KECAMATAN
PUSKESMAS
DESA
No
: ..
: ..
: ..
Jenis
Kelamin
Nama Balita
NO.RESP
NAMA RESP.
:
:
:
UMUR RESP.
TANGGAL PELAKS :
Tgl Lahir
Umur
(Bulan)
BB (Kg)
PB atau TB (Cm)
1.
Indikator Utama
1. Sudah berapa kali anak ibu ditimbang dalam 6 bulan terakhir?
2. Bila anak ibu sekarang berusia < 6 bulan, Kemarin anak ibu diberi makan apa?
1 = ASI saja
5 = 1 dan 3
2 = Susu Formula
6 = 2 dan 3
3 = Makanan Lain
7 = 1, 2, dan 3
4 = 1 dan 2
8 = Tidak berlaku
Jika tidak mempunyai bayi umur < 6 bulan, langsung kepertanyaan No.3 (jawaban dikosongi)
3 = Tidak
4. Apakah keluarga ini mengkonsumsi buah atau sayur dalam 3 hari terakhir?
1 = Ya setiap hari
2 = Biru (kurang)
3 = Tidak
5. Kandungan Iodium pada garam dapur (hasil uji dengan Iodina test)?
1 = Ungu (cukup)
2. Tidak
Jika ibu hanya mempunyai bayi usia < 6 bulan, jawaban dikosongi
7. Apakah ibu hamil mendapat tablet Fe? (bila ibu kondisi sekarang sedang hamil)
1. Ya
2. Tidak
Jika ibu kondisi tidak hamil, langsung kepertanyaan No.8 (jawaban dikosongi)
8. Apakah ibu masa nifas mendapat Vit A? (bila ibu kondisi sekarang masa nifas)
1. Ya
2. Tidak
..,
Pelaksana,
No. Resp.
No.1
No.2
No.3
No.4
No.5
No.6
No.7
No.8
Jenis
Kadarzi/
Kelamin Umur
NAMA BALITA
Tidak
(1 atau (Bln)
2)
Kadarzi
Fatan
17
Kadarzi
Krisna
13
Kadarzi
Wahyu widya
Kadarzi
Saskia putri
17
Kadarzi
Clarinta
Tidak
M Ezar
32
Kadarzi
Melyza
50
Kadarzi
Dewi Kumalasari
29
Kadarzi
Margareta
10
Kadarzi
Kaysa amelia
34
11
Tidak
Muthia
53
12
Kadarzi
Syakila
17
13
Tidak
Rafi ata W
14
Kadarzi
Airlangga
12
15
Tidak
Bilqis
14
16
Kadarzi
Khanzani
25
17
Kadarzi
Zalwa
19
18
Kadarzi
Azka Qutbi
19
Tidak
Asifa
43
20
Kadarzi
M azzam
13
21
Tidak
Nur Zahra
34
22
Kadarzi
Azizatul
13
23
Kadarzi
Putri Bia
17
24
Tidak
Syafira P
25
Tidak
Ayunda
26
Kadarzi
M Nafis
10
27
Tidak
Naila Zahrotul
58
28
Kadarzi
Vikha
29
Kadarzi
Raisha
28
Tidak
Risky Dwi A
34
30
Jumlah KADARZI
20
Keterangan :
Jenis Kelamin diisi jika Laki-laki ditulis 1 dan jika Perempuan ditulis 2
Kadarzi jika jawaban :
N0.1 = 1 N0.2 = 1 N0.3 = 1 N0.4 = 1 N0.5 = 1 N0.6 = 0 N0.7 = 0 N0.8 = 0 (Bayi < 6 bln)
N0.1 = 1 N0.2 = 1 N0.3 = 1 N0.4 = 1 N0.5 = 1 N0.6 = 0 N0.7 = 0 N0.8 = 1 (Bayi < 6 bln + Nifas)
N0.1 = 1 N0.2 = 1 N0.3 = 1 N0.4 = 1 N0.5 = 1 N0.6 = 0 N0.7 = 1 N0.8 = 0 (Bayi < 6 bln + Hamil)
N0.1 = 1 N0.2 = 0 N0.3 = 1 N0.4 = 1 N0.5 = 1 N0.6 = 1 N0.7 = 0 N0.8 = 0 (Bayi > 6 bln)
N0.1 = 1 N0.2 = 0 N0.3 = 1 N0.4 = 1 N0.5 = 1 N0.6 = 1 N0.7 = 1 N0.8 = 0 (Bayi > 6 bln + Hamil)
67%
Tidak
Singkalan, 21 Agu
Pelaksana
A. Sholakhuddin
BB
(Kg)
TB
atau
PB
(Cm)
12.3
78.6
10.3
73.2
10.5
67.3
11.5
77.3
8.6
55
20.2
87.4
17 103.5
16.4
84.7
7.5
64.2
11.1
87.3
14.3 104.2
11.7
80.2
7.7
62.1
10.2
76.2
11.5
76.8
13.5
86.7
11.5
80
6.5
54.5
12.3
98.5
10.9
72.4
17.6
88.3
11.2
76
10.9
84.2
6.9
63
9.9
62.4
16
74.2
16
113
8.3
68
16.3
86.8
14
93.2
Tidak
Sholakhuddin
No. Resp.
No.1
No.2
No.3
No.4
No.5
No.6
No.7
No.8
Jenis
Kadarzi/
Kelamin Umur
NAMA BALITA
Tidak
(1 atau (Bln)
2)
Kadarzi
Zakia
Kadarzi
Wahyu suprianto
14
Kadarzi
Dafid
18
Kadarzi
Riza
22
Kadarzi
Devinta
31
Kadarzi
Aida
43
Kadarzi
Rama
37
Kadarzi
Fatih
40
Kadarzi
Betriquel
26
10
Kadarzi
Rendra
44
11
Kadarzi
Bagas
12
12
Kadarzi
Bramesta
15
13
Kadarzi
Restu
43
14
Kadarzi
Reno
15
15
Kadarzi
Nasrul
16
Kadarzi
Adeleo
17
Kadarzi
Olifia
34
18
Kadarzi
Azam
49
19
Kadarzi
Haris
30
20
Kadarzi
Yolanda
52
21
Kadarzi
M Royyan
22
Kadarzi
Ashab
14
23
Kadarzi
Bayu
24
Kadarzi
Aqila
25
Kadarzi
Lintang
18
26
Kadarzi
Azam
49
27
Kadarzi
Raditya
15
28
Kadarzi
Abidah
26
29
Kadarzi
Adelia
10
30
Kadarzi
Nando
26
Jumlah KADARZI
30
Keterangan :
Jenis Kelamin diisi jika Laki-laki ditulis 1 dan jika Perempuan ditulis 2
Kadarzi jika jawaban :
N0.1 = 1 N0.2 = 1 N0.3 = 1 N0.4 = 1 N0.5 = 1 N0.6 = 0 N0.7 = 0 N0.8 = 0 (Bayi < 6 bln)
N0.1 = 1 N0.2 = 1 N0.3 = 1 N0.4 = 1 N0.5 = 1 N0.6 = 0 N0.7 = 0 N0.8 = 1 (Bayi < 6 bln + Nifas)
N0.1 = 1 N0.2 = 1 N0.3 = 1 N0.4 = 1 N0.5 = 1 N0.6 = 0 N0.7 = 1 N0.8 = 0 (Bayi < 6 bln + Hamil)
N0.1 = 1 N0.2 = 0 N0.3 = 1 N0.4 = 1 N0.5 = 1 N0.6 = 1 N0.7 = 0 N0.8 = 0 (Bayi > 6 bln)
N0.1 = 1 N0.2 = 0 N0.3 = 1 N0.4 = 1 N0.5 = 1 N0.6 = 1 N0.7 = 1 N0.8 = 0 (Bayi > 6 bln + Hamil)
100%
Kadarzi
Pelaksana
BB
(Kg)
TB
atau
PB
(Cm)
7.2
69.4
12.4
77.6
9.1
78.8
11
86.5
10
85.4
13.5 100.1
16.9 104.2
15.2
94.8
10.4
83.2
12.8
92.1
8.7
73.2
9.5
72.3
12.1
97
76.5
15.6
68
8.1
67.8
11.2
87
13.3
98.5
12.2
91.2
13.5
98.2
4.7
56.7
9.3
76.2
5.2
55.6
6.8
62.4
9.1
77.6
16.8 102.2
10.4
80.9
11.5
86.7
7.8
73.2
13.5
84.2
Kadarzi
.....
No. Resp.
No.1
No.2
No.3
No.4
No.5
No.6
No.7
No.8
Jenis
Kadarzi/
Kelamin Umur
NAMA BALITA
Tidak
(1 atau (Bln)
2)
Tidak
Anindya aura
19
Kadarzi
M Fauzan
18
Tidak
M fahmi
19
Kadarzi
Gadhis viona
17
Kadarzi
Nada Fjriya
17
Tidak
A Sabib
16
Kadarzi
Muzaroh ainur
16
Kadarzi
M isbir al habibi
15
Kadarzi
Belvra kafa D
15
10
Kadarzi
Qadira Nur
14
11
Kadarzi
Abdil justin
14
12
Kadarzi
Adzikra donita
14
13
Kadarzi
Kayyisa putri
14
14
Kadarzi
Bima surya
12
15
Kadarzi
M Alfin
15
16
Tidak
12
17
Kadarzi
Afika nayla
18
18
Kadarzi
M ferdiansyah
15
19
Tidak
M alfarizi
15
20
Kadarzi
14
21
Kadarzi
Adila Mayyasah
13
22
Kadarzi
Haris
12
23
Kadarzi
Nandhaka kevin
19
24
Kadarzi
Elvira nadia
17
25
Kadarzi
Haikal fadhil
16
26
Kadarzi
Argara putra
16
27
Kadarzi
Indah putri A
14
28
Kadarzi
M hafiz alkahfi
14
29
Kadarzi
Rayya fabbani
15
30
Kadarzi
Aska maulana
14
Jumlah KADARZI
25
Keterangan :
Jenis Kelamin diisi jika Laki-laki ditulis 1 dan jika Perempuan ditulis 2
Kadarzi jika jawaban :
N0.1 = 1 N0.2 = 1 N0.3 = 1 N0.4 = 1 N0.5 = 1 N0.6 = 0 N0.7 = 0 N0.8 = 0 (Bayi < 6 bln)
N0.1 = 1 N0.2 = 1 N0.3 = 1 N0.4 = 1 N0.5 = 1 N0.6 = 0 N0.7 = 0 N0.8 = 1 (Bayi < 6 bln + Nifas)
N0.1 = 1 N0.2 = 1 N0.3 = 1 N0.4 = 1 N0.5 = 1 N0.6 = 0 N0.7 = 1 N0.8 = 0 (Bayi < 6 bln + Hamil)
N0.1 = 1 N0.2 = 0 N0.3 = 1 N0.4 = 1 N0.5 = 1 N0.6 = 1 N0.7 = 0 N0.8 = 0 (Bayi > 6 bln)
N0.1 = 1 N0.2 = 0 N0.3 = 1 N0.4 = 1 N0.5 = 1 N0.6 = 1 N0.7 = 1 N0.8 = 0 (Bayi > 6 bln + Hamil)
83%
Kadarzi
Bk Temenggungan
Pelaksana
A. Sholakhuddin
NIP : 197405112008
BB
(Kg)
TB
atau
PB
(Cm)
8.7
81.2
10.7
79
9.7
84.2
9.4
78.2
10.3
80.1
11.4
78
82.1
75
10.1
78.3
7.6
72.4
7.9
73.4
8.4
73
9.5
72.6
9.7
75.3
8.2
76
9.4
74
9.2
83.4
9.5
83
9.3
82.3
9.2
78
72.5
6.8
69.3
10.8
87.6
9.7
84.7
9.6
83.2
9.5
83
8.7
78.4
10.3
81.1
12.3
82.1
9.2
79
Kadarzi
Sholakhuddin
P : 19740511200801007
No. Resp.
No.1
No.2
No.3
No.4
No.5
No.6
No.7
No.8
Jenis
Kadarzi/
Kelamin Umur
NAMA BALITA
Tidak
(1 atau (Bln)
2)
Tidak
Griselda azaila
15
Tidak
Radhintia
42
Tidak
Kayla zahra
30
Tidak
Kayla Amanda
14
Tidak
Delisha
36
Tidak
Kanzaila
18
Tidak
Azka arya
15
Tidak
Khaina
20
Tidak
Silva Nur
27
10
Tidak
Bertha alisia
39
11
Tidak
Aura hafiza
28
12
Tidak
M Farhan
40
13
Tidak
M Devan
42
14
Tidak
Meysha nur
40
15
Tidak
M Fattan
27
16
Tidak
Agila farzana
13
17
Tidak
Danu prasetya
27
18
Tidak
Nur Agni
45
19
Tidak
Nadifatul
16
20
Tidak
Rizaki
53
21
Tidak
Mufid
42
22
Tidak
Nur aini
39
23
Tidak
Fairus hizam
27
24
Tidak
M Hamdan
27
25
Tidak
M Afrian
17
26
Tidak
Ridho ilham
57
27
Tidak
Prameswari
33
28
Tidak
Luky S
21
29
Tidak
M Aditya
58
30
Tidak
Aqila asyifa
17
Jumlah KADARZI
Keterangan :
Jenis Kelamin diisi jika Laki-laki ditulis 1 dan jika Perempuan ditulis 2
Kadarzi jika jawaban :
N0.1 = 1 N0.2 = 1 N0.3 = 1 N0.4 = 1 N0.5 = 1 N0.6 = 0 N0.7 = 0 N0.8 = 0 (Bayi < 6 bln)
N0.1 = 1 N0.2 = 1 N0.3 = 1 N0.4 = 1 N0.5 = 1 N0.6 = 0 N0.7 = 0 N0.8 = 1 (Bayi < 6 bln + Nifas)
N0.1 = 1 N0.2 = 1 N0.3 = 1 N0.4 = 1 N0.5 = 1 N0.6 = 0 N0.7 = 1 N0.8 = 0 (Bayi < 6 bln + Hamil)
N0.1 = 1 N0.2 = 0 N0.3 = 1 N0.4 = 1 N0.5 = 1 N0.6 = 1 N0.7 = 0 N0.8 = 0 (Bayi > 6 bln)
N0.1 = 1 N0.2 = 0 N0.3 = 1 N0.4 = 1 N0.5 = 1 N0.6 = 1 N0.7 = 1 N0.8 = 0 (Bayi > 6 bln + Hamil)
0%
Tidak
Pelaksana
BB
(Kg)
TB
atau
PB
(Cm)
8.7
78.4
12.4
99.2
10.6
93.2
10.3
77
16.2
96.1
10.4
84
10.5
82.4
12.4
87
12.4
89.1
14.2
98
12.3
89.2
14.5 102.3
15.6
102
13.4 103.2
11.8
90.2
9.4
76.7
12
93.2
13.5 103.2
11.6
80.1
16.8 112.4
14.5
100
13.4
98.2
11.4
94.3
12.4
95
9.4
82.3
16.4 114.2
12.3
94.2
11.2
84.3
15.8 114.7
11.1
Tidak
.....
83.3
No. Resp.
No.1
No.2
No.3
No.4
No.5
No.6
No.7
No.8
Jenis
Kadarzi/
Kelamin Umur
NAMA BALITA
Tidak
(1 atau (Bln)
2)
Kadarzi
Revalina Rosdiana
26
Kadarzi
Aqila
24
Tidak
Ali figo
41
Kadarzi
Tomi
32
Kadarzi
M Riski
22
Kadarzi
Deni
35
Tidak
Gisella
33
Kadarzi
Fahrizal
Kadarzi
Ayla
33
10
Kadarzi
Rere
14
11
Kadarzi
Shafa eka R
13
12
Kadarzi
Ilham Aurendra
37
13
Kadarzi
Keyla Nur
25
14
Kadarzi
Winandra
11
15
Tidak
Imanda fabiola
54
16
Kadarzi
Amar
27
17
Tidak
Bilqis
18
Tidak
Windia zahra
19
Kadarzi
Ihtina
20
Tidak
Tifani
33
21
Tidak
Feril
22
Tidak
Nadhifa
23
Tidak
By Ny Mardiana
24
Tidak
Diaz
25
Kadarzi
Azam
26
Kadarzi
Asfina
31
27
Tidak
Asit Kabir A
28
Kadarzi
Fahrizal
29
Tidak
Rama Jihansyah
55
30
Kadarzi
Zahrina
41
Jumlah KADARZI
18
Keterangan :
Jenis Kelamin diisi jika Laki-laki ditulis 1 dan jika Perempuan ditulis 2
Kadarzi jika jawaban :
N0.1 = 1 N0.2 = 1 N0.3 = 1 N0.4 = 1 N0.5 = 1 N0.6 = 0 N0.7 = 0 N0.8 = 0 (Bayi < 6 bln)
N0.1 = 1 N0.2 = 1 N0.3 = 1 N0.4 = 1 N0.5 = 1 N0.6 = 0 N0.7 = 0 N0.8 = 1 (Bayi < 6 bln + Nifas)
N0.1 = 1 N0.2 = 1 N0.3 = 1 N0.4 = 1 N0.5 = 1 N0.6 = 0 N0.7 = 1 N0.8 = 0 (Bayi < 6 bln + Hamil)
N0.1 = 1 N0.2 = 0 N0.3 = 1 N0.4 = 1 N0.5 = 1 N0.6 = 1 N0.7 = 0 N0.8 = 0 (Bayi > 6 bln)
N0.1 = 1 N0.2 = 0 N0.3 = 1 N0.4 = 1 N0.5 = 1 N0.6 = 1 N0.7 = 1 N0.8 = 0 (Bayi > 6 bln + Hamil)
60%
Tidak
Seduri, 18 Agustus
Pelaksana
A. Sholakhuddin
BB
(Kg)
TB
atau
PB
(Cm)
9.6
82.5
9.5
83.4
14.3
94.6
12.4
87
13
89
12.1
88.2
11.1
86.3
8.9
69
13
90.3
9.2
76.7
10.8
78.8
13
98.5
9.5
78
10.4
73.2
14.6
101
14.2
89.7
6.6
66
4.3
52
5.5
62
11.6
90.5
4.9
53.4
6.5
62.3
49
6.4
63.4
8.2
67.3
10.2
86.7
48.2
8.9
72
15.8 104.2
12
95.7
Tidak
Sholakhuddin
No. Resp.
No.1
No.2
No.3
No.4
No.5
No.6
No.7
No.8
Jenis
Kadarzi/
Kelamin Umur
NAMA BALITA
Tidak
(1 atau (Bln)
2)
Kadarzi
Alda tsania
15
Tidak
Pratama
40
Kadarzi
Umi B
Tidak
Fernando
42
Kadarzi
Kenzio
37
Kadarzi
Davino
Tidak
Agra
Kadarzi
Nur aini
17
Kadarzi
Kiandra arya
32
10
Kadarzi
Quanesa
10
11
Kadarzi
Poppy
39
12
Kadarzi
Kartika
19
13
Tidak
Syarifah
33
14
Tidak
Revano
33
15
Kadarzi
Zahra
40
16
Kadarzi
Egik dwi
17
17
Tidak
Agam
48
18
Kadarzi
Gendis
21
19
Kadarzi
Cantika
16
20
Kadarzi
Gadis
15
21
Kadarzi
Bilqis
11
22
Tidak
Abelia
35
23
Kadarzi
Maya Shifa
32
24
Kadarzi
Angela cantika
25
25
Kadarzi
Abrizam
26
Kadarzi
M raju langit
27
Kadarzi
Afikah
37
28
Kadarzi
Nadira
39
29
Kadarzi
Amora
30
Kadarzi
Cahaya K
38
Jumlah KADARZI
23
Keterangan :
Jenis Kelamin diisi jika Laki-laki ditulis 1 dan jika Perempuan ditulis 2
Kadarzi jika jawaban :
N0.1 = 1 N0.2 = 1 N0.3 = 1 N0.4 = 1 N0.5 = 1 N0.6 = 0 N0.7 = 0 N0.8 = 0 (Bayi < 6 bln)
N0.1 = 1 N0.2 = 1 N0.3 = 1 N0.4 = 1 N0.5 = 1 N0.6 = 0 N0.7 = 0 N0.8 = 1 (Bayi < 6 bln + Nifas)
N0.1 = 1 N0.2 = 1 N0.3 = 1 N0.4 = 1 N0.5 = 1 N0.6 = 0 N0.7 = 1 N0.8 = 0 (Bayi < 6 bln + Hamil)
N0.1 = 1 N0.2 = 0 N0.3 = 1 N0.4 = 1 N0.5 = 1 N0.6 = 1 N0.7 = 0 N0.8 = 0 (Bayi > 6 bln)
N0.1 = 1 N0.2 = 0 N0.3 = 1 N0.4 = 1 N0.5 = 1 N0.6 = 1 N0.7 = 1 N0.8 = 0 (Bayi > 6 bln + Hamil)
77%
Kadarzi
Warueron 11 Sepe
Pelaksana
Eny W
BB
(Kg)
TB
atau
PB
(Cm)
7.3
73.2
12.2
92.1
7.7
63
14
99.2
12
93.1
5.5
55.2
9.5
64.2
10.2
77.1
13
87.2
8.3
74.2
18
90.4
10
84.7
17
87.5
13
87
15 102.4
11.6
82.1
21
99
12
80.1
11.5
78.2
10
75.2
7.9
74.7
10
89.1
13
92
10.5
83.1
71
7.3
69.2
11.5
92.2
13
90.2
72.1
16
94
Kadarzi
No. Resp.
No.1
No.2
No.3
No.4
No.5
No.6
No.7
No.8
Jenis
Kadarzi/
Kelamin Umur
NAMA BALITA
Tidak
(1 atau (Bln)
2)
Kadarzi
Vino yudistira
15
Kadarzi
Danish
26
Tidak
Anisah
39
Tidak
Fadika
48
Kadarzi
Khalisa
16
Kadarzi
Safa yunia
26
Kadarzi
Erliana
28
Tidak
Vita Yusammah
37
Kadarzi
Dwi wahyu
47
10
Kadarzi
33
11
Kadarzi
Nur Rizky
12
Kadarzi
Ardhila
19
13
Kadarzi
Chilla
20
14
Kadarzi
Faezya abyan
15
Tidak
Kanza
19
16
Kadarzi
Arya
16
17
Kadarzi
Revano
26
18
Kadarzi
Ranel
34
19
Tidak
Virin
46
20
Kadarzi
M Hasbi
54
21
Kadarzi
M Choirul
30
22
Tidak
Salwa
46
23
Kadarzi
Bilva
23
24
Tidak
Navita
60
25
Kadarzi
Aulia M
32
26
Kadarzi
Grandiz
15
27
Kadarzi
Badriyah
14
28
Kadarzi
Jevander
15
29
Kadarzi
Evelin
36
30
Tidak
Ananda
15
Jumlah KADARZI
22
Keterangan :
Jenis Kelamin diisi jika Laki-laki ditulis 1 dan jika Perempuan ditulis 2
Kadarzi jika jawaban :
N0.1 = 1 N0.2 = 1 N0.3 = 1 N0.4 = 1 N0.5 = 1 N0.6 = 0 N0.7 = 0 N0.8 = 0 (Bayi < 6 bln)
N0.1 = 1 N0.2 = 1 N0.3 = 1 N0.4 = 1 N0.5 = 1 N0.6 = 0 N0.7 = 0 N0.8 = 1 (Bayi < 6 bln + Nifas)
N0.1 = 1 N0.2 = 1 N0.3 = 1 N0.4 = 1 N0.5 = 1 N0.6 = 0 N0.7 = 1 N0.8 = 0 (Bayi < 6 bln + Hamil)
N0.1 = 1 N0.2 = 0 N0.3 = 1 N0.4 = 1 N0.5 = 1 N0.6 = 1 N0.7 = 0 N0.8 = 0 (Bayi > 6 bln)
N0.1 = 1 N0.2 = 0 N0.3 = 1 N0.4 = 1 N0.5 = 1 N0.6 = 1 N0.7 = 1 N0.8 = 0 (Bayi > 6 bln + Hamil)
73%
Kadarzi
Bakalan Wringinpi
Pelaksana
Wiwik Rahayu
BB
(Kg)
TB
atau
PB
(Cm)
10
82.3
19.5
91.2
12.4
99.4
14.7 104.5
9.5
80.2
9.9
87.5
11.5
93.2
12.4
98.8
16.5 102.6
18
96.4
4.2
55.7
8.7
84.4
9.9
86.7
6.7
68
10.8
86.4
10.1
83.4
11.4
92.1
12.2
95.3
14.8 103.2
18.7 112.8
15.4
93.2
13 102.1
10.3
87.5
18.4 114.6
13.6
95.4
9.5
80.2
10.5
78.2
10.7
78
13.2
98.6
9.3
80.1
Kadarzi
No. Resp.
No.1
No.2
No.3
No.4
No.5
No.6
No.7
No.8
Jenis
Kadarzi/
Kelamin Umur
NAMA BALITA
Tidak
(1 atau (Bln)
2)
Kadarzi
Bilqis
22
Kadarzi
Hamzah
22
Kadarzi
Rafka
19
Tidak
Mashul
19
Kadarzi
Wahhyu Dwi
17
Kadarzi
M Dava
17
Kadarzi
Aqila aurelia
17
Kadarzi
Dhalifatus
17
Kadarzi
Arjuna
15
10
Kadarzi
Salva putri
13
11
Kadarzi
Ulul albab
14
12
Kadarzi
Ayuni bilqis
15
13
Kadarzi
Fahri bahrudin
14
Kadarzi
Putri faradila
15
Tidak
Saga alfan
16
Tidak
Gadis seli
17
Kadarzi
Atika
18
Kadarzi
Chelse anabel
10
19
Kadarzi
Wildan afif
20
Kadarzi
Adin afif
21
Kadarzi
Dava maulana
22
Kadarzi
Rafa alfatih
23
Kadarzi
Refi shofia
11
24
Kadarzi
Devan
11
25
Kadarzi
Humam sidiq
12
26
Kadarzi
Bintang
11
27
Kadarzi
Ega novanto
10
28
Kadarzi
Citra nur f
13
29
Kadarzi
Tristan gilang
15
30
Kadarzi
Angga baya
12
Jumlah KADARZI
27
Keterangan :
Jenis Kelamin diisi jika Laki-laki ditulis 1 dan jika Perempuan ditulis 2
Kadarzi jika jawaban :
N0.1 = 1 N0.2 = 1 N0.3 = 1 N0.4 = 1 N0.5 = 1 N0.6 = 0 N0.7 = 0 N0.8 = 0 (Bayi < 6 bln)
N0.1 = 1 N0.2 = 1 N0.3 = 1 N0.4 = 1 N0.5 = 1 N0.6 = 0 N0.7 = 0 N0.8 = 1 (Bayi < 6 bln + Nifas)
N0.1 = 1 N0.2 = 1 N0.3 = 1 N0.4 = 1 N0.5 = 1 N0.6 = 0 N0.7 = 1 N0.8 = 0 (Bayi < 6 bln + Hamil)
N0.1 = 1 N0.2 = 0 N0.3 = 1 N0.4 = 1 N0.5 = 1 N0.6 = 1 N0.7 = 0 N0.8 = 0 (Bayi > 6 bln)
N0.1 = 1 N0.2 = 0 N0.3 = 1 N0.4 = 1 N0.5 = 1 N0.6 = 1 N0.7 = 1 N0.8 = 0 (Bayi > 6 bln + Hamil)
90%
Kadarzi
Gagang Kepuhsar
Pelaksana
Hasanah
BB
(Kg)
TB
atau
PB
(Cm)
10.5
86
10.2
87.3
9.8
83.2
9.7
84.1
9.3
82.1
9.5
86.5
10
84.1
9.8
82.8
9.2
79.2
8.8
76.5
8.9
77
9.1
79.7
7.5
70.6
6.8
60.2
6.9
63.9
7.6
64
8.5
70
8.5
74.1
7.9
72.2
7.9
72.3
7.7
71.7
8.7
74.3
9.2
74.1
9.4
76
10.3
79.6
12
75.5
8.1
73.5
8.8
76.1
9.5
79.4
8.9
76.1
Kadarzi
No. Resp.
No.1
No.2
No.3
No.4
No.5
No.6
No.7
No.8
Jenis
Kadarzi/
Kelamin Umur
NAMA BALITA
Tidak
(1 atau (Bln)
2)
Kadarzi M Fahri
Kadarzi Rayendra
Kadarzi M Alfian
Kadarzi Aqila s.
11
Kadarzi Ajeng
11
Kadarzi Almira
Kadarzi Taskia
10
Kadarzi Meillinda
11
Kadarzi Amanda
12
Kadarzi Zakya
10
13
Kadarzi Ashanah
14
Kadarzi Alya
15
Kadarzi Bilqis
16
Kadarzi Messi
23
17
Kadarzi Iqbal
25
18
Kadarzi Tirta
23
19
Kadarzi M azka
23
20
Kadarzi Elo
30
21
Kadarzi Albi
18
22
Kadarzi Irfan
18
23
Kadarzi Afrian m
17
24
Kadarzi Alfin
13
25
15
26
Kadarzi Haris
14
27
Kadarzi Wildan
14
28
Kadarzi Jihan T
19
29
19
30
Kadarzi Syakila
18
Jumlah KADARZI
30
Keterangan :
Jenis Kelamin diisi jika Laki-laki ditulis 1 dan jika Perempuan ditulis 2
Kadarzi jika jawaban :
N0.1 = 1 N0.2 = 1 N0.3 = 1 N0.4 = 1 N0.5 = 1 N0.6 = 0 N0.7 = 0 N0.8 = 0 (Bayi < 6 bln)
N0.1 = 1 N0.2 = 1 N0.3 = 1 N0.4 = 1 N0.5 = 1 N0.6 = 0 N0.7 = 0 N0.8 = 1 (Bayi < 6 bln + Nifas)
N0.1 = 1 N0.2 = 1 N0.3 = 1 N0.4 = 1 N0.5 = 1 N0.6 = 0 N0.7 = 1 N0.8 = 0 (Bayi < 6 bln + Hamil)
N0.1 = 1 N0.2 = 0 N0.3 = 1 N0.4 = 1 N0.5 = 1 N0.6 = 1 N0.7 = 0 N0.8 = 0 (Bayi > 6 bln)
N0.1 = 1 N0.2 = 0 N0.3 = 1 N0.4 = 1 N0.5 = 1 N0.6 = 1 N0.7 = 1 N0.8 = 0 (Bayi > 6 bln + Hamil)
100%
Kadarzi
Pelaksana
BB
(Kg)
TB
atau
PB
(Cm)
7.7
70.1
7.5
70.2
5.4
61.5
7.8
63
9.2
70.2
10
77.4
10.1
77.8
7.5
70.1
7.5
70
8.6
64.5
7.4
67.3
9.2
74.7
6.3
62.3
6.8
65.5
5.2
57.3
12.1
87.3
17
90.1
13.3
89.5
13.2
88.3
14.9
94.2
11.2
83
10.1
84.3
11.3
85.3
11.6
80.1
10.5
82.1
10.5
79.3
12.7
81.7
11.1
84.8
11
87
11.2
86.5
Kadarzi
.....
No. Resp.
No.1
No.2
No.3
No.4
No.5
No.6
No.7
No.8
Jenis
Kadarzi/
Kelamin Umur
NAMA BALITA
Tidak
(1 atau (Bln)
2)
Tidak
Natasya
36
Tidak
Bara
27
Tidak
Febi
43
Tidak
Rania
17
Tidak
Kaila
27
Tidak
Arga
26
Tidak
Ariyasita
36
Tidak
Septia adi
38
Tidak
Sultan
27
10
Tidak
Aska
28
11
Tidak
Afsa
15
12
Tidak
Vino
17
13
Tidak
Yuanita arum
20
14
Tidak
M Zaki
55
15
Tidak
B Brama
56
16
Tidak
Adelia P
56
17
Tidak
M Azam
57
18
Tidak
Faizah
56
19
Tidak
M Zaenal
57
20
Tidak
Ridho ilham
57
21
Tidak
Prawesti
57
22
Tidak
Luky W
57
23
Tidak
M Aditya
58
24
Tidak
M Fahria
58
25
Tidak
M Faiz
58
26
Tidak
M Arya
58
27
Tidak
Fitria agustin
58
28
Tidak
Andini
58
29
Tidak
Elysa
58
30
Tidak
Izza T
58
Jumlah KADARZI
Keterangan :
Jenis Kelamin diisi jika Laki-laki ditulis 1 dan jika Perempuan ditulis 2
Kadarzi jika jawaban :
N0.1 = 1 N0.2 = 1 N0.3 = 1 N0.4 = 1 N0.5 = 1 N0.6 = 0 N0.7 = 0 N0.8 = 0 (Bayi < 6 bln)
N0.1 = 1 N0.2 = 1 N0.3 = 1 N0.4 = 1 N0.5 = 1 N0.6 = 0 N0.7 = 0 N0.8 = 1 (Bayi < 6 bln + Nifas)
N0.1 = 1 N0.2 = 1 N0.3 = 1 N0.4 = 1 N0.5 = 1 N0.6 = 0 N0.7 = 1 N0.8 = 0 (Bayi < 6 bln + Hamil)
N0.1 = 1 N0.2 = 0 N0.3 = 1 N0.4 = 1 N0.5 = 1 N0.6 = 1 N0.7 = 0 N0.8 = 0 (Bayi > 6 bln)
N0.1 = 1 N0.2 = 0 N0.3 = 1 N0.4 = 1 N0.5 = 1 N0.6 = 1 N0.7 = 1 N0.8 = 0 (Bayi > 6 bln + Hamil)
0%
Tidak
Pelaksana
BB
(Kg)
TB
atau
PB
(Cm)
13.2
84.3
17.5
85.2
15.3
98.2
9.2
78.3
10
83.4
10.1
84.3
15.3
87.8
15.5
94.9
10.5
87.2
11.7
85.6
11.2
80.1
9.8
83.2
17.6
86.4
17
108
17.1 110.2
19.7 112.3
17.5 114.4
18.4 110.1
19.2 114.3
19
113
20 112.4
17.4 109.8
20.7 114.6
21.2 112.5
22.2 113.3
20.6 114.1
17.5 116.2
20.1 117.3
17.1 114.5
20.3 116.1
Tidak
.....
No. Resp.
No.1
No.2
No.3
No.4
No.5
No.6
No.7
No.8
Jenis
Kadarzi/
Kelamin Umur
NAMA BALITA
Tidak
(1 atau (Bln)
2)
Tidak
M Arya Ardiansyah
26
Tidak
Bilqis
21
Tidak
Resti A
23
Tidak
Aldo
17
Tidak
Dirga
12
Tidak
Andara
30
Tidak
Anisa eva
23
Tidak
Zidan Aditya
36
Tidak
M Mughidin
25
10
Tidak
A Diffan
27
11
Tidak
Anggi safira
12
Tidak
Nur Hanifah
19
13
Tidak
Nur Hanisa
18
14
Tidak
M Dzikri
35
15
Tidak
Aulia
24
16
Tidak
M Aufar
31
17
Tidak
Mesya
38
18
Tidak
Hanif hanum
19
Tidak
Rizal
28
20
Tidak
Rara prasasti
21
21
Tidak
Dynar A
22
Tidak
Yumma Z
21
23
Tidak
Afida
24
Tidak
Anisa W
25
Tidak
Raden S
26
Tidak
Revi
34
27
Tidak
Rizki
28
Tidak
Mutia
29
Tidak
Isabel
33
30
Tidak
Atika
24
Jumlah KADARZI
Keterangan :
Jenis Kelamin diisi jika Laki-laki ditulis 1 dan jika Perempuan ditulis 2
Kadarzi jika jawaban :
N0.1 = 1 N0.2 = 1 N0.3 = 1 N0.4 = 1 N0.5 = 1 N0.6 = 0 N0.7 = 0 N0.8 = 0 (Bayi < 6 bln)
N0.1 = 1 N0.2 = 1 N0.3 = 1 N0.4 = 1 N0.5 = 1 N0.6 = 0 N0.7 = 0 N0.8 = 1 (Bayi < 6 bln + Nifas)
N0.1 = 1 N0.2 = 1 N0.3 = 1 N0.4 = 1 N0.5 = 1 N0.6 = 0 N0.7 = 1 N0.8 = 0 (Bayi < 6 bln + Hamil)
N0.1 = 1 N0.2 = 0 N0.3 = 1 N0.4 = 1 N0.5 = 1 N0.6 = 1 N0.7 = 0 N0.8 = 0 (Bayi > 6 bln)
N0.1 = 1 N0.2 = 0 N0.3 = 1 N0.4 = 1 N0.5 = 1 N0.6 = 1 N0.7 = 1 N0.8 = 0 (Bayi > 6 bln + Hamil)
0%
Tidak
Pelaksana
BB
(Kg)
TB
atau
PB
(Cm)
11.2
83.4
11.5
76.5
10.8
83.4
8.6
76.7
9.3
75
82.1
10.5
81.2
15.3
89.2
11
83
11.4
86.6
7.6
67
82
8.3
76
19
102
11.2
83
12.4
86.6
12
92
4.1
51
12.3
84.7
13
83.2
10.8
72.6
12
81.3
3.9
55.5
4.5
57.4
8.3
71.2
11
86.3
3.2
52
5.3
53
13.2
87.9
10.1
81.2
Tidak
.....
No. Resp.
No.1
No.2
No.3
No.4
No.5
No.6
No.7
No.8
Jenis
Kadarzi/
Kelamin Umur
NAMA BALITA
Tidak
(1 atau (Bln)
2)
Kadarzi
Dzakia Risqi
Kadarzi
Cinta Kynara
15
Kadarzi
Putri nawang
26
Kadarzi
Akhila putri
32
Kadarzi
Keyza azzahra
21
Kadarzi
Nayla Olivia
26
Kadarzi
Latifa nadine
Kadarzi
Afifa nirma
32
Kadarzi
M Rifki
15
10
Kadarzi
Diana
30
11
Kadarzi
Diyan
30
12
Kadarzi
Andini
29
13
Kadarzi
M Reyhan
32
14
Kadarzi
Alfian ade
52
15
Kadarzi
Azril
43
16
Kadarzi
Oliviana
23
17
Kadarzi
Brinda
11
18
Kadarzi
Alan juliana
13
19
Kadarzi
M adum yusy
15
20
Kadarzi
Vita Sherly
27
21
Kadarzi
Dimas arya
36
22
Kadarzi
Rifat
48
23
Kadarzi
Binar berlian
28
24
Kadarzi
Sinar Fitria
59
25
Kadarzi
Ahdan ibrahim
19
26
Kadarzi
M Azka
27
Kadarzi
Shakira
36
28
Kadarzi
Ralin sasha
11
29
Kadarzi
Nikayla
29
30
Kadarzi
M Abid
27
Jumlah KADARZI
30
Keterangan :
Jenis Kelamin diisi jika Laki-laki ditulis 1 dan jika Perempuan ditulis 2
Kadarzi jika jawaban :
N0.1 = 1 N0.2 = 1 N0.3 = 1 N0.4 = 1 N0.5 = 1 N0.6 = 0 N0.7 = 0 N0.8 = 0 (Bayi < 6 bln)
N0.1 = 1 N0.2 = 1 N0.3 = 1 N0.4 = 1 N0.5 = 1 N0.6 = 0 N0.7 = 0 N0.8 = 1 (Bayi < 6 bln + Nifas)
N0.1 = 1 N0.2 = 1 N0.3 = 1 N0.4 = 1 N0.5 = 1 N0.6 = 0 N0.7 = 1 N0.8 = 0 (Bayi < 6 bln + Hamil)
N0.1 = 1 N0.2 = 0 N0.3 = 1 N0.4 = 1 N0.5 = 1 N0.6 = 1 N0.7 = 0 N0.8 = 0 (Bayi > 6 bln)
N0.1 = 1 N0.2 = 0 N0.3 = 1 N0.4 = 1 N0.5 = 1 N0.6 = 1 N0.7 = 1 N0.8 = 0 (Bayi > 6 bln + Hamil)
100%
Kadarzi
Pelaksana
BB
(Kg)
TB
atau
PB
(Cm)
6.7
67
13
82.4
11
82.3
10
88
11
87.1
12.5
90.2
5.8
56.5
9.5
85
12.4
80.3
9.4
86.5
10.8
85.5
10.4
86.7
12.3
90.4
15.7
99.2
15.1
91.4
13
86.5
70.2
9.7
76.4
10.9
78.2
10.6
87.1
15.7
99
12.1
91.2
11.1
87.2
17.6
105
10.1
79.6
53.1
13.2
94.2
8.4
71.2
9.2
84.3
11.4
87.3
Kadarzi
.....
No. Resp.
No.1
No.2
No.3
No.4
No.5
No.6
No.7
No.8
Jenis
Kadarzi/
Kelamin Umur
NAMA BALITA
Tidak
(1 atau (Bln)
2)
Kadarzi
Alya sheril
43
Kadarzi
Gendis khalifa
20
Kadarzi
Micayla dwi
26
Tidak
M Alfikri
28
Kadarzi
Nabila Ajriliya
27
Tidak
Zahra Indria
39
Kadarzi
Alfarizi sabil
30
Kadarzi
Nadia zakiatus
38
Tidak
Siti Faticha
33
10
Kadarzi
Tia arifky
34
11
Kadarzi
Katherina
32
12
Kadarzi
Yafi amirul H
30
13
Kadarzi
M Firdaus
16
14
Kadarzi
M Syahputra Ald
12
15
Kadarzi
Kenzi Nadisy
35
16
Tidak
Faidha zharifa
11
17
Kadarzi
Haidar Sa'adi
12
18
Tidak
Erin purdiah
37
19
Kadarzi
Fera dwi A
29
20
Kadarzi
M Aqila A
32
21
Kadarzi
Rafa pradana
22
22
Tidak
Vivi alya S
47
23
Kadarzi
Naira Syafara
18
24
Kadarzi
Fitria agustin
36
25
Kadarzi
Farzana Nur
26
Tidak
Al Hafis wahyu
33
27
Tidak
Avariella khayla
46
28
Tidak
Rizky dandy
47
29
Kadarzi
Kania aulia
29
30
Tidak
Aisyah naura
44
Jumlah KADARZI
20
Keterangan :
Jenis Kelamin diisi jika Laki-laki ditulis 1 dan jika Perempuan ditulis 2
Kadarzi jika jawaban :
N0.1 = 1 N0.2 = 1 N0.3 = 1 N0.4 = 1 N0.5 = 1 N0.6 = 0 N0.7 = 0 N0.8 = 0 (Bayi < 6 bln)
N0.1 = 1 N0.2 = 1 N0.3 = 1 N0.4 = 1 N0.5 = 1 N0.6 = 0 N0.7 = 0 N0.8 = 1 (Bayi < 6 bln + Nifas)
N0.1 = 1 N0.2 = 1 N0.3 = 1 N0.4 = 1 N0.5 = 1 N0.6 = 0 N0.7 = 1 N0.8 = 0 (Bayi < 6 bln + Hamil)
N0.1 = 1 N0.2 = 0 N0.3 = 1 N0.4 = 1 N0.5 = 1 N0.6 = 1 N0.7 = 0 N0.8 = 0 (Bayi > 6 bln)
N0.1 = 1 N0.2 = 0 N0.3 = 1 N0.4 = 1 N0.5 = 1 N0.6 = 1 N0.7 = 1 N0.8 = 0 (Bayi > 6 bln + Hamil)
67%
Tidak
Pelaksana
BB
(Kg)
TB
atau
PB
(Cm)
14.8
94.5
10.2
78
10.8
82
11.6
87.4
11.5
84
14.7
96
13.4
92.3
13.1
90.1
13.4
92
14.7
91.2
11.5
87.2
14.1
90
11
78.6
72
10.5
91.2
7.8
73.1
16.1
76.9
13.8
93.3
17.8
95
15
88.3
11.9
82.6
14.4
97.4
12.3
76.5
10.4
87.9
7.4
72
12.8
93.2
12.2
92.6
16.8
95.5
12.5
95.3
13.3
96.1
Tidak
.....
No. Resp.
No.1
No.2
No.3
No.4
No.5
No.6
No.7
No.8
Jenis
Kadarzi/
Kelamin Umur
NAMA BALITA
Tidak
(1 atau (Bln)
2)
Kadarzi
A. Alghazali
47
Kadarzi
Aliyah umroatus
41
Kadarzi
Atika arieni
33
Kadarzi
Asifa maisyaroh
51
Tidak
Fadhil lesmana
41
Kadarzi
Naufal ramadni
48
Tidak
Nazka Z
43
Tidak
Saskia putri
46
Kadarzi
Zidane muhamad
43
10
Tidak
Yayank zilzian
38
11
Tidak
Amanda keysa
52
12
Kadarzi
Britania cinta
49
13
Tidak
Fina khoirin
53
14
Kadarzi
Kayyisa azzahra
50
15
Tidak
Maulidana
54
16
Tidak
M farel
53
17
Kadarzi
M Ridwan
48
18
Kadarzi
M Sheva
45
19
Tidak
M Zacky
52
20
Kadarzi
Trias wahyu
46
21
Kadarzi
Zaenaba zaraya
45
22
Tidak
Aurel melania
49
23
Kadarzi
Adelia aisya
47
24
Kadarzi
Mesyalun zahra
48
25
Tidak
Anisa kirana
58
26
Tidak
Debby salsabila
56
27
Kadarzi
Dita dewi s
56
28
Tidak
Putri oktavia
58
29
Tidak
Mezaluna azka
50
30
Tidak
Aina an nabila
51
Jumlah KADARZI
15
Keterangan :
Jenis Kelamin diisi jika Laki-laki ditulis 1 dan jika Perempuan ditulis 2
Kadarzi jika jawaban :
N0.1 = 1 N0.2 = 1 N0.3 = 1 N0.4 = 1 N0.5 = 1 N0.6 = 0 N0.7 = 0 N0.8 = 0 (Bayi < 6 bln)
N0.1 = 1 N0.2 = 1 N0.3 = 1 N0.4 = 1 N0.5 = 1 N0.6 = 0 N0.7 = 0 N0.8 = 1 (Bayi < 6 bln + Nifas)
N0.1 = 1 N0.2 = 1 N0.3 = 1 N0.4 = 1 N0.5 = 1 N0.6 = 0 N0.7 = 1 N0.8 = 0 (Bayi < 6 bln + Hamil)
N0.1 = 1 N0.2 = 0 N0.3 = 1 N0.4 = 1 N0.5 = 1 N0.6 = 1 N0.7 = 0 N0.8 = 0 (Bayi > 6 bln)
N0.1 = 1 N0.2 = 0 N0.3 = 1 N0.4 = 1 N0.5 = 1 N0.6 = 1 N0.7 = 1 N0.8 = 0 (Bayi > 6 bln + Hamil)
50%
Tidak
Pelaksana
BB
(Kg)
TB
atau
PB
(Cm)
13.2
96.2
13.6
97
14.5
96.3
13
98.5
13.4 100.8
12.4
99.6
14.3
97.4
14.2 100.1
14.5
93.1
13.7
95
15
100
12.4
96.5
14.3
98.3
15.7 102.2
14.6
98.7
20 106.7
15.1 101.4
14.1
98.9
13.2
97.1
15.2
104
14.2 101.2
14.8 100.2
11.9
96.7
13.5
98.6
14.6
96.4
14.1
97
13.7
98.3
14.4
98.3
16.9 100.9
13.2
Tidak
.....
98.3
No. Resp.
No.1
No.2
No.3
No.4
No.5
No.6
No.7
No.8
Jenis
Kadarzi/
Kelamin Umur
NAMA BALITA
Tidak
(1 atau (Bln)
2)
Kadarzi
M Uwais
48
Tidak
Nadia Durratul
47
Kadarzi
Vania Eka
39
Tidak
Rifki pratama
37
Kadarzi
Anugerah
33
Kadarzi
Dhenaya hilya
30
Kadarzi
Fathur airlangga
29
Kadarzi
Nabila putri
27
Kadarzi
Daffa alfaro
26
10
Kadarzi
Daffa Arcena
26
11
Kadarzi
Fachry rizki
25
12
Tidak
Hanipah
18
13
Kadarzi
Ratu panca
19
14
Kadarzi
Aisyah
17
15
Kadarzi
Aurelia
18
16
Kadarzi
Wahyu Riski
18
17
Kadarzi
Afkar
17
18
Kadarzi
Hana naina
16
19
Tidak
Aisyah nur
15
20
Kadarzi
Ach Bagus
14
21
Tidak
M. Fadli Nur
47
22
Tidak
Gavin Nazri
46
23
Kadarzi
Tabitha kristian
45
24
Tidak
A. Eko joyo
37
25
Kadarzi
Konar Nailatul
33
26
Kadarzi
Khanzani Imroroatul
33
27
Kadarzi
25
28
Tidak
Yesi Putri
50
29
Kadarzi
Satria panggi
23
30
Kadarzi
Dafita N Nieza
14
Jumlah KADARZI
Arshika
22
Keterangan :
Jenis Kelamin diisi jika Laki-laki ditulis 1 dan jika Perempuan ditulis 2
Kadarzi jika jawaban :
N0.1 = 1 N0.2 = 1 N0.3 = 1 N0.4 = 1 N0.5 = 1 N0.6 = 0 N0.7 = 0 N0.8 = 0 (Bayi < 6 bln)
N0.1 = 1 N0.2 = 1 N0.3 = 1 N0.4 = 1 N0.5 = 1 N0.6 = 0 N0.7 = 0 N0.8 = 1 (Bayi < 6 bln + Nifas)
N0.1 = 1 N0.2 = 1 N0.3 = 1 N0.4 = 1 N0.5 = 1 N0.6 = 0 N0.7 = 1 N0.8 = 0 (Bayi < 6 bln + Hamil)
N0.1 = 1 N0.2 = 0 N0.3 = 1 N0.4 = 1 N0.5 = 1 N0.6 = 1 N0.7 = 0 N0.8 = 0 (Bayi > 6 bln)
N0.1 = 1 N0.2 = 0 N0.3 = 1 N0.4 = 1 N0.5 = 1 N0.6 = 1 N0.7 = 1 N0.8 = 0 (Bayi > 6 bln + Hamil)
73%
Kadarzi
Pelaksana
BB
(Kg)
TB
atau
PB
(Cm)
13.4
98.3
14.8
97.9
11.1
94.6
16.3
93.6
11.5
90.1
10.6
87
10.4
89.1
14.7
86.5
13.6
88.6
11.2
84
11.5
80.2
8.3
78
13.4
85.4
9.1
81.3
8.5
80.1
12.5
83.2
11.7
79.9
8.8
78.2
8.8
78.3
9.7
73.2
12
94.5
14
98.3
15
96.4
12.5
89
13.5
86
19.5
87.8
11.3
83
27
98
10
83
8.9
76
Kadarzi
.....
No. Resp.
No.1
No.2
No.3
No.4
No.5
No.6
No.7
1
No.8
Jenis
Kadarzi/
Kelamin Umur
NAMA BALITA
Tidak
(1 atau (Bln)
2)
Kadarzi Yolanda
Tidak
Tidak
12
Kadarzi Haidar
10
Kadarzi Aska
Kadarzi Almira
10
Kadarzi Salwa
11
12
Kadarzi Raihati
13
Kadarzi Ilham
20
14
Kadarzi A Novan
27
15
Kadarzi Aditya
14
16
Kadarzi Rafi
17
17
Kadarzi Arum
30
18
Kadarzi janita
32
19
28
20
36
21
Kadarzi Agasta
34
22
Tidak
Nur Mahmud
33
23
Tidak
Tapta
35
24
Kadarzi Vita
35
25
Tidak
42
26
Kadarzi Desika
32
27
40
28
Kadarzi Sherin
45
29
Kadarzi Alivia
42
30
Kadarzi Jesika
15
Jumlah KADARZI
Nadiva nada
Vanesa putri
Abd Wakit
25
Keterangan :
Jenis Kelamin diisi jika Laki-laki ditulis 1 dan jika Perempuan ditulis 2
Kadarzi jika jawaban :
N0.1 = 1 N0.2 = 1 N0.3 = 1 N0.4 = 1 N0.5 = 1 N0.6 = 0 N0.7 = 0 N0.8 = 0 (Bayi < 6 bln)
N0.1 = 1 N0.2 = 1 N0.3 = 1 N0.4 = 1 N0.5 = 1 N0.6 = 0 N0.7 = 0 N0.8 = 1 (Bayi < 6 bln + Nifas)
N0.1 = 1 N0.2 = 1 N0.3 = 1 N0.4 = 1 N0.5 = 1 N0.6 = 0 N0.7 = 1 N0.8 = 0 (Bayi < 6 bln + Hamil)
N0.1 = 1 N0.2 = 0 N0.3 = 1 N0.4 = 1 N0.5 = 1 N0.6 = 1 N0.7 = 0 N0.8 = 0 (Bayi > 6 bln)
N0.1 = 1 N0.2 = 0 N0.3 = 1 N0.4 = 1 N0.5 = 1 N0.6 = 1 N0.7 = 1 N0.8 = 0 (Bayi > 6 bln + Hamil)
83%
Kadarzi
Pelaksana
BB
(Kg)
TB
atau
PB
(Cm)
6.9
65.2
6.5
65
4.5
53.4
60.3
50.2
13
74.2
9.4
72.4
8.7
63.2
5.5
57.2
5.5
60.1
8.5
71.2
69.2
10.1
84
10
87
74.2
11
80.1
19
89.2
17
91.2
11
87.2
15
86.3
11
89.2
15
93.7
14
94.3
14
95
14
98.1
11
88.8
12
92.9
14 101.2
13
100
10
72.1
Kadarzi
.....
No. Resp.
No.1
No.2
No.3
No.4
No.5
No.6
No.7
No.8
Jenis
Kadarzi/
Kelamin Umur
NAMA BALITA
Tidak
(1 atau (Bln)
2)
Kadarzi
Jauhar
23
Tidak
Shinta
43
Kadarzi
Natsya
11
Kadarzi
Chelsea
20
Tidak
Fathan
44
Tidak
Eka Nur S
47
Tidak
Bayu saputra
46
Tidak
Rangga
39
Kadarzi
Epril
41
10
Kadarzi
Noval
35
11
Kadarzi
Rakha
33
12
Kadarzi
Zahra
48
13
Tidak
Rafa
49
14
Kadarzi
Mada
34
15
Tidak
Devin
52
16
Kadarzi
Zahwa
29
17
Kadarzi
April
41
18
Kadarzi
Rendy
39
19
Kadarzi
Hana
50
20
Tidak
Arya
30
21
Kadarzi
Rifky aditya
43
22
Kadarzi
Febria
18
23
Kadarzi
Bintang
32
24
Tidak
Citra
46
25
Kadarzi
Gierany
28
26
Kadarzi
Melinda putri
15
27
Kadarzi
Banyu bening
14
28
Kadarzi
Nabila putri
21
29
Kadarzi
Talitha
14
30
Kadarzi
Aisyah
33
Jumlah KADARZI
21
Keterangan :
Jenis Kelamin diisi jika Laki-laki ditulis 1 dan jika Perempuan ditulis 2
Kadarzi jika jawaban :
N0.1 = 1 N0.2 = 1 N0.3 = 1 N0.4 = 1 N0.5 = 1 N0.6 = 0 N0.7 = 0 N0.8 = 0 (Bayi < 6 bln)
N0.1 = 1 N0.2 = 1 N0.3 = 1 N0.4 = 1 N0.5 = 1 N0.6 = 0 N0.7 = 0 N0.8 = 1 (Bayi < 6 bln + Nifas)
N0.1 = 1 N0.2 = 1 N0.3 = 1 N0.4 = 1 N0.5 = 1 N0.6 = 0 N0.7 = 1 N0.8 = 0 (Bayi < 6 bln + Hamil)
N0.1 = 1 N0.2 = 0 N0.3 = 1 N0.4 = 1 N0.5 = 1 N0.6 = 1 N0.7 = 0 N0.8 = 0 (Bayi > 6 bln)
N0.1 = 1 N0.2 = 0 N0.3 = 1 N0.4 = 1 N0.5 = 1 N0.6 = 1 N0.7 = 1 N0.8 = 0 (Bayi > 6 bln + Hamil)
70%
Kadarzi
Pelaksana
BB
(Kg)
TB
atau
PB
(Cm)
13.2
85.3
14
88.2
7.8
70.7
10
78
17.3 106.2
17.5
99.7
13.2
94.5
21
92.1
11.8
98.6
16
93.4
10.5
87.3
16.4
97
15 100.2
12.1
90.1
15.3
98.3
15
87.6
17
96
10.4
90.4
10.5
98.5
14
98
12.5
94.4
15
80
21.2
98.5
12.3
89.8
12.4
92
76.3
9.5
75
12.2
88.2
9.1
76
11.1
85.1
Kadarzi
.....
No. Resp.
No.1
No.2
No.3
No.4
No.5
No.6
No.7
No.8
Jenis
Kadarzi/
Kelamin Umur
NAMA BALITA
Tidak
(1 atau (Bln)
2)
Tidak
58
58
Tidak
Neneng Dian
54
Tidak
Wildan riski
53
Tidak
Davian
50
Tidak
Adenta
48
Kadarzi Endhita F R
46
Tidak
M Rofi
45
Tidak
Anabel denara
45
10
42
11
42
12
39
13
Kadarzi Marwah A
37
14
Tidak
34
15
Kadarzi M Nizam
31
16
Kadarzi M Dafa
30
17
Kadarzi A Salim
28
18
Kadarzi Riski A
26
19
25
20
Kadarzi Meywa
25
21
Kadarzi Dinda
21
22
Tidak
17
23
Kadarzi M Insanul
15
24
Kadarzi M Syah A. K
13
25
Tidak
12
26
Kadarzi Keyla N
12
27
Tidak
Meilichia
28
Kadarzi Kheyvita
29
30
Jumlah KADARZI
M Aldira
Nizam
Nesya Alendra
M Khadafi
19
Keterangan :
Jenis Kelamin diisi jika Laki-laki ditulis 1 dan jika Perempuan ditulis 2
Kadarzi jika jawaban :
N0.1 = 1 N0.2 = 1 N0.3 = 1 N0.4 = 1 N0.5 = 1 N0.6 = 0 N0.7 = 0 N0.8 = 0 (Bayi < 6 bln)
N0.1 = 1 N0.2 = 1 N0.3 = 1 N0.4 = 1 N0.5 = 1 N0.6 = 0 N0.7 = 0 N0.8 = 1 (Bayi < 6 bln + Nifas)
N0.1 = 1 N0.2 = 1 N0.3 = 1 N0.4 = 1 N0.5 = 1 N0.6 = 0 N0.7 = 1 N0.8 = 0 (Bayi < 6 bln + Hamil)
N0.1 = 1 N0.2 = 0 N0.3 = 1 N0.4 = 1 N0.5 = 1 N0.6 = 1 N0.7 = 0 N0.8 = 0 (Bayi > 6 bln)
N0.1 = 1 N0.2 = 0 N0.3 = 1 N0.4 = 1 N0.5 = 1 N0.6 = 1 N0.7 = 1 N0.8 = 0 (Bayi > 6 bln + Hamil)
63%
Tidak
Balongbendo, 15 A
Pelaksana
A. Sholakhuddin
BB
(Kg)
TB
atau
PB
(Cm)
17.6 106.1
13.7 101.3
13.2
98.4
16.3
101
14.7
99.5
14
93.7
14.2
97.8
14
95.6
16.3
98.7
16.9
97
13.5
100
21.9
95
12.5
94
11.7
89.9
14.2
89.5
12.2
87.6
9.4
87.8
9.4
88.1
10.9
84.5
19
84.2
10.2
83.2
9.2
83.5
9.6
78.8
8.6
74.4
8.9
74.3
7.5
76.3
57
5.3
54
5.4
53
4.9
52
Tidak
Sholakhuddin
No. Resp.
No.1
No.2
No.3
No.4
No.5
No.6
No.7
No.8
Jenis
Kadarzi/
Kelamin Umur
NAMA BALITA
Tidak
(1 atau (Bln)
2)
Tidak
Tidak
Tidak
Tidak
Tidak
Tidak
Tidak
Tidak
Tidak
10
Tidak
11
Tidak
12
Tidak
13
Tidak
14
Tidak
15
Tidak
16
Tidak
17
Tidak
18
Tidak
19
Tidak
20
Tidak
21
Tidak
22
Tidak
23
Tidak
24
Tidak
25
Tidak
26
Tidak
27
Tidak
28
Tidak
29
Tidak
30
Tidak
Jumlah KADARZI
Keterangan :
Jenis Kelamin diisi jika Laki-laki ditulis 1 dan jika Perempuan ditulis 2
Kadarzi jika jawaban :
N0.1 = 1 N0.2 = 1 N0.3 = 1 N0.4 = 1 N0.5 = 1 N0.6 = 0 N0.7 = 0 N0.8 = 0 (Bayi < 6 bln)
N0.1 = 1 N0.2 = 1 N0.3 = 1 N0.4 = 1 N0.5 = 1 N0.6 = 0 N0.7 = 0 N0.8 = 1 (Bayi < 6 bln + Nifas)
N0.1 = 1 N0.2 = 1 N0.3 = 1 N0.4 = 1 N0.5 = 1 N0.6 = 0 N0.7 = 1 N0.8 = 0 (Bayi < 6 bln + Hamil)
N0.1 = 1 N0.2 = 0 N0.3 = 1 N0.4 = 1 N0.5 = 1 N0.6 = 1 N0.7 = 0 N0.8 = 0 (Bayi > 6 bln)
N0.1 = 1 N0.2 = 0 N0.3 = 1 N0.4 = 1 N0.5 = 1 N0.6 = 1 N0.7 = 1 N0.8 = 0 (Bayi > 6 bln + Hamil)
0%
Tidak
Pelaksana
BB
(Kg)
TB
atau
PB
(Cm)
Tidak
.....
No. Resp.
No.1
No.2
No.3
No.4
No.5
No.6
No.7
No.8
Jenis
Kadarzi/
Kelamin Umur
NAMA BALITA
Tidak
(1 atau (Bln)
2)
Tidak
Tidak
Tidak
Tidak
Tidak
Tidak
Tidak
Tidak
Tidak
10
Tidak
11
Tidak
12
Tidak
13
Tidak
14
Tidak
15
Tidak
16
Tidak
17
Tidak
18
Tidak
19
Tidak
20
Tidak
21
Tidak
22
Tidak
23
Tidak
24
Tidak
25
Tidak
26
Tidak
27
Tidak
28
Tidak
29
Tidak
30
Tidak
Jumlah KADARZI
Keterangan :
Jenis Kelamin diisi jika Laki-laki ditulis 1 dan jika Perempuan ditulis 2
Kadarzi jika jawaban :
N0.1 = 1 N0.2 = 1 N0.3 = 1 N0.4 = 1 N0.5 = 1 N0.6 = 0 N0.7 = 0 N0.8 = 0 (Bayi < 6 bln)
N0.1 = 1 N0.2 = 1 N0.3 = 1 N0.4 = 1 N0.5 = 1 N0.6 = 0 N0.7 = 0 N0.8 = 1 (Bayi < 6 bln + Nifas)
N0.1 = 1 N0.2 = 1 N0.3 = 1 N0.4 = 1 N0.5 = 1 N0.6 = 0 N0.7 = 1 N0.8 = 0 (Bayi < 6 bln + Hamil)
N0.1 = 1 N0.2 = 0 N0.3 = 1 N0.4 = 1 N0.5 = 1 N0.6 = 1 N0.7 = 0 N0.8 = 0 (Bayi > 6 bln)
N0.1 = 1 N0.2 = 0 N0.3 = 1 N0.4 = 1 N0.5 = 1 N0.6 = 1 N0.7 = 1 N0.8 = 0 (Bayi > 6 bln + Hamil)
0%
Tidak
Pelaksana
BB
(Kg)
TB
atau
PB
(Cm)
Tidak
.....
No. Resp.
No.1
No.2
No.3
No.4
No.5
No.6
No.7
No.8
Jenis
Kadarzi/
Kelamin Umur
NAMA BALITA
Tidak
(1 atau (Bln)
2)
Tidak
Tidak
Tidak
Tidak
Tidak
Tidak
Tidak
Tidak
Tidak
10
Tidak
11
Tidak
12
Tidak
13
Tidak
14
Tidak
15
Tidak
16
Tidak
17
Tidak
18
Tidak
19
Tidak
20
Tidak
21
Tidak
22
Tidak
23
Tidak
24
Tidak
25
Tidak
26
Tidak
27
Tidak
28
Tidak
29
Tidak
30
Tidak
Jumlah KADARZI
Keterangan :
Jenis Kelamin diisi jika Laki-laki ditulis 1 dan jika Perempuan ditulis 2
Kadarzi jika jawaban :
N0.1 = 1 N0.2 = 1 N0.3 = 1 N0.4 = 1 N0.5 = 1 N0.6 = 0 N0.7 = 0 N0.8 = 0 (Bayi < 6 bln)
N0.1 = 1 N0.2 = 1 N0.3 = 1 N0.4 = 1 N0.5 = 1 N0.6 = 0 N0.7 = 0 N0.8 = 1 (Bayi < 6 bln + Nifas)
N0.1 = 1 N0.2 = 1 N0.3 = 1 N0.4 = 1 N0.5 = 1 N0.6 = 0 N0.7 = 1 N0.8 = 0 (Bayi < 6 bln + Hamil)
N0.1 = 1 N0.2 = 0 N0.3 = 1 N0.4 = 1 N0.5 = 1 N0.6 = 1 N0.7 = 0 N0.8 = 0 (Bayi > 6 bln)
N0.1 = 1 N0.2 = 0 N0.3 = 1 N0.4 = 1 N0.5 = 1 N0.6 = 1 N0.7 = 1 N0.8 = 0 (Bayi > 6 bln + Hamil)
0%
Tidak
Pelaksana
BB
(Kg)
TB
atau
PB
(Cm)
Tidak
.....
No. Resp.
No.1
No.2
No.3
No.4
No.5
No.6
No.7
No.8
Jenis
Kadarzi/
Kelamin Umur
NAMA BALITA
Tidak
(1 atau (Bln)
2)
Tidak
Tidak
Tidak
Tidak
Tidak
Tidak
Tidak
Tidak
Tidak
10
Tidak
11
Tidak
12
Tidak
13
Tidak
14
Tidak
15
Tidak
16
Tidak
17
Tidak
18
Tidak
19
Tidak
20
Tidak
21
Tidak
22
Tidak
23
Tidak
24
Tidak
25
Tidak
26
Tidak
27
Tidak
28
Tidak
29
Tidak
30
Tidak
Jumlah KADARZI
Keterangan :
Jenis Kelamin diisi jika Laki-laki ditulis 1 dan jika Perempuan ditulis 2
Kadarzi jika jawaban :
N0.1 = 1 N0.2 = 1 N0.3 = 1 N0.4 = 1 N0.5 = 1 N0.6 = 0 N0.7 = 0 N0.8 = 0 (Bayi < 6 bln)
N0.1 = 1 N0.2 = 1 N0.3 = 1 N0.4 = 1 N0.5 = 1 N0.6 = 0 N0.7 = 0 N0.8 = 1 (Bayi < 6 bln + Nifas)
N0.1 = 1 N0.2 = 1 N0.3 = 1 N0.4 = 1 N0.5 = 1 N0.6 = 0 N0.7 = 1 N0.8 = 0 (Bayi < 6 bln + Hamil)
N0.1 = 1 N0.2 = 0 N0.3 = 1 N0.4 = 1 N0.5 = 1 N0.6 = 1 N0.7 = 0 N0.8 = 0 (Bayi > 6 bln)
N0.1 = 1 N0.2 = 0 N0.3 = 1 N0.4 = 1 N0.5 = 1 N0.6 = 1 N0.7 = 1 N0.8 = 0 (Bayi > 6 bln + Hamil)
0%
Tidak
Pelaksana
BB
(Kg)
TB
atau
PB
(Cm)
Tidak
.....
No. Resp.
No.1
No.2
No.3
No.4
No.5
No.6
No.7
No.8
Jenis
Kadarzi/
Kelamin Umur
NAMA BALITA
Tidak
(1 atau (Bln)
2)
Tidak
Tidak
Tidak
Tidak
Tidak
Tidak
Tidak
Tidak
Tidak
10
Tidak
11
Tidak
12
Tidak
13
Tidak
14
Tidak
15
Tidak
16
Tidak
17
Tidak
18
Tidak
19
Tidak
20
Tidak
21
Tidak
22
Tidak
23
Tidak
24
Tidak
25
Tidak
26
Tidak
27
Tidak
28
Tidak
29
Tidak
30
Tidak
Jumlah KADARZI
Keterangan :
Jenis Kelamin diisi jika Laki-laki ditulis 1 dan jika Perempuan ditulis 2
Kadarzi jika jawaban :
N0.1 = 1 N0.2 = 1 N0.3 = 1 N0.4 = 1 N0.5 = 1 N0.6 = 0 N0.7 = 0 N0.8 = 0 (Bayi < 6 bln)
N0.1 = 1 N0.2 = 1 N0.3 = 1 N0.4 = 1 N0.5 = 1 N0.6 = 0 N0.7 = 0 N0.8 = 1 (Bayi < 6 bln + Nifas)
N0.1 = 1 N0.2 = 1 N0.3 = 1 N0.4 = 1 N0.5 = 1 N0.6 = 0 N0.7 = 1 N0.8 = 0 (Bayi < 6 bln + Hamil)
N0.1 = 1 N0.2 = 0 N0.3 = 1 N0.4 = 1 N0.5 = 1 N0.6 = 1 N0.7 = 0 N0.8 = 0 (Bayi > 6 bln)
N0.1 = 1 N0.2 = 0 N0.3 = 1 N0.4 = 1 N0.5 = 1 N0.6 = 1 N0.7 = 1 N0.8 = 0 (Bayi > 6 bln + Hamil)
0%
Tidak
Pelaksana
BB
(Kg)
TB
atau
PB
(Cm)
Tidak
.....
No. Resp.
No.1
No.2
No.3
No.4
No.5
No.6
No.7
No.8
Jenis
Kadarzi/
Kelamin Umur
NAMA BALITA
Tidak
(1 atau (Bln)
2)
Tidak
Tidak
Tidak
Tidak
Tidak
Tidak
Tidak
Tidak
Tidak
10
Tidak
11
Tidak
12
Tidak
13
Tidak
14
Tidak
15
Tidak
16
Tidak
17
Tidak
18
Tidak
19
Tidak
20
Tidak
21
Tidak
22
Tidak
23
Tidak
24
Tidak
25
Tidak
26
Tidak
27
Tidak
28
Tidak
29
Tidak
30
Tidak
Jumlah KADARZI
Keterangan :
Jenis Kelamin diisi jika Laki-laki ditulis 1 dan jika Perempuan ditulis 2
Kadarzi jika jawaban :
N0.1 = 1 N0.2 = 1 N0.3 = 1 N0.4 = 1 N0.5 = 1 N0.6 = 0 N0.7 = 0 N0.8 = 0 (Bayi < 6 bln)
N0.1 = 1 N0.2 = 1 N0.3 = 1 N0.4 = 1 N0.5 = 1 N0.6 = 0 N0.7 = 0 N0.8 = 1 (Bayi < 6 bln + Nifas)
N0.1 = 1 N0.2 = 1 N0.3 = 1 N0.4 = 1 N0.5 = 1 N0.6 = 0 N0.7 = 1 N0.8 = 0 (Bayi < 6 bln + Hamil)
N0.1 = 1 N0.2 = 0 N0.3 = 1 N0.4 = 1 N0.5 = 1 N0.6 = 1 N0.7 = 0 N0.8 = 0 (Bayi > 6 bln)
N0.1 = 1 N0.2 = 0 N0.3 = 1 N0.4 = 1 N0.5 = 1 N0.6 = 1 N0.7 = 1 N0.8 = 0 (Bayi > 6 bln + Hamil)
0%
Tidak
Pelaksana
BB
(Kg)
TB
atau
PB
(Cm)
Tidak
.....