Format Pendataan Pus Tahun 2017

FORMAT PENDATAAN PUS TAHUN 2017
KABUPATEN : SIDOARJO
PUSKESMAS : WARU
DESA : KUREKSARI
POSYANDU : MAWAR
RT/RW : 001/004
METODE KET. KRONIS
NO NIK.KK/NO KK NIK ISTRI NAMA ISTRI TGL LAHIR NIK SUAMI NAMA SUAMI TGL LAHIR NIK ANAK NAMA ANAK JK TGL LAHIR
KB GAKIN
AISYAH
3515185404110001 14/04/2011
351518160211OO12 3515184505840004 PUJI ASTUTI 06/05/1984 3515101102010003 DWI RUDI 11/02/1981 NAURA Z P
KONDOM
1 PURNOMO ALYA KAYLA
3515185006140003 10/06/2014
AZZAHRA P
DEDI AMIN RAMADHAN

2 3515182110130021 3515186806840001 AIDA FITRIA 28/06/1984 350705020670008 02/02/1987 3515181407150003 L 14/07/2015 KONDOM
SUSANTO WENDI S.
AGUS FANESSA
3 3515181503120014 3515186203890002 ARI ISNAINI 23/03/1989 3515131505880004 15/05/1988 3515185611110005 P 16/11/2011 KONDOM
WARIYANTO AURA S.
RISWATIN ALVIN
4 3515181808110013 3515184602770012 05/05/1977 3515100807730010 SUPARMAN 06/07/1973 3515182508040003 L 25/08/2004 SUNTIK
KHASANAH HIDAYAT A.
IMAM MALIK
ABDUL 3515181301070004 L 13.01.2007
5 3515181901100025 3515186808860004 SITI AISAH 28/08/1986 3515180407790007 04/07/1979 R. S.
ROHMAN PIL
ROBBIATUL
3515186911090001 P 29/11/2009
ADZAWIA
MARIANA DJOKO IDA AYU

6 3515180308090013 351518440183007 04/01/1983 3515180404780007 04/04/1978 3515184710070007 P 07/10/2007 SUNTIK
SETIAWATI SUPRIYANTO OKTAVIANA
HENDRYANTO MOCH.
7 3515182501098392 351518670772001 ANI HASTUTI 27/07/1972 3515181903720002 19/03/1972 3515182512070006 L 25/12/2007 SUNTIK
DWI N. HANAFI A.W.
ERA AGUS DANI OCTA

8 3515182501098447 3515184410800003 04/10/1980 3515182508750001 25/08.1975 3515182910040002 L 29/10/2004 SUNTIK
SARTININGSIH SANTOSO RAMADHAN
ABDUL JIHAN HASNA

9 3515182705100015 350616500678004 JUMINI 10/06/1978 3515181409670001 14/09/1967 3515185509150004 P 15/09/2015 KONDOM
HASAN FAZILA
BUDI SATRIO BUDI

10 3515182601090471 3515184710730001 ASIYAH 07/10/1973 3515182810730001 28/10/1973 3515181902070008 L 19/02/2007 TIDAK KB
HERIYONO KARENINO
PUSKESMAS : WARU
DESA : KUREKSARI
POSYANDU : MAWAR
RT/RW : 001/004
METODE KET. KRONIS
KB GAKIN
MUCHAMMAD
3515181411070004 14/11/2007
FADLI H. L
WAHYU DUWI MUHAMMAD
11 3515182601090915 3515184205770010 02/05/1977 3515181408760001 AGUS WIDODO 14/08/1976 3515182010120002 20/10/2012 MOW
MAISAROH BAARIGH M. L
MUCHAMMAD
3515182412160005 FAQIH A.A. L 24/12/2016
SANIYA
12 3515182705100014 3515016501730001 SRIANAH 25/01/1973 3515180606720013 MULYONO 06/06/1972 3515186803060004 P 28/03/2006 TIDAK KB
MELANI P.
HERAWATI REGINA PUTRI

13 3515182404140003 3515185804760004 18/04/1976 3515181209660003 MARIO 12/09/1966 3515184804020004 P 08/04/2002 SUNTIK
TRI N. CANDRA W.
DIMAS
3515182005070002 L 20/05/2007
KHAFID Z.
14 35151880705100017 3515185703770001 ASTUTIK 17/03/1977 3515180101790058 M. IMAM A. S. 01/01/1979 PIL
ASMAUL NISA
3515186706130004 P 27/06/2013
RIZKY A.
ENDANG SAHRUL
15 3515182501098408 3515184306730001 SUPRIHATIN 03/06/1973 3515180344730006 MUSAHWI 03/04/1973 3515183105970006 AKHBAR L 31/05/1997 KONDOM
FIQIH RIFQI
3515186008990004 MA HISAH W. P 20/08/1999
NAILLAH
3515185712040004 BINTANG K. P 17/12/2004
MUHAMMAD
3515181103070001 ROSUL A. L 11/03/2004
DEVITA AL-
16 351518011215004 35151870273005 ISYOWATI 17/02/1973 3521110705820003 SUPRIYANTO 07/05/1982 3515187012070003 SYAFIRA P 30/12/2007 SUNTIK
CAHAYA
3515180801150009 MUHAMAT S. L 08/01/2015
MAT ALI FIKRI DHANI

17 3515180408100021 3515185812760009 NUR ABIDAH 18/12/1975 3516160703730004 BAKAR 07/03/1973 3515180112000009 RAMADHAN L 01/12/2000 TIDAK KB
PUSKESMAS : WARU
DESA : KUREKSARI
POSYANDU : MAWAR
RT/RW : 001/004
METODE KET. KRONIS
KB GAKIN
SUMEDI
3515180212090006 3515184504780010 SOIMAH 06/04/1976 3515180509580006 05/09/1958 3515186407900010 24/01/1999 SUNTIK
18 SUGENG INDRIYANI P
ESTI MEIRINA ELOK KARTIKA

19 3515182301130023 3515185503900002 ULANDARI 15/05/1990 3515182101800001 IMSRONSYAH 21/01/1980 3515185401090004 PUSPA DEWI P 14/01/2009 KONDOM
MAHARANI
3515184504140006 PUTRI ADELIA P 05/04/2014
LUCIKA M. RUZHA DIMAS RICHIE

20 3515181106120012 3515186506900003 ARVIANA 25/06/1990 3515181710860002 FAHLEVI 17/10/1986 3515180304090003 FABIANSKY L 03/04/2009 PIL
MUHAMMAD
3515181108120008 RICO FAHLEVI L 11/08/2012
DEWI NAYRA
21 3515182306090019 3515184107870003 SARTIKA N. 01/07/1987 3515093009860002 EKO SUSANTO 30/09/1986 3515184603100002 AYUSHIVA P 06/02/2010 SUNTIK
SAKHI
3515184402150001 HAFIZAH P 04/02/2015
NANIK ULUM
22 3515182110090024 3515186211830008 SUPARTI 22/11/1983 3515180201760011 MUHAROM 02/01/1975 3515185306050002 MUHAROMAH P 13/06/2005 PIL
IZZA NUR
3515184706120002 ROJABIYAH P 07/06/2012
ADI NADIFA
23 3515180909160011 3507065802890005 SUMIARSIH 28/02/1989 3515180912870002 SUPRIYANTO 09/12/1987 3515184503160002 NAZLA W. P 05/03/2016 PIL
MUHAMMAD
24 3515182501098440 3515186802760004 SRI WAHYUNI 28/02/1976 3515181008730019 SUMANTO 10/08/1973 3515181403950004 TAUFIK H. L 14/03/1995 PIL
NINA
3515184908030004 KURNIASARI P 09/08/2003
MAYA SEPTIAN ANINDITA

25 3515181905150005 3515186205910003 FATMAWATI 22/05/1991 3515182509900002 KUSWANTORO 25/09/1990 3515184712140003 NAVYA Z. P 07/12/2014 PIL
PUSKESMAS : WARU
DESA : KUREKSARI
POSYANDU : MAWAR
RT/RW : 001/004
METODE KET. KRONIS
KB GAKIN
VINTA SETIO AHMAD M. ASYRAF
3515180911110002 3515185706840005 27/06/1976 3515180902840001 09/02/1984 3515181101110004 11/01/2011 SUNTIK
26 RINI WAKHID A. AL-KHARIRI L
M. AZHAR AL-
3515181101110005 11/01/2011
KHARIRI L
NURI ZAURAH
3515185309130004 SALSABILA P 13/09/2013
AYUN DIAN
27 3515182501098414 3515185212730008 SRI NUNARNI 12/12/1973 3515181804760001 MUSLIKAN 18/04/1976 3515186504990001 ABDILAH P 25/04/1999 PIL
ANGGIE
3515186806080008 NISWA M. W. P 28/06/2008
NURUL MAIVO RAIVOLA

3515186508060002 P 25/08/2006 KONDOM
28 3515182809090006 3515186306860005 ISTIQAH A. 23/06/1986 3515102005840005 HENDRY 20/05/1984 NASZAURA
LATISHA
3515184802120004 P 08/02/202
AURELIA
CENDANA
29 3515182501098464 3515185404810009 TRI ASIH 14/04/1981 3515180809770008 SUHARIYANTO 08/09/1977 3515186306020003 P 23/06/2002 SUNTIK
PUTRI H.
ARJUNA
3515180208120001 L 02/08/2012
PUTRA ARYA
MEI AMBAR FILZAH

30 3515182503100010 3515184805840008 08/05/1984 3515181404/850007 14/04/1985 3515185910090001 P 19/10/2009 PIL
SIMATRIANA INDRIANTO GHANIAH I.
ANJAR BUDI NURUL AHMAD

31 3515182104120010 3515184404830014 04/04/1983 3515181505810009 15/05/1981 3515182403080007 L 24/03/2008 SUNTIK
SETIAWATI HIDAYAT HISYAM W.
AHMAD
3515184804580003 L 30/12/2012
SYAFIQ F.
LIA
32 3515182601091136 3515184101820010 MAULIANA 01/01/1982 3515181305740001 HADI LELONO 13/05/1974 3515186107030003 L 21/07/2003
ANGGRAINI
NOVI
3515185410090006 WISMALA P 14/10/2009
SARI
PUSKESMAS : WARU
DESA : KUREKSARI
POSYANDU : MAWAR
RT/RW : 001/004
METODE KET. KRONIS
KB GAKIN
GALUH
ASKAN SEDANG
33 3515182501098431 3515182801760004 SUSANAH 28/01/1976 3515180108690004 01/08/1969 3515186701980004 RAMADHANI P 27/01/1998
PRASETYO HAMIL
P.
FIRMAN
3515180305020004 L 03/05/2002
AGUNG P.
NABBIHAH
3515184911060004 P 09/11/2006
RUM P.
3515181801100002 M. SANJAYA P. L 18/01/2010
34
PUSKESMAS : WARU
DESA : KUREKSARI
POSYANDU : MAWAR
RT/RW : 001/004
METODE KET. KRONIS
KB GAKIN

PUSKESMAS : WARU
DESA : KUREKSARI
POSYANDU : MAWAR
RT/RW : 001/004
METODE KET. KRONIS
KB GAKIN

PUSKESMAS : WARU
DESA : KUREKSARI
POSYANDU : MAWAR
RT/RW : 001/004
METODE KET. KRONIS
KB GAKIN

PUSKESMAS : WARU
DESA : KUREKSARI
POSYANDU : MAWAR
RT/RW : 001/004
METODE KET. KRONIS
KB GAKIN

PUSKESMAS : WARU
DESA : KUREKSARI
POSYANDU : MAWAR
RT/RW : 001/004
METODE KET. KRONIS
KB GAKIN

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DEDI AMIN RAMADHAN

MARIANA DJOKO IDA AYU

ERA AGUS DANI OCTA

ABDUL JIHAN HASNA

BUDI SATRIO BUDI

HERAWATI REGINA PUTRI

MAT ALI FIKRI DHANI

ESTI MEIRINA ELOK KARTIKA

LUCIKA M. RUZHA DIMAS RICHIE

MAYA SEPTIAN ANINDITA

NURUL MAIVO RAIVOLA

MEI AMBAR FILZAH

ANJAR BUDI NURUL AHMAD