FORMULIR PEMANTAUAN PERTUMBUHAN BALITA DI POSYANDU

PUSKESMAS MADUKORO KECAMATAN KOTABUMI UTARA KABUPATEN LAMPUNG UTARA

LAMPUNG
PROPINSI : LAMPUNG NAMA POSYANDU
KABUPATEN / KOTA : LAMPUNG UTARA BULAN
PUSKESMAS / KECAMATAN : PUSKESMAS MADUKORO / KOTABUMI UTARA TAHUN
DESA / KELURAHAN : KALICINTA

BARAT
NIK ( NOMOR JENIS PB/TB
NO KARTU ANA TANGGAL BADAN TANGGAL BB
NO INDUK NAMA ANAK KELA NAMA ORTU ( AYAH ) NIK AYAH NO TLP/ HP ORTU ALAMAT RT RW
KELUARGA K KE LAHIR ( BB ) PENGUKURAN ( KG )
KEPENDUDUKAN ) MIN ( CM )
LAHIR

1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17
1 1803090602120002 1803094401160001 2 AISYAH NUHA ZAHIRA 04-01-2016 P 3.00 HAIRUL 1803091301830002 082183440045 CINTA SARI 001 002 6 SEPTEMBER 2018 12 95
2 1803090202110110 1803096308150001 2 HANINDHITA HANADIAS 23-08-2015 P 3.00 HARJANTO 1803094208850002 0895621433782 CINTA SARI 001 002 6 SEPTEMBER 2018 14 87
3 1803093103160002 1803100509140002 1 SEPTA SURYA PRATAMA 05-09-2014 L 3.00 SURYANTO 1803090408870008 082183440045 DUSUN 1 KALICINTA 001 001 6 SEPTEMBER 2018 16 94
4 1803090912160002 1803096811160001 2 DIANA REVLI CASELLIN 28-11-2016 P 3.1 EDI SAPUTA 1803090806900001 087832008080 CINTA SARI 001 001 6 SEPTEMBER 2018 11 88
5 1803091710170001 - 1 ILHAM PRATAMA 20-11-2017 L 2.8 ROBIN 1803020703900005 082183440045 CINTA SARI 001 001 6 SEPTEMBER 2018 9 78
6 1803091902110022 1803094208170001 2 NABILA AGUSTINA 02-08-2017 P 2.5 BEKRI 1803092007850001 082183440045 CINTA SARI 001 001 6 SEPTEMBER 2018 9.3 80
7 1803090709090013 1003095810160002 2 ASKIA SARAH MUALIFAH 18-10-2016 P 3 M. HASANUDUN 1803092612840001 085384872284 CINTA SARI 001 001 6 SEPTEMBER 2018 13 90
8 1803090402110019 1803096101180002 3 DEA RISTIANA 21-01-2018 P 3.5 M. SYUKUR 1803090908810002 082183440045 CINTA SARI 001 001 6 SEPTEMBER 2018 8 73
9 1803223110170001 - 1 ALISAH 09-01-2018 P 2.5 CANDRAWANI 1803221501970001 082183440045 DUSUN TALANG SUNGKAI 001 010 6 SEPTEMBER 2018 7 79
10 1803092810090011 - 3 SAKIRA RAMADANI 29-08-2018 P 1,9 SAHRIL 1803091212790003 082183440045 CINTA SARI 001 001 6 SEPTEMBER 2018 5 55
11 1803091902110016 1803090909170001 2 AHMAD FAHMI ALHAFIDZ 09-09-2017 L AHMAD KARIM 1803092803820001 082380729585 CINTA SARI 001 001 6 SEPTEMBER 2018 10 70
12 1803091109090023 1803097107160001 2 SYAQILA ORLIN UFAIRAH 31-07-2016 p 3.2 EKO YULIANTO 1803091807850003 082183440045 DUSUN 1 001 001 6 SEPTEMBER 2018 11 80
13 1803092310120018 1803092111160001 2 ARFANSYAH 21-11-2016 L 2.8 ARDI YANSYAH 1803092905860003 082183440045 CINTA SARI 001 001 6 SEPTEMBER 2018 11.2 81
14 1803090406090002 1803096307130001 4 ALIKA NUR AULIA RAMADHAN 23-07-2013 P 3.4 UJANG JELIHIM 1803092407680002 082183440045 DUSUN 1 KALICINTA NO.24 - - 6 SEPTEMBER 2018 15 108
15 1803090202110115 1803094609160001 2 SYAFANA ISLAMADINA MARYAM 06-09-2016 P 3.0 MAD SARI 1803091403800001 082183440045 CINTA SARI 002 001 6 SEPTEMBER 2018 10.9 72
16 1803092206150005 1803096407160001 1 ALYA ZULYA NURVA 24-07-2016 P 3.1 MUHAMMAD NUR ALI 1803091001950001 082183440045 DUSUN 1 KALICINTA 001 001 6 SEPTEMBER 2018 10.9 71
17 1803090106100002 1803090308150001 2 AHMAD EGHA PRASETIA 03-08-2015 L 3 A. RUSDI 1803092401840002 082183440045 KALICINTA 001 001 6 SEPTEMBER 2018 14 80
18 1803091807072246 - 6 SISKA OKTAVIA 27-10-2015 P 3 SUGIRI 1803092810680003 082183440045 CINTA SARI 001 002 6 SEPTEMBER 2018 13 80
19 1803091807071735 1803092305170004 3 DICKY RAMADHAN 23-05-2017 L 3.4 WAGIMIN 1803091305760001 081997531157 KALICINTA 002 001 6 SEPTEMBER 2018 10 70
20 1803090606120028 1803094402150002 2 KHOIRUNISA SALSABILA 04-02-2015 P 2.5 MUJIANTO 1803090208790003 082183440045 CINTA SARI 001 001 6 SEPTEMBER 2018 1.25 90
21 1803090202160005 - 2 SHAMILA 11-08-2017 P 3.6 SIGIT SAMI ADJI 1803020505870007 085384566838 KALICINTA 001 001 6 SEPTEMBER 2018 10 80
22 1803092903160006 1803091911160001 1 ANAS ZAIN RAMDANI 19-11-2016 L 2.5 BRAM ISWANSI 1803092406870002 082183440045 KALICINTA 001 001 6 SEPTEMBER 2018 11 85
23 1803090402110036 - 3 ADITYA PRATAMA 12-11-2017 L 2.6 SOLIHIN 1803092808750003 082183440045 CINTA SARI 001 002 6 SEPTEMBER 2018 9.5 85
24 1803091707170005 1803090707170001 2 M. SYABIL ZUNNURAINI ISROMI 07-07-2017 L 3.2 M. AL ISROMI 1803011001850004 082282146983 DESA KALICINTA 001 001 6 SEPTEMBER 2018 9.2 83
25 1803091902110003 1803090304140001 2 M. PAMUNGKAS BAYU AJI 03-04-2017 L 3 RIFA'I 1803091502810004 082183440045 DUSUN 1 KALICINTA 001 001 6 SEPTEMBER 2018 15 104
26 1803090411110001 1803091309150002 3 EMIL SALIM 13-09-2015 L 3 JOHANI 1803091507760003 082183440045 CINTA SARI 001 001 6 SEPTEMBER 2018 14 90
27 1803090504160003 1803092603170001 1 WILDAN JUHDA HILMAN 26-03-2017 L 2.3 HENDRIK 1803021702900002 082183440045 JL. WAY ABUNG III DESA CINTA SARI 001 001 6 SEPTEMBER 2018 9.2 82
28 1803092407170002 - 1 RAFA ALJORDI 14-03-2018 L 3.2 MARZUKI 1803092407170002 085269060901 CINTA SARI 001 001 6 SEPTEMBER 2018 8 70
29 1803092407170002 - 1 RAFI ALJORDI 14-03-2018 L 2.5 MARZUKI 1803092407170002 085269060901 CINTA SARI 001 001 6 SEPTEMBER 2018 8.1 71
30 1803091807073028 1803090203140001 2 ALFIAN RIZQIE PRATAMA 02-03-2014 L 3 HARIYANTO 1803092008790006 085210873216 DUSUN I 001 001 6 SEPTEMBER 2018 14.5 100
31 1803091807073028 1803202506170002 1 ATTALA RAFFA 25-06-2017 L 2.7 ARWIN PRAWIRA 1803202007920002 081299287744 JL. WAY ABUNG III NO.33 001 001 6 SEPTEMBER 2018 9 82
32 1803091602100001 1803091011130002 3 MUHAMAD YANA 10-11-2013 L 3 HERLY 1803090101820004 082183440045 CINTA SARI 001 002 6 SEPTEMBER 2018 17 106
33 180309280900010 1803092407150001 2 AZIB ARSYAD ISMAIL 24-07-2015 L 2 H. ISMAIL MACHOUD,S.Pd.I 1803092203790003 08980943381 DUSUN I KALICINTA 001 001 6 SEPTEMBER 2018 14 96
34 1803092611090001 1803095601180001 4 RIA AMELIYAH PUTRI 16-01-2018 P 2.9 ROHADI 1803090504800002 082183440045 KALICINTA HARAPAN JAYA 002 005 6 SEPTEMBER 2018 8 73
35 1803090702110026 - 3 NAZWA AISAH 07-01-2018 P 2.7 SUPOKO 1803090610700001 082183440045 KALICINTA 001 001 6 SEPTEMBER 2018 8.1 75
36 1803091110160003 1803097110130002 1 SYARTIQA SALSABILLA 31-10-2013 P 2.5 SYAHRONI 1803090807870002 082279960612 CINTA SARI 001 001 6 SEPTEMBER 2018 16 105
37 1803091807071793 - 6 DIKO FAHREZA 14-01-2018 L 3.8 ISOM 1803091212700001 082183440045 KALICINTA 001 001 6 SEPTEMBER 2018 8 72
38 1803091008150005 1808125105130001 1 NUR AINI 11-05-2013 P 3 AHMAD YANTO 1808121010880006 082183440045 KALICINTA 001 001 6 SEPTEMBER 2018 16 106
39 1803090602120003 1803091008130001 2 ADIT NUGRAHA 10-08-2013 L 2.5 KHOTIB 1803021101820001 081997530760 CINTA SARI 001 001 6 SEPTEMBER 2018 15 103
40 1803090709090002 - 2 ZAHRA AZIZAH PUTRI 02-12-2013 P 2.8 HERI 180309267780001 081377795800 CINTA SARI 001 002 6 SEPTEMBER 2018 16 103
41 1803090912140007 1803091401150001 1 NUGRAHA GILANG DIRGA 14-01-2015 L 2,9 JONI IRAWAN 1803090810860001 082183440045 DSN 8 KALI CINTA 001 001 6 SEPTEMBER 2018 16 98
42 1803090201150001 1803090201150001 1 MUHAMAD GILANG ALFARIZKI 04-05-2015 L 3,1 ASEP GUMILANG 1803090401940003 081368755253 DESA KALICINTA 001 001 6 SEPTEMBER 2018 15 97
43 1803091204180004 1803096910140002 1 ZAHRA NADYA APRIZA 29-10-2014 P 2,5 SUPRIYANTO 1803092601850004 082375561056 KALI CINTA 001 001 6 SEPTEMBER 2018 17 105
44 1803092801110018 - 2 BELLA ALVA RETA 16-07-2018 P 3,8 FAUZI RIZAL 1803091509780001 081379112247 DESA KALICINTA 004 003 6 SEPTEMBER 2018 4,5 52
45 1803090803100006 1803094102170001 2 SELLA NOVITA 01-02-2017 P 3,0 SUWARNO 1803091501750002 082375873845 KALI CINTA DUSUN 9 001 001 6 SEPTEMBER 2018 11 85
: CEMPAKA 1
: SEPTEMBER
: 2018

CARA ASI VIT A VIT A

UKUR EKSLU IMD PEBRU AGUTU KEPEMI
1=TELE SIF 1=YA, ARI S LIKAN
NTANG 1=YA,2 2=TID 1=YA,2 1=YA,2 BUKU
2=BER =TIDA AK =TIDA =TIDA KIA
DIRI K K K

18 19 20 21 22 23
2 1 1 1 1 1
2 2 1 1 1 1
2 2 1 1 1 1
1 2 1 1 1 1
1 2 2 1 1 1
1 2 2 1 1 1
1 2 2 1 1 1
1 1 2 1 1 1
1 1 2 1 1 1
1 1 2 1 1 1
1 1 2 1 1 1
2 1 1 1 1 1
2 1 1 1 1 1
2 1 1 1 1 1
2 1 1 1 1 1
2 1 1 1 1 1
2 1 1 1 1 1
2 1 1 1 1 1
1 1 1 1 1 1
2 1 1 1 1 1
1 1 1 1 1 1
2 2 2 1 1 1
1 2 2 1 1 1
1 2 1 1 1 1
1 2 2 1 1 1
2 2 1 1 1 1
1 1 1 1 1 1
1 1 1 1 1 1
1 1 1 1 1 1
2 1 1 1 1 1
1 1 1 1 1 1
2 1 1 1 1 1
2 1 1 1 1 1
1 1 1 1 1 1
1 1 1 1 1 1
2 1 1 1 1 1
1 1 1 1 1 1
2 1 1 1 1 1
2 1 1 1 1 1
2 2 1 1 1 1
2 2 1 2 1 1
2 2 1 2 1 1
2 1 2 1 2 1
1 1 1 2 1 1
1 1 2 1 1 2
 FORMULIR PEMANTAUAN PERTUMBUH
PUSKESMAS MADUKORO KECAMATAN KOTABUMI
LAMPUNG
PROPINSI : LAMPUNG
BUPATEN / KOTA : LAMPUNG UTARA
SMAS / KECAMATAN : PUSKESMAS MADUKORO / KOTABUMI UTARA
SA / KELURAHAN : KALICINTA

BARAT
JENIS
NO KARTU NIK ( NOMOR INDUK ANAK TANGGAL BADAN ( NAMA ORTU NO TLP/ HP
NO NAMA ANAK KELAMI NIK AYAH
KELUARGA KEPENDUDUKAN ) KE LAHIR BB ) ( AYAH ) ORTU
N
LAHIR
1 2 3 4 5 6 7 8 9 10 11
1 1803091011090007 1803092012160001 3 AHMAD ZUBAIR 20-12-2016 L 3 SUWITO 1803091101820001 082372573799
2 1803091507160001 1803090509160001 1 M. AL RISKY PEBRIAYAN 05-09-2016 L 3 RIO PEBRIYANDO 1803091612920001 082377531932
3 1803020511150001 1803025011150002 1 NOBITA NOA ZAKIA 19-11-2015 P 2.8 M. ASEP KAMILA 1803020307900004 0895399995627
4 1803092702140015 1803095406170002 2 ANGEL NAJWA 14-06-2017 P 3.2 RAIS 1803091412840002 082183440045
5 1803091807072850 1803095712170001 3 ASSYFA ASHALINA PUTRI 17-12-2017 P 2.8 SAMI'IN 1803091203670003 085871868726
6 1803091204110003 1803091705170001 2 MOHAMMAD IKBAL 17-05-2017 L 3.0 SURADY 1803090109880002 089514594448
7 1803091908150001 1803094302160002 1 AYSHA AILANI ARKA 03-02-2016 P 3.0 ZULI WANTO 1803090712870003 085715609855
8 1803092109100011 1803095710170001 2 DEWI SINTA 17-10-2017 P 2.8 EKO TRIWONO 1803090111880004 082279992217
9 1803090310110006 1803096902160001 1 BALQIS UFAIRAH INDRI 29-02-2017 P 3.2 HENDRIK PURNOMO 1803092911830002 081213243158
10 1803091404140005 1803096907140001 1 SAFIRA NURAINI 29-07-2014 P 2.8 SANUSI 1803091007820003 082388405202
11 1803161105150002 1803160804150002 1 RAFFY ARONI PRATAMA 08-04-2015 L 2.9 AAN RIYATNO 1803160107930009 085377015433
12 1803091710120005 1803094802170003 3 RISKA AULIA 08-02-2017 P 2.8 RONI 1803091309800004 082183440045
13 1803093007150001 1803092211150001 1 TOMY ALFARIZ 22-11-2015 P 3 SUWITO 1803091508890005 082183440045
14 1803090608120013 1803091207170001 2 SATRIA WILLDAN KHOLIK 12-07-2017 L 3 SARIFUDIN 1803091405840004 082180819283
15 1803091008090006 1803092805160001 2 RIVAL ANADO 28-05-2016 L 3 RIYANTO 1803092011840002 085379306819
16 1803092704150008 1803095206150001 1 RIRIN ARYANI 12-06-2015 P 3.3 MADNENI 1803090911800001 082375967732
17 1803092509120016 1803090109130001 3 ALDAN SAPUTRA 01-09-2013 L 3.0 RUSDIYANTO 1803090202760005 082375872972
18 1803090811120002 1803095306170001 1 KESIA OLIFIA 13-06-2017 P 2.8 EMAN 1803090907860008 085377015436
19 1809011503130003 1803092102170003 2 ACHMAD RAFLI NAJID 21-02-2017 P 3.3 KUSNADI 1809011010850024 082372803642
20 1803092909170002 - - - - - 2.8 AHMAD NURDIN 1803091209890002 082183440045
21 1803091211150002 1803095208160001 1 SYAKIRA ALMAIRA QISYA 12-08-2016 P 3 FEBRI HANANTO 1803020802920002 082281917278
22 1803091211150002 1803094104180001 2 ALAYYA GAVAPUTRI HANANDITA 01-04-2018 P 3 FEBRI HANANTO 1803020802920002 082281917278
23 1803092611120050 1803096507170001 2 AYUNDA AYAKILA ATMARINI 25-07-2017 P 2.5 AAN FIRMANTO 1803091911900002 085380426365
24 1803091807072472 1803094702160001 3 NOVI YANTIKA SARI 07-02-2016 P 2.7 DENI 1803090112760004 082183440045
25 1803092201180005 1803090811170001 1 ADI TIRTA JAYA 08-11-2017 L 3.0 YUSMADI 1803090308840003 082380725994
26 1803090311090003 1803096206160002 2 DYNA AULIA RAHMADHANI 22-06-2016 P 3 MUHAMMAD DEDI 1803096206160002 085379713372
27 1803091807072857 1803092709160001 3 HARI MUHAMAD SAPUTRA 27-09-2016 L 2.8 AHMAD TARMIZI 1803090608710001 082185059508
28 1803091001120001 1803092106170001 2 M. NIZAM AZHAR 21-06-2017 L 2.8 ZAKARIA 1803090307830002 082279183521
29 1802071312130001 1802075607150001 2 FITRIA RAMADHANI 16-07-2015 P 2.5 SOFYAN YUSUP 1802071312130001 082183440045
30 1803091807072003 1803096209140001 3 ANITA MULYASARI 22-09-2014 P 2.8 MUHAMAD SUBEKI 1803096209140001 082183440045
ERTUMBUHAN BALITA DI POSYANDU
OTABUMI UTARA KABUPATEN LAMPUNG UTARA
AMPUNG
NAMA POSYANDU : CEMPAKA III
BULAN : SEPTEMBER
TAHUN : 2018

PB/TB CARA UKUR VIT A

TANGGAL BB ASI EKSLUSIF IMD 1=YA, VIT A AGUTUS KEPEMILIKAN
ALAMAT RT RW 1=TELENTANG PEBRUARI
PENGUKURAN ( KG ) 1=YA,2=TIDAK 2=TIDAK 1=YA,2=TIDAK BUKU KIA
( CM ) 2=BERDIRI 1=YA,2=TIDAK

12 13 14 15 16 17 18 19 20 21 22 23
DUSUN II TALANG BATIN 003 002 05 SEPTEMBER 2018 13 88 2 1 1 1 1 1
TALANG BATIN 001 001 05 SEPTEMBER 2018 12.5 88.5 2 2 2 1 1 2
JL. BUNGAMAYANG NO. 354 005 006 05 SEPTEMBER 2018 15 98 2 1 2 1 1 2
TALANG BATIN 001 001 05 SEPTEMBER 2018 10 78 1 1 2 1 1 2
TALANG BATIN 001 001 05 SEPTEMBER 2018 10 76 1 1 1 1 1 2
TALANG BATIN FE 001 05 SEPTEMBER 2018 10 80 1 1 2 1 1 2
TALANG BATIN 002 003 05 SEPTEMBER 2018 13 95 2 2 2 1 1 2
TALANG BATIN 001 001 05 SEPTEMBER 2018 10 74 1 2 2 1 1 1
TALANG BATIN 001 001 05 SEPTEMBER 2018 13 90 1 1 2 1 1 1
BANJAR HARUM II 001 003 05 SEPTEMBER 2018 18.5 107 2 1 1 1 1 1
TALANG BATIN 002 002 05 SEPTEMBER 2018 14 105 2 2 1 1 1 1
TALANG BATIN 001 001 05 SEPTEMBER 2018 10 79 1 2 1 1 1 1
DUSUN 2 TALANG BATIN 002 003 05 SEPTEMBER 2018 16 97.2 2 2 1 1 1 1
TALANG BATIN 001 001 05 SEPTEMBER 2018 10 73.1 1 2 1 1 1 1
DUSUN II TALANG BATIN 002 002 05 SEPTEMBER 2018 12 93.2 2 1 1 1 1 1
TL. BATIN 001 001 05 SEPTEMBER 2018 10 85.1 2 1 1 1 1 1
TALANG BATIN 001 001 05 SEPTEMBER 2018 21 109.2 2 2 1 1 1 1
TALANG BATIN 001 001 05 SEPTEMBER 2018 10 80.1 1 2 1 1 1 1
TALANG BATIN 001 002 05 SEPTEMBER 2018 13 94.2 1 1 1 1 1 1
TALANG BATIN I 001 001 05 SEPTEMBER 2018 - - - 2 - - - -
 CINTA SARI 003 005 05 SEPTEMBER 2018 13 87 2 2 1 1 1 1
CINTA SARI 003 005 05 SEPTEMBER 2018 6.5 60 1 1 1 1 1 1
SUMBER MULYA 001 001 05 SEPTEMBER 2018 13 87 1 1 1 1 1 1
TALANG BATIN 001 001 05 SEPTEMBER 2018 14 95.1 2 1 1 1 1 1
SUMBER MULYA 001 001 05 SEPTEMBER 2018 13 87.5 1 1 1 1 1 1
TALANG BATIN 001 001 05 SEPTEMBER 2018 11 96.5 2 2 1 1 1 1
TALANG BATIN 002 002 05 SEPTEMBER 2018 13 87 2 2 1 1 1 1
TALANG BATIN 001 001 05 SEPTEMBER 2018 12.9 85 1 1 1 1 1 1
DUSUN 2 002 004 05 SEPTEMBER 2018 15 97 2 1 1 1 1 1
TALANG BATIN 001 001 05 SEPTEMBER 2018 18 105 2 2 1 1 1 1
31 1803091904100006 1803090711150001 3 DIMAS RISKI ADITIA 07-11-2015 L 26 RASIDIN 1803091910690001 082183440045
32 1803090811120016 1803092507160001 2 RAKA DWI PANGESTU 25-07-2016 L 33 HENDRO PERMANA P 1803092008900002 082183440045
33 1803092401110006 1803092805170002 2 FREDY ALVINO 28-05-2017 L 3,3 ANSORI 1803091806820003 082183440045
34 1803091707120011 1803092402170002 5 MUHAMMAD ALVANDI FEBRIANSAH 24-02-20217 L 3.2 DEDI EFENDI 1803090509800003 085273743949
35 1803090110120023 1803095405180001 2 SAVIRA AMELIA 14-05-2018 P 2,8 DES SUSANTO 1803090312840001 082183440045
36 1803090304120006 1803097011150002 3 GHADIRA QIDZAMA AFII'AH 30-11-2015 P 2,8 MUHIMIN 1803091005800001 082372191437
37 1803092211160001 1803091306170001 1 ABHISEVA KEY ELNINO 13-06-2017 L 2,8 FERI FIRMANSYAH 1803021505890001 082279996004
38 1803090711120028 1803094911160001 2 AQILLA FARIZA MUFIA 09-11-2016 P 3 YUSUF 1803093007880001 08975998764
39 1803090907130005 1803091310140001 2 AHMMAD SULTON 13-10-2014 L 3 SULIS TIYONO 1803090301860001 082183440045
40 1803090605110001 1803090602160004 2 IKHSAN BILAL HIDAYAT 06-02-2016 L 3 ISWANDI 1803092607830002 082183440045
41 1803090609160005 1803094409160001 1 CAHAYA PUSPITA SEPTIANI 04-09-2016 P 3 JUNAIDI 1803090406880004 085379308943
42 1803090202110057 1803095802180001 2 CAHAYA KHANZA ARISHA 18-02-2018 P 3,1 BUDI HARTONO 1803090309740003 082374492441
43 1803091711090003 1803090903140001 1 MUHAMMAD NIZAM RIFA'I 09-03-2014 L 2,8 HARTADI 180309280180001 082377010073
44 1803092411100001 1803096406140001 5 CAHYANI KHUMAYRO TYTO 24-06-2014 P 3 SUNARTO 1803091707750002 082282042405
45 1803092411100001 1803097011150003 6 NADHIFA ZAKIA SALSABILA 30-11-2015 P 3 SUNARTO 1803091707750002 082282042405
46 1803090202110048 1803098804140001 3 REFLY APRILIANI 18-04-2014 L 3 BASUKI 1803091510740001 085384872287
47 1803090802110025 1803090908150001 4 MAHER ALIF ADICAHAYA 09-08-2015 L 3 YAMIN 1803090908150001 082183440045
48 1803091301120016 1803090912170001 2 MUHAMMAD MIRHAN 09-12-2017 L 2,8 SYUKUR 1803092808860001 085212186633
49 1803092111120010 1803097107140002 3 AQILA SYAFITRI 31-07-2014 P 3 IWAN 1803090101830008 082378982512
50 1803092111120010 1803095409170002 4 SEPTA MEGA UTAMI 14-09-2017 P 2,6 IWAN 1803090101830008 082378982512
51 1803091305150002 1803090906160001 1 BAYU STIAWAN 09-06-2016 L 2,9 IMRAN 1803090306850002 082183440045
52 1803091511130001 1803090503140003 1 RAFA ABIDZAR PRATAMA 05-03-2014 L 3 SARIMAN 1803090503900003 085382069938
53 1803090202110051 1803091206150001 3 MUFLIH ARSYIL ALFIAN NURHADI 12-06-2015 L 3,2 NURHADI 1803091904790001 082183186481
54 1803091001120007 1803094207140001 2 FAQZIAH AQIQAH 02-07-2014 P 2,8 SUGENG SUGIYANTO 1803091010780004 085368149002
55 1803092405120013 1803092109160001 2 MUHAMMAD ERIK SAPUTRA 21-09-2016 L 3,9 SAIT 1803092109160001 087898623062
56 1803091604100002 1803096208140001 1 AFINA NUR ANZDANI 22-08-2014 P 3.5 YULIANTO 1803090707880002 089528482859
57 1803090401180002 1803095112160002 1 ALIKA NAYLA PUTRI 11-12-2016 P 3 LASTO 1803095112160002 085383322767
58 1803091911120005 1803091212140002 1 MUHAMMAD ZIDAN AL GHIFAR 12-12-2014 L 2.5 FERDIYANTO 1803091702880005 082379497434
59 1803091907120003 1803092105140001 2 KUNCORO ADYA ARTHA 21-05-2014 L 3 WITO 1803091107850002 082168422924
60 1803091907120003 1803091308170001 3 BILAL BIMANTARA 13-08-2017 L 3 WITO 1803091107850002 082168422924
61 1803092803120019 1803095607140002 2 UMMI AULIA ASFA 16-07-2014 P 3 LAMSURI 1803090807770004 082379745028
62 1803090202110049 1803092008130002 2 AYUB SAPUTRA 20-08-2013 L 3 INDRA JAYA 1803091008880007 081218024144
63 1803090202110049 1803096303180001 3 RAYSA AURELIA PUTRI 23-03-2018 P 3 INDRA JAYA 1803091008880007 081218024144
64 1803091706160003 1803092006160002 2 DAFFA IBNU HAFIZ 20-06-2016 L 2 HENDRAWANSYAH 1803031612950001 082380723585
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110 1803092211160001 1803092211160001 1 ABHISEVA KEY ALNINO
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15-05-2018 P 2.8 DES SUSANTO 803090312840001
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