TEMPAT PELAKSANAAN :

TAHUN :

JENIS
KELAMIN

NO NIK / NO INDEX NAMA BAYI/BATITA TGL LAHIR NAMA ORANG TUA

L P

1 2 3 4 5 6 7

1 07-86-00 SANIYYAH HANA AZKIYA. AN 13-Dec-16 Maman Sudarman,Tn

2 07-80-92 Wikan Abdul Aziz, An 28-Oct-16 Tri Jaka,Tn

3 08-01-32 ARDIANSYAH NUGRAHA, AN 1-Apr-17 Roma Hermawan,Tn

4 07-83-55 ALFATHAN AZKA PUTRA, AN 23-Nov-16 Hendra.Tn

5 07-77-82 Khaizan tabrizi, An 5-Oct-16 Sofwatul Laylah, Ny

6 08-13-60 Safira, By 1-Jul-17 Ramlan,Tn

7 07-92-03 Aisyah Putri Shalehah, An. 21-Jan-17 R. M Bachroni, Tn

07-98-36 Cahaya Cinta,An 9-Mar-17 Irwan Syah,Tn

08-07-19 Juaneta Ailen,An 11-May-17 Yustinus Marcel Rico K,Tn

08-14-62 Arsyila Ramadhania,An 21-Jun-17 Abdriyanto,Tn

08-09-61 Maulana Kenzie,An 27-May-17 Agus B,Tn

08-18-50 Ibrahim Firnas Ubay,An 23-Dec-14 Fatkhullah,Tn

08-00-48 Jiro Sakha Rasendria,An 25-Mar-17 Puput Hariadi,Tn

08-08-62 Muhammad Auladi Zhafran,An 20-May-17 Doddy Lesmono,Tn

8 08-06-56 SYABILA SAFA KINARA 5-Jan-17 AGRISA EKA NUGRAHAENI. N

07-80-61 M. Alby Khalid,An 2-Nov-16 Eko Purwanto,Tn

 06-42-82 Zidane Fathan Altair,An 18-Dec-14 Edwin Tri Putra,Tn

08-19-45 Mikhayla Putri,An 10-Aug-17 Tomi Yulianto,Tn

9 08-19-47 By Ny Dr. Siti Zahroh 10-Aug-17 Hariki,Tn

08-13-52 Zhafran Akbar Arazki,An 29-Jun-17 M. Rizki,Tn

10 08-19-94 By Ny Suyaningsih 12-Aug-17 Sutardjo,Tn

11 08-19-95 By Ny Nina Sarmina 12-Aug-17 Bambang Suhartono,Tn

12 08-19-75 By Ny Destyanah Husein 12-Aug-17 Ihsan Bayu Merdeka,Tn

08-14-55 By Ny Selvi Anggraini 7-Jul-17 Eris Kurniawan,Tn

07-79-50 Arkha Wildan Setiawan,An 25-Oct-16 Tri Setiawan,Tn

13 08-04-52 Emir Bosa,An 11-Apr-17 Albert,Tn

08-00-46 Elfareza Fatharian,An 25-Mar-17 Siswanto,Tn

07-75-58 Deandra A,An 23-Sep-16 Sudiono,Tn

06-66-33 Gibran Al Farabi,An 4-Apr-15 Indra Kosworo,Tn

08-16-51 Fadian,A,An 15-Jun-17 Yusrizal,Tn

14 08-80-48 Serafina Naomi Putri,An 11-Mar-14 Hary P,Tn

15 07-83-38 Mikhayla Chalinda P,An 22-Nov-16 Satria Perdana,Tn

16 08-19-45 Mikhayla Putri,An 10-Aug-17 Tomi Yulianto,Tn

17 08-04-16 Nata Sahid,An 11-Apr-17 Nanag Rudy,Tn

18 07-92-34 M. Al. Fatah,An 31-Jan-17 Heppi Frans,Tn
19
20
21
22
23
24
25
26
27
28
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30
31
32
33
34
35
36
37
38
39
40
41
42
43
44
45
46
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48
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55
56
57
58
59
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61
62
63
64
65
66
67
 PENCATATAN HASIL IMUNISASI

PUNYA BUKU KIA

Berat Lahir (gr) / Panjang Lahir
ALAMAT RT/RW NO HP (cm)

8 9 10 11

Jl. Pemuda No. 3 Kreo Selatan Larangan Selatan 0811147718 - BB 7.7kg, PB 67.5cm

JL. H SYAIP RT 005/01 NO 10A CILANDAK 085998060917 PB7.9kg, PB 73.5 cm

JL. MANGGAR III NO 13 RT 04/11 LARANGAN SELATAN, Kec. LARANGAN 021-7316319 BB 7.4kg, PB 65.5cm

KOMPLEK DEPLU 74 BLOK F NO 7 087872222507 BB8.2 kg, PB 72 cm

JL. FLA,MBOYAN Q 74 04/16 Paninggilan Kec. Ciledug 081932786862 PB 8.8 kg , PB 75cm

Komp DKI Joglo Blok M No 6 085214147777 BB 4.1 kg , PB 55cm

Jl Cendana 06/12 Jurang Mangun Barat Kec. Pondok Aren 082325176666 BB 7.4 kg, PB 67.5 cm

Komplek DKI Joglo Blok BB7 Rt 08/04 0215849355 BB 7.4kg PB 66cm

Jl. Pdk Maharta Blok C 15 No 1 Rt 007/011 081286512457 BB 3.4kg, PB 50cm

Jl. Perum Metro Permata 2 Blok 07 No 22 Kel. Karang Tengah Kec, Ciledug T 081219625484 BB 4.3kg PB 54cm

Parung Serab Rt 004/005 Ciledug 083893327077 BB 4.4 kg PB 57cm

Jl. Puri Beta 2 Taman Buah VII No 8 Rt 01/13 Tangerang 081321858908 BB 11kg

Jl. Komplek Sawah Indah Rt 01/03 No 104 Kel. Larangan Selatan Kec. Larang- BB 6.9kg PB 71cm

Jl. Inpres 17 Rt 03/09 No 52 BB 5.3kg PB 56cm

JL SEKTOR XVI 05/10 SUDIMARA JAYA Kec. CILEDUG TANGERANG 085779969448

Jl. Wisma Tajur Blok D V/3 Rt 04/07 Tajur Ciledug BB 7.7kg PB 70cm
Jl. Japos Graha Lestari Blok D6/7 Rt 002/08 08994447778 BB 14kg, PB 95cm

Kp.Pdk Jati Rt 001/003 No 35 Jurang Mangu Pdk Aren Tangsel 082213192110 BB 2950gr PB 48cm

Jl. Gotong Royong No 39 A Rt 05/01 Larangan Ciledug Tangerang 08126481842 BB 2800gr, PB 47.5cm

Japos Graha Blok 17/8 Rt 03/09 Jurang Mangu Barat BB 5.1kg PB 55cm

Jl. Masjid 2 Rt 02/11 Kel. Sudimara Selatan Kec. Ciledug Tangerang 08568484478 BB 3700gr PB 50cm

Jl. Impres 8 No 73 Kel. Larangan Utara Kec. Larangan Tangerang 081399905055 BB 3700gr, PB 50cm

Jl. Komplek Karang Tengah Permai Blok TQ /E Rt 02/014 Kel. Karang Timur K081310283407 BB 3300gr, PB 49cm

Jl. Sarmah No 49 Rt 05/07 Kel. Pdk Kacang Timur 081348072013 BB 3.5kg [B 55cm

Jl. Barokah 1 Rt 01/10 No 46 Ciledug 08128416443 BB 7.7kg PB 67.5cm

Jl. Meruya Utara Jakbar Rt 04/04 081288865761 BB 6.7kg, PB 62.5cm

Jl. Mekar Jaya No 43 Rt 03/10 Peninggilan Utara Ciledug 02173440366 BB 7.3kg, PB 64.5cm

Jl. Harapan Rt 003/02 No 35 - BB 7.5 kg, PB 71cm

Jl. H. Najih No 7 Rt 008/01 Petukangan Utara Jaksel 08115853905 BB 9kg

Jl. Perumahan Bangun Raksa Indah Rt 01/06 Kel. Pdk Pucung Kec. Karang T 081386799907 BB 4kg PB 56.5cm

Jl. Gg Shinta Rt 02/02 Larangan Utara Ciledug - BB 16 kg

Jl. Komplek Karang Tengah Permai Blok TK No 12 E BB 7 kg, BB 67cm

Kp.Pdk Jati Rt 001/003 No 35 Jurang Mangu Pdk Aren Tangsel 082213192110 BB 3.2kg

Jl. Mencong Gg Hj Rawit Rt 02/08 085715589255 BB 3.8kg BB 52cm

Jl. H. Jum 1 Rt 03/12 Peninggilan 08221305729 PB 68cm
L IMUNISASI

IMUNISASI DASAR

DPT-HB-HiB (1)

DPT-HB-HiB (2)

DPT-HB-HiB (3)

CAMPAK / CPK
HB 0 (24 jam)

RUBELLA
POLIO 1

POLIO 2

POLIO 3

POLIO 4
BCG

IPV
16 17 18 19 20 21 22 23 24 25 26

1-Aug-17

1-Aug-17

2-Aug-17 2-Aug-17

2-Aug-17 2-Aug-17

3-Aug-17 3-Aug-17

2-Aug-17 2-Aug-17

5-Aug-17 5-Aug-17

5-Aug-17 5-Aug-17

7-Aug-17 7-Aug-17

7-Aug-17

9-Aug-17
10-Aug-17 10-Aug-17

10-Aug-17

11-Aug-17

12-Aug-17

12-Aug-17

12-Aug-17

12-Aug-17 12-Aug-17

12-Aug-17

12-Aug-17

12-Aug-17 12-Aug-17

14-Aug-17

14-Aug-17

14-Aug-17 14-Aug-17

15-Aug-17

16-Aug-17

16-Aug-17
 IMUNISASI
NISASI DASAR LANJUTAN
(BOOSTER)

VIT A 6 BLN
KET

(18-24 bln)
(18-24 bln)
DPT-HB-HiB
Varicella
PCV 1

PCV 2

PCV 3

CAMPAK
27 28 29 30 31 32 33

1-Aug-17

1-Aug-17

1-Aug-17

2-Aug-17

5-Aug-17

9-Aug-17

16-Aug-17