Operasi Timbang Agustus 2019 Batu Anam

FORMULIR PENCATATAN PEMANTAUAN PERTUMBUHAN DAN PERKEMBANGAN BALITA DI PO
Provinsi : SUMATERA UTARA Nama Posyandu : MELATI, MAWAR, GELATIK, CENDRAWAS

Kabupaten/Kota : SIMALUNGUN Bulan : AGUSTUS
Puskesmas/Kecamatan : BATU ANAM Tahun : 2019
Desa/Kelurahan : DOLOK HATARAN
Kepemilik
Berat
Anak Nomor Induk Badan an Buku No
KIA/KMS IMD
Jenis No Kartu 1=Ya
No Tanggal Lahir Nama Anak Nama Ayah NIK Ayah Telp/HP Alamat RT RW
Ke Kelamin Keluarga (KK) Kependudukan (NIK) Lahir 2=Tidak
1=Ya Ayah
(gram) 2=Tidak
(1) (2) (3) (4) (5) (6) (7) (8) (9) (10) (11) (12) (13) (15) (16) (17)
1 12080117107 OBET . F. DAMOS 12021520018800
I 6/11/2017 L
0007
120801116170002
SIANTURI
2.8 1 1
SIANTURI 02
BATU V III
2 12080121061 12080107089500
I 11/21/2014 L
70009
1208012111140002 FARHAN 3 1 1 SUNANDAR
01
BATU V III
3 12080121061 12081070895000
II 3/23/2107 L
70009
1208012303170001 ARKAN 2.8 1 1 SUNANDAR
1
BATU V III
4 12080121061 12080107089500
III 6/23/2018 L
70009
RASKA 3 1 1 SUNANDAR
01
BATU V III
5 12080118101 JASON JOSEP 12080109098300

II 3/10/2016 L
20002
1208011003160001
SIJABAT
3.5 1 1 RUDY SIJABAT
02
BATU V III
6 12080117031 12091903118100
II 9/3/2014 P
40002
1208014309140001 AFIFAH SYAHBILA 2.8 1 1 NOPIANSYAH
01
BATU V III
7 12080110021 DAVID .W RUDIANTO 12082902790000

II 10/12/2014 L
10069
1208011210140001
NAINGGOLAN
3.5 1 1
NAINGGOLAN 2
BATU V III
8 12082907041 MARCELLINO JULIATOR 12082902079000

II 3/3/2016 L
10004
1208290303160001
PURBA
3.2 1 1
PURBA 02
BATU V III
9 12080120061 ARSYILA IBRAHIM 12720601600840

I 8/19/2016 P
60003
1208015908160002
HASIBUAN
3.5 1 1
HASIBUAN 002
BATU V III
10 12080115031 CHRISTIAN ERIANTO 12080126068300

III 5/24/2016 L
00032 SIAHAAN
3.8 1 1
SIAHAAN 03
BATU V III
12080104040 HORASMAN 12080118017600
11 III 12/14/2016 P ATALIA PURBA 3.2 1 1 BATU V III
80792 PURBA 01
12 12080120041 SABAN 12080118017600
III 4/21/2016 L
10013
1208012104160004 ALZIDAN AKBAR 3.3 1 1
MUHOLIS 01
BATU V III
13 12801270417 CHRISTOPER FERNANDO 12080116099100
I 5/22/2017 L
0001
1208012205172001
SIJABAT
4 1 1
SIJABAT 04
BATU V III
14 12080102081 OLIN FEBRIO HOKHOP 12080111078100

III 2/10/2017 L
30001
1208011002170001
SIMARMATA
3.5 1 1
SIMARMATA 02
BATU V III
15 12080109091 ANUGRAH WESLY 12080121039100

III 3/8/2016 L
30003 SIJABAT
3.5 1 1
SIJABAT 01
BATU V III
16 12080123091 AHMAD AZZAM . 12080114128500

III 9/23/2015 L
50001 M
3.2 1 1 SUDIBYO
05
BATU V III
17 12080112081 DADANG 12030129129200

I 25/10/2014 P
50008
1208012510140003 AZZAM SYAURI 3.5 1 1
KURNIAWAN 05
BATU V III
18 12080112081 ARSYILA DADANG 12030129129200

II 1/28/2017 P
50008 QATHRUNADA
3 1 1
KURNIAWAN 05
BATU V III
19 12081909021 ASRUL 12081913108400

II 10/6/2016 L
20005
1208190610162001 BRAGA FATONAH 4.2 1 1
SYAHPUTRA 01
BATU V III
20 12080103091 MUHAMMAD 12080109107800

II 6/13/2018 L
40001
1208011306180001
SAYID . R
3.5 1 1 HAYAT FAISAL
04
BATU V III
21 12080104040 ROHAYU 12080170079400

II 7/17/2017 P
80646
CHELSI ADELIA 3.8 1 1
SARAGIH 03
BATU V III
22 12080102081 12080114038000
I 12/12/2014 L
10007
120801121214001 ADLAN FAHYURI 3.8 1 1 MELYUDI
2
BATU V III
23 12080102081 12080114038000
II 10/11/2016 L
10007
1208011110160001 IQBAL AL FAIZ 3.8 1 1 MELYUDI
2
BATU V III
24 12080108091 RUDIANSYAH 12080101088500

III 10/6/2017 L
10004
1208010610172001 IQBAL . A SIAGIAB 3.8 1 1
SIAGIAN 5
BATU V III
25 12080108100 AKHMAD RAFLY SAMSUL . B 12080127067500

III 1/15/2015 L
90003
1208011501150001
NAINGGOLAN
3.5 1 1
NAINGGOLAN 02
BATU V III
26 12080104040 RUSDI 12080103077600

III 8/2/2017 P
80273
1208014208172001 FRISKA AULIA 3.8 1 1
HERNANTO 02
SIDOURUK
CECEP
27 12080104040 12080110066900
IV 10/17/2015 P
81024
1208015710150004 AZALEA NAHDA 3.5 1 1 HENDRIANSYA
2
SIDOURUK
H
28 12080127121 ADRIAN . P DEDISUGIATNT 12080122111400
I 11/22/2014 L
30008
1208012211140002
AMZARI
3.2 1 1
O 02
SIDOURUK
29 12080113090 12080012206800
IV 8/4/2017 P
80032
1208014408172001 NAFISYAH ZAHRA 3.5 1 1 JUNIADI
01
SIDOURUK
30 12080113090 M.DAFFA SYAHDIAWAN 12080105098600

I 8/4/2014 L
2130007
1208010408180001
NAINGGOLAN
3.5 1 1
NAINGGOLAN 02
SIDOURUK
31 12080118011 12080105077900
III 1/16/2015 L
00012
1208011601150002 ALVIN FAIZ 3.3 1 1 YULFRIANDI
02
SIDOURUK
32 12080116091 12080101078700
I 11/25/2015 P
50007
1208016511150004 ZAFIRA GHILSA 3.5 1 1 JULI ANDRIA
06
SIDOURUK
33 12080119121 12080102028200
II 11/21/2016 P
20011
1208016111160001 KHANZA LUBIS 3.5 1 1 FAISAL LUBIS
11
SIDOURUK
34 12080113031 NURSYIFA SURIYA 12080106088900

I 5/29/2015 P
50003
1208016907150001
UMFITRI
3 1 1
SANJAYA 04
SIDOURUK
35 12080113031 NURANNISA SURIYA 12080106088900
II 9/1/2017 P
50003
1208014109170001
HUSANI
3.2 1 1
SANJAYA 04
SIDOURUK
36 12080111101 12080122088200
II 12/18/2016 P
72018
1208015812162001 SITI ZULAIKA 3.5 1 1 SAMSUNAR
03
SIDOURUK
37 12080136031 ANDRI 12080103127900

III 12/7/2015 L
50005
1208010712152001 RAFA ALHAFIS 3 1 1
NUHARDI 01
SIDOURUK
38 12080117111 NABILA KHAIRU 12080125048300

V 9/16/2017 P
10010 NISA
3.2 1 1 CHAIRUDDIN
04
SIDOURUK
39 12080104040 AHMAD .S 12080125058200

III 9/24/2017 P
80391
ADIBAH DANIA 3.8 1 1
SIMAMORA 04
SIDOURUK
40 12080103111 RUBY UNAIRA BAMBANG 12080117038300

III 10/13/2017 P
00007
1208014310170003
ZAHWA
4.1 1 1
ERWIADI 01
SIDOURUK
41 12080113011 INARA AFIRA 120811111190000

I 4/16/2015 P
60001
1208015604150003
PUTRI
3.2 1 1 YASMA WIYADI
1
SIDOURUK
42 12080103101 AZZAHRA HULWA DANA 12081200587000

I 1/12/2015 P
40002
1208015201150002
TAZKIA
3.1 1 1
KESUMA 1
SIDOURUK
43 12080104040 AZIZAH P IBRAHIM 12080116048100

III 8/17/2014 P
80196
1208016708140001
SIAHAAN
3.5 1 1
SIAHAAN 02
SIDOURUK
44 12080125041 SAKIH CAHYA 12080214078200

II 12/15/2016 P
40001
1208015512160001
ADEVA
2.8 1 1 DEDI ANDRY
03
SIDOURUK
45 12080101061 KHALISHAH DWI 12080109127800

II 9/22/2014 P
00009
1208016219140001
AULTA
3.8 1 1 SUYOTO
04
SIDOURUK
46 12080101061 HAIKAL TRI 12080109127800

III 4/18/2017 L
00009
1208011804170001
DERMAWAN
2.9 1 1 SUYOTO
04
SIDOURUK
47 12080192407 SALSABILA IMBRAN 12080191011740

III 3/22/2017 P
130001 AZAHRA
3.2 1 1
BATUBARA 003
SIDOURUK
48 12080192407 IMBRAN 12080191011740

IV 12/24/2018 P
130001
NADHIFA INDIRA 3.8 1 1
BATUBARA 003
SIDOURUK
49 12081160414 12080104108000
I 2/5/2015 P
0001
120801502150001 DAFFA AL FAIZ 3.8 1 1 DANI SARTIGO
02
SIDOURUK
50 12081160414 TSABITHA 12080104108000

II 6/20/2017 P
0001
120816006172001
ALFATHUNISA
3.5 1 1 DANI SARTIGO
02
SIDOURUK
51 12081907091 14051103038000
III 2/28/2017 P
70001
1208112802170001 RAQILA AFAREZI 3.5 1 1 KARYANTO
06
SIDOURUK
52 12080104040 MUFAZZAL 12080127086900

V 5/26/2017 L
81070
1208012605170002
AKBAR
2.8 1 1 MASGIMAN
02
SIDOURUK
53 12081161209 APRILIA AZ ANDI 12080010902830

III 4/14/2015 P
0010
120815404152001
ZAHRA PUTRI
3.5 1 1
DHARMAWADI 001
SIDOURUK
54 12081161209 AZKA PUTRA ANDI 12080010902830

IV 10/1/2016 L
0010
1208010110162001
KHOIRI
3.5 1 1
DHARMAWADI 001
SIDOURUK
55 12080126061 ANGGI INSANI 12081901017800

III 7/17/2017 P
40002
1208015707170001
SINAGA
2.8 1 1 KURNIA SIAGA
01
SIDOURUK
56 12080121081 12080103-
I 5/17/2016 L
700008
1208011705100004 JEVAN P SINAGA 3.5 1 1 JELLI SINAGA
9870003
SIDOURUK
57 12080121081 JEREMY P 12080103-

II 2/24/2018 L
700008
1208012402180001
SINAGA
2.8 1 1 JELLI SINAGA
9870004
SIDOURUK
58 12080121081 JEREMY K 12080103-

III 2/24/2018 L
700008
1208012402180002
SINAGA
2.8 1 1 JELLI SINAGA
9870005
SIDOURUK
59 12080114071 12080125028800
I 11/7/2017 P
40001
1208011401130006 RIRIN 2.5 1 1 JALALUDIN
05
BATU VIII
60 12080127031 MUHAMMAD JAKA 12090110078600

II 8/21/2017 L
40015
120801210872001
ALZAKI
3.5 1 1
ANDRIANTO 03
BATU VIII
61 12080104031 SELA KRISTINA RAHMAT .T 12080128068700

I 9/6/2014 P
40015
1208014609142001
PURBA
3.5 1 1
PURBA 04
BATU VIII
62 12080104031 RAHMAT .T 12080128068700

II 5/28/2018 P
40015
BUTET PURBA 3.2 1 1
PURBA 04
BATU VIII
JOEL
63 12080104111 SHELIN ANDRI 12080160288000
I 6/10/2016 P
50003
1208015006160002
SIHALOHO
3.8 1 1 HAPOSAN
1
BATU VIII
PURBA
64 12080110111 ADNVENTIE HENGLI 12060513087900
II 12/10/2016 P
50004
1208015012160001
SINAGA
3.2 1 1
SINAGA 02
BATU VIII
65 12080220101 JOHANNES 12080117088100

II 8/10/2015 L
50007
JOHAN . S 3.5 1 1
SITANGGANG 02
BATU VIII
66 12080220101 JOHANNES 12080117088100

III 6/11/2017 L
50007
UCOK . S 3.5 1 1
SITANGGANG 02
BATU VIII
67 12080103031 ALDAFI 12080106273000

IV 6/22/2016 L
40003
1208012206160002
RAMADHAN
2.8 1 1 RUDI AFRIZAL
2
SIDOURUK
68 12080103031 KHASANAH 12080106273000

V 14/4/2018 P
40003 NURSABRINA
2.8 1 1 RUDI AFRIZAL
2
SIDOURUK
69 12080117111 BUDI 12720224068200

II 8/6/2014 P
70005
1208014608140002 CHIKA AGUTIN 3.5 1 1
RAMADHAN 04
SIDOURUK
70 12080117111 GILANG BUDI 12720224068200

III 12/19/2017 L
70005
1208011912172001
RAMADHAN
3.9 1 1
RAMADHAN 04
SIDOURUK
71 12080107111 DEDI 12080120068300

III 1/20/2018 L
20001
NADIF RAPASYAH 3.2 1 1
RAHMADANI 05
SIDOURUK
72 12081924071 ANJAS 12081903108500

II 5/17/2018 L
20003
ALFA RIZI 2.8 1 1
SINAGA 02
SIDOURUK
73 12080125101 REYNATA 12080102038200

II 8/10/2015 P
10001
1208015008150001
BARKAH
3.5 1 1 TONI
05
BATU VIII
74 12080118041 12080131126700
II 11/20/2015 P
20003
1208016011150002 SHIHA FAEYZA 3.2 1 1 NURIAN
16
BATU VIII
75 12080101031 MUHAMMAD 12080109018400

II 1/13/2018 L
20002
ALDO FAZIZ 2.8 1 1
IKSA 02
BATU VIII
76 12081130908 ZURIELA SABAR .V 12080116125900

I 9/27/2016 L
0033 SITANGGANG
3.5 1 1
SITANGGANG 01
BATU VIII
77 12080114121 HENDRA 12080120038200

I 11/12/2016 P
50002
1208015211160001 HANESSA SINAGA 2.8 1 1
SINAGA 06
BATU VIII
78 12080119071 12720512128400
I 12/16/2014 L
80006
1208011612140003 RASID NANLANA 3.2 1 1 MAULANA
03
BATU VIII
79 12080119071 12720512128400
II 1/7/2017 L
80006
1208010701170001 FAUZAN KARIM 3.5 1 1 MAULANA
03
BATU VIII
80 12080119071 12720512128400
III 7/16/2018 P
80006
IFRA MIKAYLA 3.5 1 1 MAULANA
03
BATU VIII
81 12080126061 ANDRA.S PARULIAN 12080107077500

II 3/2/2016 L
50001 NAINGGOLAN
2.8 1 1
NAINGGOLAN 06
BATU VIII
82 12080126061 FEBRY CANTIKA PARULIAN 12080107077500

III 2/5/2018 P
50001 NAINGGOLAN
2.8 1 1
NAINGGOLAN 06
BATU VIII
83 12080128091 ISMAIL .P OLOAN G 12080121038500

IV 3/1/2015 L
20001
1208010103160002
SIAHAAN
2.8 1 1
SIAHAAN 01
BATU VIII
84 12080128091 SHELA GRACE OLOAN G 12080121038500

V 10/6/2016 P
20001 SIAHAAN
3.5 1 1
SIAHAAN 01
BATU VIII
85 12080110021 JUAN FREDY 12080112048000

III 5/9/2016 L
10074 SITUMORANG
3.5 1 1
SITUMORANG 04
BATU VIII
86 12080108009 KHUNAIRO 12080121109400

I 10/10/2016 P
160001 ASYIFA
2.9 1 1 REZA NANDRA
01
BATU VIII
87 12080110051 AL-KHALIFA ZIARI HENDRO 12080121109400

I 4/9/2016 L
70004
1272061506110002
NADY
3.2 1 1
PRABOWO 01
BATU VIII
88 12722061506 INDRA 12720607098100

II 11/22/2016 L
110002
AZKA FIRZA 3.5 1 1
ADIGUNA 05
BATU VIII
89 12080104040 ABDURARAHMAN MUSHAB 12080109117600

III 10/29/2015 L
80747 SITANGGANG
3.5 1 1
SITANGGANG 01
SIDOURUK
NAHAR
90 12080112011 12080122108500
I 3/10/2017 L
70004
DAPPA DAMNAIK 3.5 1 1 DIANSYAH
01
SIDOURUK
DAMANIK
91 12080122081 MHD NAZRIL SAPTA 12080101119600

I 5/21/2015 L
60008
1208012105150002
PRASETYA
2.8 1 1
PRASETYA 03
SIDOURUK
92 12080121011 M . RIZKI SUGIANTO 12080103078100

I 3/8/2018 L
60008
1208010803180001
SIMARMATA
3.5 1 1
SIMARMATA 06
SIDOURUK
93 12080105121 SARUEENA LEA 12080110403860

I 11/14/2016 P
60003
1208015411160001
LIFA
3.2 1 1 ISNADIANTO
001
SIDOURUK
94 12080104040 HENDRI 12080121047700

IV 6/5/2018 P
80209
NAURA AKILA 3.2 1 1
SETIAWAN 01
SIDOURUK
95 12170911041 FEBRIYANTI ANTONY 12170904068900

I 2/8/2015 P
70001
1217094802150001
SIMAMHURUK
2.8 1 1
SIMAMHURUK 02
SIDOURUK
96 12080113031 CHAIRUL 12080111099200

I 12/17/2017 L
700004
MAUZA AZKA 3.5 1 1
ICHWAN 02
SIDOURUK
97 12080124021 12080117128200
V 3/19/2016 P
50005
120801242150005 EVITA SIJABAT 3.5 1 1 TOGI SIJABAT
02
BATU VIII
98 12080124021 12080117128200
VI 7/20/2018 P
50005
BUTET SIJABAT 3.5 1 1 TOGI SIJABAT
02
BATU VIII
99 12080115041 12080131058100
III 4/2/2018 L
10019
RIAN SIRAIT 2.8 1 1 R . SIRAIT
02
BATU VIII
100 12080118101 JASON JOSEF 12080119038100
II 3/10/2016 L
20002
1208011003160001
SIJABAT
3.5 1 1 RUDY SIJABAT
01
BATU VIII
101 12080104071 SALWA WIDYA DEDI 12080103485000

II 6/25/2015 P
30008
1208016506150001
PUTRI
2.8 1 1
SYAHPUTRA 2
BATU VIII
102 12080104091 YUDI 12080127128600

II 3/17/2016 L
40005
MAYSARAH 2.8 1 1
KURNIAWAN 04
BATU VIII
103 12080124091 12080107029300

I 9/10/2018 L
80004
UCOK SIADARI 2.8 1 1 RIZKY SIADARI
01
BATU VIII
104 12720210071 TAUFIK 12720214029200

I 10/9/2018 L
80001
SADEWA 3.5 1 1
HIDAYAT 05
BATU VIII
105 12710709121 EVANDER T BONAR 12710728118300

III 12/27/2017 L
10009
1271072712170001
HUTAPEA
2.8 1 1
HUTAPEA 03
BATU VIII
106 12080117021 HOTLAN 12080116077400

I 9/26/2018 P
50001
1208016609180001 MARIA .H SINAGA 3.1 1 1
SINAGA 06
BATU VIII
107 12080104040 MIKAYLO P MANAOR R 12080128097500

I 7/30/2018 L
81054
1208013007182001
SIAHAAN
3.2 1 1
SIAHAAN 01
BATU VIII
108 12080121091 RIDUAN 12080131088400

I 2/28/2016 P
50008
FRISKA TURNIP 3.1 1 1
TURNIP 06
BATU VIII
109 12080121091 RIDUAN 12080131088400

II 9/26/2018 P
50008
MARIA TURNIP 3.2 1 1
TURNIP 06
BATU VIII
110 12080114041 HANIF KHAIRI ABDUL 12081260679000

IV 8/24/2018 L
10023 AZMI
3.3 1 1
RASYID 3
SIDOURUK
111 12080127121 KEANDRO ZIO DEDI 12080179088300

II 11/28/2018 L
30008 MAHERZA
2.5 1 1
SUGIANTO 02
SIDOURUK
112 17080103031 FERI

II 10/14/2018 L
40002
BIHAN 3.4 1 1
SETIAWAN
08011910920002 SIDOURUK
113 IV 6/24/2018 L IQBAL 2.8 1 1 YOSE RIZAL SIDOURUK
114 SHAQILA DEVI
I 9/14/2018 P
YUNNA
2.8 1 1 AGUS NARULI SIDOURUK
115 12080118091 SURI 12080209099100

I 6/8/2018 L
70007
ALIF ALFARID 2.8 1 1
RAMADANI 01
BATU VIII
116 MIDUN 12316240491000

I 10/5/2018 P OLIVIA MARBUN 3.1 1 1
MARBUN 2
BATU VIII
117 DINI NIRMALA DIAN

II 11/15/2018 P
NAINGGOLA
3.2 1 1
NAINGGOLAN
BATU VIII
118 12080103031 ZEFA ALFARID ANNUARI 12080123089100

I 10/9/2018 L
82055 AHMAD
2.8 1 1
AHMAD 04
SIDOURUK
119 12080102021 SYAIFUL 12080106088600

I 3/20/2016 P
60001
CITRA . N 3.5 1 1
NAIBAHO 06
BATU VIII
120 12080102021 SYAIFUL 12080106088600

II 5/2/2017 P
60001
MELANI. N 3.2 1 1
NAIBAHO 06
BATU VIII
121 12080102021 SYAIFUL 12080106088600

III 10/2/2018 L
60001
JOSE NAIBAHO 2.8 1 1
NAIBAHO 06
BATU VIII
122 12080102121 TALITA IFAN 12080108019100

I 8/24/2014 P
60002
1208016408140002
SALSABILA
3.5 1 1
SYAHRONI 02
BATU VIII
123 12080102121 ALFAREZI RAPKI IFAN 12080108019100
II 11/28/2017 L
60002 ARKAV
2.8 1 1
SYAHRONI 02
BATU VIII
124 MUHAMMAD 12080125078400

II 2/12/2016 L TIRTA SANJAYA 3.5 1 1
SYAMSUL 02
BATU VIII
125 I 6/14/2016 L JULIATOR PURBA 2.8 1 1 YANI PURBA BATU VIII
126 12080125051 FIO AMOU REYZA SARTANI 12080100578000

I 9/9/2016 P
50001
1208014909160002
SIPAYUNG
3.2 1 1
SIPAYUNG 5
BATU VIII
127 12080115041 12080131058100

II 4/14/2015 P
10019
RIDIA SIRAIT 3.5 1 1 R . SIRAIT
02
BATU VIII
128 12080104040 HAWA PUTIH 12080125047900

III 2/19/2018 P
80673 IESYARI
2.9 1 1 RISDIAN SYAH
01
SIDOURUK
129 DIMAS 12080111292000

I 8/1/2016 L FAIZ PRATAMA 3.5 1 1
DERMANA 2
SIDOURUK
130 RINDI 12080153089900

I 11/11/2015 P AURAH KASIH 2.8 1 1
ANGGRAINI. P 02
SIDOURUK
131 RINDI 12080153089900

II 12/1/2017 P MAUDI KHODIJAH 2.8 1 1
ANGGRAINI. P 02
SIDOURUK
132 DANA 12080149118000

II 5/10/2016 L RIZKI 3.1 1 1
SARIYAH 01
SIDOURUK
133 DANA 12080149118000

III 1/8/2018 L AZRIL HANDIKA 2.8 1 1
SARIYAH 01
SIDOURUK
134 12080129121 WANDI 12080114068600

I 3/26/2017 L
60001 SYAHPUTRA
2.8 1 1 EDI SAPUTRA
06
SIDOURUK
135 12720168089300
I 8/17/2017 L M.FARID AL FATIH 2.8 1 1 DEVI AMELIA
02
SIDOURUK
136 12080124091 ABIZARD BONI .S 12720719018600

I 12/22/2018 L
30008 NAINGGOLAN
3.1 1 1
NAINGGOLAN 02
SIDOURUK
137 NURHAIDA DAHALA

II 12/13/2014 P
SIJABAT
2.8 1 1
SIJABAT
SIDOURUK
138 DAHALA
III 7/21/2015 L UCOK SIJABAT 2.8 1 1
SIJABAT
SIDOURUK
139 12080130101 CITRA KIRANA DESI CINDRA 12080155128200

I 3/1/2015 P
80005 SIBURIAN
3.1 1 1
SIBURIAN 04
BATU VIII
140 12080130101 M.NAUFAL DESI CINDRA 12080155128200

I 12/16/2017 L
80005 SIBURIAN
2.8 1 1
SIBURIAN 04
BATU VIII
141 12080113090 12080109078100

III 10/16/2016 L
80041
1208015610162001 VIRZA PRASETYA 2.8 1 1 RUDI
04
SIDOMULYO
142 12080104048 HABIBAH NGANDRIANT 12080120118000

III 3/8/2016 P
030926
1208014803160002
SYAFIRA
3.1 1 1
O 01
SIDOMULYO
143 12080110021 WAHYU DIKI 12080123128500

II 6/8/2016 L
10060
1208010806160001
RAMADHAN
3.2 1 1 NGAHADI
06
SIDOMULYO
144 12080104040 12080119118300

IV 2/27/2015 L
080105
FAIZ ADI MATA 3.2 1 1 RUDI
01
SIDOMULYO
145 12080114091 BUDI 12080316128700
I 1/19/2016 L
60013
1208011901160001 PANJI 3.5 1 1
RAMADHAN 01
SIDOMULYO
146 12080128011 DONDA 12080104069100

II 10/22/2015 P
10062
NAURA DAYANA 3.2 1 1
SUSANDI 06
SIDOMULYO
147 12080104040 DENNY 12080112018100

II 10/13/2015 L
80309
RAFA AL HAFIS 3.5 1 1
PURWANTO 02
SIDOMULYO
148 12080103101 SEGER 12080129078500

II 8/10/2016 P
40001
ASYIFA FRIANDA 2.8 1 1
PRIANTO 01
SIDOMULYO
149 12080129111 SITI NUR AISYAH SURYA HASAN 12080126017300

I 4/5/2015 P
000004
1208014504150001
LATE
2.3 1 1
LASE 03
SIDOMULYO
150 12080129091 RAMADHAN 12080206068600

I 9/17/2014 L
60003
1208011709140002 ARSYIL SINAGA 3.5 1 1
SINAGA 02
SIDOMULYO
151 12080128091 HENDRIK 12080109068800

II 1/27/2017 L
10004
1208012701172001 AZRIL ALFARIA 3.2 1 1
ALFIANSYAH 03
SIDOMULYO
152 12082812030 12082801128000

III 11/10/2016 L
80175
1208281011160001 AIDIN WAHYUDI 2.8 1 1 DARMANSYAH
01
SIDOMULYO
153 12080120121 DAHAYU LATIFAH HANI .H 12080103078400

I 5/15/2015 P
70003
1208015705150001
R
3.5 1 1
RANGKUTI 01
SIDOMULYO
154 12080104040 12080110057300

V 3/10/2016 L
80127
ZAHRA RAMADIA 2.8 1 1 GUYUB
01
SIDOMULYO
155 12080102021 12084010167000

VI 2/2/2016 L
10011
RANGGA 3.2 1 1 LEGIMEN
5
SIDOMULYO
156 12080105111 ARIEF 12080122028900

II 4/27/2016 P
20005
1208016704160001 KHADIZAH AULIA 3.5 1 1
KESUMA 04
SIDOMULYO
157 12080104041 12080102038900

II 1/15/2017 P
70003
1208011501170001 IMAM ALI ALPATIH 2.8 1 1 MULYA MOPEN
02
SIDOMULYO
158 12080119081 12081116098500

I 12/7/2014 P
50002
1208014712140001 NAURA NAZHIFA 3.5 1 1 DEBI BASUKI
07
SIDOMULYO
159 12051546011 KEISYAH HENDRI 12051517047900

II 1/6/2016 P
60001
1205154601160001
UMAYROH
2.8 1 1
SUSANTO 06
SIDOMULYO
160 12080108111 ABRORAL HADI ERDIANTO 12080113117600

III 3/13/2017 L
10025
1280113031170001
TAMBAH
1 1
TAMBAH 03
SIDOMULYO
161 12080113011 PAKHRI 12090120127500

II 11/29/2014 L
00005
1208012911140003
SYAHPUTRA
2.8 1 1 TURINAN
01
SIDOMULYO
162 12080125111 12080127054300

II 3/28/2018 P
72001
AFIKA NAILA 2.8 1 1 SUZAENAL
01
SIDOMULYO
163 12080113021 BAGAS AL 12080101058900

I 12/31/2015 L
70005
1208013112150001
KHADAFI
3.5 1 1 WIRA WIDY
03
SIDOMULYO
164 12080131011 12080103018900

I 10/21/2016 L
70001
1208013101170001 ARFI AL FATHAN 3.2 1 1 RIYAWADIR
02
SIDOMULYO
165 12080114071 12080110012100

I 9/22/2014 P
40002
1208016209140002 QORI ALIFA 3.5 1 1 ABDUL MALIK
01
SIDOMULYO
166 12080114071 12080110012100

II 4/9/2018 P
40002
NAILA HANIFAH 2.8 1 1 ABDUL MALIK
01
SIDOMULYO
167 12080114071 12080110012100
III 4/9/2018 P
40002
NAIRA HANIFAH 2.5 1 1 ABDUL MALIK
01
SIDOMULYO
168 12080110021 SURYA 12080129048600

II 2/19/2017 P
10054
BILQIS 2.8 1 1
KENCANA 03
SIDOMULYO
169 12080103081 12080125088000

II 8/12/2015 L
10010
1208011208150003 MUHAMMAD FIKRI 3.5 1 1 IRWANSYAH
01
SIDOMULYO
170 12080128011 CHOIRUL 12080116128000

II 6/27/2014 P
10061
1208016706140002 ADIBA LUBIS 2.8 1 1
LUBIS 04
SIDOMULYO
171 12080104040 AMAR DWI 12080110872000

III 11/18/2015 L
80045 AMANDA
2.8 1 1 AGUS NARULI
3
SIDOMULYO
172 12080104040 12080110872000

IV 4/5/2015 P
80045
YULIA ANGGRAINI 3.1 1 1 AGUS NARULI
3
SIDOMULYO
173 12080104081 12080110810920

I 10/17/2015 L
60002
1208011710150002 GIBRAN AL FAIH 3.5 1 1 SUPARTONO
001
SIDOMULYO
174 12080104121 RAISYAH DWI 12080108088300

II 3/11/2017 P
20008
1208015103172001
ADILA
3.5 1 1 SYAHPUTRA
04
SIDOMULYO
175 12080118011 HUSNUL 12090110128200

II 9/20/2016 P
30005
1208016009162001 AIRAH NAFIFAH 2.8 1 1
HUDAY 01
SIDOMULYO
176 12080118011 HUSNUL 12090110128200

III 8/20/2018 P
30005
AFIFAH 3.8 1 1
HUDAY 01
SIDOMULYO
177 12080122081 12081902128200

i 12/12/2016 P
60007
1208015212160001 ADILAH NAZIHA 3.2 1 1 SUPRIADI
1
SIDOMULYO
178 12080117101 12080205058500

I 10/31/2017 P
70006
1208017110170002 SITI FAUZIAH 2.8 1 1 SUTAR
05
SIDOMULYO
179 12080104040 RANIA AULIA DEA 12080106057400

II 7/10/2015 P
80067
1208015007150004
PUTRI
3.5 1 1 SUJITO
01
SIDOMULYO
180 12080110121 MUHAMMAD 12080311018700

I 9/30/2015 L
40002
1208013009150002
DEWANTARA
3.1 1 1 SURAHMAN
01
SIDOMULYO
181 12080104058 ALI IMRAN 12080104058000

II 10/23/2014 P
00001
1208016310142001 OLIVIA DAMANIK 3.2 1 1
DAMANIK 01
SIDOMULYO
182 12080104040 RAHMAD 12080127018400

III 6/3/2017 P
80879
1208013061720001 GEENA PUTRI 3.5 1 1
HIDAYAT 01
SIDOMULYO
183 12080120091 NAFEEZA BAYU 12080124019000

I 12/31/2016 L
60001
120801711216001
KHALISA
3.5 1 1
SETIAWAN 01
SIDOMULYO
184 12080104040 SAPRIAL 12080120037500

II 1/14/2017 L
80761
1208011401170002 EIJI .M SARAGIH 3.5 1 1
SARAGIH 01
SIDOMULYO
185 12080111041 12080116079000

II 10/11/2014 P
30002
CITRA ELI 2.8 1 1 SUPRIADI
11
SIDOMULYO
186 12080125041 12080113078300

I 5/7/2018 P
80004
ANISA CHIRAL 2.8 1 1 AJI MUKJI
03
SIDOMULYO
187 12080110021 12080123028300

III 12/11/2018 L
0055
M. AZKA FAISAL 2.8 1 1 RAMLI
06
SIDOMULYO
188 ARI
II 1/6/2018 P ADILA ZAHRIA 2.8 1 1
PURWANTO
SIDOMULYO
189 12080104040 12080125127500
III 7/19/2018 P
80687
1208015907180001 AZLINA PUTRI 3.8 1 1 HARIANTO
07
SIDOMULYO
190 I 8/2/2018 P AIRIN 2.8 1 1 IRMADANI SIDOMULYO
191 12080121031 12080102058800
I 8/12/2018 L
40001
M.AZRIL 3.1 1 1 WAHYUDIN
01
SIDOMULYO
192 12080114121 FAUZIAH 12080101038900

I 11/4/2018 P
80004 ADRIANTI
3.1 1 1 M. ADNAN
06
SIDOMULYO
193 12080165059300
II 11/2/2018 L IMAM 3.1 1 1 NURUL
06
SIDOMULYO
194 12080104040 12080104017000

II 9/1/2014 L
80844
1208010109142001 DAVA ALTIFAL 3.8 1 1 HARYONO
02
SIDOMULYO
195 KHONAIRAH 12080130058000

IV 2/2/2015 P
BILQIS
3.5 1 1 SUKIMAN
02
SIDOMULYO
196 GILANG DANJI 12080113117000

I 6/24/2016 L
RAMADHAN
3.5 1 1
SYAHPUTRA 01
SIDOMULYO
197 12080124021 AZZAM KHALIF ARI 12080105058800

II 5/13/2018 P
70002 ATTA FARIZ
3.5 1 1
PURYANTO 01
SIDOMULYO
198 EYINAI 12080168029100

II 3/15/2017 L M .FADILAH 3.1
NINGSIH 03
SIDOMULYO
199 12081921101 12081924108360

I 7/22/2015 L
50009
1208192207150061 ALFATIH 2.8 1 1 SYAMSUDIN
01
SIDOMULYO
200 12080127111 ISNAN 12080106037900

II 5/12/2107 L
20005
1208011205170001
NURKHOLIS
3.1 1 1 SARTOWO
02
SIDOMULYO
201 II 1/3/2015 L ALFAHMI JUANDA 2.8 1 1 AGUS NARULI SIDOMULYO

202 I 8/31/2017 P YASHOPI 3.1 1 1 SUPRIADI SIDOMULYO
203 12080107011 DAFFA IBNU 12080104048400

II 1/29/2015 L
00012 1208012901150002 HAFIS 3.8
1 1
AMER 07 SIDODADI
204 12080105081 ALFI ANDRA ANDI 12080101612860
I 12/7/2014 L
50014 1208010712140001 ADITYA 2.8
1 1
LESMANA 003 SIDODADI
205 12080118011 12080102048400
I 8/16/2014 L
00003 1208011608140001 FAIS WANSUFI 3.2
1 1
WAGIANTO 07 SIDODADI
206 12080118011 12080102048400
II 10/31/2017 L
00003 1208013110170001 DHEFINEL FATIH 3.4
1 1
WAGIANTO 07 SIDODADI
207 12080104040 12080113127600
III 1/10/2018 P
80172 KHALIZAH 2.8
1 1
SUGENG 01 SIDODADI
208 12080124041 SOVIA ALIA RIRIN 12080112089000
I 11/1/2014 P
50010 1208014111400002 ZAHRA 2.8
1 1
GUSNIAWAN 06 SIDODADI
209 12091709101 LUTFI SAKHI 12091704092000
II 11/4/2014 L
20005 ZIDANE 3.5
1 1
DEDI IRAWAN 1 SIDODADI
210 12080105071 12080107058700
II 11/5/2015 P
10006 NAZWA AZ ZAHRA 3.8
1 1
KUSMUL YADI 02 SIDODADI
211 12080112501 12080111078300
II 11/18/2014 L
0006 HAFIZ AZHARI 2.8
1 1
WIWIN 06 SIDODADI
212 12080112501 12080111078300
III 7/15/2018 P
0006 NAURA 3.5
1 1
WIWIN 06 SIDODADI
213 12081220990 ADOLFO 12001220990000
II 1/19/2017 L
0003 1208011901170002 ARIP ANGGARA 2.8
1 1
SITUMORANG 3 SIDODADI
214 12080128011 FAUZAN ALA 12080102038100
II 12/14/2015 L
10078 1208011412150002 FATHIR 3.2
1 1
SUHARMOKO 04 SIDODADI
215 12080119060 12080121028200
III 10/21/2017 L
80042 ARZIKI DAVIAN 3.4
1 1
ERWIN 04 SIDODADI
216 12080101021 NADA AZRA 12080126068400
III 10/16/2014 P
0042 NAFISHA 3.2
1 1
KISWANO 04 SIDODADI
217 12080101021 12080126068400
IV 3/14/2018 P
0042 SAHIRA 3.5
1 1
KISWANO 04 SIDODADI
218 12080123071 AMRY 12080109059000
I 9/22/2014 L
40005 GILANG GIOVANO 2.8 1
1
BACHTIAR 4 SIDODADI
219 12080129111 FARREL AJI YONI 12080129048500
II 2/12/2015 L
00007 120811202150001 PRASETYO 2.8
1 1
RUDIANSYAH 04 SIDODADI
220 12080126031 12080115048400
II 9/28/2017 P
4001 12080168091720001 MILKA KUMALA 3.5
1 1
GUNAWAN 01 SIDODADI
221 12080123091 12080123091000
III 2/6/2018 L
0003 RAFISAI 3.5
1 1
SUPIYAN 03 SIDODADI
222 12080111101 RISKI B 12080103039800
I 12/12/2017 P
72004 1208152121720001 ASSYFA AZZAHRA 2.8
1 1
SETIAWAN 03 SIDODADI
223 12080104040 12080116017800
II 12/5/2018 L
80942 ABIZARD 2.8
1 1
SUDIONO 01 SIDODADI
224 I 2/12/2016 L DIANDRA KEANU 2.8 1 1 NURHANDIANI SIDODADI
225 II 5/23/2017 P SILVY NURAINI 2.8 1 1 AYU SIDODADI
226 II 8/30/2018 P BUTET 3.1 1 1 MIRA SIDODADI
227 12080103101 ADRIAN 12080319019500
I 1/12/2016 L
80003 1208011201160001 PRADIDTA 3.2
1 1
RAMADANI 01 SIDODADI
228 SYAHRIL
III 6/26/2015 L
RAMADHAN 2.8
1 1
WATI SIDODADI
229 12080119060 MAYLANI HERDI 12080118097700
II 5/10/2016 L
80055 1208015005160002 DAMANIK 3.5
1 1
DAMANIK 01 BATU VII
230 12080113041 12081241264001
III 5/2/2018 L
10001 1208010205780001 AHMAD FAUZAN 2.8
1 1
ANAINUR 0 BATU VII
231 12080108011 12080126086000
II 8/4/2017 P
10007 RANI ANGRAINI 3.2
1 1
BAMBANG 02 BATU VII
232 12080119060 DAFIYA ZAISA 12080126127800
III 3/9/2017 P
80085 1208016903170002 ANINDRA 2.8
1 1
DORIS FRANS 01 BATU VII
233 12080125011 ALIF RAYAN YONGKI 12080103049100
II 10/10/2017 L
60003 SINAGA 2.8
1 1
SINAGA 06 BATU VII
234 12080114031 SAMUEL 12080114088000
III 8/17/2014 P
40022 1208015708140002 SARAH SIPAYUNG 3.5
1 1
SIPAYUNG 08 BATU VII
235 12080108011 PUTRA DARTI LERSIANNA 12080141047500
IV 7/28/2015 L
10023 MANIK 2.8
1 1
ARITONANG 07 BATU VII
236 12080108011 AZKA FATHI 12080116088400
II 8/10/2015 L
10016 1208011008150003 ABINAYA 3.8
1 1
BOBY ARIF 04 BATU VII
237 12080105071 RAHMAT 12080127047300
III 9/20/2014 P
00014 1208010609140002 FATINAH ZAHRA 3,5
1 1
SYAHPUTRA 02 BATU VII
238 12080119011 TRINADIA SELAMAT 12080111067700
III 8/17/2015 P
10040 1208015708150001 WULANDARI 3,2
1 1
GUNARDI 03 BATU VII
239 12080104041 NURFHADILLA 14011215118900
I 2/11/2015 P
70004 141125102150001 PUTRI 3,8
1 1
SUDARMONO 03 BATU VII
240 12080113071 12720207108200
I 12/20/2016 P
770003 1208016012160002 DINDA KHALIFA 3,2
1 1
ASWIN 03 BATU VII
241 12080108011 12080112077300
IV 4/30/2018 L
10014 KAFKA 2,8
1 1
SUKAMTO 01 BATU VII
242 MUHAMMAD 12080146048500
II 9/6/2016 L
FATHAN 2,8
1 1
SUSILA WATY 01 BATU VII
243 MUTIARA INDRA 14040904048600
II 1/13/2016 P
SYAKILA 3,5
1 1
GUNAWAN 01 BATU VII
244 MHD. ANNES 12080154040000
II 1/3/2017 L
BAYHADI 3,1
1 1
PUTRI 1 BATU VII
245 JEFRI
II 10/6/2016 L
UCOK TARIGAN 3,5
1 1
TARIGAN BATU VII
246 RENHART JEFRI
III 8/8/2017 L
TARIGAN 3,1
1 1
TARIGAN BATU VII
247 12080104040 ALYA NABILA 12080115057500
III 1/25/2016 P
80124 ZAHRA 3,1
1 1
NURMAN ALI 04 BATU VII
MIKAEL
248 9/28/2014 L 12072319081 MICHEL SIRINGO- 1 1 SIRINGO- 12110916029900
I 40009 1209012809140002 RINGO 3,2 RINGO 01 BATU VI
MIKAEL
249 6/23/2016 L 12072319081 1 1 SIRINGO- 12110916029900
II 40009 1208012306160002 MIKO KAIL NELO 3,2 RINGO 01 BATU VI
250 12080110111 VINCENT WILSON 14061312489000
I 2/26/2016 L
70003 1208012602160003 MARPAUNG 3,2
1 1
MARPAUNG 1 BATU VI
251 12080101031 RAMORA DODO 32170903058800
III 3/28/2017 P
70004 1208016803170001 SIPAYUNG 3,2
1 1
SIPAYUNG 27 BATU VI
252 12080110021 JUNIANDO 12080121068100
III 10/5/2014 L
10004 1208014510142001 VIONA MUNTHE 3,2
1 1
MUNTHE 04 BATU VI
253 12080117110 CHIKA LIBER 12080120117400
VI 11/24/2015 P
90011 1208016411150002 SIDABUTAR 3,8
1 1
SIDABUTAR 02 BATU VI
254 12080110021 ARJUNA JIMMY 12080114067900
III 10/3/2014 L
10003 1208010310140002 SIPAYUNG 2,8
1 1
SIPAYUNG 01 BATU VI
255 12080126071 NAURA OKTAVIA DOLJAK 64720501058001
II 10/7/2017 P
70011 1208014710172001 PURBA 2,8
1 1
PURBA 2 BATU VI
256 12080121061 MACGREGOR ROBBI 31720210038500
IV 4/17/2017 L
70005 1208011704170002 TONDANG 3,1
1 1
TONDANG 025 BATU VI
257 12080106051 ADRIANTO 12080117048700
IV 1/15/2018 P
10004 HANESA SINAGA 2,8
1 1
SINAGA 08 BATU VI
258 32750810110 DEARNA KANEL 32750823037600
IV 3/24/2015 L
80058 1208012403150002 SIPAYUNG 3,2
1 1
SIPAYUNG 24 BATU VI
259 12080106051 M. RIDWAN 12080131126000
IV 2/9/2015 L
10006 12080109051720001 PURBA 3,2
1 1
AKIM PURBA 28 BATU VI
260 12080104091 VALEN 12080117059000
II 12/18/2017 L
50006 1208011812172001 ADREIL SILALAHI 3,8
1 1
SILALAHI 1 BATU VI
261 II 2/16/2018 L TOBI SARAGIH 3,8 1 1 J.SARAGIH BATU VI
262 12080129101 SUHERI 120801111183000
III 11/20/2018 L
00010 KEANU 2,8
1 1
SYAHPUTRA 3 BATU VII
263 12080115081 GIOHOLNAIB HOLMES
I 5/10/2016 L
60004 TONDANG 2,8
1 1
TONDANG BATU VII
264 12080114031 SEMI DAUD SAMUEL 12080114008000
IV 8/16/2018 L
40022 SIPAYUNG 2,8
1 1
SIPAYUNG 08 BATU VI
265 KORIALINA BUNTORA
III 5/30/2018 P
SIPAYUNG 2.8
1 1
SIPAYUNG BATU VI
266 12080103081
I 2/11/2017 P
10009 1208016708140003 BUTET 2,8
1 1
J.PURBA BATU VI
267 12080123021 ELKANA GIBRON
I 6/16/2015 L
20005 PANJAITAN 3,5
1 1
PANJAITAN BATU VI
268 12080123071 HANS JOMEM LUHUT 12090122027900
II 8/3/2016 L
00003 SINAGA 3,1
1 1
SIANAGA 02 BATU VI
269 12080123071 LUHUT 12090122027900
III 2/4/2019 P
00003 BUTET 3,2
1 1
SIANAGA 02 BATU VI
270 12080103011 IMMANUEL POLTAK
I 1/6/2015 L
20006 1208010601150001 SINAGA 2,8
1 1
SINAGA BATU VI
271 12080106060 JHON NANAT 12080114047400
II 4/10/2017 L
8705 BRIAN L PURBA 3,1
1 1
PURBA 01 BATU VI
272 ANGRAINI
II 12/2/2017 L
DISTIA APRIANI 2,8
1 1
FITRIANA BATU VII
273 IV 9/9/2017 P NURHIJJAH 2,8 1 1 MESNO BATU VII
274 12080104091 ANDIKA M. VALEN 12080117059000
I 9/26/2015 L
50006 1208012609150001 SILALAHI 2,8
1 1
SILALAHI 01 BATU VI
275 12720126031 12720101027900
III 11/19/2017 P
00001 1272015911170001 KHALIFAH P 2,8
1 1
AFFANDI 06 BATU VI
276 12082908021 TOBIAS K SAUD H. 12082905018800
I 9/24/2017 L
70003 1208292409170001 SARAGIH 3,5
1 1
SARAGIH 02 BATU VI
277 I 3/6/2016 L 120960060160000 AQIAN ARIF 2,8 1 1 LASMARIA. S BATU VI
278 3/21/2019 P 12080104040 MENTARI ISMA 2,8 1 1 ADI GUNAWAN 12080102038000
I 80420 AYUNDA SARAGIH 02 SIDAURUK
279 12080122081 AISYAH SAPTA 12080101119600
II 2/19/2019 P
60008 PRASETYA 3,2
1 1
PRASETYA 03 SIDAURUK
280 2/18/2019 P 12080103101 NADHIFA 1 1 ADRI 12083030019300

I 70001 KAWISWARA ASRI 2,8 HENDARTO 01 SIDAURUK
281 12080112091 HERI 12081124048600
II 4/17/2019 L
80005
M.AZZAM 2,8 1 1
KURNIAWAN 01 SIDAURUK
283 QYRA 12080149020100
I 1/13/2019 P
AASYSYABIYAN 3,1
1 1
SUNDARI 02 SIDAURUK
284 12720615061 ARSYAH INDRA 12720607098100
III 2/8/2019 L
10002 KAMAHESA 2,8
1 1
GUNAWAN 05 SIDAURUK
285 ARSYLA MASITA ARDIANSYAH
I 4/10/2019 P
LUBIS 3,2
1 1
LUBIS SIDAURUK
286 ZALINA MUTIARA
II 5/27/2019 P
INSAM 3,1
1 1
IHSAN SIDAURUK
287 16110307061 16110302067000
III 5/10/2019 P
60002 MAZWA RANADIM 2,8
1 1
BUDIANTO 09 SIDAURUK
ABDUL
288 P 12080107091 1 1 HERMANSYAH 12080109049300
I 6/15/2019 82003 ADZKIYA 2,8 SINAGA 02 SIDAURUK
289 L 12080113031 RASKY 1 1 CHAIRUL 12080111099200
II 8/7/2019 70004 3,5 IHWAN 02 SIDAURUK
290 II 8/20/2019 P NADHIRA ALYA 3,1 1 1 ERWIN SIDAURUK
291 12080110021 12080130117800
IV 3/15/2019 L
10068 M.NURHIZAM 3,1
1 1
SUDIAR 03 SIDOMULYO
292 12080129081 YAHYA RENI 12081919058700
II 4/14/2019 P
20002
INARA
3,2
1 1
PRASETIO 01 SIDOMULYO
293 DEWI
I 4/15/2019 P
CALYA 3,2
1 1
APRIANTI SIDOMULYO
294 DEWI
II 4/15/2019 P
CAYLA 2,9
1 1
APRIANTI SIDOMULYO
295 I 4/10/2019 L 1 1
DAFA ALKHAFI 3,2 GUSTI SADAM SIDOMULYO
296 1 1
II 2/21/2019 P WINDA ULANDARI 3,1 SANI / BUDI SIDODADI
297 12720126031
IV 4/5/2019 L
0001 UCOK 3,1
1 1
AFFANDI 12720102790006 BATU VIII
298 12080106127 12711322027600
III 4/8/2019 P
0006 BUTET 3,2
1 1
SASBUDI 02 BATU VIII
299 12080126071 POLTAK 64720501058500
III 10/17/2018 P
70011 BUTET PURBA 3,2
1 1
PURBA 12 BATU VI
300 12080121061 BOBBI 31720210038500
IV 11/8/2018 L
70005 UCOK TONDANG 3,1
1 1
TONDANG 25 BATU VI
301 1 1 MUTIARA SANI 12080146039700
I 6/25/2019 P BUTET 3,1 03 SIDAURUK
INDAH
302 I 8/24/2019 L UCOK 3,2 1 1 PRASTIWI 12080155089200 SIDAURUK
RAHAYU 01
303 I 8/21/2019 P BUTET 2,8 1 1 YUNI APRITA SIDOMULYO
304 I 8/16/2019 L UCOK 3,1 1 1 ADETIA IRMA BATU VIII
305 I 7/15/2019 L UCOK 3,5 1 1 NADIA SIDOMULYO
Keterangan
Kolom Jika Ayah tidak ada, maka diisikan nama Ibu
Kolom Jika Ayah tidak ada, maka diisikan NIK Ibu
Kolom Jika Ayah tidak ada, maka diisikan no Telp/HP Ibu
Kolom Jika Pemantauan Perkembangan menggunakan kusioner pra skrining perkembangan (SDIDTK) diisi Ds (Sesuai) jika skor KPSP=9-10, Dm (Meragukan) skor=7-8, diisi Dp(Kemungkinan penyimpangan) jika skor<7
Kolom Jika Pemantauan Perkembangan menggunakan ceklist buku KIA, diisi S jika jawaban ya untuk seluruh pertanyaan, diisi TS jika ada satu atau lebih jawaban tidak untuk seluruh pertanyaan
Kolom Diisi SL (lanjutkan stimulasi dan jadwalkan kunjungan berikutnya) jika hasil pemeriksaan KPSP atau ceklist Buku KIA menghasilkan Sesuai (S)
Diisi SU (Stimulasi Ulang selama 2 minggu) jika hasil pemeriksaan melalui KPSP menghasilkan skor Meragukan (M)
Diisi R (Rujuk) jika hasil pemeriksaan melalui KPSP menghasilkan Penyimpangan (P) atau jika pemeriksaan melalui Buku KIA menghasilkan Tidak Sesuai (TS)
RTUMBUHAN DAN PERKEMBANGAN BALITA DI POSYANDU
: MELATI, MAWAR, GELATIK, CENDRAWASIH
Panjang Cara Ukur ASI Eksklusif 1=Ya 2=Tidak Perkembangan

Vitamin A Vitamin A
Tanggal BB Badan/Ti
nggi 1=Terlent Februari Agustus
Pengukuran (kg) Badan ang 1=Ya 1=Ya
2=Berdiri 2=Tidak 2=Tidak
(cm) KPSP Buku Tindak
Umur Umur 1 Umur Umur 3 Umur Umur Ds/Dm/D KIA Lanjut
0 bln bln 2 bln bln 4 bln 5 bln p S/TS SL/SU/R
(18) (19) (20) (21) (21) (22) (23) (24) (25) (26) (27) (28) (29) (30) (31)
8/23/2019 11 83.5 2 1 1 1 2 2 2 1 1 DS S SL
8/23/2019 18 101 2 1 1 2 2 2 2 1 1 DS S SL
8/23/2019 11 85.5 2 1 1 1 2 2 2 1 1 DS S SL
8/23/2019 9.5 74 2 1 1 2 2 2 2 1 1 DS S SL
8/23/2019 15 107 2 1 1 1 1 2 2 1 1 DS S SL
8/23/2019 18 103.5 2 1 1 1 2 2 2 1 1 DS S SL
8/23/2019 19.5 104.5 2 1 1 2 2 2 2 1 1 DS S SL
8/23/2019 13.5 93.5 2 1 1 1 2 2 2 1 1 DS S SL
8/23/2019 14 100 2 1 1 2 2 2 2 1 1 DS S SL
8/23/2019 13.5 96 2 1 1 1 1 2 2 1 1 DS S SL
8/23/2019 11.5 89 2 1 1 1 2 2 2 1 1 DS S SL
8/23/2019 14.5 100 2 1 1 2 2 2 2 1 1 DS S SL

8/23/2019 11.5 84.5 2 1 1 1 2 2 2 1 1 DS S SL
8/23/2019 12 86.5 2 1 1 2 2 2 2 1 1 DS S SL
8/23/2019 14 93 2 1 1 1 1 2 2 1 1 DS S SL
8/23/2019 16.5 100 2 1 1 1 2 2 2 1 1 DS S SL
8/23/2019 16.5 101 2 1 1 2 2 2 2 1 1 DS S SL
8/23/2019 13 86 2 1 1 1 2 2 2 1 1 DS S SL
8/23/2019 12.5 89.5 2 1 1 2 2 2 2 1 1 DS S SL
8/23/2019 9.5 74 2 1 1 1 1 2 2 1 1 DS S SL
8/23/2019 12 88 2 1 1 1 2 2 2 1 1 DS S SL
8/23/2019 15.5 102 2 1 1 2 2 2 2 1 1 DS S SL
8/23/2019 12.5 89.5 2 1 1 1 2 2 2 1 1 DS S SL
8/23/2019 11.5 81 2 1 1 2 2 2 2 1 1 DS S SL
8/23/2019 16.5 100 2 1 1 1 1 2 2 1 1 DS S SL
8/23/2019 11 81 2 1 1 1 2 2 2 1 1 DS S SL
8/23/2019 13 94.5 2 1 1 2 2 2 2 1 1 DS S SL
8/23/2019 16.5 101 2 1 1 1 2 2 2 1 1 DS S SL
8/23/2019 11.5 86 2 1 1 2 2 2 2 1 1 DS S SL
8/23/2019 22 104 2 1 1 1 1 2 2 1 1 DS S SL
8/23/2019 16 100 2 1 1 1 2 2 2 1 1 DS S SL
8/23/2019 14 93.5 2 1 1 2 2 2 2 1 1 DS S SL
8/23/2019 11 87 2 1 1 1 2 2 2 1 1 DS S SL
8/23/2019 13 97 2 1 1 2 2 2 2 1 1 DS S SL
8/23/2019 9.5 80 2 1 1 1 1 2 2 1 1 DS S SL
8/23/2019 12 87 2 1 1 1 2 2 2 1 1 DS S SL
8/23/2019 13 95 2 1 1 2 2 2 2 1 1 DS S SL
8/23/2019 10.5 85 2 1 1 1 2 2 2 1 1 DS S SL
8/23/2019 10.5 79.5 2 1 1 2 2 2 2 1 1 DS S SL
8/23/2019 11.5 79 2 1 1 1 1 2 2 1 1 DS S SL
8/23/2019 14.5 98 2 1 1 1 2 2 2 1 1 DS S SL
8/23/2019 12.5 101 2 1 1 2 2 2 2 1 1 DM S SL
8/23/2019 16 101 2 1 1 1 2 2 2 1 1 DS S SL
8/23/2019 13 97 2 1 1 2 2 2 2 1 1 DS S SL
8/23/2019 17 104 2 1 1 1 1 2 2 1 1 DS S SL
8/23/2019 11 85 2 1 1 1 2 2 2 1 1 DS S SL
8/23/2019 12 84 2 1 1 2 2 2 2 1 1 DS S SL
8/23/2019 7 67 2 1 1 1 2 2 2 1 1 DS S SL
8/23/2019 16 101 2 1 1 2 2 2 2 1 1 DS S SL
8/23/2019 11 82 2 1 1 1 2 2 2 1 1 DS S SL
8/23/2019 11.5 86 2 1 1 2 2 2 2 1 1 DS S SL
8/23/2019 10.5 84 2 1 1 1 2 2 2 1 1 DS S SL
8/23/2019 15.5 98.5 2 1 1 2 2 2 2 1 1 DS S SL
8/23/2019 12 89 2 1 1 1 2 2 2 1 1 DS S SL
8/23/2019 10.5 84 2 1 1 2 2 2 2 1 1 DS S SL
8/23/2019 14 85 2 1 1 1 2 2 2 1 1 DS S SL
8/23/2019 9 78 2 1 1 2 2 2 2 1 1 DS S SL
8/23/2019 9 77 2 1 1 1 1 2 2 1 1 DS S SL
8/23/2019 9.8 82 2 1 1 1 2 2 2 1 1 DS S SL
8/23/2019 10 82 2 1 1 2 2 2 2 1 1 DS S SL
8/23/2019 17 102 2 1 1 1 2 2 2 1 1 DS S SL
8/23/2019 8 72 2 1 1 2 2 2 2 1 1 DS S SL
8/23/2019 13 95 2 1 1 1 2 2 2 1 1 DS S SL
8/23/2019 14 87 2 1 1 2 2 2 2 1 1 DS S SL
8/23/2019 16 104 2 1 1 1 2 2 2 1 1 DS S SL
8/23/2019 11 84 2 1 1 2 2 2 2 1 1 DS S SL
8/23/2019 12 91 2 1 1 1 1 2 2 1 1 DM S SL
8/23/2019 10 76 2 1 1 1 2 2 2 1 1 DS S SL
8/23/2019 15 10 2 1 1 2 2 2 2 1 1 DS S SL
8/23/2019 10.5 79 2 1 1 1 2 2 2 1 1 DS S SL
8/23/2019 10 79 2 1 1 1 2 2 2 1 1 DS S SL
8/23/2019 10.5 81 2 1 1 1 2 2 2 1 1 DS S SL
8/23/2019 13 97 2 1 1 1 2 2 2 1 1 DS S SL
8/23/2019 13 94 2 1 1 2 2 2 2 1 1 DS S SL
8/23/2019 9 78 2 1 1 1 2 2 2 1 1 DS S SL
8/23/2019 12 90 2 1 1 2 2 2 2 1 1 DS S SL
8/23/2019 14 88 2 1 1 1 1 2 2 1 1 DS S SL
8/23/2019 15 104 2 1 1 1 2 2 2 1 1 DS S SL
8/23/2019 12 91 2 1 1 2 2 2 2 1 1 DS S SL
8/23/2019 10 80.5 2 1 1 1 2 2 2 1 1 DS S SL
8/23/2019 13 95 2 1 1 2 2 2 2 1 1 DS S SL
8/23/2019 10 81 2 1 1 1 2 2 2 1 1 DS S SL
8/23/2019 15 100 2 1 1 2 2 2 2 1 1 DS S SL
8/23/2019 13 92 2 1 1 1 2 2 2 1 1 DS S SL
8/23/2019 14 98 2 1 1 2 2 2 2 1 1 DS S SL
8/23/2019 13 88 2 1 1 1 1 2 2 1 1 DS S SL
8/23/2019 14 93 2 1 1 1 2 2 2 1 1 DS S SL
8/23/2019 13 94 2 1 1 2 2 2 2 1 1 DS S SL
8/23/2019 13.5 95 2 1 1 1 2 2 2 1 1 DS S SL
8/23/2019 15 98 2 1 1 2 2 2 2 1 1 DS S SL
8/23/2019 14 98 2 1 1 1 2 2 2 1 1 DS S SL
8/23/2019 9 77 2 1 1 2 2 2 2 1 1 DS S SL
8/23/2019 14 88 2 1 1 1 2 2 2 1 1 DS S SL
8/23/2019 8.8 74 2 1 1 2 2 2 2 1 1 DS S SL
8/23/2019 1 99 2 1 1 1 1 2 2 1 1 DS S SL
8/23/2019 12 80 2 1 1 1 1 1 1 1 1 DS S SL
8/23/2019 16 94 2 1 1 1 1 1 1 1 1 DS S SL
8/23/2019 8.1 71 2 1 1 1 1 1 1 1 1 DS S SL
8/23/2019 10 76 2 1 1 1 2 2 2 1 1 DS S SL
8/23/2019 13.5 93 2 1 1 2 2 2 2 1 1 DS S SL
8/23/2019 14 96 2 1 1 1 2 2 2 1 1 DS S SL
8/23/2019 15 96 2 1 1 2 2 2 2 1 1 DS S SL
8/23/2019 8 71 2 1 1 1 1 2 2 1 1 DS S SL
8/23/2019 7.5 70 2 1 1 1 2 2 2 1 1 DS S SL
8/23/2019 12 82 2 1 1 2 2 2 2 1 1 DS S SL
8/23/2019 7.5 70 2 1 1 1 2 2 2 1 1 DS S SL
8/23/2019 8.1 72 2 1 1 2 2 2 2 1 1 DS S SL
8/23/2019 14 96 2 1 1 1 1 2 2 1 1 DS S SL
8/23/2019 7.5 68 2 1 1 1 1 1 1 1 1 DS S SL
8/23/2019 8 72 2 1 1 1 1 1 1 1 1 DS S SL
8/23/2019 7.5 68 2 1 1 1 1 1 1 1 1 DS S SL
8/23/2019 7.5 70 2 1 1 1 2 2 2 1 1 DS S SL
8/23/2019 9 74 2 1 1 2 2 2 2 1 1 DS S SL
8/23/2019 8 70 2 1 1 1 2 2 2 1 1 DS S SL
8/23/2019 8.5 74 2 1 1 2 2 2 2 1 1 DS S SL
8/23/2019 10 74 2 1 1 1 1 2 2 1 1 DS S SL
8/23/2019 7 68 2 1 1 1 1 1 1 1 1 DS S SL
8/23/2019 7.5 70 2 1 1 1 2 2 2 1 1 DS S SL
8/23/2019 12 92 2 1 1 2 2 2 2 1 1 DS S SL
8/23/2019 11 83 2 1 1 1 2 2 2 1 1 DS S SL
8/23/2019 8 71 2 1 1 2 2 2 2 1 1 DS S SL
8/23/2019 16 101 2 1 1 1 1 2 2 1 1 DS S SL
8/23/2019 10 81 2 1 1 1 2 2 2 1 1 DS S SL
8/23/2019 13 93 2 1 1 2 2 2 2 1 1 DS S SL
8/23/2019 14.5 91 2 1 1 1 2 2 2 1 1 DS S SL
8/23/2019 14 96 2 1 1 2 2 2 2 1 1 DS S SL
8/23/2019 16 100 2 1 1 1 1 2 2 1 1 DS S SL
8/23/2019 10 75 2 1 1 1 1 1 1 1 1 DS S SL
8/23/2019 15 94 2 1 1 1 1 1 1 1 1 DS S SL
8/23/2019 14 94 2 1 1 1 1 1 1 1 1 DS S SL
8/23/2019 10 78 2 1 1 1 2 2 2 1 1 DS S SL
8/23/2019 14 93 2 1 1 2 2 2 2 1 1 DS S SL
8/23/2019 10 79 2 1 1 1 2 2 2 1 1 DS S SL
8/23/2019 11 85.5 2 1 1 2 2 2 2 1 1 DS S SL
8/23/2019 10.5 83 2 1 1 1 1 2 2 1 1 DS S SL
8/23/2019 7 67 2 1 1 1 1 1 1 1 1 DS S SL
8/23/2019 19.5 107 2 1 1 1 1 1 1 1 1 DS S SL
8/23/2019 16 97 2 1 1 1 1 1 1 1 1 DS S SL
8/23/2019 14 98 2 1 1 1 2 2 2 1 1 DS S SL
8/23/2019 11 79 2 1 1 2 2 2 2 1 1 DS S SL
8/18/2019 12 89 2 1 1 1 2 2 2 1 1 DS S SL
8/18/2019 14 96 2 1 1 2 2 2 2 1 1 DS S SL
8/18/2019 15 91.5 2 1 1 1 1 2 2 1 1 DS S SL
8/18/2019 16 103 2 1 1 1 1 1 1 1 1 DS S SL
8/18/2019 15 96 2 1 1 1 1 1 1 1 1 DS S SL
8/18/2019 14 96 2 1 1 1 1 1 1 1 1 DS S SL
8/18/2019 15 97 2 1 1 1 1 1 1 1 1 DS S SL
8/18/2019 14 94 2 1 1 1 1 1 1 1 1 DS S SL
8/18/2019 17 103 2 1 1 1 2 2 2 1 1 DS S SL
8/18/2019 17 104 2 1 1 2 2 2 2 1 1 DS S SL
8/18/2019 13 87 2 1 1 1 2 2 2 1 1 DS S SL
8/18/2019 14 94 2 1 1 2 2 2 2 1 1 DS S SL
8/18/2019 17 104 2 1 1 1 1 2 2 1 1 DS S SL
8/18/2019 15 95 2 1 1 1 1 1 1 1 1 DS S SL
8/18/2019 15 99 2 1 1 1 2 2 2 1 1 DS S SL
8/18/2019 13 90.5 2 1 1 2 2 2 2 1 1 DS S SL
8/18/2019 13 91 2 1 1 1 2 2 2 1 1 DS S SL
8/18/2019 16 103 2 1 1 2 2 2 2 1 1 DS S SL
8/18/2019 14 96 2 1 1 1 1 2 2 1 1 DS S SL
8/18/2019 12 86 2 1 1 1 2 2 2 1 1 DS S SL
8/18/2019 17 101 2 1 1 2 2 2 2 1 1 DS S SL
8/18/2019 8 74 2 1 1 1 2 2 2 1 1 DS S SL
8/18/2019 15 97 2 1 1 2 2 2 2 1 1 DS S SL
8/18/2019 12 88.5 2 1 1 1 2 2 2 1 1 DS S SL
8/18/2019 17 106 2 1 1 2 2 2 2 1 1 DS S SL
8/18/2019 9 74 2 1 1 1 2 2 2 1 1 DS S SL
8/18/2019 8 73.5 2 1 1 2 2 2 2 1 1 DS S SL
8/18/2019 12 85 2 1 1 1 1 2 2 1 1 DS S SL
8/18/2019 17 100 2 1 1 1 2 2 2 1 1 DS S SL
8/18/2019 2 1 1 2 2 2 2 1 1 DS S SL
8/18/2019 16 104 2 1 1 1 2 2 2 1 1 DS S SL
8/18/2019 17 103 2 1 1 2 2 2 2 1 1 DS S SL
8/18/2019 16 104 2 1 1 1 2 2 2 1 1 DS S SL
8/18/2019 12 84 2 1 1 2 2 2 2 1 1 DS S SL
8/18/2019 14 89 2 1 1 1 1 2 2 1 1 DS S SL
8/18/2019 8 70 2 1 1 1 2 2 2 1 1 DS S SL
8/18/2019 15 91 2 1 1 2 2 2 2 1 1 DS S SL
8/18/2019 11 79 2 1 1 1 2 2 2 1 1 DS S SL
8/18/2019 17 101 2 1 1 2 2 2 2 1 1 DS S SL
8/18/2019 16 98 2 1 1 1 2 2 2 1 1 DS S SL
8/18/2019 18 100 2 1 1 2 2 2 2 1 1 DS S SL
8/18/2019 11 83 2 1 1 1 1 2 2 1 1 DS S SL
8/18/2019 13 91 2 1 1 1 2 2 2 1 1 DS S SL
8/18/2019 12 87 2 1 1 2 2 2 2 1 1 DS S SL
8/18/2019 17 103 2 1 1 1 2 2 2 1 1 DS S SL
8/18/2019 8.5 73 2 1 1 2 2 2 2 1 1 DS S SL
8/18/2019 7 67 2 1 1 1 1 2 2 1 1 DS S SL
8/18/2019 10 76.5 2 1 1 1 2 2 2 1 1 DS S SL
8/18/2019 8 71 2 1 1 2 2 2 2 1 1 DS S SL
8/18/2019 9 71 2 1 1 1 2 2 2 1 1 DS S SL
8/18/2019 9 72 2 1 1 2 2 2 2 1 1 DS S SL
8/18/2019 7 66 2 1 1 1 1 2 2 1 1 DS S SL
8/18/2019 7.5 70 2 1 1 1 2 2 2 1 1 DS S SL
8/18/2019 18 103.5 2 1 1 2 2 2 2 1 1 DS S SL
8/18/2019 17 101 2 1 1 1 2 2 2 1 1 DS S SL
8/18/2019 14.5 91 2 1 1 2 2 2 2 1 1 DS S SL
8/18/2019 8.5 73 2 1 1 1 2 2 2 1 1 DS S SL
8/18/2019 12 86 2 1 1 2 2 2 2 1 1 DS S SL
8/18/2019 16 98 2 1 1 1 2 2 2 1 1 DS S SL
8/18/2019 11 85 2 1 1 2 2 2 2 1 1 DS S SL
8/18/2019 17 100 2 1 1 1 2 2 2 1 1 DS S SL
8/18/2019 10 80 2 1 1 2 2 2 2 1 1 DS S SL
8/18/2019 16 103 2 1 1 1 1 2 2 1 1 DS S SL
8/18/2019 16 102 2 1 1 1 2 2 2 1 1 DS S SL
8/18/2019 18.5 107 2 1 1 2 2 2 2 1 1 DS S SL
8/18/2019 9.5 80 2 1 1 1 2 2 2 1 1 DS S SL
8/18/2019 10 78 2 1 1 2 2 2 2 1 1 DS S SL
8/18/2019 16 104 2 1 1 1 2 2 2 1 1 DS S SL
8/18/2019 10 93.5 2 1 1 2 2 2 2 1 1 DS S SL
8/18/2019 14 103.5 2 1 1 1 2 2 2 1 1 DS S SL
8/18/2019 19 70.5 2 1 1 2 2 2 2 1 1 DS S SL
8/18/2019 8 91 2 1 1 1 2 2 2 1 DS S SL
8/18/2019 15 103 2 1 1 2 2 2 2 1 1 DS S SL
8/18/2019 14 94 2 1 1 1 2 2 2 1 1 DS S SL
8/18/2019 11 82 2 1 1 1 2 2 2 1 1 DS S SL
8/18/2019 16 103 2 1 1 2 2 2 2 1 1 DS S SL
8/18/2019 9 74.2 2 1 1 1 2 2 2 1 1 DS S SL
8/18/2019 16 101 2 1 1 2 2 2 2 1 1 DS S SL
8/18/2019 16 100 2 1 1 1 2 2 2 1 1 DS S SL
8/18/2019 9 80 2 1 1 2 2 2 2 1 1 DS S SL
8/18/2019 10 82 2 1 1 1 2 2 2 1 1 DS S SL
8/18/2019 10 82 2 1 1 2 2 2 2 1 1 DS S SL
8/18/2019 8 67 2 1 1 1 2 2 2 1 1 DS S SL
8/18/2019 15 96 2 1 1 1 2 2 2 1 1 DS S SL
8/18/2019 10 82.5 2 1 1 2 2 2 2 1 1 DS S SL
8/18/2019 9 70 2 1 1 1 2 2 2 1 1 DS S SL
8/18/2019 14 97 2 1 1 1 2 2 2 1 1 DS S SL
8/18/2019 14 98 2 1 1 2 2 2 2 1 1 DS S SL
8/19/2019 14 93 2 1 1 1 2 2 2 1 1 DS S SL
8/19/2019 9 75 2 1 1 1 2 2 2 1 1 DS S SL
8/19/2019 12 85 2 1 1 2 2 2 2 1 1 DS S SL
8/19/2019 12 84 2 1 1 1 2 2 2 1 1 DS S SL
8/19/2019 10 80.5 2 1 1 1 2 2 2 1 1 DS S SL
8/19/2019 17 106 2 1 1 2 2 2 2 1 1 DS S SL
8/19/2019 16.5 106 2 1 1 1 2 2 2 1 1 DS S SL
8/19/2019 17 101 2 1 1 1 2 2 2 1 1 DS S SL
8/19/2019 17 108 2 1 1 2 2 2 2 1 1 DS S SL
8/19/2019 18 108 2 1 1 1 2 2 2 1 1 DS S SL
8/19/2019 15 99 2 1 1 1 2 2 2 1 1 DS S SL
8/19/2019 11 86 2 1 1 2 2 2 2 1 1 DS S SL
8/19/2019 9 75 2 1 1 1 2 2 2 1 1 DS S SL
8/19/2019 13 90 2 1 1 2 2 2 2 1 1 DS S SL
8/19/2019 13 92.5 2 1 1 2 2 2 2 1 1 DS S SL
8/19/2019 13 91 2 1 1 1 2 2 2 1 1 DS S SL
8/19/2019 14 91 2 1 1 1 2 2 2 1 1 DS S SL
8/19/2019 11 83 2 1 1 2 2 2 2 1 1 DS S SL
8/19/2019 14.5 96 2 1 1 1 2 2 2 1 1 DS S SL
8/19/2019 14.5 104 2 1 1 1 2 2 2 1 1 DS S SL
8/19/2019 15 96 2 1 1 2 2 2 2 1 1 DS S SL
8/19/2019 15 96 2 1 1 2 2 2 2 1 1 DS S SL
8/19/2019 10 81 2 1 1 1 2 2 2 1 1 DS S SL
8/19/2019 15 104 2 1 1 1 2 2 2 1 1 DS S SL
8/19/2019 15 100 2 1 1 2 2 2 2 1 1 DS S SL
8/19/2019 18 107.5 2 1 1 2 2 2 2 1 1 DS S SL
8/19/2019 11 81 2 1 1 1 2 2 2 1 1 DS S SL
8/19/2019 12 86 2 1 1 2 2 2 2 1 1 DS S SL
8/19/2019 9 78 2 1 1 1 2 2 2 1 1 DS S SL
8/19/2019 16 100 2 1 1 1 2 2 2 1 1 DS S SL
8/19/2019 14 100 2 1 1 2 2 2 2 1 1 DS S SL
8/19/2019 11 80 2 1 1 1 2 2 2 1 1 DS S SL
8/19/2019 10 91 2 1 1 1 2 2 2 1 1 DS S SL
8/19/2019 9 72 2 1 1 1 2 2 2 1 1 DS S SL
8/19/2019 15 98 2 1 1 2 2 2 2 1 1 DS S SL
8/19/2019 8 72 2 1 1 2 2 2 2 1 1 DS S SL
8/19/2019 9 72 2 1 1 1 2 2 2 1 1 DS S SL
8/19/2019 12 85 2 1 1 1 2 2 2 1 1 DS S SL
8/19/2019 15 97 2 1 1 1 2 2 2 1 1 DS S SL
8/19/2019 12 90 2 1 1 2 2 2 2 1 1 DS S SL
8/19/2019 6 65 2 1 1 2 2 2 2 1 1 DS S SL
8/19/2019 16 100 2 1 1 1 2 2 2 1 1 DS S SL
8/19/2019 12 85 2 1 1 2 2 2 2 1 1 DS S SL
8/19/2019 13 80 2 1 1 1 2 2 2 1 1 DS S SL
8/19/2019 10 80 2 1 1 1 2 2 2 1 1 DS S SL
8/19/2019 15 100 2 1 1 2 2 2 2 1 1 DS S SL
8/19/2019 11 79 2 1 1 2 2 2 2 1 1 DS S SL
8/19/2019 10 81 2 1 1 1 2 2 2 1 1 DS S SL
8/19/2019 13 95 2 1 1 1 2 2 2 1 1 DS S SL
8/23/2019 6 62 1 1 1 1 1 1 1 1 1 DS S SL
8/23/2019 6.5 63 1 1 1 1 1 1 1 2 DS S SL
8/23/2019 6.5 63 1 1 1 1 1 1 1 1 DS S SL
8/23/2019 6 63 1 1 1 1 1 1 2 2 DS S SL
8/23/2019 6.5 64 1 1 1 1 1 1 1 1 DS S SL
8/23/2019 7 65 1 1 1 1 1 1 1 1 DS S SL
8/23/2019 6 63 1 1 1 1 1 1 2 2 DS S SL
8/23/2019 6.5 63 1 1 1 1 2 2 2 2 DS S SL
8/23/2019 6 62 1 1 1 1 2 2 2 2 DS S SL
8/23/2019 6 61.5 1 1 1 2 2 2 2 2 DS S SL
8/23/2019 4 55 1 1 2 2 2 2 2 2 DS S SL
8/23/2019 4 53 1 1 2 2 2 2 2 2 DS S SL
8/18/2019 6.5 65 1 1 1 1 1 1 1 2 DS S SL
8/18/2019 6.5 63 1 1 1 1 1 1 2 2 DS S SL
8/18/2019 6 63 1 1 1 1 1 1 2 2 DS S SL
8/18/2019 6.5 63 1 1 1 1 1 1 2 2 DS S SL
8/18/2019 6.5 63 1 1 1 1 1 1 2 2 DS S SL
8/18/2019 6 63 1 1 1 1 1 1 1 1 DS S SL
8/19/2019 7 63 1 1 1 1 1 1 2 2 DS S SL
8/19/2019 7 65.5 1 1 1 1 1 1 2 2 DS S SL
8/19/2019 8 70 1 1 1 1 2 2 2 1 1 DS S SL
8/19/2019 8 70 1 1 1 1 2 2 2 1 1 DS S SL
8/26/2019 4 55 1 1 1 1 2 2 2 2 DS S SL
8/25/2019 4.5 55 1 1 2 2 2 2 2 2 DS S SL
8/23/2019 4 53 1 1 2 2 2 2 2 2 DS S SL
8/23/2019 4.5 53 1 1 2 2 2 2 2 2 DS S SL
8/18/2019 4.5 55 1 1 1 2 2 2 2 2 DS S SL
diisi Dp(Kemungkinan penyimpangan) jika skor<7

FORMULIR PENCATATAN PEMANTAUAN IBU HAMIL
Provinsi : SUMATERA UTARA Nama Posyandu : MELATI, MAWAR, GELATIK, CENDRAWASIH

Puskesmas/Kecamatan : BATU ANAM / KECAMATAN Tahun : 2019
Desa/Kelurahan : DOLOK HATARAN
Berat
No Kehamilan Ke Tanggal Lahir No Kartu NIK ( Nomor Induk Nama Ibu Badan Awal Kepemilikan Nama Suami NIK Suami Alamat RT RW Tanggal
Keluarga Kependudukan) Hamil hamil/Trise Buku KIA Pengukuran
mester I
(1) (2) (3) (4) (5) (6) (7) (8) (9) (10) (11) (12) (13) (14)
9/19/1981 120801030510 120801311274 SIDOMULYO

1 4 1208014909610006 LINDA SURYA 53 ya HARIANTO 8/18/2019
0018 0025
2 2 12/7/1992 120801101214 1208017112920005 DESY RAWATI 50 ya SURAHMAN 120803210187 SIDOMULYO 8/18/2019

0002 0001
2/18/1982 120801161211 RINI AFRIDA ALI IMRAN 120801040580 SIDOMULYO

3 3 1208015802820001 55 ya 8/18/2019
0017 DOLOK SARIBU DAMANIK 0001
8/17/1987 120801100211 120801220583 SIDOMULYO

4 3 1208015708870002 SRIYANI 62 ya SUPARDI 8/18/2019
0066 0001
6/9/1991 120801200616 YUNIAR IBRAHIM 127206160884 SIDAURUK

5 2 1208014505920002 58 ya 8/23/2019
0003 ANGGRAINI HASIBUAN 0002
9/5/1992 120801130116 YASMA 120811111190 SIDAURUK

6 2 1218044509920003 SUSANTI 50 ya 8/23/2019
0001 WIYADI 0001
SRI
7 3 3/28/1985 120801191212 1208016803850003 KURNIAWAN 58 ya FAISAL LUBIS 120801020282 SIDAURUK 8/23/2019
0011 0011
SUSILAWATI
6/14/1992 120801031014 DANA 120801200587 SIDAURUK

8 2 1208055406920001 INDAH SAGITA 55 ya 8/23/2019
0002 KESUMA 0001
9 3 3/5/1986 120801010211 1208014503960003 DEWI HARIANI 56 ya SAPARUN 120801241281 BATU VII 8/19/2019
0032 0002
YUNI IRWANSYAH 120806020694 SIDAURUK
10 1 6/6/1994 1208014606940002 55 ya 8/23/2019
TRIWIDYA NASUTION 0001
Keterangan
- Kolom 9 : Jika suami tidak ada, isikan nama orang tua
- Kolom 10 : Jika suami tidak ada, isikan NIK orang tua
PENCATATAN PEMANTAUAN IBU HAMIL
: MELATI, MAWAR, GELATIK, CENDRAWASIH
TTD
Tinggi Lingkar (Tablet Jika Ya,brp Jika Ya,brp
Berat Badan Lengan Tambah butir TTD butir TTD
Badan (kg) Darah) diterima diminum
(cm) Atas (LILA) 1=Ya,2=T
idak
(15) (16) (17) (18) (19) (20)
58 155 25 1 30 20
55 153 24 1 40 20
60 156 25 1 70 60
72 157 25 1 80 70
68 155 25 1 80 70
52 150 24 1 30 20
63 165 25 1 40 30
60 155 25 1 40 30
66 155 25 1 80 70
60 160 25 1 60 50
Provinsi : Sumatera Utara Nama Posyandu : Cempaka I,II,Madu dan Melati

Kabupaten/Kota : Simalungun Bulan : Agustus
Puskesmas/Kecamatan : Batu Anam Tahun : 2019
Desa/Kelurahan : Laras Dua
Berat
Badan
Kehamilan Tanggal Lahir NIK ( Nomor Induk Awal Kepemilikan Tanggal
No No Kartu Keluarga Nama Ibu Hamil Nama Suami NIK Suami Alamat RT RW Pengukuran
Ke Kependudukan) hamil/Tr Buku KIA
isemest
er I
(1) (2) (3) (4) (5) (6) (7) (8) (9) (10) (11) (12) (13) (14)
1 3 05|06|1976 1208012903080463 1208014506760001 ISA 55 YA SAMSIADI 1208010511740003 SIDOMAKMUR 20|08|2019
2 3 12|06|1984 2171090502100005 2171094612840001 LIDIA SIMANJUNTAK 50 YA EMRIN SIMARMATA 2171090610869003 LUMBAN BUNTU 20|08|2019
3 2 07|01|1981 1208011806150012 1208014701810004 TERESIA SAGALA 51 YA KENAN SIHOTANG 1208013005760003 LUMBAN BUNTU 20|08|2019
4 2 16|07|1988 0 1208015607880003 MENDA NAIBAHO 48 YA SIRHAN SINAGA 0 LUMBAN BUNTU 20|08|2019
5 3 17|03|1989 1208010303140011 1208015703890007 ROSMENY TELAUMBANUA 45 YA ANNES MANIK 1208011412850002 CINTA MULIA 10|08|2019
6 2 24|10|1990 0 1208016410900001 OKKY FARADILA 47 YA PRATAMA 1208013005890004 JERUK 20|08|2019
7 3 13|08|1992 1208012210140002 1208285308920003 SITI MARDIAH 52 YA ROMANSYAH 1208010108910001 JERUK 20|08|2019
8
9
10
11
12
13
14
15
16
17
18
19
20
Keterangan
- Jika suami tidak ada, isikan nama orang tua
- Jika suami tidak ada, isikan NIK orang tua
Kolom 9 :
Kolom 10 :
Kabupaten/Kota: Simalungun
Puskesmas/Kec : Batu Anam
Desa/Kelurahan: Laras Dua
I,II,Madu dan Melati
TTD
Lingkar (Tablet
Berat Tinggi Tambah Jika Ya,brp Jika Ya,brp
Badan Badan Lengan butir TTD butir TTD
Atas Darah) diterima
(kg) (cm) diminum
(LILA) 1=Ya,2=T
idak
(15) (16) (17) (18) (19) (20)
70 158 25 1 90 70
72 156 24,5 1 90 70
69 155 24 1 90 70
59 150 24,3 1 90 70
56 150 24,5 1 90 70
56 159 23,5 1 90 60
60 160 24 1 90 60
FORMULIR PENCATATAN PEMANTAUAN PERTUMBUHAN DAN PERKEMBANGAN BALITA DI POSYANDU
Provinsi : Sumatera Utara Nama Posyandu : Madu,Melati,Cempaka I,Cempaka II

Puskesmas/Kecamatan : Batu Anam Tahun : 2019
Desa/Kelurahan : Laras Dua
Kepemili Panjang Cara Ukur

Berat
Jenis No Kartu Nomor Induk kan Buku IMD No Badan/T
No Anak Tanggal Badan Tanggal BB
Kelam Keluarga Kependudukan Nama Anak KIA/KMS 1=Ya Nama Ayah NIK Ayah Telp/H Alamat RT RW Pengukuran inggi 1=Terlent
Ke Lahir Lahir (kg) Badan ang
in (KK) (NIK) 1=Ya 2=Tidak P Ayah
(gram) 2=Berdiri
2=Tidak (cm)
(1) (2) (3) (4) (5) (6) (7) (8) (9) (10) (11) (12) (13) (15) (16) (17) (18) (19) (20) (21)
12080116091 1208012808760
1 3 17/05/2017 P Melani Sihaloho 3,2 1 1 Sarjono Sihaloho Lumban Buntu 20-08-2019 11 82 2
50006 006
12080418041 120801610716000 1208041808790
2 5 21/07/2016 P Yosana Sihotang 4,3 1 1 Marulitua Sihotang Lumban Buntu 20-08-2019 13,2 96,4 2
10001 1 001
12080118061 1208013005760
3 1 12/01/2016 L Detanius Sihotang 2,5 1 1 Kenan Sihotang Lumban Buntu 20-08-2019 14 98,4 2
50012 003
4 1 17/03/2017 P Silvia.R.Turnip 3,2 1 1 Supengky Turnip Lumban Buntu 20-08-2019 11,2 86,7 2
5 1 26/03/2015 L Rehan Situmorang 3.7 1 1 Juwita Simarmata Lumban Buntu 20-08-2019 15,2 101,9 2
12080129030 120801030815000 1208013011740
6 4 03/08/2015 L Damian Sijabat 3,5 1 1 Posman Sijabat Lumban Buntu 20-08-2019 14,6 99,6 2
80497 1 001
12080115011 1208010708870
7 2 5/10/2018 P Vioneta Sijabat 3,5 1 1 Hendri Sijabat Lumban Buntu 20-08-2019 8,7 70,5 1
50009 003
12080102031 1208011802720
8 3 28/06/2016 P Friska Purba 3,5 1 1 Drickson Purba Lumban Buntu 20-08-2019 13 92,8 2
20003 004
12080125111 1208011912740
9 1 01/05/2016 P Kesyaria Sinurat 2,6 1 1 Marianus Sinurat Lumban Buntu 20-08-2019 13,3 97 2
00017 002
12080125021 120801070116200 1208012212860
10 2 07/01/2016 L Dion R.Turnip 3 1 1 Swandi Turnip Lumban Buntu 20-08-2019 14,1 98,5 2
40008 1 008
12080115011 120801430916000 1208010708870
11 1 03/09/2016 P Helwina Sijabat 4,2 1 1 Hendri Sijabat Lumban Buntu 20-08-2019 13,1 92,2 2
50009 1 003
12 2 19/04/2018 L Sultan.B.Turnip 3 1 1 Supengky Turnip Lumban Buntu 20-08-2019 10,2 77,1 2
1208010412750
13 7 05/12/2018 P Cantika Sihaloho 2,9 1 1 Lambok Sihaloho Lumban Buntu 20-08-2019 8,8 69,5 2
001
Berat kan
Jenis No Kartu Nomor Induk Buku IMD No Badan/T
No Anak Tanggal Badan KIA/KMS Tanggal BB
Kelam Keluarga Kependudukan Nama Anak 1=Ya Nama Ayah NIK Ayah Telp/H Alamat RT RW Pengukuran inggi 1=Terlent
(gram) 2=Berdiri
2=Tidak (cm)
12080101111 120801610317000 1208010508890

14 1 21/03/2017 P Adelia.M.Sihotang 2,7 1 1 Ranto Sihotang Lumban Buntu 20-08-2019 11,9 87,2 2
60006 1 005
12080113121 120801410415000 1208012208790
15 2 01/04/2015 P Tamara Simarmata 3 1 1 Julen Simarmata Lumban Buntu 20-08-2019 15,6 101,7 2
10003 1 001
12080110041 1208010412750
16 5 01/08/2015 L Bintang Sihaloho 3 1 1 Lambok Sihaloho Lumban Buntu 20-08-2019 14,6 100,2 2
20013 001
12080125021 120801201217200 1208012704810
17 4 20/12/2017 L Yuditira Manik 3,5 1 1 Pedoman Manik Lumban Buntu 20-08-2019 10,9 82,6 2
40006 1 002
12080131101 1208010408740
18 2 18/04/2019 L Farel Sihotang 3,2 1 1 Mangasitua Sihotang Lumban Buntu 20-08-2019 7,6 64,1 1
10016 001
12080116091 Refan Alfaro 1208010508890
19 2 19/05/2019 L 3,5 1 1 Ranto Sihotang Lumban Buntu 20-08-2019 6,8 61,7 2
50006 Sihotang 005
12080117041 120801171114000 1208010601770
20 2 17/11/2014 L Alfian Sagala 2,7 1 1 Rellum Sagala Lumban Buntu 20-08-2019 15,9 103,3 2
40011 3 004
12080117041 120801540317000 1208010601770
21 3 14/03/2017 P Marsya Sagala 3,5 1 1 Rellum Sagala Lumban Buntu 20-08-2019 11,2 87,4 2
40011 3 004
12080113111 Johan Pratama Ady Suprengky 1208011006820
22 1 24/05/2015 L 3,2 1 1 Lumban Buntu 20-08-2019 15,9 101,6 2
40002 Pasaribu Pasaribu 003
12080113111 Ady Suprengky 1208011006820
23 2 16/10/2017 P Jesselyn Pasaribu 3 1 1 Lumban Buntu 20-08-2019 11,3 83,3 2
40002 Pasaribu 003
12080123011 120801521117000 Falika.R.Situmoran 1208011004850
24 1 12/11/2017 P 3,2 1 1 Robert Situmorang Cinta Mulia 10/8/2019 11,7 83,8 2
80004 1 g 010
12080125031 120801191114000 1208010611800
25 2 19/11/2014 L Abel N. Sigiro 4,2 1 1 Togar Sigiro Cinta Mulia 10/8/2019 16,7 105,3 2
10005 2 002
12080111031 120800129121400 Cristian 1208011504830
26 2 29/12/2014 L 3,5 1 1 Firman Simaremare Cinta Mulia 10/8/2019 15,9 103,8 2
00018 02 Simaremare 002
12080111011 120801060914000 1208012810880
27 2 06/9/2014 L Faris Turnip 3,5 1 1 Donal.F.Turnip Cinta Mulia 10/8/2019 16,8 105,2 2
20016 1 009
12080111011 Glen Alinski 1208012810880
28 3 24/7/2018 L 3,5 1 1 Donal.F.Turnip Cinta Mulia 10/8/2019 9,9 73,7 2
20016 Turnip 009
12080117101 120801270617000 Pasabar.H.Sihombin 1208011807870
29 1 27/6/2017 L Amos Sihombing 3 1 1 Cinta Mulia 10/8/2019 11,7 85,6 2
70004 2 g 002
30 3 25/08/2015 L Tristan Siregar 3 1 1 Martua Siregar Cinta Mulia 10/8/2019 15,1 99,8 2
15030907101 1219031206887
31 2 28/07/2016 L Yehezkiel Malau 3,5 1 1 Eplin Malau Cinta Mulia 10/8/2019 13,6 92,9 2
50006 0003
Berat kan
(gram) 2=Berdiri
2=Tidak (cm)
32 1 19/01/2018 L David Situmeang 3,3 1 1 Daud Situmeang Cinta Mulia 10/8/2019 10,9 90,6 2
33 1 26/04/2016 P Harfa Simamora 3,2 1 1 Ukkap Simamora Cinta Mulia 10/8/2019 13,9 93,7 2
34 1 01/09/2016 L Reihan Sirait 4 1 1 Jonris Sirait Cinta Mulia 10/8/2019 13,3 92,3 2
12080103031 120801200916200 1208011412850
35 2 20/09/2016 L Ignasius Manik 3,3 1 1 Annes Arnold Manik Cinta Mulia 10/8/2019 12,6 92,7 2
40011 1 002
12080112041 1211100807890
36 1 21/11/2018 L Alvaro Naibaho 3 1 1 Erikson Naibaho Cinta Mulia 10/8/2019 8,7 69,5 1
80001 001
12080130081 120801180518000 1208010104890
37 1 18/05/2018 L Gabriel Malau 3,4 1 1 Erickson Malau Cinta Mulia 10/8/2019 10,8 77,6 2
80001 3 005
38 1 25/07/2016 L Julistien Sidabutar 3 1 1 Euklides Sidabutar Cinta Mulia 10/8/2019 14,2 94,4 2
39 2 11/8/2017 L Sion Sidabutar 3,3 1 1 Euklides Sidabutar Cinta Mulia 10/8/2019 12,7 89,9 2
40 2 14/07/2018 P Putri Manik 3 1 1 Eliyudi Manik Cinta Mulia 10/8/2019 9,1 72,2 2
41 2 20/04/2017 p Lovely 3,5 1 1 Mangitua Cinta Mulia 10/8/2019 12,2 87,4 2
42 1 22/03/2016 L Zefanya 3,2 1 1 Mangitua Cinta Mulia 10/8/2019 14,2 97,3 2
12080102101 120801280416000 1208013112880
43 2 28/04/2016 L Alfa Suge Satria 2,4 1 1 Benni Satria Sidomakmur 20-08-2019 13,6 97,3 2
40010 1 005
44 1 26/07/2014 L Alfa Ruki 2,5 1 1 Ivan Sandi Sidomakmur 20-08-2019 14,4 104 2
12080113071 Zefanya.N.Tampub Endar.M.Tampubolo 1223080901800
45 3 13/12/2018 P 3,2 1 1 Sidomakmur 20-08-2019 8,8 69,9 1
60004 olon n 003
12080129121 120801580315000 1208012001870
46 1 18/03/2015 P Ardina Charisa 3 1 1 Arnol Turnip Sidomakmur 20-08-2019 16,5 102,7 2
40003 1 003
12080129121 120801591216000 1208012001870
47 2 19/12/2016 P Kristin Natalia 3,2 1 1 Arnol Turnip Sidomakmur 20-08-2019 12,3 89,3 2
40003 1 003
12080113121 120801240514000 1208011109810
48 2 24/05/2014 L Reguel Manihuruk 2,6 1 1 Jamson Manihuruk Sidomakmur 20-08-2019 12,7 87,5 2
10019 2 005
49 2 04/11/2017 P Sofia Barokah 3 1 1 Fery Sidomakmur 20-08-2019 11,4 82,5 2
50 12080129030 1208011201730 14,2 96,1
4 25/01/2016 P Yang Revania 2,2 1 1 Rollik Sidomakmur 20-08-2019 2
81490 002
Berat kan
(gram) 2=Berdiri
2=Tidak (cm)
12080129030 1208011201730
51 4 25/01/2016 P Yang Rainia 2,3 1 1 Rollik Sidomakmur 20-08-2019 13,9 95,9 2
81490 002
12080118111 1208012008840
52 2 12/01/2017 L Ahza Nabihan Arif 3,1 1 1 Mhd.Arif Sidomakmur 20-08-2019 13,4 89,7 2
0020 001
12080127111 347102411215000 3402100641820
53 2 01/12/2015 P Syahida Rahma 3,5 1 1 Abdul Rahman Sidomakmur 20-08-2019 14,8 97,3 2
70004 2 001
12080323121 120803590417000 1208031708810
54 4 19/04/2017 P Zoya Zunaira 3 1 1 Khairul Sidomakmur 20-08-2019 13,7 93 2
00038 1 004
12080111061 120801601218000 Gita Nathalie 1208011003840
55 2 20/12/2018 P 3 1 1 Gordon Sihaloho Sidomakmur 20-08-2019 8,2 68,2 1
40001 3 Sihaloho 003
12080323121 120803670914000 1208031708810
56 3 27/09/2014 P Nata Salwa Aqila 3 1 1 Khairul Sidomakmur 20-08-2019 16,4 105,3 2
00038 1 004
57 1 07/02/2018 P Zidny 3,2 1 1 Sifon Sidomakmur 20-08-2019 9,8 77,9 2
12080122121 1208010905850
58 2 10/11/2018 L Mhd.Abii 3,5 1 1 Lilik Sahputra Sidomakmur 20-08-2019 8,9 70,4 1
10019 005
12080110121 120801671216000 1208012212960
59 2 27/12/2016 P Asyifa Nurfadilah 4,2 1 1 Kurniawan Sidomakmur 20-08-2019 12,3 88,8 2
50004 0 001
60 2 30/08/2018 P Afiya Azzahra 3,1 1 1 Ivan Sandi Sidomakmur 20-08-2019 9,5 72,8 2
12080123021 120801110717000 Azka Khiar 1208010909880
61 1 11/07/2017 L 3,5 1 1 Suryadi Sidomakmur 20-08-2019 11,8 85,6 2
80001 4 Rayyan 003
12080126111 120801261114000 1208010512840
62 3 26/11/2014 L Rizki Anugrah W. 3,6 1 1 Suriadi Sidomakmur 20-08-2019 15,7 104,6 2
40001 2 005
63 1 3/9/2018 P Anira Septiani 3,6 1 1 Nardi Sidomakmur 20-08-2019 9,3 72,7 1
64 2 11/3/2018 P Ayra 3,2 1 1 Anto Sidomakmur 20-08-2019 10,2 76,5 2
12080114071 120801410715000 1208010904840
65 3 01/07/2015 P Vania Carissa 2,9 1 1 Efendi Sidomakmur 20-08-2019 15,2 99,7 2
00014 4 002
12080129030 1208011412650
66 4 26/03/2018 P Nurtiara Syajidah 3,1 1 1 Tasun Sidomakmur 20-08-2019 10 76,3 2
81650 001
12080116011 120801610416000 1208012602820
67 2 21/04/2016 P Nadia Khairunisa 3,5 1 1 Suhanto Sidomakmur 20-08-2019 13,7 94,7 2
30011 1 002
12080119091 1208012401950
68 1 10/5/2017 P Arshifa Syaukia 3,3 1 1 Abdul Ramadani Sidomakmur 20-08-2019 11,2 86 2
60014 002
12080121121 120801060415000 1208011407740
69 4 06/04/2015 L Rendi Al Gazali 4,3 1 1 Waris Sidomakmur 20-08-2019 15,3 102,9 2
10002 2 002
Berat kan
(gram) 2=Berdiri
2=Tidak (cm)
12080121031 120801490117000 1208020707860

70 3 09/01/2017 P Janita Michel 3,4 1 1 Irwansyah Sidomakmur 20-08-2019 11,6 89,5 2
60004 2 002
12080121031 120801241114000 1208020707860
71 2 24/11/2014 L Luthfi Sakhi 3,3 1 1 Irwansyah Sidomakmur 20-08-2019 15,8 105 2
60004 1 002
12080110121 1208022212900
72 3 4/3/2019 L Revansyah 3,1 1 1 Kurniawan Sidomakmur 20-08-2019 7,8 65,6 2
50004 001
12080102101 1208011707890
73 2 22/12/2016 L Hazril Azhar M. 3 1 1 Musdar Munthe Sidomakmur 20-08-2019 12,7 90,2 2
20012 005
12080129030 1208012711790
74 3 15/03/2019 P Sabiyan Aulia 3 1 1 Muhammad Soli Sidomakmur 20-08-2019 6,8 63,2 1
81478 002
12080105005 120801671216000 Laura Natania 1208012709710
75 3 27/12/2016 P 3,6 1 1 Manahan Sijabat Sidomakmur 20-08-2019 12,3 90,9 2
8086 1 Sijabat 001
76 7 18/10/2017 L Rolucky 3 1 1 Syaiful Anwar Sidomakmur 20-08-2019 12,6 88,1 2
12080111081 120801241014000 1275030877800
77 2 24/10/2014 L Christian Sijabat 3,6 1 1 Kerenius Sijabat Sidomakmur 20-08-2019 16,2 104,7 2
40005 0 02
78 3 21/06/2017 P Dinda.A.Ramadani 3 1 1 Ferry Irawan Sidomakmur 20-08-2019 13,2 88,9 2
12080119091 120801110216000 1208010905860
79 3 11/2/2016 L M. Yigit Pratama 3,6 1 1 Awaluddin Simbolon Sidomakmur 20-08-2019 13,9 97,4 2
10003 2 009
12080118061 120801680215000 1208012205840
80 1 18/02/2015 P Naomi Arshifa 3,5 1 1 Samsiadi Sidomakmur 20-08-2019 15,9 105 2
50010 1 003
81 3 15/12/2015 L 12080125011 120801151215000 Alby Athaya 3,8 1 1 Suriadi
1208011810800
Sidomakmur 20-08-2019 13,9 97,2 2
00013 2 002
12080102051 Aira Syafira 1208012305760
82 3 5/7/2017 P 3,8 1 1 Irfan Batubara Sidomakmur 20-08-2019 12,6 88,5 2
10012 Batubara 002
12080106031 1208012010830
83 2 4/6/2017 P Shakila Almahira 3 1 1 Mhd.Harianto Sidomakmur 20-08-2019 13 88,9 2
20001 004
84 4 16/6/2017 P Hawa Almeidina 2,8 1 1 Hendra Jeruk 20-08-2019 8 81,2 2
Alya Putri
85 1 26/07/2018 P 2,7 1 1 Pendi Silitonga Jeruk 20-08-2019 6,5 70,2 1
Silitonga
12080129030 120801430916000 1208011110770
86 5 03/09/2016 P Della Ramadani 4,2 1 1 Suparno Sidomakmur 20-08-2019 13,8 92,1 2
81435 2 001
87 1 5/6/2018 P Syafiqa Yasmin 2,7 1 1 Darmawan Sidomakmur 20-08-2019 9,2 73,8 2
12080109021 120801081116000 1216051701890
88 1 8/11/2016 L Gema.B.Siburian 3,4 1 1 Gelfrin Siburian Jeruk 20-08-2019 13,9 93,4 2
60002 1 005
Berat kan
(gram) 2=Berdiri
2=Tidak (cm)
12080129030 1208012707800
89 3 23/06/2019 P Aisyah 3,5 1 1 Sudirman Sidomakmur 20-08-2019 5,7 57,9 1
81456 001
12080129030 1208011509770
90 3 25/04/2019 L Raska Alfatih 3,8 1 1 Riadi Sidomakmur 20-08-2019 7,7 64,7 1
81500 003
12080125031 1208010510730
91 3 16/6/2017 P Ramadani 2,7 1 1 Samsudin Jeruk 20-08-2019 8 81 2
10016 002
12080105050 1208011206800
92 3 7/2/2018 L Mhd.Dafa Bayhaqi 3,3 1 1 Wasirin Jeruk 20-08-2019 11,7 82,2 2
80007 001
12080129061 120801060216000 1208010411890
93 2 6/2/2016 L Rafa Alfarizi 3 1 1 Dedi Putra Jeruk 20-08-2019 14,5 98 2
20002 1 001
12080103011 1208011412870
94 2 4/5/2018 P Mikaila 3,1 1 1 Sunardi Jeruk 20-08-2019 10,6 78,9 2
40008 002
12080102111 120801470517200 1208012802840
95 4 17/5/2017 P Rahel Simanjuntak 2,8 1 1 Bruri Simanjuntak Lumban Buntu 20-08-2019 11,9 85,4 2
00015 1 004
12080117041 120801260515000 1208010910740
96 4 25/05/2015 L Albiner Turnip 3 1 1 Marolop Turnip Janji Matogu 20-08-2019 15,2 103,5 2
40001 4 003
12080109011 Pebrian I. 1208011501760
97 5 02/02/2015 L 3,5 1 1 Poltak Sitindaon Janji Matogu 20-08-2019 15,7 104,1 2
20015 Sitindaon 003
12080113011 1208011101800
98 5 15/02/2017 L Glen Pebri S. 3,5 1 1 David Sitanggang Janji Matogu 20-08-2019 12,8 93,3 2
20007 003
12080119021 1208011109760
99 4 15/04/2016 L Romli Simarmata 3 1 1 Raden Simarmata Janji Matogu 20-08-2019 13,9 95,2 2
40006 005
12080108111 120801480317000 1571071212860
100 2 08/03/2017 L Dea Silalahi 3,5 1 1 Sahat Silalahi Janji Matogu 20-08-2019 11,8 87,1 2
60001 1 001
Berat kan
(gram) 2=Berdiri
2=Tidak (cm)
12170913050 1217091102850
101 4 25/11/2015 P Retta Abigel M. 3,3 1 1 Godlive Malau Janji Matogu 20-08-2019 13,9 98,8 2
90003 001
102 2 21/10/2015 P Bilqis Dwi Sapira 2,9 1 1 Bambang Janji Matogu 20-08-2019 13,9 97,6 2
103 1 01/10/2014 L 12080102121 120801011014000 Sam Alfian Efendi 3,5 1 1 Suratman 1208020110840 Janji Matogu 20-08-2019 16,6 104,4 2
40001 3 004
12080113121 1208011109810
104 4 14/03/2019 P Celinda Manihuruk 3,2 1 1 Jamson Manihuruk Janji Matogu 20-08-2019 7 62,7 1
10019 005
12080107100 1272050505880
105 2 28/10/2016 L Abid Pranaja BB 3,2 1 1 Hery Batubara Janji Matogu 20-08-2019 13,1 91,6 2
00015 016
106 1 12/2/2015 L Andre Pratama 2,8 1 1 Agus Saputra Janji Matogu 20-08-2019 15,4 103,5 2
12080120110 Imanuel 1208011010730
107 6 29/09/2015 L 3 1 1 Budiman Manihuruk Janji Matogu 20-08-2019 14,9 99,6 2
90010 Manihuruk 006
12080105050 1208012911740
108 3 06/01/2016 P Carissa Nainggolan 3 1 1 Maruli.P.Nainggolan Janji Matogu 20-08-2019 13,6 97,8 2
80121 001
12080119091 120801421215000 1208015406830
109 1 02/12/2015 P Indah M. Turnip 3,8 1 1 Norinawati Sinaga Janji Matogu 20-08-2019 13,8 98 2
60013 2 004
110 5 12/8/2016 P Andriella Airif S. 3,5 1 1 Pian Sinaga Janji Matogu 20-08-2019 12,9 92,9 2
12080127080 120801201215000 1208012906750
111 4 20/12/2015 L Samuel Sitanggang 4,5 1 1 Hotbin Sitanggang Janji Matogu 20-08-2019 14,8 102 2
80051 2 005
12080118061 1208013011900
112 2 21/11/2016 P Novianti Sianturi 3,5 1 1 Daniel Sianturi Janji Matogu 20-08-2019 13,5 96,3 2
50009 003
12080113101 120801490915000 Amelda 1402081305830
113 2 09/09/2015 P 3,3 1 1 Perencus Sitanggang Janji Matogu 20-08-2019 14 98,8 2
70010 5 Sitanggang 001
12080117021 120801410115000 1208011410810
114 1 01/01/2015 P Vania Sitanggang 2,9 1 1 Rianto.M.Sitanggang Janji Matogu 20-08-2019 15,3 102,7 2
70009 2 001
12080117021 120801430816000 Anastasya 1208011410810
115 2 03/08/2016 P 3,1 1 1 Rianto.M.Sitanggang Janji Matogu 20-08-2019 13,9 95,7 2
70009 1 Sitanggang 001
12080130081 120801071114000 1208010610830
116 2 07/11/2014 L Adit Sitindaon 3,5 1 1 Hermando Sitindaon Janji Matogu 20-08-2019 15,8 104,6 2
20005 2 003
117 1 07/03/2017 P Viona Sinaga 3 1 1 Sirhan Sinaga Lumban Buntu 20-08-2019 12,7 87,6 2
12080115121 120801430818200 Lovi Agustin 1208010102750
118 4 03/08/2018 P 3 1 1 Wahidin Manik Janji Matogu 20-08-2019 9,4 73,5 1
10003 1 Manik 008
12080109041 Alvander Pargaulan 1208012501710
119 5 17/07/2018 L 2,7 1 1 Janji Matogu 20-08-2019 10,7 76,9 1
20012 Nainggolan Nainggolan 003
Berat kan
(gram) 2=Berdiri
2=Tidak (cm)
120 1 21/01/2019 L Alvino Qddafi 3,2 1 1 Iko Mirza Jeruk 20-08-2019 8,9 69,3 1
12080117041 1208010103860
121 2 17/04/2018 L Kenzi Rafansyah 3 1 1 Sunarno Jeruk 20-08-2019 10,3 77,5 2
40002 009
122 2 07/03/2018 L Azka Adrinata 3,2 1 1 Andri Liadi Jeruk 20-08-2019 10,8 98,5 2
12080121081 120801681215000 Shaki Desiva 1208012309930
123 1 28/12/2015 P 3 1 1 Agum Siahaan Jeruk 20-08-2019 13,7 98 2
70003 4 Siahaan 007
12080123091 120801600117000 1208012108850
124 1 20/01/2017 P Arsyla 2,9 1 1 Ari Budiono Jeruk 20-08-2019 12,8 89,9 2
60011 1 002
12080129030 120801651216000 1208012607750
125 2 25/12/2016 P Sinta Ayu Putri 2,5 1 1 Endang Supriadi Jeruk 20-08-2019 12,3 88,7 2
81050 2 001
12080164071 1208014079300
126 2 18/01/2016 P Fauziah Rasya 3,5 1 1 Jaka Sanjaya 06 Jeruk 20-08-2019 13,6 96,3 2
30001
12080121081 Salwa Naura 1208012309930
127 2 08/10/2017 P 2,9 1 1 Agum Siahaan Jeruk 20-08-2019 10,7 81,6 2
70003 Siahaan 007
12080115041 Azzura Aqila 1208012903860
128 2 16/02/2019 P 2,5 1 1 Yan Siswanto Jeruk 20-08-2019 8 67,9 1
40001 Siswanto 004
12080116121 120801520216000 1208012104780
129 1 12/2/2016 P Hafidzah Humayra 3 1 1 Adi Susanto Jeruk 20-08-2019 14,6 96,9 2
00084 2 001
12080129030 1208012709770
130 2 06/09/2018 P Hayyun 3,5 1 1 Mansyah Efendi Jeruk 20-08-2019 9,3 72 1
80324 001
131 1 21/01/2019 P Rindu Anastsya 3 1 1 Samsir Panjaitan Janji Matogu 20-08-2019 7,8 66,3 2
132 2 24/09/2018 P Neysa Safitri 3,1 1 1 Agus Jeruk 20-08-2019 8,9 72,3 2
12080129041 120801680716200 1208011407860
133 2 28/07/2016 P Kayla Nazwa 3 1 1 Darien Jeruk 20-08-2019 12,4 92,3 2
30002 1 008
12080323051 120803231215000 1208032404880
134 2 23/12/2015 L Elfatih Zidan 3,2 1 1 Andrey Gunawan Jeruk 20-08-2019 14,4 99,3 2
40003 1 002
135 3 31/07/2018 P Rahilla Gustinar 3 1 1 Jepri Syahrizal Jeruk 20-08-2019 8,9 73,2 2
12080129030 120801510316000 1208010507720
136 3 11/03/2016 P Nafisa Zahwa 3 1 1 Poniri Sidomulyo 10/8/2019 14,7 101 2
81538 1 001
12080129030 120801531015000 1208011808790
137 4 13/10/2015 P Almi Zahira .F 3 1 1 Misriadi Sidomulyo 10/8/2019 14,3 101 2
81138 1 001
1208011408860
138 3 19/03/2016 L Arka 3 1 1 Chaidir Adnan Sidomulyo 10/8/2019 13,8 96,3 2
006
12080106071 120801520615000 1208010403860
139 2 12/06/2015 P Nayla Zahsi.S. 3,5 1 1 Ade Irwansyah Sidomulyo 10/8/2019 14,7 102 2
00009 1 005
Berat kan
(gram) 2=Berdiri
2=Tidak (cm)
12080129030 1208011312760
140 6 17/09/2015 P Puspitasari 3 1 1 Miswanto Sidomulyo 10/8/2019 14,2 96,7 2
81300 001
12080103091 120801300317000 1208011802890
141 2 30/03/2017 L Zaki Winata 3,3 1 1 Widodo Sidomulyo 10/8/2019 11,9 85 2
30005 1 001
12080123071 120801620914000 1208082006910
142 1 22/09/2014 P Callista Arsyifa 2,8 1 1 Heri Kurniawan Sidomulyo 10/8/2019 16 104,6 2
40011 2 001
12080123071 1208082006910
143 2 03/07/2016 P Dwi Arsya 3 1 1 Heri Kurniawan Sidomulyo 10/8/2019 14,8 96,2 2
40011 001
144 2 01/02/2017 P Keisha Arsyfa 2,7 1 1 Rijal surya asnan Sidomulyo 10/8/2019 12,1 88,3 2
12080130041 120801430515000 Bilqis Naziha 1208012707910
145 1 03/05/2015 P 2,9 1 1 Indra Kusuma Sidomulyo 10/8/2019 15,7 101,3 2
50010 1 Kusuma 004
12080130041 120801420418000 1208012707910
146 2 02/04/2018 p Fayola Kusuma 3,1 1 1 Indra Kusuma Sidomulyo 10/8/2019 10,7 75,7 2
50010 2 004
12080112101 1208012912810
147 3 14/06/2016 P Tri Suci Ramadani 3,5 1 1 Andi Irianto Sidomulyo 10/8/2019 13,2 93,5 2
10007 005
12080110071 120801490616000 1208010606910
148 2 09/06/2016 P Makailah Afsheen 3 1 1 Poppi Angriawan Sidomulyo 10/8/2019 13,3 93,5 2
30005 1 010
12080105111 120801080914000 1208032703970
149 1 08/09/2014 L Fuad Altazan 3 1 1 Mhd.Syahril Sidomulyo 10/8/2019 16,3 105,9 2
40012 2 005
12080129030 120801061214000 1208012301770
150 4 06/12/2014 L Yusuf Arba 2,9 1 1 Ruslian Sidomulyo 10/8/2019 15,8 103,4 2
81317 2 003
Berat kan
(gram) 2=Berdiri
2=Tidak (cm)
151 3 16/09/2015 P Selo Nada 3 1 1 Iwan Sidomulyo 10/8/2019 13,9 98,3 2

152 3 06/04/2016 L Abid Aqila 3,5 1 1 Suprianto Sidomulyo 10/8/2019 14,1 98,6 2
12080129030 120801070515000 1208011904800
153 3 07/05/2015 L Afnan Firmansyah 2,8 1 1 Suyono Sidomulyo 10/8/2019 15,5 100,3 2
81398 2 001
12080129030 120801520616000 1208011904800
154 4 12/6/2016 P Nazwa Syakira 2,9 1 1 Suyono Sidomulyo 10/8/2019 14,2 96,4 2
81398 2 001
12080104051 1208011202850
155 2 16/04/2016 L Mhd.Hanafi Arkan 3 1 1 Dedi Iskandar Sidomulyo 10/8/2019 14,3 96,8 2
10010 003
156 1 16/01/2018 L Nabil Nazwan 2,7 1 1 Anggra Donika Sidomulyo 10/8/2019 10,2 78,1 2
12080102111 120801090618000 Hafis Rafardhan 1208031509930
157 1 09/06/2018 L 3 1 1 Ridho.L.Lubis Sidomulyo 10/8/2019 9,8 75,2 2
70006 1 Lubis 002
12080118041 Arif Deri 1208011807910
158 1 29/04/2017 P Khaira Delia 3,2 1 1 Sidomulyo 10/8/2019 12,3 96,2 2
70001 Rahmansyah 003
159 1 29/06/2018 P Syifa Aulia 3 1 1 Andriansyah Sidomulyo 10/8/2019 9,5 74 2
12080122051 Hafiza Zuha 1208052310860
160 2 15/12/2017 P 3,1 1 1 Suparmono Sidomulyo 10/8/2019 10,7 79,1 2
30010 Azkayra 002
12080122121 Jihan Makailah 1208012808840
161 2 06/09/2018 P 3,5 1 1 Dedi Mulia Sidomulyo 10/8/2019 9,6 72,7 1
40002 Fakhira 008
162 1 04/04/2018 P Quinny Sipayung 3,5 1 1 Andri Sipayung Sidomulyo 10/8/2019 9,9 75,6 2
12080129030 1208012610790
163 1 08/06/2018 P Vinna Ramandani 3 1 1 Supriadi Sidomulyo 10/8/2019 9,8 74,3 2
80504 001
12080101081 120801421216000 Putri Syafira Karo- Edy Rahmat Karo- 1208012810760
164 2 02/12/2016 P 3,5 1 1 Sidomulyo 10/8/2019 13,8 90,9 2
20004 1 Karo Karo 001
165 1 09/08/2016 L Fauzan Arafah 3,2 1 1 Suharsono Jeruk 20-08-2019 13,3 93,3 2
166 2 30/04/2018 P Bilqis Syafrina 3,1 1 1 Suharsono Jeruk 20-08-2019 9,7 74,9 2
Keterangan
KolomJika Ayah tidak ada, maka diisikan nama Ibu
KolomJika Ayah tidak ada, maka diisikan NIK Ibu
KolomJika Ayah tidak ada, maka diisikan no Telp/HP Ibu
KolomJika Pemantauan Perkembangan menggunakan kusioner pra skrining perkembangan (SDIDTK) diisi Ds (Sesuai) jika skor KPSP=9-10, Dm (Meragukan) skor=7-8, diisi Dp(Kemungkinan penyimpangan) jika skor<7
KolomJika Pemantauan Perkembangan menggunakan ceklist buku KIA, diisi S jika jawaban ya untuk seluruh pertanyaan, diisi TS jika ada satu atau lebih jawaban tidak untuk seluruh pertanyaan
Berat kan
(gram) 2=Berdiri
2=Tidak (cm)
KolomDiisi SL (lanjutkan stimulasi dan jadwalkan kunjungan berikutnya) jika hasil pemeriksaan KPSP atau ceklist Buku KIA menghasilkan Sesuai (S)
MBUHAN DAN PERKEMBANGAN BALITA DI POSYANDU
ASI Eksklusif 1=Ya 2=Tidak Perkembangan

Vitamin A Vitamin A
Februari Agustus
1=Ya 1=Ya
2=Tidak 2=Tidak
KPSP Buku Tindak
Umur Umur 1 Umur Umur 3 Umur Umur Ds/Dm/ KIA Lanjut
0 bln bln 2 bln bln 4 bln 5 bln Dp S/TS SL/SU/R
(21) (22) (23) (24) (25) (26) (27) (28) (29) (30) (31)
v v v v v v 1 1 DS S SL
Vitamin A Vitamin A
Februari Agustus
1=Ya 1=Ya
2=Tidak 2=Tidak
KPSP Buku Tindak
Vitamin A Vitamin A
Februari Agustus
1=Ya 1=Ya
2=Tidak 2=Tidak
KPSP Buku Tindak
Vitamin A Vitamin A
Februari Agustus
1=Ya 1=Ya
2=Tidak 2=Tidak
KPSP Buku Tindak
Vitamin A Vitamin A
Februari Agustus
1=Ya 1=Ya
2=Tidak 2=Tidak
KPSP Buku Tindak
v v v v v v 1 1 DM S SL
Vitamin A Vitamin A
Februari Agustus
1=Ya 1=Ya
2=Tidak 2=Tidak
KPSP Buku Tindak
v v v 2 2 DS S SL
v v v v v 2 2 DS S SL
Vitamin A Vitamin A
Februari Agustus
1=Ya 1=Ya
2=Tidak 2=Tidak
KPSP Buku Tindak
Vitamin A Vitamin A
Februari Agustus
1=Ya 1=Ya
2=Tidak 2=Tidak
KPSP Buku Tindak
Vitamin A Vitamin A
Februari Agustus
1=Ya 1=Ya
2=Tidak 2=Tidak
KPSP Buku Tindak
Vitamin A Vitamin A
Februari Agustus
1=Ya 1=Ya
2=Tidak 2=Tidak
KPSP Buku Tindak
Provinsi : SUMATERA UTARA Nama Posyandu : SIMPANG MARIHAT, BONA-BONA, MULIA TANI, KAMPUNG PARDA
Desa/Kelurahan : DOLOK MARLAWAN
Kepemilik
Berat
Nomor Induk an Buku No
Jenis No Kartu Kependuduka Badan KIA/KMS IMD 1=Ya Tanggal BB
No Anak Ke Tanggal Lahir Nama Anak Nama Ayah NIK Ayah Telp/HP Alamat RT RW
Kelamin Keluarga (KK) Lahir 2=Tidak Pengukuran (kg)
n (NIK) 1=Ya Ayah
(gram) 2=Tidak
(1) (2) (3) (4) (5) (6) (7) (8) (9) (10) (11) (12) (13) (15) (16) (17) (18) (19)
12080123071 12080408011 Jeslin Pakpahan Darwin 12082106018000 Huta I Bona-
1 2 1/8/2015 P 3 1 1 - - - 9/15/2019 12:00
40010 50002 Pakpahan 03 Bona
Huta simal
2 1 8/3/2019 p - - alyah 2.5 1 1 sarif solin - - 9/15/2019 3
permai
Huta simal
3 2 8/3/2019 L - - fikri 2.6 1 1 sarif solin - - - - 9/15/2019 3.5
permai
Huta I Bona-
4 1 8/21/2019 L - - Ucok 3.2 1 1 Jansen - - - - 9/15/2019 3.5
Bona
Huta I Bona-
5 1 7/18/2019 L - - Daniel 3.1 1 1 rusdi silalahi - - - - 9/15/2019 3.8
Bona
Huta I Bona-
6 2 6/23/2019 p - - jenni Haloho 3.2 1 1 Saudur Haloho - - - - 9/15/2019 5.2
Bona
Huta I Bona-
7 1 6/12/2016 p - - claudia silalahi 3.1 1 1 binson silalahi - - - - 9/15/2019 14.6
Bona
Parlindungan Huta I Bona-
8 1 10/20/2014 L - - Simula Silaen 2.9 1 1 - - - - 9/15/2019 19
Silaen Bona
12080115061 12080144011 Kartika Sitio 12080121127600 Huta I Bona-
9 1 1/4/2015 P 2.9 1 1 Holong Sitio - - - 9/15/2019 15.3
60005 50001 02 Bona
Huta I Bona-
10 1 3/13/2015 P - - Sandra Nadaek 3.5 1 1 Horas Nadaek - - - - 9/15/2019 16
Bona
12080116061 12080124128100 Huta I Bona-
11 2 6/22/2015 P - Yohana Sitohang 3.1 1 1 Natal Sitohang - - - 9/15/2019 14.8
10015 04 Bona
12080122061 12080122061 Wahyu Natal 12080103091500 Huta I Bona-
12 2 6/22/2015 L 2.9 1 1 - - - 9/15/2019 16.5
50001 50001 Tampubolon Tampubolon 11 Bona
Huta I Bona-
13 1 6/15/2015 P - - Indah Gultom 2.8 1 1 Gipson Gultom - - - - 9/15/2019 15.5
Bona
Ragam Huta I Bona-
14 3 7/13/2015 L - - 3.1 1 1 Rama Sitohang - - - - 9/15/2019 15.9
Sihotanng Bona
Parlindungan Huta I Bona-
15 2 12/13/2015 P - - Claudia Silaen 2.8 1 1 - - - - 9/15/2019 16.2
Silaen Bona
Julianto Huta I Bona-
16 1 12/25/2015 L - - Aldi Nainggolan 2.9 1 1 - - - - 9/15/2019 15.6
Nainggolan Bona
Huta I Bona-
17 1 1/8/2016 L - - Luis Manik 3.1 1 1 Jatesun Manik - - - - 9/15/2019 15.8
Bona
Huta I Bona-
18 1 4/16/2016 L - - Gebby Saputra 2.6 1 1 Beni Manulang - - - - 9/15/2019 15.7
Bona
12080114031 12080149051 Jevania Siboro 12080108048600 Huta I Bona-
19 2 5/9/2015 P 2.7 1 1 Polma Siboro - - - 9/15/2019 15
60008 60002 05 Bona
12080120011 12080162111 Helen Siburian 12080114108600 Huta I Bona-
20 2 11/22/2015 P 3 1 1 Aman Siburian - - - 9/15/2019 16
00002 40001 02 Bona
Rafael Huta I Bona-
21 1 1/21/2016 L - - 2.8 1 1 Domaris Lintong - - - - 9/15/2019 0:00
Simanjuntak Bona
Hansen Julianto Huta I Bona-
22 1 3/8/2017 L - - 3.2 1 1 - - - - 9/15/2019 12
Nainggolan Nainggolan Bona
Huta I Bona-
23 1 3/20/2016 P - - Marsya 32 1 1 Gali - - - - 9/15/2019 13.6
Bona
12080103091 Riski Natal 12080119128600 Huta I Bona-
24 3 6/27/2017 L - 0 1 1 - - - 9/15/2019 12.4
50011 Tampubolon Tampubolon 03 Bona
Sopian Lintong Huta I Bona-
25 2 7/7/2017 L - - 2.9 1 1 - - - - 9/15/2019 12.2
Simanjuntak Simanjuntak Bona
12080128091 Samahati 12100905058701 Huta I Bona-
26 4 3/3/2017 P - Cahaya Lahagu 2.7 1 1 - - - 9/15/2019 12.6
70003 Lahagu 1 Bona
12080120011 12080114108600 Huta I Bona-
27 3 9/1/2018 L - Abies Siburian 3 1 1 Aman Siburian - - - 9/15/2019 10
00002 01 Bona
petrus Huta VI Huta
28 1 6/15/2019 p - - butet 3.1 1 1 9/22/2019 5.9
hutabarat Baru
12080116051 12080111111 Arga Pasaribu Baringin 12730310108500 Huta I Bona-
29 2 11/11/2017 L 3.3 1 1 - - - 9/15/2019 14.6
40003 60002 Pasaribu 07 Bona
Aryando Huta I Bona-
30 3 8/26/2019 L - - Ucok 3.5 1 1 - - - - 9/15/2019 3.7
Sitohang Bona
12080116051 12080141111 Sari Pasaribu Baringin 12730310108500 Huta I Bona-
31 1 11/1/2016 p 3 1 1 - - - 9/15/2019 15.5
40003 50001 Pasaribu 07 Bona
12080113120 12080153121 Renata Sagala Lambok Sagala 12080112127200 Huta I Bona-
32 4 12/13/2014 P 3.2 1 1 - - - 9/15/2019 15.6
90013 40003 05 Bona
Huta VII
33 1 7/30/2019 L - Ucok 3.3 1 1 Hutabarat 9/12/2019 4.7
Pardamean
12080105040 12080158081 Johana Marlin 12080114035300 Huta I Bona-
34 1 8/18/2015 P 3.7 1 1 - - - 9/15/2019 14.8
80583 40002 Lumbantobing Lumbantobing 01 Bona
Bintang Josep Huta I Bona-
35 1 11/29/2015 L - - 2.8 1 1 - - - - 9/15/2019 16.9
Tambunan Tambunan Bona
12080104040 12080108117400 Huta I Bona-
36 4 9/30/2018 P - Anisa 2.9 1 1 Suharto - - - 9/15/2019 10.5
80810 02 Bona
12080124081 12080108031 Yoel Nainggolan Julianto 12720120069200 Huta I Bona-
37 2 3/8/2017 L 3 1 1 - - - 9/15/2019 12
80005 70003 Nainggolan 02 Bona
38 1 7/8/2019 L leonardo 3.2 1 1 Saur Sirait Muliatani 9/22/2019 3.7
Huta I Bona-
39 2 12/30/2017 P - - Adrena Putri 3 1 1 Anto sirait - - - - 9/15/2019 12.6
Bona
Marulan
40 2 7/31/2019 L - ucok 2.8 1 1 - - Ht VII porsea - - 9/15/2019 6.2
Ambarita
Huta I Bona-
41 1 11/14/2018 P - - arista 2.9 1 1 Josep Silalahi - - - - 9/15/2019 9.8
Bona
Huta I Bona-
42 1 1/30/2015 P - - Dewi Turnip 3.3 1 1 johanen turnip - - - - 9/15/2019 16
Bona
43 4 9/28/2014 L - - Dimas Silitonga 2.8 1 1 jordan - - simp marihat - - 9/20/2019 16
44 1 5/11/2018 P - - bertania 3 1 1 poltak r.horbo - - simp marihat - - 9/20/2019 10.8
45 1 10/10/2014 L - - Imanuel Siagian 3.2 1 1 ferdinan siagian - - simp marihat - - 9/20/2019 18
46 1 6/11/2016 P - - Regina Siagian 2.9 1 1 nando siagian - - simp marihat - - 9/20/2019 14.1
47 2 5/21/2018 L - - Mikhael Siagian 2.9 1 1 nando siagian - - simp marihat - - 9/20/2019 11.9
Halman
12080105121 12080161081 Putri Fransiska 12080108058400 kamp
48 2 8/21/2015 P 3.5 1 1 Dominikus - - - 9/12/2019 18
20019 50003 Manurung 10 pardamean
Manurung
Halman
12080105121 12080156081 Aurel Agusti 12080108058400 kamp
49 3 8/16/2016 P 3.1 1 1 Dominikus - - - 3/12/2019 14.5
20019 60001 10 pardamean
Manurung
12080116061 16021505051 Arga Pratama Iwansen Siregar 16021521046500 kamp
50 4 5/5/2015 L 2.9 1 1 - - - 3/12/2019 16.4
70004 50001 Siregar 03 pardamean
12080104040 12080130091 Cornelius Binsar Rumah 12080111064000 kamp
51 4 9/30/2016 L 2.8 1 1 - - - 3/12/2019 13.5
82359 50003 Rumahorbo Horbo 01 pardamean
Demson kamp
52 4 6/23/2015 P - - Gresia Ambarita 3.1 1 1 - - - - 3/12/2019 15.8
Ambarita pardamean
Demson kamp
53 5 5/30/2017 L - - Aditia Ambarita 2.8 1 1 - - - - 3/12/2019 11.8
Ambarita pardamean
12080116061 Juliasnar Purba 12080130078000 kamp
54 2 4/25/2016 L - Davit Purba 2.9 1 1 - - - 3/12/2019 13
10003 02 pardamean
tumpak kamp
55 3 8/11/2014 L - - imelda ambarita 3.1 1 1 - - - - 3/12/2019 15.8
ambarita pardamean
12080104111 12080111081 Cinta Clara 12080103077800 kamp
56 4 3/9/2015 P 2.6 1 1 Belman Turnip - - - 3/12/2019 15
10007 40001 Turnip 05 pardamean
12080113040 12080149031 Armi Sridevi Tumpak 12080104047400 kamp
57 2 9/8/2014 P 3 1 1 - - - 3/12/2019 14.5
80043 50001 Ambarita Ambarita 03 pardamean
Silsilia kamp
58 3 9/15/2016 P - - 3.1 1 1 Masda Turnip - - - - 3/12/2019 15
Situmeang pardamean
Lamhot kamp
59 1 4/29/2017 L - - 2.7 1 1 Atur Situmorang - - - - 3/12/2019 12.2
Situmorang pardamean
Agnes kamp
60 2 11/10/2014 p - - Rosi Napitupulu 3 1 1 - - - - 3/12/2019 15.8
Napitupulu pardamean
Meriska Agnes kamp
61 3 12/15/2016 P - - 2.8 1 1 - - - - 3/12/2019 13.8
Napitupulu Napitupulu pardamean
Pramuda kamp
62 4 10/13/2017 L - - 3.2 1 1 Indra Simamora - - - - 3/12/2019 12.8
Simamora pardamean
kamp
63 4 1/11/2015 L - - Rodi Syaputra 32 1 1 Tomas Hutajulu - - - - 3/12/2019 14.9
pardamean
kamp
64 2 12/13/2018 L - - Ucok 0 1 1 Jery Siagian - - - - 3/12/2019 7.6
pardamean
Cahaya Elonia kamp
65 2 5/1/2018 P - - 2.9 1 1 Doni Sinaga - - - - 3/12/2019 7.6
sinaga pardamean
Hulkman kamp
66 1 8/21/2014 L - - Putra Manurung 2.7 1 1 - - - - 3/12/2019 14.7
Manurung pardamean
Hulkman kamp
67 2 10/13/2015 P - - Hiskia Manurung 3 1 1 - - - - 3/12/2019 14.3
Manurung pardamean
kamp
68 1 7/17/2015 L - - Wendy Sitorus 3.2 1 1 Ramses Sitorus - - - - 3/12/2019 14.8
pardamean
HugoLinus kamp
69 1 1/26/2016 L - - 3.3 1 1 Doni Sinaga - - - - 3/12/2019 13.8
Sinaga pardamean
kamp
70 3 3/18/2016 P - - Angel Ambarita 2.7 1 1 Saut Ambarita - - - - 3/12/2019 13.3
pardamean
12080102091 12080125031 Oscar Sirait 21710318018190 kamp
71 1 3/25/2016 L 3.1 1 1 Sihol Sirait - - - 3/12/2019 12.9
60001 60002 11 pardamean
Simon Raman kamp
72 2 3/3/2016 L - - 2.8 1 1 - - - - 3/12/2019 15
Simarmata Simarmata pardamean
kamp
73 2 7/28/2017 L - - Aldo Ambarita 3.2 1 1 Saut Ambarita - - - - 3/12/2019 12.6
pardamean
kamp
74 1 11/1/2016 L - - Pincen 2.9 1 1 Triwindari - - - - 3/12/2019 13.6
pardamean
Kamp
75 2 10/11/2014 L - - Perdinan Sitorus 3.2 1 1 Samrat - - - - 3/12/2019 16
Pardamean
Abdi
76 3 7/21/2019 P - - butet 33 1 1 - - ht 5 cinta maju - - 3/12/2019 3.5
simanjuntak
Septriani kamp
77 2 9/30/2014 P - - 2.9 1 1 Saut Ambarita - - - - 3/12/2019 15.9
Ambarita pardamean
kamp
78 1 1/26/2017 P - - valen 3.2 1 1 April Sitorus - - - - 3/12/2019 11.8
pardamean
Roy Kardo kamp
79 1 12/20/2017 P - - Celsi Situmeang 2.9 1 1 - - - - 3/12/2019 12
Situmeang pardamean
12080127121 12080150111 Rosilisda Daniel 12080130088500 kamp
80 2 11/10/2014 P 3.1 1 1 - - - 3/12/2019 16.1
10001 40001 Napitupulu Napitupulu 04 pardamean
Kamp
81 2 4/9/2019 p - - Alisia sirait 3 1 1 ancen sirait - - - - 3/12/2019 6.1
paardamean
82 3 7/13/2019 p - - Anita Haloho 3.2 1 1 Lacer Haloho - - huta baru - - 3/12/2019 5.6
12080106111 12080166011 Clarisyah Sitorus Aprilson Sitorus 12090124049600 kamp
83 1 1/26/2017 P 3 1 1 - - - 3/12/2019 12.7
72001 72001 04 pardamean
12080119091 ToninPetrus 12080121027800 kamp
84 3 12/13/2018 L - Roni Sitohang 2.9 1 1 - - - 3/12/2019 87
10001 Sitohang 01 pardamean
12080111011 Samuel Abas Tumpak 12080116028200 kamp
85 3 6/19/2018 L - 2.7 1 1 - - - 3/12/2019 16.5
60002 Ambarita Ambarita 02 pardamean
12080107031 12080170091 Evelin Ambarita 12080158027000 kamp
86 2 9/30/2014 P 2.8 1 1 Saut Ambarita - - - 3/12/2019 18
80002 40001 01 pardamean
12080107031 12080158031 Angeline 12080158027000 kamp
87 2 3/18/2016 P 2.9 1 1 Saut Ambarita - - - 3/12/2019 15.7
80002 60002 Ambarita 01 pardamean
12080114071 12080171815 Dewi Turnip 12080101018500
88 3 1/30/2015 P 3 1 1 Daniel Turnip - Purbauli - - 3/12/2019 15.4
10017 00002 12
12080118031 12080128061 Johanes 12080117067700
89 3 9/28/2014 L 2.7 1 1 Edi Silitonga - Purbauli - - 9/20/2019 16
00006 40003 Situmeang 02
12080120071 12080151051 Berthania Kasi 12080104107800
90 3 5/11/2015 P 3.1 1 1 kasmir - Purbauli - - 9/20/2019 15.4
10005 80001 01
12080113081 12080110101 Imanuel Siagian Hermanto 12080105048800
91 1 10/10/2014 L 3.1 1 1 - Purbauli - - 9/20/2019 18
80003 40002 Siagian 01
12080113081 12080151061 Regina Siagian Hermanto 12080105048800
92 2 6/11/2016 L 2.8 1 1 - Purbauli - - 9/20/2019 14.1
80003 60002 Siagian 01
12080113081 12080121051 Mekhael Siagian Hermanto 12080105048800
93 3 5/21/2018 L 3.4 1 1 - Purbauli - - 9/20/2019 11.9
80003 80002 Siagian 01
94 2 6/12/2015 P - - Lupiah Saragih 3.1 1 1 alexar saragih - - Purbauli - - 9/20/2019 15.9
12080116101 12080119031 Reza Nainggolan Juanda 12080125079200 081396 Purbauli

95 1 10/19/2014 L 3.2 1 1 - - 9/20/2019 16.5
40009 40001 Nainggolan 01 045238
96 3 9/23/2014 P - - Juliana Siagian 3.3 1 1 Ranto Siagian - - Purbauli - - 9/20/2019 16.8

12080110116 12080107071 Ingot Situmeang Hotlen 12080123057800
97 2 10/7/2014 L 3 1 1 - Purbauli - - 9/20/2019 18
15001 40001 Situmeang 01
98 1 10/20/2014 P - - Gres Situmorang 2.8 1 1 Rudi Situmeang 12720131019000 085276 Purbauli

- - 9/20/2019 18
03 854897
99 1 2/6/2015 P - - Dewi Simamora 2.7 1 1 heri simamora - - Purbauli - - 9/20/2019 14
12080116101 12080110041 Vio Nainggolan Juanda 12080125079200 081396 Purbauli

100 2 1/31/2015 L 2.9 1 1 - - 9/20/2019 13.9
40009 52001 Nainggolan 01 045238
101 2 4/10/2015 L - - Jeremi 3.2 1 1 Erik - - Purbauli - - 9/20/2019 13.8

12080113081 12080167061 Regina Saswati 12080110068700
102 3 5/14/2015 P 3.1 1 1 Get Manik - Purbauli - - 9/20/2019 14.5
50011 50001 04
Cheysia Hotlen
103 2 6/27/2015 P - - 2.9 1 1 - - Purbauli - - 9/20/2019 14
Situmorang Situmorang
12080107021 12080149061 Olivia Sitorus 12200819027800
104 2 10/6/2015 L 2.8 1 1 Paber Sitorus - Purbauli - - 9/20/2019 12.5
70014 70001 05
105 1 8/9/2017 L - - Samuel Siagian 3 1 1 Ranto Siagian - - Purbauli - - 9/20/2019 13.9
106 3 11/18/2015 L - - Jovan 3.2 1 1 Rudi Situmeang - - Purbauli - - 9/20/2019 13.6
107 1 3/22/2016 P 12080108091 12080158051 Argani Sitohang Frengki Sitohang 12080113048900 085371 Purbauli 9/20/2019
60003 60001 3.5 1 1 01 - - 13.5
996189
12080121061 17710825091 Boy Sihombing

108 2 5/18/2016 L 3.1 1 1 Davit Sihombing 15710706067803 - Purbauli - - 9/20/2019 13.6
70007 40001 21
109 1 5/4/2016 L - - Boama 3.4 1 1 Ester - - Purbauli - - 9/20/2019 13
12080108091
110 2 6/19/2017 L - Adrian Sitohang 3 1 1 Frengki Sitohang 12080113048900 085371 Purbauli
- - 9/20/2019 12.7
60003 01 996189
Hotma
111 1 6/9/2017 L - - 3.3 1 1 Ronal - - Purbauli - - 9/20/2019 12
Simanjuntak
Bintang Josep 082370 Purbauli

112 1 11/29/2015 L - - 3 1 1 - - - 9/20/2019 15.5
Tambunan Tambunan 326309
jepri
113 2 10/29/2017 L - - 3 1 1 M.Sitinjak - - Purbauli - - 9/20/2019 12.6
Simanjuntak
114 1 3/10/2018 L - - Alex Sirait 3 1 1 Jhoni Sirait - - Purbauli - - 9/20/2019 11'8
12080113081 12080110068700
115 3 3/8/2018 P - Triwulan 3.2 1 1 Get Manik - Purbauli - - 9/20/2019 11.6
50011 04
116 3 3/5/2018 P - - Angelita 3 1 1 Karlin - - Purbauli - - 9/20/2019 12
117 4 2/9/2018 L - - Rapael 2.9 1 1 Rudi Situmeang - - Purbauli - - 9/20/2019 12
118 2 5/21/2018 L - - Micael 2.8 1 1 Toni Saragih - - Purbauli - - 9/20/2019 11.9
119 1 8/16/2018 L - - Joice 3.7 1 1 Paulus - - Purbauli - - 9/20/2019 11
120 1 2/21/2018 P - - Humairo Alismi 3.5 1 1 Anto - - Purbauli - - 9/20/2019 10.8
Panji Firman Indra

121 1 10/31/2018 L - - 4 1 1 - - Purbauli - - 9/20/2019 10.6
Simorangkir Simorangkir
12080123031 12080114091 Ananada
122 4 9/24/2014 P 3.1 1 1 Frengky Siahaan 120801010576000 - Purbauli - - 9/20/2019 16.8
00011 40001 Siahaan 3
12080114081 valen Maruhum 120801256688000
123 1 11/14/2018 P - 2.9 1 1 - Purbauli - - 9/20/2019 10
80003 Simorangkir Simorangkr 5
11061525061 11061549081 Natania Pakan 732607100884000
124 2 8/9/2015 P 2.6 1 1 Gusti Pakan - Purbauli - - 9/20/2019 15
30001 50001 1
125 1 2/8/2018 P Vera Simamora 2.8 1 1 Esron Simamora - - Purbauli - - 9/20/2019 12
12082308101 17710825091 Andre Johanes 157107060678032

126 4 9/25/2014 L 3 1 1 - Purbauli - - 9/20/2019 18
30008 40001 Pandiangan Pandiangan 1
12080108091 12711227021 Arizal Fataya
127 1 8/9/2015 L 2.6 1 1 Windi Syaputra 120801110490000 - Purbauli - - 9/20/2019 15.4
60009 50002 1
12080108091 12080170121 Andrena Putri
128 2 12/30/2017 P 2.8 1 1 WINDI syaputra - - Purbauli - - 9/20/2019 13.6
60008 70001
12080103091 12080158051 Adelia Siallagan Radesman
129 1 9/25/2014 P 3.2 1 1 - - Purbauli - - 9/20/2019 16.9
60001 60001 Siallagan
130 11/14/2018 P - - Gisel Mnalu 3 1 1 Rinto - - Purbauli - - 9/20/2019 14.2
12080110031 12080164111 Cinta Mario Rudi 120801110474000
131 3 11/4/2015 P 2.8 1 1 - Purbauli - - 9/20/2019 15.2
00008 50001 Simanjuntak Simanjuntak 3
12080113040 12080125091 Efrain Sianturi 120801190484000
132 4 9/25/2015 L 2.7 1 1 Sahat Sianturi - Muliatani - - 9/22/2019 13.6
80180 60001 2
12080114081 12080144101 Yepani Sinaga 120801190484000
133 2 10/4/2015 P 2.6 1 1 Pahala Sinaga - Muliatani - - 9/22/2019 15.6
40009 50001 2
12080114081 120801190484000
134 2 5/8/2017 L - Natanael Sinaga 2.8 1 1 Pahala Sinaga - Muliatani - - 9/22/2019 13.8
40009 2
12080124411 12080156031 Tabita Toni 120304220583000
135 3 3/16/2015 P 3 1 1 - Muliatani - - 9/22/2019 14.9
70005 40003 Simanungkalit Simanungkalit 1
136 2 10/13/2014 L -' - Kristian Napitu 2.5 1 1 wardo napitu - - Muliatani - - 9/22/2019 16.6
Sianggaria Johan
137 2 10/1/2014 P - - 2.7 1 1 - - Muliatani - - 9/22/2019 16.9
Simangungsong Simangungsong
138 1 11/15/2014 P - -' Gabriel Manik 2.9 1 1 Delma Manik - - Muliatani - - 9/22/2019 16.6
139 2 9/18/2015 P - - Yohana Manik 3 1 1 Delma Manik - - Muliatani - - 9/22/2019 15.8
Fransiskus
140 1 4/16/2015 L - - 3.3 1 1 Gindo napitu - - Muliatani - - 9/22/2019 15.6
Napitu
12080120020 12080124061 Martinus Silalahi 120801070279000
141 1 9/24/2014 L 3.2 1 1 Brader Silalahi - Muliatani - - 9/22/2019 18
80175 40002 1
12080120020 12080160111 Tisa Silalahi 120801070279000
142 2 12/20/2017 P 2.5 1 1 Brader Silalahi - Muliatani - - 9/22/2019 13
80175 70001 1
Kristian
143 2 11/7/2014 L - - 2.9 1 1 Judika Sidabutar - - Muliatani - - 9/22/2019 18
Sidabutar
12080107021 12080156091 Rebeca Sirait 127114230576000
144 2 9/26/2014 P 2.8 1 1 Adil Sirait - Muliatani - - 9/22/2019 18.4
80001 40006 3
12080107021 12080123021 Jordan Sirait 127114230576000
145 3 2/23/2016 L 3.2 1 1 Adil Sirait - Muliatani - - 9/22/2019 18.9
80001 60002 3
12080107021 12080153091 Natania Sirait 127114230576000
146 4 9/13/2017 P 2.9 1 1 Adil Sirait - Muliatani - - 9/22/2019 12.1
80001 70002 3
12080116031 12080149051 Noela Sibarani
147 4 10/9/2014 P 3 1 1 Juniwar Sibarani 127201090674000 - Muliatani - - 9/22/2019 19.5
10008 40002 4
12080108021 12720118081 Adriani Wira
148 1 11/18/2014 L 3.3 1 1 Gordon Manik 15022703820001 - Muliatani - - 9/22/2019 16.7
70027 40001 Manik
12080108031 12080117111 Fincen Sidabutar
149 1 11/17/2014 L 3 1 1 Dedi Sidabutar 120801020986000 - Muliatani - - 9/22/2019 16.4
20009 40001 4
12080108031 12080118091 Digibrani
150 2 9/18/2017 P 3.2 1 1 Dedi Sidabutar 120801020986000 - Muliatani - - 9/22/2019 10.5
20009 70001 Sidabutar 4
12080123121 12080159101 Grace Silalahi 120801060686000
151 1 10/9/2014 P 3.3 1 1 Roni Silalahi - Muliatani - - 9/22/2019 16.5
30003 40002 2
12080120020 12080107011 Arjuna Siallagan
152 2 11/7/2014 L 3.1 1 1 Guiner Siallagan 120801220183000 - Muliatani - - 9/22/2019 16.4
80032 40002 1
12080111120 12080158011 Dewi Siadari
153 3 10/18/2014 P 3.2 1 1 Rejeki Ruandus 120801270676000 - Muliatani - - 9/22/2019 16.6
90002 40001 3
12080113031 12080130031 Sri Anugrah
154 2 3/10/2015 P 3.5 1 1 Alam Silalahi 120801260470007 - Muliatani - - 9/22/2019 15.8
20003 50001 Silalahi
155 2 10/5/2014 P - - Kalista Febiola 2.8 1 1 Agus R.Horbo - - Muliatani - - 9/22/2019 16.2
156 1 11/3/2014 P - - Geovani Siagian 3 1 1 Benni Siagian - - Muliatani - - 9/22/2019 16.1
157 1 11/13/2014 P - - Yuda Lubis 3.8 1 1 Davit Lubis - - Muliatani - - 9/22/2019 16
Bastian
158 1 3/6/2016 L - - 3.2 1 1 Sartua Samosir - - Muliatani - - 9/22/2019 14.4
Simorangkir
Elisabet
159 2 11/23/2015 P - - 3 1 1 Juna Sidabutar - - Muliatani - - 9/22/2019 15.6
Sidabutar
160 1 9/1/2015 L - - Beni Hasibuan 3.3 1 1 Rafael Hasibuan - - Muliatani - - 9/22/2019 15.8
161 2 8/16/2015 P - - Denta Siallagan Saugi Siallagan 120801050574000 - Muliatani

4 1 1 - - 9/22/2019 15.6
1
Ruben Fommbo
162 1 7/25/2015 L - - 3.8 1 1 - - Muliatani - - 9/22/2019 15
Simanjuntak Simanjuntak
Masran
163 2 7/25/2015 P - - Tiara Sihombung 3.4 1 1 - - Muliatani - - 9/22/2019 15.2
Sihombing
164 2 11/11/2015 P - - Waito Siagian 3.5 1 1 Jakson Siagian - - Muliatani - - 9/22/2019 15
165 1 11/11/2015 L - - Geovani Siregar 3.3 1 1 handra siregar - - Muliatani - - 9/22/2019 15.3
166 1 4/4/2015 P - - Regina Turnip Sintong Turnip 120801110887000 - Muliatani

4 1 1 - - 9/22/2019 15
2
167 2 10/23/2018 L - - Ucok Turnip Sintong Turnip 120801110887000 - Muliatani

4.3 1 1 - - 9/22/2019 11.8
2
168 2 5/9/2015 L - - Bragio Siagian 3.5 1 1 Resdi - - Muliatani - - 9/22/2019 14.9
Warisman
169 3 9/13/2015 L - - Alfares Jendrato 3.5 1 1 - - Muliatani - - 9/22/2019 15
Jendrato
170 2 8/6/2015 P - - Novel Siregar 4 1 1 Malen Siregar - - Muliatani - - 9/22/2019 15.2
12080116091 Poltak
171 3 9/13/2017 L - Ucok Manurung 3.5 1 1 - - Muliatani - - 9/22/2019 13
10009 Manurung
12080103021 Junias
172 2 5/26/2018 L - Ucok Situmeang 3.7 1 1 - - Muliatani - - 9/22/2019 11
20009 Situmeang
12080123111 Natan Joi
173 5 3/19/2016 L - 3.5 1 1 Welki Manurung - - Muliatani - - 9/22/2019 13.8
70002 Manurung
14050205021
174 2 2/14/2017 P - Angel 3 1 1 Saciko Hinokio - - Muliatani - - 9/22/2019 12.3
60004
12080119091 IrenIvayola
175 1 3/29/2017 p - 3 1 1 Indra Tambunan - - Muliatani - - 9/22/2019 12.4
60007 Tambunan
176 4 9/27/2016 P - - Sri aglena 3.1 1 1 Abdi R.Horbo - - Muliatani - - 9/22/2019 14
12080127071 12080105051 Danu Arta
177 2 5/5/2017 L 3 1 1 Dalenta Napitu - - Muliatani - - 9/22/2019 13.5
10002 72001 Napitu
12080120041 12080118021 Daren Arjuna
178 2 2/18/2015 L 3.2 1 1 Sahat Sagala - - Muliatani - - 9/22/2019 15.8
20007 52001 Sagala
179 1 06-10-2016 P - - Jesika 3 1 1 Pinem - - Muliatani - - 9/22/2019 15.5
12080123121 12080142051 Olivia Silalahi
180 3 5/2/2017 P 3.2 1 1 Roni Silalahi - - Muliatani - - 9/22/2019 12.5
30003 70001
12080121321 Vivi Carlisa
181 4 11/12/2018 P - 2.8 1 1 Roni Silalahi - - Muliatani - - 9/22/2019 10.6
30003 Silalahi
12080114061 Arjuna Alm Jecson Op
182 3 1/12/2017 L - 2.9 1 1 - - Muliatani - - 9/22/2019 12.4
20001 Op.sungguh Sungguh
12080114061 12080164011 Laura Manurung Holmes
183 4 1/24/2016 P 3 1 1 - - Muliatani - - 9/22/2019 13.8
20001 60002 Manurung
12080120091 12080155081 Sinar Situmeang Duffre
184 2 8/15/2015 P 2.8 1 1 - - Muliatani - - 9/22/2019 14.2
70009 50001 Situmeang
12080120091 12080158051 Rapanda Duffre
185 3 5/18/2017 P 3.2 1 1 - - Muliatani - - 9/22/2019 12.5
70009 70001 Situmeang Situmeang
12080113031 12080130031 Sri anugrah Alam Marihot
186 4 3/30/2015 P 3 1 1 - - Muliatani - - 9/22/2019 14.2
20003 50001 Silalahi Silalahi
Paniel Lamhot
187 2 2/17/2015 L - - Hamonangan 3.2 1 1 - - Muliatani - - 9/22/2019 14.3
Hamonangan
Manurung
Andreas
188 1 3/25/2016 L - - 2.9 1 1 ucok Situmeang - - Muliatani - - 9/22/2019 13.7
Hutagalung
Lumita petrus
189 2 6/12/2015 P - - 3 1 1 - - Muliatani - - 9/22/2019 14
Situmeang Situmeanf
Belecia
190 1 10/12/2014 P - - 3.2 1 1 Rudi Sidabutar - - Muliatani - - 9/22/2019 16.6
Sidabutar
Luis Kristian
191 1 9/30/2014 P - - 3 1 1 Hansen Silalahi - - Muliatani - - 9/22/2019 16.8
Silalahi
192 1 8/6/2016 P - - Felina Tanjung 3.1 1 1 Ando Sihombig - - Muliatani - - 9/22/2019 15.3
193 1 10/9/2014 p - Vania Sihombing 3 1 1 Alwi Hasibuan - - Muliatani - - 9/22/2019 16.5
Benektus
194 1 9/8/2016 L - - 2.8 1 1 Alwi Hasibuan - - Muliatani - - 9/22/2019 14
Hasibuan
Pandapotan Parlindungan
195 2 8/18/2016 L - - 3.2 1 1 - - Muliatani - - 9/22/2019 14.2
Tambunan Tambunan
Rehan Tumpak Rumah
196 1 8/10/2015 L - - 3.5 1 1 - - Muliatani - - 9/22/2019 15.6
Rumahorbo Horbo
jupri
197 1 10/4/2014 L - - Roy Simanjuntak 3.5 1 1 - - Muliatani - - 9/22/2019 16.2
Simanjuntak
198 1 9/25/2014 L - - Gabriel Haloho 3.4 1 1 Johanes Haloho - - Muliatani - - 9/22/2019 16.5
199 1 4/7/2016 P - - Zaskia Gultom 3 1 1 Richat Gultom - - Muliatani - - 9/22/2019 15.6
Zepanya Riki
200 1 6/27/2014 P - - 3.5 1 1 - - Muliatani - - 9/22/2019 15.8
Simanungkalit Simanungkalit
201 2 8/30/2014 L - - Yohanes turnip 3.2 1 1 Ronald Turnip - - Muliatani - - 9/22/2019 14.6
202 1 9/26/2014 L - - Joel Simarmata Candra - - Muliatani

2.9 1 1 - - 9/22/2019 15.6
Simarmata
203 1 10/17/2014 P - - Femil Simarmata Candra - - Muliatani

2.8 1 1 - - 9/22/2019 16
Simarmata
204 2 10/23/2014 P - - Ranti Siagian 21 1 1 Parlin Siagian - - Muliatani - - 9/22/2019 16
205 2 9/26/2014 L - - Abraham Napitu 3.5 1 1 Surya Napitu - - Muliatani - - 9/22/2019 16.4
206 1 9/23/2014 L - - Luwis Napitu 3.5 1 1 Hendi Napitu - - Muliatani - - 9/22/2019 16.6
207 2 1/28/2016 L - - Ronauli Siagian 4 1 1 firman Siagian - - Cinta Maju - - 9/22/2019 14.6
208 1 3/7/2018 L - - Melpin Tanjung 3.5 1 1 Eko Tanjung - - Muliatani - - 9/22/2019 11.8
209 2 7/18/2018 L - - Fabion nesta 2.6 1 1 Freddi - - Muliatani - - 9/22/2019 11.8
Darisa Albert
210 3 9/16/2018 L - - 3.4 1 1 - - Muliatani - - 9/22/2019 10.6
Nainggolan Nainggolan
Rohan
211 1 8/10/2015 L - - 2 1 1 pendi Manurung - - Muliatani - - 9/22/2019 15.2
Manurung
212 2 9/13/2016 P - - Ester Siregar 2.7 1 1 Agus Siregar - - Muliatani - - 9/22/2019 12.9
213 2 4/8/2015 P - - Alifah Manurung 4 1 1 pindo Manurung - - Muliatani - - 9/22/2019 15.4
214 1 3/15/2017 L - - Bezalel Manik 2.7 1 1 Simon Manik - - Muliatani - - 9/22/2019 12.6
215 1 10/8/2014 P - - Wilda 2.9 1 1 Trianto - - Muliatani - - 9/22/2019 18.6
216 2 8/5/2015 P - - Erlince Pasaribu 3'0 1 1 Carles Pasaribu - - Muliatani - - 9/22/2019 14.6
217 1 7/16/2015 p - - Debora R.horbo 3.3 1 1 Harlen R.horbo - - Muliatani - - 9/22/2019 15.7
Keterangan
UMBUHAN DAN PERKEMBANGAN BALITA DI POSYANDU
NG MARIHAT, BONA-BONA, MULIA TANI, KAMPUNG PARDAMEAN
Panjang ASI Eksklusif 1=Ya 2=Tidak Perkembangan

Badan/Ti Cara Ukur Vitamin A Vitamin A
1=Terlent Februari Agustus
nggi ang 1=Ya 1=Ya
Badan 2=Berdiri 2=Tidak 2=Tidak
(20) (21) (21) (22) (23) (24) (25) (26) (27) (28) (29) (30) (31)
104 1 1 DS S SL
2 1 1 1 1 1 1
50 - - DS S SL
1 1 1 - - - -
51 - - DS S SL
1 1 1 - - - -
50 - - DS S SL
1 1 1 - - - -
50 - - DS S SL
1 1 1 1 - - -
49 - - DS S SL
1 1 1 1 1 - -
98 1 1 DS S SL
2 1 1 1 1 1 1
107 1 1 DS S SL
2 1 1 1 1 1 1
100 1 1 DS S SL
2 1 1 1 1 1 1
106 1 1 DS S SL
2 1 1 1 1 1 1
104 1 1 DS S SL
2 1 1 1 1 1 1
104 1 1 DS S SL
2 1 1 1 1 1 1
104 1 1 DS S SL
2 1 1 1 1 1 1
103 1 1 DS S SL
2 1 1 1 1 1 1
102 1 1 DS S SL
2 1 1 1 1 1 1
102 1 1 DS S SL
2 1 1 1 1 1 1
102 1 1 DS S SL
2 1 1 1 1 1 1
101 1 1 DS S SL
2 1 1 1 1 1 1
102 1 1 DS S SL
2 1 1 1 1 1 1
103 1 1 DS S SL
2 1 1 1 1 1 1
101 1 11 DS S SL
2 1 1 1 1 1 1
88 1 1 DS S SL
2 1 1 1 1 1 1
98 1 1 DS S SL
2 1 1 1 1 1 1
89 1 1 DS S SL
2 1 1 1 1 1 1
89 1 1 DS S SL
2 1 1 1 1 1 1
88 1 1 DS S SL
2 1 1 1 1 1 1
76 1 1 DS S SL
1 1 1 1 1 1 1
58 - 1 DS S SL
1 1 1 1 - - -
98 1 1 DS S SL
2 1 1 1 1 1 1
53 - - DS S SL
1 1 1 - - - -
104 1 1 DS S SL
2 1 1 1 1 1 1
104 1 1 DS S SL
2 1 1 1 1 1 1
55 1 1 DS S SL
2 1 1 1 1 1 1
105 1 1 DS S SL
2 1 1 1 1 1 1
104 1 1 DS S SL
2 1 1 1 1 1 1
75 1 1 DS S SL
1 1 1 1 1 1 1
93 1 1 DS S SL
2 1 1 1 1 1 1
55 2 1 1 1 - - - - - DS S SL
88 1 1 DS S SL
2 1 1 1 1 1 1
56 - 1 DS S SL
2 1 1 1 - - -
70 1 1 DS S SL
2 1 1 1 1 1 1
104 1 1 DS S SL
2 1 1 1 1 1 1
103 1 1 DS S SL
2 1 1 1 1 1 1
83 2 1 1 1 1 1 1 1 1 DS S SL
104 1 1 DS S SL
2 1 1 1 1 1 1
100 2 1 1 1 1 1 1 1 1 DS S SL
80 1 1 DS S SL
2 1 1 1 1 1 1
103 1 1 DS S SL
2 1 1 1 1 1 1
98 1 1 DS S SL
2 1 1 1 1 1 1
100 1 1 DS S SL
2 1 1 1 1 1 1
93 1 1 DS S SL
2 1 1 1 1 1 1
102 1 1 DS S SL
2 1 1 1 1 1 1
90 1 1 DS S SL
2 1 1 1 1 1 1
99 1 1 DS S SL
2 1 1 1 1 1 1
102 1 1 DS S SL
2 1 1 1 1 1 1
103 1 1 DS S SL
2 1 1 1 1 1 1
102 1 1 DS S SL
2 1 1 1 1 1 1
103 1 1 DS S SL
2 1 1 1 1 1 1
87 1 1 DS S SL
2 1 1 1 1 1 1
103 1 1 DS S SL
2 1 1 1 1 1 1
99 1 1 DS S SL
2 1 1 1 1 1 1
88 1 1 DS S SL
2 1 1 1 1 1 1
101 1 1 DS S SL
2 1 1 1 1 1 1
68 1 1 DS S SL
2 1 1 1 1 1 1
68 1 1 DS S SL
1 1 1 1 1 1 1
100 1 1 DS S SL
2 1 1 1 1 1 1
93 1 1 DS S SL
2 1 1 1 1 1 1
104 1 1 DS S SL
2 1 1 1 1 1 1
98 1 1 DS S SL
2 1 1 1 1 1 1
95 1 1 DS S SL
2 1 1 1 1 1 1
97 1 1 DS S SL
2 1 1 1 1 1 1
98 1 1 DS S SL
2 1 1 1 1 1 1
86 1 1 DS S SL
2 1 1 1 1 1 1
90 1 1 DS S SL
2 1 1 1 1 1 1
104 1 1 DS S SL
2 1 1 1 1 1 1
50 - 1 DS S SL
2 1 1 1 - - -
104 1 1 DS S SL
2 1 1 1 1 1 1
87 1 1 DS S SL
2 1 1 1 1 1 1
86 1 1 DS S SL
2 1 1 1 1 1 1
104 1 1 DS S SL
2 1 1 1 1 1 1
62.1 - - DS S SL
2 1 1 1 1 1 -
57.9 2 1 1 - - - - - - DS S SL
88 1 1 DS S SL
2 1 1 1 1 1 1
68 1 1 DS S SL
1 1 1 1 1 1 1
104 1 1 DS S SL
1 1 1 1 1 1 1
105 1 1 DS S SL
2 1 1 1 1 1 1
102 1 1 DS S SL
2 1 1 1 1 1 1
103 1 1 DS S SL
2 1 1 1 1 1 1
103 1 1 DS S SL
2 1 1 1 1 1 1
103 2 1 1 DS S SL
1 1 1 1 1 1
104 2 1 1 DS S SL
1 1 1 1 1 1
100 2 1 1 DS S SL
1 1 1 1 1 1
80 2 1 1 DS S SL
1 1 1 1 1 1
102 2 1 1 1 1 1 1 1 1 DS S SL
104 2 1 1 DS S SL
1 1 1 1 1 1
104 2 1 1 1 1 1 1 1 1 DS S SL
105 2 1 1 DS S SL
1 1 1 1 1 1
104 2 1 1 DS S SL
1 1 1 1 1 1
99 2 1 1 DS S SL
1 1 1 1 1 1
99 2 1 1 DS S SL
1 1 1 1 1 1
97 2 1 1 1 1 1 1 1 1 DS S SL
100 2 1 1 DS S SL
1 1 1 1 1 1
98 2 1 1 DS S SL
1 1 1 1 1 1
88 2 1 1 DS S SL
1 1 1 1 1 1
96 2 1 1 DS S SL
1 1 1 1 1 1
95 2 1 1 DS S SL
1 1 1 1 1 1
93 2 1 1 DS S SL
1 1 1 1 1 1
95 2 1 1 DS S SL
1 1 1 1 1 1
98 2 1 1 1 1 1 1 1 1 DS S SL
86 2 1 1 DS S SL
1 1 1 1 1 1
85 2 1 1 DS S SL
1 1 1 1 1 1
103 2 1 1 DS S SL
1 1 1 1 1 1
86 2 1 1 DS S SL
1 1 1 1 1 1
78 2 1 1 1 1 1 1 1 1 DS S SL
80 2 1 1 DS S SL
1 1 1 1 1 1
82 2 1 1 1 1 1 1 1 1 DS S SL
80 2 1 1 DS S SL
1 1 1 1 1 1
79 2 1 1 1 1 1 1 1 1 DS S SL
78 2 1 1 1 1 1 1 1 1 DS S SL
85 2 1 1 DS S SL
1 1 1 1 1 1
87 2 1 1 DS S SL
1 1 1 1 1 1
104 2 1 1 DS S SL
1 1 1 1 1 1
78 2 1 1 DS S SL
1 1 1 1 1 1
102 2 1 1 DS S SL
1 1 1 1 1 1
80 2 1 1 DS S SL
1 1 1 1 1 1
104 2 1 1 DS S SL
1 1 1 1 1 1
101 2 1 1 DS S SL
1 1 1 1 1 1
99 2 1 1 DS S SL
1 1 1 1 1 1
102 2 1 1 DS S SL
1 1 1 1 1 1
98 2 1 1 1 1 1 1 1 1 DS S SL
102 2 1 1 DS S SL
1 1 1 1 1 1
93 2 1 1 DS S SL
1 1 1 1 1 1
99 2 1 1 DS S SL
1 1 1 1 1 1
86 2 1 1 DS S SL
1 1 1 1 1 1
100 2 1 1 DS S SL
1 1 1 1 1 1
103 2 1 1 1 1 1 1 1 1 DS S SL
103 2 1 1 DS S SL
1 1 1 1 1 1
102 2 1 1 1 1 1 1 1 1 DS S SL
98 2 1 1 1 1 1 1 1 1 DS S SL
103 2 1 1 DS S SL
1 1 1 1 1 1
104 2 1 1 DS S SL
1 1 1 1 1 1
88 2 1 1 DS S SL
1 1 1 1 1 1
104 2 1 1 DS S SL
1 1 1 1 1 1
103 2 1 1 DS S SL
1 1 1 1 1 1
104 2 1 1 DS S SL
1 1 1 1 1 1
86 2 1 1 DS S SL
1 1 1 1 1 1
19.4 2 1 1 DS S SL
1 1 1 1 1 1
103 2 1 1 DS S SL
1 1 1 1 1 1
104 2 1 1 DS S SL
1 1 1 1 1 1
75 2 1 1 DM S SL
1 1 1 1 1 1
104 2 1 1 DS S SL
1 1 1 1 1 1
103 2 1 1 DS S SL
1 1 1 1 1 1
103 2 1 1 DS S SL
1 1 1 1 1 1
102 2 1 1 DS S SL
1 1 1 1 1 1
102 2 1 1 1 1 1 1 1 1 DS S SL
103 2 1 1 DS S SL
1 1 1 1 1 1
101 2 1 1 1 1 1 1 1 1 DS S SL
98 2 1 1 DS S SL
1 1 1 1 1 1
99 2 1 1 DS S SL
1 1 1 1 1 1
100 2 1 1 DS S SL
1 1 1 1 1 1
98 2 1 1 DS S SL
1 1 1 1 1 1
98 2 1 1 DS S SL
1 1 1 1 1 1
99 2 1 1 DS S SL
1 1 1 1 1 1
96 2 1 1 1 1 1 1 1 1 DS S SL
101 2 1 1 DS S SL
1 1 1 1 1 1
100 2 1 1 DS S SL
1 1 1 1 1 1
80 2 1 1 DM S SL
1 1 1 1 1 1
100 2 1 1 1 1 1 1 1 1 DS S SL
98 2 1 1 DS S SL
1 1 1 1 1 1
99 2 1 1 1 1 1 1 1 1 DS S SL
90 2 1 1 DS S SL
1 1 1 1 1 1
80 2 1 1 DS S SL
1 1 1 1 1 1
94 2 1 1 DS S SL
1 1 1 1 1 1
88 2 1 1 DS S SL
1 1 1 1 1 1
88 2 1 1 DS S SL
1 1 1 1 1 1
96 2 1 1 1 1 1 1 1 1 DS S SL
90 2 1 1 DS S SL
1 1 1 1 1 1
102 2 1 1 DS S SL
1 1 1 1 1 1
101 2 1 1 1 1 1 1 1 1 DS S SL
86 2 1 1 DS S SL
1 1 1 1 1 1
78 2 1 1 DS S SL
1 1 1 1 1 1
89 2 1 1 DS S SL
1 1 1 1 1 1
90 2 1 1 DS S SL
1 1 1 1 1 1
98 2 1 1 DS S SL
1 1 1 1 1 1
88 2 1 1 DS S SL
1 1 1 1 1 1
99 2 1 1 DS S SL
1 1 1 1 1 1
100 2 1 1 DS S SL
1 1 1 1 1 1
97 2 1 1 DS S SL
1 1 1 1 1 1
101 2 1 1 DS S SL
1 1 1 1 1 1
102 2 1 1 DS S SL
1 1 1 1 1 1
103 2 1 1 DS S SL
1 1 1 1 1 1
100 2 1 1 DS S SL
1 1 1 1 1 1
102 2 1 1 DS S SL
1 1 1 1 1 1
99 2 1 1 DS S SL
1 1 1 1 1 1
100 2 1 1 DS S SL
1 1 1 1 1 1
103 2 1 1 DS S SL
1 1 1 1 1 1
103 2 1 1 DS S SL
1 1 1 1 1 1
102 2 1 1 DS S SL
1 1 1 1 1 1
102 2 1 1 1 1 1 1 1 1 DS S SL
104 2 1 1 DS S SL
1 1 1 1 1 1
103 2 1 1 DS S SL
1 1 1 1 1 1
102 2 1 1 DS S SL
1 1 1 1 1 1
102 2 1 1 DS S SL
1 1 1 1 1 1
103 2 1 1 1 1 1 1 1 1 DS S SL
102 2 1 1 DS S SL
1 1 1 1 1 1
102 2 1 1 1 1 1 1 1 1 DS S SL
99 2 1 1 DS S SL
1 1 1 1 1 1
68 2 1 1 DS S SL
1 1 1 1 1 1
79 2 1 1 1 1 1 1 1 1 DS S SL
79 2 1 1 DS S SL
1 1 1 1 1 1
99 2 1 1 DS S SL
1 1 1 1 1 1
89 2 1 1 1 1 1 1 1 1 DS S SL
100 2 1 1 DS S SL
1 1 1 1 1 1
86 2 1 1 1 1 1 1 1 1 DS S SL
103 2 1 1 1 1 1 1 1 1 DS S SL
99 2 1 1 DS S SL
1 1 1 1 1 1
103 2 1 1 1 1 1 1 1 1 DS S SL
Provinsi : SUMATERA UTARA Nama Posyandu : SIMPANG MARIHAT, BONA-BONA, MULIA TANI,
Desa/Kelurahan : DOLOK MARLAWAN
Berat
No Kehamilan Tanggal Lahir No Kartu NIK ( Nomor Induk Nama Ibu Hamil Badan Awal Kepemilikan Nama NIK Suami Alamat RT RW Tanggal Berat
Ke Keluarga Kependudukan) hamil/Trise Buku KIA Suami Pengukuran Badan (kg)
mester I
(1) (2) (3) (4) (5) (6) (7) (8) (9) (10) (11) (12) (13) (14) (15)
1 2 9/8/1982 - - Restina Siregar 57 ya Andi - ht IV Muliatani - - 9/22/2019 66
2 3 4/12/1990 - - Restina sihombing 53 ya Ronald - ht III Purbauli - - 9/20/2019 60
3
4
5
6
7
8
9
10
Keterangan
ENCATATAN PEMANTAUAN IBU HAMIL
: SIMPANG MARIHAT, BONA-BONA, MULIA TANI, KAMPUNG PARDAMEAN
TTD
Badan Lengan Tambah butir TTD butir TTD
Darah) diterima diminum
(cm) Atas (LILA) 1=Ya,2=T
idak
(16) (17) (18) (19) (20)

160 25 1 90 90
153 24.5 1 90 60
Provinsi : Sumatera Utara Nama Posyandu : Sidorejo, Jeruk, Jambu

Kabupaten : Simalungun Bulan : Agustus
Puskesmas/Kecamatan : Batu Anam / Siantar Tahun : 2019
Desa/Kelurahan : Sitalasari
Berat Kepem
Kehamila Tanggal Lahir NIK ( Nomor Induk Badan Awal ilikan
No No Kartu Keluarga Nama Ibu Hamil Nama Suami NIK Suami Alamat RT RW
n Ke Kependudukan) hamil/Trise Buku
mester I KIA
(1) (2) (3) (4) (5) (6) (7) (8) (9) (10) (11) (12) (13)
1 3 9/1/1985 1208012211120001 1272034109850001 Rorika Siagian 62 1 Praipon Mulatua Siregar 1208051503810001 Jl. Kedongdong IV
2 2 9/10/1981 1208010903100016 1208016803810003 Pondang Rostina Nainggolan 65 1 Holmen Silalahi 1208011504110001 Jl. Sawu III
3 1 6/30/1988 1208017008860003 Kusuma Dewi 58 1 Daniel W. A. Manullang 1208010504820008 Jl. Jambu
4 3 8/17/1994 1208012901180006 1218115706940002 Fina wahuni Zega 55 1 Lilis Suheri 1208013101910003 Jl. Sawo IV
5 4 12/25/1986 1208010412170011 1208016512860001 Rubiah 61 1 Sarlik 1208010503810003 Jl. Nusa Indah
6 2 6/28/1989 1208011208160004 1208016806890002 Dini Anggreini 58 1 Budi Syahputra 1208012807810002 Jl. Akasia Raya
Keterangan
- Kolom 10 :Jika suami tidak ada, isikan NIK orang tua
: Sidorejo, Jeruk, Jambu
: Agustus
TTD
(Tablet
Berat Tinggi Lingkar Tambah Jika Ya,brp Jika Ya,brp
Tanggal Badan Badan Lengan Darah) butir TTD butir TTD
Pengukuran (kg) (cm) Atas (LILA) 1=Ya,2=T diterima diminum
idak
(14) (15) (16) (17) (18) (19) (20)

8/8/2019 64 156 24.2 1 90 90
8/8/2019 67 153 25 1 90 90
8/8/2019 60 155 24.5 1 90 90
8/8/2019 57.5 156 24.3 1 90 90
8/8/2019 64 159 25.3 1 90 90
8/8/2019 61 155 25.5 1 90 90

FORMULIR PENCATATAN PEMANTAUAN PERTUMBUHAN DAN PERKEMBANGAN BALITA
Provinsi : Sumatera Utara Nama Posyandu : Sidorejo, Jeruk, Jambu

Puskesmas/Kecamatan : Batu Anam / Siantar Tahun : 2019
Desa/Kelurahan : Sitalasari
Kepemilik IMD
Berat
Jenis an Buku 1=Ya No
Anak Tanggal Kelami No Kartu Keluarga Nomor Induk Badan
No Nama Anak KIA/KMS 2=Tida Nama Ayah NIK Ayah Telp/H Alamat
Ke Lahir (KK) Kependudukan (NIK) Lahir
n 1=Ya P Ayah
(gram) k
2=Tidak
(1) (2) (3) (4) (5) (6) (7) (8) (9) (10) (11) (12) (13) (15)
1 2 01/09/2017 L 6471061602170013 6471060107170001 Simon Julia Yandra Saragih 3 1 1 Doly Anwan Saragih 1208010602760001 Jl. Semangka
2 1 25/01/2015 L 1208012901180006 1208012501150003 Rayhan Azhar Sebastian 3 1 1 Lili Suhery 1208013101910003 Jl. Semangka
3 2 01/05/2017 P 1208012901180006 1208014105170001 Alifah Askadinah 3 1 1 Lili Suhery 1208013101910003 Jl. Semangka
4 3 12/29/2014 L 1208012502080010 1208012912140004 Gibran Alfatih 3.2 1 1 Setiawan Harahap 1208011208810001 Jl. Semangka
5 1 10/20/2014 P 1208011111110012 1208016007140003 Juliah Zefaniah Purba 2.9 1 1 Virgo Erlando Purba 1208011409720003 Jl. Semangka
6 2 3/14/2018 P 1208011111110012 1208015403180001 Elizah Yohana Purba 3 1 1 Virgo Erlando Purba 1208011409720003 Jl. Semangka
7 4 10/13/2014 L 1208010804110001 1208011304130002 Muhammad Syafiq 3.1 1 1 Zulkifli Harahap 1208011804720004 Jl. Semangka
8 5 2/3/2018 P 1208010804110001 1208014302180001 Airah Syafah Nafezah Harahap 2.9 1 1 Zulkifli Harahap 1208011804720004 Jl. Semangka
9 1 4/23/2019 L 1272032407180010 1272032304190001 Faeyza Naratama 3 1 1 Indra Maulana 1272031810920001 Jl. Semangka
10 2 1/16/2015 L 1208010405110004 1208015601150001 Raisyah Yasmin Harahap 3.2 1 1 Muhammad Syukur Harahap 1208011409800007 Jl. Semangka
11 3 7/5/2018 P 1208010405110004 1208014507160001 Inarah Talita Harahap 3 1 1 Muhammad Syukur Harahap 1208011409800007 Jl. Semangka
12 2 10/12/2014 L 1208010504100003 1208016209120001 Zulfah Syahtuada Purba 3.1 1 1 Budi Tuahdi Purba 1208012404780003 Jl. Semangka
13 3 7/16/2016 L 1208010504100003 1208011607140001 Arif Ramadhan Purba 3.2 1 1 Budi Tuahdi Purba 1208012404780003 Jl. Semangka
14 1 10/29/2014 P 1208010410170010 1208016809130002 Vaniah Karissa Ambarita 3 1 1 Manotar Ambarita 1208060711800004 Jl. Mahoni Raya
15 2 6/14/2017 L 1208010410170010 1208011406170003 Boni Martua Ambarita 3.1 1 1 Manotar Ambarita 1208060711800004 Jl. Mahoni Raya
16 1 4/30/2018 P Ayu Wadirah 3 1 1 Rita Sidorejo
Kepemilik IMD
Berat
n 1=Ya P Ayah
(gram) k
2=Tidak
17 1 16/01/2017 L 1208011703170006 1208011601170001 Julfi Ardana Lubis 3 1 1 Wahyudi Syaputra Lubis 1208011501950001 Jl. Mesjid
18 3 18/08/2015 P 1208012402080075 1208015808150002 Ainayah Talita Zahra 3.1 1 1 Budi 1208011903850001 Jl. Mesjid
19 1 22/10/2014 P 1208012307140011 1208016209140002 Callista Arsifa Kurniawan 3 1 1 Heri Kurniawan 1208082006910001 Jl. Mesjid
20 2 03/07/2016 P 1208012307140011 1208014307160002 Dwi Arisya Kurniawan 3 1 1 Heri Kurniawan 1208082006910001 Jl. Mesjid
21 3 29/11/2016 L 1208012402080095 1208012911160001 Muhammad Harun 3.2 1 1 Sri Anto 1208011503780002 Huta Sidorejo
22 4 06/11/2016 P 1208012207100003 1208014611160001 Arsyfa Miftahul 3 1 1 Suyarmin 1208010304700002 Huta Sidorejo
23 1 24/04/2017 P 1208011906170005 1208016404170001 Aprilia Thalita Zahra 3 1 1 Ari Aswaja 1208012909940003 Jl. Mesjid
24 2 23/06/2019 P 1208011906170005 1208016305190001 Keisha Nabila Ramadhan 3.1 1 1 Ari Aswaja 1208012909940003 Jl. Mesjid
25 1 21/04/2018 P 1208010207180003 1208016104180001 Syabilla Chalisaturahmi 3 1 1 Handoko 1208013012890002 Huta Sidorejo
26 1 20/05/2016 L 1208012202160001 1208012005160002 Kaka Dedi Onata 3.2 1 1 Dedy Mustafa 1208011907970001 Huta Sidorejo
27 2 04/02/2019 P 1208012202160001 1208014402190001 Zaskia Atika Hasna 3 1 1 Dedy Mustafa 1208011907970001 Huta Sidorejo
28 2 19/04/2018 P 1208010110150003 1208015904182001 Fathya Aulia Nisa 3 1 1 Mandra Herianto 1272031612790005 Huta Sidorejo
29 1 16/10/2014 L 1208010904130004 1208011609140002 Baihaqi Dirgham Wijaya 3.2 1 1 Rudi Hartono 1208112502880007 Huta Sidorejo
30 2 05/06/2019 L 1208010904130004 1208010606190001 Harry Fitra Wijaya 3.1 1 1 Rudi Hartono 1208112502880007 Huta Sidorejo
31 3 21/12/2015 P 1208012601100013 1208016112150001 Afifa Nahda Rafanda 3 1 1 Syuhada 1208012508820002 Huta Sidorejo
32 3 04/02/2016 L 1208012502080137 1208010402160001 Erlangga Febriyansah 3.2 1 1 Swardi 1208010812760002 Jl. Mesjid
33 2 26/10/2014 P 1208012402080069 1208016609140004 Nikki Septia 3 1 1 Prayetno 1208011406760001 Jl. Mesjid
34 3 7/24/2018 P 1208012502080045 1208016407180003 Lubna Askia 3 1 1 Rasman 1208012302820001 Jl. Mesjid
35 2 10/4/2017 P 1208010802170020 1208014410170001 Lashira Raffanda Askadina 3.1 1 1 Taufik Julkifri 1272072508860003 Jl. Akasia Raya
36 1 9/10/2014 L 2171122708080053 2171121005140001 Hans Dominic Brilian Siregar 3.2 1 1 Obet Pramudyo Siregar 2171121210849006 Jl. Sawo III
37 2 12/25/2016 P 2171122708080053 1208016512160001 Hanna Nataline Siregar 3 1 1 Obet Pramudyo Siregar 2171121210849006 Jl. Sawo III
38 2 12/13/2014 L 1208012211120001 1208011312140002 Rade Natanael Siregar 3.1 1 1 Praypon Mula Tua Siregar 1208061503810001 Jl. Kedongdong IV
39 1 11/22/2014 P 1208012509130004 1208016211130001 Leoni Christy Sirait 2.9 1 1 Pebry Andi Sirait 1209202002800002 Jl. Akasia Raya
40 2 8/14/2017 L 1208012509130004 1208011408170001 Gevarel Sirait 3.2 1 1 Pebry Andi Sirait 1209202002800002 Jl. Akasia Raya
41 1 10/19/2017 L 1208010706170002 1208011910170001 Ahmad Alif 3.1 1 1 Sarif Hidayat 1275021009930005 Jl. Akasia Raya
Kepemilik IMD
Berat
n 1=Ya P Ayah
(gram) k
2=Tidak
42 2 6/7/2016 P 1208010304120003 1208014706160001 Navisa Putri Ramadhani 3 1 1 Dimas Prasetya 1208012705910003 Jl. Akasia Raya
43 3 7/11/2016 L 1208012402080105 1208011107160001 Aska Alghifari 3.2 1 1 Mulistio 1208011412810001 Jl. Akasia Raya
44 1 10/23/2014 P 1208011208160004 1208016310111001 Nurul Hidayah 2.9 1 1 Budi Syahputra 1208012807810002 Jl. Akasia Raya
45 1 9/8/2017 L 1208012904190001 1208010809170002 Parel Safiq Mirja 3 1 1 Wandy Saputra 1208011003960003 Huta Sidorejo
46 1 9/19/2017 L 1208011809180001 1208011909170002 Ziyad Althaf Saputra 3.2 1 1 Ilham Saputra 1272030902970001 Huta Sidorejo
47 2 11/12/2015 P 1208012212110014 1208015211150001 Viola Yolanda 2.8 1 1 Suhendra Syah Putra 1208013112870008 Huta Sidorejo
48 2 11/14/2014 L 1208012312110033 1208011411130001 Azka Nur Zikri 3.1 1 1 M. Muklis 1208012403780007 Huta Sidorejo
49 3 10/17/2017 L 1208012312110033 1208011710170002 Abizar Albi Syaif 3 1 1 M. Muklis 1208012403780007 Huta Sidorejo
50 1 11/27/2016 L 1208011305160003 1208012711160001 Azril Faeyza Ryanda 3.2 1 1 Jumendra 1272060505920003 Huta Sidorejo
51 3 10/5/2015 P 1208012502080122 1208014610150001 Fitriyah Hasanah 2.8 1 1 Mesman 1208011908760001 Huta Sidorejo
52 3 10/27/2014 P 1208010209150006 1208016702140004 Nayla Febriana 3 1 1 Kurniawan 1208030504790002 Huta Sidorejo
53 5 10/31/2017 L 1208010209150006 1208013110170002 Bintang Gilang Prasaski 3.2 1 1 Kurniawan 1208030504790002 Huta Sidorejo
54 2 6/10/2015 P 1208012712100003 1208015006150001 Nayla Afika 2.9 1 1 Makmur 1208011012800002 Huta Sidorejo
55 4 10/24/2014 L 1208011111100001 1208012409140004 Muhammad Albi 3.2 1 1 Warsiadi 1208012703700007 Huta Sidorejo
56 2 10/16/2014 P 1208012707120001 1208015609140005 Nasyah Khaira Bakti 3 1 1 Panca Surya Bakti 1208011105890005 Huta Sidorejo
57 3 10/15/2014 L 1208010412170011 1208011502140001 Arsya Tri Aditya 3.2 1 1 Sarlik 1208010503810003 Huta Sidorejo
58 1 14/12/2014 P 1208013007100014 1208014609110001 Ziparah 3.1 1 1 Dedi Rahman 1208010911810002 - Sitalasari
59 2 23/06/2015 P 1208013007100014 1208014312120001 Syahira 3.5 1 1 Dedi Rahman 1208010911810002 - Sitalasari
60 1 03/09/2014 L 1208012707120001 1208012506120001 Raihan Alfino 3.3 1 1 Panca Surya Bhakti 1208011105890005 - Sitalasari
61 2 19/09/2015 P 1208012707120001 Nasya Kahirat 3.1 1 1 Panca Surya Bhakti 1208011105890005 - Sitalasari
62 2 25/01/2015 P 1208010512110012 1208017010110001 Aisyah 3.4 1 1 Syah Budi 1208012712860006 - Sitalasari
63 1 12/10/2014 P 1208012405160003 1208014411140002 Ufairah Nuraffifah 3.5 1 1 Mhd.Arfi 1208012211880002 - Sitalasari
64 2 03/08/2015 L 1208012402080068 1208012007110002 Adam Inesta 3.3 1 1 Sartono 1208010605820007 - Sitalasari
65 3 15/11/2014 P 1208012402080068 1208015405150001 Aqilaelianurah 3.1 1 1 Sartono 1208010605820007 - Sitalasari
66 1 17/05/2014 P 1208012402080091 Zahwa Nurhalfah 3.4 1 1 Jasa Hadinata 1208012109810004 - Sitalasari
Kepemilik IMD
Berat
n 1=Ya P Ayah
(gram) k
2=Tidak
67 3 21/10/2014 P 1208012502080081 1208016805110003 Usnayah Zuraisyah 3.1 1 1 Irwan Nasution 1208010109770001 - Sitalasari
68 3 10/08/2015 P 1208012402080131 1208011310120001 Utiara 3.4 1 1 Siti Ainah 1208016406840001 - Sitalasari
69 1 22/09/2014 L 1208011512100056 1208011507110001 Arya Irfansyah 3.1 1 1 Pija Arfansyah 1208012106870003 - Sitalasari
70 2 12/10/2015 L 1208011512100056 1208011702160001 Yozi 3.4 1 1 Pija Arfansyah 1208012106870003 - Sitalasari
71 2 28/09/2014 L 1208010209150006 1208012605110003 Niki Ardiansyah 3.5 1 1 Kurniawan 1208030504790002 - Sitalasari
72 3 18/11/2015 P 1208010209150006 1208017027160004 Naila Febriana 3.3 1 1 Kurniawan 1208030504790002 - Sitalasari
73 4 21/01/2017 P 1208010209150006 Natasya Putri 3.1 1 1 Kurniawan 1208030504790002 - Sitalasari
74 1 20/04/2015 L 1208011204160001 1208012312150001 Kristan Jay Maulana 3.4 1 1 Debi Maulana 1208012612920001 - Sitalasari
75 1 5/29/2015 L 1208012905140001 1208012905140001 Mestian Aliando Sianturi 3.1 1 1 Rico Sianturi 1208010511860006 - Sitalasari
76 2 9/12/2017 L 1208012905140001 1208011209170004 Mhd. Alfarido Sianturi 3.2 1 1 Rico Sianturi 1208010511860006 - Sitalasari
77 1 2/12/2014 P 1208016409140001 Tata Airasuka 3.4 1 1 Mandra Herianto 1272031612790005 - Sitalasari
78 1 11/29/2014 L 1208012302008509 1208015711080008 Windy Fadillah 3.5 1 1 Suhendri 1208010107860002 - Sitalasari
79 2 4/27/2015 P 1208012302008509 1208014506120002 Kiki Wardani 3.3 1 1 Suhendri 1208010107860002 - Sitalasari
80 3 6/23/2017 P 1208012302008509 1208016604140001 Tia Anggaraini 3.1 1 1 Suhendri 1208010107860002 - Sitalasari
81 2 7/21/2014 P 1208012402080110 1208017005130002 Sarah 3.4 1 1 Rahmat Afandi 1208011709830001 - Sitalasari
82 1 1/18/2015 L 1208011101100001 Alfad Rahadi 3.1 1 1 Sukamto 1208011904850002 - Sitalasari
83 2 12/23/2014 P 1208012403110011 1208014110130001 Mutiara Kansyah 3.1 1 1 Ramadhani 1208010305840007 - Sitalasari
84 2 10/3/2015 L 1208012502080055 1208012509100001 Panji Wardana 3.1 1 1 Nasib 1208010910810001 - Sitalasari
85 3 9/30/2015 P 1208012402080144 1208014203130001 Zahara Auliyah 3.1 1 1 Sunardi 1208010403810001 - Sitalasari
86 1 2/25/2018 P 1208012703150007 1208015712140001 Devani Raya Winata 3.4 1 1 Noviadi Nata 1208010512890005 - Sitalasari
87 1 2/7/2014 P 1208010605110020 1208015002120001 Naila Kansa 3.1 1 1 Tugianto 1208011504740007 - Sitalasari
88 2 12/11/2016 P 1208010605110020 1208016804150002 Queen Apriliya Kansa 3.4 1 1 Tugianto 1208011504740007 - Sitalasari
89 1 4/21/2014 L 1208010712110009 1208012807100004 M. Alif Alakbar Sanjaya 3.5 1 1 Sarji 1208010708720003 - Sitalasari
90 2 1/14/2016 P 1208010712110009 1208014408110001 Unga Anggrek Suci 3.3 1 1 Sarji 1208010708720003 - Sitalasari
91 3 3/15/2017 P 1208012502080122 1208014610150001 Fitriah Hasanah 3.1 1 1 Mesman 1208011808760001 - Sitalasari
Kepemilik IMD
Berat
n 1=Ya P Ayah
(gram) k
2=Tidak
92 1 12/29/2014 P 1208010605110013 1208016308100001 Dina Amalia 3.4 1 1 Badar 1208010811800002 - Sitalasari

93 2 12/7/2016 L 1208010605110013 1208011007140001 Tegar 3.1 1 1 Badar 1208010811800002 - Sitalasari
94 3 4/3/2017 L 1208012703080362 1208015012120001 Wafa Bilkis 3.4 1 1 Mhd.Dahrem Parinduri 1208011811770001 - Sitalasari
95 1 8/20/2015 P 1208012402080154 1208014802050001 Febi Naomi 3.1 1 1 Dolok Siahaan 1208010609760001 - Sitalasari
96 2 7/27/2017 L 1208012402080154 1208010310110003 Mhd. Risky 3.1 1 1 Dolok Siahaan 1208010609760001 - Sitalasari
97 3 10/11/2015 P 1208012402080156 Keysa 3.5 1 1 Sugito 1208010912810001 - Sitalasari
98 4 10/2/2017 P 1208012402080156 Safira Refalina 3.3 1 1 Sugito 1208010912810001 - Sitalasari
99 2 4/4/2015 P Ade Aqila Tania 3.4 1 1 Harlian Kusuma 1208012007890002 - Sitalasari
100 1 5/7/2014 L 1208010304120002 1208012009120002 Abdilah Pratama 3.5 1 1 Abdul Rahman Lubis 1208012208900003 - Sitalasari
101 2 2/20/2018 P 1208010304120002 1208015706140002 Nazuah 3.3 1 1 Abdul Rahman Lubis 1208012208900003 - Sitalasari
102 3 12/11/2014 P 1208012502080183 1208014306010001 Muliyani 3.1 1 1 Ngadiman 1208011105610002 - Sitalasari
103 3 7/24/2017 P 1208012207100008 1208016307100001 Seliyana 3.4 1 1 Ariyanto 1208012202810001 - Sitalasari
104 2 8/28/2014 L 1208010409120007 1208010110110001 Winnatan 3.5 1 1 Ade Gunawan 1208012501820002 - Sitalasari
105 2 11/5/2015 P 1208012712100003 1208015006150001 Naila Afika 3.3 1 1 Makmur 1208011012800002 - Sitalasari
106 4 12/1/2017 P 1208012402080109 1208015404000004 Wina Khairinisa 3.1 1 1 Samiden 1208013112610002 - Sitalasari
107 2 4/23/2015 P 1208010440712007 1208012708130002 Hafiz 3.5 1 1 Junardi 1208011605790001 - Sitalasari
108 1 8/20/2015 P 1208012212110014 1208016701100002 Silvia 3.1 1 1 Suhendra 1208013112870008 - Sitalasari
109 2 7/27/2017 P 1208012212110014 1208015211150001 Viola 3.4 1 1 Suhendra 1208013112870008 - Sitalasari
110 2 3/15/2017 L 1208012402080092 1208011810530002 Syafano 3.5 1 1 Sumanto 1208011311760001 - Sitalasari
111 1 9/7/2017 P 1208012402080121 1208016912130001 Penti Yolanda 3.3 1 1 Pantas Sinaga 1208010407590001 - Sitalasari
112 2 8/5/2015 P 1208012402080073 1208015809150001 Anggita 3.4 1 1 Amin 1208011010820002 - Sitalasari
113 2 3/8/2016 P 1208012801140002 Cahaya Priyanda 3.4 1 1 Yopi Prayetno 1208011610850001 - Sitalasari
114 1 12/1/2015 P 1208012001109022 1208016102100001 Moza Fauziah 3.1 1 1 Wahyu Utomo 1208010505830002 - Sitalasari
115 2 3/20/2016 L 1208012302080513 1208013103110001 Habiburahman 3.1 1 1 Delfian Rambe 1208011706770001 - Sitalasari
116 1 11/3/2014 L 1208012502080045 1208014401110003 Marwah 3.5 1 1 Rasman 1208012302820001 - Sitalasari
Kepemilik IMD
Berat
n 1=Ya P Ayah
(gram) k
2=Tidak
117 2 3/22/2016 P 1208012106100004 1208016510110001 Anisa Kusirin 3.1 1 1 Jaya Indah Sakti 1208010103850006 - Sitalasari
118 2 1/25/2018 P 1208012703080448 1208010509110003 Refa Adithia 3.4 1 1 Suardi 1208010610720002 - Sitalasari
119 2 1/21/2015 P 1208010510150004 1208014202130001 Kasih Pakpahan 3.5 1 1 Binton Pakpahan 1208060608830001 - Sitalasari
120 3 11/9/2016 L 1280801270308673 1208011107110002 Ahmad Alfatana Sitinjak 3.3 1 1 Jekman Sitinjak 1208010909670001 - Sitalasari
121 2 3/13/2016 P 1208010704140004 1208014106110002 Riska 3.1 1 1 Busyira 1208010708750003 - Sitalasari
122 2 1/28/2016 P 1208011405120001 1208015910110002 Syerina 3.4 1 1 Kirana Parlin Lumban 1208012604810008 - Sitalasari
123 3 3/23/2017 L 1280801270308636 1208010402110001 Rapi Arkhan 3.5 1 1 Kamal Bahri Sinaga 1208010308650001 - Sitalasari
124 1 12/16/2015 P 1208010203160001 1208016203160002 Zefanya Rose Sinaga 3.3 1 1 Mangitua Sinaga 12190306082005 - Sitalasari
125 4 3/27/2016 L 1280801200208063 1208012906100005 Rizky M Ilham Parinduri 2.9 1 1 Darmawan Parinduri 1208012310750001 - Sitalasari
126 6 7/27/2017 P 1280801200208063 1208016707172002 Arsy Nazua Parinduri 3 1 1 Darmawan Parinduri 1208012310750001 - Sitalasari
127 1 7/16/2017 P 1208010706120007 1208014311120001 Jelita Hosianna 3.4 1 1 Jendri Manurung 1208010709810003 - Sitalasari
128 1 8/25/2015 L 1208012507120002 1208012107120001 Evan Jon Benedit 3.5 1 1 Tumpal Harianto Sijabat 1208012505800004 - Sitalasari
129 2 7/17/2017 L 1208012507120002 1208012104160001 Aksel Kris Sintong 3.3 1 1 Tumpal Harianto Sijabat 1208012505800004 - Sitalasari
130 1 5/19/2016 P 1208011808150020 1208011401160001 Rehan Siagian 3.1 1 1 Ricky Nopento Siagian 1208012311810003 - Sitalasari
131 1 3/25/2016 P 1208012312110012 1208014408130002 Akila Khairiah 3.3 1 1 Azar Lukman 1208013112810015 - Sitalasari
132 2 2/9/2016 L 1208010711120010 1208011711110002 Raynol Simangunsong 3.3 1 1 Erwin Simangunsong 1208010207780004 - Sitalasari
133 5 4/10/2016 P 1208012703080702 1208015006100001 Fathya Quisty 3.1 1 1 Suyanto 1208012505680003 - Sitalasari
134 2 4/23/2016 P 1208012502080039 1208014107100001 Azrah Salsabilla 3.4 1 1 Rahman Damanik 1208010704800005 - Sitalasari
135 2 4/10/2016 P 1208016909100005 Juwita Saragih 3.5 1 1 Afriandi Saragih 1208011804810001 - Sitalasari
136 2 4/29/2016 P 1208012302080500 1208014108100002 Dea Amelia 3.3 1 1 Pardianto 1208013006900001 - Sitalasari
137 2 6/11/2016 L 1208010605110009 1208011811110001 Lufhfi Albani 3.1 1 1 Sopyan 1208012805780002 - Sitalasari
138 1 3/24/2016 P 1208011812140004 1208014607150001 Ziham 3.4 1 1 Dian Syahputra 1208011703900002 - Sitalasari
139 1 7/12/2015 L 1208011208100001 Jaka 3.3 1 1 Samsiwadi 1208012505800003 - Sitalasari
140 2 6/29/2017 P 1208016201160001 Alisyah Humairah 3.1 1 1 Samsiwadi 1208012505800003 - Sitalasari
141 3 2/17/2014 P 1280801124020818 1208016702030002 Luna Maya 3 1 1 Sukliono 1208011005800001 - Sitalasari
Kepemilik IMD
Berat
n 1=Ya P Ayah
(gram) k
2=Tidak
142 4 7/10/2015 P 1280801030212002 1208015009100002 Fitria Septiani 2.8 1 1 Musmiran 1208011906790004 - Sitalasari
143 4 8/17/2014 P 1208012402080044 1208015708100001 Mutia Rahma Hutagalung 2.9 1 1 Lamsaruddin Hutagalung 1208012105750003 - Sitalasari
144 3 5/2/2016 P 1208010512110011 1208012505000011 Galang Purba 3 1 1 Tyo Johande Hotman Purba 1208012109770002 - Sitalasari
145 2 11/20/2017 P 1208010411090011 1208011201200003 Marsya Satfa Nasution 2.9 1 1 Boy Darma Nasution 1208011208820008 - Sitalasari
146 2 3/13/2015 L 1208010906010022 1208016303100002 Adzra Zaizafun Nasution 3 1 1 Dian Ardiansyah Nasution 1208010905810003 - Sitalasari
147 1 9/25/2014 L 1208010812090005 1208014709810002 Fauzan R. Butar-Butar 2.9 1 1 Sahat Syahputra Butar-Butar 1208011605800003 - Sitalasari
148 1 9/15/2015 L 1208011612110021 1208011509110001 Rahel Sihombing 3 1 1 Pintor Jones Sihombing 1208011909720002 - Sitalasari
149 1 11/10/2014 L 1208012503080014 1208011911100001 Muda Faiz Syabil Purba 3.2 1 1 Guntur Sumawan Purba 1208010428300001 - Sitalasari
150 2 9/17/2015 P 1208016209140001 Tricilia Batee 2.9 1 1 Medis Karo Batee 1208011308880004 - Sitalasari
151 2 8/3/2015 P 1208011900110012 1208014306140001 Vrisella Silalahi 2.9 1 1 Berlin Silalahi 1208010101840008 - Sitalasari
152 1 6/13/2015 L 1208011306150001 Revaldo Silalahi 3 1 1 Suprianto Silalahi 1272042503860002 - Sitalasari
153 1 1/20/2014 P 1205146501140002 Stevani 2.7 1 1 Natal Josepa 1206142612790007 - Sitalasari
154 1 4/26/2014 L 1208012604140001 Gilbert Purba 2.8 1 1 Risdon Purba 1208151012750001 - Sitalasari
155 1 4/16/2015 L 1208011811140003 1208011304150001 Mhd. Rayhan 3 1 1 Heri Kurniawan 1208011240458006 - Sitalasari
156 1 1/25/2015 L 1208011204080179 1208012601100001 Daniel Simbolon 3 1 1 Benny Simbolon 1208010603800003 - Sitalasari
157 2 12/1/2014 P 1208011204080179 1208014112140001 Desityah Ronauli Simbolon 2.7 1 1 Benny Simbolon 1208010603800003 - Sitalasari
158 2 10/11/2016 P 1208015110160001 Tessa Silalahi 2.9 1 1 Holmen Silalahi 1208011504810001 - Sitalasari
159 1 11/29/2014 P 1208012906090013 1208016911100003 Aurelia Simanjuntak 2.8 1 1 Fransiskus Simanjuntak 1208302303840003 - Sitalasari
160 2 1/4/2017 P 1208012906090013 1208014402170001 Madeleine Simanjuntak 2.9 1 1 Fransiskus Simanjuntak 1208302303840003 - Sitalasari
161 1 4/17/2014 L 1208011704140001 Gabriel Butarbutar 3.2 1 1 Harapan Butarbutar 1208012604830004 - Sitalasari
162 3 7/12/2015 L 1208011201130001 Imran lumbantobing 3.1 1 1 Sampe Torang Lumbantobing 1208011811760001 - Sitalasari
163 4 1/10/2017 P 1208015004150002 Humaira Lumbantobing 2.8 1 1 Sampe Torang Lumbantobing 1208011811760001 - Sitalasari
164 1 12/10/2014 L 1208010805120008 1208011012110002 William Sinaga 3.2 1 1 Alfinus Amstrong Sinaga 1208011301790002 - Sitalasari
165 2 12/12/2014 P 1208011412100061 1208015212120003 Benaya Saragi Napitu 2.8 1 1 Tommy Saragih Napitu 1208010702760005 - Sitalasari
166 5 7/30/2016 P 1208010802120001 1208017004140004 Riana Aritonang 2.8 1 1 Benny Aritonang 1208015080474003 - Sitalasari
Kepemilik IMD
Berat
n 1=Ya P Ayah
(gram) k
2=Tidak
167 1 9/27/2016 L Nicolas Huglin

1208012709160001 3.2 1 1 Wyllia Sumbayak 1208016506850002 - Sitalasari
168 2 10/10/2016 P Gracie Palensia Manalu
1208015010110003 2.7 1 1 Hery Togi Manalu 1212072407780003 - Sitalasari
169 1 8/31/2016 L 1208012806160001 Kenzy Benecity Sidabalok
1208013108160001 3 1 1 Aditya Radona Sidabalok 1208129048700001 - Sitalasari
170 1 12/10/2014 P 1280110209150008 Avira Anatacia Utama
1208011501214001 3 1 1 Satria Utama 1208112010930001 - Sitalasari
171 1 1/18/2017 P 1208012008140013 1208015801170001
Divania Simanjuntak 2.9 1 1 Rizal Ricardo Simanjuntak 1208013011740003 - Sitalasari
172 1 7/28/2016 L 1208012807160002 1208012807160001
Adriel Tedhe Pardede 3.1 1 1 Izul Karnain Pardede 1208012306850003 - Sitalasari
173 1 6/11/2016 L Viky Ramadhani 3.1 1 1 Wanto - Sitalasari
174 2 3/24/2016 P 1208012402080121 Penti Yolanda Sinaga 3.5 1 1 Pantas Sinaga 1208010407590001 - Sitalasari
175 1 2/19/2016 L Yosua 3.3 1 1 Guslim Limbong - Sitalasari
176 2 4/10/2016 L William Moregan Sinaga 3.1 1 1 A. Sinaga - Sitalasari
177 2 2/24/2016 L Yeriel 3.4 1 1 Ivan Napitu - Sitalasari
178 2 2/10/2016 L Zevanya Revaldo 3.3 1 1 Salman Ginting - Sitalasari
179 3 3/23/2016 L Beryl 3.1 1 1 Lampatar - Sitalasari
180 4 3/10/2016 P 1208011901110009 Junita Dominiq 3.4 1 1 Parlindungan Simanjuntak 1208011305780002 - Sitalasari
181 2 4/23/2016 L 1208011412100032 Giovani Silaban 3.1 1 1 Dodi Silaban 1208012201790001 - Sitalasari
182 3 10/13/2016 L Richy 3.4 1 1 Fernando - Sitalasari
183 1 2/16/2016 L Rico Febrian Siagian 3.1 1 1 Rinto Siagian - Sitalasari
184 2 3/1/2016 L 1208012503080009 1208010108110002 Pahri Ramadhan 3.4 1 1 Zulkifli 1208010407740001 - Sitalasari
185 2 10/17/2016 L Akbar Siregar 3.5 1 1 Erwin Siregar - Sitalasari
186 3 9/2/2016 L Jevan Daniel 3.3 1 1 Ridwan Napitu - Sitalasari
187 5 4/13/2016 P Nara Lumbangaol 3.1 1 1 Lamsadar Lumbangaol - Sitalasari
188 1 2/7/2016 L Marchelino 3.4 1 1 Valenus - Sitalasari
189 1 4/13/2016 L 1208012503110026 1208010712110001 Simon Petrus 3.1 1 1 Surung Sianturi 1208011304830001 - Sitalasari
190 1 07/02/2015 P Fazirah Fabiola 3.4 1 1 Jakson - Sitalasari
191 2 11/08/2015 L Dion Simanjorang 3.5 1 1 Erwin Simanjorang - Sitalasari
Kepemilik IMD
Berat
n 1=Ya P Ayah
(gram) k
2=Tidak
192 3 9/14/2016 L Adisari Napitupulu 3.1 1 1 Hengki Napitupulu - Sitalasari

193 2 2/3/2016 P Erna Marpaung 3.4 1 1 Sahat Marpaung - Sitalasari
194 1 5/19/2016 L 1208011101120012 Javandi Sirait 3.1 1 1 Jeselintong Julu Sirait 1208011606840010 - Sitalasari
195 2 3/25/2016 P Maychela Sijabat 3.4 1 1 Hot Dharmantua - Sitalasari
196 2 2/9/2016 P Kirana Batubara 3.1 1 1 Chandra Batubara - Sitalasari
197 3 4/10/2016 P Kiyara Saragih 3.4 1 1 Timbul Saragih - Sitalasari
198 2 4/23/2016 P Livana Napitupulu 3.1 1 1 Yohannes Napitupulu - Sitalasari
199 3 4/29/2016 P Metanaya Hutagaol 3.1 1 1 Lukman Hutagaol - Sitalasari
200 1 16/06/2015 P Cresella 3.1 1 1 Yendry - Sitalasari
201 2 21/07/2015 P Aqila Silalahi 3.3 1 1 Micael Silalahi - Sitalasari
202 1 23/08/2014 L Bastian Saragih 3.1 1 1 Bilmar Saragih - Sitalasari
203 2 18/12/2014 P Helen Butarbutar 3.4 1 1 Estomini Butarbutar - Sitalasari
204 2 11/12/2014 L Leon Tanjung 3.4 1 1 Mori Tanjung - Sitalasari
205 4 20/01/2015 L Azka Turnip 3.4 1 1 Arihan Turnip - Sitalasari
206 3 06/07/2014 L 1208011101120012 Jason Bastian Sirait 3.5 1 1 Jeselintong Julu Sirait 1208011606840010 - Sitalasari
207 2 16/09/2015 P 1208012707120001 Nazla 3.1 1 1 Panca Surya Bhakti 1208011105890005 - Sitalasari
208 1 08/10/2014 P 1208012402080151 Nailah Afifah 3.1 1 1 Wakidi 1208011204570003 - Sitalasari
209 2 11/01/2015 P 1208012402080068 Akilah 3.4 1 1 Sartono 1208010605820007 - Sitalasari
210 2 23/12/2015 L 1208011204160001 Thristan 3.5 1 1 Debi Maulana 1208012612920001 - Sitalasari
211 3 29/12/2014 L 1208012502080010 Gibran Harahap 3.3 1 1 Setiawan Harahap 1208011208810001 - Sitalasari
212 2 28/12/2014 L 1208012708090018 Alberto Simorangkir 3.4 1 1 Tothy Luga Simorangkir 1208011411710002 - Sitalasari
213 3 20/08/2015 P 1208012700308027 Chelsy Tambunan 3.4 1 1 John Ricki Tambunan 1208012909790002 - Sitalasari
214 3 09/06/2014 P 1208012703080701 Nikita Simanjuntak 3.1 1 1 Effendi Pandapotan Simanjuntak1208011005760004 - Sitalasari
215 4 1/27/2016 L 1208010605110011 Andika Bakkara 3.5 1 1 Gindo Ryanto Bakkara 1208010704780002 - Sitalasari
216 2 4/18/2016 L 1208011803110020 Rafayuda 3.1 1 1 Ade kimi Muis 1208012007900005 - Sitalasari
Kepemilik IMD
Berat
n 1=Ya P Ayah
(gram) k
2=Tidak
217 1 8/5/2015 P 1208011607140001 1208014508140002 Agnisyah Indah Permata 3 1 1 Agung Citra Kelana 1208012907910002 - Sitalasari
218 2 1/22/2018 L 1208011607140001 1208012201182001 Agnisyah Oriel Azka 3.2 1 1 Agung Citra Kelana 1208012907910002 - Sitalasari
219 1 11/8/2016 P 1208012408180003 1208014611160002 Zihan Amirah 3 1 1 Mhd. Akbar Azhmi 1272011509970001 - Sitalasari
220 2 10/12/2017 L 1208012610150008 1208011210170002 Gabri Gea 3 1 1 Yosua Gea 1208010706870004 - Sitalasari
221 2 12/11/2016 L 1208012911110017 1208011112160001 Widura Bintang Samudra 3.2 1 1 Edi Widodo 1208011802820004 - Sitalasari
222 2 7/2/2015 L 1208012411110001 1208010207140003 Rifai Day Ramadhan 3.2 1 1 Faisal Amri 1208011906800001 - Sitalasari
223 3 9/6/2016 P 1208012411110001 1208014607160001 Ryndiani 3 1 1 Faisal Amri 1208011906800001 - Sitalasari
224 4 3/22/2018 L 1208012411110001 1208012203182001 Razka Radttya 3.1 1 1 Faisal Amri 1208011906800001 - Sitalasari
225 2 5/21/2018 L 1208012509180002 1208012105180001 Sartia Nauli Hutapea 3 1 1 Bona Nauli Hutapea 1208011304910002 - Sitalasari
226 1 9/11/2015 P 1208012408150002 1208015109150001 Messy Salomitha Hutabarat 3 1 1 Hendar Makroni Hubarat 1218161003870005 - Sitalasari
227 2 12/4/2017 P 1208012408150002 1208014412172002 Dehandra Hutabarat 3.1 1 1 Hendar Makroni Hubarat 1218161003870005 - Sitalasari
228 3 11/26/2017 L 1208011001110006 1208012611172001 Irsyah Bagus Maulana 3.2 1 1 Irmawan 1208011709780003 - Sitalasari
229 3 9/3/2016 L 1208012402080084 1208010309160001 Fauzi Adiatwan 3.2 1 1 Suryadi 1208013008780001 - Sitalasari
230 2 11/23/2015 P 1207190912100003 1207196311140001 Nayla Virgia Pasaribu 3 1 1 Rumintar Pasaribu 1207190404820006 - Sitalasari
231 2 1/16/2018 P 1208011101130001 1208015601180001 Aulya Azahra 3 1 1 Supendi 1208012008850001 - Sitalasari
232 3 11/29/2016 L 1208012402080095 1208012911160001 Mhd. Harun 3.2 1 1 Sriyanto 1208011503780002 - Sitalasari
233 1 11/2/2017 P 1208010210120016 1208014211170001 Jasmine Cordelia Gowasa 3.1 1 1 Johannis Gowasa 1208012207850001 - Sitalasari
234 3 10/6/2015 P 1208012502080122 1208014610150001 Pitriah Hasana 3.1 1 1 Mesman 1208011908760001 - Sitalasari
235 2 9/18/2015 P 1208012402080073 1208015809150001 Anggita Dinda Azani 3 1 1 Amin 1208011010820002 - Sitalasari
236 5 10/7/2016 P 1208011107180001 1208014710160001 Ammora Hasibuan 3.2 1 1 Mariance Br. Silalahi 1208016310830004 - Sitalasari
237 1 7/22/2017 L 1208011401160001 1208012207170001 Morado Panggabean 3.1 1 1 Samuel Panggabean 1208010102820002 - Sitalasari
238 2 12/29/2015 L 1208011103100018 1208012912140002 Christian Simaremare 3.2 1 1 Firma Saoloan Simaremare 1208011504830002 - Sitalasari
239 1 4/22/2015 L 1208012402182002 1208012204152001 Arya Maulana 3.3 1 1 Laylani Br. Dalimunthe 1208014902962001 - Sitalasari
240 3 11/5/2015 P 1208012502080037 1208014511150001 Kayla Ayunda Damanik 3 1 1 Sahmen Damanik 1208011202650001 - Sitalasari
241 1 9/16/2015 L 1208010609160004 1208011609150001 Azzunathan Yuandra 3.1 1 1 Hendra Syahputra 1272073008850001 - Sitalasari
Kepemilik IMD
Berat
n 1=Ya P Ayah
(gram) k
2=Tidak
242 2 9/10/2015 P 1208012508110006 1208015009150004 Liana Zahira 3 1 1 Syahrul 1208012505800006 - Sitalasari

243 1 10/24/2018 L 1208012607170008 1208012410180001 Stephen Goklas Pohan 3.3 1 1 Samuel Oloan Pohan 1208012107850002 - Sitalasari
244 1 11/28/2018 P 1208010412170006 1208016811180001 Yalifa Aderiella Manik 3.1 1 1 Petrus Manik 1206012002850003 - Sitalasari
245 4 2/1/2019 L 1208012703080581 Rasya Albizar 3 1 1 Syaiful Chaniago 1208013012700001 - Sitalasari
246 2 2/20/2019 P 1208010910150003 Raya Inayah 3.2 1 1 Muslim Maha 1272070305340001 - Sitalasari
Keterangan
Kolom 11 Jika Ayah tidak ada, maka diisikan nama Ibu
Kolom 12 Jika Ayah tidak ada, maka diisikan NIK Ibu
Kolom 13 Jika Ayah tidak ada, maka diisikan no Telp/HP Ibu
Kolom 29 Jika Pemantauan Perkembangan menggunakan kusioner pra skrining perkembangan (SDIDTK) diisi Ds (Sesuai) jika skor KPSP=9-10, Dm (Meragukan) skor=7-8, diisi Dp(Kemungkinan penyimpangan) jika skor<7
Kolom 30 Jika Pemantauan Perkembangan menggunakan ceklist buku KIA, diisi S jika jawaban ya untuk seluruh pertanyaan, diisi TS jika ada satu atau lebih jawaban tidak untuk seluruh pertanyaan
Kolom 31 Diisi SL (lanjutkan stimulasi dan jadwalkan kunjungan berikutnya) jika hasil pemeriksaan KPSP atau ceklist Buku KIA menghasilkan Sesuai (S)
AN BALITA DI POSYANDU

Vitamin A Vitamin A
Badan/Ti
Tanggal BB nggi 1=Terlent Februari Agustus
RT RW Pengukuran (kg) Badan ang 1=Ya 1=Ya
Umur Umur Umur Umur Umur Umur Ds/Dm/ KIA Lanjut
0 bln 1 bln 2 bln 3 bln 4 bln 5 bln Dp S/TS SL/SU/R
(16) (17) (18) (19) (20) (21) (21) (22) (23) (24) (25) (26) (27) (28) (29) (30) (31)
08/08/2019 11.5 87.0 2 1 1 1 1 1 1 1 1 Ds S SL
08/08/2019 15.5 104.0 2 1 1 1 1 1 1 1 1 DS S SL
08/08/2019 11.5 85.5 2 1 1 1 1 1 1 1 1 Ds S SL
08/08/2019 18 107 2 1 1 1 1 1 1 1 1 DS S SL
08/08/2019 17 109 2 1 1 1 1 1 1 1 1 Ds S SL
08/08/2019 9.5 76.5 2 1 1 1 1 1 1 1 1 DS S SL
08/08/2019 18.5 110 2 1 1 1 1 1 1 1 1 Ds S SL
08/08/2019 9 77.5 2 1 1 1 1 1 1 1 1 DS S SL
08/08/2019 6 60.1 2 1 1 1 Ds S SL
08/08/2019 18 107 2 1 1 1 1 1 1 1 1 DS S SL
08/08/2019 8.5 74 2 1 1 1 1 1 1 1 1 Ds S SL
08/08/2019 15.5 104 2 1 1 1 1 1 1 1 1 DS S SL
08/08/2019 13.5 93 2 1 1 1 1 1 1 1 1 Ds S SL
08/08/2019 15.5 103.5 2 1 1 1 1 1 1 1 1 DS S SL
08/08/2019 12.4 90 2 1 1 1 1 1 1 1 1 Ds S SL
08/08/2019 7 68 2 1 1 1 1 1 1 1 1 DS S SL
Vitamin A Vitamin A
Badan/Ti
08/08/2019 14.2 96.6 2 1 1 1 1 1 1 1 1 Ds S SL
08/08/2019 17.3 106 2 1 1 1 1 1 1 1 1 DS S SL
08/08/2019 16 103.7 2 1 1 1 1 1 1 1 1 Ds S SL
08/08/2019 12.1 91 2 1 1 1 1 1 1 1 1 DS S SL
08/08/2019 12.2 91.5 2 1 1 1 1 1 1 1 1 Ds S SL
08/08/2019 12.6 93 2 1 1 1 1 1 1 1 1 DS S SL
08/08/2019 11.7 89 2 1 1 1 1 1 1 1 1 Ds S SL
08/08/2019 3.5 52 1 1 1 1 1 2 2 DS S SL
08/08/2019 9.2 75 2 1 1 1 1 1 1 1 1 Ds S SL
08/08/2019 13.3 94.7 2 1 1 1 1 1 1 1 1 DS S SL
08/08/2019 6.8 65.40 1 1 1 1 1 1 1 2 1 Ds S SL
08/08/2019 9 74.8 2 1 1 1 1 1 1 1 1 DS S SL
08/08/2019 18.5 112.6 2 1 1 1 1 1 1 1 1 Ds S SL
08/08/2019 5.2 57.6 1 1 1 1 1 2 2 DS S SL
08/08/2019 14.2 96.2 2 1 1 1 1 1 1 1 1 Ds S SL
08/08/2019 13.8 96.2 2 1 1 1 1 1 1 1 1 DS S SL
08/08/2019 13.9 99 2 1 1 1 1 1 1 1 1 Ds S SL
08/08/2019 8.5 73 2 1 1 1 1 1 1 1 1 DS S SL
08/08/2019 10.8 81.3 2 1 1 1 1 1 1 1 1 Ds S SL
08/08/2019 16.5 105.2 2 1 1 1 1 1 1 1 1 DS S SL
08/08/2019 12.6 93 2 1 1 1 1 1 1 1 1 Ds S SL
08/08/2019 18.2 112 2 1 1 1 1 1 1 1 1 DS S SL
08/08/2019 18.7 111.5 2 1 1 1 1 1 1 1 1 Ds S SL
08/08/2019 13.1 88.6 2 1 1 1 1 1 1 1 1 DS S SL
08/08/2019 11.2 82.4 2 1 1 1 1 1 1 1 1 Ds S SL
Vitamin A Vitamin A
Badan/Ti
08/08/2019 14.6 98.2 2 1 1 1 1 1 1 1 1 DS S SL
08/08/2019 15.4 99.6 2 1 1 1 1 1 1 1 1 Ds S SL
08/08/2019 17 110 2 1 1 1 1 1 1 1 1 DS S SL
08/08/2019 10.7 84.3 2 1 1 1 1 1 1 1 1 Ds S SL
08/08/2019 10.8 83.4 2 1 1 1 1 1 1 1 1 DS S SL
08/08/2019 14.2 100 2 1 1 1 1 1 1 1 1 Ds S SL
08/08/2019 17 110 2 1 1 1 1 1 1 1 1 DS S SL
08/08/2019 10.7 82.3 2 1 1 1 1 1 1 1 1 Ds S SL
08/08/2019 12.8 94 2 1 1 1 1 1 1 1 1 DS S SL
08/08/2019 14.4 101 2 1 1 1 1 1 1 1 1 Ds S SL
08/08/2019 15.8 103.6 2 1 1 1 1 1 1 1 1 DS S SL
08/08/2019 11 82 2 1 1 1 1 1 1 1 1 Ds S SL
08/08/2019 17 107.5 2 1 1 1 1 1 1 1 1 DS S SL
08/08/2019 17.5 109 2 1 1 1 1 1 1 1 1 Ds S SL
08/08/2019 17 110 2 1 1 1 1 1 1 1 1 DS S SL
08/08/2019 17.5 110.5 2 1 1 1 1 1 1 1 1 Ds S SL
- - 08/02/2019 17 110 2 1 1 1 1 1 1 1 1 DS S SL
- - 08/02/2019 16.4 106 2 1 1 1 1 1 1 1 1 Ds S SL
- - 08/02/2019 18.2 109 2 1 1 1 1 1 1 1 1 DS S SL
- - 08/02/2019 14.2 100 2 1 1 1 1 1 1 1 1 Ds S SL
- - 08/02/2019 18 108 2 1 1 1 1 1 1 1 1 DS S SL
- - 08/02/2019 17.1 110.5 2 1 1 1 1 1 1 1 1 Ds S SL
- - 08/02/2019 15.5 105 2 1 1 1 1 1 1 1 1 DS S SL
- - 08/02/2019 17 110 2 1 1 1 1 1 1 1 1 Ds S SL
- - 08/02/2019 19.5 117.5 2 1 1 1 1 1 1 1 1 DS S SL
Vitamin A Vitamin A
Badan/Ti
- - 08/02/2019 17.3 111 2 1 1 1 1 1 1 1 1 Ds S SL
- - 08/02/2019 15.8 106 2 1 1 1 1 1 1 1 1 DS S SL
- - 08/02/2019 17.6 112 2 1 1 1 1 1 1 1 1 Ds S SL
- - 08/02/2019 14.4 101 2 1 1 1 1 1 1 1 1 DS S SL
- - 08/02/2019 17.3 111 2 1 1 1 1 1 1 1 1 Ds S SL
- - 08/02/2019 14.4 101 2 1 1 1 1 1 1 1 1 DS S SL
- - 08/02/2019 12.1 91 2 1 1 1 1 1 1 1 1 Ds S SL
- - 08/02/2019 15.8 106 2 1 1 1 1 1 1 1 1 DS S SL
- - 08/02/2019 15.6 105.5 2 1 1 1 1 1 1 1 1 Ds S SL
- - 08/02/2019 9.6 79 2 1 1 1 1 1 1 1 1 DS S SL
- - 08/02/2019 19.7 118 2 1 1 1 1 1 1 1 1 Ds S SL
- - 08/02/2019 17.1 110.5 2 1 1 1 1 1 1 1 1 DS S SL
- - 08/02/2019 16.7 109 2 1 1 1 1 1 1 1 1 Ds S SL
- - 08/02/2019 11.9 90 2 1 1 1 1 1 1 1 1 DS S SL
- - 08/02/2019 17.6 112 2 1 1 1 1 1 1 1 1 Ds S SL
- - 08/02/2019 17.8 112.5 2 1 1 1 1 1 1 1 1 DS S SL
- - 08/02/2019 18 113 2 1 1 1 1 1 1 1 1 Ds S SL
- - 08/02/2019 14.8 102.5 2 1 1 1 1 1 1 1 1 DS S SL
- - 08/02/2019 14.7 102 2 1 1 1 1 1 1 1 1 Ds S SL
- - 08/02/2019 9.5 78.5 1 1 1 1 1 1 1 1 1 DS S SL
- - 08/02/2019 19.5 117.5 2 1 1 1 1 1 1 1 1 Ds S SL
- - 08/02/2019 12.6 93 2 1 1 1 1 1 1 1 1 DS S SL
- - 08/02/2019 17.8 112.5 2 1 1 1 1 1 1 1 1 Ds S SL
- - 08/02/2019 14.5 101.5 2 1 1 1 1 1 1 1 1 DS S SL
- - 08/02/2019 12.4 92.5 2 1 1 1 1 1 1 1 1 Ds S SL
Vitamin A Vitamin A
Badan/Ti
- - 08/02/2019 17.6 112 2 1 1 1 1 1 1 1 1 DS S SL
- - 08/02/2019 13 95 2 1 1 1 1 1 1 1 1 Ds S SL
- - 08/02/2019 12.6 93 2 1 1 1 1 1 1 1 1 DS S SL
- - 08/02/2019 17.1 110.5 2 1 1 1 1 1 1 1 1 Ds S SL
- - 08/02/2019 12.8 94 2 1 1 1 1 1 1 1 1 DS S SL
- - 08/02/2019 15.5 105 2 1 1 1 1 1 1 1 1 Ds S SL
- - 08/02/2019 11.3 87.5 1 1 1 1 1 1 1 1 1 DS S SL
- - 08/02/2019 18 113 2 1 1 1 1 1 1 1 1 Ds S SL
- - 08/02/2019 20.4 121 2 1 1 1 1 1 1 1 1 DS S SL
- - 08/02/2019 10.3 83 1 1 1 1 1 1 1 1 1 Ds S SL
- - 08/02/2019 18.6 115 2 1 1 1 1 1 1 1 1 DS S SL
- - 08/02/2019 12.8 94 2 1 1 1 1 1 1 1 1 Ds S SL
- - 08/02/2019 20 119 2 1 1 1 1 1 1 1 1 DS S SL
- - 08/02/2019 16.5 108.5 2 1 1 1 1 1 1 1 1 Ds S SL
- - 08/02/2019 10.3 83 1 1 1 1 1 1 1 1 1 DS S SL
- - 08/02/2019 18 113 2 1 1 1 1 1 1 1 1 Ds S SL
- - 08/02/2019 17.3 111 2 1 1 1 1 1 1 1 1 DS S SL
- - 08/02/2019 12.6 93 2 1 1 1 1 1 1 1 1 Ds S SL
- - 08/02/2019 13.2 96 2 1 1 1 1 1 1 1 1 DS S SL
- - 08/02/2019 10.3 83 1 1 1 1 1 1 1 1 1 Ds S SL
- - 08/02/2019 17.5 111.5 2 1 1 1 1 1 1 1 1 DS S SL
- - 08/02/2019 15.9 106.5 2 1 1 1 1 1 1 1 1 Ds S SL
- - 08/02/2019 16.2 107.5 2 1 1 1 1 1 1 1 1 DS S SL
- - 08/02/2019 16.1 107 2 1 1 1 1 1 1 1 1 Ds S SL
- - 08/02/2019 20.4 121 2 1 1 1 1 1 1 1 1 DS S SL
Vitamin A Vitamin A
Badan/Ti
- - 08/02/2019 15.5 105 2 1 1 1 1 1 1 1 1 Ds S SL
- - 08/02/2019 10.8 85 1 1 1 1 1 1 1 1 1 DS S SL
- - 08/02/2019 19 116 2 1 1 1 1 1 1 1 1 Ds S SL
- - 08/02/2019 13.4 97 2 1 1 1 1 1 1 1 1 DS S SL
- - 08/02/2019 15.5 105 2 1 1 1 1 1 1 1 1 Ds S SL
- - 08/02/2019 16.2 107.5 2 1 1 1 1 1 1 1 1 DS S SL
- - 08/02/2019 12.8 94 2 1 1 1 1 1 1 1 1 Ds S SL
- - 08/02/2019 15.5 105 2 1 1 1 1 1 1 1 1 DS S SL
- - 08/02/2019 15.6 105.5 2 1 1 1 1 1 1 1 1 Ds S SL
- - 08/02/2019 12.6 93 2 1 1 1 1 1 1 1 1 DS S SL
- - 08/02/2019 12.7 93.5 2 1 1 1 1 1 1 1 1 Ds S SL
- - 08/02/2019 17.3 111 2 1 1 1 1 1 1 1 1 DS S SL
- - 08/02/2019 12.8 94 2 1 1 1 1 1 1 1 1 Ds S SL
- - 08/02/2019 15.1 103.6 2 1 1 1 1 1 1 1 1 DS S SL
- - 08/02/2019 15.2 104 2 1 1 1 1 1 1 1 1 Ds S SL
- - 08/02/2019 15.5 105 2 1 1 1 1 1 1 1 1 DS S SL
- - 08/02/2019 14.9 103 2 1 1 1 1 1 1 1 1 Ds S SL
- - 08/02/2019 14.4 101 2 1 1 1 1 1 1 1 1 DS S SL
- - 08/02/2019 14.5 101.5 2 1 1 1 1 1 1 1 1 Ds S SL
- - 08/02/2019 14.8 102.5 2 1 1 1 1 1 1 1 1 DS S SL
- - 08/02/2019 15.2 104 2 1 1 1 1 1 1 1 1 Ds S SL
- - 08/02/2019 14.7 102 2 1 1 1 1 1 1 1 1 DS S SL
- - 08/02/2019 17.5 111.5 2 1 1 1 1 1 1 1 1 Ds S SL
- - 08/02/2019 12.6 93 2 1 1 1 1 1 1 1 1 DS S SL
- - 08/02/2019 20.2 119.5 2 1 1 1 1 1 1 1 1 Ds S SL
Vitamin A Vitamin A
Badan/Ti
- - 08/02/2019 17.3 111 2 1 1 1 1 1 1 1 1 DS S SL
- - 08/02/2019 19.2 116.5 2 1 1 1 1 1 1 1 1 Ds S SL
- - 08/02/2019 14.5 101.5 2 1 1 1 1 1 1 1 1 DS S SL
- - 08/02/2019 10.1 82 1 1 1 1 1 1 1 1 1 Ds S SL
- - 08/02/2019 17.6 112 2 1 1 1 1 1 1 1 1 DS S SL
- - 08/02/2019 18.1 113.5 2 1 1 1 1 1 1 1 1 Ds S SL
- - 08/02/2019 14.4 101 2 1 1 1 1 1 1 1 1 DS S SL
- - 08/02/2019 17.6 112 2 1 1 1 1 1 1 1 1 Ds S SL
- - 08/02/2019 14.7 102 2 1 1 1 1 1 1 1 1 DS S SL
- - 08/02/2019 17.3 111 2 1 1 1 1 1 1 1 1 Ds S SL
- - 08/02/2019 17.5 111.5 2 1 1 1 1 1 1 1 1 DS S SL
- - 08/02/2019 19.5 117.5 2 1 1 1 1 1 1 1 1 Ds S SL
- - 08/02/2019 20.4 120 2 1 1 1 1 1 1 1 1 DS S SL
- - 08/02/2019 17.5 111.5 2 1 1 1 1 1 1 1 1 Ds S SL
- - 08/02/2019 17.6 112 2 1 1 1 1 1 1 1 1 DS S SL
- - 08/02/2019 17.8 112.5 2 1 1 1 1 1 1 1 1 Ds S SL
- - 08/02/2019 12.7 93.5 2 1 1 1 1 1 1 1 1 DS S SL
- - 08/02/2019 17.6 112 2 1 1 1 1 1 1 1 1 Ds S SL
- - 08/02/2019 12.8 94 2 1 1 1 1 1 1 1 1 DS S SL
- - 08/02/2019 20 119 2 1 1 1 1 1 1 1 1 Ds S SL
- - 08/02/2019 17.3 111 2 1 1 1 1 1 1 1 1 DS S SL
- - 08/02/2019 12.9 94.5 2 1 1 1 1 1 1 1 1 Ds S SL
- - 08/02/2019 17.8 112.5 2 1 1 1 1 1 1 1 1 DS S SL
- - 08/02/2019 17.3 111 2 1 1 1 1 1 1 1 1 Ds S SL
- - 08/02/2019 14.9 103 2 1 1 1 1 1 1 1 1 DS S SL
Vitamin A Vitamin A
Badan/Ti
- - 08/02/2019 12.9 94.5 2 1 1 1 1 1 1 1 1 Ds S SL
- - 08/02/2019 17.3 111 2 1 1 1 1 1 1 1 1 DS S SL
- - 08/02/2019 14.9 103 2 1 1 1 1 1 1 1 1 Ds S SL
- - 08/02/2019 17.5 111.5 2 1 1 1 1 1 1 1 1 DS S SL
- - 08/02/2019 12.8 94 2 1 1 1 1 1 1 1 1 Ds S SL
- - 08/02/2019 15.2 104 2 1 1 1 1 1 1 1 1 DS S SL
- - 08/02/2019 15.2 104 2 1 1 1 1 1 1 1 1 Ds S SL
- - 08/02/2019 15.4 104.5 2 1 1 1 1 1 1 1 1 DS S SL
- - 08/02/2019 15.5 105 2 1 1 1 1 1 1 1 1 Ds S SL
- - 08/02/2019 15.1 103.5 2 1 1 1 1 1 1 1 1 DS S SL
- - 08/02/2019 15.5 105 2 1 1 1 1 1 1 1 1 Ds S SL
- - 08/02/2019 15.4 104.5 2 1 1 1 1 1 1 1 1 DS S SL
- - 08/02/2019 14.9 103 2 1 1 1 1 1 1 1 1 Ds S SL
- - 08/02/2019 14.9 103 2 1 1 1 1 1 1 1 1 DS S SL
- - 08/02/2019 15.1 103.5 2 1 1 1 1 1 1 1 1 Ds S SL
- - 08/02/2019 12.8 94 2 1 1 1 1 1 1 1 1 DS S SL
- - 08/02/2019 15.4 104.5 2 1 1 1 1 1 1 1 1 Ds S SL
- - 08/02/2019 15.5 105 2 1 1 1 1 1 1 1 1 DS S SL
- - 08/02/2019 12.9 94.5 2 1 1 1 1 1 1 1 1 Ds S SL
- - 08/02/2019 12.8 94 2 1 1 1 1 1 1 1 1 DS S SL
- - 08/02/2019 14.8 102.5 2 1 1 1 1 1 1 1 1 Ds S SL
- - 08/02/2019 15.2 104 2 1 1 1 1 1 1 1 1 DS S SL
- - 08/02/2019 14.8 102.5 2 1 1 1 1 1 1 1 1 Ds S SL
- - 08/02/2019 17.6 112 2 1 1 1 1 1 1 1 1 DS S SL
- - 08/02/2019 17.3 111 2 1 1 1 1 1 1 1 1 Ds S SL
Vitamin A Vitamin A
Badan/Ti
- - 08/02/2019 12.9 94.5 2 1 1 1 1 1 1 1 1 DS S SL
- - 08/02/2019 14.4 101 2 1 1 1 1 1 1 1 1 Ds S SL
- - 08/02/2019 14.9 103 2 1 1 1 1 1 1 1 1 DS S SL
- - 08/02/2019 14.7 102 2 1 1 1 1 1 1 1 1 Ds S SL
- - 08/02/2019 14.9 103 2 1 1 1 1 1 1 1 1 DS S SL
- - 08/02/2019 14.5 101.5 2 1 1 1 1 1 1 1 1 Ds S SL
- - 08/02/2019 14.4 101 2 1 1 1 1 1 1 1 1 DS S SL
- - 08/02/2019 14.7 102 2 1 1 1 1 1 1 1 1 Ds S SL
- - 08/02/2019 17.6 112 2 1 1 1 1 1 1 1 1 DS S SL
- - 08/02/2019 17.3 111 2 1 1 1 1 1 1 1 1 Ds S SL
- - 08/02/2019 20.2 119.5 2 1 1 1 1 1 1 1 1 DS S SL
- - 08/02/2019 17.8 112.5 2 1 1 1 1 1 1 1 1 Ds S SL
- - 08/02/2019 18 113 2 1 1 1 1 1 1 1 1 DS S SL
- - 08/02/2019 17.3 111 2 1 1 1 1 1 1 1 1 Ds S SL
- - 08/02/2019 20.2 119.5 2 1 1 1 1 1 1 1 1 DS S SL
- - 08/02/2019 15.6 105.5 2 1 1 1 1 1 1 1 1 Ds S SL
- - 08/02/2019 18 113 2 1 1 1 1 1 1 1 1 DS S SL
- - 08/02/2019 17.6 112 2 1 1 1 1 1 1 1 1 Ds S SL
- - 08/02/2019 15.2 104 2 1 1 1 1 1 1 1 1 DS S SL
- - 08/02/2019 17.6 112 2 1 1 1 1 1 1 1 1 Ds S SL
- - 08/02/2019 18 113 2 1 1 1 1 1 1 1 1 DS S SL
- - 08/02/2019 17.3 111 2 1 1 1 1 1 1 1 1 Ds S SL
- - 08/02/2019 19.9 118.5 2 1 1 1 1 1 1 1 1 DS S SL
- - 08/02/2019 15.2 104 2 1 1 1 1 1 1 1 1 Ds S SL
- - 08/02/2019 14.7 102 2 1 1 1 1 1 1 1 1 DS S SL
Vitamin A Vitamin A
Badan/Ti
- - 08/02/2019 17 110 2 1 1 1 1 1 1 1 1 Ds S SL
- - 08/02/2019 10.2 82.5 2 1 1 1 1 1 1 1 1 DS S SL
- - 08/02/2019 12.6 93 2 1 1 1 1 1 1 1 1 Ds S SL
- - 08/02/2019 10.3 83 2 1 1 1 1 1 1 1 1 DS S SL
- - 08/02/2019 13 95 2 1 1 1 1 1 1 1 1 Ds S SL
- - 08/02/2019 17.3 111 2 1 1 1 1 1 1 1 1 DS S SL
- - 08/02/2019 12.9 94.5 2 1 1 1 1 1 1 1 1 Ds S SL
- - 08/02/2019 9.9 81 2 1 1 1 1 1 1 1 1 DS S SL
- - 08/02/2019 9.7 80 2 1 1 1 1 1 1 1 1 Ds S SL
- - 08/02/2019 15.1 103.5 2 1 1 1 1 1 1 1 1 DS S SL
- - 08/02/2019 9.9 81 2 1 1 1 1 1 1 1 1 Ds S SL
- - 08/02/2019 10 81.5 2 1 1 1 1 1 1 1 1 DS S SL
- - 08/02/2019 12.8 94 2 1 1 1 1 1 1 1 1 Ds S SL
- - 08/02/2019 14.7 102 2 1 1 1 1 1 1 1 1 DS S SL
- - 08/02/2019 9.7 80 2 1 1 1 1 1 1 1 1 Ds S SL
- - 08/02/2019 13 95 2 1 1 1 1 1 1 1 1 DS S SL
- - 08/02/2019 10 81.5 2 1 1 1 1 1 1 1 1 Ds S SL
- - 08/02/2019 14.7 102 2 1 1 1 1 1 1 1 1 DS S SL
- - 08/02/2019 14.8 102.5 2 1 1 1 1 1 1 1 1 Ds S SL
- - 08/02/2019 12.3 92 2 1 1 1 1 1 1 1 1 DS S SL
- - 08/02/2019 12.8 94 2 1 1 1 1 1 1 1 1 Ds S SL
- - 08/02/2019 15.2 104 2 1 1 1 1 1 1 1 1 DS S SL
- - 08/02/2019 17.5 111.5 2 1 1 1 1 1 1 1 1 Ds S SL
- - 08/02/2019 14.4 101 2 1 1 1 1 1 1 1 1 DS S SL
- - 08/02/2019 14.7 102 2 1 1 1 1 1 1 1 1 Ds S SL
Vitamin A Vitamin A
Badan/Ti
- - 08/02/2019 14.8 102.5 2 1 1 1 1 1 1 1 1 DS S SL
- - 2/8/2019 5.9 61.7 1 1 1 1 1 1 1 1 1 Ds S SL
- - 2/8/2019 5.4 59.7 1 1 1 1 1 1 1 1 1 DS S SL
- - 2/8/2019 3.9 54 1 1 1 1 1 1 1 1 1 Ds S SL
- - 2/8/2019 4 54.5 1 1 1 1 1 1 1 1 1 DS S SL
a skor<7
Provinsi SUMATERA UTARA
Kabupaten/Kota SIMALUNGUN
Puskesmas/Kecamatan BATU ANAM / SIANTAR
Desa/Kelurahan LESTARI INDAH
Berat
Jenis Nomor Induk Badan
No Anak Ke Tanggal Lahir No Kartu Keluarga (KK) Nama Anak
Kelamin Kependudukan (NIK) Lahir
(gram)
(1) (2) (3) (4) (5) (6) (7) (8)

1 1 05/08/2015 L "1208011112150001 "1272060608150001 Ghafar Alfatih Aswar 3000
2 3 27/02/2017 P "1208012706130005 "1208016702170001 Kaila Natasya 3500
3 3 05/08/2017 P "1208012702080018 "1208014508170001 Alika Salsabila 3100
4 1 21/03/2015 P "1208010307140006 "1208018103150001 Kanza Mehulika 3200
5 3 28/12/2015 P "1208012902080004 "1208016812150001 Shelyn Zevanya 3000
6 1 13/04/2017 P "1208012802170006 "1208015304172001 Aqila Misha 3100
7 1 24/12/2017 L "1208013110170008 "1208012412172001 Moh. Ibnu Aqil 3100
8 3 29/07/2016 P "1208010112100005 "1208016907160004 Claudia Benaya 3100
9 1 18/04/2017 L "1208010111160004 "1208011804170003 Alfaro Mekisedek 3200
10 4 15/01/2016 P "1208012810090027 "1208011501162001 Glen Alpino 3000
11 3 07/06/2018 L "1208013006100004 Crisgio Sebastian 3000
12 1 12/22/2014 L "1208912912140006 "1208012212140001 Natanael Pratama 3000
13 2 12/22/2017 P "1208011310150008 Noelle Priskila 3000
14 2 6/14/2017 P "1208011302130001 "1208015406170001 Salma Aulia 3000
15 2 7/11/2017 P "1208012503140003 "1208011107170003 Ozakira Aftani 3100
16 1 9/11/2015 P "1208012408150002 "1208015109150001 Messy Salomitha 3200
17 2 12/4/2017 P "1208012408150002 "1208014412172002 Dheandra Solagratia 3000
18 2 6/30/2016 L "1271031104130015 "1271033006160001 Ervito 3200
19 3 2/9/2016 L "1208012702080011 "1208010902160001 Uwais Syagiro 3100
20 2 10/26/2015 P "1208011710130004 "1208016610152001 Zoya Lukresia 3500
21 1 9/25/2016 P "1208011710170009 "1208016509160004 Angela Vanaya 3000
22 1 12/4/2014 P "1208011009130003 "1208014412140001 Ayla Fathiyat Unrahma 3100
23 1 12/26/2017 P "1208010707170007 "1208016612170001 Revalyn Mikayla 3000
24 1 12/30/2016 P "1208011208160007 Anabel Kristania 3200
25 4 3/15/2015 L "1208012607110008 Dian Manjaro 3000
26 6 7/6/2014 P "1208011901100007 "1208014607140001 Sesilia Gaberis 3100
27 1 12/2/2014 P "1274060109140004 "1274064212140001 Audry Natalina 3200
28 2 4/11/2015 P "1208012703150002 "1208015104150001 Aprillia Margaret 3000
29 2 8/13/2016 L "1272082903170001 "1272081308160001 Diomixel Siallagan 3100
30 2 5/16/2015 P "1208012211110019 "1208015605150003 Chelse Angriani 3000
31 2 12/6/2016 L "1208010610110004 Nikayla Purba 3000
32 3 9/11/2017 P "1208010810130007 "1208015109170002 Ester Klarisa Telambenu3100
33 2 9/25/2014 L "1208010811100023 Putra Panorangan 3000
34 3 10/11/2016 P "1208012401100004 "1208015110160002 Cantika Elisabet 3100
35 3 12/31/2014 P "1208012902080034 "1208013103710001 Adekia Zhakaria 3100
36 3 8/6/2015 L "1208010802120040 "1208010608150002 Agathan Samuel 3000
37 4 12/10/2014 L "1208012707090004 "1208011012140004 Bezakel Millionero 3000
38 3 11/22/2014 P "12720220012100029 "1272026211140001 Sofia Nazfhifah 2900
39 2 1/26/2016 P "1208012911130001 "1208016601160002 Michelle Olisee 3000
40 2 3/23/2015 L "1208012312110044 "1208012303150001 Rayyan Aditya 3100
41 3 10/25/2016 P "1208010806110011 "1208016510160001 Nadira kezia 3000
42 3 11/10/2014 L "1208012308110005 "1208011011140001 Vedrik Do Dalanni 3200
43 1 5/27/2017 P "1208012802170007 "1208012705172001 El Afsyah 3000
44 3 8/8/2017 P "1208011507110013 "1208014808170001 Tiara Natasya 3000
45 1 11/16/2017 L "1208011507110013 Aidan Decking 3000
46 1 7/23/2016 L "1208012310140002 "1208016307160001 Jauharral Maghfirah 3000
47 2 4/27/2018 L "1208012310140002 Zidan Moh. Umar 3100
48 1 10/3/2016 L "1208010303170003 "1208010310160002 Yesaya Austin 3200
49 2 9/26/2014 P "1208011302170001 "1471016609140002 Erlin Anie Chasya 3100
50 2 3/30/2015 P "1208012804110008 "1208017003150001 Gisella Masintan 3200
51 1 7/22/2016 L "1208012903160008 "1208012207160001 Valentino Munte 3200
52 1 9/16/2016 P "120801101010160007 "1208015609160002 Adifa Chical 3200
53 2 7/18/2018 P "120801101010160007 "1208015807180001 Afifah Chika Trisco Putr3100
54 2 8/23/2014 L Riduan Lubis 3000
55 1 11/27/2014 P Nazwa 3200
56 1 11/10/2014 P "1208012310140004 "1208015011140002 Nayla Azahra 3500
57 1 11/3/2014 L Yoel Vovi Yanti Saragih 3000
58 3 6/9/2015 L "1208011312100031 "1208010906150001 Nazril Abassyah 3100
59 1 9/23/2015 P "1208011506150003 "1208016309150002 Nadhira Isquaroh 3000
60 2 1/18/2018 P "1208011506150003 Aninanta Zahra 3200
61 2 2/3/2017 L "1208012104170006 "1208010302170001 Juan Fernandes 3000
62 1 8/2/2015 L "1208012611090003 "1208012611090003 Rafael Manurung 3000
63 1 11/10/2014 P "1208012310140004 "1208015011140002 Nayla Azahra 3300
64 2 9/16/2015 P "1208012310140004 Kayla Azahra 3200
65 1 11/2/2017 P "1208010210120016 Jasmine Chordelia 3200
66 1 9/27/2016 P "1208012903170003 "1208016709160002 Khairah Sachi 3100
67 1 10/5/2014 P "1208012512090023 "1208014510140001 Keyla Zevanya 3100
68 6 10/5/2014 P "1208012512090023 Kaila Simarmata 3000
69 1 10/20/2017 P "1208012611172006 "1208016010172001 Quina Bella 3000
70 3 11/26/2014 L "12080106110160007 "1208012611140001 Ade Rizql 3000
71 4 11/26/2014 L "1208011902080037 "1208012011130005 Aqira Geoffrey 3000
72 3 4/21/2016 P "1208011806120002 Feyla Konita 3200
73 1 1/27/2016 L "1208012511140005 "120801270116001 ARDINUR RIZWAN 3200
74 2 5/13/2017 L "1208012511140005 "1208011305172001 Adam Kamil 3000
75 3 8/8/2014 P "1208012607160011 "2171074808140001 Elvina Vanisa 3000
76 2 7/18/2017 L "1208012306160003 "1208011807170001 Grizman Andriano 3000
77 1 10/13/2015 L "1208010305100015 "1208011310150002 Green Maximilliano 3200
78 2 7/27/2017 P "1208010305100015 "1208016707172001 Sharon Abigael 3100
79 2 1/28/2017 P "1208012709130013 "1208016801172002 CHINDIE SOFIA 2800
80 2 4/19/2017 L "1208032904130007 "1208031904170001 Alif Alhafie 3000
81 1 1/26/2016 P "1208012002120006 "1208016601160001 Angela K. Romaito 3200
82 2 4/7/2017 L "1208010911120001 "1208010704172001 Ahmad Zhakaria 3000
83 2 9/10/2015 P "1208012111120007 "1208015009150001 Cristy Belvania 3100
84 1 9/13/2014 P "1208011411130003 "1208015309140001 Joice Gracia 3000
85 2 4/1/2015 P "1208012201150007 "1208014104150002 Bintang Renata 3100
86 1 3/14/2016 L "1208011509110012 "1208011403160001 Al. Iataz Mhd. Zain Da 3200
87 1 4/20/2016 L "1208012704170002 "1205152004160002 Juan Tristan 3100
88 3 4/5/2017 L "1208011209120002 "1208010504170001 Cherisbey Putera 3000
89 2 6/22/2016 P "1208010112150003 "1208016206160002 Bellvania Adishi 3100
90 2 9/2/2014 P "317506100913079 "3175064209141002 Angelika Aprilia 3000
91 1 1/25/2015 L "1208011301150002 "1208016501150001 Prayson Ariphanias 3100
92 2 9/20/2015 L "1471100404130010 "1471102009150002 Meshach Efran 3200
93 3 10/17/2014 P "1208011301120002 "1208016710140001 Yemima Hosana 3000
94 1 6/28/2016 L "1208012309150005 "1208012806160001 Frans Gideon 2900
95 2 10/14/2017 P "1208012309150005 1208012806160001 Klaudia Gultom 3000
96 3 1/28/2016 L "12080111202130001 "1208112801160001 Andreas Sianturi 2900
97 2 6/5/2015 L "1208011107160001 "1271070506150001 Dastan Imanuel 3200
98 1 4/21/2016 L "1208010107100024 "1208012105160004 Equino Keynzo 3000
99 1 2/8/2017 P 1208012903160007 "1208014802170001 Alifa Zahra 2900
100 2 8/26/2017 L "1208013108120005 "1208012608170001 Edward Riski 3100
101 2 2/9/2015 P "1208011612130004 "1208014902160001 Gwen Eleanor 3200
102 1 12/27/2017 L "1208011209170005 "1208012712172003 Jose Yoan 3100
103 2 6/14/2015 L "1208012802120004 "1208011406150001 Joel Praja Purba 3200
104 1 1/26/2016 P "1208012002120006 "1208016601160001 Angela Romaito 3100
105 4 6/7/2017 L "1272043010150003 "1272040706170001 Riski Andri 3200
106 2 9/15/2017 P "1208012908170009 Dwi Anggraini 3100
107 1 12/25/2015 L "1208010701150015 "1208012512150002 Rafael Andriano 3200
108 2 4/19/2017 L "1208010701150015 Alif 3000
109 2 8/10/2014 L Baswedan 3100
110 2 11/20/2015 P Adelika Girsang 3000
111 1 28/07/2015 P "1208012702080028 "1208016807150001 Gein Shane Fransiska 3200
112 2 16/06/2015 P Elkana Panjaitan 3500
113 1 19/11/2015 L Alfaro Purba 2900
114 1 5/15/2015 L "1208011505150002 Noel Putra Arna 3300
115 2 8/21/2016 P Sivha 3000
116 2 10/3/2016 L Doly 3200
117 1 10/5/2017 L Cristian Alfaro 3000
118 2 2/5/2018 L Zhoya 3100
119 2 6/11/2017 L Choirul Ramadan 3000
120 2 12/14/2015 L Abian Lubis 3100
121 1 12/20/2017 L Gabriel Gultom 3000
122 2 12/13/2016 L Dave Manurung 3000
123 2 29/10/2017 L M. Fiqal 3000
124 2 29/01/2018 P Birdella Ghania 3100
125 3 18/01/2018 P Michelly Amore 3200
126 1 06/05/2018 L Zhufarino Alfarizal 3000
127 2 10/01/2018 P Akifa Ardila 3100
128 1 21/06/2018 P Avlora Purba 3000
129 2 06/01/2015 P Humairah 2800
130 1 15/01/2017 L 1208010410160012 1208011501170001 Jhosua Purba 3500
131 2 08/02/2017 L Bama Maruala Pakpahan3000
132 1 10/04/2017 L Jaysen Manurung 2800
133 2 25/01/2017 L Prayson Panggabean 3000
134 2 23/11/2017 L Risky Prasetia 3100
135 3 14/07/2017 P Luisa Kirana Saragih 3000
136 2 27/02/2018 L Yanfanco Hutabarat 3000
137 1 08/09/2017 P Ledy Arta Silaen 2900
138 2 06/04/2018 L 1208010701150015 1208010604180001 RifanoAdelio Simarmata3200
139 3 2/23/2017 L 1206121607180004 1206122302170001 Rafi Hidayat 3000
140 1 Angela Regina
7/15/2017 P 1208012107160005 1208015507170001 3000
Nainggolan
141 2 Mikha Queen

11/13/2015 P 1208010612170010 1208015311150002 3100
Rajagukguk
142 2 10/17/2014 P 1208011301120002 1208016710140001 Yemima Silalahi 3200
143 3 12/13/2017 P 1208011301120002 Esra Vanesha Silalahi 3000
144 3 1/28/2016 L 12080111202130001 1208012801160001 Andreas Sianturi 3100
145 2 8/8/2016 L 1208011007140004 1208010808160001 Hamizan Mughty 3000
146 1 6/28/2016 L 1208012309150005 1208012806160001 Frans Gideon Gultom 3000
147 2 10/14/2017 P 1208012309150005 Klaudia Gultom 3100
148 2 3/1/2016 L 1208011202140007 1208010103162001 Mhd .Rafie Hadinata 3000
149 2 9/25/2016 P 1208011605130002 1208016509160003 Agnes Syakila 3000
150 3 10/5/2018 L 1208011605130002 Krisna Gilbert 3200
151 1 2/13/2018 L Calixto Geraldi 3000
152 3 Bama Maruala
2/8/2017 L 3000
Pakpahan
153 11/23/2017 L Risky Prasetia 3000
154 9/8/2017 P Ledy Arta Silaen 3000
155 3 9/22/2018 P 12080115021180002 1208016209182001 Vania Judith Sirait 3100
156 1 7/16/2018 P Elfatih Raldin 3000
157 1 12/27/2018 P Raisa Kirana 3000
158 1 12/13/2018 P Rahel Cecilia Putra 3000
159 3 7/14/2017 P Luisa Kirana Saragih 3000
160 1 10/24/2018 P Rista Maria Sihotang 3100
161 1 2/1/2019 P Butet 3000
162 1 4/14/2018 L Moh.Arfan 3100
163 3 Bintang Muysbah
8/13/2018 P 1208010102110039 1208015308180001 3800
Hasibuan
164 1 7/12/2018 L Elfano Benaya Girsang 3000

165 1 6/16/2018 L 1208012304180003 1208011606182001 Ello Pratama Girsang 3000
166 1 11/14/2018 P 1277012603180005 Butet Nasution 3200
167 1 9/22/2018 P 12080115021180002 1208016209182001 Vania Judith 3000
168 1 7/16/2018 P Elfatih 3100
169 2 5/9/2018 L Moh,Arfan 3000
170 1 12/27/2014 P Raisa 3000
171 1 12/13/2018 P Rachel Cecilia Purba 3000
172 1 2/24/2019 P Butet 3000
173 1 8/1/2014 L Jesaldi Samuel 3000
174 2 12/22/2017 P Friskila Tp.Bolon 3000
175 1 1/31/2019 L Fathan Alfahri 3000
176 2 9/27/2018 P Khairah Sakhi 3100
177 3 Cristian Raphael
11/27/2014 L 3518030610170005 3518032711140002 3000
Ignasius
178 4 Samuel Ricard

7/30/2016 L 3518030610170005 351833007180001 3200
Wulandana
179 1 1/10/2018 P 1208012303180005 1208012106180001 Alifah Maysari 3000
180 1 Muhammad Shauqi
6/21/2018 L 1207211409096909 1207216305160001 3500
Alfatih
181 4 5/23/2016 P 1208013107170008 1208011012150003 Putri permadi 3000
182 1 12/10/2015 L 6472032807110017 6472036010180001 Adipati Dian Fadillah 3000
183 3 Carissa Agatha
10/20/2018 P 1271162005130002 1271165607170003 3100
Silitonga
184 4 7/16/2017 P 1271162005130002 1271166610180001 Vania Felisia Purba 3200
185 2 11/26/2018 P 1274051011110001 1274055502150001 Alisia Nathania Purba 3100
186 1 2/15/2015 P 1274051011110001 Valentin Sirait 3100
187 2 6/17/2019 P Triana Sirait 3000
188 2 12/31/2015 P Florensia Sibagariang 3000
189 3 7/16/2019 P Amora Sibagariang 3000

190 1 6/28/2019 L Enjo Simbolon 3000
191 2 5/23/2019 L Arsen Bezalen Sirait 3000
192 6/4/2019 P Elisabet Sianturi 3000
193 7/1/2019 P Quensa Alusa Siregar 3000
194 6/10/2019 P Vanessa Purba 3000
195 3 6/4/2019 P Aurella Anita 3000
196 1/31/2019 L Fatan Alfahri 3000
197 Shaquena Almahira
7/1/2019 P 3200
Damanik
198 4/12/2019 L Adriel Purba 3100
199 2 3/4/2018 L Arganatha Saragih 3000
200 7/15/2017 P Regina 3000
201 1 2/18/2019 P Vionetta Feby Damanik 3000
202 Devin Alfaro

9/15/2018 L 3000
Manullang
203 9/10/2018 P Mutiara Adelia 3000
204 2 10/19/2018 L Moh.Nazam Maulana 3000
205 1 4/1/2019 L Azam 3000
206 1 Lamhot Hotniel
4/29/2017 L 1272030810150002 1272032904170001 3300
Situmorang
207 4 3/1/2015 L 1208012809120001 1208010103150002 Ismail Pratama Siahan 3200
208 5 Shela Grace Amora

10/6/2016 P 1208112809120001 1208014610160002 3200
Siahaan
209 4 8/21/2019 L Ucok 3500
210
211
212
213
214
215
216
217
218
219
220
Keterangan
Kolom Jika Pemantauan Perkembangan menggunakan kusioner pra skrining perkembangan (SDIDTK) diisi Ds (Sesuai) jika skor KPSP=9-
Kolom Jika Pemantauan Perkembangan menggunakan ceklist buku KIA, diisi S jika jawaban ya untuk seluruh pertanyaan, diisi TS jika ad
Kolom Diisi SL (lanjutkan stimulasi dan jadwalkan kunjungan berikutnya) jika hasil pemeriksaan KPSP atau ceklist Buku KIA menghasilka
Diisi R (Rujuk) jika hasil pemeriksaan melalui KPSP menghasilkan Penyimpangan (P) atau jika pemeriksaan melalui Buku KIA men
Nama Posyandu MELATI / MELUR

Bulan AGUSTUS
Tahun 2019
Kepemilik
an Buku
KIA/KMS IMD 1=Ya Nama Ayah NIK Ayah No Telp/HP Ayah Alamat RT RW
2=Tidak
1=Ya
2=Tidak
(9) (10) (11) (12) (13) (15) (16) (17)

1 1 Yori Azwan "1208010409920002 085296495931 Cengkeh
1 1 Karmidin "1208010409780003 085296495931 Cengkeh
1 1 Hendri "1208010200820004 085296495931 Cengkeh
1 1 Trisura Haris "1208012610860004 085296495931 Cengkeh
1 1 Samson "1208011306780001 085296495931 Mangga
1 1 Hariman "1208011204940001 085296495931 Cengkeh
1 1 Moh. Safii "120803200591004 085296495931 Mangga
1 1 Tono Rido "1208011106790007 085296495931 Mangga
1 1 Ricardo "1208010203870002 085296495931 Mangga
1 1 Pesta "1208012612730005 085296495931 Mangga
1 1 Hendra Cristian "1208011900820001 085296495931 Mangga
1 1 Jonni Sahat "1208010811790003 085296495931 Mangga
1 1 Jhon Alex "1208011701850001 085296495931 Nangka
1 1 Andre Yudistira "1208012308850001 085296495931 D.Raya
1 1 Hajaruddin Ahmad "12080112104890002 085296495931 Nangka
1 1 Risdoni Taruli "1208016808850003 085296495931 Nangka
1 1 Erwin Arianto "1271032801840002 085296495931 Kom.Pusk
1 1 Harry Daniel "1208011508730001 085296495931 C.Raya
1 1 Maruly "1208012306860002 085296495931 Mangga
1 1 Ivan Roymanto "1208011105890003 085296495931 Cengkeh
1 1 Tarsona "1208011607860003 085296495931 Durian
1 1 Henrry Juni Armando "12710705069000002 085296495931 T,Raya
1 1 Reinhard Oloan "1208011509860004 085296495931 Durian
1 1 Janres Sinabutar "1208012411680002 085296495931 Durian
1 1 Wilson Sinaga "1208012812670002 085296495931 Durian
1 1 Hardianto Marpaung "6171052406790005 085296495931 C.Raya
1 1 Pandapotan Tondang "1208010402180002 085296495931 Durian
1 1 Dody Alfrin "1208010609850003 085296495931 Durian
1 1 Edianto Pasaribu "1208011709840010 085296495931 Durian
1 1 Juprin Purba "1208011703810001 085296495931 Durian
1 1 Eli Rahmad Telambenua "1208013103720003 085296495931 Durian
1 1 Charles Edward "1208012602740001 085296495931 Durian
1 1 Manson Fery "1208012811820001 085296495931 Durian
1 1 Irwansyah Saragih "1208013103710001 085296495931 N.Raya
1 1 Jonson Siboro "1208011107750003 085296495931 Nangka
1 1 Binsar Panjaitan "12080106002650001 085296495931 Nangka
1 1 Andika Kelana Lubis "1272021903770002 085296495931 Nangka
1 1 Muhammad Ridwan "1208012110770003 085296495931 D.Raya
1 1 Nur Edi "120801070180001 085296495931 D.Raya
1 1 Davis Arahman "1208010704860005 085296495931 A.Raya
1 1 Erwin Siregar "1207021908790009 085296495931 A.Raya
1 1 Dolok Franky "1208012611770006 085296495931 A.Raya
1 1 Jamiden Fernando "1208011403830001 085296495931 A.Raya
1 1 Moh.Ali Sukri "1208010309850003 085296495931 Mangga
1 1 Moh.Ali Sukri "1208010309850003 085296495931 Mangga
1 1 Joni Lesi "1208011507880003 085296495931 A.Raya
1 1 Olo Lastian "1471011005800001 085296495931 A.Raya
1 1 Fiter Fernandes "1208011902850001 085296495931 K. Raya
1 1 Marihot "1208011105900002 085296495931 Kasiavera
1 1 I'I Chical "1208010402880002 085296495931 D.Raya
1 1 I'I Chical "1208010402880002 085296495931 D.Raya
1 1 Latif Lubis 085296495931 Durian
1 1 Reja 085296495931 Nangka
1 1 Rahmad Yusnandar "1208011909930003 085296495931 Durian
1 1 Lasmaida 085296495931 Durian
1 1 Chairul Nizar "1208012011830003 085296495931 Kasiavera
1 1 Rivai Lubis "1208010310820006 085296495931 Kemiri
1 1 Rivai Lubis "1208010310820006 085296495931 Kemiri
1 1 Agus Samuel "1208011408830001 085296495931 M.Raya
1 1 Maya Sari "1208016611870002 085296495931 Kemiri
1 1 Rahmad Yusnandar "1208011909930003 085296495931 M.Raya
1 1 Rahmad Yusnandar "1208011909930003 085296495931 M.Raya
1 1 Johannis "1208012207850001 085296495931 T.Raya
1 1 Ahmad Isnaini "1208010401930001 085296495931 Kemiri
1 1 085296495931 T.Raya
1 1 Priska Sinaga "12108016012600004 085296495931 T.Raya
1 1 Bezisokhi "12080101812950005 085296495931 M.Raya
1 1 Sutrisno "1207023112710037 085296495931 Kemiri
1 1 Jumpa "1208010104720001 085296495931 Kemiri
1 1 Fauzi "1208012311820001 085296495931 Kemiri
1 1 Suandi "1272050506870003 085296495931 Kemiri
1 1 Suandi "1272050506870003 085296495931 Kemiri
1 1 Yurvani Roko "1208010306850001 085296495931 Kemiri
1 1 Cristopel Sihite "1208011712900001 085296495931 Enau
1 1 Andriyani Ottolink "1208011410740003 085296495931 Enau
1 1 Andriyani Ottolink "1208011410740003 085296495931 Enau
1 1 Sahat "1208261303860001 085296495931 Enau
1 1 Rusmiadi "1208031702790001 085296495931 Enau
1 1 Rotua SihoTang "1208012512840006 085296495931 Enau
1 1 Sawaluddin "1208021307810003 085296495931 Kasiavera
1 1 Dharma Eratirta ""1208011704820001 085296495931 Enau
1 1 Yancen Hutabarat "1208012908850009 085296495931 Enau
1 1 Hendri "1208011111720004 085296495931 Enau
1 1 Hendri "1208011111720004 085296495931 Enau
1 1 Pangihutan "1208050808850006 085296495931 Enau
1 1 Benny Findana "1208011901810004 085296495931 Enau
1 1 Jhon Nover "1272061111850006 085296495931 Enau
1 1 Ucok Arfin "3175061203830008 085296495931 Enau
1 1 Pesta Tua "1208012208830001 085296495931 Enau
1 1 Tulus Harapan "1202041804760004 085296495931 Kasiavera
1 1 Hefdi Prianto "1208012406790004 085296495931 Kasiavera
1 1 Juan Tanamal "1208012404830002 085296495931 Kasiavera
1 1 Juan Tanamal "1208012404830002 085296495931 Kasiavera
1 1 Hermanto "12080110112820005 085296495931 Kasiavera
1 1 Kristian Togutua "1271072905800004 085296495931 D.Raya
1 1 Abdi Rezeki "1208010110810003 085296495931 M.Raya
1 1 Rihwan Efendi "1271210409890002 085296495931 T.Raya
1 1 Herlan Sihombing "1208010311850003 085296495931 D.Raya
1 1 Bemri Lihardo "1208012201870002 085296495931 T.Raya
1 1 Lastro "1272012209850004 085296495931 Kasiavera
1 1 Justin Fredy "1208011211830002 085296495931 Kasiavera
1 1 Rotua Sihotang "1208012512840006 085296495931 Kasiavera
1 1 Adi Saputra "1272020112750002 085296495931 Kasiavera
1 1 Suherman "1208230207860003 085296495931 Kasiavera
1 1 Rey Pendra "1208010807840003 085296495931 Kasiavera
1 1 Sabar Siadari 085296495931 Cengkeh
1 1 Betman 085296495931 Durian
1 1 Franky "1208011705780001 085296495931 Nangka
1 1 Gibson 085296495931 Cengkeh
1 1 Jimmy 085296495931 Durian
1 1 Arditua Simanjuntak "1208010704780001 085296495931 C.Raya
1 1 Rodiatun Jefri 085296495931 Nangka
1 1 Silvia 085296495931 Durian
1 1 Benyamin 085296495931 Durian
1 1 Budi 085296495931 Cengkeh
1 1 Junedi Saputra 085296495931 Kemiri
1 1 Chairil 085296495931 A.Raya
1 1 Antoni 085296495931 Nangka
1 1 Ebenezer 085296495931 Cengkeh
1 1 Samsul Bahri 085296495931 Nangka
1 1 Syahputra 085296495931 Nangka
1 1 Wahidin Simarmata 085296495931 T.Raya
1 1 Rezeki Ramadansyah 085296495931 Durian
1 1 Zulham 085296495931 T.Raya
1 1 Dian Syahputra 085296495931 Durian
1 1 Candra 085296495931 A.Raya
1 1 Rajalin Valentino 1208011602890004 085296495931 Kemiri
1 1 B.Pakpahan 085296495931 Enau
1 1 Jospel 085296495931 Enau
1 1 Pesta 085296495931 Enau
1 1 Irwan Juandry 085296495931 Enau
1 1 Juandry 085296495931 Enau
1 1 Yansen "1208012908850009 085296495931 Enau
1 1 Hando Silaen 085296495931 Kemiri
1 1 Robinson 1206125506140002 085296495931 Kemiri
1 1 Laurensius Nainggolan 1208010110890005 085296495931 Kasiavera
1 1 Hendra Rajagukguk 1208012004840002 085296495931 Kasiavera
1 1 Hefdi Prianto 1208012405790004 085296495931 Kasiavera

1 1 Hefdi Prianto 1208012405790004 085296495931 Kasiavera
1 1 Hermanto Sianturi 1208110112820005 085296495931 Kasiavera
1 1 Ramadhan 1272022005850002 085296495931 Makadame
1 1 Juan Tanamal 1208012404830002 085296495931 Kasiavera
1 1 Juan Tanamal 1208012404830002 085296495931 Kasiavera
1 1 Ramadan 1208010106850002 085296495931 Enau
1 1 Deni Silalahi 1208011704880002 085296495931 Kasiavera
1 1 Deni Silalahi 1208011704880002 085296495931 Kasiavera
1 1 Ranto 085296495931 Kemiri
1 1 B.Pakpahan 085296495931 Makadame
1 1 Irwan 085296495931 Makadame

1 1 Hendra 085296495931 Kemiri
1 1 Agus Viktor 1208011208890003 085296495931 Durian
1 1 Nurul 085296495931 Durian Raya
1 1 085296495931 Durian
1 1 Dohar 1208012982002 085296495931 Durian
1 1 Juandry 085296495931 Komp.LP
1 1 Ronaldo 085296495931 Enau
1 1 Edi Sanusi Purba 085296495931 Kasiavera
1 1 Erfian 085296495931 Kasiavera
1 1 Febrigani Hasibuan 1208012502830005 085296495931 Durian
1 1 Edwin Girsang 085296495931 Mangga
1 1 Dedy Juniantry 1208010306870002 085296495931 Durian
1 1 Irfan Wahyudi Nasution 1277011311880004 085296495931 Durian Raya
1 1 Agus Viktor 1208011208890003 085296495931 Durian

1 1 Nurul 085296495931 Durian
1 1 Erfian Purba 085296495931 Durian
1 1 Erfian Purba 085296495931 Durian
1 1 Dohar Purba 1208012909820002 085296495931 Durian
1 1 Brano Tampubolon 085296495931 Tusam Raya
1 1 Jon Alex 085296495931 Nangka

1 1 Jon Alex 085296495931 Nangka
1 1 Suprayetno 085296495931 Enau
1 1 Ahmad Ismaini 085296495931 Enau
1 1 Hendra 910403507775001 085296495931 Nangka
1 1 Hendra 9104030507775001 085296495931 Nangka
1 1 Samuel Bahri 085296495931 Nangka
1 1 Irwansyah 120801150684001 085296495931 Nangka
1 1 Armadi 1207210301830004 085296495931 Nangka

1 1 Saputra 1208012108920001 085296495931 A.Raya
1 1 Herman Silitonga 1208212004820002 085296495931 Enau
1 1 Nganton Purba 12711614006830001 085296495931 Enau

1 1 Nganton Purba 12711614006830001 085296495931 Enau
1 1 Pahala Sirait 1218062111890001 085296495931 Kemiri
1 1 Pahala Sirait 085296495931 Kemiri
1 1 Donald Sibagariang 085296495931 Durian
1 1 Donald Sibagariang 085296495931 Durian

1 1 Ivan Simbolon 085296495931 Mangga
1 1 Andreas Sihite 085296495931 Kasiavera
1 1 Hermanto Sianturi 085296495931 Kasiavera
1 1 Abdi Rezeki 085296495931 Makadame
1 1 Valentino 085296495931 Kasiavera
1 1 Indra Girsang 085296495931 Kemiri
1 1 Suprayetno 085296495931 D.Raya
1 1 Parulian Damanik 085296495931 Enau
1 1 Viktor Purba 1208012907810001 085296495931 Kemiri

1 1 Julianus Saragih 085296495931 Komp.sdlb
1 1 Laurensius Nainggolan 085296495931 Kasiavera
1 1 Simon Boby Damanik 085296495931 Kemiri
1 1 Fredy 085296495931 Enau
1 1 Ferdinan 085296495931 Kasiavera

1 1 Nurazizah 085296495931 Kasiavera
1 1 Ahmad Fauzi Nasution '1277013010880005 085296495931 Kemiri
1 1 Atur Situmorang 12720310048110002 085296495931 Kemiri
1 1 Oloan Chandra Siahaan 1208012103850001 085296495931 Kemiri
1 1 Oloan Chandra Siahaan 1208012103850001 085296495931 Kemiri
1 1 Fauzi Harahap 085296495931 Kemiri

skor KPSP=9-10, Dm (Meragukan) skor=7-8, diisi Dp(Kemungkinan penyimpangan) jika skor<7
diisi TS jika ada satu atau lebih jawaban tidak untuk seluruh pertanyaan
A menghasilkan Sesuai (S)
Buku KIA menghasilkan Tidak Sesuai (TS)

ANDU
Panjang Cara Ukur ASI Eksklusif 1=Ya 2=Tidak Perkem

Vitamin A Vitamin A
Badan/Ti
(cm) KPSP
Umur 0 Umur 1 Umur 2 Umur 3 Umur 4 Umur 5 Ds/Dm/D
bln bln bln bln bln bln p
(18) (19) (20) (21) (21) (22) (23) (24) (25) (26) (27) (28) (29)
8/5/2019 16.1 102 2 1 1 1 1 1 1 1 1 Ds
8/5/2019 11.5 84 1 1 1 1 1 1 1 1 1 Ds
8/5/2019 11.5 84 2 1 1 1 1 1 1 1 1 Ds
8/5/2019 15.5 101 2 1 1 1 1 1 1 1 1 Ds
8/5/2019 16.5 102 2 1 1 1 1 1 1 1 1 Ds
8/5/2019 11.5 88 2 1 1 1 1 1 1 1 1 Ds
8/5/2019 11.5 84 1 1 1 1 1 1 1 1 1 Ds
8/5/2019 13.5 91.5 2 1 1 1 1 1 1 1 1 Ds
8/5/2019 12.8 89 2 1 1 1 1 1 1 1 1 Ds
8/5/2019 15.5 98 2 1 1 1 1 1 1 1 1 Ds
8/5/2019 10 75 1 1 1 1 1 1 1 1 1 Ds
8/5/2019 17 105 2 1 1 1 1 1 1 1 1 Ds
8/5/2019 11.5 84 1 1 1 1 1 1 1 1 1 Ds
8/5/2019 12.5 86 2 1 1 1 1 1 1 1 1 Ds
8/5/2019 12.5 86 2 1 1 1 1 1 1 1 1 Ds
8/5/2019 16 99 2 1 1 1 1 1 1 1 1 Ds
8/5/2019 10 80 1 1 1 1 1 1 1 1 1 Ds
8/5/2019 14 95 2 1 1 1 1 1 1 1 1 Ds
8/5/2019 15.5 98 2 1 1 1 1 1 1 1 1 Ds
8/5/2019 15.5 98 2 1 1 1 1 1 1 1 1 Ds
8/5/2019 13.5 93 2 1 1 1 1 1 1 1 1 Ds
8/5/2019 17.5 105 2 1 1 1 1 1 1 1 1 Ds
8/5/2019 11 84 1 1 1 1 1 1 1 1 1 Ds
8/5/2019 12.5 91 2 1 1 1 1 1 1 1 1 Ds
8/5/2019 16.5 102 2 1 1 1 1 1 1 1 1 Ds
8/5/2019 18.5 106 2 1 1 1 1 1 1 1 1 Ds
8/5/2019 17.5 105 2 1 1 1 1 1 1 1 1 Ds
8/5/2019 16.5 103 2 1 1 1 1 1 1 1 1 Ds
8/5/2019 14.5 94 2 1 1 1 1 1 1 1 1 Ds
8/5/2019 17.5 103 2 1 1 1 1 1 1 1 1 Ds
8/5/2019 14.5 93 2 1 1 1 1 1 1 1 1 Ds
8/5/2019 11.5 82 1 1 1 1 1 1 1 1 1 Ds
8/5/2019 16.5 105 2 1 1 1 1 1 1 1 1 Ds
8/5/2019 13.5 92 2 1 1 1 1 1 1 1 1 Ds
8/5/2019 14 99 2 1 1 1 1 1 1 1 1 Ds
8/5/2019 16.5 100 2 1 1 1 1 1 1 1 1 Ds
8/5/2019 16.5 105 2 1 1 1 1 1 1 1 1 Ds
8/5/2019 16.5 103 2 1 1 1 1 1 1 1 1 Ds
8/5/2019 15.5 98 2 1 1 1 1 1 1 1 1 Ds
8/5/2019 16.5 103 2 1 1 1 1 1 1 1 1 Ds
8/5/2019 12.5 90 2 1 1 1 1 1 1 1 1 Ds
8/5/2019 16.5 105 2 1 1 1 1 1 1 1 1 Ds
8/5/2019 11.5 85 2 1 1 1 1 1 1 1 1 Ds
8/5/2019 10.5 83 2 1 1 1 1 1 1 1 1 Ds
8/5/2019 10.5 82 2 1 1 1 1 1 1 1 1 Ds
8/5/2019 13.5 94 2 1 1 1 1 1 1 1 1 Ds
8/5/2019 9.5 77 1 1 1 1 1 1 1 1 1 Ds
8/5/2019 13 92 2 1 1 1 1 1 1 1 1 Ds
8/5/2019 18 106 2 1 1 1 1 1 1 1 1 Ds
8/5/2019 17 105 2 1 1 1 1 1 1 1 1 Ds
8/5/2019 14 93 2 1 1 1 1 1 1 1 1 Ds
8/5/2019 13 92 2 1 1 1 1 1 1 1 1 Ds
8/5/2019 9.5 74 1 1 1 1 1 1 1 1 1 Ds
8/5/2019 18.5 106 2 1 1 1 1 1 1 1 1 Ds
8/5/2019 16.5 103 2 1 1 1 1 1 1 1 1 Ds
8/5/2019 16.5 105 2 1 1 1 1 1 1 1 1 Ds
8/5/2019 16 105 2 1 1 1 1 1 1 1 1 Ds
8/5/2019 17 104 2 1 1 1 1 1 1 1 1 Ds
8/5/2019 15.5 103 2 1 1 1 1 1 1 1 1 Ds
8/5/2019 7.6 74 1 1 1 1 1 1 1 1 1 Ds
8/5/2019 12.8 89 2 1 1 1 1 1 1 1 1 Ds
8/5/2019 15 98 2 1 1 1 1 1 1 1 1 Ds
8/5/2019 16.5 104 2 1 1 1 1 1 1 1 1 Ds
8/5/2019 15.5 100 2 1 1 1 1 1 1 1 1 Ds
8/5/2019 10.5 80 2 1 1 1 1 1 1 1 1 Ds
8/5/2019 13 92 2 1 1 1 1 1 1 1 1 Ds
8/5/2019 16.5 105 2 1 1 1 1 1 1 1 1 Ds
8/5/2019 16.5 105 2 1 1 1 1 1 1 1 1 Ds
8/5/2019 10.5 82 2 1 1 1 1 1 1 1 1 Ds
8/5/2019 16.5 105 2 1 1 1 1 1 1 1 1 Ds
8/5/2019 16.5 104 2 1 1 1 1 1 1 1 1 Ds
8/5/2019 14.5 95 2 1 1 1 1 1 1 1 1 Ds
8/5/2019 15.5 98 2 1 1 1 1 1 1 1 1 Ds
8/5/2019 11.5 88 2 1 1 1 1 1 1 1 1 Ds
8/5/2019 17.5 105 2 1 1 1 1 1 1 1 1 Ds
8/5/2019 11.5 85 2 1 1 1 1 1 1 1 1 Ds
8/5/2019 15.5 98 2 1 1 1 1 1 1 1 1 Ds
8/5/2019 10.5 83 2 1 1 1 1 1 1 1 1 Ds
8/5/2019 12.5 88 2 1 1 1 1 1 1 1 1 Ds
8/5/2019 12.5 88 2 1 1 1 1 1 1 1 1 Ds
8/5/2019 14.5 97 2 1 1 1 1 1 1 1 1 Ds
8/5/2019 12.5 88 2 1 1 1 1 1 1 1 1 Ds
8/5/2019 16 100 2 1 1 1 1 1 1 1 1 Ds
8/5/2019 16.5 105 2 1 1 1 1 1 1 1 1 Ds
8/5/2019 15.5 102 2 1 1 1 1 1 1 1 1 Ds
8/5/2019 14 97 2 1 1 1 1 1 1 1 1 Ds
8/5/2019 14 95 2 1 1 1 1 1 1 1 1 Ds
8/5/2019 12.5 88 2 1 1 1 1 1 1 1 1 Ds
8/5/2019 13.5 95 2 1 1 1 1 1 1 1 1 Ds
8/5/2019 17.5 106 2 1 1 1 1 1 1 1 1 Ds
8/5/2019 16.5 105 2 1 1 1 1 1 1 1 1 Ds
8/5/2019 15.5 100 2 1 1 1 1 1 1 1 1 Ds
8/5/2019 18.5 106 2 1 1 1 1 1 1 1 1 Ds
8/5/2019 13.5 95 2 1 1 1 1 1 1 1 1 Ds
8/5/2019 10.5 82 2 1 1 1 1 1 1 1 1 Ds
8/5/2019 14.5 98 2 1 1 1 1 1 1 1 1 Ds
8/5/2019 16.5 102 2 1 1 1 1 1 1 1 1 Ds
8/5/2019 14.5 95 2 1 1 1 1 1 1 1 1 Ds
8/5/2019 12.5 90 2 1 1 1 1 1 1 1 1 Ds
8/5/2019 11.5 85 2 1 1 1 1 1 1 1 1 Ds
8/5/2019 16 103 2 1 1 1 1 1 1 1 1 Ds
8/5/2019 11.5 81 1 1 1 1 1 1 1 1 1 Ds
8/5/2019 16 102 2 1 1 1 1 1 1 1 1 Ds
8/5/2019 15 97 2 1 1 1 1 1 1 1 1 Ds
8/5/2019 11.5 86 2 1 1 1 1 1 1 1 1 Ds
8/5/2019 8.5 80 2 1 1 1 1 1 1 1 1 DS
8/5/2019 14.5 98 2 1 1 1 1 1 1 1 1 Ds
8/5/2019 12.5 88 2 1 1 1 1 1 1 1 1 Ds
8/5/2019 17 106 2 1 1 1 1 1 1 1 1 Ds
8/5/2019 15.5 98 2 1 1 1 1 1 1 1 1 Ds
8/5/2019 15.5 99 2 1 1 1 1 1 1 1 1 Ds
8/5/2019 16.5 100 2 1 1 1 1 1 1 1 1 Ds
8/5/2019 15.5 98 2 1 1 1 1 1 1 1 1 Ds
8/5/2019 16.5 102 2 1 1 1 1 1 1 1 1 Ds
8/5/2019 13.5 92 2 1 1 1 1 1 1 1 1 Ds
8/5/2019 14.5 94 2 1 1 1 1 1 1 1 1 Ds
8/5/2019 11.5 83 2 1 1 1 1 1 1 1 1 Ds
8/5/2019 10.5 80 1 1 1 1 1 1 1 1 1 Ds
8/5/2019 13 88 2 1 1 1 1 1 1 1 1 Ds
8/5/2019 16.5 100 2 1 1 1 1 1 1 1 1 Ds
8/5/2019 11.5 82 1 1 1 1 1 1 1 1 1 Ds
8/5/2019 13.5 90 2 1 1 1 1 1 1 1 1 Ds
8/5/2019 11.5 84 2 1 1 1 1 1 1 1 1 Ds
8/5/2019 9.5 78 1 1 1 1 1 1 1 1 1 Ds
8/5/2019 10 80 1 1 1 1 1 1 1 1 1 Ds
8/5/2019 9.5 78 1 1 1 1 1 1 1 1 1 Ds
8/5/2019 9.5 80 1 1 1 1 1 1 1 1 1 Ds
8/5/2019 9.5 74 1 1 1 1 1 1 1 1 1 Ds
8/5/2019 16.5 104 2 1 1 1 1 1 1 1 1 Ds
8/5/2019 12.5 89 2 1 1 1 1 1 1 1 1 Ds
8/5/2019 12.5 89 2 1 1 1 1 1 1 1 1 Ds
8/5/2019 12.5 89 2 1 1 1 1 1 1 1 1 Ds
8/5/2019 13.5 89 2 1 1 1 1 1 1 1 1 Ds
8/5/2019 10.5 82 2 1 1 1 1 1 1 1 1 Ds
8/5/2019 11.5 84 2 1 1 1 1 1 1 1 1 Ds
8/5/2019 10.5 79 1 1 1 1 1 1 1 1 1 Ds
8/5/2019 11.5 83 1 1 1 1 1 1 1 1 1 Ds
8/5/2019 10.5 78 1 1 1 1 1 1 1 1 1 Ds
8/5/2019 12.5 89 2 1 1 1 1 1 1 1 1 Ds
8/5/2019 11.5 86 2 1 1 1 1 1 1 1 1 Ds
8/5/2019 15.5 100 2 1 1 1 1 1 1 1 1 Ds
8/5/2019 16.5 105 2 1 1 1 1 1 1 1 1 Ds

8/5/2019 11.5 83 1 1 1 1 1 1 1 1 1 Ds
8/5/2019 14.5 98 2 1 1 1 1 1 1 1 1 Ds
8/5/2019 13.5 93 2 1 1 1 1 1 1 1 1 Ds
8/5/2019 14.5 95 2 1 1 1 1 1 1 1 1 Ds
8/5/2019 11.5 83 2 1 1 1 1 1 1 1 1 Ds
8/5/2019 14.5 98 2 1 1 1 1 1 1 1 1 Ds
8/5/2019 13.5 92 2 1 1 1 1 1 1 1 1 Ds
8/5/2019 8.5 72 1 1 1 1 1 1 1 1 1 Ds
8/5/2019 10.5 80 1 1 1 1 1 1 1 1 1 Ds
8/5/2019 13.5 89 2 1 1 1 1 1 1 1 1 Ds
8/5/2019 10.5 82 1 1 1 1 1 1 1 1 1 Ds
8/5/2019 10.5 82 1 1 1 1 1 1 1 1 1 Ds
8/5/2019 8 70 1 1 1 1 1 1 1 1 1 Ds
8/5/2019 9 73 1 1 1 1 1 1 1 1 1 Ds
8/5/2019 7 66 1 1 1 1 1 1 1 1 1 Ds
8/5/2019 7.5 67 1 1 1 1 1 1 1 1 1 Ds
8/5/2019 11.5 84 2 1 1 1 1 1 1 1 1 Ds
8/5/2019 7.5 69 1 1 1 1 1 1 1 1 1 Ds
8/5/2019 7 65 1 1 1 1 1 1 1 0 1 Ds
8/5/2019 9.5 78 1 1 1 1 1 1 1 1 1 Ds
8/5/2019 8.5 72 1 1 1 1 1 1 1 1 1 Ds
8/5/2019 9.5 75 1 1 1 1 1 1 1 1 1 Ds
8/5/2019 9.5 76 1 1 1 1 1 1 1 1 1 Ds
8/5/2019 7.5 69 1 1 1 1 1 1 1 1 1 Ds
8/5/2019 8.5 70 1 1 1 1 1 1 1 1 1 Ds
8/5/2019 9.5 74 1 1 1 1 1 1 1 1 1 Ds
8/5/2019 9.5 78 1 1 1 1 1 1 1 1 1 Ds
8/5/2019 17.5 105 2 1 1 1 1 1 1 1 1 Ds
8/5/2019 7.5 67 1 1 1 1 1 1 1 1 1 Ds
8/5/2019 6.5 64 1 1 1 1 1 1 1 0 1 Ds
8/5/2019 18.5 108 2 1 1 1 1 1 1 1 1 Ds

8/5/2019 10.5 80 1 1 1 1 1 1 1 1 1 Ds
8/5/2019 7.5 67 1 1 1 1 1 1 1 0 1 Ds
8/5/2019 8.5 72 1 1 1 1 1 1 1 1 1 Ds
8/5/2019 17.5 105 2 1 1 1 1 1 1 1 1 Ds
8/5/2019 14.5 93 2 1 1 1 1 1 1 1 1 Ds
8/5/2019 10 79 1 1 1 1 1 1 1 1 1 Ds
8/5/2019 9.5 76 1 1 1 1 1 1 1 1 1 Ds
8/5/2019 14.5 95 2 1 1 1 1 1 1 1 1 Ds
8/5/2019 15.5 98 2 1 1 1 1 1 1 1 1 Ds
8/5/2019 8.5 72 1 1 1 1 1 1 1 1 1 Ds
8/5/2019 11.5 84 2 1 1 1 1 1 1 1 1 Ds
8/5/2019 7.5 67 1 1 1 1 1 1 1 1 1 Ds
8/5/2019 15.5 103 2 1 1 1 1 1 1 1 1 Ds
8/5/2019 4.5 54 1 1 1 1 0 0 0 0 0 Ds
8/5/2019 16.5 100 2 1 1 1 1 1 1 1 1 Ds
8/5/2019 3.5 51 1 1 1 0 0 0 0 0 0 Ds
8/5/2019 4.5 55 1 1 1 1 0 0 0 0 0 Ds
8/5/2019 5.5 59 1 1 1 1 1 0 0 0 0 Ds
8/5/2019 5.5 59 1 1 1 1 1 0 0 0 0 Ds
8/5/2019 4.5 55 1 1 1 1 0 0 0 0 0 Ds
8/5/2019 4.5 55 1 1 1 0 0 0 0 0 0 Ds
8/5/2019 5.5 58 1 1 1 1 0 0 0 0 0 Ds
8/5/2019 7.5 66 1 1 1 1 1 1 1 0 1 Ds
8/5/2019 4.5 54 1 1 1 0 0 0 0 0 0 Ds
8/5/2019 6.5 62 1 1 1 1 1 1 0 0 0 Ds
8/5/2019 10 80 1 1 1 1 1 1 1 1 1 Ds
8/5/2019 11 84 2 1 1 1 1 1 1 1 1 Ds
8/5/2019 6.5 64 1 1 1 1 1 1 1 0 1 Ds
8/5/2019 9.5 75 1 1 1 1 1 1 1 1 1 Ds
8/5/2019 8.5 74 1 1 1 1 1 1 1 1 1 Ds
8/5/2019 9.5 74 1 1 1 1 1 1 1 1 1 Ds
8/5/2019 6.5 63 1 1 1 1 1 1 0 0 0 Ds
8/5/2019 12 89 2 1 1 1 1 1 1 1 1 Ds
8/5/2019 16 103 2 1 1 1 1 1 1 1 1 Ds
8/5/2019 13 93 2 1 1 1 1 1 1 1 1 Ds
8/5/2019 3.5 50 1 1 0 0 0 0 0 0 0 Ds
Perkembangan
Buku Tindak
KIA Lanjut
S/TS SL/SU/R
(30) (31)
S SL
S SL
S SL
S SL
S SL
S SL
S SL
S SL
S SL
S SL
S SL
S SL
S SL
S SL
S SL
S SL
S SL
S SL
S SL
S SL
S SL
S SL
S SL
S SL
S SL
S SL
S SL
S SL
S SL
S SL
S SL
S SL
S SL
S SL
S SL
S SL
S SL
S SL
S SL
S SL
S SL
S SL
S SL
S SL
S SL
S SL
S SL
S SL
S SL
S SL
S SL
S SL
S SL
S SL
S SL
S SL
S SL
S SL
S SL
BALITA SL
S SL
S SL
S SL
S SL
S SL
S SL
S SL
S SL
S SL
S SL
S SL
S SL
S SL
S SL
S SL
S SL
S SL
S SL
S SL
S SL
S SL
S SL
S SL
S SL
S SL
S SL
S SL
S SL
S SL
S SL
S SL
S SL
S SL
S SL
S SL
S SL
S SL
S SL
S SL
S SL
S SL
S SL
S SL
S SL
S SL
TS SL
S SL
S SL
S SL
S SL
S SL
S SL
S SL
S SL
S SL
S SL
S SL
S SL
S SL
S SL
S SL
S SL
S SL
S SL
S SL
S SL
S SL
S SL
S SL
S SL
S SL
S SL
S SL
S SL
S SL
S SL
S SL
S SL
S SL
S SL
S SL
S SL
S SL
S SL
S SL
S SL
S SL
S SL
S SL
S SL
S SL
S SL
S SL
S SL
S SL
S SL
S SL
S SL
S SL
S SL
S SL
S SL
S SL
S SL
S SL
S SL
S SL
S SL
S SL
S SL
S SL
S SL
S SL
S SL
S SL
S SL
S SL
S SL
S SL
S SL
S SL
S SL
S SL
S SL
S SL
S SL
S SL
S SL
S SL
S SL
S SL
S SL
S SL
S SL
S SL
S SL
S SL
S SL
S SL
S SL
S SL
S SL
S SL
S SL
S SL
S SL
S SL
S SL
S SL
Provinsi SUMATERA UTARA Nama Posyandu MELATI / MELUR
Kabupaten/Kota SIMALUNGUN Bulan AGUSTUS
Puskesmas/Keca BATU ANAM / SIANTAR Tahun 2019
Desa/Kelurahan LESTARI INDAH
Berat
Badan Kepemilik
Kehamilan Tanggal Lahir No Kartu Keluarga NIK ( Nomor Induk
No Nama Ibu Hamil Awal an Buku Nama Suami NIK Suami Alamat RT RW
Ke Kependudukan) hamil/Trise KIA
mester I
(1) (2) (3) (4) (5) (6) (7) (8) (9) (10) (11) (12) (13)
1 3 4/1/1989 1272082903170001 12088206505890003 Daniati sipayung 60 Ya Pandapotan Tondang 1208010402810002 Durian I
2 2 8/19/1987 Nova Carolina Tanjung 56 Ya Tarsono Durian III
3 1 11/5/1989 1208011510090009 1208014511890002 Khairani Siregar 58 Ya Moh. Haris Nangka Raya
4 1 7/30/1990 1208012311180003 1208017007900002 Juliani Hutabarat 60 Ya David Sianipar 12080010703880004 Kasiavera II
5 2 8/22/1992 1208012903160007 1208016208920002 Sari Paradina 56 Ya Ridwan Efendi Harahap 1271210409690002 Tusam Raya
6 1 11/18/1989 1208012007180003 1209175811890001 Risda Henny Natalia 55 Ya Jerry Jivan Hutagaol 1208010205840002 Kasiavera III
7 3 2/6/1988 1208233012140018 1208014602880002 Sisrik Hairani 60 Ya Suherman 1208230207860003 Kasiavera III
8 3 3/11/1995 1208012206150005 1208015103950002 Putri Andani 56 Ya Rico Sianturi 1208010511860006 Kasiavera II
9 3 5/13/1980 1272085305800002 Masni Hayati 60 Ya Paruliansyah Tambunan Durian I
10 1 10/19/2000 Darni Veronika 55 Ya Andre Tarigan Kasiavera III
11 3 1/15/1990 1208012503140003 1208015501900003 Iin Pratiwi 56 Ya Hajaruddin Ahmad 1208112104870002 Nangka
12 1 12/23/2001 Nanda Kumalasari 43 Ya Wahyudi Komp. Ka Pangulu
13 1 11/14/1992 Novita Sari Sinaga 55 Ya Rony Sitinjak Durian I
14 1 8/12/1991 Gustina Manullang 48 Ya Hiski Bayu Hutajulu Cengkeh Raya
15
16
17
18
19
20
Keterangan
LATI / MELUR
TTD
(Tablet
Tinggi Lingkar Tambah Jika Ya,brp Jika Ya,brp
Tanggal Berat Badan Lengan Darah) butir TTD butir TTD
Pengukuran Badan (kg) (cm) Atas (LILA) 1=Ya,2=T diterima diminum
idak
(14) (15) (16) (17) (18) (19) (20)

8/5/2019 65 160 29.5 1 30 30
8/5/2019 62 158 24 1 30 30
8/5/2019 65 160 27 1 30 30
8/5/2019 65 158 25 1 30 30
8/5/2019 58 156 24 1 30 30
8/5/2019 60 154 25 1 30 30
8/5/2019 61 162 29 1 30 30
8/5/2019 62 154 26 1 30 30
8/5/2019 68 155 29.5 1 30 30
8/5/2019 60 155 25 1 30 30
8/5/2019 60 156 24 1 30 30
8/5/2019 43 156 21 2
8/5/2019 56 156 25 2
8/5/2019 53 152 24 1 30 30
b
Provinsi : SUMATERA UTARA Nama Posyandu :

Puskesmas/Kecamatan : BATU ANAM / SIANTAR Tahun : 2019
Desa/Kelurahan : NUSA HARAPAN
Berat
Tanggal Lahir No Kartu NIK ( Nomor Induk Nama Ibu Badan Awal Kepemilikan Nama Tanggal Berat
No Kehamilan Ke NIK Suami Alamat RT RW
Keluarga Kependudukan) Hamil hamil/Trise Buku KIA Suami Pengukuran Badan (kg)
mester I
(1) (2) (3) (4) (5) (6) (7) (8) (9) (10) (11) (12) (13) (14) (15)
Sonya Aman 120801270 Jl Kenari
1 2 11/10/1999 12080119 1208015011990001 50 Ya 8/21/2019 60
Sinaga Siregar 9870002
Mhd
12/17/1988 121201140 Desi 120801061 JL
2 3 1150003 1212015712880001 40 Ya Syukri 8/21/2019 40
Mulyani 1850001 Flamboyan
Nasution
7/25/1979 120801220 Aris appe 120723230 Jl Belimbing

3 5 5180001 1207236507790008 Erna Vivian 55 Ya 8/21/2019 70
Tua 4800001
4
5
6
7
8
9
10
Keterangan
TTD
(Tablet
Badan Lengan Darah) butir TTD butir TTD
(cm) Atas (LILA) 1=Ya,2=T diterima diminum
idak
(16) (17) (18) (19) (20)
155 25 1 90
158 21 1 90
158 28 1 90
1
Provinsi : SUMATERA UTARA Nama Posyandu :

Desa/Kelurahan : NUSA HARAPAN
Berat Kepemilik
Nomor Induk an Buku IMD 1=Ya
No Anak Ke Tanggal Lahir Jenis Kelamin No Kartu Keluarga Kependuduka Nama Anak Badan KIA/KMS No Telp/HP Tanggal
2=Tidak Nama Ayah NIK Ayah Alamat RT RW
(KK) Lahir Ayah Pengukuran
n (NIK) 1=Ya
(gram) 2=Tidak
(1) (2) (3) (4) (5) (6) (7) (8) (9) (10) (11) (12) (13) (15) (16) (17) (18)
1 120801420418 120801200477
3 4/2/2018 P 1208012803080189 2001 Zein Putri 1.8 1 1 Suliono 0001 082294080509 Belimbing 8/21/2019
2 120801031115 Gracelone Elryo 537104200186
2 11/3/2015 L 1208011505130004 0001 B.Noman 3.2 1 1 Noman 0001 082294080509 Akasia raya 8/21/2019
3 120801150417 Kaelronokane Elryo 537104200186
3 4/15/2017 L 1208011505130004 0002 B.Noman 3 1 1 Noman 0001 082294080509 Akasia raya 8/21/2019
4 120960130319 120960130319
2 3/13/2016 L 1208012205180001 0000 Alfin Sitorus 3 1 1 Baja Sitorus 0000 082294080509 Karet 8/21/2019
5 120960120219 120960130319
3 2/12/2019 L 1208012205180001 0000 Arfi Sitorus 3 1 1 Baja Sitorus 0000 082294080509 Karet 8/21/2019
6 120801402160 Najwa.Nasuti M.S.Uddin 120801161075
2 2/2/2016 P 1208010907080034 0001 on 3.1 1 1 Nasution 0003 082294080509 Flamboyan 8/21/2019
7 120801271014 120801230676
1 10/27/2014 P 1208012803120001 0002 Zian Fahrezie 3.2 1 1 Agus 0002 082294080509 Flamboyan 8/21/2019
8 120801160418 Artur Saint Maraden 120801180284
3 4/16/2018 L 1208010804130005 0002 Manurung 3.2 1 1 Manurung 0004 082294080509 Karet 8/21/2019
9 120801470617 Arasi Charles 120801090192
3 6/7/2017 P 1208010911120003 2001 Tambunan 2.9 1 1 Tambunan 0001 082294080509 Flamboyan 8/21/2019
10 120733221217 Abdul 120733060991
1 12/22/2017 L 1207330504170001 0001 Rohman 3 1 1 Junaidi 0002 082294080509 Flamboyan 8/21/2019
11 121201043105 Muhammat MHD S 120801061185
1 3/4/2015 L 1212011401150003 0001 H.Nasution 3 1 1 Nasution 0001 082294080509 Flamboyan 8/21/2019
12 120801471216 Alya Khairani MHD S 120801061185
2 12/7/2016 L 1212011401150003 2001 Nasution 2.9 1 1 Nasution 0001 082294080509 Flamboyan 8/21/2019
13 120960451218 Butet Frengki 120801210398
3 12/15/2018 P 1208012102140001 0000 Sipayung 3.2 1 1 Natalia 0001 082294080509 Flamboyan 8/21/2019
14 120960550119 Zulaika Asifa Sobbarun 127701264770

3 1/15/2019 P 1208012703170006 0000 siregar 2.9 1 1 Siregar 0001 082294080509 Angsana 8/21/2019
15 120960411018 Joice Joko 120801160488
3 10/1/2018 P 1208010107130004 0000 Manurung 3.4 1 1 Manurung 0003 082294080509 Flamboyan 8/21/2019
Dwayne
16 120960431118 Rayvan Izulkarnain 120801230685
2 11/3/2018 P 1208012807160002 0000 Pardede 3.3 1 1 Pardede 0003 082294080509 Angsana 8/21/2019
Laura
17 127206500818 Yasmine Bontang 121701060489
4 8/10/2018 P 1272061512160003 0001 Sagala 3 1 1 Sagala 0001 082294080509 Kenari 8/21/2019
Asido HR
18 120801191016 Ari Imanuel Tampu 120801031080
2 10/19/2016 L 1208013012110002 0001 T.Bolon 2.9 1 1 Bolon 0003 082294080509 Belimbing 8/21/2019
19 120960440319 Mulani Dairianto 120801301115
2 10/23/2018 P 1209604403190000 0000 Audyta 2.5 1 1 Sihotang 0002 082294080509 Langsat 8/21/2019
20 120960631018 Maulana Dairianto 120801301115
2 10/23/2018 P 1208013012110002 0000 Audyta 2.6 1 1 Sihotang 0002 082294080509 Langsat 8/21/2019
21 120801550116 120801311277
3 1/15/2016 P 1208012002080297 2001 Syakira Hafiza 3.4 1 1 Sandi adrian 0002 082294080509 Flamboyan 8/21/2019
22 120801261180 Gogo Tama Hitnotis 120801120377
1 11/26/2018 L 1208012803080173 001 Sinurat 3 1 1 Sinurat 0002 082294080509 Kenari 8/21/2019
23 120801010218 Jerico Fernando 120801181287
2 2/1/2018 L 1208010204150001 2001 Sihombing 3.3 1 1 sihombing 0002 082294080509 Kenari 8/21/2019
24 120801700115 Kasih Aston M 120801070676
2 1/30/2015 P 1208011407110011 0001 A.Hutauruk 2.9 1 1 Hutauruk 0000 082294080509 Belimbing 8/21/2019
Tongam
25 120801691114 Novelita.R.Hu Lubuk 120801111271
3 11/19/2014 P 1208012005110005 0001 tapea 3 1 1 Hutapea 0004 082294080509 Kenari 8/21/2019
26 120801450416 Yona Apri Marianus 121706160966
1 4/5/2016 P 1208011908140007 0001 Sihombing 3.2 1 1 Sihombing 0002 082294080509 Kenari 8/21/2019
27 120801270318 Marco Marianus 121706160966
2 3/27/2018 L 1208011908140007 0002 Sihombing 3.3 1 1 Sihombing 0002 082294080509 Kenari 8/21/2019
28 120801121015 Rafael J.Butar PB Ronald 120801140482

2 10/12/2015 L 1208010510110002 0002 butar 3.4 1 1 Butar butar 0006 082294080509 Langsat Raya 8/21/2019
29 120960520219 Gledis Andre 120801091216
2 2/12/2019 P 1208010912160004 0000 Siburian 3.2 1 1 Siburian 0004 082294080509 Belimbing 8/21/2019
30 120801031216 Jairu Yosua Cristian 120809251281
1 12/3/2016 L 1208012607160006 0001 Sembiring 3.5 1 1 Sembiring 0002 082294080509 kenari 8/21/2019
31 120801220516 Adriel Boy 127201061088
1 5/22/2016 L 1208011202140014 0001 Harianja 3.6 1 1 Benni Putra 0001 082294080509 Kenari 8/21/2019
32 120801080815 Bintang Surya Dedy Dores 217110040979

2 8/8/2015 P 1208012406150002 000 Siregar 3.1 1 1 Siregar 0002 082294080509 Kenari 8/21/2019
33 120801260914 Reyseptian Rimbunan 127205240884

2 9/26/2014 L 1208012810130001 0001 siringioringo 3 1 1 siringo ringo 0003 082294080509 Kenari 8/21/2019
Rimbunan
34 120801281013000 12080154041 Rosabella siringo 12720524088 08229408050
3 4/14/2016 P 1 60001 Siringoringo 3.3 1 1 ringo 40003 9 Kenari 8/21/2019
Argapar Hendry
35 120801090915000 12080124091 D.Manihuru M.Manihur 12080103068 08229408050
1 9/24/2015 L 2 52001 k 3 1 1 uk 40003 9 Kenari 8/21/2019
Hendry
36 120801090915000 12080113051 Michael M.Manihur 12080103068 08229408050
2 5/13/2017 L 2 72002 Manihuruk 3.4 1 1 uk 40003 9 Kenari 8/21/2019
37 Rahmad Eka
120801090817000 12080127121 Rido makmur 12080121039 08229408050
1 12/27/2017 L 4 72002 Hasibuan 3 1 1 Syahputra 80001 9 Kenari 8/21/2019
38 120801210817000 12080129127 Ananda 12082801038 08229408050 Makadame
1 10/4/2016 L 5 70002 Gilbert 2.9 1 1 Mardian 00004 9 Raya 8/21/2019
39 120801210817000 12080170041 Adinda 12082801038 08229408050 Makadame
2 4/30/2018 P 5 82001 Aysha 3.2 1 1 Mardian 00004 9 Raya 8/21/2019
40 120801171210001 12080154081 Sarah Diva 12080108086 08229408050
3 8/14/2014 P 2 40001 Zahra 3.1 1 1 Yasir 90004 9 Langsat raya 8/21/2019
41 120801090611001 12080122011 Kenprana 12080101098 08229408050
2 1/22/2018 L 6 82002 asa Bumi 3 1 1 Reno 60002 9 Langsat 8/21/2019
42 120801040414000 12080113111 Josua Metro 12082015058 08229408050
2 11/13/2015 L 8 52001 .N.Napitu 3 1 1 Napitu 20001 9 Kenari 8/21/2019
43 127206151216000 12720662061 Adelin Bontang 12170106004 08229408050
3 6/22/2017 P 3 70001 sagala 2.5 1 1 Sagala 89001 9 Kenari 8/21/2019
44 120801060617000 12080106111 Xavier 12072429108 08229408050
1 11/6/2017 L 1 72001 Nasution 3.2 1 1 Ovallani 30002 9 Langsat Raya 8/21/2019
Zahra
45 120801190718000 12080155051 Assyifa Aman 12080127098 08229408050
Zievanya
46 120801190718000 12096054081 andini Aman 12080127098 08229408050
47 Jimmy Feri
120801130314002 12080104071 Lamhot Tua Simanjunta 12080113028 08229408050
1 7/4/2015 L 2 50002 Simanjuntak 2.9 1 1 k 30002 9 Angsana 8/21/2019
Johannes Riduan
48 127201110915000 12720102121 Tampu Tampu 12720116028 08229408050
1 12/2/2014 L 6 40002 Bolon 3 1 1 Bolon 20003 9 Karet 8/21/2019
49 127202060515000 12720204101 Matthew Jhon Hider 12720204078 08229408050

1 10/4/2015 L 1 50001 Siregar 3.2 1 1 Siregar 20004 9 Karet 8/21/2019
50 12080118121 Chandwilma Hasberd 12080113087 08229408050

2 12/18/2015 L 120801161210007 00007 n Panjaitan 3.2 1 1 Panjaitan 00001 9 belimbing 8/21/2019
Glend
51 120801091216000 12080121011 Januar Andre 12080102039 08229408050
1 1/21/2017 L 4 70002 Siburian 3.5 1 1 Siburian 70003 9 Belimbing 8/21/2019
52 120801110111001 12080167091 Lovely.S.Hut Desman 12080114127 08229408050 Makadame

4 9/27/2015 P 1 50005 agalung 2.8 1 1 Hutagalung 70001 9 Raya 8/21/2019
53 127201110915000 12096009071 Jubel Tampu T.Tampu 12720116028 08229408050

2 7/9/2017 L 6 70000 Bolon 3.2 1 1 Bolon 20003 9 Karet 8/21/2019
54 120801250415000 12096025041 Johan Hari 12080125041 08229408050

2 4/25/2015 L 0 50000 Sihombing 3.3 1 1 Sihombing 50000 9 Karet 8/21/2019
55 120801071209000 12080143081 Wisdom Ramses 12080108017 08229408050
8 6/3/2015 P 1 52001 Mora Jelita 3.3 1 1 Siahaan 60001 9 Kenari 8/21/2019
Theresia
Tampu Raysun
56 120801250512000 12080124071 bolon Tampu 12080130037 08229408050
3 6/16/2017 P 4 30001 3.2 1 1 Bolon 50004 9 Angsana 8/21/2019
57 120801210214000 12080126031 Hotniel Frengki 12080127128 08229408050
3 3/26/2017 P 1 70002 Mardaulat 3 1 1 Natalia 20001 9 Flamboyan 8/21/2019
Asido HR
58 120801301211000 Tampu 12080103108 08229408050
3 1/25/2019 L 2 Ardi .T.Bolon 3.1 1 1 Bolon 00003 9 Karet 8/21/2019
59 120801150909000 12096052071 Mona Pangihutan 12080106048 08229408050

4 7/12/2018 P 8 80000 Sibarani 3.4 1 1 Sibarani 30003 9 Karet 8/21/2019
Erin
60 120801210114000 12080144111 salsa.N.Purb Manto 12080117098 08229408050
1 11/4/2014 P 1 40001 a 3 1 1 Purba 40001 9 Kenari 8/21/2019
61 120801210114000 12096021041 Edgard Hope Manto 12080117098 08229408050

2 4/21/2018 L 1 80000 Purba 3.3 1 1 Purba 40001 9 Kenari 8/21/2019
62 120801230518000 12082831101 Raditya Maria 12080155097 08229408050
1 10/31/2014 L 2 40001 Pratama 3.3 1 1 Lestari 40001 9 Kenari 8/21/2019
63 120801080413000 12080151101 Winny saint Maraden 12080118028 08229408050

2 10/11/2016 P 5 62001 Manurung 3.2 1 1 Manurung 40004 9 Karet 8/21/2019
64
127201070312000 31750642091 Angelica Ucok Arfin 31760612038 08229408050
2 9/2/2014 P 4 41002 A.Sitorus 3.2 1 1 Hermanto 30008 9 Angsana 8/21/2019
65 12080155041 Jernih Ferry 12080102415 08229408050

1 4/5/2015 P 50001 Sihombing 3.2 1 1 sihombing 00001 9 Kenari 8/21/2019
66 Viona Patar 08229408050
1 6/8/2016 P Samosir 3.5 1 1 Samosir 9 Kenari 8/21/2019
67 120801180216000 12080128011 Iqbal Rafael Erwinsyah 12720129128 08229408050

3 1/28/2018 L 5 82001 Siregar 3 1 1 Siregar 00002 9 Mahoni Raya 8/21/2019
Natal
68 120801170517000 Carlin Edsel Susanto 12720125127 08229408050
2 2/16/2016 L 6 Sinaga 2.9 1 1 Sinaga 70003 9 Angsana 8/21/2019
Natal
69 120801170517000 12080171121 Citra Rosa Susanto 12720125127 08229408050
3 12/31/2017 P 6 72001 Sinaga 3 1 1 Sinaga 70003 9 Angsana 8/21/2019
70 120801240386000 12096019101 12080124038 08229408050
2 10/19/2014 L 3 40000 Micho Octo 3 1 1 Ronni 60003 9 Flamboyan 8/21/2019
71 120801240386000 12096054021 Mikha Dwi 12080124038 08229408050
3 2/14/2017 L 3 70000 sandi 3.1 1 1 Ronni 60003 9 Flamboyan 8/21/2019
72 120801151209000 12080142061 Norin Sintike 12080142061 08229408050

2 9/4/2019 P 13 40001 Purba 3.3 1 1 Rilo Purba 40001 9 Kenari 8/21/2019
73 120801120408134 12080052111 Lauren 12080112401 08229408050
2 11/12/2014 P 3 14000 Clow Abigail 3.3 1 1 Gultom 14081 9 Langsat 8/21/2019
74 120801201013000 12080120101 12080205088 08229408050
3 1/19/2017 P 1 30001 Stevany 3 1 1 Tony .S 10001 9 Karet 8/21/2019
75 120801451217000 12096045121 Quineta Guster 12070931120 08229408050
1 12/5/2017 P 0 70000 Manik 3.2 1 1 manik 50004 9 Karet 8/21/2019
76 120801090617000 12080158121 De eva 12080129108 08229408050
1 12/18/2017 L 8 70001 Imanuel 3.5 1 1 Ferry.D 50006 9 Karet 8/21/2019
77 120801021172000 12230122051 Fernando 12080102117 08229408050
2 5/22/2015 L 1 50001 Lukas 3.2 1 1 Rudi 20001 9 Langsat 8/21/2019
78 120801798110000 12080143111 Jelita J.Manurun 12080179811 08229408050
2 6/9/2015 P 3 20001 Manurung 3 1 1 g 00003 9 Kenari 8/21/2019
Gusman
79 120801130213000 12080126091 Gabriel.D.Si Togu 12080116128 08229408050
1 9/26/2014 P 2 40005 allagan 3.3 1 1 Siallagan 10002 9 Flamboyan 8/21/2019
80 120801011200000 12080169071 Claudia Tohorido 12080111067 08229408050

3 7/29/2016 P 5 60004 Benaya 2.9 1 1 Napitupulu 90007 9 Flamboyan 8/21/2019
81 120801011200000 Yehezkiel Tohorido 12080111067 08229408050

4 8/11/2018 L 5 Silvano 3.1 1 1 Napitupulu 90007 9 Flamboyan 8/21/2019
Audry
82 120801310718000 12740642121 Natalina Hardianto 12080124067 08229408050
1 12/2/2014 P 2 40001 Marpaung 3.2 1 1 Marpaung 90002 9 Flamboyan 8/21/2019
83 120801051112000 12080129111 Michael 12080130079 08229408050
2 11/29/2014 L 4 40002 Sihotang 3.3 1 1 Jhon Pieter 10006 9 Langsat 8/21/2019
84 120801120408034 12080158081 Aryana.A.Sia Agus 12080124087 08229408050
1 8/28/2018 P 0 40001 haan 3.2 1 1 Siahaan 00001 9 Langsat 8/21/2019
85 120801210114000 12080114111 Manto 12080117088 08229408050
1 11/4/2014 P 1 40001 Erin Purba 3.2 1 1 Purba 40001 9 Langsat 8/21/2019
86 120801101014000 12080110101 Gama Lathif Andi 12080127057 08229408050

1 10/10/2014 L 1 40001 Sinaga 3.3 1 1 Sinaga 80003 9 Langsat 8/21/2019
87 120801010713000 12080110041 Jaysen Joko 12080116048 08229408050
2 4/10/2017 L 4 70001 Manurung 3.3 1 1 Manurung 80003 9 Flamboyan 8/21/2019
88 Roni
120816170114000 12081662031 Dora Rotalia Situmoran 12081607028 08229408050
1 3/22/2017 P 1 70001 situmorang 3 1 1 g 50003 9 Flamboyan 8/21/2019
89 120801010615000 12080143121 Rodeska Darma 12080125018 08229408050
1 12/3/2015 P 8 50001 Purba 3.1 1 1 Purba 40001 9 Flamboyan 8/21/2019
Jordan
90 120801260614000 12080105101 Kristian Ferry 12080103058 08229408050
1 10/5/2014 L 1 40001 Sitepu 2.8 1 1 Maranatha 80001 9 Flamboyan 8/21/2019
91 120811504150010 12080122111 Cristian 12081150415 08229408050
1 11/22/2017 L 0 62001 W.Purba 3.3 1 1 T.Purba 00100 9 Flamboyan 8/21/2019
92 120801091112000 Jeanrobin Charles 12080109019 08229408050

3 7/3/2019 L 3 Tambunan 3.2 1 1 Tambunan 20001 9 Flamboyan 8/21/2019
93 120801160111300 12080116211 12080131088 08229408050
3 7/18/2016 L 1 30001 Gilbert Dion 3.3 1 1 Budi 70002 9 Karet 8/21/2019
94 120806190760000 12080654071 Rosnita Derman 12080190761 08229408050
2 7/14/2017 P 1 70001 Sitorus 3.2 1 1 Sitorus 00001 9 Karet 8/21/2019
95 120801080817000 12080113071 Raditya Belman 12080201076 08229408050
5 7/13/2015 L 2 50001 Sitorus 3.1 1 1 Sitorus 50002 9 Karet 8/21/2019
96 120801230330000 12080166091 12080123033 08229408050
2 9/26/2014 P 2 40000 Asyfa Bilgis 3.6 1 1 Viktor 00002 9 Flamboyan 8/21/2019
97 120801260713000 12080126081 Yuma 12080120098 08229408050
1 8/26/2014 L 3 40001 Albeza fahni 3.4 1 1 Kahari 50006 9 Angsana 8/21/2019
98 120801120408025 12080129111 Torang T.sihombin 12080111044 08229408050
1 11/29/2014 L 1 40005 Sihombing 2.8 1 1 g 30001 9 Flamboyan 8/21/2019
99 120801091112000 12080143121 Reynata Charles 12080109019 08229408050

1 12/3/2014 L 3 40000 Tambunan 3.1 1 1 Tambunan 20001 9 Flamboyan 8/21/2019
100 120801170317000 12080162071 Aila Nawa Abdul 12080119107 08229408050
1 7/22/2016 P 0 60002 Ritonga 2.4 1 1 Ritonga 40001 9 Flamboyan 8/21/2019
Vricilla Hiras
101 120801150210000 12080161011 Lumban Nelson 12080103017 08229408050
4 1/21/2016 P 4 60001 Tobing 2.8 1 1 Tobing 60002 9 Kenari 8/21/2019
102 120801270317000 12080102021 Asfa Erdo Sobbarun 12080170486 08229408050
2 2/2/2017 L 6 70001 .S.Siregar 3 1 1 Siregar 00002 9 Angsana 8/21/2019
Roshita Duma Ria

103 120801251209002 12080166121 N.Napitupul Simanguns 12080162126 08229408050
6 12/26/2015 P 7 50001 u 3.4 1 1 ong 70002 9 Angsana 8/21/2019
104 120801011214000 12080124094 Eko 12060515058 08229408050
2 9/24/2014 L 5 00002 Khafif Aizar 3.2 1 1 Pramono 00002 9 Karet 8/21/2019
Dody
105 120801100314000 12080129011 Sean Harianto 12080105028 08229408050
1 1/29/2015 L 1 50001 Aindrea 3.5 1 1 Sinaga 20005 9 Karet 8/21/2019
Aris
106 120801220518000 12080162041 Apelyn Simanjunta 12072323048 08229408050
4 4/22/2015 P 0 50001 Simanjuntak 3.4 1 1 k 00001 9 Karet 8/21/2019
107 120806197160000 12080269081 Sheril CiptoSitoru 12080619716 08229408050
1 8/29/2015 P 1 50002 Sitorus 3.5 1 1 s 00001 9 Karet 8/21/2019
Cheris Baringin
108 120801190608003 12080147111 .A.Tampu Tampu 12080120047 08229408050
4 11/7/2016 P 9 62001 Bolon 2.9 1 1 Bolon 10003 9 Langsat Raya 8/21/2019
109 120801101117000 12080103016 Azriel 12170513048 08229408050
2 8/3/2016 L 2 0002 .F.Rahman 2.8 1 1 Dimas Rivi 40004 9 Angsana 8/21/2019
110 120801140715000 12080109111 Tobyas Sarmedi 12190310108 08229408050 Angsana
2 11/9/2017 L 6 70001 Sihotang 3.2 1 1 Sihotang 70003 9 Raya 8/21/2019
111
120801210612000 12080104047 Keanu Alex Ali Widodo 12080106067 08229408050
1 4/4/2017 P 8 00004 Manurung 3.8 1 1 Manurung 60007 9 Angsana 8/21/2019
Felicia Anjuaris
112 120801288030804 12080166071 Tampu Tampu 12080126058 08229408050 Makadame
1 9/9/2016 P 1 40001 Bolon 3.2 1 1 Bolon 50001 9 Raya 8/21/2019
113 120801100915000 12080115036 Yavin Jericson 12183040493 08229408050 Angsana
1 3/15/2016 P 2 00003 Gultom 3.3 1 1 Gultom 00001 9 Raya 8/21/2019
114 120801120408060 12080110091 Bayu Abigail Liyoidhope 12080122127 08229408050

3 9/10/2014 L 3 40001 Purba 3.2 1 1 nd Purba 90002 9 Angsana 8/21/2019
115 Riko
120801240616001 12096012331 Cristian Suyanto 12080105128 08229408050
1 12/10/2017 L 1 90000 Napitupulu 3.4 1 1 Napitupulu 50001 9 Angsana 8/21/2019
Viyona
116 120801191115000 12080470009 Septiani Hotnarin 12080159088 08229408050
1 9/30/2016 P 2 16000 Haloho 2.8 1 1 R.Purba 00005 9 Flamboyan 8/21/2019
Antoni
117 12080131100 P.Pandiang 12080119058 08229408050
3 2/25/2019 L 90011 Rava Elvano 3.3 1 1 an 50004 9 Karet 8/21/2019
118 120801090211000 Septi Jimmy 12080114057 08229408050
3 5/14/2018 P 8 Saragih 3.2 1 1 M.Saragih 80001 9 Kenari 8/21/2019
119 Belvania Lehon 08229408050
1 2/10/2015 P Manalu 3.5 1 1 Manalu 9 Langsat 8/21/2019
120 Belviona Lehon 08229408050
2 3/12/2016 P Manalu 3.3 1 1 Manalu 9 Langsat 8/21/2019
121 121605060109000 Hepayo 12160520057 08229408050
5 3/2/2018 L 7 Lubis 3.4 1 1 Alex Lubis 70003 9 Karet 8/21/2019
Trio
122 120801280308047 12080125061 Raymon C Situmoran 12080110273 08229408050
3 6/25/2015 L 5 50003 Situmorang 3.5 1 1 g 00002 9 Langsat 8/21/2019
Reynard Anjuaris
123 120801171109001 12080155061 Tampu Tampu 12080120117 08229408050
2 2/11/2019 L 1 30001 Bolon 3 1 1 Bolon 40002 9 Kenari 8/21/2019
Chika
124 12080164111 Novelina Liber 12080120117 08229408050
6 11/24/2015 P 120801171190011 50002 Sidabutar 3.2 1 1 Sidabutar 40002 9 Angsana 8/21/2019
125 12080125450 Jaysen 08229408050
1 5/5/2017 L 120801263450002 0003 Saragih 3.3 1 1 9 8/21/2019
126 120801061011000 Agustinus 12080121088 08229408050
4 8/31/2018 P 9 Carolina 3 1 1 Silalahi 70002 9 Angsana 8/21/2019
127 120801301211000 Yeheskiel Dairianto 12080130111 08229408050
2 4/20/2015 L 2 Sihotang 3.5 1 1 Sihotang 50002 9 Langsat 8/21/2019
128 120801011284000 Dohar 08229408050
2 12/13/2018 P 4 Rachel 3.4 1 1 Purba 9 Kenari 8/21/2019
129 127202060515000 Yohana Jhon Hider 12720206051 08229408050

2 8/1/2019 P 4 Siregar 3. 1 1 Siregar 50004 9 Karet 8/21/2019
130 127201231017000 12720163051 Shakila Berlison 12720609096 08229408050

2 5/23/2018 P 5 80001 .A.Sidauruk 3.4 1 1 Sidauruk 30008 9 8/21/2019
131 Kenzo Patar 08229408050
3 5/19/2019 L Samosir 3.3 1 1 Samosir 9 Kenari 8/21/2019
132 120801061117200 12080166011 Clarisyah.M. Aprilson 12080124049 08229408050
1 1/26/2017 P 1 72001 Sitorus 3.2 1 1 Sitorus 60004 9 Kenari 8/21/2019
133 120801061117200 Aprilson 12080124049 08229408050
2 6/17/2019 L 1 Ucok Sitorus 3 1 1 Sitorus 60004 9 Kenari 8/21/2019
Keterangan
Panjang ASI Eksklusif 1=Ya 2=Tidak Perkembangan
Badan/Ti Cara Ukur Vitamin A Vitamin A
BB (kg) nggi 1=Terlent Februari Agustus
ang 1=Ya 1=Ya
(19) (20) (21) (21) (22) (23) (24) (25) (26) (27) (28) (29) (30) (31)
DM S SL
6.6 72 1 1 1 1 1 1 1 1 1
DS S SL
15 95 2 1 1 1 1 1 1 1 1
DS S SL
11 85 2 1 1 1 1 1 1 1 1
DS S SL
12 94 2 1 1 1 1 1 1 1 1
DS S SL
6.5 65 1 1 1 1 1 1 1 - 1
DS S SL
12.5 94 2 1 1 1 1 1 1 1 1
DS S SL
17.8 108 2 1 1 1 1 1 1 1 1
DS S SL
11.6 78 1 1 1 1 1 1 1 1 1
DS S SL
11.8 85 2 1 1 1 1 1 1 1 1
2 1 DS S SL
11.8 83 1 1 1 1 1 1 1
2 1 DS S SL
14 98 1 1 1 1 1 1 1
2 1 DS S SL
14 96 1 1 1 1 1 1 1
2 1 DS S SL
7.8 68 1 1 1 1 1 1 1
1 1 DS S SL
7.5 68 1 1 1 1 1 1 -
1 1 DS S SL
8.5 70 1 1 1 1 1 1 1
1 1 DS S SL
8.8 70 1 1 1 1 1 1 --
1 1 DS S SL
9.5 72 1 1 1 1 1 1 1
2 1 DS S SL
12.5 90 1 1 1 1 1 1 1
1 1 DS S SL
8.2 69 1 1 1 1 1 1 -
1 1 DS S SL
8.3 70 1 1 1 1 1 1 -
2 1 DS S SL
13 96 1 1 1 1 1 1 1
1 1 DS S SL
8.3 70 1 1 1 1 1 -
1 1 DS S SL
11 82 1 1 1 1 1 1 1
2 1 DS S SL
16 105 1 1 1 1 1 1 1
2 1 DS S SL
16.5 104 1 1 1 1 1 1 1
2 1 DS S SL
14 96 1 1 1 1 1 1 1
2 1 DS S SL
10 80 1 1 1 1 1 1 1
2 DS S SL
16 102 1 1 1 1 1 1 1
1 1 DS S SL
8 68 1 1 1 1 -
2 1 DS S SL
14.8 95 1 1 1 1 1 1 1
2 1 DS S SL
15 96 1 1 1 1 1 1 1
2 1 DS S SL
17 101 1 1 1 1 1 1 1
2 1 DS S SL
18.6 109 1 1 1 1 1 1 1
2 1 DS S SL
15 95 1 1 1 1 1 1 1
2 1 DS S SL
16 100 1 1 1 1 1 1 1
2 1 DS S SL
11.5 86 1 1 1 1 1 1 1
2 1 DS S SL
11 82 1 1 1 1 1 1 1
2 1 DS S SL
13 92 1 1 1 1 1 1 1
1 1 DS S SL
10 75 1 1 1 1 1 1 1
2 1 DS S SL
16.8 105 1 1 1 1 1 1 1
1 1 DS S SL
11 80 1 1 1 1 1 1 1
2 1 DS S SL
14.5 99 1 1 1 1 1 1 1
2 1 DS S SL
12 85 1 1 1 1 1 1 1
2 1 DS S SL
11 81 1 1 1 1 1 1 1
2 1 DS S SL
11.5 86 1 1 1 1 1 1 1
1 1 DM S SL
7.7 70 1 1 1 1 1 1 1
2 1 DS S SL
15.4 104 1 1 1 1 1 1 1
2 1 DS S SL
17.5 109 1 1 1 1 1 1 1
2 1 DS S SL
15.5 104 1 1 1 1 1 1 1
2 1 DS S SL
16 101 1 1 1 1 1 1 1
2 1 DS S SL
15 88 1 1 1 1 1 1 1
2 1 DM S SL
11 92 1 1 1 1 1 1 1
2 1 DS S SL
13 89 1 1 1 1 1 1 1
2 1 DS S SL
19 109 1 1 1 1 1 1 1
2 1 DS S SL
19 108 1 1 1 1 1 1 1
2 1 DS S SL
11.5 88 1 1 1 1 1 1 1
2 1 DS S SL
12 85 1 1 1 1 1 1 1
1 1 DS S SL
8.5 70 1 1 1 1 1 1 -
1 1 DS S SL
8.4 71 1 1 1 1 1 1 1
2 1 DS S SL
16 101 1 1 1 1 1 1 1
2 1 DS S SL
11 81 1 1 1 1 1 1 1
2 1 DS S SL
27 106 1 1 1 1 1 1 1
2 1 DS S SL
15 95 1 1 1 1 1 1 1
2 1 DS S SL
17 106 1 1 1 1 1 1 1
2 1 DS S SL
15.5 104 1 1 1 1 1 1 1
2 1 DS S SL
15 99 1 1 1 1 1 1 1
1 1 DS S SL
10.5 78 1 1 1 1 1 1 1
2 1 DS S SL
13 99 1 1 1 1 1 1 1
2 1 DS S SL
11.6 80 1 1 1 1 1 1 1
2 1 DS S SL
17 106 1 1 1 1 1 1 1
2 1 DS S SL
12 89 1 1 1 1 1 1 1
1 - DS S SL
5.5 60 1 1 1 1 1 1 -
2 1 DS S SL
17 105 1 1 1 1 1 1 1
2 1 DS S SL
12 86 1 1 1 1 1 1 1
2 1 DS S SL
11 80 1 1 1 1 1 1 1
2 1 DS S SL
11 80 1 1 1 1 1 1 1
2 1 DS S SL
15.5 103 1 1 1 1 1 1 1
2 1 DS S SL
14.5 103 1 1 1 1 1 1 1
2 1 DS S SL
16.5 105 1 1 1 1 1 1 1
2 1 DS S SL
12.5 89 1 1 1 1 1 1 1
1 1 DS S SL
9 34 1 1 1 1 1 1 1
2 1 DS S SL
16 105 1 1 1 1 1 1 1
2 1 DS S SL
18 108 1 1 1 1 1 1 1
1 1 DS S SL
8 72 1 1 1 1 1 1 1
2 1 DS S SL
16.5 106 1 1 1 1 1 1 1
2 1 DS S SL
17.8 105 1 1 1 1 1 1 1
2 1 DS S SL
11.6 88 1 1 1 1 1 1 1
2 1 DS S SL
11.5 87 1 1 1 1 1 1 1
2 1 DS S SL
14.7 101 1 1 1 1 1 1 1
2 1 DS S SL
26 115 1 1 1 1 1 1 1
2 1 DS S SL
12.5 85 1 1 1 1 1 1 1
1 1 DS S SL
4.5 55 1 - -
2 1 DS S SL
14 95 1 1 1 1 1 1 1
2 1 DS S SL
11 82 1 1 1 1 1 1 1
2 1 DS S SL
16 101 1 1 1 1 1 1 1
2 1 DS S SL
16 105 1 1 1 1 1 1 1
2 1 DS S SL
17 106 1 1 1 1 1 1 1
2 1 DS S SL
18 111 1 1 1 1 1 1 1
2 1 DS S SL
17 107 1 1 1 1 1 1 1
2 1 DS S SL
13 93 1 1 1 1 1 1 1
2 1 DS S SL
14 97 1 1 1 1 1 1 1
2 1 DS S SL
13 90 1 1 1 1 1 1 1
2 1 DS S SL
16 104 1 1 1 1 1 1 1
2 1 DS S SL
17.5 106 1 1 1 1 1 1 1
2 1 DS S SL
15.5 100 1 1 1 1 1 1 1
2 1 DS S SL
17 105 1 1 1 1 1 1 1
2 1 DS S SL
15 99 1 1 1 1 1 1 1
2 1 DS S SL
12 90 1 1 1 1 1 1 1
2 1 DS S SL
13.5 93 1 1 1 1 1 1 1
2 1 DS S SL
10.6 82 1 1 1 1 1 1 1
2 1 DS S SL
11.5 88 1 1 1 1 1 1 1
1 1 DS S SL
13 92 1 1 1 1 1 1 1
2 1 DS S SL
14.5 96 1 1 1 1 1 1 1
2 1 DS S SL
17 106 1 1 1 1 1 1 1
2 1 DS S SL
14 82 1 1 1 1 1 1 1
2 1 DS S SL
12.5 91 1 1 1 1 1 1 1
1 - DS S SL
7 64 1 1 1 1
1 1 DS S SL
8.8 75 1 1 1 1 1 1 1
2 1 DS S SL
20 110 1 1 1 1 1 1 1
2 1 DS S SL
14 92 1 1 1 1 1 1 1
1 1 DS S SL
11 79 1 1 1 1 1 1 1
2 1 DS S SL
15 102 1 1 1 1 1 1 1
1 1 DS S SL
8 70 1 1 1 1 1 -
2 1 DS S SL
16.5 105 1 1 1 1 1 1 1
2 1 DS S SL
14 92 1 1 1 1 1 1 1
2 1 DS S SL
8.2 72 1 1 1 1 1 - -
2 1 DS S SL
28 106 1 1 1 1 1 1 1
2 1 DS S SL
8.5 70 1 1 1 1 1 -
2 - DS S SL
4 50 1 - -
2 1 DS S SL
8.8 75 1 1 1 1 1 1 1
2 - DS S SL
7.5 54 1 1 1 - -
2 1 DS S SL
13.5 90 1 1 1 1 1 1 1
2 - DS S SL
6.5 65 1 1 - -
kor<7
Provinsi : SUMATERA UTARA Nama Posyandu

Kabupaten/Kota : SIMALUNGUN Bulan
Puskesmas/Kecamat : BATU ANAM / SIANTAR Tahun
Desa/Kelurahan : PANTOAN MAJU
Berat
NIK ( Nomor Induk Badan Awal Kepemilikan
No Kehamilan Ke Tanggal Lahir No Kartu Keluarga Nama Ibu Hamil Nama Suami NIK Suami Alamat
Kependudukan) hamil/Trise Buku KIA
mester I
(1) (2) (3) (4) (5) (6) (7) (8) (9) (10) (11)
1 3 12/15/1984 1208010607100006 1208015512840004 DERMA MIDAWATY SIAHAAN 53 1 MARKIANO.T.SILALAHI 1208012506820001 HUTA I
2 2 4/10/1992 1208010107130007 1208015004920004 SYLVIA YENI T.PANGGABEAN 50 1 SALMON ELFRIADI.S. 1208012804860003 HUTA I
3 2 1/24/1993 1272011408150001 1208016401930001 HARI ISMAYATI 49 1 DIAN AKBAR SINAGA 1272012110900004 HUTA III
4 1 9/16/1992 1208012406190011 1272015609920003 FITRI HUTAGAOL 50 1 NAZRI ADLANI 1209171712910003 HUTA III
5 3 2/3/1989 1208011412100001 1208014302890006 TRI SUSANTI 52 1 RIO ANSYAH PUTRA.P. 1208010411820007 HUTA III
6 3 11/27/1986 1208011002110015 1208016711860001 SRI CAHAYANTI SIPAYUNG 55 1 BAMBANG SUBRATA 1208010902840006 HUTA III
7 3 12/24/1993 1208011312100083 1208016412930003 PURNAMA SARI 53 1 IHWAN DAMANIK 1208011208910003 HUTA III
8 1 1/1/1990 1208012706190005 1208054101890001 ANITA PURBA 50 1 SYAHRONI SIHOTANG 1208012305919994 HUTA III
9
10
Keterangan
R PENCATATAN PEMANTAUAN IBU HAMIL
: RAMBUTAN, JAMBU AIR, MANGGIS

: AGUSTUS
: 2019
TTD
Tanggal Berat
RT RW Badan Lengan Tambah
Darah) butir TTD butir TTD
Pengukuran Badan (kg) (cm) Atas (LILA) 1=Ya,2=T diterima diminum
idak
(12) (13) (14) (15) (16) (17) (18) (19) (20)

8/20/2019 65 152 25 1 90 90
8/20/2019 72 157 24 1 90 90
8/21/2019 54 157 24 1 30 30
8/21/2019 56 156 24 1 60 60
8/21/2019 62 154 24 1 90 90
8/21/2019 56 155 24 2
8/21/2019 58 153 24 1 30 30
8/21/2019 56 155 24 1 60 60
Provinsi : SUMATERA UTARA Nama Posyandu : RAMBUTAN, FLAMBOYAN, JAMBU AIR, MANGGIS
Desa/Kelurahan : PANTOAN MAJU
Berat Kepemilik
Nomor Induk an Buku IMD 1=Ya No
Jenis No Kartu Badan KIA/KMS Tanggal BB
No Anak Ke Tanggal Lahir Kependuduka Nama Anak Nama Ayah NIK Ayah Telp/HP Alamat RT RW Pengukuran
Kelamin Keluarga (KK) Lahir 2=Tidak (kg)
n (NIK) 1=Ya Ayah
(gram) 2=Tidak
(1) (2) (3) (4) (5) (6) (7) (8) (9) (10) (11) (12) (13) (15) (16) (17) (18) (19)
1 12080128091 1272036501 NELPI E 12060760088400

1 1/25/2015 P AMELIA 3.2 1 1 HUTA I 2/20/2019 16.7
60004 150001 TARIGAN 03
2 12080128091 1208015810 RAHMAWATI NELPI E 12060760088400
2 10/18/2016 P 3.4 1 1 HUTA I 2/20/2019 12.6
60004 160003 CHANIAGO TARIGAN 03
3 12080109101 1208012008 RAFAEL 12750301019000
2 8/20/2015 L 3.2 1 1 GUNAWAN HUTA I 2/20/2019 16.5
50010 150001 JONVINO P 04
4 12080115101 1208015702 QORIANUR F M YAMIN 12080214058400
2 2/17/2014 P 3.5 1 1 HUTA I 2/20/2019 16.5
20001 140001 PURBA PURBA 02
5 12080114031 1208012304 ALVIN M RENOLD S 12081316078300
2 4/23/2015 L 3.4 1 1 HUTA I 2/20/2019 15.8
60019 150001 SILITONGA SILITONGA 02
6 12080103021 1208012904 MARIMAR H T CANDRA M 12080111038300
1 4/29/2016 L 3.2 1 1 HUTA I 2/20/2019 14.5
50004 160001 SAMOSIR SAMOSIR 05
7 12080113121 1208010708 BOY LAMHOT ROBERT 12080110068500
3 8/7/2016 L 3 1 1 HUTA I 2/20/2019 13.8
00044 160002 S LUBIS LUBIS 04
RAFLI AL
8 12080116121 1208012811 SAHDAN 12080127128100
3 11/29/2014 L AZAM 3 1 1 HUTA I 2/20/2019 16.9
00086 140004 SARAGIH 02
SARAGIH
9 12080101051 1208010406 RIZKY 12080623038400

2 6/4/2014 L 3 1 1 SUKIRNO HUTA I 2/20/2019 15.8
20009 140001 ANANDA 03
10 12080101051 1208011007 DIMAS 12080623038400
3 7/10/2016 L 3.2 1 1 SUKIRNO HUTA I 2/20/2019 13.2
20009 162001 SYAWALUDIN 03
11 12080113040 1208012802 ABDUL GOFUR ADAM 12080110096700

5 2/28/2014 L 3.5 1 1 HUTA I 2/20/2019 16.8
80258 140002 S SIREGAR MALIK S 03
12 12080113040 1208010409 RAFATAR KIKI.A 12080144089400

1 9/4/2015 L 3.7 1 1 HUTA I 2/20/2019 15.7
80258 152001 AIMAN.I SIREGAR 02
13 12080113121 1208016906 AQILA 12080123107800
3 6/29/2016 P 3.4 1 1 IRWANSYAH HUTA I 2/20/2019 13.5
00015 162001 KHUMAIRAH 06
14 32730619061 3273062810 ALEX MATTEW FERIANTO 32730624118400

2 10/28/2014 L 3.6 1 1 HUTA I 2/20/2019 16.3
20005 140002 HUTABARAT HUTABARAT 10
15 12080128081 1210140407 JULIUS KIRISVEN 12080113128000

1 7/4/2014 L 3.3 1 1 HUTA I 2/20/2019 16.6
20008 140002 SINAGA SIHALOHO 01
16 12080128081 ELVANDO KRISVEN 12080113128000
2 11/13/2018 L 3;2 1 1 HUTA I 2/20/2019 10
20008 SIHALOHO SIHALOHO 01
ABDUL ADAM
17 12080113040 1208012802 12080110096700
5 2/28/2014 L GHOFUR 3.5 1 1 MALIK HUTA I 2/20/2019 16.4
80258 140002 03
S.SIREGAR SIREGAR
KIKI
18 12080113040 1208010409 RAFATAR 12080144089400
1 9/4/2015 L 3.2 1 1 ANDRIYAN HUTA I 2/20/2019 16
80258 152001 AIMAN I 02
SIREGAR
19 12080129081 1208011909 BRAM.C.HUTA SAMSON,R.H 12080119128600

2 9/19/2015 L 3.4 1 1 HUTA I 2/20/2019 14.8
70007 150001 SOIT UTASOIT 04
20 12080129081 1208011909 ALFARO SAMSON,R.H 12080119128600
3 9/19/2017 L 3.3 1 1 HUTA I 20-022019 11.8
70007 150001 HUTASOIT UTASOIT 04
ARSYA
21 12080129041 1208011806 APRIANDA R 12080107048900
2 8/18/2014 L ZULVAN S 3.4 1 1 HUTA I 2/20/2019 18.6
10004 140004 P SIBORO 04
SIBORO
EDUWARD.M.
22 120801211011 1208015704 ARZETI NAULI 12080125017800
2 4/17/2017 P 3.5 1 1 T.SIMARMAT HUTA I 2/20/2019 12.3
0004 170003 SIMARMATA 01
A
23 120801270111 1208012804 KEVIN MEILAN.M.SI 12080114058500

3 4/23/2014 L 3.2 1 1 HUTA I 2/20/2019 16.8
0015 140003 SIMARMATA MARMATA 04
OSCAR F D
24 12080129071 1208010310 RAFAEL D J 12080116089500
1 10/3/2015 L 3.2 1 1 PANGARIBU HUTA I 2/20/2019 15.6
50005 150003 PANGARIBUAN 01
AN
25 12080128070 1208012001 LEWIS.F.HUTA LISTER 12080131077700

1 1/20/2016 L 3.5 1 1 HUTA I 2/20/2019 15.5
90005 160002 HAEAN HUTAHAEAN 02
ROSELIN
26 12080128070 1208015404 LISTER 12080131077700
5 4/14/2017 P PASKA 2.8 1 1 HUTA I 2/20/2019 11.6
90005 170003 HUTAHAEAN 02
HUTAHAEAN
27 12080113121 1208012407 STEVEN BANI BILSON.J.PAK 12080124088000

3 7/24/2015 L 3.4 1 1 HUTA I 2/20/2019 12.4
0004 150003 PAKPAHAN PAHAN 03
28 1208011407 12080127028400
1 7/14/2014 L ANDIKA 3.6 1 1 ANSEL.B. HUTA I 2/20/2019 15.8
130001 01
29 MELIONI SANDRAK
1 7/3/2016 P 3 1 1 HUTA I 2/20/2019 14.4
SIRAIT SIRAIT
JOVERI
30 1208014405 AURA KASIH 12080111028200
3 5/4/2015 P 3.5 1 1 TAMBA HUTA I 2/20/2019 16.5
150001 PURBA 03
PURBA
ABDUL R
31 AINAN NAZRA 12080106128000
3 7/25/2014 P 3.2 1 1 SITANGGAN HUTA I 2/20/2019 17.2
SITANGGANG 2
G
32 12080106050 1208014305 NADIRA H M.NUR RIJAL 12080115098000

3 5/3/2014 P 3.6 1 1 HUTA I 2/20/2019 17.5
80166 140003 DAMANIK DAMANIK 02
ASRA
33 12080125021 1208012012 ADHYASTHA N SIGIT 12720718038700 MA
1 12/20/2014 L 3.5 1 1 2/20/2019 17.5
40010 140001 PRABOWO PRABOWO 03 ARME
D
ASRA
34 12080123121 1208012407 KAISAR 12080101184000 MA
3 7/24/2015 L 3.3 1 1 SUHENDRA 2/20/2019 16.5
00049 150001 DIRGANTARA 2 ARME
D
ASRA
35 12080124021 1208010610 SATRIA.M.PUR NOVERLIN 12080128116000 MA
1 10/6/2014 L 3.4 1 1 2/20/2019 17.6
40010 140003 BA PURBA 01 ARME
D
36 120801151211 1208010206 ALBERT LESMAN 12080110108300 HUTA
2 6/2/2014 L 3 1 1 2/20/2019 16.5
0004 140001 BARUS BARUS 04 II
ASRA
37 120801110614 1208015303 ASY SYIFA JOKO.P.M.SU 12082110078800 MA
1 3/13/2014 P 3.3 1 1 2/5/2019 16.5
0007 140001 MAWADDAH SENO 04 ARME
D
ASRA
38 120801110614 1208016805 SALSABILA JOKO.P.M.SU 12082110078800 MA
2 5/28/2016 P 3.4 1 1 2/5/2019 14.9
0007 160001 ANINDITA SENO 04 ARME
D
39 12080105021 1208012712 ROLANSIUS RODO.P.PASA 12020813038700 HUTA

1 12/27/2014 L 3 1 1 2/20/2019 15.9
60007 170003 PASARIBU RIBU 02 II
40 12080106021 1208016207 AIVA AZNII BUCHORI 12080108028600 HUTA
1 7/12/2014 P 2.7 1 1 2/20/2019 15.8
50011 140002 FARA MUSLIM 02 II
41 12080113101 1208011911 AKMAL 32072601017400 HUTA
1 11/19/2014 L 2.9 1 1 SAEP 2/20/2019 16.3
50003 140003 HIDAYAT 03 II
ASRA
42 12081109021 1208114710 AQILA SILMI 12081101028200 MA
2 10/7/2015 P 2.8 1 1 KUSNO 2/5/2019 15.8
20004 150001 RAFANDA 03 ARME
D
43 12080135011 1208010901 JANSEN ROBERT 12080131128000 HUTA

1 1/9/2015 L 3.5 1 1 2/20/2019 17.5
30001 140001 BARUS BARUS 16 II
EFRAN
44 12080123121 1208011307 DIANA 12080142058400 HUTA
2 7/13/2014 L DEARDO 3.5 1 1 2/20/2019 16.4
00047 140002 SIPAKKAR 04 II
SIREGAR
ASRA
45 12080116081 1271215004 CLAUDYA.C.B. KUSRA 12712101038500 MA
2 4/10/2016 P 3.7 1 1 2/5/2019 13.7
60006 160001 PUTRI YANDRI 05 ARME
D
ASRA
46 12080123071 1208010404 INDRI 12710309088840 MA
1 4/4/2014 L AL .F.HABIBY 3.4 1 1 2/5/2019 17.4
40017 21001 PRAKASA 008 ARME
D
ASRA
47 120801150911 1208012904 RAFI SACHIO RAHMAT 12070920049000 MA
2 4/29/2014 L 3.2 1 1 2/5/2019 18.9
0009 140001 SAKHI BANISYAH 02 ARME
D
ASRA
48 12720829081 1272080506 EFRAD GHANI MESACH 12021009018700 MA 05-020-
2 6/5/2015 L 3.3 1 1 14.9
40003 150001 NABABAN NABABAN 01 ARME 2019
D
49 12080109011 1208011005 BINTANG.T.M.T TIGOR.S.T.TO 12080101057600 HUTA

2 5/10/2016 L 3.3 1 1 2/20/2019 13.8
20004 160003 OGATOROP GATOROP 04 II
50 19020228081 1208010208 DION FRENGKI 12080529109100 HUTA
1 8/2/2018 L 3.2 1 1 2/20/2019 10
70002 180001 ALFAREZI SUHARDI 02 II
;
51 12080129030 1208014304 EDELWEIS.P.GI DARMA HUTA
1 4/3/2016 P 3.5 1 1 12080106077300 2/20/2019 13.4
81675 160001 NTING GINTING II
02
52 12080102081 1208011204 WILDYANDO.I. POLTAK.H.SA 12080123108500 HUTA
2 4/12/2016 L 3.4 1 1 2/20/2019 14.6
20005 162001 SARAGIH RAGIH 04 II
53 12080125011 1208012308 RAYMON ROBERT 12080131128000 HUTA

2 8/23/2018 L 3.3 1 1 2/20/2019 10
30001 160002 ALEXANDRA.B BARUS 16 II
54 12080107021 1208016006 ANNISA.R.PAS VIJAI KAMAL 12720616098000 HUTA

3 6/20/2017 P 3.7 1 1 2/20/2019 11
70022 170003 ARIBU PASARIBU 02 II
ANARI
55 12080131011 1208015206 12720220028100 HUTA
2 6/12/2018 P NAVISYA 3.2 1 1 HERIYANTO 2/20/2019 9.5
80003 180002 02 II
PUTRI
56 120801130111 1208010804 JASTIN.P.PERA JHONI 12080125107800 HUTA

3 4/8/2014 L 3 1 1 2/20/2019 16.4
0007 140002 NGINANGIN WANDRI 02 II
57 12080130101 1208012304 STIVEN.M.NAP MARUDUT.M. 12080116127700 HUTA

1 4/23/2014 L 3.5 1 1 2/20/2019 17.6
30004 140005 ITUPULU NAPITUPULU 01 II
58 12080123121 1208016401 INSANI SHAHAMAN. 12080105048200 HUTA

2 1/24/2016 P 3.1 1 1 2/20/2019 15.8
00024 160003 ANGELINA.S. S.SARAGIH 11 II
59 12080128071 1376032108 ZIWFERNANDE DODY 13760324118400 HUTA

1 8/21/2014 L 3.3 1 1 2/20/2019 7.5
50005 140001 S HUTAGAOL DARMAN.H 01 II
60 1208016802 ELVIANA.Y.SIN RONAL.H.SIN 12080123087500 HUTA
3 2/28/2015 P 3 1 1 2/20/2019 16.5
150002 AGA AGA 02 II
61 KHALIF ANDOHAR 12080123087500 HUTA
1 9/13/2016 P 3 1 1 2/20/2019 13.9
RASHYA ROJALI 02 II
62 12081831071 ANGGRAINI BRESTON.T. 12081822098700 HUTA
1 10/15/2018 P 3.8 1 1 2/20/2019 9.8
80002 OKYAVIA M.PARDEDE 03 II
63 120801100211 1208010705 AZKA ALWI BAMBANG 12080109028400 HUTA
2 5/7/2018 L 3.7 1 1 2/21/2019 9.5
0015 180001 RAFFASYA SUBRATA 06 III
64 12080128091 1208013011 DEVANO RIO 12081107049200 HUTA
1 11/30/2017 L 32 1 1 SUHARTOYO 2/21/2019 11.7
70006 170001 ANGGARA 02 III
65 12080109011 1208015806 NASYA TALITA RISKI 12080524068900
2 6/18/2014 P 3 1 1 HUTA III 2/21/2019 17.6
40004 140001 ALFANDI 01
66 12080109011 1208014605 TATA URI RISKI 12080524068900 HUTA
3 5/6/2016 P 2.9 1 1 2/21/2019 12.9
40004 160001 WINATA ALFANDI 01 III
RINALDI
67 120801110118 1208011411 RESTU.P.SITUM 120801111288000 HUTA
1 11/14/2017 L 3.2 1 1 SITUMORAN 2/21/2019 12.5
0007 170001 ORANG 3 III
G
SUKMA
68 12080107021 1208010412 SAKHA RISKI 12080106049000 HUTA
1 12/4/2018 L 3.5 1 1 DARMANSYA 2/21/2019 9.3
70011 160002 ATTHAYA 04 III
H
ARFAN
69 12080123121 1208013005 RYAN 12080119019000 HUTA
2 5/30/2018 L GIBRAN 3.3 1 1 2/21/2019 10
40007 180001 MUSTAKIM 02 III
RAMADAN
70 12080116031 1208015304 ANINDYATA.A.I AGUS 12082817088700 HUTA

1 4/13/2016 P 3.3 1 1 2/21/2019 14.3
60004 160003 NARA SETIAWAN 02 III
71 12080109121 1208011403 ALIF HARI HARI.S.H 12080127089000 HUTA
1 3/14/2014 L 3.7 1 1 2/21/2019 16.6
60002 140004 MAULANA WIDODO 01 III
72 12080109121 1208015705 AURA AL HARI.S.H 12080127089000 HUTA
2 5/17/2017 P 2.9 1 1 2/21/2019 11.6
60002 170001 MESYAH WIDODO 01 III
73 12080128021 1208012307 MHD 12720503039400 HUTA
1 7/23/2015 L AZMI NAUFAL 2.8 1 1 2/21/2019 14.6
70015 150001 PRABOWO 01 III
74 12080128021 1208015403 FATTIHIYAH MHD 12720503039400 HUTA
2 3/14/2017 P 1.5 1 1 2/21/2019 12.7
70015 172001 AZMI PRABOWO 01 III
75 12080128021 1208015403 FATTINAH MHD 12720503039400 HUTA
3 3/14/2017 P 1.6 1 1 2/21/2019 12.9
70015 172002 AZMI PRABOWO 01 III
76 12080117021 YASDAN AL M.JULI 12080208079300 HUTA
3 3/31/2017 L 3.4 1 1 2/21/2019 12.5
70001 FAJRI ALFANDI 03 III
77 12720331081 1272034406 TATA RUDI.H.SYAP 12720327079100 HUTA
1 6/3/2016 P 3.2 1 1 2/21/2019 13.9
70004 60001 ANINDYTA UTRA 02 III
YUDI
78 12080109101 1208015909 ALIFA 12080126108800 HUTA
1 9/19/2017 P 3.2 1 1 ANSAHPUTR 2/21/2019 11.6
50016 170001 SYAFANA.Y 03 III
A
79 12080124070 1208014106 ERNA CITRA 12080145109000 HUTA

1 6/1/2016 P AISYAH RANIA 3.2 1 1 2/21/2019 13
90007 0002 DAMANIK 06 III
80 120801311011 1208014801 AFWA NUR DARMA 12080110037900 HUTA
2 1/8/2018 P 3.6 1 1 2/21/2019 10.7
20004 180001 MA'RIFAH GINTING 04 III
81 120801110210 1208015912 ZAHRATUL 12080130126900 HUTA
2 12/19/2017 P 3.5 1 1 NASRUL 2/21/2019 11.6
007 170001 SYAKILA 03 III
82 12080124081 1208010708 ARFAN ABDUL DEDI 120802111189000 HUTA
2 8/7/2016 L 3 1 1 2/21/2019 13.3
60003 160001 HAFIS SETIADI 1 III
83 12080103121 1208016306 ASIFA 12080116184000 HUTA
1 6/23/2014 P 3.5 1 1 HARYONO 2/21/2019 13.3
30020 130003 SALSABILA 2 III
84 12080103121 1208010411 12080116184000 HUTA
2 11/4/2016 L AJI.H.AQSAL 3 1 1 HARYONO 2/21/2019 12.4
30020 60002 2 III
AYATUL
85 12080113041 1208015201 12080128128600 HUTA
1 9/12/2017 P HUSNA 2.9 1 1 MULIADI 2/21/2019 16.6
60004 160001 04 III
ALMULUDI
86 12080113041 1208012109 ABRAR 12080128128600 HUTA

2 9/21/2017 P 2.7 1 1 MULIADI 2/21/2019 11.4
60004 172001 ARSHAKA .A 04 III
87 12080113121 1208010512 FYUDA 12080101078500 HUTA
2 12/5/2015 L HAIKAL.F 3.9 1 1 2/21/2019 15.5
00086 150001 RAHMAN 21 III
88 12080129030 1208012004 12080116097700 HUTA
2 4/20/2014 L FAHMI ADITYA 2.9 1 1 ARIADI.S 2/21/2019 15.5
80028 140002 01 III
RAISYA
89 120801211O1 1208015206 WIWIN.P.WID 12080118029800 HUTA
1 8/12/2017 P MANDA 3 1 1 2/21/2019 11.6
6003 170002 ODO 02 III
SYAFIRA
90 12080110031 1208015211 MYESHA NONI SRI 12080141129000 HUTA

1 11/12/2015 P 3.6 1 1 2/21/2019 14.6
50008 150002 AURELIA ASTUTI 2 III
91 12080120011 1208012201 FATHIR.A.AZZ ASAD 12080114028400 HUTA
2 1/22/2016 L 3.1 1 1 2/21/2019 14
40002 160002 AMI CHOLIL 03 III
92 12080120011 AZKA MALIQ ASAD 12080114028400 HUTA
3 4/11/2018 L 3.1 1 1 2/21/2019 10
40002 AL FARIQ CHOLIL 03 III
93 120801110314 1208016105 BENNY 12080110117500 HUTA
3 5/21/2014 P AMELLIA 2.8 1 1 2/21/2019 16.5
0006 140001 SUPRIADY 03 III
94 12080108011 1208016606 KARIN DWI ANDI 12080130058600 HUTA
2 6/26/2014 P 3.4 1 1 2/21/2019 16.6
30007 140003 ZANNAH RAMADANI 01 III
95 12080120041 1208014502 HANI HERMANSYA 12080127127900 HUTA
3 2/5/2016 P 3.1 1 1 2/21/2019 14.5
20001 160003 .P.HASIBUAN H HSB 02 III
96 12080101071 1208015812 ROHANA MISKANDI 12080131128500 HUTA
2 18-`12-2014 P 3.2 1 1 2/21/2019 15.8
30002 140003 NAULI SAHPUTRA 07 III
97 12080101071 1208011212 ALFAN MISKANDI 12080131128500 HUTA
3 12/12/2017 L 3.3 1 1 2/21/2019 10.9
30002 170001 KURNIAWAN SAHPUTRA 07 III
98 12080108011 1208016209 CAHAYA 12080217118400 HUTA
1 9/22/2015 P 3 1 1 SUKARDI 21-0202019 16.3
40009 150001 SYAFIRA 01 III
HADYAN
99 12080108011 12080217184000 HUTA
2 8/24/2018 L LUTFI AL 2.8 1 1 SUKARDI 2/21/2019 10.6
40009 1 III
FARIQI
100 12080120071 1208015910 SAHLAN 12080107097100 HUTA

3 4/19/2016 P RPA.H.HAREPA 1.9 1 1 2/21/2019 13.7
20004 160001 HAREPA 01 III
101 12080120071 1208015910 REPI.H.HAREP SAHLAN 12080107097100 HUTA
4 4/19/2016 P 2 1 1 2/21/2019 13.9
20004 160001 A HAREPA 01 III
08526
102 120801170111 1208016311 ALYSA AULIA SIMSON 12080117097900 HUTA
2 11/23/2018 P 3.2 1 1 29693 2/21/2019 9
0012 180001 DAMANIK .P.DAMANIK 03 III
88
103 120801270111 1208014707 KIKI 12080107097900 HUTA

3 7/7/2015 P 3.1 1 1 SENEN 2/21/2019 15.7
0022 150001 RAMADAN 02 III
104 12080129030 1208010705 BAHAQIAL SARIDA 12080152037800 HUTA
3 5/7/2014 L 2.9 1 1 2/21/2019 17.4
80068 140001 KAHFI SIDABUTAR 02 III
105 12080113040 1208014104 LATIFAH 12080123067600 HUTA
5 4/1/2014 P 2.8 1 1 M.SAFI'I 2/21/2019 17.4
80240 140003 AZAHRA 01 III
106 12080116081 1208011602 NAUFAL JUANDA 12080103079400 HUTA
1 2/16/2017 L 3 1 1 2/21/2019 13.9
60001 170001 AFKAR AFDI 03 III
107 120801100118 1208016903 GITSHA FIKI 12080114089600 HUTA
1 3/29/2018 P 3.2 1 1 2/21/2019 10.9
0002 182001 .R.YUANDA YUANDA 01 III
108 12080110071 FAIZAH HASIHOLAN 12080101038200 HUTA
4 11/28/2018 P 3.5 1 1 2/21/2019 9.2
70002 KHAIRUNNISA. MANURUNG 02 III
SURYA
109 12080127091 1208012211 12080123098700 HUTA
1 11/22/2014 L ALIF PRANATA 3.1 1 1 HARDIANSY 2/21/2019 17.2
60004 140004 03 III
AH
110 12080116051 1208011104 AKSA OKY SATRIA 12080111003890 HUTA

2 4/11/2017 L 2.7 1 1 2/21/2019 12.8
30008 170001 H.SUSILO SUSILO 001 III
111 12080114022 1208010107 M.REAL 12080108128900 HUTA
2 7/1/2016 L 3 1 1 BIMA SURYA 2/21/2019 13.4
10003 160001 RAMADAN 02 III
ABDI
112 12080117051 1208010208 NAUFAL.R.AR NUGROHO 12080108039000 HUTA
1 8/2/2016 L 3.3 1 1 2/21/2019 14.4
60002 160002 KAN S SITANGGAN 01 III
G
YUDI
113 12080109101 1208015909 ALIFA 12080126108800 HUTA
1 9/19/2017 p 3.5 1 1 ANSAHPUTR 2/21/2019 11
50016 170001 SYAFANA YURI 03 III
A
ABDUL
114 12080120061 1208012805 M.YUSUF.TU 12080124067600 HUTA
3 5/28/2017 L KHOLIK 3.5 1 1 2/21/2019 12
10008 170001 RNIP 03 III
TURNIP
115 12080109081 MUHAMMAD 12720618098100 HUTA

3 4/20/2016 L 3.4 1 1 M,SAFI'I 2/21/2019 14.3
70010 ALWI.S 01 III
116 12080103031 1208031001 FARHAN RISKY ALI 12080324117900 HUTA

3 4/20/2016 L 3.2 1 1 2/21/2019 14.5
40012 180002 AL FARAQH KURNIAWAN 04 III
117 120801141121 1208010805 KASLAN 12080110098300 HUTA

2 5/8/2018 L HILAL ABIYU 3.5 1 1 2/21/2019 9.4
00003 182001 TANJUNG 03 III
118 12080103031 1208012004 RIO FAZRI IWAN 12080104037600 HUTA
3 4/20/2016 L 3.7 1 1 2/21/2019 15
40012 160004 WAHYUDI SANTOSO 02 III
119 12080305017 1208030501 HAFIS 12080168039900 HUTA
1 5/5/2017 L 3.2 1 1 FUJI 2/21/2019 12.6
0002 70001 PRAYOGI 01 III
120 12080120011 1208012911 RIZKY NUR RUDI 12080168039900 HUTA
1 11/20/2014 L 3.7 1 1 2/21/2019 17.4
50002 140001 P.SIHOTANG SIHOTANG 01 III
121 12080124081 1208016709 RAESHA.S.B.T INDRA NOVA 12072610038500 HUTA

3 9/27/2016 P 3.4 1 1 2/21/2019 14.8
60002 160001 HANIEKY THANIEKY 15 III
122 12080121041 1208015808 JEFRI 12080219118700 HUTA
2 8/18/2016 P DEBY ANANDA 3.3 1 1 2/21/2019 14.2
50006 160001 SUGARA 01 III
123 12080117021 1208012307 DAVA M.JULI 12080208079300 HUTA
1 7/23/2014 L 3.1 1 1 2/21/2019 16.2
70001 140003 PRATAMA ALFANDI 03 III
124 12080117021 1208014601 BALQIS M.JULI 12080208079300 HUTA
2 1/6/2016 P 3.5 1 1 2/21/2019 16.9
70001 160001 HALIFAH ALFANDI 03 III
125 12080118021 ANANDA 12080143027500 HUTA
3 5/8/2015 L 3.4 1 1 NURMEGA 2/21/2019 16.4
0007 PRIYATMAJA 02 III
126 12080125011 1208014811 ARSI AULIA JOKO HERI 12080101129600 HUTA
1 11/8/2016 P 3.1 1 1 2/21/2019 12.7
70003 160003 PUTRI WIBOWO 01 III
127 12080128081 1208012306 ARDHAN.R.TU AGUS 12080128088500 HUTA
3 6/23/2015 L 3 1 1 2/21/2019 16
20003 150001 RNIP .K.TURNIP 08 III
128 1208- 1208014502 ALIKA AGUS 12080128088500 HUTA

4 2/5/2018 P 3.3 1 1 2/21/2019 10
12808120003 180002 KHUMAIRAH .K.TURNIP 08 III
129 12080106041 1208014611 KHALISA.DAR M.RAFI.HARI 12080114068800 HUTA

1 11/8/2015 P 3.6 1 1 2/21/2019 14.8
60014 150001 A.N.HARIANJA ANJA 03 III
130 12080112040 1208012104 AQILALIL 12080106057000 HUTA

4 4/21/2017 L 3.2 1 1 SUWINDRA 2/21/2019 12.6
81015 170002 MUTTAQIN 01 III
131 12080110041 1208012803 FARHAN 12760525088300 HUTA
2 3/28/2017 L 3.3 1 1 M.NURDIN 2/21/2019 12.3
70008 170001 NAHRAWI 01 III
132 12080110041 1208012802 AKBAR.A.DAM ULI TUA 12080105058300 HUTA
1 3/28/2017 L 3.4 1 1 2/21/2019 13.8
70004 170002 ANIK DAMANIK 04 III
DARA
133 12080101561 1208015611 M.WIRA 12080112048200 HUTA
2 11/16/2014 P AQILA.C.PURB 3.2 1 1 2/21/2019 16.3
12007 170002 PURBA 07 III
A
NUR
134 12080123121 1208015205 JUNA PANDY 12080116068400 HUTA
1 5/12/2016 P NABILA.A.SIN 3 1 1 2/21/2019 15.4
60002 160003 SINAGA 07 III
AGA
135 12072330031 1207234708 QUEISHA ANYA BAMBANG 12080731128600 HUTA

2 8/7/2014 P 3.4 1 1 2/21/2019 15.9
50006 140005 DAMANIK IRAWAN.D 06 III
136 12080128030 1208016404 12080111069000 HUTA

4 4/24/2015 P MIKAYLA.N.K 3.5 1 1 ASMADI 2/21/2019 15.4
80503 150001 1 III
137 12080129030 1208011606 ARYA FIKRI ISMAULI 12080123108200 HUTA
3 6/16/2015 L 3.3 1 1 2/21/2019 15.8
80112 150002 HASIBUAN HASIBUAN 01 III
138 12080105041 1208011311 ALI AKBAR HENDRI 12080108048800 HUTA
2 11/13/2015 L 2.7 1 1 2/21/2019 15.2
70006 150003 SIREGAR SIREGAR 05 III
139 12080120091 FARHANA R 12080105127900 HUTA
3 11/17/2016 P 3 1 1 ARVAN 2/21/2019 14.8
30003 MOZA 002 III
140 12080123121 1208013009 DEVAN WIRA RYAN 12080119019000 HUTA
1 9/30/2014 L 3 1 1 2/21/2019 15.8
40007 140001 RADITYA MUSTAKIM 02 III
QUEASAH
141 12080124081 1208015902 INDRA NOVA 12072610038500 HUTA
4 2/19/2018 P AURA 3.3 1 1 2/21/2019 10.7
60002 182001 THANIEKY 15 III
THANIEIKY
142 120801121118 1208011308 M.JUNA.TURNI JUMAT 12080128019400 HUTA

1 8/13/2018 L 3.4 1 1 2/21/2019 9.7
0002 10002 P TURNIP 03 III
143 12080120051 1208015108 HANAYA 12081105088500 HUTA
2 8/11/2018 P 2.5 1 1 HARIAJI 2/21/2019 9.7
50006 180001 ADZKIYA 04 IIII
144 120801091115 M.NUR ALIF DHIO BILL 12081921019300 HUTA
1 2/11/2016 L 2.9 1 1 2/21/2019 14.6
0009 SURBAKTI UTAMA S 03 III
145 12080109011 1208015305 ADZKA AL AGUNG 12080121069500 HUTA
1 5/13/2018 P 3.5 1 1 2/21/2019 9.9
80006 180001 MAGHFIRA SYAHPUTRA 01 III
146 12080118041 ZIDAN AGI MHD JONI 12080101019700 HUTA
1 11/1/2018 L 3.6 1 1 2/21/2019 9.4
80002 PRATAMA HAMDANI 04 III
FATHAR
147 12080127051 1208011306 RAJAMIN 12080116038900 HUTA
1 6/13/2016 L GUNTARA 3.8 1 1 2/21/2019 13.4
60002 160001 SARAGIH 01 III
SARAGIH
148 12080127051 1208016209 KYLA VANIA RAJAMIN 12080116038900 HUTA

2 9/22/2017 P 3.5 1 1 2/21/2019 12
60002 170001 SARAGIH SARAGIH 01 III
149 12080129030 1208017003 12080130016800 HUTA
3 3/30/2016 P EKA ANDINI 3.3 1 1 S.HAMZAH 2/21/2019 13.7
80079 160002 01 III
150 12080118021 1208010705 HERMAN 12080114108300 HUTA
1 5/7/2014 L GEO ALFATAH 3.4 1 1 2/21/2019 17.9
90003 140004 SYAH 02 III
151 12080124081 1208016709 RAESHA.S.B.T INDRA NOVA '12072610038500 HUTA

3 27-09-1016 P 3.2 1 1 2/21/2019 13.7
60002 160001 HANIEKY THANIEKY 15 III
152 120801251114 1208014503 QHAIRY.A.YAS LEO HUTA

1 3/5/2014 P 3.3 1 1 2/21/2019 17.6
0008 140002 MINE PRISWANTO III
153 1208011407 RAFJI SAHDAN 12080127128100 HUTA
3 11/28/2014 L 3.5 1 1 2/21/2019 16.3
130001 ALAZAM.S SARAGIH 02 III
154 1208012904 MARIMAR.H.T. CANDRA.M.V 12080111038300 HUTA
1 7/29/2016 P 2.9 1 1 2/21/2019 13.9
160001 S .S 05 III
155 12080114121 1208014405 AURA KASIH JONVERI.T.R 12080111028200 HUTA
3 5/4/2015 P 3.3 1 1 2/20/2019 14.9
00037 150001 PURBA EZEKI.P 03 II
ASRA
156 12080125021 1208012012 ADHVASTHA.N SIGIT 12720718038700 MA
1 12/24/2014 L 2.8 1 1 2/5/2019 16.4
40010 140001 .P PRABOWO 03 ARME
D
ASRA
157 120801150911 1208012904 RAHMAT 12070820049000 MA
2 4/29/2014 L RIAN.S 3.2 1 1 2/5/2019 16.6
0009 140001 BANISYAH 02 ARME
D
158 19020228081 1208010208 DION FRENGKI 12080529109100 HUTA

1 8/2/2018 L 3.6 1 1 2/20/2019 9.9
70002 180001 ALFAREZI SUHARDI 02 II
159 RONAL.H.SIN 12080123087500 HUTA
4 2/17/2016 P BUTET 3.2 1 1 2/20/2019 14.4
AGA 02 II
ASRA
160 12720721061 1376031711 MUHAMMAD SURYA 13760329068100 MA
1 11/17/2015 L 3.5 1 1 8/20/2019 17
60002 150001 RAFI BAKTI 01 ARME
D
ASRA
161 12720210616 1272075010 ANNISA DWI SURYA 13760329068100 MA
2 10/10/2017 P 3.3 1 1 8/20/2019 12.3
00002 170001 SURYANI BAKTI 01 ARME
D
ASRA
162 12080123121 1208011010 HANIF ARKAN DUWI 12080125047800 MA
3 10/10/2016 L 3.2 1 1 8/20/2019 13.6
00041 160001 MAULANA RISWAN 02 ARME
D
163 12080129041 APRIANDA R 12080107048900

3 8/17/2019 L UCOK SIBORO 3.1 1 1 HUTA I 8/20/2019 4.1
10004 P SIBORO 04
OSCAR F D
164 12080129071 12080116089500
2 6/18/2019 MARSELLO 3.5 1 1 PANGARIBU HUTA I 8/20/2019 5.8
50005 01
AN
165 12080118002 SAKIRA HERMANSYA 12080114108300 HUTA
2 6/24/2019 P 3.1 1 1 8/21/2019 5.5
190003 JARANABILA H 02 III
SHAQUEENAD
166 12080106041 M.RAFI.HARI 12080114068800 HUTA
2 6/14/2019 P ARA NAZLY 2.8 1 1 8/21/2019 5.3
60014 ANJA 03 III
HARIANJA
ALVINO
167 12720114081 1272011210 DIAN AKBAR 12720121109000 HUTA
1 10/12/2015 L PRATAMA 3.1 1 1 8/21/2019 16
50001 150001 SINAGA 04 III
SINAGA
168 12080131081 1208015805 ADZHIA ABDUL 12080110128900 HUTA

1 5/18/2019 L 4.5 1 1 8/21/2019 6.6
90028 190002 RAMADHAN ROHIM 02 III
KHANZA
169 12080127081 1208015309 PRAYOGI 120801111193000 HUTA
1 9/13/2018 P GWEN 3.5 1 1 8/21/2019 9.9
80006 180001 SAPUTRA 1 III
HUMAIRA
NURUL FARA
170 12080123121 1208014606 JUNA PANDY 12080116068400 HUTA
2 6/6/2018 P HADIBAH 3.6 1 1 8/21/2019 10.2
60002 180001 SINAGA 07 III
SINAGA
171 12080125081 1208010203 RADHITYA 12082821018600 HUTA

2 3/2/2017 L 3.3 1 1 MURSYID 8/21/2019 14.4
50002 170002 ARKAN 03 III
172 12080127031 1208011505 FATIH ROZAQ AGUS PANDU 12080118068200 HUTA

1 5/15/2015 L 3.5 1 1 8/21/2019 15
70005 150004 ALGUSTO WAHYUDI 03 III
173 ELPANO 12720325109600 HUTA

1 2/15/2019 L 3.3 1 1 SASMITO 8/21/2019 8.3
GLOPRADANA 02 III
SONYA
174 12080109081 12720610038500 HUTA
1 6/27/2019 P MAFPIRA 2.8 1 1 SUYANTO 8/21/2019 6.4
80001 04 III
ADISTA
Keterangan
TUMBUHAN DAN PERKEMBANGAN BALITA DI POSYANDU
: RAMBUTAN, FLAMBOYAN, JAMBU AIR, MANGGIS

Vitamin A Vitamin A
Badan/Ti 1=Terlenta Februari Agustus
nggi ng 1=Ya 1=Ya
(20) (21) (21) (22) (23) (24) (25) (26) (27) (28) (29) (30) (31)
105 2 1 1 1 1 1 1 1 1 DS S SL
94 2 1 1 1 1 1 1 1 1 DS S SL
101 2 1 1 1 1 1 1 1 1 DS S SL
104 2 1 1 1 1 1 1 1 1 DS S SL
104 2 1 1 1 1 1 1 1 1 DS S SL
96 2 1 1 1 1 1 1 1 1 DS S SL
98 2 1 1 1 1 1 1 1 1 DS S SL
108 2 1 1 1 1 1 1 1 1 DS S SL
104 2 1 1 1 1 1 1 1 1 DS S SL
93 2 1 1 1 1 1 1 1 1 DS S SL
108 2 1 1 1 1 1 1 1 1 DS S SL
105 2 1 1 1 1 1 1 1 1 DS S SL
11-Apr 2 1 1 1 1 1 1 1 1 DS S SL
109 2 1 1 1 1 1 1 1 1 DS S SL
110 2 1 1 1 1 1 1 1 1 DS S SL
75 1 1 1 1 1 1 1 DS S SL
108 2 1 1 1 1 1 1 1 1 DS S SL
101 2 1 1 1 1 1 1 1 1 DS S SL
99 2 1 1 1 1 1 1 1 1 DS S SL
86 2 1 1 1 1 1 1 1 1 DS S SL
109 2 1 1 1 1 1 1 1 1 DS S SL
90 2 1 1 1 1 1 1 1 1 DS S SL
109 2 1 1 1 1 1 1 1 1 DS S SL
105 2 1 1 1 1 1 1 1 1 DS S SL
105 2 1 1 1 1 1 1 1 1 DS S SL
90 2 1 1 1 1 1 1 1 1 DM S SL
89 2 1 1 1 1 1 1 1 1 DS S SL
102 2 1 1 1 1 1 1 1 1 DS S SL
97 2 1 1 1 1 1 1 1 1 DS S SL
105 2 1 1 1 1 1 1 1 1 DS S SL
112 2 1 1 1 1 1 1 1 1 DS S SL
108 2 1 1 1 1 1 1 1 1 DS S SL
105 2 1 1 1 1 1 1 1 1 DS S SL
105 2 1 1 1 1 1 1 1 1 DS S SL
110 2 1 1 1 1 1 1 1 1 DS S SL
108 2 1 1 1 1 1 1 1 1 DS S SL
102 2 1 1 1 1 1 1 1 1 DS S SL
105 2 1 1 1 1 1 1 1 1 DS S SL
108 2 1 1 1 1 1 1 1 1 DS S SL
108 2 1 1 1 1 1 1 1 1 DS S SL
103 2 1 1 1 1 1 1 1 1 DS S SL
108 2 1 1 1 1 1 1 1 1 DS S SL
108 2 1 1 1 1 1 1 1 1 DS S SL
99 2 1 1 1 1 1 1 1 1 DS S SL
114 2 1 1 1 1 1 1 1 1 DS S SL
114 2 1 1 1 1 1 1 1 1 DS S SL
104 2 1 1 1 1 1 1 1 1 DS S SL
98 2 1 1 1 1 1 1 1 1 DS S SL
74 2 1 1 1 1 1 1 1 1 DS S SL
95 1 1 1 1 1 1 1 1 1 DS S SL
97 2 1 1 1 1 1 1 1 1 DS S SL
74 2 1 1 1 1 1 1 1 1 DS S SL
90 2 1 1 1 1 1 1 1 1 DS S SL
71 2 1 1 1 1 1 1 1 1 DS S SL
111 1 1 1 1 1 1 1 1 1 DS S SL
111 2 1 1 1 1 1 1 1 1 DS S SL
104 2 1 1 1 1 1 1 1 1 DS S SL
103 2 1 1 1 1 1 1 1 1 DS S SL
103 2 1 1 1 1 1 1 1 1 DS S SL
94 2 1 1 1 1 1 1 1 1 DS S SL
75 2 1 1 1 1 1 1 1 1 DS S SL
76 1 1 1 1 1 1 1 DS S SL
82 1 1 1 1 1 1 1 1 1 DS S SL
111 2 1 1 1 1 1 1 1 1 DS S SL
93 2 1 1 1 1 1 1 1 1 DS S SL
86 2 1 1 1 1 1 1 1 1 DS S SL
70 2 1 1 1 1 1 1 1 1 DS S SL
78 1 1 1 1 1 1 1 1 1 DS S SL
97 1 1 1 1 1 1 1 1 1 DS S SL
111 2 1 1 1 1 1 1 1 1 DS S SL
89 2 1 1 1 1 1 1 1 1 DS S SL
102 2 1 1 1 1 1 1 1 1 DS S SL
90 2 1 1 1 1 1 1 1 1 DS S SL
91 2 1 1 1 1 1 1 1 1 DS S SL
90 2 1 1 1 1 1 1 1 1 DS S SL
97 2 1 1 1 1 1 1 1 1 DS S SL
86 2 1 1 1 1 1 1 1 1 DS S SL
96 2 1 1 1 1 1 1 1 1 DS S SL
78 2 1 1 1 1 1 1 1 1 DS S SL
83 2 1 1 1 1 1 1 1 1 DS S SL
90 2 1 1 1 1 1 1 1 1 DS S SL
90 2 1 1 1 1 1 1 1 1 DS S SL
87 2 1 1 1 1 1 1 1 1 DS S SL
107 2 1 1 1 1 1 1 1 1 DS S SL
86 2 1 1 1 1 1 1 1 1 DS S SL
105 1 1 1 1 1 1 1 1 DS S SL
105 2 1 1 1 1 1 1 1 1 DS S SL
84 2 1 1 1 1 1 1 1 1 DS S SL
102 2 1 1 1 1 1 1 1 1 DS S SL
108 2 1 1 1 1 1 1 1 1 DS S SL
79 2 1 1 1 1 1 1 1 1 DS S SL
109 2 1 1 1 1 1 1 1 1 DS S SL
107 2 1 1 1 1 1 1 1 1 DS S SL
101 2 1 1 1 1 1 1 1 1 DS S SL
105 2 1 1 1 1 1 1 1 1 DS S SL
80 2 1 1 1 1 1 1 1 1 DS S SL
105 2 1 1 1 1 1 1 1 1 DS S SL
76 2 1 1 1 1 1 1 1 1 DS S SL
101 1 1 1 1 1 1 1 DS S SL
100 2 1 1 1 1 1 1 1 1 DS S SL
73 2 1 1 1 1 1 1 1 1 DS S SL
100 2 1 1 1 1 1 1 DS S SL
109 2 1 1 1 1 1 1 1 1 DS S SL
112 2 1 1 1 1 1 1 1 1 DS S SL
96 2 1 1 1 1 1 1 1 1 DS S SL
83 2 1 1 1 1 1 1 1 1 DS S SL
73 1 1 1 1 1 1 1 1 1 DS S SL
106 1 1 1 1 1 1 1 1 1 DS S SL
94 2 1 1 1 1 1 1 DS S SL
97 2 1 1 1 1 1 1 1 1 DM S SL
100 2 1 1 1 1 1 1 1 1 DS S SL
87 2 1 1 1 1 1 1 1 1 DS S SL
89 2 1 1 1 1 1 1 1 1 DS S SL
101 2 1 1 1 1 1 1 1 1 DS S SL
101 2 1 1 1 1 1 1 1 1 DS S SL
76 2 1 1 1 1 1 1 1 1 DS S SL
103 2 1 1 1 1 1 1 1 1 DS S SL
87 2 1 1 1 1 1 1 1 1 DS S SL
106 2 1 1 1 1 1 1 1 1 DS S SL
100 2 1 1 1 1 1 1 1 1 DS S SL
99 2 1 1 1 1 1 1 1 1 DS S SL
106 2 1 1 1 1 1 1 1 1 DS S SL
106 2 1 1 1 1 1 1 1 1 DS S SL
107 2 1 1 1 1 1 1 1 1 DS S SL
90 2 1 1 1 1 1 1 1 1 DS S SL
105 2 1 1 1 1 1 1 1 1 DS S SL
80 2 1 1 1 1 1 1 1 1 DS S SL
104 2 1 1 1 1 1 1 1 1 DS S SL
93 2 1 1 1 1 1 1 1 1 DS S SL
93 2 1 1 1 1 1 1 1 1 DS S SL
95 2 1 1 1 1 1 1 1 1 DS S SL
105 2 1 1 1 1 1 1 1 1 DS S SL
100 2 1 1 1 1 1 1 1 1 DS S SL
105 2 1 1 1 1 1 1 1 1 DS S SL
106 2 1 1 1 1 1 1 1 1 DS S SL
103 2 1 1 1 1 1 1 1 1 DS S SL
101 2 1 1 1 1 1 1 1 1 DS S SL
100 2 1 1 1 1 1 1 1 1 DS S SL
106 2 1 1 1 1 1 1 1 1 DS S SL
81 2 1 1 1 1 1 1 1 1 DS S SL
75 2 1 1 1 1 1 1 1 1 DS S SL
73 1 1 1 1 1 1 1 1 1 DS S SL
100 1 1 1 1 1 1 1 1 1 DS S SL
75 2 1 1 1 1 1 1 1 1 DS S SL
73 1 1 1 1 1 1 1 1 1 DS S SL
96 1 1 1 1 1 1 1 DS S SL
87 2 1 1 1 1 1 1 1 1 DS S SL
99 2 1 1 1 1 1 1 1 1 DS S SL
102 2 1 1 1 1 1 1 1 1 DS S SL
112 2 1 1 1 1 1 1 1 1 DS S SL
96 2 1 1 1 1 1 1 1 1 DS S SL
112 2 1 1 1 1 1 1 1 1 DS S SL
105 2 1 1 1 1 1 1 1 1 DS S SL
99 2 1 1 1 1 1 1 1 1 DS S SL
100 2 1 1 1 1 1 1 1 1 DS S SL
107 2 1 1 1 1 1 1 1 1 DS S SL
104 2 1 1 1 1 1 1 1 1 DS S SL
74 2 1 1 1 1 1 1 1 1 DS S SL
100 2 1 1 1 1 1 1 1 1 DS S SL
102 2 1 1 1 1 1 1 1 1 DS S SL
88 2 1 1 1 1 1 1 1 1 DS S SL
95 2 1 1 1 1 1 1 1 1 DS S SL
52 1 1 2 2 2 2 2 2 2 DS S SL
57 1 1 1 1 2 2 2 2 2 DS S SL
56 1 1 1 1 2 2 2 2 2 DS S SL
56 1 1 1 1 2 2 2 2 2 DS S SL
101 2 1 1 1 1 1 1 1 1 DS S SL
60 1 1 1 1 1 2 2 2 2 DS S SL
75 1 1 1 1 1 1 1 1 1 DS S SL
77 2 1 1 1 1 1 1 1 1 DS S SL
94 2 1 1 1 1 1 1 1 1 DS S SL
100 2 1 1 1 1 1 1 1 1 DS S SL
61 1 1 1 1 1 1 1 2 2 DS S SL
59 1 1 1 1 2 2 2 2 2 DS S SL
7-8, diisi Dp(Kemungkinan penyimpangan) jika skor<7

Provinsi : SUMATERA UTARA Nama Posyandu : :MANGGA / NANGKA

Puskesmas/Kecamatan : BATU ANAM / KECAMATAN Tahun : 2019
Desa/Kelurahan : SEJAHTERA
Berat
No Kartu NIK ( Nomor Induk Nama Ibu Badan Awal Kepemilikan Nama Tanggal
No Kehamilan Ke Tanggal Lahir NIK Suami Alamat RT RW
Keluarga Kependudukan) Hamil hamil/Trise Buku KIA Suami Pengukuran
mester I
(1) (2) (3) (4) (5) (6) (7) (8) (9) (10) (11) (12) (13) (14)
; Lince Dasmer ;
1 1 120801020 1503034505840009 Jernih 52 ya Nehemia 150303120 Batu 6 21-08-2019
3170005 Margaretta Saragih 2840001
05/05/1984
2 120801150 Denni Eripdo 128012808
4 1208016909850000 49 ya Batu 5 21-08-2019
28/08/1976 8130002 Susianti Siahaan 760005
Robert
3 120801120 Merliana 120801101
1 1202077108880001 48 ya Martua Batu 5 21-08-2019
4080548 Lubis 1880006
31/08/1980 Sihombing
Yoyong
4 120801261 Halimah 217112291
3 2171125705910005 51 ya mardiansah Batu 4 20-08-2019
0170004 Tambunan 0839006
10/5/1991 Lubis
120801090 Kurnia Mangiring

5 4 1/11/1900 1208015203860006 Simanjunta 49 ya 120801051 Batu 5 21-08-2019
7150005 Sinaga
k 0840002
Desli Pormen ;
6 120801270
3 29/12/1992 1208015912920004 Argahita 48 ya Libon 120801100 Batu 5 21-08-2019
9160006
Purba Sitorus ;1920001
7 120801130 Nora Vitri Berman 120801270
1 25/10/1992 1208207010920001 52 ya Batu 6 21-08-2019
8190006 saragih Purba 9910002
Rendy Foreman
8 1 21/07/1989 120801 1201106107890002 Marcelina 48 ya Batu 4 20-08-2019
napitu
Sihotang 120801
Rijon
9 1 13/09/1989 120801 120801 Jeslin 49 ya Halomoan 120801171 Batu 5 21-08-2019
silitonga Turnip 2910003
Noisen Davit
10 4 5/11/1984 120801 120801 Simanjunta 58 ya pangaribua Batu 5 21-08-2019
k n 120801
11 Mawarni Donal
3 12/6/1997 120801 120801 48 ya Batu 4 21-08-2019
Tindaon situmeang 120801
Keterangan
ENCATATAN PEMANTAUAN IBU HAMIL
TTD
(Tablet
Berat Badan Lengan Darah) butir TTD butir TTD
Badan (kg) (cm) Atas (LILA) 1=Ya,2=T diterima diminum
idak
(15) (16) (17) (18) (19) (20)
57 156 23.5 1 30 30
58 156 23 1 90 90
58 151 23 1 90 90
63 154 24 1 90 90
58 152 23 1 90
90
57 153 23,5 1 90
90
62 156 25 1 90
90
56 153 23 1 60
60
60 153 24 1 60
60
67 154 26 1 90
90
59 152 23 1 60
60
FORMULIR PENCATATAN PEMANTAUAN PERTUMBUHAN DAN PERKEMBANGAN BALITA DI PO
Provinsi : Sumatera Utara Nama Posyan : Mangga / Nangka

Kabupaten / Kota : Simalungun Bulan : AGUSTUS
Puskesmas / Kecamatan : Batu Anam / Siantar Tahun : 2019
Desa / Kelurahan : Sejahtera
Kepemilik
Berat
Nomor Induk an Buku
Jenis No Kartu Keluarga Kependudukan Badan KIA/KMS IMD 1=Ya
No Anak Ke Tanggal Lahir Nama Anak Nama Ayah NIK Ayah No Telp/HP Ayah Alamat RT RW
Kelamin (KK) Lahir 2=Tidak
(NIK) 1=Ya
(gram) 2=Tidak
(1) (2) (3) (4) (5) (6) (7) (8) (9) (10) (11) (12) (13) (15) (16) (17)
12080104040801 '12080159081 12080128087
1 4 16/10/2014 L Parulian Rifael S. 3,2 Kg 1 1 Juanda S. 082162822873 Km. 5
49 40002 80001
12080102020801 '12080123061 12080112017
2 2 18/04/2015 L Wiliam P. 3 Kg 1 1 Jore P. 082367123239 Km. 5
23 40001 90002
12080130041500 '12080111061 12080122069
3 2 8/5/2015 L Gabriel Messi S. 3,2 Kg 1 1 Clinton S. 081363840040 Km. 5
09 40001 30001
12080115121100 '12081141101 12080110108
4 2 20/09/2014 L Albert B. 3,2 Kg 1 1 Lesman 082164594131 Km. 5
04 40002 30004
12080127111400 '12080103121 12080101098
5 2 28/01/2015 P Vatin Lubis 3,6 Kg 1 1 Sulaiman 085261519607 Km. 4
04 30003 30004
12080124021200 '12080169101 12080109017
6 4 13/10/2014 P Dwi Damanik 3,3 Kg 1 1 Dewinson 085275614413 Km. 5
04 40001 70002
12080129031200 '12720508051 12080122127
7 3 7/28/2015 P Elsa Sitepu 4 Kg 1 1 Jon Henri 081269799414 Km. 4
14 40001 70005
12080104040808 '12080101051 12080120017
8 3 4/10/2014 L Alvaro Sipayung 3,5 Kg 1 1 Utuh S. Km. 4
16 40001 40003
12080122051400 '12081040815 12080101078
9 2 30/05/2016 P Mei Indah Purba 2,7 Kg 1 1 Johan P. 081361365678 Km. 5
02 0006 30010
12080120091200 '12080109021 12080122088
10 2 27/03/2016 P Rista 3,5 Kg 1 1 Binar 082161265624 Km. 5
03 82001 00005
12080116121000 120802811140 12080127128
11 3 28/11/2014 L Rafli Saragih 3 Kg 1 1 Sahdan Km. 5
86 004 10002
12080115101400 120801240215 12080155128
12 1 24/02/2015 L Ferdian.Silalahi 3.3 kg 1 1 Yanti melda 81361365670 km 6
01 0004 80002
12080111051000 '12080123081 Rodo Risky 12080131018
13 4 13/09/2016 L 3 1 1 Jendri 082171376976 Km. 5
18 50002 Girsang 00002
12080114071000 '12080163121 12080106181
14 2 22/06/2015 P Alicia Sinaga 3.3 1 1 Harianto 081265970656 Km. 5
11 50002 0003
12080114071000 '12080152051 12080106181
15 3 22/06/2015 P Alisha Sinaga 3.1 1 1 Harianto 081265970656 Km. 5
11 82001 0003
12080128071100 '12080145101 12080103108
16 4 25/09/2014 P Alycia Gzueen 3 1 1 Sovian 081262066162 Km. 5
04 50002 30004
12080127081500 '12080126011 Timbul 12080168018
17 1 13/07/2016 P Yocelin S. 3.2 1 1 0853707885 Km. 5
10 60001 Simangunsong 40002
'1208012708150 '12080168051 12720329128
18 2 23/12/2016 L Ipmand B. 3 1 1 Joslan 082368427185 Km. 5
010 60003 40002
12080108011400 '12080155061 12080105128
19 2 26/02/2015 P Putri Kartika 3.2 1 1 Ligor 85270549085 Km. 5
07 60002 70001
12080112011200 Maulana 12080121116
20 1 14/11/2014 L 120801 3.5 1 1 Jhon Hard Km. 6
3 Damanik 90003
12080130041500 '12080129061 12080119058
21 1 4/9/2015 P Mesia Ivano Sitio 2.9 1 1 Fredy Sitio 081370003970 Km. 5
09 40001 20001
12080102041200 120801020412 12080117028
22 2 16/09/2014 P Tiovani S. 3.5 1 1 Hendra 081397843674 Km. 5
05 0005 10002
12080110071300 '12080105051 12080120098
23 1 9/9/2014 P Hanaya Sinaga 2.8 1 1 Hendri S. Km. 5
04 40003 20003
12080110071300 '12080154061 12080120098
24 2 15/12/2015 L Azarya Sinaga 3 1 1 Hendri S. Km. 5
04 80001 20003
12080125041100 '12080143051 12080121117
25 1 24/09/2014 L Gabriel Ginting 3.4 1 1 Heru G. Km. 5
08 60001 0001
12080125041100 '12180929111 12080121117
26 2 28/05/2015 L Brian Ginting 3.3 1 1 Heru G. Km. 5
08 30004 0001
12080127031400 '12080146041 12080120017
27 5 2/6/2015 P Junika Purba 2.8 1 1 Jumpaman.p Km. 5
05 80001 40006
12080120021200 '12080155031 12080130097
28 4 21/08/2015 P Cynthia Gabriela 3.3 1 1 Lambok 081375824161 Km. 5
02 50002 10003
12080113121100 '12080165011 12080106068
29 2 22/11/2015 L Maher Ahmad 2.9 1 1 Welli H. 081269489412 Km. 5
06 50002 10006
12080127021500 120801680216 12081052029
30 1 28/02/2016 P Vanesa Kristiani 3,5 Kg 1 1 Jesika S. 081284689080 Km. 4
05 2001 80002
12080118011000 '12080170121 12080130057
31 3 13/10/2014 L Elpedro Sipayung 3 Kg 1 1 David S. 085296494850 Km. 4
02 30001 50003
12080128031400 '12080506011 12080101068
32 1 9/9/2014 L Lasro Renhat 2,9 Kg 1 1 Jujur S. 081376210809 Km. 4
11 50001 60006
12080111081400 '12080111031 Alvian 14011314048
33 1 19/09/2014 L 3 Kg 1 1 Yentra S. Km. 4
01 80001 Situmorang 70006
12080111081400 '12180960071 Ardian 14011314048
34 2 19/09/2014 L 2,8 Kg 1 1 Yentra S. Km. 4
01 60001 Situmorang 70006
12080129041300 '12180941061 12080112108
35 1 9/8/2015 L Rido Ginting 3 Kg 1 1 Zulkifli 082160766044 Km. 4
03 40001 60005
12080113090800 '12080105081 12080119087
36 3 24/07/2014 P Hafizah Harahap 3,5 Kg 1 1 Pandapotan Km. 4
21 60002 20001
Kresa
37 1 18/08/2017 P 120801 120801 Indri Girsang 3,4 Kg 1 1 120801 Km. 4
Peranginangin
'12080157041
38 4 15/12/2014 L 120801 Azraf Sagala 2,8 Kg 1 1 Adi Santoso 120801 Km. 4
50001
12080112121200 120801550817 Joivanca Jimson 12080106097
39 3 15/08/2017 P 3,6 Kg 1 1 Km.5
01 0002 Limbong Limbong 60002
12160525041200 120801510615 Jhontiardo 12160527017
40 3 11/6/2016 P Sofia Ananta 3,4 Kg 1 1 Km.5
04 0001 Silalahi 90001
'12080120091
41 1 1/9/2014 P 120801 Jumiati 3,5 Kg 1 1 Lisna 120801 081384782222 Km. 4
30004
'12081108061
42 2 19/10/2015 L 120801 Jumaidin 3 Kg 1 1 Lisna 120801 081384782222 Km. 4
60001
21711122111200 '12080118011 12080165029
43 1 6/6/2015 L Bayu 2,8 Kg 1 1 Farida Km. 4
34 70001 30002
12080103111400 '12082925021 12080114048
44 1 15/04/2014 P Gebi Patricia S. 3,4 Kg 1 1 Jon Fransiskus 085276259513 Km. 4
01 40002 80005
12160525041200 Jhontiardo 12160527017
45 4 16/06/2018 L 120801 Alosius Silalahi 3,5 Kg 1 1 Km.5
04 Silalahi 90001
;
120801070619 Davin William Hendra 12080117028
46 3 7/6/2019 L 12080102041200 3,6 Kg 1 1 Km.5
0001 Togatorop Togatorop 10002
05
12080106100900 '12081923111 12080106100
47 3 22/10/2014 L Mikael Sitorus 2.8 1 1 Dormanson 082160452650 Km. 5
15 30001 90015
'12080130091
48 1 8/3/2015 L 120801 Padmanata R. 3 1 1 Indah 120801 081284623416 Km. 5
50001
12080113061100 '12080128081 12080128047
49 3 9/15/2015 L Pramlin Turnip 3.2 1 1 Carles T Km. 5
03 40001 70001
12080126101700 120801501114 12110804098
50 2 11/10/2014 P Ronauli sinaga 3 1 1 Saroha sinaga 082365700087 Km. 5
06 0003 30002
'12080168041
51 4 8/9/2015 P 120801 putri felisia 3.2 1 1 Demak pasaribu 120801 082368302684 Km. 5
70001
12080114091600 120813450715 Toni jones 12081314118
52 3 7/5/2015 L Ian Manalu 3.3 1 1 Km. 5
10 0001 malau 10001
12080111041600 '12050660001 12080131128
53 1 7/14/2016 P Margaret Sitorus 3.4 1 1 Lamhot S. 082162822870 Km. 5
06 14001 80002
12080107091600 Rehan Parulian Immanuel 12080105098
54 1 28/05/2019 L 120801 3.8 1 1 Km. 5
01 Saragih Saragih 90003
12080108071300 '12080146041 12080101118
55 1 9/10/2014 L Michael Purba 3.4 1 1 Maruli P. 081361523759 Km. 5
01 50001 20003
12080108071300 '12096043081 12080101118
56 2 11/4/2016 L Mariel Purba 3.5 1 1 Maruli P. 081361523759 Km. 5
01 80000 20003
12080128091500 '12080157081 12080106078
57 1 2/20/2016 P Felix purba 3.1 1 1 Fredi P. Km. 5
07 60001 60004
12080116081600 '12080148111 12130805079
58 1 7/5/2016 P Azizah Fitri L. 3.2 1 1 Ikhwan L. 082361329235 Km. 5
02 40002 10001
12770809011700 '12080145031 12080121109
59 1 6/19/2016 L Maxwel Tondang 3 1 1 Guntur P. Km. 5
07 80001 00002
12080118031100 '12080142031 12080121037
60 3 4/19/2016 P Adinda Azzahra 3.6 1 1 Trioso D. 085361079092 Km. 5
25 40001 60004
12080106051100 '12080127031 12080115117
61 2 27/09/2014 L Daniel Julius P. 3.5 1 1 Riwanto P. Km. 5
31 60001 70003
12080106051100 '12080149111 Vanesia 12080115117
62 3 8/2/2016 P 3.4 1 1 Riwanto P. Km. 5
31 50001 Pangaribuan 70003
12080104040805 '33170809111 12080111047
63 3 11/4/2016 L Tristan Damanik 4.3 1 1 Jonni D. 081361365670 Km. 5
56 60001 40001
12080130040800 '12080124061 12080125088
64 3 1/18/2016 L Franja 3.6 1 1 Winanto 081269326444 Km. 5
07 80001 20001
12080103031400 '12080148071 12080102180
65 2 7/9/2015 P Diva Sihombing 3.2 1 1 Saigon 085373692525 Km. 6
06 50001 0001
12080112040809 '12080102121 12080107078
66 3 7/20/2015 P Nisa Siahaan 2.9 1 1 Elbon S. 085275249027 Km. 6
89 40001 30002
12080130041200 '12080150011 12080109098
67 3 4/7/2015 P Amelia Tarigan 3.6 1 1 Gunung T. 081264812000 Km. 6
25 50001 50003
12080130041200 '12080155021 12080109098
68 4 4/7/2015 P Adelia Tarigan 3.2 1 1 Gunung T. 082283432803 Km. 6
25 80001 50003
12080113021400 '12080141031 12080121107
69 5 6/9/2014 L Tobi Sinaga 3.4 1 1 Robert S. Km. 6
02 60001 40001
12080107091100 '12080168091 12080113018
70 3 7/14/2016 P Aqila Resah 3 1 1 Isbilah Km. 6
08 40001 10001
12080109071500 140502210214 12080105108
71 2 21/09/2014 L Abigael Sinaga 3.6 1 1 Mangiring 081364854321 Km. 6
05 0002 40002
12080109071500 120801440217 Felicia putri 12080105108
72 3 2/4/2017 P 3.2 1 1 Mangiring 081364854321 Km. 6
05 2002 sinaga 40002
12080117051000 120801021015 12080104097
73 3 12/8/2015 L Jessi sinaga 3.2 1 1 Alpian Sinaga Km. 6
20 0001 90006
12080115081300 12080128067
74 4 15/08/2019 P 120801 Butet Siahaan 3.1 1 1 Eripdo Siahaan Km.5
02 60005
12080124041500 '12080171051 12080110061
75 1 6/10/2015 L Rowen Pasaribu 3.2 1 1 Erikson P. 085267616993 Km. 6
04 60001 50002
12080108041300 120801140414 Gerard 12080111018
76 1 4/10/2014 L 3.5 1 1 Lamhot R Km. 5
03 0004 Rumahorbo 30002
12080108041300 120801480316 Grimonra 12080111018
77 2 8/3/2016 L 4 1 1 Lamhot R Km. 5
03 0001 Rumahorbo 30002
12080122051500
05 '12080156051 12080118097
78 1 5/9/2015 L Reyhan S. 3.6 1 1 Rianto 082165147996 Km. 5
'1208012205150 40002 60006
005
12080122051500 '12081166021 12080118097
79 2 7/22/2016 L Rifandy S. 3.4 1 1 Rianto 082165147996 Km. 5
05 60001 60006
12080189030807 '12080115021 12080131057
80 2 19/10/2014 P Regina S. 3 1 1 Eli Hakim Km. 4
93 70001 20003
12720117031400 '12080107041 12720331038
81 3 6/21/2015 L Paulus Sinaga 3.3 1 1 Edy Sinaga 085372403825 Km. 4
03 60001 60005
12720117031400 '12080129041 12720331038
82 4 2/11/2017 P Febby sinaga 3.5 1 1 Edy Sinaga 085372403825 Km. 4
03 60002 60005
'12220107041 12080126076
83 2 9/26/2014 L 120801 Ariel 3 1 1 Angiat 081398321487 Km. 4
40003 90003
12080104081500 120801010514 12080164109
84 1 1/5/2015 L Searghana 3.1 1 1 Romsisna Km. 4
03 0003 00002
12080104040815 '12080107041 Sintia gabriel 12080131127
85 5 24/10/2014 P 3.3 1 1 Sumihar Km. 4
24 62001 Gurning 40009
'12080109051
86 2 10/8/2016 L 120801 Reyhan Turnip 3.8 1 1 Allen 120801 085207409772 Km. 4
80002
'12080104041
87 1 3/21/2017 P 120801 Marselina 3.1 1 1 Ronal 120801 082385389136 Km. 5
60002
'12080144091 Sari 12080161089
88 1 1/10/2017 P 120801 Jannah L. 3.2 1 1 081397651893 Km. 6
50001 simanjuntak 40005
12080128031400 '12080105061 12080101068
89 2 7/23/2016 P Givani 3.5 1 1 Jujur S. 081376210809 Km. 5
11 50001 60006
12080129031700 120801670916 Chairani Ahmad 12080104019
90 1 9/27/2016 P 3.1 1 1 082277848145 Km. 4
03 0002 Batubara Batubara 30001
'12080111011
91 4 8/2/2016 L 120801 Samuel P. 2.8 1 1 Demson 120801 Km. 4
70001
'12080123021
92 3 7/12/2015 P 120801 Henny P. 3 1 1 Demson 120801 Km. 4
80001
;
Jhonson 12080131058
93 2 22/05/2018 L 12080122061500 120801 Kiel Silalahi 3.2 1 1 Km. 4
Silalahi 80002
05 ;
12080121031700 Jhon Martua
94 2 18/04/2019 L 120801 Martin Sinaga 3 1 1 12082904088 Km.6
02 Sinaga
20004
'12080169111
95 2 21/11/2015 P 120801 Bella S. 3.4 1 1 Citra munte 120801 081262667775 Km. 4
30001
'12080163101 12080110881
96 4 19/10/2014 P 120801 Rodearni.S 3 1 1 Hendrik.S Km. 4
40001 0001
12080122091500 '12720745071 Kristisn Ronaldo. 12080121018
97 1 03/02/2016 L 3,4 1 1 Hendri Sijabat Km. 4
03 50001 S 40003
12080104040815 '12080169061 Sumihar 12080131127
98 5 20/10/2014 P Cyntia Gurning 3,2 1 1 Km. 4
24 60001 Gurning 40009
12080125031400 '12080118031 Febrian 12091903128
99 2 12/2/2016 L 3.1 1 1 Durahman S 085358807553 Km. 4
06 50001 sihombing 30001
12080126011000 120801160817 12080101098
100 3 16/08/2017 P Ryskia lubis 3.5 1 1 Sulaiman 085261519607 Km. 4
06 0004 30004
;
Hana Felisia Parlindungan 12080129469
101 4 28/02/2019 P 12080129030815 120801 3,2 1 1 Km. 6
Siboro Siboro 0002
97
'12080170051 12080118118
102 2 11/6/2016 L 120801 Yande Sinaga 28 1 1 Holden Sinaga 0 Km. 6
50001 70002
'12080430811 Mika Dion Lestika
103 4 25/06/2015 L 120801 3 1 1 120801 082166564700 Km. 5
4000 Sianturi Pardede
12080116041400 '12080166121 Ramos Maruba 12720829117
104 5 18/02/2017 L 3.3 1 1 085373995922 Km. 6
09 40001 simarmata simarmata 80001
12080128041700 120801110915 12080111128
105 1 11/9/2015 L Lihardo Sinaga 2.8 1 1 Sumber Sinaga 081310931286 Km. 6
01 0002 50002
12080127091600 120801080814 12080110019
106 2 8/10/2014 L FrinZ Wiliam 3.6 1 1 Pormen sitorus Km. 5
06 0001 20001
12080103111400 12080114048
107 2 26/06/2017 p 120801 Rosella sinaga 3 1 1 Jon fransiskus 085276259513 km 4
01 80006
12080103111400 12080114048
108 3 29/08/2018 L 120801 Brodher sinaga 3.6 1 1 Jon fransiskus 085276259513 km 4
01 80006
12080126101100 12080127018
109 2 16/11/2018 L 120801 Zahran harianja 3.4 1 1 Fadli Harianja KM 4
17 30007
12080110041200 Sihartua 12080117077
110 5 08/03/2018 P 120801 Marisa Tondang 2.8 1 1 km 4
23 Tondang 90002
12080129041300 120801161117 12080112108
111 2 16/11/2017 L Ikbal Ginting 3.4 1 1 Zulkifli Ginting km 4
03 2001 60005
12080101081200 12080123048
112 3 02/10/2017 p 120801 Chio zekinta 3.2 1 1 Berenta S km 4
03 10003
12080109081700 120801250118 12080120118
113 1 25-01-2018 p Orlee Sitorus 3 1 1 Liperdi Sitorus km 4
06 0001 80003
12080103121300 120801210215 12080110088
114 5 21/02/2015 L Samuel .S 2.8 1 1 Hendrik.S KM 4
02 2001 10001
12080103121300 Ucok 12080110088
115 6 28/09/2018 L 120801 3.4 1 1 Hendrik.S KM 4
02 Simorangkir 10001
12080125091200 120801221117 12080120027
116 2 22/11/2017 L Gabriel Sialagan 3.5 1 1 Maruli Sialagan km 4
03 2001 60002
12080122061500 12080131058
117 1 24/06/2015 p 120801 Agatha 3.3 1 1 Jhonson 082274040687 km 4
05 80002
12720321061600 127203580614 12710114057
118 2 18/10/2014 p Tiara Sibarani 3.2 1 1 Leonard S KM 4
04 0001 60002
12720321061600 127203140418 Leonard 12710114057
119 3 04/04/2018 L Steven Sibarani 3.5 1 1 km 4
04 0001 Sibarani 60002
12080118071700 12080108088
120 1 19/11/2017 L 120801 Axel Damanik 3.1 1 1 Bobbi Damanik 081361365670 km 4
04 90003
12170809011700 12080122038
121 2 17/02/2018 p 120801 Bella Tondang 3.8 1 1 Guntur Tondang km 5
07 80002
12080106101400 12080122038
122 2 27/06/2018 L 120801 Aska Ginting 3.5 1 1 Ridwan Ginting km 4
01 80002
12070502071200 120801648182 12070507017
123 2 20/04/2018 p Faiza Syifa 3.1 1 1 Rusumila km 4
04 0001 20003
Frendi Wira
124 1 19/08/2018 L 120801 120801 3.3 1 1 120801 km 4
Peranginangin Peranginangin
Humairah
125 1 21/02/2018 p 120801 120801 3 1 1 Doli Hasibuan 120801 km 4
Hasibuan
12081250614000 120801240215 12082308028
126 2 24/07/2015 L Juan Manurung 2.8 1 1 Salionar 082368427185 Km 4
3 20001 70006
12081250614000 120801240717 Juliando 12082308028
127 3 24/07/2017 L 3.5 1 1 Salionar M 082368427185 KM 4
3 2001 Manurung 70006
128 2 25-04-2017 L 120801 '120801 Filio Damanik 2.9 1 1 Donna 120801 082363623221 km 4
129 3 30/06/2017 L 120801 120801 Brayen alvaro 3.5 1 1 Jumpa Ginting 120801 km 4
130 1 27/05/2018 p 120801 120801 Indah melani T 3.2 1 1 Michael tobing 120801 km 4
12080113121000 120801680215 12080123087
131 3 28/02/2015 p Elviana Sinaga 2.8 1 1 Ronal sinaga km 4
30 0002 50002
12080125031400 Febrian 12091903128
132 2 02/12/2016 L 120801 3.4 1 1 Durahman S KM 4
06 sihombing 30001
21711121112003 21711112128
133 2 25/04/2017 L 120801 Alvazri 3.5 1 1 Wahyono km 4
4 69016
134 3 02/07/2017 L 120801 120801 Altorosius 3.1 1 1 Nurlela 120801 km 4
12080121011900 Jhon Fredi 12080111129
135 1 30/01/2019 L 120801 Arjun munte 3.5 1 1 km 4
04 Munthe 20005
Hanan Jhon Fredi
136 2 30/01/2019 L 120801 120801 3,4 1 1 120801 km 4
sitanggang Sitanggang
12080126101700 120801491217 Trias Wina 12110804098
137 3 9/12/2017 P 3,4 1 1 Saroha sinaga Km 5
06 2001 Sinaga 30002
12080103111600 120801420817 12080120059
138 1 2/8/2017 P Keyla Daprosa 3.5 1 1 Hotman Sinaga Km 5
06 0001 00007
12080108011400 120801660215 LIGOR 12080105128

139 2 26/02/2015 P Puri Kartika 3,2 1 1 KM 5
7 005 PANGARIBUAN 70001
12080109071500 120801440217 FELICA PUTRI MANGIRING 12080105108

140 3 4/2/2017 P 3 1 1 KM 5
5 202 SINAGA SINAGA 40002
12080111041600 120801540716 MARGARETH LAMHOT 12080131128
141 1 14/07/2016 P 2,8 1 1 KM 5
6 0002 FELICIA SITORUS 80012
HANTER
12080115081100 120801181115 RENOLD 12080110018
142 2 18/11/2015 L 3,6 1 1 JOSUHA KM 6
1 003 SIJABAT 10003
SIJABAT
HANTER
12080115081100 120801490517 12080110018
143 3 9/5/2017 P GICELE SIJABAT 3,3 1 1 JOSUHA KM 6
1 001 10003
SIJABAT
12080103081800 120801191216 ROH DAERMA ROY JULI 12720811079
144 1 19/12/2016 L 2,9 1 1 KM 6
5 002 SEMBIRING SEMBIRING 002
12080113021400 120801060314 TOBBI HISKIA ROBERT 12080121107
145 4 6/9/2014 L 3 1 1 KM 6
12080116041400 BERLIANNA MARUBAH 12720829117
146 2 25/11/2018 P 120801 3,2 1 1 KM 6
9 SIMARMATA SIMARMATA 80001
12080124041500 MAXIME ERIKSON 12230401058
147 2 15/09/2016 L 120801 3 1 1 KM 6
4 PASARIBU PASARIBU 90003
JANBER
12082926101700 JUNIOR SERVER 12082928068
148 2 7/11/208 L 120801 2,9 1 1 NANDO KM 5
3 SARAGIH 00001
SARAGIH
12080104028400 12080104028
149 4 17/8/2018 P 120801 VERENT SIGIRO 2,8 1 1 JICO SIGIRO KM 5
5 4005
JHON
12080121031700 120801260617 JUNI CRISJHON 12082904088
150 1 26/06/2017 L 3,4 1 1 MARTUAH KM 5
2 2001 SINAGA 2004
SINAGA
12080128041700 AUDREY SUMBER 12080111112
151 2 2/12/2017 P 120801 2,8 1 1 081310931286 KM 5
1 NATHANIA SINAGA 850002
12080117061500 RIFKA MAWAN 12080112098
152 2 27/06/2018 P 120801 3 1 1 KM 6
9 NAINGGOLAN NAINGGOLAN 1001
12080114071000 120801020218 SAMUEL JUAN HARIANTO 12080106118
153 4 2/2/2018 L 3,6 1 1 KM 5
12080110101300 120801060118 MICAHEL ENSEY BENNI OKTO 12080105118

154 2 6/6/2018 L 3,4 1 1 KM 6
03 001 SIMARMATA SIMARMATA 6002
12080108041000 120801250714 ARTUR JAIDEN YANDETIN 12080113018

155 1 25/09/2014 L 3 1 1 KM 6
05 003 GIRSANG GIRSANG 00005
ANGGITA
12080108041000 120801550616 YANDETIN 12080113018
156 2 15/06/2016 P ELSAHDAI 2,9 1 1 KM 6
05 001 GIRSANG 00005
GIRSANG
12080127081800 12080110027
157 1 9/11/2018 P 120801 Rini purba 3,3 1 1 RONNI PURBA KM 6
01 9004
12720319071300 127203410515 RUTH HIHORA ROLAND 12712108127
158 3 1/5/2015 P 3 1 1 KM 6
01 001 PANGGABEAN PANGGABEAN 70006
12080101031600 120801641016 ELYORA FELICIA APRIDO 12080110048

159 1 24/10/2016 P 4 1 1 KM 6
03 002 SIMAMORA SIMAMORA 30002
12080101031600 ALDRICH APRIDO 12080110048

160 2 19/04/2018 L 120801 3,3 1 1 KM 6
03 GEVARIEL S SIMAMORA 30002
12080111011000 120801410714 CARISA AYU ERWIN 12080118067
161 4 1/10/2014 P 2,8 1 1 KM 6
21 001 MARBUN MARBUN 90003
12080110071400 120801111114 RONA GOK TOMSHON 12080106127
162 3 11/11/2014 L 3,1 1 1 KM 6
03 003 SIBURIAN SIBURIAN 7004
12080129091600 120801501116 MISELLE CAKEP 11060721068

163 2 10/11/2016 P 3 1 1 KM 6
7 001 SIMANULLANG SIMANULLANG 4001
12081018121300 BOBBY D 12081002057

164 2 19/09/2016 L 12081 KEANU H PURBA 3 1 1 KM 6
1 PURBA 8003
12081018121300 CRESTER H BOBBY D 12081002057
165 3 16/11/2018 L 12081 3,2 1 1 KM 6
1 PURBA PURBA 8003
12080106050800 PUTRA RISKY JOHN RISMEN 12080121107
166 4 18/09/2017 L 120801 3,1 1 1 KM 6
96 HALOHO HALOHO 70002
Debora Donal
167 1 12/1/2015 P 120801 120801 3,3 1 1 120801 km 4
Situmeang Situmeang
Elisabrth DonalSitumean
168 2 07/04/2017 P 120801 120801 3,1 1 1 120801 km 4
Situmeang g
12080115101400 Feby eriyanti 12080155128
169 2 17/06/2018 P 120801 3 1 1 Yanti melda km 6
01 Silalahi 80002
12080113101700 CHANDRA 12080121019
170 1 16/12/2017 L 120801 Elvan c Saragih 3,2 1 1 KM 4
7 SARAGIH 00001
12080122051400 12080101078
171 1 4/10/2014 P 120801 RIAHMA PURBA 3 1 1 JOHAN PURBA KM 4
2 30010
;
12080110041200 Sihartua
172 6 3/5/2019 P 120801 Butet Tondang 3,1 1 1 12080117077 km 4
23 Tondang
90002
Jankarmen
173 4 28/01/2016 P 120801 120801 Serli Purba 3 1 1 120801 km 6
Purba
;
Breginta Jore Perangin- 12080112017
174 3 13/09/2017 P 12080113041200 120801 3,2 1 1 KM 4
Perangin-angin angin 90002
02
12080108031200 120801171114 Fincent 12080102098
175 2 17/11/2014 L 3 1 1 Dedy Sidabutar KM 4
09 0001 Sidabutar 60004
Keterangan
ERTUMBUHAN DAN PERKEMBANGAN BALITA DI POSYANDU

Vitamin A Vitamin A
Badan/Ti
(18) (19) (20) (21) (21) (22) (23) (24) (25) (26) (27) (28) (29) (30) (31)
20-08-2019 17 106 2 1 1 1 1 1 1 1 1 DS S SL
20-08-2019 16 100 2 1 1 1 1 1 1 1 1 DS S SL
8/20/2019 16.5 100 2 1 1 1 1 1 1 1 1 DS S SL
8/20/2019 16 104 2 1 1 1 1 1 1 1 1 DS S SL
8/20/2019 16.2 100 2 1 1 1 1 1 1 1 1 DS S SL
8/20/2019 17 102 2 1 1 1 1 1 1 1 1 DS S SL
8/20/2019 16 98 2 1 1 1 1 1 1 1 1 DS S SL
8/20/2019 16 107 2 1 1 1 1 1 1 1 1 DS S SL
8/20/2019 10.5 92 2 1 1 1 1 1 1 1 1 DM S SL
8/20/2019 13.5 92 2 1 1 1 1 1 1 1 1 DS S SL
8/20/2019 16 102 2 1 1 1 1 1 1 1 1 DS S SL
8/21/2019 17 102 2 1 1 1 1 1 1 1 1 DS S SL
8/20/2019 13 91 2 1 1 1 1 1 1 1 1 DS S SL
8/20/2019 16 98 2 1 1 1 1 1 1 1 1 DS S SL
8/20/2019 17 98 2 1 1 1 1 1 1 1 1 DS S SL
8/20/2019 16 102 2 1 1 1 1 1 1 1 1 DS S SL
8/20/2019 13 91 2 1 1 1 1 1 1 1 1 DS S SL
8/20/2019 12.5 88 2 1 1 1 1 1 1 1 1 DS S SL
8/20/2019 16 98 2 1 1 1 1 1 1 1 1 DS S SL
8/20/2019 17 103 2 1 1 1 1 1 1 1 1 DS S SL
8/20/2019 15.8 98 2 1 1 1 1 1 1 1 1 DS S SL
8/20/2019 17 102 2 1 1 1 1 1 1 1 1 DS S SL
8/20/2019 16.2 104 2 1 1 1 1 1 1 1 1 DS S SL
8/20/2019 16.4 100 2 1 1 1 1 1 1 1 1 DS S SL
8/20/2019 17 103 2 1 1 1 1 1 1 1 1 DS S SL
8/20/2019 16 98 2 1 1 1 1 1 1 1 1 DS S SL
8/20/2019 16.5 97 2 1 1 1 1 1 1 1 1 DS S SL
8/20/2019 16 98 2 1 1 1 1 1 1 1 1 DS S SL
8/20/2019 16 98 2 1 1 1 1 1 1 1 1 DS S SL
8/20/2019 13.4 93 2 1 1 1 1 1 1 1 1 DS S SL
8/20/2019 16.5 105 2 1 1 1 1 1 1 1 1 DS S SL
8/20/2019 17 106 2 1 1 1 1 1 1 1 1 DS S SL
8/20/2019 17 106 2 1 1 1 1 1 1 1 1 DS S SL
8/20/2019 16.5 105 2 1 1 1 1 1 1 1 1 DS S SL
8/20/2019 16 100 2 1 1 1 1 1 1 1 1 DS S SL
8/20/2019 16 102 2 1 1 1 1 1 1 1 1 DS S SL
8/20/2019 11 82 2 1 1 1 1 1 1 1 1 DS S SL
8/20/2019 17 104 2 1 1 1 1 1 1 1 1 DS S SL
8/20/2019 11 84 2 1 1 1 1 1 1 1 1 DS S SL
8/20/2019 13 90 2 1 1 1 1 1 1 1 1 DS S SL
8/20/2019 15.8 102 2 1 1 1 1 1 1 1 1 DS S SL
8/20/2019 16 100 2 1 1 1 1 1 1 1 1 DS S SL
8/20/2019 16 100 2 1 1 1 1 1 1 1 1 DS S SL
8/20/2019 16.5 108 2 1 1 1 1 1 1 1 1 DS S SL
8/20/2019 11 82 2 1 1 1 1 1 1 1 1 DS S SL
8/20/2019 5.6 58 2 1 1 1 DS S SL
8/20/2019 16.6 104 2 1 1 1 1 1 1 1 1 DS S SL
8/20/2019 16.8 103 2 1 1 1 1 1 1 1 1 DS S SL
8/21/2019 16 100 2 1 1 1 1 1 1 1 1 DS S SL
8/21/2019 16.2 105 2 1 1 1 1 1 1 1 1 DS S SL

8/21/2019 15.5 100 2 1 1 1 1 1 1 1 1 DS S SL
8/21/2019 17 100 2 1 1 1 1 1 1 1 1 DS S SL
8/21/2019 13.5 92 2 1 1 1 1 1 1 1 1 DS S SL
8/21/2019 6.8 64 2 1 1 1 1 DS S SL
8/21/2019 16 102 2 1 1 1 1 1 1 1 1 DS S SL
8/21/2019 11.5 88 2 1 1 1 1 1 1 1 1 DS S SL
8/21/2019 13.2 93 2 1 1 1 1 1 1 1 1 DS S SL
8/21/2019 13.5 92 2 1 1 1 1 1 1 1 1 DS S SL
8/21/2019 13.5 90 2 1 1 1 1 1 1 1 1 DS S SL
8/21/2019 13 90 2 1 1 1 1 1 1 1 1 DS S SL
8/21/2019 17 102 2 1 1 1 1 1 1 1 1 DS S SL
8/21/2019 12.5 88 2 1 1 1 1 1 1 1 1 DS S SL
8/21/2019 12.5 90 2 1 1 1 1 1 1 1 1 DS S SL
8/21/2019 14.4 98 2 1 1 1 1 1 1 1 1 DS S SL
8/21/2019 15.6 99 2 1 1 1 1 1 1 1 1 DS S SL
8/21/2019 15.6 97 2 1 1 1 1 1 1 1 1 DS S SL
8/21/2019 16 96 2 1 1 1 1 1 1 1 1 DS S SL
8/21/2019 15.5 99 2 1 1 1 1 1 1 1 1 DS S SL
8/21/2019 17 106 2 1 1 1 1 1 1 1 1 DS S SL
8/21/2019 12.5 92 2 1 1 1 1 1 1 1 1 DS S SL
8/21/2019 18 105 2 1 1 1 1 1 1 1 1 DS S SL
8/21/2019 11.5 104 2 1 1 1 1 1 1 1 1 DS S SL
8/21/2019 16 98 2 1 1 1 1 1 1 1 1 DS S SL
8/21/2019 3.5 50 1 1 DS S SL
8/21/2019 16 100 2 1 1 1 1 1 1 1 1 DS S SL
8/21/2019 18 106 2 1 1 1 1 1 1 1 1 DS S SL
8/21/2019 14 100 2 1 1 1 1 1 1 1 1 DS S SL
8/21/2019 17 102 2 1 1 1 1 1 1 1 1 DS S SL
8/21/2019 13 90 2 1 1 1 1 1 1 1 1 DS S SL
8/21/2019 16 100 2 1 1 1 1 1 1 1 1 DS S SL
8/21/2019 16 100 2 1 1 1 1 1 1 1 1 DS S SL
8/21/2019 12 86 2 1 1 1 1 1 1 1 1 DS S SL
8/21/2019 16 101 2 1 1 1 1 1 1 1 1 DS S SL
8/21/2019 17 102 2 1 1 1 1 1 1 1 1 DS S SL
8/21/2019 16 104 2 1 1 1 1 1 1 1 1 DS S SL
8/21/2019 13.5 90 2 1 1 1 1 1 1 1 1 DS S SL
8/21/2019 11.8 86 2 1 1 1 1 1 1 1 1 DS S SL
8/21/2019 11.5 84 2 1 1 1 1 1 1 1 1 DS S SL
8/21/2019 13.5 92 2 1 1 1 1 1 1 1 1 DS S SL
8/21/2019 13.5 92 2 1 1 1 1 1 1 1 1 DS S SL
8/21/2019 13.5 92 2 1 1 1 1 1 1 1 1 DS S SL
8/21/2019 16 98 2 1 1 1 1 1 1 1 1 DS S SL
8/21/2019 10.6 82 2 1 1 1 1 1 1 1 1 DS S SL
8/21/2019 7.6 68 2 1 1 1 1 1 DS S SL
8/21/2019 16 98 2 1 1 1 1 1 1 1 1 DS S SL
8/21/2019 17 102 2 1 1 1 1 1 1 1 1 DS S SL
8/21/2019 14 94 2 1 1 1 1 1 1 1 1 DS S SL
8/21/2019 16 104 2 1 1 1 1 1 1 1 1 DS S SL
8/21/2019 13 90 2 1 1 1 1 1 1 1 1 DS S SL
8/21/2019 12 86 2 1 1 1 1 1 1 1 1 DS S SL
8/21/2019 6.6 65 2 1 1 1 1 1 1 DS S SL
8/21/2019 15 98 2 1 1 1 1 1 1 1 1 DS S SL
8/21/2019 16 100 2 1 1 1 1 1 1 1 1 DS S SL
8/21/2019 12 84 2 1 1 1 1 1 1 1 1 DS S SL
8/21/2019 16 98 2 1 1 1 1 1 1 1 1 DS S SL
8/21/2019 17.6 106 2 1 1 1 1 1 1 1 1 DS S SL
8/20/2019 11.8 86 2 1 1 1 1 1 1 1 1 DS S SL
8/20/2019 8.6 72 1 1 1 1 1 1 1 1 DS S SL
8/20/2019 6.5 60 1 1 1 1 1 1 DS S SL
8/20/2019 7.6 76 1 1 1 1 1 1 1 1 1 DM S SL
8/20/2019 10.6 84 2 1 1 1 1 1 1 1 1 DS S SL
8/20/2019 10.5 82 2 1 1 1 1 1 1 1 1 DS S SL
8/20/2019 9.5 78 2 1 1 1 1 1 1 1 1 DS S SL
8/20/2019 16 100 2 1 1 1 1 1 1 1 1 DS S SL
8/20/2019 9 70 1 1 1 1 1 1 1 1 DS S SL
8/20/2019 10.6 84 2 1 1 1 1 1 1 1 1 DS S SL
8/20/2019 16.5 98 2 1 1 1 1 1 1 1 1 DS S SL
8/20/2019 17 103 2 1 1 1 1 1 1 1 1 DS S SL
8/20/2019 11 84 1 1 1 1 1 1 1 1 1 DS S SL
8/20/2019 10.5 82 2 1 1 1 1 1 1 1 1 DS S SL
8/21/2019 10 80 2 1 1 1 1 1 1 1 1 DS S SL
8/20/2019 10 75 1 1 1 1 1 1 1 1 1 DS S SL
8/20/2019 9 72 1 1 1 1 1 1 1 1 DS S SL
8/20/2019 9 72 1 1 1 1 1 1 1 1 1 DS S SL
8/20/2019 9.3 76 2 1 1 1 1 1 1 1 1 DS S SL
8/20/2019 15.5 96 2 1 1 1 1 1 1 1 1 DS S SL
8/20/2019 11 84 2 1 1 1 1 1 1 1 1 DS S SL
8/20/2019 9.5 78 1 1 1 1 1 1 1 1 1 DS S SL
8/20/2019 11.5 89 2 1 1 1 1 1 1 1 1 DS S SL
8/20/2019 9 72 1 1 1 1 1 1 1 1 1 DS S SL
8/20/2019 16 100 2 1 1 1 1 1 1 1 1 DS S SL
8/20/2019 13 90 2 1 1 1 1 1 1 1 1 DS S SL
8/20/2019 11.5 84 2 1 1 1 1 1 1 1 1 DS S SL
8/20/2019 11.5 84 2 1 1 1 1 1 1 1 1 DS S SL
8/20/2019 7.5 64 1 1 1 1 1 1 1 1 DS S SL
8/20/2019 7.8 66 1 1 1 1 1 1 1 1 DS S SL
8/21/2019 11.5 84 2 1 1 1 1 1 1 1 1 DS S SL
8/21/2019 10.5 80 2 1 1 1 1 1 1 1 1 DS S SL
8/21/2019 16 98 2 1 1 1 1 1 1 1 1 DS S SL
8/21/2019 11.5 88 2 1 1 1 1 1 1 1 1 DS S SL
8/21/2019 13.5 92 2 1 1 1 1 1 1 1 1 DS S SL
8/21/2019 16.4 100 2 1 1 1 1 1 1 1 1 DS S SL
8/21/2019 11.5 85 2 1 1 1 1 1 1 1 1 DS S SL
8/21/2019 13 90 2 1 1 1 1 1 1 1 1 DS S SL
8/21/2019 17 106 2 1 1 1 1 1 1 1 1 DS S SL
8/21/2019 8.5 70 1 1 1 1 1 1 1 1 DS S SL
8/21/2019 14 92 2 1 1 1 1 1 1 1 1 DS S SL
8/21/2019 8 70 1 1 1 1 1 1 1 1 DS S SL
8/21/2019 8 70 1 1 1 1 1 1 1 1 1 DS S SL
8/21/2019 11.5 84 2 1 1 1 1 1 1 1 1 DS S SL
8/21/2019 10.5 80 2 1 1 1 1 1 1 1 1 DS S SL
8/21/2019 8 76 1 1 1 1 1 1 1 1 1 DS S SL
8/21/2019 10 80 2 1 1 1 1 1 1 1 1 DS S SL
8/21/2019 11 80 1 1 1 1 1 1 1 1 1 DS S SL
8/21/2019 17 104 2 1 1 1 1 1 1 1 1 DS S SL
8/21/2019 13 90 2 1 1 1 1 1 1 1 1 DS S SL
8/21/2019 8 70 1 1 1 1 1 1 1 1 DS S SL
8/21/2019 16 98 2 1 1 1 1 1 1 1 1 DS S SL
8/21/2019 12.5 92 2 1 1 1 1 1 1 1 1 DS S SL
8/21/2019 9.5 78 2 1 1 1 1 1 1 1 1 DS S SL
8/21/2019 17 104 2 1 1 1 1 1 1 1 1 DS S SL
8/21/2019 17.5 106 2 1 1 1 1 1 1 1 1 DS S SL
8/21/2019 12.5 92 2 1 1 1 1 1 1 1 1 DS S SL
8/21/2019 13 90 2 1 1 1 1 1 1 1 1 DS S SL
8/21/2019 8 70 1 1 1 1 1 1 1 1 DS S SL
8/21/2019 11 82 2 1 1 1 1 1 1 1 1 DS S SL
8/20/2019 16 98 2 1 1 1 1 1 1 1 1 DS S SL
8/20/2019 11.8 86 2 1 1 1 1 1 1 1 1 DS S SL
8/21/2019 9.8 74 1 1 1 1 1 1 1 1 1 DS S SL
8/20/2019 10.6 80 2 1 1 1 1 1 1 1 1 DS S SL
8/20/2019 15.8 102 2 1 1 1 1 1 1 1 1 DS S SL
8/20/2019 6.2 60 1 1 1 1 1 DS S SL
8/21/2019 14 97 1 1 1 1 1 1 1 1 1 DS S SL
8/20/2019 11.5 82 2 1 1 1 1 1 1 1 1 DS S SL
8/20/2019 17 104 2 1 1 1 1 1 1 1 1 DS S SL
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FORMULIR PENCATATAN PEMANTAUAN PERTUMBUHAN DAN PERKEMBANGAN BALITA DI PO

Provinsi : SUMATERA UTARA Nama Posyandu : MELATI, MAWAR, GELATIK, CENDRAWAS

5 12080118101 JASON JOSEP 12080109098300

7 12080110021 DAVID .W RUDIANTO 12082902790000

8 12082907041 MARCELLINO JULIATOR 12082902079000

9 12080120061 ARSYILA IBRAHIM 12720601600840

10 12080115031 CHRISTIAN ERIANTO 12080126068300

14 12080102081 OLIN FEBRIO HOKHOP 12080111078100

15 12080109091 ANUGRAH WESLY 12080121039100

16 12080123091 AHMAD AZZAM . 12080114128500

17 12080112081 DADANG 12030129129200

18 12080112081 ARSYILA DADANG 12030129129200

19 12081909021 ASRUL 12081913108400

20 12080103091 MUHAMMAD 12080109107800

21 12080104040 ROHAYU 12080170079400

24 12080108091 RUDIANSYAH 12080101088500

25 12080108100 AKHMAD RAFLY SAMSUL . B 12080127067500

26 12080104040 RUSDI 12080103077600

30 12080113090 M.DAFFA SYAHDIAWAN 12080105098600

34 12080113031 NURSYIFA SURIYA 12080106088900

37 12080136031 ANDRI 12080103127900

38 12080117111 NABILA KHAIRU 12080125048300

39 12080104040 AHMAD .S 12080125058200

40 12080103111 RUBY UNAIRA BAMBANG 12080117038300

41 12080113011 INARA AFIRA 120811111190000

42 12080103101 AZZAHRA HULWA DANA 12081200587000

43 12080104040 AZIZAH P IBRAHIM 12080116048100

44 12080125041 SAKIH CAHYA 12080214078200

45 12080101061 KHALISHAH DWI 12080109127800

46 12080101061 HAIKAL TRI 12080109127800

47 12080192407 SALSABILA IMBRAN 12080191011740

48 12080192407 IMBRAN 12080191011740

50 12081160414 TSABITHA 12080104108000

52 12080104040 MUFAZZAL 12080127086900

53 12081161209 APRILIA AZ ANDI 12080010902830

54 12081161209 AZKA PUTRA ANDI 12080010902830

55 12080126061 ANGGI INSANI 12081901017800

57 12080121081 JEREMY P 12080103-

58 12080121081 JEREMY K 12080103-

60 12080127031 MUHAMMAD JAKA 12090110078600

61 12080104031 SELA KRISTINA RAHMAT .T 12080128068700

62 12080104031 RAHMAT .T 12080128068700

65 12080220101 JOHANNES 12080117088100

66 12080220101 JOHANNES 12080117088100

67 12080103031 ALDAFI 12080106273000

68 12080103031 KHASANAH 12080106273000

69 12080117111 BUDI 12720224068200

70 12080117111 GILANG BUDI 12720224068200

71 12080107111 DEDI 12080120068300

72 12081924071 ANJAS 12081903108500

73 12080125101 REYNATA 12080102038200

75 12080101031 MUHAMMAD 12080109018400

76 12081130908 ZURIELA SABAR .V 12080116125900

77 12080114121 HENDRA 12080120038200

81 12080126061 ANDRA.S PARULIAN 12080107077500

82 12080126061 FEBRY CANTIKA PARULIAN 12080107077500

83 12080128091 ISMAIL .P OLOAN G 12080121038500

84 12080128091 SHELA GRACE OLOAN G 12080121038500

85 12080110021 JUAN FREDY 12080112048000

86 12080108009 KHUNAIRO 12080121109400

87 12080110051 AL-KHALIFA ZIARI HENDRO 12080121109400

88 12722061506 INDRA 12720607098100