REGISTER HASIL PELAYANAN KB DI KLINIK KB PUSKESMAS HEDAM ABEPURA

LAMPIRAN : 1

NO

Tanggal

1
2
3
4
5
6

1/10/12
1/10/12
1/10/12
1/10/12
1/10/12
3/10/12

3/10/12

8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25

3/10/12
3/10/12
3/10/12
3/10/12
3/10/12
3/10/12
3/10/12
3/10/12
8/10/12
8/10/12
10/10/12
10/10/12
10/10/12
10/10/12
10/10/12
10/10/12
10/10/12
10/10/12

No Urut Kartu
Baru
Lama
040/12
0111/12
0034/12
0106/11
0242/01
0094/1
2
0095/1
2
0064/11
0030/11
0305/10
0028/11
0055/11
156/05
0049/11
0013/12
0002/08
0080/03
0012/12
0042/12
0094/1

Ny.marselina
Ny.astina
Ny.ritna cicilia
Ny.grees
Ny.beatrix
Ny.agustina.W

Kamkey
Organda
Pdg bulan
Organda
Entrop
Jln.biak

19
39
18
29
36
26

IRT
IRT
IRT
IRT
Bekerja
IRT

Pendidika
n Terakhir
SMA
SMA
SMA
SMA
S1
SMP

Ny.lince kekri

Uncen bwh

37

Bekerja

S1

Depo,29/12/2012

Ny.grace
Ny.lince .R
Ny.eka ruamba
Ny.salafiah
Ny.loisa
Ny.lusi
Ny.foni
Ny.herki
Ny.federika
Ny.siti maryati
Ny.selvi
Ny.sri utami
Ny.mina simbiak
Ny.ketty
Ny.rosa
Ny.sri H
Ny.sarah
Ny.kartika

Jln.jeri
USTJ
Organda

23
22
22
24
37
24
27
39
28
37
24
17
40
30
28
19
30
24

IRT
IRT
IRT
IRT
IRT
IRT
Bekerja
Bekerja
Bekerja
IRT
IRT
IRT
Bekerja
Bekerja
Bekerja
IRT
IRT
IRT

SMA
SMA
SMA
SMA
SMA
SMA
S1
S1
S1
S1
SMA
SMP
S1
S1
S1
SMA
SMA
SMA

2
1
1
4
3
2
1
2
2
5
1
1
5
4
3
1
4
1

Depo,29/12/2012
Depo,29/12/2012
Depo,29/12/2012
Pil 2 strep
Pil 2 strep
Depo,29/12/2012
Depo,29/12/2012
Depo
Cyclo,05/11/2012
Lepas implant
Depo,02/01/2013
Cyclo,07/11/2012
Depo,02/01/2013
Depo.02/01/2013
Depo.02/01/2013
Depo.02/01/2013
Depo.02/01/2013
Depo.02/01/2013

Nama Peserta

Alamat

Jln.biak
Jln.merdee
Jln. V barat
Organda
Jln.aru
Yotefa
Hedam
Jln.sekolah
Jln.kaimana
pdg bulan
Pdg bulan
Perumnas 1
Uncen bwh
Jln.sarmi

Umur Pekerjaan

Jumlah
Anak
1
2
1
3
2
3

Depo,24/12/2012
Cyclo,29/10/2012
Depo,24/12/2012
Pil 1 strep
Cyclo,29/10/2012
Depo,29/12/2012

Pelayanan

2
26
13/10/12
LAMPIRAN
:
27
13/10/12
2
NO

Tanggal

28
29
30
31

13/10/12
13/10/12
13/10/12
13/10/12

32
33
34
35

13/10/12
13/10/12
15/10/12
15/10/12

36
37
38
39
40

15/10/12
15/10/12
15/10/12
15/10/12
17/10/12

41
42
43
44
45
46
47
48
49
50

17/10/12
17/10/12
17/10/12
17/10/12
17/10/12
17/10/12
17/10/12
17/10/12
17/10/12
17/10/12

0089/11
007/11
No Urut Kartu
Baru
Lama
0083/12

22
22

IRT
IRT

SMA
SMA

2
2

Depo.05/01/2013
Depo.05/01/2013

Jumlah
Anak
2
2
1
1

Depo.05/01/2013
Depo.05/01/2013
Depo.05/01/2013
Cyclo,10/11/2012

Jln.kali acai
Jln.yotefa
Jln.baru
Jln.kali acai

24
24
21
26

IRT
IRT
IRT
Bekerja

Ny.yane
00241
Ny.ixareni
26100/03 Ny.imeliana lussy
Ny.monalisa deda

Perumnas 4
Ab.pante
Uncen bwh
organda

31
28
32
21

Bekerja
Bekerja
IRT
IRT

S1
S1
SD
SMA

2
1
6
1

Depo,05/01/2013
Depo,05/01/2013
Depo,07/01/2013
Depo,07/01/2013

26100/03 Ny.siti maryati

0110/11 Ny.dwi
0047/12 Ny.abdul rasyd
Ny.dian permatsri
Ny.kristofara

Yotefa
organda
Jln.yotefa
Jln.timika
Pdg bulan

36
43
34
35
22

IRT
IRT
Bekerja
IRT
IRT

SMA
SMA
S1
SMA
SMA

5
4
3
3
1

Depo,07/01/2013
Depo,07/01/2013
Depo,07/01/2013
Depo,07/01/2013
Depo,09/01/2013

0189/05
015/10
0011/10
0009/12

organda
organda
Perumnas 2
Kpg korem
Jln.biak
Blkg citra
Pasar yotefa
Tanah hitam
Yotefa
Blkg citra

33
23
23
26
37
38
27
23
29
25

Bekerja
Bekerja
Bekerja
Bekerja
IRT
IRT
Bekerja
IRT
IRT
IRT

S1
S1
S1
S1
SMP
SMA
SMA
SMA
S1
SMP

3
1
1
1
4
2
1
3
2
1

Cyclo,14/11/2012
Pil 1 strep
Depo,09/01/2013
Depo,09/01/2013
Cyclo,14/11/2012
Cyclo,14/11/2012
Lepas implant
Depo,09/01/2013
Cyclo,17/11/2012
Cyclo,17/11/2012

0095/1
2

0097/1
2

Perumnas 4
Jln.biak

Pendidika
n Terakhir
SMA
SMA
SMA
S1

0041/12

0096/1
2

Ny.yuli
Ny.herodia

0072/11
2520/09
0048/05
0074/12
0064/12

Nama Peserta
Ny.nur
Ny.aruanatur
Ny.novalia
Ny.sarce

Ny.yane raja-raja
Ny.natalia
Ny.cristina clau
Ny.rosalina w
Ny.yohana
Ny.indri
Ny.maria
Ny.marike
Ny.lisa
Ny.kaida

Alamat

Umur Pekerjaan

Pelayanan

51
52
53
54

17/10/12
20/10/2012
20/10/2012
20/10/2012

NO

Tanggal

55
56
57

0091/04
0014/12
0077/11
0058/05

No Urut Kartu
Baru
Lama

20/10/2012
20/10/2012
20/10/2012 0098/1
2
58
20/10/2012 0099/1
2
59
20/10/2012
60
24/10/2012
61
24/10/2012 100/12
62
24/10/2012
63
24/10/2012 101/12
64
24/10/2012 102/12
65
24/10/2012 103/12
66
27/10/2012
67
27/10/2012
68
27/10/2012
69
27/10/2012 104/12
70
27/10/2012
71
29/10/2012
LAMPIRAN
:
72
29/10/2012
3
73

0016/12

0017/12
0015/11
0085/12

0071/12
0058/10
0020/12
0065/12
106/11
111/10

Ny.rufia
Ny.treni
Ny.ribka
Ny.masita

organda
BTN puskop
Uncen ats
Pdg bulan

30
37
32
39

Bekerja
IRT
IRT
Bekerja

S1
SMP
SMP
S1

2
3
3
2

Pil 2 strep
Depo,12/01/2013
Depo,12/01/2013
Depo,12/01/2013

Jumlah
Pelayanan
Anak
3
Depo,12/01/2013
2
Depo,12/01/2013
3
Pil 1 strep

Ny.milka
Ny.oktovina
Ny.mira

Jln,biak
28
kamkey
22
Jln.kesehatan 36

Bekerja
IRT
Bekerja

Pendidika
n Terakhir
S1
SMP
S1

Ny.rita

Perum polda

23

IRT

S1

Depo,14/01/2013

Ny.agustina
Ny.kartini
Ny.mance niki
Ny.marta yowa
Ny. Grace k
Ny.novela
Ny.ruhmanti
Ny.juwita
Ny.rina
Ny.imelda
Ny.elisabet
Ny.nova
Ny.gres roya
Ny.astima

Uncen atas
Hedam
Jln.mankwari
kotaraja
organda
T.hitam
T.hitam
Jln.sekolah
organda
Kali acai
Uncen bwh
Pdg bulan
organda
organda

28
40
25
23
24
37
29
21
38
23
28
22
29
39

IRT
Bekerja
IRT
IRT
IRT
Bekerja
IRT
IRT
Bekerja
IRT
IRT
Bekerja
IRT
IRT

SD
S1
S1
SMA
SMA
S1
SMA
SMP
SMA
SMA
SMP
SMP
SMA
S1

4
3
1
1
1
3
2
1
3
2
4
1
3
2

Depo,14/01/2013
Depo,16/01/2013
Depo,16/01/2013
Depo,16/01/2013
Pil 1 strep
implant
implant
Depo,19/01/2013
Depo,19/01/2013
Depo,19/01/2013
Depo,19/01/2013
Cyclo,24/11/2012
Pil 1 strep
Cyclo,26/11/2012

Nama Peserta

Alamat

Umur Pekerjaan