PENCATATAN DAN PELAPORAN PELAYANAN VAKSINASI BAGI LANSIA DI KABUPATEN SUMBAWA

Puskesmas : TARANO
Tanggal 28-Dec-21

KEPERSERTAAN BPJS
(TULIS "YA" PADA KOLOM DOSIS I DOSIS 2
YANG SESUAI) KETERANGAN (DITUNDA/TIDAK
NO NO. REGISTRASI NIK NAMA PENERIMA VAKSIN (SESUAI JENIS KELAMIN TANGGAL LAHIR PEKERJAAN ALAMAT (SESUAI KTP) NO. HP MEREK TANGGAL DIBERIKAN/LANJUT), JELASKAN ALASAN BILA
KTP) VAKSIN SCREENING
DITUNDA/TIDAK DIBERIKAN
BPJS NON TGL PEMBERIAN TANGGAL
BPJS PBI NON ANGGO NO. BATCH PEMBERIAN NO BATCH
PBI TA VAKSINASI VAKSINASI

1 5201156804970002 LISA LESTARI p MASYARAKAT UMUM

LAB BONTONG 082341888594 PFIZER 12/28/2021 FF8847

5201154107570226 AMINAH 082341888594

2 p MASYARAKAT UMUM DUSUN TONGKEK PFIZER 12/28/2021 FF8848

5204251702030001 ADITNYA PASYA LAB BONTONG 082341888594

3 L MASYARAKAT UMUM PFIZER 12/28/2021 FF8849

4 5204255209930001 RINI ANGGARAINI P MASYARAKAT UMUM

LAB BONTONG 082341888594 ASTRA 12/28/2021 A1051

5204251709970001 WITRI WARDANI LAB BONTONG 082341888594

5 P MASYARAKAT UMUM ASTRA 12/28/2021 A1051

5204254609980002 RAMDANI LAB BONTONG 082341888594

6 P MASYARAKAT UMUM ASTRA 12/28/2021 A1051

7 5206035007000008 TUTI APRIANI P MASYARAKAT UMUM

DADI BOU 082341888594 ASTRA 12/28/2021 A1051

5204250503920001 HAMDANI PRIADI LAB BONTONG 082341888594

8 L MASYARAKAT UMUM ASTRA 12/28/2021 A1051

5204256509000001 NURUL ARAFAH 082341888594

9 P MASYARAKAT UMUM LAB JAMBU ASTRA 12/28/2021 A1051

10 5204251508990001 GUSRAN RUSWANTO L MASYARAKAT UMUM

LAB BONTONG 082341888594 ASTRA 12/28/2021 A1051

11 5204257112510003 RUKYAH P LANSIA

LAB BONTONG 082341888594 SINOVAC 12/28/2021 202109208G

5204250212040002 SURYA TAQWA LAB BONTONG 082341888594

12 L REMAJA SINOVAC 12/28/2021 202109208G

5204254107550035 MASTARI LAB BONTONG 082341888594

13 L LANSIA ASTRA 12/28/2021 A1051

5204251308630001 HASAN LAB BONTONG 082341888594

14 L MASYARAKAT UMUM PFIZER 12/28/2021 FF8849

5201154710740001 MURNIYANTI LAB BONTONG 082341888594

15 P MASYARAKAT UMUM ASTRA 12/28/2021 A1051

16 5204140212900003 SUDIRMAN L MASYARAKAT UMUM

LAB BONTONG 082341888594 PFIZER 12/28/2021 FF8849

5204255709870003 DINA SUSILAWATI LAB BONTONG 082341888594

17 P MASYARAKAT UMUM SINOVAC 12/28/2021 202109208G

5204252809070002 SATRIA SEPTA HARJO LAB BONTONG 082341888594

18 L REMAJA SINOVAC 12/28/2021 202109208G

19 5204251502960001 IRVAN SAPUTRA L MASYARAKAT UMUM

LAB BONTONG 082341888594 PFIZER 12/28/2021 FF8849

5204250503460001 SAHRIN LAB BONTONG 082341888594

20 L LANSIA PFIZER 12/28/2021 FF8849

5204254704850001 DINA APRIANA LAB BONTONG 082341888594

21 P MASYARAKAT UMUM ASTRA 12/28/2021 A1051

22 5204251104820002 ABDUL KADIR L MASYARAKAT UMUM

LAB BONTONG 082341888594 ASTRA 12/28/2021 A1051

5204254407040001 NIRWANA LAB BONTONG 082341888594

23 P REMAJA SINOVAC 12/28/2021 202109208G
5204251206850001 BADARUDDIN LAB BONTONG 082341888594
24 L MASYARAKAT UMUM PFIZER 12/28/2021 FF8849

25 5204252404000001 MARIO L MASYARAKAT UMUM

LAB BONTONG 082341888594 PFIZER 12/28/2021 FF8849

5204250202890002 ARDIANSYAH LAB BONTONG 082341888594

26 L MASYARAKAT UMUM PFIZER 12/28/2021 FF8849

52042541076200004 HAWATI LAB BONTONG 082341888594

27 P MASYARAKAT RENTAN ASTRA 12/28/2021 A1051

28 5204255904000002 LINDA AFRIYANTI P MASYARAKAT UMUM

LAB BONTONG 082341888594 PFIZER 12/28/2021 FF8849

5204255012620001 MATU LAB BONTONG 082341888594

29 L MASYARAKAT UMUM PFIZER 12/28/2021 FF8849

RUSDIANSYAH LAB BONTONG 082341888594

30 5204251705020002 L MASYARAKAT UMUM PFIZER 12/28/2021 FF8849

31 5204142802860002 ALWAN WIJAYA L MASYARAKAT UMUM

PAMANTO 082341888594 PFIZER 12/28/2021 FF8849

32 5204255505820002 ATIKA P
NAKES LAB BONTONG 082341888594 PFIZER 12/28/2021 FF8849

33 5204255305900001 DESI ANDRIANI P

MASYARAKAT UMUM LAB BONTONG 082341888594 ASTRA 12/28/2021 A1051

34 5204254508870001 SUJIARTI P
MASYARAKAT UMUM LAB BONTONG 082341888594 ASTRA 12/28/2021 A1051

35 5204251204800001 MUSTAMIN L
MASYARAKAT UMUM LAB BONTONG 082341888594 ASTRA 12/28/2021 A1051

36 5204254107840003 RAMLAH P
MASYARAKAT UMUM LAB BONTONG 082341888594 ASTRA 12/28/2021 A1051

37 5204255304770002 DEWI RAHAYU P

MASYARAKAT UMUM LAB BONTONG 082341888594 SINOVAC 12/28/2021 202109208G

38 5204255507670005 SUBAEDAH P
MASYARAKAT UMUM LAB BONTONG 082341888594 SINOVAC 12/28/2021 202109208G
ROHANA MASYARAKAT UMUM LAB BONTONG 082341888594
39 5204254107800008 P PFIZER 12/28/2021 FF8849

40 5204254505980004 SRI ENDANG WATI P

MASYARAKAT UMUM LAB BONTONG 082341888594 PFIZER 12/28/2021 FF8849

5204250107870015 JUFRI ADI MASYARAKAT UMUM LAB BONTONG 082341888594

41 L PFIZER 12/28/2021 FF8849

42 5204251606040001 DANDI L REMAJA

LAB BONTONG 082341888594 SINOVAC 12/28/2021 202109208G

43 5204255002080002 NABIL ALDIFARI L REMAJA

LAB BONTONG 082341888594 SINOVAC 12/28/2021 202109208G

5204250107650026 MAHMUD LAB BONTONG 082341888594

44 L MASYARAKAT UMUM ASTRA 12/28/2021 A1051

45 5204256108620001 RASIMA P MASYARAKAT UMUM

LAB BONTONG 082341888594 ASTRA 12/28/2021 A1051

46 5204082303630001 SAENUDDIN K L MASYARAKAT UMUM

LAB BONTONG 082341888594 ASTRA 12/28/2021 A1051

5204252309810001 DADIK DARMADI LAB BONTONG 082341888594

47 L MASYARAKAT UMUM ASTRA 12/28/2021 A1051

48 5204250601970002 SULKIFLI L MASYARAKAT UMUM

LAB BONTONG 082341888594 ASTRA 12/28/2021 A1051
 DIDI FATONI LAB BONTONG 082341888594
49 5204251702830001 L MASYARAKAT UMUM ASTRA 12/28/2021 A1051

50 5204254701800013 MAANI P MASYARAKAT UMUM

LAB BONTONG 082341888594 ASTRA 12/28/2021 A1051

51 5204252606800001 MUNAWIR L MASYARAKAT UMUM

LAB BONTONG 082341888594 SINOVAC 12/28/2021 202109208G
NURLIANTI LAB BONTONG 082341888594
52 5204255401770001 L MASYARAKAT UMUM SINOVAC 12/28/2021 202109208G

520410511860003 DESI KUMALASARI LAB BONTONG 082341888594

53 P MASYARAKAT UMUM SINOVAC 12/28/2021 202109208G
SYAFARUDDIN LAB BONTONG 082341888594
54 5204250708750003 L MASYARAKAT UMUM PFIZER 12/28/2021 FF8849

5204140506040003 INDRA SABARUDDIN REMAJA ONGKO 082341888594

55 L SINOVAC 12/28/2021 202109208G

56 5204255009600001 SRI HARIYATI P

MASYARAKAT UMUM LAB BONTONG 082341888594 SINOVAC 12/28/2021 202109208G

5204254412600002 SARIIANI LANSIA LAB BONTONG 082341888594

57 P PFIZER 12/28/2021 FF8849

58 5204254701880010 NUHAYATI P MASYARAKAT UMUM

LAB BONTONG 082341888594 PFIZER 12/28/2021 FF8849
5204256304650001 LAB BONTONG 082341888594
59 NURIMBA P MASYARAKAT UMUM SINOVAC 12/28/2021 202109208G

5204254408850002 LELISTINA LAB BONTONG 082341888594

60 P MASYARAKAT UMUM ASTRA 12/28/2021 A1051

5204252101910001 ARIYA WAHYU S LAB BONTONG 082341888594

61 L MASYARAKAT UMUM SINOVAC 12/28/2021 202109208G

5204145005800001 SRI MULIANI LAB BONTONG 082341888594

62 P MASYARAKAT UMUM PFIZER 12/28/2021 FF8849

63 5204254203850001 RAHMA P MASYARAKAT UMUM

LAB BONTONG 082341888594 PFIZER 12/28/2021 FF8849

5204250303010001 MUHAMMAD AMRI LAB BONTONG 082341888594

64 L MASYARAKAT UMUM ASTRA 12/28/2021 A1051

65 5204251712880002 HERMANSYAH L MASYARAKAT UMUM

LAB BONTONG 082341888594 PFIZER 12/28/2021 FF8849

66 5204250610830001 SUHERMAN L MASYARAKAT UMUM

LAB BONTONG 082341888594 PFIZER 12/28/2021 FF8849
5204251012740003 MUHIDI ARSYAT LAB BONTONG 082341888594
67 L MASYARAKAT UMUM ASTRA 12/28/2021 FF8849

5204251006780002 NURALIAN LAB BONTONG 082341888594

68 P MASYARAKAT UMUM ASTRA 12/28/2021 A1051

5204144903970002 NILAM ADE KAYANTI JOTANG BERU 082341888594

69 P MASYARAKAT UMUM ASTRA 12/28/2021 A1051

5204252006950002 JODI SAPUTRA LAB BONTONG 082341888594

70 L MASYARAKAT UMUM ASTRA 12/28/2021 A1051

71 5204255111920001 NOVITASARI P MASYARAKAT UMUM

LAB BONTONG 082341888594 ASTRA 12/28/2021 A1051

5204252504940002 ARI APRIANSYA LAB BONTONG 082341888594

72 L MASYARAKAT UMUM ASTRA 12/28/2021 A1051

73 5204140901730001 AHASIM HADI L MASYARAKAT UMUM

LAMENTA 082341888594 ASTRA 12/28/2021 A1051

5204250307680002 ABDUL WAHAB B LAB BONTONG 082341888594

74 L MASYARAKAT UMUM ASTRA 12/28/2021 A1051

5204250701940001 LAB BONTONG 082341888594

75 IRVANDI SUCIPTA L MASYARAKAT UMUM ASTRA 12/28/2021 A1051

76 5205055007830010 SRI HETI KUSENDANG P MASYARAKAT UMUM

LAB BONTONG 082341888594 ASTRA 12/28/2021 A1051

5204252509990001 DANIL ILWANSYAH LAB BONTONG 082341888594

77 L MASYARAKAT UMUM ASTRA 12/28/2021 A1051

5204254510690001 HAWIYAH LAB BONTONG 082341888594

78 P MASYARAKAT UMUM SINOVAC 12/28/2021 202109208G
JUHAN MADAWA 082341888594
79 5205030107750102 L MASYARAKAT UMUM PFIZER 12/28/2021 FF8849

SOFIAN HADI LAB BONTONG 082341888594

80 5204251611020001 L MASYARAKAT UMUM ASTRA 12/28/2021 A1051

5204251602050002 SUHENDRI LAB BONTONG 082341888594

81 L REMAJA SINOVAC 12/28/2021 202109208G

82 5204144802750003 MASTIA P MASYARAKAT UMUM

LAB BONTONG 082341888594 SINOVAC 12/28/2021 202109208G

83 5204254110740003 SRI MULYATI P MASYARAKAT UMUM

LAB BONTONG 082341888594 SINOVAC 12/28/2021 202109208G

5204250507050002 HARDIANSYAH LAB BONTONG 082341888594

84 L REMAJA SINOVAC 12/28/2021 202109208G

5204251706870003 HENDI SANTOSO LAB BONTONG 082341888594

85 L MASYARAKAT UMUM ASTRA 12/28/2021 A1051

5204252207640001 AMURAT LAB BONTONG 082341888594

86 L MASYARAKAT UMUM ASTRA 12/28/2021 A1051

5204254107660010 MARUPIA LAB BONTONG 082341888594

87 P MASYARAKAT UMUM ASTRA 12/28/2021 A1051

5204251508830001 YADI BUDI HARYATI LAB BONTONG 082341888594

88 L MASYARAKAT UMUM ASTRA 12/28/2021 A1051

89 5204251009750002 SAHABUDDIN L MASYARAKAT UMUM

LAB BONTONG 082341888594 ASTRA 12/28/2021 A1051

90 7308031010930003 FADLI L MASYARAKAT UMUM

AIPAYA 082341888594 ASTRA 12/28/2021 A1051

91 5204250511920001 SUPRIADI L MASYARAKAT UMUM

LAB BONTONG 082341888594 ASTRA 12/28/2021 A1051

92 5204146206950001 DITAPURWITASARI P MASYARAKAT UMUM

LAB BONTONG 082341888594 ASTRA 12/28/2021 A1051

5206034107720154 SALMAH LAB BONTONG 082341888594

93 P MASYARAKAT UMUM PFIZER 12/28/2021 FF8849

5206036208970001 ASTUTI LAB BONTONG 082341888594

94 P MASYARAKAT UMUM PFIZER 12/28/2021 FF8849

5206030906720002 JAKARIA LAB BONTONG 082341888594

95 P MASYARAKAT UMUM PFIZER 12/28/2021 FF8849

5204254702590001 SITI HAWA LAB BONTONG 082341888594

96 P LANSIA PFIZER 12/28/2021 FF8849
SARJAN LAB BONTONG 082341888594
97 5204251006880002 L MASYARAKAT UMUM ASTRA 12/28/2021 FF8849

98 5204253112500012 AHMAD HAYASAM L LANSIA LAB BONTONG 082341888594 ASTRA 12/28/2021 A1051
99 520414540850001 MARDIAH P LANSIA LAB BONTONG 082341888594 ASTRA 12/28/2021 A1051

100 5204254404860002 SULMIATI P MASYARAKAT UMUM

LAB BONTONG 082341888594 ASTRA 12/28/2021 A1051

101 5204256411820001 SARMINI P MASYARAKAT UMUM

LAB BONTONG 082341888594 ASTRA 12/28/2021 A1051

102 5204250107800044 AHMAD JUNIADI L MASYARAKAT UMUM

LAB BONTONG 082341888594 ASTRA 12/28/2021 A1051

103 5204256109920002 MANIATI P MASYARAKAT UMUM

LAB BONTONG 082341888594 ASTRA 12/28/2021 A1051
 5204252306010001 AKBAR LAB BONTONG 082341888594
104 L MASYARAKAT UMUM ASTRA 12/28/2021 A1051

105 52042507740019 SUPRIADI AHMAD L MASYARAKAT UMUM

LAB BONTONG 082341888594 SINOVAC 12/28/2021 202109208G

106 5204256505010001 TITEN LESTARI P MASYARAKAT UMUM

LAB BONTONG 082341888594 SINOVAC 12/28/2021 202109208G

5204255707970002 RUSDIANA LAB BONTONG 082341888594

107 P MASYARAKAT UMUM SINOVAC 12/28/2021 202109208G

5204250612650002 M SALEH LAB BONTONG 082341888594

108 L MASYARAKAT UMUM SINOVAC 12/28/2021 202109208G

5204251311740001 M SALEH LAB BONTONG 082341888594

109 L MASYARAKAT UMUM ASTRA 12/28/2021 A1051

5204255006870004 ETI PUSPITAWATI LAB BONTONG 082341888594

110 P MASYARAKAT UMUM ASTRA 12/28/2021 A1051

111 5204060707820005 SYARIFUDDIN L MASYARAKAT UMUM

LAB BONTONG 082341888594 PFIZER 12/28/2021 FF8849

5204520411070001 AFRISAL LAB BONTONG 082341888594

112 L REMAJA SINOVAC 12/28/2021 202109208G

113 5204250107970015 LIKMAN L MASYARAKAT UMUM

LAB BONTONG 082341888594 ASTRA 12/28/2021 A1051

114 5204084204810003 JULIANI L MASYARAKAT UMUM KEL UMA SIMA

082341888594 ASTRA 12/28/2021 A1051

520425550589001 KABITIA LAB BONTONG 082341888594

115 P MASYARAKAT UMUM ASTRA 12/28/2021 A1051

5204032002850001 AMIRULLAH LAB BONTONG 082341888594

116 L MASYARAKAT UMUM PFIZER 12/28/2021 FF8849

5204250508780001 KAMIRUDDIN LAB BONTONG 082341888594

117 L MASYARAKAT UMUM PFIZER 12/28/2021 FF8849

118 5204250701820016 GUFRIANTO L MASYARAKAT UMUM

LAB BONTONG 082341888594 SINOVAC 12/28/2021 202109208G

5204250505770001 BURHANUDDIN LAB BONTONG 082341888594

119 L MASYARAKAT UMUM SINOVAC 12/28/2021 202109208G

120 5204254106430002 MEKO WANI L LANSIA

LAB BONTONG 082341888594 SINOVAC 12/28/2021 202109208G

121 5204254302810001 SITI HADIJA P MASYARAKAT UMUM

LAB BONTONG 082341888594 SINOVAC 12/28/2021 202109208G

122 5204142105060001 DIMAS NUAGRA PUTRA L REMAJA NYARINYING 085333791685 SINOVAC 12/28/2021 202109208G

123 5204141511740001 HAMSAN WADI L MASYARAKAT UMUM NYARINYING 085333791685 SINOVAC 12/28/2021 202109208G

5205010705820001 MULTAMAT WAHYUDI LAB BONTONG 082341888594

124 L MASYARAKAT UMUM SINOVAC 12/28/2021 202109208G

5204250505060002 ROBI HARDIANSYAH LAB BONTONG 082341888594

125 L MASYARAKAT UMUM SINOVAC 12/28/2021 202109208G

126 5204250109800001 M SIDIK P L MASYARAKAT UMUM

LAB BONTONG 082341888594 ASTRA 12/28/2021 A1051

5206035506870002 SUMARNI LAB BONTONG 082341888594

127 P MASYARAKAT UMUM ASTRA 12/28/2021 A1051

128 5204254705530001 HALIMA B P LANSIA

LAB BONTONG 082341888594 SINOVAC 12/28/2021 202109208G

5204253012750001 M YASIN LAB BONTONG 082341888594

129 L MASYARAKAT UMUM ASTRA 12/28/2021 A1051

130 5204255712000001 SUPRIADI HERMAN L MASYARAKAT UMUM

LAB BONTONG 082341888594 ASTRA 12/28/2021 A1051

133

134

135

136

137

138

139

140

141

142
 SANAFIAH LANSIA JOTANG
98 5204141707550001

99 5204144501060002 ERLY SUSANTI REMAJA JOTANG 11/22/2021 202109150O

 POLISI
52040825 SYAMSUD WAKAPOL
1 S-D53D1E603640002 DIN L 25-03-1964 SEK RT 002/RW8.236E+10

POLRI
BABINKA
52030803 SAMSUL MTIBMAS
2 S-8515D9B 05870016 LUTFI L 3/5/1987 TOLO'OI RT003/RW08.521E+10

POLRI
BABINKA
52050205 JUVITAR MTIBMAS
3 N-7662020 11930002 DWI RIZKY L 5/11/1993 MATA RT 001/RW8.521E+10

POLRI
BABINKA
MTIBMAS
52041414 BAMBAN LAB.
4 S-41F36E7012840001 G HRP L 14-12-1984 JAMBU RT 002/RW8.224E+10

POLRI
BABINKA
MTIBMAS
52041422 BANTULA
5 S-095D7F2 08820001 NURJA'AN L 22-08-1982 NTEH DUSUN KAR8.234E+10

POLRI
BABINKA
MTIBMAS
52061830 NASUTIO LAB.
6 S-3E9C9CE 12800002 N L 30-12-1980 BONTONG DUSUN TIU8.225E+10

ABU POLRI
52010116 BAKAR BABINKA
08781000 KUSMANT MTIBMAS
7 P-63IQIK2T1 O L 16-0801978 LAB. AJI BTN REYAN8.134E+10

TNI
BABINSA
52050327 LAB.
8 S-1A5C3C1 11840002 BIS'UD L 27-11-1984 BONTONG DUSUN LEPA
8.219E+10

TNI
35160801 SYAMSUD BABINSA
9  P-63RN1HD3
10790005 DIN L 1/10/1979 MATA DESA NAN 8.234E+10

TNI
91010108 HERIYANT BABINSA
10 P-63LFLWA06840005 O L 8/6/1984 LAB. AJI DUSUN RAS8.234E+10
 POLRI
52061203 EDI BABINKA
05961000 IWANSYA MTIBMAS
11 S-6F0C47E74 H L 3/5/1996 BANDA DUSUN SEM8.533E+10

TNI
52720331 BABINSA
12 S-3005A3F 12740036 JUNAID L 31-12-1974 PIDANG ASRAMA KO8.521E+10

TNI
BABINSA
52041805 MOCHAM BANTULA
13 P-63UBGF605770001 AD ANIF L 5/5/1977 NTEH DUSUN KAR8.534E+10
52041419 PNS
14 S-4AA4A6304710001 AHMADIN L 19-04-1971 GURU DUSUN TAL8.225E+10

ABDUL TNI
33730316 MOENTAL BABINSA
15 S-5DF6158 09820002 IF L 16-09-1982 TOLO'OI DUSUN KAR8.139E+10

M. POLRI
SULHAN BABINKA
52041222 YUSNI MTIBMAS
16 P-645YWE306850004 UMAR L 22-06-1985 PIDANG LEMPEH 8.125E+10
52042531
17 S-A1ADF5912710003 MURSYID L 31-12-1971 PNS GURU DUSUN TAR8.236E+10

PNS
52040520 BUDI KEPALA
18 S-6D6DD6D05770002 SUSILO L 20-05-1977 SEKOLAH DUSUN TEL8.525E+10

52042524 IYAR NAKES

19 P-63DVSY8J12910001 SISWANDI L 24-12-1991 PERAWAT DUSUN KER8.138E+10
52042531
20 S-4A014ED 12630016 MUHDAR L 31-12-1963 PNS GURU DUSUN PAR8.534E+10

52042556 WINDA NAKES

21 P-67WM5810940001 NURDINA P 16-10-1994 BIDAN DUSUN PID8.533E+10
52041405 PNS
22 S-F1A751C 03650001 A. KHALID L 5/3/1965 SEKCAM DUSUN KER8.533E+10

KEPALA
52042501 SUKIRMA DESA
23 P-64PJNL2707820012 N L 7/1/1982 MATA DUSUN MAT
8.534E+10

KADES
52042520 BRAMAW LAB.
24 P-655C6FH 04880001 AN DHANI L 20-04-1988 BONTONG DUSUN PAR8.524E+10
 KEPALA
52042503 SYARIFUD DESA
25 P-65BQQSJ09820001 DIN L 3/9/1982 PIDANG DUSUN PID8.234E+10

KEPALA
52042502 JOHANSY DESA
26 P-658QQI3 05770001 AH L 2/5/1977 TOLO'OI DUSUN BAT8.533E+10

KEPALA
DESA
52042516 ABDUL BANTULA
27 S-A9E5485 08660001 GANI B L 15-06-1965 NTEH DUSUN BAN8.533E+10

35251449 dr. IZZATI

01910002 CHOIRIYA NAKES
28 P-48F4138 2 H L 9/1/1991 DOKTER DUSUN SUN8.124E+10

KEPALA
52042503 MUSYKIL DESA LAB.
29 P-63Z9DBK 03830002 HARTSHA L 3/3/1983 JAMBU DUSUN JAM8.124E+09

TNI
33082016 BABINSA
04820000 RUDI LAB.
30 P-64YS41T 4 HARTONO L 16-04-1982 JAMBU DUSUN SIP 8.521E+10

KEPALA DUSUN
52042502 DESA LAB. AMPU
31 P-65FDJM003770005 SUPARDI L 2/3/1977 AJI LAB. AJI 8.234E+10

MOHAMA
52041402 D
32 S-51E3D83 04700002 NASUKHA L 2/4/1970 PNS GURU DUSUN KER8.524E+10
52041427 M. CAMAT
33 S-8E4685C 03650001 TAHKIQ L 27-03-1965 TARANO DUSUN KER8.534E+10

KEPALA
52042507 DESA
34 P-65I7H1D 03760001 JUMRIADI L 7/3/1976 BANDA DUSUN BAN8.134E+10

11710422 dr. SAIFUL NAKES

35 N-AE0DBE311810001 AKBAR L 22-11-1981 DOKTER DUSUN KER8.136E+10
52042570 HELMIAN NAKES
36 N-5FD467B03880001 A P 30-03-1988 BIDAN DUSUN GEN8.124E+10

PETUGAS
52050701 DANDI KEBERSIH
37 P-65LUCAF 07980263 IRAWAN L 1/7/1998 AN PKM DUSUN JAM8.524E+10

ADMIN
52041319 M. KEUANGA
38 P-665XQQH05960002 ISMULLAH L 19-05-1996 N DUSUN MU8.533E+10
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TIDAK DIBERIKAN VAKSIN KARENA CKD

DITUNDA TETAPI DI PCARE SUDAH DIBERIKAN

TIDAK DIBERIKAN VAKSIN KARENA RIW PPOK

1 5204252308100002 WAHYU AGUSTIAN L

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5204255204730027 P
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P-84AATC22 5204254107870022 RATNA P
10
5204250500970002 AKHMADIN L
11
520425505830003 ROSDIANA
12

5204251205050001 FAUZUL MUBIN

13

5204254408950002 FITRIANI
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5204254408950002 FITRIANI
15
5204251805020001 ARDIANSYAH
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8/23/2010 REMAJA DUSUN KUNIL, DESA LABUHAN JAMBU 85238486799

MASYARAKAT UMUM LABUHAN PIDANG 85238081405

MASYARAKAT UMUM DUSUN MALALO 85253671559
12/14/1977

1/19/1991 MASYARAKAT UMUM DUSUN MALALO 85333424152

DUSUN MALALO
MASYARAKAT UMUM 85253671559
DUSUN MALALO
85253671559

MASYARAKAT UMUM DUSUN KETAPANG KEC TARANO 85238883855

12/31/1974
MASYARAKAT UMUM DUSUN JEMPELONG KEC. TARANO 82340722260
LANSIA DUSUN AMPU DESAB LAB.AJI 82340568318
2/12/1950
7/1/1987 MASYARAKAT UMUM DESA PIDANG 082339696659

PELAYAN PUBLIK DESA PIDANG 082339696659

MASYARAKAT UMUM DUSUN AIPAYA 85237709145

REMAJA DUSUN AIPAYA 82239192481

MASYARAKAT UMUM DUSUN AIPAYA

85338961360

MASYARAKAT UMUM DUSUN AIPAYA

85338961360
MASYARAKAT UMUM DUSUN AIPAYA
85333291130
MASYARAKAT UMUM DUSUN AIPAYA 82340684445
MASYARAKAT UMUM DUSUN AIPAYA 82340684445
DESA BANDA (SMPN 5 BANDA) 082340680913
DESA BANTULANTEH (SMPN 5 BANDA) 082340680913
DESA BANDA (SMPN 5 BANDA) 082340680913
12/31/1969 MASYARAKAT UMUM DUSUN LAB LIANG DESA LAB JAMBU 081338890854
MASYARAKAT UMUM DUSUN LAB LIANG DESA LAB JAMBU 081338890854
11/15/1975 MASYARAKAT UMUM DUSUN LAB LIANG DESA LAB JAMBU 081338890854
10/2/1998 MASYARAKAT UMUM DUSUN LAB LIANG DESA LAB JAMBU 081338890854
9/13/1981 MASYARAKAT UMUM DUSUN LAB LIANG DESA LAB JAMBU 081338890854

11/17/1994 MASYARAKAT UMUM DUSUN LAB LIANG DESA LAB JAMBU 081338890854

1/7/2002 MASYARAKAT UMUM DUSUN LAB LIANG DESA LAB JAMBU 081338890854

12/31/1974 MASYARAKAT UMUM DUSUN LAB LIANG DESA LAB JAMBU 081338890854
1/19/1994 MASYARAKAT UMUM DUSUN LAB LIANG DESA LAB JAMBU 081338890854

7/5/1983 MASYARAKAT UMUM DUSUN LAB LIANG DESA LAB JAMBU 081338890854

1/18/1987 MASYARAKAT UMUM DUSUN LAB LIANG DESA LAB JAMBU 081338890854

10/7/1992 MASYARAKAT UMUM DUSUN LAB LIANG DESA LAB JAMBU 081338890854
1/15/1987 MASYARAKAT UMUM DUSUN LAB LIANG DESA LAB JAMBU 081338890854
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NGAMBILAN DATA KE KECPEN

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