DATA IMUNISASI DASAR LENGKAP PUSKESMAS SUATANG BARU

TAHUN 2022
Bulan : APRIL
Tahun : 2023
Puskesmas : SUATANG BARU
Tgl.Imunisasi
Jenis
No Nama Tgl.Lahir Nama Ortu Desa DPT-HB-HiB DPT-HB-HiB DPT-HB-HiB
Kelamin HB0 BCG / Polio 1 IPV CAMPAK MR
1/Polio 2 2/Polio 3 3/Polio 4

1 ASKARA ARSYA N 7/26/2022 L ASRIPAH SUATANG BARU 7/26/2022 9/7/2022 10/13/2022 11/14/2022 12/13/2022 2/22/2023 5/13/2023 5/13/2023

2 GALIH TIRTA 7/13/2022 L M. FAUZI SUATANG BARU 7/14/2022 8/10/2022 10/10/2022 11/10/2022 12/10/2022 1/10/2023 5/10/2023 5/10/2023

3 AZHAR 8/13/2022 L AGUS SUATANG BARU 8/12/2022 9/10/2022 9/22/2022 11/10/2022 12/10/2022 12/10/2022 5/22/2023 5/22/2023

4 REVIA 7/16/2022 P TRI NORWATI SUATANG BARU 7/16/2022 9/3/2022 10/3/2022 1/3/2023 4/3/2023 3/3/2023 5/3/2023 5/3/2023

5 M RAHMAT SALAM 7/8/2022 L FAUZI SUATANG BARU 7/8/2022 9/6/2022 10/6/2022 11/7/2022 12/6/2022 1/6/2023 5/6/2023 5/6/2023

6 M ALFARIZKI 8/12/2022 L NUR HASANAH SUATANG BARU 8/12/2022 9/22/2022 10/22/2022 11/22/2022 1/7/2023 12/22/2022 5/20/2023 5/20/2023

ALZAM ZAVIER
7 ABDILLAH 7/26/2022 L NOVITA SUATANG BARU 7/26/2022 9/7/2022 10/7/2022 11/7/2022 2/7/2023 12/7/2022 5/10/2022 5/10/2022

8 DAFFA ARIQIN 6/11/2022 L SRI REJEKI SUATANG 6/12/2022 7/18/2022 8/23/2022 9/19/2022 11/19/2022 3/21/2023 5/19/2023 5/19/2023

9 ADARPA AYUDIA 7/13/2022 P M SALEH SENIUNG JAYA 7/13/2022 9/12/2022 10/12/2022 11/14/2022 1/12/2023 2/11/2023 5/12/2023 5/12/2023

10 ADELA 7/18/2022 P HARIANI SAING PRUPUK 7/18/2022 8/20/2022 9/20/2022 1/20/2023 4/27/2023 3/20/2023 5/20/2023 5/20/2023

Mengetahui Suatang Baru, APRIL 2023

Kepala Puskesmas Suatang Baru Pengelola Program Imunisasi

dr. Farida Fitriyah Retno Mandasari, A.Md.Kep

NIP. 19840702 201403 2 002 NIP. 19920321 202203 2 013
 DATA IMUNISASI DASAR LENGKAP PUSKESMAS SUATANG BARU
TAHUN 2022
Bulan : APRIL
Tahun : 2023
Puskesmas : SUATANG BARU
Tgl.Imunisasi
Jenis
No Nama Tgl.Lahir Nama Ortu Desa DPT-HB-HiB DPT-HB-HiB DPT-HB-HiB
Kelamin HB0 BCG / Polio 1 IPV CAMPAK MR
1/Polio 2 2/Polio 3 3/Polio 4

1 M DIMAS RIZKY 6/6/2022 L RUSDIANA SENIUNG JAYA 6/12/2022 7/12/2022 9/12/2022 11/14/2022 1/12/2023 2/11/2023 4/12/2023 4/12/2023

2 M AZKA A 6/1/2022 L LIA SENIUNG JAYA 6/1/2022 7/12/2022 8/12/2022 10/12/2022 11/14/2022 12/12/2022 4/12/2023 4/12/2023

3 M ZIVRAN 4/19/2022 L ANA S SENIUNG JAYA 4/20/2022 5/12/2022 7/12/2022 8/12/2022 11/14/2022 12/12/2022 4/12/2023 4/12/2023

4 M RAFFASYA 6/12/2022 L M IRFAN SUATANG 6/12/2022 7/15/2022 8/15/2022 9/15/2022 10/15/2022 11/15/2022 4/15/2023 4/15/2023

5 ALEYA ZALFA SAFIRA 11/4/2021 P ASANI SUATANG 11/10/2021 1/15/2022 4/15/2022 5/14/2022 8/15/2022 4/15/2023 2/15/2023 2/15/2023

6 ZAIDAN NAFISHAN 7/6/2022 L IRNAWATI SUATANG BARU 7/6/2022 9/7/2022 10/7/2022 11/22/2022 1/7/2023 1/7/2023 4/8/2023 4/8/2023

7 AZKIA NUR SAFITRI 5/14/2022 P SITI F SUATANG BARU 5/14/2022 6/7/2022 8/3/2022 11/7/2022 4/6/2023 3/24/2023 2/22/2023 2/22/2023

10

Mengetahui Suatang Baru, APRIL 2023

Kepala Puskesmas Suatang Baru Pengelola Program Imunisasi

dr. Farida Fitriyah Retno Mandasari, A.Md.Kep

NIP. 19840702 201403 2 002 NIP. 19920321 202203 2 013
 DATA IMUNISASI DASAR LENGKAP PUSKESMAS SUATANG BARU
TAHUN 2022
Bulan : MARET
Tahun : 2023
Puskesmas : SUATANG BARU
Tgl.Imunisasi
Jenis
No Nama Tgl.Lahir Nama Ortu Desa DPT-HB-HiB DPT-HB-HiB DPT-HB-HiB
Kelamin HB0 BCG / Polio 1 IPV CAMPAK MR
1/Polio 2 2/Polio 3 3/Polio 4

1 M. AZKA 4/11/2022 L SITI RAHAYU SUATANG 4/11/2022 6/15/2022 8/15/2022 9/15/2022 1/16/2023 3/15/2023 2/15/2023 2/15/2023

2 CELMIRA 4/17/2022 P ARDIANSYAH KETEBAN 4/17/2022 6/9/2022 7/8/2022 8/9/2022 9/9/2022 10/11/2022 3/9/2023 3/9/2023

3 M. KENZI 4/23/2022 L VERNI KRISIS SENIUNG JAYA 4/25/2022 5/12/2022 6/11/2022 7/12/2022 9/12/2022 10/2/2022 3/11/2023 3/11/2023

4 RIZKI IKRAMUL 1/28/2022 L ASENAH SUATANG 2/3/2022 4/4/2022 5/4/2022 6/4/2022 8/4/2022 10/4/2022 3/4/2023 3/4/2023

5 NAZIA MALIKA 3/16/2022 P NGATMAN SUATANG BARU 3/17/2022 4/13/2022 5/3/2022 6/22/2022 3/13/2022 7/22/2022 2/22/2023 2/22/2023

6 M. ADRIANSYAH 6/14/2022 L NORLINA SAING PRUPUK 6/15/2022 7/13/2022 8/20/2022 9/20/2022 10/20/2022 1/21/2022 3/20/2022 3/20/2022

7 AZRI MIRZA 3/22/2022 L RINI L SAING PRUPUK 3/22/2022 5/20/2022 8/20/2022 12/20/2022 9/20/2022 2/20/2023 3/20/2022 3/20/2022

7 AMANDA SALSABILA 6/1/2022 P SUMALI SUATANG BARU 6/1/2022 7/7/2022 8/3/2022 9/3/2022 11/3/2022 10/3/2022 3/3/2023 3/3/2023

8 M. ATHAR ABIZAR 5/13/2022 L RATNAWATI SUATANG 5/14/2022 7/11/2022 8/20/2022 11/10/2022 1/10/2023 2/10/2023 3/4/2022 3/4/2022

10 NANDA MAIDA N 5/24/2022 P TINI SUATANG BARU 5/24/2022 6/22/2022 8/10/2022 9/10/2022 11/10/2022 12/10/2022 3/10/2022 3/10/2022

11 ABYAN ATHAR R 5/25/2022 L PUTRI SUATANG BARU 5/25/2022 5/7/2022 7/6/2022 9/6/2022 10/6/2022 11/5/2022 3/6/2023 3/6/2023

Mengetahui Suatang Baru, MARET 2023

Kepala Puskesmas Suatang Baru Pengelola Program Imunisasi

dr. Farida Fitriyah Retno Mandasari, A.Md.Kep

NIP. 19840702 201403 2 002 NIP. 19920321 202203 2 013
 DATA IMUNISASI DASAR LENGKAP PUSKESMAS SUATANG BARU
TAHUN 2022
Bulan : FEBRUARI
Tahun : 2023
Puskesmas : SUATANG BARU
Tgl.Imunisasi
Jenis
No Nama Tgl.Lahir Nama Ortu Desa DPT-HB-HiB DPT-HB-HiB DPT-HB-HiB
Kelamin HB0 BCG / Polio 1 IPV CAMPAK MR
1/Polio 2 2/Polio 3 3/Polio 4

1 KENZO 3/11/2022 L BUKAR/KOIS SUATANG 3/11/2022 4/11/2022 6/10/2022 7/11/2022 8/10/2022 9/10/2022 2/10/2023 2/10/2023

2 AKTHAR BILAL C 4/1/2022 L NETTY ANDRIANI SENIUNG JAYA 4/1/2022 4/24/2022 5/25/2022 7/12/2022 8/12/2022 1/12/2023 2/11/2023 2/11/2023

3 M. RIZKY R 4/20/2022 L RAZAK KETEBAN 4/20/2022 6/9/2022 7/8/2022 8/9/2022 9/9/2022 1/9/2023 2/9/2023 2/9/2023

ISMIYATI
4 FAHRIANSYAH 4/4/2022 L SULEMAN SUATANG BARU 4/4/2022 5/12/2022 6/22/2022 7/22/2022 9/22/2022 9/22/2022 2/7/2023 2/7/2023

5 M. ARIFIN ILHAM 10/9/2021 L CITRA SUATANG BARU 10/9/2021 11/22/2021 12/20/2021 1/20/2022 2/21/2022 11/21/2022 2/20/2023 2/20/2023

6 AL KHALIFI 4/27/2022 L TRI/EKA SUATANG BARU 4/27/2022 6/6/2022 7/6/2022 10/7/2022 12/6/2022 11/7/2022 2/7/2023 2/7/2023

7 IMANUEL KRISTIAN V 5/19/2022 L MARIA M SAING PRUPUK 5/19/2022 6/23/2022 7/20/2022 9/20/2022 11/21/2022 1/20/2023 2/20/2023 2/20/2023

SOLIHIN/EKA
8 KEYSHA 5/9/2022 P SUATANG BARU 5/10/2022 6/17/2022 9/7/2022 10/13/2022 12/13/2022 11/14/2022 2/13/2023 2/13/2023
LINDA

DEVI MAY INDAH

9 ZEVANISYA A.M 4/30/2022 P SUATANG BARU 4/30/2022 6/7/2022 8/8/2022 9/7/2022 12/7/2022 12/7/2022 2/22/2023 2/22/2023
SARI

10 NADHIRA ZAMEENA 3/17/2022 P SRI PUJIANINGSIH SUATANG BARU 3/17/2022 5/9/2022 8/3/2022 9/3/2022 1/3/2023 12/3/2022 2/22/2023 2/22/2023

11 M. ALZAM RIADI 5/3/2022 L JOKO PURNOMO SUATANG 5/3/2022 6/18/2022 8/20/2022 9/19/2022 10/18/2022 12/19/2022 2/21/2023 2/21/2023

Mengetahui Suatang Baru, Februari 2023

Kepala Puskesmas Suatang Baru Pengelola Program Imunisasi

dr. Farida Fitriyah Retno Mandasari, A.Md.Kep

NIP. 19840702 201403 2 002 NIP. 19920321 202203 2 013
 DATA IMUNISASI DASAR LENGKAP PUSKESMAS SUATANG BARU
TAHUN 2022
Bulan : JANUARI
Tahun : 2023
Puskesmas : SUATANG BARU
Tgl.Imunisasi
Jenis
No Nama Tgl.Lahir Nama Ortu Desa DPT-HB-HiB DPT-HB-HiB DPT-HB-HiB
Kelamin HB0 BCG / Polio 1 IPV CAMPAK MR
1/Polio 2 2/Polio 3 3/Polio 4

1 NAZEEVA GHANIA 3/17/2022 P SRI PUJIANINGSIH SUATANG BARU 3/17/2022 4/22/2022 7/4/2022 8/3/2022 9/3/2022 10/3/2022 1/3/2023 1/3/2023

SANDY W/
2 ALIFA SYAKILA 3/18/2022 P SUATANG BARU 3/18/2022 5/12/2022 6/16/2022 8/6/2022 9/6/2022 10/5/2022 1/6/2023 1/6/2023
IRMIYATI

3 DZIHNI MECCA 2/2/2022 P IBIK W/TRI M SUATANG BARU 2/2/2022 3/7/2022 4/6/2022 7/6/2022 10/6/2022 11/5/2022 1/6/2023 1/6/2023

4 M. RAYYAN AL-FARIZI 4/1/2022 L RIKA SUATANG BARU 4/1/2022 5/20/2022 7/20/2022 8/20/2022 9/20/2022 8/21/2022 1/20/2023 1/20/2023

5 ANANDA NAFIZATUL 3/15/2022 P NINING/HILMI SUATANG APAR 3/15/2022 5/11/2022 6/4/2022 7/4/2022 9/6/2022 8/4/2022 1/4/2023 1/4/2023

6 FAZRUL 11/10/2022 L RAHMAD F SUATANG APAR 11/11/2021 11/22/2021 1/4/2022 3/7/2022 5/11/2022 7/4/2022 1/4/2023 1/4/2023

10

Mengetahui Suatang Baru, April 2022

Kepala Puskesmas Suatang Baru Pengelola Program Imunisasi

dr. Farida Fitriyah Pita Suci Syah Putri, A.Md.Kep

NIP. 19840702 201403 2 002 NIP. -