makanan
                                ("00","Tidak Ada"),
                                ("01","Seafood"),
                                ("02","Gandum"),
                                ("03","Susu Sapi"),
                                ("04","Kacang-Kacangan"),
                                ("05","Makanan Lain"),
udara
                                ("00","Tidak Ada"),
                                ("01","Udara Panas"),
                                ("02","Udara Dingin"),
                                ("03","Udara Kotor"),
obat
                                ("00","Tidak Ada"),
                                ("01","Antibiotik"),
                                ("02","Antiinflamasi"),
                                ("03","Non Steroid"),
                                ("04","Aspirin"),
                                ("05","Kortikosteroid"),
                                ("06","Insulin"),
                                ("07","Obat-Obatan Lain"),
prognosa
                                ("01","Sanam (Sembuh)"),
                            ("02","Bonam (Baik)"),
                            ("03","Malam (Buruk/Jelek)"),
                            ("04","Dubia Ad Sanam/Bonam (Tidak tentu/Ragu-ragu, Cenderung Sembuh/Baik)"),
                            ("05","Dubia Ad Malam (Tidak tentu/Ragu-ragu, Cenderung Buruk/Jelek)"),

status pulang
                            ("1" data-select2-id="128","Meninggal"),
                            ("3" data-select2-id="129","Berobat Jalan"),
                            ("R" data-select2-id="130","Rujuk")
Pelayanan Non Kapitasi
("01","Pelayanan KB"),
("03","Pelayanan PNC"),
("04","Pelayanan Ambulance"),
("27","Skrining Kesehatan"),
("25","Skrining Kanker Serviks"),
("15","Pelayanan Krio Terapi"),
("26","Skrining DM")



Rujukan Horizontal
Pelayanan Tindakan Non-Kapitasi

<select style="width:100%" class="form-control" id="nonkapitasi_cb","("" selected="" hidden="" disable="","---Pilih Pelayanan---"),
("1","Paket Persalinan per Vaginam dengan tindakan emergensi dasar"),
("2","Paket Persalinan per Vaginam Normal (Bidan),"),
("3","Paket Persalinan per Vaginam Normal (Dokter),"),
("4","Pelayanan ANC"),
("5","Pelayanan KB : Pemasangan IUD/Implant"),
("6","Pelayanan KB : Suntik"),
("7","Pelayanan komplikasi KB pasca persalinan"),
("8","Pelayanan PNC"),
("9","Pelayanan Pra Rujukan pada komplikasi kebidanan dan neonatal"),
("10","Pelayanan tindakan pasca persalinan"),
("11","Rawat Inap di Ruang Perawatan Biasa"),
("12","Pelayanan MOP/Vasektomi"),
("13","Protesa Gigi"),
("31","Tele EKG"),
("32","Tele USG"),
("33","Tele Konsultasi"),
("34","ANC dengan USG"),</select,"

Pelayanan Laboratorium

<select style="width:100%" class="form-control" id="laboratorium_cb","("" selected="" hidden="" disable="","---Pilih Pelayanan---"),
("14","Gula Darah Puasa (GDP), - PRB/Prolanis"),
("15","Pemeriksaan IVA"),
("16","Pemeriksaan Papsmear"),
("17","Pelayanan Terapi Krio"),
("18","Pemeriksaan HbA1C"),
("19","Microalbuminuria"),
("20","Ureum"),
("21","Kreatinin"),
("22","Kolesterol Total"),
("23","Kolesterol LDL"),
("24","Kolesterol HDL"),
("25","Trigliserida"),</select,"

Pelayanan Program

<select style="width:100%" class="form-control" id="program_cb","("" selected="" hidden="" disable="","---Pilih Pelayanan---"),
("26","Tuberkulosis (TBC),"),
("28","HIV/AIDS"),
("30","Imunisasi Rutin"),</select,"

Rujukan Kacamata

<select style="width:100%" class="form-control" id="kacamata_cb","("" selected="" hidden="" disable="","---Pilih Pelayanan---"),
("29","FKTP Mampu Pemeriksaan Refraksi"),</select,"

Rujukan Vertikal
Kondisi Khusus
<select style="width:100%" class="form-control" id="khusus_cb","("HDL","HEMODIALISA"),
("THA","THALASEMIA"),
("HEM","HEMOFILI"),
("JIW","JIWA"),
("KLT","KUSTA"),
("PAR","TB-MDR"),
("KEM","SARANA KEMOTERAPI"),
("RAT","SARANA RADIOTERAPI"),
("HIV","HIV-ODHA"),</select,"

Spesialis
Spesialis
<select style="width:100%" class="form-control" id="spesialis1" name="spesialis1" onchange="Rujukan.instance.readSubSpesialis('spesialis1', 'subSpesialis1'),;","("" selected="" hidden="" disable="","---Pilih Spesialis---"),
("155","Sport, shoulder and elbow"),
("192","Pelayanan aritmia"),
("ANA","ANAK"),
("AND","ANDROLOGI"),
("BDA","BEDAH ANAK"),
("BDM","GIGI BEDAH MULUT"),
("BDP","BEDAH PLASTIK"),
("BED","BEDAH"),
("BSY","BEDAH SARAF"),
("BTK","BTKV (BEDAH THORAX KARDIOVASKULER),"),
("GIG","GIGI"),
("GIZ","GIZI KLINIK"),
("GND","GIGI ENDODONSI"),
("GOR","GIGI ORTHODONTI"),
("GPR","GIGI PERIODONTI"),
("GRD","GIGI RADIOLOGI"),
("INT","PENYAKIT DALAM"),
("IRM","Installasi Rehabilitasi Medik"),
("JAN","JANTUNG DAN PEMBULUH DARAH"),
("JIW","JIWA"),
("KDK","KEDOKTERAN KELAUTAN"),
("KDN","KEDOKTERAN NUKLIR"),
("KDO","KEDOKTERAN OKUPASI"),
("KDP","KEDOKTERAN PENERBANGAN"),
("KLT","KULIT KELAMIN"),
("KON","GIGI PEDODONTIS"),
("KOR","KEDOKTERAAN OLAHRAGA"),
("MAT","MATA"),
("OBG","OBGYN"),
("ORT","ORTHOPEDI"),
("PAR","PARU"),
("PNM","GIGI PENYAKIT MULUT"),
("PTD","GIGI PROSTHODONTI"),
("RDT","RADIOTERAPI"),
("SAR","SARAF"),
("THT","THT-KL"),
("URO","UROLOGI"),</select,"

