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	<parameter name="namars" class="java.lang.String"/>
	<parameter name="alamatrs" class="java.lang.String"/>
	<parameter name="kotars" class="java.lang.String"/>
	<parameter name="propinsirs" class="java.lang.String"/>
	<parameter name="kontakrs" class="java.lang.String"/>
	<parameter name="emailrs" class="java.lang.String"/>
	<parameter name="logo" class="java.io.InputStream"/>
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		<![CDATA[select reg_periksa.no_reg,reg_periksa.no_rawat,reg_periksa.tgl_registrasi,reg_periksa.jam_reg, reg_periksa.kd_dokter,dokter.nm_dokter,reg_periksa.no_rkm_medis,pasien.nm_pasien,pasien.jk,pasien.umur,poliklinik.nm_poli,
reg_periksa.p_jawab,reg_periksa.almt_pj,reg_periksa.hubunganpj,reg_periksa.biaya_reg,
reg_periksa.stts_daftar,penjab.png_jawab,pasien.no_peserta,pasien.tgl_lahir 
from reg_periksa inner join dokter inner join pasien inner join poliklinik inner join penjab
on reg_periksa.kd_dokter=dokter.kd_dokter and reg_periksa.no_rkm_medis=pasien.no_rkm_medis and reg_periksa.kd_pj=penjab.kd_pj and reg_periksa.kd_poli=poliklinik.kd_poli]]>
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	<field name="jam_reg" class="java.sql.Time">
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	<field name="kd_dokter" class="java.lang.String">
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	<field name="nm_dokter" class="java.lang.String">
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	<field name="no_rkm_medis" class="java.lang.String">
		<fieldDescription><![CDATA[]]></fieldDescription>
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	<field name="nm_pasien" class="java.lang.String">
		<fieldDescription><![CDATA[]]></fieldDescription>
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	<field name="umur" class="java.lang.String">
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	<field name="nm_poli" class="java.lang.String">
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	<field name="p_jawab" class="java.lang.String">
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	<field name="almt_pj" class="java.lang.String">
		<fieldDescription><![CDATA[]]></fieldDescription>
	</field>
	<field name="hubunganpj" class="java.lang.String">
		<fieldDescription><![CDATA[]]></fieldDescription>
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	<field name="biaya_reg" class="java.lang.Double">
		<fieldDescription><![CDATA[]]></fieldDescription>
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	<field name="stts_daftar" class="java.lang.String">
		<fieldDescription><![CDATA[]]></fieldDescription>
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	<field name="png_jawab" class="java.lang.String">
		<fieldDescription><![CDATA[]]></fieldDescription>
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	<field name="no_peserta" class="java.lang.String">
		<fieldDescription><![CDATA[]]></fieldDescription>
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	<field name="tgl_lahir" class="java.sql.Date">
		<fieldDescription><![CDATA[]]></fieldDescription>
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				<textElement textAlignment="Center" verticalAlignment="Middle" lineSpacing="Single">
					<font fontName="Tahoma" size="14"/>
				</textElement>
				<text><![CDATA[PELAYANAN JAMINAN KESEHATAN MASYARAKAT]]></text>
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			<textField>
				<reportElement x="41" y="32" width="510" height="18"/>
				<textElement textAlignment="Center" lineSpacing="Single">
					<font fontName="Tahoma" size="14"/>
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				<textElement textAlignment="Center" verticalAlignment="Middle" lineSpacing="Single">
					<font fontName="Tahoma" size="16"/>
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				<text><![CDATA[SURAT JAMINAN DAN BUKTI PELAYANAN RAWAT JALAN]]></text>
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				<textElement textAlignment="Center" verticalAlignment="Middle" lineSpacing="Single">
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				<text><![CDATA[Diisi oleh bagian pendaftaran]]></text>
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				<text><![CDATA[Tgl Pendaftaran]]></text>
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				<textElement verticalAlignment="Middle" lineSpacing="Single">
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				<text><![CDATA[Nomor Pendaftaran]]></text>
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				<text><![CDATA[Nama Pasien]]></text>
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				<textElement verticalAlignment="Middle" lineSpacing="Single">
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				<text><![CDATA[No. MR]]></text>
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			<staticText>
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				<textElement verticalAlignment="Middle" lineSpacing="Single">
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				<text><![CDATA[Jenis Kelamin]]></text>
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				<text><![CDATA[Alamat]]></text>
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				<text><![CDATA[:]]></text>
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					<font fontName="Tahoma" size="9"/>
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				<textFieldExpression class="java.util.Date"><![CDATA[$F{tgl_registrasi}]]></textFieldExpression>
			</textField>
			<textField pattern="">
				<reportElement x="132" y="105" width="206" height="12"/>
				<textElement lineSpacing="Single">
					<font fontName="Tahoma" size="9"/>
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				<textFieldExpression class="java.lang.String"><![CDATA[$F{no_rawat}]]></textFieldExpression>
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				<textElement lineSpacing="Single">
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				<textFieldExpression class="java.lang.String"><![CDATA[$F{almt_pj}]]></textFieldExpression>
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				<textElement verticalAlignment="Middle" lineSpacing="Single">
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				<text><![CDATA[:]]></text>
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				<textElement verticalAlignment="Middle" lineSpacing="Single">
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				<text><![CDATA[No. Kartu Pasien]]></text>
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				<text><![CDATA[No. SKP]]></text>
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				<textElement verticalAlignment="Middle" lineSpacing="Single">
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				<text><![CDATA[Tanggal Lahir]]></text>
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				<text><![CDATA[:]]></text>
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				<textFieldExpression class="java.lang.String"><![CDATA[$F{nm_poli}]]></textFieldExpression>
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				<text><![CDATA[Poli Tujuan/ Unit]]></text>
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				<textElement textAlignment="Center" verticalAlignment="Middle" lineSpacing="Single">
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				<text><![CDATA[Diisi oleh masing-masing Unit]]></text>
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				<textElement textAlignment="Center" verticalAlignment="Middle" lineSpacing="Single">
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				<text><![CDATA[Pelayanan]]></text>
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				<text><![CDATA[Uraian]]></text>
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				<text><![CDATA[TT. Pelaksana]]></text>
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				<text><![CDATA[TT. Pasien]]></text>
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				<text><![CDATA[Tarif BLUD]]></text>
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				<text><![CDATA[LABORATORIUM]]></text>
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				<text><![CDATA[- Radio Diagnostik]]></text>
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				<text><![CDATA[- Elektro Medik]]></text>
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				<textElement verticalAlignment="Middle" lineSpacing="Single">
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				<text><![CDATA[- Paket Fisioteraphy]]></text>
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				<text><![CDATA[  ( 4 kali )]]></text>
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				<text><![CDATA[- Kegiatan Lain]]></text>
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				<text><![CDATA[Tindakan Medik]]></text>
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					<font fontName="Tahoma" size="9"/>
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				<text><![CDATA[Diagnosa utama maupun sekunder serta obat-obatan]]></text>
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				<text><![CDATA[ditulis ulang dan ditandatangani oleh perawat berdasarkan tulisan dokter pada list dan resep]]></text>
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				<text><![CDATA[Diagnosa ....]]></text>
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				<text><![CDATA[Penetapan koding >>>>>>>>>>>> diisi dan ditandatangani oleh petugas rekam medis]]></text>
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				<text><![CDATA[Dokter yang merawat]]></text>
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				<text><![CDATA[Veripikator Klaim]]></text>
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