FORMULIR REKAPITULASI DATA KELUARGA DAN ANGGOTA KELUARGA

PROPINSI : D.I. YOGYAKARTA

KABUPATEN/KOTA :BANTUL
KECAMATAN :SEWON
PUSKESMAS :SEWON 1

II. KETE
NO URUT KODE KK RT Kampung Nama KK 3 4
Y T Y
1 P 1 1 0 0 5 TIMBULHARJO SUTADI 1
1 1 0 0 5 TIMBULHARJO
1 1 0 0 5 TIMBULHARJO
2 P 1 2 0 0 4 TIMBULHARJO AZIZ SHOLIHIN 1 1
1 2 0 0 4 TIMBULHARJO
1 2 0 0 4 TIMBULHARJO
1 2 0 0 4 TIMBULHARJO SURATIMAN 1 1
3 P 1 3 0 0 4 TIMBULHARJO
1 3 0 0 4 TIMBULHARJO
1 3 0 0 4 TIMBULHARJO
4 P 1 4 0 0 4 TIMBULHARJO DWI GIANTORO 1 1
TIMBULHARJO
TIMBULHARJO
TIMBULHARJO
TIMBULHARJO 1 1
5 TIMBULHARJO SAMIJAN
TIMBULHARJO
TIMBULHARJO
TIMBULHARJO 1 1
 TIMBULHARJO
6 p 2 1 0 0 4 TIMBULHARJO ZAKARI 1
TIMBULHARJO 1
TIMBULHARJO
TIMBULHARJO
7 P 2 2 0 0 4 TIMBULHARJO ADI SALMI 1 1
TIMBULHARJO
TIMBULHARJO 1 1
TIMBULHARJO
8 P 2 3 0 0 4 TIMBULHARJO DAROYAH 1
TIMBULHARJO 1 1
TIMBULHARJO
9 P 2 4 0 0 4 TIMBULHARJO NURYADI 1 1
TIMBULHARJO 1 1
TIMBULHARJO
TIMBULHARJO 1 1
10 P 2 5 0 0 4 TIMBULHARJO JUMARI 1 1
TIMBULHARJO
TIMBULHARJO 1 1
TIMBULHARJO
11 P 3 1 0 0 4 TIMBULHARJO BURHAN BAYU KARTIKA 1 1
TIMBULHARJO
TIMBULHARJO
TIMBULHARJO
TIMBULHARJO
TIMBULHARJO
12 P 3 2 0 0 4 TIMBULHARJO HERI KUSNANTO 1
TIMBULHARJO
TIMBULHARJO
TIMBULHARJO
TIMBULHARJO
13 P 3 3 0 0 4 TIMBULHARJO TEDI HARTANTO 1 1
TIMBULHARJO
TIMBULHARJO
14 P 3 4 0 0 4 TIMBULHARJO SUKARDIYONO 1 1
TIMBULHARJO
TIMBULHARJO
15 P 3 5 0 0 4 TIMBULHARJO ROHMAT 1 1
TIMBULHARJO
TIMBULHARJO
TIMBULHARJO
TIMBULHARJO
19 C 2 9 0 0 1 RENDENG WETAN NGATMANTO 1 1
RENDENG WETAN
RENDENG WETAN
20 C 2 10 0 0 1 RENDENG WETAN SURANTA 1 1
RENDENG WETAN
21 C 2 11 0 0 1 RENDENG WETAN GAYUH EKO P 1 1
RENDENG WETAN
21 C 3 1 0 0 1 RENDENG WETAN ROHADI 1
RENDENG WETAN
RENDENG WETAN
RENDENG WETAN
23 C 3 2 0 0 1 RENDENG WETAN PARDI UTOMO 1 1
RENDENG WETAN
24 C 3 3 0 0 1 RENDENG WETAN EKO PRASETYO 1 1
RENDENG WETAN
RENDENG WETAN
RENDENG WETAN
25 C 3 4 0 0 1 RENDENG WETAN DARTIPAWIRO 1 1
RENDENG WETAN
26 C 3 5 0 0 1 RENDENG WETAN ANOM WAHYU NUGROHO 1 1
27 C 3 6 0 0 1 RENDENG WETAN SAMBUDI 1 1
 RENDENG WETAN
RENDENG WETAN
28 C 3 7 0 0 1 RENDENG WETAN RIZAL BAHARUDIN 1 1
RENDENG WETAN
RENDENG WETAN
RENDENG WETAN
29 C 3 8 0 0 1 RENDENG WETAN HARDIYO 1 1
30 C 3 9 0 0 1 RENDENG WETAN WISNU EFENDI 1 1
RENDENG WETAN
RENDENG WETAN
RENDENG WETAN
31 C 3 10 0 0 1 RENDENG WETAN FREDY WIBOWO 1 1
RENDENG WETAN
32 C 3 11 0 0 1 RENDENG WETAN JUWARIYAH 1 1
33 C 3 12 0 0 1 RENDENG WETAN SUHARJO 1 1
RENDENG WETAN
RENDENG WETAN
34 C 3 13 0 0 1 RENDENG WETAN KASWANTO 1 1
RENDENG WETAN
RENDENG WETAN
35 C 3 14 0 0 1 RENDENG WETAN ALIP 1 1
RENDENG WETAN
36 C 4 1 0 0 1 RENDENG WETAN JULI PURNOMO 1 1
0 0 1 RENDENG WETAN
0 0 1 RENDENG WETAN
0 0 1 RENDENG WETAN
0 0 1 RENDENG WETAN
37 C 4 2 0 0 1 RENDENG WETAN BUDI RAHARJO 1 1
0 0 1 RENDENG WETAN
0 0 1 RENDENG WETAN
0 0 1 RENDENG WETAN
38 C 4 3 0 0 1 RENDENG WETAN SUNARYADI 1 1
39 C 4 4 0 0 1 RENDENG WETAN SURYANTO 1 1
0 0 1 RENDENG WETAN
0 0 1 RENDENG WETAN
40 C 4 5 0 0 1 RENDENG WETAN SUNARTO WIDYO 1 1
0 0 1 RENDENG WETAN
41 C 4 6 0 0 1 RENDENG WETAN JEDIK PRAPTOWO 1 1
0 0 1 RENDENG WETAN
0 0 1 RENDENG WETAN
0 0 1 RENDENG WETAN
0 0 1 RENDENG WETAN
41 C 4 7 0 0 1 RENDENG WETAN BAROTO 1 1
0 0 1 RENDENG WETAN
0 0 1 RENDENG WETAN
42 C 4 8 0 0 1 RENDENG WETAN SUGIMIN 1 1
0 0 1 RENDENG WETAN
0 0 1 RENDENG WETAN
0 0 1 RENDENG WETAN
0 0 1 RENDENG WETAN
43 C 4 9 0 0 1 RENDENG WETAN JAROT SUTRANGGONO 1 1
0 0 1 RENDENG WETAN
0 0 1 RENDENG WETAN
44 C 4 10 0 0 1 RENDENG WETAN SAPTA PURNAWAN, SE 1 1
0 0 1 RENDENG WETAN
0 0 1 RENDENG WETAN
45 C 4 11 0 0 1 RENDENG WETAN SUKIMAN 1 1
0 0 1 RENDENG WETAN
0 0 1 RENDENG WETAN
46 C 4 12 0 0 1 RENDENG WETAN AGUNG NUGROHO 1 1
47 C 4 13 0 0 1 RENDENG WETAN HERU TRI 1 1
0 0 1 RENDENG WETAN
0 0 1 RENDENG WETAN
48 C 5 1 0 0 2 RENDENG WETAN SURADI 1 1
 C 5 1 0 0 2 RENDENG WETAN
C 5 1 0 0 2 RENDENG WETAN
49 C 5 2 0 0 2 RENDENG WETAN WAKIDI 1 1
C 5 2 0 0 2 RENDENG WETAN
C 5 2 0 0 2 RENDENG WETAN
C 5 2 0 0 2 RENDENG WETAN
50 C 5 3 0 0 2 RENDENG WETAN MOLYONO 1 1
C 5 3 0 0 2 RENDENG WETAN
C 5 3 0 0 2 RENDENG WETAN
C 5 3 0 0 2 RENDENG WETAN
51 C 5 4 0 0 2 RENDENG WETAN MARJONO 1 1
C 5 4 0 0 2 RENDENG WETAN
C 5 4 0 0 2 RENDENG WETAN
52 C 5 5 0 0 2 RENDENG WETAN MUKIJAN 1 1
C 5 5 0 0 2 RENDENG WETAN
53 C 5 6 0 0 2 RENDENG WETAN SUMARNO 1 1
54 C 5 7 0 0 2 RENDENG WETAN ARIYANTO 1 1
C 5 7 0 0 2 RENDENG WETAN
55 C 5 8 0 0 2 RENDENG WETAN PARYONO 1 1
C 5 8 0 0 2 RENDENG WETAN
56 C 5 9 0 0 2 RENDENG WETAN ACI LESTARI 1 1
57 C 5 10 0 0 2 RENDENG WETAN KASIAH 1 1
C 5 10 0 0 2 RENDENG WETAN
58 C 5 11 0 0 2 RENDENG WETAN KASMAN 1 1
C 5 11 0 0 2 RENDENG WETAN
59 C 5 12 0 0 2 RENDENG WETAN WIJARTO 1 1
C 5 12 0 0 2 RENDENG WETAN
C 5 12 0 0 2 RENDENG WETAN
60 C 5 13 0 0 2 RENDENG WETAN KASIJO 1 1
C 5 13 0 0 2 RENDENG WETAN
C 5 13 0 0 2 RENDENG WETAN
61 C 6 1 0 0 2 RENDENG WETAN CIPTO MUGI RAHARJO/ WALIJO 1 1
6 1 0 0 2 RENDENG WETAN

62 C 6 2 0 0 2 RENDENG WETAN WAGIRI 1 1

2 0 0 2 RENDENG WETAN
2 0 0 2 RENDENG WETAN
2 0 0 2 RENDENG WETAN

63 C 6 3 0 0 2 RENDENG WETAN TAUFIK 1 1

64 C 6 4 0 0 2 RENDENG WETAN SAPTO DIHARJO/ WALIMIN 1 1

65 C 6 5 0 0 2 RENDENG WETAN SUBIYANTO 1 1

66 C 6 6 0 0 2 RENDENG WETAN SUPANDI 1 1

67 C 6 7 0 0 2 RENDENG WETAN WALIJAN 1 1

68 C 6 8 0 0 2 RENDENG WETAN SUGIYANTO 1 1

69 C 6 9 0 0 2 RENDENG WETAN SUMADI 1 1

70 C 6 10 0 0 2 RENDENG WETAN SUPRIYANTO 1 1

71 C 6 11 0 0 2 RENDENG WETAN JAYADI/ JUMIDAH 1 1

72 C 6 12 0 0 2 RENDENG WETAN KURNIASIH 1 1

73 C 7 1 0 0 2 RENDENG WETAN MAKMUN AKHSAN 1 1

RENDENG WETAN
RENDENG WETAN
74 C 7 2 0 0 2 RENDENG WETAN GIMAN 1 1
RENDENG WETAN
75 C 7 3 0 0 2 RENDENG WETAN SAPARDI 1 1
RENDENG WETAN
RENDENG WETAN
RENDENG WETAN
RENDENG WETAN
75 C 7 4 0 0 2 RENDENG WETAN DIMYATI PAIKEM 1 1
76 C 7 5 0 0 2 RENDENG WETAN SUNARTI 1 1
RENDENG WETAN
RENDENG WETAN
77 C 7 6 0 0 2 RENDENG WETAN WIHENI 1 1
RENDENG WETAN
78 C 7 7 0 0 2 RENDENG WETAN BAYU KUSNANDAR 1 1
RENDENG WETAN
RENDENG WETAN
RENDENG WETAN
79 C 7 8 0 0 2 RENDENG WETAN NGATIJEM 1 1
80 C 7 9 0 0 2 RENDENG WETAN ENDRA SUWITO 1 1
RENDENG WETAN
RENDENG WETAN
RENDENG WETAN
81 C 7 10 0 0 2 RENDENG WETAN WAGIRAH SOSCO WIYARJO 1 1
RENDENG WETAN
82 C 7 11 0 0 2 RENDENG WETAN SUDOMO PRANOTO 1 1
83 C 7 12 0 0 2 RENDENG WETAN SUBARDI 1 1
RENDENG WETAN

84 C 8 1 RENDENG WETAN NUR PRIHANTANTO 1 1

RENDENG WETAN
RENDENG WETAN
RENDENG WETAN
RENDENG WETAN
85 C 8 2 RENDENG WETAN TOK SUHARTO 1 1
RENDENG WETAN
RENDENG WETAN
RENDENG WETAN
RENDENG WETAN
C 8 3 RENDENG WETAN SUMIEM 1 1
RENDENG WETAN
C 8 4 RENDENG WETAN SAJILAN 1 1
RENDENG WETAN
RENDENG WETAN
RENDENG WETAN
C 8 5 RENDENG WETAN SUSANTO 1 1
RENDENG WETAN
RENDENG WETAN
RENDENG WETAN
RENDENG WETAN
C 8 6 RENDENG WETAN YACOBUS WISNUJATI 1 1
RENDENG WETAN
RENDENG WETAN
RENDENG WETAN
C 8 7 RENDENG WETAN RINTO SUDARMO SUHIRNO 1 1
RENDENG WETAN
RENDENG WETAN
C 8 8 RENDENG WETAN MUJIMAN 1 1
C 8 9 RENDENG WETAN HERU KURNIADI 1 1
C 8 10 RENDENG WETAN ENDRO ARI PURNOMO 1 1
RENDENG WETAN
RENDENG WETAN
C 8 11 RENDENG WETAN SISWO RAHARJO 1 1

C 9 1 RENDENG WETAN SUMANTO 1 1

RENDENG WETAN
C 9 2 RENDENG WETAN DHEDI SAPUTRA 1 1
RENDENG WETAN
RENDENG WETAN
RENDENG WETAN
RENDENG WETAN
C 9 3 RENDENG WETAN SANTOSO 1 1
RENDENG WETAN
RENDENG WETAN
RENDENG WETAN
C 9 4 RENDENG WETAN SUMARMI 1 1
RENDENG WETAN
RENDENG WETAN
C 9 5 RENDENG WETAN SULISTYO WIDODO 1 1
RENDENG WETAN
RENDENG WETAN
 RENDENG WETAN
RENDENG WETAN
RENDENG WETAN
C 9 6 RENDENG WETAN JAWADI 1 1
RENDENG WETAN
RENDENG WETAN
RENDENG WETAN
RENDENG WETAN
C 9 7 RENDENG WETAN DAMAR APRIYANTO 1 1
RENDENG WETAN
RENDENG WETAN
C 9 8 RENDENG WETAN SUTOMO 1 1
RENDENG WETAN
RENDENG WETAN
RENDENG WETAN
C 9 9 RENDENG WETAN BUDIYANTO 1 1
RENDENG WETAN
RENDENG WETAN
RENDENG WETAN
C 9 10 RENDENG WETAN SANDING UTOYO 1 1

C 9 11 RENDENG WETAN NURYANTO 1 1

C 9 12 RENDENG WETAN AGUNG MUSTOFA 1 1

II. KETE
NO URUT KODE KK RT Kampung Nama KK 3 4
Y T Y
C 10 1 0 0 3 RENDENG WETAN HARYONO 1 1
C 10 2 0 0 3 RENDENG WETAN RUBIDAH 1 1
C 10 3 0 0 3 RENDENG WETAN SUGENG SUDI MANDOYO 1 1

C 10 4 0 0 3 RENDENG WETAN ARI SUSANTO 1 1

C 10 5 0 0 3 RENDENG WETAN SUWONO 1 1

C 10 6 0 0 3 RENDENG WETAN BASUKI 1 1

C 10 7 0 0 3 RENDENG WETAN SUPRIYANTO 1 1

C 10 8 0 0 3 RENDENG WETAN PRIHONO 1 1

II. KETE
RT Kampung Nama KK 3 4
KODE KK Y T Y
C 10 9 0 0 3 RENDENG WETAN ALI MUHTI 1 1
C 10 10 0 0 3 RENDENG WETAN JUMADI 1 1

C 10 11 0 0 3 RENDENG WETAN EKO SUDARMANTO 1 1

C 10 12 0 0 3 RENDENG WETAN MUHAMMAD NURUL ARIFIN 1 1

C 10 13 0 0 3 RENDENG WETAN LANJAR 1 1

C 10 14 0 0 3 RENDENG WETAN PAK SUROTO 1 1

C 10 15 0 0 3 RENDENG WETAN NURYADI 1 1

C 11 1 0 0 3 RENDENG WETAN 1 1
0 0 3 RENDENG WETAN BAIDI
0 0 3 RENDENG WETAN
0 0 3 RENDENG WETAN
0 0 3 RENDENG WETAN
C 11 2 0 0 3 RENDENG WETAN 1 1
SANTOSO

C 11 3 0 0 3 RENDENG WETAN 1 1
 NGADIMAN ADI PAWIRO
C 11 4 0 0 3 RENDENG WETAN 1 1
AGUS INDARTO

C 11 5 0 0 3 RENDENG WETAN 1 1
JUMINGAN
C 11 6 0 0 3 RENDENG WETAN
KARJAN MUGHARJO

C 11 7 0 0 3 RENDENG WETAN 1 1
C 11 8 0 0 3 RENDENG WETAN ASMONO DIGDO WIHARJO 1 1
MUH KHATIM

C 11 9 0 0 3 RENDENG WETAN 1 1
Rr. MUNADHIROH

C 11 10 0 0 3 RENDENG WETAN
SURATNO

C 11 11 0 0 3 RENDENG WETAN 1 1
H. SIHONO
C 11 12 0 0 3 RENDENG WETAN 1 1
MOKH YUNUS

C 11 13 0 0 3 RENDENG WETAN 1 1
TABIN
C 11 14 0 0 3 RENDENG WETAN 1 1
ANDRI WIYANTA

C 11 15 0 0 3 1 1
TORIAWAN HARI PURNOMO

C 11 16 0 0 3 1 1
C 11 17 0 0 3 SLAMET SRI ASTUTI 1 1
KUSNAWADI

C 12 1 0 0 3 RENDENG WETAN 1 1
SUTARYATI
C 12 2 0 0 3 RENDENG WETAN 1 1
TRI SIGIT HARYADI

C 12 3 0 0 3 RENDENG WETAN 1 1
ENDRA SETIYAWAN

C 12 4 0 0 3 RENDENG WETAN 1 1
PARDI

C 12 5 0 0 3 RENDENG WETAN 1 1
TUWANDI

C 12 6 0 0 3 RENDENG WETAN 1 1
HUDAMIR
C 12 7 0 0 3 RENDENG WETAN 1 1
FARIDA. S.E.

C 12 8 0 0 3 RENDENG WETAN 1 1
SUPARTI
C 12 9 0 0 3 RENDENG WETAN 1 1
ZUWANTI
C 12 10 0 0 3 RENDENG WETAN 1 1
MARSINI
C 12 11 0 0 3 RENDENG WETAN 1 1
MUJIRAN
C 13 1 0 0 3 RENDENG WETAN 1 1
JONO

C 13 2 0 0 3 RENDENG WETAN 1 1
JAJANG GUNAWAN

C 13 3 0 0 3 RENDENG WETAN 1 1
C 13 4 0 0 3 RENDENG WETAN MUSKINAH 1 1
SRI SURATI
C 13 5 0 0 3 RENDENG WETAN 1 1
MUHAMMAD ZEN

C 13 6 0 0 3 RENDENG WETAN 1 1
 SUPARMAN
C 13 7 0 0 3 RENDENG WETAN 1 1
R ZUKHRUFUS SURUR

C 13 8 0 0 3 RENDENG WETAN 1 1
SAPTONO

C 13 9 0 0 3 RENDENG WETAN 1 1
AHMAD IKHSAN KHOLIDIN

C 13 10 0 0 3 RENDENG WETAN 1 1
SARJIMAN
C 13 11 0 0 3 RENDENG WETAN 1 1
ZAENAL ARIFIN
C 13 12 0 0 3 RENDENG WETAN 1 1
NUGROHO SANTOSO
C 13 13 0 0 3 RENDENG WETAN 1 1
LIDY SUTANTO

C 13 14 0 0 3 RENDENG WETAN 1 1
GANA ADI WIBOWO
 2 170
170
 II. KETERANGAN KELUARGA
4 5 6 7 8 9
T Y T Y T Y T Y T Y T
2 1 1 2 2

1 1 2 1

1 1 1 1 1

1 1 1 1 1

1 1 1 1 1

1 1 1 1 1
1 1 1 1 1
1 1 1 1 1

1 1 1 1

1 1 1 1 1

1 1 1 1 1
1 1 1 1 1

1 2 1
1 1 1 1 1

1 1 1 1 1
1 1 1

1 1 1 1 1

1 1 1 1

1 1 1 1 1
 1 1 1 1

1 1 1 1

1 1 1 1

1 1 1 1 1

1 1 1 1 1

1 1 1 1 1

1 1 1 1 1 1

1 1 1 1

1 1 1 1 1

1 1 1 1 1

1 1 1 1 1
1 1 1 1 1
1 1 1 1 1

1 1 1 1 1
1 1 1 1 1

1 1 1 1 1

1 1 1 1 1
1 1 1 1 1

1 1 1 1 1

1 1 1 1 1

1 1 1 1 1

1 1 1 1 1

1 1 1 1 1
1 1 1 1 1

1 1 1 1 1

1 1 1 1 1

1 1 1 1 1

1 1 1 1 1

1 1 1 1 1

1 1 1 1 1

1 1 1 1 1

1 1 1 1 1
1 1 1 1 1

1 1 1 1
1 1 1 1

1 1 1 1

1 1 1 1

1 1 1 1

1 1 1 1 1
1 1 1 1

1 1 1 1

1 1 1 1
1 1 1 1

1 1 1 1

1 1 1 1

1 1 1
1 1 1 1

1 1 1 1

1 1 1 1

1 1 1 1

1 1 1 1

1 1 1 1

1 1 1 1

1 1 1 1
1 1 1 1

1 1 1 1

1 1 1 1

1 1 1 1

1 1 1 1

1 1 1 1

1 1 1 1

1 1 1 1
1 1 1 1

1 1 1 1

1 1 1 1

1 1 1 1
1 1 1 1

1 1 1 1

1 1 1 1
1 1 1 1

1 1 1 1 1

1 1 1 1 1

1 1 1 1 1

1 1 1 1 1

1 1 1 1 1
1 1 1 1 1

1 1 1 1 1

1 1 1 1 1
1 1 1 1 1
1 1 1 1 1

1 1 1 1

1 1 1 1

1 1 1 1

1 1 1 1

1 1 1 1

1 1 1 1
 1 1 1 1

1 1 1 1

1 1 1 1

1 1 1 1

1 1 1 1

1 1 1 1
1 1 1 1

II. KETERANGAN KELUARGA

4 5 6 7 8 9
T Y T Y T Y T Y T Y T
1 1 1 1
1 1 1 1
 1 1 1 1

1 1 1 1

1 1 1 1

1 1 1 1

1 1 1 1

1 1 1 1

II. KETERANGAN KELUARGA

4 5 6 7 8 9
T Y T Y T Y T Y T Y T
1 1 1 1
1 1 1 1

1 1 1 1

1 1 1 1

1 1 1 1

1 1 1 1

1 1 1 1

1 1 1 1 1

1 1 1 1 1

1 1 1 1 1
1 1 1 1 1

1 1 1 1 1

1 1 1 1 1
1 1 1 1 1

1 1 1 1 1

1 1 1 1 1

1 1 1 1 1

1 1 1 1 1
1 1 1 1 1

1 1 1 1 1

1 1 1 1 1
1 1 1 1 1

1 1 1 1 1

1 1 1 1 1

1 1 1 1 1

1 1 1 1 1

1 1 1 1 1

1 1 1 1 1
1 1 1 1 1

1 1 1 1

1 1 1 1

1 1 1 1 1

1 1 1 1 1

1 1 1 1 1

1 1 1 1 1

1 1 1 1 1
1 1 1 1 1

1 1 1 1 1

1 1 1 1 1
1 1 1 1 1

1 1 1 1 1

1 1 1 1 1

1 1 1 1 1

1 1 1 1 1

1 1 1 1 1

1 1 1 1 1

1 1 1 1 1
6 171 6 173 1 15 169 17 18 167
90
 Nama Anggota Keluarga Tanggal Lahir Gol Umur Gol Umur
2 Hubungan Keluarga 4 0-11 bln 12-59 bln 6-12 th 13-19
SUTADI KEPALA KELUARGA 1 9 0 5 1 9 7 4
YENI KURNIAWATI ISTRI 2 8 0 9 1 9 8 6
MUHAMAD TEGAR SAPUTRA ANAK 2 8 0 8 2 0 1 8 1
AZIZ SHOLIHIN KEPALA KELUARGA 1 2 0 2 1 9 9 2
ANITA DWI ASTUTI ISTRI 2 2 0 3 1 9 9 7
GHAISKA AMELIA RAHMADHANI ANAK 1 6 0 4 2 0 2 3 1
SURATIMAN KEPALA KELUARGA 1 5 0 7 1 9 7 6
LUTFIYAH ISTRI 1 1 0 1 1 9 8 4
RAKHA MUHAMMAD KAMAL ANAK 2 9 0 5 2 0 0 6 1
SHAHA NURIN ATHAYA ANAK 1 1 0 6 2 0 1 2 1
DWI GIANTORO KEPALA KELUARGA 2 9 0 5 1 9 6 5
ROKHIYANTI ISTRI 1 7 1 1 1 9 7 5
ACHMAD FIKRI RUBIYANTO ORO ANAK 1 3 0 8 2 0 0 6 1
RAISYA FITRIA YASMIN RUBIYANTORO ANAK 3 0 0 6 2 0 1 1 1
ABHITAH MULIAWAN ROISY RUBIYANTOR ANAK 0 7 0 5 2 0 1 4 1
SAMIJAN KEPALA KELUARGA 1 1 0 4 1 9 6 8
DALINAH ISTRI 1 6 1 2 1 9 7 8
MUHAMMAD RIZAL EFENDI ANAK 1 3 0 4 2 0 0 4 1
ULI SARWENDAH LESTARI ANAK 0 3 0 2 2 0 0 8 1
ZAKARI KEPALA KELUARGA 0 7 0 8 1 9 6 2
NGADIEM ISTRI 0 8 1 2 1 9 6 7
SUYUF HARYANTO ANAK 2 6 0 6 2 0 0 2
ARIES SETIAWAN ANAK 1 4 0 6 2 0 4 0
ADI SALMI KEPALA KELUARGA 1 3 0 4 1 9 7 4
TUGIYATMII ISTRI 2 1 0 3 1 9 7 4
GILANG ARDHI SYAPUTRA ANAK 2 9 0 4 2 0 0 1
CAHYO DWI WICAKSONO ANAK 1 3 0 3 2 0 1 1
DAR0YAH KEPALA KELUARGA 2 0 1 2 1 9 9 7
CINDY KHAERANI CUCU 2 5 0 5 2 0 0 4
RAHMAWATI BAHRIYAH FAMILI LAIN 0 8 0 6 2 0 4 0
NURYADI KEPALA KELUARGA 0 2 0 4 1 9 7 0
RIS SURYANINGSIH ISTRI 1 4 0 4 1 9 7 8
RINDI NUR AFNI ANAK 2 2 0 7 2 0 0 0
MUHAMMAD YUDA FIRMANSYAH ANAK 0 7 0 5 2 0 0 5
JUMARI KEPALA KELUARGA 2 4 0 8 1 9 7 1
JUMIATI ISTRI 2 8 0 8 1 9 7 4
DESI RAHMAWATI ANAK 1 6 1 2 2 0 0 4
DEVI RAHMAWATI ANAK 1 6 1 2 2 0 0 4
BURHAN BAYU KARTIKA KEPALA KELUARGA 2 1 1 0 1 9 8 2
NURINDAHPANGASTUTI ISTRI 1 2 0 4 1 9 8 2
ARNEAL RAFLI APRILIANO ANAK 1 2 0 4 2 0 0 7 1
NEILA NUR RATNAMA ANAK 0 9 0 6 2 0 0 9 1
KINETA DEVA NUR AURELIA ANAK 2 1 0 7 2 0 1 0 1
MUHAMMAD NIZAMAPITA A ANAK 0 1 0 5 2 0 1 3 1
HERI KUSNANTO 1 1 4 0 4 1 9 8 4
SEMI LESTARI 2 1 8 0 9 1 9 8 2
SATIYA ADHITIYA PUTRI UTAMI 3 0 2 0 9 2 0 0 5
FACHRY ADHITYA PRATAMA 3 3 1 0 8 2 0 0 8 1
SHAKILA INARA PUTRI 3 1 0 0 3 2 0 0 2
TEDI HARTANTO 1 1 0 0 2 1 9 9 3
IDA MEYKA YANTI 2 2 1 0 5 1 9 9 4
NAYLA AZZAHRA PUTRI HARTANTO 3 3 1 0 5 2 0 2 3 1
SUKARDIYONO 1 0 6 1 0 1 9 7 6
NURUL SHOIMAH 2 1 0 0 8 1 9 7 9
ADE NOER RAHMAN 3 2 5 0 5 2 0 0 7 1
ROMAT 1 0 2 0 2 1 9 7 4
SRI SULASTRI 2 1 4 0 1 1 9 7 0
ARMAN FEBRIAN RAMADANI 3 1 4 1 1 1 9 4 8 1
BUNGA MELANI RAHMASARI 3 1 0 0 2 2 0 0 4 1
3 2 6 0 5 2 0 0 8
NGATMANTO
SUPARMI 2 1 2 0 3 1 9 4 3
SISKA DAMAYANTI 3 2 5 0 1 2 0 4 0
SURANTA 1 3 0 1 0 1 9 4 2
DEVI ANDRIYANI 2 1 8 1 2 1 9 4 5 1
GAYUH EKO P 1 2 1 0 3 1 9 4 3
RENI KARTIKASARI 2 0 9 0 8 1 9 4 3
ROHADI 1 1 2 0 6 1 9 4 3
HARIYANTI 2 0 4 0 1 1 9 4 2
PANDU GALIH EKA R 3 2 2 1 0 2 0 4 5 1
REANDRA DAFIN M 3 1 6 0 8 2 0 4 7 1
PARDI UTOMO 1 3 0 1 2 1 9 4 6
PARJIYEM 2 3 0 1 2 1 9 4 9
EKO PRASETYO 1 0 8 0 4 1 9 4 6
RIZKI MURLIASARI 2 3 1 0 5 1 9 4 0
KARISMA LINTANG Q R 3 0 1 0 9 2 0 4 4 1
KARISMA LANGIT N R 3 0 3 0 3 2 0 4 0 1
DARTI PAWIRO 1 0 4 1 2 1 9 4 3
SARIYAH 2 3 0 1 2 1 9 4 2
ANOM WAHYU NUGROHO 1 1 6 0 6 1 9 4 7
SAMBUDI 1 0 4 0 7 1 9 4 2
SITI SHOLIKHAH 2 1 8 0 6 1 9 4 5
IMAM NUR SAID 3 2 6 1 1 2 0 4 2 1
RIZAL BAHARUDIN 1 0 5 0 6 1 9 4 2
PUJI LESTARI 2 1 8 0 3 1 9 4 1
FAUZIAH NABILA PUTRI BAHARUDIN 3 1 4 0 9 2 0 4 7 1
HAIKAL PUTRA BAHARUDIN 3 2 6 0 6 2 0 4 1 1
HARDIYO 1 2 2 0 7 1 9 4 8
WISNU EFENDI 1 2 1 1 1 1 9 4 4
ADITA RAHMA NINGTYAS 2 2 1 1 1 1 9 4 4
SALMA GHAISANI 3 0 4 0 6 2 0 4 1 1
HILMA NADHIFA GHAISANI 3 2 7 0 2 2 0 4 6 1
FREDY WIBOWO 1 0 8 0 9 1 9 4 2
CANDRA MURTI AGUSTINA 2 1 4 0 8 1 9 4 2
JUWARIYAH 1 1 3 1 2 1 9 4 3
SUHARJO 1 0 9 0 5 1 9 4 3
SUMARYATI 2 0 4 0 7 1 9 4 9
MUNIROTUL HIDAYAH 3 0 8 0 7 2 0 4 2 1
KASWANTO 1 0 8 1 2 1 9 4 7
WARTINEM 2 1 9 0 4 1 9 4 5
ARDIANSYAH RAHARJO 3 1 2 0 1 1 9 4 5
ALIP 1 0 1 0 8 1 9 4 7
MINPARDIYAH 2 0 8 0 3 1 9 4 5
JULI PURNOMO 1 0 8 0 7 1 9 4 3
ARIYANI BEKTI UTAMI 2 2 5 0 2 1 9 4 1
KINANTHI AYUMNA PURNOMO 3 1 7 1 0 2 0 4 2 1
ALISHA KAMALIYA PURNOMO 3 2 5 1 2 2 0 4 7 1
ALGHAISAN PUTRA PURNOMO 3 1 3 1 2 2 0 4 0 1
BUDI RAHARJO 1 3 1 1 2 1 9 4 9
BONIYEM 2 3 0 1 2 1 9 4 4
SLAMET WIJAYANTO 3 1 6 0 6 1 9 4 3
VERRY SETIAWAN 3 0 7 1 0 2 0 4 1
SUNARYADI 1 0 8 1 2 1 9 4 8
SURYANTO 1 0 4 0 1 2 9 4 0
DIYAH DWI ARIAWATI 2 1 1 1 1 1 9 4 5
YAZUKI RIZQI M.A 3 0 2 0 4 2 0 4 6 1
SUNARTO WIDYO 1 2 4 0 4 1 9 4 6
ERLIN KARYANINGSIH 3 9 1 0 5 1 9 4 5
JEDIK PRAPTOWO 1 1 5 1 2 1 9 4 6
NUR JAMILAH K. 2 2 5 1 2 1 9 4 2
DESDILA INTAN T.S 3 1 0 1 2 2 0 4 3 1
MUHAMMAD KEVIN T.H 3 0 1 1 2 2 0 4 9 1
M. KENZIE A.R 3 1 4 0 1 2 0 4 4 1
BAROTO 1 0 7 0 6 1 9 4 5
SUKINEM 2 1 1 0 5 1 9 4 0
RAHMAD DANI HIDAYAT 3 0 1 1 0 2 0 4 3 1
SUGIMIN 1 0 4 1 1 1 9 4 1
SRI ASTUTI 2 0 5 0 9 1 9 4 9
NDARU SETIAWAN 3 0 2 0 4 2 0 4 2
PUPUT WULANDARI 3 0 2 0 8 2 0 4 4 1
RAMADIKA RIZKI 3 0 2 0 9 2 0 4 8 1
JAROT SUTRANGGONO 1 0 2 1 1 1 9 4 0
ALFIANI JATININGSIH 3 0 2 0 7 1 9 4 9
MUHAMMAD ADHIYATMOKO 3 0 0 5 2 0 4 2
SAPTA PURNAWAN 1 0 6 1 2 1 9 4 5
ANIK KURNIAWATI 2 2 0 0 4 1 9 4 6
QAILA ANANTA K. 3 0 6 0 7 2 0 4 4 1
SUKIMAN 1 1 9 0 7 1 9 4 1
KARTINAH 2 1 8 0 9 1 9 4 6
DITO FIRMANSYAH 3 2 5 0 1 2 0 4 6 1
AGUNG NUGROHO 1 3 1 1 2 1 9 4 7
HERU TRI S. 1 1 1 0 4 1 9 4 3
DWI BUDI A.S 2 2 0 0 4 1 9 4 0
DENO ARZIKI P. 3 0 4 0 4 2 0 4 8 1
SURADI KEPALA KELUARGA 2 8 1 1 1 9 4 4
NGATINEM ITSRI 3 1 1 2 1 9 4 5
UMI NUR KHASANAH ANAK 2 7 0 7 2 0 4 0
WAKIDI KEPALA KELUARGA 1 2 1 1 1 9 4 7
WAGILAH ISTRI 3 0 1 2 1 9 4 3
NURIANTO ANAK 0 5 0 8 1 9 4 7
FAJAR KURNIATI ANAK 2 5 1 2 1 9 4 9
MOLYONO KEPALA KELUARGA 0 3 1 1 1 9 4 3
YULI LESTARI ISTRI 2 8 0 7 1 9 4 8
MUHAMAD ZIDAN PUTRA PRATAMA ANAK 0 1 0 7 2 0 4 0 1
QUEENSHA USWATUN KHASANAH ANAK 3 0 0 8 2 0 4 2 1
MARJONO KEPALA KELUARGA 1 8 1 2 1 9 4 9
DENOK SRI RAHAYU ISTRI 0 1 0 9 1 9 4 9
MUHAMMAD RAMZI PUTRA DHEQO ANAK 2 6 0 3 2 0 4 5 1
MUKIJAN KEPALA KELUARGA 1 1 1 1 1 9 4 8
SAINEM ISTRI 3 0 1 1 1 9 4 4
SUMARNO KEPALA KELUARGA 0 3 0 7 1 9 4 8
ARIYANTO KEPALA KELUARGA 2 2 0 4 1 9 4 8
FAIZAH HUSNA NURILYA ISTRI 0 6 1 1 1 9 4 9
PARYONO KEPALA KELUARGA 0 3 1 2 1 9 4 4
SRI WAHYU WIDARTI ISTRI 2 9 0 9 1 9 4 3
ACI LESTARI KEPALA KELUARGA 0 5 0 4 1 9 4 4
KASIAH KEPALA KELUARGA 1 5 1 0 1 9 4 7
AN NURIL MUBIN PRATAMA ANAK 1 2 1 2 2 0 4 8 1
KASMAN KEPALA KELUARGA 2 7 0 4 1 9 4 9
SENEN ISTRI 1 0 1 0 1 9 4 6
WIJARTO KEPALA KELUARGA 0 8 0 6 1 9 4 0
YURIYAH ISTRI 0 8 1 2 1 9 4 8
HAFIZH FAHMI ADITYA ANAK 2 2 0 3 2 0 4 2 1
KASIJO KEPALA KELUARGA 3 1 1 2 1 9 4 3
SUMARSIH ISTRI 0 6 0 6 1 9 4 8
EKO RIYANTO ANAK 1 4 0 1 1 9 4 8
CIPTO MUGI RAHARJP/ WALIJO 1 3 1 1 2 1 9 4 9
BIYEM 2 3 1 1 2 1 9 4 3

WAGIRI 1 1 8 0 7 1 9 7 5
SUPARYANTI 2 2 1 0 3 1 9 7 5
PRAMUDYA SATYAGRAHA 3 1 0 0 4 2 0 0 8 1
MUHAMMAD MUSHAB ALKASAH 3 2 1 0 1 2 0 1 5 1

TAUFIK 1 3 1 1 1 1 9 7 2
SUPARTINI 2 0 6 0 1 1 9 8 1

SAPTO DIHARJO/ WALIMIN 1 3 1 1 2 1 9 5 6

SUBIRAH 2 3 0 1 2 1 9 6 1
HERI TRISWANTO 3 2 5 1 1 1 9 8 2

SUBIYANTO 1 0 2 1 2 1 9 8 0
MEI UIS TANTI 2 0 5 0 5 1 9 8 6
MUHAMMAD MIFTAKHUL HAUWAFA 3 2 0 0 4 2 0 1 1 1
MUHAMMAD AKBAR ALFARUK 3 2 3 0 5 2 0 1 7 1

SUPANDI 1 0 4 0 2 1 9 9 1
DAMARYANTI 2 1 8 0 8 1 9 9 6
KEANU ALVERO 3 2 6 0 4 2 0 1 8 1
GHAZAAL TAKBIR 3 1 2 0 5 2 0 2 1 1

SISWO WIYONO/ WALIJAN 1 1 5 0 9 1 9 5 4

WAGINEM 2 3 0 1 2 1 9 6 1

SUGIYANTO 1 2 6 0 7 1 9 7 4
DWI MARYATI 2 2 1 0 3 1 9 8 5
ADIZA NANDA HAPSARI 3 1 7 1 0 2 0 0 5 1
ANINDYA DINDA HAPSARI 3 2 3 0 9 2 0 1 7 1
SUMADI PURWANTO/ SUMADI 1 1 7 0 8 1 9 5 3
SUPIMAH 2 3 1 1 2 1 9 5 5
SUPRIYANTO 1 0 9 0 5 1 9 7 8
HENI KUSMIYATI 2 0 7 0 9 1 9 8 0
KHAYLA ZAHIRA NUR HASNA 3 2 1 0 8 2 0 1 5 1
JAYADI 1 3 1 1 2 1 9 5 9
JUMIDAH 2 3 0 1 0 1 9 6 4
ANAS KHOIRUDIN 3 0 4 1 0 2 0 0 3 1
KURNIASIH 1 1 3 0 9 1 9 8 0
ILHAM SYAH PANGARIBOWO 2 2 1 1 0 2 0 0 2
BINTANG NOER PANGARIBOWO 3 1 2 0 9 2 0 1 2 1
MAKMUN AKHSAN 1 0 3 0 8 1 9 8 1
NURUL SUCIATI 2 3 0 1 2 1 9 9 5
SARAH ALFATHUNNISA RAFIFAH 3 0 8 0 9 2 0 2 0 1
GIMAN 1 1 9 1 0 1 9 5 2
SITI ROHAYAH 2 0 6 0 9 1 9 5 6
SAPARDI 1 2 7 0 4 1 9 7 0
SITI KHAMIMAH 2 1 6 0 6 1 9 7 5
RIGEN MANDEGANI 3 0 4 0 3 2 0 0 0
MUHAMMAD AIDAN KHAIRULLOH 3 3 1 0 8 2 0 1 1 1
MUHAMMAD ARBA GANSHI 3 1 6 0 9 2 0 1 7 1
DIMYATI PAIKEM 1 3 1 1 2 1 9 4 7
SUNARTI 1 1 5 1 1 1 9 5 9
SARIYANTO 3 0 3 0 5 1 9 9 4
MUHAMMAD ISKAK 3 2 8 1 1 1 9 9 6
WIHENI 1 2 9 0 9 1 9 8 1
REVITA RIMA PERMATA 3 0 1 0 6 2 0 0 4 1
BAYU KUSNANDAR 1 2 7 1 2 1 9 8 3
FITRIA NURJANAH 2 1 0 0 6 1 9 8 6
BANU RESTU AJI 3 0 9 0 7 2 0 0 8 1
YUFI NARYAMA HANIF 3 0 1 0 4 2 0 1 2 1
NGATIJEM 1 1 5 0 2 1 9 6 2
ENDRA SUWITO 1 1 7 0 3 1 9 8 6
RETNO SUDARSIH 2 1 5 0 1 1 9 8 7
ANINDYA GARDA KIRANA 3 1 4 0 3 2 0 1 2 1
NIZAM GARDA RAFIF 3 2 4 0 5 2 0 1 7 1
WAGIRAH SOSCO WIYARJO 1 3 1 1 2 1 9 4 4
SUMIASIH 3 0 5 0 7 1 9 7 6
SUDOMO PRANOTO 1 2 8 1 2 1 9 4 6
SUBARDI 1 1 2 0 9 1 9 6 1
WARSIATI 2 0 5 0 2 1 9 7 0

2 13 22 29
NUR PRIHANTANTO 1 2 1 0 4 1 9 7 5
YUNIARWARDANI 2 1 1 1 1 1 9 7 3
ZAHID NUR A 3 2 8 0 9 1 9 9 7
HUSNA NUR A 3 0 3 0 4 2 0 0 1
TSAIQ NUR K 3 2 1 0 2 2 0 0 6 1
TOK SUHARTO 1 0 1 0 3 1 9 6 2
NGATININGSIH 2 2 6 0 2 1 9 6 7
DOMINICUS ALFERDO 3 2 3 0 6 2 0 0 3
MARIA REGINA NADILA 3 1 3 0 7 2 0 0 5 1
THERESIA AYUNANI CHRISTY 3 1 7 0 3 2 0 0 7 1
SUMIYEM 1 2 4 2 4 1 9 6 8
AVIVA FEBRIANA RIESMITA 3 2 6 0 2 2 0 0 9 1
SAJILAN 1 0 2 0 2 1 9 7 3
KASTURI 2 1 6 0 5 1 9 6 8
ARIF RANDU MUSTOFA 3 1 6 0 5 1 9 9 8
DIKNIA AISYAH 3 3 1 0 3 2 0 0 2
SUSANTO 1 2 5 0 6 1 9 7 8
ISTI NURYANI 2 1 5 0 2 1 9 8 2
AQSA ILHAM ABDALLAH 3 1 4 1 2 2 0 0 3
QEUZAL DAMON AGATHA 3 0 9 0 2 2 0 0 9 1
NAJWA ALMIRA ATABINA 3 2 8 0 8 2 0 1 8 1 1
YACOBUS WISNUJATI 1 1 9 0 5 1 9 7 9
DWI WIJAYANTI 2 1 1 1 0 1 9 8 4
AGATHA AINA PUTRI 3 0 8 0 9 2 0 1 2 1
YOHANES ELVANO 3 3 1 1 0 2 0 2 0 1
RONTO SUDARMO SUHIRNO 1 2 5 0 7 1 9 6 0
SUPRIHATIN 2 1 3 1 2 1 9 6 4
BEKTI ISKANDAR 3 0 8 1 2 1 9 9 0
MUJIMAN 1 1 5 1 1 1 9 5 3
HERI KURNIADI 1 1 1 0 5 1 9 7 4
ENDRO ARI PURNOMO 1 2 1 0 5 1 9 8 3 1
VIVI WIJAYANTI 2 1 9 0 8 1 8 9 1 1
BILAR ARVIND FATIH 3 2 8 0 6 2 0 1 8 1
SISWA RAHARDJO 1 3 1 1 2 1 9 5 2
JUMIDAH 2 3 1 1 2 1 2 5 3
HARJONO 3 1 2 0 4 1 9 8 1
SUMANTO 1 3 1 1 2 1 9 6 1
WIYATI 2 0 7 0 9 1 9 6 4
DHEDI SAPUTRA 1 0 9 1 2 1 9 9 1
RATIH RETNOSARI 2 1 7 0 4 1 9 9 2
AISYAH AYUDIA 3 2 2 0 8 2 0 1 4 1
ARKANA ADHYATSA 3 1 9 1 1 2 0 1 7 1
DIANDRA ZIVANA A 3 0 3 1 1 2 0 2 2 1
SANTOSO 1 0 2 0 9 1 9 7 1
TUGIYANI 2 0 7 0 2 1 9 7 2
ARIF PRASETYO 3 2 8 0 6 1 9 9 9
WAHYU DWI P 3 0 4 1 1 2 0 0 5 1
SUMARMI 1 1 1 0 6 1 9 6 8
EKO PRASETYO 3 0 8 0 4 1 9 9 6
ZAHRA ARIFAH 3 2 7 0 6 2 0 0 3
SULISTYO WIDODO 1 2 3 0 2 1 9 8 6
PURWANINGSIH 2 1 7 0 9 1 9 8 8
LA TAHZAN BAILEYS 3 2 0 1 2 2 0 0 9 1
WISANGGENI ABIL 3 0 3 0 8 2 0 1 2 1
ALICE CAHYANING W 3 1
JENJEM 6 1 2 0 4 1 9 5 4
JAWADI 1 1 4 0 8 1 9 8 2
DARWATI 2 2 4 1 2 1 9 7 9
DAFFA AGUNG A 3 2 7 1 1 2 0 0 4 1
SHAFA NAJWA 3 2 7 0 9 2 0 0 6 1
INDRI PUSPITA SARI 3 0 8 0 5 2 0 1 4 1
DAMAR APRIYANTO 1 1 8 0 4 1 9 8 8
RICHA DWI MAROCCANA 2 1 1 0 1 1 9 8 9
KATHAN AHMAD A 3 0 8 0 8 2 0 1 8 1
SUTOMO 1 1 0 0 7 1 9 7 5
PURWANTININGSIH 2 2 1 1 1 1 9 8 7
ANDREAS FIRMAN 3 2 1 1 1 2 0 0 8 1
SORAYA EVARINA 3 2 7 1 1 2 0 1 1 1
BUDIYANTO 1 1 0 0 1 1 9 8 8
AL ROSITA 2 2 8 0 4 1 9 9 3
BELLA MAHARANI 2 1 5 0 2 2 0 1 1 1
LAILY AFRIRIYA M 2 0 9 0 4 2 0 1 8 1
SANDING UTOYO 1 1 4 0 2 1 9 7 6
YUNIARI NUR CAHYA 2 1 4 0 6 1 9 8 3
RAKA ARYA D 3 1 7 0 7 2 0 0 3 1
AKHTIAR NUR F 3 2 1 0 6 2 0 1 2 1
NURYANTO 1 0 1 0 1 1 9 7 3
AGUNG MUSTOFA 1 0 8 0 9 1 9 8 5

Nama Anggota Keluarga Tanggal Lahir Gol Umur Gol Umur

2 Hubungan Keluarga 4 0-11 bln 12-59 bln 6-12 th 13-19
HARYONO 1 2 6 0 6 1 9 7 4
RUBIDAH 1 3 0 1 2 1 9 4 7
KUSRINI 3 2 2 1 1 1 9 7 2
ARIS KUSWANTO 3 0 4 1 0 1 9 7 6
KUSNAWADI 3 2 0 0 6 1 9 7 6
SUGENG SUDI MANDOYO 1 1 1 1 1 1 9 5 8
JUMIDAH 2 2 5 1 2 1 9 6 3
KOKOH ISDINNTO 3 0 7 0 8 1 9 9 4
ARI SUSANTO 1 1 6 0 5 1 9 8 4
EMI MARYANI 2 1 5 0 5 1 9 9 2
EVA VARANISA AZIZAH 3 1 6 0 2 2 0 1 5 1
SUWONO 1 3 1 1 2 1 9 6 9
NURIYAH 2 1 8 0 4 1 9 7 3
ACHMAD ANWAR 3 0 1 0 9 1 9 9 8
BASUKI 1 1 9 1 2 1 9 6 3
DJAP SUSAN 2 1 3 0 4 1 9 7 1
SUPRIYANTO 1 2 4 1 0 1 9 8 3
SUWARNI 2 1 4 0 8 1 9 8 0
GHAZY ZAHFRAN ARROYAN 3 1 5 0 9 2 0 0 8 1
AISYAH AZZAHRA FIRDAUS 3 0 1 0 3 2 0 1 0 1
PRIHOHO 1 3 0 1 0 1 9 6 7
MARKINAH 2 2 6 0 6 1 9 7 3
SYARIF PRAYUDA HIDAYATULLAH 2 1 0 0 9 1 9 9 5
ALYA KHOIRUN NISA 3 0 6 0 2 2 0 0 4 1
RAMINEM 9 1 0 1 2 1 9 5 3
ELVARA ASNA AFIFANO 3 0 6 0 4 2 0 0 9 1

Nama Anggota Keluarga Tanggal Lahir Gol Umur Gol Umur

2 Hubungan Keluarga 4 0-11 bln 12-59 bln 6-12 th 13-19
ALI MUHTI 1 1 7 1 1 1 9 8 2
BUNISA 2 1 2 0 6 1 9 8 4
MUHAMMAD SAHRONI 3 1 5 0 9 2 0 0 6 1
ABDURROHIM 3 1 9 0 8 2 0 0 9 1
JUMADI 1 1 3 0 4 1 9 6 3
ROHDIYAH 2 2 5 1 2 1 9 6 4
RIZA AGUSTINI 3 2 6 0 8 1 9 9 2
WAGIYEM 6 3 0 1 2 1 9 4 6
EKO SUDARMANTO 1 0 6 0 1 1 9 7 5
YUNIATI 2 0 4 0 6 1 9 8 4
DHIMAS KURNIAWAN 3 2 1 0 6 2 0 0 5 1
GEBY DHEA ANGGRAINI 3 0 9 0 6 2 0 1 1 1
MUHAMMAD NURUL ARIFIN 1 1 7 1 2 1 9 9 4
RINTA SANUSI 2 2 4 0 4 1 9 9 3
ADIVA FARZANA AYUNDYA ARIFIN 3 0 3 0 1 2 0 1 5 1
JUMANA 2 3 0 1 2 1 9 6 3
ANI LESTARI 3 1 8 0 9 1 9 9 8
SUROTO 1 0 1 0 5 1 9 6 4
SUSI ANGGOROWATI 2 1 6 0 7 1 9 6 8
NURYADI 1 1 7 0 7 1 9 6 8
T. ISNI WIJAYANTI 2 0 3 0 9 1 9 6 9
DANIELSA SORAYA WAHYU SAPUTRI 3 1 6 0 3 2 0 0 4 1

BAIDI 1 0 5 0 7 1 9 7 0
JUWARIYAH 2 1 9 0 4 1 9 7 0
ROCHMAT HIDAYAT 3 1 3 0 5 1 9 9 4
IFTAH FARIHAH 3 1 2 0 1 2 0 0 3
ALIYAH 7 1 0 0 6 1 9 4 0
SANTOSO 1 1 1 0 1 1 9 6 2
ERNA OKTAVIANI 2 2 6 1 0 1 9 8 6
ALKHANSA MINNAHUSSANIYYAH 3 0 2 1 0 2 0 0 7 1
MUHAMMAD DZIBAN AL GHOZI 3 0 9 0 2 2 0 1 1 1
SAYYAAF MUAMMAR MUSA 3 2 7 0 3 2 0 1 8 1
NGADIMAN ADI PAWIRO 1 3 0 1 2 1 9 4 2
TUKIRAH 2 3 0 1 2 1 9 4 8
AGUS INDARTO 1 2 5 0 7 1 9 7 7
PARINTEN 2 1 6 0 1 1 9 7 7
AMRINA ROSADA 3 2 3 0 5 2 0 1 3 1
JUMINGAN 1 1 5 0 5 1 9 4 5
TUKINAH 2 3 0 1 2 1 9 5 4
KARJAN MUGHARJO 1 3 0 1 2 1 9 5 8
PONIJAH 2 3 0 1 2 1 9 6 0
GALUH PAMUMPUT 3 2 8 0 8 2 0 0 1
ASMONO DIGDO WIHARJO 1 0 2 0 2 1 9 3 0
MUH KHATIM 1 1 7 0 6 1 9 7 0
RR. ZAHROTIN 2 3 0 0 3 1 9 7 1
AKHMAD ILYAS FIRMANSYAH 3 2 2 1 2 2 0 0 4 1
MUHAMMAD NUR FAJRIANSYAH 3 1 2 0 2 2 0 1 0 1
Rr. MUNADHIROH 1 2 8 0 4 1 9 6 3
R. ZUKHRUFUS SURUR 3 1 2 0 8 1 9 9 1
DIWAN HILIZA YAHYA 3 1 2 0 6 1 9 9 8
MUHAMMAD MUSTHOFA 3 1 0 1 1 1 9 9 4
SURATNO 1 0 2 0 1 1 9 7 7
FATMIYATUN 2 0 4 0 6 1 9 7 8
SITI NUR AISYAH 3 1 6 0 3 2 0 0 4 1
NURUL LATHIFAH 3 2 0 0 4 2 0 1 4 1
H. SIHONO 1 3 0 1 2 1 9 4 0
SUKIJEM 2 3 0 1 2 1 9 4 8
MOKH YUNUS 1 0 9 0 4 1 9 7 4
CHOLISHOTUL ARIYATI 2 0 4 0 6 1 9 8 1
MUHAMMAD RAIHAN YASIN ROMADHON 3 1 9 1 1 2 0 0 3 1
FATIMAH NISA UZZAHRA 3 2 9 0 9 2 0 1 6 1
TABIN 1 2 7 1 2 1 9 8 4
FATMA WIDYA KANAKA 2 2 4 0 6 1 9 8 4
MUHAMMAD AZAM I 3 3 1 0 3 2 0 1 1 1
MUHAMMAD YASIR F 3 2 6 0 1 2 0 1 6 1
ALMIR SHANUUMKHAZANAH 3 0 7 0 3 2 0 1 7 1
ANDRI WIYANTA 1 0 9 0 3 1 9 8 6
DEWITA 2 0 4 1 2 1 9 8 9
ANDRITA KEYLLA ARELIE 3 2 1 0 9 2 0 1 1 1
KENZO YUSUFFA BLEZANDRIO 3 0 5 0 4 2 0 1 7 1
TORIAWAN HARI PURNOMO 1 1 7 1 0 1 9 8 3
HERNI NURHAYATI 2 0 5 0 4 1 9 8 2
NAJWA DENTA AULIA 3 1 8 1 0 2 0 1 0 1
SLAMET SRI ASTUTI 1 1 0 0 7 1 9 7 3
KUSNAWADI 1 2 0 0 6 1 9 8 3
ARI SETIA WANDARI 2 1 5 0 9 1 9 8 6
DARREL CLEARESTA ADELARD 3 1 5 0 7 2 0 1 0 1
MUHAMMAD WILDAN NARENDRA 3 2 1 0 8 2 0 1 6 1
SUTARYATI 1 3 0 1 2 1 9 5 0
MARSITO 3 3 0 1 2 1 9 7 8
TRI SIGIT HARYADI 1 0 7 0 8 1 9 8 2
RIYANI 2 1 2 0 1 1 9 8 6
ANGGUN PUTRI PRATAMA 3 1 4 0 6 2 0 0 7 1
BRIAN FIRMANSYAH HARIYADI 3 2 2 0 8 2 0 1 7 1
ENDRA SETIYAWAN 1 1 3 0 1 1 9 8 9
YUANAWATI 2 2 0 0 4 1 9 9 1
SALMA APRILIA MAHARANI 3 2 6 0 4 2 0 1 1 1
SATRIA ARSENIO OKTAVIAN 3 0 5 1 0 2 0 1 6 1
PARDI 1 3 0 1 2 1 9 6 2
MARINEM 2 3 0 1 2 1 9 6 3
YOGA TRI WIBOWO 3 1 2 0 4 2 0 0 5 1
TUWANDI 1 0 7 0 4 1 9 6 3
LESTARI 2 2 4 1 2 1 9 6 8
HALLA PRATIWI 3 1 5 0 9 1 9 9 1
FAIZ ROZIKIN 3 2 0 0 8 1 9 9 8
HUDAMIR ROBIKIM 1 0 5 0 4 1 9 7 1
NANI INDYASTUTI 2 1 3 0 9 1 9 7 6
ARBAIN MUFLIHAH 3 2 1 0 9 2 0 0 0
KHOIRUN NISA 3 2 0 0 4 2 0 0 9 1
FARIDA. S.E. 1 1 7 0 5 1 9 7 2
SRI SUPRIHATINI. S.P 2 1 6 1 0 1 9 7 5
FARHAN ABDURAHMAN FARID 3 0 9 0 8 2 0 0 4 1
FANEZIA AYUNDANI PUTRI FARID 3 1 1 0 6 2 0 0 9 1
MAULANA MAGHRIBI FARID 3 0 3 0 5 2 0 1 2 1
SUPARTI 1 3 0 1 2 1 9 5 8
YUWANTO 3 2 4 0 7 1 9 8 4
ZUWANTI 1 0 6 1 1 1 9 8 7
AHMAD MUSHOFA HAFIANTO 3 1 3 0 2 2 0 1 3 1
MARSINI 1 0 4 0 7 1 9 6 5
ISNANDARI INDRIA FAJRIN 3 2 0 1 0 2 0 0 0
MUJIRAN 1 0 8 1 1 1 9 6 2
SURTI 2 1 1 0 6 1 9 6 5
JONO 1 1 0 0 8 1 9 7 2
ROHANI 2 2 3 1 0 1 9 7 5
AL IHZZA JIHAN R 3 2 7 0 1 1 9 9 9
AL CHAREVA JEHAN 3 2 1 1 2 2 0 0 8 1
JAJANG GUNAWAN 1 2 1 0 3 1 9 8 4
SUDARINI 2 0 4 0 4 1 9 8 8
RIFKI ADITYA GUNAWAN 3 1 1 1 2 2 0 1 0 1
ADNAN ZIKRI GUNAWAN 3 2 7 0 5 2 0 1 3 1
MUSKINAH 1 0 1 1 1 1 9 6 1
SRI SURATI 1 2 0 0 8 1 9 8 5
ANISA 3 2 0 1 1 1 9 9 4
MUHAMMAD ZEN 1 1 5 1 1 1 9 7 6
SRI NURSANTI 2 0 7 0 8 1 9 8 3
AHMAD MAHA SIN ZAIN 3 2 4 1 1 2 0 0 5 1
NURUL IZZA 3 2 0 0 3 2 0 0 7 1
ZAKI ZAINI AHSAN 3 2 5 0 7 2 0 1 2 1
SUPARMAN 1 1 7 0 2 1 9 7 7
TRI KARYATUN 2 2 6 0 3 1 9 7 2
R ZUKHRUFUS SURUR 1 1 2 0 8 1 9 9 1
PENI PRATIWI 2 2 4 1 1 1 9 9 3
KANEISHA SYIFA AULIA 3 1 3 0 2 2 0 1 9 1
SAPTONO 1 1 7 0 7 1 9 7 7
KUN AMINATUN 2 0 1 0 9 1 9 7 4
MIFTACHUL ZAKIAH 3 0 5 0 4 2 0 0 5 1
DZAKIRA DZATIL 3 1 7 0 2 2 0 1 5 1
AHMAD IKHSAN 1 2 9 1 2 1 9 9 1
MASLAHAH 2 1 3 1 1 1 9 9 2
MU'AYYDATUL 3 1 3 0 6 2 0 1 8 1
NAQIYUL KHUTH 3 0 2 0 2 2 0 2 2 1
SARJIMAN TRISNA 1 1 0 0 7 1 9 5 9
MUDJIASIH 2 0 6 0 2 1 9 5 7
ZAENAL ARIFIN 1 2 1 1 2 1 9 8 0
MURNIATI 2 0 7 0 2 1 9 8 0
NUGROHO SANTOSO 1 2 4 0 6 1 9 9 1
VINA M 2 1 4 0 5 1 9 9 4
LIDY SUTANTO 1 2 2 1 2 1 9 6 7
JUMIRAH 2 1 2 1 1 1 9 6 4
FRIDIAN LIDY NOVIANTO 3 0 6 1 1 1 9 9 2
FARMASIRIANA DELITANTIAS 3 2 2 1 2 1 9 9 7
GANA ADI WIBOWO 1 0 1 0 9 1 9 8 0
DWI MARTINI 2 2 6 1 0 1 9 8 6
CAHYADEWI ARUNDAYA W 3 1 9 0 9 2 0 0 8 1
MARSEKAL PRATAMA W 3 0 1 0 3 2 0 1 0 1

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Gol Umur Usia produktif / tidak produktif 6 (JK) 7 (Status Perkawinan) Hamil (wanita) 9 (AGAMA) 10 (PENDIDIKAN
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35 40

Gol Umur Usia produktif / tidak produktif 6 (JK) 7 (Status Perkawinan) Hamil (wanita) 9 (AGAMA) 10 (PENDIDIKAN
20-59 th ≥60 th 15-64 th <15 th & >64 th L P 1 2 3 4 Ya Tdk 1 2 3 4 5 6 1 2
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Gol Umur Usia produktif / tidak produktif 6 (JK) 7 (Status Perkawinan) Hamil (wanita) 9 (AGAMA) 10 (PENDIDIKAN
20-59 th ≥60 th 15-64 th <15 th & >64 th L P 1 2 3 4 Ya Tdk 1 2 3 4 5 6 1 2
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 B. GANGGUAN KESEHAT
10 (PENDIDIKAN) 11 (KERJAAN) 1 2 3 4 5 6 7 8 9
3 4 5 6 7 1 2 3 4 5 6 7 8 9 Y T Y T Y T Y T Y T Y T Y T Y T Y
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53 47 113 15 18 59 62 16 35 44 7 0 69 24
B. GANGGUAN KESEHAT
10 (PENDIDIKAN) 11 (KERJAAN) 1 2 3 4 5 6 7 8 9
3 4 5 6 7 1 2 3 4 5 6 7 8 9 Y T Y T Y T Y T Y T Y T Y T Y T Y
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B. GANGGUAN KESEHAT
10 (PENDIDIKAN) 11 (KERJAAN) 1 2 3 4 5 6 7 8 9
3 4 5 6 7 1 2 3 4 5 6 7 8 9 Y T Y T Y T Y T Y T Y T Y T Y T Y
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1 1 1 1 1 1 1 1 1
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1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1
 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1
 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1
154 126 286 55 62 152 165 47 107 123 33 15 176 73 422 30 128 329 452 8 459 3 15 463 12 258 14 438 25 455 24
B. GANGGUAN KESEHATAN
9 10 11 12 13 14 15 CATATAN
T Y T Sistolik Diastolik Y T Y T Y T Y T Y T
2 1 1 2 0 0 7 0
2 1 1 1 0 0 8 0 1 1
2 1 1
2 1
2 1 1 1 0 0 7 0 1 1 1 1 1
2 1
1 1 1 0 0 0 8 0
1 1 1 2 0 0 7 0 1
1 1
1 1 1
1 1 1 5 0 0 8 0
1 1 1
1 1
1 1
1 1
1 1 1 3 0 0 8 0 1
1 1
1 1 1
1 1
1 1 1
1 1 2 5 0 8 5 1 1
1 1 1 1
1 1 1 1
1 1 1 1
1 1
1 1 1
1 1 2 0 0 9 0 1
1 1 1
1 1 1
1 1 1
1 1 3 0 0 8 0 1
1 1
1 1

1 1
1 1 3 0 0 9 0 1
1 1
1 1
1 1
1 1 3 0 0 8 0 1 1

1 2 0 0 0 8 0 1
1
1 1 1
1 1
1 1
 1 1 3 5 0 8 0 1 1 1 1

1 1 1

1
1

1 1
1 1 1
1 1 1
1 1
1 1
1 1 1
1 1
1 1 1
1 1
1
1 1
1 1
1 1
1 1
1 1
1 1
1 1
1 1
1 1
1 1
1 1
1 1
1 1 1
1 1
1 1
1 1 1
1 1
1 1 1
1 1
1 1
1 1
1 1
1 1
1 1
1 1
1 1
1 1
1 1
1 1
1 1
1 1
1 1
1 1
1 1
1 1
1 1 1
1 1
1 1
1 1 1
1 1
1 1
1 1
1 1
1 1
1 1
1 1 1
1 1
1 1
1 1 1
1 1
1 1 1
1 1
1 1
1 1
1 1 1
1 1
1 1
1 1
1 1 1
1 1
1 1
1 1
1 1
1 1
1 1
1 1
1 1
1 1 1
1 1
1 1 1
1 1
1 1
1 1
1 1 1
1 1
1
 1
1
1
1 1
1
1 1
1
1 1 1
1
1 1 1 1
1 1
1
1
1 1
1 1 1
1 1
1 1
1 1 1
1 1
1 1 1
1 1 1
1 1
1 1
1
1 1 1
1 1
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1 1
1 1
1 1 1
1 1
 1 1
1 1 1

1
1 1
1
1

1 1
1 1

1
1
1

1 1
1 1
1
1

1 1
1 1
1
1

1 1 RIWAYAT PENYAKIT TBC DAN GULA KERING

1 1

1 1
1 1
1
1 1
 1
1
1 1
1 1
1
1
1 MENDERITA PENYAKIT JANTUNG, ASAM LAMBUNG, DAN GULA
1
1 1
1
1
1 1
1 1 1
1 1 1
1 1
1
1
1 1
1
1
1
1
1
1
1
1 1
1
1
1 1
1
1
1
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1 1
1
1
1
1
1
1
1 1

1
1 1 1 1
1 1
1 1
1 1
1 1
1 1 1 1
1 1
1 1
1 1
1 1 1 1
1 1 1 1
1 1 1 1
1 1 1 1
1 1 1 1
1 1 1 1
1 1 1 1
1 1 1 1
1 1 1 1
1 1 1 1
1 1 1 1 1
1 1 1 1
1 1 1 1
1 1 1 1
1 1 1 1
1 1 1 1
1 1 1 1
1 1 1 1
1 1 1 1
1 1 1 1
1 1 1 1
1 1 1 1
1 1 1 1
1 1 1 1
1 1 1 1
1 1 1 1
1
1
1
1 1 1 1 1 1
1
1
1
1
1 1
1
1
1
1
1
1
1 1
1
 1
1
1
1
1 1
1
1
1
1
1 1
1
1
1 1
1
1
1
1 1
1
1
1
1 1
1
1
1
1

B. GANGGUAN KESEHATAN
9 10 11 12 13 14 15 CATATAN
T Y T Sistolik Diastolik Y T Y T Y T Y T Y T
1
1
 1 1
1 1

1 1

1 1

1 1

1 1

1 1

B. GANGGUAN KESEHATAN
9 10 11 12 13 14 15
T Y T Sistolik Diastolik Y T Y T Y T Y T Y T CATATAN
1 1
1 1
 1 1

1 1

1 1

1 1
1 1

1 1 1
1 1 1 1
1 1
1 1
1 1
1 1
1 1
1 1
1 1
1 1
1 1
1 1
1 1
1 1
1 1
1 1
1 1
1 1
1 1
1 1
1 1
1 1
1 1
1 1
1 1
1 1
1 1
1 1
1 1
1 1
1 1
1 1
1 1
1 1
1 1
1 1
1 1
1 1
1 1
1 1
1 1
1 1
1 1
1 1
1 1
1 1
1 1
1 1
1 1
1 1
1 1
1 1
1 1
1 1
1 1
1 1
1 1
1 1
1 1
1 1 1
1 1
1 1
1 1
1 1 1
1 1
1 1
1 1
1 1
1 1
1 1
1 1 1
1 1
1 1
1
1 1 1
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1 1
1 1
1 1 1
1 1
1 1
1 1
1 1
1 1
1 1 1
1 1
1 1
1 1
1 1
1 1
1 1
1 1
1 1
1 1
1 1
1 1
1 1
1 1
1 1
1 1
1 1
1 1
1 1
1 1
1 1
1 1
1 1
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1 1
1 1
1 1
1 1
1 1
1 1
1 1
1 1
1 1
1 1
1 1
1 1
1 1
1 1
1 1
1 1
1 1
1 1
1 1
1 1
1 1
1 1
1 1
1 1
1 1
313 33 440 65 90 59 0 31 0 32 0 44 2
SAM LAMBUNG, DAN GULA
 FORMULIR REKAPITULASI DATA KELUARGA DAN ANGGOTA KELUARGA
PROPINSI : D.I. YOGYAKARTA
KABUPATEN/KOTA :BANTUL
KECAMATAN :SEWON
PUSKESMAS :SEWON 1

II. KETERANGAN KELUARGA

NO URUT KODE KK RT Kampung Nama KK 3 4 5 6 7 8 9
Y T Y T Y T Y T Y T Y T Y T
1 A 0 1 0 0 7 DAGAN SURONO 1 1 1 1 1 1 1
0 0 7 DAGAN
2 A 0 2 0 0 7 DAGAN SASTRO WIDODO 1 1 1 1 1 1 1
0 0 7 DAGAN
0 0 7 DAGAN
3 A 0 3 0 0 7 DAGAN SUROTO 1 1 1 1 1 1 1
A 0 3 0 0 7 DAGAN
4 A 0 4 0 0 7 DAGAN WONGSO REDJO 1 1 1 1 1 1 1
A 0 4 0 0 7 DAGAN
5 A 0 5 0 0 7 DAGAN KUNTALA UTAMI DEWI 1 1 1 1 1 1 1
0 0 7 DAGAN
0 0 7 DAGAN
6 A 0 6 0 0 7 DAGAN SRIYATI 1 1 1 1 1 1 1
0 0 7 DAGAN
0 0 7 DAGAN
7 A 0 7 0 0 7 DAGAN SOFYAN RIZKA ANANDA 1 1 1 1 1 1 1
0 0 7 DAGAN
0 0 7 DAGAN
8 A 0 8 0 0 7 DAGAN BARDIYANTA SRI SUBEKTI 1 1 1 1 1 1 1

9 A 1 1 0 0 7 DAGAN JUWARNO 1 1 1 1 1 1 1
0 0 7 DAGAN
10 A 1 2 0 0 7 DAGAN SUPARTINAH 1 1 1 1 1 1 1
11 A 1 3 0 0 7 DAGAN HADI WINOTO/SUKARJAN 1 1 1 1 1 1 1
0 0 7 DAGAN
12 A 1 4 0 0 7 DAGAN NGATINI 1 1 1 1 1 1 1
13 A 1 5 0 0 7 DAGAN MUJIYEM 1 1 1 1 1 1 1
14 A 1 6 0 0 7 DAGAN SUROYO 1 1 1 1 1 1 1
0 0 7 DAGAN
0 0 7 DAGAN
0 0 7 DAGAN
15 A 1 7 0 0 7 DAGAN SATRI 1 1 1 1 1 1 1
0 0 7 DAGAN
0 0 7 DAGAN
0 0 7 DAGAN
16 A 1 8 0 0 7 DAGAN MUJIONO 1 1 1 1 1 1 1
0 0 7 DAGAN
0 0 7 DAGAN
17 A 1 9 0 0 7 DAGAN SUKARDI 1 1 1 1 1 1 1
0 0 7 DAGAN
0 0 7 DAGAN
18 A 1 10 0 0 7 DAGAN PURWANTO 1 1 1 1 1 1 1
0 0 7 DAGAN
0 0 7 DAGAN
0 0 7 DAGAN
19 A 2 1 0 0 7 DAGAN ARWAN 1 1 1 1 1 1 1
0 0 7 DAGAN
0 0 7 DAGAN
20 A 2 2 0 0 7 DAGAN WAGIYO 1 1 1 1 1 1 1
0 0 7 DAGAN
21 A 2 3 0 0 7 DAGAN SUSANTO 1 1 1 1 1 1 1
0 0 7 DAGAN
0 0 7 DAGAN
22 A 2 4 0 0 7 DAGAN WIYONO DWI WIYARTO 1 1 1 1 1 1 1
0 0 7 DAGAN
23 A 2 5 0 0 7 DAGAN SUDI REJO UTOMO/ SUGENG 1 1 1 1 1 1 1
0 0 7 DAGAN
0 0 7 DAGAN
24 A 2 6 0 0 7 DAGAN SURATMAN 1 1 1 1 1 1 1
0 0 7 DAGAN
0 0 7 DAGAN
25 A 2 7 0 0 7 DAGAN TUKIYO 1 1 1 1 1 1 1
0 0 7 DAGAN
0 0 7 DAGAN
26 A 2 8 0 0 7 DAGAN TUGIRAN 1 1 1 1 1 1 1
0 0 7 DAGAN
27 A 2 9 0 0 7 DAGAN AGUS SALIM 1 1 1 1 1 1 1
A 2 9 0 0 7 DAGAN
A 2 9 0 0 7 DAGAN
28 A 3 1 0 0 7 DAGAN SUMADI 1 1 1 1 1 1 1
A 3 1 0 0 7 DAGAN
A 3 1 0 0 7 DAGAN
29 A 3 2 0 0 7 DAGAN SUMINI 1 1 1 1 1 1 1
30 A 3 3 0 0 7 DAGAN SURADI 1 1 1 1 1 1 1
A 3 3 0 0 7 DAGAN
A 3 3 0 0 7 DAGAN
 A 3 3 0 0 7 DAGAN
31 A 3 4 0 0 7 DAGAN IWAN PRASETYO 1 1 1 1 1 1 1
A 3 4 0 0 7 DAGAN
A 3 4 0 0 7 DAGAN
32 A 3 5 0 0 7 DAGAN EKO PRASETYO 1 1 1 1 1 1 1
A 3 5 0 0 7 DAGAN
33 A 3 6 0 0 7 DAGAN TUKIYEM 1 1 1 1 1 1 1
34 A 3 7 0 0 7 DAGAN MULYADI 1 1 1 1 1 1 1
A 3 7 0 0 7 DAGAN
A 3 7 0 0 7 DAGAN
35 A 3 8 0 0 7 DAGAN DIKI WIJAYANTO 1 1 1 1 1 1 1
A 3 8 0 0 7 DAGAN
A 3 8 0 0 7 DAGAN
36 A 3 9 0 0 7 DAGAN TITIK ESTI P. 1 1 1 1 1 1 1
37 A 3 10 0 0 7 DAGAN HERI PRABOWO 1 1 1 1 1 1 1
A 3 10 0 0 7 DAGAN
A 3 10 0 0 7 DAGAN
A 3 10 0 0 7 DAGAN
A 3 10 0 0 7 DAGAN
38 A 4 1 0 0 7 DAGAN WALIJO 1 1 1 1 1 1 1
A 4 1 0 0 7 DAGAN
A 4 1 0 0 7 DAGAN
39 A 4 2 0 0 7 DAGAN BUSTAM 1 1 1 1 1 1 1
A 4 2 0 0 7 DAGAN
40 A 4 3 0 0 7 DAGAN SUGITO 1 1 1 1 1 1 1
A 4 3 0 0 7 DAGAN
A 4 3 0 0 7 DAGAN
A 4 3 0 0 7 DAGAN
A 4 3 0 0 7 DAGAN
41 A 4 4 0 0 7 DAGAN JUWAINI 1 1 1 1 1 1 1
A 4 4 0 0 7 DAGAN
A 4 4 0 0 7 DAGAN
A 4 4 0 0 7 DAGAN
42 A 4 5 0 0 7 DAGAN WAKIJAN 1 1 1 1 1 1 1
43 A 4 6 0 0 7 DAGAN ENDRA NUR MALIK 1 1 1 1 1 1 1
A 4 6 0 0 7 DAGAN
A 4 6 0 0 7 DAGAN
A 4 6 0 0 7 DAGAN
44 A 4 7 0 0 7 DAGAN ANJAR TRI SASONGKO 1 1 1 1 1 1 1
A 4 7 0 0 7 DAGAN
A 4 7 0 0 7 DAGAN
A 4 7 0 0 7 DAGAN
45 A 4 8 0 0 7 DAGAN MUHAMMAD FAJRI 1 1 1 1 1 1 1
A 4 8 0 0 7 DAGAN
A 4 8 0 0 7 DAGAN
A 4 8 0 0 7 DAGAN
46 A 4 9 0 0 7 DAGAN YUSWO UNTORO 1 1 1 1 1 1 1
A 4 9 0 0 7 DAGAN
A 4 9 0 0 7 DAGAN
A 4 9 0 0 7 DAGAN
47 A 5 1 0 0 7 DAGAN SUPRIYANTO 1 1 1 1 1 1 1
A 5 1 0 0 7 DAGAN
A 5 1 0 0 7 DAGAN
A 5 1 0 0 7 DAGAN
48 A 5 2 0 0 7 DAGAN SUDILAH 1 1 1 1 1 1 1
A 5 2 0 0 7 DAGAN
A 5 2 0 0 7 DAGAN
49 A 5 3 0 0 7 DAGAN ARIS WIDODO 1 1 1 1 1 1 1
A 5 3 0 0 7 DAGAN
A 5 3 0 0 7 DAGAN
50 A 5 4 0 0 7 DAGAN SARIYANTO 1 1 1 1 1 1 1
A 5 4 0 0 7 DAGAN
A 5 4 0 0 7 DAGAN
A 5 4 0 0 7 DAGAN
51 A 5 5 0 0 7 DAGAN TUKIJAN 1 1 1 1 1 1 1
A 5 5 0 0 7 DAGAN
A 5 5 0 0 7 DAGAN
A 5 5 0 0 7 DAGAN
52 A 5 6 0 0 7 DAGAN KISMIYANTO 1 1 1 1 1 1 1
A 5 6 0 0 7 DAGAN
53 A 5 7 0 0 7 DAGAN FUAD PURNAMA 1 1 1 1 1 1 1
A 5 7 0 0 7 DAGAN
A 5 7 0 0 7 DAGAN
54 A 5 8 0 0 7 DAGAN ANDI WIDIYANTO 1 1 1 1 1 1 1
A 5 8 0 0 7 DAGAN
A 5 8 0 0 7 DAGAN
A 5 8 0 0 7 DAGAN
55 A 6 1 0 0 7 DAGAN PAIMAN 1 1 1 1 1 1 1
A 6 1 0 0 7 DAGAN
A 6 1 0 0 7 DAGAN
56 A 6 2 0 0 7 DAGAN SUGENG PRAJOKO 1 1 1 1 1 1 1
A 6 2 0 0 7 DAGAN
A 6 2 0 0 7 DAGAN
57 A 6 3 0 0 7 DAGAN AGUS ZALI 1 1 1 1 1 1 1
A 6 3 0 0 7 DAGAN
A 6 3 0 0 7 DAGAN
58 A 6 4 0 0 7 DAGAN SUYITNO 1 1 1 1 1 1 1
A 6 4 0 0 7 DAGAN
A 6 4 0 0 7 DAGAN
59 A 6 5 0 0 7 DAGAN IIN SANTOSO 1 1 1 1 1 1 1
0 0 7 DAGAN
A 6 5 0 0 7 DAGAN
60 A 6 6 0 0 7 DAGAN MARSITO UTOMO 1 1 1 1 1 1 1
A 6 6 0 0 7 DAGAN
61 A 6 7 0 0 7 DAGAN WIRYANTO 1 1 1 1 1 1 1
A 6 7 0 0 7 DAGAN
A 6 7 0 0 7 DAGAN
62 A 6 8 0 0 7 DAGAN AGUNG PAMUNGKAS 1 1 1 1 1 1 1
A 6 8 0 0 7 DAGAN
A 6 8 0 0 7 DAGAN
A 6 8 0 0 7 DAGAN
63 A 6 9 0 0 7 DAGAN SUTARNO 1 1 1 1 1 1 1
A 6 9 0 0 7 DAGAN
A 6 9 0 0 7 DAGAN
64 A 6 10 0 0 7 DAGAN ANTON HERWANTORO 1 1 1 1 1 1 1
A 6 10 0 0 7 DAGAN
A 6 10 0 0 7 DAGAN
A 6 10 0 0 7 DAGAN
65 A 6 11 0 0 7 DAGAN WORO SUKAPTI 1 1 1 1 1 1 1
A 6 11 0 0 7 DAGAN
A 6 11 0 0 7 DAGAN
A 6 11 0 0 7 DAGAN
A 6 11 0 0 7 DAGAN
66 A 7 1 0 0 7 DAGAN SUMARDI 1 1 1 1 1 1 1
A 7 1 0 0 7 DAGAN
67 A 7 2 0 0 7 DAGAN EDWIN MURTANTO 1 1 1 1 1 1 1
A 7 2 0 0 7 DAGAN
A 7 2 0 0 7 DAGAN
A 7 2 0 0 7 DAGAN
68 A 7 3 0 0 7 DAGAN WALIDI 1 1 1 1 1 1 1
A 7 3 0 0 7 DAGAN
A 7 3 0 0 7 DAGAN
69 A 7 4 0 0 7 DAGAN ANDRI FEBRIYANTO 1 1 1 1 1 1 1
A 7 4 0 0 7 DAGAN
A 7 4 0 0 7 DAGAN
A 7 4 0 0 7 DAGAN
70 A 7 5 0 0 7 DAGAN JOWASITO 1 1 1 1 1 1 1
A 7 5 0 0 7 DAGAN
A 7 5 0 0 7 DAGAN
A 7 5 0 0 7 DAGAN
71 A 7 6 0 0 7 DAGAN TEGUH PRAYOGO 1 1 1 1 1 1 1
A 7 6 0 0 7 DAGAN
A 7 6 0 0 7 DAGAN
A 7 6 0 0 7 DAGAN
72 A 7 7 0 0 7 DAGAN JONI TRIANTO 1 1 1 1 1 1 1
A 7 7 0 0 7 DAGAN
A 7 7 0 0 7 DAGAN
73 A 7 8 0 0 7 DAGAN TULUS PRIYADI 1 1 1 1 1 1 1
A 7 8 0 0 7 DAGAN
A 7 8 0 0 7 DAGAN
73 0 73 0 73 0 73 0 0 73 0 73 0 73

6 Distribusi Keluarga Berdasarkan Keterlindungan sumber air bersih

7 Distribusi Keluarga Berdasarkan Kepemilikan/ketersediaan Jamban
8 Distribusi Keluarga Berdasarkan Jenis Jamban yg dimiliki
9 Distribusi Keluarga Berdasarkan Riwayat Gangguan Jiwa
10 Distribusi Keluarga Berdasarkan Kedisiplinan Minum Obat Ggn Jiwa
11 Distribusi Keluarga Berdasarkan Kasus Pemasungan

12 Distribusi Penduduk Berdasarkan Jenis Kelamin

13 Distribusi Penduduk Berdasarkan Status Perkawinan
14 Distribusi Ibu Hamil Berdasarkan Golongan Umur
15 Distribusi Penduduk Berdasarkan Agama
16 Distribusi Penduduk Berdasarkan Pendidikan
17 Distribusi Penduduk Berdasarkan Pekerjaan

18 Distribusi Penduduk Berdasarkan Kepemilikan Jaminan Kesehatan

19 Distribusi Penduduk Berdasarkan Kebiasaan merokok
20 Distribusi Penduduk Berdasarkan Kebiasaan BAB
21 Distribusi Penduduk Berdasarkan Kebiasaan Penggunaan Air Bersih
22 Distribusi Penduduk Berdasarkan Riwayat TBC
23 Distribusi Penderita TBC Berdasarkan Kepatuhan Minum Obat TBC
24 Distribusi Penduduk Berdasarkan Riwayat /keluhan batuk
25 Distribusi Penduduk Berdasarkan Riwayat Hipertensi
26 Distribusi Penderita Hipertensi Berdasarkan Kepatuhan Minum Obat Hipertensi
27 Distribusi Penduduk Berdasarkan Pengukuran Tekanan darah ( Diukur-Tidak diukur)

28 Distribusi PUS Berdasarkan Keikutsertaan KB

29 Distribusi Ibu Bersalin Berdasarkan Tempat Persalinan
30 Distribusi Bayi Berdasarkan Pemberian ASI Eksklusive
31 Distribusi Bayi Berdasarkan Kelengkapan Imunisasi
32 Distribusi Balita Berdasarkan Pemantauan Pertumbuhan di Bulan Terakhir
Nama Anggota Keluarga Tanggal Lahir Gol Umur Bayi/Balita Gol Umur
Hubungan keluarga 4 0-11 bln 12-59 bln 6-12 th 13-19 20-59 th ≥60 th
SURONO 1 3 1 1 2 1 9 5 4 1
PAILAH 2 3 1 1 2 1 9 5 8 1
SASTRO WIDODO 1 3 1 1 2 1 9 4 3 1
SRI WAHYUNI 2 3 1 1 2 1 9 5 2 1
MULYONO 3 0 8 0 5 1 9 7 3 1
SUROTO 1 0 5 0 4 1 9 5 5 1
SARMINI 2 2 7 0 4 1 9 6 4 1
WONGSO REDJO 1 1 4 0 7 1 9 5 2 1
PUJIRAH 2 0 5 0 2 1 9 5 5 1
KUNTALA UTAMI DEWI 1 0 4 0 1 1 9 8 6 1
KHAIRANA ROHDATUL A. H. 3 0 4 1 0 2 0 1 0 1
M. HANENDA ADHIYASTO P. 3 0 6 1 1 2 0 1 8 1
SRIYATI 1 0 3 1 0 1 9 6 3 1
ENY PRASETIYOWATI 3 1 8 1 1 1 9 9 2 1
WINDA SUCI LESTARI 3 0 1 0 4 1 9 9 5 1
SOFYAN RIZKA ANANDA 1 0 6 0 1 1 9 9 4 1
DENI DWI KURNIASARI 2 0 1 0 4 1 9 9 2 1
SHAKA QUINO DANENDRA A. 3 2 0 0 5 2 0 2 2 1
BARDIYANTA SRI SUBEKTI 1 2 1 0 8 1 9 6 3 1
MUTINGAH 2 1 5 0 5 1 9 7 1 1
AMMAR DZULFIQAR ABDUL.A 3 1 4 0 6 2 0 0 0 1
JUWARNO 1 3 1 1 2 1 9 5 9 1
YOHAN ADEPUTRA 3 0 4 0 4 1 9 9 1 1
SUPARTINAH 1 3 1 1 2 1 9 4 0 1
HADI WINOTO/SUKARJAN 1 2 0 1 2 1 9 3 8 1
NGATINI 2 1 8 0 1 1 9 4 8 1
NGATINI 1 3 1 1 2 1 9 4 5 1
MUJIYEM 1 3 1 1 2 1 9 5 0 1
SUROYO 1 1 7 0 9 1 9 8 5 1
AMIYARTI 2 2 0 0 5 1 9 8 8 1
NAYAKA ARKANANTA F. 3 0 8 0 6 2 0 0 9 1
ALMEERA AURORA M. 3 2 4 1 2 2 0 1 8 1
SATRI 1 2 4 0 3 1 9 8 8 1
FERI DWI SUSANTI 2 0 3 0 2 1 9 9 1 1
HAMDAN DINAN SHAQIRI 3 2 6 1 2 2 0 1 4 1
GHAISAN ISCO SHAQIRI 3 1 0 0 7 2 0 2 1 1
MUJIONO 1 3 1 1 2 1 9 6 1 1
JUMINTEN 2 3 0 1 2 1 9 7 0 1
SUPRIYANTO 3 0 5 0 4 1 9 9 4 1
SUKARDI 1 3 1 1 2 1 9 7 9 1
TUGIYATI 2 0 9 0 6 1 9 7 2 1
OTA FAHRIKSAN 3 0 7 0 2 2 0 0 8 1
PURWANTO 1 0 1 0 6 1 9 7 9 1
SIMPING LESTARI 2 1 9 0 7 1 9 8 9 1
NASYIFA RAMADHANI P. 3 2 3 0 8 2 0 1 0 1
DELISHA SAFWANA P. 3 2 7 0 1 2 0 2 1 1
ARWAN 1 2 2 0 8 1 9 8 3 1
RETNA YUNITASARI 2 0 7 0 6 1 9 9 3 1
PUTRI ARDHELIA MAHARANI 3 2 9 0 5 2 0 1 1 1
WAGIYO 1 1 2 0 7 1 9 6 3 1
AJI PRASETYO 3 0 2 1 1 1 9 9 6 1
SUSANTO 1 2 1 0 4 1 9 8 4 1
TINA PUSPITASARI, S.Pd 2 1 1 0 1 1 9 8 7 1
AISYA NADIRA SABILLA 3 2 3 0 3 2 0 1 7 1
WIYONO DWI WIYARTO 1 3 1 1 2 1 9 6 2 1
PONIRAH 2 3 0 1 2 1 9 5 9 1
SUDI REJO UTOMO/ SUGENG 1 3 1 1 2 1 9 4 8 1
SARJIYEM 2 3 1 1 2 1 9 5 5 1
IVAN ELIANDA ERSANTA 5 3 1 1 0 2 0 0 3 1
SURATMAN 1 3 1 1 2 1 9 5 6 1
PARTINI 2 3 1 1 2 1 9 6 0 1
SUHARYANTO 3 2 2 1 0 1 9 8 7 1
TUKIYO / SETYO RAHARJO 1 0 1 0 9 1 9 6 1 1
JUMIYEM 2 0 4 1 1 1 9 6 1 1
LESTARI 3 2 9 0 6 2 0 0 3 1
TUGIRAN 1 2 3 1 2 1 9 7 0 1
PARMILAH 2 0 6 0 1 1 9 6 7 1
AGUS SALIM 1 2 8 0 7 1 9 9 4 1
FEBRI ARI ASTUTI 2 1 2 0 2 1 9 9 3 1
AULIA KIRANA PUTRI 3 1 2 0 1 2 0 1 9 1
SUMADI 1 1 1 0 6 1 9 6 9 1
JARIYAH 2 1 5 0 9 1 9 6 8 1
MUHAMMAD KEVIN 3 1 7 0 2 2 0 0 4 1
SUMINI 1 3 1 1 2 1 9 6 4 1
SURADI 1 1 2 0 5 1 9 6 7 1
PURWANTINAH 2 1 4 0 4 1 9 7 6 1
ALIF FIRMANSYAH 3 1 3 0 4 2 0 1 0 1
YUDHA DWI DARMAWAN 3 0 4 1 1 2 0 1 1 1
IWAN PRASETYO 1 2 4 0 7 2 9 9 2 1
VENI RINDA SEPTININGSIH 2 0 1 0 9 1 9 9 4 1
KEANO ATTARASYA A 3 0 8 1 0 2 0 2 0 1
EKO PRASETYO 1 1 0 0 9 1 9 8 3 1
INTAN AFIKA DEVI 2 2 9 0 8 1 9 9 9 1
TUKIYEM 1 0 5 0 7 1 4 4 4 1
MULYADI 1 1 2 0 2 1 9 7 1 1
INTAN WIJAYANTI 2 0 8 1 1 1 9 8 3 1
AINUN SELFIANA W 3 1 7 1 0 2 0 0 8 1
DIKI WIJAYANTO 1 0 8 0 3 1 9 9 3 1
DWI SUWASTINAH 2 0 7 0 9 1 9 9 0 1
RIO NURROHMAN 3 2 2 0 7 2 0 1 9 1
TITIK ESTI P. 1 3 1 1 2 1 9 5 9 1
HERI PRABOWO 1 2 7 1 2 1 9 7 3 1
DWI UTAMI 2 2 6 0 8 1 9 7 5 1
HANNA ALGHUMAIDA 3 0 8 0 7 2 0 0 3 1
YAHYA ATTAQY MUHAMMAD 3 0 5 1 0 2 0 0 5 1
SHAFIYAH SALMA WAFDA 3 2 2 1 1 2 0 0 7 1
WALIJO 1 2 8 1 2 1 9 7 0 1
SUPARNI 2 0 9 0 2 1 9 7 7 1
DIAN ANNISA 3 2 4 0 3 2 0 0 4 1
BUSTAM 1 3 1 1 2 1 9 6 4 1
SURATMI 2 2 7 0 7 1 9 6 8 1
SUGITO 1 1 1 0 3 1 9 7 0 1
LASIJEM 2 0 1 0 4 1 9 6 4 1
JANU WANTO 3 0 2 0 1 1 9 9 5 1
NOVIANTY 3 1 6 0 6 1 9 9 6 1
WISNU RIANTO 3 1 6 0 7 1 9 9 8 1
JUWAINI 1 1 2 1 0 1 9 8 1 1
SITI YUMAROH 2 1 2 0 4 1 9 8 3 1
RAHMAWATI NUR KUMALASARI 3 1 0 0 2 2 0 0 6 1
MUHAMMAD ZAINUL MUTTAQIN 3 2 7 0 8 2 0 1 6 1
WAKIJAN 1 3 0 1 2 1 9 6 5 1
ENDRA NURMALIK 1 0 1 0 9 1 9 9 1 1
TITIK KURNIATI 2 0 3 0 6 1 9 8 9 1
RADIT PRAMUDITA MALIK 3 1 3 0 7 2 0 1 1 1
RENGGA NANDANA MALIK 3 1 1 1 1 2 0 1 5 1
ANJAR TRI SASONGKO 1 0 2 1 2 1 9 8 7 1
DILLA MAWARNI 2 0 3 0 4 1 9 8 8 1
DEVDAN NAYOTAMA SASONGK 3 0 3 1 0 2 0 1 3 1
DEVANO NARATAMA ATAQI SA 3 2 1 0 3 2 0 1 9 1
MUHAMMAD FAJRI 1 2 3 0 8 1 9 7 6 1
PIHASNIWATI 2 1 7 1 1 1 9 7 4 1
HASNA ATHIFA 3 0 1 0 6 2 0 0 2 1
HANIF ANSHARUL HAQQI 3 1 2 0 4 2 0 0 7 1
YUSWO UNTORO 1 0 5 0 5 1 9 7 0 1
SUMIYATI 2 1 7 1 1 1 9 8 0 1
CITRA ANGGUN YUSMIA 3 3 1 1 0 1 9 9 8 1
HANAFIA NAFISATUL YUSMIA 3 0 5 0 1 2 0 1 2 1
SUPRIYANTO 1 1 0 0 3 1 9 8 3 1
SAMIATUN 2 1 1 0 1 1 9 8 1 1
KIRANI 3 2 2 0 8 2 0 0 8 1
ALAZKA NABIHAN 3 1 3 0 6 2 0 1 6 1
SUDILAH 1 1 7 0 3 1 9 8 9 1
DWI KRISWANTO 9 0 3 0 8 1 9 9 8 1
HANIFAH PUTRI K. 3 2 5 0 6 2 0 1 2 1
ARIS WIDODO 1 1 2 0 6 1 9 7 0 1
RUBINEM 2 2 4 1 2 1 9 6 3 1
ADITYA 3 2 9 0 7 2 0 1 0 1
SARIYANTO 1 0 6 1 2 1 9 7 5 1
SUTINI 2 0 6 0 4 1 9 8 2 1
GALANG ADITYA 3 2 6 0 5 2 0 0 5 1
IRAMDA HELMALIA 3 0 4 0 8 2 0 1 4 1
TUKIJAN 1 0 8 0 6 1 9 6 8 1
SUMIYATI 2 0 5 1 0 1 9 7 3 1
SIGIT PURNAMA 3 2 2 0 5 1 9 9 9 1
WAHYU DWI HANDAYANI 3 1 7 0 7 2 0 0 8 1
KISMIYANTO 1 0 1 0 3 1 9 5 8 1
SUMIYATI 2 3 0 1 2 1 9 6 2 1
FUAD PURNAMA 1 0 7 0 4 1 9 9 5 1
ICHA DEWI SETYOWATI 2 2 5 0 2 1 9 9 4 1
KINARA RUKA LITUHAYU 3 2 0 0 8 2 0 2 0 1
ANDI WIDIYANTO 1 1 5 1 0 1 9 7 3 1
ARI LESTARININGSIH 2 1 3 0 1 1 9 7 6 1
M. AHSAN ARDIAN 3 1 1 0 9 2 0 0 9 1
M. ADAM ARDIAN 3 0 6 0 5 2 0 1 4 1
PAIMAN 1 3 1 1 2 1 9 6 9 1
SUMARSIH 2 1 4 1 1 1 9 7 5 1
AZIZ DANUARTO 3 0 2 0 1 2 0 0 7 1
SUGENG PRAJOKO DIKORO 1 3 0 1 2 1 9 6 0 1
WIJIATI 2 0 3 0 3 1 9 6 0 1
NADYA DEBY RIYANTIANA 3 2 4 0 7 1 9 9 5 1
AGUS ZALI 1 0 6 0 8 1 9 7 5 1
TRI RAHAYU NINGSIH 2 0 5 1 0 1 9 7 5 1
AULIA SYAFADILLA AZALIA 3 1 5 0 7 2 0 0 2 1
SUYITNO 1 1 1 0 8 1 9 7 5 1
WARIYANTI 2 3 0 1 2 1 9 7 9 1
MUHAMMAD RIZKY PUTRA PRA 3 0 2 0 4 2 0 0 3 1
IIN SANTOSO 1 0 9 1 2 1 9 7 3 1
INDRI PUJI ASTUTI 2 1 0 0 7 1 9 7 7 1
MUHAMMAD ANGGIT WIRATAMA 3 1 6 0 4 2 0 0 3 1
MARSITO UTOMO 1 2 7 0 7 1 9 6 6 1
WARSILAH 1 2 8 1 2 1 9 7 0 1
WIRYANTO 1 2 8 0 9 1 9 7 5 1
HARI SUDARWATI 2 2 0 0 7 1 9 7 5 1
FAISAL ABI 3 2 5 0 3 2 0 0 7 1
AGUNG PAMUNGKAS 1 0 2 1 1 1 9 7 9 1
DWI PURWANI 2 0 9 0 4 1 9 8 0 1
AMANDA CALISTA SAFITRI 3 2 5 0 9 2 0 0 8 1
ANANDA AQILA SAPUTRA 3 2 7 0 3 2 0 1 2 1
SUTARNO 1 0 5 1 1 1 9 8 0 1
AL-FARIZKY HILMI ARNOVAL 3 2 9 0 4 2 0 0 3 1
NABILA AULIA PUTRI 3 0 3 0 4 2 0 0 5 1
ANTON HERWANTORO 1 1 1 0 5 1 9 8 8 1
FITRIYA NURCAHYANI 2 2 5 0 5 1 9 8 8 1
ALFIAN RAKA KURNIAWAN 3 1 7 1 2 2 0 1 2 1
GAIZHAN RAFFASYA HAFIZ 3 2 4 0 2 2 0 2 0 1
WORO SUKAPTI 1 2 4 0 3 1 9 7 3 1
RAMADHANA SATRIANDITA PUT 3 2 1 0 1 1 9 9 8 1
MAHJATI SAMHANA PURNOMO 3 2 4 0 9 2 0 0 3 1
RAIHAN PURNOMO SYACH PUT 3 1 3 1 2 2 0 0 6 1
ATTAYA MAIRA PURNOMO PUTR 3 1 5 0 1 2 0 1 3 1
SUMARDI 1 3 1 1 2 1 9 6 1 1
ANI BARUSTININGSIH 3 0 3 0 5 2 0 0 1 1
EDWIN MURTANTO 1 2 0 0 4 1 9 6 6 1
YUNI PURWASTUTI 2 0 6 0 6 1 9 6 4 1
DIMAS AGUNG SISWORO A 3 2 5 0 5 1 9 3 3 1
MUHAMMAD SINGGIH P 3 1 9 1 1 1 9 9 8 1
WALIDI 1 3 1 1 2 1 9 6 3 1
IRIYANTI 2 0 3 0 5 1 9 6 3 1
DYAH RENAWATI 3 2 8 0 9 2 0 0 0 1
ANDRI FEBRIYANTO 1 2 8 0 4 1 9 9 0 1
TRI YULIANI 2 0 9 0 7 1 9 8 8 1
AURELLA KHANAYA 3 1 1 0 3 2 0 1 0 1
MUHAMMAD BAIHAQI R 3 0 9 1 1 2 0 1 9 1
JOWASITO 1 3 0 1 1 1 9 6 0 1
SUPRIHATIN 2 1 6 1 1 1 9 6 8 1
DEDI HERWANTO 3 1 5 0 7 1 9 8 8 1
DEWI RAHMA SARI 3 1 9 1 0 2 0 0 1 1
TEGUH PRAYOGO 1 2 4 0 7 1 9 9 1 1
ARI KRISTIYANTI 2 0 1 0 3 1 9 9 5 1
UNNA MIKAELA PRAYOGO 3 1 5 0 5 2 0 1 9 1
ELENA SARALEE PRAYOGO 3 0 1 1 2 2 0 2 2 1
JONI TRIANTO 1 0 1 1 2 1 9 8 8 1
JUMIYATI 2 0 7 1 2 1 9 7 3 1
ILHAM ALIF FIANTO 3 1 1 0 5 2 0 0 1 1
TULUS PRIYADI 1 2 5 0 2 1 9 7 8 1
SUMIYATI 2 1 8 0 5 1 9 7 7 1
HANUM LUSMIANDHITA 3 2 4 0 1 2 0 1 4 1
2 12 18 28 130 27
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1 2 3 4 Ya Tdk 1 2 3 4 5 6 1 2 3 4 5 6 7 1 2 3 4 5 6 7
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 FORMULIR REKAPITULASI DATA KELUARGA DAN ANGGOTA KELUARGA

PROPINSI : D.I. YOGYAKARTA

KABUPATEN/KOTA :BANTUL
KECAMATAN :SEWON
PUSKESMAS :SEWON 1

II. KETERANGAN KELUARGA B. GANGGUAN KESEHATAN

NO URUT KODE KK RT Kampung Nama KK 3 4 5 6 7 8 9 Nama Anggota Keluarga Tanggal Lahir Gol Umur Gol Umur Usia produktif / tidak produktif 6 (JK) 7 (Status Perkawinan) Hamil (wanita) 9 (AGAMA) 10 (PENDIDIKAN) 11 (KERJAAN) 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 CATATAN
Y T Y T Y T Y T Y T Y T Y T 2 Hubungan Keluarga 4 0-11 bln 12-59 bln 6-12 th 13-19 20-59 th ≥60 th 15-64 th <15 th & >64 th L P 1 2 3 4 Ya Tdk 1 2 3 4 5 6 1 2 3 4 5 6 7 1 2 3 4 5 6 7 8 9 Y T Y T Y T Y T Y T Y T Y T Y T Y T Y T Sistolik Diastolik Y T Y T Y T Y T Y T
CONTOH A 0 1 0 0 7 DAGAN JUWARNO 1 1 1 1 1 1 JUWARNO 3 1 1 2 1 9 5 9 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 2 0 0 8 0 1
B 1 1 0 0 5 JOMBLANG SUGENG 1 1 1 1 1 1 1 SUGENG KEPALA KELUARGA 0 9 1 2 1 9 6 3 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1
B 1 SUMINI ISTRI 1 7 0 6 1 9 6 6 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 3 0 0 8 0 1
B 1 2 0 0 5 JOMBLANG BUDI MASTORO 1 1 1 1 1 1 1 BUDI MASTORO KEPALA KELUARGA 0 2 0 5 1 9 8 7 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1
B 1 ERNA SUSILOWATI ISTRI 1 0 0 2 1 9 8 7 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 0 0 7 0 1
B 1 AISYAH AZARINE UFAIRA ANAK 2 3 0 6 2 0 1 3 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1
B 1 MUHAMMAD FAYYAZ ARZACHEL ANAK 1 0 0 6 2 0 1 6 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1
B 1 3 0 0 5 JOMBLANG RIFQI SETIAWAN 1 1 1 1 1 1 1 RIFQI SETIAWAN KEPALA KELUARGA 1 2 0 3 1 9 9 3 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1
B 1 HENI NUE KHASANAH ISTRI 2 0 0 5 1 9 9 4 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 2 0 0 7 5 1
B 1 MAFAZA HILYA AGHNIA ANAK 1 9 0 4 2 0 2 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1
B 1 4 0 0 5 JOMBLANG RIBUT 1 1 1 1 1 1 1 RIBUT KEPALA KELUARGA 0 2 0 2 1 9 6 0 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 6 0 0 9 0 1
B 1 NGATINI ISTRI 0 5 0 4 1 9 6 4 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1
B 1 5 0 0 5 JOMBLANG PARGIYO 1 1 1 1 1 1 1 PARGIYO KEPALA KELUARGA 0 3 0 9 1 9 6 4 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1
B 1 MAHMINI ISTRI 0 3 1 2 1 9 6 9 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1
B 1 MUHAMMAD ARIF NUGROHO ANAK 0 2 0 4 1 9 9 7 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 0 0 8 0
B 1 6 0 0 4 JOMBLANG MAINAH 1 1 1 1 1 1 1 MAINAH KEPALA KELUARGA 3 0 1 2 1 9 5 4 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1
B 1 SEPTIAN KRISTANTO ANAK 2 5 0 9 1 9 8 9 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1
B 1 7 0 0 4 JOMBLANG JOKO LUKITO 1 1 1 1 1 1 1 JOKO LUKITO KEPALA KELUARGA 2 0 0 5 1 9 7 3 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1
B 1 YULIANI PURWANTI ISTRI 1 9 0 7 1 9 7 8 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1
B 1 NASWA RIHADATUL AISY ANAK 2 2 0 4 2 0 0 3 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1
B 1 SALMA LUTHFIANA DHEA ULHAQ ANAK 0 1 0 6 2 0 0 9 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1
B 1 8 0 0 6 NGENTAK DWI SUSANTO 1 1 1 1 1 1 1 DWI SUSANTO KEPALA KELUARGA 0 4 0 2 1 9 7 5 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1
B 1 SRI SUHESTI ISTRI 2 6 1 0 1 9 5 6 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1
B 1 CHICA AYU DEWI AGESTI ANAK 0 2 0 4 1 9 9 8 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1
B 1 AAN FERDIANSAH ANAK 2 4 0 3 2 0 0 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1
B 1 DESTA FAJRI HESTU NUR ROHMAH ANAK 1 8 1 2 2 0 1 0 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1
B 1 9 0 0 6 JOMBLANG SARJANA 1 1 1 1 1 1 1 SARJANA KEPALA KELUARGA 2 4 0 3 1 9 6 8 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1
B 1 LESTARI NINGSIH ISTRI 1 2 0 8 1 9 6 7 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1
B 1 ANGGA ANDIKA PRADANA ANAK 1 4 0 5 1 9 9 4 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1
B 1 IRFAN FADHILLA ANDREANSYAH ANAK 2 6 1 1 2 0 0 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1
B 1 ZIDNI NAUFADLYN HIDAYATUS SOFI FAMILI LAIN 0 4 0 1 2 0 1 9 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1
B 1 10 0 0 6 NGENTAK JUMAT/HADI SASMITO 1 1 1 1 1 1 1 JUMAT/HADI SASMITO KEPALA KELUARGA 3 1 1 2 1 9 5 9 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1
B 1 TUMINAH ISTRI 3 1 1 2 1 9 6 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1
B 2 1 0 0 4 JOMBLANG RUDIANTO 1 1 1 1 1 1 1 RUDIANTO Kepala Keluarga 1 9 1 2 1 9 7 7 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 5 0 8 5
SRI LESTARI istri 2 7 0 3 1 9 8 2 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 2 0 0 8 5 1 1 1 1
MUHAMMAD RIZKI OKTAVIAN anak 0 1 1 0 2 0 0 4 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 - - - - - -
DINDA NU'MA IRFANA anak 0 7 0 6 2 0 1 3 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 0 0 8 0 1 1
MUHAMMAD LUCKY SAHAL HUSAIN anak 1 4 0 8 2 0 2 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 - - - - - - 1
B 2 2 0 0 5 JOMBLANG SUKINEM 1 1 1 1 1 1 1 SUKINEM Kepala Keluarga 3 0 1 2 1 9 4 6 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 3 0 0 8 2 1
B 2 3 0 0 4 JOMBLANG ISWANDI 1 1 1 1 1 1 1 ISWANDI Kepala Keluarga 2 0 0 6 1 9 6 8 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 - - - - - -
PARINI Istri 1 0 0 7 1 9 6 9 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 6 0 0 9 5 1
KUNCORO YAHYA Anak 2 9 0 1 1 9 9 9 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 - - - - - -
DEWI ISWINDARINI Anak 0 2 0 6 2 0 0 6 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 - - - - - -
B 2 4 0 0 4 JOMBLANG EKO WAHONO 1 1 1 1 1 1 1 EKO WAHONO Kepala Keluarga 3 1 1 2 1 9 6 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 - - - - - -
HARTIYAH Istri 1 6 0 7 1 9 6 8 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 - - - - - - 1
B 2 5 0 0 4 JOMBLANG SENO AJI NUGROHO 1 1 1 1 1 1 1 SENO AJI NUGROHO Kepala Keluarga 2 9 1 1 1 9 8 4 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 - - - - - -
NISA PUTRIYATI Istri 1 2 0 9 1 9 9 4 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 - - - - - -
AQILLA VERONICA CHARISSA NADA Anak 0 4 1 2 2 0 1 4 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 - - - - - -
B 2 6 0 0 4 JOMBLANG ARIEF NOVI ANTONO 1 1 1 1 1 1 1 ARIEF NOVI ANTONO WAHONO Kepala Keluarga 0 6 1 1 1 9 9 0 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 - - - - - -
DWINITA NUR ANDYANI Istri 0 7 1 1 1 9 9 3 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 0 0 7 0 1
KEIVAN ALVARENDRA AL HANAN Anak 1 0 0 2 2 0 1 7 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 - - - - - -
B 2 7 0 0 5 JOMBLANG PARJIMAN 1 1 1 1 1 1 1 PARJIMAN Kepala Keluarga 2 3 0 1 1 9 6 8 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 - - - - - -
WALIYAH Istri 0 4 0 2 1 9 7 3 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 - - - - - -
YOGI DWIYANTO Anak 1 8 1 0 1 9 9 8 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 - - - - - -
B 2 8 0 0 4 JOMBLANG SURYOWIDODO 1 1 1 1 1 1 1 SURYOWIDODO Kepala Keluarga 2 8 1 2 1 9 7 5 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 - - - - - -
TRI MUJIASIH Istri 0 2 0 3 1 9 8 0 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 - - - - - - 1
KARINA MALIDA SARI Anak 0 4 0 3 2 0 0 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 - - - - - -
B 2 9 0 0 4 JOMBLANG BEJO 1 1 1 1 1 1 1 BEJO Kepala Keluarga 1 4 1 1 1 9 6 6 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 - - - - - -
SUMIYATI Istri 2 8 0 2 1 9 7 3 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 - - - - - -
B 2 10 0 0 6 JOMBLANG YHENI FITRA HARYANT 1 1 1 1 1 1 1 YHENI FITRA HARYANTO Kepala Keluarga 1 0 1 0 1 9 8 5 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 - - - - - -
ERNA KURNIAWATI Istri 2 8 0 3 1 9 8 6 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 - - - - - - 1
AKBAR GADING LEGAWA Anak 3 0 1 1 2 0 1 0 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 - - - - - -
NAGITA ZAHWA PUTRI Anak 2 4 0 6 2 0 2 0 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 - - - - - - 1
B 3 1 0 0 4 JOMBLANG ANWARI 1 1 1 1 1 1 1 ANWARI KEPALA KELUARGA 1 8 1 0 1 9 5 9 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 6 0 0 9 0 1
SITI MASRICHAH ISTRI 2 7 0 5 1 9 6 3 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 6 5 1 0 0 1
ZIDAN AHMAD RIFAI ANAK 2 3 0 1 2 0 0 7 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1
B 3 2 0 0 4 JOMBLANG DWI HATMOKO 1 1 1 1 1 1 1 DWI HATMOKO KEPALA KELUARGA 1 7 0 4 1 9 8 9 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 0 0 7 8 1 1 1 1
MITA HANDAYANI ISTRI 0 2 0 8 1 9 9 8 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 0 0 0 6 9 1 1 1 1 1
AGAM ABDILLAH PRATAMA HATMOKO ANAK 0 1 0 7 2 0 1 7 1 1 1 1 1 1 1 1 1 1 1 1
AGHNA VALERIE HATMOKO ANAK 2 8 0 3 2 0 2 0 1 1 1 1 1 1 1 1 1 1 1 1
B 3 3 0 0 5 JOMBLANG PIPIT MUSTOFA 1 1 1 1 1 1 1 PIPIT MUSTOFA KEPALA KELUARGA 0 7 1 0 1 9 8 9 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 0 0 0 7 5 1
RIKA ARYANI ISTRI 1 5 0 4 1 9 9 3 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 0 9 0 0 5 0 1 1
NAILA SYAKIRA SAYBA ANAK 1 1 0 6 2 0 1 9 1 1 1 1 1 1 1 1 1 1 1
B 3 4 0 0 5 JOMBLANG WAHYUDI 1 1 1 1 1 1 1 WAHYUDI KEPALA KELUARGA 1 9 0 7 1 9 7 4 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 0 9 0 7 9 1 IAS
SUMARNI ANAK 2 3 0 1 1 9 7 6 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 0 9 8 0 7 0 1 IAS
B 3 5 0 0 5 JOMBLANG SUBAGIYA 1 1 1 1 1 1 1 SUBAGIYA KEPALA KELUARGA 2 5 0 3 1 9 5 2 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 2 1 0 9 0 1
NUR AGUSTIN SUNARTO ISTRI 1 4 0 7 1 9 8 5 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 3 0 0 9 5 1
AZZAM BARA DZULFIKAR ANAK 0 7 0 4 2 0 1 0 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1
B 3 6 0 0 6 JOMBLANG ISDIYONO 1 1 1 1 1 1 1 ISDIYONO KEPALA KELUARGA 1 1 0 9 1 9 9 2
DEVI LESTARI ISTRI 0 7 1 0 1 9 9 2
DAFFA IBNUHAFIZ ANAK 2 8 0 4 2 0 1 8
B 3 7 0 0 4 JOMBLANG DEDE RAHMAT 1 1 1 1 1 1 1 DEDE RAHMAT KEPALA KELUARGA 1 5 0 4 1 9 8 9 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 0 0 0 7 0 1
IRMAYANTI ISTRI 1 5 0 7 1 9 9 0 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 0 9 0 0 6 0 1 1
AVIRA AL TAUFANISSA RAHMAT ANAK 0 2 0 6 2 0 1 3 1 1 1 1 1 1
ELFIAN FATIH ARRAHMAT ANAK 0 5 0 2 2 0 2 2 1 1 1 1 1 1 1 1 1
B 3 8 0 0 5 JOMBLANG PRENGGO UTOMO 1 1 1 1 1 1 1 PRENGGO UTOMO KEPALA KELUARGA 3 0 1 2 1 9 3 2 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1
SUHARYANTO ANAK 2 4 0 3 1 9 7 0 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1
B 3 9 0 0 4 JOMBLANG SETIYO ARJO 1 1 1 1 1 1 1 SETIYO ARJO KEPALA KELUARGA 0 1 0 3 1 9 5 0 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1
WAGINEM ISTRI 2 5 1 1 1 9 5 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1
B 3 10 0 0 4 JOMBLANG DIRIN 1 1 1 1 1 1 1 DIRIN KEPALA KELUARGA 3 0 1 2 1 9 5 0 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1
TUMIYEM ISTRI 3 0 1 2 1 9 5 5 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1
RUSGIYANTO ANAK 2 5 0 3 1 9 7 7 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1
B 4 1 0 0 4 JOMBLANG RUSMANTO 1 1 1 1 1 1 1 RUSMANTO KEPALA KELUARGA 0 6 0 7 1 9 7 5 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 3 0 0 8 0 1
KASANAH ISTRI 0 5 0 7 1 9 8 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 2 5 0 7 0 1
IKA SAFIRA ANAK 2 5 0 3 2 0 0 2 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1
NAILA AMEILIA RUSDINATA ANAK 1 6 0 5 2 0 1 4 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1
B 4 2 0 0 4 JOMBLANG SETIYO ARJO 1 1 1 1 1 1 1 SETIYO ARJO KEPALA KELUARGA 0 1 0 3 1 9 5 0 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 4 0 0 8 5
B 4 3 0 0 4 JOMBLANG SALASA AGUS EKOYAD 1 1 1 1 1 1 1 SALASA AGUS EKOYADI KEPALA KELUARGA 0 4 1 0 1 9 7 2 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1
SURANI ISTRI 3 1 1 2 1 9 7 9 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1
HANIFAH ZULFA NIAWATI ANAK 3 1 0 5 2 0 0 2 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1
B 4 4 0 0 4 JOMBLANG HENDRI ZULLIJAR 1 1 1 1 1 1 1 HENDRI ZULLIJAR KEPALA KELUARGA 1 2 0 3 1 9 8 4 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1
BARIYATI ISTRI 0 5 0 2 1 9 8 4 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1
CUT MUTIAJENG ANAK 0 2 1 1 2 0 0 9 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1
TEUKU AZRIL NURDIANSYAH ANAK 2 7 0 8 2 0 1 8 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1
B 4 5 0 0 5 JOMBLANG ISMAIL 1 1 1 1 1 1 1 ISMAIL KEPALA KELUARGA 1 4 0 1 1 9 6 6 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1
SUMINI ISTRI 1 6 0 9 1 9 7 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1
NISMA FAUZIYAH ISTIQOMAH ANAK 2 8 0 4 2 0 0 0 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1
MUHAMMAD ULIN NUHA ANAK 1 1 0 4 2 0 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1
MA'RIFATUS SALSABILA ANAK 0 1 0 5 2 0 1 3 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1
ADI PAWIRO. NY MERTUA 3 0 1 2 1 9 4 3 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1
B 4 6 0 0 5 JOMBLANG SUKARDI 1 1 1 1 1 1 1 SUKARDI KEPALA KELUARGA 1 1 0 8 1 9 5 8 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1
SRI SUHARTI ISTRI 2 6 0 9 1 9 6 9 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 2 8 0 7 8 1
YUSTIKA NOOR ZAINUN ANAK 2 6 0 6 1 9 9 9 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1
B 4 7 0 0 5 JOMBLANG WIRYO SUKISMO 1 1 1 1 1 1 1 WIRYO SUKISMO KEPALA KELUARGA 1 2 0 2 1 9 4 0 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1
ROCHAYATUN ISTRI 1 4 0 3 1 9 4 8 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1
SURYONO ANAK 0 6 0 7 1 9 8 2 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1
B 4 8 0 0 5 JOMBLANG WURYANTA 1 1 1 1 1 1 1 WURYANTA KEPALA KELUARGA 2 7 1 1 1 9 6 7 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1
SUGIYANTI ISTRI 2 4 0 9 1 9 7 4 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 2 8 0 8 2 1
CANDRA SAPUTRA ANAK 0 5 0 3 2 0 0 6 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1
GIBRAN MALIK AHMAD ANAK 2 6 0 4 2 0 1 8 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1
B 4 9 0 0 2 KOMP GSO BLOK F2 NO.13 SUGITO 1 1 1 1 1 1 1 SUGITO KEPALA KELUARGA 1 6 0 3 1 9 6 3 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1
LINA ISTRI 1 7 0 1 1 9 6 9 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 5 0 8 0 1
HADI RAMADHAN ANAK 2 9 1 0 2 0 0 3 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1
B 4 10 0 0 6 JOMBLANG ALFIN SARIYANTO 1 1 1 1 1 1 1 ALFIN SARIYANTO KEPALA KELUARGA 1 7 1 1 1 9 7 9 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1
ERNI/TRI HARTATI ISTRI 2 6 1 0 1 9 8 2 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 5 0 8 0 1
DEVA VERI NUR ASTUTI ANAK 2 7 0 4 2 0 0 3 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1
SHAFA AMANDA RAMADAN ANAK 2 7 0 8 2 0 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1
B 5 1 0 0 4 JOMBLANG WAHADI YULIONO 1 1 1 1 1 1 1 WAHADI YULIONO KEPALA KELUARGA 0 2 0 7 1 9 8 7 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 3 8 0 8 8 1
DESTIA HARTATI ISTRI 0 9 1 2 1 9 8 9 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 5 0 8 5 1
ILHAAM PRADANA ANAK 2 6 0 9 2 0 1 2 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1
B 5 2 0 0 4 JOMBLANG SLAMET 1 1 1 1 1 1 1 SLAMET KEPALA KELUARGA 1 3 0 8 1 9 5 0 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 4 0 0 9 0 1
LASIYEM ISTRI 3 0 0 9 1 9 5 0 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 3 5 0 8 5 1
B 5 3 0 0 4 JOMBLANG AGUS DWI JATMIKO 1 1 1 1 1 1 1 AGUS DWI JATMIKO KEPALA KELUARGA 2 6 0 8 1 9 8 7 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1
WARIHARMIYATI ISTRI 3 0 0 3 1 9 8 9 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1
ALIYA HUSNA FARIZAH ANAK 1 3 0 8 2 0 1 2 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 2 5 0 8 5
ANNASYA ADREENA SAILA ANAK 2 0 0 8 2 0 1 6 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 0 5 0 7 5
B 5 4 0 0 6 JOMBLANG MUNJIYAH 1 1 1 1 1 1 1 MUNJIYAH KEPALA KELUARGA 0 7 0 1 1 9 6 5 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 3 0 0 8 0 1
B 5 5 0 0 6 JOMBLANG NGADIRIN 1 1 1 1 1 1 1 NGADIRIN KEPALA KELUARGA 0 2 0 7 1 9 5 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 4 5 1 0 0
SULASTRI ISTRI 0 4 1 0 1 9 4 5 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 2 7 0 7 0
ANA SUKYA RAHMATIN CUCU 2 5 1 0 1 9 9 7 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 0 0 8 5
B 5 6 0 0 5 JOMBLANG SABAR 1 1 1 1 1 1 1 SABAR KEPALA KELUARGA 2 0 0 4 1 9 7 5 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 2 8 0 8 8 1
SRI LESTARI ISTRI 1 4 1 2 1 9 7 5 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 0 9 5 0 7 0 1
SITI NUR LATIFAH ANAK 2 1 0 6 2 0 0 5 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1
LISNAWATI NURONGAINI ANAK 2 3 0 8 2 0 1 6 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1
B 5 7 0 0 5 JOMBLANG PONIMAN 1 1 1 1 1 1 1 PONIMAN KEPALA KELUARGA 3 0 1 2 1 9 7 3 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 4 0 0 8 5 1
SUTINEM ISTRI 2 5 1 0 1 9 7 3 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 2 5 0 7 5 1
LINDA RAHMADANI ANAK 3 0 0 4 2 0 0 5 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 0 0 0 6 0 1
B 5 8 0 0 5 JOMBLANG ISMOYO 1 1 1 1 1 1 1 ISMOYO KEPALA KELUARGA 1 2 0 8 1 9 7 5 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 2 0 0 7 0 1
DIAN ANGGREANI ISTRI 0 1 0 7 1 9 9 9 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 0 0 6 0 1
B 5 9 0 0 4 JOMBLANG NGADIRIN 1 1 1 1 1 1 1 NGADIRIN KEPALA KELUARGA 1 2 0 4 1 9 6 4 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 3 0 0 9 0 1
QODARIYAH ISTRI 2 1 1 1 1 9 7 0 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 2 5 0 8 0 1
DWI AFRIYANI ANAK 1 5 0 3 2 0 0 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 2 0 0 8 0
B 6 0 0 0 4 JOMBLANG JOKO LUKITO 1 1 1 1 1 1 1 JOKO LUKITO KEPALA KELUARGA 2 0 0 5 1 9 7 3 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 2 0 0 8 3 1
YULIANI PURWANTI ISTRI 1 0 0 7 1 9 7 8 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 8 0 7 8 1
NASWA RIHADATUL AISY ANAK 2 2 0 4 2 0 0 3 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1
SALMA LUTHFIANA DHEA ULHAP ANAK 0 1 0 6 2 0 0 9 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1
B 6 1 0 0 5 JOMBLANG AHMAD RAWI 1 1 1 1 1 1 1 AHMAD RAWI KEPALA KELUARGA 0 5 0 2 1 9 8 3 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 2 0 0 9 0 1
NIMAH ISTERI 0 1 0 7 1 9 8 7 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 3 0 0 8 5 1
NURUL AINI ANAK 2 8 0 3 2 0 0 4 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 2 5 0 8 0 1
ABDUL QODIR JAILANI ANAK 2 1 0 3 2 0 2 2 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1
KHUMAIRA RAMADHANI CUCU 2 8 0 4 2 0 2 2 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1
B 6 2 0 0 5 JOMBLANG AHMAD AMINUDIN SU 1 1 1 1 1 1 1 AHMAD AMINUDIN SUDIN KEPALA KELUARGA 1 9 1 1 1 9 8 5 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 2 0 0 8 3
ARDIAN WORO MARLISA ISTERI 0 3 0 3 1 9 9 2 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 2 0 0 7 5 1
1 ALDEA NABILLA SALVINA AMINUDIN ANAK 1 1 0 3 2 0 1 5 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1
KHAIRA ZHAFIRA PUTRI AMINUDIN ANAK 2 9 0 9 2 0 2 0 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1
B 6 3 0 0 5 JOMBLANG PANUT WIDODO 1 1 1 1 1 1 1 PANUT WIDODO KEPALA KELUARGA 1 6 0 1 1 9 7 3 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1
ROBIYANTI ISTERI 1 5 0 8 1 9 8 8 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1
B 6 4 0 0 6 JOMBLANG SUDIYONO 1 1 1 1 1 1 1 SUDIYONO KEPALA KELUARGA 0 3 0 5 1 9 5 9 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1
HARNI ISTERI 1 6 0 5 1 9 6 7 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1
B 6 5 0 0 6 JOMBLANG NANANG SETYAWAN 1 1 1 1 1 1 1 NANANG SETYAWAN KEPALA KELUARGA 1 7 0 2 1 9 8 3 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1
WAHYU NURYANAH ISTRI 1 5 0 7 1 9 8 5 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1
KHANSA KANAYA ANAK 0 8 0 5 2 0 1 2 1 1 1 1 1 1 1 1 1 1 1 1 1 1
KALILA ATHIFA ANAK 1 0 0 9 2 0 1 3 1 1 1 1 1 1 1 1 1 1 1 1 1 1
B 6 6 0 0 6 JOMBLANG PAIRAH 1 1 1 1 1 1 1 PAIRAH KEPALA KELUARGA 3 0 1 2 1 9 5 5 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1
B 6 7 0 0 6 JOMBLANG SUKIRNO 1 1 1 1 1 1 SUKIRNO KEPALA KELUARGA 3 0 1 2 1 9 6 3 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1
WAKIRAH ISTERI 3 0 1 2 1 9 6 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1
RIDWAN DWI PRASETYA ANAK 2 3 1 0 1 9 9 7 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1
B 6 8 0 0 4 JOMBLANG DEDI RISTANTO 1 1 1 1 1 1 1 DEDI RISTANTO KEPALA KELUARGA 2 8 1 2 1 9 8 7 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1
SUGIYARTI ISTERI 3 0 0 7 1 9 8 4 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1
ARFA FAUSTA RAZIQ ANAK 1 8 0 5 2 0 1 4 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1
ARSYA FAUSTA FAEZYA ANAK 2 0 1 1 2 0 1 7 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1
B 6 9 0 0 4 JOMBLANG PARJIMAN 1 1 1 1 1 1 1 PARJIMAN KEPALA KELUARGA 2 3 0 1 1 9 6 8 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 2 0 0 8 0
WALIYAH ISTRI 0 4 0 2 1 9 7 3 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 4 5 0 9 0
B 7 1 0 0 4 JOMBLANG SURADI 1 1 1 1 1 1 1 SURADI KEPALA KELUARGA 1 5 1 1 1 9 7 6 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 3 5 8 5 1
B 7 WIJAYATUN ISTRI 1 2 1 0 1 9 7 6 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 3 0 8 0 1
B 7 AMALINA FATHUL SALSABIL ANAK 3 1 0 1 2 0 0 2 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 0 7 0 1
B 7 ZAKI BAHTIAR YUMNA ANAK 2 6 1 2 2 0 0 5 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1
B 7 2 0 0 4 JOMBLANG NGADINEM 1 1 1 1 1 1 1 NGADINEM KEPALA KELUARGA 3 0 1 2 1 9 5 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 3 5 8 0
B 7 3 0 0 4 JOMBLANG ISQODARIYAH ISQODARIYAH KEPALA KELUARGA 2 1 1 1 1 9 7 0 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 3 0 7 0 1
B 7 DWI AFRIYANI ANAK 1 6 0 3 2 0 0 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1
B 7 4 0 0 5 JOMBLANG PARDI WIYONO WIDI U 1 1 1 1 1 1 1 PARDI WIYONO WIDI UTOMO KEPALA KELUARGA 2 5 0 3 1 9 4 9 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 3 5 8 5 1
B 7 PONIYEM ISTRI 3 1 1 2 1 9 4 0 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 2 0 7 0
B 7 5 0 0 5 JOMBLANG LANJAR MARSUDI UTO 1 1 1 1 1 1 1 LANJAR MARSUDI UTOMO KEPALA KELUARGA 0 7 1 2 1 9 6 0 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 4 0 7 5
B 7 ISJULIANTO ANAK 1 2 0 7 1 9 9 6 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1
B 7 6 0 0 5 JOMBLANG PARJIMAN 1 1 1 1 1 1 1 PARJIMAN KEPALA KELUARGA 2 4 0 4 1 9 7 0 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 4 0 8 5 1
B 7 LUCI ARBAYNA ISTRI 1 3 0 1 1 9 8 0 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 2 5 7 5 1
B 7 UMI ROSYIDA MALINA WATI ANAK 3 0 1 0 2 0 0 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1
B 7 QOMARIAH ANNUR MALINAWATI ANAK 3 0 0 8 2 0 0 6 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 0 8 0 1
B 7 7 0 0 6 JOMBLANG SARIYANTO 1 1 1 1 1 1 1 SARIYANTO KEPALA KELUARGA 0 7 0 6 1 9 6 4 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 3 5 7 0 1
B 7 PARTINEM ISTRI 1 5 0 5 1 9 7 0 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 3 0 8 0 1
B 7 IDRIS SYAFI'I ANAK 1 3 0 3 1 9 9 4 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 2 0 8 0
B 7 8 0 0 6 JOMBLANG ASIH RAHMA SETIYON 1 1 1 1 1 1 1 ASIH RAHMA SETIYONO KEPALA KELUARGA 2 0 1 1 2 0 0 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 3 0 8 0 1
B 7 ERLINA ISTRI 0 4 0 7 2 0 0 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 2 0 7 0 1 1
B 7 ARISTA KHALIDA RAMADHANI ANAK 2 4 0 4 2 0 2 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1
B 7 ARASELLY SALSABELA ZANETHA ANAK 1 7 1 2 2 0 2 2 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1
B 7 9 0 0 6 JOMBLANG AGUS SUYONO TONGK 1 1 1 1 1 1 1 AGUS SUYONO TONGKLENG KEPALA KELUARGA 0 2 0 2 1 9 6 0 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 4 0 9 0 1
B 7 PARYANTI ISTRI 1 7 0 3 1 9 7 4 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1
B 7 MUHAMMAD ANDRA PRAMUDIA ANANTO ANAK 0 1 0 1 2 0 0 5 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 0 7 0
B 7 GENDHIS AULIA PUTRI ANAK 1 6 0 8 2 0 0 8 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 0 0 7 0 1
B 7 10 0 0 6 JOMBLANG SAMINAH 1 1 1 1 1 1 1 SAMINAH KEPALA KELUARGA 3 0 1 2 1 9 5 8 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 3 5 8 0
B 8 1 0 0 5 Jomblang INDRO UPOYO 1 1 1 1 1 1 1 INDRO UPOYO KEPALA KELUARGA 1 3 1 1 1 9 6 2 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 4 0 8 0
NIYATI ISTERI 0 2 1 2 1 9 6 4 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 5 0 9 0
B 8 2 0 0 5 Jomblang SETIYONO 1 1 1 1 1 1 1 SETIYONO KEPALA KELUARGA 1 5 0 7 1 9 7 9 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 2 0 7 0
SITI LESTARI ISTERI 2 4 1 1 1 9 7 8 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 0 6 0
HANIFAH WINDA ADELIA ANAK 0 6 0 6 2 0 0 3 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1
CINDY ELLYA RISMAYA ANAK 3 5 0 5 2 0 0 5 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1
KHOIRUL RASYA FAHREZI ANAK 1 9 1 1 2 0 1 0 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1
B 8 3 0 0 5 Jomblang KASMIYATI 1 1 1 1 1 1 1 KASMIYATI KEPALA KELUARGA 1 9 0 1 1 9 6 5 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 6 0 8 0
B 8 4 0 0 4 Jomblang SURYOWIDODO 1 1 1 1 1 1 1 SURYOWIDODO KEPALA KELUARGA 2 8 1 2 1 9 7 5 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 3 0 7 6 1
TRI MUJIASIH ISTERI 0 2 0 3 1 9 8 0 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 2 0 7 0 1
KARINA MALDA SARI ANAK 0 4 0 3 2 0 0 1 1 1 1 1 1 1 1 2 1 1 1 1 1 1 1 1 1 1 1 1 0 7 0
B 8 5 0 0 4 Jomblang WIJI LESTARI 1 1 1 1 1 1 1 WIJI LESTARI KEPALA KELUARGA 0 5 0 7 1 9 5 3 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 4 0 7 0
B 8 6 0 0 4 Jomblang MARTO DHARJO 1 1 1 1 1 1 1 MARTO DIHARJO KEPALA KELUARGA 3 0 1 2 1 9 4 8 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 5 0 8 0
MURSIYAH ISTERI 3 0 1 2 1 9 5 6 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 3 0 7 0
B 8 7 0 0 6 Ngentak (Pleret) ANNAS SASTRAWAN 1 1 1 1 1 1 1 ANNAS SASTRAWAN KEPALA KELUARGA 0 2 0 5 1 9 8 3 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 2 0 7 0 1
IKA WIJAYANTI ISTERI 2 8 0 5 1 9 8 4 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 2 0 6 0 1
RAFFA NAZRIEL ALKHALIFI ANAK 2 6 0 5 2 0 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1
B 8 8 0 0 6 Ngentak SUBAKIN 1 1 1 1 1 1 1 SUBAKIN KEPALA KELUARGA 1 4 1 0 1 9 7 4 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 2 0 8 0 1
INDARNINGSIH ISTERI 1 7 0 4 1 9 7 5 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 2 4 7 0 1
ZAHRA INATSANFULKI ZAYN ANAK 1 0 1 2 2 0 1 0 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1
DITA ARDIYANING PUTRI ANAK 1 6 1 1 1 9 9 7 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 0 7 4
B 8 9 0 0 6 Ngentak SAMIDJO 1 1 1 1 1 1 1 SAMIDJO KEPALA KELUARGA 3 0 1 2 1 9 4 0 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 6 0 8 0
 EYUP ISTERI 3 0 1 2 1 9 4 5 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 5 0 7 8
B 8 10 0 0 6 Ngentak SUJATI 1 1 1 1 1 1 1 SUJATI KEPALA KELUARGA 0 5 0 4 1 9 5 8 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 5 2 8 0
VINA SAPTARINI ANAK 0 5 0 7 1 9 9 0 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 0 6 8
B 9 1 0 0 4 JOMBLANG PONIJAN 1 1 1 1 1 1 1 PONIJAN KEPALA KELUARGA 1 0 0 2 1 9 6 0 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 3 0 9 0
SARDINEM ISTRI 3 0 0 6 1 9 6 4 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 0 7 0
B 9 2 0 0 4 JOMBLANG AHMAD FAUZAN 1 1 1 1 1 1 1 AHMAD FAUZAN KEPALA KELUARGA 0 3 0 6 1 9 9 2 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 3 0 9 0 1
YENI RISTIANAWATI ISTRI 1 7 0 4 1 9 9 4 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 2 5 8 0 1
B 9 3 0 0 4 JOMBLANG PARJO 1 1 1 1 1 1 1 PARJO KEPALA KELUARGA 3 1 1 2 1 9 6 3 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 2 0 8 0 1
WASINGAH ISTRI 0 3 0 6 1 9 6 9 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 0 9 0 1
ACHMAD SAYYIT ANAK 2 0 0 6 1 9 9 4 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 2 0 7 0 1
B 9 4 0 0 0 JOMBLANG MUHAMMAD SYAFIQ BR 1 1 1 1 1 1 1 MUHAMMAD SYAFIQ BRILLIAN KEPALA KELUARGA 2 6 0 4 1 9 8 9 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 3 5 8 5 1
ESTRIYANTI ISTRI 2 6 0 3 1 9 8 9 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 2 0 7 0 1
B 9 5 0 0 6 KARANGTALUN IKSAN NURUDIN 1 1 1 1 1 1 1 IKSAN NURUDIN KEPALA KELUARGA 1 2 0 6 1 9 8 6 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 5 7 0 1
PATMIYATI ISTRI 2 4 1 1 1 9 8 4 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 0 8 5 1
KEYSA NASWA PUTRI ANAK 2 9 0 3 2 0 0 5 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 2 5 8 0 1
NANDA SAFIAN NURUDIN ANAK 0 8 0 7 2 0 0 9 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 2 0 7 5 1
B 9 6 0 0 5 JOMBLANG DINA PRATIWI 1 1 1 1 1 1 1 DINA PRATIWI KEPALA KELUARGA 2 3 0 8 1 9 8 6 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 2 0 8 0 1
RAFKA DIRA ARDINA ANAK 0 7 0 3 2 0 1 3 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 0 8 5 1
B 9 7 0 0 5 JOMBLANG SARJONO 1 1 1 1 1 1 1 SARJONO KEPALA KELUARGA 1 3 1 1 1 9 7 9 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 2 0 7 0 1
MARYANI ISTRI 3 0 1 2 1 9 8 2 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 4 5 9 5 1
FITRIYANI ANAK 2 5 1 1 2 0 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 0 7 0 1
B 9 8 0 0 6 JOMBLANG MARGONO/ SISWO HA 1 1 1 1 1 1 1 MARGONO/ SISWO HARJONO KEPALA KELUARGA 0 5 1 2 1 9 5 2 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 2 0 8 5 1
NGATINEM ISTRI 0 4 1 2 1 9 6 4 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 0 7 0 1
B 9 9 0 0 6 JOMBLANG ISNAWAN DWIYANTO 1 1 1 1 1 1 1 ISNAWAN DWIYANTO KEPALA KELUARGA 0 4 0 3 1 9 8 3 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 5 7 5 1
PUJI UTAMI ISTRI 1 5 0 6 1 9 9 0 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 2 0 8 0 1
FAREL AZKA PUTRA ANAK 0 5 0 4 2 0 1 5 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 0 0 7 0 1
FAREL AZKIRA PUTRI ANAK 2 9 1 2 2 0 2 2 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1
B 9 10 0 0 5 JOMBLANG PANCASAKTI FAJARRUL 1 1 1 1 1 1 1 PANCASAKTI FAJARRULILLAH KEPALA KELUARGA 2 7 0 2 1 9 8 8 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 3 0 7 5 1
B 10 1 0 0 5 JOMBLANG HENDI DISEMBRA DEI 1 1 1 1 1 1 1 HENDI DISEMBRA DEIDOMPAS KEPALA KELUARGA 3 1 1 2 1 9 9 3 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 2 0 8 0
SUN YOVI SUGIYARTI ISTRI 0 2 1 1 1 9 9 6 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 2 6 7 5 1 1
HEVINDITA KEISHA ZAHRA ANAK 3 0 0 3 2 0 1 6 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1
B 10 2 0 0 5 JOMBLANG FENDI MIDIASTONO 1 1 1 1 1 1 1 FENDI MIDIASTONO KEPALA KELUARGA 0 5 1 1 1 9 9 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1
NIMAS IRENE ANJANI ISTRI 0 5 1 1 1 9 9 3 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 9 8 0 1 1
1 1 SHABIRA ALMAHYRA ANDINI ANAK 0 3 1 1 2 0 1 9 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1
NIZAM YUSUF AL BARRA ANAK 0 1 0 9 2 0 2 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1
B 10 3 0 0 6 JOMBLANG YUSWO PURNOMO JUM 1 1 1 1 1 1 1 YUSWO PURNOMO JUMINTEN KEPALA KELUARGA 0 9 0 2 1 9 5 2 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 4 0 9 0 1
SURGIYANTORO ANAK 1 6 0 2 1 9 7 3 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 3 5 9 0
B 10 4 0 0 6 JOMBLANG MARGO UTOMO/MARIJ 1 1 1 1 1 1 1 MARGO UTOMO/MARIJAN KEPALA KELUARGA 3 0 1 2 1 9 4 8 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 5 2 9 5
NGADINAH ISTRI 3 0 1 2 1 9 5 2 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 3 0 8 0 1
IRSYAD DANNU NUR RAFIQ CUCU 1 3 1 0 2 0 1 0 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1
B 10 5 0 0 6 JOMBLANG JUMILAH 1 1 1 1 1 1 1 JUMILAH KEPALA KELUARGA 3 0 1 2 1 9 4 4 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 4 0 8 7 1
B 10 6 0 0 6 JOMBLANG BEJO MULYONO 1 1 1 1 1 1 1 BEJO MULYONO KEPALA KELUARGA 0 6 0 6 1 9 6 7 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 4 3 9 0
PASRI ISTRI 0 3 0 6 1 9 7 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 3 8 8 0 1
ASEP KURNIAWAN ANAK 1 6 0 9 1 9 9 6 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1
B 10 7 0 0 6 JOMBLANG WIJAYANTO 1 1 1 1 1 1 1 WIJAYANTO KEPALA KELUARGA 2 5 0 2 1 9 9 0 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 4 5 8 5
RIKA NUR FIANI ISTRI 2 8 0 3 1 9 8 8 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 3 0 8 0 1
ANGGITA NADYA PRATIWI ANAK 0 2 0 9 2 0 0 5 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1
ANDIKA BINTANG SAPUTRA ANAK 0 4 0 6 2 0 0 7 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1
ZAHRA NUR RASYIQ ANAK 2 3 0 2 2 0 0 9 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1
B 10 8 0 0 4 JOMBLANG PARJAN 1 1 1 1 1 1 1 PARJAN KEPALA KELUARGA 0 9 0 5 1 9 5 3 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1
WIJI LESTARI ISTRI 3 0 1 2 1 9 5 5 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1
B 10 9 0 0 4 JOMBLANG SIHANA 1 1 1 1 1 1 1 SIHANA KEPALA KELUARGA 1 6 0 9 1 9 6 7 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1
MUCHAYATI ISTRI 1 6 0 3 1 9 7 0 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1
B 10 10 0 0 4 JOMBLANG JUMIYO 1 1 1 1 1 1 1 JUMIYO/WIGYO UTOMO KEPALA KELUARGA 2 7 0 8 1 9 4 5 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1
TUKIYEM ISTRI 0 5 1 2 1 9 4 8 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1
B 11 1 0 0 4 JOMBLANG HARTONO 1 1 1 1 1 1 1 HARTONO KEPALA KELUARGA 0 9 0 9 1 9 6 3 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 7 0 8 5
B 11 2 0 0 5 JOMBLANG ISTI MURNIATI 1 1 1 1 1 1 1 ISTI MURNIYATI KEPALA KELUARGA 1 8 0 6 1 9 7 2 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 6 4 9 0
ASHAQ AL ARAFAH ANAK 1 6 0 1 2 0 0 2 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1
SAQAF GHOIBULLAH ANAK 0 7 0 1 2 0 0 3 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1
B 11 3 0 0 5 JOMBALNG PURWANTO 1 1 1 1 1 1 1 PURWANTO KEPALA KELUARGA 2 2 0 2 1 9 6 7 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 7 8 7 0 1
SUMARTINI ISTRI 2 7 0 2 1 9 8 3 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 3 2 8 0 1
ANANDA PRIMA RESWARA ANAK 2 6 1 2 2 0 0 4 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1
ASTI PAVITA ARDIYANTI ANAK 2 0 1 1 2 0 1 3 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1
B 11 4 0 0 5 JOMBLANG MURDI UTOMO/KASIMA 1 1 1 1 1 1 1 MURDI UTOMO/KASIMAN KEPALA KELUARGA 3 1 1 2 1 9 2 8 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 6 9 7 8
MURDI UTOMO/JUMIYEM, NY ISTRI 3 1 1 2 1 9 2 3 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 6 0 9 0
PONIJAN ANAK 3 1 1 2 1 9 7 0 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 2 8 7 8
B 11 5 0 0 6 JOMBLANG ALFIN SARIYANTO 1 1 1 1 1 1 1 ALFIN SARYANTO KEPALA KELUARGA 1 7 1 1 1 9 7 9 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 5 5 9 2 1
ERNI TRI HARTATI ISTRI 2 6 1 0 1 9 8 2 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 2 7 8 3 1
DEVA VERI NUR ASTUTI ANAK 2 7 0 4 2 0 0 3 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1
SHAFA AMANDA RAMADANI ANAK 2 7 0 8 2 0 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1
B 11 6 0 0 6 JOMBLANG JAWADI 1 1 1 1 1 1 1 JAWADI KEPALA KELUARGA 1 2 0 9 1 9 6 9 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 5 9 9 5 1
SUWARNI ISTRI 1 6 0 6 1 9 7 0 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 6 0 9 0 1
B 11 7 0 0 6 JOMBLANG WINTOLO 1 1 1 1 1 1 1 WINTOLO KEPALA KELUARGA 1 8 0 5 1 9 6 9 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 2 0 8 3 1
TEMU ISTRI 3 0 1 2 1 9 6 5 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 8 7 8 1
B 11 8 0 0 6 JOMBLANG PITAYA PRIYA PRATAM 1 1 1 1 1 1 1 PITAYA PRIYA PRATAMA KEPALA KELUARGA 1 2 0 9 1 9 8 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 2 4 7 3 1
TRI SATIFA ISTRI 0 5 0 7 1 9 8 2 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 5 8 5 1
SAFIRA YAFA NIRANA ANAK 1 1 0 3 2 0 0 9 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1
ANINDITA TAFA PRATISTA ANAK 0 3 0 5 2 0 1 6 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1
B 11 9 0 0 6 JOMBLANG MASIRAN 1 1 1 1 1 1 1 MASIRAN KEPALA KELUARGA 1 8 0 7 1 9 6 4 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 8 5 8 6
B 11 10 0 0 6 JOMBLANG SUGITO 1 1 1 1 1 1 1 SUGITO KEPALA KELUARGA 1 6 0 3 1 9 6 3 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 2 6 7 0
LINA ISTRI 1 7 0 1 1 9 6 9 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 9 8 1 1
HADI RAMADAN ANAK 2 9 1 0 2 0 0 3 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1
B 12 1 0 0 4 JOMBLANG AMIRUL HASAN 1 1 1 1 1 1 1 AMIRUL HASAN KEPALA KELUARGA 2 8 0 8 1 9 9 4 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 2 2 0 7 6 1
TRI RAHAYU ISTRI 2 0 0 3 1 9 9 6 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 5 0 8 0 1 1
GISKA AMIRA SALVINA ANAK 1 9 1 1 2 0 2 0 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1
B 12 2 0 0 4 JOMBLANG SISWO HADI PRANOTO 1 1 1 1 1 1 1 SISWO HADI PRANOTO KEPALA KELUARGA 3 0 1 2 1 9 5 9 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 3 2 0 8 0 1
TUMILAH ISTRI 1 4 0 7 1 9 6 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 3 3 0 8 3 1 1
ARIS WIBOWO ANAK 1 2 0 9 1 9 8 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 2 7 0 7 5 1
TRI RAHAYU ANAK 2 0 0 3 1 9 9 8 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 2 0 0 7 6 1
B 12 3 0 0 5 JOMBLANG ASHARI WIYONO 1 1 1 1 1 1 1 ASHARI WIYONO KEPALA KELUARGA 1 8 0 5 1 9 5 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 4 9 0 8 6
DALIYEM ISTRI 2 0 0 8 1 9 4 7 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 3 2 0 8 2
B 12 4 0 0 5 JOMBLANG HADI PRAYITNO JUMEN 1 1 1 1 1 1 1 HADI PRAYITNO JUMENO KEPALA KELUARGA 2 3 0 3 1 9 6 6 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 3 0 0 8 0 1 1
ROCHAYATUN ISTRI 0 9 1 0 1 9 6 9 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 3 5 0 7 8 1
NOR SETIAWAN ANAK 0 2 0 7 1 9 9 8 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 2 0 0 8 0
KHOLIFATUN NUR NUGRAHINI ANAK 1 9 0 5 2 0 0 4 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 0 0 0 8 5
B 12 5 0 0 5 JOMBLANG SUHONO 1 1 1 1 1 1 1 SUHONO KEPALA KELUARGA 0 1 0 9 1 9 7 6 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 3 0 8 2 1
SRI SUMINAH ISTRI 0 2 0 1 1 9 8 2 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 2 4 8 0 1
MUHAMMAD RAIHAN NURRIDHA ANAK 3 0 0 6 2 0 0 4 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 2 2 0 8 6
FADIAH JALILAL NUR AINI ANAK 2 7 0 3 2 0 0 9 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 0 5 0 7 0
B 12 6 0 0 6 JOMBLANG ABDUL ROZAK 1 1 1 1 1 1 1 ABDUL ROZAK KEPALA KELUARGA 1 7 0 2 1 9 8 4 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 2 0 0 8 0 1
SRI QONAAH ISTRI 0 8 0 3 1 9 8 5 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 5 0 8 2 1 1
ALYA AN NAJWA ANAK 2 7 0 3 2 0 1 0 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 0 9 0 0 7 0
ALIKA SHAKEELA ANAK 2 2 1 0 2 0 1 3 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1
ALARIC ABDUL ZAHID ANAK 0 1 0 5 2 0 2 0 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1
B 12 7 0 0 6 JOMBLANG SUMARYONO 1 1 1 1 1 1 1 SUMARYONO KEPALA KELUARGA 2 6 0 6 1 9 6 2 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 3 7 0 8 4
SUKASNI ISTRI 1 3 0 4 1 9 6 3 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 4 0 0 8 5
B 12 8 0 0 6 JOMBLANG NIKO ROHMAD NUGRO 1 1 1 1 1 1 1 NIKO ROHMAD NUGROHO KEPALA KELUARGA 2 9 0 8 1 9 8 9 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 2 3 0 7 0 1
DYAH AYU HANDAYANI ISTRI 1 4 1 0 1 9 9 7 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 0 6 7 1
B 12 9 0 0 6 JOMBLANG YHENI FITRA HARYANT 1 1 1 1 1 1 1 YHENI FITRA HARYANTO KEPALA KELUARGA 1 0 1 0 1 9 8 5 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 2 1 0 7 2 1
ERNA K ISTRI 2 0 0 3 1 9 8 6 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 2 0 0 7 0 1 1
AKBAR GADING L ANAK 3 0 1 0 2 0 1 0 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 0 9 8 0 6 5
B 12 10 0 0 6 JOMBLANG SUYATI 1 1 1 1 1 1 1 SUYATI KEPALA KELUARGA 0 7 0 4 1 9 6 6 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 3 4 0 7 8 1
VINA S ANAK 0 5 0 7 2 0 0 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 5 0 7 5
1 B 13 1 0 0 4 JOMBLANG MUJIYONO 1 1 1 1 1 1 1 MUJIYONO KEPALA KELUARGA 0 5 0 4 1 9 5 3 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 2 0 8 0 1 1
BARIYEM ISTRI 1 9 0 3 1 9 5 4 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 0 7 5 1 1
FANI RUSDIYANTO ANAK 1 4 0 6 1 9 9 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 2 0 8 5 1 1
2 B 13 2 0 0 5 JOMBLANG SATIMAH 1 1 1 1 1 1 1 SATIMAH KEPALA KELUARGA 3 0 1 2 1 9 5 9 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 5 6 5 1 1
MUJILAH ISTRI 3 0 1 2 1 2 6 4 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 0 7 0 1 1
B 13 3 0 0 5 JOMBLANG SUGIYANTOI 1 1 1 1 1 1 1 SUGIYANTO KEPALA KELUARGA 3 1 1 2 1 9 6 7 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 5 8 0 1 1
SEMIYATI ISTRI 0 1 1 2 1 9 8 0 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 0 0 6 5 1 1
BAGAS FEBRIYANTO ANAK 1 4 0 2 1 9 9 6 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 5 7 5 1 1
DWI RUJIYANTO ANAK 2 0 0 3 2 0 0 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 2 3 6 9 1 1
MUHAMMAD TRI WIDIYANTO ANAK 2 1 0 3 2 0 0 3 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 2 0 7 5 1 1
B 13 4 0 0 5 JOMBLANG SURADI 1 1 1 1 1 1 1 SURADI KEPALA KELUARGA 2 8 0 4 1 9 6 7 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 9 7 3 1 1
EVI DIAH ASMARANI ANAK 2 5 0 3 2 0 0 0 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 3 5 8 5 1 1
1 1 1 1 1 1 1 RUSDIANA ANAK 0 3 0 1 2 0 0 9 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 2 0 9 0 1 1
B 13 5 0 0 4 JOMBLANG SARDI UTOMO 1 1 1 1 1 1 1 SARDI UTOMO KEPALA KELUARGA 2 2 0 9 1 9 5 6 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 3 5 7 6 1 1
SUMILAH ISTRI 3 0 1 2 1 9 5 9 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 2 0 8 0 1 1
B 13 6 0 0 6 JOMBLANG HABIB BULLOH 1 1 1 1 1 1 1 HABIB BULLOH KEPALA KELUARGA 2 7 0 7 1 9 8 3 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 2 4 7 8 1 1
NUR PRIYATI ISTRI 1 0 0 1 1 9 8 2 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 2 0 6 6 1 1
MIFTACHUL AMIN SALAMAH ANAK 1 4 0 6 2 0 0 9 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 2 0 7 0 1 1
B 13 7 0 0 6 JOMBLANG RASYADAN RADIVAN 1 1 1 1 1 1 1 RASYADAN RADIVAN KEPALA KELUARGA 1 0 0 2 1 9 9 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 2 5 8 0 1 1
RADEN RORO VICI PRASDYARINDHA YUDHIATI ISTRI 0 5 0 9 1 9 9 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 2 0 7 0 1 1
RADEN AKSSA RIVAN WIRHESTAMA ANAK 1 8 1 0 2 0 1 8 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 2 3 7 8 1 1
B 13 8 0 0 5 JOMBLANG MURYANI 1 1 1 1 1 1 1 MURYANI KEPALA KELUARGA 0 3 0 4 1 9 5 9 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 0 0 8 5 1 1
NUR MALIKHAH ISTRI 2 3 0 9 2 0 0 3 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 5 9 0 1 1
B 13 9 0 0 6 JOMBLANG SUTRIYATI 1 1 1 1 1 1 1 SUTRIYATI KEPALA KELUARGA 0 5 1 0 1 9 6 0 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 0 7 5 1 1
B 13 10 0 0 5 JOMBLANG PARYONO 1 1 1 1 1 1 1 PARYONO KEPALA KELUARGA 1 3 0 6 1 9 7 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 0 8 5 1 1

118 1 108 11 119 1 97 21 1 118 1 119 1 118 2 17 28 40 198 58 225 92 158 184 193 129 3 14 191 341 1 0 0 0 0 52 34 56 57 112 12 17 75 57 12 38 28 32 4 72 19 302 40 51 286 335 3 335 2 1 335 1 278 2 335 36 299 22 240 180 153 42 127 14 0 12 1 12 1 17 4