DAFTAR KUNJUNGAN PESERTA SAKIT

Kantor Cabang : SAMARINDA - 1601

FKTP : dr Hotman Wilson S - 0302U133

TANGGAL TANGGAL JENIS STATUS

NO NO KUNJUNGAN NO KARTU NAMA PESERTA JENIS PESERTA DIAGNOSA PRB PROLANIS
PELAYANAN ENTRI KELAMIN PULANG

0302U1330524P00 31-05-2024 03-06-2024

1 0000010555648 DHEDY IRAWAN L PNS DAERAH Headache Berobat Jalan
0615 00:00 14:40
0302U1330524P00 31-05-2024 03-06-2024 Acute pharyngitis,
2 0000120338559 BUDI SAHJAYA L PNS DAERAH Berobat Jalan
0607 00:00 14:29 unspecified
0302U1330524P00 31-05-2024 03-06-2024 PEGAWAI Acute pharyngitis,
3 0000902905031 APRIL HERIATY P Berobat Jalan
0608 00:00 14:30 SWASTA unspecified
0302U1330524P00 31-05-2024 03-06-2024 PEGAWAI
4 0001408500944 ELIS RANTE P Headache Berobat Jalan
0609 00:00 14:30 SWASTA

Diarrhoea and
0302U1330524P00 31-05-2024 03-06-2024 PEGAWAI
5 0001436202887 MAGFIRAH P gastroenteritis of Berobat Jalan
0605 00:00 14:23 SWASTA
presumed infectious origin

Medical observation and

0302U1330524P00 31-05-2024 03-06-2024 PEGAWAI
6 0001628166565 INDAH LESTARI JAYANTI P evaluation for suspected Berobat Jalan
0614 00:00 14:39 SWASTA
diseases and conditions
0302U1330524P00 31-05-2024 03-06-2024 PEGAWAI
7 0001645104442 ERNA YASIN P Infective dermatitis Berobat Jalan
0602 00:00 14:21 SWASTA

Diarrhoea and
0302U1330524P00 31-05-2024 03-06-2024 MAULIDAN ADZAN PEGAWAI
8 0001676257132 L gastroenteritis of Berobat Jalan
0606 00:00 14:24 AKHBAR SWASTA
presumed infectious origin

0302U1330524P00 31-05-2024 03-06-2024 PEGAWAI

9 0001676261902 NURLIA P Cough Berobat Jalan
0613 00:00 14:39 SWASTA
0302U1330524P00 31-05-2024 31-05-2024 PEGAWAI
10 0001741988801 JULKIFLI L Dislocation of knee Rujuk Vertikal
0558 00:00 20:06 SWASTA
0302U1330524P00 31-05-2024 03-06-2024 PEKERJA
11 0001791289539 RAHMAWATY P Headache Berobat Jalan
0611 00:00 14:33 MANDIRI
0302U1330524P00 31-05-2024 03-06-2024
12 0001925165169 SALASIAH P PBI (APBD) Fever, unspecified Berobat Jalan
0604 00:00 14:22
0302U1330524P00 31-05-2024 03-06-2024 Acute pharyngitis,
13 0002097070672 AHMAD NUR FAIZ L PEGAWAI BUMN Berobat Jalan
0610 00:00 14:32 unspecified
0302U1330524P00 31-05-2024 03-06-2024 PEKERJA
14 0002203848066 SURYADI L Infective dermatitis Berobat Jalan
0616 00:00 14:41 MANDIRI
0302U1330524P00 31-05-2024 03-06-2024 PEKERJA
15 0002203848336 HASNAWATI P Infective dermatitis Berobat Jalan
0617 00:00 14:42 MANDIRI
0302U1330524P00 31-05-2024 03-06-2024 Acute upper respiratory
16 0002723955625 NADYA MUTIA AZZAHRA P PBI (APBD) Berobat Jalan
0603 00:00 14:21 infection, unspecified
 DAFTAR KUNJUNGAN PESERTA SAKIT

Kantor Cabang : SAMARINDA - 1601

FKTP : dr Hotman Wilson S - 0302U133

0302U1330524P00 31-05-2024 03-06-2024 PEGAWAI

17 0003085621672 APRILIANA P Fever, unspecified Berobat Jalan
0612 00:00 14:33 SWASTA
Gastric ulcer, unspecified
0302U1330524P00 30-05-2024 30-05-2024 PEGAWAI as acute or chronic,
18 0001177546094 MARIANA P Rujuk Vertikal
0556 00:00 19:47 SWASTA without haemorrhage or
perforation
Non-insulin-dependent
0302U1330524P00 30-05-2024 30-05-2024 PEGAWAI
19 0001545917376 RISKI AMALIA SARI P diabetes mellitus with Rujuk Vertikal
0555 00:00 19:45 SWASTA
unspecified complications
0302U1330524P00 30-05-2024 03-06-2024 PEGAWAI
20 0001654207097 NOVITA AKE' TONAPA P Cough Berobat Jalan
0596 00:00 14:16 SWASTA
0302U1330524P00 30-05-2024 03-06-2024 PEKERJA
21 0002070557662 ANDI RAISSA AFIFAH P Dyspepsia Berobat Jalan
0598 00:00 14:18 MANDIRI
0302U1330524P00 30-05-2024 03-06-2024 MUHAMMAD RAFA PEGAWAI Acute upper respiratory
22 0002195827705 L Berobat Jalan
0597 00:00 14:17 SETIAWAN SWASTA infection, unspecified
0302U1330524P00 30-05-2024 03-06-2024
23 0002239458513 WINI JULIANTI P PBI (APBD) Headache Berobat Jalan
0600 00:00 14:19
0302U1330524P00 30-05-2024 03-06-2024 PEGAWAI
24 0002279251776 UMAR DHANI L Fever, unspecified Berobat Jalan
0601 00:00 14:20 SWASTA
0302U1330524P00 30-05-2024 30-05-2024 ZAHRA PUTRI KORINA PEKERJA
25 0002764892586 P Otitis media, unspecified Rujuk Vertikal
0553 00:00 19:25 SARI MANDIRI
0302U1330524P00 30-05-2024 30-05-2024
26 0002943143965 AFIYYA AZZAHRA P PBI (APBD) Haemangioma, any site Rujuk Vertikal
0554 00:00 19:31
0302U1330524P00 30-05-2024 03-06-2024 PEGAWAI
27 0003073464775 DEDY SAAD L Headache Berobat Jalan
0599 00:00 14:19 SWASTA
PEGAWAI
PEMERINTAH
0302U1330524P00 29-05-2024 03-06-2024
28 0001153811597 HERMAN FELANI L DENGAN Low back pain Berobat Jalan
0593 00:00 14:14
PERJANJIAN
KERJA
0302U1330524P00 29-05-2024 03-06-2024
29 0001611057363 MUHAMMAD KHAIRUDDIN L PBI (APBD) Fever, unspecified Berobat Jalan
0618 00:00 14:50
0302U1330524P00 29-05-2024 03-06-2024
30 0001860175776 ALYA MAULIDA P PNS DAERAH Fever, unspecified Berobat Jalan
0619 00:00 14:51
0302U1330524P00 29-05-2024 03-06-2024
31 0001923481822 HJ.MASANG P PBI (APBN) Dyspepsia Berobat Jalan Hipertensi
0594 00:00 14:15
0302U1330524P00 29-05-2024 03-06-2024 PEGAWAI
32 0001969562744 CANDRA L Fever, unspecified Berobat Jalan
0589 00:00 14:11 SWASTA
 DAFTAR KUNJUNGAN PESERTA SAKIT

Kantor Cabang : SAMARINDA - 1601

FKTP : dr Hotman Wilson S - 0302U133

Diarrhoea and
0302U1330524P00 29-05-2024 03-06-2024 PEGAWAI
33 0002079065542 JONI L gastroenteritis of Berobat Jalan
0621 00:00 14:52 SWASTA
presumed infectious origin

0302U1330524P00 29-05-2024 03-06-2024 PEKERJA

34 0002200692947 NOR KHATIMAH P Fever, unspecified Berobat Jalan
0587 00:00 14:10 MANDIRI
Non-insulin-dependent
0302U1330524P00 29-05-2024 29-05-2024 PEKERJA diabetes mellitus with Diabetes
35 0002247383709 SITI AISYAH P Rujuk Vertikal
0552 00:00 20:03 MANDIRI peripheral circulatory Mellitus
complications

Diarrhoea and
0302U1330524P00 29-05-2024 03-06-2024 PEKERJA
36 0002260320478 NURMINI P gastroenteritis of Berobat Jalan
0590 00:00 14:12 MANDIRI
presumed infectious origin

0302U1330524P00 29-05-2024 29-05-2024 PEKERJA

37 0002269657574 EDY SURIONO L Congestive heart failure Rujuk Vertikal
0551 00:00 19:45 MANDIRI
PEGAWAI
PEMERINTAH
0302U1330524P00 29-05-2024 03-06-2024 Acute upper respiratory
38 0002315278383 ELIANSYAH L DENGAN Berobat Jalan
0620 00:00 14:51 infection, unspecified
PERJANJIAN
KERJA
0302U1330524P00 29-05-2024 03-06-2024 MUHAMMAD ALFATIH PEGAWAI
39 0002493464736 L Cough Berobat Jalan
0591 00:00 14:13 NAIF SWASTA
0302U1330524P00 29-05-2024 03-06-2024 PEKERJA
40 0002755319916 HERMANSYAH L Dyspepsia Berobat Jalan
0592 00:00 14:13 MANDIRI
0302U1330524P00 29-05-2024 03-06-2024 KHEYRA ALIZA PEGAWAI
41 0002769310528 P Fever, unspecified Berobat Jalan
0622 00:00 14:52 PURNAMASARI SWASTA
0302U1330524P00 29-05-2024 03-06-2024 MUHAMMAD HAFIZH
42 0002919627718 L PBI (APBD) Headache Berobat Jalan
0588 00:00 14:11 PRADANA
0302U1330524P00 29-05-2024 03-06-2024 PEGAWAI
43 0003085621672 APRILIANA P Fever, unspecified Berobat Jalan
0595 00:00 14:15 SWASTA
0302U1330524P00 29-05-2024 03-06-2024 KEENAN ALVARENDRA PEGAWAI Acute upper respiratory
44 0003132426633 L Berobat Jalan
0623 00:00 14:53 PURNAMA SWASTA infection, unspecified
0302U1330524P00 29-05-2024 29-05-2024 NAULINA CECILIA
45 0003515843171 P - Patent ductus arteriosus Rujuk Vertikal
0550 00:00 19:29 TOGATOROP
0302U1330524P00 28-05-2024 03-06-2024 RICHARD MAILANDRO PEGAWAI Acute upper respiratory
46 0001408500966 L Berobat Jalan
0582 00:00 14:04 PALUARAN SWASTA infection, unspecified

Diarrhoea and
0302U1330524P00 28-05-2024 03-06-2024 MAULIDAN ADZAN PEGAWAI
47 0001676257132 L gastroenteritis of Berobat Jalan
0585 00:00 14:08 AKHBAR SWASTA
presumed infectious origin
 DAFTAR KUNJUNGAN PESERTA SAKIT

Kantor Cabang : SAMARINDA - 1601

FKTP : dr Hotman Wilson S - 0302U133

0302U1330524P00 28-05-2024 03-06-2024 Acute pharyngitis,

48 0001860161139 HERLINA P PNS DAERAH Berobat Jalan
0580 00:00 14:03 unspecified
0302U1330524P00 28-05-2024 03-06-2024 PEKERJA
49 0002070557662 ANDI RAISSA AFIFAH P Infective dermatitis Berobat Jalan
0586 00:00 14:09 MANDIRI
0302U1330524P00 28-05-2024 28-05-2024 Atherosclerotic heart
50 0002093294722 HARIANI P - Rujuk Vertikal Hipertensi Hipertensi
0544 00:00 19:15 disease
0302U1330524P00 28-05-2024 28-05-2024 RIFKY NOVAN PEKERJA
51 0002199488095 L Hearing loss, unspecified Rujuk Vertikal
0545 00:00 19:39 RUSLIANSYAH MANDIRI
0302U1330524P00 28-05-2024 28-05-2024 PEKERJA Visual disturbance,
52 0002263402258 NURHAYATI P Rujuk Vertikal
0546 00:00 19:51 MANDIRI unspecified
0302U1330524P00 28-05-2024 28-05-2024 RAJENDRA RAMADHAN PEKERJA Visual disturbance,
53 0002263409998 L Rujuk Vertikal
0547 00:00 19:53 BASUKI MANDIRI unspecified
0302U1330524P00 28-05-2024 28-05-2024 PEKERJA Visual disturbance,
54 0002322822925 HELMINA WIJITIRANTI P Rujuk Vertikal
0549 00:00 19:59 MANDIRI unspecified
0302U1330524P00 28-05-2024 28-05-2024 GHAFARA NUR ANSORI Urinary calculus,
55 0002434146693 L - Rujuk Vertikal
0548 00:00 19:58 GHOFUR unspecified
0302U1330524P00 28-05-2024 03-06-2024 KHEYRA ALIZA PEGAWAI
56 0002769310528 P Fever, unspecified Berobat Jalan
0584 00:00 14:07 PURNAMASARI SWASTA
0302U1330524P00 28-05-2024 03-06-2024 MUHAMMAD RIZKY PEKERJA Acute upper respiratory
57 0002927279968 L Berobat Jalan
0581 00:00 14:04 ADITYA RAHMAN MANDIRI infection, unspecified
0302U1330524P00 28-05-2024 03-06-2024 KEENAN ALVARENDRA PEGAWAI
58 0003132426633 L Fever, unspecified Berobat Jalan
0583 00:00 14:06 PURNAMA SWASTA
0302U1330524P00 27-05-2024 27-05-2024 PENERIMA Acute pharyngitis,
59 0000120353185 YOHANA MALI P Berobat Jalan
0541 00:00 21:37 PENSIUN PNS unspecified
0302U1330524P00 27-05-2024 03-06-2024 PENERIMA
60 0000120353196 YOURY PASANDA L Fever, unspecified Berobat Jalan
0559 00:00 13:47 PENSIUN PNS
0302U1330524P00 27-05-2024 03-06-2024 PEGAWAI
61 0000120411606 ANNISA NUR RABIAH P Cough Berobat Jalan
0568 00:00 13:52 SWASTA
0302U1330524P00 27-05-2024 03-06-2024 Acute upper respiratory
62 0000120416398 DARWIS L PNS DAERAH Berobat Jalan
0569 00:00 13:52 infection, unspecified
0302U1330524P00 27-05-2024 03-06-2024
63 0000120532375 ERNIWATI P PNS PUSAT Headache Berobat Jalan
0565 00:00 13:50
0302U1330524P00 27-05-2024 03-06-2024
64 0000120532397 TAUFIQURRAHMAN L PNS PUSAT Dyspepsia Berobat Jalan
0564 00:00 13:50
PEGAWAI
PEMERINTAH
0302U1330524P00 27-05-2024 27-05-2024 GILANG RIZKY
65 0000120866804 L DENGAN Fever, unspecified Berobat Jalan
0507 00:00 20:07 RAMADHAN
PERJANJIAN
KERJA
 DAFTAR KUNJUNGAN PESERTA SAKIT

Kantor Cabang : SAMARINDA - 1601

FKTP : dr Hotman Wilson S - 0302U133

0302U1330524P00 27-05-2024 27-05-2024 PEKERJA

66 0000202987102 INDRA YUSNITA P Status asthmaticus Rujuk Vertikal
0537 00:00 21:36 MANDIRI
0302U1330524P00 27-05-2024 03-06-2024 RIDHO ADRIANE PIO
67 0000209205819 L PNS DAERAH Gastritis, unspecified Berobat Jalan
0570 00:00 13:53 MACHARUMFA
False labour before 37
0302U1330524P00 27-05-2024 27-05-2024 MAIMUNAH DESRIYANI PEGAWAI
68 0001388527018 P completed weeks of Rujuk Vertikal
0508 00:00 20:36 KHAIRULLAH SWASTA
gestation
PEGAWAI
PEMERINTAH Diarrhoea and
0302U1330524P00 27-05-2024 03-06-2024
69 0001389795726 SUKRIANTO L DENGAN gastroenteritis of Berobat Jalan
0560 00:00 13:47
PERJANJIAN presumed infectious origin
KERJA
PEGAWAI
PEMERINTAH
0302U1330524P00 27-05-2024 03-06-2024
70 0001389795963 ARBAYAH P DENGAN Infective dermatitis Berobat Jalan
0561 00:00 13:48
PERJANJIAN
KERJA
0302U1330524P00 27-05-2024 03-06-2024 PEGAWAI Acute pharyngitis, Diabetes
71 0001482592364 AGUS MIRAN L Berobat Jalan
0562 00:00 13:48 SWASTA unspecified Mellitus
0302U1330524P00 27-05-2024 03-06-2024 PEKERJA
72 0001545214342 SYAFRUDDIN L Fever, unspecified Berobat Jalan
0577 00:00 14:01 MANDIRI

Diarrhoea and
0302U1330524P00 27-05-2024 03-06-2024 PEGAWAI
73 0001545918377 EDIL JUMADI L gastroenteritis of Berobat Jalan
0574 00:00 13:59 SWASTA
presumed infectious origin

0302U1330524P00 27-05-2024 03-06-2024 PEGAWAI Acute upper respiratory

74 0001546444473 RUSLANSYAH L Berobat Jalan
0578 00:00 14:01 SWASTA infection, unspecified
0302U1330524P00 27-05-2024 27-05-2024
75 0001551668185 MARIA GORETI NGGALO P PBI (APBD) Arthrosis, unspecified Rujuk Vertikal
0506 00:00 20:03
0302U1330524P00 27-05-2024 27-05-2024 PEKERJA Atherosclerotic heart Diabetes
76 0001724212405 TONY L Rujuk Vertikal
0542 00:00 21:41 MANDIRI disease Mellitus
0302U1330524P00 27-05-2024 03-06-2024 PEKERJA
77 0001727845626 MUCHLIS FADILLAH L Low back pain Berobat Jalan
0571 00:00 13:56 MANDIRI
0302U1330524P00 27-05-2024 03-06-2024
78 0001808855649 IRA AISYA P PNS DAERAH Headache Berobat Jalan
0579 00:00 14:02
0302U1330524P00 27-05-2024 27-05-2024 PEGAWAI
79 0001824515368 DEDI IRAWAN L Fever, unspecified Berobat Jalan
0540 00:00 21:37 SWASTA
0302U1330524P00 27-05-2024 27-05-2024 PEKERJA
80 0001927293513 VALEN SATRIA FEBRIAN L Headache Berobat Jalan
0539 00:00 21:36 MANDIRI
0302U1330524P00 27-05-2024 03-06-2024
81 0001928464536 PITER L - Fever, unspecified Berobat Jalan
0576 00:00 14:00
 DAFTAR KUNJUNGAN PESERTA SAKIT

Kantor Cabang : SAMARINDA - 1601

FKTP : dr Hotman Wilson S - 0302U133

0302U1330524P00 27-05-2024 03-06-2024 PEKERJA Acute upper respiratory

82 0002066319944 SITI RUKANA ILAM SARI P Berobat Jalan
0563 00:00 13:49 MANDIRI infection, unspecified
Chronic obstructive
0302U1330524P00 27-05-2024 27-05-2024 PEKERJA pulmonary disease with
83 0002203848066 SURYADI L Rujuk Vertikal
0491 00:00 19:42 MANDIRI acute exacerbation,
unspecified
0302U1330524P00 27-05-2024 03-06-2024 PEKERJA Acute upper respiratory
84 0002237104552 ABDUL MALIK L Berobat Jalan
0575 00:00 13:59 MANDIRI infection, unspecified

Diarrhoea and
0302U1330524P00 27-05-2024 03-06-2024 PEGAWAI
85 0002237548757 ELIAZER SIMON L gastroenteritis of Berobat Jalan
0566 00:00 13:51 SWASTA
presumed infectious origin

0302U1330524P00 27-05-2024 27-05-2024 PEGAWAI

86 0002257006421 WELLY MARDIANI P Fever, unspecified Berobat Jalan
0535 00:00 21:35 SWASTA
0302U1330524P00 27-05-2024 27-05-2024
87 0002269467628 ASIH P PBI (APBN) Fever, unspecified Berobat Jalan
0538 00:00 21:36
0302U1330524P00 27-05-2024 03-06-2024 Acute upper respiratory
88 0002312668708 IRA ASWARA P - Berobat Jalan
0567 00:00 13:51 infection, unspecified
0302U1330524P00 27-05-2024 03-06-2024 MUHAMMAD MUGNI PEGAWAI
89 0002620606487 L Cough Berobat Jalan
0572 00:00 13:57 HABIBI SWASTA
0302U1330524P00 27-05-2024 03-06-2024 PEKERJA
90 0002755319916 HERMANSYAH L Headache Berobat Jalan
0573 00:00 13:58 MANDIRI
0302U1330524P00 27-05-2024 27-05-2024 PEGAWAI Acute pharyngitis,
91 0003107074397 AGUS L Berobat Jalan
0536 00:00 21:36 SWASTA unspecified
0302U1330524P00 27-05-2024 27-05-2024 AISHA NADHIRA AZ PEGAWAI
92 0003271521071 P Acute epiglottitis Rujuk Vertikal
0509 00:00 20:44 ZAHRA SWASTA
0302U1330524P00 27-05-2024 27-05-2024
93 0003523533884 MUHAMMAD RAFKA L PBI (APBD) Cleft lip, unilateral Rujuk Vertikal
0543 00:00 21:44
0302U1330524P00 25-05-2024 27-05-2024 Acute upper respiratory
94 0000120835877 ABU SAMSUDIN L - Berobat Jalan
0525 00:00 21:30 infection, unspecified
0302U1330524P00 25-05-2024 27-05-2024 Insulin-dependent Diabetes
95 0000120861944 SUPRAPTO L PNS DAERAH Berobat Jalan
0530 00:00 21:33 diabetes mellitus Mellitus
0302U1330524P00 25-05-2024 27-05-2024 PEGAWAI
96 0001177546094 MARIANA P Fever, unspecified Berobat Jalan
0523 00:00 21:25 SWASTA
0302U1330524P00 25-05-2024 27-05-2024 PEKERJA
97 0001435154286 WIDJANARKO L Headache Berobat Jalan
0533 00:00 21:34 MANDIRI
0302U1330524P00 25-05-2024 27-05-2024 PEKERJA
98 0001437144052 HALIMAH P Headache Berobat Jalan
0522 00:00 21:24 MANDIRI
0302U1330524P00 25-05-2024 27-05-2024 PEGAWAI
99 0001474430771 WAWAN APRIYANTO L Fever, unspecified Berobat Jalan
0531 00:00 21:33 SWASTA
 DAFTAR KUNJUNGAN PESERTA SAKIT

Kantor Cabang : SAMARINDA - 1601

FKTP : dr Hotman Wilson S - 0302U133

Insulin-dependent
0302U1330524P00 25-05-2024 25-05-2024 PEGAWAI
100 0001482592364 AGUS MIRAN L diabetes mellitus without Rujuk Vertikal
0478 00:00 19:34 SWASTA
complications
0302U1330524P00 25-05-2024 27-05-2024
101 0001545217659 BERLIANI TANDI SAU' P PBI (APBD) Headache Berobat Jalan
0534 00:00 21:34
0302U1330524P00 25-05-2024 27-05-2024 PEGAWAI
102 0001545311992 ADRY TIRTO DALEKSONO L Cough Berobat Jalan
0529 00:00 21:32 SWASTA

Diarrhoea and
0302U1330524P00 25-05-2024 27-05-2024 PEGAWAI
103 0001545914957 MUSTAKIM L gastroenteritis of Berobat Jalan
0532 00:00 21:33 SWASTA
presumed infectious origin

0302U1330524P00 25-05-2024 27-05-2024

104 0001818583659 TANTY P - Fever, unspecified Berobat Jalan
0521 00:00 21:24
0302U1330524P00 25-05-2024 27-05-2024 PEKERJA
105 0001836443801 SRI WAHYUNI P Headache Berobat Jalan
0528 00:00 21:31 MANDIRI
PEGAWAI
PEMERINTAH
0302U1330524P00 25-05-2024 25-05-2024 Thyrotoxicosis
106 0002034372699 ASRIANI P DENGAN Rujuk Vertikal
0490 00:00 21:42 [hyperthyroidism]
PERJANJIAN
KERJA
0302U1330524P00 25-05-2024 27-05-2024 PEGAWAI
107 0002203707767 AGUSTINUS TANDIRING L Headache Berobat Jalan
0520 00:00 21:24 SWASTA
0302U1330524P00 25-05-2024 27-05-2024 NUR SHOBA DEWI PEKERJA
108 0002292465137 P Infective dermatitis Berobat Jalan
0519 00:00 21:20 RACHMAN MANDIRI
0302U1330524P00 25-05-2024 25-05-2024 PEKERJA Cerebral infarction,
109 0002300883153 ACHMAD SUPENO L Rujuk Vertikal
0489 00:00 21:17 MANDIRI unspecified
0302U1330524P00 25-05-2024 25-05-2024
110 0002375657177 DINA ASIK ALLO P - Cataract, unspecified Rujuk Vertikal Hipertensi
0477 00:00 19:29
0302U1330524P00 25-05-2024 27-05-2024 ZAHRA PUTRI KORINA PEKERJA Acute upper respiratory
111 0002764892586 P Berobat Jalan
0526 00:00 21:31 SARI MANDIRI infection, unspecified
0302U1330524P00 25-05-2024 27-05-2024 ANISA PUTRI KORINA PEKERJA
112 0002764892665 P Headache Berobat Jalan
0527 00:00 21:31 SARI MANDIRI
0302U1330524P00 25-05-2024 25-05-2024 MUHAMMAD IMAN PEGAWAI Chronic sinusitis,
113 0002922769416 L Rujuk Vertikal
0486 00:00 19:51 TAUFIQ SWASTA unspecified
0302U1330524P00 25-05-2024 27-05-2024
114 0003004133591 FIRDAUS L - Fever, unspecified Berobat Jalan
0524 00:00 21:28
0302U1330524P00 25-05-2024 25-05-2024 PEKERJA
115 0003284789815 MANDARIAH P Arthrosis, unspecified Rujuk Vertikal
0488 00:00 20:57 MANDIRI
 DAFTAR KUNJUNGAN PESERTA SAKIT

Kantor Cabang : SAMARINDA - 1601

FKTP : dr Hotman Wilson S - 0302U133

Diarrhoea and
0302U1330524P00 22-05-2024 25-05-2024
116 0000120360508 NORDIANA P - gastroenteritis of Berobat Jalan
0481 00:00 19:46
presumed infectious origin

0302U1330524P00 22-05-2024 22-05-2024

117 0000120833537 KARYONO L PNS DAERAH Headache Berobat Jalan Hipertensi Hipertensi
0472 00:00 20:14
Insulin-dependent
0302U1330524P00 22-05-2024 22-05-2024 Diabetes Diabetes
118 0000148844081 MUHAMMAD SALEH AFIF L PNS DAERAH diabetes mellitus without Rujuk Vertikal
0476 00:00 20:48 Mellitus Mellitus
complications
0302U1330524P00 22-05-2024 27-05-2024 PEKERJA
119 0001320662665 SRINAH P Fever, unspecified Berobat Jalan
0500 00:00 20:01 MANDIRI
0302U1330524P00 22-05-2024 22-05-2024 PEGAWAI
120 0001408500933 JONI PALUARAN L Fever, unspecified Berobat Jalan
0473 00:00 20:15 SWASTA
0302U1330524P00 22-05-2024 27-05-2024
121 0001545214419 KRISTINA DAUN SARIRA P - Fever, unspecified Berobat Jalan
0514 00:00 21:18
0302U1330524P00 22-05-2024 27-05-2024 PEGAWAI
122 0001545216592 NAOMI SAKKUNG P Headache Berobat Jalan Hipertensi
0513 00:00 21:17 SWASTA
0302U1330524P00 22-05-2024 27-05-2024 PEGAWAI
123 0001545914395 YOHANIS SALLAA L Headache Berobat Jalan
0501 00:00 20:01 SWASTA
0302U1330524P00 22-05-2024 27-05-2024 PEGAWAI
124 0001548763569 RUDI GOLMER L Headache Berobat Jalan
0511 00:00 21:16 SWASTA
0302U1330524P00 22-05-2024 27-05-2024 PEGAWAI
125 0001611058048 RUSNAWATI P Fever, unspecified Berobat Jalan Hipertensi
0517 00:00 21:18 SWASTA
0302U1330524P00 22-05-2024 27-05-2024
126 0001654906149 MUHAMMAD YUNUS L - Headache Berobat Jalan
0505 00:00 20:02
0302U1330524P00 22-05-2024 27-05-2024 PEGAWAI Acute pharyngitis,
127 0001654906151 MARMI P Berobat Jalan
0518 00:00 21:19 SWASTA unspecified
0302U1330524P00 22-05-2024 25-05-2024 PEKERJA
128 0001722744268 BUNGATI P Fever, unspecified Berobat Jalan
0484 00:00 19:47 MANDIRI
0302U1330524P00 22-05-2024 25-05-2024 MUHAMMAD DEDY PEKERJA
129 0001722744281 L Dyspepsia Berobat Jalan
0483 00:00 19:47 AKMAL MANDIRI
0302U1330524P00 22-05-2024 27-05-2024 PEGAWAI
130 0001788345404 ARDI PERMANA PUTRA L Headache Berobat Jalan
0515 00:00 21:18 SWASTA
0302U1330524P00 22-05-2024 27-05-2024 PEKERJA Acute pharyngitis,
131 0001798614292 NURSANI P Berobat Jalan
0512 00:00 21:17 MANDIRI unspecified
0302U1330524P00 22-05-2024 27-05-2024
132 0001860173133 ISNAWATI P PNS DAERAH Infective dermatitis Berobat Jalan
0494 00:00 19:59
0302U1330524P00 22-05-2024 27-05-2024 SERAFINUS ELVANDO PEGAWAI
133 0001906509903 L Headache Berobat Jalan
0492 00:00 19:58 SATRIA PRATAMA SWASTA
 DAFTAR KUNJUNGAN PESERTA SAKIT

Kantor Cabang : SAMARINDA - 1601

FKTP : dr Hotman Wilson S - 0302U133

0302U1330524P00 22-05-2024 27-05-2024 PEGAWAI Acute upper respiratory

134 0001927894509 HAIRANI L Berobat Jalan
0499 00:00 20:00 SWASTA infection, unspecified
0302U1330524P00 22-05-2024 27-05-2024 Acute pharyngitis,
135 0001931729962 AHMAD RIFQI HAMIZAN L - Berobat Jalan
0503 00:00 20:02 unspecified
0302U1330524P00 22-05-2024 27-05-2024 Acute upper respiratory
136 0002078805071 RUSNAINI P - Berobat Jalan
0516 00:00 21:18 infection, unspecified
0302U1330524P00 22-05-2024 27-05-2024
137 0002200143969 SIA BIN TOA P PBI (APBN) Fever, unspecified Berobat Jalan
0504 00:00 20:02
0302U1330524P00 22-05-2024 27-05-2024 PEKERJA Acute pharyngitis,
138 0002226427503 HJ.MARWIYAH P Berobat Jalan
0502 00:00 20:01 MANDIRI unspecified
0302U1330524P00 22-05-2024 27-05-2024
139 0002239457646 DARMAWAN L - Fever, unspecified Berobat Jalan
0510 00:00 21:16
Medical observation and
0302U1330524P00 22-05-2024 22-05-2024
140 0002239458693 WINDA APRIANTY P PBI (APBD) evaluation for suspected Berobat Jalan
0475 00:00 20:16
diseases and conditions
0302U1330524P00 22-05-2024 27-05-2024 PEKERJA
141 0002263402258 NURHAYATI P Gastritis, unspecified Berobat Jalan
0497 00:00 20:00 MANDIRI
0302U1330524P00 22-05-2024 27-05-2024
142 0002263402574 RINJANI BADRIYAH PUTRI P - Headache Berobat Jalan
0498 00:00 20:00
0302U1330524P00 22-05-2024 25-05-2024 RAJENDRA RAMADHAN PEKERJA
143 0002263409998 L Headache Berobat Jalan
0482 00:00 19:46 BASUKI MANDIRI
0302U1330524P00 22-05-2024 25-05-2024 PEKERJA Acute upper respiratory
144 0002265099851 VENDY TUMIGOLUNG L Berobat Jalan
0480 00:00 19:46 MANDIRI infection, unspecified
0302U1330524P00 22-05-2024 22-05-2024
145 0002422859196 MUHAMMAD AZID RIFKI L PBI (APBD) Hearing loss, unspecified Rujuk Vertikal
0471 00:00 20:09
PEGAWAI
PEMERINTAH
0302U1330524P00 22-05-2024 27-05-2024 MUHAMMAD ABIDZAR AL
146 0002464816757 L DENGAN Fever, unspecified Berobat Jalan
0493 00:00 19:58 FARABI
PERJANJIAN
KERJA
0302U1330524P00 22-05-2024 25-05-2024 PEKERJA
147 0002475139061 SYAHRIANI P Headache Berobat Jalan
0485 00:00 19:50 MANDIRI
0302U1330524P00 22-05-2024 27-05-2024 PEKERJA Acute upper respiratory
148 0002773950614 SUKRI L Berobat Jalan
0495 00:00 19:59 MANDIRI infection, unspecified
0302U1330524P00 22-05-2024 27-05-2024 PEGAWAI
149 0002914568425 SUPRIADI RUPA' L Fever, unspecified Berobat Jalan
0496 00:00 19:59 SWASTA
0302U1330524P00 22-05-2024 22-05-2024 KEENAN ALVARENDRA PEGAWAI
150 0003132426633 L Fever, unspecified Berobat Jalan
0474 00:00 20:15 PURNAMA SWASTA
0302U1330524P00 22-05-2024 25-05-2024 CHARIS TRIVENA POLIN PEKERJA
151 0003526493657 P Headache Berobat Jalan
0479 00:00 19:45 TUMIGOLUNG MANDIRI
 DAFTAR KUNJUNGAN PESERTA SAKIT

Kantor Cabang : SAMARINDA - 1601

FKTP : dr Hotman Wilson S - 0302U133

0302U1330524P00 21-05-2024 22-05-2024 PENERIMA

152 0000120314046 CHAIRIL ANWAR L Fever, unspecified Berobat Jalan
0437 00:00 18:41 PENSIUN PNS
0302U1330524P00 21-05-2024 21-05-2024 NICKEN RAHMADANI PEGAWAI Other and unspecified
153 0000120534287 P Rujuk Vertikal
0417 00:00 19:17 NASTITI SWASTA ovarian cysts
0302U1330524P00 21-05-2024 22-05-2024
154 0000902033649 MUHAMMAD YUSUF L PBI (APBN) Fever, unspecified Berobat Jalan
0457 00:00 19:47
PEGAWAI
PEMERINTAH
0302U1330524P00 21-05-2024 22-05-2024
155 0001389795963 ARBAYAH P DENGAN Headache Berobat Jalan
0439 00:00 18:43
PERJANJIAN
KERJA
0302U1330524P00 21-05-2024 21-05-2024 PEKERJA Chronic renal failure,
156 0001424699559 ROSMINI P Rujuk Vertikal
0422 00:00 21:04 MANDIRI unspecified
0302U1330524P00 21-05-2024 22-05-2024 PEKERJA
157 0001435155311 SUSILOWATI P Headache Berobat Jalan
0436 00:00 18:40 MANDIRI
0302U1330524P00 21-05-2024 22-05-2024 Acute pharyngitis,
158 0001545214419 KRISTINA DAUN SARIRA P - Berobat Jalan
0463 00:00 19:50 unspecified
0302U1330524P00 21-05-2024 22-05-2024 DANA YUDHA
159 0001545908938 L - Headache Berobat Jalan
0447 00:00 18:51 DIRGANTARA
0302U1330524P00 21-05-2024 22-05-2024 PEGAWAI
160 0001545912336 ASRIANI P Fever, unspecified Berobat Jalan
0462 00:00 19:50 SWASTA
0302U1330524P00 21-05-2024 22-05-2024 Acute pharyngitis,
161 0001546203947 M FAJAR L - Berobat Jalan
0441 00:00 18:45 unspecified
0302U1330524P00 21-05-2024 22-05-2024 PEGAWAI Acute upper respiratory
162 0001610282979 KURNIANSYAH L Berobat Jalan
0455 00:00 19:47 SWASTA infection, unspecified
0302U1330524P00 21-05-2024 22-05-2024 PEKERJA
163 0001728166511 RIDZKA ADDIA U SYFA P Otitis media, unspecified Berobat Jalan
0464 00:00 19:55 MANDIRI
0302U1330524P00 21-05-2024 22-05-2024
164 0001729457706 MARIANA PORE P INVESTOR Headache Berobat Jalan
0467 00:00 19:57
0302U1330524P00 21-05-2024 22-05-2024
165 0001729457717 WILDAN REHAN L INVESTOR Headache Berobat Jalan
0442 00:00 18:45
0302U1330524P00 21-05-2024 22-05-2024 Acute upper respiratory
166 0001738421357 IDRIS SAWALUDIN L - Berobat Jalan
0452 00:00 19:01 infection, unspecified
0302U1330524P00 21-05-2024 22-05-2024 PEKERJA
167 0001806807126 ACHMAD L Fever, unspecified Berobat Jalan
0453 00:00 19:43 MANDIRI
0302U1330524P00 21-05-2024 22-05-2024
168 0001890945797 EVI TA'BA' P - Headache Berobat Jalan
0454 00:00 19:43
0302U1330524P00 21-05-2024 22-05-2024 Acute pharyngitis,
169 0001926677733 ACHMAD L - Berobat Jalan
0469 00:00 19:59 unspecified
 DAFTAR KUNJUNGAN PESERTA SAKIT

Kantor Cabang : SAMARINDA - 1601

FKTP : dr Hotman Wilson S - 0302U133

0302U1330524P00 21-05-2024 22-05-2024 Acute pharyngitis,

170 0001926677744 HELDA P - Berobat Jalan
0468 00:00 19:58 unspecified
0302U1330524P00 21-05-2024 22-05-2024 RIA ROSIANNA
171 0001962021914 P PNS PUSAT Fever, unspecified Berobat Jalan
0440 00:00 18:44 SIMBOLON
0302U1330524P00 21-05-2024 22-05-2024 PEKERJA
172 0002220673318 SAMING P Headache Berobat Jalan
0445 00:00 18:47 MANDIRI
0302U1330524P00 21-05-2024 22-05-2024 PEKERJA Acute pharyngitis,
173 0002231760126 AGUSTINA P Berobat Jalan
0446 00:00 18:49 MANDIRI unspecified
0302U1330524P00 21-05-2024 22-05-2024 PEKERJA
174 0002237920569 SUPRAYITNO L Headache Berobat Jalan
0451 00:00 19:01 MANDIRI
0302U1330524P00 21-05-2024 22-05-2024
175 0002239458513 WINI JULIANTI P PBI (APBD) Headache Berobat Jalan
0461 00:00 19:49
0302U1330524P00 21-05-2024 21-05-2024 Acute appendicitis,
176 0002239458693 WINDA APRIANTY P PBI (APBD) Rujuk Vertikal
0418 00:00 19:29 unspecified
0302U1330524P00 21-05-2024 22-05-2024
177 0002244421056 KURNIA P PBI (APBD) Infective dermatitis Berobat Jalan
0459 00:00 19:48

Diarrhoea and
0302U1330524P00 21-05-2024 22-05-2024 PEKERJA
178 0002249004813 HARINA P gastroenteritis of Berobat Jalan
0456 00:00 19:47 MANDIRI
presumed infectious origin

0302U1330524P00 21-05-2024 22-05-2024

179 0002283003922 INDO REMANG P PBI (APBN) Fever, unspecified Berobat Jalan
0460 00:00 19:49
0302U1330524P00 21-05-2024 22-05-2024 PEKERJA
180 0002292469042 NURHAYATI P Fever, unspecified Berobat Jalan
0448 00:00 18:52 MANDIRI
0302U1330524P00 21-05-2024 22-05-2024 PEGAWAI
181 0002311359221 YANA P Fever, unspecified Berobat Jalan
0450 00:00 18:53 SWASTA
0302U1330524P00 21-05-2024 22-05-2024
182 0002312665648 MUHAMMAD IQBAL L - Headache Berobat Jalan
0449 00:00 18:53
0302U1330524P00 21-05-2024 22-05-2024 PEKERJA
183 0002327930392 NUR AISYAH P Headache Berobat Jalan
0458 00:00 19:48 MANDIRI
0302U1330524P00 21-05-2024 22-05-2024 PEKERJA
184 0002451586318 SALMAWATI P Fever, unspecified Berobat Jalan
0444 00:00 18:46 MANDIRI
0302U1330524P00 21-05-2024 22-05-2024 PEKERJA
185 0002451586386 MUHAMMAD FATIR L Fever, unspecified Berobat Jalan
0443 00:00 18:45 MANDIRI
0302U1330524P00 21-05-2024 22-05-2024 Acute upper respiratory
186 0002761362213 RATU APRILIA HERSYA P - Berobat Jalan
0470 00:00 19:59 infection, unspecified
0302U1330524P00 21-05-2024 22-05-2024
187 0002906593953 ANASTHASYA OKTAVIANI P - Fever, unspecified Berobat Jalan
0438 00:00 18:42
0302U1330524P00 21-05-2024 22-05-2024 KEENAN ALVARENDRA PEGAWAI
188 0003132426633 L Fever, unspecified Berobat Jalan
0465 00:00 19:56 PURNAMA SWASTA
 DAFTAR KUNJUNGAN PESERTA SAKIT

Kantor Cabang : SAMARINDA - 1601

FKTP : dr Hotman Wilson S - 0302U133

0302U1330524P00 21-05-2024 22-05-2024 AISHA NADHIRA AZ PEGAWAI Acute upper respiratory

189 0003271521071 P Berobat Jalan
0466 00:00 19:56 ZAHRA SWASTA infection, unspecified
0302U1330524P00 20-05-2024 21-05-2024
190 0000010555648 DHEDY IRAWAN L PNS DAERAH Low back pain Berobat Jalan
0420 00:00 19:59
0302U1330524P00 20-05-2024 20-05-2024 PENERIMA Acute renal failure with
191 0000120352116 SUDARMAN L Rujuk Vertikal
0398 00:00 19:59 PENSIUN PNS tubular necrosis
0302U1330524P00 20-05-2024 20-05-2024
192 0000120416398 DARWIS L PNS DAERAH Fever, unspecified Berobat Jalan
0409 00:00 20:38
0302U1330524P00 20-05-2024 20-05-2024 PENERIMA Acute pharyngitis,
193 0000120437234 ISMA BASRI L Berobat Jalan
0404 00:00 20:33 PENSIUN PNS unspecified
0302U1330524P00 20-05-2024 20-05-2024
194 0000120526222 EMIL YANTO L PNS PUSAT Calculus of kidney Rujuk Vertikal
0414 00:00 21:29

Diarrhoea and
0302U1330524P00 20-05-2024 20-05-2024 PENERIMA
195 0000120830646 NGADINEM P gastroenteritis of Berobat Jalan
0384 00:00 18:44 PENSIUN PNS
presumed infectious origin

0302U1330524P00 20-05-2024 20-05-2024 Essential (primary)

196 0000120862923 AMINATUS SHOLIHAH P - Berobat Jalan
0355 00:00 15:19 hypertension
0302U1330524P00 20-05-2024 20-05-2024 RIDHO ADRIANE PIO
197 0000209205819 L PNS DAERAH Headache Berobat Jalan
0410 00:00 20:39 MACHARUMFA
0302U1330524P00 20-05-2024 20-05-2024 Acute upper respiratory
198 0000902033649 MUHAMMAD YUSUF L PBI (APBN) Berobat Jalan
0405 00:00 20:34 infection, unspecified
PEGAWAI
PEMERINTAH
0302U1330524P00 20-05-2024 22-05-2024
199 0001125248354 ANGGREA MARDIN L DENGAN Headache Berobat Jalan
0430 00:00 18:24
PERJANJIAN
KERJA
0302U1330524P00 20-05-2024 22-05-2024 PEGAWAI Acute pharyngitis,
200 0001179587878 HERU HANDOKO L Berobat Jalan
0425 00:00 18:20 SWASTA unspecified
0302U1330524P00 20-05-2024 20-05-2024 PEGAWAI
201 0001285304613 RAHMAWATI P Fever, unspecified Berobat Jalan
0388 00:00 18:47 SWASTA
0302U1330524P00 20-05-2024 20-05-2024 PEKERJA
202 0001435154286 WIDJANARKO L Dyspepsia Berobat Jalan
0401 00:00 20:32 MANDIRI
0302U1330524P00 20-05-2024 20-05-2024 PEKERJA
203 0001480219288 NURHIDAYAH PANCE P Otitis media, unspecified Rujuk Vertikal
0396 00:00 19:51 MANDIRI
0302U1330524P00 20-05-2024 20-05-2024 AURELY NAJWA Acute pharyngitis,
204 0001545914417 P - Berobat Jalan
0390 00:00 18:52 MARIANGGA unspecified
0302U1330524P00 20-05-2024 21-05-2024 PEGAWAI
205 0001611058037 SAMSURI L Headache Berobat Jalan Hipertensi
0419 00:00 19:40 SWASTA
 DAFTAR KUNJUNGAN PESERTA SAKIT

Kantor Cabang : SAMARINDA - 1601

FKTP : dr Hotman Wilson S - 0302U133

0302U1330524P00 20-05-2024 22-05-2024

206 0001651262916 ABIANUS L - Headache Berobat Jalan
0431 00:00 18:29
0302U1330524P00 20-05-2024 20-05-2024 MUHAMMAD DEDY PEKERJA
207 0001722744281 L Gastritis, unspecified Berobat Jalan
0391 00:00 18:52 AKMAL MANDIRI
0302U1330524P00 20-05-2024 20-05-2024 PEKERJA
208 0001798898646 MUHAMMAD ASSABIRIN L Dyspepsia Berobat Jalan
0385 00:00 18:44 MANDIRI
0302U1330524P00 20-05-2024 20-05-2024 PEKERJA
209 0001799147125 jariah P Fever, unspecified Berobat Jalan
0387 00:00 18:45 MANDIRI
0302U1330524P00 20-05-2024 20-05-2024 PEKERJA Acute pharyngitis,
210 0001806807126 ACHMAD L Berobat Jalan
0399 00:00 20:31 MANDIRI unspecified
0302U1330524P00 20-05-2024 20-05-2024 PEKERJA Acute pharyngitis,
211 0001806825701 DARMIATI P Berobat Jalan
0403 00:00 20:33 MANDIRI unspecified
PEGAWAI
PEMERINTAH
0302U1330524P00 20-05-2024 22-05-2024 Acute upper respiratory
212 0001837680974 TRISNAWATI P DENGAN Berobat Jalan
0426 00:00 18:21 infection, unspecified
PERJANJIAN
KERJA

Diarrhoea and
0302U1330524P00 20-05-2024 22-05-2024
213 0001923481822 HJ.MASANG P PBI (APBN) gastroenteritis of Berobat Jalan Hipertensi
0427 00:00 18:21
presumed infectious origin

0302U1330524P00 20-05-2024 20-05-2024 PEGAWAI

214 0001923504658 NINGSIH P Arthrosis, unspecified Rujuk Vertikal
0397 00:00 19:57 SWASTA
0302U1330524P00 20-05-2024 22-05-2024 Essential (primary)
215 0001928464536 PITER L - Berobat Jalan
0435 00:00 18:37 hypertension
0302U1330524P00 20-05-2024 22-05-2024 LINDA ESLINA PEGAWAI
216 0001929478364 P Fever, unspecified Berobat Jalan
0428 00:00 18:22 LUMBANTORUAN SWASTA
0302U1330524P00 20-05-2024 22-05-2024 MIKAEL SEPTIAN PEGAWAI
217 0001929478375 L Fever, unspecified Berobat Jalan
0433 00:00 18:35 SIAHAAN SWASTA
0302U1330524P00 20-05-2024 22-05-2024 YUDHA PRAYOGA PEGAWAI
218 0002001388048 L Fever, unspecified Berobat Jalan
0434 00:00 18:36 ROSIAN SWASTA
0302U1330524P00 20-05-2024 20-05-2024 SAID MUHAMMAD NUR
219 0002080969244 L PBI (APBN) Fever, unspecified Berobat Jalan
0386 00:00 18:45 AULIA RAHMAN
0302U1330524P00 20-05-2024 22-05-2024 Acute upper respiratory
220 0002097070672 AHMAD NUR FAIZ L PEGAWAI BUMN Berobat Jalan
0432 00:00 18:35 infection, unspecified
PEGAWAI
PEMERINTAH
0302U1330524P00 20-05-2024 20-05-2024 Cutaneous abscess,
221 0002210884457 NURDIYANTI P DENGAN Rujuk Vertikal
0407 00:00 20:35 furuncle and carbuncle
PERJANJIAN
KERJA
 DAFTAR KUNJUNGAN PESERTA SAKIT

Kantor Cabang : SAMARINDA - 1601

FKTP : dr Hotman Wilson S - 0302U133

0302U1330524P00 20-05-2024 20-05-2024 NUR ZHAFEERA AHMAD

222 0002211729287 P - Fever, unspecified Berobat Jalan
0393 00:00 19:16 BARAQBAH
False labour before 37
0302U1330524P00 20-05-2024 21-05-2024
223 0002216755956 AGUSTINA P - completed weeks of Rujuk Vertikal
0415 00:00 16:12
gestation
0302U1330524P00 20-05-2024 20-05-2024 PEKERJA
224 0002231600038 KUSMIYADI L Congestive heart failure Rujuk Vertikal
0395 00:00 19:40 MANDIRI
0302U1330524P00 20-05-2024 20-05-2024 PEKERJA
225 0002235953979 ROSMIATI P Headache Berobat Jalan
0400 00:00 20:31 MANDIRI
0302U1330524P00 20-05-2024 20-05-2024 PEKERJA Acute pharyngitis,
226 0002249004813 HARINA P Berobat Jalan
0402 00:00 20:32 MANDIRI unspecified
0302U1330524P00 20-05-2024 21-05-2024 Pregnancy-related
227 0002273926713 KARMILA P PBI (APBN) Rujuk Vertikal
0416 00:00 18:52 condition, unspecified
0302U1330524P00 20-05-2024 20-05-2024 RAFID ALIEVAN DAF
228 0002294138395 L PNS DAERAH Fever, unspecified Berobat Jalan
0408 00:00 20:37 MACHARUMFA
0302U1330524P00 20-05-2024 20-05-2024 PEKERJA
229 0002299915923 MURTALA MALLU L Headache Rujuk Vertikal
0413 00:00 21:16 MANDIRI

Diarrhoea and
0302U1330524P00 20-05-2024 20-05-2024
230 0002310198423 DEFIN GANI RAHMAN L - gastroenteritis of Berobat Jalan
0389 00:00 18:48
presumed infectious origin

0302U1330524P00 20-05-2024 20-05-2024 PEKERJA

231 0002327930392 NUR AISYAH P Fever, unspecified Berobat Jalan
0406 00:00 20:34 MANDIRI
0302U1330524P00 20-05-2024 20-05-2024
232 0002470788538 ITJE J RUMAGIT P PBI (APBN) Thyroiditis, unspecified Rujuk Vertikal
0394 00:00 19:20
0302U1330524P00 20-05-2024 20-05-2024 PEKERJA
233 0002475139061 SYAHRIANI P Headache Berobat Jalan
0392 00:00 18:52 MANDIRI
PEGAWAI
PEMERINTAH
0302U1330524P00 20-05-2024 22-05-2024 NUR ZAYNAB AHMAD Acute upper respiratory
234 0002774134372 P DENGAN Berobat Jalan
0429 00:00 18:22 BARAQBAH infection, unspecified
PERJANJIAN
KERJA
PEGAWAI
PEMERINTAH
0302U1330524P00 20-05-2024 20-05-2024 KHAYLA AZZAHRA
235 0002894974143 P DENGAN Fever, unspecified Berobat Jalan
0411 00:00 20:47 MARDIN
PERJANJIAN
KERJA
General examination and
0302U1330524P00 20-05-2024 22-05-2024 PEKERJA investigation of persons
236 0002917532946 ABDUL AZIS L Berobat Jalan
0424 00:00 18:20 MANDIRI without complaint and
reported diagnosis
 DAFTAR KUNJUNGAN PESERTA SAKIT

Kantor Cabang : SAMARINDA - 1601

FKTP : dr Hotman Wilson S - 0302U133

PEGAWAI
PEMERINTAH
0302U1330524P00 20-05-2024 22-05-2024 Acute upper respiratory
237 0003534654104 shanum rizkanaya aisyah P DENGAN Berobat Jalan
0423 00:00 18:19 infection, unspecified
PERJANJIAN
KERJA
0302U1330524P00 20-05-2024 20-05-2024 MUHAMMAD FAQIH PEKERJA
238 0003540715964 L Headache Berobat Jalan
0412 00:00 20:50 ARKANA MANDIRI
0302U1330524P00 18-05-2024 20-05-2024 Acute upper respiratory
239 0000120338559 BUDI SAHJAYA L PNS DAERAH Berobat Jalan
0378 00:00 15:34 infection, unspecified
Medical observation and
0302U1330524P00 18-05-2024 20-05-2024
240 0000120534996 EUIS SUCIATI P - evaluation for suspected Berobat Jalan
0379 00:00 15:35
diseases and conditions
0302U1330524P00 18-05-2024 20-05-2024 Essential (primary)
241 0000120862912 SUBAKIR L - Berobat Jalan Hipertensi
0356 00:00 15:20 hypertension
0302U1330524P00 18-05-2024 20-05-2024 Essential (primary)
242 0000120862923 AMINATUS SHOLIHAH P - Berobat Jalan Hipertensi
0383 00:00 18:21 hypertension
0302U1330524P00 18-05-2024 20-05-2024 AGUNG RIFANEO PEGAWAI
243 0000166528023 L Infective dermatitis Berobat Jalan
0380 00:00 15:36 INDRAPUTRA SWASTA
0302U1330524P00 18-05-2024 20-05-2024 Acute upper respiratory
244 0000166528091 DIVA FARNITA RIFANEO P PNS DAERAH Berobat Jalan
0370 00:00 15:28 infection, unspecified
0302U1330524P00 18-05-2024 20-05-2024 Essential (primary)
245 0001136368585 MUHAMMAD BASRI L - Berobat Jalan Hipertensi
0360 00:00 15:22 hypertension
0302U1330524P00 18-05-2024 20-05-2024 PEKERJA
246 0001180874799 JAITUN P Headache Berobat Jalan
0369 00:00 15:28 MANDIRI
0302U1330524P00 18-05-2024 20-05-2024 PEKERJA Acute pharyngitis,
247 0001188125594 ABIGAEL ANDATUH P Berobat Jalan
0373 00:00 15:30 MANDIRI unspecified
0302U1330524P00 18-05-2024 20-05-2024 PEGAWAI
248 0001545918377 EDIL JUMADI L Headache Berobat Jalan
0381 00:00 15:36 SWASTA
0302U1330524P00 18-05-2024 20-05-2024 PEGAWAI Essential (primary)
249 0001611058037 SAMSURI L Berobat Jalan Hipertensi
0363 00:00 15:24 SWASTA hypertension
0302U1330524P00 18-05-2024 20-05-2024 PEGAWAI Essential (primary)
250 0001611058048 RUSNAWATI P Berobat Jalan Hipertensi
0364 00:00 15:24 SWASTA hypertension
0302U1330524P00 18-05-2024 20-05-2024 Essential (primary)
251 0001728166487 HENDRI ARRASYID L - Berobat Jalan Hipertensi
0362 00:00 15:23 hypertension
0302U1330524P00 18-05-2024 20-05-2024 Essential (primary)
252 0001728166498 SURYATI AZIZ P - Berobat Jalan Hipertensi
0361 00:00 15:23 hypertension
0302U1330524P00 18-05-2024 20-05-2024 Acute upper respiratory
253 0001729457706 MARIANA PORE P INVESTOR Berobat Jalan
0374 00:00 15:30 infection, unspecified
0302U1330524P00 18-05-2024 20-05-2024
254 0001729457717 WILDAN REHAN L INVESTOR Infective dermatitis Berobat Jalan
0372 00:00 15:29
 DAFTAR KUNJUNGAN PESERTA SAKIT

Kantor Cabang : SAMARINDA - 1601

FKTP : dr Hotman Wilson S - 0302U133

0302U1330524P00 18-05-2024 20-05-2024 Essential (primary)

255 0001807069566 ASNAWI L - Berobat Jalan Hipertensi
0354 00:00 15:19 hypertension
0302U1330524P00 18-05-2024 20-05-2024 Essential (primary)
256 0001923719804 SABRIANI P - Berobat Jalan Hipertensi
0351 00:00 15:17 hypertension
0302U1330524P00 18-05-2024 20-05-2024 PEKERJA
257 0001927293513 VALEN SATRIA FEBRIAN L Headache Berobat Jalan
0375 00:00 15:31 MANDIRI
0302U1330524P00 18-05-2024 20-05-2024 Essential (primary)
258 0002093294722 HARIANI P - Berobat Jalan Hipertensi Hipertensi
0357 00:00 15:21 hypertension
0302U1330524P00 18-05-2024 20-05-2024
259 0002198050817 MUHAMMAD AL MADHANI L PNS DAERAH Infective dermatitis Berobat Jalan
0371 00:00 15:29
0302U1330524P00 18-05-2024 20-05-2024 Essential (primary)
260 0002213352819 ADRIANSYAH L - Berobat Jalan Hipertensi
0359 00:00 15:22 hypertension
0302U1330524P00 18-05-2024 20-05-2024 Essential (primary)
261 0002213352876 SAIDAH P - Berobat Jalan Hipertensi
0358 00:00 15:21 hypertension
0302U1330524P00 18-05-2024 20-05-2024 Essential (primary)
262 0002227379703 HERIYANTO L - Berobat Jalan Hipertensi
0366 00:00 15:26 hypertension
0302U1330524P00 18-05-2024 20-05-2024 Essential (primary)
263 0002227379848 ROBIAH P - Berobat Jalan Hipertensi
0365 00:00 15:25 hypertension
0302U1330524P00 18-05-2024 20-05-2024
264 0002239458298 MARHAENI P PBI (APBD) Gastric ulcer Berobat Jalan
0376 00:00 15:32
Localized swelling, mass
0302U1330524P00 18-05-2024 20-05-2024
265 0002239458513 WINI JULIANTI P PBI (APBD) and lump of skin and Berobat Jalan
0377 00:00 15:33
subcutaneous tissue
0302U1330524P00 18-05-2024 20-05-2024 PENERIMA Acute pharyngitis,
266 0002262098417 FITRIANY P Berobat Jalan
0367 00:00 15:26 PENSIUN PNS unspecified
0302U1330524P00 18-05-2024 20-05-2024 PENERIMA
267 0002262098608 ALIF AHMAD KOETAI L Dyspepsia Berobat Jalan
0368 00:00 15:27 PENSIUN PNS
0302U1330524P00 18-05-2024 20-05-2024 Essential (primary)
268 0002313464343 THOBER L - Berobat Jalan Hipertensi
0352 00:00 15:18 hypertension
0302U1330524P00 18-05-2024 20-05-2024 PEGAWAI
269 0002314738798 OMO SISWANTO L Low back pain Berobat Jalan
0382 00:00 15:37 SWASTA
0302U1330524P00 18-05-2024 20-05-2024 Essential (primary)
270 0002375657177 DINA ASIK ALLO P - Berobat Jalan Hipertensi
0353 00:00 15:18 hypertension
0302U1330524P00 18-05-2024 18-05-2024 PEKERJA Calculus of kidney and
271 0002764892362 KORINTUS L Rujuk Vertikal
0350 00:00 19:49 MANDIRI ureter
0302U1330524P00 17-05-2024 17-05-2024 PENERIMA
272 0000120285573 SYAMSIAH P Headache Berobat Jalan
0321 00:00 19:40 PENSIUN PNS
Gastro-oesophageal reflux
0302U1330524P00 17-05-2024 18-05-2024 LUCIANUS HANDRI
273 0000120528652 L PNS PUSAT disease without Berobat Jalan
0342 00:00 19:23 GUNANTO
oesophagitis
 DAFTAR KUNJUNGAN PESERTA SAKIT

Kantor Cabang : SAMARINDA - 1601

FKTP : dr Hotman Wilson S - 0302U133

0302U1330524P00 17-05-2024 17-05-2024

274 0000120534985 ERIANSYAH L - Headache Berobat Jalan
0319 00:00 19:39
PEGAWAI
PEMERINTAH
0302U1330524P00 17-05-2024 18-05-2024
275 0001202212056 NENENG PUSPITA DEWI P DENGAN Headache Berobat Jalan
0341 00:00 19:23
PERJANJIAN
KERJA
0302U1330524P00 17-05-2024 17-05-2024 PEKERJA
276 0001320662665 SRINAH P Fever, unspecified Berobat Jalan
0327 00:00 19:44 MANDIRI
0302U1330524P00 17-05-2024 18-05-2024 PEKERJA
277 0001435155311 SUSILOWATI P Headache Berobat Jalan
0348 00:00 19:42 MANDIRI
0302U1330524P00 17-05-2024 18-05-2024 PEGAWAI
278 0001474429465 PUSPITA INDAH ROSIAN P Headache Berobat Jalan
0344 00:00 19:37 SWASTA
0302U1330524P00 17-05-2024 18-05-2024 PEKERJA
279 0001480219288 NURHIDAYAH PANCE P Hearing loss, unspecified Berobat Jalan
0343 00:00 19:25 MANDIRI
0302U1330524P00 17-05-2024 18-05-2024
280 0001545214419 KRISTINA DAUN SARIRA P - Fever, unspecified Berobat Jalan
0349 00:00 19:45
0302U1330524P00 17-05-2024 17-05-2024 PEGAWAI Acute pharyngitis,
281 0001545914395 YOHANIS SALLAA L Berobat Jalan
0328 00:00 19:46 SWASTA unspecified
0302U1330524P00 17-05-2024 17-05-2024 PEGAWAI
282 0001545917365 DEDY IRAWAN L Fever, unspecified Berobat Jalan
0336 00:00 19:51 SWASTA
0302U1330524P00 17-05-2024 18-05-2024 PEGAWAI
283 0001546444495 RUSLIYANA ROLAND P Fever, unspecified Berobat Jalan
0345 00:00 19:38 SWASTA
0302U1330524P00 17-05-2024 17-05-2024 PEGAWAI Other and unspecified
284 0001550683438 MARSUKI PAMUTTU L Rujuk Vertikal
0317 00:00 19:26 SWASTA premature depolarization
0302U1330524P00 17-05-2024 17-05-2024 PEGAWAI
285 0001550683449 RIBKA MALLARI P Headache Berobat Jalan
0316 00:00 19:24 SWASTA
0302U1330524P00 17-05-2024 17-05-2024 PEGAWAI
286 0001611058048 RUSNAWATI P Headache Berobat Jalan Hipertensi
0333 00:00 19:49 SWASTA

Diarrhoea and
0302U1330524P00 17-05-2024 17-05-2024
287 0001654906149 MUHAMMAD YUNUS L - gastroenteritis of Berobat Jalan
0331 00:00 19:48
presumed infectious origin

0302U1330524P00 17-05-2024 17-05-2024 PEGAWAI

288 0001654906151 MARMI P Fever, unspecified Berobat Jalan
0332 00:00 19:48 SWASTA
0302U1330524P00 17-05-2024 18-05-2024 PEKERJA Acute pharyngitis,
289 0001727845626 MUCHLIS FADILLAH L Berobat Jalan
0338 00:00 19:21 MANDIRI unspecified
0302U1330524P00 17-05-2024 18-05-2024
290 0001729457706 MARIANA PORE P INVESTOR Fever, unspecified Berobat Jalan
0340 00:00 19:22
 DAFTAR KUNJUNGAN PESERTA SAKIT

Kantor Cabang : SAMARINDA - 1601

FKTP : dr Hotman Wilson S - 0302U133

0302U1330524P00 17-05-2024 17-05-2024 PEGAWAI Acute upper respiratory

291 0001788345404 ARDI PERMANA PUTRA L Berobat Jalan
0335 00:00 19:50 SWASTA infection, unspecified
0302U1330524P00 17-05-2024 17-05-2024 PEGAWAI Acute upper respiratory
292 0001818613438 ALDHIE DWI PUTRA L Berobat Jalan
0329 00:00 19:47 SWASTA infection, unspecified
0302U1330524P00 17-05-2024 17-05-2024 Acute upper respiratory
293 0001860173133 ISNAWATI P PNS DAERAH Berobat Jalan
0322 00:00 19:40 infection, unspecified
Medical observation and
0302U1330524P00 17-05-2024 18-05-2024
294 0001860174347 NURDIANSYAH L PNS DAERAH evaluation for suspected Berobat Jalan
0337 00:00 19:20
diseases and conditions

Diarrhoea and
0302U1330524P00 17-05-2024 17-05-2024 PEGAWAI
295 0001927894509 HAIRANI L gastroenteritis of Berobat Jalan
0326 00:00 19:44 SWASTA
presumed infectious origin

0302U1330524P00 17-05-2024 17-05-2024 LINDA ESLINA PEGAWAI

296 0001929478364 P Gastritis, unspecified Berobat Jalan
0334 00:00 19:49 LUMBANTORUAN SWASTA
0302U1330524P00 17-05-2024 17-05-2024 PEGAWAI
297 0001929517942 ROSNAWATI P Fever, unspecified Berobat Jalan
0320 00:00 19:40 SWASTA
0302U1330524P00 17-05-2024 18-05-2024 MUHAMMAD RAFA PEGAWAI
298 0002195827705 L Fever, unspecified Berobat Jalan
0347 00:00 19:41 SETIAWAN SWASTA
0302U1330524P00 17-05-2024 17-05-2024
299 0002200143969 SIA BIN TOA P PBI (APBN) Headache Berobat Jalan
0330 00:00 19:47
0302U1330524P00 17-05-2024 17-05-2024 PEGAWAI
300 0002210038097 HERMANSYAH L Headache Berobat Jalan
0318 00:00 19:32 SWASTA
0302U1330524P00 17-05-2024 17-05-2024 PEKERJA Acute pharyngitis,
301 0002263402258 NURHAYATI P Berobat Jalan
0324 00:00 19:42 MANDIRI unspecified
0302U1330524P00 17-05-2024 17-05-2024
302 0002263402574 RINJANI BADRIYAH PUTRI P - Fever, unspecified Berobat Jalan
0325 00:00 19:43
0302U1330524P00 17-05-2024 18-05-2024 PEGAWAI
303 0002286095872 RAHMAH ROLAND P Headache Berobat Jalan
0346 00:00 19:38 SWASTA
0302U1330524P00 17-05-2024 17-05-2024 Acute pharyngitis,
304 0002310196634 MUSTAFA L - Berobat Jalan
0315 00:00 19:23 unspecified
0302U1330524P00 17-05-2024 17-05-2024
305 0002310198671 DANU AKBAR RABBANI L - Fever, unspecified Berobat Jalan
0314 00:00 19:22
0302U1330524P00 17-05-2024 17-05-2024 PEGAWAI
306 0002914568425 SUPRIADI RUPA' L Fever, unspecified Berobat Jalan
0323 00:00 19:41 SWASTA
0302U1330524P00 17-05-2024 18-05-2024 PEGAWAI
307 0003273358869 RANIA SHANUM HERSYA P Cough Berobat Jalan
0339 00:00 19:22 SWASTA
 DAFTAR KUNJUNGAN PESERTA SAKIT

Kantor Cabang : SAMARINDA - 1601

FKTP : dr Hotman Wilson S - 0302U133

Diarrhoea and
0302U1330524P00 16-05-2024 17-05-2024
308 0000120355929 RINI ELIANA P - gastroenteritis of Berobat Jalan
0296 00:00 18:43
presumed infectious origin

0302U1330524P00 16-05-2024 17-05-2024 PEGAWAI

309 0000120360521 NIDIA KARUNIA AISYAH P Dyspepsia Berobat Jalan
0304 00:00 18:48 SWASTA
Gastric ulcer, unspecified
0302U1330524P00 16-05-2024 16-05-2024 as acute or chronic,
310 0000120445391 MAULIDA NUR AL-SIFA P - Rujuk Vertikal
0290 00:00 19:39 without haemorrhage or
perforation
0302U1330524P00 16-05-2024 16-05-2024 Non-insulin-dependent Diabetes
311 0000120538585 SUSILOWATI P PNS PUSAT Rujuk Vertikal
0292 00:00 19:52 diabetes mellitus Mellitus
0302U1330524P00 16-05-2024 17-05-2024
312 0000148844092 SRI WINDA ASTUTI P PNS DAERAH Cough Berobat Jalan
0311 00:00 18:54
0302U1330524P00 16-05-2024 17-05-2024 ELIESER PAPA KALLO PEKERJA Essential (primary)
313 0001545214408 L Berobat Jalan Hipertensi
0294 00:00 18:41 LANGI' MANDIRI hypertension
0302U1330524P00 16-05-2024 17-05-2024 CHRISTINE ANASTASIA PEGAWAI Acute pharyngitis,
314 0001610048946 P Berobat Jalan
0293 00:00 18:39 SIBARANI SWASTA unspecified
0302U1330524P00 16-05-2024 16-05-2024 PEGAWAI Thyrotoxicosis
315 0001610990278 JONI SAMBARA L Rujuk Vertikal
0289 00:00 19:23 SWASTA [hyperthyroidism]
0302U1330524P00 16-05-2024 17-05-2024
316 0001724683858 SYAHYUNI L - Infective dermatitis Berobat Jalan
0298 00:00 18:45
0302U1330524P00 16-05-2024 17-05-2024 PEKERJA Acute upper respiratory
317 0001724683882 AULIA NABILA P Berobat Jalan
0297 00:00 18:44 MANDIRI infection, unspecified
0302U1330524P00 16-05-2024 17-05-2024 OKTOVIANUS TANDI
318 0001738749824 L - Fever, unspecified Berobat Jalan
0313 00:00 19:16 BENDON
0302U1330524P00 16-05-2024 17-05-2024 MUHAMMAD NUGIE PEKERJA
319 0001787833034 L Headache Berobat Jalan
0299 00:00 18:46 SUGEHA MANDIRI

Diarrhoea and
0302U1330524P00 16-05-2024 17-05-2024 PEKERJA
320 0001798898646 MUHAMMAD ASSABIRIN L gastroenteritis of Berobat Jalan
0305 00:00 18:49 MANDIRI
presumed infectious origin

0302U1330524P00 16-05-2024 17-05-2024 PEKERJA Acute pharyngitis,

321 0001852677022 ALIMUDDIN SIKKI L Berobat Jalan
0307 00:00 18:50 MANDIRI unspecified
0302U1330524P00 16-05-2024 17-05-2024 PEGAWAI
322 0001928251348 YANUAR SETIADI GUNA L Fever, unspecified Berobat Jalan
0300 00:00 18:46 SWASTA
Medical observation and
0302U1330524P00 16-05-2024 17-05-2024
323 0001928464536 PITER L - evaluation for suspected Berobat Jalan
0312 00:00 18:56
diseases and conditions
 DAFTAR KUNJUNGAN PESERTA SAKIT

Kantor Cabang : SAMARINDA - 1601

FKTP : dr Hotman Wilson S - 0302U133

General examination and

0302U1330524P00 16-05-2024 17-05-2024 investigation of persons
324 0002195057395 NASMIATI SILALAN P - Berobat Jalan
0295 00:00 18:43 without complaint and
reported diagnosis
0302U1330524P00 16-05-2024 17-05-2024 MUHAMMAD AMMAR
325 0002198929353 L PNS DAERAH Infective dermatitis Berobat Jalan
0308 00:00 18:51 SYAHID AFIF
0302U1330524P00 16-05-2024 17-05-2024 PEGAWAI Acute upper respiratory
326 0002218390582 SITI RAMADANNIAH P Berobat Jalan
0310 00:00 18:53 SWASTA infection, unspecified
0302U1330524P00 16-05-2024 17-05-2024 MUHAMMAD NAUFAL PEKERJA
327 0002227380298 L Fever, unspecified Berobat Jalan
0301 00:00 18:46 FAJAR MANDIRI
0302U1330524P00 16-05-2024 17-05-2024 PEKERJA Acute pharyngitis,
328 0002242820384 AGUS SOPYAN L Berobat Jalan
0302 00:00 18:47 MANDIRI unspecified
0302U1330524P00 16-05-2024 17-05-2024 PEKERJA
329 0002276993507 LINDA AGUSTINA P Fever, unspecified Berobat Jalan
0303 00:00 18:47 MANDIRI
0302U1330524P00 16-05-2024 16-05-2024 PEKERJA Malignant neoplasm of
330 0002282930695 COLLENG L Rujuk Vertikal
0291 00:00 19:51 MANDIRI rectum
PEGAWAI
PEMERINTAH Diarrhoea and
0302U1330524P00 16-05-2024 17-05-2024
331 0002451601866 NUR SYAHIDA RASYA P DENGAN gastroenteritis of Berobat Jalan
0309 00:00 18:52
PERJANJIAN presumed infectious origin
KERJA
0302U1330524P00 16-05-2024 17-05-2024 PEKERJA
332 0002939236749 AABID SHAKEEL L Fever, unspecified Berobat Jalan
0306 00:00 18:50 MANDIRI
0302U1330524P00 15-05-2024 15-05-2024 PENERIMA Acute upper respiratory
333 0000120285573 SYAMSIAH P Berobat Jalan
0272 00:00 22:29 PENSIUN PNS infection, unspecified

Diarrhoea and
0302U1330524P00 15-05-2024 15-05-2024 PEGAWAI
334 0001280584629 MUHAMMAD ALAMSYAH L gastroenteritis of Berobat Jalan
0287 00:00 22:36 SWASTA
presumed infectious origin

0302U1330524P00 15-05-2024 15-05-2024 PEKERJA Fracture of forearm, part

335 0001373670336 BUNGA PRUISTIN SAFITRI P Rujuk Vertikal
0245 00:00 20:08 MANDIRI unspecified
0302U1330524P00 15-05-2024 15-05-2024 PEKERJA
336 0001424699559 ROSMINI P Congestive heart failure Rujuk Vertikal
0246 00:00 20:53 MANDIRI
0302U1330524P00 15-05-2024 15-05-2024 PEGAWAI Acute upper respiratory
337 0001546444473 RUSLANSYAH L Berobat Jalan
0288 00:00 22:36 SWASTA infection, unspecified
0302U1330524P00 15-05-2024 15-05-2024 PEGAWAI Acute upper respiratory
338 0001546444484 HERLIANA P Berobat Jalan
0276 00:00 22:31 SWASTA infection, unspecified
0302U1330524P00 15-05-2024 15-05-2024 PEGAWAI
339 0001546444495 RUSLIYANA ROLAND P Fever, unspecified Berobat Jalan
0275 00:00 22:30 SWASTA
0302U1330524P00 15-05-2024 15-05-2024 PEGAWAI
340 0001546444506 RUSYDAH ROLAND P Fever, unspecified Berobat Jalan
0274 00:00 22:30 SWASTA
 DAFTAR KUNJUNGAN PESERTA SAKIT

Kantor Cabang : SAMARINDA - 1601

FKTP : dr Hotman Wilson S - 0302U133

Disorders of lipoprotein
0302U1330524P00 15-05-2024 15-05-2024 PEGAWAI
341 0001631160448 DEWI PUJIARTI P metabolism and other Berobat Jalan
0269 00:00 22:28 SWASTA
lipidaemias
0302U1330524P00 15-05-2024 15-05-2024 Acute pharyngitis,
342 0001654207064 MATHIUS DOMMI L PBI (APBD) Berobat Jalan
0277 00:00 22:31 unspecified
Diabetes
0302U1330524P00 15-05-2024 15-05-2024 Essential (primary) Diabetes
343 0001654207075 YUNITA TONAPA P - Berobat Jalan Mellitus
0278 00:00 22:32 hypertension Mellitus
Hipertensi
0302U1330524P00 15-05-2024 15-05-2024 PEGAWAI
344 0001654207097 NOVITA AKE' TONAPA P Fever, unspecified Berobat Jalan
0248 00:00 20:55 SWASTA
0302U1330524P00 15-05-2024 15-05-2024 PEGAWAI
345 0001831192042 FACHRIYANTI P Gastritis, unspecified Berobat Jalan Hipertensi
0280 00:00 22:33 SWASTA
0302U1330524P00 15-05-2024 15-05-2024 PEGAWAI
346 0001923504658 NINGSIH P Fever, unspecified Berobat Jalan
0282 00:00 22:34 SWASTA
0302U1330524P00 15-05-2024 15-05-2024 PEGAWAI
347 0001969562744 CANDRA L Haemorrhoids Berobat Jalan
0247 00:00 20:54 SWASTA
0302U1330524P00 15-05-2024 15-05-2024 PEKERJA Dysmenorrhoea,
348 0002054242089 NIRMALA WATI P Rujuk Vertikal
0249 00:00 21:00 MANDIRI unspecified
0302U1330524P00 15-05-2024 15-05-2024 MUH. GHAZY DAFFA'
349 0002195057709 L - Headache Berobat Jalan
0270 00:00 22:28 SAMPE
0302U1330524P00 15-05-2024 15-05-2024 PEGAWAI Acute pharyngitis,
350 0002218389873 MUHAMMAD SALEH L Berobat Jalan
0281 00:00 22:33 SWASTA unspecified

Diarrhoea and
0302U1330524P00 15-05-2024 15-05-2024 PEKERJA
351 0002234279777 SAMSIAH P gastroenteritis of Berobat Jalan
0271 00:00 22:29 MANDIRI
presumed infectious origin

0302U1330524P00 15-05-2024 15-05-2024

352 0002236839546 SINTA YANTI P PBI (APBD) Cough Berobat Jalan
0286 00:00 22:35
0302U1330524P00 15-05-2024 15-05-2024 PEGAWAI
353 0002286095872 RAHMAH ROLAND P Fever, unspecified Berobat Jalan
0273 00:00 22:30 SWASTA
0302U1330524P00 15-05-2024 15-05-2024
354 0002422859196 MUHAMMAD AZID RIFKI L PBI (APBD) Cough Berobat Jalan
0285 00:00 22:35
0302U1330524P00 15-05-2024 15-05-2024 PEKERJA
355 0002936124156 MUHAMMAD NAZRIN L Fever, unspecified Berobat Jalan
0279 00:00 22:32 MANDIRI
0302U1330524P00 15-05-2024 15-05-2024 PEGAWAI Acute upper respiratory
356 0003073465844 SUSI SUSANTI P Berobat Jalan
0283 00:00 22:34 SWASTA infection, unspecified
0302U1330524P00 15-05-2024 15-05-2024
357 0003259523272 ASYAFIA SYAHIRA P PBI (APBD) Cough Berobat Jalan
0284 00:00 22:35
0302U1330524P00 14-05-2024 14-05-2024 LUCIANUS HANDRI
358 0000120528652 L PNS PUSAT Haematemesis Rujuk Vertikal
0237 00:00 20:04 GUNANTO
 DAFTAR KUNJUNGAN PESERTA SAKIT

Kantor Cabang : SAMARINDA - 1601

FKTP : dr Hotman Wilson S - 0302U133

0302U1330524P00 14-05-2024 15-05-2024 SRI HARININGRUM

359 0000120531791 P PNS DAERAH Headache Berobat Jalan
0252 00:00 22:17 SULISTYANINGSIH
0302U1330524P00 14-05-2024 15-05-2024
360 0000120532678 SUSANNA P PNS PUSAT Dyspepsia Berobat Jalan
0254 00:00 22:18
0302U1330524P00 14-05-2024 15-05-2024
361 0000120532691 DAVINA MELLYSA P - Infective dermatitis Berobat Jalan
0253 00:00 22:17
0302U1330524P00 14-05-2024 15-05-2024
362 0000902033649 MUHAMMAD YUSUF L PBI (APBN) Cough Berobat Jalan
0263 00:00 22:23
0302U1330524P00 14-05-2024 14-05-2024
363 0000903104515 JUNAEDA P PBI (APBN) Ganglion Rujuk Vertikal
0238 00:00 20:17
0302U1330524P00 14-05-2024 15-05-2024 PEKERJA Acute upper respiratory
364 0001261200611 ARIANI P Berobat Jalan
0258 00:00 22:20 MANDIRI infection, unspecified
0302U1330524P00 14-05-2024 15-05-2024 PEGAWAI
365 0001280585373 HAIRUNISAH P Myalgia Berobat Jalan
0268 00:00 22:26 SWASTA
Pleural effusion in
0302U1330524P00 14-05-2024 14-05-2024 PEGAWAI
366 0001545914147 RUSLYADI L conditions classified Rujuk Vertikal
0239 00:00 20:30 SWASTA
elsewhere
0302U1330524P00 14-05-2024 15-05-2024 PEGAWAI
367 0001545917455 HELMI YANI P Headache Berobat Jalan
0261 00:00 22:22 SWASTA
0302U1330524P00 14-05-2024 14-05-2024 PEGAWAI
368 0001548846123 WIWIEK SRI RAHAYU P Myalgia Berobat Jalan
0234 00:00 19:49 SWASTA
0302U1330524P00 14-05-2024 15-05-2024
369 0001738421357 IDRIS SAWALUDIN L - Headache Berobat Jalan
0243 00:00 18:44
0302U1330524P00 14-05-2024 15-05-2024 Acute pharyngitis,
370 0001738421381 REYHAN ADI SAPUTRA L - Berobat Jalan
0242 00:00 18:43 unspecified

Diarrhoea and
0302U1330524P00 14-05-2024 15-05-2024
371 0001959384666 MARLINA BIU' P - gastroenteritis of Berobat Jalan
0251 00:00 22:16
presumed infectious origin

Diarrhoea and
0302U1330524P00 14-05-2024 15-05-2024 PEGAWAI
372 0001969562744 CANDRA L gastroenteritis of Berobat Jalan
0265 00:00 22:24 SWASTA
presumed infectious origin

0302U1330524P00 14-05-2024 15-05-2024 Acute pharyngitis,

373 0002085298312 IKHSAN SETIYAWAN L - Berobat Jalan
0256 00:00 22:19 unspecified
0302U1330524P00 14-05-2024 15-05-2024 PEKERJA
374 0002201242803 ALIAH P Myalgia Berobat Jalan
0257 00:00 22:20 MANDIRI
0302U1330524P00 14-05-2024 15-05-2024 Acute pharyngitis,
375 0002210598123 HARUDDIN L PBI (APBD) Berobat Jalan
0250 00:00 22:16 unspecified
 DAFTAR KUNJUNGAN PESERTA SAKIT

Kantor Cabang : SAMARINDA - 1601

FKTP : dr Hotman Wilson S - 0302U133

0302U1330524P00 14-05-2024 15-05-2024 Other surgical follow-up

376 0002213724655 RINDA RAHMY AULIA P PNS PUSAT Berobat Jalan
0266 00:00 22:24 care
0302U1330524P00 14-05-2024 14-05-2024 MUHAMMAD ACHSAN PEGAWAI
377 0002234993578 L Status asthmaticus Rujuk Vertikal
0233 00:00 19:42 MAULANA RIZQULLAH SWASTA

Diarrhoea and
0302U1330524P00 14-05-2024 15-05-2024 PEKERJA
378 0002237920569 SUPRAYITNO L gastroenteritis of Berobat Jalan
0241 00:00 18:41 MANDIRI
presumed infectious origin

0302U1330524P00 14-05-2024 15-05-2024

379 0002280007203 NURDIN L - Fever, unspecified Berobat Jalan
0259 00:00 22:21
0302U1330524P00 14-05-2024 14-05-2024 Other and unspecified
380 0002296558348 NURLINA P PBI (APBD) Rujuk Vertikal
0223 00:00 19:30 abdominal pain
0302U1330524P00 14-05-2024 15-05-2024 PEGAWAI
381 0002311359221 YANA P Headache Berobat Jalan
0240 00:00 18:41 SWASTA
PEGAWAI
PEMERINTAH
0302U1330524P00 14-05-2024 14-05-2024
382 0002315278383 ELIANSYAH L DENGAN Headache Berobat Jalan
0235 00:00 19:49
PERJANJIAN
KERJA
0302U1330524P00 14-05-2024 15-05-2024 PEKERJA
383 0002327930392 NUR AISYAH P Headache Berobat Jalan
0264 00:00 22:23 MANDIRI
0302U1330524P00 14-05-2024 15-05-2024 PEKERJA Acute upper respiratory
384 0002498451129 NURJAMAH P Berobat Jalan
0244 00:00 18:49 MANDIRI infection, unspecified
0302U1330524P00 14-05-2024 15-05-2024
385 0003004133591 FIRDAUS L - Fever, unspecified Berobat Jalan
0260 00:00 22:21
0302U1330524P00 14-05-2024 15-05-2024 PEGAWAI
386 0003070259155 PERLI PRANATA L Gastritis, unspecified Berobat Jalan
0255 00:00 22:18 SWASTA
0302U1330524P00 14-05-2024 14-05-2024 KEENAN ALVARENDRA PEGAWAI Acute upper respiratory
387 0003132426633 L Berobat Jalan
0236 00:00 19:50 PURNAMA SWASTA infection, unspecified
0302U1330524P00 14-05-2024 15-05-2024
388 0003284789332 SYAHRUDDIN L - Cough Berobat Jalan
0262 00:00 22:22
0302U1330524P00 14-05-2024 15-05-2024 AZIZAH MAHRAMI Acute upper respiratory
389 0003535640583 P - Berobat Jalan
0267 00:00 22:25 SALSABILA infection, unspecified
0302U1330524P00 13-05-2024 13-05-2024 Acute upper respiratory
390 0000120360508 NORDIANA P - Berobat Jalan
0191 00:00 20:55 infection, unspecified
0302U1330524P00 13-05-2024 14-05-2024 PEGAWAI Acute pharyngitis,
391 0000120441881 MUNAWWAROH P Berobat Jalan
0228 00:00 19:39 SWASTA unspecified
0302U1330524P00 13-05-2024 13-05-2024 PENERIMA
392 0000120723682 ADILAH HUDA HANIM P Pterygium Rujuk Vertikal
0171 00:00 20:11 PENSIUN PNS
 DAFTAR KUNJUNGAN PESERTA SAKIT

Kantor Cabang : SAMARINDA - 1601

FKTP : dr Hotman Wilson S - 0302U133

0302U1330524P00 13-05-2024 13-05-2024 PENERIMA Secondary hypertension,

393 0000120769672 SRI WAHYUNINGSIH P Berobat Jalan Hipertensi Hipertensi
0188 00:00 20:53 PENSIUN PNS unspecified
0302U1330524P00 13-05-2024 13-05-2024
394 0000120854812 ARIF MUSTAKIM L PNS DAERAH Paranoid schizophrenia Berobat Jalan
0193 00:00 21:08
0302U1330524P00 13-05-2024 13-05-2024 PEGAWAI
395 0000901562196 SURIYAMAH P Fever, unspecified Berobat Jalan
0203 00:00 21:17 SWASTA
0302U1330524P00 13-05-2024 14-05-2024 PEKERJA Other joint disorders, not
396 0000902462861 SRI UTAMI P Berobat Jalan
0220 00:00 19:05 MANDIRI elsewhere classified
0302U1330524P00 13-05-2024 13-05-2024 PEGAWAI
397 0001132012989 MUSTHOHA L Calculus of ureter Rujuk Vertikal
0192 00:00 20:56 SWASTA
0302U1330524P00 13-05-2024 13-05-2024 PEGAWAI
398 0001196078084 MARDIANA P Fever, unspecified Berobat Jalan
0201 00:00 21:16 SWASTA
0302U1330524P00 13-05-2024 13-05-2024 MUHAMMAD ZIDANE ASH PEGAWAI
399 0001298466213 L Headache Berobat Jalan
0200 00:00 21:16 SHIDDIQY SWASTA
0302U1330524P00 13-05-2024 14-05-2024 PEGAWAI
400 0001310247641 YODI KORVINO SALU L Headache Berobat Jalan
0225 00:00 19:36 SWASTA
0302U1330524P00 13-05-2024 14-05-2024 PEKERJA Essential (primary)
401 0001433918845 ANNA P Berobat Jalan Hipertensi
0232 00:00 19:41 MANDIRI hypertension
0302U1330524P00 13-05-2024 14-05-2024 Acute upper respiratory
402 0001440229331 AHMAD SHOBIRIN L PNS DAERAH Berobat Jalan
0211 00:00 18:59 infection, unspecified
0302U1330524P00 13-05-2024 14-05-2024
403 0001440246543 EVI SUSANA P PBI (APBN) Infective dermatitis Berobat Jalan
0214 00:00 19:02
0302U1330524P00 13-05-2024 14-05-2024 SASKIA OLIVIA TATIA Acute upper respiratory
404 0001440247915 P PBI (APBN) Berobat Jalan
0213 00:00 19:01 RAMADHANA infection, unspecified
0302U1330524P00 13-05-2024 14-05-2024 PEGAWAI
405 0001482034656 UBAIDILLAH IBNU THOHA L Fever, unspecified Berobat Jalan
0207 00:00 18:57 SWASTA
0302U1330524P00 13-05-2024 14-05-2024 Acute pharyngitis,
406 0001545219325 AISYAH P PBI (APBD) Berobat Jalan
0206 00:00 18:56 unspecified
0302U1330524P00 13-05-2024 13-05-2024
407 0001545219336 EFENDI TANJUNG L PBI (APBD) Headache Berobat Jalan
0204 00:00 21:18
0302U1330524P00 13-05-2024 14-05-2024
408 0001545219371 DESI ERNAWATY P PBI (APBD) Headache Berobat Jalan
0205 00:00 18:47
0302U1330524P00 13-05-2024 13-05-2024 PEGAWAI
409 0001545221968 DEBY TODING KALLANG P Headache Rujuk Vertikal
0166 00:00 19:15 SWASTA
0302U1330524P00 13-05-2024 13-05-2024 PEGAWAI
410 0001545914957 MUSTAKIM L Cough Berobat Jalan
0199 00:00 21:14 SWASTA
0302U1330524P00 13-05-2024 14-05-2024 PEGAWAI
411 0001548432909 DJUSTIAWAN L Headache Berobat Jalan
0212 00:00 19:01 SWASTA
 DAFTAR KUNJUNGAN PESERTA SAKIT

Kantor Cabang : SAMARINDA - 1601

FKTP : dr Hotman Wilson S - 0302U133

0302U1330524P00 13-05-2024 14-05-2024 PEKERJA

412 0001550010227 SAMSUAR L Headache Berobat Jalan
0222 00:00 19:07 MANDIRI
0302U1330524P00 13-05-2024 13-05-2024
413 0001550801125 SUMANTO L - Hearing loss, unspecified Rujuk Vertikal
0168 00:00 20:00
0302U1330524P00 13-05-2024 14-05-2024 PEGAWAI Other joint disorders, not
414 0001631160448 DEWI PUJIARTI P Berobat Jalan
0217 00:00 19:04 SWASTA elsewhere classified
0302U1330524P00 13-05-2024 13-05-2024 PEGAWAI Acute pharyngitis,
415 0001724192796 MASDJUMADI GRAHA L Berobat Jalan
0196 00:00 21:13 SWASTA unspecified
0302U1330524P00 13-05-2024 14-05-2024 PEGAWAI Acute upper respiratory
416 0001788345404 ARDI PERMANA PUTRA L Berobat Jalan
0221 00:00 19:07 SWASTA infection, unspecified
0302U1330524P00 13-05-2024 14-05-2024 NURSYIFA MEISYA PEGAWAI Acute pharyngitis,
417 0001791950321 P Berobat Jalan
0216 00:00 19:03 SABRINA SWASTA unspecified
0302U1330524P00 13-05-2024 13-05-2024
418 0001860173133 ISNAWATI P PNS DAERAH Fever, unspecified Berobat Jalan
0197 00:00 21:13
0302U1330524P00 13-05-2024 13-05-2024
419 0001860175776 ALYA MAULIDA P PNS DAERAH Cough Berobat Jalan
0198 00:00 21:13
0302U1330524P00 13-05-2024 14-05-2024
420 0001873058578 HERDY NUGRAHA L - Fever, unspecified Berobat Jalan
0229 00:00 19:39
0302U1330524P00 13-05-2024 14-05-2024 PEKERJA
421 0001927293513 VALEN SATRIA FEBRIAN L Headache Berobat Jalan
0209 00:00 18:58 MANDIRI
0302U1330524P00 13-05-2024 14-05-2024 PEGAWAI Other joint disorders, not
422 0002194625553 EKI YUPRIANTI SAPUTRI P Berobat Jalan
0219 00:00 19:05 SWASTA elsewhere classified
0302U1330524P00 13-05-2024 14-05-2024 PEGAWAI Acute upper respiratory
423 0002210038097 HERMANSYAH L Berobat Jalan
0224 00:00 19:34 SWASTA infection, unspecified
PEGAWAI
PEMERINTAH
0302U1330524P00 13-05-2024 13-05-2024 Acute upper respiratory
424 0002212425843 DESTA NUR RAHMAN L DENGAN Berobat Jalan
0194 00:00 21:11 infection, unspecified
PERJANJIAN
KERJA
0302U1330524P00 13-05-2024 14-05-2024
425 0002236839546 SINTA YANTI P PBI (APBD) Gastritis, unspecified Berobat Jalan
0227 00:00 19:38
0302U1330524P00 13-05-2024 13-05-2024 Visual disturbance,
426 0002244421056 KURNIA P PBI (APBD) Rujuk Vertikal
0167 00:00 19:50 unspecified

Diarrhoea and
0302U1330524P00 13-05-2024 13-05-2024
427 0002252982295 MEYDI NURHASAN L PBI (APBN) gastroenteritis of Berobat Jalan
0202 00:00 21:17
presumed infectious origin

0302U1330524P00 13-05-2024 14-05-2024 PEKERJA

428 0002256182122 AYU NINGSIH P Dyspepsia Berobat Jalan
0218 00:00 19:04 MANDIRI
 DAFTAR KUNJUNGAN PESERTA SAKIT

Kantor Cabang : SAMARINDA - 1601

FKTP : dr Hotman Wilson S - 0302U133

Diarrhoea and
0302U1330524P00 13-05-2024 14-05-2024 PEKERJA
429 0002263402258 NURHAYATI P gastroenteritis of Berobat Jalan
0230 00:00 19:40 MANDIRI
presumed infectious origin

0302U1330524P00 13-05-2024 14-05-2024 PEGAWAI

430 0002272318593 PADAUNAN 'RUDI L Fever, unspecified Berobat Jalan
0226 00:00 19:37 SWASTA
0302U1330524P00 13-05-2024 13-05-2024 PEKERJA
431 0002299916902 HELMIATI P Myalgia Berobat Jalan
0195 00:00 21:11 MANDIRI
0302U1330524P00 13-05-2024 14-05-2024 Acute pharyngitis,
432 0002312662149 INDA L - Berobat Jalan
0231 00:00 19:40 unspecified
PEGAWAI
PEMERINTAH
0302U1330524P00 13-05-2024 14-05-2024 Acute upper respiratory
433 0002315278383 ELIANSYAH L DENGAN Berobat Jalan
0215 00:00 19:02 infection, unspecified
PERJANJIAN
KERJA
0302U1330524P00 13-05-2024 13-05-2024 PEKERJA Acute upper respiratory
434 0002437213656 LILIS MARIANI P Berobat Jalan
0187 00:00 20:51 MANDIRI infection, unspecified

Diarrhoea and
0302U1330524P00 13-05-2024 13-05-2024 PEKERJA
435 0002437216378 RIZKY BAYANGKARA L gastroenteritis of Berobat Jalan
0189 00:00 20:54 MANDIRI
presumed infectious origin

0302U1330524P00 13-05-2024 14-05-2024 PEGAWAI

436 0003107074397 AGUS L Infective dermatitis Berobat Jalan
0208 00:00 18:58 SWASTA

Diarrhoea and
0302U1330524P00 13-05-2024 14-05-2024 PEKERJA
437 0003519637413 ALMAIRA AYU ALSYIFA P gastroenteritis of Berobat Jalan
0210 00:00 18:59 MANDIRI
presumed infectious origin

Dislocation, sprain and

0302U1330524P00 13-05-2024 13-05-2024 MUHAMMAD GHANIM PEGAWAI
438 0003592423438 L strain of joint and Rujuk Vertikal
0190 00:00 20:54 DZAKKI P SWASTA
ligaments of hip
0302U1330524P00 11-05-2024 MOH. HAIDAR ANDI PENERIMA
439 05-11-2024 0000120816213 L Dyspepsia Berobat Jalan
0158 20:10 MANSUR PENSIUN PNS
0302U1330524P00 11-05-2024 PEGAWAI
440 05-11-2024 0001474430771 WAWAN APRIYANTO L Low back pain Berobat Jalan
0162 20:17 SWASTA
0302U1330524P00 11-05-2024 PEKERJA
441 05-11-2024 0001545221913 MULYADI L Chronic kidney disease Rujuk Vertikal
0152 19:53 MANDIRI

Diarrhoea and
0302U1330524P00 11-05-2024 PEGAWAI
442 05-11-2024 0001550704094 DAFFA HAIKAL L gastroenteritis of Berobat Jalan
0161 20:16 SWASTA
presumed infectious origin

0302U1330524P00 11-05-2024 CHRISTINE ANASTASIA PEGAWAI Visual disturbance,

443 05-11-2024 0001610048946 P Rujuk Vertikal
0151 19:49 SIBARANI SWASTA unspecified
 DAFTAR KUNJUNGAN PESERTA SAKIT

Kantor Cabang : SAMARINDA - 1601

FKTP : dr Hotman Wilson S - 0302U133

0302U1330524P00 11-05-2024 PEGAWAI Secondary hypertension,

444 05-11-2024 0001831192042 FACHRIYANTI P Berobat Jalan Hipertensi
0165 20:19 SWASTA unspecified
0302U1330524P00 11-05-2024 PEGAWAI
445 05-11-2024 0001900802452 YUSHAR L Infective dermatitis Berobat Jalan
0159 20:11 SWASTA
0302U1330524P00 11-05-2024 PEKERJA Malignant neoplasm of
446 05-11-2024 0002074968257 MARDIANA P Rujuk Vertikal
0160 20:16 MANDIRI breast
0302U1330524P00 11-05-2024 Acute pharyngitis,
447 05-11-2024 0002195057395 NASMIATI SILALAN P - Berobat Jalan
0163 20:18 unspecified
0302U1330524P00 11-05-2024 PEGAWAI
448 05-11-2024 0002231496617 SITI MASITAH P Amenorrhoea, unspecified Rujuk Vertikal
0135 19:01 SWASTA
0302U1330524P00 11-05-2024 PEGAWAI
449 05-11-2024 0002237548757 ELIAZER SIMON L Gastritis, unspecified Berobat Jalan
0154 20:06 SWASTA
0302U1330524P00 11-05-2024 PEKERJA
450 05-11-2024 0002296839159 RASYID L Dyspepsia Berobat Jalan
0156 20:08 MANDIRI
0302U1330524P00 11-05-2024 PEGAWAI
451 05-11-2024 0003073466125 NABILA RAFA FATHINA P Hearing loss, unspecified Rujuk Vertikal
0149 19:32 SWASTA
0302U1330524P00 11-05-2024 PEGAWAI Acute pharyngitis,
452 05-11-2024 0003081898438 AISYAH AULIA KAMAL P Berobat Jalan
0157 20:09 SWASTA unspecified
PEGAWAI
PEMERINTAH
0302U1330524P00 11-05-2024
453 05-11-2024 0003084646566 UWAIS ALFARIZI MARDIN L DENGAN Infective dermatitis Berobat Jalan
0164 20:18
PERJANJIAN
KERJA

Diarrhoea and
0302U1330524P00 11-05-2024 PEGAWAI
454 05-11-2024 0003216325498 NURJANAH P gastroenteritis of Berobat Jalan
0155 20:07 SWASTA
presumed infectious origin

0302U1330524P00 08-05-2024 Cerebral infarction,

455 05-08-2024 0000120728351 MATHIUS PAPPA' L PNS DAERAH Rujuk Vertikal
0113 20:14 unspecified
0302U1330524P00 13-05-2024 PEGAWAI
456 05-08-2024 0000120728362 DERLIN PAPPA P Fever, unspecified Berobat Jalan
0176 20:21 SWASTA
0302U1330524P00 13-05-2024 Pure
457 05-08-2024 0000120861933 ARBAINI P PNS DAERAH Berobat Jalan Hipertensi
0178 20:23 hypercholesterolaemia
0302U1330524P00 13-05-2024 Pure Diabetes
458 05-08-2024 0000120861944 SUPRAPTO L PNS DAERAH Berobat Jalan
0177 20:22 hypercholesterolaemia Mellitus

Diarrhoea and
0302U1330524P00 11-05-2024
459 05-08-2024 0001309627484 FAUZIAH P PBI (APBD) gastroenteritis of Berobat Jalan
0146 19:28
presumed infectious origin

0302U1330524P00 08-05-2024 RONNAORANSKA ROMBE PEKERJA Other and unspecified

460 05-08-2024 0001317207453 P Rujuk Vertikal
0132 21:01 PAMANGIN MANDIRI ovarian cysts
 DAFTAR KUNJUNGAN PESERTA SAKIT

Kantor Cabang : SAMARINDA - 1601

FKTP : dr Hotman Wilson S - 0302U133

0302U1330524P00 13-05-2024 PEGAWAI

461 05-08-2024 0001320663677 FARI HARIATMO L Fever, unspecified Berobat Jalan
0183 20:34 SWASTA
0302U1330524P00 13-05-2024
462 05-08-2024 0001390174446 RUSDIANSYAH RAYS L PBI (APBD) Headache Berobat Jalan
0174 20:19
0302U1330524P00 13-05-2024 PEGAWAI Acute pharyngitis,
463 05-08-2024 0001408500933 JONI PALUARAN L Berobat Jalan
0179 20:28 SWASTA unspecified
0302U1330524P00 08-05-2024 Visual disturbance,
464 05-08-2024 0001550801125 SUMANTO L - Rujuk Vertikal
0133 21:26 unspecified
0302U1330524P00 13-05-2024
465 05-08-2024 0001860161139 HERLINA P PNS DAERAH Infective dermatitis Berobat Jalan
0184 20:36
0302U1330524P00 13-05-2024 PEGAWAI
466 05-08-2024 0001923504647 SYAMSUDDIN L Infective dermatitis Berobat Jalan
0175 20:20 SWASTA
0302U1330524P00 13-05-2024 Other surgical follow-up
467 05-08-2024 0001928464536 PITER L - Berobat Jalan
0186 20:37 care
0302U1330524P00 13-05-2024 PEKERJA Acute pharyngitis,
468 05-08-2024 0002057489201 SUHARNANI P Berobat Jalan
0173 20:19 MANDIRI unspecified
0302U1330524P00 13-05-2024 PEKERJA Acute upper respiratory
469 05-08-2024 0002201243207 MUHAMMAD REHAN L Berobat Jalan
0170 20:09 MANDIRI infection, unspecified
0302U1330524P00 13-05-2024 PEKERJA Acute pharyngitis,
470 05-08-2024 0002203848066 SURYADI L Berobat Jalan
0169 20:08 MANDIRI unspecified
0302U1330524P00 11-05-2024
471 05-08-2024 0002220673623 SUBAIDAH P - Infective dermatitis Berobat Jalan
0147 19:29
0302U1330524P00 11-05-2024 PEKERJA Acute upper respiratory
472 05-08-2024 0002224054056 RAMLAH P Berobat Jalan
0145 19:27 MANDIRI infection, unspecified
0302U1330524P00 11-05-2024 Acute upper respiratory
473 05-08-2024 0002225491209 IRMAWATI P - Berobat Jalan
0148 19:31 infection, unspecified
0302U1330524P00 11-05-2024 Acute upper respiratory
474 05-08-2024 0002239458298 MARHAENI P PBI (APBD) Berobat Jalan
0150 19:48 infection, unspecified
0302U1330524P00 13-05-2024 PEKERJA
475 05-08-2024 0002242820518 ELITA YOHANA P Headache Berobat Jalan
0182 20:33 MANDIRI
0302U1330524P00 13-05-2024 MUHAMMAD KHAIRIL PEGAWAI
476 05-08-2024 0002486232742 L Status asthmaticus Berobat Jalan
0185 20:36 RAMADHANI SWASTA
0302U1330524P00 13-05-2024 MUHAMMAD ALFATIH PEGAWAI
477 05-08-2024 0002493464736 L Infective dermatitis Berobat Jalan
0172 20:18 NAIF SWASTA
0302U1330524P00 13-05-2024 PEKERJA
478 05-08-2024 0002882177291 JAMALUDDIN L Fever, unspecified Berobat Jalan
0180 20:29 MANDIRI
0302U1330524P00 13-05-2024 RAINHARD GEOVANY PEGAWAI
479 05-08-2024 0003076308088 L Fever, unspecified Berobat Jalan
0181 20:30 HOSEA PELLENG SWASTA
 DAFTAR KUNJUNGAN PESERTA SAKIT

Kantor Cabang : SAMARINDA - 1601

FKTP : dr Hotman Wilson S - 0302U133

0302U1330524P00 07-05-2024 PENERIMA

480 05-07-2024 0000120314057 ALFIAH P Pterygium Rujuk Vertikal
0104 20:46 PENSIUN PNS
0302U1330524P00 08-05-2024 PENERIMA
481 05-07-2024 0000120360497 USEP SUMARYANA L Fever, unspecified Berobat Jalan
0112 20:12 PENSIUN PNS
0302U1330524P00 11-05-2024
482 05-07-2024 0000120526222 EMIL YANTO L PNS PUSAT Dyspepsia Berobat Jalan
0140 19:22
0302U1330524P00 11-05-2024 NICKEN RAHMADANI PEGAWAI
483 05-07-2024 0000120534287 P Fever, unspecified Berobat Jalan
0141 19:23 NASTITI SWASTA
0302U1330524P00 08-05-2024 PENERIMA Acute pharyngitis,
484 05-07-2024 0000120766961 DAHLIANA A P Berobat Jalan
0129 20:53 PENSIUN PNS unspecified
0302U1330524P00 08-05-2024 PEGAWAI
485 05-07-2024 0001132012989 MUSTHOHA L Dyspepsia Berobat Jalan
0108 18:53 SWASTA
0302U1330524P00 08-05-2024 PEGAWAI
486 05-07-2024 0001320663677 FARI HARIATMO L Headache Berobat Jalan
0128 20:52 SWASTA
0302U1330524P00 08-05-2024 PEKERJA Acute upper respiratory
487 05-07-2024 0001432299205 PANNE P Berobat Jalan
0107 18:52 MANDIRI infection, unspecified
0302U1330524P00 07-05-2024 PEKERJA
488 05-07-2024 0001480217815 SUDIRMAN AMBOTUO L Calculus of ureter Rujuk Vertikal
0100 20:07 MANDIRI
0302U1330524P00 08-05-2024 PEKERJA
489 05-07-2024 0001545213881 YUNUS L Headache Berobat Jalan
0131 20:58 MANDIRI
0302U1330524P00 08-05-2024 PEGAWAI Acute pharyngitis,
490 05-07-2024 0001550540147 SURYANATA L Berobat Jalan
0111 19:01 SWASTA unspecified
0302U1330524P00 08-05-2024 PEGAWAI Acute upper respiratory
491 05-07-2024 0001550704094 DAFFA HAIKAL L Berobat Jalan
0115 20:19 SWASTA infection, unspecified
0302U1330524P00 08-05-2024 SILVIANI C. EVANGELISTA PEGAWAI
492 05-07-2024 0001551668196 P Fever, unspecified Berobat Jalan
0117 20:20 REA SWASTA
0302U1330524P00 11-05-2024 Essential (primary)
493 05-07-2024 0001728166487 HENDRI ARRASYID L - Berobat Jalan Hipertensi
0136 19:10 hypertension
0302U1330524P00 07-05-2024 PEGAWAI
494 05-07-2024 0001800413302 FITRIA NINGSIH P Epilepsy, unspecified Rujuk Vertikal
0099 19:32 SWASTA
0302U1330524P00 08-05-2024 PEKERJA
495 05-07-2024 0001806807126 ACHMAD L Fever, unspecified Berobat Jalan
0106 18:52 MANDIRI

Diarrhoea and
0302U1330524P00 08-05-2024
496 05-07-2024 0001890945797 EVI TA'BA' P - gastroenteritis of Berobat Jalan
0118 20:21
presumed infectious origin

0302U1330524P00 08-05-2024 Acute upper respiratory

497 05-07-2024 0001929129726 ADRIANA TANGKELANGI P - Berobat Jalan
0119 20:21 infection, unspecified
0302U1330524P00 08-05-2024 PEGAWAI Acute pharyngitis,
498 05-07-2024 0001929129737 ELVIRA GRACE PAMASI P Berobat Jalan
0120 20:22 SWASTA unspecified
 DAFTAR KUNJUNGAN PESERTA SAKIT

Kantor Cabang : SAMARINDA - 1601

FKTP : dr Hotman Wilson S - 0302U133

0302U1330524P00 07-05-2024 PEGAWAI

499 05-07-2024 0002019623207 BUSTAN L Calculus of ureter Rujuk Vertikal
0102 20:17 SWASTA
Unilateral or unspecified
0302U1330524P00 07-05-2024
500 05-07-2024 0002037654674 SUYUTI L PBI (APBD) inguinal hernia, without Rujuk Vertikal
0101 20:11
obstruction or gangrene
0302U1330524P00 08-05-2024 MUHAMMAD MIRZA PEKERJA
501 05-07-2024 0002066321158 L Fever, unspecified Berobat Jalan
0116 20:20 ADITYA MANDIRI
0302U1330524P00 11-05-2024 PEGAWAI Acute pharyngitis,
502 05-07-2024 0002075066807 ANDI ABDURAHMAN L Berobat Jalan
0138 19:10 SWASTA unspecified
PEGAWAI
PEMERINTAH
0302U1330524P00 07-05-2024 MUHAMMAD FIRZA Hyperkinetic disorder,
503 05-07-2024 0002210037941 L DENGAN Rujuk Vertikal
0062 15:32 ANWAR unspecified
PERJANJIAN
KERJA
0302U1330524P00 08-05-2024 PEGAWAI
504 05-07-2024 0002210039785 ELSA FITRIYANI P Dyspepsia Berobat Jalan
0123 20:39 SWASTA

Diarrhoea and
0302U1330524P00 08-05-2024
505 05-07-2024 0002227379703 HERIYANTO L - gastroenteritis of Berobat Jalan Hipertensi
0105 18:48
presumed infectious origin

0302U1330524P00 08-05-2024 MUHAMMAD NAUFAL PEKERJA

506 05-07-2024 0002227380298 L Fever, unspecified Berobat Jalan
0130 20:54 FAJAR MANDIRI
0302U1330524P00 11-05-2024
507 05-07-2024 0002236839546 SINTA YANTI P PBI (APBD) Cough Berobat Jalan
0142 19:24
0302U1330524P00 11-05-2024 Acute upper respiratory
508 05-07-2024 0002237999714 VERANICA SIMON P - Berobat Jalan
0137 19:10 infection, unspecified
0302U1330524P00 08-05-2024 Acute pharyngitis,
509 05-07-2024 0002239089636 NIRMALA P - Berobat Jalan
0109 18:53 unspecified
0302U1330524P00 08-05-2024 MUHAMMAD DAFFA Acute upper respiratory
510 05-07-2024 0002239090356 L - Berobat Jalan
0122 20:34 DARWIS infection, unspecified
0302U1330524P00 08-05-2024
511 05-07-2024 0002256241432 RINA FEBRIANA P PBI (APBN) Headache Berobat Jalan
0121 20:33
0302U1330524P00 08-05-2024 PEGAWAI
512 05-07-2024 0002289304023 ABIYYAH KHAIRUN NISA P Headache Berobat Jalan
0125 20:41 SWASTA
0302U1330524P00 08-05-2024 PEGAWAI
513 05-07-2024 0002289306532 AYRA SAYYIDATUN NISA P Fever, unspecified Berobat Jalan
0126 20:51 SWASTA
0302U1330524P00 08-05-2024 SEVERUS FERILIANO PEGAWAI
514 05-07-2024 0002299818802 L Fever, unspecified Berobat Jalan
0124 20:40 RAINHARD SWASTA
 DAFTAR KUNJUNGAN PESERTA SAKIT

Kantor Cabang : SAMARINDA - 1601

FKTP : dr Hotman Wilson S - 0302U133

PEGAWAI
PEMERINTAH
0302U1330524P00 11-05-2024
515 05-07-2024 0002319577312 AMELIA P DENGAN Headache Berobat Jalan
0139 19:19
PERJANJIAN
KERJA
0302U1330524P00 08-05-2024
516 05-07-2024 0002400866313 SUKMA AYU PRATIWI P PBI (APBN) Headache Berobat Jalan
0110 18:55
0302U1330524P00 08-05-2024 Acute upper respiratory
517 05-07-2024 0002421806398 ANTON WIBOWO L - Berobat Jalan
0114 20:18 infection, unspecified
0302U1330524P00 11-05-2024 Acute upper respiratory
518 05-07-2024 0002422859196 MUHAMMAD AZID RIFKI L PBI (APBD) Berobat Jalan
0144 19:25 infection, unspecified
0302U1330524P00 08-05-2024 ARSENIO LEMUEL Acute upper respiratory
519 05-07-2024 0002473049092 L PNS PUSAT Berobat Jalan
0127 20:51 JOSEPH LEPONG infection, unspecified
0302U1330524P00 07-05-2024 Fever of other and
520 05-07-2024 0003101725765 MUTHIAH SYAHIDAH P - Rujuk Vertikal
0103 20:30 unknown origin
0302U1330524P00 11-05-2024 Acute upper respiratory
521 05-07-2024 0003259523272 ASYAFIA SYAHIRA P PBI (APBD) Berobat Jalan
0143 19:25 infection, unspecified
0302U1330524P00 07-05-2024
522 05-06-2024 0000010555648 DHEDY IRAWAN L PNS DAERAH Headache Berobat Jalan
0098 18:53
0302U1330524P00 07-05-2024 PENERIMA
523 05-06-2024 0000120285573 SYAMSIAH P Fever, unspecified Berobat Jalan
0075 18:35 PENSIUN PNS
0302U1330524P00 07-05-2024 AMAKARELIA TANDI
524 05-06-2024 0000120317771 P ANGGOTA POLRI Headache Berobat Jalan
0080 18:38 SERU MATASAK
0302U1330524P00 07-05-2024
525 05-06-2024 0000120728351 MATHIUS PAPPA' L PNS DAERAH Dyspepsia Berobat Jalan
0077 18:36
False labour at or after 37
0302U1330524P00 06-05-2024
526 05-06-2024 0000902360981 MURIYATI P PBI (APBD) completed weeks of Rujuk Vertikal
0056 19:59
gestation
PEGAWAI
PEMERINTAH
0302U1330524P00 07-05-2024
527 05-06-2024 0001389795963 ARBAYAH P DENGAN Dyspepsia Berobat Jalan
0069 18:32
PERJANJIAN
KERJA
0302U1330524P00 07-05-2024 PEGAWAI
528 05-06-2024 0001408500933 JONI PALUARAN L Fever, unspecified Berobat Jalan
0086 18:43 SWASTA
0302U1330524P00 07-05-2024 PEGAWAI
529 05-06-2024 0001408500944 ELIS RANTE P Headache Berobat Jalan
0085 18:42 SWASTA
0302U1330524P00 07-05-2024 PEGAWAI
530 05-06-2024 0001430619412 KAMALIYAH P Fever, unspecified Berobat Jalan
0096 18:51 SWASTA
0302U1330524P00 07-05-2024 PEKERJA
531 05-06-2024 0001480217815 SUDIRMAN AMBOTUO L Gastritis, unspecified Berobat Jalan
0097 18:52 MANDIRI
 DAFTAR KUNJUNGAN PESERTA SAKIT

Kantor Cabang : SAMARINDA - 1601

FKTP : dr Hotman Wilson S - 0302U133

Diarrhoea and
0302U1330524P00 07-05-2024 PEKERJA
532 05-06-2024 0001483293699 SAIFUL ANWAR L gastroenteritis of Berobat Jalan
0076 18:35 MANDIRI
presumed infectious origin

0302U1330524P00 07-05-2024 PEKERJA

533 05-06-2024 0001545221913 MULYADI L Headache Berobat Jalan
0082 18:39 MANDIRI
0302U1330524P00 07-05-2024 PEGAWAI Other and unspecified
534 05-06-2024 0001545912325 NUR WAHYUDI L Berobat Jalan
0095 18:51 SWASTA abdominal pain
0302U1330524P00 07-05-2024 PEGAWAI Acute pharyngitis,
535 05-06-2024 0001545914395 YOHANIS SALLAA L Berobat Jalan
0071 18:33 SWASTA unspecified
0302U1330524P00 06-05-2024 ANJAS DIONISIUS PEGAWAI Perforation of tympanic
536 05-06-2024 0001545914428 L Rujuk Vertikal
0044 19:17 SALLAA' SWASTA membrane, unspecified
0302U1330524P00 07-05-2024 PEGAWAI Acute upper respiratory
537 05-06-2024 0001545916893 BUDIONO L Berobat Jalan
0068 18:32 SWASTA infection, unspecified

Diarrhoea and
0302U1330524P00 07-05-2024 PEGAWAI
538 05-06-2024 0001550704094 DAFFA HAIKAL L gastroenteritis of Berobat Jalan
0091 18:49 SWASTA
presumed infectious origin

0302U1330524P00 07-05-2024 PEGAWAI

539 05-06-2024 0001610282979 KURNIANSYAH L Headache Berobat Jalan
0064 18:28 SWASTA
0302U1330524P00 07-05-2024 PEGAWAI Acute upper respiratory
540 05-06-2024 0001631101599 YOHANA SUKA P Berobat Jalan
0088 18:46 SWASTA infection, unspecified
0302U1330524P00 07-05-2024 Acute upper respiratory
541 05-06-2024 0001633419134 SURYO DEWO PRATAMA L - Berobat Jalan
0070 18:33 infection, unspecified
0302U1330524P00 07-05-2024
542 05-06-2024 0001724522139 MUHAMMAD AMIN L PBI (APBN) Headache Berobat Jalan
0079 18:37
0302U1330524P00 07-05-2024 MUHAMMAD ZIDAN PEGAWAI
543 05-06-2024 0001791951333 L Headache Berobat Jalan
0094 18:50 FABIAN SWASTA
0302U1330524P00 07-05-2024 Acute upper respiratory
544 05-06-2024 0001798130632 HASBI HERMAWAN L - Berobat Jalan
0074 18:35 infection, unspecified
0302U1330524P00 07-05-2024 PEGAWAI
545 05-06-2024 0001799100088 ESRI TATOTO L Dyspepsia Berobat Jalan
0084 18:40 SWASTA
0302U1330524P00 07-05-2024 PEGAWAI
546 05-06-2024 0001923504658 NINGSIH P Gastritis, unspecified Berobat Jalan
0065 18:29 SWASTA
0302U1330524P00 07-05-2024 PEKERJA
547 05-06-2024 0001927293513 VALEN SATRIA FEBRIAN L Fever, unspecified Berobat Jalan
0089 18:47 MANDIRI
0302U1330524P00 07-05-2024 PEGAWAI
548 05-06-2024 0001928473211 JEVI YUSTIWAN L Headache Berobat Jalan
0078 18:36 SWASTA
0302U1330524P00 07-05-2024 PEGAWAI
549 05-06-2024 0002019623207 BUSTAN L Fever, unspecified Berobat Jalan
0090 18:48 SWASTA
 DAFTAR KUNJUNGAN PESERTA SAKIT

Kantor Cabang : SAMARINDA - 1601

FKTP : dr Hotman Wilson S - 0302U133

0302U1330524P00 07-05-2024 PEGAWAI Acute upper respiratory

550 05-06-2024 0002078981199 GHAIZKA ARMEDINA P Berobat Jalan
0092 18:49 SWASTA infection, unspecified
0302U1330524P00 07-05-2024 PEGAWAI Acute upper respiratory
551 05-06-2024 0002195057968 MUH RIZKY ANUGRAH L Berobat Jalan
0072 18:34 SWASTA infection, unspecified
0302U1330524P00 06-05-2024 MUHAMMAD RAFA PEGAWAI
552 05-06-2024 0002195827705 L Epilepsy, unspecified Rujuk Vertikal
0059 20:12 SETIAWAN SWASTA
0302U1330524P00 06-05-2024 PEKERJA Tuberculosis of bones and
553 05-06-2024 0002197229523 OKTAVIANUS PAMASI L Rujuk Vertikal
0053 19:47 MANDIRI joints
0302U1330524P00 07-05-2024 PEKERJA Acute upper respiratory
554 05-06-2024 0002218298894 SALMIAH P Berobat Jalan
0063 18:25 MANDIRI infection, unspecified
0302U1330524P00 07-05-2024 PEKERJA Acute pharyngitis,
555 05-06-2024 0002237104719 SUGRAWATI P Berobat Jalan
0083 18:39 MANDIRI unspecified
0302U1330524P00 06-05-2024 Atherosclerotic heart
556 05-06-2024 0002267432651 ARBAYAH P PBI (APBD) Rujuk Vertikal
0061 20:42 disease
0302U1330524P00 06-05-2024 MUHAMMAD ZAENAL
557 05-06-2024 0002267433549 L PBI (APBD) Fever, unspecified Berobat Jalan
0060 20:41 ARIFIN SYAM
0302U1330524P00 07-05-2024
558 05-06-2024 0002274429958 BAMBANG KURNIAWAN L PBI (APBN) Infective dermatitis Berobat Jalan
0081 18:38
0302U1330524P00 07-05-2024 PEKERJA
559 05-06-2024 0002296839159 RASYID L Headache Berobat Jalan
0087 18:44 MANDIRI
0302U1330524P00 07-05-2024 MUHAMMAD ABDUL PEKERJA Acute upper respiratory
560 05-06-2024 0002305132187 L Berobat Jalan
0073 18:34 MAJID AL GHAZALI MANDIRI infection, unspecified
0302U1330524P00 06-05-2024
561 05-06-2024 0002305224887 SYAMSUDDIN ALWI L - Hyperplasia of prostate Rujuk Vertikal
0045 19:28
0302U1330524P00 06-05-2024 PEGAWAI Acute upper respiratory
562 05-06-2024 0002371429361 NUR KALYLA NAFISAH P Berobat Jalan
0054 19:55 SWASTA infection, unspecified
0302U1330524P00 06-05-2024 PEKERJA Atherosclerotic heart
563 05-06-2024 0002764891473 ROSITA P Rujuk Vertikal
0055 19:56 MANDIRI disease
0302U1330524P00 07-05-2024 Acute upper respiratory
564 05-06-2024 0002877101717 SURIATI P - Berobat Jalan
0066 18:31 infection, unspecified
0302U1330524P00 07-05-2024
565 05-06-2024 0002877101739 PUTRI LIA AMELIA P - Fever, unspecified Berobat Jalan
0067 18:31
False labour before 37
0302U1330524P00 06-05-2024
566 05-06-2024 0002897974574 SERMA MAHARANI P - completed weeks of Rujuk Vertikal
0058 20:09
gestation
0302U1330524P00 06-05-2024 MUHAMMAD AHNAF PEGAWAI Acute bronchitis,
567 05-06-2024 0002902407153 L Rujuk Vertikal
0057 20:03 FARIS AL-FURQON SWASTA unspecified
0302U1330524P00 06-05-2024 PEGAWAI Dengue haemorrhagic
568 05-06-2024 0003101835374 ALKHALIFI HAMIZAN L Rujuk Vertikal
0028 15:04 SWASTA fever
 DAFTAR KUNJUNGAN PESERTA SAKIT

Kantor Cabang : SAMARINDA - 1601

FKTP : dr Hotman Wilson S - 0302U133

Tuberculosis of lung,
0302U1330524P00 06-05-2024 PEKERJA confirmed by sputum
569 05-06-2024 0003136605783 HANIF TAJAR L Rujuk Vertikal
0052 19:43 MANDIRI microscopy with or without
culture
0302U1330524P00 07-05-2024 Acute pharyngitis,
570 05-06-2024 0003544746985 GIDEON SIGA BOLI L - Berobat Jalan
0093 18:50 unspecified
0302U1330524P00 06-05-2024 Insulin-dependent Diabetes
571 05-04-2024 0000120861944 SUPRAPTO L PNS DAERAH Berobat Jalan
0047 19:35 diabetes mellitus Mellitus
0302U1330524P00 04-05-2024 Stroke, not specified as
572 05-04-2024 0000120862912 SUBAKIR L - Berobat Jalan Hipertensi
0024 21:02 haemorrhage or infarction
0302U1330524P00 04-05-2024 Stroke, not specified as
573 05-04-2024 0000120862923 AMINATUS SHOLIHAH P - Berobat Jalan Hipertensi
0023 21:02 haemorrhage or infarction
0302U1330524P00 04-05-2024 Other surgical follow-up
574 05-04-2024 0000209267368 JOSHUA JULIANO SAPAN L PNS DAERAH Rujuk Vertikal
0020 20:33 care
0302U1330524P00 06-05-2024 PEGAWAI Acute upper respiratory
575 05-04-2024 0001134047777 OBET TANDI PADANG L Berobat Jalan
0042 19:02 SWASTA infection, unspecified
0302U1330524P00 04-05-2024 AHADYA SONA PEGAWAI
576 05-04-2024 0001168327056 P Status asthmaticus Rujuk Vertikal
0021 20:51 RHOMANSYAH SWASTA
0302U1330524P00 04-05-2024 AHADINI SONA PEGAWAI
577 05-04-2024 0001171506429 P Headache Berobat Jalan
0026 21:03 RHOMANSYAH SWASTA
0302U1330524P00 06-05-2024 PEKERJA
578 05-04-2024 0001480217815 SUDIRMAN AMBOTUO L Dyspepsia Berobat Jalan
0051 19:37 MANDIRI
0302U1330524P00 06-05-2024 PEGAWAI
579 05-04-2024 0001545038932 HARTATI P Headache Berobat Jalan
0050 19:37 SWASTA
0302U1330524P00 06-05-2024 PEGAWAI
580 05-04-2024 0001545181132 ZAKARIA L Fever, unspecified Berobat Jalan
0049 19:36 SWASTA
0302U1330524P00 06-05-2024 PEGAWAI
581 05-04-2024 0001545914957 MUSTAKIM L Cough Berobat Jalan
0046 19:35 SWASTA
0302U1330524P00 04-05-2024
582 05-04-2024 0001550801125 SUMANTO L - Keloid scar Rujuk Vertikal
0019 20:30
0302U1330524P00 04-05-2024 PETER PARDAMEAN PEGAWAI
583 05-04-2024 0001610048935 L Hearing loss, unspecified Rujuk Vertikal
0017 19:32 SIBARANI SWASTA
0302U1330524P00 04-05-2024 PEGAWAI
584 05-04-2024 0001851787449 SYAHRINA P Nontoxic diffuse goitre Rujuk Vertikal
0018 20:07 SWASTA
0302U1330524P00 06-05-2024
585 05-04-2024 0001928464536 PITER L - Headache Berobat Jalan
0043 19:02

Diarrhoea and
0302U1330524P00 04-05-2024 PEGAWAI
586 05-04-2024 0002230400428 YUNUS ARRUAN L gastroenteritis of Berobat Jalan
0027 21:04 SWASTA
presumed infectious origin
 DAFTAR KUNJUNGAN PESERTA SAKIT

Kantor Cabang : SAMARINDA - 1601

FKTP : dr Hotman Wilson S - 0302U133

0302U1330524P00 04-05-2024 PEKERJA

587 05-04-2024 0002235953979 ROSMIATI P Fever, unspecified Berobat Jalan
0022 20:58 MANDIRI
0302U1330524P00 04-05-2024 PEKERJA Other surgical follow-up
588 05-04-2024 0002236058864 MUHAMMAD IQBAL L Berobat Jalan
0025 21:02 MANDIRI care
0302U1330524P00 04-05-2024 PEKERJA
589 05-04-2024 0002324858387 M. SAKRONI L Haemangioma, any site Rujuk Vertikal
0016 19:27 MANDIRI
0302U1330524P00 06-05-2024
590 05-04-2024 0002375657177 DINA ASIK ALLO P - Fever, unspecified Berobat Jalan Hipertensi
0041 19:01
0302U1330524P00 06-05-2024 PEGAWAI
591 05-04-2024 0003076306468 ICE' DALMATIA P Headache Berobat Jalan
0048 19:36 SWASTA
0302U1330524P00 06-05-2024 PEKERJA Acute upper respiratory
592 05-03-2024 0001066452175 LA JONI L Berobat Jalan
0035 18:44 MANDIRI infection, unspecified
0302U1330524P00 06-05-2024 PEGAWAI Acute upper respiratory
593 05-03-2024 0001177546094 MARIANA P Berobat Jalan
0030 18:39 SWASTA infection, unspecified
0302U1330524P00 06-05-2024 PEGAWAI
594 05-03-2024 0001280584629 MUHAMMAD ALAMSYAH L Headache Berobat Jalan
0040 18:47 SWASTA
0302U1330524P00 06-05-2024 PEGAWAI
595 05-03-2024 0001408498852 MASKUNI ARIFIN L Fever, unspecified Berobat Jalan
0033 18:41 SWASTA
0302U1330524P00 06-05-2024 ANJAS DIONISIUS PEGAWAI
596 05-03-2024 0001545914428 L Hearing loss, unspecified Berobat Jalan
0038 18:45 SALLAA' SWASTA
PEGAWAI
PEMERINTAH
0302U1330524P00 06-05-2024
597 05-03-2024 0001814049887 HAMSIAH P DENGAN Dyspepsia Berobat Jalan
0036 18:44
PERJANJIAN
KERJA
0302U1330524P00 06-05-2024 Acute pharyngitis,
598 05-03-2024 0001923481822 HJ.MASANG P PBI (APBN) Berobat Jalan Hipertensi
0039 18:47 unspecified
0302U1330524P00 06-05-2024 PEKERJA
599 05-03-2024 0001927293513 VALEN SATRIA FEBRIAN L Headache Berobat Jalan
0032 18:40 MANDIRI
0302U1330524P00 06-05-2024 PEKERJA Acute upper respiratory
600 05-03-2024 0002236058864 MUHAMMAD IQBAL L Berobat Jalan
0034 18:42 MANDIRI infection, unspecified
0302U1330524P00 06-05-2024
601 05-03-2024 0002296558348 NURLINA P PBI (APBD) Fever, unspecified Berobat Jalan
0037 18:45
0302U1330524P00 06-05-2024 PEGAWAI Acute pharyngitis,
602 05-03-2024 0003303008087 GHINA PUTRI ALMAYRA P Berobat Jalan
0031 18:39 SWASTA unspecified
0302U1330524P00 02-05-2024 PEGAWAI
603 05-02-2024 0000120717753 INDAH KARMILA SARI P Headache Berobat Jalan
0013 19:58 SWASTA
0302U1330524P00 02-05-2024
604 05-02-2024 0000121942539 SRI RAHMAH P PNS PUSAT Headache Berobat Jalan
0014 19:58
 DAFTAR KUNJUNGAN PESERTA SAKIT

Kantor Cabang : SAMARINDA - 1601

FKTP : dr Hotman Wilson S - 0302U133

0302U1330524P00 02-05-2024
605 05-02-2024 0001148544178 ADHANI NUKA L PBI (APBD) Dyspepsia Berobat Jalan
0004 19:54
0302U1330524P00 02-05-2024 PEGAWAI Thyrotoxicosis,
606 05-02-2024 0001545184473 HASMIAH P Rujuk Vertikal
0002 19:18 SWASTA unspecified
0302U1330524P00 06-05-2024
607 05-02-2024 0001724522139 MUHAMMAD AMIN L PBI (APBN) Fever, unspecified Berobat Jalan
0029 18:38
0302U1330524P00 02-05-2024 PEGAWAI
608 05-02-2024 0001732151114 HAIRIAH P Fever, unspecified Berobat Jalan
0006 19:55 SWASTA
0302U1330524P00 02-05-2024 PEKERJA Cerebral infarction,
609 05-02-2024 0001798361842 HASANUDDIN L Rujuk Vertikal
0003 19:21 MANDIRI unspecified
0302U1330524P00 02-05-2024 PEGAWAI Acute upper respiratory
610 05-02-2024 0001824515368 DEDI IRAWAN L Berobat Jalan
0012 19:57 SWASTA infection, unspecified
PEGAWAI
PEMERINTAH
0302U1330524P00 02-05-2024
611 05-02-2024 0001837680974 TRISNAWATI P DENGAN Arthrosis, unspecified Rujuk Vertikal
0001 19:13
PERJANJIAN
KERJA
0302U1330524P00 02-05-2024 PEKERJA Acute pharyngitis,
612 05-02-2024 0002057489201 SUHARNANI P Berobat Jalan
0005 19:55 MANDIRI unspecified
0302U1330524P00 02-05-2024 PEKERJA Acute upper respiratory
613 05-02-2024 0002231759856 E.K PANGALINGAN L Berobat Jalan Hipertensi
0007 19:55 MANDIRI infection, unspecified
0302U1330524P00 02-05-2024 PEKERJA
614 05-02-2024 0002303575222 KARTINI P Fever, unspecified Berobat Jalan
0008 19:56 MANDIRI
0302U1330524P00 02-05-2024
615 05-02-2024 0002439519581 ASRIANI P PBI (APBD) Headache Berobat Jalan
0011 19:57
0302U1330524P00 02-05-2024 PEKERJA
616 05-02-2024 0002696342883 SAHRUL L Fever, unspecified Berobat Jalan
0009 19:56 MANDIRI

Diarrhoea and
0302U1330524P00 02-05-2024 KEENAN ALVARENDRA PEGAWAI
617 05-02-2024 0003132426633 L gastroenteritis of Berobat Jalan
0015 19:59 PURNAMA SWASTA
presumed infectious origin

0302U1330524P00 02-05-2024
618 05-02-2024 0003535252266 ARUMI ALMAHIRA RISAH P PBI (APBN) Headache Berobat Jalan
0010 19:57