DATA SASARAN IMUNISASI POLIO

NAMA PAUD / KB/TK : RA. FATHUL BASHAR

ALAMAT PAUD / KB/TK : DUKUH BULAK BANTENG GG PATRIOT 3A/15

NO HP : 081703542243
NAMA ORTU JANUARI ( PUTARANFEBRUARI
1) ( PUTARAN 2)
NO NAMA ANAK TGL LAHIR L/P NIK ANAK ALAMAT
AYAH IBU TGL NO BATH TGL NO BATH
1 AHMAD NIZAM ALFARIZI 28/09/2018 L 3578172809180006 Wesil Halimatus Sa'diyah Dukuh Bulak Banteng II No. 25
2 FITRIA RAMADHANI 14/06/2018 P 3578125406180003 Syamsul Arifin Siti Komaria Dukuh Bulak Banteng GG. Patriot 4/14
3 INESYA PUTRI AZZAHRA 23/04/2018 P 3578176304180006 Mat Sahri Anisatur Robbaniyah Dukuh Bulak Banteng II No. 33
4 JALALUDIN EL - RUMI 19/08/2018 L 3578171908180004 Zainul Hasan Vijayanti Mala Dukuh Bulak Banteng Patriot 6/17
5 LUBABUL FUQAHA 26/09/2018 L 3578162609180006 Mugni Nugraha Istianah Dukuh Bulak Banteng Patriot 3A/48
6 LUQMANUL HAKIM RAMADHAN 13/05/2019 L 3578171305190003 Muh. Zainuddin Romadon Sulfia Dukuh Bulak Banteng Sekolahan 13A/61
7 MOCH. HAIDAR SAADI 06/05/2018 L 3578160605180001 Abd. Karim Khotijah Dukuh Bulak Banteng Timur 6/8-A
8 MOH. HAFIDZ MUBAROK 30/11/2018 L 3578173011180002 Moh. Soleh Mukaromah Dukuh Bulak Banteng GG. Patriot 4/14
9 MUHAMMAD HABIBI RAMADHAN 30/05/2018 L 3578173005180002 Masmudi Nurhayati Kedung ManguTimur VII/14
10 PUTRA RAMADHANI 15/05/2018 L 3578171505180002 Abd. Muntholib Halimah Bulak Banteng Madya 4/24
11 SIDAN ROMADONI 15/05/2018 L 3578171505180006 Imam Hambali Rezeki Indayati Dukuh Bulak Banteng Patriot 7/45
12 SINTIYA KIKI PUSPITA 25/01/2019 P 3578176501190005 Kiki Fendi Setiawan Siti Ratnasari Dukuh Bulak Banteng Patriot 7/45
13 UMATUS SULAIKHA 03/02/2018 P 3578174302180004 Moch. Nur Hamsah Nur Fadilah Dukuh Bulak Banteng Pandu 4/12
14 VARISA ALINA HASNA SYA'BANIA 02/05/2018 P 3578154105180006 Febri Nor Mujianto Yasminia Nur Baiti Dukuh Bulak Banteng II No. 25
15 YUSUP 29/05/2018 L 3578172905180005 Syafii Isdarliyah Dukuh Bulak Banteng Patriot 3/41
16 ANISAH ARIATI PUTRI 07/01/2019 P 3578174701190003 M. Rokim Tutik Dukuh Bulak Banteng II No. 25
17 Achmad Mirza Fahlevi 14/01/2017 L 3578171401170004 Moch. Zainudin Siti Rohmatus Sittiyah Dukuh Bulak Banteng Patriot 4/24
18 Achmad Muji Bur Rohman 12/06/2017 L 3578171206170001 Muzamil Siti Fatima Bulak Banteng Lor Bhineka 1/75
19 Ahmad Farhan 29/03/2017 L 3578172903170002 Yusup Romlah Dukuh Bulak Banteng Pandu 4/12
20 Aisyah Zaen 21/04/2017 P 3527056104170005 Zaini Fatima Kedung ManguTimur VI/106
21 Fitrah Al Hakim 26/02/2017 L 3578112602170001 Moch. Rido'i Komariyah Dukuh Bulak Banteng Patriot 5/5
22 Ghaza Muhammad Al Ghozali 14/07/2017 L 3578171407170003 Sin Weni Ita Ratna Sari Dukuh Bulak Banteng Patriot 3A/18A
23 Hilya Ramadhani 27/05/2017 P 3578176705170003 Rohman Sufil Uyuni Dukuh Bulak Banteng Patriot 4/19
24 Irmawati 14/07/2017 P 3527055407170002 Moch. Shaleh Hasiyeh Dukuh Bulak Banteng Patriot 4/23
25 Jalynda Hazimah Permata Sari 21/06/2018 P 3578176106180002 Joni Kibagus Siti Salamah, M.Pd.I Dukuh Bulak Banteng Patriot 3A/19
26 M. Noval Rehan Askar 11/01/2017 L 3527051101170001 Subaidi Yuliati Kedinding Lor 4A/54
27 Muhammad Ammar Fathoni 18/12/2016 L 3578171812160003 Hoiruddin Ainur Rodiyah Dukuh Bulak Banteng Patriot 4/33
28 Muhammad Putra Zainul Akbar 02/12/2015 L 3578170212150003 Funidin Siti Fatimah, Almh Dukuh Bulak Banteng Patriot 4/19
29 Muhammad Romdhony Lutqoh 27/05/2017 L 3578102705170008 Lutfi Nur Syafiqoh Kapas Baru 9/40
30 Muntazam Ahmad Alfarisi 23/09/2017 L 3578172309170003 Pusimin Bahri Nursiyah Dukuh Bulak Banteng Suropati 8/27
31 Qurrotul Nur Aini 12/02/2017 P 3527055202170001 Moh. Romli Hoiriyeh Dukuh Bulak Banteng Patriot 4
32 Salsabela 27/11/2017 P 3578176711170001 Makmun Misbeh Dukuh Bulak Banteng Patriot 3A/50
33 Sella Sintia Bella 20/02/2017 P 3578176002170006 Imam Hambali Rezeki Indayati Dukuh Bulak Banteng Patriot 7/45
34 Siti Aisyah 28/06/2017 P 3578176806170004 Saiful Arifin Juharotul Maula Bulak Banteng Lor Bhineka 1/78-A
35 Sofiatus Soleha 19/10/2017 P 3578115910170003 Syaiful Anam Julaicha Dukuh Bulak Banteng GG. Patriot 2A
36 Zahira Putri Alfia 05/08/2017 P 3578174508170001 Ali Thohir Firda Dukuh Bulak Banteng Patriot 4/9
37 AHMAD ZUHAERI 21/02/2016 L 3524242102160001 Marzudi Danik Ainur Rohma Platuk Donomulyo Utara 1A/21
38 HILYA NAFISA 01/09/2017 P 3526134109170001 Holili Rohma Wati Dukuh Bulak Banteng Patriot 5
39 INAYAH KAMILAH 12/08/2017 P 3578175208170003 Abdul Mu'is Maisaroh Dukuh Bulak Banteng GG. Patriot 2A/38
40 KAFANY ROBBY 28/10/2017 L 3526162810170001 M. Yasin Alia Kedinding GG. Dahlia
41 SITI MAULIDIA 10/12/2017 P 3578165012170003 Moch. Fauzi Niyah Dukuh Bulak Banteng Patriot 4
42 LULUK RIANI MAULIDIA 28/11/2017 P 3578176811170004 Choirul Safandi Irma Fibriyanti Dukuh Bulak Banteng Patriot 5/5