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PENDATAAN SASARAN KEGIATAN KESEHATAN

Nama Desa : Taipa


Jumlah Penduduk : Jiwa
Jumlah KK : KK
Jumlah PUS :
Luas Wilayah Desa : 3,57

Remaja
Alamat / Kartu
No. No. Tgl Lahir / Hub. PUS PUS PUS KB Anak
Nama JK Pekerjaan Dusun / PUS WUS Gakin 4T ALKI Aktif Bayi Balita Apras 10-14 15-18 Bumil Bulin Bufas Lansia BPJS /
KK Jiwa Umur Keluarga KIS
RT/RW
L P L P
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25
1 1 Miso L 03-10-1968/48 Suami Swasta
2 Dalnia P 06-06-1979/37 Istri IRT
3 Sari yanti P 16-06-1992/24 Anak
4 Elfian Rahmadani P 30-06-2001/15 Anak

2 Jufri L 01-07-1977/39 Suami Nelayan


Saomi P 17-03-1978/38 Istri IRT
Helda P 30-12-2002/14 Anak
Agista P 10-08-2005/11 Anak
Arista P 03-02-2010/ 7 Anak
Armita P 24-01-2017/ 1

3 Ikbal L 17-08-1973/43 Suami Tani


Soriyani P 20-08-1982/34 Istri IRT
Ardianto L 15-07-2001/15 Anak

5 Kaisar L 22-03-1994/22 Suami Swasta


Arsita Minang Sari P 22-03-199 / Istri IRT
Dzakiyah Najwa Z P 02-10-2015/ Anak

1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25
6 Ajis L 12-04-1978/38 Suami Nelayan
Sukmawati P 26-04-1979/37 Istri IRT
Andriyani P 22-10-2001/15 Anak
Fitriyani P 07-09-2002/14 Anak
Dimas Alamsyah L 21-08-2006/10 Anak

7 Samsuddin L 01-01-1976/40 Suami Nelayan


Yuga P 10-11-1973/43 Istri IRT
M. Hendra L 10-12-1995/21 Anak
Peti Verawati P 10-02-1998/18 Anak
Hastian P 25-06-2006/10 Anak
Hasrif L 06-03-2008 / 8 Anak

8 Sabahu L 03-07-1931/85 Suami Tani


Salangge P 02-06-1935/81 Istri IRT
Sakira P 03-05-1934/82 Istri IRT
Ronal L 12-01-1997/19 Cucu

9 Irham L 25-04-1992/24 Suami Swasta


Djumaeda P 13-09-1992/24 Istri IRT
L 14-10-2015/ Anak

10 Alimuddin L 15-03-1959/57 Suami PNS


ST.Hasna P 15-04-1964/52 Istri IRT
Riska P 14-02-2000/16 Anak
11 Faisal L 20-04-1953/63 Suami Nelayan
Bungala P 11-03-1955/61 Istri IRT
Samsul L 03-05-1975/41 Anak
Rosmawati P 10-04-2001/15 Anak
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24
12 Aden Rahmat L 02-05-1986/30 Suami Swasta
Nursaida P 05-12-1986/30 Istri Honorer
Adni P 03-01-2015 / 2 Anak

13 Samanang L 07-11-1980/36 Anak Swasta


Bustamin L 03-05-1983/33 Anak Swasta

14 Hamsah Adam L 03-12-1945/71 Suami Nelayan


Denggo P 02-06-1951/65 Istri IRT
Sulkarnain L 10-04-2004/12 Cucu

15 Yuyun L 11-07-1979/37 Suami Nelayan


Jumartin P 20-01-1980/36 Istri IRT
Mawar P 17-03-2008/ 8 Anak
L 10-12-2015/ Anak

16 Burhan L 08-07-1956/60 Suami Kades


Hudaya P 17-10-1956/60 Istri IRT
Rino L 20-11-1986/30 Anak Swasta

17 Juslan L 05-05-1987/29 Suami Swasta


Eli Ermawati P 10-05-1986/30 Istri IRT
Susno Soesatyo S L 06-03-2010 / 6 Anak
18 Udin Fajar L 05-05-1976/40 Suami Swasta
Rita P 07-07-1984/32 Istri IRT
Intan P 03-11-2004/12 Anak
Marisa P 09-03-2009 / 7 Anak

19 Baedaro P 05-04-1961/55 Suami Tani


Maulana P 06-11-1996/20 Istri

1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24
20 Anton Slamet L 01-01-1967/49 Suami Nelayan
Musni P 06-02-1971/45 Istri IRT
Merry P 08-06-2001/15 Anak
Mirdat L 15-04-2007 / 9 Anak
Mursalin L 18-10-2008 / 8 Anak
Salsa P 28-03-2012 / 4 Anak

21 Ahiyar L 05-05-1968/48 Suami Nelayan


Hasnawati P 12-04-1969/47 Istri IRT
Randi L 01-08-1992/24 Anak
Dewi P 04-01-1997/19 Anak
Aril L 06-06-2005/11 Anak

22 Saeni L 10-11-1956/60 Suami Nelayan


Salna P 10-07-1968/48 Istri IRT
Joni L 17-05-1996/20 Anak
Ririn P 02-06-2000/16 Anak
Reno L 02-01-2007/ 9 Anak

23 Ismail L 03-04-1994/22 Suami Swasta


Wida P 03-04-1994/ Istri IRT
L 22-12-2015/ Anak

24 Muh. Nur L 06-07-1973/43 Suami Tani


Misba P 10-12-1973/43 Istri IRT
Jero Febrianto L 18-02-2003/13 Anak
Mey P 21-05-2008 / 8 Anak

25 Agustam L 07-08-1993/23 Suami Swasta


Sriana P 06-09-1996/20 Istri IRT
M. Fauzan L 26-06-2014/ 2 Anak

1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24
26 Sumaeddin L 05-06-1977/39 Suami Tani
Lisna S P 06-03-1983/33 Istri IRT
Adriansyah L 04-01-2006/11 Anak
Nia Rahmadani P 26-08-2010 / 6 Anak

27 Wangucu P 09-07-1953/63 Janda IRT


Ferdinan L 20-09-2005/11 Anak

28 Rahman K L 05-04-1981/35 Suami Honor


Rosmawati P 17-03-1984/32 Istri IRT
Misrayanti P 01-10-2009/13 Anak
Marsyanti P 05-01-2007 / 9 Anak
Muh.Marpin L 07-09-2009 / 7 Anak

29 Sutra, S.Ag L 15-06-1972/44 Suami PNS


Hudaya P 02-12-1982/34 Isrti IRT
Nur Sulistiawati P 08-10-2001/15 Anak
Nurul Hikni P 07-01-2011 / 5 Anak

30 Ndegar L 06-11-1969/47 Suami Swasta


Harni P 04-07-1970/46 Istri IRT

31 Muh. Ali Akbar L 27-07-1993/23 Suami Swasta


Reni Apriyani P 20-04-1995/21 Istri IRT
Khanza P 14-02-2014 / 2 Anak

32 Rabil Syahputra L 27-04-1987/29 Suami Swasta


Nurjanah P 19-05-1983/33 Istri IRT
Nur Aisyah P 16-05-2012 / 4 Anak
Nur Berlian P 19-02-2015/ 1 Anak

1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24
33 Rahman T L 15-01-1986/30 Suami Nelayan
Risna P 08-02-1992/24 Istri IRT
M. Risman L 12-05-2012 / 4 Anak

34 Anwar L 25-04-1968/48 Suami Nelayan


Nurhayati P 06-02-1977/39 Isrti IRT
Risma P 04-04-1997/19 Anak
Ardiansah L 23-07-2004/12 Anak

35 Abd. Latif L 08-01-1946/70 Suami Nelayan


Karlina P 09-02-1953/63 Istri IRT

36 Abd. Rahim L 01-07-1986/30 Suami Nelayan


Ratna P 21-12-1990/26 Istri IRT
Saskia Syafitri P 17-05-2012/ 4 Anak

37 Muhlis L 12-06-1976/40 Suami Nelayan


Hastian P 05-12-1986/30 Istri IRT
Rusli L 01-07-2009/ 7 Anak
Muh. Arif L 13-05-2017/

38 Ramlin L L 08-11-1971/45 Suami Nelayan


Jumiatin P 04-05-1974/42 Isrti IRT
Rima Adriana P 27-10-1994/22 Anak
Aswin L 28-12-1999/17 Anak

39 Aco L 09-05-1964/52 Suami Nelayan


Djaena P 07-04-1965/51 Istri IRT

40 Marlina P 19-12-1950/66 Janda IRT


Basriyuli L 23-04-1981/35 Anak Nelayan
Haerul L 12-05-1989/27 Anak
Sabil L 09-03-1995/21 Anak
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24
41 Abd. Manang L 11-02-1979/37 Suami Nelayan
Karmiati P 01-01-1983/33 Istri IRT
Riswan L 25-03-2003/13 Anak
Citra P 21-09-2006/10 Anak

42 Makmir L 05-05-1972/44 Suami Nelayan


Rusni P 11-10-1975/41 Istri IRT
Arman L 14-06-1990/26 Anak
Irma P 28-12-1996/20 Anak

43 Bahdar L 17-04-1983/33 Suami Nelayan


Yuliana P 15-04-1985/31 Istri IRT
Aulia P 10-09-2006/10 Anak
Bayu L 26-11-2009 / 7 Anak
P 23-12-2015/ Anak

44 Maryam P 07-10-1945/71 Janda

45 Bahrun L 09-10-1980/36 Suami Nelayan


Surni P 02-03-1983/33 Istri IRT
Rijal L 09-01-1999/17 Anak

46 Bahar L 25-01-1982/34 Suami Nelayan


Sarifa P 20-05-1988/28 Istri IRT
Dedi L 02-04-2007 / 9 Anak
Sapira P 26-07-2012 / 4 Anak

47 Sultan L 05-05-1973/43 Suami Nelayan


Siti Peda P 01-10-1973/43 Istri IRT
Raldin L 02-11-2000/16 Anak
Aditia L 25-07-2005/11 Anak

1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24
48 Mulking L 11-05-1993/23 Suami Swasta
Lili P 11-05-199 / Istri Honorer
Abi L 00-05-2015/ Anak

49 Basia P 20-05-1944/72 Janda

50 Anton B L 05-06-1976/40 Suami Nelayan


Munartin P 11-09-1980/36 Istri IRT
Arningsi P 03-07-2001/15 Anak
Ardan L 08-05-2003/13 Anak
Helpian P 15-03-2007 / 9 Anak

51 Hasrim D L 06-08-1983/33 Suami Nelayan


Hamria P 01-06-1987/29 Istri IRT
Rafly L 31-07-2005/11 Anak
Muh. Faudzan L 25-03-2013 / 3 Anak

52 Abang L 02-11-1977/39 Suami Nelayan


Lisna P 12-03-1980/36 Istri IRT
Lisayanti P 08-08-2000/16 Anak
Cici Desianti P 24-05-2006/10 Anak

53 La Ode Muda L 14-09-1943/73 Duda Nelayan

54 Irwan L 10-07-1987/29 Suami Swasta


Lusiana P 07-01-1989/27 Istri IRT
M.Fino Alfadil L 10-03-2014 / 2 Anak

55 Jumadil M L 29-12-1971/45 Suami Swasta


Hawaena P 01-01-1974/42 Istri IRT
Eka Riskayanti P 07-04-1996/20 Anak
Ika Alvariza P 03-08-2003/13 Anak
Fatnurainun Nazar P 19-04-2010 / 6 Anak
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24
56 Yunus M L 13-01-1970/46 Suami Swasta
Hasma P 31-12-1977/39 Istri IRT
Rosmayanti P 01-09-1997/19 Anak
Riswan L 01-06-2000/16 Anak

57 Sulha L 10-05-1977/39 Suami Swasta


Suriati P 05-10-1980/36 Istri IRT
Arini Sulastri P 11-11-2001/15 Anak
Rasti Sulastri P 25-01-2008 / 8 Anak
Rahmat L 26-12-2014 / 2 Anak

58 Nurhana P 29-09-1965/41 Janda IRT


Derwanta L 26-08-1989/27 Anak
Darmawan L 22-06-1991/25 Anak
Indriyani P 21-04-1995/21 Anak

59 Lumasa L 09-11-1962/54 Suami Nelayan


Kartini P 10-05-1970/46 Istri IRT
Mustapa L 02-06-1982/34 Anak Swasta
Suleman L 11-06-1989/27 Anak TNI
Vivi Anggraeni P 23-10-2001/15 Anak

60 Samsir L 10-04-1981/35 Suami Tani


Isra P 18-08-1985/31 Istri IRT
Wulan P 09-08-2001/15 Anak
M.Abizar Alzakat L 01-04-2014 / 2 Anak

61 Tunis L 22-06-1980/36 Suami Swasta


Halwiya P 10-09-1979/37 Istri IRT
Puja P 07-05-1996/20 Anak
Riski L 01-03-2004/12 Anak
Resni P 29-08-2008 / 8 Anak
Hamira P 05-03-1948/68 Anak

1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24
62 Pebrianto L 08-03-1995/ Suami Swasta
Nike P 08-03-1995/21 Istri IRT
Muh. Revan L 13-05-2013 / 3 Anak
Marni P 01-03-2015/ Anak

63 Hasmin L 27-01-1988/28 Suami Swasta


Nur P 07-05-1986/30 Istri IRT
Sriyani P 06-12-2009 / 7 Anak
Atri P 25-04-2015/ Anak

64 Amir S L 15-03-1980/36 Suami Swasta


Rusmini P 20-03-1986/30 Istri IRT
Alfin Febrianto L 20-02-2006/10 Anak
Alif Fajrin L 19-02-2010 / 6 Anak

65 Guntur L 08-01-1977/39 Suami Nelayan


Saliang P 03-09-1979/37 Istri IRT
Rey L 06-11-1996/20 Anak
Reki L 01-04-2006/10 Anak
Celsi P 29-09-2008 / 8 Anak

66 D. G Siti P 05-03-1944/72 Janda

67 Abd. Mursi 19-03-1985/31 Suami Swasta


Mimang 01-07-1987/29 Istri IRT
Hamsi 20-10-2010/ 6 Anak
Nanda 10-11-2011/ 5 Anak
M.Arjun 22-02-2014 / 2 Anak
Nurlia 30-10-2015/ Anak

68 Abdullah Tahir L 05-09-1982/34 Suami Swasta


Selni P 10-01-1986/30 Istri IRT
Aimal Setiawan L 15-09-2004/12 Anak
Aid Hikmawan L 03-01-2008 / 8 Anak
Asmarani P 27-04-2010 / 6 Anak
Raya Naya P 26-12-2014 / 2 Anak
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24
69 Lamonea L 10-12-1956/60 Suami Swasta
Mina P 04-06-1966/50 Istri IRT
Munasir L 23-07-2005/11 Anak

70 Muis L 14-12-1990/24 Suami Swasta


Rina P 14-12-1998/18 Istri IRT

71 Ali L 10-11-1980/36 Suami Swasta


Nartin P 02-05-1982/34 Istri IRT
Mulianti P 13-10-2000/16 Anak
Dirma P 06-08-2003/13 Anak
Dion L 01-01-2005/11 Anak
Riko L 03-11-2007 / 9 Anak
Lilis P 25-11-2015/ Anak

72 Mahiya P 11-10-1968/48 Janda IRT

73 Hanise P 01-06-1962/54 Janda Pedagang


Muhais L 05-07-1986/30 Anak TNI

74 Mustamin L 15-05-1979/37 Suami Swasta


Rania P 08-03-1980/36 Istri IRT
Fani P 29-03-2010/ 6 Anak

75 Kodiama L 09-02-1974/42 Suami Tani


Gaosa P 16-03-1973/43 Istri IRT
Risal L 17-06-1994/22 Anak
Ribal L 01-12-2001/15 Anak
Rijal L 07-08-2004/12 Anak

76 Haking L 01-08-1950/66 Suami Nelayan


Nursia P 09-07-1960/56 Istri IRT

1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24
77 Leni P 12-08-1979/37 Janda Swasta
Fatma P 07-04-2001/15 Istri
Haidir L 27-06-2007 / 9 Anak

78 Agus K L 17-08-1965/51 Suami Swasta


Karni P 12-12-1972/44 Istri IRT
Sandri L 05-01-1991/25 Anak
Alda Priani P 12-01-1999/17 Anak
Alma P 07-01-2001/15 Anak
Rian L 27-07-2007 / 9 Anak
Abel L 31-10-2011 / 5 Anak

79 Erwin L 10-02-1986/30 Suami Swasta


Dewi P 09-03-1988/28 Istri IRT
Rila P 05-11-2011 / 5 Anak
80 Hamme P 07-09-1957/59 Janda

81 Halim L 16-09-1979/37 Suami Swasta


Nur Fatimah P 15-06-1983/33 Istri IRT
Riad L 04-05-2010 / 6 Anak

82 Kanne P 11-09-1952/64 Istri


Hasria P 18-05-1982/34 Anak Swasta
Sahrir L 10-01-1987/28 Anak Swasta

83 Jusman L 20-05-1986/30 Suami Nelayan


Ramlia P 11-07-1987/29 Istri IRT
Nabila P 10-10-2005/11 Anak
Nur Asni P 06-09-2007 / 9 Anak

84 Kamme P 11-09-1952/64 Janda

1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24
85 Husen M L 01-07-1953/63 Suami Nelayan
Becce P 06-08-1950/66 Istri IRT
Rimon L 11-02-1990/26 Suami

86 Saharudin L 01-07-1971/45 Suami Swasta


Haerani P 01-03-1980/36 Istri IRT
M. Jaya L 24-01-2015/ 2 Anak

87 Musriki L 01-07-1948/68 Duda Nelayan


Ashar L 03-07-2004/12 Cucu

88 Alex L 01-04-1982/34 Suami Swasta


Cemming P 03-03-1986/30 Istri IRT
Siti aiza P 21-11-2010 / 6 Anak

89 Mursan L 02-03-1995/21 Suami Nelayan


Sari Muna P 11-12-1996/20 Istri IRT
Suci P 23-07-2013 / 3 Anak

90 Naing L 23-11-1959/57 Suami Nelayan


Kursia P 01-07-1957/59 Istri IRT

91 Ishak L 26-06-1982/34 Suami Nelayan


Mely Sriana P 01-05-1991/25 Istri IRT
M. Haikal A L 13-10-2010 / 6 Anak

92 Sulo P 06-04-1965/51 Istri IRT

93 Mansur L 01-07-1978/38 Suami Nelayan


Yanti P 11-03-1984/32 Istri IRT
Masrul L 22-07-2001/15 Anak
Nabila P 10-06-2004/12 Anak
Yudi Apandi L 11-12-2007 / 9 Anak
Rahma Azahra P 28-12-2010 / 6 Anak
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24
94 Muhajir L 10-10-1979/37 Suami Tukang
Suhaemi P 26-05-1986/30 Istri IRT
Mutmaina P 30-12-2000/16 Anak
Radiatul adawia P 18-03-2011 / 5 Anak
Ridwan L 18-03-2011 / 5 Anak
Mukhlis L 20-02-2012 / 4 Anak

95 Iskandar L 10-03-1970/46 Suami Nelayan


Hartati P 12-04-1976/40 Istri IRT
Idhar L 03-10-1996/20 Anak
Idram L 20-10-1999/17 Anak
Yuniar P 11-08-2001/15 Anak

96 Sugiono L 00-00-1988/28 Suami Swasta


Risnayati P 00-00-1989/27 Istri IRT
Anggi Safitri P 00-00-2009 / 7 Anak

97 Maswan L 07-06-1977/39 Suami Tani


Yusnawati P 30-01-1977/39 Istri IRT
Juswanto L 04-02-1997/19 Anak
Sri Ainun P 26-04-1999/17 Anak
Hidayatullah L 17-06-2010 / 6 Anak

98 Ahkam H. Ali L 20-06-1968/48 Suami PNS


Samsia P 21-04-1970/46 Istri IRT
Anggi P 22-07-1991/25 Anak
Arinda Wulandari P 09-12-1992/24 Anak
Ilham L 05-04-2005/11 Anak

99 Hapid L 05-01-1956/60 Suami Nelayan


Lumu P 01-07-1968/48 Istri IRT
Mariyono L 11-10-1983/33 Anak
Fikat Riani P 21-02-1992/24 Anak
Akbar L 27-12-1999/17 Anak
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24
100 H. Abu Bakar L 08-06-1960/56 Suami Swasta
Hj. Nika P 09-05-1963/54 Istri IRT
Randi Pratama L 10-04-1994/22 Anak

101 Imon, Amd.Kep L 16-07-1988/28 Suami Honorer


Suswati, AM.Keb P 27-09-1987/29 Istri PNS
Nova Cahyani I. P 09-11-2010 / 6 Anak

102 Muh.Hasan,S.Pd L 16-03-1979/37 Suami PNS


Asniatin, A.Mk P 05-11-1978/38 Istri PNS
Azizah Shafa Y P 21-07-2007 / 9 Anak
Muh.Azyar R L 15-08-2010 / 6 Anak
L -03-2015/ Anak

103 H. Ahmad L 10-07-1957/59 Suami Tani


Webau P 05-11-1960/56 Istri IRT
Suliawan L 26-03-1998/18 Anak

104 Haryono L 08-04-1984/32 Suami Swasta


Yuni P 05-11-1986/30 Istri IRT
Salsabilah P 10-12-2011/ 5 Anak

105 Harsia P 20-04-1956/60 Janda IRT

106 Emiriah P 01-06-1973/43 Istri Swasta


Irda P 09-08-1998/18 Anak
Anisa P 10-02-2002/13 Anak
Indri K P 02-02-2006/10 Anak

107 Rusdin L 05-03-198 / Suami Swasta


Yuni P 05-03-1988/28 Istri IRT

1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24
108 Esi Madanda L 01-03-1967/49 Suami Tani
Surni P 05-05-1970/46 Istri IRT
Sawal L 01-01-1994/22 Anak
Ebit L 07-05-2005/11 Anak

109 Salide L 02-06-1973/43 Suami Tani


Halna, S.Pd P 04-06-1974/42 Istri PNS
Jumi Surlianti P 09-10-1998/18 Anak
Hijratul L 28-08-2003/13 Anak
Eprilda P 09-04-2006/10 Anak

110 Ramlin Hasan L 02-05-1964/52 Suami Tani


Emi Rianti L P 16-04-1965/51 Istri IRT
Erman K L 22-10-1989/27 Anak TNI
Rinop Jaya L 06-03-1992/24 Anak Swasta
Eri Irawan L 16-06-1995/21 Anak

111 Rafil L 05-07-1981/35 Suami Tani


Musni P 08-06-1982/33 Istri IRT
Suci Olifia P 06-05-2007 / 9 Anak
M. Abdurahman G L 01-02-2013 / 3 Anak

112 Muh. Aril L 18-05-1978/38 Suami Swasta


Ida Rahmawati P 21-12-1983/33 Istri Honorer
Nur Sulfika P 23-08-2010 / 6 Anak
113 Supirman L 06-05-1985/31 Suami Swasta
Asma P 22-12-1992/24 Istri IRT
Airin Aryanti P 20-12-2009 / 7 Anak

114 Rustam L 14-05-1979/37 Suami Nelayan


Hana P 07-11-1985/31 Istri IRT
Rikhy Anugrah L 18-05-2011 / 5 Anak
Zakhy Arafah L 08-05-2014 / 2 Anak
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24
115 Masna P 03-12-1968/48 Janda

116 Dedi MS L 23-03-1991/25 Suami Swasta


Hijra P 18-08-1994/22 Istri IRT
M. Danil L 22-04-2011 / 5 Anak
Putri P 29-12-2014/ 1

117 Ruslan L 04-03-1977/39 Suami Nelayan


Nartin R P 27-07-1980/36 Istri IRT
Arham L 21-12-2002/14 Anak
Arlan L 03-11-2004/12 Anak

118 Hikmar L 05-02-1978/38 Suami Nelayan


Jumiati P 23-05-1977/39 Istri IRT
Muh. Amil L 02-06-2007 / 9 Anak
Nur Amalia P 01-06-2012 / 4 Anak

119 Alfin L 25-08-1971/45 Suami Tani


Maniatin P 25-08-1981/35 Istri IRT
Asrianto L 17-02-1997/19 Anak
Asniatin P 28-08-2006/10 Anak
Asrianti P 25-08-2008 / 8 Anak

120 Firman L 20-05-1960/56 Suami Tani


Bulang P 10-06-1971/45 Istri IRT
Supardin L 30-07-1997/19 Anak
Zhulfikri L 26-06-2004/12 Anak
Sukriyadi L 26-03-2006/10 Anak
Sulrifki L 12-02-2009 / 7 Anak

1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24
121 Surahman L 28-06-1989/27 Suami Swasta
Sulhija P 05-05-1985/31 Istri IRT
Muh. Azar L 29-12-2011 / 5 Anak

122 Supriadi L 16-06-1991/25 Suami Swasta


Nita P 07-08-1996/20 Istri IRT
Muh. Azril L 02-07-2013 / 3 Anak

123 M. Jus L 06-05-1958/58 Suami Nelayan


Hastian P 20-07-1967/49 Istri IRT
Novrian L 10-11-2007 / 9 Cucu
Noval L 11-11-2008 / 8 Cucu

124 H. Rahman L 03-06-1928/88 Suami Tani


Roni P 10-07-1982/34 Istri Tani
Muthasana L 05-04-2004/12 Anak
Nur Fitriani R P 10-08-2011 / 5 Anak

125 Sege L 03-03-1979/37 Suami Tani


Efi P 10-06-1994/22 Istri IRT
Habil L 28-06-2004/12 Anak

126 Yamin S L 16-01-1973/43 Suami Tani


Musi P 17-03-1977/39 Istri IRT
Rusmin L 15-06-1998/18 Anak
Bana L 10-11-2002/14 Anak
Murdin L 19-09-2005/11 Anak
Jumran L 05-10-2007 / 9 Anak
Ririn P 05-11-2012 / 4 Anak
L 20-04-2015 / Anak

1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24
127 Ferdi L 13-12-1975/41 Suami Swasta
Tina P 19-03-1979/37 Istri IRT
Fitriani P 09-08-2000/16 Anak
M. Rafli L 02-04-2006/10 Anak
M. Sapri L 30-04-2012 / 4 Anak

128 Boduala L 04-06-1952/64 Suami Tani


Angonia P 06-09-1967/49 Istri Tani
Nurwati P 10-12-1987/29 Anak
Yuyun L 07-08-1998/18 Anak
Aurel P 06-04-2009 / 7 Anak
129 Jumadil L 05-08-1978/38 Suami Tani
Saltin P 20-12-1985/31 Istri IRT
Fina P 03-10-2002/14 Anak
Fika P 08-04-2005/11 Anak

130 Anson L 10-09-1983/33 Suami Swasta


Rianti P 04-06-1984/32 Istri IRT
Adrian L 28-09-2004/12 Anak
Rina P 27-09-2006/10 Anak

131 Sapir L 25-10-1980/36 Suami Swasta


Gunawati P 19-12-1983/33 Istri IRT
Mirnawati P 07-07-2002/14 Anak
Mirpan L 12-02-2005/11 Anak
Adi saputra L 27-04-2011 / 5 Anak

132 Ujang Yayat L 20-02-1966/50 Suami TNI


Nurhayati P 12-07-1979/37 Istri IRT
Aan Ardiansyah L 08-08-2002/14 Anak
Agung Hidayat L 13-07-2005/11 Anak
Tri Abisar s. L 03-07-2013 / 3 Anak
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24
133 Saida P 11-11-1991/25 Janda Honorer
Faris L 13-03-2012 / 4 Anak

134 Suradin L 01-07-1975/41 Suami Swasta


Salma P 02-05-1963/53 Istri IRT
Holisar L 02-05-1999/17 Anak

135 Jamarudin L 31-12-1960/56 Duda Tani


Hardin L 11-04-1982/34 Anak Swasta

136 Nasir L 01-10-1959/57 Suami Tani


Hamona P 01-03-1971/45 Istri IRT
Harmomo L 13-02-1985/31 Anak Swasta
Nur Vita P 14-09-2010 / 6 Anak

137 Hasimu L 07-05-1954/62 Suami Swasta


Wenanasi P 04-03-1960/56 Istri IRT
Diman L 13-02-1995/21 Anak
Sule L 09-04-1998/18 Anak
Dimas L 08-06-2008 / 8 Anak

138 Amir Saleh L 29-10-1977/39 Suami Swasta


Juharsi R, SKM P 24-04-1976/40 Istri PNS
M. Adji Hidayat L 27-07-2005/11 Anak
Nurul Ayumi P 05-09-2010 / 6 Anak

139 Hawaena P 10-09-1962/54 Janda


Siti Humaera P 01-03-1997/19 Anak

140 Agus Laloasa L 29-11-1987/29 Anak Honorer


St. Hariani P 05-05-1979/ IRT

141 Binti P 03-07-1944/72 Janda

1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24
142 Hamid L 10-08-1976/40 Suami PNS
Sartika P 05-05-1979/37 Istri IRT
Asni P 05-05-1979/ Anak
Awaludin L 17-08-1986/30 Anak
Armin L 08-08-2000/16 Anak
Ayu P 20-07-2003/13 Anak
Fita Ariani P 05-05-1979/ Anak

143 Andi Baso L 10-12-1976/40 Suami Swasta


Harlian P 12-07-1976/40 Istri IRT
Asmaul L 28-08-1999/17 Anak
Nurlela P 12-12-2006/10 Anak
Nuraida P 27-06-2010 / 6 Anak

144 M. Amin T L 01-06-1958/58 Suami Swasta


Hatija P 10-07-1967/49 Istri IRT
Rustian P 06-06-1995/21 Anak
Hismawati P 06-06-2000/16 Anak

145 Pebrianto L 25-08-1989/ Suami Swasta


Hastuti P 25-08-1989/27 Istri Honorer

146 Hamsa P L 01-07-1963/53 Suami Swasta


Nurjana P 01-09-1970/46 Istri IRT

147 Edi Sudrajat L 12-11-1982/34 Suami Swasta


Irawati P 14-09-1985/31 Istri IRT
Nelson L 14-11-2001/15 Anak
Ita Sasmita P 11-07-2006/10 Anak
M. Abd.Sandi L 13-01-2009 / 7 Anak

148 Dedi L 13-04-1989/27 Suami Swasta


Risma P 08-04-1987/29 Istri IRT
Darmawan L 01-11-2012 / 4 Anak
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24
149 Ikram L 11-05-1991/25 Suami Swasta
Masniatin P 09-09-1994/22 Istri IRT
Muh, Akwal N L 01-11-2011 / 5 Anak

150 Suksono L 01-01-1975/41 Suami Swasta


Sumartin P 12-01-1978/38 Istri IRT
Iwit Harbia R P 24-12-2002/14 Anak
Ari Awan L 27-05-2012 / 4 Anak

151 Mania P 15-07-1962/54 Janda IRT

152 Muh. Ikbal Sufu L 12-02-1986/30 Suami Honorer


Dalnia M, S.Pd P 25-09-1987/29 Istri Honorer
Muh. Alan L 01-08-2010 / 6 Anak
Asyifa P 23-03-2013 / 3 Anak

153 Saidin L 20-05-1974/42 Suami Swasta


Hidar P 15-07-1986/30 Istri IRT
Irfan L 15-05-2002/14 Anak
Hapsa Andini P 01-06-2007 / 9 Anak
Ket

26
26
25
25
25
25
25
25
25
25
25
25
25
25
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PENDATAAN SASARAN KEGIATAN KESEHATAN
Nama Desa : Taipa
Jumlah Penduduk : Jiwa
Jumlah KK : KK
Jumlah PUS :
Luas Wilayah Desa : 3,57

Remaja
Alamat / Kartu
No. No. Hub. PUS PUS PUS KB Bayi Anak Apras
Nama JK Tgl Lahir / Umur Keluarga Pekerjaan Dusun / PUS WUS Gakin 10-14 15-18 Bumil Bulin Bufas Lansia BPJS /
KK Jiwa 4T ALKI Aktif Balita
RT/RW KIS
L P L P
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26
1 1 ANTON. B L 06-02-1976 /41 Suami Nelayan
2 MUNARTIN P 06-06-1980 /37 Istri IRT
3 ARNINGSI P 20-11-2001 /16 Anak
4 ARDAN SYAPUTRA L 04-02-2003 /14 Anak
5 NELPIAN SYAPUTRI P 09-10-2007 /10 Anak
6 NUR AINI P 15-08-2017 / Anak

2 7 BASIA P 01-07-1965 /52 Janda

3 8 BAHAR L 13-06-1983 /34 Suami Nelayan


9 SARIPA P 15-03-1988 /28 Istri IRT
10 DERY SAPUTRA L 05-10-2007 /10 Anak
11 SAPIRA AYU P 26-07-2012 /5 Anak

4 12 SULTAN L 05-05-1971 /46 Suami Nelayan


13 SITI PEDA P 01-10-1972 /45 Istri IRT
14 RALDIN L 02-11-2000 /17 Anak
15 ADITIA L 23-11-2005 /12 Anak

5 16 SAKIRA P 01-07-1952 /65 Janda Petani


17 ARPA L 01-07-1975 /42 Anak

6 18 MULKING L 29-08-1993 /24 Suami Petani


19 LILINZA P 02-04-1990 /27 Istri Honorer
20 MUHAMAD AL-ABIZAR L 14-05-2015 / 2 Anak
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26
7 21 BAHRUN L 10-10-1980 /37 Suami Nelayan
22 SURNI P 02-03-1983 /34 Istri IRT
23 RIJAL L 05-01-2000 /17 Anak
24 MUH. TAHIR L 20-07-1988 /29 Adik
25 SULKAEDAH L 09-01-1992 /25 Adik

8 26 MARYAM P 01-07-1947 /70 Janda

9 27 MAKMIR L 05-05-1972 /45 Suami Nelayan


28 RUSNI P 04-08-1975 /42 Istri IRT
29 ARMAN L 12-06-1990 /27 Anak

10 30 IRHAM L 05-08-1995/22 Suami Swasta


31 IRMA P 28-12-1996 /21 Istri IRT
32 MHEYUAHA IRHAM P 03-05-2017 / Anak

11 33 BAHDAR L 17-04-1983 /34 Suami Nelayan


34 YULIANA P 15-04-1985 /32 Istri IRT
35 HAMID DANIEL L 05-12-2002 /15 Adik
36 AULIA SITI RAHMA DANI P 10-04-2006 /11 Anak
37 MUH. BAYU L 26-11-2009 / 8 Anak
38 KARTIKA PUTRI P 23-12-2015 / 2 Anak

12 39 ABD. MANAN L 11-02-1979 /38 Suami Nelayan


40 KARMIATI ACHMAD P 01-01-1980 /37 Istri IRT
41 RISWAN. M L 23-03-2003 /14 Anak
42 CITRA. M P 21-09-2006 /11 Anak
13 43 MARLINA. D P 01-07-1963 /54 Janda Petani
44 BASRI YULI L 15-07-1987 /30 Anak Swasta
45 HAERUL L 17-10-1994 /23 Anak Swasta
46 SABIL L 15-02-1991 /26 Anak

14 47 RAMLI. L L 08-11-1971 /46 Suami Nelayan


48 JUMIATIN. R P 04-05-1974 /43 Istri IRT
49 RIMA INDRIYAWATI P 27-10-1995 /22 Anak
50 ASWIN L 28-12-1999 /18 Anak
51 SESILIA P 24-03-2016 / 1 Anak
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26
15 52 ACO. J L 01-07-1961 /56 Suami Nelayan
53 JAENA P 01-07-1963 /54 Istri IRT

16 54 MUHLIS L 01-07-1978 /39 Suami Nelayan


55 HASTIAN P 05-12-1986 /31 Istri IRT
56 RUSLI L 01-07-2009 / 8 Anak
57 MUHAMAD ARIF L 13-05-2017 / Anak

17 58 ABDUL LATIF L 01-07-1928 /89 Suami Nelayan


59 KARLINA. L P 01-07-1953 /64 Istri IRT

18 60 ABDUL RAHIM L 01-07-1986 /31 Suami Pedagang


61 RATNA P 21-12-1990 /27 Istri IRT
62 SASKIA RAHIM P 17-05-2012 / 5 Anak
63 YUNUS L Duda

19 64 ANWAR L 25-04-1968 /49 Suami Nelayan


65 NURHAYATI P 06-07-1977 /40 Istri IRT
66 RISMA P 04-04-1997 /20 Anak
67 ARDIANSAH L 23-07-2004 /13 Anak

20 68 RABIL SAPUTRA L 27-04-1987 /30 Suami Nelayan


69 NURJANNAH P 09-05-1983 /34 Istri IRT
70 NUR AIZAH P 16-05-2012 / 5 Anak
71 NUR BERLIAN P 19-02-2015 /2 Anak

21 72 HARNI P 01-07-1970/47 Janda

22 73 SUTRA, S.Ag L 15-06-1972 /45 Suami PNS


74 HUDAYA P 02-12-1982 /35 Istri IRT
75 NUR SULISTIAWATI P 08-10-2001 /16 Anak
76 NURUL HIKNI P 07-01-2011 /6 Anak
77 NUR ADRESIA AYATUL H. P 14-04-2016 /1 Anak

23 78 IRHAM. J L 25-04-1992 /25 Suami Swasta


79 JUNAEDA, AM.Keb P 13-09-1992 /25 Istri IRT
80 MUHAMMAD AL-AZIZ L 14-10-2015 /2 Anak
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26
24 81 MISO L 03-10-1968 /49 Suami Swasta
82 DALMIA P 13-06-1979 /38 Istri IRT
83 SARIYANTI P 16-05-1992 /25 Anak
84 ERPIAN RAHMA DANI P 30-06-2001 /26 Anak

25 85 JUPRI L 01-07-1977 /40 Suami Nelayan


86 SAOMI P 10-07-1978 /39 Istri IRT
87 HELDA SULIS TINA P 30-12-2002 /15 Anak
88 AGISTA SARBIA P 10-08-2005 /12 Anak
89 ARISTA SARIANTI P 03-02-2010 /7 Anak
90 ARMITA NUR AKKA P 27-01-2017 / Anak

26 91 IKBAL L 13-07-1973 /44 Suami Petani


92 SURIANI P 29-07-1975 /42 Istri IRT
93 RIKI ARDIANTO L 18-05-2002 /15 Anak

27 94 KAISAR, S.Pd L 22-03-1993 /24 Suami Swasta


95 ARSITA MINANG SARI P 23-03-1995 /22 Istri IRT
96 ZAKIYYAH NAJWA ZAHRA P 02-10-2015 / 2 Anak

28 97 AJIS L 12-04-1978 /39 Suami Nelayan


98 SUKMAWATI P 26-04-1979 /38 Istri IRT
99 ANDRIYANI P 10-05-2001 /16 Anak
100 FITRIYANI P 07-09-2002 /15 Anak
101 DIMAS ALAMSYA L 21-08-2006 /11 Anak

29 102 SAMSUDDIN L 11-10-1975 /42 Suami Petani


103 YUGA P 10-12-1973 /44 Istri IRT
104 MUH. HENDRA L 10-12-1995 /22 Anak
105 FETI PERAWATI P 09-05-1998 /19 Anak
106 HASTIAN P 29-05-2006 /11 Anak
107 HASRIP L 09-06-2008 /9 Anak

30 108 SALANGGE P 01-07-1957/60 Janda


109 ALDO L 25-07-2009 / 8 Cucu
110 RONALDO L 03-06-2000/17 Cucu

1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26
31 111 SITI HASNAH P 15-04-1964 /53 Janda
112 RISKA ARDIANTI P 14-12-2000 /17 Anak

32 113 PAISAL L 12-07-1960 /57 Suami Swasta


114 BUNGALA P 01-07-1963 /54 Istri IRT
115 SAMSUL L 20-02-1983 /34 Anak
116 ROSMAWATI P 10-04-2001 /16 Anak

33 117 ADEN RACHMAT ENEM, SE L 02-05-1986 /31 Suami Swasta


118 NURSAIDA, S.Pd P 05-12-1986 /31 Istri Guru
119 ADNI CAHYA MAULIDYA A. P 03-01-2015 / 2 Anak
34 120 HAMSAH. A L 01-07-1952 /65 Suami Swasta
121 DENGGO P 10-02-1951 /66 Istri IRT
122 SULKARNAIN L 12-05-2004 /13 Cucu

35 123 WAHYUDIN L 10-07-1979/38 Suami Swasta


124 JUMARTIN P 20-01-1989/28 Istri IRT
125 MAWAR PUTRI ADE LINA P 11-05-2008 / 9 Anak
126 MUH. IRSYAD L 12-12-2015 / 2 Anak

36 127 BURHAN L 08-07-1956 /61 Suami Swasta


128 HUDAYA P 17-10-1958 /59 Istri IRT
129 RINO L 20-11-1986 /31 Anak
130 LAASAMANA L 07-11-1980/37 Anak
131 BUSTAMIN L 03-05-1983/34 Anak

37 132 BAEDARO P 01-07-1960 /57 Janda Petani


133 MAULANA P 06-11-1996 /21 Anak

38 134 UDIN FAJAR. ST L 03-05-1976 /41 Suami Swasta


135 RITA SAMI P 07-06-1984 /33 Istri IRT
136 INTAN SUCI RAMADHANI P 03-11-2004 /13 Anak
SITI MARISA RUKMANA
137 P 19-03-2009 / 8 Anak
FAJAR

1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26
39 138 ANTON. S L 01-05-1970/47 Suami Nelayan
139 MUSNI. S P 16-02-1971/46 Istri IRT
140 MERY ASRIANI P 08-06-2001/16 Anak
141 MIRDAD SLAMET L 10-04-2007/10 Anak
142 SUPARMIN L 18-09-2008 / 9 Anak
143 SALSA NABILA P 23-03-2012 / 5 Anak
40 144 AHYA L 15-05-1968 /49 Suami Nelayan
145 HASNAWATI P 12-04-1969 /48 Istri IRT
146 ARIL L 06-06-2005/12 Anak

41 147 RANDI. A L 01-01-1992 /25 Suami Swasta


148 NITRA P 27-01-1993 /24 Istri IRT
149 NAYZILA. R P 09-11-2014 / 3 Anak

42 150 SAENI L 10-11-1956 /61 Suami Nelayan


151 SALNA P 10-07-1968 /49 Istri IRT
152 JONI ISKANDAR L 17-05-1996 /21 Anak
153 RIRIN P 12-08-2000 /17 Anak
154 DIRLIN L 02-04-2007 /10 Anak

43 155 ISMAIL L 03-04-1994 /23 Suami Nelayan


156 ERNITA SARI P 03-06-1998 /19 Istri IRT

44 157 AGUSTAM L 17-08-1993 /24 Suami Petani


158 SRIANA P 03-03-1996 /21 Istri IRT
159 MUH. ALFAUSAN L 26-06-2014 /3 Anak

45 160 SUMAEDDIN L 05-06-1977 /40 Suami Nelayan


161 LISNA. J P 10-03-1983 /34 Istri IRT
162 ADRIANSYAH L 04-02-2006 /11 Anak
163 NIA RAHMADANI P 26-08-2010 /7 Anak

46 164 ERWIN L 07-11-1986 /31 Suami Nelayan


165 DEWI P 24-04-1989 /28 Istri IRT
166 RILA AFRILIA P 15-09-2011 /6 Anak

1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26
47 167 JUMADIL. M L 29-12-1971 /46 Suami Nelayan
168 HAWAENA P 01-01-1974 /43 Istri IRT
169 ARIYANA EKA RISKIA WATI P 07-04-1996 /21 Anak
170 FATHUR AHLUN NAZAR L 03-08-2003 /14 Anak
171 IKA ALFARIZAH P 19-04-2010 /7 Anak

48 172 HASRIM L 06-08-1983 /34 Suami Nelayan


173 HAMRIA P 01-06-1987 /30 Istri IRT
MUHAMMAD RAFLY
174 L 31-07-2005 /12 Anak
PRATAMA
175 MUH. FAUDZAN ALFARIDZ L 25-03-2013 /4 Anak

49 176 YUNUS L 13-01-1970 /47 Suami Nelayan


177 ASMA P 31-12-1977 /40 Istri IRT
178 RISWAN L 01-09-1997 /20 Anak

50 179 SYAWAL, SH L 01-01-1994 /23 Suami Swasta


180 ROSMAYANTI P 01-06-2000 /17 Istri IRT

51 181 SULHA L 10-07-1977 /40 Suami Tukang


182 JUMIATIN. S P 05-10-1988 /29 Istri IRT
183 ARINI SULASTRI P 01-01-2001 /16 Anak
184 RASTI SULASTRI P 25-01-2008 / 9 Anak
185 RAHMAT. S L 26-12-2014 / 3 Anak

52 186 WEMODA P 29-09-1965 /52 Janda


187 DERWANTA L 26-08-1989 /28 Anak Swasta
188 DERMAWAN L 22-06-1991 /26 Anak
189 ANDRIAN P 21-04-1995 /22 Anak Honorer

53 190 LUMASA L 08-11-1962 /55 Suami Swasta


191 KARTINI P 09-12-1970 /47 Istri IRT
192 SULEMAN L 11-06-1989 /28 Anak
193 MUSTAPA L 02-06-1992 /25 Anak
194 VIVI ANGRAINI P 23-10-2001 /16 Anak
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26
54 195 LUSMAN L 04-08-1986 /31 Suami Swasta
196 IRMA P Istri IRT
197 AL L Anak

55 198 IMON L 16-07-1988 /29 Suami Honorer


199 SUSWATI P 27-09-1987 /30 Istri PNS
200 NOVA CAHYANTI P 09-11-2010 /7 Anak

56 201 SAMSIR L 10-04-1981 /36 Suami Nelayan


202 ISRA P 18-08-1985 /32 Istri IRT
203 SRIWULANDARI P 09-08-2001 /16 Anak
204 FAREL L 04-04-2014 /3 Anak

57 205 HAMIRA P 05-03-1948 /69 Janda

58 206 TUNIS L 22-06-1980 /37 Suami Nelayan


207 HALWIAH P 10-09-1979 /38 Istri IRT
208 PUJA P 09-06-1996 /21 Anak
209 RESKY L 01-03-2004 /13 Anak
210 RESNI P 29-08-2008 /9 Anak
211 P 09-12-2017 / Anak

59 212 FEBRIANTO L 07-02-1992 /25 Suami Nelayan


213 NIKEN P 08-03-1995 /22 Istri IRT
214 REFAN L 13-05-2013 / 4 Anak
215 MARNI P 01-03-2015 / 2 Anak
216 MARSYA P 31-08-2016 / 1 Anak

60 217 HASMIN L 10-04-1991 /26 Suami Nelayan


218 NURJANA P 05-07-1986 /31 Istri IRT
219 TRIANA P 16-12-2009 / 8 Anak
220 ATRIANI P 25-04-2015 / 2 Anak

61 221 MUSTAMIN L 15-05-1979 /38 Suami Nelayan


222 RAMIA P 27-03-1980 /37 Istri IRT
223 MURTI FANI. A P 29-03-2010 /7 Anak
224 ZAHIRA ALFANNISA P 12-05-2016 /1 Anak
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26
62 225 AMIR. S L 15-03-1984 /33 Suami Swasta
226 RASMINI P 30-03-1986 /31 Istri IRT
227 ALFIN FEBRIANTO L 20-02-2006 /11 Anak
228 ALIF PAJRIN L 19-02-2011 /6 Anak

63 229 GUNTUR L 08-01-1977 /40 Suami Nelayan


230 SALIANG P 03-09-1979 /38 Istri IRT
231 REY ARIANTO L 06-09-1995 /22 Anak
232 REKI ADRIANSA L 01-03-2004 /13 Anak
233 CELSY P 29-07-2008 /9 Anak

64 234 ABDULLAH TAHIR L 08-06-1982 /35 Suami Nelayan


235 SELNI P 16-04-1986 /31 Istri IRT
236 AMAL SETIAWAN L 15-05-2004 /13 Anak
237 ADIT HIMAWAN L 13-01-2008 /9 Anak
238 A'AT CAHYANI P 27-04-2010 /7 Anak
239 NADJWARAYA P 26-12-2014 /3 Anak

65 240 KAME P 01-07-1961 /56 Janda

66 241 DAENG SITI P 05-03-1944 /73 Janda

67 242 ALI. N L 03-04-1979 /38 Suami Nelayan


243 NARTIN P 06-03-1985 /32 Istri IRT
244 MULIANTI P 09-02-2000 /17 Anak
245 DIRMA P 07-10-2002 /15 Anak
246 RIKO L 08-03-2006 /11 Anak
247 DION L 06-05-2007 /10 Anak
248 LILIS P 25-12-2015 /2 Anak

68 249 ABD. MURSIT L 19-03-1985 /32 Suami Nelayan


250 MIMANG P 01-07-1987 /30 Istri IRT
251 HAMSI L 20-10-2010 / 7 Anak
252 NANDA P 10-11-2011 / 6 Anak
253 M. ARJUN L 22-02-2014 / 3 Anak
254 NUR LIA P 30-10-2015 /2 Anak

1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26
69 255 LAMONEA L 10-12-1956 /61 Suami Nelayan
256 MINA P 04-06-1966 /51 Istri IRT
257 MUNASIR L 13-05-2005 /12 Anak

70 258 MAHYA P 01-06-1962 /55 Janda

71 259 ROBIN L 01-04-1989 /28 Duda Nelayan


260 ANA P 27-12-2009 /8 Anak

72 261 HANISE P 01-06-1962 /55 Janda

73 262 KODIAMA L 27-12-1970 /47 Suami Petani


263 GAOSA P 08-03-1976 /41 Istri IRT
264 RISAL L 11-04-1999 /18 Anak
265 IPAL L 09-11-2002 /15 Anak
266 RIJAL L 08-05-2004 /13 Anak

74 267 ABANG L 01-07-1977 /40 Suami Nelayan


268 LISNA. A P 04-07-1980 /37 Istri IRT
269 Lisayant P 08-08-2000/16 Anak
270 CICI P 01-01-2006 /11 Anak

75 271 ODE MUDA L 01-07-1943 /74 Duda Nelayan

76 272 RIANUS L 11-06-1974 /43 Suami Petani


273 RISNAWATI P 05-07-1984 /33 Istri IRT
274 ARIL L 02-07-2003 /14 Anak
275 RIFKA RIANTI P 03-03-2008 /9 Anak

77 276 ALIPIN L 20-08-1971 /46 Suami Petani


277 MANIATIN P 20-08-1982 /35 Istri IRT
278 ASRIANTO L 17-02-1997 /20 Anak
279 ASNIATIN P 26-08-2006 /11 Anak
280 ASTRID P 28-08-2009 /8 Anak

1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26
78 281 HIKMAR L 05-02-1978 /39 Suami Nelayan
282 JUMIATI P 23-05-1977 /40 Istri IRT
283 MUH. AMIL L 02-06-2007 /10 Anak
284 NUR AMALIA P 01-06-2012 / 5 Anak

79 285 RUSLANG L 03-04-1977 /40 Suami Nelayan


286 NARTIN. R P 10-01-1980 /37 Istri IRT
287 ARHAM L 21-12-2002 /15 Anak
288 ARLAN L 03-11-2004 /13 Anak
289 L 24-12-2017 / Anak

80 290 MASNA P 03-12-1968 /49 Janda


291 RUNDU ALAM L 01-01-1991 /26 Anak Swasta

81 292 DEDY ROMANSYAH L 23-03-1990 /27 Suami Nelayan


293 HIJRA P 18-08-1994 /23 Istri IRT
294 DANI ROMANSYAH L 03-04-2011 / 6 Anak
295 PUTRI VERA P 29-12-2014 / 3 Anak
296 ILHAM ROMANSYAH L 09-07-2017 / Anak

82 297 RUSTAM. E L 15-04-1979 /38 Suami Nelayan


298 HANA P 07-11-1985 /32 Istri IRT
299 RIKHY ANUGRAH L 18-05-2011 / 6 Anak
300 ZAKHY ARAFAH L 08-05-2014 / 3 Anak

83 301 RAMLIN HASAN L 02-05-1964 /53 Suami Petani


302 EMI RIANTI. L P 05-08-1965 /52 Istri IRT
303 ERMAN. K L 22-10-1989 /28 Anak TNI
304 ERI IRAWAN L 16-06-1996 /21 Anak

84 305 SUPIRMAN L 19-03-1985 /32 Duda Swasta

85 306 MUHAMAD HARIS L 18-05-1978 /39 Suami Swasta


307 IDA RAHMAWATI P 21-03-1983 /34 Istri IRT
308 RENDI PRATAMA L 08-10-2007 /10 Anak
309 IKA PUSPITA P 23-08-2010 / 7 Anak
310 PUTRI P 11-10-2011 / 6 Anak
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26
86 311 RINOP JAYA L 06-03-1992/25 Suami Swasta
312 DEWI P 04-01-1997/20 Istri IRT
313 AZZAM PUTRA JAYA L 02-11-2017 / Anak

87 314 SALIDE L 02-06-1973 /44 Suami Petani


315 HALNA, S.Pd P 04-06-1974 /43 Istri PNS
316 JUMI SERLIANTI P 09-10-1998 /19 Anak
317 HIJRATUL ARWANSYABILLAH L 20-08-2003 /14 Anak
318 EFRILDA SRY MAULIJAH P 09-04-2006 /11 Anak
88 319 ESI MADANDA L 03-03-1967 /50 Suami Petani
320 SURNI P 05-05-1970 /47 Istri IRT
321 EBIT L 07-05-2005 /12 Anak

89 322 HARSIA P 01-07-1958 /59 Janda

90 323 EMIRIAH P 01-07-1973 /44 Janda


324 IRDAYANTI ISKANDAR P 07-08-1998 /19 Anak
325 ANISA JAYANTI SAPUTRI P 18-07-2001 /16 Anak
326 INDRI ASKIA ISKANDAR P 02-02-2007 /10 Anak

91 327 RUSDIN L 01-041987 /30 Suami Nelayan


328 YUNIATIN P 05-03-1988 /29 Istri IRT
329 DEA ANANDARA P 30-04-2016 / 1 Anak

92 330 H. AHMAD L 10-07-1957 /60 Suami Petani


331 HJ. BAU P 05-11-1960 /57 Istri IRT

93 332 MUHAMMAD AHSAN, S.Pd L 16-03-1979 /38 Suami PNS


333 ASNIATIN P 05-04-1978 /39 Istri PNS
334 AZIZAH SHAFA YULIA P 21-07-2007 /10 Anak
335 MUHAMMAD AZYAR R. L 15-08-2010 /7 Anak
336 MUHAMMAD ADLI FAUZI L 26-03-2015 /2 Anak

94 337 H. ABU BAKAR L 08-06-1960 /57 Suami Nelayan


338 HJ. NIKA P 09-05-1963 /54 Istri IRT
339 RANDI PRATAMA PUTRA L 10-04-1994 /23 Anak
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26
95 340 MASWAN L 07-06-1977 /40 Suami Swasta
341 YUSNAWATI P 30-01-1977 /40 Istri IRT
342 YUSWANTO L 04-02-1997 /20 Anak
343 SRI AINUN P 26-04-1999 /18 Anak
344 HIDAYATTULAH L 17-06-2010 /7 Anak
96 345 HAPID L 05-01-1956 /61 Suami Petani
346 LUMU P 01-07-1968 /49 Istri IRT
347 AKBAR L 27-12-1999 /18 Anak

97 348 HARIYONO L 17-07-1984 /33 Suami Petani


349 YUNINGSIH P 21-06-1991 /26 Istri IRT
350 ALMUTIAS SALSABILLA. HN P 10-12-2012 / 5 Anak

98 351 MARIONO L 11-10-1987 /30 Suami Swasta


352 SUSIANTI P 12-03-1993 /24 Istri
353 JIHAN NURIA P 02-04-2016 /1 Anak

99 354 AHKAM, SH L 20-06-1968 /49 Suami PNS


355 SAMSIAH P 21-04-1970 /47 Istri IRT
356 ANA ADRIANGGI. AHKAM H. P 22-06-1991 /26 Anak
ARINDA WULANDARI. H. ALI,
357 P 09-12-1992 /25 Anak Honorer
AM.Keb
358 MUH. ILHAM. H. ALI L 05-04-2002 /15 Anak

100 359 ISKANDAR L 10-03-1970 /47 Suami Nelayan


360 HARTATI P 12-11-1976 /41 Istri IRT
361 IDHAR L 03-10-1996 /21 Anak
362 IDRAM L 20-10-1999 /18 Anak
363 YUNIAR P 11-08-2001 /16 Anak

101 364 KANNE P 11-09-1952 /65 Janda Petani


365 HASRIA P 18-05-1982 /35 Anak Nelayan
366 SAHRIR L 10-01-1987 /30 Anak

102 367 HAME P 01-07-1942 /75 Janda

1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26
103 368 MUHAJIR L 19-10-1979 /38 Suami Petani
369 SUHAEMI P 01-04-1986 /31 Istri IRT
370 MUTMAINNA P 30-12-2000 /17 Anak
371 M. RIDWAN L 18-03-2011 / 6 Anak
372 RABIATUL P 18-03-2011 / 6 Anak
373 MUH. MUHSIN L 20-02-2012 / 5 Anak
374 L 12-10-2017 / Anak

104 375 SULO P 01-07-1953 /64 Janda

105 376 MANSUR L 01-07-1978 /39 Duda Nelayan


377 MASRUL L 22-06-2001 /16 Anak
378 NABILA P 01-06-2004 /13 Anak
379 YUDI AFANDI L 11-12-2007 /10 Anak
380 RAHMA AZAHRA P 28-05-2010 / 7 Anak

106 381 KURSIA P 01-07-1966 /51 Janda

107 382 ISHAK L 29-06-1982 /35 Suami Nelayan


383 MELLYSRIANI P 01-05-1991 /26 Istri IRT
384 MUH. HAIKAL L 13-10-2010 /7 Anak
385 ANISQIRANI P 12-04-2017 / Anak

108 386 MUSRIKI L 01-07-1948 /69 Duda Nelayan


387 MURSAN L 08-07-1988 /29 Suami Nelayan

109 388 CEMING P 03-03-1986 /31 Janda Swasta


389 SITI AISYAH P 21-11-2009 / 8 Anak

110 390 HALIMIN L 16-05-1979 /38 Suami Petani


391 NURPATIMA P 15-06-1983 /34 Istri IRT
392 ASHAR L 03-07-2004 /13 Anak
393 ALHAT SARIAT L 07-06-2010 /7 Anak
394 MUH. ALI BAS KORO L 10-11-2011 /6 Anak

111 395 BECE P 01-07-1965 /52 Janda


396 RIMON L 11-02-1990 /27 Anak Swasta
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26
112 397 SAHARUDDIN L 01-07-1972 /45 Suami Swasta
398 HAERANI P 01-02-1981 /36 Istri IRT
399 M. JAYA. S L 24-01-2015 / 2 Anak
400 L 19-11-2017 / Anak

113 401 NURSIAH P 09-07-1960 /57 Janda

114 402 LENING P 12-08-1979 /38 Janda


403 ANDI ATMA FAUSIAH P 24-04-2002 /15 Anak
404 ANDI MUH. HAIDIR YAHYAT L 08-01-2008 /9 Anak

115 405 YASIR L 03-01-1973 /44 Suami Swasta


406 AMRIAM P 08-10-1987 /30 Istri IRT
407 FAIZUAN L 06-09-2011 / 6 Anak

116 408 JOHAR L 15-08-1960 /57 Suami PNS


409 BOLONG P 06-02-1969 /48 Istri IRT
410 M. ALIF MA'RUF L 26-09-1999 /18 Anak
411 ABD. RAHMAN L 30-12-2009 / 8 Anak

117 412 AGUS. K L 17-08-1965 / 52 Suami Nelayan


413 KARNI P 12-12-1972 /45 Istri IRT
414 SANDRI L 06-01-1991 /26 Anak
415 ALMA P 07-01-2001 /16 Anak
416 RIAN L 27-07-2007 /10 Anak
417 ABEL L 31-10-2012 / 5 Anak

118 418 JAMARUDDIN L 31-12-1960 /57 Duda Petani


119 419 SAIDIN L 09-07-1979 /38 Suami Petani
420 HIDAR P 18-07-1986 /31 Istri IRT
421 M. IRPAN L 15-05-2002 /15 Anak
422 HAFSA ANDINI P 01-08-2007 /10 Anak

120 423 HAMZAH. P L 01-07-1963 /54 Suami Petani


424 NURJANA P 05-05-1967 /50 Istri IRT
425 IDA WATI P 02-05-1990 /27 Anak Honorer
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26
121 426 JUSMAN L 20-05-1986 /31 Suami Swasta
427 RAMLIA P 11-07-1987 /30 Istri IRT
428 NABILA P 10-10-2005 /12 Anak
429 LAILA P 06-09-2007 /10 Anak

122 430 DEDY HAMZAH L 13-04-1988 /29 Suami Nelayan


431 RISMA P 14-08-1989 /28 Istri IRT
432 M. ASPUAR. M L 28-08-2012 / 5 Anak

123 433 IKRAM L 28-02-1991 /26 Suami Nelayan


434 MASNIA P 01-09-1994 /23 Istri IRT
435 M. AKWAL L 01-11-2011 / 6 Anak

124 436 MANIA P 15-07-1963 /54 Janda

125 437 AHMAD IQBAL SUPU L 12-02-1986 /31 Suami Honorer


438 DALNIYA MERONDA P 25-09-1987 /30 Istri Honorer
439 MUH. ALAN PRADITYA SUPU L 01-08-2010 / 7 Anak
440 ASIFA NUR FAUZIA P 23-03-2014 / 3 Anak

126 441 M. AMIN. T L 01-06-1958 /59 Suami Petani


442 HATIJA P 10-07-1972 /45 Istri Petani
443 ROSTIAN P 06-05-1995 /22 Anak
444 HISMAWATI P 23-04-2000 /17 Anak

127 445 ISRAWAL PEBRIANTO L 12-02-1991 /26 Suami Swasta


446 HASTUTI, S.Pdi P 25-08-1989 /28 Istri Honorer
447 AIMAR AL FARUP L 21-05-2016 / 1 Anak

128 448 SUKSONO L 01-12-1975 /42 Suami Swasta


449 SUMARTIN P 12-01-1978 /39 Istri IRT
450 IWIT HARBIA RAHMAN P 24-12-2002 /15 Anak
451 MUH. ARIAWAN L 28-05-2012 / 5 Anak

129 452 BINTI P 03-07-1944 /73 Janda

1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26
130 453 ANDI BASO L 19-12-1976 /41 Suami Petani
454 HARLIAN P 17-10-1977 /40 Istri IRT
455 ASMAUL HUSNA L 28-08-1999 /18 Anak
456 NURLAELA P 12-12-2006 /11 Anak
457 NURSAIDA P 27-06-2010 /7 Anak

131 458 EDI SUDRAJAD L 12-12-1982 /35 Suami Swasta


459 IRAWATI P 04-03-1986 /31 Istri IRT
460 NELSON L 14-09-2002 /15 Anak
461 ITA SASMITA P 11-07-2006 /11 Anak
462 M. ABD. SANDI L 28-01-2008 / 9 Anak

132 463 HAWAENA P 10-09-1962 Janda


464 SITI HUMAERA P 01-03-1997 Anak

133 465 ARMAN RAHARJA L 07-08-1989 /28 Suami Swasta


466 TRI SATRIA SAFITRI P 14-08-1976 /41 Istri IRT
467 GEOVANI PUTRA PERDANA L 22-10-2012 /5 Anak
134 468 AGUS LALOASA, A.Md L 29-11-1987 /30 Suami Swasta
469 SITI HARIANA P 10-06-1992 /25 Istri IRT
470 ASKANAH SAKHI JAMRUN L 14-04-2016 /1 Anak

135 471 JAMIL. B L 10-08-1976 /41 Suami PNS


472 HADIJA P 14-07-1981 /36 Istri IRT
473 AWALUDIN L 08-07-1994 /23 Anak
474 ASNI P 20-12-1996 /21 Anak
475 AMIN DANGGO L 08-08-2000 /17 Anak
476 NENENG AYU P 20-07-2003 /14 Anak
477 PITRI ANDRIANI P 03-04-2011 /6 Anak
478 ALAMSYAH L 14-01-2013 /4 Anak
479 ARDIANSYAH. S L 29-08-2014 /3 Anak
480 ALBISAR L 12-07-2016 /1 Anak

1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26
136 481 AMIR SALEH LAASAMANA L 29-10-1977 /40 Suami Swasta
482 JUHARSIH RASJID P 23-04-1976 /41 Istri PNS
483 IRNALDHY KUSUMAJAYA L 13-07-1996 /21 Anak
484 INTAN NURUL AINI. K P 25-06-2002 /15 Anak
485 MUH. ADJI HIDAYAT L 27-04-2006 /11 Anak
486 NURUL AYUMI P 05-09-2010 / 7 Anak

137 487 WENANASI P 11-05-1960 /57 Suami


488 DIMAN L 12-05-2002 /15 Istri
489 DIMAS L 05-07-2008 /9 Anak
490 SALIM L 05-09-2009 /8 Anak

138 491 M. WIRA RASYID L 26-10-1994 /23 Suami Petani


492 TEA P Istri IRT
493 NAIRA P 03-03-2017 / Anak

139 494 SOPIA P 27-10-1970 /47 Janda

140 495 UJANG YAYAT. R L 20-02-1966 /51 Suami TNI


496 NURHAYATI P 12-12-1979 /38 Istri IRT
497 AAN ARDIANSYAH L 08-08-2002 /15 Anak
498 AGUNG HIDAYAT L 13-06-2004 /13 Anak
499 TRI ABIZAR SYABAN L 03-07-2013 /4 Anak

141 500 NASIR L 01-10-1959 /58 Suami Petani


501 HAMONA P 01-03-1971 /46 Istri IRT
502 HARMONO, S.Sos L 13-02-1985 /32 Anak
503 NURFITRA. N P 14-09-2010 / 7 Anak
504 AISYAH NUR SAHARA P 08-08-2016 / 1 Anak

142 505 SAMAD NGGOLELE L 07-07-1989 /28 Suami Swasta


506 FAJRIA P 26-01-1993 /24 Istri IRT
507 ANNISYA KASTURI NAING P 14-05-2015 / 2 Anak

143 508 SURADIN L 05-10-1977 /40 Suami


509 SALMA P 02-05-1963 /54 Istri
510 HOLISAR L 02-05-1998 /19 Anak
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26
144 511 BUDUALA L 04-06-1952 /65 Suami Swasta
512 AGONIA P 06-09-1967 /50 Istri IRT
513 YUYUN L 07-08-1998 /19 Anak
514 AURE P 27-04-2008 /9 Anak

145 515 JUMADIN. B L 05-08-1978 /39 Suami Petani


516 SALTIN P 20-12-1985 /32 Istri IRT
517 PINA P 03-10-2002 /15 Anak
518 PIKA P 08-04-2005 /12 Anak

146 519 ANSON L 10-09-1983 /34 Suami Swasta


520 RIANTI P 04-06-1984 /33 Istri IRT
521 ARDIAN NUR ALAM L 28-09-2004 /13 Anak
522 RINA RAHMADANI P 27-09-2006 /11 Anak

147 523 YAMIN. S L 10-01-1973 /44 Suami Petani


524 MUSI P 17-07-1977 /40 Istri IRT
525 RUSMIN L 16-06-1998 /19 Anak
526 YUSRIP L 10-10-2002 /15 Anak
527 MURDIN L 19-09-2005 /12 Anak
528 JUMRAN L 05-10-2007 /10 Anak
529 RIRIN P 05-11-2012 / 5 Anak
530 ARDIN L 20-04-2015 / 2 Anak

148 531 SEGE. M L 03-03-1979 /38 Duda Swasta


532 ARIYAWAN L 28-04-2004 /13 Anak IRT

149 533 H. RAHMAN L 03-06-1928 /89 Suami Petani


534 RONI P 10-07-1982 /35 Istri IRT
535 MULTAZAM L 05-04-2004 /13 Anak
536 NUR FITRIANI RAHMAN P 10-08-2011 /6 Anak

150 537 M. JUS L 01-01-1958 / 59 Suami Swasta


538 HARTIN P 17-08-1967 /50 Istri IRT
539 NOVRIAN L 09-11-2007 /10 Cucu
540 NOVAL JERIKAL L 11-11-2008 /9 Cucu

1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26
151 541 FIRMAN L 01-07-1960 /57 Suami Petani
542 BULANG P 10-06-1971 /46 Istri IRT
543 SUPARDIN L 31-07-1997 /20 Anak
544 SUL FIKRI RAMADAN L 27-05-2004 /13 Anak
545 SUKRIADI L 27-03-2006 /11 Anak
546 SUL RIFKI L 19-02-2009 /8 Anak

152 547 SUPRIADI L 01-01-1991 /26 Suami Nelayan


548 NITA P 01-07-1994 /23 Istri IRT
549 MUH. ASRIL L 01-07-2013 / 4 Anak

153 550 SURAHMAN L 26-06-1988 /29 Suami Swasta


551 SULHIJA P 05-05-1983 /34 Istri IRT
552 MUH. ASSAR L 29-12-2011 /6 Anak

154 553 JUSLAN L 05-05-1987 /30 Suami Swasta


554 ELY ERMAWATI P 10-05-1986 /31 Istri IRT
555 SUSNO SOESATYO SAPUTRA L 03-03-2010 / 7 Anak
7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24
Ket

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27
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FORM IMIGASI PESERTA
JENIS PESERTA :
NAMA INSTANSI/ / BADAN / PERUSAHAAN :
KODE VIRTUAL ACCOUNT :
BANK TEMPAT PEMBAYARAN IURAN :
TANGGAL REGISTRASI :
NOOMOR PKS :
KODE PKS :
MASA BERLAKU :
KODE TANGGUNGAN :
KODE KC :
KODE DATI 2 :

STATUS KAWIN
TANGGAL LAHIR JENIS
PISAT 1=K
KELAMIN ALAMAT
No NOMOR KARTU NO KK NIK/KITAS/KITAP NAMA LENGKAP 2=B TEMPAT RT RW
TINGGAL
P/I/S/A1.3/ TEMPAT LAHIR TGL/BLN/THN 1=L 3=J
T1..n 2=P 4=D
1 2 3 4 5 6 7 8 9 10 11 12 13
1 7409060302100018 7409060310680001 MISO P TAIPA 03-10-1968 1 1 DESA TAIPA 001 -
7409065306790001 DALMIA I TAIPA 13-06-1979 2 1
7409065605920001 SARIYANTI A1 TAIPA 16-05-1992 2 2
7409067006010001 ERPIAN RAHMA DANI A2 TAIPA 30-06-2001 2 2

2 7409060302100012 7409061307730001 IKBAL P MOTUI 13-07-1973 1 1 DESA TAIPA 001 001


7409066907750001 SURIYANI I TAIPA 29-07-1975 2 1
7409061805020001 RIKI ARDIANTO A1 TAIPA 18-05-2002 1 2
7409062203930001 KAISAR A2 TAIPA 22-03-1993 1 2

3 7409060412130004 7409060906080001 HASRIP A1 TAIPA 09-06-2008 1 2 DESA TAIPA 001 001

4 7409060302100005 7409060107400001 SABAHU P TAIPA 03-07-1931 1 1 DESA TAIPA 001 001


7409064107570004 SALANGGE I TAIPA 01-07-1957 2 1
7409060107990008 RONALDO A1 TAIPA 03-06-2000 1 2

5 7409062801150001 7409064107520004 SAKIRA P ASERA 01-07-1952 2 3 DESA TAIPA 001 -

6 7409060810140001 7409060205860001 ADEN RACHMAT ENEM P KENDARI 02-05-1986 1 1 DESA TAIPA 001 001
7409066106860001 NURSAIDA, S.Pd I TAIPA 05-12-1986 2 1
ADNI A1 TAIPA 03-01-2015 2 2

7 7409063107130002 7409061509600001 PAISAL P TAIPA 12-07-1960 1 1 DESA TAIPA 002 002


7409064911630001 BUNGALA I BUNGGUOSU 01-07-1963 2 1
7409062002830001 SAMSUL A1 TAIPA 20-02-1983 1 2
7409064104010001 ROSMAWATI A2 TAIPA 10-04-2001 2 2

8 7409061705160001 7409060301730001 YASIR P TAIPA 03-01-1973 1 1 DESA TAIPA 001 001


7409064810870001 AMRIANI I BULUKUMBA 08-10-1987 2 1
7409060609110001 FAISWAN A1 TAIPA 06-09-2011 1 2

9 7409060202100044 7409061212150001 MUHAMMAD IRSYAD A1 TAIPA 12-12-2015 1 2 DESA TAIPA 001 001

10 740906202100042 7409061401570001 BURHAN P WANGGUDU 08-07-1956 1 1 DESA TAIPA 003 001


7409064505560001 HUDAYA I TAIPA 17-10-1958 2 1
7409052011860001 RINO A1 TAIPA 20-11-1986 1 2

11 7409060202100039 7409060505870001 JUSLAN P WANGGUDU RAYA 05-05-1987 1 1 DESA TAIPA 001 001
7409065005860003 ELY ERMAWATI I TAIPA 10-05-1986 2 1
7409060203100001 SUSNO SOESATYO SAPU A1 TAIPA 03-03-2010 1 2

12 7409062907130002 7409060305760001 UDIN FAJAR, ST P TOBUUHA 03-05-1976 1 1 DESA TAIPA 001 001
7409064706840001 RITA SAMI I TAIPA 07-06-1984 2 1
7409064311040001 INTAN SUCI RAMADHAN A1 TAIPA 03-11-2004 2 2
7409065903090001 SITI MARISA RUKMANA A2 TAIPA 19-03-2009 2 2

13 7409060202100036 7409064107600011 BAEDARO P TAIPA 01-07-1960 2 3 DESA TAIPA 001 -


7409064609970001 MAULANA A1 TAIPA 06-11-1996 2 2

14 7409060202100033 7409064105910001 SALSA NABILA A1 TAIPA 23-03-2012 2 2 DESA TAIPA 002 002

15 7409061612140003 7409060108920001 RANDI P TAIPA 01-01-1992 1 1 DESA TAIPA 001 -


7409066701930001 NITRA I KENDARI 27-01-1993 2 1
7409064911140001 NAYZILA. R A1 KENDARI 09-11-2014 2 2

16 7409061206120002 7409060902680001 AHYA P TAIPA 15-05-1968 1 1 DESA TAIPA 001 -


7409065204690002 HASNAWATI I TAIPA 12-04-1969 2 1
7409064401970001 DEWI A1 TAIPA 04-01-1997 2 2
7409060606050003 ARIL A2 TAIPA 06-06-2005 1 2

17 7409062307140001 7409060507690001 NDEGAR P TAPUNGGAYA 05-07-1969 1 1 DESA TAIPA 001 001


7409064107700008 HARNI I TAIPA 01-07-1970 2 1
7409065004950001 RENI HARDIANTI A1 TAIPA 10-04-1995 2 2

18 7409061706140003 7409060107780014 RABIL SAPUTRA P TAIPA 27-04-1987 1 1 DESA TAIPA 001 -


7409064905830001 NURJANNAH I PANGKA JENE 09-05-1983 2 1
7409066806120001 NUR AIZAH A1 KENDARI 16-05-2012 2 2
7471015602150001 NUR BERLIAN A2 TAIPA 19-02-2015 2 2
STATUS KAWIN
TANGGAL LAHIR JENIS
PISAT 1=K ALAMAT
KELAMIN
No NOMOR KARTU NO KK NIK/KITAS/KITAP NAMA LENGKAP 2=B TEMPAT RT RW
TINGGAL
P/I/S/A1.3/ TEMPAT LAHIR TGL/BLN/THN 1=L 3=J
T1..n 2=P 4=D
1 2 3 4 5 6 7 8 9 10 11 12 13
19 7409060707140001 7409060405890001 RAHMAN T P TAIPA 15-01-1986 1 1 DESA TAIPA 001 001
7409064802920001 RISNAWATI I ABELI 08-02-1992 2 1
7409061205120002 MUH. RISMAN A1 LAPULU 12-05-2012 1 2

20 7409062207130001 7409062504380001 ANWAR P LEMOBAJO 25-04-1968 1 1 DESA TAIPA 001 001


7409064607770002 NURHAYATI I TAIPA 06-07-1977 2 1
7409064404970001 RISMA A1 TAIPA 04-04-1997 2 2
7409062307040001 ARDIANSAH A2 TAIPA 23-07-2004 1 2

21 7409060302100004 7409060107280002 LATIF P BONE 01-07-1928 1 1 DESA TAIPA 001 001


7409064107530009 KARLINA I TAIPA 01-07-1953 2 1

22 7409062207130002 7409060107860009 ABDUL RAHIM P TAIPA 01-07-1986 1 1 DESA TAIPA 001 001
7409066112900001 RATNA I BONE 21-12-1990 2 1
7409065705120001 SASKIA RAHIM A1 TAIPA 17-05-2012 2 2

23 7409061206120016 7409060107780013 MUHLIS P TAIPA 01-07-1978 1 1 DESA TAIPA 001 -


7409064512860004 HASTIAN I WANGGUDU 05-12-1986 2 1
7409060107090005 RUSLI A1 TAIPA 01-07-2009 1 2

24 7409060302100002 7409060811710001 RAMLI L P TAIPA 08-11-1971 1 1 DESA TAIPA 001 001


7409064405740002 JUMIATIN I LALONGGASUMEETO 04-05-1974 2 1
7409066710950001 RIMA INDRIYAWATI A1 TAIPA 27-10-1995 2 2
7409062812990001 ASWIN A2 TAIPA 28-12-1999 1 2
7409066403160001 SESILIA A3 KENDARI 24-03-2016 2 2

25 7409060202100046 7409060107610005 ACO J. P TAIPA 01-07-1961 1 1 DESA TAIPA 001 -


7409064107630014 JAENA I TAIPA 01-07-1963 2 1

26 7409060202100041 7409064107630013 MARLINA P TAIPA 01-07-1963 2 3 DESA TAIPA 001 -


7409060507830002 BASRIYULI A1 TAIPA 15-07-1987 1 2
7409060401910001 HAERUL A2 TAIPA 17-10-1994 1 2
7409061202950001 SABIL A3 TAIPA 15-02-1991 1 2

27 7409060202100040 7409061102790001 ABD. MANNANG P TAIPA 11-02-1979 1 1 DESA TAIPA 001 001
7409064101830001 KARMIATI ACHMAD I WAWOTOBI 01-01-1980 2 1
7409062303030002 RISWAN M. A1 TAIPA 23-03-2003 1 2
7409066109060001 CITRA M. A2 TAIPA 21-09-2006 2 2

28 7409060202100038 7409060903700001 MAKMIR P KOKAPI 05-05-1972 1 1 DESA TAIPA 001 001


7409064408760002 RUSNI I TAIPA 04-08-1975 2 1
7409061206900002 ARMAN A1 TAIPA 12-06-1990 1 2
7409065702970001 IRMA A2 TAIPA 28-12-1996 2 2

29 7409060202100035 7409060306030001 HAMID DANIEL A1 B0R0-BORO 05-12-2002 1 2 DESA TAIPA 001 -


7409066312150001 KARTIKA PUTRI A2 KENDARI 23-12-2015 2 2

30 7409062212140004 7409064107580011 MARIAM P TAIPA 01-07-1947 P 3 DESA TAIPA 001 -

31 7409060202100029 7409061306830001 BAHAR P TAIPA 13-06-1983 1 1 DESA TAIPA 001 2


7409064402880001 SARIPA I TAIPA 15-03-1988 2 1
7409060601080001 DERY SAPUTRA A1 TAIPA 05-10-2007 1 2
7409066607120001 SAPIRA AYU A2 TAIPA 26-07-2012 2 2

32 7409060202100027 7409064107650011 BASIA P TAIPA 01-07-1965 2 3 DESA TAIPA 001 -

33 7409060402100003 7409062503130001 MUH.FAUDZAN ALFARID A1 TAIPA 25-03-2013 1 2 DESA TAIPA 001 001

34 7409060302100017 7409060107600009 ODE MUDA P RAHA 01-07-1943 1 4 DESA TAIPA 001 -

35 7409060402100006 7409060107650014 YUNUS P TAIPA 13-01-1970 1 1 DESA TAIPA 001 -


7409064107730012 HASMA I SAWA 31-12-1977 2 1
7409065604970001 ROSMAYANTI A1 TAIPA 01-09-1997 2 2
7409060305000001 RISWAN A2 TAIPA 01-06-2000 1 2

36 7409060402100005 7409061007770006 SULHA P TAIPA 10-07-1977 1 1 DESA TAIPA 001 001


7409064510880001 JUMIATIN I SAWA 05-10-1988 2 1
7409064101010001 ARINI SULASTRI A1 TAIPA 01-01-2001 2 2
7409066501080001 RASTI SULASTRI A2 TAIPA 25-01-2008 2 2
7409062612140001 RAHMAT ADITIA SULHA A3 TAIPA 26-12-2014 1 2

37 7409062607110001 7409062608890004 DERWANTA A1 TAIPA 26-08-1989 1 2 DESA TAIPA 002 001


7409062206910003 DERMAWAN A2 TAIPA 22-06-1991 1 2
7409066104950002 ANDRIANI A3 TAIPA 21-04-1995 2 2

38 7409063107130035 7409060811620001 LUMASA S RAHA 08-11-1962 1 1 DESA TAIPA 001 001


7409064912700001 KARTINI I TAIPA 09-12-1970 2 1
7409060408860001 USMAN A1 TAIPA 04-08-1986 1 1
7409060206920001 MUSTAPA A2 TAIPA 02-06-1992 1 2
7409066310010001 VIVI ANGGRAINI A3 TAIPA 23-10-2001 2 2

39 7409060912140002 7409060702920001 PEBRIANTO P TAIPA 07-02-1992 1 1 DESA TAIPA 001 002


7409061303130001 MUH. REVAN A1 TAIPA 13-05-2013 1 2
MARNI A2 TAIPA 01-03-2015 2 2

40 7409060202100018 7409064107580010 MAHYA P TAIPA 01-06-1962 2 3 DESA TAIPA 002 -

STATUS KAWIN
TANGGAL LAHIR JENIS
PISAT 1=K ALAMAT
KELAMIN
No NOMOR KARTU NO KK NIK/KITAS/KITAP NAMA LENGKAP 2=B TEMPAT RT RW
TINGGAL
P/I/S/A1.3/ TEMPAT LAHIR TGL/BLN/THN 1=L 3=J
T1..n 2=P 4=D
1 2 3 4 5 6 7 8 9 10 11 12 13
41 7409061206120010 7409061004910001 HASMIN P TAIPA 10-04-1991 1 1 DESA TAIPA 001 001
7409064507880001 NURJANA I KENDARI 05-07-1986 2 1
7409065612090001 TRIANA A1 KENDARI 16-12-2009 2 2
7409066504150001 ATRI ANI A2 TAIPA 25-04-2015 2 2

42 7409060202100011 7409060107830012 ABD. MURSIT P KAYU ABANG 19-03-1985 1 1 DESA TAIPA 002 -
7409064107880003 MIMANG I TAIPA 01-07-1987 2 1
7409062010000001 HAMSI A1 TAIPA 20-10-2010 1 2
7409065011110002 NADA A2 TAIPA 10-11-2011 2 2
7409062201140001 M. ARJUN A3 KAYU ABANG 22-02-2014 1 2
NURLIA A4 TAIPA 30-10-2015 2 2

43 7409061706140002 7409064107640006 HANISE P TAIPA 01-06-1962 2 3 DESA TAIPA 001 001

44 7409060102100012 7409063110120001 ABEL A1 TAIPA 31-10-2012 1 2 DESA TAIPA 002 001

45 7409060202100006 7409064107420002 HAME P TAIPA 01-07-1942 2 3 DESA TAIPA 002 -

46 7409062208110001 7409062005860001 JUSMAN P PEBUNOOHA 20-05-1986 1 1 DESA TAIPA 001 002


7409065107870001 RAMLIA I TAIPA 11-07-1987 2 1
7409065010050001 NABILA A1 KENDARI 10-10-2005 2 2
7409064906070001 LAILA A2 KENDARI 06-09-2007 2 2

47 7409060202100010 7409064107610006 KAME P TAIPA 01-07-1961 2 3 DESA TAIPA 002 -

48 7409060102100015 7409060705570001 HUSEN M P TAIPA 01-07-1962 1 1 DESA TAIPA 002 -


7409064608800002 BECE I TAIPA 01-07-1965 2 1
7409060102900001 RIMON A1 TAIPA 11-02-1990 1 2
7409061506020001 IRPAN A2 TAIPA 15-05-2002 1 2

49 7409060112140001 7409060107720008 SAHARUDDIN P JENEPONTO 01-07-1972 1 1 DESA TAIPA 001 001


7409065204880001 HAERANI I TAIPA 01-02-1981 2 1
7409062401150001 MUH. JAYA S A1 TAIPA 24-01-2015 1 2

50 7409060202100021 7409060104820001 ALEX P TAIPA 01-04-1982 1 1 DESA TAIPA 002 -


7409064303860001 CEMING I TAIPA 03-03-1986 2 1
7409066111090001 SITI AIZAH A1 TAIPA 21-11-2009 2 2

51 7409060202100003 7409062711540001 NAING P TAIPA 27-11-1954 1 1 DESA TAIPA 002 -


7409064107660005 KURSIA I TAIPA 01-07-1966 2 1

52 7409060202100008 7409060107720004 MANSUR P TAIPA 01-07-1978 1 1 DESA TAIPA 001 002


7409064107860009 MBIA I BAHO 01-07-1984 2 1
7409060901010001 MASRUL A1 TAIPA 22-06-2001 1 2
7409064106040001 NABILA SASKIA A2 TAIPA 01-06-2004 2 2
7409060704080001 YUDI AFANDI A3 TAIPA 11-12-2007 1 2
7409064405020001 RAHMA AZAHRA A4 TAIPA 28-05-2010 2 2

53 7409060202100005 7409064107530008 SULO P TAIPA 01-07-1953 2 3 DESA TAIPA 002 -

54 7409060302100028 7409060101650002 ISKANDAR P TAIPA 10-03-1970 1 1 DESA TAIPA 001 -


7409064711760001 HARTATI I TAIPA 12-11-1976 2 1
7409061204950001 IDHAR A1 TAIPA 03-10-1996 1 2
7409062010990001 IDRAM A2 TAIPA 20-10-1999 1 2
7409064307020003 YUNIAR A3 TAIPA 11-08-2001 2 2
55 7409061206120004 7409062002120001 MUH. MULISIN A1 TAIPA 20-02-2012 1 2 DESA TAIPA 002 -

56 7409060302100024 7409060107680014 H. ABU BAKAR P TAIPA 08-06-1960 1 1 DESA TAIPA 002 -


7409064107610007 Hj. NIKA I TAIPA 09-05-1963 2 1
7409061809940001 RANDI PRATAMA PUTRA A1 KENDARI 10-04-1994 1 2

57 7409062910570001 H. AHMAD P KOKAPI 10-07-1957 1 1 DESA TAIPA 002 -


7409064703580001 BAU I TAIPA 05-11-1960 2 1
7409062603980001 SUCIAWAN A1 TAIPA 26-03-1998 1 2

58 7409060810140002 7409060902850001 HARIONO P TAIPA 17-07-1984 1 1 DESA TAIPA 001 001


7409066106910002 YUNINGSIH I KENDARI 21-06-1991 2 1
7409065012120001 ALMUTIAS SALSABILA HN A1 KENDARI 10-12-2012 2 2

59 7409062311150004 7409064107580012 HARSIA P TAIPA 01-07-1958 2 3 DESA TAIPA 001 -

60 7409061012130001 7409060407740001 ISKANDAR P SELAYAR 04-07-1974 1 1 DESA TAIPA 001 -


7409064107730017 EMIRIAH I TAIPA 01-07-1973 2 1
7409064708980001 IDAYANTI ISKANDAR A1 TAIPA 07-08-1998 2 2
7409065807010001 ANNISA JAYANYI S. A2 TAIPA 18-07-2001 2 2
7409064202070001 INDRI ASKIA ISKANDAR A3 TAIPA 02-02-2007 2 2

61 7409061009130002 7409060104850002 RUSDIN P LAONTI 01-041987 1 1 DESA TAIPA 001 001


7409064503880002 YUNIATIN I TAIPA 05-03-1988 2 1
DEA ANANDARA R A1 TAIPA 30-04-2016 2 2

62 7409060302100022 7409060206610001 ESI MADANDA P TAIPA 03-03-1967 1 1 DESA TAIPA 003 002
7409064401700001 SURNI I PADALEU 05-05-1970 2 1
7409060502930001 SYAWAL A1 TAIPA 01-01-1994 2 2
7409060507050001 EBIT A2 TAIPA 07-05-2005 2 2

STATUS KAWIN
TANGGAL LAHIR JENIS
PISAT 1=K ALAMAT
KELAMIN
No NOMOR KARTU NO KK NIK/KITAS/KITAP NAMA LENGKAP 2=B TEMPAT RT RW
TINGGAL
P/I/S/A1.3/ TEMPAT LAHIR TGL/BLN/THN 1=L 3=J
T1..n 2=P 4=D
1 2 3 4 5 6 7 8 9 10 11 12 13
63 74090602120801080 7409060205640002 RAMLIN HASAN P TAIPA 02-05-1964 1 1 DESA TAIPA 002 -
7409064506650001 EMI RIANTI L I BAU-BAU 05-08-1965 2 1
7409060605920001 RINOP JAYA A1 TAIPA 06-03-1992 1 2
7409061608960001 ERI IRAWAN A2 TAIPA 16-06-1996 1 2

64 7409061509140001 7409061805780001 MUHAMAD HARIS P LALOWARU 18-05-1978 1 1 DESA TAIPA 001 001
7409066103830002 IDA RAHMAWATI I TAIPA 21-03-1983 2 1
7409060810070001 RENDI PRATAMA A1 LALOWARU 08-10-2007 1 2
7409066308100001 IKA PUSPITA A2 TAIPA 23-08-2010 2 2
7409065110110002 PUTRI A3 KENDARI 11-10-2011 2 2

65 7409060302100009 7409061903850002 SUPIRMAN P TAIPA 19-03-1985 1 1 DESA TAIPA 001 001


7409062212010002 ASMA I ABUKI 22-12-1991 2 1
7409062012090001 AIRIN ARYANTI A1 KONDARA 20-12-2009 2 2

66 7409061504150003 7401011504790003 RUSTAM E P TAIPA 15-04-1979 1 1 DESA TAIPA 002 002


7401014711850002 HANA I RAHA 07-11-1985 2 1
7409061805100001 RIKHY ANUGRAH A1 TAIPA 18-05-2011 1 2
7409060805140001 ZAKHY ARAFAH A2 TAIPA 08-05-2014 1 2

67 7409060302100033 7409064107690007 MASNA P TAIPA 03-12-1968 2 3 DESA TAIPA 001 -


7409060107850007 RUNDU ALAM T1 TAIPA 01-01-1991 1 2

68 7409062105120002 7409062303900001 DEDI ROMANSAH P TAIPA 23-03-1990 1 1 DESA TAIPA 001 -


7409065808940001 HIJRAH I TAIPA 18-08-1994 2 1
7409062204110001 DANI ROMANSAH A1 TAIPA 03-04-2011 1 2
7409066911140001 PUTRI VERA ASTAGINA A2 TAIPA 29-12-2014 2 2

69 7409060202100004 7409060903760001 HIKMAR P TAIPA 05-02-1978 1 1 DESA TAIPA 002 -


7409064704770001 JUMIATI I TAIPA 23-05-1977 2 1
7409060206070002 MUH. AMIL A1 TAIPA 02-06-2007 1 2
7409064106120001 NUR AMALIA A2 TAIPA 01-06-2012 2 2

70 7409062212140003 7409066711040001 NITA I KAMPONG BUNGA 01-07-1994 2 1 DESA TAIPA 001 001
7409060107100002 MUH. ASRIL A1 KAMPONG BUNGA 01-07-2013 1 2

71 74090628011000006 7409064511120001 RIRIN A1 TAIPA 05-11-2012 2 2 DESA TAIPA 003 -


7409062004150001 ARDIN A2 TAIPA 20-04-2015 1 2

72 7409062907130004 7409061009830001 ANSON P LABELA 10-09-1983 1 1 DESA TAIPA 001 001


7409064406840004 RIYANTI I TAIPA 04-06-1984 2 1
7409062809040001 ADRIYANT NUR ALAM A1 TAIPA 28-09-2004 1 2
7409066709060001 RINA RAHMADANI A2 TAIPA 27-09-2006 2 2
7409066604080001 BERIL AZURA AURELYA A3 TAIPA 26-04-2008 2 2
73 7409060102100011 7409060107600008 JAMARUDDIN P TAIPA 31-12-1960 1 4 DESA TAIPA 002 001

74 7409062801100009 7409060110590001 NASIR P SAWA 01--10-1959 1 1 DESA TAIPA 003 -


7409064103710001 HAMONA I LEMBO 01-03-1971 2 1
7409061302850001 HARMONO A1 TAIPA 13-02-1985 1 2
7409060707890001 SAMAD NGGOLELE A2 TAIPA 07-07-1989 1 2
7409064509100001 NURFITRA A3 TAIPA 14-09-2010 2 2

75 7409063001100002 7409064509100001 NURUL AYUMI A1 TAIPA 05-09-2010 2 2 DESA TAIPA 003 -

76 7409060102100007 7409060106580001 M. AMIN T. P TAIPA 01-06-1958 1 1 DESA TAIPA 002 -


7409064107720007 HATIJA I MOTUI 10-07-1972 2 1
7409064107940006 ROSTIAN A1 TAIPA 06-05-1995 2 2
7409066304000001 HISMAWATI A2 TAIPA 23-04-2000 2 2

77 7409060412150002 7405191202910003 ISRAWAL PEBRIANTO P KENDARI 12-02-1991 1 1 DESA TAIPA 001 001
7409066512890001 HASTUTI , S.PdI I TAIPA 25-08-1989 2 1
7409062105160001 AIMAR ALFARUQ A1 KENDARI 21-05-2016 1 2

78 7409060102100010 7409060107630011 HAMZAH P. P TAIPA 01-07-1963 1 1 DESA TAIPA 002 -


7409064505670001 NURJANA I SAWA 05-05-1967 2 1
7409064107850017 MARYANTI A1 TAIPA 01-07-1985 2 2
7409064205900001 IDA WATI A2 TAIPA 02-05-1990 2 2

79 7409060912140003 7409065408890001 DEDY. H P TAIPA 13-04-1988 1 1 DESA TAIPA 002 -


7409065408890002 RISMA I POSO 14-08-1989 2 1
7409062808010001 M.ASFHAR MAHARDIKA A1 KOLAKA 28-08-2012 1 2

80 7409006180412006 7409062802910001 IKRAM P TAIPA 28-02-1991 1 1 DESA TAIPA - -


7409064109940001 MASNIATIN I SAWA 01-09-1994 2 1
7409060111110001 MUH. AKWAL N A1 TAIPA 01-11-2011 1 2

81 7409060102100008 7409060112750002 SUKSONO P TAIPA 01-12-1975 1 1 DESA TAIPA 002 -


7409065201780001 SUMARTIN I TAIPA 12-01-1978 2 1
7409066412020001 IWIT HARBIA RAHMAN A1 TAIPA 24-12-2002 2 2
7409062805120001 MUH. ARIAWAN A2 TAIPA 28-05-2012 1 2

82 7409062606130001 7409060406850001 AHMAD IQBAL SUPU P TAIPA 12-02-1986 1 1 DESA TAIPA 001 001
7409066509870002 DALNIYA MERONDA I TAIPA 25-09-1987 2 1
7409060108100001 MUH. ALAN PRADITYA S A1 TAIPA 01-08-2010 1 2
7409066303140001 AZIFA NUR FAUZIAH A2 TAIPA 23-03-2014 2 2

STATUS KAWIN
TANGGAL LAHIR JENIS
PISAT 1=K ALAMAT
KELAMIN
No NOMOR KARTU NO KK NIK/KITAS/KITAP NAMA LENGKAP 2=B TEMPAT RT RW
TINGGAL
P/I/S/A1.3/ TEMPAT LAHIR TGL/BLN/THN 1=L 3=J
T1..n 2=P 4=D
1 2 3 4 5 6 7 8 9 10 11 12 13
83 7409061507140005 7409061212820001 EDI SUDRAJAD P R. PAKA 12-12-1982 1 1 DESA TAIPA 002 002
7409064403860002 IRA WATI I TAIPA 04-03-1986 2 1
7409061409020001 NELSON MANDELA A1 R. PAKA 14-09-2002 1 2
7409065107060002 ITA SASMITA A2 R. PAKA 11-07-2006 2 2
7409062801080001 M. ABD. SANDI A3 R. PAKA 28-01-2008 1 2

84 7409060102100009 7409064107630012 MANIA P TAIPA 15-07-1963 2 3 DESA TAIPA 002 001

85 7409060807130001 7409060506770001 SUMAEDDIN P TOREO 05-06-1977 1 1 DESA TAIPA 001 001


7409065003830001 LISNA I TAIPA 10-03-1983 2 1
7409060402060002 ADRIANSYAH A1 TAIPA 04-02-2006 1 2
7409066608100001 NIA RAHMADANI A2 TAIPA 26-08-2010 2 2

86 7409061206120011 7409061004710005 LAHEMA P TAIPA 10-04-1971 1 1 DESA TAIPA


7409065312720001 FITRI I PUULEMO 13-12-1972 2 1
7409066805000002 HETRI DIOCTA A1 TAIPA 28-05-2000 2 2
7409061610090001 RAFI ALZAIR A2 TAIPA 16-10-2009 1 2
7409062210110002 AUFAR RANDU A3 TAIPA 22-10-2011 1 2

87 74090609038800002 ARMAN RAHARJA P LABUAN 07-08-1989 1 1 DESA TAIPA 003 -

88 7409060804850001 AGUS LALOASA P LABUAN 29-11-1987 1 1 DESA TAIPA 003 -


7409151006920001 SITI HARIANA I LEMBO 10-06-1992 2 1

89 BINTI P 03-07-1944 2 3 DESA TAIPA 003 -

90 MUH. NUR P MOTUI 06-07-1973 1 1 DESA TAIPA 001 -


740906500873001 MISBA I TAIPA 10-12-1973 2 1
JERO FEBRIANTO A1 TAIPA 18-02-2003 1 2
TIARA A2 TAIPA 21-05-2008 2 2

91 7409061708930001 AGUSTAM S TAIPA 17-08-1993 1 1 DESA TAIPA 001 -


7409062606140001 M. FAUZAN A1 TAIPA 26-06-2014 1 2
93 7409060302100011 M. ABIZAR ALZAKAR A1 TAIPA 01-04-2014 1 2 DESA TAIPA 001 -

94 7409061605780001 HALIMIN P JAWA 16-05-1979 1 1 DESA TAIPA - -


7409065506830001 NURPATIMA I TAIPA 15-06-1983 2 1
7409061005100001 ALHAT SARIAT A1 JAWA 07-06-2010 1 2
MUH. ALI BAS KORO A2 JAWA 10-11-2011 1 2

95 7409102507110002 7409060107650012 LAMONEA P RAHA 10-12-1956 1 1 DESA TAIPA 002 002


7409064107710005 MINA I TAIPA 04-06-1966 2 1
MUNASIR A1 TAIPA 13-05-2005 1 2

96 7409060402920000 MUIS P TAIPA 14-12-1992 1 1 DESA TAIPA 002 002


RINA I PASIR PUTIH 15-07-1995 2 1
ARAMSYA SAPUTRA A1 TAIPA 26-01-2016 1 2

97 7409060202100015 LILIS A1 TAIPA 25-11-2015 2 2 DESA TAIPA 002 -

98 74090602041229235 7409060104890001 ROBIN S TAIPA 10-11-1984 L K DESA TAIPA 001 001


ANA I MANDAR 18-11-1984 P K
PIRA A1 TAIPA 30-10-2010 P B

99 7409060305530001 HAKING p TAIPA 01-08-1950 1 1 DESA TAIPA 002 -


7409064907600001 NURSIAH I TAIPA 09-07-1960 2 1

100 7409065208790001 LENING P TAIPA 12-08-1979 2 3 DESA TAIPA 002 -


7409066404020001 ANDI ATMA FAUSIA A1 KENDARI 24-04-2002 2 2
7409060801080001 ANDI MUH. HAIDIR YAHYAT A2 KENDARI 08-01-2008 1 2

101 740906711860001 ERWIN P TAIPA 07-11-1986 1 1 DESA TAIPA 002 -


740215619890001 DEWI I UNAAHA 24-04-1989 2 1
RIL AFRILIA A1 UNAAHA 15-09-2011 2 2

102 7409064707430002 KANNE P TAIPA 11-09-1952 2 3 DESA TAIPA 002 -


7409065003720001 HASRIA A1 TAIPA 18-05-1982 2 2
74090670770006 SAHRIR A2 TAIPA 10-01-1987 1 2

103 7409060107400013 MUSRIKI P RAHA 01-07-1948 1 4 DESA TAIPA 002 -


7409061501050001 ASHAR A1 TAIPA 03-07-2004 1 2

104 740906110680001 MARIONO P TAIPA 11-10-1987 1 1 DESA TAIPA 002 -


740907520393002 SUSIANTI I TONGAUNA 12-03-1993 2 1
JIHAN NURIA A1 TAIPA 02-04-2016 2 2

105 7409060706770002 MASWAN P TAIPA 07-06-1977 1 1 DESA TAIPA 002 -


7409067001770001 YUSNAWATI I PADALEU 30-01-1977 2 1
7409060402970002 JUSWANTO A1 TAIPA 04-02-1997 1 2
7409066604000004 SRI AINUN A2 TAIPA 26-04-1999 2 2
740906170610001 HIDAYATULLAH A3 TAIPA 17-06-2010 1 2

106 7409061407970001 MURSAN P TAIPA 14-07-1997 1 1 DESA TAIPA 002 -


STATUS KAWIN
TANGGAL LAHIR JENIS
PISAT 1=K ALAMAT
KELAMIN
No NOMOR KARTU NO KK NIK/KITAS/KITAP NAMA LENGKAP 2=B TEMPAT RT RW
TINGGAL
P/I/S/A1.3/ TEMPAT LAHIR TGL/BLN/THN 1=L 3=J
T1..n 2=P 4=D
107 7409021104740002 INDRA P POASAA 11-04-1974 1 1 DESA TAIPA 003 002
740906501100001 ERMIDA I TAIPA 17-08-1988 2 1

108 7409060101580001 M. JUS P 01-01-1958 1 1 DESA TAIPA 001 -


7409065708670001 HARTIN I 17-08-1967 2 1
7409064911070001 NOVRIAN T1 09-11-2007 1 2
NOVAL T2 11-11-2008 1 2

109 7409061007870001 IRHAM J P TAIPA 25-04-1992 1 1 DESA TAIPA 001 -


7409065309910001 JUNAEDA, AM.Keb I TONGKOSENG 13-09-1992 2 1
MUH. AL AZIZ A1 TONGKOSENG 14-10-2015 1 2

110 7409061007870001 IRWAN P 10-07-1987 1 1 DESA TAIPA 001 -


LUSIANA I 07-01-1989 2 1
M. FINO ALFADIL A1 10-03-2014 1 2

111 H. RAHMAN P 03-06-1928 1 1 DESA TAIPA 003 -


RONI I 10-07-1982 2 1
MUTHASANA A1 05-04-2004 1 2
NUR FITRIANI R A2 10-08-2011 2 2

112 SAIDA P 11-11-1991 2 3 DESA TAIPA 003 -


FARIS A1 13-03-2012 1 2

113 FERDI P 13-12-1975 1 1 DESA TAIPA 003 -


TINA I 19-03-1979 2 1
FITRIANI A1 09-08-2000 2 2
M. RAFLI A2 02-04-2006 1 2
M. SAPRI A3 30-04-2012 1 2

114 JUMADIL P 05-08-1978 1 1 DESA TAIPA 003 -


SALTIN I 20-12-1985 2 1
FINA A1 03-10-2002 2 2
FIKA A2 08-04-2005 2 2

115 HAMIRA P 05-03-1948 2 3 DESA TAIPA 001 002

116 D. G SITI P 05-03-1944 2 3 DESA TAIPA 001 -

117 RAYA NAYA A1 TAIPA 26-12-2014 2 2 DESA TAIPA 002 -

118 MUH. AZAR A1 29-12-2011 1 2 DESA TAIPA 001 -

119 7409010204830006 Agus Purnama P Wawotobi 02-04-1983 1 1 DESA TAIPA 001 -


7409064705830001 Alis Dariant I Taipa 07-05-1983 2 1
Rifka Agus A1 Taipa 13-11-2007 2 2

120 7409060107750012 Arpa P Taipa 01-071975 1 4 DESA TAIPA

121 740904050895001 Irham P Kiaea 05-08-1995 1 1 DESA TAIPA


7409065702970001 Irma I Taipa 28-12-1996 2 1
KELAS
STATUS
KODE NAMA RAWAT
KODE NAMA
KODE KODE NAMA KODE FASKES FASKES NOMOR TMT
NAMA DESA FASKES FASKES EMAIL NPP JABATAN 1 = Tetap 1 = Kelas I UPAH
POS KECAMATAN KECAMATAN DESA DOKTER DOKTER TELEPON KERJA
TK.1 TK.1 GIGI GIGI 2 = Kontrak 2 = Kelas II
3 = Paruh Waktu 3 = Kelas III
14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30
93353 LEMBO TAIPA

93353 LEMBO TAIPA

93353 LEMBO TAIPA

93353 LEMBO TAIPA

93353 LEMBO TAIPA

93353 LEMBO TAIPA

93353 LEMBO TAIPA

93353 LEMBO TAIPA

93353 LEMBO TAIPA

93353 LEMBO TAIPA

93353 LEMBO TAIPA

93353 LEMBO TAIPA

93353 LEMBO TAIPA

93353 LEMBO TAIPA

93353 LEMBO TAIPA

93353 LEMBO TAIPA


93353 LEMBO TAIPA

93353 LEMBO TAIPA

KELAS
STATUS
KODE NAMA RAWAT
KODE NAMA
KODE KODE NAMA KODE FASKES FASKES NOMOR TMT
NAMA DESA FASKES FASKES EMAIL NPP JABATAN 1 = Tetap 1 = Kelas I UPAH
POS KECAMATAN KECAMATAN DESA DOKTER DOKTER TELEPON KERJA
TK.1 TK.1 2 = Kontrak 2 = Kelas II
GIGI GIGI
3 = Paruh Waktu 3 = Kelas III
14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30
93353 LEMBO TAIPA

93353 LEMBO TAIPA

93353 LEMBO TAIPA

93353 LEMBO TAIPA

93353 LEMBO TAIPA

93353 LEMBO TAIPA

93353 LEMBO TAIPA

93353 LEMBO TAIPA

93353 LEMBO TAIPA

93353 LEMBO TAIPA

93353 LEMBO TAIPA

93353 LEMBO TAIPA

93353 LEMBO TAIPA

93353 LEMBO TAIPA

93353 LEMBO TAIPA

93353 LEMBO TAIPA

93353 LEMBO TAIPA

93353 LEMBO TAIPA


93353 LEMBO TAIPA

93353 LEMBO TAIPA

93353 LEMBO TAIPA

9335 LEMBO TAIPA

KELAS
STATUS
KODE NAMA RAWAT
KODE NAMA
KODE KODE NAMA KODE FASKES FASKES NOMOR TMT
NAMA DESA FASKES FASKES EMAIL NPP JABATAN 1 = Tetap 1 = Kelas I UPAH
POS KECAMATAN KECAMATAN DESA DOKTER DOKTER TELEPON KERJA
TK.1 TK.1 2 = Kontrak 2 = Kelas II
GIGI GIGI
3 = Paruh Waktu 3 = Kelas III
14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30
93353 LEMBO TAIPA

9335 LEMBO TAIPA

9335 LEMBO TAIPA

9335 LEMBO TAIPA

9335 LEMBO TAIPA

9335 LEMBO TAIPA

9335 LEMBO TAIPA

9335 LEMBO TAIPA

9335 LEMBO TAIPA

9335 LEMBO TAIPA

93353 LEMBO TAIPA

93353 LEMBO TAIPA

93353 LEMBO TAIPA

93353 LEMBO TAIPA


93353 LEMBO TAIPA

93353 LEMBO TAIPA

93353 LEMBO TAIPA

93353 LEMBO TAIPA

93353 LEMBO TAIPA

93353 LEMBO TAIPA

93353 LEMBO TAIPA

93353 LEMBO TAIPA

KELAS
STATUS
KODE NAMA RAWAT
KODE NAMA
KODE KODE NAMA KODE FASKES FASKES NOMOR TMT
NAMA DESA FASKES FASKES EMAIL NPP JABATAN 1 = Tetap 1 = Kelas I UPAH
POS KECAMATAN KECAMATAN DESA DOKTER DOKTER TELEPON KERJA
TK.1 TK.1 2 = Kontrak 2 = Kelas II
GIGI GIGI
3 = Paruh Waktu 3 = Kelas III
14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30
93353 LEMBO TAIPA

93353 LEMBO TAIPA

93353 LEMBO TAIPA

93353 LEMBO TAIPA

93353 LEMBO TAIPA

93353 LEMBO TAIPA

93353 LEMBO TAIPA

93353 LEMBO TAIPA

93353 LEMBO TAIPA

93353 LEMBO TAIPA


93353 LEMBO TAIPA

93353 LEMBO TAIPA

93353 LEMBO TAIPA

93353 LEMBO TAIPA

93353 LEMBO TAIPA

93353 LEMBO TAIPA

93353 LEMBO TAIPA

93353 LEMBO TAIPA

93353 LEMBO TAIPA

93353 LEMBO TAIPA

KELAS
STATUS
KODE NAMA RAWAT
KODE NAMA
KODE KODE NAMA KODE FASKES FASKES NOMOR TMT
NAMA DESA FASKES FASKES EMAIL NPP JABATAN 1 = Tetap 1 = Kelas I UPAH
POS KECAMATAN KECAMATAN DESA DOKTER DOKTER TELEPON KERJA
TK.1 TK.1 2 = Kontrak 2 = Kelas II
GIGI GIGI
3 = Paruh Waktu 3 = Kelas III
14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30
93353 LEMBO TAIPA

93353 LEMBO TAIPA

93353 LEMBO TAIPA

93353 LEMBO TAIPA

93353 LEMBO TAIPA

93353 LEMBO TAIPA

93353 LEMBO TAIPA

93353 LEMBO TAIPA

93353 LEMBO TAIPA


93353 LEMBO TAIPA

93353 LEMBO TAIPA

9335 LEMBO TAIPA

9335 LEMBO TAIPA

9335 LEMBO TAIPA

93353 LEMBO TAIPA

9335 LEMBO TAIPA

9335 LEMBO TAIPA

9335 LEMBO TAIPA

9335 LEMBO TAIPA

9335 LEMBO TAIPA

93353 LEMBO TAIPA

93353 LEMBO TAIPA

93353 LEMBO TAIPA


KELAS
STATUS
KODE NAMA RAWAT
KODE NAMA
KODE KODE NAMA KODE FASKES FASKES NOMOR TMT
NAMA DESA FASKES FASKES EMAIL NPP JABATAN 1 = Tetap 1 = Kelas I UPAH
POS KECAMATAN KECAMATAN DESA DOKTER DOKTER TELEPON KERJA
TK.1 TK.1 2 = Kontrak 2 = Kelas II
GIGI GIGI
3 = Paruh Waktu 3 = Kelas III
93353 LEMBO TAIPA

93353 LEMBO TAIPA

93353 LEMBO TAIPA

93353 LEMBO TAIPA

93353 LEMBO TAIPA

93353 LEMBO TAIPA

93353 LEMBO TAIPA


93353 LEMBO TAIPA

93353 LEMBO TAIPA

93353 LEMBO TAIPA

9335 LEMBO TAIPA

93353 LEMBO TAIPA

93353 LEMBO TAIPA

93353 LEMBO TAIPA

93353 LEMBO TAIPA


KEWARGA
NEGARAAN ASURANSI LAINNYA NO. NO.
NPWP PASSPORT
1 = WNI NO. NAMA
2 = WNA POLIS ASURANSI
31 32 33 34 35
KEWARGA ASURANSI LAINNYA
NEGARAAN NO. NO.
NPWP PASSPORT
1 = WNI NO. NAMA
2 = WNA POLIS ASURANSI
31 32 33 34 35
KEWARGA
NEGARAAN ASURANSI LAINNYA NO. NO.
NPWP PASSPORT
1 = WNI NO. NAMA
2 = WNA POLIS ASURANSI
31 32 33 34 35
KEWARGA
NEGARAAN ASURANSI LAINNYA NO. NO.
NPWP PASSPORT
1 = WNI NO. NAMA
2 = WNA POLIS ASURANSI
31 32 33 34 35
KEWARGA
NEGARAAN ASURANSI LAINNYA NO. NO.
NPWP PASSPORT
1 = WNI NO. NAMA
2 = WNA POLIS ASURANSI
31 32 33 34 35
KEWARGA
NEGARAAN ASURANSI LAINNYA NO. NO.
NPWP PASSPORT
1 = WNI NO. NAMA
2 = WNA POLIS ASURANSI