FORMULIR VITAMIN A BALITA

KABUPATEN BANDUNG BULAN AGUSTUS TAHUN 2023

Kecamatan : BALEENDAH
Puskesmas : JELEKONG
Kelurahan : JELEKONG
Posyandu : ANGGREK XI
Tanggal Ukur : 8 JULI 2023

Anak Ke JK Nama Ortu

No. Tgl Lahir NIK Balita Nama Balita NIK Ortu (Ayah / Ibu) Alamat RT RW
- (L/P) (Ayah dan Ibu)

1 1 05/10/2018 L 3204320510180000 Azka Nur Alam Tomi Permana 3204320106840000 Jelekong 5 11

2 4 15/11/2018 L 1511180005 Ihsan Maulana Arsyad/Dian 3204325106740000 Jelekong 1 11
3 1 26/11/2018 P Faiha Sabila Gubah/Rina Jelekong 5 11
4 2 27/11/2018 p 3204126711180000 FathiaShakila Dian/Weni 320412710186 Jelekong 3 11
5 1 27/01/2019 L 3204322701190000 Raffa Athala Fuji/Irfan 3204324405970010 Jelekong 3 11
6 2 10/02/2019 P 3204305002190000 Alea yumna Hani/Dadang k 3204305707900000 Jelekong 4 11
7 1 10/02/2019 L 3204321002190000 Syaddad Ruzain Mathla/Cendekia 3204280709960000 Jelekong 2 11
8 1 26/10/2019 P 3273226610190000 Clarisa Syabian ratna/Sopian 3273214208930000 Jelekong 4 11
9 2 26/11/2019 P Syakila Naura Rima/rendi Jelekong 1 11
10 1 17/12/2019 L Maqil Fannan Vivi/Lukman Jelekong 1 11
11 2 25/01/2020 P azzifa Fakhira Siti/yudi Jelekong 4 11
12 3 30/01/2020 L Zicho Satria Imas/Asep Jelekong 1 11
13 2 12/03/2020 L Randika al taff Rosi/Rano Jelekong 6 11
14 1 18/03/2020 L Nuzail Zeeshan Nina/Ihsan Jelekong 4 11
15 2 31/05/2020 P Mirzeta khashia Jelekong 2 11
16 2 17/08/2020 P Shaima Ayyubia mathla/Cendekia Jelekong 2 11
17 2 10/09/2020 P Nadira Alesha resti/Heru Jelekong 1 11
18 3 16/09/2020 P Azreena Arkadina dwi kartika/Arsy Jelekong 1 11
20 2 16/09/2020 L Sheva reyshaka saskia dita/Prabu Jelekong 2 11
21 1 18/09/2020 L Prasya Rausyan Sella/Amirul Jelekong 6 11
22 3 29/10/2020 L Akra Diaska Vina/Beben Jelekong 3 11
23 3 10/01/2021 P Adzkia Tsurayya Lismilah/Dedih R Jelekong 4 11
24 6 12/03/2021 L Kenzie Melvano Rita S/Iwa K Jelekong 1 11
25 4 26/06/2021 L M. Alfarizi Diaz Tini S/Asep M Jelekong 1 11
26 1 28/06/2021 L Arzio Refandra Sonia/Fajar Jelekong 3 11
27 4 25/07/2021 L Shidqi Abqary Sri G/Opik T Jelekong 1 11
28 1 17/08/2021 L M. Atha Al-K Kosyatilah/Dedi A Jelekong 1 11
29 1 11/02/2020 P Hanindya S Hindun/Aldi Jelekong 3 11
30 1 09/09/2021 L Dzukhairi A K Dinda/Desta Jelekong 1 11
31 1 21/12/2021 P Raya Elmeira S Reni A/Budi Jelekong 2 11
32 2 30/12/2021 L Faris Delvara Yuliani/Ades Jelekong 2 11
33 1 22/02/2022 P Alia Naura P Diana/Akbar Jelekong 5 11
34 1 12/03/2022 L Mahesa Daud Wemi/Indra Jelekong 3 11
35 2 17/05/2022 P Azkayra N Annisa/Ikbal Jelekong 1 11
36 1 17/06/2022 L Arzanka S P Reval/Supriadi Jelekong 6 11
37 1 01/08/2022 L Regamanta G Putri/Ferry Jelekong 3 11
38 1 03/08/2022 L M. Alvan A Alvini/Ujang Jelekong 4 11
39 1 27/12/2022 P Syakila Nur Ulfah/Saeful Jelekong 2 11