
2024/04/03/000654 121606 ALYA DEMIAR LL008 LILLY A ANEMIA, SEPSIS ANEMIA, SEPSIS 03/04/2024 15:20:19 04/04/2024 12:33:24 Rp 200,000.00
AZZAHRA
2024/04/04/000518 121662 AISHA ADEEVA LL008 LILLY A DHF DHF 04/04/2024 11:01:21 05/04/2024 13:31:51 Rp 200,000.00
ZAHRANI
2024/04/04/000544 121672 ANDIKA NOVA LL010 LILLY A DHF GRADE I DHF GRADE I 04/04/2024 12:57:21 07/04/2024 10:05:50 Rp 400,000.00
2024/04/05/000391 069181 AYLA ZALFA AZ LL008 LILLY A DEMAM DENGUE DEMAM DENGUE 05/04/2024 04:49:24 07/04/2024 14:17:45 Rp 300,000.00
2024/04/05/000349 004124 FADLI MUAZZAM LL003 LILLY A DHF GR I DHF GR I 05/04/2024 11:20:10 06/04/2024 13:29:46 Rp 200,000.00
2024/04/06/000536 121762 AHMAD GIBRAN LL010 LILLY A SUSP TB SUSP TB 06/04/2024 15:58:30 08/04/2024 18:36:26 Rp 300,000.00
KAUTSAR
2024/04/07/000038 121788 AQIO AL GAFI LL003 LILLY A DEMAM THYPOID DEMAM THYPOID 07/04/2024 14:22:01 09/04/2024 13:02:25 Rp 300,000.00
2024/04/07/000075 121772 MOH. ALFIANSYAH LL008 LILLY A DHF dhf 07/04/2024 22:33:07 09/04/2024 13:05:24 Rp 300,000.00
PUTRA
2024/04/08/000302 121825 MUHAMMAD FAHRI LL010 LILLY A KDS KDS 08/04/2024 23:37:50 09/04/2024 13:25:23 Rp 200,000.00
RAMADHAN
2024/04/09/000165 121770 MUHAMMAD DZAKIR LL008 LILLY A DHF GRADE I DHF GRADE I 09/04/2024 21:15:01 12/04/2024 08:20:13 Rp 400,000.00
KHAFADI
2024/04/10/000198 121856 ALIKA NUR LL008 LILLY A DEMAM DENGUE DEMAM DENGUE 10/04/2024 12:32:45 13/04/2024 13:00:54 Rp 400,000.00
2024/04/10/000176 103059 RAFFASYA QIYAS LL003 LILLY A GEA DRS GEA DRS 10/04/2024 12:50:54 13/04/2024 09:56:07 Rp 400,000.00
IRAWAN
2024/04/11/000249 032981 RAYA RIZKIA PUTRI LL010 LILLY A DEMAM DENGUE DEMAM DENGUE 11/04/2024 10:00:56 15/04/2024 14:40:41 Rp 500,000.00
2024/04/14/000033 121968 AISYAH NUR ZAHIRA LL008 LILLY A DEMAM DENGUE DEMAM DENGUE 14/04/2024 17:04:13 17/04/2024 12:28:21 Rp 400,000.00
2024/04/14/000061 121979 ALUIS ALDAFFA LL003 LILLY A febris H-4 ec dengue DENGUE FEVER 14/04/2024 22:56:15 17/04/2024 12:25:47 Rp 400,000.00
BERLIAN fever low intake
leukopenia
2024/04/15/000417 121992 ALESHA BUNGA LL010 LILLY A DHF GRADE II DHF GRADE II 15/04/2024 13:16:24 18/04/2024 12:39:46 Rp 400,000.00
DENITA
2024/04/17/000299 072321 AQILA MAULIDYAH LL003 LILLY A ASMA ASMA 17/04/2024 14:03:08 19/04/2024 19:11:45 Rp 300,000.00
BALQIS EKSASERBASI EKSASERBASI
AKUT,
7/19/24, 8:39 PM Page 7 of 17
NO.RAWAT NO.R.M. NAMA PASIEN NO.KAMAR NAMA KAMAR DIAGNOSA AWAL DIAGN.AKHIR TGL.MASUK TGL.KELUAR BIAYA KAMAR
2024/04/17/000322 116262 AHMAD FARZANA LL008 LILLY A ANEMIA ANEMIA 17/04/2024 17:02:42 19/04/2024 14:07:33 Rp 300,000.00
2024/04/17/000329 025827 MUHAMMAD ZAKY LL003 LILLY A DHF GRADE I DHF 17/04/2024 18:52:21 20/04/2024 13:16:49 Rp 400,000.00
ARDANI
2024/04/18/000230 122166 KALILA ARIFDA LL010 LILLY A DHF GRADE II DHF 18/04/2024 16:08:18 21/04/2024 15:12:23 Rp 400,000.00
2024/04/19/000364 100541 MUHAMMAD FADHIL LL008 LILLY A DHF GRADE I DHF GRADE I 19/04/2024 19:52:30 21/04/2024 15:53:53 Rp 300,000.00
2024/04/19/000448 122233 THARIQ ABBAS LL003 LILLY A DENGUE FEVER DENGUE FEVER 19/04/2024 23:15:40 25/04/2024 12:14:11 Rp 700,000.00
ROUDHON
2024/04/20/000166 003641 NUR ANDREA PUTRI LL010 LILLY A THYPOID FEVER THYPOID FEVER 20/04/2024 16:39:45 23/04/2024 13:22:07 Rp 400,000.00
2024/04/21/000036 122278 AHMAD OMAR LL008 LILLY A DHF DHF 21/04/2024 12:40:05 23/04/2024 13:32:40 Rp 300,000.00
HAWARI
2024/04/21/000072 101586 RAFA OMAIR LL010 LILLY A GEA DRS GEA DRS 21/04/2024 21:16:28 24/04/2024 14:25:43 Rp 400,000.00
ZAAHIRULHAQ H
2024/04/23/000519 122422 DIKI CAHYO LL008 LILLY A DHF DHF 23/04/2024 16:55:51 25/04/2024 13:35:50 Rp 300,000.00
2024/04/23/000539 122428 ROBBY MAULANA LL008 LILLY A DEMAM DENGUE DEMAM DENGUE 23/04/2024 19:35:10 26/04/2024 10:32:59 Rp 400,000.00
AHMAD
2024/04/24/000245 121875 KAYLA SAHANI LL010 LILLY A DENGU FEVER DENGU FEVER 24/04/2024 10:21:20 26/04/2024 14:29:11 Rp 300,000.00
2024/04/24/000327 058554 REHANA NUR LL003 LILLY A VOMITUS PROFUS VOMITUS 24/04/2024 22:55:05 28/04/2024 12:56:07 Rp 500,000.00
FADILLAH
2024/04/25/000202 029745 BRILIAN KUSUMO LL010 LILLY A DENGUE FEVER DENGUE FEVER 25/04/2024 09:54:37 27/04/2024 14:10:35 Rp 300,000.00
AGUNG
2024/04/26/000523 122588 ASKIATUL NUR LL008 LILLY A DHF DHF 26/04/2024 21:46:15 29/04/2024 14:01:48 Rp 400,000.00
AMELIA
2024/04/26/000533 122594 RINI ASTI AZIRA LL003 LILLY A DHF DHF 26/04/2024 23:22:20 29/04/2024 14:14:28 Rp 400,000.00
2024/04/27/000644 122545 MUHAMMAD ZAKY LL003 LILLY A DENGU FEVER DENGU FEVER 27/04/2024 13:14:39 30/04/2024 12:09:23 Rp 400,000.00
HASANI
2024/04/27/000639 122537 IBRAHIM NIDZAR LL010 LILLY A DENGU FEVER DENGUE FEVER 27/04/2024 17:58:21 30/04/2024 12:56:48 Rp 400,000.00
2024/04/28/000008 122626 FAJRIN RIZKY LL003 LILLY A VOMITUS DRS VOMITUS DRS 28/04/2024 08:43:57 30/04/2024 11:55:17 Rp 300,000.00
2024/04/29/000639 122651 YASNA NUR LL008 LILLY A VOMITUS VOMITUS 29/04/2024 15:13:45 01/05/2024 13:57:21 Rp 300,000.00
RAMADHANI
2024/04/29/000641 004285 FARZANA HAMIZAN LL010 LILLY A DHF GRADE I DHF GRADE I 29/04/2024 15:14:18 01/05/2024 14:29:41 Rp 300,000.00
2024/04/29/000684 065878 QURRATUL NURAINI LL003 LILLY A DENGU FEVER DENGU FEVER 29/04/2024 23:55:41 02/05/2024 14:35:16 Rp 400,000.00
2024/04/30/000278 074761 ATHALLA NAUFAL LL008 LILLY A KDS KDS 30/04/2024 18:10:27 02/05/2024 14:39:17 Rp 300,000.00
RAMADHAN
2024/04/02/000378 009742 AFIQAH SHABIRAH LL006 LILLY B DHF GRADE I DHF GRADE I 02/04/2024 07:05:45 04/04/2024 12:27:57 Rp 300,000.00
2024/04/02/000428 008234 MUHAMMAD LL005 LILLY B THYPOID FEVER THYPOID FEVER 02/04/2024 09:05:30 04/04/2024 12:25:42 Rp 300,000.00
MUSHLIH AZZAM
2024/04/03/000657 070239 MUHAMMAD DHAFI LL005 LILLY B FEBRIS, BACTERIAL FEBRIS, 03/04/2024 16:14:21 05/04/2024 15:54:16 Rp 300,000.00
FAHREZI INFECTION BACTERIAL
INFECTION
2024/04/03/000675 121603 DELA AMALIA LL006 LILLY B DHF DHF 03/04/2024 19:51:55 06/04/2024 11:21:20 Rp 400,000.00
2024/04/05/000350 121709 MUHAMMAD AHZAM LL006 LILLY B DHF GR II DHF GR II 05/04/2024 14:06:48 07/04/2024 08:04:37 Rp 300,000.00
2024/04/05/000439 121744 SABILI AL MAQDIS LL005 LILLY B DHF DHF 06/04/2024 00:19:35 09/04/2024 13:06:32 Rp 400,000.00
2024/04/07/000025 121783 ALZAN ZEA SADIYA LL006 LILLY B GEA DRS GEA DRS 07/04/2024 11:56:20 08/04/2024 09:20:36 Rp 200,000.00
2024/04/08/000172 100425 MUHAMMAD SAFIQ LL006 LILLY B DEMAM DENGUE DEMAM DENGUE 08/04/2024 08:08:42 10/04/2024 20:45:58 Rp 400,000.00
ADAM RAMA
2024/04/11/000297 121851 NAIRA AZKA LL006 LILLY B DENGUE FEVER DENGUE FEVER 11/04/2024 20:20:59 15/04/2024 14:34:52 Rp 500,000.00
SALSABILA
2024/04/13/000071 121940 MUHAMMAD AKBAR LL006 LILLY B DEMAM DENGUE SEVERE 13/04/2024 10:07:49 16/04/2024 13:41:41 Rp 400,000.00
KHADAFI DENGAN WARNING DENGUE DG

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NO.RAWAT NO.R.M. NAMA PASIEN NO.KAMAR NAMA KAMAR DIAGNOSA AWAL DIAGN.AKHIR TGL.MASUK TGL.KELUAR BIAYA KAMAR
SIGN TERKOMPENSAS
2024/04/13/000073 121885 NAURAH SHAFWAH LL005 LILLY B DENGUE FEVER DENGUE FEVER 13/04/2024 11:03:22 15/04/2024 14:38:17 Rp 300,000.00
ILHAM
2024/04/16/000483 054510 MUHAMMAD LATIF LL005 LILLY B DHF DHF 16/04/2024 15:26:57 17/04/2024 12:12:02 Rp 200,000.00
2024/04/16/000506 034927 AILIN NATANIA LL006 LILLY B COLIC ABDOMEN COLIC ABDOMEN 16/04/2024 15:27:32 18/04/2024 12:27:02 Rp 300,000.00
WINATA
2024/04/17/000131 122072 FAIZAN LOKATARA LL005 LILLY B DENGUE FEVER DENGUE FEVER 17/04/2024 06:42:20 20/04/2024 13:04:48 Rp 400,000.00
2024/04/18/000224 122164 FITRI RAMADHANI LL006 LILLY B DHF GRADE I DHF 18/04/2024 14:53:43 21/04/2024 19:59:59 Rp 400,000.00
2024/04/20/000068 054510 MUHAMMAD LATIF LL005 LILLY B DHF DHF 20/04/2024 05:58:45 23/04/2024 13:18:44 Rp 400,000.00
2024/04/21/000063 090412 MUHAMMAD LL006 LILLY B GEA DRS Intake sulit GEA DRS Intake 21/04/2024 18:49:49 23/04/2024 14:31:52 Rp 300,000.00
RAFFASYAH sulit
2024/04/22/000344 122339 RANGGA RADITYA LL006 LILLY B DHF + ISPA DHF + ISPA 22/04/2024 15:56:15 26/04/2024 11:19:21 Rp 500,000.00
SETIAWAN
2024/04/23/000401 071839 FARDHAN HADI LL005 LILLY B DEMAM DENGUE DEMAM DENGUE 23/04/2024 02:30:05 24/04/2024 17:37:43 Rp 200,000.00
GHAZALI W/WARNING W/WARNING
2024/04/23/000500 061147 RAISA RAMADHANI LL005 LILLY B ASMA asma 23/04/2024 12:55:44 25/04/2024 20:08:50 Rp 300,000.00
2024/04/25/000247 070434 MIRZA MAKAILA LL005 LILLY B DEMAM DENGUE DEMAM DENGUE 25/04/2024 14:54:47 29/04/2024 14:13:09 Rp 500,000.00
UKAIL
2024/04/26/000531 122589 RIDHO ARYA LL006 LILLY B DENGUE FEVER DENGUE FEVER 26/04/2024 13:23:31 01/05/2024 14:00:28 Rp 600,000.00
WIBOWO
2024/04/29/000645 036291 RHEYVITA LL005 LILLY B TUMOR TELINGA TUMOR TELINGA 29/04/2024 16:15:06 30/04/2024 17:12:33 Rp 200,000.00
RASSYDATU NAZWA KIRI
2024/04/30/000131 046495 ERDOGAN ZAYID LL005 LILLY B FEBRIS FEBRIS 30/04/2024 00:23:10 02/05/2024 14:32:12 Rp 300,000.00
MARHARIS
2024/04/30/000301 122742 NADHIFA TALITA LL006 LILLY B DENGU FEVER DENGU FEVER 30/04/2024 22:01:21 02/05/2024 14:20:08 Rp 300,000.00
ZAHIDA
2024/04/01/000321 121526 NIZAM ASMARI LL011 LILLY C HIPERPEREKSIA HIPERPEREKSIA 01/04/2024 15:29:07 03/04/2024 13:28:30 Rp 300,000.00
2024/04/02/000476 118109 MUHAMAD SYAKIR LL004 LILLY C PROLONGED PROLONGED 02/04/2024 18:04:39 04/04/2024 14:23:32 Rp 300,000.00
ALAMSYAH FEVER
2024/04/03/000123 121573 AHMAD NAJIB LL007 LILLY C GEA GEA 03/04/2024 02:05:09 05/04/2024 13:39:59 Rp 300,000.00
2024/04/03/000639 040883 RAFQIANA ADNAN LL011 LILLY C DHF GR I DHF GR I 03/04/2024 14:08:56 07/04/2024 10:54:40 Rp 500,000.00
IBRAHIM
2024/04/03/000640 121637 AINAYYA SLAVINA LL009 LILLY C DHF GRADE II DHF GRADE II 03/04/2024 14:19:51 05/04/2024 13:37:04 Rp 300,000.00
2024/04/04/000604 121687 NIMAH WAFIRA LL004 LILLY C susp choking obs susp choking obs 04/04/2024 20:31:51 06/04/2024 13:50:41 Rp 300,000.00
febris H1 febris H1
2024/04/04/000619 103357 DRASTHA KIRANA LL004 LILLY C GEA TB ON OAT TB ON OAT 04/04/2024 23:18:47 08/04/2024 13:49:51 Rp 500,000.00
PENGOBATAN
BULAN KE-4
2024/04/05/000290 093577 M ELZIO GHIFARI / LL007 LILLY C KDS KDS 05/04/2024 08:18:05 08/04/2024 12:04:51 Rp 400,000.00
BY NY WARSIANI S
2024/04/05/000301 106833 MUHAMMAD RAZZEL LL009 LILLY C BRONCHOPNEUMO BRONCHOPNEU 05/04/2024 08:41:59 08/04/2024 14:27:44 Rp 400,000.00
ALFATIH NIA MONIA
2024/04/06/000530 121761 MUHAMMAD SHAKI LL004 LILLY C DENGUE DENGUE 06/04/2024 13:33:46 07/04/2024 10:26:08 Rp 200,000.00
ZAIDAN YULIYANTO HAEMORRAGIC HAEMORRAGIC
FEVER
2024/04/06/000560 121771 NURAINI PUTRI LL011 LILLY C GEA DRS GEA 06/04/2024 22:19:47 08/04/2024 17:26:35 Rp 300,000.00
FIRMANSYAH
2024/04/08/000246 023300 MUHAMMAD NICKY LL007 LILLY C SOFT TISSUE SOFT TISSUE 08/04/2024 14:16:53 09/04/2024 16:37:45 Rp 200,000.00
PRATAMA TUMOR
2024/04/08/000250 110983 AHMAD SYAFII LL009 LILLY C KDS kds 08/04/2024 14:55:20 09/04/2024 13:15:33 Rp 200,000.00

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NO.RAWAT NO.R.M. NAMA PASIEN NO.KAMAR NAMA KAMAR DIAGNOSA AWAL DIAGN.AKHIR TGL.MASUK TGL.KELUAR BIAYA KAMAR
2024/04/08/000257 054155 KHAIRA AZZAHRA LL004 LILLY C DHF GRADE II DHF GRADE II 08/04/2024 15:23:53 11/04/2024 11:47:36 Rp 400,000.00
2024/04/09/000142 096977 BUNAYYA ALYSSA LL011 LILLY C FEBRIS EC FEBRIS EC 09/04/2024 13:00:05 10/04/2024 07:47:20 Rp 200,000.00
AZZAHRA TYPHOID
2024/04/12/000389 107310 ARSYILA NAIFA LL004 LILLY C BRONCHOPNEUMO BRONCHOPNEU 12/04/2024 06:32:37 14/04/2024 16:58:26 Rp 300,000.00
IFANDY NIA + GEA MONIA + GEA
2024/04/15/000281 118561 ABIDZAR LL004 LILLY C BRONCHOPNEUMO BRONCHOPNEU 15/04/2024 05:48:52 16/04/2024 13:32:22 Rp 200,000.00
HARBIANSYAH NIA MONIA
2024/04/15/000430 113286 ERZAN ALKHALIFI LL009 LILLY C BP BP 15/04/2024 15:26:04 17/04/2024 12:50:26 Rp 300,000.00
MAULANA
2024/04/16/000480 103204 SINTA WIDIYA LL011 LILLY C DHF DHF 16/04/2024 14:26:06 17/04/2024 12:45:27 Rp 200,000.00
LESTARI
2024/04/16/000511 080182 MUHAMMAD EZRA LL004 LILLY C KEJANG DEMAM KEJANG DEMAM 16/04/2024 21:28:09 18/04/2024 11:25:32 Rp 300,000.00
SAPUTRA KOMPLEK KOMPLEK
2024/04/16/000518 122068 ISTINUR HABIBAH LL007 LILLY C KEJANG DEMAM KEJANG DEMAM 16/04/2024 23:17:50 19/04/2024 15:00:33 Rp 400,000.00
SEDERHANA SEDERHANA
2024/04/17/000159 122073 NAVIA AUREIYA LL009 LILLY C VOMITUS DRS VOMITUS DRS 17/04/2024 06:40:15 18/04/2024 12:03:03 Rp 200,000.00
JUANSAH
2024/04/17/000314 093241 ALFARIZQI UWAIS LL011 LILLY C HIPERPIREKSIA, BP, HIPERPIREKSIA, 17/04/2024 16:02:59 19/04/2024 14:58:22 Rp 300,000.00
RAMADHAN BI BP, BI
2024/04/18/000180 122137 IBRAHIM AL KHALIF LL009 LILLY C KDS KDS 18/04/2024 10:27:58 20/04/2024 14:42:48 Rp 300,000.00
2024/04/19/000159 101291 RAINA ADZKIYA LL007 LILLY C KDS + ISPA KDS + ISPA 19/04/2024 06:53:22 20/04/2024 13:22:49 Rp 200,000.00
FADELA /BY NY
NURMALAWATI
2024/04/19/000392 035569 KENZIE BYAKTA LL009 LILLY C DHF GRADE II DHF GRADE II 19/04/2024 15:52:08 22/04/2024 20:00:34 Rp 400,000.00
SWASONO
2024/04/19/000393 103823 MUHAMMAD ARHAM LL004 LILLY C KDS KDS 19/04/2024 15:53:09 21/04/2024 20:48:50 Rp 300,000.00
MAFAZA LATHIF
2024/04/19/000423 116057 MUHAMMAD ALWI LL004 LILLY C DEMAM DENGUE DEMAM DENGUE 19/04/2024 17:30:10 21/04/2024 22:54:47 Rp 300,000.00
TABRANI-BY NY
FITRIYANI
2024/04/19/000450 122235 RIZQIA MAULIDY LL007 LILLY C BI, ISPA ISPA 19/04/2024 23:17:15 22/04/2024 15:15:14 Rp 400,000.00
2024/04/20/000190 122254 ARSHAKA LL011 LILLY C BP BRONKOPNEUM 20/04/2024 21:10:24 23/04/2024 14:02:39 Rp 400,000.00
NARENDRA ONIA
2024/04/20/000193 122256 MUHAMMAD LL009 LILLY C BACTERIAL BACTERIAL 20/04/2024 21:37:12 22/04/2024 20:12:10 Rp 300,000.00
SYADZILI ARFAI INFECTION INFECTION
2024/04/21/000059 100592 M HABIBIE AL LL004 LILLY C obs febris h4 ec obs febris h4 ec 21/04/2024 18:04:28 23/04/2024 15:03:03 Rp 300,000.00
BAHWADI demam dengue intake demam dengue
sulit intake sulit
2024/04/21/000069 122291 SALWAH HANIFAH LL007 LILLY C DHF Grade 1 DHF GRADE I 21/04/2024 19:54:47 23/04/2024 13:32:44 Rp 300,000.00
2024/04/22/000393 102841 MANJILAH NAURA LL009 LILLY C GEA DRS GEA DRS 23/04/2024 00:36:08 24/04/2024 11:14:29 Rp 200,000.00
CAHAYA
2024/04/24/000127 115440 TYANAJJA SAKYA LL004 LILLY C BI, VOMITUS BI, VOMITUS 24/04/2024 02:41:18 26/04/2024 19:20:07 Rp 300,000.00
UWAIS
2024/04/24/000273 072070 TIANISYA CLEMIRA LL009 LILLY C VOMITUS, GEA VOMITUS, GEA 24/04/2024 12:24:11 26/04/2024 11:19:05 Rp 300,000.00
SAKHI
2024/04/25/000228 122499 MUHAMMAD LL007 LILLY C VOMITUS + GEA VOMITUS + GEA 25/04/2024 11:51:50 27/04/2024 13:49:42 Rp 300,000.00
SASKARA JINAN DRS
2024/04/26/000532 122584 FATIHA EL SAKEENA LL004 LILLY C ASMA ASMA 26/04/2024 23:18:34 29/04/2024 13:54:49 Rp 400,000.00
POETRY
2024/04/27/000538 122599 MUHAMMAD EL LL011 LILLY C GEA DRS GEA DRS 27/04/2024 02:35:18 28/04/2024 14:25:44 Rp 200,000.00

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NO.RAWAT NO.R.M. NAMA PASIEN NO.KAMAR NAMA KAMAR DIAGNOSA AWAL DIAGN.AKHIR TGL.MASUK TGL.KELUAR BIAYA KAMAR
2024/04/27/000645 118806 MUHAMMAD RAFKA LL007 LILLY C GEA gea 27/04/2024 18:10:40 29/04/2024 16:03:51 Rp 300,000.00
ARRAFI
2024/04/27/000658 119724 MUHAMMAD HABIBI LL009 LILLY C DIARE AKUT DIARE AKUT 27/04/2024 22:29:20 29/04/2024 18:21:37 Rp 300,000.00
IBRAHIM
2024/04/28/000001 107900 MUHAMMAD FAHRI LL011 LILLY C KDK KDK 28/04/2024 00:30:00 30/04/2024 14:08:44 Rp 300,000.00
ALFARIZY
2024/04/28/000010 101150 MAURA AZURAH LL009 LILLY C KDS , GEA KDS , GEA 28/04/2024 07:30:23 01/05/2024 14:01:02 Rp 400,000.00
PUTRI ALFARIDTIA
2024/04/29/000642 122659 ARKAN GIO LL007 LILLY C VIRAL INFECTION VIRAL 29/04/2024 16:15:47 02/05/2024 14:28:51 Rp 400,000.00
RAMADHAN
2024/04/29/000668 108927 GHAISAN RAFFA LL004 LILLY C HIPEREKSIA HIPEREKSIA 29/04/2024 20:36:24 01/05/2024 14:21:40 Rp 300,000.00
NOERDIANSYAH
2024/04/30/000264 122730 ALVARO TSAQIF LL011 LILLY C DHF GRADE I DHF 30/04/2024 14:43:25 03/05/2024 16:14:02 Rp 400,000.00
ARRAUF
2024/04/02/000406 121565 BY NY PUTRI M008 MELATI BAYI A NCB SMK NCB SMK 02/04/2024 12:51:58 03/04/2024 15:38:04 Rp 200,000.00
HARDIYANTI
2024/04/02/000407 121566 BY NY RAHMAWATI M015 MELATI BAYI A NCB SMK NCB SMK 02/04/2024 12:52:17 03/04/2024 15:30:06 Rp 200,000.00
2024/04/04/000498 121649 BY NY MUZAENAH M003 MELATI BAYI A NCB SMK NCB SMK 04/04/2024 14:05:45 05/04/2024 20:03:17 Rp 200,000.00
2024/04/04/000500 121650 BY NY INTAN M008 MELATI BAYI A NCB SMK NCB SMK 04/04/2024 14:06:10 05/04/2024 19:59:30 Rp 200,000.00
PAJRIANI
2024/04/05/000308 121701 BY NY NUR ARINI M015 MELATI BAYI A NCB SMK NCB SMK 05/04/2024 12:50:06 06/04/2024 16:58:50 Rp 200,000.00
2024/04/05/000307 121700 SHAYLA ATHALIA M020 MELATI BAYI A NCB SMK ncb smk 05/04/2024 12:50:15 06/04/2024 14:06:49 Rp 200,000.00
NAEMI
2024/04/05/000306 121695 BY NY ALFIANI M022 MELATI BAYI A NCB SMK NCB SMK 05/04/2024 12:50:45 06/04/2024 16:59:32 Rp 200,000.00
ROSYIDAH SAFITRI
2024/04/05/000434 121745 ALMIRA ALYA M008 MELATI BAYI A NCB SMK NCB SMK 05/04/2024 22:25:57 07/04/2024 12:17:32 Rp 300,000.00
RAMADHANI-BY NY
FITRIA
2024/04/06/000504 121758 BY NY SITI SYARAH M003 MELATI BAYI A NCB SMK NCB SMK 06/04/2024 19:20:01 07/04/2024 20:17:53 Rp 200,000.00
2024/04/09/000153 121823 BY NY LILIS NOGO M003 MELATI BAYI A NCB SMK NCB SMK 09/04/2024 20:14:22 10/04/2024 16:44:13 Rp 200,000.00
KUNG
2024/04/12/000381 121914 BY NY MAE JUNITA M003 MELATI BAYI A NCB SMK NCB SMK 12/04/2024 10:44:17 13/04/2024 15:45:19 Rp 200,000.00
2024/04/12/000394 121916 CHELSEA APRILIA M003 MELATI BAYI A NCB SMK NCB SMK 12/04/2024 12:58:35 13/04/2024 15:12:00 Rp 200,000.00
MANURUNG
2024/04/13/000099 121950 HANNANIA ZIVANA M003 MELATI BAYI A NCB SMK NCB SMK 13/04/2024 17:08:40 14/04/2024 18:38:26 Rp 300,000.00
SYAWALI
2024/04/15/000308 121983 ELISA FEODORA (BY M003 MELATI BAYI A NCB SMK NCB SMK 15/04/2024 06:06:36 16/04/2024 13:05:38 Rp 200,000.00
NY RIKA HEWILDA)
2024/04/16/000355 122029 BY NY HANINAH M008 MELATI BAYI A NCB SMK NCB SMK 16/04/2024 00:30:27 17/04/2024 11:45:10 Rp 200,000.00
PRATIWI APRILIA
2024/04/17/000249 122104 SKY KANAKA M003 MELATI BAYI A NCB SMK NCB SMK 17/04/2024 10:04:49 18/04/2024 15:24:03 Rp 200,000.00
ARFARENDRA (BY
NY EVIVA
2024/04/17/000188 122069 ABQARY MIHRAN AL M008 MELATI BAYI A NCB SMK NCB SMK 17/04/2024 13:20:44 18/04/2024 14:05:05 Rp 200,000.00
FATIH / BY NY ANGGI
2024/04/17/000186 122070 NADHIF M SYAWAL / M015 MELATI BAYI A NCB SMK NCB SMK 17/04/2024 13:21:00 18/04/2024 19:49:29 Rp 200,000.00
BY NY ATIKAWATI
2024/04/17/000297 122117 BY NY DITI MEIDIFA M020 MELATI BAYI A NCB SMK NCB SMK 17/04/2024 16:22:26 18/04/2024 16:14:13 Rp 200,000.00
2024/04/18/000190 122131 BY NY RIZKIA AULIA M003 MELATI BAYI A NCB SMK NCB SMK 18/04/2024 15:47:39 19/04/2024 13:37:01 Rp 200,000.00
2024/04/19/000367 122189 BY NY TURINAH M003 MELATI BAYI A NCB SMK NCB SMK 19/04/2024 14:07:29 20/04/2024 15:41:52 Rp 200,000.00

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NO.RAWAT NO.R.M. NAMA PASIEN NO.KAMAR NAMA KAMAR DIAGNOSA AWAL DIAGN.AKHIR TGL.MASUK TGL.KELUAR BIAYA KAMAR
2024/04/19/000410 122228 BY NY INTAN FAJAR M008 MELATI BAYI A NCB SMK NCB SMK 19/04/2024 17:19:19 21/04/2024 12:55:01 Rp 300,000.00
KURNIYATI
2024/04/20/000194 122265 BY NY KUSTANTI M015 MELATI BAYI A NCB SMK NCB SMK 20/04/2024 21:43:02 22/04/2024 13:40:19 Rp 300,000.00
ROJANAH
2024/04/22/000225 122305 RADEVA ZAIN M003 MELATI BAYI A NCB SMK NCB SMK 22/04/2024 13:31:14 23/04/2024 14:07:09 Rp 200,000.00
2024/04/22/000224 122309 BY NY LENY SETIA M008 MELATI BAYI A NCB SMK NCB SMK 22/04/2024 13:31:26 23/04/2024 17:27:14 Rp 200,000.00
NINGSIH
2024/04/22/000318 122308 BY NY PUSPITA M015 MELATI BAYI A NCB SMK NCB SMK 22/04/2024 15:58:33 23/04/2024 15:06:09 Rp 200,000.00
ANGGRAINI
2024/04/22/000229 122322 BY NY FATIAH M020 MELATI BAYI A NCB SMK NCB SMK 22/04/2024 19:39:42 23/04/2024 17:16:36 Rp 200,000.00
2024/04/23/000412 122390 BY NY CLAUDIA M022 MELATI BAYI A NCB SMK NCB SMK 23/04/2024 04:11:04 24/04/2024 10:41:15 Rp 200,000.00
LAILLA
2024/04/23/000450 122379 LORAH APRILLIA M003 MELATI BAYI A NCB SMK NCB SMK 23/04/2024 20:20:26 24/04/2024 14:46:29 Rp 200,000.00
2024/04/24/000197 122434 RADJA ABHISEKA D M003 MELATI BAYI A NCB SMK NCB SMK 24/04/2024 19:00:07 25/04/2024 14:07:14 Rp 200,000.00
ARM
2024/04/25/000186 122483 BY NY SUKARSIH M008 MELATI BAYI A NCB SMK ncb smk 25/04/2024 13:35:16 26/04/2024 15:30:47 Rp 200,000.00
2024/04/26/000462 122570 BY NY DIAN RANA M015 MELATI BAYI A NCB SMK NCB SMK 26/04/2024 13:04:58 27/04/2024 21:32:45 Rp 200,000.00
AFRILIA
2024/04/26/000423 122538 BY NY RANI M003 MELATI BAYI A NCB SMK NCB SMK 26/04/2024 22:37:34 27/04/2024 12:45:25 Rp 200,000.00
ROSDYAWANSYAH
2024/04/27/000614 122614 BY NY NURUL NISA M008 MELATI BAYI A NCB SMK ncb smk 27/04/2024 10:47:23 28/04/2024 06:32:15 Rp 200,000.00
SEPTYANI
2024/04/29/000523 122642 BY NY MARDIANAH M008 MELATI BAYI A NCB SMK NCB SMK 29/04/2024 09:17:54 30/04/2024 16:28:45 Rp 200,000.00
2024/04/29/000522 122647 BY NY LIEN M003 MELATI BAYI A NCB SMK NCB SMK 29/04/2024 13:41:30 30/04/2024 17:17:25 Rp 200,000.00
RISNAWATI
2024/04/30/000213 122701 BY NY WIRATNA M008 MELATI BAYI A NCB SMK NCB SMK 30/04/2024 17:05:02 01/05/2024 14:02:22 Rp 200,000.00
ENDAH ARI
STYONUGRAHENI
2024/04/30/000241 122727 BY NY M015 MELATI BAYI A NCB SMK NCB SMK 30/04/2024 17:05:15 01/05/2024 13:53:24 Rp 200,000.00
2024/04/03/000611 121632 BY NY FIRDASALI M023 MELATI BAYI B NCB SMK NCB SMK 04/04/2024 19:29:32 06/04/2024 13:16:50 Rp 300,000.00
2024/04/01/000294 037586 RAHMAWATI M006 MELATI IBU A PRO SC POST SC 01/04/2024 15:22:05 03/04/2024 15:26:47 Rp 300,000.00
2024/04/01/000316 121551 SITI UMUL KULSUM M002 MELATI IBU A INFARTU PK 1 INFARTU PK 1 01/04/2024 15:29:55 02/04/2024 18:42:12 Rp 200,000.00
LATEN
2024/04/01/000317 121044 PUTRI HARDIYANTI M007 MELATI IBU A PRO SC POST SC 01/04/2024 15:47:57 03/04/2024 15:36:48 Rp 300,000.00
2024/04/01/000329 088156 LYANA MALIDA M016 MELATI IBU A G3P2A0 HAMIL 35-36 G3P2A0 HAMIL 01/04/2024 17:28:38 01/04/2024 19:43:52 Rp 100,000.00
MG LET LINTANG + 35-36 MG LET
PPT LINTANG + PPT
2024/04/02/000371 121570 UMI MAHMUDZA M016 MELATI IBU A HEG HEG PERBAIKAN 02/04/2024 03:06:30 03/04/2024 12:55:58 Rp 200,000.00
2024/04/03/000645 094086 MUZAENAH M016 MELATI IBU A G2P1A0 , BSC , R/SC BSC 03/04/2024 14:39:51 05/04/2024 13:52:32 Rp 300,000.00
2024/04/03/000649 121396 MEFTAHUL JANAH M005 MELATI IBU A SISA KONSEPSI SISA KONSEPSI 03/04/2024 14:54:17 04/04/2024 14:03:57 Rp 200,000.00
PRO KURET CITO PRO KURET
2024/04/03/000656 112666 FITRIA M006 MELATI IBU A POST TERM, POST TERM, 03/04/2024 15:55:10 07/04/2024 12:14:59 Rp 500,000.00
G3P2A0 H 40-41 G3P2A0 H 40-41
MINGGU
2024/04/03/000663 037719 NUR ARINI M007 MELATI IBU A G1P0A0 hamil 38 G1P0A0 hamil 38 03/04/2024 19:06:46 06/04/2024 15:47:14 Rp 400,000.00
minggu, belum inpartu minggu, belum
inpartu
2024/04/04/000558 065306 ALFIANI ROSYIDAH M005 MELATI IBU A BSC 2X + G3P2A0 , BSC 2X + G3P2A0 04/04/2024 15:25:10 06/04/2024 16:07:03 Rp 300,000.00
SAFITRI R/SC , R/SC
2024/04/04/000587 053632 LIDIA APRIANI M002 MELATI IBU A GG4P3A0 HAMIL 10 GG4P3A0 HAMIL 04/04/2024 18:52:15 07/04/2024 12:54:34 Rp 400,000.00

7/19/24, 8:39 PM Page 12 of 17

NO.RAWAT NO.R.M. NAMA PASIEN NO.KAMAR NAMA KAMAR DIAGNOSA AWAL DIAGN.AKHIR TGL.MASUK TGL.KELUAR BIAYA KAMAR
MINGGU DENGAN 10 MINGGU
HEG DENGAN HEG
2024/04/05/000420 121358 SRI PUJIYANTI M016 MELATI IBU A mioma geburt MIOMA 05/04/2024 18:55:39 06/04/2024 17:11:55 Rp 200,000.00
2024/04/07/000053 121756 INDARYATI M002 MELATI IBU A PRO KURETASE PRO KURETASE 07/04/2024 17:44:23 08/04/2024 18:09:36 Rp 200,000.00
2024/04/07/000063 046992 TSAMIROH M005 MELATI IBU A KEMATIAN KEMATIAN 07/04/2024 19:53:18 09/04/2024 21:42:33 Rp 400,000.00
MUDIGAH
2024/04/08/000218 086135 LASMINI M006 MELATI IBU A G3P2A0 hamil 29 G3P2A0 hamil 29 08/04/2024 10:54:01 09/04/2024 21:28:48 Rp 300,000.00
mgg dg HAP ec mgg dg HAP ec
Plasenta previa Plasenta previa
2024/04/08/000254 116490 LILIS NOGO KUNG M007 MELATI IBU A PRO SC PRO SC 08/04/2024 15:12:18 10/04/2024 16:43:57 Rp 300,000.00
2024/04/11/000248 074203 DEBORA KORAH M002 MELATI IBU A G1 H 33 MINGGU PRE KONTRAKSI 11/04/2024 09:59:19 13/04/2024 10:27:19 Rp 300,000.00
ROMPIS PRE KONTRAKSI
2024/04/12/000366 117373 FATMALA WATI M005 MELATI IBU A G3P2A0 H 37-38 MG G3P2A0 H 37-38 12/04/2024 10:01:20 13/04/2024 15:12:06 Rp 200,000.00
INPARTU PK I FASE MG INPARTU PK I
LATEN FASE LATEN
2024/04/12/000380 121913 MAE JUNITA M006 MELATI IBU A INPARTU PK 2 INPARTU PK 2 12/04/2024 10:39:59 13/04/2024 15:45:10 Rp 200,000.00
2024/04/13/000029 112018 DIYAH M016 MELATI IBU A PK I LATEN PK I LATEN 13/04/2024 00:39:07 13/04/2024 16:53:33 Rp 200,000.00
2024/04/13/000115 117633 YUNIAH M002 MELATI IBU A G4P3A0 (AH 2) hamil G4P3A0 (AH 2) 13/04/2024 20:50:40 14/04/2024 03:25:07 Rp 200,000.00
37-38 minggu dengan hamil 37-38
BSC 1x + PLR + LTP minggu dengan
1x pro SC BSC 1x + PLR +
LTP 1x pro SC
2024/04/13/000129 121962 HANINAH PRATIWI M005 MELATI IBU A G1P0A0 H. 39-40 G1P0A0 H. 39-40 14/04/2024 06:18:04 14/04/2024 12:01:01 Rp 100,000.00
APRILIA minggu jpkth belum minggu jpkth
inpartu belum inpartu
2024/04/14/000035 121731 RIKA HEWILDA M005 MELATI IBU A PRO SC POST SC 14/04/2024 15:12:11 16/04/2024 13:05:29 Rp 300,000.00
BR.TOBING
2024/04/15/000372 113917 ATIKAWATI M006 MELATI IBU A ISK ISK 15/04/2024 09:46:04 18/04/2024 18:01:59 Rp 400,000.00
2024/04/15/000434 121962 HANINAH PRATIWI M016 MELATI IBU A G1P0A0 H39 - 40 PP SPONTAN 15/04/2024 15:49:58 17/04/2024 11:44:53 Rp 300,000.00
APRILIA MGG DG INPARTU
2024/04/16/000505 122065 INTAN FAJAR M002 MELATI IBU A HAMIL DENGAN HAMIL DENGAN 16/04/2024 19:53:33 21/04/2024 10:16:51 Rp 600,000.00
KURNIYATI ANEMIA BERAT PRO ANEMIA BERAT
TRANSFUSI PRO TRANSFUSI
2024/04/16/000499 019178 HALIMATUSSADIYYA M005 MELATI IBU A HEG + HIPOKALEMI HEG 16/04/2024 20:07:02 21/04/2024 17:31:55 Rp 600,000.00
2024/04/17/000127 114249 EVIVA META M007 MELATI IBU A INFARTU PK 1 INFARTU PK 1 17/04/2024 04:47:15 18/04/2024 15:23:54 Rp 200,000.00
RAHARDJO LATEN
2024/04/17/000313 115313 TURINAH M016 MELATI IBU A PRO SC POST SC 17/04/2024 16:15:33 20/04/2024 15:31:23 Rp 400,000.00
2024/04/18/000247 122170 MUTIA RANTI M007 MELATI IBU A INPARTU PK II INPARTU PK II 18/04/2024 18:04:19 19/04/2024 18:02:56 Rp 200,000.00
YULIANTARI LATEN
2024/04/19/000396 122153 NURLAELA M006 MELATI IBU A PRO KURETASE POST KURETASE 19/04/2024 15:30:00 21/04/2024 09:45:28 Rp 300,000.00
2024/04/19/000416 095750 ZAHRA HASNIA M007 MELATI IBU A ANEMIA IN ANEMIA IN 19/04/2024 16:55:17 20/04/2024 18:28:45 Rp 200,000.00
AHMAD PREGNANCY PREGNANCY
2024/04/20/000154 121636 KUSTANTI ROJANAH M002 MELATI IBU A INPARTU PK I PARTUS 20/04/2024 12:31:39 22/04/2024 13:40:04 Rp 300,000.00
2024/04/21/000041 122243 PUSPITA ANGGRAINI M006 MELATI IBU A PRO SC post SC 21/04/2024 13:20:46 23/04/2024 14:27:38 Rp 300,000.00
2024/04/21/000046 122280 KHOLILAH M007 MELATI IBU A G1P0A0 h 8 mg + G1P0A0 H 8 MGG 21/04/2024 15:32:09 23/04/2024 12:49:31 Rp 300,000.00
HEG DG HEG
PERBAIKAN
2024/04/22/000160 122245 SUSI LAWATI M002 MELATI IBU A G4P2A1 H 34 DG G4P2A1 H 34 DG 22/04/2024 02:29:11 22/04/2024 10:28:38 Rp 100,000.00
KPD. HAP KPD + HAP
2024/04/22/000352 121396 MEFTAHUL JANAH M002 MELATI IBU A G4P1A2 hamil ? G4P1A2 hamil ? 22/04/2024 16:14:54 24/04/2024 10:54:37 Rp 300,000.00

7/19/24, 8:39 PM Page 13 of 17

NO.RAWAT NO.R.M. NAMA PASIEN NO.KAMAR NAMA KAMAR DIAGNOSA AWAL DIAGN.AKHIR TGL.MASUK TGL.KELUAR BIAYA KAMAR
dengan susp. abortus dengan susp.
inkomplit abortus inkomplit
2024/04/22/000353 051556 RHOSMADIANA M005 MELATI IBU A PRO SC PRO SC 22/04/2024 16:19:26 24/04/2024 13:49:22 Rp 300,000.00
2024/04/23/000499 076030 MEDHIA HARTANTI M007 MELATI IBU A PRO SC POST SC 23/04/2024 12:50:02 25/04/2024 14:06:31 Rp 300,000.00
2024/04/23/000503 120094 MARYAM M002 MELATI IBU A G2P1A0 H 33-34 MG, G2P1A0 H 33-34 23/04/2024 13:13:10 23/04/2024 19:21:17 Rp 100,000.00
BSC 1X, PEB, KPD, MG, BSC 1X,
DMG PEB, KPD, DMG
2024/04/23/000525 122412 AIDA PASYAH M006 MELATI IBU A AB IMMINENS AB IMMINENS 23/04/2024 17:12:45 26/04/2024 15:36:34 Rp 400,000.00
2024/04/25/000240 083880 RANI M016 MELATI IBU A G3P1A1 H37 MGG POST SC 25/04/2024 13:37:55 27/04/2024 12:45:36 Rp 300,000.00
ROSDYAWANSYAH PRO SC
2024/04/26/000428 111358 PUJI ASTUTI M007 MELATI IBU A G5P4(gemelly)A1 (AH G5P4(gemelly)A1 26/04/2024 10:02:16 27/04/2024 11:37:05 Rp 200,000.00
3) hamil 16-17 minggu (AH 3) hamil 16-17
dengan abortus minggu dengan
provokatus abortus
2024/04/26/000452 121347 DIAN RANA AFRILIA M005 MELATI IBU A INPARTU INPARTU 26/04/2024 11:41:37 27/04/2024 14:10:09 Rp 200,000.00
2024/04/26/000496 122575 EVI NUR SAFITRI M006 MELATI IBU A G1 hamil 34 minggu, G1 hamil 34 26/04/2024 17:10:12 27/04/2024 15:54:39 Rp 200,000.00
anemia, skoliosis, minggu, anemia,
JPKTH skoliosis, JPKTH
2024/04/27/000570 121718 NURUL NISA M002 MELATI IBU A G1P0A0 H39 MGG G1P0A0 H39 27/04/2024 07:56:37 28/04/2024 12:45:38 Rp 200,000.00
SEPTYANI INPARTU PK I MGG INPARTU
PK I LATEN
2024/04/28/000025 075472 LIEN RISNAWATI M005 MELATI IBU A PRO SC post sc 28/04/2024 10:37:45 30/04/2024 13:26:05 Rp 300,000.00
2024/04/28/000039 050530 MARDIANAH M006 MELATI IBU A BSC IX, LL- PPM BSC IX, LL- PPM 28/04/2024 14:40:38 30/04/2024 16:27:35 Rp 300,000.00
G4O3A0 PRO SC G4O3A0 POST
2024/04/29/000467 121537 ZAHRA MUTIAH M007 MELATI IBU A G1P0A0 hamil 38-39 G1P0A0 hamil 38- 29/04/2024 05:29:59 29/04/2024 20:06:24 Rp 200,000.00
mnggu dgn inpartu Pk 39 mnggu dgn
1 laten + high myopia inpartu Pk 1 laten
+ high myopia
2024/04/29/000636 122689 OPA YUNANI M002 MELATI IBU A AB IMMINENS AB IMMINENS 29/04/2024 15:13:29 30/04/2024 15:51:14 Rp 200,000.00
2024/04/29/000673 074203 DEBORA KORAH M007 MELATI IBU A pretern kontraksi pretern kontraksi 29/04/2024 21:44:26 01/05/2024 15:48:19 Rp 300,000.00
ROMPIS
2024/04/30/000159 121537 ZAHRA MUTIAH M016 MELATI IBU A INPARTU PK I INPARTU PK I 30/04/2024 07:09:11 30/04/2024 22:05:23 Rp 200,000.00
LATEN
2024/04/30/000273 122726 MARYATI M002 MELATI IBU A KEMATIAN KEMATIAN 30/04/2024 16:37:46 03/05/2024 12:47:52 Rp 400,000.00
MUDIGAH PRO MUDIGAH PRO
KURET
2024/04/01/000270 112602 MAQFIROH M011 MELATI IBU B G1P0A0 H 37 MG POST SC 01/04/2024 11:34:01 04/04/2024 11:12:37 Rp 400,000.00
OLIGOHIDRAMNION,
PRO SC
2024/04/03/000651 013480 INTAN PAJRIANI M012 MELATI IBU B g3p2a0 gr aterm; let POST SC 03/04/2024 15:01:12 05/04/2024 13:57:41 Rp 300,000.00
su oligohidramnion ,
r/sc
2024/04/03/000606 119106 FIRDASALI M018 MELATI IBU B PRO SC CITO POST SC CITO 03/04/2024 19:10:15 06/04/2024 13:16:33 Rp 400,000.00
2024/04/04/000557 121669 SILVIA M010 MELATI IBU B G1 hamil 26-27mg ANEMIA 04/04/2024 15:05:18 05/04/2024 15:49:15 Rp 200,000.00
JTHIU anemia
2024/04/04/000565 084705 SRI UTAMI M011 MELATI IBU B CPD, LTP2X,G2P0A1 pro sc 04/04/2024 16:17:40 06/04/2024 14:06:26 Rp 300,000.00
HAMIL 37-38
MINGGU , R/SC
2024/04/05/000314 117740 NUR AINI M018 MELATI IBU B HEG HEG 05/04/2024 09:21:25 07/04/2024 11:36:34 Rp 300,000.00
2024/04/05/000440 112018 DIYAH M010 MELATI IBU B g3p2a0 h 37-38 mg g3p2a0 h 37-38 06/04/2024 00:36:37 07/04/2024 17:19:17 Rp 200,000.00
inaprtu pk i laten mg inaprtu pk i

7/19/24, 8:39 PM Page 14 of 17

NO.RAWAT NO.R.M. NAMA PASIEN NO.KAMAR NAMA KAMAR DIAGNOSA AWAL DIAGN.AKHIR TGL.MASUK TGL.KELUAR BIAYA KAMAR
laten
2024/04/06/000468 118895 SITI SYARAH M012 MELATI IBU B g1p0a0 hamil 37-38g1p0a0 hamil 37- 06/04/2024 07:12:55 07/04/2024 13:02:52 Rp 200,000.00
inpartu pk i laten38 inpartu pk i
laten
2024/04/06/000527 115384 MAEMUNAH M017 MELATI IBU B G3P2A0 HAMIL 34 G3P2A0 HAMIL 06/04/2024 12:44:21 09/04/2024 13:08:06 Rp 400,000.00
MINGGU JPBOTH 34 MINGGU
JANIN CEND BESAR, JPBOTH JANIN
PRO SC CEND BESAR,
2024/04/08/000260 121804 APRIANI M010 MELATI IBU B ABORTUS ABORTUS 08/04/2024 15:46:40 09/04/2024 21:46:28 Rp 300,000.00
INKOMPLIT PRO INKOMPLIT POST
KURETASE
2024/04/13/000081 090368 AIDA AUDINA M010 MELATI IBU B INPARTU PK 1 INPARTU PK 1 13/04/2024 11:57:33 14/04/2024 18:48:51 Rp 200,000.00
RAHMANISA LATEN
2024/04/13/000082 119422 NOVITA INDRIYANTI M011 MELATI IBU B G1P0A0 H 17-18 MG 0A0 H 17-18 MG 13/04/2024 11:58:17 14/04/2024 21:04:08 Rp 200,000.00
ANEMIA PRO ANEMIA PRO
TRANSFUSI TRANSFUSI
2024/04/15/000407 107791 SELFI M011 MELATI IBU B SISA KONSEPSI SISA KONSEPSI 15/04/2024 13:06:01 16/04/2024 18:20:31 Rp 300,000.00
PRO KURET + PRO KURET +
ANEMIA PRO ANEMIA PRO
TRANSFUSI
2024/04/15/000432 047319 BELLA M012 MELATI IBU B G5P2A2 H 6-7 MG G5P2A2 H 6-7 MG 15/04/2024 15:44:37 17/04/2024 12:51:54 Rp 300,000.00
AB INKOMPLIT AB INKOMPLIT
2024/04/16/000467 121621 ANGGI ANDIKA M010 MELATI IBU B PRO SC POST SC 16/04/2024 13:01:30 18/04/2024 14:04:56 Rp 300,000.00
MARANTIA
2024/04/17/000300 106441 DITI MEIDIFA M011 MELATI IBU B PRO SC POST SC 17/04/2024 14:14:12 18/04/2024 16:14:06 Rp 200,000.00
2024/04/17/000310 036218 RIZKIA AULIA M012 MELATI IBU B PRO SC POST SC 17/04/2024 16:05:12 19/04/2024 13:36:53 Rp 300,000.00
2024/04/19/000418 071214 NURHASANAH M010 MELATI IBU B PRETERM PRETERM 19/04/2024 17:09:02 21/04/2024 16:04:51 Rp 300,000.00
KONTRAKSI
2024/04/19/000419 122227 NUR AINI M011 MELATI IBU B P1A0 PP SPONTAN P1A0 PP 19/04/2024 17:13:49 20/04/2024 21:44:41 Rp 200,000.00
2024/04/21/000022 067262 FATIAH YUSUF M011 MELATI IBU B PRO SC POST SC 21/04/2024 09:20:01 23/04/2024 17:16:29 Rp 300,000.00
2024/04/21/000027 104269 LENY SETIA NINGSIH M012 MELATI IBU B PRO SC POST SC 21/04/2024 10:31:14 23/04/2024 17:26:56 Rp 300,000.00
2024/04/21/000038 114227 METY HAIRUN NISYA M017 MELATI IBU B PRO SC POST SC 21/04/2024 13:02:45 23/04/2024 14:07:00 Rp 300,000.00
2024/04/22/000154 041379 FAIZAH M010 MELATI IBU B hamil 28-29 mg hamil 28-29 mg 22/04/2024 00:09:55 24/04/2024 22:27:43 Rp 300,000.00
dengan preterm dengan preterm
kontraksi, HSK kontraksi, HSK
2024/04/22/000319 003526 ISTIANAH M018 MELATI IBU B AB IMMINENS AB IMMINENS 22/04/2024 13:13:51 24/04/2024 11:37:28 Rp 300,000.00
2024/04/23/000405 120696 CLAUDIA LAILLA M018 MELATI IBU B PK I LATEN PK 1 LATEN 23/04/2024 03:56:48 24/04/2024 10:41:20 Rp 200,000.00
ALGHASYIYAH
2024/04/24/000296 121730 SUKARSIH M011 MELATI IBU B PRO SC PRO SC 24/04/2024 15:17:20 26/04/2024 15:30:39 Rp 300,000.00
2024/04/25/000251 117834 KURNIATI M018 MELATI IBU B PRETERM PRETERM 25/04/2024 15:27:18 26/04/2024 19:15:51 Rp 200,000.00
KONTRAKSI + KONTRAKSI +
G6P4A1 + H36-37 G6P4A1 + H36-37
MG
2024/04/27/000554 122602 JESICA HERDIANA M010 MELATI IBU B ABORTUS ABORTUS 27/04/2024 06:46:36 27/04/2024 16:14:15 Rp 100,000.00
INKOMPLIT
2024/04/29/000604 080666 WIRATNA ENDAH M018 MELATI IBU B PRO SC POST SC 29/04/2024 12:55:30 01/05/2024 14:07:00 Rp 300,000.00
ARI
2024/04/30/000238 071214 NURHASANAH M017 MELATI IBU B SC CITO POST SC 30/04/2024 10:40:45 01/05/2024 13:53:32 Rp 200,000.00
2024/04/06/000504 121758 BY NY SITI SYARAH NI1 NICU NCB SMK - 06/04/2024 10:26:50 06/04/2024 19:20:01 Rp 800,000.00
2024/04/09/000169 121848 HUMAIRAH ARSYILA NI1 NICU GEA GEA 09/04/2024 22:12:48 11/04/2024 07:21:05 Rp 2,400,000.00

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NO.RAWAT NO.R.M. NAMA PASIEN NO.KAMAR NAMA KAMAR DIAGNOSA AWAL DIAGN.AKHIR TGL.MASUK TGL.KELUAR BIAYA KAMAR
SABRINA
2024/04/18/000257 122177 BY NY MUTIA RANTI NI1 NICU NKB KMK NKB KMK + 18/04/2024 19:48:26 19/04/2024 01:30:00 Rp 1,600,000.00
YULIANTARI RESPIRATORY
DISTRESS
2024/04/01/000312 121552 BY NY MAQFIROH P001 PERINA NCB SMK NCB SMK 01/04/2024 19:29:23 05/04/2024 20:23:07 Rp 1,000,000.00
2024/04/02/000406 121565 BY NY PUTRI P001 PERINA NCB SMK - 02/04/2024 08:27:32 02/04/2024 12:51:58 Rp 200,000.00
HARDIYANTI
2024/04/02/000407 121566 BY NY RAHMAWATI P001 PERINA NCB SMK - 02/04/2024 08:28:23 02/04/2024 12:52:17 Rp 200,000.00
2024/04/03/000611 121632 BY NY FIRDASALI P001 PERINA NCB SMK - 03/04/2024 11:13:15 04/04/2024 19:29:32 Rp 400,000.00
2024/04/04/000498 121649 BY NY MUZAENAH P002 PERINA NCB SMK - 04/04/2024 08:05:58 04/04/2024 14:05:45 Rp 200,000.00
2024/04/04/000500 121650 BY NY INTAN P002 PERINA NCB SMK NCB SMK 04/04/2024 08:06:47 04/04/2024 14:06:10 Rp 200,000.00
PAJRIANI
2024/04/04/000551 121035 VHEIZYRA ARUMY P001 PERINA HIPERBILIRUBIN HIPERBILIRUBIN 04/04/2024 14:01:15 06/04/2024 12:59:38 Rp 600,000.00
SWARA EMIA
2024/04/05/000308 121701 BY NY NUR ARINI P002 PERINA NCB SMK - 05/04/2024 09:00:03 05/04/2024 12:50:06 Rp 200,000.00
2024/04/05/000306 121695 BY NY ALFIANI P002 PERINA NCB SMK - 05/04/2024 09:00:51 05/04/2024 12:50:45 Rp 200,000.00
ROSYIDAH SAFITRI
2024/04/08/000160 121795 BY NY MAEMUNAH / P002 PERINA NKB BMK NKB BMK 08/04/2024 12:31:37 09/04/2024 13:08:20 Rp 400,000.00
KHAYIRA ULYA
2024/04/09/000153 121823 BY NY LILIS NOGO P001 PERINA NCB SMK - 09/04/2024 16:14:40 09/04/2024 20:14:22 Rp 400,000.00
KUNG
2024/04/15/000308 121983 ELISA FEODORA (BY P001 PERINA NCB SMK - 15/04/2024 06:46:08 15/04/2024 06:06:36 Rp 200,000.00
NY RIKA HEWILDA)
2024/04/15/000388 121795 BY NY MAEMUNAH / P002 PERINA HIPERBILIRUBINEMI HIPERBILIRUBIN 15/04/2024 11:03:09 17/04/2024 13:10:31 Rp 600,000.00
KHAYIRA ULYA EMIA
2024/04/17/000186 122070 NADHIF M SYAWAL / P001 PERINA NCB SMK - 17/04/2024 07:59:58 17/04/2024 13:21:00 Rp 200,000.00
BY NY ATIKAWATI
2024/04/17/000188 122069 ABQARY MIHRAN AL P002 PERINA NCB SMK - 17/04/2024 08:01:01 17/04/2024 13:20:44 Rp 200,000.00
FATIH / BY NY ANGGI
2024/04/17/000254 121700 SHAYLA ATHALIA P001 PERINA HIPERBILIRUBINEMI HIPERBILIRUBIN 17/04/2024 10:13:20 18/04/2024 16:45:50 Rp 400,000.00
NAEMI EMIA
2024/04/17/000297 122117 BY NY DITI MEIDIFA P001 PERINA NCB SMK - 17/04/2024 14:27:06 17/04/2024 16:22:26 Rp 200,000.00
2024/04/18/000190 122131 BY NY RIZKIA AULIA P001 PERINA NCB SMK - 18/04/2024 08:06:24 18/04/2024 15:47:39 Rp 200,000.00
2024/04/19/000367 122189 BY NY TURINAH P001 PERINA NCB SMK - 19/04/2024 12:27:27 19/04/2024 14:07:29 Rp 200,000.00
2024/04/22/000225 122305 RADEVA ZAIN P001 PERINA NCB SMK - 22/04/2024 07:50:28 22/04/2024 13:31:14 Rp 200,000.00
2024/04/22/000224 122309 BY NY LENY SETIA P002 PERINA NCB SMK - 22/04/2024 07:50:44 22/04/2024 13:31:26 Rp 200,000.00
NINGSIH
2024/04/22/000318 122308 BY NY PUSPITA P002 PERINA NCB SMK - 22/04/2024 12:56:03 22/04/2024 15:58:33 Rp 200,000.00
ANGGRAINI
2024/04/22/000229 122322 BY NY FATIAH P001 PERINA NCB SMK - 22/04/2024 13:55:41 22/04/2024 19:39:42 Rp 200,000.00
2024/04/23/000450 122379 LORAH APRILLIA P001 PERINA NCB SMK - 23/04/2024 08:17:13 23/04/2024 20:20:26 Rp 400,000.00
2024/04/24/000197 122434 RADJA ABHISEKA D P001 PERINA NCB SMK - 24/04/2024 08:20:16 24/04/2024 19:00:07 Rp 200,000.00
ARM
2024/04/25/000186 122483 BY NY SUKARSIH P001 PERINA NCB SMK - 25/04/2024 08:14:17 25/04/2024 13:35:16 Rp 200,000.00
2024/04/25/000245 122515 AHMAD RAYYAN P002 PERINA JAUNDICE, JAUNDICE, 25/04/2024 14:49:36 27/04/2024 09:26:27 Rp 600,000.00
ALMAIR HIPERBIL
2024/04/26/000423 122538 BY NY RANI P001 PERINA NCB SMK - 26/04/2024 09:47:58 26/04/2024 22:37:34 Rp 400,000.00
ROSDYAWANSYAH
2024/04/26/000510 122581 FIONA SYAFAZEA P001 PERINA HIPERBILIRUBIN HIPERBILIRUBIN 26/04/2024 19:49:25 29/04/2024 16:41:35 Rp 800,000.00

7/19/24, 8:39 PM Page 16 of 17

NO.RAWAT NO.R.M. NAMA PASIEN NO.KAMAR NAMA KAMAR DIAGNOSA AWAL DIAGN.AKHIR TGL.MASUK TGL.KELUAR BIAYA KAMAR
HUSAIN
2024/04/29/000522 122647 BY NY LIEN P002 PERINA NCB SMK - 29/04/2024 09:15:27 29/04/2024 13:41:30 Rp 200,000.00
RISNAWATI
2024/04/29/000523 122642 BY NY MARDIANAH P002 PERINA NCB SMK - 29/04/2024 09:15:47 29/04/2024 09:17:54 Rp 400,000.00
2024/04/30/000213 122701 BY NY WIRATNA P001 PERINA NCB SMK - 30/04/2024 09:13:29 30/04/2024 17:05:02 Rp 200,000.00
ENDAH ARI
STYONUGRAHENI
2024/04/30/000241 122727 BY NY P002 PERINA NCB SMK - 30/04/2024 10:48:43 30/04/2024 17:05:15 Rp 200,000.00
2024/04/12/000419 115030 ABDUL AZIZ P1 PICU GEA DENGAN GEA DENGAN 12/04/2024 19:35:25 14/04/2024 09:56:45 Rp 3,000,000.00
HYPOKALEMIA HYPOKALEMIA
2024/04/13/000087 037305 DINA SETIAWATI P2 PICU PARAPARESIS EC PARAPARESIS 13/04/2024 13:59:23 15/04/2024 14:53:33 Rp 3,000,000.00
HIPOKALEMI EC HIPOKALEMI
2024/04/18/000099 079039 NURHIKMAH P1 PICU DEHIDRASI BERAT PENURUNAN 18/04/2024 02:24:51 18/04/2024 11:21:18 Rp 1,000,000.00
CHAIRANI KESADARAN
SUSP
ENSEFALITIS +
2024/04/26/000435 101532 MUHAMMAD P2 PICU GEA DEHIDRASI GEA DEHIDRASI 26/04/2024 10:26:23 30/04/2024 13:48:36 Rp 5,000,000.00
RAFFANSYAH BERAT BERAT

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