| Nama | : | Ratih Gunadi |
| Jabatan | : | Ketua komite mutu dan keselamatan RS |
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| Nama | : | Datu Anggarani |
| Jabatan | : | Sekretaris |
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| Nama | : | drg Christinne Triwidawati |
| Jabatan | : | Dokter Gigi |
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