FORMAT PENDATAAN POSYANDU SASARAN BIAN

SASARAN IMUNISASI TAMBAHAN CAMPAK RUBELA ADALAH 9-59 BULAN DAN SASARAN IMUNISASI KEJAR
PELAKSANAAN : AGUSTUS 2022
Provinsi : JAWA BARAT
Kota : BANDUNG
Puskesmas : PELINDUNG HEWAN
Isilah kolom yang berwarna PUTIH!

Tanggal Lahir
No. Nama Anak Jenis Kelamin (L/ P)

1 VIRZA AFNAN  L  17 Desember 2018

2 KANAKA HAFIZ  L  03 Maret 2018
3 NADIRA KAMELIA  P  03 Juni 2019
4 ADEEFA  P  06 November 2018
5 AKIA ALENA   P  02 Januari 2021
6 ADEVA KIRANA PUTRI  P  06 Oktober 2018
7 HAMZAH KHATIBUL UMAM  L  14 Agustus 2018
8 RIZKI RAMDANI  L  22 Februari 2018
9 AQILA AFRIANTI  P  19 April 2017
10 M ABDUL RASYID  L  27 Mei 2017
11 RIANDI  L  25 Mei 2017
12 RIZVIA FATINA R  P  22 Juni 2017
13 SARVENAS AG  P  10 September 2017
14 AZFAR  L  21 November 2017
15 AZRIL FAUZAN  L  15 Januari 2018
16 AKBAR  L  17 Maret 2018
17 JURAIS ABSYAR  L  01 Mei 2018
18 RASYA PUTRI  P  20 Mei 2018
19 ARSYILA S NABILA  P  13 November 2018
20 KAYSHA LATHIFAH  P  15 November 2018
21 FIRSYA  L  19 November 2018
22 TALITA YUMNA  P  06 Juli 2019
23 SHAQILA KINARA  P  27 Juni 2019
24 NADIRA AZKIYA K  P  25 Agustus 2019
25 M JABBAR ARKANA  L  26 November 2019
26 MAIRA AZKIYA Z  P  26 Juni 2020
27 TITANIA SYAKIRA ANWAR  P  19 Mei 2020
28 RAYA RAIMA LULUK  P  18 Mei 2020
29 ADIVA YASNA UMAIZA  P  16 Mei 2020
30 RASHEED REYNAND  L  07 November 2020
31 CLARISSA DWI AYUNDA  P  15 September 2020
32 RAKA DEWA NANDA  L  11 Februari 2020
33 QUINZHA KANAYA ADIVA  P  29 Juli 2020
34 CHAYRA   P  26 November 2020
35 VIONA RINJANI  P  19 Desember 2020
36 NAURA CALYSTA  P  22 Desember 2019
37 HAGIA HAIDE LUBNA  P  08 September 2020
38 NATTHA
AURORA SAFIRRA 
CLARISSA ELVINA P  22 Agustus 2021
39 ZELINE  P  29 April 2021
40 MOCH. HAFIZ  L  02 Juni 2021
41 RIANA  P  23 Juli 2021
42 CANTIKA AZURA MELODY  P  30 Agustus 2021
43 RAFQA ALFARIZQY  L  01 Agustus 2021
44 ANISA ARDELIA  P  04 Januari 2018
45 SHAKIRA KINARA  P  07 Desember 2017
46 ADZKIYA  P  28 Juli 2018
47 FATIMAH SIDQIA P  P  06 Juni 2020
48 AKSARA ZAYN KAHFI  L  22 Desember 2020
49 AKASYA ZAYNA KAFIAH  P  22 Desember 2020
50 RASYA PUTRA RENALDI  L  01 Juni 2019
51 DARREN DELWYN SUKMANA  L  13 Desember 2019
52 QYANDRA DWI AZZAHRA  P  10 Februari 2019
53 SHANUM DIA SYAKIRA  P  21 Januari 2021
54 HAZEEMA MAUZA ALMASHYRA  P  20 Januari 2021
55 SALSA NABILA KAMALIA  P  17 Januari 2021
56 MUHAMAD ALFIL ALFARIZKI  L  09 Desember 2018
57 DZAKI   L  21 September 2019
58 RAINA ANINDYA PUTRI  P  06 Januari 2021
59 SELLY AGUSTIN  P  13 Agustus 2020
60 SILVIA DZAKIRA  P  29 April 2020
61 ELVANO TEGUH DHANESA  L  26 Mei 2021
62 GHAISAN AL KHAFIF  L  26 Juni 2021
63 FAUZI AHMAD PAMUNGKAS  L  14 Juni 2021
64 AYUNDA
MUHAMMAD SUKMARA PURADI 
VIRENDRA P  26 April 2021
65 DZUHAIRI  L  06 Juli 2021
66 ASLAN ALIRAIS  L  25 Mei 2020
67 AMMAR TAQI P  L  05 Agustus 2020
68 ADEEVA AFSHEEN  P  23 April 2017
69 AHMAD RAMADHAN 
NAURA RIZQIANA AZ P  23 April 2021
70 HAERUNISSA  P  30 November 2021
71 ADAM RAJENDRA  L  13 November 2018
72 ALBIANSYAH YUSUF  L  24 Februari 2022
73
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498
499
500

TOTAL
IP Vaksin:
MR = 8
OPV = 8
IPV = 4
DPT-HB-Hib = 4
Catatan:
Anak yang sudah mendapatkan ORI Campak Rubela, tidak perlu mendapatkan imunisasi tambahan Campak Rubela s
Total kebutuhan vial yang dibutuhkan yang mengacu pada perhitungan baris total vial vaksin
Anak usia 18-24 bulan yang pada saat bersamaan mendapatkan imunisasi rutin (DPT-HB-Hib4 dan Campak rubella 2)
Kebutuhan Vaksin Khusus Campak Rubela = (Total Sasaran - Sudah Mendapatkan ORI Campak Rubela sejak Januar
SASARAN IMUNISASI BIAN:
Imunisasi Kejar : Lahir pada bulan Sept 2017 - bulan Agust 2021
Imunisasi CR : Lahir pada bulan Sept 2017 - bulan Oktober 2021

Kolom Tambahan:
*) Jumlah Dosis Vaksin yang pernah didapat
JENIS KELAMIN
L
P
59 BULAN DAN SASARAN IMUNISASI KEJAR ADALAH 12-59 BULAN
01 Agustus 2022 (Disesuaikan dengan tgl pelaksanaan di masing-masing Posyandu)
Desa/Kelurahan : PELINDUNG HEWAN
Posyandu : 2. Posyandu Cempaka
NG HEWAN

Apakah anak
mendapatkan ORI
NIK Nama Orang Tua (IBU) Alamat Campak Rubela sejak
Januari 2022
(Ya =1, Tidak=0)

3273101712180001   ASEP SUDRAJAT  7 0

3273100303180002   DADAN SUHAERI  7 0
3273104306190004   SANDRA AHMAD H  7
3273105104810006   DADANG  7
3273504201217233   rahmat  7
3273104610180007   DADANG SUTIAWAN  7
3305031408180001   TEGUH KUATNO  7
3273102202180002   7
3273105904170001   WAHIDUN  3
3273102705170001   ASEP RAHMAT KOMARA  3
3278105507850004   USMAN  3
3273106206170002   RAHMAT HIDAYAT  3
3273105009170001   YOSEP  3
3273102111170001   SISWANTO  3
3279031501180002   TUMIRAN  3
3273101703180002   UJANG SOPANDI  3
3273100105180002   ANDI YUSADI  3
3205315704910005   DORI  3
3273105311180001   SOLIHIN  3
327310551180003   AFID SAEPULLOH  3
3273101911190001   ASA SOBIRIN  3
3273104607190002   yenna rizki s  3
3273106706190002   ANGGA HINDUN  3
3273102508190001   WIWIN PONIDI  3
3273102611190001   BANGBANG TETI S  3
3273104606200001   ADIAN N  3
3273105905200001   ahmad khoiril a  3
3273105805200004   ASEP R  3
3273105605200001   saimin  3
3273100711200002   YOSEP  3
3273105509200001   jaenal  3
3273101102200001   sutomo  3
3273106907200001   dindin z  3
3273106611200001   sarwono  3
3273505912203382   yusef syihabudin  3
3273106212190002   ecep irvan  3
3273104809200002   risan oky kristiady  3
3273506208213178   Siswanto/aprianti 
Rudiyanto/Dita anti 3
3273506904212451   sucianti 
Eka permana/ineke indri 3
3273500206212937   puspita sari  3
3217154809960003   Tumiran/Ratnasari  3
3273105708210002   Sidiq/risa  3
3273500108215365   Indra chakra/ismawati  3
3273104401180001   NANA  1
3273034712170001   PUAD HALIM  1
3273106807180001   YAYAN  1
3273134401640003   SYARIF HIDAYAT  1
3273102212200002   irvan emiwan  Pelindung Hewan RT 5
3273106212200004   irvan emiman  Pelindung Hewan RT 5
3273100106200002   ALDI RENALDI  Pelindung Hewan RT 6
3273101312190002   RAMDAN SUKMANA  Pelindung Hewan RT 6
3273105002190001   PAWIT DWI KUSWANTO  Pelindung Hewan RT 6
3273506101214200   DIKI SURYAMAN  Pelindung Hewan RT 5
3273506001212181   JAILANI  Pelindung Hewan RT 4
3273505701218826   nceng kurdi  Pelindung Hewan RT 6
3273060912180004   eman sulaeman  Pelindung Hewan RT 5
3273502109192788   gugun gunawan  Pelindung Hewan RT 5
3273504601218713   aldi renaldi  Pelindung Hewan RT 6
3273505308201181   DADANG  Pelindung Hewan RT 5
3273106904200001   dadan ramdan  Pelindung Hewan RT 4
3273502605211155   sukmara  Pelindung Hewan RT 6
3273502606215546   ervan bahtera   Pelindung Hewan RT 5
3273501406218270   saripah melati  Pelindung Hewan RT 5
3273106604210001   sukmara  Pelindung Hewan RT 6
3273500607213865   herin firmansyah  Pelindung Hewan RT 6
3205272505200002   rois sentosa  Pelindung Hewan RT 5
3273500508207461   ulan sari  Pelindung Hewan RT 5
3273106304170001   mus mulyadi  Pelindung Hewan RT 4
3273506304214599   mus mulyadi  Pelindung Hewan RT 4
3273507011218472   yayan taryana  Pelindung Hewan RT 5
3273041311180002   bagas ahmad zulfikar  Pelindung Hewan RT 5
3273502402224097   eman s/ hani  Pelindung Hewan RT 5
TOTAL 0
dapatkan imunisasi tambahan Campak Rubela sejak Januari 2022
baris total vial vaksin
sasi rutin (DPT-HB-Hib4 dan Campak rubella 2) maka tetap masuk dalam Sasaran Imunisasi Kejar
Mendapatkan ORI Campak Rubela sejak Januari 2022)/IP vaksin

bulan Sept 2017 - bulan Agust 2021

bulan Sept 2017 - bulan Oktober 2021
*) Jumlah Dosis Vaksin yang Apakah anak merupakan Apakah anak sasaran Imunisasi Kejar
pernah didapat sasaran Imunisasi (Ya = 1, Tidak = 0)
Umur (bulan) Tambahan
Campak Rubella (Ya=1,
Tidak = 0)
OPV IPV DPT-HB-Hib OPV IPV

0 0 43 1 1 1
0 0 0 52 1 1 1
0 37 1 0 1
44 0 #VALUE! 0
18 1 #VALUE! 0
45 1 #VALUE! 0
47 1 1 1
53 1 #VALUE! 0
63 0 0 0
62 0 0 0
62 0 0 0
61 0 0 0
58 1 1 1
56 1 1 1
54 1 1 1
52 1 1 1
51 1 1 1
50 1 1 1
44 1 1 1
44 1 1 1
44 1 1 1
36 1 1 1
37 1 1 1
35 1 1 1
32 1 1 1
25 1 1 1
26 1 1 1
26 1 1 1
26 1 1 1
20 1 1 1
22 1 1 1
29 1 1 1
24 1 1 1
20 1 1 1
19 1 1 1
31 1 1 1
22 1 1 1
11 1 0 0
15 1 1 1
13 1 1 1
12 1 1 1
11 1 0 0
12 1 1 1
54 1 1 1
55 1 1 1
48 1 1 1
25 1 1 1
19 1 1 1
19 1 1 1
38 1 1 1
31 1 1 1
41 1 1 1
18 1 1 1
18 1 1 1
18 1 1 1
43 1 1 1
34 1 1 1
18 1 1 1
23 1 1 1
27 1 1 1
14 1 1 1
13 1 1 1
13 1 1 1
15 1 1 1
12 1 1 1
26 1 1 1
23 1 1 1
63 0 0 0
15 1 1 1
8 0 0 0
44 1 1 1
5 0 0 0
1471 0 0 0
1471 0 0 0
1471 0 0 0
1471 0 0 0
1471 0 0 0
1471 0 0 0
1471 0 0 0
1471 0 0 0
1471 0 0 0
1471 0 0 0
1471 0 0 0
1471 0 0 0
1471 0 0 0
1471 0 0 0
1471 0 0 0
1471 0 0 0
1471 0 0 0
1471 0 0 0
1471 0 0 0
1471 0 0 0
1471 0 0 0
1471 0 0 0
1471 0 0 0
1471 0 0 0
1471 0 0 0
1471 0 0 0
1471 0 0 0
1471 0 0 0
1471 0 0 0
1471 0 0 0
1471 0 0 0
1471 0 0 0
1471 0 0 0
1471 0 0 0
1471 0 0 0
1471 0 0 0
1471 0 0 0
1471 0 0 0
1471 0 0 0
1471 0 0 0
1471 0 0 0
1471 0 0 0
1471 0 0 0
1471 0 0 0
1471 0 0 0
1471 0 0 0
1471 0 0 0
1471 0 0 0
1471 0 0 0
1471 0 0 0
1471 0 0 0
1471 0 0 0
1471 0 0 0
1471 0 0 0
1471 0 0 0
1471 0 0 0
1471 0 0 0
1471 0 0 0
1471 0 0 0
1471 0 0 0
1471 0 0 0
1471 0 0 0
1471 0 0 0
1471 0 0 0
1471 0 0 0
1471 0 0 0
1471 0 0 0
1471 0 0 0
1471 0 0 0
1471 0 0 0
1471 0 0 0
1471 0 0 0
1471 0 0 0
1471 0 0 0
1471 0 0 0
1471 0 0 0
1471 0 0 0
1471 0 0 0
1471 0 0 0
1471 0 0 0
1471 0 0 0
1471 0 0 0
1471 0 0 0
1471 0 0 0
1471 0 0 0
1471 0 0 0
1471 0 0 0
1471 0 0 0
1471 0 0 0
1471 0 0 0
1471 0 0 0
1471 0 0 0
1471 0 0 0
1471 0 0 0
1471 0 0 0
1471 0 0 0
1471 0 0 0
1471 0 0 0
1471 0 0 0
1471 0 0 0
1471 0 0 0
1471 0 0 0
1471 0 0 0
1471 0 0 0
1471 0 0 0
1471 0 0 0
1471 0 0 0
1471 0 0 0
1471 0 0 0
1471 0 0 0
1471 0 0 0
1471 0 0 0
1471 0 0 0
1471 0 0 0
1471 0 0 0
1471 0 0 0
1471 0 0 0
1471 0 0 0
1471 0 0 0
1471 0 0 0
1471 0 0 0
1471 0 0 0
1471 0 0 0
1471 0 0 0
1471 0 0 0
1471 0 0 0
1471 0 0 0
1471 0 0 0
1471 0 0 0
1471 0 0 0
1471 0 0 0
1471 0 0 0
1471 0 0 0
1471 0 0 0
1471 0 0 0
1471 0 0 0
1471 0 0 0
1471 0 0 0
1471 0 0 0
1471 0 0 0
1471 0 0 0
1471 0 0 0
1471 0 0 0
1471 0 0 0
1471 0 0 0
1471 0 0 0
1471 0 0 0
1471 0 0 0
1471 0 0 0
1471 0 0 0
1471 0 0 0
1471 0 0 0
1471 0 0 0
1471 0 0 0
1471 0 0 0
1471 0 0 0
1471 0 0 0
1471 0 0 0
1471 0 0 0
1471 0 0 0
1471 0 0 0
1471 0 0 0
1471 0 0 0
1471 0 0 0
1471 0 0 0
1471 0 0 0
1471 0 0 0
1471 0 0 0
1471 0 0 0
1471 0 0 0
1471 0 0 0
1471 0 0 0
1471 0 0 0
1471 0 0 0
1471 0 0 0
1471 0 0 0
1471 0 0 0
1471 0 0 0
1471 0 0 0
1471 0 0 0
1471 0 0 0
1471 0 0 0
1471 0 0 0
1471 0 0 0
1471 0 0 0
1471 0 0 0
1471 0 0 0
1471 0 0 0
1471 0 0 0
1471 0 0 0
1471 0 0 0
1471 0 0 0
1471 0 0 0
1471 0 0 0
1471 0 0 0
1471 0 0 0
1471 0 0 0
1471 0 0 0
1471 0 0 0
1471 0 0 0
1471 0 0 0
1471 0 0 0
1471 0 0 0
1471 0 0 0
1471 0 0 0
1471 0 0 0
1471 0 0 0
1471 0 0 0
1471 0 0 0
1471 0 0 0
1471 0 0 0
1471 0 0 0
1471 0 0 0
1471 0 0 0
1471 0 0 0
1471 0 0 0
1471 0 0 0
1471 0 0 0
1471 0 0 0
1471 0 0 0
1471 0 0 0
1471 0 0 0
1471 0 0 0
1471 0 0 0
1471 0 0 0
1471 0 0 0
1471 0 0 0
1471 0 0 0
1471 0 0 0
1471 0 0 0
1471 0 0 0
1471 0 0 0
1471 0 0 0
1471 0 0 0
1471 0 0 0
1471 0 0 0
1471 0 0 0
1471 0 0 0
1471 0 0 0
1471 0 0 0
1471 0 0 0
1471 0 0 0
1471 0 0 0
1471 0 0 0
1471 0 0 0
1471 0 0 0
1471 0 0 0
1471 0 0 0
1471 0 0 0
1471 0 0 0
1471 0 0 0
1471 0 0 0
1471 0 0 0
1471 0 0 0
1471 0 0 0
1471 0 0 0
1471 0 0 0
1471 0 0 0
1471 0 0 0
1471 0 0 0
1471 0 0 0
1471 0 0 0
1471 0 0 0
1471 0 0 0
1471 0 0 0
1471 0 0 0
1471 0 0 0
1471 0 0 0
1471 0 0 0
1471 0 0 0
1471 0 0 0
1471 0 0 0
1471 0 0 0
1471 0 0 0
1471 0 0 0
1471 0 0 0
1471 0 0 0
1471 0 0 0
1471 0 0 0
1471 0 0 0
1471 0 0 0
1471 0 0 0
1471 0 0 0
1471 0 0 0
1471 0 0 0
1471 0 0 0
1471 0 0 0
1471 0 0 0
1471 0 0 0
1471 0 0 0
1471 0 0 0
1471 0 0 0
1471 0 0 0
1471 0 0 0
1471 0 0 0
1471 0 0 0
1471 0 0 0
1471 0 0 0
1471 0 0 0
1471 0 0 0
1471 0 0 0
1471 0 0 0
1471 0 0 0
1471 0 0 0
1471 0 0 0
1471 0 0 0
1471 0 0 0
1471 0 0 0
1471 0 0 0
1471 0 0 0
1471 0 0 0
1471 0 0 0
1471 0 0 0
1471 0 0 0
1471 0 0 0
1471 0 0 0
1471 0 0 0
1471 0 0 0
1471 0 0 0
1471 0 0 0
1471 0 0 0
1471 0 0 0
1471 0 0 0
1471 0 0 0
1471 0 0 0
1471 0 0 0
1471 0 0 0
1471 0 0 0
1471 0 0 0
1471 0 0 0
1471 0 0 0
1471 0 0 0
1471 0 0 0
1471 0 0 0
1471 0 0 0
1471 0 0 0
1471 0 0 0
1471 0 0 0
1471 0 0 0
1471 0 0 0
1471 0 0 0
1471 0 0 0
1471 0 0 0
1471 0 0 0
1471 0 0 0
1471 0 0 0
1471 0 0 0
1471 0 0 0
1471 0 0 0
1471 0 0 0
1471 0 0 0
1471 0 0 0
1471 0 0 0
1471 0 0 0
1471 0 0 0
1471 0 0 0
1471 0 0 0
1471 0 0 0
1471 0 0 0
1471 0 0 0
1471 0 0 0
1471 0 0 0
1471 0 0 0
1471 0 0 0
1471 0 0 0
1471 0 0 0
1471 0 0 0
1471 0 0 0
1471 0 0 0
1471 0 0 0
1471 0 0 0
1471 0 0 0
1471 0 0 0
1471 0 0 0
1471 0 0 0
1471 0 0 0

1471 0 0 0
1471 0 0 0
1471 0 0 0
1471 0 0 0
1471 0 0 0
1471 0 0 0
1471 0 0 0
1471 0 0 0
1471 0 0 0
1471 0 0 0
1471 0 0 0
1471 0 0 0
1471 0 0 0
1471 0 0 0
1471 0 0 0
1471 0 0 0
1471 0 0 0
1471 0 0 0
1471 0 0 0
1471 0 0 0
1471 0 0 0
1471 0 0 0
1471 0 0 0
1471 0 0 0
1471 0 0 0
1471 0 0 0
1471 0 0 0
1471 0 0 0
1471 0 0 0
1471 0 0 0
1471 0 0 0
1471 0 0 0
1471 0 0 0
1471 0 0 0
1471 0 0 0
1471 0 0 0
1471 0 0 0
1471 0 0 0
1471 0 0 0
1471 0 0 0
1471 0 0 0
1471 0 0 0
1471 0 0 0
1471 0 0 0
1471 0 0 0
1471 0 0 0
1471 0 0 0
1471 0 0 0
1471 0 0 0
1471 0 0 0
1471 0 0 0
1471 0 0 0

64 #VALUE! 59

TOTA
k sasaran Imunisasi Kejar Apakah Anak Jumlah dosis yang dibutuhkan untuk Rencana Pemberian Dosis Sasaran
a = 1, Tidak = 0) merupakan sasaran melengkapi status imunisasi Imunisasi Kejar & CR Pada Bulan Agu
imunisasi KEJAR
(Ya = 1 , Tidak = 0)
DPT-HB-Hib OPV IPV DPT-HB-Hib OPV IPV

0 1 4 1 #VALUE! 1 1
1 1 4 1 4 1 1
0 1 #VALUE! 1 #VALUE! #VALUE! 1
0 #VALUE! #VALUE! #VALUE! #VALUE! #VALUE! #VALUE!
0 #VALUE! #VALUE! #VALUE! #VALUE! #VALUE! #VALUE!
0 #VALUE! #VALUE! #VALUE! #VALUE! #VALUE! #VALUE!
1 1 4 1 4 1 1
0 #VALUE! #VALUE! #VALUE! #VALUE! #VALUE! #VALUE!
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
1 1 4 1 4 1 1
1 1 4 1 4 1 1
1 1 4 1 4 1 1
1 1 4 1 4 1 1
1 1 4 1 4 1 1
1 1 4 1 4 1 1
1 1 4 1 4 1 1
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1 1 4 1 4 1 1
1 1 4 1 4 1 1
1 1 4 1 4 1 1
1 1 4 1 4 1 1
1 1 4 1 4 1 1
1 1 4 1 4 1 1
0 0 0 0 0 0 0
1 1 4 1 3 1 1
1 1 4 1 3 1 1
1 1 4 1 3 1 1
0 0 0 0 0 0 0
1 1 4 1 3 1 1
1 1 4 1 4 1 1
1 1 4 1 4 1 1
1 1 4 1 4 1 1
1 1 4 1 4 1 1
1 1 4 1 4 1 1
1 1 4 1 4 1 1
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1 1 4 1 4 1 1
1 1 4 1 4 1 1
1 1 4 1 4 1 1
1 1 4 1 4 1 1
1 1 4 1 4 1 1
1 1 4 1 4 1 1
1 1 4 1 4 1 1
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1 1 4 1 3 1 1
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1 1 4 1 3 1 1
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1 1 4 1 4 1 1
1 1 4 1 4 1 1
0 0 0 0 0 0 0
1 1 4 1 3 1 1
0 0 0 0 0 0 0
1 1 4 1 4 1 1
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
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0 0 0 0 0 0 0
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0 0 0 0 0 0 0
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0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
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0 0 0 0 0 0 0
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0 0 0 0 0 0 0
0 0 0 0 0 0 0
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0 0 0 0 0 0 0
0 0 0 0 0 0 0
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0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
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0 0 0 0 0 0 0
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0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
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0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
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0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
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0 0 0 0 0 0 0
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0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
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0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
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0 0 0 0 0 0 0
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0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
57 #VALUE! #VALUE! #VALUE! #VALUE! #VALUE! #VALUE!

TOTAL VIAL VAKSIN (Jumlah Vial = Jumlah Total Sasaran/IP Vaksin) #VALUE! #VALUE!
 Diisi pada saat pelayanan imunisasi Kejar & CR bulan Agustus (
ncana Pemberian Dosis Sasaran
Sasaran Apakah anak September) 2022
sasi Kejar & CR Pada Bulan Agustus (JIKA DIIMUNISASI, ISI TANGGAL PELAYAN
Suntikan sasaran BIAN
Bulan Agustus (Agustus)
DPT-HB-Hib CR OPV IPV

#VALUE! 1 #VALUE! #VALUE!

1 1 3 1
#VALUE! 1 #VALUE! #VALUE!
#VALUE! 0 #VALUE! #VALUE!
#VALUE! 1 #VALUE! #VALUE!
#VALUE! 1 #VALUE! #VALUE!
1 1 3 1
#VALUE! 1 #VALUE! #VALUE!
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
1 1 3 1
1 1 3 1
1 1 3 1
1 1 3 1
1 1 3 1
1 1 3 1
1 1 3 1
1 1 3 1
1 1 3 1
1 1 3 1
1 1 3 1
1 1 3 1
1 1 3 1
1 1 3 1
1 1 3 1
1 1 3 1
1 1 3 1
1 1 3 1
1 1 3 1
1 1 3 1
1 1 3 1
1 1 3 1
1 1 3 1
1 1 3 1
1 1 3 1
0 1 1 1
1 1 3 1
1 1 3 1
1 1 3 1
0 1 1 1
1 1 3 1
1 1 3 1
1 1 3 1
1 1 3 1
1 1 3 1
1 1 3 1
1 1 3 1
1 1 3 1
1 1 3 1
1 1 3 1
1 1 3 1
1 1 3 1
1 1 3 1
1 1 3 1
1 1 3 1
1 1 3 1
1 1 3 1
1 1 3 1
1 1 3 1
1 1 3 1
1 1 3 1
1 1 3 1
1 1 3 1
1 1 3 1
1 1 3 1
0 0 0 0
1 1 3 1
0 0 0 0
1 1 3 1
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
 0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
#VALUE! 64 #VALUE! #VALUE! 0 0
#VALUE! 8 0 0
asi Kejar & CR bulan Agustus (termasuk Sweeping pada Diisi pada saat pelayanan imunisasi Kejar pada September
September) 2022 2022
NISASI, ISI TANGGAL PELAYANAN) (JIKA DIIMUNISASI, ISI TANGGAL PELAYANAN)

DPT-HB-Hib CR OPV IPV DPT-HB-Hib

0 0 0 0 0
0 0 0 0 0
 FORMAT PENDATAAN POSYANDU SASARAN BIAN
SASARAN IMUNISASI TAMBAHAN CAMPAK RUBELA ADALAH 9-59 BULAN DAN SASARAN IMUNISASI KEJ
PELAKSANAAN : AGUSTUS
01 Agustus 2022 (Disesuaikan dengan tgl pelaksanaan di masing-masing Posyand
Provinsi : Desa/Kelurahan : Setia (Contoh)
Kabupaten : kkkk Posyandu : 1. Posyandu Mawar
Puskesmas : mmmm
Isilah kolom yang berwarna PUTIH! kan ORI
Tanggal Campak *) Jumlah Dosis Vaksin yang
No. Nama Anak
Jenis Kelamin (L/ P)
Lahir NIK Nama Orang Tua (IBU)
Alamat Rubela pernah didapat
sejak OPV
Januari
1 3273104409170 0 0
SERINA  P  ### 003   NANANG 
SYARIFAH 3273107009170 0 0
2 YUKI  P  ### 004   ERWAN 
3 ALIFFAH 3273104108170 1
AISYAH  P  ### 001   DEDE 
LUTFITA 3273105309840 1 2
4 SAFIA  P  ### 008   DEDE 

M.
5 FACHRUL 3273102710170 1
ZEN  P  ### 004   ADE P 
3273106412170 YUDISTIR 1
6 BILQIS  P  ### 001   A 
7 3273106512170
AZKAIRA  P  ### 001   DEDI 
3273216512170 2
8 ARSYILA  P  ### 001   SYAHRIAL 
9 3273100101180
FAUZAN  L  ### 004   ERVAN 
3273104501180 ASEP
10 MYESA  P  ### 002   MAIL 
11 NATHAN 3273102103180
KEANU  L  ### 002   ANDI 

M. 3273101604180
12 GHAISAN  L  ### 003   DIAN M 
13 DELLA 3273104406180
EMILIE  P  ### 003   DIKI 
M. 3273102306180 SAMSUDI
14 AZZAM  L  ### 001   N 
15 3273176605180
AUDREY  P  ### 003   SUFIAN 
3273104407180
16 SHAVIRA  P  ### 001   IWAN 
17 AZURA 3273106307180
SYAQILA  P  ### 001   TISNA 
 ASEP
3273100808180 KUSWAN
18 M. FAQIH  L  ### 001   DI 

19 ALISYA 3273106608180
AZZAHRA  P  ### 003   JIMI H 
HASBI 3273106501870
20 NIZAM  L  ### 007   DINDIN S 
21 ABIZAR 3273102209180 M.
ARFAN  L  ### 001   RAMLAN 
AFIKA 3273104410180
22 SARI  P  ### 002   TEDI 
23 M. FIKRI 3273100121800
AZKA  L  ### 01   ASEP 

HADI
3273101212180 MUHARA
24 ISNAN R  L  ### 001   M 
25 3273104102920 TATA
NAMINA  P  ### 003   TAUFIK 
AZKADIN 3273106211180
26 A  P  ### 003   ERVAN 
27 NEYSHA 3273105702190
ZAHRA  P  ### 001   FERDY 
3273104302980
28 ABIL  L  ### 003   DONI 
29 3273106112940
LATIF  L  ### 001   RAMLI 
3273104402190
30 ELVIRA  P  ### 001   WAHYU J 
31 M 3273100705190
ALFATIH  L  ### 001   M YAMIN 

DIKDIK
AUFAR 3204093008190 PERMAN
32 SYAKIRI  L  ### 001   A 

LUTHFI
33 MUHAM
MAD 3273100707200 DEDE
SYAHIR  L  ### 001   SURYA 
3273500407204
34 DHEFIN  L  ### 274   DIKI 

35 ADZRIEL
ZHAFRAN AGUNG
NUGRAH 3273100807200 NUGRAH
A  L  ### 002   A 
 ANINDYA
PUTRI 3273106112190 deni
36 SAPAAT  P  ### 001   sapaat 

RAINA
37 PUTRI 3273105409200 SARIPUDI
ANDINI  P  ### 002   N 

RAY
SHAKA
ZAYDEN 3273101008200
38 ARSENIO  L  ### 001   wukiyono 

39 GHINA
PUTRI 3273104411200
MAULIDA  P  ### 001   MARYADI 

M FATAH ASEP
MAULIDA 3273100911200 KUSWAN
40 N  L  ### 003   DI 

ASEP
41 FARAH 3273104911200 KUSWAN
ISNAINI  P  ### 001   DI  

M FAREL
PERMAN 3273500312209
42 A  L  ### 845   ginANJAR 

43 QUEENSH
A 3273504509207 agus
MEKKAH   P  ### 712   rusnadi 

DERI
FAJAR
RAUDHA 3273505111207 NUGRAH
44 FATIMAH  P  ### 584   A 

45 GREY FITRAH
ELZARO 3273101201200 PANJI
PRASETIA  L  ### 002   PRASETIA 

SYAFA
AMELIA 3273106411200 andi
46 PUTRI  P  ### 001   syahril 

MOHAM
47 MAD
DERIL
SETIAWA 3273101512200
N  L  ### 002   aep 
 AKSARA
ZAYN 3273102212200 irvan
48 KAHFI  L  ### 002   emiwan 

AKASYA
49 ZAYNA 3273106212200 irvan
KAFIAH  P  ### 004   emiman 

RASYA
PUTRA 3273100106200 ALDI
50 RENALDI  L  ### 002   RENALDI 

DARREN
51 DELWYN RAMDAN
SUKMAN 3273101312190 SUKMAN
A  L  ### 002   A 

PAWIT
QYANDRA DWI
DWI 3273105002190 KUSWAN
52 AZZAHRA  P  ### 001   TO 

SHANUM DIKI
53
DIA 3273506101214 SURYAMA
SYAKIRA  P  ### 200   N 

HAZEEMA
MAUZA
ALMASHY 3273506001212
54 RA  P  ### 181   JAILANI 

55 SALSA
NABILA 3273505701218 nceng
KAMALIA  P  ### 826   kurdi 

MUHAMA
D ALFIL
ALFARIZKI 3273060912180 eman
56   L  ### 004   sulaeman 

57 3273502109192 gugun
DZAKI   L  ### 788   gunawan 

RAINA
ANINDYA 3273504601218 aldi
58 PUTRI  P  ### 713   renaldi 

59 SELLY 3273505308201
AGUSTIN  P  ### 181   DADANG 
SILVIA 3273106904200 dadan
60 DZAKIRA  P  ### 001   ramdan 
 ELVANO
61 TEGUH
DHANESA 3273502605211
  L  ### 155   sukmara 

GHAISAN
AL 3273502606215 ervan
62 KHAFIF  L  ### 546   bahtera  

FAUZI
63 AHMAD
PAMUNG 3273501406218 saripah
KAS  L  ### 270   melati 

AYUNDA
SUKMARA 3273106604210
64 PURADI  P  ### 001   sukmara 

MUHAM
MAD
65
VIRENDR
A herin
DZUHAIRI 3273500607213 firmansya
  L  ### 865   h 
ASLAN 3205272505200 rois
66 ALIRAIS  L  ### 002   sentosa 
67 AMMAR 3273500508207
TAQI P  L  ### 461   ulan sari 

ADEEVA 3273106304170 mus

68 AFSHEEN  P  ### 001   mulyadi 

AHMAD
69
RAMADH 3273506304214 mus
AN  P  ### 599   mulyadi 

NAURA
RIZQIANA
AZ
HAERUNI 3273507011218 yayan
70 SSA  P  ### 472   taryana 

ADAM bagas
71 RAJENDR 3273041311180 ahmad
A  L  ### 002   zulfikar 

ALBIANSY
AH 3273502402224 eman s/
72 YUSUF  L  ### 097   hani 
73
74
75
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77
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79
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81
82
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481
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494
495
496
497
498
499
500
TOTAL 1

IP Vaksin:
MR = 8
OPV = 8
IPV = 4
DPT-HB-Hib = 4
Catatan:
Anak yang sudah mendapatkan ORI Campak Rubela, tidak perlu mendapatkan imunisasi tambahan Campak Rubel
Total kebutuhan vial yang dibutuhkan yang mengacu pada perhitungan baris total vial vaksin
Anak usia 18-24 bulan yang pada saat bersamaan mendapatkan imunisasi rutin (DPT-HB-Hib4 dan Campak rubella
Kebutuhan Vaksin Khusus Campak Rubela = (Total Sasaran - Sudah Mendapatkan ORI Campak Rubela sejak Janu
SASARAN IMUNISASI BIAN:
Imunisasi Kejar : Lahir pada bulan Sept 2017 - bulan Agust 2021
Imunisasi CR : Lahir pada bulan Sept 2017 - bulan Oktober 2021

Kolom Tambahan:
*) Jumlah Dosis Vaksin yang pernah didapat
DAN SASARAN IMUNISASI KEJAR ADALAH 12-59 BULAN
anaan di masing-masing Posyandu)

*) Jumlah Dosis Vaksin yang n sasaran Apakah anak sasaran Imunisasi an

Jumlah dosis yang dibutuhkan
Imunisasi Kejar untuk melengkapi status
pernah didapat Umur (bulan) sasaran
Tambahan (Ya = 1, Tidak = 0) imunisasi
IPV DPT-HB-Hib OPV IPV DPT-HB-Hib imunisasi OPV IPV
Campak
0 1
58 1 1 1 1 1 4 1

0 0
58 1 1 1 1 1 4 1

0 3
60 0 0 0 0 0 0 0

2 2
58 0 0 0 1 1 0 0

3 4
57 1 0 0 0 0 0 0

3 1
55 1 0 0 1 1 0 0

55 1 1 1 1 1 4 1

1 3
55 1 1 0 1 1 2 0

55 1 1 1 1 1 4 1

54 1 1 1 1 1 4 1

52 1 1 1 1 1 4 1

51 1 1 1 1 1 4 1

49 1 1 1 1 1 4 1

49 1 1 1 1 1 4 1

50 1 1 1 1 1 4 1

48 1 1 1 1 1 4 1

48 1 1 1 1 1 4 1
47 1 1 1 1 1 4 1

47 1 1 1 1 1 4 1

46 1 1 1 1 1 4 1

46 1 1 1 1 1 4 1

45 1 1 1 1 1 4 1

44 1 1 1 1 1 4 1

43 1 1 1 1 1 4 1

41 1 1 1 1 1 4 1

44 1 1 1 1 1 4 1

41 1 1 1 1 1 4 1

37 1 1 1 1 1 4 1

37 1 1 1 1 1 4 1

41 1 1 1 1 1 4 1

35 1 1 1 1 1 4 1

35 1 1 1 1 1 4 1

24 1 1 1 1 1 4 1

24 1 1 1 1 1 4 1

24 1 1 1 1 1 4 1
31 1 1 1 1 1 4 1

22 1 1 1 1 1 4 1

23 1 1 1 1 1 4 1

20 1 1 1 1 1 4 1

20 1 1 1 1 1 4 1

20 1 1 1 1 1 4 1

19 1 1 1 1 1 4 1

22 1 1 1 1 1 4 1

20 1 1 1 1 1 4 1

30 1 1 1 1 1 4 1

20 1 1 1 1 1 4 1

19 1 1 1 1 1 4 1
19 1 1 1 1 1 4 1

19 1 1 1 1 1 4 1

38 1 1 1 1 1 4 1

31 1 1 1 1 1 4 1

41 1 1 1 1 1 4 1

18 1 1 1 1 1 4 1

18 1 1 1 1 1 4 1

18 1 1 1 1 1 4 1

43 1 1 1 1 1 4 1

34 1 1 1 1 1 4 1

18 1 1 1 1 1 4 1

23 1 1 1 1 1 4 1

27 1 1 1 1 1 4 1
 14 1 1 1 1 1 4 1

13 1 1 1 1 1 4 1

13 1 1 1 1 1 4 1

15 1 1 1 1 1 4 1

12 1 1 1 1 1 4 1

26 1 1 1 1 1 4 1

23 1 1 1 1 1 4 1

63 0 0 0 0 0 0 0

15 1 1 1 1 1 4 1

8 0 0 0 0 0 0 0

44 1 1 1 1 1 4 1

5 0 0 0 0 0 0 0
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1471 0 0 0 0 0 0 0
1471 0 0 0 0 0 0 0
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1471 0 0 0 0 0 0 0
1471 0 0 0 0 0 0 0
1471 0 0 0 0 0 0 0
1471 0 0 0 0 0 0 0
1471 0 0 0 0 0 0 0
1471 0 0 0 0 0 0 0
1471 0 0 0 0 0 0 0
1471 0 0 0 0 0 0 0
1471 0 0 0 0 0 0 0
1471 0 0 0 0 0 0 0
1471 0 0 0 0 0 0 0
1471 0 0 0 0 0 0 0
1471 0 0 0 0 0 0 0
1471 0 0 0 0 0 0 0
1471 0 0 0 0 0 0 0
1471 0 0 0 0 0 0 0
1471 0 0 0 0 0 0 0
1471 0 0 0 0 0 0 0
1471 0 0 0 0 0 0 0
1471 0 0 0 0 0 0 0
1471 0 0 0 0 0 0 0
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1471 0 0 0 0 0 0 0
1471 0 0 0 0 0 0 0
1471 0 0 0 0 0 0 0
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1471 0 0 0 0 0 0 0
1471 0 0 0 0 0 0 0
1471 0 0 0 0 0 0 0
1471 0 0 0 0 0 0 0
1471 0 0 0 0 0 0 0
1471 0 0 0 0 0 0 0
1471 0 0 0 0 0 0 0
1471 0 0 0 0 0 0 0
1471 0 0 0 0 0 0 0
1471 0 0 0 0 0 0 0
1471 0 0 0 0 0 0 0
1471 0 0 0 0 0 0 0
1471 0 0 0 0 0 0 0
1471 0 0 0 0 0 0 0
1471 0 0 0 0 0 0 0
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1471 0 0 0 0 0 0 0
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1471 0 0 0 0 0 0 0
1471 0 0 0 0 0 0 0
1471 0 0 0 0 0 0 0
1471 0 0 0 0 0 0 0
1471 0 0 0 0 0 0 0
1471 0 0 0 0 0 0 0
1471 0 0 0 0 0 0 0
1471 0 0 0 0 0 0 0
1471 0 0 0 0 0 0 0
1471 0 0 0 0 0 0 0
1471 0 0 0 0 0 0 0
1471 0 0 0 0 0 0 0
1471 0 0 0 0 0 0 0
1471 0 0 0 0 0 0 0
1471 0 0 0 0 0 0 0
1471 0 0 0 0 0 0 0
1471 0 0 0 0 0 0 0
1471 0 0 0 0 0 0 0
1471 0 0 0 0 0 0 0
1471 0 0 0 0 0 0 0
1471 0 0 0 0 0 0 0
1471 0 0 0 0 0 0 0
1471 0 0 0 0 0 0 0
1471 0 0 0 0 0 0 0
1471 0 0 0 0 0 0 0
1471 0 0 0 0 0 0 0
1471 0 0 0 0 0 0 0
1471 0 0 0 0 0 0 0
1471 0 0 0 0 0 0 0
1471 0 0 0 0 0 0 0
1471 0 0 0 0 0 0 0
1471 0 0 0 0 0 0 0
1471 0 0 0 0 0 0 0
1471 0 0 0 0 0 0 0
1471 0 0 0 0 0 0 0
1471 0 0 0 0 0 0 0
1471 0 0 0 0 0 0 0
1471 0 0 0 0 0 0 0
1471 0 0 0 0 0 0 0
1471 0 0 0 0 0 0 0
1471 0 0 0 0 0 0 0
1471 0 0 0 0 0 0 0
1471 0 0 0 0 0 0 0
1471 0 0 0 0 0 0 0
1471 0 0 0 0 0 0 0
1471 0 0 0 0 0 0 0
1471 0 0 0 0 0 0 0
1471 0 0 0 0 0 0 0
1471 0 0 0 0 0 0 0
1471 0 0 0 0 0 0 0
1471 0 0 0 0 0 0 0
1471 0 0 0 0 0 0 0
1471 0 0 0 0 0 0 0
1471 0 0 0 0 0 0 0
1471 0 0 0 0 0 0 0
1471 0 0 0 0 0 0 0
1471 0 0 0 0 0 0 0
1471 0 0 0 0 0 0 0
1471 0 0 0 0 0 0 0
1471 0 0 0 0 0 0 0
1471 0 0 0 0 0 0 0
1471 0 0 0 0 0 0 0
1471 0 0 0 0 0 0 0
1471 0 0 0 0 0 0 0
1471 0 0 0 0 0 0 0
1471 0 0 0 0 0 0 0
1471 0 0 0 0 0 0 0
1471 0 0 0 0 0 0 0
1471 0 0 0 0 0 0 0
1471 0 0 0 0 0 0 0
1471 0 0 0 0 0 0 0
1471 0 0 0 0 0 0 0
1471 0 0 0 0 0 0 0
1471 0 0 0 0 0 0 0
1471 0 0 0 0 0 0 0
1471 0 0 0 0 0 0 0
1471 0 0 0 0 0 0 0
1471 0 0 0 0 0 0 0
1471 0 0 0 0 0 0 0
1471 0 0 0 0 0 0 0
1471 0 0 0 0 0 0 0
1471 0 0 0 0 0 0 0
1471 0 0 0 0 0 0 0
1471 0 0 0 0 0 0 0
1471 0 0 0 0 0 0 0
1471 0 0 0 0 0 0 0
1471 0 0 0 0 0 0 0
1471 0 0 0 0 0 0 0
1471 0 0 0 0 0 0 0
1471 0 0 0 0 0 0 0
1471 0 0 0 0 0 0 0
1471 0 0 0 0 0 0 0
1471 0 0 0 0 0 0 0
1471 0 0 0 0 0 0 0
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1471 0 0 0 0 0 0 0
1471 0 0 0 0 0 0 0
1471 0 0 0 0 0 0 0
1471 0 0 0 0 0 0 0
1471 0 0 0 0 0 0 0
1471 0 0 0 0 0 0 0
1471 0 0 0 0 0 0 0
1471 0 0 0 0 0 0 0
1471 0 0 0 0 0 0 0
1471 0 0 0 0 0 0 0
1471 0 0 0 0 0 0 0
1471 0 0 0 0 0 0 0
1471 0 0 0 0 0 0 0
1471 0 0 0 0 0 0 0
1471 0 0 0 0 0 0 0
1471 0 0 0 0 0 0 0
1471 0 0 0 0 0 0 0
1471 0 0 0 0 0 0 0
1471 0 0 0 0 0 0 0
1471 0 0 0 0 0 0 0
1471 0 0 0 0 0 0 0
1471 0 0 0 0 0 0 0
1471 0 0 0 0 0 0 0
1471 0 0 0 0 0 0 0
1471 0 0 0 0 0 0 0
1471 0 0 0 0 0 0 0
1471 0 0 0 0 0 0 0
1471 0 0 0 0 0 0 0
1471 0 0 0 0 0 0 0
1471 0 0 0 0 0 0 0
1471 0 0 0 0 0 0 0
1471 0 0 0 0 0 0 0
1471 0 0 0 0 0 0 0
1471 0 0 0 0 0 0 0
1471 0 0 0 0 0 0 0
1471 0 0 0 0 0 0 0
1471 0 0 0 0 0 0 0
1471 0 0 0 0 0 0 0
1471 0 0 0 0 0 0 0
1471 0 0 0 0 0 0 0
1471 0 0 0 0 0 0 0
1471 0 0 0 0 0 0 0
1471 0 0 0 0 0 0 0
1471 0 0 0 0 0 0 0
1471 0 0 0 0 0 0 0
1471 0 0 0 0 0 0 0
1471 0 0 0 0 0 0 0
1471 0 0 0 0 0 0 0
1471 0 0 0 0 0 0 0
1471 0 0 0 0 0 0 0
1471 0 0 0 0 0 0 0
1471 0 0 0 0 0 0 0
1471 0 0 0 0 0 0 0
1471 0 0 0 0 0 0 0
1471 0 0 0 0 0 0 0
1471 0 0 0 0 0 0 0
1471 0 0 0 0 0 0 0
1471 0 0 0 0 0 0 0
1471 0 0 0 0 0 0 0
1471 0 0 0 0 0 0 0
1471 0 0 0 0 0 0 0
1471 0 0 0 0 0 0 0
1471 0 0 0 0 0 0 0
1471 0 0 0 0 0 0 0
1471 0 0 0 0 0 0 0
1471 0 0 0 0 0 0 0
1471 0 0 0 0 0 0 0
1471 0 0 0 0 0 0 0
1471 0 0 0 0 0 0 0
1471 0 0 0 0 0 0 0
1471 0 0 0 0 0 0 0
1471 0 0 0 0 0 0 0
1471 0 0 0 0 0 0 0
1471 0 0 0 0 0 0 0
1471 0 0 0 0 0 0 0
1471 0 0 0 0 0 0 0
1471 0 0 0 0 0 0 0
1471 0 0 0 0 0 0 0
1471 0 0 0 0 0 0 0
1471 0 0 0 0 0 0 0
1471 0 0 0 0 0 0 0
1471 0 0 0 0 0 0 0
1471 0 0 0 0 0 0 0
1471 0 0 0 0 0 0 0
1471 0 0 0 0 0 0 0
1471 0 0 0 0 0 0 0
1471 0 0 0 0 0 0 0
1471 0 0 0 0 0 0 0
1471 0 0 0 0 0 0 0
1471 0 0 0 0 0 0 0
1471 0 0 0 0 0 0 0
1471 0 0 0 0 0 0 0
1471 0 0 0 0 0 0 0
1471 0 0 0 0 0 0 0
1471 0 0 0 0 0 0 0
1471 0 0 0 0 0 0 0
1471 0 0 0 0 0 0 0
1471 0 0 0 0 0 0 0
1471 0 0 0 0 0 0 0
1471 0 0 0 0 0 0 0
1471 0 0 0 0 0 0 0
1471 0 0 0 0 0 0 0
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1471 0 0 0 0 0 0 0
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67 65 64 67 67 258 64
TOTAL VIAL VAKSIN (Jumlah Vial = Jumlah Total Sasaran/IP Vaksin)

munisasi tambahan Campak Rubela sejak Januari 2022

DPT-HB-Hib4 dan Campak rubella 2) maka tetap masuk dalam Sasaran Imunisasi Kejar
an ORI Campak Rubela sejak Januari 2022)/IP vaksin
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Rencana Pemberian Dosis Sasaran
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Imunisasi Kejar & CR Pada Bulan Agustus
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