FORMULIR PEMANTAUA

Provinsi : LAMPUNG
Kabupaten/Kota : LAMPUNG TENGAH
Puskesmas/Kecamatan : SUKANEGARA/BANGUNREJO
Desa/Kelurahan : SIDODADI

NIK (Nomor Induk

No No Kartu Keluarga Kependudukan) IBU Nama Ibu Hamil NIK Suami
HAMIL

(1) (2) (3) (4)

1 1802020105120016 1802024304900013 ASMAWATI 0
2 1802020608180014 1802015708930002 HARI AGUSTINI 1802020402900013
3 1802022310120019 1802026705910003 WIYANTI 1802021505840006
4 1802021301110039 1802024908890006 EKA LESTARI 1802022707880004
5 1802021807180002 3175036804791001 DARSINI 3175031004720019
6 1802021104120002 1802026107890001 ERNAH 1802020211850002
7 1802021301110057 1802024706780004 SUNARTI 1802021204680004
8 1802021706110025 1802026008920002 ENI PUTRI LESTARI 1802021609870002
9 1802020601140009 1802025611850002 ERNAWATI 1802020111870008
10 1802021105120012 18020267009900001 KUSTANTI HANDAYANI 1802020107850263
11 1802021711170023 1802016412990004 NATALIA PRISKILA 1802020801970001
12 1802020608180012 1802026903940003 ASTRI HASAN NUR FITRI 1802021108860002
13 1802020204100013 1802026212810002 PONIAH 1802021007830006
 FORMULIR PEMANTAUAN IBU HAMIL

Nama Posyandu :
Bulan : NOVEMBER
Tahun : 2018

Berat Berat Tinggi

Badan Tanggal
Nama Suami Alamat RT RW Tanggal Lahir pengukuran Badan Badan
sebelum (kg) (cm)
hamil

(5) (6) (7) (8) (9) (10) (11) (12)

48 SIDODADI 003 004 3-04-1990 20-11-2018 59 156
WAHYUDI 38 SIDODADI 010 005 17-08-1993 20-11-2018 47 149
GUNTORO 45 SIDODADI 010 005 27-05-1991 20-11-2018 52 153
SAIIN ARIANTO 42 SIDODADI 011 005 09-08-1989 18-11-2018 50 155
TUGIWAN 70 SIDODADI 012 005 28-04-1979 18-11-2018 74 150
SLAMET 84 SIDODADI 012 005 21-07-1989 18-11-2018 89 156
PONIRIN 60 SIDODADI 012 005 07-06-1978 18-11-2018 66 152
SIGIT RIFANI 47 SIDODADI 003 002 20-08-1992 14-11-2018 65 154
YASIN ADI NUGROHO 49 SIDODADI 006 003 16-11-1985 15-11-2018 53 150
TUGIMAN 51 SIDODADI 002 001 27-09-1990 13-11-2018 57 153
HANIF ROMADONI 48 SIDODADI 003 002 24-12-1999 14-11-2018 53 155
LUKMANUL HAKIM 55 SIDODADI 005 003 29-03-1994 15-11-2018 69 153
SLAMET PAHRUDIN 61 SIDODADI 003 002 21-12-1981 14-11-2018 68 155
 TTD
(Tablet
Lingkar Jika YA, brp
Lengan Atas Hamil ke Tambah butir TTD
darah)
(LiLA) didapat
1=YA,
2=Tidak

(13) (14) (15) (16)

27 2 1 30
23.5 1 1 30
24 4 1 30
23 2 1 30
28 3 1 30
30 2 1 30
30 3 1 30
24 2 1 30
25 2 1 30
26 1 1 30
24 2 1 30
29 2 1 30
32 2 1 30
 FORMULIR PEMANTAUAN PERTUMBUHAN BALITA DI POSYANDU

Provinsi : LAMPUNG Nama Posyandu : WIJAYA KUSUMA

Kabupaten/Kota : LAMPUNG TENGAH Bulan :
Puskesmas/Kecamatan : SUKANEGARA/BANGUNREJO Tahun : 2018
Desa/Kelurahan : SIDODADI

Panja
ng
Berat Bada
No No Kartu Keluarga NIK (Nomor Induk Ana Tanggal Lahir Badan Nama Ortu n/
Nama anak NIK Ayah No Tlp/ HP Ortu RT Tinggi jan feb mart april mei jun jul agust
Kependudukan) k Ke (BB) (Ayah)
Lahir Bada
n
(cm)

(1) (2) (3) (4) (5) (6) (8) (9) (10) (11) (13) (17)
1 1802021405055925 1802026903160001 6 Areta Khanza Zhayna 29-Mar-16 3100 Sutiman 1802020603720001 082281680800 001 88

2 1802022605140002 1802020510130003 1 Daffa Nauffal Adzaki 5-Oct-14 3200 Sodikin 1802020303850006 082281680800 004 101

3 1802021405055032 1802023010150003 3 Mikail Gibran Fahreza 30-Oct-15 3400 Bambang - 082281680800 003 97

4 1802021405055833 1802025009170001 3 Muslimah 10-Sep-17 1000 Untung 1802021607710001 082281680800 001 66

5 1802022901150007 1802026611170002 1 Andini Ashyla Putri 26-Nov-17 2800 Agus Budianto 1802022504920003 082281680800 003 75

6 1802021209090021 1802024410150003 2 Inayah Fatiyatuurahmah 4-Oct-15 3000 Purnawan 1802020906810002 082281680800 003 90

7 1802022111170014 1802022803180001 2 Abidzar Rizki Pratama 28-Mar-18 2900 Nasib Santoso 1802020105850002 082281680800 004 71

8 1802021405054347 1802020908150001 3 M. Bagas Prayoga 9-Aug-15 3000 Suroso 1802020107670018 082281680800 003 102

9 1802021304170009 1802022307150001 1 Azka Maulana Sidik 23-Jul-15 3300 Hermawan 1802020903810004 082281680800 004 93

10 1802022912070016 1802020711160001 3 M. Faqih Alfiansyah 7-Nov-16 2700 Herlianto 1802020108790004 082281680800 003 84

11 1802022912070016 1802020301180001 4 M. Alfiansyah 3-Jan-18 1800 Herlianto 1802020108790004 082281680800 003 68

12 1802022912070015 1802024711160002 2 Novi Alfiani Aulia 7-Nov-16 2000 Imam Muhdori 1802020305800001 082281680800 004 82

13 1802022912070015 1802024711160001 3 Nova Alfiana Aulia 7-Nov-16 2300 Imam Muhdori 1802020305800001 082281680800 004 83

14 1802021803110056 1802023110140002 2 M. Abu Hanifah 31-Oct-14 2950 M. Nadi 1802020506800004 082281680800 003 102

15 1802022701120007 1802024308160003 2 Aulia Adila Rachma 3-Aug-16 2800 Nur Udin 1802022806850001 082281680800 002 84

16 1802022001100007 1802027006150002 2 Hafiza Silviana Putri 30-Jun-15 2200 Ides 1802022306800002 082281680800 006 94

17 1802021803110034 1802020809160001 2 Rosyid Assoleh 8-Sep-16 3000 Ahmad Samsuri 1802023012740004 082281680800 003 84

18 1802010807140001 1802016401140003 1 Vanela Azzahra 24-Jan-14 2600 Andri Riyanto 1802012704900008 082281680800 004 89

19 1802023108170002 1802021502170002 1 Mauza Agraha Alfahrezi 15-Feb-17 2900 M. Jabir 1802021004810003 082281680800 003 83

20 1802021206120011 1802021504170002 2 Fazli Ibni Fikhar 15-Apr-17 3100 Sodiran 1802022306790003 082281680800 004 85

21 1802022708090013 1802026811140002 3 Nadia Maulida Husna 8-Nov-14 3200 Sutaryo 1802020312750002 082281680800 003 92

22 1802022609130017 1802026910130003 1 Keisha Assiva Agustin 29-Oct-13 3100 Agus Susanto 1802020202890002 082281680800 004 110

23 18020101091600041802015010140002 1 Ainun Syahrifa Ahmad 10-Oct-14 3200 Ahmad Supeno 1802011404900004 082281680800 007 95

24 18020221061000021802025503140001 2 Najwa Anisa 15-Mar-14 3800 Nur Udin 1802020205770009 082281680800 003 104

25 18020210061400201802026508150003 2 Ananda Dwi Syakila 25-Aug-15 3100 Sobirin 1802021909740001 082281680800 004 86

26 18020212090900191802026103150002 2 Itsnaini Khoiriyatul Ulum 21-Mar-15 2600 Wiyono 1802021707790001 082281680800 004 88

27 19020214050543141802022712140002 2 Dava Mahendra 27-Dec-14 3000 Sumakun 1802021507800007 082281680800 003 97

28 18020207121500021802020903150002 1 Ahmad Dzaki Istamir 9-Mar-15 3100 Salman Alfaris 1802030107880049 082281680800 004 96

29 18020215091400071802024302150001 2 Ferliana Dahlan 3-Feb-15 2900 Sosiyanto 1802020605750001 082281680800 003 91

30 1802021410140009 - 2 Arsya Dwi Saputra 19-Jul-17 3000 Tusiman 1802021607870004 082281680800 004 76
31 1802021207170010 1802022810170001 1 Faris Eka Pratama 28-Oct-17 3100 Sugeng hariyadi 1802020201880001 082281680800 003 73

32 18020219091400041802026009140001 1 Agam Abdillah 20-Sep-14 3000 Jemino 1802021504860002 082281680800 003 106

33 1802021207120016 2 Damara 7/4/2018 2800 nur kholis 1802020805810005 082281680800 003 68

34 1 M. Farhan habib 8/8/2018 3200 muhaimin 082281680800 003 69

35 18020227011200071802025710180001 2 nina nurdiansa 17-10-2018 3300 nur udin 1802022806850001 082281680800 003 51

36 1802022912170010 1 alifa hibatillah 19-10-2018 3200 jamaludin 1802021512870002 082281680800 003 50

37 18020218031100351802020710160001 4 albert ihya'ulumudin 10/7/2016 3100 rosidin 1802022604760003 082281680800 003 85

38 2 yumna afza 9/3/2018 2900 sodikin 082281680800 003 58

39 1802021304170008 2 m rohan aditia 18-08-2017 3300 budi 1802030906930006 082281680800 003 74

40 18020226091700011802025812170002 1 zhafira muna azizah 18-12-2017 3000 Roy Jordy Riki MV 1802152503920001 082281680800 003 74

41 1802020604180006 1 eka dirga patria 17-08-2018 3200 R. Agung D 1802020207950001 082281680800 003 66

42 1802020112140002 2 Aqifa Naila 8/14/2018 3000 Sukri 082281680800 003 63

43 18020227031700061802022105170002 1 M. angga firmansyah 21-05-2017 3200 suyono 1802022506870004 082281680800 003 76

44 M. Nur Kholik 31-052017 3400 Suwarno 082281680800 003 79

45 1802023011170005 1 Alvin Fajar 06-08-018 3000 Anif Hidayat 1802011605900002 082281680800 003 64

46 18020214050550731802026112170002 6 Azkaira Tanisha Hulya 12/21/2017 2700 Saun Asrori 1802022612730001 082281680800 003 72

47 18022217121500021802225502160001 1 Kinara Syafani 15-02-2016 3300 Saiful ikhwan 1802221510900001 082281680800 004 88

48 180202290118005 1802026702180002 2 Hafiza Khaira lubna 2/27/2918 3200 Suyanto 1802022211870002 082281680800 006 62

49 1 Rizki Ramadhan 6/27/2015 3200 Satman 082281680800 003 98

50 18020204121400031802022301160001 1 Ahmad Maulana 1/23/2016 3200 Hermawan 1802021201880004 082281680800 003 90

51 1802021408120021 2 Delia diah ayu Cahyani 24-09-2018 3500 suroso 1802021020770010 082281680800 003 58

52 2 al fatih rizky 27-06-2016 3300 satman 082281680800 003 85

53 1 ainnuha soraya 26-09-2018 3100 M.C Noefendi 1571012810860141 082281680800 003 60

54 18020229081600121802010308160002 1 Hafidhotul mahfudhoh 03-08-2016 3200 syamsul basri 1802010404900006 082281680800 003 90
MBUHAN BALITA DI POSYANDU

sept okt nov des

 FORMULIR PEMANTAUAN PERTUMBUHAN BALITA DI POSYANDU

Provinsi : LAMPUNG Nama Posyandu : ANGGREK

Kabupaten/Kota : LAMPUNG TENGAH Bulan :
Puskesmas/Kecamatan : SUKANEGARA/BANGUNREJO Tahun : 2019
Desa/Kelurahan : SIDOADI
ang
Bada
A Berat n/
NIK (Nomor Induk na Tanggal Badan Nama Ortu No Tlp/ HP RT Ting
No No Kartu Keluarga Nama anak NIK Ayah jan feb mart aprl mei jun jul agust
Kependudukan) k Lahir (BB) (Ayah) Ortu gi
Ke Lahir Bada
n
(1) (2) (3) ### (5) (6) (8) (9) (10) (11) (13) (17)
1 1802021107120002 1802020507140001 3 Bintang Ramadhan 5-Jul-14 3100 Giman 1802021402680001 082281680800 005 97

2 1802021806120004 1802022303160001 3 Sahrurrozi 22-Mar-16 3600 Juweni 1802022212840002 082281680800 005 93

3 1802022009170015 1802021101170002 1 Shauqi Zidhan Willdansyah 11-Jan-17 2750 Defi Ardiansyah 1802023112900001 082281680800 006 86

4 1802020508090001 1802020111150004 2 Azmi Nizar Tsaqib 1-Nov-15 3200 Munawar 1802020605840001 082281680800 005 97

5 1802021508140002 1802020503170001 2 Madina Alfatin 5-Mar-17 2900 Khusni 1802022306880003 082281680800 003 78

6 1802021112120015 1802025410150001 2 Felicia Gita Cahyoda 14-Oct-15 3300 Sutoyo 1802022101780005 082281680800 006 99

7 1802021812140005 1802020408170003 2 Dava Ubay Hanafi 1-Sep-17 3300 Adi Muhyidin 1802020112880002 082281680800 005 79

8 1802021905090001 1802026911160001 3 Assyava Amala 29-Nov-16 3100 Ismail 1802021108720003 082281680800 006 85

9 1802021112170002 1802222712130001 1 Devin Bagus Prasetyo 27-Dec-13 3300 Hariyanto 1802021605880001 082281680800 006 110

10 1802020903110021 1802025810170002 2 Syakilla Mar'atus Soleha 18-Oct-17 3000 Muhtadi 1802020810770003 082281680800 005 71

11 1802021301110002 1802024906170001 3 Alma Salsabila 9-Jun-17 3000 Sarijan 1802020309780001 082281680800 006 80

12 1802020808170003 1802022511170002 1 Dio Pratama 25-Nov-17 3100 Dibyo Sutrisno 1802020901870002 082281680800 005 77

13 1802022909090016 1802025210170002 2 Rahma Choirunnisa 12-Oct-17 2900 Edi Erwan 1802022303820007 082281680800 006 71
14 1802020903110023 1802025112160002 2 Dinda Humaimah Khalilah 11-Dec-16 2800 Komarudin 1802022804850001 082281680800 005 83

15 3 Salsabila Khoiri 2-Mar-18 2700 M. Talkis 082281680800 005 70

16 1802022605140001 1802026402160001 2 Adella Mysha 24-Feb-16 2800 Amin Mustofa 1802020704820007 082281680800 006 85

17 1802021301110022 1802022604140001 2 Safiq Al Mubaroq 26-Apr-14 3200 Agus Supriyanto 1802022708800004 082281680800 006 98

18 1802021601170006 1802020910170002 2 Aulian Fahreza 9-Oct-17 3000 Lesmanto 1804141012780004 082281680800 005 74

19 3 Noval Aryana 8-Aug-17 2700 Zaelani 082281680800 006 74

20 1802020709170001 1 M. Fahmi Al Azam 20-Apr-18 3400 Fauzul Amin 1802022103920002 082281680800 005 66

21 1802020812170003 1802025210140004 2 Nanda Oktavia 12-Oct-14 3200 Dani Wijayanto 1802022912900004 082281680800 006 98

22 1802021601170006 1802025003140002 1 Fatimatu Zahra 10-Mar-14 3300 Lesmanto 1804141012780004 082281680800 005 100

23 1802022407090011 1802022208150002 2 Nugraha Marvel 22-Aug-15 3100 Iswanto 1802021604820001 082281680800 006 89

24 1802021405055869 1802024304140001 3 Aprilia Dahayu 3-Apr-14 3100 Kartiman 1802021207740004 082281680800 006 99
25 2 Nurida 27-May-17 2800 Sukartono 082281680800 005 77
26 1802020812170003 1802024612170001 2 Cahya Tri M 6-Dec-17 3200 Dani Wijayanto 1802022912900004 082281680800 005 72

27 18020227111700005 1 Satria Fahrezi Danendra 4-Mar-18 3300 Rendra 1802022706890003 082281680800 006 72

28 1802021112120015 1802026503180002 2 Fayza Arshi Cahyoda 25-Mar-18 3100 Sutoyo 1802022107800005 082281680800 006 67

29 1802021712080003 2 Andini Maharani 20-Dec-17 3200 Suyanto 1802021709830002 082281680800 006 69

30 1 Ikhsan Maulana 24-Jul-16 3500 Kaswanto 082281680800 006 82

31 1 Ratu Aminun 16-Nov-17 3800 Yulius 082281680800 006 75

32 1802020709150003 1802025910140001 1 Cecilya Nur Azizah 19-Oct-14 3000 Sudiono 1802020201830012 082281680800 006 94

33 3 Suci Amelia 25-Feb-18 2800 Suhelmi 082281680800 006 67

34 1802021905140002 1802020707180001 2 M. Nasrulloh 7-Jul-18 3200 Darusin 1802022606840002 082281680800 006 65

35 1802022609160007 1802025212150002 2 Sofi Kristanti 12-Dec-15 2900 Suhelmi 1802012808840004 082281680800 006 88

36 1802020712150001 1802021904150002 1 Gibran Alvin Pranata 19-Apr-15 3000 Tursiman 1802031006850001 082281680800 005 93

37 2 Luthfiana Ika P 16-Nov-17 3100 Ngalimun 082281680800 005 64

38 1802021803110064 1802026407160001 2 Dinda Permatasari 24-Jul-16 2800 Mulyono 1802020101800009 082281680800 001 89

39 2 Afika 29-Jun-18 3100 Irham 082281680800 005 63

40 1802021202180025 1802024508180001 1 Khalisa Aulia 5-Aug-18 3400 Paino 1802021504890006 082281680800 005 63

41 2 Masya Ulfairah 27-Sep-14 2900 Dwi Sungkono 082281680800 005 95

42 3 Rasya Zahra R 10-May-16 3200 Dwi Sungkono 082281680800 005 90

43 1802021503180007 1802020808180001 1 Ahmad Husyen Maulana 8-Aug-18 3400 Hayatulloh 1802022103940001 082281680800 001 64

44 1802021603110025 1802023107140003 3 M. Faza syauqillah 31-Aug-14 3100 Indaman 1802020705720002 082281680800 005 106

45 1802020609180001 1 Devina Azahra 4-Oct-18 3700 Teguh Ariyanto 1802021209930002 082281680800 006 59

46 1802020608180012 2 Nakhla Humaira 18-Sep-18 2700 Lukman Al Hakim 1802021108860002 082281680800 005 59

47 1802021809120011 1802021104170001 4 Ferdi Kurniawan 11-Apr-17 3000 Sudar 1802021606730006 082281680800 006 83

49 1802021301110009 1802023108170002 3 Aftab Rizki fatihan 8/31/2017 2900 Saiman 1802023001680001 082281680800 6 75

50
MBUHAN BALITA DI POSYANDU

sep okt nov des

 FORMULIR PEMANTAUAN PERTUMBUHAN BALITA DI POSYANDU

Provinsi : LAMPUNG Nama Posyandu : MELATI

Kabupaten/Kota : LAMPUNG TENGAH Bulan :
Puskesmas/Kecamatan : SUKANEGARA/BANGUNREJO Tahun : 2019
Desa/Kelurahan : SIDOADI
Panj
ang
Berat Bad
NIK (Nomor Induk Ana Bada an/
Tanggal Nama Ortu No Tlp/ HP
No No Kartu Keluarga k Nama anak n NIK Ayah RT Ting jan feb mart april mei jun jul agus sept
Kependudukan) Lahir (Ayah) Ortu
Ke (BB) gi
Lahir Bad
an
(cm)
(1) (2) (3) (4) (5) (6) (8) (9) (10) (11) (13) (17)
1 1802020202120012 1802026801150001 2 Naviya Khoirunisa 28-Jan-15 2900 Agus 1802022208880003 082281680800 012 94

2 1802022112170001 1802022209170002 1 Adam Hafis 22-Sep-17 3000 Iman Saputra 1802021201950005 082281680800 012 73

3 1802021306170006 1802022305170001 1 Reyval Diksa 23-May-17 2950 Endrik 1802021205940005 082281680800 011 76

4 1802021509160006 1802021709140002 1 Devan Adi 17-Oct-14 3200 Dian 1802022306960003 082281680800 012 97

5 1802021301110048 1802025809170003 2 Naura Vita 18-Sep-17 2400 Muhaimin 1802020205860008 082281680800 012 66

6 1802022509170007 1802025009170002 1 Andreana Kamila M 10-Sep-17 2950 Teguh Trianto 1802021611890001 082281680800 002 75

7 1802022401170013 1802020106170002 1 M. Rasya 1-Jun-17 3000 Masdar 1802011212910003 082281680800 011 82

8 1802022606150004 1802020906150001 1 M. Razan al gifari 9-Jun-15 2900 Masrudiyanto 1802020712930001 082281680800 012 99

9 1802021012150002 1802021810150003 1 Revan Ferdika 18-Oct-15 3100 Kamaludin 1802021809910003 082281680800 011 98

10 1802023012070027 1802024304150001 1 Syahra Khaira 3-Apr-15 2800 Mujianto 1802022108840002 082281680800 010 97

11 1802021405059246 1802025202150001 4 Andinda Alya F 13-Feb-15 2750 Sarbini 1802020708760002 082281680800 012 97
12 1802022801150001 1802022712140001 1 Rafael Aditama H 27-Dec-14 3200 Suherman 1802020907890003 082281680800 011 103

13 1802021608110002 1802021609140001 2 Aldi Adriansyah 16-Sep-14 2950 Mustakim 1802023101870001 082281680800 012 98

14 1802021912130008 1802024102160002 1 Ismiati Aulia 1-Feb-16 2800 Yusuf - 082281680800 011 90

15 1802021110160008 1802025104170001 1 Aqila Nur Rahmawati 11-Apr-17 2700 Tri 1802020809930002 082281680800 011 73

16 1802022608090009 1802020405150001 2 David Faza K 4-May-15 3200 Sukamto 1802021612730002 082281680800 012 95

17 1 Savina 16-Dec-15 3400 Daud 082281680800 012 89

18 1802021701110003 1802025106170001 2 Mufida Nuzulul Q 11-Jun-17 3400 Saryono 1802022707870005 082281680800 011 74

19 1802021307130007 1802026104160001 2 Afiqa Zahira 12-Apr-16 2800 Amin Wahyudi 1802020206860003 082281680800 012 91

20 1802022304130013 1802022906160001 2 M. Riski Aditya 19-Jun-16 3000 Seno 1802021007810008 082281680800 012 95

21 1802021701110008 1802024408140002 2 Luxviona yunita S 4-Aug-14 3100 Toni Setiawan 1802020206880004 082281680800 011 95

22 1802020502160009 1802024305160002 2 Maylin A.P 3-May-16 3000 Nurohman 1802020303860010 082281680800 010 83

23 2 M. Jalaludin 2-Aug-18 2700 Daud 082281680800 010 59

24 2 Nur Tadho Alfarizi 14-Jul-18 2900 Agus 082281680800 010 63

25 1802021701140005 1802025012130001 1 Alvian Gavriel 10-Dec-13 3000 Bowo 1802022602870001 082281680800 012 103

26 1802021508120011 1802021102170002 2 M. Hasbi Maulana 11-Feb-17 3100 Suradi 1802021703830005 082281680800 011 76

27 1 Arsenio Dirgantara 17-Aug-18 3300 Tugino 082281680800 011 64

28 1802022310120013 1802021009180003 2 M. Wisnu Novansyah 10-Sep-18 3000 Kasriono 1802021606850008 082281680800 011 58

29 1802022701140010 1802020801140002 1 Kevin Aditya 8-Jan-14 3400 Heri 1802022802890001 082281680800 011 105

30 1802021701140005 2 Syanum ayudia 3-Nov-18 3500 bowo 1802022602870001 082281680800 012 49

31 1802022912110013 2 Raihanun zhaswa 14-10-2018 3200 JARWO 1802021507850010 082281680800 011 50

32 1802022607180004 2 Dila Sivaziza 8/10/2018 3300 M aziz 1811031510900001 082281680800 011 50

33 1802022105110012 2 Iftina Fauziyah 6/11/2018 3000 Sutarmin 1802020507810006 082281680800 011 49

34 1802020304170003 1802020811180002 2 Rafli Misdiyansyah 11/8/2018 3700 Darni 1802020505850014 082281680800 011 50
UHAN BALITA DI POSYANDU

okt nov des

 FORMULIR PEMANTAUAN PERTUMBUHAN BALITA DI POSYANDU

Provinsi : LAMPUNG Nama Posyandu : TERATAI

Kabupaten/Kota : LAMPUNG TENGAH Bulan : NOVEMBER
Puskesmas/Kecamatan : SUKANEGARA/BANGUNREJO Tahun : 2018
Desa/Kelurahan : SIDODADI

Panj
ang
Berat Bad
(Nomor Induk An Bada Nama Ortu an/
No No Kartu Keluarga NIK Tanggal No Tlp/ HP
ak Nama anak n NIK Ayah RT Ting JAN FEB MART APRIL MEI JUN JUL AGUS
Kependudukan) Ke Lahir (Ayah) Ortu
(BB) gi
Lahir Bad
an
(cm)

(1) (2) (3) (4) (5) (6) (8) (9) (10) (11) (13) (17)
1 1802022508090007 1802025009170003 2 Khanza Aurelia H 10-Sep-17 3200 Mariman 1802020308860002 082281680800 010 75

2 1802020109140015 1802026106140001 1 Nabilla Azzahra 21-Jun-14 2900 Budiyanto 1802022003790002 082281680800 010 95

3 1802022912170014 1802022308160001 2 Jovi Dirgantara 23-Aug-16 3400 Ernanto 1802021303870003 082281680800 010 87

4 1802022912170014 1802022012170001 3 Thio Arga Adistian 20-Dec-17 3600 Ernanto 1802021303870003 082281680800 010 77

5 1802021001180011 1802020712170001 1 Ahmad Latief Alfarizi 7-Dec-17 2900 Solihin 1802221703890002 082281680800 010 75

6 1802021612160001 1802024208170001 1 Milkha Hilyatus Solihah 2-Aug-17 3200 Sugeng Riyadi 1802021003900002 082281680800 001 77

7 1802022212170013 1802020210170001 2 M. Fadli Maulana 2-Oct-17 2700 M. Nur Hiday 1802020505860002 082281680800 007 72

8 1802022307150002 1802020907150001 1 M. Ibnu Attho'illah 9-Jul-15 3200 Miftahurohim1802021912880002 082281680800 010 98

9 1802021112120011 1802025608160001 2 Ayunda Khoirunnisa 16-Aug-16 2500 Nur Ikhsan 1802022311860001 082281680800 007 77

10 1802021112120011 1802025608160002 3 Adinda Khoirunnisa 16-Aug-16 2300 Nur Ikhsan 1802022311860001 082281680800 007 79

11 1802023105170011 1 Niswa Hilmatun 25-Jul-17 2900 Nasrulloh 1802021410920002 082281680800 007 78

12 1802022501130008 1802021208160002 2 Alvin Arasyid Prasetya 12-Aug-16 3200 Suparno 1802022507690004 082281680800 007 83

13 1802022303170002 1802022409170001 2 Nizam Syarif Rahman 24-Sep-17 3000 Muhammad Kh

1802021105860005 082281680800 010 76

14 1802021407170007 1802025203180001 2 Shinta Afiqotul Qifti 12-Mar-18 2700 Badri 1802020609840009 082281680800 010 69

15 1802022312150001 1802024106150001 1 Asilah Fathin Azizah 1-Jun-15 2800 Adi Saputra 1802021310900003 082281680800 010 90

16 1802022811120014 1802022609160003 2 Eren bastian 26-Sep-16 3200 Supriyono 1802020507810009 082281680800 007 86

17 1802022108170012 1802024711170004 1 Alycia Putri 7-Nov-17 3000 Agung Priono 1802022404960004 082281680800 007 73

18 1802020609160009 1802022104160001 3 M. Althaf Rizki Alfarezi 21-Apr-16 2700 Masrurozi 1802021502720001 082281680800 010 85

19 1802020510150004 1802026005940005 1 Naura Zulfa Azzahra 3-Apr-15 3200 Aryadi Putran 1802020208930002 082281680800 003 95

20 1802021405056761 1802027009150003 3 Lia Habibatul Khumairoh 30-Aug-15 3200 Mukarom 1802020109670002 082281680800 010 95

21 1802021612100002 1802027008140001 2 Septiani 30-Aug-14 3300 Kasnan 1802020805800003 082281680800 011 98

22 1802022903170001 1802025705170001 2 Anindya Qanita 17-May-17 3100 Wagino 1802021203900001 082281680800 010 79

23 1802021405058312 1802025407150001 1 Arifah Ziyadatul Husna 14-Jul-15 2900 T. Farid Ma'ru 1802021405730003 082281680800 010 97

24 1802021505050111 1802021307170002 1 Azril Haikal Alindra 13-Jul-17 3100 Saring 1802021505800002 082281680800 010 81

25 1802022302150002 1802024305150001 1 Raihanna Jinan Ulya 3-May-15 2800 Ahmad Tauhi 1802021405900001 082281680800 010 94

26 1802021602100007 1802022104180002 2 Aden Ibrahim 21-Apr-18 2900 Casmani 1802021506840005 082281680800 007 64

27 - 1 Arsyla Althafunisa 5-Jan-18 2900 Heri - 082281680800 007 7.1

28 3175061601093229 3 Nada Fajriyah 8-Apr-18 2800 Tursiman 3175060509780001 082281680800 007 68

29 3175061601093229 3175062004141006 2 M Ilham nurmansyah 20-Apr-14 3200 Tursiman 3175060509780001 082281680800 007 98

29 1802020502160001 1802022004180002 2 Alvin Salim Zarkasi 20-Apr-18 2700 Suwawan 1810011505840003 082281680800 011 64
30 1802020303110051 1802022203180001 3 M. Ali Musyafa K 22-Mar-18 3000 Eko Purwanto 1802022804840003 082281680800 010 70

31 1802021210160010 2 Alifah Alfika 5-Jun-18 2900 Tafsir 3276040204820007 082281680800 010 62

32 1802021202130011 1802022901170001 2 Ali Novansya 29-Jan-17 3200 Aminudin 1802022003830010 082281680800 010 84

33 M. Baehaki 13-Feb-18 2900 M. Saripudin 082281680800 007 71

34 1802021806120007 1802025807180001 2 Aisyah Nurul husna 18-Jul-18 3000 Umaryono 1802021909840003 082281680800 010 71

35 1802021112090010 1802025709180001 2 Alma Nur Aulia 17-Sep-18 2900 Sutoyo 1802022808740004 082281680800 010 58

36 1802021407170007 3301181207140001 1 Dava Arian R B 13-Jul-14 2600 Badri 1802020609840009 082281680800 010 97

37 1802020305120013 1802025604180001 2 Miti Kusuma Ningrum 16-Apr-18 3500 Sutiyono 1802020405810002 082281680800 007 70

38 1802020205130007 2 Hanif Aqil Maulana 28-Apr-18 3600 Sapari 1802021312780001 082281680800 007 68

39 1802022312150001 2 Fiona Alma Qairen 3-Oct-17 3200 Adi Saputra 1802021310900003 082281680800 010 71

40 180202110800001 1802022808160002 2 Reza Prastyo 28-08-2016 3000 Rusmadi 1802020903830005 082281680800 010 84

41 1802021001180010 1802022809170001 1 Anjar Albiansyah 28-Sep-17 3000 Julianto 1802022907950005 082281680800 007 73

42 1802020712150003 1802020604150003 1 Reza Aprilio Pratama 6-Apr-15 3400 Wahidin 1802020303930004 082281680800 010 96

43 1802021405056770 1802025904170002 3 AriZka Intan APrilianti 19-Apr-17 3400 Edi Susanto 1802021806680001 082281680800 007 75

44 5 Ramadhanis 12-Jun-18 3400 Jumidi 082281680800 007 68

45 1802021906140004 1802027105140001 1 Silvi Reviana 31-May-14 3100 Budi Sarwono1802021003840010 082281680800 010 98

46
MBUHAN BALITA DI POSYANDU

SEPT OKT NOV DES

 FORMU

Provinsi : LAMPUNG Nama Posyandu

Kabupaten/Kota : LAMPUNG TENGAH Bulan
Puskesmas/Kecamatan : SUKANEGARA/BANGUNREJO Tahun

Desa/Kelurahan : SIDODADI

Berat
NIK (Nomor Induk Anak Tanggal
No No Kartu Keluarga Nama anak Badan
Kependudukan) Ke Lahir (BB) Lahir

(1) (2) (3) (4) (5) (6) (8)

1 1802020303110028 1802022802160001 2 ZULMI FAKHRI FADILLAH 28-Feb-16 4100
2 1802020303110035 1802022608170003 2 FAHRUL SETIA NOVANSYAH 26-Aug-17 3400
3 1802020212130010 1802021912130001 1 NIKOLA ALFIANO 19-Dec-13 3000
4 1802022909170001 1802020112170001 1 ACHTAR FAEZA DINATA 1-Dec-17 2900
5 1802022910150002 1802022409150001 1 M. NUR HAFIZ 24-Sep-15 2900
6 1802022910150002 2 M. ZAFRAN 21-Feb-18 3000
7 1802020303110044 1802025803170002 3 AFRILIANA AZZAHRA 18-Mar-17 3200
8 1802021705170006 1802021712140003 2 DAVI IRWANSYAH 17-Dec-14 3000
9 1802022801150010 1802026512140002 1 FIRZA DESTI AULIA SARI 25-Dec-14 3100
10 1802021610170009 1802022008160003 1 FIAN AL AZIZ 20-Aug-16 3200
11 1802023110170008 1802024112150003 1 AQILA ALESHA ZAHRA 1-Dec-15 3200
12 1802021705100019 1802021807170001 2 RAYZAL ANDIKA 18-Jul-17 3100
13 1802021912140001 1802024802150003 2 FEBRINA KHOIRUNNISA 8-Feb-15 2800
14 1802021311170012 1802025809170001 3 SEPTINA LATRI WULANDARI 18-Sep-17 2900
15 1802021505050124 1802026506160004 2 ERLIN PUTRI RAHMADANI 25-Jun-16 3200
16 1802021401110034 1802020902150002 2 AKMAL ZULFADLI RAHMANI 3-Sep-15 2700
17 1802022411150001 1802026307150002 2 JIHAN BILQIS SYAKIROH 23-Jul-15 3200
18 1802021405058285 1802020811170001 3 FIQRI WAHYU SAPUTRA 8-Nov-17 3300
19 1802021003150003 2 ANNISA ARDELYA 9-Sep-16 3200
20 1802021202130006 1802026604150001 2 ERIKA AVRILLIA ANJANI 26-Apr-15 2900
21 1802021910150021 1802021609150002 1 ARSYAD RIFAI PRATAMA 16-Sep-15 3100
22 1802021910150021 1802020108170003 2 ARKHA EL MALIQ 1-Aug-17 3000
23 1802020812140010 1802021410170002 2 RADIT OKTAVIAN FERDIANSYAH 14-Oct-17 3100
24 1802021311170011 1802024505160003 3 TRI LESTARI WAHYUNINGSIH 5-May-16 3000
25 1802022909160001 1802026712150002 1 SILNA RASTA FARADISA 27-Dec-15 2800
26 - - 2 CIKA RESIANA 29-Oct-17 2980
27 - - 2 KHAINDRA IBRA 28-Jun-16 3000
28 - - 1 ATAMA ALFATIH 9-Oct-17 2800
29 1 DAFIN 18-Aug-18 3600
30 1802021902110027 1802020309140002 2 TEGAR WICAKSONO 3-Sep-14 3200
31 - - 2 AISYAH ALTHAFUNNISA 14-Apr-17 3200
32 1802022007160008 1802025110160001 1 ANASYA KAILA AURISKA 11-Oct-16 3500
33 1802011003150002 1802013110140002 1 F. GALIH PRATAMA 31-Oct-14 3500
34 1802022801120010 1802020910150004 4 NGASIF NGANAN 9-Oct-15 3300
35 - - 2 AZKA MARCELL 30-Mar-18 3100
36 1802020406180004 - 1 FAIQAH MUTIA 10-Aug-18 2900
37 - - 1 NAUVAL GAVIN 31-Dec-15 3100
38 - - 1 MISYA 16-Nov-15 3100
39 1802022808120002 1802024906180001 2 BELVANIA RAHMADHANI 9-Jun-18 3200
40 1802022001110027 1802025412140001 2 DESTIANA DWI SAPUTRI 14-Dec-14 3800
41 - - 2 NAFISA NUR RIYANI 31-Jul-14 2400
42 2 ZAHIDAH ULINNUHA 25-10-2018 2700
43 1802021012150007 1802026709150003 1 DITA NIRMALA 27-Sep-15 3300
44 1802021003150004 1802022010180001 2 M FILDAN ALFAHRI 20-10-2018 2600
45 1802022801150010 1802026512140002 1 FIRZA DESTI AULIA SARI 25-Dec-14 3100
46 1802021902110022 1802026511130003 2 KINAR ANASTASYA 25-Nov-13 3200
47 1802021201150008 1802022609180001 2 ARYA ARDI KURNIAWAN 26-09-2018 3300
48 6102160412170001 6102166602180001 1 FEBRI NUR ASYIFA 26-02-2018 3200
 FORMULIR PEMANTAUAN PERTUMBUHAN BALITA DI POSYANDU

Nama Posyandu : DAHLIA

: NOVEMBER
: 2018

Panj
ang
Bada
n/
Nama Ortu NIK Ayah No Tlp/ HP Ortu RT Ting jan feb mart
(Ayah) gi
Bada
n
(cm)

(9) (10) (11) (13) (17)

LUKMAN UBA 1802020906850002 082281680800 010 89
HASAN 1802020704720005 082281680800 009 77
SUYONO 1802022010840003 082281680800 009 100
MARDIYANTO 1802022503920001 082281680800 001 71
YURNANDO 1802020801930002 082281680800 011 97
YURNANDO 1802020801930002 082281680800 011 73
RISWANTO 1802022404790002 082281680800 009 77
NURI 1802021201850003 082281680800 011 98
AHMAD SIDIQ 1802012912860003 082281680800 008 93
USRIN SUPRI 1802020210920001 082281680800 009 83
RIO IRAWAN 1802022606930002 082281680800 008 96
HARIYANTO 1802021603880007 082281680800 008 81
ROSADI 1802021712720001 082281680800 008 94
PONIRAN 1802021812740001 082281680800 008 75
ARIFUDIN 1802022507870006 082281680800 001 85
MIROT 1802021401110034 082281680800 008 97
WAHIDIN 1802022603830002 082281680800 008 98
BEJO UTOMO 1802020811170001 082281680800 008 78
EKA PERDANA 1802020908830002 082281680800 008 90
SLAMET ANW 1802020507800017 082281680800 009 99
MUSTOFA 1802021609150002 082281680800 006 93
MUSTOFA 1802021609150002 082281680800 006 79
DEVIANTO 1802020812140010 082281680800 008 74
BAMBANG RI 1802022206820003 082281680800 008 87
SURANTO 1802021209890003 082281680800 008 90
RUDI - 082281680800 010 74
SUTARYANTO - 082281680800 009 88
SALAMAH - 082281680800 009 74
AMIM - 082281680800 009 63
LAMBANG 1802020305820005 082281680800 009 98
MARTIJO - 082281680800 009 75
ROHMAD 1802020107890188 082281680800 008 81
NOVENDI 1802011411840002 082281680800 009 106
WARSITO 1802021407660003 082281680800 009 88
RINO - 082281680800 009 71
SENDI KURNI 1802022209970002 082281680800 009 62
UJANG - 082281680800 009 89
KHOLIK - 082281680800 009 97
SOBIHAN 1802020508820009 082281680800 008 66
TRI WIDODO 1802021308860006 082281680800 008 97
KAWIT - 082281680800 009 101
PRAYITNO 082281680800 009 50
DEDI PRIYAN 1802022401810002 082281680800 009 93
EKO SUSANTO1802021101900001 082281680800 009 52
AHMAD SIDIQ 1802012912860003 082281680800 008 93
ISNAENI 1802021004770009 082281680800 009 100
DEDI KURNI 1802021410890001 082281680800 008 50
NUR SALIM 1802020603900004 082281680800 008 50
april mei jun jul agus sept okt nov des
 FORMULIR PEMANTAUAN PERTUMBUHAN BALITA DI POSYANDU

Provinsi : LAMPUNG Nama Posyandu : MAWAR

Kabupaten/Kota : LAMPUNG TENGAH Bulan :
Puskesmas/Kecamatan : SUKANEGARA/BANGUNREJO Tahun : 2019
Desa/Kelurahan : SIDODADI

Panj
ang
Bada
Berat n/
NIK (Nomor Induk Ana
No No Kartu Keluarga Nama anak Tanggal Lahir Badan Nama Ortu (Ayah) NIK Ayah No Tlp/ HP Ortu RT Ting jan feb maret april mei juni juli agust
Kependudukan) k Ke (BB) gi
Lahir Bada
n
(cm)

(1) (2) (3) (4) (5) (6) (8) (9) (10) (11) (13) (17)
1 1802022704160003 1802020509160001 1 ALTHAF FADIL GHANIM 5-Sep-16 2790 MUHAMMAD TAMAM 1802020101870003 082281680800 001 89

2 1802022410120030 1802024901150003 2 ZAHRA AFIFAH 9-Jan-15 3000 EDI SUSIANTO 1802021505860016 082281680800 002 97

3 1802021803180005 1802022403160002 3 DANIS ALMUBAROK 24-Mar-16 2300 ERWIN RISWANTO 1802020406810004 082281680800 001 86

4 1802022008150004 1802021609160001 1 ARSAKA VIRENDRA SAFWAN 16-Sep-15 3200 EDI PURNOMO 1802022708880005 082281680800 001 100

5 1802021701130001 1802025412150001 2 DESTIA BAHRI P 14-Dec-15 3100 SAMSUL BAHRI 1802020704860008 082281680800 001 86

6 1802021405054322 1802026211140004 3 GALIYA GINA ABILA 22-Nov-14 3200 SUTIYO 1802021204700002 082281680800 002 92

7 1802020903150008 1802025109160001 2 ZIA NAFIZA QODRIYA 11-Sep-16 3200 BUDIANTO 1802020902880001 082281680800 002 80
8 1802021405054245 1802023108160004 2 STEVEN BERLIYANO 31-Aug-16 3300 MARZUKI 1802020612800004 082281680800 002 85

9 1802021501180004 1802026206160003 3 LAILA ARUM RAMADHANIA 22-Jun-16 3000 M. SANI 1802023012820001 082281680800 001 88

10 1802021003140004 1802021004160004 2 IBNU CHANDRA FIRDAUS 10-Apr-16 3000 TRI SUTRISNO 1802021302890002 082281680800 002 93

11 1802020709150004 1802024811150003 1 KEYSA ALMIRA PUTRI 8-Nov-15 2900 DWI HANTORO 1802020712830004 082281680800 002 88

12 1802010807140001 1802016401140003 1 VANELA AZZAHRA 24-Jan-14 2800 ANDRI RIYANTO 1802012704900008 082281680800 004 101

13 1802022002180015 1802026909170001 3 INAYAH KHOIRUNNISA 29-Sep-17 1800 SUGIRAN 1804091605710001 082281680800 002 73

14 1802021702110063 1802026109170002 2 ELENA NIKMATUL JANNAH 21-Sep-17 2700 SABAR SANTOSO 1802021507830008 082281680800 002 69

15 1802020702180021 1802026312170001 2 AULIA NATASYA PERMATA H 23-Dec-17 3100 AMIN HIDAYAT 3201020908830008 082281680800 002 75

16 1802021405054276 1802022703160001 6 M. FAISAL SAHRI 27-Mar-16 3200 TURIMAN 1802020909710001 082281680800 001 87

17 1802020710110011 1802022012140002 2 AHMAD FARHAN 20-Dec-14 3100 SAMSUDIN 1802021908770002 082281680800 002 99

18 1802022912070007 1802020905150003 2 ALVIAN RIZKI ARDIANTO 9-May-15 3400 ARI MUJIONO 1802022302820001 082281680800 003 92

19 1802021405053547 1802021711170001 3 AHMAD FARIS MAULANA 17-Nov-17 3200 MARSINDON 1802021011540002 082281680800 001 73

20 1802020502180002 1802030101170002 2 ALFINO SETIAWAN 1-Jan-17 2800 MAHFUDIN 1802022509800002 082281680800 002 81

21 1802022408090014 1802023001140003 2 SATRIA MANDALA PUTRA 30-Jan-14 3200 SUSANTO 1802022804830001 082281680800 002 104

22 1802022408090014 1802021509160001 3 ARJUNA PURBAJAYA 15-Sep-16 3300 SUSANTO 1802022804830001 082281680800 002 83

23 - - 2 ABIZAR 21-Oct-17 2800 ALDI - 082281680800 002 76

24 - - 2 PUTRI AULIA 22-Dec-14 3100 BASORI - 082281680800 002 98

25 1802021809120018 1802024704180004 2 ALISHA AMIRA FAHIMA 7-Apr-18 3200 ANDI SAPUTRA 1802020811860004 082281680800 002 65

26 1802020704160003 1802022005170003 1 ATHAFARIS ADNAN ALHADI 20-May-17 3000 SAIPUL HADI 1806111110880001 082281680800 002 79

27 - - 2 ZAKI MIRZA 12-Dec-15 3700 TEDI K - 082281680800 002 98

28 - - 3 FARIDA 25-May-17 2600 KUWAT - 082281680800 002 75

29 2 ARSYLA FHARA FARZANA 11-Apr-18 3000 HENDRIK 082281680800 002 70

30 1 ALFIAN MALIQ ZAKIN 26-1--2018 3200 SUPRIANTO 1802020704930001 082281680800 002 50

31 1802021801160001 2 WIRA ALJABU 31-10-2018 2900 JUNAEDI 1802031505930005 082281680800 002 51

32 1802022302150005 2 M. NAZRIEL 7/10/2018 3300 SUKAR 1802020802780001 082281680800 002 50

33 1802020505150001 1802024104150001 1 NABILLA CHINTYA PUTRI 01-04-2015 2900 MIFTAKHUL MUNIR 1802021407850003 082281680800 001 96

34 1802021405054330 1802026012160002 5 AINUN MUTIARA PUTRI 20-12-2016 2800 SAMSUL KOMAR 1802021006650004 082281680800 001 79
MBUHAN BALITA DI POSYANDU

sept oktb Nov des