Vous êtes sur la page 1sur 17

1 2 3 4

NO NO URUT NAMA USIA PERUSAHAAN

1 1 ROMAN SAPTARILLAH 37 AI. ASAM ASAM


2 2 AZWAL 34 AI. ASAM ASAM
3 3 GILANG 25 AI. ASAM ASAM
4 4 SUBHAN ASPARI 37 AI. ASAM ASAM
5 5 SAHRIL 37 AI. ASAM ASAM
6 6 BETARA N 25 AI. ASAM ASAM
7 7 M ZAINAL KAHRI 26 AI. ASAM ASAM
8 8 NODI WINATA 26 AI. ASAM ASAM
9 9 M AL RASYID 31 AI. ASAM ASAM
10 10 RUKUN SANYOTO 36 AI. ASAM ASAM
11 11 AGUS SALIM 29 AI. ASAM ASAM
12 12 SYAHRANI 32 AI. ASAM ASAM
13 13 M RIDHA 26 AI. ASAM ASAM
14 14 M BASIR 31 AI. ASAM ASAM
15 15 AGUS SALIM 39 AI. ASAM ASAM
16 16 EKO D.S 26 AI. ASAM ASAM
17 17 RONY BACHTIAR 22 AI. ASAM ASAM
18 18 TARTO 42 AI. ASAM ASAM
19 19 M FAIZUN KHOLIK 23 AI. ASAM ASAM
20 20 RULIANSYAH 26 AI. ASAM ASAM
21 21 FUJI BAGIYONO 39 AI. ASAM ASAM
22 22 DENY SETIAWAN 33 AI. ASAM ASAM
23 23 TIAS MAULANA 25 AI. ASAM ASAM
24 24 MULYANOR 30 AI. ASAM ASAM
25 25 ANDI 36 AI. ASAM ASAM
26 26 A. MUCHAROMIN 24 AI. ASAM ASAM
27 27 ANTONIUS BADI WELAN 27 AI. ASAM ASAM
28 28 DESY VIANUS O.N 25 AI. ASAM ASAM
29 29 DUNI EKA RIANTO 25 AI. ASAM ASAM
30 30 HERMAN 22 AI. ASAM ASAM
31 31 PARLINDUNGAN S 46 AI. ASAM ASAM
32 32 M ABU BAKAR 31 AI. ASAM ASAM
33 33 LUQMAN HAKIM 24 AI. ASAM ASAM
34 34 RUSLIANSYAH 26 AI. ASAM ASAM
35 35 NURHIDAYAT 20 AI. ASAM ASAM
36 36 SUROSO 28 AI. ASAM ASAM
37 37 YEHEZKIEL 23 AI. ASAM ASAM
38 38 M NOOR 38 AI. ASAM ASAM
39 39 DECKY DWI I 25 AI. ASAM ASAM
40 40 M SALIM A. 41 AI. ASAM ASAM
41 41 CITRA MULIA S 29 AI. ASAM ASAM
42 42 M HENDRI 23 AI. ASAM ASAM
43 43 PUJIARTO 31 AI. ASAM ASAM
44 44 ISUR 39 AI. ASAM ASAM
45 45 MARTONO 44 AI. ASAM ASAM
46 46 M SHALINDRA 22 AI. ASAM ASAM
47 47 BAGUS PURWANTO 24 AI. ASAM ASAM
48 48 SUMARLIN 29 AI. ASAM ASAM
49 49 RATNA HIDAYANTI 23 AI. ASAM ASAM
50 50 AULIA RAHMAN 33 AI. ASAM ASAM
51 51 WIDAYATI 30 AI. ASAM ASAM
52 52 ILHAM 35 AI. ASAM ASAM
53 53 IRIYADI 24 AI. ASAM ASAM
54 54 AHMAD ANSHARI 21 AI. ASAM ASAM
55 55 IBRAHIM 24 AI. ASAM ASAM
56 56 MANSYUR 32 AI. ASAM ASAM
57 57 DWI SANTOSO 39 AI. ASAM ASAM
58 58 WASPAN 33 AI. ASAM ASAM
59 59 ASWANDI IKHVAN 24 AI. ASAM ASAM
60 60 SUKUR M 28 AI. ASAM ASAM
61 61 M SHUBIRIN NUR 26 AI. ASAM ASAM
62 62 SUGIARTA 30 AI. ASAM ASAM
63 63 M DIANSYAH 30 AI. ASAM ASAM
64 64 N. ARIF P 25 AI. ASAM ASAM
65 65 PURWANTO 36 AI. ASAM ASAM
66 66 AMINUDIN 22 AI. ASAM ASAM
67 67 ADI MULYADI 36 AI. ASAM ASAM
68 68 JEREMY 31 AI. ASAM ASAM
69 69 AKHMAT JUNAEDI 37 AI. ASAM ASAM
70 70 YANDI MAULANA 21 AI. ASAM ASAM
71 71 ARIFIN 42 AI. ASAM ASAM
72 72 M ARIE IRAWAN 29 AI. ASAM ASAM
73 73 SURYA ATMAJA 31 AI. ASAM ASAM
74 74 LIA NOVITA SARI 27 AI. ASAM ASAM
75 75 ABDUL HADI 38 AI. ASAM ASAM
76 76 M TAHIR D 45 AI. ASAM ASAM
77 77 RANDY FASUN 29 AI. ASAM ASAM
78 78 IKHSANUDIN 26 AI. ASAM ASAM
79 79 M ARYANI 47 AI. ASAM ASAM
80 80 MAYA YOLANDA 23 AI. ASAM ASAM
81 81 ABDUL HAKAM 25 AI. ASAM ASAM
82 82 BAYU PURNOMO 25 AI. ASAM ASAM
83 83 INDRA DJ 31 AI. ASAM ASAM
84 84 RONNIE FURQONY 40 AI. ASAM ASAM
85 85 RUSDIANUR 36 AI. ASAM ASAM
86 86 AHMAD GADJALI 37 AI. ASAM ASAM
87 87 MADE PASEK 37 AI. ASAM ASAM
88 88 NOOR MUSTAQIM 26 AI. ASAM ASAM
89 89 ERNI SETIAWATI 38 AI. ASAM ASAM
90 90 ANDI ALVHIAN NOOR 31 AI. ASAM ASAM
91 91 RAHMAT SYAHPUTRA 35 AI. ASAM ASAM
92 92 YESSY G 39 AI. ASAM ASAM
93 93 M NURHILMIANSYAH 51 AI. ASAM ASAM
94 94 FAJRI HAIRANNOR 40 AI. ASAM ASAM
95 95 BUDI KUSWANTO 37 AI. ASAM ASAM
96 96 YOHANES R. D 54 AI. ASAM ASAM
97 97 AL AMIN 27 AI. ASAM ASAM
98 98 PRIGER HANI A 32 AI. ASAM ASAM
99 99 ARIES DWI S 34 AI. ASAM ASAM
100 100 TEDI MARDETA 33 AI. ASAM ASAM
101 101 NURUL YAKIN 30 AI. ASAM ASAM
102 102 M YUSUF 42 AI. ASAM ASAM
103 103 ZAINUDDIN 49 AI. ASAM ASAM
104 104 ADAM GITA A 27 AI. ASAM ASAM
105 105 NURIMAN 31 AI. ASAM ASAM
106 106 ACH RIZKY 31 AI. ASAM ASAM
107 107 ENDANG WAWAN 36 AI. ASAM ASAM
108 108 RAHMANDITO J 27 AI. ASAM ASAM
109 109 M WILDAN AJI H 29 AI. ASAM ASAM
110 110 ILHAM INDRAPRAJA 28 AI. ASAM ASAM
111 111 ANGGA MAULIUDIN 26 AI. ASAM ASAM
112 112 M SYAFAAT 34 AI. ASAM ASAM
113 113 EFFENDI EKO MULYONO 34 AI. ASAM ASAM
114 114 UUT PUJIASTOMO 29 AI. ASAM ASAM
115 115 AHMAT JUAENI 38 AI. ASAM ASAM
116 116 KAPSUL ANWAR 32 AI. ASAM ASAM
117 117 AI. ASAM ASAM
118 118 AI. ASAM ASAM
119 119 AI. ASAM ASAM
120 120 AI. ASAM ASAM
121 121 AI. ASAM ASAM
122 122 AI. ASAM ASAM
AI. ASAM ASAM
AI. ASAM ASAM
AI. ASAM ASAM
AI. ASAM ASAM
AI. ASAM ASAM
AI. ASAM ASAM
AI. ASAM ASAM
AI. ASAM ASAM
AI. ASAM ASAM
AI. ASAM ASAM
AI. ASAM ASAM
AI. ASAM ASAM
AI. ASAM ASAM
AI. ASAM ASAM
AI. ASAM ASAM
AI. ASAM ASAM
AI. ASAM ASAM
AI. ASAM ASAM
AI. ASAM ASAM
AI. ASAM ASAM
AI. ASAM ASAM
AI. ASAM ASAM
AI. ASAM ASAM
AI. ASAM ASAM
AI. ASAM ASAM
AI. ASAM ASAM
AI. ASAM ASAM
AI. ASAM ASAM
AI. ASAM ASAM
AI. ASAM ASAM
AI. ASAM ASAM
AI. ASAM ASAM
AI. ASAM ASAM
AI. ASAM ASAM
AI. ASAM ASAM
AI. ASAM ASAM
AI. ASAM ASAM
AI. ASAM ASAM
AI. ASAM ASAM
AI. ASAM ASAM
AI. ASAM ASAM
AI. ASAM ASAM
AI. ASAM ASAM
AI. ASAM ASAM
AI. ASAM ASAM
AI. ASAM ASAM
AI. ASAM ASAM
AI. ASAM ASAM
AI. ASAM ASAM
AI. ASAM ASAM
AI. ASAM ASAM
AI. ASAM ASAM
AI. ASAM ASAM
AI. ASAM ASAM
AI. ASAM ASAM
AI. ASAM ASAM
AI. ASAM ASAM
AI. ASAM ASAM
AI. ASAM ASAM
AI. ASAM ASAM
AI. ASAM ASAM
AI. ASAM ASAM
AI. ASAM ASAM
AI. ASAM ASAM
AI. ASAM ASAM
AI. ASAM ASAM
AI. ASAM ASAM
5 6 7 8 9 10 11 12
FREQUENCY
TGL PERIKSA RIGHT
500 hz 1000 hz 2000 hz 3000 hz 4000 hz 6000 hz 8000 hz
### 20 15 15 25 30 15 15
### 15 15 15 15 15 15 15
### 25 20 15 15 15 15 15
### 35 30 15 15 15 15 15
### 20 20 20 15 15 30 15
### 15 15 15 15 15 15 15
### 25 20 15 15 15 15 15
### 25 15 15 15 15 15 15
### 25 15 15 20 15 15 20
### 15 15 15 15 15 15 15
### 30 15 15 15 15 40 35
### 30 20 15 15 15 15 15
### 25 20 15 15 15 15 15
### 15 15 15 15 15 20 15
### 25 20 15 15 15 15 15
### 15 15 15 15 30 45 20
### 25 20 15 20 25 20 25
### 20 15 15 15 15 15 15
### 20 15 15 15 15 15 15
### 20 25 25 20 25 30 25
### 25 25 25 25 50 35 20
### 20 15 15 15 15 15 15
### 30 20 15 15 20 15 15
### 25 15 15 20 25 15 15
### 35 25 15 15 15 15 15
### 15 15 15 15 20 15 15
### 15 15 15 15 15 15 15
### 15 15 15 15 15 15 20
### 15 15 15 15 15 25 15
### 30 20 15 15 15 15 15
### 25 15 15 15 15 25 20
### 30 20 15 20 40 20 15
### 15 15 15 15 15 15 15
### 25 20 15 15 15 15 15
### 15 15 15 15 15 15 15
### 35 20 25 20 15 15 15
### 30 15 15 15 15 15 15
### 40 20 15 15 15 20 15
### 30 20 15 15 15 15 15
### 35 25 15 15 15 15 15
### 30 15 25 15 15 25 15
### 45 45 30 20 15 55 35
### 40 45 45 25 20 30 45
### 40 30 20 25 35 30 30
### 25 20 15 20 15 35 25
### 35 25 20 25 20 25 20
### 35 20 15 15 15 20 15
### 40 30 20 20 20 20 15
### 20 20 15 15 15 15 20
### 30 15 15 15 15 65 45
### 35 25 15 15 15 15 15
### 20 15 20 15 15 15 15
### 50 25 15 15 15 15 15
### 25 15 15 15 15 15 15
### 30 20 15 15 15 15 15
### 40 20 15 30 70 65 80
### 40 20 15 15 15 15 15
### 25 20 15 30 25 20 20
### 20 15 15 15 15 15 15
### 25 15 15 15 15 20 15
### 30 20 15 15 15 15 15
### 30 15 15 20 25 30 15
### 30 20 15 20 15 15 15
### 35 25 15 15 15 20 15
### 35 20 15 15 15 15 15
### 30 20 15 15 15 20 25
### 40 20 15 15 15 20 15
### 40 20 15 20 20 15 15
### 25 15 15 25 45 40 15
### 35 20 15 15 15 15 15
### 35 20 30 40 30 45 50
### 30 20 15 15 15 20 15
### 45 20 15 15 15 15 15
### 35 20 15 15 15 20 15
### 40 25 15 15 15 15 15
### 20 15 15 15 15 15 15
### 25 15 15 30 15 20 15
### 30 20 15 15 15 15 15
### 35 20 20 20 20 50 70
### 25 15 15 15 15 15 25
### 25 25 15 15 15 15 15
### 30 25 15 15 35 65 55
### 30 15 15 15 15 15 15
### 25 15 20 15 20 15 15
### 25 20 15 15 30 15 15
### 25 15 15 15 15 15 15
### 15 20 15 15 15 15 15
### 15 15 15 15 15 15 15
### 30 15 15 15 15 20 15
### 15 15 15 15 15 15 15
### 30 20 15 15 15 20 15
### 20 20 15 15 50 35 30
### 20 15 15 15 15 15 15
### 15 15 15 15 15 30 30
### 25 15 15 15 15 25 15
### 20 15 20 25 30 30 15
### 25 15 15 20 15 25 15
### 35 15 15 15 15 15 15
### 25 15 15 20 15 15 15
### 15 15 15 15 15 15 15
### 25 15 15 15 15 15 15
### 20 15 15 15 15 15 15
### 15 15 25 15 15 15 15
### 25 25 25 20 15 15 15
### 30 15 15 15 15 15 15
### 15 15 15 15 15 15 15
### 30 20 15 15 15 15 15
### 20 15 15 15 15 15 15
### 25 20 15 15 15 15 15
### 15 15 15 15 15 15 15
### 20 15 15 15 15 15 15
### 15 15 15 15 15 15 15
### 15 15 15 15 15 15 15
### 20 15 15 15 15 15 15
### 15 15 15 15 15 55 15
### 20 20 20 15 25 20 15
### 35 20 25 20 15 15 15
### 40 20 15 15 15 20 15
### 30 20 15 15 15 15 15
### 35 25 15 15 15 15 15
### 30 20 15 15 15 15 15
### 35 25 15 15 15 15 15
13 14 15 16 17 18 19
FREQUENCY
LEFT RIGHT
500 hz 1000 hz 2000 hz 3000 hz 4000 hz 6000 hz 8000 hz 500 hz 1000 hz 2000 hz
30 15 15 45 40 30 15 5 5 5
30 15 15 20 15 25 15
25 20 15 15 15 15 15
45 30 15 15 15 15 15
25 15 15 20 15 15 15
15 15 15 15 15 15 15
35 20 15 15 15 20 15
30 15 15 15 15 15 15
30 15 15 15 15 15 15
25 15 15 15 15 15 15
45 15 15 15 15 25 35
30 20 15 15 15 30 15
20 15 15 15 15 15 15
20 25 15 20 15 15 15
25 15 15 15 15 15 15
30 15 15 15 15 35 20
30 15 15 20 15 25 20
25 15 15 15 15 15 15
25 15 15 15 15 15 15
30 20 15 20 15 20 25
30 25 25 25 50 45 40
20 15 15 15 15 15 15
35 15 15 25 30 15 20
15 15 15 25 45 25 20
30 20 20 15 15 15 15
20 15 15 15 30 15 15
20 15 15 15 15 15 15
25 15 15 15 15 15 15
20 20 15 15 15 15 15
35 20 15 15 15 15 15
30 15 15 20 20 20 15
35 20 15 15 20 20 15
15 15 15 15 15 15 15
25 20 20 15 15 15 15
15 15 15 15 15 15 15
35 25 20 20 15 15 15
25 20 15 15 20 15 15
40 25 15 20 20 40 25
20 15 15 15 15 15 15
40 25 15 15 15 20 15
25 15 15 15 15 25 15
45 30 25 15 20 20 20
60 55 30 30 20 25 80
35 25 20 15 20 15 15
30 20 15 25 35 40 35
35 35 25 25 20 30 20
45 25 15 15 15 20 15
40 25 20 20 20 20 15
15 20 15 15 15 15 35
35 15 15 15 20 20 15
25 20 15 15 15 15 15
20 15 15 15 15 15 15
45 30 15 20 15 20 15
15 15 15 15 15 15 15
35 15 15 15 15 15 15
35 25 15 15 25 20 15
45 30 15 15 15 20 15
35 25 15 25 25 40 20
20 15 15 15 15 15 15
15 15 20 15 20 25 30
20 15 15 15 20 35 15
25 20 15 30 25 25 20
35 20 15 15 15 15 15
35 25 15 15 15 20 15
35 30 15 15 15 20 15
30 20 15 15 15 20 15
30 25 15 15 15 15 15
35 25 15 15 35 20 15
30 15 15 30 45 35 15
30 20 15 15 15 15 15
30 25 20 30 40 25 30
25 20 15 20 20 15 15
35 25 15 15 15 15 15
30 25 15 15 15 15 15
40 30 15 15 20 15 15
30 15 15 20 15 15 15
15 15 15 15 15 20 15
45 30 15 15 15 20 30
45 20 25 25 45 65 55
20 15 15 15 15 15 15
30 15 15 15 15 15 15
20 20 15 20 40 65 75
20 15 15 15 15 15 15
25 15 15 35 20 15 20
20 15 15 15 20 15 15
30 15 15 15 15 15 15
35 20 15 30 15 20 15
15 15 15 15 15 15 15
30 20 15 15 15 15 15
15 15 15 15 15 15 20
35 20 15 15 15 15 30
30 15 15 15 20 15 15
25 15 15 15 15 15 15
15 15 15 15 15 35 45
20 15 15 15 20 40 15
25 15 20 20 15 15 15
25 15 15 15 20 15 15
25 15 15 15 15 15 15
25 15 15 15 15 15 15
25 15 15 15 15 15 15
15 15 20 15 15 15 15
20 15 15 15 15 15 15
20 15 25 20 15 15 15
25 20 30 20 15 15 15
40 15 15 25 15 30 25
20 15 15 15 15 15 15
30 15 15 15 15 15 15
35 15 15 15 15 15 15
25 15 15 15 15 20 15
20 15 15 15 15 15 15
20 15 15 15 15 15 15
25 20 15 20 20 15 40
15 15 15 15 15 15 15
15 15 15 15 20 15 15
15 15 15 20 15 20 15
20 20 25 15 30 30 20
35 25 20 20 15 15 15
40 25 15 20 20 40 25
20 15 15 15 15 15 15
40 25 15 15 15 20 15
20 15 15 15 15 15 15
40 25 15 15 15 20 15
BONE
RIGHT LEFT
3000 hz 4000 hz 6000 hz 500 hz 1000 hz 2000 hz 3000 hz 4000 hz 6000 hz
5 5 5 5 5 5 5 5 5
RUMAH SAKIT PERTAMINA BALIKPAPAN
Jl Jenderal Sudirman No 1 Balikpapan, 76111
Telp: (0542) 734020 ext 4318 AUDIOMETRI
NAMA : ROMAN SAPTARILLAH
USIA : 37 tahun
PERUSAHAAN : AI. ASAM ASAM
TGL PEMERIKSAAN : Friday, September 11, 2015
NO PEMERIKSAAN : ###

RIGHT LEFT
-15 -15
-10 -10
500 hz 1000 hz 2000 hz 3000 hz 4000 hz 6000 hz 8000-5
hz -5 hz
500 1000 hz 2000 hz 3000 hz 4000 hz 6000 hz 8000 hz
0 0
5 5
10 10
15 15
20 20
25 25
30 30
35 35
40 40
45 45
50 50
55 55
60 60
65 65
70 70
75 75
80 80
85 85
90 90
95 95
100 100
105 105
110 110
115 115
120 120

AIR CONDUCTION BONE


FREQUENCY FREQUENCY
RIGHT LEFT RIGHT LEFT
500 hz 20 30 500 hz 5 5
1000 hz 15 15 1000 hz 5 5
2000 hz 15 15 2000 hz 5 5
3000 hz 25 45 3000 hz 5 5
4000 hz 30 40 4000 hz 5 5
6000 hz 15 30 6000 hz 5 5
8000 hz 15 15

KESIMPULAN :

Dokter Pemeriksa