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[{"$nulls":3},"SURAT ELEGIBILITAS PESERTA"]
[{"$nulls":3},"RS PERSADA HOSPITAL"]
[]
["No.SEP",":","0212R0260119V000024"]
["Tgl.SEP",":","2019-01-25",null,"Peserta",":","PEGAWAI SWASTA"]
["No.Kartu",":","0001179217056 ( MR. 123456 )",null,"COB",":","-"]
["Nama Peserta",":","KRISMAWATI FITRIANA",null,"Jns.Rawat",":","R.Jalan"]
["Tgl. Lahir",":","1988-04-10 Kelamin : Perempuan",null,"Kls.Rawat",":","-"]
["No. Telepon",":","085731234234",null,"Penjamin",":"]
["Sub/Spesialis",":","BEDAH ONKOLOGI"]
["Faskes Perujuk",":","KLINIK MELATI"]
["Diagnosa Awal",":","C50 - Malignant neoplasm of breast"]
["Catatan",":","tes"]
[]
["*Saya menyetujui BPJS Kesehatan menggunakan informasi medis pasien jika diperlukan.\nSEP Bukan sebagai bukti penjaminan peserta.",{"$nulls":6},"Pasien/Keluarga Pasien"]
[]
[]
["Cetakan ke 1 25-10-2019 10:59:50"]

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