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FORMAT DATA KELUARGA

NO NIP NAMA PESERTA JNS TANGGAL LAHIR ALAMAT NAMA ISTRI/ ANAK JNS
KEL KEL
1 19820510 200903 2 005 dr. DIYANI BUDI UTAMI P 10 Mei 1982 Kamolan RT 4 RW 4 , Banjarejo dr. GUNTUR WIBOWO L
SYIFA AULIA NURBAITI P
2 19630315 198903 1 016 SUTRISNO L 15 maret 1963 Buluroto , Banjarejo SITI NURHAYATI P
AGUNG ARIK ARDIANTO L
NURUL AZIZAH RAHMAWATI P
ELVIRA RAHMA DAMAYANTI P
3 19671005 198803 2 006 RR. SUSILAWATI P 5 Oktober 1967 Karang Rt 1 RW 1, Bogorejo TRIMA, S.Pd. L
NUR ENY LATIFAH P
TRI WIDYA AGI SUSTYAWAN L
4 19650205 198703 1 016 BAMBANG AGUS SUJOKO L 5 Februari 1965 Karang Rt 1 RW 1, Bogorejo SRI SUDARTI P
CANDRA YOGA TAMA L
CANDRA AYU DWI SINTIA P
5 19700412 199003 1 003 SUYANTO L 12 April 1970 Gayam Rt 1 RW 2, Bogorejo ANA KHOIRIYAH, S.Pd. P
R.FAHMI A L
R.RAHMAN H L
6 19730112 199203 2 003 SRI WUWUH P 12 Januari 1973 Nglengkir , Bogorejo RIYANTOYO,SE. L
ARFIKA RISTIYAN R P
ALFIAN YUSRISTYANDANI L
ARFALILKA FIKRISTYAN HALILA P
7 19720705 199302 2 002 WARJINI P 5 Juli 1972 Bogorejo RT 3 RW 2, Bogorejo SANTOSO L
IMROATUN NUR M P
FIRDO AKSA FA L
8 19730102 199702 2 002 SRI MULYATI P 2 januari 1973 Bogorejo RT 1 RW , Bogorejo ACHMAD KHAMIM L
GLADI IMAN NANDA L
DIO DINDA TA L

9 19610609 198801 2 001 SRI WAHYUNI P 9 Juni 1961 Gayam Rt 1 RW 1, Bogorejo EDY SUMARSONO L
EKO SUARYONO L
DWI WULANDARI p
10 19750407 200604 2 017 SUSI WIDHIASTUTI P 7 April 1975 Bogorejo RT 1 RW 1, Bogorejo PUJIRANTO L
INTAN NARARIA P P
MAULANA JIHAN L
11 19760412 200604 2 028 JATI RAHAYU P 17 April 1975 Gandu, Bogorejo SUTEMOK L
DIMAS
12 19810410 200801 2 024 PUJIWATI P 10 April 1981 Yonif 410 Bangkle, Blora BAMBANG SUTEJO L
NADYNE AMELIA ZAHRA PRAMESTI P
MUHAMMAD NAADHIR ATSAAL L
13 19810204 200903 2 008 ENDANG SRI NURHAYATI P ### Gayam, Bogorejo SUTOPO L
SUBHAN FAREL AFIFUDDIN L
14 19760717 201101 2 006 YULITA ANA ERFIYANTI P Saturday, July 17, 1976 Balun srikaton Gg 9 No 1 B TRI GESANGANTO L
INSYIRA SALMA ROSYADA P
15 19760925 200604 2 015 FITRI HARI MULYANTI P ### GAYAM KC. BOGOREJO ANTON SETYANTO, SE L
DIFA ALFARISI L
DAFA MIKAEL L
TANGGAL LAHIR AGA HUB KODE KODE
MA KEL HUBKEL TUNJ
Thursday, March 03, 1983 Islam Suami 10 1
Wednesday, April 20, 2011 Islam Anak I 11 1
Wednesday, January 13, 1971 Islam Istri 10 1
Monday, July 06, 1992 Islam Anak I 11 1
Friday, August 13, 2004 Islam Anak II 12 1
Saturday, May 05, 2007 Islam Anak III 13 0
Thursday, September 01, 1955 Islam Suami 10 0
10-Feb-90 Islam Anak I 11 0
Wednesday, August 30, 1995 Islam Anak II 12 0
Sunday, August 09, 1970 Islam Istri 10 1
Wednesday, July 15, 1992 Islam Anak I 11 1
Tuesday, December 22, 1998 Islam Anak II 12 1
Saturday, September 05, 1970 Islam Istri 10 1
Thursday, January 12, 1995 Islam Anak I 11 1
Wednesday, January 12, 2005 Islam Anak II 12 1
Tuesday, September 08, 1964 Islam Suami 10 1
Wednesday, May 25, 1994 Islam Anak I 11 1
Sunday, October 21, 2001 Islam Anak II 12 1
Thursday, March 18, 2010 Islam Anak III 13 0
Sunday, January 05, 1969 Islam Suami 10 1
Sunday, May 11, 1997 Islam Anak I 11 1
Sunday, August 01, 2004 Islam Anak II 12 1
Friday, April 14, 1967 Islam Suami 10 1
Friday, October 28, 1994 Islam Anak I 11 1
Sunday, September 26, 1999 Islam Anak II 12 1

Monday, December 15, 1958 Islam Suami 10 1


Thursday, February 10, 1983 Islam Anak I 11 0
Friday, October 19, 1984 Islam Anak II 12 0
Thursday, June 05, 1969 Islam Suami 10 1
Friday, August 11, 1995 Islam Anak I 11 1
Sunday, September 23, 2001 Islam Anak II 12 1
Saturday, March 06, 1976 Islam Suami 10 1
Friday, December 22, 2006 Islam Anak I 11 1
Thursday, August 08, 1974 Islam Suami 10 0
Tuesday, January 17, 2006 Islam Anak I 11 0
Sunday, May 08, 2011 Islam Anak II 12 0
Saturday, August 14, 1976 Islam Suami 10 0
Monday, December 08, 2008 Islam Anak I 11 0
Thursday, August 08, 1968 Islam Suami 10 1
Tuesday, March 07, 2006 Islam Anak I 11 1
Saturday, December 18, 1976 Islam Suami 10 1
Tuesday, July 03, 2001 Islam Anak I 11 1
Saturday, April 25, 2009 Anak II 12 1

KEPALA UPTD PUSKESMAS


BOGOREJO

dr Diyani Budi Utami


NIP 198205102009032005