Microplanning Bian Sukagalih

FORMAT PENDATAAN KEBUTUHAN TENAGA DAN JADWAL PELAKSANAAN BULAN IMUNISASI ANAK NASIONAL
Provinsi : Jawa Barat Puskesmas : Sukagalih

Kabupaten : Sumedang
Jumlah Sasaran Imunisasi Kejar

Nama Tempat (Usia 12-59 bulan)
No. Nama Puskesmas Nama Kelurahan
Pelaksanaan Imunisasi
OPV IPV DPT-HB-Hib
1 Sukagalih CIPAMEUNGPEUK ASTER 0 0 0

2 CIPAMEUNGPEUK MAWAR 1 3 0
3 CIPAMEUNGPEUK KENANGA 5 22 4
4 CIPAMEUNGPEUK CEMPAKA 1 14 1
5 CIPAMEUNGPEUK MELATI I 0 0 0
6 CIPAMEUNGPEUK MELATI II 0 13 0
7 CIPAMEUNGPEUK MELATI III 0 5 2
8 CIPAMEUNGPEUK ANGGREK I 2 1 3
9 CIPAMEUNGPEUK ANGGREK II 0 5 0
10 SUKAGALIH SIMPATI I 0 5 0
11 SUKAGALIH SIMPATI II 0 7 0
12 SUKAGALIH SIMPATI III 4 14 1
13 SUKAGALIH SIMPATI IV 1 8 1
14 SUKAGALIH SIMPATI V 0 0 0
15 SUKAGALIH SIMPATI VI 0 0 0
16 GUNASARI MURAI 0 21 0
17 GUNASARI GELATIK 2 9 2
18 GUNASARI MERPATI 2 24 3
19 GUNASARI PIPIT I 0 9 0
20 GUNASARI PIPIT II 1 2 1
21 BAGINDA TERATAI I 1 6 1
22 BAGINDA TERATAI II 0 0 0
23 BAGINDA TERATAI III 0 10 0
24 BAGINDA TERATAI IV 0 5 0
25 BAGINDA TERATAI V 0 11 2
26 CIPANCAR CITRA MELATI I 3 9 1
27 CIPANCAR CITRA MELATI II 0 0 0
28 CIPANCAR CITRA MELATI III 2 3 2
29 CIPANCAR CITRA MELATI IV 0 5 0
30 CIPANCAR CIRTA MELATI V 0 2 1
31 CIPANCAR CITRA MELATI VI 0 4 0
32 CIPANCAR CITRA MEMLATI VII 3 5 1
33 CITENGAH MAWAR I 0 0 0
34 CITENGAH MAWAR II 0 0 0
35 CITENGAH MAWAR III 0 0 0
TOTAL 28 222 26
Mengetahui
Kepala Puskesmas Sukagalih
Ida Warlinda, S.Kep.Ners

NIP: 19870918 199703 2 003
ISASI ANAK NASIONAL
Jumlah Sasaran Tambahan Campak Rubela Jumlah Kebutuhan Tenag

Jumlah Total
Sasaran
Usia 12 -<15 thn
Usia 9-59 bln Usia 5 - <7 thn Usia 7-<12 thn
(bagi 5 Prov.) Vaksinator
41 41 41 123 1
46 49 49 148 1
79 105 105 320 1
37 52 52 157 1
57 57 57 171 1
30 43 43 129 1
29 36 36 108 1
82 86 86 260 1
25 30 30 90 1
32 37 37 111 1
20 27 27 81 1
58 73 73 223 1
39 48 48 145 1
13 13 13 39 1
20 20 20 60 1
78 99 99 297 1
66 77 77 233 1
120 147 147 443 1
66 75 75 225 1
22 25 25 76 1
69 76 76 229 1
21 21 21 63 1
49 59 59 177 1
64 69 69 207 1
70 83 83 249 1
37 47 47 144 1
25 25 25 75 1
22 27 27 83 1
20 25 25 75 1
32 35 35 105 1
14 18 18 54 1
12 18 18 57 1
37 37 37 111 1
42 42 42 126 1
33 33 33 99 1
1507 1755 1755 0 5293
Jumlah Kebutuhan Tenaga Tanggal
Daftar Nama Tim Pelaksanaan
Pelaksana
Layanan
Nakes lainnya Guru/Kader Supervisor
1 1 1 Ela,Aas,Gigin 18 August 2022

1 1 1 Irma, Lestari, Bella 15 August 2022
1 1 1 Irma, Ruri, Elis 12 August 2022
1 1 1 Dede esih,Lina Lilik 04 August 2022
1 1 1 Purdianti, Wilman ,Ati 24 August 2022
1 1 1 Markos, Sri Suci, Devi 09 August 2022
1 1 1 Erna, Imas, Wikeu 16 August 2022
1 1 1 Markos, Dedah, Adita 12 August 2022
Sumedang, 06 Juli 2022

pemegang Program
Irma Wanty
FORMAT PENDATAAN KEBUTUHAN LOGISTIK DAN COLD CHAIN
Nama Provinsi : Jawa Barat

Nama Kabupaten : Sumedang
Nama Puskesmas : Sukagalih
Nama Nama Pos Jumlah Kebutuhan Vaksin (Vial) Jumlah Kebutuhan Log
No.
Desa/Kelurahan Pelayanan
OPV IPV DPT-HB-Hib Campak Rubela Dropper Pelarut MR ADS 5 ml
1 CIPAMEUNGPEUK ASTER 0 0 0 5 0 5 5
2 CIPAMEUNGPEUK MAWAR 1 1 0 5 1 5 5
3 CIPAMEUNGPEUK KENANGA 1 5 1 8 1 8 8
4 CIPAMEUNGPEUK CEMPAKA 1 3 1 4 1 4 4
5 CIPAMEUNGPEUK MELATI I 0 0 0 6 0 6 6
6 CIPAMEUNGPEUK MELATI II 0 3 0 3 0 3 3
7 CIPAMEUNGPEUK MELATI III 1 1 1 3 1 3 3
8 CIPAMEUNGPEUK ANGGREK I 0 1 1 9 0 9 9
9 CIPAMEUNGPEUK ANGGREK II 0 1 0 3 0 3 3
10 SUKAGALIH SIMPATI I 0 1 0 4 0 4 4
11 SUKAGALIH SIMPATI II 1 2 0 2 1 2 2
12 SUKAGALIH SIMPATI III 1 3 1 6 1 6 6
13 SUKAGALIH SIMPATI IV 0 2 1 4 0 4 4
14 SUKAGALIH SIMPATI V 0 0 0 2 0 2 2
15 SUKAGALIH SIMPATI VI 0 0 0 3 0 3 3
16 GUNASARI MURAI 0 5 0 8 0 8 8
17 GUNASARI GELATIK 1 2 1 7 1 7 7
18 GUNASARI MERPATI 1 5 1 12 1 12 12
19 GUNASARI PIPIT I 0 2 0 7 0 7 7
20 GUNASARI PIPIT II 1 1 1 3 1 3 3
21 BAGINDA TERATAI I 1 2 1 7 1 7 7
22 BAGINDA TERATAI II 0 0 0 3 0 3 3
23 BAGINDA TERATAI III 0 2 0 5 0 5 5
24 BAGINDA TERATAI IV 0 1 0 7 0 7 7
25 BAGINDA TERATAI V 0 3 1 7 0 7 7
26 CIPANCAR CITRA MELATI I 1 2 1 4 1 4 4
27 CIPANCAR CITRA MELATI II 0 0 0 3 0 3 3
28 CIPANCAR CITRA MELATI III 1 1 1 3 1 3 3
29 CIPANCAR CITRA MELATI IV 0 1 0 2 0 2 2
30 CIPANCAR CIRTA MELATI V 0 1 1 4 0 4 4
31 CIPANCAR CITRA MELATI VI 0 1 0 2 0 2 2
32 CIPANCAR CITRA MEMLATI VII 1 1 1 2 1 2 2
33 CITENGAH MAWAR I 0 0 0 4 0 4 4
34 CITENGAH MAWAR II 0 0 0 5 0 5 5
35 CITENGAH MAWAR III 0 0 0 4 0 4 4
TOTAL 13 53 15 166 13 166 166
mlah Kebutuhan Logistik
ADS 0.5 ml Safety box Pen Marker

41 1 1
49 1 1
105 1 1
52 1 1
57 1 1
43 1 1
36 1 1
86 1 1
30 1 1
37 1 1
27 1 1
73 1 1
48 1 1
13 1 1
20 1 1
99 1 1
77 1 1
147 1 1
75 1 1
25 1 1
76 1 1
21 1 1
59 1 1
69 1 1
83 1 1
47 1 1
25 1 1
27 1 1
25 1 1
35 1 1
18 1 1
18 1 1
37 1 1
42 1 1
33 1 1
1755 35 35
,M
Nama Provinsi : Jawa Barat

Nama Kabupaten : Sumedang
Nama Puskesmas : Sukagalih
Nama Nama Pos Jumlah Kebutuhan Vaksin (Vial) Jumlah K

No. TANGGAL
Desa/Kelurahan Pelayanan
OPV IPV DPT-HB-Hib Campak Rubela Dropper Pelarut MR
1 CIPANCAR 8/1/2022 CITRA MELATI VII 1 1 1 2 1 2
2 CIPAMEUNGPEUK 8/2/2022 ANGGREK II 0 1 0 3 0 3
3 CIPANCAR 8/2/2022 CITRA MELATI I 1 2 1 4 1 4
4 CIPAMEUNGPEUK 8/4/2022 CEMPAKA 1 3 1 4 1 4
5 CIPANCAR 8/4/2022 CITRA MELATI VI 0 1 0 2 0 2
6 SUKAGALIH 8/5/2022 SIMPATI VI 0 0 0 3 0 3
7 CIPAMEUNGPEUK 8/9/2022 MELATI II 0 3 0 3 0 3
8 GUNASARI 8/9/2022 MURAI 0 5 0 8 0 8
9 CIPAMEUNGPEUK 8/10/2022 ANGGREK I 0 1 1 9 0 9
10 GUNASARI 8/10/2022 GELATIK 1 2 1 7 1 7
11 GUNASARI 8/10/2022 PIPIT I 0 2 0 7 0 7
12 CITENGAH 8/10/2022 MAWAR III 0 0 0 4 0 4
13 CIPAMEUNGPEUK 8/11/2022 MELATI III 1 1 1 3 1 3
14 SUKAGALIH 8/11/2022 SIMPATI I 0 1 0 4 0 4
15 GUNASARI 8/11/2022 PIPIT II 1 1 1 3 1 3
16 CIPANCAR 8/11/2022 CITRA MELATI IV 0 1 0 2 0 2
17 CIPAMEUNGPEUK 8/12/2022 KENANGA 1 5 1 8 1 8
18 SUKAGALIH 8/12/2022 SIMPATI IV 0 2 1 4 0 4
19 CIPANCAR 8/12/2022 CITRA MELATI III 1 1 1 3 1 3
20 CIPAMEUNGPEUK 8/15/2022 MAWAR 1 1 0 5 1 5
21 SUKAGALIH 8/15/2022 SIMPATI II 1 2 0 2 1 2
22 CIPANCAR 8/15/2022 CIRTA MELATI V 0 1 1 4 0 4
23 SUKAGALIH 8/16/2022 SIMPATI III 1 3 1 6 1 6
24 CIPAMEUNGPEUK 8/18/2022 ASTER 0 0 0 5 0 5
25 SUKAGALIH 8/18/2022 SIMPATI V 0 0 0 2 0 2
26 BAGINDA 8/18/2022 TERATAI I 1 2 1 7 1 7
27 CIPANCAR 8/18/2022 CITRA MELATI II 0 0 0 3 0 3
28 CITENGAH 8/18/2022 MAWAR I 0 0 0 4 0 4
29 GUNASARI 8/19/2022 MERPATI 1 5 1 12 1 12
30 BAGINDA 8/19/2022 TERATAI V 0 3 1 7 0 7
31 BAGINDA 8/22/2022 TERATAI II 0 0 0 3 0 3
32 CITENGAH 8/22/2022 MAWAR II 0 0 0 5 0 5
33 BAGINDA 8/23/2022 TERATAI IV 0 1 0 7 0 7
34 CIPAMEUNGPEUK 8/24/2022 MELATI I 0 0 0 6 0 6
35 BAGINDA 8/24/2022 TERATAI III 0 2 0 5 0 5
TOTAL 13 53 15 166 13 166
Jumlah Kebutuhan Logistik
ADS 5 ml ADS 0.5 ml Safety box Pen Marker

2 18 1 1
3 30 1 1
4 47 1 1
4 52 1 1
2 18 1 1
3 20 1 1
3 43 1 1
8 99 1 1
9 86 1 1
7 77 1 1
7 75 1 1
4 33 1 1
3 36 1 1
4 37 1 1
3 25 1 1
2 25 1 1
8 105 1 1
4 48 1 1
3 27 1 1
5 49 1 1
2 27 1 1
4 35 1 1
6 73 1 1
5 41 1 1
2 13 1 1
7 76 1 1
3 25 1 1
4 37 1 1
12 147 1 1
7 83 1 1
3 21 1 1
5 42 1 1
7 69 1 1
6 57 1 1
5 59 1 1
166 1755 35 35
FORMAT JADWAL KEGIATA
No Nama Puskesmas Nama Desa/Kelurahan
1 Sukagalih Wilker PKM Sukagalih

2 Cipameungpeuk
3 Sukagalih
4 Gunasari
5 Baginda
6 Cipancar
7 Citengah
8 Cipameungpeuk
9 Sukagalih
10 Gunasari
11 Baginda
12 Cipancar
13 Citengah
14 Cipameungpeuk
15 Sukagalih
16 Gunasari
17 Baginda
18 Cipancar
19 Citengah
FORMAT JADWAL KEGIATAN PENDUKUNG PELAKSANAAN BIAN
Kegiatan yang Akan Dilaksanakan Waktu Pelaksanaan
sosialisasi BIAN pada kader posyandu dan TP-PKK 02 Juli 2022

sosialisasi BIAN pada Masyarakat Jdwl Posy. Juli
Pelaksanaa Imunisasi jadwl Posy. Agust
Sweeping Imunisasi september
NG PELAKSANAAN BIAN
Penanggung
Tempat Pelaksanaan Sasaran Kegiatan Sumber Dana
Jawab Keg
GOR Desa Sukagalih Kader Posyandu dan TP-PKK BOK korim

Posyandu Ibu Bayi & Balita Promkes
Posyandu anak usia 9-59 bulan BOK korim
FORMAT PENDATAAN POSYANDU SASARAN BIAN
SASARAN IMUNISASI TAMBAHAN CAMPAK RUBELA ADALAH 9-59 BULAN DAN SASARAN IMUNISASI KEJAR
PELAKSANAAN : AGUSTUS 2022 18 Agustus 2022
Provinsi : JAWA BARAT Desa/Kelurahan
Kabupaten : UMEDANG Posyandu
Puskesmas : SUKAGALIH
Isilah kolom yang berwarna PUTIH!
Tanggal Lahir
No. Nama Anak Jenis Kelamin (L/ P) NIK
1 SALWA SALSABILA L 13 Mei 2021 3211175305210001

2 ZAYN RAYYAN 26 Maret 2021 3211172603210001
3 ALYA NUR 10 November 2021
4 NAYANIKA A. 23 Oktober 2021 3211176310210002
5 FADHILA ERSA 16 Oktober 2021 3211175610210003
6 FAZHILA NAWAL 16 Oktober 2021 3211175610210002
7 RAINA AACYAH 21 September 2021 3211176108210002
8 ARUMI NASYA 31 Maret 2021 3211177103210002
9 M.KAHFI S. 07 April 2021
10 M.ADELIO 16 Oktober 2020 3211171610200001
11 KADITA 03 Maret 2020 3211174303200002
12 INNARA K 15 Maret 2020 3211175503200001
13 RACHAEL 16 November 2020 3211175611200002
14 DELLA PUTRI 08 April 2020 3211174804200003
15 HAFZHAN CEYA 10 Juli 2020 3211175007200001
16 QALYSA 14 Maret 2020
17 KHANAYA P. 04 Maret 2020 3211174403200001
18 SHIFA K. 13 Januari 2019 3211170706180001
19 SULISTIA N. 21 Juli 2019 3211176107190002
20 NAFISA NAJWA 14 April 2019 3211175407190001
21 M.FATIH 08 November 2019 3211170811190001
22 ZAHROTUSSITA 15 Januari 2019 3211175501190001
23 M.YUSUF 02 Agustus 2019 3211170208190001
24 DEFAIRA R 10 Juli 2019 3211175007190003
25 M.ALI RIDWAN 07 Juni 2018 3211170706180001
26 AULIA AYU 06 Maret 2018 3211174603180001
27 AIMAR N 16 Januari 2018 3211171601180001
28 M.RAFFA A. 11 Desember 2018 3211171112180002
29 ASKARAKAI 24 Desember 2018 3211172412180001
30 SAHILA SITI 14 Juli 2018 3211174905180001
31 DE ALWI FATIH 26 Desember 2018 3211172612100001
32 KAYLA NUR 22 Maret 2018 3211176203180001
33 RAPPASYA 24 Januari 2018 3211172401180001
34 ALIF SOGA 26 Oktober 2017 3211172610170003
35 GITA OKTAVIANI 24 Oktober 2017 3211176410170004
36 HARDIANSYAH 18 Desember 2017 3211170812170004
37 ARSY PUTRI 29 November 2018 3211176911180002
38 ALFIA N. 20 Oktober 2018 3273136010180005
39 ALBY RADEYA 31 Oktober 2017 3211173110170002
40 FADHIL H. 11 Agustus 2017 3211171108170001
41 AHMAD M. 30 November 2018 3211173011180003
42
43
44
45
46
47
48
49
50
TOTAL
SASARAN IMUNISASI KEJAR ADALAH 12-59 BULAN
(Disesuaikan dengan tgl pelaksanaan di masing-masing Posyandu)
: CIPAMEUNGPEUK
: ASTER
Campak *) Jumlah Dosis Vaksin yang

Nama Orang Tua (IBU) Alamat Rubela pernah didapat Umur (bulan)
sejak OPV IPV DPT-HB-Hib
RIYAN CIPAMEUNGPEUK 2/5 Januari
0 4 1 4 15
FAJAR CIPAMEUNGPEUK 2/5 0 4 1 4 16
KOKO CIPAMEUNGPEUK 2/5 0 4 1 4 9
JAKA CIPAMEUNGPEUK 3/5 0 4 1 4 9
GERRY CIPAMEUNGPEUK 3/5 0 4 1 4 10
GERRY CIPAMEUNGPEUK 3/5 0 4 1 4 10
DEDE CIPAMEUNGPEUK 3/5 0 4 1 4 10
ASEP CIPAMEUNGPEUK 4/5 0 4 1 4 16
YAYAN CIPAMEUNGPEUK 4/5 0 4 1 4 16
WILDAN CIPAMEUNGPEUK 1/5 0 4 1 4 22
M.RYAN CIPAMEUNGPEUK 1/5 0 3 0 3 29
IDRISA CIPAMEUNGPEUK 1/5 0 4 1 4 29
MUCHLIS CIPAMEUNGPEUK 1/5 0 4 1 4 21
DEDEN CIPAMEUNGPEUK 2/5 0 4 1 4 28
SUGANDI CIPAMEUNGPEUK 3/5 0 3 0 3 25
WAWA CIPAMEUNGPEUK 4/5 0 4 1 4 29
ELLAN CIPAMEUNGPEUK 4/5 0 4 1 4 29
UCI CIPAMEUNGPEUK 1/5 0 4 1 4 43
DWI CIPAMEUNGPEUK 1/5 0 4 1 4 36
ISA CIAPMEUNGPEUK 2/5 0 3 0 4 40
DEDI CIAPMEUNGPEUK 3/5 0 4 1 4 33
ONI CIPAMEUNGPEUK 4/5 0 4 1 4 43
JONI CIPAMEUNGPEUK 4/5 0 3 0 3 36
YAYA S CIPAMEUNGPEUK 4/5 0 4 1 4 37
PIA CIPAMEUNGPEUK 1/5 0 4 1 4 50
DENI M CIPAMEUNGPEUK 1/5 0 3 0 4 53
NANANG CIPAMEUNGPEUK 1/5 0 4 1 4 55
ACEP CIPAMEUNGPEUK 1/5 0 4 1 4 44
ADITIA CIPAMEUNGPEUK 1/5 0 4 1 4 43
ASEP CIPAMEUNGPEUK 2/5 0 4 1 4 49
RIYAN CIPAMEUNGPEUK 2/5 0 4 1 4 43
DADAN S CIPAMEUNGPEUK 2/5 0 4 1 4 52
INDAH CIPAMEUNGPEUK 3/5 0 4 1 4 54
SOGA CIPAMEUNGPEUK 1/5 0 4 1 4 57
NANANG CIPAMEUNGPEUK 2/5 0 4 1 4 57
DUDI CIPAMEUNGPEUK 2/5 0 4 1 4 56
SAMSUL CIPAMEUNGPEUK 2/5 0 4 1 4 44
M.SUYUDHI CIPAMEUNGPEUK 4/5 0 4 1 4 45
YANYAN CIPAMEUNGPEUK 3/5 0 3 0 3 57
CECEP CIPAMEUNGPEUK 4/5 0 4 1 4 60
CECEP CIPAMEUNGPEUK 3/5 0 4 1 4 44
1471
1471
1471
1471
1471
1471
1471
1471
1471
0
TO
n sasaran Apakah anak sasaran Imunisasi an
Jumlah dosis yang dibutuhkan Rencana Pemberian Dosis Sasaran
Imunisasi Kejar untuk melengkapi status
(Ya = 1, Tidak = 0) sasaran imunisasi
Imunisasi Kejar & CR Pada Bulan Agust
Tambahan OPV IPV DPT-HB-Hib imunisasi OPV IPV DPT-HB-Hib OPV IPV
Campak
1 0 0 0 0 0 0 0 0 0
1 0 0 0 0 0 0 0 0 0
1 0 0 0 0 0 0 0 0 0
1 0 0 0 0 0 0 0 0 0
1 0 0 0 0 0 0 0 0 0
1 0 0 0 0 0 0 0 0 0
1 0 0 0 0 0 0 0 0 0
1 0 0 0 0 0 0 0 0 0
1 0 0 0 0 0 0 0 0 0
1 0 0 0 0 0 0 0 0 0
1 1 1 1 1 1 1 1 1 1
1 0 0 0 0 0 0 0 0 0
1 0 0 0 0 0 0 0 0 0
1 0 0 0 0 0 0 0 0 0
1 1 1 1 1 1 1 1 1 1
1 0 0 0 0 0 0 0 0 0
1 0 0 0 0 0 0 0 0 0
1 0 0 0 0 0 0 0 0 0
1 0 0 0 0 0 0 0 0 0
1 1 1 0 1 1 1 0 1 1
1 0 0 0 0 0 0 0 0 0
1 0 0 0 0 0 0 0 0 0
1 1 1 1 1 1 1 1 1 1
1 0 0 0 0 0 0 0 0 0
1 0 0 0 0 0 0 0 0 0
1 1 1 0 1 1 1 0 1 1
1 0 0 0 0 0 0 0 0 0
1 0 0 0 0 0 0 0 0 0
1 0 0 0 0 0 0 0 0 0
1 0 0 0 0 0 0 0 0 0
1 0 0 0 0 0 0 0 0 0
1 0 0 0 0 0 0 0 0 0
1 0 0 0 0 0 0 0 0 0
1 0 0 0 0 0 0 0 0 0
1 0 0 0 0 0 0 0 0 0
1 0 0 0 0 0 0 0 0 0
1 0 0 0 0 0 0 0 0 0
1 0 0 0 0 0 0 0 0 0
1 1 1 1 1 1 1 1 1 1
0 0 0 0 0 0 0 0 0 0
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
40 6 6 4 6 6 6 4 6 6
TOTAL VIAL VAKSIN (Jumlah Vial = Jumlah Total Sasaran/IP Vaksin) 1 2
Sasaran anak & CR bulan Agustus (termasuk Sweeping imunisasi Kejar pada
na Pemberian Dosis Sasaran
i Kejar & CR Pada Bulan Agustus Suntikan sasaran pada September) 2022 September 2022
DPT-HB-Hib CR Bulan BIAN (JIKA DIIMUNISASI,
OPV ISI TANGGAL
IPV DPT-HB-Hib CR (JIKA DIIMUNISASI,
OPV IPV ISI
Agustus (Agustus
0 1 1 1
0 1 1 1
0 1 1 1
0 1 1 1
0 1 1 1
0 1 1 1
0 1 1 1
0 1 1 1
0 1 1 1
0 1 1 1
1 1 3 1
0 1 1 1
0 1 1 1
0 1 1 1
1 1 3 1
0 1 1 1
0 1 1 1
0 1 1 1
0 1 1 1
0 1 2 1
0 1 1 1
0 1 1 1
1 1 3 1
0 1 1 1
0 1 1 1
0 1 2 1
0 1 1 1
0 1 1 1
0 1 1 1
0 1 1 1
0 1 1 1
0 1 1 1
0 1 1 1
0 1 1 1
0 1 1 1
0 1 1 1
0 1 1 1
0 1 1 1
1 1 3 1
0 0 0 0
0 1 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
4 40 50 40 0 0 0 0 0 0
1 5 0 0 0 0 0 0
nisasi Kejar pada
ptember 2022
DIIMUNISASI, ISI
DPT-HB-Hib
0
0
SASARAN IMUNISASI TAMBAHAN CAMPAK RUBELA ADALAH 9-59 BULAN DAN SASARAN IMUNISASI KEJ
Tanggal Lahir
1 NIKEYSA P 07 September 2017 3211174709170002

2 FATIMAH P 10 September 2017 3211175009170003
3 ASSIFA P 15 Desember 2017 3211175512170001
4 DIVALERI P 24 Januari 2018 3211176401180001
5 ARFAN IBNU L 11 Juni 2018 3211171186180002
6 RAFASYA P 21 Februari 2018 3211172102180003
7 HAFIS L 26 April 2018 3211172604180001
8 RIZKY R L 12 Juni 2018 3211171206180004
9 ZAIN RIZKY L 09 Oktober 2018 3211170910180003
10 NAIMA P 29 Oktober 2018
11 REGIA P 31 Oktober 2018 3211177110180001
12 RENDI L 31 Oktober 2018 32111737110180002
13 SITI UMMU P 01 Januari 2019 3211174101190003
14 ELEANOOR P 10 Januari 2019 3211175001190002
15 AILA P 21 Januari 2019 3211176101190003
16 ARSILA P 23 Januari 2019 3211176301190001
17 YUSRIT P 03 Februari 2019 3211170302180001
18 ARSKA L 08 Februari 2019 3211170802190002
19 AZRIEL P 02 Maret 2019 3211170203190001
20 TISYA P 15 Mei 2019 3211175505790003
21 MIKAILA P 15 September 2019 32111755099190002
22 ZAKI L 02 Oktober 2019 3211180210190002
23 M.YUSUP L 13 Desember 2019 3204131312190002
24 SAHWA P 25 Januari 2020 3211176501200000
25 ZABDAN L 26 Maret 2020 321117603200003
26 ANNISA P 26 April 2020 3211176604200003
27 DAFFA L 02 Mei 2020 321117020520003
28 MAHEERA L 03 Mei 2020 3211174305200001
29 AKMAL L 30 Mei 2020 3211224212880005
30 FADLAN L 07 April 2020 3211170704200002
31 RAINA P 22 Juli 2020 3211176207200001
32 AISYAH P 06 Agustus 2020 3211174608200001
33 ALESYA P 07 April 2021 3211174704210004
34 M. RAFFAN L 08 November 2020 32111710811200001
35 AL ZAIDAN L 12 Desember 2020
36 NAZA/ARBANI L 17 Januari 2021 3211171701210001
37 ARSAKA L 27 Maret 2021 3211172703210001
38 ARKA L 13 Juni 2021 3211171307210001
39 ZAID L 06 Juli 2021
40 AZRIEL P 17 Juli 2021 3206301707210001
41 HAIKAL L 24 April 2021 3211172407210001
42 ZIHAN P 11 Juli 2021 3211175106210003
43 NADHEERA P 27 Juli 2021 3211176507210001
44 M. BALYA L 14 November 2021 3211171411210006
45 AL THAIR L 18 November 2021 3211171811210001
46 M. RAFA L 19 Juli 2019 3211171907190004
47
48
49
50
51
52
53
54
55
56
57
58
59
60
61
62
63
64
65
66
67
68
69
70
71
72
73
74
75
76
77
78
79
80
81
82
83
84
85
86
87
88
89
90
TOTAL
N SASARAN IMUNISASI KEJAR ADALAH 12-59 BULAN
: CIPAMEUNPEUK
: MAWAR
Campak *) Jumlah Dosis Vaksin yang pernah didapat

Nama Orang Tua (IBU) Alamat Rubela
ANI CIPAMEUNGPEUK 3/4 Januari
0 4 1 4
AKYA CIPAMEUNGPEUK 1/4 0 4 1 4
AISYAH CIPAMEUNGPEUK 4/4 0 4 1 4
TATI CIPAMEUNGPEUK 3/4 0 4 1 4
YUSTI CIPAMEUNPEUK 4/3 0 4 1 4
FUJI CIPAMEUNGPEUK 4/4 0 4 1 4
RISKU CIPAMEUNGPEUK 4/3 0 4 1 4
ANA CIPAMEUNGPEUK 4/4 0 0 0 0
ASTIANA CIPAMEUNGPEUK 4/3 0 4 1 4
ANI CIPAMEUNGPEUK 3/4 0 4 1 4
HETI CIPAMEUNPEUK 1/3 0 4 1 4
MILY CIPAMEUNGPEUK 1/4 0 4 0 4
GINA CIPAMEUNGPEUK 3/4 0 4 0 4
ELIZA CIPAMEUNGPEUK 3/4 0 4 1 4
ELIN CIPAMEUNGPEUK 1/4 0 4 1 4
ELA CIPAMEUNGPEUK 2/4 0 4 1 4
ELAH CIPAMEUNGPEUK 4/4 0 4 0 4
AI CIPAMEUNGPEUK 4/4 0 4 1 4
JANI CIPAMEUNGPEUK 3/4 0 4 0 4
NANI CIPAMEUNGPEUK 1/3 0 4 1 4
SITI CIPAMEUNGPEUK 1/4 0 4 1 4
FERA CIPAMEUNGPEUK 1/4 0 4 1 4
DUSLA CIPAMEUNGPEUK 1/3 0 4 1 4
SULASTRI CIPAMEUNGPEUK 2/4 0 4 0 4
WINDI CIPAMEUNGPEUK 4/4 0 4 1 4
NURLINDA CIPAMEUNGPEUK 1/4 0 4 0 4
SRI CIPAMEUNGPEUK 2/4 0 3 1 4
NITA CIPAMEUNGPEUK 1/3 0 4 1 4
DINI CIPAMEUNGPEUK 3/3 0 4 1 4
NIA CIPAMEUNGPEUK 4/4 0 4 1 4
FUJI CIPAMEUNGPEUK 4/4 0 3 0 3
WILDA CIPAMEUNGPEUK 2/3 0 4 1 4
YATIE CIPAMEUNGPEUK 3/4 0 4 1 4
TITI. R CIPAMEUNGPEUK 4/4 0 4 1 4
NORA CIPAMEUNGPEUK 4/4 0 4 0 4
NURDINI CIPEMEUNGPEUK 3/3 0 4 0 4
RAINI CIPAMEUNPEUK 1/3 0 4 0 4
YUSTI CIPAMEUNGPEUK 4/3 0 4 1 4
ASTIANI CIPAMEUNPEUK 4/3 0 4 0 4
YUNI CIPAMEUNGPEUK 3/3 0 4 0 4
NANI CIPAMEUNPEUK 3/3 0 4 0 4
HANISA CIPAMEUNGPEUK 1/4 0 4 0 4
ANI CIPAMEUNGPEUK 1/3 0 4 0 4
GINA CIPAMEUNGPEUK 3/4 0 4 0 4
AI. S CIPAMEUNGPEUK 4/4 0 4 0 4
MERI CIPAMEUNPEUK 2/4 0 4 0 4
0 4 1 4
0 4 1 4
0 4 0 4
0 4 1 4
0 4 1 4
0 4 1 4
0 3 1 3
0 4 1 4
0 3 0 3
0 4 1 4
0 4 1 4
0 4 1 4
0 4 1 4
0 4 1 4
0 4 1 4
0 4 1 4
0 4 1 4
0 4 1 4
0 4 1 4
0 4 1 4
0 4 1 4
0 4 0 4
0 4 1 4
0 4 1 4
0 4 1 4
0 4 1 4
0 4 1 4
0 4 1 4
0 4 1 4
0 4 1 4
0 4 1 4
0 4 1 4
0 4 1 4
0
Apakah anak sasaran Imunisasi Jumlah dosis yang dibutuhka
Apakah anak merupakan sasaran Kejar an untuk melengkapi status
Umur (bulan) Imunisasi Tambahan (Ya = 1, Tidak = 0) sasaran
Campak Rubella (Ya=1, Tidak = 0) OPV IPV DPT-HB-Hib imunisasi OPV
59 1 0 0 0 0 0
59 1 0 0 0 0 0
56 1 0 0 0 0 0
54 1 0 0 0 0 0
50 1 0 0 0 0 0
53 1 0 0 0 0 0
51 1 0 0 0 0 0
50 1 1 1 1 1 4
46 1 0 0 0 0 0
45 1 0 0 0 0 0
45 1 0 0 0 0 0
45 1 0 1 0 1 0
43 1 0 1 0 1 0
43 1 0 0 0 0 0
42 1 0 0 0 0 0
42 1 0 0 0 0 0
42 1 0 1 0 1 0
42 1 0 0 0 0 0
41 1 0 1 0 1 0
39 1 0 0 0 0 0
35 1 0 0 0 0 0
34 1 0 0 0 0 0
32 1 0 0 0 0 0
30 1 0 1 0 1 0
28 1 0 0 0 0 0
27 1 0 1 0 1 0
27 1 1 0 0 1 1
27 1 0 0 0 0 0
26 1 0 0 0 0 0
28 1 0 0 0 0 0
24 1 1 1 1 1 1
24 1 0 0 0 0 0
16 1 0 0 0 0 0
21 1 0 0 0 0 0
20 1 0 1 0 1 0
18 1 0 1 0 1 0
16 1 0 1 0 1 0
14 1 0 0 0 0 0
13 1 0 1 0 1 0
12 1 0 1 0 1 0
15 1 0 1 0 1 0
13 1 0 1 0 1 0
12 1 0 1 0 1 0
9 1 0 0 0 0 0
8 0 0 0 0 0 0
36 1 0 1 0 1 0
1471 0 0 0 0 0 0
1471 0 0 0 0 0 0
1471 0 0 0 0 0 0
1471 0 0 0 0 0 0
1471 0 0 0 0 0 0
1471 0 0 0 0 0 0
1471 0 0 0 0 0 0
1471 0 0 0 0 0 0
1471 0 0 0 0 0 0
1471 0 0 0 0 0 0
1471 0 0 0 0 0 0
1471 0 0 0 0 0 0
1471 0 0 0 0 0 0
1471 0 0 0 0 0 0
1471 0 0 0 0 0 0
1471 0 0 0 0 0 0
1471 0 0 0 0 0 0
1471 0 0 0 0 0 0
1471 0 0 0 0 0 0
1471 0 0 0 0 0 0
1471 0 0 0 0 0 0
1471 0 0 0 0 0 0
1471 0 0 0 0 0 0
1471 0 0 0 0 0 0
1471 0 0 0 0 0 0
1471 0 0 0 0 0 0
1471 0 0 0 0 0 0
1471 0 0 0 0 0 0
1471 0 0 0 0 0 0
1471 0 0 0 0 0 0
1471 0 0 0 0 0 0
1471 0 0 0 0 0 0
1471 0 0 0 0 0 0
1471 0 0 0 0 0 0
1471 0 0 0 0 0 0
1471 0 0 0 0 0 0
1471 0 0 0 0 0 0
1471 0 0 0 0 0 0
1471 0 0 0 0 0 0
1471 0 0 0 0 0 0
1471 0 0 0 0 0 0
1471 0 0 0 0 0 0
1471 0 0 0 0 0 0
1471 0 0 0 0 0 0
45 3 17 2 18 6
TOTAL VIAL VAKSIN (Jumlah Vial = Jumlah Total Sasaran/IP Vaksi
Jumlah dosis yang dibutuhkan Sasaran anak & CR bulan Agustus (termasuk Sweepi
Rencana Pemberian Dosis Sasaran
untuk melengkapi status
Imunisasi Kejar & CR Pada Bulan Agustus Suntikan sasaran pada September) 2022
imunisasi
IPV DPT-HB-Hib OPV IPV DPT-HB-Hib CR Bulan BIAN (JIKA DIIMUNISASI,
OPV IPV ISI TANGGAL
Agustus (Agustus
0 0 0 0 0 1 1 1
0 0 0 0 0 1 1 1
0 0 0 0 0 1 1 1
0 0 0 0 0 1 1 1
0 0 0 0 0 1 1 1
0 0 0 0 0 1 1 1
0 0 0 0 0 1 1 1
1 4 1 1 1 1 3 1
0 0 0 0 0 1 1 1
0 0 0 0 0 1 1 1
0 0 0 0 0 1 1 1
1 0 0 1 0 1 2 1
1 0 0 1 0 1 2 1
0 0 0 0 0 1 1 1
0 0 0 0 0 1 1 1
0 0 0 0 0 1 1 1
1 0 0 1 0 1 2 1
0 0 0 0 0 1 1 1
1 0 0 1 0 1 2 1
0 0 0 0 0 1 1 1
0 0 0 0 0 1 1 1
0 0 0 0 0 1 1 1
0 0 0 0 0 1 1 1
1 0 0 1 0 1 2 1
0 0 0 0 0 1 1 1
1 0 0 1 0 1 2 1
0 0 1 0 0 1 1 1
0 0 0 0 0 1 1 1
0 0 0 0 0 1 1 1
0 0 0 0 0 1 1 1
1 1 1 1 1 1 3 1
0 0 0 0 0 1 1 1
0 0 0 0 0 1 1 1
0 0 0 0 0 1 1 1
1 0 0 1 0 1 2 1
1 0 0 1 0 1 2 1
1 -1 0 1 0 1 2 1
0 0 0 0 0 1 1 1
1 -1 0 1 0 1 2 1
1 -1 0 1 0 1 2 1
1 -1 0 1 0 1 2 1
1 -1 0 1 0 1 2 1
1 -1 0 1 0 1 2 1
0 0 0 0 0 1 1 1
0 0 0 0 0 0 0 0
1 0 0 1 0 1 2 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
17 -1 3 17 2 45 64 45 0 0
= Jumlah Total Sasaran/IP Vaksin) 1 5 1 6 0 0
an Agustus (termasuk Sweeping imunisasi Kejar pada
pada September) 2022 September 2022
DIIMUNISASI, ISI TANGGAL
DPT-HB-Hib CR (JIKA DIIMUNISASI,
OPV ISI
IPV DPT-HB-Hib
0 0 0 0 0
0 0 0 0 0
Tanggal Lahir
1 ZAYNA P 14 November 2021

2 AZZAM L 14 November 2021 3211171411210005
3 M.MAUZA L 14 Oktober 2021 3211171410210002
4 NAZMA ADIBA. P P 02 September 2021 3211174209210001
5 M. ALFATIH L 12 September 2021 3211174129211029
6 NADIRA Z.T.A P 18 September 2021 3211185809210003
7 NAILA.M.R.A P 18 September 2021 3211185809210002
8 M. ABDUL. MALIK L 22 Agustus 2021 3211172208210003
9 REYSKA.M.G P 09 Juli 2021 3211170907210001
10 M. CELLO. A L 08 Juni 2021 3215010806210001
11 NAFISA DZAKIRA P 10 Juni 2021 3211175006210001
12 M. ARIZKY L 22 April 2021 3211172204210003
13 IBROHIM. F.E L 27 April 2021 3211172704210001
14 ADZRA. SHIDQI.A L 22 Maret 2021 3211172203210002
15 IBRAHIM ALDEBARAN L 06 Februari 2021 3211170602210002
16 DANEEN ALLEN . K L 08 Februari 2021 3211174802210002
17 KHUMAIRA.M.A P 19 Januari 2021 3211175901210001
18 KHANZIA SRI.I P 01 Desember 2021 3211174112200005
19 MUSA ANNUFAIL.S P 05 Desember 2020 3211170512200005
20 M. SAHAL. T L 13 Desember 2020 321117132200002
21 JIHAN SHAIMA.R.S P 22 Desember 2020 3211176212200002
22 KHIRANI SETIA. D P 29 November 2020 3211176911200002
23 ARGHANI. G. A L 09 Oktober 2020 3211170910200004
24 DHAFA PRATAMA L 16 Oktober 2020 3211171610200003
25 ARSYA SHAQUILLE P 01 Agustus 2020 3211170108200001
26 KHAWLA.A.C P 02 Agustus 2020 3211174208200001
27 FEISYA P 05 Juli 2020 3211174507200001
28 TIARA NINDYA. P P 07 Juli 2020 3211174707200002
29 FAYRA ADZIKRA.P L 10 Juli 2020 3211175007200002
30 AYESHA P 04 Juni 2020 3211174406200001
31 M. SALMAN AL-FATIN L 11 Juni 2020 3211171106200002
32 JUNIAR P 13 Juni 2020 3211175306200006
33 PUTRA KURNIA L 25 Juni 2020 3211172506200001
34 KIREINA P 27 Juni 2020 3211176706200001
35 SYAHILA P 14 Mei 2020 3211175405200003
36 NADHIRA. N P 18 Mei 2020 3211175805200001
37 SATYA ANAKING. B.J L 09 Maret 2020 3211170903200002
38 SHALMEERA P 27 Februari 2020 3211176702200005
39 GAVIN ABIDZAR. A L 02 Januari 2020 32111702012000001
40 GAGAH SURYA. R L 05 Januari 2020 3211170501200001
41 GHANIA. A. R P 17 Desember 2019 3211175712190001
42 DAFI HAAZIQ.E L 05 Oktober 2019 3211170510190001
43 ALBY RAMADAN L 02 September 2019 3211170209190001
44 M. AIDIL L 11 Agustus 2019 3211171109190002
45 M. RAFFASYA.E.A L 08 Agustus 2019 3211171809190001
46 M. FAUZI. L 11 Juli 2019 3211171107170001
47 AISYAH SHAFITRIAN P 05 Juni 2019 3211174506190001
48 RAYYA ALIYYA P P 06 Juni 2019 3211172706190001
49 ELGIO L 07 Juni 2019 3211172706190002
50 TAFATHZANI M.B.T L 03 April 2019 3211174304190001
51 MYSHA A.K. P 12 Maret 2019 3211175203190001
52 HASNA KIRANA A. P 16 Maret 2019 3211175603190002
53 M.RAFASSYA L 16 Februari 2019 3211171602190001
54 YAHYA P 01 Desember 2018 3211170112180001
55 AHNAF H.A.G L 01 Desember 2018 3211170112180001
56 HANUM SRI G.B. P 29 Desember 2018 3211176912180002
57 RAYYAN L.A. L 11 Oktober 2018 3211171110180005
58 ARSHAKA F.G L 22 Oktober 2018 3211172210180002
59 INTANIA K.P.A. P 03 September 2018 3211174309180001
60 ABIZARD A.M L 13 September 2018 3211171309180002
61 UDZMA G.M. P 31 Agustus 2018 3211177108180001
62 M.RAFFASYA A. L 14 Juli 2018 3211171407180002
63 SUSANTI WIJAYA P 02 Juni 2018 3211174206180001
64 KANIA A.F. P 15 Juni 2018 3211175506180003
65 M.DEFANDRA L 10 Mei 2018 3211171005180001
66 AKHTAR S.L L 21 Mei 2018 3211172105180001
67 M.IRWAN S. L 26 Mei 2018 3211172605180002
68 NADHIRA R.M. P 13 April 2018 3211175304180002
69 CHINTYA R.A.S. P 15 April 2018 3211185504180003
70 M.AZHRIL F. L 12 Maret 2018 3211171203180002
71 BANI HAMZAH L 10 Januari 2018 3211171001180001
72 M.RAZKA L 31 Januari 2018 3211173101180001
73 BRAVE L 14 Desember 2017 3211171412170001
74 AISYAH N. P 31 Desember 2017 3211177112170001
75 AL GHAZALI L 11 November 2017 3211171111170001
76 M.ALWI A. L 30 November 2017 3211173011170001
77 M.ZAKY R.S L 16 November 2017 3215011611170002
78 M.RAFIF A. L 26 Oktober 2017 3211172610170004
79 AZMA S.N P 08 September 2017 3211174809170001
80
81
82
83
84
85
86
87
88
89
90
TOTAL
N DAN SASARAN IMUNISASI KEJAR ADALAH 12-59 BULAN
: CIPAMEUNPEUK
: KENANGA
*) Jumlah Dosis Vaksin yang n sasaran

Campak
pernah didapat Imunisasi
Nama Orang Tua (IBU) Alamat Rubela Umur (bulan)
OPV IPV DPT-HB-Hib Tambahan
sejak
Campak
GANDI KEBONCAU 2/1 Januari
0 4 1 4 8 0
DIAN. N KEBONCAU 2/1 0 4 1 4 8 0
DENI KEBONCAU 3/2 0 4 1 4 9 1
MISWAR KEBONCAU 4/1 0 4 1 4 11 1
DEDE KEBONCAU 1/2 0 4 1 4 11 1
ISEP INDRA KEBONCAU 3/1 0 4 1 4 10 1
ISEP INDRA KEBONCAU 3/1 0 4 1 4 10 1
HAFID KEBONCAU 4/1 0 0 0 0 11 1
DEDE.H KEBONCAU 3/1 0 4 1 4 13 1
KRISNA.M KEBONCAU 3/1 0 4 1 4 14 1
ABDUL. R KEBONCAU 4/1 0 4 1 4 14 1
ARJUN.S CIMURUY 1/1 0 4 0 4 15 1
EDWIN.S KEBONCAU 3/2 0 4 0 4 15 1
ADE.K KEBONCAU 3/2 0 4 1 4 16 1
HERDIYANTO KEBONCAU 2/2 0 4 1 4 18 1
ANGGRA. V KEBONCAU 3/2 0 4 1 4 18 1
AKBAR KEBONCAU 2/1 0 4 0 4 18 1
KANDI.K CIMURUY 1/1 0 4 1 4 8 0
BAGJA KEBONCAU 2/1 0 4 0 4 20 1
JAJAT. S KEBONCAU 4/1 0 4 1 4 19 1
PANJI. S KEBONCAU 2/2 0 4 1 4 19 1
DIYAN.H KEBONCAU 4/1 0 4 1 4 20 1
SEPTIANA KEBONCAU 4/1 0 4 1 4 22 1
MAMAT.R CIMURUY 1/1 0 4 0 4 21 1
DEVI. C KEBONCAU 4/1 0 4 0 4 24 1
ARRI.P KEBONCAU 3/1 0 3 1 4 25 1
DONI.G KEBONCAU 2/2 0 4 1 4 25 1
ABDI.I KEBONCAU 3/2 0 4 1 4 25 1
PERI KEBONCAU 4/1 0 4 1 4 26 1
ODEN.M KEBONCAU 4/1 0 3 0 3 26 1
DANNI.H KEBONCAU 4/1 0 4 1 4 25 1
SANDI. K KEBONCAU 3/1 0 4 1 4 25 1
ANDRI KEBONCAU 1/2 0 4 1 4 25 1
CAHYANA KEBONCAU 2/2 0 4 0 4 26 1
AGUS. S KEBONCAU 2/1 0 4 0 4 26 1
ARIES.B.P KEBONCAU 1/2 0 4 0 4 29 1
DODI KEBONCAU 1/2 0 4 1 4 29 1
RISMAN KEBONCAU 4/1 0 4 0 4 31 1
DIAN.P KEBONCAU 1/2 0 4 0 4 31 1
M. RAMDHAN KEBONCAU 1/2 0 4 0 4 31 1
DEDE.I KEBONCAU 4/1 0 4 0 4 34 1
AGUS.R KEBONCAU 3/2 0 4 0 4 35 1
MAMAT KEBONCAU 3/1 0 4 0 4 36 1
RIAN KEBONCAU 2/1 0 4 0 4 36 1
NYANA KEBONCAU 2/1 0 4 0 4 37 1
SANDI F KEBONCAU 2/1 0 4 1 4 38 1
WARSONO KEBONCAU 2/1 0 4 1 4 38 1
DIANI KEBONCAU 4/1 0 4 0 4 38 1
ANGGRA KEBONCAU 3/2 0 4 1 4 40 1
ASEP A. KEBONCAU 4/1 0 4 1 4 40 1
ENCEP KEBONCAU 3/1 0 3 1 3 41 1
TENDI H KEBONCAU 4/1 0 4 1 4 44 1
HENRY KEBONCAU 4/1 0 3 0 3 44 1
TEDI S. KEBONCAU 4/1 0 4 1 4 43 1
GANDI KEBONCAU 4/1 0 4 1 4 46 1
FEBRIANA KEBONCAU 2/1 0 4 1 4 45 1
YAYAN S. KEBONCAU 3/2 0 4 1 4 47 1
JAJANG KEBONCAU 2/1 0 4 1 4 46 1
DIAN H. KEBONCAU 2/1 0 4 1 4 47 1
NANA S. KEBONCAU 4/1 0 4 1 4 48 1
ENGKON CIMURUY 1/1 0 4 1 4 50 1
SUSILO KEBONCAU 4/1 0 4 1 4 49 1
HARUN KEBONCAU 2/1 0 4 1 4 51 1
TAMPAN KEBONCAU 2/1 0 4 1 4 50 1
HILMAN CIMURUY 1/1 0 4 1 4 50 1
DIMAR KEBONCAU 4/1 0 4 0 4 51 1
M.SYAEFULLOH CIMURUY 1/1 0 4 1 4 51 1
IYUS KEBONCAU 4/1 0 4 1 4 53 1
AHDIAT KEBONCAU 4/1 0 4 1 4 55 1
ASIM KEBONCAU 3/1 0 4 1 4 54 1
BETTINA KEBONCAU 2/2 0 4 1 4 55 1
RELY R. KEBONCAU 3/2 0 4 1 4 55 1
ARIF KEBONCAU 4/1 0 4 1 4 56 1
KRISNA.M KEBONCAU 3/1 0 4 1 4 56 1
RIKI H KEBONCAU 2/1 0 4 1 4 57 1
TENDI S. KEBONCAU 4/1 0 4 1 4 59 1
1471 0
1471 0
1471 0
1471 0
1471 0
1471 0
1471 0
1471 0
1471 0
1471 0
1471 0
0 76
TOTAL
Apakah anak sasaran Imunisasi Jumlah dosis yang dibutuhkan Rencana Pemberian Dosis Sasaran
Kejar an untuk melengkapi status
Imunisasi Kejar & CR Pada Bulan Agustus
OPV IPV DPT-HB-Hib imunisasi OPV IPV DPT-HB-Hib OPV IPV DPT-HB-Hib
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 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 0 1 0 1 -1 0 1 0
0 1 0 1 0 1 -1 0 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 1 0 1 0 1 0 0 1 0
0 0 0 0 0 0 0 0 0 0
0 1 0 1 0 1 0 0 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 1 0 1 0 1 0 0 1 0
0 0 0 0 0 0 0 0 0 0
0 1 0 1 0 1 0 0 1 0
1 0 0 1 1 0 0 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
1 1 1 1 1 1 1 1 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 1 0 1 0 1 0 0 1 0
0 1 0 1 0 1 0 0 1 0
0 1 0 1 0 1 0 0 1 0
0 0 0 0 0 0 0 0 0 0
0 1 0 1 0 1 0 0 1 0
0 1 0 1 0 1 0 0 1 0
0 1 0 1 0 1 0 0 1 0
0 1 0 1 0 1 0 0 1 0
0 1 0 1 0 1 0 0 1 0
0 1 0 1 0 1 0 0 1 0
0 1 0 1 0 1 0 0 1 0
0 1 0 1 0 1 0 0 1 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 1 0 1 0 1 0 0 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
1 0 1 1 1 0 1 1 0 1
0 0 0 0 0 0 0 0 0 0
1 1 1 1 1 1 1 1 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
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 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 0 1 0 1 0 0 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
4 21 3 23 4 21 1 4 21 3
TOTAL VIAL VAKSIN (Jumlah Vial = Jumlah Total Sasaran/IP Vaksin) 1 6 1
ian Dosis Sasaran
R Pada Bulan Agustus Suntikan sasaran pada September) 2022 September 2022
CR Bulan BIAN (JIKA DIIMUNISASI,
OPV ISI TANGGAL
OPV ISI
IPV DPT-HB-Hib
Agustus (Agustus
0 0 0
0 0 0
1 1 1
1 1 1
1 1 1
1 1 1
1 1 1
1 1 1
1 1 1
1 1 1
1 1 1
1 2 1
1 2 1
1 1 1
1 1 1
1 1 1
1 2 1
0 0 0
1 2 1
1 1 1
1 1 1
1 1 1
1 1 1
1 2 1
1 1 1
1 2 1
1 1 1
1 1 1
1 1 1
1 1 1
1 3 1
1 1 1
1 1 1
1 1 1
1 2 1
1 2 1
1 2 1
1 1 1
1 2 1
1 2 1
1 2 1
1 2 1
1 2 1
1 2 1
1 2 1
1 2 1
1 1 1
1 1 1
1 2 1
1 1 1
1 1 1
1 1 1
1 2 1
1 1 1
1 3 1
1 1 1
1 1 1
1 1 1
1 1 1
1 1 1
1 1 1
1 1 1
1 1 1
1 1 1
1 1 1
1 1 1
1 1 1
1 2 1
1 1 1
1 1 1
1 1 1
1 1 1
1 1 1
1 1 1
1 1 1
1 1 1
1 1 1
1 1 1
1 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
76 100 76 0 0 0 0 0 0 0
10 0 0 0 0 0 0 0
DPT-HB-Hib
SASARAN IMUNISASI TAMBAHAN CAMPAK RUBELA ADALAH 9-59 BULAN DAN SASARAN IMUNISASI KEJA
Tanggal Lahir
1 ALVAN K. A L 17 September 2021 32111709210001

2 ANINDIRA P 20 Agustus 2021 3211176008210002
3 AZRIL R L 20 Mei 2021 3211172005210005
4 AZKARYA L 03 Oktober 2020
5 M KHALID L 04 Januari 2021 3211170401210002
6 AL RAI. AL-Y L 02 Januari 2021 3211220201210003
7 AGNIA. K P 13 Oktober 2020 3211175310200001
8 KHANZA. N P 18 September 2020 3211175809200004
9 M. ALI. Z L 13 September 2020 3211171309200002
10 CLARISA P 23 April 2020
11 JUAN. A L 09 April 2020 3211170904200002
12 INDAH. P.N P 02 Maret 2020 3211174203200002
13 NADINDA . Y P 07 Maret 2020 3211174703200002
14 M. SYARIF. H L 20 Februari 2020 321117200220001
15 M. ABDUL. KHOER L 05 Februari 2020 3211170502200001
16 AZAM L 30 Januari 2020 3211183001200001
17 DANISH . A.F L 03 Desember 2020 3211170312190001
18 FAIHA. N.Z P 16 November 2019 321326561190003
19 M. DZIKRI L 11 September 2019 3211171105190001
20 ARKANA L 11 Juni 2019 3211171106190004
21 AZRI P.P L 24 April 2019 3211172404190003
22 ZIANITA P 24 April 2019 3211026304190001
23 PUTRI WULAN P 06 April 2019 3211174604190001
24 AKHMAL L 13 Maret 2019 3211171303190002
25 ROS AJUD P 28 Januari 2019 321117680190002
26 PAIZAR. P L 01 November 2018 321117011180002
27 M. ARSYA. A L 25 November 2018 3211172511180003
28 ZAIDAN L 07 Juni 2018 3211180706180004
29 AUNIAH P 13 Maret 2018 3211175303180001
30 RINDI. A.P P 11 Maret 2018 3211175103180001
31 VALENNISA. F P 14 Februari 2018 3211175402180001
32 REISYA . D. A P 06 Februari 2018 3211174602180001
33 ARSYLA. R.F P 27 Januari 2018 3211176701180002
34 M. SULAEMAN L 09 Desember 2017 3211170912170002
35 NOVIANI L 15 November 2017 321115511170006
36 KANAYA P 18 Oktober 2017 32111758101700009
37 RAHI. A L 29 Oktober 2017 3211176910170001
38
39
40
41
42
43
44
45
TOTAL
AN SASARAN IMUNISASI KEJAR ADALAH 12-59 BULAN
: CIPAMEUNGPEUK
: CEMPAKA
Imunisa Apakah anak sasaran

ORI Campak *) Jumlah Dosis Vaksin
Imunisasi Kejar
Nama Orang Tua (IBU) Alamat Rubela sejak yang pernah didapat Umur (bulan) si
Tambah (Ya = 1, Tidak = 0)
Januari 2022 OPV IPV DPT-HB-Hib OPV
an
IMEL CIPAMEUNGPEUK 2/7 (Ya0=1, 4 1 4 10 1 0
YANTI CIPAMEUNGPEUK 2/7 0 4 1 4 11 1 0
SELLY CIPAMEUNGPEUK 3/7 0 4 1 4 14 1 0
RIANI CIPAMEUNGPEUK 3/7 0 4 0 4 22 1 0
ELISNITA CIPAMEUNGPEUK 3/7 0 4 1 4 19 1 0
AI. R CIPAMEUNGPEUK 1/7 0 4 1 4 19 1 0
ANA. L CIPAMEUNGPEUK 2/7 0 4 1 4 21 1 0
RISKA CIPAMEUNGPEUK 3/7 0 4 1 4 22 1 0
SERLY CIPAMEUNGPEUK 3/7 0 4 0 4 22 1 0
RIMA CIPAMEUNGPEUK 2/7 0 3 0 3 27 1 1
LIA CIPAMEUNGPEUK 3/7 0 4 1 4 27 1 0
RINI CIPAMEUNGPEUK 2/7 0 4 0 4 29 1 0
FARIDA CIPAMEUNGPEUK 1/7 0 4 0 4 28 1 0
NIA CIPAMEUNGPEUK 3/7 0 4 0 4 29 1 0
ETI CIPAMEUNGPEUK 1/7 0 4 0 4 29 1 0
WIWIT CIPAMEUNGPEUK 3/7 0 4 0 4 30 1 0
DANIATI CIPAMEUNGPEUK 2/7 0 4 0 4 20 1 0
IRA CIPAMEUNGPEUK 2/7 0 4 0 4 32 1 0
FITRI CIPAMEUNGPEUK 3/7 0 4 1 4 34 1 0
DEDE CIPAMEUNGPEUK 1/7 0 4 1 4 37 1 0
AI.H CIPAMEUNGPEUK 2/7 0 4 1 4 39 1 0
RANI CIPAMEUNGPEUK 3/7 0 4 1 4 39 1 0
ALIN CIPAMEUNGPEUK 3/7 0 4 0 4 39 1 0
SITI CIPAMEUNGPEUK 1/7 0 4 0 4 40 1 0
WAWAT CIPAMEUNGPEUK 1/7 0 4 1 4 42 1 0
PIA CIPAMEUNGPEUK 3/7 0 4 1 4 45 1 0
CINDRAWATI CIPAMEUNGPEUK 3/7 0 4 1 4 44 1 0
SINTA CIPAMEUNGPEUK 3/7 0 4 1 4 49 1 0
NABILA CIPAMEUNGPEUK 3/7 0 4 1 4 52 1 0
RIKA CIPAMEUNGPEUK 3/7 0 4 0 4 53 1 0
TRININGSIH CIPAMEUNGPEUK 1/7 0 4 1 4 53 1 0
WINA CIPAMEUNGPEUK 1/7 0 4 1 4 54 1 0
ELA CIPAMEUNGPEUK 2/7 0 4 0 4 55 1 0
ENI CIPAMEUNGPEUK 3/7 0 4 1 4 56 1 0
NURUL CIPAMEUNGPEUK 3/7 0 4 1 4 57 1 0
DEVI CIPAMEUNGPEUK 1/7 0 4 1 4 57 1 0
1471 0 0
1471 0 0
1471 0 0
1471 0 0
1471 0 0
1471 0 0
1471 0 0
1471 0 0
0 37 1
TOTAL VIAL VAKSIN (Jumla
Apakah anak sasaran kan Rencana Pemberian Dosis Sasaran Sasaran anak
dibutuhkan untuk
Imunisasi Kejar sasaran melengkapi status
Imunisasi Kejar & CR Pada BulanSuntika sasara
(Ya = 1, Tidak = 0)
IPV DPT-HB-Hibimunisa OPV IPV DPT-HB-Hib OPV Agustus
IPV DPT-HB-Hib CR n Bulan n BIAN
si KEJAR Agustus (Agustu
0 0 0 0 0 0 0 0 0 1 1 1
0 0 0 0 0 0 0 0 0 1 1 1
0 0 0 0 0 0 0 0 0 1 1 1
1 0 1 0 1 0 0 1 0 1 2 1
0 0 0 0 0 0 0 0 0 1 1 1
0 0 0 0 0 0 0 0 0 1 1 1
0 0 0 0 0 0 0 0 0 1 1 1
0 0 0 0 0 0 0 0 0 1 1 1
1 0 1 0 1 0 0 1 0 1 2 1
1 1 1 1 1 1 1 1 1 1 3 1
0 0 0 0 0 0 0 0 0 1 1 1
1 0 1 0 1 0 0 1 0 1 2 1
1 0 1 0 1 0 0 1 0 1 2 1
1 0 1 0 1 0 0 1 0 1 2 1
1 0 1 0 1 0 0 1 0 1 2 1
1 0 1 0 1 0 0 1 0 1 2 1
1 0 1 0 1 0 0 1 0 1 2 1
1 0 1 0 1 0 0 1 0 1 2 1
0 0 0 0 0 0 0 0 0 1 1 1
0 0 0 0 0 0 0 0 0 1 1 1
0 0 0 0 0 0 0 0 0 1 1 1
0 0 0 0 0 0 0 0 0 1 1 1
1 0 1 0 1 0 0 1 0 1 2 1
1 0 1 0 1 0 0 1 0 1 2 1
0 0 0 0 0 0 0 0 0 1 1 1
0 0 0 0 0 0 0 0 0 1 1 1
0 0 0 0 0 0 0 0 0 1 1 1
0 0 0 0 0 0 0 0 0 1 1 1
0 0 0 0 0 0 0 0 0 1 1 1
0 0 0 0 0 0 0 0 0 1 1 1
1 0 1 0 1 0 0 1 0 1 2 1
0 0 0 0 0 0 0 0 0 1 1 1
0 0 0 0 0 0 0 0 0 1 1 1
1 0 1 0 1 0 0 1 0 1 2 1
0 0 0 0 0 0 0 0 0 1 1 1
0 0 0 0 0 0 0 0 0 1 1 1
0 0 0 0 0 0 0 0 0 1 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 0 0
0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0
14 1 14 1 14 1 1 14 1 37 52 37
TOTAL VIAL VAKSIN (Jumlah Vial = Jumlah Total Sasaran/IP Vaksin) 1 4 1 5
imunisasi Kejar pada
Agustus (termasuk Sweeping pada
September) 2022 September 2022
OPV IPV DPT-HB-Hib CR (JIKA
OPV DIIMUNISASI, ISI
IPV DPT-HB-Hib
0 0 0 0 0 0 0
0 0 0 0 0 0 0
Tanggal Lahir
1 HASAN L 03 Oktober 2017 32111703110170001

2 HUSEN L 04 Oktober 2017 3211170410170001
3 RIFKI.M.A L 18 September 2017 3211171809170001
4 M. NATHAN L 07 Desember 2017 3211170712170001
5 M. KHAYRU L 22 Juni 2018 3209090976180002
6 M. RASYID L 22 Februari 2019 3211172202190001
7 GINAN P 27 Juli 2018 3211172707180002
8 ANGGARA L 05 September 2018 32111050509180001
9 M. ABIZAR L 22 Oktober 2018 3211172210180004
10 RAYAN L 25 November 2018 3211172511180001
11 HILMI L 14 Desember 2018 3211171412180003
12 EL FATIH L 02 Juli 2019 3211170207190001
13 EL HAFIZ L 20 Mei 2019 3211172005190002
14 ABIAN L 29 Mei 2018 3211172905180005
15 ANFA L 10 September 2019 3211171009190004
16 ABBAD FAIZ L 22 Juni 2018 3211222206180001
17 M FATRHIR L 14 September 2019 3211171409190001
18 M. HABIBIE L 08 Desember 2019 3211170812190004
19 ADITAMA L 16 Desember 2019
20 AL BIRU L 30 Desember 2019 3211173012190000
21 M. REVAN L 28 September 2019 3211182809170002
22 ABDURASYID L 14 Oktober 2020 3211221410200002
23 ASSRA L 05 Juli 2020 321117050720002
24 M. YUSUF L 21 Mei 2020 3211182105200001
25 JIBRIL ILHAM L 19 Mei 2020 3211171905200001
26 AZKA RAFFA L 15 Maret 2021 3211171503210001
27 JANUAR L 28 Oktober 2020
28 DILSHAD L 03 Maret 2020 3211170303200001
29 M. ALWI L 18 Maret 2021
30 M. ARDAN L 18 Maret 2021 3211171803210002
31 PARIS. R L 02 Juli 2021
32 ABIZAR L 07 November 2021
33 SITI AZWA P 16 Oktober 2021 3211175611170001
34 NAZWA P 13 Maret 2018 3211175303180003
35 YASMIN P 12 Oktober 2019 3211166210190001
36 MUTIARA P 05 September 2019 3211174509190000
37 IIS NUR DZALIKA P 17 Desember 2019 3211175712190003
38 SUCI P 27 Mei 2019
39 SHIFANIA P 22 Januari 2019 3211176201200002
40 ARSYLA P 17 Februari 2018 3211175702180001
41 DEWI. A P 25 Februari 2018 3211176502180002
42 ALMIRA P 28 November 2018 3211176811180001
43 ANISA P 17 Mei 2020 3211175705200002
44 CAHAYA P 08 Mei 2020 3174044805200007
45 ALMAHIRA P 25 Juni 2020 321117650200001
46 SALWA. A P 03 Agustus 2020 321117430820000
47 SALMA P 03 Agustus 2020 3211174308200005
48 ALESHA P 13 Februari 2021 3211175302210002
49 SALSABILA P 26 Februari 2021 3211176602210003
50 SITI KHODIJAH P 03 April 2021 3211174301210002
51 SUSI. S P 02 Januari 2020 3211171201200001
52 RAHMA P 14 April 2021 3211175404210001
53 ALMAIRA P 30 Mei 2021 321117005210003
54 YURI P 07 April 2021 3211174704210003
55 DAMIYA L 14 Agustus 2021 3211175408210001
56 ASQIA P 05 Agustus 2021 3211174508210001
57 ADKIYA P 30 Juni 2021
58
59
60
61
62
63
64
65
TOTAL
ASARAN IMUNISASI KEJAR ADALAH 12-59 BULAN
: CIPAMEUNPEUK
: MELATI I
*) Jumlah Dosis Vaksin yang n sasaran Apakah anak sasaran Imunisasi

Campak Kejar
Nama Orang Tua (IBU)
Alamat Rubela Umur (bulan) (Ya = 1, Tidak = 0)
OPV IPV DPT-HB-Hib Tambahan OPV IPV
sejak
Campak
ANI CIPAK 3/6 Januari
0 4 1 4 58 1 0 0
ANI CIPAK 3/6 0 4 1 4 58 1 0 0
PIPIT CIPAK 6/6 0 4 1 4 59 1 0 0
LINA CIPAK 4/6 0 4 1 4 56 1 0 0
YAYU CIPAK 2/6 0 4 1 4 50 1 0 0
HANI CIPAK 4/6 0 4 1 4 42 1 0 0
NENI CIPAK 2/6 0 4 1 4 48 1 0 0
INA CIPAK 4/6 0 4 1 4 47 1 0 0
INTAN CIPAK 5/6 0 4 1 4 46 1 0 0
INTAN CIPAK 3/6 0 4 1 4 44 1 0 0
YUNI CIPAK 6/6 0 4 1 4 44 1 0 0
PIPIT CIPAK 6/6 0 4 1 4 37 1 0 0
YETI CIPAK 4/6 0 4 1 4 39 1 0 0
DIANA CIPAK 6/6 0 4 1 4 50 1 0 0
METI CIPAK 2/6 0 4 1 4 35 1 0 0
YULIANTI CIPAK 2/6 0 4 1 4 50 1 0 0
FIRA CIPAK 6/6 0 4 1 4 35 1 0 0
SRI CIPAK 6/6 0 4 1 4 32 1 0 0
MEY CIPAK 4/6 0 4 1 4 32 1 0 0
DEVI CIPAK 4/6 0 4 1 4 31 1 0 0
HANI CIPAK 1/6 0 4 1 4 34 1 0 0
YULIANTI CIPAK 2/6 0 4 1 4 22 1 0 0
WIWIN CIPAK 3/6 0 4 1 4 25 1 0 0
TITIN CIPAK 6/6 0 4 1 4 27 1 0 0
RIKA CIPAK 1/6 0 4 1 4 27 1 0 0
SANTI CIPAK 5/6 0 4 1 4 17 1 0 0
NOVI CIPAK 1/6 0 4 1 4 21 1 0 0
RINRIN CIPAK 1/6 0 4 1 4 29 1 0 0
RIA CIPAK 4/6 0 4 1 4 17 1 0 0
ANGGI CIPAK 4/6 0 4 1 4 17 1 0 0
NUR CIPAK 2/6 0 4 1 4 13 1 0 0
RISKA CIPAK 1/6 0 4 1 4 9 1 0 0
PIPIT CIPAK 4/6 0 4 1 4 10 1 0 0
ELI CIPAK 5/6 0 4 1 4 53 1 0 0
AYU CIPAK 6/6 0 4 1 4 34 1 0 0
NUR CIPAK 6/6 0 4 1 4 35 1 0 0
ULI CIPAK 4/6 0 4 1 4 32 1 0 0
LANI CIPAK 2/6 0 4 1 4 38 1 0 0
NENENG CIPAK 6/6 0 4 1 4 43 1 0 0
MERLIN CIPAK 4/6 0 4 1 4 54 1 0 0
ISAR CIPAK 5/6 0 4 1 4 53 1 0 0
YANAH CIPAK 6/6 0 4 1 4 44 1 0 0
HERA CIPAK 5/6 0 4 1 4 27 1 0 0
WINA CIPAK 3/6 0 4 1 4 27 1 0 0
JUJU CIPAK 3/6 0 4 1 4 25 1 0 0
NENI CIPAK 5/6 0 4 1 4 24 1 0 0
NENI CIPAK 5/6 0 4 1 4 24 1 0 0
POPON CIPAK 6/6 0 4 1 4 18 1 0 0
EUIS CIPAK 5/6 0 4 1 4 17 1 0 0
CHELY CIPAK 5/6 0 4 1 4 16 1 0 0
EEN CIPAK 3/6 0 4 1 4 31 1 0 0
FITRI CIPAK 1/6 0 4 1 4 16 1 0 0
TISNA CIPAK 4/6 0 4 1 4 14 1 0 0
RINA CIPAK 6/6 0 4 1 4 16 1 0 0
ELIN CIPAK 6/6 0 4 1 4 12 1 0 0
FITRIA CIPAK 1/6 0 4 1 4 12 1 0 0
LIEN CIPAK 1/6 0 4 1 4 13 1 0 0
1471 0 0 0
1471 0 0 0
1471 0 0 0
1471 0 0 0
1471 0 0 0
1471 0 0 0
1471 0 0 0
1471 0 0 0
0 57 0 0
TOTAL VIAL VAKSIN (Jumlah V
nak sasaran Imunisasi Jumlah dosis yang dibutuhkan Rencana Pemberian Dosis Sasaran Sasaran
an
Kejar untuk melengkapi status
Imunisasi Kejar & CR Pada Bulan Agustus Suntikan
a = 1, Tidak = 0) sasaran imunisasi
DPT-HB-Hib imunisasi OPV IPV DPT-HB-Hib OPV IPV DPT-HB-Hib CR Bulan
Agustus
0 0 0 0 0 0 0 0 1 1
0 0 0 0 0 0 0 0 1 1
0 0 0 0 0 0 0 0 1 1
0 0 0 0 0 0 0 0 1 1
0 0 0 0 0 0 0 0 1 1
0 0 0 0 0 0 0 0 1 1
0 0 0 0 0 0 0 0 1 1
0 0 0 0 0 0 0 0 1 1
0 0 0 0 0 0 0 0 1 1
0 0 0 0 0 0 0 0 1 1
0 0 0 0 0 0 0 0 1 1
0 0 0 0 0 0 0 0 1 1
0 0 0 0 0 0 0 0 1 1
0 0 0 0 0 0 0 0 1 1
0 0 0 0 0 0 0 0 1 1
0 0 0 0 0 0 0 0 1 1
0 0 0 0 0 0 0 0 1 1
0 0 0 0 0 0 0 0 1 1
0 0 0 0 0 0 0 0 1 1
0 0 0 0 0 0 0 0 1 1
0 0 0 0 0 0 0 0 1 1
0 0 0 0 0 0 0 0 1 1
0 0 0 0 0 0 0 0 1 1
0 0 0 0 0 0 0 0 1 1
0 0 0 0 0 0 0 0 1 1
0 0 0 0 0 0 0 0 1 1
0 0 0 0 0 0 0 0 1 1
0 0 0 0 0 0 0 0 1 1
0 0 0 0 0 0 0 0 1 1
0 0 0 0 0 0 0 0 1 1
0 0 0 0 0 0 0 0 1 1
0 0 0 0 0 0 0 0 1 1
0 0 0 0 0 0 0 0 1 1
0 0 0 0 0 0 0 0 1 1
0 0 0 0 0 0 0 0 1 1
0 0 0 0 0 0 0 0 1 1
0 0 0 0 0 0 0 0 1 1
0 0 0 0 0 0 0 0 1 1
0 0 0 0 0 0 0 0 1 1
0 0 0 0 0 0 0 0 1 1
0 0 0 0 0 0 0 0 1 1
0 0 0 0 0 0 0 0 1 1
0 0 0 0 0 0 0 0 1 1
0 0 0 0 0 0 0 0 1 1
0 0 0 0 0 0 0 0 1 1
0 0 0 0 0 0 0 0 1 1
0 0 0 0 0 0 0 0 1 1
0 0 0 0 0 0 0 0 1 1
0 0 0 0 0 0 0 0 1 1
0 0 0 0 0 0 0 0 1 1
0 0 0 0 0 0 0 0 1 1
0 0 0 0 0 0 0 0 1 1
0 0 0 0 0 0 0 0 1 1
0 0 0 0 0 0 0 0 1 1
0 0 0 0 0 0 0 0 1 1
0 0 0 0 0 0 0 0 1 1
0 0 0 0 0 0 0 0 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
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 57 57
anak & CR bulan Agustus (termasuk Sweeping imunisasi Kejar pada
sasaran pada September) 2022 September 2022
BIAN (JIKA DIIMUNISASI,
OPV ISI TANGGAL
OPV ISI
IPV DPT-HB-Hib
(Agustus
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
0
0
0
0
0
0
0
0
57 0 0 0 0 0 0 0
0 0 0 0 0 0 0
Tanggal Lahir
1 ALFAHRI. ATAARRAZKA L 22 Juni 2021

2 M. RIZKI KEMBARA L 27 Juni 2021 3211172706210001
3 M. RAFQI FATHIR. A L 24 April 2021 3211172304210005
4 SYAKILA NASHANA P 07 Juni 2021 3211174710210002
5 SITI KHALISA KEMBARI P 27 Juni 2021 3211176706210001
6 KAMILA KHOIRUNISA P 17 Desember 2020
7 ALFIAN AKBAR ARDHIANA L 26 September 2020 321117260920001
8 ANGGI MULYANA S L 31 Desember 2020 3211173112200024
9 MUHAMMAD REYHAN L 17 Juni 2020 321117170620005
10 M. YUSUF. SAPUTRA L 15 Juni 2020 32111750620001
11 MAHREEN SHAFANA. A P 23 Juni 2020 321117640620001
12 AZKA NUSRIFA P 15 Januari 2020 3211171501200001
13 RAIHAN MAULANA L 01 Maret 2019 3211170103190004
14 REZA AGUNG L 28 Agustus 2019 3211172808190003
15 RANGGA DENDRA . S L 03 Juli 2019 3211170307190001
16 DILFAN L 08 Agustus 2019 3211170808190001
17 HANANIA P 09 April 2019 32111749004190001
18 AZKIA L 27 Juli 2019 3201117670719000
19 ARKA ALFARIZI L 17 Februari 2019 32111702190003
20 ARFAN RABANI L 06 April 2019 3211170604190001
21 ARFAN FAUZAN L 10 Juli 2018 3211171007180003
22 FAUZAN L 26 Oktober 2018 3211172610180001
23 HANISA ASYFA P 28 Januari 2018 3211176801180002
24 NAURA. Z. S P 20 Desember 2018 3211176012180002
25 INARA. AISHA. PUTRI P 27 Maret 2018 3211176703180001
26 HAICAL NURIZKY L 14 Oktober 2017 3211171410170002
27 ALDAFI ATHAT MAUZA L 08 Desember 2017 3211170812170003
28 ARSYILA BUNGA CARISA P 18 Desember 2017 3211175812170001
29 AZAHRA KHAIRUNNISA P 25 Oktober 2017 32111788510170004
30 M. ASKANA ARDIANSYAH L 04 Juli 2019 3211240407190003
31
32
33
34
35
TOTAL
: CIPAMEUNPEUK
: 1. MELATI II

Campak
sejak
Campak
NURNGALIATIN CIPAMEUNGPEUK 2/9 Januari
0 4 1 4 13 1
RIKA KURNIASARI CIPAMEUNGPEUK 2/9 0 4 1 4 13 1
IYAR. W CIPAMEUNGPEUK 2/9 0 4 0 4 15 1
LIA. F CIPAMEUNGPEUK 2/9 0 4 1 4 14 1
RIKA KURNIASARI CIPAMEUNGPEUK 2/9 0 4 1 4 13 1
YAYU WIJAYANTI CIPAMEUNGPEUK 2/9 0 4 1 4 19 1
TINA CIPAMEUNGPEUK 2/9 0 4 1 4 22 1
WIWI.W CIPAMEUNGPEUK 3/9 0 4 1 4 19 1
NIA. K CIPAMEUNGPEUK 1/9 0 4 1 4 25 1
ELI. M CIPAMEUNGPEUK 3/9 0 4 1 4 25 1
NANDIA DEWI CIPAMEUNGPEUK 2/9 0 4 1 4 25 1
RUSMIATI CIPAMEUNGPEUK 1/9 0 4 0 4 30 1
TIKTIK CIPAMEUNGPEUK 3/9 0 4 0 4 41 1
DETI. K CIPAMEUNGPEUK 3/9 0 4 0 4 35 1
WIWI.WIDIA CIPAMEUNGPEUK 3/9 0 4 0 4 37 1
SUSANTI CIPAMEUNGPEUK 1/9 0 4 0 4 36 1
SUSI CIPAMEUNGPEUK 1/9 0 4 1 4 40 1
WINA CIPAMEUNGPEUK 1/9 0 4 0 4 36 1
SUMI CIPAMEUNGPEUK 1/9 0 4 1 4 41 1
ANI.N CIPAMEUNGPEUK 1/9 0 4 0 4 40 1
MIMIN CIPAMEUNGPEUK 1/9 0 4 1 4 48 1
NANI. S CIPAMEUNGPEUK 1/9 0 4 0 4 45 1
DETI CIPAMEUNGPEUK 2/9 0 4 0 4 54 1
YULI CIPAMEUNGPEUK 2/9 0 4 1 4 43 1
DELA. B CIPAMEUNGPEUK 3/9 0 4 1 4 52 1
DEDE.S CIPAMEUNGPEUK 3/9 0 4 0 4 57 1
NANI. SURYANI CIPAMEUNGPEUK 2/9 0 4 1 4 56 1
CUCU. NURMALA CIPAMEUNGPEUK 3/9 0 4 1 4 55 1
ELIS. NOPI CIPAMEUNGPEUK 3/9 0 4 0 4 57 1
SANTI CIPAMEUNGPEUK 1/9 0 4 0 4 37 1
1471 0
1471 0
1471 0
1471 0
1471 0
0 30
TO
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 1 0 1 0 1 -1 0 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 1 0 1 0 1 0 0 1 0
0 1 0 1 0 1 0 0 1 0
0 1 0 1 0 1 0 0 1 0
0 1 0 1 0 1 0 0 1 0
0 1 0 1 0 1 0 0 1 0
0 0 0 0 0 0 0 0 0 0
0 1 0 1 0 1 0 0 1 0
0 0 0 0 0 0 0 0 0 0
0 1 0 1 0 1 0 0 1 0
0 0 0 0 0 0 0 0 0 0
0 1 0 1 0 1 0 0 1 0
0 1 0 1 0 1 0 0 1 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 1 0 1 0 1 0 0 1 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 1 0 1 0 1 0 0 1 0
0 1 0 1 0 1 0 0 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 13 0 13 0 13 -1 0 13 0
ian Dosis Sasaran
OPV ISI TANGGAL
OPV ISI
IPV DPT-HB-Hib
Agustus (Agustus
1 1 1
1 1 1
1 2 1
1 1 1
1 1 1
1 1 1
1 1 1
1 1 1
1 1 1
1 1 1
1 1 1
1 2 1
1 2 1
1 2 1
1 2 1
1 2 1
1 1 1
1 2 1
1 1 1
1 2 1
1 1 1
1 2 1
1 2 1
1 1 1
1 1 1
1 2 1
1 1 1
1 1 1
1 2 1
1 2 1
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
30 43 30 0 0 0 0 0 0 0
4 0 0 0 0 0 0 0
DPT-HB-Hib
Tanggal Lahir
1 MUHAMMAD ZIYADATUL L 21 Oktober 2021 3211172110210002

2 MUHAMMAD ALI . N.R L 19 Oktober 2021 3211171910210001
3 MISNI HUSNA N. F P 30 Mei 2021 3211177005210002
4 MUHAMMAD SULAEMAN L 12 Maret 2021 321117203210001
5 MUHAMMAD BILAL .K. F L 25 Februari 2021 3211172502210002
6 NOVARANI P 29 November 2020 3211176911200001
7 ALNAIRA. K P 28 Oktober 2020 3211176810200002
8 WULANDARI P 17 Oktober 2020 3211175710200003
9 MUHAMMAD RAIHAN L 09 Oktober 2020 3211170910200006
10 MUHAMMAD HABBIB L 15 Juli 2020 3211171507200001
11 MUHAMMAD ZIDAN L 11 Juni 2020 3211171106200001
12 ADEEVA. KIRANA P 10 Juni 2020 3211175006200002
13 KANAYA. SALWA P 02 April 2020 3211174204200001
14 VICKA P 20 Januari 2020
15 SITI. NURALIZIAH P 10 November 2019 3211175011190001
16 MUHAMMAD RESTU L 10 September 2019 321117009190003
17 SITI AMINATUSSAADAH P 18 Agustus 2019 3211175808190001
18 HANIFA. A P 28 Maret 2019 3211176803190001
19 AZRIEL. SYADDAD. A L 13 Maret 2019 3211171303190004
20 AZKA. F L 25 Februari 2019 3211172502190005
21 MUHAMMAD ZAKIR. J L 24 Januari 2019 3211172401190001
22 ALFIZA. N P 26 September 2018 3211176609180001
23 MIQDAD ZOLANAFI. A L 12 September 2018 321117209180001
24 SHOFIYAH. YUMNA P 20 Agustus 2018 3211176008180001
25 NAFEEZA.S.A.R P 29 Juli 2018 321176907180001
26 ZIQRI. HUSNI. N L 15 Juni 2018 3211171506180001
27 AGNI. NUR P 04 Juni 2018 3211174406180003
28 ISSYANA P 11 Februari 2018 3211175102180002
29 ADIBA. S P 22 Oktober 2017 321117620170001
30
31
32
33
34
35
TOTAL
SARAN IMUNISASI KEJAR ADALAH 12-59 BULAN
: CIPAMEUNPEUK
: 1. MELATI III

Nama Orang Tua (IBU) Alamat Rubela pernah didapat Umur (bulan)
WINI CIPAMEUNGPEUK 2/8 Januari
0 4 1 4 9
SITI. F CIPAMEUNGPEUK 1/8 0 4 1 4 9
IIS. P CIPAMEUNGPEUK 2/8 0 4 1 4 14
LINDA CIPAMEUNGPEUK 4/8 0 4 1 4 16
IRMATANTI CIPAMEUNGPEUK 1/8 0 4 1 4 17
ROROH CIPAMEUNGPEUK 1/8 0 4 0 4 20
DESI CIPAMEUNGPEUK 1/8 0 4 1 4 21
EVI CIPAMEUNGPEUK 1/8 0 4 0 4 21
RATIH CIPAMEUNGPEUK 1/8 0 4 0 4 22
YUNITA CIPAMEUNGPEUK 1/8 0 4 1 4 24
AISKA CIPAMEUNGPEUK 2/8 0 4 1 4 26
DEWI CIPAMEUNGPEUK 2/8 0 4 1 4 26
ENEN CIPAMEUNGPEUK 3/8 0 4 1 4 28
PIPIT CIPAMEUNGPEUK 3/8 0 4 1 4 30
FITRIANI CIPAMEUNPEUK 1/8 0 4 1 4 33
RATIH CIPAMEUNGPEUK 1/8 0 3 0 3 35
SITI.F CIPAMEUNGPEUK 2/8 0 4 0 4 35
RISMA CIPAMEUNGPEUK 1/8 0 4 1 4 40
SITI. M CIPAMEUNGPEUK 2/8 0 4 1 4 40
OOM.K CIPAMEUNPEUK 1/8 0 4 1 4 41
FITRI CIPAMEUNPEUK 3/8 0 4 1 4 42
YUNITA CIPAMEUNGPEUK 1/8 0 4 1 4 46
VENY CIPAMEUNGPEUK 1/8 0 4 1 4 46
RENI CIPAMEUNPEUK 1/8 0 4 1 3 47
NENENG CIPAMEUNPEUK 2/8 0 4 1 4 48
SRI.H CIPAMEUNGPEUK 2/8 0 4 1 4 49
EVI CIPAMEUNGPEUK 1/8 0 4 1 4 50
CACIH CIPAMEUNGPEUK 1/8 0 4 1 4 54
TITING CIPAMEUNGPEUK 1/8 0 4 1 4 57
1471
1471
1471
1471
1471
1471
0
Campak
1 0 0 0 0 0 0 0 0 0
1 0 0 0 0 0 0 0 0 0
1 0 0 0 0 0 0 0 0 0
1 0 0 0 0 0 0 0 0 0
1 0 0 0 0 0 0 0 0 0
1 0 1 0 1 0 1 0 0 1
1 0 0 0 0 0 0 0 0 0
1 0 1 0 1 0 1 0 0 1
1 0 1 0 1 0 1 0 0 1
1 0 0 0 0 0 0 0 0 0
1 0 0 0 0 0 0 0 0 0
1 0 0 0 0 0 0 0 0 0
1 0 0 0 0 0 0 0 0 0
1 0 0 0 0 0 0 0 0 0
1 0 0 0 0 0 0 0 0 0
1 1 1 1 1 1 1 1 1 1
1 0 1 0 1 0 1 0 0 1
1 0 0 0 0 0 0 0 0 0
1 0 0 0 0 0 0 0 0 0
1 0 0 0 0 0 0 0 0 0
1 0 0 0 0 0 0 0 0 0
1 0 0 0 0 0 0 0 0 0
1 0 0 0 0 0 0 0 0 0
1 0 0 1 1 0 0 1 0 0
1 0 0 0 0 0 0 0 0 0
1 0 0 0 0 0 0 0 0 0
1 0 0 0 0 0 0 0 0 0
1 0 0 0 0 0 0 0 0 0
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
29 1 5 2 6 1 5 2 1 5
OPV ISI TANGGAL
OPV IPV ISI
Agustus (Agustus
0 1 1 1
0 1 1 1
0 1 1 1
0 1 1 1
0 1 1 1
0 1 2 1
0 1 1 1
0 1 2 1
0 1 2 1
0 1 1 1
0 1 1 1
0 1 1 1
0 1 1 1
0 1 1 1
0 1 1 1
1 1 3 1
0 1 2 1
0 1 1 1
0 1 1 1
0 1 1 1
0 1 1 1
0 1 1 1
0 1 1 1
1 1 2 1
0 1 1 1
0 1 1 1
0 1 1 1
0 1 1 1
0 1 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
2 29 36 29 0 0 0 0 0 0
1 4 0 0 0 0 0 0
nisasi Kejar pada
ptember 2022
DIIMUNISASI, ISI
DPT-HB-Hib
0
0
Tanggal Lahir
1 MUTHYA TRI P 30 Desember 1899 3211174309170001

2 AQSHA L 17 September 2017 3211221709170001
3 GIBRAN L 30 September 2017 3211173009170002
4 SHOFI AISHI P 09 November 2017 3211174911170001
5 RAQIYA ATIKAH P 03 Januari 2018 3211174301180002
6 AFIFA P 04 Januari 2018 3211174401180001
7 MARSHA P 10 Januari 2018 3211175001180001
8 RIZKI L 18 Januari 2018 3211171801180003
9 REGGAN L 03 Februari 2018 3211170902180003
10 PADIA P P 27 Februari 2018 3211176702180002
11 GIBRAL L 06 Maret 2018 3211170603180003
12 M.RAIHAN L 10 Maret 2018 3211171003180004
13 M.AZRIL L 21 Oktober 2018 3211172103180002
14 KELVIN L 05 April 2018 3211170504180002
15 RIZHA H L 17 Juli 2018 3211171707180003
16 AL-BILAL L 22 Juli 2018 3211172207180002
17 CITRA M P 06 Agustus 2018 3211174608180001
18 ARSYILA P 10 September 2018 3211175009180002
19 HAMIZAN L 20 September 2018 3211172009180002
20 CASSANDRA P 18 Oktober 2018 3211175810180002
21 ADZKA M. L 08 November 2018 3211170811180001
22 RAFFA NOVAL L 19 November 2018 3211171911180003
23 MUTISPA S. P 18 Desember 2018 3211174812180002
24 AZKHIRA N P 19 Desember 2018 3211171912180003
25 M.ABIZAR L 16 Januari 2019 3211171601190001
26 DEAN L 18 Januari 2019 3211171801190001
27 AZRIL L 20 Januari 2019 3211172001190002
28 NURAFNI P 07 Februari 2019 3211174702190003
29 DHEFIN L 20 Februari 2019 3211172002190001
30 M.ATHAYA L 26 Maret 2019 3211172603190002
31 A.RAIHAN L 30 April 2019 3211173004190002
32 SHAFIQ L 02 Mei 2019 3211170205190001
33 SYAKILA P 09 Mei 2019 3211174905190004
34 ALFAN L 01 Juni 2019 3205420106190004
35 TRISTAN L 12 Juni 2019 3211171206190001
36 RAZAQQY L 03 Juli 2019 3211173007190002
37 M.RAFFA L 06 Juli 2019 3211170607190001
38 M.ALMAHARKA L 14 Juli 2019 3211171407190001
39 RATU P 17 Juli 2019 3211175707190002
40 ZILAN L 30 Juli 2019 3211173007190001
41 EILEN P 19 Agustus 2019 3211175908190001
42 MUTIARA P 28 Agustus 2019 3211176808190002
43 ALVINO L 17 September 2019 32111717090001
44 KHALISA P 28 September 2019 3211176809190001
45 M.BAGUS YASIN L 29 September 2019 3211172909190002
46 EMIER L 03 November 2019 3211170311190001
47 M.ALGHANDI L 04 November 2019 3211170411190001
48 ARSYILA P 14 November 2019 3211175411190001
49 ALVIANI P 24 November 2019 3211176411190001
50 KHAIRANA P 06 Desember 2019 3211174612190001
51 FAIZAH P 20 Desember 2019 3211176012190001
52 M.RAYYAN L 01 Januari 2020 3211170101200001
53 ADZRIEL L 04 Januari 2020 3211170401200002
54 SABILA P 05 Januari 2020 3211174501200001
55 PRABU JALU L 07 Januari 2020 3211170701200001
56 ABBID L 05 Maret 2020 3211170503200001
57 ARVINO L 01 April 2020 3211170104200000
58 KHANEA P 03 Mei 2020 3211174305200002
59 MEYLANI P 09 Mei 2020 3211174905200004
60 ALEXA P 11 Mei 2020 3211175505200000
61 AQMAL L 12 Mei 2020 3211171205200001
62 SILMA P 06 Juni 2020 32111746060200001
63 ANEU P 26 Juni 2020 32111766062000
64 REZA L 06 Agustus 2020 3211170608200002
65 AL RIZKI L 01 September 2020 321117010920003
66 AL FARIZQI L 31 Oktober 2020 3211173110200001
67 NOUREN P 09 November 2020 3211170911200001
68 KHAYYAPA N P 16 November 2020 3211175611200002
69 M RAYYAN. A L 10 Desember 2020 321117101220005
70 MUSA ASA L 01 Januari 2021 3211170101210001
71 IBRAHIM A L 04 Februari 2021 3211170402210001
72 KHAYRA P 13 Maret 2021 3211055303210001
73 AL FAHMI L 18 Maret 2021 3211171803210003
74 DEVAN HAIKAL L 23 Juli 2021 3211172304210001
75 ASHEEQA P 17 Mei 2021 3211175705210001
76 ALESHRA. N P 17 Juli 2021 321115707210002
77 REYZKI. M L 01 Agustus 2021 3211170108210003
78 SULTAN L 08 Oktober 2021 3211170810210002
79 CAHYANA L 11 Oktober 2021 3211171110210002
80 NAYLA P 15 Oktober 2021 321117510210002
81 RINGGA L 16 Oktober 2021 321117610210003
82 M. ZEVIER L 10 Oktober 2021 3211171910210004
83
84
85
86
87
88
89
90
91
92
93
94
95
96
97
98
99
100
101
102
103
104
105
106
107
108
109
110
111
112
113
114
115
116
117
118
119
120
121
122
123
124
125
126
127
128
129
130
131
132
133
134
135
136
137
138
139
140
141
142
143
144
145
146
147
148
149
150
151
152
153
154
155
156
157
158
159
160
161
162
163
164
165
166
167
168
169
170
171
172
173
174
175
176
177
178
179
180
181
182
183
184
185
186
187
188
189
190
191
192
193
194
195
196
197
198
199
200
201
202
203
204
205
206
207
208
209
210
211
212
213
214
215
216
217
218
219
220
221
222
223
224
225
226
227
228
229
230
231
232
233
234
235
236
237
238
239
240
241
242
243
244
245
246
247
248
249
250
251
252
253
254
255
256
257
258
259
260
261
262
263
264
265
266
267
268
269
270
271
272
273
274
275
276
277
278
279
280
281
282
283
284
285
286
287
288
289
290
291
292
293
294
295
296
297
298
299
300
301
302
303
304
305
306
307
308
309
310
311
312
313
314
315
316
317
318
319
320
321
322
323
324
325
326
327
328
329
330
331
332
333
334
335
336
337
338
339
340
341
342
343
344
345
346
347
348
349
350
351
352
353
354
355
356
357
358
359
360
361
362
363
364
365
366
367
368
369
370
371
372
373
374
375
376
377
378
379
380
381
382
383
384
385
386
387
388
389
390
391
392
393
394
395
396
397
398
399
400
401
402
403
404
405
406
407
408
409
410
411
412
413
414
415
416
417
418
419
420
421
422
423
424
425
426
427
428
429
430
431
432
433
434
435
436
437
438
439
440
441
442
443
444
445
446
447
448
449
450
451
452
453
454
455
456
457
458
459
460
461
462
463
464
465
466
467
468
469
470
471
472
473
474
475
476
477
478
479
480
481
482
483
484
485
486
487
488
489
490
491
492
493
494
495
496
497
498
499
500
TOTAL
: CIPAMEUNGPEUK
: ANGGREK I
Imunisa Apakah anak sasaran

ORI Campak *) Jumlah Dosis Vaksin
Imunisasi Kejar
Nama Orang Tua (IBU) Alamat Rubela sejak yang pernah didapat Umur (bulan) si
Tambah (Ya = 1, Tidak = 0)
Januari 2022 OPV IPV DPT-HB-Hib OPV
an
YENI CIPAMEUNGPEUK 2/10 (Ya0=1, 4 1 4 1471 0 0
NOVI CIPAMEUNGPEUK 6/10 0 4 1 4 58 1 0
TITI CIPAMEUNGPEUK 5/10 0 4 1 4 56 1 0
DESI CIPAMEUNGPEUK 5/10 0 4 1 4 54 1 0
SUSI CIPAMEUNGPEUK 4/10 0 4 1 4 54 1 0
RIZKA CIPAMEUNGPEUK 6/10 0 4 1 4 54 1 0
APONG CIPAMEUNGPEUK 6/10 0 4 1 4 53 1 0
WILAN CIPAMEUNGPEUK 5/10 0 4 1 4 53 1 0
PINI CIPAMEUNGPEUK 5/10 0 4 1 4 52 1 0
ADE CIPAMEUNGPEUK 5/10 0 4 1 4 52 1 0
DEHESTI CIPAMEUNGPEUK 6/10 0 4 1 4 45 1 0
NENI CIPAMEUNGPEUK 6/10 0 4 1 4 51 1 0
MERI CIPAMEUNGPEUK 1/10 0 4 1 4 48 1 0
LILIS CIPAMEUNGPEUK 5/10 0 4 1 4 48 1 0
NUR CIPAMEUNGPEUK 6/10 0 4 1 4 47 1 0
WINA CIPAMEUNGPEUK 5/10 0 4 1 4 46 1 0
WIDI CIPAMEUNGPEUK 6/10 0 4 1 4 46 1 0
SRI CIPAMEUNGPEUK 6/10 0 4 1 4 45 1 0
PAPAT CIPAMEUNGPEUK 4/10 0 4 1 4 44 1 0
DEWI CIPAMEUNGPEUK 3/10 0 4 1 4 44 1 0
HENDRA CIPAMEUNGPEUK 2/10 0 4 1 4 43 1 0
SANTI CIPAMEUNGPEUK 1/10 0 4 1 4 43 1 0
LIA CIPAMEUNGPEUK 4/10 0 4 1 4 42 1 0
CICIH CIPAMEUNGPEUK 2/10 0 4 1 4 42 1 0
AAN CIPAMEUNGPEUK 2/10 0 4 1 4 42 1 0
TITIN CIPAMEUNGPEUK 2/10 0 4 1 4 41 1 0
DAHLIAH CIPAMEUNGPEUK 6/10 0 4 1 4 40 1 0
SUSI CIPAMEUNGPEUK 4/10 0 4 1 4 39 1 0
RISMA CIPAMEUNGPEUK 3/10 0 4 1 4 38 1 0
IMAS CIPAMEUNGPEUK 6/10 0 4 1 4 38 1 0
RIKA CIPAMEUNGPEUK 2/10 0 4 1 4 37 1 0
HENI CIPAMEUNGPEUK 2/10 0 4 1 4 36 1 0
KOMI CIPAMEUNGPEUK 6/10 0 4 1 4 36 1 0
NANDA CIPAMEUNGPEUK 6/10 0 4 1 4 36 1 0
ERI CIPAMEUNGPEUK 5/10 0 4 1 4 36 1 0
ATI CIPAMEUNGPEUK 6/10 0 4 1 4 35 1 0
EKA CIPAMEUNGPEUK 3/10 0 4 1 4 35 1 0
NINA CIPAMEUNGPEUK 1/10 0 4 1 4 34 1 0
DINI CIPAMEUNGPEUK 5/10 0 4 1 4 34 1 0
IMAS CIPAMEUNGPEUK 2/10 0 4 1 4 32 1 0
MELAN CIPAMEUNGPEUK 2/10 0 4 1 4 32 1 0
ETI CIPAMEUNGPEUK 2/10 0 4 1 4 32 1 0
TETI CIPAMEUNGPEUK 1/10 0 4 1 4 31 1 0
ANISA CIPAMEUNGPEUK 6/10 0 4 1 4 31 1 0
EKO CIPAMEUNGPEUK 6/10 0 4 1 4 31 1 0
YUNITA CIPAMEUNGPEUK 2/10 0 4 1 4 30 1 0
DEWI CIPAMEUNGPEUK 2/10 0 4 1 4 30 1 0
DESI CIPAMEUNGPEUK 5/10 0 4 1 4 28 1 0
ELIS CIPAMEUNGPEUK 3/10 0 4 1 4 28 1 0
FITRIA CIPAMEUNGPEUK 1/10 0 4 1 4 26 1 0
ELSA CIPAMEUNGPEUK 5/10 0 4 1 4 25 1 0
ERMA CIPAMEUNGPEUK 2/10 0 4 1 4 25 1 0
MERI CIPAMEUNGPEUK 1/10 0 4 1 4 23 1 0
EUIS CIPAMEUNGPEUK 6/10 0 4 1 4 23 1 0
META CIPAMEUNGPEUK 3/10 0 4 1 4 21 1 0
YOSI CIPAMEUNGPEUK 6/10 0 4 1 4 20 1 0
IRENA CIPAMEUNGPEUK 6/10 0 4 1 4 20 1 0
RIA CIPAMEUNGPEUK 4/10 0 4 1 4 19 1 0
APRILIA CIPAMEUNGPEUK 6/10 0 4 1 4 19 1 0
YUNI CIPAMEUNGPEUK 6/10 0 4 1 4 16 1 0
DENI CIPAMEUNGPEUK 5/10 0 4 1 4 16 1 0
SUNENGSIH CIPAMEUNGPEUK 5/10 0 4 1 4 12 1 0
YANI CIPAMEUNGPEUK 6/10 0 4 1 4 14 1 0
SANTI CIPAMEUNGPEUK 1/10 0 4 1 4 12 1 0
TITA CIPAMEUNGPEUK 6/10 0 4 1 4 12 1 0
NINA CIPAMEUNGPEUK 3/10 0 4 1 4 9 1 0
IKA CIPAMEUNGPEUK 5/10 0 4 1 4 9 1 0
LELI CIPAMEUNGPEUK 2/10 0 4 1 4 9 1 0
SINTA CIPAMEUNPEUK 2/10 0 4 1 4 9 1 0
TITIN CIPAMEUNGPEUK 2/10 0 4 1 4 9 1 0
1471 0 0
1471 0 0
1471 0 0
1471 0 0
1471 0 0
1471 0 0
1471 0 0
1471 0 0
1471 0 0
1471 0 0
1471 0 0
1471 0 0
1471 0 0
1471 0 0
1471 0 0
1471 0 0
1471 0 0
1471 0 0
1471 0 0
1471 0 0
1471 0 0
1471 0 0
1471 0 0
1471 0 0
1471 0 0
1471 0 0
1471 0 0
1471 0 0
1471 0 0
1471 0 0
1471 0 0
1471 0 0
1471 0 0
1471 0 0
1471 0 0
1471 0 0
1471 0 0
1471 0 0
1471 0 0
1471 0 0
1471 0 0
1471 0 0
1471 0 0
1471 0 0
1471 0 0
1471 0 0
1471 0 0
1471 0 0
1471 0 0
1471 0 0
1471 0 0
1471 0 0
1471 0 0
1471 0 0
1471 0 0
1471 0 0
1471 0 0
1471 0 0
1471 0 0
1471 0 0
1471 0 0
1471 0 0
1471 0 0
1471 0 0
1471 0 0
1471 0 0
1471 0 0
1471 0 0
1471 0 0
1471 0 0
1471 0 0
1471 0 0
1471 0 0
1471 0 0
1471 0 0
1471 0 0
1471 0 0
1471 0 0
1471 0 0
1471 0 0
1471 0 0
1471 0 0
1471 0 0
1471 0 0
1471 0 0
1471 0 0
1471 0 0
1471 0 0
1471 0 0
1471 0 0
1471 0 0
1471 0 0
1471 0 0
1471 0 0
1471 0 0
1471 0 0
1471 0 0
1471 0 0
1471 0 0
1471 0 0
1471 0 0
1471 0 0
1471 0 0
1471 0 0
1471 0 0
1471 0 0
1471 0 0
1471 0 0
1471 0 0
1471 0 0
1471 0 0
1471 0 0
1471 0 0
1471 0 0
1471 0 0
1471 0 0
1471 0 0
1471 0 0
1471 0 0
1471 0 0
1471 0 0
1471 0 0
1471 0 0
1471 0 0
1471 0 0
1471 0 0
1471 0 0
1471 0 0
1471 0 0
1471 0 0
1471 0 0
1471 0 0
1471 0 0
1471 0 0
1471 0 0
1471 0 0
1471 0 0
1471 0 0
1471 0 0
1471 0 0
1471 0 0
1471 0 0
1471 0 0
1471 0 0
1471 0 0
1471 0 0
1471 0 0
1471 0 0
1471 0 0
1471 0 0
1471 0 0
1471 0 0
1471 0 0
1471 0 0
1471 0 0
1471 0 0
1471 0 0
1471 0 0
1471 0 0
1471 0 0
1471 0 0
1471 0 0
1471 0 0
1471 0 0
1471 0 0
1471 0 0
1471 0 0
1471 0 0
1471 0 0
1471 0 0
1471 0 0
1471 0 0
1471 0 0
1471 0 0
1471 0 0
1471 0 0
1471 0 0
1471 0 0
1471 0 0
1471 0 0
1471 0 0
1471 0 0
1471 0 0
1471 0 0
1471 0 0
1471 0 0
1471 0 0
1471 0 0
1471 0 0
1471 0 0
1471 0 0
1471 0 0
1471 0 0
1471 0 0
1471 0 0
1471 0 0
1471 0 0
1471 0 0
1471 0 0
1471 0 0
1471 0 0
1471 0 0
1471 0 0
1471 0 0
1471 0 0
1471 0 0
1471 0 0
1471 0 0
1471 0 0
1471 0 0
1471 0 0
1471 0 0
1471 0 0
1471 0 0
1471 0 0
1471 0 0
1471 0 0
1471 0 0
1471 0 0
1471 0 0
1471 0 0
1471 0 0
1471 0 0
1471 0 0
1471 0 0
1471 0 0
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0 82 0
TOTAL VIAL VAKSIN (Jumla
Apakah anak sasaran kan Rencana Pemberian Dosis Sasaran Sasaran anak
dibutuhkan untuk
Imunisasi Kejar sasaran melengkapi status
Imunisasi Kejar & CR Pada BulanSuntika sasara
(Ya = 1, Tidak = 0)
IPV DPT-HB-Hibimunisa OPV IPV DPT-HB-Hib OPV Agustus
IPV DPT-HB-Hib CR n Bulan n BIAN
si KEJAR Agustus (Agustu
0 0 0 0 0 0 0 0 0 0 1 1
0 0 0 0 0 0 0 0 0 1 1 1
0 0 0 0 0 0 0 0 0 1 1 1
0 0 0 0 0 0 0 0 0 1 1 1
0 0 0 0 0 0 0 0 0 1 1 1
0 0 0 0 0 0 0 0 0 1 1 1
0 0 0 0 0 0 0 0 0 1 1 1
0 0 0 0 0 0 0 0 0 1 1 1
0 0 0 0 0 0 0 0 0 1 1 1
0 0 0 0 0 0 0 0 0 1 1 1
0 0 0 0 0 0 0 0 0 1 1 1
0 0 0 0 0 0 0 0 0 1 1 1
0 0 0 0 0 0 0 0 0 1 1 1
0 0 0 0 0 0 0 0 0 1 1 1
0 0 0 0 0 0 0 0 0 1 1 1
0 0 0 0 0 0 0 0 0 1 1 1
0 0 0 0 0 0 0 0 0 1 1 1
0 0 0 0 0 0 0 0 0 1 1 1
0 0 0 0 0 0 0 0 0 1 1 1
0 0 0 0 0 0 0 0 0 1 1 1
0 0 0 0 0 0 0 0 0 1 1 1
0 0 0 0 0 0 0 0 0 1 1 1
0 0 0 0 0 0 0 0 0 1 1 1
0 0 0 0 0 0 0 0 0 1 1 1
0 0 0 0 0 0 0 0 0 1 1 1
0 0 0 0 0 0 0 0 0 1 1 1
0 0 0 0 0 0 0 0 0 1 1 1
0 0 0 0 0 0 0 0 0 1 1 1
0 0 0 0 0 0 0 0 0 1 1 1
0 0 0 0 0 0 0 0 0 1 1 1
0 0 0 0 0 0 0 0 0 1 1 1
0 0 0 0 0 0 0 0 0 1 1 1
0 0 0 0 0 0 0 0 0 1 1 1
0 0 0 0 0 0 0 0 0 1 1 1
0 0 0 0 0 0 0 0 0 1 1 1
0 0 0 0 0 0 0 0 0 1 1 1
0 0 0 0 0 0 0 0 0 1 1 1
0 0 0 0 0 0 0 0 0 1 1 1
0 0 0 0 0 0 0 0 0 1 1 1
0 0 0 0 0 0 0 0 0 1 1 1
0 0 0 0 0 0 0 0 0 1 1 1
0 0 0 0 0 0 0 0 0 1 1 1
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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
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0 0 0 0 0 0 0 0 0 81 82 82
Agustus (termasuk Sweeping pada
September) 2022 September 2022
OPV IPV DPT-HB-Hib CR (JIKA
OPV DIIMUNISASI, ISI
IPV DPT-HB-Hib
0 0 0 0 0 0 0
0 0 0 0 0 0 0
Tanggal Lahir
1 M. SIGIT L 01 September 2021 3211170109210002

2 HAIKAL L 02 Desember 2020 3211170212200002
3 ZAIDAN. A L 26 November 2020 321117261120000
4 M. ANGGI PRADIPTA L 01 November 2020 3211175407200001
5 CHERUN PUTRI R P 14 Juli 2020 3211175407200001
6 GIBRAN HAIDAR L 16 Juni 2020 3211171606200000
7 GIAN ANGGA L 07 Juni 2020 321117070620001
8 MIRZA L 13 Desember 2019 3211171312190001
9 M. NAUFAL L 06 November 2019 3211170611190001
10 NAURA WULANDARI P 31 Agustus 2019 3211173108190001
11 AZQIA P 22 Agustus 2019 3211176208190001
12 ABYAN BIMA SENA L 04 Januari 2019 321117040119000
13 HAIFA AZAHRA P 01 Oktober 2018 3211174110180002
14 M. ARFAN L 17 September 2018 3211171709180000
15 NADHITA YUSTIANA P 26 September 2018 321117260910002
16 DAFFA. R.M L 14 Juli 2018 3211174909180001
17 M. HAIKAL . A L 16 Juli 2018 3211171607180000
18 NOAH SYUHADA R L 28 Mei 2018 3211172105180002
19 DIKA IRWAN L 30 Maret 2018 3211173003180001
20 SELLY SONIA PUTRI P 22 Maret 2018 3211172033180000
21 VELLINDA B. HIDAYAT P 25 Februari 2018 321117250218000
22 WIDYA SARI P 24 Februari 2018 3211176402180002
23 FUJI SASTRA M P 03 Februari 2008 3211170302180002
24 ASYQO FAHRA P 23 Januari 2018 3211176301180002
25 ALIF HIDAYAT L 31 Oktober 2017 3211173110170001
26
27
28
29
30
TOTAL
: CIPAMEUNPEUK
: ANGGREK II-CPK

Campak
sejak
Campak
WATI CIPAK 2/11 Januari
0 4 1 4 11 1
DIANTI CIPAK 4/11 0 4 1 4 20 1
SRI CIPAK 3/11 0 4 1 4 20 1
SRI IKEU CIPAK 2/11 0 4 1 4 21 1
NENENG TATI CIPAK 3/11 0 4 1 4 24 1
RETA CIPAK 2/11 0 4 1 4 25 1
WININGSIH CIPAK 4/11 0 4 1 4 26 1
II JUWITA CIPAK 3/11 0 4 1 4 31 1
II JUWITA CIPAK 1/11 0 4 1 4 33 1
SITI. D CIPAK 3/11 0 4 1 4 35 1
ATIN. Y CIPAK 1/11 0 4 1 4 35 1
SHINTA. N CIPAK 2/11 0 4 1 4 43 1
ROKASIH CIPAK 2/11 0 4 1 4 46 1
SUSI. S CIPAK 4/11 0 4 1 4 46 1
DEDE CIPAK 4/11 0 4 1 4 46 1
SELLA. Y CIPAK 2/11 0 4 1 4 48 1
SUKAESIH CIPAK 1/11 0 4 1 4 48 1
ELIS.W CIPAK 3/11 0 4 1 4 50 1
CICIH. M CIPAK 1/11 0 4 1 4 52 1
II JUWITA CIPAK 1/11 0 4 1 4 52 1
MELIYANTI CIPAK 1/11 0 4 1 4 53 1
CAHYANI CIPAK 1/11 0 4 1 4 53 1
MALINDA. R CIPAK 3/11 0 4 1 4 174 0
CARMILAH CIPAK 1/11 0 4 1 4 54 1
ATIKAH CIPAK 4/11 0 4 1 4 57 1
1471 0
1471 0
1471 0
1471 0
1471 0
0 24
TOTAL VI
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
ian Dosis Sasaran
OPV ISI TANGGAL
OPV ISI
IPV DPT-HB-Hib
Agustus (Agustus
1 1 1
1 1 1
1 1 1
1 1 1
1 1 1
1 1 1
1 1 1
1 1 1
1 1 1
1 1 1
1 1 1
1 1 1
1 1 1
1 1 1
1 1 1
1 1 1
1 1 1
1 1 1
1 1 1
1 1 1
1 1 1
1 1 1
0 0 0
1 1 1
1 1 1
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
24 24 24 0 0 0 0 0 0 0
3 0 0 0 0 0 0 0
DPT-HB-Hib
Tanggal Lahir
1 SAPITA L 23 September 2017 3211172309170001

2 M.FADHLAN 06 Agustus 2018
3 ALINGGA 20 Agustus 2018 3211182005180003
4 M.LATIF 11 Oktober 2018 3211171101180004
5 SANDA SEPTIANO S 13 Januari 2019 3211171301190001
6 RAYIDHAN 13 Maret 2019 3211171303190003
7 M.RIZKY 23 Februari 2019 3211172302190002
8 RIZKY M. 24 April 2019
9 SATRIA 07 Juli 2019 3211170707190001
10 MUHAMAD FAISAL 24 Juli 2019 3211172407190001
11 BINTANG 08 Agustus 2019 321117080819000
12 AZRIEL 20 Maret 2020 3211182003200001
13 M.DZAKI 11 Mei 2020
14 ASIYAH AZIZAH 20 Oktober 2017 3211176710170002
15 SAFANA 14 Januari 2018 3211174401180001
16 CITRA M. 06 Agustus 2018 3211174608160001
17 ARSYLA 16 Juni 2018 3211175606180002
18 AZKIA PUTRI 01 Agustus 2019 3211174108190003
19 RALIN NJINAN A. 07 Oktober 2019 3211174710190001
20 ANUM BADIA 05 November 2019 3211174411190003
21 MAHREEN NUHA 11 Januari 2020 3211175101200002
22 HARMI YAMNA 06 Mei 2020
23 M.ABIZAR 03 Juni 2020 3211170306200003
24 M.AL'ABSAR 22 November 2020 3211172212200002
25 SHAUGY H 18 November 2020 3211170202210002
26 MAGIL 02 Februari 2021 3211170202210002
27 DEVIA NASHA 21 Desember 2020 3211176112200001
28 KYRAL 10 Agustus 2020
29 CHANDANY SORAYA 17 Maret 2021
30 M.ALFATIH 21 Juli 2021
31 NAYARA 08 Oktober 2021
32
33
34
35
36
37
38
39
40
41
42
43
44
45
46
47
48
49
50
51
52
53
54
55
56
57
58
59
60
61
62
63
64
65
66
67
68
69
70
71
72
73
74
75
76
77
78
79
80
81
82
83
84
85
86
87
88
89
90
91
92
93
94
95
96
97
98
99
100
101
102
103
104
105
106
107
108
109
110
111
112
113
114
115
116
117
118
119
120
121
122
123
124
125
126
127
128
129
130
131
132
133
134
135
136
137
138
139
140
141
142
143
144
145
146
147
148
149
150
151
152
153
154
155
156
157
158
159
160
161
162
163
164
165
166
167
168
169
170
171
172
173
174
175
176
177
178
179
180
181
182
183
184
185
186
187
188
189
190
191
192
193
194
195
196
197
198
199
200
201
202
203
204
205
206
207
208
209
210
211
212
213
214
215
216
217
218
219
220
221
222
223
224
225
226
227
228
229
230
231
232
233
234
235
236
237
238
239
240
241
242
243
244
245
246
247
248
249
250
251
252
253
254
255
256
257
258
259
260
261
262
263
264
265
266
267
268
269
270
271
272
273
274
275
276
277
278
279
280
281
282
283
284
285
286
287
288
289
290
291
292
293
294
295
296
297
298
299
300
301
302
303
304
305
306
307
308
309
310
311
312
313
314
315
316
317
318
319
320
321
322
323
324
325
326
327
328
329
330
331
332
333
334
335
336
337
338
339
340
341
342
343
344
345
346
347
348
349
350
351
352
353
354
355
356
357
358
359
360
361
362
363
364
365
366
367
368
369
370
371
372
373
374
375
376
377
378
379
380
381
382
383
384
385
386
387
388
389
390
391
392
393
394
395
396
397
398
399
400
401
402
403
404
405
406
407
408
409
410
411
412
413
414
415
416
417
418
419
420
421
422
423
424
425
426
427
428
429
430
431
432
433
434
435
436
437
438
439
440
441
442
443
444
445
446
447
448
449
450
451
452
453
454
455
456
457
458
459
460
461
462
463
464
465
466
467
468
469
470
471
472
473
474
475
476
477
478
479
480
481
482
483
484
485
486
487
488
489
490
491
492
493
494
495
496
497
498
499
500
TOTAL
SASARAN IMUNISASI KEJAR ADALAH 12-59 BULAN
: SUKAGALIH
: SIMPATI 1

Campak
sejak
Campak
KUSMARIAH SUKAGLIH 2/1 Januari
0 4 1 4 58 1
EVA SUKAGLIH 3/1 0 4 1 4 48 1
DESI SUKAGALIH 1/1 0 4 1 4 47 1
HENI SUKAGALIH 1/1 0 4 1 4 46 1
JULIANTI SUKAGLIH 1/1 0 4 1 4 42 1
ENTAY SUKAGALIH 1/1 0 4 1 4 40 1
ENDAWATI SUKAGALIH 2/1 0 4 1 4 41 1
SUKAGALIH 0 4 1 4 39 1
NENDEN SUKAGALIH 1/1 0 4 1 4 37 1
NENG ENDAH SUKAGALIH 1/1 0 4 1 4 36 1
TITI SUKAGALIH 3/1 0 4 1 4 36 1
OPI SUKAGALIH 3/1 0 4 0 4 28 1
FADILLA SUKAGALIH 3/1 0 4 1 4 57 1
TITIN SUKAGALIH 1/1 0 4 1 4 54 1
NUR SUKAGALIH 3/1 0 4 1 4 48 1
EFIT SUKAGALIH 1/1 0 4 1 4 49 1
IRMA SUKAGALIH 1/1 0 4 1 4 36 1
MIA SUKAGALIH 3/1 0 4 1 4 34 1
ENTIN SUKAGALIH 1/1 0 4 1 4 33 1
GYTHA SUKAGALIH 3/1 0 4 1 4 31 1
YUNIAR SUKAGALIH 1/1 0 4 1 4 20 1
RANI SUKAGALIH 1/1 0 4 1 4 20 1
MINAR SUKAGALIH 1/1 0 4 1 4 19 1
AGVIAN SUKAGALIH 0 4 0 4 12 1
1471 0
1471 0
1471 0
1471 0
1471 0
1471 0
1471 0
1471 0
1471 0
1471 0
1471 0
1471 0
1471 0
1471 0
1471 0
1471 0
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1471 0
1471 0
1471 0
1471 0
1471 0
1471 0
1471 0
1471 0
1471 0
1471 0
1471 0
1471 0
1471 0
1471 0
1471 0
1471 0
1471 0
1471 0
1471 0
1471 0
1471 0
1471 0
1471 0
1471 0
1471 0
1471 0
1471 0
1471 0
1471 0
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1471 0
1471 0
1471 0
1471 0
1471 0
1471 0
1471 0
1471 0
1471 0
1471 0
1471 0
1471 0
1471 0
1471 0
1471 0
1471 0
1471 0
1471 0
1471 0
1471 0
1471 0
1471 0
1471 0
1471 0
1471 0
1471 0
1471 0
1471 0
1471 0
1471 0
1471 0
1471 0
1471 0
1471 0
1471 0
1471 0
1471 0
1471 0
1471 0
1471 0
1471 0
1471 0
1471 0
1471 0
1471 0
1471 0
1471 0
1471 0
1471 0
1471 0
1471 0
1471 0
1471 0
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0 31
TOT
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 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 0 1 0 1 0 0 1 0
0 1 0 1 0 1 0 0 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
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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 1 0 1 0 1 0 0 1 0
0 0 0 0 0 0 0 0 0 0
0 1 0 1 0 1 -1 0 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
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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
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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
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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 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 4 0 4 0 4 -1 0 4 0
ian Dosis Sasaran
OPV ISI TANGGAL
OPV ISI
IPV DPT-HB-Hib
Agustus (Agustus
1 1 1
1 1 1
1 1 1
1 1 1
1 1 1
1 1 1
1 1 1
1 1 1
1 1 1
1 1 1
1 1 1
1 2 1
1 2 1
1 1 1
1 1 1
1 1 1
1 1 1
1 1 1
1 1 1
1 1 1
1 1 1
1 1 1
1 1 1
1 1 1
1 1 1
1 1 1
1 1 1
1 2 1
1 1 1
1 2 1
1 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 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
31 35 31 0 0 0 0 0 0 0
4 0 0 0 0 0 0 0
DPT-HB-Hib
Tanggal Lahir
1 RAFASHA L 18 Juni 2021 3211161806210001

2 ATHA MUZAIN 16 Juni 2021 3211171606210003
3 DHAFIN 03 Juni 2021 3211170306210001
4 M.DEVAN 24 Mei 2021 3211172405210001
5 ADZRIEL REDEYA S 09 Mei 2021 3211170905210008
6 ELVAN SAHREZA 31 Mei 2021 321117310321000
7 ARSHAKA FAWWAZ 19 November 2020 3211171911200001
8 WABIL 05 September 2020 3211170509200002
9 DEVIANISA 25 November 2020 3211176511200001
10 ANASYA 17 Oktober 2020 3211175710200001
11 AZKIYA NURSYIFA 20 September 2020 3211176009200001
12 NAZRIEL RAFFANSYA 29 Juni 2020 3211172906200001
13 ELVANO AZKA P 01 Juni 2020 3211170106200005
14 CLARETA AZKIA S. 13 Mei 2020 3211175305200002
15 NAZERA RIEANOR 21 April 2020 3211176104200001
16 AFKAR 28 Desember 2019 3211172112190001
17 SHERINA GEBY 24 November 2019 3211176411190001
18 ARRASYA 28 Oktober 2019 3211172810190002
19 M.AZRIL 14 Juni 2019 3211171406190001
20 SHAUMA 02 Juni 2019 3211174206190002
21 NAYLA 30 Mei 2019 3211177005190001
22 FAKHIRA DAFINA 10 Mei 2019 3211175005190003
23 SHAYMA ANDIEN H 10 Desember 2018 3211175012180001
24 RADITYA NAUFAL 04 Agustus 2018 3211170408180001
25 NAJMI 09 Mei 2018 3211174905180002
26 REISYA BUNGA 14 Mei 2018 3211175405180002
27 M.AZZAM R.H 20 November 2017 3211172011170001
28 M.ARSYA P. 25 Oktober 2021 3211222510210001
29
30
31
32
33
34
35
TOTAL
: SUKAGLIH
: SIMPATI II

Campak
sejak
Campak
ZAENI SUKAGALIH 2/6 Januari
0 4 1 4 13 1
ROSITA SUKAGALIH 3/6 0 4 1 4 13 1
DEDE LINA SUKAGALIH 1/6 0 4 1 4 14 1
KHUSNUL SUKAGALIH 2/6 0 4 1 4 14 1
TESA SUKAGLALIH 1/6 0 4 1 4 15 1
CUCU SUKAGALIH 2/6 0 4 1 4 14 1
NETTI SUKAGALIH 3/6 0 4 1 4 20 1
RIFKA SUKAGALIH 2/6 0 4 1 4 23 1
KARTIKA SUKAGALIH 1/6 0 4 1 4 20 1
ERNA SUKAGALIH 1/6 0 4 1 4 21 1
YUNI SUKAGALIH 3/6 0 4 1 4 22 1
NYIMAS SUKAGALIH 3/6 0 4 1 4 25 1
WILLY SUKAGALIH 3/6 0 4 1 4 26 1
INTAN SUKAGALIH 1/6 0 4 0 4 27 1
DINI SUKAGALIH 3/6 0 4 1 4 27 1
DESI SUKAGALIH 3/6 0 4 1 4 31 1
ELIM SUKAGALIH 1/6 0 4 0 4 32 1
FITRI SUKAGALIH 3/6 0 4 0 4 33 1
NINA SUKAGALIH 2/6 0 4 0 4 38 1
YANTI SUKAGALIH 1/6 0 4 1 4 38 1
LISTANIA SUKAGALIH 3/6 0 4 0 4 38 1
YUYUN SUKAGALIH 2/6 0 4 1 4 39 1
DE ANIS SUKAGALIH 3/6 0 4 1 4 44 1
ROSITA SUKAGALIH 3/6 0 4 1 4 48 1
RESTI SUKAGALIH 2/6 0 4 1 4 51 1
FUIS SUKAGALIH 2/6 0 4 1 4 51 1
NINA M. SUKAGALIH 1/6 0 4 0 4 56 1
KIKI SUKAGALIH 3/6 0 4 0 4 9 1
1471 0
1471 0
1471 0
1471 0
1471 0
1471 0
1471 0
0 28
TOTAL
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 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 0 1 0 1 0 0 1 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 1 0 1 0 1 0 0 1 0
0 1 0 1 0 1 0 0 1 0
0 1 0 1 0 1 0 0 1 0
0 0 0 0 0 0 0 0 0 0
0 1 0 1 0 1 0 0 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 1 0 1 0 1 0 0 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 6 0 6 0 6 0 0 6 0
ian Dosis Sasaran
OPV ISI TANGGAL
OPV ISI
IPV DPT-HB-Hib
Agustus (Agustus
1 1 1
1 1 1
1 1 1
1 1 1
1 1 1
1 1 1
1 1 1
1 1 1
1 1 1
1 1 1
1 1 1
1 1 1
1 1 1
1 2 1
1 1 1
1 1 1
1 2 1
1 2 1
1 2 1
1 1 1
1 2 1
1 1 1
1 1 1
1 1 1
1 1 1
1 1 1
1 2 1
1 1 1
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
28 34 28 0 0 0 0 0 0 0
4 0 0 0 0 0 0 0
DPT-HB-Hib
PELAKSANAAN : AGUSTUS 2022
Provinsi : JAWA BARAT
Kabupaten : UMEDANG
Tanggal Lahir
No. Nama Anak Jenis Kelamin (L/ P)
1 TANISHA K. L 08 November 2021

2 M.YUSUF 17 Oktober 2021
3 NIZAM 09 Oktober 2021
4 ATHARVA 04 Oktober 2021
5 M.FAKHRI 22 September 2021
6 SANTANA 12 Agustus 2021
7 M.AZRIL 07 Juni 2021
8 KALANDRA 17 Mei 2021
9 ABILLA 18 Mei 2021
10 ABIDZAR 20 Maret 2021
11 M.SHAFIE 18 Februari 2021
12 GHAVA 25 Desember 2020
13 M.NAZRIL 03 Desember 2020
14 AZRINNA 02 Oktober 2020
15 M.KARIM 17 Juli 2020
16 SACITA 12 Juli 2020
17 HAWA 17 Juni 2020
18 FAIZAN 24 Juni 2020
19 AFKAR 25 Juni 2020
20 NAOMI 28 Mei 2020
21 ALMIRA 31 Mei 2020
22 M.REVINO 19 April 2020
23 JAISYAN 16 April 2020
24 KHALISA 21 Maret 2020
25 SIGIT 27 Februari 2020
26 QAISAR 13 Februari 2020
27 FATHIAN 12 Februari 2020
28 RIMBA 06 Februari 2020
29 NABILA 12 Januari 2020
30 ALFARIZKI 23 Januari 2020
31 SATRIO 10 Desember 2019
32 ASYALIRA 01 Oktober 2019
33 QONITA 23 Oktober 2019
34 M.FADIAN A 26 Oktober 2019
35 DEMYAN 19 September 2019
36 AULIA 07 Juli 2019
37 SYABILA 27 Juli 2019
38 M.KEVIN 12 Juni 2019
39 SITI K.H. 19 Juni 2019
40 TANISA 10 Mei 2019
41 KHAERUNISA 10 Mei 2019
42 DAFFA 19 Mei 2019
43 DINDA 12 April 2019
44 M.FADLAN M. 22 April 2019
45 ATHAR 22 Februari 2019
46 FEBIAN 15 Februari 2019
47 AZKA R. 12 Desember 2018
48 RAYHAN 09 November 2018
49 SYAQILLA 15 September 2018
50 SHAQIL 27 September 2018
51 KAEVAND 23 Juni 2018
52 M.AKBAR 10 Juni 2018
53 M.GHAISAN 09 Juni 2018
54 YUMNA 12 April 2018
55 FEBRIAN 10 Februari 2018
56 DIAS 22 Januari 2018
57 M.ALWI 22 Desember 2017
58 HABIBIE 16 Oktober 2017
59
60
61
62
63
64
65
TOTAL
9-59 BULAN DAN SASARAN IMUNISASI KEJAR ADALAH 12-59 BULAN
16 Agustus 2022 (Disesuaikan dengan tgl pelaksanaan di masing-masing Posyandu)
Desa/Kelurahan : SUKAGALIH
Posyandu : SIMPATI III

NIK Nama Orang Tua (IBU) Alamat Rubela pernah didapat
sejak OPV IPV
3211174811210001 YANI SUKAGALIH 4/3 Januari
0 3 1
3211171710210002 SURYATI SUKAGALIH 4/3 0 4 1
3211170910210002 MEGA SUKAGALIH 4/3 0 4 1
3211170410210002 YANTI SUKAGALIH 2/4 0 4 0
3211172209210002 PUTRI SUKAGALIH 1/3 0 4 1
3211171208210001 DEWI SUKAGALIH 4/3 0 4 1
3211170706210003 PUTRI SUKAGALIH 4/3 0 4 1
3211171705210002 IRMA SUKAGALIH 3/3 0 4 0
3211175805210000 ELIS SUKAGALIH 1/3 0 0 0
3211172003210002 ULPA SUKAGALIH 1/3 0 4 1
3211171802210001 FITRI SUKAGALIH 2/3 0 4 1
3211172512200001 MEILSA SUKAGALIH 1/3 0 4 1
3211170312200003 RENI SUKAGALIH 4/3 0 4 1
3211174210200003 TITA SUKAGALIH 4/3 0 4 0
32111717200003 DEDE IRMA SUKAGALIH 1/3 0 4 0
3211175207200003 KOKOM SUKAGALIH 1/3 0 4 1
3211175706200002 YUNI SUKAGALIH 4/3 0 4 1
3211172406200001 SAFITRI SUKAGALIH 3/3 0 4 1
3211172506200001 ELIN SUKAGALIH 3/3 0 4 1
3211176805200004 IYAN SUKAGALIH 2/3 0 4 1
321117710520000 YULI SUKAGALIH 4/3 0 4 0
3211171904200001 PUTRI SUKAGALIH 2/3 0 4 1
3211171604200002 ALIDINA SUKAGALIH 2/3 0 4 1
3211176103200001 NINA SUKAGALIH 4/3 0 4 1
3211172702200001 RENI SUKAGALIH 4/3 0 4 1
3211171302200002 NANDA SUKAGALIH 1/3 0 4 1
3211171202200001 AI PUPU SUKAGALIH 2/3 0 4 1
3211170602200001 RISNA SUKAGALIH 1/3 0 4 1
3211175201200001 PAMELIA SUKAGALIH 4/3 0 4 0
3211172301200001 NENENG 3/3 SUKAGALIH 3/3 0 4 0
3211171012190001 NENI SUKAGALIH 1/3 0 4 1
3211174110190003 IMAS SUKAGALIH 1/3 0 4 0
3211176310190001 ELI SUKAGALIH 1/3 0 4 0
3211172610190001 CUCU SUKAGALIH 3/3 0 4 0
3211171909190001 NOPI SUKAGALIH 2/3 0 4 0
3211174707190001 DEDAH SUKAGALIH 1/3 0 3 0
3211176707190003 SITI SUKAGALIH 4/3 0 4 1
3211171206190001 SURYATI SUKAGALIH 4/3 0 4 1
3211175906190001 NENG YAYAS SUKAGALIH 3/3 0 4 0
3211175005190000 YUNENGSIH SUKAGALIH 1/3 0 4 1
3211175005190004 TETI SUKAGALIH 4/3 0 4 1
3211171905190000 ROSMAYATI SUKAGALIH 2/3 0 4 1
3211175204190011 INA SUKAGALIH 1/3 0 4 1
3211171204190002 FITRI SUKAGALIH 2/3 0 4 1
3211172202190001 RISMA SUKAGALIH 3/3 0 4 1
3211171502190001 ADAS SUKAGALIH 3/3 0 4 1
3211171212180001 ANI SUKAGALIH 2/3 0 4 1
3211170911180002 KARTINI SUKAGALIH 1/3 0 4 1
3211175509180001 MEGA SUKAGALIH 3/3 0 4 1
3211172709180001 SUSI SUKAGALIH 4/3 0 4 1
3211172306180001 NETI SUKAGALIH 2/3 0 4 1
3211171006180001 RINI SUKAGALIH 2/3 0 4 1
3211170906180001 AI PUPU SUKAGALIH 2/3 0 4 1
3211175204180003 NENI SUKAGALIH 2/3 0 4 1
3211171002180001 YANI SUKAGALIH 4/3 0 4 1
3211172201180002 CUCU SUKAGALIH 4/3 0 4 1
3211172212170002 DEVI SUKAGALIH 1/3 0 4 1
3211171610170001 TSARA SUKAGALIH 1/3 0 4 1
TOTAL 0
ah Dosis Vaksin yang n sasaran Apakah anak sasaran Imunisasi an
Jumlah dosis yang dibutuhkan
ernah didapat Umur (bulan) sasaran
Tambahan (Ya = 1, Tidak = 0) imunisasi
DPT-HB-Hib OPV IPV DPT-HB-Hib imunisasi OPV IPV DPT-HB-Hib
Campak
4 9 1 0 0 0 0 0 0 0
4 9 1 0 0 0 0 0 0 0
4 10 1 0 0 0 0 0 0 0
4 10 1 0 0 0 0 0 0 0
4 10 1 0 0 0 0 0 0 0
4 12 1 0 0 0 0 0 0 0
4 14 1 0 0 0 0 0 0 0
4 14 1 0 1 0 1 0 1 -1
0 14 1 1 1 1 1 4 1 3
4 16 1 0 0 0 0 0 0 0
4 17 1 0 0 0 0 0 0 0
4 19 1 0 0 0 0 0 0 0
4 20 1 0 0 0 0 0 0 0
4 22 1 0 1 0 1 0 1 0
4 24 1 0 1 0 1 0 1 0
4 25 1 0 0 0 0 0 0 0
4 25 1 0 0 0 0 0 0 0
4 25 1 0 0 0 0 0 0 0
4 25 1 0 0 0 0 0 0 0
4 26 1 0 0 0 0 0 0 0
4 26 1 0 1 0 1 0 1 0
4 27 1 0 0 0 0 0 0 0
4 28 1 0 0 0 0 0 0 0
4 28 1 0 0 0 0 0 0 0
4 29 1 0 0 0 0 0 0 0
4 30 1 0 0 0 0 0 0 0
4 30 1 0 0 0 0 0 0 0
4 30 1 0 0 0 0 0 0 0
4 31 1 0 1 0 1 0 1 0
4 30 1 0 1 0 1 0 1 0
4 32 1 0 0 0 0 0 0 0
4 34 1 0 1 0 1 0 1 0
4 33 1 0 1 0 1 0 1 0
4 33 1 0 1 0 1 0 1 0
4 34 1 0 1 0 1 0 1 0
4 37 1 1 1 0 1 1 1 0
4 36 1 0 0 0 0 0 0 0
4 38 1 0 0 0 0 0 0 0
4 37 1 0 1 0 1 0 1 0
4 39 1 0 0 0 0 0 0 0
4 39 1 0 0 0 0 0 0 0
4 38 1 0 0 0 0 0 0 0
4 40 1 0 0 0 0 0 0 0
4 39 1 0 0 0 0 0 0 0
4 41 1 0 0 0 0 0 0 0
4 42 1 0 0 0 0 0 0 0
4 44 1 0 0 0 0 0 0 0
4 45 1 0 0 0 0 0 0 0
4 47 1 0 0 0 0 0 0 0
4 46 1 0 0 0 0 0 0 0
4 49 1 0 0 0 0 0 0 0
4 50 1 0 0 0 0 0 0 0
4 50 1 0 0 0 0 0 0 0
4 52 1 0 0 0 0 0 0 0
4 54 1 0 0 0 0 0 0 0
4 54 1 0 0 0 0 0 0 0
4 55 1 0 0 0 0 0 0 0
4 58 1 0 0 0 0 0 0 0
1471 0 0 0 0 0 0 0 0
1471 0 0 0 0 0 0 0 0
1471 0 0 0 0 0 0 0 0
1471 0 0 0 0 0 0 0 0
1471 0 0 0 0 0 0 0 0
1471 0 0 0 0 0 0 0 0
1471 0 0 0 0 0 0 0 0
58 2 13 1 13 5 13 2
TOTAL VIAL VAKSIN (Jumlah Vial = Jumlah Total Sasaran/IP Vaksin)
Sasaran anak & CR bulan Agustus (termasuk Sweeping
OPV IPV DPT-HB-Hib CR Bulan BIAN (JIKA DIIMUNISASI,
OPV ISI TANGGAL
IPV DPT-HB-Hib CR
Agustus (Agustus
0 0 0 1 1 1
0 0 0 1 1 1
0 0 0 1 1 1
0 0 0 1 1 1
0 0 0 1 1 1
0 0 0 1 1 1
0 0 0 1 1 1
0 1 0 1 2 1
1 1 1 1 3 1
0 0 0 1 1 1
0 0 0 1 1 1
0 0 0 1 1 1
0 0 0 1 1 1
0 1 0 1 2 1
0 1 0 1 2 1
0 0 0 1 1 1
0 0 0 1 1 1
0 0 0 1 1 1
0 0 0 1 1 1
0 0 0 1 1 1
0 1 0 1 2 1
0 0 0 1 1 1
0 0 0 1 1 1
0 0 0 1 1 1
0 0 0 1 1 1
0 0 0 1 1 1
0 0 0 1 1 1
0 0 0 1 1 1
0 1 0 1 2 1
0 1 0 1 2 1
0 0 0 1 1 1
0 1 0 1 2 1
0 1 0 1 2 1
0 1 0 1 2 1
0 1 0 1 2 1
1 1 0 1 2 1
0 0 0 1 1 1
0 0 0 1 1 1
0 1 0 1 2 1
0 0 0 1 1 1
0 0 0 1 1 1
0 0 0 1 1 1
0 0 0 1 1 1
0 0 0 1 1 1
0 0 0 1 1 1
0 0 0 1 1 1
0 0 0 1 1 1
0 0 0 1 1 1
0 0 0 1 1 1
0 0 0 1 1 1
0 0 0 1 1 1
0 0 0 1 1 1
0 0 0 1 1 1
0 0 0 1 1 1
0 0 0 1 1 1
0 0 0 1 1 1
0 0 0 1 1 1
0 0 0 1 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
2 13 1 58 72 58 0 0 0 0
1 4 1 8 0 0 0 0
September 2022
(JIKA DIIMUNISASI,
OPV ISI
IPV DPT-HB-Hib
0 0 0
0 0 0
PELAKSANAAN : AGUSTUS 2022 12 Agustus 2022 (Disesuaikan dengan tgl pelaks
Provinsi : JAWA BARAT Desa/Kelurahan : SUKAGALIH
Kabupaten : UMEDANG Posyandu : SIMPATI IV
Tanggal Lahir
No. Nama Anak Jenis Kelamin (L/ P) NIK Nama Orang Tua (IBU)
1 ARIF MAULANA L 18 Agustus 2017 3211171808170001 IIS

2 M.HILMI 17 November 2017 3211171711170001 AAS
3 CARLOTE 25 September 2017 3211176509170003 SITI
4 RAFASYA 12 Januari 2018 3211171201180002 AI
5 WIDI 24 Februari 2018 3211172402180001 LILIS
6 KAMAYAL 02 September 2018 3211170209180001 EGGA
7 PUTRI AGUS 12 Oktober 2018 3211175510180001 SRI
8 SYAKILA 24 Oktober 2018 3211176410180002 YENI
9 AJENG 02 November 2018 3211174211180002 SISKA
10 ANARGYA 02 November 2018 3211174211180003 LILIS
11 RADHIKA 04 Desember 2018 3211170412180002 DETIE
12 DANIEL 09 Desember 2018 3211170912180001 OLISA
13 ARFAN 20 Januari 2019 32111720011900002 ELAWATI
14 SITI LIZA N. 22 Februari 2019 3211176202190002 CUCU
15 AQILA 19 April 2019 3211175904190002 EKA
16 AL-NAIRA 21 April 2019 3211172104190002 PIPIH
17 KEISHA 25 Mei 2019 3211176505190001 YUNI
18 KIRANIA 26 Juni 2019 3211176606190002 PAPAT
19 DAFFA 25 Agustus 2019 3211172508190003 SRI
20 AFNAN 26 Agustus 2020 3211172608200002 NYDA
21 MAS RIZKY 10 September 2019 3211171009190001 ANA
22 M.DEVIAN 14 Oktober 2019 3211171410190001 MIMIN
23 HEIBA 26 Oktober 2019 3211176610190002 NURWULAN
24 RAFANI 20 Desember 2019 3211176012190001 EGGI
25 NAZIA 27 Januari 2020 3211176701200001 OLISA
26 KHAIRIN 13 Februari 2020 3211176302200001 LILIS
27 FEBRAN 15 Februari 2020 3211171502200002 SRI
28 MUSSA ABIMAEL 17 Maret 2020 3211171703200003 AI.S
29 RIFA AZMYA 04 April 2020 3211176404200001 REFLI
30 WILLONA 15 Agustus 2020 3211175508200002 NIA
31 DAVIN RAZENDRA 12 Agustus 2020 3211171208200001 LESTRI
32 M.NIZAM 28 Oktober 2020 3211172810200002 YENI
33 ATHAFARIZ 02 November 2020 3211170211200002 NESA
34 M.THABINA 02 Desember 2020 3211170212200002 IDA
35 BILQIS 11 Februari 2021 3211175102210002 RENI
36 CHAIRIL 05 Mei 2021 3211170505210001 SRI
37 M.FAKHRI 23 April 2021 3211172304210002 WINARTI
38 M.PRATAMA 28 Mei 2021 3211172805210001 SRI
39 WAFA FAUZIAH 02 Juni 2021 3211174206210001 TITA
40
41
42
43
44
45
46
47
48
49
50
TOTAL
AN IMUNISASI KEJAR ADALAH 12-59 BULAN
uaikan dengan tgl pelaksanaan di masing-masing Posyandu)
*) Jumlah Dosis Vaksin yang n sasaran Apakah anak sasaran Imunisasi

Campak Kejar
Alamat Rubela Umur (bulan) (Ya = 1, Tidak = 0)
OPV IPV DPT-HB-Hib Tambahan OPV IPV
sejak
Campak
SUKAGALIH 1/4 Januari
0 4 1 4 59 1 0 0
SUKAGALIH 1/4 0 4 1 4 56 1 0 0
SUKAGALIH 3/4 0 4 1 4 58 1 0 0
SUKAGALIH 2/4 0 4 1 4 55 1 0 0
SUKAGALIH 5/4 0 4 0 4 53 1 0 1
SUKAGALIH 1/4 0 4 1 4 47 1 0 0
SUKAGALIH 2/4 0 4 1 4 46 1 0 0
SUKAGALIH 0 4 1 4 45 1 0 0
SUKAGALIH 2/4 0 4 1 4 45 1 0 0
SUKAGALIH 2/4 0 3 0 3 45 1 1 1
SUKAGALIH 2/4 0 4 1 4 44 1 0 0
SUKAGALIH 4/4 0 4 1 4 44 1 0 0
SUKAGALIH 5/4 0 4 1 4 42 1 0 0
SUKAGALIH 1/4 0 4 1 4 41 1 0 0
SUKAGALIH 3/4 0 4 1 4 39 1 0 0
SUKAGALIH 3/4 0 4 1 4 39 1 0 0
SUKAGALIH 2/4 0 4 1 4 38 1 0 0
SUKAGALIH 5/4 0 4 1 4 37 1 0 0
SUKAGALIH 3/4 0 4 1 4 35 1 0 0
SUKAGALIH 2/4 0 4 1 4 23 1 0 0
SUKAGALIH 2/4 0 4 0 4 35 1 0 1
SUKAGALIH 2/4 0 4 1 4 33 1 0 0
SUKAGALIH 4/4 0 4 1 4 33 1 0 0
SUKAGALIH 1/4 0 4 0 4 31 1 0 1
SUKAGALIH 4/4 0 4 0 4 30 1 0 1
SUKAGALIH 2/4 0 4 0 4 29 1 0 1
SUKAGALIH 1/4 0 4 1 4 29 1 0 0
SUKAGALIH 2/4 0 4 1 4 28 1 0 0
SUKAGALIH 1/4 0 4 1 4 28 1 0 0
SUKAGALIH 2/4 0 4 1 4 23 1 0 0
SUKAGALIH 1/4 0 4 0 4 24 1 0 1
SUKAGALIH 1/4 0 4 1 4 21 1 0 0
SUKAGALIH 3/4 0 4 1 4 21 1 0 0
SUKAGALIH 3/4 0 4 1 4 20 1 0 0
SUKAGALIH 2/4 0 4 1 4 18 1 0 0
SUKAGALIH 1/4 0 4 1 4 15 1 0 0
SUKAGALIH 1/4 0 4 1 4 15 1 0 0
SUKAGALIH 1/4 0 4 0 4 14 1 0 1
SUKAGALIH 1/4 0 4 1 4 14 1 0 0
1471 0 0 0
1471 0 0 0
1471 0 0 0
1471 0 0 0
1471 0 0 0
1471 0 0 0
1471 0 0 0
1471 0 0 0
1471 0 0 0
1471 0 0 0
1471 0 0 0
0 39 1 8
TOTAL VIAL VAKSIN (Jumlah Vial =
nak sasaran Imunisasi Jumlah dosis yang dibutuhkan Rencana Pemberian Dosis Sasaran Sasaran
an
Kejar untuk melengkapi status
Imunisasi Kejar & CR Pada Bulan Agustus Suntikan
a = 1, Tidak = 0) sasaran imunisasi
DPT-HB-Hib imunisasi OPV IPV DPT-HB-Hib OPV IPV DPT-HB-Hib CR Bulan
Agustus
0 0 0 0 0 0 0 0 1 1
0 0 0 0 0 0 0 0 1 1
0 0 0 0 0 0 0 0 1 1
0 0 0 0 0 0 0 0 1 1
0 1 0 1 0 0 1 0 1 2
0 0 0 0 0 0 0 0 1 1
0 0 0 0 0 0 0 0 1 1
0 0 0 0 0 0 0 0 1 1
0 0 0 0 0 0 0 0 1 1
1 1 1 1 1 1 1 1 1 3
0 0 0 0 0 0 0 0 1 1
0 0 0 0 0 0 0 0 1 1
0 0 0 0 0 0 0 0 1 1
0 0 0 0 0 0 0 0 1 1
0 0 0 0 0 0 0 0 1 1
0 0 0 0 0 0 0 0 1 1
0 0 0 0 0 0 0 0 1 1
0 0 0 0 0 0 0 0 1 1
0 0 0 0 0 0 0 0 1 1
0 0 0 0 0 0 0 0 1 1
0 1 0 1 0 0 1 0 1 2
0 0 0 0 0 0 0 0 1 1
0 0 0 0 0 0 0 0 1 1
0 1 0 1 0 0 1 0 1 2
0 1 0 1 0 0 1 0 1 2
0 1 0 1 0 0 1 0 1 2
0 0 0 0 0 0 0 0 1 1
0 0 0 0 0 0 0 0 1 1
0 0 0 0 0 0 0 0 1 1
0 0 0 0 0 0 0 0 1 1
0 1 0 1 0 0 1 0 1 2
0 0 0 0 0 0 0 0 1 1
0 0 0 0 0 0 0 0 1 1
0 0 0 0 0 0 0 0 1 1
0 0 0 0 0 0 0 0 1 1
0 0 0 0 0 0 0 0 1 1
0 0 0 0 0 0 0 0 1 1
0 1 0 1 -1 0 1 0 1 2
0 0 0 0 0 0 0 0 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
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 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 8 1 8 0 1 8 1 39 48
anak & CR bulan Agustus (termasuk Sweeping imunisasi Kejar pada
sasaran pada September) 2022 September 2022
BIAN (JIKA DIIMUNISASI,
OPV ISI TANGGAL
OPV ISI
IPV DPT-HB-Hib
(Agustus
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
0
0
0
0
0
0
0
0
0
0
0
39 0 0 0 0 0 0 0
0 0 0 0 0 0 0
Tanggal Lahir
1 SYIRA L 31 Desember 2019 321117711219000

2 FATIMAH 26 November 2019 3211174205180002
3 ARVINO 22 November 2018 321117221180001
4 KANAYA 02 Mei 2018 3211174205180002
5 AISYAH 04 Agustus 2018 3211174408180001
6 APRILIAN 05 April 2020 321117050420001
7 ANGGIA 24 September 2017 3211176409170003
8 RAZKA 06 Oktober 2017 3211170610170002
9 NAVISHA 31 Januari 2019 3211177101190001
10 ELYSIA 07 April 2018 3211174704180001
11 JIHAN 01 Agustus 2020 3211174108200001
12 AZZAKA 27 Mei 2021 3211176705210000
13 KHARINA 01 Maret 2018 3211174103180001
14
15
16
17
18
19
20
21
22
23
24
25
TOTAL
LAN DAN SASARAN IMUNISASI KEJAR ADALAH 12-59 BULAN
: SUKAGALIH
SIMPATI V

Campak
sejak
Campak
DELIA SUKAGALIH 2/5 Januari
0 4 1 4 31 1
YRTI SUKAGALIH 2/5 0 4 1 4 32 1
NOPI SUKAGALIH 1/5 0 4 1 4 44 1
NANI SUKAGALIH 2/5 0 4 1 4 51 1
IPAT SUKAGALIH 1/5 0 4 1 4 48 1
RISKA SUKAGALIH 3/5 0 4 1 4 28 1
ERNI SUKAGALIH 3/5 0 4 1 4 58 1
IKA SUKAGALIH 3/5 0 4 1 4 58 1
EPA SUKAGALIH 3/5 0 4 1 4 52 1
EPA SUKAGALIH 3/5 0 4 1 4 24 1
INTAN SUKAGALIH 1/5 0 4 1 4 14 1
SRI SUKAGALIH 1/5 0 4 1 4 53 1
1471 0
1471 0
1471 0
1471 0
1471 0
1471 0
1471 0
1471 0
1471 0
1471 0
1471 0
1471 0
0 13
TOTAL
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
ian Dosis Sasaran
OPV ISI TANGGAL
OPV ISI
IPV DPT-HB-Hib
Agustus (Agustus
1 1 1
1 1 1
1 1 1
1 1 1
1 1 1
1 1 1
1 1 1
1 1 1
1 1 1
1 1 1
1 1 1
1 1 1
1 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
13 13 13 0 0 0 0 0 0 0
2 0 0 0 0 0 0 0
DPT-HB-Hib
Tanggal Lahir
1 ARBANI L 15 Agustus 2017 3211171508170002

2 KAMORA 16 Agustus 2018 3211175608180001
3 AZALEA 16 Juni 2018 3211174506180001
4 ABIL 28 Juli 2018 3211172807180003
5 PADIL 29 Oktober 2018 3211172910180001
6 ARTA 01 November 2019 3211174111190001
7 ARYA 01 Juni 2019 3211174111190002
8 DONI 15 Juni 2019 3211171506190003
9 SHAKIRA 16 Juli 2019 3211175607190001
10 SHALGI 19 September 2019 3211181909190002
11 ALBIANDRA 12 November 2020 321117121120001
12 DEVANDRA 12 November 2020 321117121120002
13
14
15
16
17
18
19
20
TOTAL
: SUKAGALIH
: SIMPATI VI
*) Jumlah Dosis Vaksin yang n sasaran Apakah anak sasaran Imun

Campak
Nama Orang Tua (IBU) Alamat Rubela Umur (bulan) (Ya = 1, Tidak = 0)
OPV IPV DPT-HB-Hib Tambahan OPV
sejak
Campak
EVA SUKAGALIH 1/2 Januari
0 4 1 4 59 1 0
FITRI SUKAGALIH 2/2 0 4 1 4 47 1 0
YEYET SUKAGALIH 1/2 0 4 1 4 49 1 0
DEWI SUKAGALIH 1/2 0 4 1 4 48 1 0
EKA SUKAGALIH 3/2 0 4 1 4 45 1 0
SOPIAN SUKAGALIH 3/2 0 4 1 4 33 1 0
RIKA SUKAGALIH 1/2 0 4 1 4 38 1 0
DEDAH SUKAGALIH 2/2 0 4 1 4 37 1 0
YENI SUKAGALIH 2/2 0 4 1 4 36 1 0
RINDA SUKAGALIH 2/2 0 4 1 4 34 1 0
RISNA SUKAGALIH1/2 0 4 1 4 20 1 0
RISNA SUKAGALIH 1/2 0 4 1 4 20 1 0
1471 0 0
1471 0 0
1471 0 0
1471 0 0
1471 0 0
1471 0 0
1471 0 0
1471 0 0
0 12 0
TOTAL VIAL VAKS
IPV DPT-HB-Hib imunisasi OPV IPV DPT-HB-Hib OPV IPV DPT-HB-Hib CR
0 0 0 0 0 0 0 0 0 1
0 0 0 0 0 0 0 0 0 1
0 0 0 0 0 0 0 0 0 1
0 0 0 0 0 0 0 0 0 1
0 0 0 0 0 0 0 0 0 1
0 0 0 0 0 0 0 0 0 1
0 0 0 0 0 0 0 0 0 1
0 0 0 0 0 0 0 0 0 1
0 0 0 0 0 0 0 0 0 1
0 0 0 0 0 0 0 0 0 1
0 0 0 0 0 0 0 0 0 1
0 0 0 0 0 0 0 0 0 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 12
Suntikan sasaran pada September) 2022 September 2022
Bulan BIAN (JIKA DIIMUNISASI,
OPV ISI TANGGAL
OPV ISI
IPV DPT-HB-Hib
Agustus (Agustus
1 1
1 1
1 1
1 1
1 1
1 1
1 1
1 1
1 1
1 1
1 1
1 1
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
12 12 0 0 0 0 0 0 0
0 0 0 0 0 0 0
Tanggal Lahir
1 MUHAMAD AZKA FADILAH 15 September 2017 32111715091700002

2 GALANG GUMILAR 26 Oktober 2017 3211172610170001
3 ABYAN ARKANA PUTRA 07 November 2017 3211170711170001
4 FILIA ARKARI HINDIYANA 03 November 2017 3211170311170001
5 M. NOVAN AFANDI 02 November 2017 3211174710170003
6 NAIWA ZULFA 07 Oktober 2017 32111747100170003
7 DEVEN ALGHAZALI 11 Desember 2017 3211171112170002
8 MUHAMAD FADNIL .M 05 Desember 2017 3211170512170005
9 MUHAMAD NOVA 14 November 2017 3211171411170002
10 RIGA ZAYDAN Z 10 Januari 2018 3211171001180001
11 VANIA UTAMI 29 Desember 2017 3211176912170001
12 SRI ARSYLA 17 Januari 2018 3211175701180002
13 AQILA MISHA SAFANA 05 Maret 2018 3211174503180001
14 ARSYLA ADIVA PUTRI 07 Maret 2018 3211174703180001
15 IFRA MIKAYLA 11 Januari 2018 3211175101180004
16 ARSYLA SEPRIYANTI 30 September 2018 3211177009180001
17 FATHYA KHALIFA 09 Oktober 2018 3211175910180002
18 QALESHA. A 09 Juli 2018 3211174907180001
19 M. FADHIL RIZKI 19 Oktober 2018 3211171910180001
20 NABILA PUTRI A 28 Oktober 2018 3211176810180002
21 ANISA FAUZIAH A 13 Januari 2019 3211175301190001
22 MUTIARA DINAN 15 Februari 2019 3211175501190001
23 RAFFASYA A 08 Februari 2019 3211170802190001
24 VICKY SAPUTRA 12 Maret 2019 3211171203190003
25 AYUNDA JASMIN 23 Maret 2019 3211176303190001
26 ARIQA FATINA 09 April 2019 3211174904190001
27 RIFKI NURWANSYAH 14 September 2019 321117403190001
28 FAIZ ABDULAH 23 Maret 2019 3211172303190001
29 GHAITSAN RAFASYA 08 Juni 2019 3211170806190002
30 MUHAMAD ALVINO 23 Maret 2019 3211172303190001
31 VIA SELFIANA 24 Maret 2019 3211176403190001
32 AFFIFAH KHOERUNISA 11 Juni 2019 3211175106190001
33 M. RAIS ALFARIZKI 13 September 2019 3211171309190001
34 M. RAFKA. A 01 Oktober 2019 3211170110190001
35 KEINATA FANISA 08 November 2019 3211174811190002
36 FAUZA YAGZLAN 30 November 2019 3211173011190002
37 AGHNI KAAMILATUR 30 November 2019 3211177011190001
38 DARA FEBRIANA 11 Februari 2020 3211175102200001
39 NADHIRA DZIKRA 20 Januari 2020 3211176001200009
40 ALDEFARO NAJIB 20 Februari 2020 3211172502200001
41 ZEA SAILA MECCA 21 Maret 2020 3211176103200002
42 ERNI SOFIAH 02 Maret 2020 3211174203200001
43 INAYA PUTRI P 14 April 2020 3211175404200002
44 HAIKAL NAFIS 29 April 2020 321117290420001
45 RUMAISYA 10 April 2020 3211175004200001
46 IZZATUNISA. A 01 April 2020 3211174104200001
47 AZRIL RAFI 06 April 2020 3211170604200002
48 M. FAIZ. PRATAMA 13 Februari 2020 321117130220001
49 M. QOIS 15 Mei 2020 321117505200001
50 GALVIN AKBAR 25 Mei 2020 3211172405200001
51 ELVANO ADHITAMA 31 Mei 2020 3211173105200001
52 ANINDHITA 09 Juni 2020 3211174906200001
53 SAFANA ZAHRA 16 Agustus 2020 3211175608200002
54 AISYA PUTRI 08 Juli 2020 321117480720001
55 RAFI CAHYANA 05 Juni 2020 3211170506200002
56 RIZKY FIRMANSYAH 14 Maret 2020 3211171403200002
57 SALSABILA MAHARANI 08 September 2020 3211174809200004
58 ARQYAN VISAKA 21 September 2020 3211172109200004
59 FAHREZA AKBAR 28 September 2020 3211172809200001
60 FAUZAN ALFARIZKI 26 November 2020 321117261120001
61 NADIRA AZMI 07 Desember 2020 3211174712200002
62 M. IQBAL HANDISA 11 Januari 2021 3211171101210001
63 ALFI ZAYDAN 29 September 2020 3211172909200004
64 M. ALFATIH FIRDAUS 19 Februari 2021
65 FAIZ KENZIE H 23 Maret 2021 3211172303210001
66 RAFFASYA MUJAYIN 24 Maret 2021 3211172403210001
67 NAVASYA DWI FALISA 07 April 2021 3211174704210001
68 NADA ZAHIRA 11 April 2021 3211175104210001
69 M. RAMDAN 28 April 2021 321117280421
70 HAIDAR SHAKA 05 April 2021 3211170504210003
71 RAYYAN. I 10 Mei 2021 3211171005210001
72 AYESHA ZAIDATUL 06 Juni 2021 3211174606210002
73 ZAHRANA SHEVA 05 Juni 2021
74 NAHDA RAFANDA 07 Juni 2021 3211174706210004
75 SABRINA ANESKHA 06 April 2021 3211174609210001
76 NUMA NURAHMAN 07 September 2021 3211174709210001
77 ATHARAZKA 10 Oktober 2021 3211171010210001
78 OKTAVIA AULIA 16 Oktober 2021 3211175610210001
79
80
81
82
83
84
85
TOTAL
DAN SASARAN IMUNISASI KEJAR ADALAH 12-59 BULAN
: CIPANCAR
: MURAI
kan ORI
Campak
sejak
Campak
Januari
0 4 1 4
GUNAWAN GUNSARI 02/01 58 1
ANDI GUNASARI 02/01 0 4 1 4 57 1
ERIK RISNANDAR GUNASARI 03/01 0 4 1 4 57 1
ANDI SUWANDI GUNASARI 03/01 0 4 1 4 57 1
SUHERLAN GUNASARI 03/01 0 4 1 4 57 1
ENDANG S GUNASARI 01/01 0 4 1 4 58 1
AHMAD ABIDIN GUNASARI 01/06 0 4 1 4 55 1
GUNAWAN GUNASARI 01/06 0 4 1 4 56 1
RIO JULWANTO GUNASARI 03/06 0 4 1 4 54 1
ZULFIKAR S GUNASARI 01/01 0 4 1 4 55 1
HENDRA S GUNASARI 03/01 0 4 1 4 54 1
IRWAN K GUNASARI 01/06 0 4 1 4 53 1
JAJANG RIAN GUNASARI 02/01 0 4 1 4 53 1
ANDRI JAENUDIN GUNASARI 01/01 0 4 1 4 54 1
SARYA GUNASARI 01/01 0 4 1 4 46 1
HARJANA GUNASARI 03/01 0 4 1 4 46 1
ABDURAHMAN GUNASARI 03/06 0 4 1 4 49 1
AJUN GUNASARI 02/01 0 4 1 4 45 1
TARYADI GUNSARAI 02/01 0 4 1 4 45 1
AA SUPRIATNA GUNASARI 01/01 0 4 1 4 42 1
DAHLAN GUNASARI 01/01 0 4 1 4 41 1
GUNAWAN GUNSARAI 01/01 0 4 1 4 42 1
OYAT SUDRAJAT GUNASARI 03/06 0 4 1 4 40 1
LILI JUANDA GUNASARI 03/06 0 4 1 4 40 1
DANU GUNASARI 03/01 0 4 1 4 40 1
IWAN. T GUNASARI 01/01 0 4 1 4 34 1
WAWAN D GUNASARI 03/06 0 4 1 4 40 1
DIAN IRIANA GUNASARI 01/01 0 4 1 4 38 1
BABAN GUNASARI 02/01 0 4 1 4 40 1
SURYAMIN GUNASARI 01/06 0 4 1 4 40 1
DIAN KUDUS GUNASARI 03/01 0 4 1 4 37 1
HENDRA. J GUNASARI 03/06 0 4 1 4 34 1
M.ALFARIZKI GUNSARAI 02/06 0 4 1 4 34 1
SUPARMAN GUNASARI 03/06 0 4 1 4 33 1
RIDWAN.D GUNASARI 03/06 0 4 1 4 32 1
AHMAD H GUNASARI 02/06 0 4 1 4 32 1
IMAN NUGRAHA GUNASARI 01/06 0 4 1 4 29 1
INDRA ABA GUNASARI 01/06 0 4 1 4 30 1
YUSUF GUNASARI 03/06 0 4 1 4 29 1
FALQIT GUNASARI 01/06 0 4 1 4 28 1
ROHENDI GUNASARI 02/01 0 4 1 4 29 1
ABIL HAPID GUNASARI 02/01 0 4 1 4 27 1
DIVA. A GUNASARI 01/01 0 4 1 4 27 1
DESI. S GUNASARI 03/06 0 4 1 4 27 1
SUHADNI GUNASARI 02/06 0 4 1 4 28 1
IJA GUNASARI 01/01 0 4 1 4 28 1
ADE YUSUF GUNASARI 01/01 0 4 1 4 29 1
HERMAN GUNSARI 03/01 0 4 1 4 26 1
ASEP SALAMET GUNASARI 01/01 0 4 1 4 26 1
ERYAN GUNASARI 02/06 0 4 1 4 26 1
KIKI MARZUKI GUNASARI 02/01 0 4 1 4 26 1
M. RIZKI GUNASARI 02/01 0 4 1 4 23 1
RIAN GUNASARI 01/06 0 4 1 4 25 1
ANDRI SOPIAN GUNASARI 01/01 0 4 1 4 26 1
IRWANSYAH GUNASARI 03/01 0 4 1 4 28 1
HERI. H GUNASARI 02/01 0 4 0 4 23 1
ANDRI. J GUNASARI 01/01 0 4 0 4 22 1
IRFA. AJI GUNASARI 03/06 0 4 0 4 22 1
YANYAN GUNASARI 01/06 0 4 0 4 20 1
RIKI. M GUNASARI 03/01 0 4 0 4 20 1
HILMAN GUNASARI 01/01 0 4 1 4 18 1
YAYAN. H GUNASARI 03/01 0 4 1 4 22 1
TEGUH RAHMAT GUNASARI 03/06 0 4 1 4 17 1
SUHENDAR GUNASARI 03/01 0 4 1 4 16 1
INDY QULIA GUNASARI 03/01 0 4 1 4 16 1
ALIYUDIN GUNASARI 03/06 0 4 1 4 16 1
NANANG GUNASARI 03/01 0 4 1 4 15 1
RENALDI GUNASARI 01/01 0 4 1 4 16 1
CHEVI. R GUNASARI 01/06 0 4 1 4 14 1
HERU GUNASARI 03/01 0 4 1 4 14 1
SUANRTO GUNASARI 03/01 0 4 1 4 14 1
JENI. K PERUM 0 4 1 4 14 1
ANDIKA GUNASARI 02/06 0 4 1 4 16 1
AJISKA GUNASARI 03/06 0 4 1 4 11 1
WIGUNA GUNASARI 02/06 0 4 1 4 9 1
IWAN GUNASARI 02/01 0 4 1 4 9 1
1471 0
1471 0
1471 0
1471 0
1471 0
1471 0
1471 0
0 78
TOTAL VIAL
Apakah anak sasaran Imunisasi merupak Jumlah dosis yang dibutuhkan Rencana Pemberian Dosis Sasaran
0 0 0 KEJAR
0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 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 0 1 0 1 0 0 1 0
0 1 0 1 0 1 0 0 1 0
0 1 0 1 0 1 0 0 1 0
0 1 0 1 0 1 0 0 1 0
0 1 0 1 0 1 0 0 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 5 0 5 0 5 0 0 5 0
ian Dosis Sasaran
Bulan BIAN (JIKA DIIMUNISASI, ISI TANGGAL (JIKA DIIMUNISASI, ISI
CR OPV IPV DPT-HB-Hib CR OPV IPV DPT-HB-Hib
Agustus (Agustus
1 1 1
1 1 1
1 1 1
1 1 1
1 1 1
1 1 1
1 1 1
1 1 1
1 1 1
1 1 1
1 1 1
1 1 1
1 1 1
1 1 1
1 1 1
1 1 1
1 1 1
1 1 1
1 1 1
1 1 1
1 1 1
1 1 1
1 1 1
1 1 1
1 1 1
1 1 1
1 1 1
1 1 1
1 1 1
1 1 1
1 1 1
1 1 1
1 1 1
1 1 1
1 1 1
1 1 1
1 1 1
1 1 1
1 1 1
1 1 1
1 1 1
1 1 1
1 1 1
1 1 1
1 1 1
1 1 1
1 1 1
1 1 1
1 1 1
1 1 1
1 1 1
1 1 1
1 1 1
1 1 1
1 1 1
1 1 1
1 2 1
1 2 1
1 2 1
1 2 1
1 2 1
1 1 1
1 1 1
1 1 1
1 1 1
1 1 1
1 1 1
1 1 1
1 1 1
1 1 1
1 1 1
1 1 1
1 1 1
1 1 1
1 1 1
1 1 1
1 1 1
1 1 1
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
78 83 78 0 0 0 0 0 0 0
10 0 0 0 0 0 0 0
DPT-HB-Hib
Tanggal Lahir
1 MUHAMAD ILYAS AL-FARUQ 10 November 2021 3211171011210001

2 ELMAYRA ZAKIY YATUL ADREENA 09 Juli 2020 321117490720001
3 AZKIA SITI R 16 Agustus 2020 3211175608200003
4 ALMIRA AZZAHRA PRATIWI 10 September 2020
5 MUHAMMAD FARHAN ZAENI 16 September 2020 3211171609200004
6 MUHAMMAD RAQILLA 29 November 2020
7 ADINDA KIRANA KHOERUNISA 09 Desember 2020 3211174912200002
8 RANTI NURHASANAH 11 Januari 2021 3211175001210001
9 SITI FATIMAH AZ ZAHRA 03 Februari 2021 3211174302200002
10 ALGIFARI ZAKI FEBRIANSYAH 28 Februari 2021 3211062802210001
11 KANZA AZKADI NA HASNUL 01 April 2021 321174104210001
12 SHANUM KAHIYANG SANDI 22 Juni 2021 3211176206210001
13 RAFLY MUHAMMAD SHAN 09 Juni 2021
14 AZZAHRA FATHA RANI 26 Juni 2021
15 MIKAYLA AZZALEA PUTRI 17 September 2017 3211175709170003
16 REZI ALJAUHARI 20 Oktober 2017 3211172010170001
17 ALNAIRA ARSYA. P 22 November 2017 3211176211170001
18 RAIFA TSULISTSI ROHAENI 20 Januari 2018 3211176001180001
19 TAUQON HAFIZUDIN 06 Agustus 2018 32111706001180001
20 ALWI RAJAB 20 Maret 2018 3211172003180002
21 FAUZAN ROHIMAN 31 Maret 2018 3211173103180001
22 APRILIA ASRI SUWANDI 06 April 2018 3211174604180003
23 DAIRA NAFISATUI QOLBI 09 April 2018 3211170904180002
24 NAILANURLATIFAH 04 Mei 2018 3211174405180001
25 FAHMI ANDRIAN ALFAREZI 12 Mei 2018 3211171205180001
26 DELISYA KHUZAIKAL RULAN 14 Mei 2018 3211175405180001
27 SYIPA ULFATUL QOLBI 04 Juni 2018 3211174406180001
28 FADIL 04 Juli 2018
29 CHANDRA SAPUTRA 07 Juli 2018 3211170707180002
30 M. RIZKI 08 Februari 2018
31 MUHAMMAD SALIM SYAWALI 17 Juni 2018 3211171706180001
32 MUHAMMAD AZMAL PRANADIPA 17 November 2018 3211171711180001
33 M. ARKA RAFASYA 29 November 2018
34 M. HABSYI ALGIFARI 30 November 2018 3211173011180001
35 GHEA GHANIA ANDARPAN 14 Desember 2018 3211175412180002
36 MEYDA NURJIHAN 26 Desember 2018 3211176612180002
37 NAFISAH NUR ZAKKIYAH 23 Februari 2018 3211176302180004
38 ARFAH PUTRA RUHDIFA 12 Februari 2019 321117202190001
39 RIZKY HANA 24 Februari 2019 3211176402190003
40 AFIZA AL MAHYRA 01 April 2019 3211174104190001
41 WINA NURHAYATI 12 April 2019 3211175204190007
42 GRIZELLE 12 April 2019 3211175204190007
43 SAFIQA PUTRI AULIA MAULANI 13 April 2019
44 FAYYAD RAMADHAN 12 Mei 2019 3211171205190001
45 MUHAMMAD RAMDHAN CUNARA 18 Mei 2019 3211171805190002
46 NADHIRA 26 Juni 2019 3211176606190001
47 ALDIANSYAH 20 Juli 2019 321117200719
48 ABIJAR MUBAROQ 15 Agustus 2019 32111715018190001
49 RAFFASYA KHALFI MAULANA 25 September 2019 3211172509190001
50 GILBY AL HASBY 10 Oktober 2019 3211171010190001
51 NAZMA NUR AZIZA 23 November 2019 3211176311190001
52 RAZKA ARGHI 30 November 2019 3211173011190004
53 RAI AAQILA .N 10 Desember 2019 3211175012190001
54 MUHAMMAD NIZAM MUBAROK 13 Januari 2020 3211171301200001
55 MUHAMMAD ABDUL RAHMAN 16 Januari 2020 321117160120004
56 DEPA ADNA MANAF 28 Desember 2018 3211182812180003
57 NICKY HINIBAR BUANA 26 Maret 2020
58 RASIMA ALTHAF 12 Mei 2020 321117
59 MELKA NURALIYAH 28 Mei 2021 3211176805200002
60 HANA HUMAIRA 11 Juni 2020 3211175110200002
61 LUCHIO ELVANDER ROHIM 13 Februari 2018 32111791302180001
62 MUHAMMAD RAFFA ABDUL MANAF 04 Agustus 2021
63 NABILA ZIA SITI AL MASHYRA 05 September 2021 3211174509210001
64 NAYLA NUR AZIZAH 20 Maret 2020 3211176003200001
65 RAMA FATWA ANGGADA 27 Maret 2019 32140129703190001
66 RAYSA PUTRI EKATAMA 17 Mei 2018 3211175705180001
67
68
69
70
71
72
73
74
75
TOTAL
SARAN IMUNISASI KEJAR ADALAH 12-59 BULAN
: CIPANCAR
: GELATIK
mendapatkan *) Jumlah Dosis Vaksin yang n sasaran

ORI Campak pernah didapat Imunisasi
Nama Orang Tua (IBU) Alamat Umur (bulan)
Rubela sejak OPV IPV DPT-HB-Hib Tambahan
Januari 2022 Campak
SYIPA SEMBIR 04/02 0 4 1 4 9 1
MALNI SEMBIR 01/09 0 4 1 4 25 1
HASANAH SEMBIR 02/09 0 3 0 3 23 1
TATI TARMINI SEMBIR 01/02 0 4 1 4 23 1
ENI ROHAENI SEMBIR 04/02 0 4 1 4 22 1
DESI JUARIAH SEMBIR 04/02 0 4 1 4 20 1
YULI SEMBIR 01/02 0 4 1 4 20 1
SURYANI SEMBIR 02/09 0 4 1 4 18 1
RINI SYAFARI SEMBIR 03/02 0 4 1 4 18 1
TITI KURAESIN SEMBIR 04/02 0 4 1 4 17 1
LILIS SURYANI SEMBIR 04/09 0 4 1 4 16 1
SRI MARYANI SEMBIR 04/02 0 4 1 4 13 1
RATIH S SEMBIR 01/02 0 4 1 4 14 1
RINA SEMBIR O1/02 0 4 1 4 13 1
RITA ROSITA SEMBIR 01/02 0 4 1 4 58 1
PIPIH SEMBIR 01/09 0 4 1 4 57 1
HANI SEMBIR 01/09 0 4 1 4 56 1
ILA SUSILAWATI SEMBIR 03/02 0 4 1 4 54 1
EROS ROSMINI SEMBIR 04/09 0 4 1 4 48 1
TRIYATI N SEMBIR 04/09 0 4 1 4 52 1
AAN NURJANAH SEMBIR 04/09 0 4 1 4 52 1
NENTI ASIH S SEMBIR 01/09 0 4 1 4 52 1
TATING R SEMBIR 02/02 0 4 1 4 52 1
YATNI SEMBIR 02/09 0 4 1 4 51 1
NERIL. K SEMBIR 04/09 0 4 1 4 50 1
SARI WIDAYANTI SEMBIR 04/02 0 4 1 4 50 1
TITIN .M SEMBIR 01/02 0 4 1 4 50 1
IA SEMBIR 03/02 0 4 1 4 49 1
RENI SURYANI SEMBIR 04/09 0 4 1 4 49 1
ETI SEMBIR/01/02 0 4 1 4 54 1
WIWIN WINARTI SEMBIR 02/02 0 4 1 4 49 1
AMELIA SEMBIR 02/09 0 4 1 4 44 1
YUNI SEMBIR 04/09 0 4 1 4 44 1
NOVISARI SEMBIR 04/02 0 4 1 4 44 1
PANPATWATI SEMBIR 01/09 0 4 1 4 43 1
RANI FEBRIANI SEMBIR 01/09 0 4 1 4 43 1
NURUL HASANAH SEMBIR 01/09 0 4 1 4 53 1
NAFA. N SEMBIR 04/09 0 4 1 4 41 1
SITI NUR .U SEMBIR 02/02 0 4 1 4 41 1
SHINTA DEWI R SEMBIR 01/02 0 4 1 4 40 1
SINTA HANDAYANI SEMBIR 04/02 0 4 1 4 39 1
YANYAN SEMBIR 02/02 0 4 1 4 39 1
JUWITA SEMBIR 01/02 0 4 1 4 39 1
HENI NURSARI SEMBIR 03/09 0 4 1 4 38 1
IIN MARLINA SEMBIR 04/02 0 4 1 4 38 1
NURUL SEMBIR 03/09 0 4 0 4 37 1
EUIS SEMBIR 04/09 0 4 0 4 36 1
ANI SUSTINI SEMBIR 02/09 0 4 0 4 35 1
FUJI ASTUTI SEMBIR 01/02 0 4 1 4 34 1
TIVANI AYULY SEMBIR 04/09 0 4 0 4 34 1
ADE DWI YANTI SEMBIR 04/02 0 4 0 4 32 1
AI GUSTINA SEMBIR 03/09 0 4 1 4 32 1
NENG KUSTARI SEMBIR 02/09 0 4 1 4 32 1
RINRIN K SEMBIR 01/09 0 4 1 4 30 1
SITI NUR D SEMBIR 03/02 0 0 0 0 30 1
DITA SEMBIR 01/02 0 4 1 4 43 1
FITRI SEMBIR 01/02 0 4 1 4 28 1
DEA SEMBIR 03/02 0 4 1 4 26 1
DEIS FITRIANI SEMBIR 03/02 0 4 0 4 14 1
AYU SEMBIR 04/09 0 4 0 4 25 1
SOPIA SEMBIR 01/02 0 4 1 4 53 1
LIANA. L SEMBIR 04/02 0 4 1 4 12 1
WINA SEMBIR 04/09 0 4 1 4 11 1
RINI ANDRIANI SEMBIR 03/09 0 4 1 4 28 1
CASWATI SEMBIR 01/02 0 4 1 4 40 1
VINA SEMBIR 03/02 0 4 1 4 50 1
1471 0
1471 0
1471 0
1471 0
1471 0
1471 0
1471 0
1471 0
1471 0
0 66
TO
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
1 1 1 1 1 1 1 1 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
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 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 0 1 0 1 0 0 1 0
0 1 0 1 0 1 0 0 1 0
0 1 0 1 0 1 0 0 1 0
0 0 0 0 0 0 0 0 0 0
0 1 0 1 0 1 0 0 1 0
0 1 0 1 0 1 0 0 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
1 1 1 1 4 1 4 1 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 1 0 1 0 1 -1 0 1 0
0 1 0 1 0 1 0 0 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
2 9 2 9 5 9 4 2 9 2
ian Dosis Sasaran
OPV ISI TANGGAL
OPV ISI
IPV DPT-HB-Hib
Agustus (Agustus
1 1 1
1 1 1
1 3 1
1 1 1
1 1 1
1 1 1
1 1 1
1 1 1
1 1 1
1 1 1
1 1 1
1 1 1
1 1 1
1 1 1
1 1 1
1 1 1
1 1 1
1 1 1
1 1 1
1 1 1
1 1 1
1 1 1
1 1 1
1 1 1
1 1 1
1 1 1
1 1 1
1 1 1
1 1 1
1 1 1
1 1 1
1 1 1
1 1 1
1 1 1
1 1 1
1 1 1
1 1 1
1 1 1
1 1 1
1 1 1
1 1 1
1 1 1
1 1 1
1 1 1
1 1 1
1 2 1
1 2 1
1 2 1
1 1 1
1 2 1
1 2 1
1 1 1
1 1 1
1 1 1
1 3 1
1 1 1
1 1 1
1 1 1
1 2 1
1 2 1
1 1 1
1 1 1
1 1 1
1 1 1
1 1 1
1 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
66 77 66 0 0 0 0 0 0 0
9 0 0 0 0 0 0 0
DPT-HB-Hib
Tanggal Lahir
1 REYSA SEPTIANI 18 September 2017 3211175809170001

2 ASSYFA AULIA P 13 Oktober 2017 3211179310170001
3 NAURA NUR LATIFAH 01 November 2017 32111741111700001
4 NANA ALMERA. N 02 Desember 2017 3211174212700001
5 RAFFA NUGRAHA 04 Desember 2017 321117512170005
6 DEBRIAN ALVARO 16 Desember 2017 3211171612170001
7 AQILA JENAA. M 30 Desember 2017 3211177012170001
8 CANTIKA ALMAIRA 09 Januari 2018 3211174901180001
9 KAYESHA FEBRIANI 23 Februari 2018 3211176302180008
10 CHIKA KHANZA. K 23 Februari 2018 3211176302180003
11 ALEA QUEENELA 26 Februari 2018 3211174602180002
12 SYABILA FITRIATNI 11 Maret 2018 3211175103180001
13 RAFIF RASALAL 18 Maret 2018 321117803180001
14 MIKAYLA NADZHIFA 31 Maret 2018 3211177103180001
15 ANISA APRIL S 07 April 2018 321117470418000
16 KHALISA AZZAHRA 07 April 2018 3211176704180003
17 DEVANA SULTANSYAH 02 Mei 2018 3211170205180001
18 KANAYA ANATASYA 07 Mei 2019 3211174705180002
19 KHOLIQ SINAM 08 Mei 2018 3211170805180001
20 HERNI MELAWATI 20 Mei 2018 3211176005180001
21 AISYA ATAYA. R 05 Juni 2018 3211170506180001
22 SITI NOFIFAH. A 10 Juni 2018 3211174806180002
23 DEFARAZ MULYANA 27 Juni 2018 3211172006180001
24 ADITYA RIFQI 17 Juli 2018 3211171707180001
25 GIRAN HASBY. A 21 Juni 2018 3211172107180001
26 RENI NURAENI 23 Juni 2018 3211176307180001
27 AULIAN MUHAMAD 26 Juli 2018 321117607180001
28 SITI PARIDA AZANAH 07 Juli 2018 32111707180002
29 AILA RIFATUL. A 06 September 2018 3211174609180003
30 NAZRIEL MAULANA 08 September 2018 321117080918000
31 RFKI AHMAD RIFAI 12 September 2018 3211171209180003
32 M. NAZRIL PAUJI 23 September 2018 3211172309180001
33 ELVANO PRATAMA 14 Oktober 2018 321117141018000
34 ASHEEGA NAJAHA 28 Oktober 2018 3211176810180001
35 SITI MARATUS 30 Oktober 2018 3211176910180001
36 AKIFA INTANIA 25 Oktober 2018 32111765110180001
37 ELVINA NAILA 05 November 2018 3211174511180001
38 M.FADILAH 06 November 2018 3211170611180002
39 NAILA ULANI 07 November 2018 3211174711180001
40 ADEEVA WIDYA. K 11 November 2018 3211176411180001
41 NAIRA QIRA NAFISA 07 Desember 2018 3211174712180002
42 GIBRAN ALVARO 18 Desember 2018 3211171812180001
43 ALYA ZAHIRA . M 02 Januari 2019 3211174201190001
44 ALFAN RAFKA. P 23 Januari 2019 3211172301190001
45 KHALISA UMAIRA 15 Maret 2019 3211175503190001
46 AFIFAH NAHDA . R 17 April 2019 3211175704190001
47 M. RAIHAN PRATAMA 04 Mei 2019 3211170405190001
48 RAMADANTI FITRIANI 23 Mei 2019 3211176305190002
49 ADIZA ZULIA LUCIANA 23 Juli 2019 3211176307190003
50 ZULFAN HAFIDZ 05 Agustus 2019 3211170508190002
51 SUGIH SETIAWAN 25 Agustus 2019 3211172508190001
52 YANYAN AGUSTINA 31 Agustus 2019 3211173108190001
53 AQILA NURFADILAH 07 September 2019 3211174709190001
54 DELISA SEPTIA. R 06 Oktober 2019
55 M SYAID AL-BUSYIRI 10 Oktober 2019
56 M. RIZKY HAFIZ 20 Oktober 2019 3211172010190002
57 AXL ARKANEY. T 22 Oktober 2019 3211172210190002
58 SYAPA ZAHIRA. N 23 Oktober 2019 3211176310190001
59 ARSYILA KHUMAIRA 31 Oktober 2019 3211177110190001
60 FAHRI IBNU UMAR 17 November 2019 3211171711190001
61 SYILLA SHEILA QUENA 15 Maret 2019 321117570319000
62 ALMAIRA SYADIYYA 13 Oktober 2019 3211175310190001
63 M. RAFFY 22 November 2019 321117211190002
64 RIZKIANA ALKADLAN 30 November 2019 3211173011190005
65 ADRIANSYAH PUTRA 10 Desember 2019 3211171012190001
66 NAUVAL RIVATUL. A 24 Desember 2019 3211172412190001
67 DAFFA FAIZ H 28 Desember 2019 3211172812190001
68 HARUNA NIHALA 29 Desember 2019 3211176912190001
69 ELSA CALISTA 06 Januari 2020 3211174601200001
70 RIFANI QUARATU. A 10 Januari 2020 3211175001200002
71 FEBRI IDRIS. A 22 Februari 2020 3211172202200001
72 AFIFAH NUR 09 Maret 2020 32110493200001
73 KANIA DEWI A 12 Maret 2020 321117520320000
74 M. BISYIR AL-HAFI 16 Maret 2020 3211171603200001
75 ERINA NURFAIZAH 22 Maret 2020 321117620320000
76 APRILIAN NUR. H 04 April 2020 3211174404200002
77 NAZLA APRILIANI 30 April 2020 321117700420000
78 SYAFA FUZIANISSA 18 April 2020 3211174804200005
79 MASSYA FAQIH.N 14 Mei 2020 321117540520001
80 ALMEER NABIL 22 Mei 2020 3211172205200002
81 SYAFANA ALMAIRA 09 Juni 2020 3211175906200001
82 KHAISAN FAQIH . N 21 Mei 2020 3211172105210004
83 KEYRA ANANDITA 17 Juni 2020 3211175706200001
84 AZRIEL JULYAWAN 11 Juli 2020 321117110720005
85 RAKA NUGRAHA 27 Juli 2020 3211172707200001
86 SRI AYUNDA PUTRI 27 Agustus 2020 3211176708200001
87 GIBRAN AL-KAHFI 13 Oktober 2020 3211171310200001
88 PRAMADITA GANTARI 20 Oktober 2020 3211176010200001
89 PARAMITA LARASATI 18 November 2020 3211175811200002
90 NATAN ARDIANSYAH 29 November 2020 3211172911200002
91 DESTA ARROHMAN 12 Desember 2020 3211171212200004
92 ABIL DAFFA .M 22 Desember 2020 3211172212200001
93 RAYHAN FARUROHMAN 24 Desember 2020 321117241220001
94 AIRA RIZKIANI 07 Februari 2021 32111747012100001
95 ROHMAN MULANA 26 Februari 2021 321117260221000
96 ABIL DAFFA 20 Februari 2021
97 REYDIK SAPUTRA S 23 Maret 2021 3211172203210001
98 INEZKA 06 April 2021
99 ZEEMA ABIA ZIKRI 18 April 2021 3211171804210002
100 ALGIO NADIF 09 Mei 2021 3211170905210003
101 LIVIYA NURLISTIANI 26 Mei 2021 3211176605210001
102 RIFQI ALDY. A 13 Juli 2021
103 RAFFA ALFARIQZI 23 Juli 2021
104 HUMAYRA SHAKILA 11 Agustus 2021 3211175108210008
105 NAOVAN AGUSTIN 08 Agustus 2021
106 AGHISNA KANZA. A 19 Agustus 2021
107 ELVIRA PUTRI.N 16 September 2021 3211175609210002
108 M. SYAQIL ALBIRRU 28 September 2021
109 DHIKRY FADILLAH 08 Oktober 2021
110 SHELMA RAISYA.S.I 18 Oktober 2021 3211175810210001
111 M. RAIHAN EZHILAN 18 Oktober 2021 3211171810210001
112 CIARA SYAQUINA. W 23 Oktober 2021
113 GIANDRA WIJAYA 14 November 2021
114 SHANUM ALZENA .Q 14 November 2021
115 AZZURA FINAYA 18 November 2021 3211175811210001
116 ANINDITHA HAYVA 21 November 2021 3211176111210001
117 ZAINAL MUSTOFA 21 November 2021 3211172111210001
118 ALFARIZI ALTEZA. F 05 November 2021 3211170511210002
119 JINGGA LEMBAH 24 Desember 2020 3211176412210002
120 HILYA NUR AZKIA 22 Juni 2020 3211176206200003
121
122
123
124
125
126
127
128
129
130
TOTAL
: GUNASARI
: MERPATI

Campak
sejak
Campak
SUNSUN CIHONJE 3/7 Januari
0 4 1 4 59 1
SALIM CIHONJE 2/7 0 4 1 4 58 1
HERMAN JUNADI CIHONJE 3/7 0 4 1 4 57 1
ERWIN CIHONJE 3/7 0 4 0 4 56 1
DERAJAT CIHONJE 2/8 0 4 1 4 56 1
DERIYANTO CIHONJE 5/3 0 4 1 4 56 1
TATA CIHONJE 4/3 0 4 1 4 55 1
RIDWAN CIHONJE 4/3 0 4 1 4 55 1
SUPRIATNA CIHONJE 1/8 0 4 1 4 53 1
ENANG CIHONJE 2/3 0 4 1 4 53 1
SONI CIHONJE 1/8 0 4 1 4 53 1
IMAN S CIHONJE 2/3 0 4 1 4 53 1
ARIS CIHONJE 3/7 0 4 1 4 53 1
DUDUN CIHONJE 3/7 0 4 1 4 52 1
DEDE S CIHONJE 4/3 0 4 1 4 52 1
UDIN RUHIAT CIHONJE 1/7 0 4 0 4 52 1
IRMAN CIHONJE 1/3 0 4 1 4 51 1
FIRMAN CIHONJE 2/7 0 4 1 4 39 1
DENSI ROHMAN CIHONJE 2/7 0 4 1 4 51 1
KOSASIH CIHONJE 2/7 0 4 1 4 50 1
SALIM CIHONJE 2/7 0 4 1 4 50 1
ADIN SYARIF CIHONJE 2/8 0 4 1 4 50 1
RAHMAT CIHONJE 1/3 0 4 1 4 49 1
JAENUDIN CIHONJE 2/7 0 4 1 4 49 1
SUNARDI IVAN CIHONJE 4/3 0 4 1 4 49 1
NANA MULYANA CIHONJE 1/8 0 4 1 4 49 1
DIDI CIHONJE 4/3 0 4 0 4 48 1
YANA H CIHONJE 2/8 0 4 1 4 49 1
RAMA CIHONJE 1/7 0 4 1 4 47 1
EDIN CIHONJE 2/7 0 4 1 4 47 1
JUJU CIHONJE 2/7 0 4 1 4 47 1
DENDI CIHONJE 5/3 0 4 1 4 46 1
SONI RAMDANI CIHONJE 1/8 0 4 1 4 46 1
KIKI KIDEY CIHONJE 2/5 0 4 1 4 45 1
WILDAN CIHONJE 2/8 0 4 1 4 45 1
TAHWAN CIHONJE 2/3 0 4 1 4 45 1
YOSI CAHYADI CIHONJE 3/7 0 4 1 4 45 1
EDI YANA CIHONJE 2/8 0 4 1 4 45 1
ONDI.R CIHONJE 1/2 0 4 1 4 45 1
WAWAN CIHONJE 2/3 0 4 1 4 45 1
DADANG .S CIHONJE 2/3 0 4 1 4 44 1
GIAIN CIHONJE 2/2 0 4 1 4 44 1
KIKIN CIHONJE 1/7 0 4 1 4 43 1
ICANG CIHONJE 3/8 0 4 1 4 42 1
ROHMAN CIHONJE 1/7 0 4 1 4 41 1
RIFAN AGUNG CIHONJE 1/7 0 4 1 4 40 1
ANGGA. S CIHONJE 3/3 0 4 1 4 39 1
UDUNG. S CIHONJE 3/7 0 4 1 4 38 1
IOS SUGIANTO CIHONJE 2/3 0 4 0 4 36 1
LABIB CIHONJE 4/7 0 4 1 4 36 1
FUAD ILMI CIHONJE 2/7 0 4 0 4 35 1
ENDUY CIHONJE 3/8 0 4 0 4 35 1
SONI SUKMA CIHONJE 1/8 0 4 1 4 35 1
MAMAT CIHONJE 3/7 0 4 1 4 34 1
OHAN CIHONJE 1/8 0 0 0 0 34 1
M. DAVID CIHONJE 5/3 0 4 0 4 33 1
YOGI YANA CIHONJE 2/3 0 4 0 4 33 1
JAKA. S CIHONJE 2/7 0 4 0 4 33 1
KOKO CIHONJE 3/7 0 4 0 4 33 1
VANI FAHADIA CIHONJE 2/8 0 4 0 4 33 1
ROHMAN CIHONJE 1/7 0 4 1 4 41 1
AGUNG. R CIHONJE 5/3 0 4 0 4 34 1
AGUS CIHONJE 2/7 0 4 0 4 32 1
SONI CIHONJE 2/8 0 4 1 4 32 1
TONO. H CIHONJE 1/7 0 4 1 4 32 1
ADI CIHONJE 4/7 0 4 0 4 31 1
RIZWAN CIHONJE 5/3 0 4 1 4 31 1
FAHMI CIHONJE 1/3 0 4 0 4 31 1
FREDI CIHONJE 1/7 0 4 0 4 31 1
M. ARIF CIHONJE 1/7 0 4 0 4 31 1
DORISMAN CIHONJE 4/3 0 4 1 4 29 1
DENI CIHONJE 3/3 0 4 0 4 29 1
SONI ABDUR CIHONJE 3/3 0 4 1 4 29 1
ANWAR CIHONJE 1/8 0 3 0 3 29 1
ABDUL SALAM CIHONJE 1/8 0 4 1 4 28 1
EGI CIHONJE 3/8 0 4 1 4 28 1
FAHRUZ ZAMAN CIHONJE 3/3 0 4 1 4 27 1
YAYANG FAJAR CIHONJE 3/8 0 4 1 4 28 1
ARI ARDIANSYAH CIHONJE 3/7 0 4 1 4 27 1
BAMBANG CIHONJE 4/3 0 4 1 4 26 1
M. RIZKI CIHONJE 2/7 0 4 0 4 26 1
DENAI CIHONJE 2/7 0 4 0 4 26 1
DADANG D CIHONJE 2/8 0 4 0 4 26 1
ADI GUNAWAN CIHONJE 5/3 0 4 1 4 25 1
RIJAN. F CIHONJE 2/8 0 4 1 4 24 1
IWAN SUHERWAN CIHONJE 1/7 0 4 1 4 23 1
RAHMAT. H CIHONJE 3/7 0 4 1 4 22 1
KUSNADI CIHONJE 1/8 0 4 1 4 21 1
OMAN CIHONJE 3/3 0 4 1 4 21 1
SAMSUDIN CIHONJE 1/7 0 4 1 4 20 1
DANA CIHONJE 3/8 0 4 1 4 20 1
CEPI CIHONJE 3/8 0 4 1 4 19 1
YUYU. W CIHONJE 3/7 0 4 0 3 19 1
YANYAN CIHONJE 1/7 0 4 1 4 18 1
PRIANTO CIHONJE 2/7 0 4 1 4 17 1
FARIZAL ADUNA CIHONJE 1/7 0 4 1 4 17 1
DIDIN.S CIHONJE 3/8 0 4 1 4 16 1
HENDRA. K CIHONJE 1/3 0 4 1 4 16 1
CUCU SUNARYA CIHONJE 4/7 0 4 1 4 16 1
DEYAN. R CIHONJE 2/8 0 4 1 4 15 1
CECEP MULYANA CIHONJE 4/2 0 4 1 4 14 1
AEP CIHONJE 4/3 0 4 1 4 13 1
M. NURDIN CIHONJE 3/2 0 4 1 4 12 1
EFRI.F CIHONJE 5/3 0 4 1 4 12 1
DADANG CIHONJE 3/7 0 4 1 4 12 1
DENIAR BAYU CIHONJE 1/8 0 4 1 4 12 1
JAJANG TAUFIL CIHONJE 3/2 0 4 1 4 11 1
NIKI PURNAMA CIHONJE 3/3 0 4 1 4 10 1
TATAN. R CIHONJE 3/8 0 4 1 4 10 1
RODIANA. R CIHONJE 2/8 0 4 1 4 10 1
RODIANA. R CIHONJE 2/8 0 4 1 4 10 1
ATEP SUCITA CIHONJE 2/3 0 4 1 4 9 1
SANTANA CIHONJE 2/3 0 4 1 4 9 1
FIRMAN CIHONJE 2/7 0 4 1 4 9 1
DIAN MAULANA CIHONJE 5/7 0 4 1 4 9 1
NANA SUDRAJAT CIHONJE 2/3 0 4 1 4 8 0
HAPIDIN CIHONJE 2/2 0 4 1 4 8 0
SODIKIN CIHONJE 4/3 0 4 1 4 9 1
DADAN.H CIHONJE 4/7 0 4 1 4 19 1
ARMAN. R CIHONJE 1/8 0 4 1 4 25 1
1471 0
1471 0
1471 0
1471 0
1471 0
1471 0
1471 0
1471 0
1471 0
1471 0
0 118
TOTAL VIAL
0 0 0 0 0 0 0 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 0 1 0 1 0 0 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 1 0 1 0 1 0 0 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 1 0 1 0 1 0 0 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 1 0 1 0 1 0 0 1 0
0 0 0 0 0 0 0 0 0 0
0 1 0 1 0 1 0 0 1 0
0 1 0 1 0 1 0 0 1 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
1 1 1 1 4 1 4 1 1 1
0 1 0 1 0 1 0 0 1 0
0 1 0 1 0 1 0 0 1 0
0 1 0 1 0 1 0 0 1 0
0 1 0 1 0 1 0 0 1 0
0 1 0 1 0 1 0 0 1 0
0 0 0 0 0 0 0 0 0 0
0 1 0 1 0 1 0 0 1 0
0 1 0 1 0 1 0 0 1 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 1 0 1 0 1 0 0 1 0
0 0 0 0 0 0 0 0 0 0
0 1 0 1 0 1 0 0 1 0
0 1 0 1 0 1 0 0 1 0
0 1 0 1 0 1 0 0 1 0
0 0 0 0 0 0 0 0 0 0
0 1 0 1 0 1 0 0 1 0
0 0 0 0 0 0 0 0 0 0
1 1 1 1 1 1 1 1 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 1 0 1 0 1 0 0 1 0
0 1 0 1 0 1 0 0 1 0
0 1 0 1 0 1 0 0 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 1 1 1 0 1 1 0 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
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
2 24 3 24 5 24 6 2 24 3
ian Dosis Sasaran
OPV ISI TANGGAL
OPV ISI
IPV DPT-HB-Hib
Agustus (Agustus
1 1 1
1 1 1
1 1 1
1 2 1
1 1 1
1 1 1
1 1 1
1 1 1
1 1 1
1 1 1
1 1 1
1 1 1
1 1 1
1 1 1
1 1 1
1 2 1
1 1 1
1 1 1
1 1 1
1 1 1
1 1 1
1 1 1
1 1 1
1 1 1
1 1 1
1 1 1
1 2 1
1 1 1
1 1 1
1 1 1
1 1 1
1 1 1
1 1 1
1 1 1
1 1 1
1 1 1
1 1 1
1 1 1
1 1 1
1 1 1
1 1 1
1 1 1
1 1 1
1 1 1
1 1 1
1 1 1
1 1 1
1 1 1
1 2 1
1 1 1
1 2 1
1 2 1
1 1 1
1 1 1
1 3 1
1 2 1
1 2 1
1 2 1
1 2 1
1 2 1
1 1 1
1 2 1
1 2 1
1 1 1
1 1 1
1 2 1
1 1 1
1 2 1
1 2 1
1 2 1
1 1 1
1 2 1
1 1 1
1 3 1
1 1 1
1 1 1
1 1 1
1 1 1
1 1 1
1 1 1
1 2 1
1 2 1
1 2 1
1 1 1
1 1 1
1 1 1
1 1 1
1 1 1
1 1 1
1 1 1
1 1 1
1 1 1
1 3 1
1 1 1
1 1 1
1 1 1
1 1 1
1 1 1
1 1 1
1 1 1
1 1 1
1 1 1
1 1 1
1 1 1
1 1 1
1 1 1
1 1 1
1 1 1
1 1 1
1 1 1
1 1 1
1 1 1
1 1 1
1 1 1
1 1 1
0 0 0
0 0 0
1 1 1
1 1 1
1 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
118 145 118 0 0 0 0 0 0 0
15 0 0 0 0 0 0 0
DPT-HB-Hib
Kabupaten : UMEDANG
Tanggal Lahir
1 M. GHAERAN A. F 31 Oktober 2021

2 ASAKA SHAQUELLE. A 09 Oktober 2021
3 AZZARA SHAQUEENA 21 Oktober 2021
4 IHSAN KAMIL 01 Agustus 2021
5 AISYAH NAZYA. A 25 Juli 2021
6 NABILA HASNA .S 20 Juli 2021
7 FAYRA AGHNIA. L 12 Juni 2021
8 AIRLANGGA DWIKA. S 24 Mei 2021
9 MAEZURA RIZQIA. S 18 Mei 2021
10 AQILA RAIQA. Z 05 Maret 2021
11 MUSAFFA KHOLIFATUR . M 24 Februari 2021
12 ELFINA RAFFANIA. D 18 Februari 2021
13 NAZIA WAFA ABQURA 16 Januari 2021
14 ALFAHRI NUR FALAH 12 Januari 2021
15 KEINARRA SALVIA. M 01 Januari 2021
16 ROMMY HARDIANSYAH 30 Desember 2020
17 CAILA PARAMITA 30 Desember 2020
18 KEYLA NADHIFA. A 01 Desember 2020
19 M.IRFAN MARDANI 26 Desember 2020
20 RITA AMELIA 22 November 2020
21 FACHIL.M.IDRUS 22 Oktober 2020
22 ESHAN KAINDRA.A 27 September 2020
23 AZQIA 12 Juli 2020
24 ZAYN ATHAFARIZ.P 07 Juli 2020
25 NANDANA KAHIYANG.W 10 Juni 2020
26 AZKA MUFAZAL. G 28 Mei 2020
27 ANDRA 06 Juni 2020
28 NADIRA PUTRI AYLA 09 Mei 2020
29 DINA SIPATUL NAZWA 17 April 2020
30 AZZAM ZAYDAN. P 18 April 2020
31 M.ALZAIDAN 30 Maret 2020
32 ARSI 10 Januari 2020
33 SAFIYYA NUR. A 25 Januari 2020
34 JAJANG 23 Januari 2020
35 M. RAFFIE. A 12 Desember 2019
36 KHALISA SYAFA.F 12 November 2019
37 ELFANO GUFRON. M 27 September 2019
38 KEYSHA NURFADILLAH 28 Juni 2019
39 ADRIAN NAUFAL. F 21 Juni 2019
40 JUNIARKA AKKIRA 18 Juni 2019
41 ARFAM MIYAZ MAUZA 23 April 2019
42 MUHAMMAD IBRAHIM 14 Maret 2019
43 SHALLOM KALEA. G 25 Februari 2019
44 ANASSYA 15 Februari 2019
45 MIKAYLA 30 Maret 2019
46 SHAKEY 18 Januari 2019
47 KAIRA NURUL KAMILA 03 Januari 2019
48 HANA MIZUKI. N 01 Desember 2018
49 DESI SALSABILA 11 Desember 2018
50 SALVIRA NURHANIFAH 18 September 2018
51 NEISHA IZZATUNNISA 18 September 2018
52 NEVAN ALFIAN RIZQI 18 September 2018
53 FATIYA AULIA NISA 03 Agustus 2018
54 RAMA ADITYA PUTRA 05 Juni 2018
55 GIGIH NAILA . R 01 Juni 2018
56 HAMDAN RAMADHAN 25 Mei 2018
57 MEIKA SARAH 03 Mei 2018
58 SYOFI HABIBAH. G 13 April 2018
59 RAFFASYA DAFA. A 13 Februari 2018
60 KAILA RAHMAWATI 08 Maret 2018
61 ARSYLA NAVISHA. A 03 Desember 2017
62 SAIQA AZAHRA 16 November 2017
63 SAMAIRA RAFANI 08 November 2017
64 CELSI OKTAVIANTI 28 Oktober 2017
65 NENG NAZWA ELIANA 06 September 2017
66 AFIF NAUFAL ARIZQI 01 November 2021
67
68
69
70
71
72
73
74
75
TOTAL
9-59 BULAN DAN SASARAN IMUNISASI KEJAR ADALAH 12-59 BULAN
Desa/Kelurahan : GUNASARI
Posyandu : PIPIT I

3211173110210001 CICI CIAWI 4/4 Januari
0 4 1 4
3211170910210001 DEDE.L CIAWI 1/4 0 4 1 4
3211176110210001 ANI CIAWI 4/4 0 4 1 4
321117010821 DEDE. M CIAWI 4/4 0 4 1 4
32111725072100003 HALIMAH CIAWI 4/4 0 4 1 4
321117600721 AI.W CIAWI 4/4 0 4 1 4
321117520621000 DINA CIAWI 2/4 0 4 1 4
3211172405210002 LUSI CIAWI 1/4 0 4 1 4
3211175805210003 AI.NUR.E CIAWI 2/4 0 4 1 4
321117450321 YUSRI CIAWI 2/4 0 4 1 4
3211172402210002 IIS CIAWI 2/4 0 4 1 4
3211175802210001 YULIANTI CIAWI 6/4 0 4 0 4
3211175601210001 ERNAWATI CIAWI 1/4 0 4 1 4
3211171201210003 SUSI CIAWI 4/4 0 4 1 4
3211174101210001 IYAR CIAWI 3/4 0 4 1 4
3211173012210004 CARINI CIAWI 1/4 0 4 1 4
3211177012200002 NURHAYATI CIAWI 6/4 0 4 1 4
321117411200001 OVY CIAWI 4/4 0 4 1 4
3211172612200001 NENENG CIAWI 2/4 0 4 1 4
3211176211200001 WIDA CIAWI 4/4 0 4 1 4
3211172210200001 SUCI CIAWI 3/4 0 4 1 4
3211172709200001 ANISA CIAWI 3/4 0 4 1 4
3211175207200006 SELA CIAWI 6/4 0 4 1 4
32111707020000 SANTI CIAWI 5/4 0 4 1 4
321117100620002 ASTRI YANTI CIAWI 4/4 0 4 1 4
321117805200001 ASRI CIAWI 6/4 0 4 1 4
3211170606200000 AIDAH CIAWI 6/4 0 4 1 4
3211174905200001 SANTI CIAWI 1/4 0 4 1 4
321117570420003 NUR ASRI CIAWI 4/4 0 4 1 4
321117804200004 RANI CIAWI 5/4 0 4 1 4
3211173003200002 IRUMNIASIH CIAWI 3/4 0 4 1 4
3211175001200001 YUSRI CIAWI 2/4 0 4 1 4
3211176501200002 NADYA CIAWI 2/4 0 4 0 4
3211172301200000 DEDE CIAWI 2/4 0 4 1 4
3211171212190003 RATIH CIAWI 1/4 0 4 0 4
3211175211190001 MARYATI CIAWI 3/4 0 4 0 4
3211172709190001 PITRI CIAWI 3/4 0 4 1 4
3211176806190003 SARI CIAWI 5/4 0 4 0 4
3211172106190001 SITI. P CIAWI 2/4 0 4 0 4
3211171806190001 ELI CIAWI 1/4 0 4 0 4
3211172304190002 SUSI CIAWI 5/4 0 4 1 4
3211171403190001 SITI.H CIAWI 6/4 0 4 0 4
321117690219 RESA CIAWI 4/4 0 4 0 4
3211175502190001 SITI.M CIAWI 4/4 0 4 1 4
3211177003190001 SITI.M CIAWI 2/4 0 4 1 4
3211171801190002 ELA CIAWI 1/4 0 4 1 4
3211174301190001 KOKOM CIAWI 5/4 0 4 1 4
3211174112180001 WITRI CIAWI 5/4 0 4 1 4
3211175112180002 LILIS CIAWI 3/4 0 4 1 4
3211175809180001 RESA CIAWI 4/4 0 4 1 4
3211175809180005 IRA CIAWI 3/4 0 4 1 4
321117809180002 IRA CIAWI 3/4 0 4 1 4
3211174308180003 ATI CIAWI 2/4 0 4 1 4
3211170506180003 ANI CIAWI 1/4 0 4 1 4
3211174106180004 VIVIT CIAWI 4/4 0 4 1 4
3211172505180003 DEDE CIAWI 4/4 0 4 1 4
3211174305180002 MIMIN CIAWI 4/4 0 4 1 4
3211175304180001 DEDEH CIAWI 5/4 0 4 1 4
3211171303180003 YUNI CIAWI 4/4 0 4 1 4
3211174803180003 SRI.N CIAWI 6/4 0 4 1 4
3211174312170001 AI.W CIAWI 4/4 0 4 1 4
3211175611170002 BINTANG CIAWI 3/4 0 4 1 4
3211174811170002 IAN CIAWI 6/4 0 4 1 4
321117680170001 DEDE. M CIAWI 4/4 0 4 1 4
3211174609170004 LINA CIAWI 1/4 0 4 1 4
3211170111210003 SITI. N CIAWI 6/4 0 4 1 4
TOTAL 0
Jumlah dosis yang dibutuhkan Rencana Pemberian Dosi
Umur (bulan) (Ya = 1, Tidak = 0) sasaran imunisasi
Imunisasi Kejar & CR Pada B
Tambahan OPV IPV DPT-HB-Hib imunisasi OPV IPV DPT-HB-Hib OPV
Campak
9 1 0 0 0 0 0 0 0 0
10 1 0 0 0 0 0 0 0 0
9 1 0 0 0 0 0 0 0 0
12 1 0 0 0 0 0 0 0 0
12 1 0 0 0 0 0 0 0 0
12 1 0 0 0 0 0 0 0 0
13 1 0 0 0 0 0 0 0 0
14 1 0 0 0 0 0 0 0 0
14 1 0 0 0 0 0 0 0 0
17 1 0 0 0 0 0 0 0 0
17 1 0 0 0 0 0 0 0 0
17 1 0 1 0 1 0 1 -1 0
18 1 0 0 0 0 0 0 0 0
18 1 0 0 0 0 0 0 0 0
19 1 0 0 0 0 0 0 0 0
19 1 0 0 0 0 0 0 0 0
19 1 0 0 0 0 0 0 0 0
20 1 0 0 0 0 0 0 0 0
19 1 0 0 0 0 0 0 0 0
20 1 0 0 0 0 0 0 0 0
21 1 0 0 0 0 0 0 0 0
22 1 0 0 0 0 0 0 0 0
24 1 0 0 0 0 0 0 0 0
25 1 0 0 0 0 0 0 0 0
26 1 0 0 0 0 0 0 0 0
26 1 0 0 0 0 0 0 0 0
26 1 0 0 0 0 0 0 0 0
27 1 0 0 0 0 0 0 0 0
27 1 0 0 0 0 0 0 0 0
27 1 0 0 0 0 0 0 0 0
28 1 0 0 0 0 0 0 0 0
31 1 0 0 0 0 0 0 0 0
30 1 0 1 0 1 0 1 0 0
30 1 0 0 0 0 0 0 0 0
31 1 0 1 0 1 0 1 0 0
32 1 0 1 0 1 0 1 0 0
34 1 0 0 0 0 0 0 0 0
37 1 0 1 0 1 0 1 0 0
37 1 0 1 0 1 0 1 0 0
37 1 0 1 0 1 0 1 0 0
39 1 0 0 0 0 0 0 0 0
40 1 0 1 0 1 0 1 0 0
41 1 0 1 0 1 0 1 0 0
41 1 0 0 0 0 0 0 0 0
40 1 0 0 0 0 0 0 0 0
42 1 0 0 0 0 0 0 0 0
43 1 0 0 0 0 0 0 0 0
44 1 0 0 0 0 0 0 0 0
43 1 0 0 0 0 0 0 0 0
46 1 0 0 0 0 0 0 0 0
46 1 0 0 0 0 0 0 0 0
46 1 0 0 0 0 0 0 0 0
48 1 0 0 0 0 0 0 0 0
50 1 0 0 0 0 0 0 0 0
50 1 0 0 0 0 0 0 0 0
50 1 0 0 0 0 0 0 0 0
51 1 0 0 0 0 0 0 0 0
51 1 0 0 0 0 0 0 0 0
53 1 0 0 0 0 0 0 0 0
53 1 0 0 0 0 0 0 0 0
56 1 0 0 0 0 0 0 0 0
56 1 0 0 0 0 0 0 0 0
57 1 0 0 0 0 0 0 0 0
57 1 0 0 0 0 0 0 0 0
59 1 0 0 0 0 0 0 0 0
9 1 0 0 0 0 0 0 0 0
1471 0 0 0 0 0 0 0 0 0
1471 0 0 0 0 0 0 0 0 0
1471 0 0 0 0 0 0 0 0 0
1471 0 0 0 0 0 0 0 0 0
1471 0 0 0 0 0 0 0 0 0
1471 0 0 0 0 0 0 0 0 0
1471 0 0 0 0 0 0 0 0 0
1471 0 0 0 0 0 0 0 0 0
1471 0 0 0 0 0 0 0 0 0
66 0 9 0 9 0 9 -1 0
TOTAL VIAL VAKSIN (Jumlah Vial = Jumlah Total Sasaran/IP Vaksin) 0
Imunisasi Kejar & CR Pada Bulan Agustus Suntikan sasaran pada September) 2022 September 2022
IPV DPT-HB-Hib CR Bulan BIAN (JIKA DIIMUNISASI,
OPV ISI TANGGAL
IPV DPT-HB-Hib CR (JIKA DIIMUNISASI, ISI
OPV
Agustus (Agustus
0 0 1 1 1
0 0 1 1 1
0 0 1 1 1
0 0 1 1 1
0 0 1 1 1
0 0 1 1 1
0 0 1 1 1
0 0 1 1 1
0 0 1 1 1
0 0 1 1 1
0 0 1 1 1
1 0 1 2 1
0 0 1 1 1
0 0 1 1 1
0 0 1 1 1
0 0 1 1 1
0 0 1 1 1
0 0 1 1 1
0 0 1 1 1
0 0 1 1 1
0 0 1 1 1
0 0 1 1 1
0 0 1 1 1
0 0 1 1 1
0 0 1 1 1
0 0 1 1 1
0 0 1 1 1
0 0 1 1 1
0 0 1 1 1
0 0 1 1 1
0 0 1 1 1
0 0 1 1 1
1 0 1 2 1
0 0 1 1 1
1 0 1 2 1
1 0 1 2 1
0 0 1 1 1
1 0 1 2 1
1 0 1 2 1
1 0 1 2 1
0 0 1 1 1
1 0 1 2 1
1 0 1 2 1
0 0 1 1 1
0 0 1 1 1
0 0 1 1 1
0 0 1 1 1
0 0 1 1 1
0 0 1 1 1
0 0 1 1 1
0 0 1 1 1
0 0 1 1 1
0 0 1 1 1
0 0 1 1 1
0 0 1 1 1
0 0 1 1 1
0 0 1 1 1
0 0 1 1 1
0 0 1 1 1
0 0 1 1 1
0 0 1 1 1
0 0 1 1 1
0 0 1 1 1
0 0 1 1 1
0 0 1 1 1
0 0 1 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
9 0 66 75 66 0 0 0 0 0
3 0 9 0 0 0 0 0
September 2022
(JIKA DIIMUNISASI, ISI
IPV DPT-HB-Hib
0 0
0 0
Tanggal Lahir
1 RIHANA L 29 November 2017 3211176911170001

2 DZAKIRA 25 Januari 2018 3211176501180001
3 MUHAMMAD ARSYIL 16 April 2018 3211171604180001
4 M. AZRIL .F 19 November 2018 3211171911180002
5 DHILFI 30 November 2018 3211177011180001
6 M. ABDUL. KHOLIQ 16 Februari 2019 321117702190001
7 HAIDAR ABDUL. F 20 Juni 2019 3211172006190001
8 M. HIBATULLOH 15 September 2019 3211171509190002
9 KEISHA MARZIA. S 06 September 2019 3211174610190001
10 SHAFIRA N 07 Januari 2019 321117470120003
11 AUREL G.N.A 13 Januari 2020 321115301200001
12 M. DAKIQ 28 Januari 2020 321117280120001
13 JIHAN. A.R 17 Maret 2020 3211175103200003
14 KHANZA 10 September 2020 3211174109200002
15 NAURA ALEA.S 14 September 2020 3211175409200001
16 ALIFQI 26 Desember 2020 3211172812200002
17 M. NAWAWI 09 Februari 2021 3211170902210001
18 ABDILLAH 10 Maret 2021 3211171003210001
19 M.SULAIMA.JAZULI 12 Maret 2021 3211171203210001
20 AISYAH 21 Agustus 2021 3211176106210001
21 M. DZIKRI. A 25 Juli 2021 3211172507210001
22 M. RIZKI. M L 16 Juli 2021 3211171607210002
23
24
25
26
27
28
29
30
TOTAL
: GUNASARI
: PIPIT 2

ORI Campak
Nama Orang Tua (IBU) Alamat Rubela sejak Umur (bulan)
Januari 2022
Campak
DEDE NANGGERANG 03/05 (Ya0=1, 4 1 4 56 1
KURNIA NANGGERANG 02/05 0 4 1 4 54 1
DENI NANGGERANG 02/05 0 4 1 4 51 1
RUSLAN NANGGERANG 02/05 0 4 1 4 44 1
AMINUDIN NANGGERANG 02/05 0 4 1 4 44 1
WIYAN NANGGERANG 02/05 0 0 0 0 41 1
SOFIAN NANGGERANG 02/05 0 4 0 4 37 1
GUMILAR NANGGERANG 02/05 0 4 1 4 34 1
KHUSNA NANGGERANG 02/05 0 4 1 4 35 1
RUDI NANGGERANG 02/05 0 4 1 4 43 1
JIJI NANGGERANG 02/05 0 4 1 4 30 1
FIRMA NANGGERANG 02/05 0 4 1 4 30 1
JAJANG NANGGERANG 02/05 0 4 1 4 28 1
ENANG NANGGERANG 02/05 0 4 1 4 23 1
YANA.M NANGGERANG 02/05 0 4 1 4 22 1
RUDI. R NANGGERANG 02/05 0 4 1 4 19 1
FIRMANJA NANGGERANG 02/05 0 4 1 4 18 1
ADANG. K NANGGERANG 02/05 0 4 1 4 17 1
AGUS. J NANGGERANG 02/05 0 4 1 4 16 1
JAJANG ILHAM NANGGERANG 02/05 0 4 1 4 11 1
DEDE.K NANGGERANG 02/05 0 4 1 4 12 1
NABAWI NANGGERANG 02/05 0 4 1 4 12 1
1471 0
1471 0
1471 0
1471 0
1471 0
1471 0
1471 0
1471 0
0 22
TOTAL
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 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 1 1 4 1 4 1 1 1
0 1 0 1 0 1 0 0 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
1 2 1 2 4 2 4 1 2 1
ian Dosis Sasaran
OPV ISI TANGGAL
OPV ISI
IPV DPT-HB-Hib
Agustus (Agustus
1 1 1
1 1 1
1 1 1
1 1 1
1 1 1
1 3 1
1 2 1
1 1 1
1 1 1
1 1 1
1 1 1
1 1 1
1 1 1
1 1 1
1 1 1
1 1 1
1 1 1
1 1 1
1 1 1
1 1 1
1 1 1
1 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
22 25 22 0 0 0 0 0 0 0
3 0 0 0 0 0 0 0
DPT-HB-Hib
SASARAN IMUNISASI TAMBAHAN CAMPAK RUBELA ADALAH 9-59 BULAN DAN SASARAN IMUNISASI K
Tanggal Lahir
1 M.FAREL A.M. L 04 September 2017 3211170411170001

2 AJI LARANG L 02 Oktober 2017 3211170210170004
3 M RAIF L 04 November 2017 3211170411170002
4 HANIF L 28 November 2017 3273247311170002
5 AGIYU L 24 Desember 2017 3211172412170000
6 AZMIYA P 15 Desember 2017 3211175912170002
7 MEDINA P 26 Agustus 2018 3211176608180001
8 KINANTI P 26 Agustus 2018 3211176608180004
9 M.ALIF L 13 Februari 2018 3211171302180002
10 ABRISANI L 14 Agustus 2018 3211171004180004
11 NAJWA P 23 Mei 2018 3211176205180004
12 HANA P 25 Juni 2018
13 ALFIAN L 23 Juli 2018 3211172307180002
14 WIRA L 21 Juni 2018
15 NEVAN L 13 Maret 2018 3211171303180001
16 FACRI L 10 Juli 2018 3211171007180002
17 HANIFAH P 28 November 2017 3273247311170003
18 ARSYLA P 25 Juni 2018 3211176506180004
19 RASKA P 30 April 2018
20 ADEVA P 05 Maret 2018
21 RAFANSYA L 07 Agustus 2018 3211170708180002
22 M.RAFIL L 18 Agustus 2018
23 ZULFIKAR L 03 Agustus 2018 3211170308180002
24 SYABIL L 08 September 2018 3211170809180001
25 NAURA P 18 Januari 2018 3211175801190001
26 AZALEA P 05 Januari 2018 3211174501180003
27 KANAYA B. P 04 Juli 2019 3277024407190005
28 CEYSA P 30 Desember 2018 3211177017180002
29 ADIBA P 05 Juli 2019 3211174507190001
30 NAYARA P 22 Desember 2019 3211176212190002
31 KENZA L 05 Februari 2019 3204284502190002
32 AL FATIH L 26 Juli 2019
33 SAUKI L 18 Agustus 2019 3211171808190005
34 ADINDA P 02 September 2019 3211174209190003
35 M.TAUFIK L 30 November 2019 3211173011190001
36 FATIMAH P 09 September 2019
37 KHALIFA P 30 Desember 2020 3211173012200002
38 HAFIQ L 09 November 2018
39 SEPTIANI M P 21 September 2017 3211186109170001
40 SYABIL P 20 Maret 2020 3211172003200001
41 AKMAL L 24 Maret 2020
42 AI FIANSYAH P 03 April 2020
43 NAFIQ P 15 Mei 2020
44 KENZIE P 26 April 2020 3211172604200001
45 CHAKIRA L 26 Mei 2020 3211176605200001
46 DEWI P 03 Juni 2020 3211174306200001
47 M.ARSYAD L 09 Agustus 2020 3211170908200003
48 AFIFA P 11 September 2020 3211175109200002
49 ANISA P 15 November 2020 3211175511200001
50 NESSA P 03 Januari 2021
51 NEYMA P 03 Januari 2021
52 AJKAYARA P 03 November 2020
53 NAYLA P 22 Oktober 2020
54 FAZIA HASNA P 18 Maret 2021 3211175803210002
55 KAGUMI L 16 Maret 2021
56 SABIRA P 12 Maret 2021
57 TAUFIQ L 07 April 2021 3211170704210001
58 GAISAN L 26 Mei 2021 3211172605210002
59 M.AZRIEL L 15 Mei 2021 3211171205210004
60 M.GIBRAN L 28 Januari 2021 3211172801210003
61 SELMA P 25 Juli 2021
62 ALIA LINGGITA P 02 Juli 2021 3211174207210003
63 FAHMI L 15 Agustus 2021
64 ZAIHAN P 03 Oktober 2021
65 M.ARKANZA L 02 Oktober 2021
66 QOBIYATUL L 25 Januari 2018 3211176501180002
67 M.SYIFA L 19 Juli 2018 3211251907180002
68 M.ABDUL AZIZ L 17 Juni 2020 32111251706200001
69 SRI LESTARI P 31 Mei 2019
70
71
72
73
74
75
76
77
78
79
80
TOTAL
: BAGINDA
: TERATAI 1

ORI Campak
Nama Orang Tua (IBU) Alamat Rubela sejak Umur (bulan)
Januari 2022
Campak
ENDH BAGINDA 2/1 (Ya0=1, 4 1 4 59 1
TINI BAGINDA 4/1 0 4 1 4 58 1
RANI BAGINDA 6/1 0 4 1 4 57 1
SITI BAGINDA 4/1 0 4 1 4 56 1
EVA BAGINDA 2/1 0 4 1 4 55 1
INA BAGINDA 1/1 0 4 1 4 56 1
TUTI BAGINDA 2/1 0 4 1 4 47 1
SANTI BAGINDA 6/1 0 4 1 4 47 1
AI BAGINDA 4/1 0 4 1 4 54 1
GIA BAGINDA 5/1 0 4 1 4 48 1
LIA BAGINDA 4/1 0 4 1 4 50 1
YANI BAGINDA 1/3 0 4 1 4 49 1
SRI BAGINDA 5/1 0 4 1 4 48 1
NUR BAGINDA 1/3 0 4 1 4 49 1
KULSUM BAGINDA 4/1 0 4 1 4 53 1
SUNENDRA BAGINDA 4/1 0 4 0 4 49 1
SITI BAGINDA 4/1 0 4 0 4 56 1
YANDI BAGINDA 6/1 0 4 1 4 49 1
TINA BAGINDA 3/1 0 4 1 4 51 1
DWI BAGINDA 6/1 0 4 1 4 53 1
SUSI BAGINDA 4/1 0 4 1 4 48 1
SITI BAGINDA 5/1 0 4 1 4 48 1
RIMA BAGINDA 2/1 0 4 1 4 48 1
CUCU BAGINDA 2/1 0 4 1 4 47 1
EMI BAGINDA 1/1 0 4 1 4 55 1
DEVI BAGINDA 1/1 0 4 1 4 55 1
RITA BAGINDA 1/1 0 4 1 4 37 1
TEDI/GIAS BAGINDA 4/1 0 4 1 4 43 1
DEDE BAGINDA 5/1 0 4 1 4 37 1
BANGBANG BAGINDA 4/1 0 4 0 4 31 1
DENI BSGINDS 1/1 0 4 1 4 42 1
INDRI BAGINDA 6/1 0 4 1 4 36 1
AI BAGINDA 4/1 0 4 1 4 36 1
INTAN BAGINDA 1/1 0 4 1 4 35 1
WIDA BAGINDA 4/1 0 4 1 4 32 1
AJENG BAGINDA 1/3 0 4 1 4 35 1
SUSI BAGINDA 3/1 0 4 1 4 19 1
NETI BAGINDA 4/1 0 4 1 4 45 1
YUYUN BAGINDA 1/1 0 4 1 4 58 1
ELI BAGINDA 5/1 0 4 1 4 28 1
YANI BAGINDA 2/1 0 4 1 4 28 1
ROSITA BAGINDA 4/1 0 4 1 4 28 1
SURYATI BAGINDA 4/1 0 4 1 4 27 1
YULI BAGINDA 3/1 0 4 1 4 27 1
NURUL BAGINDA 1/1 0 4 1 4 26 1
IRMA BAGINDA 5/1 0 4 1 4 26 1
YANDI BAGINDA 6/1 0 4 1 4 24 1
ELIN BAGINDA 3/1 0 4 1 4 23 1
SITI BAGINDA 4/1 0 4 1 4 21 1
EVA BAGINDA 1/1 0 4 1 4 19 1
EVA BAGINDA 1/1 0 4 1 4 19 1
RIYANI BAGINDA 6/1 0 4 1 4 21 1
NIA BAGINDA 1/1 0 4 1 4 21 1
RIMA BAGINDA 2/1 0 4 1 4 17 1
RITA BAGINDA 1/1 0 4 1 4 17 1
CUCU BAGINDA 2/1 0 4 1 4 17 1
IBAD BAGINDA 1/1 0 4 1 4 16 1
LALA BAGINDA 1/1 0 4 1 4 14 1
TETIN BAGINDA 5/1 0 4 1 4 15 1
SNAFY BAGINDA 5/1 0 4 1 4 18 1
VIVI BAGINDA 6/1 0 4 1 4 12 1
ARNI BAGINDA 2/1 0 4 1 4 13 1
FARIDI BAGINDA 2/1 0 4 1 4 12 1
AI BAGINDA 2/1 0 4 1 4 10 1
VINA BAGINDA 2/1 0 4 1 4 10 1
EVI BAGINDA 5/1 0 4 1 4 54 1
CAHYA BAGINDA 1/1 0 4 0 4 48 1
CAHYA BAGINDA 1/1 0 4 0 4 26 1
YEYEN BAGINDA 4/1 0 4 0 4 38 1
1471 0
1471 0
1471 0
1471 0
1471 0
1471 0
1471 0
1471 0
1471 0
1471 0
1471 0
0 69
TOTAL V
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 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 0 1 0 1 0 0 1 0
0 1 0 1 0 1 0 0 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 1 0 1 0 1 0 0 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 1 0 1 0 1 0 0 1 0
0 1 0 1 0 1 0 0 1 0
0 1 0 1 0 1 0 0 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 6 0 6 0 6 0 0 6 0
ian Dosis Sasaran
Suntikan sasaran pada September) 2022 September 2022
R Pada Bulan Agustus
OPV ISI TANGGAL
OPV ISI
IPV DPT-HB-Hib
Agustus (Agustus
1 1 1
1 1 1
1 1 1
1 1 1
1 1 1
1 1 1
1 1 1
1 1 1
1 1 1
1 1 1
1 1 1
1 1 1
1 1 1
1 1 1
1 1 1
1 2 1
1 2 1
1 1 1
1 1 1
1 1 1
1 1 1
1 1 1
1 1 1
1 1 1
1 1 1
1 1 1
1 1 1
1 1 1
1 1 1
1 2 1
1 1 1
1 1 1
1 1 1
1 1 1
1 1 1
1 1 1
1 1 1
1 1 1
1 1 1
1 1 1
1 1 1
1 1 1
1 1 1
1 1 1
1 1 1
1 1 1
1 1 1
1 1 1
1 1 1
1 1 1
1 1 1
1 1 1
1 1 1
1 1 1
1 1 1
1 1 1
1 1 1
1 1 1
1 1 1
1 1 1
1 1 1
1 1 1
1 1 1
1 1 1
1 1 1
1 1 1
1 2 1
1 2 1
1 2 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
69 75 69 0 0 0 0 0 0 0
9 0 0 0 0 0 0 0
DPT-HB-Hib
Tanggal Lahir
1 AMIRA P 26 Oktober 2017 3211176610170002

2 M.ADHI RAJASA M. L 27 Oktober 2017 3213072710170003
3 NADIR ARMAGAN L 10 April 2018 3211171004180001
4 QORI KHAIRUNISA L 10 Desember 2018
5 RAHAMA P 27 Maret 2019 3211176703190001
6 M.ARSYAD M. L 19 Maret 2019 3211171903190003
7 SYAIRA RAHMA L 11 Februari 2019 3211175102190003
8 SYAKILA RIMA P 13 Juni 2019 3211175306190001
9 NARENDRA P 29 Agustus 2019 3211172908190003
10 M.ZIO ALKAHFI L 24 November 2019 3211172411190000
11 RADHEA TRIJI H. L 30 Desember 2019 3211173012190001
12 SYAKILLA SYANUM P 29 April 2020 3213076904200002
13 M. FARHAN L 04 Mei 2020 3211170405200001
14 KLAYESHA RAHMA S P 11 Juni 2020 3211175106200001
15 ALEENA S.A P 19 Oktober 2020 3211175910200002
16 ABIANSYAH N.A L 17 November 2020 3211171711200001
17 ARGADIAZ ZAHAIR L 10 Desember 2020 3211171012200002
18 A ARIZ GAFFA AL F. L 01 Maret 2021 32111710103210001
19 NADHERA N. P 18 Juli 2021
20 GHIBRAN NAUFAL R. L 22 Agustus 2021 3211172208210002
21 NUR ASYIFA B P 16 Agustus 2021 3211175608210001
22
23
24
25
26
27
28
29
30
TOTAL
: BAGINDA
: TERATAI II
mendapatkan ORI *) Jumlah Dosis Vaksin yang pernah didapat

Nama Orang Tua (IBU) Alamat Campak Rubela
sejak Januari 2022 OPV IPV DPT-HB-Hib
SITI N BAGINDA 1/2 (Ya =1, 0
Tidak=0) 4 1 4
NINA BAGINDA 1/2 0 4 1 4
RIRI BAGINDA 3/2 0 4 1 4
AMBAR BAGINDA 1/2 0 4 1 4
INDRIYAANI BAGINDA 2/2 0 4 1 4
SITI D BAGINDA 3/2 0 4 1 4
RIKA BAGINDA 1/2 0 4 1 4
SITI BAGINDA 1/2 0 4 1 4
SRI BAGINDA 1/2 0 4 1 4
SITI BAGINDA 3/2 0 4 1 4
IA W BAGINDA 3/2 0 4 1 4
NINA BAGINDA 1/2 0 4 1 4
VINA BAGINDA 1/2 0 4 1 4
TINA BAGINDA 2/2 0 4 1 4
PEMI BAGINDA 1/2 0 4 1 4
DEBY BAGINDA 1/2 0 4 1 4
SRI M. BAGINDA 1/2 0 4 1 4
TINAH BAGINDA 1/2 0 4 1 4
RINI BAGINDA 3/2 0 4 1 4
AI N BAGINDA 1/2 0 4 1 4
LIGAR BAGINDA 2/2 0 4 1 4
0
Campak
57 1 0 0 0 0 0 0 0 0
57 1 0 0 0 0 0 0 0 0
52 1 0 0 0 0 0 0 0 0
44 1 0 0 0 0 0 0 0 0
40 1 0 0 0 0 0 0 0 0
41 1 0 0 0 0 0 0 0 0
42 1 0 0 0 0 0 0 0 0
38 1 0 0 0 0 0 0 0 0
35 1 0 0 0 0 0 0 0 0
32 1 0 0 0 0 0 0 0 0
31 1 0 0 0 0 0 0 0 0
27 1 0 0 0 0 0 0 0 0
27 1 0 0 0 0 0 0 0 0
26 1 0 0 0 0 0 0 0 0
22 1 0 0 0 0 0 0 0 0
21 1 0 0 0 0 0 0 0 0
20 1 0 0 0 0 0 0 0 0
17 1 0 0 0 0 0 0 0 0
13 1 0 0 0 0 0 0 0 0
12 1 0 0 0 0 0 0 0 0
12 1 0 0 0 0 0 0 0 0
1471 0 0 0 0 0 0 0 0 0
1471 0 0 0 0 0 0 0 0 0
1471 0 0 0 0 0 0 0 0 0
1471 0 0 0 0 0 0 0 0 0
1471 0 0 0 0 0 0 0 0 0
1471 0 0 0 0 0 0 0 0 0
1471 0 0 0 0 0 0 0 0 0
1471 0 0 0 0 0 0 0 0 0
1471 0 0 0 0 0 0 0 0 0
21 0 0 0 0 0 0 0 0
OPV ISI TANGGAL
OPV
Agustus (Agustus
0 0 1 1 1
0 0 1 1 1
0 0 1 1 1
0 0 1 1 1
0 0 1 1 1
0 0 1 1 1
0 0 1 1 1
0 0 1 1 1
0 0 1 1 1
0 0 1 1 1
0 0 1 1 1
0 0 1 1 1
0 0 1 1 1
0 0 1 1 1
0 0 1 1 1
0 0 1 1 1
0 0 1 1 1
0 0 1 1 1
0 0 1 1 1
0 0 1 1 1
0 0 1 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 21 21 21 0 0 0 0 0
0 0 3 0 0 0 0 0
September 2022
IPV DPT-HB-Hib
0 0
0 0
SASARAN IMUNISASI TAMBAHAN CAMPAK RUBELA ADALAH 9-59 BULAN DAN SASARAN IMUNISASI K
Kabupaten : UMEDANG
Tanggal Lahir
1 YOARA L 14 November 2017

2 M. FAHTAR L 01 Desember 2017
3 KIANA P 29 Januari 2018
4 NAJMA A P 13 Februari 2018
5 GEA P 15 Maret 2018
6 M.SAMSYIL L 04 April 2018
7 DIANDRA A P 11 Mei 2018
8 KHALIFA P 20 Agustus 2018
9 ABIZAR P 19 Agustus 2018
10 M.AZZAM L 14 September 2018
11 M.ABDUL H. L 14 September 2018
12 ANGGUN P 06 Oktober 2018
13 GIO L 11 Oktober 2018
14 RIZKI B.R. L 27 November 2018
15 IBNU L 20 Desember 2018
16 LANGITJANARI L 12 Desember 2018
17 RIZKI P.I. L 23 Desember 2018
18 SITI ROSIDAH P 27 Desember 2018
19 ARDAN L 19 April 2019
20 ADEEVA P 16 Mei 2019
21 ROSMIATI P 09 Mei 2019
22 ARSILA P 02 September 2019
23 PAUZAN L 17 September 2019
24 PARHAN L 20 Oktober 2019
25 M.AL-FATIH L 19 Oktober 2019
26 M.IDRIS L 09 Januari 2020
27 FADEL L 24 Februari 2020
28 KHUMAIRA L 10 Februari 2020
29 M.SALMAN L 06 Mei 2020
30 GINANDIYA L 13 Juni 2020
31 DZIKRI A.P. L 14 Agustus 2020
32 M.RIFKI L 16 Agustus 2020
33 NASYA A. P 06 September 2020
34 BAIHAKI L 25 November 2020
35 REINA P.A P 29 November 2020
36 M.YAFI L 25 Desember 2020
37 NAISHA A.K. P 23 Desember 2020
38 M.DAFFA L 05 Februari 2021
39 M.SURYA L 14 Februari 2021
40 DWI ANGGA P 24 Februari 2021
41 GUMAISHA L 26 Februari 2021
42 AFIFAH H.A. P 13 Maret 2021
43 RANIA N.A. P 05 April 2021
44 DIANIKA A.N. L 21 Juni 2021
45 SHABIRA P 05 Juni 2021
46 INDANA Z P 10 September 2021
47 SAFIA T.M P 26 September 2021
48 M RASYID L 09 Oktober 2021
49 ARUMI P 06 November 2021
50
51
52
53
54
55
TOTAL
DALAH 9-59 BULAN DAN SASARAN IMUNISASI KEJAR ADALAH 12-59 BULAN
Desa/Kelurahan : BAGINDA
Posyandu : TERATAI III
rna PUTIH!
mendapatkan *) Jumlah Dosis Vaksin yang
ORI Campak pernah didapat
NIK Nama Orang Tua (IBU) Alamat
Rubela sejak OPV
Januari 2022
3211175411170001 TIKE BAGINDA 3/3 0 4
SITI BAGINDA 2/3 0 4
NANI S BAGINDA 4/3 0 4
RAVINKA BAGINDA 3/3 0 4
LAELA BAGINDA 2/3 0 4
3211170404180001 TETI BAGINDA 3/3 0 4
HESTI BAGINDA 4/3 0 4
MIRA BAGINDA 4/3 0 4
3211171909180004 FEBI BAGINDA 1/3 0 4
3211171409180001 NIAR BAGINDA 4/3 0 4
321117140918000 NURJANAH BAGINDA 3/3 0 4
3211174610180000 ENI BAGINDA 4/3 0 4
3211171110180001 YUSNI BAGINDA 3/3 0 4
3211172711180001 HENA BAGINDA 3/3 0 4
321112012180002 NIA BAGINDA 2/3 0 4
3211171212180003 RISYE BAGINDA 5/3 0 4
3211172312180002 DEDE BAGINDA 1/3 0 4
321117212180001 HILMI BAGINDA 3/3 0 4
3211171904190001 HENI BAGINDA 1/3 0 4
3211175505190002 DEWI BAGINDA 1/3 0 4
3211174905190002 SUSI BAGINDA 2/3 0 4
3211184209190001 IRA BAGINDAB 2/3 0 4
3211170979000 ELIS BAGINDA 3/3 0 4
3211172010190003 ENDANG BAGINDA 1/3 0 4
3211171910190001 NINA BAGINDA 3/3 0 4
3211170901200001 YULI BAGINDA 2/3 0 4
3211172402200000 WIDA BAGINDA 1/3 0 4
3211175002200001 SUTISNA BAGINDA 3/3 0 4
3211170605200001 ANIS BAGINDA 4/3 0 4
3211175306200001 DEVI BAGINDA 5/3 0 4
3211171408200001 KARINA BAGINDA 2/3 0 4
3211171608200003 TITA BAGINDA 1/3 0 4
3211174609200001 SITI BAGINDA 2/3 0 4
3211172511200001 GITA BAGINDA 4/3 0 4
3211176811200001 EMA BAGINDA 4/3 0 4
3211172512200004 MIMIN BAGINDA 4/3 0 4
3211172312200003 FITRI BAGINDA 5/3 0 4
3211170502210001 SUSI BAGINDA 4/3 0 4
3211171402210001 SUSI BAGINDA 4/3 0 4
3211172402210003 RIA BAGINDA 4/3 0 4
3211176602210001 IPAH BAGINDA 5/3 0 4
3211175303210002 YULIATI BAGINDA 1/3 0 4
321117050421000 SANTI BAGINDA 1/3 0 4
3211176106210002 RIKA BAGINDA 3/3 0 4
3211174506210002 AI TATI BAGINDA 3/3 0 4
ENTIN BAGINDA 2/3 0 4
CAHYA BAGINDA 3/3 0 4
TITA BAGINDA 3/3 0 4
RENI BAGINDA 4/3 0 4
TOTAL 0
*) Jumlah Dosis Vaksin yang n sasaran Apakah anak sasaran Imunisasi an
pernah didapat Umur (bulan) sasaran
IPV DPT-HB-Hib OPV IPV DPT-HB-Hib imunisasi OPV IPV
Campak
1 4 57 1 0 0 0 0 0 0
1 4 56 1 0 0 0 0 0 0
1 4 54 1 0 0 0 0 0 0
1 4 54 1 0 0 0 0 0 0
1 4 53 1 0 0 0 0 0 0
1 4 52 1 0 0 0 0 0 0
1 4 51 1 0 0 0 0 0 0
1 4 48 1 0 0 0 0 0 0
1 4 48 1 0 0 0 0 0 0
1 4 47 1 0 0 0 0 0 0
1 4 47 1 0 0 0 0 0 0
1 4 46 1 0 0 0 0 0 0
1 4 46 1 0 0 0 0 0 0
1 4 44 1 0 0 0 0 0 0
1 4 44 1 0 0 0 0 0 0
1 4 44 1 0 0 0 0 0 0
1 4 44 1 0 0 0 0 0 0
1 4 43 1 0 0 0 0 0 0
1 4 40 1 0 0 0 0 0 0
1 4 39 1 0 0 0 0 0 0
1 4 39 1 0 0 0 0 0 0
1 4 35 1 0 0 0 0 0 0
1 4 35 1 0 0 0 0 0 0
1 4 34 1 0 0 0 0 0 0
1 4 34 1 0 0 0 0 0 0
1 4 31 1 0 0 0 0 0 0
1 4 30 1 0 0 0 0 0 0
1 4 30 1 0 0 0 0 0 0
1 4 27 1 0 0 0 0 0 0
1 4 26 1 0 0 0 0 0 0
1 4 24 1 0 0 0 0 0 0
1 4 24 1 0 0 0 0 0 0
1 4 23 1 0 0 0 0 0 0
1 4 20 1 0 0 0 0 0 0
1 4 20 1 0 0 0 0 0 0
1 4 19 1 0 0 0 0 0 0
1 4 20 1 0 0 0 0 0 0
1 4 18 1 0 0 0 0 0 0
1 4 18 1 0 0 0 0 0 0
1 4 18 1 0 0 0 0 0 0
1 4 17 1 0 0 0 0 0 0
1 4 17 1 0 0 0 0 0 0
1 4 16 1 0 0 0 0 0 0
1 4 14 1 0 0 0 0 0 0
1 4 14 1 0 0 0 0 0 0
1 4 11 1 0 0 0 0 0 0
1 4 10 1 0 0 0 0 0 0
1 4 10 1 0 0 0 0 0 0
1 4 9 1 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
49 0 0 0 0 0 0
dosis yang dibutuhkan Sasaran anak & CR bulan Agustus (termasuk Sweeping
melengkapi status Suntikan sasaran pada September) 2022
imunisasi
DPT-HB-Hib OPV IPV DPT-HB-Hib CR Bulan BIAN (JIKA DIIMUNISASI,
OPV ISI TANGGAL
IPV DPT-HB-Hib
Agustus (Agustus
0 0 0 0 1 1 1
0 0 0 0 1 1 1
0 0 0 0 1 1 1
0 0 0 0 1 1 1
0 0 0 0 1 1 1
0 0 0 0 1 1 1
0 0 0 0 1 1 1
0 0 0 0 1 1 1
0 0 0 0 1 1 1
0 0 0 0 1 1 1
0 0 0 0 1 1 1
0 0 0 0 1 1 1
0 0 0 0 1 1 1
0 0 0 0 1 1 1
0 0 0 0 1 1 1
0 0 0 0 1 1 1
0 0 0 0 1 1 1
0 0 0 0 1 1 1
0 0 0 0 1 1 1
0 0 0 0 1 1 1
0 0 0 0 1 1 1
0 0 0 0 1 1 1
0 0 0 0 1 1 1
0 0 0 0 1 1 1
0 0 0 0 1 1 1
0 0 0 0 1 1 1
0 0 0 0 1 1 1
0 0 0 0 1 1 1
0 0 0 0 1 1 1
0 0 0 0 1 1 1
0 0 0 0 1 1 1
0 0 0 0 1 1 1
0 0 0 0 1 1 1
0 0 0 0 1 1 1
0 0 0 0 1 1 1
0 0 0 0 1 1 1
0 0 0 0 1 1 1
0 0 0 0 1 1 1
0 0 0 0 1 1 1
0 0 0 0 1 1 1
0 0 0 0 1 1 1
0 0 0 0 1 1 1
0 0 0 0 1 1 1
0 0 0 0 1 1 1
0 0 0 0 1 1 1
0 0 0 0 1 1 1
0 0 0 0 1 1 1
0 0 0 0 1 1 1
0 0 0 0 1 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 49 49 49 0 0 0
otal Sasaran/IP Vaksin) 0 0 0 7 0 0 0
(termasuk Sweeping imunisasi Kejar pada
ember) 2022 September 2022
ASI, ISI TANGGAL
CR (JIKA DIIMUNISASI,
OPV ISI
IPV DPT-HB-Hib
0 0 0 0
0 0 0 0
Tanggal Lahir
1 NABIL ARFADHIA L 07 Oktober 2021 3211170710210003

2 CITRALOKA 12 September 2021
3 SYABQILA 20 September 2021 3211176009210002
4 MARYAM 23 Oktober 2021 3211176310210003
5 ANGGUN 28 Agustus 2021
6 KHALISA 08 November 2021
7 FAIZ KENZIE 06 Januari 2021 3211170601210001
8 M.SHEVA 14 Februari 2021 3211171402210006
9 FATHAN 05 April 2021 3211170504210001
10 M.ENJI ALFAIRUZ 25 Mei 2021 3211172505210001
11 REYHAN 12 Juni 2021 3211171206210001
12 ANDINI 28 Juni 2021 3211176806210004
13 AYUDIA 18 Januari 2021 3211175801210001
14 AZHAR 06 November 2020 3211170611200003
15 ALESHA 06 November 2020
16 SITI SOPIAH 18 Oktober 2020
17 SYAKIRA 18 Oktober 2020 3211175810200001
18 ARUMI NASHA 19 Oktober 2020 3211175910200001
19 SHANUM DIYA S 22 November 2020 3211176211200002
20 SALSABILA 28 Oktober 2020 3211176810200001
21 ADZKIYA N 07 Februari 2021 32111784702210002
22 MELODI 21 Februari 2021
23 FARADINA 06 Maret 2021 3211174603210002
24 SITI KAMILA 28 Maret 2021 3211176803210001
25 AGNI LAURA 05 April 2021 3211174504210001
26 BAGJA 07 September 2017 3211170709170001
27 AZZAM FAHREZA 21 Agustus 2017 3211172108170001
28 AGAM 12 Desember 2017 3211171212170001
29 HANIF 29 Mei 2018 3211172905180001
30 REYNAN 10 Juli 2018 3211171007180001
31 DYLAN 12 September 2018 3211171209180002
32 YOGI 21 Oktober 2018 3211172110180003
33 GUMILAR 31 Oktober 2018
34 NATHAN 07 Desember 2018 3211170712180002
35 ATHAYA 01 April 2019 3211170104190002
36 M.FADIL 14 Juni 2019 3211171406190003
37 IQBAL 19 Juli 2019 3211171907190003
38 EVAN HIDAYAT 22 Agustus 2019 3211172208190001
39 FAIZAL 12 Maret 2018 3211171203180001
40 M.ABDUL ARROIS 13 Maret 2020 3211171303200001
41 M.BAGAS ARIZKI 17 April 2020 3211171704200001
42 NAYYARA 29 September 2017 3211176808170001
43 AZQIYA 02 September 2017 3211174209170002
44 AZRINA SILMA 20 September 2017 3211176009170001
45 ANISA 11 September 2017 3211175109170002
46 PUTRI DWI SENO 26 Agustus 2018 3211176608180002
47 AISYAH 16 Januari 2018 3211175601180002
48 SIVA 21 Januari 2018 3211176001180003
49 ANINDIA 03 Mei 2018 3211174305180001
50 ARSYILA S 30 Juni 2018 3211177006180001
51 CALYA AURA M 29 Juni 2018 3211176906180001
52 DESILA HUSNA 01 Desember 2018 321117410112180004
53 ALYA 29 Desember 2018 3211176912180003
54 VERWINA TRIZANTINI 24 Februari 2019 3211176402190002
55 ARSYILA APRILIANI 30 April 2019 3211177004190001
56 SRI 22 Juli 2019
57 HANI 09 Juli 2019
58 ANNASYIA 10 Juli 2019
59 ZAARA 03 Januari 2020 3211174301200003
60 NAMZA 28 Desember 2019 3217096812190003
61 MILANDA 29 Maret 2020 3211176903200002
62 SALSA 03 Maret 2020 3211174303200004
63 APRIL 22 April 2020 3211176204200001
64 NATSYA RAHMA H 10 Maret 2021 3211175003210003
65
66
67
68
69
70
TOTAL
: BAGINDA
: TERATAI IV
mendapatkan ORI *) Jumlah Dosis Vaksin yang

Nama Orang Tua (IBU) Alamat Campak Rubela pernah didapat Umur (bulan)
sejak Januari 2022 OPV IPV DPT-HB-Hib
SUPARTI BAGINDA 2/4 (Ya =1, 0
Tidak=0) 4 1 4 10
NITA BAGINDA 3/4 0 4 1 4 11
ARNI BAGINDA 1/4 0 4 1 4 11
SARI BAGINDA 1/4 0 4 1 4 10
RIA BAGINDA 2/4 0 4 1 4 11
TANIA BAGINDA 1/4 0 4 1 4 9
YENI BAGINDA 2/4 0 4 1 4 19
NOVI BAGINDA 3/4 0 4 1 4 18
SRI BAGINDA 3/4 0 4 1 4 16
AI K BAGINDA 3/4 0 4 1 4 14
NAWANG BAGINDA 4/4 0 4 1 4 14
RINDI BAGINDA 4/4 0 4 1 4 13
ELIN BAGINDA 2/4 0 4 1 4 19
RIATI BAGINDA 2/4 0 4 1 4 21
INA BAGINDA 2/4 0 4 1 4 21
WARTINI BAGINDA 4/4 0 4 1 4 22
SUSI BAGINDA 1/4 0 4 1 4 22
SRI BAGINDA 2/4 0 4 1 4 21
LINLIN BAGINDA 4/4 0 4 1 4 21
RITA BAGINDA 1/4 0 4 1 4 18
YULIA 4/4 BAGINDA 4/4 0 4 1 4 18
FITRIA BAGINDA 3/4 0 4 1 4 17
HERNI BAGINDA 4/4 0 4 1 4 16
TITING BAGINDA 4/4 0 4 1 4 16
ROHIMAT BAGINDA 3/4 0 4 1 4 59
FITRI BAGINDA 1/4 0 4 1 4 60
RENI BAGINDA 1/4 0 4 1 4 56
RINI BAGINDA 4/4 0 4 1 4 50
IRMA BAGINDA 3/4 0 4 1 4 49
OLGA BAGINDA 3/4 0 4 1 4 47
ELIN BAGINDA 2/4 0 4 1 4 46
DEDAH BAGINDA 4/4 0 4 1 4 45
DINI BAGINDA 4/4 0 4 1 4 44
TIA BAGINDA 3/4 0 4 1 4 40
LILIS BAGINDA 3/4 0 4 1 4 38
ROSITA BAGINDA 4/4 0 4 1 4 37
WAWANG BAGINDA 1/4 0 4 0 4 36
WIWIS BAGINDA 4/4 0 4 1 4 53
YATI BAGINDA 1/4 0 4 1 4 29
CUCU BAGINDA 4/4 0 4 1 4 28
YULIA BAGINDA 3/4 0 4 1 4 58
ATIN BAGINDA 3/4 0 4 1 4 59
YANTI BAGINDA 1/4 0 4 1 4 59
NURSAADAH BAGINDA 1/4 0 4 1 4 59
IPAH BAGINDA 2/4 0 4 1 4 47
DIAH BAGINDA 2/4 0 4 1 4 55
TITING BAGINDA 3/4 0 4 1 4 55
NURYANTI BAGINDA 4/4 0 4 1 4 51
RITA BAGINDA 1/4 0 4 1 4 49
LUSI BAGINDA 1/4 0 4 1 4 49
ADE BAGINDA 2/4 0 4 1 4 43
SILVIA BAGINDA 1/4 0 4 1 4 41
METI BAGINDA 4/4 0 4 0 4 39
EMPAT BAGINDA 3/4 0 4 1 4 37
RANI BAGINDA 1/4 0 4 0 4 37
WIARTINI BAGINDA 2/4 0 4 0 4 37
TETI BAGINDA 3/4 0 4 0 4 31
NENI BAGINDA 2/4 0 4 1 4 31
MILAH BAGINDA 4/4 0 4 1 4 28
RENI BAGINDA 4/4 0 4 1 4 29
EMPAT BAGINDA 4/4 0 4 1 4 28
LILIS BAGINDA 3/4 0 4 1 4 17
1471
1471
1471
1471
1471
1471
0
TO
Campak
1 0 0 0 0 0 0 0 0 0
1 0 0 0 0 0 0 0 0 0
1 0 0 0 0 0 0 0 0 0
1 0 0 0 0 0 0 0 0 0
1 0 0 0 0 0 0 0 0 0
1 0 0 0 0 0 0 0 0 0
1 0 0 0 0 0 0 0 0 0
1 0 0 0 0 0 0 0 0 0
1 0 0 0 0 0 0 0 0 0
1 0 0 0 0 0 0 0 0 0
1 0 0 0 0 0 0 0 0 0
1 0 0 0 0 0 0 0 0 0
1 0 0 0 0 0 0 0 0 0
1 0 0 0 0 0 0 0 0 0
1 0 0 0 0 0 0 0 0 0
1 0 0 0 0 0 0 0 0 0
1 0 0 0 0 0 0 0 0 0
1 0 0 0 0 0 0 0 0 0
1 0 0 0 0 0 0 0 0 0
1 0 0 0 0 0 0 0 0 0
1 0 0 0 0 0 0 0 0 0
1 0 0 0 0 0 0 0 0 0
1 0 0 0 0 0 0 0 0 0
1 0 0 0 0 0 0 0 0 0
1 0 0 0 0 0 0 0 0 0
1 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
1 0 0 0 0 0 0 0 0 0
1 0 0 0 0 0 0 0 0 0
1 0 0 0 0 0 0 0 0 0
1 0 0 0 0 0 0 0 0 0
1 0 0 0 0 0 0 0 0 0
1 0 0 0 0 0 0 0 0 0
1 0 0 0 0 0 0 0 0 0
1 0 0 0 0 0 0 0 0 0
1 0 0 0 0 0 0 0 0 0
1 0 0 0 0 0 0 0 0 0
1 0 1 0 1 0 1 0 0 1
1 0 0 0 0 0 0 0 0 0
1 0 0 0 0 0 0 0 0 0
1 0 0 0 0 0 0 0 0 0
1 0 0 0 0 0 0 0 0 0
1 0 0 0 0 0 0 0 0 0
1 0 0 0 0 0 0 0 0 0
1 0 0 0 0 0 0 0 0 0
1 0 0 0 0 0 0 0 0 0
1 0 0 0 0 0 0 0 0 0
1 0 0 0 0 0 0 0 0 0
1 0 0 0 0 0 0 0 0 0
1 0 0 0 0 0 0 0 0 0
1 0 0 0 0 0 0 0 0 0
1 0 0 0 0 0 0 0 0 0
1 0 0 0 0 0 0 0 0 0
1 0 0 0 0 0 0 0 0 0
1 0 1 0 1 0 1 0 0 1
1 0 0 0 0 0 0 0 0 0
1 0 1 0 1 0 1 0 0 1
1 0 1 0 1 0 1 0 0 1
1 0 1 0 1 0 1 0 0 1
1 0 0 0 0 0 0 0 0 0
1 0 0 0 0 0 0 0 0 0
1 0 0 0 0 0 0 0 0 0
1 0 0 0 0 0 0 0 0 0
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
63 0 5 0 5 0 5 0 0 5
OPV ISI TANGGAL
OPV IPV ISI
Agustus (Agustus
0 1 1 1
0 1 1 1
0 1 1 1
0 1 1 1
0 1 1 1
0 1 1 1
0 1 1 1
0 1 1 1
0 1 1 1
0 1 1 1
0 1 1 1
0 1 1 1
0 1 1 1
0 1 1 1
0 1 1 1
0 1 1 1
0 1 1 1
0 1 1 1
0 1 1 1
0 1 1 1
0 1 1 1
0 1 1 1
0 1 1 1
0 1 1 1
0 1 1 1
0 1 1 1
0 0 0 0
0 1 1 1
0 1 1 1
0 1 1 1
0 1 1 1
0 1 1 1
0 1 1 1
0 1 1 1
0 1 1 1
0 1 1 1
0 1 1 1
0 1 2 1
0 1 1 1
0 1 1 1
0 1 1 1
0 1 1 1
0 1 1 1
0 1 1 1
0 1 1 1
0 1 1 1
0 1 1 1
0 1 1 1
0 1 1 1
0 1 1 1
0 1 1 1
0 1 1 1
0 1 1 1
0 1 1 1
0 1 2 1
0 1 1 1
0 1 2 1
0 1 2 1
0 1 2 1
0 1 1 1
0 1 1 1
0 1 1 1
0 1 1 1
0 1 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 63 68 63 0 0 0 0 0 0
0 8 0 0 0 0 0 0
nisasi Kejar pada
ptember 2022
DIIMUNISASI, ISI
DPT-HB-Hib
0
0
Tanggal Lahir
1 KEYRA RIZKI L 11 September 2017

2 RAYDENARA A I 09 September 2017 3211172909170002
3 ASSYFA PUTRI AURA Z 28 September 2017 3211176809170002
4 REYFAN NUGRAHA 30 Oktober 2017 3206233009170001
5 PUTRI MUSTIKA DEWI N W 29 November 2017 3211186911170003
6 BANYU SUKMA AJI 20 Desember 2017 3211172012170001
7 ARFAN KHUJAINI A 06 Desember 2017 3211170612170002
8 ZUNAIRA ANINDYA QHOLBU 13 Maret 2018 3211175303180004
9 DEVINA AUFANESSA ANHU 28 April 2018 3211176804180002
10 MOCH RAIHAN SAPUTRA 12 Maret 2018 3210071203180001
11 SITI SALMA KHODIZAH 06 April 2018 '3211174604180002
12 HANA AGNIA PUTRI 12 Agustus 2018 3211175208180002
13 RADITYA AHMAD FADILAH 07 Juni 2018 3211170706180004
14 ARSHILLA SHIZA HERDIKHAN 02 Oktober 2018 3205014210180002
15 HAIDA TARWIATUSSAADAH 27 Oktober 2018 3211176710180001
16 M FATHUR ALGHIFARI 13 Oktober 2018 3211171310180001
17 M CHANDRA SAEPULLOH 13 November 2018 3211171311180001
18 GISTA LATIF 29 November 2018 3211176911180004
19 DINAR CANTIKA NURAISHA 06 Januari 2019 3211174601190001
20 DIKA HAIDAR KHALIIL 04 Januari 2019 3211170401190002
21 M ARKAN NUGRAHA 15 Februari 2019 3211171502190003
22 M AZZAM SYAHPUTRA 15 Februari 2019 3211172402190002
23 WILDAN NUGRAHA 09 Februari 2019 3211170903190002
24 REZFAN AQUA RAMADHAN 17 Mei 2019 3211171705190001
25 JUNITA ATEA DEANDRA 11 Juni 2019 '3211175106190003
26 ALVARO 26 Juli 2019
27 NIKO CHANDRA GUMILAR 06 Agustus 2019 3211170608190002
28 ALISYA SAFHIRA OKTAVIA 19 Oktober 2019 3211175910190002
29 RAFI RADHIKA A 18 Oktober 2019
30 HALIMAH NUR SA'DIYAH 22 November 2019 3211176211190001
31 AZALEA ANINDIRA YUMNA 02 Desember 2019 3211174212190002
32 SYABILLA 26 Desember 2019
33 GIGIS SYAIRA N 24 Januari 2020 3211176401200001
34 BRICIA LAURIE E H 14 Februari 2020 3211175402200002
35 FEBRI 25 Februari 2020
36 KANZIA NAURA RANIA 14 Maret 2020 3211175403200001
37 RAYHAN KARIM A 10 Maret 2020 3211171003200002
38 DEVYA NUR AZIZAH 26 Maret 2020 3211176603200002
39 REXI JO 08 April 2020 3211170804200002
40 AISYAH SALSABILA P 19 April 2020 3211175904200000
41 M RIDWAN 20 April 2020 3211172004200002
42 SATRIA MUSTIKA K S 26 Mei 2020 3211172605200002
43 ALFARIZI NIZAM FAUZI 30 Juni 2020 3211173006200001
44 SHALIMAR NUR LAILA 18 Juli 2020 3211175807200001
45 VANYA ARUMI NASYA 26 Juli 2020 3211175207200004
46 M HAIKAL NAZRIL 09 Juli 2020 3211170907200002
47 SITI JAENAB 09 Agustus 2020
48 AQILQ ZELMIRA 18 September 2020 '3211175809200003
49 NAURA RAHMANIA KANZHA 23 Oktober 2020 '3211176310200001
50 DEDE ABDUL J A 31 Oktober 2020
51 GADIS RAFIFAH AMANDA 22 Desember 2020 3211186212200002
52 ALMIRA MUAZZARA U 02 Desember 2020 3211174212200001
53 ARI RAMADON 14 Januari 2021
54 FAIQ FAIZAL AFSHEEN 05 Februari 2021 3211170502210003
55 AMINA 08 Februari 2021 3211171802210003
56 MARSYA ELSANUM 11 Februari 2020 3211175102210003
57 AFKAR PALAH K 01 Maret 2021 3211170102210002
58 ZHAFIRA KHEISYA A 21 Maret 2021 3211176103210001
59 GHIBRAN NAUFAL AL G 27 April 2021 3211172704210002
60 FAIZAN AZRIL P 18 Mei 2021 32111718052100001
61 RAFASYA ALGHIFAR G 04 April 2021 3211170403210002
62 FATIH MALIK 22 Agustus 2021 3211172208210004
63 ALVAN ARIZKI YANUAR 11 September 2021 3211171109210001
64 M HAFIZ ARAYAN 11 Oktober 2021
65 AQLAN A U 27 Oktober 2021 3211172710210004
66 IBNU ABDUL QORY R 17 Oktober 2021 32111717102100000
67 M ARBANI R 27 Oktober 2021
68 WANDA AGNIA PUTRI 06 November 2021
69 HADI MUHAMAD IKHSAN 20 September 2019 3211172009190001
70 FEBIAN ALVARENDRA 3211172102180002
71
72
73
74
75
76
77
78
79
80
TOTAL
RAN IMUNISASI KEJAR ADALAH 12-59 BULAN
: BAGINDA
: TERATAI V

Campak
sejak
Campak
SEPTI / UTEN RT 01 /RW 05 Januari
0 4 0 4 59 1
ERNA / RAMDAN RT 04 /RW 05 0 4 0 4 59 1
TETA / ADE H RT 05 /RW 05 0 4 0 4 58 1
DEWI / YANDI RT 01 /RW 05 0 4 0 4 57 1
RITA / DIDI RT 05 /RW 05 0 4 0 4 56 1
IKA / NURHADIS RT 06 /RW 05 0 4 0 4 55 1
HASNA / OMAY RT 01 /RW 05 0 4 0 4 56 1
NURAENI / AMUNG RT 02 /RW 05 0 4 0 4 53 1
TETI R / DANI RT 02 /RW 05 0 4 0 4 51 1
ATIH S / HENDRI RT 05 /RW 05 0 4 0 4 53 1
YAYU / YOPA RT 06 /RW 05 0 4 0 4 52 1
KUSWANTI / WAHYU RT 03 /RW 05 0 4 1 4 48 1
IKA / EDI RT 03 /RW 05 0 4 1 4 50 1
RISA / HERDIANSYAH RT 01 /RW 05 0 4 1 4 46 1
ELIS / BUN BUN RT 01 /RW 05 0 4 1 4 45 1
DELIA / HENDI RT 02 /RW 05 0 4 1 4 46 1
SUSI / AGUS RT 06 /RW 05 0 4 1 4 45 1
ENUNG / ANDRI CPCR 01/01 0 4 1 4 44 1
IIN / YANYAN RT 05 /RW 05 0 4 1 4 43 1
AMIN / ADE RT 03 /RW 05 0 4 1 4 43 1
IDA / AGUNG RT 02 /RW 05 0 4 1 4 42 1
MIMIH / NANA RT 02 /RW 05 0 4 1 4 42 1
ROSITA / TETEP RT 01 /RW 05 0 4 1 4 42 1
IDAS / TATA RT 04 /RW 05 0 4 1 4 39 1
YULIA / SANSAN RT 02 /RW 05 0 4 1 4 38 1
WULAN FADIL RT 03 /RW 05 0 4 1 4 36 1
LIA / DINDIN RT 02 /RW 05 0 4 1 4 36 1
ISRI / ENDAR RT 06 /RW 05 0 4 1 4 34 1
LINA / DIDIK RT 03 /RW 05 0 4 1 4 34 1
YAYAH / ERLAN CPCR 01/01 0 4 1 4 32 1
NEVI / EDI RT 02 /RW 05 0 4 1 4 32 1
SUSI / OMA RT 06 /RW 05 0 4 1 4 31 1
PUPU / ASEP RT 03 /RW 05 0 4 1 4 30 1
PUJI / ANGGI RT 02 /RW 05 0 4 1 4 30 1
YUYUN RT 02 /RW 05 0 4 1 4 29 1
TITIN / ENTIS RT 02 /RW 05 0 4 1 4 29 1
HALIMAH / RT 02 /RW 05 0 4 1 4 29 1
NINDA / HENDI RT 02 /RW 05 0 4 1 4 28 1
INA / BEBEN RT 01 /RW 05 0 4 1 3 28 1
D MILA / SUHADA RT 01 /RW 05 0 4 1 4 28 1
SITI C / WAWAN RT 05 /RW 05 0 4 1 4 27 1
RITA / DIDI RT 05 /RW 05 0 4 1 4 26 1
LINA R / FACHRI RT 03 /RW 05 0 4 1 4 25 1
SRI M / ALI RT 01 /RW 05 0 4 1 4 25 1
LENI / CECEP RT 03 /RW 05 0 4 1 4 24 1
NURHAYATI / ALAN RT 03 /RW 05 0 4 1 4 25 1
ISTIGOSAH / ANDRI RT 05 /RW 05 0 4 1 4 24 1
SITI / TOTO RT 03 /RW 05 0 4 1 4 23 1
AAS / NANA RT 05 /RW 05 0 4 1 4 21 1
TITIN / DEZA RT 05 /RW 05 0 4 1 3 21 1
YUNISARI / SONSON RT 04 /RW 05 0 4 1 4 19 1
INTAN / DERI RT 04 /RW 05 0 4 1 4 20 1
MINTARSIH RT 03 /RW 05 0 4 1 4 19 1
ELIS / UNDANG RT 02 /RW 05 0 4 1 4 18 1
EEN / ATIP RT 04 /RW 05 0 4 1 4 18 1
NINING / WIJANA RT 02 /RW 05 0 4 1 4 30 1
YUSNETI / DADANG RT 02 /RW 05 0 4 1 4 17 1
ANISA / DANI RT 02 /RW 05 0 4 1 4 16 1
SRI / DINDIN RT 01 /RW 05 0 4 1 4 15 1
ANI / INDRA RT 02 /RW 05 0 4 1 4 15 1
YAYAH / SONI RT 03 /RW 05 0 4 1 4 16 1
DEDEH / JAJAT RT 02 /RW 05 0 4 1 4 11 1
SELA / RT 02 /RW 05 0 4 1 4 11 1
ITA RT 04 /RW 05 0 4 1 4 10 1
DINI / RT 04 /RW 05 0 4 1 4 9 1
FITRI / DEDE RT 02 /RW 05 0 4 1 4 10 1
YULIA / SANSAN RT 02 /RW 05 0 4 1 4 9 1
KUSWANTI / WAHYU RT 03 /RW 05 0 4 1 4 9 1
YUYUN / CIAWI 0 4 1 4 34 1
DINI F / INDRA M CPCR 01/01 0 4 1 4 1471 0
1471 0
1471 0
1471 0
1471 0
1471 0
1471 0
1471 0
1471 0
1471 0
1471 0
0 69
TOT
0 1 0 1 0 1 0 0 1 0
0 1 0 1 0 1 0 0 1 0
0 1 0 1 0 1 0 0 1 0
0 1 0 1 0 1 0 0 1 0
0 1 0 1 0 1 0 0 1 0
0 1 0 1 0 1 0 0 1 0
0 1 0 1 0 1 0 0 1 0
0 1 0 1 0 1 0 0 1 0
0 1 0 1 0 1 0 0 1 0
0 1 0 1 0 1 0 0 1 0
0 1 0 1 0 1 0 0 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 1 1 0 0 1 0 0 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 1 1 0 0 1 0 0 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 11 2 13 0 11 2 0 11 2
ian Dosis Sasaran
OPV ISI TANGGAL
OPV ISI
IPV DPT-HB-Hib
Agustus (Agustus
1 2 1
1 2 1
1 2 1
1 2 1
1 2 1
1 2 1
1 2 1
1 2 1
1 2 1
1 2 1
1 2 1
1 1 1
1 1 1
1 1 1
1 1 1
1 1 1
1 1 1
1 1 1
1 1 1
1 1 1
1 1 1
1 1 1
1 1 1
1 1 1
1 1 1
1 1 1
1 1 1
1 1 1
1 1 1
1 1 1
1 1 1
1 1 1
1 1 1
1 1 1
1 1 1
1 1 1
1 1 1
1 1 1
1 2 1
1 1 1
1 1 1
1 1 1
1 1 1
1 1 1
1 1 1
1 1 1
1 1 1
1 1 1
1 1 1
1 2 1
1 1 1
1 1 1
1 1 1
1 1 1
1 1 1
1 1 1
1 1 1
1 1 1
1 1 1
1 1 1
1 1 1
1 1 1
1 1 1
1 1 1
1 1 1
1 1 1
1 1 1
1 1 1
1 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
69 82 69 0 0 0 0 0 0 0
9 0 0 0 0 0 0 0
DPT-HB-Hib
Kabupaten : UMEDANG
Tanggal Lahir
1 Khansa P 10 September 2017

2 Haikal L 09 Oktober 2017
3 Adinda . M P 01 Desember 2017
4 M FAJRI L 06 Desember 2017
5 SABILA P 16 Februari 2017
6 ZIHAN P 23 Desember 2017
7 RICHELLE L 15 Januari 2018
8 FEBIAN L 21 Februari 2018
9 SITI SAADAH P 22 Juni 2018
10 ARSYA L 02 September 2018
11 AKBAR Y L 06 Oktober 2018
12 AZHAR L 15 November 2018
13 ANNISA P 21 Desember 2018
14 WIDYA P 19 Desember 2018
15 DAELAMI L 16 Maret 2019
16 RADTYA L 24 Mei 2019
17 M. FAUZAN L 29 September 2018
18 ANNISA .F P 10 Juli 2019
19 KEISHA P 10 Maret 2018
20 M. WAIS L 07 Desember 2019
21 RAI. H L 12 Desember 2019
22 ZAHIRA P 22 Januari 2020
23 M. GALIH. A. SOLEH L 23 Januari 2020
24 INTAN P 22 Maret 2020
25 NAFUZA P 26 April 2020
26 AZQIA P 14 Juli 2020
27 PASYA L 20 Agustus 2020
28 ARFAN L 16 September 2020
29 RAISYA P 07 November 2020
30 M. FAIZ L 11 Desember 2020
31 HUSEN L 03 Desember 2020
32 A. WAHID L 04 April 2021
33 SITI. KHODIJAH P 17 Juni 2021
34 REINDRA L 14 Oktober 2021
35 AISYA P 11 September 2021
36 M. FATTAN L 16 Juli 2021
37 M. ARSHAKA L 02 Juli 2021
38
39
40
41
42
43
44
45
TOTAL
AH 9-59 BULAN DAN SASARAN IMUNISASI KEJAR ADALAH 12-59 BULAN
Desa/Kelurahan : CIPANCAR
Posyandu : CITRA MELATI I

321175009170004 SANTI Cipancar 04/01 Januari
0 4 1 4
3211170910170003 DEDE Cipancar 02/01 0 4 1 4
3211174112170001 MUMUNG CIPANCAR 03/01 0 4 1 4
3211170512170002 PRAMA Cipancar 02/01 0 4 1 4
321117561217000 AI SARI CIPANCAR 01/01 0 4 1 4
3211176312170002 YENYEN Cipancar 02/01 0 4 1 4
3211175501180003 RANI Cipancar 02/01 0 4 1 4
321117210218000 DINI CIPANCAR 01/01 0 4 1 4
32111762061800012 EMA Cipancar 02/01 0 4 0 4
3211170209180002 IMAS CIPANCAR 01/01 0 4 1 4
3211170610180001 ANI CIPANCAR 01/01 0 4 1 4
3211171511180001 S. LIFIAH Cipancar 04/01 0 4 1 4
3211176112180002 SRI Cipancar 04/01 0 3 1 4
321175912180001 SRI Cipancar 04/01 0 4 1 4
321171603190001 RODIAH Cipancar 04/01 0 4 1 4
321172405190001 MIA Cipancar 02/01 0 4 0 4
WITRI CIPANCAR 03/01 0 4 1 4
3211175007190002 DIAN CIPANCAR 01/01 0 4 0 4
3216195003180003 SITI CIPANCAR 01/01 0 4 0 4
3211170712190001 INA CIPANCAR 03/01 0 4 1 4
321117211219000 HAPID Cipancar 02/01 0 4 0 4
3211176201200001 NEPI CIPANCAR 01/01 0 4 1 4
3211172301200001 AYU Cipancar 02/01 0 4 0 4
3211176203200001 MIMING Cipancar 02/01 0 4 1 4
3211172604200004 SUCI CIPANCAR 01/01 0 4 1 4
321117470720000 MIMING CIPANCAR 01/01 0 3 1 4
321117200920000 YUMI CIPANCAR 01/01 0 4 1 4
32111760920001 SUKMA Cipancar 04/01 0 4 0 4
321117471120000 S. LIFIAH Cipancar 04/01 0 4 1 4
3211171112200001 ROHIDAH CIPANCAR 01/01 0 4 1 4
3211170312200001 RINI Cipancar 02/01 0 0 0 0
3211170404210001 NINING Cipancar 04/01 0 4 1 4
3211175706210003 EMAH Cipancar 04/01 0 4 1 4
321117140210001 DEWI CIPANCAR 01/01 0 4 0 4
3211175109210004 ERLINA CIPANCAR 03/01 0 4 1 4
3211171607210001 SRI CIPANCAR 01/01 0 4 1 4
3211170207210001 DEWI CIPANCAR 03/01 0 4 1 4
TOTAL 0
Campak
58 1 0 0 0 0 0 0 0 0
57 1 0 0 0 0 0 0 0 0
56 1 0 0 0 0 0 0 0 0
55 1 0 0 0 0 0 0 0 0
65 0 0 0 0 0 0 0 0 0
55 1 0 0 0 0 0 0 0 0
54 1 0 0 0 0 0 0 0 0
53 1 0 0 0 0 0 0 0 0
49 1 0 1 0 1 0 1 0 0
47 1 0 0 0 0 0 0 0 0
45 1 0 0 0 0 0 0 0 0
44 1 0 0 0 0 0 0 0 0
43 1 1 0 0 1 1 0 0 1
43 1 0 0 0 0 0 0 0 0
40 1 0 0 0 0 0 0 0 0
38 1 0 1 0 1 0 1 0 0
46 1 0 0 0 0 0 0 0 0
36 1 0 1 0 1 0 1 0 0
52 1 0 1 0 1 0 1 0 0
31 1 0 0 0 0 0 0 0 0
31 1 0 1 0 1 0 1 0 0
30 1 0 0 0 0 0 0 0 0
30 1 0 1 0 1 0 1 0 0
28 1 0 0 0 0 0 0 0 0
27 1 0 0 0 0 0 0 0 0
24 1 1 0 0 1 1 0 0 1
23 1 0 0 0 0 0 0 0 0
22 1 0 1 0 1 0 1 0 0
20 1 0 0 0 0 0 0 0 0
19 1 0 0 0 0 0 0 0 0
19 1 1 1 1 1 4 1 4 1
15 1 0 0 0 0 0 0 0 0
13 1 0 0 0 0 0 0 0 0
9 1 0 0 0 0 0 0 0 0
10 1 0 0 0 0 0 0 0 0
12 1 0 0 0 0 0 0 0 0
13 1 0 0 0 0 0 0 0 0
1471 0 0 0 0 0 0 0 0 0
1471 0 0 0 0 0 0 0 0 0
1471 0 0 0 0 0 0 0 0 0
1471 0 0 0 0 0 0 0 0 0
1471 0 0 0 0 0 0 0 0 0
1471 0 0 0 0 0 0 0 0 0
1471 0 0 0 0 0 0 0 0 0
1471 0 0 0 0 0 0 0 0 0
36 3 8 1 10 6 8 4 3
OPV ISI TANGGAL
OPV
Agustus (Agustus
0 0 1 1 1
0 0 1 1 1
0 0 1 1 1
0 0 1 1 1
0 0 0 0 0
0 0 1 1 1
0 0 1 1 1
0 0 1 1 1
1 0 1 2 1
0 0 1 1 1
0 0 1 1 1
0 0 1 1 1
0 0 1 1 1
0 0 1 1 1
0 0 1 1 1
1 0 1 2 1
0 0 1 1 1
1 0 1 2 1
1 0 1 2 1
0 0 1 1 1
1 0 1 2 1
0 0 1 1 1
1 0 1 2 1
0 0 1 1 1
0 0 1 1 1
0 0 1 1 1
0 0 1 1 1
1 0 1 2 1
0 0 1 1 1
0 0 1 1 1
1 1 1 3 1
0 0 1 1 1
0 0 1 1 1
0 0 1 1 1
0 0 1 1 1
0 0 1 1 1
0 0 1 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
8 1 36 45 36 0 0 0 0 0
2 1 5 0 0 0 0 0
September 2022
IPV DPT-HB-Hib
0 0
0 0
SASARAN IMUNISASI TAMBAHAN CAMPAK RUBELA ADALAH 9-59 BULAN DAN SASARAN IMUNISASI KEJAR A
Tanggal Lahir
1 Adelia P 20 Juli 2017 32111706007170001

2 M Rizki. F L 17 April 2018 3211171704180002
3 Ilham Maliki L 10 Mei 2018 3211171407200001
4 Alzea N.M P 06 Juni 2018 3211174606180001
5 M Arfan W L 18 Agustus 2018 3211181808180005
6 Ichwan L 27 Agustus 2018 3213142708170001
7 M Setiawan L 28 September 2018 3211172809180002
8 Widya P.S. R P 20 Desember 2018 3211176012180001
9 Siti Kh Husna P 17 Maret 2019 3211175703190002
10 Aksara Pena S L 13 April 2019 321117304150003
11 Salsa Qaila P 11 Juni 2019 3211175106190002
12 Nadine P 07 Agustus 2019 3211174708190001
13 Gaisan Prabu R L 10 Agustus 2019 3211170908190001
14 Aisyah A P 12 Desember 2019 3211175121190002
15 Raiqa P 08 April 2020 3211174804200001
16 Khoir Hapid L 14 Juli 2020 3211171407200002
17 Almaira P 26 Agustus 2020 3211176608200002
18 Adillla P 18 September 2020 3211175809200002
19 Felisha P 19 September 2020 3211175909200001
20 Azaela P 24 Oktober 2020 3211176410200001
21 Maryam A.N P 15 Mei 2021 3211175505210003
22 Yamina A P 18 Juni 2021 "3211175805210001
23 Rania N P 28 Juni 2021 3211176806210001
24 Afida S P 05 Juli 2021
25 Bainaqi. I.F L 09 November 2021
26
27
28
29
30
31
32
33
34
35
TOTAL
: CIPANCAR
: CITRA MELATI II

Campak
sejak
Campak
Imas Cipancar 03/02 Januari
0 4 1 4 60 0
Santi Cipancar 03/02 0 4 1 4 52 1
Cicih Cipancar 01/02 0 4 1 4 51 1
Dini Cipancar 02/02 0 4 1 4 50 1
Resti Cipancar 02/02 0 4 1 4 48 1
Ira Cipancar 03/02 0 4 1 4 47 1
Aniyah Cipancar 03/02 0 4 1 4 46 1
wanti Cipancar 02/02 0 4 1 4 43 1
Aay Cipancar 02/02 0 4 1 4 41 1
Parin Cipancar 03/02 0 4 1 4 40 1
Kokom Cipancar 03/02 0 4 1 4 38 1
Ai Rose Cipancar 01/02 0 4 1 4 36 1
Ipah Cipancar 01/02 0 4 1 4 36 1
Iroh Cipancar 03/02 0 4 1 4 32 1
Irma Cipancar 0 4 1 4 28 1
Risya Cipancar 01/02 0 4 1 4 25 1
Sumirah Cipancar 03/02 0 4 1 4 23 1
Lani Cipancar 02/02 0 4 1 4 23 1
Endang Cipancar 02/02 0 4 1 4 22 1
Rinrin Cipancar 03/02 0 4 1 4 21 1
Tika Cipancar 03/02 0 4 1 4 15 1
Riana Cipancar 01/02 0 4 1 4 14 1
Ida Cipancar 01/02 0 4 1 4 13 1
Kokom Cipancar 02/02 0 4 1 4 13 1
Santi Cipancar 03/02 0 4 1 4 9 1
1471 0
1471 0
1471 0
1471 0
1471 0
1471 0
1471 0
1471 0
1471 0
1471 0
0 24
TOTAL VIAL
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
ian Dosis Sasaran
OPV ISI TANGGAL
OPV ISI
IPV DPT-HB-Hib
Agustus (Agustus
0 0 0
1 1 1
1 1 1
1 1 1
1 1 1
1 1 1
1 1 1
1 1 1
1 1 1
1 1 1
1 1 1
1 1 1
1 1 1
1 1 1
1 1 1
1 1 1
1 1 1
1 1 1
1 1 1
1 1 1
1 1 1
1 1 1
1 1 1
1 1 1
1 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
24 24 24 0 0 0 0 0 0 0
3 0 0 0 0 0 0 0
DPT-HB-Hib
Tanggal Lahir
1 ANISA REVIANI P 29 September 2017 3211176609170002

2 LATIFAH AGNIA L 05 Oktober 2017 3211174510170001
3 GIBRAN L 06 November 2017 3211170611170001
4 NIZAR. A L 03 Maret 2018 3211170303180001
5 NAILA MUFIDA P 01 Januari 2018 3211174101180001
6 FIKRI JULIAN L 30 Juli 2018 3211173007180004
7 M. AZLAN ZAIDAN L 11 Oktober 2018 3211170160003
8 SILVIA HAWA P 06 Oktober 2018 3207336709920004
9 FAREL. A L 14 Desember 2018 3211171412180002
10 SAYIDAH. W P 02 November 2018 3211174211180001
11 T. SURAYA L 14 Maret 2019 3211175403190003
12 HAYDAR L 03 Agustus 2018 3211170308190001
13 CHAYRA L 28 Oktober 2019 3211176810190001
14 M. RAYZAN P 18 Juni 2019 321117180619000
15 RAFIQ L 27 Juli 2019 3211150200719000
16 AYUMI P 14 Desember 2019 3211175412190002
17 M EZHAR ZAFRAN L 26 April 2020 3211172604200003
18 HALWA ABIBA P 26 Juni 2020 3211176606200002
19 M ZAENI D L 29 September 2020 3211172909200006
20 MUAMMAR. A L 13 Maret 2021 32111713032100001
21 VELISYA P 23 Januari 2021 3211176301210001
22 RAYYAN L 21 April 2021 3211221504210002
23
24
25
26
27
28
29
30
TOTAL
: CIPANCAR
: CITRA MELATI III

Campak
sejak
Campak
EVI CIPANCAR 03/03 Januari
0 4 1 4 58 1
EMI CIPANCAR 02/03 0 4 1 4 58 1
WILDA CIPANCAR 02/03 0 4 1 4 57 1
INDAH CIPANCAR 01/03 0 4 1 4 53 1
TITI CIPANCAR 01/03 0 4 1 4 55 1
YULI CIPANCAR 02/03 0 0 0 0 48 1
ENTIN CIPANCAR 02/03 0 4 1 4 46 1
RIMA CIPANCAR 02/03 0 4 1 4 46 1
DESI CIPANCAR 02/03 0 4 1 4 43 1
NENENG CIPANCAR 03/03 0 4 1 4 45 1
EVA CIPANCAR 02/03 0 4 1 4 40 1
ELANG CIPANCAR 01/03 0 4 0 4 48 1
NORI CIPANCAR 02/03 0 4 1 4 33 1
ADAM CIPANCAR 02/03 0 4 1 4 37 1
MEITA CIPANCAR 01/03 0 4 0 4 36 1
MILAH CIPANCAR 02/03 0 4 1 4 31 1
GINA CIPANCAR 03/03 0 4 1 4 27 1
FITRI CIPANCAR 03/03 0 4 1 4 25 1
IMAI CIPANCAR 02/03 0 4 1 4 22 1
ATIH CIPANCAR 03/03 0 4 1 4 16 1
YULI CIPANCAR 02/03 0 0 0 0 18 1
ARVAH CIPANCAR 02/03 0 4 1 4 15 1
1471 0
1471 0
1471 0
1471 0
1471 0
1471 0
1471 0
1471 0
0 22
TOTAL VIAL
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 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 1 1 4 1 4 1 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 1 0 1 0 1 0 0 1 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 1 0 1 0 1 0 0 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
1 1 1 1 4 1 4 1 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
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
2 4 2 4 8 4 8 2 4 2
ian Dosis Sasaran
OPV ISI TANGGAL
OPV ISI
IPV DPT-HB-Hib
Agustus (Agustus
1 1 1
1 1 1
1 1 1
1 1 1
1 1 1
1 3 1
1 1 1
1 1 1
1 1 1
1 1 1
1 1 1
1 2 1
1 1 1
1 1 1
1 2 1
1 1 1
1 1 1
1 1 1
1 1 1
1 1 1
1 3 1
1 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
22 28 22 0 0 0 0 0 0 0
3 0 0 0 0 0 0 0
DPT-HB-Hib
SASARAN IMUNISASI TAMBAHAN CAMPAK RUBELA ADALAH 9-59 BULAN DAN SASARAN IMUNISASI KEJAR A
Tanggal Lahir
1 SANDI AGUSTIAN L 31 Agustus 2017 3211173108170001

2 MOH. AL-FATIH P 02 Oktober 2017 3211170210170000
3 DHITA KANIA M P 06 Desember 2017 3211174612170002
4 MOH IFTAR Z L 14 Desember 2017 3211171412170004
5 MIKALIA SAKINAH. M P 03 April 2018 3211174304180000
6 FINA HASANAH P 12 April 2018 3211175204180002
7 MOH. SYAUQI. F L 22 April 2018 321112204180000
8 IZMA HUWAIDA P 08 Juli 2018 3211174807180000
9 RAIHAN TRI AGUSTINA L 17 Agustus 2018 3211171708180001
10 KANAKAN RAIBARA L 25 November 2018 32111725111800002
11 AINAYA TALITA P 23 Agustus 2019 3211176308190002
12 FAIZA IKRIMA L 06 Desember 2019 3211174612190002
13 RANGGA ARYA L 06 Januari 2020 3211170601200001
14 NAURA P 31 Januari 2020 3211177101200001
15 ALEA FARHANA M P 10 Oktober 2020 3211175010200001
16 KHAISA WAFA. A P 30 November 2020 3211177011200001
17 NUR AZIZAH P 07 Januari 2021 3211174701210002
18 LAILATUL RAMADHAN L 08 Mei 2021 3211170805210002
19 SYAKILA P 31 Juli 2021 3211177107210000
20 M. AL-AZIS L 24 September 2021 3211172409210000
21
22
23
24
25
26
27
28
29
30
TOTAL
AN DAN SASARAN IMUNISASI KEJAR ADALAH 12-59 BULAN
: CIPANCAR
: CITRA MELATI IV

Campak
sejak
Campak
WAWAT CIPANCAR 03/04 Januari
0 4 1 4 59 1
RISMA CIPANCAR 1/4 0 4 0 4 58 1
MIMIN CIPANCAR 2/4 0 4 1 4 56 1
MIMIN CIPANCAR 3/4 0 4 1 4 55 1
WIDI CIPANCAR 1/4 0 4 1 4 52 1
WAWAT CIPANCAR 3/4 0 4 1 4 51 1
RIDAA CIPANCAR 1/4 0 4 1 4 51 1
IRMA CIPANCAR 3/4 0 4 1 4 49 1
ELI CIPANCAR 1/4 0 4 1 4 47 1
TITA CIPANCAR 2/4 0 4 1 4 44 1
RATNA CIPANCAR 2/4 0 4 0 4 35 1
ISMAH CIPANCAR 3/4 0 4 0 4 32 1
EROS CIPANCAR 3/4 0 4 0 4 31 1
METI CIPANCAR 3/4 0 4 0 4 30 1
YULIA CIPANCAR 2/4 0 4 1 4 22 1
ENIATY CIPANCAR 2/4 0 4 1 4 20 1
SEPTI CIPANCAR 2/4 0 4 1 4 19 1
SANTI CIPANCAR 2/4 0 4 1 4 15 1
MILA CIPANCAR 1/5 0 4 1 4 12 1
YUYUN CIPANCAR 01/04 0 4 1 4 10 1
1471 0
1471 0
1471 0
1471 0
1471 0
1471 0
1471 0
1471 0
1471 0
1471 0
0 20
TOT
0 0 0 0 0 0 0 0 0 0
0 1 0 1 0 1 0 0 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 1 0 1 0 1 0 0 1 0
0 1 0 1 0 1 0 0 1 0
0 1 0 1 0 1 0 0 1 0
0 1 0 1 0 1 0 0 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 5 0 5 0 5 0 0 5 0
ian Dosis Sasaran
OPV ISI TANGGAL
OPV ISI
IPV DPT-HB-Hib
Agustus (Agustus
1 1 1
1 2 1
1 1 1
1 1 1
1 1 1
1 1 1
1 1 1
1 1 1
1 1 1
1 1 1
1 2 1
1 2 1
1 2 1
1 2 1
1 1 1
1 1 1
1 1 1
1 1 1
1 1 1
1 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
20 25 20 0 0 0 0 0 0 0
3 0 0 0 0 0 0 0
DPT-HB-Hib
Kabupaten : SUMEDANG
Tanggal Lahir
1 NADIFA SYAKIRA M L 14 Desember 2017

2 DIO NEYMARIO 31 Mei 2018
3 JAVIER LIU A 07 Agustus 2018
4 SANDI ANINDITO 06 September 2018
5 ESHAL ERIN 30 November 2018
6 PUTRI ANGGRAENI 06 Desember 2018
7 ALIKA NAYRA PUTRI 11 Juli 2018
8 RAISYA ARSILLA S 14 Juli 2019
9 BILAL ZAKI A 03 November 2019
10 IRNI DESTIANI 02 Desember 2019
11 AZKIA AZMI N. 15 April 2020
12 RAFKA SHAKEIL ZAIDAN 29 April 2020
13 AISYAH 05 Mei 2020
14 M. GINANJAR 25 Juli 2020
15 M.ARSYA HASANAN.S 29 Juli 2020
16 RAFANDRA HAFIZ A. 31 Juli 2020
17 KHALYA NEVA A 09 Agustus 2020
18 ALMIRA SEPTIANI 20 September 2020
19 ADZRA SYAPUTRA 23 September 2020
20 M.FAHLEVI JOVIAN A. 03 Oktober 2020
21 RESPATI 08 Oktober 2020
22 GIBRAN JAYA MALIK 25 Oktober 2020
23 ADIFA MAULIDYA K 10 November 2020
24 ALYA MAULIDA 19 November 2020
25 SADHIKA NAZRIL A. 15 Desember 2020
26 SUHAIL SYAHRUNNI 21 Desember 2020
27 M.RIFKI FADHILAH 19 Januari 2021
28 DAFFA AQMAR AZAM 23 April 2021
29 NAYRA BAETUL S. 05 Mei 2021
30 NELLYA ELMAIRA G. 04 September 2021
31 M.RIZKY MAULANA 10 September 2021
32 M.HALIF ANNABIL 09 November 2021
33
34
35
36
37
TOTAL
-59 BULAN DAN SASARAN IMUNISASI KEJAR ADALAH 12-59 BULAN
Desa/Kelurahan : CIPANCAR
Posyandu : CITRA MELATI V
Campak *) Jumlah Dosis Vaksin y

sejak OPV
3211175412170001 ACE/LENI CIPANCAR 2/5 Januari
0 4
3211173105180005 RYAN/RAHMILA CIPANCAR 2/5 0 4
3211170708180001 HENDRI/DEWI CIPANCAR 2/5 0 4
3211174609180002 SAMSUDIN/RITA CIPANCAR 2/5 0 4
3211177011180002 A JUAENI/IDA CIPANCAR 2/5 0 4
3211174612180002 OTIN/SITI CIPANCAR 2/5 0 4
3211175507180003 AGUS/ITA CIPANCAR 2/5 0 4
3211175407190000 AA DADAN/RISMA CIPANCAR 1/5 0 4
3211170311190001 SUJANA/FITRI CIPANCAR 3/5 0 3
3211174212190001 EDI/IRMA CIPANCAR 1/5 0 4
3211175504200002 AGUS/ANISA CIPANCAR 1/5 0 4
3211172904200002 SAMSUDIN/RITA CIPANCAR 1/5 0 4
3211174505200003 ILYAS/LINA CIPANCAR 1/5 0 4
3211112507200002 AYUN/KAYIMAH CIPANCAR 4/5 0 4
3211172907200002 WAHYU/MAYANG CIPANCAR 1/5 0 4
3211173107200001 ROHENDI/HOLIPAH CIPANCAR 2/5 0 4
3211174908200002 HENDRI/DESRI CIPANCAR 4/5 0 4
3211176009200002 IIM/AI ERNI CIPANCAR 3/5 0 4
3211172309200002 HERI/SUMIATI CIPANCAR 4/5 0 4
3211170310200001 DANI/NINA CIPANCAR 4/5 0 4
3211170810200001 LALAN/EKA CIPANCAR 2/5 0 4
3211172510200001 HARRY/LILIS CIPANCAR 2/5 0 4
3211175011200001 IMAN/HENI CIPANCAR 3/5 0 4
3211175911200002 UDIN/YUYUN CIPANCAR 4/5 0 4
3211171512200001 WAWAN/SITI CIPANCAR 1/6 0 4
3211172112200002 RONI/PIPIH CIPANCAR 1/5 0 4
3211171901210003 EDI/NINING CIPANCAR 4/5 0 4
3211172304210002 DANI/MELI CIPANCAR 2/5 0 4
3211174505210002 IKHSAN/TITIN CIPANCAR 4/5 0 4
3211174409210001 ASEP/AI WIWIN CIPANCAR 4/5 0 4
3211171009210001 AJI/DEDE CIPANCAR 4/5 0 4
3216210911210003 NASRUDIN/NISA CIPANCAR 1/5 0 4
TOTAL 0
IPV DPT-HB-Hib OPV IPV DPT-HB-Hib imunisasi OPV IPV
Campak
0 4 56 1 0 1 0 1 0 1
1 4 50 1 0 0 0 0 0 0
1 4 48 1 0 0 0 0 0 0
1 4 47 1 0 0 0 0 0 0
1 4 44 1 0 0 0 0 0 0
1 4 44 1 0 0 0 0 0 0
1 3 49 1 0 0 1 1 0 0
1 4 37 1 0 0 0 0 0 0
1 4 33 1 1 0 0 1 1 0
1 4 32 1 0 0 0 0 0 0
1 4 28 1 0 0 0 0 0 0
1 4 27 1 0 0 0 0 0 0
1 4 27 1 0 0 0 0 0 0
1 4 24 1 0 0 0 0 0 0
1 4 24 1 0 0 0 0 0 0
1 4 24 1 0 0 0 0 0 0
1 4 24 1 0 0 0 0 0 0
1 4 22 1 0 0 0 0 0 0
1 4 22 1 0 0 0 0 0 0
1 4 22 1 0 0 0 0 0 0
1 4 22 1 0 0 0 0 0 0
1 4 21 1 0 0 0 0 0 0
1 4 21 1 0 0 0 0 0 0
1 4 20 1 0 0 0 0 0 0
1 4 20 1 0 0 0 0 0 0
1 4 19 1 0 0 0 0 0 0
1 4 18 1 0 0 0 0 0 0
1 4 15 1 0 0 0 0 0 0
1 4 15 1 0 0 0 0 0 0
1 4 11 1 0 0 0 0 0 0
1 4 11 1 0 0 0 0 0 0
1 4 9 1 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
32 1 1 1 3 1 1
dosis yang dibutuhkan Sasaran anak & CR bulan Agustus (termasuk Sweeping
melengkapi status
imunisasi
DPT-HB-Hib OPV IPV DPT-HB-Hib CR Bulan BIAN (JIKA DIIMUNISASI,
OPV ISI TANGGAL
IPV DPT-HB-Hib
Agustus (Agustus
0 0 1 0 1 2 1
0 0 0 0 1 1 1
0 0 0 0 1 1 1
0 0 0 0 1 1 1
0 0 0 0 1 1 1
0 0 0 0 1 1 1
1 0 0 1 1 2 1
0 0 0 0 1 1 1
0 1 0 0 1 1 1
0 0 0 0 1 1 1
0 0 0 0 1 1 1
0 0 0 0 1 1 1
0 0 0 0 1 1 1
0 0 0 0 1 1 1
0 0 0 0 1 1 1
0 0 0 0 1 1 1
0 0 0 0 1 1 1
0 0 0 0 1 1 1
0 0 0 0 1 1 1
0 0 0 0 1 1 1
0 0 0 0 1 1 1
0 0 0 0 1 1 1
0 0 0 0 1 1 1
0 0 0 0 1 1 1
0 0 0 0 1 1 1
0 0 0 0 1 1 1
0 0 0 0 1 1 1
0 0 0 0 1 1 1
0 0 0 0 1 1 1
0 0 0 0 1 1 1
0 0 0 0 1 1 1
0 0 0 0 1 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
1 1 1 1 32 34 32 0 0 0
otal Sasaran/IP Vaksin) 1 1 1 4 0 0 0
(termasuk Sweeping imunisasi Kejar pada
ember) 2022 September 2022
ASI, ISI TANGGAL
CR (JIKA DIIMUNISASI,
OPV ISI
IPV DPT-HB-Hib
0 0 0 0
0 0 0 0
Tanggal Lahir
1 AHMAD TAUFIK L 24 September 2017 3211172409170001

2 PYKY L 01 Desember 2017 3211170112170004
3 AISYA NURUL Q P 17 April 2018 3211175704180001
4 DESTA ALVARO L 22 Juni 2018 32111723061800
5 ANINDITA P 17 Juli 2018 3211175807180002
6 MARZIA P 29 Juli 2018 321176907180004
7 LELI FATULJANNAH P 07 Mei 2018 3211174705190001
8 NAZIVA P 02 Juli 2019 32111766031990001
9 ALISYA MEDIANA P 11 Agustus 2019 3211175108190001
10 NADING L 14 Maret 2020 321117540320000
11 NAURA P 07 Mei 2020 3211174705200001
12 ANJAS L 15 Juni 2020 3211171506200003
13 GIANA P 14 Mei 2021 3211175405210000
14 M.RIZKI L 01 Juni 2021 3211170106210000
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
TOTAL
: CIPANCAR
: CITRA MELATI VI

Campak
sejak
Campak
IRMAN CIPANCAR 2/6 Januari
0 4 1 4 58 1
YAYA CIPANCAR 3/6 0 4 1 4 56 1
EMAN S CIPANCAR 02/06 0 4 1 4 51 1
DADAN R CIPANCAR 01/06 0 4 1 4 49 1
HERI CIPANCAR 03/06 0 4 1 4 48 1
BUDI A CIPANCAR 02/06 0 4 1 4 48 1
M. RIDWAN CIPANCAR 01/06 0 4 1 4 50 1
RUDIANSYAH CIPANCAR 03/06 0 4 0 4 37 1
YAYAT CIPANCAR 3/6 0 4 0 4 35 1
ENDAH CIPANCAR 3/6 0 4 1 4 28 1
ANDI CIPANCAR 3/6 0 4 0 4 26 1
YOYO CIPANCAR 3/6 0 4 1 4 25 1
YAYAT CIPANCAR 2/6 0 4 1 4 14 1
ISKANDAR CIPANCAR 3/6 0 4 0 4 14 1
1471 0
1471 0
1471 0
1471 0
1471 0
1471 0
1471 0
1471 0
1471 0
1471 0
1471 0
1471 0
1471 0
1471 0
1471 0
1471 0
0 14
TOTAL
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 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 0 1 0 1 0 0 1 0
0 1 0 1 0 1 0 0 1 0
0 0 0 0 0 0 0 0 0 0
0 1 0 1 0 1 0 0 1 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 1 0 1 0 1 -1 0 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 4 0 4 0 4 -1 0 4 0
ian Dosis Sasaran
OPV ISI TANGGAL
OPV ISI
IPV DPT-HB-Hib
Agustus (Agustus
1 1 1
1 1 1
1 1 1
1 1 1
1 1 1
1 1 1
1 1 1
1 2 1
1 2 1
1 1 1
1 2 1
1 1 1
1 1 1
1 2 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
14 18 14 0 0 0 0 0 0 0
2 0 0 0 0 0 0 0
DPT-HB-Hib
Tanggal Lahir
1 SRI ANJANI 15 November 2017 3211175511170007

2 REZA AHMAD J 24 Maret 2018 3205382403180001
3 ADIS RAYYAN 15 Mei 2018 3211171505180001
4 AKBAR RIZKI SAGARA 31 Juli 2018 3211173107180001
5 RIZKIA SITI R 17 Agustus 2018 321117520010002
6 AL-ZAIDAN 10 Desember 2018 3211171012180001
7 M. AZRIL 05 Januari 2019 321117050490001
8 M RIFAN 05 Mei 2019 3211170505190001
9 HAIDAR IRSYAD 20 Agustus 2019 3211172008190001
10 ANAILA SYATA N 22 Desember 2019 3211176212190001
11 M. RIZKI Z 01 Maret 2020 3211170103200004
12 M YAZID 26 Juni 2020 3211172606200002
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
32
33
34
35
36
37
38
39
40
41
42
43
44
45
46
47
48
49
50
51
52
53
54
55
56
57
58
59
60
61
62
63
64
65
66
67
68
69
70
71
72
73
74
75
76
77
78
79
80
81
82
83
84
85
86
87
88
89
90
91
92
93
94
95
96
97
98
99
100
101
102
103
104
105
106
107
108
109
110
111
112
113
114
115
116
117
118
119
120
121
122
123
124
125
126
127
128
129
130
131
132
133
134
135
136
137
138
139
140
141
142
143
144
145
146
147
148
149
150
151
152
153
154
155
156
157
158
159
160
161
162
163
164
165
166
167
168
169
170
171
172
173
174
175
176
177
178
179
180
181
182
183
184
185
186
187
188
189
190
191
192
193
194
195
196
197
198
199
200
201
202
203
204
205
206
207
208
209
210
211
212
213
214
215
216
217
218
219
220
221
222
223
224
225
226
227
228
229
230
231
232
233
234
235
236
237
238
239
240
241
242
243
244
245
246
247
248
249
250
251
252
253
254
255
256
257
258
259
260
261
262
263
264
265
266
267
268
269
270
271
272
273
274
275
276
277
278
279
280
281
282
283
284
285
286
287
288
289
290
291
292
293
294
295
296
297
298
299
300
301
302
303
304
305
306
307
308
309
310
311
312
313
314
315
316
317
318
319
320
321
322
323
324
325
326
327
328
329
330
331
332
333
334
335
336
337
338
339
340
341
342
343
344
345
346
347
348
349
350
351
352
353
354
355
356
357
358
359
360
361
362
363
364
365
366
367
368
369
370
371
372
373
374
375
376
377
378
379
380
381
382
383
384
385
386
387
388
389
390
391
392
393
394
395
396
397
398
399
400
401
402
403
404
405
406
407
408
409
410
411
412
413
414
415
416
417
418
419
420
421
422
423
424
425
426
427
428
429
430
431
432
433
434
435
436
437
438
439
440
441
442
443
444
445
446
447
448
449
450
451
452
453
454
455
456
457
458
459
460
461
462
463
464
465
466
467
468
469
470
471
472
473
474
475
476
477
478
479
480
481
482
483
484
485
486
487
488
489
490
491
492
493
494
495
496
497
498
499
500
TOTAL
: CIPANCAR
: CITRA MELATI VII

Campak
sejak
Campak
DEDEH CIPANCAR 01/07 Januari 56 1
HILDA CIPANCAR 01/07 52 1
SUGIARTI CIPANCAR 02/07 50 1
TITI CIPANCAR 03/07 48 1
AI TITI CIPANCAR 03/07 47 1
RENA CIPANCAR 02/07 43 1
WIWI CIPANCAR 03/07 42 1
CUCUN CIPANCAR 03/07 38 1
KARMINIATI CIPANCAR 02/07 35 1
MALA CIPANCAR 02/07 31 1
YANTI CIPANCAR 02/07 29 1
ATI M CIPANCAR 02/07 25 1
1471 0
1471 0
1471 0
1471 0
1471 0
1471 0
1471 0
1471 0
1471 0
1471 0
1471 0
1471 0
1471 0
1471 0
1471 0
1471 0
1471 0
1471 0
1471 0
1471 0
1471 0
1471 0
1471 0
1471 0
1471 0
1471 0
1471 0
1471 0
1471 0
1471 0
1471 0
1471 0
1471 0
1471 0
1471 0
1471 0
1471 0
1471 0
1471 0
1471 0
1471 0
1471 0
1471 0
1471 0
1471 0
1471 0
1471 0
1471 0
1471 0
1471 0
1471 0
1471 0
1471 0
1471 0
1471 0
1471 0
1471 0
1471 0
1471 0
1471 0
1471 0
1471 0
1471 0
1471 0
1471 0
1471 0
1471 0
1471 0
1471 0
1471 0
1471 0
1471 0
1471 0
1471 0
1471 0
1471 0
1471 0
1471 0
1471 0
1471 0
1471 0
1471 0
1471 0
1471 0
1471 0
1471 0
1471 0
1471 0
1471 0
1471 0
1471 0
1471 0
1471 0
1471 0
1471 0
1471 0
1471 0
1471 0
1471 0
1471 0
1471 0
1471 0
1471 0
1471 0
1471 0
1471 0
1471 0
1471 0
1471 0
1471 0
1471 0
1471 0
1471 0
1471 0
1471 0
1471 0
1471 0
1471 0
1471 0
1471 0
1471 0
1471 0
1471 0
1471 0
1471 0
1471 0
1471 0
1471 0
1471 0
1471 0
1471 0
1471 0
1471 0
1471 0
1471 0
1471 0
1471 0
1471 0
1471 0
1471 0
1471 0
1471 0
1471 0
1471 0
1471 0
1471 0
1471 0
1471 0
1471 0
1471 0
1471 0
1471 0
1471 0
1471 0
1471 0
1471 0
1471 0
1471 0
1471 0
1471 0
1471 0
1471 0
1471 0
1471 0
1471 0
1471 0
1471 0
1471 0
1471 0
1471 0
1471 0
1471 0
1471 0
1471 0
1471 0
1471 0
1471 0
1471 0
1471 0
1471 0
1471 0
1471 0
1471 0
1471 0
1471 0
1471 0
1471 0
1471 0
1471 0
1471 0
1471 0
1471 0
1471 0
1471 0
1471 0
1471 0
1471 0
1471 0
1471 0
1471 0
1471 0
1471 0
1471 0
1471 0
1471 0
1471 0
1471 0
1471 0
1471 0
1471 0
1471 0
1471 0
1471 0
1471 0
1471 0
1471 0
1471 0
1471 0
1471 0
1471 0
1471 0
1471 0
1471 0
1471 0
1471 0
1471 0
1471 0
1471 0
1471 0
1471 0
1471 0
1471 0
1471 0
1471 0
1471 0
1471 0
1471 0
1471 0
1471 0
1471 0
1471 0
1471 0
1471 0
1471 0
1471 0
1471 0
1471 0
1471 0
1471 0
1471 0
1471 0
1471 0
1471 0
1471 0
1471 0
1471 0
1471 0
1471 0
1471 0
1471 0
1471 0
1471 0
1471 0
1471 0
1471 0
1471 0
1471 0
1471 0
1471 0
1471 0
1471 0
1471 0
1471 0
1471 0
1471 0
1471 0
1471 0
1471 0
1471 0
1471 0
1471 0
1471 0
1471 0
1471 0
1471 0
1471 0
1471 0
1471 0
1471 0
1471 0
1471 0
1471 0
1471 0
1471 0
1471 0
1471 0
1471 0
1471 0
1471 0
1471 0
1471 0
1471 0
1471 0
1471 0
1471 0
1471 0
1471 0
1471 0
1471 0
1471 0
1471 0
1471 0
1471 0
1471 0
1471 0
1471 0
1471 0
1471 0
1471 0
1471 0
1471 0
1471 0
1471 0
1471 0
1471 0
1471 0
1471 0
1471 0
1471 0
1471 0
1471 0
1471 0
1471 0
1471 0
1471 0
1471 0
1471 0
1471 0
1471 0
1471 0
1471 0
1471 0
1471 0
1471 0
1471 0
1471 0
1471 0
1471 0
1471 0
1471 0
1471 0
1471 0
1471 0
1471 0
1471 0
1471 0
1471 0
1471 0
1471 0
1471 0
1471 0
1471 0
1471 0
1471 0
1471 0
1471 0
1471 0
1471 0
1471 0
1471 0
1471 0
1471 0
1471 0
1471 0
1471 0
1471 0
1471 0
1471 0
1471 0
1471 0
1471 0
1471 0
1471 0
1471 0
1471 0
1471 0
1471 0
1471 0
1471 0
1471 0
1471 0
1471 0
1471 0
1471 0
1471 0
1471 0
1471 0
1471 0
1471 0
1471 0
1471 0
1471 0
1471 0
1471 0
1471 0
1471 0
1471 0
1471 0
1471 0
1471 0
1471 0
1471 0
1471 0
1471 0
1471 0
1471 0
1471 0
1471 0
1471 0
1471 0
1471 0
1471 0
1471 0
1471 0
1471 0
1471 0
1471 0
1471 0
1471 0
1471 0
1471 0
1471 0
1471 0
1471 0
1471 0
1471 0
1471 0
1471 0
1471 0
1471 0
1471 0
1471 0
1471 0
1471 0
1471 0
1471 0
1471 0
1471 0
1471 0
1471 0
1471 0
1471 0
1471 0
1471 0
1471 0
1471 0
1471 0
1471 0
1471 0
1471 0
1471 0
1471 0
1471 0
1471 0
1471 0
1471 0
1471 0
1471 0
1471 0
1471 0
1471 0
1471 0
1471 0
1471 0
1471 0
1471 0
1471 0
1471 0
1471 0
1471 0
1471 0
1471 0
1471 0
1471 0
1471 0
1471 0
1471 0
1471 0
0 12
TOTAL VIA
1 1 1 1 4 1 4 1 1 1
1 1 1 1 4 1 4 1 1 1
1 1 1 1 4 1 4 1 1 1
1 1 1 1 4 1 4 1 1 1
1 1 1 1 4 1 4 1 1 1
1 1 1 1 4 1 4 1 1 1
1 1 1 1 4 1 4 1 1 1
1 1 1 1 4 1 4 1 1 1
1 1 1 1 4 1 4 1 1 1
1 1 1 1 4 1 4 1 1 1
1 1 1 1 4 1 4 1 1 1
1 1 1 1 4 1 4 1 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
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
12 12 12 12 48 12 48 12 12 12
ian Dosis Sasaran
OPV ISI TANGGAL
OPV ISI
IPV DPT-HB-Hib
Agustus (Agustus
1 3 1
1 3 1
1 3 1
1 3 1
1 3 1
1 3 1
1 3 1
1 3 1
1 3 1
1 3 1
1 3 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
12 36 12 0 0 0 0 0 0 0
2 0 0 0 0 0 0 0
DPT-HB-Hib
Kabupaten : SUMEDANG Posyandu
Tanggal Lahir
1 KIARA L 9/21/2021
2 AIRA 9/7/2021
3 ALMAIRA 8/14/2021
4 ARSILA 7/10/2021 3211171408990001
5 ALIFIA 3/17/2021 32111757032100000
6 AYUDIA 5/29/2021
7 RAYANIKA 2/26/2021
8 ALBIRAN 7/19/2021
9 DAVIN FAAZ 6/16/2021 321117200816621000
10 RAFKA R 6/22/2021 32111717200822600000
11 KAIRA 8/15/2020 321117550820001
12 AUNA 10/25/2020
13 ADRIAN 2/3/2021 3211175907070000
14 BURHAN 2/2/2021 3211170202210000
15 ALFARIZKI 7/6/2020 3211170607200000
16 M NIZAM 7/4/2020 321117200847201000
17 M HAIKAL 11/9/2020 3211172008111420000
18 KAINDRA 12/28/2020 321117281120002
19 ADIBA 6/7/2018 32111747068180000
20 NARA 7/18/2018 3211175807180000
21 ATAYA 9/27/2018 3211176709180000
22 ARVENIAR 10/20/2018 3211176010180000
23 ARSILA 12/23/2018 3211176312180000
24 QUESNA 3/13/2019 321117530390004
25 SITI HANUM 8/17/2019 3211175708190000
26 TANISYA 4/10/2019 32111750041900000
27 SAHLA 12/10/2019 3211172008101210000
28 GIBRAN 7/10/2017
29 GIANDRA 3/6/2018 3317100603180000
30 DONI W 3/9/2018 3211170903180000
31 M IRGI 3/10/2018 3211171003180000
32 M RAMDANI 4/3/2018 17200813718849
33 GHIPARI 9/14/2018 3211171509180000
34 ADERAL 10/12/2018 3211171210180000
35 BILAL 3/12/2019 3211171203190000
36 RAIKA 5/26/2019 3211172605190000
37 M HISYAM 2/20/2020 321117200220001
38
39
40
41
TOTAL
: CITENGAH
: MAWAR 1
mendapatkan *) Jumlah Dosis Vaksin yang

ORI Campak pernah didapat
Nama Orang Tua (IBU) Alamat Umur (bulan)
Rubela sejak OPV IPV DPT-HB-Hib
Januari 2022
SITI/MINADI CITENGAH 1/1 0 4 1 4 10
WINDI/SAHAL CITENGAH 1/1 0 4 1 4 11
AAM/ADAM CITENGAH 3/1 0 4 1 4 12
NURJANAH/RAHMAT CITENGAH 02/01 0 4 1 4 13
ENENG/AHMAD CITENGAH 1/1 0 4 1 4 17
METI/AMAN CITENGAH 1/1 0 4 1 4 14
RIZA/RENDI CITENGAH 1/1 0 4 1 4 17
LAELA/DAVA CITENGAH 1/1 0 4 1 4 12
EKA/LALAN CITENGAH 2/1 0 4 1 4 14
IRMA/ARIF CITENGAH 3/1 0 4 1 4 13
NITA/LILI CITENGAH 1/1 0 4 1 4 24
SAFITRI/ADE CITENGAH 2/1 0 4 1 4 21
SITI/JAJAT CITENGAH 2/1 0 4 1 4 18
SITI/ADITYA CITENGAH 2/1 0 4 1 4 18
HARUN/YADI CITENGAH 3/1 0 4 1 4 25
FIRDA/SOPIAN CITENGAH 2/1 0 4 1 4 25
IMAS/SUPRIATNA CITENGAH 2/1 0 4 1 4 21
MILA/BUDI CITENGAH 1/1 0 4 1 4 19
FITRIA/YANYAN CITENGAH 2/1 0 4 1 4 50
EVA/PUDIN CITENGAH 1/1 0 4 1 4 49
YANTI/SAEPUL CITENGAH 1/1 0 4 1 4 46
RANI/DADAN CITENGAH 1/1 0 4 1 4 45
NENG/AHMAD CITENGAH 1/1 0 4 1 4 43
ALIN/IWAN CITENGAH 2/1 0 4 1 4 41
SRI/NONO CITENGAH 3/1 0 4 1 4 36
FIFIT/GALUH CITENGAH 2/1 0 4 1 4 40
LENI/NAT CITENGAH 2/1 0 4 1 4 32
ERNA/KIKI CITENGAH 2/1 0 4 1 4 61
TITIN/ARBIANTO CITENGAH 3/1 0 4 1 4 53
FIRTI/KURNAEDI CITENGAH 2/1 0 4 1 4 53
MIMIN/IMAN CITENGAH 2/1 0 4 1 4 53
LENI/IAT CITENGAH 1/1 0 4 1 4 52
JUJU/KUSNADI CITENGAH 2/1 0 4 1 4 47
ROSMIATI/ENJANG CITENGAH 2/1 0 4 1 4 46
NUR/DARISMAN CITENGAH 1/1 0 4 1 4 41
RIZA/RENDI CITENGAH 1/1 0 4 1 4 38
GITA/YANTO CITENGAH 3/1 0 4 1 4 29
1471
1471
1471
1471
0
Apakah anak sasaran Imunisasi Jumlah dosis yang dibutuhkan Rencana Pemberian Dos
merupakan sasaran Kejar an untuk melengkapi status
Imunisasi Tambahan (Ya = 1, Tidak = 0) sasaran imunisasi
Campak Rubella OPV IPV DPT-HB-Hib imunisasi OPV IPV DPT-HB-Hib OPV
(Ya=1, Tidak
1 = 0) 0 0 0 0 0 0 0 0
1 0 0 0 0 0 0 0 0
1 0 0 0 0 0 0 0 0
1 0 0 0 0 0 0 0 0
1 0 0 0 0 0 0 0 0
1 0 0 0 0 0 0 0 0
1 0 0 0 0 0 0 0 0
1 0 0 0 0 0 0 0 0
1 0 0 0 0 0 0 0 0
1 0 0 0 0 0 0 0 0
1 0 0 0 0 0 0 0 0
1 0 0 0 0 0 0 0 0
1 0 0 0 0 0 0 0 0
1 0 0 0 0 0 0 0 0
1 0 0 0 0 0 0 0 0
1 0 0 0 0 0 0 0 0
1 0 0 0 0 0 0 0 0
1 0 0 0 0 0 0 0 0
1 0 0 0 0 0 0 0 0
1 0 0 0 0 0 0 0 0
1 0 0 0 0 0 0 0 0
1 0 0 0 0 0 0 0 0
1 0 0 0 0 0 0 0 0
1 0 0 0 0 0 0 0 0
1 0 0 0 0 0 0 0 0
1 0 0 0 0 0 0 0 0
1 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0
1 0 0 0 0 0 0 0 0
1 0 0 0 0 0 0 0 0
1 0 0 0 0 0 0 0 0
1 0 0 0 0 0 0 0 0
1 0 0 0 0 0 0 0 0
1 0 0 0 0 0 0 0 0
1 0 0 0 0 0 0 0 0
1 0 0 0 0 0 0 0 0
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
36 0 0 0 0 0 0 0 0
OPV ISI TANGGAL
OPV
Agustus (Agustus
0 0 1 1 1
0 0 1 1 1
0 0 1 1 1
0 0 1 1 1
0 0 1 1 1
0 0 1 1 1
0 0 1 1 1
0 0 1 1 1
0 0 1 1 1
0 0 1 1 1
0 0 1 1 1
0 0 1 1 1
0 0 1 1 1
0 0 1 1 1
0 0 1 1 1
0 0 1 1 1
0 0 1 1 1
0 0 1 1 1
0 0 1 1 1
0 0 1 1 1
0 0 1 1 1
0 0 1 1 1
0 0 1 1 1
0 0 1 1 1
0 0 1 1 1
0 0 1 1 1
0 0 1 1 1
0 0 0 0 0
0 0 1 1 1
0 0 1 1 1
0 0 1 1 1
0 0 1 1 1
0 0 1 1 1
0 0 1 1 1
0 0 1 1 1
0 0 1 1 1
0 0 1 1 1
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 36 36 36 0 0 0 0 0
0 0 5 0 0 0 0 0
September 2022
IPV DPT-HB-Hib
0 0
0 0
Tanggal Lahir
1 AFZAL ATALAH L 28 Juni 2021 18200628821930

2 AZZAHRA N P 14 Mei 2021 17200814521847
3 M. RAFARDAN A L 22 Maret 2021 172008223211144
4 M. RAFLI ADELIO L 10 April 2021 3211171412150002
5 M. BERIL L 25 April 2021 3211172504210002
6 M. SAKHA L 08 Maret 2021 1720883211117
7 HALWA N P 14 Februari 2021 17200814221147
8 FAZRIN L 19 Januari 2021 17200819121850
9 ALIYA P 15 Januari 2021 3211175501210001
10 ANINDIYA P 21 September 2020 3211176109200002
11 CAMELIA P 20 Agustus 2020 3211176008200001
12 AZZAM L 23 Juni 2022 3211172306200002
13 ALEZA F L 19 Juni 2020 3211175906200001
14 KENZI S L 03 Juni 2020 3211170306200002
15 ALIFA N P 28 Mei 2020 3211176805200001
16 MEIRA P 21 Mei 2020 3211176105200001
17 DANIS L 12 Maret 2020 3211171203200001
18 M. RIFALDI L 11 Januari 2020 3215291101200002
19 AZZALEA L 01 Januari 2020 1720081120826
20 M DERIS L 08 Desember 2019 3211170812190003
21 M. FAJAR L 24 Desember 2019 1720082412191219
22 ASYHAB D L 17 Desember 2019 3211171712190002
23 KHAIRA N P 08 November 2019 3211174811190001
24 AYRA L 01 November 2019 3211174111190002
25 M. OKTA L 22 Oktober 2019 3211172210190001
26 ASHALINA P 23 Agustus 2019 3211176708190003
27 RADITYA L 30 Juli 2019 3211173007190003
28 RIFAL L 10 Juni 2019 172008106191428
29 ARKA R L 13 Mei 2019 3211171305190001
30 M.RAFFASA L 15 April 2019 3211171504190002
31 M. HAFIZ L 31 Maret 2019 3211173103190002
32 SIFA A P 26 Januari 2019 3211176601190001
33 DENA N P 29 Desember 2018 3211172907180001
34 GILBY L 29 Juli 2018 3211172907180001
35 RAMDAN ALIF L 29 Mei 2018 3211172405180001
36 M. MAHREZ L 05 Maret 2018 3273140503180003
37 HARFY L 08 Januari 2018 3211170801180001
38 HAFIDZAH L 07 Desember 2017 3211174712170001
39 AULIA HUSNA P 23 September 2017 3211176309170001
40 SARIF FATAH P 12 Agustus 2017 3211171208170001
41 DAVIANKA P 12 Juli 2017 3211172407170002
42 ALI PURNAMA L 23 Juli 2017 3211172307170001
43
44
45
46
47
TOTAL
AN DAN SASARAN IMUNISASI KEJAR ADALAH 12-59 BULAN
: CITENGAH
: MAWAR 2
ORI Campak *) Jumlah Dosis Vaksin yang pernah didapat

Nama Orang Tua (IBU) Alamat Rubela sejak
Januari 2022 OPV IPV DPT-HB-Hib
NENDEN CITENGAH 2/2 0 4 1 4
IMAS M CITENGAH 1/2 0 4 1 4
DEVI CITENGAH 2/2 0 4 1 4
TITI CITENGAH 1/2 0 4 1 4
EKA CITENGAH 1/2 0 4 1 4
REVI CITENGAH 1/2 0 4 1 4
AMBARNIA CITENGAH 2/2 0 4 1 4
MARLINA CITENGAH 1/2 0 4 1 4
AMAH M CITENGAH 3/2 0 4 1 4
MIRNA CITENGAH 3/2 0 4 1 4
IIS R CITENGAH 4/2 0 4 1 4
DESI CITENGAH 3/2 0 4 1 4
NINING CITENGAH 3/2 0 4 1 4
EVI CITENGAH 3/2 0 4 1 4
WAHYUNI CITENGAH 1/2 0 4 1 4
MIRA CITENGAH 1/2 0 4 1 4
IDA HAYATI CITENGAH 3/2 0 4 1 4
YANTI CITENGAH 2/2 0 4 1 4
MERI CITENGAH 1/2 0 4 1 4
ATIN CITENGAH 2/2 0 4 1 4
KOYATI CITENGAH 3/2 0 4 1 4
HASANAH CITENGAH 3/2 0 4 1 4
RENI CITENGAH 1/2 0 4 1 4
SRI UTAMI CITENGAH 2/2 0 4 1 4
YULIMAR CITENGAH 2/2 0 4 1 4
ALIN CITENGAH 3/2 0 4 1 4
WINA CITENGAH 3/3 0 4 1 4
NISA CITENGAH 2/2 0 4 1 4
MELIASANTI CITENGAH 2/2 0 4 1 4
ENDAH Y CITENGAH 1/2 0 4 1 4
MIMIN CITENGAH 3/2 0 4 1 4
ANI K CITENGAH 3/2 0 4 1 4
RINA CITENGAH 1/2 0 4 1 4
SITI KOMALA CITENGAH 1/2 0 4 1 4
SITI R CITENGAH 2/2 0 4 1 4
EKA CITENGAH 1/2 0 4 1 4
NANI CITENGAH 2/2 0 4 1 4
ROHAENI CITENGAH 3/2 0 4 1 4
CUCU F CITENGAH 3/2 0 4 1 4
HASANAH CITENGAH 3/2 0 4 1 4
RATNA CITENGAH 2/2 0 4 1 4
YAYAH CITENGAH 2/2 0 4 1 4
0
n sasaran Apakah anak sasaran Imunisasi Kejar Apakah Anak Jumlah dosis yang dibutuhka
Imunisasi (Ya = 1, Tidak = 0) merupakan sasaran melengkapi status imunis
Umur (bulan)
Tambahan OPV IPV DPT-HB-Hib imunisasi KEJAR OPV
Campak (Ya = 1 , Tidak = 0)
13 1 0 0 0 0 0
15 1 0 0 0 0 0
17 1 0 0 0 0 0
16 1 0 0 0 0 0
15 1 0 0 0 0 0
17 1 0 0 0 0 0
18 1 0 0 0 0 0
19 1 0 0 0 0 0
19 1 0 0 0 0 0
23 1 0 0 0 0 0
24 1 0 0 0 0 0
1 0 0 0 0 0 0
26 1 0 0 0 0 0
26 1 0 0 0 0 0
26 1 0 0 0 0 0
27 1 0 0 0 0 0
29 1 0 0 0 0 0
31 1 0 0 0 0 0
31 1 0 0 0 0 0
32 1 0 0 0 0 0
31 1 0 0 0 0 0
32 1 0 0 0 0 0
33 1 0 0 0 0 0
33 1 0 0 0 0 0
34 1 0 0 0 0 0
35 1 0 0 0 0 0
36 1 0 0 0 0 0
38 1 0 0 0 0 0
39 1 0 0 0 0 0
40 1 0 0 0 0 0
40 1 0 0 0 0 0
42 1 0 0 0 0 0
43 1 0 0 0 0 0
48 1 0 0 0 0 0
50 1 0 0 0 0 0
53 1 0 0 0 0 0
55 1 0 0 0 0 0
56 1 0 0 0 0 0
58 1 0 0 0 0 0
60 0 0 0 0 0 0
61 0 0 0 0 0 0
60 0 0 0 0 0 0
1471 0 0 0 0 0 0
1471 0 0 0 0 0 0
1471 0 0 0 0 0 0
1471 0 0 0 0 0 0
1471 0 0 0 0 0 0
38 0 0 0 0 0
TOTAL VIAL VAKSIN (Jumlah Vial = Jumlah Total Sasaran
Sasaran anak & CR bulan Agustus (termasuk
Jumlah dosis yang dibutuhkan untuk Rencana Pemberian Dosis Sasaran
Suntikan sasaran pada September) 202
melengkapi status imunisasi Imunisasi Kejar & CR Pada Bulan Agustus
IPV DPT-HB-Hib OPV IPV DPT-HB-Hib CR Bulan BIAN OPV DIIMUNISASI, ISI TAN
(JIKA
Agustus (Agustus
0 0 0 0 0 1 1 1
0 0 0 0 0 1 1 1
0 0 0 0 0 1 1 1
0 0 0 0 0 1 1 1
0 0 0 0 0 1 1 1
0 0 0 0 0 1 1 1
0 0 0 0 0 1 1 1
0 0 0 0 0 1 1 1
0 0 0 0 0 1 1 1
0 0 0 0 0 1 1 1
0 0 0 0 0 1 1 1
0 0 0 0 0 0 0 0
0 0 0 0 0 1 1 1
0 0 0 0 0 1 1 1
0 0 0 0 0 1 1 1
0 0 0 0 0 1 1 1
0 0 0 0 0 1 1 1
0 0 0 0 0 1 1 1
0 0 0 0 0 1 1 1
0 0 0 0 0 1 1 1
0 0 0 0 0 1 1 1
0 0 0 0 0 1 1 1
0 0 0 0 0 1 1 1
0 0 0 0 0 1 1 1
0 0 0 0 0 1 1 1
0 0 0 0 0 1 1 1
0 0 0 0 0 1 1 1
0 0 0 0 0 1 1 1
0 0 0 0 0 1 1 1
0 0 0 0 0 1 1 1
0 0 0 0 0 1 1 1
0 0 0 0 0 1 1 1
0 0 0 0 0 1 1 1
0 0 0 0 0 1 1 1
0 0 0 0 0 1 1 1
0 0 0 0 0 1 1 1
0 0 0 0 0 1 1 1
0 0 0 0 0 1 1 1
0 0 0 0 0 1 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 38 38 38 0
mlah Vial = Jumlah Total Sasaran/IP Vaksin) 0 0 0 5 0
& CR bulan Agustus (termasuk Sweeping imunisasi Kejar pada
(JIKA DIIMUNISASI, ISI TANGGAL
IPV DPT-HB-Hib CR OPV DIIMUNISASI,
(JIKA ISI
IPV DPT-HB-Hib
0 0 0 0 0 0
0 0 0 0 0 0
Tanggal Lahir
1 SUGIH ABIZAR L 20 Agustus 2021 3211173008210001

2 AZAHRA R A P 02 April 2021 32111774204210001
3 ALGIFARI P 21 Maret 2021 3211176706950001
4 ARSHAKA P 07 Maret 2021 3211170703210001
5 RATIH A.J. P 10 Maret 2021 3211175003210002
6 FEBI P 17 Februari 2021
7 AISYAH M.A. P 06 Februari 2021 3211175602210003
8 AFIFA G.N. P 23 Februari 2021 3211176302210001
9 ZESIKA P 27 Januari 2021
10 RAFA A P 16 Desember 2020 3211171612200001
11 FAREL R.A P 10 November 2020 3211171011200001
12 ARYASATYA R P 15 November 2020 3211171511200001
13 WILLY A P 03 Oktober 2020
14 GAFI . F. I P 26 September 2020 32111726042040002
15 ALYA. S.P P 19 Agustus 2020 3211176008200002
16 ANINDIRA. H P 02 Agustus 2020 321117320820006
17 ASHA . G. K P 28 Mei 2020 3211176805200001
18 KAMILA P 30 Mei 2020 3211177005200004
19 NANDA. A P 10 Februari 2020 321117005003200
20 HAMNA N. R P 12 Februari 2020 32111770052022
21 JIHAN P 20 Februari 2020 3211176002200001
22 BAYU P 10 Desember 2019 321117101290008
23 M ALPIAN P 28 November 2019 321117811190007
24 PADIYA P 27 Oktober 2019 3211176012110001
25 ARASYA. N P 29 Juli 2019 3211176907190002
26 HABIL P 30 Juni 2019 3211173006190001
27 RINJANI. M P 15 Juni 2019 3211175506190001
28 AGRAF. F P 13 Desember 2018 321117312180001
29 ALAISYA . L P 08 Desember 2018 3211174812180001
30 DELISA. K.F P 01 Februari 2018 3211174102180001
31 LUVITA . N P 28 Desember 2017 3211176812170006
32 NABILA. APIATUN P 16 Desember 2017 3211175612170006
33 NURPITRI P 29 Juli 2017 3211176907170001
34 P
35 P
36 P
37 P
38 P
39 P
40 P
TOTAL
mlah Total Sasaran/IP Vaksin)
-59 BULAN DAN SASARAN IMUNISASI KEJAR ADALAH 12-59 BULAN
: CITENGAH
: MAWAR 3

Campak
sejak
Campak
HALIMAH CITENGAH 3/3 Januari
0 4 1 4 11 1
ROSITA CITENGAH 3/3 0 4 1 4 16 1
DEA CITENGAH 3/3 0 4 1 4 16 1
NINING CITENGAH 3/3 0 4 1 4 17 1
RITA CITENGAH 3/3 0 4 1 4 17 1
DEWI CITENGAH 2/3 0 4 1 4 17 1
DATI CITENGAH 2/3 0 4 1 4 18 1
RINA CITENGAH 3/3 0 4 1 4 17 1
SARI CITENGAH 1/3 0 4 1 4 18 1
NITA CITENGAH 2/3 0 4 1 4 19 1
SRI R CITENGAH 3/3 0 4 1 4 21 1
SITI M CITENGAH 2/3 0 4 1 4 20 1
TUTI CITENGAH 3/3 0 4 1 4 22 1
TATI CITENGAH 1/3 0 4 1 4 22 1
ESTI CITENGAH 1/3 0 4 1 4 23 1
AI SULASTRI CITENGAH 2/3 0 4 1 4 24 1
IMAS .S CITENGAH 3/3 0 4 1 4 26 1
NANAY CITENGAH 1/3 0 4 1 4 26 1
PRISKA CITENGAH 3/3 0 4 1 4 30 1
HERLINA CITENGAH 3/3 0 4 1 4 29 1
EKA . N CITENGAH 3/3 0 4 1 4 29 1
YANI. M CITENGAH 3/3 0 4 1 4 32 1
WIWI CITENGAH 2/3 0 4 1 4 32 1
LINA. H CITENGAH 1/3 0 4 1 4 33 1
NINNING . R CITENGAH 3/3 0 4 1 4 36 1
DEDE .S CITENGAH 2/3 0 4 1 4 37 1
IVON VONYA CITENGAH 3/3 0 4 1 4 37 1
HAYATI CITENGAH 2/3 0 4 1 4 43 1
KARMILAH CITENGAH 2/3 0 4 1 4 44 1
ROHAENI CITENGAH 3/3 0 4 1 4 54 1
DASTI CITENGAH 2/3 0 4 1 4 55 1
TUTI CITENGAH 3/3 0 4 1 4 55 1
WIWIT CITENGAH 3/3 0 4 1 4 60 0
1471 0
1471 0
1471 0
1471 0
1471 0
1471 0
1471 0
0 32
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0
ian Dosis Sasaran
OPV ISI TANGGAL
OPV ISI
IPV DPT-HB-Hib
Agustus (Agustus
1 1 1
1 1 1
1 1 1
1 1 1
1 1 1
1 1 1
1 1 1
1 1 1
1 1 1
1 1 1
1 1 1
1 1 1
1 1 1
1 1 1
1 1 1
1 1 1
1 1 1
1 1 1
1 1 1
1 1 1
1 1 1
1 1 1
1 1 1
1 1 1
1 1 1
1 1 1
1 1 1
1 1 1
1 1 1
1 1 1
1 1 1
1 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
32 32 32 0 0 0 0 0 0 0
4 0 0 0 0 0 0 0
DPT-HB-Hib
PELAKSANAAN : AGUSTUS 2022 01 Agustus 2022 (Disesuaikan dengan tgl pelaksanaan di masing-ma
Provinsi : JAWA BARAT Desa/Kelurahan :
Kabupaten : UMEDANG Posyandu :
Campak
Tanggal Lahir
No. Nama Anak
Jenis Kelamin (L/ P) NIK Nama Orang Tua (IBU)
Alamat Rubela
sejak
1 L Januari
0
2 0
3
4 1
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
32
33
34
35
36
37
38
39
40
41
42
43
44
45
46
47
48
49
50
51
52
53
54
55
56
57
58
59
60
61
62
63
64
65
66
67
68
69
70
71
72
73
74
75
76
77
78
79
80
81
82
83
84
85
86
87
88
89
90
91
92
93
94
95
96
97
98
99
100
101
102
103
104
105
106
107
108
109
110
111
112
113
114
115
116
117
118
119
120
121
122
123
124
125
126
127
128
129
130
131
132
133
134
135
136
137
138
139
140
141
142
143
144
145
146
147
148
149
150
151
152
153
154
155
156
157
158
159
160
161
162
163
164
165
166
167
168
169
170
171
172
173
174
175
176
177
178
179
180
181
182
183
184
185
186
187
188
189
190
191
192
193
194
195
196
197
198
199
200
201
202
203
204
205
206
207
208
209
210
211
212
213
214
215
216
217
218
219
220
221
222
223
224
225
226
227
228
229
230
231
232
233
234
235
236
237
238
239
240
241
242
243
244
245
246
247
248
249
250
251
252
253
254
255
256
257
258
259
260
261
262
263
264
265
266
267
268
269
270
271
272
273
274
275
276
277
278
279
280
281
282
283
284
285
286
287
288
289
290
291
292
293
294
295
296
297
298
299
300
301
302
303
304
305
306
307
308
309
310
311
312
313
314
315
316
317
318
319
320
321
322
323
324
325
326
327
328
329
330
331
332
333
334
335
336
337
338
339
340
341
342
343
344
345
346
347
348
349
350
351
352
353
354
355
356
357
358
359
360
361
362
363
364
365
366
367
368
369
370
371
372
373
374
375
376
377
378
379
380
381
382
383
384
385
386
387
388
389
390
391
392
393
394
395
396
397
398
399
400
401
402
403
404
405
406
407
408
409
410
411
412
413
414
415
416
417
418
419
420
421
422
423
424
425
426
427
428
429
430
431
432
433
434
435
436
437
438
439
440
441
442
443
444
445
446
447
448
449
450
451
452
453
454
455
456
457
458
459
460
461
462
463
464
465
466
467
468
469
470
471
472
473
474
475
476
477
478
479
480
481
482
483
484
485
486
487
488
489
490
491
492
493
494
495
496
497
498
499
500
TOTAL 1
n tgl pelaksanaan di masing-masing Posyandu)

Jumlah dosis yang dibutuhk
Tambahan (Ya = 1, Tidak = 0)
OPV IPV DPT-HB-Hib OPV IPV DPT-HB-Hib imunisasi OPV
Campak
0 0 1 1471 0 0 0 0 0 0
0 0 0 1471 0 0 0 0 0 0
1 0 3 1471 0 0 0 0 0 0
2 2 2 1471 0 0 0 0 0 0
1 3 4 1471 0 0 0 0 0 0
1 3 1 1471 0 0 0 0 0 0
1471 0 0 0 0 0 0
2 1 3 1471 0 0 0 0 0 0
1471 0 0 0 0 0 0
1471 0 0 0 0 0 0
1471 0 0 0 0 0 0
1471 0 0 0 0 0 0
1471 0 0 0 0 0 0
1471 0 0 0 0 0 0
1471 0 0 0 0 0 0
1471 0 0 0 0 0 0
1471 0 0 0 0 0 0
1471 0 0 0 0 0 0
1471 0 0 0 0 0 0
1471 0 0 0 0 0 0
1471 0 0 0 0 0 0
1471 0 0 0 0 0 0
1471 0 0 0 0 0 0
1471 0 0 0 0 0 0
1471 0 0 0 0 0 0
1471 0 0 0 0 0 0
1471 0 0 0 0 0 0
1471 0 0 0 0 0 0
1471 0 0 0 0 0 0
1471 0 0 0 0 0 0
1471 0 0 0 0 0 0
1471 0 0 0 0 0 0
1471 0 0 0 0 0 0
1471 0 0 0 0 0 0
1471 0 0 0 0 0 0
1471 0 0 0 0 0 0
1471 0 0 0 0 0 0
1471 0 0 0 0 0 0
1471 0 0 0 0 0 0
1471 0 0 0 0 0 0
1471 0 0 0 0 0 0
1471 0 0 0 0 0 0
1471 0 0 0 0 0 0
1471 0 0 0 0 0 0
1471 0 0 0 0 0 0
1471 0 0 0 0 0 0
1471 0 0 0 0 0 0
1471 0 0 0 0 0 0
1471 0 0 0 0 0 0
1471 0 0 0 0 0 0
1471 0 0 0 0 0 0
1471 0 0 0 0 0 0
1471 0 0 0 0 0 0
1471 0 0 0 0 0 0
1471 0 0 0 0 0 0
1471 0 0 0 0 0 0
1471 0 0 0 0 0 0
1471 0 0 0 0 0 0
1471 0 0 0 0 0 0
1471 0 0 0 0 0 0
1471 0 0 0 0 0 0
1471 0 0 0 0 0 0
1471 0 0 0 0 0 0
1471 0 0 0 0 0 0
1471 0 0 0 0 0 0
1471 0 0 0 0 0 0
1471 0 0 0 0 0 0
1471 0 0 0 0 0 0
1471 0 0 0 0 0 0
1471 0 0 0 0 0 0
1471 0 0 0 0 0 0
1471 0 0 0 0 0 0
1471 0 0 0 0 0 0
1471 0 0 0 0 0 0
1471 0 0 0 0 0 0
1471 0 0 0 0 0 0
1471 0 0 0 0 0 0
1471 0 0 0 0 0 0
1471 0 0 0 0 0 0
1471 0 0 0 0 0 0
1471 0 0 0 0 0 0
1471 0 0 0 0 0 0
1471 0 0 0 0 0 0
1471 0 0 0 0 0 0
1471 0 0 0 0 0 0
1471 0 0 0 0 0 0
1471 0 0 0 0 0 0
1471 0 0 0 0 0 0
1471 0 0 0 0 0 0
1471 0 0 0 0 0 0
1471 0 0 0 0 0 0
1471 0 0 0 0 0 0
1471 0 0 0 0 0 0
1471 0 0 0 0 0 0
1471 0 0 0 0 0 0
1471 0 0 0 0 0 0
1471 0 0 0 0 0 0
1471 0 0 0 0 0 0
1471 0 0 0 0 0 0
1471 0 0 0 0 0 0
1471 0 0 0 0 0 0
1471 0 0 0 0 0 0
1471 0 0 0 0 0 0
1471 0 0 0 0 0 0
1471 0 0 0 0 0 0
1471 0 0 0 0 0 0
1471 0 0 0 0 0 0
1471 0 0 0 0 0 0
1471 0 0 0 0 0 0
1471 0 0 0 0 0 0
1471 0 0 0 0 0 0
1471 0 0 0 0 0 0
1471 0 0 0 0 0 0
1471 0 0 0 0 0 0
1471 0 0 0 0 0 0
1471 0 0 0 0 0 0
1471 0 0 0 0 0 0
1471 0 0 0 0 0 0
1471 0 0 0 0 0 0
1471 0 0 0 0 0 0
1471 0 0 0 0 0 0
1471 0 0 0 0 0 0
1471 0 0 0 0 0 0
1471 0 0 0 0 0 0
1471 0 0 0 0 0 0
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1471 0 0 0 0 0 0
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1471 0 0 0 0 0 0
1471 0 0 0 0 0 0
1471 0 0 0 0 0 0
1471 0 0 0 0 0 0
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1471 0 0 0 0 0 0
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1471 0 0 0 0 0 0
1471 0 0 0 0 0 0
1471 0 0 0 0 0 0
1471 0 0 0 0 0 0
1471 0 0 0 0 0 0
1471 0 0 0 0 0 0
1471 0 0 0 0 0 0
1471 0 0 0 0 0 0
1471 0 0 0 0 0 0
1471 0 0 0 0 0 0
1471 0 0 0 0 0 0
1471 0 0 0 0 0 0
1471 0 0 0 0 0 0
1471 0 0 0 0 0 0
1471 0 0 0 0 0 0
1471 0 0 0 0 0 0
1471 0 0 0 0 0 0
1471 0 0 0 0 0 0
1471 0 0 0 0 0 0
1471 0 0 0 0 0 0
1471 0 0 0 0 0 0
1471 0 0 0 0 0 0
1471 0 0 0 0 0 0
1471 0 0 0 0 0 0
1471 0 0 0 0 0 0
1471 0 0 0 0 0 0
1471 0 0 0 0 0 0
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1471 0 0 0 0 0 0
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1471 0 0 0 0 0 0
1471 0 0 0 0 0 0
1471 0 0 0 0 0 0
1471 0 0 0 0 0 0
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1471 0 0 0 0 0 0
1471 0 0 0 0 0 0
1471 0 0 0 0 0 0
0 0 0 0 0 0
TOTAL VIAL VAKSIN (Jumlah Vial = Jumlah Total Sasaran/IP Vaks
Jumlah dosis yang dibutuhkan Sasaran anak & CR bulan Agustus (termasuk Sweepi
untuk melengkapi status
imunisasi
IPV DPT-HB-Hib OPV IPV DPT-HB-Hib CR Bulan BIAN (JIKA DIIMUNISASI,
OPV IPV ISI TANGGAL
Agustus (Agustus
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
= Jumlah Total Sasaran/IP Vaksin) 0 0 0 0 0 0
an Agustus (termasuk Sweeping imunisasi Kejar pada
DIIMUNISASI, ISI TANGGAL
DPT-HB-Hib CR (JIKA DIIMUNISASI,
OPV ISI
IPV DPT-HB-Hib
0 0 0 0 0
0 0 0 0 0

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FORMAT PENDATAAN KEBUTUHAN TENAGA DAN JADWAL PELAKSANAAN BULAN IMUNISASI ANAK NASIONAL

Provinsi : Jawa Barat Puskesmas : Sukagalih

Jumlah Sasaran Imunisasi Kejar

1 Sukagalih CIPAMEUNGPEUK ASTER 0 0 0

Ida Warlinda, S.Kep.Ners

Jumlah Sasaran Tambahan Campak Rubela Jumlah Kebutuhan Tenag

1 1 1 Ela,Aas,Gigin 18 August 2022

Sumedang, 06 Juli 2022

Nama Provinsi : Jawa Barat

ADS 0.5 ml Safety box Pen Marker

Nama Provinsi : Jawa Barat

Nama Nama Pos Jumlah Kebutuhan Vaksin (Vial) Jumlah K

ADS 5 ml ADS 0.5 ml Safety box Pen Marker

No Nama Puskesmas Nama Desa/Kelurahan

1 Sukagalih Wilker PKM Sukagalih

Kegiatan yang Akan Dilaksanakan Waktu Pelaksanaan

sosialisasi BIAN pada kader posyandu dan TP-PKK 02 Juli 2022

GOR Desa Sukagalih Kader Posyandu dan TP-PKK BOK korim

1 SALWA SALSABILA L 13 Mei 2021 3211175305210001

Campak *) Jumlah Dosis Vaksin yang

1 NIKEYSA P 07 September 2017 3211174709170002

Campak *) Jumlah Dosis Vaksin yang pernah didapat

1 ZAYNA P 14 November 2021

*) Jumlah Dosis Vaksin yang n sasaran

1 ALVAN K. A L 17 September 2021 32111709210001

Imunisa Apakah anak sasaran

1 HASAN L 03 Oktober 2017 32111703110170001

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

1 ALFAHRI. ATAARRAZKA L 22 Juni 2021

*) Jumlah Dosis Vaksin yang n sasaran

1 MUHAMMAD ZIYADATUL L 21 Oktober 2021 3211172110210002

Campak *) Jumlah Dosis Vaksin yang

1 MUTHYA TRI P 30 Desember 1899 3211174309170001

Imunisa Apakah anak sasaran

1 M. SIGIT L 01 September 2021 3211170109210002

*) Jumlah Dosis Vaksin yang n sasaran

1 SAPITA L 23 September 2017 3211172309170001

*) Jumlah Dosis Vaksin yang n sasaran

1 RAFASHA L 18 Juni 2021 3211161806210001

*) Jumlah Dosis Vaksin yang n sasaran

1 TANISHA K. L 08 November 2021

Campak *) Jumlah Dosis Vaksin yang

1 ARIF MAULANA L 18 Agustus 2017 3211171808170001 IIS

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

1 SYIRA L 31 Desember 2019 321117711219000

*) Jumlah Dosis Vaksin yang n sasaran

1 ARBANI L 15 Agustus 2017 3211171508170002

*) Jumlah Dosis Vaksin yang n sasaran Apakah anak sasaran Imun

1 MUHAMAD AZKA FADILAH 15 September 2017 32111715091700002

1 MUHAMAD ILYAS AL-FARUQ 10 November 2021 3211171011210001

mendapatkan *) Jumlah Dosis Vaksin yang n sasaran

1 REYSA SEPTIANI 18 September 2017 3211175809170001

*) Jumlah Dosis Vaksin yang n sasaran

1 M. GHAERAN A. F 31 Oktober 2021

Campak *) Jumlah Dosis Vaksin yang

1 RIHANA L 29 November 2017 3211176911170001

*) Jumlah Dosis Vaksin yang n sasaran

1 M.FAREL A.M. L 04 September 2017 3211170411170001

*) Jumlah Dosis Vaksin yang n sasaran

1 AMIRA P 26 Oktober 2017 3211176610170002

mendapatkan ORI *) Jumlah Dosis Vaksin yang pernah didapat

1 YOARA L 14 November 2017

1 NABIL ARFADHIA L 07 Oktober 2021 3211170710210003