var rs = ["Royal Progress", "RSUP Dr Cipto Mangunkusumo", "RSUP Fatmawati", "RSUP Persahabatan"]

var name = document.getElementById('name').value;
var nama = "Berliana Sipahutar"

var no-bpjs = document.getElementById('no-bpjs').value;
var bpjs = 123

var date = document.getElementById('date').value;
var tanggal-lahir = 20/08/1942 

var nik = document.getElementById('nik').value;
var nikk = 

var faskes1 = "Tanjung Priok"
var rs = ["Royal Progress", "RSUP Dr Cipto Mangunkusumo", "RSUP Fatmawati", "RSUP Persahabatan"]

var name = document.getElementById('name').value;
var nama = "Berliana Sipahutar"

var no-bpjs = document.getElementById('no-bpjs').value;
var bpjs = 123

var date = document.getElementById('date').value;
var tanggal-lahir = 20/08/1942 

var nik = document.getElementById('nik').value;
var nikk = 
Remove faskes variable