TANGGAL
NO NAMA BAYI ALAMAT PENGAMBILAN
SPESIMEN
1 By. Ny. Yeti Mulyati Cengkareng Barat 13/12 14/6/2015
2 By. Ny. Rini Cengkareng Barat 7/7 14/6/2015
3 By. Ny. Eni Herawati Kapuk 6/6 14/6/2015
4 By. Ny. Darliati Kapuk 7/3 15/6/2015
5 By. Ny. Dawiyah Cengkareng Barat 4/7 16/6/2015
6 By. Ny. Komaria Kapuk 11/12 16/6/2015
7 By. Ny. Sri Wahyuningsih Kapuk 4/6 16/6/2015
8 By. Ny. Nurhayati Rawa Buaya 16/4 16/6/2015
9 By. Ny. Helda Kapuk 2/3 16/6/2015
10 By. Ny. Septi Kapuk 12/3 16/6/2015
11 By. Ny. Saliamah Kapuk 17/12 16/6/2015
12 By. Ny. Dena Teresa Cengkareng Timur 2/5 17/6/2015
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Tanda tangan, nama lengkap dan stempel RS