Registration Requirements

  • Filling out the Patient Identity Form
  • Photocopy of the patient's ID card 1 sheet (If the patient is a child, please attach a photocopy of the parent's ID card)
  • Filling out the Patient Identity Form
  • It is mandatory to bring the original Referral Letter and original BPJS Card
  • Photocopy of referral from Secondary Health Facility or Second Level Health Facility (Local Hospital/Regional Hospital)
  • Photocopy of Patient's BPJS Card
  • Photocopy of patient's ID card (If the patient is a child, please attach a photocopy of the parent's ID card)