Sensus Ri Paru

7/24/2019 Sensus Ri Paru

1/162

Bulan Agustus 2015

Pasien Aw 3

Kelas I:

Kelas II

Kelas III :

VIP :

PASIEN MASUK

NO Tanggal Nama Pasien Umur Nomor RMKelas Ra

LK PR I II

1 03/08/2015 Tumira 035!00 1 1

2 03/08/2015 "lmiwati 2#2$0$ 1

3 03/08/2015 Mas%a 2#5!35 1

& 0&/08/2015 Kamaria 2#53!0 1

5 05/08/2015 'a(i)ur*R 2##08$ 1

# 0#/08/2015 +atima 258#!0 1

$ 0$/08/2015 Misarianto 2##10& 1

8 0$/08/2015 Rominaten 2##253 1

! 0$/08/2015 Mas,arnia 2##528 1 1

10 08/08/2015 -ain .usien 2##538 1

11 10/08/2015 M*aei 2##5&8 1

12 11/08/2015 .alima 2##5!5 1

13 11/08/2015 a%ia 2###80 11& 12/08/2015 Nursia 2##$0$ 1

15 12/08/2015 Mari 2###!8 1

1# 12/08/2015 ina* 2##$18 1

1$ 12/08/2015 .atta 2##$21 1

18 13/08/2015 4,is 2#5#5! 1

1! 1&/08/2015 'a(i)ur*R 2##08$ 1

20 15/08/2015 +atima 258#!0 1

21 15/08/2015 uar,ani 2##$#3 1

22 1$/08/2015 amsir 2#$13! 1 1

23 18/08/2015 u6ri 2&!8!& 12& 18/08/2015 4),ul ama, 00&238 1

25 18/08/2015 7o,i 2#$1#$ 1

2# 1!/08/2015 7umia 2#$205 1

2$ 20/08/2015 "rnawati 2#$2## 1

28 21/08/2015 ini 4ngela 2#$281 1

2! 22/08/2015 ustamar 118032 1

30 22/08/2015 alan,a6 2#$&3# 1

31 22/08/2015 ugito 2#$& 1 1


2/162

32 2&/08/2015 4nto 2#$&$3 1 1

33 2&/08/2015 'uli 2#$&!8 1

3& 25/08/2015 Isnun 2#$501 1

35 2#/08/2015 I,rus 2#$5 1

3# 28/08/2015 uten,ra 2#$$18 1

3$ 28/08/2015 emang 23&!53 1

38 31/08/2015 4snawi 25!#&$ 1


3/162


4/162

7UML4.

KETERANGANKelas Rawatan

I II

1* Pasien 4wal

2* Pasien Masu6

3* Total %asien irawat

&* Pasien ii(in6an Pulang

5* Pasien i%in,a6an

#* Pasien iruu6

$* Pasien Pin,a Ke R Lain8* Pasien Pulang Pa6sa

!* Pasien Melari6an iri

10* Pasien 6eluar .i,u%


5/162

PASIEN MASUK RUANG RAWAT INAP

PASIEN PINDAH DARI RUANGAN LAIN

atTanggal Nama Pasien Umur Nomor RM

7enis Kelamin

III LK PR

1

1

1

1

1

1

1

1

1

1

11

1

1

1

1

1

1

1

11

1

1

1

1

1

1


6/162

1

1

1

1

1

1


7/162


8/162

KETERANGAN

I

11* Mati 9 &8 7am

12* Mati : &8 am

13* Total Pasien Meninggal

1&* Total Pasien Keluar

15* ;ana6 Pasien g masi irawat

1#* P g Masu6 ,an Keluar Pa,a ari g ama


9/162

PASIEN PINDA

Kelas RawatanTanggal Nama Pasien Nomor RM

7enis

I II III


10/162


11/162


12/162

Kelas Rawatan

II III


13/162

SENSUS HARIAN PASIEN RAWAT INAP PARU

KERUANGAN LAIN

elaminTgl Masu6

losKL Ke Ruang Tanggal

PR

1 3 I=U 02/08/2015

1 11/08/2015 1 3 I=U 03/08/2015

1$/08/2015 1 1 I=U 0#/08/2015

0#/08/2015

0$/08/2015

08/08/2015

0!/08/2015

10/08/2015

11/08/2015

11/08/2015

12/08/2015

12/08/2015

13/08/201513/08/2015

15/08/2015

15/08/2015

1#/08/2015

18/08/2015

18/08/2015

1!/08/2015

1!/08/2015

1!/08/2015

22/08/201522/08/2015

22/08/2015

2&/08/2015

2&/08/2015

25/08/2015

2#/08/2015

28/08/2015

28/08/2015


14/162


15/162


16/162


17/162

RSUD PURI HUSADA TEMBILAHAN

PASIEN

KELUA

Nama Pasien Umur Nomor RM7enis Kelamin Kelas Rawatan LO

LK PR I II III I II

Tamrin 2##02# 1 1

Kas%ul 2##1#1 1 1

"lmiwati 2#2$0$ 1 1

Mas%a 2#5!35 1 1

Kamaria 2#53!0 1 1

'a(i)ur*R 2##08$ 1 1

+atima 2#8#!0 1 1

Tumira 035!00 1 1 $

Misarianto 2##10& 1 1

Mas,arnia 2##528 1 1 &

-ain .usien 2##538 1 1

Rominaten 2##253 1 1

M*aei 2##5&8 1 1.alima 2##5!5 1 1

Mari 2###!8 1 1

ina* 2##$18 1 1

4,is 2#5#5! 1 1

.atta 2##$21 1 1

'a(i)ur*R 2##08$ 1 1

Nursia 2##$0$ 1 1

+atima 258#!0 1 1

uar,ani 2##$#3 1 1

"rnawati 2#$2## 1 17umia 2#$205 1 1

4),ul ama, 00&238 1 1

u6ri 2&!8!& 1 1

ini 4ngela 2#$281 1 1

ustamar 118032 1 1

7o,i 2#$1#$ 1 1

4nto 2#$&$3 1 1 &

'uli 2#$&!8 1 1


18/162


19/162


20/162


21/162

KELUAR RAWAT INAP

RUMAH SAKIT

Tgl Masu6 iagnosa Keluar P7P=ar

III Umum 7K 7KN>M

& 2!/$/2015 1

# 28/$/2015

3 03/08/2015 1

3 03/08/2015 1

3 0&/08/2015 1

3 05/08/2015 1

3 0#/08/2015

03/08/2015 1

& 0$/08/2015 1

0$/08/2015 1

& 08/08/2015 1

5 0$/08/2015 1

3 10/08/2015 12 11/08/2015 1

3 12/08/2015 1

3 12/08/2015 1

3 13/08/2015

# 12/08/2015 1

& 1&/08/2015 1

$ 12/08/2015 1

& 15/08/2015 1

& 15/08/2015 1

2 20/08/2015 13 1!/08/2015 1

& 18/08/2015 1

# 18/08/2015 1

3 21/08/2015 1

3 22/08/2015 1

8 18/08/2015 1

2&/08/2015 1

& 2&/08/2015


22/162


23/162


24/162


25/162

CARA PASIEN KELUAR

;aariruu6 R Lari

7KN>P;I PT ratis

1

1 1

1

1

1

1

1 1

1

1

1

1

1

11

1

1

1 1

1

1

1

1

1

11

1

1

1

1

1

1

1 1

i i(in6anPulang

iruu6Pus6esmas

Pulang%a6sa


26/162


27/162


28/162


29/162

MATI

Tanggal

RIN=I4N P4I"N

9 2& 74M : &8 74MPasien isa

I II III


30/162


31/162


32/162


33/162

Bulan September 2015

Pasien Aw 5

Kelas I 1

Kelas II :

Kelas III 4

VIP :

PASIEN MASUK


LK PR I II

1 01/0!/2015 4mran 23#2#! 1 1

2 02/0!/2015 an,imen 2#$!$0 1 1

3 03/0!/2015 4rsa, 2#$!83 1 1

& 0&/0!/2015 "lmiwati 2#$$0$ 1

5 0&/0!/2015 U,in 2#$!!& 1 1

05/0!/2015 atriani 2#8&5! 1

0$/0!/2015 Na(rim 2#8333 1

0$/0!/2015 +atmawati 2#835$ 1 1

08/0!/2015 auti 2#: 1 1

0!/0!/2015 Miswanto 2#8188 1

10/0!/2015 4),ul Muin 0302#8 1

11/0!/2015 Ni6ma 032352 1

11/0!/2015 Illo 2#82$& 1 11&/0!/2015 Ramaini 1285&5 1 1

1#/0!/2015 Pari,a 2#!008 1

1$/0!/2015 ami6un 2#882! 1

1$/0!/2015 Nuraati 2#8!1$ 1

20/0!/2015 ustamar 118032 1

2#/0!/2015 Rusli*M 2#10&& 1

2#/0!/2015 .*4ina 2#!82! 1

2$/0!/2015 .i,aatulla 2#!8#0 1

2$/0!/2015 Mase 2#!851 1

2$/0!/2015 u6arti 001080 1 128/0!/2015 Kartini 2#310& 1 1

28/0!/2015 ;ustamar 118032 1

2!/0!/2015 umina 2#!!23 1


34/162


35/162


36/162

7UML4.


I II

1* Pasien 4wal

2* Pasien Masu6



5* Pasien i%in,a6an

#* Pasien iruu6





37/162




7enis Kelamin

III LK PR

1

1

1

1

1

1

1

1

1

1

1

1

1

1

1

1


38/162


39/162


40/162

KETERANGAN

I

11* Mati 9 &8 7am

12* Mati : &8 am






41/162

SENSUS

PASIEN PINDAH KER


7enis

I II III


42/162


43/162


44/162

Kelas Rawatan

II III


45/162

HARIAN PASIEN RAWAT INAP PARU RSUD PURI HUSAD

ANGAN LAIN

elaminTgl Masu6 KL Ke Ruang Tanggal Nama Pasien Umur

PR

1 1&/0!/2015 1


46/162


47/162


48/162


49/162

TEMBILAHAN

PASIEN KELUAR RAWAT I

KELUAR RUMAH SAKIT

Nomor RM7enis Kelamin Kelas Rawatan

Tgl Masu6 iagnosa KeluarLK PR I II III

23#2#! 1 1 01/0!/2015

2#$&3# 1 1 22/08/2015

2#$501 1 1 25/08/2015

23&!53 1 1 28/08/2015

25!#&$ 1 1 31/08/2015

2#$!$0 1 1 02/0!/2015

2#$!83 1 1 03/0!/2015

2#$!!& 1 1 0&/0!/2015

2#8&5! 1 1 05/0!/2015

2#: 1 1 08/0!/2015

0302#8 1 1 10/0!/2015

2#$$0$ 1 1 0&/0!/2015

2#8188 1 1 0!/0!/20152#8333 1 1 0$/0!/2015

2#835$ 1 1 0$/0!/2015

2#82$& 1 1 11/0!/2015

2#$$18 1 1 28/08/2015

032352 1 1 11/0!/2015

2#!008 1 1 1#/0!/2015

2#882! 1 1 1$/0!/2015

2#8!1$ 1 1 1$/0!/2015

118032 1 1 20/0!/2015

2#!82! 1 1 2#/0!/20152#!851 1 1 2$/0!/2015

2#!8#0 1 1 2$/0!/2015

001080 1 1 2$/0!/2015


50/162


51/162


52/162


53/162

AP

P7P=ara ;aar

Umum 7K 7KN>M 7KN>P;I PT ratis

1

1 1

1 1

1 1

1 1

1 1

1 1

1

1 1

1 1

1

1 1

1 11 1

1 1

1 1

1 1

1 1

1

1 1

1 1

1 1

11 1

1 1

1 1

i i(in6anPulang


54/162


55/162


56/162


57/162

CARA PASIEN KELUAR MATI

Tanggal

iruu6 R Lari 9 2& 74M : &8 74M

I

1 01/0!/2015 2

02/0!/2015 2

03/0!/2015 2

0&/0!/2015 2

05/0!/2015 2

0#/0!/2015 2

0$/0!/2015 2

1 08/0!/2015 2

0!/0!/2015 2

10/0!/2015 1

1 11/0!/2015 2

12/0!/2015 2

13/0!/20151&/0!/2015 1

15/0!/2015

1#/0!/2015

1$/0!/2015

18/0!/2015

1 1!/0!/2015

20/0!/2015

21/0!/2015

22/0!/2015

1 23/0!/20152&/0!/2015

25/0!/2015

2#/0!/2015

2$/0!/2015 1

28/0!/2015 2

2!/0!/2015 2

30/0!/2015 1

30

iruu6Pus6esmas

Pulang%a6sa


58/162


59/162


60/162


61/162

IN=I4N P4I"N

Pasien isa

II III


62/162

1


63/162


64/162


65/162

Bulan Oktober 2015

Pasien Aw 3

Kelas I 1

Kelas II :

Kelas III 2

VIP :

PASIEN MASUK


LK PR I II

1 01/10/2015 al)ia 2#!&58 1 1

2 01/10/2015 ?ar,io 2##$33 1

3 01/10/2015 4),*Ma(i, 2#!#2$ 1

& 02/10/2015 Isa 2#!#$# 1

5 02/10/2015 Mar,ia 2#!#88 1

# 0&/10/2015 Ni6ma 032352 1

$ 05/10/2015 uten,ra 2#$$18 1

8 05/10/2015 Marto 2$0300 1

! 05/10/2015 -a6aria 035830 1

10 05/10/2015 Mamuri 2$032! 1

11 0#/10/2015 ami6un 2#882! 1

12 0$/10/2015 ?ai,in 2$0#01 1

13 0$/10/2015 alan 2&803# 11& 0!/10/2015 7asmiati 2$0!32 1

15 10/10/2015 Lase6 25$280 1

1# 10/10/2015 Kusmaran 2$081& 1

1$ 12/10/2015 armawati 03! 1

18 13/10/2015 is6a 2#$352 1

1! 13/10/2015 Matam 2$102& 1

20 13/10/2015 4tansa 2$1023 1

21 1&/10/2015 Rama,an 0&13#& 1

22 1&/10/2015 'usu 2#&5!8 1

23 1#/10/2015 -a6aria 035830 12& 1#/10/2015 ulaiman 2$1&08 1 1

25 1$/10/2015 'uli 2$1&23 1

2# 1$/10/2015 4l@in*4 2$11$5 1 1

2$ 1$/10/2015 -ain*. 2##538 1

28 1!/10/2015 M*Nur 2$1528 1 1

2! 1!/10/2015 4*'ani 1&8238 1 1

30 20/10/2015 Kartini 2#310& 1

31 21/10/2015 Purnomo 2$12!0 1

7enisKelamin


66/162

32 22/10/2015 armawati 03! 1

33 23/10/2015 ;ustamar 118032 1

3& 2&/10/2015 ;e,u 2$2005 1

35 2$/10/2015 Murniati 0$80!3 1

3# 28/10/2015 4),*Raman 2$18&2 1

3$ 28/10/2015 -aini 2$2202 1

38 28/10/2015 .amsan 2$2203 13! 2!/10/2015 I)raim 2$223# 1 1

&0 31/10/2015 o%an*. 2$22$8 1


67/162


68/162

7UML4.


I II

1* Pasien 4wal

2* Pasien Masu6



5* Pasien i%in,a6an

#* Pasien iruu6





69/162




7enis Kelamin

III LK PR

1

1

1

1

1

1

1

1

1

1

1

11

1

1

1

1

1

1

1

1

1

1

1

1

1


70/162

1

1

1

1

1

1

1

1


71/162


72/162

KETERANGAN

I

11* Mati 9 &8 7am

12* Mati : &8 am






73/162

SENSUS

PASIEN PINDAH KER


7enis

I II III


74/162


75/162


76/162


77/162

HARIAN PASIEN RAWAT INAP ANAK RSUD PURI HUSADA

ANGAN LAIN

elaminTgl Masu6 KL Ke Ruang Tanggal Nama Pasien Umur

PR

0$/10/2015 3


78/162

2$/10/2015;ustamar

30/10/2015-a6aria

31/10/2015.amsan

31/10/2015 4),*Raman

31/10/2015 Murniati


79/162


80/162


81/162

TEMBILAHAN

PASIEN KELUAR RAWAT I

KELUAR RUMAH SAKIT

Nomor RM7enis Kelamin Kelas Rawatan


2#!!23 1 1 2!/0!/2015

118032 1 1 28/0!/2015

2#!#2$ 1 1 01/10/2015

2#!&58 1 1 01/10/2015

2#!#88 1 1 02/10/2015

2##$33 1 1 01/10/2015

2$0300 1 1 05/10/2015

2#!#$# 1 1 02/10/2015

032352 1 1 0&/10/2015

035830 1 1 05/10/2015

2$032! 1 1 05/10/2015

2&803# 1 1 0$/10/2015

2$081& 1 1 10/10/201525$280 1 1 10/10/2015

2$0!32 1 1 0!/10/2015

2#882! 1 1 0#/10/2015

2#$$18 1 1 05/10/2015

2#310& 1 1 28/0!/2015

03! 1 1 12/10/2015

2$102& 1 1 13/10/2015

2$1023 1 1 13/10/2015

0&13#& 1 1 1&/10/2015

2#$352 1 1 13/10/20152#&5!8 1 1 1&/10/2015

2$1&23 1 1 1$/10/2015

2$1&08 1 1 1#/10/2015

2$12!0 1 1 21/10/2015

2##538 1 1 1$/10/2015

2$1528 1 1 1!/10/2015

03! 1 1 22/10/2015

2$2005 1 1 2&/10/2015


82/162

118032 1 1 23/10/2015

035830 1 1 1#/10/2015

2$2203 1 1 28/10/2015

2$18&2 1 1 28/10/2015

0$80!3 1 1 2$/10/2015


83/162


84/162


85/162

AP

P7P=ara ;aar


1 1

1 1

1 1

1 1

1 1

1 1

1

1 1

1 1

1 1

1 1

1 1

11 1

1 1

1 1

1 1

1 1

1 1

1 1

1 1

1 1

1 11 1

1 1

1 1

1 1

1 1

1 1

1 1

1 1

i i(in6anPulang


86/162

1 1

1 1

1 1

1 1

1 1


87/162


88/162


89/162


Tanggal

iruu6 R Lari 9 2& 74M : &8 74M

I

01/10/2015 2

02/10/2015 2

03/10/2015 2

0&/10/2015 1

05/10/2015 1

0#/10/2015 1

1 0$/10/2015 1

08/10/2015 1

0!/10/2015 1

10/10/2015 1

11/10/2015 1

12/10/2015 1

1 13/10/2015 11&/10/2015

15/10/2015

1#/10/2015 1

1$/10/2015 1

18/10/2015 1

1!/10/2015 2

20/10/2015 1

21/10/2015 1

22/10/2015 1

23/10/2015 12&/10/2015 1

25/10/2015 1

2#/10/2015

2$/10/2015

28/10/2015

2!/10/2015 1

30/10/2015 1

31/10/2015

iruu6Pus6esmas

Pulang%a6sa


90/162


91/162


92/162


93/162

IN=I4N P4I"N

Pasien isa

II III


94/162


95/162


96/162


97/162

Bulan Noember 2015

Pasien Aw :

Kelas I:

Kelas II :

Kelas III !

VIP :

PASIEN MASUK


LK PR I II

1 01/11/2015 4r)ain 0&0122 1

2 01/11/2015 ariana 2$25$& 1

3 01/11/2015 armawati 03! 1 1

& 01/11/2015 4),*Kair 1##552 1 1

5 01/11/2015 4(is 2$120$ 1

# 0&/11/2015 emi 2#31$8 1

$ 0&/11/2015 ;eo 2#&5!5 1

8 0&/11/2015 4mrani 2$2$15 1

! 11/11/2015 Ramang 2$325! 1

10 11/11/2015 arianti 15!!30 1 1

11 12/11/2015 Mu6lis 2$1!51 1

12 13/11/2015 M*4li 'usni 2$32!2 1

13 15/11/2015 ;ustamar 118032 11& 1#/11/2015 4mrani 2$2$15 1

15 1#/11/2015 -ainu,in 2$3&1$ 1 1

1# 1#/11/2015 iti emang 2$2!!1 1 1

1$ 1#/11/2015 ;atiar 2$3&31 1

18 18/11/2015 ;eo 2#&5!5 1

1! 1!/11/2015 4,is 2#5#5! 1

20 21/11/2015 .*Kota 2$3&$$ 1

21 21/11/2015 .ar,ianto 0388$2 1

22 22/11/2015 aria 2$2$#8 1

23 23/11/2015 Nasir 2$3555 1 12& 23/11/2015 I,ris 2#!$3# 1 1

25 23/11/2015 +atima 0#& 1

2# 23/11/2015 us%ian 2$35#2 1

2$ 2&/11/2015 -ailani 2$35#& 1

28 2&/11/2015 Nursian 2$358# 1

2! 25/11/2015 4),*ani6 2$&22& 1

30 25/11/2015 uara 2$&228 1

31 2#/11/2015 4smuni 2$&250 1 1

7enisKelamin


98/162

32 2#/11/2015 Misnur 2$&25# 1

33 2$/11/2015 7oansa 1!&5!1 1

3& 28/11/2015 -alea 2$&1!$ 1

35 28/11/2015 imati 25###!# 1 1

3# 28/11/2015 Pa66a 2$ 1

3$ 30/11/2015 arlius 2$#& 1

38 30/11/2015 Kamisa 2#380# 1


99/162


100/162

7UML4.


I II

1* Pasien 4wal

2* Pasien Masu6



5* Pasien i%in,a6an

#* Pasien iruu6





101/162




7enis Kelamin

III LK PR

1

1

1

1

1

1

1

1

1

11

1

1

1

1

1

1

1

1

1

1

1

1


102/162

1

1

1

1

1

1


103/162


104/162

KETERANGAN

I

11* Mati 9 &8 7am

12* Mati : &8 am






105/162

SENSU

PASIEN PINDAH KE


7enis

I II III


106/162


107/162


108/162

Kelas Rawatan

II III


109/162


110/162

28/11/2015 Nasir

2!/11/2015 4smuni

30/11/2015Nursian


111/162


112/162


113/162

SADA TEMBILAHAN

PASIEN KELUAR RAWAT IN

KELUAR RUMAH SAKIT

Umur Nomor RM7enis Kelamin Kelas Rawatan


2$2202 1 1 28/10/2015

1##552 1 1 01/11/2015

2$22$8 1 1 31/10/2015

2$120$ 1 1 01/11/2015

03! 1 1 01/11/2015

2#310& 1 1 20/10/2015

2$2$15 1 1 0&/11/2015

0&0122 1 1 01/11/2015

2#&5!5 1 1 0&/11/2015

2$25$& 1 1 01/11/2015

15!!30 1 1 11/11/2015

2$1!51 1 1 12/11/2015

2#31$8 1 1 0&/11/20152$325! 1 1 11/11/2015

118032 1 1 15/11/2015

2$2!!1 1 1 1#/11/2015

2$3&31 1 1 1#/11/2015

2$32!2 1 1 13/11/2015

2$2$15 1 1 1#/11/2015

2$3&1$ 1 1 1#/11/2015

2#5#5! 1 1 1!/11/2015

2$3&$$ 1 1 21/11/2015

0388$2 1 1 21/11/20152#&5!5 1 1 18/11/2015

2$2$#8 1 1 22/11/2015

0#& 1 1 23/11/2015

2$35#2 1 1 23/11/2015

2#!$3# 1 1 23/11/2015

2$&228 1 1 25/11/2015

2$&25# 1 1 2#/11/2015

2$&22& 1 1 25/11/2015


114/162

2$3555 1 1 23/11/2015

2$&250 1 1 2#/11/2015

2$358# 1 1 2&/11/2015


115/162


116/162


117/162

P

P7P=ara ;aar


1 1

1 1

1 1

1 1

1 1

1

1 1

1 1

1 1

1 1

1 1

1

11 1

1 1

1 1

1 1

1 1

1 1

1 1

1 1

1

1 11 1

1 1

1 1

1

1 1

1 1

1 1

1 1

i i(in6anPulang


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1 1

1 1

1


119/162


120/162


121/162


Tanggal

iruu6 R Lari 9 2& 74M : &8 74M

I

01/11/2015 2

02/11/2015 2

03/11/2015 1

0&/11/2015 1

05/11/2015 1

1 0#/11/2015 1

0$/11/2015 1

08/11/2015

0!/11/2015

10/11/2015

11/11/2015 1

1 12/11/2015 1

1 13/11/20151&/11/2015

15/11/2015

1#/11/2015 2

1$/11/2015 2

18/11/2015 2

1!/11/2015 1

20/11/2015

21/11/2015

1 22/11/2015

23/11/2015 22&/11/2015 2

25/11/2015 2

2#/11/2015 2

1 2$/11/2015 2

28/11/2015 2

2!/11/2015 1

30/11/2015 1

iruu6Pus6esmas

Pulang%a6sa


122/162

1


123/162


124/162


125/162


126/162


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129/162

Bulan "esember 2015

Pasien Aw :

Kelas I 1Kelas II :

Kelas III 5

VIP :

PASIEN MASUK

NO Tanggal Nama Pasien Umur Nomor RMKel

LK PR I

1 01/12/2015 Ma(ia 2$&$53 1

2 02/12/2015 Ir(al 2$&$#$ 13 0&/12/2015 Ka,ia 2$&$2& 1

& 05/12/2015 4r)ain 0&0122 1

5 05/12/2015 Maimuna 2$&!52 1

# 0#/12/2015 alu 2$&!85 1

$ 0#/12/2015 Raa taer 2$&&3& 1

8 0$/12/2015 M* Rai( 2$52&1 1 1

! 0$/12/2015 alama 2$5311 1

10 08/12/2015 7amalu,in 2$533$ 1

11 10/12/2015 M* Nasir 2$3555 1

12 11/12/2015 "lom salam 2$50#8 113 12/12/2015 M* U6as 2$5508 1

1& 13/12/2015 utina 2$5530 1 1

15 13/12/2015 Mu6tar 25$031 1 1

1# 1&/12/2015 4gus suma,i 2$55#& 1

1$ 15/12/2015 ulaiman 2$5&3# 1

18 15/12/2015 iti 4isa 2$5211 1

1! 1#/12/2015 u6ar,i 2$3#33 1

20 1!/12/2015 aliana 2$211! 1

21 20/12/2015 utina 2$5530 1 1

22 22/12/2015 7oansa 1!&5!1 123 22/12/2015 7umaia 2$1315 1 1

2& 22/12/2015 ariman 2$#08& 1

25 23/12/2015 Rie 2$#11! 1

2# 23/12/2015 Noi 2$#132 1

2$ 2&/12/2015 Mursi, 02$1!5 1 1

28 2#/12/2015 Mu6tar 25$031 1 1

2! 2$/12/2015 M* 7aari 2$#22& 1

7enisKelamin


130/162


131/162


132/162

7UML4.


I II

1* Pasien 4wal

2* Pasien Masu6



5* Pasien i%in,a6an

#* Pasien iruu6

$* Pasien Pin,a Ke R Lain

8* Pasien Pulang Pa6sa




133/162


PASIEN PINDAH DARI RUANGA

s RawatTanggal Nama Pasien Umur Nomor RM

7enis K

II III LK

1

11

1

1

1

1

1

1

1

11

1

1

1

1

1

1

1

1

1

1


134/162


135/162


136/162

KETERANGAN

11* Mati 9 &8 7am

12* Mati : &8 am






137/162

LAIN PA

lamin Kelas RawatanTanggal Nama Pasien

PR I II III


138/162


139/162


140/162

Kelas Rawatan

I II III


141/162

SENSUS HARIAN PASIEN RAWAT INAP ANAK R

IEN PINDAH KERUANGAN LAIN

Nomor RM7enis Kelamin

Tgl Masu6 KL Ke Ruang TanggalLK PR

02/12/2015

03/12/20150&/12/2015

0&/12/2015

0&/12/2015

05/12/2015

05/12/2015

0#/12/2015

08/12/2015

10/12/2015

10/12/2015

11/12/201512/12/2015

12/12/2015

1&/12/2015

15/12/2015

15/12/2015

1#/12/2015

1!/12/2015

1!/12/2015

1!/12/2015

1!/12/201521/12/2015

22/12/2015

22/12/2015

23/12/2015

25/12/2015

25/12/2015

30/12/2015

31/12/2015


142/162


143/162


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145/162

SUD PURI HUSADA TEMBILAHAN

PASIEN

KELUAR RUMAH

Nama Pasien Umur Nomor RM7enis Kelamin Kelas Rawatan

Tgl Masu6LK PR I II III

Pa66a 2$ 1 1 28/11/2015

arlius 2$#& 1 1 30/11/20157oansa 1!&5!1 1 1 2$/11/2015

-alea 2$&1!$ 1 1 28/11/2015

imati 25###!# 1 1 28/11/2015

Kamisa 2#380# 1 1 30/11/2015

Ma(ia 2$&$53 1 1 01/12/2015

Ka,ia 2$&$2& 1 1 0&/12/2015

Ir(al 2$&$#$ 1 1 02/12/2015

alu 2$&!85 1 1 0#/12/2015

alama 2$5311 1 1 0$/12/2015

Raa taer 2$&&3& 1 1 0#/12/2015M* Rai( 2$52&1 1 1 0$/12/2015

Maimuna 2$&!52 1 1 05/12/2015

"lom salam 2$50#8 1 1 11/12/2015

M* Nasir 2$3555 1 1 10/12/2015

M* U6as 2$5508 1 1 12/12/2015

7amalu,in 2$533$ 1 1 08/12/2015

Mu6tar 25$031 1 1 13/12/2015

utina 2$5530 1 1 13/12/2015

u6ar,i 2$3#33 1 1 1#/12/2015

iti 4isa 2$5211 1 1 15/12/2015ulaiman 2$5&3# 1 1 15/12/2015

utina 2$5530 1 1 20/12/2015

4gus suma,i 2$55#& 1 1 1&/12/2015

7umaia 2$1315 1 1 22/12/2015

Rie 2$#11! 1 1 23/12/2015

7oansa 1!&5!1 1 1 22/12/2015

Noi 2$#132 1 1 23/12/2015

4r)ain 0&0122 1 1 11/1/2015


146/162


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149/162

ELUAR RAWAT INAP

SAKIT

iagnosa Keluar P7P=ara ;aar

Umum 7K 7KN>M 7KN>P;I PT

1

11

1

1

1

1

1

1

1

1

11

1

1

1

1

1

1

1

1

11

1

1

1

1

1

1

1


150/162


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153/162


iruu6 R Lari 9 2& 74M : &8 74Mratis

1

11

1

1

1

1

1

1

1

1

11

1

1

1

1

1

1

1

1

11

1

1

1

1

1

1

1

i i(in6anPulang

iruu6Pus6esmas

Pulang%a6sa


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Tanggal

RIN=I4N P4I"N

Pasien isa

I II III


158/162


159/162


160/162


161/162

ana

SENSUS RAWA

NO ;ulan

Pasien Masu6 Pasien Keluar

I Pin,aan i%in,a6an ii(in6an iruu6 iruu6

R*Ina% 6eruangan lain Pulang R Pus6esmas

1 7anuari AR"+B AR"+B AR"+B AR"+B AR"+B

2 +e)ruari AR"+B

3 Maret

& 4%ril

5Mei

# 7uni

$ 7uli

8 4gustus 38 0 3 31 0 0

! e%tem)er 2# 0 2 21 1 0

10O6to)er &0 0 & 3& 0 0

11No@em)er 38 0 1 28 0 0

12esem)er 2! 0 0 25 1 0


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INAP

=4R4 ;4'4R P4I"N CKeluar .i,u% ,an MatiD

Pulang Lari MatiUmum 7K 7KN>M 7KN>P;I PT ratis

Pa6sa 92& 7am :&8 7am

AR"+B AAA AR"+B AR"+B AR"+B AAA AR"+B AR"+B AA AR"+B

0 0 0 0 2 1! # 3 1

3 0 1 0 8 12 # 0 0 0

0 0 2 0 & 2& 8 0 0 0

0 0 # 0 1 21 12 0 0 0

0 0 & 0 1 22 5 0 2 0

Sensus Ri Paru

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