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| RSUD Haji Surabaya | RS Siti Khodijah Muhammadiyah Sepanjang | RSUD Soetomo Surabaya | RSUD Ibnu Sina Gresik |
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| RSI Darus Syifa Surabaya | RS Wiyung Sejahtera | RS Muhammadiyah Surabaya | RS Muhammadiyah Gresik |
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| RSJ Menur | DKK Kota Surabaya |
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| RSUD Haji Surabaya | RS Siti Khodijah Muhammadiyah Sepanjang | RSUD Soetomo Surabaya | RSUD Ibnu Sina Gresik |
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| RSI Darus Syifa Surabaya | RS Wiyung Sejahtera | RS Muhammadiyah Surabaya | RS Muhammadiyah Gresik |
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| ||
| RSJ Menur | DKK Kota Surabaya |
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