FORMAT PENDATAAN POSYANDU SASARAN BIAN

SASARAN IMUNISASI TAMBAHAN CAMPAK RUBELA ADALAH 9-59 BULAN DAN SASARAN IMUNISASI KEJAR
PELAKSANAAN : 01 Agustus 2022
Provinsi : Jawa Barat Desa/Kelurahan
Kabupaten : Karawang Posyandu
Puskesmas : Majalaya
Isilah kolom yang berwarna PUTIH!

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

1 Atthalah Razka Ramadhan L 10 Mei 2020 3215211005200001

2 Muhammad Iqbal Al Fatih L 14 Mei 2022 3312046206910001
3 Muhamad Ghibran W. L 10 Juni 2018 3209321006150002
4 Albi Izqian Amir L 02 Desember 2017 3215210212170002
5 Brayan Lasro Siagian L 08 Januari 2021 3215210801210002
6 Asyifa Putri Fachrira P 16 November 2019 3215215611190002
7 Azkia Putri Fachrira P 10 April 2021 3215215004210001
8 Araseiy Aneska Fadhila P 06 November 2020 3304055005840006
9 Inaya Azmi Athifa P 12 Februari 2020 3215215202200001
10 Karoline Felicia Nababan P 06 Desember 2018 3215214612180001
11 Hasna Azmiyya Almahira P 10 Juli 2018 3217085007180003
12 Naura Afrahunnisa P 20 Januari 2021 3217086001210003
13 Ayumna Zhafira Valiani P 04 Juli 2018 3216194407180004
14 Steven Boy Gerrard Aritonang L 04 Oktober 2019 3215264805900007
15 Robert Imanuel Sialiagan L 06 Juni 2022 1601096102000004
16 Muhammad Akhdan Ziyad L 08 Agustus 2020 3275030808200009
17 Adevva Ghania Khaerudin P 12 November 2018 3215215211180001
18 Cahaya Salsabila P 10 Desember 2017 3329035012170001
19 Saila Annasya P 26 November 2021 3329036611210004
20 Luigi Farha Maulana L 28 September 2018 3208072809180001
21 Rachelia P 02 Juni 2020 3215154808980004
22 Alea Azra Fredeila P 09 Agustus 2021 3215214908210001
23 Elvano L 14 Januari 2021 3204336904910001
24 Safina Tunnaja P 26 Mei 2020 3275115406790006
25 Ahmad Daffa G. L 30 September 2021 3301226404940002
26 Azkia Dinda A.L. P 28 Juli 2020 3215216807200003
27 Nasya Almaira Yusuf P 27 Januari 2021 3202296701210002
28 M. Arsyad L 29 Januari 2021 3171015510960005
29 M. AAL Fatih L 26 September 2018 3215212609180001
30 Naima Hanaya Gadiza P 21 November 2021 3206166111210001
31 Khanza Safwah P 17 Juni 2020 32152070620000
32 Dara Adiba Tazkia P 04 September 2018 3215214409180005
33 Gyan Muhammad Arsavin L 09 April 2019 3519110904190002
34 Adham Ghassan A.L. L 01 April 2020 3207170104200001
35 Rahma Azkia P 31 Juli 2018 3215217107180002
36 Afizah Zahwa N. P 22 Oktober 2019 3328016210190001
37 Mahres Yanwar A. L 06 Januari 2019 3326095612830001
38 Tama L 17 Agustus 2020 3329094707870007
39 Audy Quensha Putri P 27 Februari 2018 3327086702180001
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
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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
IP Vaksin:
MR = 8
OPV = 8
IPV = 4
DPT-HB-Hib = 4
Catatan:
Anak yang sudah mendapatkan ORI Campak Rubela, tidak perlu mendapatkan imunisasi tambahan Campak Rubela s
Total kebutuhan vial yang dibutuhkan yang mengacu pada perhitungan baris total vial vaksin
Anak usia 18-24 bulan yang pada saat bersamaan mendapatkan imunisasi rutin (DPT-HB-Hib4 dan Campak rubella 2)
Kebutuhan Vaksin Khusus Campak Rubela = (Total Sasaran - Sudah Mendapatkan ORI Campak Rubela sejak Januar
SASARAN IMUNISASI BIAN:
Imunisasi Kejar : Lahir pada bulan Sept 2017 - bulan Agust 2021
Imunisasi CR : Lahir pada bulan Sept 2017 - bulan Oktober 2021

Kolom Tambahan:
*) Jumlah Dosis Vaksin yang pernah didapat
JENIS KELAMIN
L
P
RAN IMUNISASI KEJAR ADALAH 12-59 BULAN
(Disesuaikan dengan tgl pelaksanaan di masing-masing Posyandu)
:

Apakah anak *) Jumlah Dosis Vaksin yang

mendapatkan ORI pernah didapat
Nama Orang Tua (IBU) Alamat Campak Rubela sejak
Januari 2022
(Ya =1, Tidak=0)
OPV IPV DPT-HB-Hib

Oka Sugianti CKM Blok X15/01 1 4 1 4

Eva Rusdiana CKM Blok X15/02 1 1
Winda Astuti CKM Blok X15/03 1 4 1 4
Ika Rusahada CKM Blok X15/04 1 4 1 4
Evi Fransiska Simangunsong CKM Blok X15/05 1 4 1 4
Ira Bariroh CKM Blok X6/15 1 4 1 4
Ira Bariroh CKM Blok X16/15 1 4 1 4
Sunarti CKM Blok X16/16 1 4 1 4
Mega Mustika CKM Blok X16/19 4 1 4
Chriestien Rodesima CKM Blok X16/23 4 1 4
Eka Jayanti Winarto CKM Blok X14/16B 4 1 4
Eka Jayanti Winarto CKM Blok X14/16B 4 1 4
Ike Mardianah CKM Blok X14/16C 4 1 4
Dina Tiur Maulipakpahan CKM Blok X14/16E 4 1 4
Rohatna CKM Blok X15/9 4 1 4
Nurhasanah Syifa CKM Blok X15/11 4 1 4
Mulyanti CKM Blok X15/12 4 1 4
Anita Amalia CKM Blok X15/12A 4 1 4
Anita Amalia CKM Blok X15/12A 4 1 4
Suprianah CKM Blok X15/14 4 1 4
Lely Indah D. CKM Blok X12/6 4 1 4
Anah Rostian CKM Blok X12/7 4 1 4
Defi Apriyanti CKM Blok X12/10 4 1 4
Sri Rahayu CKM Blok X12/12 4 1 4
Maryunah CKM Blok X12/14 4 1 4
Hartini CKM Blok X12/15 4 1 4
Shella CKM Blok X12/16 4 1 4
Tika CKM Blok X12/17 4 1 4
Ernawati CKM Blok X13/18
Elin Siti Marwiah CKM Blok X12/9 4 1 4
Tati Sugyarti CKM Blok X13/19 4 1 4
Lani Handyani CKM Blok X13/20 4 1 4
Reri Mujiawati CKM Blok X13/23 4 1 4
Nining Ledya CKM Blok X13/24 4 1 4
Ayu Rahayu CKM Blok X13/28 4 1 4
Triska Sari CKM Blok X13/29 4 1 4
Almatul Karimah CKM Blok X13/30 4 1 4
Nurul Nasiroton CKM Blok X13/27 4 1 4
Mayang CKM Blok X13/33 4 1 4
8
bahan Campak Rubela sejak Januari 2022

4 dan Campak rubella 2) maka tetap masuk dalam Sasaran Imunisasi Kejar
pak Rubela sejak Januari 2022)/IP vaksin

an Agust 2021
an Oktober 2021
 Apakah anak merupakan Apakah anak sasaran Imunisasi Kejar Apakah Anak
sasaran Imunisasi (Ya = 1, Tidak = 0) merupakan sasaran
Umur (bulan) Tambahan
Campak Rubella (Ya=1,
imunisasi KEJAR
Tidak = 0) (Ya = 1 , Tidak = 0)
OPV IPV DPT-HB-Hib

26 0 0 0 0 0
2 0 0 0 0 0
49 0 0 0 0 0
55 0 0 0 0 0
18 0 0 0 0 0
32 0 0 0 0 0
15 0 0 0 0 0
20 0 0 0 0 0
29 1 0 0 0 0
43 1 0 0 0 0
48 1 0 0 0 0
18 1 0 0 0 0
48 1 0 0 0 0
33 1 0 0 0 0
1 0 0 0 0 0
23 1 0 0 0 0
44 1 0 0 0 0
55 1 0 0 0 0
8 0 0 0 0 0
46 1 0 0 0 0
25 1 0 0 0 0
11 1 0 0 0 0
18 1 0 0 0 0
26 1 0 0 0 0
10 1 0 0 0 0
24 1 0 0 0 0
18 1 0 0 0 0
18 1 0 0 0 0
46 1 1 1 1 1
8 0 0 0 0 0
 25 1 0 0 0 0
46 1 0 0 0 0
39 1 0 0 0 0
28 1 0 0 0 0
48 1 0 0 0 0
33 1 0 0 0 0
42 1 0 0 0 0
23 1 0 0 0 0
53 1 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0
1471 0 0 0 0 0

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

28 1 1 1 1

TOTAL VIAL VAKSIN (Jumlah Vial = Jum

Jumlah dosis yang dibutuhkan untuk Rencana Pemberian Dosis Sasaran
melengkapi status imunisasi Imunisasi Kejar & CR Pada Bulan Agustus

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

0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 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 0 0 0 0 0 1
0 0 0 0 0 0 1
0 0 0 0 0 0 1
0 0 0 0 0 0 1
0 0 0 0 0 0 1
0 0 0 0 0 0 0
0 0 0 0 0 0 1
0 0 0 0 0 0 1
0 0 0 0 0 0 1
0 0 0 0 0 0 0
0 0 0 0 0 0 1
0 0 0 0 0 0 1
0 0 0 0 0 0 1
0 0 0 0 0 0 1
0 0 0 0 0 0 1
0 0 0 0 0 0 1
0 0 0 0 0 0 1
0 0 0 0 0 0 1
0 0 0 0 0 0 1
4 1 4 1 1 1 1
0 0 0 0 0 0 0
0 0 0 0 0 0 1
0 0 0 0 0 0 1
0 0 0 0 0 0 1
0 0 0 0 0 0 1
0 0 0 0 0 0 1
0 0 0 0 0 0 1
0 0 0 0 0 0 1
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4 1 4 1 1 1 28

AL VAKSIN (Jumlah Vial = Jumlah Total Sasaran/IP Vaksin) 1 1 1 4

 Diisi pada saat pelayanan imunisasi Kejar & CR bulan Agustus (termasuk Sweeping pada
Sasaran Apakah anak September) 2022
Suntikan sasaran BIAN (JIKA DIIMUNISASI, ISI TANGGAL PELAYANAN)
Bulan Agustus (Agustus)
OPV IPV DPT-HB-Hib

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30 28 0 0 0
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gustus (termasuk Sweeping pada Diisi pada saat pelayanan imunisasi Kejar pada
September 2022
ELAYANAN) (JIKA DIIMUNISASI, ISI TANGGAL PELAYANAN)

CR OPV IPV DPT-HB-Hib

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