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LAPORAN PELAYANAN PEMBEDAHAN

DI UNIT KAMAR OPERASI RSI SITI HAJAR SIDOARJO


BULAN JANUARI TAHUN 2018

KLASSIFIKASI JNS
UMUR SPESIAL DX DX DOKTER RWT
NO NO. REG NAMA PASIEN OPERASI TGL OPERASI TINDAKAN ANAST
KH B S K ISASI PRE OP POST OP OPERATOR INAP
P HESI
1 421660 Ny.Sulis 24th √ Obgyn 01/01/2018 G2P1A0+CPD LSCS G2P1A0+CPD dr.Kery SAB III/VK
2 421620 Ny.Siti fatimah 27th √ Obgyn G2P1A0+Post date LSCS G2P1A0+Post date dr.Umi SAB II/VK

3 419121 Tn.Soni suryono 49th √ Umum 02/01/2018 HIL D Herniotomy HIL D dr.Sukarno SAB I
4 421706 Ny.Nur hayati 27th √ Obgyn G2P1A0 +BSC lscs G2P1A0 +BSC dr.Kery SAB II/VK
5 350213 Ny.Tri indriyani 27th √ Obgyn G1P0A0+Let lin lscs G1P0A0+Let lin dr. Haris SAB II/VK
6 410510 Ny.Khusiniati 46th √ Obgyn Cystoma ovarii cystectomy+sod Cystoma ovarii dr.Kery SAB I/VK
7 316524 Ny.Agustina S 46th √ Obgyn Myoma uteri SVH+SOD Myoma uteri+cistoma ovarii dr.Kery SAB I/VK
8 416753 Ny.Suernik 40th √ Umum Struma nodusa S Subtotal lobectomy Struma nodusa S dr.Sukarno Intubasi II
G4P1A2+Prolong laten G4P1A2+Prolong laten
9 405587 Ny.Uswatun H 32th √ Obgyn phase LSCS phase dr.Kery SAB I/VK
10 421199 Tn.Khumaidi 52th √ Umum HIL S Herniotomy HIL S dr.Hernowo SAB III
11 421591 Tn.Sutikno 58th √ Umum Abces pedis + DM Incisi +debridement Abces pedis + DM dr.Hernowo SAB III

12 421242 Ny.Wahyu T 21th √ Umum FAM D Exterpasi FAM D dr.Hernowo Masker II


13 420103 Tn.Sulaiman 67th √ Umum Burcitis caltus D Excisi +osteotomy Burcitis caltus D dr.Hary C SAB II

14 364596 Ny..Riesta P 29th √ Obgyn G2P0A0+CPD LSCS G2P0A0+CPD dr.Umi SAB II/VK
15 276743 Nn.Umi kholailati 24th √ Umum 03/01/2018 FAM D Exterpasi FAM D dr.Sukarno Masker II
16 388239 Ny.Mudawama 31th √ Obgyn G3P1A0+BSC LSCS G3P1A0+BSC dr.Kery SAB II/VK
17 6477 Ny.Ismiyati 43th √ Umum FAM D Exterpasi FAM D dr.Sukarno Masker I
18 313817 Ny.Nur Vita V 29th √ Obgyn G3P1A1+BSC LSCS G3P1A1+BSC dr.Kery SAB II/VK
19 259653 Tn.Anton Sujatmiko 48th √ Umum HIM S Repair buli HIM S+Sarcoma inguinal dr.Yan P SAB I
20 421425 Tn.Edwin Kalumata 43th √ Umum Tumor Kistic punggung Exterpasi Tumor Kistic punggung dr.Yan P SAB II

KETERANGAN :

U : UMUM EL: ELEKIF B: BERSIH KTR : KOTOR

BPJS : BPJS CY: CYTO BK: BERSIH KONTAMINASI

As. : ASURANSI K: KONTAMINASI

LAPORAN PELAYANAN PEMBEDAHAN


DI UNIT KAMAR OPERASI RSI SITI HAJAR SIDOARJO
BULAN JANUARI TAHUN 2018

KLASSIFIKASI JNS
UMUR SPESIAL DX DX DOKTER RWT
NO NO. REG NAMA PASIEN OPERASI TGL OPERASI TINDAKAN ANAST
KH B S K ISASI PRE OP POST OP OPERATOR INAP
L P HESI
21 360026 Ny.Mujayanah 51th √ Obgyn 03/01/2018 Cystoma ovarii SVH Cystoma ovarii+mioma uteri dr.Kery SAB II
22 421757 Ny.Siti Fatimah 26th √ Obgyn G3P22 A0 +Tum or vagina LSCS G3P22 A0 +Tum or vagina dr.Kery SAB II/VK
23 268174 Ny.Hanlista 55th √ Obgyn Prolap uteri Open produden Prolap uteri dr.Kery SAB I/VK
24 411314 Ny.Nur Aini 61th √ Ortho CTS Release tendon CTS dr.Danang Masker II/TC
25 411651 Ny.Nurul Lasmini 48th √ Ortho Trigger figger Release tendon Trigger figger dr.Danang Masker I/TC
26 282018 Ny.Eka Suci A 30th √ Umum Mioma uteri Excisi FAM D dr.Bambang Tiva II/TC
Debridement+orif
27 349038 Ny.Mahmudah 60th √ Umum Cl fr angkle D plating+pinning Cl fr angkle D dr.Danang SAB II/TC
28 173659 Tn.Ucuk Nur √ Umum HIL D Herniotomy HIL D dr.Bambang SAB III/TC
29 421939 Ny.Indalloh Nur 24th √ Obgyn 1/4/2018 G1P0A0+PROM LSCS G1P0A0+PROM dr. Kery SAB II/VK
30 421939 Ny.Alif Shofia 26th √ Obgyn G1P1A1+post date LSCS G1P1A1+post date dr.Haris SAB II/VK
31 304809 Ny.Khoirun Nisa 21th √ Obgyn G3P1A1+KPP+BSC LSCS G3P1A1+KPP+BSC dr.Umi SAB III/VK
32 416309 Ny.Lailatul F 27th √ Obgyn G2P1A0+High miopi LSCS G2P1A0+High miopi dr. Kery SAB II/VK
33 421932 Ny.Dwi Wahyuni 36th √ Obgyn G1P10A0+Cistoma ovarii LSCS G1P10A0+Cistoma ovarii dr. Kery SAB II/VK
34 421529 N.y.Zuliyati 30th √ Obgyn G2P1-1A0+BSC LSCS G2P1-1A0+BSC dr. Kery SAB II/VK
35 396790 Ny.Sri Mulatsih 46th √ Obgyn Mioma uteri SVH Mioma uteri dr. Kery SAB II/VK
36 421284 Ny.Siti Wahyu 26th √ Umum Tumor mandibula Excisi Tumor mandibula dr.Yan P Tiva II/TC
37 421863 Ny.Ismidah 57th √ Umum Abces punggung Incisi+debridement Abces punggung dr.Hernowo Masker III

38 374083 Ny.Anik Kustiani 49th √ Umum Abces inguinal +DM Incisi+debridement Abces inguinal +DM dr.Hernowo SAB III
39 421943 An.Rehan Zufar 12th √ Umum Apendik perforasi Laparatomy Apendik perforasi dr.Hernowo SAB I
40 422002 Ny.Ira Mayasari 26th √ Obgyn G2P1A0+Let Lintang LSCS G2P1A0+Let Lintang dr.Umi SAB II/VK

KETERANGAN :

U : UMUM EL: ELEKIF B: BERSIH KTR : KOTOR

BPJS : BPJS CY: CYTO BK: BERSIH KONTAMINASI

As. : ASURANSI K: KONTAMINASI


LAPORAN PELAYANAN PEMBEDAHAN
DI UNIT KAMAR OPERASI RSI SITI HAJAR SIDOARJO
BULAN JANUARI TAHUN 2018

KLASSIFIKASI JNS
UMUR SPESIAL DX DX DOKTER RWT
NO NO. REG NAMA PASIEN OPERASI TGL OPERASI TINDAKAN ANAST
KH B S K ISASI PRE OP POST OP OPERATOR INAP
L P HESI
41 240982 Tn.Abidin 58th √ Urologi 04/01/2018 BPH Open prostectomy BPH dr.Kristianto SAB I

42 420982 Ny.Cristin Liber 30th √ Obgyn G1P0A0+Oligohidramnion LSCS G1P0A0+Oligohidramnion dr.Umi SAB II/VK
43 421722 Ny.Dwi Ira 33th √ Obgyn Abortus incompleitus Curetage Abortus incompleitus dr.Umi SAB II/VK
44 410954 Ny.Widya Fitri 28th √ Obgyn G2P1A0+BSC LSCS+Insersi IUD G2P1A0+BSC dr.Umi SAB II/VK
45 421854 Ny.Rifatul M 20th √ Obgyn G2P1A0+fetal distres LSCS G2P1A0+fetal distres dr.Umi SAB II/VK
46 218966 Sdr.Agil Fajar 20th √ Umum 05/01/2018 Ganglion carpi Excisi Ganglion carpi dr.Yan P Masker VIP B
47 407891 Ny.Insani Fitri A 23th √ Obgyn KET Laparatomy KET dr.Umi SAB II/VK
48 421415 Ny.Karsiti 46th √ Ortho Cl.Fr.Humeri +mal union Rekontruksi,plating,pinning Cl.Fr.Humeri +mal union dr.Hary C intubasi II/TC
49 420608 Ny.Munasaroh 48th √ Umum Struma Subtotal lobectomy Struma dr.Yan P intubasi II/TC
50 218764 An.Yustiara M 11th √ Ortho Cl fr radius ulna S Reposisi gips Cl fr radius ulna S dr.Danang intubasi VVIPA
51 209904 Tn.Pandu Agung 33th √ Umum Tumor Pre aurrcle S Excisi Tumor Pre aurrcle S dr.Hernowo TIVA II/TC
52 406757 Ny.Adinda N 25th √ Obgyn G1P0A0 +CPD LSCS G1P0A0 +CPD dr.Umi SAB I/VK
53 422150 Ny.Eka Septi M 24th √ Obgyn 1/6/2018 GIP0A0+faetal distres LSCS GIP0A0+faetal distres dr.Heru B SAB I/VK
54 326896 Ny.Nur Atika Septa 25th √ Obgyn G2P11A0+Featal distres LSCS G2P11A0+Featal distres dr.Umi SAB III/VK
55 405328 Ny.Annisa Rizky 27th √ Obgyn GIP0A0+faetal distres LSCS GIP0A0+faetal distres dr.Umi SAB VIP/VK
56 400825 Ny.Ainun Yatimah 32th √ Obgyn G2P1A0+BSC LSCS G2P1A0+BSC dr.Umi SAB II/VK
57 417595 Ny.Umi Fitriyah 36th √ Obgyn G3P1A1 +BSC LSCS G3P1A1 +BSC dr.Umi SAB I/VK
58 409993 Ny.Pipit Wahyu 24th √ Obgyn G1P0A0+Oligohidramnion LSCS G1P0A0+Oligohidramnion dr.Umi SAB II/VK
59 422309 Ny.Ari Triyawati 29th √ Obgyn 1/8/2018 G1PP0A0+Letsu LSCS G1PP0A0+Letsu dr. Kery SAB III/VK
60 351176 Ny.Meirista S 23th √ Obgyn G2P1A0+BSC LSCS G2P1A0+BSC dr. Kery SAB II/VK

KETERANGAN :

U : UMUM EL: ELEKIF B: BERSIH KTR : KOTOR

BPJS : BPJS CY: CYTO BK: BERSIH KONTAMINASI

As. : ASURANSI K: KONTAMINASI

LAPORAN PELAYANAN PEMBEDAHAN


DI UNIT KAMAR OPERASI RSI SITI HAJAR SIDOARJO
BULAN JANUARI TAHUN 2018

KLASSIFIKASI JNS
UMUR SPESIAL DX DX DOKTER RWT
NO NO. REG NAMA PASIEN OPERASI TGL OPERASI TINDAKAN ANAST
KH B S K ISASI PRE OP POST OP OPERATOR INAP
L P HESI
61 310198 Ny.Ruth Indriyani 33th √ Obgyn 1/8/2018 G2P1A0+BSC+PRM LSCS G2P1A0+BSC+PRM dr.Kery SAB II/VK
62 420658 Sdr.Novendra D 15th √ Umum Tumor leher Excisi Tumor leher dr.Yan P TIVA II/TC
63 401065 Nn.Anggun S 18th √ Umum Tumor pedis Excisi Tumor pedis dr.Yan P TIVA II/TC
64 422087 Ny.Riris Wijayanti 47th √ Umum Tumor mamae multiple Excisi Tumor mamae multiple dr.Yan P Masker II/TC
65 422087 Ny.Sri Widyaningrum 49th √ Umum CKD AV Shunt CKD dr.Hernowo LA I
66 421189 Ny.Badiyatul M 34th √ Umum Fam D Excisi Fam D dr.Hernowo TIVA I/TC
67 320125 Ny.Endah Sri L 48th √ Umum Lipoma bracialis Excisi Lipoma bracialis dr.Hernowo Masker I/TC
68 015257 Tn.Barry Satria 34th √ Umum HIL Herniotomy HIL dr.Bambang SAB II
69 421457 Tn.Supoyo 69th √ Umum HIL Herniotomy HIL dr.Bambang SAB II/TC
70 282147 Nn.Wahyuni Eka 24th √ Umum Multiple Fam D Excisi Multiple Fam D dr.Hernowo TIVA II
71 418978 Ny.Marfiatun 55th √ Umum Ca Mamae D Mastektomy Ca Mamae D dr.Hernowo intubasi III/TC
72 420296 Nn.Adinda Setia 20th √ Umum Apendicitis Laparatomy Apendicitis dr.Bambang SAB II/TC
73 422295 Ny.Olan Mukti 30th √ Obgyn G3P1A1+PROM+PEB LSCS G3P1A1+PROM+PEB dr.Umi SAB II/VK
74 400238 Ny.Kustiyani 37th √ Obgyn G4P2A1+BSC LSCS +MOW G4P2A1+BSC dr.Umi SAB II/VK
75 388951 Tn.Trisasongko 42th √ Ortho Burcitis Genu D Excisi Burcitis Genu D dr.Danang SAB II/TC
76 322699 Tn.Judianto 42th √ Umum Tumor sub clavicula Excisi Tumor sub clavicula dr.Bambang Masker II/TC
77 422103 Tn.Ronny Reppy 46th √ Umum Gall Stone Cholocistectomy Gall Stone dr.Hernowo SAB II
78 422229 Sdr.Riyan P 25th √ Umum Apendicitis Apendictomy Apendicitis dr.Hernowo SAB III
79 327826 Ny.Nadiya Sabila 28th √ Obgyn GIP0A0+CPD LSCS GIP0A0+CPD dr.Umi SAB I/VK
80 418238 Ny.Ika Yuluiani 35th √ Obgyn G3P2A0+BSC 2X LSCS +MOW G3P2A0+BSC 2X dr.Umi SAB I/VK

KETERANGAN :

U : UMUM EL: ELEKIF B: BERSIH KTR : KOTOR

BPJS : BPJS CY: CYTO BK: BERSIH KONTAMINASI

As. : ASURANSI K: KONTAMINASI


LAPORAN PELAYANAN PEMBEDAHAN
DI UNIT KAMAR OPERASI RSI SITI HAJAR SIDOARJO
BULAN JANUARI TAHUN 2018

KLASSIFIKASI JNS
UMUR SPESIAL DX DX DOKTER RWT
NO NO. REG NAMA PASIEN OPERASI TGL OPERASI TINDAKAN ANAST
KH B S K ISASI PRE OP POST OP OPERATOR INAP
L P HESI
81 421304 Ny.Evi Rahmawati 31th √ Obgyn 08/01/2018 G4P3A0+BSC LSCS+Insersi IUD G4P3A0+BSC dr.Umi SAB I/VK
82 417264 Ny.Sri Wulandari 34th √ Obgyn G3P2A0+BSC LSCS+insersi IUD G3P2A0+BSC dr.Umi SAB II/VK
83 406750 Ny.Ayu Nur Farida 24th √ Obgyn 1/9/2018 G2P1A0+BSC LSCS G2P1A0+BSC dr.Umi SAB II/VK
84 421075 Ny.Zaliyanti 31th √ Obgyn G1P0A0+Gemeli LSCS G1P0A0+Gemeli dr.Kery SAB II/VK
85 415782 Ny.Dwi Faridah 23th √ Obgyn G2P1A0+PP LSCS G2P1A0+PP dr.Kery SAB II/VK
86 258994 Ny.Emi Juliastuti 45th √ Obgyn Cystoma ovarii SOS +Myomectomy Cystoma ovarii dr.Kery SAB III/VK
87 419376 Ny.Suwartiningsih 53th √ Umum Struma nodusa Sub total lobectomy Struma nodusa dr.Yan P SAB II
88 422369 Tn.Satar 75th √ Umum HIL D +Apendicitis Herniotomy+appendictomy HIL D +Apendicitis dr.Hernowo SAB II
89 422456 Ny.Sisilia Kartika 27th √ Obgyn G1P0A0+Post date LSCS G1P0A0+Post date dr.Kery SAB II/VK
90 416421 Ny.Roihatin 34th √ Obgyn G4P3A0+Oligohidramnion LSCS+Insersi IUD G4P3A0+Oligohidramnion dr.umi SAB III/VK

91 421685 Tn.M.Dahlan 60th √ urologi BPH Sachze+TUR P BPH dr.Kristianto SAB I


92 411397 Ny.Ferawati Nur 20th √ Obgyn 10/01/2018 G2P1A0+BSC LSCS G2P1A0+BSC dr.Kery SAB III/VK
93 417984 Ny.Umi Saadah 40th √ Umum Hemoroid G II Hemoroidectomy Hemoroid G II dr.Yan P SAB II/TC
94 422548 Ny.Nur Aini 20th Obgyn Abortus incompletus Curetage Abortus incompletus dr.Kery SAB III/VK
95 417986 Ny.Astrid F 36th √ Obgyn G2P1A0+BSC LSCS G2P1A0+BSC dr.Kery SAB I/VK
96 238137 An.M.Nasar R 6th √ Mata Herdiolum Incisi Herdiolum dr.Hanny Masker II/TC
97 415767 Tn.Arija Waspada 60th √ Urologi Ca prostad Subcapsuler orcidectomy Ca prostad dr.Kristianto SAB II
98 419638 Ny.Suwartiningsih 75th √ Umum Apendic cronic Apendictomy Apendic cronic dr.Hernowo SAB III
99 389064 Ny.Emma Suhada 55th √ Umum Ganglion wrist Excisi Ganglion wrist dr.Hernowo Masker I
100 422092 Ny.Titi Nurjanna 38th √ Umum Multiple lipoma Excisi Multiple lipoma dr.Hernowo Masker II

KETERANGAN :

U : UMUM EL: ELEKIF B: BERSIH KTR : KOTOR

BPJS : BPJS CY: CYTO BK: BERSIH KONTAMINASI

As. : ASURANSI K: KONTAMINASI

LAPORAN PELAYANAN PEMBEDAHAN


DI UNIT KAMAR OPERASI RSI SITI HAJAR SIDOARJO
BULAN JANUARI TAHUN 2018

KLASSIFIKASI JNS
UMUR SPESIAL DX DX DOKTER RWT
NO NO. REG NAMA PASIEN OPERASI TGL OPERASI TINDAKAN ANAST
KH B S K ISASI PRE OP POST OP OPERATOR INAP
L P HESI
101 257971 Nn.Juvanka R 19th √ Umum 1/10/2018 Fam S Excisi Fam S dr.Hernowo Masker I

102 422440 Ny.Cholifatu Ula 39th √ Obgyn G2P1A0+PEB LSCS+Insersi IUD G2P1A0+PEB dr.umi SAB II/VK
103 372969 Ny.Santi H 39th √ Obgyn G4P3A0+PP LSCS+Insersi IUD G4P3A0+PP dr.umi SAB I/VK
104 421429 Ny.Siti Chusna 30th √ Obgyn G4P1A2+BSC LSCS G4P1A2+BSC dr.umi SAB III/VK
105 421585 Ny.Cholifah A 45th √ Obgyn Cystoma ovarii SOD+Oovarectomy Cystoma ovarii dr.umi SAB II/VK
106 406420 Ny.Umi Masruroh 33th √ Obgyn G3P2A0+Let lin LSCS G3P2A0+Let lin dr.umi SAB II/VK
107 420266 Sdr.Altdho S 21th √ Umum 11/01/2018 Tumor leher Excisi Tumor leher dr.Yan P Masker I/TC
108 356025 Ny.Dewi Zulaikah 38th √ Obgyn G2P1A0+BSC LSCS G2P1A0+BSC dr.umi SAB VVIP
109 407881 Ny.Fitri Ayu 20th √ Obgyn G1P0A0+PP LSCS G1P0A0+PP dr.umi SAB III/VK
110 199330 Ny.Krissantini D 34th √ Obgyn G2P1A0+Letsu LSCS G2P1A0+Letsu dr.umi SAB II/VK
111 337942 Tn. Sunar 70th √ Urologi BPH Tur p BPH dr.Kristianto SAB II
112 422198 Ny.Atik Kusumawa 37th √ Umum Gallstone Cholecistectomy Gallstone dr.Hernowo SAB I
113 422381 Ny.Casrilah 33th √ Umum 12/01/2018 FAM D Excisi FAM D dr.Sukarno Masker II
114 256289 Ny.Suriyanah 48th √ Umum Haemoroid Hemoroidectomy Haemoroid dr.Sukarno SAB II
115 389681 Ny.Luluk Endarwati 49th √ Umum DM +Ganggren Debridement DM +Ganggren dr.Sukarno SAB II
116 422594 Ny.Sri martini 33th √ Umum Mamae Abran Excisi Mamae Abran dr.Bambang TIVA II

117 288762 Tn.M.Harun A 25th √ Umum HIL D Herniotomy HIL D dr.Hernowo SAB III
118 421905 Sdr.Bayu Santosa 22th √ Urologi Varicocle S Vasoligasi tinggi palomo Varicocle S dr.Kristianto SAB II
119 397555 Ny.Kurniah Anisa 25th √ Obgyn G1P0A0+CPD LSCS G1P0A0+CPD dr.Umi SAB II/VK
120 422813 Ny.Nurul Agustin 28th √ Obgyn 13/01/2018 G2P1A0+BSC LSCS G2P1A0+BSC dr.Kery SAB II/VK

KETERANGAN :

U : UMUM EL: ELEKIF B: BERSIH KTR : KOTOR

BPJS : BPJS CY: CYTO BK: BERSIH KONTAMINASI

As. : ASURANSI K: KONTAMINASI


LAPORAN PELAYANAN PEMBEDAHAN
DI UNIT KAMAR OPERASI RSI SITI HAJAR SIDOARJO
BULAN : JANUARI TAHUN 2018

KLASSIFIKASI JNS
UMUR SPESIAL DX DX DOKTER RWT
NO NO. REG NAMA PASIEN OPERASI TGL OPERASI TINDAKAN ANAST
KH B S K ISASI PRE OP POST OP OPERATOR INAP
L P HESI
121 421532 Tn.Tutur W 53th √ Umum 13/01/218 HIL Herniotomy HIL dr.Hernowo SAB I
122 291259 Ny.Lilik Nuryatin 53th √ Obgyn Polip cervix Exterpasi Polip cervix dr.Umi SAB II/VK
123 422166 Ny.Rizkiana 28th √ Obgyn G3P1A1+BSC LSCS+Insersi IUD G3P1A1+BSC dr.Umi SAB II/VK
124 422806 Ny.Risawatul 32th √ Obgyn G2P1A0+PEB LSCS G2P1A0+PEB dr.Kery SAB III/VK
125 421187 Ny.Aris Setyowati 35th √ Obgyn 14/01/2018 G2P1A0+Oligohidramniaon LSCS G2P1A0+Oligohidramniaon dr.Umi SAB II/VK
126 230985 Ny.Fitri Meta Eka 28th √ Obgyn G2P1A0+BSC+PRM LSCS G2P1A0+BSC+PRM dr.Umi SAB I/VK
127 422950 Ny.Nur Indah P 27th √ Obgyn KET SOS KET dr.Kery SAB II/VK
128 396130 Ny.Anita Agusty 34th √ Obgyn 15/01/2018 G2P1A0+BSC+PRM LSCS G2P1A0+BSC+PRM dr.Kery SAB II/VK
129 428660 Ny.Nur Handayani 35th √ Obgyn Ab incomplit Curetage Ab incomplit dr.Kery SAB II/VK
130 422757 Tn.Eko Setyo B 42th √ Umum Tumor paha Excisi Tumor paha dr.Yan P TIVA II/TC
131 422891 An.M.Muadzaky 13th √ Umum Tumor pedis Excisi Tumor pedis dr.Yan P TIVA II/TC
132 422750 Ny.Yayuk Ernawati 33th √ Umum Haemoroid G III Haemoroidectomy Haemoroid G III dr.Yan P SAB II/TC
133 422457 Ny.Setya Rahayu 44th √ Umum Mamae abrant Excisi Mamae abrant dr.Yan P SAB III/TC
134 312148 Ny.Hanny Mei U 34th √ Obgyn G3P2A0+BSC LSCS+MOW G3P2A0+BSC dr.Haris SAB II/VK
135 422959 Ny.Fitri Lutfiah 25th √ Obgyn G3P2A0+BSC LSCS+MOW G3P2A0+BSC dr.Haris SAB III/VK
136 422956 Ny.Fateni 31th √ Obgyn G3P2A0+HbSAg+ LSCS G3P2A0+HbSAg+ dr.Haris SAB II/VK
G1P0A0+High miopi+ket
137 420682 Ny.Mila Wahyu 25th √ Obgyn G1P0A0+High miopi LSCS mekoneal dr.Umi SAB II/VK
138 306920 Tn.Syaichur R 43th √ Umum Abces sub mandibula Incisi+debridement Abces sub mandibula dr.Hernowo TIVA II
139 422637 Tn.Fadhli 47th √ Umum Abces cruris+DM Incisi+debridement Abces cruris+DM dr.Hernowo SAB III
140 422977 Tn.Susiyanto 43th √ Umum Abces perianal Incisi+debridement Abces perianal dr.Hernowo SAB VVIPA

KETERANGAN :

U : UMUM EL: ELEKIF B: BERSIH KTR : KOTOR

BPJS : BPJS CY: CYTO BK: BERSIH KONTAMINASI

As. : ASURANSI K: KONTAMINASI

LAPORAN PELAYANAN PEMBEDAHAN


DI UNIT KAMAR OPERASI RSI SITI HAJAR SIDOARJO
BULAN : JANUARI TAHUN 2018

KLASSIFIKASI JNS
UMUR SPESIAL DX DX DOKTER RWT
NO NO. REG NAMA PASIEN OPERASI TGL OPERASI TINDAKAN ANAST
KH B S K ISASI PRE OP POST OP OPERATOR INAP
L P HESI
141 415889 Ny.Alyffia Lintang 29th √ Obgyn 15/01/2018 G2P1A0+HT LSCS+Insesrsi IUD G2P1A0+HT dr.Umi SAB II/VK
142 392505 Ny.Farida Ariani 39th √ Obgyn G4P3A0+PPM LSCS+MOW G4P3A0+PPM dr.Umi SAB II/VK
143 422989 Tn.Sunaryo 62th √ Umum 16/01/2018 Li[poma punggung Excisi Li[poma punggung dr.Sukarno TIVA II
144 422385 Tn.Hendra Krisna 35th √ Umum Multiple clavus Excisi Multiple clavus dr.Sukarno SAB II
145 422999 Tn.Sujar 65th √ Umum HIL Herniotomy HIL dr.Sukarno SAB III/TC
146 422486 Tn.Dhopar D 42th √ Umum Lipoma lengan D Exterpasi Lipoma lengan D dr.Sukarno TIVA I
Peritonitis generalisata+app
147 423091 Sdr.Masrukin 24th √ Umum Appendic+cholelitiasis Laparatomy+cholesistectomy perforasi+cholelitiasis dr.Sukarno SAB III
148 345521 Ny.Chusnul Maulid 26th √ Obgyn G3P0A2+PER LSCS G3P0A2+PER dr.Kery SAB I/VK
149 256755 Ny.Fouria Wuwuk 48th √ Obgyn Mioma uteri SVH+SOS Mioma uteri+cistoma ovarii dr.Kery SAB I/VK
150 422318 Ny.Dian Andiktiyar 26th √ Obgyn Mioma uteri Miomectomy+incisi hematus Mioma uteri+hematosalping dr.Kery SAB II/VK
151 423105 Ny.Yayuk Winarmi 48th √ Obgyn Mioma uteri SVH+driling ovarium D Mioma uteri+cistoma ovarii dr.Kery SAB I/VK
152 405714 Ny.Chusnul H 26th √ Obgyn G1P0A0+Post date LSCS G1P0A0+Post date dr.Haris SAB I/VK
153 202395 Ny.Kiluk Undarwati 31th √ Obgyn G1P0A0+Condiloma LSCS G1P0A0+Condiloma dr.Haris SAB I/VK
√ Haemoroidectomy+incisi Haemoroid G III+condiloma
154 422760 Nn.Biba Retno F 23th Umum Haemoroid G III condiloma acuminata dr.Yan P SAB II/TC
155 237721 An.Ragil Putra 6th √ Ortho Cl fr humerus S Orif wiring Cl fr humerus S dr.Hary C Intubasdi I

156 397384 Tn.Al Firdaus 57th √ Urologi Batu buli multiple Vesicolithotomy Batu buli multiple dr.Kristianto SAB III
157 367805 Ny.Niken Endah 26th √ Obgyn G2P1A0+BSC LSCS+Insesrsi IUD G2P1A0+BSC dr.Umi SAB II/VK
158 321188 Ny.Hartutik 55th √ Ortho Cl fr radius Orif wiring Cl fr radius dr.Hary C IntubasdiII
159 420227 Ny.Eka Putri 24th √ Obgyn 17/01/2018 Cistoma ovarii Wedge resection Cistoma ovarii duplex dr.Kery SAB III/VK
160 422060 Ny.Fitria 36th √ Obgyn G2P1A0+BSC LSCS G2P1A0+BSC dr.Haris SAB II/VK

KETERANGAN :

U : UMUM EL: ELEKIF B: BERSIH KTR : KOTOR

BPJS : BPJS CY: CYTO BK: BERSIH KONTAMINASI

As. : ASURANSI K: KONTAMINASI


LAPORAN PELAYANAN PEMBEDAHAN
DI UNIT KAMAR OPERASI RSI SITI HAJAR SIDOARJO
BULAN : JANUARI TAHUN 2018

KLASSIFIKASI JNS
UMUR SPESIAL DX DX DOKTER RWT
NO NO. REG NAMA PASIEN OPERASI TGL OPERASI TINDAKAN ANAST
KH B S K ISASI PRE OP POST OP OPERATOR INAP
L P HESI
161 390864 Ny.Eka Ernawati 24th √ Obgyn 17/01/2018 G2P1A0+BSC LSCS G2P1A0+BSC dr.Haris SAB II/VK
162 413709 Ny.Latifatus 44th √ Obgyn Mioma uteri SVH+BSO Multiple mioma uteri dr.Haris SAB II/VK
163 411509 Ny.Sriyati 39th √ Obgyn G2P1A0+KPP LSCS+MOW G2P1A0+KPP dr.Umi SAB II/VK
164 402115 Nn.Riris Carasati 24th √ Umum FAM Excisi FAM dr.Hernowo TIVA II
165 380403 Ny.Suwarti 52th √ Umum Struma uni nodusa Sub total lobectomy Struma uni nodusa dr.Hernowo Intubasi II
166 423181 Tn.Sujoko 44th √ Umum Abces mandibula Incisi abces Abces mandibula dr.Hernowo LA III
167 422754 Sdr.Jihan Sinatra 19th √ Urologi Varicocle Vasoligasi tinggi palomo Varicocle dr.Kristianto SAB II
168 423268 Ny.Kriswinanti 21th √ Ortho Op fr digiti IV manus D Orif pining+debridement Op fr digiti IV manus D dr.Danang Intubasi II
169 423174 Ny.Indah Oktavia 33th √ Umum Peritonitis Lap appendictomy+biopsi Tumor abdominal dr.Sukarno SAB III
170 222419 Ny.Diah Puspita 30th √ Obgyn G4P3A0+BSC LSCS+MOW G4P3A0+BSC dr.Umi SAB III/VK
171 371589 Ny.Winarsih 34th √ Obgyn G4P3A0+BSC+PEB LSCS G4P3A0+BSC+PEB dr.Umi SAB II/VK
172 422885 Ny.Khoiriyah 38th √ Obgyn G3P2A0+BSC LSCS G3P2A0+BSC dr.Umi SAB I/VK
173 353723 Ny.Wahyu Hidaya 32th √ Obgyn G3P2A0+BSC+HbSAg+ LSCS+MOW G3P2A0+BSC+HbSAg+ dr.Umi SAB I/VK
174 423164 Tn.M.Basuki 57th √ Syaraf CVA bloading+HT Trepanasi CVA bloading+HT dr.Fauzi Intubasi I/ICU
175 405312 Ny.Vivi Nilasari 25th √ Obgyn 18/01/2018 G2P0A1+Kepala floatiing LSCS G2P0A1+Kepala floatiing dr.Heru B SAB II/VK
176 419328 Ny.Sucianti Kris 33th √ Obgyn G2P1A0+BSC LSCS G2P1A0+BSC dr.Heru B SAB I/VK
177 406928 Ny.Ernita Eko F 30th √ Obgyn G2P1A0+BSC LSCS G2P1A0+BSC dr.Heru B SAB I/VK
178 423219 Ny.Ririn Teguh P 34th √ Obgyn G3P2A0+BSC LSCS+MOW G3P2A0+BSC dr.Haris SAB II/VK
179 253464 Ny.Nining Wahyu 34th √ Obgyn G2P1A0+BSC LSCS G2P1A0+BSC dr.Haris SAB II/VK
180 422651 Ny.Dwi Fitri W 28th √ Obgyn G2P1A0+BSC+anemis LSCS G2P1A0+BSC+anemis dr.Kery SAB II/VK

KETERANGAN :

U : UMUM EL: ELEKIF B: BERSIH KTR : KOTOR

BPJS : BPJS CY: CYTO BK: BERSIH KONTAMINASI

As. : ASURANSI K: KONTAMINASI

LAPORAN PELAYANAN PEMBEDAHAN


DI UNIT KAMAR OPERASI RSI SITI HAJAR SIDOARJO
BULAN : JANUARI TAHUN 2018

KLASSIFIKASI JNS
UMUR SPESIAL DOKTER RWT
NO NO. REG NAMA PASIEN OPERASI TGL OPERASI TINDAKAN ANAST
KH B S K ISASI OPERATOR INAP
L P HESI
181 298862 Ny.Siti Khotijah 43th √ Umum 18/01/2018 Multiple lipoma Excisi Multiple lipoma dr.Bambang SAB II/TC
182 423265 Ny.Munawaroh 59th √ Umum Tumor dinding abdominal Excisi Tumor dinding abdominal dr.Bambang SAB III/TC
183 000231 Ny.Siti Mualifah 42th √ Ortho CTS Release tendon CTS dr.Dananag Masker II/TC
184 423124 An.A.Fadkur Zaini 14th √ Ortho Cl fr radius ulna Orif plating Cl fr radius ulna dr.Dananag Intubasi III
185 271609 Ny.Fristy Sarila 28th √ Obgyn G3P1A1+Fetal distress LSCS G3P1A1+Fetal distress dr.Umi SAB I/VK
186 248569 Ny.Dewi Sartika 39th √ Obgyn G5P2A2+BSC LSCS+MOW G5P2A2+BSC dr.Umi SAB II/V
187 423324 Tn.Tjong Tjeng 56th √ Ortho Op fr cruris Debridement+backslep Op fr cruris dr.Dananag SAB II
188 423367 Tn.Kasan 64th √ Ortho Cl fr radius Reposisi+pasang gips Cl fr radius dr.Dananag Intubasi III
189 418243 Ny.Adinda Septi 21th √ Obgyn G1P0A0+High miopi LSCS G1P0A0+High miopi dr.Umi SAB III/VK
190 380601 Ny.Maya Sofianti 39th √ Obgyn Mioma geburt Miomectomy Mioma geburt dr.Umi SAB I/VK
191 423172 An.Tio Ari Ambar 11th √ THT Adenotonsilitis Kronis ATE Adenotonsilitis Kronis dr.Noer Sofi Intubasi I
192 423068 Nn.Nadia Adinda 17th √ Umum 19/01/2018 Lipoma leher Exterpasi Lipoma leher dr.Sukarno Masker II
193 423009 Ny.Siti Rahayu 48th √ Umum Tumor mamae Exterpasi Tumor mamae dr.Sukarno Masker II
194 423159 Ny.Elinda Nur H 34th √ Umum Appendic akut Appendictomy Appendic akut dr.Sukarno SAB II
195 423368 Sdr.Genta Alam 17th √ Umum Perianal fistel Fistulectomy Perianal fistel dr.Sukarno SAB I/TC
196 423338 Sdr.Sulkan Efendi 27th √ Umum Tumor punggung Excisi Tumor punggung dr.Yan P TIVA III
197 422328 Ny.Selvi Melani 45th √ Umum Cholelitiasis Cholesistectomy Cholelitiasis dr.Hernowo SAB III
198 422892 Ny.Luluk Mardiya 52th √ Umum Ulcus pedis S+DM Nekrotomy+debridement Ulcus pedis S+DM dr.Hernowo SAB III
199 288400 Ny.Siti Maisaroh 47th √ Umum Ulcus pedis D+DM Nekrotomy+debridement Ulcus pedis D+DM dr.Hernowo SAB II
200 423199 Ny.Sandi Wimarya 50th √ Umum Nekrosis digiti II pedis S+DM Amputasi+debridement Nekrosis digiti II pedis S+DM dr.Hernowo SAB I

KETERANGAN :

U : UMUM EL: ELEKIF B: BERSIH KTR : KOTOR

BPJS : BPJS CY: CYTO BK: BERSIH KONTAMINASI

As. : ASURANSI K: KONTAMINASI


LAPORAN PELAYANAN PEMBEDAHAN
DI UNIT KAMAR OPERASI RSI SITI HAJAR SIDOARJO
BULAN : JANUARI TAHUN 2018

KLASSIFIKASI JNS
UMUR SPESIAL DX DOKTER RWT
NO NO. REG NAMA PASIEN OPERASI TGL OPERASI ANAST
KH B S K ISASI POST OP OPERATOR INAP
L P HESI
201 422342 An.M.Fanda F 13th √ Ortho 19'01'2018 Cl fr tibia 1/3 tengah S Orig plating Cl fr tibia 1/3 tengah S dr.Dananag SAB II
202 295866 Ny.Himatun Nikma 23th √ Obgyn G1P0A0+hipertiroid LSCS+Insersi IUD G1P0A0+hipertiroid dr.Umi SAB III/VK
203 322621 Ny.Upi Oktaviani 28th √ Obgyn G2P1A0+BSC LSCS G2P1A0+BSC dr.Umi SAB II/VK
204 245749 Ny.Supriyanti 37th √ Obgyn G5P2A2+BSC LSCS+MOW G5P2A2+BSC dr.Umi SAB II/VK
205 295414 Ny.Alfa Variyana 34th √ Obgyn 20/01/2018 G2P1A0+fetal distress LSCS G2P1A0+fetal distress dr.Kery SAB II/VK
206 423503 Ny.Riris Wanda 25th √ Obgyn G1P0A0+PRM LSCS G1P0A0+PRM dr.Kery SAB II/VK
207 423076 Tn.Suntoro 63th √ Umum HIL Herniotomy HIL dr.Hernowo SAB III/TC
208 423039 Tn.Anshori 62th √ Umum HIL Herniotomy HIL dr.Hernowo SAB III/TC
209 275729 Ny.Tri Andayani 34th √ Obgyn G2P1A0+BSC LSCS G2P1A0+BSC dr.Kery SAB II/VK
210 423577 Tn.M.Usman 66th √ Ortho Cross injuri manus D Debridement+hip plasty Cross injuri manus D dr.Hary C Intubasi II/TC
211 423589 Tn.Daniel Boijani 38th √ Ortho Op fr 1/3 proximal tibia S Origf plating+debridement Op fr 1/3 proximal tibia S dr.Hary C SAB III/TC
212 423644 Ny.Meri Ariska 24th √ Obgyn 1/22/2018 G1P0A0+CPD LSCS G1P0A0+CPD dr.Kery SAB III/VK
213 423642 Ny.Sutrani 36th √ Obgyn G3P1A1+PER LSCS G3P1A1+PER dr.Kery SAB III/VK
214 423458 Nn.Erlina Aditya 30th √ Umum FAM D Excisi FAM D dr.Yan P TIVA II
215 423145 Ny.Sandra Puspita 50th √ Umum Tumor punggung Excisi Tumor punggung dr.Yan P Masker II
216 423572 Tn.M.Yovi Ardian 30th √ Umum Multiple lipoma Excisi Multiple lipoma dr.Hernowo TIVA II
217 375993 Ny.Nikmah 60th √ Umum Gangren pedis S+DM Debridement Gangren pedis S+DM dr.Sukarno SAB III/TC
218 216133 Ny.Herni Septi A 30th √ Umum Tumor colli posterior Excisi Tumor colli posterior dr.Hernowo TIVA II/TC
219 423666 Ny.Noer Ainiyah 43th √ Obgyn G3P2A0+PEB LSCS+MOW G3P2A0+PEB dr.Kery SAB II/VK
220 423695 Ny.Aisyah Alma 22th √ Obgyn G1P0A0+PP LSCS G1P0A0+PP dr.Kery SAB II/VK

KETERANGAN :

U : UMUM EL: ELEKIF B: BERSIH KTR : KOTOR

BPJS : BPJS CY: CYTO BK: BERSIH KONTAMINASI

As. : ASURANSI K: KONTAMINASI

LAPORAN PELAYANAN PEMBEDAHAN


DI UNIT KAMAR OPERASI RSI SITI HAJAR SIDOARJO
BULAN : JANUARI TAHUN 2018

KLASSIFIKASI JNS
UMUR SPESIAL DX DOKTER RWT
NO NO. REG NAMA PASIEN OPERASI TGL OPERASI ANAST
KH B S K ISASI POST OP OPERATOR INAP
L P HESI
221 409523 Ny.Siti Khotimah 35th √ Obgyn 22/01/2018 Condiloma aluminata Couter Condiloma aluminata dr.Umi SAB II/VK
G1P0A0+PROM+Fetal G1P0A0+PROM+Fetal
222 405974 Ny.Shikhatul M 30th √ Obgyn distress LSCS distress dr.Umi SAB I/VK
223 422780 Ny.Nur Hayanah 28th √ Umum 23/01/2018 Tumor dinding abdomen Excisi Tumor dinding abdomen dr.Sukarno TIVA II/TC
224 422664 Ny.Sri Wahyuni 36th √ Obgyn G3P2A0+BSC LSCS+MOW G3P2A0+BSC dr.Kery SAB II/VK
225 326919 Ny.Yunita P 36th √ Obgyn Mioma uteri SVH+SOD Mioma uteri+cistoma ovarii dr.Kery SAB I/VK
226 422630 Ny.Linda Purwati 32th √ Obgyn Cistoma ovarii SOD+Miomectomy Cistoma ovarii+mioma uteri dr.Kery SAB III/VK
227 374061 Ny.Kusmaningrum 41th √ Obgyn G2P1A0+BSC+KIFL LSCS G2P1A0+BSC+KIFL dr.Kery SAB II/VK
228 412089 Ny.Siti Nur Habiba 28th √ Obgyn Menimetrorarghia Curetage Menimetrorarghia dr.Kery SAB II/VK
229 323511 Nn.Fera Sinar W 16th √ Obgyn Neuro fibromatosis Excisi Neuro fibromatosis dr.Yan P SAB II/TC
230 171779 Tn.Lukman Fanani 50th √ Umum Abses manus D Incisi multiple+debridement Abses manus D dr.Hernowo Masker VVIPB
Mal union fr femur post Mal union fr femur post
231 239159 Ny.Mariani 52th √ Ortho plating Aff plte plating dr.Hary C SAB III/TC
232 407159 Tn.Iswan 66th √ Urologi BPH TUR prostat+buli BPH+susp Ca buli dr.Kristianto SAB II/TC
233 423839 Ny.Ernawaty 26th √ Obgyn G1P0A0+PRM LSCS G1P0A0+PRM dr.Umi SAB II/VK
234 423168 Ny.Eny Suharianti 37th √ THT Septal deviasi epitaksis Septolipsi Septal deviasi epitaksis dr.Noer Sofi Intubasi I/TC
235 423845 An.m.Nizar Al I 12th √ Umum 24/01/2018 Multiple clavus pedis D Exterpasi Multiple clavus pedis D dr.Sukarno Masker I/TC
236 236669 Ny.Lilik Suprapti 45th √ Umum Tumor mamae Exterpasi Tumor mamae dr.Sukarno Masker II
Peritonitis+generalesata+ap Peritonitis+generalesata+ap
237 186095 An.Daffa Ryan S 13th √ Umum pendic
Explorasi appendictomy
pendic dr.Yan P SAB I
Debridement+tendoraphy+pi
238 423865 Sdr.A.Fauzi 21th √ Ortho Op fr ankle+fr phalank III ning Op fr ankle+fr phalank III dr.Hary C SAB III
239 423002 Ny.Ida Wahyu 45th √ Obgyn Multiple mioma uteri SVH Multiple mioma uteri dr.Kery SAB II/VK
240 423881 Ny.Amelia Yolanda 23th √ Obgyn G1P0A0+Letsu LSCS G1P0A0+Letsu dr.Umi SAB III/VK

KETERANGAN :

: UMUM EL: ELEKIF B: BERSIH KTR : KOTOR

: BPJS CY: CYTO BK: BERSIH KONTAMINASI

As. : ASURANSI K: KONTAMINASI


LAPORAN PELAYANAN PEMBEDAHAN
DI UNIT KAMAR OPERASI RSI SITI HAJAR SIDOARJO
BULAN : JANUARI TAHUN 2018

KLASSIFIKASI JNS
UMUR SPESIAL DX DOKTER RWT
NO NO. REG NAMA PASIEN OPERASI TGL OPERASI ANAST
KH B S K ISASI POST OP OPERATOR INAP
L P HESI
241 423803 Ny.RR.Febriana K 32th √ Obgyn 24/01/2018 G3P1A1+BSC+PEB LSCS G3P1A1+BSC+PEB dr.Umi SAB III/VK
242 409845 Ny.Muasyiah 55th √ Umum Appendic perforasi Lap explorasi Appendic perforasi dr.Hernowo SAB III
243 395824 Nn.Winda Fionita 31th √ Umum Tumor dinding dada Excisi Tumor dinding dada dr.Hernowo TIVA I
244 325982 Nn.Farhana Chaira 19th √ Umum Appendicitis Appendictomy Appendicitis dr.Hernowo SAB I/TC
245 220383 Ny.Susanti 68th √ Umum HIL Herniotomy HIL dr.Hernowo SAB I
246 421503 Ny.Ani Uswatun K 27th √ Obgyn G1P0A0+floating head LSCS G1P0A0+floating head dr.Umi SAB II/VK
247 420773 Ny.Rizki Amelia 29th √ Obgyn G2P1A0+BSC LSCS+Insersi IUD G2P1A0+BSC dr.Umi SAB I/VK
248 422311 Ny.Novia Dian A 30th √ Obgyn 25/01/2018 G2P1A0+BSC LSCS G2P1A0+BSC dr.Kery SAB I/VK
249 407468 Ny.Tri Wiraswati 31th √ Obgyn Mioma uteri Miomectomy Mioma uteri dr.Kery SAB II/VK
250 306162 Ny.Nur Aini 41th √ Obgyn Geborn mioma Miomectomy+curetage Geborn mioma dr.Heru B SAB II/VK
√ Cl fr tibia 1/3 distal+fr fibula
251 423932 Ny.Suhartatik 58th Ortho sigmental S Orif plating tibia Fr kominutif tibia distal dr.Danang SAB I/TC
Susp fr metatarsal digiti V Debridement+heacting+bac Susp fr metatarsal digiti V
252 423977 Sdr.Zaki Hamdan 17th √ Ortho pedis S kslep pedis S dr.Danang SAB III/TC
253 421012 Tn.Gunawan 69th √ Urologi BPH TUR Prostat BPH dr.Kristianto SAB I/TC
254 413955 Ny.Ratnawati 29th √ Obgyn G2P1A0+Gemeli+letsu LSCS G2P1A0+Gemeli+letsu dr.Umi SAB II/VK
255 421775 Ny.Umi Kholisah 25th √ Obgyn G3P1A1+PPT LSCS G3P1A1+PPT dr.Umi SAB II/VK
G4P3A0+Letsu+NST non G4P3A0+Letsu+NST non
256 422333 Ny.Sri Puji Lestari 36th √ Obgyn reaktif LSCS+Insersi IUD reaktif dr.Umi SAB I/VK
257 312610 Ny.Khusnul K 47th √ THT Septum deviasi Septoplasty Septum deviasi dr.Noer Sofi Intubasi II
258 423086 Ny.Sari Dewi 21th √ Obgyn G1P0A0+Oligohidramnion LSCS G1P0A0+Oligohidramnion dr.Umi SAB III/VK
259 305489 Ny.Fatimah 32th √ Obgyn G3P2A0+Oligohidramnion LSCS+Insersi IUD G3P2A0+Oligohidramnion dr.Umi SAB VVIPA/VK

260 423237 Ny.Khofifah 62th √ Obgyn Polip cervik Exterpasi polip Polip cervik dr.Umi SAB I/VK

KETERANGAN :

U : UMUM EL: ELEKIF B: BERSIH KTR : KOTOR

BPJS : BPJS CY: CYTO BK: BERSIH KONTAMINASI

As. : ASURANSI K: KONTAMINASI

LAPORAN PELAYANAN PEMBEDAHAN


DI UNIT KAMAR OPERASI RSI SITI HAJAR SIDOARJO
BULAN : JANUARI TAHUN 2018

KLASSIFIKASI JNS
UMUR SPESIAL DX DOKTER RWT
NO NO. REG NAMA PASIEN OPERASI TGL OPERASI ANAST
KH B S K ISASI POST OP OPERATOR INAP
L P HESI
261 423898 Ny.Desi Rachma 29th √ Obgyn 26/01/2018 G1P0A0+NST non reaktif LSCS G1P0A0+NST non reaktif dr.Kery SAB II/VK
262 135073 Ny.Ririn Trisna 39th √ Umum Giant lipoma punggung Exter[pasi Giant lipoma punggung dr.Sukarno Masker I/TC
263 418187 Ny.Sulichah 60th √ Anestesi CKD Pasang CVC CKD dr.Ary F LA VVIPB
264 418476 Ny.Rima Lailatus 21th √ Obgyn G1P0A0+PPT LSCS G1P0A0+PPT dr.Kery SAB II/VK
265 391736 Ny.Setiana 35th √ Obgyn G2P1A0+IUFD LSCS G2P1A0+IUFD dr.Kery SAB II/VK
266 423924 Tn.Abd.Rachman 59th √ Umum HIL Herniotomy HIL dr.Bambang SAB III/TC
267 367157 Ny.Kasiani 44th √ Umum Tumor punggung Excisi Tumor punggung dr.Bambang TIVA I/TC
268 423874 Tn.Kodim 58th √ Umum Fistula perianal Fistulectomy Fistula perianal dr.Bambang SAB III/TC
269 423914 Tn.Abd.Rohmad 35th √ Umum Tumor punggung Excisi Tumor punggung dr.Hernowo SAB II/TC
270 235873 Tn.Arianto Poetra 48th √ Umum Tumor colli posterior Excisi Tumor colli posterior dr.Hernowo TIVA VVIPA
271 346101 Ny.Ima Nur Indah 62th √ Ortho Cl fr colles humerus D Radical gips Cl fr colles humerus D dr.Dananag Masker I
272 422111 Ny.Wiji Astutik 49th √ Umum Ca mamae Modified radical mastectomy Ca mamae dr.Hernowo Intubasi VVIPB
273 077789 Ny.Yeni Herawati 38th √ Obgyn 27/01/2018 KET SOS KET dr.Kery SAB III/VK
274 424098 Ny.Indriyani 31th √ Obgyn G2P1A0+BSC LSCS G2P1A0+BSC dr.Kery SAB I/VK
275 422215 Ny.Amilatun N 30th √ Obgyn G1P0A0+Oligohidramnion LSCS G1P0A0+Oligohidramnion dr.Kery SAB I/VK
276 422215 Sdr.Akfun Muntako 19th √ Umum Haemoroid Haemoroidectomy Haemoroid dr.Hernowo SAB II
277 423936 Nn.Nova Rahma 15th √ Umum FAM Excisi FAM dr.Hernowo Masker III
278 422669 Ny.Lilik Masmania 38th √ Obgyn G4P2A1+PEB+BSC LSCS G4P2A1+PEB+BSC dr.Kery SAB II/VK
279 252281 Nn.Mauliana A 16th √ Umum Tumor scalp Excisi Tumor scalp dr.Yan P TIVA I
280 352178 Ny.Markatin 49th √ Umum Cholelitiasis Cholesistectomy Cholelitiasis dr.Hernowo SAB II

KETERANGAN :

U : UMUM EL: ELEKIF B: BERSIH KTR : KOTOR

BPJS : BPJS CY: CYTO BK: BERSIH KONTAMINASI

As. : ASURANSI K: KONTAMINASI


LAPORAN PELAYANAN PEMBEDAHAN
DI UNIT KAMAR OPERASI RSI SITI HAJAR SIDOARJO
BULAN : JANUARI TAHUN 2018

KLASSIFIKASI JNS
UMUR SPESIAL DX DOKTER RWT
NO NO. REG NAMA PASIEN OPERASI TGL OPERASI ANAST
KH B S K ISASI POST OP OPERATOR INAP
L P HESI
281 424153 Ny.Nur Zulaikah 32th √ Obgyn 27/01/2018 Abortus incomplit Curetage Abortus incomplit dr.Kery SAB II
282 424193 Sdr.Rahardyan S 29th √ Ortho Ruptur tendon Debridement+blakslep Ruptur tendon dr.Hary C SAB II
283 423451 Tn.Robby Sandria 27th √ Umum 29/01/2018 Atheroma punggung Exterpasi Atheroma punggung dr.Sukarno TIVA II/TC
284 359050 Ny.Suyekti Ambar 34th √ Obgyn G4P2A1+BSC LSCS+MOW G4P2A1+BSC dr.Kery SAB III/VK
285 423989 Ny.Fatchul F 29th √ Umum FAM Excisi FAM dr.Yan P Masker II/TC
286 305121 Ny.Hilda Nadia 29th √ Obgyn G1P0A0+PEB LSCS G1P0A0+PEB dr.Kery SAB II/VK
287 417292 Ny.Suyanti 37th √ Obgyn G3P2A0+BSC LSCS+MOW G3P2A0+BSC dr.Kery SAB III/VK
288 293429 Ny.Watini 29th √ Umum Corpus aleneum susuk KB Extraxi Corpus aleneum susuk KB dr.Yan P Masker II
289 293429 Ny.Ika Suryani 26th √ Obgyn G4P2A1+Post date LSCS G4P2A1+Post date dr.Haris SAB II/VK
290 424200 Ny.Anikah 49th √ Umum Phlegmon mandibula Incisi Phlegmon mandibula dr.Yan P TIVA I
291 392445 Tn.Lukfi Iksan 43th √ Umum CKD AV Shunt CKD dr.Hernowo LA RJ
Mal union fr clavicula post Mal union fr clavicula post
292 416804 Ny.Enty Suliswita 48th √ Ortho plating Aff plat plating dr.Danang Intubasi I
293 045980 Sdr.Rangga Eka 14th √ Ortho Cl epifisiologi radius distal S Pasang gips Cl epifisiologi radius distal S dr.Danang TIVA III
294 182116 Ny.Sukemi 46th √ Umum Cholelitiasis Cholesistectomy Cholelitiasis dr.Hernowo SAB VIP
295 408386 Ny.Umi Aida 23th √ Umum Tumor mamae D Excisi Tumor mamae D dr.Hernowo Masker II
296 424050 Nn.Nada Giyan 20th √ Ortho Mal union fr fibula 1/3 distal Orig plating Mal union fr fibula 1/3 distal dr.Danang SAB I
297 206018 Ny.Levana Sheila 28th √ Obgyn G2P1A0+BSC LSCS+Insersi IUD G2P1A0+BSC dr.Umi SAB I/VK
298 315151 Ny.Lila Khiqma 37th √ Obgyn G3P2A1+NST nonreaktif LSCS+Insersi IUD G3P2A1+NST nonreaktif dr.Umi SAB III/VK
299 422897 Ny.Uni Alfiatur 23th √ Obgyn G1P0A0+PROM LSCS G1P0A0+PROM dr.Umi SAB II/VK
300 420745 Ny.Iis Novita 24th √ Obgyn G1P0A0+Oligohidramnion LSCS+Insersi IUD G1P0A0+Oligohidramnion dr.Umi SAB II/VK

KETERANGAN :

U : UMUM EL: ELEKIF B: BERSIH KTR : KOTOR

BPJS : BPJS CY: CYTO BK: BERSIH KONTAMINASI

As. : ASURANSI K: KONTAMINASI

LAPORAN PELAYANAN PEMBEDAHAN


DI UNIT KAMAR OPERASI RSI SITI HAJAR SIDOARJO
BULAN : JANUARI TAHUN 2018

KLASSIFIKASI JNS
UMUR SPESIAL DX DOKTER RWT
NO NO. REG NAMA PASIEN OPERASI TGL OPERASI ANAST
KH B S K ISASI POST OP OPERATOR INAP
L P HESI
301 409126 Ny.Ratna Kartika 27th √ Obgyn 30/01/2018 G2P1A0+BSC LSCS G2P1A0+BSC dr.Umi SAB II/VK
302 419588 Ny.Dea Safitri H 23th √ Obgyn G1P0A0+PP LSCS G1P0A0+PP dr.Kery SAB II/VK
303 420861 Ny.Artha Mardesi 27th √ Obgyn G2P1A0+Letsu LSCS G2P1A0+Letsu dr.Kery SAB III/VK
Mamae abram+lipoma Mamae abram+lipoma
304 294799 Ny.Suhariyati 42th √ Umum punggung Excisi punggung dr.Sukarno Masker II/TC
305 424311 Ny.Roudhotul J 28th √ Obgyn G3P1A0+OD gagal LSCS G3P1A0+OD gagal dr.Kery SAB II/VK
306 404284 Ny.Dyah Larasati 34th √ Obgyn Abortus incomplit Curetage Abortus incomplit dr.Umi SAB II/VK
307 424366 Ny.Eli Indarti 38th √ Obgyn G2P1A0+BSC LSCS G2P1A0+BSC dr.Haris SAB II/VK
308 403164 Ny.Winartin 44th √ Obgyn Mioma uteri SVH Mioma uteri dr.Kery SAB III/VK
309 225326 Ny.Kurnia Oktavia 29th √ Obgyn Cistoma ovarii Wedge resection S+D Cistoma ovarii dr.Kery SAB III/VK
310 224403 Ny.Insiyah 75th √ Umum Tumor dinding dada Excisi Tumor dinding dada dr.Hernowo SAB I/TC
311 424132 Ny.Ruchamiyah 67th √ Umum Ulcus pedis+DM Nekrotomy+debridement Ulcus pedis+DM dr.Hernowo SAB I
312 423933 Ny.Mia Trisnani 33th √ Umum Tumor punggung Excisi Tumor punggung dr.Hernowo SAB I
313 387718 Ny.Evi Amirul 29th √ Obgyn G5P4A0+PP LSCS G5P4A0+PP dr.Umi SAB II/VK
314 383289 Sdr.Fatkul Awaludin 16th √ Umum Appendic acut Appendictomy Appendic acut dr.Sukarno SAB VVIPA
315 421747 Ny.Eny Muchaiya 42th √ Obgyn G2P1A0+BSC LSCS G2P1A0+BSC dr.Umi SAB II/VK
316 393071 Ny.Sri Suryani 43th √ Urologi Batu staghon Extended pyelolithotomy Batu staghon dr.Kristianto Intubasi II
OD incisi chalazion with
317 423297 An.Laurensia R 10th √ Mata 31/01/2018 OD Chalazion removol of capsul OD Chalazion dr.Yuliarti II
318 294966 Ny.Luki Retno 25th √ Obgyn G3P1A1+BSC LSCS G3P1A1+BSC dr.Kery SAB II/VK
319 297815 Ny.Imroatul Mufid 33th √ Obgyn G3P2A0+BSC LSCS G3P2A0+BSC dr.Kery SAB III/VK
320 424426 Ny.Mutiara Ken N 71th √ Umum Ganglion poplitea Excisi Ganglion poplitea dr.Yan P SAB II

KETERANGAN :

: UMUM EL: ELEKIF B: BERSIH KTR : KOTOR

BPJS : BPJS CY: CYTO BK: BERSIH KONTAMINASI

As. : ASURANSI K: KONTAMINASI


LAPORAN PELAYANAN PEMBEDAHAN
DI UNIT KAMAR OPERASI RSI SITI HAJAR SIDOARJO
BULAN : JANUARI TAHUN 2018

KLASSIFIKASI JNS
UMUR SPESIAL DX DOKTER RWT
NO NO. REG NAMA PASIEN OPERASI TGL OPERASI ANAST
KH B S K ISASI POST OP OPERATOR INAP
L P HESI
321 424435 Ny.Tumiati 42th √ Umum 31/01/2018 Lipoma gluteus Exterpasi Lipoma gluteus dr.Sukarno SAB III/TC
322 424411 Tn.M.Yaulil 44th √ Umum HIL permagna bilateral Herniotomy+omentectomy HIL permagna bilateral dr.Yan P SAB II
323 354364 Ny.Eni Kurnia 37th √ Obgyn G3P1A1+prolap uteri LSCS G3P1A1+prolap uteri dr.Umi SAB II/VK
324 420793 Ny.Iis Anggraeni 38th √ Obgyn G2P1A0+KIFL+BSC LSCS G2P1A0+KIFL+BSC dr.Umi SAB II/VK
325 424510 Ny.Ririn Yuliani 36th √ Obgyn G2P1A0+PPT LSCS G2P1A0+PPT dr.Haris SAB II/VK
326 414673 Ny.Yuli Handayani 44th √ Umum Tumor mamae Excisi Tumor mamae dr.Hernowo Masker I/TC
327 290100 Tn.Ananato P 45th √ Umum HIL S Herniotomy HIL S dr.Hernowo SAB II
328 424158 Tn.Juwadiyono u 51th √ Umum Multiple lipoma Excisi Multiple lipoma dr.Hernowo TIVA I/TC
Mal union fr metacarpal post Mal union fr metacarpal post
329 424264 Sdr.Taufik Ihya 19th √ Ortho wire Aff wire wire dr.Hary C Masker II/TC
Op fr phalanx distal digiti V Op fr phalanx distal digiti V
330 424529 Tn.Mudjiono 62th √ Ortho manus S Debridement+pining manus S dr.Danang Intubasi II/TC
331 353864 Ny.Ismiati 37th √ Obgyn G2P1A0+BSC LSCS G2P1A0+BSC dr.Umi SAB II/VK
332 235625 Ny.Erna 26th √ Obgyn G2P1A0+BSC LSCS G2P1A0+BSC dr.Umi SAB II/VK
333
334
335
336
337
338
339
340

KETERANGAN :

U : UMUM EL: ELEKIF B: BERSIH KTR : KOTOR

BPJS : BPJS CY: CYTO BK: BERSIH KONTAMINASI

As. : ASURANSI K: KONTAMINASI


N PEMBEDAHAN
I SITI HAJAR SIDOARJO
TAHUN 2018

OK JDWL OP KAT. LUKA OP BIAYA


ronde EL CY B BK K KTR U BPJS As.
3/I √ √ √

3/II √ √ √

1/I √ √ √

3/II √ √ √

1/II √ √ √

3/II √ √ √

2/I √ √ √

4/I √ √ √

2/II √ √ √

1/II √ √ √

1/III √ √ √

4/II √ √ √

3/II √ √ √

4/I √ √ √
3/I √ √ √

4/II √ √ √

3/II √ √ √

1/I √ √ √

1/II √ √ √

4/III √ √ √

Sidoarjo, …………………………….

Kaur Kamar Operasi

Agus Wiyono

N PEMBEDAHAN
I SITI HAJAR SIDOARJO
TAHUN 2018

OK JDWL OP KAT. LUKA OP BIAYA


ronde EL CY B BK K KTR U BPJS As.
4/II √ √ √

4/II √ √ √

3/I √ √ √

4/III √ √ √
3/II √ √ √

3/I √ √ √

1/I √ √ √

3/II √ √ √

4/II √ √ √

4/I √ √ √

1/II √ √ √

4/III √ √ √

1/II √ √ √

1/IV √ √ √

1/III √ √ √

3/III √ √ √

4/III √ √ √

4/IV √ √ √

3/V √ √ √

1/V √ √ √

Sidoarjo, …………………………….

Kaur Kamar Operasi

Agus wiyono
N PEMBEDAHAN
I SITI HAJAR SIDOARJO
TAHUN 2018

OK JDWL OP KAT. LUKA OP BIAYA


ronde EL CY B BK K KTR U BPJS As.
4/IV √ √ √

3/V √ √ √

1/V √ √ √

4/IV √ √ √

3/III √ √ √

2/I √ √ √

3/I √ √ √

4/II √ √ √

2/II √ √ √

1/II √ √ √

2/III √ √ √

2/IV √ √ √

3/IV √ √ √

3/I √ √ √
2/I √ √ EQUITY
3/III √ √ √

2/II √ √ √

3/III √ √ √

3/III √ √ √

2/I √ √ √

Sidoarjo, …………………………….

Kaur Kamar Operasi

Agus wiyono

N PEMBEDAHAN
I SITI HAJAR SIDOARJO
TAHUN 2018

OK JDWL OP KAT. LUKA OP BIAYA


ronde EL CY B BK K KTR U BPJS As.
3/I √ √ √

1/I √ √ √

1/II √ √ √

1/III √ √ √
4/I √ √ √

1/III √ √ √

2/II √ √

4/ √ √ √

3/III √ √ √

I/IV √ √ √

2/IV √ √ √

3/IV √ √ √

2/II √ √ √

3/III √ √ √

3/IV √ √ √

1/V √ √ √

4/II √ √ √

2/V √ √ √

3/V √ √ √

2/IV √ √ √

Sidoarjo, …………………………….

Kaur Kamar Operasi

Agus wiyono
N PEMBEDAHAN
I SITI HAJAR SIDOARJO
TAHUN 2018

OK JDWL OP KAT. LUKA OP BIAYA


ronde EL CY B BK K KTR U BPJS As.
2/IV √ √ √

3/VI √ √ √

2/V √ √ √

3/I √ √ √

3/II √ √ √

2/IV √ √ √

2/II √ √ √

2/III √ √ √

3/III √ √ √

1/III √ √ √

2/III √ √ √

3/I √ √ √

1/I √ √ √

3/II √ √ √
2/I √ √ √

1/III √ √ √

2/III √ √ √

1/III √ √ √

4/I √ √ √

2/IV √ √ √

Sidoarjo, …………………………….

Kaur Kamar Operasi

Agus wiyono

N PEMBEDAHAN
I SITI HAJAR SIDOARJO
TAHUN 2018

OK JDWL OP KAT. LUKA OP BIAYA


ronde EL CY B BK K KTR U BPJS As.
1/I √ √ √

3/III √ √ √

2/V √ √ √

3/IV √ √ √
3/V √ √ √

2/V √ √ √

1/I √ √ √

3/I √ √ √

4/II √ √ √

1/I √ √ √

2/I √ √ √

4/II √ √ √

3/I √ √ √

1/I √ √ √

1/II √ √ √

2/II √ √ √

1/III √ √ √

2/II √ √ √

2/III √ √ √

3/I √ √ √

Sidoarjo, …………………………….

Kaur Kamar Operasi

Agus wiyono
N PEMBEDAHAN
I SITI HAJAR SIDOARJO
I TAHUN 2018

OK JDWL OP KAT. LUKA OP BIAYA


ronde EL CY B BK K KTR U BPJS As.
2/I √ √ √

1/I √ √ √

3/II √ √ √

3/III √ √ √

2/I √ √ √

3/I √ √ √

3/II √ √ √

3/I √ √ √

1/I √ √ √

1/II √ √ √

2/I √ √ √

2/III √ √ √

2/II √ √ √

3/III √ √ √
3/II √ √ √

1/II √ √ √

4/I √ √ √

1/II √ √ √

1/III √ √ √

1/IV √ √ √

Sidoarjo, …………………………….

Kaur Kamar Operasi

Agus Wiyono

N PEMBEDAHAN
I SITI HAJAR SIDOARJO
I TAHUN 2018

OK JDWL OP KAT. LUKA OP BIAYA


ronde EL CY B BK K KTR U BPJS As.
3/III √ √ √

3/IV √ √ √

1/I √ √ √

4/I √ √ √
1/II √ √ √

2/IV √ √ √

2/III √ √ √

2/I √ √ √

3/I √ √ √

3/II √ √ √

1/III √ √ √

4/II √ √ jiwa sraya


4/III √ √ √

2/III √ √ √

4/III √ √ √

2/IV √ √ √

3/IV √ √ √

4/III √ √ √

3/I √ √ √

2/I √ √ √

Sidoarjo, …………………………….

Kaur Kamar Operasi

Agus Wiyono
N PEMBEDAHAN
I SITI HAJAR SIDOARJO
I TAHUN 2018

OK JDWL OP KAT. LUKA OP BIAYA


ronde EL CY B BK K KTR U BPJS As.
1/I √ √ √

3/II √ √ √

3/III √ √ √

1/II √ √ √

2/II √ √ √

1/III √ √ √

2/III √ √ √

4/I √ √ ketenagakerjaan

3/IV √ √ √

2/IV √ √ √

3/V √ √ √

2/V √ √ √

1/V √ √ √

4/II √ √ √
3/I √ √ √

2/I √ √ √

3/II √ √ √

1/I √ √ √

2/II √ √ √

3/III √ √ √

Sidoarjo, …………………………….

Kaur Kamar Operasi

Agus Wiyono

N PEMBEDAHAN
I SITI HAJAR SIDOARJO
I TAHUN 2018

OK JDWL OP KAT. LUKA OP BIAYA


ronde EL CY B BK K KTR U BPJS As.
1/II √ √ √

1/III √ √ √

4/I √ √ √

4/II √ √ √
3/IV √ √ √

3/V √ √ √

4/III √ √ √

4/IV √ √ √

2/V √ √ √

3/VI √ √ √

2/VI √ √ √

2/I √ √ √

2/II √ √ √

1/I √ √ √

1/II √ √ √

1/III √ √ RBH
2/III √ √ √

1/IV √ √ √

1/V √ √ √

1/VI √ √ √

Sidoarjo, …………………………….

Kaur Kamar Operasi

Agus Wiyono
N PEMBEDAHAN
I SITI HAJAR SIDOARJO
I TAHUN 2018

OK JDWL OP KAT. LUKA OP BIAYA


ronde EL CY B BK K KTR U BPJS As.
4/I √ √ √

2/IV √ √ √

3/I √ √ √

2/V √ √ √

3/I √ √ √

2/I √ √ √

1/I √ √ √

2/II √ √ √

3/III √ √ √

4/I √ √

4/II √ √ √

3/I √ √ √

2/I √ √ √

3/II √ √ √
1/III √ √ √

3/II √ √ √

1/III √ √ √

2/II √ √ √

2/III √ √ √

3/II √ √ √

Sidoarjo, …………………………….

Kaur Kamar Operasi

Agus Wiyono

N PEMBEDAHAN
I SITI HAJAR SIDOARJO
I TAHUN 2018

JDWL OP KAT. LUKA OP BIAYA

EL CY B BK K KTR U BPJS As.


2/IV √ √ √

3/I √ √ √

1/I √ √ √

3/I √ √ √
2/I √ √ √

3/II √ √ √

1/II √ √ √

3/III √ √ √

1/III √ √ √

1/IV √ √ √

4/I √ √ √

2/II √ √ √

2/IV √ √ √

4/II √ √ √

2/I √ √ √

3/I √ √ √

1/I √ √ √

4/I √ √ jasa raharja


3/II √ √ √

2/III √ √ √

Sidoarjo, …………………………….

Kaur Kamar Operasi

Agus Wiyono
N PEMBEDAHAN
I SITI HAJAR SIDOARJO
I TAHUN 2018

JDWL OP KAT. LUKA OP BIAYA

EL CY B BK K KTR U BPJS As.


3/II √ √ √

1/III √ √ √

2/III √ √ √

3/III √ √ √

2/IV √ √ √

3/IV √ √ √

4/II √ √ √

3/I √ √ √

2/I √ √ √

1/III √ √ √

4/I √ √ √

4/II √ √ √

2/III √ √ √

3/III √ √ √
2/III √ √ √

3/IV √ √ √

4/I √ √ √

2/IV √ √ √

1/IV √ √ √

3/V √ √ √

Sidoarjo, …………………………….

Kaur Kamar Operasi

Agus Wiyono

N PEMBEDAHAN
I SITI HAJAR SIDOARJO
I TAHUN 2018

JDWL OP KAT. LUKA OP BIAYA

EL CY B BK K KTR U BPJS As.


3/I √ √ √

2/I √ √ √

1/I √ √ √

3/II √ √ √
3/III √ √ √

4/I √ √ √

1/I √ √ √

1/IIII √ √ √

1/II √ √ √

2/II √ √ √

4/III √ √ √

2/III √ √ √

2/I √ √ √

3/I √ √ SIMAS
2/I √ √ JAI
1/I √ √ √

2/II √ √ √

3/II √ √ √

4/I √ √ √

2/II √ √ √

Sidoarjo, …………………………….

Kaur Kamar Operasi

Agus Wiyono
N PEMBEDAHAN
I SITI HAJAR SIDOARJO
I TAHUN 2018

JDWL OP KAT. LUKA OP BIAYA

EL CY B BK K KTR U BPJS As.


2/III √ √ √

4/II √ √ √

1/I √ √ √

3/I √ √ √

4/I √ √ √

2/I √ √ √

3/II √ √ √

2/II √ √ √

4/II √ √ √

1/II √ √ √

1/III √ √ √

4/I √ √ √

1/III √ √ √

2/III √ √ √
2/V √ √ √

4/III √ √ √

2/IV √ √ √

3/IV √ √ √

2/IV √ √ √

3/IV √ √ √

Sidoarjo, …………………………….

Kaur Kamar Operasi

Agus Wiyono

N PEMBEDAHAN
I SITI HAJAR SIDOARJO
I TAHUN 2018

JDWL OP KAT. LUKA OP BIAYA

EL CY B BK K KTR U BPJS As.


3/III √ √ √

2/I √ √ √

3/I √ √ √

1/I √ √ √
3/II √ √ √

1/II √ √ √

3/IV √ √ √

2/III √ √ √

3/III √ √ √

2/III √ √ JAI
1/IV √ √ √

1/III √ √ √

3/IV √ √ √

2/IV √ √ √

3/V √ √ √

4/I √ √ √

1/I √ √ √

2/II √ √ √

3/I √ √ √

1/II √ √ √

Sidoarjo, …………………………….

Kaur Kamar Operasi

Agus Wiyono
N PEMBEDAHAN
I SITI HAJAR SIDOARJO
I TAHUN 2018

JDWL OP KAT. LUKA OP BIAYA

EL CY B BK K KTR U BPJS As.


2/I √ √ √

3/II √ √ √

1/III √ √ √

2/II √ √ √

3/III √ √ √

4/II √ √ √

1/III √ √ √

2/IV √ √ √

4/I √ √ √

4/II √ √ √
3/IV √ √ √

4/III √ √ √

Sidoarjo, …………………………….

Kaur Kamar Operasi

Agus Wiyono
LAPORAN PELAYANAN PEMBEDAHAN
DI UNIT KAMAR OPERASI RSI SITI HAJAR SIDOARJO
BULAN FEBRUARI TAHUN 2018

KLASSIFIKASI JNS
UMUR SPESIAL DX DX DOKTER RWT
NO NO. REG NAMA PASIEN OPERASI TGL OPERASI TINDAKAN ANAST
KH B S K ISASI PRE OP POST OP OPERATOR INAP
P HESI
6 422014 Ny.Suliani 28th √ Obgyn G3P1A1+BSC LSCS G3P1A1+BSC dr.Umi SAB II/VK
7 423439 Ny.Ernita Catur 26th √ Obgyn G1P0A0+Post date+PRM LSCS G1P0A0+Post date+PRM dr.Umi SAB II/VK
8 422688 Ny.Ernawati Catur 38th √ Obgyn G4P3A0+PP LSCS+MOW G4P3A0+PP dr.Umi SAB II/VK
11 344397 Ny.Susan Kristiani 33th √ Obgyn G3P2A0+BSC LSCS G3P2A0+BSC dr.Umi SAB II/VK
12 203095 Ny.Feri Herawati 29th √ Obgyn G3P2A0+PPM LSCS G3P2A0+PPM dr.Umi SAB II/VK
14 418668 Ny.Fitri Mulya 31th √ Obgyn G2P1A0+BSC LSCS G2P1A0+BSC dr.Umi SAB II/VK
15 349535 Ny.Keni Siswati 38th √ Obgyn G3P1A1+Letsu LSCS+MOW G3P1A1+Letsu dr.Umi SAB II/VK
√ G1P0A0+NST non G1P0A0+NST non
16 407465 Ny.Nurul Azizah 27th Obgyn LSCS dr.Umi SAB I/VK
reaktif reaktif
G1P0A0+High miopi+ket
27 411848 Ny.Niken Einstein 24th √ Obgyn G1P0A0+high miopi LSCS mekoneal dr.Umi SAB II/VK
28 234253 Ny.Rica Ananda 30th √ Obgyn G2P1A0+BSC LSCS G2P1A0+BSC dr.Umi SAB II/VK
29 242713 Ny.Farida Ariani 36th √ Obgyn G2P1A0+BSC LSCS G2P1A0+BSC dr.Umi SAB II/VK
32 422849 Ny.Minhawa Ifta 25th √ Obgyn G1P0A0+PPP LSCS G1P0A0+PPP dr.Umi SAB II/VK
34 424829 Ny.Wiwik Rochila 38th √ Obgyn G3P2A0+Prolong aktif phase LSCS G3P2A0+Prolong aktif phase dr.Umi SAB III/VK
35 424828 Ny.Nuril Yunita 24th √ Obgyn G1P0A0+NST non reaktif LSCS G1P0A0+NST non reaktif dr.Umi SAB II/VK
42 405776 Ny.Ayu Ratnasari 26th √ Obgyn G1P0A0+Oligohidramnion LSCS+Insresi IUD G1P0A0+Oligohidramnion dr.Umi SAB II/VK
43 300829 Ny.Rena Zulfah 26th √ Obgyn G2P1A0+PPT LSCS G2P1A0+PPT dr.Umi SAB II/VK
44 423041 Ny.Sudarwati 39th √ Obgyn G6P4A2+Oligohidramnion LSCS+Insresi IUD G6P4A2+Oligohidramnion dr.Umi SAB III/VK
74 425276 Ny.Syafaatul A 24th √ Obgyn G2P1A0+Fetal distress LSCS G2P1A0+Fetal distress dr.Umi SAB II/VK
75 425304 Ny.Siti Yunia M 22th √ Obgyn G1P0A0+PRM LSCS G1P0A0+PRM dr.Umi SAB II/VK
89 424699 Ny.Darmiati 42th √ Obgyn G3P2A0+High miopi LSCS+MOW G3P2A0+High miopi dr.Umi SAB II/VK
90 425273 Ny.Lailul M 25th √ Obgyn G2P1A0+BSC LSCS G2P1A0+BSC dr.Umi SAB II/VK

91 424590 Ny.Siti Roifah 31th √ Obgyn G4P3A0+PPM LSCS G4P3A0+PPM dr.Umi SAB III/VK
100 312334 N y.Kartika Dina 32th √ Obgyn G3P2A0+BSC LSCS+Insersi IUD G3P2A0+BSC dr.Umi SAB II/VK
102 420801 Ny.Sarifah 33th √ Obgyn 11/02/2018 G2P1A0+PROM LSCS G2P1A0+PROM dr.Umi SAB II/VK

107 419837 Ny.Lilis Suriyani 29th √ Obgyn G1P0A0+PRM LSCS G1P0A0+PRM dr.Umi SAB I/VK
108 308717 Ny.Lanura M 28th √ Obgyn Abortus incompleitus Curetage Abortus incompleitus dr.Umi SAB I/VK
115 319910 Ny.Indah Wahyu 35th √ Obgyn G3P2A0+BSC LSCS +MOW G3P2A0+BSC dr.Umi SAB I/VK
125 409306 Ny.Laili Faujiah 40th √ Obgyn G2P1A0+IUFD LSCS G2P1A0+IUFD dr.Umi SAB II/VK
126 425691 Ny.Fitriyah W 33th √ Obgyn G2P1A0+CPD lscs +iud G2P1A0+CPD dr.Umi SAB III/VK
137 353824 Ny.Cavenol Mery 36th √ Obgyn G3P2A0+KIFL LSCS +MOW G3P2A0+KIFL dr.Umi SAB II/VK
138 219495 Ny.Arviyani 35th √ Obgyn G4P2A0+BSC LSCS +MOW G4P2A0+BSC dr.Umi SAB III/VK
139 352052 Ny.Indah Kariyanti 35th √ Obgyn GVIP4A1+BSC LSCS +MOW GVIP4A1+BSC dr.Umi SAB II/VK
146 423875 Ny.Nati Zumaroh 45 √ Obgyn G3P2A0+BSC+PROM LSCS+MOW G3P2A0+BSC+PROM dr.Umi SAB III/VK
147 425344 Ny.Erlina Wahyuni 36th √ Obgyn Mioma uteri+cistoma ovarii SVH Mioma uteri+cistoma ovarii dr.Umi SAB II/VK
148 324374 Ny.Erniawati 30th √ Obgyn G2P1A0+PPM LSCS G2P1A0+PPM dr.Umi SAB II/VK
149 425966 Ny.Dwi Novitasari 23th √ Obgyn 16/02/2018 G2P0A1+KPP LSCS G2P0A1+KPP dr.Umi SAB I/VK
150 425969 Ny.Siti Khotimah 47th √ Obgyn Torsi cista ovarium SOD Torsi cista ovarium dr.Umi SAB III/VK
160 311145 Ny.Diah Ayu M 25th √ Obgyn G2P1A0+BSC LSCS G2P1A0+BSC dr.Umi SAB III/VK
161 262503 Ny.Debora P 35th √ Obgyn 19/02/2018 G4P3A0+BSC LSCS+MOW G4P3A0+BSC dr.Umi SAB II/VK
G3P1A1+NST
174 367209 Ny.Mariska Alfisa 25th √ Obgyn G3P1A1+NST suspectius LSCS+Insersi IUD suspectius+ket mekoneal dr.Umi SAB II/VK
175 313149 Ny.Nur Laila 48th √ Obgyn Mioma uteri SVH+SOS Mioma uteri dr.Umi SAB VVIPB
186 349163 Ny.Nur Fresi A 26th √ Obgyn G2P1A0+BSC LSCS+Insersi IUD G2P1A0+BSC dr.Umi SAB IIVK
187 288402 Ny.Roudhotul J 25th √ Obgyn G2P1A0+BSC LSCS+Insersi IUD G2P1A0+BSC dr.Umi SAB III/VK
195 308016 Ny.Nur Dzulqo'da 27th √ Obgyn G2P1A0+BSC LSCS G2P1A0+BSC dr.Umi SAB II/VK
196 425167 Ny.Sunarmi 49th √ Obgyn Mioma uteri SVH Mioma uteri dr.Umi SAB II/VK
198 422332 Ny.Suprapti 34th √ Obgyn Polip cervix Exterpasi Polip cervix dr.Umi SAB II/VK
219 420257 Ny.Siti Marlahan 36th √ Ortho 25/02/2018 G2P1A0+IUFD+BSC LSCS G2P1A0+IUFD+BSC dr.Umi SAB II/VK
220 426772 Ny.Silvi Rahma 22th √ Obgyn G3P0A2+PEB+IUFD LSCS G3P0A2+PEB+IUFD dr.Umi SAB III/VK
221 406668 Ny.Luluk Hadziroh 32th √ Obgyn 25/02/2018 G6P4A1+Prolong phase aktif LSCS G6P4A1+Prolong phase aktif dr.Umi SAB VVIPA
222 388218 Ny.Dian Erichawati 24th √ Obgyn G1P0A0+KIFL LSCS G1P0A0+KIFL dr.Umi SAB II/VK
225 426819 Ny.Laili Nurul H 38th √ Obgyn G4P1A2+BSC LSCS G4P1A2+BSC dr.Umi SAB I/VK
233 426844 Ny.Azmil Umur 40th √ Obgyn G2P1A0+Post term LSCS+MOW G2P1A0+Post term dr.Umi SAB I/VK
234 424762 Ny.Teny Fitriana 24th √ Obgyn G1P0A0+High miopi LSCS G1P0A0+High miopi dr.Umi SAB II/VK
235 309192 Ny.Mamik K 35th √ Obgyn G2P1A0+Letlin LSCS+Insesrsi IUD G2P1A0+Letlin dr.Umi SAB II/VK
236 425237 Ny.Halimatus S 33th √ Obgyn G3P2A0+PP partialis+HBsAg+ LSCS G3P2A0+PP partialis+HBsAg+ dr.Umi SAB I/VK
256 427041 Ny.E;y Indiastuti 30th √ Obgyn G2P1A0+Oligohidramnion LSCS G2P1A0+Oligohidramnion dr.Umi SAB II/VK
257 426891 Ny.Syafitri Indar 23th √ Obgyn G1P0A0+PROM LSCS G1P0A0+PROM dr.Umi SAB III/VK
258 426047 Ny.Sumiati 34th √ Obgyn G3P2A0+BSC LSCS+MOW G3P2A0+BSC dr.Umi SAB I/VK

KLASSIFIKASI JNS
UMUR SPESIAL DX DX DOKTER RWT
NO NO. REG NAMA PASIEN OPERASI TGL OPERASI TINDAKAN ANAST
KH B S K ISASI PRE OP POST OP OPERATOR INAP
L P HESI
261
262
263
264
265
266
267
268
269
270
271
272
273
274
275
276
277
278
279
280

KETERANGAN :

U : UMUM EL: ELEKIF B: BERSIH KTR : KOTOR

BPJS : BPJS CY: CYTO BK: BERSIH KONTAMINASI

As. : ASURANSI K: KONTAMINASI

LAPORAN PELAYANAN PEMBEDAHAN


DI UNIT KAMAR OPERASI RSI SITI HAJAR SIDOARJO
BULAN FEBRUARI TAHUN 2018

KLASSIFIKASI JNS
UMUR SPESIAL DX DX DOKTER RWT
NO NO. REG NAMA PASIEN OPERASI TGL OPERASI TINDAKAN ANAST
KH B S K ISASI PRE OP POST OP OPERATOR INAP
L P HESI
281
282
283
284
285
286
287
288
289
290
291
292
293
294
295
296
297
298
299
300

KETERANGAN :

U : UMUM EL: ELEKIF B: BERSIH KTR : KOTOR

BPJS : BPJS CY: CYTO BK: BERSIH KONTAMINASI


As. : ASURANSI K: KONTAMINASI

LAPORAN PELAYANAN PEMBEDAHAN


DI UNIT KAMAR OPERASI RSI SITI HAJAR SIDOARJO
BULAN FEBRUARI TAHUN 2018

KLASSIFIKASI JNS
UMUR SPESIAL DX DX DOKTER RWT
NO NO. REG NAMA PASIEN OPERASI TGL OPERASI TINDAKAN ANAST
KH B S K ISASI PRE OP POST OP OPERATOR INAP
L P HESI
301
302
303
304
305
306
307
308
309
310
311
312
313
314
315
316
317
318
319
320

KETERANGAN :

U : UMUM EL: ELEKIF B: BERSIH KTR : KOTOR

BPJS : BPJS CY: CYTO BK: BERSIH KONTAMINASI

As. : ASURANSI K: KONTAMINASI

LAPORAN PELAYANAN PEMBEDAHAN


DI UNIT KAMAR OPERASI RSI SITI HAJAR SIDOARJO
BULAN FEBRUARI TAHUN 2018

KLASSIFIKASI JNS
UMUR SPESIAL DX DX DOKTER RWT
NO NO. REG NAMA PASIEN OPERASI TGL OPERASI TINDAKAN ANAST
ISASI OPERATOR INAP
HESI
JNS
SPESIAL DOKTER RWT
NO NO. REG NAMA PASIEN TGL OPERASI TINDAKAN ANAST
KH B S K ISASI PRE OP POST OP OPERATOR INAP
L P HESI
321
322
323
324
325
326
327
328
329
330
331
332
333
334
335
336
337
338
339
340

KETERANGAN :

U : UMUM EL: ELEKIF B: BERSIH KTR : KOTOR

BPJS : BPJS CY: CYTO BK: BERSIH KONTAMINASI

As. : ASURANSI K: KONTAMINASI


N PEMBEDAHAN
SITI HAJAR SIDOARJO
TAHUN 2018

OK JDWL OP KAT. LUKA OP BIAYA


ronde EL CY B BK K KTR U BPJS As.
3/III √ √ √

2/IV √ √ √

3/IV √ √ √

3/V √ √ √

3/IV √ √ √

2/IV √ √ √

3/VI √ √ √

2/VI √ √ √

2/V √ √ √

3/IV √ √ √

2/VI √ √ √

2/III √ √ √

3/I √ √ √

2/I √ √ √
3/II √ √ √

2/II √ √ √

3/III √ √ √

3/III √ √ √

2/III √ √ √

3/III √ √ √

2/III √ √ √

3/IV √ √ √

3/III √ √ √

3/II √ √ √

2/I √ √ √

3/II √ √ √

3/II √ √ √

1/II √ √ √

3/III √ √ √

2/III √ √ √

3/IV √ √ √

2/IV √ √ √

3/III √ √ √

2/IV √ √ √
3/IV √ √ √

3/I √ √ √

3/II √ √ √

3/I √ √ √

2/II √ √ √

3/III √ √ √

2/IV √ √ st.hajar

3/III √ √ √

2/IV √ √ √

3/III √ √ √

4/I √ √ √

1/IV √ √ √

2/I √ √ √

3/I √ √

2/II √ √ √

3/II √ √ √

12/I √ √ √

2/III √ √ √

3/III √ √ √

2/IV √ √ √
3/IV √ √ √

3/III √ √ √

4/I √ √ admedika

3/IV √ √ √

OK JDWL OP KAT. LUKA OP BIAYA


ronde EL CY B BK K KTR U BPJS As.
Sidoarjo, …………………………….

Kaur Kamar Operasi

Agus Wiyono

N PEMBEDAHAN
SITI HAJAR SIDOARJO
TAHUN 2018

OK JDWL OP KAT. LUKA OP BIAYA


ronde EL CY B BK K KTR U BPJS As.
Sidoarjo, …………………………….

Kaur Kamar Operasi


Agus Wiyono

N PEMBEDAHAN
SITI HAJAR SIDOARJO
TAHUN 2018

OK JDWL OP KAT. LUKA OP BIAYA


ronde EL CY B BK K KTR U BPJS As.
Sidoarjo, …………………………….

Kaur Kamar Operasi

Agus Wiyono

N PEMBEDAHAN
SITI HAJAR SIDOARJO
TAHUN 2018

OK JDWL OP KAT. LUKA OP BIAYA


ronde EL CY B BK K KTR U BPJS As.
Sidoarjo, …………………………….

Kaur Kamar Operasi

Agus Wiyono
LAPORAN PELAYANAN PEMBEDAHAN
DI UNIT KAMAR OPERASI RSI SITI HAJAR SIDOARJO
BULAN MARET TAHUN 2018

KLASSIFIKASI JNS
UMUR SPESIAL DX DX DOKTER RWT
NO NO. REG NAMA PASIEN OPERASI TGL OPERASI TINDAKAN ANAST
KH B S K ISASI PRE OP POST OP OPERATOR INAP
L P HESI
12 260388 Ny.Tri Wahyu H 27th √ Obgyn G2P1A0+BSC LSCS G2P1A0+BSC dr.Umi SAB II/VK
13 421870 Ny.Wanda Amilta 31th √ Obgyn G2P1A0+BSC LSCS G2P1A0+BSC dr.Umi SAB II/VK
20 335010 Ny.Sri winarni 30th Obgyn G2P1A0+BSC LSCS G2P1A0+BSC dr.Umi SAB II/VK
√ G2P1A0+BSC+Ket
29 423298 Ny.Hesti Lusiana 29th Obgyn G2P1A0+BSC LSCS mekoneal dr.Umi SAB II/VK
30 00174 Ny.Setyowati 31th √ Obgyn G2P1A0+BSC LSCS G2P1A0+BSC dr.Umi SAB VVIPB
31 408012 Ny.Nuning M 24th √ Obgyn G1P0A0+High miopi LSCS+MOW G1P0A0+High miopi dr.Umi SAB II/VK
32 406223 Ny.Ifana Esta 35th √ Obgyn G1P0A0=PP Excisi G1P0A0=PP dr.Umi SAB II/VK
33 423007 Ny.Retno Wulan 41th √ Obgyn G3P1A1+BSC LSCS G3P1A1+BSC dr.Umi SAB II/VK
34 348463 Ny.Sri Hariyati 34th √ Obgyn G4P3A0+PPM LSCS G4P3A0+PPM dr.Umi SAB II/VK
39 425279 Ny.Margaretha S 23th √ Obgyn G2P1A0+BSC LSCS G2P1A0+BSC dr.Umi SAB II/VK
61 421754 Ny.Uswatun H 31th √ Obgyn G2P1A0+BSC LSCS G2P1A0+BSC dr.Umi SAB II/VK
74 394607 Ny.Sriani 41th √ Obgyn Blighted ovum Curetage Blighted ovum dr.Umi SAB II/VK
75 278032 Ny.Viki Noer J 29th √ Obgyn G2P1A0+BSC LSCS+Insersi IUD G2P1A0+BSC dr.Umi SAB I/VK
76 427263 Ny.Sriani 38th √ Obgyn G2P1A0+BSC LSCS+Insersi IUD G2P1A0+BSC dr.Umi SAB II/VK
77 427861 Ny.Nur Laila 24th √ Obgyn G2P1A0+BSC LSCS G2P1A0+BSC dr.Umi SAB III/VK
88 365755 Ny.Sri Handayani 36th √ Obgyn G3P1A1+Oligohidramnion LSCS G3P1A1+Oligohidramnion dr.Umi SAB II/VK
92 425606 Ny.Eka Reni S 33th √ Obgyn G2P1A0+BSC LSCS+Insersi IUD G2P1A0+BSC dr.Umi SAB II/VK

93 427972 Ny.Rohmadillah 19th √ Obgyn G2P1A0+An cephal LSCS G2P1A0+An cephal dr.Umi SAB III/VK
94 320477 Ny.Irma Iva I 28th √ Obgyn G2P0A1+inpartu kala II lama LSCS G2P0A1+inpartu kala II lama dr.Umi SAB I/VK
99 314228 Ny.Maherti Utami 33th √ Obgyn Dead conceptus Curetage Dead conceptus dr.Umi SAB I/VK
100 391171 Ny.Riana Trisna 25th √ Obgyn Abortus incomplit Curetage Abortus incomplit dr.Umi SAB I/VK
101 405231 Ny.Anita Rachma 32th √ Obgyn G2P1A0+PPT LSCS G2P1A0+PPT dr.Umi SAB II/VK
102 209703 Ny.Henis Junaida 33th √ Obgyn G2P1A0+PROM LSCS+Insersi IUD G2P1A0+PROM dr.Umi SAB I/VK
103 399410 Ny.Yuliana Dyah 24th √ Obgyn 11/03/2018 G2P1A0+KIFA+fetal distress LSCS G2P1A0+KIFA+fetal distress dr.Umi SAB I/VK

110 350933 Ny.A.Murtiningsih 35th √ Obgyn G3P1A1+NST non rektif LSCS G3P1A1+NST non rektif dr.Umi SAB I
126 408610 Ny.Siti Fatimatus 24th √ Obgyn G1P0A0+CPD LSCS G1P0A0+CPD dr.Umi SAB II/VK
143 351830 Ny.Erwin A 27th √ Obgyn G1P0A0+PEB LSCS G1P0A0+PEB dr.Umi SAB II/VK
144 357043 Ny.Dwi Martina 29th √ Obgyn G2P1A0+BSC LSCS G2P1A0+BSC dr.Umi SAB I/VK
152 378458 Ny.Erna Tri L 29th √ Obgyn G2P1A0+BOH LSCS G2P1A0+BOH dr.Umi SAB I/VK
153 427420 Ny.Amirul M 39th √ Obgyn G3P2A0+PPT LSCS+MOW G3P2A0+PPT dr.Umi SAB I/VK
154 423015 Ny.Virli Amalia 27th √ Obgyn G1P0A0+Oligohidramnion LSCS G1P0A0+Oligohidramnion dr.Umi SAB II/VK
155 427382 Ny.Nunuk Iswanti 32th √ Obgyn Cistoma ovarii SOS+driling Cistoma ovarii dr.Umi SAB I/VK
157 426704 Ny.Dwi Agusti 33th √ Obgyn G2P1A0 +BSC LSCS+MOW G2P1A0 +BSC dr.Umi SAB II/VK
158 424666 Ny.Melda Aptovia 29th √ Obgyn G2P1A0+BSC LSCC+IUD G2P1A0+BSC dr.Umi SAB II/VK
159 417972 Ny.Desy Dwi R 36th √ Obgyn G3P1A1BSC LSCS G3P1A1BSC dr.Umi SAB II/VK
160 428632 Ny.Bertha A 32th √ Obgyn G1P0A0+NST non reaktif LSCS G1P0A0+NST non reaktif dr.Umi SAB II/VK
161 427585 Ny.Fahrul Hidaya 23th √ Obgyn 16/03/2018 G2P1A0+BSC LSCS G2P1A0+BSC dr.Umi SAB II/VK
162 293404 Ny.Aventri U 36th √ Obgyn G4P2A1+NST non reaktif LSCS G4P2A1+NST non reaktif dr.Umi SAB II/VK
166 419975 Ny.Eli Faridah 35th √ Obgyn G4P2A1+BSC LSCS+MOW G4P2A1+BSC dr.Umi SAB III/VK
175 239589 Ny.Lintang Jauhari 35th √ Obgyn G3P2A0+PP LSCS+MOW+SOD G3P2A0+PP+Cistoma ovarii dr.Umi SAB II/VK
176 428150 Ny.Umamah 38th √ Obgyn G3P2A0+PPM LSCS G3P2A0+PPM dr.Umi SAB II/VK
Cista coklat Cista coklat ovarii susp TB
177 426865 Nn.Karoma Sania 20th √ Obgyn ovarii[endometrioma]
Biopsi peritoneum+omentum
usus dr.Umi SAB II/VK
193 428158 Ny.Ratna Surya 31th √ Obgyn G3P1A1+High miopi LSCS G3P1A1+High miopi+ket dr.Umi SAB III/VK
mekoneal
194 242319 Ny.Andika Chandra 24th √ Obgyn Cista coklat ovarium Oovarectomypartial D+SOS Cista coklat ovarium dr.Umi SAB II/VK
G2P0A1+PROM+OD
205 000413 Ny.Ratna Rosida 23th √ Obgyn G2P0A1+PROM+OD gagal LSCS gagal+ket mekoneal dr.Umi SAB II/VK
G2P1A0+BSC+ket
206 428773 Ny.Ani Ainiyah 28th √ Obgyn G2P1A0+BSC LSCS mekoneal dr.Umi SAB II/VK
207 421859 Ny.Winda Agustia 28th √ Obgyn G1P0A0+PEB+DM LSCS G1P0A0+PEB+DM dr.Umi SAB II/VK
212 420059 Ny.Ani Yulia 31th √ Obgyn G2P1A0+prolong aktif phase LSCS G2P1A0+prolong aktif phase dr.Umi SAB II/VK
213 428860 Ny.Nunung 27th √ Obgyn G3P2A0+Gemelli LSCS G3P2A0+Gemelli dr.Umi SAB II/VK
218 415127 Ny.Nur Holidah 25th √ Obgyn G3P1A1+PRM LSCS G3P1A1+PRM dr.Umi SAB III/VK
219 426750 Ny.Nawang Aria 29th √ Obgyn G2P1A0+PPT LSCS+Insesrsi IUD G2P1A0+PPT dr.Umi SAB I/VK
220 429141 Ny.Riska Diana 24th √ Obgyn G1P0A0+PROM+BBLB LSCS G1P0A0+PROM+BBLB dr.Umi SAB II/VK
221 349954 Ny.Hidayah 58th √ Obgyn 22/03/2018 Prolap uteri TAH+BSO Prolap uteri dr.Umi SAB III/VK
235 244811 Ny.Indah Nur H 36th √ Obgyn G1P0A0+PPT+Primitua LSCS G1P0A0+PPT+Primitua dr.Umi SAB II/VK
236 383856 Ny.Cicik Minarsi 42th √ Obgyn G3P2A0+BSC LSCS+MOW G3P2A0+BSC dr.Umi SAB II/VK
237 410739 Ny.Siti Kumailla 40th √ Obgyn G2P1A0+BSC+HbSAg+ LSCS+Insersi IUD G2P1A0+BSC+HbSAg+ dr.Umi SAB III/VK
250 428054 Ny.Sudarweni 41th √ Obgyn G3P2A0+Letsu LSCS G3P2A0+Letsu dr.Umi SAB II/VK
252 427862 Ny.Hanisah 37th √ Obgyn G4P3A0+PROM+PPM LSCS+MOW G4P3A0+PROM+PPM dr.Umi SAB II/VK
264 426366 Ny.Nur Lailiyah R 23th √ Obgyn G2P1A0+BSC LSCS G2P1A0+BSC dr.Umi SAB II/VK
265 428807 Ny.Nurmasari 30th √ Obgyn G1P0A0+PEB+Letlin LSCS G1P0A0+PEB+Letlin dr.Umi SAB II/VK
266 426351 Ny.Fatimatiz Z 25th √ Obgyn G1P0A0+NST non reaktif LSCS G1P0A0+NST non reaktif dr.Umi SAB II/VK
267 427271 Ny.Sudarwati 40th √ Obgyn Cistoma ovarii Oovarectomy partial D Cistoma ovarii dr.Umi SAB II/VK
273 347584 Ny Sri Zulfi R 30th √ Obgyn G2P0A1+CPD LSCS+Insersi IUD G2P0A1+CPD dr.Umi SAB II/VK
274 419234 Ny.Endah Tri W 43th √ Obgyn G3P2A0+KPP LSCS G3P2A0+KPP dr.Umi SAB II/VK
277 248922 Ny.Novia Wianto 36th √ Obgyn G3P2A0+BSC LSCS G3P2A0+BSC dr.Umi SAB I/VK
278 429663 Ny.Lupita Oktavia 26th √ Obgyn G1P0A0+KPP LSCS G1P0A0+KPP dr.Umi SAB II/VK
285 397683 Ny.Nur Afifah 28th √ Obgyn G2P0A1+CPD LSCS G2P0A1+CPD dr.Umi SAB II/VK
290 418633 Ny.Mita Ferdiana 22th √ Obgyn G1P0A0+CPD LSCS G1P0A0+CPD dr.Umi SAB II/VK
291 390574 Ny.Ririn Juwariya 39th √ Obgyn G4P2A1+PP LSCS G4P2A1+PP dr.Umi SAB I/VK
302 429430 Ny.Rachma A 23th √ Obgyn Abortus spontan Curetage Abortus spontan dr.Umi SAB III/VK
306 429615 Ny.Almar'atus S 38th √ Obgyn G2P1A0+BSC LSCS G2P1A0+BSC dr.Uim SAB II/VK
LAPORAN PELAYANAN PEMBEDAHAN
DI UNIT KAMAR OPERASI RSI SITI HAJAR SIDOARJO
BULAN MARET TAHUN 2018

KLASSIFIKASI JNS
UMUR SPESIAL DX DX DOKTER RWT
NO NO. REG NAMA PASIEN OPERASI TGL OPERASI TINDAKAN ANAST
KH B S K ISASI PRE OP POST OP OPERATOR INAP
L P HESI
321
322
323
324
325
326
327
328
329
330
331
332
333
334
335
336
337
338
339
340

KETERANGAN :

U : UMUM EL: ELEKIF B: BERSIH KTR : KOTOR

BPJS : BPJS CY: CYTO BK: BERSIH KONTAMINASI

As. : ASURANSI K: KONTAMINASI


ANAN PEMBEDAHAN
I RSI SITI HAJAR SIDOARJO
ET TAHUN 2018

OK JDWL OP KAT. LUKA OP BIAYA


ronde EL CY B BK K KTR U BPJS As.
3/IV √ √ √

2/IV √ √ √

3/IV √ √ √

3/IV √ √ √

2/IV √ √ √

2/V √ √ √

3/IV √ √ √

2/IV √ √ √

1/II √ √ √

2/II √ √ √

3/IV √ √ √

2/V √ √ √

3/IV √ √ √

2/IV √ √ √
2/V √ √ √

3/III √ √ √

3/IV √ √ √

3/IV √ √ √

3/V √ √ √

3/II √ √ √

1/II √ √ √

2/III √ √ √

2/I √ √ √

2/II √ √ √

3/I √ √ √

3/III √ √ √

2/V √ √ √

3/IV √ √ √

3/III √ √ √

3/IV √ √ √

2/IV √ √ √

2/V √ √ √ √

3/I √ √ √

2/II √ √ √
2/I √ √ √

3/IV √ √ √

3/II √ √ √

2/II √ √ √

2/I √ √ √

3/III √ √ √

2/IV √ √ √

3/IV √ √ √

3/V √ √ √

2/IV √ √ √

3/IV √ √ √

2/IV √ √ √

3/V √ √ √

2/III √ √ √

3/III √ √ √

3/III √ √ √

2/IV √ √ √

3/IV √ √ √

2/IV √ √ √

3/IV √ √ √
2/IV √ √ √

1/III √ √ √

2/II √ √ √

3/II √ √ √

3/IV √ √ √

2/IV √ √ √

3/IV √ √ √

2/IV √ √ √

3/II √ √ √

2/III √ √ √

2/IV √ √ √

3/V √ √ √

2/II √ √ √

3/III √ √ √

2/IV √ √ √

1/III √ √ √

3/II √ √ √
ANAN PEMBEDAHAN
I RSI SITI HAJAR SIDOARJO
ET TAHUN 2018

OK JDWL OP KAT. LUKA OP BIAYA


ronde EL CY B BK K KTR U BPJS As.
Sidoarjo, …………………………….

Kaur Kamar Operasi

Agus Wiyono
LAPORAN PELAYANAN PEMBEDAHAN
DI UNIT KAMAR OPERASI RSI SITI HAJAR SIDOARJO
BULAN APRIL TAHUN 2018

KLASSIFIKASI JNS
UMUR SPESIAL DX DX DOKTER RWT
NO NO. REG NAMA PASIEN OPERASI TGL OPERASI TINDAKAN ANAST
KH B S K ISASI PRE OP POST OP OPERATOR INAP
L P HESI
1 053273 Ny.Dwi Dani M 38th √ Umum 01/04/2018 Apendicsitis acut Appendictomy√ Apendicsitis acut dr.Yan P SAB VIP
2 266411 Ny.Andri Perdani 33th √ Obgyn 02/04/2018 G2P1A0+BSC LSCS G2P1A0+BSC dr.Kery SAB I
3 430100 Ny.Dania 26th √ Obgyn G1P0A0+PP LSCS G1P0A0+PP dr.Kery SAB II/VK
4 233290 Ny.Diah Amalia 37th √ Obgyn G3P2A0+BSC LSCS +MOW G3P2A0+BSC dr.Umi SAB II/VK
5 301505 Ny.Safia 15th √ Umum Apendicitis acut Appendictomy√ Apendicitis acut dr.Yan P SAB I
6 337413 Ny.Binti 42th √ Obgyn G2P1A0+BSC LSCS G2P1A0+BSC dr.Haris SAB II/VK
7 430087 Ny.Dwi Susanti 31th √ Obgyn G3P11+BSC LSCS G3P11+BSC dr.Haris SAB II/VK
8 298172 Ny.Siti Nur 23th √ Obgyn G1P0A0 +TB Paru LSCS G1P0A0 +TB Paru dr.Haris SAB II/VK
9 419783 Ny.Ika Yuliani 32th √ Obgyn G3P1A1+BSC LSCS G3P1A1+BSC dr.Haris SAB I/VK
10 000316 Ny.Resti Dwi 28th √ Obgyn G2P1A0+BSC LSCS +IUD G2P1A0+BSC dr.Umi SAB VVIPA
11 403672 Tn.Trihono S 59th √ Umum HIL S Herniotomy HIL S dr.Bambang SAB II/TC
12 429704 Tn.Bastomi 40th √ Umum Soft tissu tumor frontal Exsisi Soft tissu tumor frontal dr.Bambang Masker III/TC
13 316759 Ny.Neny 46th √ Umum Struma multinodusa Sub total lobectomy Struma multinodusa dr.Yan P Intubasi III
14 430103 Sdr.M.Ali Akbar 17th √ Ortho Cl fr tibia fibula D Orif plating Cl fr tibia fibula D dr.Danang SAB II/TC
15 166303 Ny.Rini Indah 50th √ Umum Ganglion manus Exsisi Ganglion manus dr.Yan P Masker I/T
16 429605 Ny.Riyanti 58th √ Umum Tumor mamae Exsisi Tumor mamae dr.Yan P Masker I/T
17 316075 Ny.Indra Susilowati 36th √ Obgyn G5P1A3+BSC LSCS G5P1A3+BSC dr.Umi SAB II/VK
18 234641 An.Noval Ivan 9th √ Ortho Cl fr femur D Orif plating Cl fr femur D dr.Danang Intubasi III
19 430213 Ny.Marnisa Dela 30th √ Obgyn 03/04/2018 G3P2A0+BSC LSCS G3P2A0+BSC dr.Kery SAB III/VK
20 429721 Ny.Tri Pristiwi 25th √ Obgyn G2P1A0+Nst non reaktif LSCS G2P1A0+Nst non reaktif dr.Kery SAB II/VK

KETERANGAN :

U : UMUM EL: ELEKIF B: BERSIH KTR : KOTOR

BPJS : BPJS CY: CYTO BK: BERSIH KONTAMINASI

As. : ASURANSI K: KONTAMINASI

LAPORAN PELAYANAN PEMBEDAHAN


DI UNIT KAMAR OPERASI RSI SITI HAJAR SIDOARJO
BULAN APRIL TAHUN 2018

KLASSIFIKASI JNS
UMUR SPESIAL DX DX DOKTER RWT
NO NO. REG NAMA PASIEN OPERASI TGL OPERASI TINDAKAN ANAST
KH B S K ISASI PRE OP POST OP OPERATOR INAP
L P HESI
21 238076 Ny.Dwi Ratna W 31th √ Obgyn 03/04/2018 G3P2A1+BSC LSCS G3P2A1+BSC dr.Kery SAB III/VK
22 411829 Ny.Laili Jumaati 35th √ Obgyn G3P2A1+BSC LSCS G3P2A1+BSC dr.Kery SAB II/VK
23 427347 Ny.Ika Riwayati 30th √ Obgyn G4P1A2+PP LSCS G4P1A2+PP dr.Kery SAB I/VK
24 430212 Ny.Novie Aprilya 31th √ Ortho Cl fr radius 1/3 distal Orif plating Cl fr radius 1/3 distal dr.Danang Intubasi II/TC
25 427488 Tn.Dwi Hatmanto √ Anestesi CKD Pasang double lumen CKD dr.Ary F LA RJ
26 269330 Tn.Agung Santoso √ Anestesi CKD Pasang double lumen CKD dr.Ary F LA RJ
27 429983 Nn.Nisa Auliya 14th √ Umum Appendic akut Appendictomy Appendic akut dr.Yan p SAB I
28 013439 Ny.Lien Ngoing 66th √ Umum Gangren pedis+DM Debridement Gangren pedis+DM dr.Yan p Masker I
29 213073 Ny.Supiyah 42th √ Ortho Tendovaginitis manus D Release tendon Tendovaginitis manus D dr.Hary C Masker II
Heminolamenectomy
30 312299 Ny.Munawaroh 49th √ Ortho HNP L5-S1 decompresi+disectomy HNP L5-S1 dr.Larona Intubasi VIPB
31 291158 Ny.Kuswenang 30th √ Urologi Hydropynoprosis D Nephrectomy Hydropynoprosis D dr.Kristianto Intubasi VIP
32 340510 Tn.Slamet 52th √ Umum Ulcus pedis Debridement Ulcus pedis dr.Yan p SAB PAV
33 422647 Tn.Qoirul Anang 43th √ THT Septum deviasi Septoplasti Septum deviasi dr.Noer Sofi Intubasi II
34 430021 Tn.Andriono 55th √ Umum Ulcus pedis Debridement Ulcus pedis dr.Yan p SAB VVIPB
35 253263 Ny.Titik Marotin √ Obgyn Cystoma ovarii SOD Cystoma ovarii dr.Kery SAB I/VK
36 429312 Ny.Sulastri 47th √ Obgyn 04/04/2018 Myoma uteri SVH Myoma uteri dr.Kery SAB II/VK
37 426202 Ny.Fitri Maya 21th √ Obgyn G1P1A0+CPD LSCS G1P1A0+CPD dr.Kery SAB I/VK

38 196975 Ny.Fitri H 37th √ Obgyn Menometroralgi Curetage Menometroralgi dr.Heru SAB III/VK
39 305403 Ny.Stifani Dian 27th √ Obgyn G5P1A1+BSC LSCS G5P1A1+BSC dr.Kery SAB III/VK
40 429806 Ny.Kasmiyati 59th √ Obgyn Prolap uteri Histerektomy Prolap uteri dr.Kery SAB II/VK

KETERANGAN :

U : UMUM EL: ELEKIF B: BERSIH KTR : KOTOR

BPJS : BPJS CY: CYTO BK: BERSIH KONTAMINASI


As. : ASURANSI K: KONTAMINASI

LAPORAN PELAYANAN PEMBEDAHAN

DI UNIT KAMAR OPERASI RSI SITI HAJAR SIDOARJO


BULAN APRIL TAHUN 2018

KLASSIFIKASI
UMUR Obgyn DX DX DOKTER SAB RWT
NO NO. REG NAMA PASIEN OPERASI TGL OPERASI TINDAKAN
KH B S K Obgyn PRE OP POST OP OPERATOR SAB INAP
L P
41 413123 Ny.Astrilika 25th √ Obgyn 04/04/2018 G1P0A0+PP LSCS G1P0A0+PP dr.Haris SAB I/VK
42 430226 Ny.Dita Sesiliya 27th √ Obgyn G2P1A0+PP LSCS G2P1A0+PP dr.Haris SAB II/VK
43 429589 Ny.Eka yuli 30th √ Obgyn G2P1A0+BSC LSCS G2P1A0+BSC dr.Haris SAB II/VK
44 429113 Ny.Lailaturrohma 27th √ Obgyn Myoma uteri SVH +SOD Myoma uteri dr.Haris SAB III/VK
45 428201 Tn.Rizki Dwi 32th √ Umum Tumor femur Excisi Tumor femur dr.Hernowo SAB VIP B
46 412371 Ny.Sonda Sari 52th √ Umum Multiple lipoma Excisi Multiple lipoma dr.Hernowo Masker I
47 426739 Tn.Fadil Isron 39th √ Umum Nekrosis pedis Amputasi +debridement Nekrosis pedis dr.Hernowo SAB III
48 225331 Ny.Fitria Astutik 26th √ Obgyn 05'04'2018 G2P1A0+Hemoroid LSCS G2P1A0+Hemoroid dr.Kery SAB VIPA
49 338691 Ny.Azzizatul 23th √ Obgyn G1P1A0+CPD LSCS G1P1A0+CPD dr.Kery SAB II/VK
50 430441 Ny.Ndayik L 31th √ Obgyn G2P1A0+PRM LSCS G2P1A0+PRM dr.Kery SAB III/VK
51 259138 Ny.Ani Mariyani 45th √ Obgyn Cystoma ovarii SVH +SOD Cystoma ovarii dr.Kery SAB II/VK
52 430409 Ny.Aries Wulandari 32th √ Obgyn G3P2A0+BSC LSCS +MOW G3P2A0+BSC dr.Haris SAB II/VK
53 422283 Ny.Warsini 60th √ Obgyn Prolap uteri Histerektomi Prolap uteri dr.Kery SAB III/VK
54 429088 Ny.Suparti 39th √ Umum FAM S Excisi FAM S dr.Sukarno Masker II
55 430375 An.Venny Seftiani 13th √ Umum Tumor mandibula Excisi Tumor mandibula dr.Yan P tiva III
56 314874 Ny.Mulyati 60th √ Umum AV shunt Av shunt AV shunt dr.Hernowo LA RJ
57 430301 Sdr.Dimas S 14th √ Umum Tumor palpebra Excisi Tumor palpebra dr.Bambang TIVA I
58 430403 Tn.Sugiman 67th √ Umum HIL D Herniotomy HIL D dr.Bambang SAB III
59 430382 Ny.Siti Fatimah 63th √ Mata OD Pterigium Exterpasi pterigium OD Pterigium dr.Rika LA III/TC
60 429250 Tn.Suyitno 49th √ Urologi Batu buli-buli vesicolitotripsi Batu buli -buli dr.Candra SAB III/TC

KETERANGAN :

U : UMUM EL: ELEKIF B: BERSIH KTR : KOTOR

BPJS : BPJS CY: CYTO BK: BERSIH KONTAMINASI

As. : ASURANSI K: KONTAMINASI

LAPORAN PELAYANAN PEMBEDAHAN


DI UNIT KAMAR OPERASI RSI SITI HAJAR SIDOARJO
BULAN APRIL TAHUN 2018

KLASSIFIKASI JNS
UMUR SPESIAL DX DX DOKTER RWT
NO NO. REG NAMA PASIEN OPERASI TGL OPERASI TINDAKAN ANAST
KH B S K ISASI PRE OP POST OP OPERATOR INAP
L P HESI
61 430456 An.Dzarmizi 13th √ Bdh plastik 05'04'2018 Vulnus apertum neck Rekontruksi Vulnus apertum neck dr,Ariek SAB PAV
62 278928 Ny.Endang P 37th √ Obgyn G3P2A0+BSC LSCS +MOW G3P2A0+BSC dr.Umi SAB I/VK
63 428875 Ny.Fitriya 24th √ Obgyn G2P1A0+APBH +BSC LSCS G2P1A0+APBH +BSC dr.Umi SAB III/VK
64 384716 Ny.Lina yuliana 25th √ Obgyn G3P1A1+BSC LSCS +Insersi IUD G3P1A1+BSC dr.Umi SAB II/VK
65 429110 Ny.Ninik S 33th √ Obgyn G3P2A0+BSC LSCS +MOW G3P2A0+BSC dr.Umi SAB II/VK
66 410289 Ny.Restuningsih 38th √ Obgyn G4P2A1+PP LSCS +MOW G4P2A1+PP dr.Umi SAB II/VK
67 425472 Ny.Yulis S 35th √ Obgyn G2P1A0+BSC LSCS G2P1A0+BSC dr.Umi SAB II/VK
68 430506 Ny.Yeni Novitasari 24th √ Obgyn Abortus incomplietus Curetage Abortus incomplietus dr.Heru B SAB II/VK
69 430542 Ny.Rumiyati 34th √ Obgyn G3P2A0+BSC LSCS G3P2A0+BSC dr.Umi SAB III/VK
70 364967 Ny.Rinda Nur H 28th √ Obgyn 06/04/3018 G3P2A0+BSC LSCS G3P2A0+BSC dr.Haris SAB II/VK
71 430504 Tn.Hendy Surya 36th √ Umum Lipoma punggung Exterpasi Lipoma punggung dr.Sukarno TIVA II/TC
72 391812 Tn.M.Irwan A 29th √ Umum Haemoroid Haemoroidectomy Haemoroid dr.Sukarno SAB II/TC
73 419351 Tn.Wawan H 31th √ Umum Abses perianan Explorasi Abses perianan dr.Yan P SAB II
74 352945 Ny.Wahyuningtyas 29th √ Obgyn G1P0A0+PRM LSCS G1P0A0+PRM dr.Kery SAB II/VK
G5P2A2+Prolong active G5P2A2+Prolong active
75 148241 Ny.Widi Astutik 37th √ Obgyn phase LSCS+MOW phase dr.Kery SAB I/VK
Spinal kanal sterosis L5-5 ec Decompresi Spinal kanal sterosis L5-5 ec
76 426547 Ny.Umi Hanik 46th √ Ortho HNP L5-S1 laminectomy+disectomy HNP L5-S1 dr.Larona Intubasi I
77 429581 Ny.Nur Sulik S 54th √ Umum Tumor punggug Excisi Tumor punggug dr.Hernowo TIVA III
78 161563 Ny.Sulis Setyowati 34th √ Umum FAM D Excisi FAM D dr.Hernowo Masker II
79 379688 Ny.Erna Susilowati 29th √ Umum Cholelitiasis Cholesistectomy Cholelitiasis dr.Hernowo SAB II
80 420435 Ny.Nikmatur R 28th √ Obgyn G1P0A0+PP LSCS G1P0A0+PP dr.Umi SAB II/VK

KETE KETERANGAN :

U : UMU EL: ELEKIF B: BERSIH KTR : KOTOR

BPJS : BPJSCY: CYTO BK: BERSIH KONTAMINASI


As. : ASURANSI K: KONTAMINASI

LAPORAN PELAYANAN PEMBEDAHAN


DI UNIT KAMAR OPERASI RSI SITI HAJAR SIDOARJO
BULAN APRIL TAHUN 2018

KLASSIFIKASI JNS
UMUR SPESIAL DX DX DOKTER RWT
NO NO. REG NAMA PASIEN OPERASI TGL OPERASI TINDAKAN ANAST
KH B S K ISASI PRE OP POST OP OPERATOR INAP
L P HESI
81 244785 Ny.Reyma Triana 38th √ Obgyn 06/04/2018 G2P1A0+BSC LSCS G2P1A0+BSC dr.Umi SAB II/VK
82 319378 Ny.Siti Nur F 30th √ Obgyn G3P2A0+BSC LSCS G3P2A0+BSC dr.Umi SAB II/VK
83 351305 Ny.Putri Nilam 35th √ Obgyn G3P2A0+BSC LSCS+MOW G3P2A0+BSC dr.Umi SAB II/VK
84 173706 Ny.Niti Kurniasari 33th √ Obgyn G2P1A0+PP+Letsu LSCS G2P1A0+PP+Letsu dr.Umi SAB I/VK
85 394205 Ny.Sumarti 34th √ Obgyn 07/04/2018 G4P3A0+BSC LSCS+MOW G4P3A0+BSC dr.Kery SAB II/VK
86 429518 Ny.Diah Paramita 25th √ Obgyn G1P0A0+PP LSCS G1P0A0+PP dr.Kery SAB I/VK
87 430629 Ny.Kiki 20th √ Ortho Cl fr phalang digiti IV D Pining+debridement Cl fr phalang digiti IV D dr.Danang SAB II/TC
88 352650 Ny.Robiatul A 26th √ Umum Appendicitis akut Appendictomy Appendicitis akut dr.Sukarno SAB III
89 430634 Tn.Ligito 58th √ Umum Nekrosis digiti II pedis S Amputasi+debridemen Nekrosis digiti II pedis S dr.Hernowo SAB II
90 430673 Ny.Ririn Pujiati 30th √ Obgyn G3P1A1+BSC LSCS G3P1A1+BSC dr.Kery SAB II/VK
91 430299 Ny.Wijati Munif 61th √ Umum Abses colli Incisi+debridemen Abses colli dr.Hernowo LA III
92 429438 Ny.Puji Indah Y 27th √ Umum G2P1A0+PROM LSCS G2P1A0+PROM dr.Umi SAB I/VK

93 427488 Tn.Dwi Hatmanto 51th √ Umum CKD AV Shunt CKD dr.Hernowo LA RJ


94 429577 Ny.Retno Setiasi 32th √ bdh mulut Multiple impected teet Multiple ondectomy Multiple impected teet dr.Henry Intubasi II/TC
95 329300 Ny.Kurnia Fitriani 27th √ Obgyn G2P1A0+BSC LSCS G2P1A0+BSC dr.Umi SAB II/VK
96 213332 Ny.Tennylia Evi 32th √ Obgyn G3P2A0+BSC 2X LSCS+Inserssi IUD G3P2A0+BSC 2X dr.Umi SAB I/VK
97 313775 Tn.H.Hidayat 62th √ Umum Tumor lengan multiple Excisi Tumor lengan multiple dr.Yan P TIVA II/TC
Bartholine abses labia mayor Bartholine abses labia mayor
98 430628 Ny.Sulis Prasetya 54th √ Obgyn S Cistectomy S dr.Kery SAB VVIPB
99 430238 Ny.Nia Ayu P 27th √ Obgyn G3P2A0+BSC 2X LSCS G3P2A0+BSC 2X dr.Kery SAB III/VK
100 403962 Ny.Nila Oktaviani 23th √ Obgyn 08/04/2018 G2P0A1+KPP LSCS G2P0A1+KPP dr.Umi SAB II/VK

KETERANGAN :

U : UMUM EL: ELEKIF B: BERSIH KTR : KOTOR

BPJS : BPJS CY: CYTO BK: BERSIH KONTAMINASI

As. : ASURANSI K: KONTAMINASI

LAPORAN PELAYANAN PEMBEDAHAN


DI UNIT KAMAR OPERASI RSI SITI HAJAR SIDOARJO
BULAN APRIL TAHUN 2018

KLASSIFIKASI JNS
UMUR SPESIAL DOKTER RWT
NO NO. REG NAMA PASIEN OPERASI TGL OPERASI DX TINDAKAN DX ANAST
KH B S K ISASI OPERATOR INAP
L P HESI
101 430765 Ny.Yudha Rini T 26th √ Obgyn 08/04/32018 G2P1A0+Letsu+KPP LSCS G2P1A0+Letsu+KPP dr.Umi SAB II/VK
102 430763 Sdr.A.Abraham 19th √ Umum Appendicitis Appendictomy Appendicitis dr.Hernowo SAB II
103 379905 Ny.Anisa Prianti 34th √ Umum Cholelitiasis Cholesistectomy Cholelitiasis dr.Yan P SAB III/TC
104 430826 Ny.Ayu Septiana 27th √ Obgyn G1P0A0+Hidramnion LSCS G1P0A0+Hidramnion dr.Kery SAB II/VK
105 429825 Ny.Khusnul Kh 36th √ Umum Tumor mamae Excisi Tumor mamae dr.Yan P Masker III/TC
106 233806 Nn.Deby Putri 25th √ Umum Tumor supra pubis Excisi Tumor supra pubis dr.Yan P SAB II/TC
107 430668 Tn.M.Samsul 29th √ Umum HIL D Herniotomy HIL D dr.Hernowo SAB III/TC
Vasoligasi tinggi palomo
108 430192 Tn.Bambang 37th √ Urologi Varicocle duplex duplex Varicocle duplex dr.Kristianto SAB VIP
109 309864 Ny.Senikah 50th √ Umum Nekrosisi digiti I pedis S Amputasi+debridemen Nekrosisi digiti I pedis S dr.Hernowo SAB I
110 430551 Ny.Sri Rahayu 42th √ Umum Cholelitiasis Cholesistectomy Cholelitiasis dr.Hernowo SAB II
111 430919 Ny.Evi Wulandari 27th √ Obgyn G3P2A0+Prolong aktif LSCS G3P2A0+Prolong aktif dr.Umi SAB II/VK
112 341038 Nn.Millenia Puji 18th √ Umum Abses perianal Incisi+debridemen Abses perianal dr.Hernowo SAB I/TC
113 137592 Ny.Endah Tri S 39th √ Obgyn G4P2A1+PEB+BSC LSCS G4P2A1+PEB+BSC dr.Umi SAB I/VK
114 430123 Ny.Roudhotur R 27th √ Obgyn G3P1A1+PP LSCS G3P1A1+PP dr.Umi SAB I/VK
115 427918 Ny.Umiyatin 36th √ Obgyn Cistoma ovarii SOD Cistoma ovarii dr.Umi SAB III/VK
116 328456 Ny.Enggar Sri W 31th √ Obgyn 10/04/2018 G3P2A0+BSC LSCS+MOW G3P2A0+BSC dr.Kery SAB III/VK

117 430933 Ny.Rifna Distiarini 26th √ Obgyn G1P0A0+Haemoroid LSCS G1P0A0+Haemoroid dr.Kery SAB II/VK
118 412875 Ny.Ria Melani 36th √ Obgyn G3P1A0+BSC LSCS+MOW G3P1A0+BSC dr.Kery SAB II/VK
119 422555 Ny.Fifi Fransisca 30th √ Obgyn G1P0A0+PP LSCS G1P0A0+PP dr.Kery SAB II/VK
120 429776 Ny.Sriwiyanti 39th √ Obgyn Cistoma ovarii SOD Cistoma ovarii dr.Kery SAB II/VK

KETERANGAN :

U : UMUM EL: ELEKIF B: BERSIH KTR : KOTOR

BPJS : BPJS CY: CYTO BK: BERSIH KONTAMINASI


As. : ASURANSI K: KONTAMINASI

LAPORAN PELAYANAN PEMBEDAHAN


DI UNIT KAMAR OPERASI RSI SITI HAJAR SIDOARJO
BULAN APRIL TAHUN 2018

KLASSIFIKASI JNS
UMUR SPESIAL DOKTER RWT
NO NO. REG NAMA PASIEN OPERASI TGL OPERASI DX TINDAKAN DX ANAST
KH B S K ISASI OPERATOR INAP
L P HESI
121 313869 Tn.A.Harianto 82th √ Umum 10/04/2018 HIL S Herniotomy HIL S dr.Yan P SAB PAV
122 396450 Nn.Bogie Assa 22th √ Ortho Soft tissue manaus D Excisi Soft tissue manaus D dr.Danang Masker I/TC
123 425943 Ny.Suwani 44th √ Ortho Sacroliac joint artritis S Injeksi s1 joint block Sacroliac joint artritis S dr.Larona LA III/TC
124 156346 Ny.Dwi Harianti 44th √ Ortho Sacroliac joint artritis S Injeksi s1 joint block Sacroliac joint artritis S dr.Larona LA RJ
125 221328 Ny.Titik Cahya 41th √ Obgyn Dead conceptus Curetage Dead conceptus dr.Umi SAB III/VK
126 423890 Tn.Jumadi 53th √ Obgyn Batu phylum S Extended pyelolitotomy Batu phylum S dr.Kristianto Intubasi I/TC
127 422710 Sdr.A.Lutfi K 14th √ THT Septum deviasi Septoplasty Septum deviasi dr.Noer Sofi Intubasi I
128 430570 Ny.Beni Erlina 27th √ Obgyn G2P1A0+BSC LSCS G2P1A0+BSC dr.Kery SAB III/VK
129 001512 Ny.Risa Nadia I 18th √ Obgyn G1P0A0+CPD LSCS G1P0A0+CPD dr.Kery SAB II/VK
130 402224 Sdr.A.Rohman 40th √ THT Septum deviasi Septoplasty Septum deviasi dr.Noer Sofi Intubasi II/TC
131 306601 Ny.I Made Ayu 21th √ Obgyn 11/04/2018 G2P0A1+NST non reaktif LSCS G2P0A1+NST non reaktif dr.Heru B SAB I/VK
132 382148 Ny.Siti Ismaniyah 32th √ Obgyn G3P2A0+BSC LSCS+MOW G3P2A0+BSC dr.Kery SAB II/VK
133 431032 Ny.Ruri Indah S 34th √ Obgyn G2P1A0+BSC LSCS G2P1A0+BSC dr.Kery SAB II/VK
134 234621 Ny.Anas Tasiah 30th √ Obgyn G3P1A1+BSC LSCS G3P1A1+BSC dr.Umi SAB II/VK
135 212509 Ny.Dwi Ismayanti 34th √ Obgyn Cistoma ovarii SOD Cistoma ovarii dr.Kery SAB II/VK
136 430874 Tn.A.Rokim 72th √ Umum HIL D Herniotomy HIL D dr.Yan P SAB II/TC
137 428145 Ny.Elisabeth 39th √ Umum Tumor punggung Excisi Tumor punggung dr.Hernowo SAB I/TC
138 428411 Tn.Elok Probo S 29th √ Urologi Varicocle S Vasoligasi tinggi palomo S Varicocle S dr.Kristianto SAB II/TC
139 258672 Ny.Margareta √ Obgyn G2P1A0+BSC+Letsu LSCS G2P1A0+BSC+Letsu dr.Kery SAB II/VK
Cl fr radius ulna 1/3 proximal Cl fr radius ulna 1/3 proximal
140 430974 An.Iqbal Eka 13th √ Ortho S Orif plating S dr.Danang Intubasi III/TC

KETERANGAN :

U : UMUM EL: ELEKIF B: BERSIH KTR : KOTOR

BPJS : BPJS CY: CYTO BK: BERSIH KONTAMINASI

As. : ASURANSI K: KONTAMINASI

LAPORAN PELAYANAN PEMBEDAHAN


DI UNIT KAMAR OPERASI RSI SITI HAJAR SIDOARJO
BULAN APRIL TAHUN 2018

KLASSIFIKASI JNS
UMUR SPESIAL DX DX DOKTER RWT
NO NO. REG NAMA PASIEN OPERASI TGL OPERASI TINDAKAN ANAST
KH B S K ISASI PRE OP POST OP OPERATOR INAP
L P HESI
141 430947 Tn.Suroto 43th √ Umum 11/04/2018 Peritonitis generalisata Resecti ileum+collostomy Peritonitis generalisata dr.Yan P SAB III
142 431028 Ny.Mara'atus 38th √ Obgyn G2P1A0+BSC LSCS G2P1A0+BSC dr.Kery SAB II/VK
143 207193 Ny.Reny Awalin 36th √ Obgyn G3P2A0+BSC LSCS+MOW G3P2A0+BSC dr.Umi SAB II/VK
144 223982 Ny.Siti Zahrotul 40th √ Obgyn G3P2A0+Haemoroid LSCS+MOW G3P2A0+Haemoroid dr.Umi SAB I/VK
145 18723 Ny.Ika Noviati 35th √ Obgyn 12/04/2018 G1P0A0+PROM LSCS G1P0A0+PROM dr.Umi SAB II/VK
146 431151 Ny.Winda Puji 21th √ Obgyn G1P0A0+Visus-5 LSCS G1P0A0+Visus-5 dr.Kery SAB II/VK
147 339682 Ny.Fitriya H 44th √ Umum Abses colli Incisi+debridemen Abses colli dr.Hernowo TIVA III/TC
148 430959 Tn.Isron 58th √ Umum Tumor dinding abdomen Incisi Tumor dinding abdomen dr.Yan P SAB III
149 429038 Ny.Amilus S 44th √ Umum Struma D Total lobectomy Struma D dr.Bambang Intubasi II
150 108663 Tn.Firman W 32th √ Urologi Batu buli buli Vesicolitotripsi Batu buli buli dr.Candra SAB II/TC
151 431122 Ny.Yanti 50th √ Anesthesi CKD Double lumen CKD dr.Ary F LA RJ
152 397441 Tn.Imam G 32th √ Ortho Cl fr tibia posterior Orif srew Cl fr tibia posterior dr.Danang SAB II/TC
153 421164 Ny.Nailul Rifah 41th √ Obgyn G4P3A0+BSC LSCS G4P3A0+BSC dr.Umi SAB I/VK
G1P0A0+PROM+Ket
154 407102 Ny.Yessy Yulia R 32th √ Obgyn G1P0A0+PROM LSCS mekoneal dr.Umi SAB I/VK
G3P1A1+BSC+Ket
155 426110 Ny.Dwi Febriyanti 32th √ Obgyn G23P1A1+BSC LSCS mekoneal dr.Umi SAB III/VK
156 430380 Ny,Wina Agustina 40th √ Obgyn G3P2A0+PER+PP LSCS G3P2A0+PER+PP dr.Umi SAB III/VK
157 430513 Ny.Siti maisyaroh 29th √ THT Septum deviasi Septoplasty Septum deviasi dr.Noer Sofi Intubasi II/TC
158 431188 Sdr.Adi Putra 16th √ Umum 13/04/2018 Clavus multiple pedis Exterpasi Clavus multiple pedis dr.Sukarno SAB II/TC
159 424646 Ny.Nurmala Indah 29th √ Obgyn G3P2A0+KPP LSCS G3P2A0+KPP dr.Heru B SAB I/VK
160 431264 Ny.Alfiyah 26th √ Obgyn G1P0A0+PROM LSCS G1P0A0+PROM dr.Heru B SAB I/VK

KETERANGAN :

U : UMUM EL: ELEKIF B: BERSIH KTR : KOTOR


BPJS : BPJS CY: CYTO BK: BERSIH KONTAMINASI

As. : ASURANSI K: KONTAMINASI

LAPORAN PELAYANAN PEMBEDAHAN


DI UNIT KAMAR OPERASI RSI SITI HAJAR SIDOARJO
BULAN APRIL TAHUN 2018

KLASSIFIKASI JNS
UMUR SPESIAL DX DX DOKTER RWT
NO NO. REG NAMA PASIEN OPERASI TGL OPERASI TINDAKAN ANAST
KH B S K ISASI PRE OP POST OP OPERATOR INAP
L P HESI
161 210762 Ny.Laesmini 34th √ Umum 13/04/2018 Tumor colli Excisi Tumor colli dr.Yan P Intubasi III/TC
162 430583 Ny.Endang Lestari 35th √ Obgyn G2P1A0+PRM+High miopi LSCS G2P1A0+PRM+High miopi dr.Kery SAB III/VK
163 427945 Ny.Widiastuti 42th √ Umum FCD Mamae Excisi FCD Mamae dr.Hernowo Masker II/TC
super
164 420127 Tn.Sri Pujiono 47th √ Umum Bursitis elbow Excisi Bursitis elbow dr.Hernowo Masker VVIPB
165 430925 Sdr.Dedi Wijayanto 26th √ Umum Tumor shoulder Excisi Tumor shoulder dr.Hernowo TIVA II
166 346384 Ny.Farica Ica 35th √ Umum Appendic kronis Appendictomy Appendic kronis dr.Hernowo SAB III/TC
167 319352 An.Naufal 6th √ Umum Phimosis Sircumsisi Phimosis dr.Bambang Masker II
Union fr radius ulna post Union fr radius ulna post
168 210718 Sdr.Arya Sena 15th √ Ortho plating Aff plate plating dr.Danang Intubasi PAV
169 428226 Ny.Afri Icu L 35th √ Umum Ca mamae Mastectomy Ca mamae dr.Hernowo Intubasi II/TC
170 362810 Ny.Yeni Yustika 33th √ Obgyn G2P1A0+BSC LSCS+Insersi IUD G2P1A0+BSC dr.Umi SAB II/VK
171 430947 Tn.Suroto 43th √ Umum Leokage stoma Revisi stoma Leokage stoma dr.Yan P Intubasi III
172 431243 Ny.Suwanih 55th √ Urologi Stenosis uretra Sachse Stenosis uretra dr.Candra SAB VVIPA
173 430878 Ny.Siti Masrifah 41th √ Obgyn G3P2A0+BSC LSCS+MOW G3P2A0+BSC dr.Umi SAB III/VK
174 121194 Ny.Mutiara Asri 25th √ Obgyn G1P0A0+NST non reaktif LSCS+Insersi IUD G1P0A0+NST non reaktif dr.Umi SAB II/VK
Rekontruksi
175 421853 Tn.Daryanto 47th √ Ortho 15/04/2018 Degloving plantar pedis
otot+debridement
Degloving plantar pedis dr.Hari C SAB II
176 336487 Ny.Fransiska 31th √ Obgyn 16/04/2018 G2P1A0+BSC LSCS G2P1A0+BSC dr.Kery SAB I/VK
177 430803 Ny.Yuliati Ningsih 30th √ Umum Cholelitiasis Cholesistectomy Cholelitiasis dr.Sukarno SAB II
178 419805 Ny.Shofiyah I 36th √ Umum Ganglion wrist Excisi Ganglion wrist dr.Yan P TIVA II/TC
179 424602 Ny.Gusti Putu J 35th √ Umum Tumor colli multiple Excisi Tumor colli multiple dr.Yan P TIVA II/TC
180 299048 Ny.Imroatus Soliha 29th √ Obgyn G2P1A0+BSC LSCS G2P1A0+BSC dr.Umi SAB III/VK

KETERANGAN :

U : UMUM EL: ELEKIF B: BERSIH KTR : KOTOR

BPJS : BPJS CY: CYTO BK: BERSIH KONTAMINASI

As. : ASURANSI K: KONTAMINASI

LAPORAN PELAYANAN PEMBEDAHAN


DI UNIT KAMAR OPERASI RSI SITI HAJAR SIDOARJO
BULAN APRIL TAHUN 2018

KLASSIFIKASI JNS
UMUR SPESIAL DX DX DOKTER RWT
NO NO. REG NAMA PASIEN OPERASI TGL OPERASI TINDAKAN ANAST
KH B S K ISASI PRE OP POST OP OPERATOR INAP
L P HESI
181 430962 Tn.Puryanto 45th √ Umum 16/04/2018 HIL S Herniotomy HIL S dr.Yan P SAB II
182 072772 Ny.Mega Asrifa 50th √ Umum Ganglion wrist Excisi Ganglion wrist dr.Hernowo Masker II
183 430609 Ny.Sri Rejeki 45th √ Umum Tumor mamae Excisi Tumor mamae dr.Hernowo Masker II/TC
184 358315 An.Mahardika S 6th √ Umum Lipoma maligna colli Excisi+biopsi Lipoma maligna colli dr.Hernowo Masker II/TC
185 399823 Tn.A.Subagio 53th √ Umum Ulkus pedis+DM Nekrotomy+debridemen Ulkus pedis+DM dr.Hernowo SAB III
186 429421 Ny.Latifah 38th √ Obgyn Dead conceptus Curetage Dead conceptus dr.Umi SAB II/VK
187 423994 Ny.Sulastri 39th √ Obgyn G4P3A1+PER LSCS G4P3A1+PER dr.Umi SAB II/VK
188 341840 Ny.Indah Nuraeni 35th √ Obgyn G3P2A0+PPT LSCS+Insersi IUD G3P2A0+PPT dr.Umi SAB II/VK
189 431490 Ny.Ida Royani 31th √ Obgyn G2P1A0+BSC LSCS G2P1A0+BSC dr.Umi SAB III/VK
190 390040 Ny.Dia Purwanti 25th √ Obgyn 17/04/2018 G1P0A0+PP LSCS G1P0A0+PP dr.Kery SAB II/VK
191 431559 Ny.Ririn Candra 28th √ Obgyn G3P1A0+BSC LSCS G3P1A0+BSC dr.Kery SAB II/VK
192 336797 Ny.Ajeng Safitri 22th √ Obgyn G1P0A0+PEB LSCS G1P0A0+PEB dr.Kery SAB II/VK
193 431609 Ny.Desi Herawati 40th √ Obgyn G4P3A0+PP LSCS G4P3A0+PP dr.Kery SAB II/VK
194 431537 Tn.A.Kusaeni 50th √ Umum Fibroma wajah Exterpasi Fibroma wajah dr.Sukarno TIVA III/TC
195 431367 Ny.Istiqomah 35th √ Obgyn Abortus incomplit Curetage Abortus incomplit dr.Kery SAB III/VK
196 430859 An.Shofiyah F 37th √ Umum Tumor lidah Excisi Tumor lidah dr.Yan P Intubasi II/TC
197 403165 Tn.Mulyadi 44th √ Umum Tumor telinga Excisi Tumor telinga dr.Yan P TIVA I/TC
198 399828 Ny.Ratna Kumala 25th √ Obgyn G1P0A0+PRM LSCS G1P0A0+PRM dr.Kery SAB II/VK
199 415628 Ny.Diah Rahma 31th √ Obgyn G1P0A0+PRM LSCS G1P0A0+PRM dr.Kery SAB I/VK
200 205377 Ny.Rina Lestari 34th √ Obgyn G3P2A0+BSC LSCS+MOW G3P2A0+BSC dr.Kery SAB III/VK

KETERANGAN :

U : UMUM EL: ELEKIF B: BERSIH KTR : KOTOR


BPJS : BPJS CY: CYTO BK: BERSIH KONTAMINASI

As. : ASURANSI K: KONTAMINASI

LAPORAN PELAYANAN PEMBEDAHAN


DI UNIT KAMAR OPERASI RSI SITI HAJAR SIDOARJO
BULAN APRIL TAHUN 2018

KLASSIFIKASI JNS
UMUR SPESIAL DX DX DOKTER RWT
NO NO. REG NAMA PASIEN OPERASI TGL OPERASI TINDAKAN ANAST
KH B S K ISASI PRE OP POST OP OPERATOR INAP
L P HESI
201 431111 Ny.Sri Rahayu 49th √ Umum 17/04/2018 Haemoroid Haemoroidectomy Haemoroid dr.Bambang SAB I
202 332294 Ny.Rika Fuji W 30th √ Umum Appendicitis akut Appendictomy Appendicitis akut dr.Bambang SAB II/TC
203 305832 An.Al Khalifi Z 3th √ Umum Phimosis Sircumsisi Phimosis dr.Kristianto Masker VVIPB
204 347632 Ny.Tutik Purwanti 70th √ Umum Soft tisue tumor pedis D Excisi Soft tisue tumor pedis D dr.Bambang Masker II/TC
205 417845 Ny.Ainun Widanti 32th √ Obgyn G2P1A0+BSC LSCS G2P1A0+BSC dr.Kery SAB III
206 185492 Ny.Hj.Afifah 63th √ Ortho Fr ankle Orif plating+orif wiring Fr ankle dr.Hari C SAB II/TC
207 429313 N.Sulastri 40th √ Obgyn Mioma uteri SVH+SOD Mioma uteri dr.Kery SAB III/VK
208 427285 Tn.Asmari 52th √ Urologi Batu pyelum Pyelolitotomy S Batu pyelum dr.Kristianto Intubasi II/VK
209 192213 Ny.Yayuk Agustin 33th √ Obgyn G3P2A0+PRM+BSC LSCS G3P2A0+PRM+BSC dr.Umi SAB II/VK
210 426215 Ny.Priski Aprilia 21th √ Obgyn G2P1A0+BSC LSCS G2P1A0+BSC dr.Umi SAB II/VK
211 431567 Sdr.Nendra S 31th √ Ortho Cl fr tibia+fibula Orif plating Cl fr tibia+fibula dr.Hari C SAB II
212 428542 Sdr.Aqshal A 17th √ THT Adenotonsislitis ATE Adenotonsislitis dr.Noer Sofi Intubasi II
Cervical corpectomy L4,L5
213 340578 Tn.Haryoto S 78th √ Ortho Cervical myelopati anterio spinal fusison Cervical myelopati dr.Larona Intubasi VVIPA
214 229170 Nn.Dian Islamiati 24th √ THT Septum deviasi Septoplasty Septum deviasi dr.Noer Sofi Intubasi II
215 226898 Ny.Sutrianingsih 29th √ Obgyn 18/04/2018 G1P0A0+Post term LSCS G1P0A0+Post term dr.Heru B SAB III/VK
216 431710 Ny.Endah Airli A 33th √ Obgyn G3P1A1+BSC LSCS G3P1A1+BSC dr.Kery SAB II/VK
217 430473 Ny.Ameliana S 23th √ Obgyn G1P0A0+Gemelli LSCS G1P0A0+Gemelli dr.Kery SAB II/VK
218 431719 Ny.Nur Ziana 27th √ Obgyn G3P1A1+BSC LSCS G3P1A1+BSC dr.Kery SAB I/VK
219 412807 Ny.Fuji Faida Y 27th √ Obgyn G3P1A1+BSC LSCS G3P1A1+BSC dr.Kery SAB III/VK
220 414822 Ny.Yusnia Puput 28th √ Umum Tumor abdomen Laparatomy explorasi excisi Tumor abdomen dr.Sukarno SAB III/TC

KETERANGAN :

U : UMUM EL: ELEKIF B: BERSIH KTR : KOTOR

BPJS : BPJS CY: CYTO BK: BERSIH KONTAMINASI

As. : ASURANSI K: KONTAMINASI

LAPORAN PELAYANAN PEMBEDAHAN


DI UNIT KAMAR OPERASI RSI SITI HAJAR SIDOARJO
BULAN APRIL TAHUN 2018

KLASSIFIKASI JNS
UMUR SPESIAL DX DX DOKTER RWT
NO NO. REG NAMA PASIEN OPERASI TGL OPERASI TINDAKAN ANAST
KH B S K ISASI PRE OP POST OP OPERATOR INAP
L P HESI
221 359147 Ny.Reni Suryati 25th √ Obgyn 18/04/2018 G1P0A0+Oligohidramnion LSCS G1P0A0+Oligohidramnion dr.Umi SAB II/VK
222 271640 Tn.Sutriyo 72th √ Umum Ganglion manus Excisi Ganglion manus dr.Hernowo Masker I
223 421958 Ny.Uswatun Ch 40th √ Umum G1P0A0+mioma uteri LSCS G1P0A0+mioma uteri dr.Umi SAB II/VK
224 273445 Ny.Erna Irmawati 27th √ Obgyn G3P1A1+BSC LSCS G3P1A1+BSC dr.Kery SAB II/VK
225 414220 Ny.Suyati 41th √ Obgyn G1P0A0+BSC LSCS+MOW G1P0A0+BSC dr.Kery SAB II/VK
226 246997 Nu.Umi Syukrotin 28th √ Obgyn G2P1A0+PP LSCS G2P1A0+PP dr.Kery SAB II/VK
227 281573 Ny.Indri Damianti 29th √ Obgyn G2P1A0+PP LSCS G2P1A0+PP dr.Umi SAB II/VK
228 431828 Ny.Ngatini 41th √ Obgyn G3P2A0+BSC LSCS+MOW G3P2A0+BSC dr.Kery SAB I/VK
229 431829 Ny.Umi Tatik 37th √ Obgyn G3P2A0+BSC LSCS+MOW G3P2A0+BSC dr.Kery SAB II/VK
G3P2A0+BSC+cistoma G3P2A0+BSC+cistoma
230 431823 Ny.Sri Wahyuni 34th √ Obgyn ovarii LSCS+MOW+SOD ovarii dr.Kery SAB II/VK
231 415268 Ny.Sri Wahyuni 35th √ Obgyn G2P1A0+CPD LSCS G2P1A0+CPD dr.Kery SAB II/VK
232 429003 Ny.Nikmatus T 28th √ Obgyn G2P1A0+BSC LSCS G2P1A0+BSC dr.Kery SAB II/VK
233 431199 Tn.Solekan 42th √ Umum Tumor frontal Excisi Tumor frontal dr.Hernowo Masker III/TC
234 265491 An.Immanuel E 14th √ Umum Kista ductus tiroglum Excisi Kista ductus tiroglum dr.Yan P Intubasi II/TC
235 363241 Tn.Joharis T 71th √ Umum HIL S Herniotomy HIL S dr.Hernowo SAB II/TC
236 395464 Ny.Deni Asri R 27th √ Umum Mamae abaram Excisi Mamae abaram dr.Yan P Masker II/TC
237 429209 Ny.Fitri Endang 51th √ Ortho Tendovaginitis Release tendon Tendovaginitis dr.Hari C Masker VVIPB
238 000170 Tn.Choiri Nur A 42th √ Ortho Cl fr clavicula Orif plating Cl fr clavicula dr.Hari C Intubasi II/TC
239 309034 Ny.Sri Rahayu 45th √ Umum Abses perianal Incisi Abses perianal dr.Yan P SAB III
240 421505 Ny.Erna Wahyu 32th √ Obgyn G2P1A0+BSC LSCS G2P1A0+BSC dr.Kery SAB II/VK

KETERANGAN :

U : UMUM EL: ELEKIF B: BERSIH KTR : KOTOR


BPJS : BPJS CY: CYTO BK: BERSIH KONTAMINASI

As. : ASURANSI K: KONTAMINASI

LAPORAN PELAYANAN PEMBEDAHAN


DI UNIT KAMAR OPERASI RSI SITI HAJAR SIDOARJO
BULAN APRIL TAHUN 2018

KLASSIFIKASI JNS
UMUR SPESIAL DX DX DOKTER RWT
NO NO. REG NAMA PASIEN OPERASI TGL OPERASI TINDAKAN ANAST
KH B S K ISASI PRE OP POST OP OPERATOR INAP
L P HESI
241 431603 Ny.F.Elys Setya 58th √ Ortho 19/04/2018 Cl fr ankle Orif plating Cl fr ankle dr.Hari C SAB II/TC
242 276473 Ny.Fenty Hidaya 43th √ Obgyn G4P2A1+BSC LSCS G4P2A1+BSC dr.Kery SAB II/VK
243 409115 Ny.Monica S 43th √ Obgyn Mioma uteri SVH+SOS Mioma uteri dr.Kery SAB II/VK
244 431731 Sdr.M.Ardi Andre 19th √ THT Tonsilitis kronis ATE Tonsilitis kronis dr.Noer Sofi Intubasi III
245 431866 Ny.Iin Safitri 29th √ Obgyn G2P1A0+Hidramnion LSCS G2P1A0+Hidramnion dr.Heru B SAB II/VK
246 430370 Ny.Budi Astuti 41th √ Obgyn 20/04/2018 Menometrorargi Curetage Menometrorargi dr.Heru B SAB II/VK
247 213099 Ny.Lailatuz Z 34th √ Umum Mamae abram Excisi Mamae abram dr.Sukarno SAB II/VK
248 269330 Tn.Agung Santoso 47th √ Anesthesi CKD Revisi DL CKD dr.Ary F LA RJ
249 431626 Tn.Samsul Arif 31th √ Umum Appendicitis akut Lap appendictomy Appendicitis akut dr.Sukarno SAB II
250 431573 An.Selfi Nur A 13th √ Umum Tumor pedis Excisi Tumor pedis dr.Heru B Masker II
Anterior cervical disectomy
251 171200 Ny.Endang Sati 35th √ Ortho HNP cervical L4-5,S5-6 spinal+fusion
HNP cervical L4-5,S5-6 dr.Larona Intubasi PAV
252 002928 Ny.RR.Retno W 59th √ Mata 21/04/2018 OD katarak imatur OD PE+IOL OD katarak imatur dr.Rika LA I/TC
G2P1A0+KPP+Floating G2P1A0+KPP+Floating
253 432016 Ny.Surati Nur A 29th √ Obgyn head LSCS head dr.Heru B SAB II/VK
254 431812 Ny.Arbaiyah 63th √ Mata OS katarak imatur OS PE+IOL OS katarak imatur dr.Rika LA II/TC
255 422994 Ny.Suparsih 41th √ Mata OS katarak imatur OS PE+IOL OS katarak imatur dr.Rika LA II/TC
256 431584 Ny.Anifah 59th √ Mata OS katarak imatur OS PE+IOL OS katarak imatur dr.Rika LA III/TC
257 430295 Tn.Kohar 77th √ Mata OD katarak imatur OD PE+IOL OD katarak imatur dr.Rika LA III/TC
258 305053 Ny.Yulia Noor D 43th √ Obgyn G1P0A0+kepala floating LSCS G1P0A0+kepala floating dr.Heru B SAB I/VK
259 423520 Tn.Abdul Aziz 60th √ Anesthesi CKD Double lumen CKD dr.Ary F LA RJ
260 341019 Ny.Lutfiyah 45th √ Anesthesi CKD Double lumen CKD dr.Ary F LA RJ

KETERANGAN :

U : UMUM EL: ELEKIF B: BERSIH KTR : KOTOR

BPJS : BPJS CY: CYTO BK: BERSIH KONTAMINASI

As. : ASURANSI K: KONTAMINASI

LAPORAN PELAYANAN PEMBEDAHAN


DI UNIT KAMAR OPERASI RSI SITI HAJAR SIDOARJO
BULAN APRIL TAHUN 2018

KLASSIFIKASI JNS
UMUR SPESIAL DX DX DOKTER RWT
NO NO. REG NAMA PASIEN OPERASI TGL OPERASI TINDAKAN ANAST
KH B S K ISASI PRE OP POST OP OPERATOR INAP
L P HESI
261 427696 Ny.Suwatin 64th √ √ Mata 21/04/2018 OS katarak imatur OS PE+IOL OS katarak imatur dr.Rika LA III/TC
262 207934 Nn.Farah Shafiah 17th √ Mata OD conj cist OD distrip conj cyste OD conj cist dr.Rika TIVA II/TC
263 431587 Ny.Sumarni 54th √ Mata OS katarak imatur OS SICS+IOL OS katarak imatur dr.Rika LA III/TC
264 428260 Ny.Sumiati 63th √ Mata OD katarak imatur OD SICS+IOL OD katarak imatur dr.Rika LA I/TC
265 432027 Ny.Diana Mayang 30th √ Obgyn G2P0A1+IUFD LSCS G2P0A1+IUFD dr.Heru B SAB II/VK
266 269330 Tn.Agung Santoso 41th √ CKD CKD AV Shunt CKD dr.Hernowo LA RJ
267 321910 Ny.Lenny Hartuti 42th √ Umum Cholelitiasis Cholesistectomy Cholelitiasis dr.Hernowo SAB VVIPB
Rinosinusitis Rinosinusitis
268 430511 Ny.Titik Nur K 28th √ THT kronis+epitaksis FES etiodectomy kronis+epitaksis dr.Noer Sofi Intubasi III
269 291780 Ny.Rochani 36th √ Obgyn 22/04/2018 G2P1A0+PEB LSCS G2P1A0+PEB dr.Haris SAB III/VK
Orif
Op dislokasi ankle D+op fr Op dislokasi ankle D+op fr
270 432085 Tn.Suyut 49th √ Ortho digiti IV manus D
pining+debridemen+heactin
digiti IV manus D dr.Danang Intubasi II/TC
g
271 312216 Ny.Rita Yuliati 45th √ Obgyn 23/04/2018 Mioma uteri SVH+BSO Mioma uteri dr.Haris SAB II/VK
√ Cistoma ovarii perlengketan
272 270835 Ny.Yanti Susanti 39th Obgyn Cistoma ovarii Laparatomy usus dr.Haris SAB II/VK
273 409939 Ny.Kumaniah 52th √ Umum Celulitis cruris D Excisi multiple+debridemen Celulitis cruris D dr.Sukarno SAB VVIPB
274 424901 Ny.Cahya Prasasti 27th √ Umum Ganglion wrist Excisi Ganglion wrist dr.Hernowo Masker I/TC
275 432022 Tn.Susilo Hadi P 35th √ Umum Tumor punggung Excisi Tumor punggung dr.Hernowo TIVA II
276 288897 Ny.Indri Dwita 26th √ Umum Fam D Excisi Fam D dr.Hernowo Masker II/TC
277 410224 Ny.Misanah 63th √ Umum Apendicitis Apendictomy Apendicitis dr.Bambang SAB III/TC
278 431122 Ny.Yanti 32th √ Umum CKD AV Shunt CKD dr.Hernowo LA RJ
279 420692 Sdr.Geofanrio 18th √ Umum Tumor femur Excisi Tumor femur dr.Yan P SAB II
280 268320 Ny.Rita Anggraeni 31th √ Obgyn G2P1A0+BSC LSCS G2P1A0+BSC dr.Umi SAB II/VK

KETERANGAN :

U : UMUM EL: ELEKIF B: BERSIH KTR : KOTOR


BPJS : BPJS CY: CYTO BK: BERSIH KONTAMINASI

As. : ASURANSI K: KONTAMINASI

LAPORAN PELAYANAN PEMBEDAHAN


DI UNIT KAMAR OPERASI RSI SITI HAJAR SIDOARJO
BULAN APRIL TAHUN 2018

KLASSIFIKASI JNS
UMUR SPESIAL DX DX DOKTER RWT
NO NO. REG NAMA PASIEN OPERASI TGL OPERASI TINDAKAN ANAST
KH B S K ISASI PRE OP POST OP OPERATOR INAP
L P HESI
281 429588 Nn.Maria Eliza 30th √ Bdh mulut 23/04/2018 Multiple impected Multiple ondectomy Multiple impected dr.Henry Intubasi VVIPB
282 332651 Sdr.Hendrik Agus 25th √ Umum Hemoroid grd III Haemoroidectomy Hemoroid grd III dr.Bambang SAB II/TC
283 430853 An.Rhamdan 1th √ Ortho Cl fr humerus supra konduler Oestotomy+orif wiring Cl fr humerus supra konduler dr.Hari C Intubasi III
284 429524 Ny.Yuli Sri Rejeki 49th √ Umum Cholelitiasis Cholecistectomy Cholelitiasis dr.Yan P SAB III
285 423368 Sdr.Genta Alam 18th √ Bdh mulut Multiple impected Multiple ondectomy Multiple impected dr.Henry Intubasi I
286 430354 Ny.Isnarti 73th √ Umum Cholelitiasis Cholecistectomy Cholelitiasis dr.Yan P SAB II
287 420372 Ny.Eva Muji 29th √ Obgyn G2P1A0+BSC LSCS G2P1A0+BSC dr.Umi SAB II/VK
288 432173 Ny.Chustianingsih 22th √ Obgyn G1P0A0+NST Non reaktif LSCS G1P0A0+NST Non reaktif dr.Umi SAB III/VK
289 426060 Ny.Harini 32th √ Obgyn 24/04/2018 G2P1A0+BSC LSCS G2P1A0+BSC dr.Kery SAB III/VK
290 273426 Ny.Dwi Wijayanti 34th √ Obgyn G4P2A1+BSC LSCS G4P2A1+BSC dr.Kery SAB II/VK
291 231838 Ny.Rika Fitriyah 26th √ Obgyn G1P0A0+CPD LSCS G1P0A0+CPD dr.Kery SAB I/VK
292 202142 Ny.Purwaning K 40th √ Obgyn Mioma uteri SVH+SOD Mioma uteri dr.Kery SAB I/VK
293 231518 Ny.Suherni 40th √ Umum Tumor mamae Excisi Tumor mamae dr.Yan P Masker II/TC
294 431659 Tn Riyadi 61th √ Umum Tumor dinding dada Excisi Tumor dinding dada dr.Yan P SAB III/TC
295 430926 Tn.Suyatno 42th √ Urologi Batu buli buli Vesicolithotomy Batu buli buli dr.Kristianto SAB II/TC
296 432170 Tn Sutrisno 52th √ Mata Pterigium GR IV duplex Exterpasi gram Pterigium GR IV duplex dr.Rika LA III/TC
297 378890 Tn.Arif Rakhman 40th √ Urologi Batu ureter distal Uretrolitotomy Batu ureter distal dr.Candra SAB I
Lumbal canal spinal stenosis Lumbal canal spinal stenosis
298 296528 Ny.Erni 48th √ Ortho L3-4,L4-5 Laminectomy L3-4,L4-5 dr.Larona Intubasi II/TC
299 429087 Ny.Enik Indahyani 39th √ Obgyn 25/04/2018 G4P23A0+PP LSCS G4P23A0+PP dr.Kery SAB II/VK
300 414000 Ny.Laksmi Maya 28th √ Obgyn G2P1A0+Haemoroid LSCS G2P1A0+Haemoroid dr.Kery SAB II/VK

KETERANGAN :

: UMUM EL: ELEKIF B: BERSIH KTR : KOTOR

BPJS : BPJS CY: CYTO BK: BERSIH KONTAMINASI

As. : ASURANSI K: KONTAMINASI

LAPORAN PELAYANAN PEMBEDAHAN


DI UNIT KAMAR OPERASI RSI SITI HAJAR SIDOARJO
BULAN APRIL TAHUN 2018

KLASSIFIKASI JNS
UMUR SPESIAL DX DX DOKTER RWT
NO NO. REG NAMA PASIEN OPERASI TGL OPERASI TINDAKAN ANAST
KH B S K ISASI PRE OP POST OP OPERATOR INAP
L P HESI
301 432298 Ny.Nur Widi A 40th √ Obgyn 25/04/2018 G4P2A1+BSC LSCS+MOW G4P2A1+BSC dr.Kery SAB II/VK
302 430895 Ny.Sri Diah Widia 27th √ Obgyn G3P1A1+PLR LSCS G3P1A1+PLR dr.Heru B SAB III/VK
303 432258 Ny.Dwi Arumsari 35th √ Obgyn G2P1A0+BSC LSCS G2P1A0+BSC dr.Kery SAB III/VK
304 289837 Ny.Ruchillah 37th √ Obgyn Cistoma ovarii SOS Cistoma ovarii dr.Kery SAB II/VK
305 431999 Nn.Siti Rokayah 23th √ Umum Ganglion wrist Excisi Ganglion wrist dr.Hernowo Masker II/TC
306 251064 Nn.Kiki Resti 24th √ Umum Appendicitis akut Appendictomy Appendicitis akut dr.Bambang SAB II
307 431600 Ny.Tri Silvia 26th √ Umum FAM S Excisi FAM S dr.Hernowo Masker II/TC
308 432302 Nn.Ika Septya 20th √ Umum Appendicitis akut Appendictomy Appendicitis akut dr.Sukarno SAB II/TC
309 184425 Tn.Pujiantoro 58th √ Umum Appendicitis akut Laparatomy explorasi Appendicitis akut dr.Hernowo SAB PAV
310 432334 Ny.Lailatul Badria 24th √ Obgyn KET SOS KET dr.Kery SAB I/VK
311 428729 Ny.Anisah 38th √ Obgyn G4P2A1+BSC LSCS+MOW G4P2A1+BSC dr.Kery SAB II/VK
312 431022 Ny.Lailil Murroh 39th √ Obgyn G34P3A0+Haemoroid anemi LSCS G34P3A0+Haemoroid anemi dr.Kery SAB II/VK
313 191939 Ny.Tiara Galuh 24th √ Obgyn G1P0A0+KIFL LSCS G1P0A0+KIFL dr.Umi SAB VVIPB
314 431056 Ny.Khusni 33th √ Obgyn G23P2A0+BSC LSCS+MOW G23P2A0+BSC dr.Umi SAB II/VK
Cl epifiolisis radius distal+cl Cl epifiolisis radius distal+cl
315 094982 An.Aldi F 13th √ Ortho fr ulna Gips+debridement fr ulna dr.Danang TIVA III/TC
316 371267 An.Raihan Syarif 2th √ Ortho 26/04/2018 Cl fr greenstik antebracii S Reposisi+debridement Cl fr greenstik antebracii S dr.Danang Masker VVIPB
317 407691 Ny.Dasi Antari 29th √ Obgyn G2P1A0+BSC LSCS G2P1A0+BSC dr.Kery SAB II/VK
318 425471 Ny.Sriatun 35th √ Obgyn Cistoma ovarii Cistoma ovarii dr.Kery SAB II/VK
319 431284 Ny.Asnifah 54th √ Obgyn Prolap uteri SVH Prolap uteri dr.Kery SAB III/VK
G5P3A1+BSC+cistoma G5P3A1+BSC+cistoma
320 427859 Ny.Ana Setyo W 32th √ Obgyn ovarii
LSCS+SOD+Insersi IUD
ovarii dr.Umi SAB II/VK

KETERANGAN :

U : UMUM EL: ELEKIF B: BERSIH KTR : KOTOR


BPJS : BPJS CY: CYTO BK: BERSIH KONTAMINASI

As. : ASURANSI K: KONTAMINASI

LAPORAN PELAYANAN PEMBEDAHAN


DI UNIT KAMAR OPERASI RSI SITI HAJAR SIDOARJO
BULAN APRIL TAHUN 2018

KLASSIFIKASI JNS
UMUR SPESIAL DX DX DOKTER RWT
NO NO. REG NAMA PASIEN OPERASI TGL OPERASI TINDAKAN ANAST
KH B S K ISASI PRE OP POST OP OPERATOR INAP
L P HESI
321 432257 Nn.Fanny Gusteri 19th √ Umum 26/04/2018 FAM S Excisi FAM S dr.Yan P Masker II/TC
322 432253 Ny.Prastiwi Tri W 44th √ Umum Hernia umbilicalis Herniotomy in lay mesh Hernia umbilicalis dr.Yan P SAB II/TC
323 432387 Ny.Siti Romlah 52th √ Umum Appendicitis Appendictomy Appendicitis dr.Bambang SAB I/TC
Nekrosis digiti II,III,IV pedis Nekrosis digiti II,III,IV pedis
324 385615 Ny.Nurasih 53th √ Umum S
Amputasi+debridemen S dr.Hernowo SAB I
325 432344 Ny.Kholifah 33th √ Ortho Cl fr tibia fibula Reposisi+psg gips Cl fr tibia fibula dr.Danang TIVA III/TC
326 365862 An.Nizam 2th √ Umum Mucocle bibir bawah Excisi Mucocle bibir bawah dr.Hernowo Masker II
327 302575 Ny.Titik Iswati 32th √ Obgyn G4P2A1+BSC+letsu LSCS+Insesrsi IUD G4P2A1+BSC+letsu dr.Umi SAB II/VK
328 356832 Ny.Agatha Bella 22th √ Obgyn G2P1A0+BSC LSCS+Insesrsi IUD G2P1A0+BSC dr.Umi SAB II/VK
329 229715 Ny.Ulfa Dian 35th √ Obgyn G3P1A0+BSC LSCS+Insesrsi IUD G3P1A0+BSC dr.Umi SAB II/VK
330 411627 Ny.Dina Ariyani 34th √ Obgyn G3P2A0+BSC LSCS+MOW G3P2A0+BSC dr.Umi SAB VVIPA

331 225178 Ny.Imatus Solika 26th √ Obgyn 27/04/2018 G1P0A0+Post date LSCS G1P0A0+Post date dr.Kery SAB III/VK
332 430241 Ny.Lilik Alwiya 36th √ Obgyn G3P1A1+letsu LSCS G3P1A1+letsu dr.Kery SAB III/VK
333 248557 Tn.Dulkanit S 59th √ Mata Katarak imatur PE+IOL Katarak imatur dr.Rika LA II/TC
334 422422 Ny.Djahuratul Kh 55th √ Mata Katarak imatur PE+IOL Katarak imatur dr.Rika LA II/TC
335 431944 Tn.Buaji 57th √ Mata Katarak hipermatur SICS+IOL Katarak hipermatur dr.Rika LA III/TC
336 432284 Ny.Minarun 55th √ Mata Katarak imatur PE+IOL Katarak imatur dr.Rika LA II/TC
337 366795 Ny.Sri Yuda S 66th √ Mata Katarak imatur PE+IOL Katarak imatur dr.Rika LA I/TC
338 413934 Ny.Fatmawati 46th √ Mata Katarak hipermatur SICS+IOL Katarak hipermatur dr.Rika LA III/TC
339 426284 Ny.Khurotul Aini 68th √ Mata Katarak imatur PE+IOL Katarak imatur dr.Rika LA III/TC
340 429057 Ny.Sri Umami 59th √ Mata Katarak imatur PE+IOL Katarak imatur dr.Rika LA I/TC

KETERANGAN :

U : UMUM EL: ELEKIF B: BERSIH KTR : KOTOR

BPJS : BPJS CY: CYTO BK: BERSIH KONTAMINASI

As. : ASURANSI K: KONTAMINASI

LAPORAN PELAYANAN PEMBEDAHAN


DI UNIT KAMAR OPERASI RSI SITI HAJAR SIDOARJO
BULAN APRIL TAHUN 2018

KLASSIFIKASI
UMUR DX DX JNS
OPERASI SPESIAL DOKTER RWT
NO NO. REG NAMA PASIEN TGL OPERASI TINDAKAN ANAST
KH B S K ISASI PRE OP POST OP OPERATOR INAP
L P HESI
341 364189 Ny.Erika Rachma 35th √ Obgyn 27/04/2018 G4P1A2+PRM LSCS G4P1A2+PRM dr.Kery SAB II/VK
342 432410 Tn.A.Rifai 23th √ Umum Appendic akut Appendictomy Appendic akut dr.Hernowo SAB III
343 284620 Sdr.Danang Arya 16th √ Umum Tumor frontal Excisi Tumor frontal dr.Hernowo TIVA II
344 412099 Ny.Dianita H 25th √ Obgyn G2P1A0+PLR LSCS G2P1A0+PLR dr.Umi SAB II/VK
345 430038 Ny.Titin Ma'rifah 34th √ Obgyn G2P1A0+BSC LSCS G2P1A0+BSC dr.Umi SAB II/VK
346 427731 Ny.Dwi Agusti 27th √ Obgyn G2P1A0+BSC LSCS+Insersi IUD G2P1A0+BSC dr.Umi SAB III/IV
347 431635 Ny.Laula Eka S 40th √ Obgyn G5P2A2+oligohidramnion LSCS G5P2A2+oligohidramnion dr.Umi SAB II/VK
348 425150 Ny.Anggista A 28th √ Obgyn G1P0A0+NST non reaktif LSCS G1P0A0+NST non reaktif dr.Umi SAB III/VK
349 328045 Ny.Siti Nur Badila 26th √ Obgyn 28/04/2018 G1P0A0+Condiloma LSCS+Couter G1P0A0+Condiloma dr.Kery SAB III/VK
350 416512 Ny.Galih Kumala 28th √ Obgyn G1P0A0+Visus -5 LSCS G1P0A0+Visus -5 dr.Kery SAB I/VK
351 431701 Tn.Suratmin 49th √ THT Septum deviasi Septoplasti Septum deviasi dr.Noer Sofi Intubasi II
352 431907 Ny.Suswanti 38th √ THT Septum deviasi Septoplasti Septum deviasi dr.Noer Sofi Intubasi II
353 365728 Ny.Lupi Ratnawati 32th √ THT Septum deviasi Septoplasti Septum deviasi dr.Noer Sofi Intubasi II
354 312979 Ny.Afidah T 27th √ Obgyn G1P0A0+PEB LSCS G1P0A0+PEB dr.Kery SAB II/VK
355 290880 Ny.Eka Anjar 27th √ Obgyn G2P1A0+BSC LSCS+Insersi IUD G2P1A0+BSC dr.Umi SAB II/VK
356 428472 Ny.Ainun Jariah 33th √ Obgyn G2P1A0+BSC LSCS+Insersi IUD G2P1A0+BSC dr.Umi SAB II/VK
357 165502 Ny.Catur Hari 36th √ Obgyn G2P1A0+PPT LSCS G2P1A0+PPT dr.Umi SAB I/VK
358 429726 Ny.Kusliana 30th √ Obgyn G2P1A0+BSC LSCS G2P1A0+BSC dr.Umi SAB II/VK
Decompresi
Lumbal canal spinal stenosis Lumbal canal spinal stenosis
359 430568 Tn.Budiono 50th √ Ortho L3-4,L4-5,L5,S1
laminectomy+furaminectomy
L3-4,L4-5,L5,S1 dr.Larona Intubasi I
+disectomy (PLIF)
360 432611 Ny.Anis Nuril 39th √ Ortho Op fr antebrachii Orif plating+debridement Op fr antebrachii dr.Hari C Intubasi I

KETERANGAN :

U : UMUM EL: ELEKIF B: BERSIH KTR : KOTOR

BPJS : BPJS CY: CYTO BK: BERSIH KONTAMINASI

As. : ASURANSI K: KONTAMINASI

LAPORAN PELAYANAN PEMBEDAHAN


DI UNIT KAMAR OPERASI RSI SITI HAJAR SIDOARJO
BULAN APRIL TAHUN 2018

KLASSIFIKASI
UMUR DX DX JNS
OPERASI SPESIAL DOKTER RWT
NO NO. REG NAMA PASIEN TGL OPERASI TINDAKAN ANAST
KH B S K ISASI PRE OP POST OP OPERATOR INAP
L P HESI
361 432406 Ny.Yeni Purwati 32th √ Obgyn 28/04/2018 G2P1A0+BSC LSCS G2P1A0+BSC dr.Kery SAB III/VK
362 323878 Ny.Zazirotul U 25th √ Obgyn 29/04/2014 G2P1A0+PROM+BSC LSCS G2P1A0+PROM+BSC dr.Umi SAB II/VK
363 361532 Ny.Anisa Nur F 27th √ Obgyn 30/04/2018 G2P1A0+hipermyopia LSCS G2P1A0+hipermyopia dr.Kery SAB II/VK
364 191627 Ny.Nina Dyah 33th √ Obgyn G3P2A0+PEB LSCS+MOW G3P2A0+PEB dr.Kery SAB I/VK
365 208325 Ny.Lilik Fanda 41th √ Obgyn G3P2A0+BSC LSCS+MOW G3P2A0+BSC dr.Kery SAB II/VK
366 432179 Tn.A.Sujai E 56th √ Mata OS selulitis orbita+anemis Incisi orbita+debridemen OS selulitis orbita+anemis dr.Yuliati LA III/TC
367 354347 Ny.Iin Astuti 41th √ Obgyn G4P3A0+BSC LSCS+MOW G4P3A0+BSC dr.Kery SAB I/VK
368 414211 Ny.Sriatun 37th √ Obgyn G3P2A1+KIFL+BSC LSCS G3P2A1+KIFL+BSC dr.Umi SAB III/VK
369 272289 Ny.Lusi Herawati 48th √ Umum Struma nodusa D Sub total lobectomy Struma nodusa D dr.Sukarno Intubasi II
370 432417 Ny.Sutari 60th √ Umum Tumor turolodorsialis Excisi Tumor turolodorsialis dr.Yan P TIVA III/TC
371 1999054 Sdr.Bintang P 16th √ Umum Corpus alineum Lidah Ekstraxi corpus Corpus alineum Lidah dr.Yan P TIVA II
372 377784 Ny.Ahziatul M 45th √ Umum FAM Excisi FAM dr.Bambang TIVA II/TC
373 432378 Tn.Hariyadi W 32th √ Umum Multiple lipoma manus D Multiple excisi Multiple lipoma manus D dr.Bambang TIVA I/TC
Soft tissue tumor Soft tissue tumor
374 406017 Tn.Budianto 38th √ Umum submandibula Excisi submandibula dr.Bambang TIVA III/TC
375 220214 Ny.Nur Kholifah 43th √ Umum FAM multiple D Excisi FAM multiple D dr.Yan P Masker II/TC
376 201244 Tn.Dono 54th √ Umum CKD AV Shunt CKD dr.Hernowo LA RJ
377 391440 Ny.Silvia P 30th √ Umum Abses mamae Incisi drainage Abses mamae dr.Bambang TIVA II/TC
378 321396 Ny.Dita Sandra 36th √ Umum Mamae abrant Excisi Mamae abrant dr.Hernowo Masker II
379 432589 Tn.Eko Yulianto 48th √ Umum Abses pedis Incisi+debridement Abses pedis dr.Hernowo SAB I/TC
380 432706 Ny.Ida Anngieta 23th √ Obgyn G1P0A0+Haemoroid LSCS G1P0A0+Haemoroid dr.Kery SAB III/VK

KETERANGAN :

U : UMUM EL: ELEKIF B: BERSIH KTR : KOTOR

BPJS : BPJS CY: CYTO BK: BERSIH KONTAMINASI


As. : ASURANSI K: KONTAMINASI

LAPORAN PELAYANAN PEMBEDAHAN


DI UNIT KAMAR OPERASI RSI SITI HAJAR SIDOARJO
BULAN APRIL TAHUN 2018

KLASSIFIKASI
UMUR DX DX JNS
OPERASI SPESIAL DOKTER RWT
NO NO. REG NAMA PASIEN TGL OPERASI TINDAKAN ANAST
KH B S K ISASI PRE OP POST OP OPERATOR INAP
L P HESI
381 413857 An.Clarovna B 8th √ Ortho 30/04/2018 Fr humerus post wiring Aff wire Fr humerus post wiring dr.Hari C Masker II/TC
382 268174 Ny.Harulista 55th √ Ortho Tringer finger digiti III Release tendon Tringer finger digiti III dr.Danang Masker I/TC
383 292416 Ny.Rukmiati 60th √ Ortho Tringer finger digiti I Release tendon Tringer finger digiti I dr.Hari C Masker II
Union fr clavicula post Union fr clavicula post
384 261114 Tn.M.Ilyas 50th √ Ortho plating Aff plat plating dr.Danang Intubasi I
385 322528 Ny.Lailiyul A 26th √ Obgyn G2P1A0+BSC LSCS G2P1A0+BSC dr.Umi SAB I/VK
386 412639 Ny.Nur Hidayati 39th √ Obgyn G4P2A1+PPT LSCS G4P2A1+PPT dr.Umi SAB I/VK
387 432640 Sdr.Ricky Kartiko 21th √ Ortho Cl fr femur D Orif plating Cl fr femur D dr.Hari C Intubasi I
388 395873 Ny.Nur Hafizah 29th √ Obgyn G2P1A0+BSC LSCS+Insersi IUD G2P1A0+BSC dr.Umi SAB I/VK
389 181570 Ny.Lily Indah 45th √ Obgyn G4P2A1+PPT LSCS+MOW G4P2A1+PPT dr.Umi SAB I/VK
390 378196 Ny.Mutmainah 43th √ Obgyn Bligted ovum Curetage Bligted ovum dr.Umi SAB III/VK
391
392
393
394
395
396
397
398
399
400

KETERANGAN :

U : UMUM EL: ELEKIF B: BERSIH KTR : KOTOR

BPJS : BPJS CY: CYTO BK: BERSIH KONTAMINASI

As. : ASURANSI K: KONTAMINASI


N PEMBEDAHAN
SITI HAJAR SIDOARJO
AHUN 2018

OK JDWL OP KAT. LUKA OP BIAYA


ronde EL CY B BK K KTR U BPJS As.
1/I √ √ lppni
3/I √ √ √

2/I √ √ √

3/II √ √ √

1/I √ √ √

2/I √ √ √

1/II √ √ √

2/II √ √ √

3/II √ √ √

4/I √ √ √

2/III √ √ √

2/IV √ √ √

4/I √ √ √

5/I √ √ √
1/III √ √ √

1/IV √ √ Inhealt

3/IV √ √ √

5/II √ √ √

3/I √ √ √

1/I √ √ √

Sidoarjo, …………………………….

Kaur Kamar Operasi

Agus Wiyono

N PEMBEDAHAN
SITI HAJAR SIDOARJO
AHUN 2018

OK JDWL OP KAT. LUKA OP BIAYA


ronde EL CY B BK K KTR U BPJS As.
2/I √ √ √

3/II √ √ √

2/II √ √ √
4/I √ √ tenagakerjaan

RR √ √

RR √ √

1/II √ √ √

1/III √ √ √

3/III √ √ √

5/I √ √ √

2/I √ √ √

1/II √ √ √

4/I √ √ √

1/III √ √

1/II √ √ √

2/I √ √ √

3/I √ √ √

4/I √ √ √

1/I √ √ √

2/II √ √ √

Sidoarjo, …………………………….

Kaur Kamar Operasi


Agus wiyono

PEMBEDAHAN

SITI HAJAR SIDOARJO


AHUN 2018

OK JDWL OP KAT. LUKA OP BIAYA


ronde EL CY B BK K KTR U BPJS As.
3/II √ √ √

4/I √ √ √

3/III √ √ √

2/III √ √ √

4/II √ √ admedika
1/III √ √ √

1/IV √ √

3/I √ √ √

2/I √ √ √

3/II √ √ √

2/II √ √ √
√ √ √

3/III √ √ √
1/I √ √ √

3/IV √ √ √

4/I √ √ √

2/IV √ √ √

1/III √ √ √

5/I √ √ √

2/IV √ √ √

Sidoarjo, …………………………….

Kaur Kamar Operasi

Agus wiyono

N PEMBEDAHAN
SITI HAJAR SIDOARJO
AHUN 2018

OK JDWL OP KAT. LUKA OP BIAYA


ronde EL CY B BK K KTR U BPJS As.
4/I √ √ √

3/III √ √ √

3/IV √ √ √
2/IV √ √ √

2/V √ √ √

1/III √ √ √

3/V √ √ √

1/IV √ √ √

4/III √ √ √

3/I √ √ √

2/I √ √ √

1/I √ √ √

1/II √ √ √

3/II √ √ √

3/III √ √ √

5/I √ √

2/II √ √ √

2/I √ √ √

4/I √ √ √

1/I √ √ √

Sidoarjo, …………………………….

Kaur Kamar Operasi


Agus wiyono

N PEMBEDAHAN
SITI HAJAR SIDOARJO
AHUN 2018

OK JDWL OP KAT. LUKA OP BIAYA


ronde EL CY B BK K KTR U BPJS As.
3/III √ √ √

3/II √ √ √

II/VI √ √ √

3/V √ √ √

2/I √ √ √

3/I √ √ √

4/I √ √ √

1/I √ √ RBH
1/II √ √ √

2/I √ √ √

1/III √ √ √

3/II √ √ √

4/IV √ √ √
2/III √ √ √

3/III √ √ √

2/IV √ √ √

2/V √ √ √

1/II √ √ √

3/III √ √ √

2/I √ √ √

Sidoarjo, …………………………….

Kaur Kamar Operasi

Agus wiyono

N PEMBEDAHAN
SITI HAJAR SIDOARJO
AHUN 2018

OK JDWL OP KAT. LUKA OP BIAYA


ronde EL CY B BK K KTR U BPJS As.
2/II √ √

1/I √ √ √

2/I √ √ √
3/I √ √ √

2/II √ √ √

1/III √ √ √

4/I √ √ √
sinar
3/II √ √ mas
1/IV √ √ √

4/II √ √ √

3/III √ √ √

1/III √ √ √

3/II √ √ ADIRA

2/III √ √ √

2/IV √ √

3/I √ √

2/I √ √

1/I √ √

2/II √ √

3/II √ √

Sidoarjo, …………………………….

Kaur Kamar Operasi


Agus wiyono

N PEMBEDAHAN
SITI HAJAR SIDOARJO
AHUN 2018

OK JDWL OP KAT. LUKA OP BIAYA


ronde EL CY B BK K KTR U BPJS As.
2/III √ √ √

4/I √ √ √

5/I √ √ √

5/II √ √ great estrn


1/III √ √ √

2/IV √ √ √

4/II √ √ √

3/IV √ √ √

2/IV √ √ √

4/III √ √ √

3/V √ √ √

3/I √ √ √
3/II √ √ √

4/I √ √ √

3/II √ √ √

2/II √ √ √

4/II √ √ √

2/III √ √ √

1/III √ √ √

5/I √ √ √

Sidoarjo, …………………………….

Kaur Kamar Operasi

Agus Wiyono

N PEMBEDAHAN
SITI HAJAR SIDOARJO
AHUN 2018

OK JDWL OP KAT. LUKA OP BIAYA


ronde EL CY B BK K KTR U BPJS As.
1/I √ √ √

2/I √ √ √
2/IV √ √ √

3/III √ √ √

3/I √ √ √

1/I √ √ √

1/II √ √ √

1/III √ √ √ √

2/II √ √ √ √

3/II √ √ √

RR √ √ √

4/I √ √ √

3/II √ √ √

2/III √ √ √

3/III √ √ √

2/IV √ √ √

5/I √ √ √

1/I √ √ √

3/I √ √ √

2/I √ √ √

Sidoarjo, …………………………….

Kaur Kamar Operasi


Agus Wiyono

N PEMBEDAHAN
SITI HAJAR SIDOARJO
AHUN 2018

OK JDWL OP KAT. LUKA OP BIAYA


ronde EL CY B BK K KTR U BPJS As.
1/II √ √ √

3/II √ √ √

4/II √ √ √

4/I √ √ great estrn


2/II √ √ √

1/II √ √ √

2/III √ √ √

5/I √ √ √

4/II √ √ √

2/IV √ √ √

1/II √ √ √

2/IV √ √ √
3/IV √ √ √

3/V √ √ √

4/I √ √ √ √

3/I √ √ √

2/I √ √ √

2/II √ √ √

1/II √ √ √

3/II √ √ √

Sidoarjo, …………………………….

Kaur Kamar Operasi

Agus Wiyono

N PEMBEDAHAN
SITI HAJAR SIDOARJO
AHUN 2018

OK JDWL OP KAT. LUKA OP BIAYA


ronde EL CY B BK K KTR U BPJS As.
1/I √ √ √

2/II √ √ √
1/II √ √ √

2/III √ √ √

1/III √ √ √

2/IV √ √ √

3/I √ √ √

2/V √ √ JAI
3/II √ √ √

3/I √ √ √

2/I √ √ √

3/II √ √ √

1/II √ √ √

1/I √ √ √

2/II √ √ √

1/III √ √ √

1/IV √ √ √

3/III √ √ √

3/IV √ √ √

3/V √ √ √

Sidoarjo, …………………………….

Kaur Kamar Operasi


Agus Wiyono

N PEMBEDAHAN
SITI HAJAR SIDOARJO
AHUN 2018

OK JDWL OP KAT. LUKA OP BIAYA


ronde EL CY B BK K KTR U BPJS As.
1/III √ √ √

1/IV √ √ √

2/II √ √ comfeed
1/III √ √ √

3/VI √ √ JAI
4/I √ √ √

3/V √ √ √

2/III √ √ √

1/V √ √ √

1/VI √ √ √

4/II √ √ √

2/IV √ √ √
5/I √ √ √

2/V √ √ √

4/I √ √ JAI
2/I √ √ √

3/I √ √ √

3/II √ √ √

1/II √ √ √

1/I √ √ √

Sidoarjo, …………………………….

Kaur Kamar Operasi

Agus Wiyono

N PEMBEDAHAN
SITI HAJAR SIDOARJO
AHUN 2018

OK JDWL OP KAT. LUKA OP BIAYA


ronde EL CY B BK K KTR U BPJS As.
2/II √ √ √

1/II √ √ √
2/II √ √ √

1/II √ √ √

3/III √ √ √

2/IV √ √ √

1/IV √ √ √

3/I √ √ √

4/I √ √ √

3/II √ √ √

2/II √ √ √

1/I √ √ √

2/III √ √ √

1/II √ √ √

3/III √ √ √

1/II √ √ √

4/I √ √ √

5/I √ √ √

1/III √ √ √

2/IV √ √ √

Sidoarjo, …………………………….

Kaur Kamar Operasi


Agus Wiyono

N PEMBEDAHAN
SITI HAJAR SIDOARJO
AHUN 2018

OK JDWL OP KAT. LUKA OP BIAYA


ronde EL CY B BK K KTR U BPJS As.
4/II √ √ √

3/V √ √ √

1/V √ √ √

4/III √ √ √

3/V √ √ √

1/I √ √ √

2/I √ √ √

RR √ √ √

1/II √ √ √

2/II √ √ √

5/I √ √ Inhealth
5/I √ √ √
3/I √ √ √

5/II √ √ √

5/III √ √ √

5/IV √ √ √

5/V √ √ √

2/I √ √ √

RR √ √ √

RR √ √ √

Sidoarjo, …………………………….

Kaur Kamar Operasi

Agus Wiyono

N PEMBEDAHAN
SITI HAJAR SIDOARJO
AHUN 2018

OK JDWL OP KAT. LUKA OP BIAYA


ronde EL CY B BK K KTR U BPJS As.
5/VI √ √ √

5/VII √ √ √
5/VIII √ √ √

5/IX √ √ √

3/II √ √ √

4/I √ √ √

2/I √ √ √

2/II √ √ √

2/I √ √ √

4/I √ √ √

3/I √ √ √

2/I √ √ √

1/I √ √ Lippo
4/I √ √ √

3/II √ √ √

4/II √ √ √

1/I √ √ √

4/III √ √ √

1/III √ √ √

3/III √ √ √

Sidoarjo, …………………………….

Kaur Kamar Operasi


Agus Wiyono

N PEMBEDAHAN
SITI HAJAR SIDOARJO
AHUN 2018

OK JDWL OP KAT. LUKA OP BIAYA


ronde EL CY B BK K KTR U BPJS As.
4/II √ √ √

1/II √ √ √

5/I √ √ √

2/III √ √ √

4/II √ √ √

2/I √ √ √

2/IV √ √ √

3/III √ √ √

3/I √ √ √

2/I √ √ √

3/II √ √ √

1/I √ √ √
1/II √ √ √

1/III √ √ √

2/III √ √ RBH
4/II √ √ √

2/IV √ √ √

5/I √ √ √

3/I √ √ √

2/I √ √ √

Sidoarjo, …………………………….

Kaur Kamar Operasi

Agus Wiyono

N PEMBEDAHAN
SITI HAJAR SIDOARJO
AHUN 2018

OK JDWL OP KAT. LUKA OP BIAYA


ronde EL CY B BK K KTR U BPJS As.
1/I √ √ √

3/II √ √ √
2/II √ √ √

1/II √ √ √

4/I √ √ √

2/IV √ √ √

1/II √ √ √

2/III √ √ √

1/III √ √ √

4/II √ √ √

3/IV √ √ √

2/IV √ √ √

3/V √ √ Icon plus


2/IV √ √ √

4/III √ √ √

4/I √ √ √

3/I √ √ √

2/I √ √ √

3/II √ √ √

2/II √ √ √

Sidoarjo, …………………………….

Kaur Kamar Operasi


Agus Wiyono

N PEMBEDAHAN
SITI HAJAR SIDOARJO
AHUN 2018

OK JDWL OP KAT. LUKA OP BIAYA


ronde EL CY B BK K KTR U BPJS As.
4/II √ √ √

3/III √ √ √

1/I √ √ √

1/II √ √ √

4/II √ √ √

2/III √ √ √

2/IV √ √ √

3/IV √ √ √
2/V √ √ √

3/V √ √ √

3/I √ √ JAI
2/I √ √ √

5/IV √ √ √

5/V √ √ √

5/II √ √ √

5/VIII √ √ √

5/VII √ √ √

5/I √ √ √

5/VI √ √ √

5/III √ √ √

Sidoarjo, …………………………….

Kaur Kamar Operasi

Agus Wiyono

N PEMBEDAHAN
SITI HAJAR SIDOARJO
AHUN 2018

OK JDWL OP KAT. LUKA OP BIAYA

ronde
EL CY B BK K KTR U BPJS As.
3/II √ √ √

1/I √ √ √

4/I √ √ √

3/III √ √ √

2/III √ √ √

3/IV √ √ √

2/V √ √ √

3/V √ √ simas
2/I √ √ √

3/I √ √ jacindo
4/I √ √ √

4/II √ √ √

4/III √ √ √

3/II √ √ √

2/II √ √ √

3/III √ √ √
3/V √ √ √

2/IV √ √ √

5/I √ √ √

4/IV √ √ √

Sidoarjo, …………………………….

Kaur Kamar Operasi

Agus Wiyono

N PEMBEDAHAN
SITI HAJAR SIDOARJO
AHUN 2018

OK JDWL OP KAT. LUKA OP BIAYA

ronde
EL CY B BK K KTR U BPJS As.
2/V √ √ √

3/I √ √ √

2/I √ √ √
3/I √ √ √

1/I √ √ √

1/II √ √ √

3/II √ √ √

2/II √ √ √

4/I √ √ √

1/II √ √ √

1/IV √ √ √

2/III √ √ √

3/IV √ √ √

2/V √ √ √

1/III √ √ √

3/III √ √ √

1/V √ √ √

3/III √ √ √

1/III √ √ √

2/VI √ √ √

Sidoarjo, …………………………….

Kaur Kamar Operasi


Agus Wiyono

N PEMBEDAHAN
SITI HAJAR SIDOARJO
AHUN 2018

OK JDWL OP KAT. LUKA OP BIAYA

ronde
EL CY B BK K KTR U BPJS As.
4/II √ √ √

5/I √ √ √

5/II √ √ √

4/III √ √ √

2/VII √ √ √

3/IV √ √ √

5/II √ √ √

3/V √ √ √

2/V √ √ √

3/VI √ √ √
Sidoarjo, …………………………….

Kaur Kamar Operasi

Agus Wiyono
LAPORAN PELAYANAN PEMBEDAHAN
DI UNIT KAMAR OPERASI RSI SITI HAJAR SIDOARJO
BULAN MEI TAHUN 2018

KLASSIFIKASI JNS
UMUR SPESIAL DX DX DOKTER RWT
NO NO. REG NAMA PASIEN OPERASI TGL OPERASI TINDAKAN ANAST
KH B S K ISASI PRE OP POST OP OPERATOR INAP
L P HESI
1 432774 Sdr.Hendro S 24th √ Umum 02/05/2018 Clavus multiple Excisi Clavus multiple dr.Sukarno SAB III/TC
2 432752 Tn.Ponijan 58th √ Umum Lipoma punggung Exterpasi Lipoma punggung dr.Sukarno Intubasi III/TC
3 432750 Ny.Ramayanti 34th √ Umum Fibroma inguinalis D Exterpasi Fibroma inguinalis D dr.Sukarno SAB II/TC
4 432411 Ny.Wiwik Irawati 56th √ Umum FAM Excisi FAM dr.Yan P Masker II/TC
5 432524 Nn.Alifatul K 18th √ Umum FAM Excisi FAM dr.Yan P Masker III/TC
6 003911 Ny.Vivit Enisa 33th √ Obgyn G3P2A0+PP LSCS G3P2A0+PP dr.Kery SAB II/VK
7 431198 Ny.Falricha S 28th √ Obgyn G2P1A0+BSC LSCS G2P1A0+BSC dr.Kery SAB II/VK
8 409249 Ny.Desi Wijayanti 33th √ Obgyn G2P1A0+BSC LSCS G2P1A0+BSC dr.Kery SAB II/VK
9 304576 Ny.Restianik Y 27th √ Obgyn G2P1A0+BSC LSCS G2P1A0+BSC dr.Kery SAB II/VK
10 296770 Ny.Istiqlaliayah 47th √ Obgyn Cistoma ovarii SOS Cistoma ovarii dr.Kery SAB VVIPA
11 425863 Ny.Sri Astutik 45th √ Umum Tumor pyloides Excisi Tumor pyloides dr.Hernowo Masker III/TC
Tumor mandibula impected Tumor mandibula impected
12 430450 Tn.Budiono 33th √ Bdh mulut
teeth
Excisi+oodentectomy teeth dr.Henry Intubasi II/TC
13 432439 Tn.Yesiron Labuno 37th √ Umum HIL D Herniotomy HIL D dr.Bambang SAB II/TC
14 432445 Sdr.Valentino R 19th √ Urologi Varicocle S Vasoligasi tinggi palomo S Varicocle S dr.Kristianto SAB II
15 305667 Tn.Ign Sugih A 43th √ Mata OD pteregium GR III-IV OD extrac OD pteregium GR III-IV dr.Rika LA I/TC
16 365219 Ny.Dias Widya 24th √ Umum Ganglion corpus S Excisi Ganglion corpus S dr.Bambang Masker II
Impected teeth+nekrosis Impected teeth+nekrosis
17 355607 Ny.Sulistyowati 31th √ Bdh mulut
pulpa oodentectomy pulpa dr.Henry Intubasi II
18 380040 Ny.Suharmi 68th √ Umum Abses mamae Incisi+debridemen Abses mamae dr.Hernowo Masker I
19 430579 Ny.Dina Salim A 57th √ Umum Cholelitiasis Cholesistectomy Cholelitiasis dr.Hernowo SAB VVIPA
20 432713 Ny.Yudha Susanti 51th √ Umum Abses pedis Incisi+debridemen dr.Hernowo SAB III

KETERANGAN :

U : UMUM EL: ELEKIF B: BERSIH KTR : KOTOR

BPJS : BPJS CY: CYTO BK: BERSIH KONTAMINASI

As. : ASURANSI K: KONTAMINASI

LAPORAN PELAYANAN PEMBEDAHAN


DI UNIT KAMAR OPERASI RSI SITI HAJAR SIDOARJO
BULAN MEI TAHUN 2018

KLASSIFIKASI JNS
UMUR SPESIAL DX DX DOKTER RWT
NO NO. REG NAMA PASIEN OPERASI TGL OPERASI TINDAKAN ANAST
KH B S K ISASI PRE OP POST OP OPERATOR INAP
L P HESI
Finger tip ijury digiti III Finger tip ijury digiti III
21 432938 Tn.Eka Puji L 21th √ Ortho 02/05/2018 manus S
Debridemen+V Y plasty
manus S dr.Danang Masker II/TC
22 137203 Ny.Luluk Suprapti 34th √ Mata 03/05/2018 Os Calazion Incisi Calazion Os Calazion dr.Yulianti LA II
23 414176 Tn.Ranu Asmoro 52th √ Mata OD Pterigium Excisi pterigium OD Pterigium dr.Yulianti LA III
24 428142 Ny.Yusti Roza 34th √ Obgyn G3P2A0+BSC LSCS G3P2A0+BSC dr.Kery SAB I/VK
25 430125 Ny.Siti Cholifah 23th √ Obgyn G1P0A0+PP LSCS G1P0A0+PP dr.Kery SAB II/VK
26 431674 Ny.Rizky Wijaya 28th √ Obgyn G2P1A0+BSC LSCS G2P1A0+BSC dr.Kery SAB II/VK
27 203383 Ny.Lita Wahyuni 36th √ Obgyn Myoma uteri SVH Myoma uteri dr.Kery SAB II/VK
28 432675 Ny.Eni Suhartini 54th √ Umum Cholelitiasis Cholecistectomy Cholelitiasis dr.Sukarno SAB VVIP
29 432964 Ny.Siti Fatimah 41th √ Umum Appendicitis Apendictomy Appendicitis dr.Sukarno SAB III
30 432891 Ny.Nur aliyah 36th √ Umum Fam S Excisi Fam S dr.Yan P Masker II/TC
31 307481 Ny.Lianti Ratna 37th √ Ortho Cl fr humerus D Orif plating Cl fr humerus D dr.Hary C Intubasi II
32 431681 Tn.Sunoto R 40th √ Urologi Varicocle D Vasoligasi tinngi Varicocle D dr.Kristianto SAB II
33 289165 Ny.Nur Urifah 57th √ Urologi Striktur uretra Sacshe Striktur uretra dr.Kristianto SAB III
34 313453 Ny.Eli Yulianti 54th √ Ortho Trigger figger Release tendon Trigger figger dr.Danang Masker VVIPB
35 431545 Tn Agung S 31th √ Ortho Fr olecranon post wiring Aff wire Fr olecranon post wiring dr.Hary C Masker III
36 372100 Ny.Nani Kursanti 32th √ Obgyn G1P0A0+Letsu LSCS G1P0A0+Letsu dr.Kery SAB II/VK
37 432615 Sdr.Sony P 28th √ THT Adenotonsilitis ATE Adenotonsilitis dr.Noer Sofi Intubasi I/TC

38 380320 Tn.Arifin Tansil 63th √ THT Septudevisiasi Sipplant Septudevisiasi dr.Noer Sofi Intubasi II/TC
39 353486 Ny.Mufaridah H 30th √ Obgyn G3P2A0+BSC LSCS +MOW G3P2A0+BSC dr.Kery SAB II/VK
40 433071 Ny.Suliswiyati 46th √ Umum 5/4/2018 Appendicitis Apendictomy Appendicitis dr.Yan P SAB II

KETERANGAN :

U : UMUM EL: ELEKIF B: BERSIH KTR : KOTOR

BPJS : BPJS CY: CYTO BK: BERSIH KONTAMINASI


As. : ASURANSI K: KONTAMINASI

LAPORAN PELAYANAN PEMBEDAHAN

DI UNIT KAMAR OPERASI RSI SITI HAJAR SIDOARJO


BULAN MEI TAHUN 2018

KLASSIFIKASI
UMUR Obgyn DX DX DOKTER SAB RWT
NO NO. REG NAMA PASIEN OPERASI TGL OPERASI TINDAKAN
KH B S K Obgyn PRE OP POST OP OPERATOR SAB INAP
L P
41 353486 Ny.Mufaridah H 30th √ Obgyn 04/05/2018 G3P2A0+BSC LSCS G3P2A0+BSC dr.Kery SAB II/VK
42 266441 Ny.Lely Rahma 28th √ Obgyn G2P1A0+BSC LSCS G2P1A0+BSC dr.Kery SAB II/VK
43 433009 An.Sabrina M 7th √ Umum Clavus pedis Excisi Clavus pedis dr.Sukarno SAB PAV
44 361156 Ny.Ina Nuriyah 34th √ Umum Hemoroid eksternal Hemoroidectomy Hemoroid eksternal dr.Yan P SAB II/TC
45 433011 Tn.Suhari 50th √ Umum Hil D Herniotomy Hil D dr.Sukarno SAB III/TC
46 432992 Tn.Rojikan 35th √ Umum Tumor dinding dada Excisi Tumor dinding dada dr.Yan P Masker III/TC
47 396144 Ny.Dwi Madya 47th √ Umum Tumor punggung Excisi Tumor punggung dr.Hernowo TIVA II
48 430634 Tn.Lugito 58th √ Umum Abces cruris Nekrotomy+debridemen Abces cruris dr.Hernowo SAB II
49 201878 Sdr.Miftah Faviz 20th √ Ortho Hematros genue S Pungsi hematros Hematros genue S dr.Danang LA II
50 433086 Ny.Sri Astuti 36th √ Obgyn G3P2A0+BSC LSCS G3P2A0+BSC dr.Kery SAB III/VK
51 425345 Ny.Eka Yuliati 31th √ Obgyn G2P1A0+Post date LSCS G2P1A0+Post date dr.Kery SAB III/VK
52 433088 Ny.Trini Megasari 32th √ Obgyn 5/5/2018 G2P1A0+BSC LSCS G2P1A0+BSC dr.Kery SAB II/VK
53 432901 Ny.Diana Lista 26th √ Obgyn G2P1A0+BSC LSCS G2P1A0+BSC dr.Kery SAB II/VK
54 377504 Ny.Ika 28th √ Obgyn G4P3A0+BSC 2X LSCS+MOW G4P3A0+BSC 2X dr.Kery SAB II/VK
55 414101 Ny.Linda 24th √ Obgyn G1P1A0+KPP LSCS G1P1A0+KPP dr.Heru B SAB II/VK
56 422647 Tn.Qorul Anang 43th √ THT Rhinosinisitis K Uncinectomy Rhinosinisitis K dr.Noer Sofi Intubasi II
57 402691 Tn Ricky A 27th √ THT Rhinosinisitis K Uncinectomy Rhinosinisitis K dr.Noer Sofi Intubasi II
58 426567 Ny.Suwarni 79th √ Mata Katarak hipermatur SICS Katarak hipermatur dr.Rika LA III/TC
59 348105 Ny.Sunarsih 61th √ Mata Katarak hipermatur PE+IOL Katarak hipermatur dr.Rika LA I/TC
60 432287 Ny.Alfiyah 59th √ Mata Katarak imatur PE+IOL Katarak imatur dr.Rika LA II/TC

KETERANGAN :

U : UMUM EL: ELEKIF B: BERSIH KTR : KOTOR

BPJS : BPJS CY: CYTO BK: BERSIH KONTAMINASI

As. : ASURANSI K: KONTAMINASI

LAPORAN PELAYANAN PEMBEDAHAN


DI UNIT KAMAR OPERASI RSI SITI HAJAR SIDOARJO
BULAN MEI TAHUN 2018

KLASSIFIKASI JNS
UMUR SPESIAL DX DX DOKTER RWT
NO NO. REG NAMA PASIEN OPERASI TGL OPERASI TINDAKAN ANAST
KH B S K ISASI PRE OP POST OP OPERATOR INAP
L P HESI
61 419546 Ny.Nur Aini 62th √ Mata 05/05/2018 Katarak imatur PE+IOL Katarak imatur dr.Rika LA II/TC
62 428853 Tn.Khamim 62th √ Mata Katarak imatur PE+IOL Katarak imatur dr.Rika LA III/TC
63 432779 Tn.Rusdi 58th √ Mata Katarak imatur PE+IOL Katarak imatur dr.Rika LA III/TC
64 431830 Tn.Husin 72th √ Mata Katarak imatur PE+IOL Katarak imatur dr.Rika LA III/TC
65 432426 Tn.Suhud 56th √ Mata Katarak imatur PE+IOL Katarak imatur dr.Rika LA III/TC
66 212644 Tn.Sulton 52th √ Mata Katarak imatur PE+IOL Katarak imatur dr.Rika LA II/TC
67 418187 Ny.Hj.Sholikah 60th √ Anestesi CKD Psg double lumen CKD dr.Ary F LA RJ
68 429621 Ny.Oke Rahayu A 30th √ Bdh mulut Impected teeth Extraksi+odontectomy Impected teeth dr.Henry Intubasi II/TC
69 433118 Sdr.Rio Andreas 22th √ Umum Appedicitis akut Appendictomy Appedicitis akut dr.Hernowo SAB III
70 291096 Ny.Ulfa Yatim 61th √ Umum Abses punggung Incisi+debridemen Abses punggung dr.Hernowo Intubasi VVIPB
71 429622 Ny.Alfita Irnas 29th √ Bdh mulut Multiple impected teeth Excisi+ondectomy Multiple impected teeth dr.Henry Intubasi II/TC
72 433153 Ny.Diana Andriani 33th √ Obgyn G3P2A0+Post date LSCS G3P2A0+Post date dr.Kery SAB II/VK
73 433218 Nn.Dwi Irmawati 20th √ Umum 07/05/2018 FAM S Excisi FAM S dr.Yan P Masker III/TC
74 403648 Tn.Trimo 44th √ Umum Tumor scalp Excisi Tumor scalp dr.Yan P Masker II/TC
75 433280 Ny.Erni Kuswatin 33th √ Obgyn G4P2A1+BSC LSCS G4P2A1+BSC dr.Kery SAB III/VK
76 433300 Ny.Mei Sulistyo 32th √ Obgyn G3P1A1+gemelli LSCS G3P1A1+gemelli dr.Kery SAB III/VK
77 294633 Ny.Rosa Christi 31th √ Obgyn G3P2A1+BSC LSCS+MOW G3P2A1+BSC dr.Kery SAB III/VK
78 432392 Ny.Lillik Ainul M 25th √ Obgyn G2P1A0+BSC LSCS G2P1A0+BSC dr.Kery SAB III/VK
79 433080 Ny.Ratih Rantina 36th √ Obgyn G4P2A1+PP LSCS G4P2A1+PP dr.Kery SAB II/VK
80 381748 Tn.Sugiono 32th √ Umum Tumor skull Excisi Tumor skull dr.Hernowo SAB II

KETE KETERANGAN :

U : UMU EL: ELEKIF B: BERSIH KTR : KOTOR

BPJS : BPJSCY: CYTO BK: BERSIH KONTAMINASI


As. : ASURANSI K: KONTAMINASI

LAPORAN PELAYANAN PEMBEDAHAN


DI UNIT KAMAR OPERASI RSI SITI HAJAR SIDOARJO
BULAN MEI TAHUN 2018

KLASSIFIKASI JNS
UMUR SPESIAL DX DX DOKTER RWT
NO NO. REG NAMA PASIEN OPERASI TGL OPERASI TINDAKAN ANAST
KH B S K ISASI PRE OP POST OP OPERATOR INAP
L P HESI
81 181500 Ny.Siti Watucha 53th √ Umum 07/05/2018 Tumor dinding dada Excisi Tumor dinding dada dr.Yan P Masker III/TC
82 432311 Ny.Sunarse 44th √ Umum Cholelitiasis Cholesistectomy Cholelitiasis dr.Bambang SAB II/TC
83 432895 Tn.Mujiono 62th √ Umum HIL D Herniotomy HIL D dr.Yan P SAB III/TC
84 283024 Ny.Angela Narici 45th √ Umum Struma milti nodusa Sub total lobectomy Struma milti nodusa dr.Hernowo Intubasi I/TC
85 315767 Ny.Munawaroh 57th √ Umum Nuero febroma punggung Excisi Nuero febroma punggung dr.Hernowo Masker I
86 354281 Tn.Kasan Basori 69th √ Umum HIL D Herniotomy HIL D dr.Hernowo SAB II/TC
87 424150 Ny.Setyowati 44th √ Ortho Tinger finger digiti I manus S Release tendon Tinger finger digiti I manus S dr.Hary Masker III/TC
88 237331 An.Intan Dewi 11th √ Ortho Cl fr femur Orif plating Cl fr femur dr.Hary SAB II
89 433238 Tn.Abd.Manap 53th √ Ortho Cl fr humerus Orif plating Cl fr humerus dr.Hary Intubasi III/TC
90 424954 Ny.Fr.Murni 41th √ Obgyn G2P1A0+BSC LSCS G2P1A0+BSC dr.Kery SAB II/VK
91 409913 Ny.Devin Sundari 33th √ Umum Cholelitiasis Cholesistectomy Cholelitiasis dr.Hernowo SAB II
92 345146 Ny.Ratna Aulia 36th √ Obgyn G4P3A2+BSC LSCS G4P3A2+BSC dr.Kery SAB II/VK

93 432982 Ny.Ida Yuliana 29th √ Obgyn G2P1A0+OD gagal LSCS G2P1A0+OD gagal dr.Kery SAB II/VK
94 433361 Ny.Marni Indriati 37th √ Obgyn G1P0A0+PROM LSCS G1P0A0+PROM dr.Umi SAB II/VK
95 196409 Ny.Anies Rama 33th √ Obgyn G2P0A1+HSVB LSCS G2P0A1+HSVB dr.Umi SAB I/VK
96 172768 Ny.Ratih Ayu P 32th √ Obgyn G4P2A1+BSC LSCS+MOW G4P2A1+BSC dr.Umi SAB II/VK
97 418041 Ny.Dewi Mariyam 34th √ Obgyn G3P2A0+BSC LSCS+MOW G3P2A0+BSC dr.Umi SAB I/VK
98 429708 Ny.Cici Nur Indah 30th √ Obgyn G2P1A0+BSC+Hb S Ag+ LSCS G2P1A0+BSC+Hb S Ag+ dr.Umi SAB II/VK
99 307569 Ny.Dwi Yulustia 27th √ Obgyn G2P1A0+BSC LSCS+Insersi IUD G2P1A0+BSC dr.Umi SAB I/VK
100 413823 Ny.Susiani 35th √ Obgyn G4P2A1+NST non reaktif LSCS G4P2A1+NST non reaktif dr.Umi SAB II/VK

KETERANGAN :

U : UMUM EL: ELEKIF B: BERSIH KTR : KOTOR

BPJS : BPJS CY: CYTO BK: BERSIH KONTAMINASI

As. : ASURANSI K: KONTAMINASI

LAPORAN PELAYANAN PEMBEDAHAN


DI UNIT KAMAR OPERASI RSI SITI HAJAR SIDOARJO
BULAN MEI TAHUN 2018

KLASSIFIKASI JNS
UMUR SPESIAL DOKTER RWT
NO NO. REG NAMA PASIEN OPERASI TGL OPERASI DX TINDAKAN DX ANAST
KH B S K ISASI OPERATOR INAP
L P HESI
101 430698 Ny.Kristina Yulista 33th √ Obgyn 07/05/2018 G3P2A0+BSC LSCS+MOW G3P2A0+BSC dr.Kery SAB I/VK
102 432900 Ny.Ernawati 37th √ Mata 08/05/2018 OD Daryocystitis Incisi OD Daryocystitis dr.Yulianti LA I/TC
103 433335 Tn.Didik Wagianto 39th √ Umum Neurofibroma Excisi Neurofibroma dr.Yan P Masker II
104 431777 Ny.Lailatul F 28th √ Umum Struma nodusa Ismu lobectomy Struma nodusa dr.Yan P Intubasi II
105 296375 An.Sulthon Dwi 8th √ Obgyn Vulnus iktum Incisi+debridemen Vulnus iktum dr.Hernowo Masker II
106 429554 Tn.Agus Santosa 44th √ Urologi Batu pyelum Pielolitotomy Batu pyelum dr.KristiantoInt Intubasi I
107 433498 Ny Fifin Nur A 28th √ obgyn G2P1A0+Defleksi LSCS G2P1A0+Defleksi dr.umi SAB II/VK
108 433460 Tn Sayudi 58th √ Ortho Op fr fibula D Debridement +pinning Op fr fibula D dr.Hary C SAB III/TC
109 240593 Ny.Warti 68th √ Ortho Radiculopaty Epidurall steroid Radiculopaty dr.Larona LA II/TC
110 431479 Ny.Laeli J 42th √ Obgyn G2P1A0+PEB LSCS+MOW G2P1A0+PEB dr.umi SAB II/VK
111 122806 Ny.Susi arijani 47th √ Obgyn Abortus incompleitus Curetage Abortus incompleitus dr.umi SAB I/VK
112 397403 Ny.Fenni L 30th √ Obgyn Blighted ovum Curetage Blighted ovum dr.umi SAB I/VK
113 411897 Ny Lailiyah 31th √ Obgyn G1P0A0+PP LSCS +IUD G1P0A0+PP dr.umi SAB I/VK
114 419295 Nn.Fariska A 14th √ Umum Apendicitis Apendictomy Apendicitis dr.Sukarno SAB III
115 433502 Tn.I putu Karyana 56th √ Umum Perianal abces Incisi +debridement Perianal abces dr.Sukarno SAB PAV
116 278254 Ny.Ririn Sukma 31th √ Obgyn G1P0A0+PP LSCS G1P0A0+PP dr.umi SAB II/VK
117 433554 Tn.Aswin 44th √ Umum HIL D Herniotomy HIL D dr.Hernowo SAB III/TC
118 306073 An.Fariel Athariz 4th √ Umum Atheruma retro auricle Excisi Atheruma retro auricle dr.Hernowo Masker III
119 433544 Ny.Tri Isnawati 33th √ Umum Appendicitis akut perforasi Lap appendictomy Appendicitis akut perforasi dr.Bambang SAB III
120 430995 Nn.Puji Rahayu 21th √ Umum Cholelitiasis Cholesistectomy Cholelitiasis dr.Bambang SAB III/TC

KETERANGAN :

U : UMUM EL: ELEKIF B: BERSIH KTR : KOTOR

BPJS : BPJS CY: CYTO BK: BERSIH KONTAMINASI


As. : ASURANSI K: KONTAMINASI

LAPORAN PELAYANAN PEMBEDAHAN


DI UNIT KAMAR OPERASI RSI SITI HAJAR SIDOARJO
BULAN MEI TAHUN 2018

KLASSIFIKASI JNS
UMUR SPESIAL DOKTER RWT
NO NO. REG NAMA PASIEN OPERASI TGL OPERASI DX TINDAKAN DX ANAST
KH B S K ISASI OPERATOR INAP
L P HESI
121 401539 An.Adinda Airly 13th Umum 09/05/2018 Appendicitis akut Appendictomy Appendicitis akut dr.Hernowo SAB II/TC
122 432421 Tn.Subur 53th Anestesi CKD Double lumen CKD dr.Ary F LA RJ
123 432766 An.Rafael Azzam 7th Ortho Cl fr humerus S Orif wiring+backslap Cl fr humerus S dr.Hary C Masker II/TC
124 431496 Tn.Agus Jati 40th Ortho Cl fr ulna D Orif plating Cl fr ulna D dr.Hary C Intubasi III/TC
125 433609 Ny.Titis Rahmi 25th Obgyn G1P0A0+Fetal distress LSCS G1P0A0+Fetal distress dr.Umi SAB II/VK
126 285325 Ny.Suhartatik 42th Obgyn G4P2A1+KPP+MOW LSCS+MOW G4P2A1+KPP+MOW dr.Umi SAB II/VK
127 433595 Ny.Murtini 36th Obgyn G2P1A0+Letsu LSCS G2P1A0+Letsu dr.Umi SAB II/VK
128 432250 Ny.Dini Mei S 22th Obgyn 10/05/2018 G3P1A1+BSC LSCS G3P1A1+BSC dr.Umi SAB II/VK
129 365043 Ny.Leny Kurnia 25th Obgyn G1P0A0+PP LSCS G1P0A0+PP dr.Umi SAB I/VK
Op fr phalang digiti I manus Op fr phalang digiti I manus
130 072976 Tn.Slamet Abidin 45th Ortho D
Orif pining+debridement
D dr.Danang Masker II/TC
131 433591 Ny.Kurniatul L 28th Obgyn G2P1A0+fetal distress LSCS G2P1A0+fetal distress dr.Umi SAB III/VK
132 427858 Ny.Zerlis Maulid 21th Obgyn G1P0A0+Asma bronkial LSCS G1P0A0+Asma bronkial dr.Umi SAB II/VK
133 345478 Ny.Riski Febriana 27th Obgyn G3P1A0+PEB LSCS G3P1A0+PEB dr.Heru B SAB III/VK
134 433647 Ny.Dewi Puspita 21th Obgyn G1P0A0+kepala floating LSCS G1P0A0+kepala floating dr.Heru B SAB III/VK
Op fr digiti III phalang distal Op fr digiti III phalang distal
135 353914 An.Fatimah Talita 2th Ortho pedis D
Debridement+orif pining
pedis D dr.Hary C Masker I/TC
136 433570 Ny.Niken Susy H 30th Umum 11/05/2018 FAM D Excisi FAM D dr.Yan P Masker II
137 432936 Ny.Dewi Kurnia 31th Obgyn G3P2A0+KIFL LSCS G3P2A0+KIFL dr.Umi SAB III/VK
138 427409 Tn.Wagiman Budi 45th Umum Tumor pedis Superlicus polidectomy Tumor pedis dr.Yan P SAB I/TC
139 253736 Tn.Haryo Hadi 27th Umum Ganglion manus Excisi Ganglion manus dr.Yan P TIVA II/TC
140 388396 Tn.M.Asan 63th Umum Tumor pedis Excisi Tumor pedis dr.Yan P TIVA II/TC

KETERANGAN :

U : UMUM EL: ELEKIF B: BERSIH KTR : KOTOR

BPJS : BPJS CY: CYTO BK: BERSIH KONTAMINASI

As. : ASURANSI K: KONTAMINASI

LAPORAN PELAYANAN PEMBEDAHAN


DI UNIT KAMAR OPERASI RSI SITI HAJAR SIDOARJO
BULAN MEI TAHUN 2018

KLASSIFIKASI JNS
UMUR SPESIAL DX DX DOKTER RWT
NO NO. REG NAMA PASIEN OPERASI TGL OPERASI TINDAKAN ANAST
KH B S K ISASI PRE OP POST OP OPERATOR INAP
L P HESI
141 433192 Tn.Satuji 55th Umum 11/05/2018 HIL Herniotomy HIL dr.Hernowo SAB I/TC
142 433589 An.M.Dimas P 12th Umum Veruca multiple pedis D+S Excisi Veruca multiple pedis D+S dr.Hernowo TIVA II
143 433701 Ny.Mira Ratna S 26th Obgyn G1P0A0+KPP LSCS G1P0A0+KPP dr.Heru B SAB II/VK
144 170524 Ny.Sandy Tieas 31th Obgyn G2P1A0+BSC LSCS+Insersi IUD G2P1A0+BSC dr.Umi SAB I/VK
145 380797 Ny.Rohmani A 21th Obgyn G2P1A+Haemoroid LSCS G2P1A+Haemoroid dr.Umi SAB I/VK
146 254914 Ny.Lindarsih 34th Obgyn G2P1A0+BSC LSCS G2P1A0+BSC dr.Umi SAB I/VK
147 433302 Ny.Rini Fajarwati 35th Obgyn G1P0A0+polihidramnion LSCS G1P0A0+polihidramnion dr.Umi SAB I/VK
148 418552 Ny.Mubarokah 47th Obgyn Mioma uteri TAH+BSO Mioma uteri dr.Umi SAB II/VK
149 395706 Ny.Wulansari W 26th Obgyn 12/05/2018 G2P0A1+Letsu LSCS G2P0A1+Letsu dr.Umi SAB II/VK
150 432988 Tn.M.Choiron 54th Mata OD katarak imatur SICS OD katarak imatur dr.Rika LA II/TC
151 431575 Ny.Poniah 54th Mata OS katarak imatur PE+IOL OS katarak imatur dr.Rika LA I/TC
152 433592 Tn.Ghozali 63th Mata OS katarak imatur PE+IOL OS katarak imatur dr.Rika LA I/TC
153 334694 Tn.Marwan H 74th Mata OD katarak imatur PE+IOL OD katarak imatur dr.Rika LA I/TC
154 433401 Ny.Sarikatin 59th Mata OD katarak imatur PE+IOL OD katarak imatur dr.Rika LA III/TC
155 422966 Ny.Umyana 61th Mata OS katarak imatur PE+IOL OS katarak imatur dr.Rika LA II/TC
156 432805 Tn.Sodik 80th Mata OS katarak imatur PE+IOL OS katarak imatur dr.Rika LA III/TC
157 433332 Tn.Slamet 69th Mata OD katarak imatur PE+IOL OD katarak imatur dr.Rika LA III/TC
158 336109 Ny.Eko Budiati 39th Obgyn Abortus incomplit Curetage Abortus incomplit dr.Heru B SAB II/VK
159 433746 Ny.Siti Yuliatin 32th Obgyn Abortus incomplit Curetage Abortus incomplit dr.Heru B SAB II/VK
160 379943 An.Alysia Chumairo 24th THT Adenotonsilitis ATE Adenotonsilitis dr.Noer Sofi Intubasi VIP

KETERANGAN :

U : UMUM EL: ELEKIF B: BERSIH KTR : KOTOR


BPJS : BPJS CY: CYTO BK: BERSIH KONTAMINASI

As. : ASURANSI K: KONTAMINASI

LAPORAN PELAYANAN PEMBEDAHAN


DI UNIT KAMAR OPERASI RSI SITI HAJAR SIDOARJO
BULAN MEI TAHUN 2018

KLASSIFIKASI JNS
UMUR SPESIAL DX DX DOKTER RWT
NO NO. REG NAMA PASIEN OPERASI TGL OPERASI TINDAKAN ANAST
KH B S K ISASI PRE OP POST OP OPERATOR INAP
L P HESI
161 433505 Ny.Sri Lhamini 24th THT 12/05/2018 Abses auriculer Incici+drainage abses Abses auriculer dr.Noer Sofi Intubasi III
162 433742 Tn.M.Farid 35th Umum Haemoroid Haemoroidectomy Haemoroid dr.Bambang SAB I/TC
163 431651 An.Tria Ananda 13th Bdh mulut Mucocle labialis inferior Excisi Mucocle labialis inferior dr.Henry Masker II
164 412753 Tn.Vri Nuriadi 36th Ortho Cl fr femur D Orif plating Cl fr femur D dr.Hary C SAB II/TC
165 396725 Tn.Fadeli 47th Umum Cholelitiasis Cholesistectomy Cholelitiasis dr.Hernowo SAB III
166 233609 Tn.Budi Priyatin 54th Bdh mulut Abses bucal spore Incisi abses+exterpasi gusi Abses bucal spore dr.Henry Masker III
167 430500 Tn.M.Sholeh 38th Umum Abses periana Incisi+debridement Abses periana dr.Hernowo SAB II
168 306521 Tn.Zulfadilah Y 52th Umum Tumor shoulder+terinfeksi Excisi Tumor shoulder+terinfeksi dr.Yan P Masker II
169 414401 Tn.Chalim 64th Umum Ganglion pedis Excisi Ganglion pedis dr.Yan P SAB III
170 433460 Tn.Sayudi 58th Ortho Nekrose post op cruris D Amputasi cruris Nekrose post op cruris D dr.Hary C SAB III/TC
171 379793 Ny.RR.Titien A 39th Obgyn G3P1A1+BSC LSCS G3P1A1+BSC dr.Umi SAB II/VK
172 426446 Ny.Dyah Pitasari 34th Obgyn G2P1A0+NST non reaktif LSCS G2P1A0+NST non reaktif dr.Umi SAB I/VK
173 317874 Ny.Hariatiningsih 39th Obgyn G5P2A2+BSC LSCS+MOW G5P2A2+BSC dr.Umi SAB II/VK
174 165502 Ny.Catur Hari S 36th Obgyn Late HPP Curetage Late HPP dr.Umi SAB II/VK
175 369310 Ny.Anis Junaidah 30th Obgyn G5P2A2+BSC LSCS G5P2A2+BSC dr.Umi SAB II/VK
176 428268 Ny.Ana Wahyuni 37th Obgyn G3P2A0+BSC LSCS+MOW G3P2A0+BSC dr.Umi SAB II/VK
177 328716 Ny.Nanik 56th Umum Appendic akut Lap appendictomy Appendic akut dr.Hernowo SAB II
178 430152 Ny.Ariani 31th Obgyn G3P2A0+CPD LSCS G3P2A0+CPD dr.Umi SAB III/VK
179 428019 Ny.Retno Palupi 34th Obgyn 14/05/2018 G1P0A0+KPP LSCS G1P0A0+KPP dr.Haris SAB I/VK
G3P2A0+BSC+Vistoma
180 399990 Ny.Indah Mayang 25th Obgyn G3P2A0+BSC LSCS+SOS ovarii dr.Umi SAB II/VK

KETERANGAN :

U : UMUM EL: ELEKIF B: BERSIH KTR : KOTOR

BPJS : BPJS CY: CYTO BK: BERSIH KONTAMINASI

As. : ASURANSI K: KONTAMINASI

LAPORAN PELAYANAN PEMBEDAHAN


DI UNIT KAMAR OPERASI RSI SITI HAJAR SIDOARJO
BULAN MEI TAHUN 2018

KLASSIFIKASI JNS
UMUR SPESIAL DX DX DOKTER RWT
NO NO. REG NAMA PASIEN OPERASI TGL OPERASI TINDAKAN ANAST
KH B S K ISASI PRE OP POST OP OPERATOR INAP
L P HESI
181 431966 Ny.Suparmi 27th Obgyn 14/05/2018 Abortus incomplit Curetage Curetage dr.Heru B SAB II/VK
182 190065 Tn.Noer Muhamad 50th Umum Tumor punggung Excisi Excisi dr.Hernowo TIVA III/TC
183 433343 Tn.Sumidjan 61th Urologi Batu buli buli Litotripsi Litotripsi dr.Kristianto SAB II/TC
184 432236 Ny.Dwi Ernawati 45th Umum Struma multi nodusa Sub total lobectomy Sub total lobectomy dr.Hernowo Intubasi I
185 204200 Ny.Afrida Nur A 25th Obgyn G1P0A0+PP LSCS LSCS dr.Umi SAB II/VK
186 432905 Ny.Sukesi 37th Obgyn G2P1A0+BSC LSCS LSCS dr.Umi SAB II/VK
187 303488 Ny.Retno Widya 26th Obgyn G2P1A0+BSC LSCS+Insersi IUD LSCS+Insersi IUD dr.Umi SAB II/VK
188 398566 Ny.Dina Syahdiya 30th Obgyn Dead conceptus Curetage Curetage dr.Umi SAB III/VK
189 298497 Ny.Reni Damayanti 37th Obgyn 15/05/2018 G3P2A0+BSC LSCS LSCS dr.Heru B SAB II/VK
190 334587 Ny.Miftakhul K 30th Obgyn G2P1A0+BSC LSCS LSCS dr.Umi SAB I/VK
191 433969 Ny.Siti Maulidatul 21th Obgyn G1P0A0+Post date LSCS LSCS dr.Haris SAB II/VK
192 282568 Ny.Luanda Tri E 30th Obgyn G2P1A0+BSC LSCS LSCS dr.Haris SAB II/VK
193 433081 Ny.Weny Kartika 34th Obgyn G3P0A0+KPP LSCS LSCS dr.Haris SAB II/VK
194 429194 Ny.Novianti 36th Obgyn Abortus incomplit Curetage Curetage dr.Haris SAB III/VK
195 388702 Ny.Asmaul Khusna 51th Anestesi CKD Pasang CVC Pasang CVC dr.Ary F LA VVIPA
196 366418 Tn.Sulkan 45th Ortho Dislokasi caput humerus Reposisi Reposisi dr.Danang TIVA I
anterior D
197 432725 Ny.Yohana Maria 62th Ortho Infeksi post pining Debridement Debridement dr.Hary C Intubasi I/TC
198 416626 Ny.Misni 69th Ortho Cl fr femur Orif plating Orif plating dr.Hary C SAB II/TC
Sacro iliac joint artritis Injeksi atreoid sacroiliac Injeksi atreoid sacroiliac
199 393335 Ny.Nuzula 56th Ortho joint+joint block joint+joint block dr.Larona LA II/TC
200 373918 Tn.Sudajakfar 68th Urologi Ca buli TUR Buli TUR Buli dr.Candra SAB PAV

KETERANGAN :

U : UMUM EL: ELEKIF B: BERSIH KTR : KOTOR


BPJS : BPJS CY: CYTO BK: BERSIH KONTAMINASI

As. : ASURANSI K: KONTAMINASI

LAPORAN PELAYANAN PEMBEDAHAN


DI UNIT KAMAR OPERASI RSI SITI HAJAR SIDOARJO
BULAN MEI TAHUN 2018

KLASSIFIKASI JNS
UMUR SPESIAL DX DX DOKTER RWT
NO NO. REG NAMA PASIEN OPERASI TGL OPERASI TINDAKAN ANAST
KH B S K ISASI PRE OP POST OP OPERATOR INAP
L P HESI
201 433329 Ny.Miftakhur R 25th Obgyn G1P0A0+High miopi LSCS G1P0A0+High miopi dr.Umi SAB II/VK
202 267052 Ny.Anis Zulmi 29th Obgyn G3P1A1+BSC LSCS G3P1A1+BSC+ket mekoneal dr.Umi SAB II/VK
203 186600 Ny.Indah Lailiah 33th Obgyn G6P3A1+PPM LSCS+Insersi IUD G6P3A1+PPM dr.Umi SAB I/VK
204 414893 Ny.Eva Rizqiah 29th Obgyn G2P1A0+BSC LSCS G2P1A0+BSC dr.Umi SAB II/VK
205 433788 Ny.Martiningtyas 34th Obgyn G2P1A0+BSC LSCS G2P1A0+BSC dr.Umi SAB II/VK
206 393909 Ny.Dyah Fatma 44th Obgyn Mioma uteri TAH+SOS Mioma uteri dr.Umi SAB II/VK
207 387767 Ny.Lilis Purnia 31th Obgyn Blighted ovum Curetage Blighted ovum dr.Umi SAB I/VK
208 264391 Tn.Sugiono 52th Mata 16/05/2018 OD Pteregium OD Pteregium dr.Yulianti LA II/TC
209 363465 Ny.Umi Kusmaia 39th Anestesi CKD Double lumen CKD dr.Ary F LA III
210 000791 Tn.Imam Syafii 53th Mata OD Chalazion OD Chalazion dr.Yulianti LA PAV
211 432730 Ny.Luluk Rosidah 49th Obgyn Cistoma ovarii SOD Cistoma ovarii dr.Kery SAB II/VK
212 234232 Ny.Poliah 37th Obgyn Tumor cervix Exterpasi+curetage Tumor cervix dr.Heru B SAB I/VK
213 434058 Tn.Sucahyono 35th Umum Haemoroid Haemoroidectomy Haemoroid dr.Sukarno SAB II
214 433878 Sdr.M.Fahmi 28th Umum HIL Herniotomy HIL dr.Sukarno SAB PAV
215 434096 Ny.Iswati 37th Obgyn G3P2A0+BSC LSCS G3P2A0+BSC dr.Haris SAB II/VK
216 434111 Ny.Novianti W 29th Obgyn G2P1A0+BSC LSCS G2P1A0+BSC dr.Haris SAB II/VK
217 434038 Ny.Yohani Kartika 37th Obgyn Mioma giborn Exterpasi+curetage Mioma giborn dr.Haris SAB II/VK
218 434102 Ny.Syahrina Amel 35th Obgyn G3P1A1+BSC LSCS G3P1A1+BSC dr.Haris SAB I/VK
219 266069 Tn.Hairul Hidayat 45th Umum Tumor occipital Excisi Tumor occipital dr.Yan P Masker I/TC
220 432939 Tn.Khoirul A 32th Urologi Varicocle S Vasoligasi palomo S Varicocle S dr.Kristianto SAB II/TC

KETERANGAN :

U : UMUM EL: ELEKIF B: BERSIH KTR : KOTOR

BPJS : BPJS CY: CYTO BK: BERSIH KONTAMINASI

As. : ASURANSI K: KONTAMINASI

LAPORAN PELAYANAN PEMBEDAHAN


DI UNIT KAMAR OPERASI RSI SITI HAJAR SIDOARJO
BULAN MEI TAHUN 2018

KLASSIFIKASI JNS
UMUR SPESIAL DX DX DOKTER RWT
NO NO. REG NAMA PASIEN OPERASI TGL OPERASI TINDAKAN ANAST
KH B S K ISASI PRE OP POST OP OPERATOR INAP
L P HESI
221 428571 Ny.Retno Mardia 30th Obgyn 16/05/2018 G1P0A0+Oligohidramnion LSCS G1P0A0+Oligohidramnion dr.Kery SAB II/VK
222 306563 Tn.Indra Jaksa 61th Ortho Op fr digiti III,IV distal Orif pining+debridemen Op fr digiti III,IV distal dr.Danang SAB I/TC
223 434044 Ny.Ernawati 35th Obgyn 17/05/2018 G3P2A0+BSC LSCS+MOW G3P2A0+BSC dr.Kery SAB II/VK
224 334473 Ny.Endang Sari 38th Obgyn G4P3A0+PEB LSCS+MOW G4P3A0+PEB dr.Kery SAB II/VK
225 429707 Ny.Dwi Rani R 25th Obgyn G1P0A0+PP LSCS G1P0A0+PP dr.Kery SAB II/VK
226 432264 Tn.Oemardi 61th Urologi BPH TUR P BPH dr.Candra SAB III
227 433820 Nn.Risdia Rahma 25th THT Adenotonsilitis ATE Adenotonsilitis dr.Noer Sofi Intubasi III
228 428006 Ny.Dessira Rizki 31th Obgyn G2P1A0+BSC LSCS G2P1A0+BSC dr.Kery SAB VVIPB
229 191938 Ny.Erika Widiastuti 25th Obgyn 18/05/2018 G1P0A0+Asma LSCS G1P0A0+Asma dr.Kery SAB II/VK
230 417807 Ny.Nur Laila 36th Obgyn G3P2A0+PP LSCS+MOW G3P2A0+PP dr.Kery SAB II/VK
231 434229 Ny.Tutik maslaha 27th Obgyn G1P0A0+Post date LSCS G1P0A0+Post date dr.Haris SAB II/VK
232 434228 Ny.Puji Rahayu 31th Obgyn Abortus incomplit Curetage Abortus incomplit dr.Haris SAB III/VK
233 434262 Ny.Zein Kharisma 26th Obgyn G2P1A0+Letsu LSCS G2P1A0+Letsu dr.Kery SAB II/VK
234 432459 Tn.Wahyudi 37th Umum Lipoma cruris Excisi Lipoma cruris dr.Sukarno SAB I
235 430840 Ny.Eky Farahuda 27th Obgyn G3P1A2+partus kasep LSCS G3P1A2+partus kasep dr.Kery SAB III/VK
236 348067 Ny.Nurul Utiana 27th Umum Ganglion angkle Excisi Ganglion angkle dr.Yan P SAB II/TC
237 238605 An.Dimas Aditya 12th Umum Tumor wajah multiple Excisi Tumor wajah multiple dr.Yan P TIVA VIP
Op dislokasi pip join digiti II Op dislokasi pip join digiti II
238 434243 Ny.Anantariatyas 42th Ortho pedis S
Orif pining+debridemen
pedis S dr.Danang SAB I/TC
Finger trip injury digiti IV Finger trip injury digiti IV
239 434286 Tn.Imron Sholeh 38th Ortho manus S
Debridemen+repair stamp
manus S dr.Danang TIVA II/TC
240 432907 Ny.Jumini 42th Umum FCD mamae Excisi FCD mamae dr.Hernowo TIVA II

KETERANGAN :

U : UMUM EL: ELEKIF B: BERSIH KTR : KOTOR


BPJS : BPJS CY: CYTO BK: BERSIH KONTAMINASI

As. : ASURANSI K: KONTAMINASI

LAPORAN PELAYANAN PEMBEDAHAN


DI UNIT KAMAR OPERASI RSI SITI HAJAR SIDOARJO
BULAN MEI TAHUN 2018

KLASSIFIKASI JNS
UMUR SPESIAL DX DX DOKTER RWT
NO NO. REG NAMA PASIEN OPERASI TGL OPERASI TINDAKAN ANAST
KH B S K ISASI PRE OP POST OP OPERATOR INAP
L P HESI
241 422978 Tn.Sudirman 50th Umum 18/05/2018 Gall stone Cholesistectomy Gall stone dr.Hernowo SAB III/TC
242 433898 Tn.Saiun 68th Umum Tumor femur D Excisi Tumor femur D dr.Hernowo SAB III/TC
243 385067 Tn.Eshas Agvan 27th Umum Haemoroid G III Haemoroidectomy Haemoroid G III dr.Bambang SAB VIP
244 339899 An.Jonathan A 12th Umum Ganglion carpi Excisi Ganglion carpi dr.Bambang Masker I/TC
245 434143 An.M.Ozil Prawira 8bln Umum HIL D Herniotomy HIL D dr.Bambang Masker III/TC
246 287092 Ny.Ana Riawati 43th Umum Struma S Sub total lobectomy Struma S dr.Hernowo Intubasi III
247 434316 Ny.Yeni Ekasari 24th Obgyn G1P0A0+PRM LSCS G1P0A0+PRM dr.Kery SAB III/VK
248 434330 Tn.Harianto 54th Ortho Dislokasi shoulder Reposisi Dislokasi shoulder dr.Danang TIVA III
249 432631 Ny.Nurul Lola H 25th Obgyn 19/05/2018 G1P0A0+High miopi LSCS G1P0A0+High miopi dr.Kery SAB II/VK
250 425165 Ny.Arik Wiranti 36th Obgyn G3P1A1+BSC LSCS G3P1A1+BSC dr.Kery SAB II/VK
251 434028 Ny.Aris Yunita 30th Obgyn G2P1A0+BSC LSCS G2P1A0+BSC dr.Kery SAB II/VK
252 375160 Tn.M.Kharis 23th THT Rhinosinositis FESS Rhinosinositis dr.Noer Sofi Intubasi II
253 373515 Tn.m.Nur Arifin 33th Umum HIL S Herniotomy HIL S dr.Sukarno SAB I/TC
254 433438 Sdr.Ari Dwi R 25th THT Rhinosinositis FESS Rhinosinositis dr.Noer Sofi Intubasi II/TC
255 264971 Nn.Rose Paramita 24th Bdh mulut Tumor labialis Excisi Tumor labialis dr.Henry LA II/TC
256 409593 An.Ananda Talita 10th Bdh mulut Kista mandibula+nekrosis Excisi+extraksi gigi Kista mandibula+nekrosis dr.Henry Intubasi III
257 434063 Tn.Abd.Kahar M 74th Urologi BPH TUR P BPH dr.Candra SAB II
258 349493 Ny.Iva Rusdiana 29th Obgyn G3P2A1+BSC LSCS G3P2A1+BSC dr.Kery SAB II/VK
259 434375 Ny.Dian Ariani 31th Obgyn G2P1A0+kepala floating LSCS G2P1A0+kepala floating dr.Kery SAB III/VK
260 434236 Tn.Abd.Hadi 59th Urologi Striktur uretra Sachse Striktur uretra dr.Candra SAB I

KETERANGAN :

U : UMUM EL: ELEKIF B: BERSIH KTR : KOTOR

BPJS : BPJS CY: CYTO BK: BERSIH KONTAMINASI

As. : ASURANSI K: KONTAMINASI

LAPORAN PELAYANAN PEMBEDAHAN


DI UNIT KAMAR OPERASI RSI SITI HAJAR SIDOARJO
BULAN MEI TAHUN 2018

KLASSIFIKASI JNS
UMUR SPESIAL DX DX DOKTER RWT
NO NO. REG NAMA PASIEN OPERASI TGL OPERASI TINDAKAN ANAST
KH B S K ISASI PRE OP POST OP OPERATOR INAP
L P HESI
261 248095 Ny.Kusmiati 26th Obgyn 19/05/208 G2P1A0+PRM LSCS dr.Kery SAB II/VK
262
263
264
265
266
267
268
269
270
271
272
273
274
275
276
277
278
279
280

KETERANGAN :

U : UMUM EL: ELEKIF B: BERSIH KTR : KOTOR


BPJS : BPJS CY: CYTO BK: BERSIH KONTAMINASI

As. : ASURANSI K: KONTAMINASI

LAPORAN PELAYANAN PEMBEDAHAN


DI UNIT KAMAR OPERASI RSI SITI HAJAR SIDOARJO
BULAN MEI TAHUN 2018

KLASSIFIKASI JNS
UMUR SPESIAL DX DX DOKTER RWT
NO NO. REG NAMA PASIEN OPERASI TGL OPERASI TINDAKAN ANAST
KH B S K ISASI PRE OP POST OP OPERATOR INAP
L P HESI
281
282
283
284
285
286
287
288
289
290
291
292
293
294
295
296
297
298
299
300

KETERANGAN :

: UMUM EL: ELEKIF B: BERSIH KTR : KOTOR

BPJS : BPJS CY: CYTO BK: BERSIH KONTAMINASI

As. : ASURANSI K: KONTAMINASI

LAPORAN PELAYANAN PEMBEDAHAN


DI UNIT KAMAR OPERASI RSI SITI HAJAR SIDOARJO
BULAN MEI TAHUN 2018

KLASSIFIKASI JNS
UMUR SPESIAL DX DX DOKTER RWT
NO NO. REG NAMA PASIEN OPERASI TGL OPERASI TINDAKAN ANAST
KH B S K ISASI PRE OP POST OP OPERATOR INAP
L P HESI
301
302
303
304
305
306
307
308
309
310
311
312
313
314
315
316
317
318
319
320

KETERANGAN :

U : UMUM EL: ELEKIF B: BERSIH KTR : KOTOR


BPJS : BPJS CY: CYTO BK: BERSIH KONTAMINASI

As. : ASURANSI K: KONTAMINASI

LAPORAN PELAYANAN PEMBEDAHAN


DI UNIT KAMAR OPERASI RSI SITI HAJAR SIDOARJO
BULAN MEI TAHUN 2018

KLASSIFIKASI JNS
UMUR SPESIAL DX DX DOKTER RWT
NO NO. REG NAMA PASIEN OPERASI TGL OPERASI TINDAKAN ANAST
KH B S K ISASI PRE OP POST OP OPERATOR INAP
L P HESI
321
322
323
324
325
326
327
328
329
330
331
332
333
334
335
336
337
338
339
340

KETERANGAN :

U : UMUM EL: ELEKIF B: BERSIH KTR : KOTOR

BPJS : BPJS CY: CYTO BK: BERSIH KONTAMINASI

As. : ASURANSI K: KONTAMINASI

LAPORAN PELAYANAN PEMBEDAHAN


DI UNIT KAMAR OPERASI RSI SITI HAJAR SIDOARJO
BULAN MEI TAHUN 2018

KLASSIFIKASI
UMUR DX DX JNS
OPERASI SPESIAL DOKTER RWT
NO NO. REG NAMA PASIEN TGL OPERASI TINDAKAN ANAST
KH B S K ISASI PRE OP POST OP OPERATOR INAP
L P HESI
341
342
343
344
345
346
347
348
349
350
351
352
353
354
355
356
357
358
359
360

KETERANGAN :

U : UMUM EL: ELEKIF B: BERSIH KTR : KOTOR

BPJS : BPJS CY: CYTO BK: BERSIH KONTAMINASI

As. : ASURANSI K: KONTAMINASI

LAPORAN PELAYANAN PEMBEDAHAN


DI UNIT KAMAR OPERASI RSI SITI HAJAR SIDOARJO
BULAN MEI TAHUN 2018

KLASSIFIKASI
UMUR DX DX JNS
OPERASI SPESIAL DOKTER RWT
NO NO. REG NAMA PASIEN TGL OPERASI TINDAKAN ANAST
KH B S K ISASI PRE OP POST OP OPERATOR INAP
L P HESI
361
362
363
364
365
366
367
368
369
370
371
372
373
374
375
376
377
378
379
380

KETERANGAN :

U : UMUM EL: ELEKIF B: BERSIH KTR : KOTOR

BPJS : BPJS CY: CYTO BK: BERSIH KONTAMINASI


As. : ASURANSI K: KONTAMINASI

LAPORAN PELAYANAN PEMBEDAHAN


DI UNIT KAMAR OPERASI RSI SITI HAJAR SIDOARJO
BULAN MEI TAHUN 2018

KLASSIFIKASI
UMUR DX DX JNS
OPERASI SPESIAL DOKTER RWT
NO NO. REG NAMA PASIEN TGL OPERASI TINDAKAN ANAST
KH B S K ISASI PRE OP POST OP OPERATOR INAP
L P HESI
381
382
383
384
385
386
387
388
389
390
391
392
393
394
395
396
397
398
399
400

KETERANGAN :

U : UMUM EL: ELEKIF B: BERSIH KTR : KOTOR

BPJS : BPJS CY: CYTO BK: BERSIH KONTAMINASI

As. : ASURANSI K: KONTAMINASI


N PEMBEDAHAN
SITI HAJAR SIDOARJO
HUN 2018

OK JDWL OP KAT. LUKA OP BIAYA


ronde EL CY B BK K KTR U BPJS As.
1/I √ √

2/I √ √ √

1/II √ √ √

1/IV √ √ √

1/III √ √ √

3/I √ √ √

2/III √ √ √

2/II √ √ √

2/IV √ √ √

3/III √ √ √

4/I √ √

2/IV √ √ √

1/V √ √ √

3/V √ √ √
5/I √ √ √

1/VI √ √ √

2/V √ √ √

1/VII √ √ √

4/II √ √ √

1/VIII √ √ √

Sidoarjo, …………………………….

Kaur Kamar Operasi

Agus Wiyono

N PEMBEDAHAN
SITI HAJAR SIDOARJO
HUN 2018

OK JDWL OP KAT. LUKA OP BIAYA


ronde EL CY B BK K KTR U BPJS As.
4/II √ √ √

1/I √ √ √

1/II √ √ √
2/II √ √ √

2/I √ √ √

3/I √ √ √

2/II √ √ √

4/I √ √

1/I √ √ √

1/II √ √ √

5/I √ √ √

2/III √ √ √

2IV √ √ √

4/I √ √ √

5/II √ √ √

3/III √ √ √

2/IV √ √ √

2/V √ √ √

3/I √ √ √

1/II √ √ √

Sidoarjo, …………………………….

Kaur Kamar Operasi


Agus wiyono

PEMBEDAHAN

SITI HAJAR SIDOARJO


HUN 2018

OK JDWL OP KAT. LUKA OP BIAYA


ronde EL CY B BK K KTR U BPJS As.
3/I √ √ √

2/I √ √ √

4/I √ √ √

1/I √ √ √

4/II √ √ √

1/III √ √ √

2/III √ √ √

1/V √ √ √

2/IV √ √ √

3/IV √ √ √

4/II √ √ √

3/I √ √ √

2/I √ √ √
3/II √ √ √

1/I √ √ √

4/II √ √ √

4/I √ √ √

5/I √ √ √

5/II √ √ √

5/III √ √ √

Sidoarjo, …………………………….

Kaur Kamar Operasi

Agus wiyono

N PEMBEDAHAN
SITI HAJAR SIDOARJO
HUN 2018

OK JDWL OP KAT. LUKA OP BIAYA


ronde EL CY B BK K KTR U BPJS As.
5/V √ √ √

5/VI √ √ √

5/IV √ √ √
5/VII √ √ √

5/VIII √ √ √

5/IX √ √ √

RR √ √ √

2/III √ √ √

1/II √ √ √

1/III √ √ √

2/IV √ √ √

3/IV √ √ √

1/II √ √ √

1/I √ √ √

3/I √ √ √

2/I √ √ √

1/III √ √ √

3/II √ √ √

1/IV √ √ √

4/I √ √ √

Sidoarjo, …………………………….

Kaur Kamar Operasi


Agus wiyono

N PEMBEDAHAN
SITI HAJAR SIDOARJO
HUN 2018

OK JDWL OP KAT. LUKA OP BIAYA


ronde EL CY B BK K KTR U BPJS As.
1/III √ √

2/II √ √

1/IV √ √

4/II √ √

3/III √ √

1/IV √ √

4/III √ √

5/I √

5/II √ √

3/IV √ √

2/IV √ √

1/V √ √

2/V √ √
4/III √ √

3/V √ √

3/VI √ √

2/V √ √

1/V √ √

2/VI √ √

4/IV √ √

Sidoarjo, …………………………….

Kaur Kamar Operasi

Agus wiyono

N PEMBEDAHAN
SITI HAJAR SIDOARJO
HUN 2018

OK JDWL OP KAT. LUKA OP BIAYA


ronde EL CY B BK K KTR U BPJS As.
3/VI √ √ √

1/I √ √ √

1/II √ √ √
4/I √ √ √

1/II √ √ √

2/II √ √ √

3/I √ √ √

4/I √ √ √

5/I √ √ √

3/II √ √ √

1/IV √ √ √

3/III √ √ √

2/III √ √ √

3/I √ √ √

1/I √ √ √

3/I √ √

2/III √ √

2/IV √ √

1/II √ √

2/II √ √

Sidoarjo, …………………………….

Kaur Kamar Operasi


Agus wiyono

N PEMBEDAHAN
SITI HAJAR SIDOARJO
HUN 2018

OK JDWL OP KAT. LUKA OP BIAYA


ronde EL CY B BK K KTR U BPJS As.
1/III
RR
5/I
5/II
3/III
2/III
3/IV
3/V
2/IV
4/III
2/V
2/VI
2/I
3/I
4/I
2/I
3/I
1/II
2/II
2/III

Sidoarjo, …………………………….

Kaur Kamar Operasi

Agus Wiyono

N PEMBEDAHAN
SITI HAJAR SIDOARJO
HUN 2018

OK JDWL OP KAT. LUKA OP BIAYA


ronde EL CY B BK K KTR U BPJS As.
2/IV
1/II
2/III
2/IV
1/II
2/III
3/II
2/III
3/II
5/I
5/II
5/III
5/IV
5/V
5/VI
5/VII
5/VIII
3/II
3/II
2/I

Sidoarjo, …………………………….

Kaur Kamar Operasi


Agus Wiyono

N PEMBEDAHAN
SITI HAJAR SIDOARJO
HUN 2018

OK JDWL OP KAT. LUKA OP BIAYA


ronde EL CY B BK K KTR U BPJS As.
1/I
2/II
2/III
4/I
3/III
2/IV
1/II
1/III
1/IV
4/II
2/IV
3/II
2/V
3/V
2/II
3/VI
1/IV
3/V
2/I
3/I

Sidoarjo, …………………………….

Kaur Kamar Operasi

Agus Wiyono

N PEMBEDAHAN
SITI HAJAR SIDOARJO
HUN 2018

OK JDWL OP KAT. LUKA OP BIAYA


ronde EL CY B BK K KTR U BPJS As.
4/I
1/I
3/I
2/II
3/II
2/III
3/III
1/III
3/I
2/I
3/II
1/I
2/II
3/III
1/II
1/I
4/I
5/I
5/II
2/IV

Sidoarjo, …………………………….

Kaur Kamar Operasi


Agus Wiyono

N PEMBEDAHAN
SITI HAJAR SIDOARJO
HUN 2018

OK JDWL OP KAT. LUKA OP BIAYA


ronde EL CY B BK K KTR U BPJS As.
3/IV
2/IV
3/IV
1/III
1/IV
3/V
2/VI
4/I
RR
4/II
2/I
4/III
1/II
1/I
3/I
2/II
2/III
3/III
1/III
2/IV

Sidoarjo, …………………………….

Kaur Kamar Operasi

Agus Wiyono

N PEMBEDAHAN
SITI HAJAR SIDOARJO
HUN 2018

OK JDWL OP KAT. LUKA OP BIAYA


ronde EL CY B BK K KTR U BPJS As.
3/IV
4/I
3/I
3/II
2/I
2/II
4/I
3/III
3/I
3/II
1/I
1/II
2/I
4/I
3/III
1/III
1/IV
4/I
4/II
2/III

Sidoarjo, …………………………….

Kaur Kamar Operasi


Agus Wiyono

N PEMBEDAHAN
SITI HAJAR SIDOARJO
HUN 2018

OK JDWL OP KAT. LUKA OP BIAYA


ronde EL CY B BK K KTR U BPJS As.
3/IV
2/II
1/V
1/II
1/IV
2/IV
3/V
4/III
3/I
3/II
2/I
4/I
1/I
4/II
4/III
4/IV
2/II
3/III
4/II
2/III

Sidoarjo, …………………………….

Kaur Kamar Operasi

Agus Wiyono

N PEMBEDAHAN
SITI HAJAR SIDOARJO
HUN 2018

OK JDWL OP KAT. LUKA OP BIAYA


ronde EL CY B BK K KTR U BPJS As.
3/III
Sidoarjo, …………………………….

Kaur Kamar Operasi


Agus Wiyono

N PEMBEDAHAN
SITI HAJAR SIDOARJO
HUN 2018

OK JDWL OP KAT. LUKA OP BIAYA


ronde EL CY B BK K KTR U BPJS As.
Sidoarjo, …………………………….

Kaur Kamar Operasi

Agus Wiyono

N PEMBEDAHAN
SITI HAJAR SIDOARJO
HUN 2018

OK JDWL OP KAT. LUKA OP BIAYA


ronde EL CY B BK K KTR U BPJS As.
Sidoarjo, …………………………….

Kaur Kamar Operasi


Agus Wiyono

N PEMBEDAHAN
SITI HAJAR SIDOARJO
HUN 2018

OK JDWL OP KAT. LUKA OP BIAYA


ronde EL CY B BK K KTR U BPJS As.
Sidoarjo, …………………………….

Kaur Kamar Operasi

Agus Wiyono

N PEMBEDAHAN
SITI HAJAR SIDOARJO
HUN 2018

OK JDWL OP KAT. LUKA OP BIAYA

ronde
EL CY B BK K KTR U BPJS As.
Sidoarjo, …………………………….

Kaur Kamar Operasi

Agus Wiyono

N PEMBEDAHAN
SITI HAJAR SIDOARJO
HUN 2018

OK JDWL OP KAT. LUKA OP BIAYA

ronde
EL CY B BK K KTR U BPJS As.
Sidoarjo, …………………………….

Kaur Kamar Operasi


Agus Wiyono

N PEMBEDAHAN
SITI HAJAR SIDOARJO
HUN 2018

OK JDWL OP KAT. LUKA OP BIAYA

ronde
EL CY B BK K KTR U BPJS As.
Sidoarjo, …………………………….

Kaur Kamar Operasi

Agus Wiyono

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