| C0001 | SUJONO | dr. LINGGAWATI, Sp. THT | BPJS | |
| B0001 | MARIAH | dr. MUHAMMAD MA'RUF, Sp. OT | BPJS | |
| B0002 | DJAP A KAIJ | dr. MUHAMMAD MA'RUF, Sp. OT | BPJS | |
| B0003 | FAM CIT SIAN | dr. MUHAMMAD MA'RUF, Sp. OT | BPJS | |
| B0004 | ENDANG SUSILOWATI | dr. NOVIA NASIR, Sp. M | BPJS | |
| C0002 | ASLI | dr. ENDANG KUSRENI, Sp. JP | BPJS | |
| B0005 | INAS FADIYAH | drg. ANDI DAHNIAR, Sp, KG | BPJS | |
| B0006 | MEGA YUSTIKA | drg. ANDI DAHNIAR, Sp, KG | BPJS | |
| D0001 | MARIDAH | dr. LIYAH GIOVANAH, Sp. P | BPJS | |
| B0007 | HAFNISAR | dr. NOVIA NASIR, Sp. M | BPJS | |
| B0008 | LIM JE LI | dr. NOVIA NASIR, Sp. M | BPJS | |
| B0009 | RANTINI | dr. NOVIA NASIR, Sp. M | BPJS | |
| C0003 | ROMLA | dr. ENDANG KUSRENI, Sp. JP | BPJS | |
| C0004 | LIOE TJIT TJAI | dr. ESA FREDIGUSTA, Sp.JP | BPJS | |
| C0005 | HALIMAH | dr. RISMAN SARAGIH, Sp.S | BPJS | |
| C0006 | SUMANTRI | dr. ENDANG KUSRENI, Sp. JP | BPJS | |
| A0001 | SABYLA MAYANG SARI | dr. MUHAMMAD RUCHYAT AMAR YASIN, Sp. OG | BPJS | |
| B0010 | MUI HO | dr. MUHAMMAD MA'RUF, Sp. OT | BPJS | |
| B0011 | ELDY ASIKIN MC | dr. NOVIA NASIR, Sp. M | BPJS | |
| C0007 | WANTI HUSEN | dr. ENDANG KUSRENI, Sp. JP | BPJS | |
| B0012 | BAARE ABIYU | drg. ANDI DAHNIAR, Sp, KG | BPJS | |
| C0008 | SYAHRIZAH | dr. RISMAN SARAGIH, Sp.S | BPJS | |
| B0013 | SISKA | dr. MUHAMMAD MA'RUF, Sp. OT | BPJS | |
| B0014 | SUKOTUN NAJUWA | drg. ANDI DAHNIAR, Sp, KG | BPJS | |
| B0015 | RUDY | dr. DAMERIA HASTARI, Sp. PD | BPJS | |
| C0009 | YAN RIZKAN AMIR | dr. RISMAN SARAGIH, Sp.S | BPJS | |
| C0010 | SUMANTRI | dr. ENDANG KUSRENI, Sp. JP | BPJS | |
| B0016 | RISKI RHAMADITA | dr. MEILANO ROBINSYAH, Sp. PD | BPJS | |
| A0002 | WULAN PURNAMA SARI | dr. MUHAMMAD RUCHYAT AMAR YASIN, Sp. OG | BPJS | |
| B0017 | SANIRAH | dr. NOVIA NASIR, Sp. M | BPJS | |
| A0003 | EVI HOSPITASARI | dr. MUHAMMAD RUCHYAT AMAR YASIN, Sp. OG | BPJS | |
| B0018 | TARWINA | dr. DAMERIA HASTARI, Sp. PD | BPJS | |
| B0019 | MUK LAN | dr. DAMERIA HASTARI, Sp. PD | BPJS | |
| B0020 | MUHAMAD REIHAN | dr. MUHAMMAD MA'RUF, Sp. OT | BPJS | |
| B0021 | NIKHLAH ZANZABILA NANDA | drg. ANDI DAHNIAR, Sp, KG | BPJS | |
| B0022 | ASMAH | dr. DAMERIA HASTARI, Sp. PD | BPJS | |
| C0011 | HUSIN BASRI | dr. RISMAN SARAGIH, Sp.S | BPJS | |
| B0023 | NURUL EZKANANDYTA | dr. NOVIA NASIR, Sp. M | BPJS | |
| C0012 | ARYANI | dr. RISMAN SARAGIH, Sp.S | BPJS | |
| B0024 | NG LIE NIE | dr. NOVIA NASIR, Sp. M | BPJS | |
| C0013 | LIDIA ELVIRA | dr. ANDRA VERNANDI, Sp. N | BPJS | |
| B0025 | SINTA DEWIE | dr. YUDI YUSRIZAL, Sp.PD | BPJS | |
| B0026 | ROZIANA | dr. NOVIA NASIR, Sp. M | BPJS | |
| B0027 | BURHAN | dr. MUHAMMAD MA'RUF, Sp. OT | BPJS | |
| B0028 | MARLINA | dr. DAMERIA HASTARI, Sp. PD | BPJS | |
| B0029 | AGUSTINA | drg. ANDI DAHNIAR, Sp, KG | BPJS | |
| B0030 | MUHAMMAD DJIBRAN | drg. ANDI DAHNIAR, Sp, KG | BPJS | |
| C0014 | ROSMINI | dr. RISMAN SARAGIH, Sp.S | BPJS | |
| B0031 | RESTU HAYATI | dr. NOVIA NASIR, Sp. M | BPJS | |
| A0004 | MUHAMMAD FARHAN ARJUN | dr. REGGY AMBARDY DWI PUTRA, Sp. A | BPJS | |
| B0032 | DWI ERYANA | dr. DAMERIA HASTARI, Sp. PD | BPJS | |
| C0015 | TONGGO SIMANJUNTAK | dr. ENDANG KUSRENI, Sp. JP | BPJS | |
| B0033 | MEYSHA NAFEEZA ALQILAH SYFA | drg. ANDI DAHNIAR, Sp, KG | BPJS | |
| D0002 | SUPRIYO | dr. LIYAH GIOVANAH, Sp. P | BPJS | |
| C0016 | NOVALIANTO | dr. ESA FREDIGUSTA, Sp.JP | BPJS | |
| D0003 | NURAINUN | dr. LIYAH GIOVANAH, Sp. P | BPJS | |
| A0005 | GILANG ANUGRAH | dr. REGGY AMBARDY DWI PUTRA, Sp. A | BPJS | |
| C0017 | RICKI M | dr. RISMAN SARAGIH, Sp.S | BPJS | |
| B0034 | PAIMIN | dr. MEILANO ROBINSYAH, Sp. PD | BPJS | |
| B0035 | FRANKIE PRATAMA | drg. ANDI DAHNIAR, Sp, KG | BPJS | |
| B0036 | MARLINA | dr. MEILANO ROBINSYAH, Sp. PD | BPJS | |
| C0018 | RASTIKA FITRI | dr. RISMAN SARAGIH, Sp.S | BPJS | |
| B0037 | ANTHONY .S | dr. YUDI YUSRIZAL, Sp.PD | BPJS | |
| B0038 | TJEN A EN | dr. MUHAMMAD MA'RUF, Sp. OT | BPJS | |
| C0019 | MARETA PERMATASARI | dr. LINGGAWATI, Sp. THT | BPJS | |
| C0020 | ALIFIA SYALSABILA | dr. CARLES, Sp. KJ, M, Sc | BPJS | |
| C0021 | ABDURAHMAN | dr. ENDANG KUSRENI, Sp. JP | BPJS | |
| C0022 | SUKARDI | dr. RISMAN SARAGIH, Sp.S | BPJS | |
| B0039 | SUNOTO TJENDROJOYO | dr. DAMERIA HASTARI, Sp. PD | BPJS | |
| B0040 | NUR RUFAIDAH AKBAR | drg. ANDI DAHNIAR, Sp, KG | BPJS | |
| B0041 | RAYES AKBAR | drg. MUTIA AULIANY, Sp. B. M | BPJS | |
| B0042 | RISKIE RELICA | drg. ANDI DAHNIAR, Sp, KG | BPJS | |
| B0043 | DEANDRA ARAVARIYAN | dr. YOGI YAMANI, Sp. B | BPJS | |
| B0044 | TUNISIAH | dr. MEILANO ROBINSYAH, Sp. PD | BPJS | |
| B0045 | ZULAIHA | dr. MUHAMMAD MA'RUF, Sp. OT | BPJS | |
| B0046 | HAMSINAH | dr. MUHAMMAD MA'RUF, Sp. OT | BPJS | |
| C0023 | SAPRAH | dr. ENDANG KUSRENI, Sp. JP | BPJS | |
| C0024 | TJHIN SOIEJ FA | dr. RISMAN SARAGIH, Sp.S | BPJS | |
| D0004 | RUSMIDA | dr. LIYAH GIOVANAH, Sp. P | BPJS | |
| C0025 | HERMANTO | dr. ENDANG KUSRENI, Sp. JP | BPJS | |
| C0026 | CHI SUI YIN | dr. ENDANG KUSRENI, Sp. JP | BPJS | |
| D0005 | SURIATI | dr. LIYAH GIOVANAH, Sp. P | BPJS | |
| B0047 | VILLYSIA | dr. MEILANO ROBINSYAH, Sp. PD | BPJS | |
| B0048 | INNEKE IKHFA KHAIRANI | drg. ANDI DAHNIAR, Sp, KG | BPJS | |
| B0049 | AMINAH | dr. MUHAMMAD MA'RUF, Sp. OT | BPJS | |
| B0050 | RASNIAR | dr. NOVIA NASIR, Sp. M | BPJS | |
| B0051 | AQILA LATHIFAH | drg. ANDI DAHNIAR, Sp, KG | BPJS | |
| A0006 | AHMAD AZAM | dr. REGGY AMBARDY DWI PUTRA, Sp. A | BPJS | |