29 Desember 2021

Nama Puskesmas/Fasyankes/Pos
Kabupaten/Kota
Provinsi
Hari, Tanggal
No No. Tiket NIK
1 5320051003040001
2 5320014809050004
3 5311131811020001
4 5320052011620001
5 5320050410090002
6 5320052711050001
7 5320050410090001
8 5311114603850001
9 5320052005740001
10 5320052411710001
: PUSKESMAS EIMADAKE
: Sabu Raijua
: Nusa Tenggara Timur
: 29/12/2021
Pekerjaan*
Jenis
Nama Penerima Vaksin
Kelamin
PANGERAN IVANTRI DOKO L REMAJA

IKA SEFRINA MANU P REMAJA
UMBU KUDU KATAUHI MILA L MASY UMUM

PETRUS MANU PADJA L MASYARAKAT UMUM
RUBA ADIPUTRA NEGO RATA L REMAJA
NOFANTO MANU PADJA L REMAJA
TULU KAKA PUTRA NEGO RATA L REMAJA
RUT MANU P MASY UMUM
WEMPY ITO L MASY UMUM
IMANUEL ROHI L MASY UMUM

FORMAT PENCATATAN PELAKSANAAN VAKSINASI COVID-19
TINGKAT PUSKESMAS/FASYANKES/POS VAKSINASI
Kepesertaan
BPJS (tulis 'Ya'
Umur pada kolom
Kelompok yang sesuai)
Tanggal Lahir (18 sd ≥ 60 Alamat No. Hp
tahun) Umur BPJ
BPJS S
PBI Non
PBI
3/10/2004 19 18-30 EILODE 81339266452
11/8/2005 17 12-17 DESA EILODE 082229114910
11/18/2003 19 18-30 SUMBA TIMUR 81338227311

11/20/1962 60 60-150 EILODE 85338193078
10/4/2009 13 12-17 DESA EILODE 81337150661
11/27/2005 17 12-17 DESA EILODE 085338193079
10/4/2009 13 12-17 DESA EILODE 81337150661
3/6/1985 38 31-45 DESA EILODE 082229114910
5/20/1974 49 46-59 DESA EILODE 081337150661
11/24/1971 51 46-59 DESA EILODE 081337150661

9
Kepesertaan
BPJS (tulis 'Ya'
Dosis I
pada kolom
yang sesuai) Tanggal Nama/Jenis/Merek Vaksin***
Screening
Non
Angg Tanggal Pemberian No. Batch
Vaksinasi
ota
11/25/2021 VAKSIN COVID-19 BIOFARMA 11/25/2021 202108122H
10/25/2021 VAKSIN COVID-19 BIOFARMA 10/25/2021

12/29/2021 VAKSIN COVID-19 BIOFARMA 12/29/2021 24203321

Dosis 2
No. Serial Tanggal Pemberian No. Batch No. Serial

Vaksinasi
16298092634625 12/29/2021 24203321 16333444265920

12/29/2021 24203321 16333444265920
12/29/2021 24203321 16333444265920

16298092634625 12/29/2021 24203321 16333444265920
16333444265920
16333444265920
16333444265920
16333444265920
16333444265920
16333444265920
Keterangan
(Ditunda/Tidak Asal Instansi
Diberikan/Lanjut)
SELESAI EILODE
SELESAI EILODE
SELESAI EILODE
SELESAI EILODE
LANJUT DESA EILODE
LANJUT DESA EILODE
LANJUT DESA EILODE
LANJUT DESA EILODE
LANJUT DESA EILODE
LANJUT DESA EILODE

Kabupaten/Kota
Provinsi
Hari, Tanggal
No No. Tiket NIK
1
5320051305840001
2 5320050410820001
3 5320050209020002
P-K9OG82AH
4 5320054201420001
5 5320051311560001
6 5320051207450001
5320056408450001
7
8 5320054603340001
9 5320055704820001
10 5320055602640001
11
5320056907580001
12 5320054709560001
13 5320055403070001
14
5320055007880002
15
5320051211070002
16 5320052604040001
17 5320052410090001
18 5320020109670001
19 5320052112730001
20 5371056312900001
21 5320052402360001
22 5320054707070001
23 5320052510050001
24 5320026509470001
25 5320056110090001
26 5320050107800002
27 5320051509550001
28 'P-T344ZSSK 5320055112030001
29 'P-T7EKANPL 5320051303870001
30 P-T7N6ZW4M 5320052811970003
31 P-T7SE0QXA 5320056808870002
32 : : : : : DESA
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
: Sabu Raijua
: 24/12/2021
Pekerjaan*
Jenis
Kelamin
L MASYARAKAT UMUM
IMANUEL LUDJI PUTI
EFA DJAMI L MASYARAKAT UMUM
MERTHEN BANGNGU KORO L MASYARAKAT UMUM
NAOMI HUKI LENA P LANSIA
NICOLAS KANA LUDJI L MASYARAKAT UMUM
GODLIF RIWU DJAMI L LANSIA

AGUSTINA DOMA P LANSIA
BENDELINA NARA DILA P LANSIA
MARSELINA BANGNGU KORO P MASYARAKAT UMUM
ESTER MANU PADJA P MASY UMUM
P LANSIA
MARGERITA KIRA
WELMINCE LAGA LOMI P LANSIA
SANTI NEGO RATA P REMAJA
TERSIANA BALE HURU P MASY UMUM
NOVRIT MIRA MANGNGI P REMAJA

NELSRON A. DJARA RABA L REMAJA
RIA RIHI P REMAJA
TITUS BALE BANE L MASY UMUM
DELIMA BALE BANE L MASY UMUM
DEWI YANTI WADU P MASY UMUM
PETRUS MIHA LENA L LANSIA
FLORESITA MIHA BALO P REMAJA
ARDIANTO ROBINSON MAGE TIE L REMAJA
MATELDA WILA DIDA P LANSIA
TAMAR NARA DILA P REMAJA
MASRINUS MIHA LOBO L MASY UMUM
RATU KUDJI P LANSIA
DELVI MANU PADJA p MASY UMUM
SOLEMAN RATA L MASY UMUM
DITA LOMI KAHO P MASY UMUM
HABA UDJU P MASY UMUM

Kepesertaan
BPJS (tulis 'Ya'
Umur pada kolom
Kelompok yang sesuai)
Tanggal Lahir (18 sd ≥ 60 Alamat No. Hp
tahun) Umur BPJ
BPJS S
PBI Non
PBI
37 EILODE
5/13/1984 81337150661
10/4/1982 39 EILODE 082144150272
9/2/2002 19 EILODE 081353026059
1/2/1942 79 EILODE 082237099254
11/13/1966 55 EILODE 081337150661
7/12/1945 76 DESA EILODE 085233729445

8/24/1945 76 DESA EILODE 085338193077
3/6/1934 87 EILODE 082237099254
4/17/1982 39 EILODE 082237099254
2/16/1964 57 EILODE
85338193078
79 EILODE
8/7/1942 81338002539
9/7/1956 65 EILODE 081337150661
3/14/2007 14 EILODE 081337150661
081337150661
7/10/1988 33 EILODE
11/12/2007 14 EILODE 082237099254

4/26/2004 17 EILODE
082237099254
10/24/2009 12 EILODE 081353026059
9/1/1967 54 EILODE 082190820918
12/21/1973 48 DESA EILODE 086233729445
12/23/1990 31 EILODE 085236047190
2/24/1934 87 EILODE 081353026059
7/7/2007 14 EILODE 081353026059
10/25/2005 30 EILODE 85338193078

25-Sep-47 74 EILODE 082246266215
10/21/2009 12 EILODE 081337150661
7/1/1980 41 EILODE 081353026059
9/15/1955 66 EILODE 082141175824
12/11/2003 18 EILODE 081353026059
4/18/1987 34 EILODE 082340246782
1998-07-25 23 JIWUWU 085238838465
8/28/1987 34 EILODE 081337150661

9
Kepesertaan
BPJS (tulis 'Ya'
Dosis I
pada kolom
yang sesuai) Tanggal Nama/Jenis/Merek Vaksin***
Screening
Non
Angg Tanggal Pemberian No. Batch
Vaksinasi
ota
12/27/2021 ASTRA ZENECA 12/27/2021 A1087
12/27/2021 ASTRA ZENECA 12/27/2021 A1087
VAKSIN COVID-19 BIOFARMA 202108175F

11/29/2021 11/29/2021
11/17/2021 VAKSIN COVID 29 BIOFARMA 11/17/2021 202108140H
12/27/2021 ASTRA ZENECA 12/27/2021 A1087
12/27/2021 ASTRA ZENECA 12/27/2021 A1087

11/29/2021 VAKSIN COVID-19 BIOFARMA 11/29/2021 202108175F

12/27/2021 ASTRA ZENECA 12/27/2021 A1087
12/27/2021 ASTRA ZENECA 12/27/2021 A1087
12/27/2021 ASTRA ZENECA 12/27/2021 A1087
12/27/2021 ASTRA ZENECA 12/27/2021 A1087
12/27/2021 ASTRA ZENECA 12/27/2021 A1087
12/27/2021 ASTRA ZENECA 12/27/2021 A1087

Dosis 2
No. Serial Tanggal Pemberian No. Batch No. Serial

Vaksinasi
16298092634625 12/27/2021 24203321 16333444265296
16333444265296
16333444265296
16322913899004 12/27/2021 24203321 16333444265296

16319375256635
12/27/2021 24203321 16333444265296
16333444265296
16298092634625 12/27/2021 24203321 16333444265296
16298092634625 12/27/2021 24203321 16333444265296
16333444265296
16333444265296
16333444264516
16333444264516
16333444264516
12/27/2021 24203321 16333444264516
16322913899004
16333444264516
16333444264516
16298092634625 12/27/2021 24203321 16333444264516
16333444264516
16333444264516
16333444264516
Keterangan
Diberikan/Lanjut)
SELESAI EILODE
LANJUT EILODE
LANJUT EILODE
LANJUT EILODE
LANJUT EILODE
SELESAI DESA EILODE
SELESAI DESA EIMAU
LANJUT EILODE
LANJUT EILODE
SELESAI EILODE
SELESAI EILODE
LANJUT EILODE
LANJUT SMP 1 SATENG
LANJUT EILODE
LANJUT SMP 1 SATENG

LANJUT SMA 1 SABU TIMUR
LANJUT SMP 1 SATENG
SELESAI EILODE
LANJUT DESA EILODE
LANJUT EILODE
LANJUT EILODE
LANJUT SMP 1 SATENG
SELESAI EILODE
LANJUT EILODE
LANJUT SMP 1 SATENG
LANJUT EILODE
LANJUT EILODE
LANJUT EILODE
LANJUT EILODE
LANJUT JIWUWU
LANJUT EILODE
Kabupaten/Kota
Provinsi
Hari, Tanggal
No No. Tiket NIK
1 5320035603920001
2 5320050907970001
3 5320052308900001
4 5320056410030001
5 5320051001760001
6 5320056706880001
7 5320050807960001
8 5320050201790001
9 5320052106690003
10 5320024504010002
11 5320051111920001
12 5320051504960001
13 5320054701740001
14 5320055010840002
15 5320051411830001
16 5320050403960002
17 5320055910880001
18 5320050407690001
19 5320052010840001
20 5320050805950001
21 5320050303750001
22 5320050503730001
23 5320051902470001
24 5320056806550001
25 5320051701580001
26 5320056311610001
27 5320054707380001
28 5320055501050002
29 5320054202550001
30 5320054207580001
31 5320051907070002
32 5320051303860001
33 5371021504890003
34 5320055103960001
35 5320054708050001
36 5320054502790001
37 5320051204050003
38 5320050907070002
39 5320051610040002
40 5320055803090001
41 5320052007870001
42 5371026604900001
43 5320051708820001
44 5320051903560001
45 5320052304080002
46 5320054212060002
47 5320050911900002
48 5320056004680001
49 5320054310750001
50 5320052707080001
51 5320053010060001
52 5320056009820001
53 5320026711860001
54 5320055402030001
55 5311162811940002
56 5320051408840001
57 5320053011000003
58 5320051302980001
59 5320054610990001
60 5320021904090004
61 5327122303060005
62 5320054207700001
63 5320051303090001
: Sabu Raijua
: 23/12/2021
Pekerjaan*
Jenis
Kelamin
HENDERINA TALO L MASY UMUM
WEMPI WILA PA L MASY UMUM
MELKIANUS LAY L MASY UMUM
RITA BANGNGU BIRE P MASY UMUM
MARTINUS BANGNGU BIRE L MASY UMUM
CHINDY LENA LAY P MASY UMUM
MARTINUS MIRA L MASY UMUM
MATIAS HABA GEA L MASY UMUM
MARKUS MATA L MASY UMUM
MARTINA RIWU P MASY UMUM
HENOK DJARI L MASY UMUM
APRIANUS TADI LULU L MASY UMUM
PETRONELA RIHI P MASY UMUM
RIN KALE LAY P MASY UMUM
MARTINUS WIE L MASY UMUM

ERWINSON TANGA L MASY UMUM
TERSIA RIHI P MASY UMUM
MOSES HABA GEA L MASY UMUM
WELEM LAY LEO L MASY UMUM
IBRAHIM RIWU L MASY UMUM
RUBEN ROHI L MASY UMUM
TERSIA HAGA P MASY UMUM
PITER LEO L LANSIA
DORKAS BALLO P LANSIA
ELIA DOKO P LANSIA
PETRONELA RADJA P LANSIA
WELDIANA MANGNGI P LANSIA
ERMI ROSALIN LAY P REMAJA
DINA MANGNGI P REMAJA
MARGERITA TADI LULU P LANSIA
ARIVIN LAY LEO L REMAJA
MARKORIUS GA NGARA L MASY UMUM
DAMIANUS ELIAZER NABEN L PELAYAN PUBLIK
WELHEN RIWU L MASY UMUM
LUISA RIWU P REMAJA
WELMINCE LOMI RIHI P MASY UMUM
YOSTAN FILISTON WIE L REMAJA
YOSUA SAMUEL WIE L REMAJA
ARJUN F. MIRA L REMAJA
NINGSI ANJELIN GA NGARA P REMAJA
PAULUS HABA GEA L MASY UMUM
SETRA HONIN L MASY UMUM
YONATAN KAHO RIHI P MASY UMUM
WELEM DJARI L LANSIA

RIVEN HAGA L REMAJA
ERNIATI MATA P REMAJA
RUBEN MANGNGI L MASY UMUM
RIBKA WIE P MASY UMUM
MARTA KORE P MASY UMUM
ESTON DIDJAYA MIRA L REMAJA
VALEN KAHO RIHI L REMAJA
RUT LEO P MASY UMUM

RIANTI KADJA DILA P MASY UMUM
ANTONETA ROHI MUHU P MASY UMUM
NOFRET KALE UKE L MASY UMUM
ANDERIAS RAGA LOMI L MASY UMUM
ROCKY R LEO DJULA L MASY UMUM
FERDINAN LIBU L MASY UMUM
RAHEL DJAMI KORE P MASY UMUM
PATRICIA ORLANDO LOBO P REMAJA
RAFINDRA PRATAMA DIMU L REMAJA
KATI DJAMI L MASY UMUM
RIAN AFANDY EDO PITA L REMAJA

Kepesertaan
BPJS (tulis
'Ya' pada
Umur kolom yang
Kelompok
Tanggal Lahir (18 sd ≥ 60 Alamat No. Hp sesuai)
BPJ
Umur BPJ
tahun) S
S
Non
PBI
PBI
3/16/1992 29 DESA MATEI 082236395841
7/9/1997 24 DESA BEBAE 082147624666
8/23/1990 31 DESA TADA 082341416232
10/22/2003 19 18-30 DESA LOBOADJU 81238094200
1/10/1976 47 46-59 DESA LOBOADJU 81238094200
6/27/1988 33 DESA BEBAE 081337783340
7/8/1995 26 DESA BEBAE 082147624666
1/2/1979 42 DESA BEBAE 082147624666
6/21/1969 52 DESA BEBAE 082147624666
2/27/2001 20 DESA BEBAE 085339080621
11/11/1992 29 DESA BEBAE 082134517914
4/15/1996 25 DESA BEBAE 082147624666
1/7/1974 47 DESA BEBAE 082147624666
10/10/1984 37 DESA BEBAE 082147624666
11/14/1983 38 DESA BEBAE 082147624666

4/3/1996 25 DESA BEBAE 082147624666
10/19/1988 33 DESA BEBAE 082147624666
7/4/1969 52 DESA BEBAE 082147624666
5/18/1984 37 DESA BEBAE 082147624666
5/8/1995 26 DESA BEBAE 082147624666
3/3/1975 46 DESA BEBAE 082147624666
3/5/1973 48 DESA BEBAE 082147624666
2/19/1947 74 DESA BEBAE 082147624666
28-Jun-55 66 DESA BEBAE 082147624666
1/17/1958 63 DESA BEBAE 082147624666
11/23/1961 60 DESA BEBAE 082147624666
7/7/1938 83 DESA BEBAE 082147624666
1/15/2005 16 DESA BEBAE 082145355992
2/2/1955 66 DESA BEBAE 082147624666
7/2/1958 63 DESA BEBAE 082147624666
7/19/2007 14 DESA BEBAE 082147624666
3/13/1986 35 DESA BEBAE 082147624666
4/15/1989 42 BEBAE 082138785046
3/11/1996 25 DESA BEBAE 082111395392
8/7/2005 16 DESA BEBAE 085339080621
2/5/1979 42 DESA BEBAE 085339080621
4/12/2005 16 DESA BEBAE 082147624666
7/9/2007 14 DESA BEBAE 082147624666
10/16/2004 17 DESA BEBAE 082147624666
3/18/2009 12 DESA BEBAE 082147624666
7/20/1987 34 DESA BEBAE 082147624666
4/26/1990 31 DESA BEBAE 082145707566
8/17/1982 39 DESA BEBAE 082145707566
3/19/1956 65 DESA BEBAE 082145707566

4/23/2008 13 DESA BEBAE 085239088174
12/2/2006 15 DESA BEBAE 081353362284
11/9/1990 31 DESA BEBAE 082147624666
4/20/1968 53 DESA BEBAE 082147624666
10/3/1975 46 DESA BEBAE 082147624666
7/27/2008 13 DESA BEBAE 082147624666
10/30/2007 14 DESA BEBAE 081338758501
9/20/1982 39 DESA BEBAE 081338758501

11/27/1988 34 31-45 DESA EIMAU 081339096890
2/14/2003 20 18-30 DESA JIWUWU 082321427018
11/28/1994 28 18-30 DESA MATEI 082144857356
8/14/1984 38 31-45 DESA EIMAU
11/30/2000 22 18-30 DESA EIMADAKE 082282241975
2/13/1998 25 18-30 DESA EIMADAKE 081239946826
10/6/1999 23 18-30 DESA TADA 082339556382
4/19/2009 14 12-17 DESA EIMADAKE 081236296046
3/23/2006 17 12-17 DESA MATEI 85237621804
7/2/1970 51 46-59 EILODE 81338169836

3/13/2009 12 12-17 TADA 085253895668
9
Kepesertaan
BPJS (tulis
'Ya' pada Dosis I
kolom yang Tanggal
sesuai) Nama/Jenis/Merek Vaksin***
Non Screening
Tanggal Pemberian
Ang No. Batch
Vaksinasi
gota
12/23/2021 ASTRA ZENECA 12/23/2021 A1067
12/23/2021 ASTRA ZENECA 12/23/2021 A1067
12/23/2021 ASTRA ZENECA 12/23/2021 A1067
10/22/2021 ASTRAZENECA 10/22/2021 210155
10/22/2021 ASTRAZENECA 10/22/2021 210155
12/23/2021 ASTRA ZENECA 12/23/2021 A1067
12/23/2021 ASTRA ZENECA 12/23/2021 A1067
12/23/2021 ASTRA ZENECA 12/23/2021 A1067
12/23/2021 ASTRA ZENECA 12/23/2021 A1067
12/23/2021 ASTRA ZENECA 12/23/2021 A1067
12/23/2021 ASTRA ZENECA 12/23/2021 A1067
12/23/2021 ASTRA ZENECA 12/23/2021 A1067
12/23/2021 ASTRA ZENECA 12/23/2021 A1067
12/23/2021 ASTRA ZENECA 12/23/2021 A1067
12/23/2021 ASTRA ZENECA 12/23/2021 A1067

12/23/2021 ASTRA ZENECA 12/23/2021 A1067
12/23/2021 ASTRA ZENECA 12/23/2021 A1067
12/23/2021 ASTRA ZENECA 12/23/2021 A1067
12/23/2021 ASTRA ZENECA 12/23/2021 A1067
12/23/2021 ASTRA ZENECA 12/23/2021 A1067
12/23/2021 ASTRA ZENECA 12/23/2021 A1067
12/23/2021 ASTRA ZENECA 12/23/2021 A1067
12/23/2021 VAKSIN COVID19 BIOFARMA 12/23/2021 24203321
7/14/2021 CORONAVAC 7/14/2021 24003121

12/23/2021 VAKSIN COVID19 BIOFARMA

11/17/2021 VAKSIN COVID BIOFARMA 11/17/2021 202108175F
9/20/2021 VAKSIN COVID BIOFARMA 9/20/2021 2021081601

Dosis 2
Tanggal Pemberian
No. Serial No. Batch No. Serial
Vaksinasi
10000006661171
10000006661171
10000006661171
12/23/2021 24203321 16302891933290
12/23/2021 24203321 16302891933290
10000006661171
10000006661171
10000006661171
10000006661171
10000006661171
10000006661171
10000006661171
10000006661171
10000006661171
10000006661171
10000006661171
10000006661171
10000006661171
10000006661171
10000006661171
10000006661171
10000006661171
16302891933290
16302891933290
16302891933290
16302891933290
16302891933290
16302891933290
16302891933290
16302891933290
16302891933290
16302891933290
16182780909572 12/23/2021 24203321 16333444273720
16333444273720
12/23/2021 24203321 16333444273720
12/23/2021 24203321 16333444273720
16333444273720
16333444273720
16333444273720
16333444273720
16333444273720
16333444273720
16333444264672
16333444264672
16333444264672
16333444264672
16333444264672
16333444264672
16333444264672
16333444264672
16333444264672
16333444264672
16311457458128
16311457458128
16311457458128
16311457458128
16311457458128
16311457458128
16311457458128
16311457458128
16322913899004 12/23/2021 24203421 16311457458128
16298092634625 12/23/2021 24203421 16311457458128
16301222846863 12/23/2021 24203421 16311457458128

Keterangan
Diberikan/Lanjut)
LANJUT DESA MATEI
LANJUT DESA BEBAE
LANJUT DESA TADA
SELESAI DESA LOBOADJU
LANJUT DESA BEBAE
LANJUT DESA BEBAE
LANJUT DESA BEBAE
LANJUT DESA BEBAE
LANJUT DESA BEBAE
LANJUT DESA BEBAE
LANJUT DESA BEBAE
LANJUT DESA BEBAE
LANJUT DESA BEBAE
LANJUT DESA BEBAE

LANJUT DESA BEBAE
LANJUT DESA BEBAE
LANJUT DESA BEBAE
LANJUT DESA BEBAE
LANJUT DESA BEBAE
LANJUT DESA BEBAE
LANJUT DESA BEBAE
LANJUT DESA BEBAE
LANJUT DESA BEBAE
LANJUT DESA BEBAE
LANJUT DESA BEBAE
LANJUT DESA BEBAE
LANJUT DESA BEBAE
LANJUT DESA BEBAE
LANJUT DESA BEBAE
LANJUT DESA BEBAE
LANJUT KADER LANSIA DESA BEBAE
SELESAI DESA BEBAE
LANJUT DESA BEBAE
SELESAI DESA BEBAE
SELESAI DESA BEBAE
LANJUT DESA BEBAE
LANJUT DESA BEBAE

LANJUT DESA BEBAE
LANJUT DESA BEBAE
LANJUT DESA BEBAE
LANJUT DESA BEBAE
LANJUT DESA BEBAE
LANJUT DESA BEBAE
LANJUT DESA BEBAE
LANJUT DESA BEBAE
LANJUT DESA BEBAE
LANJUT DESA BEBAE
LANJUT DESA BEBAE
LANJUT DESA BEBAE
LANJUT DESA BEBAE
LANJUT DESA BEBAE
LANJUT DESA EIMAU
LANJUT DESA JIWUWU
LANJUT DESA MATEI
LANJUT DESA EIMAU
LANJUT DESA EIMADAKE
LANJUT DESA TADA
SELESAI EILODE
SELESAI EILODE
SELESAI SMP N 1 SATENG

Kabupaten/Kota
Provinsi
Hari, Tanggal
No No. Tiket NIK
1 5320054404900001
2 5320051208760001
3 5320050311670001
4 5320051303650001
5 5320051111540002
6 5320056305570001
7 5320052703570001
D2 8 5320056210050001
D2 9 P-K478JO31 5320054504930001
D2 10 P-RODEUK61 5320052103800001
D2 11 5320050306030001
12 5320052004030002
13 5320055005640001
14 5320056404550001
15 5320052306020001
16 5320055101950001
17 5320053105930001
18 5320052804980001
19 5320052212900001
20 5320055305840002
DOSIS 1
LANSIA
MU
REMAJA
PP
ASTRA
SINO
: Sabu Raijua
: 21/12/2021
Pekerjaan*
Jenis
Kelamin
MISRA DJU NINA P MASY UMUM
KAREL DIMA LENA L MASY UMUM
BERNADUS DJU NINA L MASY UMUM
LAMBERTUS BUNGA TADE L MASY UMUM
NIKOLAS BAKI DJU L LANSIA
HENDERINA MINA BELO P LANSIA
MELKIANUS LOBO L LANSIA
IVON BANGNGU BIRE P REMAJA
LINA ROHI P MASY UMUM
RUBEN GA RATA L MASY UMUM
JEFRI HAWU LEKU L MASY UMUM
HARKEKI LEONARDO PUNGA L MASY UMUM
APLONIA KAHA P MASY UMUM
ROSALIN PIGA KIRI P MASY UMUM
JEFRISON MIRA MANGNGI L MASY UMUM

ELISABETH MIHA LOBO P MASY UMUM
FIKA BANGNGU BIRE P REMAJA
PETRUS LUDJI LOBO L MASY UMUM
DENIS ARIYANTO LENA BANGNGU L MASY UMUM
HENDERINA DJU NINA P MASY UMUM
D2
LANSIA 3
REMAJA 1
MU 7
DOSIS 2
LANSIA
8 MU
1 REMAJA
PP
12 (1 VIAL)
8 ( 1 VIAL)
Kepesertaan
BPJS (tulis
'Ya' pada
Umur kolom yang
Kelompok
Tanggal Lahir (18 sd ≥ 60 Alamat No. Hp sesuai)
BPJ
Umur BPJ
tahun) S
S
Non
PBI
PBI
8/12/1976 46 46-59 DESA LOBOADJU 81238732823
8/12/1976 46 46-59 DESA LOBOADJU 81238732823
11/3/1967 55 46-59 DESA LOBOADJU 85333827893
3/13/1965 58 46-59 DESA LOBOADJU 81238732823
11-Nov-54 68 60-150 DESA LOBOADJU 81238732823
5/23/1957 66 60-150 DESA LOBOADJU 85339692625
3/27/1957 66 DESA JIWUWU 82143654545
10/24/2005 17 12-17 DESA LOBOADJU 81339234068
4/5/1993 30 18-30 DESA JIWUWU 082139375654
3/21/1980 43 31-45 DESA TADA 085238415280
6/12/2003 20 18-30 DESA EIMADAKE 081340366944
4/20/2003 20 18-30 DESA TADA 085238375459
9/29/1964 58 46-59 DESA TADA 081238628664
8/27/1965 57 46-59 DESA MATEI 085339088830
6/23/2002 21 18-30 DESA EILODE 081237353354

1/17/1995 28 18-30 DESA EILODE 081338208777
10/4/2008 14 12-17 DESA LOBOADJU 081339234068
4/28/1998 25 18-30 DESA EILODE 081346484563
12/22/1990 32 31-45 DESA LOBOADJU 082339469943
5/13/1984 39 31-45 DESA BEBAE 082235865101
3
7
1
9
Kepesertaan
BPJS (tulis
'Ya' pada Dosis I
kolom yang Tanggal
sesuai) Nama/Jenis/Merek Vaksin***
Non Screening
Tanggal Pemberian
Ang No. Batch
Vaksinasi
gota
10/22/2021 ASTRAZENECA 10/22/2021 210155
10/22/2021 ASTRAZENECA 10/22/2021 210155
10/22/2021 ASTRAZENECA 10/22/2021 210155
10/22/2021 ASTRAZENECA 10/22/2021 210155
10/22/2021 ASTRAZENECA 10/22/2021 210155
10/22/2021 ASTRAZENECA 10/22/2021 210155
11/10/2021 ASTRAZENECA 11/10/2021 A1077
11/24/2021 VAKSIN COVID19 BIOFARMA 11/24/2021 202108175F
10/11/2021 VAKSIN COVID19 BIOFARMA 10/11/2021 202108119H
7/19/2021 VAKSIN COVID19 BIOFARMA 7/19/2021
12/22/2021 ASTRAZENECA 12/22/2021 A1087
12/22/2021 ASTRAZENECA 12/22/2021 A1087
12/22/2021 ASTRAZENECA 12/22/2021 A1087
12/22/2021 ASTRAZENECA 12/22/2021 A1087

12/22/2021 ASTRAZENECA 12/22/2021 A1087

Dosis 2 Keterangan
(Ditunda/Tidak
Tanggal Diberikan/Lanju
No. Serial Pemberian No. Batch No. Serial t)
Vaksinasi
12/22/2021 A1087 10000006783625 SELESAI
12/22/2021 A1087 10000006783625 SELESAI
12/22/2021 A1087 10000006783625 SELESAI
12/22/2021 A1087 10000006783625 SELESAI
12/22/2021 A1087 10000006783625 SELESAI
12/22/2021 A1087 10000006783625 SELESAI
10000005812263 12/22/2021 A1087 10000006783625 SELESAI
12/22/2021 24203421 16306347632131 SELESAI
16322913899004 12/22/2021 24203421 16306347632131 SELESAI
16295072867328 12/22/2021 24203421 16306347632131 SELESAI
12/22/2021 24203421 16306347632131 SELESAI
10000006783625 LANJUT
10000006783625 LANJUT
10000006783625 LANJUT
10000006783625 LANJUT
10000006783625 LANJUT
16306347632131 LANJUT
16306347632131 LANJUT
16306347632131 LANJUT
16306347632131 LANJUT
Asal Instansi
DESA LOBOADJU
DESA LOBOADJU
DESA LOBOADJU
DESA LOBOADJU
DESA LOBOADJU
DESA LOBOADJU
DESA JIWUWU
DESA LOBOADJU
DESA JIWUWU
DESA TADA
DESA EIMADAKE
DESA TADA
DESA TADA
DESA MATEI
DESA EILODE
DESA EILODE
DESA LOBOADJU
DESA EILODE
DESA LOBOADJU
DESA BEBAE
Kabupaten/Kota
Provinsi
Hari, Tanggal
No No. Tiket NIK
1 5320052106720001
Q-001FTCTT
2 5320054101850001
Q-001FTO29
3 5320055311500001
Z-000D034S
4 5320054904020001
Q-001IW7Y0
5 5320054303840003
Q-001IW7XM
6 P-QPANNN40 5320054905920001
7 5320050503790001
Q-001IW7XM
8 P-QO8KF8OJ 5320052409930001
9 P-PAT643A2 5320016202950002
10 5320055705830001
Q-001IWP7F
11 Q-0012LKPF 5320051302020001
12 5371031807870004
Q-001IWP7L
13 5320054111710001
Q-001IW7WC
14 5320056907790001
Q-001IWHVU
15 P-R4U6FDKE 5320050506890001
16 P-R4SJ8NZL
5371054506680001
17 S-7E80497A
5320015810560001
18 5320051202650001
Q-001TR2F1
19 5320052510060001
Q-001TR2OG
20
Q-000HOADH 5320050503060001
21 5320057012050001
Q-0015RMQR
22
Q-0015SUY5 5320051204050001
23
Q-0015PMPE 5320052010050002
24
Q-0015QQRH 5320052010050001
25 NIK MASALAH 5320011602060001
26
Z-000ELTQR 5320055105460001
5320021512960001
27
Q-001TVPAO
28 5320051104060002
Q-001NURHJ
29 5320012403050001
P-QORJUGLL
30 5320050107650001
Q-001IW7X4
31 P-QPX6PGWJ 5320050310740001
32 537132606870007
Q-001H7Y0D
33 NIK MASALAH 5320051609040001
34 5320011004050001
P-QR4JQZCD
35 P-QRNPAWIB 5320054505050001
36 P-QT3S3OOE 5320011605900002
37 P-PAVWXM2C 5320050612640002
38 5320055712490001
39 5320050510550001
40 5320050702550001
41 5320050304480001
42 5320054310460001
43 5320054404500001
44 5320051309600001
45 5320051109300001
46 5320055504680001
47 5320052606750001
48 5320055303680001
49 5320056505860001
50 5320052803720001
51 5320051703720001
52 5320055702920001
53 5320057011830001
54 5320034102700001
55 5320056302030001
56
5320055907390001
57 5320031405990001
58 5320055403020001
59 5320050507920001
60 5320057010960001
61 5320050301970001
62 5320052704980001
63 5320056710650001
64 5320054701620001
65 5320050607940002
66 5320050104690001
67 5320051112000001
68 532005010020001
69 5320051111670001
70 5320050603980002
71 5320056704710001
72 5320055302750001
73 5320056412700001
74 5320053010030001
75 5320055107670001
76 5320050302770001
77 5320051708920001
78 5311013108840008
79 5320054310570001
80 5320051510590002
81 5320050305310001
82 5320055008590001
83 5320055307470001
84 5320051507540001
85 5320052909570001
86 5320055003450001
87 5320055909600001
88 5320054510400001
89 5320055403610001
90 5320052707510001
91 5320054402580001
92 5320051306360001
93 5320056606050001
94 5320055005060001
95 5320054607030001
96 5320055911070001
97 5320055110050001
98 5320021512040002
99 53200525001090001
100 5320052510050002
101 5320050202050001
: Sabu Raijua
: 21/12/2021
Pekerjaan*
Jenis
Kelamin
BENYAMIN PUNGA L MASY UMUM
SITI MU'MINAH P MASY UMUM
ROSALIN NGADDA P LANSIA
P MASY UMUM
DEWI AFRIANITA DJAMI
MARTHA RATU DJAMI P MASY UMUM
NOLI BANGNGU P MASYARAKAT UMUM
LUKAS MAGE TIE L MASY UMUM
URBANUS NEGO L MASYARAKAT UMUM
ARNI ROHI DJAMI P MASYARAKAT UMUM
ELISADON ANIN L MASY UMUM
FRANS UDJU LOMI MASY UMUM
YULIUS MAGE TIE L MASY UMUM
YULIANA BALE BANE P MASY UMUM

JUBLINA DJO RATE P MASY UMUM
JONISON DIMA LENA L MASY UMUM
P MASY UMUM
ELISABETH DIRA
P
KATHARINA HEDO HARI LANSIA
WELEM UDJU LOMI L MASY UMUM
L REMAJA
DION ROLITA UDJU LOMI
MIGEL WATTI L REMAJA
CHRISTIN MERLIYANTI DJARA P

REMAJA
FLETUS A. DJAMI LENA L REMAJA
OPI OTNIEL DJARA L REMAJA
ONAN F. DJARA L REMAJA

VICKY IMANUEL RONNY L REMAJA
P LANSIA
ELISABET BANGNGU BIRE
L
YOHANIS KANA MANGNGI MASY UMUM
JUAN SEBASTIAN GA RATA L REMAJA
MATIUS DJAMI KORE L REMAJA
THOBIAS LUDJI DJARA L MASY UMUM
MIKAEL PARA RADE L MASY UMUM
DOMINIKUS WADU ERE L MASY UMUM
GENESTOP HAU L REMAJA
SEPRI ROHI HABA L REMAJA
JOSY PUTRI RIWU P REMAJA
YUSTON FREDRIK DJO TALO L MASY UMUM
BERNAD LOBO HABA L MASY UMUM

RAHEL HEKE P LANSIA
MARKUS WILA L LANSIA
RIHI LUDJI L LANSIA
DARA WENYI P LANSIA
MAMO KORE P LANSIA
MINA PAU P LANSIA
MARKUS ARA DIMU L LANSIA
BUNGA KAHI P LANSIA
KAHI LOMI P MASY UMUM
LAKI HURU L MASY UMUM
PIKA RIHO P MASY UMUM
MOKO HAKKU P MASY UMUM
BOLE KADJA P MASY UMUM
PETRUS LUDJI L MASY UMUM
FEBI MARIANA HEKE P MASY UMUM
MIMA WADU P MASY UMUM
BENDELINA KALE TE P MASY UMUM
DIMA DARA P MASY UMUM
MARTA KOLI PUI P LANSIA
KITA NGAHU L MASY UMUM
DULE RIHI L MASY UMUM
MIGU RIHI L MASY UMUM
MARIANA RIWU P MASY UMUM
KALE RATU L MASY UMUM

NATAN UNTUNG KRISTIAN LEO KITU L MASY UMUM
BUI DIMU L MASY UMUM
LUHA LADO L MASY UMUM
YOHANES DULE HAKKU L MASY UMUM
RIWU LAU L MASY UMUM
WILA UDJU L MASY UMUM
ESTER ENJELINA DJAMI P MASY UMUM
LUKAS PAGA L MASY UMUM
PAULUS PAU HAKKU L MASY UMUM
TERSIANA RADJA HEKE P MASY UMUM
NISRI ULY L MASY UMUM
DELVIA KORE GEWA P MASY UMUM
ARIANTO DJARA BALE L MASY UMUM
MAMO LUDJI P MASY UMUM
ZEDKAM PUTI L MASY UMUM
LIMA DJARA L MASY UMUM
AGUSTINUS TOGE MANU L MASY UMUM
WENYI DIMA P LANSIA
RIHI BANGNGU L LANSIA
IE LULU L LANSIA
WENYI GAE P LANSIA
LINE KADO L LANSIA
LAMBERTUS DJAWA L LANSIA
ALBERTH DJAMI L LANSIA
LUISA WIE LAWA P LANSIA

DORKAS HAKKU P LANSIA
GA BALE P LANSIA
TIGE LUDJI L LANSIA
LORENTIUS MITA MANGNGI L LANSIA
MARIANA KALE P LANSIA
LOBO PAU L LANSIA
MARIA MARTHAVIANA HEKE P REMAJA
MELANI PUTRI LUDJI P REMAJA
TADA UJU L REMAJA
NOVANTI LEO KITU P REMAJA
VERONIKA ENGGELINA KAHO HAMU P REMAJA
PATRI YANTO LOMI KAHO L REMAJA
JEFLANDI LOBO L REMAJA
ANDREAN JOFIRTSON LOBO L REMAJA
LAMBERTUS LULU LEO L REMAJA

Umur
Tanggal Lahir (18 sd ≥ 60 Kelompok Umur Alamat
tahun)
6/21/1972 49 MATEI
1/1/1985 36 MATEI
11/13/1950 71 MATEI
4/9/2002 21 18-30 DESA EILODE
3/3/1984 39 31-45 DESA EILODE
5/9/1988 33 31-45 DESA EIMAU
3/5/1979 44 31-45 DESA EILODE
9/24/1993 28 DESA EILODE
2/22/1995 26 DESA TADA
5/17/1983 40 31-45 DESA EILODE
2/13/2002 19 DESA TADA
7/18/1987 36 31-45 DESA EILODE
11-Jan-71 52 46-59 DESA EILODE

7/29/1979 43 31-45 DESA EILODE
6/5/1989 32 31-45 DESA LOBOAJU
53 DESA LOBOAJU
6/5/1968
65 DESA RAENYALE
10/18/1956
56 46-59 DESA TADA
2/12/1965
15 12-17 DESA TADA
10/25/2006
3/5/2005 16 DESA LOBOAJU
16
12/30/2005 EIMADAKE
4/12/2005 16 LOBOAJU
10/20/2005 16 EIMADAKE
10/20/2005 16 EIMADAKE
2/16/2006 15 RAEKORE
12/6/1942 79 EIMADAKE
25
12/15/1996 DESA TADA
4/11/2006 17 12-17 DESA TADA
1/31/2005 16 12-17 RAEKORE
7/1/1965 58 46-59 DESA EILODE
10/3/1974 47 46-59 DESA EIMADAKE
6/26/1987 36 31-45 DESA LOBOADJU
9/16/2004 17 DESA TADA
4/10/2005 16 RAEKORE
5/5/2005 16 EIMADAKE
5/16/1990 31 DEPE
12/12/1969 52 JIWUWU
12/17/1949 73 60-150 DESA JIWUWU
10/5/1955 67 60-150 DESA JIWUWU
2/7/1955 68 60-150 DESA JIWUWU
4/3/1948 75 60-150 DESA JIWUWU
10/3/1946 76 60-150 DESA JIWUWU
4/4/1950 73 60-150 DESA JIWUWU
9/13/1960 62 60-150 DESA JIWUWU
9/19/1930 92 60-150 DESA JIWUWU
4/15/1968 55 46-59 DESA JIWUWU
6/26/1975 48 46-59 DESA JIWUWU
3/13/1968 55 46-59 DESA JIWUWU
5/25/1986 37 31-45 DESA JIWUWU
3/28/1972 51 46-59 DESA JIWUWU
3/17/1972 51 46-59 DESA JIWUWU
2/17/1992 31 31-45 DESA JIWUWU
11/30/1983 39 31-45 DESA JIWUWU
2/1/1970 53 46-59 DESA JIWUWU
2/23/2003 20 18-30 DESA JIWUWU
1939-07-19 82 DESA JIWUWU
5/14/1999 24 18-30 DESA JIWUWU
3/14/2002 21 18-30 DESA JIWUWU
7/5/1992 31 31-45 DESA JIWUWU
10/30/1998 24 18-30 DESA JIWUWU
3/5/1999 24 18-30 DESA JIWUWU

12/17/2003 19 18-30 DESA JIWUWU
10/27/1965 57 46-59 DESA JIWUWU
1/7/1962 61 60-150 DESA JIWUWU
2/1/1996 27 18-30 DESA JIWUWU
4/1/1969 54 46-59 DESA JIWUWU
5/20/2002 21 18-30 DESA JIWUWU
10/22/2002 20 18-30 DESA JIWUWU
11/11/1967 55 46-59 DESA JIWUWU
3/6/1998 25 18-30 DESA JIWUWU
4/27/1971 52 46-59 DESA JIWUWU
2/13/1975 48 46-59 DESA JIWUWU
12/24/1970 52 46-59 DESA JIWUWU
11/9/2003 19 18-30 DESA JIWUWU
7/11/1967 56 46-59 DESA JIWUWU
2/3/1977 46 46-59 DESA JIWUWU
8/17/1992 30 18-30 DESA JIWUWU
8/31/1984 38 31-45 DESA JIWUWU
10/3/1957 65 60-150 DESA JIWUWU
10/15/1959 63 60-150 DESA JIWUWU
5/3/1931 92 60-150 DESA JIWUWU
8/10/1959 63 60-150 DESA JIWUWU
7/13/1947 76 60-150 DESA JIWUWU
7/15/1943 80 60-150 DESA JIWUWU
9/29/1957 65 60-150 DESA JIWUWU
3/10/1945 78 60-150 DESA JIWUWU

9/19/1960 62 60-150 DESA JIWUWU
10/5/1940 82 60-150 DESA JIWUWU
3/14/1961 62 60-150 DESA JIWUWU
7/27/1951 71 60-150 DESA JIWUWU
6/25/1957 66 60-150 DESA JIWUWU
6/13/1936 87 60-150 DESA JIWUWU
10/26/2005 17 12-17 DESA JIWUWU
5/10/2006 17 12-17 DESA JIWUWU
7/5/2005 18 18-30 DESA JIWUWU
11/19/2007 15 12-17 DESA JIWUWU
11/25/2005 17 12-17 DESA JIWUWU
12/15/2004 18 18-30 DESA JIWUWU
1/25/2009 14 12-17 DESA JIWUWU
10/20/2005 17 12-17 DESA JIWUWU
2/2/2005 18 18-30 DESA JIWUWU

ASI COVID-19
NASI
Kepesertaan BPJS (tulis 'Ya' pada kolom

yang sesuai)
No. Hp Tanggal Screening
BPJS Non
BPJS PBI Non Anggota
PBI
085253755644 10/19/2021
085337307935 10/19/2021
085239004410 10/19/2021
82359403499 10/26/2021
81338885203 10/26/2021
081246802904 12/21/2021
081338885203 10/26/2021
081239615616 12/21/2021
085333831409 12/21/2021
081236619244 10/26/2021
081353891200 9/23/2021
085236047147 10/26/2021
085339928700 10/26/2021
081246266215 10/26/2021
085239107090 12/21/2021
12/21/2021
085239107090
12/21/2021
081236225535
085204425345 11/23/2021
82147310614 11/23/2021
082145560919
7/16/2021
082342724424 9/29/2021
081337457868 9/29/2021
085337339641 9/29/2021
085337339641 9/29/2021
082147310614 12/21/2021
085330861435 11/6/2021
082144820070 11/23/2021
11/6/2021
85338856312
081239558712 12/21/2021
082144620982 10/26/2021
082236316819 12/21/2021
81238732823 10/22/2021
081239558712 12/21/2021
082236337164 12/21/2021
082852834696 12/21/2021
082237589851 12/21/2021
082359403509 12/21/2021
082144023169 12/21/2021
082144023169 12/21/2021
081239475815 12/21/2021
082144859686 12/21/2021
082144859686 12/21/2021
082144974741 12/21/2021
082340264693 12/21/2021
081239476576 12/21/2021
082339469978 12/21/2021
081239232570 12/21/2021
082144974741 12/21/2021
081234604879 12/21/2021
082189446307 12/21/2021
081337975602 12/21/2021
082340264693 12/21/2021
082144974741 12/21/2021
082235800032 12/21/2021
082216880165 12/21/2021
082235800032 18-Oct-21
082144942567 8/5/2021
082312427018 12/21/2021
081339224017 12/21/2021
081339751161 12/21/2021
081339751161 12/21/2021
082146679871 12/21/2021
082341274364 12/21/2021
082341274364 12/21/2021
082341274364 12/21/2021
082341274364 12/21/2021
082359324845 12/21/2021
082341274364 12/21/2021
082341274364 12/21/2021
082359403509 12/21/2021
082359403509 12/21/2021
082341274364 12/21/2021
082359403509 12/21/2021
081398750526 12/21/2021
085339273279 12/21/2021
081237854220 12/21/2021
082341274364 12/21/2021
082359403509 12/21/2021
081246026377 12/21/2021
082235800032 12/21/2021
082144859686 12/21/2021
082235800032 12/21/2021
082341274364 12/21/2021
082341274364 12/21/2021
081335680359 12/21/2021
085339273279 12/21/2021
082341274364 12/21/2021
082145355967 12/21/2021
082359403509 12/21/2021
082340258049 12/21/2021
081222505251 12/21/2021
082359403509 12/21/2021
081338496116 12/21/2021
081239475815 12/21/2021
081239232570 12/21/2021
082236537109 12/21/2021
085339273279 12/21/2021
081353295482 12/21/2021
081338228245 12/21/2021
081338228245 12/21/2021
081239422703 12/21/2021
Dosis I
Nama/Jenis/Merek Vaksin***
Tanggal Pemberian
No. Batch
Vaksinasi
ASTRA ZENECA 10/19/2021 210155
ASTRA ZENECA 10/19/2021 210155
ASTRA ZENECA 10/19/2021 210155
ASTRAZENECA 10/26/2021 210155
ASTRAZENECA 10/26/2021 210155
ASTRAZENECA 12/21/2021
A1087
ASTRAZENECA 10/26/2021 210155
A1087
A1087
ASTRAZENECA 10/26/2021 210155
ASTRAZENECA
9/23/2021 AZD005A
ASTRAZENECA 10/26/2021 210155
ASTRAZENECA 10/26/2021 210155

ASTRAZENECA 10/26/2021 210155
A1087
A1087
VAKSIN COVID19 BIOFARMA 12/21/2021
24203421
VAKSIN COVID19 BIOFARMA 11/23/2021 24200721
VAKSIN COVID19 BIOFARMA 11/23/2021 202108175F
VAKSIN COVID19 BIOFARMA

7/16/2021 24003121
VAKSIN COVID 19 BIOFARMA 9/29/2021 202108167I
VAKSIN COVID 19 BIOFARMA

12/21/2021
24203421
11/6/2021
202108122H
11/6/2021
202108122H
12/21/2021
24203421
10/26/2021 210155
12/21/2021
24203421
12/21/2021
24203421
12/21/2021
24203421
12/21/2021
24203421
12/21/2021
24203421
A1087
ASTRAZENECA 12/21/2021 A1087
ASTRAZENECA 10/18/2021 210155
ASTRAZENECA
12/21/2021 24203421
12/21/2021 24203421
12/21/2021 24203421
12/21/2021 24203421
12/21/2021 24203421
12/21/2021 24203421
12/21/2021 24203421
12/21/2021 24203421
12/21/2021 24203421
12/21/2021 24203421
12/21/2021 24203421
12/21/2021 24203421
12/21/2021 24203421
12/21/2021 24203421
12/21/2021 24203421
12/21/2021 24203421
12/21/2021 24203421
12/21/2021 24203421
12/21/2021 24203421
12/21/2021 24203421
12/21/2021 24203421
12/21/2021 24203421
12/21/2021 24203421
12/21/2021 24203421
12/21/2021 24203421
VAKSIN COVID 19 BIOFARMA 12/21/2021 24203421
Dosis 2
Tanggal Pemberian
No. Serial No. Batch
Vaksinasi
02889498682509 12/21/2021
A1087
02889498682509 12/21/2021
A1087
02889498682509 12/21/2021
A1087
12/21/2021
A1087
12/21/2021
A1087
10000006783625
12/21/2021
A1087
10000006783625
10000006783625
12/21/2021
A1087
12/21/2021
A1087
12/21/2021
A1087
12/21/2021
A1087
12/21/2021
A1087
10000006783625
10000006783625
16306347632131
16322913899004 12/21/2021
24203421
16322913899004 12/21/2021
24203421
12/21/2021
24203421
16309332221288
12/21/2021
24203421
16309339722882
12/21/2021
24203421
16309339722882
12/21/2021
24203421
16309339722882
12/21/2021
24203421
16306347632131
12/21/2021
24203421
16322913899004 12/21/2021
24203421
16298092626190
12/21/2021
24203421
16306347632131
12/21/2021
24203421
16306347632131
16319520957886 12/21/2021
24203421
16306347632131
16306347632131
16306347632131
16306347632131
10000006783625
10000006783625
10000006783625
10000006783625
10000006783625
10000006783625
10000006783625
10000006783625
10000006783625
10000006783625
10000006783625
10000006783625
10000006783625
10000006783625
10000006783625
10000006783625
10000006783625
10000006783625
10000006783625
02889498682509 12/21/2021 A1087
12/21/2021 A1087
16306367296493
16306367296493
16306367296493
16306367296493
16306367296493
16306367296493
16306367296493
16306367296493
16306367296493
16306367296493
16306367296493
16306367296493
16306367296493
16306367296493
16306367296493
16306367296493
16306367296493
16306367296493
16306367296493
16306367296493
16306367296493
16306367296493
16306367296493
16306367296493
16306367296493
16306367296493
16306367296493
16306367296493
16306367296493
16306367296493
16306367296493
16306367296493
16306367296493
16306367296493
16306367296493
16306367296493
16306367296493
16306367296493
16306367296493
16306367296493
16306367296493
16306367296493
16306367296493
16306367296493
Keterangan
Diberikan/Lanjut)
No. Serial
10000006783625 SELESAI MATEI
10000006783625 SELESAI DESA EILODE
LANJUT DESA EIMAU
LANJUT DESA EILODE
LANJUT DESA TADA
10000006783625 SELESAI DESA TADA

LANJUT DESA LOBOAJU
LANJUT DESA LOBOAJU
LANJUT DESA RAENYALE
16306347632131 SELESAI DESA LOBOAJU
16306347632131 SELESAI SMA N 1 SATENG
LANJUT SMA N 1 SATENG
16306347632131 SELESAI DESA EIMADAKE
16306347632131 SELESAI DESA LOBOADJU
LANJUT DESA TADA
LANJUT DESA RAEKORE
LANJUT DESA DEPE
LANJUT DESA JIWUWU

LANJUT DESA JIWUWU
LANJUT DESA JIWUWU
LANJUT DESA JIWUWU
LANJUT DESA JIWUWU
LANJUT DESA JIWUWU
LANJUT DESA JIWUWU
LANJUT DESA JIWUWU
LANJUT DESA JIWUWU
LANJUT DESA JIWUWU
LANJUT DESA JIWUWU
LANJUT DESA JIWUWU
LANJUT DESA JIWUWU
LANJUT DESA JIWUWU
LANJUT DESA JIWUWU
LANJUT DESA JIWUWU
LANJUT DESA JIWUWU
LANJUT DESA JIWUWU
LANJUT DESA JIWUWU
10000006783625 SELESAI DESA JIWUWU
LANJUT DESA JIWUWU
LANJUT DESA JIWUWU
LANJUT DESA JIWUWU
LANJUT DESA JIWUWU

LANJUT DESA JIWUWU
LANJUT DESA JIWUWU
LANJUT DESA JIWUWU
LANJUT DESA JIWUWU
LANJUT DESA JIWUWU
LANJUT DESA JIWUWU
LANJUT DESA JIWUWU
LANJUT DESA JIWUWU
LANJUT DESA JIWUWU
LANJUT DESA JIWUWU
LANJUT DESA JIWUWU
LANJUT DESA JIWUWU
LANJUT DESA JIWUWU
LANJUT DESA JIWUWU
LANJUT DESA JIWUWU
LANJUT DESA JIWUWU
LANJUT DESA JIWUWU
LANJUT DESA JIWUWU
LANJUT DESA JIWUWU
LANJUT DESA JIWUWU
LANJUT DESA JIWUWU
LANJUT DESA JIWUWU
LANJUT DESA JIWUWU
LANJUT DESA JIWUWU
LANJUT DESA JIWUWU

LANJUT DESA JIWUWU
LANJUT DESA JIWUWU
LANJUT DESA JIWUWU
LANJUT DESA JIWUWU
LANJUT DESA JIWUWU
LANJUT DESA JIWUWU
LANJUT DESA JIWUWU
LANJUT DESA JIWUWU
LANJUT DESA JIWUWU
LANJUT DESA JIWUWU
LANJUT DESA JIWUWU
LANJUT DESA JIWUWU
LANJUT DESA JIWUWU
LANJUT DESA JIWUWU
LANJUT DESA JIWUWU

Kabupaten/Kota
Provinsi
Hari, Tanggal
No No. Tiket NIK
1 P-Q4BTVDB0 5320050802050002
2 P-Q6WSEAW4 5320050908990001
3 P-Q76VJON6 5320055109920001
4
5320052409970001
5 5320053110010004
6 5320051202070001
Q-0011ORRS
7 5320014209010002
8 5320054702070001
9 5320050107060003
10 5320056511030001
11 5320034909940001
12 5320051604820001
13 5320055204640001
14 5320051508770001
15 5320054109030001
16 5320050212960001
17 53200325002000003
18 5320055310030001
19 5320054102520001
20 5320055604940001
21 5320056406830001
22 5320053105060001
23 5320020206060004
24 5320051501840001
25 P-QIABRZC2 5320050709810001
26 5320050207450001
5320052505950002
27
28 5320054808630001
29 5320054512830001
30 5320057003980001
31 5320050302900001
32 5320052805930001
: Sabu Raijua
: 20/12/2021
Pekerjaan*
Jenis
Kelamin
HERIBERTUS TUKA L REMAJA
DIAN SRILANY HAE P MASY UMUM
INA DEWINDRA YANTI HAE P MASY UMUM
L MASY UMUM
JIBRAEL LADO GA
MARTHEN LEO L MASY UMUM
STEFEN PUTRA LENA NGURU L REMAJA
WELMINA NARA P MASY UMUM
FEBI GA RATA P REMAJA
JESIKA SUSANTI GA RATA P

REMAJA
ESTYN KANA MANGNGI P
REMAJA
DAMAYANTI LAURIN DJITA P MASY UMUM
EFRAIM PARA RADE L MASY UMUM
DAMARIS WAKE LULU P MASY UMUM

LEXI DOKO L MASY UMUM
SELFINA DIMA LENA P MASY UMUM
DERIDUS LENA DJILA L MASY UMUM
LAMBERTUS DJAMI HAU L MASY UMUM
CHELSEA GRACHIA DESFRIDA MATA T P MASY UMUM
WELMINCE HAU P LANSIA
ERLIN KANA MANGNGI P MASY UMUM
LISA LULU WADU P MASY UMUM
SPRIANUS DEHE DJIMO L REMAJA
HAKKU LANGO L REMAJA
DOMINGGUS LOBO L MASY UMUM
DONISIUS WEO L PELAYAN PUBLIK
HERMAN UDJU LOMI L LANSIA
MELKI UDJU LOMI L MASYARAKAT UMUM
BENIAS UDJU LOMI L MASYARAKAT UMUM
NAOMI UDJU LOMI P MASYARAKAT UMUM
MARIANA UDJU LOMI P MASYARAKAT UMUM
FERDIK UDJU LOMI L MASYARAKAT UMUM
MEFI UDJU LOMI L MASYARAKAT UMUM

Umur
tahun)
2005-02-08 16 DESA EIMAU
2000-12-09 21 DESA MATEI
9/11/1992 29 DESA MATEI
24 DESA EILODE
9/24/1997
2/12/2007 14 12-17 DESA LOBOADJU
9/2/2000 20 DELO
2/7/2007 16 12-17 TADA
6/1/2005 16 TADA
15
6/25/2006 MATEI
9/9/1994 28 18-30 DESA MATEI
4/16/1982 41 31-45 DESA EIMADAKE
12/4/1964 58 46-59 DESA EIMADAKE

8/15/1977 45 31-45 DESA BEBAE
9/1/2003 19 18-30 DESA LOBOADJU
12/2/1997 25 18-30 DESA MATEI
2/25/2000 23 18-30 DESA LOBOADJU
10/13/2003 19 18-30 DESA EIMAU
2/1/1952 71 60-150 MATEI
4/16/1994 29 18-30 MATEI
6/24/1983 40 31-45 MATEI
5/31/2006 17 12-17 DESA EIMAU
6/2/2006 17 12-17 DESA EIMAU
1/15/1984 39 31-45 DESA LOBOADJU
9/7/1981 41 31-45 LOBOADJU
7/2/1945 78 60-150 MATEI
5/25/1995 28 18-30 MATEI
8/8/1963 59 46-59 MATEI
12/5/1983 39 31-45 MATEI
3/30/1998 25 18-30 MATEI
2/3/1990 33 31-45 MATEI
5/28/1993 30 18-30 MATEI

ASI COVID-19
NASI

yang sesuai)
BPJS Non
PBI
081338950117 12/20/2021
081239149097 12/20/2021
082310997378 12/20/2021
12/20/2021
081337180748
081238496094 12/20/2021
85333928496 9/22/2021
082236190418 9/16/2021
81239421998 10/15/2021
9/29/2021
081237421998
082342724424 9/29/2021
082144857356 12/20/2021
081338787985 12/20/2021
085337873445 12/20/2021
85338856076 12/20/2021
85348209650 12/20/2021
082237247158 12/20/2021
081339226165 12/20/2021
081337586960 12/20/2021
081218966930 10/19/2021
081342010338 10/19/2021
081384057648 10/19/2021
082159356758 12/20/2021
082247103473 12/20/2021
085337349716 12/20/2021
082 144 974 953 6/29/2021
085238375065 11/15/2021
082340375288 11/15/2021
085238375065 11/15/2021
085238325065 11/15/2021
085238375065 11/15/2021
085238375065 11/15/2021
082340375288 11/15/2021
Dosis I
Tanggal Pemberian
No. Batch
Vaksinasi
VAKSIN COVID19 BIOFARMA 9/22/2021 202108160I
VAKSIN COVID PT BIOFARMA 9/16/2021 24004821
VAKSIN COVID PT BIOFARMA 10/15/2021 202108119H

ASTRA ZENECA 12/20/2021 24203421
ASTRA ZENECA 12/20/2021 24203421
ASTRA ZENECA 12/20/2021 24203421

ASTRA ZENECA 12/20/2021 24203421
ASTRA ZENECA 12/20/2021 24203421
ASTRA ZENECA 12/20/2021 24203421
ASTRA ZENECA 12/20/2021 24203421
ASTRA ZENECA 12/20/2021 24203421
ASTRA ZENECA 10/19/2021 210155
ASTRA ZENECA 10/19/2021 210155
ASTRA ZENECA 10/19/2021 210155
VAKSIN COVID BIOFARMA 12/20/2021 24203421
CORONAVAC 6/29/2021 24200721
VAKSIN COVID BIOFARMA 11/15/2021 202108167I

Dosis 2
Tanggal Pemberian
Vaksinasi
16311457454681
16311457454681
16311457454681
16311457454681
16311457454681
16301222848738 12/20/2021
24203421
16254562262696 12/20/2021
24203421
16295072867328 12/20/2021
24203421
16309339722882
12/20/2021
24203421
16309332221288
12/20/2021
24203421
16306367296493
16306367296493
16306367296493
16306367296493
16306367296493
16306367296493
16306367296493
16306367296493
02889498682509 12/20/2021 A1087
02889498682509 12/20/2021 A1087
02889498682509 12/20/2021 A1087
16306367296493
16306367296493
16306367296493
16221717765576 12/20/2021 24203421
16309339725384 12/20/2021 24203421
16309339725384 12/20/2021 24203421
16309339725384 12/20/2021 24203421
16309339725384 12/20/2021 24203421
16309339725384 12/20/2021 24203421
16309339725384 12/20/2021 24203421
16309339725384 12/20/2021 24203421

Keterangan
Diberikan/Lanjut)
No. Serial
LANJUT DESA MATEI
LANJUT DESA MATEI
LANJUT DESA EILODE
LANJUT DESA EILODE
LANJUT DESA MATEI

LANJUT DESA BEBAE
LANJUT DESA LOBOADJU
LANJUT DESA MATEI
LANJUT DESA EIMAU
LANJUT SMA SATENG
LANJUT SMA SATENG
16306367296493 SELESAI PANWASLU DESA LOBOAJU
16306367296493 SELESAI DESA MATEI

Kabupaten/Kota
Provinsi
Hari, Tanggal
No No. Tiket NIK
1 P-EI8URXF9 5320054207040001
2 P-FBDET6SE 5320055707040002
3 P-RPJ44WFF 5371046506880007
4 P-EUWPIXU5
5320054711070001
5 P-GHMXKLIX 5320052303020001
6 P-GTDOHNCG
5320051312030003
7 5320056910040002
Q-0015RNT4
8 P-K1TLJGAB 5320050504030002
9 P-KJVXRBLZ 5320052504830001
10 S-83C1758B 5320054507470001
11 Z-000E4R3V
5320052011700001
12 P-PKCXTXEI 5320052310800001
13 P-86KWKL8Z 5320051205000001
14 P-2W3CO6HL 5320050908060002
15 Q-001SHZL4 5320052605050001
16 5320055408050002
P-T4PGGIVT
17 P-5ABVAIID 5320052903050003
18 5305011307010001
Q-0012HNZO
19 Y-000052KN 5320054503430001
20 NIK TDK TEMUKAN 5320051612080002
21 NIK TDK TEMUKAN 5320050806090001
5320054611090003
22
5320056010090001
23
5320052501060001
24
25 5320051508090001
26 5320050508340001
27 5320050908760001
28 5320062409060002
29 5320050305090001
30 5320056001090001
31 5320031408080001
32 5320030701090001
33 5320054507080001
34 5320051512090001
35 5320056611090001
36
5320055911090002
37 5320055807090003
38
5320056601050001
39 5320056305070002
40 5320021707080001
41 5320050309770001
42 5320054105890004
43 5320051911890001
44 5320032610950001
45 5301061307030001
46 5320051111030001
47 532005152020001
48 5320056506060001
49 5320055006670001
50 5320053011650001
51 5320052503920001
52 532005500560003
53 5320055504880001
54 5320050305860001
55 5320054712870001
56 5320054205820001
57 5320055512710001
58 5320055511010002
59 5320056908990001
60 5320052404820001
61 5320050211870001
62 5371041703890002
63 5320050211020001
64 5320050403000003
65 5320050806030001
66 5320034706000001
67 5320052907830001
68 5320055303940001
69 5320050910790001
70 5320052508570001
71 5320022104540001
72 5320024709450002
73 5320056503560001
74 5320054205460001
75 5320051007610001
76 5320051211420001
: Sabu Raijua
: 17/12/2021
Pekerjaan*
Jenis
Kelamin
RUT ARIANTI RIWU P REMAJA
JESIKA WADU P REMAJA
MARGARET ENGGELINA MENGNGI ULY P MASY UMUM
P REMAJA
YOVITA MONICHA KAHA
HERMENSEN MARTEN DOKO L MASY UMUM
L MASY UMUM
SABDERS IMANUEL LEO DJULA
ERLIN KURNIA ROSITA LUDJI P

REMAJA
ALPIUS MIHA BALO L MASY UMUM
DOMINGGUS DOKO L MASY UMUM
ANA HENDERINA DURI P LANSIA
PELAYAN PUBLIK
SAMTRISNO LADO DJO L
OKI HESBER DJU L MASY UMUM
LAMBERTUS DJARA MANNO L MASY UMUM

PAULUS BALE WAADU L REMAJA
HENDRIK KRISTIAN YOHANIS L REMAJA
MEGI ANASTASIA LEO P REMAJA
MARTHEN IMANUEL DALA BALO L REMAJA
SANDI MUSKANAN L MASY UMUM
TADA TENGA P LANSIA
BRIAN MIHA BALO L REMAJA
JEMS MIHA BALO L REMAJA
FANISYAH PRISTIANI UDJU EDO L REMAJA
NENCI LONVIN HAE P REMAJA
AKRISI VIKTOR IMANUEL L REMAJA
STEFEN KANA MANGNGI L REMAJA
NATANIEL DJARA ROHI L LANSIA
PETRUS LENA BANGNGU L MASY UMUM
MELDISON L RADJA L REMAJA
YEDIJA ABIANTO LAY RADJA L REMAJA
PRETI ENJEL KALE PAO P REMAJA
ANDRI FANTRYO ROPA BALE L REMAJA
DESMON ADU L REMAJA
MARSYAH ARYANTI DJO HEGI P REMAJA
MELSEN ADY PUTRA KORE BANGNGU L REMAJA
NOVITA LODO P REMAJA
L REMAJA
NIKY TRISAPUTRI RIWU
L REMAJA
FANI ULY REKE
REMAJA
FITRI NIALDI KALE UKE P
CAHAYA PUTRA HAU L REMAJA
ESTON RIWU L REMAJA
DAUD KALE UKE L MASY UMUM
AMELIA LEBA LUDJI P MASY UMUM
WELSEB NOPER TULU WANYNYI L MASY UMUM
IMANUEL DJARA HAU L MASY UMUM
DAFID ANDRISON TARI L MASY UMUM
RONAL DJARA HADJO L MASY UMUM
ARCHY DESTA MIHA BALO L MASY UMUM
RINO S KANA MANGNGI L MASY UMUM
PETRONELA DJARA BANGNGU P MASY UMUM
TOMAS TARI L MASY UMUM
EVERSON KANA MANGNGI L MASY UMUM
LUISA HERE HIA P LANSIA
DINA MARIANA HABA GEA P PELAYAN PUBLIK
MALEAKI DJO HEGI L PELAYAN PUBLIK
ADELVIA SINSILIA NARA P MASY UMUM
KORLINA KALE DJARA P MASY UMUM
TERSIA RIWU DJETA P MASY UMUM
NOFRI YANTI KALE UKE P MASY UMUM
LAFRIANA KALE UKE P MASY UMUM
KAREL OLIMPIANUS HAE L MASY UMUM
THOMAS LUDJI LINGU L MASY UMUM

MOSES RIHI HAU L MASY UMUM
IVAN HARSAB DUNOV KANA MANGNGIL MASY UMUM
NIKSON RIVANDO LODO L MASY UMUM
MELKI KRISYANTO LODO L MASY UMUM
LIDIA MONE KE P MASY UMUM
HERYANTO DJO HEGI L MASY UMUM
LENI MARNITA LENA DJILA P MASY UMUM
MIN WAKE LULU L MASY UMUM
LEONARD ULY REKE L LANSIA
NARA HADI L LANSIA
MARIAM HIGA HUKI P LANSIA
RAHEL UDJU EDO P LANSIA
MODJO ROHI L LANSIA
PETRUS DIMU LUDJI L LANSIA
ISAK DJARI L LANSIA

Umur
tahun)
7/2/2004 17 DESA EIMADAKE
1988-06-25 33 DESA TADA
14 DESA LOBOAJU
2007-11-07
2002-03-23 19 DESA BEBAE
18 DESA EIMADAKE
12/13/2003
10/29/2004 16 TADA
: 2003-04-05 18 DESA EIMADAKE
11/20/1970 51 DESA MATEI

1980-10-23 41 DESA EIMADAKE

8/9/2006 15 DESA JIWUWU
5/26/2005 18 18-30 DESA MATEI
8/14/2005 16 DESA BEBAE
6/13/2001 20 KEL. MANUTAPEN
11/6/2021 12 MATEI
12-17
10/20/2009 12 MATEI
12-17
1/25/2006 16 MATEI
12-17
8/15/2009 12 12-17 TADA
8/5/1934 88 60-150 DESA MATEI
8/9/1976 46 46-59 DESA MATEI
9/24/2006 16 12-17 DESA TADA
5/30/2009 14 12-17 DESA TADA
1/20/2009 14 12-17 DESA TADA
8/14/2008 14 12-17 DESA TADA
12/7/2009 13 12-17 DESA LOBODEI
6/21/2008 15 12-17 DESA MATEI
12/15/2009 13 12-17 DESA MATEI
11/26/2009 13 12-17 DESA MATEI
13 12-17 DESA MATEI

11/19/2009
7/16/2009 14 12-17 DESA MATEI
18 18-30
1/26/2005 DESA MATEI
5/23/2007 16 12-17 DESA TADA
7/17/2008 15 12-17 DESA BEBAE
9/3/1977 45 31-45 DESA MATEI
5/1/1989 34 31-45 DESA TADA
11/19/1989 33 31-45 DESA MATEI
10/26/1995 27 18-30 DESA BEBAE
7/13/2003 20 18-30 DESA EIADA
11/11/2000 22 18-30 DESA MATEI
12/15/2002 20 18-30 DESA MATEI
11/25/2003 19 18-30 DESA MATEI
6/10/1967 56 46-59 DESA BEBAE
11/30/1965 57 46-59 DESA BEBAE
3/25/1992 31 31-45 DESA MATEI
5/10/1956 67 60-150 DESA TADA
3/15/1988 35 31-45 DESA BEBAE
5/31/1986 35 31-45 DESA MATEI
12/7/1987 33 31-45 DESA MATEI
5/2/1982 39 31-45 DESA MATEI
12/15/1971 51 46-59 DESA MATEI
11/15/2001 21 18-30 DESA MATEI
8/29/1999 23 18-30 DESA MATEI
4/24/1982 41 31-45 DESA MATEI
10/22/1987 35 31-45 DESA TADA

4/7/1988 35 31-45 DESA MATEI
11/2/2002 20 18-30 DESA MATEI
3/4/2000 23 18-30 DESA MATEI
6/8/2003 20 18-30 DESA MATEI
7/6/2000 23 18-30 DESA BEBAE
7/29/1983 39 31-45 DESA MATEI
3/13/1994 29 18-30 DESA MATEI
10/9/1979 43 31-45 DESA MATEI
8/25/1957 65 60-150 DESA MATEI
4/21/1954 69 60-150 DESA MATEI
9/7/1945 77 60-150 DESA MATEI
2/13/1956 67 60-150 DESA MATEI
5/2/1946 77 60-150 DESA TADA
3/16/1957 66 60-150 DESA MATEI
11/12/1942 80 60-150 DESA BEBAE

ASI COVID-19
NASI

yang sesuai)
BPJS Non
PBI
082353161434 12/18/2021
081239423045 12/18/2021
082144830021 12/18/2021
12/18/2021
081339750973
081339435187 12/18/2021
12/18/2021
082147023909
9/29/2021
085238339842
082145842925 12/18/2021
082145842925 12/18/2021
085338294667 12/18/2021
081239605204 11/8/2021
082144653280 12/18/2021
081239596903 12/18/2021
081239942862 12/18/2021
85237621804 11/17/2021
081239555388 12/18/2021
081223293380 12/18/2021
081238931283
082158353680 12/18/2021
081237630418 12/18/2021
085283969101 12/18/2021
085339088918 11/16/2021
085339439512 11/16/2021
082145361507 11/16/2021
081338108011 9/21/2021
11/6/2021
85339080316
85338122146 7/2/2021
12/18/2021
085333012135
12/18/2021
085333012135
12/18/2021
081339866185
12/18/2021
085333831365
12/18/2021
085281934073
12/18/2021
085238862459
12/18/2021
082359095060
12/18/2021
085338371468
12/18/2021
82339911827
12/18/2021
81337066567
12/18/2021
081337494727
12/18/2021
081337722683
12/18/2021
081339220531
12/18/2021
082340374382
12/18/2021
085333012135
12/18/2021
081237829571
12/18/2021
081338885646
12/18/2021
081213790223
12/18/2021
082145687226
12/18/2021
081353362336
12/18/2021
085333539751
12/18/2021
085339080564
12/18/2021
085339080564
12/18/2021
085281934082
12/18/2021
085338855925
12/18/2021
085333060278
85253280290 9/21/2021
81338099115 9/21/2021
82147083821 9/21/2021
81377221165 11/17/2021
81337494727 12/18/2021
81337494727 12/18/2021
082247873276 12/18/2021
085213965516 12/18/2021
085338819756 12/18/2021
082359095787 12/18/2021
085333078389 12/18/2021
081337722849 12/18/2021
081358598230 12/18/2021
085238862459 12/18/2021
081246869450 12/18/2021
082145355182 12/18/2021
981337066567 12/18/2021
085338819756 12/18/2021
081338990465 12/18/2021
081338990465 12/18/2021
081342010338 12/18/2021
081342010338 12/18/2021
081358598230 12/18/2021
Dosis I
Tanggal Pemberian
No. Batch
Vaksinasi

202108122H

VAKSIN COVID BIOFARMA 11/17/2021 202108175F
VAKSIN COVID 19 BIOFARMA 11/16/2021 202108140H

11/6/2021
202108122H
CORONAVAC 7/2/2021 24200721

ASTRAZENECA 9/21/2021 PV46700
ASTRAZENECA 11/17/2021 ABZ9883


Dosis 2
Tanggal Pemberian
Vaksinasi
16311457345964
16311457345964
16311457345964
16311457345964
16311457345964
16311457345964
16309332221288
12/18/2021 24203421
16311457345964
16311457345964
16311457345964
12/18/2021 24203421
1631147345964
1631147345964
1631147345964
16322913899004 12/18/2021 24203421
1631147345964
1631147345964
12/18/2021 24203421
1631147345964
1631147345964
1631147345964
16319375256635 12/18/2021 24203421
16319375256635 12/18/2021 24203421
16319375256635 12/18/2021 24203421
12/18/2021 24203421
16301222846863
16298088677347 12/18/2021 24203421
12/18/2021 24203421
1622111549867
16306347632131
16306347632131
16306347632131
16306347632131
16306347632131
16306347632131
16306347632131
16306347632131
16306347632131
16306347632131
16306347632131
16306347632131
16306347632131
16306347632131
16306347632131
16306347632131
16306347632131
16306347632131
16306347632131
16306347632131
16306347632131
16306347632131
16306347632131
16306347632131
16306347632131
16306347632131
02639419435755 12/18/2021 A1087
02639419435755 12/18/2021 A1087
02639419435755 12/18/2021 A1087
08996318571300 12/18/2021 A1087
10000006781350
10000006781350
10000006781350
10000006781350
10000006781350
10000006781350
10000006781350
10000006781350
10000006781350
10000006781350
10000006781350
10000006781350
10000006781350
10000006781350
10000006781350
10000006781350
10000006781350
10000006781350
10000006781350
Keterangan
Diberikan/Lanjut)
No. Serial
LANJUT DESA TADA
LANJUT DESA LOBOAJU
LANJUT DESA BEBAE
16311457345964 SELESAI TADA
1631147345964 SELESAI
DESA MATEI
LANJUT DESA LOBOAJU

LANJUT DESA JIWUWU
LANJUT DESA BEBAE
1631147345964 SELESAI KEL. MANUTAPEN
LANJUT DESA LOBOAJU
16306347632131 SELESAI SMP 3 SATENG
16306347632131 SELESAI SMP 3 SATENG
16306347632131 SELESAI
SMPN 3 SATENG
16306347632131 SELESAI
DESA MATEI
16306347632131 SELESAI
DESA MATEI
LANJUT SMP 3 SATENG
LANJUT SMP 3 SATENG
LANJUT SMP 3 SATENG
LANJUT SMP 3 SATENG
LANJUT SMP 3 SATENG
LANJUT SMP 3 SATENG
LANJUT SMP 3 SATENG
LANJUT SMP 3 SATENG
LANJUT SMP 3 SATENG
LANJUT SMP 3 SATENG

LANJUT SMP 3 SATENG
LANJUT SMP 3 SATENG
LANJUT SMP 3 SATENG
LANJUT DESA MATEI
LANJUT DESA TADA
LANJUT DESA MATEI
LANJUT DESA BEBAE
LANJUT DESA EIADA
LANJUT DESA MATEI
LANJUT DESA MATEI
LANJUT DESA MATEI
LANJUT DESA BEBAE
LANJUT DESA BEBAE
LANJUT DESA MATEI
LANJUT DESA TADA
LANJUT DESA BEBAE
LANJUT DESA MATEI
LANJUT DESA MATEI
LANJUT DESA MATEI
LANJUT DESA TADA

LANJUT DESA MATEI
LANJUT DESA MATEI
LANJUT DESA MATEI
LANJUT DESA MATEI
LANJUT DESA BEBAE
LANJUT DESA MATEI
LANJUT DESA MATEI
LANJUT DESA MATEI
LANJUT DESA MATEI
LANJUT DESA MATEI
LANJUT DESA MATEI
LANJUT DESA MATEI
LANJUT DESA TADA
LANJUT DESA MATEI
LANJUT DESA BEBAE

LAPORAN REKAPITULASI HASIL
TINGKAT KABUPATEN
Kabupaten/Kota SABU RAIJUA

Provinsi NUSA TENGGARA TIMUR
PEMAKAIAN VAKSIN & LOGISTIK

VAKSIN
No Tanggal Bulan Pelaksanaan ASTRA ZENECA
DITERIMA DIPAKAI Rusak SISA
1 2 3 4 5
1 1-Dec-21 200 0 200
2 2-Dec-21 200 20 180
3 12/3/2021 0
4 12/4/2021 0
5 12/6/2021 180 40 140
6 7-Dec-21 0
7 8-Dec-21 140 10 130
8 9-Dec-21 130 10 120
9 10-Dec-21 420 140 280
10 11 Des 2021 280 10 270

11 13 DES 2021 270 110 160
12 14 DES 2021 160 70 90
13 15 DES 2021 390 150 240
14 16 DES 2021 240 70 170
15 17 DES 2021 170 60 110
16 18 DES 2021 110 20 90
17 20 DES 2021 690 10 680
18 21 DES 2021 680 40 640
22 DES 2021 640 10 630
23-Dec-21 630 20 610
24 DES 2021 610 10 600

JUMLAH 850 80 770
KAPITULASI HASIL PELAKSANAAN IMUNISASI COVID-19
UPATEN
Vaksin Covid-19 BF (Multi dose Vial) Moderna mRNA-1273

DITERIMA (dosis) DIPAKAI (dosis) Rusak SISA (dosis) DITERIMA (dosis) DIPAKAI (dosis) Rusak
6 7 8
300 40 260 14 0
260 200 60
260 0 260 14 14
0
460 170 290
290 90 200
200 50 150
150 90 60
360 90 270
270 70 200
200 50 150
150 50 100
800 20 780
780 60 720
720 10 710
710 40 670
670 20 650
2900 900 0 5530 28 14 0
ADS 0,5 ml
VAKSIN COVID 19 DUA DOSIS/VIAL
SISA (dosis) DITERIMA(DOSIS) DIPAKAI(DOSIS) RUSAK SISA(DOSIS) DITERIMA
9
14 78 2 0 76 643
76 6 70 600
70 6 64 574
0 568
0 64 12 52 564
52 6 46 499
46 8 38 493
38 18 20 475
20 2 18 947
18 14 4 613
4 2 2 494
2 2 0 320
748
492
347
233
1455
1423
1320
1300
1235
14 7538
SAFETY BOX ALCOHOL SWAB
DIPAKAI Rusak SISA DITERIMA DIPAKAI SISA DITERIMA DIPAKAI SISA
10 11 12 13 14 15 16 17
43 0 600 4 0 4 664 43 621
25 1 574 4 0 4 621 25 596
6 568 4 0 4 596 6 590
200 4 364 4 1 3 590 200 390
64 1 499 3 0 3 590 64 526
6 0 493 3 0 3 526 6 520
18 475 3 0 3 520 18 502
28 0 447 3 0 3 502 28 474
329 5 613 3 0 3 974 332 642
115 4 494 3 0 3 642 115 527

171 3 320 3 0 3 527 171 356
170 2 148 3 2 1 356 170 186
251 5 492 1 0 1 786 251 535
143 2 347 1 0 1 535 143 392
111 3 233 1 1 0 392 111 281
76 2 155 281 76 205
32 1423 10 0 10 1505 32 1473
101 2 1320 1473 101 1372
20 1300 1372 20 1352
63 2 1235 1352 63 1289
1204
31 1289 31 1258
1426 32 6822 41 3 49 7894 1429 14087
FORMAT REKAPITULASI HARIA
TINGKAT K
Kabupaten/Kota : Sabu Raijua

Provinsi : NTT
Hari, Tanggal Dec-21
Sasaran
Tahap 1 Tahap 2
Puskesmas/Fasyankes/
NO
Pos Vaksinasi
SDM Kesehatan Lansia
1 1-Dec-21 5
2 12/2/2021 1
3 12/3/2021
4 12/4/2021 30
5 12/6/2021 6 7
6 12/7/2021 3
7 12/8/2021 2
8 12/9/2021 4
9 12/10/2021 40
10 12/11/2021 2
11 12/13/2021 19
12 12/14/2021 22
13 12/15/2021 42
12/16/2021 23
12/17/2021 15
12/18/2021 11
20 DES 2021 2
21 DES 2021 26
22 DES 2021 3
23 des 2021 8
27 DES 2021 9
TOTAL 6 274
APITULASI HARIAN PELAKSANAAN VAKSINASI COVID-19
TINGKAT KABUPATEN/KOTA
Sasaran
Tahap 2 Tahap 3 Total Dosis I

(Semua Tahapan)
Masyarakat Rentan + Total Sasaran

Pelayan Publik Remaja
Umum
#
1 36 1 43 42
22 2 25 19
4 2 6 4
4 153 13 200 0
46 5 64 48
3 6 6
14 2 18 13
24 28 21
4 208 77 329 234
7 20 86 115 73
4 129 19 171 146
1 108 39 170 126
6 175 28 251 215
1 107 12 143 134
3 78 15 111 92
3 35 27 76 62
1 22 7 32 16
0 54 21 101 76
15 2 20 9
1 39 15 63 55
15 7 31 24
35 1307 25 362 119
Nakes
Dosis 1
0
OVID-19
Penerima Vaksin Dosis 1
Total Dosis I Tahap 1 Tahap 2

(Semua Tahapan)
SDM Kesehatan Lansia Pelayan Publik
% # % # % #
97.6744186 #DIV/0! 5 100 0

76 #DIV/0! 1 100
66.6666667 #DIV/0! #DIV/0!
0 #DIV/0! 0
75 0 7 100
100 #DIV/0! 3 100
72.2222222 1 50
75 0
71.1246201 29 72.5 2
2 100 7
18 94.73684211 3
16 72.72727273
39 92.85714286 4
19 82.60869565
14 93.33333333 2
10 90.90909091 1
23
8
6
32.8729282 0 0 17 6.204379562 0
Nakes Petugas pubik Lansia

Dosis 2 Dosis 3 Dosis 1 Dosis 2 Dosis 1 Dosis 2
0 6 0 5 17 30
Jumlah
Dosis 1 Dosis 2 Dosis 3
969 414 6
a Vaksin Dosis 1
Tahap 3 Total Dosis 2 Tahap 1

(Semua Tahapan)
Masyarakat Rentan +
Pelayan Publik Remaja SDM Kesehatan
Umum
% # % # % # % #
0 36 100 1 100 1 2.325581

#DIV/0! 18 81.818182 0 6 24
#DIV/0! 4 100 0 2 33.33333
0 0 0 200 100
#DIV/0! 37 80.434783 4 80 10 15.625
#DIV/0! 3 100 #DIV/0! 0 0
#DIV/0! 11 78.571429 1 50 5 27.77778
#DIV/0! 21 87.5 3 10.71429
50 152 73.076923 51 66.23377 95 28.87538
100 16 80 48 55.81395 42 36.52174
114 88.372093 11 57.89474 25 14.61988
81 75 29 74.35897 44 25.88235
148 84.571429 24 85.71429 36 14.34263
104 97.196262 11 91.66667 9 6.293706
65 83.333333 11 73.33333 19 17.11712
30 85.714286 21 77.77778 14 18.42105
13 59.090909 3 42.85714 16 50
39 72.222222 14 66.66667 25
8 53.333333 1 50 11
35 89.74359 12 80 8
12 80 6 85.71429 7
0 947 72.456006 5 20 219 60.49724 0
Masyarakat Remaja
Dosis 1 Dosis 2 Dosis 1 Dosis 2
947 360 5 19
Penerima Vaksin Dosis 2
Tahap 1 Tahap 2 Tahap 3 Total Dosis 3
Masyarakat
SDM Kesehatan Lansia Pelayan Publik Remaja
Rentan + Umum
% # % # % # % # % #
#DIV/0! 0 1 100 0 0 0
#DIV/0! 0 #DIV/0! 4 18.18182 2 100 0
#DIV/0! #DIV/0! #DIV/0! 0 2 100 0
#DIV/0! 30 100 4 100 153 100 13 100 0
0 0 #DIV/0! 9 19.56522 1 20 6
#DIV/0! 0 #DIV/0! 0 #DIV/0! 0
1 50 #DIV/0! 3 21.42857 1 50
0 #DIV/0! 3 12.5 #DIV/0!
11 27.5 2 50 56 26.92308 26 33.76623
0 0 4 20 38 44.18605
1 5.263158 1 25 15 11.62791 8 42.10526
6 27.27273 1 100 27 25 10 25.64103
3 7.142857 2 33.33333 27 15.42857 4 14.28571
4 17.3913 1 100 3 2.803738 1 8.333333
1 6.666667 1 33.33333 13 16.66667 4 26.66667
1 9.090909 2 66.66667 5 14.28571 6 22.22222
2 100 1 100 9 40.90909 4 57.14286
3 11.53846 15 27.77778 7 33.33333
3 100 7 46.66667 1 50
1 4 10.25641 3 20
3 3 20 1 14.28571
0 30 10.94891 5 14.28571 360 27.54399 19 76 6

Penerima Vaksin
Indeks Pemak
dosis 3
Total Dosis 3 Dosis 3
Coronavac Vaksin Covid-19 BF
SDM Kesehatan (1 vial 2 dosis) (Multi Dose Vial)
Jmlh Vial Jmlh Jmlh Vial Jmlh

% # % IP
Terpakai Diimunisasi Terpakai Diimunisasi
#DIV/0! #DIV/0! 1 2 2.0 4 41

#DIV/0! #DIV/0! 3 6 2.0
#DIV/0! #DIV/0! 3 6 2.0
#DIV/0! #DIV/0! #DIV/0! 20 200
#DIV/0! #DIV/0! 6 12 2.0
#DIV/0! #DIV/0! 3 6 2.0
4 8 2.0
9 18 2.0
1 2 2.0 17 170
7 14 2.0 9 90
1 2 2.0 5 53
1 2 2.0 9 93
9 93
7 69
5 52
5 53
2 21
6 64
1 8
4 41
2 21
30 0 #DIV/0! 39 78 2.0 105 1069

Indeks Pemakaian Vaksin Berdasarkan Merek
Covid-19 BF
Astra Zeneca (1 vial 8 dosis) Astra Zeneca (1 vial 10 dosis) Moderna
Dose Vial)
Jmlh
Jmlh Vial Jmlh Jmlh Vial Jmlh Vial
IP IP Diimunis IP
Terpakai Diimunisasi Terpakai Terpakai
asi
10.3 #DIV/0! #DIV/0!

#DIV/0! #DIV/0! 2 19 9.5
#DIV/0! #DIV/0! #DIV/0!
10.0 #DIV/0! #DIV/0!
#DIV/0! #DIV/0! 4 38 9.5 1
#DIV/0! #DIV/0! #DIV/0!
1 10 10
1 10 10
10.0 14 157 11.2142857
10.0 1 11 11
10.6 11 116 10.5454545
10.3 7 75 10.7142857
10.3 15 158 10.5333333
9.9 7 74 10.5714286
10.4 6 59 9.83333333
10.6 2 23 11.5
10.5 1 11 11
10.7 4 37 9.25
8.0 1 12 12
10.3 2 22 11
10.5 1 10 10
10.2 #DIV/0! 80 842 #DIV/0!

Moderna
Jmlh
IP
Diimunisasi
#DIV/0!
#DIV/0!
#DIV/0!
#DIV/0!
14 14
#DIV/0!
338 #DIV/0!
Kabupaten/Kota
Provinsi
Hari, Tanggal
No No. Tiket NIK
1 P-8GODFSGE 5320055605850001
2 5320055205710001
Q-001NUPJC
3 5320050310050001
P-AVAU11D0
4
P-C1XL9PM6 5320022305830001
5 5320055401870001
P-CLW4WCW1
6
P-E3YUQDQU 5320056912030001
7 5320051111730002
P-ESMWWNIS
8 5320053006040001
P-FMQX7NRC
9 5320055603070002
P-G4THFNT2
10 5320055004770001
P-GMSSAJKT
11 5320050304000002
P-HI4K1HYT
12 5320055501030001
Q-001PI4Q2
13 5320030702830001
P-JVNVSG95
14 5320032702800001
P-LVHFM32G
15 5320031906750001
P-MQFZSZZ0
16 5320031303930003
P-NA67GVOK
17 5320055205930001
P-OCM3FJNR
18 5320033011910001
P-P6O7RFTS
19 5320050205660001
P-P76W5NEO
20 5320054211020002
P-P7D5QZ0M
21 5320053012450001
S-16FB8D75
22 5320056012920003
P-EOP0ZK5I
23 5320056503520001
24 5320030409470001
S-CA4D481D
25 5320036009080001
P-P7ZAJPEL
26 5320054701850002
P-P8A1HUPI
27 5320030903860001
P-P8CXMJKM
28 5320054906840001
P-P8NBJYQR
29 5320035211880001
P-P8FF3DBO
30 5320052507620002
P-P8IUTR8X
31 5320052803851001
P-P8UTOOG7
32 5320030704430001
S-169F8B86
33 5320052802580001
S-476C8DBF
34 5320055510830002
P-P9J6OKPW
35 5320056209920001
P-P9MBGTQX
36 5320051306010001
P-PA4PJZOR
37 5320021705010001
P-PA7EJNAT
38 5320056305340001
S-8E222046
39 5320030703950001
P-KXNHU7P6
40 5320055111420002
S-29ABE6CA
41 5320050206970002
P-PAHG0EZY
42 5320052005880002
P-PAL93VCG
43 5320051412020002
P-PANKPQSX
44
P-PA1OMJE3 5320050811900001
45 5320051005860001
P-PATAG5UT
46 5320053112010001
P-PAYJOLSV
47 5371052305950001
P-PB14X52A
48 5320052202040001
P-PB4RJR06
49 S-E0F6E720
5320054107600005
50 5320055111040001
Q-0011RQIB
51 5320054203940001
Q-000KWEE3
52 5320055707050002
P-PB9O6X21
53 5320024606080005
P-PBCFRVS2
54 5320056307040002
Q-0013BT9G
55 5320025406040001
Q-00135ZJL
56 5320052008350001
S-259CF4F8
57 5320031111840001
P-PCYNV7Y8
58 5320051801700001
P-PBUUKQ3E
59 5320054212650001
P-PD8UYLD7
60 5320050303850001
P-J02ZA92G
61 5320052906790001
P-PEAILIXB
62 D1 5320052602060001
63 D1
5320052704080002
64 D1 5320054506020001
65 D1 5320051309050001
66 D1 5320055908340001
67 D1 5320055905560001
68 D1 5320051711600001
69 D1 5320050604640001
70 D1 1607105003900009
71 D1 5320055007620001
72 D1 5320056403980001
73 D1 5320050212970001
74 D1 5320054809700002
75 D1 5320050112030001
76 D1 5320056404880001
77
P-6APFIKBH 5320052711060002
78 5320050708880002
79 5320051603830003
P-AXYDVS0L
80 P-4UFW0PCD 5320052604880002
81 5320051609750001
82 5320050912570001
83 P-RLC0HHMC 5320052605650001
84 5320055710770003
85 5320054701990002
86 5320055009910001
87 5320010408890003
88 P-MHUIQPHY 5304161802990002
89 5320056607820002
90 D1 5320051706420001
91 D1 5320055202440001
92 D1 532002520200002
93 D1 5320054705930001
94 D1 5320052203620001
95 D1 5320054608670001
96 D1 5320050506830001
97 D1 5320052702980002
98 D1 5320036002010001
99 D1 5320055907960001
100 D1 5320053004830002
101 D1 5320050510010001
102 D1 5320052704000002
103 D1 5320052101020002
104 D1 5371010505890003
105 D1 5320055007780001
106 D1 5314035511950001
107 D1 5320055210990002
108 D1 5320052003800001
109 D1 5320054408780001
110 D1 5320053103720001
111 D1 5320054410880001
: Sabu Raijua
: 17/12/2021
Pekerjaan*
Jenis
Kelamin
DAMARIS KALE LENA P MASY UMUM
YULI KRISTIN BALE P MASY UMUM
PASKALIS PEKE BALE LENA L REMAJA
L MASY UMUM
RAFAEL RADJA
RAHEL MAGE TIE P MASY UMUM
P MASY UMUM
REHE DUBU
DUBU UDJU L MASY UMUM
FAREL LULU RIHO L REMAJA
MIRVANDI LULU RIHO L REMAJA
DAMARIS TALLO L MASY UMUM
DARUN WAKE ITO L MASY UMUM
MARLIN LULU RIHO P MASY UMUM
PE DIDA L MASY UMUM

WIE HAE L MASY UMUM
YERMIAS DJAMI L MASY UMUM
HENDRIK KAHO LEDE L MASY UMUM
KADO LEDE P MASY UMUM
BUWE DIDA L MASY UMUM
KIRENIUS KAHO HAMU L MASY UMUM
KUDJI DUBU P MASY UMUM
MANNO WILA L LANSIA
P MASY UMUM
DEWI A DJARA RABA
DANGA LOMI P LANSIA
LENA RIWU L LANSIA
TINA BUWE P REMAJA
KIRE LADO P MASY UMUM
NGADE WARA L MASY UMUM
MARE LAY P MASY UMUM
LUSIANA DARI MARA P MASY UMUM
MANNO LUDJI L MASY UMUM
DONI KRISTIANUS NGURU L MASY UMUM
MATA TARI L LANSIA
HAKKU PAU L LANSIA
MARIANA TALI DIMA P MASY UMUM
NORLINA RADJA P MASY UMUM
L MASY UMUM
YERMIAS BALE WADU
DOMINICUS LUDJI L MASY UMUM

HAPU KAHO P LANSIA
WADU KORE L MASY UMUM
LONI MANGNGI P LANSIA
YULIUS RADJA L
MASY UMUM
HENGA WADU L MASY UMUM
JEMIANTO KAHO HAMU L MASY UMUM
JUSTINUS MANU L MASY UMUM
HENDRIK LOBO HABA L MASY UMUM
STARGINO RADJA L MASY UMUM
TITUS ARIANTO LAY L MASY UMUM
DOMINGGUS RADJA L REMAJA
WAHI BALE P LANSIA
LUISA LOBO HABA P REMAJA
MARIANCE LOBO HABA P MASY UMUM
WINDRI JULIAN LEO KITU P REMAJA
LIWU DUBU P REMAJA
JELITA PUDJO LUDJI P REMAJA
MARIANCE KAHO LUDJI P REMAJA
KALE TADE P LANSIA
KARE KANNI L MASY UMUM
KIDO IE L MASY UMUM
NATI GEA P MASY UMUM
MANGNGI LULU L MASY UMUM
UJU HURU L MASY UMUM

FIGO FERGUSEN YONATAN L REMAJA
REMAJA
ARIF ARIEL YONATAN L
ANDRYAN EGNEUS LEBA LUDJI L REMAJA
LITA NGE P REMAJA
MARCHA M HAE P LANSIA
ANTONIA ROHI P LANSIA
HUKE WILA L LANSIA
MARKUS DIDA L MASY UMUM
SONI MARETA SINAGA P MASY UMUM
TADA MANNO L MASY UMUM
KORLINA HAU P MASY UMUM
DEN ALFARES DIDA L MASY UMUM
LEANITA HABA GEA P MASY UMUM
SONIDES LUDJI LINGU L MASY UMUM
ATRIANA LAKE P MASY UMUM
L REMAJA
NOLDI HAWU LEKU
AYUB YUNIOR NATGUM NEA L MASY UMUM
L PELAYAN PUBLIK
HERMAN DIMA LENA
MARTEN DJUNINA L MASY UMUM
MASY UMUM
BERNAD DJAWA L
ROBERTUS DJU NINA L LANSIA
MATEOS RIWU DJETA L MASY UMUM
OLY ADOLVINA KITU P MASY UMUM
MELIANA DIMA LENA P MASY UMUM
APRIANA DIMA LENA P MASY UMUM

NIKODEMUS DJU NINA L MASY UMUM
FRITS YANDUS NAHAK L MASY UMUM
YULIANA BAKI DJU P MASY UMUM
ABRAHAM KALE LAY L LANSIA
DAMARIS KANI P LANSIA
VINORIA RAGA LOMI P PELAYAN PUBLIK
MERSI MATA TAGA P PELAYAN PUBLIK
HERMANUS EDO PITA L MASY UMUM
WELHELMINA RATU RODI P MASY UMUM
YUDI YULIUS LAY L MASY UMUM
FERDIK EDO PITA L MASY UMUM
FEBE DESRIANA DJAMI RANGA P MASY UMUM
YUNI SANTIANA WILA PA P MASY UMUM
YOHANIS DJU NINA L MASY UMUM
SATRYA P KANA MANGNGI L MASY UMUM
ANTON ULY REKE L MASY UMUM
YANU ULY REKE L MASY UMUM
ROBERT KALE PAO L MASY UMUM
KATRINA KAHO HAMU P MASY UMUM
NEGAWATI APRIANA DELLU P MASY UMUM
WILA KORE L MASY UMUM
TONI DIDA L MASY UMUM
AGUSTINA LUWU P MASY UMUM
RUBEN LODO L MASY UMUM
DAMARIS RAME LUDJI P MASY UMUM

Umur
tahun)
5/16/1984 37 JIWUWU
5/12/1971 52 46-59 DESA JIWUWU
10/3/2006 15 JIWUWU
38 JIWUWU
5/23/1983
1987-01-14 34 JIWUWU
18 JIWUWU
12/29/2003
11-Nov-73 48 JIWUWU
7/30/2005 16 JIWUWU
2007-03-16 14 JIWUWU
6/12/1979 42 JIWUWU
4/3/2000 21 JIWUWU
2/7/1983 38 DESA KELIHA

1980-02-27 41 DESA KELIHA
3/13/1994 27 JIWUWU
1993-05-12 28 JIWUWU
5/2/1966 55 JIWUWU
2001-09-24 20 JIWUWU
12/30/1945 76 JIWUWU
12/1/1992 29 JIWUWU
3/25/1952 69 JIWUWU
6/9/1984 37 JIWUWU
7/25/1962 59 JIWUWU
2/28/1958 63 JIWUWU
10/15/1983 38 JIWUWU
9/22/1992 29 JIWUWU
2001-06-13 20 JIWUWU
5/7/2001 20 JIWUWU
5/23/1934 87 JIWUWU
11/11/1942 79 JIWUWU
1997-06-10 24 JIWUWU
6/6/1982 39 JIWUWU
14-Dec-02 19 JIWUWU
1990-03-05 31 JIWUWU
5/10/1986 35 JIWUWU
1/5/2003 18 JIWUWU
5/23/1995 26 JIWUWU
2/22/2004 17 JIWUWU
7/1/1960 61 JIWUWU
1/9/2004 17 JIWUWU
2/3/1997 24 JIWUWU
2005-07-17 16 JIWUWU
6/6/2008 13 JIWUWU
7/23/2004 17 JIWUWU
6/14/2004 17 JIWUWU
8/20/1935 86 JIWUWU
12/2/1965 56 JIWUWU

2/26/2006 15 12-17 DESA MATEI
15 12-17 DESA MATEI

4/27/2006
8/25/2004 17 12-17 DESA MATEI
8/13/2005 16 12-17 DESA MATEI
8/19/1934 87 60-150 DESA MATEI
5/19/1956 65 60-150 DESA TADA
11/17/1960 61 60-150 DESA TADA
4/6/1964 57 46-59 DESA TADA
3/10/1990 31 31-45 DESA JIWUWU
7/10/1962 59 46-59 DESA TADA
3/24/1998 23 18-30 DESA TADA
12/2/1997 24 18-30 DESA TADA
5/15/1966 55 46-59 DESA TADA
12/1/2003 18 18-30 DESA TADA
4/24/1997 24 18-30 DESA BEBAE
15 EIMADAKE
11/11/2006
8/7/1988 33 31-45 DESA LOBOADJU
16 MARET 1983 37 31-45 LOBOADJU

4/26/1988 33 LOBOAJU
9/16/1975 46 46-59 DESA EIMADAKE

12/9/1957 64 60-150 DESA LOBOADJU
5/26/1965 56 MATEI
10/17/1977 44 31-45 DESA LOBOADJU
1/7/1999 22 18-30 DESA LOBOADJU
9/10/1991 30 18-30 DESA LOBOADJU

8/4/1989 32 31-45 DESA LOBOADJU
7/26/1982 39 31-45 DESA LOBOADJU
6/17/1942 79 60-150 DESA EIMADAKE
2/12/1944 77 60-150 DESA TADA
2/12/2000 21 18-30 DESA EIMAU
5/7/1993 28 18-30 DESA EIMADAKE
3/22/1962 59 46-59 DESA TADA
8/6/1967 54 46-59 DESA TADA
7/5/1983 38 31-45 DESA TADA
2/27/1998 23 18-30 DESA TADA
2/20/2001 20 18-30 DESA BODAE
7/19/1996 25 18-30 DESA TADA
4/30/1983 38 31-45 DESA LOBOADJU
10/5/2001 20 18-30 DESA TADA
4/27/2000 21 18-30 DESA MATEI
1/21/2002 19 18-30 DESA MATEI
5/5/1989 32 31-45 DESA BEBAE
7/10/1978 43 31-45 DESA EILODE
11/15/1995 26 18-30 DESA LOBOADJU
8/16/1997 24 18-30 DESA EILODE
3/20/1980 41 31-45 DESA TADA
8/4/1978 43 31-45 DESA MATEI
3/31/1972 49 46-59 DESA MATEI
10/4/1988 33 31-45 DESA TADA

ASI COVID-19
NASI

yang sesuai)
BPJS Non
PBI
0812396007222 12/17/2021
11/6/2021
82350420110
082236853875 12/17/2021
12/17/2021
081239615375
082144859686 12/17/2021
12/17/2021
082144859686
082144859686 12/17/2021
082236316819 12/17/2021
081335474257 12/17/2021
082235082833 12/17/2021
081335474257 12/17/2021
11/10/2021
81239585838
081337227247 12/17/2021
081231357112 12/17/2021
081337224247 12/17/2021
082144859686 12/17/2021
081239615375 12/17/2021
082144261926 12/17/2021
085238721451 12/17/2021
082157026779 12/17/2021
082144859686 12/17/2021
082195364275 12/17/2021
082236316819 12/17/2021
081353012140 12/17/2021
082235800032 12/17/2021
081337224247 12/17/2021
081337224247 12/17/2021
082339273279 12/17/2021
081337224247 12/17/2021
082144859686 12/17/2021
081236836233 12/17/2021
082359403509 12/17/2021
082144859686 12/17/2021
082144859686 12/17/2021
082359403509 12/17/2021
081238687039 12/17/2021
081239615693 12/17/2021
082359403509 12/17/2021
081337224247 12/17/2021
082359403509 12/17/2021
082261879652
12/17/2021
082261879634 12/17/2021
081236834909 12/17/2021
081246943801 12/17/2021
082359403509 12/17/2021
082299828440 12/17/2021
081228441969 12/17/2021
082299828440 12/17/2021
082359403509 12/17/2021
081239293044 12/17/2021
082147298285 12/17/2021
82359403509 12/17/2021
082359403509 12/17/2021
082353161507 12/17/2021
082146043590
12/17/2021
082235800032 12/17/2021
082235800032 12/17/2021
082359403509 12/17/2021
082235800032 12/17/2021
081338619252 12/17/2021
082235800032 12/17/2021
085338389381 12/17/2021
085338389381 12/17/2021
081236183600 12/17/2021
085337339396 12/17/2021
082340374385 12/17/2021
082340290987 12/17/2021
085281934069 12/17/2021
085281934069 12/17/2021
081353039693 12/17/2021
085281934069 12/17/2021
085281934069 12/17/2021
085281934069 12/17/2021
085281934069 12/17/2021
08533071247 12/17/2021
081237463657 12/17/2021
11/15/2021
081338129808
82339570307 10/22/2021
082 339 556 548 6/29/2021

081238777451 7/19/2021
11/6/2021
82146946215
81239946804 10/22/2021
081246906506 10/19/2021
81238732823 10/22/2021
85337737634 10/22/2021
81238732823 10/22/2021
85333445162 10/22/2021
081 239 864 783 9/9/2021
82359274184 10/22/2021
081238480973 12/17/2021
081239421997 12/17/2021
081239146112 12/17/2021
085253421993 12/17/2021
082145689472 12/17/2021
082145689472 12/17/2021
081239101760 12/17/2021
082145689472 12/17/2021
082145689472 12/17/2021
081239101760 12/17/2021
082339570307 12/17/2021
0985339266659 12/17/2021
085337339389 12/17/2021
085337339389 12/17/2021
085337854970 12/17/2021
081269313454 12/17/2021
081211084867 12/17/2021
082236776458 12/17/2021
085333078557 12/17/2021
085333538986 12/17/2021
085333538986 12/17/2021
095333078557 12/17/2021
Dosis I
Tanggal Pemberian
No. Batch
Vaksinasi
11/6/2021
202108122H
VAKSIN COVID19 BIOFARMA 12/17/2021 VAKSIN COVID19 BIOFARMA



9/24/2021

CORONAVAC 6/29/2021 24200721

CORONAVAC 7/19/2021 24200721

202108122H
ASTRAZENECA 10/22/2021 210155
ASTRA ZENECA 10/19/2021 210155
ASTRAZENECA 10/22/2021 210155
ASTRAZENECA 10/22/2021 210155
ASTRAZENECA 10/22/2021 210155

ASTRAZENECA 10/22/2021 210155
ASTRAZENECA 10/22/2021 210155

Dosis 2
Tanggal Pemberian
Vaksinasi
10000006781350
16298092626190
1631459693592
10000006781350
1631459693592
10000006781350
1631459693592
1631459693592
1631459693592
1631459693592
10000006781350
16309339725384
10000006781350
10000006781350
10000006781350
10000006781350
10000006781350
10000006781350
1631459693592
1631459693592
16311457440172
16311457440172
16311457440172
16311457440172
16311457440172
16311457440172
10000006781350
16311457440172
10000006781350
16311457440172
10000006781350
16311457440172
16311457440172
16311457443136
16311457443136
10000006781350
10000006781350
16311457443136
10000006781350
16311457443136
10000006781350
10000006781350
10000006781350
10000006781350
10000006781350
10000006781350
10000006781350
16311457443136
16311457443136
12/17/2021 A1087
16311457443136
16311457443136
16311457443136
10000006781350
10000006781350
10000006781350
10000006781350
10000006781350
16306344200556
16306344200556
16306344200556
16306344200556
16306344200556
16306344200556
16306344200556
16306344200556
16306344200556
16306344200556
16306344200556
16306344200556
16306344200556
16306344200556
16306344200556
16309339725384 12/17/2021 24203421
16319520957886 12/17/2021 24203421
16221717766356 12/17/2021 24203421
162210005769993 12/17/2021 24203421

16298088677347 12/17/2021 24203421
12/17/2021 A1083
02889498682509 12/17/2021 A1083
12/17/2021 A1083
12/17/2021 A1083
12/17/2021 A1083
12/17/2021 A1083
01864954830490 12/17/2021 A1083
12/17/2021 A1083
10000006254388
10000006254388
10000006254388
10000006254388
10000006254388
10000006254388
10000006254388
10000006254388
10000006254388
10000006254388
10000006254388
10000006254388
10000006254388
10000006254388
10000006254388
10000006254388
10000006254388
10000006254388
10000006254388
10000006254388
10000006254388
10000006254388
Keterangan
Diberikan/Lanjut)
No. Serial
LANJUT JIWUWU
LANJUT JIWUWU
LANJUT JIWUWU
LANJUT JIWUWU
LANJUT JIWUWU
LANJUT JIWUWU
LANJUT JIWUWU
LANJUT JIWUWU
LANJUT JIWUWU
LANJUT JIWUWU
LANJUT DESA KELIHA

LANJUT DESA KELIHA
LANJUT DESA KELIHA
LANJUT JIWUWU
LANJUT JIWUWU
LANJUT DESA KELIHA
LANJUT JIWUWU
LANJUT JIWUWU
LANJUT JIWUWU
LANJUT JIWUWU
LANJUT JIWUWU
LANJUT DESA KELIHA
LANJUT DESA KELIHA
LANJUT DESA KELIHA
LANJUT DESA KELIHA
LANJUT JIWUWU
LANJUT DESA KELIHA
LANJUT JIWUWU
LANJUT DESA JIWUWU
LANJUT DESA KELIHA
LANJUT JIWUWU
LANJUT JIWUWU
LANJUT JIWUWU
LANJUT JIWUWU
LANJUT JIWUWU
LANJUT JIWUWU
LANJUT DESA KELIHA
LANJUT JIWUWU
LANJUT JIWUWU
LANJUT JIWUWU
LANJUT JIWUWU
LANJUT JIWUWU
LANJUT JIWUWU
LANJUT JIWUWU
LANJUT JIWUWU
LANJUT JIWUWU
LANJUT JIWUWU
16311457443136 SELESAI JIWUWU
LANJUT JIWUWU
LANJUT JIWUWU
LANJUT JIWUWU
LANJUT DESA KELIHA
LANJUT DESA JIWUWU
LANJUT JIWUWU
LANJUT DESA JIWUWU
LANJUT DESA JIWUWU

LANJUT DESA MATEI
LANJUT DESA MATEI
LANJUT DESA MATEI
LANJUT SMA 1 SATENG
LANJUT DESA MATEI
LANJUT DESA TADA
LANJUT DESA TADA
LANJUT DESA TADA
LANJUT DESA JIWUWU
LANJUT DESA TADA
LANJUT DESA TADA
LANJUT DESA TADA
LANJUT DESA TADA
LANJUT DESA TADA
LANJUT DESA BEBAE
16306344200556 SELESAI LINMAS LOBOADJU

LANJUT DESA TADA
LANJUT DESA EIMAU
LANJUT SDN EILODE
LANJUT DESA TADA
LANJUT DESA TADA
LANJUT DESA TADA
LANJUT DESA TADA
LANJUT DESA BODAE
LANJUT DESA TADA
LANJUT DESA TADA
LANJUT DESA MATEI
LANJUT DESA MATEI
LANJUT DESA BEBAE
LANJUT DESA EILODE
LANJUT DESA EILODE
LANJUT DESA TADA
LANJUT DESA MATEI
LANJUT DESA MATEI
LANJUT DESA TADA

Kabupaten/Kota
Provinsi
Hari, Tanggal
No No. Tiket NIK
1 P-J5G40PVH 5320056306660001
2 S-E2561816 5320051503600001
3 S-ADC326CF 5320010305520001
4 P-KVMSN5T0
5320051110850002
5 P-LDAEUS4S 5320050501920001
6 P-LRGXL8C8
5320044806980001
7 Z-000EAJKQ 5320054107600004
8 5320050203930001
P-MGOLG27F
9 P-N6P70I1F 5320051204840001
10 P-NMFNS1FP 5320054709810001
11 9171034303910002
Q-0009CATU
12 : Q-001RF8UI
5320024106910001
13 5320050912660001
P-OOKJYGAA
14 P-HZYNQ50H 5320054809700001
15 P-OAEMC6AU 5320051408830001
16 P-OOU7G9A1 5320050903950001
17 5320054210460001
S-B175934C
18 P-OOBU1JFI 5320055204890002
19 P-OOMIXTUL 5320051303900002
20 P-OORD4UDX 5320055503950001
21 P-OIL1MKDL 5320050908650001
22 P-OP4PTAJ0 5320016005890001
23 S-F5CD6EF1 5320010803650001
24 5320010706930002
P-OPAR7YEQ
25 P-OP0IFE2L 5320052303030002
26 Q-001POSWS 5320051301000001
27 5307055004780010
P-ORXRTEPN
28 P-OPKV3MDQ : 5313051108690002
29 5320014203530001
S-DD966CE5
30 5320015109980001
P-OPU0ARVK
31 S-6EABD137 5320050107570003
32 S-F534980D 5320054107600003
33 P-OQ34NQ1P 5320031010790001
34 P-OQPP85HG 5320052908820001
35 P-OQV2MJ5N 5320052107770001
36 P-OR2NS5G1 5320054305980001
37 P-OR8ITPTG 5320054510660001
38 P-ORGIGNNC 5320055104000001
39 P-ORN3MNY2 5320056906950001
40 P-ORQ4KRRP 5320055005630001
41 Q-0015RO55 5320055012040002
42 5320034503950003
P-OS0QKBAG
43 P-OS4YCU48 5320051206870001
44 NIK TDK TEMUKAN 5320054802960001
45 5320054107570004
S-F9016539
46 P-OTA76JRG 5320050303960002
47 P-OTHFZF7H 5320050605900001
48 P-OTK3LMJU 5320050812800001
49 P-OTDM8ZOF 5320051306750002
50 5320050709790001
P-OJA7GN3I
51 5320050107360002
S-9DD51BBF
52 5320050310850001
P-OUZZWH6H
53 5320050707070002
P-OVEWWWAU
54 5320015008950002
P-OV4X62XE
55 5320054107600001
S-5869940E
56 5320050306810001
P-OVGB1J2G
57 5320052708760001
P-OV2SPN8G
58 P-OT6NHL3Y 5320054507790001
59 5320052202090003
P-OVXQHSYJ
60 P-OW28J3JD 5320051008820001
61 Q-000YS77D 5320054107300002
62 5320054105970001
P-OWC5S0QV
63 5320050110070001
P-OW4CVCO9
64
: Q-001EB5B0 5320055302090002
65 5320056911050001
P-OXBDHVLP
66 P-P0TAFAR3 5371010607830002
67 5320011505640002
P-P0ZTTSG8
68 5320015809750001
P-P16VNPGF
69 5320015103680001
P-P1EMEWRE
70 5320015808910002
P-P1KEBZL2
71 5320012401020001
: P-P1Q5JAW6
72 5371044401920008
P-P1V10KPH
73 5320014705990002
74 5320054807010001
75
5320051503090001
76 5320020503550001
77 5320050107570002
78 5320050107580001
79 5320050107390002
80 5320052107040001
81 5320055105070001
82 5320052011060001
83 5320053110070002
84 5320051510040001
85 5320052507020001
86 5320054509910001
87 5320052606810001
88 5320054605730001
89 5320055201890001
90 5320050906790001
91 532005478830001
92 5371041902870001
93 5320052910790001
94 5320054310850001
95 5320056007920001
96 5320052512910001
97 5320026005890001
98 5320052404980001
99 5320054506900001
100 5320050506010001
101 5320051209910001
102 5306035504870003
103 53200511005570001
104 5320050109560001
105 5320051508550001
106 5320055504570001
107 5320052002550001
108 5320051609500001
109 5320051005900001
110 53200554201780001
111 5320052512020001
112 5320050601910002
113 5320051707670002
114 5320065117900001
115 5320050704740003
116 5320052806670001
117 5320056008700001
118 5371065704850001
119 5320051909800001
120 5320050906850001
121 5320056410900002
122 53200507-7710001
123 5320035505900002
124 5320054403950001
125 5320054503800001
126 5320054110830001
127 5320050105880001
128 5320054703950001
129 5320050101700001
130 5320056202880001
131 5320055908860001
132 5320050902790001
133 5304212507910001
134 5320054107650001
135 5320055204650001
136 5320055204020001
137 5320055605750002
138 5320054209990001
139 5320052406820001
140 530106310190006
141 5320041908890002
142 5320051108690001
143 5320055571830001
: Sabu Raijua
: 16/12/2021
Pekerjaan*
Jenis
Kelamin
LELY VERONIKA TADA ARA P MASY UMUM
TITUS MAGE MATA L LANSIA
SAMUEL WADU L LANSIA
L MASY UMUM
OKTOFIANUS KANA LUDJI
LEO TALO L MASY UMUM
P MASY UMUM
AGUSTINA HULE
MARE TE L LANSIA
TITUS PA DJU L MASY UMUM
PILE ORO RADE L MASY UMUM
THRES RIWU LONI P MASY UMUM
DINA MARIANA SUNIUF P PELAYAN PUBLIK
P MASY UMUM
MARIAM MANGNGI
PILEMON PA L MASY UMUM
TAGITA WADU P MASY UMUM
AHAD BALLE DOTO L MASY UMUM
KELVIN ROHI MIHA L MASY UMUM
RUT DUBU P LANSIA
FRANSISKA WAHI NGURU P MASY UMUM
MIKAEL DJARA L MASY UMUM
WAHI PE DEHE P MASY UMUM
LOBO KUDJI L MASY UMUM
L MASY UMUM
FRIYANTI LEDE TO
EBEN YANCE DJABBE L LANSIA
ISAK WADU L MASY UMUM
LABAN DEHE DJIMO L MASY UMUM
ARIS LAGA TITA L MASY UMUM
WELMINCE KAHA P MASY UMUM
SAUL RATU L MASY UMUM
RINCE HEO P LANSIA
SANTI LUDJI P MASY UMUM
LAKI HIA L LANSIA
PIGA HIHO P MASY UMUM
HAE LUDJI L MASY UMUM
MARKUS ANDREAS PARA PA L MASY UMUM
LEU RIHI L MASY UMUM
P MASY UMUM
MARLINCE KANA LUDJI
ENGGELINA LAI DJAMI P MASY UMUM

DEBORA KANA LUDJI P MASY UMUM
ANESITA KITU PENU P MASY UMUM
TABITA MAGE TIE P MASY UMUM
ANTONIA KITU PENU P

REMAJA
WELHELMINA WILA RIHI P MASY UMUM
ERASTUS TADJI L MASY UMUM
HILU WADU P MASY UMUM
THABITA KOLO LADO P LANSIA
BOBO HANYE L MASY UMUM
: DOMINGGUS KALE KITU L MASY UMUM
BERNAD BALE BANE L MASY UMUM
PAULUS KANA L MASY UMUM
WELE LAKI HIA L MASY UMUM
MATA RIHI L LANSIA
DAI LI WADU L MASY UMUM
EPAFERDITUS WELE L REMAJA
INTAN PRASETIA RATU KALE P MASY UMUM
DJAGA MIRA P LANSIA
YERMIAS JARA TALO L MASY UMUM
GAJA UDJU L MASY UMUM
YULIANA DJAMI P MASY UMUM
TIHE HADI P REMAJA
DJAJI MIHA P REMAJA
WARNI SULASRI LAGA TITA P REMAJA

TRIPENA LAGA TITA P MASY UMUM
NAWA HADI P REMAJA
NENO LEU P REMAJA

PANE HADI L REMAJA
YERMIAS EDYSON YESKIEL LENGGU L MASY UMUM
LORENS DJAMI KALE L MASY UMUM
PAULINA HEO DIMA P MASY UMUM
MARTINCE RIWU P MASY UMUM
VIN ASTARIA DJAMI P MASY UMUM
JEFERENZMART DJAMI L MASY UMUM
DELFI ICE MARIDA TALOIM P MASY UMUM
ASMY SARY DJAMI P MASY UMUM
ARIANCE LADO HINA P MASY UMUM

REMAJA
SEDI KORE LIHU P
WELEM LUDJI L LANSIA
MARTHEN LUDJI LO BO L LANSIA
RATU KADJA P LANSIA
DANIEL RIHI L LANSIA
JEFRI KORE LIHU L REMAJA
MERLIN R LUDJI LOBO P REMAJA
DEDY KORE LIHU L REMAJA
FANDI KORE LIHU L REMAJA
OKTOVIANUS RIHI L REMAJA
KRIPTON RIHI HEKE L REMAJA
FIRANTI KANNI DIMU P MASY UMUM

MIKAEL LADO HINA L MASY UMUM
DURU MANGNGI L MASY UMUM
MARSELINA MIHA LOBO P MASY UMUM
RIHI DJAMI L MASY UMUM
MINE UDJU P MASY UMUM
RONALDY BA L MASY UMUM
SEMUEL ULY L MASY UMUM
YUNIARTI BALE BANE P MASY UMUM
JELITA TAKAEB P MASY UMUM
IMANUEL RAJA L MASY UMUM
RAHEL LAI WIE P MASY UMUM
DAVID ELO L MASY UMUM
MARLIN KALE P MASY UMUM
DIMU PARA L MASY UMUM
KELVIN KOTA WIE DIMA L MASY UMUM
APRIANI KOTA P MASY UMUM
RIHI KADJA L LANSIA
PARA KANI L LANSIA
YERMIAS BANA PAH L LANSIA
RAHEL RATA P LANSIA
RADJA HIDE L LANSIA
YERMIAS BANGNGU KORO L LANSIA

JUAN LUDJI LOBO L MASY UMUM
ANTONIA LOBO MIGU P MASY UMUM
DENS SUJANTO KANA L MASY UMUM
MARTHEN MIRA MANGNGI L MASY UMUM
PETRUS KALE MODJO L MASY UMUM
HAWA DJARA BALE P MASY UMUM
MARKUS F AGA LOMI L MASY UMUM

DOMINGGUS RIHI L MASY UMUM
AGUSTINA DORO MAGE P MASY UMUM
NOVILIA RADJA RIGE P MASY UMUM
PETRUS KORE LIHU L MASY UMUM
DOMINGGUS MAGE L MASY UMUM
FONI RAGA LOMI P MASY UMUM
WELHELMUS Y BALE HURU L MASY UMUM
TAMAN RATA L MASY UMUM
MARVIN KORE LIHU L MASY UMUM
TERSIA LAI LIHU P MASY UMUM
MINA PARA P MASY UMUM
CHRISTIAN RIHI HEKE L MASY UMUM
MAMO RIHI P MASY UMUM
WELEM DORO MAGE L MASY UMUM
AFLIANA RIWU DATI P MASY UMUM
NISRI LAI MANGNGI L MASY UMUM
JANUARD RIHI L MASY UMUM
YOS RIWU DJATI L MASY UMUM
DORKAS RIWU P MASY UMUM
HENDERINA TAGA P MASY UMUM
DELFIA LUDJI LOBO P MASY UMUM
ALBERTINA NGAHU KALE L MASY UMUM
LODIA KAHO P MASY UMUM
DONSIUS DJAMI KORE L MASY UMUM
YANUARD LUDJI LEO L MASY UMUM
LUKAS TIGE KORE L MASY UMUM
WELEM ELO L MASY UMUM
PAULINA LOBO P MASY UMUM
Umur
tahun)
2/23/1966 55 DESA EIMAU
3/15/1960 61 DESA EIMAU
3/18/1952 69 MENIA
34 DESA EIMAU
10/10/1987
1/5/1992 29 DESA EIMAU
23 DESA EIMAU
8/6/1998
1-Jul-60 61 DESA EIMAU
1984-04-12 37 DESA EIMAU
1981-09-07 40 EILODE
1991-03-03 30 EILODE
30 EIMAU
6/1/1991
12/9/1966 55 DESA EIMAU
8/14/1983 38 EILODE
3/3/1995 26 EILODE
4/12/1989 32 DESA EIMAU
3/13/1990 31 DESA EIMAU
5/14/1993 28 DESA EIMAU
5/20/1989 32 DESA EIMAU
11/6/1955 66 DESA MENIA
1993-01-13 28 DESA MENIA
3/23/2002 19 DESA EIMAU
8/11/1969 52 DESA EIMAU
3/2/1953 68 DESA MENIA
9/11/1998 23 DESA DELO
1979-10-10 42 DESA BODAE
1982-08-29 39 DESA EIMAU
7/21/1977 44 DESA EIMAU
: 1966-10-05 55 DESA EIMAU

12/29/2002 19 DESA EIMAU
6/29/1995 26 DESA EIMAU
5/10/1965 56 DESA EIMAU
12/10/2004 17 EIMAU
1996-03-05 25 DESA LOBORAI
15-Dec-86 35 DESA EIMAU
2/8/1986 35 EIMAU
1957-07-01 64 DESA EIMAU
12/5/1986 35 DESA EIMAU
8/12/1979 42 DESA EIMAU
6/13/1975 46 DESA EIMAU
10/3/1985 36 DESA EIMAU
7/16/2007 14 DESA EIMAU
1995-08-10 26 RAEMUDE
1976-08-27 45 DESA EIMAU
1979-07-05 42 DESA EIMAU
2/22/2009 12 DESA EIMAU
8/10/1982 39 DESA EIMAU
9/5/2004 17 EIMAU
10/1/2007 14 DESA EIMAU
2/13/2009 14 12-17 DESA EIMAU

11/29/2005 16 DESA EIMAU
7/6/1983 38 RAELORO
5/15/1964 57 RAELORO
1975-08-25 46 RAELORO
3/11/1968 53 RAELORO
8/18/1991 30 RAELORO
9/24/2002 19 RAELORO
1/4/1992 29 RAELORO
5/7/1999 22 RAELORO
7/8/2001 22 18-30 DESA EILODE
12-17 DESA EILODE

3/15/2009 12
3/5/1955 68 60-150 DESA EILODE
7/2/1957 66 60-150 DESA EILODE
7/1/1958 65 60-150 DESA EILODE
10/10/1945 77 60-150 DESA EILODE
7/21/2004 18 18-30 DESA EILODE
5/11/2007 16 12-17 DESA EILODE
11/20/2006 16 12-17 DESA EILODE
10/31/2007 15 12-17 DESA EILODE
10/15/2004 18 18-30 DESA EILODE
7/25/2005 17 12-17 DESA EILODE
9/5/1991 31 31-45 DESA EILODE

6/26/1981 42 31-45 DESA EILODE
5/6/1973 50 46-59 DESA EILODE
1/12/1989 34 31-45 DESA EILODE
6/9/1979 44 31-45 DESA EILODE
8/7/1983 39 31-45 DESA EILODE
2/19/1987 36 31-45 DESA EILODE
10/29/1979 43 31-45 DESA EILODE
10/3/1985 37 31-45 DESA EILODE
7/20/1992 30 18-30 DESA EILODE
12/25/1991 31 31-45 DESA EILODE
5/20/1989 34 31-45 DESA EILODE
4/24/1998 25 18-30 DESA EILODE
6/5/1990 33 31-45 DESA EILODE
6/5/2001 22 18-30 DESA EILODE
5/2/1991 32 31-45 DESA EILODE
4/15/1987 36 31-45 DESA EILODE
5/11/1957 66 60-150 DESA EILODE
9/1/1956 66 60-150 DESA EILODE
8/18/1955 67 60-150 DESA EILODE
4/15/1957 66 60-150 DESA EILODE
2/20/1953 70 60-150 DESA EILODE
9/16/1950 72 60-150 DESA EILODE
5/10/1990 33 31-45 DESA EILODE
1/2/1978 45 31-45 DESA EILODE
12/25/2002 20 18-30 DESA EILODE
1/6/1991 32 31-45 DESA EILODE
7/17/1967 56 46-59 DESA EILODE
10/25/1979 43 31-45 DESA EILODE
4/7/1974 49 46-59 DESA EILODE

6/18/1967 56 46-59 DESA EILODE
8/20/1970 52 46-59 DESA EILODE
3/5/1980 43 31-45 DESA EILODE
9/19/1980 42 31-45 DESA EILODE
6/9/1985 38 31-45 DESA EILODE
10/24/1990 32 31-45 DESA EILODE
7/7/1971 52 46-59 DESA EILODE
5/15/1990 33 31-45 DESA EILODE
5/25/1986 37 31-45 DESA EILODE
3/5/1980 43 31-45 DESA EILODE
10/1/1983 39 31-45 DESA EILODE
5/1/1989 34 31-45 DESA EILODE
3/7/1995 28 18-30 DESA EILODE
7/1/1970 53 46-59 DESA EILODE
2/22/1988 35 31-45 DESA EILODE
8/19/1986 36 31-45 DESA EILODE
2/9/1979 44 31-45 DESA EILODE
7/25/1991 31 31-45 DESA EILODE
7/1/1965 58 46-59 DESA EILODE
12/04/1965 57 46-59 DESA EILODE
4/12/2002 21 18-30 DESA EILODE
5/16/1975 48 46-59 DESA EILODE
9/2/1999 23 18-30 DESA EILODE
6/24/1982 41 31-45 DESA EILODE
1/31/1995 28 18-30 DESA EILODE
7/17/1988 35 31-45 DESA EILODE
8/11/1969 53 46-59 DESA EILODE
11/15/1983 39 31-45 DESA EILODE
ASI COVID-19
NASI

yang sesuai)
BPJS Non
PBI
082339940480 12/16/2021
082339940480 12/16/2021
082339940480 12/16/2021
12/16/2021
082339940480
082339940480 12/16/2021
12/16/2021
082339940480
082339940480 11/11/2021
082247692655 12/16/2021
081238913445 12/16/2021
081237785954 12/16/2021
08124689305 12/16/2021
11/16/2021
081337722749
082339940480 12/16/2021
082339940480 12/16/2021
081337862341 12/16/2021
081211487780 12/16/2021
082339940480 12/16/2021
082339940480 12/16/2021
082339940480 12/16/2021
082339940480 12/16/2021
812388859430 12/16/2021
082339940480 12/16/2021
082339940480 12/16/2021
082339940480 12/16/2021
081246943821 12/16/2021
081334228082 11/11/2021
082339940480 12/16/2021
082339940480 12/16/2021
082339940480 12/16/2021
082339940480 12/16/2021
082339940480 12/16/2021
082339940480 12/16/2021
082339940480 12/16/2021
082214368409 12/16/2021
0821475539411 12/16/2021
081337703697 12/16/2021
081337703697 12/16/2021
081236193834 12/16/2021
081339928963 12/16/2021
081236193834 12/16/2021
082342724424 9/29/2021
081339224278 12/16/2021
082339940480 12/16/2021
082339940480 12/16/2021
082339940480 12/16/2021
081338554153 12/16/2021
081338351541 12/16/2021
082147744586 12/16/2021
082339940480 12/16/2021
081338226719 12/16/2021
082145842663 12/16/2021
082144681202 12/16/2021
081338226719 12/16/2021
081339887107 12/16/2021
082145842663 12/16/2021
081338227441 12/16/2021
082339940480 12/16/2021
081239947258 12/16/2021
081337407715 12/16/2021
082339940480 12/16/2021
082145687183 9/16/2021
082145687183 12/16/2021
081337407715 12/16/2021
85253895668 9/28/2021
081337407715 12/16/2021
081239877626 12/16/2021
081246801045 12/16/2021
085239781972 12/16/2021
081246801045 12/16/2021
082339337058 12/16/2021
085238339269 12/16/2021
081239675289 12/16/2021
085337514817 12/16/2021
9/28/2021
81287749624
082144825396 9/27/2021
085253039289 12/16/2021
081237993603 12/16/2021
081238718241 12/16/2021
085338193078 12/16/2021
082171804329 12/16/2021
085338193078 12/16/2021
082175097289 12/16/2021
081246033457 12/16/2021
085338193078 12/16/2021
081237993603 12/16/2021
081246918103 12/16/2021
081246918103 12/16/2021
085338193078 12/16/2021
085338193078 12/16/2021
085338193078 12/16/2021
085338193078 12/16/2021
081254739190 12/16/2021
081237993603 12/16/2021
085338193078 12/16/2021
081237993603 12/16/2021
081237993603 12/16/2021
081237993603 12/16/2021
081237993603 12/16/2021
082141175824 12/16/2021
081237993603 12/16/2021
081237993603 12/16/2021
082297217362 12/16/2021
081237993603 12/16/2021
082146043546 12/16/2021
082338153172 12/16/2021
081246011135 12/16/2021
085257437022 12/16/2021
085338193078 12/16/2021
085338193078 12/16/2021
082247326093 12/16/2021
085257437022 12/16/2021
082145097970 12/16/2021
085338193078 12/16/2021
082299261702 12/16/2021
085338193078 12/16/2021
085338193078 12/16/2021
085338193078 12/16/2021
081236084109 12/16/2021
082171804329 12/16/2021
082338153172 12/16/2021
082338153172 12/16/2021
085338193078 12/16/2021
081246011135 12/16/2021
085338193078 12/16/2021
081238413505 12/16/2021
082146043546 12/16/2021
082260483965 12/16/2021
082260483965 12/16/2021
082260483965 12/16/2021
085338193078 12/16/2021
081246033457 12/16/2021
081246033457 12/16/2021
085338193078 12/16/2021
085338193078 12/16/2021
085338193078 12/16/2021
081243447967 12/16/2021
085338193078 12/16/2021
085338193078 12/16/2021
081238413505 12/16/2021
082138875353 12/16/2021
085338193078 12/16/2021
085338193078 12/16/2021
085338193078 12/16/2021
Dosis I
Tanggal Pemberian
No. Batch
Vaksinasi
ASTRA ZENECA 12/16/2021 A1087
VAKSIN COVID BIOFARMA 11/16/2021 202108140H



CORONAVAC 9/28/2021 2021081601
9/28/2021 2021081601
9/27/2021 2021081601


Dosis 2
Tanggal Pemberian
Vaksinasi
10000006781350
16311459699692
16311459699692
10000006781350
16311459699692
10000006781350
16309339721322 12/16/2021 24203421
10000006781350
10000006781350
10000006781350
12/16/2021 24203421
16309375256635 12/16/2021 24203421
10000006781350
16311459699692
16311459699692
10000006781350
16311459699692
16311459699692
10000006781350
10000006781350
10000006781350
10000006781350
10000006781350
10000006781350
10000006781350
16309332120843 12/16/2021 24203421
10000006781350
10000006781350
10000006781350
10000006781350
1631459705932
1631459705932
10000006781350
10000006781350
10000006781350
10000006781350
1631459705932
10000006781350
1631459705932
1631459705932
16309332221288
12/16/2021 24203421
1631459705932
10000006781350
1631459705932
16311459699224
10000006781350
10000006781350
10000006781350
16311459699224
10000006781350
16311459699224
10000006781350
16311459699224
10000006781350
16311459699224
10000006781350
10000006781350
10000006781350
16311459699224
16311459699224
16301222850300 12/16/2021 24203421

16311459802792
16311459802792
16301222796250
12/16/2021 24203421
16311459699224
16311459699224
16311459699224
16311459699224
16311459699224
16311459699224
16311459699224
16311459699224
16311459699224
16301222796250
12/16/2021 24203421
16301222796250
12/16/2021 24203421
16306344200556
16306344200556
16306344200556
16306367296493
16306367296493
16306367296493
16306367296493
16306344200556
16306344200556
16306344200556
16306367296493
16306367296493
16306367296493
16306367296493
16306344200556
16306344200556
16306344200556
16306344200556
16306344200556
16306344200556
16306344200556
16306344200556
16306344200556
16306344200556
16306344200556
16306344200556
16306344200556
10000006429028
10000006429028
10000006429028
10000006429028
10000006254388
10000006254388
10000006254388
10000006254388
10000006254388
10000006254388
10000006254388
10000006254388
10000006254388
10000006254388
10000006254388
10000006429028
10000006429028
10000006429028
10000006429028
10000006429028
10000006429028
10000006429028
10000006429028
10000006429028
10000006429028
10000006429028
10000006429028
10000006429028
10000006429028
10000006429028
10000006429028
10000006429028
10000006429028
10000006429028
10000006429028
10000006429028
10000006429028
10000006429028
10000006429028
10000006429028
10000006429028
Keterangan
Diberikan/Lanjut)
No. Serial
LANJUT EIMAU
LANJUT EIMAU
LANJUT EIMAU
LANJUT EIMAU
LANJUT EIMAU
LANJUT EIMAU
16311459699692 SELESAI DESA EIMAU
LANJUT EIMAU
LANJUT EIMAU
LANJUT EIMAU
16311459699692 SELESAI EIMAU
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16311459699224 SELESAI SMPN 1 SABU TENGAH
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Kabupaten/Kota
Provinsi
Hari, Tanggal
No No. Tiket NIK
1 S-188E6D78 5320050101600001
2 5320052412660001
P-11B43XJC
3 3578240803640001
P-9Y1TS7FN
4
Q-001RFA6R 5320050405860001
5 5320010509560001
: Z-000EAN7Q
6
Q-001RF9VT 5320035910880001
7 5371016603860004
P-D48UDWL1
8 5320056505050001
P-MV8MQ3K8
9 5320010504980002
P-CIWLWGCS
10 5320050501700001
P-DSKNC4LV
11 5320050403420001
S-96E5C466
12 5320055010840003
Q-001PS9CY
13 5371012409770001
P-FOR2UTWC
14 5320051708000001
P-G69VXLX8
15 5320051205450001
S-A9DCFF1D
16 5320050609560001
S-E6E8C9E9
17 5306040510900001
P-J2FQUPEC
18 7105184811900001
P-KKQU8UB6
19 5320055005640002
P-M1TLT4LA
20 5320020704730002
P-MPBQDB9L
21 5320051309680001
Q-001PVNO7
22 5320054701490001
S-8E00479F
23 5320054908530001
P-OALHFBBO
24 5320050307860001
P-OARFZFEF
25 5320050305530001
S-38ECB949
26 5320051001610001
P-NDN3BWBP
27 5320054611800001
P-OAW7Y637
28 5320052206760001
P-OB0R5AWI
29 5320055202010001
P-OB3HGHHZ
30 5320014309950001
P-OB7EZLQK
31 5320015205690001
P-OBAGJYVV
32 5320054107650004
P-OBDA3ZZ8
33 5320054201920001
P-OBGNKB5A
34 5320050107990002
P-OBKQR3ZS
35 5320054207890001
K-00022PF5
36 53200544902950002
Q-000A6JST
37 5320016805530001
S-CED2869C
38 5320014111570001
S-E01E74BC
39 5320051106590001
S-10F2A69D
40 5307054101790007
Q-001PVNN0
41 5320051110850001
P-OBWT5IX8
42 5320051008850003
P-OC2BVSVE
43 5320056404840005
Q-000HNP5E
44 5320051007010002
P-OC7U3IS5
45 5320051208420001
S-CA3CDE37
46 5320050608800001
P-OCET53H4
47 5320054107820001
P-OCLJOR46
48 5320024205740001
P-OCNRIYVG
49 5320056610750002
P-OCQPEUQ1
50 5320055603980001
P-OCSU9KUK
51 5320056103080001
P-OD3FDJBH
52 5320050505720001
P-OD6YMSCG
53 5320051711680001
P-EP63NVZ3
54 5320011105970003
Q-001R6UZY
55 5320050812750001
P-N9KJB1O5
56 5320054608840001
P-ODFE0AMS
57 5320024405890002
: Q-001PTUPB
58 5320052907990001
P-ODM5RQPE
59 5320056302970002
Q-001PTUV5
60 5320052104980001
: Q-001PVNND
61 5320050510890001
: Q-001PVNO4
62 5320050204900002
: Q-001PVNOG
63 5320050210800001
P-ODPRTVNJ
64 5320015211890001
P-ODXQLUWR
65 5320054412000001
P-OE5COFWA
66 5320050106900001
P-ODRNIXHM
67 5320044304880001
P-OE8IQSAI
68 5320050801680001
: Q-001PQXZX
69 5320050306940001
P-OEESNC4X
70 5320024604910001
P-OEGXX3QC
71 5320051810820001
P-OEIV2XUP
72 5320055012920001
Q-001PTKM3
73 5320055303840001
P-OEP3ASFU
74 5320055506910001
Q-001RUT82
75 5320052806580001
S-4D3F9E71
76 5320054106570001
S-BE939691
77 5320052302050002
P-OGGA4LTX
78 5320054405530001
S-A0416953
79 5320054706850001
P-OFFN0497
80 : S-CDEF427D 5320054107490001
81 P-OIFWFQZG 5308082007810001
82 P-OFJNWHR3 5320051505030001
83 P-OFLBWJKU 5320050712970001
84 Q-001PQJOE 5320050806830001
85 : P-OFVTC98E 5320051508700001
86 : P-OF0RDR3Z 5320050608860001
87 P-OFXKSSA3 5303053110930002
88 P-OFZEULQO 5320055305090001
89 Q-001PSQKG 5308204505920002
90 P-OGD6EI2C 5320050510050001
91 NIK MASALAH 5320050506860001
92 BRU ENTRY BACK DA5320052211060001

93 P-OILVW51V 5320051010970001
94 : P-OINJHQ9S : 5320054510080001
95 Q-000YPRNX 5320055202000001
96 P-G8HWSOXM 5320051911710001
97 P-OIOI9QAV 5320050607810003
98 Q-0003I8HH 5320050202920001
99 P-OITGJIEF 5320055604890001
100 P-NEF2DMOR 5320016812890001
101 P-OIW0UMG7 5320054107650005
102 P-OIWXIVMH 5320050107700001
103 P-OIZ8FT2A 5320054809900001
104 P-OJ171MYS 5320054812020001
105 P-OJ31VXVR 5320050606800001
106 Q-001PP5V5 5320051705620001
107 P-OJ4VX2C0 5320050604960001
108 P-OJBHTMGJ 5320011207870002
109 P-OJCC4FZK 5320012003000002
110 P-OJEGP8PD 5320052108800001
111 Q-001J427C 5320056811050001

112 S-90CEF3A6 5320050107550002
113 P-OJP1OQSO 5320024505840002
114 : Q-001NSTHV 5320052307680001
115 Q-001PQ3T1 5320050406920001

116 P-OJUDE2AR 5320050101030001
117 P-OJSNFTJC 5320052309890002
118 P-OJX1Z6QN 5320056102080001
119 BLM ENTRY 5320050704900001
120 Q-001PTKB3 5320051606820001
121 Q-001PTKCV 5320056903830001
122 P-OKTTM5F1 5320050905720001
123 P-OK0H5MNY 5320050101880003
124 P-OLA4SFXY 5320051108020001
125 P-E5YOZCGG 5301082905020005
126 P-OK4AK4FC 5371056404950001
127 P-OKG9X24F 5320051305080001
128 Q-001PSQJJ 5320010501040001
129 : Q-001PVNNV 5320013011750001
130 P-OKOK49D5 5320050111990003
131 P-OKPDPHPG 5320055107990002
132 S-457552F1 5320055011550001
133 P-OKSZP1XM 5320022105860002
134 P-OKN9CM0J 5320056109710001
135 P-OKRIUPMZ 5320055303950001
136 5320054208930001
P-OKQ0NYON
137 P-OKNVC2T0 5320055105030001
138 P-OKMOFVWK 5320050107620006
139 P-OKLSLOSR 5320054406660001
140 S-25FF83B9 5320015004530001
141 P-OKLISTSN 5320050107620005
142 P-UE7BXHDH 5320056402820001
143 P-OKF9TQVQ 5320055011740001
144 P-OJHO6KA1 5320054107650003
145 P-OIPM4433 5320050108550001
146 : S-096917EB 5320050701590001
147 P-OKCLEDLD 5371012310920003
148 P-OKAWZC87 5320050410790001
149 P-OKBQ11GJ 5320050510860001
150 P-OK9WSBUG 5320055603910001
151 P-OK8IJCJG 5320051609970001
152 P-OK6N488G 5320051708820003
153 P-OK5JBE8K 5320012103960001
154 DATA MSLAH NIK 530820180478

TDK LNGKP
155 5320051007550001
156 532005191500001
157 5320056212580001
158 5320055403500001
159 5320055707610001
160 53200515004540001
161 5320010508420001
162 5320056006520001
163 5320050609540001
164 5320055504580001
165 5320050202560001
166 5320055212460001
167 5320050301650001
168 5320051501700001
169 5320056604680001
170 5320055704830001
171 5320050604790001
172 5320052606860001
173 5320050706920003
174 5320050305990002
175 5320052808880001
176 5320050205670001
177 5320053110790002
178 5320051700380002
179 5320054308950001
180 5320044502980001
181 5320012304930003
182 5320055012880002
183 5320051407790001
184 5320051007950002
185 5320052604900001
186 5320044405940003
187 5320051303930001
188 5320052202640001
189 5320054305690001
190 5320056406970001
191 5320054504690001
192 5320051302630001
193 5320036409020002
194 5320014705640002
195 5320050811990001
196 5320052511990001
197 5320010404630001
198 5320056205900002
199 5320051905910001
200 5320052104970003
201 5320052306030003
202 5320050809640001
203 5320055606940001
204 5320050811880001
205 5320050802840001
206 5320052812730001
207 5320054502850001
208 5320050806810001
209 5320034708690001
210 5320054410940002
211 5320051010880002
212 5320050904090001
213 P-MANA72RQ 5320053006930003
214 P-PRF7PNAB '5320051001940001
215 5320055511090002
216 5320050606120001
217 5320050204080001
218 5320050412730001
219 5320026012080003
220 5320052807070001
221 5320016812050003
222 5320026801070001
223 5320021205050004
224 5320053003050001
225 5320052511050001
226 5320050610080001
227 5320052205060002
228 5320052412060001
229 5320052702090001
230 5320051004090001
231 5320050907790002
232 5320054210590001
233 5320050501500001
234 5320014706550001
235 5320051703640001
236 5320052601810001
237 5320032006760001
238 5320056011010001
239 5320056011010002
240 5320057103030001
241 5320050909820001
242 5320051203800001
243 5320055010840001
244 5320051805820001
245 5320051510650001
246 5320050402510001
247 5320050104970001
248 S-B00E34FC 5371045204820020
249 S-2AF81B63 5312105104830002
250 S-11F9709F 5320011909860002
251 S-102322B0 5320010901670001
: Sabu Raijua
: 15/12/2021
Pekerjaan*
Jenis
Kelamin
YAFET RAGA LOMI L LANSIA
YONATAN RAGA LOMI L LANSIA
MARTHEN SEMUEL LUTAPORU L MASYARAKAT UMUM
L MASY UMUM
EPA FORDITUS PA
NIKOLAS DANGA L LANSIA
P MASY UMUM
OKTOFIANA DOGA
CHAMELIA LADO - MANGNGI P MASY UMUM
YANTI DJARI P REMAJA
FERDISON HUBI MONE L MASY UMUM
YAKOB KANA LUDJI L MASY UMUM
MELKIANUS BALU KEBI L LANSIA
MINCE MARIANA LUDJI MANGNGI P MASY UMUM
LAURENS G. A. H. HAWU PAO L MASY UMUM

AGUSTINUS WADU RIWU L MASY UMUM
HENOK HAWU PAO L LANSIA
ISAK TARI L LANSIA
OKTAVIANUS ABRIANTO PATI LEWAR L MASY UMUM
NORSEDEBI RAGA LOMI P MASY UMUM
DORKAS WILA P MASY UMUM
MAXIMIANUS NADU NGE L MASY UMUM
LELO BANE L LANSIA
LANSIA
YOHANA KAHA
YULIANA HIA KE LANSIA
NIMROD DEHE DJIMO MASY UMUM
PETRUS RIWU WADU LANSIA
YOHANIS DJARA RABA LANSIA
PAULINA DELE DJO MASY UMUM
TOMAS LADO KALLI MASY UMUM
ROSALINA SEDA MASY UMUM
WALDINA MONE MASY UMUM
MARTHA MIHA MASY UMUM
KAROLINA LADO MANGNGI MASY UMUM
ELEN KALE KITU MASY UMUM
ANTONIUS EPA PADA MASY UMUM
YULIANA KOLO LADO P MASY UMUM
P PELAYAN PUBLIK
TERSIA KANA MANGNGI
BENDELINA HUBI LANSIA

WELHEMINA PA LANSIA
LI TUKA LANSIA
ELVIVANIA KAHA P MASY UMUM
SOLEMAN HAWU PAO MASY UMUM
AGUSTINUS NGENA DJO MASY UMUM
ADELSI DIMU LUDJI P MASY UMUM
ADISAPUTRA KOLO LADO MASY UMUM
IE KADJA LANSIA
IGNASIUS TALO TUKA MASY UMUM
REGINA REHE LONI MASY UMUM
MARIAM KE MANNO MASY UMUM
YULIANA ROHI MASY UMUM
VERONIKA EDE NGURU MASY UMUM
EVIN ERNAWATI DANGA REMAJA
RAFAEL BANGNGU BIRE MASY UMUM
MELDISON MUDI NGE MASY UMUM
STEPANUS HUBI MONE MASY UMUM
MOSES LAY MASY UMUM
HENDERINA RATU MASY UMUM
MARSELINA HERE HIA P MASY UMUM
JEFRI HURU MASY UMUM
IJE PAU HIA P MASY UMUM
MELKIANUS ALA RADE L MASY UMUM
KARE RODA L MASY UMUM

EFRAIM TADJI L MASY UMUM
SERVANUS PANNU PALI MASY UMUM
RUTH DATO MASY UMUM
SUSANA WATY LUDJI HE MASY UMUM
MANGNGI BANNI MASY UMUM
WELMINCE BANGNGU MASY UMUM
GABRIEL BALE BANE L LANSIA
DADU TALO MASY UMUM
DINA DJAMI KORE MASY UMUM
KRISTIAN DUKE HETU MASY UMUM
WELMINCE DJARA LAO P MASY UMUM
KATARINA RAME PADA MASY UMUM
P MASY UMUM
REDE RIHI MANGNGI
DAVID RAGA LOMI LANSIA
ELISABET HEPE PARA LANSIA
EUGENIUS SEDA REMAJA
PAULA PATRICIA LADO MANGNGI LANSIA
NGETA RODA MASY UMUM
RUT TADJI LANSIA
YUNUS TARI MASY UMUM
KANISIUS AKA GAI DJO MASY UMUM
KOTA RODA MASY UMUM
TAPE PAU L MASY UMUM
DOMINGGUS DJABBE MASY UMUM
HORAS TARI MASY UMUM

MARTEN DJABBE MASY UMUM
MARIA FATIMA MARE PE REMAJA
SARI KORO TADJI P MASY UMUM
OKTOVIANUS OTO DAGA REMAJA
PENINA KOLO LADO REMAJA
ZEFANYA KOLO LADO L REMAJA
NGURU TALO MASY UMUM
TRIFOSA TIGE ALA REMAJA
ANTONETA MANU TARA P MASY UMUM
NATHANIEL LODO DJARA MASY UMUM
BERNADUS KADJA DILA MASY UMUM
HENDRIKUS HAWU PAO L MASY UMUM
MARGERITA HURU MASY UMUM
MARTA DJABBE MASY UMUM
HENDERINA KORE MASY UMUM
KRISTOVEL DEHE DJIMO MASY UMUM
DIANA TARRU MASY UMUM
TERSIANA TADE DURI MASY UMUM
TIMOTIUS TUKA TALO MASY UMUM
AHAD RAGA LOMI L MASY UMUM
RETU RUBA MASY UMUM
KALEB DANGA MASY UMUM
YUSUF RONI NIKO DANGA MASY UMUM
DANIEL DUBU MASY UMUM

REMAJA
CHANTIKA CHRISTIANI P
PE MANGNGI LANSIA
FIVI LASARI KAHO DJIMO MASY UMUM
MIKAEL TARI L MASY UMUM
ALEKSANDER MANU TARA MASY UMUM

KRISPINUS GURU ALA MASY UMUM
JONI HURU MASY UMUM
VERA FEBRIANTI HURU REMAJA
TOBO RIHI MASY UMUM
HIA LAKI L MASY UMUM
GITA WADU P MASY UMUM
DEWI SARTIKA LOBO MASY UMUM
HAE TALO MASY UMUM
ABRAHAM WELE MASY UMUM
MESRI GA RADJA MASY UMUM
ASRI DIANI NAWA MATA MASY UMUM
MARTEN MATA DURI REMAJA
YULAN ADE PUTRA DJO RATE P MASY UMUM
DOMINGGUS DJO RATE L MASY UMUM
OVI RENST DJAMI DJARA MASY UMUM
TERSIANA KORE DULE MASY UMUM
ARIANCE DJINGI LANSIA
PELIPUS PALI KALLI MASY UMUM
SEMY YOSIS KITU PENU FORAH MASY UMUM
PETRONELA BANI MASY UMUM
ETI MIHA MASY UMUM
ESTORINA KITU PENU MASY UMUM
PAU HIA MASY UMUM
BUNGA MIRA MASY UMUM
PILPINA HUBI MONE LANSIA
ITO HETA MASY UMUM
MARTA KAHO DJIMO MASY UMUM
MARTINA MATE PAU MASY UMUM
NEPE OLI MASY UMUM
LUKAS TAGA MASY UMUM
REHABEAM KALE KITU LANSIA
DJEKI WALU LOGO MASY UMUM
STEFANUS ROHI RETU MASY UMUM
BALE RIHI HEKE MASY UMUM
DORKAS DEHE DJIMO MASY UMUM
YANSIS PARA PA MASY UMUM
AGUSTINUS DJARA MASY UMUM
MARTEN DADI MASY UMUM
WELFRIDUS G.L.MOA MASY UMUM
AGUSTINUS KORE L LANSIA

MARKUS WIE L LANSIA
MARIAM LEO P LANSIA
TAMAR MANGNGI P LANSIA
LUISA RIWU DJETA P LANSIA
LASARUS LENA LAY L LANSIA
TOBIAS WADU L LANSIA
RUT LENA WIE P LANSIA
WILLEM LUMU LAY L LANSIA
WILDA DJAMI KORE P LANSIA
KANA RIWU L LANSIA
LENA BANGNGU P LANSIA
YONATAN WIE L LANSIA
SOLEMAN LAY L MASY UMUM
SARA HADJA P MASY UMUM
TABITA LENA LAY P MASY UMUM
TITUS KANA MANGNGI L MASY UMUM
BENYAMIN LAY LEO L MASY UMUM
ROBINSON RAME RIMA L MASY UMUM
RIFAN ANDIKA MIRA L MASY UMUM
KANA HUKE L MASY UMUM
DANIEL LEO L MASY UMUM
MARTHEN LUTHER RIHI L MASY UMUM
MARTHEN TANGA L MASY UMUM
JEK ARIANTO KORE DIDA L MASY UMUM
MINA NGETA P MASY UMUM
DOMINGGUS RAME LUDJI L MASY UMUM
DORCI LAY P MASY UMUM
YUSAK LAY L MASY UMUM
MELMELTHYS RIWU P MASY UMUM
ROBINSON DIDA L MASY UMUM
MARTA PATI P MASY UMUM
DAVID KANA MANGNGI L MASY UMUM
PITER DIDA L MASY UMUM
WELMINCE RAME LUDJI P MASY UMUM
ARNI ROSITA DIDA P MASY UMUM
KOPE RADJA P MASY UMUM
FERDINAND KANA MANGNGI L MASY UMUM
SOPIA LULU P MASY UMUM
ELISABET RAGA P MASY UMUM
FERDI WIE L MASY UMUM
MANGNGI DARA L MASY UMUM
DAUD DJAMI KORE L MASY UMUM
WELHELMINA LENA LAY P MASY UMUM
YERMIAS LUDJI LINGU L MASY UMUM
IVAN BALE LAY L MASY UMUM
JOVAN KALE UKE L MASY UMUM
THOMAS KALE UKE L MASY UMUM
LIA DESTRIA DIDA P MASY UMUM
HENDRIK BALE LAY L MASY UMUM
KORE RIWU L MASY UMUM
IMANUEL KANA MANGNGI L MASY UMUM
RIN LAY P MASY UMUM
KORNELIUS LUDJI LINGU L MASY UMUM
TABITA NGAHU P MASY UMUM
PRISANDY S LUMU LAY P MASY UMUM
MELKIANUS HAU L MASY UMUM
ANDIKA F LAY L REMAJA
FRENGKI LEO L PELAYANPUBLIK
SEPSEL LAY L PELAYAN PUBLIK
ADE ROSITA GA NGARA L REMAJA
ORPHA LAY P REMAJA
ALVONS DIDA L REMAJA
JESKIN WIE P REMAJA
VERA VERONIKA LAY P REMAJA
LINTAR DIDA L REMAJA
PUTRI HERE P REMAJA
DJEIN FLISTIANI LAY L REMAJA
YERMIAS KALFINSON BARI L REMAJA
YORDIN EVERSUNI TANGA L REMAJA
STEVEN LAY L REMAJA
JOSUA TRISMEN RIVALDO LAY L REMAJA
ERNAWATI LUDJI LINGU P REMAJA
YONATAN LUDJI LINGU L REMAJA
ADIPUTRA RIWU L REMAJA
YESAYA SAPUTRA RIHI L REMAJA
PETRUS LUDJI LINGU L LANSIA
HELENA ROSALIN BALE LAY P LANSIA
RUBEN GA NGARA L LANSIA
WARA REDE P LANSIA
NATANIEL BALE L MASY UMUM
RAFAEL LUDJI LINGU L MASY UMUM
YERMIAS KANA MANGNGI L MASY UMUM
RUSNI LAY L MASY UMUM
ELMIN LAY L MASY UMUM
ADE DELVITA LAY L MASY UMUM
HERMANUS WIE L MASY UMUM
LORENS PRATAMA LUMU LAY L MASY UMUM
LODIA WIE DODU P MASY UMUM
HENDRA GA NGARA L MASY UMUM
MARTINUS LAY L MASY UMUM
RAFAEL KANA MANGNGI L LANSIA
MIGU MANGNGI L MASY UMUM
APLONIA ARININGSIH RIHI LEBA P PELAYAN PUBLIK
ALBERTINA LODA BULU P PELAYAN PUBLIK
MELKIANUS HUPU LODO L PELAYAN PUBLIK
JAVID SEM JONI LIUS NDU UFI L PELAYAN PUBLIK
Umur
tahun)
1960-01-01 61 DESA EIMAU
12/24/1961 60 DESA EIMAU
34 EIMAU
5/4/1986
32 EIMAU
10/19/1988
3/26/1986 35 DESA EIMAU
5/25/2005 16 DESA BEBAE
4/5/1998 23 DESA DELO
1942-03-04 79 DESA EIMAU
3/21/1983 38 DESA EIMAU
1977-09-24 44 DESA EIMAU

8/17/1999 22 DESA EIMAU
1945-05-12 76 DESA EIMAU
10/5/1990 31 DESA EIMAU
11/6/1989 32 DESA EIMAU
10/5/1964 57 DESA EIMAU
9/13/1968 54 46-59 DESA EIMAU
1949-01-07 72 DESA EIMAU
1961-01-10 60 EIMADAKE
11/6/1980 41 DESA EIMAU
6/22/1976 45 DESA EIMAU
2/26/2001 20 DESA EIMAU
10/15/1965 56 DESA EIMAU
6/17/1967 54 DESA EIMAU
3/26/1991 30 DESA EIMAU
6/28/2001 20 DESA EIMAU
09 FEBRUARI 1995 26 EIMAU
5/28/1953 68 DESA EIMAU

1/1/1979 44 31-45 DESA EIMAU
10/11/1985 36 DESA EIMAU
8/10/1985 36 DESA EIMAU
24-Apr-84 37 EIMAU
7/10/2001 20 DESA EIMAU
8/12/1942 79 DESA EIMAU
1980-08-06 41 DESA EIMAU
10/26/1975 46 DESA EIMAU
3/16/1998 23 DESA EIMAU
3/21/2008 13 DESA EIMAU
5/5/1972 49 EIMADAKE
11/17/1968 53 DESA EIMAU
1997-05-11 24 DESA EIMAU
1975-12-08 46 DESA BEBAE
7/29/1999 22 DESA EIMAU
4/22/1997 24 DESA EIMAU
4/21/1998 25 18-30 DESA EIMAU
10/5/1989 33 31-45 DESA EIMAU

3/8/1989 34 31-45 DESA EIMAU
5/14/1981 40 DESA EIMAU
1/12/1989 32 DESA DELO
12/4/2000 21 DESA EIMAU
1990-06-01 31 DESA EIMAU
8/1/1968 54 46-59 DESA EIMAU
10/5/1992 29 DESA EIMAU
10/18/1982 39 DESA EIMAU
12/10/1992 29 DESA EIMAU
8/19/1984 37 DESA EIMAU
32 DESA EIMAU
8/6/1989
1958-06-28 63 DESA EIMAU
2005-03-23 16 DESA EIMAU
1949-07-01 72 DESA EIMAU
7/20/1981 40 DESA EIMAU
5/21/2003 18 DESA EIMAU
12/7/1997 24 DESA EIMAU
6/8/1983 38 31-45 DESA EIMAU
1970-08-15 51 DESA EIMAU

10/31/1992 29 DESA EIMAU
2009-05-13 12 DESA EIMAU
2005-10-05 16 DESA EIMAU
11/13/2006 15 DESA EIMAU
11/22/2006 16 12-17 EIMAU
10/5/2008 13 DESA EIMAU
2/2/2002 19 EIMAU
9/19/1971 50 DESA EIMAU
4/16/1989 32 DESA EIMAU
1989-12-28 32 DESA EIMAU
1965-07-01 56 DESA EIMAU
2002-12-08 19 DESA EIMAU
4/17/1962 59 46-59 DESA EIMAU
7/17/1987 34 DESA EIMAU
3/20/2000 21 DESA EIMAU
8/21/1980 41 DESA EIMAU
11/28/2005 17 12-17 EIMAU

1955-07-01 66 DESA EIMAU
7/23/1968 54 46-59 DESA EIMAU

6/10/1989 32 DESA EIMAU
2/21/2008 13 DESA EIMAU
6/16/1982 39 DESA EIMAU
3/29/1983 38 DESA EIMAU
6/18/1993 28 DESA EIMAU
11/8/2002 19 DESA EIMAU
5/29/2002 19 DESA EIMAU
4/24/1995 26 DESA EIMAU
5/13/2008 13 DESA EIMAU
2004-01-05 17 DESA EIMAU
11/30/1975 47 46-59 DESA EIMAU
11/1/1999 22 DESA EIMAU
7/11/1999 22 DESA EIMAU
11/10/1955 66 DESA EIMAU
1986-05-21 35 DESA EIMAU
9/21/1971 50 DESA EIMAU
3/13/1993 28 DESA EIMAU
2003-05-11 18 DESA EIMAU
5/16/1987 34 DESA EIMAU
2/24/1982 39 DESA EIMAU
1974-11-10 47 DESA EIMAU
1975-08-01 46 DESA EIMAU
1/15/1959 62 DESA EIMAU
10/23/1992 29 DESA EIMAU
10/4/1979 42 DESA EIMAU
10/5/1986 35 EILODE
3/16/1991 30 DESA EIMAU
9/16/1997 24 DESA EIMAU
8/17/1982 39 DESA EIMAU
3/21/1996 25 DESA EIMAU
4/16/1978 43 DESA EIMAU
7/10/1955 68 60-150 DESA EIMAU

11/19/1950 72 60-150 DESA TADA
12/22/1958 64 60-150 DESA TADA
3/14/1950 73 60-150 DESA TADA
7/17/1961 62 60-150 DESA TADA
4/15/1954 69 60-150 DESA TADA
8/5/1942 80 60-150 DESA TADA
6/20/1952 71 60-150 DESA TADA
11/6/1954 68 60-150 DESA TADA
10/8/1958 64 60-150 DESA TADA
2/2/1956 67 60-150 DESA TADA
12/12/1946 76 60-150 DESA TADA
1/3/1955 68 60-150 DESA TADA
1/15/1970 53 46-59 DESA TADA
4/26/1968 55 46-59 DESA TADA
4/17/1983 40 31-45 DESA TADA
4/6/1979 44 31-45 DESA TADA
6/26/1986 37 31-45 DESA TADA
6/13/1992 31 31-45 DESA TADA
5/3/1999 24 18-30 DESA BEBAE
8/28/1988 34 31-45 DESA TADA
5/2/1967 56 46-59 DESA TADA
10/31/1979 43 31-45 DESA TADA
3/17/1983 40 31-45 DESA TADA
8/3/1995 27 18-30 DESA TADA
2/5/1998 25 18-30 DESA TADA
4/23/1993 30 18-30 DESA RAEKORE
12/10/1988 34 31-45 DESA TADA
7/14/1979 44 31-45 DESA TADA
7/10/1995 28 18-30 DESA TADA
4/26/1990 33 31-45 DESA TADA
8/5/1992 30 18-30 DESA TADA
3/16/1995 28 18-30 DESA TADA
2/22/1964 59 46-59 DESA TADA
5/3/1964 59 46-59 DESA TADA
6/24/1997 26 18-30 DESA TADA
05/04/1969 54 46-59 DESA TADA
2/13/1963 60 60-150 DESA TADA
9/25/2003 19 18-30 DESA TADA
5/7/1964 59 46-59 DESA RAEKORE
6/21/1999 24 18-30 DESA TADA
12/25/1999 23 18-30 DESA TADA
6/1/1969 54 46-59 DESA TADA
5/22/1990 33 31-45 DESA TADA
5/19/1991 32 31-45 DESA TADA
4/20/1997 26 18-30 DESA TADA
6/23/2003 20 18-30 DESA TADA
9/8/1964 58 46-59 DESA TADA
6/16/1994 29 18-30 DESA TADA
11/8/1988 34 31-45 DESA TADA
2/8/1984 39 31-45 DESA TADA
12/28/1973 49 46-59 DESA TADA
2/5/1985 38 31-45 DESA TADA
6/8/1981 42 31-45 DESA TADA
8/7/1969 53 46-59 DESA EIADA
3/15/1995 28 18-30 DESA TADA
10/10/1988 34 31-45 DESA TADA
4/9/2009 14 12-17 DESA BEBAE
7/31/1993 28 DESA TADA
9/11/1994 27 18-30 TADA
11/15/2009 27 18-30 DESA TADA
6/24/2008 15 12-17 DESA TADA
4/2/2008 15 12-17 DESA TADA
12/4/2009 13 12-17 DESA TADA
12/20/2008 14 12-17 DESA TADA
7/28/2007 15 12-17 DESA TADA
12/28/2005 17 12-17 DESA TADA
1/28/2007 16 12-17 DESA TADA
5/12/2005 18 18-30 DESA BEBAE
3/30/2005 18 18-30 DESA BEBAE
11/25/2005 17 12-17 DESA TADA
10/6/2008 14 12-17 DESA TADA
4/9/2008 15 12-17 DESA TADA
12/24/2006 16 12-17 DESA TADA
2/27/2009 14 12-17 DESA TADA
4/10/2009 14 12-17 DESA BEBAE
7/9/1942 81 60-150 DESA TADA
2/3/1961 62 60-150 DESA TADA
1/5/1950 73 60-150 DESA TADA
4/20/1954 69 60-150 DESA RAEKORE
3/17/1964 59 46-59 DESA TADA
1/26/1981 42 31-45 DESA TADA
6/20/1976 47 46-59 DESA TADA
9/20/2001 21 18-30 DESA TADA
9/20/2001 21 18-30 DESA TADA
3/30/2003 20 18-30 DESA TADA
9/9/1982 40 31-45 DESA BEBAE
2/12/1980 43 31-45 DESA TADA
10/10/1984 38 31-45 DESA BEBAE
11/4/1982 40 31-45 DESA TADA
10/15/1965 57 46-59 DESA TADA
3/5/1961 62 60-150 DESA TADA
4/1/1997 26 18-30 DESA TADA
1982-04-12 39 31-45 LOBORUI
4/11/1983 MENIA
9/19/1986 MENIA
1/9/1967 RAELORO
ASI COVID-19
NASI

yang sesuai)
BPJS Non
PBI
082339940480 12/15/2021
082339940480 12/15/2021
08123323004 12/15/2021
11/16/2021
085237919660
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085 239 26 545 0002108928227 01 JULI 2021
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00008720959
081 238 718 230 16 JULI 2021
15
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085237129594 6/29/2021
85239255553
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081246998982 11/15/2021
085253411040 11/15/2021
085333333201 11/15/2021
081338444467 11/15/2021
Dosis I
Tanggal Pemberian
No. Batch
Vaksinasi

VAKSIN COVID19 BIOFARMA 10/12/2021 202108119H
CORONAVAC 01 JULI 2021 24200721

VAKSIN COVID19 BIOFARMA 12/15/2021 A1087


ASTRA ZENECA

VAKSIN COVID 19 BIOFARMA 10/27/2021 202108169F

202108122H

ASTRAZENECA 11/15/2021 24203421
ASTRAZENECA 11/15/2021 24203421
CORONAVAC 28 JUNI 2021 24200721
CORONAVAC 6/29/2021 24200721
CORONAVAC
Dosis 2
Tanggal Pemberian
Vaksinasi
10000006784634
10000006784634
10000006784634
16309375256635 12/15/2021 24203421
16309339721322 12/15/2021 24203421
16309375256635 12/15/2021 24203421
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16295072867328 12/15/2021 24203421
10000006784634
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10000006784634
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10000006784634
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10000006784634
10000006784634
12/15/2021 24203421
10000006784634
16311459801388
16309339721322 12/15/2021 24203421
10000006784634
16309339721322 12/15/2021 24203421
16295072867328 12/15/2021 24203421
16295072867328 12/15/2021 24203421

16295072867328 12/15/2021 24203421
10000006784634
10000006784634
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16311459802948
16295072867328 12/15/2021 24203421
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16309339721322 12/15/2021 24203421
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16319375256635
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16311459802948
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16309339721322 12/15/2021 24203421
10000006784634
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10000006784634
16311459802948
16309339721322 12/15/2021 24203421
16311459802948
10000006784634
16295072867328 12/15/2021 24203421
10000006784634
16311459802948
16254561590320 12/15/2021 24203421
10000006784634
10000006784634
12/15/2021 A1087
10000006784634
10000006784634
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10000006784634
10000006784634
10000006784634
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16309332120843 12/15/2021 24203421
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10000006784634
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16298092626190 12/15/2021 24203421
16309332120843 12/15/2021 24203421

10000006784634
10000006784634
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16309339721322 12/15/2021 24203421
16309339721322 12/15/2021 24203421
10000006784634
10000006784634
10000006784634
10000006784634
10000006784634
'16311459694996
16309339721322 12/15/2021 24203421
16295072867328 12/15/2021 24203421
'16311459694996
'16311459694996
'16311459694996
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Keterangan
Diberikan/Lanjut)
No. Serial
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Kabupaten/Kota
Provinsi
Hari, Tanggal
No No. Tiket NIK
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: Sabu Raijua
: 14/12/2021
Pekerjaan*
Jenis
Kelamin
WELEM DJARA DJATA L MASY UMUM
WIE MOLA L MASY UMUM
BENY WOLO L MASY UMUM
YULIANA ROHI MOLA P LANSIA
TITUS HIGA HUKI L MASY UMUM
DOMINGGUS LUWU L MASY UMUM
YONATAN DJAWWU L MASY UMUM
FERNANDES LUWU L MASY UMUM
NAHUM KANNI L LANSIA
HENDERINA RIWU P LANSIA
TINCE ROHI IE P LANSIA
SHERLYN DJAWA DJAMI P MASY UMUM
BENDELINA ROHI IE P MASY UMUM

MARCELINA HAGI WILA P MASY UMUM
MARTA M. DJARA DJATA P MASY UMUM
YANTI MARIAM DJABBE P MASY UMUM
WELDIANA HADJA P MASY UMUM
TERSIA LOMI RIHI P MASY UMUM
BENYAMIN HADJA L MASY UMUM
KESIA ROHI NGURU P MASY UMUM
PAULUS DJARA DJATA L MASY UMUM
P MASY UMUM
MARSELINA RATU KAHO
TITUS RIWU HIPA L MASY UMUM
GABRIEL KANNI L MASY UMUM
YOHANIS STEFANUS KANNI L MASY UMUM
MELI RIYANTI TARI P MASY UMUM
MERLIN LODO P MASY UMUM
NINGSIH KANNI P MASY UMUM
ETYN SILFIAN LAY P MASY UMUM
DARWIN KARNO TANGA L MASY UMUM
ANTONIA LAY P MASY UMUM
RUBEN DJARA BANGNGU L MASY UMUM
IRVAN HERE HIA L MASY UMUM
MOLA WIE L LANSIA
RICHARD ANDERSON ROHI NGURU L REMAJA
OLVIN ORIONGKI ROHI NGURU P REMAJA
AGUS MIHE L MASY UMUM

YOHANA TARI P MASY UMUM
ANTONIA UDJU P MASY UMUM
JUBLINA DJARI P LANSIA
YOHANES EDISON KANA MANGNGI L MASY UMUM
RIAN LUWU L REMAJA
ISHAK UDJU L LANSIA
BENYAMIN RATU KAHO L REMAJA
MARLINCE DJAWWU P MASY UMUM
DORIS LAY P MASY UMUM
MARTINA HADJA P MASY UMUM
ANDO LUWU L REMAJA
BERNABAS NESTAPA HAE L MASY UMUM
MARTEN ROHI IE L MASY UMUM
VERAWATI LUWU P REMAJA
APRIANA LUWU P MASY UMUM
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KRISTINA DJAWA P MASY UMUM
EFI YUNITA TADI LULU P MASY UMUM
EDISON LOBO PIGA L MASY UMUM
STEVEN TADI LULU L REMAJA
ELEN NOVITA LAKE P REMAJA

FUSRIANTO RIHI L REMAJA
PETRUS MONE WEO L REMAJA
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ELVIS RADJA L MASY UMUM
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RANTO ADIPUTRA DJU L REMAJA
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LUKAS LEO L LANSIA
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KARDIA FIDROLINO RADJA P REMAJA

PUTRA DJARA HAU L REMAJA
NOLDI TADI LULU L REMAJA
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JUAN DJARA DJATA L REMAJA
WAHYUNINGSIH DJARA HAU P REMAJA
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RAHEL LOBO P MASY UMUM
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SEFEN MEISEN LEO L MASY UMUM
FILEMON MANU RIWU L MASY UMUM
NOFRI ADE IRMA HAGA L MASY UMUM
TITUS HABA GEA L LANSIA
NOVRIANTI BALE P MASY UMUM
DANIEL KORE L MASY UMUM
RUT KALE LEO P MASY UMUM
WELEM DARA L MASY UMUM
AGUSTINA LAY P MASY UMUM
WELHELMINA DJARA BANGNGU P MASY UMUM
AGUSTINA LOMI LADO P MASY UMUM
WISDOM WILLYAM TOMA L MASY UMUM
HABEL DJAWA L MASY UMUM
DAMARIS LEO P LANSIA
LALU RONA L LANSIA
MARTHA IE NUWI P LANSIA
YUNI DJARI P MASY UMUM
ELIUS LEO L MASY UMUM
WELMINCE MAGE P MASY UMUM
MELKIANUS TANGA L MASY UMUM

LAI LUDJI L LANSIA
GUS KRISTIAN DARA L REMAJA
DEBI YULIANA RADJA P REMAJA
ADEL OLIVIA RADJA P REMAJA
ALDY HABA L REMAJA
DONOFA BRIKSON DOKO L REMAJA
ARIS DJARI L REMAJA
EDWIN ALDRIN LUPA BOLE L REMAJA
ISAK ADRIAN RADJA L REMAJA
CELVI LOIVIA RIWU P REMAJA
TIARA ANGELLIN LAT P REMAJA
SERLIN LAY P REMAJA
ELVIN NOVITA DJARI P REMAJA
MARGERITA TUKA RADJA P PELAYAN PUBLIK
KORNELIUS KALE PAO L LANSIA
IMANUEL RADJA L LANSIA
REGINA GA P LANSIA
LUISA NGURU P LANSIA
MARTA WILA PA P LANSIA
WELHELMINA HABA GEA P MASY UMUM
WELHEDRIKES LOMI RIHI P MASY UMUM
TERSIA RADJA P MASY UMUM
FERDERIKA HABA GEA P MASY UMUM
WELKI DJARA DJATA L MASY UMUM
PELIPUS RIWU L MASY UMUM
TOMAS RIWU L MASY UMUM
NIKOLAS KANNI L MASY UMUM
ROBERT KANNI L MASY UMUM
BENYAMIN TARI L MASY UMUM
YOHANIS LUWU L MASY UMUM
DELVITA ROSALIA LUMU LAY P MASY UMUM
MIDRA SUKARNI DJU P MASY UMUM
BENDELINA HABA GEA P MASY UMUM
BRIAN MANUAL RADJA L MASY UMUM
ASER TADI LULU L MASY UMUM
LINDA ROSINTA LY RATU P MASY UMUM
ROSALINDA KALE DJARA P MASY UMUM
PAULINA LAO P MASY UMUM
JEMIEL RADJA GERE L MASY UMUM
DOMINGGUS KANNI L MASY UMUM
ZILPA ODJA L MASY UMUM
LISA MONE WEO P MASY UMUM
ALFRET LEO L MASY UMUM
PUTRA HERE L MASY UMUM
ANUS HAGA L MASY UMUM
MOSES MONE WEO L MASY UMUM
MARIA REGINA LAKE P MASY UMUM
YUS ERWIN ADI P BALE L MASY UMUM
MESAK LUPA BOLE L MASY UMUM
YANUARI DJARA DJATA L MASY UMUM
OMI SERLINA TADE LULU P MASY UMUM
RUBEN DJU L MASY UMUM
SEPTEN A G LENA RATU L MASY UMUM
NIKODEMUS PADA PITA L MASY UMUM
SEPTE KRISTIAN RIWU L MASY UMUM
Umur
Tanggal Lahir Kelompok Umur Alamat
(18 sd ≥ 60 tahun)
11/22/1980 41 EIADA
3/30/1983 38 EIADA
5/7/1983 38 EIADA
7/22/1961 60 EIADA
7/24/1974 47 EIADA
11/12/1962 59 BEBAE
1/7/1972 49 EIADA
3/13/1997 24 BEBAE
5/1/1956 65 BEBAE
12/12/1958 63 EIADA
7/17/1957 64 BEBAE
9/28/1998 23 EIMADAKE
11/17/1994 27 TADA
3/25/1973 48 EIADA
4/20/2001 20 BEBAE
3/3/1997 24 BEBAE
4/14/1990 31 BEBAE
7/8/1963 58 EIADA
4/26/1992 29 BEBAE
2/8/1990 31 EIADA
7/13/1998 23 BEBAE
10/28/2002 19 BEBAE
4/28/1987 34 BEBAE
1/28/1985 36 BEBAE
10/19/1967 54 BEBAE
5/3/1998 23 EIADA
5/15/2003 18 MATEI
1/15/2001 20 BEBAE
11/13/1985 36 BEBAE
3/26/2000 21 BEBAE
2/28/1988 33 BEBAE
12/10/1987 34 BEBAE
11/18/1999 22 RAEKORE
2/15/1955 66 EIADA
4/7/2006 15 EIADA
10/9/2004 17 EIADA
8/10/1998 23 EIADA
9/3/1964 57 BEBAE
10/23/1979 42 BEBAE
10/3/1950 71 MATEI
3/22/1987 34 TADA
10/22/2008 13 BEBAE
7/1/1950 71 EIADA
4/5/2005 16 BEBAE
3/13/2000 21 EIADA
5/3/1995 25 TADA
4/13/1978 43 EIADA
4/29/2006 15 BEBAE
5/5/1976 45 LOBODEI
12/13/1983 38 BEBAE
3/2/2004 17 BEBAE
5/20/2003 18 EIADA
5/3/1996 25 BEBAE
11/20/2000 21 EIADA
7/27/1977 44 EIADA
8/12/1988 33 EIADA
11/14/1991 30 EIADA
6/12/1996 25 BEBAE
11/3/1977 44 BEBAE
9/25/2005 16 BEBAE
11/4/2006 15 BEBAE
5/27/2005 16 BEBAE
8/27/2009 12 BEBAE
12/25/2003 17 BEBAE
12/2/1983 38 BEBAE
6/2/2007 14 BEBAE
3/15/2004 17 BEBAE
7/6/2004 17 BEBAE
11/28/2002 19 BEBAE
12/2/2009 12 BEBAE
6/19/2004 17 BEBAE
3/13/1980 41 BEBAE
12/19/2008 13 BEBAE
19/02/2008 13 BEBAE
12/9/1977 44 BEBAE
9/3/1984 37 BEBAE
15-Jun-04 17 BEBAE
1/13/1973 48 BEBAE
3/21/1991 30 EIADA
4/16/2009 12 BEBAE
9/1/1956 66 60-150 DESA BEBAE
7/1/1947 76 60-150 DESA EIADA
12/25/1950 72 60-150 DESA EIADA
7/1/1947 76 60-150 DESA EIADA
7/16/1945 78 60-150 DESA BEBAE
13 12-17 DESA BEBAE

11/14/2009
7/28/2003 19 18-30 DESA EIADA
10/20/2007 15 12-17 DESA BEBAE
1/18/2007 16 12-17 DESA EIADA
10/6/2009 13 12-17 DESA BEBAE
2/14/2008 15 12-17 DESA EIADA
1/15/2007 16 12-17 DESA BEBAE
11/12/1988 34 31-45 DESA BEBAE
5/10/1997 26 18-30 DESA BEBAE
12/23/1990 32 31-45 DESA BEBAE
5/7/2002 19 DESA BEBAE
3/29/1997 24 DESA BEBAE
12/28/2002 20 18-30 DESA BEBAE
11/15/1960 62 60-150 DESA BEBAE
11/1/2003 19 18-30 DESA BEBAE
1996-08-20 25 DESA BEBAE
4/25/1984 37 DESA BEBAE
12/101/1979 42 DESA BEBAE
8/9/1986 36 31-45 BEBAE
12/20/1963 59 46-59 BEBAE
9/3/1984 38 31-45 DESA BEBAE
9/21/2001 21 18-30 DESA BEBAE
1/15/1975 48 46-59 DESA EIMADAKE
4/15/1943 80 60-150 DESA BEBAE
2/3/1947 76 60-150 DESA BEBAE
9/12/1949 73 60-150 DESA EIMADAKE
7/2/2003 20 18-30 DESA BEBAE
11/20/1970 52 46-59 DESA BEBAE
11/23/1972 50 46-59 DESA BEBAE
1/7/1972 51 46-59 DESA BEBAE

6/11/1932 91 60-150 DESA EIMADAKE
8/18/2009 13 12-17 DESA BEBAE
12/19/2004 18 18-30 DESA BEBAE
10/14/2008 14 12-17 DESA BEBAE
9/11/2006 16 12-17 DESA BEBAE
11/26/2006 16 12-17 DESA BEBAE
5/25/2005 18 18-30 DESA BEBAE
3/5/2006 17 12-17 DESA EIADA
9/21/2008 14 12-17 DESA BEBAE
10/17/2009 13 12-17 DESA BEBAE
8/31/2006 16 12-17 DESA BEBAE
9/7/2006 16 12-17 DESA BEBAE
2/9/2007 16 12-17 DESA BEBAE
2/3/1985 38 31-45 DESA BEBAE
1/20/1947 76 60-150 DESA BEBAE
7/10/1960 63 60-150 DESA BEBAE
8/2/1959 63 60-150 DESA EIADA
1/7/1949 74 60-150 DESA EIADA
1/19/1960 63 60-150 DESA BEBAE
1/20/1962 61 60-150 DESA BEBAE
7/13/1969 54 46-59 DESA BEBAE
2/5/1969 54 46-59 DESA BEBAE
7/1/1975 48 46-59 DESA BEBAE
2/3/1975 48 46-59 DESA BEBAE
2/15/1980 43 31-45 DESA BEBAE
2/15/2003 20 18-30 DESA BEBAE
6/6/1964 59 46-59 DESA BEBAE
5/8/1965 58 46-59 DESA BEBAE
7/1/1980 43 31-45 DESA EIADA
4/19/1981 42 31-45 DESA BEBAE
11/20/1993 29 18-30 DESA TADA
11/19/2002 20 18-30 DESA BEBAE
7/5/1972 51 46-59 DESA BEBAE
6/12/1986 37 31-45 DESA BEBAE
6/17/1977 46 46-59 DESA BEBAE
11/2/2003 19 18-30 DESA BEBAE
6/18/1998 25 18-30 DESA TADA
7/22/1980 42 31-45 DESA BEBAE
6/10/1999 24 18-30 DESA BEBAE
9/13/1970 52 46-59 DESA BEBAE
12/2/1969 53 46-59 DESA EIADA
12/20/2000 22 18-30 DESA BEBAE
7/31/1993 29 18-30 DESA TADA
6/14/2003 20 18-30 DESA TADA
10/25/1973 49 46-59 DESA BEBAE
3/21/1993 30 18-30 DESA BEBAE
5/24/2003 20 18-30 DESA BEBAE
7/21/1997 25 18-30 DESA BEBAE
9/9/1970 52 46-59 DESA EIADA
1/31/2003 20 18-30 DESA BEBAE
10/4/2002 20 18-30 DESA BEBAE
12/29/1968 54 46-59 DESA BEBAE
9/8/1998 24 18-30 DESA KEDURU
11/29/1988 34 31-45 DESA KEDURU
9/15/1992 30 18-30 DESA EIMADAKE
ASI COVID-19
NASI

yang sesuai)
BPJS Non
PBI
085211210382 12/14/2021
085211210382 12/14/2021
085211210382 12/14/2021
085211210382 12/14/2021
085211210382 12/14/2021
085339080315 12/14/2021
085211210382 12/14/2021
085281934093 12/14/2021
085237128021 12/14/2021
085211210382 12/14/2021
085237128021 12/14/2021
085237128021 12/14/2021
081218966930 10/19/2021
085211210382 12/14/2021
082341596177 12/14/2021
085337808515 12/14/2021
082359274202 12/14/2021
085211210382 12/14/2021
085337808515 12/14/2021
081339712450 12/14/2021
085339080635 12/14/2021
082146390219 12/14/2021
082147624666 12/14/2021
082147624666 12/14/2021
082147624666 12/14/2021
081254745790 12/14/2021
081338951500 12/14/2021
082147624666 12/14/2021
081339037312 12/14/2021
082145187442 12/14/2021
081254745790 12/14/2021
081254745790 12/14/2021
081342489603 12/14/2021
085211210382 12/14/2021
085211210382 12/14/2021
085211210382 12/14/2021
085211210382 12/14/2021
085339080315 12/14/2021
085333087889 12/14/2021
085339080521 12/14/2021
081218966930 12/14/2021
085281934093 12/14/2021
085211210382 12/14/2021
085339080315 12/14/2021
085339080315 12/14/2021
085281934093 12/14/2021
085211210382 12/14/2021
085233343564 12/14/2021
082236195801 12/14/2021
082147624666 12/14/2021
085233343564 12/14/2021
081338837839 12/14/2021
082145402675 12/14/2021
081338837839 12/14/2021
081338837839 12/14/2021
082267348208 12/14/2021
082359274202 12/14/2021
081254745790
082147624666 12/14/2021
082262784635 12/14/2021
081236763126 12/14/2021
082236335171 12/14/2021
082147624666 12/14/2021
082145402785 12/14/2021
082147624666 12/14/2021
082236395813 12/14/2021
082145358619 12/14/2021
082339557173 12/14/2021
082144013129 12/14/2021
082147624666 12/14/2021
082147310537 12/14/2021
082147624666 12/14/2021
082147624666 12/14/2021
082147624666 12/14/2021
082147624666 12/14/2021
082147624666 12/14/2021
082145506110 12/14/2021
082147264666 12/14/2021
081254745790 12/14/2021
081237247905 12/14/2021
082147624666 10/13/2021
82147624666 11/13/2021
82147624666 11/13/2021
82147624666 11/13/2021
82147624666 11/13/2021
082147624666 11/15/2021
082147624666 11/15/2021
10/25/2021
82340359071 11/15/2021
82147624666 11/13/2021
082147624666 11/15/2021
11/15/2021
082147624666
81254745790 11/13/2021
81254745790 11/13/2021
081237503930 10/13/2021
081338411197 10/13/2021
82147624666 11/13/2021
82147624666 11/13/2021
082147624666 11/15/2021
081358598230 10/13/2021
085337816401 10/13/2021
082147264666 10/13/2021
81257124907 11/13/2021
85333831353 11/13/2021
82147624666 11/13/2021
82147624666 11/13/2021
82339252370 11/6/2021
082144942598 12/14/2021
081254745790 12/14/2021
082237241892 12/14/2021
082142624666 12/14/2021
081254745790 12/14/2021
082339201516 12/14/2021
082142624666 12/14/2021
082237241892 12/14/2021
082142624666 12/14/2021
082145402718 12/14/2021
085333417869 12/14/2021
081239579320 12/14/2021
082144942598 12/14/2021
082171151536 12/14/2021
085333827864 12/14/2021
082144859740 12/14/2021
081237439221 12/14/2021
081254745790 12/14/2021
081257124907 12/14/2021
082145402688 12/14/2021
082 147 624 666 9/13/2021
082147624666 12/14/2021
082147624666 12/14/2021
08123646009 12/14/2021
08123646009 12/14/2021
081254745790 12/14/2021
082142624666 12/14/2021
082142624666 12/14/2021
082147624666 12/14/2021
082147624666 12/14/2021
082147624666 12/14/2021
082147624666 12/14/2021
082147624666 12/14/2021
082147624666 12/14/2021
082147624666 12/14/2021
082147624666 12/14/2021
082147624666 12/14/2021
082147624666 12/14/2021
085339080485 12/14/2021
081254745790 12/14/2021
082144859740 12/14/2021
081339226454 12/14/2021
082147624666 12/14/2021
082147624666 12/14/2021
082147624666 12/14/2021
081254745790 12/14/2021
082147624666 12/14/2021
08123646009 12/14/2021
082147624666 12/14/2021
082231644726 12/14/2021
082210042994 12/14/2021
08123646009 12/14/2021
082147624666 12/14/2021
082147624666 12/14/2021
081337922541 12/14/2021
081254745790 12/14/2021
081338885378 12/14/2021
081339226454 12/14/2021
082147624666 12/14/2021
082339811282 12/14/2021
081239476016 12/14/2021
082146449829 12/14/2021
Dosis I
Tanggal Pemberian
No. Batch
Vaksinasi
ASTRA ZENECA 10/19/2021 210155





202108122H
VAKSIN COVID19 BIOFARMA 24203421 16306344200556

Dosis 2
No. Serial Tanggal Pemberian Vaksinasi No. Batch
10000006429028
10000006429028
10000006429028
10000006429028
10000006429028
10000006429028
10000006429028
10000006429028
10000006429028
10000006429028
10000006429028
10000006429028
02889498682509 12/14/2021 A1083

10000006429028
10000006429028
10000006429028
10000006429028
10000006429028
10000006429028
10000006429028
10000006429028
10000006429028
10000006429028
10000006429028
10000006429028
10000006429028
10000006429028
10000006429028
10000006429028
10000006429028
10000006429028
10000006429028
10000006429028
16306393122608
12/14/2021 24203421
16306393122608
16306393122608
16306393122608
16306393122608
16306393122608
12/14/2021 24203421
16306393122608
16306393122608
16306393122608
16306393122608
16306393122608
16306393122608
16306393122608
12/14/2021 24203421
12/14/2021 24203421
16306393122608
16306393122608
16306393122608
16306393122608
16306393122608
16306393122608
16306393122608
12/14/2021 24203421
12/14/2021 24203421
1636355430496
1636355430496
1636355430496
16306393121812
16306393121812
12/14/2021 24203421
16306393121812
16306393121812
16306393121812
12/14/2021 24203421
16306393121812
16306393121812
16306393121812
12/14/2021 24203421
16306393121812
12/14/2021 24203421
12/14/2021 24203421
12/14/2021 24203421
12/14/2021 24203421
12/14/2021 24203421
16306393121812
16295072866703 12/14/2021 24203421
16309332120843 12/14/2021 24203421
16309332120843 12/14/2021 24203421
16309332120843 12/14/2021 24203421
16309332120843 12/14/2021 24203421
16319375256635 12/14/2021 24203421

16319375256635 12/14/2021 24203421
12/14/2021 24203421
16319375256635 12/14/2021 24203421
16309332120843 12/14/2021 24203421
16319375256635 12/14/2021 24203421
16319375256635 12/14/2021 24203421
12/14/2021 24203421
16309332120843 12/14/2021 24203421
16309332120843 12/14/2021 24203421
16295072866703 12/14/2021 24203421
16295072866703 12/14/2021 24203421
16309332120843 12/14/2021 24203421
16309332120843 12/14/2021 24203421
16319375256635 12/14/2021 24203421
16295072866703 12/14/2021 24203421
16295072866703 12/14/2021 24203421
16295072866703 12/14/2021 24203421
16309332120843 12/14/2021 24203421
16309332120843 12/14/2021 24203421
16309332120843 12/14/2021 24203421
16309332120843 12/14/2021 24203421

16298088677347 12/14/2021 24203421
01864954830490 12/14/2021 A1083
10000006254388
10000006254388
10000006254388
10000006254388
10000006254388
10000006254388
10000006254388
10000006254388
10000006254388
10000006254388
10000006254388
10000006254388
10000006254388
10000006254388
10000006254388
10000006254388
10000006254388
10000006254388
10000006254388
10000006254388
10000006254388
10000006254388
10000006254388
10000006254388
10000006254388
10000006254388
10000006254388
10000006254388
10000006254388
10000006254388
10000006254388
10000006254388
10000006254388
10000006254388
10000006254388
10000006254388
10000006254388
10000006254388
10000006254388
10000006254388
10000006254388
Keterangan
Diberikan/Lanjut)
No. Serial
LANJUT EIADA
LANJUT EIADA
LANJUT EIADA
LANJUT EIADA
LANJUT EIADA
LANJUT BEBAE
LANJUT EIADA
LANJUT BEBAE
LANJUT BEBAE
LANJUT EIADA
LANJUT BEBAE
LANJUT EIMADAKE

LANJUT EIADA
LANJUT BEBAE
LANJUT BEBAE
LANJUT BEBAE
LANJUT EIADA
LANJUT BEBAE
LANJUT EIADA
LANJUT BEBAE
LANJUT BEBAE
LANJUT BEBAE
LANJUT BEBAE
LANJUT BEBAE
LANJUT EIADA
LANJUT MATEI
LANJUT BEBAE
LANJUT BEBAE
LANJUT BEBAE
LANJUT BEBAE
LANJUT BEBAE
LANJUT RAEKORE
LANJUT EIADA
16306393122608 SELESAI EIADA
LANJUT EIADA
LANJUT EIADA
LANJUT BEBAE
LANJUT BEBAE
LANJUT MATEI
LANJUT BEBAE
LANJUT EIADA
LANJUT BEBAE
LANJUT EIADA
LANJUT TADA
LANJUT EIADA
LANJUT BEBAE
16306393122608 SELESAI LOBODEI
16306393122608 SELESAI BEBAE
LANJUT BEBAE
LANJUT EIADA
LANJUT BEBAE
LANJUT EIADA
LANJUT EIADA
LANJUT EIADA
LANJUT EIADA
LANJUT BEBAE
LANJUT BEBAE
LANJUT BEBAE
LANJUT BEBAE
LANJUT BEBAE
LANJUT BEBAE
LANJUT BEBAE
LANJUT BEBAE
LANJUT BEBAE
LANJUT BEBAE
LANJUT BEBAE
LANJUT BEBAE
16306393121812 SELESAI EIADA
LANJUT BEBAE
16306344200556 SELESAI DESA EIADA

LANJUT DESA BEBAE
LANJUT DESA BEBAE
LANJUT DESA BEBAE
LANJUT DESA BEBAE
LANJUT DESA BEBAE
LANJUT DESA BEBAE

LANJUT DESA BEBAE
LANJUT DESA BEBAE
LANJUT DESA BEBAE
LANJUT DESA BEBAE
LANJUT DESA BEBAE
LANJUT DESA BEBAE
LANJUT DESA EIADA
LANJUT DESA BEBAE
LANJUT DESA BEBAE
LANJUT DESA BEBAE
LANJUT DESA BEBAE
LANJUT DESA BEBAE
10000006254388 SELESAI KADER POSY HAIDOI
LANJUT DESA BEBAE
LANJUT DESA BEBAE
LANJUT DESA EIADA
LANJUT DESA EIADA
LANJUT DESA BEBAE
LANJUT DESA BEBAE
LANJUT DESA BEBAE
LANJUT DESA BEBAE
LANJUT DESA BEBAE
LANJUT DESA BEBAE
LANJUT DESA BEBAE
LANJUT SMA SATIM
LANJUT DESA BEBAE
LANJUT DESA BEBAE
LANJUT DESA EIADA
LANJUT DESA BEBAE
LANJUT DESA TADA
LANJUT DESA BEBAE
LANJUT DESA BEBAE
LANJUT DESA BEBAE
LANJUT DESA BEBAE
LANJUT DESA BEBAE
LANJUT DESA TADA
LANJUT DESA BEBAE
LANJUT DESA BEBAE
LANJUT DESA BEBAE
LANJUT DESA EIADA
LANJUT DESA BEBAE
LANJUT DESA TADA
LANJUT DESA TADA
LANJUT DESA BEBAE
LANJUT DESA BEBAE
LANJUT DESA BEBAE
LANJUT DESA BEBAE
LANJUT DESA EIADA
LANJUT DESA BEBAE
LANJUT DESA BEBAE
LANJUT DESA BEBAE
LANJUT DESA KEDURU
LANJUT DESA KEDURU
Kabupaten/Kota
Provinsi
Hari, Tanggal
No No. Tiket NIK
1 P-73HT5M31 5320056103850001
2 P-7K8CQRAJ 5371037107700004
3 P-86LAMCXQ 5320055009720001
4 5320056109020001
P-9FC9MNSG
5 5320050103900001
P-A77DE5N7
6 5320051408030001
P-AGVWRQPJ
7 5320052610690001
P-AZFQG0XO
8 5320050407620001
P-BNQNKDOT
9 5320051506030002
P-1SEWZZCO
10 5320054107840001
P-4OV2BGR3
11 5320051708760001
P-0GSB0DYV
12 P-0ONAYC0S 5320054511630001
13 5320050703640001
P-22XNGVEQ
14 5320054510740001
P-1EB2TL4R
15 Q-001GCTV3 5320055404080002
16 5302012108930002
P-2MP09A5K
17 5320027012010002
P-32MI7MZE
18 5320050205770002
P-3H4GXTGF
19 5320053110020001
P-3VFRSCQP
20 P-4A5IAVNG 5320050110780001
21 5320052304070002
P-524U9JB8
22 5320051105810001
DATA MSLH
23 5320051010900001
Q-0009CBPR
24 P-7UFGMC0S 5320056012740001
25 5320053008710001
P-8O6WVGRK
26 5320050402830001
Q-001ILPXJ
27 5320050505800002
P-ABFMBPGJ
28 5320055509930001
P-AOUHT24H
29 5320050303960001
P-B6V001P2
30 5320056011730001
P-BKVFL756
31 5371051505840001
P-BVX7WOZX
32 5320054905470001
S-5CD2CE64
33 5371045505650010
P-CJD2AQRD
34 5320050606620001
P-CRATJNIK
35 5320055104970003
P-CXWXAPH1
36 5320055110870001
P-D6OCUTJG
37 5320024912010001
P-DGLSPJK2
38 5320034503910001
Q-00099FR4
39 5320056106790001
P-DPTOKVCR
40 5320054307530001
S-DCE0C768
41 5320055503490001
S-AB09C3AA
42 5320054611961001
P-E5XYDAOK
43 5320052911950002
P-ECOMAXQN
44 5320055706530001
S-B51A9423
45 5320050107550001
S-ACDC6A9E
46 5320055505600001
S-5A2D084A
47 5320054107830001
P-FFMODNEL
48 5320056706050002
P-FK0ZI1ZJ
49 5320051611990001
P-G0ZJXZ3H
50 5320050911930001
P-FOSRHE41
51 : P-G6K9WUF2 5320050109030003
52 5320055504790001
P-GGYBCIQC
53 5320051111740001
P-GXC1PNIF
54 5320015912970002
P-JFWC5LOD
55 5320010904840002
P-H5IP88GF
56 5320056701760001
P-HFASIB0T
57 5320055011970002
P-RWHL1ERD
58 5371012909900009
P-HN7XWTW5
59 5320011109890004
P-HRAYRH3R
60 5320050309860001
P-HWAP2FR0
61 5320050908720001
P-I3JF3LI3
62 5320050612700001
P-IF5CNJ02
63 5320054405920001
P-EPLBCW2M
64 5320034406930001
P-ILIR3513
65 5320056106950001
P-JUTKGTPZ
66 5320026710670001
S-C7BB00C8
67 5320021210710001
P-JZVRJUSP
68 5320054304980002
P-LFHEK53E
69 P-LP4WHB5A 5320021903910001
70 5320055107990003
P-LYGN3HE0
71 5320052810760001
BLM ENTRY
72 P-M1LLEOLS 5320051503040002
73 5320020707870001
P-MEFQ09FW
74 5320055010520001
S-85F6F897
75 3508015509820001
P-MYVBTX8O
76 5320055105570001
S-7EC41598
77 5311135512040002
P-NRK7J5KN
78 5371046402890003
Z-000EAJ0Z
79 5320054902900001
P-NRSFKML1
80 P-NRYZERPG 5371030608770003
81 Q-00198123 3315022608860005
82 5320051404050001
83 5320057108820001
84 5320033108060001
85 5320026502080001
86 5320055908080001
87 5320055002620002
88 P-F9GK1EW7 5320055605750001
89 5320050701050002
90 5320056002650001
91 5303190302920003
92 5320055604840001
93 5320052808050001
94 5320051110030001
95 53200514030300001
96 5320050804050001
97 5320051303040001
98 5320052006050001
99 5320056203040001
100 5320052101050001
101 5320051512030001
102 5320051807650001
103 5320054308750001
104 5320056607030001
105 5320052309000001
106 5320051710550001
107 5320051507860001
108 5320054710570001
109 5320051009770001
110 5320053004620001
111 5320031111700001
112 5320054102700001
113 5320051601690001
114 5320054509820002
115 5320031004840001
116 5320055608800001
117 5320051003940002
118 5320032410010001
119 5301194801050003
120 5320051909060001
121 5320035602040002
122 S-9B436807 5320054103590002
123 P-BBHOWLKX 5371031010800021
124 P-RVTJVLUI 5320051709950001
125 P-7W4HV1QL 5320035504900004
126 P-BHY8TEX7 5320056909870001
127 5320056204910001
128 5371032205810003
129 5320050212700001
130 5320055208730001
131 5320050107620009
132 5320057009650002
133 5320021708000005
134 5320056608870001
135 5320055303860002
136 5320010607650002
137 5320052103030003
138 5320056308680001
139 5320022512990003
140 5320050512750002
141 5320051310740001
142 5320054409840001
143 5320050405950001
144 5320031212700002
145 5371011609910001
146 5371046112010007
147 5320053003840001
148 5320035401030001
149 5320031401940001
150 5304140109000003
151 5320052606840001
152 5320026909890003
153 5320054211930001
154 5320055005030004
155 5320056410010001
156 5320054607770004
157 5320050203990001
158 5320051305940002
159 5320051707700001
160 5320052611020001
161 5320055308690001
162 5320051307730001
163 5320053107990001
164 5320050112860001
165 5320055505830004
166 5320051307590001
167 5320050505550001
168 5320056107480001
169 5320052007550001
170 5320055007520001
171 5320051208590001
: Sabu Raijua
: 13/12/2021
Pekerjaan*
Jenis
Kelamin
PAULINA LOBO P MASY UMUM
YULIANA ROHI LEO BIRE P MASY UMUM
SARAH WOLO P MASY UMUM
IRNA RATU DUBU P MASY UMUM
YANTO SUGIANTO KIRA L MASY UMUM
ARIANTO BANGNGU KORO L MASY UMUM
MARKUS KANA L MASY UMUM
PAULUS BANGNGU KORO L MASY UMUM
BOBY YUDISTIRA BANGNGU KORO L MASY UMUM
TABITA BANGNGU KORO P MASY UMUM
HENDRIK BANGNGU KORO L MASY UMUM
MARIANCE RAGA LOMI P MASY UMUM
RAFAEL LILO HIMA L MASY UMUM

DELFIA WANNYI P MASY UMUM
VALENTINA BANGNGU KORO P REMAJA
SIMRON FAOT L MASY UMUM
MARTA RIHI HEKE P MASY UMUM
MEGARIA RATA L MASY UMUM
SEMUEL LUDJI LEO L MASY UMUM
YUNUS WOLO L MASY UMUM
APRIANUS LUDJI LEO L REMAJA
LAMBERTUS NGAHU KALE L MASY UMUM
L PELAYAN PUBLIK
MARSILUS RATU GEWA(HILU RATU)
DERDELINA ALU - LOBO HABA P MASY UMUM
RIDOLOF BANA PAH L MASY UMUM
ROBINSON RATA L MASY UMUM
KAREL NGAHU KALE L MASY UMUM
LINDA DJAWA P MASY UMUM
LORENTIUS FRANS DJAWA L MASY UMUM
REGINA ANJELINA DJAMI P MASY UMUM
JOKI GEWA L MASY UMUM
ANTONETA NGAHU P LANSIA
MODJO MOKKO P MASY UMUM
WILSON REHI ROHI L MASY UMUM
DEARLY PRISKA PUNGA P MASY UMUM
ERNI PAU HIA P MASY UMUM
DESI LADO P MASY UMUM

P MASY UMUM
Marta Ha"e
ANI RATA P MASY UMUM
LUISA KIRA L LANSIA
PAULINA PUTI P LANSIA
MERLIN DOKO P MASY UMUM
IBRAHIM RATA L MASY UMUM
DAMARIS ULY P LANSIA
RUBEN TARRU L LANSIA
HENDERINA RIHI P LANSIA
YULIANA LADO HINA P MASY UMUM
FITRI HELMI DO PUTI P REMAJA
LEKXI DIDA L MASY UMUM
LASARUS WOLO L MASY UMUM
TOSI LAY L MASY UMUM
MARIAM HERE HIA P MASY UMUM
HERMAN KORE DIDA L MASY UMUM
DINDA DERISTA RAGA LAWA P PELAYAN PUBLIK
PELIPUS HERE HIA L MASY UMUM
MARTHA MAGE P MASY UMUM
ANCE DJU P MASY UMUM
SAPTA ARYANTO L MASY UMUM
ERWIN LUDJI LEO L MASY UMUM
YANTO YEFRESON RATA L MASY UMUM
ALEX LOBO MIGU L MASY UMUM

HABEL NGURU L MASY UMUM
BANNI KORE P MASY UMUM
FEBI DANE BALE L MASY UMUM
TABITA BANGNGU KORO P MASY UMUM
BENDELINA MONE KE P PELAYAN PUBLIK
REINHARD MANU L MASY UMUM
MARLIN MANU TARRA P MASY UMUM
TOBIAS LILO HIMA L MASY UMUM
MARIANA RATA P MASY UMUM
RUBEN BANGNGU KORO L MASY UMUM
SEMAR SAPTANIUS WOLO L MASY UMUM
STEVANUS LENA DJILA L MASY UMUM
GETREDA WILA DIDA P LANSIA
SULENING TYASLIPUR P MASY UMUM
MINA LADO P LANSIA
KRISLIN KATAUHI MILA P REMAJA
LIA ANDARWATI SRIANTI P MASY UMUM
NITA SRIYANTI RAME LUDJI P MASY UMUM
THOMAS WILA DIDA L MASY UMUM
JATMIKO L MASY UMUM
DAVID KAHO L REMAJA
MARGERITA LADO BALE P MASY UMUM
TOBIAS TULU GA L REMAJA
FEBRIANTI LUDJI P REMAJA
JUBLINA WILA P REMAJA

PADA RIWU L MASY UMUM
LUHA DIMU L MASY UMUM
JERMI BANGNGU ROHI L REMAJA
LEDO DJAKO L MASY UMUM
FEMRIANUS NAIMUNI L MASY UMUM
WALU LILO L MASY UMUM
SURYA GEMILANG RATU L REMAJA
OKTOVIANUS MANU L MASY UMUM
MELY K L LOBO HABA P REMAJA
ANDERIAS WILA L MASY UMUM
MAKSI LAY L REMAJA
JHONI FERNATA RADJA GERE L REMAJA
MARE ROHI P REMAJA
BENEDIKTUS HADJO KUDJI L REMAJA
JUANDER SAPUTRA DJAMI LENA L MASY UMUM
EGE HADJO L MASY UMUM
DJAMMA LUDJI L MASY UMUM
HEGE PADA UDJU L REMAJA
DIMU ROHI L MASY UMUM
LAI LADO L LANSIA
ANDREAS MANU L MASY UMUM
KAHI LAU L LANSIA
GERSON WILA L MASY UMUM
WADU RIWU L LANSIA
MATA LILO L MASY UMUM
MATHELDA MATE DJAMI P MASY UMUM
LAMBERTUS BALE WADU L MASY UMUM
SELVIANA LUDJI P MASY UMUM
LODEWIK MIHA MEDO L MASY UMUM

BUNGA HAKKU P MASY UMUM
ADY RADJA L MASY UMUM
DO NGAHU L MASY UMUM
JIHAN MARFELTA NAMAH P REMAJA
STEVEN JULIATUS KOLO DAKE L REMAJA
FEBI TARI P REMAJA
WELEM DJAPA HEO L LANSIA
JUFRI DJAPA HEO L MASY UMUM
ALLAN EGE L MASY UMUM
PE LOMI P MASY UMUM
ESTER KAHO P MASY UMUM
NORINCE KARTINI LOBO L PELAYAN PUBLIK
THOMAS HISKIA HADJO L MASY UMUM
HILIANUS MODJU L MASY UMUM
EDO DIDA L MASY UMUM
LOAMI MANU L MASY UMUM
ESTER MANNO P MASY UMUM
MATIUS SUKTRI LUDJI L MASY UMUM
AGUSTINA GA ARA P MASY UMUM
NEPE BUWE P MASY UMUM
THOMAS AGUSTINUS PAULUS RAME HAU L MASY UMUM
ADRIANUS KAHO WILA L MASY UMUM
LILO LUDJI L MASY UMUM
NATANIEL MITA MANGNGI L MASY UMUM
MARKUS LADO HINA L MASY UMUM
GUSTI KAHO WILA L MASY UMUM
WELMINCE WILA PAU P MASY UMUM
MICHAEL KAHO L MASY UMUM
PETRUS HAE L MASY UMUM
STEVEN ROBINSON BAISILA L MASY UMUM
DESSY YOHANA NATALIA SAILANA P MASY UMUM
OTO MANNO L MASY UMUM
IDA SUMA WANNTI MANNO WADU P MASY UMUM
JEMS ORINTES DAO LAY L MASY UMUM
STEFANUS NANA L MASY UMUM
RONALDO RAE MARA L MASY UMUM
SELFI DOLIYANTI RUNESI P MASY UMUM
FRANSINA LEO KITU P MASY UMUM
MARLIN CHAHAYATI KORE LIHU P MASY UMUM
MATE DJAMI P MASY UMUM
LUDU HURU L MASY UMUM
MELDISON RAGA LOMI L MASY UMUM
NGE MIGU L MASY UMUM
ROHI RADJA L MASY UMUM
FERI HEKE L MASY UMUM
BANNI HEHE P MASY UMUM
MITA BUNGA P MASY UMUM
UNTUNG YULIUS KALE BOLE L MASY UMUM
KIRENIUS KALE TE L MASY UMUM
ALU MANNO P LANSIA
RATU BANGNGU L LANSIA
RADJA LAU L LANSIA
BANNI DIMU P LANSIA
WAKE ITO L LANSIA
NERLINCE KANA WILA P LANSIA
ROBERT DJARA BALE L LANSIA
Umur
(18 sd ≥ 60 tahun)
3/21/1985 36 EILODE
7/31/1970 51 EILODE
10/9/1972 49 EILODE
2002-09-21 19 EILODE
1990-01-05 31 EILODE
2003-08-14 18 EILODE
10/26/1969 52 EILODE
4/7/1964 57 EILODE
2003-06-15 18 EILODE
3/23/1990 31 EILODE
8/17/1976 45 EILODE
11/5/1963 58 EILODE
7/3/1964 57 EILODE
6/5/1976 45 EILODE
2008-04-14 13 EILODE
1993-08-21 28 EILODE
12/30/2001 20 EILODE
5/2/1977 44 EILODE
10/31/2002 19 EILODE
1/10/1978 43 EILODE
4/23/2007 14 EILODE
5/11/1981 40 EILODE
12 AGUSTUS 1990 31 31-45 EILODE
12/20/1974 47 EILODE
8/30/1977 44 EILODE
2/4/1983 40 31-45 DESA EILODE
5/5/1980 41 EILODE
9/15/1993 28 EILODE
4/1/1996 25 EILODE
11/20/1973 48 EILODE
5/15/1984 37 EILODE
5/9/1947 74 EILODE
5/15/1965 56 EILODE
6/6/1962 59 EILODE
4/11/1997 24 EILODE
10/11/1987 34 EILODE
12/9/2001 20 EILODE
05 MARET 1990 30 18-30 EILODE
6/21/1979 42 EILODE
7/3/1953 68 EILODE
3/15/1949 72 EILODE
11/6/1996 25 EILODE
11/29/1995 26 EILODE
6/17/1953 68 EILODE
7/1/1955 66 EILODE
5/15/1960 61 EILODE
7/1/1983 38 EILODE
2005-06-27 16 EILODE
11/16/1999 22 TADA
1993-11-09 28 EILODE
9/1/2003 18 TADA
4/15/1979 42 TADA
11/11/1974 47 TADA
12/19/1997 24 NADAWAWI
4/9/1984 37 RAEKORE
2/21/1976 45 TADA
11/10/1997 24 TADA
1990-09-29 31 EILODE
9/11/1985 36 MENIA
1993-09-13 28 EILODE
8/9/1972 49 EILODE
12/6/1970 51 EILODE
3/6/1992 29 EILODE
6/4/1993 28 EIADA
6/21/1985 36 EILODE
10/27/1967 54 MOLIE
10/12/1971 50 MOLIE
1998-04-03 23 EILODE
19/03/1991 30 EILODE
1996-07-11 25 EILODE
10/28/1976 45 EILODE
2004-03-15 17 EILODE
1987-07-07 34 MATEI
10/10/1952 69 EILODE
9/15/1982 39 EILODE
5/11/1957 64 EILODE
2004-12-15 17 EIADA
2/24/1989 32 RAEMADIA
2/9/1990 31 TADA
8/6/1977 44 EILODE
8/26/1986 36 31-45 DESA PANGKALAN
4/14/2005 18 18-30 DESA JIWUWU
8/31/1982 40 31-45 DESA JIWUWU
8/17/2007 15 12-17 DESA KELIHA
2/25/2008 15 12-17 DESA JIWUWU
8/19/2008 14 12-17 DESA JIWUWU

2/10/1962 61 60-150 DESA JIWUWU
5/16/1975 48 46-59 DESA JIWUWU
1/7/2005 18 18-30 DESA JIWUWU
2/2/1985 38 31-45 DESA JIWUWU
2/3/1992 31 31-45 KAB TTU
4/16/1984 39 31-45 DESA JIWUWU
8/28/2005 17 12-17 DESA JIWUWU
10/10/2003 19 18-30 DESA JIWUWU
9/14/2004 18 18-30 DESA JIWUWU
7/20/2005 17 12-17 DESA JIWUWU
3/13/2004 19 18-30 DESA JIWUWU
6/20/2005 18 18-30 DESA JIWUWU
3/22/2004 19 18-30 DESA JIWUWU
5/1/2005 18 18-30 DESA JIWUWU
12/5/2003 19 18-30 DESA LOBOADJU
7/18/1965 58 46-59 DESA JIWUWU
8/3/1975 47 46-59 DESA JIWUWU
7/26/2003 19 18-30 DESA JIWUWU
9/23/2000 22 18-30 DESA JIWUWU
5/17/1955 68 60-150 DESA JIWUWU
7/15/1986 37 31-45 DESA JIWUWU
10/7/1957 65 60-150 DESA JIWUWU
9/10/1977 45 31-45 DESA JIWUWU
4/30/1949 74 60-150 DESA JIWUWU
11/11/1970 52 46-59 DESA KELIHA
2/1/1970 53 46-59 DESA JIWUWU
1/16/1969 54 46-59 DESA JIWUWU
9/5/1982 40 31-45 DESA JIWUWU
4/10/1984 39 31-45 DESA JIWUWU

8/16/1980 42 31-45 DESA JIWUWU
8/1/1995 27 18-30 DESA JIWUWU
10/24/2001 21 18-30 DESA KUJIRATU
1/8/2005 18 18-30 DESA JIWUWU
9/19/2006 16 12-17 DESA JIWUWU
2/16/2004 19 18-30 DESA EIADA
3/1/1959 62 60-150 DESA JIWUWU
10/10/1980 41 31-45 DESA JIWUWU
4/27/1995 28 18-30 DESA JIWUWU
4/15/1990 33 31-45 DESA JIWUWU
9/29/1987 35 31-45 DESA JIWUWU
4/21/1991 32 31-45 DESA JIWUWU
5/22/1981 42 31-45 DESA LOBORAI
12/2/1970 52 46-59 DESA JIWUWU
8/12/1973 49 46-59 DESA JIWUWU
7/1/1962 61 60-150 DESA JIWUWU
9/30/1965 57 46-59 DESA JIWUWU
8/17/2000 22 18-30 DESA JIWUWU
8/26/1987 35 31-45 DESA JIWUWU
3/13/1986 37 31-45 DESA JIWUWU
7/6/1965 58 46-59 DESA JIWUWU
3/21/2003 20 18-30 DESA JIWUWU
8/23/1968 54 46-59 DESA JIWUWU
12/25/1999 23 18-30 DESA JIWUWU
5/7/1999 24 18-30 DESA JIWUWU
10/13/1974 48 46-59 DESA JIWUWU
9/4/1984 38 31-45 DESA JIWUWU
7/15/1996 27 18-30 DESA JIWUWU
12/12/1977 45 31-45 DESA JIWUWU
9/16/1991 31 31-45 NUNBAUN
12/21/2001 21 18-30 DESA JIWUWU
10/30/1984 38 31-45 DESA JIWUWU
1/14/2003 20 18-30 DESA BODAE
1/14/1994 29 18-30 DESA KUJIRATU
9/1/2000 22 18-30 KAB MALAKA
6/26/1984 39 31-45 DESA JIWUWU
9/29/1989 33 31-45 DESA JIWUWU
2/2/1992 31 31-45 DESA JIWUWU
5/10/2003 20 18-30 DESA EILODE
11/27/2001 21 18-30 DESA JIWUWU
7/6/1977 46 46-59 DESA JIWUWU
3/2/1999 24 18-30 DESA EIMAU
5/13/1994 29 18-30 DESA JIWUWU
7/17/1970 53 46-59 DESA JIWUWU
11/26/2002 20 18-30 DESA JIWUWU
5/20/1969 54 46-59 DESA JIWUWU
7/13/1973 50 46-59 DESA JIWUWU
1/4/2002 21 18-30 DESA JIWUWU
12/1/1986 36 31-45 DESA JIWUWU
7/13/1959 64 60-150 DESA JIWUWU
7/13/1959 64 60-150 DESA JIWUWU
5/5/1955 68 60-150 DESA JIWUWU
7/21/1948 74 60-150 DESA JIWUWU
7/20/1955 67 60-150 DESA JIWUWU
7/10/1952 71 60-150 DESA JIWUWU
8/12/1956 66 60-150 DESA JIWUWU
ASI COVID-19
NASI

yang sesuai)
BPJS Non
PBI
8123994306 12/13/2021
85238511895 12/13/2021
081334754334 12/13/2021
081338885520 12/13/2021
082271382719 12/13/2021
081238038019 12/13/2021
082293559315 12/13/2021
082236259850 12/13/2021
082236259850 12/13/2021
082260465741 12/13/2021
081239038103 12/13/2021
081324338157 12/13/2021
081337150661 12/13/2021
081337150661 12/13/2021
085253895668 10/21/2021
082247561143 12/13/2021
081238931283 12/13/2021
081337150661 12/13/2021
082236335058 12/13/2021
082247326093 12/13/2021
082146197767 12/13/2021
081337150661 12/13/2021
082 141 175 824 6/29/2021
082293559328 12/13/2021
081221719329 12/13/2021
85338193078 10/26/2021
081239562461 12/13/2021
081337150661 12/13/2021
081337150661 12/13/2021
081237366373 12/13/2021
081337150661 12/13/2021
081337150661 12/13/2021
081337150661 12/13/2021
081337150661 12/13/2021
085237215399 12/13/2021
081353026059 12/13/2021
082138752271 12/13/2021
085 333 843 083 6/29/2021
082359466337 12/13/2021
081337150661 12/13/2021
081337150661 12/13/2021
082359466337 12/13/2021
082359466337 12/13/2021
081337150661 12/13/2021
081337150661 12/13/2021
081337150661 12/13/2021
081337150661 12/13/2021
082145842658 12/13/2021
082147360934 12/13/2021
081339220188 12/13/2021
082353161426 12/13/2021
081337150661 12/13/2021
081337150661 12/13/2021
082339350750 12/13/2021
081337150661 12/13/2021
081339037322 12/13/2021
082235777867 12/13/2021
082237450950 12/13/2021
082237450950 12/13/2021
082145355957 12/13/2021
081239659344 12/13/2021
081337150661 12/13/2021
081239796274 12/13/2021
082342036407 12/13/2021
081337150661 12/13/2021
085333726818 12/13/2021
085338470312 12/13/2021
085238338311 12/13/2021
081337150661 12/13/2021
081337150661 12/13/2021
081337150661
082257326093 12/13/2021
081337150661 12/13/2021
081337150661 12/13/2021
081236798694 12/13/2021
081337150661 12/13/2021
085239494842 12/13/2021
081338227432 12/13/2021
085237915617 12/13/2021
082154275630 12/13/2021
10/6/2021
081339226138 9/24/2021
082144877040 12/13/2021
082231649020 12/13/2021
081246026386 12/13/2021
081338886676 12/13/2021
82146508885 11/6/2021
081233675987 18-Oct-21
85338856011 24-Sep-21
11/6/2021
81237920086
081238481825 7/19/2021
82359463509 11/6/2021
085216020252 9/24/2021
082138875429
081238893556
81246213186 12/13/2021
81238251250 12/13/2021
81353246165 12/13/2021
08223580032 12/13/2021
081239615634 12/13/2021
082247554105 12/13/2021
082195463298 12/13/2021
081238913639 12/13/2021
081238913639 12/13/2021
08223580032 12/13/2021
08223580032 12/13/2021
08223580032 12/13/2021
08223580032 12/13/2021
08223580032 12/13/2021
08223580032 12/13/2021
08223580032 12/13/2021
08223580032 12/13/2021
08223580032 12/13/2021
081338129815 12/13/2021
081337742554 12/13/2021
08223580032 12/13/2021
082359403509 12/13/2021
081239251250 12/13/2021
08223580032 12/13/2021
81338856452 12/13/2021
82147460950 12/13/2021
081246447153 18-Oct-21
081238469682 18-Oct-21
082 359 552 141 9/9/2021
081238783636 18-Oct-21
082321427018 18-Oct-21
082143654545 12/13/2021
081315448315 12/13/2021
082145361472 12/13/2021
082235800032 12/13/2021
082235800032 12/13/2021
082144472456 12/13/2021
082195463298 12/13/2021
082195463298 12/13/2021
082195463298 12/13/2021
082144838151 12/13/2021
082147310217 12/13/2021
082195463298 12/13/2021
082213080628 12/13/2021
082195463298 12/13/2021
082147310217 12/13/2021
082195463298 12/13/2021
082340258049 12/13/2021
0823590949990 12/13/2021
082235199494 12/13/2021
082340258049 12/13/2021
081377221274 12/13/2021
0823590949990 12/13/2021
082144877104 12/13/2021
081238826335 12/13/2021
08223580032 12/13/2021
08223580032 12/13/2021
081338935215 12/13/2021
085339435176 12/13/2021
085339435176 12/13/2021
08133772252 12/13/2021
082312606809 12/13/2021
81236836313 12/13/2021
8223580032 12/13/2021
81238893556 12/13/2021
81237920086 12/13/2021
082189446307 12/13/2021
08223580032 12/13/2021
08223580032 12/13/2021
082147553296 12/13/2021
08223580032 12/13/2021
082316765646 12/13/2021
082144859686 12/13/2021
082235800032 12/13/2021
082213080628 12/13/2021
0821444472456 12/13/2021
Dosis I
Tanggal Pemberian
No. Batch
Vaksinasi

CORONAVAC 6/29/2021 24200721

CORONAVAC 6/29/2021 24200721


202108122H
VAKSIN COVID PT BIOFARMA 10/18/2021 202108175F
VAKSIN COVID PT BIOFARMA 24-Sep-21

202108122H

202108122H

ASTRAZENECA 10/18/2021 210155
ASTRAZENECA 10/18/2021 210155
ASTRAZENECA 10/18/2021 210155
ASTRAZENECA 10/18/2021 210155
Dosis 2
10000006254388
10000006254388
10000006254388
10000006254388
10000006254388
10000006254388
10000006254388
10000006254388
10000006254388
10000006254388
10000006254388
10000006254388
10000006254388
10000006254388
16322841592331 12/13/2021 24203421
10000006254388
10000006254388
10000006254388
10000006254388
10000006254388
16306391201948
10000006254388
1620922189093 12/13/2021 24203421
10000006254388
10000006254388
16322913910407 12/13/2021 24203421
10000006254388
10000006254388
10000006254388
10000006254388
10000006254388
10000006254388
10000006254388
10000006254388
10000006254388
10000006254388
10000006254388
16221717766356 12/13/2021 24203421
10000006254388
16306391201948
10000006254388
16306391201948
10000006254388
10000006254388
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16306391201948
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16306391201948
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12/13/2021 24203421
16306391201948
10000006254388
16306391201948
10000006254388
10000006254388
16306391201948
16306391201948
10000006254388
10000006254388
12/13/2021 24203421
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12/13/2021 24203421
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12/13/2021 24203421
12/13/2021 24203421
16298097478724
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16322913906033 12/13/2021 24203421
12/13/2021 24203421
16298092626190
12/13/2021 24203421
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16298097478724
12/13/2021 24203421
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16306344200556
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02889498682509 12/13/2021 A1083
02889498682509 12/13/2021 A1083
01864954830490 12/13/2021 A1083
02889498682509 12/13/2021 A1083
02889498682509 12/13/2021 A1083
10000006254388
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Keterangan
Diberikan/Lanjut)
No. Serial
LANJUT EILODE
LANJUT EILODE
LANJUT EILODE
LANJUT EILODE
LANJUT EILODE
LANJUT EILODE
LANJUT EILODE
LANJUT EILODE
LANJUT EILODE
LANJUT EILODE
LANJUT EILODE
LANJUT EILODE
LANJUT EILODE
LANJUT EILODE
16306391201948 SELESAI SMP N 1 SATENG
LANJUT EILODE
LANJUT EILODE
LANJUT EILODE
LANJUT EILODE
LANJUT EILODE
LANJUT SMP N 1 SATENG
LANJUT EILODE
16306391201948 SELESAI PTPS KEC SATENG
LANJUT EILODE
LANJUT EILODE
LANJUT EILODE
LANJUT EILODE
LANJUT EILODE
LANJUT EILODE
LANJUT EILODE
LANJUT EILODE
LANJUT EILODE
LANJUT EILODE
LANJUT EILODE
LANJUT EILODE
LANJUT EILODE
LANJUT EILODE
LANJUT EILODE
LANJUT EILODE
LANJUT EILODE
LANJUT EILODE
LANJUT EILODE
LANJUT EILODE
LANJUT EILODE
LANJUT EILODE
LANJUT EILODE
LANJUT TADA
LANJUT E
LANJUT TADA
LANJUT TADA
LANJUT TADA
LANJUT NADAWAWI
LANJUT RAEKORE
LANJUT TADA
LANJUT TADA
LANJUT EILODE
LANJUT MENIA
LANJUT EILODE
LANJUT EILODE
LANJUT EILODE
LANJUT EILODE
LANJUT EIADA
LANJUT EILODE
LANJUT MOLIE
LANJUT MOLIE
LANJUT EILODE
LANJUT EILODE
LANJUT EILODE
16306391201948 SELESAI EILODE
LANJUT EILODE
LANJUT MATEI
LANJUT EILODE
LANJUT EILODE
LANJUT EILODE
LANJUT EIADA
LANJUT RAEMADIA
LANJUT TADA
LANJUT EILODE
16306344200556 SELESAI DESA PANGKALAN
16306344200556 SELESAI DESA KELIHA
16306344200556 SELESAI SMP 1 EILODE
16306344200556 SELESAI SMP 1 ATAP KUDJI RATU
16306344200556 SELESAI SMP 1 EILODE

16306344200556 SELESAI SMA SATIM
16306344200556 SELESAI KAB TTU
LANJUT SMA SATIM
LANJUT SMA SATIM
LANJUT SMA SATIM
LANJUT SMA SATIM
LANJUT SMA SATIM
LANJUT DESA JIWUWU
LANJUT DESA JIWUWU
LANJUT DESA JIWUWU
LANJUT DESA JIWUWU
LANJUT DESA JIWUWU
LANJUT DESA JIWUWU
LANJUT DESA JIWUWU
LANJUT DESA JIWUWU
LANJUT DESA JIWUWU
LANJUT DESA KELIHA
LANJUT DESA JIWUWU
LANJUT DESA JIWUWU
LANJUT DESA JIWUWU
LANJUT DESA JIWUWU

LANJUT DESA JIWUWU
LANJUT DESA JIWUWU
LANJUT DESA KUJIRATU
LANJUT SMA SATIM
LANJUT SMP EILODE
LANJUT SMA SATIM
LANJUT DESA JIWUWU
LANJUT DESA LOBORAI
LANJUT DESA JIWUWU
LANJUT DESA JIWUWU
LANJUT DESA JIWUWU
LANJUT DESA JIWUWU
LANJUT DESA JIWUWU
LANJUT DESA JIWUWU
LANJUT DESA JIWUWU
LANJUT DESA JIWUWU
LANJUT SMA SATIM
LANJUT DESA JIWUWU
LANJUT DESA JIWUWU
LANJUT DESA JIWUWU
LANJUT DESA JIWUWU
LANJUT DESA JIWUWU
LANJUT DESA JIWUWU
LANJUT DESA JIWUWU
LANJUT NUNBAUN
LANJUT DESA JIWUWU
LANJUT DESA JIWUWU
LANJUT SMA SATIM
LANJUT DESA KUJIRATU
LANJUT KAB MALAKA
LANJUT DESA JIWUWU
LANJUT DESA JIWUWU
LANJUT DESA JIWUWU
LANJUT SMA SATIM
LANJUT SMA SATIM
LANJUT DESA JIWUWU
LANJUT DESA EIMAU
LANJUT DESA JIWUWU
LANJUT DESA JIWUWU
LANJUT SMA SATIM
LANJUT DESA JIWUWU
LANJUT DESA JIWUWU
LANJUT SMK 1 SEBA
LANJUT DESA JIWUWU
LANJUT DESA JIWUWU
LANJUT DESA JIWUWU
LANJUT DESA JIWUWU
LANJUT DESA JIWUWU
LANJUT DESA JIWUWU
LANJUT DESA JIWUWU
LANJUT DESA JIWUWU
Kabupaten/Kota
Provinsi
Hari, Tanggal
No No. Tiket NIK
1 5320055605660001
2 5320054703780001
3 5320052106750001
4 5320054308020001
5 5320054807770001
6 5371014503010002
7 5320051804930003
8 5320026612900002
9 7601064911940001
10 5320055505730001
11 5320050911980001
1 12 5.32005230752000E+15
2 13 532005079960001
3 14 5.32005060490000E+15
4 15 5320031911700001
5 16 5.32005280887000E+15
6 17 5.32005201100000E+15
7 18 5.32005201265000E+15
8 19 5.32005240474000E+15
9 20 5.32005480300000E+15
10 21 532005450770001
11 22 5.32005580479000E+15
12 23 5.32005261262000E+15
13 24 5.32005180697000E+15
14 25 5.32005181065000E+15
15 26 532005161
16 27 5.32005161080000E+15
17 28 5.32005010759000E+15
18 29 5.32005431062000E+15
19 30 5.32005170678000E+15
20 31 5.32005050978000E+15
21 32 5.32005260678000E+15
22 33 5.32005091169000E+15
23 34 5.32001471193000E+15
24 35 5.32005161093000E+15
25 36 5.32001041291000E+15
26 37 5.32005230658000E+15
27 38 5.32005550358000E+15
28 39 5.32003120971000E+15
29 40 5.32005640602000E+15
30 41 5.32005160776000E+15
31 42 5320050703880001
32 43 5320054507670001
33 44 5320051712730001
34 45 5320051611880002
35 46 532005241120002
36 47 5320055002830001
37 48 5320051812970001
38 49 5320051206600001
39 50 5320056507790001
40 51 5320050210620001
41 52 5320055103970004
42 53 5320051411700001
43 54 5320050101700001
44 55 5320050704680001
45 56 5320051206560001
46 57 5320054912660001
47 58 5320050207770001
48 59 5320055609780001
49 60 5320055111570001
50 61 5320050901730001
51 62 5320051706740001
52 63 5320052402650001
53 64 5320050503690001
54 65 5320025802960001
55 66 5320011502920001
56 67 5320056104910002
57 68 5320052010730001
58 69 5320055903720001
59 70 5320050101760001
60 71 5320050606810002
61 72 5320052906820001
62 73 5320015208990001
63 74 5320052903810003
64 75 5320050107830001
65 76 5320052910990001
66 77 530230461840001
67 78 5320055308980001
68 79 5320052908910001
69 80 5320056803860003
70 81 5320054207850001
71 82 5320053009020002
72 83 5320054508620001
73 84 5320052303960001
74 85 5320052602990001
75 86 5320055806670001
76 87 5320056111800002
77 88 5320052705010001
78 89 5320050506720001
79 90 5320050711650001
80 91 5320050108830001
81 92 5320052212640001
82 93 5320055508690001
83 94 5320016202970001
84 95 5320052204970001
85 96 5320055402870002
86 97 5320055511760001
87 98 5320014611980001
88 99 5320051303770001
89 100 5320010202800004
90 101 5371036811870005
91 102 5320054101870002
92 103 5320015703790001
93 104 5320051405770001
94 105 5320011008870001
95 106 5320056007970002
96 107 5320055710860003
97 108 5320052403680001
98 109 5320054803900002
99 110 5320050505590001
100 111 5320051004980001
101 112 5320051702790001
102 113 5320056411780001
103 114 5320056612690001
104 115 5320051103860002
105 116 5320050504690001
106 117 5320056908950001
107 118 5320054211630001
108 119 5320055605010001
109 120 5320054705780001
110 121 5320050810930001
122 5320055707590001
123 5320050703610001
124 5320050812520001
125 5320050208730001
126 5320051105900002
127 5320010606890002
128 5320056106720001
129 5320054306700001
130 5320056304730001
131 5320050503700001
132 5320057005870001
133 5320054203970001
134 5320014909950001
135 5320054402680001
136 5320050312000001
137 5320054107790002
138 5320051507630001
139 5320025507900005
140 530118278690001
141 5320055609990001
142 5320050806990002
143 5320050202030001
144 5320054602720001
145 5320056101890001
146 5320051911020001
147 5320056903000001
148 5320055103010002
149 5320050909840001
150 5320055301980001
151 5320055002940001
152 5320051301860001
153 5320056112850001
154 5320054704940001
155 5320036603950001
156 5320056103980001
157 5320050204890002
158 5320051101640002
159 P-ESTEEUUI 5320052712950001
160 P-Q34D2JFY 5320054207770001
161 5320054201360001
162 5320050402080001
163 P-DKPGEH0S 5320056611070001
164 P-28IVWB3T 5320051707070001
165 P-5ROJDXIJ 5320056708080001
166 5320050906480001
167 P-XG7LRUIM 5320056312080002
168 5320052507520001
169 5320037009780001
170 5320032909710001
171 P-5NJ90XWP 5320054706650001
172 5320051002990001
173 5320056007680001
174 P-XLEW6TYD 5320012202070002
175 P-4YQUFNSJ 5371016004070001
176 P-1ZB5YOYF 5320055005080001
177 P-U235XKNX 5320051203080002
178 P-2FUS1N1V 5320054904070003
179 P-XIFE3RZN 5320010907070001
180 P-1GUZ5MSP 5320050211070001
181 P-VTWRQ6EL 5320053004080003
182 5320056909060001
183 5320056004790002
184 5.32003051004000E+15
185 P-SUHQRZ0O 5320055110070001
186 5320050205900001
187 P-5KGI4NCU 5320051203000002
188 P-VQBKLQIJ 5320056602080001
189 5320055711000001
190 5320051005480001
191 P-XL14EYTU 5320052911070001
192 P-FIXC1BXV 5320050303060002
193 5320055105980001
194 5320053007550003
195 5320050306650001
196 P-G4ZJQMN9 5320056505790002
197 P-RVHC5GEU 5320050809020004
198 P-WVADEOZ5 5320051002070001
199 P-1UZ1FN6F 5320052411060001
200 P-0W29KBYE 5320056503090001
201 5320051710390001
202 P-DXXVOEV6 5320035404970001
203 5320051110610001
204 5320054203560002
205 5320056808940001
206 P-DI43MBBW 5320055212890001
207 5320050809960001
208 P-G7F7FPKR 5308086603870001
209 P-65ELX4MF 5320051306760001
210 P-G3EO349G 5320053010940001
211 P-G310TYEY 5320054107670001
212 P-G6EGA7MT 5320054508850001
213 P-G614LLWM 5320055506790002
214 P-FWYM6NHV 5320055611950001
215 P-2M5WILNG 5320051501850001
216 P-G44S2NPS 5320054303840001
217 P-FX37CEIS 5320055904990001
218 P-FYSCNQD0 5320055404760001
219 P-G0QWKG5P 5320055004820002

220 P-G1C3HY4W 5320054506800001
221 P-G15FNNX7 5320051506750001
222 P-25DZHKHA 5320054504980001
223 P-2OZUAT7L 5320050107640001
224 P-G2F8LWPM 5320055212760001
225 P-G1XAW6YD 5320056404010001
226 P-G281T502 5320054404040001
227 P-G110WHTU 5320020402930001
228 P-G5NU2KHU 5320051702680001
229 P-G7NN6II4 5320055110640001
230 P-5OH41R2F 5371016506940005
231 P-G6AQ80LC 5320055610840001
232 P-G6JCKWNP 5320055207890001
233 537105206940001
234 P-G0MFO6SG 5320055509050001
235 P-1X2BGKUV 5320056507090003
236 P-FZC0T1FQ 5320055611040001
237 5320055507040001
238 S-9009631C 5320052104570001
239 5320052406580001
SU 240 5320054504060001
241 S-C8CCCD3F 5320016408580003
1 242 5320051511470001
2 243 5320055102500001
3 244 5320054509820001
4 245 5320055309010002
5 246 5320052707490001
6 247 5.32005100860000E+15
7 248 5.32005241006000E+15
8 249 5.32005240307000E+15
9 250 5.32001430653000E+15
10 251 5.32005050573000E+15
11 252 5.32005140837000E+15
12 253 5.32001430765000E+15
13 254 5.32005070855000E+15
14 255 5.32005540108000E+15
18 256 5.32005080607000E+15
19 257 5.32001410701000E+15
20 258 5.32005090757000E+15
34 259 5.32005040856000E+15
37 260 5.32005410788000E+15
15 261 5.32005160872000E+15
16 262 5.32005050708000E+15
17 263 5.32005220707000E+15
21 264 5.32001690107000E+15
22 265 63716520790001
23 266 5.32001640905000E+15
24 267 5.32005461107000E+15
25 268 5.32005650509000E+15
26 269 5.32005050205000E+15
27 270 5.32005301109000E+15
28 271 5.32005600205000E+15
29 272 5.32005300906000E+15
30 273 5.32005420110000E+15
31 274 5.32005080808000E+15
32 275 6.32002411108000E+15
33 276 5.32005631109000E+15
35 277 532005550110002
36 278 5.32001611009000E+15
38 279 5.32005071209000E+15
39 280 5320054801100001
40 281 5320057001090002
41 282 5.32005420408000E+15
42 283 5.32005131207000E+15
43 284 5320051102090001
44 285 5320051406080001
45 286 5320050309050001
287 NIK MASALAH 5320026505090002
288 5320054810080001
289 5320054505040001
290 5320051503060001
291 5320054312060002
292 5320055403040001
293 5320055310050001
294 5320012404080002
295 5320051205090003
296 5320022405090003
297 5320014108080001
298 5320056211090003
299 5320055303050002
300 5320053010050001
301 5320054306720001
302 5320055108970001
303 5320010808790003
304 5320054203620002
305 5320055109710001
306 53200525010001
307 5320056201810001
308 5320056303940005
309 NIK MASALAH 5320052612040003
310 5320051405070001
311 5320051306060002
312 5320050812070001
313 5320055104040001
314 5320055104050002
315 5320010916040004
316 5320024206060004
317 NIK MASALAH 5320054504510001
318 532005111590001
319 5320051511550001
320 5320050802580001
321 5320054109340001
322 5320051505320001
323 5320055406480001
324 5320055809400002
325 5320054602610001
326 5320016707800001
327 5320052010800002
328 5320050508930001
329 5371045011860005
: Sabu Raijua
: 09/12/2021
Pekerjaan*
Jenis
Nama Penerima Vaksin Tanggal Lahir
Kelamin
LODYA BANGNGU RADJA P MASY UMUM 5/16/1966
MARSELINA RIWU DJAMI P MASY UMUM 3/7/1978
YUNUS DJARA L MASY UMUM 6/21/1975
AGUS LENA DJILA L MASY UMUM 8/3/2002
ANTONIA RIWU P MASY UMUM 6/4/1977
IMELDA UDJU LOMI P MASY UMUM 3/5/2001
YEHUDA YANRIANUS KALE DJARA L MASY UMUM 4/18/1993
DEBI NENO HAIFETO P MASY UMUM 12/26/1990
NOFRISANTI BAKI DJU P MASY UMUM 11/9/1994
TABITA BALE DILA P MASY UMUM 5/15/1973
JEFRI A DIRA L MASY UMUM 11/9/1998
HENDRIK AGUS L LANSIA 7/23/1952
LEONARD WILA PA L MASY UMUM 9/7/1996
LODIA KORE BANGNGU P MASY UMUM 4/14/1983
FRANS WILA PA L MASY UMUM 11/19/1970
DAUD ROHI IDE L MASY UMUM 8/25/1987

DARIUS ROHI EDE L MASY UMUM 11/20/2000
HABEL DIMA LENA L MASY UMUM 12/20/1965
CHARLES LENA BANGNGU L MASY UMUM 4/24/1974
NENE SALINDRA KANA P MASY UMUM 3/8/2000
LOIS KOLO LADO L MASY UMUM 10/5/1977
TERSIA LENA BANGNGU P MASY UMUM 4/18/1979
RAFAEL TUKA REHI L MASY UMUM 12/26/1962
GUSTI TUKA REHI L MASY UMUM 8/18/1997
OSYAS MIHA BALO L MASY UMUM 10/18/1965
FREDINAND ROHI EDE L MASY UMUM 10/16/1974
OKTOVIANUS ULLI REKE L MASY UMUM 10/16/1980
RUBEN KOLI L LANSIA 7/1/1959
OKTORINCE MIHA BALO P MASY UMUM 10/3/1962
MARTEN TULU WANYI L MASY UMUM 7/17/1978
DJEFRIADI DJO HEGI L MASY UMUM 9/5/1978
MALEAKI DIMU RABA L MASY UMUM 6/26/1978
DOMINGGUS MIHA BALO L MASY UMUM 11/9/1969
HENDERINA HUBI MONE P MASY UMUM 11/7/1993
DAUD LOBO L MASY UMUM 10/16/1993
OKTOVIANUS HINA LEDE L MASY UMUM 10/4/1991
YONATAN MIHA BALO L LANSIA 6/23/1958
LONI WATTI L LANSIA 3/15/1958
YONATAN ADI L MASY UMUM 12/12/1971
JELITA LULU RIHO P MASY UMUM 6/24/2002
HENOK DJO HEGI L MASY UMUM 7/16/1976
MAD SEVENDJARA RABA L MASY UMUM 3/1/1988
YETI ROHI P MASY UMUM 4/21/1970
HENDRIK ULI L MASY UMUM 12/17/1973
RAFAEL DJUKA L MASY UMUM 11/16/1988

SALMON WADU LOGO L MASY UMUM 11/24/2001
HELI HANYE L MASY UMUM 2/10/1983
DARIUS KANA MANGNGI L MASY UMUM 12/18/1997
PETRUS KANA MANGNGI L LANSIA 9/8/1960
BALE RIWU L MASY UMUM 7/25/1979
MESAK WALU LOGO L MASY UMUM 10/2/1962
MARSELINA DJAWA P MASY UMUM 3/11/1997
YULIUS LENA DJILA L MASY UMUM 11/14/1970
MIRA DJARI L MASY UMUM 1/1/1970
KORNELIUS KALE UKE L MASY UMUM 4/7/1968
PITER DIDA L LANSIA 6/12/1956
YULIANA KALE UKE P MASY UMUM 12/9/1966
DO LULU L MASY UMUM 7/2/1977
HURI DJAWA L MASY UMUM 9/16/1978
SELFIANA LENA BANGNGU P LANSIA 11/11/1957
HEN LEBA LUDJI L MASY UMUM 1/9/1973
JIBRAEL KANA MANGNGI L MASY UMUM 6/17/1974
DOMINGGUS KOLA MOHE L MASY UMUM 2/24/1965
DIDIMUS KANA MANGNGI L MASY UMUM 3/5/1969
FEBI BANGNGU BIRE P MASY UMUM 2/18/1996
MATEOS RATU DJAMI L MASY UMUM 2/15/1992
RUTH LUDJI LOBO P MASY UMUM 5/21/1991
ROBERT RADJA L MASY UMUM 10/20/1973
MATELDA WILA DIDA P MASY UMUM 1/18/1970
HENDRIK KANA MANGNGI L MASY UMUM 1/1/1976
YULIUS DJO HEGI L MASY UMUM 6/6/1981
ELIAS RATU L MASY UMUM 6/29/1982
RESTI ANGRENI DJARA HURU P MASY UMUM 12/18/2000
YOHANIS ULI ROHI L MASY UMUM 3/29/1981

TUKA GAI DJO L MASY UMUM 7/15/1980
DAMIANUS LIDA L MASY UMUM 10/29/1999
YANSE TAPENU L MASY UMUM 1/6/1984
AGUSTINA DJU NINA P MASY UMUM 8/13/1998
LUKAS WEO L MASY UMUM 8/29/1992
MARTA ROHI DOMA P MASY UMUM 3/28/1985
YULIANA GA ARA P MASY UMUM 7/21/1985
RUY COSTA MIHA BALO L MASY UMUM 9/30/2002
PETRONELA KOLO LADO P MASY UMUM 8/5/1962
MELKIANUS HABA ITO L MASY UMUM 3/23/1996
YOSUA DJARA BALE L MASY UMUM 2/26/2000
MARTA KALE P MASY UMUM 6/18/1967
LENI ADRIANA RADJA P PELAYAN PUBLIK 11/21/1980
DOMINGGUS WEO L MASY UMUM 5/27/2001
HABEL DJU NINA L MASY UMUM 6/5/1972
LUKAS UDJU LOMI L MASY UMUM 11/2/1965
FERDI EDISON UJU EDO L MASY UMUM 8/1/1983
THOMAS GA RATA L MASY UMUM 12/22/1964
DORKAS DIDA P MASY UMUM 8/18/1969
YULIANA ROHI DJAMI P MASY UMUM 2/22/1997
APRIYANTO LENA BANGNGU L MASY UMUM 4/22/1997
HENDERINA KE LUDJI P MASY UMUM 2/14/1987
KATI KATO P MASY UMUM 11/15/1976
NOFLIN WAKE L MASY UMUM 11/6/1998
FERBUCE DUBU P MASY UMUM 3/13/1977
DAVID DJAMI KORE L MASY UMUM 2/2/1980
ESTER NEGO P MASY UMUM 11/28/1987
LUISA RATU P MASY UMUM 1/1/1987
RIVANIATI KRISTIANI DIDA P MASY UMUM 3/17/1979

HERMAN LAGA TITA L MASY UMUM 5/14/1977
ANDRIAS KANA LEDE L MASY UMUM 8/10/1987
YULIANA DJAMI P MASY UMUM 7/20/1997
ALFINA DJARA P MASY UMUM 10/17/1986
EBEN TARI L MASY UMUM 3/24/1968
IMELDA JIDE ALA P MASY UMUM 6/15/1990
YUNUS KITU PENU L LANSIA 5/5/1959
OSKAR ARIFIN DIMU DIHA L MASY UMUM 10/4/1999
RIHIANUS DIDA L MASY UMUM 2/17/1979
TEROCI BULI P MASY UMUM 11/24/1978
DORKAS DJARA RIWU P MASY UMUM 12/26/1969
DANIEL DIDA L MASY UMUM 3/11/1986
RUBEN DJUKA L MASY UMUM 4/5/1969
BELANDINA LAGA TITA P MASY UMUM 8/29/1995
ROVINA TADA HABA P MASY UMUM 12/12/1963
AMELIA DUBU P MASY UMUM 6/26/2001
RIA KUDJI P MASY UMUM 5/7/1978
BENYAMIN DIRA L MASY UMUM 10/8/1993
MARGERITA ULY P LANSIA 7/17/1959
HARUN TODA L LANSIA 3/7/1961
HENDRIK DIRA L LANSIA 12/8/1952
PAPELIUS KOLO LADO L MASY UMUM 8/2/1973
SIMON DOKO L MASY UMUM 5/11/1990
STEFANUS LEDE GA L MASY UMUM 6/4/1988
BANNI KUDJI P MASY UMUM 6/21/1972
BENDELINA ITO P MASY UMUM 9/7/1967
YULIANA KORE TAGA P MASY UMUM 4/23/1973
YANTI MIHA BALO P MASY UMUM 2/5/1993
MELIANA NADA DAMU P MASY UMUM 5/30/1987

YEFLIANA KITU PENU P MASY UMUM 2/3/1996
FEBRI RATU L MASY UMUM 9/9/1995
PILPINA RAGA LOMI P MASY UMUM 2/4/1968
PELIPUS DIDA L MASY UMUM 1/8/2001
RAYANTI BANGNGU HUKE P MASY UMUM 2/5/1979
DANIEL DJUKA L MASY UMUM 7/15/1963
ICE DJAMI RANE P MASY UMUM 7/15/1990
AGUSTINUS RATU WAHI L MASY UMUM 8/27/1969
ENSEPSEM LENA DJILA L MASY UMUM 9/16/1999
DOMINGGUS BARA RIGE L MASY UMUM 2/11/2000
FERDINAN DIRA L MASY UMUM 2/2/2003
YANE MARINCE GATA P MASY UMUM 6/2/1972
SOFRIANA W LOGO P MASY UMUM 1/21/1989
IFAN ARIFIN BALU KEBI L MASY UMUM 11/19/2002
MARTA MANU TARA P MASY UMUM 3/29/2002
FEBRIYANTI KOLO LADO P MASY UMUM 11/3/2001
LUKAS MANU TARA L MASY UMUM 9/9/1984
SERAH LAGA TITA L MASY UMUM 1/13/1999
FITRIANI KORE MANNO P MASY UMUM 2/10/1994
YERMIAS PARA PA L MASY UMUM 1/13/1986
RADJI PAU L MASY UMUM 12/21/1985
ARDIATI BALE BANE L MASY UMUM 4/7/1994
EWITH LAY KANNI L MASY UMUM 3/26/1995
MARTINA DJUKA P MASY UMUM 3/21/1998
MOSES MANGNGI HEDI L MASY UMUM 4/2/1989
HENDRIK BALE L MASY UMUM 1/11/1964
YONATAN EDE L PELAYAN PUBLIK 27 DESEMBER 19
YULIANA DAWA P PELAYAN PUBLIK 7/2/1977
GERTHORUIDE DJARA ROHI P LANSIA 1/2/1936

FERISON BAKI DJU L REMAJA 2/4/2008
NOVRIANTI ITO L REMAJA 11/26/2007
ADITIA DJARA L REMAJA 2007-07-17
VIVI AGUSTIN MANU PADJA P REMAJA 8/27/2008
MARKUS DJARA ROHI L LANSIA 6/9/1948
YEDELIA BANA PAH P REMAJA 12/23/2008
KALEB LAY LADO L LANSIA 7/25/1952
MARSELINA RIWU DJETA P MASY UMUM 9/30/1978
RUBEN RIWU ROHI L MASY UMUM 9/29/1971
YOHANA DJADA KORO P MASY UMUM 07 JUNI 1965
OCTOVIANUS BANGNGU BIRE L MASY UMUM 10/2/1999
YULIANA KOLA MOHE P MASY UMUM 7/20/1968
EFRAIM RATU DJAMI L REMAJA 2/22/2007
ANGEL KAMELIA LOBO P REMAJA 4/20/2007
AMELIA KAHO P REMAJA 5/10/2008
WILFRIDUS DEHE DJIMO L REMAJA 3/12/2008
MELINDA FLORASITHA ESTER WADU P REMAJA 4/9/2007
DEFINTO GIOVAN WADU L REMAJA 7/9/2007
IMANUEL FATHER MAOTIUS WILA DIDA L REMAJA 11/2/2007
SILFESTER LUDJI HE L REMAJA 4/30/2008
DORCI DIMU RABA P REMAJA 9/12/2007
MARINCE DJARA HADJO P MASY UMUM 20-Apr-79
ASERIS FERNANDO DANGA L REMAJA 10/5/2004
ELSI INDIANTI SAPUTRA EDE P REMAJA 10/11/2006
FAVELUZY MIRA MANGNGI L MASY UMUM 5/2/1990
RIOVAN LULU RIHO L MASY UMUM 16 MARET 2000
ARIANTI RIHI P REMAJA 2/6/2008
NOVIA DJU NINA P MASY UMUM 11/17/2000
WELEM DJU NINA L LANSIA 5/1/1948

AYUB WALU LOGO L REMAJA 11/29/2007
RIO ANDIKA KORE LIHU L REMAJA 3/3/2006
ARNIWATI RIWU P MASY UMUM 5/11/1998
LARIANUS KALE TE L LANSIA 7/30/1958
RADE DOKO P MASY UMUM 4/8/1965
MUKA MONE P MASY UMUM 5/25/1979
DOMIANTHO EDO PITA L MASY UMUM 9/8/2002
STEFER ENRICHO EDO PITA L REMAJA 2/10/2007
ECONG JUVINTO KORO L REMAJA 11/24/2006
SILVI MARTALIA DJEKE P REMAJA 3/25/2009
MANGNGI DJAPA HEO L LANSIA 10/17/1939
YULIANA LOMI DJAWA P MASY UMUM 4/14/1997
DARIUS DJARA BALE L LANSIA 1/1/1961
MARIANA LUDJI LOBO P LANSIA 3/8/1948
YANA YULIUS DJARA HADJO P MASY UMUM 8/8/1994
ANGELINA LUDU DOKO P MASY UMUM 12/12/1989
FRENGKY JON TARI L MASY UMUM 9/8/1996
WATI MIRA LINDA POLIN P MASY UMUM 3/26/1987
TIMOTIUS KOLO LADO L MASY UMUM 1976-06-13
OPNIEL KANA LUDJI L MASY UMUM 1994-10-30
BENDELINA KITU PENU P MASY UMUM 7/1/1967
MARINCE LAPE RANO P MASY UMUM 1988-03-07
YULIANA LI TUKA P MASY UMUM 6/15/1979
NORLINA HADJA P MASY UMUM 11/16/1995
HERONIMUS HAE NGURU L MASY UMUM 1/15/1985
TRISINA WAHI TAI P MASY UMUM 3/3/1984
AVSINTHA RONDO P MASY UMUM 4/19/1999
DEBORA HABEL DANGA P MASY UMUM 4/14/1976
HELENA WADU RIWU P MASY UMUM 4/10/1982

RIBKA WAHI TAI P MASY UMUM 6/5/1982
LAMBERTUS KOLO LADO L MASY UMUM 6/15/1974
APRIANA SRYSANTI DJARA BALE P MASY UMUM 4/5/1999
DEMETRIUS LAGA TITA L MASY UMUM 5/25/1964
GETREDA LAI HAWU P MASY UMUM 12/12/1976
NESRIANA RIHI P MASY UMUM 4/15/2001
YULIANA DEHE DJIMO P MASY UMUM 4/4/2003
DAUD WADU L MASY UMUM 2/4/1993
YESKIEL HURU L MASY UMUM 12/10/1968
PENINA BALU KEBI P MASY UMUM 10/11/1964
YANE MARIANCE DJUKA P MASY UMUM 6/25/1994
DEBORA DJARA LAO P MASY UMUM 10/16/1984
MARSELINA DJARA BANGNGU P MASY UMUM 7/12/1989
YOLANDA PATI P MASY UMUM 6/12/1994
EVITA WELE P REMAJA 4/15/2005
DESI PUTRI KALEB MANNO P REMAJA 7/25/2009
LUISA KAHO P REMAJA 2004-11-16
ENGGELINA BARA RIGE P MASY UMUM 6/15/2004
PAULUS NGENA DJO L LANSIA 4/21/1957
DOMINGGUS RIWU LONI L LANSIA 6/24/1954
SURYATI LENA DJILA P REMAJA 4/5/2006
FEBE TARI p LANSIA 8/24/1958
YUNUS EDE L LANSIA 11/15/1947
ALBERTINA LENA BANGNGU P LANSIA 2/11/1950
MARTINCE MIHA BALO P MASY UMUM 9/5/1982
GITA NGE P MASY UMUM 4/15/2001
KAREL LENA BANGNGU L LANSIA 7/27/1949
NGE ADU P LANSIA 8/10/1960
IMANUEL DIMU RABA L REMAJA 10/24/2006

WINGKI SAPUTRA ULI REKE L REMAJA 3/24/2007
NAOMI DJO RATE P LANSIA 11/1/1953
LUKAS PADJU L MASY UMUM 5/5/1973
YAFET RIWU DJETA L LANSIA 8/14/1937
LODIA HUBI MONE P MASY UMUM 7/3/1965
JIBRAEL TADE L LANSIA 8/7/1955
YESTIN KANA MANGNGI P REMAJA 1/1/2008
GUIDO LOBO KUDJI L REMAJA 6/8/2007
NOFRIATI ROHI DJAMI P MASY UMUM 11/6/2002
YERMIAS KANA MANGNGI L LANSIA 7/9/1957
BERNADUS BANGNGU BIRE L LANSIA 3/8/1959
IMELDA LAY WADU P MASY UMUM 7/1/1988
DANCE DIRA L MASY UMUM 8/16/1972
DIKSON KORE LIHU L REMAJA 6/15/2008
JULFRID KALE LENA L REMAJA 6/22/2007
DESI RATNASAROI DANGA P REMAJA 12/29/2007
ESRY VALISTA RADJA P REMAJA 7/12/2009
SERLIN KERABA P REMAJA 9/24/2005
NORITA NAISILLA MAGE P REMAJA 11/6/2007
MERSI MARGERITA MAGE P REMAJA 5/25/2009
BERNAD MANGNGI LADO L REMAJA 2/5/2005
NOVE ADHI CHARSA DJARA L REMAJA 11/30/2008
FEBRIANA TUKA WEO P REMAJA 2/20/2005
LASARUS LOBO L REMAJA 11/30/2005
DEWIANTI LOBO HABA P REMAJA 1/7/2010
AGUSTINA MANU TARA P REMAJA 8/8/2008
NOSEPTI ARTALIA LOBO HABA P REMAJA 11/1/2008
TATISKA PUTRIANI LOBO HABA P REMAJA 11/24/2009
YENI TADA WATTI P REMAJA 1/15/2010

ANGELICHA GABRIELA NGE P REMAJA 10/21/2009
YOHANES KRISTIAN RATU L REMAJA 12/9/2009
GARCE RATU DUBU P REMAJA 1/8/2010
ITA RATNA SARI DIMU DIHA P REMAJA 7/30/2009
ANGELANI DESWITA MAHARANI EDO PITAP REMAJA 4/2/2008
DENI APRIANUS MAGE L REMAJA 3/12/2007
PUTRA RAGA LOMI L REMAJA 2/11/2009
IBRAHIM RABA L REMAJA 6/14/2008
YANDIT PRATAMA UDJU EDO L REMAJA 9/3/2005
FEBI MIHA BALO P REMAJA 2/15/2009
BETAVIANA ULI P REMAJA 8/10/2008
MEGAWATI S A R LAY LENA P REMAJA 5/5/2004
SAID SAPUTRA A R LAY LENA L REMAJA 3/15/2006
DESTRIANI KAHA P REMAJA 12/3/2006
HUTRIYANI BUNGA TADE P REMAJA 3/14/2004
LAU MATE L REMAJA 2/23/2007
ALKI DANGA L REMAJA 4/26/2008
MANO PADA L REMAJA 10/9/2007
YOSAFAT DOMA L REMAJA 5/24/2009
DELI ANA RATU P REMAJA 8/1/2004
JEANICE MENIRY P REMAJA 11/22/2009
PAULINA KALE UKE P REMAJA 3/13/2005
HERMAN HARI NGENA L REMAJA 10/30/2005
THERESIA TALI MONE P MASY UMUM 6/3/1972
MATELDA KORE BANGNGU P MASY UMUM 8/11/1997
DIDIMUS DJABBE L MASY UMUM 8/8/1979
MARGERITA MIRA P MASY UMUM 3/2/1962
MARTA MANO L MASY UMUM 9/11/1971
FRID ARISON DJULA L MASY UMUM 5/25/2001

SUSANA TRI FLORIDA KANA P PELAYAN PUBLIK 1/22/1981
ELISABET DJAWA P MASY UMUM 3/23/1994
NATALINO DANIEL IMANUEL L REMAJA 12/26/2003
MELVI ULY L REMAJA 5/14/2007
YERI DIRA L REMAJA 6/13/2006
DODI LUDJI L REMAJA 9/4/2006
ADRIANA DIMU DOHA P REMAJA 4/11/2004
TANTRI KANA MANGNGI P REMAJA 4/11/2005
DIKSON FES NANDO A WADU L REMAJA 10/9/2004
YUNITA DIRA P REMAJA 6/2/2006
OLIVIA MAGE LUHI P LANSIA 4/5/1951
NIKOLAS LOBO L LANSIA 11/11/1959
ALEXSANDER DJARA PARA L LANSIA 11/15/1955
FEBRUCES IMANUEL LOMI L LANSIA 2/8/1958
BENDELINA KANA MANGNGI P LANSIA 9/1/1934
ROBO RIWU L LANSIA 5/15/1932
LODIA KATI P LANSIA 6/14/1948
MARTA DJO RATE RIWU DJAMI P LANSIA 9/18/1940
HELENA TUKA P LANSIA 2/6/1961
MARIANA TAGA P MASY UMUM 7/27/1980
BERNABAS MAGE MATA L MASY UMUM 10/20/1980
YOHANES ARI ALE L MASY UMUM 8/5/1993
ANGELINA INTAN P MASY UMUM 11/10/1985

Kepesertaan BPJS (tulis 'Ya' pada

Umur sesuai)
(18 sd ≥ 60 Kelompok Umur Alamat No. Hp
tahun)
BPJS PBI
57 46-59 DESA MATEI 85253280500
43 31-45 DESA MATEI 81213864571
46 46-59 DESA MATEI 81213864571
20 18-30 DESA MATEI 81246869450
46 46-59 DESA MATEI 81338885642
20 DESA TADA 082340374495
28 18-30 DESA MATEI 81238865318
30 18-30 DESA MATEI 81238865318
28 DESA JIWUWU 081338886604
48 46-59 DESA MATEI 85253454103
24 18-30 DESA LOBOADJU 81337703698
70 60-150 DESA EIMAU 82146364793
26 18-30 DESA EIADA 81339637697
40 31-45 DESA MATEI 81246006387
52 46-59 DESA BEBAE 81339637697
35 31-45 DESA MATEI 85210125311

22 18-30 DESA TADA 82339807599
57 46-59 DESA LOBOADJU 82145793285
49 46-59 DESA MATEI 85210125311
23 18-30 DESA MATEI 81353362336
45 31-45 DESA EIMAU 82266176658
44 31-45 DESA MATEI 85237577251
60 60-150 DESA LOBOADJU 85333228835
25 18-30 DESA LOBOADJU 85333228835
57 46-59 DESA MATEI 81384057648
48 46-59 DESA MATEI 81339750693
42 31-45 DESA MATEI 81337066567
64 60-150 DESA EIMADAKE 82339009249
60 60-150 DESA MATEI 85338473831
45 31-45 DESA MATEI 81339750693
44 31-45 DESA MATEI 85238924302
45 31-45 DESA MATEI 81339750693
53 46-59 DESA EIMADAKE 82340374821
29 18-30 DESA EIMAU 81338226671
29 18-30 DESA MATEI 81237278030
31 31-45 DESA EIMAU 81338226671
65 60-150 DESA MATEI 81384057648
65 60-150 DESA EIMADAKE 82145793285
51 46-59 DESA KEDURU 82339311846
21 18-30 DESA JIWUWU 82145826228
47 46-59 DESA MATEI 85238924302
35 31-45 DESA EIMADAKE 082145689475
53 46-59 DESA EIMADAKE 081338950094
49 46-59 DESA EIMAU 085337538957
34 31-45 DESA EIMADAKE 082145689475

21 18-30 DESA EIMAU 082147360866
40 31-45 DESA EIMAU 082236537243
25 18-30 DESA MATEI 082258795425
62 60-150 DESA MATEI 082258795425
43 31-45 DESA EIMAU 081221731245
60 60-150 DESA EIMAU 081220759297
26 18-30 DESA EIMADAKE 081338886040
52 46-59 DESA MATEI 081339223900
53 46-59 DESA LOBOADJU 082145793285
55 46-59 DESA MATEI 081339223900
67 60-150 DESA BEBAE 085239939238
56 46-59 DESA MATEI 081339223900
46 46-59 DESA JIWUWU 085338856067
44 31-45 DESA JIWUWU 085338856067
65 60-150 DESA MATEI 085338473831
50 46-59 DESA MATEI 082231640547
49 46-59 DESA MATEI 081353362336
58 46-59 DESA MATEI 082147552412
54 46-59 DESA MATEI 081353362336
27 18-30 DESA LOBOADJU 081239422452
31 31-45 DESA DELO 082339835117
32 31-45 DESA LOBOADJU 081339720350
49 46-59 DESA JIWUWU 081338606383
53 46-59 DESA LOBOADJU 085238856762
47 46-59 DESA MATEI 085253458312
42 31-45 DESA MATEI 085253458312
41 31-45 DESA EIMAU 081337705115
22 18-30 DESA EIMAU 082339940480
42 31-45 DESA EIMADAKE 081338950094

43 31-45 DESA EIMAU 085237814118
23 18-30 DESA EIMADAKE 081338950094
39 31-45 DESA JIWUWU 081337620341
24 18-30 DESA LOBOADJU 081353249165
30 18-30 DESA LOBOADJU 085333876896
38 31-45 DESA EIMAU 081338496133
37 31-45 DESA EIMADAKE 081239204357
20 18-30 DESA EIMADAKE 082145653380
60 60-150 DESA EIMAU 081339225285
27 18-30 DESA EILODE 081236822788
23 18-30 DESA JIWUWU 082236853875
56 46-59 DESA JIWUWU 082236853875
42 31-45 DESA EIMADAKE 082339985844
22 18-30 DESA LOBOADJU 085333876896
51 46-59 DESA LOBOADJU 081353249165
57 46-59 DESA MATEI 082199682870
39 31-45 DESA MATEI 081337407700
58 46-59 DESA TADA 085238564896
53 46-59 DESA MATEI 081337407700
26 18-30 DESA MATEI 085333539571
26 18-30 DESA MATEI 085333831738
36 31-45 DESA EIMAU 081338396137
46 46-59 DESA JIWUWU 08225800032
24 18-30 DESA JIWUWU 085280586951
46 46-59 DESA EIMAU 081238448284
43 31-45 DESA MENIA 082339940480
35 31-45 DESA EILODE 082145007083
36 31-45 DESA EIMAU 082236537243
44 31-45 DESA EIMAU 081353533227

46 46-59 DESA EIMAU 082145687183
35 31-45 DESA EIMAU 081346484432
25 18-30 DESA EIMAU 082260372276
36 31-45 DESA EIMAU 081220759256
55 46-59 DESA EIMAU 081351215933
33 31-45 DESA EIMAU 081246010429
64 60-150 DESA EIMAU 082339940480
23 18-30 DESA EIMAU 081338651524
44 31-45 DESA EIMADAKE 082339345891
44 31-45 DESA EIMAU 082195463251
53 46-59 DESA EIMAU 081238913547
37 31-45 DESA EIMADAKE 081238038081
54 46-59 DESA EIMADAKE 082236537243
27 18-30 DESA EIMAU 081338496044
59 46-59 DESA EIMAU 081339223801
22 18-30 DESA EIMAU 085333078503
45 31-45 DESA EIMAU 082339940480
29 18-30 DESA LOBOADJU
64 60-150 DESA EIMADAKE 082252434593
62 60-150 DESA LOBOADJU 082298220435
70 60-150 DESA LOBOADJU
49 46-59 DESA EIMAU 082145794541
33 31-45 DESA EIMADAKE 082147025166
35 31-45 DESA MENIA 082339940480
51 46-59 DESA EIMAU 082339940480
55 46-59 DESA EIMAU 082236537243
50 46-59 DESA EIMAU 081236116816
30 18-30 DESA EILODE 082247103383
36 31-45 DESA EIMAU 081221731245

27 18-30 DESA EIMAU 082339940480
27 18-30 DESA EIMAU 081238351541
55 46-59 DESA EIMAU 085333538957
22 18-30 DESA EIMADAKE 082247666589
44 31-45 DESA EIMAU 082211884119
60 60-150 DESA EIMADAKE 082147025166
33 31-45 DESA EIMADAKE 081337798391
53 46-59 DESA LOBOADJU 082298220534
23 18-30 DESA MATEI
23 18-30 DESA EIMAU 081238095024
20 18-30 DESA LOBOADJU 082145793285
51 46-59 DESA EIMAU 085333538957
34 31-45 DESA EIMAU 081220759297
20 18-30 DESA EIMAU 085339187368
21 18-30 DESA EIMAU 085339187368
21 18-30 DESA EIMAU 082339940480
38 31-45 DESA EIMAU 082339940480
24 18-30 DESA EIMAU 082271248562
29 18-30 DESA EIMAU 081339225042
37 31-45 DESA EIMAU 082214439546
37 31-45 DESA EIMAU 082339940480
29 18-30 DESA EIMAU 082339940480
28 18-30 DESA EIMADAKE 082340374791
25 18-30 DESA EIMADAKE 081246430808
34 31-45 DESA EIMAU 082144036269
59 46-59 DESA EIMADAKE 85333538988
26 18-30 DESA MATEI 0821 4463 6665
44 31-45 EIMADAKE 085333958961
87 60-150 DESA MATEI 85339080316

15 12-17 DESA JIWUWU 85253895668
15 12-17 DESA EILODE 85253895668
14 DESA EIMAU 081337782851
14 12-17 DESA EILODE 85253895668
75 60-150 DESA MATEI 85281934095
14 12-17 DESA EILODE 85253895668
70 60-150 DESA LOBOADJU 81238732823
44 31-45 DESA MATEI 81339424761
51 46-59 DESA MATEI 81339424761
56 DESA EIMADAKE 081 370 537 268
23 18-30 DESA EIMADAKE 85333228878
54 46-59 DESA LOBOADJU 81238732823
16 12-17 DESA DELO 85253895668
14 JIWUWU 085253895668
13 JIWUWU 085253895668
15 12-17 DESA EIMAU 85253895668
14 EIMAU 085253895668
16 12-17 DESA MENIA 85253895668
13 EIMADAKE 085253895668
13 EIMAU 085253895668
14 MATEI 082144820070
44 31-45 DESA MATEI 82341231893
18 18-30 DESA BODAE 81218159589
14 TADA 081337703959
33 31-45 DESA EILODE 8237099254
21 DESA JIWUWU 082 138 874 431
15 12-17 DESA EILODE 85253895668
22 18-30 DESA LOBOADJU 82147247104
73 60-150 DESA LOBOADJU 82339556423

15 12-17 DESA EIMAU 85253895668
15 JIWUWU 085253895668
25 DESA JIWUWU 81239585838
64 DESA JIWUWU 81239585838
58 46-59 DESA EIMAU 82339940480
42 DESA EIMAU 082339940480
19 18-30 DESA TADA 081378885100
14 EIMADAKE 085253895668
13 EIMADAKE 85253895668
12 JIWUWU 085253895668
83 DESA JIWUWU 81239585838
24 DESA JIWUWU 085337079774
62 DESA JIWUWU 81239585838
75 DESA JIWUWU 82146447386
28 18-30 DESA MATEI 85280586951
32 31-45 DESA EIMAU 82266229665
26 18-30 DESA EIMAU 81351215933
34 DESA EIMAU 082339940480
45 DESA EIMAU 082339940480
27 DESA EIMAU 081266834459
54 DESA EIMAU 082339940480
33 DESA EIMAU 082339940480
42 DESA EIMAU 082339940480
26 DESA EIMAU 81234704931
36 31-45 DESA EIMAU 082266229665
37 DESA EIMAU 082339940480
22 DESA JIWUWU 081239232570
45 31-45 DESA EIMAU 082339940480
39 31-45 DESA EIMAU 082339940480

39 DESA EIMAU 082339940480
47 DESA EIMAU 082339940480
22 DESA JIWUWU 082261880169
57 46-59 DESA EIMAU 081353533263
45 DESA EIMAU 082145171591
20 DESA EIMAU 082195463251
18 DESA EIMAU 082145171591
28 DESA EIMAU 081237689062
53 DESA EIMAU 085339940480
57 DESA EIMAU 082339940480

082147025166
27 EIMADAKE
37 DESA EIMAU 081239674130
32 DESA EIMAU 082339940480
29 18-30 DESA MATEI 85280586951
16 DESA EIMAU 081337079810
12 JIWUWU 0852252434608
17 DESA JIWUWU 081339224058
19 18-30 DESA EIMAU 82145144529
64 DESA EIMAU 082339940480
69 60-150 DESA EIMADAKE 82339557808
17 12-17 DESA MATEI 82247103473
63 60-150 DESA EIMAU 0823339940480
75 60-150 DESA MATEI 82144636665
73 60-150 DESA MATEI 82144636665
40 31-45 DESA TADA 81339224258
22 18-30 DESA MATEI 82145361507
73 60-150 DESA MATEI 85338473831
62 60-150 DESA MATEI 82145361507
16 12-17 DESA MATEI 81339750693

16 12-17 DESA MATEI 81337006567
69 60-150 DESA EIMAU 82271246983
50 46-59 DESA EILODE 82144847338
85 60-150 DESA MATEI 82359095787
58 46-59 DESA EIMAU 81338226671
67 60-150 DESA MATEI 81337722538
15 12-17 DESA TADA 81339224258
16 12-17 DESA EIMAU 81339223801
20 18-30 DESA RAEKORE 82144636665
66 60-150 DESA MATEI 81338100763
64 60-150 DESA EIMADAKE 85333228878
35 31-45 DESA EIMAU 82144644726
50 46-59 DESA LOBOADJU 82145793285
15 12-17 DESA JIWUWU 82189446307
16 12-17 DESA JIWUWU 82236395811
15 12-17 DESA EIMAU 82214387384
14 12-17 DESA EILODE 82117009297
17 12-17 DESA DELO 81239300954
15 12-17 DESA EILODE 82247164082
14 12-17 DESA EILODE 85337521109
18 18-30 DESA EIMAU 82214352186
14 12-17 DESA EIMADAKE 85337339741
18 18-30 DESA LOBOADJU 81353783098
17 12-17 DESA EIMADAKE 82247164082
12 12-17 DESA JIWUWU 82247164082
14 12-17 DESA EIMAU
14 12-17 DESA JIWUWU 81239293029
13 12-17 DESA JIWUWU 81337418350
12 12-17 DESA EIMADAKE 85337201602

13 12-17 DESA EIMAU 81237632241
13 12-17 DESA EILODE 82247164082
12 12-17 DESA EILODE 82144838025
13 12-17 DESA EIMAU 82247164082
15 12-17 DESA TADA 82247164082
16 12-17 DESA EILODE 085337521109
14 12-17 DESA EILODE 082214387294
15 12-17 DESA EIMADAKE 082247164082
17 12-17 DESA MATEI 82145361507
14 12-17 DESA EILODE 82247164082
14 12-17 DESA EIMAU 85333538957
19 18-30 DESA MATEI 81236391403
17 12-17 DESA MATEI
16 12-17 DESA EIMADAKE 85333528671
19 18-30 DESA LOBOADJU 85337079475
16 12-17 DESA JIWUWU 081236294678
15 12-17 DESA MENIA 081246517785
15 12-17 DESA JIWUWU 082236395851
14 12-17 DESA EIMAU 08123603630
18 18-30 DESA MENIA 082247164082
13 12-17 DESA JIWUWU 082235800032
18 18-30 DESA MATEI 082214635845
17 12-17 DESA EIMAU 081329554272
51 46-59 DESA EIMAU 82339940480
25 18-30 DESA MATEI 82145155679
43 31-45 DESA EIMAU 82244947078
61 60-150 DESA EIMADAKE 8214559825
51 46-59 DESA EIMAU 81351215933
22 18-30 DESA LOBOADJU 82340264692

42 31-45 DESA EIMADAKE 85253723441
29 18-30 DESA EIMADAKE 82146946215
19 18-30 DESA EIMADAKE 85338294667
16 12-17 DESA JIWUWU 82213130802
17 12-17 DESA LOBOADJU 82145793285
16 12-17 DESA JIWUWU 982235800032
19 18-30 DESA EIMAU 081238913547
18 18-30 DESA TADA 081339224258
18 18-30 DESA EIMAU 085333538961
17 12-17 DESA LOBOADJU 082145793285
72 60-150 DESA JIWUWU 082236853875
63 60-150 DESA EIMADAKE 085338370715
67 60-150 DESA EIMADAKE 082237171324
65 60-150 DESA LOBOADJU 082145793285
88 60-150 DESA MATEI 085253458312
91 60-150 DESA EIMADAKE 082237171324
75 60-150 DESA EIMADAKE 085339690164
82 60-150 DESA EIMADAKE 081339451201
62 60-150 DESA LOBOADJU 082298220435
42 31-45 DESA EIMAU 082244947078
42 31-45 DESA EIMAU 081238731588
29 18-30 DESA EIMAU 081390826461
37 31-45 DESA EIMAU 081390826461

aan BPJS (tulis 'Ya' pada kolom yang
Tanggal Screening Nama/Jenis/Merek Vaksin***

BPJS Non
Non Anggota
PBI
9/21/2021 ASTRAZENECA
6/29/2021 CORONAVAC
0000869886887 6/29/2021 CORONAVAC

9/28/2021 CORONAVAC
9/28/2021 CORONAVAC
9/28/2021 CORONAVAC
9/28/2021 CORONAVAC
19 JULI 2021 CORONAVAC
9/28/2021 CORONAVAC
9/28/2021 CORONAVAC
9/28/2021 CORONAVAC
9/27/2021 CORONAVAC
9/29/2021 VAKSIN COVID 19 BIOFARMA
9/16/2021 VAKSIN COVID PT BIOFARMA
19 JULI 2021 CORONAVAC
9/28/2021 CORONAVAC
9/9/2021 CORONAVAC

9/28/2021 CORONAVAC
9/27/2021 CORONAVAC
18-Oct-21 VAKSIN COVID PT BIOFARMA


000087152
7/19/2021 CORONAVAC
9016




Dosis I
Tanggal Pemberian
No. Batch No. Serial
Vaksinasi
9/21/2021 PV46700 02639419435755
9/21/2021 PV46700 02639419435755
9/21/2021 PV46700 02639419435755
9/11/2021
9/21/2021 PV46700 02639419435755
9/9/2021 PV46700 01864954830490
9/21/2021 PV46700 02639419435755
9/21/2021 PV46700 02639419435755
9/9/2021 PV46700 01864954830490
9/21/2021 PV46700 02639419435755
4/19/2021
11/10/2021 A1083 100000062544388
11/10/2021 A1083 100000062544388
11/10/2021 A1083 100000062544388
11/10/2021 A1083 100000062544388
11/10/2021 A1083 100000062544388

11/10/2021 A1083 100000062544388
11/10/2021 A1083 100000062544388
11/10/2021 A1083 100000062544388
11/10/2021 A1083 100000062544388
11/10/2021 A1083 100000062544388
11/10/2021 A1083 100000062544388
11/10/2021 A1083 100000062544388
11/10/2021 A1083 100000062544388
11/10/2021 A1083 100000062544388
11/10/2021 A1083 100000062544388
11/10/2021 A1083 100000062544388
11/10/2021 A1083 100000062544388
11/10/2021 A1083 100000062544388
11/10/2021 A1083 100000062544388
11/10/2021 A1083 100000062544388
11/10/2021 A1083 100000062544388
11/10/2021 A1083 100000062544388
11/10/2021 A1083 100000062544388
11/10/2021 A1083 100000062544388
11/10/2021 A1083 100000062544388
11/10/2021 A1083 100000062544388
11/10/2021 A1083 100000062544388
11/10/2021 A1083 100000062544388
11/10/2021 A1083 100000062544388
11/10/2021 A1083 100000062544388
11/10/2021 A1083 100000062544388
11/10/2021 A1083 100000062544388
11/10/2021 A1083 100000062544388
11/10/2021 A1083 100000062544388

11/10/2021 A1083 100000062544388
11/10/2021 A1083 100000062544388
11/10/2021 A1083 100000062544388
11/10/2021 A1083 100000062544388
11/10/2021 A1083 100000062544388
11/10/2021 A1083 100000062544388
11/10/2021 A1083 100000062544388
11/10/2021 A1083 100000062544388
11/10/2021 A1083 100000062544388
11/10/2021 A1083 100000062544388
11/10/2021 A1083 100000062544388
11/10/2021 A1083 100000062544388
11/10/2021 A1083 100000062544388
11/10/2021 A1083 100000062544388
11/10/2021 A1083 100000062544388
11/10/2021 A1083 100000062544388
11/10/2021 A1083 100000062544388
11/10/2021 A1083 100000062544388
11/10/2021 A1083 100000062544388
11/10/2021 A1083 100000062544388
11/10/2021 A1083 100000062544388
11/10/2021 A1083 100000062544388
11/10/2021 A1083 100000062544388
11/10/2021 A1083 100000062544388
11/10/2021 A1083 100000062544388
11/10/2021 A1083 100000062544388
11/10/2021 A1083 100000062544388
11/10/2021 A1083 100000062544388
11/10/2021 A1083 100000062544388

11/10/2021 A1083 100000062544388
11/10/2021 A1083 100000062544388
11/10/2021 A1083 100000062544388
11/10/2021 A1083 100000062544388
11/10/2021 A1083 100000062544388
11/10/2021 A1083 100000062544388
11/10/2021 A1083 100000062544388
11/10/2021 A1083 100000062544388
11/10/2021 A1083 100000062544388
11/10/2021 A1083 100000062544388
11/10/2021 A1083 100000062544388
11/10/2021 A1083 100000062544388
11/10/2021 A1083 100000062544388
11/10/2021 A1083 100000062544388
11/10/2021 A1083 100000062544388
11/10/2021 A1083 100000062544388
11/10/2021 A1083 100000062544388
11/10/2021 A1083 100000062544388
11/10/2021 A1083 100000062544388
11/10/2021 A1083 100000062544388
11/10/2021 A1083 100000062544388
11/10/2021 A1083 100000062544388
11/10/2021 A1083 100000062544388
11/10/2021 A1083 100000062544388
11/10/2021 A1083 100000062544388
11/10/2021 A1083 100000062544388
11/10/2021 A1083 100000062544388
11/10/2021 A1083 100000062544388
11/10/2021 A1083 100000062544388

11/10/2021 A1083 100000062544388
11/10/2021 A1083 100000062544388
11/10/2021 A1083 100000062544388
11/10/2021 A1083 100000062544388
11/10/2021 A1083 100000062544388
11/10/2021 A1083 100000062544388
11/10/2021 A1083 100000062544388
11/10/2021 A1083 100000062544388
11/10/2021 A1083 100000062544388
11/10/2021 A1083 100000062544388
11/10/2021 A1083 100000062544388
11/10/2021 A1083 100000062544388
11/10/2021 A1083 100000062544388
11/10/2021 A1083 100000062544388
11/10/2021 A1083 100000062544388
11/10/2021 A1083 100000062544388
11/10/2021 A1083 100000062544388
11/10/2021 A1083 100000062544388
11/10/2021 A1083 100000062544388
11/10/2021 A1083 100000062544388
11/10/2021 A1083 100000062544388
11/10/2021 A1083 100000062544388
11/10/2021 A1083 100000062544388
11/10/2021 A1083 100000062544388
11/10/2021 A1083 100000062544388
11/10/2021 A1083 100000062544388
11/10/2021 A1083 100000062544388
11/10/2021 A1083 100000062544388
11/10/2021 A1083 100000062544388

11/10/2021 A1083 100000062544388
11/10/2021 A1083 100000062544388
11/10/2021 A1083 100000062544388
11/10/2021 A1083 100000062544388
11/10/2021 A1083 100000062544388
11/10/2021 A1083 100000062544388
11/10/2021 A1083 100000062544388
11/10/2021 A1083 100000062544388
11/10/2021 A1083 100000062544388
11/10/2021 A1083 100000062544388
11/10/2021 A1083 100000062544388
11/10/2021 A1083 100000062544388
11/10/2021 A1083 100000062544388
11/10/2021 A1083 100000062544388
11/10/2021 A1083 100000062544388
11/10/2021 A1083 100000062544388
11/10/2021 A1083 100000062544388
11/10/2021 A1083 100000062544388
11/10/2021 A1083 100000062544388
11/10/2021 A1083 100000062544388
11/10/2021 A1083 100000062544388
11/10/2021 A1083 100000062544388
11/10/2021 A1083 100000062544388
11/10/2021 A1083 100000062544388
11/10/2021 A1083 100000062544388
11/6/2021 202108122H 16298088677347
6/29/2021 24200721 16221717766356
6/29/2021 24200721 16221113517306
11/6/2021 202108122H 16298088677347

9/28/2021 2021081601 16301222796250
9/28/2021 2021081601 16301222796250
10/26/2021 2021081671 16309339725384
9/28/2021 2021081601 16301222796250
11/6/2021 202108122H 16298097478724
9/28/2021 2021081601 16301222796250
10/22/2021 202108169F 16319520957886
11/6/2021 202108122H 16298097478724
11/6/2021 202108122H 16298088677347
19 JULI 2021 24200721 16221005976365
11/6/2021 202108122H 16298088677347
10/22/2021 202108169F 16319520957886
9/28/2021 2021081601 16301222796250
9/22/2021 2021081601 16301222796250
10/26/2021 2021081671 16309339725384
9/28/2021 2021081601 16301222796250
10/26/2021 2021081671 16309339725384
9/28/2021 2021081601 16301222796250
10/26/2021 202108175F 16322841592331
9/27/2021 2021081601 16301222796250
9/29/2021 202108167I 16309332221288
11/6/2021 202108122H 16298088677347
10/25/2021
9/16/2021 24004821 16254561383636
11/6/2021 202108122H 16298092626190
19 JULI 2021 24200721 16221005976365
9/28/2021 2021081601 16301222796250
9/9/2021
9/22/2021 202108160I 16301222848738

9/28/2021 2021081601 16301222796250
9/22/2021 2021081601 16301222796250
11/10/2021 202108167I 16309339725384
11/10/2021 202108167I 16309339725384
10/12/2021 202108119H 16295072867328
11/11/2021 202108167I 16309339721322
10/11/2021 202108119H 16295072867328
9/27/2021 2021081601 16301222796250
10/26/2021 202108175F 16322841592331
10/26/2021 202108175F 16322841592331
11/10/2021 202108167I 16309339725384
10/18/2021 202108175F 16322913906033
11/10/2021 202108167I 16309339725384
11/10/2021 202108167I 16309339725384
11/6/2021 202108122H 16298088677347
11/11/2021 202108167I 16309332120843
11/6/2021 202108122H 16298092626190
11/11/2021 202108167I 16309339721322
11/11/2021 202108167I 16309332120843
11/11/2021 202108167I 16309339721322
11/11/2021 202108167I 16309339721322
11/11/2021 202108167I 16309339721322
11/11/2021 202108167I 16309339721322
11/11/2021 202108167I 16309339721322
11/11/2021 202108167I 16309332120843
11/11/2021 202108167I 16309339721322
10/18/2021 202108175F 16322913906033
11/11/2021 202108167I 16309339721322
11/11/2021 202108167I 16309339721322

11/11/2021 202108167I 16309339721322
11/11/2021 202108167I 16309339721322
10/18/2021 202108175F 16322913906033
11/11/2021 202108167I 16309332120843
11/11/2021 202108167I 16309339721322
11/11/2021 202108167I 16309339721322
11/11/2021 202108167I 16309339721322
11/11/2021 202108167I 16309339721322
11/11/2021 202108167I 16309339721322
11/11/2021 202108167I 16309339721322
7/19/2021 24200721 16221005970281
11/11/2021 202108167I 16309339721322
11/11/2021 202108167I 16309339721322
11/6/2021 202108122H 16298088677347
11/11/2021 202108167I 16309339721322
10/26/2021 202108175F 16322841592331
10/18/2021 202108175F 16322913906033
10/12/2021 202108119H 16295072867328
11/11/2021 202108167I 16309332120843
11/6/2021 202108122H 16298097478724
9/22/2021 202108122H 16298097478724
11/11/2021 202108167I 16309339721322
11/10/2021 24203421 16306351024533
11/10/2021 24203421 16306351024533
11/10/2021 24203421 16306351024533
11/10/2021 24203421 16306351024533
11/10/2021 24203421 16306351024533
11/10/2021 24203421 16306351024533
11/10/2021 24203421 16306351024533

11/10/2021 24203421 16306351024533
11/10/2021 24203421 16306351024533
11/10/2021 24203421 16306351024533
11/10/2021 24203421 16306351024533
11/10/2021 24203421 16306351024533
11/10/2021 24203421 16306351024533
11/10/2021 24203421 16306351024533
11/10/2021 24203421 16306351024533
11/10/2021 24203421 16306351024533
11/10/2021 24203421 16306351024533
11/10/2021 24203421 16306351024533
11/10/2021 24203421 16306351024533
11/10/2021 24203421 16306351024533
11/10/2021 24203421 16306351024533
11/10/2021 24203421 16306351024533
11/10/2021 24203421 16306351024533
11/10/2021 24203421 16306351024533
11/10/2021 24203421 16306351024533
11/10/2021 24203421 16306351024533
11/10/2021 24203421 16306351024533
11/10/2021 24203421 16306351024533
11/10/2021 24203421 16306351024533
11/10/2021 24203421 16306351024533
11/10/2021 24203421 16306351024533
11/10/2021 24203421 16306351024533
11/10/2021 24203421 16306351024533
11/10/2021 24203421 16306351024533
11/10/2021 24203421 16306351024533
11/10/2021 24203421 16306351024533

11/10/2021 24203421 16306351024533
11/10/2021 24203421 16306351024533
11/10/2021 24203421 16306351024533
11/10/2021 24203421 16306351024533
11/10/2021 24203421 16306351024533
11/10/2021 24203421 16306351024533
11/10/2021 24203421 16306351024533
11/10/2021 24203421 16306351024533
11/10/2021 24203421 16306351024533
11/10/2021 24203421 16306351024533
11/10/2021 24203421 16306351024533
11/10/2021 24203421 16306351024533
11/10/2021 24203421 16306351024533
11/10/2021 24203421 16306351024533
11/10/2021 24203421 16306351024533
11/10/2021 24203421 16306351024533
11/10/2021 24203421 16306351024533
11/10/2021 24203421 16306351024533
11/10/2021 24203421 16306351024533
11/10/2021 24203421 16306351024533
11/10/2021 24203421 16306351024533
11/10/2021 24203421 16306351024533
11/10/2021 24203421 16306351024533
11/10/2021 24203421 16306351024533
11/10/2021 24203421 16306351024533
11/10/2021 24203421 16306351024533
11/10/2021 24203421 16306351024533
11/10/2021 24203421 16306351024533
11/10/2021 24203421 16306351024533

11/10/2021 24203421 16306351024533
11/10/2021 24203421 16306351024533
11/10/2021 24203421 16306351024533
11/10/2021 24203421 16306351024533
11/10/2021 24203421 16306351024533
11/10/2021 24203421 16306351024533
11/10/2021 24203421 16306351024533
11/10/2021 24203421 16306351024533
11/10/2021 24203421 16306351024533
11/10/2021 24203421 16306351024533
11/10/2021 24203421 16306351024533
11/10/2021 24203421 16306351024533
11/10/2021 24203421 16306351024533
11/10/2021 24203421 16306351024533
11/10/2021 24203421 16306351024533
11/10/2021 24203421 16306351024533
11/10/2021 24203421 16306351024533
11/10/2021 24203421 16306351024533
11/10/2021 24203421 16306351024533
11/10/2021 24203421 16306351024533
11/10/2021 24203421 16306351024533
11/10/2021 24203421 16306351024533
11/10/2021 24203421 16306351024533

Dosis 2
Tanggal Pemberian Vaksinasi No. Batch No. Serial
11/10/2021 A1083 100000062544388
11/10/2021 A1083 100000062544388
11/10/2021 A1083 100000062544388
11/10/2021 A1083 100000062544388
11/10/2021 A1083 100000062544388
11/10/2021 A1083 100000062544388
11/10/2021 A1083 100000062544388
11/10/2021 A1083 100000062544388
11/10/2021 A1083 100000062544388
11/10/2021 A1083 100000062544388
11/10/2021 A1083 100000062544388

11/10/2021 24203421 16306351024533
11/10/2021 24203421 16306351024533
11/10/2021 24203421 16306351024533
11/10/2021 24203421 16306351024533

11/10/2021 24203421 16306351024533
11/10/2021 24203421 16306351024533
11/10/2021 24203421 16306351024533
11/10/2021 24203421 16306351024533
11/10/2021 24203421 16306351024533
11/10/2021 24203421 16306351024533
11/10/2021 24203421 16306351024533
11/10/2021 24203421 16306351024533
11/10/2021 24203421 16306351024533
11/10/2021 24203421 16306351024533
11/10/2021 24203421 16306351024533
11/10/2021 24203421 16306351024533
11/10/2021 24203421 16306351024533
11/10/2021 24203421 16306351024533
11/10/2021 24203421 16306351024533
11/10/2021 24203421 16306351024533
11/10/2021 24203421 16306351024533
11/10/2021 24203421 16306351024533
11/10/2021 24203421 16306351024533
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11/10/2021 24203421 16306351024533
11/10/2021 24203421 16306351024533
11/10/2021 24203421 16306351024533
11/10/2021 24203421 16306351024533
11/10/2021 24203421 16306351024533
11/10/2021 24203421 16306351024533
11/10/2021 24203421 16306351024533
11/10/2021 24203421 16306351024533
11/10/2021 24203421 16306351024533

11/10/2021 24203421 16306351024533
11/10/2021 24203421 16306351024533
11/10/2021 24203421 16306351024533
11/10/2021 24203421 16306351024533
11/10/2021 24203421 16306351024533
11/10/2021 24203421 16306351024533
11/10/2021 24203421 16306351024533
11/10/2021 24203421 16306351024533
11/10/2021 24203421 16306351024533
11/10/2021 24203421 16306351024533
11/10/2021 24203421 16306351024533
11/10/2021 24203421 16306351024533
11/10/2021 24203421 16306351024533
11/10/2021 24203421 16306351024533
11/10/2021 24203421 16306351024533
11/10/2021 24203421 16306351024533
11/10/2021 24203421 16306351024533
11/10/2021 24203421 16306351024533
11/10/2021 24203421 16306351024533
11/10/2021 24203421 16306351024533
11/10/2021 24203421 16306351024533
11/10/2021 24203421 16306351024533
11/10/2021 24203421 16306351024533
11/10/2021 24203421 16306351024533
11/10/2021 24203421 16306351024533
11/10/2021 24203421 16306351024533
11/10/2021 24203421 16306351024533
11/10/2021 24203421 16306351024533
11/10/2021 24203421 16306351024533

11/10/2021 24203421 16306351024533
11/10/2021 24203421 16306351024533
11/10/2021 24203421 16306351024533
11/10/2021 24203421 16306351024533
11/10/2021 24203421 16306351024533
11/10/2021 24203421 16306351024533
11/10/2021 24203421 16306351024533
11/10/2021 24203421 16306351024533
11/10/2021 24203421 16306351024533
11/10/2021 24203421 16306351024533
11/10/2021 24203421 16306351024533
11/10/2021 24203421 16306351024533
11/10/2021 24203421 16306351024533
11/10/2021 24203421 16306351024533
11/10/2021 24203421 16306351024533
11/10/2021 24203421 16306351024533
11/10/2021 24203421 16306351024533
11/10/2021 24203421 16306351024533
11/10/2021 24203421 16306351024533
11/10/2021 24203421 16306351024533
11/10/2021 24203421 16306351024533
11/10/2021 24203421 16306351024533

Keterangan
Diberikan/Lanjut)
SELESAI DESA MATEI
SELESAI DESA MATEI
SELESAI DESA MATEI
SELESAI DESA MATEI
SELESAI DESA MATEI
SELESAI DESA TADA
SELESAI DESA MATEI
SELESAI DESA MATEI
SELESAI DESA JIWUWU
SELESAI DESA MATEI
SELESAI DESA MATEI
LANJUT DESA EIMAU
LANJUT DESA EIADA
LANJUT DESA MATEI
LANJUT DESA BEBAE
LANJUT DESA MATEI

LANJUT DESA TADA
LANJUT DESA MATEI
LANJUT DESA MATEI
LANJUT DESA EIMAU
LANJUT DESA MATEI
LANJUT DESA MATEI
LANJUT DESA MATEI
LANJUT DESA MATEI
LANJUT DESA MATEI
LANJUT DESA MATEI
LANJUT DESA MATEI
LANJUT DESA MATEI
LANJUT DESA EIMAU
LANJUT DESA MATEI
LANJUT DESA EIMAU
LANJUT DESA MATEI
LANJUT DESA KEDURU
LANJUT DESA JIWUWU
LANJUT DESA MATEI
LANJUT DESA EIMAU

LANJUT DESA EIMAU
LANJUT DESA EIMAU
LANJUT DESA MATEI
LANJUT DESA MATEI
LANJUT DESA EIMAU
LANJUT DESA EIMAU
LANJUT DESA MATEI
LANJUT DESA MATEI
LANJUT DESA BEBAE
LANJUT DESA MATEI
LANJUT DESA JIWUWU
LANJUT DESA JIWUWU
LANJUT DESA MATEI
LANJUT DESA MATEI
LANJUT DESA MATEI
LANJUT DESA MATEI
LANJUT DESA MATEI
LANJUT DESA DELO
LANJUT DESA JIWUWU
LANJUT DESA MATEI
LANJUT DESA MATEI
LANJUT DESA EIMAU
LANJUT DESA EIMAU

LANJUT DESA EIMAU
LANJUT DESA JIWUWU
LANJUT DESA EIMAU
LANJUT DESA EIMAU
LANJUT DESA EILODE
LANJUT DESA JIWUWU
LANJUT DESA JIWUWU
LANJUT DESA MATEI
LANJUT DESA MATEI
LANJUT DESA TADA
LANJUT DESA MATEI
LANJUT DESA MATEI
LANJUT DESA MATEI
LANJUT DESA EIMAU
LANJUT DESA JIWUWU
LANJUT DESA JIWUWU
LANJUT DESA EIMAU
LANJUT DESA MENIA
LANJUT DESA EILODE
LANJUT DESA EIMAU
LANJUT DESA EIMAU

LANJUT DESA EIMAU
LANJUT DESA EIMAU
LANJUT DESA EIMAU
LANJUT DESA EIMAU
LANJUT DESA EIMAU
LANJUT DESA EIMAU
LANJUT DESA EIMAU
LANJUT DESA EIMAU
LANJUT DESA EIMAU
LANJUT DESA EIMAU
LANJUT DESA EIMAU
LANJUT DESA EIMAU
LANJUT DESA EIMAU
LANJUT DESA EIMAU
LANJUT DESA EIMAU
LANJUT DESA MENIA
LANJUT DESA EIMAU
LANJUT DESA EIMAU
LANJUT DESA EIMAU
LANJUT DESA EILODE
LANJUT DESA EIMAU

LANJUT DESA EIMAU
LANJUT DESA EIMAU
LANJUT DESA EIMAU
LANJUT DESA EIMAU
LANJUT DESA MATEI
LANJUT DESA EIMAU
LANJUT DESA EIMAU
LANJUT DESA EIMAU
LANJUT DESA EIMAU
LANJUT DESA EIMAU
LANJUT DESA EIMAU
LANJUT DESA EIMAU
LANJUT DESA EIMAU
LANJUT DESA EIMAU
LANJUT DESA EIMAU
LANJUT DESA EIMAU
LANJUT DESA EIMAU
LANJUT DESA EIMAU
SELESAI DESA EIMADAKE
SELESAI PTPS DESA MATEI
SELESAI KADER POSYANDU BB DESA EIMADAKE
SELESAI DESA MATEI

SELESAI SMPN 1 SABU TENGAH
SELESAI DESA MATEI
SELESAI DESA MATEI
SELESAI DESA MATEI
SELESAI SMA N 1 SATENG
SELESAI DESA MATEI
SELESAI DESA BODAE
SELESAI SMA NEGERI 1 SATENG
SELESAI DESA EILODE

SELESAI DESA JIWUWU
SELESAI DESA JIWUWU
SELESAI DESA EIMAU
SELESAI DESA EIMAU
SELESAI DESA TADA
SELESAI DESA JIWUWU
SELESAI DESA JIWUWU
SELESAI DESA JIWUWU
SELESAI DESA JIWUWU
SELESAI DESA MATEI
SELESAI DESA EIMAU
SELESAI DESA EIMAU
SELESAI DESA EIMAU
SELESAI DESA EIMAU
SELESAI DESA EIMAU
SELESAI DESA EIMAU
SELESAI DESA EIMAU
SELESAI DESA EIMAU
SELESAI DESA EIMAU
SELESAI DESA EIMAU
SELESAI DESA EIMAU
SELESAI DESA JIWUWU
SELESAI DESA EIMAU
SELESAI DESA EIMAU

SELESAI DESA EIMAU
SELESAI DESA EIMAU
SELESAI DESA JIWUWU
SELESAI DESA EIMAU
SELESAI DESA EIMAU
SELESAI DESA EIMAU
SELESAI DESA EIMAU
SELESAI DESA EIMAU
SELESAI DESA EIMAU
SELESAI DESA EIMAU
SELESAI DESA EIMAU
SELESAI DESA EIMAU
SELESAI DESA MATEI
SELESAI DESA EIMAU
SELESAI DESA JIWUWU
SELESAI DESA EIMAU
SELESAI DESA EIMAU
SELESAI DESA MATEI
SELESAI DESA EIMAU
LANJUT DESA MATEI
LANJUT DESA MATEI
LANJUT DESA TADA
LANJUT DESA MATEI
LANJUT DESA MATEI
LANJUT DESA MATEI
LANJUT DESA MATEI

LANJUT DESA MATEI
LANJUT DESA EIMAU
LANJUT DESA EILODE
LANJUT DESA MATEI
LANJUT DESA EIMAU
LANJUT DESA MATEI
LANJUT DESA TADA
LANJUT DESA EIMAU
LANJUT DESA RAEKORE
LANJUT DESA MATEI
LANJUT DESA EIMAU
LANJUT SMPN 1 SATENG
LANJUT SD PADADUE

LANJUT SMA SATIM
LANJUT SMA1 SABAR
LANJUT SMA1 SABAR
LANJUT SMA SATIM
LANJUT SMA SATENG
LANJUT SMA SATENG
LANJUT SMA PGRI
LANJUT DESA EIMAU
LANJUT DESA MATEI
LANJUT DESA EIMAU
LANJUT DESA EIMAU

LANJUT DESA JIWUWU
LANJUT DESA JIWUWU
LANJUT DESA EIMAU
LANJUT DESA TADA
LANJUT DESA EIMAU
LANJUT DESA JIWUWU
LANJUT DESA MATEI
LANJUT DESA EIMAU
LANJUT DESA EIMAU
LANJUT DESA EIMAU
LANJUT DESA EIMAU

calcu
Kabupaten/Kota
Provinsi
Hari, Tanggal
No No. Tiket NIK
1 P-MWXOOIY4 5320055105630004
2 P-G7H0S04J 5320056606650001
3 P-MX065JLU 5320055712990001
4 P-MX5DWFJR 5320052310960002
5 P-IFI2SW8T 5320050609890001
6 P-HSW37KST 5320051211870001
7 P-H8JOEEDQ 5320054603870001
8 P-HOA561D1 5320055303880001
9 P-H0EPWCII 5320035307960001
10 P-GFOHN68R 5320055504730001
11 P-ACZC3S3X 5320030711070005
12 P-AKFU8Y2A 5320056205040001
13 S-095042DC 5320050508520001
14 P-F3FVEXDF 5320056301830001
15 P-G67AC4PB 5320054211770001
16 Q-001J4WFP 5320051711030001
17 Q-001NUQXF 5320051806840001
18 Q-001CEIRT 5320057112890001
19 S-A62FE6C4 53200052005510001
20 P-4IPKUSK9 5320052704920001
21 S-527779D2 5320056603550001
22 S-DA70AE9A 5320053012550001
23 P-2ODXASYU 5320050406010001
24 P-KHAGWDUS 5320055005030001
25 P-K8S4FG5P 5320055502710001
26 P-JL2U734A 5320051605820001
27 P-J07GO54Q 5320056404820002
28 P-IS8VPBNU 5320056204650001
: Sabu Raijua
: 09/12/2021
Pekerjaan*
Jenis
Kelamin
HENDERINA BANGNGU P MASY UMUM 5/11/1963
MARCE HENDERINA ODJA P MASY UMUM 6/26/1965
MAGDALENA TADI LULU P MASY UMUM 12/17/1999
MELKIANUS KALE PAO L MASY UMUM 10/23/1996
MESAK DJAMI KORE L MASY UMUM 9/6/1989
RIZAL WILIAM RADJA RIGE L MASY UMUM 11/12/1987
DORKAS DJAMI KORE P MASY UMUM 3/6/1987
ATO KAHO HAMU P MASY UMUM 3/13/1988
PETRI YUNI JUITA ADI P MASY UMUM 7/13/1996
JUBLINA DIDA HAWU P MASY UMUM 4/15/1973
ROMI LEO L MASY UMUM 11/7/2003
MELDIANA LEO P MASY UMUM 5/22/2004
RAFAEL LOBO L LANSIA 8/5/1952
YULIANA WADU P MASY UMUM 1/23/1983
TERSIANA LEO P MASY UMUM 11/2/1977

MASY UMUM
NELSON UDJU LOMI P 12/17/2001
MELKIANUS LEO BIRE L MASY UMUM 6/18/1984
ADE ROSITA HABA GEA P MASY UMUM 1989-12-31
ANDERIAS ROHI DOMA L LANSIA 5/20/1950
RAJUN DIDA L MASY UMUM 4/27/1992
MARGERITHA NARA WALU P LANSIA 3/26/1955
LEONIDAS BALE DABBO L LANSIA 12/30/1955
ISAK HADJA L MASY UMUM 6/8/2001
VIVIN A. KOLO BIRE P MASY UMUM 5/10/2003
DAMARIS WILA DIDA P MASY UMUM 2/15/1971
PETRUS HUKI L MASY UMUM 5/16/1982

SOLFASINA BENU P MASY UMUM 4/24/1987
HELENA DJAMI KORE P MASY UMUM 4/22/1965
Kepesertaan BPJS (tulis 'Ya'

Umur pada kolom yang sesuai)
Kelompok
(18 sd ≥ 60 Alamat No. Hp
Umur
tahun)
BPJS BPJS Non
PBI PBI
58 DESA BEBAE 082144859740
56 DESA MATEI 082339811237
22 DESA BEBAE 082144859740
25 DESA BEBAE 082144859740
32 DESA TADA 081325707040
34 DESA EILODE 08137706451
34 DESA EILODE 08137706451
33 DESA EILODE 08137706451
25 DESA KEDURU 081337603339
48 DESA BEBAE 085238428930
18 DESA EIADA 082145653263
17 DESA BEBAE 081236835867
69 DESA LOBOAJU 082158353680
38 DESA LOBOAJU 082158353680
44 DESA BEBAE 085338856076
21 18-30 MATEI 82359455653

39 31-45 DESA LOBOADJU 081246069396
32 DESA BEBAE 082144859740
71 DESA MATEI 081236159436
29 DESA TADA 081254745790
66 DESA RAEKORE 081236159436
66 DESA MATEI 081236836391
20 DESA BEBAE 081246499412
18 DESA LOBOAJU 082298673907
50 DESA LOBOAJU 081246499163
39 DESA EIMADAKE 082236191779

34 DESA EIMADAKE 082236191779
56 DESA TADA 081325707040
aan BPJS (tulis 'Ya'
Dosis I
om yang sesuai)
Non Tanggal Pemberian
Anggota Vaksinasi

10/27/2021 VAKSIN COVID 19 BIOFARMA 10/27/2021
12/9/2021 ASTRA ZENECA 12/9/2021
12/9/2021 ASTRA ZENECA 12/9/2021
12/9/2021 ASTRA ZENECA 12/9/2021
12/9/2021 ASTRA ZENECA 12/9/2021
12/9/2021 ASTRA ZENECA 12/9/2021
12/9/2021 ASTRA ZENECA 12/9/2021
12/9/2021 ASTRA ZENECA 12/9/2021
12/9/2021 ASTRA ZENECA 12/9/2021

12/9/2021 ASTRA ZENECA 12/9/2021
12/9/2021 ASTRA ZENECA 12/9/2021
Dosis 2
Tanggal Pemberian
No. Batch No. Serial No. Batch
Vaksinasi
202108140H 16319351805904
202108140H 16319351805904
202108140H 16319351805904
202108140H 16319351805904
202108140H 16319351805904
202108140H 16319351805904
202108140H 16319351805904
202108140H 16319351805904
202108140H 16319351805904
202108140H 16319351805904
202108140H 16319351805904
202108140H 16319351805904
202108140H 16319351805904
202108140H 16319351805904
202108140H 16319351805904
202108169F 16322913910407 12/9/2021 202108140H

16298092626190 12/9/2021 202108140H
202108122H
202108119H 16295072866703 12/9/2021 202108140H
ABZ9883 02935766436369
ABZ9883 02935766436369
ABZ9883 02935766436369
ABZ9883 02935766436369
ABZ9883 02935766436369
ABZ9883 02935766436369
ABZ9883 02935766436369
ABZ9883 02935766436369
ABZ9883 02935766436369
ABZ9883 02935766436369
Keterangan
Diberikan/Lanjut)
No. Serial
LANJUT DESA BEBAE
LANJUT DESA MATEI
LANJUT DESA BEBAE
LANJUT DESA BEBAE
LANJUT DESA TADA
LANJUT DESA EILODE
LANJUT DESA EILODE
LANJUT DESA EILODE
LANJUT DESA KEDURU
LANJUT DESA BEBAE
LANJUT DESA EIADA
LANJUT DESA BEBAE
LANJUT DESA LOBOAJU
LANJUT DESA LOBOAJU
LANJUT DESA BEBAE

16319351805904 SELESAI
LANJUT DESA MATEI
LANJUT DESA TADA
LANJUT DESA RAEKORE
LANJUT DESA MATEI
LANJUT DESA BEBAE
LANJUT DESA LOBOAJU
LANJUT DESA LOBOAJU

LANJUT DESA TADA
Kabupaten/Kota
Provinsi
Hari, Tanggal
No No. Tiket NIK
1 5320052512520002
2 5320051110030002
3 5371055912950001
4 5320052207910001
5 5320051703950001
6 5320051403870002
7 5320051007670001
8 5320051705800002
9 5320052905020001
10 532005040803001
11 5320050405690001
12 5320030804060003
13 5320050809050001
14 5320056704040001
15 5320050309060003
16 5320051411030001
17 5320056411040001
18 6371010103060001
19 5320024112050004
20 5320052205060002
21 5320022707060003
22 5320052208060001
23 5320051103060001
24 5320015011060002
25 5320050107040001
26 5320050111050001
27 5320010902020002
28 5320054205050002
29 5320055002050001
30 5320052608060001
31 5320052401040001
32 5320054203830001
33 5320025703040001
34 5320061201080001
35 5320054207000001
36 5320030006010002
37 5320050606000004
38 5320020506040003
39 5320051909790001
40 53200563100500002
41 5320054605060001
42 5320051104050001
43 5320050107030001
44 532005461880001
45 5320054406640001
46 5320055504600001
47 5320050712620001
48 5320051810980001
49 5320054905830002
50 5320022905050003
29
51 5320054912860001
42
52 5320050607040006
23
53 53200551801070001
75
54 5320051301060001
20
55 5320025605030002
18
56 5320054306030001
62
57 5311104203050001
21
58 5371022303060005
59 5320056612040001
60 5320051510050001
61 5320012812070003
62 5320054710030003
63 5320055906050001
6
64 5320050107020002
9
65 5320057004020002
61
66 5320056503070001
67 5320055501050001
60
68 5320055302050001
4
69 5320050703030001
56
70 5320052303070002
39
71 5320054208060001
43
72 5320051505060001
15
73 5320050412050003
37
74 5320015312030004
8
75 5320014906030001
13
76 5320051305070001
66
77 5320012002070003
31
78 5320051507050001
79 5320056405010003
2
80 S-F14F61E5 5320014109790001
81 P-HIZA34ZU 5320050210740001
82 P-2H3HTKXW 5320032005630001
83 P-HZNIELDZ 5320054303780003
84 Q-001GCDWQ 5320050410080003
85 Q-001GCTTX 5320050209060001
86 Q-001IOILS 5320052005080002
87 Q-001OI4VD 5320057108070002
88 P-3WUO7IJ8 5320022101080001
89 P-2TUMAKLU 5320052001070001
90 P-63MNDT0A 5320052111080001
91 Q-00152RV6 5320051103070001
92 P-6RTR8TE7 5320051308070001
93 S-EDCA31CE 5320014805840002
94 P-97WQ36D2 5320025703070001
95 P-AG1NMYAK 5320051401090001
96 S-A7393BD4 5371011003880001
97 P-C0MKM5WF 5320056003060002
98 Q-001512KR 5320055008070002
99 P-CRKL8NR1 5320054612090002
100 Q-001GCTW9 5320057010070002
101 S-9FF1D8BF 5301080204890001
102 Q-001GCTVK 5320055307050001
103 Q-001GCTXP 5320054210090002
104 P-GUI6WOX0 5320055402080002
105 P-HETA3GIK 5320055909070001
106 P-HSWI9Y6M 5320055110060001
107 P-ICGDLQ00 5320056210090001
108 P-DRE7FLO4 5320055810090001
109 P-J6GYTX94 5320050706080001
110 Q-00151663 5320057004080001

111 P-X7Q5UNXC 5320052001080002
112 P-MMP8SONH 5320052202070001
113 5320052407080001
Q-0010LJSG
114 Q-00153TAI 5320052608070001
115 P-JXNMODKN 5320050408080002

: Sabu Raijua
: 11/12/2021
Pekerjaan*
Jenis
Kelamin
DAUD LENA BANGNGU L LANSIA
PAPELIUS RAGA LOMI L MASY UMUM
WARA WIDIAWATI LOBO P PELAYAN PUBLIK
BENYAMIN DJARA L MASY UMUM
SPOTSI MARTHEN NAE L MASY UMUM
DOMINGGUS TUKA REHI L MASY UMUM
PELIPUS KOLO BIRE L MASY UMUM
HERMAN LOBO L PELAYAN PUBLIK
YULENS LIBRIAN WOLO L MASY UMUM
ARIANTO DIRA L MASY UMUM
EMIL RABA L MASY UMUM
SIMSON A MIHA LEO L REMAJA
GUSTIVAN ULI L REMAJA

RIFKA WAKE LULU L REMAJA
SHEVA MIHA BALO L REMAJA
NOLDI WETTI L REMAJA
NOFRIANA YANTI DJABBE L REMAJA
ARYA ARJUNA HAWU HABA L REMAJA
DEWI DHINIATI RADJA DJAWA P REMAJA
RIFAN LUDJI LINGU L REMAJA
SATRIA ADI SAPUTRA TARI L REMAJA
APLIATUS PA L REMAJA
HAKKO HAE L REMAJA
MELAN DJO RATE P REMAJA
REMOND DJAMI LENA L REMAJA
RISKY PRATAMA KALE ULY L REMAJA
GUSTAV J RIWU BANGNGU L REMAJA
RAHEL MUHU DJO P REMAJA
VEBI VELDIANA DJO RATE P REMAJA
OSKAR DJABBE L REMAJA
RIDOLF RABA L REMAJA
YUNITA GA NGARA P REMAJA
MARTIN SUSANTI RAGA LOMI P REMAJA
ARISTA WADU L REMAJA
WELHELMINA MANGNGI P MASY UMUM
ISAK DJO L MASY UMUM
SISKA DJAMI P REMAJA

ARDI PUTRA S DOKO L REMAJA
TOMI F BALE LAY L REMAJA
DARI OVIAN ULY L REMAJA
MERLIN DJUKA P REMAJA
RICKY BANGNGU KORO L REMAJA
DIMU MANU L REMAJA
GIDEON PA L REMAJA
MARINCE WAKE LULU ROHI P MASY UMUM
TEROCI HAWU LEKU P LANSIA
PAULUS KOTA L MASY UMUM
TOMI MIHA BALO L MASY UMUM
WELHELMINA KANA MANGNGI P MASY UMUM
MARSEINO WILA HAU L REMAJA
OKTOVIANUS TUKA WEO L REMAJA
JEFRI MIRA MATA L REMAJA
YANDRI SETIAWAN DIMU RABA L REMAJA
YANDRI WAKE LULU L REMAJA
MERSI DJAWA P MASY UMUM
MARSELINA NGURU P REMAJA
OKTA SOVIANA ULY P REMAJA
RAFINDRA P DIMU L REMAJA
ROSLIN GA P REMAJA
OSKAR WADU MANNO L REMAJA
DAVID ALVARO LODO L REMAJA

OKTOVIAN MIRA MANGNGI L MASY UMUM
LISLEN PAULINA DJARA P REMAJA
YUNIOR RAGA LOMI L REMAJA
DEWI A. ROHI P REMAJA
MERI AFRIANI LUDJI LINGU P REMAJA
YUNITA BANGNGU HEGI P REMAJA
MELANI PERTIWI EDE P REMAJA
ADAM IMANUEL KALE LOMI L MASY UMUM
KORNELIUS MA'U LADO L REMAJA
ANITA BANGNGU BIRE P REMAJA
ROY URBANUS L REMAJA
DANY KALE ULY L REMAJA
RENI NATALIA DJAMI P REMAJA
YUYUN SUKAWATI HEBI HIRA P MASY UMUM
KENAN KANA MANGNGI L REMAJA
FARREL A. HATU RIWU L REMAJA
ALDI KANA MANGNGI L REMAJA
SARI AYUNINGSIH TAGA P REMAJA
ATINORMIATI LUDJI P PELAYAN PUBLIK
GABRIEL RATU DUBU L MASY UMUM
EBENHAEZER BOIFALA L PELAYAN PUBLIK
ANTONIA DUBU P MASY UMUM
ETHWIN OTHNIEL RATA L REMAJA
SEPRIANUS NGURU L REMAJA
ELIASER RATU DUBU L REMAJA

JULA LEU L REMAJA
DJEFRI KAHO LUDJI L REMAJA
JEMI LULU RIHO L REMAJA
ARJUN STEVEN LOBO HABA L REMAJA
LODIWIK RIHI L REMAJA
DANIEL DJAMI L REMAJA
MESRY APRIANA RIHI MONE P PELAYAN PUBLIK
ALISA NETA HILU P REMAJA

REMAJA
WILIANS LAKI HIA L
MOREYS JANTODEL MASU L PELAYAN PUBLIK
DORKAS KOLO LADO P REMAJA
AGUSTYNA ROSSALYN KAHO HAMU P REMAJA
DESRI ROVINA RIWU P REMAJA
OKTOVINNIA BANGNGU KORO P REMAJA
SEFRIANUS DJARA BALE L PELAYAN PUBLIK
SELI BOLE P REMAJA
FRIDA OKTAVIA LEO DJULA P REMAJA
ESTER FALENTINA LAGA TITA P REMAJA
DURU BOLE P REMAJA
MARGERITA LIDA P REMAJA
DEWI NOVRIYANTI DJARA P REMAJA
BENDELINA BEDE PANNU L REMAJA
ADYSUCIPTO MIRA MANGNGI L REMAJA
INTHAN PUDJO LUDJI P REMAJA
KALEB HEROSANDI DJAMI ADI L REMAJA
EFRAIN BANNI L REMAJA
MIZAEL PRAJA IMANUEL L REMAJA
DONATUS DO NGENA L REMAJA
DIONISIUS TARI L REMAJA

Umur
(18 sd ≥ 60 tahun)
12/25/1952 70 60-150 DESA LOBOADJU
10/11/2003 19 18-30 DESA EIMAU
12/19/1995 27 18-30 DESA MATEI
7/22/1991 31 31-45 DESA EIMADAKE
3/17/1995 28 18-30 DESA MATEI
3/14/1987 36 31-45 DESA LOBOADJU
7/10/1967 56 46-59 DESA LOBOADJU
5/17/1980 43 31-45 DESA TADA
5/29/2002 21 18-30 DESA EILODE
8/13/2003 19 18-30 DESA LOBOADJU
5/4/1969 54 46-59 DESA EIMADAKE
4/8/2006 17 12-17 DESA RAEKORE
8/9/2005 17 12-17 DESA EIMAU

4/27/2004 19 18-30 DESA LOBOADJU
11/3/2006 16 12-17 DESA EIMADAKE
11/14/2004 18 18-30 DESA LOBOADJU
11/24/2004 18 18-30 DESA EIMAU
3/1/2005 18 18-30 DESA LOBOADJU
12/1/2005 17 12-17 DESA EIMAU
5/22/2006 17 12-17 DESA TADA
7/27/2006 16 12-17 DESA EIMAU
9/22/2006 16 12-17 DESA EIMAU
3/11/2006 17 12-17 DESA EIMAU
11/10/2006 16 12-17 DESA EIMAU
7/1/2004 19 18-30 DESA LOBOADJU
11/1/2005 17 12-17 DESA EIMADAKE
2/11/2004 19 18-30 DESA RAEKORE
5/2/2004 19 18-30 DESA EIMADAKE
2/10/2004 19 18-30 DESA EIMADAKE
7/28/2006 16 12-17 DESA EIMAU
10/24/2004 18 18-30 DESA EIMADAKE
6/25/2007 16 12-17 DESA TADA
3/17/2004 19 18-30 DESA EIMAU
6/3/2005 18 18-30 DESA EIMAU
7/2/2002 21 18-30 DESA MATEI
6/6/2001 22 18-30 DESA EILODE
6/12/2005 18 18-30 DESA EILODE

6/5/2004 19 18-30 DESA JIWUWU
9/13/2004 18 18-30 DESA TADA
10/23/2005 17 12-17 DESA EILODE
5/6/2006 17 12-17 DESA EIMADAKE
4/11/2005 18 18-30 DESA EILODE
5/6/2005 18 18-30 DESA EILODE
11/22/2004 18 18-30 DESA EIMAU
6/4/1964 59 46-59 DESA EIMADAKE
4/15/1960 63 60-150 DESA EIMADAKE
12/7/1962 60 60-150 DESA EIMADAKE
10/18/1988 34 31-45 DESA MATEI
5/9/1983 40 31-45 DESA TADA
5/29/2005 16 EIMADAKE
10/23/2006 14 LOBOAJU
7/6/2004 17 EIMAU
1/18/2007 14 MATEI
1/13/2006 15 MATEI
4/12/2003 18 EILODE
6/5/2004 17 EILODE
10/2/2005 15 EIMADAKE
3/23/2006 17 12-17 DESA MATEI
12/26/2004 18 18-30 DESA EIMADAKE
10/15/2005 17 12-17 DESA TADA
12/28/2007 15 12-17 DESA MENIA

10/7/2003 19 18-30 DESA EIMADAKE
6/19/2005 18 18-30 EIMAU
6/3/2006 17 12-17 EIMAU
4/30/2005 16 EILODE
3/25/2007 16 12-17 TADA
1/15/2005 16 TADA
2/13/2005 18 18-30 MATEI
03/03/2003 18 MATEI
3/23/2007 14 MATEI
8/20/2006 15 EIMADAKE
15-May-06 17 12-17 LOBOADJU
12/4/2006 15 EIMADAKE
12/13/2003 19 18-30 RAEKORE
6/9/2003 20 18-30 DELO
5/17/2007 16 12-17 MATEI
2/20/2007 16 12-17 RAEKORE
7/15/2005 18 18-30 MATEI
5/24/2001 22 18-30 EILODE
1979-09-01 -42 MENIA
2/10/1975 -46 DESA EILODE
5/20/1963 58 DESA BODAE
10/4/2008 13 EILODE
9/3/2007 13 EILODE
5/28/2008 13 EILODE
8/31/2007 14 EIMAU
3/11/2007 14 12-17 DESA EILODE
2007-08-13 14 DESA EILODE
1984-05-08 37 DESA MENIA
3/17/2007 14 DESA EIMAU
1/14/2009 12 DESA EIMAU

3/10/1988 33 DESA RAELORO
2009-03-28 12 DESA EIMAU
8/10/2007 14 12-17 DESA JIWUWU
10/30/2007 14 EILODE
13/07/2005 16 JIWUWU
10/2/2009 12 EIMADAKE
2/14/2008 -13 DESA EIMAU
10/22/2009 12 DESA EIMAU
10/18/2009 12 DESA EIMAU
4/30/2008 13 12-17 DESA JIWUWU
2/22/2007 14 DESA EIMAU
7/24/2008 13 12-17 JIWUWU
8/25/2007 14 12-17 DESA EIMAU

ASI COVID-19
NASI

yang sesuai)
BPJS Non
PBI
081237732823 12/11/2021
081239943166 12/11/2021
082144286421 12/11/2021
082171804388 12/11/2021
082214353007 12/11/2021
082341402198 12/11/2021
082298673907 12/11/2021
082341402198 12/11/2021
081 239 555 367 12/11/2021
081337703698 12/11/2021
082339556735 12/11/2021
081239572300 12/11/2021
081338884996 12/11/2021
081236209282 12/11/2021
082229092722 12/11/2021
081338885076 12/11/2021
082144817839 12/11/2021
082147299760 12/11/2021
081237182890 12/11/2021
082147535709 12/11/2021
082252435171 12/11/2021
082285214670 12/11/2021
082236395794 12/11/2021
082145653178 12/11/2021
085320402589 12/11/2021
085339088692 12/11/2021
081339233594 12/11/2021
081339225543 12/11/2021
081339225543 12/11/2021
12/11/2021
082339556735 12/11/2021
081339750971 12/11/2021
085338153172 12/11/2021
081353917512 12/11/2021
082340375271 12/11/2021
081239853162 12/11/2021
081236636072 12/11/2021
082339811285 12/11/2021
082339557810 12/11/2021
081337078099 12/11/2021
082138875363 12/11/2021
082236364353 12/11/2021
081338884996 12/11/2021
082252435171 12/11/2021
085338840350 12/11/2021
082171804388 12/11/2021
082171804388 12/11/2021
082340375271 12/11/2021
081238094471 12/11/2021
082145174906 9/29/2021
082342724424 9/29/2021
081238039197 9/29/2021
081 239 555242 16 JULI 2021
082286809627 9/29/2021
085238924254 9/29/2021
081338152193 9/16/2021
082342724424 9/29/2021
081239293238
082147299771
085237423100
081239908117
081335795281
81337889595 10/27/2021
81237178468 10/27/2021
081337796040 9/16/2021
85333002384 10/15/2021
085237423100 9/16/2021
85333088660 10/27/2021
081338885076 9/16/2021
085237769249 9/29/2021
081238662778 9/29/2021
85237854960 10/27/2021
085339078484 9/29/2021
81338885528 10/27/2021
81338885528 10/27/2021
081236863248 9/16/2021
082342724424 9/29/2021
81236863248
81338885528 9/29/2021
085253014745 12/11/2021
082288527422 12/11/2021
082171151543 12/11/2021
082288527422 12/11/2021
085253895668 10/21/2021
085253895668 10/21/2021
085253895668 10/26/2021
085253895668 10/26/2021
085333078407 12/11/2021
085333078407 12/11/2021
081339223893 12/11/2021
85253895668 9/28/2021
085240819124 12/11/2021
082217418955 12/11/2021
081236195242 12/11/2021
081338885619 12/11/2021
085253859866 12/11/2021
081312558371 12/11/2021
9/28/2021
81236834909
081144102550 12/11/2021
082138888170 10/21/2021
08123626922 12/11/2021
081335795203 10/21/2021
085253895668 10/21/2021
085240819124 12/11/2021
085240819124 12/11/2021
085240819124 12/11/2021
082133557522 12/11/2021
085240819124 12/11/2021
081246351506 12/11/2021
85253895668 9/28/2021
085253895668 12/11/2021
085240819124 12/11/2021
085253895668 9/20/2021
85253895668 9/28/2021
082252458443 12/11/2021
Dosis I
Tanggal Pemberian
No. Batch
Vaksinasi





CORONAVAC 9/28/2021 2021081601

CORONAVAC 9/28/2021 2021081601

CORONAVAC 9/28/2021 2021081601

CORONAVAC 9/28/2021 2021081601

Dosis 2
10000006254388
10000006254388
10000006254388
10000006254388
10000006254388
10000006254388
10000006254388
10000006254388
10000006254388
10000006254388
10000006254388
16306351024533
16306351024533
16306351024533
16306351024533
16306351024533
16306351024533
16306351024533
16306351024533
16306351024533
16306351024533
16306351024533
16306351024533
16306351024533
16306351024533
16306351024533
16306351024533
16306351024533
16306351024533
16306351024533
16306351024533
16306351024533
16306351024533
16306351024533
16306351024533
16306351024533
16306351024533
16306351024533
16306351024533
16306351024533
16306351024533
16306351024533
16306351024533
16306351024533
16306351024533
16306351024533
16306351024533
16306351024533
16306351024533
16309339722882 12/11/2021 24203421
16309332221288 12/11/2021 24203421
16309339722882 12/11/2021 24203421
16182780907700 12/11/2021 24203421
16309339722882 12/11/2021 24203421
16309339722882 12/11/2021 24203421
16254561379736 12/11/2021 24203421
16309339722882 12/11/2021 24203421
12/11/2021 24203421
12/11/2021 24203421
12/11/2021 24203421
12/11/2021 24203421
12/11/2021 24203421
16322913910407 12/11/2021 24203421
16322913910407 12/11/2021 24203421
16254561379736 12/11/2021 24203421
16295072867328 12/11/2021 24203421
16254561590008 12/11/2021 24203421
16322913910407 12/11/2021 24203421
16254561385040 12/11/2021 24203421
16309332221288 12/11/2021 24203421
16309332221288 12/11/2021 24203421
16322913910407 12/11/2021 202108140H
16309332221288 12/11/2021 202108140H
16322913910407 12/11/2021 202108140H
16322913910407 12/11/2021 202108140H
16254561387068 12/11/2021 202108140H
16309339722882 12/11/2021 202108140H
16295072867328 12/11/2021 202108140H
16309339722882 12/11/2021 202108140H
16306351024533
16306351024533
16306351024533
16306351024533
16322841592331 12/11/2021 24203421
16322841592331 12/11/2021 24203421
16309339725384 12/11/2021 24203421

16322841592331 12/11/2021 24203421
16306351024533
16306351024533
16306351024533
16301222796250 12/11/2021 24203421
16306351024533
16306351024533
16306351024533
16306351024533
16306351024533
16306351024533
16301222796250 12/11/2021 24203421
16306351024533
16322841592331 12/11/2021 24203421
16306351024533
16322841592331 12/11/2021 24203421
16322841592331 12/11/2021 24203421
16306351024533
16306351024533
16306351024533
16306351024533
16306351024533
16306351024533
16301222796250 12/11/2021 202108140H
16306351024533
16306351024533
16301222846863 12/11/2021 202108140H

16301222796250 12/11/2021 202108140H
16306351024533
Keterangan
Diberikan/Lanjut)
No. Serial
LANJUT DESA MATEI
LANJUT DESA MATEI
LANJUT SD N TADA


LANJUT DESA MATEI
LANJUT DESA TADA
16306351024533 SELESAI SMA NEGERI 1 SATENG

LANJUT DESA EILODE
LANJUT DESA EILODE

LANJUT SD I EIMAU

93
119
Kabupaten/Kota
Provinsi
Hari, Tanggal
No No. Tiket NIK
1 5320054705940002
P-HVN8WBMA
2 5320056601690001
P-AIMEFDTJ
3 5320055804020001
P-A9O695FI
4 5320051206530001
S-38A59C52
5 5320050707730001
P-1MHEPUZJ
6 5320055308960001
S-24308FE1
7 5320051707620002
P-3KSMS6X3
8 5320052104530001
S-FC01FC72
9 5320024702860001
P-57RD8MT7
10 5320021605640002
P-6Y4YXBWT
11 5320055607670001
P-80WTGM08
12 5320054802500002
S-ECDD7B04
13 5320050111090001
P-9MTIQN00
14 5320055405320001
S-C4FA57FF
15 5320054206970001
P-BHY7UNRW
16 5320054210840002
P-BIHZE4QJ
17 5320055412780001
P-BUBZENBC
18 5320051602740002
P-CLDV5RLZ
19 5371042210860008
P-CYK7DPIP
20 5320056604850002
P-CZQUUNZK
21 5320051106660001
P-DZBGX0RI
22 5320050305670001
P-F9NAXXJP
23 5320051012690001
P-GCKTICMX
24 5320053010000001
P-GK6YVKM4
25 P-H3UEL66F 5320052806880002
26 5320054305700001
P-HUJUG5Z7
27 5320050405560001
S-65A61673
28 P-J4NVRN8B 5320051303720001
29 5320056504980001
P-J3SX50Y9
30 5320035709010001
P-JNHOFIE8
31 532005212880001
: Q-0009CBFG
32 5320056306000001
P-JZI8KKRZ
33 5320051503840001
P-K1WS1VR6
34 5320056510970001
P-KDYU8TPP
35 5320051909920001
P-KO6OPZGC
36 5320014910970001
P-KTDA3BMR
37 5320056703970001
Q-0011P132
38 P-LHWBIKGR 5301254105960002
39 5320031810850001
P-LDP6PKZE
40 5320052508990003
P-LKG3J8AD
41 5320022404910001
P-LKH129XQ
42 5320054404720003
P-LKDSJTCC
43 5320046602900001
S-159E2DED
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
1 95
2 96
3 97
4 98
5 99
6 100
7 101
8 102
9 103
104
10
105
11
106
12
107
13
108
14
109
15
110
16
111
17
112
18
113
19
114
20
115
21
116
22
23
24
25
26
27
28
29
30
31
32
33
34
35
: Sabu Raijua
: 01/12/2021
Pekerjaan*
Jenis
Kelamin
MARIANA DJABBE P MASY UMUM

LUISA RAME WILA P MASY UMUM
PUTRI ARIATI DJARA P MASY UMUM

JULIUS DJU L LANSIA
RUBEN MUHU DJO L MASY UMUM
Dewiyanti Agustina Bire P MASY UMUM

GREGORIUS KAHA L MASY UMUM
WEMFRIT WILA DIDA L LANSIA
ATA MALAI MAKANI P MASY UMUM
HENCI GA L MASY UMUM
TRIANA KALE LAY P MASY UMUM
FERDERIKA DJU NINA WADU ERE P LANSIA
YULIUS ALVINO DJARA RABA L REMAJA
HENDERINA WILA DIDA P LANSIA
YENI DJEBBE P MASY UMUM
NAOMI KADJA DILA P MASY UMUM

MARTHA TALO P MASY UMUM
ABIA BALE HURU L MASY UMUM
OKTOBERNAT LUDJI L MASY UMUM
MARIANI TUKA REHI P MASY UMUM
THOMAS DJAWA L MASY UMUM
MAGELHAENS RIWU DJAMI L MASY UMUM
LAMBERTUS RIWU L MASY UMUM
CALVIN ADHITIA RIWU L MASY UMUM
DOMINGGUS GEWE L MASY UMUM
BENDELINA MANU TARA P MASY UMUM
MARTHINUS HAWU LEKU L LANSIA
PITERSON DALA BALO L MASY UMUM
APRIANA DJUKA P MASY UMUM
DEWI KRISNAWATI RIHI LOWE P MASY UMUM
DENIS WAKE LULU L PELAYAN PUBLIK
MARINCE NORLIANA KOTA P MASY UMUM
HERMAN DJARA MANNO L MASY UMUM
OKTOVIANA MANU PADJA P MASY UMUM
SEPTENIUS MIHA BALO L MASY UMUM
OVYNSRI YATI LEDE TUKA P MASY UMUM
NEDO MIRA P MASY UMUM
YANE ESTER KASE P MASY UMUM
SONI ROHI NGURU L MASY UMUM
NIKODEMUS LENA LEO L MASY UMUM
EFRAIM DIDA L MASY UMUM
KORNELIA TUKA L MASY UMUM
Febriana Ga P MASY UMUM

Umur
tahun)


12/14/1978 43 DESA EIMAU
2/16/1974 47 DESA EIMAU

4/26/1985 36 DESA EIMAU
24 DESEMBER 1988 32 31-45 LOBOADJU
1985-10-18 36 DESA EIADA

ASI COVID-19
NASI

kolom yang sesuai)
BPJS Non
PBI
081338886040 12/1/2021
082299261741 12/1/2021
081338886040 12/1/2021
081237188055 12/1/2021
081338886040
12/1/2021
082147165251
12/1/2021
082299261741
12/1/2021
081236798998 12/1/2021
081238732823 12/1/2021
081338886040 12/1/2021
081338886040 12/1/2021
081238732823 12/1/2021
085339690164 12/1/2021
081237188055 12/1/2021
081358742446 12/1/2021
082147744586 12/1/2021
081337751574 12/1/2021
81237704296 12/1/2021
085238144612 12/1/2021
081337751574 12/1/2021
081338886040 12/1/2021
082147023909 12/1/2021
082147023909 12/1/2021
082252434638 12/1/2021
085215743288 12/1/2021
081237301114 12/1/2021
082147023909 12/1/2021
082147023909 12/1/2021
082147025166 12/1/2021
081237437789 12/1/2021
081 239 555 408 6/29/2021
081237437789 12/1/2021
081237912023 12/1/2021
081338657119 12/1/2021
082145115608 12/1/2021
082145115608 12/1/2021
081239478550 12/1/2021
081239944356 12/1/2021
082144012966 12/1/2021
081339220082 12/1/2021
081239944356 12/1/2021
081339220082 12/1/2021
081238456978 12/1/2021
Dosis I
Tanggal Pemberian
No. Batch
Vaksinasi

CORONAVAC 6/29/2021 24200721

Dosis 2
Tanggal Pemberian
Vaksinasi
16306344277879
16306344277879
16306344277879
16306344277879
16306344277879
16306344277879
16306344277879
16306344277879
16306344277879
16306344277879
16306344277879
16306344277879
16306344277879
16306344277879
16306344277879
16306344277879
16306344277879
16306344277879
16306344277879
16306344277879
16306344277879
16306344277879
16306344277879
16306344277879
16306344277879
16306344277879
16306344277879
16306344277879
16306344277879
16306344277879
16221717765576
16306344277879
16306344277879
16306344277879
16306344277879
16306344277879
16306344277879
16306344277879
16306344277879
16306344277879
16319351805904
16319351805904
16306344277879
Keterangan
Diberikan/Lanjut)
LANJUT DESA LOBOAJU
LANJUT DESA LOBOAJU
LANJUT DESA EIMAU

LANJUT DESA EIMAU
LANJUT DESA EIMAU

LANJUT DESA LOBOAJU
LANJUT DESA EIMAU
LANJUT DESA EIMAU
SELESAI LOBOADJU
LANJUT DESA LOBOAJU
LANJUT DESA EIADA
LANJUT DESA LOBOAJU
LANJUT DESA LOBOAJU
LANJUT DESA LOBOAJU

Kabupaten/Kota
Provinsi
Hari, Tanggal
No No. Tiket NIK
1 5320055405710001
P-KM4BMMSV
2 5320054306010001
P-JB5CF6CF
3 5320034707930001
P-JSN7KVOH
4 5320056307920001
Q-001F677O
5
Q-001K4HPI 5320051507040002
6 5371050705830005
P-GUZ1QYQE
7 5320051705570001
S-A0FDB2D4
8 5320054312810001
P-HXSQJGDR
9 5320055304720001
P-IBVLZNQQ
10 5320054701900002
P-IXOJWK0Y
11 5320055107860002
P-J4Q1U29Z
12 5320050507950004
P-DZNCBJAZ
13 5320056103780002
Q-001KTJ9L
14 5320054304830001
P-GASQ63QL
15 5320054102030002
P-GGIUATPH
16 5320055010700001
P-GOZ6UKRT
17 5320034612940001
P-DEFZT4I5
18 5320034711900001
P-9RLXUT5N
19
Q-0014NGQF 5320056803080002
20 5320056412750001
P-1S9HONCN
21 5320055211730001
: P-7OGZ8MUD
22 5320056110750001
P-8LQPJVDT
23 5320050203950001
Q-001F518P
24 5320056303000002
Q-001F4XUV
25 P-LVNZYNTG 5371056802890003
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
1 95
2 96
3 97
4 98
5 99
6 100
7 101
8 102
9 103
104
10
105
11
106
12
107
13
108
14
109
15
110
16
111
17
112
18
113
19
114
20
115
21
116
22
23
24
25
26
27
28
29
30
31
32
33
34
35
: Sabu Raijua
: 02/12/2021
Pekerjaan*
Jenis
Kelamin
PIGA HUKE L MASY UMUM

BETRIS LULU RIHO P MASY UMUM
NAOMI MIHA LENA P MASY UMUM

NENI ENJELINA LEOHURU P MASY UMUM
JOSHUA SABUIN L REMAJA

DAVID KALE DJAMI L MASY UMUM
LEDE LOBO L LANSIA
IE DJULA L MASY UMUM
DETA KAHO P MASY UMUM
RIBKA RAJA GERE P MASY UMUM
WANYI KALE P MASY UMUM
MARTHINUS KAHO L MASY UMUM
JUBLINA KOLI PUI P MASY UMUM
YORI PUTRIANA DJAMI P MASY UMUM
ARNI KAHO P MASY UMUM
WENYI WARA P MASY UMUM

RINCE MIHA MEDO P MASY UMUM
DAMARIS MIHA MEDO P MASY UMUM

REMAJA
MARETI KAHO P
DESRIYANTI WILA P MASY UMUM
WELHEMINA ULY P MASY UMUM
YULIANA RIWU P MASY UMUM
ANTON ARIANTO RADJA L MASY UMUM
BELA SINTIA RADJA P MASY UMUM
LINA VERONIKA KOLI PUI P MASY UMUM

Umur
tahun)
7/14/2004 19 18-30 JIWUWU


3/28/2008 13 JIWUWU

ASI COVID-19
NASI

kolom yang sesuai)
BPJS Non
PBI
082144877189 12/2/2021
081238095181 12/2/2021
082147083521 12/2/2021
081246026377 18-Oct-21
82340963821 10/28/2021
082144653218
12/2/2021
081338886676
12/2/2021
081338866676 12/2/2021
081246026377 12/2/2021
081238095181 12/2/2021
081238095181 12/2/2021
082144653218 12/2/2021
085238924286 10/30/2021
082145355967 12/2/2021
082261880243 12/2/2021
082144653218 12/2/2021
082144837913 12/2/2021
082144837913 12/2/2021
9/27/2021
081339445801
081338886676 12/2/2021
082261880243 12/2/2021
081239293044 12/2/2021
082210550373 18-Oct-21
082210550373 18-Oct-21
085333009700 12/2/2021
Dosis I
Tanggal Pemberian
No. Batch
Vaksinasi
ASTRA ZENECA 12/2/2021 ABZ9883


CoronaVac 10/30/2021 202108144G

CORONAVAC 9/27/2021 2021081601


Dosis 2
Tanggal Pemberian
Vaksinasi
4267258373482
4267258373482
4267258373482
16322913906033 12/1/2021 202108140H 16319351805904
16322913910407 12/1/2021 202108140H 16319351805904
4267258373482
4267258373482
4267258373482
4267258373482
4267258373482
4267258373482
4267258373482
12/1/2021 202108140H 16319351805904
4267258373482
4267258373482
4267258373482
4267258373482
4267258373482
16301222796250
12/1/2021 202108140H 16319351805904
4267258373482
4267258373482
4267258373482
16322913906033 12/1/2021 202108140H 16319351805904
16322913906033 12/1/2021 202108140H 16319351805904
4267258373482
Keterangan
Diberikan/Lanjut)
LANJUT DESA JIWUWU
LANJUT DESA JIWUWU
LANJUT DESA JIWUWU
SELESAI DESA JIWUWU
SELESAI JIWUWU
LANJUT DESA JIWUWU
LANJUT DESA JIWUWU
LANJUT DESA JIWUWU
LANJUT DESA JIWUWU
LANJUT DESA JIWUWU
LANJUT DESA JIWUWU
LANJUT DESA JIWUWU
SELESAI DESA JIWUWU
LANJUT DESA JIWUWU
LANJUT DESA JIWUWU
LANJUT DESA JIWUWU

LANJUT DESA JIWUWU
LANJUT DESA JIWUWU

SELESAI JIWUWU
LANJUT DESA JIWUWU
LANJUT DESA JIWUWU
LANJUT DESA JIWUWU
SELESAI DESA JIWUWU
SELESAI DESA JIWUWU
LANJUT DESA JIWUWU

Kabupaten/Kota
Provinsi
Hari, Tanggal
No No. Tiket NIK
1 5320012911980003
P-4AHCJX3Y
2 5320055512720001
P-M26LM44S
3 5320020203040002
Q-0015ROI2
4 5320012809020003
P-M22650J3
5
P-9PMUPO4G 5320052107650001
6
Q-0015P3R9 5320050607060002
7
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
1 95
2 96
3 97
4 98
5 99
6 100
7 101
8 102
9 103
104
10
105
11
106
12
107
13
108
14
109
15
110
16
111
17
112
18
113
19
114
20
115
21
116
22
23
24
25
26
27
28
29
30
31
32
33
34
35
: Sabu Raijua
: 03/12/2021
Pekerjaan*
Jenis
Kelamin
MARTHEN DJAMI L MASY UMUM

LUHA DIRE L MASY UMUM
MONE MARVIN LENA LABBA L REMAJA
DAVID DJAMI L MASY UMUM
SEKEOS LEO L MASY UMUM
JOVANDER EDO PITA L REMAJA

Umur
tahun)
1998-11-29 23 DESA DELO
3/2/2004 17 MATEI
2002-09-28 19 DESA DELO
7/21/1965 56 DESA BEBAE
7/6/2006 15 TADA
ASI COVID-19
NASI

kolom yang sesuai)
BPJS Non
PBI
082144424597 12/3/2021
082247540544 12/3/2021
081338727354 9/29/2021
082145653324 12/3/2021
082147624666
12/3/2021
082342724424 9/29/2021
Dosis I
Tanggal Pemberian
No. Batch
Vaksinasi


Dosis 2
Tanggal Pemberian
Vaksinasi
16319351805904
16319351805904
16309339722882
16319351805904
16319351805904
16309339722882
Keterangan
Diberikan/Lanjut)
LANJUT DESA DELO
LANJUT DESA JIWUWU
LANJUT DESA DELO
LANJUT DESA BEBAE

Kabupaten/Kota
Provinsi
Hari, Tanggal
No No. Tiket NIK
1 5320055706920001
: Q-001NQWGP
2 5320054802930001
Q-001NQI18
3 5320051403640001
: Q-001NOII0
4
5371032511770006
5
Z-000E26JQ 5320055507420002
6
Q-001NN5N9 5320055607980003
7 5320053103010001
: Q-001NOGM0
8
Q-001NN5AI 5320055204790001
9
Q-001NN0Z9 5320051307830001
10 532005511960001
Q-001NQGN9
11 5320055209690001
Q-001NSHKP
12 5320050407320001
: Z-000E22TT
13 5320055902780001
Q-001NOIFZ
14 5320055210500001
Z-000E2LNM
15 5320012711820001
Q-001NOH0A
16 5320050502950001
Q-001NOMCN
17
: Q-001NN0V5 5320050301720001
18
Z-000E250H 5320057004580001
19 5320054503830001
: Q-001NTQUU
20 5320054503780001
: Q-001NNDSC
21 5320055804860002
: Q-001NTQLL
22 5320052409020001
Q-001NO5I8
23
Z-000E21S1 5320052911530001
24 532001101900001
Q-001NOIGF
25 4320015202990001
Q-001NOL0F
26 5320052412950001
: Q-001NNDC4
27
Z-000E26JS 5320054307350001
28 5320055507780002
29 5320055602520001
30 5320055502460001
31 5320055502960001
32 5320057007650001
33 5320050910630002
34 5320056410500001
35
5320054106600001
36 5320056112790001
37 5320054707540001
38 537101170890003
39 5320051905720001
40 5320054107820002
41 5320052306690002
42 5320056703580001
43 5320050202620001
44
5320050805040001
45 5320054210630001
46
5320055505590001
47
5320025511040001
48 5320050210830001
49
5320051102040001
50 5320050107360007
51
5320051406840001
52
5320050110540001
53
5320054204840001
54 53205030450001
55 5320054501980001
56
5320054701440001
57 5320052010030004
58 5320056912530001
59
5320051108950001
60 5320055506470001
61
5320052502030003
62
5320036505960001
63 5320054404740001
64
5320052510640001
65
5320051907070001
66
5320052811920003
67 5320022905200002
68 5320051607980001
69
5320054205800004
70 537104180500002
71 5320050706720001
72 5320021111000002
73 5320022808740001
74 5320052003700001
75 5320050810790001
76 5320055808790001
77 5320050107700007
78 5320054701660001
79 5320051204900002
80 5320050508840001
81 5320051505700001
82 5320051211880001
83 5320054504940001
84 5320054507660001
85
5320050812740001
86 5320024112950001
87 53200564110020001
88 5320052506050001
89 5320055111630001
90 5320051704080001
91 5320054411640001
92 5320050605720002
93 5320055411670001
94
5320054102470001
1 95 5320054608020001
2 96 5320055603000001
3 97 5320054903480001
4 98 53200556100001
5 99 5320055006840001
6 100 5320034201950001
7 101 5320055207900003
8 102 5320052111990001
103 5320050509650002
9 104
5320052202960004
105
10 5320057008900001
106
11 5320051506880001
107
12 5320031508930001
108
13 5320056611030001
109
14
5320054205590001
110
15 5320054103420001
111
16 5320053006930005
112
17 5320021509050001
113
18
5320052711990001
114
19 5320055002700001
115
20
5320056105960002
116
21 5320055101800001
117
22 5320053010040003
DATA MASLH
118
23 5320055804870003
119
24 5320051305910001
120
25
5320050107540001
121
26 5320050512540001
122
27 5320054604720002
123
28 5320055009580001
124
29 5320054503610001
125
30 5320051306970001
126
31 5320055206880001
127
32
5320055108720001
128
33 5320057011980001
129
34 5320056912780001
35 130 5320055911870001
131 5320050104880001
132 5320054611700001
133 5320052910890001
134 5320055401840001
135 5320050408920001
136 5320054605930001
137 5320055301880001
138 5320055911580001
139 5320054103590001
140 5320051710590001
141 5320054610740001
142 5320054806740001
143 5320022007940001
144 5320052610730001
145 5320052512650001
146
5320032909710001
147
5320051702060002
148
5320050701030001
149
5320054203790002
150 5320051806000001
151 5320057005780001
152
5320050210700001
153 5320052606950001
154 5320055504990001
155 5320051311030001
156 5320055501790001
157 5320054812020002
158 5320056408030001
159 5320054903830001
160
5320050912010001
161 5320052003000001
162 5320050507840001
163 5320050108730001
164 5320055810980001
165 5320052606940002
166 5320051412870001
167 5320054104020001
168 5320050708740001
169 5320054611810001
170 5320055503830001
171
5320054405970001
172 5320056010970001
173 5320022512820002
174 5320024107040008
175
5320052802790001
176 5301105803950002
177 5320050709660002
178 5320053012060001
179
5320056812620001
180 5320052103870001
181
5320050607590001
182 5320055606860001
183 5320053009060002
184 5320057110760001
185 5320050301510001
186 5320051204850001
187 5320055304770002
188 5320051506030001
189 5320055610690001
190 5302176905950001
191 5320056209850000
192 5320051307010001
193 5320054702740001
194 5320054407030001
195 5320054606880003
196 5320050503900001
197 5320052301970001
198
5320054301720001
199 5320050203650001
200
5320051202840001
201
202
203
204
205
206
207
208
209
210
211
212
213
214
215
216
217
218
219
220
: Sabu Raijua
: 04/12/2021
Pekerjaan*
Jenis
Kelamin
ANA KORO P MASY UMUM
LUISA KALE UKE P MASY UMUM

RUBEN A DO LALU L MASY UMUM
MASY UMUM
NICSON ROBINSON BULE LOGO L
P LANSIA
AGUSTINA DJAMI ADI PUNGA
P MASY UMUM
TADE MANGNGI ULY
OSYAN ARIES YONATAN L MASY UMUM
DULE BANGNGU BIRE L MASY UMUM

MASY UMUM
MARKUS LENA DJILA L
OSIN MARSELINDA SILVIANA DJ P MASY UMUM
RAHEL DJU NINA P MASY UMUM
NIKOLAS LENA NGURU L LANSIA
YETI KANA MANGNGI P MASY UMUM
BENDELINA LOMI P LANSIA

L MASY UMUM
RUBEN TAGA
ARI WADU L MASY UMUM
KAREL UDJU LOMI L MASY UMUM
P MASY UMUM
MARTHA BANGNGU
MARIANCE DJU NINA P MASY UMUM
MERLIN RADJA P MASY UMUM
LORIANA DJU NINA P MASY UMUM
SEPTE ADRIANUS LAY DJAMI L MASY UMUM
NIKOLAS WEO MATA L LANSIA

TRISDAWATI NIKO DANGA P MASY UMUM
HERLIIANCE EDO P MASY UMUM
IMANUEL LEO BIRE L MASY UMUM
TERSIANA BIRE MANNO P LANSIA

HENDERINA UDJU LOMI P MASY UMUM
PETRONELA DJU P LANSIA
LEA DJAMI MARA P LANSIA
INA RADJA DEDA P MASY UMUM
EKRIANA UDJU LOMI P MASY UMUM
BALTASAR RADJA DEDA L MASY UMUM
AGUSTINA GA MARA P LANSIA
MARINCE W LULU P LANSIA

TERSIANA MARA P MASY UMUM
KORNELIA KANA MANGNGI P LANSIA
RICHARD RADJA RIGE L MASY UMUM
ROBINSON R LONI L MASY UMUM
MADA KANA MANGNGI P MASY UMUM
ISAK KALE ULY L MASY UMUM
MARTA UDJU LOMI P LANSIA
DOMINGGUS HAWU HABA L MASY UMUM

REMAJA
SOLEMAN DJAPA HEO L
OCTOVIANA UDJU DEDA P PELAYAN PUBLIK
MASY UMUM
TERSELINA KALE TE P
JESSICA ROSALINE P REMAJA

MEFIBOFET KOLO BIRE L MASY UMUM
VITO LAVIARY L REMAJA

MELKIANUS BULE LOGO L LANSIA
MASY UMUM
JEFRI LOBO L
HERMAN NAGA L LANSIA
NOFRIYANTI UJU LIE P MASY UMUM

MARKUS GA ARA L LANSIA
INA DIANA RABA P MASY UMUM

LANSIA
MARTA PADA P
OKY KALE ULY L MASY UMUM
JUBLINA KALE HIA P LANSIA

MASY UMUM
MAKSI LODO L
REGINA LENA NGURU P LANSIA
MASY UMUM
FALDI ADI BANGNGU KORO L
SHINTA ARIANTI WEGA P MASY UMUM

NINSI RIWU NAPI P MASY UMUM
PITER YEFERSON KANA MANGNGI L MASY UMUM
DONI DEVI SAPUTRA RIWU L REMAJA
NOVRIANUS BAE KANA L MASY UMUM
LEWI GA ARA L MASY UMUM
FERDIANTO KALE ULY L MASY UMUM

MASY UMUM
TERINCE WEO P
GLEN ADIPUTRA BULE LOGO L REMAJA
BERNADUS HAWU HABA L MASY UMUM
PITNOR GA RATA L MASY UMUM
NIKOLAS NESSI L MASY UMUM
MAX MIHA LENA L MASY UMUM
OKTOVIANUS DJULA L MASY UMUM
RAHEL JAWU P MASY UMUM
HENOK HERE HIA L MASY UMUM
BELANDINA HUKI P MASY UMUM
DANIEL NAWA WANY L MASY UMUM
PE LEDE L LANSIA
DADDU PARA L MASY UMUM
DIDA LEDE L MASY UMUM
ADRIYANTI LAGA TITA L MASY UMUM
DORKAS MIHA BANE P MASY UMUM
WELEM KAHO L MASY UMUM
DORCE RATU P PELAYAN PUBLIK

ANITA AMELIA KAHO P MASY UMUM
FRENGKI BANGNGU ROI L REMAJA
MARTHA DIRA P MASY UMUM
RANGGA A DJAMI ADI L MASY UMUM
SOPIA KAHO P MASY UMUM
TITUS MAGE TIE L MASY UMUM
HENDERINA RADJA P MASY UMUM
LANSIA
LEUNORA BANA PA P
ANANDA CIKITA DJARA P MASY UMUM
YUNITA LODO KANA P MASY UMUM
LUISA LADO KAHO P LANSIA
HELENA MARIAM MANNO DIDA P MASY UMUM
MARGERITA LAWA P MASY UMUM
FEBRIANTI WATTI P MASY UMUM
YUBLINA DJARA P MASY UMUM
AHAD MAGE L MASY UMUM
MANGNGI HAWU HABA L MASY UMUM
HENDRIK DJARA MANNO L MASY UMUM

MARIAM DJARI P MASY UMUM
YULIUS LABBA GADJA L MASY UMUM
DAUD LOBO L MASY UMUM

NOFRIANTO DJARA MANNO P REMAJA
ANTONETA HUKI P LANSIA

DELFINA LEO ERE P LANSIA
YUNUS LUDJI LOBO L MASY UMUM
STEVEN IMANUEL RIWU L REMAJA
MASY UMUM
MARDEN B BIRE L
TEROCI LEO BIRE P MASY UMUM
MASY UMUM
AMELIA RIWU ROHI P
NOFASIANA MIHA BALO P MASY UMUM
ANDI ARISON BALE MIHA L REMAJA
TERSIANA LEBA UDJU P MASY UMUM
GABRIEL KORE LIHU L MASY UMUM
LANSIA
WELEM DIDA L
KORNELIUS DJAMI L LANSIA
MARIANA GA ARA P MASY UMUM
TERSIANA LENA BANGNGU P LANSIA
BENDELINA MAGE TIE P MASY UMUM
JEFRI RONALDO KOTA L MASY UMUM
MARGERITA KALE TE P MASY UMUM
MASY UMUM
AGUSTINA KAHO P
P PELAYAN PUBLIK
DEBE M. DJAPA HEO
DEBORA HUBI P MASY UMUM
RAJI BANGNGU L MASY UMUM
DOMINGGUS ARA DIMU L MASY UMUM

PAULINA ULY P MASY UMUM
OKTOVIANUS LOBO HABA L MASY UMUM
DEBORAOBO RABA P MASY UMUM
DAUD LOBO HABA L MASY UMUM
MERSI RADJA P MASY UMUM
YULIANA MANU P MASY UMUM
NURIANCE DURI P LANSIA
BERTHA ROHI MIHA P LANSIA
TRIANUS DJAWA L LANSIA
DINA MANU TARA P MASY UMUM
MATE RADJA L MASY UMUM
ROLITARIO UDJU DEDA L MASY UMUM
YAKOBUS KANA MANGNGI L MASY UMUM
LUISHERMAN KANA MANGNGI L MASY UMUM
RUBEN RIWU ROHI L MASY UMUM

REMAJA
FRENGKY RIWU ROHI L
MASY UMUM
LORENTIUS BALE LAY L
P MASY UMUM
TI DIMA
EFRAIM KANA MANGNGI L MASY UMUM
MARIA MUHU DJO P MASY UMUM
AYUB DJARA L MASY UMUM

YURET KANA MANGNGI L MASY UMUM
MARIANA DULI NAPI P MASY UMUM
RUDI FRANCESCO TOTI DJULA L REMAJA
TERSIANA GA KELO P MASY UMUM
LASTI NOVITA KALE LENA P MASY UMUM
SARI TARRU P MASY UMUM
PETRONELA MATA RIGE P MASY UMUM
GUSTI DEVRETES OBO RABA L MASY UMUM

KELVIN BALE HURU L MASY UMUM
RISKI KAHO LUDJI L MASY UMUM
AYUB DJULA L MASY UMUM
LODYA OCTOVINA OBO RABA P MASY UMUM
IVAN ARDYANTO KAHA L MASY UMUM
DAVID MANNO DIDA L MASY UMUM
INTAN KANA MANGNGI P MASY UMUM
KAREL KALE LAI L MASY UMUM
DINE MATA P MASY UMUM
MERLIN RIWU LONI P MASY UMUM

MASY UMUM
MEYLANI DJU P
SEMILIA KAHO L MASY UMUM
YONATAN DURI L MASY UMUM
ERNESTA BALE WADU P REMAJA
MIRA MELKIANUS RIHI L MASY UMUM
MARINCE DOKO P MASY UMUM
STEPANUS RABA L MASY UMUM
DICKY DANIEL RABA L REMAJA

MASY UMUM
YUMIMA DURI P
SOLEMAN DJARA RABA L MASY UMUM
KORNELIUS MANNO DIDA L LANSIA

AGUSTINA BALE DABBO P MASY UMUM
NIKODEMUS MIHA BALO L MASY UMUM
BENDELINA KAHA P MASY UMUM
THOMAS ELFA E WAKE LULU L LANSIA
SAM ANTONIUS HABA BANGNGU L MASY UMUM
ROSALINDA DJARA MANNO P MASY UMUM
ADE ARJUNA MAKABORANG L MASY UMUM
ELISABET MANGNGI LONI P MASY UMUM

MIRA YATI BENU P MASY UMUM
SARLIN MARGARITHA BIRE P MASY UMUM
KRISTIAN RADJA DEDA L MASY UMUM
DARA KATO P MASY UMUM
ERNI JUITA LOBO HABA P MASY UMUM
YENI BALE BABBO P MASY UMUM
DAKKA RIHI L MASY UMUM
JON ARNOLDUS LAY DJAMI L MASY UMUM
RINCE WADU LAI P MASY UMUM

LODEWIK DURI L MASY UMUM
DEDDY RIWU LONI L PELAYAN PUBLIK

Umur
tahun)
5/3/1993 30 18-30 DESA JIWUWU
2/18/1993 30 18-30 DESA MATEI

3/14/1964 59 46-59 DESA MATEI
11/25/1977 45 31-45 DESA EIMADAKE
7/15/1942 81 60-150 DESA EIMADAKE
7/16/1998 25 18-30 DESA MATEI
3/31/2001 22 18-30 DESA CMATEI
4/12/1979 44 31-45 DESA MATEI
7/13/1983 40 31-45 DESA MATEI

7/27/1995 27 18-30 DESA LOBOADJU
9/12/1969 53 46-59 DESA LOBOADJU
7/4/1932 91 60-150 DESA TADA
2/19/1978 45 31-45 DESA MATEI
10/12/1950 72 60-150 DESA JIWUWU
40 31-45 DESA EIMAU

11/27/1982
2/5/1995 28 18-30 DESA JIWUWU
46-59 DESA MATEI
1/3/1972 51
65 60-150 DESA EIMADAKE
4/30/1958
3/5/1983 40 31-45 DESA LOBOADJU
3/5/1978 45 31-45 DESA TADA
4/18/1986 37 31-45 DESA LOBOADJU
9/24/2002 20 18-30 DESA EIMAU
11/29/1953 69 60-150 DESA MATEI

1/31/1990 33 31-45 DESA EIMAU
2/12/1999 24 18-30 DESA MENIA
12/24/1995 27 18-30 DESA EIMADAKE
7/3/1935 88 60-150 DESA TADA

7/15/1978 45 31-45 DESA EIMADAKE
2/16/1952 71 60-150 DESA EIMADAKE
2/15/1946 77 60-150 DESA LOBOADJU
2/15/1996 27 18-30 DESA EIMADAKE
7/30/1965 57 46-59 DESA EIMADAKE
10/9/1963 59 46-59 DESA EIMADAKE
10/25/1950 72 60-150 DESA EIMADAKE
6/1/1960 63 60-150 DESA EIMADAKE

12/21/1979 43 31-45 DESA MATEI
7/7/1954 69 60-150 DESA EIMADAKE
8/17/1990 32 31-45 DESA EILODE
46-59 DESA EIMADAKE

5/19/1972 51
7/1/1982 41 31-45 DESA EIMADAKE
6/23/1969 54 46-59 DESA EIMADAKE
3/27/1958 65 60-150 DESA LOBOADJU
2/2/1962 61 60-150 DESA EIMADAKE
5/8/2004 19 18-30 DESA JIWUWU

10/2/1963 59 46-59 DESA EIMADAKE
5/15/1969 54 46-59 DESA JIWUWU
12/15/2004 18 18-30 DESA JIWUWU

2/10/1983 40 31-45 DESA LOBOADJU
2/11/2004 19 18-30 DESA JIWUWU

3/3/1945 78 60-150 DESA EIMADAKE
6/14/1984 39 31-45 DESA JIWUWU
4/10/1955 68 60-150 DESA EIMADAKE
4/2/1984 39 31-45 DESA JIWUWU

3/3/1945 78 60-150 DESA EIMADAKE
1/5/2000 23 18-30 DESA EIMADAKE
1/7/1944 79 60-150 DESA LOBOADJU

10/20/2003 19 18-30 DESA EIMADAKE
12/29/1953 69 60-150 DESA MATEI
8/11/1995 27 18-30 DESA MATEI

6/15/1947 76 60-150 DESA TADA
2/25/2003 20 18-30 DESA EILODE
5/25/1996 27 18-30 DESA MATEI

4/4/1974 49 46-59 DESA LOBOADJU
10/25/1964 58 46-59 DESA MATEI
7/19/2007 16 12-17 DESA EIMADAKE
11/28/1992 30 18-30 DESA MATEI
5/15/1982 41 31-45 DESA EIMADAKE
7/16/1998 25 18-30 DESA EIMADAKE
5/2/1980 43 31-45 DESA EIMADAKE

5/18/2008 15 12-17 DESA EIMADAKE
6/7/1972 51 46-59 DESA EIMADAKE
11/11/2000 22 18-30 DESA TADA
8/28/1974 48 46-59 DESA LOBOADJU
3/20/1970 53 46-59 DESA EILODE
10/8/1979 43 31-45 DESA EIMADAKE
8/18/1979 43 31-45 DESA MATEI
6/8/1974 49 46-59 DESA MATEI
1/7/1966 57 46-59 DESA EIMADAKE
4/3/1993 30 18-30 DESA EIMADAKE
8/5/1984 38 31-45 DESA JIWUWU
6/15/1970 53 46-59 DESA JIWUWU
11/12/1988 34 31-45 DESA JIWUWU
4/5/1994 29 18-30 DESA EIMAU
7/5/1966 57 46-59 DESA EIMAU
12/8/1974 48 46-59 DESA JIWUWU
01 DESEMBER 1995 25 EILODE

11/24/2002 20 18-30 DESA JIWUWU
8/25/2005 17 12-17 DESA EIMADAKE
11/11/1963 59 46-59 DESA LOBOADJU
4/17/2008 15 12-17 DESA EIMADAKE
11/4/1964 58 46-59 DESA JIWUWU
7/6/1972 51 46-59 DESA EILODE
11/14/1987 35 31-45 DESA JIWUWU
2/1/1947 76 60-150 DESA EILODE

06/08/2002 21 18-30 DESA EILODE
6/16/2001 22 18-30 DESA MATEI
3/9/1949 74 60-150 DESA EILODE
10/16/1990 32 31-45 DESA EIMADAKE
6/27/1984 39 31-45 DESA EILODE
1/1/1995 28 18-30 DESA LOBOADJU
11/5/1990 32 31-45 DEESA EILODE
11/21/1999 23 18-30 DESA EILODE
9/5/1965 57 46-59 DESA EIMADAKE
2/22/1996 27 18-30 DESA EIMADAKE

8/30/1990 32 31-45 DESA MATEI
6/15/1988 35 31-45 DESA MATEI
8/15/1993 29 18-30 DESA KELIHA

11/26/2003 19 18-30 DESA EIMADAKE
64 60-150
5/2/1959 DESA EIMADAKE
3/1/1942 81 60-150 DESA EIMADAKE
6/30/1993 30 18-30 DESA JIWUWU
9/15/2005 17 12-17 DESA EIMADAKE
23 18-30
2/10/1970 53 46-59 DESA EIMADAKE
27 18-30
1/1/1980 43 31-45 DESA LOBOADJU
10/30/2004 18 18-30 DESA JIWUWU
4/18/1987 36 31-45 DESA EIMADAKE
4/5/1997 26 18-30 DESA JIWUWU
69 60-150
12/5/1954 68 60-150 DESA EIMADAKE
6/4/1972 51 46-59 DESA EIMADAKE
9/10/1958 64 60-150 DESA LOBOADJU
10/10/1973 49 46-59 DESA EIMADAKE
6/13/1997 26 18-30 DESA EIMADAKE
6/8/1986 37 31-45 DESA JIWUWU
50 46-59
22 JIWUWU
11/30/1998
12/29/1978 44 31-45 DESA EIMADAKE
11/19/1987 35 31-45 DESA JIWUWU
4/1/1988 35 31-45 DESA JIWUWU

11/6/1970 52 46-59 DESA JIWUWU
10/29/1989 33 31-45 DESA JIWUWU
1/14/1984 39 31-45 DESA EIMADAKE
5/6/1993 30 18-30 DESA JIWUWU
13-Jan-88 35 31-45 DESA JIWUWU
11/19/1958 64 60-150 DESA EIMADAKE
3/1/1959 64 60-150 DESA JIWUWU
10/17/1959 63 60-150 DESA EIMADAKE
6-Oct-79 43 31-45 DESA EIMADAKE
7/8/1974 49 46-59 DESA JIWUWU
7/20/1994 28 18-30 DESA EIMADAKE
10/26/1973 49 46-59 DESA MATEI
12/25/1965 57 46-59 DESA MATEI
9/29/1971 51 46-59 DESA MATEI
2/17/2006 17 12-17 DESA EIMADAKE
1/7/2003 20 18-30 DESA TADA

TADA
3/2/1979
6/18/2000 23 18-30 DESA MATEI
5/30/1978 45 31-45 DESA EIMADAKE
10/2/1970 52 46-59 DESA EIMADAKE

6/26/1995 28 18-30 DESA MATEI
7/15/1999 24 18-30 DESA JIWUWU
11/13/2003 19 18-30 DESA EIMADAKE
1/15/1979 44 31-45 DESA JIWUWU
12/8/2002 20 18-30 DESA EILODE
8/24/2003 19 18-30 DESA EILODE
3/9/1983 40 31-45 DESA JIWUWU
12/9/2001 21 18-30 DESA EIMADAKE

3/20/2000 23 18-30 DESA JIWUWU
7/5/1984 39 31-45 DESA JIWUWU
8/1/1973 49 46-59 DESA EIMADAKE
10/18/1998 24 18-30 DESA EIMADAKE
6/26/1996 27 18-30 DESA EIMADAKE
12/14/1987 35 31-45 DESA EIMADAKE
4/1/2002 21 18-30 DESA JIWUWU
8/7/1974 48 46-59 DESA EIMADAKE
11/6/1981 41 31-45 DESA JIWUWU
3/15/1983 40 31-45 DESA EIMADAKE
5/4/1997 26 18-30 DESA EIMADAKE

10/20/1997 25 18-30 DESA JIWUWU
12/25/1982 40 31-45 DESA EIMADAKE
7/1/2004 19 18-30 DESA JIWUWU
7/28/1979 43 31-45 DESA EIMADAKE
3/18/1995 28 18-30 DESA EIMADAKE
9/7/1966 56 46-59 DESA EIMADAKE
12/30/2006 16 12-17 DESA EIMADAKE
12/28/1962 60 60-150 DESA EIMADAKE

3/21/1987 36 31-45 DESA EIMADAKE
7/6/1959 64 60-150 DESA EIMADAKE

7/5/1986 37 31-45 DESA EIMADAKE
6/13/2006 17 12-17 DESA EIMADAKE
10/31/1976 46 46-59 DESA EIMADAKE
1/3/1951 72 60-150 DESA LOBOADJU
4/12/1985 38 31-45 DESA EIMADAKE
4/13/1977 46 46-59 DESA EIMADAKE
6/15/2003 20 18-30 DESA BEBAE
10/16/1969 53 46-59 DESA EIMADAKE

5/29/1995 28 18-30 DESA EIMADAKE
9/22/1985 37 31-45 DESA EIMADAKE
8/13/2001 21 18-30 DESA LOBOADJU
2/7/1974 49 46-59 DESA JIWUWU
4-Jul-03 18 31-45 DESA JIWUWU
6/6/1988 35 31-45 DESA EIMADAKE
3/5/1990 33 31-45 DESA JIWUWU
11/23/1997 25 18-30 DESA EIMADAKE
1/3/1972 51 46-59 DESA EIMADAKE

3/2/1965 58 46-59 DESA EIMADAKE
12/12/1984 37 31-45 DESA EIMADAKE

ASI COVID-19
NASI

kolom yang sesuai)
BPJS Non
PBI
81237920086 11/6/2021
82237893354 11/6/2021
85339080316 11/6/2021
85253090963 11/6/2021
11/6/2021
81339220511
11/6/2021
81239654995
82339252365 11/6/2021
81239654995 11/6/2021
11/6/2021
82211472456
85238179195 11/6/2021
82340374604 11/6/2021
82138975149 11/6/2021
11/6/2021
85238336771
82144859686 11/6/2021
11/6/2021
85324019922
81339886569 11/6/2021
11/6/2021
81239146038
11/6/2021
81337441447
81237301135 11/6/2021
81337722775 11/6/2021
85237886157 11/6/2021
81238251370 11/6/2021
81246388357 11/6/2021
81239422192 11/6/2021
81343158352 11/6/2021
81237878528 11/6/2021
81239600620 11/6/2021
85339187422 11/6/2021
82147023909 11/6/2021
85333094204 11/6/2021
82340375275 11/6/2021
82340375275 11/6/2021
82340375275 11/6/2021
81246869396 11/6/2021
11/6/2021
85333094204 11/6/2021
81337441447 11/6/2021
81353026059 11/6/2021
11/6/2021
81339096899
81246869396 11/6/2021
85339187422 11/6/2021
85333228945 11/6/2021
85234574573 11/6/2021
11/6/2021
82339332365
82144299501 11/6/2021
11/6/2021
82247687416
11/6/2021
81239149077
81237685693 11/6/2021
82359403419 11/6/2021
11/6/2021
11/6/2021
81338228245
81246869396 11/6/2021
81338228245 11/6/2021
81237877105 11/6/2021
82144650008 11/6/2021
11/6/2021
82145171757
85339187422 11/6/2021
85339326514 11/6/2021
11/6/2021
81236206930
11/6/2021
85237016951
11/6/2021
85237888050
81339556571 11/6/2021
81246996865 11/6/2021
11/6/2021
82144674085
85234574753 11/6/2021
81339556571 11/6/2021
81237877105 11/6/2021
85234574573 11/6/2021
82273129057 11/6/2021
11/6/2021
85339690164 11/6/2021
82339780583 11/6/2021
81246869396 11/6/2021
85338193078 11/6/2021
81236940083 11/6/2021
81238251302 11/6/2021
82145725873 11/6/2021
81246869396 11/6/2021
81339448794 11/6/2021
82235800032 11/6/2021
82147361025 11/6/2021
82235800032 11/6/2021
81238582530 11/6/2021
81238582530 11/6/2021
11/6/2021
81239615364
081 337 079 141 01 JULI 2021

82145355967 11/6/2021
85337244206 11/6/2021
81246996865 11/6/2021
81353484573 11/6/2021
85216871635 11/6/2021
81237615591 11/6/2021
82195463275 11/6/2021
11/6/2021
81234654788
81239654788 11/6/2021
81236474231 11/6/2021
81337432478 11/6/2021
81337432478 11/6/2021
85338193078 11/6/2021
82339469943 11/6/2021
81239654788 11/6/2021
81237615591 11/6/2021
82147023909 11/6/2021
11/6/2021
85333228944
11/6/2021
81338885184
11/6/2021
82359274258
11/6/2021
82359403519
11/6/2021
82236335114
11/6/2021
81246266268
11/6/2021
81339494552
11/6/2021
82146497386
11/6/2021
81237877105
81236836060 11/6/2021
11/6/2021
11/6/2021
11/6/2021
81353783098
11/6/2021
82235800032
11/6/2021
81338227310
11/6/2021
81338077687
11/6/2021
81246266268
11/6/2021
81236296450
11/6/2021
85239792297
11/6/2021
82339469943
11/6/2021
81236296450
11/6/2021
82339252370
11/6/2021
82235800032
11/6/2021
82339252370
082145361472 0000870934105 1 JULI 2021
11/6/2021
81237615591
82147553296 11/6/2021
81246590418 11/6/2021
82195463275 11/6/2021
82195463275 11/6/2021
85253775646 11/6/2021
082145361472 18-Oct-21
82144023169 11/6/2021
81246197790 11/6/2021
82339252370 11/6/2021
82235800032 11/6/2021
82339252370 11/6/2021
81337221281 11/6/2021
81246590418 11/6/2021
81343862208 11/6/2021
81338100763 11/6/2021
81338100763 11/6/2021
11/6/2021
81339424761
11/6/2021
11/6/2021
81339450924
082145747647 11/4/2021
85333539751 11/6/2021
85233661170 11/6/2021
11/6/2021
85233661170
85333539751 11/6/2021
82339433278 11/6/2021
81236940083 11/6/2021
82147361025 11/6/2021
82297214685 11/6/2021
85338855997 11/6/2021
85216871639 11/6/2021
085333009743 9/7/2021
81239232570 11/6/2021
82195463275 11/6/2021
82147023909 11/6/2021
85739009905 11/6/2021
82239946454 11/6/2021
81338496085 11/6/2021
81338077687 11/6/2021
81338954642 11/6/2021
82189446307 11/6/2021
82147023909 11/6/2021
82144572897 11/6/2021
82144653218 11/6/2021
81338496095 11/6/2021
82236335042 11/6/2021
11/6/2021
81246266268
81337705089 11/6/2021
11/6/2021
82144572897
81337733056 11/6/2021
11/6/2021
81246266268
85339690164 11/6/2021
81246266268 11/6/2021
11/6/2021
81338496085
82340374821 11/6/2021
81339098890 11/6/2021
85238727609 11/6/2021
81338897290 11/6/2021
81377221281 11/6/2021
85337347184 11/6/2021
81377221281 11/6/2021
82190117763 11/6/2021
82146958530 11/6/2021
82339138753 11/6/2021
82235800032 11/6/2021
081337418350 9/21/2021
81239946617 11/6/2021
82147083521 11/6/2021
82190117763 11/6/2021
81246266268 11/6/2021
82146958530 11/6/2021
082145922627 11/6/2021
Dosis I
Tanggal Pemberian
No. Batch
Vaksinasi

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202108122H
11/6/2021
202108122H
11/6/2021
202108122H
11/6/2021
202108122H

11/6/2021
202108122H
202108122H
202108122H
202108122H
202108122H
202108122H

202108122H
202108122H
202108122H
202108122H
202108122H
202108122H
202108122H
202108122H
202108122H
202108122H
202108122H
202108122H
202108122H
2021081671
202108122H
202108122H
202108122H
202108122H
202108122H
202108122H
202108122H
202108122H
202108122H
202108122H
202108122H
202108122H
202108122H
202108122H
202108122H
202108122H
202108122H
202108122H
202108122H
202108122H
202108122H
202108122H
202108122H
202108122H
202108122H
202108122H
202108122H
202108122H
202108122H
202108122H
202108122H
202108122H
202108122H
202108122H
202108122H
202108122H
202108122H
202108122H
202108122H
202108122H
202108122H
202108122H
202108122H

202108122H
202108122H
202108122H
202108122H
202108122H
202108144H
Dosis 2
Tanggal Pemberian
Vaksinasi
16298097478724 12/4/2021 24203421 16306344277879

16298097478724 12/4/2021 24203421 16306344277879
16298088677347 12/4/2021 24203421 16306344277879
16298088677347 12/4/2021 24203421 16306344277879
16298088677347 12/4/2021 24203421 16306344277879
16298088677347 12/4/2021 24203421 16306344277879
16298088677347 12/4/2021 24203421 16306344277879
16298088677347 12/4/2021 24203421 16306344277879
16298088677347 12/4/2021 24203421 16306344277879
16298097478724 12/4/2021 24203421 16306344277879
16298097478724 12/4/2021 24203421 16306344277879
16298088677347 12/4/2021 24203421 16306344277879
16298088677347 12/4/2021 24203421 16306344277879
16298092626190 12/4/2021 24203421 16306344277879
16298088677347 12/4/2021 24203421 16306344277879
16298088677347 12/4/2021 24203421 16306344277879
16298088677347 12/4/2021 24203421 16306344277879
16298088677347 12/4/2021 24203421 16306344277879
16298092626190 12/4/2021 24203421 16306344277879
16298088677347 12/4/2021 24203421 16306344277879
16298092626190 12/4/2021 24203421 16306344277879
16298088677347 12/4/2021 24203421 16306344277879
16298088677347 12/4/2021 24203421 16306344277879
16298088677347 12/4/2021 24203421 16306344277879
16298088677347 12/4/2021 24203421 16306344277879
16298088677347 12/4/2021 24203421 16306344277879
16298088677347 12/4/2021 24203421 16306344277879
16298097478724 12/4/2021 24203421 16306344277879
16298092626190 12/4/2021 24203421 16306344277879
16298097478724 12/4/2021 24203421 16306344277879
16298097478724 12/4/2021 24203421 16306344277879
16298097478724 12/4/2021 24203421 16306344277879
16298097478724 12/4/2021 24203421 16306344277879
16298088677347 12/4/2021 24203421 16306344277879
16298088677347 12/4/2021 24203421 16306344277879
16298097478724 12/4/2021 24203421 16306344277879
16298088677347 12/4/2021 24203421 16306344277879
16298097478724 12/4/2021 24203421 16306344277879
16298088677347 12/4/2021 24203421 16306344277879
16298088677347 12/4/2021 24203421 16306344277879
16298097478724 12/4/2021 24203421 16306344277879
16298092626190 12/4/2021 24203421 16306344277879
16298097478724 12/4/2021 24203421 16306344277879
16298088677347 12/4/2021 24203421 16306344277879
16298088677347 12/4/2021 24203421 16306344277879
16298088677347 12/4/2021 24203421 16306344277879
16298088677347 12/4/2021 24203421 16306344277879
16298097478724 12/4/2021 24203421 16306344277879
16298088677347 12/4/2021 24203421 16306344277879
16298088677347 12/4/2021 24203421 16306344277879
16298097478724 12/4/2021 24203421 16306344277879
16298088677347 12/4/2021 24203421 16306344277879
16298097478724 12/4/2021 24203421 16306344277879
16298088677347 12/4/2021 24203421 16306344277879
16298088677347 12/4/2021 24203421 16306344277879
16298088677347 12/4/2021 24203421 16306344277879
16298097478724 12/4/2021 24203421 16306344277879
16298097478724 12/4/2021 24203421 16306344277879
16298088677347 12/4/2021 24203421 16306344277879
16298088677347 12/4/2021 24203421 16306344277879
16298088677347 12/4/2021 24203421 16306344235079
16298088677347 12/4/2021 24203421 16306344235079
16298097478724 12/4/2021 24203421 16306344235079
16298097478724 12/4/2021 24203421 16306344235079
16298097478724 12/4/2021 24203421 16306344235079
16298088677347 12/4/2021 24203421 16306344235079
16298097478724 12/4/2021 24203421 16306344235079
16298097478724 12/4/2021 24203421 16306344235079
16298097478724 12/4/2021 24203421 16306344235079
16298088677347 12/4/2021 24203421 16306344235079
16298092626190 12/4/2021 24203421 16306344235079
16298088677347 12/4/2021 24203421 16306344235079
16298092626190 12/4/2021 24203421 16306344235079
16298097478724 12/4/2021 24203421 16306344235079
16298092626190 12/4/2021 24203421 16306344235079
16298097478724 12/4/2021 24203421 16306344235079
16298088677347 12/4/2021 24203421 16306344235079
16298097478724 12/4/2021 24203421 16306344235079
16298097478724 12/4/2021 24203421 16306344235079
16298092626190 12/4/2021 24203421 16306344235079
16298092626190 12/4/2021 24203421 16306344235079
16298092626190 12/4/2021 24203421 16306344235079
16298088677347 12/4/2021 24203421 16306344235079
16298097478724 12/4/2021 24203421 16306344235079
16298092626190
12/4/2021 24203421 16306344235079
1622115492110 12/4/2021 24203421 16306344235079

16298092626190 12/4/2021 24203421 16306344235079
16298092626190 12/4/2021 24203421 16306344235079
16298097478724 12/4/2021 24203421 16306344235079
16298092626190 12/4/2021 24203421 16306344235079
16298092626190 12/4/2021 24203421 16306344235079
16298097478724 12/4/2021 24203421 16306344235079
16298097478724 12/4/2021 24203421 16306344235079
16298088677347 12/4/2021 24203421 16306344235079
16298097478724 12/4/2021 24203421 16306344235079
16298097478724 12/4/2021 24203421 16306344235079
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16298088677347 12/4/2021 24203421 16306344235079
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16298092626190 12/4/2021 24203421 16306344235079
16298097478724 12/4/2021 24203421 16306344235079
16298097478724 12/4/2021 24203421 16306344235079
16298092626190 12/4/2021 24203421 16306344235079
16298088677347 12/4/2021 24203421 16306344235079
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12/4/2021 24203421 16306344235079
16298088677347
12/4/2021 24203421 16306344235079
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12/4/2021 24203421 16306344235079
16298092626190
12/4/2021 24203421 16306344235079
16298097478724
12/4/2021 24203421 16306344235079
16298092626190
12/4/2021 24203421 16306344235079
16298097478724
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16298097478724
12/4/2021 24203421 16306344235079
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12/4/2021 24203421 16306344235079
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16298097478724
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16298092626190
12/4/2021 24203421 16306344235079
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12/4/2021 24203421 16306344235079
16298092626190
12/4/2021 24203421 16306344235079
16298097478724
12/4/2021 24203421 16306344235079
16298097478724
12/4/2021 24203421 16306344235079
16298092626190
12/4/2021 24203421 16306344235079
16298092626190
12/4/2021 24203421 16306344235079
16298092626190
12/4/2021 24203421 16306344235079
16298097478724
12/4/2021 24203421 16306344235079
16298092626190
12/4/2021 24203421 16306344235079
16298097478724
12/4/2021 24203421 16306344235079
16221115700838 12/4/2021 24203421 16306344235079

16298097478724
12/4/2021 24203421 16306344235079
16298092626190 12/4/2021 24203421 16306344235079
16298092626190 12/4/2021 24203421 16306344235079
16298097478724 12/4/2021 24203421 16306344235079
16298097478724 12/4/2021 24203421 16306344235079
16298092626190 12/4/2021 24203421 16306344235079
1622841590769 12/4/2021 24203421 16306344235079

16298092626190 12/4/2021 24203421 16306344235079
16298097478724 12/4/2021 24203421 16306344235079
16298088677347 12/4/2021 24203421 16306344235079
16298092626190 12/4/2021 24203421 16306344235079
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16298092626190 12/4/2021 24203421 16306344235079
16298092626190 12/4/2021 24203421 16306344235079
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16298097478724 12/4/2021 24203421 16306344235079
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16298088677347 12/4/2021 24203421 16306344235079
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16309339725384 12/4/2021 24203421 16306344235079
16298097478724 12/4/2021 24203421 16306344235079
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16298092626190 12/4/2021 24203421 16306344235079
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16298092626190 12/4/2021 24203421 16306344235079
16298092626190 12/4/2021 24203421 16306344235079
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16298092626190 12/4/2021 24203421 16306344235079
16298092626190 12/4/2021 24203421 16306344235079
16298092626190 12/4/2021 24203421 16306344235079
16298092626190 12/4/2021 24203421 16306344235079
16298088677347 12/4/2021 24203421 16306344235079
16298097478724 12/4/2021 24203421 16306344235079
16298092626190 12/4/2021 24203421 16306344235079
16298097478724 12/4/2021 24203421 16306344235079
16298092626190 12/4/2021 24203421 16306344235079
16298092626190 12/4/2021 24203421 16306344235079
16298088677347 12/4/2021 24203421 16306344235079
16298092626190 12/4/2021 24203421 16306344235079
16298092626190 12/4/2021 24203421 16306344235079
16298092626190 12/4/2021 24203421 16306344235079
16298088677347 12/4/2021 24203421 16306344235079
16298088677347 12/4/2021 24203421 16306344235079
16298088677347 12/4/2021 24203421 16306344235079
16298097478724 12/4/2021 24203421 16306344235079
16298097478724 12/4/2021 24203421 16306344235079
16298097478724 12/4/2021 24203421 16306344235079
16298088677347 12/4/2021 24203421 16306344235079
16298097478724 12/4/2021 24203421 16306344235079
16298092626190 12/4/2021 24203421 16306344235079
16298092626190 12/4/2021 24203421 16306344235079
16298097478724 12/4/2021 24203421 16306344235079
16298092626190 12/4/2021 24203421 16306344235079
16298097478724 12/4/2021 24203421 16306344235079
16298092626190 12/4/2021 24203421 16306344235079
16298092626190 12/4/2021 24203421 16306344235079
16298092626190 12/4/2021 24203421 16306344235079
16298088677347 12/4/2021 24203421 16306344235079
16298097478724 12/4/2021 24203421 16306344235079
16298092626190 12/4/2021 24203421 16306344235079
12/4/2021 24203421 16306344235079

16298092626190 12/4/2021 24203421 16306344235079
16298097478724 12/4/2021 24203421 16306344235079
16298092626190 12/4/2021 24203421 16306344235079
16298097478724 12/4/2021 24203421 16306344235079
16298088677347 12/4/2021 24203421 16306344235079
12/4/2021 24203421 16306344235079

Keterangan
Diberikan/Lanjut)
SELESAI DESA JIWUWU
SELESAI DESA MATEI
SELESAI DESA MATEI
SELESAI DESA MATEI
SELESAI DESA CMATEI
SELESAI DESA MATEI
SELESAI DESA MATEI
SELESAI DESA TADA
SELESAI DESA MATEI
SELESAI DESA JIWUWU
SELESAI DESA EIMAU
SELESAI DESA JIWUWU

SELESAI DESA MATEI
SELESAI DESA TADA
SELESAI DESA EIMAU
SELESAI DESA MATEI
SELESAI DESA EIMAU
SELESAI DESA MENIA
SELESAI DESA TADA
SELESAI DESA MATEI
SELESAI DESA EILODE
SELESAI DESA JIWUWU
SELESAI SDN EIMADAKE

SELESAI DESA JIWUWU
SELESAI DESA JIWUWU
SELESAI DESA JIWUWU
SELESAI DESA JIWUWU
SELESAI DESA JIWUWU
SELESAI DESA MATEI
SELESAI DESA MATEI
SELESAI DESA TADA
SELESAI DESA EILODE
SELESAI DESA MATEI
SELESAI DESA MATEI
SELESAI DESA MATEI

SELESAI DESA TADA
SELESAI DESA EILODE
SELESAI DESA MATEI
SELESAI DESA MATEI
SELESAI DESA JIWUWU
SELESAI DESA JIWUWU
SELESAI DESA JIWUWU
SELESAI DESA EIMAU
SELESAI DESA EIMAU
SELESAI DESA JIWUWU
SELESAI KADER POSY BUGU 1

SELESAI DESA JIWUWU
SELESAI DESA JIWUWU
SELESAI DESA EILODE
SELESAI DESA JIWUWU
SELESAI DESA EILODE
SELESAI DESA EILODE
SELESAI DESA MATEI
SELESAI DESA EILODE
SELESAI DESA EILODE
SELESAI DEESA EILODE
SELESAI DESA EILODE
SELESAI DESA MATEI
SELESAI DESA MATEI
SELESAI DESA KELIHA

SELESAI DESA JIWUWU
SELESAI DESA JIWUWU
SELESAI DESA JIWUWU
SELESAI DESA JIWUWU
SELESAI KPPS DESA JIWUWU
SELESAI DESA JIWUWU
SELESAI DESA JIWUWU

SELESAI DESA JIWUWU
SELESAI DESA JIWUWU
SELESAI DESA JIWUWU
SELESAI DESA JIWUWU
SELESAI DESA JIWUWU
SELESAI DESA JIWUWU
SELESAI DESA JIWUWU
SELESAI DESA MATEI
SELESAI DESA MATEI
SELESAI DESA MATEI
SELESAI DESA TADA
SELESAI DESA TADA
SELESAI DESA MATEI
SELESAI DESA MATEI
SELESAI DESA JIWUWU
SELESAI
SELESAI DESA JIWUWU
SELESAI DESA EILODE
SELESAI DESA EILODE
SELESAI DESA JIWUWU

SELESAI DESA JIWUWU
SELESAI DESA JIWUWU
SELESAI DESA JIWUWU
SELESAI DESA JIWUWU
SELESAI DESA JIWUWU
SELESAI DESA JIWUWU
SELESAI DESA BEBAE

SELESAI DESA JIWUWU
SELESAI DESA EIADA
SELESAI DESA JIWUWU

Kabupaten/Kota
Provinsi
Hari, Tanggal
No No. Tiket NIK
1 5320052404800001
Q-000Q5TW3
2 5320056512880002
P-BHSHFB1H
3 5320057011670001
P-BEFB96AN
4 5320054706940001
P-BC6E4HWR
5 5320054605830001
P-C3NLVPV2
6 5320050301700001
Q-000SE68P
7 5320055404870001
P-BPJWSI3E
8 5320050302040001
P-BKKKPOFL
9 5320056910090001
Q-001OI71O
10 5320051508050001
P-CP5FHQIG
11 5320051301010001
Q-001O7I1Y
12 5320031001050001
P-D12IQMFU
13 5320050207980001
Q-001OIVJU
14 5320050606000003
Q-001OIJD8
15 5320020909970002
Q-001OIJJ4
16 5320055505060001
P-B1XSXA8X
17 5320056107830001
Z-000E5YM8
18 5320036512000002
Q-001MW61E
19 5320051901030001
P-FX6QLROK
20 5320051308050002
P-FE034GGBS
21 5320050411610001
P-8Z2BDAGA
22 5320056812570001
S-2BC4D461
23 5320056103780001
P-77C8JUXR
24 5320010907990002
P-5D86PA3X
25 5320052403900001
P-5L5RFDHX
26 5320022406930001
P-5Q48X58F
27 5320035907940001
P-OM45JI96
28 5320055711810001
P-6ELZN88X
29 5320055711740001
P-6C1N9H2A
30 : 5320051304750001
P-6J5MTYVF
31 5320054107710002
P-7HDSC1NN
32 5320056907820001
P-7D2213QU
33 5320051207730001
P-6TWVPAWR
34 5320056909560001
S-C5A7FCDC
35 5320055006000001
P-AV7BHPA4
36 5320055804590001
S-DD495093
37 5320052703030001
P-AXK0UK3U
38 5320054203530001
S-9C1164F7
39 5320050101890003
S-39937C92
40 5320052611680001
P-9NNTPYC1
41 5320051007650001
P-AJV1IG5B
42 5320051404780001
P-BPP0AWUS
43 5320052512830001
P-BHW2IRAE
44 5320054712630002
P-B6D0RUIL
45 5320055503680001
P-DV7GLVUR
46 5320050709680004
P-D4OTA2G2
47 5320056409940003
P-CW2SNNP6
48 5320055303990001
P-CTYAT1PG
49 5320054608870002
P-CC0OWBX6
50 5320052808520001
S-00D270D2
51 P-E6A1Z7NT 5320050303020001
52 : P-EBPCKLOK 5371020607840005
53 P-G485P7OI 5371040611840007
54 5320054102030003
P-G02G30AF
55 5320025501870002
Q-001190BJ
56 5320051403830001
P-DQUCHKML
57 5320055703980001
Q-00039210
58 5320054101710001
P-DGW3XKBA
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
1 95
2 96
3 97
4 98
5 99
6 100
7 101
8 102
9 103
104
10
105
11
106
12
107
13
108
14
109
15
110
16
111
17
112
18
113
19
114
20
115
21
116
22
23
24
25
26
27
28
29
30
31
32
33
34
35
: Sabu Raijua
: 03/12/2021
Pekerjaan*
Jenis
Kelamin
YAKOBUS DJU NINA L MASY UMUM
DORDIANA DUBU P MASY UMUM
YULIANA LEBA P MASY UMUM
PENINA DJAMI KORE P MASY UMUM

PETRONELA KORE LIHU P MASY UMUM
MATHEOS LOMI DJAMI L MASY UMUM
PETRONELA RIWU DJAMI P MASY UMUM
FERINDUS KANA MANGNGI L REMAJA
NADIVA JESICA NDODA LOUDOE P REMAJA

IVAN AGUSTINO KIRA L REMAJA
FRENGKY ARY ERE L MASY UMUM
JHONRY RIWU L REMAJA
DEDI KIRA P MASY UMUM
BOBY PUTRA WIA DIDA L MASY UMUM
DAVID SEPTENIUS LILO L MASY UMUM
ANI SAKRIANA RABA P REMAJA

JULIET ANTHONETA BULE LOGO P MASY UMUM
DEWI YULIANTI KIRE KADJA P MASY UMUM

DJOFRITI ARISON PIGA TULU L MASY UMUM
NILIA KORE LIHU P REMAJA
PITERSON HUKI LENA L LANSIA
MARTINA WADU MANNO P LANSIA
AGUSTINA WILA KORE P MASY UMUM
WELEM RAME LUDJI L MASY UMUM
LEWI KALE DJARA L MASY UMUM
JEPRON BABIS L MASY UMUM
YULIANA LULU P MASY UMUM
MARIANA GA RATA P MASY UMUM
MARGERITA DJARA P MASY UMUM
DOMINGGUS EDE L MASY UMUM
MARSELINA LOBO P MASY UMUM
LIDIA KALE LAY P MASY UMUM
HABEL DJAMI EDO L MASY UMUM
MARIANA TODA P LANSIA

YANTI KALE UKE P MASY UMUM
WELMINCE KANA MANGNGI P LANSIA
ROBINSON BALE DABBO L MASY UMUM
AGUSTINA LEBA LUDJI P LANSIA
ALEKSANDER ULI REKE L LANSIA
YOHANIS LEBA LUDJI L MASY UMUM
MELKIANUS KANA MANGNGI L MASY UMUM
APRIANUS KANA MANGNGI L MASY UMUM
DAUD ROHI EDE L MASY UMUM
MARIAN TINGE P MASY UMUM
WELMINCE RADJA P MASY UMUM

DARIUS TOMA L MASY UMUM
MARGERITA KIRE P MASY UMUM
DOTI KALE L MASY UMUM
LUKWINA BALE LENA L MASY UMUM
DJIBRAEL LAY LENA L LANSIA
WELHELMUS DJARA PE L MASY UMUM
ISAK KALE DJARA L MASY UMUM
KIRENIUS DIMU LUDJI L MASY UMUM
FEBI FRANSISKA LEO HA'U P MASY UMUM
YULIANTI LUDJI P MASY UMUM
HENDRIK KORE BANGNGU L MASY UMUM

SANDRA BIRE P MASY UMUM
DURU DJAMI L MASY UMUM

Umur
tahun)
4/24/1980 41 LOBOAJU
12/25/1988 33 Desa eimau
11/30/1967 54 Desa eilode
1/3/1970 51 DESA MATEI
4/14/1987 34 Desa matei
2/3/2004 17 Desa matei
1/13/2001 20 DESA TADA
1/10/2005 16 Desa eiada
6-Jun-00 21 DESA EILODE
5/15/2006 15 Desa eimadake

7/21/1983 38 DESA MENIA
12/25/2000 21 DESA TADA
1/19/2003 18 Desa matei
12/28/1957 64 60-150 DESA LOBOAJU
3/21/1978 43 31-45 DESA BEBAE
7/9/1999 22 DESA RAEKORE
1990-03-24 31 DESA MATEI
6/24/1993 28 DESA MATEI
7/19/1994 27 DESA KEDURU
11/17/1981 40 DESA TADA.
4/13/1975 46 DESA TADA
6/10/2000 21 Desa Tada
4/18/1959 62 Desa Matei
3/27/2003 18 Desa Matei
3/2/1954 67 Desa Matei
5/15/1958 63 Desa Matei
11/26/1968 53 Desa Matei
7/10/1965 56 Desa Matei
4/14/1978 43 Desa Matei
12/25/1983 38 Desa Matei
9/7/1963 58 DESA MATEI
3/15/1968 53 DESA BEBAE

9/7/1968 53 Desa bebae
9/24/1994 27 Desa Eilode
8/6/1987 -966 Desa Eilode
8/28/1952 69 DESA MATEI
3/18/1984 37 Desa matei
11/6/1984 37 Desa matei
2/1/2003 18 Desa matei
1/15/1987 34 DESA MATEI
3/21/1984 37 Desa matei


ASI COVID-19
NASI

kolom yang sesuai)
BPJS Non
PBI
081238732823
082214514839
082278470186
082290315087
081353026059
081212735794
082147360784
081317210506
081220759284
082287149341
082359403460
081338496208
081210242962
081337102544
081246137784
082339556755
082359324377
081339194740
081238865480
081239423161
081339220238
081232576462
082145747647
082145747647
081338885184
082237893354
081237457130
085333831459
082339556735
085333831459
81270733498
081270733490
082147310626
081236576462
082260387964
081259564059
081236836391
081259564059
081259564049
081259564049
081259564049
085333094204
085333094204
082260387964
082147708697
081339496208
081239423161
082236780849
082290315087
08124699558
08124699558
0852337307935
081342010338
082236396167
085253734462
085337347004
085282840941
081353026059
Dosis I
Tanggal Pemberian
No. Batch
Vaksinasi
MODERNA 8/27/2021 083D21A
MODERNA 002F21A
MODERNA 002F21A
MODERNA 002F21A
MODERNA 002F21A
MODERNA 9/1/2021 083D21A
MODERNA 002F21A
MODERNA 002F21A
202108122H
202108122H
ASTRA ZANECA 12/6/2021 ABZ9883
ASTRA ZANECA 9/21/2021 PV46700

Dosis 2
Tanggal Pemberian
Vaksinasi
00380777273983 12/6/2021 002F21A
00380777273983 12/6/2021 002F21A
12/6/2021 202108140H 16319351805904
16319351805904
16319351805904
16319351805904
16319351805904
16319351805904
16319351805904
16319351805904
12/6/2021 202108140H 16319351805904
16319351805904
16319351805904
16319351805904
03019244223426
03019244223426
03019244223426
03019244223426
03019244223426
03019244223426
03019244223426
03019244223426
03019244223426
03019244223426
03019244223426
03019244223426
03019244223426
03019244223426
03019244223426
03019244223426
03019244223426
03019244223426
03019244223426
03019244223426
03019244223426
03019244223426
03019244223426
03019244223426
03019244223426
03019244223426
03019244223426
03019244223426
03019244223426
03019244223426
03019244223426
03019244223426
03019244223426
03019244223426
02639419435755 12/6/2021 ABZ9883 03019244223426
03019244223426
03019244223426
03019244223426
Keterangan
Diberikan/Lanjut)
SELESAI LOBOAJU
LANJUT Desa eimau
LANJUT Desa eilode
LANJUT Desa eilode
LANJUT Desa eilode
SELESAI DESA MATEI
LANJUT Desa matei
LANJUT Desa matei
SELESAI DESA EILODE
LANJUT Desa eilode
LANJUT DESA TADA
LANJUT Desa eiada
LANJUT DESA EILODE
LANJUT DESA EILODE
LANJUT DESA EILODE
LANJUT Desa eimadake

SELESAI DESA MENIA
LANJUT DESA TADA
LANJUT Desa matei
LANJUT DESA EILODE
LANJUT DESA LOBOAJU
LANJUT DESA LOBOAJU
LANJUT DESA BEBAE
LANJUT DESA RAEKORE
LANJUT DESA MATEI
LANJUT DESA MATEI
LANJUT DESA KEDURU
LANJUT DESA TADA.
LANJUT DESA TADA
LANJUT DESA EILODE
LANJUT DESA EILODE
LANJUT DESA LOBOAJU
LANJUT DESA LOBOAJU
LANJUT Desa Tada
LANJUT Desa Matei
LANJUT Desa Matei
LANJUT Desa Matei
LANJUT Desa Matei
LANJUT Desa Matei
LANJUT Desa Matei
LANJUT Desa Matei
LANJUT Desa Matei
LANJUT DESA MATEI
LANJUT DESA BEBAE

LANJUT Desa bebae
LANJUT Desa Eilode
LANJUT Desa eilode
LANJUT Desa Eilode
LANJUT DESA MATEI
LANJUT DESA EILODE
LANJUT Desa matei
LANJUT Desa matei
LANJUT Desa matei
SELESAI DESA MATEI
LANJUT Desa matei
LANJUT Desa eilode

Kabupaten/Kota
Provinsi
Hari, Tanggal
No No. Tiket NIK
1 S-C57E3C0A 5320056808540001
2 S-73CD2732 5320054207420001
3 S-6FBB4B73 5320055004490001
4 P-ET9SLTIB 5320056303770001
5 P-FAJY67GW 5320052811030001
6 P-EXIZO3HL 5320050505850001
7
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
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
1 95
2 96
3 97
4 98
5 99
6 100
7 101
8 102
9 103
104
10
105
11
106
12
107
13
108
14
109
15
110
16
111
17
112
18
113
19
114
20
115
21
116
22
23
24
25
26
27
28
29
30
31
32
33
34
35
: Sabu Raijua
: 03/12/2021
Pekerjaan*
Jenis
Kelamin
KATERINA LAY P LANSIA

KATERINA PIGA TULU P LANSIA
RAHEL DJO HAU P LANSIA
DJUBLINA WAHI TAI P MASYARAKAT UMUM
ROBINSON HERE HIA L MASYARAKAT UMUM
TEOFILUS DEHE DJIMO L MASYARAKAT UMUM

Umur
tahun)
8/28/1954 67 MATEI
7/2/1942 79 MATEI
4/10/1949 72 MATEI
8/6/1979 42 EIMAU
11/28/2003 18 MATEI
5/5/1985 36 MATEI
ASI COVID-19
NASI

kolom yang sesuai)
BPJS Non
PBI
085253439523 12/7/2021
085253439523 12/7/2021
085253439523 12/7/2021
081337418678 12/7/2021
082145725873 12/7/2021
085210109415 12/7/2021
Dosis I
Tanggal Pemberian
No. Batch
Vaksinasi
VAKSIN COVID-19 BIOFARMA 12/7/2021 202108140H

Dosis 2
Tanggal Pemberian
Vaksinasi
16319351805904
16319351805904
16319351805904
16319351805904
16319351805904
16319351805904
Keterangan
Diberikan/Lanjut)
LANJUT DESA MATEI
LANJUT DESA MATEI
LANJUT DESA MATEI
LANJUT DESA EIMAU
LANJUT DESA MATEI
LANJUT DESA MATEI

Kabupaten/Kota
Provinsi
Hari, Tanggal
No No. Tiket NIK
1 Z-000E988Y 5320050702500001
2 Q-0010QWKD 5320055006040001
3 Q-00119AWA 5320050504820001
4 P-DWELIACJ 5320054203780002
5 P-CYBD190U 5320051808660001
6 P-CMASTEVO 5320057007020001
7 P-CAF8KVJX 5320050709740001
8 S-0DAF7CC4 5320056405390001
9 N-FD815666 5320051210910001
10 P-GCFM8B0B 5320051704680001
11 P-F5HLHYRH 5320052702760000
12 P-FR26OJRC 5320055503790000
13 Q-001NQJP2 5320050507730001
14 Q-001NQJWT 5320055108770002
15 P-MNOH8BGS 5320050708030000
16 P-MNJB2X15 5320051307050001
17 P-MOVMRTPL 5320050211600001
18 P-MOX8TARM 5320055807870001
: Sabu Raijua
: 08/12/2021
Pekerjaan*
Jenis
Kelamin
MARKUS DJARA BALE L LANSIA 2/7/1950
SITI SUKMA WATI PIGA TULU P REMAJA 6/10/2004
LAMBERTUS PIGA TULU L MASY UMUM 4/5/1982
NAOMI TADI P MASY UMUM 3/2/1978
DOMINGGUS WADU MANNO L MASY UMUM 8/18/1966
YUNITA SUSANTI EDE P MASY UMUM 7/30/2002
SOLEMAN GA RATA L MASY UMUM 9/7/1974
JUBLINA RIHI P LANSIA 8/15/1939
ODI BERNAD RAGA LOMI L MASY UMUM 10/12/1991
NIKOLAS KANA MANGNGI L MASY UMUM 4/17/1968
HENOK LUDJI LINGU L MASY UMUM 2/27/1976
ELISABET RADJA P MASY UMUM 3/15/1979
HABEL NAWA WANYI L MASY UMUM 7/5/1973
MARTHA NGAHU P MASY UMUM 8/11/1977
VIKTOR NEGO RATA L MASY UMUM 8/7/2003
VICTOR ROBINSON LAY DJAMI L REMAJA 2/13/2005

WELEM LENA LAY L MASY UMUM 10/25/1983
YULIANA DJARI P MASY UMUM 7/18/1987

Kepesertaan BPJS (tulis 'Ya'

Umur pada kolom yang sesuai)
Kelompok
(18 sd ≥ 60 Alamat No. Hp
Umur
tahun)
BPJS BPJS Non
PBI PBI
73 DESA JIWUWU 82144859686
19 DESA MATEI 85237621804
41 31-45 DESA MATEI 81338885642
45 DESA BEBAE 81339252147
56 DESA TADA 82142514381
20 DESA TADA 85333078446
48 DESA TADA 82339780583
83 DESA TADA 82339780583
31 DESA EIMAU 82145995089
55 DESA TADA 82145192627
47 DESA TADA 081333772720
44 DESA TADA 081337722720
50 46-59 DESA EIMADAKE 82339252370
45 31-45 DESA EIMADAKE 82339252370
19 DESA EILODE 082147310223
18 DESA EILODE 085210105403

39 DESA TADA 81238510404
36 DESA TADA 81238510404

aan BPJS (tulis 'Ya'
Dosis I
om yang sesuai)
Non Tanggal Pemberian
Anggota Vaksinasi
9/21/2021 ASTRAZENECA 9/21/2021
12/8/2021 ASTRAZENECA 12/8/2021
12/8/2021 ASTRAZENECA 12/8/2021
12/8/2021 ASTRAZENECA 12/8/2021
12/8/2021 ASTRAZENECA 12/8/2021
12/8/2021 ASTRAZENECA 12/8/2021
12/8/2021 ASTRAZENECA 12/8/2021
12/8/2021 ASTRAZENECA 12/8/2021
12/8/2021 ASTRAZENECA 12/8/2021
12/8/2021 ASTRAZENECA 12/8/2021

D2
BIOFARMA L
MU
D2
ASTRA MU
D1
MU
L
Dosis 2
Tanggal Pemberian
No. Batch No. Serial No. Batch
Vaksinasi
202108167I 16309339725384 12/8/2021 202108140H
2021071341 12/8/2021 202108140H
PV46700 02639419435755 12/8/2021 ABZ9883
ABZ9883 4267258373482
ABZ9883 4267258373482
ABZ9883 4267258373482
ABZ9883 4267258373482
ABZ9883 4267258373482
ABZ9883 4267258373482
ABZ9883 4267258373482
ABZ9883 4267258373482
ABZ9883 4267258373482
202108122H 16298097478724 12/8/2021 202108140H
202108122H 16298097478724 12/8/2021 202108140H
202108140H 16306344235079
202108140H 16306344235079
202108140H 16306344235079
202108140H 16306344235079
D1
1 R 1
1 MU 3
8
1
Keterangan
Diberikan/Lanjut)
No. Serial
LANJUT DESA EILODE
LANJUT DESA EIMAU
LANJUT DESA JIWUWU
LANJUT DESA BEBAE
LANJUT DESA TADA
LANJUT DESA MATEI
LANJUT DESA EILODE
LANJUT DESA EILODE
LANJUT DESA EILODE

LANJUT DESA TADA
LANJUT DESA TADA

29 Desember 2021

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29 Desember 2021

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Format Tersedia

Nama Puskesmas/Fasyankes/Pos

No No. Tiket NIK

PANGERAN IVANTRI DOKO L REMAJA

UMBU KUDU KATAUHI MILA L MASY UMUM

NOFANTO MANU PADJA L REMAJA

TULU KAKA PUTRA NEGO RATA L REMAJA

RUT MANU P MASY UMUM

WEMPY ITO L MASY UMUM

IMANUEL ROHI L MASY UMUM

TINGKAT PUSKESMAS/FASYANKES/POS VAKSINASI

11/18/2003 19 18-30 SUMBA TIMUR 81338227311

11/27/2005 17 12-17 DESA EILODE 085338193079

10/4/2009 13 12-17 DESA EILODE 81337150661

3/6/1985 38 31-45 DESA EILODE 082229114910

5/20/1974 49 46-59 DESA EILODE 081337150661

11/24/1971 51 46-59 DESA EILODE 081337150661

10/12/2021 VAKSIN COVID-19 BIOFARMA 10/12/2021

12/29/2021 VAKSIN COVID-19 BIOFARMA 12/29/2021 24203321

12/29/2021 VAKSIN COVID-19 BIOFARMA 12/29/2021 24203321

12/29/2021 VAKSIN COVID-19 BIOFARMA 12/29/2021 24203321

12/29/2021 VAKSIN COVID-19 BIOFARMA 12/29/2021 24203321

12/29/2021 VAKSIN COVID-19 BIOFARMA 12/29/2021 24203321

No. Serial Tanggal Pemberian No. Batch No. Serial

16298092634625 12/29/2021 24203321 16333444265920

12/29/2021 24203321 16333444265920

LANJUT DESA EILODE

LANJUT DESA EILODE

LANJUT DESA EILODE

LANJUT DESA EILODE

LANJUT DESA EILODE

No No. Tiket NIK

MERTHEN BANGNGU KORO L MASYARAKAT UMUM

NAOMI HUKI LENA P LANSIA

NICOLAS KANA LUDJI L MASYARAKAT UMUM

GODLIF RIWU DJAMI L LANSIA

BENDELINA NARA DILA P LANSIA

MARSELINA BANGNGU KORO P MASYARAKAT UMUM

ESTER MANU PADJA P MASY UMUM

SANTI NEGO RATA P REMAJA

TERSIANA BALE HURU P MASY UMUM

NOVRIT MIRA MANGNGI P REMAJA

RIA RIHI P REMAJA

TITUS BALE BANE L MASY UMUM

DELIMA BALE BANE L MASY UMUM

DEWI YANTI WADU P MASY UMUM

PETRUS MIHA LENA L LANSIA

FLORESITA MIHA BALO P REMAJA

ARDIANTO ROBINSON MAGE TIE L REMAJA

MATELDA WILA DIDA P LANSIA

TAMAR NARA DILA P REMAJA

MASRINUS MIHA LOBO L MASY UMUM

RATU KUDJI P LANSIA

DELVI MANU PADJA p MASY UMUM

SOLEMAN RATA L MASY UMUM

DITA LOMI KAHO P MASY UMUM

HABA UDJU P MASY UMUM

TINGKAT PUSKESMAS/FASYANKES/POS VAKSINASI

9/2/2002 19 EILODE 081353026059

1/2/1942 79 EILODE 082237099254

11/13/1966 55 EILODE 081337150661

7/12/1945 76 DESA EILODE 085233729445

3/6/1934 87 EILODE 082237099254

4/17/1982 39 EILODE 082237099254