PENDATAAN SASARAN IMUNISASI CAMPAK RUBELLA USIA 5 - 15 TAHUN

Provinsi : Lampung Desa/Kelurahan : Umpu Bhakti

Kabupaten : Way Kanan Nama Sekolah : SDN 01 Umpu Bhakti
Puskemas : UPT Puskesmas Blambangan Umpu

Isilah kolom yang tidak berwarna!

Apakah anak merupakan sasaran Imunisasi Tambahan
Campak Rubella (Ya=1, Tidak = 0)
Apakah anak mendapatkan ORI
Campak Rubela sejak Januari
No. Nama Anak Nama Orang Tua Alamat Tanggal Lahir Umur (tahun) Usia 12 -<15 thn
2022 Usia 5 - <7 thn Usia 7-<12 thn
(Ya =1, Tidak=0) (Ya=1, Tidak=0) (Ya=1, Tidak=0) (bagi 5 Prov.)
(Ya=1, Tidak=0)

1 ABDIEL JUSTIN WIJAYA Tindung Nuryo Utomo Umpu Bhakti 20/06/2015 86 0 0

2 AQILA AYU DEWI SRIKANDI Sutadi Umpu Bhakti 29/05/2015 86 0 0
3 INTAN OLIFIA PUTRI Edi Purwanto Umpu Bhakti 27/05/2015 87 0 0
4 KENZO HISYAM PRATAMA Destriono Umpu Bhakti 29/05/2015 86 0 0
5 MUHAMMAD MAULANA AMINUDIN Damin Gunung Sangkaran 17/08/2015 84 0 0
6 NOVELLA ULVA ANDESYA Sponiando Umpu Bhakti 14/09/2015 83 0 0
7 QEIZEN AL FATIH SETYAWAN Deska Setiawan Umpu Bhakti 27/05/2015 87 0 0
8 RAMDHAN SANUSI Iwan Sanusi Umpu Bhakti 22/06/2015 86 0 0
9 SOFYATI MA'ARIF Sutiyono Umpu Bhakti 05/06/2015 86 0 0
10 ADELIA RATRI PRAMUDITA Pono Prianto Umpu Bhakti 12/05/2015 87 0 0
11 AFRILIO RAZIDAN A. Yadi Susilo Umpu Bhakti 11/04/2015 88 0 0
12 AHMAD MABRUR AL MUZAKI SYARIFUDIN Syarifudin Umpu Bhakti 18/09/2014 95 0 0
13 ANAIKA AUDI RUDKAN Rudi Aryanto Umpu Bhakti 20/03/2015 89 0 0
14 ANISTYA SEPTIYANI Ahmad Wahyudi Umpu Bhakti 18/09/2014 95 0 0
15 ASKA PRASETIA EFENDI Yuli Efendi Umpu Bhakti 29/12/2014 91 0 0
16 CESI MUTIARA Jupri Yanto Gunung Sangkaran 22/01/2015 91 0 0
17 DESTIAS PUDRIGA REVILA NANDA Mahfudi Umpu Bhakti 08/12/2014 92 0 0
18 FAQIH KHAIRY HADINOTO Tukijo Hadinoto Umpu Bhakti 14/01/2015 91 0 0
19 HESTY Heriyadi Gunung Sangkaran 17/12/2014 92 0 0
20 JOSTAN ANDIKA SURATNO Suratno Umpu Bhakti 20/04/2015 88 0 0
21 KEVIN FERDIANSYAH Budi Utomo Umpu Bhakti 02/05/2015 87 0 0
22 KINARA ANINDYA AZAHRA Sutrisno Umpu Bhakti 08/03/2015 89 0 0
23 MUHAMMAD ZIDAN ALFARIZI Sunaryo Umpu Bhakti 03/03/2015 89 0 0
24 NAUFAL DAFFA PRANAJA Hendri Efendi Umpu Bhakti 17/05/2015 87 0 0
25 NINGRUM WIDIA Mujimin Umpu Bhakti 08/08/2014 96 0 0
26 NUA LANGIT JHORA ILMA OZORA Jhoni Yahya Jl. Ibrahim Haji 10/07/2014 97 0 0
27 REVA ANHARA KIRANA Slamet Umpu Bhakti 22/12/2014 92 0 0
28 RIFKHY PANDU PRANATA Mediyanto Umpu Bhakti 21/08/2014 96 0 0
29 SULIS SUSILAWATI Setiyono Umpu Bhakti 05/09/2014 95 0 0
30 TALITA HASNA HUMAIRA Solihin Umpu Bhakti 17/10/2014 94 0 0
31 ABDIATUN HANIFAH RHANESTI Irawan Putra Bhakti 14/07/2014 97 0 0
32 NADIA ULYA ARRIZKY Sumadi Umpu Bhakti 09/08/2014 96 0 0
33 DZAKIRA TALITA ZAHRA Suroso Umpu Bhakti 22/07/2014 97 0 0
34 REGA PRABOWO Roni Gunung Sangkaran 03/06/2014 98 0 0
35 REGINA PARWATI Roni Gunung Sangkaran 03/06/2014 98 0 0
36 ADITIYA PURYA PRATAMA Yatiman Umpu Bhakti 29/04/2014 100 0 0
37 AFIKA OLIV SALSABILA Edi Waluyo Umpu Bhakti 25/02/2014 102 0 0
38 ANGGA PRASETYA ZAILANI Erpan Zailani Umpu Bhakti 05/04/2014 100 0 0
39 YUDHA ATMAJA PASETYA Sel Widodo Umpu Bhakti 13/04/2014 100 0 0
40 AFRELIA ERNA SUSANTI Ali Husin Gunung Sangkaran 07/04/2014 100 0 0
41 AGUS RAMAYASA Sutrisno Umpu Bhakti 09/08/2013 108 0 0
42 AKHDAN BUDI YUDHISTIRA Budi Setianto Guntur 14/12/2013 104 0 0
43 AL AYUB MANDALA Amirul Mukminin Karya Bakti 05/02/2014 102 0 0
44 ALDI DWI ANGGARA Ansori Gunung Sangkaran 17/11/2013 105 0 0
45 ASSYIFA IZZATUNNISA Yanbastinal Guntur 30/12/2013 104 0 0
46 GISELLIA AZ-ZAHRA Suyoto Mayjend Ryacudu 28/07/2013 109 0 0
47 KHALISA ISNANI FAQIHA Mad Sobirin, S.A.N Putra Bhakti 11/10/2013 106 0 0
48 LIDIYA SAFIRA Hairul Gunung Sangkaran 09/05/2014 99 0 0
49 MARVIN PUTRA JUANDA Eka Juanda Umpu Bhakti 01/09/2013 108 0 0
50 MUHAMMAD YAASIR RAMADHAN Hermansyah Umpu Bhakti 23/07/2013 109 0 0
51 OLIF AFIFA AZAHRA Muksin Way Kanan 07/05/2014 99 0 0
52 RENATA SYAFIQAH MEHA Yudi Hasan Umpu Bhakti 06/12/2013 104 0 0
53 THERA SEPTIA NIRMALA Supriono Umpu Bhakti 05/09/2013 107 0 0
54 ALFARO HUZAIRI BAKTI Mudiono Umpu Bhakti 06/12/2013 104 0 0
55 AZKA ALDRIC VIRMANDA Suparman Umpu Bhakti 07/11/2013 105 0 0
56 DERA OLIVIA Mukromin Jl. 12/12/2013 104 0 0
57 EL NAVITA EVELIN Eko Yulianto Umpu Kencana 21/11/2013 105 0 0
58 KELPIN Iskandar Gunung Sangkaran 08/05/2014 99 0 0
59 KENZO FEBRIANTO Uut Sugianto Umpu Kencana 20/02/2014 102 0 0
60 PUTRA PRATAMA Subagio Umpu Bhakti 29/04/2014 100 0 0
61 RAFI ABDUL ZUFAR Agus Dwi Antoro Umpu Bhakti 29/11/2013 105 0 0
62 RIZQIANSYAH PERMADI Permadi Umpu Bhakti 07/10/2013 106 0 0
63 SONIA ANGGRAINI Aripin Umpu Bhakti 21/07/2013 109 0 0
64 VHINA ULAN DARI Ersan Gunung Sangkaran 13/07/2013 109 0 0
65 YEZI PUTRIMA Subihi Gunung Sangkaran 05/04/2014 100 0 0
66 CHIKA WULANDARI Riyan Widianto Jl. 28/06/2013 110 0 0
67 ERA WATI Anton Budiman Gunung Sangkaran 08/06/2013 110 0 0
68 QAIREEN RAMADHANI CARDIANSYAH Cardiansyah Jl. 17/07/2013 109 0 0
69 ADLI BAGAS FADILAH Agus Suryadi Umpu Bhakti 15/06/2013 110 0 0
70 AL-HAVID CANDREAN Candra Jl. 12/06/2013 110 0 0
71 AQILA FANESA Hhhhhhhhhhhhh Gunung Sangkaran 25/06/2013 110 0 0
72 ZAKY RIDWAN SETIAWAN Pajar Setiawan Rambutan 24/05/2013 111 0 0
73 KEYLA AZURA ANDIVA Andi Saputra Wijaya,S.Pd Umpu Bhakti 30/04/2013 112 0 0
74 MUHAMMDAH FAQIH KHOIRUL AZAM Musiban Umpu Bhakti 21/01/2013 115 0 0
75 SILVIA MARTASELA Atam Umpu Bhakti 07/03/2013 114 0 0
76 YESI NUR AMELIA Iwan Sanusi Umpu Bhakti 05/12/2012 117 0 0
77 MAYHESHYA RIZKY PRATAMA Lis Wantoro Kampung Bhakti Negara 13/05/2013 111 0 0
78 ALIFIO KING HERWANSYAH Dodi Herwansyah Jl. Umpu Bhakti 02/05/2013 112 0 0
79 ALVERO HEAVI PRAMUDYA Heriyanto Umpu Bhakti 18/07/2012 121 0 0
80 ANAN TRISTYO Daryanto Putra Bhakti 30/08/2012 120 0 0
81 ATHIFA INDAH SYAFITRI Edi Mulyono Umpu Bhakti 07/09/2012 120 0 0
82 DIAH AYU MULYA SARI Muliman Jl. 27/03/2013 113 0 0
83 DZAKI FAKHRIZAL Abu Rizal Setiawan - 28/02/2013 114 0 0
84 ERLANGGA ANTONIAGA Anton Setia Negara 02/05/2013 112 0 0
85 KHANZA AULIYA TRIBUANA NINGRUM Triyono Putra Bhakti 17/10/2012 118 0 0
86 MUHAMAD ROBITUL HASAN Sumantri Umpu Bhakti 12/09/2012 119 0 0
87 ROLAN NASTION Marsasi Jl. 14/03/2013 113 0 0
88 SALSABILA April Hasanudin Gunung Sangkaran 20/10/2012 118 0 0
89 TIRTA ADITYA Rudi Hernando Gunung Sangkaran 04/10/2012 119 0 0
90 WINARSIH Chandra Ariyadi Jl. Bambu Kuning 23/02/2013 114 0 0
91 ZAHRANA ANINDITA WIGUNA PUTRI Irwantoni Jl. 12/09/2012 119 0 0
92 AKBAR BISRI MUSTOFA Heri Sagita Umpu Bhakti 24/02/2013 114 0 0
93 AMIRA Ddddddd Gunung Sangkaran 01/08/2012 121 0 0
94 BAGUS WIJAYA Sardi Jl. 22/09/2012 119 0 0
95 DESCHA ALENSYA Andosi Saputra Gunung Sangkaran 21/09/2012 119 0 0
96 DIKA AFRIZA Bbbbbbbbbbb Gunung Sangkaran 12/12/2012 116 0 0
97 M. RAEHAN PRATAMA M Burhan - 04/03/2013 114 0 0
98 MUHAMMAD IQBAL NURFALAH Takin Kurniawan Jl. 05/05/2013 112 0 0
99 MUHAMMAD RIZIQ AZHABUR RASSY Ri Tantri Setia Nopriyadi Jl. 15/05/2013 111 0 0
100 PUTRI SABILLA HURI Daman Huri Umpu Bhakti 18/02/2013 114 0 0
101 RAFI JASIKA Ismail Gunung Sangkaran 27/01/2013 115 0 0
102 BRAYEN FAARIS SUDIRMAN Masrul Saputra Guntur Bhakti 13/09/2012 119 0 0
103 FARIZZA ALVIRA MAHARATU Robani Jl. Guntur 07/07/2012 122 0 0
104 ILHAM AKBAR MARIMANSYAH Marimansyah Umpu Bhakti 24/06/2012 122 0 0
105 MARISA SELVIA Jupriyanto Dusun Putra Bhakti 08/09/2012 120 0 0
106 SEKAR RANESTI Irawan Umpu Bhkti 24/05/2012 123 0 0
107 SINTA WILY ANJANI Sarkam Umpu Bhakti 31/05/2012 123 0 0
108 ZASKYA GENDES SUSANTI Marjoko Jl.Umpu Bhakti 26/07/2012 121 0 0
109 ICA OKTAVIA Jefriyadi Umpu Bhakti 16/10/2011 130 0 0
110 MEYSA AYU ANGGRAINI Rekian Umpu Bhakti 02/05/2012 124 0 0
111 PUTRI Chandra Ariyadi Jl. Bambu Kuning 21/04/2012 124 0 0
112 PUTRA ANOM Ccccccccccccc Umpu Bhakti 20/03/2012 125 0 0
113 RIO APRIANSYAH Umpu Bhakti 24/04/2012 124 0 0
114 ABDUL FATIR HADYNOTO Tukijo Hadinoto Umpu Bhakti 24/11/2011 129 0 0
115 AFIF LUQMAN NAJIB A. Sipin Umpu Bhakti 04/10/2011 131 0 0
116 AIDAN PRANAJA IRAWAN Doni Irawan Umpu Bhakti 30/03/2012 125 0 0
117 AL MUKTI ROSID BAGAS PADANTIA Budiyanto Jalan Mulya Bhakti 12/06/2011 135 0 0
118 ALDI WIRANATA Turno Jl. Guntur 06/12/2011 129 0 0
119 ALYA RATNA MAYA Hadi Jambul Umpu Bhakti 05/01/2012 128 0 0
120 ANANDA FUDZAN FEBRIANSYAH Mahfudi Umpu Bhakti 25/02/2012 126 0 0
121 AQILA ZAHRA IKLIL FATISHA Ahmad Muhlisin Umpu Bhakti 31/03/2012 125 0 0
122 ARINA IZZATAL ILMA Mad Sobirin Umpu Bhakti 09/02/2012 127 0 0
123 FATHUR ROJIY Bambang Irawan Umpu Bhakti 22/03/2012 125 0 0
124 GEBRELLA ELIYANA Sulaiman Gunung Sangkaran 27/03/2012 125 0 0
125 M-AL-ZAKI PERTAMA Achmad Zuli Guntur Bhakti 11/11/2011 130 0 0
126 NAJWA AYU PUTRI LARAS WATI Sutadi Umpu Bhakti 01/12/2011 129 0 0
127 NAZZALA THREEGIRL ZILVYLIA Osep Umpu Bhakti 28/02/2012 126 0 0
128 NOVELLA SELIYANE Slamet Santoso Umpu Bhakti 13/11/2011 130 0 0
129 PANDU ADITIYA PRATAMA Junaidi Umpu Bhakti 29/12/2011 128 0 0
130 PANDU WINATA Miswan Umpu Bhakti 04/04/2012 125 0 0
131 RHEYGA BELL FABREGAS Rindra Permana Jl.Umpu Bhakti 01/03/2012 126 0 0
132 RIZQI DEPRIYANSAH Herwanto Putra Bhakti 10/03/2012 126 0 0
133 SATRIA SAPUTRA Hanapi Putra Bhakti 29/11/2011 129 0 0
134 SILVA QALILA RISTA SARI Suyatno Umpu Bhakti 19/09/2011 131 0 0
135 WIDYA CAHYA AULLIA Wiji Kurniawan Umpu Bhakti 12/01/2012 128 0 0
136 ADELIA ANGGRAENI NIFA Agus Setiawan Umpu Bhakti 21/05/2011 135 0 0
137 AL FATAN AZZAKI Mamat Jl. Palapa Iii No. 04 02/07/2011 134 0 0
138 ANITA SABRINA Satimun Umpu Bhakti 31/05/2011 135 0 0
139 KALI YANATANTRI Jamhir Gunung Sangkaran 08/09/2011 132 0 0
140 MAYLA HANNA OKTARIMA Daryanto Putra Bhaktii 25/05/2011 135 0 0
141 NAZWA ASYYIFA LATIF Budi Purwanto Abdi Negara 01/09/2011 132 0 0
142 QEIZA SETYAWITAMA AL FALIQ Deska Setiawan Umpu Bhakti 05/02/2012 127 0 0
143 REVA RISQI DWI PUTRI Yatimin Umpu Bhakti 28/05/2011 135 0 0
144 TAHTA CHAYANI PUTRI Sartijo Umpu Bhakti 03/09/2011 132 0 0
145 WAVIKA CINDY AULIA Yoyok Pristianto Umpu Bhakti 12/06/2011 135 0 0
146 GITA SIFANIA AZAHRA Ahmad Suja'i Umpu Bhakti 09/04/2011 137 0 0
147 AINUN SUZANNE Herman Rejo Agung 28/09/2010 143 0 0
148 ALVIN HAFIS SETIAWAN Iwan Setiawan Umpu Bhakti 22/10/2010 142 0 0
149 ANISA RAHMAWATI Endro Siswanto Umpu Bhakti 11/12/2010 141 0 0
150 AZKA BENZEMA NASIDIK Didik Irawan Umpu Bhakti 01/02/2011 139 0 0
151 BIMA SUKMA WIBOWO Eko Sumawibowo Umpu Bhakti 17/04/2011 137 0 0
152 CELVIN MAULANA ZAKY Dedi Heriyanto Umpu Bhakti 28/02/2011 138 0 0
153 DHONI PRATAMA Winardi Umpu Bhakti 30/11/2010 141 0 0
154 DIANA WULAN DARI Junaidi Umpu Bhakti 28/01/2011 139 0 0
155 ELOVIA ZALLICA AIGISTA Eko Yulianto Umpu Kencana 14/08/2010 145 0 0
156 IBNU FAUZAN PRATAMA Suryono Umpu Bhakti 20/03/2011 137 0 0
157 MUHAMAD RAFLI ANUGRAH PRATAMA Sugiono Umpu Bhakti 03/05/2011 136 0 0
158 MUHAMMAD LUBABUL MUBAHISIN Ali Ma'sum Umpu Bhakti 12/04/2011 137 0 0
159 MUHAMMAD PANDU APRILIO Akhlaludin Umpu Bhakti 21/04/2011 136 0 0
160 MUHAMMAD RIZIK SIHAB Slamet Umpu Bhakti 18/09/2010 144 0 0
161 NAJWA SALSABILLA Sutarmin Umpu Bhakti 14/05/2011 136 0 0
162 RIA LUT FIYANAH Wiyono Umpu Bhakti 08/01/2011 140 0 0
163 RIYO RESKI ALFATLI Hamdani Gunung Sangkaran 16/04/2011 137 0 0
164 TIARA AFITASARI Ali Sodikin Umpu Bhakti 10/02/2011 139 0 0
165 WULAN RATNA DEWI Sudarmaji Pematang Sari 27/03/2011 137 0 0
166 ALANDIKA PRATAMA HUDA Aprizal Km. 2 Blambangan Umpu 14/10/2010 143 0 0
167 ALIFA ZAURA Agus Triono Umpu Bhakti 29/09/2010 143 0 0
168 ARSINTA NURUL AINI Edi Purwanto Mulya Bhakti 09/12/2010 141 0 0
169 ATHIFA THEONA SEPTIA Dadang Setiyawan Umpu Bhakti 20/08/2010 145 0 0
170 CAHYA AYU PUSPITASARI Guntur Syaifullah Komplek Ptpn Vii 17/02/2011 139 0 0
171 MUHAMAD RIZKI ISTAZQIA ROMADHONI Purwadi Umpu Bhakti 24/08/2010 144 0 0
172 MUHAMMAD RANGGA ADITYA TAMA Suraji Prabowo Umpu Bhakti 10/08/2010 145 0 0
173 SATRIA WIRA WICAKSANA Sigit Mardianto Umpu Bhakti 18/11/2010 142 0 0
174 ZAHRA KOMARIA Amarudin Umpu Bhakti 01/12/2010 141 0 0

TOTAL 0 0 0 0
TOTAL VIAL VAKSIN (Jumlah Vial = Jumlah Total Sasaran/IP Vaksin) 0
 Format Tanggal
Contoh :11/12/1998
 PENDATAAN SASARAN IMUNISASI CAMPAK RUBELLA USIA 5 - 15 TAHUN

Provinsi : Lampung Desa/Kelurahan : Umpu Bhakti

Kabupaten : Way Kanan Nama Sekolah : SDN 01 Umpu Bhakti
Puskemas : UPT Puskesmas Blambangan Umpu

Isilah kolom yang tidak berwarna!

Apakah anak merupakan sasaran Imunisasi Tambahan
Campak Rubella (Ya=1, Tidak = 0)
Apakah anak mendapatkan ORI
Campak Rubela sejak Januari
No. Nama Anak Nama Orang Tua Alamat Tanggal Lahir Umur (tahun) Usia 12 -<15 thn
2022 Usia 5 - <7 thn Usia 7-<12 thn
(Ya =1, Tidak=0) (Ya=1, Tidak=0) (Ya=1, Tidak=0) (bagi 5 Prov.)
(Ya=1, Tidak=0)

1 ABDIEL JUSTIN WIJAYA Tindung Nuryo Utomo Umpu Bhakti 20/06/2015 86 0 0

2 AQILA AYU DEWI SRIKANDI Sutadi Umpu Bhakti 29/05/2015 86 0 0
3 INTAN OLIFIA PUTRI Edi Purwanto Umpu Bhakti 27/05/2015 87 0 0
4 KENZO HISYAM PRATAMA Destriono Umpu Bhakti 29/05/2015 86 0 0
5 MUHAMMAD MAULANA AMINUDIN Damin Gunung Sangkaran 17/08/2015 84 0 0
6 NOVELLA ULVA ANDESYA Sponiando Umpu Bhakti 14/09/2015 83 0 0
7 QEIZEN AL FATIH SETYAWAN Deska Setiawan Umpu Bhakti 27/05/2015 87 0 0
8 RAMDHAN SANUSI Iwan Sanusi Umpu Bhakti 22/06/2015 86 0 0
9 SOFYATI MA'ARIF Sutiyono Umpu Bhakti 05/06/2015 86 0 0
10 ADELIA RATRI PRAMUDITA Pono Prianto Umpu Bhakti 12/05/2015 87 0 0
11 AFRILIO RAZIDAN A. Yadi Susilo Umpu Bhakti 11/04/2015 88 0 0
12 AHMAD MABRUR AL MUZAKI SYARIFUDIN Syarifudin Umpu Bhakti 18/09/2014 95 0 0
13 ANAIKA AUDI RUDKAN Rudi Aryanto Umpu Bhakti 20/03/2015 89 0 0
14 ANISTYA SEPTIYANI Ahmad Wahyudi Umpu Bhakti 18/09/2014 95 0 0
15 ASKA PRASETIA EFENDI Yuli Efendi Umpu Bhakti 29/12/2014 91 0 0
16 CESI MUTIARA Jupri Yanto Gunung Sangkaran 22/01/2015 91 0 0
17 DESTIAS PUDRIGA REVILA NANDA Mahfudi Umpu Bhakti 08/12/2014 92 0 0
18 FAQIH KHAIRY HADINOTO Tukijo Hadinoto Umpu Bhakti 14/01/2015 91 0 0
19 HESTY Heriyadi Gunung Sangkaran 17/12/2014 92 0 0
20 JOSTAN ANDIKA SURATNO Suratno Umpu Bhakti 20/04/2015 88 0 0
21 KEVIN FERDIANSYAH Budi Utomo Umpu Bhakti 02/05/2015 87 0 0
22 KINARA ANINDYA AZAHRA Sutrisno Umpu Bhakti 08/03/2015 89 0 0
23 MUHAMMAD ZIDAN ALFARIZI Sunaryo Umpu Bhakti 03/03/2015 89 0 0
24 NAUFAL DAFFA PRANAJA Hendri Efendi Umpu Bhakti 17/05/2015 87 0 0
25 NINGRUM WIDIA Mujimin Umpu Bhakti 08/08/2014 96 0 0
26 NUA LANGIT JHORA ILMA OZORA Jhoni Yahya Jl. Ibrahim Haji 10/07/2014 97 0 0
27 REVA ANHARA KIRANA Slamet Umpu Bhakti 22/12/2014 92 0 0
28 RIFKHY PANDU PRANATA Mediyanto Umpu Bhakti 21/08/2014 96 0 0
29 SULIS SUSILAWATI Setiyono Umpu Bhakti 05/09/2014 95 0 0
30 TALITA HASNA HUMAIRA Solihin Umpu Bhakti 17/10/2014 94 0 0
31 ABDIATUN HANIFAH RHANESTI Irawan Putra Bhakti 14/07/2014 97 0 0
32 NADIA ULYA ARRIZKY Sumadi Umpu Bhakti 09/08/2014 96 0 0
33 DZAKIRA TALITA ZAHRA Suroso Umpu Bhakti 22/07/2014 97 0 0
34 REGA PRABOWO Roni Gunung Sangkaran 03/06/2014 98 0 0
35 REGINA PARWATI Roni Gunung Sangkaran 03/06/2014 98 0 0
36 ADITIYA PURYA PRATAMA Yatiman Umpu Bhakti 29/04/2014 100 0 0
37 AFIKA OLIV SALSABILA Edi Waluyo Umpu Bhakti 25/02/2014 102 0 0
38 ANGGA PRASETYA ZAILANI Erpan Zailani Umpu Bhakti 05/04/2014 100 0 0
39 YUDHA ATMAJA PASETYA Sel Widodo Umpu Bhakti 13/04/2014 100 0 0
40 AFRELIA ERNA SUSANTI Ali Husin Gunung Sangkaran 07/04/2014 100 0 0
41 AGUS RAMAYASA Sutrisno Umpu Bhakti 09/08/2013 108 0 0
42 AKHDAN BUDI YUDHISTIRA Budi Setianto Guntur 14/12/2013 104 0 0
43 AL AYUB MANDALA Amirul Mukminin Karya Bakti 05/02/2014 102 0 0
44 ALDI DWI ANGGARA Ansori Gunung Sangkaran 17/11/2013 105 0 0
45 ASSYIFA IZZATUNNISA Yanbastinal Guntur 30/12/2013 104 0 0
46 GISELLIA AZ-ZAHRA Suyoto Mayjend Ryacudu 28/07/2013 109 0 0
47 KHALISA ISNANI FAQIHA Mad Sobirin, S.A.N Putra Bhakti 11/10/2013 106 0 0
48 LIDIYA SAFIRA Hairul Gunung Sangkaran 09/05/2014 99 0 0
49 MARVIN PUTRA JUANDA Eka Juanda Umpu Bhakti 01/09/2013 108 0 0
50 MUHAMMAD YAASIR RAMADHAN Hermansyah Umpu Bhakti 23/07/2013 109 0 0
51 OLIF AFIFA AZAHRA Muksin Way Kanan 07/05/2014 99 0 0
52 RENATA SYAFIQAH MEHA Yudi Hasan Umpu Bhakti 06/12/2013 104 0 0
53 THERA SEPTIA NIRMALA Supriono Umpu Bhakti 05/09/2013 107 0 0
54 ALFARO HUZAIRI BAKTI Mudiono Umpu Bhakti 06/12/2013 104 0 0
55 AZKA ALDRIC VIRMANDA Suparman Umpu Bhakti 07/11/2013 105 0 0
56 DERA OLIVIA Mukromin Jl. 12/12/2013 104 0 0
57 EL NAVITA EVELIN Eko Yulianto Umpu Kencana 21/11/2013 105 0 0
58 KELPIN Iskandar Gunung Sangkaran 08/05/2014 99 0 0
59 KENZO FEBRIANTO Uut Sugianto Umpu Kencana 20/02/2014 102 0 0
60 PUTRA PRATAMA Subagio Umpu Bhakti 29/04/2014 100 0 0
61 RAFI ABDUL ZUFAR Agus Dwi Antoro Umpu Bhakti 29/11/2013 105 0 0
62 RIZQIANSYAH PERMADI Permadi Umpu Bhakti 07/10/2013 106 0 0
63 SONIA ANGGRAINI Aripin Umpu Bhakti 21/07/2013 109 0 0
64 VHINA ULAN DARI Ersan Gunung Sangkaran 13/07/2013 109 0 0
65 YEZI PUTRIMA Subihi Gunung Sangkaran 05/04/2014 100 0 0
66 CHIKA WULANDARI Riyan Widianto Jl. 28/06/2013 110 0 0
67 ERA WATI Anton Budiman Gunung Sangkaran 08/06/2013 110 0 0
68 QAIREEN RAMADHANI CARDIANSYAH Cardiansyah Jl. 17/07/2013 109 0 0
69 ADLI BAGAS FADILAH Agus Suryadi Umpu Bhakti 15/06/2013 110 0 0
70 AL-HAVID CANDREAN Candra Jl. 12/06/2013 110 0 0
71 AQILA FANESA Hhhhhhhhhhhhh Gunung Sangkaran 25/06/2013 110 0 0
72 ZAKY RIDWAN SETIAWAN Pajar Setiawan Rambutan 24/05/2013 111 0 0
73 KEYLA AZURA ANDIVA Andi Saputra Wijaya,S.Pd Umpu Bhakti 30/04/2013 112 0 0
74 MUHAMMDAH FAQIH KHOIRUL AZAM Musiban Umpu Bhakti 21/01/2013 115 0 0
75 SILVIA MARTASELA Atam Umpu Bhakti 07/03/2013 114 0 0
76 YESI NUR AMELIA Iwan Sanusi Umpu Bhakti 05/12/2012 117 0 0
77 MAYHESHYA RIZKY PRATAMA Lis Wantoro Kampung Bhakti Negara 13/05/2013 111 0 0
78 ALIFIO KING HERWANSYAH Dodi Herwansyah Jl. Umpu Bhakti 02/05/2013 112 0 0
79 ALVERO HEAVI PRAMUDYA Heriyanto Umpu Bhakti 18/07/2012 121 0 0
80 ANAN TRISTYO Daryanto Putra Bhakti 30/08/2012 120 0 0
81 ATHIFA INDAH SYAFITRI Edi Mulyono Umpu Bhakti 07/09/2012 120 0 0
82 DIAH AYU MULYA SARI Muliman Jl. 27/03/2013 113 0 0
83 DZAKI FAKHRIZAL Abu Rizal Setiawan - 28/02/2013 114 0 0
84 ERLANGGA ANTONIAGA Anton Setia Negara 02/05/2013 112 0 0
85 KHANZA AULIYA TRIBUANA NINGRUM Triyono Putra Bhakti 17/10/2012 118 0 0
86 MUHAMAD ROBITUL HASAN Sumantri Umpu Bhakti 12/09/2012 119 0 0
87 ROLAN NASTION Marsasi Jl. 14/03/2013 113 0 0
88 SALSABILA April Hasanudin Gunung Sangkaran 20/10/2012 118 0 0
89 TIRTA ADITYA Rudi Hernando Gunung Sangkaran 04/10/2012 119 0 0
90 WINARSIH Chandra Ariyadi Jl. Bambu Kuning 23/02/2013 114 0 0
91 ZAHRANA ANINDITA WIGUNA PUTRI Irwantoni Jl. 12/09/2012 119 0 0
92 AKBAR BISRI MUSTOFA Heri Sagita Umpu Bhakti 24/02/2013 114 0 0
93 AMIRA Ddddddd Gunung Sangkaran 01/08/2012 121 0 0
94 BAGUS WIJAYA Sardi Jl. 22/09/2012 119 0 0
95 DESCHA ALENSYA Andosi Saputra Gunung Sangkaran 21/09/2012 119 0 0
96 DIKA AFRIZA Bbbbbbbbbbb Gunung Sangkaran 12/12/2012 116 0 0
97 M. RAEHAN PRATAMA M Burhan - 04/03/2013 114 0 0
98 MUHAMMAD IQBAL NURFALAH Takin Kurniawan Jl. 05/05/2013 112 0 0
99 MUHAMMAD RIZIQ AZHABUR RASSY Ri Tantri Setia Nopriyadi Jl. 15/05/2013 111 0 0
100 PUTRI SABILLA HURI Daman Huri Umpu Bhakti 18/02/2013 114 0 0
101 RAFI JASIKA Ismail Gunung Sangkaran 27/01/2013 115 0 0
102 BRAYEN FAARIS SUDIRMAN Masrul Saputra Guntur Bhakti 13/09/2012 119 0 0
103 FARIZZA ALVIRA MAHARATU Robani Jl. Guntur 07/07/2012 122 0 0
104 ILHAM AKBAR MARIMANSYAH Marimansyah Umpu Bhakti 24/06/2012 122 0 0
105 MARISA SELVIA Jupriyanto Dusun Putra Bhakti 08/09/2012 120 0 0
106 SEKAR RANESTI Irawan Umpu Bhkti 24/05/2012 123 0 0
107 SINTA WILY ANJANI Sarkam Umpu Bhakti 31/05/2012 123 0 0
108 ZASKYA GENDES SUSANTI Marjoko Jl.Umpu Bhakti 26/07/2012 121 0 0
109 ICA OKTAVIA Jefriyadi Umpu Bhakti 16/10/2011 130 0 0
110 MEYSA AYU ANGGRAINI Rekian Umpu Bhakti 02/05/2012 124 0 0
111 PUTRI Chandra Ariyadi Jl. Bambu Kuning 21/04/2012 124 0 0
112 PUTRA ANOM Ccccccccccccc Umpu Bhakti 20/03/2012 125 0 0
113 RIO APRIANSYAH Umpu Bhakti 24/04/2012 124 0 0
114 ABDUL FATIR HADYNOTO Tukijo Hadinoto Umpu Bhakti 24/11/2011 129 0 0
115 AFIF LUQMAN NAJIB A. Sipin Umpu Bhakti 04/10/2011 131 0 0
116 AIDAN PRANAJA IRAWAN Doni Irawan Umpu Bhakti 30/03/2012 125 0 0
117 AL MUKTI ROSID BAGAS PADANTIA Budiyanto Jalan Mulya Bhakti 12/06/2011 135 0 0
118 ALDI WIRANATA Turno Jl. Guntur 06/12/2011 129 0 0
119 ALYA RATNA MAYA Hadi Jambul Umpu Bhakti 05/01/2012 128 0 0
120 ANANDA FUDZAN FEBRIANSYAH Mahfudi Umpu Bhakti 25/02/2012 126 0 0
121 AQILA ZAHRA IKLIL FATISHA Ahmad Muhlisin Umpu Bhakti 31/03/2012 125 0 0
122 ARINA IZZATAL ILMA Mad Sobirin Umpu Bhakti 09/02/2012 127 0 0
123 FATHUR ROJIY Bambang Irawan Umpu Bhakti 22/03/2012 125 0 0
124 GEBRELLA ELIYANA Sulaiman Gunung Sangkaran 27/03/2012 125 0 0
125 M-AL-ZAKI PERTAMA Achmad Zuli Guntur Bhakti 11/11/2011 130 0 0
126 NAJWA AYU PUTRI LARAS WATI Sutadi Umpu Bhakti 01/12/2011 129 0 0
127 NAZZALA THREEGIRL ZILVYLIA Osep Umpu Bhakti 28/02/2012 126 0 0
128 NOVELLA SELIYANE Slamet Santoso Umpu Bhakti 13/11/2011 130 0 0
129 PANDU ADITIYA PRATAMA Junaidi Umpu Bhakti 29/12/2011 128 0 0
130 PANDU WINATA Miswan Umpu Bhakti 04/04/2012 125 0 0
131 RHEYGA BELL FABREGAS Rindra Permana Jl.Umpu Bhakti 01/03/2012 126 0 0
132 RIZQI DEPRIYANSAH Herwanto Putra Bhakti 10/03/2012 126 0 0
133 SATRIA SAPUTRA Hanapi Putra Bhakti 29/11/2011 129 0 0
134 SILVA QALILA RISTA SARI Suyatno Umpu Bhakti 19/09/2011 131 0 0
135 WIDYA CAHYA AULLIA Wiji Kurniawan Umpu Bhakti 12/01/2012 128 0 0
136 ADELIA ANGGRAENI NIFA Agus Setiawan Umpu Bhakti 21/05/2011 135 0 0
137 AL FATAN AZZAKI Mamat Jl. Palapa Iii No. 04 02/07/2011 134 0 0
138 ANITA SABRINA Satimun Umpu Bhakti 31/05/2011 135 0 0
139 KALI YANATANTRI Jamhir Gunung Sangkaran 08/09/2011 132 0 0
140 MAYLA HANNA OKTARIMA Daryanto Putra Bhaktii 25/05/2011 135 0 0
141 NAZWA ASYYIFA LATIF Budi Purwanto Abdi Negara 01/09/2011 132 0 0
142 QEIZA SETYAWITAMA AL FALIQ Deska Setiawan Umpu Bhakti 05/02/2012 127 0 0
143 REVA RISQI DWI PUTRI Yatimin Umpu Bhakti 28/05/2011 135 0 0
144 TAHTA CHAYANI PUTRI Sartijo Umpu Bhakti 03/09/2011 132 0 0
145 WAVIKA CINDY AULIA Yoyok Pristianto Umpu Bhakti 12/06/2011 135 0 0
146 GITA SIFANIA AZAHRA Ahmad Suja'i Umpu Bhakti 09/04/2011 137 0 0
147 AINUN SUZANNE Herman Rejo Agung 28/09/2010 143 0 0
148 ALVIN HAFIS SETIAWAN Iwan Setiawan Umpu Bhakti 22/10/2010 142 0 0
149 ANISA RAHMAWATI Endro Siswanto Umpu Bhakti 11/12/2010 141 0 0
150 AZKA BENZEMA NASIDIK Didik Irawan Umpu Bhakti 01/02/2011 139 0 0
151 BIMA SUKMA WIBOWO Eko Sumawibowo Umpu Bhakti 17/04/2011 137 0 0
152 CELVIN MAULANA ZAKY Dedi Heriyanto Umpu Bhakti 28/02/2011 138 0 0
153 DHONI PRATAMA Winardi Umpu Bhakti 30/11/2010 141 0 0
154 DIANA WULAN DARI Junaidi Umpu Bhakti 28/01/2011 139 0 0
155 EKA SERLY REGINA PUTRI Eko Budiyono Umpu Bhakti 13/07/2010 146 0 0
156 ELOVIA ZALLICA AIGISTA Eko Yulianto Umpu Kencana 14/08/2010 145 0 0
157 IBNU FAUZAN PRATAMA Suryono Umpu Bhakti 20/03/2011 137 0 0
158 JUNANDA IBNU TAMAM Suparni Umpu Bhakti 20/06/2010 147 0 0
159 MUHAMAD RAFLI ANUGRAH PRATAMA Sugiono Umpu Bhakti 03/05/2011 136 0 0
160 MUHAMMAD LUBABUL MUBAHISIN Ali Ma'sum Umpu Bhakti 12/04/2011 137 0 0
161 MUHAMMAD PANDU APRILIO Akhlaludin Umpu Bhakti 21/04/2011 136 0 0
162 MUHAMMAD RIZIK SIHAB Slamet Umpu Bhakti 18/09/2010 144 0 0
163 NAJWA SALSABILLA Sutarmin Umpu Bhakti 14/05/2011 136 0 0
164 RIA LUT FIYANAH Wiyono Umpu Bhakti 08/01/2011 140 0 0
165 RIYO RESKI ALFATLI Hamdani Gunung Sangkaran 16/04/2011 137 0 0
166 TIARA AFITASARI Ali Sodikin Umpu Bhakti 10/02/2011 139 0 0
167 WULAN RATNA DEWI Sudarmaji Pematang Sari 27/03/2011 137 0 0
168 AHMAD WILDAN ALFIYANATA Parman Umpu Bhakti 29/06/2010 146 0 0
169 ALANDIKA PRATAMA HUDA Aprizal Km. 2 Blambangan Umpu 14/10/2010 143 0 0
170 ALIFA ZAURA Agus Triono Umpu Bhakti 29/09/2010 143 0 0
171 ARGA PRASETIO Armin Umpu Bhakti 06/06/2010 147 0 0
172 ARISTA LAILA MASRO Mohammad Qhodari Arifin Umpu Bhakti 02/06/2010 147 0 0
173 ARSINTA NURUL AINI Edi Purwanto Mulya Bhakti 09/12/2010 141 0 0
174 ATHIFA THEONA SEPTIA Dadang Setiyawan Umpu Bhakti 20/08/2010 145 0 0
175 CAHYA AYU PUSPITASARI Guntur Syaifullah Komplek Ptpn Vii 17/02/2011 139 0 0
176 EDI PRASTIO Boidi Umpu Bhakti 25/07/2010 145 0 0
177 HAIKAL MAULANA Kikis Dedi Guntoro Umpu Bhakti 12/06/2010 147 0 0
178 HARIS ARDIAN SYAH Tasar Idhar Umpu Bhakti 26/06/2010 146 0 0
179 MUHAMAD RIZKI ISTAZQIA ROMADHONI Purwadi Umpu Bhakti 24/08/2010 144 0 0
180 MUHAMMAD RANGGA ADITYA TAMA Suraji Prabowo Umpu Bhakti 10/08/2010 145 0 0
181 OCCA JULIYANTI Edik Purnomo Umpu Bhakti 12/07/2010 146 0 0
182 SATRIA WIRA WICAKSANA Sigit Mardianto Umpu Bhakti 18/11/2010 142 0 0
183 ZAHRA KOMARIA Amarudin Umpu Bhakti 01/12/2010 141 0 0
184 PARIKESIT GILANG LANANG TERGINAS Sutadi Umpu Bhakti 26/03/2010 149 0 0
185 ADLY SURYA PRATAMA Nasib Barlean Umpu Bhakti 18/12/2009 153 0 0
186 AJI DWI ANDIKA Asmadi Umpub Bhakti 07/12/2009 153 0 0
187 ALVAN DWI SAPUTRA Junaidi Umpu Bhakti 02/08/2009 157 0 0
188 DIANA OKTAVIANA Dedek Sriyanto Umpu Bhakti 12/10/2009 155 0 0
189 DIANA OKTAVIANI Dedek Sriyanto Umpu Bhakti 12/10/2009 155 0 0
190 EVAN WIRANDA Eka Saputra Umpu Bhakti 07/12/2009 153 0 0
191 FEBRI PRATAMA SUNJA Sponiando Umpu Bhakti 12/02/2010 151 0 0
192 GITA PUSPITA SARI Rismanto Umpu Bhakti 24/09/2009 156 0 0
193 IHSAN AL HAKIM Rasiman Umpu Bhakti 26/02/2010 150 0 0
194 HUSNAH Sardi Jln.Sawo 17/03/2010 150 0 0
195 JESSICA JEAN MAURETHA Jaini Karang Umpu 26/03/2010 149 0 0
196 KELFIN FERDY YANSYAH Muhamad Jalal Sayun Umpu Bhakti 23/03/2010 150 0 0
197 KESIA Sugiono Gunung Sangkaran 14/08/2009 157 0 0
198 LEO AJI SAPUTRA Ignatius Klutuk Yulianto Umpu Bhakti 18/05/2010 148 0 0
199 MARTADINATA ADETYA Mardiono Umpu Bhakti 19/09/2009 156 0 0
200 MEGA PRASETYA PUTRI Sunarto Umpu Bhakti 10/05/2010 148 0 0
201 RIFWA FEBRIANA Muhamad Rifa'i Umpu Bhakti 24/02/2010 150 0 0
202 SILVI ELBI PRATIWI Hanubi Umpu Bhakti 29/04/2010 148 0 0
203 SULTHAN ZAID AR RAIHAN Yahmin Umpu Bhakti 21/04/2010 149 0 0
204 SYAVIRA AVRILIA VIRMANDA Suparman Lintas Sumatera 23/04/2010 149 0 0
205 YUSUF HAFIZ AL GHIFARI Irwantoni Umpu Bhakti 21/12/2009 153 0 0
TOTAL 0 0 0 0
TOTAL VIAL VAKSIN (Jumlah Vial = Jumlah Total Sasaran/IP Vaksin) 0
 Format Tanggal
Contoh :11/12/1998