DATA DAN ANALISIS HASIL

SURVEI MAWAS DIRI (SMD)

UPT PUSKESMAS SIDAMULYA
Jl. Sidamulya No. 375A Kec. Astanajapura Kab. Cirebon Telp. 0231-8845226 Kode Pos 45181 Email: puskes_sidamulya@yahoo.co.id
DESA : MERTAPADAKULON JUMLAH PERTANYAAN : 86
RUKUN WARGA : 001 s/d 010 SURVEYOR : Antik Athiah, S.Kep
JUMLAH SURVILAN : 150 WAKTU PELAKSANAAN : Desember 2017

ALAMAT TANGGAL PENDIDIK- PENGHASILAN STATUS JUMLAH TOTAL

NO. NAMA WARGA PROFESI ASURANSI
RT/RW LAHIR AN PERBULAN EKONOMI BENAR SALAH SKOR
1 bpk. Sidik rt 01 7/1/1959 SD BURUH KIS PBI 500,000 Pra KS 7 79 7
2 siti fatimah rt01 9/3/1980 SLTA IRT KIS NON PBI KS 9 77 9
3 fauji rt01 9/3/1954 SLTA Pensiunan KIS NON PBI 2,000,000 KS 9 77 9
4 khabibah rt01 8/4/1948 SD IRT KIS PBI Pra KS
5 muslik rt01 8/3/1978 SLTA Pedagang KIS NON PBI 1,000,000 Pra KS
6 fatimah rt01 8/4/1984 SLTA IRT Pra KS
7 ibu nani rt 01 8/20/1976 SLTA IRT KIS PBI Pra KS
8 atikah rt 01 8/12/1969 SLTA IRT KIS PBI Pra KS
9 nanang rt 01 2/16/1970 SLTA Sekdes KIS PBI 1,750,000 KS
10 H.A. jaelani rt 01 7/6/1971 Sarjana Kuwu KIS PBI 2,500,000 KS
11 ahmad harist rt 01 1/15/1968 SLTA BURUH KIS PBI 1,500,000 Pra KS
12 ibu maemun rt 01 3/10/1949 SD Pedagang KIS PBI 200,000 Pra KS
13 choiriyah rt 02 8/22/1993 SLTA IRT KIS PBI Pra KS
14 ibu uming rt 02 8/1/1979 d2 IRT KIS NON PBI KS
15 anis suhadi rt 02 5/14/1960 SLTA aparat desa KIS PBI 1,250,000 Pra KS
16 saefudin rt 02 1/1/1974 Sarjana PNS KIS NON PBI 3,500,000 KS
17 aam aminah rt 02 8/17/1979 SLTP IRT KIS NON PBI KS
18 siti aisyah rt 02 6/20/1980 SLTA IRT KIS NON PBI Pra KS
19 ibu aminah rt 02 7/4/1982 SLTA IRT KIS PBI Pra KS
20 samidah rt03 1/31/1964 SLTP Dagang KIS PBI 300,000 Pra KS
21 masanah rt03 7/7/1962 SLTA IRT KIS NON PBI KS
22 asoh khulasoh rt03 4/4/1979 SLTA Dagang KIS PBI 500,000 Pra KS
23 atun sa'diyah rt03 12/14/1986 SLTA Dagang KIS PBI 700,000 Pra KS
24 ibu juwinah rt03 6/7/1973 SLTA IRT KIS PBI Pra KS
25 khalimatus sadiyah rt03 4/19/1983 Sarjana Guru RA KIS NON PBI Pra KS
26 siti maulidah rt03 10/19/1992 SLTA IRT KIS PBI Pra KS
27 HJ.yiyin hayyinah rt03 2/9/1977 Sarjana Kepala Tk KIS NON PBI 3,000,000 KS
28 ibu habibah/jenah rt04 10/30/1993 SD IRT KIS PBI Pra KS
29 qomarriyah rt04 10/25/1967 SLTA IRT KIS PBI Pra KS
30 kasinah rt04 7/1/1943 SD IRT KIS PBI Pra KS
31 ibu yati sumiyati rt04 5/7/1979 SLTP IRT KIS PBI Pra KS
32 ibu meliyanah rt04 5/28/1984 SLTA IRT KIS PBI Pra KS
33 mery maryani rt04 1/27/1994 SLTA IRT KIS PBI Pra KS
34 H.akhyas safitri rt04 9/6/1974 Sarjana Anggota DPRD KIS NON PBI 10,000,000 KS
35 eni nuraeni rt05 6/2/1979 SLTA IRT Pra KS
36 ibu nurwahyuni rt05 10/12/1985 Sarjana Guru honor KIS NON PBI 500,000 Pra KS
37 ibu umi linda rt05 1/8/1987 SLTA IRT KIS PBI Pra KS
38 bpk Yayat rt05 11/5/1980 Sarjana Guru KIS PBI 2,000,000 KS
39 khodijah rt05 5/2/1956 SD Dagang KIS PBI 900,000 Pra KS
40 ibu faridah rt05 5/2/1973 SLTA Dagang KIS PBI 600,000 Pra KS
41 nurbayi rt05 3/4/1995 SD IRT KIS PBI Pra KS
42 ibu sri rahayu rt05 4/21/1986 SLTA IRT Pra KS
43 kiki indriyanti rt06 3/28/1991 SLTA IRT KIS PBI Pra KS
44 lamri rt06 8/17/1965 SLTP ojeg KIS PBI 400,000 Pra KS
45 ibu entin rt06 8/17/1970 SLTP IRT Pra KS
46 wiwin winarsih rt06 8/15/1989 SLTA IRT KIS NON PBI Pra KS
47 kanifah rt06 6/4/1983 SLTP IRT KIS PBI Pra KS
48 siti rohanah rt06 5/23/1985 SLTP IRT KIS PBI Pra KS
49 masniah rt07 8/17/1955 SD IRT KIS PBI Pra KS
50 nining rt07 6/10/1974 SLTA IRT KIS PBI 600,000 Pra KS
51 agus mulyadi rt07 8/19/1973 SLTA IRT KIS PBI 2,000,000 Pra KS
52 sri mulyani rt07 7/17/1983 SLTA IRT KIS NON PBI Pra KS
53 entik kartika rt07 8/28/1988 Sarjana Guru KIS NON PBI 1,000,000 Pra KS
54 khusnul khotimah rt07 8/21/1961 SD IRT KIS PBI Pra KS
55 safiah rt06 7/14/1954 SLTP IRT KIS PBI Pra KS
56 sarifah rt08 7/14/1957 SD Dagang KIS PBI 500,000 Pra KS
57 ade mulyanti rt08 11/1/1988 SLTA Dagang 600,000 Pra KS 40 46 40
58 samrotul puah rt08 7/2/1976 SLTP IRT KIS PBI KS 23 63 23
59 endang ernmawati rt08 4/24/1986 SLTP IRT KIS PBI Pra KS
60 hj sopiyah rt08 7/1/1940 KIS PBI Pra KS
61 hj titin suhenti rt08 6/4/1971 SLTA KIS PBI Pra KS
62 bpk tachrir rt09 6/15/1952 SD Dagang KIS NON PBI 600,000 Pra KS
63 bpk h.heri rt09 10/10/1953 SD Dagang 6,000,000 KS
64 masripah rt09 12/12/1959 SD Dagang KIS PBI 600,000 Pra KS
65 ibu iin rt09 3/27/1974 SLTA IRT KIS NON PBI KS
66 ayuna rt09 11/3/1979 SLTP IRT Pra KS
67 sumyati rt09 3/27/1974 SLTP IRT Pra KS
68 ati adiati rt10 10/10/1980 SD IRT Pra KS
69 lilis lisafaati rt10 2/22/1985 SLTA IRT KIS PBI Pra KS
70 khurotulaeni rt10 1/2/1987 SLTA IRT KIS PBI Pra KS
71 halimah rt10 12/11/1977 SLTA Dagang KIS PBI 400,000 Pra KS
72 lutfiah rt10 4/17/1987 SLTP IRT KIS PBI Pra KS
73 zoni munandar rt10 2/3/1986 SLTP Dagang KIS PBI 1,500,000 Pra KS
74 khabibah rt10 11/8/1991 SLTP IRT KIS PBI Pra KS
75 khusen rt10 6/16/1958 SD Dagang KIS PBI 1,500,000 Pra KS
76 hj.titik nz rt11 6/5/1971 Sarjana Guru TK KS
77 zakiyah rt11 8/3/1974 MTs Dagang KIS NON PBI 1,500,000 KS
78 somimah rt11 12/8/1962 SLTA IRT KIS NON PBI KS
79 masitoh rt11 5/30/1970 SLTA IRT KIS NON PBI KS
80 hj.zanubaida SPDI rt11 9/10/1960 Sarjana Guru TK 1,500,000 KS
81 hj. Fatumaturzahro rt11 8/13/1987 Sarjana Guru TK KIS NON PBI KS
82 komaruddin rt11 9/11/1961 SLTA Perangkat Desa KIS PBI 1,250,000 Pra KS
83 sumarna rt11 8/20/1958 SD Linmas KIS PBI 500,000 Pra KS
84 moh fauroni rt12 9/14/1984 Sarjana Guru honor KIS NON PBI 1,000,000 Pra KS
85 ibu uus rt12 9/22/1986 SLTA IRT KIS PBI Pra KS
86 iin insyiah rt12 9/13/1967 MTs IRT KIS PBI Pra KS
87 nuraeni rt12 5/4/1983 SLTA IRT KIS PBI Pra KS
88 nurjannah rt13 6/6/1985 SLTA IRT KIS PBI Pra KS
89 attakoh rt13 5/12/1987 SLTA IRT KIS PBI Pra KS
90 ilyas rt13 10/13/1967 SLTP Dagang KIS PBI 10,000,000 Pra KS
91 khulaelah rt13 1/9/1969 SD IRT KIS PBI Pra KS
92 ibu khammimah rt13 7/1/1964 Madrasah tukang jahit KIS PBI 300,000 Pra KS
 93 yati sopiyati rt13 9/12/1973 SLTP IRT Pra KS
94 farhatun rt14 8/12/1987 Sarjana IRT Pra KS
95 nani mulyani rt14 7/12/1980 SD IRT KIS PBI Pra KS
96 siti khanah rt14 7/13/1975 MTs IRT KIS PBI Pra KS
97 fatkhiyah rt14 10/20/1973 MTs Dagang KIS PBI 300,000 Pra KS
98 saroh rt14 4/3/1971 SLTP IRT KIS PBI Pra KS
99 moh hamdi rt14 4/16/1978 SLTA Perangkat Desa KIS PBI 1,200,000 Pra KS
100 syakiroh rt14 9/15/1969 MTs ART KIS PBI 500,000 Pra KS
101 sopiyah rt15 7/30/1980 SLTA IRT KIS PBI Pra KS
102 eli nurhayati rt15 7/30/1980 SLTA IRT KIS PBI Pra KS
103 bpk iskak rt15 4/7/1964 Sarjana P3N KIS NON PBI 900,000 Pra KS
104 nuraeni rt15 8/11/1979 SLTA IRT KIS PBI Pra KS
105 barokah rt15 11/25/1977 SLTP IRT KIS PBI Pra KS
106 h.moch.akhsan rt15 9/16/1954 Sarjana Pensiunan KIS NON PBI 2,650,000 KS
107 siti zulfah rt16 10/18/1995 SLTA IRT KIS PBI Pra KS
108 aisyah rt16 6/16/1963 SLTP IRT KIS PBI Pra KS
109 fitriyah rt16 8/3/1979 Sarjana IRT KIS PBI Pra KS
110 siti khotimah rt16 4/22/1989 SLTA IRT KIS PBI Pra KS
111 arum nawati rt16 5/20/1989 SLTP IRT KIS PBI Pra KS
112 muawanah rt17 4/1/1983 SLTA IRT KIS PBI Pra KS
113 aisyah rt17 8-6-191954 IRT KIS PBI Pra KS
114 ru'yat maula rt17 12/22/1968 Madrasah IRT KIS PBI Pra KS
115 hikmatul maula rt17 9/13/1975 SLTP IRT KIS PBI Pra KS
116 bpk muslim rt17 10/10/1963 SLTA tukang becak KIS PBI Pra KS
117 saniah rt17 2/25/1970 SD IRT KIS PBI Pra KS
118 mariyah ulfah rt18 5/13/1981 S2 Dosen KIS PBI 2,000,000 KS
119 siti zulfah rt18 5/4/1995 SLTA IRT KIS PBI Pra KS
120 fitri mulyati rt18 10/16/1990 SLTA IRT KIS PBI Pra KS
121 lisa kurnia rt18 10/3/1996 SLTA IRT KIS PBI Pra KS
122 bpk ahmad nasir rt18 10/20/1969 SLTA Wiraswasta KIS NON PBI 3,000,000 KS
123 uum sumiyati rt18 10/10/1971 SLTP IRT KIS PBI Pra KS
124 yayah fajriyah rt18 9/6/1986 SLTA IRT KIS PBI Pra KS
125 hj.kapsah rt18 7/1/1953 SD IRT KIS NON PBI Pra KS
126 suheni rt20
127 siti jenah rt20
128 ratnasari rt20
129 wita rt20
130 mumun rt20
131 kurniasih rt20
132 syamsuri rt20
133 bpk debbi rt20
134 poni trisnawati rt20
135 nurlaela rt20
136 garnis rt20
137 tarsih rt20
138 ibu yani rt19
139 bpk yani rt19
140 wasriyani rt19
141 supriyono rt19
142 ibu yevi rt19
143 uti rt21
144 bpk suherman rt21
145 alin rt21
146 irah rt21
147 ibu cuti rt21
148 munparijah rt21
149 eni nuraeni rt21
150 bpk udin/nining rt21 0 86 0
A DAN ANALISIS HASIL
VEI MAWAS DIRI (SMD)
PUSKESMAS SIDAMULYA
on Telp. 0231-8845226 Kode Pos 45181 Email: puskes_sidamulya@yahoo.co.id

NILAI

8.13953
10.4651
10.4651
46.5116
26.7442
0
 JUMLAH WARGA SURVILAN

150

NO. NAMA WARGA

1 bpk. Sidik
2 siti fatimah
3 fauji
4 khabibah
5 muslik
6 fatimah
7 ibu nani
8 atikah
9 nanang
10 H.A. jaelani
11 ahmad harist
12 ibu maemun
13 choiriyah
14 ibu uming
15 anis suhadi
16 saefudin
17 aam aminah
18 siti aisyah
19 ibu aminah
20 samidah
21 masanah
22 asoh khulasoh
23 atun sa'diyah
24 ibu juwinah
25 khalimatus sadiyah
26 siti maulidah
27 HJ.yiyin hayyinah
28 ibu habibah/jenah
29 qomarriyah
30 kasinah
31 ibu yati sumiyati
32 ibu meliyanah
33 mery maryani
34 H.akhyas safitri
35 eni nuraeni
36 ibu nurwahyuni
37 ibu umi linda
38 bpk Yayat
39 khodijah
40 ibu faridah
41 nurbayi
42 ibu sri rahayu
43 kiki indriyanti
44 lamri
45 ibu entin
46 wiwin winarsih
47 kanifah
48 siti rohanah
49 masniah
50 nining
51 agus mulyadi
52 sri mulyani
53 entik kartika
54 khusnul khotimah
55 safiah
56 sarifah
57 ade mulyanti
58 samrotul puah
59 endang ernmawati
60 hj sopiyah
61 hj titin suhenti
62 bpk tachrir
63 bpk h.heri
64 masripah
65 ibu iin
66 ayuna
67 sumyati
68 ati adiati
69 lilis lisafaati
70 khurotulaeni
71 halimah
72 lutfiah
73 zoni munandar
74 khabibah
75 khusen
76 hj.titik nz
77 zakiyah
78 somimah
79 masitoh
80 hj.zanubaida SPDI
81 hj. Fatumaturzahro
82 komaruddin
83 sumarna
84 moh fauroni
85 ibu uus
86 iin insyiah
87 nuraeni
 88 nurjannah
89 attakoh
90 ilyas
91 khulaelah
92 ibu khammimah
93 yati sopiyati
94 farhatun
95 nani mulyani
96 siti khanah
97 fatkhiyah
98 saroh
99 moh hamdi
100 syakiroh
101 sopiyah
102 eli nurhayati
103 bpk iskak
104 nuraeni
105 barokah
106 h.moch.akhsan
107 siti zulfah
108 aisyah
109 fitriyah
110 siti khotimah
111 arum nawati
112 muawanah
113 aisyah
114 ru'yat maula
115 hikmatul maula
116 bpk muslim
117 saniah
118 mariyah ulfah
119 siti zulfah
120 fitri mulyati
121 lisa kurnia
122 bpk ahmad nasir
123 uum sumiyati
124 yayah fajriyah
125 hj.kapsah
126 suheni
127 siti jenah
128 ratnasari
129 wita
130 mumun
131 kurniasih
132 syamsuri
133 bpk debbi
134 poni trisnawati
135 nurlaela
136 garnis
137 tarsih
138 ibu yani
139 bpk yani
140 wasriyani
141 supriyono
142 ibu yevi
143 uti
144 bpk suherman
145 alin
146 irah
147 ibu cuti
148 munparijah
149 eni nuraeni
150 bpk udin/nining
 KUNCI JAWABAN
BACACDAABBABBAAAABAAAAAACAAAAAAAAAAAAAAAAAAAAAAECAACACAEDCDDDAEABACBBAABAFEABAABAAAAA

RINCIAN JAWABAN

ABCACBACBACCACBACB
ABCACBACBBCBAABACC
BCCAABACBBCBAABACC
D00000000000000BAAABBAABCBAABACAABBABABBAAAABCBEC0ACAC0EDCDDAAEA0AABAA00ABEBBABAD0ABAA
D00000000000000baaabaaaabbabbabacabbaabacbec0acac0adcdddaecbabaaaobababbaccdaabaa
CD

S
JUMLAH QUISONER TERJAWA
 TOTAL
JUMLAH SOAL SKOR BENAR SKOR SALAH SKALA NILAI TOTAL SKOR
WARGA

86 150 1 0 100 86

KIA GIZI IMUNISASI USILA, PTM DAN PROLANIS

STATUS
JAWABAN 1 2 3 4 5 1 2 3 4 5 1 2 3 4 5 1 2 3 4 5 6
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21
Kurang 0 0 1 1 1 0 1 0 1 0 0 0 0 0 0 1 0 1 0 0 0
Kurang 0 0 1 1 1 0 1 0 1 1 0 1 0 1 0 1 0 0 0 0 0
Kurang 1 0 1 1 0 0 1 0 1 1 0 1 0 1 0 1 0 0 0 0 0

0 0 0 0
Kurang 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 1 0 0
Kurang 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 1 0 1
 Kurang 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
JUMLAH : 1 0 3 3 2 0 3 0 3 2 0 2 3 2 0 3 2 1 2 0 1
TERKECIL: 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
TERBESAR : 1 1 1 1 1 1 1 1 3 1 1 1 1 1 1
RATA-RATA: 0.2 0.5 0.4 0.3 0.4 0.5 0.3 0.3 0.4 0.3 0.4 0.3 0.2 0.3 0.2
SIMPANGAN BAKU : 0.4 0.5 0.5 0.5 0.5 0.5 0.5 0.5 1.1 0.5 0.5 0.5 0.4 0.5 0.4
WAB DENGAN BAIK : 9 8 7 15
PTM DAN PROLANIS OBAT PROMKES KESLING P2 DBD
7 8 9 10 1 2 3 4 5 1 2 3 4 1 2 3 4 5 6 1 2 3 4 5
22 23 24 25 26 27 28 29 30 31 32 33 34 35 36 37 38 39 40 41 42 43 44 45
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
1 1 0 1 0 1 1 0 1 0 1 1 0 0 1 0 1 0 0 1 1 1 1 0
1 1 1 0 0 1 0 0 1 0 1 0 1 0 0 1 1 0 1 0 0 0 0 0
 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
2 2 1 1 0 2 1 0 2 0 2 1 1 0 1 1 2 0 1 1 1 1 1 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1
0.3 0.3 0.2 0.2 0.3 0.2 0.3 0.3 0.2 0.2 0.2 0.2 0.3 0.2 0.2 0.2 0.2 0.2
0.5 0.5 0.4 0.4 0.5 0.4 0.5 0.5 0.4 0.4 0.4 0.4 0.5 0.4 0.4 0.4 0.4 0.4
15 5 4 5 4
 JIWA KUSTA TB HAJI INDERA UKS & GIGI MUL
1 2 3 4 5 1 2 3 4 5 1 2 3 4 5 1 2 3 1 2 3 4 5 1
46 47 48 49 50 51 52 53 54 55 56 57 58 59 60 61 62 63 64 65 66 67 68 69
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 1 1 0 1 1 1 1 0 1 1 1 1 1 0 1 1 1 0 1 0 1 0
1 0 0 1 0 1 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 1
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
1 0 1 2 0 2 1 1 1 0 1 1 1 1 1 0 1 1 2 0 1 0 1 1
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1
0.2 0.2 0.3 0.3 0.2 0.2 0.2 0.2 0.2 0.2 0.2 0.2 0.2 0.2 0.3 0.2 0.2 0.2
0.4 0.4 0.5 0.5 0.4 0.4 0.4 0.4 0.4 0.4 0.4 0.4 0.4 0.4 0.5 0.4 0.4 0.4
4 5 5 2 4 6
UKS & GIGI MULUT DIARE ISPA PERKESMAS JUMLAH
2 3 4 5 1 2 3 4 5 1 2 3 4 5 1 2 3 NILAI
BENAR SALAH
70 71 72 73 74 75 76 77 78 79 80 81 82 83 84 85 86
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 7 79 8.140
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 9 77 10.465
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 9 77 10.4651
1 0 0 1 0 1 0 1 1 0 0 0 0 1 0 1 1 40 46 46.5116
1 0 1 1 0 0 0 0 1 0 0 1 0 0 0 0 0 23 63 26.7442
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 86 0
2 0 1 2 0 1 0 1 2 0 0 1 0 1 0 1 1 88 428
0 0 0 0 0 0 0 0 0 0
1 1 1 1 1 1 1 1 1 1
0.3 0.2 0.3 0.2 0.2 0.3 0.2 0.2 0.2 0.2
0.5 0.4 0.5 0.4 0.4 0.5 0.4 0.4 0.4 0.4
6 4 2 2
 DAFTAR NAMA - NAMA SASARAN SMD
DESA MERTAPADA KULON
TAHUN 2017
NO NAMA TGL LAHIR pendidikan penghasilan asuransi penghasilan alamat STATUS EKONOMI
1 bpk. Sidik 7/1/1959 SD buruh kis PBI 500,000 rt 01 pra KS
2 siti fatimah 9/3/1980 slta irt kis nonpbi rt01 ks
3 fauji 9/3/1954 slta pensiunan kis nonpbi 2,000,000 rt01 ks
4 khabibah 8/4/1948 sd irt kis PBI rt01 praks
5 muslik 8/3/1978 slta dagang kis nonpbi 1,000,000 rt01 praks
6 fatimah 8/4/1984 slta irt rt01 praks
7 ibu nani 8/20/1976 slta irt kis pbi rt 01 pra ks
8 atikah 8/12/1969 slta irt kis PBI rt 01 pra KS
9 nanang 2/16/1970 slta sekdes kis PBI 1,750,000 rt 01 ks
10 H.A. jaelani 7/6/1971 sarjana kuwu kis PBI 2,500,000 rt 01 ks
11 ahmad harist 1/15/1968 slta buruh kis PBI 1,500,000 rt 01 pra ks
12 ibu maemun 3/10/1949 sd dagang kis PBI 200,000 rt 01 pra ks
13 choiriyah 8/22/1993 slta irt kis PBI rt 02 pra ks
14 ibu uming 8/1/1979 d2 irt kis nonpbi rt 02 ks
15 anis suhadi 5/14/1960 slta aparat desa kis PBI 1,250,000 rt 02 pra KS
16 saefudin 1/1/1974 sarjana pns kis nonpbi 3,500,000 rt 02 ks
17 aam aminah 8/17/1979 sltp irt kis nonpbi rt 02 ks
18 siti aisyah 6/20/1980 slta irt kis nonpbi rt 02 pra KS
19 ibu aminah 7/4/1982 slta irt kis PBI rt 02 pra KS
20 samidah 1/31/1964 sltp dagang kis PBI 300,000 rt03 pra KS
21 masanah 7/7/1962 slta irt kis nonpbi rt03 ks
22 asoh khulasoh 4/4/1979 slta dagang kis pbi 500,000 rt03 pra KS
23 atun sa'diyah 12/14/1986 slta dagang kis PBI 700,000 rt03 pra KS
24 ibu juwinah 6/7/1973 slta irt kis PBI rt03 pra KS
25 khalimatus sadiyah 4/19/1983 sarjana guru RA kis nonpbi rt03 pra KS
26 siti maulidah 10/19/1992 slta irt kis PBI rt03 pra KS
27 HJ.yiyin hayyinah 2/9/1977 sarjana kepala Tk kis nonpbi 3,000,000 rt03 ks
28 ibu habibah/jenah 10/30/1993 sd irt kis PBI rt04 pra KS
29 qomarriyah 10/25/1967 slta irt kis PBI rt04 pra KS
30 kasinah 7/1/1943 sd irt kis PBI rt04 pra KS
31 ibu yati sumiyati 5/7/1979 sltp irt kis PBI rt04 pra KS
32 ibu meliyanah 5/28/1984 slta irt kis PBI rt04 pra KS
33 mery maryani 1/27/1994 slta irt kis PBI rt04 pra KS
34 H.akhyas safitri 9/6/1974 sarjana anggota dewan kis nonpbi 10,000,000 rt04 ks
35 eni nuraeni 6/2/1979 slta irt rt05 pra KS
36 ibu nurwahyuni 10/12/1985 sarjana guru honor kis nonpbi 500,000 rt05 pra KS
37 ibu umi linda 1/8/1987 slta irt kis PBI rt05 pra KS
38 bpk Yayat 11/5/1980 sarjana guru kis PBI 2,000,000 rt05 ks
39 khodijah 5/2/1956 sd dagang kis PBI 900,000 rt05 pra KS
40 ibu faridah 5/2/1973 slta dagang kis PBI 600,000 rt05 pra KS
41 nurbayi 3/4/1995 sd irt kis PBI rt05 pra KS
42 ibu sri rahayu 4/21/1986 slta irt rt05 pra KS
43 kiki indriyanti 3/28/1991 slta irt kis PBI rt06 pra KS
44 lamri 8/17/1965 sltp ojeg kis PBI 400,000 rt06 pra KS
45 ibu entin 8/17/1970 sltp irt rt06 pra KS
46 wiwin winarsih 8/15/1989 slta irt kis nonpbi rt06 pra KS
47 kanifah 6/4/1983 sltp irt kis PBI rt06 pra KS
48 siti rohanah 5/23/1985 sltp irt kis PBI rt06 pra KS
49 masniah 8/17/1955 sd irt kis PBI rt07 pra KS
50 nining 6/10/1974 slta irt kis PBI 600,000 rt07 pra KS
51 agus mulyadi 8/19/1973 slta irt kis PBI 2,000,000 rt07 pra KS
52 sri mulyani 7/17/1983 slta irt kis nonpbi rt07 pra KS
53 entik kartika 8/28/1988 sarjana guru kis nonpbi 1,000,000 rt07 pra KS
54 khusnul khotimah 8/21/1961 sd irt kis PBI rt07 pra KS
55 safiah 7/14/1954 sltp irt kis PBI rt06 pra KS
56 sarifah 7/14/1957 sd dagang kis PBI 500,000 rt08 pra KS
57 ade mulyanti 11/1/1988 slta dagang 600,000 rt08 pra ks
58 samrotul puah 7/2/1976 sltp irt kis PBI rt08 ks
59 endang ernmawati 4/24/1986 sltp irt kis PBI rt08 pra ks
60 hj sopiyah 7/1/1940 kis PBI rt08 pra ks
61 hj titin suhenti 6/4/1971 slta kis PBI rt08 pra ks
62 bpk tachrir 6/15/1952 SD dagang kis nonpbi 600,000 rt09 pra ks
63 bpk h.heri 10/10/1953 SD dagang 6,000,000 rt09 ks
64 masripah 12/12/1959 SD dagang kis PBI 600,000 rt09 pra KS
65 ibu iin 3/27/1974 slta irt kis nonpbi rt09 ks
66 ayuna 11/3/1979 sltp irt rt09 pra KS
67 sumyati 3/27/1974 sltp irt rt09 pra KS
68 ati adiati 10/10/1980 sd irt rt10 pra KS
69 lilis lisafaati 2/22/1985 slta irt kis PBI rt10 pra KS
70 khurotulaeni 1/2/1987 slta irt kis PBI rt10 pra KS
71 halimah 12/11/1977 slta dagang kis PBI 400,000 rt10 pra KS
72 lutfiah 4/17/1987 smp irt kis PBI rt10 pra KS
73 zoni munandar 2/3/1986 smp dagang kis PBI 1,500,000 rt10 pra KS
74 khabibah 11/8/1991 smp irt kis PBI rt10 pra KS
75 khusen 6/16/1958 sd dagang kis PBI 1,500,000 rt10 pra KS
76 hj.titik nz 6/5/1971 sarjana guru tk rt11 ks
77 zakiyah 8/3/1974 mts dagang kis nonpbi 1,500,000 rt11 ks
78 somimah 12/8/1962 slta irt kis nonpbi rt11 ks
79 masitoh 5/30/1970 slta irt kis nonpbi rt11 ks
80 hj.zanubaida SPDI 9/10/1960 sarjana guru tk 1,500,000 rt11 ks
81 hj. Fatumaturzahro 8/13/1987 sarjana guru tk kis nonpbi rt11 ks
82 komaruddin 9/11/1961 slta perangkat desa kis PBI 1,250,000 rt11 pra KS
83 sumarna 8/20/1958 sd linmas kis PBI 500,000 rt11 pra KS
84 moh fauroni 9/14/1984 sarjana guru honor kis nonpbi 1,000,000 rt12 pra KS
85 ibu uus 9/22/1986 slta irt kis PBI rt12 pra KS
86 iin insyiah 9/13/1967 mts irt kis PBI rt12 pra KS
87 nuraeni 5/4/1983 slta irt kis PBI rt12 pra KS
88 nurjannah 6/6/1985 slta irt kis PBI rt13 pra KS
89 attakoh 5/12/1987 slta irt kis PBI rt13 pra KS
90 ilyas 10/13/1967 smp dagang kis PBI 10,000,000 rt13 pra KS
91 khulaelah 1/9/1969 sd irt kis PBI rt13 pra KS
92 ibu khammimah 7/1/1964 madrasah tukang jahit kis PBI 300,000 rt13 pra KS
93 yati sopiyati 9/12/1973 smp irt rt13 pra KS
94 farhatun 8/12/1987 sarjana irt rt14 pra KS
95 nani mulyani 7/12/1980 sd irt kis PBI rt14 pra KS
 96 siti khanah 7/13/1975 mts irt kis PBI rt14 pra KS
97 fatkhiyah 10/20/1973 mts dagang kis PBI 300,000 rt14 pra KS
98 saroh 4/3/1971 smp irt kis PBI rt14 pra KS
99 moh hamdi 4/16/1978 slta perangkat desa kis PBI 1,200,000 rt14 pra KS
100 syakiroh 9/15/1969 mts ART kis PBI 500,000 rt14 pra KS
101 sopiyah 7/30/1980 slta irt kis PBI rt15 praks
102 eli nurhayati 7/30/1980 slta irt kis PBI rt15 praks
103 bpk iskak 4/7/1964 sarjana P3N kis nonpbi 900,000 rt15 praks
104 nuraeni 8/11/1979 slta irt kis PBI rt15 praks
105 barokah 11/25/1977 smp irt kis PBI rt15 praks
106 h.moch.akhsan 9/16/1954 sarjana pensiunan kis nonpbi 2,650,000 rt15 ks
107 siti zulfah 10/18/1995 slta irt kis PBI rt16 praks
108 aisyah 6/16/1963 smp irt kis PBI rt16 praks
109 fitriyah 8/3/1979 sarjana irt kis PBI rt16 praks
110 siti khotimah 4/22/1989 slta irt kis PBI rt16 praks
111 arum nawati 5/20/1989 smp irt kis PBI rt16 praks
112 muawanah 4/1/1983 slta irt kis PBI rt17 praks
113 aisyah 8-6-191954 irt kis PBI rt17 praks
114 ru'yat maula 12/22/1968 madrasah irt kis PBI rt17 praks
115 hikmatul maula 9/13/1975 smp irt kis PBI rt17 praks
116 bpk muslim 10/10/1963 slta tukang becak kis PBI rt17 praks
117 saniah 2/25/1970 sd irt kis PBI rt17 praks
118 mariyah ulfah 5/13/1981 s2 dosen kis PBI 2,000,000 rt18 ks
119 siti zulfah 5/4/1995 slta irt kis PBI rt18 praks
120 fitri mulyati 10/16/1990 slta irt kis PBI rt18 praks
121 lisa kurnia 10/3/1996 slta irt kis PBI rt18 praks
122 bpk ahmad nasir 10/20/1969 slta wiraswasta kis nonpbi 3,000,000 rt18 ks
123 uum sumiyati 10/10/1971 smp irt kis pbi rt18 praks
124 yayah fajriyah 9/6/1986 slta irt kis pbi rt18 praks
125 hj.kapsah 7/1/1953 sd irt kis nonpbi rt18 praks
126 suheni rt20
127 siti jenah rt20
128 ratnasari rt20
129 wita rt20
130 mumun rt20
131 kurniasih rt20
132 syamsuri rt20
133 bpk debbi rt20
134 poni trisnawati rt20
135 nurlaela rt20
136 garnis rt20
137 tarsih rt20
138 ibu yani rt19
139 bpk yani rt19
140 wasriyani rt19
141 supriyono rt19
142 ibu yevi rt19
143 uti rt21
144 bpk suherman rt21
145 alin rt21
146 irah rt21
147 ibu cuti rt21
148 munparijah rt21
149 eni nuraeni rt21
150 bpk udin/nining rt21