LAPORAN HASIL PEMERIKSAAN RAPID TES ANTIGEN

PUSKESMAS SIDOTOPO WETAN

TANGGAL RAPID TES 19 SEPTEMBER 2022
PJ DATA : SUTIK ANDRIYANI NO TLP 088216998077

NO NAMA UMUR STATUS NIK JENIS KELAMIN ALAMAT KTP ALAMAT DOMISILI KOTA NO. TELP RS/PUSKESMAS JENIS SAMPEL SAMPEL KE- TANGGAL SWAB TANGGAL KIRIM HASIL
TGL LAHIR

1 ERNI 27 Skrining 357814703950002 7/3/1995 P BULAK BANTENG KIDUL 4/10 BULAK BANTENG KIDUL 4/10 SURABAYA 083854444958 Puskesmas Sidotopo Wetan NS 1 19/9/2022 19/9/2022 negatif

2 NAURA NADIFAH 4 Skrining 3578176301950003 25/9/2018 P KEDUNG MANGU SELATAN 3/25 KEDUNG MANGU SELATAN 3/25 SURABAYA 085604037174 Puskesmas Sidotopo Wetan NS 1 19/9/2022 19/9/2022 negatif

3 NOR HALIMAH 31 Skrining 3527126502930006 2/6/1990 P BULAK BANTENG BARU ANGGREK 1/8 BULAK BANTENG BARU ANGGREK 1/8 SURABAYA 0858562777732 Puskesmas Sidotopo Wetan NS 1 19/9/2022 19/9/2022 negatif

4 CAHAYA AYU 8 Skrining 3578175207140004 12/7/2014 P SIDOTOPO WETAN 2/70 SIDOTOPO WETAN 2/70 SURABAYA 08955700513838 Puskesmas Sidotopo Wetan NS 1 19/9/2022 19/9/2022 negatif

5 FAIZA ALYA NADHIFAH 7 Skrining 3578285705150001 17/5/2015 P BULAK BANTENG BARU TERATAI 3A BULAK BANTENG BARU TERATAI 3A SURABAYA 081937073040 Puskesmas Sidotopo Wetan NS 1 19/9/2022 19/9/2022 negatif

6 TITIK INDALIYAH 55 Skrining 3578170607660003 26/7/1966 P PLATUK DONOMULYO 13/14 PLATUK DONOMULYO 13/14 SURABAYA 081280184442 Puskesmas Sidotopo Wetan NS 1 19/9/2022 19/9/2022 negatif

7 ERNAWATI 64 Skrining 3578175201580001 12/1/1958 P BULAK BANTENG MADYA 1/10 BULAK BANTENG MADYA 1/10 SURABAYA 081249788766 Puskesmas Sidotopo Wetan NS 1 19/9/2022 19/9/2022 negatif

8 ALDI IRWANSYAH 10 Skrining 3578170210140002 2/10/2011 L KEDUNG MANGU 7/5 KEDUNG MANGU 7/5 SURABAYA 087885044687 Puskesmas Sidotopo Wetan NS 1 19/9/2022 19/9/2022 negatif

9 DIAH FITRI ASRI 19 Skrining 3578164312020002 3/12/2002 P TENGGUMUNG WETAN MANGGIS TENGGUMUNG WETAN MANGGIS SURABAYA Puskesmas Sidotopo Wetan NS 1 19/9/2022 19/9/2022 negatif

RIANA 47 Skrining 3578176810740004 28/10/1974 P RANDU AGUNG 1/5 RANDU AGUNG 1/5 SURABAYA 083849118345 Puskesmas Sidotopo Wetan NS 1 19/9/2022 19/9/2022 negatif
10

HAMIMAH 3578174305780005 3/5/1978 P SURABAYA Puskesmas Sidotopo Wetan NS 1 19/9/2022 19/9/2022 negatif
11 39 Skrining 083141746484
BULAK BANTENG BARU GG ANGGREK NO MI MAHIR AR RIYADL PUSKESMAS
SRI WIDYAWATI 45 3578175009770005 P BULAK BANTENG BARU GG ANGGREK NO 110 110 SURABAYA 083119023249 SIDOTOPO WETAN NS 1 19/9/2022 19/9/2022 negatif
12 Skrining 10-09-1977
MI MAHIR AR RIYADL PUSKESMAS
NISMA RODIYAH 32 3578175603900002 P BULAK BANTENG TENGAH 1 NO 17 BULAK BANTENG TENGAH 1 NO 17 SURABAYA 085648118130 NS 1 19/9/2022 19/9/2022 negatif
13 Skrining 16-03-1990 SIDOTOPO WETAN

MI MAHIR AR RIYADL PUSKESMAS

RINA FITRIA 25 3578104902970002 P DUKUH SETRO 7 NO 4 DUKUH SETRO 7 NO 4 SURABAYA 083853079664 NS 1 19/9/2022 19/9/2022 negatif
14 Skrining 09-02-1997 SIDOTOPO WETAN

MI MAHIR AR RIYADL PUSKESMAS

NURUL HUSNAH 37 3525125902850001 P BULAK BANTENG WETAN GG 10 NO 2 BULAK BANTENG WETAN GG 10 NO 2 SURABAYA 08990212227 SIDOTOPO WETAN NS 1 19/9/2022 19/9/2022 negatif
15 Skrining 19-02-1985
MI MAHIR AR RIYADL PUSKESMAS
LAHMIRZA NUR SAFIRA 24 3578174811980001 P DK BULAK BANTENG PATRIOT 8 /4A DK BULAK BANTENG PATRIOT 8 /4A SURABAYA 081332670413 SIDOTOPO WETAN NS 1 19/9/2022 19/9/2022 negatif
16 Skrining 08-11-1998
MI MAHIR AR RIYADL PUSKESMAS
AIDA SUSILOWATI 45 3578164810770002 P KUNTI 69 KUNTI 69 SURABAYA 081259965788 NS 1 19/9/2022 19/9/2022 negatif
17 Skrining 08-10-1977 SIDOTOPO WETAN

MI MAHIR AR RIYADL PUSKESMAS

FARADILLA NUR AZIZA 24 3578175006980001 P BULAK BANTENG WETAN GG 8 NO 46-A BULAK BANTENG WETAN GG 8 NO 46-A SURABAYA 082132654336 NS 1 19/9/2022 19/9/2022 negatif
18 Skrining 10-06-1998 SIDOTOPO WETAN

MI MAHIR AR RIYADL PUSKESMAS

NURUL LATIFA MAULIDYA 19 3603184205030001 P BULAK BANTENG WETAN 11/17 BULAK BANTENG WETAN 11/17 SURABAYA 081585689800 NS 1 19/9/2022 19/9/2022 negatif
19 Skrining 02-05-2003 SIDOTOPO WETAN

BULAK BANTENG BARU GG GADING MI MAHIR AR RIYADL PUSKESMAS

ANDIRA DEVANI 11 3578174501110005 P SURABAYA +6288803099383 SIDOTOPO WETAN NS 1 19/9/2022 19/9/2022 negatif
20 Skrining 05-01-2011 BULAK BANTENG BARU GG GADING NO.54A NO.54A

3578172106170004 P SURABAYA MI MAHIR AR RIYADL PUSKESMAS NS 1 19/9/2022 19/9/2022 negatif

21 APRILIA KAYSA PUTRI ZAKIYA 12 Skrining 09-04-2010 BULAK BANTENG BARU GG MELATI NO 25 BULAK BANTENG BARU GG MELATI NO 25 SIDOTOPO WETAN

MI MAHIR AR RIYADL PUSKESMAS

HILYATU DIYANATI TOYYIBAH 12 3678166510100003 P SURABAYA +6281232019782 NS 1 19/9/2022 19/9/2022 negatif
22 Skrining 25-10-2010 BULAK BANTENG BARU GG GADING NO.36 BULAK BANTENG BARU GG GADING NO.36 SIDOTOPO WETAN

BULAK BANTENG BARU GG GADING MI MAHIR AR RIYADL PUSKESMAS

MOCH. AMIN 11 3578161901110005 L SURABAYA +6281331476383 NS 1 19/9/2022 19/9/2022 negatif
23 Skrining 19-01-2011 BULAK BANTENG BARU GG GADING NO.100 NO.100 SIDOTOPO WETAN

MI MAHIR AR RIYADL PUSKESMAS

RAFELINO PRATAMA 12 3678172309100002 L SURABAYA +6285708591057 SIDOTOPO WETAN NS 1 19/9/2022 19/9/2022 negatif
24 Skrining 23-09-2010 BULAK BANTENG BARU GG GADING NO.57 BULAK BANTENG BARU GG GADING NO.57

MI MAHIR AR RIYADL PUSKESMAS

RIFNU SEPTIAMSYAH 12 3578171309100003 L BULAK BANTENG BARU GG KENANGA SURABAYA +6281333076730 NS 1 19/9/2022 19/9/2022 negatif
SIDOTOPO WETAN
25 Skrining 13-09-2010 BULAK BANTENG BARU GG KENANGA 3/88 3/88

MI MAHIR AR RIYADL PUSKESMAS

WAHYU KURNIAWAN 12 3528121405100001 L SURABAYA +6287703336790 NS 1 19/9/2022 19/9/2022 negatif
SIDOTOPO WETAN
26 Skrining 14-05-2010 BULAK BANTENG MADYA GG 15 NO.1 BULAK BANTENG MADYA GG 15 NO.1

MI MAHIR AR RIYADL PUSKESMAS

Achmad Yazid Alfarisy 11 L SURABAYA +62 838-4934-2157 NS 1 19/9/2022 19/9/2022 negatif
SIDOTOPO WETAN
27 Skrining 3578172304110003 23-04-2011 Bulak Banteng Baru Gg Melati No. 19 Bulak Banteng Baru Gg Melati No. 19
 MI MAHIR AR RIYADL PUSKESMAS
11 L SURABAYA +62 895-4295-00406 NS 1 19/9/2022 19/9/2022 negatif
SIDOTOPO WETAN
28 Achmad Zulfikar Skrining 3578172506110001 25-06-2011 Bulak Banteng Baru Gg Dahlia No. 50-A Bulak Banteng Baru Gg Dahlia No. 50-A

MI MAHIR AR RIYADL PUSKESMAS

11 L SURABAYA +62 838-5767-4176 NS 1 19/9/2022 19/9/2022 negatif
SIDOTOPO WETAN
29 Alfin Nandito Skrining 3578172503110003 25-03-2011 BL. Banteng Baru Gg Kenanga 3/68 BL. Banteng Baru Gg Kenanga 3/68

MI MAHIR AR RIYADL PUSKESMAS

11 P SURABAYA +62 831-9286-2648 NS 1 19/9/2022 19/9/2022 negatif
SIDOTOPO WETAN
30 Aprilia Nur Aini Skrining 3578164504110002 05-04-2011 Bulak Banteng Baru Gading No. 31-B Bulak Banteng Baru Gading No. 31-B

MI MAHIR AR RIYADL PUSKESMAS

10 P SURABAYA +62 831-3972-7528 NS 1 19/9/2022 19/9/2022 negatif
SIDOTOPO WETAN
31 Areta Malfaliya Putri Skrining 3578174211110003 02-11-2011 DK. Bulak Banteng Suropati 3/95 DK. Bulak Banteng Suropati 3/95

MI MAHIR AR RIYADL PUSKESMAS

10 L SURABAYA +62 838-5498-0195 SIDOTOPO WETAN NS 1 19/9/2022 19/9/2022 negatif
32 Muhammad Al Farisyi Skrining 3578172911110002 29-11-2011 Bulak Banteng Baru Dahlia 50 Bulak Banteng Baru Dahlia 50

MI MAHIR AR RIYADL PUSKESMAS

11 L SURABAYA +62 877-0476-4530 NS 1 19/9/2022 19/9/2022 negatif
SIDOTOPO WETAN
33 Rahul Amin Skrining 3578111011100003 10-11-2010 Seng 58 Bulak Banteng Baru Gg Aggrek

MI MAHIR AR RIYADL PUSKESMAS

10 P SURABAYA +62 812-3400-7038 SIDOTOPO WETAN NS 1 19/9/2022 19/9/2022 negatif
34 Farisca Putri Anggara Skrining 3578296912110001 29-12-2011 Bulak Banteng Baru Gg Mawar 34-A Bulak Banteng Baru Gg Mawar 34-A

MI MAHIR AR RIYADL PUSKESMAS

10 P SURABAYA +62 878-5558-6803 NS 1 19/9/2022 19/9/2022 negatif
SIDOTOPO WETAN
35 Halwa Safira Skrining 3578174201120001 02-01-2012 Bulak Banteng Baru Tanjung 1/43 Bulak Banteng Baru Tanjung 2/80

MI MAHIR AR RIYADL PUSKESMAS

11 L SURABAYA +62 812-3246-1335 SIDOTOPO WETAN NS 1 19/9/2022 19/9/2022 negatif
36 Rahmad Hidayatullah Skrining 3528052611100002 26-11-2010 DSN Timur Bulak Banteng Madya I/ 21-A

MI MAHIR AR RIYADL PUSKESMAS

11 L SURABAYA +62 878-5388-5249 NS 1 19/9/2022 19/9/2022 negatif
SIDOTOPO WETAN
37 Maulana Ishak Skrining 3578161701110002 17-01-2011 Bulak Banteng Baru Gg Anggrek 2/29-A Bulak Banteng Baru Gg Anggrek 2/29-A

MI MAHIR AR RIYADL PUSKESMAS

12 P SURABAYA +62 812-3028-7235 SIDOTOPO WETAN NS 1 19/9/2022 19/9/2022 negatif
38 Raissa Kamalia Skrining 3578166006100001 20-06-2010 DK. Bulak Banteng Suropati 3/95 DK. Bulak Banteng Suropati 3/95

MI MAHIR AR RIYADL PUSKESMAS

11 P SURABAYA +62 877-8206-1617 SIDOTOPO WETAN NS 1 19/9/2022 19/9/2022 negatif
39 Siti Aisyah Skrining 3578166306110004 23-06-2011 Bulak Banteng Baru Gg Gading No.70 Bulak Banteng Baru Gg Gading No.70

MI MAHIR AR RIYADL PUSKESMAS

P SURABAYA +62 882-2718-4759 NS 1 19/9/2022 19/9/2022 negatif
SIDOTOPO WETAN
40 Aurel Jezika 11 Skrining 3578174708110004 07-08-2011 DK. Bulak Banteng II Suropati 2/109 DK. Bulak Banteng II Suropati 2/109

MI MAHIR AR RIYADL PUSKESMAS

Abdurrahman Navis 11 SURABAYA +62 831-1453-6660 SIDOTOPO WETAN NS 1 19/9/2022 19/9/2022 negatif
41 Skrining 3578162206110005 22-06-2011 L Bulak Banteng Gg Bhinneka 5 No. 15 Bulak Banteng Gg Bhinneka 5 No. 16

MI MAHIR AR RIYADL PUSKESMAS

10 SURABAYA +62 895-3647-04913 NS 1 19/9/2022 19/9/2022 negatif
SIDOTOPO WETAN
42 Muhammad Amsyar Dzakka Putra Skrining 3578171301120002 13-01-2012 L Bulak Banteng Baru Gading No. 58 Bulak Banteng Baru Gading No. 59

MI MAHIR AR RIYADL PUSKESMAS

11 L SURABAYA +62 858-9523-9254 SIDOTOPO WETAN NS 1 19/9/2022 19/9/2022 negatif
43 Ahmad Issuddin Skrining 3578172711100002 27-11-2010 Bulak Banteng Baru Kenanga 3/85-B Bulak Banteng Baru Kenanga 3/85-B

SDN SIDOTOPO WETAN 1/256

KREMBANGAN JAYA SELATAN 1/48-A KREMBANGAN JAYA SELATAN 1/48-A SURABAYA NS 1 19/9/2022 19/9/2022 negatif
PUSKESMAS SIDOTOPO WETAN
44 ABDUL ROZAK Skrining 3578150603100004 3/6/2010 L

SDN SIDOTOPO WETAN 1/256

TENGGUMUNG BARU MULYA 3/34 TENGGUMUNG BARU MULYA 3/34 SURABAYA PUSKESMAS SIDOTOPO WETAN NS 1 19/9/2022 19/9/2022 negatif
45 ADINATA SUWARDI Skrining 3578120604100001 4/6/2010 L

SDN SIDOTOPO WETAN 1/256

SIDOMULYO 1-C/25 SIDOMULYO 1-C/25 SURABAYA PUSKESMAS SIDOTOPO WETAN NS 1 19/9/2022 19/9/2022 negatif
46 ADITYA PRATAMA Skrining 3578170405100007 5/4/2010 L

SDN SIDOTOPO WETAN 1/256

KEDUNG MANGU SELATAN 4/56 KEDUNG MANGU SELATAN 4/56 SURABAYA NS 1 19/9/2022 19/9/2022 negatif
PUSKESMAS SIDOTOPO WETAN
47 ALVIAN ALGIS PRATAMA SALEH Skrining 3578172208090002 8/22/2009 L

SDN SIDOTOPO WETAN 1/256

PLATUK NO. 2-B PLATUK NO. 2-B SURABAYA PUSKESMAS SIDOTOPO WETAN NS 1 19/9/2022 19/9/2022 negatif
48 ALVIN PUTRA PRASETYO Skrining 3578171809100002 9/18/2010 L

SDN SIDOTOPO WETAN 1/256

RANDU BARAT VI BUNTU NO. 40 RANDU BARAT VI BUNTU NO. 40 SURABAYA NS 1 19/9/2022 19/9/2022 negatif
PUSKESMAS SIDOTOPO WETAN
49 CRISNA ARDIANSYAH Skrining 3578172907100001 7/29/2010 L

SDN SIDOTOPO WETAN 1/256

TENGGUMUNG BARU SEL DONGKI 21 TENGGUMUNG BARU SEL DONGKI 21 SURABAYA PUSKESMAS SIDOTOPO WETAN NS 1 19/9/2022 19/9/2022 negatif
50 FAIRUS WADHIR WIDODO SAPUTRO Skrining 3578161004100001 4/10/2010 L
 SDN SIDOTOPO WETAN 1/256
SIDOTOPO WETAN 2/39 SIDOTOPO WETAN 2/39 SURABAYA NS 1 19/9/2022 19/9/2022 negatif
PUSKESMAS SIDOTOPO WETAN
51 MOCHAMMAD FARDAN ERWANDANI Skrining 3578172701110004 1/27/2010 L

SDN SIDOTOPO WETAN 1/256

SIDOTOPO WETAN BARU 1/33 SIDOTOPO WETAN BARU 1/33 SURABAYA NS 1 19/9/2022 19/9/2022 negatif
PUSKESMAS SIDOTOPO WETAN
52 MOCH. WILDAN AL-FALAKH Skrining 3578172012090003 12/20/2009 L

SDN SIDOTOPO WETAN 1/256

KEDUNG MANGU 2/15-B KEDUNG MANGU 2/15-B SURABAYA NS 1 19/9/2022 19/9/2022 negatif
PUSKESMAS SIDOTOPO WETAN
53 RADITYA GILANG ARDIANSYACH Skrining 3524250708100003 8/7/2010 L

SDN SIDOTOPO WETAN 1/256

SIDOTOPO WETAN BARU 5-C/37 SIDOTOPO WETAN BARU 5-C/37 SURABAYA NS 1 19/9/2022 19/9/2022 negatif
PUSKESMAS SIDOTOPO WETAN
54 RAFKA FABIAN ADI PRATAMA Skrining 3522031202100001 2/12/2010 L

SDN SIDOTOPO WETAN 1/256

PLATUK DONOMULYO 6/9 PLATUK DONOMULYO 6/9 SURABAYA PUSKESMAS SIDOTOPO WETAN NS 1 19/9/2022 19/9/2022 negatif
55 RAIHAN ARIF NASHRULLAH Skrining 3578170508100002 8/5/2010 L

SDN SIDOTOPO WETAN 1/256

TENGGUMUNG BARU SELATAN 5/25 TENGGUMUNG BARU SELATAN 5/25 SURABAYA NS 1 19/9/2022 19/9/2022 negatif
PUSKESMAS SIDOTOPO WETAN
56 RASYA ADITYA RACHMAD Skrining 3578161502100003 2/15/2010 L

SDN SIDOTOPO WETAN 1/256

POGOT BARU 3/15 POGOT BARU 3/15 SURABAYA PUSKESMAS SIDOTOPO WETAN NS 1 19/9/2022 19/9/2022 negatif
57 SYARIF HIDAYATULLAH Skrining 3578170907100004 7/9/2010 L

SDN SIDOTOPO WETAN 1/256

PLATUK RELA NO. 25 PLATUK RELA NO. 25 SURABAYA NS 1 19/9/2022 19/9/2022 negatif
PUSKESMAS SIDOTOPO WETAN
58 WILDAN ALIF ELFANI Skrining 3578171210100002 10/12/2010 L

SDN SIDOTOPO WETAN 1/256

KENJERAN 4/14 KENJERAN 4/14 SURABAYA PUSKESMAS SIDOTOPO WETAN NS 1 19/9/2022 19/9/2022 negatif
59 ADI WINARKO Skrining 3578110803100002 3/8/2010 L

SDN SIDOTOPO WETAN 1/256

PLATUK GG BUNTU 31 PLATUK GG BUNTU 31 SURABAYA NS 1 19/9/2022 19/9/2022 negatif
PUSKESMAS SIDOTOPO WETAN
60 ARDHEA DAVIN PRATAMA Skrining 3523140205100002 5/2/2010 L

SDN SIDOTOPO WETAN 1/256

BULAK BANTENG MADYA 8/35 BULAK BANTENG MADYA 8/35 SURABAYA PUSKESMAS SIDOTOPO WETAN NS 1 19/9/2022 19/9/2022 negatif
61 AXEL REVALLENT DRICUS KANI Skrining 3507300702100001 2/7/2010 L

SDN SIDOTOPO WETAN 1/256

BULAK BANTENG WETAN 14/17-A BULAK BANTENG WETAN 14/17-A SURABAYA PUSKESMAS SIDOTOPO WETAN NS 1 19/9/2022 19/9/2022 negatif
62 GALANG WIRA ARTAMA Skrining 3578171405100001 5/14/2010 L

SDN SIDOTOPO WETAN 1/256

SIDOTOPO WETAN I-D/61 SIDOTOPO WETAN I-D/61 SURABAYA NS 1 19/9/2022 19/9/2022 negatif
PUSKESMAS SIDOTOPO WETAN
63 HAMKA ALAMSYAH KUSUMA Skrining 3578171911090003 11/19/2009 L

SDN SIDOTOPO WETAN 1/256

SIDOTOPO WETAN BARU 5-B/39 SIDOTOPO WETAN BARU 5-B/39 SURABAYA PUSKESMAS SIDOTOPO WETAN NS 1 19/9/2022 19/9/2022 negatif
64 IBRAHIM AMIR AL KHOIR Skrining 3578162101110001 1/21/2011 L

SDN SIDOTOPO WETAN 1/256

PLATUK DONOMULYO 2/50 PLATUK DONOMULYO 2/50 SURABAYA NS 1 19/9/2022 19/9/2022 negatif
PUSKESMAS SIDOTOPO WETAN
65 KEVIN DIYAS PRATAMA Skrining 3525011204110002 4/12/2011 L

SDN SIDOTOPO WETAN 1/256

LIBRA NO.24-B LIBRA NO.24-B SURABAYA PUSKESMAS SIDOTOPO WETAN NS 1 19/9/2022 19/9/2022 negatif
66 MOCH. ALFAN NORVIANSYAH Skrining 3528070511110003 11/5/2010 L

SDN SIDOTOPO WETAN 1/256

KEDUNG MANGU SELATAN 5-A/43 KEDUNG MANGU SELATAN 5-A/43 SURABAYA NS 1 19/9/2022 19/9/2022 negatif
PUSKESMAS SIDOTOPO WETAN
67 MOCH. FIKI Skrining 3578171311100002 11/13/2010 L

SDN SIDOTOPO WETAN 1/256

PLATUK NO.20-C PLATUK NO.20-C SURABAYA PUSKESMAS SIDOTOPO WETAN NS 1 19/9/2022 19/9/2022 negatif
68 MUHAMMAD DAFFA AMANATULLOH Skrining 3578102411100003 11/24/2010 L

SDN SIDOTOPO WETAN 1/256

BULAK BANTENG WETAN 1/5 BULAK BANTENG WETAN 1/5 SURABAYA PUSKESMAS SIDOTOPO WETAN NS 1 19/9/2022 19/9/2022 POSITIF
69 MUHAMMAD NIZAM Skrining 3578171508100002 8/15/2010 L

SDN SIDOTOPO WETAN 1/256

DK.BULAK BANTENG SEKOLAHAN 3/1 DK.BULAK BANTENG SEKOLAHAN 3/1 SURABAYA NS 1 19/9/2022 19/9/2022 negatif
PUSKESMAS SIDOTOPO WETAN
70 RAFA MUHIBBIN NURUZZAMAN Skrining 3578170805100004 5/8/2010 L

SDN SIDOTOPO WETAN 1/256

SIDOTOPO WETAN 1-D/34 SIDOTOPO WETAN 1-D/34 SURABAYA PUSKESMAS SIDOTOPO WETAN NS 1 19/9/2022 19/9/2022 negatif
71 RAKHA NAUFAL BACHTIAR Skrining 3578101309100003 9/13/2010 L

SDN SIDOTOPO WETAN 1/256

POGOT BARU KARYA BAKTI NO. 32 POGOT BARU KARYA BAKTI NO. 32 SURABAYA NS 1 19/9/2022 19/9/2022 negatif
PUSKESMAS SIDOTOPO WETAN
72 REYZON ALMER ZAIDAN EFFENDI Skrining 3578172901100002 1/29/2010 L

SDN SIDOTOPO WETAN 1/256

TENGGUMUNG BARU SEL DONGKI 2-C TENGGUMUNG BARU SEL DONGKI 2-C SURABAYA PUSKESMAS SIDOTOPO WETAN NS 1 19/9/2022 19/9/2022 negatif
73 REZANO ALFARIZI RAHADIAN Skrining 3578161102100001 2/11/2010 L
 SDN SIDOTOPO WETAN 1/256
KEDUNG MANGU SELATAN 4/18 KEDUNG MANGU SELATAN 4/18 SURABAYA NS 1 19/9/2022 19/9/2022 negatif
PUSKESMAS SIDOTOPO WETAN
74 RIDHO MIFTAHUL FAUZAN Skrining 3578170103100003 3/1/2010 L

SDN SIDOTOPO WETAN 1/256

SIDOTOPO WETAN BARU 5-C/32 SIDOTOPO WETAN BARU 5-C/32 SURABAYA NS 1 19/9/2022 19/9/2022 negatif
PUSKESMAS SIDOTOPO WETAN
75 WAHYU PUTRA RAMADHAN Skrining 3578170909100001 9/9/2010 L

SDN SIDOTOPO WETAN 1/256

SIDOTOPO WETAN 1-L/16 SIDOTOPO WETAN 1-L/16 SURABAYA NS 1 19/9/2022 19/9/2022 negatif
PUSKESMAS SIDOTOPO WETAN
76 WIBISANA ADJIE PRATANU AMBAMI Skrining 3578290909100002 9/9/2010 L

SDN SIDOTOPO WETAN 1/256

SIDOTOPO WETAN BARU 5-C/32 SIDOTOPO WETAN BARU 5-C/32 SURABAYA NS 1 19/9/2022 19/9/2022 negatif
PUSKESMAS SIDOTOPO WETAN
77 ACHMAD HIDAYATULLAH PUTRA SASMITA Skrining 3578173001100006 1/30/2010 L

SDN SIDOTOPO WETAN 1/256

SIDOTOPO WETAN 1-L/16 SIDOTOPO WETAN 1-L/16 SURABAYA PUSKESMAS SIDOTOPO WETAN NS 1 19/9/2022 19/9/2022 negatif
78 ACHMAD RIFKY ARTHA Skrining 3508122709100001 9/27/2010 L

SDN SIDOTOPO WETAN 1/256

PLATUK DONOMULYO 2/12-A PLATUK DONOMULYO 2/12-A SURABAYA NS 1 19/9/2022 19/9/2022 negatif
PUSKESMAS SIDOTOPO WETAN
79 AHMAD AFATIR ROHIM Skrining 3578171606100004 6/16/2010 L

SDN SIDOTOPO WETAN 1/256

KEDUNG MANGU SELATAN 5-A/9 KEDUNG MANGU SELATAN 5-A/9 SURABAYA PUSKESMAS SIDOTOPO WETAN NS 1 19/9/2022 19/9/2022 negatif
80 ALAN FATHIR ALFARIZI Skrining 3578172404100003 4/24/2010 L

SDN SIDOTOPO WETAN 1/256

SIDOTOPO WETAN 1 DALAM 57 SIDOTOPO WETAN 1 DALAM 57 SURABAYA NS 1 19/9/2022 19/9/2022 negatif
PUSKESMAS SIDOTOPO WETAN
81 ALVIAR RIZKY ELZIRAZI Skrining 3578173107100002 7/31/2010 L

SDN SIDOTOPO WETAN 1/256

BULAK BANTENG WETAN 2/21 BULAK BANTENG WETAN 2/21 SURABAYA PUSKESMAS SIDOTOPO WETAN NS 1 19/9/2022 19/9/2022 negatif
82 BRIAN RANDI PUTRA PRATAMA Skrining 3578161606100002 6/16/2010 L

SDN SIDOTOPO WETAN 1/256

SIDOTOPO WETAN BARU 5/25 SIDOTOPO WETAN BARU 5/25 SURABAYA NS 1 19/9/2022 19/9/2022 negatif
PUSKESMAS SIDOTOPO WETAN
83 DAVID PARSAULIAN TAMPUBOLON Skrining 3578170805100001 5/8/2010 L

SDN SIDOTOPO WETAN 1/256

PLATUK GG TELADAN 7 PLATUK GG TELADAN 7 SURABAYA PUSKESMAS SIDOTOPO WETAN NS 1 19/9/2022 19/9/2022 negatif
84 FATHIN HALIDAR MUHTARAM Skrining 3578171107100002 7/11/2010 L

SDN SIDOTOPO WETAN 1/256

SIDOMULYO 2-B/2-B SIDOMULYO 2-B/2-B SURABAYA PUSKESMAS SIDOTOPO WETAN NS 1 19/9/2022 19/9/2022 negatif
85 JONATHAN KEVAN NOVELIMBER SIANIPAR Skrining 3578170510100001 10/5/2010 L

SDN SIDOTOPO WETAN 1/256

TANAH MERAH 4/11 TANAH MERAH 4/11 SURABAYA NS 1 19/9/2022 19/9/2022 negatif
PUSKESMAS SIDOTOPO WETAN
86 KRISNA ADITYA KURNIA PUTRA HERMAWAN Skrining 3578172302100001 2/23/2010 L

SDN SIDOTOPO WETAN 1/256

TENGGUMUNG BARU 152 TENGGUMUNG BARU 152 SURABAYA PUSKESMAS SIDOTOPO WETAN NS 1 19/9/2022 19/9/2022 negatif
87 LAXSMANA JAGAT BAYU FIRDAUS Skrining 3578162912100002 12/29/2010 L

SDN SIDOTOPO WETAN 1/256

SIDOTOPO WETAN 3/12 SIDOTOPO WETAN 3/12 SURABAYA NS 1 19/9/2022 19/9/2022 negatif
PUSKESMAS SIDOTOPO WETAN
88 MOCHAMAD BRAMA ARSETYA Skrining 3578170912090004 12/9/2009 L

SDN SIDOTOPO WETAN 1/256

PLATUK NO. 21 PLATUK NO. 21 SURABAYA PUSKESMAS SIDOTOPO WETAN NS 1 19/9/2022 19/9/2022 negatif
89 MOCHAMMAD RIZKY WIDHIYANTO Skrining 3578171403100001 3/14/2010 L

SDN SIDOTOPO WETAN 1/256

SIDOMULYO 3-B/6 SIDOMULYO 3-B/6 SURABAYA NS 1 19/9/2022 19/9/2022 negatif
PUSKESMAS SIDOTOPO WETAN
90 PUTRA ADITYA Skrining 3578171812100007 12/18/2010 L

SDN SIDOTOPO WETAN 1/256

SIDOMULYO 3-C/15 SIDOMULYO 3-C/15 SURABAYA PUSKESMAS SIDOTOPO WETAN NS 1 19/9/2022 19/9/2022 negatif
91 RAKHA PRATAMA MAULIDAN Skrining 3578172502100004 2/25/2010 L

SDN SIDOTOPO WETAN 1/256

SIDOTOPO WETAN 3/36-A SIDOTOPO WETAN 3/36-A SURABAYA PUSKESMAS SIDOTOPO WETAN NS 1 19/9/2022 19/9/2022 negatif
92 RASSEL FIRMANSYAH Skrining 3578172110100001 10/21/2010 L

SDN SIDOTOPO WETAN 1/256

POGOT BARU 4/35 POGOT BARU 4/35 SURABAYA NS 1 19/9/2022 19/9/2022 negatif
PUSKESMAS SIDOTOPO WETAN
93 RINO PUTRA PRASTYA Skrining 3578172801090001 1/28/2009 L