{"id":4815,"date":"2018-12-14T16:13:03","date_gmt":"2018-12-14T09:13:03","guid":{"rendered":"http:\/\/awalbros.com\/?page_id=4815"},"modified":"2025-10-07T11:40:39","modified_gmt":"2025-10-07T04:40:39","slug":"make-appointment","status":"publish","type":"page","link":"https:\/\/primayahospital.com\/en\/make-appointment\/","title":{"rendered":"Make Appointment"},"content":{"rendered":"\t\t<div data-elementor-type=\"wp-page\" data-elementor-id=\"4815\" class=\"elementor elementor-4815\" data-elementor-post-type=\"page\">\n\t\t\t\t\t\t<section class=\"elementor-section elementor-top-section elementor-element elementor-element-8fadc48 elementor-section-stretched elementor-section-full_width elementor-section-height-default elementor-section-height-default\" data-id=\"8fadc48\" data-element_type=\"section\" data-e-type=\"section\" data-settings=\"{&quot;stretch_section&quot;:&quot;section-stretched&quot;}\">\n\t\t\t\t\t\t<div class=\"elementor-container elementor-column-gap-no\">\n\t\t\t\t\t<div class=\"elementor-column elementor-col-100 elementor-top-column elementor-element elementor-element-8fd43a2\" data-id=\"8fd43a2\" data-element_type=\"column\" data-e-type=\"column\">\n\t\t\t<div class=\"elementor-widget-wrap elementor-element-populated\">\n\t\t\t\t\t\t<div class=\"elementor-element elementor-element-7b969ec elementor-widget elementor-widget-image\" data-id=\"7b969ec\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"image.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<img fetchpriority=\"high\" decoding=\"async\" width=\"1920\" height=\"539\" src=\"https:\/\/primayahospital.com\/wp-content\/uploads\/2018\/12\/appointment.jpg\" class=\"attachment-full size-full wp-image-3791\" alt=\"pembuatan janji konsultasi, rumah sakit awal bros\" srcset=\"https:\/\/primayahospital.com\/wp-content\/uploads\/2018\/12\/appointment.jpg 1920w, https:\/\/primayahospital.com\/wp-content\/uploads\/2018\/12\/appointment-300x84.jpg 300w, https:\/\/primayahospital.com\/wp-content\/uploads\/2018\/12\/appointment-768x216.jpg 768w, https:\/\/primayahospital.com\/wp-content\/uploads\/2018\/12\/appointment-1024x287.jpg 1024w, https:\/\/primayahospital.com\/wp-content\/uploads\/2018\/12\/appointment-1536x431.jpg 1536w\" sizes=\"(max-width: 1920px) 100vw, 1920px\" \/>\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/section>\n\t\t\t\t<section class=\"elementor-section elementor-top-section elementor-element elementor-element-3de44740 elementor-section-boxed elementor-section-height-default elementor-section-height-default\" data-id=\"3de44740\" data-element_type=\"section\" data-e-type=\"section\">\n\t\t\t\t\t\t<div class=\"elementor-container elementor-column-gap-default\">\n\t\t\t\t\t<div class=\"elementor-column elementor-col-100 elementor-top-column elementor-element elementor-element-8243a6a\" data-id=\"8243a6a\" data-element_type=\"column\" data-e-type=\"column\">\n\t\t\t<div class=\"elementor-widget-wrap elementor-element-populated\">\n\t\t\t\t\t\t<div class=\"elementor-element elementor-element-2107682f elementor-widget elementor-widget-heading\" data-id=\"2107682f\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"heading.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t<h2 class=\"elementor-heading-title elementor-size-default\">Appointment<\/h2>\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/section>\n\t\t\t\t<section class=\"elementor-section elementor-top-section elementor-element elementor-element-592e270 elementor-section-boxed elementor-section-height-default elementor-section-height-default\" data-id=\"592e270\" data-element_type=\"section\" data-e-type=\"section\">\n\t\t\t\t\t\t<div class=\"elementor-container elementor-column-gap-default\">\n\t\t\t\t\t<div class=\"elementor-column elementor-col-100 elementor-top-column elementor-element elementor-element-117a440\" data-id=\"117a440\" data-element_type=\"column\" data-e-type=\"column\">\n\t\t\t<div class=\"elementor-widget-wrap elementor-element-populated\">\n\t\t\t\t\t\t<div class=\"elementor-element elementor-element-0ed848d elementor-widget elementor-widget-text-editor\" data-id=\"0ed848d\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t\t\t<p style=\"text-align: center;\">Registration through the <strong>website\u00a0<\/strong>via the form below.<br \/>If you experience any issues, please contact our Contact Center at <strong><a href=\"tel:1500007\">1 500 007<\/a><\/strong><\/p>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/section>\n\t\t\t\t<section class=\"elementor-section elementor-top-section elementor-element elementor-element-3c1ad00 elementor-section-boxed elementor-section-height-default elementor-section-height-default\" data-id=\"3c1ad00\" data-element_type=\"section\" data-e-type=\"section\">\n\t\t\t\t\t\t<div class=\"elementor-container elementor-column-gap-default\">\n\t\t\t\t\t<div class=\"elementor-column elementor-col-25 elementor-top-column elementor-element elementor-element-345b7a8\" data-id=\"345b7a8\" data-element_type=\"column\" data-e-type=\"column\">\n\t\t\t<div class=\"elementor-widget-wrap\">\n\t\t\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t<div class=\"elementor-column elementor-col-50 elementor-top-column elementor-element elementor-element-a4c020a\" data-id=\"a4c020a\" data-element_type=\"column\" data-e-type=\"column\">\n\t\t\t<div class=\"elementor-widget-wrap elementor-element-populated\">\n\t\t\t\t\t\t<div class=\"elementor-element elementor-element-8efcbaa elementor-widget elementor-widget-shortcode\" data-id=\"8efcbaa\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"shortcode.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t<div class=\"elementor-shortcode\"><input type=\"hidden\" id=\"quform-ajax-url\" value=\"https:\/\/primayahospital.com\/wp-admin\/admin-ajax.php\"><input type=\"hidden\" id=\"quform-doctor-schedule-nonce\" value=\"9496cd741b\"><div class=\"bpjs_message_wrapper\"><div class=\"bpjs_message bpjs_KG\" style=\"display:none;font-weight:bold;\"><\/div><div class=\"bpjs_message bpjs_FMC\" style=\"display:none;font-weight:bold;\"><\/div><div class=\"bpjs_message bpjs_UK\" style=\"display:none;font-weight:bold;\"><\/div><div class=\"bpjs_message bpjs_RA\" style=\"display:none;font-weight:bold;\"><\/div><div class=\"bpjs_message bpjs_HE\" style=\"display:none;font-weight:bold;\"><\/div><div class=\"bpjs_message bpjs_DE\" style=\"display:none;font-weight:bold;\"><\/div><div class=\"bpjs_message bpjs_CK\" style=\"display:none;font-weight:bold;\"><\/div><div class=\"bpjs_message bpjs_SG\" style=\"display:none;font-weight:bold;\"><\/div><div class=\"bpjs_message bpjs_SK\" style=\"display:none;font-weight:bold;\"><\/div><div class=\"bpjs_message bpjs_PK\" style=\"display:none;font-weight:bold;\"><\/div><div class=\"bpjs_message bpjs_BW\" style=\"display:none;font-weight:bold;\"><\/div><div class=\"bpjs_message bpjs_Q\" style=\"display:none;font-weight:bold;\"><\/div><div class=\"bpjs_message bpjs_P\" style=\"display:none;font-weight:bold;\"><\/div><div class=\"bpjs_message bpjs_SR\" style=\"display:none;font-weight:bold;\"><\/div><div class=\"bpjs_message bpjs_F\" style=\"display:none;font-weight:bold;\">Untuk melakukan pendaftaran, silakan mengirim pesan WhatsApp (WA) ke nomor <a href=\"https:\/\/wa.me\/6285299917878\" target=\"_blank\">085299917878<\/a><\/div><div class=\"bpjs_message bpjs_N\" style=\"display:none;font-weight:bold;\"><\/div><div class=\"bpjs_message bpjs_E\" style=\"display:none;font-weight:bold;\">Untuk melakukan pendaftaran, silakan mengirim pesan WhatsApp (WA) ke nomor  <a href=\"https:\/\/wa.me\/6287784981817\" target=\"_blank\">087784981817<\/a><\/div><div class=\"bpjs_message bpjs_M\" style=\"display:none;font-weight:bold;\">Untuk melakukan pendaftaran, silakan mengirim pesan WhatsApp (WA) ke nomor  <a href=\"https:\/\/wa.me\/6287775666662\" target=\"_blank\">087775666662<\/a><\/div><div class=\"bpjs_message bpjs_D\" style=\"display:none;font-weight:bold;\">Untuk melakukan pendaftaran, silakan mengirim pesan WhatsApp (WA) ke nomor  <a href=\"https:\/\/wa.me\/62811188232\" target=\"_blank\">0811188232<\/a> dengan format: Nama Lengkap \/ Tanggal lahir \/ Poli yang Dituju \/ Tanggal dan jam berobat \/ BPJS \/ Nomor Kartu BPJS \/ Asal Rujukan \/ No Rujukan \/ Nomor yang bisa dihubungi.<br \/>\r\nPendaftaran khusus dilakukan sehari sebelum berobat serta pada pukul 09:00-14:00 dan di hari Senin - Jumat<\/div><div class=\"bpjs_message bpjs_C\" style=\"display:none;font-weight:bold;\">Untuk melakukan pendaftaran, silakan mengirim pesan WhatsApp (WA) ke nomor <a href=\"https:\/\/wa.me\/628118100108\" target=\"_blank\">0811-8100-108<\/a> dengan format:  Nama pasien#Tanggal lahir (DD\/MM\/YYYY)#Nama dokter tujuan#Poliklinik tujuan#tanggal berobat#BPJS upload foto Kartu identitas pasien, foto kartu BPJS, foto KK, dan foto Surat rujukan Pendaftaran dilakukan H-1<\/div><\/div><div id=\"quform-9d40b7\" class=\"quform quform-7 quform-support-page-caching\"><form id=\"quform-form-9d40b7\" class=\"quform-form quform-form-7\" action=\"\/en\/wp-json\/wp\/v2\/pages\/4815#quform-9d40b7\" method=\"post\" enctype=\"multipart\/form-data\" novalidate=\"novalidate\" data-options=\"{&quot;id&quot;:7,&quot;uniqueId&quot;:&quot;9d40b7&quot;,&quot;theme&quot;:&quot;&quot;,&quot;ajax&quot;:true,&quot;logic&quot;:{&quot;logic&quot;:{&quot;60&quot;:{&quot;action&quot;:true,&quot;match&quot;:&quot;any&quot;,&quot;rules&quot;:[{&quot;elementId&quot;:&quot;10&quot;,&quot;operator&quot;:&quot;eq&quot;,&quot;optionId&quot;:&quot;2&quot;,&quot;value&quot;:&quot;2&quot;}]},&quot;71&quot;:{&quot;action&quot;:true,&quot;match&quot;:&quot;any&quot;,&quot;rules&quot;:[{&quot;elementId&quot;:&quot;10&quot;,&quot;operator&quot;:&quot;eq&quot;,&quot;optionId&quot;:&quot;2&quot;,&quot;value&quot;:&quot;2&quot;}]},&quot;85&quot;:{&quot;action&quot;:true,&quot;match&quot;:&quot;all&quot;,&quot;rules&quot;:[{&quot;elementId&quot;:&quot;10&quot;,&quot;operator&quot;:&quot;eq&quot;,&quot;optionId&quot;:&quot;2&quot;,&quot;value&quot;:&quot;2&quot;}]},&quot;75&quot;:{&quot;action&quot;:true,&quot;match&quot;:&quot;any&quot;,&quot;rules&quot;:[{&quot;elementId&quot;:&quot;10&quot;,&quot;operator&quot;:&quot;eq&quot;,&quot;optionId&quot;:&quot;3&quot;,&quot;value&quot;:&quot;1&quot;}]},&quot;76&quot;:{&quot;action&quot;:true,&quot;match&quot;:&quot;any&quot;,&quot;rules&quot;:[{&quot;elementId&quot;:&quot;10&quot;,&quot;operator&quot;:&quot;eq&quot;,&quot;optionId&quot;:&quot;3&quot;,&quot;value&quot;:&quot;1&quot;}]},&quot;86&quot;:{&quot;action&quot;:true,&quot;match&quot;:&quot;all&quot;,&quot;rules&quot;:[{&quot;elementId&quot;:&quot;10&quot;,&quot;operator&quot;:&quot;eq&quot;,&quot;optionId&quot;:&quot;3&quot;,&quot;value&quot;:&quot;1&quot;}]},&quot;79&quot;:{&quot;action&quot;:true,&quot;match&quot;:&quot;all&quot;,&quot;rules&quot;:[{&quot;elementId&quot;:&quot;7&quot;,&quot;operator&quot;:&quot;not_empty&quot;,&quot;optionId&quot;:null,&quot;value&quot;:&quot;&quot;},{&quot;elementId&quot;:&quot;10&quot;,&quot;operator&quot;:&quot;eq&quot;,&quot;optionId&quot;:&quot;4&quot;,&quot;value&quot;:&quot;3&quot;}]},&quot;80&quot;:{&quot;action&quot;:true,&quot;match&quot;:&quot;all&quot;,&quot;rules&quot;:[{&quot;elementId&quot;:&quot;7&quot;,&quot;operator&quot;:&quot;not_empty&quot;,&quot;optionId&quot;:null,&quot;value&quot;:&quot;&quot;},{&quot;elementId&quot;:&quot;10&quot;,&quot;operator&quot;:&quot;eq&quot;,&quot;optionId&quot;:&quot;4&quot;,&quot;value&quot;:&quot;3&quot;}]},&quot;81&quot;:{&quot;action&quot;:true,&quot;match&quot;:&quot;all&quot;,&quot;rules&quot;:[{&quot;elementId&quot;:&quot;7&quot;,&quot;operator&quot;:&quot;not_empty&quot;,&quot;optionId&quot;:null,&quot;value&quot;:&quot;&quot;},{&quot;elementId&quot;:&quot;10&quot;,&quot;operator&quot;:&quot;eq&quot;,&quot;optionId&quot;:&quot;4&quot;,&quot;value&quot;:&quot;3&quot;}]},&quot;9&quot;:{&quot;action&quot;:true,&quot;match&quot;:&quot;all&quot;,&quot;rules&quot;:[{&quot;elementId&quot;:&quot;7&quot;,&quot;operator&quot;:&quot;not_empty&quot;,&quot;optionId&quot;:null,&quot;value&quot;:&quot;&quot;},{&quot;elementId&quot;:&quot;10&quot;,&quot;operator&quot;:&quot;not_empty&quot;,&quot;optionId&quot;:null,&quot;value&quot;:&quot;&quot;},{&quot;elementId&quot;:&quot;82&quot;,&quot;operator&quot;:&quot;not_empty&quot;,&quot;optionId&quot;:null,&quot;value&quot;:&quot;&quot;}]},&quot;11&quot;:{&quot;action&quot;:true,&quot;match&quot;:&quot;all&quot;,&quot;rules&quot;:[{&quot;elementId&quot;:&quot;7&quot;,&quot;operator&quot;:&quot;not_empty&quot;,&quot;optionId&quot;:null,&quot;value&quot;:&quot;&quot;},{&quot;elementId&quot;:&quot;10&quot;,&quot;operator&quot;:&quot;not_empty&quot;,&quot;optionId&quot;:null,&quot;value&quot;:&quot;&quot;},{&quot;elementId&quot;:&quot;82&quot;,&quot;operator&quot;:&quot;not_empty&quot;,&quot;optionId&quot;:null,&quot;value&quot;:&quot;&quot;}]},&quot;14&quot;:{&quot;action&quot;:true,&quot;match&quot;:&quot;all&quot;,&quot;rules&quot;:[{&quot;elementId&quot;:&quot;7&quot;,&quot;operator&quot;:&quot;not_empty&quot;,&quot;optionId&quot;:null,&quot;value&quot;:&quot;&quot;},{&quot;elementId&quot;:&quot;10&quot;,&quot;operator&quot;:&quot;not_empty&quot;,&quot;optionId&quot;:null,&quot;value&quot;:&quot;&quot;},{&quot;elementId&quot;:&quot;82&quot;,&quot;operator&quot;:&quot;not_empty&quot;,&quot;optionId&quot;:null,&quot;value&quot;:&quot;&quot;}]},&quot;41&quot;:{&quot;action&quot;:true,&quot;match&quot;:&quot;all&quot;,&quot;rules&quot;:[{&quot;elementId&quot;:&quot;7&quot;,&quot;operator&quot;:&quot;not_empty&quot;,&quot;optionId&quot;:null,&quot;value&quot;:&quot;&quot;},{&quot;elementId&quot;:&quot;10&quot;,&quot;operator&quot;:&quot;not_empty&quot;,&quot;optionId&quot;:null,&quot;value&quot;:&quot;&quot;},{&quot;elementId&quot;:&quot;82&quot;,&quot;operator&quot;:&quot;not_empty&quot;,&quot;optionId&quot;:null,&quot;value&quot;:&quot;&quot;}]},&quot;4&quot;:{&quot;action&quot;:true,&quot;match&quot;:&quot;all&quot;,&quot;rules&quot;:[{&quot;elementId&quot;:&quot;10&quot;,&quot;operator&quot;:&quot;not_empty&quot;,&quot;optionId&quot;:null,&quot;value&quot;:&quot;&quot;},{&quot;elementId&quot;:&quot;82&quot;,&quot;operator&quot;:&quot;not_empty&quot;,&quot;optionId&quot;:null,&quot;value&quot;:&quot;&quot;}]},&quot;5&quot;:{&quot;action&quot;:true,&quot;match&quot;:&quot;all&quot;,&quot;rules&quot;:[{&quot;elementId&quot;:&quot;10&quot;,&quot;operator&quot;:&quot;not_empty&quot;,&quot;optionId&quot;:null,&quot;value&quot;:&quot;&quot;},{&quot;elementId&quot;:&quot;82&quot;,&quot;operator&quot;:&quot;not_empty&quot;,&quot;optionId&quot;:null,&quot;value&quot;:&quot;&quot;}]},&quot;17&quot;:{&quot;action&quot;:true,&quot;match&quot;:&quot;all&quot;,&quot;rules&quot;:[{&quot;elementId&quot;:&quot;10&quot;,&quot;operator&quot;:&quot;not_empty&quot;,&quot;optionId&quot;:null,&quot;value&quot;:&quot;&quot;},{&quot;elementId&quot;:&quot;82&quot;,&quot;operator&quot;:&quot;not_empty&quot;,&quot;optionId&quot;:null,&quot;value&quot;:&quot;&quot;}]},&quot;18&quot;:{&quot;action&quot;:true,&quot;match&quot;:&quot;all&quot;,&quot;rules&quot;:[{&quot;elementId&quot;:&quot;10&quot;,&quot;operator&quot;:&quot;not_empty&quot;,&quot;optionId&quot;:null,&quot;value&quot;:&quot;&quot;},{&quot;elementId&quot;:&quot;82&quot;,&quot;operator&quot;:&quot;not_empty&quot;,&quot;optionId&quot;:null,&quot;value&quot;:&quot;&quot;}]},&quot;39&quot;:{&quot;action&quot;:true,&quot;match&quot;:&quot;all&quot;,&quot;rules&quot;:[{&quot;elementId&quot;:&quot;10&quot;,&quot;operator&quot;:&quot;not_empty&quot;,&quot;optionId&quot;:null,&quot;value&quot;:&quot;&quot;},{&quot;elementId&quot;:&quot;82&quot;,&quot;operator&quot;:&quot;not_empty&quot;,&quot;optionId&quot;:null,&quot;value&quot;:&quot;&quot;}]},&quot;20&quot;:{&quot;action&quot;:true,&quot;match&quot;:&quot;all&quot;,&quot;rules&quot;:[{&quot;elementId&quot;:&quot;10&quot;,&quot;operator&quot;:&quot;not_empty&quot;,&quot;optionId&quot;:null,&quot;value&quot;:&quot;&quot;},{&quot;elementId&quot;:&quot;82&quot;,&quot;operator&quot;:&quot;not_empty&quot;,&quot;optionId&quot;:null,&quot;value&quot;:&quot;&quot;}]},&quot;42&quot;:{&quot;action&quot;:true,&quot;match&quot;:&quot;all&quot;,&quot;rules&quot;:[{&quot;elementId&quot;:&quot;20&quot;,&quot;operator&quot;:&quot;eq&quot;,&quot;optionId&quot;:&quot;2&quot;,&quot;value&quot;:&quot;Pasien Baru&quot;}]},&quot;58&quot;:{&quot;action&quot;:true,&quot;match&quot;:&quot;all&quot;,&quot;rules&quot;:[{&quot;elementId&quot;:&quot;20&quot;,&quot;operator&quot;:&quot;eq&quot;,&quot;optionId&quot;:&quot;2&quot;,&quot;value&quot;:&quot;Pasien Baru&quot;}]},&quot;83&quot;:{&quot;action&quot;:true,&quot;match&quot;:&quot;all&quot;,&quot;rules&quot;:[{&quot;elementId&quot;:&quot;20&quot;,&quot;operator&quot;:&quot;eq&quot;,&quot;optionId&quot;:&quot;2&quot;,&quot;value&quot;:&quot;Pasien Baru&quot;}]},&quot;51&quot;:{&quot;action&quot;:true,&quot;match&quot;:&quot;all&quot;,&quot;rules&quot;:[{&quot;elementId&quot;:&quot;20&quot;,&quot;operator&quot;:&quot;eq&quot;,&quot;optionId&quot;:&quot;2&quot;,&quot;value&quot;:&quot;Pasien Baru&quot;}]},&quot;53&quot;:{&quot;action&quot;:true,&quot;match&quot;:&quot;all&quot;,&quot;rules&quot;:[{&quot;elementId&quot;:&quot;20&quot;,&quot;operator&quot;:&quot;eq&quot;,&quot;optionId&quot;:&quot;2&quot;,&quot;value&quot;:&quot;Pasien Baru&quot;}]},&quot;54&quot;:{&quot;action&quot;:true,&quot;match&quot;:&quot;all&quot;,&quot;rules&quot;:[{&quot;elementId&quot;:&quot;20&quot;,&quot;operator&quot;:&quot;eq&quot;,&quot;optionId&quot;:&quot;2&quot;,&quot;value&quot;:&quot;Pasien Baru&quot;}]},&quot;55&quot;:{&quot;action&quot;:true,&quot;match&quot;:&quot;all&quot;,&quot;rules&quot;:[{&quot;elementId&quot;:&quot;20&quot;,&quot;operator&quot;:&quot;eq&quot;,&quot;optionId&quot;:&quot;2&quot;,&quot;value&quot;:&quot;Pasien Baru&quot;}]},&quot;44&quot;:{&quot;action&quot;:true,&quot;match&quot;:&quot;all&quot;,&quot;rules&quot;:[{&quot;elementId&quot;:&quot;20&quot;,&quot;operator&quot;:&quot;eq&quot;,&quot;optionId&quot;:&quot;2&quot;,&quot;value&quot;:&quot;Pasien Baru&quot;}]},&quot;45&quot;:{&quot;action&quot;:true,&quot;match&quot;:&quot;all&quot;,&quot;rules&quot;:[{&quot;elementId&quot;:&quot;20&quot;,&quot;operator&quot;:&quot;eq&quot;,&quot;optionId&quot;:&quot;2&quot;,&quot;value&quot;:&quot;Pasien Baru&quot;}]},&quot;46&quot;:{&quot;action&quot;:true,&quot;match&quot;:&quot;all&quot;,&quot;rules&quot;:[{&quot;elementId&quot;:&quot;20&quot;,&quot;operator&quot;:&quot;eq&quot;,&quot;optionId&quot;:&quot;2&quot;,&quot;value&quot;:&quot;Pasien Baru&quot;}]},&quot;47&quot;:{&quot;action&quot;:true,&quot;match&quot;:&quot;all&quot;,&quot;rules&quot;:[{&quot;elementId&quot;:&quot;20&quot;,&quot;operator&quot;:&quot;eq&quot;,&quot;optionId&quot;:&quot;2&quot;,&quot;value&quot;:&quot;Pasien Baru&quot;}]},&quot;48&quot;:{&quot;action&quot;:true,&quot;match&quot;:&quot;all&quot;,&quot;rules&quot;:[{&quot;elementId&quot;:&quot;20&quot;,&quot;operator&quot;:&quot;eq&quot;,&quot;optionId&quot;:&quot;2&quot;,&quot;value&quot;:&quot;Pasien Baru&quot;}]},&quot;49&quot;:{&quot;action&quot;:true,&quot;match&quot;:&quot;all&quot;,&quot;rules&quot;:[{&quot;elementId&quot;:&quot;20&quot;,&quot;operator&quot;:&quot;eq&quot;,&quot;optionId&quot;:&quot;2&quot;,&quot;value&quot;:&quot;Pasien Baru&quot;}]},&quot;50&quot;:{&quot;action&quot;:true,&quot;match&quot;:&quot;all&quot;,&quot;rules&quot;:[{&quot;elementId&quot;:&quot;20&quot;,&quot;operator&quot;:&quot;eq&quot;,&quot;optionId&quot;:&quot;2&quot;,&quot;value&quot;:&quot;Pasien Baru&quot;}]},&quot;28&quot;:{&quot;action&quot;:true,&quot;match&quot;:&quot;all&quot;,&quot;rules&quot;:[{&quot;elementId&quot;:&quot;10&quot;,&quot;operator&quot;:&quot;neq&quot;,&quot;optionId&quot;:&quot;4&quot;,&quot;value&quot;:&quot;3&quot;},{&quot;elementId&quot;:&quot;10&quot;,&quot;operator&quot;:&quot;not_empty&quot;,&quot;optionId&quot;:null,&quot;value&quot;:&quot;&quot;}]},&quot;2&quot;:{&quot;action&quot;:true,&quot;match&quot;:&quot;all&quot;,&quot;rules&quot;:[{&quot;elementId&quot;:&quot;20&quot;,&quot;operator&quot;:&quot;not_empty&quot;,&quot;optionId&quot;:null,&quot;value&quot;:&quot;&quot;}]}},&quot;dependents&quot;:{&quot;10&quot;:[60,71,85,75,76,86,79,80,81,9,11,14,41,4,5,17,18,39,20,28,28],&quot;7&quot;:[79,80,81,9,11,14,41],&quot;82&quot;:[9,11,14,41,4,5,17,18,39,20],&quot;20&quot;:[42,58,83,51,53,54,55,44,45,46,47,48,49,50,2]},&quot;elementIds&quot;:[60,71,85,75,76,86,79,80,81,9,11,14,41,4,5,17,18,39,20,42,58,83,51,53,54,55,44,45,46,47,48,49,50,28,2],&quot;dependentElementIds&quot;:[&quot;10&quot;,&quot;7&quot;,&quot;82&quot;,&quot;20&quot;],&quot;animate&quot;:true},&quot;currentPageId&quot;:1,&quot;errorsIcon&quot;:&quot;&quot;,&quot;updateFancybox&quot;:true,&quot;hasPages&quot;:false,&quot;pages&quot;:[1],&quot;pageProgressType&quot;:&quot;numbers&quot;,&quot;tooltipsEnabled&quot;:true,&quot;tooltipClasses&quot;:&quot;qtip-quform-dark qtip-shadow&quot;,&quot;tooltipMy&quot;:&quot;left center&quot;,&quot;tooltipAt&quot;:&quot;right center&quot;,&quot;isRtl&quot;:false,&quot;scrollOffset&quot;:-50,&quot;scrollSpeed&quot;:800}\"><button class=\"quform-default-submit\" name=\"quform_submit\" type=\"submit\" value=\"submit\" aria-hidden=\"true\" tabindex=\"-1\"><\/button><div class=\"quform-form-inner quform-form-inner-7\"><input type=\"hidden\" name=\"quform_form_id\" value=\"7\" \/><input type=\"hidden\" name=\"quform_form_uid\" value=\"9d40b7\" \/><input type=\"hidden\" name=\"quform_count\" value=\"1\" \/><input type=\"hidden\" name=\"form_url\" value=\"https:\/\/primayahospital.com\/en\/wp-json\/wp\/v2\/pages\/4815\" \/><input type=\"hidden\" name=\"referring_url\" value=\"\" \/><input type=\"hidden\" name=\"post_id\" value=\"\" \/><input type=\"hidden\" name=\"post_title\" value=\"\" \/><input type=\"hidden\" name=\"quform_current_page_id\" value=\"1\" \/><input type=\"hidden\" name=\"quform_loaded\" value=\"1777307000|a3667caba225086decc65e3dac19b025\" \/><input type=\"hidden\" name=\"quform_csrf_token\" value=\"mcZh3QSXG8kv4vFiwsr054Xv0Qdrgy2SVBpzuc8F\" \/><div class=\"quform-elements quform-elements-7 quform-cf quform-responsive-elements-phone-landscape\"><div class=\"quform-element quform-element-page quform-page-1 quform-page-7_1 quform-cf quform-group-style-plain quform-first-page quform-last-page quform-current-page\"><div class=\"quform-child-elements\"><input type=\"hidden\" name=\"quform_7_84\" value=\"\" \/><div class=\"quform-element quform-element-html quform-element-7_89 quform-cf\"><div class=\"quform-spacer\">Belum punya akun? <a href=\"\/login\">Daftar Disini.<\/a><\/div><\/div><div class=\"quform-element quform-element-select quform-element-7_7 quform-cf quform-element-required\"><div class=\"quform-spacer\"><div class=\"quform-label quform-label-7_7\"><label class=\"quform-label-text\" for=\"quform_7_7_9d40b7\">Rumah Sakit<span class=\"quform-required\">*<\/span><\/label><\/div><div class=\"quform-inner quform-inner-select quform-inner-7_7\"><div class=\"quform-input quform-input-select quform-input-7_7 quform-cf\"><select id=\"quform_7_7_9d40b7\" name=\"quform_7_7\" class=\"quform-field quform-field-select quform-field-7_7\"><option value=\"\" selected=\"selected\">Select Hospital<\/option><option value=\"FMC\">FMC Hospital (Bogor)<\/option><option value=\"E\">Primaya Evasari Hospital<\/option><option value=\"N\">Primaya Hospital Betang Pambelum<\/option><option value=\"BW\">Primaya Hospital Bhakti Wara<\/option><option value=\"DE\">Primaya Hospital Depok<\/option><option value=\"M\">Primaya Hospital East Bekasi<\/option><option value=\"HE\">Primaya Hospital Hertasning<\/option><option value=\"SR\">Primaya Hospital Inco Sorowako<\/option><option value=\"Q\">Primaya Hospital Karawang<\/option><option value=\"KG\">Primaya Hospital Kelapa Gading<\/option><option value=\"F\">Primaya Hospital Makassar<\/option><option value=\"P\">Primaya Hospital North Bekasi<\/option><option value=\"CK\">Primaya Hospital PGI Cikini<\/option><option value=\"PK\">Primaya Hospital Pasar Kemis<\/option><option value=\"SG\">Primaya Hospital Semarang<\/option><option value=\"SK\">Primaya Hospital Sukabumi<\/option><option value=\"C\">Primaya Hospital Tangerang<\/option><option value=\"D\">Primaya Hospital West Bekasi<\/option><option value=\"RA\">Primaya Rajawali Hospital (Bandung)<\/option><option value=\"UK\">UKRIDA Hospital (Jakarta Barat)<\/option><\/select><\/div><\/div><\/div><\/div><input type=\"hidden\" name=\"quform_7_30\" class=\"quform-field quform-field-hidden quform-field-7_30\" data-default=\"\" \/><div class=\"quform-element quform-element-select quform-element-7_10 quform-cf quform-element-required\"><div class=\"quform-spacer\"><div class=\"quform-label quform-label-7_10\"><label class=\"quform-label-text\" for=\"quform_7_10_9d40b7\">Pembayaran<span class=\"quform-required\">*<\/span><\/label><\/div><div class=\"quform-inner quform-inner-select quform-inner-7_10\"><div class=\"quform-input quform-input-select quform-input-7_10 quform-cf\"><select id=\"quform_7_10_9d40b7\" name=\"quform_7_10\" class=\"quform-field quform-field-select quform-field-7_10\"><option value=\"\" selected=\"selected\">Pilih Pembayaran<\/option><option value=\"0\">Pribadi<\/option><option value=\"2\">Asuransi<\/option><option value=\"1\">Perusahaan<\/option><option value=\"3\">BPJS<\/option><\/select><\/div><\/div><\/div><\/div><input type=\"hidden\" name=\"quform_7_61\" class=\"quform-field quform-field-hidden quform-field-7_61\" data-default=\"\" \/><div class=\"quform-element quform-element-text quform-element-7_60 quform-cf quform-element-required\"><div class=\"quform-spacer\"><div class=\"quform-label quform-label-7_60\"><label class=\"quform-label-text\" for=\"quform_7_60_9d40b7\">Nama Asuransi<span class=\"quform-required\">*<\/span><\/label><\/div><div class=\"quform-inner quform-inner-text quform-inner-7_60\"><div class=\"quform-input quform-input-text quform-input-7_60 quform-cf\"><input type=\"text\" id=\"quform_7_60_9d40b7\" name=\"quform_7_60\" class=\"quform-field quform-field-text quform-field-7_60\" \/><\/div><\/div><\/div><\/div><div class=\"quform-element quform-element-file quform-element-7_71 quform-cf quform-element-optional\"><div class=\"quform-spacer\"><div class=\"quform-label quform-label-7_71\"><label class=\"quform-label-text\" for=\"quform_7_71_9d40b7\">Foto Kartu Asuransi <span class=\"quform-required\">*<\/span><\/label><\/div><div class=\"quform-inner quform-inner-file quform-inner-7_71\"><div class=\"quform-input quform-input-file quform-input-7_71 quform-cf quform-button-style-theme\"><input type=\"file\" id=\"quform_7_71_9d40b7\" name=\"quform_7_71[]\" class=\"quform-field quform-field-file quform-field-7_71\" \/><\/div><\/div><\/div><\/div><input type=\"hidden\" name=\"quform_7_87\" class=\"quform-field quform-field-hidden quform-field-7_87\" data-default=\"\" \/><div class=\"quform-element quform-element-html quform-element-7_85 quform-cf\"><div class=\"quform-spacer\"><span id=\"user-profile-image-foto_asuransi\"><\/span><\/div><\/div><div class=\"quform-element quform-element-text quform-element-7_75 quform-cf quform-element-required\"><div class=\"quform-spacer\"><div class=\"quform-label quform-label-7_75\"><label class=\"quform-label-text\" for=\"quform_7_75_9d40b7\">Nama Perusahaan<span class=\"quform-required\">*<\/span><\/label><\/div><div class=\"quform-inner quform-inner-text quform-inner-7_75\"><div class=\"quform-input quform-input-text quform-input-7_75 quform-cf\"><input type=\"text\" id=\"quform_7_75_9d40b7\" name=\"quform_7_75\" class=\"quform-field quform-field-text quform-field-7_75\" \/><\/div><\/div><\/div><\/div><div class=\"quform-element quform-element-file quform-element-7_76 quform-cf quform-element-optional\"><div class=\"quform-spacer\"><div class=\"quform-label quform-label-7_76\"><label class=\"quform-label-text\" for=\"quform_7_76_9d40b7\">Foto Jaminan Perusahaan <span class=\"quform-required\">*<\/span><\/label><\/div><div class=\"quform-inner quform-inner-file quform-inner-7_76\"><div class=\"quform-input quform-input-file quform-input-7_76 quform-cf quform-button-style-theme\"><input type=\"file\" id=\"quform_7_76_9d40b7\" name=\"quform_7_76[]\" class=\"quform-field quform-field-file quform-field-7_76\" \/><\/div><\/div><\/div><\/div><input type=\"hidden\" name=\"quform_7_88\" class=\"quform-field quform-field-hidden quform-field-7_88\" data-default=\"\" \/><div class=\"quform-element quform-element-html quform-element-7_86 quform-cf\"><div class=\"quform-spacer\"><span id=\"user-profile-image-foto_perusahaan\"><\/span><\/div><\/div><div class=\"quform-element quform-element-text quform-element-7_79 quform-cf quform-element-required\"><div class=\"quform-spacer\"><div class=\"quform-label quform-label-7_79\"><label class=\"quform-label-text\" for=\"quform_7_79_9d40b7\">No Kartu BPJS<span class=\"quform-required\">*<\/span><\/label><\/div><div class=\"quform-inner quform-inner-text quform-inner-7_79\"><div class=\"quform-input quform-input-text quform-input-7_79 quform-cf\"><input type=\"text\" id=\"quform_7_79_9d40b7\" name=\"quform_7_79\" class=\"quform-field quform-field-text quform-field-7_79\" \/><\/div><\/div><\/div><\/div><div class=\"quform-element quform-element-text quform-element-7_80 quform-cf quform-element-required\"><div class=\"quform-spacer\"><div class=\"quform-label quform-label-7_80\"><label class=\"quform-label-text\" for=\"quform_7_80_9d40b7\">No Surat Rujukan BPJS<span class=\"quform-required\">*<\/span><\/label><\/div><div class=\"quform-inner quform-inner-text quform-inner-7_80\"><div class=\"quform-input quform-input-text quform-input-7_80 quform-cf\"><input type=\"text\" id=\"quform_7_80_9d40b7\" name=\"quform_7_80\" class=\"quform-field quform-field-text quform-field-7_80\" \/><\/div><\/div><\/div><\/div><input type=\"hidden\" name=\"quform_7_82\" class=\"quform-field quform-field-hidden quform-field-7_82\" data-default=\"\" \/><div class=\"quform-element quform-element-html quform-element-7_81 quform-cf\"><div class=\"quform-spacer\"><button id=\"check_rujukan\" class=\"btn btn-sm btn-primary\" style=\"cursor: pointer;\" href=\"#\" name=\"check_bpjs\">Cek Rujukan<\/button><\/div><\/div><div class=\"quform-element quform-element-select quform-element-7_9 quform-cf quform-element-required\"><div class=\"quform-spacer\"><div class=\"quform-label quform-label-7_9\"><label class=\"quform-label-text\" for=\"quform_7_9_9d40b7\">Poli<span class=\"quform-required\">*<\/span><\/label><\/div><div class=\"quform-inner quform-inner-select quform-inner-7_9\"><div class=\"quform-input quform-input-select quform-input-7_9 quform-cf\"><select id=\"quform_7_9_9d40b7\" name=\"quform_7_9\" class=\"quform-field quform-field-select quform-field-7_9 check-rujukan\"><\/select><\/div><\/div><\/div><\/div><input type=\"hidden\" name=\"quform_7_31\" class=\"quform-field quform-field-hidden quform-field-7_31\" data-default=\"\" \/><div class=\"quform-element quform-element-date quform-element-7_11 quform-cf quform-element-required\"><div class=\"quform-spacer\"><div class=\"quform-label quform-label-7_11\"><label class=\"quform-label-text\" for=\"quform_7_11_9d40b7\">Tanggal Berobat<span class=\"quform-required\">*<\/span><\/label><\/div><div class=\"quform-inner quform-inner-date quform-inner-7_11\"><div class=\"quform-input quform-input-date quform-input-7_11 quform-cf quform-has-field-icon-left\"><input type=\"text\" id=\"quform_7_11_9d40b7\" name=\"quform_7_11\" class=\"quform-field quform-field-date quform-field-7_11 check-rujukan\" placeholder=\"YYYY-MM-DD\" data-options=\"{&quot;format&quot;:&quot;yyyy-MM-dd&quot;,&quot;min&quot;:&quot;2026-04-27&quot;,&quot;max&quot;:&quot;&quot;,&quot;start&quot;:&quot;month&quot;,&quot;depth&quot;:&quot;month&quot;,&quot;showFooter&quot;:true,&quot;locale&quot;:&quot;id-ID&quot;,&quot;placeholder&quot;:&quot;&quot;,&quot;autoOpen&quot;:true,&quot;identifier&quot;:&quot;7_11&quot;}\" readonly \/><span class=\"quform-field-icon quform-field-icon-left\"><i class=\"qicon-calendar\"><\/i><\/span><\/div><\/div><\/div><\/div><div class=\"quform-element quform-element-select quform-element-7_14 quform-cf quform-element-required\"><div class=\"quform-spacer\"><div class=\"quform-label quform-label-7_14\"><label class=\"quform-label-text\" for=\"quform_7_14_9d40b7\">Dokter<span class=\"quform-required\">*<\/span><\/label><\/div><div class=\"quform-inner quform-inner-select quform-inner-7_14\"><div class=\"quform-input quform-input-select quform-input-7_14 quform-cf\"><select id=\"quform_7_14_9d40b7\" name=\"quform_7_14\" class=\"quform-field quform-field-select quform-field-7_14 check-rujukan\"><\/select><\/div><\/div><\/div><\/div><input type=\"hidden\" name=\"quform_7_62\" class=\"quform-field quform-field-hidden quform-field-7_62\" data-default=\"\" \/><div class=\"quform-element quform-element-select quform-element-7_41 quform-cf quform-element-required\"><div class=\"quform-spacer\"><div class=\"quform-label quform-label-7_41\"><label class=\"quform-label-text\" for=\"quform_7_41_9d40b7\">Jam Berobat<span class=\"quform-required\">*<\/span><\/label><\/div><div class=\"quform-inner quform-inner-select quform-inner-7_41\"><div class=\"quform-input quform-input-select quform-input-7_41 quform-cf\"><select id=\"quform_7_41_9d40b7\" name=\"quform_7_41\" class=\"quform-field quform-field-select quform-field-7_41 check-rujukan\"><\/select><\/div><\/div><\/div><\/div><div class=\"quform-element quform-element-text quform-element-7_4 quform-cf quform-element-required\"><div class=\"quform-spacer\"><div class=\"quform-label quform-label-7_4\"><label class=\"quform-label-text\" for=\"quform_7_4_9d40b7\">Nama Lengkap<span class=\"quform-required\">*<\/span><\/label><\/div><div class=\"quform-inner quform-inner-text quform-inner-7_4\"><div class=\"quform-input quform-input-text quform-input-7_4 quform-cf\"><input type=\"text\" id=\"quform_7_4_9d40b7\" name=\"quform_7_4\" class=\"quform-field quform-field-text quform-field-7_4 check-rujukan\" \/><\/div><\/div><\/div><\/div><div class=\"quform-element quform-element-date quform-element-7_5 quform-cf quform-element-required\"><div class=\"quform-spacer\"><div class=\"quform-label quform-label-7_5\"><label class=\"quform-label-text\" for=\"quform_7_5_9d40b7\">Tanggal Lahir Pasien<span class=\"quform-required\">*<\/span><\/label><\/div><div class=\"quform-inner quform-inner-date quform-inner-7_5\"><div class=\"quform-input quform-input-date quform-input-7_5 quform-cf quform-has-field-icon-left\"><input type=\"text\" id=\"quform_7_5_9d40b7\" name=\"quform_7_5\" class=\"quform-field quform-field-date quform-field-7_5 check-rujukan\" placeholder=\"YYYY-MM-DD\" data-options=\"{&quot;format&quot;:&quot;&quot;,&quot;min&quot;:&quot;&quot;,&quot;max&quot;:&quot;&quot;,&quot;start&quot;:&quot;decade&quot;,&quot;depth&quot;:&quot;month&quot;,&quot;showFooter&quot;:false,&quot;locale&quot;:&quot;id-ID&quot;,&quot;placeholder&quot;:&quot;&quot;,&quot;autoOpen&quot;:true,&quot;identifier&quot;:&quot;7_5&quot;}\" readonly \/><span class=\"quform-field-icon quform-field-icon-left\"><i class=\"qicon-calendar\"><\/i><\/span><\/div><\/div><\/div><\/div><div class=\"quform-element quform-element-text quform-element-7_17 quform-cf quform-element-required\"><div class=\"quform-spacer\"><div class=\"quform-label quform-label-7_17\"><label class=\"quform-label-text\" for=\"quform_7_17_9d40b7\">Email<span class=\"quform-required\">*<\/span><\/label><\/div><div class=\"quform-inner quform-inner-text quform-inner-7_17\"><label id=\"quform_7_17_9d40b7_sub_label_above\" class=\"quform-sub-label quform-sub-label-above\">(Alur pendaftaran akan dijelaskan via email)<\/label><div class=\"quform-input quform-input-text quform-input-7_17 quform-cf\"><input type=\"text\" id=\"quform_7_17_9d40b7\" name=\"quform_7_17\" class=\"quform-field quform-field-text quform-field-7_17 check-rujukan\" \/><\/div><\/div><\/div><\/div><div class=\"quform-element quform-element-text quform-element-7_18 quform-cf quform-element-required\"><div class=\"quform-spacer\"><div class=\"quform-label quform-label-7_18\"><label class=\"quform-label-text\" for=\"quform_7_18_9d40b7\">No. Handphone<span class=\"quform-required\">*<\/span><\/label><\/div><div class=\"quform-inner quform-inner-text quform-inner-7_18\"><div class=\"quform-input quform-input-text quform-input-7_18 quform-cf\"><input type=\"text\" id=\"quform_7_18_9d40b7\" name=\"quform_7_18\" class=\"quform-field quform-field-text quform-field-7_18 check-rujukan\" \/><\/div><\/div><\/div><\/div><div class=\"quform-element quform-element-text quform-element-7_39 quform-cf quform-element-required\"><div class=\"quform-spacer\"><div class=\"quform-label quform-label-7_39\"><label class=\"quform-label-text\" for=\"quform_7_39_9d40b7\">No. KTP<span class=\"quform-required\">*<\/span><\/label><\/div><div class=\"quform-inner quform-inner-text quform-inner-7_39\"><div class=\"quform-input quform-input-text quform-input-7_39 quform-cf\"><input type=\"text\" id=\"quform_7_39_9d40b7\" name=\"quform_7_39\" class=\"quform-field quform-field-text quform-field-7_39 check-rujukan\" \/><\/div><\/div><\/div><\/div><div class=\"quform-element quform-element-radio quform-element-7_20 quform-cf quform-element-required\"><div class=\"quform-spacer\"><div class=\"quform-label quform-label-7_20\"><label class=\"quform-label-text\" id=\"quform_7_20_9d40b7_label\">Apakah Anda<span class=\"quform-required\">*<\/span><\/label><\/div><div class=\"quform-inner quform-inner-radio quform-inner-7_20\"><div class=\"quform-input quform-input-radio quform-input-7_20 quform-cf\"><div class=\"quform-options quform-cf quform-options-inline quform-options-simple\" role=\"radiogroup\" aria-labelledby=\"quform_7_20_9d40b7_label\"><div class=\"quform-option\"><input type=\"radio\" name=\"quform_7_20\" id=\"quform_7_20_9d40b7_1\" class=\"quform-field quform-field-radio quform-field-7_20 quform-field-7_20_1 check-rujukan\" value=\"Pasien Lama\" \/><label for=\"quform_7_20_9d40b7_1\" class=\"quform-option-label quform-option-label-7_20_1\"><span class=\"quform-option-text\">Pasien Lama<\/span><\/label><\/div><div class=\"quform-option\"><input type=\"radio\" name=\"quform_7_20\" id=\"quform_7_20_9d40b7_2\" class=\"quform-field quform-field-radio quform-field-7_20 quform-field-7_20_2 check-rujukan\" value=\"Pasien Baru\" \/><label for=\"quform_7_20_9d40b7_2\" class=\"quform-option-label quform-option-label-7_20_2\"><span class=\"quform-option-text\">Pasien Baru<\/span><\/label><\/div><\/div><\/div><\/div><\/div><\/div><input type=\"hidden\" name=\"quform_7_63\" class=\"quform-field quform-field-hidden quform-field-7_63\" data-default=\"\" \/><input type=\"hidden\" name=\"quform_7_64\" class=\"quform-field quform-field-hidden quform-field-7_64\" data-default=\"\" \/><input type=\"hidden\" name=\"quform_7_65\" class=\"quform-field quform-field-hidden quform-field-7_65\" data-default=\"\" \/><input type=\"hidden\" name=\"quform_7_66\" class=\"quform-field quform-field-hidden quform-field-7_66\" data-default=\"\" \/><input type=\"hidden\" name=\"quform_7_67\" class=\"quform-field quform-field-hidden quform-field-7_67\" data-default=\"\" \/><input type=\"hidden\" name=\"quform_7_68\" class=\"quform-field quform-field-hidden quform-field-7_68\" data-default=\"\" \/><div class=\"quform-element quform-element-checkbox quform-element-7_28 quform-cf quform-element-required\"><div class=\"quform-spacer\"><div class=\"quform-label quform-label-7_28\"><label class=\"quform-label-text\" id=\"quform_7_28_9d40b7_label\">Pernyataan<span class=\"quform-required\">*<\/span><\/label><\/div><div class=\"quform-inner quform-inner-checkbox quform-inner-7_28\"><div class=\"quform-input quform-input-checkbox quform-input-7_28 quform-cf\"><div class=\"quform-options quform-cf quform-options-block quform-options-simple\" role=\"group\" aria-labelledby=\"quform_7_28_9d40b7_label\"><div class=\"quform-option\"><input type=\"checkbox\" name=\"quform_7_28[]\" id=\"quform_7_28_9d40b7_1\" class=\"quform-field quform-field-checkbox quform-field-7_28 quform-field-7_28_1\" value=\"Menyetujui Pernyataan\" \/><label for=\"quform_7_28_9d40b7_1\" class=\"quform-option-label quform-option-label-7_28_1\"><span class=\"quform-option-text\">Saya menyatakan bahwa apa yang telah saya beritahukan di atas adalah benar dan lengkap <span style=\"color:red\">*<\/span><\/span><\/label><\/div><\/div><\/div><\/div><\/div><\/div><input type=\"hidden\" name=\"quform_7_72\" class=\"quform-field quform-field-hidden quform-field-7_72\" data-default=\"\" \/><input type=\"hidden\" name=\"quform_7_73\" class=\"quform-field quform-field-hidden quform-field-7_73\" data-default=\"\" \/><input type=\"hidden\" name=\"quform_7_74\" class=\"quform-field quform-field-hidden quform-field-7_74\" data-default=\"\" \/><input type=\"hidden\" name=\"quform_7_91\" class=\"quform-field quform-field-hidden quform-field-7_91\" data-default=\"\" \/><input type=\"hidden\" name=\"quform_7_92\" class=\"quform-field quform-field-hidden quform-field-7_92\" data-default=\"\" \/><input type=\"hidden\" name=\"quform_7_93\" class=\"quform-field quform-field-hidden quform-field-7_93\" data-default=\"\" \/><div class=\"quform-element quform-element-textarea quform-element-7_514574 quform-sr-only quform-cf\" style=\"clip: rect(1px, 1px, 1px, 1px); clip-path: inset(50%); position: absolute !important; height: 1px; width: 1px; overflow: hidden;\"><div class=\"quform-spacer\"><div class=\"quform-label quform-label-7_514574\"><label class=\"quform-label-text\" for=\"quform_7_514574_9d40b7\">Phone Number<span class=\"quform-required\">*<\/span><\/label><\/div><div class=\"quform-inner quform-inner-7_514574\"><textarea id=\"quform_7_514574_9d40b7\" name=\"quform_7_514574\" class=\"quform-field quform-field-textarea quform-field-7_514574\" tabindex=\"-1\" autocomplete=\"new-password\"><\/textarea><\/div><\/div><\/div><div class=\"quform-element quform-element-submit quform-element-7_2 quform-cf quform-button-style-theme\"><div class=\"quform-button-submit quform-button-submit-default quform-button-submit-7_2\"><button name=\"quform_submit\" type=\"submit\" class=\"quform-submit\" value=\"submit\"><span class=\"quform-button-text quform-button-submit-text\">Buat Janji<\/span><\/button><\/div><div class=\"quform-loading quform-loading-position-left quform-loading-type-spinner-1\"><div class=\"quform-loading-inner\"><div class=\"quform-loading-spinner\"><div class=\"quform-loading-spinner-inner\"><\/div><\/div><\/div><\/div><\/div><\/div><\/div><\/div><\/div><\/form><\/div><\/div>\n\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t<div class=\"elementor-column elementor-col-25 elementor-top-column elementor-element elementor-element-28c08ad\" data-id=\"28c08ad\" data-element_type=\"column\" data-e-type=\"column\">\n\t\t\t<div class=\"elementor-widget-wrap\">\n\t\t\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/section>\n\t\t\t\t<section class=\"elementor-section elementor-top-section elementor-element elementor-element-e171a6e elementor-section-boxed elementor-section-height-default elementor-section-height-default\" data-id=\"e171a6e\" data-element_type=\"section\" data-e-type=\"section\">\n\t\t\t\t\t\t<div class=\"elementor-container elementor-column-gap-default\">\n\t\t\t\t\t<div class=\"elementor-column elementor-col-25 elementor-top-column elementor-element elementor-element-15e3de7\" data-id=\"15e3de7\" data-element_type=\"column\" data-e-type=\"column\">\n\t\t\t<div class=\"elementor-widget-wrap\">\n\t\t\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t<div class=\"elementor-column elementor-col-50 elementor-top-column elementor-element elementor-element-dea6be5\" data-id=\"dea6be5\" data-element_type=\"column\" data-e-type=\"column\">\n\t\t\t<div class=\"elementor-widget-wrap elementor-element-populated\">\n\t\t\t\t\t\t<div class=\"elementor-element elementor-element-0916c58 elementor-widget elementor-widget-heading\" data-id=\"0916c58\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"heading.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t<h3 class=\"elementor-heading-title elementor-size-default\">You can also schedule an appointment via:<\/h3>\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-82c436a elementor-icon-list--layout-inline elementor-align-center elementor-list-item-link-full_width elementor-widget elementor-widget-icon-list\" data-id=\"82c436a\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"icon-list.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t<ul class=\"elementor-icon-list-items elementor-inline-items\">\n\t\t\t\t\t\t\t<li class=\"elementor-icon-list-item elementor-inline-item\">\n\t\t\t\t\t\t\t\t\t\t\t<a href=\"https:\/\/api.whatsapp.com\/send\/?phone=6282288889702&#038;text&#038;type=phone_number&#038;app_absent=0\">\n\n\t\t\t\t\t\t\t\t\t\t\t\t<span class=\"elementor-icon-list-icon\">\n\t\t\t\t\t\t\t<i aria-hidden=\"true\" class=\"fab fa-whatsapp\"><\/i>\t\t\t\t\t\t<\/span>\n\t\t\t\t\t\t\t\t\t\t<span class=\"elementor-icon-list-text\"><\/span>\n\t\t\t\t\t\t\t\t\t\t\t<\/a>\n\t\t\t\t\t\t\t\t\t<\/li>\n\t\t\t\t\t\t\t\t<li class=\"elementor-icon-list-item elementor-inline-item\">\n\t\t\t\t\t\t\t\t\t\t\t<a href=\"https:\/\/play.google.com\/store\/apps\/details?id=com.primaya.mobile&#038;hl=id\">\n\n\t\t\t\t\t\t\t\t\t\t\t\t<span class=\"elementor-icon-list-icon\">\n\t\t\t\t\t\t\t<i aria-hidden=\"true\" class=\"fab fa-google-play\"><\/i>\t\t\t\t\t\t<\/span>\n\t\t\t\t\t\t\t\t\t\t<span class=\"elementor-icon-list-text\"><\/span>\n\t\t\t\t\t\t\t\t\t\t\t<\/a>\n\t\t\t\t\t\t\t\t\t<\/li>\n\t\t\t\t\t\t\t\t<li class=\"elementor-icon-list-item elementor-inline-item\">\n\t\t\t\t\t\t\t\t\t\t\t<a href=\"https:\/\/apps.apple.com\/id\/app\/primaya-hospital\/id6446129845\">\n\n\t\t\t\t\t\t\t\t\t\t\t\t<span class=\"elementor-icon-list-icon\">\n\t\t\t\t\t\t\t<i aria-hidden=\"true\" class=\"fab fa-apple\"><\/i>\t\t\t\t\t\t<\/span>\n\t\t\t\t\t\t\t\t\t\t<span class=\"elementor-icon-list-text\"><\/span>\n\t\t\t\t\t\t\t\t\t\t\t<\/a>\n\t\t\t\t\t\t\t\t\t<\/li>\n\t\t\t\t\t\t\t\t<li class=\"elementor-icon-list-item elementor-inline-item\">\n\t\t\t\t\t\t\t\t\t\t\t<a href=\"tel:1500007\">\n\n\t\t\t\t\t\t\t\t\t\t\t\t<span class=\"elementor-icon-list-icon\">\n\t\t\t\t\t\t\t<i aria-hidden=\"true\" class=\"fas fa-phone-alt\"><\/i>\t\t\t\t\t\t<\/span>\n\t\t\t\t\t\t\t\t\t\t<span class=\"elementor-icon-list-text\"><\/span>\n\t\t\t\t\t\t\t\t\t\t\t<\/a>\n\t\t\t\t\t\t\t\t\t<\/li>\n\t\t\t\t\t\t<\/ul>\n\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t<div class=\"elementor-column elementor-col-25 elementor-top-column elementor-element elementor-element-2bfb6f4\" data-id=\"2bfb6f4\" data-element_type=\"column\" data-e-type=\"column\">\n\t\t\t<div class=\"elementor-widget-wrap\">\n\t\t\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/section>\n\t\t\t\t<section class=\"elementor-section elementor-top-section elementor-element elementor-element-b5706bc elementor-section-boxed elementor-section-height-default elementor-section-height-default\" data-id=\"b5706bc\" data-element_type=\"section\" data-e-type=\"section\">\n\t\t\t\t\t\t<div class=\"elementor-container elementor-column-gap-default\">\n\t\t\t\t\t<div class=\"elementor-column elementor-col-100 elementor-top-column elementor-element elementor-element-fcf42b4\" data-id=\"fcf42b4\" data-element_type=\"column\" data-e-type=\"column\">\n\t\t\t<div class=\"elementor-widget-wrap elementor-element-populated\">\n\t\t\t\t\t\t<div class=\"elementor-element elementor-element-593812b elementor-widget elementor-widget-spacer\" data-id=\"593812b\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"spacer.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t<div class=\"elementor-spacer\">\n\t\t\t<div class=\"elementor-spacer-inner\"><\/div>\n\t\t<\/div>\n\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/section>\n\t\t\t\t<\/div>\n\t\t","protected":false},"excerpt":{"rendered":"<p>Appointment Registration through the website\u00a0via the form below.If you experience any issues, please contact our Contact Center at 1 500 007 You can also schedule [&hellip;]<\/p>\n","protected":false},"author":2,"featured_media":0,"parent":0,"menu_order":112,"comment_status":"closed","ping_status":"closed","template":"","meta":{"_exactmetrics_skip_tracking":false,"_exactmetrics_sitenote_active":false,"_exactmetrics_sitenote_note":"","_exactmetrics_sitenote_category":0,"footnotes":""},"class_list":["post-4815","page","type-page","status-publish","hentry"],"_links":{"self":[{"href":"https:\/\/primayahospital.com\/en\/wp-json\/wp\/v2\/pages\/4815","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/primayahospital.com\/en\/wp-json\/wp\/v2\/pages"}],"about":[{"href":"https:\/\/primayahospital.com\/en\/wp-json\/wp\/v2\/types\/page"}],"author":[{"embeddable":true,"href":"https:\/\/primayahospital.com\/en\/wp-json\/wp\/v2\/users\/2"}],"replies":[{"embeddable":true,"href":"https:\/\/primayahospital.com\/en\/wp-json\/wp\/v2\/comments?post=4815"}],"version-history":[{"count":24,"href":"https:\/\/primayahospital.com\/en\/wp-json\/wp\/v2\/pages\/4815\/revisions"}],"predecessor-version":[{"id":77320,"href":"https:\/\/primayahospital.com\/en\/wp-json\/wp\/v2\/pages\/4815\/revisions\/77320"}],"wp:attachment":[{"href":"https:\/\/primayahospital.com\/en\/wp-json\/wp\/v2\/media?parent=4815"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}