DINAS KESEHATAN KABUPATEN SARMI

PUSKESMAS ARBAIS
PROGRAM IMUNISASI

DATA NAMA NAKES DAN NON NAKES/PNS.TNI.POLRI.MASYARAKAT YANG SUDAH DI VAKSINASI

VAKSIN COVID 19(SINOVAD)BULAN JANUARI - MARET 2021

No Back Tgl Vaksin Jam Vaksinasi Tempat No Back Tgl Vaksin Jam Vaksinasi Tempat
No Nama Umur Nik Profesi Keterangan
Vaksin Thp I Thp I Vaksinasi Vaksin Thp II Thp II Vaksinasi

1 FEBRIANI TANGKE ALLO 24 Thn 9110012802970000 Perawat 202011045 18/02/2021 13.31 PKM ARBAIS 202011045 6/6/2021 12.50 PKM ARBAIS Selesai
2 MITAKHUL HUDA 24 Thn 9110012981970000 Nakes lainnya 202011045 18/02/2021 14.00 PKM ARBAIS 202011045 6/6/2021 12.53 PKM ARBAIS Selesai
3 HARNIATI 35 Thn 7308074107860026 202011045 18/02/2021 13.21 PKM ARBAIS 202011045 6/6/2021 12.55 PKM ARBAIS Selesai
4 YERMIAS CATUE 42 Thn 9110030603790001 202011045 18/02/2021 13.13 PKM ARBAIS 202011045 6/6/2021 12.58 PKM ARBAIS Selesai
5 ESTER AYOMI 46 Thn 9110037006740001 202011045 18/02/2021 14.14 PKM ARBAIS 202011045 6/6/2021 13.01 PKM ARBAIS Selesai
6 SITI QOMARIYAH 30 Tnh 9171026007910006 202011045 18/02/2021 13.11 PKM ARBAIS 202011045 6/6/2021 13.04 PKM ARBAIS Selesai
7 IRYANTI 37 Thn 9110014305840002 202011045 18/02/2021 13.31 PKM ARBAIS 202011045 6/6/2021 13.14 PKM ARBAIS Selesai
8 REGINA RACHEL SAWAY 51 Thn 9110034220690001 202011045 18/02/2021 13.15 PKM ARBAIS 202011045 6/6/2021 13.12 PKM ARBAIS Selesai
9 BERTHA SISAU 51 Thn 9110036502690001 202011045 18/02/2021 13.10 PKM ARBAIS 202011045 6/6/2021 13.10 PKM ARBAIS Selesai
10 HENDRA SASTRA SARAGIH 34 Thn 9171054101870003 202011045 18/02/2021 13.55 PKM ARBAIS 202011045 6/6/2021 13.44 PKM ARBAIS Selesai
11 PILEMON MARBO 45 Thn 9110031202750001 Non medis 202011045 18/02/2021 13.03 PKM ARBAIS 202011045 6/6/2021 13.19 PKM ARBAIS Selesai
12 YASRIANTI LUTA 34 Thn 9110015502870002 202011045 18/02/2021 13.05 PKM ARBAIS 202011045 6/6/2021 13.10 PKM ARBAIS Selesai
13 YUNI SARI DWI 25 Thn 9110015212960001 202011045 18/02/2021 13.39 PKM ARBAIS 202011045 6/6/2021 13.50 PKM ARBAIS Selesai
14 KARTIKA CANDRA DEWI 25 Thn 9110015506950002 202011045 18/02/2021 13.24 PKM ARBAIS 202011045 6/6/2021 11.29 PKM ARBAIS Selesai
15 SITI AMINAH 26 Thn 9111024706940001 202011045 18/02/2021 13.23 PKM ARBAIS 202011045 6/6/2021 11.21 PKM ARBAIS Selesai
16 MEKETISON RUMBRAPUK 33 Thn 9106022710870001 202011045 18/02/2021 14.28 PKM ARBAIS 202011045 6/6/2021 12.23 PKM ARBAIS Selesai
17 BETI LOWISA MAKMAKER 33 Thn 9106036204880001 202011045 18/02/2021 13.30 PKM ARBAIS 202011045 6/6/2021 13.25 PKM ARBAIS Selesai
18 YAKOBUS PARERUNG 30 Thn 7326081812910001 202011045 18/02/2021 13.01 PKM ARBAIS 202011045 6/6/2021 13.27 PKM ARBAIS Selesai
19 ALFIAN F BUINEY 25 Thn 9171010511950001 202011045 18/02/2021 12.45 PKM ARBAIS 202011045 6/6/2021 13.35 PKM ARBAIS Selesai
20 PENINA RACHEL MANIPORA 31 Thn 9110014502900001 202011045 18/02/2021 13.18 PKM ARBAIS 202011045 6/6/2021 13.33 PKM ARBAIS Selesai
21 ELIZAR 25 Thn 9110016610970001 202011045 18/02/2021 13.35 PKM ARBAIS 202011045 6/6/2021 13.38 PKM ARBAIS Selesai
22 SUKO WINARNI 25 Thn 3374124808960001 202011045 18/02/2021 12.51 PKM ARBAIS 202011045 6/6/2021 13.40 PKM ARBAIS Selesai
23 KIKI CHOTIMAH 30 Thn 9110015702910003 202011045 18/02/2021 13.19 PKM ARBAIS 202011045 6/6/2021 13.31 PKM ARBAIS Selesai
24 NURHIKMAHWATI 31 Thn 9110016208900002 202011045 18/02/2021 12.48 PKM ARBAIS 202011045 6/6/2021 13.49 PKM ARBAIS Selesai
25 DENI SANADI 29 Thn 9106011912920001 202011045 18/02/2021 13.16 PKM ARBAIS 202011045 6/6/2021 13.37 PKM ARBAIS Selesai
 No Back Tgl Vaksin Jam Vaksinasi Tempat No Back Tgl Vaksin Jam Vaksinasi Tempat
No Nama Umur Nik Profesi Keterangan
Vaksin Thp I Thp I Vaksinasi Vaksin Thp II Thp II Vaksinasi

26 MARTA IDA YAAS 44 Thn 9110034605770001 202011045 18/02/2021 13.43 PKM ARBAIS 202011045 6/6/2021 13.50 PKM ARBAIS Selesai
27 ERWIN MATASIK 32 Thn 7326021208890001 202011045 18/02/2021 13.46 PKM ARBAIS 202011045 6/6/2021 13.46 PKM ARBAIS Selesai
28 dr.ENDAH PURANINGTYAS 35 Thn 9171034309860005 202011045 12/2/2021 14.00 PKM ARBAIS 202011045 6/6/2021 13.47 PKM ARBAIS Selesai
29 HENOK JEKSON SUNUK 35 Thn 9110031206860001 202011045 18/02/2021 14.03 PKM ARBAIS 202011045 3/11/2021 13.00 PKM ARBAIS Selesai
30 YULIANUS ABIDONDIFU 25 Thn 9110012906970001 202011045 18/02/2021 13.22 PKM ARBAIS 202011045 3/16/2021 14.05 PKM ARBAIS Selesai
31 FRANSINA LATUMAHINA 30 Thn 9110075810910001 202011045 3/6/2021 14.01 PKM ARBAIS 202011045 3/20/2021 11.00 PKM ARBAIS Selesai
32 MINCE KLORICE WATTIMENA 33 Thn 9171056709880004 202011045 3/6/2021 14.03 PKM ARBAIS 202011045 3/20/2021 `11.03 PKM ARBAIS Selesai
33 YUNIKE AWETA 46 Thn 9110014109750002 202011045 3/6/2021 14.11 PKM ARBAIS 202011045 3/20/2021 11.06 PKM ARBAIS Selesai
34 ERIC BETHEL MISSI 43 Thn 9171011110780003 202011045 3/6/2021 14.00 PKM ARBAIS 202011045 3/20/2021 11.09 PKM ARBAIS Selesai
35 ISAK MERNE 42 Thn 9110031608790001 202011045 3/6/2021 14.06 PKM ARBAIS 202011045 3/20/2021 11.12 PKM ARBAIS Selesai
36 EKO BUDI PRASETYO 29 Thn 3510032412920004 202011045 3/6/2021 13.58 PKM ARBAIS 202011045 3/20/2021 11.15 PKM ARBAIS Selesai
36 HELLEN C MALATUNI 30 Thn 9110014505910001 202011045 3/6/2021 14.04 PKM ARBAIS 202011045 3/20/2021 11.18 PKM ARBAIS Selesai
38 NELLA WABRAR 50 Thn 9110034801710001 202011045 3/6/2021 14.09 PKM ARBAIS 202011045 3/20/2021 11.21 PKM ARBAIS Selesai
39 PAULUS KEMBANG 54 Thn 9110010405670001 202011045 3/6/2021 14.13 PKM ARBAIS 202011045 3/20/2021 11.24 PKM ARBAIS Selesai
40 HENGKI MERNE 39 Thn 9110031001820001 202011045 3/6/2021 14.07 PKM ARBAIS 202011045 3/20/2021 11.27 PKM ARBAIS Selesai

Mengetahui Penanggung Jawab Penanggung Jawab

Kepala Puskesmas Sarmi Vaksinator Program Imunisasi Puskesmas Arbais Vaksinator KIPI Puskesmas Arbais

AGUSTINA K BOSEREN,SKM.MM YUNIKE AWETA,S.SiT dr.ENDAH PURANINGTYAS

 PEMERINTAH KABUPATEN SARMI
DINAS KESEHATAN
PUSKESMAS SARMI

No Nama Nakes Nik

O1 O2 O3
1 Agustina K Boseren 9110015909720001
2 Virta Nengsi Pakiding 7318114311910001
3 Widya Fitriani 9171036812890003
4 Yuli Rumawak 9110035405900001
5 Diana Ode 9171025408880001
6 Elisabet Dimara 9106116307920001
7 Vebe Sunuk 9110036107870001
N SARMI

Nomor Hp Keterangan
O4 O5
081240999703 TUNDA
081343736932 TUNDA
082190931879 HAMIL
0 TUNDA
082349704893 HAMIL
082380564029 HAMIL
0 TUNDA

0
 PEMERINTAH KABUPATEN SARMI
DINAS KESEHATAN
PUSKESMAS SARMI

No Nama Nakes
O1 O2
1 Agustina K Boseren
2 Virta Nengsi Pakiding
3 Widya Fitriani
4 Yuli Rumawak
5 Diana Ode
6 Elisabet Dimara
7 Vebe Sunuk
8
9