Juni 2017

PROGRAM OPERASI INSTALASI BEDAH SENTRAL
HARI / TANGGAL : KAMIS, 01 JUNI 2017
PENJAMIN
ASISTEN
REKAM
NO NAMA PASIEN KLS TGL LAHIR L/P RUANG DIAGNOSA TINDAKAN Tamb Alat OPERATOR PERAWAT
MEDIS
AI
1 Abdul Aziz 1 NPBI 46 th L KPD LD C638827 Abses Peritonsil Dx Tonsilektomi + Evakuasi Abses RR (THT) EV,SA
2 Agung Bawa Laksana 1 NPBI 24 th L MRK L1 C638486 Impaksi Gigi 2 Rahang Odontektomi Bor NSK RP S:
3 Ida Yuliastanti VIP NPBI 25 th P GRD L3 C510639 Polip Endometrium Multiple Histeroskopi Operatif HR
4 Edo Irian Pradana 1 NPBI 23 th L MRK 2 C624026 Defect Cranium Cranioplasty MTA
5 Suhadi 3 NPBI 64 th L R2B C625105 Bone Defect reg Temporal Cranioplasty Miniplate AJ
6 Siti Komisah 3 NPBI 49 th P R2A C530509 Meningioma Cranioplasty AJ
7 Muslimah 3 PBI 53 th P R3A C619568 Mata Kanan Kiri Enteropion Mata Kanan Kiri Koreksi Enteropion INA TW,AM
LD I, II,
8 Callista Meylina 2 NPBI 1 th P Transit C633793 Laringomalasia Supraglatotomy DAT
Endoskopi
9 Soemadi 1 NPBI 74 th L KTL C152365 Ca Laring Pasang NGT + LF DAT
10 Sri Hartini 3 NPBI 7/7/1991 P R3A C356661 Adeno Ca Sinonasal + Fistel Oronasal Maksilektomi Medial +Tutup Fistel DAT
HNP L3 - 4, 4-5, 5- S4 Degeneratif Disc
11 Wahyuningsih 3 NPBI 62 th P R3A C272984 Percutaneus Disectomy + Neuroplasty C Arm TRI ANM
Desease
12 Fransiskus Stefanus L 2 NPBI 41 th L MRK LD C638023 RSK + SD + RA FESS + SR + Konka Reduksi Endoskopi RH EM,DN*
Endoskopi +
13 Rachel 1 NPBI 6 th P Anak D C629422 Mata Kiri Susp ODNL Kongenital Mata Kiri Eksternal + Endo DCR FESS + Lumina INA+RH
Kecil 0-30
14 Joko Agus Susantho 1 NPBI 48 th L KTL C633973 Mata Kiri RRD Mata Kiri Vitrectomy + EL + Gas / SO Opmic AW DI,TU
15 Edy Supardi 1 NPBI 62 th L KPD LD C633123 Mata Kiri Afakia + Lensa Drop Mata Kiri Vx + SI + Endofragmen Opmic AW S:
16 Aisyah VIP NPBI 9/23/1935 P GRD L4 C638772 Mata Kanan Retinal Detachment Mata Kanan Vitrektomi + EL + Gas AW
17 Arif Maret Pribadi VIP NPBI 52 th L GRD L5 C638714 Mata Kanan Ablatio Retina Mata Kanan SB + Vitrectomi AW
18 Adam Baim Albiruni 3 JMK 5 bln L Anak LD C638404 Hidrocephalus VP Shunt MP L-Connector GK LW,EA
19 M Arsyad 3 NPBI 14 th L Anak LD C636948 Epilepsi Craniotomi Bedah Epilepsi ZM
20 Kuswati 3 NPBI 51 th P R2A C627373 Meningioma Craniotomi DP S:
21 Kumaeroh 3 NPBI 45 th P R2A C629561 Avaskular Nekrosis Caput Humerus Sin Hemiartroplasty Shoulder Sin DRY DY*,RA
22 Destiya Alif Prayoga 1 NPBI 1 th L Anak D C556090 CTEV Post ORIF + Gips Aff Implant + Gips DRY
Instrumen
23 Matius Misranto 1 NPBI 59 th L KPD 1 C632582 RCT Dextra Arthroscopy RC Rekonstruksi k/p Open Shoulder DID
( Tawada)
M : NO,AF,AD,AR,BY SORE PROGRAM : NH,RG*,RE,DA,DM,TK,VT,MW*,MF,YS
HARI / TANGGAL : JUMAT, 02 JUNI 2017

RAL
J. SERAH TERIMA
DPJP ANESTESI
JAM PROGRAM
PEMBERSIHAN
JAM DTG RIIL
Jenis anestesi
OK
OK
CT
1 GA 06.30 07.00
1 GA 09.00 120
1 GA 12.00
1 GA 14.00
1 GA 16.00
1 GA 18.00
2 GA 07.30 08.00 180
2 GA 10.00
2 GA 13.00
2 GA 14.00
3 LA 09.30 10.00
4 GA 07.30 08.00
4 GA 11.00
8 GA 07.30 08.00 120

8 GA 10.00 120
8 GA 12.00 120
8 GA 14.00
9 GA 06.30 07.00
9 GA 09.00 300
9 GA 14.00
10 GA 07.30 08.00
10 GA 10.30
10 GA 12.00
RAL
PENJAMIN
ASISTEN
REKAM
MEDIS
SL,HE, DJ,
S : WU,RK,RE
DY,VQ
Hipospadia Tp Penoscrotal Post Uretroplasty 1
1 Aan Kurniawan 3 NPBI 18 th L R2B C376331 Re Uretroplasty ADS EV,AU
th yll
2 Wiro Supar 3 NPBI 82 th L R2B C629713 Massa VU, Hematuria Sistoskopi Biopsi ADS S : ER,DM
3 Misranto 2 NPBI 15 th L Pol URO C637743 Retensi Urin Sistoscopy ADS
4 Muhtadi 3 NPBI 57 th L R1B C618710 Nefrolithiasis Dextra Nefrolitotomi Dextra ADS
Mata Kanan Proptosis d.d Lifoma susp Selulitis Mata Kanan Eksenterasi Bulbi + Rhinotomi
5 Amat Slamet 3 NPBI 51 th L R3B C637186 Endoskopi TL + DAT AI,AO
orbita + Massa Sinonasal Lateral
6 Kaswaji 2 NPBI 55 th L MRK LD B390941 Otitis Eksterna Maligna Kuret Granulasi Mikroskop, ME ZUL
FASTACK
Artroscopy
7 Nia Ariska 2 NPBI 19 th P KPD LD C632884 ACL Ankle + Stiffnus Knee ACL Rekonstruksi k/p Liberation DID
Suture Passer
Tawada
Mata kanan kiri Retinal Detachment + Mata

8 Tariyem 3 NPBI 70 th P Pol MTA C630283 Mata kanan Phaco + IOL Opmic RF YW,TU*,MK
Kanan KSI
9 Victoria Karnasih 2 NPBI 53 th P Pol MTA C603572 Mata kanan kiri POAG, Mata kiri KSI Mata Kiri Phacoemulsifikasi + IOL Opmic FI S : TR
10 Kardi 3 PBI 55 th L Pol MTA C603552 Mata kiri PACG + KSI Mata kiri triple Procedure Opmic MR
Mata kanan kiri pseudofakia + High
11 Suti 3 PBI 72 th P Pol MTA C6289917 Mata kanan buka jahitan Opmic WIS
Astigmatisma
12 Rusmiyati 3 NPBI 50 th P Pol MTA C620942 Mata Kanan Missed Calculated IOL Mata kanan IOL Exchange Opmic WIS
13 Suyati 3 NPBI 54 th P Pol MTA C627801 Mata kiri Afakia Mata kiri Secondary Implant + Iris Clip Opmic, Iris clip WIS
14 Rokhanah 1 NPBI 54 th P KPD L1 C638527 Efusi Pleura WSD FTR
15 Sudarmanto 3 NPBI 48 th L HCU C610762 Efusi Pleura Dextra WSD FTR
16 Fitri Suharwati 3 NPBI 3/11/1983 P Obstetri C631030 NOS + Ascites Susp Kista Hepar SOU + FS s.d CSS KD 3 INU TW,NI
17 Umiyati 1 NPBI 38 th P Obstetri C483294 NOK c/ Ganas Laparatomi + FS KD 2 EN S : TK
18 Suharso Arif W 2 NPBI 57 th L KPD LD C629406 Cholelithiasis Laparascopy Cholesistektomi ERI
19 Sudarmi 3 NPBI 46 th P R2A C637382 Hernia Umbilical Residif Laparatomi Repair Hernia + Mesh ERI
20 Ali Mursidi 3 NPBI 35 th L R1B C627223 Appendicitis Kronis Laparascopy Appendictomy STORZ MM TD,BD
21 Turinah 1 NPBI 65 th P KTL C637041 Ascites Masif c/ Serosis Hepatis Drainase Ascites + Sitologi MG S :ES
22 Junaryo 3 NPBI 38 th L R2B C637907 Ikterik Obstruktif ec Tumor Duodenum Whiple Procedure k/p By Pass MG
23 Trio Budi Prasetyo U 3 NPBI 26 th L R2B C634359 Fistel Perianal Fistulotomi ERI
24 Ahmad Ali Ramadhan 3 NPBI 11 bln L Anak LD C621522 STT Femur Sin c/ Ganas Wide Eksisi + Rekonstruksi DH AZ,TM,ID
25 Rusmi 3 NPBI 46 th P R2A C616943 SNNT Sin c/ Ganas Ishmolobektomi + FS ganas Total Tiroidektomi UUD S :MY,MF
Ishmolobektomi + FS ganas Total Tiroidektomi
26 Dwi Rahmi Aningdyah 3 NPBI 38 th P R2A C615371 SMNT Bilateral, STT UUD
+ Eksisi Biopsi
Superficial Parotidectomy + FS ganas Total
27 Darmadi Susanto 3 NPBI 27 th L R2B C634056 Tumor Parotis Sin c/ Ganas UUD
Parotidectomy
28 Sutomo 3 NPBI 53 th L R2B C621969 BCC Regio Nasal Pasca Ekstirpasi Rekonstruksi NJT TA,RA
29 Slamet Mulyono 3 NPBI 53 th L R1B C638843 Fr Corpus Sin Mandibula Rekonstruksi ORIF Miniplate PJ S : YS
30 Saroah 3 NPBI 51 th P R3A C637682 Ulkus Dekubitus Debridement ALI
Debridement + Eksplorasi k/p Amputasi Below
31 Sri Murti 3 NPBI 62 th P GER LD C636275 Selulitis Wrist Joint Distal ALI
Elbow
Mata Kanan Ekstraksi Lensa + PPC + PI + IOL Opmic,Benang
32 Moh Zaenul Aslam 3 NPBI 10 th L Anak LD C630930 Mata Kanan Katarak Traumatika LN NK,HR
+ Vitrectomi Anterior Skleral Fiksasi
33 Eko Budi Santoso 1 NPBI 58 th L KPD L1 C636827 Mata kanan Total Retinal Detachment Mata kanan Vitrektomi + EL + SO / Gas AL
Mata Kanan SO Filled Eye + Katarak

34 Muhammad Fahmi 3 NPBI 25 th L R1B C599683 Mata Kanan Evakuasi SO + Phaco + IOL Opmic AL S : HA
Komplikata
DPJP ANESTESI
JAM PROGRAM
PEMBERSIHAN
JAM DTG RIIL
Jenis anestesi
J. SERAH
TERIMA
OK
OK
CT
1 GA 07.30 08.00
1 GA 10.00 AM
1 GA 11.00
1 GA 12.00 TU
2 GA 07.30 08.00 SE
2 GA 13.00 120 YN US
2 GA 15.00
3 LA 08.00
3 LA 10.00
3 LA 11.00
3 LA 12.00
3 LA 12.30
3 LA 13.30
3 LA 14.30
3 LA 15.30
4 GA 07.30 08.00
4 GA 13.00
4 GA 15.00
4 GA 17.00
5 GA 07.30 08.00 60
5 GA 10.00 60
5 GA 13.00 180
5 GA 19.00 60
6 GA 07.30 08.00 160
6 GA 11.30 160
6 GA 14.30 180
6 GA 17.30
120
7 GA 07.30 08.00
7 GA 10.00
7 GA 14.00
7 GA 15.30
8 GA 06.00 06.30 90
8 GA 08.00
8 GA 10.00 120
Mata Kanan Pseudofakia + RRD, Mata Kiri
35 Suparno 2 NPBI 59 th L MRK D C638759 Mata Kanan Vitrektomi + EL + SO/ Gas AL
Glaukoma Absolut ( HBSAg + )
36 Suherman Privat UM 30 th L Pol GRD C637642 Mata kiri Katarak Traumatika + Iridoreksis Mata Kiri Ekstraksi Lensa + Jahit Iris RF
37 Sunaryo Gana VIP NPBI 57 th L GRD L4 C059436 HNP Fusi Posterior + Laminektomi Kompleks Pedicle Screw ZM LW,SF
S : SA,SU
38 Endang Retnowati 3 NPBI 52 th P R4B C633689 Fr. Kompresi Vertebra L 5, Canal Stenosis PSRS C arm APR PR,AP
39 Tri Iwan Arianto 3 NPBI 35 th L R2B C638108 Plexus Brachialis Injury Sin Neurotisasi + Rekonstruksi Tl Wajah DRY+ RZ S : AN
40 Sri Lestari 2 NPBI 61 th P KPD LD C610772 OA Genu Dx TKR Dx FASTRACK BIN
41 Bernardus Gilang 1 NPBI 18 th L MRK 2 C613239 Osteosarcoma Femur Sinistra Amputasi BIN
EN,MA,DI,
BP,SS,IM
S :VT,WI
42 Wardinah 3 PBI 72 th P R6A C637183 NOK dg Bagian Padat SOU + FS KD 1 EW NP,WD,PL
43 Ina Muskhafiati 2 NPBI 23 th P Transit C637090 NOK SOU + FS KD 5 VG
44 Dewi Sekartaji 3 NPBI 25 th P R4B B314930 Adenomiosis Osada Prosedur GYN GBS HR AL,AM*,DN
45 SCTP ER
46 SCTP ER
47 M Abid Miftahurrohman 3 NPBI 11 bln L Anak LD C606615 UDT Bilateral Orchidopexy Bilateral EDW AH,RI*
48 Adelia Faranisa 3 NPBI 1 th P Anak LD C617477 PSARP Failure, MAR on Kolostomi Re-PSARP RR
49 Ria Sofia 2 NPBI 38 th P KPD LD C625525 Ca Mamae Diseksi Axilla Dx FASTRACK YAN GI,SE*
50 Masirah 3 NPBI 56 th P R5B C632054 SMNT Sin c/ Ganas Ishmolobektomi + FS ganas Total Tiroidektomi YAN
51 Yayuk Abrurroji 1 NPBI 26 th L KTL C637924 Ruptur Uretra Posterior PER WAN AY,AS, ANM
52 Sukartini 1 NPBI 76 th P MRK L1 C638526 Abses Perianal Insisi Drainase Abses ERI S : JF,MW
53 Corinna Ramadani 10 th P C634770 Fever of unknown Lumbal Pungsi HAPSARI
54 Nuriya Susilawati 3 NPBI 32 th P Obstetri C431530 P3A0 Ingin Steril MOW PS
55 Sri Wahyuni 2 NPBI 39 th P Transit C638620 TB Paru Bronchoscopy THOM YR,US*,SC
56 Endang Sri Utami 2 NPBI 39 th P MRK LD C637779 Suspect Massa Paru Kiri Bronchoscopy SFY
57 Brian Indra VIP NPBI 35 th L GRD L5 C635091 Obesitas post gastricplication EGD MG
58 Herwi L 3 NPBI 39 th P R5B C606156 Konstipasi ec Tumor Extralumen Colonoscopy Stenting MG
59 Puji Rahayu 3 NPBI 48 th P Pol DIG C638151 Tumor Intra Abdomen Colonoscopy ERI
60 Daqoiq 3 NPBI 50 th L Pol DIG C635833 Tumor Intra Abdomen Colonoscopy ERI
61 Aryati 3 NPBI 61 th P Pol DIG C575386 Hematoschezia Colonoscopy ERI
62 Ramto 1 NPBI 64 th L KTL C636950 Ikterik Obstruktif ERCP C-ARM HRY
63 Maryono VIP NPBI 86 th L GRD L4 C224742 Akalasia EGD HRY MR,EW
64 Dwi Isworo VIP NPBI 39 th L GRD L4 C478729 Dyspepsia EGD AGG
65 Ragu Rahman 2 NPBI 73 th L KPD C596590 Melena EGD AGG
66 Tumijo 2 NPBI 47 th L ICU C636328 Post Craniotomi ec EDH Bronchial Toilet FRD
67 Supariyah 3 NPBI 40 th P HCU C419867 Pneumonia Bronchial Toilet FTR
68 Padni 3 NPBI 51 th P Pol URO C625020 Nefrolithiasis ESWL MAS AK
69 Kosim 3 NPBI 67 th L Pol URO C581359 Nefrolithiasis ESWL MAS
70 Ratini 3 NPBI 45 th P Pol URO C609340 Nefrolithiasis ESWL MAS
71 Jasmi 3 NPBI 38 th P Pol URO C610084 Nefrolithiasis ESWL WAN
M : NH,II,AD,BY,RG,UM RR : FA,EM,RM MID : SAM,ST RR GRD :SR, EA SORE PROGRAM : WU,RK,SA*,AN*,RE,DA*,DM,TK,VT,YN,ER,ES,HA,MY,JF,WI,MW,MF,YS,SU,TR ALAT : PUR,CA (
L : AR,AG,AF,AT,BR,DB,ET,HI,IS,PS,NO,PM
Ratna Yunita 2 NPBI 36 th P KPD LD C621228 Mata Kanan Kiri VH + TRD + PDR Mata Kanan Vx + EL + Gas / SO Opmic AW
Meyla Putriani 3 NPBI 3 th P Anak LD C634850 STT Flank Sin Eksisi + Rekonstruksi PTY Mau MSCT
HARI / TANGGAL : SABTU, 03 JUNI 2017

8 GA 13.00
8 GA VL 14.30
9 GA JH 06.30 07.00 240
9
10 GA 06.30 07.00
10 GA 10.30 180
10 GA 16.00
10 GA 18.00
JTG
JTG
GR 1 GA 07.30 08.00 160
GR 1 GA 12.30
GR 2 GA 07.30 08.00 120
GR 2 GA 10.00 120
GR 2 GA 11.30
GR 3 GA 07.30 08.00 180
GR 3 GA 10.30 300
GR 4 GA 07.00 07.30
GR 4 GA 09.00 180
DS 1 GA 07.00 07.30
DS 1 RA 09.00
DS 1 LA 10.30
DS 1 LA 13.00
DS 2 GA 07.30 08.00
DS 2 09.00
DS 2 GA 10.00
DS 2 GA 11.30
DS 2 GA 13.00
DS 2 GA 14.00
DS 2 GA 15.00
DS 3 GA 07.30 08.00
DS 3 GA 10.00
DS 3 LA 11.00
DS 3 LA 11.30
ICU GA 13.00
HCU GA 14.00
DS LA 08.00
DS LA 10.00
DS LA 13.00
DS LA 15.00
TK,VT,YN,ER,ES,HA,MY,JF,WI,MW,MF,YS,SU,TR ALAT : PUR,CA ( S: YN )
RAL
PENJAMIN
ASISTEN
REKAM
MEDIS
LW,HR,AU,
PLH : AH,AP EW, RM,MK,
SR, TM
PINDAHAN OK GRD BERSIH 2 OK

NK,YW,TR,VQ,NP,AL,WD,AM 1 : AO,IM 5 : TD,BD 9 : SF, YN
ANEST : HE,BP,YR,SC 2 : AI, DW 6 : AZ,ID 10 : PR,PL
MEJA OP : AS,SL,SS 4 : TW,RI 7 : TA,SE JT : EN,MA
DS : GN,AY,US,MR
1 Sakuri 3 NPBI 47 th L R3B C577048 Ca Sinonasal + Mata Kiri Proptosis Hemimaksilektomi + Orbitotomi Anterior WY + TL
2 Ahmad Rizki Khoirul A 3 NPBI 7 bl L Anak D C606521 MAR Tanpa Fistel Post Kolostomi PSARP PTY
3 Sunarsih 2 NPBI 56 th P MRK LD C633357 Adeno Ca Endometrium IA Surgical Staging MZ RE
C-Arm, Pedicle
4 Masriah 1 NPBI 54 th P KPD LD C633645 Spondilitis Lumbalis Laminectomy Lumbalis Screw, Nut, MTA + AJ SA,DY
Cros Link, Root
5 Oemi Salamah 2 NPBI 82 th P KPD LD C635427 Ca Sinonasal Aff Tampon + NF Endoskopi WY AY
6 Ramto 1 NPBI 64 th L KTL C636950 Ikterik Obstruktif ERCP C-ARM HRY GN,MR,US
7 Maryono VIP NPBI 86 th L GRD L4 C224742 Achalasia Achalasia r/ EGD Baloning k/p Open C arm HRY + MG
8 Jindan 3 NPBI 45 th L P. Uro C585500 Nefrolithiasis ESWL MAS AK
9 M. Nur Wahid 3 NPBI 22 th L P. Uro C588321 Nefrolithiasis ESWL ADS
10 Aris Asmoro 3 NPBI 41 th L P. Uro C556133 Nefrolithiasis ESWL ADS
M : NH,UM,TK,VT,RG,MW RR : EM,RM,SAM,ST,EA SORE PROGRAM : RK,ER,AN,SA,SU,RE,DY,ES,JF,WI,YS ALAT : PUR,CA ( S: YN )
L : AR,AG,AF,AT,NI,BR,BY,DA,DM,DN,DB,DI,DJ,ET,HA,HI,IS,II,MY,TU,ANM,PS,MF,NO,PM,RA
ASI INSTALASI BEDAH SENTRAL
HARI / TANGGAL : MINGGU, 04 JUNI 2017

PENJAMIN
ASISTEN
REKAM
MEDIS
AY,AG,
NI,BR,WU,
HI,MY,ANM,
PL, WD
1 Ratna Yunita 2 NPBI 36 th P KPD D C621228 Mata Kanan Kiri Proliferatif Diabetic Retinopath Mata Kanan Vitrectomy + EL + MP + SO AW AG,WD
M : RK,AN,TK,VT,MW
DPJP ANESTESI
JAM PROGRAM
PEMBERSIHAN
JAM DTG RIIL
Jenis anestesi
J. SERAH
TERIMA
OK
OK
CT
1 GA 13.30 14.00 180

2 GA 14.30 15.00
4 GA WA 13.30 14.00 120
9 GA 13.30 14.00
180
DS 1 LA 07.30 08.00 45
DS 2 GA 07.30 08.00
DS 2 GA 10.00
DS LA 08.00
DS LA 09.30
DS LA 10.30
DPJP ANESTESI
JAM PROGRAM
PEMBERSIHAN
JAM DTG RIIL
Jenis anestesi
J. SERAH
TERIMA
OK
OK
CT
GR2 GA 08.00
HARI / TANGGAL : SENIN, 05 JUNI 2017
PENJAMIN
ASISTEN
REKAM
MEDIS
SL,HE,SE,IS,
S : NO,AY, EA
DJ*
1 Sholikin VIP Um 61 th L GRD L6 C638813 Hidronefrosis + Nefrolithiasis URS Dx et Sin + Pasang DJ Stent Dx et Sin ADS EV,AO,ID
2 Imam Iswanto 3 NPBI 48 th L R2B C631788 Nefrolithiasis Dx PCN C-Arm ADS S : AU
3 Iqbal Prisma Pradana 1 NPBI 24 th L MRK L1 C474895 Pasca Transplantasi Ginjal dg CAPD Aff CAPD ADS
4 M Ismail 2 NPBI 45 th L KPD L1 C552921 Papiloma Laring LD + Biopsi FASTRACK DAT AI,EM,YN
5 Muh Shaffnan Nurul 2 NPBI 16 th L IGD C639154 Fr Femur Dx 1/3 Prox ORIF DID
6 Nor Kalim 2 NPBI 47 th L MRK LD C594140 Nefrolithiasis Dx + Ca Buli Re-PCN Dx C-Arm MAS
7 Arief Gunarto 2 NPBI 56 th L KPD L1 C609149 CKD Psg Double Lumen Longterm FASTRACK WW
8 Alimatul Abidah 2 NPBI 32 th P Obstetri C637444 NOK c/ Ganas SOU + FS EN TW,NI
9 Siti Hartatik 3 NPBI 34 th P Obstetri C631767 NOK SOU + FS INU S : DA
10 Suripna 3 NPBI 67 th L R2B C588112 Hernia Inguinalis Sin Residif Hernia Repair + Mesh MM TD,RE*
11 Ain 3 NPBI 19 th L R1B C609142 Post Colostomy Laparatomi Anastomosis Colon MM S : TM
12 Indra 2 NPBI 40 th L KPD LD C621243 Cholelithiasis Laparoscopy Cholesistektomi ERI
13 Nurul Indah Fitriani 2 NPBI 44 th P KPD LD C624985 Tumor Colon Ascenden Hemicolektomi Dx ERI
14 Rojikin B Risjad 3 NPBI 38 th L R3B C636333 Hepatomegali + Nodul Laparoscopy Biopsi ERI
15 Abdul Said 3 NPBI 59 th L R6B C633580 Multiple Nodul Hepar (Hbs Ag +) ERI
16 Nuriyadi 3 NPBI 39 th L R1B C637342 STT Reg Thorax Anterior Insisi Biopsi BIS AZ,DN
17 Suyono 3 NPBI 58 th L R C638494 Tumor Rongga Mulut C/ Ganas Eksisi Biopsi KGB Colli BIS S : RM
Isthmolobektomi + FS ganas Total
18 Casmirah 3 PBI 70 th P GER LD C636943 SNNT c/ Ganas UUD
Tiroidektomi
19 Sulistyowati 3 NPBI 42 th P R4A C634908 SMNT c/ Ganas + Stenosis Esofagus UUD + PB
Tiroidektomi + Gastrojejunostomi
Wide Eksisi + Rekonstruksi free flap +
20 Rukayin 3 PBI 46 th L R1B C633659 Ulkus Kronis reg calcaneus dex c/ malignansi ETH + UUD TA,ES*
adenektomi + FS, gns-Groin Disection
S : ANM
21 Adam Slamet Purnomo 3 NPBI 8 bl L Anak D C602902 Hernia Umbilikalis Post Repair Omphalocele Abdominoplasty RR (BA) ET,BR,MY
22 Syakira Afika Naila 3 NPBI 1 th P Anak D C636482 Tumor Hepar C/ Hepatoblastoma Biopsi RR (BA) S :HI,VQ
23 Rimbunsari 1 NPBI 6/21/1971 P Obstetri C633059 NOK SOU + FS EW
LW,SF
S :AT
24 Muhammad Solikhin 3 NPBI 47 th L Transit C638831 Fr collum humeri sin Debridement + Wire APR PR,AP
25 Hidayat Abdulloh 3 NPBI 25 th L R2B C625977 Plexus Brachialis Injury Dextra Neurotisasi Tahap 1 DRY S : AG
26 Musnunah 1 NPBI 54 th P Transit C495487 Fr. Collum Humeri Sinistra ORIF BIN
27 Abdul Rojak 3 NPBI 26 th L R1B C636875 Dislokasi Posterior Hip Joint THR Dx BIN
EN,MA,WI
BP,SS,AS
S : BD,DM
Mata Kanan APAC, Mata Kiri PACG + Katarak
28 Sumiati 3 NPBI 58 th P R3A C637881 Mata Kanan Trabekulektomi Opmic MR YW,HA,RI
Senilis Imatur
RAL
DPJP ANESTESI
JAM PROGRAM
PEMBERSIHAN
JAM DTG RIIL
Jenis anestesi
J. SERAH
TERIMA
OK
OK
CT AI
1 GA JL 07.30 08.00 08.30

1 GA JL 09.00 12.30
1 GA JL 13.00 60
2 GA JL 07.30 08.00 09.00 60
2 GA JL 09.30 11.00
2 GA JL 11.30
3 LA 08.00
4 GA HA 07.30 08.00 11.30
4 GA HA 12.00 120
5 GA HA 07.30 08.00 09.00 60
5 GA HA 09.30 12.00 120
5 GA VL 12.30 14.00 120
5 GA HA 14.30 16.00 120
5 GA HA 16.30 17.00 60
5 GA HA 17.30 120
6 GA DN 06.30 07.00 08.00 30
6 GA DN 08.30 09.30
6 GA DN 10.00 13.30 180
6 GA DN 14.00
300
7 GA DN 07.30 08.00
8 GA VL 08.00 10.00 120

8 GA VL 10.30 14.30 120
8 GA VL 15.00
9
9
10 GA HR 08.00 10.00 120
10 GA HR 10.30 14.30
10 GA HR 15.00 16.30 120
10 GA HR 17.00
JTG
JTG
GR 1 LA 07.20 07.30 08.00

60
Mata Kanan Vitrektomi Eye + SO Filled Eye +
29 Djajoes Joeswadji 1 NPBI 74 th L KPD 1 C427688 Mata Kanan Evakuasi SO AL NK,HR
Glaukoma Sekunder
Mata Kanan Kiri Proliferatif Diabetic
30 Enny Lestari 1 NPBI 57 th P KTL C624869 Retinopathy + Mata Kanan Tractional Retinal Mata Kanan Vitrectomy + EL + Gas / SO Opmic AL S : DI,TU,MK
Detachment
31 Andi Setyo Nugroho 1 NPBI 29 th L MRK L2 C577773 Mata Kiri Katarak Komplikata + SO Filled Eye Mata Kiri Phaco + IOL + Evakuasi SO Opmic AL
Mata Kanan Kiri Subluksasi Lensa ec Marfan

32 Meri Linda 3 NPBI 12 th P Anak L1 C637419 Mata Kanan EKIK + AC IOL (Iris Clip) Opmic RF
Syndrome
33 Warti 3 NPBI 49 th P Obstetri C631317 Mioma Uteri TAH BES NP,AM,WD
34 Nur Aini 2 NPBI 46 th P MRK LD C637778 Mioma Uteri + Heavy Menstruasi Bleeding Miomektomi s/d TAH TF
35 Djoko Rasmanto 3 Jmkt 57 th L R1B C638817 Mata kanan Glaukoma Sekunder Mata kanan Cyclocryoterapi Opmic MR
36 Yuliati 1 NPBI 53 th P KPD LD C620415 TMS Eksisi Biopsi YAN AL,TR
37 Astuti 1 NPBI 57 th P KPD L1 C637007 SMNT c/ Ganas Subtotal Tiroidektomi + FS UUD
Plate 2.0 10mm

38 Atho'illah Yusqi 1 NPBI 38 th L MRK L1 C615493 Osteomyelitis Mandibula Pasca ORIF Debridement + Rekonstruksi Mandibula 10 hole (I), RZ AH,AF*,PL
Screw 2.0 (10)
39 Purwati 3 NPBI 45 th P R4A C608474 Ca Cervix St 3b, Moderate HN + HU Sistoskopi + Biopsi WAN ST,PM,IM
40 Mustaidah 3 UM 72 th P P. Uro C638132 Massa VU Sistoskopi + Biopsi WAN
41 Nuryadi 2 NPBI 54 th L KPD L1 C624487 Post DJ Stent Aff DJ Stent FASTRACK MAS
42 Warti 2 NPBI 57 th P KPD L1 C628521 Moderate HN + HU Bilateral Pasang DJ Stent MAS
43 Jaminah 2 NPBI 62 th P Transit C555782 Hematuria c/ Metas Ca Cervix Sistoskopi + Biopsi MAS S : SC,MR
44 Wasmu 3 NPBI 65 th L R6B C637528 Massa VU TUR Buli MAS
45 Umar Syarif 3 NPBI 65 th L P. Uro C634358 Post Nefrolithotomi + DJ Stent Aff DJ Stent ADS
46 Sumarti 3 JMK 58 th P P. Kand C636460 Condiloma Accuminata Kauterisasi INU
47 Reisya 3 NPBI 6 th P P. Anak C633649 Susp Keganasan Hematologi BMP HER YR,US,MF
48 Fitrotul G 14 th P P. Anak C622701 ALL BMP HER
49 Reisya NPBI 6 th P P. Anak C633649 Susp Keganasan Hematologi BMP HER
50 Fiki Nur 3 NPBI 15 th L Anak 1 C638779 Susp Keganasan Hematologi BMP HER
51 Yusro 3 PBI 1/29/2012 P Anak 1 C637157 CML BMP MOED
52 Sarwoto 3 NPBI 55 th L P. Dalam C636274 Sirosis EGD HRY GN,EW,RA
53 Rasmono 3 NPBI 54 th L P. THT C639209 Susp Massa Nasofaring NF + NBI + Biopsi DAT
54 Siran 3 NPBI 53 th L P. THT C639228 Limfadenopati Sin LF + NBI + Biopsi DAT
55 Amat Slamet 3 NPBI 51 th L R3B C637186 Massa Sinonasal Pasca Hemimaksilektomi Aff Tampon + NF DAT
56 Muhtarom Priv Um 46 th L P. GRD C639130 Massa Supraglotis LF ZUL
57 Daqoiq 3 NPBI 50 th L P. DIIG C635833 Tumor Intra Abdomen Colonoscopy ERI
58 Hendi Setiawan 3 NPBI 50 th L P. Dalam C637849 Tumor Intra Abdomen Colonoscopy ERI
59 Sumarno 3 NPBI 29 th L P. DIG C638686 Tumor Intra Abdomen Colonoscopy ERI
60 Sri Kawelas 3 NPBI 52 th P P. Uro C173052 Batu Renal Sinistra ESWL MAS AK
61 Tomi Tawaf 3 NPBI 54 th L P. Uro C319443 Batu Renal Sinistra ESWL MAS
62 Pusriah 3 NPBI 57 th P P.Uro C316986 Nefrolithiasis ESWL MAS
63 Joni Priyo 3 NPBI 53 th L P. Uro C634025 Nefrolithiasis ESWL ADS
M :RK,AN,DY,JF,YS,SA,SU RR : FA,SAM,SR* MID : DB,ER RR GRD : WU,PS SORE PROGRAM : NO,AY,AR*,AU,AG,AT*,BD,DA,DM,DI,EA,HI,TU,MR,ANM*,MK,RM,SC,TM,VQ ALAT : PUR,CA
L : AD,BY,TK,VT,II,MW,NH,RG,UM
Sulastri 2 NPBI 47 th P Transit C638708 Fr Kompresi VTh 11-12 PSRS APR selasa
Mukaromah 3 NPBI 41 th P Pol MTA C638192 Mata kanan kiri pterygium rekuren Mata kiri eksisi pterygium Opmic DN
39
GR 2 GA DS 07.30 08.00 09.30
GR 2 GA DS 10.00 11.30
120
GR 2 GA DS 12.00 13.30 120
GR 2 GA DS 14.00
90
GR 3 GA SF 07.30 08.00 10.00
GR 3 GA SF 10.30 14.30 120
GR3 GA SF 15.00
GR 4 GA SF 07.20 07.30 08.30 60
GR 4 GA SF 09.00 180
GR 5 GA 07.30 08.00 11.30
DS 1 GA HR 06.30 07.00 07.20

DS 1 GA HR 07.30 07.45
DS 1 GA HR 08.00 08.30
DS 1 GA HR 09.00 09.30 60
DS 1 GA HR 10.00 10.30 60
DS 1 GA HR 11.00 11.30 60
DS 1 GA HR 12.00 12.30
DS 1 GA HR 13.00
DS 2 GA HR 08.00 08.30
DS 2 GA HR 09.00 09.30
DS 2 GA HR 10.00 10.30
DS 2 GA HR 11.00 11.30
DS 2 GA HR 12.00
DS 3 GA HR 08.00 08.30 60
DS 3 LA 09.00 09.20
DS 3 LA 09.30 09.45
DS 3 GA HR 10.00 10.20
DS 3 LA 10.30 10.45
DS 3 GA HR 11.00 11.30
DS 3 GA HR 12.00 12.30
DS 3 GA HR 13.00
DS LA 08.00
DS LA 09.00
DS LA 10.00
DS LA 11.00
BD,DA,DM,DI,EA,HI,TU,MR,ANM*,MK,RM,SC,TM,VQ ALAT : PUR,CA ( S: DW )
GR 5 GA 12.00
HARI / TANGGAL : SELASA, 06 JUNI 2017
PENJAMIN
ASISTEN
REKAM
MEDIS
S : NO,AY, EA SL,II,HE,IS, DJ
1 Moh. Alim Istiawan 3 NPBI 10 th L Anak LD C602907 Hipospadia Uretroplasty ADS EV,AO,ID
2 Suwarni 2 NPBI P Obstetri C580160 HN e.c Ca cervix PNS, URS USG, PNS Set MAS
3 Marsam 3 NPBI 52 th L R1B C614466 OMSK Kiri Thympanoplasty Kiri Mikroskop PW S : AU
4 Lagi 3 NPBI 56 th L R6B C635019 Efusi Pleura Dextra Loculated Thorakotomi

ALI
Mata Kanan Endo DCR + Silikon Tube +
5 Setya Havis 3 PBI 5 th L Anak LD C630680 Mata Kanan Ateroma dd/ Dacryosistocele INA + RH AI,EM,ND
Probing + FESS1+Endoscopy
Mata Kanan Anofthalmia, Lagofthalmos ec
6 Karsidi 3 NPBI 30 th L R1B C628855 Mata Kanan Rekonstruksi Palpebra INA S : AR
Traumatik
7 Wasmuri 3 NPBI 50 th L R1B C638633 Compartement Syndrome post fasciotomi Eksplorasi Vaskuler, Tromboembolektomi AS
8 Khumaedah VIP NPBI 45 th P GRD L4 C604349 Ca Cervix Radikal Histerektomi + FS KD 1 EW TW,YN

9 Sriyati 2 NPBI 50 th P Obstetri C622653 Endometrioid Ca Endometrium St II Klinis Surgical Staging KD 2 EW S : SE
10 Yenny Susilowati 3 NPBI 38 th P R5B C638823 Cholecystitis, Cholesistolithiasis Cholecystectomy MM TD,RE
11 Suaimah 3 NPBI 56 th P R4B C638561 Multiple Cholelithiasis Laparoscopy Cholesistectomy ERI S : TM
12 By Hesty Dwi A 2 NPBI 2 bln P Anak LD C634277 Septik Arthritis Genu Sin Debridement + Kultur Jaringan BIN
13 Sunti 3 NPBI 49 th P R2A C631116 Ca Papilary Thyroid Completion TT BIS AZ*,DN
14 Hartutik 3 NPBI 50 th P R5B C625500 SMNT c/ Ganas T4NoMo DWT
Tiroidektomi
15 Endang Haryani 1 NPBI 51 th P KPD L1 C610185 Ca Mamae Sin Gr III Wide Eksisi + Diseksi Axilla UUD S : RM
16 Mardiyah IRIN NPBI 44 th P ICU C632369 Ulkus Granulosum Cruris Pedis Sin Amputasi Above Knee NJT TA,AD
17 Teguh Azmi 3 NPBI 2 th L Pol DIG C626602 Ulkus Tranfesus Debridement PJ
18 Firma Afrido 3 NPBI 18 th L R5A C639327 Fr Mandibula Rekonstruksi Fr Tulang Wajah Mini Plate PJ S : ANM
19 Muhammad Hasan AL B 3 NPBI 2 th L Anak LD C632001 Megacolon Kongenital TAPT Retractor Bulat RR ET,BR,MY
20 Ambyah 1 NPBI 63 th P KPD L1 C629804 Neuralgia Trigeminal Dx Microvaskular Dekompresi DP S : AG,AT
21 Sri Wahyuni 1 NPBI 37 th P MRK L1 C638811 Meningioma Tuberculum Selae Craniotomi Dasar Tengkorak ZM LW*,SF
S :BY
22 Sulastri 2 NPBI 47 th P Transit C638708 Paraparese ec Lumbal Stenosis Vth 11-12 PSRS C-Arm APR PR,AP
23 M Misbah IRIN PBI 33 th L ICU C638891 Fr Femur Sin, Fr Ulna Sin, Fr Radius Sin ORIF C-Arm DRY S : HI
24 Matius Misranto 1 NPBI 59 th L KPD L1 C632582 Dislokasi Gleno Humeral Arthroscopy Shoulder C-Arm DID
EN,MA,WI
25 Handayani Megarini 2 NPBI 36 th P Elang 1 C593346 ASD II L-R Shunt ASD Closure SF
BP,SS,AS
26 Muhamad Syafiq 3 NPBI 3 th L Elang 1 C505379 PDA 4 mm Ligasi PDA SF S : BD,NI
Mata Kanan Afakia + Glaukoma Sekunder + Mata Kanan Vitrektomi + Sekunder Implant +
27 Siti Robiatun 2 NPBI 61 th P Transit C373650 AL NK,HR
Lens Drop Endofragment
RAL
DPJP ANESTESI
JAM PROGRAM
PEMBERSIHAN
JAM DTG RIIL
Jenis anestesi
J. SERAH
TERIMA
OK
OK
CT HN
1 GA DN 07.30 08.00 10.30

120
1 GA DN 11.00 12.30
1 GA DN 13.00 15.30 30
1 GA DN 16.00
2 GA DN 07.30 08.00 10.30

180
2 GA DN 11.00 16.30 120
2 GA DN 17.00
4 GA WA 07.30 08.00 11.30 180

4 GA BI 12.00 120
5 GA BI 07.30 08.00 09.30 120
5 GA BI 10.00 12.30
5 GA BI 13.00
6 GA JL 06.30 07.00 09.30
6 GA JL 10.00 13.30 240

6 GA JL 14.00 120
7 GA JL 07.30 08.00 09.30 120
7 GA JL 10.00 10.30
7 GA JL 11.00 240
8 GA EL 07.30 08.00 11.00 120
8 GA EL 11.30
9 GA EL 07.30 08.00 240
10 GA WA 07.30 08.00 11.00 180

10 GA WA 11.30 17.30
10 GA WA 18.00
JTG GA HR 07.00 10.00 13.30

300
JTG GA HR 14.00
GR 1 GA HA 07.20 07.30 10.30

28 Djoko Widodo 3 JMK 41 th L R5A C636870 Mata Kanan Glaukoma Neovaskular Mata Kanan Cyclocryoterapi Opmic MR
29 Abdul Hadi VIP NPBI 48 th L GRD L4 C639311 Impaksi Gigi 2 Rahang Odontektomi 2 Rahang Bor NSK RP
30 Seger 3 PBI 63 th L P. Mata C638901 Mata Kanan KSI, Mata Kiri Leukoma Kornea Mata Kanan ECCE + IOL RF YW,HA,RI
Mata Kiri Subluksasi Lensa + Glaukoma

31 Solikin 3 PBI 47 th L R1B C639359 Mata Kiri EKIK + Vitrectomi Anterior Opmic WIS S : DI,TU,MK
Sekunder
Mata Kanan Pseudofakia + Phimosis Capsula
32 Rohmatul Anam 1 NPBI 53 th L P. Mata C636834 Mata Kanan Kapsulotomi Anterior WIS
Anterior
Mata Kanan Kiri Injeksi Steroid Triamcinolone

33 Sunyi 3 PBI 44 th P P. Mata C619239 Mata Kanan Kiri Grave, Opthalmopati TL
Acetat Sub Muller + Peribulber
34 Semi 3 NPBI 58 th P R4B C610419 NOS c/ Ganas, NOK TAH + BSO + FS s/d CSS KD 3 INU AF,AM
35 Sumirah 3 NPBI 57 th P R4B C605096 Mioma Uteri TAH KD 5 AF
36 Ahmad Muhajir 3 NPBI 17 th L Anak LD C639206 SNNT Total Tiroidektomi YAN AL,TR*,MF
Angle
37 Witiyanti 1 NPBI 58 th P KPD LD C638164 Curiga Ameloblastoma Hemimandibulektomi + Rekonstruksi Mandibular YAN
Plate
38 Jamaludin 3 NPBI 20 th L R6B C611376 Ektima Gangrenosa Insisi Biopsi + Debridement + STSG ETH AH,PL
39 Melinda Nur Andriana 3 NPBI 14 th P Anak LD C637481 Ulkus Granulosum Gluteal Debridement + STSG RZ
40 Bagas Puguh Widodo 1 Um 20 th L MRK L1 C637087 Ulkus Granulosum Femur s/d Cruris Dx et Sin Debridement + STSG RZ
41 Soenarto VIP NPBI 75 th L GRD L6 C624262 Batu Ginjal Kanan Kiri Aff DJ Stent MAS ST*,PM,IM
42 Dasi 3 NPBI 56 th P R6A C632315 Multiple Renal Cyst Ureteroscopy + Biopsi MAS S : SC,MR
43 Ratmin 3 NPBI 31/12/1939 L R3B C637208 Massa Buli Sistoskopi Biopsi MAS
44 Yuliarni 2 NPBI 32 th P Transit C638592 Fr Distal Radius Dx Ttp Nk, Fr Steloid Ulna Dx ORIF BIN
45 David Yudha 1 NPBI 18 th L KPD L1 C631142 Pnemoni suspect sikatrik Bronchoscopy AVIS YR,US
46 Wahyu Wulan 2 NPBI 23 th P Transit C638659 Massa Paru Kanan Bronchoscopy SFY
47 Anggita 3 NPBI 19 th P Pol THT C564632 KNF Nasofaringoscopy Flexible + NBI DAT
48 Suyanto 3 NPBI 39 th L Pol THT C629052 Ca Laring Laringoscopy Flexible + Ganti NGT DAT
49 Sakuri 3 NPBI 47 th L R3B C577068 Ca Sinonasal Aff Tampon WY
50 Yusra K 3 NPBI 5 th P Anak L1 C637157 CML BMP Evaluasi MOED
51 Edy Kurniawan VIP NPBI 21 th L GRD L5 C637750 PSCBA EGD AGG GN,EW*,RA
52 Rastinah 3 NPBI 54 th P Pol PD C636032 Tumor Recto Sigmoid Colonoscopy MM
53 Kusni 3 NPBI 59 th L Pol DIG C582519 Tumor Rectie c/ ganas Colonoscopy ERI
54 Sawiyem 3 NPBI 48 th P Pol VAS C620609 CKD AV Shunt ALI
55 Ngarikan 3 NPBI 61 th L Pol URO C629412 Nefrolithiasis ESWL WAN
56 Miftahudin 3 NPBI 56 th L Pol URO C630533 Batu Ren Dextra ESWL MAS AK
57 Sutarmuto 3 NPBI 51 th L Pol URO C630447 Batu Ureter ESWL MAS
58 Riwayati 3 NPBI 54 th P Pol URO C615452 Nefrolithiasis ESWL ADS
M : DA,DM,DY,NH,SA,SU,VQ RR : FA,SAM,SR MID : DB,ER RR GRD : PS MID : WU SORE PROGRAM : NO,AY,TW,AR,AU*,AG*,AT,BD,DI,EA,HI,TU,MR,ANM,MK,RM,SC,TM,NI,BY* ALAT : PU
L : AN,TK,VT,JF,MW,YS,NP,RK,RG,UM,WD
Chrisna Setyaningsih 1 NPBI 45 th P KPD LD C636604 HN + HU Bilateral dg Perforasi Obstruktif Pasang DJ Stent ADS RABU
GR 1 GA HA 11.00 12.00 120
GR 1 GA HA 12.30
GR 2 LA 09.00 09.30
GR 2 LA 10.00 10.30
GR 2 LA 11.00 12.00
GR 2 LA 12.30
GR 3 GA HA 07.30 08.00 11.30

GR 3 GA HA 12.00
GR 4 GA AI 06.45 07.00 09.30 180
GR 4 GA AI 10.00
240
GR 5 GA AI 07.00 07.30 09.30
GR 5 GA AI 10.00 11.30 120
GR 5 GA AI 12.00
DS 1 GA HS 07.30 08.00 08.20

DS 1 GA 08.30 08.45
DS 1 GA 09.00 09.20
DS 1 GA 11.00
DS 2 GA 07.30 08.00 08.30

DS 2 GA 09.00 09.30
DS 2 LA 10.00 10.20
DS 2 LA 10.30 10.45
DS 2 GA 11.00 11.30
DS 2 GA 12.00
DS 3 LA 07.30 08.00 08.30
DS 3 GA 09.00 10.00
DS 3 GA 10.30 12.30
DS 3 GA 13.00
DS LA 08.00
DS LA 10.00
DS LA 12.00
DS LA 14.00
*,AG*,AT,BD,DI,EA,HI,TU,MR,ANM,MK,RM,SC,TM,NI,BY* ALAT : PUR,CA ( S: DW )
HARI / TANGGAL : RABU, 07 JUNI 2017
PENJAMI
ASISTEN
REKAM
N
MEDIS
S : NO, WU,
SL,II,HE,SE ,IS
NI
1 Moh Alim Istiawan 3 NPBI 10 th L Anak LD C602907 Hipospadia Uretroplasty ADS EV,AO,ID
2 Tri Endang Kurniasih VIP NPBI 57 th P GRD L3 B225769 Ca Cervix, CKD, Hidronefrosis Dx Nefrostomy Dx Open ADS S : WD
3 Chrisna Setyaningsih 1 NPBI 45 th P KPD LD C636604 Hidronefrosis + Hidroureter Bilateral Pasang DJ Stent ADS
4 Wiro Supar 3 NPBI 82 th L R2B C629713 Prostat Enlargement + Tumor Buli TUR Prostat + TUR Buli ADS
5 Kasmijan 3 NPBI 52 th L R1B C633880 Hidropneumothorax Sinistra Thoracoplasty ALI
Laparotomi Eksplorasi + reseksi tumor k/p
6 By Ny Kholifah 3 NPBI 10 hr P PBRT C638573 Massa Sacro Ileococcygeal dd/ Teratoma Debulking k/p reseksi anastomosis usus k/p EDW AI*,YN*
Stoma
7 Muh Hasan AL Bashri 3 NPBI 2 th L Anak LD C632001 Megacolon Kongenital TAPT Retractor Bulat RR S : AR
8 Zubaidah 3 NPBI 14 th P Anak LD C639151 OMSK Mastoidektomi Radikal Telinga Kanan Mikroskop ZUL
9 Wahyu Ariyadi 3 NPBI 19 th L R3B C604394 OMSK Kiri dg Kolesteatom Tympanoplasty Kiri Mikroskop PW
10 Temu 3 NPBI 59 th P R2A C636960 Myelopathy Lumbal + HNP Percutanius Disectomy + Neuroplasty C-Arm TRI A ND
11 Rumiyatun VIP NPBI 64 th P GRD L5 C636407 Susp Ca Ovarii, DM, Hipertensi Surgical Staging + Laparotomi + FS KD 1 EN EM,ES
12 Ade Ariyani 2 NPBI 44 th P Obstetri C522234 Uterus Miomatus, Adenomiosis TAH KD 2 EW S : TW
13 Untung VIP NPBI 55 th L GRD L4 C639579 Rhinosinusitis dg Septum Deviasi FESS + SR DAT
14 Stefanus Wisnu 3 NPBI 34 th L R1B C633928 Ca Sinonasal Infiltrasi Maksilektomi Medial Endoskopi WY
15 Hasniasih VIP NPBI 54 th P GRD L6 C638142 Cholelithiasis Laparoscopy Cholecystectomy JS TD,RE
16 Djuwadi VIP NPBI 54 th L GRD L5 C563961 Infiltrat Abdomen Laparoscopy Explorasi k/p Laparatomi PB S : RG
17 Cessa Nahlil 1 NPBI 2/3/2009 P PICU C636515 Prolonged ET Tracheostomi DAT
18 Widodo Rahardjo VIP NPBI 71 th L GRD L4 C224937 Abses Paru Thoracotomy WW
19 Khamsinok 3 NPBI 51 th P R2A C638872 ILC Gr III Diseksi Axilla BIS AZ,DN
Ishmolobektomi + FS ganas Total
20 Haryati 1 NPBI 53 th P KPD LD C629240 SMNT c/ Ganas T3N1Mo DH S : RM
Tiroidektomi, Adenektomi + FS ganas RND
21 Tatik Muryani VIP NPBI 45 th P GRD L4 C636537 Tumor Mamae Dx Wide Eksisi + FS UUD
22 Fahmi Alfan 3 NPBI 15 th L Anak LD C638585 Fr. Tulang Wajah Rekonstruksi Fr. Tulang Wajah NJT
23 Sudharti 1 NPBI 57 th P GER L1 B042784 Ulkus DM Reg Pedis Sin Debridement ETH TA,AD*
24 Djumiko 3 NPBI 44 th L R2B C638066 Luka Bakar 17% Debridement + STSG ETH S : ANM
25 Khumaidi 3 NPBI 19 th L R2B C638967 Pan Facial Fr Rekonstruksi PJ
26 Anwaz Azwar 1 NPBI 31 th L KTL C515780 Tumor Intradura Extra Medular d.d Kista Bedah Micro MS, Laminectomy HY ET,UM
S : AG,AT
27 Siti Fatichach 1 NPBI 48 th P KPD LD C637634 Meningioma Tentorium Craniotomi Dasar Tengkorak Cusa DP LW,SF
28 Slamet 3 NPBI 57 th L R5A C636440 Schwanoma VC 2-3 Bedah Mikro MS + Laminectomy IOM HY + AJ S : BY,BR
29 Wardjini 3 NPBI 71 th P R2A C639411 Fr Interthrocanter Femur Sin ORIF DRY PR,AP
Shaver Blad,
30 Panggih Prayitno 3 NPBI 17 th L Anak L1 C631274 Arthritis Genu Dx et Sin Arthroscopy DID S : HI
Abaltron Penuil
31 Siska Ita Nur Susanti 3 NPBI 28 th P R2A C638597 Multiple Fraktur ORIF C-Arm BIN
EN,MA,WI
32 Suparmi 1 NPBI 48 th P Elang 1 C455947 MS Severe, AS Severe, AR Mild DVR SF
BP,SS,AS
33 Ruben Surya Pratama VIP NPBI 21 th L Elang 2 C638656 Tumor Mediastinum Sternotomi Eksplorasi Angkat Tumor SF S : BD,NI
Mata Kanan Kiri Katarak Kongenital ec Rubella Mata Kanan Ekstraksi Katarak + PPC + PI +
34 Muhammad Nasrul Ilmi 3 NPBI 1 th 4 bln L Anak LD C639011 Opmic LN NK,HR*
Syndrome IOL+ Vx Anterior
Mata Kanan Ablatio Retina dd/ RRD dengan
35 Yosi Maryono 3 NPBI 43 th L R2B C639362 Mata Kanan Vitrectomi + EL + Gas / SO Opmic AL
Makula on
Mata Kiri Ablatio Retina + Susp Endoftalmitis Mata Kiri Vitrektomi + Inj. AB Intravitreal
36 Saliyem 3 NPBI 61 th P R3A C638847 Opmic AL
dd/ VH (Vancomicin dan Ceftazidim)
RAL
PEMBERS
ANESTESI
J. SERAH
JAM DTG
PROGRA
IHAN OK
TERIMA
anestesi
DPJP
Jenis
JAM
RIIL
OK
M
CT EL
1 GA HR 07.30 08.00 10.30 180

1 GA WA 11.00 12.00 60
1 GA HR 12.30 13.00 60
1 GA HR 13.30 15.30 120
1 GA HR 16.00
2 GA HR 07.30 08.00 10.30
2 GA HR 11.00 13.30 180

2 GA HR 14.00 18.30 150
2 GA HR 19.00
3 LA 08.00 150
4 GA DS 07.30 08.00 10.30
4 GA SF 11.00 13.30 120
4 GA DN 14.00 16.30
4 GA SF 17.00 150
5 GA VL 07.30 08.00 10.00
5 GA VL 10.30 12.30
5 GA SF 13.00 14.30
5 GA WA 15.00 180
6 GA DS 07.30 08.00 10.30 180
6 GA DS 11.00 15.00
6 GA JL 15.30 60
7 GA DS 07.30 08.00 09.30
7 GA DS 10.00 11.00 120
7 GA DS 11.30 12.30 60
7 GA DS 13.00 120
8 GA TA 07.30 08.00 120
8 GA TA 120
9 GA TA 06.30 07.00 11.30
9 GA TA 12.00
10 GA UB 07.30 08.00 09.30 120
10 GA UB 10.00 18.30
120
10 GA UB 19.00 300
JTG GA HN 07.00 10.00 13.30
360
JTG GA HN 14.00 240
GR 1 GA WA 07.20 07.30 08.30
90
GR 1 GA WA 09.00 11.00 120
GR 1 GA WA 11.30 13.00 120
Mata Kanan Evakuasi SO + Secondary
37 Mulyono 1 NPBI 57 th L KPD LD C540799 Mata Kanan SO Filled Eye + Afakia Opmic AL
Implant (Iris Claw)
Mata Kanan Buka Jahitan, Mata Kiri Phaco +
38 Soekarno Atjip 2 NPBI 84 th L P. Mata C204038 Mata Kanan Pseudofakia, Mata Kiri KSI Opmic RF YW,HA,RI
IOL
39 Drajat Suitanto 1 NPBI 67 th L MRK L2 C542395 Mata Kanan Kiri Glaukoma Sekunder +KSI Mata Kiri Phaco + IOL Opmic WIS S : DI,TU,MK
40 Sunarti 3 PBI 53 th P P. Mata C637361 Mata Kanan Pseudofakia, Mata Kiri KSI Mata Kanan Reposisi IOL Opmic WIS
Artisan Afakia
41 Sudarjono Priv PT 65 th L Poli Grd C514994 Mata Kanan Dislokasi IOL Mata Kanan Evaluasi IOL + Iris Fixasi (iris clip) AL
15.5 iris clip
42 Marmiyati 1 NPBI 56 th P P. Mata B304938 Mata Kiri Katarak Senilis Imatur + High Miopia Mata Kiri Phaco + IOL Opmic MR
43 Sulastri 3 PBI 58 th P P. Mata C635860 Mata Kanan PACG + KSI Mata Kanan Phaco + IOL Opmic MR
Mata Kanan Kiri PACG, Mata Kanan Katarak
44 Sri Marjanah 3 JMK 64 th P P. Mata C631829 Mata Kanan Phaco + IOL Opmic MR
Senilis Imatur
45 Murdiyaningsih 2 NPBI 37 th P KPD LD C572162 Multiple Mioma Laparoscopy Miomektomi TF AF,AM
Mata Kanan Kiri Proptosis dd/ Retinoblastoma,
46 Bilqis Astila Rahma 3 NPBI 3 th 1 bln P Anak L1 C638087 Mata Kanan Kiri Biopsi + PA TL
Neuroblastoma
47 Tri Jumiyati VIP NPBI 55 th P GRD L6 C240262 Ca Papillary Thyroid Total Thyroidectomy YAN AL,TR
48 Mahmudin 3 NPBI 40 th L R6B C637515 Multiple Limfadenopati Colli Limfadenektomi Biopsi YAN
49 Dwi Wijayanti 2 NPBI 45 th P KPD LD C599009 Ca Mamae Wide Eksisi FASTRACK UUD
50 RZ AH*,PL,MF
FASTRACK
51 Tenti Anita Aries 2 NPBI 39 th P KPD LD C639238 Impaksi Odontektomi DV
Bor, Tang
FASTRACK
52 Alexander Gumilang 2 NPBI 31 th L KPD L1 C638921 Impaksi 2 Rahang Odontektomi 2 Rahang DV
Bor, Tang
53 Ulfiah 3 NPBI 18 th P R2A C638993 Impaksi 2 Rahang Odontektomi 2 Rahang DV
54 Danaroh 3 NPBI 52 th P R4B C632568 Ca Cervix c/ Metastasis VU Sistoskopi Biopsi WAN PM,IM,TM
55 Fitria P Iswanda 2 NPBI 30 th P MRK LD C634355 Polip Endometrium Histeroskopi HR S : AY,MR
56 Carisa IRIN B PBI 3 bln L HCU C638504 Suspect Infant BMP HER
57 M. Wahyu Herdian 3 BPJS 4 th L Pol ANK C631367 ALL BMP HER
58 Sriyoto 1 NPBI 54 th L KPD LD C096369 PSCBA EGD HRY YR,US
59 Wahyudi 1 NPBI 57 th L MRK L2 C290042 PSCBA EGD HRY
60 Sri Priantini VIPA NPBI 52 th P GRD L4 A532675 Epigastric EGD HRY
61 Ahmadi 3 NPBI 68 th L Pol PD C639263 Hematomesis EGD HRY
62 Laniwati 3 NPBI 51 th P Pol PD C617904 Hepatitis C EGD HRY
63 Edi Kurniawan VIP NPBI 21 th L GRD L5 C637750 EGD AGG
64 Nur Kholis 3 NPBI 48 th L Pol PD C584367 Ca Rectie Colonoscopy AGG
65 Mursiyamsah Privat NPBI 54 th P Pol GRD C571361 Ca Cervix + Cholithis Colonoscopy + APC DD
66 Hisyam 1 NPBI 28 th L MRK L1 C620574 EGD DD
67 Haryoko 64 th L Elang C639325 CHF, Anemia, Melena EGD DD
68 Sobirin 2 NPBI 50 th L MRK LD C638828 Diare kronik Colonoscopy DD
69 M. Sodikin 3 NPBI 48 th L R3B C637523 Suspect CRC Colonoscopy DD
70 Ahmad Sadjat 3 NPBI 73 th L R3B C637830 Tumor Paru Bronchoscopy FRD GN,EW*,RA
71 Reni Setiawati 43 th P RS HRMNA Striktur Spiner Aff Stent CBD / ERCP C-Arm MG
72 Wahyu W 2 NPBI 23 th L Transit C638659 Massa Paru Kanan Bronchoscopy SFY
73 Gafar Sidik 1 NPBI 61 th L KPD LD C634190 Massa Paru Bronchoscopy FTR
74 Ida Aryani 3 NPBI 44 th P Pol THT C615018 Ca Laring Laringoscopy Flexible + NBI + Ganti Kanul DAT
75 Dwi Andika Wati 3 NPBI 22 th P Pol THT C659649 LPR Laringoscopy Flexible FAR
76 Romyati 3 NPBI 50 th P Pol THT C639671 Obs. Hoarnes Laringoscopy Flexible FAR
77 Johari 3 NPBI 53 th L Pol URO C599612 Batu Ren Sin ESWL MAS
78 Andreas Suwarso 3 NPBI 54 th L Pol URO C617867 Batu Ginjal Kanan ESWL MAS AK
79 Karmen 3 NPBI 45 th L Pol URO C636984 Nefrolithiasis ESWL WAN
M : BD,AU,EA,PS,SC,VQ RR : FA,SAM,SR MID : DB,ER RR GRD : ST MID : YS SORE PROGRAM : NO,WU,AY*,AR,AG,NI,AT,BR*,BY,DI,HI,TU,MR,ANM,MK*,RG,RM,TW,WD ALAT : PUR,CA
L : AN,DA,DM,TK,VT,DY,JF,MW,NP,NH,RK,SA,SU
GR 1 GA WA 13.30
120
GR 2 LA 07.30 08.00 08.30
60
GR 2 LA 09.00 09.30 60
GR 2 LA 10.00 10.30 30
GR 2 LA 11.00 11.20 30
GR 2 LA 11.30 12.00 60
GR 2 LA 12.30 13.00 60
GR 2 LA 13.30
60
GR 3 GA WA 07.30 08.00 09.30 90
GR 3 GA WA 10.00
GR 4 GA WA 07.20 07.30 10.30 120

GR 4 LA 11.00 11.30
GR 4 GA JL 12.00
GR 5 GA JL 07.30 08.00 10.30
GR 5 GA JL 11.00 12.30
GR 5 GA JL 13.00 14.30 120
GR 5 GA JL 15.00 120
DS 1 GA UB 06.45 07.00 07.30 60
DS 1 GA UB 08.00 09.30
DS 1 GA UB 10.00 10.30
DS 1 GA UB 11.00 120
DS 2 LA 07.30 08.00 08.20
DS 2 LA 08.30 08.45
DS 2 LA 09.00 09.20
DS 2 LA 09.30 09.45
DS 2 LA 10.00 10.30
DS 2 LA 11.00 11.20
DS 2 GA UB 11.30 12.00
DS 2 GA HA 12.30 13.20
DS 2 RA UB 13.30 13.45
DS 2 LA 14.00 14.20
DS 2 GA UB 14.30 15.00
DS 2 GA UB 15.30
DS 3 GA UB 07.30 08.00 08.30
DS 3 GA UB 09.00 09.30
DS 3 GA UB 10.00 10.30
DS 3 GA UB 11.00 11.30
DS 3 LA 12.00 12.30
DS 3 LA 13.00 13.20
DS 3 LA 13.30
DS LA 08.00
DS LA 10.00
DS LA 12.00
,AT,BR*,BY,DI,HI,TU,MR,ANM,MK*,RG,RM,TW,WD ALAT : PUR,CA ( S: DW )
Purwanto 3 NPBI 51 th L R2B C632442 STT Reg Femur Sin c/ Ganas T2bNoMo Eksisi + PA UUD
PENJAMIN
ASISTEN
REKAM
MEDIS
S : NO, WU,
SL,II,HE,SE ,IS
DN
1 Ruslan 1 NPBI 64 th L KPD 1 C612512 Nefrolithiasis Dextra Nefrolitotomi Dextra ADS EV,AO,ID
2 Dekon Soim 2 NPBI 71 th L MRK LD C628508 Prostat Enlargement TURP ADS S : WD
3 Parijan 3 NPBI 55 th L R1B C638690 Abses Ginjal Dextra Drainase Abses ADS
4 Mudhori Muri 3 NPBI 03/05/1945 L R1B C636656 Prostat Enlargement TVP WAN
5 Untung VIP NPBI 55 th L GRD L4 C639579 Rhinosinusitis dg Septum Deviasi + Impaksi FESS + SR + Odontektomi DAT + RP AI,YN
6 Rustiyanto VIP NPBI 56 th L GRD L4 C639351 Massa Sinonasal Hemimaksilektomi DAT S : AR

Ca Sinonasal, Mata Kiri Proptosis ec Massa Ekstirpasi Massa + Mata Kiri Orbitotomi
7 Liskiyah 3 NPBI 34 th P R3A C635130 Endoskopi DAT + TL
Sinonasal Anterior + Biopsi + PA
8 Fathin Afkari Rafi 1 NPBI 10 th L Anak LD C629056 Tonsilofaringitis Kronis Adeno Tonsilektomi TE Diseksi ZUL
9 Jarwati 3 NPBI 48 th P R3A C629180 Myelopathy Lumbal, Spondylolitesis HNP Percutanius Disectomy + Neuroplasty C-Arm TRI A ND
10 Ngatemi 3 NPBI 50 th P Obstetri C633040 NOK SOU + FS OP EM*,ES
Endoskopi,
11 Susanto 1 NPBI 55 th L KPD LD C635189 Pansinusitis FESS RH S : TW
Rhino Set
Mikroskop, Bor,
12 Miftakhul Iza 3 NPBI 27 th L R3B C628071 OMK Dry Ear Dupleks Tympanoplasty PW
Timpano Set
13 Djuharipin 3 NPBI 53 th L R5A C612115 Ca Sinonasal Nekrotomi WY
14 Soediono 3 NPBI 65 th L R5A C628248 Ca Vestibula Nasi Ekstirpasi Massa + Nasolabio Flap Endoskopi WY
15 Roidah 3 NPBI 21 th P R3A C626632 Post Jejenustomi Feeding Tutup Stoma PB TD,RE
16 Djumadi 3 NPBI 82 th L R2B C626525 Hernia Scrotalis Sinistra Reponible Laparoscopy Repair Hernia MG S : RM
17 Purwanto 3 NPBI 51 th L R2B C632442 STT Reg Femur Sin c/ Ganas T2bNoMo Eksisi + PA UUD
18 Rukmiyatun 3 NPBI 43 th P R2A C602367 Fibro Cyst MST T4aNoMx MRM DWT
19 Wantini 3 NPBI 47 th P R2A C637984 IDC Gr II MS T2NoMx BCS BIS AZ,DJ
20 Ariyanti VIP NPBI 39 th P GRD L6 C638945 TMD c/ ganas T3N0M0 Wide Eksisi + FS, Ganas-MRM DH
Hemiglosektomi, Adenektomi + FS, Ganas
21 Sumitro 1 NPBI 53 th L KPD 1 C628707 Tumor Lidah C/ Ganas T2N3M0 DH S : ET
RND
22 Septian Pandu Prastya 3 NPBI 19 th L R2B C632551 Flap Nekrotik Debridement PJ
23 Sarah Titi By Ny IRIN NPBI 1 bln P PBRT C638981 Megacolon Kongenital TAPT PTY TA,AD
24 Sairoh By Ny IRIN NPBI 20 hr P PBRT C638524 Atresia Duodenum dd/ Duodenal Webb Laparotomi Eksplorasi k/p Duodenoduodenotomi EDW S : ANM
25 Muh Abro Jiha 3 NPBI 1 th 7 bln L Anak L1 C635758 Multiple Limfadenopati Colli Limfadenektomi Biopsi RR (BA)
Multiple Abses Cerebri + in growing nail dig I
26 Sefina Febru Siswaka NPBI 13 th P IGD C639769 Craniotomi Evakuasi Abses + Roserplasty DP + PJ UM,BY
Pedis Dextra
27 Slamet 3 NPBI 57 th L R5A C636440 Schwanoma VC 2-3 Bedah Mikro MS + Laminectomy IOM HY + AJ S : TM,MY
28 Adam Baim Albiruni 3 JKD 12/30/2016 L Anak D C638404 Hidrocephalus Pemasangan VP Shunt MP, L Connect GK LW,SF
29 Labibatus Syifa Aisyah 1 NPBI 5 th P Anak D C322495 Epilepsi Tuberosclerosis Craniotomi Epilepsi + EEG Intrakranial ZM S : AF,BR
30 Musyarofah 3 NPBI 47 th P R3A C636779 Mata Kiri Proptosis C/ Meningioma Craniotomi Mikro Ds Tengkorak MTA
31 Hidayati 3 PBI 48 th P R3A C637898 Paraparese Inferior ec Fr Kompresi VL1 PSRS C-Arm APR PR,AP*
32 Zhafran Haidar 1 NPBI 20 th L KPD LD B434108 Fr Malleolus Lateral OS Fibula Sin ORIF Wire C-Arm APR S : HI
33 Rini Novitasari 3 NPBI 19 th P R3A C638419 Osteomyelitis Pedis Dx, Bilateral CTEV Debridement + Rekonstruksi CTEV C-Arm Wire 1,8 DRY
34 Titi Sri Hastuti NPBI 66 th P GER L1 C624970 Neglected Fr Os Fibula Sinistra Artrodesis Ankle Sin C-Arm BIN
EN,MA,WI
35 Nurita 3 NPBI 54 th P Elang 1 C607356 MR Severe MVR SF
BP,SS,AS
RAL
DPJP ANESTESI
JAM PROGRAM
PEMBERSIHAN
JAM DTG RIIL
Jenis anestesi
J. SERAH
TERIMA
OK
OK
CT VL
1 GA HA 07.30 08.00 10.30 120

1 GA HA 11.00 12.30
1 GA HA 13.00 14.30
1 GA HA 15.00
2 GA DN 07.30 08.00 10.30

120
2 GA DN 11.00 13.30
2 GA HA 14.00 16.30
2 GA HA 17.00
3 LA 07.30 08.00 150 AT
4 GA AI 06.00 06.30 09.30
4 GA AI 10.00 11.30
4 GA AI 12.00 15.30 120

4 GA AI 16.00 16.30 60
4 GA AI 17.00 120
5 GA AI 07.30 08.00 10.00
5 GA AI 10.30 12.30
5 GA AI 13.00 14.30
5 GA AI 15.00 HI
6 GA BI 06.30 07.00 09.30 240
6 GA BI 10.00 12.30 180
6 GA BI 13.00 180
7 GA BI 04.30 05.00 07.30
7 GA BI 08.00 10.30 120
7 GA BI 11.00 13.30 120
7 GA BI 14.00
8 GA SF 06.00 06.30 10.30
8 GA SF 11.00
9 GA SF 06.30 07.00 08.00
9 GA SF 08.30 13.30 180
9 GA SF 14.00
10 GA HS 06.30 07.00 10.30
10 GA HS 11.00 12.30
10 GA HS 13.00 14.30 120
10 GA HS 15.00
JTG GA WA 07.00 10.00 13.30

360
S : NI,RG
36 Asrori VIP NPBI 45 th L GRD L6 C636578 Mata Kanan Ablatio Retina Mata Kanan Vitrectomi Opmic AW NK,MK
Mata Kanan Katarak Komplikata + SO Filled
37 Wanto 3 NPBI 32 th L R3A C526836 Mata Kanan Phaco + IOL + Evakuasi SO AW
Eye
38 Fuad Suryoprojo 1 NPBI 45 th L KPD L1 C632657 Mata Kiri Pseudofakia + RRD Mata Kiri Vitrectomi + EL + SO / Gas Opmic AW
Mata Kanan TRD ec PDR + KSI, Mata Kiri Mata Kanan Vitrectomi + EL + SO / Gas +
39 Machmudin Latif 3 PBI 58 th L R3B C247069 Opmic AW
Total Ablatio Retina Phaco + IOL
Mata kanan secondary Implant + Vitrektomi
40 Soepardi 3 NPBI 72 th L Pol MTA C638034 Mata kanan Afakia Opmic, Iris Clip RF YW,HA,RI
Anterior (Iris Clip)
41 Sukari 2 NPBI 59 th L Pol MTA C635788 Mata kiri Afakia Mata kiri Secondary Implant (Iris Clip) Opmic, Iris Clip RF S : DI,TU,AG
42 Suryati Privat NPBI 58 th P Pol GRD C612199 Mata kiri Katarak Komplikata Mata kiri Phaco + IOL AW
43 Martina Sri Privat NPBI 62 th P Pol GRD C627287 Mata kanan katarak komplikata Mata kanan Phaco + IOL AW
44 Mari 3 PBI 67 th P Pol MTA C604609 Mata kiri Glaukoma Absolut Mata kiri Cyclocryoterapi Opmic FI
45 Sri Yuniati 1 NPBI 44 th P Obstetri C637229 Ca Ovarii Surgical Staging MZ NP,AM
46 Naslim Ni'mah 2 NPBI 38 th P Obstetri C638676 Kista Ovarii Bilateral Laparoscopy TF
Mata Kanan Endofthalimitis Eksogen Post Mata Kanan Evisecrasi Bulbi + DFG + Vitreous
47 Marwah 3 NPBI 56 th L R6B C639512 DN
Operatif + Ulkus Kornea Tap
48 Catharina Anggraini VIP NPBI 43 th P GRD L5 C302430 Ca Thyroid RND Sin Harm. Focus YAN AL*,TR
49 Istianingsih 3 NPBI 50 th P R5B C618824 Invasive Ca of WST MD T2NoMo MRM Dx YAN
50 Nadia Priv Um 35 th P Poli Grd C639592 Lipodystropy Liposuction leher + Malarplasti RZ AH,PL,MF
Miniplate 2,0 10
51 Andi Hermawan 1 NPBI 18 th L MRK 1 C639584 Fr. Segmented Mandibula Rekonstruksi Fr Tlg Wajah NJT
H
Striktur Urethra Pars Prostatika+ Prostat
52 Sunyoto 1 NPBI 59 th L KPD 1 C630462 Sachse + TURP C arm MAS PM,DM,DA
Enlargement
53 Asiyatun Asiah 3 NPBI 44 th P Obstetri C637356 P2A0 Post Partum Ingin Steril MOW HT S : AY,MW
54 Rini Windi Yanti 3 NPBI 34 th P R5B C553360 Polip Endometrium Multiple Histeroskopi HR
55 Naufal Maulana 16 th L Anak LD C601403 Ca Nasofaring Nasofaringoscopy Flexible + Biopsi DWT YR,US,IM
56 Watini VIP NPBI 60 th P GRD L5 C639368 Suspect Paru Kanan Bronchoscopy SFY
57 Setyo Palupi 1 BPJS 30 th P Pol THT C621071 Ca Lidah Pemasangan NGT DAT
58 Purwadi 3 NPBI 57 th L Pol THT C623641 Laringoscopy Flexible DAT
59 Mustofa 3 NPBI 54 th L Pol THT C619112 LNH Laring Dekanulasi + Laringoscopy Flexible WY
60 Sri Munjanah 3 NPBI 56 th P Pol THT C343514 Ca Sinonasal Laringoscopy Flexible + Masal Irigasi WY
61 Nur Hayati 3 NPBI 38 th P Pol THT C595786 Ca Nasofaring Nasofaringoscopy Flexible + Biopsi WY
62 Miftahul Huda 3 NPBI 21 th L Pol ONK C566447 Tumor Intra Abdomen Colonoscopy MG
63 Khanapi 3 NPBI 40 th L Pol DIG C638115 Adeno Ca Rectie Colonoscopy ERI
64 Kalimatur R 3 NPBI 29 th P Pol DIG C638159 Tumor Rectie c/ Ganas Colonoscopy ERI
65 M. Saleh Rasyad 1 NPBI 69 th L GER L1 C636923 Melena EGD DD GN,MR*,RA
66 Zazin 38 th L R3B C613479 PSCBA EGD DD
67 Sarmo 3 PBI 50 th L R3B C639214 PSCBA EGD DD
68 Riyanto 3 NPBI 55 th L Pol PD C629534 Curiga Tumor Gaster EGD AGG
69 Sunarto 3 NPBI 63 th L Pol PD C638039 Hematoschezia Colonoscopy AGG
70 Kamirah 3 NPBI P Pol PD C636168 Melena EGD AGG
71 Agus Wijayanti 3 NPBI 32 th P R4B B243416 Ca Cervix Colonoscopy AGG
72 Sugiyati 3 NPBI 59 th P Pol URO C597267 Batu Ginjal ESWL MAS
73 Saerah 3 NPBI 58 th P Pol URO C606210 Nefrolithiasis ESWL ADS AK
74 Dewi Sukowati 3 NPBI 44 th P Pol URO C635297 Batu Ureter ESWL ADS
M : BD,HR,AU,EA,EW,SC,PS RR : FA,SAM,SR MID : DB,ER RR GRD : ST MID : YS SORE PROGRAM : NO,WU,AY,TW,ET,AR,AG,AF,NI,BR,DN,DI,MY*,TU,ANM,MW,RG*,RM,TM,WD ALAT : P
L : AN,DA,DM,TK,VT,DY,JF,MW,NP,NH,RK,SA,SU
Suliman 3 NPBI 4/3/1947 L R1B C259062 Prostat Enlargement TURP WAN JUMAT
Pariman Hadiantok 3 NPBI 53 th L R2B C636711 SNNT Dx c/ Ganas T4bN1Mo Isthmolobektomi + FS ganas TT + RND BIS
JUMAT
14.00 300
GR 1 GA VL 07.30 08.00 09.30
GR 1 GA DN 10.00 11.30
GR 1 GA VL 12.00 13.30
GR 1 GA DN 14.00
120
GR 2 LA 08.00 08.30
GR 2 LA 09.00 10.00
GR 2 LA 10.30 11.00
GR 2 LA 11.30 12.30
GR 2 LA 13.00
GR 3 GA DN 07.30 08.00 10.00 180
GR 3 GA DN 10.30 12.30
GR 3 GA DN 13.00
GR 4 GA DS 07.20 07.30 10.30

GR 4 GA DS 11.00 120
GR 5 GA HA 07.30 08.00 09.30
GR 5 GA DS 10.00
DS 1 GA HS 07.30 08.00 09.30
DS 1 GA HS 10.00 12.30
DS 1 GA HS 13.00
DS 2 GA HS 07.30 08.00 08.30
DS 2 GA HS 09.00 09.20
DS 2 LA 09.30 09.45
DS 2 LA 10.00 10.20
DS 2 LA 10.30 10.45
DS 2 LA 11.00 11.20
DS 2 LA 11.30 11.45
DS 2 GA HS 12.00 12.30
DS 2 GA HS 13.00 13.30
DS 2 GA HS 14.00
DS 3 LA 07.30 08.00 08.20
DS 3 LA 08.30 08.45
DS 3 LA 09.00 09.30
DS 3 LA 10.00 10.30
DS 3 LA 11.00 11.30
DS 3 LA 12.00 12.30 AU
DS 3 GA HS 13.00 BD
DS LA 08.00 EA
DS LA 10.00 EW
DS LA 12.00 HR
,AR,AG,AF,NI,BR,DN,DI,MY*,TU,ANM,MW,RG*,RM,TM,WD ALAT : PUR,CA ( S: DW ) PS
SC
Susilowati 3 NPBI 61 th P Elang 1 C637818 LA Myxoma Operasi Jantung Terbuka Angkat Myxoma SF
Mata Kanan Proptosis ec Susp Massa
Prawito 3 PBI 51 th L R1B C636259 Mata Kanan Orbitotomi Anterior + Biopsi + PA TL
Retrobulber
Suprihati Bayi Ny NPBI 8 hr L PBRT C639369 SOL Parieto Tipe Occipital Craniotomi Evakuasi Tumor MTA
PENJAMIN
ASISTEN
REKAM
MEDIS
NH,SL*,HE,IS,
S : ET,II, DN
VT
1 Sutomo 3 NPBI 41 th L R1B C609167 Nefrolithiasis Dx + DJ Stent Dx Nefrolithotomi Dx + Ganti DJ Stent Dx ADS EV,AO,ID
2 Suni 3 NPBI 61 th P R4B C632051 Tumor Renal Sinistra Biopsi Renal Sinistra ADS S : TK
3 Sumiyati 2 NPBI 51 th P KPD LD C637335 NOK c/ Ganas TAH + BSO + FS s/d CSS + URS + DJ Stent KD 3 EN + ADS
4 Ngadenin 3 NPBI 53 th L R2B C549848 Squamousa Cell Carsinoma Rekonstruksi Palpebra Dx ETH AI,AN
Endoscopy,
5 Sutarno VIP NPBI 56 th L GRD L5 C639603 Pansinusitis FESS + CWL RH
Rhinoset 1
RSK + SD + Konka Hipertrofi Pasca FESS + Endoskopi,
6 Saeful Anwar 1 NPBI 27 th L KPD LD C609199 Sinekiektomi RH
SR + Konkoplasty Sinekia FESS 1
Endoskopi,
Septoplasty + Konkoplasty Ligasi Spheno
7 Sholihin 3 NPBI 61 th L R1B C623909 Epistaksis Anterior, Septum Deviasi Rhino Set, ANNA S : AR
Palatum
FESS 3
8 Siti Nuraeni 1 NPBI 58 th P MRK L2 C630505 HNP + Spondyliosis Cervical Neuroplasty + Endoneurolysis C-Arm TRI A ND,HI
9 Tarti 1 NPBI 49 th P MRK 2 C639798 Efusi Pleura Dextra Psg Pigtail SFY
10 Hesty Sativa J VIP NPBI 45 th P GRD L3 C605991 Kistoma Ovarii Multiple Laparotomi + Salpingoooforektomi + FS KD 1 MZ EM,ES
11 Siti Rahayu 1 NPBI 49 th P KTL C634887 Cystadenoma Ovarii Mesentrium Papiliferum SOU + FS KD 2 VG S : TW
12 Maryati 3 NPBI 56 th P R2A C637011 TMS c/ Ganas T4NoMo Insisi Biopsi DWT
13 Suprihatin 2 NPBI 32 th P MRK LD C632586 Tumor Hepar Laparoscopy Biopsi k/p Open JS TD, RK
RSK Pasca Etmoidectomi + Evaluasi
14 Devi Ayu Lestari 3 NPBI 19 th P R3A C639707 Aff Tampon Posterior + Evaluasi Eksplorasi DAT S : RM
Perdarahan
Mata Kanan Proptosis ec Susp Massa
15 Prawito 3 PBI 51 th L R1B C636259 Mata Kanan Orbitotomi Anterior + Biopsi + PA TL
Retrobulber
Ishmolobektomi + FS ganas Total Tiroidektomi
16 Pariman Hadiantok 3 NPBI 53 th L R2B C636711 SNNT Dx c/ Ganas T4bN1Mo BIS AZ,DJ
+ RND
17 Pami 3 NPBI 41 th P R3A C636467 SNNT Sin c/ Ganas T2NoMx UUD S : MF
Tiroidektomi
18 Imam Sutrisno 2 NPBI 51 th L KPD L1 C638744 Ca Papila Thyroid Total Tiroidektomi FASTRACK DWT
19 Siti Rahmiatun VIP NPBI 7/8/1967 P GRD L4 C636517 Tumor Parotis Wide Eksisi + PA DWT
20 Siti Mulyani IRIN NPBI 69 th P ICU C637060 Ganggren Pedis Sin + Ulkus Decubitus Amputasi Bellow Knee Sin + Debridement NJT TA,AD
21 Suyono 2 NPBI 61 th L KPD L1 C582658 Massa Sub Glotis LD + Ekstirpasi Massa k/p Biopsi FASTRACK FAR
22 Sumiyani 3 NPBI 47 th P R4B B061356 Hiperplasia Glandularis Endometrium TAH KD 5 EW S : RA
23 Suyono 1 NPBI 56 th L MRK L1 C639144 Selulitis dd/ Abses Femur Dx Debridement ALI
FASTRACK
24 Sri Pudjiati 2 NPBI 50 th P KPD LD C635504 OA Genu Dx TKR BIN UM,BY
Corentec
25 Andhika Wildan K 2 NPBI 21 th L KPD L1 C634428 ACL Tear ACL Rekonstruksi FASTRACK DID S : TM,MY
ORIF Clavicula + LD Ekstirpasi Massa 1/3 Tubular
26 Ainur Rofiq 2 NPBI 50 th L Transit C633596 Fr Clavicula Dx 1/3 Tengah Displ Ttp Nk BIN + FAR
Supraglotis Plate 7 Hole
27 Maslan Ahmad 3 NPBI 47 th L R2B C638773 SOL Temporo Parietal Craniotomi Dasar Tengkorak MTA LW,SF
13:00
RAL
DPJP ANESTESI
JAM PROGRAM
PEMBERSIHAN
JAM DTG RIIL
Jenis anestesi
J. SERAH
TERIMA
OK
OK
CT BI
1 GA WA 07.30 08.00 10.30

1 GA WA 11.00 12.30
1 GA WA 13.00 120
2 GA WA 06.30 07.00 08.30
2 GA HS 09.00 11.30 180

2 GA WA 12.00 14.30 120
2 GA WA 15.00
180
3 LA 07.30 08.00 11.30 90
3 LA 12.00
4 GA WA 07.30 08.00 12.00
4 GA TA 12.30 14.30 120

4 GA TA 15.00 120
5 GA TA 07.30 08.00 09.30 60
5 GA TA 10.00 12.30
5 GA TA 13.00
6 GA HN 06.30 07.00 12.30

240
6 GA HN 13.00 15.30 180
6 GA HN 16.00 16.30
6 GA JL 17.00 30
7 GA HN 07.30 08.00 09.30 180
7 GA HN 10.00 12.30 120
7 GA HN 13.00 14.30 0
7 GA HN 15.00 60
8 GA HA 06.30 07.00 09.30
8 GA HA 10.00 13.30
8 GA HA 14.00
9 GA HA 07.30 08.00 13.30 180

28 Suprihati By Ny IRIN NPBI 10 hr P PBRT C639369 SOL Craniotomi Evaluasi Tumor MTA S : AF,BR
29 Sri Wahyuni 2 NPBI 39 th P Transit C638620 Canal Stenosis Vth 11-12 PSRS C-Arm APR PR,AP
30 Rodin 1 NPBI 50 th L KPD L1 C638583 Charcot Joint Fraktur Arthrodesis APR S : PM
31 Tio Mie Ing 2 NPBI 58 th P KPD LD C620998 OA Genu TKR FASTRACK BIN
EN,MA,WI
32 Susilowati 3 NPBI 61 th P Elang 1 C637818 LA Myxoma Operasi Jantung Terbuka Angkat Myxoma SF
BP,SS,AS*
33 Kumaeri 1 NPBI 40 th L MRK 1 C638898 Tumor Mediastinum Chamberlain Procedure + Biopsi ALI S : RG,SE
Mata Kiri Ekstraksi Lensa + Vitrektomi Anterior Opmic Alat
34 Ananda 3 NPBI 8 bl L Anak L1 C638022 Mata Kiri Katarak Kongenital LN NK,HA*
+ PPC + PI Vitrektomi
Mata Kanan SO Filled Eye + Still Detach, Mata Mata Kanan Sckleral Buckle + Re-Vitrectomi +
35 Dian Adi Saputra 3 NPBI 12 th L Anak L1 C619287 Opmic AL
Kiri TRD SO Exchange + MP
36 Endang Sulistiyowati 1 NPBI 48 th P KPD LD C565199 Mata Kanan PDR + TRD Mata Kanan Vitrectomi + EL + Gas / SO Opmic AL
37 Caswari 3 PBI 63 th L P.Mata C636480 Mata Kiri PACG Mata Kiri Triple Procedure FI YW,AG,RI
Mata Kanan Luksasi IOL + Glaukoma
38 A Fatkhurrozak Priv NPBI 57 th L P. GRD C638916 Mata Kanan Explantasi IOL WIS S : DI,TU,AM
sekunder
39 Benny Sutanto Priv Um 39 th L P. GRD C594830 Mata Kiri CMV Retinitis Mata Kiri Injeksi Gancyclolvir Intravitreal DN
40 Lamijah 3 NPBI 76 th P R4A C634328 NOK dg Bag. Padat, Rectocele Gr III TAH + BSO + FS + Kolpoperineorapi Posterior GYN GBS TF NP,RE,AT
41 Siti Alfiah 1 NPBI 49 th P Obstetri B332445 Fistula Vesico Vagina Repair Fistula Recto Vagina ER
42 Citra Juhana 1 NPBI 34 th P KPD LD C511467 Tonsilitis Kronik + Adenoid Hipertensi Adenotonsilektomi AYU
43 Ipit Laelasari 1 NPBI 44 th P KPD 1 C639335 Ca mamae Sinistra MRM Sinistra YAN AL,TR
44 Turadah 3 NPBI 63 th P R2A C572439 SNNT Sin C/ Ganas T3N1M0 Isthmolobektomi Sinistra + FS, Ganas TT YAN
45 Chalimah VIP NPBI 11/5/1949 P GRD L4 C434351 Nodul Axilla Wide Eksisi Axilla+ PA DWT
46 Adib Maliki Alma VIP NPBI 22 th L GRD L5 C639764 Impaksi Gigi 2 Rahang Odontektomi 2 Rahang Bor NSK RP AH,PL,MF
47 Hisyam Syafi'ie 1 NPBI 28 th L MRK L1 C620574 Impaksi Gigi 2 Rahang, CKD Odontektomi 2 Rahang Bor NSK RP
48 Desy Cristiana 3 NPBI 25 th P R2A C266661 Fr Mandibula Rekonstruksi Fr Tulang Wajah PJ
49 Suliman 3 NPBI 70 th L R1B C259062 Prostat Enlargement TURP WAN NO,DM*,DA
50 Jasmirah 3 NPBI 42 th P R3A C620934 Nefrolithiasis Sin Pasca DJ Stent Aff DJ Stent WAN
51 Warsimin 3 NPBI 36 th L R2B C603004 Strikture Uretra Posterior Sachse MAS S : AY,MW
52 Museri 3 NPBI 67 th L Ger D C639639 Massa Buli TUR Buli MAS
53 Risya 1 NPBI 8 th P Transit C441062 ALL BMP HER
Obs Pansitopenia d.d Anemia Aplastik, AML,
54 Mukhairil Lazimin 3 Um 8 th L Anak 1 C639760 BMP MOED
ALL
55 Sumari 3 NPBI 31 th L P. Ort C633456 Post ORIF Wire Aff Wire DID
56 Airlangga Rizki 3 NPBI 7 bl L Anak 1 C639853 Hematemesis Melena Endoskopi NNG YR,US,IM
57 Duriah 3 NPBI 63 th P R6A C638027 TB Putus Obat, Hemoptoe Bronkoskopi FRD
58 Sholikhin 3 PBI 57 th L P. THT C571263 Post Kemoradiasi LF DAT
59 Isturiningsih 3 NPBI 63 th P P. THT C477063 LPR LF + NBI DAT
60 Jumiirah 3 NPBI 54 th P P. THT C639821 LPR LF DAT
61 Saodah 3 NPBI 49 th P P. THT C639815 Limfadenopati Colli + Disfagia LF k/p Biopsi + Psg NGT DAT
62 Supadio Priv NPBI 63 th L P. GRD C640009 Disfonia LF AYU
63 Sunarmi 2 NPBI P Ger D C638645 Sirosis Hepatis EGD HRY MR,JF
64 Riski Rofifat Priv NPBI 29 th L P. GRD C635317 Hepatitis B EGD HRY
65 Tan Slamet 1 NPBI 58 th L KPD 1 C559390 CKD EGD HRL
66 Muh Nur Aziz VIP NPBI 50th L GRD L5 C638835 Hematomesis EGD AGG
67 Sugimin 2 NPBI 54 th L MRK D C637504 Adeno Carcinoma Mix Neuro Bronkoskopi FTR
68 Endah Susilowati 3 47 th P R4A C638684 Efusi Pleura Susp TB Bronkoskopi THOM
69 Gunarto VIP NPBI 63 th L ICU GRD C512858 ICH, IVH, SAH, BRPN Bronchial Toilet FTR
70 Surtinah 3 NPBI 64 th P P. Uro C636820 Nefrolithiasis ESWL WAN
71 Warso 3 NPBI 40 th L P. Uro C576298 Nefrolithiasis ESWL WAN AK
72 Priyanto 3 NPBI 37 th L P. Uro C589312 Nefrolithiasis ESWL ADS
M : WU,HR,EW,WD,NI,MK,ANM RR : FA,SAM,SR MID : DB,ER RR GRD : ST MID : YS* SORE PROGRAM : NO,WU,AY,TW,ET,AR,AG,AF,NI,BR,DN,DI,MY*,TU,ANM,MW,RG*,RM,TM,WD ALAT
L : AU,BD,CA,DY,EA,PS,SC,SA,GI,SU,VQ
9 GA HA 14.00
10 GA DS 06.30 07.00 10.00 180
10 GA DS 10.30 15.30 120
10 GA DS 16.00
JTG GA HR 07.00 10.00 13.30 300

JTG GA HR 14.00
GR 1 GA VL 07.20 07.30 08.30
GR 1 GA VL 09.00 12.00 180

GR 1 GA HA 12.30 120
GR 2 LA 07.30 08.00 08.30
GR 2 LA 09.00 09.30
GR 2 LA 10.00
GR 3 GA VL 07.20 07.30 09.30 120
GR 3 GA VL 10.00 11.30 120
GR 3 GA VL 12.00 180
GR 4 GA HR 07.20 07.30 09.30
GR 4 GA HR 10.00 12.30 120
GR 4 GA HR 13.00
GR 5 GA HR 07.20 07.30 08.30 180
GR 5 GA HR 09.00 10.30
GR 5 GA HR 11.00 60
DS 1 GA DS 06.00 06.30 07.00 60
DS 1 LA 07.30 07.45
DS 1 GA DS 08.00 08.30
DS 1 GA DS 09.00 10.00
DS 1 GA DS 10.30 10.45
DS 1 GA DS 11.00 12.30
DS 1 GA DS 13.00
DS 2 GA DS 07.30 08.00 08.30
DS 2 GA DS 09.00 09.30
DS 2 LA 10.00 10.20
DS 2 LA 10.30 10.45
DS 2 LA 11.00 11.20
DS 2 LA 11.30 11.45
DS 2 LA 12.00
DS 3 LA 07.30 08.00 08.20
DS 3 LA 08.30 08.45
DS 3 GA DS 09.00 09.30
DS 3 LA 10.00 10.20
DS 3 GA TA 10.30 11.00
DS 3 GA DS 11.30 12.30 BD
ICU GA DS 13.00 CA
DS LA 08.00 EA
DS LA 09.00 PS
DS LA 10.00 SC
,ET,AR,AG,AF,NI,BR,DN,DI,MY*,TU,ANM,MW,RG*,RM,TM,WD ALAT : PUR,YN ( S: DW ) SA
GI
SU
Sariyatun 3 NPBI 50 th P R2A C620083 Adeno Ca Pleomorfik Adenoma Total Parotidektomi DWT senin

JAMI
ASIS
REKAM
PEN
TEN
N
MEDIS
HE,AO,ES,
PLH : NO AH,EV,AL,TA,AP,PR,YW,TU,RI
DA,WI,SE
Plate 2.0 (10),
1.6 (10), 1.2
1 Jamaludin 1 NPBI 34 th L MRK L1 C639321 Pan Facial Fraktur Rekonstruksi Tulang Wajah PJ RK,YN,ID
(10), Screw
2.0, 1.6, 1.2
2 Isnanto 3 NPBI 28 th L R2B C636219 Disfagia Esofageal ec Striktur Esofagus Esofaguscopy + Dilatasi DAT
Ameloblastoma Maxilla Kiri + Konka Hipertrofi Ekstirpasi Massa + FESS + Konka Reduksi + FESS,
3 Sudaryono 3 NPBI 45 th L R3B C243303 DAT + RP
+ RSK + Impaksi Odontektomi Endoskopi
G2P1A0 Hamil 38 Minggu Bekas SC Panggul
4 Riyanti Dewi 2 NPBI 24 th P Obstetri C636933 SCTP + IUD OP NH,HI,DW
Sempit
G3P2A0 Hamil 37 Minggu SOL Intra Cranial
5 Turyani 3 NPBI 29 th P Obstetri C639931 SCTP + MOW OP
dd/ Meningioma Astrositoma
6 Heni Widiastuti VIP NPBI 43 th P GRD L3 C640066 G3P2A0 Hamil 38 Minggu Bekas SC 2x SCTP + MOW MZ
Casserian Ganglionectomy Simpathectomy
7 Ahmad Zaeni 3 NPBI 43 th L R3B C638262 Cephalgia Kronis / Hemifacial Spasme Sinistra C arm TRI ND,JF
Cervical
8 Rukilah 2 NPBI 53 th P MRK LD C636863 Susp Ca Ovarii Laparotomi + FS KD 1 EW TW,DM
9 Issasatul Ifadah 3 NPBI 24 th P R4A C637815 NOK dg Bag. Padat c/ Ganas Salpingo Ooforektomi + FS KD 2 EW
10 Mudrikah 2 NPBI 29 th P KPD LD C574993 Kista Ovarii Bilateral Laparoscopy INU
Fistel Recto Vagina on Kolostomi Post Repair
11 Aura Dwi Agustin 3 NPBI 10 bln P Anak LD C601747 Reseksi Anastomose Colon End To End PTY TD,TU
Fistel
12 Yunita Dyah VIP NPBI 22 th P GRD L6 C638841 TBC Inksmail Laparoscopy Biopsi ERI
13 Ida Ridar B VIP NPBI 56 th P GRD L4 C395568 Tumor Sigmoid c/ Ganas Laparotomi Sigmoidectomi Anterior Reseksi ERI
14 Ita Mustikasari VIP NPBI 34 th P GRD L4 C585643 Hymenoplasty ETH
Endoskopi,
15 Sri Murdiyanti VIP NPBI 51 th P GRD L5 C638050 Multisinusitis FESS + Konka Reduksi + CWL Rhino Set, RH AZ,DJ
CWL
Endoskopi,
Septoplasty + Konkoplasty + Ligasi a Spheno
16 Sholihin 3 NPBI 61 th L R1B C623909 Epitaksis Anterior, Septum Deviasi Berat Rhino Set, ANNA
Palatum
FESS 3
17 Maulina Wahyu Dewi 3 PBI 1 th 5 bln P Anak LD C564591 Palatoschiziz Komplit Palatoplasty NJT EM,RG,YS
Rekonstruksi Hidung + Palatoplasty +
18 Sholikah 3 NPBI 49 th P R5B C614107 Palatoschiziz NJT
Ekstraksi gigi
UM,BY
19 Siti Zulikatun 3 NPBI 46 th P R2A C630735 Meningioma Falk Craniotomi DP LW,SF
EN,MA,BP,
SS,AS*
20 Tri Prasetyaningtyas VIP NPBI 53 th P GRD L6 B197208 Massa Paru Kanan Bronkoskopi SF YR,US,IM
GN,MR
AK
M : WU,WD,NI,MK,ANM,RM RR : SAM,SR,DB,ER SORE PROGRAM : ET,II,AF,AM,BR,DN,TK,DI,MY,MW,MF*,PM*,RA,IS,TM,TR ALAT : PUR,CA
L : AR,AU,AT,RE,AY,AD,BD,VT,DY,EA,EW,HR,PS,NK,PL,SC,SA,GI,SU,VQ,NP
PENJ
AMIN
ASIS
REKAM
TEN
MEDIS
VQ
RAL
TERI
GRA
PEM
PRO
anes
DTG
BER
ANE
SER
JAM
JAM
STE
DPJ
RIIL
Jeni
SIH
tesi
MA
OK
AN
AH
OK
SI
M
J.
P
s
CT
1 GA 05.30 06.00 10.30
1 GA 11.00 11.30 60
1 GA 12.00
180
2 GA 06.30 07.00 08.00 180
2 GA 08.30 10.30 180
2 GA WA 11.00 120
3 LA 08.30 09.00
4 GA WA 08.30 09.00 11.30

4 GA 12.00 14.30
4 GA 15.00
5 GA 07.00 07.30 10.30
5 GA VL 11.00 11.30 60
5 GA VL 12.00 180
6 GA 07.30 08.00 09.30
6 GA 10.00 12.30 180
6 GA 13.00
180
7 GA 07.30 08.00 09.00
7 GA 09.30
8
9 GA
JTG
DS 2 GA HN 07.30 08.00 30
DS 3
DS
RAL
STES
DPJP
N OK
anest
SIHA
Jenis
TERI
PRO
GRA
PEM
DTG
BER
SER
ANE
JAM
JAM
RIIL
MA
AH
esi
OK
M
J.
I
ST,AT,AR,
RE,AD, VT*,
DY, NK,
SA,SU*
1 Ika Maryati 3 NPBI 34 th P R4B C637107 Ca Endometrium Surgical Staging EW
Endoskopi,
2 Safiul Anam 3 NPBI 23 th L R3B C624863 Septum Deviasi + Konka Hipertropi + RSK FESS + Konka Reduksi + SR ANA
Rhinoset I
M : ET,SE,PS,AM,RM SORE : II,PM,TR,MF,RA
HARI / TANGGAL : SENIN, 12 JUNI 2017 PENJAMIN
ASISTEN
REKAM
MEDIS
NH,SL,HE,
S : RK, II, ND
BD,SU
1 Chrisna Setyaningsih 2 NPBI 45 th P KPD LD C636604 Nefropati Obstruktif HN + HU URS Dextra + Repair DJ Stent Dextra ADS UM,AR,ID
2 Kumisih 3 NPBI 52 th P R5B C633696 Ca Cervix + HN + HU Sistoskopi + DJ Stent ADS S : AN
3 Desi Akhirana Resdiawati 2 NPBI 42 th P MRK LD C626873 Adeno Ca cervix Std IV A Nefrostomi WAN
4 Tarminto Hadi 3 NPBI 69 th L R3B C639063 Tumor Mediastinum + SVCS Chamberlain Procedure WW
5 Suntoyo 3 NPBI 66 th L R2B C639414 Ruptur Uretra Posterior PER MAS AO,AU,TK*
STORZ,
Harmonic
6 Tri Ernawanti 2 NPBI 42 th P Transit C639370 Abses Ginjal Laparoscopy Nefrectomy
Scalpel,
MAS S : AI
Hemolok
7 Jumadi 3 NPBI 66 th L R3B C622918 Fistula Oronasal Fistula Clossure Endoskopi WY
BY
8 MZ TW,YN
9 Novy Zulaykha P 2 NPBI 22 th P Obstetri C631297 Abses Vagina Eksisi Abses + Pasang Threeway HR S : ES
10 Labiba Najiya 3 NPBI 2 bln P Anak L1 C634566 Eventerasio Diafragma Sin Plikasi Diafragma Sin ALI
11 Heni 3 NPBI 19 th P R6A C635706 Empyema Thorakotomi Dekortikasi ALI
12 Sriningsih 2 NPBI 48 th P Transit C639100 Gall Bladder Sludge Laparoscopy Cholecystomy STORZ MM TD,TM
13 Sugiri 2 NPBI 55 th L GER LD C639511 Adeno Ca Recti LAR Stapler PB S : PM
14 Naisah 3 NPBI 56 th P R5B C630269 Ikterus Obstruktif ec Cholangitis Postouw Procedure ERI
15 Anan Wahyu Hadiyanto 3 NPBI 13 th L R1B C636412 Tumor Maxilla Kiri c/ Ganas Hemimandibulektomi Sin BIS AZ,DB
16 Nurrochmah 3 NPBI 47 th P R2A C616431 SNNT Sin c/ Ganas T3NoMo Istmolobectomy + FS, Ganas TT UUD S : SR
17 Sulastri 2 NPBI 54 th P KPD LD C625904 Ca Mamae MRM FASTRACK DWT
18 Sariyatun 3 PBI 51 th P R2A C620083 Adeno Ca Parotis Total Parotidectomy DWT
STT Reg Flank Sin dd/ Limfangioma
19 Meyla Putriani 3 NPBI 3 th P Anak LD C634850 Eksisi Biopsi RR (BA) DY, EA
Hemangioma
FASTRACK
20 Muhammad Ulin 2 NPBI 22 th L KPD L1 C639528 Impkasi Gigi 2 Rahang Odontektomi 2 Rahang DV S : TA
Bor NSK
SF,AF
S : AT
LW,BR
S : SA
21 Jenny Winoto 1 NPBI 46 th P KPD LD C639939 Fr Maleolus Medial Sin ORIF APR PR,AP
CT
GA 08.30 09.00 240 AM

GA 09.30 10.00 RM
RAL
DPJP ANESTESI
JAM PROGRAM
PEMBERSIHAN
JAM DTG RIIL
Jenis anestesi
J. SERAH
TERIMA
OK
OK
CT AI
1 GA JL 07.30 08.00 09.30

1 GA JL 10.00 10.30 60
1 GA JL 11.00 12.30
1 GA JL 13.00
2 GA JL 07.30 08.00 10.30
2 GA JL 11.00 15.30
180
2 GA JL 16.00 120
3
3
4 GA HA 07.30 08.00 10.30 180
4 GA HA 11.00 13.30
4 GA HA 14.00 16.30 180
4 GA HA 17.00
5 GA HA 07.30 08.00 10.00 120 MF
5 GA HA 10.30 13.30 180
5 GA HA 14.00 180
6 GA EL 07.30 08.00 11.00 180 PL
6 GA EL 11.30 14.30 240
6 GA EL 15.00 16.30
6 GA EL 17.00 180
7 GA EL 07.30 08.00 09.30
60 ST
7 GA EL 10.00
120
8
8
9
9
10 GA HR 06.30 07.00 08.30
22 Yoga Paripurna 2 NPBI L KPD L1 C378588 Post ORIF Wire Lepas K-Wire FASTRACK APR S : HI
23 Mujib Rohman 3 NPBI 24 th L R2B C637982 Fr Pillon Negleted Rekonstruksi ORIF DID
24 Nurul Fadillah 2 NPBI 25 th P KPD LD C637210 Ruptur ACL Arthroscopy ACL FASTRACK BIN
EN,MA,VT
BP,SS, AS
25 Kuruga Suro Sutarso VIP NPBI 56 th L GRD L 6 C385000 Efusi Pleura Kiri, Loculated Thoracoscopy WW S : WI,
26 Rusmiyati 3 NPBI 45 th P R3A C547830 Mata Kanan Kiri VH ec PDR Mata Kanan Vitrectomi Opmic AL NK,DI
27 Suyami 1 NPBI 54 th P KPD D C539775 Mata Kanan Kiri PDR + VH Mata Kanan Vitrektomi + EL + SO/Gas AL
Mata Kanan SO Filled Eye + Still Detach, Mata
28 Utomo 3 NPBI 23 th L R5A C556402 Mata Kanan SB + Re-Vitrectomi + SO Opmic AL
Kiri Vx Eye + TRD + Pseudofakia
Mata Kanan Kiri Glaukoma Sekunder e.c
29 Nurcholis 3 NPBI 33 th L R1B C581232 Mata Kanan Trabekulektomi Opmic, MMC FI YW,TU,RI
Steroid
30 Suharto 1 NPBI 56 th L P. Mata C570639 Mata Kanan Pseudofakia, Mata Kiri KSI Mata Kiri Phaco + IOL Opmic RF S : HA,AG, IS
31 Saifudin Ahmad 1 NPBI 63 th L P. Mata C639866 Mata Kanan Kiri Katarak Juvenile Mata Kiri Phaco + IOL Opmic RF
32 Mahfud Privat NPBI 75 th L Pol GRD C629176 Mata kanan kiri katarak Mata kanan phaco + IOL AL
Mata Kanan Koroidal Neovaskularisasi
33 Sukarni 3 NPBI 59 th P P. Mata C197729 Mata Kanan Injeksi TCA / Anti VEGF Opmic AL
Mata Kanan Kiri PDR + CSME, Mata Kanan Mata Kanan Injeksi Triamcinolone Acetat Sub
34 Endang Suprihatiningsih 3 NPBI 58 th P P. Mata C619806 AL
Post CRVO Tenon
35 Solikatun 3 PBI 58 th P R6A C636781 Mata Kana Kiri Glaukoma Neovaskuler Mata Kanan Kiri Trabekulektomi + MMC MR
Mata Kiri Eksisi Pterigium + Limbal Stem Cell
36 Panus 3 NPBI 68 th L P. Mata C638238 Mata Kanan Kiri Pterigium DN
Graft
37 Benny Sutanto Privat UM 39 th L Pol GRD C594830 Mata kiri CMV Retinitis Inj. Gancyclovir Intravitreal DN
38 Fatimah 3 NPBI 44 th P R4A C625197 Adeno Ca Endometrium St II Surgical Staging EN NP*,RE,YS
39 Sumarno 2 NPBI 29 th L MRK D C638686 Tumor Intra Abdomen Laparoskopi Biopsi Aesculap ERI
40 Siti Kusmayati 3 NPBI 55 th P R2A C624946 IDC Gr III MD T4bN2Mo MRM YAN AL,AD
41 Barikah 3 NPBI 58 th P R2A C618027 Ca Papilary Thyroid Total Tiroidektomi YAN
42 Waslim 3 NPBI 42 th L R1B C482515 Mata Kiri Kista Konjungtiva Mata Kiri Eksisi Kista + Rekonstruksi Palpebra INA
43 Mulyo Diharjo 3 NPBI 27 th L R1B C635530 Ulkus Granulosum Reg Pelvis Anterior Debridement + STSG PJ AH,ER,DN
44 Alfin Azizi 3 NPBI 20 th L R2B C639132 Pasca Amputasi Above Elbow Bilateral Repair Stump Bilateral PJ
45 Masitoh 3 NPBI 52 th P R5B C604543 Ca Cervix c/ Metas VU Sistoskopi Biopsi WAN AY,DM,DA
46 Sudjatwati 3 NPBI 60 th P R4A C592086 Ca Cervix Uteri c/ Metas VU Sistoskopi Biopsi WAN
47 Arif Yakun NPBI L KPD L1 C480881 Batu Ginjal FASTRACK MAS
48 Liskiyah 3 PBI 39 th P R3A C635130 Ca Sinonasal Aff Tampon DAT
49 Joharipin 3 NPBI 53 th L R5A C612115 Ca Sinonasal Aff Tampon WY
50 Muhammad Syafiq 2 NPBI 3 th L RPO C505379 Wound Dehiscense Rehecting ALI
51 Riyanto 48 th L KTL C490958 Riwayati Colonoscopy k/p Biopsi MM YR,MW
52 Sutamar 3 NPBI 61 th L Pol THT C273137 Laringitis Kronis Laringoscopy Flexible DAT S : US,JF
53 Paini 3 PBI 56 th P Pol DIG C630254 Ca Epidermoid Colonoscopy ERI
54 Rokanah 3 NPBI 34 th P Pol DIG C404543 Hematoschezia Colonoscopy ERI
55 Azka Lutfi M 3 NPBI 3 th L Pol DIG C596500 Stricture Esofagus EGD ERI
56 Fatimah 3 PBI 56 th P R4A C500552 Ca Cervix Colonoscopy ERI
57 Waseni 3 PBI 64 th P R3A C639817 Tumor Intra Abdomen Colonoscopy PB
58 M. Khoiri 3 NPBI 45 th L Pol PD B409297 Hepatitis B EGD HRY GN,MR
59 Ngatinem 3 NPBI 38 th P Pol PD C639470 Dispepsia EGD HRY
60 Sutarmen 3 NPBI 58 th L Pol PD C638688 Nodul Hepar EGD HRY
61 Ratna Catur 3 NPBI 30 th P Pol PD C589160 Ca Colon Colonoscopy AGG
62 M. Ardiyana Pratama 1 NPBI 26 th L MRK L1 C588353 Rematik EGD DD
63 Jumaryono 3 NPBI 59 th L R6B C637418 Diare Kronis, Multiple Nodul Colonoscopy + Biopsi DD
64 Sobirin 2 NPBI 50 th L MRK LD C638828 Diare Kronik Colonoscopy DD
65 Sudiyono 3 NPBI 65 th L R5A C628248 Ca Cavumnasi Nasofaringoscopy Flexible WY
66 Sriniati 3 NPBI 63 th P Pol URO C596291 Nefrolithiasis ESWL ADS
67 Nuraeni 3 NPBI 58 th P Pol URO C278584 Batu Ureter ESWL MAS
68 Nurul Hidayah 3 NPBI 64 th P Pol URO C620103 Batu Ureter ESWL MAS AK
69 I Made Gunana 3 NPBI 57 th L Pol URO C232424 Batu Ginjal ESWL MAS
10 GA HR 09.00 09.30
10 GA HR 10.00 12.30
10 GA HR 13.00
JTG
JTG GA WA 15.00 180

GR 1 GA TA 07.30 08.00 09.00
GR 1 GA TA 09.30 12.00
GR 1 GA TA 12.30 180
GR 2 LA 07.30 08.00 08.30
GR 2 LA 09.00 09.30 60
GR 2 LA 10.00 10.30 60
GR 2 LA 11.00 11.20
GR 2 LA 11.30 11.45
GR 2 LA 12.00 12.30
GR 2 LA 13.00 13.30
GR 2 LA 14.00 14.30
GR 2 LA 15.00
GR 3 GA TA 07.30 08.00 11.30 60
GR 3 GA TA 12.00
GR 4 GA BI 07.20 07.30 08.30 240
GR 4 GA BI 09.00 12.30 180
GR 4 GA BI 13.00
GR 5 GA BI 07.30 08.00 10.30 180
GR 5 GA BI 11.00 GI
DS 1 LA 06.30 07.00 07.30 30
DS 1 LA 08.00 08.30 30
DS 1 GA HR 09.00 10.30
DS 1 TA HR 11.00 11.30 AM
DS 1 LA 12.00 12.30 ET
DS 1 GA HR 13.00
DS 2 GA HR 07.30 08.00 08.30 SE
DS 2 LA 09.00 09.30 TR
DS 2 GA HR 10.00 10.30
DS 2 GA HR 11.00 11.30
DS 2 GA HR 12.00 12.30
DS 2 GA HR 13.00 13.30
DS 2 GA HR 14.00
DS 3 LA 08.00 08.20 NI
DS 3 LA 08.30 08.45 CA
DS 3 LA 09.00 09.30 EW
DS 3 GA HR 10.00 10.30 HR
DS 3 LA 11.00 11.20
DS 3 GA HR 11.30 11.45
DS 3 GA HR 12.30 13.00 ANM
DS 3 LA 13.30 MK
DS LA 07.30 RM
DS LA 09.30
DS LA 11.30 WU
DS LA 13.30 WD
M : ET,EM,SE,TR,AM,PS,RA RR : FA,SAM,IM MID : MY,SC RR GRD : RG MID : VQ SORE PROGRAM : EV,RK,AI,II,TA,AN,AG,AT,DJ,ES,HA,HI,IS,JF,WI,MF,ND,PM,PL,SA,SR,ST,US ALAT : PU
L : NI,CA,EW,HR,ANM,MK,NO,RM,WU,WD
Winggenah (BATAL) 3 NPBI 57 th P P. Mata C610717 Mata Kanan Kiri AMD Wet Mata Kanan Injeksi STTA AL
Giarti (BATAL) 3 NPBI 58 th P P. Mata C502620 Mata Kiri AMD Mata Kiri Injeksi STTA AL

PENJAMIN
ASISTEN
REKAM
MEDIS
NH,SL,HE,
S : RK,ND, DJ
BD,SU
Rhino set +
1 Akbar Agustiansyah 3 PBI 8 th L Anak LD C625190 Mata Kiri Fistula Saluran Lakrimalis Mata Kiri Endo DCR + FESS RH + INA ST,AR,ID*
Endoscopy
2 Ratini 3 NPBI 43 th P R2A C636020 Polikistik Laparoscopy Unroofing Kista MAS + ERI S : AN
3 Maryamah 3 NPBI 58 th P R3A C637705 Tumor Rectie Miles Procedure MG
4 Romyati 3 NPBI 50 th P R4A C639671 Massa Laring LD + Ekstirpasi Mssa + Biopsi Endoskopi FAR AO,AU,TK
Plate + 6
5 Muhlisin VIP NPBI 30 th L GRD L4 C638991 Ameloblastoma Mandibula Dx Hemimandibulektomi Dx + Rekonstruksi Screw, OEN S : AI
Osteomed
6 Saodah 3 NPBI 49 th P R4A C639815 Metastasis Ca Coli, Dypsnae Trachea Trakeostomi DAT
BY
7 Kinah 2 NPBI 61 th P Obstetri C636174 NOK c/ Ganas SOU + FS s/d CSS MZ TW*,YN,PL
8 Kumiyatun 2 NPBI 44 th P MRK LD C636825 NOK dg Bag. Padat c/ Ganas SOU + FS s/d CSS EW S : SR
9 Desiyani 2 NPBI 29 th P MRK LD C632989 NOK SOU + FS EW
10 Suwarti 3 NPBI 74 th P R2A C639860 Fr Collum Femur Dx Bipolar k/p THR BIN
11 Subandi 3 NPBI 53 th L R5A C626281 Tumor Intra Abdomen c/ Extra Luminer Laparatomi Biopsi PB TD,TM
12 Bambang Sukamto 3 NPBI 54 th L R6B C634267 Ca Esofagus Post Jejunostomi Feeding Repair Wound Dehisence ERI S : JF,RI
13 Amriti 3 NPBI 58 th P R3A C628488 Splenomegali Splenektomi ERI
14 Nugroho 3 NPBI 51 th L R2B C639434 Tumor Recto Sigmoid Laparatomi LAR Harmonic ERI
15 Nasahi 3 NPBI 54 th L R1B C638119 Melanoma Maligna Reg Inguinal Dx Wide Eksisi + Groin Diseksi k/p Rekonstruksi BIS AZ,DB
16 H Riau Anna 1 NPBI 52 th P KPD L1 C627648 Ca Mamae Insisi Biopsi UUD S : YS
17 Asmaah 3 NPBI 56 th P R2A C617389 IDC Gr II MD TxNoM1 (Kontra Lateral) MRM Dx UUD
18 Ninghati 3 NPBI 47 th P R2A C491372 IDC Gr II MS T4bNoMo MRM UUD
19 Sumadi 3 NPBI 57 th L R2B C635049 Limfadenopati Colli Limfadenektomi Biopsi UUD
20 Afif Zakaria Ahmad 3 NPBI 4 th L Anak L1 C640249 Cumbustio Gr II 18% Debridement NJT DY,EA
21 Suwono 1 NPBI 70 th L GER L1 C637479 Ulkus Cruris Debridement + Flap PJ S : TA
Plate 2.0, 1.6,
22 Jamaludin 1 NPBI 34 th L MRK L1 C639321 Pan Facial Fraktur ( HBSAg + ) Rekonstruksi Tulang Wajah (ORIF IDW IMW) 1.2, Screw 2.0, PJ
1.6, 1.2
23 Muh Komsiyanto S 3 NPBI 8 bln L Anak L1 C639242 Hidrocephalus VP Shunt GK SF,AF
24 By Ny Suprihati IRIN NPBI 13 hr L PBRT C639369 SOL Parieto Temporo Occipital Sin Craniotomi Biopsi MTA S : AT
25 Umi Rahmawati 3 PBI 6 th P Anak LD C624849 lipomeningocelle three layer reconstruction ER (BS)
26 Silvia Lu'Luatul Hasna 3 NPBI 12 th P Anak LD C637621 Epilepsi Hemisferectomy Sinistra ZM LW,BR
27 Sopingi 1 NPBI 61 th L MRK L2 B288982 Tumor Intra Suprasella Bedah Mikro Transpenoid ZM S : SA
28 Gunawan 1 NPBI 64 th L MRK L1 C639471 HNP L4-5 Laminektomi + PSRS C-Arm APR PR*,AP
29 Risky Haerul 1 NPBI 24 th L MRK L2 C621153 Spondilitis Laminektomi + PSRS C-Arm APR S : HI
30 Maulana Ikhsan 3 NPBI 15 th L Anak LD C640312 Fr. Clavicula Sin 1/3 tengah ttp NK Pasang Figure APR
AG,AT,DJ,ES,HA,HI,IS,JF,WI,MF,ND,PM,PL,SA,SR,ST,US ALAT : PUR,DW* ( S: )
RAL
JAM PROGRAM
PEMBERSIHAN
JAM DTG RIIL
Jenis anestesi
ANESTESI
J. SERAH
TERIMA
DPJP
OK
OK
CT JH
1 GA HR 06.30 07.00 10.00
1 GA HR 10.30 14.00
1 GA HR 14.30
2 GA HR 06.30 07.00 08.30 120
2 GA HR 09.00 14.00
300
2 GA HR 14.30 60
3
4 GA SF 07.30 08.00 11.00 180
4 GA WA 11.30 14.00 180
4 GA WA 14.30 18.30 180
4 GA SF 19.00
5 GA SF 07.30 08.00 09.30
5 GA SF 10.00 12.00 120
5 GA SF 12.30 14.30 120
5 GA SF 15.00 120
6 GA DS 06.00 06.30 10.00 180
6 GA DS 10.30 11.30 30
6 GA DS 12.00 14.00 120
6 GA DS 14.30 17.00 180
6 GA DS 17.30 60
7 GA DS 07.30 08.00 09.00 60
7 GA DS 09.30 11.00
7 GA DS 11.30
240
8 GA TA 06.00 06.30 07.30
8 GA TA 08.00 13.30 300
8 GA TA 14.00 120
9 GA TA 07.30 08.00 14.30 360
9 GA TA 15.00 240
10 GA UB 06.30 07.00 09.30 120
10 GA UB 10.00 13.30
10 GA UB 14.00 14.20
31 M Misbah 3 NPBI 33 th L R2B C638891 Fr Femur Sin 1/3 Tengah Ttp Nk ORIF DRY
32 M. I. Buntari 2 NPBI 69 th L Transit C598481 Fr Patologis Tibia Sin 1/3 Tengah Ttp Nk ORIF DID
33 Djoko Slameto Rohadi VIP NPBI 67 th L GER L1 B354504 Fr Tibia Dx Pasang Gips C-Arm DID
EN,MA*,VT
34 Bintang Tentrem Rahayu 3 NPBI 11 th P Elang 1 C572351 TOF post BT Shunt Total Koreksi SF
BP,SS, AS
35 Saminah 3 NPBI 41 th P R5B C482624 Tumor Mediastinum Thoracotomi Debulking ALI S : WI
Mata Kiri Ekstraksi Lensa + Vx Anterior + PPC
36 M. Hafidz Al Bahri 3 NPBI 5 bln L Anak LD C629525 Mata Kiri Katarak Kongenital ec Rubella Opmic LN NK,DI*
+ PI
Mata Kanan Kiri Katarak Kongenital ec Rubella Mata Kanan Ekstraksi Lensa + PPC + PI + Vx
37 Kayla Nada Putri 3 NPBI 5 bln P CILD C636946 Opmic LN
Syndrome Anterior
38 By Ny Sulami 3 NPBI 18 hr L PBRT C639479 Mata Kanan Kiri ROP St III + Plus Disease Mata Kanan Kiri Inj. Avastin + Retcam EUA Opmic, Avastin AW
39 Kuswanto 3 NPBI 61 th L R1B C575842 Mata Kiri SO Filled Eye + Katarak Komplikata Mata Kiri Evakuasi SO + Phaco + IOL Opmic AW
40 Marju 3 NPBI 56 th L R1B C568940 Mata Kanan SO Filled eye Mata Kanan Evakuasi SO + Phaco + IOL Opmic AW
Mata Kanan Glaukoma Sekunder + SO Filled
41 Sutomo 3 NPBI 35 th L R2B C482813 Mata Kanan Evakuasi SO Opmic AW
Eye
42 Agung Cahyono VIPA NPBI 40 th L GRD L4 C637440 Mata Kanan Kiri PDR + TRD Mata kanan Vitrektomi + EL + SO / Gas AW
43 Yamtini Privat NPBI 75 th P Pol GRD C638996 Mata kiri Katarak + Glaukoma Mata kiri Trabekulektomi + Phaco + IOL MR YW,TU
Opmic, Rohto
44 Perti 3 PBI 56 th P P. Mata C605209 Mata Kanan Kiri POAG + KSI Mata Kiri Phaco + IOL MR S : HA,AG, IS
Fold 21.5 D
45 Suhardi 3 NPBI 43 th L P. Mata C634422 Mata Kanan Pseudofakia Mata Kanan Irigasi Aspirasi Sisa korteks Opmic RF
Mata Kiri Subluksasi Lensa + Glaukoma
46 Aziz Soedarman 3 NPBI 68 th L P. Mata C636806 Mata Kiri EKIK Opmic WIS
Sekunder
47 Septa Nugroho 3 NPBI 19 th L P. Mata B202591 Mata Kanan Kiri Pseudofakia Mata Kiri PPC + Vitrectomi Anterior Opmic WIS
48 Parmin Privat NPBI 70 th L Pol GRD C599748 Mata kiri KSI + HBsAg (+) Mata kiri Phaco + IOL WIS
49 Zumaroh 2 NPBI 45 th P KPD LD C636499 NOS c/ Ganas TAH + BSO + FS s/d CSS EN NP,RE,ES
50 Sri Lestari VIP NPBI 32 th P GRD L4 C640142 Kista Ovarii Laparoscopy INU
Eksisi + FS ganas Wide Eksisi + FS Bebas
51 Nur Yuliasih 3 NPBI 47 th P R2A C623292 Tumor Kulit c/ Ganas c/ Basalioma DH+NJT HR,AD
Tumor + Rekonstruksi
52 Pariyono 3 NPBI 71 th L R2B C632273 Tumor Parotis Dx c/ Ganas T4N1Mo Total Parotidektomi UUD
53 Anindita Nur Keisha Z 3 NPBI 1 th 3 bln P Anak LD C601945 MAR on Kolostomi Post PSARP Tutup Kolostomi (Reseksi + Anastomosis) EDW AH,ER,DN
Mata Kanan Massa Saluran Lakrimalis + Mata Kanan Wide Eksisi + FS + Rekonstruksi
54 Muhammad Rifa'i 2 NPBI 70 th L KPD LD C622285 TL
Fistula Palpebra
55 Tsenia Alvi Nofika 3 NPBI 12 th P Anak L1 C638449 Mata Kanan Kiri Galukoma Juvenile Mata Kanan Kiri Trabekulektomi Opmic FI opmic
56 Didik Setiadi 3 NPBI 28 th L R1B C535426 Striktur Uretra Posterior Sache + Sectio Alta WAN AY,DM,DA
57 Sudimah Privat PLN 67 th P Pol GRD C640416 DJ Stent Neglected Aff DJ Stent MAS
58 Mahmudi 3 NPBI 43 th L R2B C634659 Post PER Pasang Kateter Silikon MAS
59 Rusmi 3 PBI 50 th P R6A C638807 HN + HU Dupleks Ureteroscopy + URS MAS
60 M. Rafa P 3 NPBI 1 th L Anak L1 C640310 Talasemia BMP HER
61 Dzaka Putra A 3 NPBI 2 th L Anak L1 C640229 Kejang Demam Lumbal Fungsi TUN
62 Sulastri 2 NPBI 47 th P MRK LD C636340 Fr Pelvis Lepas Skeletal Traksi DRY
63 Tutur Rohani 3 PBI 35 th L R3B C640285 Meningitis Lumbal Fungsi YOVITA
64 Bastian Anugrah 3 NPBI 4 th L Anak LD C616931 c/ polip rectie dd/ tumor recti Colonoscopy RR (BA) EW,MW
65 Taryono 1 NPBI 61 th L KTL C638306 Hematoschezia Colonoscopy MM S : YR,US
66 Sukarjo 2 NPBI 71 th L MRK LD C575869 Ca Rectie Colonoscopy PB
67 Rustam 3 60 th L R3B C542873 Tumor Recto Sigmoid Colonoscopy PB
68 Purwati 3 NPBI 45 th P R4A C608474 Melena, c/ fistula rectosigmoid Colonoscopy k/p Biopsi PB
69 Purwanto 1 NPBI 65 th L KPD L1 C639388 Diare Kronik Colonoscopy DD GN,MR
70 Sutini 3 NPBI 67 th P Pol PD C525853 Ca Colon Colonoscopy DD
71 Eli Pujiati 1 NPBI 60 th P MRK L1 C074890 Cholithis Colonoscopy + APC DD
72 Romyati 3 NPBI 50 th P R4A C639671 Pneumonia Bronchoscopy AVIS
73 Tri Wulandari 3 NPBI 22 th P Pol THT C640409 Massa Lidah Laringoscopy Flexible + Biopsi FAR
74 Poniman Budi R 1 NPBI 68 th L KPD LD C634975 Hemoptoe Bronchoscopy FTR
75 Widodo 3 NPBI 44 th L Pol URO C623536 Batu Ren Dextra ESWL MAS
10 GA UB 14.30 18.30 180
10 GA UB 19.00 20.30 120
10 GA UB 21.00
JTG GA HN 07.00 10.00 13.30 300

JTG GA HN 14.00
GR 1 GA JL 07.20 07.30 08.00
GR 1 GA JL 08.45 09.30 90
GR 1 GA JL 10.00 11.30
GR 1 GA JL 12.00 13.30
GR 1 GA JL 14.00 15.30
GR 1 GA JL 16.00 17.30
GR 1 GA WA 18.00 120
GR 2 LA 08.00 08.30
GR 2 LA 09.00 09.30 60
GR 2 LA 10.00 10.30 60
GR 2 LA 11.00 11.30 60
GR 2 LA 12.00 12.30 60
GR 2 LA 13.00
GR 3 GA JL 07.30 08.00 11.00 180
GR 3 GA HA 11.30
GR 4 GA WA 07.20 07.30 11.30

180
GR 4 GA WA 12.00 180
GR 5 GA WA 07.30 08.00 09.30 120
GR 5 GA HA 10.00 13.30 120
GR 5 GA WA 14.00
DS 1 GA UB 07.30 08.00 09.00 60
DS 1 GA HS 09.30 09.45
DS 1 GA UB 10.00 10.30
DS 1 GA UB 11.00 11.30 60
DS 1 GA UB 12.00 12.30
DS 1 TV UB 13.00 13.30
DS 1 GA UB 14.00 14.30 30
DS 1 GA UB 15.00
DS 2 GA UB 07.30 08.00 08.30
DS 2 GA UB 09.30 10.30
DS 2 GA VL 11.00 11.30
DS 2 GA UB 12.00 12.30
DS 2 GA UB 13.00
DS 3 GA UB 07.30 08.00 08.30
DS 3 GA UB 09.00 09.30
DS 3 GA UB 10.00 10.30
DS 3 GA UB 11.00 11.30
DS 3 LA 12.00 12.30
DS 3 GA UB 13.00
DS LA 08.00
76 Edy Sutanto 3 NPBI 49 th L Pol URO C627070 Batu Ren Sin ESWL MAS
77 Suciati Privat NPBI 49 th P Pol GRD C635070 Batu ren Sinistra ESWL MAS
78 Siti Sundaitiyah 3 NPBI 54 th P R2A C579927 Nefrolithiasis Post PCN ESWL MAS AK
79 Ngatimin 3 NPBI 61 th L Pol URO C546769 Nefrolithiasis ESWL WAN
M : EM,II,UM,TR,PM,MF,RA RR : FA,SAM,IM MID : MY,SC RR GRD : RG MID : VQ SORE PROGRAM : RK,AI,TA,AN,AT,DJ,HA,HI,JF,WI,MF,ND,SA,SR,US,CA,RI,YR,AG*,IS* ALAT : PUR,DW (
L : AM,NI,ET,ANM,PS,MK,RM,SE,WU,WD,NO Pelatihan : QQ,AL,EV,Anto I

ASISTE
PENJA REKAM
MIN
N
MEDIS
S: NH,SL,HE,
EV,RK,ND,PL BD,SU
1 Wartinah 1 NPBI 57 th P KPD LD C639635 Nefrolithiasis Dx + Hidronefrosis Dx URS + DJ Stent Dx ADS AU,WD,ID
2 Supriyanto 2 NPBI 48 th L KPD L1 C635831 Batu Ureter URS Sin + DJ Stent Sin FASTRACK ADS S : AN
3 Isnawati 3 NPBI 32 th P R4A C638501 Ca Cervix Uteri St III B + Hidronefrosis Nefrostomi ADS
4 Budi Prastiyo 3 NPBI 17 th L R2B C624114 Kista Atherom Telinga Kanan Kiri Rekuren Ekstirpasi Kista Atherom Mikroskop PW
5 Fajar Budi Setyawan 3 NPBI 26 th L R1B C637054 Kolesteatoma Eksterna Kanan Ekstirpasi Kolesteatom Eksterna Kanan Mikroskop PW
Mata Kanan Perforasi Bulbi ec Galukoma
6 Ardiansyah 3 NPBI 6 th L Anak L1 C298854 Mata Kanan Eviscerasi Bulbi + DFG Opmic LN AO,TK
Sekunder
Endoskopi,
7 Shodiq 3 NPBI 46 th L R2B C635307 Massa Cavum Nasi Ekstripasi Massa FESS Set, ANNA S : AI
Rhino Set
Pansinusitis Kronis + Perforasi Septum + FESS + Ekstraksi Gigi + Odontektomi 2 Endoskopi,
8 Ngatmi 3 NPBI 59 th P R2A C636836 ANNA + RP
Gangren Pulpa + Gangren Radix + Impaksi Rahang FESS 3
9 Sugimin 2 NPBI 54 th L MRK LD C637504 Limfadenopati Colli Limfadenektomi + Biopsi WY
Endoskopi,
10 Zuhaimi Goraahe 1 NPBI 50 th L KPD LD C640278 Fr Maksila Facial Evaluasi Hemato Sinus WY
FESS, CWL
11 Musinah 2 NPBI 57 th P GER LD C305026 Efusi Pleura Dextra Pigtail THOM BY
12 Budiono 3 UM 45 th L Pol VAS C640509 CKD AV Shunt WW
13 Tri Martini 3 NPBI 41 th P Obstetri C640329 P3A1 Plasenta Restant MOW OP TW,UM,YN
14 Muawanah 2 NPBI 29 th P MRK LD C610700 NOK SOU + FS EN S : SR
15 Iswanti 3 NPBI 42 th P R4B C636034 NOK dg Bag. Padat SOU + FS VG
16 Titik Maswah 3 NPBI 55 th P R2A C627527 Ulkus Pedis Cruris Dextra Debridement WW
17 Sri Andayani 3 NPBI 41 th P R3A C634086 POAD Tungkai Dextra Rehecting + Amputasi ALI
18 Djuwadi VIP NPBI 54 th L GRD L5 C563961 Ileus ec Peritonitis Laparotomi Eksplorasi PB TD,TM,YS
19 Junaryo 3 NPBI 39 th L R2B C637907 Ikterik Obstruktif ec Tumor Duodenum Whiple Procedure MG S : JF
20 Tarminah 2 NPBI 67 th P Transit C639795 Tumor Ileocaecal Hemikolektomi ERI
21 Slamet Mamuk 3 NPBI 64 th L R2B C136538 Tumor Caput Pankreas c/ Ganas Laparoscopy Biopsi ERI
22 Retnowati Wibowo N 2 NPBI 34 th P KPD LD C639500 SNNT Bilateral Ismolobektomi + FS ganas Total Tiroidektomi BIS AZ,DB,DN*
23 Wahyuni 3 NPBI 40 th P R3A C638259 Ca Papilary Thyroid Total Thyroidectomi BIS
24 Ika Siptin Fidyastuti VIP NPBI 54 th P GRD L6 C639246 Tumor Mamae Dupleks c/ Jinak Multiple Wide Eksisi + FS UUD S : ES
Superficial Parotidectomi + FS ganas Total
25 Supardi 3 NPBI 68 th L R2B C629341 Tumor Parotis Dx c/ Ganas T2N1Mo UUD
Parotidectomi
26 Nafisha Syakila 3 NPBI 7 bln P Transit C639975 Multiple limpadenopati colli Limpadenectomi Biopsi PTY DY,EA
27 Prasetia Abdi P 3 PBI 6 bln L Anak LD C617850 MAR dg Fistel recto perineal on colostomi PSARP RR (BA) S : AR
28 Auliya Fadilatussa'adah 3 NPBI 5 th P Anak LD C635537 Tumor Intra Abdomen Laparatomi Biopsi Tumor EDW
29 Suparti 2 NPBI 32 th P KPD LD C640398 Limfadenopati Colli Limfadenektomi + PA FASTRACK DWT
30 Harmanto 3 NPBI 57 th L R3B C637805 Spondilits TB PSRS C-Arm HY SF,AF*
31 Rita Hastuti VIP NPBI 53 th P MRK L2 C634938 LCS Leakage Laminektomi Tutup Defek HY S : AT*
32 Juningsih 3 NPBI 36 th P R2A C633317 Meningioma Craniotomi Dasar Tengkorak DP LW,BR
33 Subatin 3 PBI 49 th P R2A C637347 Meningioma Sphenoid Craniotomi Dasar Tengkorak MTA S : SA
DS LA 10.00
DS LA 12.00
DS LA 14.00
DS LA 16.00
J,HA,HI,JF,WI,MF,ND,SA,SR,US,CA,RI,YR,AG*,IS* ALAT : PUR,DW ( S : CA )
RAL
TERIMA
anestesi
PROGR
PEMBE
SERAH
ANEST
RSIHA
DPJP
N OK
Jenis
DTG
JAM
JAM
RIIL
ESI
AM
OK
J.
CT JH
1 GA HR 07.30 08.00 09.30 60

1 GA HR 10.00 11.30
1 GA HR 12.00 13.00 60
1 GA HR 13.30 15.00 120
1 GA HR 15.30 180
2 GA HR 06.00 06.30 08.30
60
2 GA HR 09.00 12.00
120
2 GA HR 12.30 15.30 180
2 GA HR 16.00 16.30 120
2 GA HR 17.00 120
3 LA 09.30 10.00
3 LA 12.00
4 GA SF 06.00 06.30 07.30 30
4 GA SF 08.00 11.00 180
4 GA SF 11.30 14.30 120
4 GA SF 15.00 16.30
4 GA SF 17.00
5 GA VL 07.30 08.00 10.00 120
5 GA SF 10.30 15.30 180
5 GA SF 16.00 18.30 120
5 GA SF 19.00 60
6 GA DS 05.30 06.00 09.00 180
6 GA DS 09.30 12.30
6 GA VL 13.00 16.00 60
6 GA DS 16.30
180
7 GA DS 07.30 08.00 08.30 120
7 GA DS 09.00 11.30
7 GA DS 12.00 14.30 120
7 GA DS 15.00
8 GA TA 08.00 08.30 11.30
8 GA TA 12.00
9 GA TA 07.30 08.00 14.00
9 GA TA 14.30 240
34 Nasihah 3 NPBI 42 th P R3A C529522 Paraparese Inferior ec Fr Kompresi VL4-5 PSRS C-Arm APR PR,AP
35 Rizal Muslihuddin 3 NPBI 16 th L Anak L1 C639659 PSRS C-Arm APR
36 Indina 2 NPBI 21 th P KPD LD C586102 Fr Supracondylus Sin Aff Plate FASTRACK APR S : AD
37 Muh. Rozikan 2 NPBI 32 th L Transit C636944 BCT of tendon + Osteomilitis Kronis Debridement + Kultur + Pengecatan Gram DRY
38 Yulita Hernani VIPA NPBI 40 th P GRD L6 C585761 Neglected femur patela Rekonstruksi Patela BIN
EN,MA,VT
39 Suyati 3 NPBI 54 th P Elang 1 C292084 AS Severe AVR SF
BP,SS,AS
40 Suwardi 3 NPBI 56 th L R6B C636974 Tumor Paru Kanan Tranduced Biopsi / Core Biopsi WW S : WI
41 Sulistyani VIP NPBI 55 th P GRD L6 C630370 Mata Kanan Proptosis Mata Kanan Orbitotomi Anterior AK NK*,DI
42 Bambang Supriyadi VIP NPBI 51 th L GRD L4 C639976 Mata Kanan Ablatio Retina Mata Kanan Vitrectomi Opmic AL
43 Titien Suharni VIP NPBI 61 th P GRD L4 C639746 Mata Kanan Vitreus Haemoraghe Mata Kanan Vitrectomi Opmic AL
Mata Kanan NPDR, Mata Kiri RRD, Mata
44 Soeparno 2 NPBI 74 th L GER LD C387201 Mata Kiri Vitrectomi + EL + SO Opmic AL
Kanan Kiri Pseudofakia + PCB
45 Andra Eka 1 NPBI 18 th L Pol MTA C423029 Mata Kanan Nevus Pigmentosa Mata kanan Eksisi Nevus + PA AK YW,TU*
Mata kiri Katarak komplikata + High Myiopia +
46 Ely Sofiyanti 1 NPBI 41 th P Pol MTA C640419 Mata kiri EKIK Opmic WIS S : HA,IS
Sub luksasi lensa
47 Sutarno 3 PBI 56 th L Pol MTA C636605 Mata kiri katarak komplikata Mata kiri sinekiektomi + ECCE Diagnostik Opmic WIS
48 Matraji 3 NPBI 58 th L Pol MTA C638671 Mata kiri KSM Mata kiri ECCE + IOL Opmic WIS
49 Tukini 1 NPBI 64 th P Pol MTA C615361 Mata kiri PACG + KSI Mata kiri Phacoemulsifikasi + IOL Alcon SN 2.0 FI
50 Mashadi 3 PBI 60 th L Pol MTA C629539 Mata kanan kiri PACG, Mata Kanan KSI Mata kanan Triple Procedure Opmic FI
Prolaps Uteri Gr IV, Sistokel Gr III, Rectocele
51 Marsini VIP NPBI 69 th P GRD L3 C640118 TVH + Kolporafi Anterior + Kolpoperineorafi ER NP,RE
Gr III
52 Mulyanto 2 NPBI 57 th L KPD L1 C572109 Plate Exposed Mandibula + Fr Mandibula Aff Implant FASTRACK PJ
53 Sugiarto 3 NPBI 26 th L R5A C639748 Fr Basis Orbita Sin + Fr ZMC Sin Rekonstruksi Fr Tulang Wajah Kompleks PJ
54 Sulasi 3 NPBI 43 th P R2A C623658 IDC Gr II MS TxN1M0 Wide Eksisi + Diseksi Axilla Sinistra YAN AL,HR
55 Sugiarti 3 NPBI 39 th P R2A C562828 SNNT dextra c/ ganas T2N0M0 Ishtmolobectomi + FS, Gns-Total Thyroidectomi YAN
56 Ni'Matul 2 NPBI 10 th P Anak LD C640536 Skin Nekrotik ec Closed Degloving Debridement RZ AH,ER,MK
57 Sukardi 3 Um 51 th L R1B C640293 Cumbustio Gr II-III Debridement NJT
Mata Kanan Cyclocryotherapy + Wide Eksisi +
58 Cipto Utoyo 3 PBI 53 th L R1B C623869 Mata Kanan Susp OSSN dd/ Papiloma TL
PA
Mata Kanan Panoftalmitis + Ulkus Kornea
59 Djoko Rasmanto 3 PBI 57 th L R1B C638817 Mata Kanan Eviscerasi Bulbi + Vitreus Tap DN
Inpending Perforasi
60 Teguh Azam 3 NPBI 3 th L Pol PLA C626602 Ulkus Granulosum Luas Debridement PJ
61 Abdul Basyid 1 NPBI 44 th L KPD L1 C453526 Nefrolithiasis Bilateral + HN Bilateral URS + DJ Stent Bilateral MAS
62 Rohadi Privat NPBI 58 th L Pol GRD C639497 Fistel Uretrorectal Sistoscopy ADS AY,DM,DA
63 Rumisih 3 NPBI 48 th P R5B C633986 Ca Cervix Uteri Std III B + HN Sistoscopy Biopsi + DJ Stent ADS
64 Dhina Maulana P NPBI 9 th P Anak L1 C640368 Suspect Keganasan Hematologi BMP HER
65 MM. Liem Lanawati VIP NPBI 66 th P GRD L6 C638952 Wound Dehiscense post laparatomi eksplorasi Repair Wound Dehiscense + Debridement ERI
66 Ngarno 3 NPBI 64 th L R2B C626946 Adeno Ca Rectie Post Hartman Colonoscopy MG EW,MW
67 Abdul Rouf 3 NPBI 60 th L Pol PD C541426 Colonoscopy AGG S : YR,US
68 Ardianto Sugiarto Privat UM 66 th L Pol GRD C639565 Hepatitis C Kronik EGD HRY
69 Kasmini Privat NPBI 49 th P Pol GRD C623420 Hepatitis B Kronik EGD HRY
70 Toermudi 3 NPBI 71 th L Pol PD C484668 Serosis Hepatis EGD HRY
71 Salimin 3 NPBI 55 th L Pol PD C638519 Sirhep EGD HRY
72 Dwi Astuti VIP NPBI 56 th P GRD L4 C640507 PSCBA EGD HRY
73 Suyikno VIP NPBI 42 th L GRD L6 C497323 Serosis Hepatis, Pasca Hematomesis EGD HRY
74 Yudith Merdian 3 NPBI 36 th L Pol PD C580116 Procnitis Radiasi Colonoscopy + APC DD
75 Waenah 2 NPBI 57 th P GER LD C596648 PSCBA EGD DD
76 Mawar Supemi 3 NPBI 43 th P R4B C511031 Hematoschezia Colonoscopy DD
77 Sukadi 3 NPBI 59 th L R3B C637932 Ikterus Obstruksi ERCP C-Arm HRY GN,MR,ANM
78 Shelly Lianawati 3 NPBI 34 th P R2A C640083 Ikterik Obstruktif c/ CBD ERCP C-Arm PB
79 Oesti 3 NPBI 86 th P Pol THT A505628 Hipertropi Tonsila Laringoscopy Flexible FAR
80 Ruki 3 NPBI 52 th L Pol THT C620244 Cavumnasi Nasofaringoscopy Flexible + NBI DAT
81 Lilis Lestari 3 NPBI 49 th P Pol THT C408346 KNF Nasofaringoscopy Flexible DAT
82 Harjo 3 NPBI L Pol THT C576017 Ca Laring Laringoscopy Flexible DAT
10 GA UB 06.30 07.00 10.00
10 GA UB 10.30 13.30
10 GA UB 14.00 15.00 60
10 GA UB 15.30 18.30
10 GA VL 19.00 120
JTG GA HN 07.00 10.00 14.00
300
JTG GA HN 14.30
GR 1 GA DS 06.40 07.00 08.30
GR 1 GA JL 09.00 10.30 90
GR 1 GA JL 11.00 12.30 90
GR 1 GA JL 13.00
120
GR 2 LA 08.00 08.30
GR 2 LA 09.00 09.30
GR 2 LA 10.00 10.30
GR 2 LA 11.00 11.30
GR 2 LA 12.00 12.30
GR 2 LA 13.00
GR 3 GA WA 07.30 08.00 10.30

180
GR 3 GA JL 11.00 12.30
GR 3 GA JL 13.00
GR 4 GA WA 07.20 07.30 10.30 180
GR 4 GA WA 11.00 240
GR 5 GA WA 07.30 08.00 09.30 120
GR 5 GA WA 10.00 11.30 60
GR 5 GA WA 12.00 13.30 90
GR 5 GA WA 14.00
DS 1 GA UB 08.00 09.30
DS 1 GA UB 10.00 10.30
DS 1 LA 11.00 11.20
DS 1 RA UB 11.30 11.45
DS 1 GA UB 12.00 12.30
DS 1 GA UB 13.00
DS 2 GA UB 07.30 08.00 08.30

DS 2 GA UB 09.00 09.30
DS 2 LA 10.00 10.20
DS 2 LA 10.30 10.45
DS 2 LA 11.00 11.20
DS 2 LA 11.30 11.45
DS 2 LA 12.00 12.20
DS 2 LA 12.30 12.45
DS 2 GA UB 13.00 13.30
DS 2 LA 14.00 14.30
DS 2 GA UB 15.00
DS 3 GA UB 07.30 08.00 09.30
DS 3 GA UB 10.00 11.30
DS 3 LA 12.00 12.20
DS 3 LA 12.30 12.45
DS 3 LA 13.00 13.20
DS 3 LA 13.30 13.45
83 Rohmi 3 NPBI 67 th P GER LD C640200 Tumor Rectie 1/3 Distal Colonoscopy ERI
84 Rohman 3 NPBI 60 th L R6B C637199 Massa Paru Kanan Bronchoscopy SFY
85 Supariyah 3 PBI 40 th P ICU C419867 Miastenia Gravis, Pneumonia Bronchial Toilet FTR
86 Tumijo 2 NPBI 57 th L ICU C636328 Post Craniotomi ec ICH, Pneumonia Bronchial Toilet FRD
87 Siti Aminah 3 NPBI 61 th P Pol URO C520812 Nefrolithiasis ESWL WAN AK
88 Tono Margianto 3 NPBI 55 th L Pol URO C631451 Nefrolithiasis ESWL WAN
89 Abdul Hadi 3 NPBI 57 th L Pol URO C471729 Nefrolithiasis ESWL WAN
M : II,ST,AG,PM,HI,DJ,RI RR : FA,SAM,IM MID : MY,SC RR GRD : RG MID : VQ SORE PROGRAM : EV,RK,AI,AN,HA,JF,WI,ND,SA,SR,US,CA,YR,IS,AD,ES,PL,AR*,AT* ALAT : PUR,DW ( S : CA
L : AM,ET,EM,PS,MF,RM,RA,SE,TR,TA,WU,NO
By Ny Suprihati IRIN NPBI 13 hr L PBRT C639369 SOL Parieto Temporo Occipital Sin Craniotomi Biopsi MTA

PENJAMIN
ASISTEN
REKAM
MEDIS
SL,HE,SU, ST,
S : EV,RK,ND
DN
1 Yezi Suci Ratnawati 3 NPBI 18 th P R4B C631413 NOK Kistektomi + FS KD 3 INU AU,WD*,ID
2 Muh. Rozikan 2 NPBI 32 th L Transit C636944 BCT of tendon + Osteomilitis Kronis Debridement + Kultur + Pengecatan Gram DRY S : AR
3 Wawan Uliyono 2 NPBI 26 th L KPD LD C637369 Fr OS Nasal Reposisi OS Nasal + SR Endoskopi WY
Massa Sinonasal dd/ Polip Nasi Gr III, Mata FESS + Polipektomi + Mata Kiri Orbitotomi
4 Denis Wisnu 3 Um 8 th L Anak L1 C637878 WY + TL
Kiri Proptosis ec massa Sinonasal Anterior + Biopsi + PA
Endoskopi,
5 Irfan Maulana 3 NPBI 10 th L Anak L1 C635452 RSK FESS + Adenoidektomi Rhino Set 1,TE RH NO*,AO
Sluder
Pansinusitis Kronis + Konka Hipertropi septum
6 Casduri 3 NPBI 56 th L R1B C635849 FESS + CWL ANA S : AI
Deviasi
LD 1 + LD 2,
7 Ari Wibowo 3 PBI 22 th L R3B C370659 Stenosis Trachea LD + Inj. Kenakort + Ganti Kanul Endoskopi + DAT
Bipolar
8 Eddy Susanto 3 PBI 29 th L R2B C640541 Sudden Deafness Telinga Psg Gromet + Inj. Steroid Membran Timpani Mikroskop ZUL
BY*
9 Naili Rohmah 2 NPBI 19 th P MRK LD C639626 NOK SOU + FS KD 1 MZ TW,YN,RM
10 Hartatik 2 NPBI 49 th P KPD LD C543398 Susp Ca Ovarii Laparotomi Biopsi + FS KD 2 EW S : ES
11 Wahyudi 3 NPBI 34 th L Transit C639531 Ulkus Variko pedis dextra Stripping Varises ALI
12 dr. Debora Ikawati VIP NPBI 36 th P GRD L6 C445160 Tumor Paru Thoracotomi ALI
13 Eko Subiyakto 2 NPBI 39 th L MRK LD C638586 Cholangio Ca Laparotomi Cholesistektomi k/p Biopsi PB TD*,TM
14 Sri Laraswati 3 NPBI 59 th P R6A C639129 Ikterus Obstruksi ec Choledocolithiasis Laparatomi Eksplorasi CBD Harm. Scalple ERI S : JF*,TA
15 Kristinah 2 NPBI 46 th P KPD LD C535604 Ca Mamae Sin Residif Wide Eksisi BIS AZ,DB,DN
16 Saimah 3 NPBI 67 th P R2A C637821 TMS c/ Ganas T4bN1Mx Insisi Biopsi + PA BIS
17 Nurnaningsih 3 NPBI 36 th P R2A C618387 Maligna Spindel Cell Reg Pelvis Sin Wide Eksisi + PA DWT S : PL
18 Amazi 3 PBI 54 th L ICU C636602 Tumor Mediastinum Prolong Ventilator Tracheostomi ALI
19 M Nur Fakhri 3 NPBI 10/28/2009 L Elang 1 C607006 VSD, Prolaps RCC, Carries Dentis Ekstraksi Gigi DV DY,EA*
20 Masrokhan 2 NPBI 27 th L MRK LD C639644 Tumor Mandibula Reseksi Mandibula + Rekonstruksi Plat Rekonstruks RP + OEN S : YS
21 Tri Windarti VIP NPBI 31 th P GRD L5 C639199 Otitis Media Kronis Thympanoplasti PW
22 Tirta Setiadji 1 NPBI 73 th L GER L1 C229545 Canal Stenosis Vertebrae Cervicalis 5-6 Lateral Mess Screw HY SF,AF
23 Munasri 3 NPBI 46 th P R6B C639102 Spondilitis TB PSRS C-Arm AJ S : AT
24 Titik Rustiana 3 PBI 45 th P R2A C636454 Meningioma Sphenoid Craniotomi Dasar Tengkorak ZM LW,BR
S : SA
DS 3 GA UB 14.00 14.30
DS 3 GA UB 15.00 15.30
ICU GA 08.00
ICU GA 09.00
DS LA 08.00
DS LA 10.00
DS LA 12.00
I,ND,SA,SR,US,CA,YR,IS,AD,ES,PL,AR*,AT* ALAT : PUR,DW ( S : CA )
RAL
DPJP ANESTESI
JAM PROGRAM
PEMBERSIHAN
JAM DTG RIIL
Jenis anestesi
J. SERAH
TERIMA
OK
OK
CT VL
1 GA DS 07.30 08.00 10.30

1 GA DS 11.00 12.30
1 GA DS 13.00 16.30 120
1 GA DS 17.00
120
2 GA DS 07.30 08.00 10.30

180
2 GA WA 11.00 13.30 12.00
2 GA DS 14.00 15.30
2 GA DS 16.00 30 11.00
3
4 GA AI 07.30 08.00 11.00 180
4 GA AI 11.30 14.30 11
4 GA AI 15.00 16.30 180
4 GA HS 17.00
5 GA AI 07.30 08.00 10.30 180
5 GA AI 11.00
6 GA BI 06.30 07.00 07.30 120
6 GA BI 08.00 09.30 60
6 GA BI 10.00 12.30
6 GA BI 13.00 120
7 GA BI 07.00 07.30 08.30 120
7 GA BI 09.00 13.30 240
7 GA WA 14.00
8 GA SF 07.30 08.00 13.30
8 GA SF 14.00
9 GA SF 07.30 08.00
9
Fr. Femur Dextra 1/3 dextra transver displ ttp
25 Sukirah 3 NPBI 47 th P Transit C640389 GIPS APR PR,AP
NK
26 Soedarmini 1 NPBI 82 th P MRK L1 C155306 Fr Collum Femur Sin Bipolar Hemiarthroplasty APR S : AD*
27 Santoso 3 NPBI 51 th P Ger D C545458 Fr. Costae Clipping Costae + ORIF Radius Ulna ALI + APR
28 Rosid Khoirul Anam 3 NPBI 17 th L Anak LD C640311 Fr Clavicula Sin 1/3 Tgh Com Disp Ttp Nk ORIF Clavicula DID
EN,MA,TK
29 Novita Anggraeni 2 NPBI 20 th P Elang 1 C625000 ASD II L-Shunt ASD Closure SF
BP,SS,AS
30 Badrun 2 NPBI 51 th L KPD LD C638361 Massa Paru Thorakotomi Open Biopsi WW S : BD,WI
31 Matsalim 1 NPBI 74 th L KPD LD C629271 Mata kanan Cholesterolosis + KSI Mata kanan Vitrektomi + Phaco + IOL AL NK,DI
Mata Kanan Phaco + IOL + Vitrectomi + MP +
32 Fitriyati 2 NPBI 54 th P Transit C630710 Mata Kanan Kiri PDR + VH Opmic AW
EL/SO
33 Kamal Bahtiyar 3 PBI 30 th L R2B C626842 Mata Kanan Kiri Glaukoma Sekunder Mata Kanan Kiri Trabekulektomi Opmic MR YW,TU
34 Casmen Privat NPBI 53 th P Pol GRD C640740 Mata kanan KSI Mata kanan Phaco + IOL AK S : HA,VT
Mata Kanan Kiri Glaukoma Sekunder ec
35 Nurcholis 3 NPBI 33 th L R1B C581232 Mata Kiri Trabekulektomi Opmic FI
Steroid
Mata kanan kiri iol capture + Pseudofakia,
36 Faizul Mubin 3 NPBI 18 th L Pol MTA B275886 Mata kanan PPC + Pupiloplasty Opmic WIS
Mata kiri Keratopati
Mata Kanan Post Hecting Kornea + Ulkus
37 Khumaidi 3 NPBI 49 th L P.Mata C630879 Mata Kanan Aff Hecting Loose Suture DN
Kornea
38 Benny Sutanto Privat UM 39 th L Pol GRD C6534830 Mata kiri CMV Retinitis Mata kiri Inj. Gancyclovir IVT DN
39 Putri Nanda Fatimah VIP NPBI 26 th P GRD L5 C633496 Hidrosalping Laparoscopy TF NP,RE
40 Sugiarti 2 NPBI 22 th P KPD LD C545973 MRKH Vaginoplasty + Neovaginoplasty ER
41 Ikhsan Zuhri 1 NPBI 18 th L MRK 2 C639987 Multiple Limfadenopati Colli Eksisi Biopsi YAN AL,HR
42 Romlah 3 NPBI 63 th P R2A C637784 Ca Papilary Thyroid Total Tiroidektomi YAN
43 Muhammad Wildan VIP NPBI 14 th L GRD L3 C614767 Chron's Disease Laparotomi Re-Anastomosis Ileocolon RR (BA) AH,ER,MK
44 Darmo Adji 3 NPBI 63 th L R2B C623148 Uretrolithiasis + Post DJ Stent Sistoscopy + Aff DJ Stent MAS AY,DM,DA
45 Soeparni 1 NPBI P Merpati C542515 Ca Buli Sistoscopy Biopsi MAS
46 Indah 3 NPBI 4 bln P Pol PL C633253 Hemangioma Inj. Triamcinolone PJ
47 Eko Daryanto 3 PBI 27 th L Pol DIG C627976 Condiloma Akuminata Kauterisasi JS
Debridement + Aff Hecting + Eksplorasi +
48 Bani Yoga D 3 NPBI 22 th L Pol ORT C611962 Flexus Kontraktur DRY
Rekonstruksi Kontraktur
49 Novalin Pemela 2 NPBI 31 th P Obstetri C636181 Polip Endometrium Histeroskopi HR
50 Tarti VIP NPBI 49 th P MRK L2 C639798 Efusi Pleura Bronchoscopy SFY EW,MW
51 Siti Khotimah 3 NPBI 37 th P R3A C608252 Fistula Enterocutan Colonoscopy JS S : YR,US
52 Rubiah 3 PBI 59 th P GER LD C639935 Tumor Paru Bronchoscopy AVIS
53 Yasin Yusuf 3 NPBI 23 th L R6B C640067 Tumor Mediastinum Bronchoscopy AVIS
54 Gafar Sidik 3 NPBI 51 th L KPD LD C639190 Massa Paru Bronchoscopy FTR
55 Sayudi Alias Abdul 3 NPBI 43 th L Pol THT C582322 Ca Nasofaring Nasofaringoscopy Flexible + NBI DAT
56 Subchan 3 NPBI 68 th L Pol THT C485800 Ca Nasofaring Nasofaringoscopy Flexible + NBI WY
57 Tugirin 3 NPBI 64 th L Pol THT C598219 Ca Laring Laringoscopy Flexible + NBI WY
58 Jeminah 3 NPBI 54 th P Pol DIG C557657 Tumor Rectie 1/3 distal Colonoscopy MG
59 Hadmini 3 NPBI 49 th P Pol DIG C554184 Adeno Ca Rectie Colonoscopy ERI
60 Moch. Rochim 3 NPBI 75 th L GER LD C639812 Tumor Colon Ascenden Colonoscopy DD GN,MR,ANM
61 Valentina Laksmi VIP NPBI 23 th P GRD L5 C640363 Dyspepsia EGD HRY
62 Ristianto 2 NPBI 24 th L MRK LD C639276 CBD Stone ERCP C-ARM AGG
63 Suprihatin 2 NPBI 32 th P MRK LD C632586 Tumor Hepar Gastroscopy AGG
64 Kriswahyuni 3 NPBI 58 th P Pol PD C526137 Cholithis Radiasi Colonoscopy AGG
65 Sutarmi 3 PBI 49 th P Pol PD C618833 DM + Ca Rectie Colonoscopy AGG
66 Yasni 3 PBI 57 th P Pol ONK C636857 Metastasis Undiff Ca Nasofaring Nasofaringoscopy Flexible + Biopsi DH
67 Djuharipin 3 NPBI 53 th L R5A C612115 Ca Sinonasal Aff Tampon WY
68 Tumijo 2 NPBI 57 th L ICU C636328 Post Craniotomi ec ICH, Pneumonia Bronchial Toilet FRD
69 Supraptiningsih 3 NPBI 72 th P Pol URO C557209 Nefrolithiasis ESWL WAN AK
70 Wahyudin 3 NPBI 39 th L Pol URO C636429 Nefrolithiasis ESWL MAS
71 Sumaryo 3 NPBI 51 th L Pol URO C632392 Nefrolithiasis ESWL MAS
10 GA HS 06.30 07.00 07.30
10 GA HS 08.00 10.30
10 GA HS 11.00 14.30
10 GA HS 15.00 90
JTG GA WA 07.00 10.00 13.30
300
JTG GA WA 14.00
GR 1 GA HN 07.20 07.30 08.30
GR 1 GA HN 09.00
120
GR 2 LA 07.30 08.00 08.30
GR 2 LA 09.00 09.30
GR 2 LA 10.00 10.30 60
GR 2 LA 11.00 11.30
GR 2 LA 12.00 12.30
GR 2 LA 13.00
GR 3 GA WA 07.20 07.30 09.30 120
GR 3 GA JH 10.00 120
GR 4 GA JH 07.20 07.30 09.00 240
GR 4 GA JH 09.30
GR 5 GA HN 07.30 08.00
DS 1 GA HS 07.30 08.00 08.30
DS 1 GA HS 09.00 09.30
DS 1 GA HS 10.00 10.20
DS 1 GA HS 10.30 11.00
DS 1 GA HS 11.30 12.30
DS 1 GA HS 13.00 120
DS 2 GA HN 07.20 07.30 08.00
DS 2 GA HS 08.30 09.00
DS 2 GA HS 09.30 10.00
DS 2 GA HS 10.30 11.00
DS 2 GA HS 11.30 12.00
DS 2 LA 12.30 12.45
DS 2 LA 13.00 13.20
DS 2 LA 13.30 13.45
DS 2 GA HS 14.00 14.30
DS 2 GA HS 15.00
DS 3 GA HS 07.20 07.30 08.00
DS 3 LA 08.30 08.45
DS 3 GA HS 09.00 10.30
DS 3 LA 11.00 11.20
DS 3 GA HS 11.30 12.00
DS 3 GA HS 12.30 12.45
DS 3 LA 13.00 13.30
DS 3 GA HS 14.00
ICU GA 09.00
DS LA 08.00
DS LA 10.00
DS LA 12.00
72 Chrisna Setyaningsih 2 NPBI 45 th P KPD LD C636604 Nefrolithiasis Bilateral ESWL ADS
73 Supriyanto 2 NPBI 41 th L KPD L1 C635831 nefrolithiasis Sinistra ESWL ADS
M : NH,HI,SR,AG,DJ,IS,RI RR : FA,IM,TR MID : MY,SC RR GRD : RG MID : VQ SORE PROGRAM : EV,RK,AI,TA,AR,AT,AD,BD,VT,ES,HA,JF,WI,YS,ND,PL,SA,US,YR ALAT : PUR,DW ( S : CA )
L : AM,NI,ET,EM,II,PS,MF,PM,RA,SAM,SE,UM,WU
Yudhi Budianto 1 NPBI 63 th L KPD LD C605656 Mata Kiri Ablatio Retina Mata Kiri Vitrectomi + EL + SO Opmic AW
JUMAT 13.00

PENJAMIN
ASISTEN
REKAM
MEDIS
SL,HE,SU, ST,
S : EV,RK,ND
DN
1 Rafa Azka Putra VIP NPBI 2 th L GRD L3 C636053 UDT Dx Orchidopexy Dx ADS AU*,WD,ID
2 Pandu Soedjitro VIP NPBI 64 th L GRD L4 C558963 Bladder Neck Sclerosis Residif Bladder Neck Incisi ADS S : JF,AN
3 Markinah 3 NPBI 58 th P R4A C632644 Ca Cervix Susp Metas VU Sistoskopi Biopsi ADS
4 Ahmad Romadhon 3 NPBI 29 th L R6B C638954 Buerger Disease Amputasi WW
5 Sobana 3 NPBI 56 th L Transit C640884 DVT Femoral Sin Thrombectomy WW
6 Elizabeth Alenanentte 3 PBI 2 th P Anak LD C616966 Mata Kanan Ptosis Kongenital Mata Kanan Koreksi Ptosis INA NO,AO
Endoskopi,
7 Christina Lestari 1 NPBI 60 th P KPD L1 C639724 RSK + Konka Hipertrofi FESS + CWL + Konkoplasty Rhino Set, RH S : AI
CWL
Endoskopi,
8 Suparno 3 NPBI 6/8/1953 L R1B C635834 RSK + SR + Konka Hipertropi FESS + SR + CWL + Konkoplasty Rhino Set, RH
CWL
9 Aisyah Novita Sari 3 NPBI 18 th P R3A C637578 OMSK Dupleks ME Simple + Thimpanoplasty Kanan Mikroskop AYU
10 M. Fadloli 3 NPBI 41 th L Pol VAS C640913 CKD AV Shunt WW WU,
11 Woro Yuli VIP NPBI 47 th P GRD L5 C639317 CKD Pemasangan Double Lumen WW
12 Sugiyanto 3 NPBI 53 th L R2B C638562 Tumor Paru Kiri, Efusi Pleura Kiri Repair WSD ALI
13 Munawaroh 2 NPBI 52 th P Transit C640633 NOK SOU + FS VG TW,AM*
14 Dimah 1 NPBI 68 th P KPD LD C639043 NOK Laparotomi SOU + FS MZ S : RE
LD 1 + LD 2,
15 Tri Wulandari 3 PBI 22 th P R5B C640409 Massa Basis Lidah LD + Ekstirpasi Massa k/p Tracheostomi FAR
Endoskopi
16 Tasrip 3 PBI 63 th L R3B C640299 Hernia Scrotalis Sin, Hernia Inguinalis Dx Hernioraphy Kanan Kiri JS TD,RM
17 Sumadi 3 NPBI 50 th L R1B C639493 Fistel Rectovesica Adeno Ca Rectie Colostomy PB S : TM
18 Puji Rahayu 1 NPBI 48 th P KPD LD C638151 Tumor Intra Abdomen Extra Luminer Cauda Pankreatektomi ERI
19 Suradal 1 NPBI 58 th L MRK L2 611930 Laparoscopy Biopsi ERI
20 Muzaenal VIP NPBI 56 th L GRD L4 C639698 Struma Nodusa, HT, Azotemia Isthmolobektomi + FS k/p Total Tiroidektomi YAN AZ,DB*
21 Candidus Handi Anuto 1 NPBI 68 th L MRK L2 C638711 Tumor Intra Abdomen c/ LMNH Laparoscopy Biopsi MG S : PL*
22 Supoyo 3 NPBI 47 th L R2B C628507 Massa Sinonasal Ekstirpasi Massa WY
23 Yuni Hidayati 3 NPBI 24 th P R2A C634494 Ca Sinonasal Ekstirpasi Massa dg Endoskopi Endoskopi WY
24 Mukhalali 3 PBI 13 th L Transit C640805 Fraktur Mandibula Rekonstruksi Fraktur Mandibula RZ TA, ET*
DS LA 14.00
DS LA 16.00
D,BD,VT,ES,HA,JF,WI,YS,ND,PL,SA,US,YR ALAT : PUR,DW ( S : CA )
JUMAT 13.00
RAL
DPJP ANESTESI
JAM PROGRAM
PEMBERSIHAN
JAM DTG RIIL
Jenis anestesi
J. SERAH
TERIMA
OK
OK
CT BI
1 GA WA 07.30 08.00 60
1 GA WA 10.00 60
1 GA WA 11.30 60
1 GA WA 13.00 90
1 GA WA 15.00 60
2 GA WA 6.30 07.00 120
2 GA WA 09.00
180
2 GA WA 12.30
2 GA WA 17.00 180
3 LA 09.00
3 LA 10.00
3 LA 13.00
4 GA TA 07.30 08.00
4 GA TA 13.00
4 GA TA 16.00
60
5 GA TA 07.30 08.00 180
5 GA TA 11.00 120
5 GA TA 13.00 120
5 GA TA 15.30 60
6 GA WA 06.30 07.00
6 GA HN 13.00 120
6 GA HN 15.00
6 GA HN 19.00
7 GA HN 06.30 07.00
25 Moh Nur Solikin 3 NPBI 24 th L Transit C640711 Fraktur ZMC Sin Rekonstruksi Tulang Wajah RZ S : YS
26 Febrian Resa Widayat 3 NPBI 22 th L R2B C640865 Luka Bakar Listrik 27% Debridement RZ
27 Mita Kristia 3 NPBI 14 th P Anak L1 C630493 Craniotomi ER SF,AF
S : BY,BR*
28 Sunjoto 3 NPBI 48 th L R3B A551528 Spondilitis TB PSRS AJ LW,NI
29 Tan Slamet Tano 1 NPBI 58 th L KPD L1 C559390 Multiple Gigi Gangren + CKD Odontektomi 2 Rahang Bor NSK RP S : SA,WI
30 Lina Kristianti 1 NPBI 68 th P KPD LD C640229 Fr Femur Sin, Fibula Dx ORIF Femur + Fibula APR PR,BD
31 Santoso 3 NPBI 51 th P GER LD C545458 Fr. Costae Clipping Costae + ORIF Radius Ulna ALI + APR S : MW
32 Siti Kabsah 2 NPBI 60 th P KPD LD C636213 OA TKR FASTRACK BIN
EN,MA,TK
33 Muhamad Wildan Ajda 3 NPBI 3 th L Elang 1 C594482 ASD ASD Closure SF
BP,SS,AS
34 Samiyah 2 NPBI 76 th P GER LD C640303 Mata Kiri Glaukoma Sekunder + Nukleus Drop Mata Kiri VitreKtomi+ Endofragmentasi Opmic AL NK,DI
35 Ibrahim Riziq VIP NPBI 5/2/2017 L GRD L3 C637420 Mata Kanan ODNL Congenital Mata Kanan Probing + Spoeling, Mkaki EUA Probing LN
Mata Kiri Katarak Komplikata d.d Katarak

Mata Kiri Ekstraksi Lensa+ Vitrektomi Anterior
36 Kardi 3 NPBI 15 th L Transit C601892 Traumatika e.c Uveitis Sanata + Band LN
+ PPC + PI + IOL
Keratopathy
37 Eko Purwanto 2 NPBI 29 th L MRK LD C626029 Mata Kiri Post Eksternal DCR + Abses Mata Kiri Insisi Abses + Drainase INA YW,HR
38 Nur Asykin 3 NPBI 53 th P P. Mata C633159 Mata Kanan Kiri KSI Mata Kanan Phacoemulsifikasi + IOL WIS S : HA,VT,EA
P. Mata
39 Jumirah Priv NPBI 58 th P C639690 Mata Kanan Dislokasi IOL Mata Kanan Explantasi IOL+ Vitrektomi AnteriorOpmic WIS
GRD
40 Djoko Sujono 1 NPBI 55 th L P. Mata C116890 Mata Kiri KSI Mata Kiri Phacoemulsifikasi + IOL WIS
Mata Kanan Kiri POAG + Katarak Senilis Alcon SN
41 Harwan 1 NPBI 68 th L P. Mata C280467 Mata Kiri Phacoemulsifikasi + IOL MR
Imatur 17,5 D
42 Jaliyah 3 PBI 51 th P R4B C640391 Mata Kanan PACG, Mata Kiri APAC Mata Kiri Triple Procedure MR
43 Munafiah 1 NPBI 39 th P KPD LD C630682 Mioma Uteri TAH INU ER,PS
44 Leonora Flora R 1 NPBI 71 th P MRK 1 C639070 Susp Ca Ovarii Laparoskopi Diagnostik EW
45 Kustiyah 3 NPBI 38 th P R3A C636159 NOK, ITP SOU + FS EN
46 Tri Gunarni VIP NPBI 9/17/1967 P GRD L4 C637374 Post Mastektomi Eksisi + PA BIS
47 Yamini 3 NPBI 55 th P R2A C598559 IDC Gr II MS T4bNoM1 MRM Sin BIS AL,MK
Total Tiroidektomi + Limfadenektomi + FS,
48 Sunardi 3 NPBI 48 th L R5A C487559 Ca Papilary Thyroid UUD
Ganas RND
49 Moh Firman Maulana 3 PBI 12 th L Anak LD C635215 Microta Dx et Sin Rekonstruksi Telinga NJT AH,TU
50 Dimas Saputra 3 NPBI 1 th L Anak D C633519 Megakolon Kongenital Duhamel Prosedur EDW
51 Wartini 2 NPBI 50 th P KPD LD C559959 Batu Ginjal Lepas + Ganti DJ Stent FASTRACK MAS AY,DM,DA
52 Muh. Syaeful Amin 2 NPBI 34 th L KPD L1 C592080 Batu Ginjal URS k/p DJ Stent FASTRACK MAS
53 Kasiyem 3 NPBI 55 th P R2A C618928 Post DJ Stent Aff DJ Stent MAS
54 Natasya Eka 1 UM 4 th P Anak LD C640553 Suspect Keganasan Hematologi BMP NYO
55 Elgan 3 NPBI 9 th L Anak LD C560726 ALL BMP HER
56 Ahmad dafa 3 NPBI 9 th L Pol ANK C631064 ALL BMP HER
57 Agung 3 NPBI 14 th L Anak LD C640582 Anemia BMP HER
58 Rastam 3 NPBI 60 th L R3B C542873 Fistel Perianal Fistulektomi PB
59 Kevin Ronaldo Privat UM 19 th L Pol GRD C572863 Kondiloma Akuminata ( HIV + ) Eksisi Kondiloma MG
60 Tukiyerri 3 NPBI 63 th L C639445 Massa Paru Kanan Bronchoscopy SFY YR,EW
61 Rokhimah 3 PBI 52 th P Pol PD C640197 DM + TB Bronchoscopy SFY S : SC,US
62 Masrukan 1 NPBI 51 th L KPD L1 C638757 Tumor Paru dd/ mediastinum Bronchoscopy AVIS
63 Mulyani 3 NPBI 57 th P R3B C640421 Tumor Paru Bronchoscopy AVIS
64 Kholiq Anwar Privat NPBI 41 th L Pol GRD C599070 KNF Nasofaringoscopy Flexible + NBI DAT
65 Zuhaimi G 3 NPBI 50 th L KPD LD C640278 Fr. Maksilofacial pasca evakuasi Aff Tampon WY
66 M. Azam Kamil 1 NPBI 24 th L KPD L1 C151976 Massa Nasofaring Nasofaringoscopy Flexible + NBI WY
67 Sakuri Privat NPBI 53 th L Pol GRD C638838 Dyspepsia EGD HRY GN,MR,ANM
68 Sugiyem 3 P Pol PD C164138 Ca Cervix Colonoscopy AGG
69 Ensial Winoto VIP NPBI 75 th L GRD L5 C538221 Tumor Recto Sigmoid Colonoscopy PB
70 Sutiaji 3 NPBI 37 th P Pol DIG C466896 Adeno Ca rectie Colonoscopy JS
7 GA HN 09.30 120
7 GA HN 13.00 60
8 GA HA 07.30 08.00
9 GA HA 07.30 08.00 180

9 GA HA 11.00
10 GA DS 06.30 07.00 120
10 GA DS 10.00
10 GA DS 14.30
JTG GA HR 07.00 10.00
GR 1 GA SF 06.30 07.00
GR 1 GA VL 09.30
GR 1 GA SF 11.30
GR 2 LA 08.30 09.00 30
GR 2 LA 10.00
GR 2 LA 11.00
GR 2 LA 12.00
GR 2 LA 13.00
GR 2 LA 14.00
GR 3 GA VL 07.20 07.30 120
GR 3 GA VL 10.00
GR 3 GA VL 13.00 180
GR 4 GA WA 07.20 07.30
GR 4 GA VL 09.00
GR 4 GA VL 12.00
GR 5 GA SF 07.30 08.00 120

GR 5 GA SF 10.00 60
DS 1 GA DS 07.30 08.00
DS 1 GA DS 09.00
DS 1 GA DS 10.00 30
DS 1 GA DS 11.00
DS 1 GA DS 12.00
DS 1 GA DS 14.00
DS 1 GA DS 15.00
DS 1 GA DS 16.00
DS 1 GA VL 17.00
DS 2 GA DS 07.30 08.00
DS 2 GA DS 09.00
DS 2 GA DS 10.00
DS 2 GA DS 11.00
DS 2 LA 12.00
DS 2 LA 13.00
DS 2 LA 14.00
DS 3 LA 08.00
DS 3 GA DS 09.00
DS 3 GA VL 10.00
DS 3 GA DS 11.00
71 Tutik Maryati 3 NPBI 37 th P Pol THT C640795 Obs. Disfagia + Disfonia Laringoscopy Flexible AYU
72 M. Amin Privat NPBI 54 th L Pol GRD C527206 Nefrolithiasis ESWL MAS AK
73 Sulipah 3 NPBI 67 th P Pol GRD C625572 Nefrolithiasis ESWL ADS
74 Inza Hermawan Privat NPBI 54 th L Pol GRD C407553 Batu Ureter Sin ESWL ADS
M : NH,AR,AT,AD,ES,SR,IS RR : FA,IM,DY* MID : MY,SC RR GRD : RG MID : VQ ,NP SORE PROGRAM : EV,RK,AI,AN,SA,RE,BR,BY,VT,EA,HA,JF,WI,MW,YS,ND,PL,SC,TM,US ALAT : PUR,D
L : AG,AP,CA,DJ,EM,HI,II,MF,PM,RI,RA,SAM,GI,UM
Fistula Dentigenerous Pasca FESS + Fistula Endoskopi,

Anik Sri Suharning Dwi 1 NPBI 31 th P MRK L2 C591656 FESS + Fistula Dosure RH
Oroantral Rhino Set
Ong Kwie Thay Priv NPBI 79 th P Pol. Grd C627325 Mata Kiri Entropia Mata Kiri Koreksi Entropia Opmic AK

PENJAMIN
ASISTEN
REKAM
MEDIS
SL*,UM,AM,
PLH : YW,HR CA,YN,HE,ET,TR,PS,AY,YR,EW,MR BUKU PUTIH + KOMPETENSI : GN,EV,TA,AL,AH*
ANM*,VQ*
1 Uwais Abid Ar Rasyid 3 NPBI 10 bl L Anak 1 C632978 HIL Dextra Reponible Herniotomi PTY NO,WD
2 Aisyah Novita Sari 3 NPBI 18 th P R3A C637578 OMSK Dupleks ME Simple + Thimpanoplasty Kanan Mikroskop AYU
Endoskopi, LD1
3 Noval Akbar Mahendra 1 NPBI 3 th L Transit C470742 Obs Dyspneu Pasca Tracheostomi LD + Evaluasi DAT AI,AO,RE
+ LD2
Stenosis Trachea, Stiffnes MIT dig IV - V, Pasang Kanul T-Tube + Inj. Kenakort + LD, Endoskopi, LD
4 Wenty Dwi Septiana 3 NPBI 26 th P R5B C507340 DAT + BIN
Manus Sinistra Release Manual Trakeostomi
Endoskopi,
Massa Cavum Nasi Kiri dd/ Inverted Papiloma Ekstirpasi Massa dg Endoskopi + CWL k/p Rhino Set,
5 Suliyanto 3 JMK 43 th L R3B C638885 DAT
Polip Nasi Rhinotomi Lateral CWL,
Maxilektomi
6 Sri Waluyo 2 NPBI 44 th L MRK D C640125 Myelopathi Lumbal Neuroplasty WU
7 Tuginem Al Sunarsih 2 NPBI 54 th P KPD LD C638749 NOS c/ Ganas Laparotomi + FS EW TW,AM
8 Siti Rochwati VIP NPBI 63 th P GRD L6 C136201 Susp Ca Ovarii Laparotomi + FS (Surgical Staging) EW
Mata Kanan Massa Palpebra ec Trichilemmal
9 Sri Umi 3 PBI 53 th P R2A C456822 Mata Kanan Re-Wide Eksisi + FS + PA TL TD,RM,YS
Ca
10 Sunari 3 NPBI 37 th L R2A C637405 Impaksi Gigi Odontektomi 4 Gigi Bor, Tang DV AZ,DB,DN
11 Moh Zahuri 3 NPBI 42 th L R1B C638870 Impaksi Gigi Odontektomi 4 Gigi Bor, Tang DV
Endoskopi,
12 Suparno 3 NPBI 63 th L R1B C635834 RSK + SD + Konka Hipertrofi FESS + SR + CWL + Konkoplasty FESS, Rhino RH SU,DM*
Set, CWL Set
SF
LW,SA
13 Nurul Kumariyatun 1 NPBI 66 th P MRK 1 C638052 HNP Laminektomi + PSRS APR PR,BD,DM*
14 Khairil Romza 2 NPBI 32 th P KPD LD C639227 Ruptur ACL Sin Repair ACL Sin FASTRACK BIN
EN,MA,BP,
SS,AS
Mata Kanan Vx Eye + KSI, Mata Kiri PDR +
15 Makhfudz 1 NPBI 54 th L KPD L1 C557958 Mata Kiri Vx + EL + SO / Gas Opmic AW NK,DI,TU
TRD + VH
16 Narto 3 NPBI 37 th L R1B C636473 Mata Kanan Retinal Detachment dg Makula on Mata Kanan Vitrectomi + EL + SO / Gas Opmic AW
17 Sukarno 3 NPBI 51 th L R5A C640094 Massa Paru Kanan Bronchoscopy SFY YR,EW
18 Wartini 2 NPBI 50 th P KPD LD C559959 Batu Ren Post DJ Stent ESWL MAS AK
19 Syaeful Amin 1 NPBI 34 th L KPD L1 C592080 Nefrolithiasis Dextra Post DJ Stent ESWL MAS
DS 3 LA 13.00
DS LA 08.30
DS LA 10.30
DS LA 13.00
,RE,BR,BY,VT,EA,HA,JF,WI,MW,YS,ND,PL,SC,TM,US ALAT : PUR,DW ( S : YN )
RAL
PEMBERS
ANESTESI
J. SERAH
JAM DTG
PROGRA
IHAN OK
TERIMA
anestesi
DPJP
Jenis
JAM
RIIL
OK
M
CT
1 GA 07.30 08.00 09.30 180

1 GA 10.00 120
2 GA 08.30 09.00 10.00
60
2 10.30 12.30
2 GA 13.00
180
3 LA 07.30 08.00
4 GA 08.30 09.00 11.30 180
4 GA WA 12.00 180
5 GA 07.30 08.00
120
120
6 GA 07.30 08.00 09.30
6 GA 10.00
7 GA 08.30 09.00
8 AN
9 NI
10 GA 07.30 08.00 10.30 120 BY
10 GA 11.00 120 DA
JTG EA
GR 1 GA VL 10.00 11.30
120 HA
GR 1 GA 12.00 120 JF
DS 2 GA 08.00
DS LA 08.00
DS LA 10.00
M : RK,AT,AR,AD,VT,ES RR : FA,DY,MY,SE SORE PROGRAM : AN,AU,NI,BR,BY,DA,EA,HA*,JF,WI,MW,MK,ND,PL,SC*,TM ALAT : PUR, DW
L : AG,AP,TK,DJ,EM,ER,HI,ID,IS,II,MF,NP,NH,PM,RG,RI,RA,SAM,SR,ST,US

PENJAMI
ASISTEN
REKAM
N
MEDIS
AP,BD,TK,
PS,ID,MK,
MF,RA,TR, US
1 Siti Nur Aisyah 3 NPBI 2 bln P Anak LD C640175 Hidrocephalus VP Shunt LP + L-Connector GK
M : RK,AN,BY,RE,BR,MW S : AU,ER,RG*,VQ*

PENJAMIN
ASISTEN
REKAM
MEDIS
S : NO,WU, SL,HE*,UM,
SE AG ,RM
Nefrolithiasis Sin, Ureterolithiasis Sin,
1 Tafrikan Lutfi 3 NPBI 16 th L Anak L1 C006321 Nefrolithotomi Sin + DJ Stent ADS EV*,DB
Hidronefrosis Sin
FASTARCK
2 Sutamar 2 NPBI 61 th L KPD L1 C273137 Massa Glotis LD + Ekstirpasi Massa Endoskopi, LD1 DAT S : DM
+ LD2
3 Kustini P Tonsilitis Kronis Tonsilektomi FASTRACK RR (THT)
4 Sumirah 3 PBI 68 th P R2A C612202 Mata Kanan Obstruksi Saluran Lakrimalis Mata Kanan Re-Endo DCR + FESS INA + RH AI,AO,ID
Endoskopi,
5 Surono 1 NPBI 59 th L KPD L1 A529241 RSK + SD + Konka Hipertrofi FESS + SR + Konka Reduksi RH S : DN,ANM
Rhino Set
6 Lufi Hendra P 3 PBI 38 th L R1B C488968 Ca Sinonasal Ekstripasi Massa Endoskopi WY
TU
7 Kautsaroh 2 NPBI 32 th P KPD LD C637987 Mioma Uteri Miomektomi HR TW,PL
8 Fitri Nur Aini 2 NPBI 42 th P MRK LD C634425 NOK c/ Ganas TAH + BSO + FS EN S : SU
9 Tasrip 3 PBI 63 th L R3B C640299 Hernia Scrotalis Sin, Hernia Inguinalis Dx Hernioraphy Kanan Kiri JS TD, HA
10 Sobirin 2 NPBI 50 th L MRK LD C638828 Tumor Desenal Laparoscopy Hemikolektomi Sin MG S : DY,ER
11 Moch Rachim 2 NPBI 75 th L GER LD C639812 Tumor Colon Ascenden c/ Ganas Laparotomi Hemikolektomi ERI
12 Amriti 3 NPBI 58 th P R3A C628488 Splenomegali Splenektomi ERI
13 Ali Nastain 3 NPBI 52 th L R2B C638256 Malignant Soft Tissue Tumor Cruris Dx Eksisi + FS ganas Wide Eksisi BIS AZ,ET
14 Nurrochmah 3 NPBI 47 th P R2A C616431 SNNT c/ Ganas Ismolobektomi + FS ganas Total Tiroidektomi UUD S : DA
15 Firdaus Gilang 3 NPBI 9 bln L Anak LD C632009 Megacolon Kongenital on Kolostomi Duhamel Procedure EDW EM,MY
Laparotomi Eksplorasi + Eksisi Tumor k/p
16 Jesica Olyvia 3 NPBI 5 bln P Anak L1 C639304 Teratoma Imatur RR (BA) S : YS
Debulking
II, SA
S : AF,NI
LW, HI
S : SF, VQ
RAL
ANESTES
J. SERAH
JAM DTG
PROGRA
PEMBER
TERIMA
anestesi
SIHAN
DPJP
Jenis
JAM
RIIL
OK
OK
M
I
CT
9 GA 08.00 60 BR
RAL
DPJP ANESTESI
JAM PROGRAM
PEMBERSIHAN
JAM DTG RIIL
Jenis anestesi
J. SERAH
TERIMA
OK
OK
CT
1 GA 07.30 08.00 10.30

120
1 GA 11.00 12.00
60
1 GA 12.30
2 GA 06.30 07.00 10.30 180
2 GA 11.00 14.30
2 GA 15.00 120
3
4 GA 07.30 08.00 10.30
4 GA 11.00 180
5 07.30 08.00 09.00
5 GA 09.30 11.00
5 GA 11.30 14.00 150
5 GA 14.30 180
6 GA 06.30 07.00 09.00
120
6 GA WA 09.30 240
7 GA 07.30 08.00 10.00 120
7 GA 10.30
180
8
8
9
9
17 Fitri Fudian 3 NPBI 38 th L R1B C639814 Fr. Scapula Dextra , Fr. Acromion Dextra ORIF APR PR,WD
FASTRACK
18 Dyah Lestari 2 NPBI 19 th P KPD L1 C445785 Ruptur Meniscus Arthroscopy Meniscus Fast Fix, S : PM
Ablation Pencil
EN,MA,TK
BP,SS,AS, ND
S : BD,WI
19 V Sardju 1 NPBI 64 th L KPD LD B204539 Mata Kiri SO Filled Eye Mata Kiri Evakuasi Silicon Opmic AL NK,DI
Mata Kanan SO Filled Eye + Katarak
20 Sugiyati 1 NPBI 56 th P KPD LD C589037 Mata Kanan Evakuasi SO + Phaco + IOL Opmic AL
Komplikata
21 Ikhman Riyadi 2 NPBI 40 th L KPD LD C611974 Mata Kiri SO Filled Eye + KSI Mata Kiri Evakuasi SO + Phaco + IOL Opmic AL
22 Dwi Winarto 2 NPBI 52 th L Pol MTA C628469 Mata kanan Kiri KSI Mata kanan phaco + IOL Opmic RF YW,HR
Mata kanan Pseudofakia + Decompensated
23 Suramti 1 NPBI 60 th P Pol MTA A526105 Mata kanan evakuasi IOL Opmic WIS S : MK,RI
Cornea
24 Khoiriyah 1 NPBI 64 th P Pol MTA C636757 Mata kanan Katarak Komplikata Mata kanan Sinekiektomi + Phaco + IOL Opmic WIS
25 Martiani Susanti Priv NPBI 3/4/1948 P P. GRD C558851 Mata kiri glaukoma absolut Mata kiri Cyclocryotherapy AK
26 Sri Pangesti Priv NPBI 2/26/1958 P P. GRD C601320 Mata kiri glaukoma sekunder Mata kiri Rekonstruksi COA AL
27 Benny Susanto Priv Um 5/1/1978 L P. GRD C594830 Mata Kiri CMV Retinitis Mata Kiri Injeksi Gancyclovir Intra Vitreal DN
28 Rosalia Dwi Kartika P VIP NPBI 33 th P GRD L3 C038255 Adenomiosis + Tuba Ovarial Abses Laparoscopy TF NP,AM,RA
29 Indah Sri Windaryani 1 NPBI 37 th P MRK L2 C639665 NOK SOU + FS VG
30 Mohamad Junaedi 2 NPBI 46 th L Ger D C635789 Limfadenopati Colli Eksisi Biopsi KGB Colli YAN AL,TM
Plate,
31 Rudy Darmawan 2 NPBI 17 th L MRK LD C637884 Tumor Mandibula Reseksi Mandibula + Rekonstruksi RP + DV
Osteomed
32 Afif Zakaria Ahmad 3 NPBI 4 th L Anak L1 C640249 Luka Bakar Derajat Iib-III 20,5% Debridement NJT TA,DJ*
33 Miftahudin 2 NPBI 56 th L KPD L1 C630533 Batu Ginjal Aff DJ Stent + ESWL FASTRACK MAS AY,SC ,MF
34 Asih Sofiani 3 NPBI 39 th P Pol ORTO C601839 Fr. Ulna Aff Implant DRY S : RG
35 Satia Hartono 3 NPBI 50 th L Pol ORTO C173772 Union SAHA Aff Implant C-ARM DRY
36 Fahri Sigit 3 NPBI 7 th L Pol ANK C636717 ALL BMP HER
37 Nazara Raisya 3 NPBI 7 th P Pol ANK C623857 ALL BMP HER
38 Wijiningsih 3 NPBI 46 th P R3A C640976 Efusi Pleura Kiri Masif Pasang Pigtail SFY
39 Dwi Waluyo 3 NPBI L R3B C640243 PSCBA EGD DD YR,EW
40 Swapitono 3 PBI 59 th L R6B C640587 PSCBA + SH EGD DD
41 Widyamurti Ariana 3 NPBI 35 th P Pol DIG C066108 Gist EGD MG
42 Sri Hartiningsih 3 NPBI 65 th P Pol DIG C555179 Ca Cervix Colonoscopy PB
43 Rohmi 2 NPBI 67 th P GER LD C640200 Tumor Rectie 1/3 Distal Colonoscopy ERI
44 Rasmiono 3 NPBI 55 th L Pol THT C639209 Massa Nasofaring Nasofaringoscopy Flexible + NBI + Biopsi DAT
45 Nur Hamid 3 NPBI 56 th L Pol THT C620183 Obs. Dyspnoe Laringoscopy Flexible MYS
46 Denis Wisnu 3 NPBI 8 th L Anak L1 C637878 Massa Sinonasal Aff Tampon WY
47 Wawan Uliyono 2 NPBI 26 th L KPD LD C637369 Fr. Of Nasal Aff Tampon WY
48 Eddy Susanto 3 NPBI 29 th L R2B C640541 Sudden Deafness Telinga Kanan Inj. Steroid Intra Timpani ZUL
49 Rasmono 3 NPBI 55 th L Pol THT C639209 Massa Nasofaring dd/ LNH, Carsinoma Nasofaringoscopy Flexible + NBI + Biopsi DAT
50 Sri Lestari VIP NPBI 66 th P MRK L2 C636617 Batu CBD ERCP C-ARM HRY GN,MR,US
51 Raharjo 3 NPBI 62 th L Pol PD C589018 Ca Colon Colonoscopy HRY
52 Asrori 51 th L Pol PD C640481 Diare Kronik Colonoscopy HRY
53 Wahono 1 NPBI 31 th L KPD LD C565208 CKD Endoscopy HRY
54 Deni Setiawan 2 NPBI 43 th L Transit C592587 PSCBA EGD HRY
55 Sugiyem 3 PBI P Pol PD C164138 Ca Cervix Colonoscopy AGG
56 Sripah 3 NPBI 79 th P R3A C640716 PSCBA EGD AGG
57 Ersiah Winoto VIPA NPBI 1/31/1942 P GRD L5 C538221 Tumor Recto Sigmoid Colonoscopy PB
58 Pajiyem 3 NPBI 56 th P Pol URO C638020 Nefrolithiasis ESWL MAS AK
59 Iis Kristianto 3 NPBI 30 th L Pol URO C637848 Nefrolithiasis Sin ESWL ADS
60 Abdul Khalim 3 NPBI 57 th L Pol URO C625260 Nefrolithiasis ESWL ADS
M : NH,AN,AU,BY,RE,EA,MW RR : FA,IM,TR MID : SAM,ST RR GRD : JF MID : PS SORE PROGRAM : NO,WU,SF,AF,NI,DA,DM,DN,DY,YN,ER,WI,ANM,MK,YS,PM,RG,RI,SE,SU,VQ,BD*,ANM*
10 GA 07.30 08.00 10.00
10 GA 10.30
JTG
GR 1 GA 07.30 08.00 09.30 120

GR 1 GA 10.00 11.30 120
GR 1 GA 12.00 120
GR 2 LA 08.00 08.30
GR 2 LA 09.00 09.30
GR 2 LA 10.00 10.30
GR 2 LA 11.00 11.20
GR 2 LA 11.30 12.00
GR 2 LA 12.30
GR 3 GA VL 07.30 08.00 09.00
GR 3 GA 09.30 180
GR 4 GA 07.20 07.30 09.30
GR 4 GA 10.00
GR 5 GA 07.30 08.00 60
DS 1 GA 07.30 08.00 08.30 30
DS 1 GA 09.00 09.30
DS 1 GA 10.00 10.30
DS 1 GA 11.00 11.30
DS 1 GA 12.00 12.30
DS 1 LA 13.00
DS 2 LA 07.20 07.30 07.45
DS 2 GA 08.00 08.30
DS 2 GA 09.00 09.30
DS 2 GA 10.00 10.30
DS 2 GA 11.00 11.30
DS 2 LA 12.00 12.20
DS 2 LA 12.30 12.45
DS 2 LA 13.00 13.20
DS 2 LA 13.30 13.45
DS 2 LA 14.00 14.20
DS 2 LA 14.30
DS 3 GA 07.30 08.00 08.30
DS 3 LA 09.00 09.30
DS 3 LA 10.00 10.30
DS 3 LA 11.00 11.30
DS 3 LA 12.00 12.30
DS 3 GA 13.00 13.30
DS 3 LA 14.00 14.30
DS 3 GA VL 15.00
DS LA 08.00
DS LA 10.00
DS LA 12.00
A,DM,DN,DY,YN,ER,WI,ANM,MK,YS,PM,RG,RI,SE,SU,VQ,BD*,ANM* ALAT : PUR, CA ( S : YN )
L : AH,AR,AP,AT,AD,BR,VT,ES,IS,RK,SR
selasa
Mata Kanan Retinal Detachment, Mata Kiri
Endri Fajar Bowo L 3 NPBI 20 th L R2B C425488 Mata Kanan Vitrectomi + EL + SO / Gas Opmic AW
Katarak Komplikata
Nanang Kosim 3 PBI 36 th L R3B C637232 Mata Kiri Proptosis + Susp Pseudo Tumor Mata Kiri Orbitotomi Lateral + Biopsi + PA AK

PENJAMIN
ASISTEN
REKAM
MEDIS
S : NO,WU, SL,HE,UM,
SE TU ,RM
1 Karto Jaman 3 PBI 70 th L R1B C612373 Ca Laring Laringektomi WY EV,DB
2 Agung Bahtiar 2 NPBI 31 th L KPD LD C616924 Ca Palatum Ekstipasi Massa Palatum WY S : IS, DM
Endoskopi,
3 Akhsani 3 NPBI 1 th 2 bln L Anak D C619679 Papiloma Laring LD Evaluasi + Ekstirpasi Massa FAR
LD1+2
Endoskopi,
4 Hari Sasongko 2 NPBI 39 th L KPD LD C259690 RSK + Adenotonsilitis Kronik FESS + ATE Rhino Set, TE RH AI,AO,ID
Diseksi
5 Mahmudi 3 NPBI 49 th L R3B C623527 Malignant Tumor Nasofaring Biopsi Massa Nasofaring Endoskopi DAT S : PS
Endoskopi,
6 Amanah 3 NPBI 51 th P R3A C629268 Massa Palatum Ekstipasi Massa + Tracheostomi DAT
Maksilektomi
7 Ngadinem 3 NPBI 56 th P R6A C591873 Myelopathy Lumbal HNP, Spondiliosis Lumbal Neuroplasty Rhizotomy C-Arm TRI A AG*
8 Sundari 2 NPBI 38 th P MRK LD C641153 Miomektomi TAH OP TW,TK

9 Christiana Sugiarti 2 NPBI 40 th P KPD LD C635285 NOK SOU + FS EN S : DN
10 Tuti Hartati 3 PBI 38 th P R3A C622254 Mata Kiri Proptosis ec Massa Retrobulber Mata Kiri Orbitotomi Anterior + Biopsi + PA TL
11 Jose Marie Pelayo S 1 NPBI 32 th L Ger 1 C641275 Cholelithiasis Laparoscopy Cholesistectomi k/p Open PB TD, HA
12 Jumain Um NPBI 1/2/1998 L R5A C640890 Vulnus Sclopetorium Thoracotomi Explorasi Ekstraksi Corpal C arm WW S : DY
13 Bayu 3 NPBI L R6B C202602 Massa Mediastinum Sternotomi + Eksisi Tumor Mediastinum ALI
BMP + Multiple Eksisi / Adenektomi (Colli,
14 Jonathan Krisna VIP NPBI 9/13/2006 L GRD L3 C639113 Massa Colli BIS + NYO AZ,ET
Axilla) + PA
15 Sumiyati 3 NPBI 57 th P R2A C588141 Invasive Ca Mamae Dx Re-Eksisi + PA BIS S : DA
16 Sulhan 3 PBI 41 th L R1B C629424 Rabdomiosarcoma wide eksisi + FS + limfadenectomy DWT
17 Zaskia 3 NPBI 1 bln P Anak L1 C637601 Tumor Colli c/ Hygroma Colli Eksisi Biopsi EDW EM,MY
18 Muhammad Rafka Putra 3 NPBI 8 bln L Anak L1 C639569 Observasi Kolestasis Laparotomi Biopsi Hepar PTY S : YS
19 Mohamad Gunawan 3 NPBI 8 th L Anak L1 C640898 Massa Intra Abdomen C/ Lympoma Laparotomi Biopsi RR (BA)
20 Karwi 2 NPBI 66 th L GER LD C640266 Osteomilitis Luas Debridement Luas DID
VP Shunt Low
21 Rustani 1 NPBI 68 th P KPD L1 C639949 Normo Pressure Hidrocephalus VP Shunt ER II, SA
Pressure
22 Helmi Arifudin 3 NPBI 39 th L R3B C640374 Abses Multiple Intra Cranial Craniotomi AJ S : AF,NI
23 Nihayatus Sholihah 3 NPBI 31 th P R4B C639536 Meningioma Falx Craniotomi Dasar Tengkorak ZM LW,HI*
S : SF
RAL
DPJP ANESTESI
JAM PROGRAM
PEMBERSIHAN
JAM DTG RIIL
Jenis anestesi
J. SERAH
TERIMA
OK
OK
CT HN
1 GA DN 06.30 07.00 16.30

1 GA HN 17.00
2 GA DN 06.30 07.00 09.00
2 GA DN 09.30 12.30
2 GA DN 13.00 13.30 30
2 GA DN 14.00
120
3 LA 07.30 08.00
150
4 GA BI 05.30 06.00 08.30 120
4 GA BI 09.00 15.30 180
4 GA BI 16.00
5 GA BI 07.30 08.00 13.30
5 GA BI 14.00 16.30
5 GA BI 17.00
6 GA BI 06.30 07.00 09.30
6 GA JL 10.00 12.30 180

6 GA JL 13.00 120
7 GA JL 07.30 08.00 09.00 120
7 GA JL 09.30 12.30
7 GA JL 13.00 20.30
7 GA JL 21.00
8 GA JH 05.30 06.00 07.30

60
8 GA JH 08.00
9 GA JH 07.30 08.00 240
24 Dimas Aji Maulana 3 NPBI 20 th L R1B C640324 Boxer Fraktur Manus Dx ORIF C-Arm APR PR,WD
25 Rudi Sugiyarto 2 NPBI 25 th L Kenari C639937 Plate Failure Humerus Sin Post ORIF ORIF APR S : PM
26 Rusmiyati 3 NPBI 62 th P R2A B279520 Closed Fr Collum Femur Sin Bipolar Hemiarthroplasty Hip Sin BIN
EN,MA,VT
27 Siti Maslikha 2 NPBI 33 th P Elang 1 C639319 AR Severe, MR Severe DVR SF
BP,SS,AS, ND
28 Zilda Anjelia Meela 3 NPBI 9 th P Elang 1 C592118 PDA Ligasi PDA SF S : BD,WI
Mata Kiri Katarak Kongenital ec Rubella Mata Kiri Ekstraksi Lensa + Vx Anterior + IOL
29 Muh. Nasrul Ilmi 3 NPBI 1 th 4 bln L Anak L1 C639011 Opmic LN NK,DI,DW
Syndrome + PPC + PI
30 Suroto 3 NPBI 31 th L R3B C638306 Mata Kiri Luksasi Lensa + Hemoftalmus Mata Kiri Endofragmentasi + vitrektomi Opmic AW
Mata Kanan Retinal Detachment, Mata Kiri
31 Endri Fajar Bowo 3 NPBI 20 th L R2B C425488 Mata Kanan Vitrectomi + EL + SO Opmic AW
Katarak Komplikata
Mata Kanan Secondary Implant (Iris Claw) +
32 Siti Maemonah 3 NPBI 68 th P P. Mata C640742 Mata Kanan Afakia FET YW,HR
Vitrektomi Anterior
33 Sucipto 3 PBI 39 th L P. Mata C638218 Mata Kanan Kiri Myopia Degeneratif Mata Kiri Clear Lens Extraction FET S : MK,RI,ER
34 Murtini 3 NPBI 56 th P P. Mata C511419 Mata Kiri KSI + Pupil Atropi Mata Kiri Phaco + IOL WIS
35 Sri Yanti 2 NPBI 58 th p P. Mata c508792 Mata Kanan KSI + PDR + CSME Mata Kanan Phaco + IOL WIS
Mata Kanan Glaukoma Sekunder Post
36 Pri Suhertin Puspitowa 1 NPBI 57 th P KPD L1 C484574 Mata Kanan Re-Trabekulektomi Opmic FI
Vitrectomi
37 Sunarti 3 NPBI 48 th P R5B C619392 Mioma Uteri TAH HR NP,AM,RA
38 Nandana Adhyasta A 3 PBI 2 th P Anak L1 C639106 Mata Kiri Retino Blastoma Mata Kiri Enukleasi Bulbi + Graft TL
39 Istikomah 3 NPBI 46 th P R2A C585809 Maligna Spindel Cell Wide Eksisi + PA UUD AL,TM
40 Nanang Kosim 3 NPBI 36 th L R3B C637232 Mata Kiri Proptosis ec Susp Pseudo Tumor Mata Kiri Orbitotomi Lateral + Biopsi + PA AK
41 Nimatul 3 NPBI 9/4/2015 P Anak D C633666 Ulkus Granulosum Sacrum e.c Skin Avulsi Debridement + STSG RZ
42 Darwanto 3 NPBI 40 th L R2B C641177 Fr. Parasimfisis Mandibula Rekonstruksi Fr. Tlg Wajah Komplek RZ TA,DJ
43 Bagas Puguh Widodo 1 NPBI 20 th L MRK L2 C637087 Ulkus Granulosum Tungkai Debridement + STSG RZ
44 Febrian Resa Widayat 3 NPBI 22 th L R2B C640865 Combostio Gr 2a-b 27% Debridement RZ
45 Ricardo Ryuzaki VIP L GRD L3 C598073 Epilepsi Lumbal Pungsi ALIF AY*,SC ,MF
46 E Didit Tri Widianto 1 NPBI 45 th L KTL C588726 Fistel Para Anal Fistulektomi PB S : RG
47 Cahya Ariestia B Privat UM 23 th P Pol GRD C641081 Sindroma Nefrotik Biopsi Ginjal DL
48 Naura Falita 3 PBI 4 th P Anak L1 C641007 Observasi Pansipenia BMP MOED
49 Rohmad 3 NPBI 59 th L GER LD C640257 Diare Kronis Colonoscopy AGG YR,JF
50 Siti Nur Azizah 3 NPBI 25 th P Pol THT C556628 Ca Nasofaring Nasofaringoscopy + NBI DAT
51 Parmi 3 NPBI 50 th P Pol THT C565166 Ca Nasofaring Nasofaringoscopy + NBI + Biopsi DAT
52 M. Alizen Privat UM 10 th L Pol GRD C488709 Adenoid Hipertropi Nasofaringoscopy Flexible FAR
53 Wakiman Privat NPBI 58 th L Pol GRD C640425 Parese Plika Vokalis Laringoscopy Flexible FAR
54 Maryono 3 NPBI 42 th P R6B C629880 Pneumothorax on WSD Bronchoscopy FTR

55 Mini 3 NPBI 71 th P GER LD C638506 Vomitus Farsisten EGD DD GN,MR
56 Karsini Privat NPBI 46 th P Pol GRD C441911 Ca Colon Colonoscopy DD
57 Tjiong Agus J 3 NPBI 49 th L Pol PD C640181 Diare Kronik Colonoscopy DD
58 Sariya 3 NPBI 48 th P Pol URO C601327 Nefrolithiasis ESWL WAN AK
59 Zaini 3 NPBI 70 th L Pol URO C082542 Nefrolithiasis ESWL WAN
60 Rasmi 3 NPBI 50 th P Pol URO C638864 Nefrolithiasis ESWL WAN
M : NH,AU,SU,TR,VQ,EW,ANM RR : FA,IM,SR MID : SAM,ST RR GRD : JF MID : PL SORE PROGRAM : NO,SF*,WU,AF,NI,BD,DA*,DM,DN,DY,ER,IS,WI,PS,MK,YS,PM,RG,RI,SE ALAT : PUR, C
10 GA WA 06.30 07.00 09.00 120
10 GA WA 09.30 11.30 120
10 GA WA 12.00 180
JTG GA HR 07.00 10.00 14.00
360
JTG GA HR 14.30 300
GR 1 GA HR 07.20 07.30 08.30
90
GR 1 GA HR 09.00 10.30 120
GR 1 GA HR 11.00
120
GR 2 LA 08.00 08.30
GR 2 LA 09.00 09.30
GR 2 LA 10.00 10.30
GR 2 LA 11.00 11.30
GR 2 LA 12.00
60
GR 3 GA TA 07.30 08.00 10.00 120
GR 3 GA TA 10.30 120
GR 4 GA TA 07.30 08.00 10.30
GR 4 GA TA 11.00
GR 5 GA HR 07.00 07.15 08.30

GR 5 GA HR 09.00 11.30 180
GR 5 GA HR 12.00 13.30
GR 5 GA HR 14.00
DS 1 LA 07.30 08.00 08.30
DS 1 GA WA 09.00 10.30
DS 1 LA 11.00 11.30
DS 1 GA WA 12.00
DS 2 GA WA 07.30 08.00 08.30
DS 2 LA 09.00 09.20
DS 2 LA 09.30 09.45
DS 2 LA 10.00 10.20
DS 2 LA 10.30 10.45
DS 2 GA WA 11.00
DS 3 LA 07.30 08.00 08.30
DS 3 GA WA 09.00 09.30
DS 3 GA WA 10.00
DS LA 08.00
DS LA 10.00
DS LA 12.00
,BD,DA*,DM,DN,DY,ER,IS,WI,PS,MK,YS,PM,RG,RI,SE ALAT : PUR, CA ( S : YN )
L : AH,AR,AP,AN,AT,RE,AD,BR,BY,EA,ES,MW,RK,GI
Para Plegi Inferior ec Fr Kompresi Vth 8-9 dan

Tarmin 3 NPBI 50 th L R3B C616706
VL 1-2
PSRS C-Arm APR RABU

PENJAMIN
ASISTEN
REKAM
MEDIS
SL*,HE,UM,
S : NO,ET,SE
AR, RM
1 Treas Sukmani 2 NPBI 6 th P Anak LD C640713 Curiga UPJ Stenosis Dex et Sin URS Diagnostik ADS EV,DM,DB
2 Tri Endang Kurniasih VIP NPBI 57 th P GRD L3 B225769 Ca Cervic, CKD Repair Nefrostomi + Fluoroscopy C arm ADS S : IS*,AM
3 Sulistyono 2 Um 44 th L KPD L1 C641451 Massa Cavum Nasi Ekstirpasi Massa FASTRACK DAT AI,AO,ID
4 Tarsiti VIP NPBI 9/8/1965 P GRD L5 C640054 Ca Sinonasal Aff Tampon DAT S : PS
5 Painem 2 NPBI 81 th P GER LD C628202 Ca Sinonasal Hemimaksilektomi Medial Endoskopi WY
Mata Kiri Tumor Orbita ec Suspek Metastasis Mata Kiri Orbitotomi Anterior + Biopsi + PA +
6 Samsuri 3 PBI 53 th L R5A C591137 TL + WY
Ca Sinonasal Hemimandibulektomi
AG
7 Sri Wahyuni VIP NPBI 51 th P GRD L3 C126778 Susp Sarcoma Uteri Laparotomi Histerektomi + BSO EN TW,TK
8 Yaroh 3 NPBI 25 th P R4A C491091 NOK dg Bagian Padat c/ Ganas SOU + FS s/d CSS HR S : DN
Laparotomi Eksplorasi Reseksi Tumor k/p
9 Waseni 3 NPBI 64 th P R3A C639817 Adeno Ca Recti Well Diff PB TD, ER
Stoma
10 Siti Khotimah 3 NPBI 37 th P R3A C608252 Fistula Enterocutan + Distal Obstruksi Laparotomi Eksplorasi k/p Stoma ERI S : DY, BD
11 Johana Widhi P 1 NPBI 45 th P KPD L1 C629770 Fibrolipoma Sternodalicular Wide Eksisi + Bone Graft + ORIF UUD + APR AZ*,AT,ES
Fr Femur, Fr Tibia Fibula, Fr Parasimpisis
12 Fiki Rosalia 3 NPBI 19 th P R2A C640555 ORIF + Rekonstruksi Fr Tlg Wajah C-Arm DID + RZ S : DA
Mandibula
13 Anasya Khoirun Nisa NPBI 16 hr P PBRT C640684 Teratoma Reg Sacrum Eksisi Tumor k/p Laparotomi RR (BA) EM,MY,AD
14 Muhamad Jafar Jamil NPBI 9 th L Anak 1 C641127 Abses Hepar Laparoskopi k/p Laparotomi Drainase Abses RR (BA) S : YS
15 Amalia Nur Arifin NPBI 1/23/2017 P Anak D C622013 Atresia Colon Laparotomi Anastomose Colon RR (BA)
16 Sri Mulyani NPBI 3/13/2014 P Anak D C608023 MAR On Kolostomi dg Fistel Rectovestibuler PSARP RR (BA)
17 Rochimah 2 NPBI 72 th P Ger D C638516 ICH, IVH On EVD Pemasangan VP Shunt L Connector HY
18 Ikhsani Zuhri 1 NPBI 18 th L MRK L2 C639987 SOL Fronto Temporal Dx Craniotomi Dasar Tengkorak Mikroskop ER II, SA,BR
19 Darwin 3 PBI 51 th L R1B C641027 Fr Impresi OS Frontal Dx + Fr Femur Dx Koreksi Fr Impresi + Craniotomi AJ S : AF,NI
20 Sutiyem 3 NPBI 39 th P R2A C636823 Meningioma Suprasella Craniotomi Dasar Tengkorak DP LW,HI
S : SF
21 Abrianto Pradono 1 NPBI 28 th L KPD L1 C641281 Fr Kompresi Laminektomi + PSRS C-Arm APR PR,AP
22 Fatimah Handiani Privat UM 56 th P Pol GRD C640888 Fr. Choles Sinistra Reposisi APR
23 Ratri Ade Hapsari IRIN NPBI 22 th P R1A C640247 Fr Clavicula Dx ORIF APR S : PM
24 Atik Winarsih 3 NPBI 24 th P R3A C571026 OA Genu Sin TKR BIN
EN,MA,VT
25 Titik Kadarwati 2 NPBI 57 th P Elang 1 C590261 ASD II ASD Closure SF
BP,SS,AS, ND
Mata Kiri Afakia + Retinal Detachment +

26 Hasri Purwati 1 NPBI 63 th P KPD L1 C639954 Mata Kiri Vitrectomi + EL + SO / Gas Opmic AL NK,DI,DW
Vitreus Haemorage
27 Jawadi 3 NPBI 53 th L R2B C621661 Mata Kiri Ablatio Retina Mata Kiri Vitrectomi + EL + SO / Gas Opmic AL
RAL
DPJP ANESTESI
JAM PROGRAM
PEMBERSIHAN
JAM DTG RIIL
Jenis anestesi
J. SERAH
TERIMA
OK
OK
CT JH
1 GA HR 07.30 08.00 09.30

1 GA WA 10.00
2 GA DN 07.30 08.00 09.30
2 GA DN 10.00 13.30
2 GA HR 14.00 19.00 120
2 GA HR 19.30
180
3
4 GA DS 07.30 08.00 10.30 180

4 GA SF 11.00 180
5 GA SF 07.30 08.00 11.00
180
5 GA SF 11.30 120
6 GA DS 07.30 08.00 10.30
6 GA DS 11.00
120
7 GA DS 07.30 08.00 11.00
7 GA DS 11.30 13.30
7 GA DS 14.00 16.00
7 GA DS 16.30
8 GA TA 06.00 06.30 07.30
8 GA TA 08.00 15.30 360
8 GA TA 16.00 300
9 GA TA 07.30 08.00
10 GA UB 07.30 08.00 10.30

10 GA UB 11.00 11.30
10 GA UB 12.00 13.00 120
10 GA UB 13.30 120
JTG GA HN 07.00 10.00
300
GR 1 GA WA 07.30 08.00 09.30
120
GR 1 GA WA 10.00 11.30 120
Mata Kanan Kiri High Miopi + Afakia + Mata
28 Diah Mega Lestari 3 NPBI 18 th P R2A C640401 Mata Kiri Vitrectomi + EL + SO / Gas Opmic AL
Kiri Rheugmatogen Retinal Detachment
Mata Kanan Kiri Glaukoma Neovaskuler, Mata Mata Kanan Reposisi IOL (IRIS CLIP) + Re- Tris Clip,Lensa
29 Ngatini 1 NPBI 55 th P MRK L1 C619494 FI + RF
Kanan Dislokasi IOL Trabekulektomi Artisan 17,5D
30 Martiani Susanti Priv NPBI 3/4/1948 P P. GRD C558851 Mata Kiri Glaukoma Mata Kiri Cyclocryotherapi AK YW,HR
31 Putri Septiani Gusari Priv NPBI 9/27/1987 P P. GRD C641320 Mata Kiri Katarak Mata Kiri Phacoemulsifikasi + IOL AK
Mata Kanan Kiri Katarak Senilis Imatur +
32 Hartono 3 NPBI 58 th L P. Mata C63330 Mata Kanan Phacoemulsifikasi + IOL RF S : RI,HA
NPDR
Mata Kanan Katarak Komplikata,Mata Kiri Mata Kiri Secondary Implant + IOL +
33 Dino P 3 NPBI 31 th L P. Mata C640476 WIS
Afakia Vitrektomi Anterior ( Iris Claw)
Mata Kanan Kiri POAG + Katarak Senilis
34 Tarmuji 3 PBI 54 th L P. Mata C513851 Mata Kiri Phacoemulsifikasi + IOL MR
Imatur
35 Sofi`i 3 NPBI 57 th L P. Mata C595497 Mata Kiri Glaukoma Absolut Mata Kiri Cyclocryotherapi FI
36 Slamet Salikun Priv NPBI 12/30/1955 L P. GRD C636417 Mata Kiri Katarak Senilis Imatur Mata Kiri Phacoemulsifikasi + IOL Alcon 18 D FET
37 Anindita Rosenda H VIP NPBI 29 th P GRD L3 C581579 NOK, Torsi Laparoscopy Diagnostik Persiapan Laparotomi TF NP,RA
38 Srimah VIP NPBI 43 th P GRD L3 C640369 Adenomiosis Laparoscopy TF
39 Nanang Kosim 3 PBI 36 th L R3B C637232 Mata Kiri Proptosis ec Susp Pseudo Tumor Mata Kiri Orbitotomi Lateral + Biopsi + PA AK AL,TM
40 Muhamad Gunawan NPBI 8 th L Anak L1 C460898 Pansitopenia BMP NYO

Fr Maksila ZMC Sin, Dislokasi Anterior Sin
41 Rangga Tegar Lingga 3 PLN 13 th L Anak LD C641222 Rekonstruksi Fr Tulang Wajah RZ TA,DJ
Mandibula
42 Sukardi 3 NPBI 51 th L R1B C640293 Combustio 32% Debridement NJT
43 Sugeng Kurniawan 2 NPBI 45 th L KPD L1 C640136 Striktur Uretra, Batu Uretra Sachse + Litotripsi FASTRACK MAS AY,SC ,MF
44 Muslichatun 3 NPBI 56 th P Pol ONK C238170 KGB Colli Limfadenectomi Biopsi BIS S : RG
45 Jarman Privat NPBI 56 th L Pol GRD C641479 Tumor Rectum Distal Colonoscopy PB YR,JF
46 Sri Pujiati 3 NPBI 57 th P Po DIG C640932 Tumor Intra Abdomen Colonoscopy MM
47 Dalu Eko Ari 3 NPBI 33 th P Pol PD C638470 Hepatitis C EGD HRY
48 Bambang Husodo 2 NPBI 67 th L MRK LD C409070 Adeno Ca Prostat + Melena EGD HRY
49 Emmy Yuliati 1 NPBI 65 th P MRK L2 C641602 Hematoschezia Colonoscopy HRY
50 Paimin 3 NPBI 65 th L Pol THT C610557 LNH Tonsil Nasofaringoscopy Flexible + NBI WY
51 Bahtaman 3 NPBI 63 th L Pol THT C641307 Obs. Hoarness Laringoscopy Flexible + Biopsi RR (THT)
52 Sipan 3 NPBI 64 th L Pol THT C568985 Ca Nasofaring Nasofaringoscopy Flexible + NBI k/p Biopsi DAT
53 Suyatno 1 NPBI 59 th L KPD L1 C637573 Obstructive Jaundice ERCP C-Arm HRY GN*,MR,US
54 Kasnan 3 NPBI 57 th L R6B C601861 CBD Stone ERCP C-Arm HRY
55 Zainal Arifin Privat NPBI 36 th L Pol GRD C639709 Hepato Megali Colonoscopy AGG
56 Chaidir Syah 3 NPBI 73 th L R6B C640251 Suspect TB Paru Bronchoscopy THOM
57 Sumino 3 NPBI 60 th L R5A C368548 Anemia Colonoscopy DD
58 Art. Anom Saputro 3 NPBI 60 th L Pol URO C620241 Nefrolithiasis Sin ESWL MAS AK
59 Sutarmuto 1 NPBI 51 th L Pol GRD C639447 Batu Ureter ESWL MAS
60 Santoso 3 NPBI 53 th L Pol URO C587958 Uretrolithiasis ESWL WAN
61 Bowo 3 NPBI 48 th L Pol URO C618732 Nefrolithiasis ESWL WAN
62 Risyanto 3 NPBI 48 th L Pol URO C628065 Nefrolithiasis ESWL WAN
M : WU,EW,WI,ANM,TR,SU,MK RR : FA,IM,SR MID : SAM,ST RR GRD : WD MID : PL SORE PROGRAM : NO,SF*,WU,AF,NI,BD,DA*,DM,DN,DY,HA,IS,WI,PS,MK,YS,PM,RG,RI,SE ALAT : PUR,
L : AN,AU,RE,BY,EA,MW,NH,RK,GI,VQ

NJAMIN
ISTEN
REKAM
MEDIS
GR 1 GA WA 12.00 13.30
120
GR 1 GA WA 14.00 120
GR 2 LA 09.00 09.20
GR 2 LA 09.30 09.45
GR 2 LA 10.00 10.30
GR 2 LA 11.00 11.30
GR 2 LA 12.00 12.30
GR 2 LA 13.00 13.30
GR 2 LA 14.00
GR 3 GA VL 07.20 07.30 09.30
GR 3 GA VL 10.00 120
GR 4 GA HN 07.00 07.15 11.00
GR 4 GA HN 11.30
GR 5 GA WA 07.00 07.15 10.30

120
GR 5 GA WA 11.00 180
DS 1 GA UB 07.30 08.00 09.30
DS 1 LA 10.00
DS 2 GA VL 08.00 08.30
DS 2 GA UB 09.00 09.30
DS 2 LA 10.00 10.30
DS 2 LA 11.00 11.30
DS 2 LA 12.00 12.30
DS 2 LA 13.00 13.20
DS 2 LA 13.30 13.45
DS 2 LA 14.00
DS 3 GA UB 07.30 08.00 09.30
DS 3 GA UB 10.00 11.30
DS 3 GA DN 12.00 12.30
DS 3 GA UB 13.00 13.30
DS 3 GA UB 14.00
DS LA 08.30
DS LA 10.30
DS LA 12.30
DS LA 14.30
DS LA 16.30
NI,BD,DA*,DM,DN,DY,HA,IS,WI,PS,MK,YS,PM,RG,RI,SE ALAT : PUR, CA ( S : YN )
RAL
ANESTESI
ROGRAM
ERSIHAN
DTG RIIL
anestesi
SERAH
RIMA
OK
OK
PENJAMIN
ASISTEN
REKAM
MEDIS
19 Rukayah Priv NPBI 8/24/1937 P P. GRD C632460 Mata Kiri Afakia Mata Kiri Sekunder Implant + Iris Claw Sensar 26 D AK YW,HR*
20 E Rini sukowati Priv NPBI 10/26/1973 P P. GRD C637799 Mata Kanan Glaukoma Juvenil Mata Kanan Trabekulektomi MR S :AH,AG, RI
21 E Rini sukowati Priv NPBI 5/1/1978 L P. GRD C594830 Mata Kiri CMV Retinitis Mata Kiri Injeksi Gancyclovir Intravitreal Cymeven 1 Vial DN
22 Yuliati VIP NPBI 30 th P GRD L4 C436049 Kista Endometriosis + PID Laparoscopy TF NP,RA
AL*,TM
23 Sri Djumikowarni 1 NPBI 57 th P GER L1 C624908 Gangren Pedis ec DM Amputasi Below Knee ETH TA,TU
24 Rukayin 3 PBI 45 th L R1B C633659 Ulkus Kronis Reg Cruris Pasca Rekonstruksi Debridement ETH
25 Jamiatun 3 NPBI 47 th P R4B C561898 Ca Cervix Post DJ Stent Aff DJ Stent WAN AY,SC ,PS
26 Nurul Azizah 1 16 th P Transit C641386 Pansitopenia BMP NYO
27 Malzuri 1 NPBI 57 th L KPD 1 C636427 Efusi Pleura Psg Pigtail THOM
28 Shezan Althafunnisa 3 NPBI 1 th 8 bln P Anak LD C641286 Susp Neuroblastoma BMP HER S : MW
29 Ryan Sanjaya 3 NPBI 33 th L R6B C641264 Infiltrat Nodul Cleans ( HIV +) Bronkoskopi FRD YR,JF
30 Musiri 3 NPBI 52 th L P. THT C612655 Ca Nasofaring NF + NBI DAT
31 Hemagita R 3 PBI 21 th L P. THT C602760 Ca Epidermoid Nasofaring NF WY
32 Musarofah 3 PBI 42 th P P. THT C606388 Ca Nasofaring NF + Ganti Kanul WY
33 Bambang Sayekti 3 PBI 59 th L R3B C629207 Massa Sinonasal Aff Tampon WY
34 Lufi Hendra 3 PBI 35 th L R1B C488968 Massa Sinonasal Aff Tampon WY
35 Nanik Dwi Wahyuni 1 NPBI 49 th P MRK 1 C641368 Observasi Jaundice ERCP C arm HRY GN,MR,US
36 Wedok 3 NPBI 46 th P P. Kand C623377 Ca Cervix St II a Colonoscopy PB
37 Nur Chasanah 3 45 th P R4A C593000 Adeno Ca Sigmoid Colonoscopy MG
38 Nur Wakid 3 NPBI 30 th L P. Uro C588321 Nefrolithiasis ESWL ADS AK
39 Agus Sulistiono 3 NPBI 55 th L P. Uro C596093 Nefrolithiasis ESWL MAS
40 Sujanah 3 NPBI 48 th P P. Uro C628191 Batu Renal Dextra ESWL MAS
41 Jahudi 3 NPBI 45 th L P. Uro C454189 Batu Renal ESWL MAS
M : WU,SE,NI,BD,DY,WI,RG RR : FA,IM,SR,SS MID : SAM,ST RR GRD : HA MID : PL SORE PROGRAM : NO,SF*,WU,AF,NI,BD,DA*,DM,DN,DY,HA,IS,WI,MF,MK,YS,PM,RG,RI,SE ALAT : PUR,
L : AN,AU,RE,BY,EA,EW,ANM,MK,NH,GI,SU,TR

PENJAMIN
ASISTEN
REKAM
MEDIS
RAL
DPJP ANESTESI
JAM PROGRAM
PEMBERSIHAN
JAM DTG RIIL
Jenis anestesi
J. SERAH
TERIMA
OK
OK
GR 2 LA 08.00 08.30
GR 2 LA 09.00 09.30
GR 2 LA 10.00
GR 3 GA DN 07.20 07.30
GR 4
GR 5 GA DS 07.30 08.00 09.30 120

GR 5 GA DS 10.00
120
DS 1 LA 07.30 08.00 09.00 60
DS 1 GA HS 09.30 10.00
DS 1 LA 10.30 11.00
DS 1 GA HS 11.30 30
DS 2 GA HS 07.30 08.00 08.30
DS 2 LA 09.00 09.20
DS 2 LA 09.30 09.45
DS 2 LA 10.00 10.30
DS 2 LA 11.00 11.20
DS 2 LA 11.30
DS 3 GA HS 07.20 07.30 09.00
DS 3 GA HS 09.30 10.30
DS 3 GA HS 11.00
DS LA 08.00
DS LA 09.30
DS LA 10.30
DS LA 12.00
NI,BD,DA*,DM,DN,DY,HA,IS,WI,MF,MK,YS,PM,RG,RI,SE ALAT : PUR, CA ( S : YN )
RAL
DPJP ANESTESI
JAM PROGRAM
PEMBERSIHAN
JAM DTG RIIL
Jenis anestesi
J. SERAH
TERIMA
OK
OK
PENJAMIN
ASISTEN
REKAM
MEDIS
SL,AL,AM,RE,BR,DM,DN,TK,VT,DJ,ES,HA,HR,HI,II,MR,SAM,TM,TW,VQ
M : NO,BD,DY,RG,SE,SU,NI SORE PROGRAM : ET,SA,AF,AG,AT,DB,EA,MY,PS,MW,YS,PM,RI,RM,WD

PENJAMIN
ASISTEN
REKAM
MEDIS
AL,AN,AU,AM,RE,DM,EA,MY,PS,SC,SAM,VQ
M : NO,ET,SA,AG,BR,DN,YS SORE PROGRAM : AT,TK,HA,DB,HI,IS,MW,PM,RI,RM,WD

HARI / TANGGAL : SENIN, 3 JULI 2017
PENJAMIN
ASISTEN
REKAM
MEDIS
SL,HE,UM,YS
EV, AS
Mikroskop, Bor
1 Fajar Sidiq 2 NPBI 2/7/1997 L Fastrack C640818 Perforasi Membran Tympani e.c Trauma Tympanoplasty Kiri THT, Tympano AYU AI,GI,ID
set
TW,SU
ET,ANM
AZ,RI
WU,DM
SF,AF
LW,BY,DY
2 Mariza Sultanah 2 NPBI 2/5/1996 P Fastrack C589011 Fr tibia Dextra ORIF BIN PR,DB
EN,MA,WD,BP
,SS,IM
RAL
RAL
RAL
9
8
7
6
5
4
2
1
JT
10
CT
OK
OK
OK
Jenis anestesi Jenis anestesi Jenis anestesi
GA
GA
DPJP ANESTESI DPJP ANESTESI DPJP ANESTESI
J. SERAH J. SERAH J. SERAH

TERIMA TERIMA TERIMA
JAM DTG RIIL JAM DTG RIIL JAM DTG RIIL
JAM PROGRAM JAM PROGRAM JAM PROGRAM
08.00
07.00
PEMBERSIHAN PEMBERSIHAN PEMBERSIHAN
OK OK OK
PENJAMIN
ASISTEN
REKAM
MEDIS
NK,HR,DW
YW,MY
NP,RE
AL,MW
TA,ER
AY,PM
YR,SC
GN,MR
AK
M : NH,EM,BD,EW,WI,RG,MK RR : FA,PS,SAM RR GRD : AH SORE PROGRAM : AP,AN,AU,AG,PM,AD,CA,DN,DI,DJ,EA,HA,HI,JF,TU,MF,NO,RA,SE,SA,ST,TM,TD,TR,US ALAT : PUR, YN
L : AR,AO,NI,AT,BR,TK,VT,ES,IS,II,ND,PL,RK,SR,VQ
RAL
DS
OK
DS3
DS2
DS1
GR2
GR 5
GR 4
GR 3
GR 1
Jenis anestesi
DPJP ANESTESI
J. SERAH
TERIMA
JAM DTG RIIL
JAM PROGRAM
PEMBERSIHAN
OK
RAL
OK
Jenis anestesi
DPJP ANESTESI
J. SERAH
TERIMA
JAM DTG RIIL
JAM PROGRAM
PEMBERSIHAN
OK
PROGRAM TAMBAHAN OPERASI ELEKTIF
HARI / TANGGAL : SELASA, 2 MEI 2017
PENJAMIN
OPERATOR
REKAM
NO NAMA PASIEN KLS TGL LAHIR L/P RUANG DIAGNOSA TINDAKAN Tamb Alat OK
MEDIS
53 E Didit 1 NPBI 1/5/1972 L MRK 1 C588726 Epilepsi temporal Sisnitra Kraniotomi Mikro Bedah Epilepsi ZM 2
54 Sutarni 2 NPBI 40 th P KPD D C601533 Makroadenoma Hipofise Craniotomi Transphenoid ZM 9
55 Aswin Satya Mahendra 1 NPBI 41 th L Elang 1 C603437 CHF NYHA II, e.c CAD 2 VD CABG SF JT
56 Lina Syifa 2 NPBI 12/31/2011 P Elang 1 C556046 VSD dg Caries dentis Ekstraksi Gigi DV 10
57 Kustiani Prawoto VIP NPBI 63 th P GRD L4 C633605 AP Perforasi Tympanoplasty Tympanoplasty ZUL 5
58 Adhia Reza 2 7 th L IGD C634819 Fr. Dentoalveolar + Avulsi Palatum Rekonstruksi fr Tl Wajah PJ 7
59 Sulimah 3 NPBI 12/31/1962 P R2A C634661 DVT Tungkai Kanan Embolektomi k/p Amputasi Above Knee AS
60 Abdur Rohman 3 NPBI L R2B C630239 Pseudoaneurisma Cruris Dextra Eksplorasi Evakuasi Cloth & Repair Arteri AS
61 Reisya Alsabita 3 NPBI P Anak 1 C633649 Susp Keganasan Hematologi BMP NYO DS 1
62 Budi Suroso 1 NPBI 39 th L KPD 1 C538181 Fistula Duodenum retaine Stone CBD ERCP PB DS 3
63 Ibarhim 1 NPBI L MRK 1 C078870 PSCBA EGD DI DS 2
64 Uti Soetinah VIP NPBI P GRD C412628 CKD Pemasangan NGT Freca WY DS 2
65 Nurodli 3 NPBI 52 th L R5A C634674 Massa Nasofaring C/ Ganas NF + NBI + NGT DS 2
66 Lasimin 2 NPBI 58 th L MRK D C634080 Hidropneumothorax Dx Repair WSD + Ganti Selang SFY 3
67 Damiah Priv NPBI P Merpati CKD St V Psg DL AS
68 Yatmi 1 NPBI 52 th P KTL C633064 CKd On HD AV Shunt AS
69 Subianto Priv NPBI L Merpati CKD Psg DL AS
70 Ngapinah Priv NPBI P Merpati CKD AV Shunt AS
71 Rifai Priv NPBI L Merpati CKD AV Shunt AS
72 Suyati Priv NPBI L Merpati CKD Psg DL AS
73 Zulfikar Priv NPBI L Merpati CKD Psg DL AS

HARI / TANGGAL : RABU, 3 MEI 2017
PENJAMIN
OPERATOR
REKAM
MEDIS
85 .Nur Khasanah VIP A 57 th P GRD L4 8972572 Tu Mammae Sin. Wide Excisi FS k/p MRM DWT
86 Ny.Cahyaningsih VIP A JKN 64 th P GRD L5 C569591 MfM Sin Wide Excisi + Skin Graf UUD
87 Shima Dwi Jayanti VIP A BPJS P GRD L6 C634985 Batu Ureter URS C Arm MAS
88 Heri Setiawan 38 th L KPD D 8966100 DVT V Tibia DX Embolectomi AS
89 Dwi Retno Asih 2 JKN 34 th P MRK D C611375 CKD Ligasi AV Shunt +Doble lument AS
90 Ahmad Mujiono 28 th L R 3B C631963 Post Amputasi Debridemant AS

PENJAMIN
OPERATOR
REKAM
MEDIS
85 Cahyaningsih VIP A NPBI 64 th P GRD L5 C569591 MFM Sin Wide Eksisi + Skin Graft UUD
86 Noor Khasanah VIP A NPBI 57 th P GRD L4 C558398 Tumor Mammae Sin Wide Eksisi + FS k/p MRM DWT
87 Shima Dwi Jayanti VIP A NPBI 31 th P GRD L6 C634985 Batu Ureter URS C Arm MAS DS
88 Hery Setiawan 2 NPBI 38 th L KPD D C545196 DVT V Tibia DX Embolektomi AS
89 Dwi Retno Asih 2 NPBI 34 th P MRK D C611375 CKD Ligasi AV Shunt + Double Lumen AS
90 Ahmad Mujiono 3 NPBI 28 th L R3B C631963 Post Amputasi Debridement AS
91 Hardiyanto Priv NPBI 58 th L Poli CKD Double Lumen AS

92 Subianto Priv NPBI 56 th L Poli CKD Double Lumen AS
93 Waryono Priv NPBI 56 th L Poli CKD Double Lumen AS
94 Rosmiati Priv NPBI 53 th P Poli CKD Double Lumen AS
95 Suligi Priv NPBI 56 th P Poli CKD Double Lumen AS
96 Sri Masmuni Priv NPBI 46 th P Poli CKD Double Lumen AS
97 Dwi Retno Priv NPBI 45 th P Poli CKD Double Lumen Long Term AS
98 Djumiah Priv NPBI 55 th P Poli CKD AV Shunt AS
99 Hariyati Priv NPBI 50 th P Poli CKD AV Shunt AS
100 Tuti Priv NPBI 45 th P Poli CKD AV Shunt AS
101 Suminah Priv NPBI 45 th P Poli CKD AV Shunt AS
102 Waras Priv NPBI 52 th P Poli CKD AV Shunt AS
103 Wiwik Priv NPBI 47 th P Poli CKD AV Shunt AS
HARI / TANGGAL : KAMIS, 4 MEI 2017
PENJAMIN
OPERATOR
REKAM
MEDIS
78 Lifditya Puri Rachmawati 2 NPBI 25 th P MRK D C231504 SOL Intracranium C/ Residif Craniotomi MTA 9
Endoskopi,
79 Mujiyatun 3 NPBI 42 th P R2A C616692 RSK Dg Polip Nasi FESS + Polipektomi
Rhinoset ANA
80 Sutrima 3 NPBI L R2B Wound Dehisence reg femur dextra By Pass Arteri AS
81 Muslim VIP NPBI 60 th L GRD L4 C086155 Disfagia LF + Psg NGT NGT Freca AYU DS
82 Siti Aminah 3 NPBI 44 th P R3A C626007 CKD Repair Double Lumen AS
83 Daryuni 50 th P Poli CKD AV Shunt AS
84 Sudarminah 57 th P Poli CKD Double Lumen AS
85 Yamini 50 th P Poli CKD AV Shunt AS
86 Damini P Poli CKD Double Lumen AS

HARI / TANGGAL : JUMAT, 5 MEI 2017
PENJAMIN
OPERATOR
REKAM
MEDIS
80 Alv Hamzan Tsany 2 NPBI 1 bl L Anak D C633502 Hernia Herniotomy EDW GR 1

81 Badriyatul Hidayah 3 NPBI 9/12/2007 P Anak D C634649 Bisitopenia BMP HER DS 1
82 Gito 3 NPBI 12/8/1963 L P. Bedah C477145 Stenosis Vena Tutup AV Shunt WW

HARI / TANGGAL : SENIN, 8 MEI 2017
PENJAMIN
OPERATOR
REKAM
MEDIS
81 Faisal Nur Afif 3 NPBI 13 th L Anak D C606588 Mata Kiri Massa Konjungtiva d.d Kista Derma Mata Kiri Eksisi Kista + Biopsi + PA 8
TL
82 Wielda Kartika Sari 2 NPBI 29 th P KPD D C295357 Localized Efusi Pleura Dextra Thoracoscopy ( VATS) WW
83 3 NPBI P R2A Meningioma Craniotomi Ds Tengkorak DP 9
84 Mugiono 3 PBI 44 th L R3B C282256 Trigeminal Neuralgia Dx Craniotomi MVD N.V MTA 9
85 Ahmad Al By Alkholifi 3 NPBI 1 th L Anak 1 C563847 Malformasi Vaskuler Bucal Sisi Dextra Rekonstruksi Lanjutan ETH
Plate
86 Mohtadin 3 NPBI 3/20/2000 L C635732 Fr. Parasymphisis Dextra Mandibula Rekonstruksi Fr. Tlg Wajah 7
Mandibula ETH
87 Maudziina Ardiana Sari 2 NPBI 12/31/2016 P IGD C627989 Hemangioma Labium Oris Superior Reduksi PJ 7
88 Nur Fauzi 3 NPBI 12 th L IGD C633179 Kontraktur Dermatogen Tipe Flexi Reg Cruris Release Kontraktur 7
PJ
89 Elawati 3 NPBI 21 th P R3A C635378 Fr. Dentoalveolar + Fr. Maxilla Lefort I Rekonstruksi Fr. Tlg Wajah PJ 7
90 Agus Wiryadi 2 NPBI 56 th L Elang 2 C623622 CAD 3 VD CABG SF JT
91 Mardiyah 3 NPBI 44 th P R3A C634050 Hemoroid Internal Gr III Hemoroidektomi MG 2
92 Kumarsi VIP NPBI 2/19/1964 L GRD L5 C414906 Stenosis Laring LD DAT
93 Sutarwi 1 NPBI 55 th L KTL C635203 Hematuria C/Tumor Buli Sistoskopi Evakuasi Cloth ADS DS 1
94 Toriyah 1 NPBI 55 th L MRK 2 C589859 Ureterolithiasis Dextra URS + DJ Stent MAS DS 1
95 Marfuati VIP NPBI 12/15/1969 P GRD L4 C633705 Ca Papiler Thiroid Total Thiroidektomi DWT
96 Rami 2 NPBI 62 th P Transit C635694 Ulkus DM Pedis Sinistra Amputasi Digiti III AS
97 Sulasih Priv NPBI P Merpati CKD AV Shunt AS

98 Riyatun Priv NPBI P Merpati CKD AV Shunt AS
99 Joko Waluyo Priv NPBI L Merpati CKD AV Shunt AS

PENJAMIN
OPERATOR
REKAM
MEDIS
77 Ruzaenah 1 NPBI 11/23/1954 P MRK 2 C631190 CKD St V Psg DL Longterm AS

78 Mardiyah 3 PBI P R2A C631327 CKD on HD Psg DL Longterm AS
79 Siti Jamilah 3 NPBI 67 th P R4A C524963 Efusi Pleura Dextra Psg WSD DWT
80 Ginem 2 NPBI 12/11/1960 P Ger C628762 CKD Psg DL Longterm AS
81 Mardi L Poli CKD AV Shunt AS
82 Harni P Poli CKD AV Shunt AS
83 Maemonah P Poli CKD Double Lumen AS
84 Kasmini P Poli CKD Double Lumen AS
85 Sumarti P Poli CKD Double Lumen AS
86 Waras L Poli CKD AV Shunt AS
87 Waryono L Poli CKD AV Shunt AS
88 Hardiatono L Poli CKD Double Lumen AS
89 Zerri Kadang Tolis 3 UM 7/1/1993 L R3B C634986 Meningitis Lumbal Pungsi RETNO

HARI / TANGGAL : JUMAT, 12 MEI 2017
PENJAMIN
OPERATOR
REKAM
MEDIS
62 Muhamad Fathin Patkar 3 NPBI 15 th L Elang 1 C590230 ASD ASD Closure SF JT

63 Soeparti 2 NPBI 56 th P MRK D C628980 SNNT Sub Total Thiroidektomi + FS, Ganas TT DWT 6
64 Mexiatlia Setiawati VIP NPBI 2/27/1967 P GRD L6 C085560 Limfadenopati Limfadenectomy Biopsi UUD 9
65 Falih Ubaidillah 1 NPBI 1 th L Anak D C622541 Hidrocephalus VP Shunt GK 9
Mata Kanan Obstruksi Ductus Naso
66 Ariyadi 1 NPBI 54 th L KPD 1 C579066 Mata Kanan Endo DCR
Lakrimalis INA + RH
67 Mustianah 3 NPBI 65 th P R3A C223556 Mata Kiri Endoftalmitis Eksogen Post Operatif Mata Kiri Eviserasi Bulbi + DFG
DN
68 Munasarotul K 3 NPBI 1/18/1971 P R3A C595326 LNH Tonsil Ekstirpasi Massa TE Deseksi WY 1
69 Wahyu Trijotho VIP NPBI 3/15/1968 P GRD L4 C636010 Cholelithiasis ERCP MG DS 3
70 Muh Arkan Nizar 3 NPBI 8/2/2008 L Anak D C625094 ALL BMP HER GR
71 Oka Giang Fahreza 3 NPBI 14 th L Anak 1 C630890 ALL Post Kemo BMP Evaluasi MOED GR
72 M Ridho Maulana 3 NPBI 4 th L Anak 1 C635998 Susp Keganasan Hematologi BMP MOED GR
73 Handa Mardiansyah 2 NPBI 34 th L MRK D C587156 Hipertensi Porat EGD HRY DS 2
74 Djatmika 1 NPBI 7/18/1968 L MRK 2 C574940 CKD AV Shunt ALI 3
75 Lastri 1 NPBI 37 th P MRK 2 C597882 Myastenia Gravis Psg DL Long Term WW 3
76 Yusuf Wibowo 2 NPBI 58 th L Transit C624386 CKD St V on HD Psg DL Long Term AS 3

HARI / TANGGAL : SENIN , 15 MEI 2017
PENJAMIN
OPERATOR
REKAM
MEDIS
68 Sumarti 1 NPBI 41 th P Elang 1 C606440 MS Severe + TR Severe MVR SF JT

69 Kusmiatun 2 NPBI 41 th P KPD D C6372220 Clinoid Meningioma Craniotomi Ds Tengkorak DP
70 Sri Pujiati VIP NPBI 7/28/1971 P GRD L5 C636130 Kista Ovarii Laparotomi + FS EW 2
Mata Kanan Steroid Induced Glaukoma, Mata
71 Andrius Budi Darminto 3 PBI 20 th L R5A C623003 Mata Kanan Kiri Cyclocryotherapi
Kiri Glaukoma Absolut MR
72 Gaozhan Tristan P 1 NPBI 1 th L MRK D C560590 Stenosis Trakhea LD + Dekanulasi DAT
73 Isnanto 3 NPBI 28 th L R2B C636219 Disfagia Esofagus e.c Striktur Esofagus LF DAT
74 Yulita Hartini VIP NPBI 7/30/1962 P GRD L5 C397828 Cholesistolithiasis Laparoskopi Cholesistektomi MG
75 Giyanto VIP NPBI L GRD L5 C636558 Hematoschezia, Anemia Berat Colonoscopy DID
76 Heri Setiawan 2 NPBI 46 th L KPD D C545196 CKD St V On HD Embolektomi AS
77 Tjasidi VIP NPBI 65 th L GRD L4 C636180 Ulkus Debridement k/p Amputasi AS
78 Mirza Ali 3 NPBI 12/7/2006 L Transit C636406 Sindroma Vena Cava BMP NYO
79 Nabila Zulfa 3 NPBI 8/11/2009 P Anak 1 C635989 BMP, Keganasan Hematologi BMP
80 Mufid Mu'tazin VIP NPBI 5/8/2012 L GRD L3 C636503 Susp Keganasan Hematologi BMP NYO
81 Malik Athalla Nasyit 2 NPBI 5/25/2009 L Transit C636303 Susp Keganasan Hematologi BMP HER
82 By Ny. Munani 2 NPBI 4/10/2017 P PBRT C632174 Dislokasi Pemasangan Gips

83 Sudirman 3 NPBI 58 th L R1B C634880 Mata Kanan POAG, Mata Kanan Kiri KSI Mata Kiri Trabekulektomi MR
84 Tri Endang Kurniasih VIP NPBI 7/26/1959 P GRD L3 B225769 Ca Cervix, CKD HN Repair DL AS
85 Yusuf Wibowo 1 NPBI 58 th L KPD D C624386 CKD St V On HD Psg DL Longterm AS
86 M Muntholib VIP NPBI 12/18/1971 L GRD L6 C402770 CKD St V On HD AV Shunt AS
87 Yusuf 2 NPBI 58 th L KPD D C624386 CKD St V On HD Psg DL Longterm AS
88 Sulasih Priv NPBI 58 th P P. Merpati CKD St V On HD Psg DL Longterm AS
89 Misriyah Priv NPBI 56 th P P. Merpati CKD St V On HD AV Shunt AS
90 Suroyo Priv NPBI 56 th L P. Merpati CKD St V On HD Psg DL Longterm AS
91 dr Bachtin Priv NPBI 82 th L P. Merpati CKD St V On HD Psg DL Longterm AS
92 Tri Cahyo Priv NPBI 41 th L P. Merpati CKD St V On HD Psg DL Longterm AS
93 Tri Endang VIP NPBI 57 th P GRD L3 B225769 CKD St V On HD Psg DL Longterm AS

HARI / TANGGAL : SELASA , 16 MEI 2017
PENJAMIN
OPERATOR
REKAM
MEDIS
79 M Hafizh Arfaditya VIP Um 10 bl L GRD L3 C635927 Hernia Inguinalis Lateral Dextra Laparoskopi Herniotomi PTY 2
80 Heri Setiawan 2 NPBI 46 th L KPD D C545196 CKD St V On HD Embolektomi AS
81 Djumadi 2 NPBI 58 th L Transit C575808 CKD Psg DL Longterm AS 3
82 Totok Karnoto Priv NPBI 56 th L Merpati CKD Psg DL Longterm AS 3
83 Hadiatomo Priv NPBI 56 th L Merpati CKD AV Shunt AS 3
84 Maemonah Priv NPBI 58 th P Merpati CKD Psg DL Longterm AS 3
85 Khosimah Priv NPBI 55 th P Merpati CKD AV Shunt AS 3
86 Ropiah Priv NPBI 32 th P Merpati CKD Psg DL Longterm AS 3

HARI / TANGGAL : RABU , 17 MEI 2017
PENJAMIN
OPERATOR
REKAM
MEDIS
72 Novita Sari 3 NPBI 19 th P R1A C635293 Fr Cervical Fusi Anterior + Laminektomi ADD + AJ 9
73 Janti Mariana VIP NPBI 8/7/1947 P GRD L5 C636942 Otitis Media Efusi Insersi Gromet Opmic AYU
74 Djumadi 2 NPBI 58 th L Transit C575808 CKD Psg DL Longterm ALI DS 1

75 Budi Santoso 2 NPBI 49 th L MRK D C636896 Laringitis Kronik c/ TBC LF FAR
76 Suratno 2 NPBI 61 th L MRK 1 C349354 Observasi Disfonia LF FAR

HARI / TANGGAL : KAMIS , 18 MEI 2017
PENJAMIN
OPERATOR
REKAM
MEDIS
59 Rami 1 NPBI 62 th P MRK D C635694 Ulkus Pedis Dextra Debridement Luas AS
60 Wiwik Widowati 1 NPBI 48 th P MRK 2 C225653 CKD on HD Repair Dobel Lumen AS

61 Suharwito Priv 60 th L Merpati CKD on HD AV Shunt AS
62 Wardi Priv 60 th L Merpati CKD on HD Psg DL AS
63 Sumiati Priv 55 th P Merpati CKD on HD Psg DL AS
64 Legiman Priv 50 th L Merpati CKD on HD Psg DL AS
65 Suharyati Priv 60 th P Merpati CKD on HD Psg DL AS
66 Heri Ismulyanto Priv 55 th L Merpati CKD on HD Psg DL AS
67 Walijah Priv 62 th P Merpati CKD on HD Psg DL AS
68 Pujiono Priv 55 th L Merpati CKD on HD Psg DL AS
69 Immacukalata Priv 50 th Merpati CKD on HD Psg DL AS
70 Nur Chamidi Priv 60 th L Merpati CKD on HD AV Shunt AS
71 Suprihartini Priv 50 th P Merpati CKD on HD AV Shunt AS
72 Nur Chemisah Priv 59 th P Merpati CKD on HD AV Shunt AS
Wiwik 1 40 th P MRK 2 CKD on HD Psg DL Longterm AS

HARI / TANGGAL : SENIN , 22 MEI 2017
PENJAMIN
OPERATOR
REKAM
MEDIS
59 Sukini 3 NPBI 51 th P R2A C624885 Meningioma Clinoid Sinistra Craniotomi Mikro Ds Tengkorak DP 9
60 Siti 3 NPBI 57 th P R4A C637152 SOL Cerebellum Craniotomi + IOM DP + MTA 9
61 Murdiansyah 3 NPBI 69 th P Elang 1 C605001 CAD 3 VD + MI Severe CABG SF JT
62 Zakiyah 1 NPBI 15 th P Elang 1 B356541 PDA Ligasi PDA SF JT
63 Faradilla Shandradewi 1 NPBI 22 th P KPD D C625467 Stiffnes Pasca Avulsi ACL Rekonstruksi Stiff Knee Artroscopy DID
64 Siti Kodriyatun 2 NPBI 47 th P KPD D C322089 Obs Hoarness LD + Ekstirpasi DAT
65 Naning Yuningtik 1 NPBI 6/27/1955 P KTL C609248 Ca Sinonasal Trakeostomi + Psg NGT Freca DAT
66 Tri Gunarni VIP NPBI 9/17/1967 P GRD L4 C637374 Tumor Mamae Eksisi + FS k/p Mastektomi BIS
67 Kiswanto 2 NPBI 3/7/1989 L KPD 1 C632084 SCC Wide Eksisi DWT
68 Agung Yuhono 1 NPBI 41 th L KPD 1 C633529 Ameloblastoma Residif Total Mandibulektomi DWT
69 Ahmad Taryono VIP NPBI 8/2/1964 L GRD L4 C322937 Soft Tissue Tumor Wide Eksisi Multiple DWT
Endoskopi ,
70 Syaekhah Affah 3 NPBI 5/14/2001 P Anak D C617976 RSK + SD + Konka Hipertropi + Adenoid FESS + SR + Konkotomy + Adenektomi
FESS, TE ANA
71 Feri Hardin Bukhori 3 NPBI 43 th L R2B C637223 Mata Kanan Ulkus Kornea Perforasi Mata Kanan Eviserasi Bulbi + DFG DN 8
72 Zainal Abidin 3 NPBI 62 th L R1B C637706 Plegmon Dasar Mulut Evakuasi Abses + Odontektomi DV
73 Henni Puji Astuti 2 NPBI 1/24/2003 P Transit C563213 MDS BMP HER
74 Fatkhun Najah 3 NPBI 7/24/2002 L Anak D C490537 Susp Keganasan Hematologi BMP HER
75 Naufal Eki Alfariz 3 NPBI 3/21/2005 L Anak 1 C637510 Susp Keganasan Hematologi BMP HER
Mata Kanan Kiri PDR, Mata Kiri Glaukoma
76 Darmadi 3 PBI 47 th L R3B C591613 Mata Kiri Trabekulektomi
Sekunder MR
77 Fahrul Faizul Niam 3 NPBI 17 th L Anak 1 C637463 Tetraparese Flacid d.d TB LP TRI
78 Tatiek Samsudiyati 1 NPBI 53 th P MRK 2 C389604 CKD On HD Psg DL AS
79 Luhur Soedijat 1 NPBI 71 th L KTL C466312 CKD on HD Psg DL ALI
80 Rudiasih P Poli CKD AV Shunt AS
81 Rukati P Poli CKD Double Lumen AS
82 Leginah P Poli CKD Double Lumen AS
83 Bandiyah P Poli CKD AV Shunt AS
84 Ponirah P Poli CKD Double Lumen AS
85 Warinem P Poli CKD Double Lumen Longterm AS
86 Miyati P Poli CKD AV Shunt AS
87 Wardi L Poli CKD Double Lumen AS
88 Elsa P Poli CKD AV Shunt AS
89 Fasicha P Poli CKD Double Lumen AS

HARI / TANGGAL : SELASA , 23 MEI 2017
PENJAMIN
OPERATOR
REKAM
MEDIS
74 Anang Ferdiyanto Priv NPBI 12 th L P. Bdh C628011 Coxitis TB Aff K Wire + Aff Gips BIN DS 2
75 Janadi 1 NPBI 46 th L P. Mata C620430 Mata Kanan Pseudofakia Mata Kanan Buka Jahitan WIS 3
76 Lestari 30 th P Poili CKD AV Shunt AS
77 Supardi 50 th L Poli CKD AV Shunt AS
78 Supeno 55 th L Poli CKD AV Shunt AS
79 Taufik 45 th L Poli CKD AV Shunt AS
80 Dwi Susanto 45 th L Poli CKD Doble Lument AS

HARI / TANGGAL : RABU , 24 MEI 2017
PENJAMIN
OPERATOR
REKAM
MEDIS
81 Agung Yuhono 1 NPBI 41 th L KPD 1 C633529 Sarcoma Rongga Mulut Total Mandibulektomi + Tracheostomy DWT 6
82 Endang Sulastri VIP NPBI 6/21/1967 P GRD L6 C622883 Tu Mamae Sinistra Wide Eksisi + FS, Ganas BCS DWT 6
83 Sri Aniyah VIP NPBI 2/15/1957 P MRK 2 C637089 Dispepsia, HT EGD HRY DS 3
84 Supandi 3 PBI 12/14/1955 L IGD C612157 C aLaring Pasca Laringektomi Ganti NGT DAT DS 2
85 Sarwono 3 12/11/1972 L IGD C611500 CKD St V Psg DL AS
86 Markani 3 NPBI 64 th L IGD C638102 CKD St V Repair DL AS
HARI / TANGGAL : JUMAT , 26 MEI 2017
PENJAMIN
OPERATOR
REKAM
MEDIS
71 Khusnul Amrin 1 NPBI 12 th L Elang 1 C275310 PS Valvular PFO Tutup PFO, Reseksi PS SF JT
72 Luna Syifa Ulan Aulia 1 NPBI 5 th P Elang 1 C556046 VSD PMD VSD Closure SF JT
73 Muhlis 3 NPBI 24 th L R2B C637675 EDH Craniotomi AJ 9
74 Suparmi 3 NPBI 50 th P R5B C637618 Hidronefrosis Bilateral CKD on HD PNS Open Nefrostomi usg, Carm MAS
Ureterolithiasis Post Laparoskopi
75 Mamik K 3 NPBI 44 th P R2A C625513 Revisi DJ Stent URS, C Arm
Ureterolitotomi MAS
76 Nur Roichanah 2 NPBI 11/29/1949 P KPD D OA Genu TKR Fastrack BIN 10
77 Dea Amelia 3 NPBI 14 th P Anak D C618163 Massa Dorsum Nasi Ekstirpasi Massa WY
78 Siti Nur 3 NPBI 15 th P R2A C635942 Tumor Hepar C/ HCC Laparoskopi Biopsi PTY
79 Ahmad saifudin 3 NPBI 4/11/2000 L Anak D C635467 Massa Sinonasal Aff Tampon Anterior WY
80 Nurul Qomar 3 NPBI 49 th L R2B C608333 CKD Psg DL Longterm AS

81 Teguh 1 NPBI L KTL PSCBA EGD HRY DS
82 Nasikum 3 NPBI L Lesi Orofaringeal NF DAT DS
83 Siti Maharajoe VIP NPBI P ICU GRD C054667 Bronkopnemonia Bronchial Toilet FTR ICU
84 Dwi Khamid 60 th L Pol Privat CKD Double Lumen AS
85 Bandriyah 50 th P Pol Privat CKD Repair AV Shunt AS
86 Fitrianto L Pol Privat CKD Double Lumen AS
87 Supardi 50 th L Pol Privat CKD Double Lumen AS
88 Suradji 58 th L Pol Privat CKD AV Shunt AS
89 Rizki 40 th Pol Privat CKD AV Shunt AS
90 Nurul Qomar R2B CKD Double Lumen Long Term AS

HARI / TANGGAL : SABTU, 27 MEI 2017
PENJAMIN
OPERATOR
REKAM
MEDIS
22 Aldila Mareta 1 NPBI 23 th P MRK 1 C535721 CKD Pasang CAPD ADS 1

23 Oktavia Kurniasari VIP NPBI 29 th P GRD L3 C267267 G2P1A0 Hamil Aterm Bekas SC SCTP + MOW ER 2
24 Marsini 3 NPBI 49 th P R6A C636979 SOL Reg Thalamus Craniotomi DP 9
25 Mujiati 1 NPBI 43 th P KTL C637471 Meningioma Craniotomi Konveksitas ER 10
26 Luna Syifa 2 NPBI 5 th P Elang 1 C556046 VSD PMO + MSA VSD Closure SF JTG
27 Saryati 2 NPBI 65 th P IGD C638426 Mata Kiri Endoftalmitis Post Operatif Mata Kiri Injeksi AB IVT DN 3
28 Wasupi 3 NPBI 68 th L R2B C638394 Mata Kanan Endofthalmitis Post Operatif Mata Kanan Injeksi AB IVT DN 3
29 Saroni 2 NPBI 62 th L GER D C345028 Fraktur OS Pasang Gips BIN 5
30 Wagiyo 3 NPBI 59 th L R2B C636955 Laringitis Kronis Spesifik LF FAR DS 2

HARI / TANGGAL : SENIN, 29 MEI 2017
PENJAMIN
OPERATOR
REKAM
MEDIS
68 Latifah Hanum 1 NPBI 49 th P KPD LD C628937 Mioma Uteri TAH EW

69 Lila Setiawati VIP NPBI 20 th P GRD L6 C638414 Appendicitis Laparoscopy Appendiktomi k/p Open MG
70 Ani Setyowati 1 NPBI 58 th P KPD LD C630281 Ca Sinonasal Maksilektomi WY
71 Kholifah 3 PBI 55 th P R2A C636413 Abses Cerebri Dx Craniotomi HY 9
72 Sukirno 3 NPBI 51 th L R1B C628471 Stenosis L4-5 Laminektomi HY + AJ 9
73 Ilham Ramadhan 3 NPBI 18 th L Elang 1 C235001 MR Severe, TR Severe DVR SF JTG
74 Kartika Setiawati VIP Um 61 th P GRD L6 C637947 Ca Mamae Sin Insisi + Core Biopsi DH GRD
75 Ramto 1 NPBI 64 th L KPD L1 C636950 Obstruktif Jaundice ERCP HRY DS 3
76 Jupriyadi VIP NPBI 64 th L GRD L5 C637825 Ulkus Selulitis Insisi Drainase + Debridement Luas AS
77 Santoso Aribowo 1 NPBI 53 th L KPD L1 C637477 Ulkus DM Pedis Sin Debridement AS
78 Masiyo 3 NPBI 81 th L R2B C638377 POAD Debridement k/p Amputasi AS
79 Bambang Priv NPBI 59 th L Poli Priv CKD Psg Double Lumen AS

80 Januari Priv NPBI 50 th L Poli Priv CKD Psg Double Lumen AS
81 Heri Kuswanto Priv NPBI 50 th L Poli Priv CKD Psg Double Lumen AS
82 Hakim Jepara Priv NPBI 40 th L Poli Priv CKD Psg Double Lumen AS
83 Zubaedi Priv NPBI 32 th L Poli Priv CKD Psg Double Lumen AS
84 Fatimah Priv NPBI 40 th P Poli Priv CKD Psg Double Lumen AS

HARI / TANGGAL : SELASA, 30 MEI 2017
PENJAMIN
OPERATOR
REKAM
MEDIS
65 Noor Arifin VIP NPBI 29 th L GRD L4 C638696 SNNT Isthmolobectomy + FS k/p TT DWT 1
66 Tinyem VIP NPBI 49 th P GRD L4 C512538 Ikterik Obstruktif Biliodigestiv Shunting ERI 5
67 Jumini 3 NPBI 33 th P R4B C637623 Ruptur Buli, Ascites Laparotomi Eksplorasi Repair Buli MAS CITO
68 Hartatik 2 NPBI 9/11/1967 P Transit C543398 Ascites Permagna, Ca Mamae st IV Drainage Ascites DWT
69 Suparna 1 NPBI KTL CKD Psg DL AS
70 Chamidah 3 NPBI P. Merpati CKD Psg DL AS
71 Elya 3 NPBI P P. Merpati CKD AV Shunt AS
72 Supardi 3 NPBI L P. Merpati CKD Psg DL AS
73 Kosimah 3 NPBI P P. Merpati CKD Psg DL AS
74 Badriyah 3 NPBI P P. Merpati CKD Psg DL AS
75 Sujak 3 NPBI P P. Merpati CKD Psg DL AS
76 Immaculata 3 NPBI P P. Merpati CKD Psg DL AS

PENJAMIN
OPERATOR
REKAM
MEDIS
87 Agus Minarto 1 NPBI 65 th L KPD 1 C637702 Retensio Urine TMP Prosedur MAS
88 Koriah 3 NPBI 58 th P R2A C633341 Spondilolithesis L3 - L4 - L5 PSRS C Arm HY/AJ 9

PENJAMIN
OPERATOR
REKAM
MEDIS
72 Adelliya Intan Ariana 3 NPBI 5 th P Elang 1 C321273 VSD VSD Closure SF JT

73 Rahma Devia Fitriyah 3 NPBI 7 th P Elang 1 C578491 PDA Ligasi PDA SF JT
Opmic,
Jarum spinal,
74 Hiendarto 1 NPBI L MRK 1 C636629 OME Telinga Kiri Insersi Gromet (dr. Ferdi 08881332165 )
Tympanoplas
ty set
AYU
75 Thohir 2 NPBI 26 th L MRK D C638601 Nekrosis Digiti II - IV Manus Dextra Amputasi BIN
76 Rohmat Shofie 1 NPBI 68 th L MRK 1 C234829 Dislokasi Elbow Joint Reposisi Tertutup dg Carm APR 10
77 Dwi Agustina Arini 2 NPBI 26 th P Obstetri C639094 SC ER GR 2
78 Novita Agung Prameswari VIP NPBI 35 th P GRD L3 C615849 G3P2A0 Bekas SC SC + MOW ER GR 2
79 Sri Pangesti VIP NPBI 2/26/1958 P GRD L5 C601320 Mata Kiri Vitreus Hemorage Mata Kiri Vitrektomi + Endolaser AL 8
80 Siti Nurhidayah VIP NPBI 11/11/1969 P GRD L5 C466051 Perdarahan Per Vaginam Kuretage DC
81 Yusro Fadhil 3 NPBI 1/7/2001 L Anak 1 C638975 Susp Keganasan Hematologi BMP NYO DS 2
82 Syakila Inara Putri 3 NPBI 9/19/2015 P Anak D C638201 Susp Keganasan Hematologi BMP NYO DS 2
83 Pravita Ani Astuti 1 NPBI 12/18/1986 P Kenari C638296 Susp ME LP Suryadi DS 3

84 Khadijah VIP NPBI 8/15/1950 P GRD L4 C367674 Acites, Hipertensi Porta EGD HRY DS 3
Mata Kanan Primary Angle Glaukoma +
85 Nurul Qomariyah 1 NPBI 67 th P Transit C635938 Mata Kanan Trabekulektomi 3
Pseudofakia MR
Mata Kanan Katarak Traumatika + Glaukoma
86 Kastolani 3 NPBI 47 th L R3B C639075 Mata Kanan EKIK + Vitrektomi Anterior 3
Sekunder RF

PENJAMIN
OPERATOR
REKAM
MEDIS
64 Sujinah 3 NPBI 44 th P Elang 1 C604103 MI + AI MVR + AVR SF JT

65 Kuswati 3 NPBI 51 th P R2A C627373 Meningioma Craniotomi Mikro Ds Tengkorak DP 9
66 Suwarno 3 NPBI 59 th L R2B C631692 Spondilosis Laminektomi + Fusi Posterior AJ + HY 9
67 Suhri 3 NPBI 53 th L R1B C621273 Adenohipofise Transphenoid MTA 9
68 Lagi 3 NPBI 56 th L R6B C635019 Efusi Pleura Dextra Loculated Thorakotomi ALI 1
69 Wasmuri 3 NPBI 50 th L R1B C638633 Compartement Syndrome Eksplorasi Vaskuler, Tromboembolektomi AS
70 Pravita Afi Astuti 1 NPBI 12/18/1986 P Kenari C638296 Susp Meningoencephalitis LP Suryadi
71 Muhamad Adnan 1 NPBI 4/24/2001 L Anak D C639051 Susp Keganasan Hematologi BMP NYO DS 2
72 Ernest Timothy C 2 NPBI 8 th L KPD D C638966 Fr Fissure Intercondyler Humeri Sinistra Pemasangan Gips DRY
73 Tri Endang Kurniasih VIP NPBI 7/26/1959 P GRD L3 B225769 Ca Cervix, CKD, HN Bongkar Psg DL AS
Chest Tube
74 Monsiti 2 NPBI 12/12/1974 P Transit C277561 Atelektasis Paru Dextra Psg WSD
no 28 ALI
75 Sri Hartini 3 NPBI P R3A C356661 Adeno Ca Sinonasal Post Maxilektomy Aff Tampon Anterior DAT
76 Soemadi 1 NPBI L KPD 1 C152365 Ca Laring Psg NGT Freka DAT
77 Soemadi 1 NPBI L KPD 1 C152365 Ca Laring Psg NGT Freka DAT
78 Mahmudah Priv NPBI 45 th P Poli CKD Psg Double Lumen AS

79 Rina Priv NPBI 50 th P Poli CKD Psg Double Lumen AS
80 Rosmiyati Priv NPBI 50 th P Poli CKD Psg Double Lumen AS
81 Setyoningsih Priv NPBI 58 th P Poli CKD Psg Double Lumen AS
82 Sutarmi Priv NPBI 55 th P Poli CKD Psg Double Lumen AS
83 Hakim Priv NPBI 50 th L Poli CKD Psg Double Lumen AS
84 Jarwani Priv NPBI 55 th L Poli CKD Psg Double Lumen AS
85 Yuda Priv NPBI 25 th L Poli CKD Psg Double Lumen AS
86 Sarifudin Priv NPBI 42 th L Poli CKD Psg Double Lumen AS
87 Titus Priv NPBI 40 th L Poli CKD Psg Double Lumen Long Term AS
88 Siti Masfuah Priv NPBI 45 th P Poli CKD Psg Double Lumen + AV Shunt AS
89 Rukati Priv NPBI 50 th P Poli CKD AV Shunt AS
90 Ismoyo Priv NPBI 50 th L Poli CKD AV Shunt AS
91 Zubaedi Priv NPBI 32 th L Poli CKD AV Shunt AS

PENJAMIN
OPERATOR
REKAM
MEDIS
59 Suratno VIP NPBI 7/27/1959 L GRD L4 C634144 Osteosarcoma Amputasi Trans Femoral APR 10
Pedicle
Screw 8, Nut
60 Marjuki 2 NPBI 59 th L MRK D C455430 Spondilosis Lumbalis Laminektomi + PSRS AJ 8
8, Crosslink
1 Rod 2
61 Leonora Flora Rebecca Kip 1 NPBI 71 th P MRK 1 C639070 SOL Bronkoskopi THOM DS 3
62 Carisa Efris Anindita 2 NPBI 4/25/2017 P HCU C638504 Susp Infant Leukimia BMP HER
63 Gunarto ICU NPBI 4/2/1954 L ICU GRD C512858 Bronkopneumonia Broncial Toilet FTR
64 Siti Marrahajoe ICU NPBI 6/1/1934 P ICU GRD C654667 Pneumonia, Bronkokonstriksi Broncial Toilet FTR
65 Ruth Nurwahyuningsih 1 NPBI 55 th P P. Bedah C479753 CKD St V AV Shunt WW DS 2

66 Chotidjah VIP NPBI 7/27/1948 P GRD L5 C579391 CKD Psg DL WW DS 2
67 Suradal 1 NPBI 58 th L MRK L2 C611930 CKD Psg DL AS

68 Ibrahim 3 NPBI 60 th L Poli CKD Psg DL AS
69 Sunaryo 3 NPBI 58 th L Poli CKD AV Shunt AS
PENJAMIN
OPERATOR
REKAM
MEDIS
80 Fairuz Khilfi Al Bahij NPBI 4 th L Transit C639431 Susp ALL BMP HER DS
81 Sumiyati VIP NPBI 7/26/1966 P GRD L5 B198269 Batu Ureter ( UPJ ) dextra URS + DJ Stent MAS DS
82 Jaminah 3 NPBI 62 th P Obstetri C555782 Mal Fungsi DJ Stent Repair DJ Stent Sinistra, Sistoskopi MAS DS
83 Siti Cholifah VIP NPBI 12/4/1971 P GRD L4 C586680 Tu Mamae Sinistra Wide Eksisi DWT
84 Uswatun Chasanah VIP NPBI p GRD L3 G3P2A0, Bekas SC SC DC GR 2
PENJAMIN
OPERATOR
REKAM
MEDIS
75 Dr. Suprijono SpOG VIP NPBI 7/19/1948 L GRD L4 C541889 Adeno Ca Colon Pasang Chest Port WW DS 1
76 Jumilatun VIP NPBI 4/15/1958 P GRD L4 C639903 Tumor Mamae sinistra Eksisi Biopsi + PA DWT
77 Fairuz Khilfi 2 NPBI 4 th L Anak D C639431 Susp ALL BMP HER
PENJAMIN
OPERATOR
REKAM
MEDIS
73 Sugeng Suprapto 1 NPBI 47 th L KPD 1 C613598 Batu Ginjal Aff DJ Stent + ESWL Fastrack MAS DS1
74 Artini Supridayah 2 NPBI 9/24/1954 P Transit C425346 PSCBA EGD HRY DS 2
75 Wainah 3 NPBI 57 th P Ger D C569968 CKD St V On HD Psg DL ALI

PENJAMIN
OPERATOR
REKAM
MEDIS
70 Indahwati 1 NPBI 58 th P Obstetri C243370 Wound Dehisence Riw TAH + BSO Repair Wound Dehisence MZ 4
71 Endang Purwati 3 NPBI 59 th P R2A C476029 IDC Gr II MS, TxN2aMo Post MRM Diseksi Axilla + Limfadenektomi Colli DWT 6
72 Karsini 3 NPBI 49 th P R2A C638381 Hidrocephalus VP SHunt HY 8
73 Mutmainah Setyo L 1 NPBI 46 th P MRK L1 C083919 Multiple SOL VP Shunt GK 8
74 Sri Hayati 1 NPBI 55 th P MRK L1 C637968 SOL Craniotomi ER 8
75 Sri Minatun 1 NPBI 50 th P MRK L1 C625998 Meningioma Craniotomi Dasar Tengkorak DP 9
76 Kenya Kenesti 3 NPBI 7 th P Anak LD C621402 CCF Ligasi Carotis Eksterna MTA 9
77 Hartono Hadi Abidin 1 NPBI 65 th L Elang L1 C624733 CAD 3 VD CABG SF JTG
78 Musnad 1 NPBI 57 th L MRK L1 C639944 Ulkus Pedis Dx Debridement k/p Amputasi ALI
79 Masiyo 3 NPBI 81 th L R2B C638377 POAD Amputasi Pedis AS
80 Dzaka Putra Ardhani 3 NPBI 1 th 9 bln L Anak L1 C640233 Kejang Demam Kompleks Lumbal Pungsi TUN
81 Gunarto 1 NPBI 63 th L ICU GRD C512858 BRPN Bronchial Toilet FTR DS
82 Tumaroh 3 NPBI 34 th P R4A C638871 Tumor Mediastinum Bronkoskopi AVIS DS
83 Ainur Rofiq 2 NPBI 50 th L MRK LD C633596 Hemangioma Laring LF FAR DS
84 Henny Ekajanti 2 NPBI 65 th P Elang L1 C635767 CHF Nyha Pasang CVP AI
85 Galih Mudi Nugroho 3 NPBI 24 th L R2B C640076 CKD Pasang Double Lumen AS
86 Suryani 2 NPBI 64 th P IGD CKD on HD Pasang Double Lumen AS

OPERATOR
PENJAMIN
REKAM
MEDIS
80 Ubaidir Rohman VIP Um 13 th L GRD L3 9030574 Labioskitis Labioplasty NJT 7

81 Solikin VIP NPBI 51 th L GRD L4 C579845 Soft Tissue Tumor Wide Eksisi + PA DWT
82 Josephinne Wahjuni 1 NPBI 74 th P KPD L1 C640288 DVT Embolektomi AS
83 Darmaji 3 NPBI 40 th L R3B C628932 Meningitis Lumbal Pungsi

84 Shopiyah IRIN NPBI 50 th P HCU C315405 CKD on HD Pasang Double Lumen AS
85 Dhasto Nugroho 3 NPBI 49 th L R6B C476352 CKD on HD Pasang Double Lumen AS

OPERATOR
PENJAMIN
REKAM
MEDIS
90 By. Ny. Suprihati 2 NPBI 5/30/2017 L PBRT C639369 SOL Parieto Temporo Occipital Sinistra Craniotomi Biopsi MTA
91 Ita Ulya VIP NPBI 6/26/1984 P GRD L5 C640638 Limfadenopati Colli Limfadenectomy DWT
92 Josephine Wahjuni 1 NPBI 74 th P KPD 1 C640288 DVT Embolektomi AS
93 Yayuk 1 NPBI 32 th P KPD 1 C626297 Sirosis Hepatis EGD HRY

OPERATOR
PENJAMIN
REKAM
MEDIS
74 Hariyanto 2 NPBI 34 th L Transit C637871 Hidrocephalus e.c tumor Pineal VP Shunt MP shunt AJ 9
75 Budi Wahyuni VIP NPBI 6/11/1964 P GRD L4 C230214 Ca Sinonasal Nekrotomi DAT 7
Endoskopi,
76 Tsalitsa VIP NPBI 20 th P GRD L5 C639598 RSK + Adeno Tonsilitis Kronik FESS + ATE 5
TE Deseksi RH
77 Maria Suliyem 3 NPBI 9/2/1969 P R6A C630853 Ulkus Diabetikum Pedis - Cruris Dextra Debridement AS

OPERATOR
PENJAMIN
REKAM
MEDIS
61 Sudarno 3 NPBI 64 th L R2B C640128 Craniopharingioma Craniotomi Ds Tengkorak DP 9

62 Siti Sumirah 1 NPBI 42 th P MRK 2 Massa Paravertebra Laminektomi Biopsi + Fusi HY+AJ 8
63 Hendra Wibowo 3 NPBI 63 th L Elang 1 C628251 CAD 3 VD CABG SF JT
64 Yuni Hidayati 3 NPBI P R2A C634494 Ca Sinonasal Aff Tampon Anterior Dan Cavum Nasi
WY
65 Bambang Sayekti Wibowo 3 NPBI 59 th L R3B C629207 Massa Sinonasal Rhinotomi Lateral WY
Mata Kiri Proptosis e.c Susp Metastase Ca
66 Umi Kulsum 3 PBI 37 th P R3A C637767 Mata Kiri Enukleasi Bulbi + Biopsi + PA
Mamae d.d Susp Massa Sinonasal TL + DAT
67 Sri Sunarsi VIP NPBI 6/27/1959 P GRD L4 C314269 Adeno Ca Colon Laparotomi Dan Reseksi Colon ERI 5
68 Indra Setiawan VIP NPBI 1/29/1993 L GRD L4 C640380 Tumor Parotis Sinistra Superficial Parotidektomi Sin + FS BIS GR 5
69 H Yusuf Efendi 2 NPBI 58 th L Elang 1 C640393 CKD on HD, CAD 3 VD Pasang DL WW 3

70 Wenty Dwi Septiana 3 NPBI 9/20/1990 P R5B C507340 Stenosis Trachea Laringoskopi Flexible + Evaluasi DAT DS
71 Sutomo 3 NPBI 41 th L R1B C609167 CKD Psg DL C. Arm AS
72 Sunarni 3 NPBI 50 th P R3A C620210 CKD Repair AV Shunt AS
73 Sunanti 3 NPBI 54 th P R3A B038804 CKD Repair DL AS

OPERATOR
PENJAMIN
REKAM
MEDIS
63 Fuad Arrasid Fitriyanto 3 NPBI 21 th L R2B C641478 Fr Radius Ulna Sinistra ORIF BIN 10
64 Sri Yatin NPBI 68 th P Obstetri C513058 Ca Ovarii Terpasang DJ Stent Sistokopi Lepas Ganti DJ Stent Longlife C arm MAS DS 1

OPERATOR
PENJAMIN
REKAM
MEDIS
42 Sri Moeljanto VIP NPBI 12/8/1942 L GRD L4 C620570 Pneumonia Ganti Kanul Trachea AVIS GR 4
43 Mirna Nawi Butun 1 NPBI 60 th P MRK 1 C637692 Ca Paru Psg WSD + aff Pigtail WW 5
44 Supardi NPBI 7/5/1969 L Transit C641709 Fr. Colles Sinistra Ttp NK ORIF APR 10
45 Sudirnya 3 NPBI 61 th L R1B C641646 Hidrocephalus VP Shunt ER 8
46 Slamet 1 NPBI 16 th L KPD 1 C641699 Fr Impresi Os Frontal Repair fr. Impresi DP 8
47 Dewan Saputra 3 NPBI 12 th L Anak 1 C641404 Multiple Limfadenopati Colli + Axilla Eksisi Biopsi EDW
AHAN OPERASI ELEKTIF
JAM PROGRAM
Jenis Anestesi
ANESTESI
DPJP
GA
GA
GA 10.00
GA
GA JL
GA
GA
GA
GA
GA
LA
LA
LA
LA 11.00
LA
LA
LA
LA
LA
LA
LA

JAM PROGRAM
Jenis Anestesi
ANESTESI
DPJP
GA
GA
GA 20.00
GA
GA
JAM PROGRAM
Jenis Anestesi
ANESTESI
DPJP
GA
GA
GA
GA 20.00
GA
GA
LA
LA
LA
LA
LA
LA
LA
LA
LA
LA
LA
LA
LA
JAM PROGRAM
Jenis Anestesi
ANESTESI
DPJP
GA 10.00
GA
GA
LA
LA
LA
LA
LA
LA
JAM PROGRAM
Jenis Anestesi
ANESTESI
DPJP
GA 08.00
GA
LA

JAM PROGRAM
Jenis Anestesi
ANESTESI
DPJP
GA 17.00
GA
GA
GA
GA
GA
GA 06.30
GA
GA
GA 10.00
GA 17.00
GA DN
GA
GA
GA JL
GA
LA
LA
LA
AHAN OPERASI ELEKTIF JAM PROGRAM

Jenis Anestesi
ANESTESI
DPJP
LA
LA
LA
LA
LA
LA
LA
LA
LA
LA
LA
LA
LA
JAM PROGRAM
Jenis Anestesi
ANESTESI
DPJP
GA 09.00
GA
GA HR 11.00
GA 09.00
GA
GA 18.00
GA 16.00
GA DN
GA
GA
GA
LA 08.30
LA
LA
LA

JAM PROGRAM
Jenis Anestesi
ANESTESI
DPJP
GA 10.00
GA 08.00
GA WA 16.00
GA
GA
GA
GA HA
GA
GA
GA
GA
GA
GA
GA
LA
LA
LA
LA
LA
LA
LA
LA
LA
LA
LA

JAM PROGRAM
Jenis Anestesi
ANESTESI
DPJP
GA HA
GA
LA
LA
LA
LA
LA
LA
JAM PROGRAM
Jenis Anestesi
ANESTESI
DPJP
GA 15.00
GA 20.00
LA
LA
LA
JAM PROGRAM
Jenis Anestesi
ANESTESI
DPJP
GA
LA
LA
LA
LA
LA
LA
LA
LA
LA
LA
LA
LA
LA
LA
JAM PROGRAM
Jenis Anestesi
ANESTESI
DPJP
GA
GA
GA 10.00
GA 15.00
GA
GA
GA 18.00
GA
GA
GA
GA WA
GA
GA 14.30
GA
GA
GA
GA
LA
LA
LA
LA
LA
LA
LA
LA
LA
LA
LA
LA
LA
LA
JAM PROGRAM
Jenis Anestesi
ANESTESI
DPJP
GA
LA
LA
LA
LA
LA
LA
JAM PROGRAM
Jenis Anestesi
ANESTESI
DPJP
GA
GA
LA
LA
LA
LA
JAM PROGRAM
Jenis Anestesi
ANESTESI
DPJP
GA 09.00
GA 14.00
GA
GA
GA
GA
GA
GA
GA
LA
LA
LA
GA
LA
LA
LA
LA
LA
LA
LA

JAM PROGRAM
Jenis Anestesi
ANESTESI
DPJP
GA 10.00
GA 11.00
GA 10.00
GA 08.00
GA 12.00
LA 08.00
LA 09.00
LA 12.00
LA 09.30

JAM PROGRAM
Jenis Anestesi
ANESTESI
DPJP
GA WA
GA DN
GA HN 18.30
GA 08.00
GA 12.00
GA 10.00
GA AI
GA WA 08.00
GA 21.00
GA
GA
LA
LA
LA
LA
LA
LA
JAM PROGRAM
Jenis Anestesi
ANESTESI
DPJP
GA 15.00
GA
GA
LA
LA
LA
LA
LA
LA
LA
LA
LA

JAM PROGRAM
Jenis Anestesi
ANESTESI
DPJP
GA
GA
JAM PROGRAM
Jenis Anestesi
ANESTESI
DPJP
GA 10.00
GA 14.00
GA 15.00
GA
GA 07.00
GA HR 10.30
GA HR 11.30
GA HN 19.00
GA VL
GA
GA
LA
LA
LA
LA

JAM PROGRAM
Jenis Anestesi
ANESTESI
DPJP
GA 10.00
GA 07.00
GA 15.00
GA 19.30
GA
GA
GA
GA
LA
LA
LA
LA
LA
LA
LA
LA
LA
LA
LA
LA
LA
LA
LA
LA
LA
LA
LA
LA

Jenis Anestesi Jenis Anestesi Jenis Anestesi

LA
LA
LA
LA
LA
GA
GA
GA
GA
GA
GA
GA
GA
GA
GA
GA
GA
GA
GA
DPJP DPJP DPJP
JL
VL
HS
HR
ANESTESI ANESTESI ANESTESI
JAM PROGRAM JAM PROGRAM JAM PROGRAM
11.00
10.00
12.00
10.00
JAM PROGRAM
Jenis Anestesi
ANESTESI
DPJP
GA
LA
LA
JAM PROGRAM
Jenis Anestesi
ANESTESI
DPJP
GA 08.00
GA
GA 06.00
GA 08.00
GA
GA 07.00
GA
GA 07.00
GA
GA 21.00
GA
GA
GA
LA
LA
LA 20.00
LA
JAM PROGRAM
Jenis Anestesi
ANESTESI
DPJP
GA JL
GA JL
GA
LA
LA
LA

JAM PROGRAM
Jenis Anestesi
ANESTESI
DPJP
GA
GA DS
GA
LA
JAM PROGRAM
Jenis Anestesi
ANESTESI
DPJP
GA
GA DN 17.00
GA JH 14.00
GA
JAM PROGRAM
Jenis Anestesi
ANESTESI
DPJP
GA 08.00
GA 08.00
GA 10.00
LA
14.00
TIVA
GA 17.00
GA
GA VL
GA WA
LA
LA
LA
LA
LA

Jenis Anestesi Jenis Anestesi

LA
GA
GA
GA
GA
GA
GA
GA
DPJP DPJP
ANESTESI ANESTESI
JAM PROGRAM JAM PROGRAM

11.00
09.00
DAFTAR PASIEN OPERASI INSTALASI BEDAH SENTRAL HARI / TANGGAL : KAMIS, 4 MEI 2017
No Nama pasien No Rekam Diagnosis Tindakan Operator DPJP Verifikasi Verifikasi Dokumenta Marking
Medis Anestesi Bedah Anestesi si Marking Pasien
1 Dava Risky Kurniawan C557605 Hipospadia Uretroplasty + Release Chordae ADS

2 Imza Hermawan C107553 Batu Staghorn Sin PCN Sin k/p open, Nefrolitotomi Sin ADS
OMSK Kiri dg
3 Nur Kamalia C607331 Mastoidektomi
Kolesteatoma ZUL
4 Rusnaningsih C631649 Massa CAE Thympanoplasty ZUL
5 Tukiyah C596560 Moderate HN Dx + HU Dx URS + DJ Stent k/p PNS MAS
Hidronefrosis +
6 Khodijah C634449 URS + DJ Stent MAS
Hidroureter Sinistra
7 Sujana C628191 Nefrolithiasis Dextra PCN MAS
8 Yuni Hidayati C634494 Susp Massa Maksila Kiri FESS + CWL + Odontektomi ANNA + RP
9 Surati C361765 Mata kanan PACG + KSI Mata kanan phacoemulsifikasi + IOL MR
Mata kanan KSI, Mata Kiri
10 Hariyadi C215600 Mata kanan phacoemulsifikasi + IOL WIS
Pseudofakia
Mata kiri katarak
11 Sutikno C627639 Mata kiri phaco + IOL ( Iris Claw ) AW
traumatika
Mata kanan pterygium
12 Nur Asyikin C633159 Mata kanan eksisi pterygium DN
nasale
13 Theresia Dewi K C634631 CKD on HD Double Lumen LESTARI
14 Murtiyah C633304 NOK Susp Ganas + CKD SOU + FS MZ
15 Mifta Janati C548000 Ca Ovarii Residif Sistoreduksi EN

16 Mutrofi C203453 Ulkus DM Pedis Distal Debridement ALI
17 Sulistiowati C634654 CKD on HD Double Lumen ALI
18 Hilal Azzam Zaidan C630238 Kista Ductus Choledocus Laparascopic Eksisi Kista k/p by pass
PTY+ERI
Massa Hipofaring post
19 Ahmad Thohiron C629059 Ganti Kanul + Laringoscopy Flexible FAR
Tracheostomi
20 Abid Raditia Saputra C550339 Fibrosarcoma Cavum Nasi Ekstirpasi Massa DAT
Sub Total Thyroidectomi + Adenectomi +
21 Sutarminah C622617 SMNT c/ ganas BIS
FS, gns, TT + RND
22 Sunarto C412981 Tumor Pedis Sinistra Insisi Biopsi + PA DH
23 Tuaniyah C632145 Malformasi Vaskuler Insisi Biopsi + PA UUD
Ishmolobektomi + FS ganas Total
24 Ina Tutyaona C631101 SNNT c/ Ganas UUD
Tiroidektomi
Wide Eksisi + FS tepi bebas tumor +
25 Imbang Tri Hanekowati B050549 Basalioma DWT + NJT
Eksisi Rekonstruksi
26 Marinem B386676 Ulkus Diabeticum Reg Pedi Debridement PJ
Mata Kanan Subluksasi

Mata Kanan Ekstraksi Lensa + IOL +
27 Tri Arif Yuda N C615914 Lensa, Mata Kiri LN
Vitrektomi Anterior
Pseudofakia
28 Haryanto C618551 Mata Kiri TRD Mata Kiri Vitrectomi AL
Mata Kanan Afakia, Mata Mata Kiri Ekstraksi Lensa + PPC +

29 Agam Abdillah C595858 LN
Kiri Katarak Kongenital Vitrektomi Anterior
Mata Kanan Evakuasi Silicon +

30 Sugiyo Pranoto C586745 Mata Kanan Silicon Filled E AW
Secondary Implant
Mata Kanan SO Filled

31 Punirah C552436 Mata Kanan Phaco + IOL + Evakuasi SO AW
Eye+ Katarak Komplikata
Mata Kanan Ablatio

32 Ugi Sutikno C610481 Retina, Mata Kanan Kiri Mata Kanan Vitrectomi + EL + Gas/SO AW
High Miopia
33 By. Ny. Dayanti Hasta Dewi C633801 Meningocele Kraniotomi ER (BS)
34 Sutiyatun C632957 Meningioma Craniotomi DP

35 Catur Retno Utami B001136 OA Reg Wrist Dx Release Kontraktur DRY
Mata Kanan Ptosis
36 Devia Azzalea Putri C633520 Mata Kanan Koreksi Ptosis INA
Kongenital
37 Markamah C631826 Charcot Foot Dx Arthrodesis BIN
38 Slamet C614035 Neglected Dislokasi Poster THR Dextra BIN
39 Tuntoro C539771 MR Severe, TR Severe MVR SF
DAFTAR PASIEN OPERASI INSTALASI BEDAH SENTRAL HARI / TANGGAL : JUMAT, 5 MEI 2017
1 Umar Syarif C634358 Nefrolithiasis Dextra Nefrolitotomi Dextra + DJ Stent ADS
2 Bernadinus Tukidjo C634531 Nefrolithiasis URS ADS
3 Sri Untari Mioma Uteri Laparotomi Histerektomi VG
4 Musripah C635186 Plegmon Dasar Mulut Insisi OEN
NOK, Riw. Ca Mammae,
5 Mutmainah C620864 SOU + FS DC
Riw. Op. Kandungan
Susp Hemangioma
6 Ainur Rofiq C633596 LD + Ekstirpasi Massa + Biopsi FAR
Supraglotis
7 Muhamad Ismail C552921 Papiloma Laring LD + Ekstirpasi Massa + Biopsi DAT
8 Aspuntik C572223 Fistula Oroantral Fistula Clossure DAT
Mata Kiri Dakriosistocele

9 Eko Purwanto C626029 Dengan Perforasi + Mata Kiri External DCR + Pembentukan O INA+AK
Fistula + ( HBSAg + )
10 Khusnul Khotimah C631556 NOK c/ Ganas SOU + FS, Persiapan CSS EN

Selulitis Pedis Dextra et
11 Aguswanto C633890 Debridement ALI
Sinistra
12 Tri Purwati C062901 Abses Insisi Drainase Abses ALI
13 Eko Harminto C634445 Hernia Inguinalis Dextra Repair Hernia ( open ) Mesh MM
14 Sarni Endah S C635024 Massa post lien c/ abses Laparatomi Splenektomi PB
Adeno Squamous
15 Noor Hasyim C611823 Repair Jejenustomi Feeding PB
Esofagus
16 Petra Dewi Asri B263382 Limpadenopati Colli Limpadenectomi DWT
17 Soekarto C62959 SNNT c/ ganas T3N0M0 Near Total Thyroidectomi DWT
18 Darmanto C522980 Ca Thyroid Adenektomi + FS, Gns-RND BIS
19 Titin Suwartini C593422 Inv Ca Of MST Gr III, MD MRM BIS
20 Sugiarti C495120 SCC Lidah Well Diff Hemiglosektomi UUD
Wound Dehiscense & ILO

21 Kusyantini B129568 pasca laparatomi dd tumor Rekonstruksi + Debridement RZ
intraperitoneal
22 Yuli Suprayitno C626844 Ulkus Femur Bilateral + De Debridement ETH+ALI
23 Tasripin C632218 Tumor kulit c/ ganas scc sh Wide Eksisi + Rekonstruksi UUD+PJ
Mata Kiri Katarak

Mata kiri Ekstraksi Lensa + Vitrektomi
24 Setyorini C551236 Kongenital + Esotropia LN
Anterior+ PPC + IOL
Sensoris
25 Tri Hadi Lestari C634341 Mata kanan Ablatio Retina Mata kanan Vitrektomi AL
26 Karsipah C593695 Mata Kiri RRD Mata kiri vitrektomi + EL + C3F8 AL

Mata kanan pseudofakia,
Mata kiri ekstraksi Lensa + IOL +
27 Rania Putri Kusmawati C619465 Mata kiri katarak LN
PPC+Vitrektomi Anterior
kongenital
Mata kanan RRD +
28 Tarsudi C633947 Mata kanan Vitrektomi + EL + Gas / SO AW
Pseudofakia + PCO
29 Tarmidi C581883 Ca Laring Pasca DeltopectoRepair Flap WY
Spondilithiasis + HNP
30 M. Syaefudin C632478 Disectomi DP
VL4-5
31 Purwanto C627409 Canal Stenosis PSRS APR

32 Agus Surya L C462160 Osteomilitis Remove Implant + Debridement BIN
33 Mardjuki C632432 Central Dislokasi Hip Sin Revisi THR BIN
34 Earlina Dwi Larasati C548230 VSD PMO VSD Closure SF
35 Khairul Afif C596009 PDA Ligasi PDA WW
36 Samsudin C613236 Ruptur Total Uretra Sectio Alta & Sachse WAN
37 Umbarwanto C622179 Lumbal Pungsi YOVITA
38 Naila Hanifa C584689 MDS BMP MOED
Ulkus Granulosum Pasca
39 M. Teguh Azmi C626602 Debridement PJ
Luka Bakar
40 Nabil Rahman Saputra C628335 Bulloe Regio Colli Anterior Pungsi Bulloe ETH
41 Suwarji C003429 Hepatitis C EGD HRY

42 Iroh B C633961 IBS Colonoscopy HRY
43 Jupri C634066 Melena EGD HIRLAN
44 Maekah Maslikah C408839 Melena EGD DD
45 Kustini C632650 ERCP AGG
46 Siti Amaroh C634196 Massa Paru Kiri Bronchoscopy THOM
47 Sulistyowati C634908 Disfagia Esofageal Esofaguscopy + Pasang NGT Freka MYS
DAFTAR PASIEN OPERASI INSTALASI BEDAH SENTRAL HARI / TANGGAL : SENIN, 8 MEI 2017
1 Ali Murni C632042 Hipospadia Penoscrotal Uretroplasty ADS

2 Supardjo B327248 Prostat Enlargement TURP ADS
3 Djamari C624150 Prostat Enlargement TURP ADS
Hidroureter Sinistra Batu
4 Ngasmi C629333 Psg DJ Stent ADS
Staghorn Sin
5 Djoko Suseno C629998 Massa Glotis Anterior Laringoscopy Direct + Biopsi RR (THT)
6 Pasni C570892 NKT cell lympoma + Defek Release Pedicle Flap WY
RSK + Polipnasi Pasca
7 Mujiyanti C616692 Aff Tampon dan Eksplorasi RH + ANA
FESS
8 Bayu Aji Prayogo C471260 Ameloblastoma Hemimandibulectomy OEN
Perforasi Membran
9 Aril Vinusa Putra C630377 Tympanoplasty Kiri AYU
Timpani e.c Trauma
10 Sutinah C634127 NOK Susp Ganas SOU + FS k/p CSS MZ
11 Suharti C631799 NOK SOU + FS k/p CSS MZ
12 Mustadliroh C633129 Suspect Ca Ovarii Surgical Staging EW
13 Sukayati C632224 NOK C/ Ganas SOU + FS k/p CSS EW
14 Sukiman C627836 Hepatomegali C/ HCC Laparotomi Biopsi JS
15 Pamungkas Dedy C575016 Fistula Dinding Abdomen Rectoscopy + Insisi Infiltrat Para Anal
MM
16 Dany Prasteyo K C595476 Ca Gaster Total Gastrectomy PB
17 Supriyatiningsih C620500 Metastasis Adeno Ca Hepa Right Liver lobectomy ERI
18 Sitrus Purnomo C477564 STT Eksisi + FS, Ganas Eksisi Luas BIS
19 Pudji Hastuti C635083 Ca Mamae Dextra MRM BIS
20 Minarsih C631461 TMD Wide Eksisi + PA DWT
21 Muchayaroh C420649 Ca Thiroid Tiroidektomi DWT
22 Zakia Khansa Khamida Labiognatopalatoschizis Palatoplasty NJT
23 Irsyad Baskara C608541 Osteomyelitis Reg Sisi Sini Debridement ETH

24 Kasmari C633619 Post End Ileostomi Laparatomi Eksplorasi Anastomosis ERI
Mata Kiri Afakia, Mata

Kanan Pseudofakia,Mka Mata Kiri Secondary Implant + IOL + Vx
25 Muhamad Rasyid Fasha C583298 LN
Mki Esotropia Sensorik + Anterior
Nistagmus
Mata Kiri Katarak Mata Kiri Ekstraksi Lensa + PPC + Vx

26 Rafi Nawabi C627182 LN
Kongenital Anterior + IOL
Mata Kanan Vitreus
27 Makrifah C634951 Mata Kanan Vitrektomi AL
Hemorrhage
Mata Kanan
28 Supardjo C634736 Mata Kanan Vitrektomi AL
Hemophtalmus
Mata Kanan Silicon Filled
29 Munajad C632150 Eye + Glaukoma Mata Kanan Evakuasi Silikon AL
Sekunder
30 Widayanto C586917 Ankylosing Elbow Knee Rekonstruksi Elbow Knee DRY

Giant Cell Tumor Reg
31 Kartini C402161 Bonegraft DID
Cruris Dextra
Fr. Phalang Proximal
32 Ahmad Labib C634775 Pasang Gips Back Slap DID
Manus Dextra
33 Abdul Gofur C634112 Fr. Fibula , Fr. Maleolar ORIF Fibula + Maleolar DID
34 Heriyanto C635308 CKD Ganti DL WW
35 RR. Sri Puji C627495 CKD AV Shunt WW
DAFTAR PASIEN OPERASI INSTALASI BEDAH SENTRAL HARI / TANGGAL : SELASA, 9 MEI 2017
No Rekam DPJP Verifikasi Verifikasi Dokumenta Marking
No Nama pasien Medis Diagnosis Tindakan Operator Anestesi Bedah Anestesi si Marking Pasien
1 Djuwahir C633909 Prostat Hiperplasia TURP MAS

2 Sujana C628191 Nefrolithiasis Dextra PCN MAS
3 Widodo C623536 Multiple Nefrolithiasis Dex PCN MAS
4 Tasya Ayu Anggraeni C635520 Atresia Esofagus Gastrostomi Feeding PTY
Post Op
Duodenojejunostomi +
5 By. Ny. Nurul Talibah C632198 Rehecting PTY
Gastrostomi dekompresi
dg wound dehisense
Mata Kiri Proptosis, Mata

Mata Kiri Elongasi Muskulus Levator
6 Rusnadi C597382 Kanan Kiri Grave TL
Palpebra Superior
Ophtalmopati
7 Ruslani C626812 Mata Kanan Tumor Mata Kanan Orbitotomi Anterior + Insisi +
Palpebra Inferior + Ptosis Biopsi + PA TL
Mata Kanan Anoftalmia Mata Kanan Debridement + Jahit Sklera
8 Taulya Dewi C466964 INA
Exposure Sklera + Konjungtiva
9 Supardi C593963 Mata Kiri PACG + KSI Mata Kiri Phacoemulsifikasi + IOL MR
Mata Kanan Secondary Implant +
10 Kasminah C634317 Mata Kanan Afakia RF
Kapsulotomi Posterior
Mata Kanan High Miopia +
11 Suhardi C634422 Mata Kanan Phaco + IOL RF
Komplikata
12 Tutik Susilowati C497524 Endometrioid Ca Ovarii In Laparotomi Sito Reduksi EN + ERI
Kista Ovarii Bilateral +
13 Suwantini C626201 Laparoscopy Kistektomi + Neo Salpingost HR
Oklusi Tuba
14 Bambang Supriyadi C635487 SNNT Isthmolobectomy + FS DWT
Adeno Ca Ovarii On
15 Ngatemii C562014 Tutup Stoma Colostomy
Colostomy PB
16 Ronald Kusumah C620756 Adeno Ca Colon Laparotomi Explorasi k/p Colostomy ERI
17 Nafi'ah C633063 Prolap Rectum Laparotomi Rectopeksi ERI
18 Sri Sunarni C344416 Wound Dehisense Repair Wound Dehisense BIS
Wide Eksisi + FS Bebas Tumor +
19 Muntiah C630247 Tumor Kulit C/ Ganas BIS+RZ
Rekonstruksi
20 Budi Irawan C634995 Ruptur Perineum Debridement + Repair Perineum ETH
Skin Loss + Soft Tissue
21 Danu Setyo Widodo C634302 Debridement k/p Rekonstruksi ETH
Loss
22 Supriantoro C631547 Kista Ductus Thyroglosus Sistrunk Procedure DH
Mata Kana PCO, Mata Mata Kanan Vitrektomi Anterior +

23 Nur Madhoni C616335 LN
Kanan Kiri Pseudofakia Kapsulotomi Posterior + IOL
24 Suharto C632519 Mata Kiri RRD Mata Kiri Vitrektomi + EL + Gas AW
Mata Kanan Kiri Vitreus Mata Kiri Vitrektomi + EL + Gas / SO +
25 Sudanarko C595974 AW
Hemorage MP
Mata Kanan Vitreus
26 Achamd Muchdori C633134 Mata Kanan Vitrektomi AW
Hemorage
Mata Kanan Ulkus Kornea
27 Rupadi C500494 Mata Kanan Periosteal Graft DN
Perforasi
28 Abdurohim Al Farizi C634460 Meduloblastoma Craniotomi Mikro ds Tengkorak ZM
Glioma Temporo Parietal
29 Parinah C633513 Craniotomi Mikro Ds Tengkorak DP
Sinistra
30 Komara Titis Hardini C405831 Fr. Femur Sin 1/3 tengah ORIF APR
31 Bambang Heriyanto C603765 Non Union Femur Dextra ORIF APR
32 Y Wahyuni Dewi K C555276 Mal Union Fr Tibia Dextra Revisi ORIF BIN
Fr. Clavicula dextra 1/3

33 Slamet Senari C635007 ORIF DID
tengah
34 Julianto C634977 Fr. Tibia post amputasi dig ORIF Tibia DID
35 Naning Martdiastuti C629253 RSK + SD + KH FESS + SR + Konkoplasty RH
DAFTAR PASIEN OPERASI INSTALASI BEDAH SENTRAL HARI / TANGGAL : RABU,10 MEI 2017
1 Farizan C634271 Ruptur Uretra Pars Membr PER ADS

Diah Ayu Senja Puspita
2 C595841 Ca Cervix Pasang DJ Stent Dupleks ADS
Sari
3 Gibran C628226 Suspect Tumor Buli Sistoscopy ADS
4 Sri Hardjanto C634535 Mata kiri Tumor Palpebra Mata kiri Wide Ekisi + Cryo + PA + Rekons AK
5 Adi Teguh C629350 Mastoiditis ME Simple ZUL

6 Suratno C349354 Ca Prostat Subcapsuler Orchidectomi MAS
7 Sri Kuswati C632274 Ameloblastoma Reseksi Mandibula + Rekonstruksi OEN
8 Asih Sholihah C629194

Massa Sinonasal Dextra Maksilektomi Medial WY
9 Munosarotul K C595326 LNH Tonsil Ekstirpasi Massa Tumor WY
16 Reyna Christiana C633155 NOK C/ Ganas SOU + FS s.d CSS HR
Post Partum Spontan,
17 Siti Fatonah C635762 MOW JD
PEB
Mata Kanan Kiri Tumor
18 Slamet Raharjo C626852 Mata Kanan kiri Orbitotomi Anterior + Bio TL
palpebra Superior
Mata Kiri Massa Kantus Mata Kiri Orbitotomi Anterior + Biopsi +
19 Poniman C608420 TL
Lakrimalis PA
20 Jefri Arif Pambudi C471261 OMK Kanan Tympanoplasty telinga kanan PW
21 Tan Ermin Nio C497244 Ca Rectum Laparotomi Hartman Prosedur PB
22 Agnes Elisabeth P C499880 Cholelithiasis Laproscopy Cholesistectomy PB
Tumor Intra Abdomen,
23 Ghupron C635311 Laparotomi Biopsi + PA PB
HbsAg +
Laparotomi Explorasi Resksi k/p
24 Sutar C281359 Adeno Ca Rectosigmoid ERI
Colostomy
25 Lucia Sunarsih C633507 Struma Adenomatosa TT BIS
SNNT Dextra C/ Ganas Isthmolobektomi + FS, Ganas TT
26 Endang Utami Sayekti C623451 DWT
T3N0M0 Limfadenektomi + FS, Ganas RND
27 Nur Hidayati C509509 Ca Mamae Wide Eksisi DWT
28 Sumini C618290 Ca Mamae Sinistra MRM Sinistra DWT
29 Kenzie Varen Rafassya C633666 Tumor Maxilla Sinistra Biopsi CWL + Limfadenectomy UUD
30 Fransisca Sri Mugiarti C633829 Ulkus Diabetikum Pedis Debridement PJ
Insisi Biopsi Mamae + Isthmolobektomi +
31 Sri Widiastuti C622853 Tumor mamae, SNNT UUD
FS, Ganas TT
32 Sukarlin C628283 Inv Breast Cancer, NST, Gr Wide
I Eksisi + Diseksi Axilla UUD
Mata Kanan Kiri
Glaukoma Kongenital,
33 Nizam Hazzar C629535 Mata Kiri Trabekulotomi +Trabekulektomi LN
Mata Kanan Post
Trabekulektomi + MMC
Mata Kanan Kiri Nukleus Mata Kanan Vitrektomi +

34 Fadlan Hadi Chuseno C602562 AL
Drop Endofragmentasi + Iris Fiksasi IOL
35 Tohari C630044 Mata Kanan Afakia + RRD Mata Kanan Vitrektomi + EL + Gas / SO AL
Mata Kanan Kiri POAG +

Katarak Senilis Imatur +
36 Machfud C629176 Mata Kiri Vitrektomi + Phaco AL
Mata Kiri Vitreus
Hemorage
Mata kanan ulkus kornea

37 Sulaiman Soediharto C634250 Mata kanan eviscerasi bulbi + DFG DN
perforasi epitelisasi
Leakage LCS Post Burr

38 Rafanda C632536 Repair Leakage LCS DP
Hole
tumor Intrinsik Frontal
39 Dwi Setiono C634481 Craniotomi Lobektomi Frontal Dextra ZM
Dextra
40 Sri Handayani C602880 IDO Debridement + Rehecting AJ
Striktur Uretra + Fr. Pelvis
41 Mahmudi C634659 PER + ORIF Symphysiolisis APR+MAS
Vertical Shear
Fr. Scapula Komunitif
42 Dian Syah C633749 ORIF Clavicula + Scapula + Costae DID + ALI
Dextra + Clavicula
43 Akhmad Samlawi B265322 Ruptur Rotator Cuff Artroscopy Debridement BIN
44 Tumini C632438 OA Genu TKR BIN
45 Samron C577743 AR Severe AVR SF
46 Pujaiyah C634224 Massa Mediastinum Thoracoscopy k/p Thoracotomy WW
DAFTAR PASIEN OPERASI INSTALASI BEDAH SENTRAL HARI / TANGGAL : KAMIS,11 MEI 2017
1 Rita Wulandari C634638 Ca Ovarii Inadequate Stagi Laparotomi MZ

2 Syfa Maulida Agustina C629075 G2P1A0, Hml 32 mgg, Ca NSCTP OP
Mata Kanan Pseudofakia, Mata Kiri Secondary Implant + Virectomi

3 Keysha Azalia C596278 LN
Mata Kiri Afakia Anterior + IOL
4 Aufa Salsabila C632111 Craniofaringioma Cranotomi Mikro Dasar Tengkorak DP
Mata Kanan Afakia e.c

Mata Kanan Vitrektomi Anterior + IOL
5 Muhamad Afif C624755 Katarak Traumatika + LN
( Iris Clip )
Leukoma Kornea
Mata Kiri Katarak

Mata Kiri Ekstraksi Lensa + Vitrektomi
6 Naveen Kalila C625088 Traumatika + Lekoma LN
Anterior
Kornea
7 Sudarmono C634315 Mata Kanan Vitreus Hemor Mata Kanan Vitrektomi + EL + SO AL
8 Harinus C630746 HNP Cervical 4 -5 Cranioplasty open door HY + AJ
9 Sukirman B249402 Fr. Cervical II Frankle C Laminektomi Dekompresi AJ
Wound Dehisense Reg

10 Cahyaningsih C585641 Vertebra Post Debridement APR
Laminektomi
11 Slamet Arifin C084065 Dislokasi Acromioclavicular Repair Acromioclaviculare Joint Dextra APR
DAFTAR PASIEN OPERASI INSTALASI BEDAH SENTRAL HARI / TANGGAL : JUMAT,12 MEI 2017
No Nama pasien Diagnosis Tindakan Operator
Hipospadia Penoscrotal
2 Sutinah C404767 Uretroplasty ADS
dan Fistel Uretrocutan
3 Marji Nefrolithiasis Pasang Ureter Kateter ADS
4 Rofi Handayani C473331 Ca Buli Sistoscopy ADS
5 Robiyati C618113 LNH Tonsil Ekstirpasi Massa Tonsil WY
6 By,. Nila Witria C636059 Atresia Ani, Fistel

Rectovestibula Kolostomi RR (BA)
Laparotomi Reseksi Ileum +
7 M. Rino Nur Syafa'a C634720 Post Laparotomi Reseksi Il RR ( BA)
Anastomosis End to End
Granuloma Umbilicalis e.c

8 Arza Alfian S C628298 Ductus Omphalocele Laparotomi Reseksi + Anastomose End T EDW
Mesenterium
9 Neneng Zubaidah C635291 Kista Ovarii Laparotomi + FS EW

Mata kiri glaukoma
14 Ngatinem C623705 sekunder ec katarak Mata kiri ECCE + IOL + Trabekulektomi FI
hipermatur
15 Isnaeni C632632 Mioma Uteri Histerektomi MZ

16 Diana Mocodompis C635104 Mioma Uteri Histerektomi MZ
17 Sri Sukadarmaningsih C635047 Ca Cervix St I Radikal Histerektomi EN
Tumor Colon
18 Saodah C634318 Laparotomi Biopsi k/p Hemikolektomi Kiri
Transversum Distal JS
19 Sugiyem A482137 Poliksitik Hepar Laparotomi Unroofing MM
20 Ummi Syafaah C532885 Cholelithiasis Laparoskopi Cholesistektomi K/p Open

PB
21 Ngatemi C562014 Ca Ovarii On Colostomy Tutup Colostomy PB
22 Kariyati Limfadenitis Colli Sinistra Limfadenektomi Biopsi Colli Sinistra

C634969 UUD
23 Dwi Kesumawati C607862 Ca Mamae MRM DWT
24 Ita Rustiana C630399 Ca Throid TT DWT
25 Muslikah C630358 Tumor Mamae Insisi Biopsi DWT
Skin necrotic e.c
26 Sri Hidayah C627750 Degloving Regio Limb Debridement + STSG NJT
Sacrum + Fr. Pelvis
27 Haryono C635768 Combustio Gr III 51 % Debridement NJT
Ulkus Granulosum Reg

Wrist Joint Reg Genu
28 Sulkan C635396 Debridement PJ
Dextra et Sinistra E.c
Combustio Listrik
29 Rohyadi C635312 Massa Glotis LD + Ekstirpasi Massa k/p Tracheostomi FAR
Mata Kanan Pseudofakia,

Mata Kiri Ekstraksi Lensa + PPC +
30 Dinda Dewi C625372 Mata Kiri Katarak LN
Vitrektomi Anterior + IOL
Kongenital
Mata Kiri Ablatio Retina
31 Esther Yuniarti C192225 Mata Kiri Vitrektomi + EL + Gas/SO AL
(Makula on)
Mata Kiri RRD +
32 Warjo C604110 Mata Kiri Vitrektomi + EL + Gas AL
Pseudofakia
Mata Kanan Pseudofakia, Mata Kanan Buka Jahitan, Mata Kiri

33 Gimin C628120 RF
Mata Kiri KSI Phaco + IOL

34 Ahmad Dul Wahab C597101 Mata Kiri Phaco + IOL RF
Mata Kiri Katarak Juvenile
35 Muhamad Dhori C239129 Mata Kiri Afakia Mata Kiri Secondary Implant + Iris Clip RF
Mata kanan kiri KSI, Mata

36 Sujarmi C633980 Mata kiri Cyclocryoterapi MR
kiri Glaukoma Absolut
37 Hasnna Putri C556522 Mata Kanan Ptosis Mata Kanan Koreksi Ptosis AK
38 Nuryati C632514 OA Genu Sinistra TKR Sinistra BIN
Plate Exposed Cruris
39 Teguh Basuki C625538 Amputasi BIN
Dextra, Osteomyelitis
DAFTAR PASIEN OPERASI INSTALASI BEDAH SENTRAL HARI / TANGGAL : SENIN,15 MEI 2017
1 Najata Tahta Auliya C573672 Ambigus Genitalia Laparoskopi ADS

2 Hery Susanto C632585 Kista Ginjal Dextra et Sinist Laparoskopi ADS
Ca Ovarium Mild HN + HU
3 Nikmah C593670 Aff DJ Stent ADS
Sinistra
4 Lian Afaf Adil Saputra C634954 Massa Ginjal Kiri e.c RCC Biopsi Ginjal ADS
5 Ani Tristianti C633383 Massa Sinonasal Maksilektomi WY

6 Farras Auzan Al M C628197 Megacolon Congenital Trans Anal Pull Trough EDW
7 Anisa Wianida Nurjanah C629175 Malformasi Vaskuler

Thorakal Eksisi + Rekonstruksi RR ( BA )
Laparotomi Reseksi Ileum +
8 M. Rino Nur Syafa'a C634720 Post Laparotomi Reseksi Il RR ( BA)
Anastomosis End to End
14 Linggayanti Wijaya C635260 NOK C Ganas SOU + FS s.d CSS EN
15 An M. Teguh Azmi C626602 Ulkus Granulosum Luas Pa Debridement PJ
16 Nur Solikhin C634498 Tonsilektomi Kronis Tonsilektomi FAR
Biliodigestif Shunting +
17 Mulyatin C620444 Tumor Caput Pancreas
Gastroyeyenustomi JS
18 Rukanah C559230 LMNH Relaparotomi Eksisi k/p Biopsi PB
Mata Kiri Proptosis e.c
Mata Kiri Orbitotomi Lateral + Biopsi +
19 Nurul Hidayah C376676 Massa Orbita d.d Gland
PA
Lakrimalis TL
Mata Kanan Massa
Mata Kanan Orbitotomi Anterior Trans
20 Leginah C628097 Konjungtiva d.d Lifoma
Konjungtiva + Incisi + Biopsi + PA
Maligna TL
SNNT Sin C/ Ganas
21 Yayah Isthmolobektomi + FS, Ganas TT
C633121 T2N0M0 UUD
22 Wahyu Erlina C493277 Tumor Mamae Eksisi Biopsi UUD
23 Lina Safitri C631813 Tumor Gingiva Insisi + Biopsi UUD
24 Paini C633358 Ca Mamae Mastektomi MRM DWT
25 Yuniati C635872 Tumor Mamae Dextra Wide Eksisi DWT
26 Agus Priyono C624300 SCC reg Bucal Dextra Hemimandibulektomi + Rekonstruksi UUD + NJT
27 Abyar Rizqi C636050 Fr. Metacarpal V ORIF DID
28 Siti Rochaniah C629073 Bonelast Aff Implant + Debridement DID

Mata Kiri Ekstraksi Lensa + PPC +
29 Dinda Dewi C625372 Mata Kiri Katarak LN
Vitrektomi Anterior + IOL
Kongenital

Mata Kiri Ekstraksi Lensa + Vitrektomi
30 Ahmad Denis C631191 Mata Kiri Katarak LN
Anterior +PPC +IOL
Kongenital + Esotropia
Mata Kiri Afakia ( Post

Mata Kiri Secondary Implant ( Iris Clip) +
31 Zara Safia C624632 Ekstraksi Lensa e.c LN
IOL + Vitrektomi Anterior
Katarak Traumatika)
Mata Kanan Massa

32 Muhamad Farel C632576 Palpebra Superior Suspek Mata Kanan Eksisi Massa + Biopsi + PA LN
Kista Dermoid
Mata Kiri pseudofakia, Mata Kanan Secondary Implant +
33 Vania Three C577988 LN
Mata Kanan Afakia Vitrektomi Anterior + IOL
Mata Kanan Afakia, Mata Mata Kiri Ekstraksi Lensa + Vitrektomi

34 Ulya Azizah C620081 LN
Kiri Katarak Kongenital Anterior PI
35 Fathiya Tanisha N C557654 Plexus Brachialis Injury Neuroplasty Plexus Brachialis Injury DRY
Fr. Subtrochanter Femur
36 Darimah C418895 ORIF DRY
Dextra
37 Sukamto C432553 Union Fr. Tibia Aff Implant BIN
38 Putri Wulan C584347 Post ORIF Remove Implant BIN
39 Sugiyanto B032273 Union Fr. Aff Implant BIN
Fr. Femur Post Revisi
40 Mardjuki C632432 ORIF Femur Sinistra BIN
THR Sisnitra
DAFTAR PASIEN OPERASI INSTALASI BEDAH SENTRAL HARI / TANGGAL : SELASA,16 MEI 2017
1 M. Amin C527906 Batu Ginjal ( HBSAg + ) PCN-URS MAS

2 Tri Endang K B225769 Ca Cervix, Hidronefrosis, Pasang DJ Stent ADS
3 Chamidah C622934 Nefrolithiasis Dupleks Nefrolitotomi Dextra + DJ Stent Dextra ADS
4 Sri Munjanah C343514 Ca Sinonasal Hemimaksilektomi Medial WY

Thorakal Eksisi + Rekonstruksi PTY
6 Al Ariq Davi Rafandra C556442 Fistel Uretrocutan Uretroplasty EDW
7 Zafran Fatkhur Rafizqi C621416 Hernia Scrotalis Sinistra Laparoscopy Herniotomi PTY
8 Sri Andayani C634086 POAD BY Pass Arteri ALI
Elongatio Colli Post
13 Sri Kusmiyani C557678 SSF + TVH ER
Histerektomi Supravaginal
14 Sri Kuntari C635856 Prolaps Uteri, Elongatio ColManchester Fortagile ER

15 Tri Handayani C615405 Sistokel Gr III Kolporafi Anterior ER
16 Tanyu C605282 NOK C/ Ganas SOU + FS s.d CSS SR
17 Yanuar Fermana Putra C630679 Wound dehisence post DV Debridement + Rehecting ALI
18 Munafiah C636378 Ulkus Diabetikum Pedis De Debridement ALI
19 Eveline Sarkam C384701 Hernia Umbilikalis Open Hernia Repair Mesh MM
20 Mundiroh C628088 Abses Hepar Segmen 6 Laparascopy Drainase Abses ERI
Patern ductus uracus
21 Subarta C121099 Laparatomi Eksplorasi
terinfeksi ERI
22 Sutar C281359 Adeno Ca Recto Sigmoid Laparatomi Eksplorasi k/p colostomi

ERI
Cholecystolithiasis + Laparatomi Eksplorasi + Cholesistectomi
23 Wiranto C635699 ERI
Choledocolithiasis + CBD CBD Explore
24 Trisadar Santoso C633331 SNNT Bilateral Total Thyroidectomi BIS
25 Fenustin Oktolina C626529 Ca Mammae Sin MRM Sin DH
26 Muntaroh C594497 Ca Mammae Sin Residif Wide Eksisi + Diseksi Aksila UUD
Invasive ca of WST Gr II
27 Safinati MRM Dextra
C598127 MD T4bN1M0 UUD
Metaplastic Ca Mamae
28 Sulistinah C613627 Wide Eksisi + Diseksi Aksila
Sinistra UUD
29 Tarsih C630951 Fore Head Flap Potong Pedicle Flap RZ
30 Tumin C412665 Infeksi Daerah Operasi Debridement NJT
31 Rizki Imam Mundori C636630 Fr. Os Nasal Rekonstruksi NJT
Fr. Parasimfisis Sinistra
32 Riyandi C635976 ORIF + IDW + IMW NJT
Mandibula
33 Aksin C633180 Ulkus Granulosum Flap Lokal PJ
Ulkus Granulosum reg
34 Sukamto Haryono C633932 Rekonstruksi + Flap Supraclavicula PJ
Colli
Mata kanan massa
35 Reni Puspitasari C608749 Mata kanan re-eksisi massa konjungtiva AK
konjungtiva
Mata kiri endoftalmitis
36 Mustianah C223556 Mata kiri Eviscerasi Bulbi + DFG DN
post operatif
37 Ina C636519 ORIF BIN
Mata kanan kiri nevus
38 Afifah C627426 Mata kanan kiri eksisi nevus TL
pigmentosa
Mata kanan proptosis ec Mata kanan orbitotomi lateral + Biopsi +
39 Sukati C631998 TL
massa retrobulbar PA
40 Suntini C621848 Meningioma Petrosal Craniotomi Dasar Tengkorak ZM
41 Johari Firdaus C620642 Post FSE Bone Graft APR

42 Nurchasanah C634901 LBP e.c HNP VL 4 - 5 PSRS Flexis APR
43 Rizal Muhaimin C589148 Post ORIF Fibula Dextra Fibular Graft DRY
Fr. Femur Post Revisi
44 Mardjuki C632432 ORIF Femur Sinistra BIN
THR Sisnitra
45 Oetarijah B404509 OA Genu TKR Genu Dextra DID
46 Yulda Lena C603537 MR Severe, MS Mild MVR SF
47 Ido Rikardo C453119 VSD VSD Closure SF
DAFTAR PASIEN OPERASI INSTALASI BEDAH SENTRAL HARI / TANGGAL : RABU,17 MEI 2017
Undensensus
1 Zidan Ivan Azhar C636767 Testiculorum Sinistra + Orchidopexy Sinistra + Sircumsisi
Fimosis
2 Ukik Yulianto C621886 Striktur Uretra Reseksi Anastomosis
3 M. Khoerul Azam C633130 Tumor Ginjal Dextra Open Biopsi Ginjal
Nefrolithiasis Dextra,
4 Marji C609358 Nefrolitotomi Dextra
Hidroneferosis Dextra

Thorakal Eksisi + Rekonstruksi
6 Hakiki Kurnia Wicaksono C636341 Fr Distal Radius Sinistra ORIF Distal Radius
Fr. Costae 4-5-6-7 + Fr.
7 Ariati Mawarih Atmojo C191350 Clipping Costae + ORIF Scapula
Scapula
14 Riyatun C636400 NOK C/ Ganas SOU + FS s.d CSS
15 Sri Murtini C630719 OMSK Kanan Dg Kolestea ME Radikal
16 Tjai Seng C637005 Cholelithiasis Laparoscopy Cholesistectomi
17 Gafur Rahadian C635414 Cholesistolithiasis Laparoscopy Cholesistectomi
Striktur Esofagus / Massa
18 Bambang Sukamto C634267 Gastrostomy Feeding
esofagus
19 Yahya C346187 Cholesistolithiasis Laparoscopy Cholesistectomy
20 Sri Narwati C557105 TMS C/ Ganas Core Biopsi
Inv Breast Ca MS Gr I - II
21 Wasiah MRM
C614066 T3N0M0 Post KT 3 x
Tumor Parotis sin c/ Superficial Parotidectomi + FS Ganas,
22 Wasiti
C634874 ganas TP
Wide eksisi + FS tepi bebas tumor,
23 Kalimah Tumor kulit c/ ganas
C634888 rekontruksi
Fr. Squesterd Symphisis
24 Christian Dedy Wibowo C635869 Rekonstruksi Fr. Tlg Wajah
Mandibula
25 Ali Akhwan C636675 Combustio Gr II Debridement
26 Khoirul Imam C636628 Luka Bakar Gr II, III 18 % Debridement
27 Mulyo Diharjo C635530 Skin Nekrotik Reg Pelvis Debridement + STSG

Ulkus Granulosum Reg
28 Sulkan C635396 Groin Flap
Cruris Dextra
Mata Kanan Afakia + Mata Kanan Secondary Implant +IOL+

29 Nafiah Afnan C595234
Eksotropia + Mikrokornea Vitrektomi Anterior
Mata Kanan Glaukoma

30 Muhamad Lizamudin C636705 Mata Kanan Trabekulotomi + Trabekulektomi +PI
Kongenital
Mata Kanan Massa Mata Kanan Orbitotomi Anterior
31 M Ali Murtadho C614721
Palpebra Superior Transkutaneous + biopsi + PA
Mata Kanan Squamous
Mata Kanan Eksenterasi Bulbi / Wide
32 Sudri C567229 Cell Carcinoma Well Diff
Eksisi + Biopsi + FS
Orbita
33 Warmiati C634901 SOL Cerebellum Craniotomi Ds Tengkorak
34 Nurhayati C626246 Spondilosis VL 1 S1 PSRS

Fr. Metatarsal + Fr
35 Budi Mulyanti C636140 ORIF
Metacarpal
Fr. Costae 4,5,6,7, Fr.
36 Sutarmi C635500 ORIF + ORIF Costae
Pelvis
37 Koo Djoe Thay C574894 Fr Femur Dextra Bipolar Hemiarthroplasty
Osteosarcoma Cruris
38 Dedy Surya Pranoto C606602 Reseksi Tumor
Sinistra
DAFTAR PASIEN OPERASI INSTALASI BEDAH SENTRAL HARI / TANGGAL : KAMIS,18 MEI 2017
No Nama pasien Diagnosis Tindakan Operator
1 Samin C627199 Nefrolithiasis Dextra PCN ADS

2 Ngasmi C629333 Nefrolithiasis Sinistra Retrograde Intra Renal Surgery ADS
Mioma Uteri Eksklusi
3 Supriyanti C631293 Histeroscopy HR
Tuba Bilateral
4 Gilang Agustian Pradian C632346 Severe Chordae Release Chordae EDW
Megacolon Kongenital on
5 Rayhan Dybala A C604123 Duhamel Prosedur EDW
Colostomi
6 Muhamad Zidan Arzaqul C635825 Massa Mediastinum Thoracoscopy Biopsi ALI
10 Sutarni C630248 NOS C/ Ganas SOU + FS, Persiapan CSS MZ
Neglected Fr Dislokasi
11 Ahmad Zamroni C636220 ORIF BIN
Ankle Dextra
12 Sri Rahayu C105747 Pansinusitis FESS + CWL Sinistra + Konka Reduksi

DAT
OMSK Kiri Dg
13 Bambang Susanto C402987 Mastoidektomi Radikal
Kolesteatoma PW
14 Rosikha C634853 SNNT Dextra C/ Ganas Isthmolobektomi + FS, Ganas TT BIS
15 Juminah SMNT C/ Ganas T2N1M0 Isthmolobectomy + FS, Ganas TT

C635824 BIS
Inv Breast Ca Of NST Gr
16 Sutiah Wide Eksisi + Deseksi Axilla
C629956 II MS BIS
Ca Papilary Reg Colli
17 Karsiti C635776 Isthmolobektomi Dextra + FS, Ganas TT DWT
Dextra Susp Ca Thiroid
SNNT Dextra et Sinistra c/
18 Kusuma Rahayu C597102 Isthmolobektomi + FS, Gns TT DWT
ganas T3N0M0
Defect Wajah Pasca
19 Agus Priyono C624900 Rekonstruksi Wajah Komplek NJT
Eksisi Tumor Luas
Multiple Fr + Fr.
20 Heri C635731 Parasymphisis Dextra ORIF DID + PJ
Mandibula
Mata Kiri Silicon Oil Filled
21 M Ali Sahid C577695 Mata Kiri Re Vitrektomi + SO Exchange AL
Eye + Still Detachment
Mata Kanan Proliferatif

Diabetik Retinopati + Mata Kanan Vitrektomi + MP + Endolaser
22 Kuswati C562052 AW
Tractional Retinal + Silicon Oil
Detachment
Mata Kanan Vitreus

Hemorage + Mata Kanan
23 Yahmin Daladi C622125 Mata Kanan Vitrektomi + EL+SO/ Gas AW
Kiri Proliferatif Diabetic
Retinopati
Mata Kanan & Kiri

Proliferatif Diabetic
24 Jarmani C607671 Retinopati + Tractional Mata Kanan Vitrektomi + EL+SO/ Gas AW
Retinal Detachment +
Vitreous Haemorhage
Mata Kanan Tumor Mata Kanan Orbitotomi Anterior + DCR +

25 Kuni C627281
Saccus Lakrimalis Silikon Tube TL
26 Rita Hastuti C634938 Tumor Ekstradural VL 4 - 5 Hemilaminektomi HY
27 Sri Handayani C621578 Meningioma Clinoid Craniotomi Mikro Ds Tengkorak ZM
28 Dhifan Ilmi Fr. Radius Ulna Dextra ORIF APR
Canal Stenosis V
29 Tasni C634132 PSRS APR + BIN
Lumbalis
Fr. Ulna Sinistra, Fr.
30 Aditya C636641 Metacarpal Sinistra, Fr. ORIF APR
Radius Sinistra
31 Suprihati C603439 MS Severe, MR Moderate, DVR SF

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PROGRAM OPERASI INSTALASI BEDAH SENTRAL

HARI / TANGGAL : KAMIS, 01 JUNI 2017

PROGRAM OPERASI INSTALASI BEDAH SENTRAL

HARI / TANGGAL : JUMAT, 02 JUNI 2017

8 GA 07.30 08.00 120

Mata kanan kiri Retinal Detachment + Mata

Mata Kanan SO Filled Eye + Katarak

PROGRAM OPERASI INSTALASI BEDAH SENTRAL

HARI / TANGGAL : SABTU, 03 JUNI 2017

PINDAHAN OK GRD BERSIH 2 OK

3 Sunarsih 2 NPBI 56 th P MRK LD C633357 Adeno Ca Endometrium IA Surgical Staging MZ RE

5 Oemi Salamah 2 NPBI 82 th P KPD LD C635427 Ca Sinonasal Aff Tampon + NF Endoskopi WY AY

ASI INSTALASI BEDAH SENTRAL

HARI / TANGGAL : MINGGU, 04 JUNI 2017

1 GA 13.30 14.00 180

4 GA WA 13.30 14.00 120

HARI / TANGGAL : SENIN, 05 JUNI 2017

1 GA JL 07.30 08.00 08.30

8 GA VL 08.00 10.00 120

GR 1 LA 07.20 07.30 08.00

Mata Kanan Kiri Subluksasi Lensa ec Marfan

Plate 2.0 10mm

GR 5 GA 07.30 08.00 11.30

DS 1 GA HR 06.30 07.00 07.20

HARI / TANGGAL : SELASA, 06 JUNI 2017

3 Marsam 3 NPBI 52 th L R1B C614466 OMSK Kiri Thympanoplasty Kiri Mikroskop PW S : AU

4 Lagi 3 NPBI 56 th L R6B C635019 Efusi Pleura Dextra Loculated Thorakotomi

8 Khumaedah VIP NPBI 45 th P GRD L4 C604349 Ca Cervix Radikal Histerektomi + FS KD 1 EW TW,YN

1 GA DN 07.30 08.00 10.30

2 GA DN 07.30 08.00 10.30

4 GA WA 07.30 08.00 11.30 180

6 GA JL 10.00 13.30 240

10 GA WA 07.30 08.00 11.00 180

JTG GA HR 07.00 10.00 13.30

GR 1 GA HA 07.20 07.30 10.30

Mata Kiri Subluksasi Lensa + Glaukoma

Mata Kanan Kiri Injeksi Steroid Triamcinolone

GR 3 GA HA 07.30 08.00 11.30

DS 1 GA HS 07.30 08.00 08.20

DS 2 GA 07.30 08.00 08.30

1 GA HR 07.30 08.00 10.30 180

2 GA HR 07.30 08.00 10.30

2 GA HR 11.00 13.30 180

GR 4 GA WA 07.20 07.30 10.30 120

PROGRAM OPERASI INSTALASI BEDAH SENTRAL

HARI / TANGGAL : KAMIS, 08 JUNI 2017

6 Rustiyanto VIP NPBI 56 th L GRD L4 C639351 Massa Sinonasal Hemimaksilektomi DAT S : AR

1 GA HA 07.30 08.00 10.30 120

2 GA DN 07.30 08.00 10.30

4 GA AI 12.00 15.30 120

8 GA SF 06.00 06.30 10.30

JTG GA WA 07.00 10.00 13.30

GR 4 GA DS 07.20 07.30 10.30

DS 1 GA HS 07.30 08.00 09.30

PROGRAM OPERASI INSTALASI BEDAH SENTRAL

HARI / TANGGAL : JUMAT, 09 JUNI 2017

1 GA WA 07.30 08.00 10.30

2 GA HS 09.00 11.30 180

4 GA TA 12.30 14.30 120