Pendaftaran

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Perjanjian untuk pasien rawat jalan dapat dilakukan melalui : [/bt_text][/bt_column][/bt_row][bt_row][bt_column width=”1/1″][bt_hr top_spaced=”topSemiSpaced” bottom_spaced=”not-spaced” transparent_border=”noBorder” publish_datetime=”” expiry_datetime=”” el_class=”” el_style=”” responsive=””][/bt_hr][/bt_column][/bt_row][bt_row][bt_column width=”1/3″ align=”left” vertical_align=”btTopVertical” border=”no_border” cell_padding=”default” animation=”no_animation” text_indent=”no_text_indent” highlight=”no_highlight” background_color=”” opacity=”” inner_background_color=”” background_image=”” el_class=”” el_style=””][bt_icons][bt_icon icon=”s7_e670″ icon_title=”(0376) 23888″ icon_type=”btIcoFilledType” icon_color=”btIcoAccentColor” icon_size=”btIcoMediumSize” icon_animation=”” icon_outline=”” url=”” target=”no_target” el_class=”” el_style=””][/bt_icon][/bt_icons][/bt_column][bt_column width=”2/3″ align=”left” vertical_align=”btMiddleVertical” border=”no_border” cell_padding=”default” animation=”no_animation” text_indent=”no_text_indent” highlight=”no_highlight” background_color=”” opacity=”” inner_background_color=”” background_image=”” el_class=”” el_style=””][bt_text] Perjanjian melalui telepon dapat dilakukan pada jam 07.00 – 15.00 WITA [/bt_text][/bt_column][/bt_row][bt_row][bt_column width=”1/1″][bt_hr top_spaced=”topSmallSpaced” bottom_spaced=”not-spaced” transparent_border=”noBorder” publish_datetime=”” expiry_datetime=”” el_class=”” el_style=”” responsive=””][/bt_hr][/bt_column][/bt_row][bt_row][bt_column width=”1/3″ align=”left” vertical_align=”btTopVertical” border=”no_border” cell_padding=”default” animation=”no_animation” text_indent=”no_text_indent” highlight=”no_highlight” background_color=”” opacity=”” inner_background_color=”” background_image=”” el_class=”” el_style=””][bt_icons][bt_icon icon=”fa_f232″ icon_title=”085930981134″ icon_type=”btIcoFilledType” icon_color=”btIcoAccentColor” icon_size=”btIcoMediumSize” icon_animation=”” icon_outline=”” url=”” target=”no_target” el_class=”” el_style=””][/bt_icon][/bt_icons][/bt_column][bt_column width=”2/3″ align=”left” vertical_align=”inherit” border=”no_border” cell_padding=”default” animation=”no_animation” text_indent=”no_text_indent” highlight=”no_highlight” background_color=”” opacity=”” inner_background_color=”” background_image=”” el_class=”” el_style=””][bt_text] Perjanjian melalui SMS/Whatsapp dapat dilakukan dengan format : [/bt_text][bt_hr top_spaced=”topSmallSpaced” bottom_spaced=”not-spaced” transparent_border=”noBorder” publish_datetime=”” expiry_datetime=”” el_class=”” el_style=”” responsive=””][/bt_hr][bt_row_inner][bt_column_inner width=”1/2″ align=”left” cell_padding=”default” vertical_align=”inherit” highlight=”no_highlight” background_color=”” opacity=”” el_class=”” el_style=”” responsive=””][bt_header superheadline=”” headline=”Pasien Baru” headline_size=”small” dash=”bottom” dash_style=”btNormalDash” subheadline=”” publish_datetime=”” expiry_datetime=”” el_class=”” el_style=”” responsive=””][/bt_header][bt_text]
  • Nama Lengkap :
  • Tanggal Lahir :
  • Jenis Kelamin :
  • Alamat :
  • Nama Dokter/Poli :
  • HP :
  • Tanggal Periksa:
  • Jaminan :
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  • Nama Lengkap :
  • Tanggal Lahir :
  • Jenis Kelamin :
  • Alamat :
  • Nomor Kartu Kunjungan :
  • Nama Dokter/Poli :
  • HP :
  • Tanggal Periksa:
  • Jaminan :
[/bt_text][/bt_column_inner][/bt_row_inner][bt_hr top_spaced=”topSmallSpaced” bottom_spaced=”not-spaced” transparent_border=”noBorder” publish_datetime=”” expiry_datetime=”” el_class=”” el_style=”” responsive=””][/bt_hr][bt_text] atau dapat dengan langsung mengklik link berikut ini [/bt_text][/bt_column][/bt_row][/bt_section][bt_section layout=”boxed” top_spaced=”not-spaced” bottom_spaced=”not-spaced” skin=”inherit” full_screen=”no” vertical_align=”inherit” divider=”no” back_image=”” back_color=”” back_video=”” video_settings=”” parallax=”” parallax_offset=”” animation=”” animation_back=”” animation_impress=”” el_id=”” el_class=”” el_style=”” responsive=””][bt_row][bt_column width=”1/1″][bt_hr top_spaced=”topSemiSpaced” bottom_spaced=”not-spaced” transparent_border=”noBorder” publish_datetime=”” expiry_datetime=”” el_class=”” el_style=”” responsive=””][/bt_hr][/bt_column][/bt_row][bt_row][bt_column width=”1/1″][bt_tabs responsive=”” publish_datetime=”” expiry_datetime=””][bt_tabs_items headline=”Dokumen yang diperlukan”]
  1. Pasien Baru
Bagi pasien baru, anda akan diminta untuk mengisi data identitas sebelum melakukan pemeriksaan. Silahkan melapor pada petugas registrasi di Front Office. Demi kelancaran proses pendataan, mohon disiapkan beberapa dokumen yang perlu dibawa:
  • Kartu identitas (WNI) atau Paspor (WNA)
  • Kartu Kontrol Pasien
  • Kartu asuransi (Jika ada)
  • Formulir asuransi (Jika reimburst)
  • Jaminan perusahaan (Jika biaya dijamin perusahaan)
Jika anda adalah peserta JKN KIS ( Kartu BPJS ) ada bisa menggunakan kartu JKN KIS ( Kartu BPJS ) anda dengan menyiapkan beberapa dokumen yang perlu dibawa
  • Kartu Identitas
  • Kartu Keluarga
  • Kartu JKN KIS ( BPJS )
Surat Rujukkan dari Faskes Tingkat 1
  1. Pasien Lama
Pada kunjungan selanjutnya, anda dapat menggunakan kartu kontrol yang telah diberikan pada kunjungan pertama untuk mempercepat proses pendaftaran dan waktu tunggu. Kartu perjanjian tersebut, mencantumkan nama, nomor rekam medik, dan tanggal pemeriksaan. Dokumen yang perlu disiapkan untuk pasien lama :
  • Kartu Kontrol Pasien
  • Kartu asuransi (Jika ada)
  • Formulir asuransi (Jika reimburst)
  • Jaminan perusahaan (Jika biaya dijamin perusahaan)
Jika anda adalah peserta JKN KIS ( Kartu BPJS ) ada bisa menggunakan kartu JKN KIS ( Kartu BPJS ) anda dengan menyiapkan beberapa dokumen yang perlu dibawa :
  • Kartu Identitas
  • Kartu Keluarga
  • Kartu JKN KIS ( BPJS )
  • Surat Kontrol
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