Jenis

Umur No. Rekam Medis

No Nama* (th/bln)* Kelamin (jika ada) No. Telepon
*
1 RUSDIYANTI 28 P
2 SITI RUKAYAH 36 P 085225323782
3 SRI UTAMI 33 P 08562678801
4 DIAH SUDARYATI 20 P
5 MUNTI ASIH 26 P
6 RIMAWASIH 32 P
7 RAHAYU 34 P
8 ISTIQOMAH 31 P 085866884644
9 EKO NURYANI 26 P 085326839510
10 ROHMIATI 40 P 088221557202
11 EKA RAHAYU 31 P 08222367024
12 PRIHATININGSIH 28 P 08577332549
13 DEWI INDRAYANI 31 P
14 SITI ASPIYATUN 33 P
15 QOIC NUR 28 P 087828298514
16 RIBUT 30 P
17 RISMA KHOIRUNNISA 21 P 082134141737
18 ETIK AL QORIAH 33 P 085201413615
19 SOFIDAH 27 P 082325181387
20 JUMIYEM 43 P 082314712686
 FORM PERMINTAAN VTM IBU HAMIL
UPTD PUSKESMAS BANCAK KEC. BANCAK
KAB. SEMARANG

NIK* Tanggal Lahir* Alamat*

3322164605920002 6/5/1992 PENGGUNG 02/05, BOTO

3322164611840001 30/11/1984 MUNGKRUK 1/3 REJOSARI
3322164302870001 3/2/1987 Boto 1/7 Boto
3322165805000002 18/5/2000 BANYURIPAN 1/5 REJOSARI
3322164207940002 7/2/1994 Banjarsari, RT.04/RW.09, Bancak
3305084507880001 5/7/1988 Bamban 1/4 Lembu
3322165704860002 17/04/1986 krajan 4/2, Plumutan
3322166802890001 28/02/1989 Krajan II 2/2 , Pucung
3322166110940002 21/10/1994 KREMPEL 1/5LEMBU
3322165503800002 3/15/1980 Ngebleng rt 01/06,lembu
3322045112880003 11/12/1988 Krajan III 1/3 ,Pucung
3321144707920004 7/7/1992 Krajan rt 02/02, Lembu
3322124711890001 7/11/1989 GUNUNG 01/02, BOTO
3322166704870001 27/04/1987 Jumbelng 4/5,Wonokerto
3322064602920002 6/2/1992 Karangjati 2/7 , Pucung
3322164906900002 9/6/1990 randusari 9/2, Plumutan
3322164609990001 6/9/1999 KALISAT 1/7 REJOSARI
3322164502870002 5/2/1987 Gayam 2/8 Bantal
3322164505930002 5/5/1993 Krajan III 1/3, Pucung
3309175606770002 6/16/1977 Boto 1/7 Boto
MIL
NCAK

Kasus (Kontak Erat/Rapid Instansi Pengirim Swab I

Reaktif,dll) (Puskesmas / RS)*
JUMLAH VTM
Tgl Swab II Tgl

HAMIL TM 3 PUSKESMAS BANCAK

HAMIL TM 3 PUSKESMAS BANCAK
HAMIL TM 3 PUSKESMAS BANCAK
HAMIL TM 3 PUSKESMAS BANCAK
HAMIL TM 3 PUSKESMAS BANCAK
HAMIL TM 3 PUSKESMAS BANCAK
HAMIL TM 3 PUSKESMAS BANCAK
HAMIL TM 3 PUSKESMAS BANCAK
HAMIL TM 3 PUSKESMAS BANCAK
HAMIL TM 3 PUSKESMAS BANCAK
HAMIL TM 3 PUSKESMAS BANCAK
HAMIL TM 3 PUSKESMAS BANCAK
HAMIL TM 3 PUSKESMAS BANCAK
HAMIL TM 3 PUSKESMAS BANCAK
HAMIL TM 3 PUSKESMAS BANCAK
HAMIL TM 3 PUSKESMAS BANCAK
HAMIL TM 3 PUSKESMAS BANCAK
HAMIL TM 3 PUSKESMAS BANCAK
HAMIL TM 3 PUSKESMAS BANCAK
HAMIL TM 3 PUSKESMAS BANCAK
HPL UMUR KEHAMILAN

14/11/2020 39 MGG
15/11/2020 39 MGG
18/11/2020 38MGG
17/11/2020 38 MGG
22/11/2020 38 MGG
16/11/2020 38 MGG
21/11/2020 37 MGG
27/11/2020 37 MGG
27/11/2020 37 MGG
30/11/2020 37 MGG
21/11/2020 37 MGG
04/12/2020 36 MGG
4/12/2020 36 MGG
7/12/2020 36 MGG
27/11/2020 36 MGG
27/11/2020 36 MGG
12/12/2020 35 MGG
4/12/2020 35 MGG
5/12/2020 35 MGG
21/12/2020 34 MGG