DAFTAR HADIR ROLANIS

DESA :

NO NAMA ALAMAT TANGGAL NIK NO.BPJS TTD

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 HASIL PEMERIKSAAN PESERTA PROLANIS

DESA :

HASIL PEMERIKSAAN
NO NAMA DIAGNOSA
TENSI KADAR GULA
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 HASIL PEMERIKSAAN PESERTA PROLANIS

DESA : KEDAWUNG

TANGGAL HASIL PEMERIKSAAN

NO NAMA ALAMAT LAHIR NIK NO.BPJS DIAGNOSA
TENSI KADAR GULA
1 MUAYAH 1/1 1/12/1966 3328035512660000 0000622882438 HT 160/90
2 NUR SIDIK 3/3 1/5/1946 3328030104460000 0000623940197 HT 140/80
3 SAIRAH 2/2 16/7/1962 3328035607620000 0000622993871 HT 190/100
4 WALUYO 13/4/1960 3328031304600000 0001615250608 HT 140/90
5 RUKAYAH 1/3 1/6/1969 3328034706690000 0000622860737 HT & DM 150/90 401
6 KURISAH 4/2 1/1/1968 3328034101680000 000062374221 HT 160/90
7 SAMROH 3/3 1/3/1979 3328036003740000 0000624153611 HT 160/90
8 SUNARTI 19/9/1976 3328035909760000 0001615250619 DM 325
9 DENISAH 4/3 1/7/1966 3328036007660000 0000624125597 HT 180/110
10 DUMYATI 3/2 5/5/1945 3328034505450000 0001078985643 HT 140/90
11 SUMARTININGSIH 3/2 1/1/1957 3328034102570000 0002267738379 HT 110/90
12 ARI KURNIASIH 3/2 15/4/1979 3328035504790000 00016999791265 HT 140/110
13 DIMYANTO 2/2 1/6/1959 3328030104590000 0000622992969 HT 120/80
14 JATNO 3/2 1/2/1943 3328031002430000 0000623695871 HT 160/90
15 MUTLIAH 3/3 11/1/1979 3328035101790000 0000622851052 HT 120/90
16 MIRAH (SUMIRAH) 1/2 17/6/1947 3328035706470000 0000624145948 HT 200/100
17 SUMARKI 2/2 3328034107370000 0000623741804 HT 150/90
18 KHOTIMAH 1/2 28/2/1971 3328034102715280 0002175705775 HT 150/90
19 KASWI 0000622913376 HT 140/100
20 SUPARTI 0001030864397 HT 150/90
21 RINAH 0000622950322 HT 140/90
22 SITI AISAH 2/2 1/1/1962 3328034101680000 0002498819229 DM 270
DESA : SUNIARSIH

TANGGAL HASIL PEMERIKSAAN

NO NAMA ALAMAT LAHIR NIK NO.BPJS DIAGNOSA
TENSI KADAR GULA
1 KARSITI 4/1 1/7/1927 0001915525697 HT 200/100
2 JUBAEDAH 4/1 7/10/1951 3328034710510000 0000623165512 DM 366
3 SUNIASIH 4/1 31/12/1953 3328037112530050 0000624207712 DM 367
4 YULIANAH 1/1 12/7/1971 3328035207710000 0002124558472 HT 190/100
5 PAOJIAH 1/1 3/2/1970 3328034302700000 0000622944988 DM 403
6 SUNI 2/1 31/12/1961 3328037112610050 0000625551243 HT 130/90
7 TINI 2/1 31/12/1939 3328037112390020 0000624580042 HT 190/100
8 MURITI 2/1 17/12/1959 0000624584474 HT 120/70
9 SUSMAWATI 4/1 1/11/1984 0000624159066 DM 277
10 SUIRAH 4/1 4/9/1947 3328035409470000 0000624339652 HT 150/90
11 KHOBULI 4/1 30/5/1960 3328033005600000 000007954`943 HT 180/100
12 KUSTINAH 8/2 29/9/1954 3328036909540000 0002314186705 DM 426
13 MUTIROH 1/1 1/12/1965 0000624369273 HT 200/130
14 SARITI 4/1 31/12/1962 3328037112620090 0000623134449 HT 190/90
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DESA : KARANGMULYA

TANGGAL HASIL PEMERIKSAAN

NO NAMA ALAMAT LAHIR NIK NO.BPJS DIAGNOSA
TENSI KADAR GULA
1 RANI 3328034707480002 0000625046578 HT 160/100
2 SAMAH 17/6/1954 3328035706540001 0000625204991 HT 180/100
3 SLAMET 0000624463299 HT 180/100
4 MURSITI 1/5/1961 3328034107570098 0000625185088 HT 150/90
5 SHOIPAH 1/1/1952 3328034101520007 0001789822203 HT 150/100
6 ROYANAH 24/12/1964 3328036412640001 0000623450215 HT 150/100
7 KITOL 31/12/1948 3328037112430009 0000624051459 HT 220/100
8 KUSMIYATI 2/4/1970 3328034204700001 0000624652841 HT 160/90
9 SAIYAH 28/12/1949 3328036812490002 0000624524703 HT 160/100
10 TAWEN 10/7/1956 3328035007560007 0000623701866 HT 100/60
11 TARIAH 20/7/1960 3328036007600001 0000625160632 HT 150/90
12 BAWON 6/5/1960 3328034605600002 0000623921078 HT 150/100
13 WASEM 20/6/1958 3328036006580004 0000623462084 HT 180/100
14 SAMAH 1/7/1964 3328034107640022 0000624929376 HT 150/90
15 WASRI 30/12/1955 3328037012550002 0000624970462 HT 190/100
16 DARMEN 1/7/1940 3328034107400023 0000623932307 HT 140/90
17 JAMILAH 6/5/1946 3328034605460001 0000624600393 HT 140/90
18 SARMEN 30/12/1957 3328037012570006 0000625098734 HT 160/100
19 RIPAH 8/6/1951 3328034906470001 0000624239291 HT 160/100
20 NURHILAH 26/10/1966 3328036610660001 0002572240803 HT 150/100
21 KAPURI 8/6/1958 3328030806580001 0000625100141 HT 160/90
22 UMAYAH 6/6/1965 3328034606650003 0001986628522 HT 200/100
23 TARNI 30/11/1964 3328037011640002 0000624613781 HT 140/100
24 SAINAH 30/12/1959 3328037012590004 0000624795658 HT 160/100
25 DAIMAH 20/7/1955 3328036007550002 0000623880011 HT 180/100
26 WASRI. S 20/7/1951 3328036007510002 0002213366477 HT 190/100
27 WATI 13/11/1966 3328035311660001 0000624517863 HT 140/90
28 KHOTIMAH 15/8/1965 3328035508650005 0000624463582 HT 190/100
29 ANSOR 30/12/1956 3328033012560015 0000624543164 HT 160/100
30 TARISAH 11/7/1961 3328035107610003 0001030865714 HT 170/100
31 SAUNI 15/7/1944 3328035507440001 0000623142235 HT 180/100
32 WITAH 0000624974883 HT 170/100
33 TOSLAH 3328034107640054 0000624543579 HT 130/90
DESA : TUWEL

TANGGAL HASIL PEMERIKSAAN

NO NAMA ALAMAT LAHIR NIK NO.BPJS DIAGNOSA
TENSI KADAR GULA
1 ROMLAH 1/2 11/12/1966 3328035112660001 0001030869257 HT 140/100
2 ROKHILAH 4/2 1/7/1969 3328034107690045 0001030870247 HT 170/100
3 MARTINAH 1/2 21/7/1959 3328036107590001 0000623788121 HT 180/100
4 NURKHIKMAH 1/2 12/12/1965 3328035212650001 0000624597693 HT 150/110
5 DANO 3/5 1/7/1955 3328030107550119 0000624112391 HT 170/100
6 TASRIAH 2/2 31/12/1956 3328037112560025 0000623069526 HT 200/140
7 SAMROHATI 2/1 30/4/1969 3328037004690001 0000624755902 HT 200/100
8 TAIROH 3/2 12/10/1972 3328030312720001 0000624753224 HT 140/80
9 MAPRHOKA 2/2 5/1/1966 3328034501660001 0000624026586 HT 240/120
10 KOMARIYAH 1/2 14/2/1971 3328035402710001 0002572239115 HT 140/90
11 SITI NUR AJIJAH 1/2 27/11/1975 3328036711750005 0000623930488 HT 160/100
12 FASIKHA 1/5 31/12/1955 3328037112550023 00001460918193 HT 190/100
13 NUR PUJI WININGSIH 1/2 10/10/1982 3328035010820012 0000624074545 HT 190/100
14 WANIDAH 1/2 19/8/1951 3328035908510001 0001915525877 HT 140/100
15 SRI RAHAYU 2/2 10/5/1962 3328035005620004 0000624368204 HT 130/90
16 ANISAH DUNIKHA 1/5 30/12/1950 3328037012500005 0001310015452 HT 170/100
17 ERNAWATI 2/2 23/6/1983 332803630830001 0002677908823 HT 160/100
DESA : LENGKONG

TANGGAL HASIL PEMERIKSAAN

NO NAMA ALAMAT LAHIR NIK NO.BPJS DIAGNOSA
TENSI KADAR GULA
1 SALI 1/2 17/3/1965 3328035703650002 000103087533 HT&DM 140/80 214
2 MARIYAH 4/3 3328037112700056 0001030875208 HT 160/100
3 KIPUL 1/2 30/6/1947 3328030107470127 0001030875129 HT 200/120
4 HAYATUN 2/3 31/12/1965 3328037112650156 0001030875963 DM 440
5 SODIAH 3/2 9/11/1950 3328034911500001 0000624708022 HT&DM 160/100 176
6 KATUN 2/3 10/12/1957 3328035012570005 0000624593417 HT 140/80
7 SITI ROPIAH 4/3 31/12/1959 3328037112590027 0000624187315 HT 160/100
8 WAPI 5/3 0000621456787 HT 160/100
9 MANIS 1/2 1/7/1942 3328034107420102 0000624908327 HT 190/100
10 MAKMUROH 2/1 2/5/1970 3328034205700003 0000625281412 HT 140/80
11 SUPI 1/1 1/7/1944 332803410715092 0000625230505 HT 200/120
12 KAMINAH 3/3 3328037112570070 0000625195618 HT 150/100
13 KARIPAH 3/3 5/5/1966 3328037112670051 0001986352187 HT 170/100
14 JANATIN 2/3 16/5/1962 3328035605620001 0000624704758 HT 160/100
15 SAIROH 4/1 24/11/1970 3328035111670001 0001030876007 HT 160/100
16 SAINAH 1/1 7/9/1970 3328034709700005 0000624160866 HT 200/100
17 BAWON 1/1 1/7/1965 3328034107150114 0000624229255 HT 180/100
18 SAMURI 3/3 7/4/1947 332803121150001 0001030875524 HT 140/80
19 SUNI'MAH 1/2 14/6/1972 3328035406720003 0000624262847 HT&DM 160/100 354
20 MASITOH 5/1 17/7/1970 3328035707700003 0000624514476 HT 140/80
21 SOLIKHA 2/3 31/12/1962 3328037112620096 0000624859492 HT&DM 140/80 196
22 SAIROH 1/2 11/3/1975 3328035103750004 0001030874578 DM 200
23 KARPU 3328037112500035 0000625246885 HT 180/100
24 SUIRAH 6/3 3328034107760080 0000624869616 HT 170/100
DESA : BUNIWAH

TANGGAL HASIL PEMERIKSAAN

NO NAMA ALAMAT LAHIR NIK NO.BPJS DIAGNOSA
TENSI KADAR GULA
1 KALIP ASIKIN 1/1 3/5/1950 3328030305500002 0001030873432 HT 170/90
2 ROYATI 1/1 31/12/1950 3328037112450028 0001030873252 HT 120/70
3 DUSRO 4/1 1/9/1947 3328030109470002 0000624076367 HT 140/70
4 RACIK 2/1 0001030873948 HT 150/90
5 SUPRAYICO 2/1 3328030702440004 0000624157642 HT 180/100
6 ZAETUN 2/1 18/12/1948 3328034107500079 0000624129557 HT 200/80
7 TAISAH 4/1 16/9/1970 3328035609720003 0000624208353 HT 160/70
8 KHOTIMAH 4/1 12/8/1970 3328035208700002 0000624937959 HT 160/90
9 TAKBIR 1/1 24/8/1956 3328032408580003 0002427505097 HT 160/70
10 IMAMUDIN 4/1 14/3/1969 3328031403690002 0000624945374 HT 200/140
11 SUSNIYATI 1/1 25/7/1955 3328036507550002 0001030873443 HT 210/100
12 SURTINI 1/1 8/9/1962 3328034809620004 0002124049948 HT 190/100
13 RAHMAT 1/1 31/12/1952 3328033112520027 0001030873793 HT & DM 180/90 587
14 KHOMISAH 1/1 1/7/1958 3328034107580052 0000624142719 HT 190/80
15 NARYONO 1/1 24/5/1947 3328032405470002 0000046458314 HT 160/90
16 KAMILAH 1/1 8/10/1958 3328034810580003 0000624985209 HT 180/100
17 SUDRIYATI 1/1 18/10/1950 3328035810500002 0000079426585 HT 180/100
18 ENDANG KARTIKAWATI 1/1 1/3/1970 3328034103700006 0000079113071 HT 150/90
19 RUMYATI 3/1 12/12/1957 3328035212570006 0000622893497 HT 150/70
DESA : DUKUTENGAH

TANGGAL HASIL PEMERIKSAAN

NO NAMA ALAMAT LAHIR NIK NO.BPJS DIAGNOSA
TENSI KADAR GULA
1 MUNAH 4/1 20/12/1953 3328036012530001 0000623918766 HT 120/80
2 SUTIRAH 4/1 9/12/1968 3328034912680003 0000624747047 HT 140/80
3 DAIB 1/1 1/8/1951 3328031208510001 0000623343903 HT 130/70
4 ROIPAH 3/1 10/7/1965 3328031208510001 0000623876714 HT 130/70
5 ROMISAH 4/1 6/4/1964 3328034604640001 0001030861462 HT 170/90
6 SOIPAH 4/1 24/6/1971 3328036406710001 0001030862856 HT 180/100
7 DIRAH 4/1 6/3/1959 3328034603590002 0000624654246 HT 140/80
8 KARIJAH 4/1 17/7/1957 3328035707570001 0001030862079 HT 200/110
9 RASWEN 4/1 24/8/1957 3328036408570001 0000623723218 HT 160/80
10 SURATNO 4/1 12/6/1932 3328031206320001 0001030863126 HT 170/90
11 WAPIROH 4/1 6/6/1960 3328034606600006 0000624655541 HT 160/90
12 NINIK SUSANTI 4/1 5/9/1965 3328034509650001 0000624122234 HT&DM 180/100 410
13 WARIYAH 4/1 13/4/1972 3328035304720001 0001030861631 HT&DM 160/80 242
14 ENTI 4/1 11/7/1976 3328035107760001 0000624194098 DM 235
15 RUKI NURYANTI 1/1 1/10/1975 3328037011750001 0000624691607 DM 232
16 MUTOHAROH 2/1 25/12/1986 3328036612850001 0000624227613 DM 552
17 RITA TRINAH 3/1 1/7/1964 3328034107640008 0002577911758 HT&DM 170/100 255
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DESA : BOJONG

TANGGAL HASIL PEMERIKSAAN

NO NAMA ALAMAT LAHIR NIK NO.BPJS DIAGNOSA
TENSI KADAR GULA
1 SOBIRIN 6/1 17/8/1955 33280317201170855012 0000624511912 HT&DM 160/90 246
2 JALIYAH 7/1 12/5/1961 3328035205610003 0000624959605 HT 120/80
3 SOBENO 0000079058373 DM
4 SUTIRAH 7/1 28/12/1963 3328036812630001 0002577910948 HT 140/90
5 WURIYAH 5/1 31/12/1966 3328037112660072 0000624623163 HT 150/90
6 ROKHILAH 6/1 5/7/1945 3328034507450002 000079298065 HT 230/110
7 DAIYAH 1/1 31/12/1959 3328037112490030 000191456517 HT 150/90
8 RUKOYAH 6/1 31/8/1954 3328037108540005 0000624873993 HT 150/90
9 WIJAH 5/1 18/3/1960 332803580360001 0000625037139 HT 210/110
10 MU'MIN 7/1 8/7/1963 3328030807630001 0001030871992 HT 120/80
11 KHOTIMAH 6/1 10/3/1964 3328035003640001 0000624512362 HT 150/90
12 MUTAMIMAH 6/1 17/8/1972 3328035708720004 0000625046297 HT 150/90
13 SUTIRAH 4/1 10/11/1977 3328035011770009 0000625112436 HT&DM 140/80 437
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DESA : REMBUL

TANGGAL HASIL PEMERIKSAAN

NO NAMA ALAMAT LAHIR NIK NO.BPJS DIAGNOSA
TENSI KADAR GULA
1 RANTES 5/3 5/2/1955 3328034502550002 0000623735087 HT 160/90
2 DAWI 7/3 2/9/1930 3328034107570595 0000625009285 HT 150/90
3 WARSEM 6/3 26/6/1962 3328036706530001 0000623628336 HT 150/90
4 KHAYATI 7/3 26/9/1970 3328036609700003 0000622976927 HT 170/110
5 RIDAH 7/3 1/7/1962 3328034107620117 0000623697221 HT 160/100
6 MINI/SARMINI 7/3 1/7/1966 3328034107660034 0000624468857 HT 140/90
7 TARMO 6/3 18/1/1956 3328031801560002 0000624004593 HT 220/120
8 PARTO 6/3 31/12/1953 3328033112530023 0000625090296 HT 140/90
9 SUPRATI 7/3 22/6/1962 3328003620662002 0000623968209 HT 180/110
10 RANYEM 6/3 14/7/1946 3328035407530001 0000624261161 HT 190/100
11 TOMIR 7/3 30/11/1961 3328030112610001 0000623679264 HT 150/100
12 SAMI 7/3 21/12/1963 3328036112630001 0000623679579 HT 150/100
13 TASRIAH 7/3 1/7/1953 3328034107610046 0000624245141 HT 150/100
14 SAROH 0000624371152 HT
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