LAPORAN HASIL IMUNISASI RUTIN

RS UNIVERSITAS ANDALAS
KOTA PADANG
PROV. SUMBAR
BULAN : MARET 2019

TANGGAL PEMBERIAN IMUNISASI

TGL LAHIR
NO. NAMA BAYI JK NAMA ORTU ALAMAT HB 0 PENTAVALEN PENTAVALEN PENTAVALEN BERAT BADAN
BAYI (0<7 hr)
BCG POLIO 1
(1)
POLIO 2
(2)
POLIO 3
(3)
POLIO 4 CAMPAK

By. Ny. Lucia Agusman I 01-03-

1 LK Ny. Lucia Agusman I √ 1500 gr
2019
By. Ny. Lucia Agusman II 01-03-
2 LK Ny. Lucia Agusman I √ 1400 gr
2019
05-03-
3 By. Ny. Yulinda LK Ny. Yulinda √ 3300 gr
2019

05-03- Ny. Mardani

4 By. Ny. Mardani LK √ 3500 gr
2019
By. Ny. Berti Dwizany 07-03-
5 PR Ny. Berty Dwizani √ 2750 gr
2019
By. Ny. Tri Roza Ria 10-03-
6 LK Ny. Tri Roza Ria √ 2600 gr
2019
By. Ny. Sasri Melda Y 12-03-
7 LK Ny. Sasri Melda Y √ 3000 gr
2019
By. Ny. Pani Selvia 12-03-
8 PR Ny. Pani Selvia √ 2900 gr
2019
By. Ny. Metri Trang 13-03-
9 PR Ny. Metri Trang √ 2800 gr
2019
By. Ny. Halimah Ayu 14-03-
10 PR Ny. Halimah Ayu √ 2800 gr
2019
By. Ny. Resti Eka Fitri 16-03-
11 PR Ny. Resti Eka Fitri √ 2960 gr
2019
By. Ny. Yulia Gumala S 20-03-
12 LK Ny. Yulia Gumala S √ 3000 gr
2019