ma Puskesmas/Fasyankes/Pos : PUSKESMAS TUNJUNGAN

Kabupaten/Kota : BLORA
Provinsi : JAWA TENGAN
TGL PELAKSANAAN :

NO NAMA No Hp

1 DARSO
2 KASMURI
3 DARTI
4 PARJI
5 SITI KHUSNUN
6 SUHARNO
7 SITI FATMAWATI
8 NANANG DWI PRASETYO
9 AHMAD KEVIN FIRMANSAH
10 AMINAH
11 VILLA VINANDHA
12 SUPARMAN
13 PARNI
14 DARSIH
15 AMINUL LATIF
16 SRI KARWATI
17 SANURI
18 SHAFA'ATI ROBI'AH
19 SRI KARTINAH
20 SULASMI
21 RINDY PARAMITA APRILIANI
22 DWIKI ADI PRATAMA
23 DAVIN EKA ARIK WIBOWO
24 AGUNG SUPRAYITNO
25 SURATIN
26 ISKAK
27 SUHARI
28 RETNO MUJIASIH
29 SITI ANDRAWATI
30 SUGIYAH
31 SUPANGAT
32 SRI INDAH WARTINI
33 DANELO AKBAR CAKRA NAGARI
34 SITI ROUDHOTUL AZIZAH
35 ACHMAD SIGID PURNOMO
36 DARMI ASTUTI
37 ARDELIA PUTRI RAMADANI
38 SHERINA OKTAVIA PUTRI
39 VINA NORANA
40 SITI NUR AZIZAH
41 KHOIRUL ANAM
42 ERISA NOVA PUTRI KUSUMANINGRUM
43 NADIA CHANDRA DINATA
44 PURWATI
45 SRI WULANDARI
46 SUPRI
47 DAMI
48 RUMI
49 SITI NUR ROHMATIS SYAFAAH
50 M ALI MUSTAKIM
51 ARBRAHAM
52 SUSILO
53 INES AMELIA SANTIKA SAFITRIANI
54 RASYID MIFTAH NURSALIM
55 NANIK PRAWITI
56 FARHAN ADRIAN NURSALIM
A SINTA MAHARANI
58 TARMI
59 SUKIMAH
60 TARNO
61 SUPARMI
62 MUHAMMAD ADI ANDRA
63 TUKIRAH
64 LUKMAN ALIF KURNIAWAN
65 FERY ARDIAN SAPUTRA
66 WATINI
67 SUMIYATUN
68 SUJIMAN
69 IMAM YAHYA
70 WAGINAH
71 SUPARMAN
72 PUJIWANTO
73 SUTIK
74 SUPRIHADI
75 AHMAD HADI SYAHRI
76 SUJINAH
77 GIBRAN FIRDAUS YUSUF
78 DESTIANA PUTRI LESTARI
79 MUHAMAD ILHAM MAHENDRA
80 FITO ALFIYANTORO
81 RAHMAT REIHAN INDRA PRASTIYA
82 NUR LAYLI RAMADHANI
83 DARJI
84 WARSI
85 ELSA VITRIYANNI
86 JULIYA INDRI NATASYA
87 JUWADI
88 WASI
89 SITI NURAINI
90 ALFIAN RHOMDHONI SAPUTRA
91 SYIHABUDIN ANWAR
92 SUYATI
93 SUMIATI
94 SUNTARI
95 SADAM
96 SUNO
97 SUDJINAH
98 AHMAD SODIKIN
99 WIJI YATNO
100 ELISA KAYLLA PUTRI
101 WINARTI
102 SUNWANTO
103 EDI PRASTIYO
104 MUHAMAD CANDRA BAGUS SETYAWAN
105 SUTIKMAN
106 SULASIH
107 SITI MUSYAROFAH
108 ACHMAD KUSSAIRI
109 PURWANTO
110 EKO SAPUTRO
111 SUMINI
112
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 FORMAT PENCATATAN PELAKSANAAN VAKSINASI COVID-19

NIK ALAMAT (DESA rt rw) TGL LAHIR UMUR

3316100107630225 TAMBAHREJO 1/5 7/1/63 59.1

3316103012750005 TAMBAHREJO 4/5 12/30/75 46.6
3316106506840001 TAMBAHREJO 3/4 6/25/1984 38.1
3316101207680003 TAMBAHREJO 4/4 7/12/1968 54.0
3316104907910003 TAMBAHREJO 1/5 7/9/1991 31.0
3313110702580001 TAMBAKAMPEL 2/7/1958 64.5
3316125611940001 TAMBAHREJO 1//1 11/16/94 27.7
3316100611980001 GRESIK 11/6/1998 23.7
3316101910090003 TAMBAHREJO 2/2 10/19/09 12.7
3316104204660001 TAMBAHREJO 2/2 4/2/66 56.3
3316105806100002 TAMBAHREJO 1/5 6/18/2010 12.1
3316100102520001 TRITEH TAMBAHREJO 2/1/1952 70.5
3316104107320056 TAMBAHREJO 2/4 7/1/1932 90.1
331610501040001 TAMBAHREJO 2/2 10/10/1940 81.8
3316101408970001 TAMBAHREJO 4/5 8/14/97 24.9
3316105205750006 TAMBAHREJO 1/4 12/5/1975 46.6
3374091402560001 TAMBAHREJO 1/4 2/14/1956 66.5
3316107003110001 TAMBAHREJO 1/5 3/30/2011 11.3
3374094110660002 TAMBAHREJO 1/4 10/1/1966 55.8
3316104310490001 TAMBAHREJO 1/4 10/3/1949 72.8
3316146804990001 TAMBAHREJO 2/4 4/28/1999 23.2
3316100310990004 TAMBAHREJO 1/4 10/3/99 22.8
3316102212090001 TAMBAHREJO 4/1 12/22/2009 12.6
3522150503780005 TAMBAHREJO 2/1 7/25/1977 45.0
3316104107580238 TAMBAHREJO 2/1 7/1/58 64.1
3316101406370001 TAMBAHREJO 3/4 6/14/37 85.1
3316102410850001 TAMBAHREJO 3/1 10/24/1985 36.7
3316106605120001 TAMBAHREJO 1/3 5/26/2012 10.1
3316106502950002 TAMBAHREJO 1/2 2/25/1995 27.4
3316104603670001 TAMBAHREJO 2/5 3/6/1967 55.4
3316100107620151 TAMBAHREJO 2/1 7/1/1962 60.1
3316104303720002 TAMBAHREJO 1/4 3/3/1972 50.4
3316101405100002 ADIREJO 2/1 5/14/2010 12.2
3316106303120001 TAMBAHREJO 1/3 3/23/2012 10.3
3316101810110001 TAMBAHREJO 1/2 10/18/2011 10.7
3316105704760003 TAMBAHREJO 1/6 4/17/1976 46.3
3316104808110002 TAMBAHREJO 1/3 8/8/2011 10.9
331610471010001 TAMBAKHREJO 2/3 10/7/2010 11.8
316106711090002 TAMBAHREJO 2/3 11/27/09 12.6
316106502110001 TAMBAHREJO 4/2 2/25/11 11.4
3316103103110005 TAMBAHREJO 4/2 3/31/2011 11.3
3316105711080002 TAMBAHREJO 1/1 11/17/08 13.7
3316105505090002 TAMBAHREJO 2/3 5/15/09 13.2
3316107001720003 TAMBAHREJO 2/5 1/30/72 50.5
3316104401910003 TAMBAHREJO 1/2 1/4/1991 31.5
3316105012590001 TAMBAHREJO TRITEH 12/10/59 62.6
3316104107460087 TAMBAHREJO TRITEH 7/1/1946 76.1
3316104107510104 TAMBAHREJO 4/4 7/1/51 71.1
3316104902100001 TAMBAHREJO 1/3 2/9/2010 12.4
3316102510910002 TAMBAHREJO 3/6 10/25/91 30.7
1256240809810007 TAMBAHREJO 3/6 9/2/81 40.9
3316080705870006 TAMBAHREJO 4/5 5/7/1987 35.2
3316106009090002 TAMBAHREJO 4/5 9/20/09 12.8
3171023006101004 JAKARTA 6/30/2010 12.0
3172026610860012 TAMBAHREJO 2/4 10/26/1986 35.7
3171020212131002 JAKARTA 12/2/13 8.6
3272065408120002 SUKABUMI 8/14/12 9.9
3316104107630300 TAMBAHREJO 1/1 1/7/63 59.6
316107008680001 TAMBAHREJO 2/3 8/30/68 53.9
3316100510550001 TAMBAHREJO 10/5/55 66.8
3316104509700001 TAMBAHREJO 2/4 9/5/70 51.9
3316102602120002 TAMBBAHREJO 3/2 2/26/2012 10.4
331610440672001 TAMBAHREJO 1/6 6/4/75 47.1
3316101012990003 TAMBBAHREJO 1/5 12/10/99 22.6
3316101606120002 TAMBAHREJO 1/2 6/16/12 10.1
3316105607610002 TAMBAHREJO 1/6 7/16/1961 61.0
3316104804680001 TAMBAHREJO 4/3 4/8/68 54.3
316100107650242 TAMBAHREJO 4/4 7/1/65 57.1
3316102605020002 TAMBAHREJO 4/3 5/26/2002 20.1
3316104211660002 TAMBAHREJO 3/6 11/2/1966 55.7
3316100107720078 TAMBAHREJO 2/1 7/1/72 50.1
3316101207630002 TAMBAHREJO 4/4 7/12/1963 59.0
3316101507630002 TAMBAHREJO 2/2 7/15/63 59.0
3316101404790003 TAMBAHREJO 1/2 4/14/1979 43.3
3316102903080002 TAMBAHREJO 1/3 3/29/2008 14.3
3316105209580001 TAMBAHREJO 9/12/58 63.9
3316101801150001 TAMBAHREJO 3/2 1/18/2015 7.5
3316107112090001 TAMBAHREJO 1/1 12/31/2009 12.5
3316100911130002 TAMBAHREJIO 4/2 11/9/2013 8.7
3316100807110003 TAMBAHREJO 3/1 7/8/2011 11.0
331610080110001 TAMBAHREJO 3/5 1/8/10 12.5
316105107140001 TAMBAHREJO 4/2 7/11/2014 8.0
3316100307610001 TAMBAHREJO 3/4 7/3/1961 61.1
3316104105600001 TAMBAHREJO 3/1 01/05/1960 62.2
3316104401140002 TAMBAHREJO 1/1 04/01/2014 8.5
3316106407090001 TAMBAHREJO 1/3 24/07/2009 13.0
9171030708770015 TAMBAHREJO 5/1 07/08/1977 45.0
3316104107660269 TAMBAHREJO 4/2 7/1/1966 56.1
3316114201850004 TAMBAHREJO 1/4 02/01/1985 37.6
316112610080002 TAMBAHREJO 1/4 26/10/2008 13.7
3316102009090002 TAMBAHREJO 2/4 20/09/2009 12.8
316106701820003 TAMBAHREJO 3/3 27/01/1982 40.5
3316104107580001 TAMBAHREJO 2/5 7/1/1958 64.1
3316164110820001 TAMBAHREJO 2/5 10/1/82 39.8
3316100107560119 TAMBAHREJO 2/1 7/1/56 66.1
3316100107580184 TAMBAHREJO 1/1 7/1/1958 64.1
3316104504570001 TAMBAHREJO 4/4 4/5/1957 65.3
3316102407070004 TAMBAHREJO 2/3 7/24/07 15.0
3316102506760003 TAMBAHREJO 4/4 6/25/1976 46.1
3316105006150001 TAMBAHREJO 2/2 6/10/15 7.1
3316105508720002 TAMBAHREJO 8/15/1972 49.9
3316101403640001 TAMBAHREJO 1/5 3/14/1964 58.4
3316101801040001 TAMBAHREJO 2/1 1/18/2004 18.5
3307073010090002 TAMBAHREJO 2/1 10/30/2009 12.7
3316100507830002 TAMBAHREJO 4/3 7/5/83 39.0
3316104509610001 TAMBAHREJO 2/4 9/5/1961 60.9
3315135808850003 TAMBAHREJO 4/2 8/18/85 36.9
3316100106950001 TAMBAHREJO 1/1 6/1/1995 27.1
3317020808870001 TAMBAHREJO 4/1 8/8/1987 35.0
3316101808870006 TAMBAHREJO 1/4 8/18/1987 34.9
TAMBAHREJO 1/3 122.6
122.6
122.6
122.6
122.6
122.6
122.6
122.6
122.6
122.6
122.6
122.6
122.6
122.6
122.6
122.6
122.6
122.6
122.6
122.6
122.6
122.6
122.6
122.6
122.6
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122.6
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122.6
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122.6
122.6
122.6
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122.6
122.6
122.6
122.6
122.6
122.6
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122.6
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122.6
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122.6
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122.6
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 DOSIS 1

JENIS VAKSIN NO Batch DOSIS 1 DOSIS 2 DOSIS 3 KETERANG

AN ANA
K

REM
AJA
ASTRA ZENECA CTMAV5141 V FULL DOSIS
PFIZER PAA174601 V

ASTRA ZENECA CTMAV5141 V 1/2 DOSISCORONA

PFIZER PAA174601 V
ASTRA ZENECA CTMAV5141 V 1/2 DOSISCORONA
PFIZER PAA174601 V
ASTRA ZENECA CTMAV5141 V 1/2 DOSISCORONA
CORONA VAC 202109148O V
PFIZER PAA174601 V
ASTRA ZENECA CTMAV5141 V
PFIZER PAA174601 V
PFIZER PAA174601 V
PFIZER PAA174601 V
ASTRA ZENECA CTMAV5141 V
CORONA VAC 202109148O V
ASTRA ZENECA CTMAV5141 V 1/2 DOSISCORONA
ASTRA ZENECA CTMAV5141 V 1/2 DOSISCORONA
CORONA VAC 202109148O V
ASTRA ZENECA CTMAV5141 V 1/2 DOSISCORONA
PFIZER PAA174601 V
ASTRA ZENECA CTMAV5141 V
ASTRA ZENECA CTMAV5141 V CORONA
PFIZER PAA174601 V
PFIZER PAA174601 V
ASTRA ZENECA CTMAV5141 V CORONA
ASTRA ZENECA CTMAV5141 V CORONA
ASTRA ZENECA CTMAV5141 V
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CORONA VAC 202109148O V
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ASTRA ZENECA CTMAV5141 V CORONA
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ASTRA ZENECA CTMAV5141 V
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ASTRA ZENECA CTMAV5141 V CORONA
ASTRA ZENECA CTMAV5141 V
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PFIZER PAA174601 V
PFIZER PAA174601 V
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PFIZER PAA174601 V
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PFIZER PAA174601 V
PFIZER PAA174601 V
PFIZER PAA174601 V
CORONA VAC 202109148O V
ASTRA ZENECA CTMAV5141 V CORONA
ASTRA ZENECA CTMAV5141 V CORONA
PFIZER PAA174601 V
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ASTRA ZENECA CTMAV5141 V
ASTRA ZENECA CTMAV5141 V
ASTRA ZENECA CTMAV5141 V
ASTRA ZENECA CTMAV5141 V CORONA
ASTRA ZENECA CTMAV5141 V CORONA
ASTRA ZENECA CTMAV5141 V
ASTRA ZENECA CTMAV5141 V CORONA
 DOSIS 1 DOSIS 2 DOSIS 3

ANA
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UM YAN LAN BU BILIT REM UM YAN LANS BU BILIT REM UM YANB LAN BUM
UM BLIK SIA MIL AS AJA UM BLIK IA MIL AS AJA UM LIK SIA IL
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