FORMAT PENDATAAN SASARAN IMUNISASI CAMPAK RUBELLA USIA 5 - 15 TAHUN

Provinsi : Kepulauan Riau Desa/Kelurahan : Sagulung Kota

Kabupaten : Kota Batam Nama Sekolah : SDS ORA ET LABOORA
Puskemas : Selekop

Isilah kolom yang tidak berwarna!

Tanggal Umur
No. Nama Anak NIK ANAK Nama Orang Tua NIK IBU NO HP Alamat
Lahir (tahun)

Adelya Pamela
1 2171115107140002 Larisma Limbong 081276914946 Sagulung Indah 2014-07-11 8
Siringo-ringo

2 Aditia Sihombing 2171111307110005 Maylita Pakpahan 2171115805789008 081268150360 Batu AJI Permai 2010-07-13 12

AERIL YN
3 BELLVANIA 2171114502150002 IDA MARLINA GRIYA BATUAJI ASRI 2015-02-05 7
NAHAMPUN
GULTOM

AGUNG
PERUMAHAN VILLA
4 APRILYANDO FITRA SINAGA 2171094108919019 081275919446 2015-04-03 7
NAMORA
PANJAITAN

Albert Eleison Asli Hermina

5 Marudut Siregar 2171112102120002 Siahaan 2171116908789000 081242566373 Sagulung Jaya Blok B 2012-02-21 10

Albryan Cristopel
6 Siagian 2171111412090002 Marsiya sirait 2171115503789002 081242566393 jalan dapur 12 2009-12-14 13
 ALEX SANDRO Perum Senowangi Asri
7 2171120301150001 ANNI PARDOSI 081291507954 2015-01-31 7
REWARD Blok G no 7

Alycia Talenta Kiki Rahayu

8 1207266405110011 081377140070 Perum Puskopkar 2011-05-25 11
Elisabeth Simamora

Perm.Buana Raja
Amayar Myint
9 2171026801130002 Lina Adriana 2171024702829006 082169696922 Residence Queen C 2013-01-28 10
Aung
No.11

Anastasya Lasmaria Perum Arse Indah Blok

10 Meiliana Pardede 2171114205120006 Simarmata 2171116212759008 089685501317 C No. 5 2012-05-02 10

Arslin Nesty Hotto

Andik Christian Kav.Sagulung Jaya Blok
11 Sihombing 2171112712130002 Pronter 2171116903819005 089652424295 D No.80 2013-12-27 9
Lumbantobing

12 Andreas Sitohang 2171110604100005 Masarina Saragih 2171114110709001 081268592567 Jln Dapur 12 2010-04-06 12

Antonio
Perum Puri Mas Blok E2
13 Candreva Sili - 2171121909130001 Magdalena Lupang 2171126606769010 089678982778 2013-07-19 9
No. 05
Making

14 Aryo Alvian 2171111901130002 Sarmaida Sianturi 2171116109799007 082377252406 Sagulung Indah 2013-01-19 10
Simanjuntak

Audrey Leticia
15 3273130805100001 Mindo Desy Manik 3273136112810001 0895385022221 Batu Aji Lama 2010-05-08 12
Lauren

Barita Fortuna Sagulung Jaya Blok B

16 2171112206120004 Rosdewi Harefa 2171076802820001 081364600377 2012-06-22 10
Nainggolan No.35

Batsyeba Talita Rusliana

17 2171021602090035 2171026303809900 081371781980 Batu Aji Setemiang 2010-02-08 12
Taringan Simatupang
 Berry Christian Duma Br Batuaji Permai
18 2171112005130007 2171114702730001 081276328929 2013-05-20 9
Siahaan Tampubolon Kav.Lama Blok a2/12

Bileam
19 2171111306130003 Rusmani Sirait 2171116911749001 081293264389 Sagulung Jaya B/ 71 2012-06-13 10
Nainggolan

Boas Nigel Duma Br

20 2171111107120005 082283477377 KAv. Sagulung 2012-07-11 10
Siahaan Tampubolon

Brian Sugara Marsinta Hotmauli

21 Siburian 2171120604110004 Sihombing 2171126910870002 081374759766 Sagulung Abadi jaya 2011-04-06 11

Callysta Sabella Plorida Raya

22 Sidabutar 2171116409110005 Adelina 2171076907849006 082117853299 Kav Pelopor 2011-09-24 11

Chelse Tri
23 Agustina Siagian 2171114108110004 Benti Flora Sitorus 2171115101790001 089512480620 Sagulung Jaya 2011-08-01 11

Chelsea
24 Naloresta 2171116008110006 Rosarda SInaga 2171115204690002 081364743811 Bukit Seroja II 2011-08-20 11
Siallagan

CHELSEA
2171115010140004 EVA RONA
KAV.BUKIT KAMBOJA
25 YOHANA 2014-10-10 8
NAINGGOLAN BLOK V NO 83
SIHOMBING

Ledi Sumarni Kav.Batu Aji Permai BLK

26 Christian Alvaro 2171110806130003 2171127012859004 081369114696 2013-06-08 9
Saragih J No.91

CHRISTIAN DEWI SAGULUNG JAYA BLOK

27 GRACIANO 2171112204150012 2015-04-22 7
SIMANUNGKALIT B NO 6
AMBARITA

Christiani Debora BATU AJI PERMAI KAV.

28 2171115912110004 ANEKE LUMENTA 2171116604829001 081364177602 2011-12-19 11
Seleky LAMA
 Christina
29 Anggreiny 2171077003110004 Elderika Sitorus 2171076511709004 082166787074 Sagulung Abadi Jaya 2011-03-30 11
Simanjuntak

Kamp. Sayur Ruli Batu

30 Cristian Gabriel S 2171111707120004 Rosta Tindaon 2171116711650002 082285926945 2012-07-17 10
Aji Riau Bertuah

Daniel
31 2171111612090006 Hetty Silalahi 2171114206819007 081269006839 Jln Kav Lama 2009-12-16 13
Lumbantobing

32 David Yehezkiel S 2171112709110003 Mewah Panjaitan 2171116712860001 081277974214 Perum Villa Namora 2011-09-27 11

Denis Sofian Kav.Lama Batu Aji

33 Simanjuntak 2171071205140003 Elderika Sitorus 2171076511709004 082166787074 Permai Blok G No.46 2014-05-12 8

Detha Nosela Perum BUana Bukit

34 Parapat 2171116011110004 Elfiera Sianturi 2171115905859004 082154385202 Permata Blok Mutiara 2011-11-20 11

DICK WARREN
SONTA RUMETI SAGULUNG JAYA BLOK
35 OLOAN 2171112908140003 2171115901750003 085376482384 2014-08-29 8
AMBARITA A NO.22
PANJAITAN

36 Efraim Gracio 2171121404140001 Helima Sinaga 2171125403839004 085364282431 Kav.Batu Aji Permai 2014-04-14 8
Blok J No.63

Elfany Perum Mutiara

37 2171116804140004 Duliri Manurung 2171116501879001 081267054425 2014-04-28 8
Simanjuntak Mantang Blok A No.33

38 Elly Apryanti 6172055404090002 T jin Lie Nah 6172055703850002 082128327205 Jl. Padang Pasir 2009-04-14 13

Erik Manson Destri Erisendi

39 2171111909090003 2171115512703004 081277510045 Jln Kav Lama 2009-09-19 13
Napitupulu Siburian
 Fadli Juan Batuaji Permai
40 2171111606120007 Maylita Pakpahan 2171115805789008 081268150360 2012-06-16 10
Sihombing Kav.Lama

Farel Andika Kav. Sagulung Jaya blok

41 2171111706120007 Marsiya Sirait 2171115503789003 081242566393 2012-06-17 10
Siagian B/48

Felixander Choki Petronela Rawa

42 5306121401120001 5306125006840001 081266201214 Balaweling Noten 2012-01-14 11
Ratu Lele Borot

43 Ferderico 2171101111090009 Nurhayati 081372482868 Kav. Mandiri 2010-11-22 12

Fiona Olivia Putri Perum Villa Namora

44 S 2171115507130001 Mewah Panjaitan 2171116712860001 081276962511 JL.Yuan No.11 2013-07-15 9

Flora Rosentia
45 Silitonga 2171116911090009 Merida Manalu 2171116005819007 082174068121 Kav. Marlegot 2009-11-29 13

Francisko Petronela Rawa

46 5306121507090001 5306125006840001 081266201214 Kav.Lama 2009-07-15 13
Adriano Atahala Boret

47 Frans 2171110603140004 Lasmaida Saida 2171126403889003 085264245282 Sagulung Indah No. 41 2013-03-06 9
Banjarnahor Silalahi

Fransisco Kelly Batuaji Permai

48 Emiliana Dai 2171115602779003 082171854793 2010-12-06 12
Felu Kav.Lama

Gabryella Artha Kav. Sei Lekop Blok E

49 2171114109110004 Dumaria Sitorus 2171114607799004 081364272342 2011-09-01 11
Ulina Siagian No. 171

Gabstian
50 2171110409100006 Christina Siahaan 2171114503720002 087894188843 Sagulung Jaya 2010-09-04 12
Aritonang
 GAVRA ELLIORA PERUM VILLA NAMORA
51 2171116009140009 EVA KRISTA 2171114704899005 081977879324 2014-09-20 8
SITINJAK JL EURO NO.18

GIDEON
HERNAWATI PERUM FORTUNA RAYA
52 HERINATAL 2171112010100011 082385183820 2010-10-20 12
SIRAIT I GG 19
DAMANIK

53 Githa Inara Sirait 2171116707110006 Sarieni SARAGIH 2171116409879003 082166013494 Batu Aji Permai 2011-07-27 11

Glen Sefril
54 Limbong 2171110704130012 Junita Manalu 2172074506859014 087836298547 Sagulung Indah 2013-04-07 9

Gracena
55 Siringoringo 2171035607110002 Larisma Limbong 2171037012780011 081276914946 Sagulung Indah 2011-07-16 11

Gracia Kaila Sorta Ryana Sagulung Mandiri Blok

56 AnjelinSiagian 2171115604110003 Hutasoit 2171115809780001 0895362684488 A No. 111 2011-04-16 11

GREGORIUS RUSUNAWA SIMPANG

57 KEVIN SAPUTRA 2171123107140003 MARIA DAI DORE 085273757172 BATAMEC BLK F1-L1 2014-07-31 8
DERIOLEH NO.2

NEW HAPPY KAVLING SAGULUNG

58 GYTA LIA SARI 2171116912140005 NATALIDA 085363985730 SUMBER MULIA C6 2014-12-29 8
PASARIBU
PASARIBU NO.37

Hacello Putra Irma Rohana Perum Nusa Batam Elok

59 2171122705140003 2171127003799001 082384710519 2014-05-27 8
Kenan Sijabat Sinaga H No.25

HAIKEL PITTA ULI PERUM MANTANG

60 PERNANDO 2171112108140012 081289092095 2014-08-21 8
SITANGGANG BLOK W NO.79
NABABAN

Hani Abenia Sari any

61 2171116110120001 085264332833 Per. Hutatap 2012-10-20 10
Sianipar Simarmata
 Helpin Rich Dewi Sartika Kav.Nato Berseri Blok C
62 2171112509130014 2171076804849003 081364040877 2013-09-25 9
Rumabutar Siregar No.14

Henny Zaneta Irma Rohana Perum Nusa Batam

63 2171124611110002 2171127003799001 082384710519 2011-11-06 11
Sijabat Sinaga Blok H No. 25

Indriana Putri
64 2171114305100007 Harnota Sianturi 2171065206830001 081910234785 Jln Kav Lama 2010-05-03 12
Elisabet Silaban

INGRID FEDORA NOVAWITA PERUM HUTATAP BLOK

65 HALOHO 2171126611140003 SARAGIH 0895412404064 I NO.1A 2014-11-26 8

66 Jason Juliano 6172050608130002 T Jin Lie Nah 6172055703850002 082128327205 JL. Padang Pasir 2013-08-06 9

Jesy Aprilia
67 Simanjuntak 2171114504110001 Duliri Manurung 2171116501879001 085763631889 Kav.Lama 2011-04-05 11

Sagulung Bersatu Blok

68 Jhon Rizky 2171111606110002 Sefriani Purba 2171124109869005 085374555011 2011-06-16 11
K/07

69 Joey Jerico 2171113007100007 Erna Verawati 2171115402799006 081270274913 Jln Dapur 12 2010-07-30 12
Aritonang Sinaga

Jordan Gabriel
70 2171112107100004 Sefriani purba 2171124109869005 085374555011 jalan dapur 12 2010-07-21 12
Simanjuntak

Jose Natanael Romauli Br Batu Aji Permai Kavling

71 2171111512130004 2171116702819008 081293077344 2013-12-15 9
Sitorus Limbong Lama Blok J No.47

Juan Asido
72 2171111207100005 Ani Harianja 2171115112669001 08998786465 kavling Sagulung Jaya 2010-07-12 12
Simanungkalit
 Juan Fasco Aslayanti Kavling Sagulung Jaya
73 2171121208130005 2171104106849015 081372919657 2013-08-12 9
Lumban Tobing Situmorang Blok B No.18

Kelyn Tanesa Perum Fortuna Raya

74 2171112102210001 Lena Sagala 2171116105799004 082172569540 2014-02-21 8
Saragih AA/12

KENZIE
ROSMERI KAV.BATU AJI PERMAI
75 ADIRAJASA 2171110710140006 085264240950 2014-10-07 8
SIANTURI BLOK J NO. 101
SEMBIRING

Kevin Gilbert Jenny Tiolida

76 Pasaribu 2171111504110002 Sihombing 2171116608750002 085762845610 Sagulung Sumber Jaya 2011-04-15 11

77 Kevin Yehezkiel 2171021602090035 Nora Sidabutar 085767676690 Kebun Sayur 2011-05-16 11

KEYLA ENDANG ICI

78 ARITONANG 2171126005150004 SITINJAK 082171472639 TEMBESI JAYA 2015-05-20 7

Keyla Frederica Arslin Nesty HP

79 2171115311100006 2171116903819005 089637851437 Sagulung Jaya 2010-11-13 12
Sihombing Lumbantobing

80 Kristania Yolanda 2171116510100006 Lando Sidabalok 2171117005790005 085264141821 Sagulung Mandiri 2010-10-25 12
Sirait

81 Linda 2171115003110009 Suryami 2171114509889003 082170118993 Kav Pelopor 2011-03-10 11

Ludwig Van
82 Beethoven 2171111002110005 Remina Siahaan 2171114301779002 081277738603 Sagulung Jaya 2011-02-10 11
Manurung

Margaretha Kav Sagulung Abadi

83 2171126503110003 Lerna Sijabat 2171124304780001 082391067781 2011-03-25 11
Laurensia Manik Jaya
 Marsel Wiliam Delvia Seleky
84 2171111706080065 087831130369 Batu Aji permai 2009-06-28 13
Seleky Ninkeula

Marsya Abygail Merlin Memori Sagulung Jaya Blok C

85 1272035404140002 1272034709910003 082165049215 2014-04-14 8
Siregar Manurung No. 21

Mawar Searon
86 2171116509110006 Marta Samosir 2171114303839002 082288432626 Kav Mandiri 2011-09-25 11
Hutabarat

87 Melfiana 2171101111090009 Nurhayati 081267937486 Kav. Mandiri 2009-05-23 13

88 Melki sitohang 2171110906100003 Helima sihombing 2171116905660001 082283899120 Jalan sekolah 2010-06-09 12

Michel fedric
89 Situmorang 2171110903100006 Rosiani Simarmata 2171116510759006 082276102477 Jalan dapur 12 2010-03-09 12

MIKA VIRGINIA KAV BUKIT KAMBOJA

90 2171116303150003 LAMRIA BONDAR 081270140657 2015-03-23 7
SIHOMBING BLOK V NO.83

Naomy
91 Velaphirina Koil 2171111514094001 Christina Magdalia 5305015912900005 0895635755577 Kavling Bukit Melati 2014-07-15 8
Laukamang Faet Blok G2 No 97
Gawen

Nathania
Griya Sagulung Permai
92 Griesella Putri 2171110806149001 Marta Br Sinaga 2171114302799007 081277266350 2014-07-08 8
Blok B/14
Purba

Menny Kav. Lama Sagulung

93 Njelieska Loves 2171118105139006 2171116409749004 0895712522242 2013-05-18 9
Banjarnahor Indah

Noel Alvaro
94 2171121711110006 Vovawita Saragih 2171025605869004 0895603645681 Bambu Kuning Depan 2011-11-17 11
Haloho
 Oktavia Artha Arta Nurbaya
95 2171116810090002 2171115208809007 082172560620 Jalan sapur 12 2009-10-28 13
sari Purba Simanullang

Olivia M
96 2171116708110002 Tiar Pandiangan 2171026708830002 081364984707 Kav Mandiri 2011-08-27 11
Manurung

Olivia Togi Marito Perum Batuaji Riau

97 2171115010130002 Nelvi Pardosi 2171095204809010 082171487962 2013-10-10 9
Pasaribu Bertuah G/5

ONIRA CECYLIA
98 MANURUNG 2171116508140012 TIAR PANDIANGIN 2171026708830002 081266030485 DAPUR 12 2014-08-25 8

Petronela Kristina
99 Alica 2171124608120010 Maria Dai Dore 2171125905879008 085273757172 Kampung Paradise 2012-08-06 10

100 Pricilia Aurelia 2171106071300001 Maria Petronela 2171117112649036 081372588749 Buana Raja Residence 2013-06-07 9

Princes Manuela Khusus Rouli

101 2171115105120003 2171115510749006 082171485195 Graha Nusa Batam 2012-05-11 10
Sitanggang Purba

102 Putra Natar 2171110111120009 Nurtobing 2171116207710001 082283111417 Kav. Sagulung Mandiri 2012-11-01 10
Hutabarat Situmeang Blok E No. 123

Putri Setiani Kamp Baru Indosat

103 2171034109130001 Tiurma Sianturi 2171034306870002 081372502816 2013-08-01 9
Sinaga No.11

Raymoses
104 Abelard 1208142607110003 Lisbet Situmorang 1208146809790001 081268976114 Kav Pelopor 2011-07-26 11
Pandapotan
Damanik

Regano Kristi Herrywaty

105 2171112912100005 2171115904799011 081372896011 Sagulung Indah 2010-12-29 12
Siregar Sigalingging
106 Revan Rafael 2171020709090003 Nora Sidabutar 2171026106879006 085763158243 jalan batu ampar 2009-09-07 13

Ribka cheryl Erlinawati

107 2171116303100005 2171096108870002 0895360380006 jalan dapur 12 2010-03-23 12
silaen Simamora

Richie Susi Yanti Kamp. Marlegot

108 2171112002130001 2171115801869004 082173602540 2013-02-20 9
Christhoper Sirait Simangunsong Sagulung Indah No. 54

Rindu Yearn Herrywaty

109 Marito Siregar 2171111307130005 Sigalingging 2171115904799011 081372896011 Sagulung Indah 2013-07-13 9

Rinto Harapan
110 Simamora 2171112301120003 Rukia Butar- Butar 2171116012839005 082381005088 Kav. Sagulung Mandiri 2012-01-23 11

Kavling Sagulung
111 Riris Marito Sirait 2171114302150004 Lando Sidabalok 081364449055 Mandiri A/83 2015-02-03 7

Riwaldi Rosna Oriati Batu Aji Permai Kav.

112 2171110310110008 2171114503860005 085376088901 2011-10-03 11
Tambunan Gultom Lama

ROMAULI Arslin Nesty Hotto

113 NURCAHAYA 2171114505150001 Pronter 081372436940 Kav. Sagulung Jaya Blok 2015-05-05 7
D No. 80
SIHOMBING Lumbantobing

Rona Uli Oktavia Dormal Lumban Buana Raya Boulevard

114 2171115410140001 2171116606860007 082169186336 2014-10-14 8
Simanjuntak Raja B.15/2

Sandrina Romauli Simp. Hutatap Depan

115 Damaiyana 2171115204130007 2171114301809016 082279742775 2013-04-12 9
Sihombing SMUN .05
Simaremare

Sarah Abigael
116 2171115512090006 Vera Pardede 2171115502680001 087794901135 perum hutatap 2009-12-15 13
Siagian
 Sebastian Saurma Romauli Batu Aji Permai
117 2171110111140003 2171115608869006 085640132608 2014-07-01 8
Natanael Munthe Butar Butar Kav.Lama

Serlin Oulia
118 2171115309090006 Dian Marwati 2171116707799019 082371814061 Jln Dapur 12 2009-09-13 13
Lolaro

Sheryl Margaret Rotua Idawati

119 2171074403100002 2171116209760001 089604496436 Kavling Lama Sagulung 2010-03-04 12
Dinata Manurung Purba

Sintya Novalia
120 Siagian 2171114211090008 Benti Flora Sitorus 2171115101790001 089512480620 Jln Dapur 12 2009-11-02 13

Siva Gavrila
121 Tuwonaung 2171114607110002 Kartini Sidabutar 2171116210790002 081276800915 Kav Pelopor 2011-07-06 11

Steven Leonaldo Pitta Uli Perum Anggara Graha

122 Nababan 2171110310120005 Sitanggang 1202106604830002 081289092095 Blok M 12 2012-10-03 10

Sukmawati Saurma Romauli

123 2171115108090005 2171115608869006 085640132608 Jln Dapur 12 2009-08-11 13
Rohani Munthe Butar-Butar

124 Syalomikha 2171116206110005 Dornauli Bakara 2171116909849012 081270612610 Sagulung Jaya 2011-06-22 11
Silaen

TIFANY
DENIATI KAV SAGULUNG ABADI
125 VERONIKA 2171116303150012 2015-03-23 7
SITUNGKIR JAYA BLOK E NO25
SAGALA

MARIANTI KAV. SAGULUNG ABADI

126 TREESYA SINAGA 2171124905140002 2171066008869004 081375474730 2014-05-09 8
SIMARMATA JAYA BLOK D2 NO. 3

Valeria Excel Rotua Idawati

127 2171076704130002 2171116209760001 089604496436 Kampung Salak 2013-04-27 9
Nauli Purba
 Vicky Peri Perum Buana Bukit
128 2171111603100002 Elfiera Sianturi 2171115905859004 082154385202 2010-03-16 12
Parapat Permata

VILLIAN SUSAN DELVIA SELEKY- Batu Aji Permai Kav.

129 2171111706080065 087831130369 2012-01-29 11
SELEKY NINKEULA Lama

Wesly Marsel
130 2171031906100006 Berlina Samosir 2171034608800001 081267960309 Batu Aji Permai 2010-06-19 12
Tampubolon

Yellyta
131 Sihombing 2171115312110004 Henno br Sinaga 2171116610770001 081262209020 SAGULUNG INDAH 1 2011-12-13 11

Yeriko Afryandi Kavling Bukit Kamboja

132 Sihombing 2171112603120003 Lamria Bondar 2171115501820002 081270140657 Blok V No.83 2012-03-26 10

Kavling Sagulung Jaya

133 Yohana Pardosi 2171116510130008 Martina Manurung 2171104103899004 082172439089 Blok B No.03 2013-10-25 9

134 Yohanes Arfando 2171103011280002 Maria Petronela 2171117112649036 0895629065130 Buana Raja Residence 2012-03-01 10

135 Yosua Scolary 2171110507140003 Heldiana Siregar 2171127011749001 082283248341 Sagulung Abadi Jaya 2014-07-05 8
Simanjuntak

Zefanya Maysel Hasdu Irawaty Br Kav. Mandiri Blok E No.

136 2171115305130005 2171096811889008 0895603672220 2013-05-13 9
Lumban Raja Simamora 179

Ziella Octaviana
137 2171115110130006 Asnida Situmorang 2171116212809008 082383975324 Kavling Pelopor 2013-10-15 9
Simanjuntak

TOTAL
TOTAL VIAL VAKSIN (Jumlah Vial = Jumlah Total Sasaran/IP Vaksin)
A ET LABOORA

Apakah anak merupakan sasaran Imunisasi Tambahan

Apakah anak Campak Rubella (Ya=1, Tidak = 0)
mendapatkan ORI
Campak Rubela
sejak Januari 2022
Usia 5 - <7 thn Usia 7-<12 thn Usia 12 -<15 thn
(Ya =1, Tidak=0)
(Ya=1, Tidak=0) (Ya=1, Tidak=0) (bagi 5 Prov.)
(Ya=1, Tidak=0)

0 0 1 0

0 0 1 0

0 0 1 0

0 0 1 0

0 0 1 0

0 0 1 0
0 0 1 0

0 0 1 0

0 0 1 0

0 0 1 0

0 0 1 0

0 0 1 0

0 0 1 0

0 0 1 0

0 0 1 0

0 0 1 0

0 0 1 0
0 0 1 0

0 0 1 0

0 0 1 0

0 0 1 0

0 0 1 0

0 0 1 0

0 0 1 0

0 0 1 0

0 0 1 0

0 0 1 0

0 0 1 0
0 0 1 0

0 0 1 0

0 0 1 0

0 0 1 0

0 0 1 0

0 0 1 0

0 0 1 0

0 0 1 0

0 0 1 0

0 0 1 0

0 0 1 0
0 0 1 0

0 0 1 0

0 0 1 0

0 0 1 0

0 0 1 0

0 0 1 0

0 0 1 0

0 0 1 0

0 0 1 0

0 0 1 0

0 0 1 0
0 0 1 0

0 0 1 0

0 0 1 0

0 0 1 0

0 0 1 0

0 0 1 0

0 0 1 0

0 0 1 0

0 0 1 0

0 0 1 0

0 0 1 0
0 0 1 0

0 0 1 0

0 0 1 0

0 0 1 0

0 0 1 0

0 0 1 0

0 0 1 0

0 0 1 0

0 0 1 0

0 0 1 0

0 0 1 0
0 0 1 0

0 0 1 0

0 0 1 0

0 0 1 0

0 0 1 0

0 0 1 0

0 0 1 0

0 0 1 0

0 0 1 0

0 0 1 0

0 0 1 0
0 0 1 0

0 0 1 0

0 0 1 0

0 0 1 0

0 0 1 0

0 0 1 0

0 0 1 0

0 0 1 0

0 0 1 0

0 0 1 0

0 0 1 0
0 0 1 0

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3