DESA : Randulawang DESA : RANDULAWANG

KECAMATAN : Jati KECAMATAN : JATI

Jenis Status

Kelam

Hub Kelg Tgl Lahir in Kawin

1=Pegawai Tempat dd/mm/yyyy 1= L 1= BK
NO NO KK NIK Nama Lengkap
2= Suami 2=K
3= Istri 3=CH,
4= Anak 4 CM,
5=Tanggung 5=Tdk
an Lahir ( 16/04/1983) 2=P Tahu
1 3316012601083959 3316017112500114 SARIYEM 5 BLORA 31/12/1960 2 4
2 3316012601083959 3316014711840002 NYUMI 3 BLORA 07/11/1984 2 2
3 3316012601083959 3316012102820002 SUPRIYANTO 2 BLORA 21/02/1982 1 2
4 3316012601083959 3316017007160001 ZAHRA AYUNI 4 BLORA 30/7/2015 2 1
5 3316012601083959 3316010108090002 RASYA ALDINO PUTRA 4 BLORA 01/08/2009 1 1
6 3316012410130003 3316020802760001 SUPARNO 2 BLORA 08/02/1976 1 2
7 3316012601083967 3316013112500102 SUWONO 2 BLORA 31/12/1950 1 2
8 3316012601083967 3316017112600182 SUKARNI 3 BLORA 31/12/1960 2 2
9 3316012601083251 3316012006120001 ALDERA GILANG PRATA 5 BLORA 20/06/2012 1 1
10 3316011309110001 3316016811110001 SRI WIJIASTUTIK 4 BLORA 28/11/2011 2 1
11 3316012601083262 3316012912120002 HAIKAL AKBAR 4 BLORA 29/12/2012 1 1
12 3316012601083261 3316013112590056 PONIMAN 2 BLORA 31/12/1959 1 2
13 3316012601083261 3316017112680078 SUWARTI 3 BLORA 31/12/1968 2 2
14 3316012601083261 3316015604940003 DWI RAHAYU 4 BLORA 31/12/1930 2 1
15 331601 2601083800 331601 111266002 lasidin 2 Blora 11/12/1966 1 2
16 331601 2601083800 331601 5704720000 suwarni 3 Blora 17/4/1972 2 2
17 331601 2601083800 331601 2509980001 aziz dwi risvan 4 Blora 25/9/1998 1 1
18 331601 2808120006 331601 0710890001 aris mugi utomo 2 Blora 7/10/1989 1 2
19 331601 2808120006 331602 8712920010 pina panduwinata 3 Blora 27/12/1992 2 1
20 331601 2808120006 331601 681112000`1 almaira kirana larasati 4 Blora 18/11/2012 2 1
21 331601 2601083803 331601 1703730002 sugiarno 2 Blora `17/3/1973 1 2
22 331601 2601083803 331601 4406740003 suwarni 3 Blora 4/6/1974 2 2
23 331601 2601083803 331601 2709060001 dheny purbo anggoro 4 Blora 1/12/1998 1 1
24 331601 2601083803 331601 2709060001 dhino ivan ramadhan 4 Blora 27/9/2006 1 1
25 3316010103100002 3316010507780003 SUPRIYANTO 2 BLORA 5-07-1978 1 2
26 3316010103100002 3316014207840002 SARIYATUN 3 BLORA 02-07-1984 2 2
27 3316010103100002 3316016310090001 NABILA PUTRI APRITASA 4 BLORA 23-10-2009 2 1
28 3316012601083807 3316012404810004 RASMIN 2 BLORA 24-04-1981 1 2
29 3316012601083807 3316016808810002 PUJIASIH 3 BLORA 28-08-1981 2 2
30 3316012601083807 3316016702010001 YAHNI WULANDARI 4 BLORA 27-02-2001 2 1
31 3316012601083807 3316015905100001 MURTINI 4 BLORA 19-05 2010 2 1
32 3316012601084234 3316012901640001 LILIK JOKO SULISTYONO 2 BLORA 29-01-1964 1 2
35 3316012601083790 3316011405690001 SUHARNO 2 BLORA 14-05-1969 1 2
36 3316012601083790 3316014102740001 TARMINAH 3 KEBUMEN 01-02-1974 2 2
37 3316012601083790 3316017012980004 SUCI ARTHANINGRUNG 4 BLORA 30-12-1998 2 1
38 3316012601083790 3316014102050001 FERLINA DWI ARTHANI 4 BLORA 01-02 2 1
39 3316012601084086 3316011512820004 Juwadi 2 BLORA 15/12/1982 1 2
40 3316012601084086 3316017011850003 jumiati 3 BLORA 30/11/1985 2 2
41 3316012601084086 3316010612060001 ilham adhi pratama 4 BLORA 6/12/2006 1 1
42 3316012601084086 3316016108130001 Vitri Aulia Dwi V 4 BLORA 11/8/2013 2 1
43 3316012811083796 3316010203600001 Samin 2 BLORA 2/3/1960 1 2
44 3316012811083796 3316016812630001 Suwarsih 3 BLORA 28/12/1963 2 2
45 3316012811083796 3316010908910001 Dwi utomo 4 BLORA 9/8/1991 1 1
46 3316012601084052 3316014411100002 Annisa Novia Dewi 4 BLORA 4/11/2010 2 1
47 3316012601083751 3316010407700004 SETU 2 BLORA 4/7/1970 1 2
48 3316012601083751 3316016009710001 MURNI 3 BLORA 20/9/1971 2 2
49 3316012601083751 33160 12709970001 NUR RAHMAN HIDAYAT 4 BLORA 27/9/1997 1 1
50 3316012601083751 33160 11808030000 IKSANUL ARIFIN 4 BLORA 18/8/2003 1 1
51 3316012601084050 3316012712030001 RIDWAN MUSTOFA 4 BLORA 27-12-2013 1 1
52 3316013105120002 3316011508860003 SUMBITO 2 BLORA 15-08-1986 1 2
53 3316013105120002 3316011012120002 RISKI ABDUL ROHMAN 4 BLORA 10-12-2012 1 1
 Kode Pos Kode Nama KodeDesa Kode Faskes Nama Faskes Tk 1
Kecamatan( Tk 1( diisi
Kecamat Nma Desa petugas)
diisi
Nma Faskes
Alamat Tempat Tinggal RT RW petugas) an (diisipetugas)
Tk I

RANDULAWANG 17 8 58384 JATI RANDULAWANG RANDULAWANG

RANDULAWANG 17 8 58384 JATI RANDULAWANG RANDULAWANG
RANDULAWANG 17 8 58384 JATI RANDULAWANG RANDULAWANG
RANDULAWANG 17 8 58384 JATI RANDULAWANG RANDULAWANG
RANDULAWANG 17 8 58384 JATI RANDULAWANG RANDULAWANG
RANDULAWANG 17 8 58384 JATI RANDULAWANG RANDULAWANG
RANDULAWANG 17 8 58384 JATI RANDULAWANG RANDULAWANG
RANDULAWANG 17 8 58384 JATI RANDULAWANG RANDULAWANG
KARANGGENENG 6 3 58384 JATI RANDULAWANG RANDULAWANG
KARANGGENENG 5 3 58384 JATI RANDULAWANG RANDULAWANG
KARANGGENENG 6 3 58384 JATI RANDULAWANG RANDULAWANG
KARANGGENENG 6 3 58384 JATI RANDULAWANG RANDULAWANG
KARANGGENENG 6 3 58384 JATI RANDULAWANG RANDULAWANG
KARANGGENENG 6 3 58384 JATI RANDULAWANG RANDULAWANG
randulawang 2 1 58384 jati randulawang randulawang
randulawang 2 1 58384 jati randulawang randulawang
randulawang 2 1 583284 jati randulawang randulawang
randulawang 2 1 58384 jati randulawang randulawang
randulawang 2 1 58384 jati randulawang randulawang
randulawang 2 1 58384 jati randulawang randulawang
randulawang 2 1 58384 jati randulawang randulawang
randulawang 2 1 58384 jati randulawang randulawang
randulawang 2 1 58384 jati randulawang randulawang
randulawang 2 1 58384 jati randulawang randulawang
NGROMBO 2 1 58384 JATI RANDULAWANG RANDULAWANG
NGROMBO 2 1 58384 JATI RANDULAWANG RANDULAWANG
NGROMBO 2 1 58384 JATI RANDULAWANG RANDULAWANG
NGROMBO 2 1 58384 JATI RANDULAWANG RANDULAWANG
NGROMBO 2 1 58384 JATI RANDULAWANG RANDULAWANG
NGROMBO 2 1 58384 JATI RANDULAWANG RANDULAWANG
NGROMBO 2 1 58384 JATI RANDULAWANG RANDULAWANG
TROJIWO 20 9 58384 JATI RANDULAWANG RANDULAWANG
NGROMBO 1 1 58384 JATI RANDULAWANG RANDULAWANG
NGROMBO 1 1 58384 JATI RANDULAWANG RANDULAWANG
NGROMBO 1 1 58384 JATI RANDULAWANG RANDULAWANG
NGROMBO 1 1 58384 JATI RANDULAWANG RANDULAWANG
NGROMBO 1 1 58384 JATI RANDULAWANG RANDULAWANG
NGROMBO 1 1 58384 JATI RANDULAWANG RANDULAWANG
NGROMBO 1 1 58384 JATI RANDULAWANG RANDULAWANG
NGROMBO 1 1 58384 JATI RANDULAWANG RANDULAWANG
NGROMBO 2 1 58384 JATI RANDULAWANG RANDULAWANG
NGROMBO 2 1 58384 JATI RANDULAWANG RANDULAWANG
NGROMBO 2 1 58384 JATI RANDULAWANG RANDULAWANG
NGROMBO 3 2 58384 JATI RANDULAWANG RANDULAWANG
NGROMBO 1 1 58384 JATI RANDULAWANG RANDULAWANG
NGROMBO 1 1 58384 JATI RANDULAWANG RANDULAWANG
NGROMBO 1 1 58384 JATI RANDULAWANG RANDULAWANG
NGROMBO 1 1 58384 JATI RANDULAWANG RANDULAWANG
NGROMBO 1 1 58384 JATI RANDULAWANG RANDULAWANG
NGROMBO 2 1 58384 JATI RANDULAWANG RANDULAWANG
NGROMBO 2 1 58384 JATI RANDULAWANG RANDULAWANG
58384
58384
58384
DESA :Pelem
KECAMATAN : Jati

Jenis Status

NO

Hub Kelg Tgl Lahir Kelamin Kawin

NO KK NIK Nama Lengkap 1=Pegawai Tempat dd/mm/yyyy 1= L 1= BK
2= Suami 2=K
3= Istri 3=CH, 4
4= Anak CM,
5=Tanggung 5=Tdk
an Lahir ( 16/04/1983) 2=P Tahu
1 3316012501084409 3316014608820004 ENDANG SETYOWATI 3 BLORA 06/08/1982 2 2
2 3316012501084409 3316010603010002 HENDRA PURWO 4 BLORA 06-03-2001 1 1
3 3316012501084409 3316016603090001 DWI ZAHRA ULZAITY 4 BLORA 26/03/2009 2 1
4 3316011109080001 3316010106820004 SUDARI 2 BLORA 01/06/1982 1 2
5 3316011109080001 3316014503830002 SITI YULAIKAH 3 BLORA 05/03/1983 2 2
6 3316011109080001 3316014505070001 NURUL AISYAH FADHILA 4 BLORA 05/05/2007 2 1
7 3316011109080001 3316014202150001 KHAIRINA RAHMATIANIULAN 4 BLORA 02/02/2015 2 1
8 3316012501083873 3316011911690001 SUWARNO 2 BLORA 19/11/1969 1 2
9 3316012501083873 3316014303800004 SRI WAHYUTI 3 BLORA 03/03/1980 2 2
10 3316012501083873 3316012011010004 WAHYU ALVIANTO 4 BLORA 20/11/2001 1 1
11 3316012501083873 3316010304090001 SETO KURNIAWAN 4 BLORA 03/04/2009 1 1
12 3316012501084181 3316010901750001 NGADIMAN 2 BLORA 09/01/1975 1 2
13 3316012501084181 3316016204760001 SUPATMI 3 BLORA 22/04/1976 2 2
14 3316012501084181 3316015101990001 ELINDA PRIMA ANANDA 4 BLORA 11/01/1999 2 1
15 3316012501084181 3316010101030004 BOYKE PRIMA ANANDA 4 BLORA 01/01/2003 1 1
16 3316012501084181 3316014112100001 ADINDA PRIMA 4 BLORA 01/12/2010 2 1
17 3316012501084527 3316011708690001 SYAKING 2 BLORA 17/08/1969 1 2
18 3316012501084527 3316015312730001 SITI MARIYAM 3 BLORA 13/12/1973 2 2
19 3316012501084527 3316012709960001 AGUS WIDODO 4 BLORA 27/09/1996 1 1
20 3316012501084537 3316011607490001 sagi 2 Blora 16/7/1949 1 2
21 3316012501084537 331601 4911590000 laminah 3 Blora 9/11/1959 2 2
22 3316012807090015 3316015003860006 SUKARTI 3 BLORA 10/03/1986 2 2
23 3316012807090015 3316020901800006 SUNARDI 2 BLORA 9/1/1930 1 2
24 3316012807090015 3316011807050001 EKO YULIANTO 4 BLORA 18/07/2005 1 1
25 3316012807090015 3316016811120002 ALIKHA RADELLIA NOVIANTI 4 BLORA 28/11/2012 2 1
26 3316011411680002 3316010902800002 SUSILO 2 BLORA 09/02/1980 1 2
27 3316011411680002 3316044307860003 SUPRIHARTINI 3 BLORA 03/198607/ 2 2
28 3316011411680002 3318018708100001 ALFREDA RAMADHANI AUGU 4 BLORA 27-08-2010 2 1
29 3316012501084185 3316010703660001 SUPARNO 2 BLORA 07-03-1966 1 2
30 3316012501084185 3316014401660001 MURWATI 3 BLORA 04-01-1966 2 2
31 3316012501084185 3316016703990001 FIVI YULAEDHIA DIAHYA 4 BLORA 27-03-1999 2 1
32 3316012501084673 3316010806780004 WINARTO 2 BLORA 08-06-1978 1 2
33 3316012501084673 3316016212870001 SRI YUNITA 3 BLORA 22-12-1987 2 2
34 3316012501084673 3316010311070003 RENDRA MAHARDIKA SAPU 4 BLORA 03-11-2007 1 1
35 3316011011090004 3316011803780005 SUTARNO 2 BLORA 18-03-1978 1 2
36 3316011011090004 3316014603850007 TANTI 3 BLORA 06-03-1985 2 2
37 3316011011090004 3316015303050002 LILIS NUR ANNISSA 4 BLORA 13-03-2005 2 1
38 3316011011090004 3316015802100002 PUTRI DWI ANJARWATI 4 BLORA 18-02-2010 2 1
39 3316012501084234 3316013012580005 Kasno 2 BLORA 30/12/1956 1 2
40 3316012501084234 3316017112600147 Jumirah 3 BLORA 31/12/1960 2 2
41 3316011706100002 3316012001840001 Ngaji 2 BLORA 20/01/1984 1 2
42 3316011706100002 3316016504920002 Aprilia Prehatiningsih 3 BLORA 25/04/1992 2 2
43 3316011706100002 3316015404100001 Afriresta Zivelia Putri 4 BLORA 14/04/2010 2 1
44 3316012501084379 3316012506720001 Wiryanto 2 BLORA 25/06/1972 1 2
45 3316012501084379 3316015203800004 Pasri 3 BLORA 12/3/1980 2 2
46 3316012501084379 3316014110970001 Dina Nurul Oktavianti 4 BLORA 1/10/1997 2 1
47 3316012501084379 3316013106010001 Rofik Firmansyah 4 BLORA 31/08/2001 1 1
48 3316012501084379 3316010312120002 Nizzam Brillianto 4 BLORA 3/12/2012 1 1
49 33160 12501084553 33160 10809390001 JIMAN 2 BLORA 8/9/1939 1 2
50 33161 12501084553 33160 15504500001 SUPI 3 BLORA 15/4/1950 2 2
51 33160 11809150001 33160 10906870001 SANTOSO 2 BLORA 9/5/1987 1 2
52 33161 11809150001 33160 15007870007 TARMINI 3 BLORA 10/7/1987 2 2
53 33162 11809150001 33160 5503120002 MELISA EKE RATNASARI 4 BLORA 15/3/2012 2 1
54 33163 11809150001 33160 15212300004 NYAMI 5 BLORA 12/12/1930 2 5
55 33160 12501084570 33160 10402660001 JARWO 2 BLORA 4/2/1965 1 2
56 33161 12501084570 33160 14603660001 DARMINI 3 BLORA 5/3/1966 2 2
57 33160 12501084518 33160 11005790001 SUSITO 2 BLORA 1/5/19791 1 2
58 33161 12501084518 33160 15709810001 SASMIATI 3 BLORA 17/9/1981 2 2
59 33162 12501084518 33160 11901060003 ESNAWAN RESTU H U 4 BLORA 19/1/2006 2 1
60 33163 12501084518 33160 14606130001 SHAFA NUR AZIZAH 4 BLORA 6/6/2013 2 1
61 33160 12204150007 33160 1615107370001LAMPI 3 BLORA 11/7/1937 2 5
62 3316011912080001 3316012605780003 RIYANTO 2 BLORA 26-05-1978 1 2
63 3316011912080001 3316016710830001 SURYANI 3 BLORA 27-10-1983 2 2
64 3316011912080001 3316016710830001 JELITA NURA RAMADHANI 4 BLORA 25-09-2008 2 1
65 3316012501084428 3316010811620001 LOMO 2 BLORA 08-11-1962 1 2
66 3316012501084428 3316014403670002 SARMINI 3 BLORA 04-03-1967 2 2
67 3316012601084534 3316011204720004 NGADI 2 BLORA 12-04-1972 1 2
68 3316012601084534 3316016712770001 WARTINI 3 BLORA 27-12-1977 2 2
69 3316012601084534 3316010208990003 TEGUH SETYAWAN 4 BLORA 02-08-1999 1 1
70 3316012601084534 3316015405090001 MELINDA SETYA NINGRUM 4 BLORA 14-05-2009 2 1
71 3316012309100002 3316011705880004 MUHAMAD NUR SOLIKIN 2 BLORA 17-05-1988 1 2
72 3316012309100002 3316014101830002 SULASIH 3 BLORA 01-01-1983 2 2
73 3316012309100002 3316011909290003 MUHAMAD EKA RAMDHANI 4 BLORA 19-09-2009 1 1
74 3316011805090005 3316013007830001 WIDODO 2 BLORA 30-07-1983 1 2
75 3316011805090005 3316016307830003 DORISWATI 3 BLORA 23-07-1983 2 2
76 3316011805090005 3316015104100002 AFRINA NURUL ASTARI 4 BLORA 11-04-2010 2 1
77 3316011805090005 3316015506380003 RASMI 5 BLORA 15-06-1938 2 4
 Kode Pos Kode Nama KodeDesa Kode Nama Faskes Tk 1 KETERANGAN
Faskes Tk
Kecamata
Kecamata Nma Desa 1( diisi
n( diisi (diisipetu petugas)
Nma
Alamat Tempat Tinggal RT RW petugas) n gas) Faskes Tk
I SUDAH PUNYA

JAMKESMAS BARU
MINDI 9 5 58384 JATI PELEM RANDULAWANG
MINDI 9 5 58384 JATI PELEM RANDULAWANG
MINDI 9 5 58384 JATI PELEM RANDULAWANG
PELEM 1 1 58384 JATI PELEM RANDULAWANG
PELEM 1 1 58384 JATI PELEM RANDULAWANG
PELEM 1 1 58384 JATI PELEM RANDULAWANG
PELEM 1 1 58384 JATI PELEM RANDULAWANG
PELEM 1 1 58384 JATI PELEM RANDULAWANG
PELEM 1 1 58384 JATI PELEM RANDULAWANG
PELEM 1 1 58384 JATI PELEM RANDULAWANG
PELEM 1 1 58384 JATI PELEM RANDULAWANG
MINDI 8 5 58384 JATI PELEM RANDULAWANG
MINDI 8 5 58384 JATI PELEM RANDULAWANG
MINDI 8 5 58384 JATI PELEM RANDULAWANG
MINDI 8 5 58384 JATI PELEM RANDULAWANG
MINDI 8 5 58384 JATI PELEM RANDULAWANG
KD GLAGAH 6 4 58384 JATI PELEM RANDULAWANG
KD GLAGAH 6 4 58384 JATI PELEM RANDULAWANG
KD GLAGAH 6 4 58384 JATI PELEM RANDULAWANG
pelem 6 4 58384 JATI PELEM RANDULAWANG
pelem 6 4 58384 JATI PELEM RANDULAWANG
MINDI 9 5 58384 JATI PELEM RANDULAWANG
MINDI 9 5 58384 JATI PELEM RANDULAWANG
MINDI 9 5 58384 JATI PELEM RANDULAWANG
MINDI 9 5 58384 JATI PELEM RANDULAWANG
MINDI 8 5 58384 JATI PELEM RANDULAWANG
MINDI 8 5 58384 JATI PELEM RANDULAWANG
MINDI 8 5 58384 JATI PELEM RANDULAWANG
MINDI 8 5 58384 JATI PELEM RANDULAWANG
MINDI 8 5 58384 JATI PELEM RANDULAWANG
MINDI 8 5 58384 JATI PELEM RANDULAWANG
MINDI 8 5 58384 JATI PELEM RANDULAWANG
MINDI 8 5 58384 JATI PELEM RANDULAWANG
MINDI 8 5 58384 JATI PELEM RANDULAWANG
KD GLAGAH 7 4 58384 JATI PELEM RANDULAWANG
KD GLAGAH 7 4 58384 JATI PELEM RANDULAWANG
KD GLAGAH 7 4 58384 JATI PELEM RANDULAWANG
KD GLAGAH 7 4 58384 JATI PELEM RANDULAWANG
MINDI 10 5 58384 JATI PELEM RANDULAWANG
MINDI 10 5 58384 JATI PELEM RANDULAWANG
MINDI 10 5 58384 JATI PELEM RANDULAWANG
MINDI 10 5 58384 JATI PELEM RANDULAWANG
MINDI 10 5 58384 JATI PELEM RANDULAWANG
MINDI 8 5 58384 JATI PELEM RANDULAWANG
MINDI 8 5 58384 JATI PELEM RANDULAWANG
MINDI 8 5 58384 JATI PELEM RANDULAWANG
MINDI 8 5 58384 JATI PELEM RANDULAWANG
MINDI 8 5 58384 JATI PELEM RANDULAWANG
GLAGAH 7 4 58384 JATI RANDULAWANG RANDULAWANG
GLAGAH 7 4 58384 JATI RANDULAWANG RANDULAWANG
GLAGAH 6 4 58384 JATI RANDULAWANG RANDULAWANG
GLAGAH 6 4 58384 JATI RANDULAWANG RANDULAWANG
GLAGAH 6 4 58384 JATI RANDULAWANG RANDULAWANG
GLAGAH 6 4 58384 JATI RANDULAWANG RANDULAWANG
GLAGAH 7 4 58384 JATI RANDULAWANG RANDULAWANG
GLAGAH 7 4 58384 JATI RANDULAWANG RANDULAWANG
GLAGAH 6 4 58384 JATI RANDULAWANG RANDULAWANG
GLAGAH 6 4 58384 JATI RANDULAWANG RANDULAWANG
GLAGAH 6 4 58384 JATI RANDULAWANG RANDULAWANG
GLAGAH 6 4 58384 JATI RANDULAWANG RANDULAWANG
GLAGAH 6 4 58384 JATI RANDULAWANG RANDULAWANG
KD GLAGAH 6 4 58384 JATI PELEM RANDULAWANG
KD GLAGAH 6 4 58384 JATI PELEM RANDULAWANG
KD GLAGAH 6 4 58384 JATI PELEM RANDULAWANG
KD GLAGAH 7 4 58384 JATI PELEM RANDULAWANG
KD GLAGAH 7 4 58384 JATI PELEM RANDULAWANG
KD GLAGAH 6 4 58384 JATI PELEM RANDULAWANG
KD GLAGAH 6 4 58384 JATI PELEM RANDULAWANG
KD GLAGAH 6 4 58384 JATI PELEM RANDULAWANG
KD GLAGAH 6 4 58384 JATI PELEM RANDULAWANG
KD GLAGAH 8 4 58384 JATI PELEM RANDULAWANG
KD GLAGAH 8 4 58384 JATI PELEM RANDULAWANG
KD GLAGAH 8 4 58384 JATI PELEM RANDULAWANG
KD GLAGAH 6 4 58384 JATI PELEM RANDULAWANG
KD GLAGAH 6 4 58384 JATI PELEM RANDULAWANG
KD GLAGAH 6 4 58384 JATI PELEM RANDULAWANG
KD GLAGAH 6 4 58384 JATI PELEM RANDULAWANG
KETERANGAN

JAMKESMAS

LAMA/ JAMKESDA
Jamkesda Th 2010, no. 33.16.01.379

Jamkesda no. 33.16.01.12026

DESA : TOBO
KECAMATAN : JATI

NO NO KK NIK Nama Lengkap Hub Kelg

1=Pegaw
ai 2=
Suami 3=
Istri
4= Anak
5=Tanggu
ngan
1 3316012601084240 3316017112580006 RAYATI 3
2 3316010406140004 3316012804920002 AGUS PUJIONO 2
3 3316010406140004 3316016212920001 MARTIWI 3
4 3316010406140004 3316016111140001 PUTRI AYU NOVITA SARI 4
5 3316010803130001 3316021308800003 MADIN 2
6 3316010803130001 3316016808940002 AGUSTINA WULANDARI 3
7 3316010803130001 3316016101130002 HUSNA ALIFIA PUTRI 4
8 3316012601084130 3316010902840004 BASUKI 2
9 3316012601084130 3316015511840002 SRI JUMINI 3
10 3316012601084130 3316016303090001 RISNI NURMILA SARI 4
11 3316010504120003 3316017112690003 SUMI 3
12 3316010706120002 3316023112830082 SUYANTO 2
13 3316010706120002 3316015006820003 PASIYEM 3
14 3316010706120002 3316011103070003 MUHAMAD DWI ARIANTO 4
15 3316010706120002 3316011609140001 JEFRI FAJAR SEPTIANO 4
16 3316012601084528 3316010402720001 SUPRIYO 2
17 3316012601084528 3316015602780003 PUJIATI 3
18 3316012601084528 3316015911010002 IRENZA RAMADHANTI 4
19 3316012601084528 3316011802110001 AHMAD SHOHIBUL KAFI 4
20 3316011506110001 3316011506870007 DWI WINARYO 2
21 3316011506110001 3305215402900001 IDA HARIYANTI 3
22 3316011506110001 3316016103110002 SITI NAIM NAISYAROH 4
23 3316012601084358 3316010111790002 MOCHADI 2
24 3316012601084358 3316015212810003 SUMIYATI 3
25 3316012601084358 3316011208050001 RAFI LUQMAN SAPUTRA 4
26 3316012601084358 3316012412120001 YUSUF KARUNIA RAHMAT 4
27 3316012601084181 3316013112650082 SUMADI 2
28 3316012601084181 3316017009710003 SUPATMI 3
29 3316012601084181 3316015204990003 CACIK TRI RAHAYU 4
30 3316012601084181 3316017112360059 PARIYEM 5
31 3316012601084226 3316015203770002 SITI SUWARNI 3
32 3316011212110006 3316012104720004 MUHAMMAD MASYKUR 2
33 3316011212110006 3316014205880005 KHAYATUS SARIFAH 3
34 3316011212110006 3316011805070001 AHMAD SHOHIBUL FATHON 4
35 3316011212110006 3316011509110001 AHMAD AHSANUL KHOLID 4
36 3316011310150006 3316011409930002 RUDI SUHARTONO 2
37 3316011310150006 3315136207940002 RINA ZULIYANTI 3
38 3316012601084265 3316010602650003 SUWARDI 2
39 3316012601084265 3316017101760001 SITI NURKAYATUN 3
40 3316012601084265 3316016910050002 EKI ERAWATI 4
41 3316012403140002 3316014701940001 VIVINVINATA SUCI RAHAYU 2
42 3316012403140002 3316017009140001 VELLY SEPTINA PUTRI 3
43 3316012601084242 3316013112680090 SUMARJI 2
44 3316012601084242 3316017112680131 SUMINI 3
45 3316012601084242 3316010608960002 SUMARSONO 4
46 3316012601084242 3316016711020002 YAYUK SETYANINGSIH 4
47 3316012601084392 3316013112370038 DAYAT 2
48 3316012601084392 3316015210740002 SITI NARTI 4
49 3316012601084315 3316016908120002 LIVIAAGUSTINA 4
50 3316012905090007 3316013009820003 BUDI SARTOMO 2
51 3316012905090007 3316014607880006 SUYATINI 3
52 3316012905090007 3316015711070001 PUTRI REGINA NURMALYN 4
53 3316012905090007 3316011501140001 MUHAMMAD ALFI ZAHRIL 4
 Jenis Status

Tgl Lahir Kelamin Kawin Alamat Tempat TinggRT RW

Tempat dd/mm/yyyy 1= L 1= BK
2=K
3=CH,
4 CM,
5=Tdk
Lahir ( 16/04/1983) 2=P Tahu
GROBOGAN 31-12-1958 2 4 TOBO 8 2
BLORA 28-04-1992 1 2 TOBO 5 2
BLORA 22-12-1994 2 2 TOBO 5 2
BLORA 21-11-2014 2 1 TOBO 5 2
BLORA 13-08-1980 1 2 SUMBERJO 2 3
BLORA 28-08-1994 2 2 SUMBERJO 2 3
BLORA 21-01-2013 2 1 SUMBERJO 2 3
BLORA 09-02-1984 1 2 SUMBERJO 1 3
BLORA 15-11-1984 2 2 SUMBERJO 1 3
BLORA 23-03-2009 2 1 SUMBERJO 1 3
BLORA 31-12-1969 2 4 SUMBERJO 1 3
BLORA 31-12-1983 1 2 TOBO 4 2
BLORA 10-06-1982 2 2 TOBO 4 2
BLORA 11-03-2007 1 1 TOBO 4 2
Blora 15-09-2014 1 1 TOBO 4 2
Blora 04-02-1972 1 2 CERME 2 1
WONOSOBO 16-02-1978 2 2 CERME 2 1
Blora 19-11-2001 2 1 CERME 2 1
Blora 18-02-2011 1 1 CERME 2 1
Blora 15-06-1987 1 2 SUMBERJO 2 3
KEBUMEN 14-02-1990 2 2 SUMBERJO 2 3
Blora 21-03-2011 2 1 SUMBERJO 2 3
SEMARANG 01-11-1979 1 2 TOBO 3 2
Blora 12-12-1981 2 2 TOBO 3 2
BLORA 12-08-2005 1 1 TOBO 3 2
BLORA 24-12-2012 1 1 TOBO 3 2
BLORA 31-12-1965 1 2 SUMBERJO 2 3
BLORA 30-09-1971 2 2 SUMBERJO 2 3
BLORA 12-05-1999 2 1 SUMBERJO 2 3
BLORA 31-12-1936 2 4 SUMBERJO 2 3
BLORA 12-03-1977 2 2 TOBO 6 2
BLORA 21-04-1972 1 2 TOBO 5 2
GROBOGAN 02-05-1988 2 2 TOBO 5 2
GROBOGAN 18-05-2007 1 1 TOBO 5 2
BLORA 15-09-2011 1 1 TOBO 5 2
BLORA 14-09-1993 1 2 TOBO 5 2
GROBOGAN 22-07-1994 2 2 TOBO 5 2
BLORA 06-02-1965 1 2 TOBO 5 2
BLORA 31-01-1976 2 2 TOBO 5 2
BLORA 29-10-2005 2 1 TOBO 5 2
BLORA 07-01-1994 2 2 TOBO 2 2
SEMARANG 30-09-2014 2 1 TOBO 2 2
BLORA 31-12-1960 1 2 TOBO 8 1
BLORA 31-12-1968 2 2 TOBO 8 1
BLORA 06-08-1996 1 1 TOBO 8 1
BLORA 27-11-2002 2 1 TOBO 8 1
BLORA 31-12-1937 1 2 TOBO 1 2
BLORA 12-10-1974 2 2 TOBO 1 2
BLORA 29-08-2012 2 1 TOBO 4 2
BLORA 30-09-1982 1 2 TOBO 4 2
BLORA 07-07-1988 2 2 TOBO 4 2
BLORA 17-11-2007 2 1 TOBO 4 2
BLORA 15-01-2014 1 1 TOBO 4 2
4 2
Kode Pos Kode Nama KodeDesa Kode
Faskes Tk
Kecamata 1( diisi
Kecamata Nma Desa petugas)
n( diisi (diisipetu Nma
Faskes Tk
petugas) n gas) I

58384 JATI TOBO

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58384 JATI TOBO
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58384
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Nama Faskes Tk 1

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RANDULAWANG
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DESA : KEPOH
KECAMATAN : JATI

NO

Hub Kelg
NO KK NIK Nama Lengkap 1=Pegaw
ai 2=
Suami 3=
Istri
4= Anak
5=Tanggu
ngan
1 3316012801130002 3316021003960001 Slamet 2
2 3316012801130002 3316015110940003 Lastri 3
3 3316012801130002 3316015904130002 Khusnul Khotimatul 4
4 3316012501082809 3316010605560001 Wartono 2
5 3316012501082809 3316014604550003 Waginah 3
6 3316012501082809 3316010202780002 Sukirno 4
7 3316012501082809 3316034211640003 Karni 5
8 3316012501082809 3316012911020001 Pipit Samsuri 5
9 3316012501082809 3316012506100003 Muhamad Munil L 5
 Jenis Status Alamat Tempat

Tgl Lahir Kelamin Kawin Tinggal RT RW

Tempat dd/mm/yyyy 1= L 1= BK
2=K
3=CH, 4
CM,
5=Tdk
Lahir 2=P Tahu
BLORA 10/3/1988 1 2 Sugih 16 10
BLORA 11/10/1994 2 2 Sugih 16 10
BLORA 19/04/2013 2 1 Sugih 16 10
BLORA 5/5/1955 1 2 Sugih 16 10
BLORA 6/4/1955 2 2 Sugih 16 10
BLORA 2/2/1978 1 2 Sugih 16 10
BLORA 2/11/1984 2 2 Sugih 16 10
BLORA 29/11/2002 2 1 Sugih 16 10
BLORA 25/06/2010 1 1 Sugih 16 10
Kode Pos Kode Nama KodeDesa Kode Faskes

Kecamata Tk 1( diisi
Kecamata Nma Desa
n( diisi (diisipetuga petugas) Nma

petugas) n s) Faskes Tk I

58384 JATI Kepoh

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Nama Faskes Tk 1

RANDULAWANG
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