Format Rekapan Pis-Pk TGT

REKAPAN PIS PK
KETERANGAN ANGGOTA KELUARGA
Jenis
NO Kelamin
Nama NIK RT/ RW Hub. Anggota Keluarga Tanggal Lahir Umur
1. Pria
2. Wanita
1 2 3 4 5 6 7 8
1 Kartina Barek Duli 5306 1261 0476 0003 008/004 1 21/04/1976 42 2

2 Febronia Janetsa Barek Angin 5306 1248 0601 0001 008/004 3 28/06/2001 17 2
3 Gabriel Demon Lonek 5306 1222 0702 0001 008/004 3 28/07/2002 16 1
4 Leontinus Laga Payon 5306 1227 0106 0001 008/004 3 27/01/2006 12 1
5 Louis Kopong Miten Puhugelon 5306 1228 0407 0001 008/004 3 28/04/2007 11 1
6 Michaelis J Molan Tokan 5306 1229 1012 0001 008/004 3 29/10/2012 16 1
7 Fransiska 008/004 7 27/04/2000 18 2
8 Gabriel 008/004 7 9/5/2002 14 1
1 Simon Kia Boli 5306 1218 1052 0001 008/004 1 18/10/1952 66 1
2 Benedikta Kewa Lela 5306 1261 1162 0001 008/004 2 1/7/1962 56 2
3 Martinus Wadan Penana 5306 1219 0500 0001 008/004 3 2/5/2005 3 1
4 Kornelis Kopong Solot 5306 1219 1204 0001 008/004 3 19/12/2004 4 1
1 Emerlinda Bengan Dorok 5306 1267 0375 0001 008/004 2 27/03/1975 43 2
2 Brigida Palan Lito 5306 1241 0204 0001 008/004 3 1/2/2004 4 2
3 Eleonora Palan Duli 5306 1256 0206 0002 008/004 3 16/02/2006 2 2
4 Natalis Emanuel Ola Angin 5306 1224 1212 0002 008/004 3 24/12/2012 6 1
5 Teodeta Kenato Lema 008/004 6 1/5/1950 68 2
1 Sumina Binti Kasmin 5306 1242 0540 0001 008/004 1 28/11/1950 68 2
1 Veronika Uba Penaten 5306 1271 1256 0011 008/004 1 31/12/1956 62 2
1 Veronika Oren Lanan 5306 1241 0744 0027 008/004 1 1/7/1944 74 2
1 Titus Ola Payon 5306 1241 0741 0035 008/004 1 1/8/1941 77 1
2 Margareta Uba Lela 5306 1243 0551 0001 008/004 2 3/4/1950 68 2
1 Sofia Tuto Soge 008/004 1 1/1/1943 75 2
1 Theresai Uba Kopon 008/004 1 7/3/1981 37 2
2 Susana Tugiyem 008/004 3 28/02/2011 7 2
3 bayi 008/004 3 2
1 Dominika Date Rugi 5306 1260 0535 0001 008/004 1 1/7/1935 83 2
1 Nikolaus Sani Kopon 5306 1213 0279 0001 008/004 1 13/02/1979 39 1
2 Yovita Masi Lakun 5306 1244 0284 0002 008/004 2 4/2/1984 34 2
3 Brigita Nikole Tanah Bolen 008/004 3 8/12/2013 5 2
1 Aloysius Wisok Mangu 5306 1226 1264 0001 008/004 1 1964 54 1
2 Theresia Tulit Kasa 5306 1258 0658 0001 008/004 2 1958 60 2
3 Filigius Kadu Roman 5306 1226 0792 0001 008/004 3 26/07/1992 26 1
4 Agustinus Kia Bahin 5306 1217 0895 0001 008/004 3 19/05/1995 23 1
1 Veronika Bribin Mado 5306 1256 0756 0001 008/004 1 31/12/1953 65 2
1 Lusia Sili Lolon 008/004 1 1/6/1943 75 2
1 Bernadus Kopong Bura 008/004 1 1
2 Theresia Sabu Bisa 008/004 2 2
1 David Boli Sanga 5306 1227 0242 0001 008/004 1 8/7/1941 77 1
2 Maria Somi Biri 5306 1252 0550 0001 008/004 2 1/1/1951 67 2
3 Yoseph Bali Diri 5306 1219 0272 0001 008/004 3 19/02/1972 46 1
1 Dominikus Boli Aman 5306 1215 0857 0001 008/004 1 15/08/1957 61 1
2 Katarina Kewa Lela 5306 1255 1258 0001 008/004 2 15/12/1958 60 2
3 Mateus Usen Miten 5306 1213 0684 0002 008/004 kepala keluarga 13/06/1/984 34 1
4 Erlinda Fivianti 5306 008/004 2 2
1 Timotius Kopong Usen 5306 1231 1265 0001 008/004 1 12/021965 43 1
2 Paulina Palan Boli 5306 1247 1065 0001 008/004 2 7/10/1965 43 2
1 Laurensius Tupen Liat 5306 008/004 1 1
2 5306 008/004 3 1
3 5306 008/004 3 2
1 Lukas Lein Kuma 5306 1201 0747 0036 007/004 1 1/7/1947 71 1

2 Yuliana Anu Pati 5306 1262 0957 0001 007/004 2 22/09/1957 61 2
3 Gergorius Geli Laga 5306 1223 0993 0001 007/004 3 23/09/1993 25 1
4 Benyamin Sili Rotok 5306 1230 0387 0001 007/004 kk 30/03/1987 31 1
5 Agustina Peni Lagan 5306 1246 0890 0001 007/004 2 6/8 1990 28 2
6 Maria Prisiliani Kurman 007/004 3 28/09/2014 4 2
1 Maria Masi Dike 007/004 1 1921 97 2
1 Titus Ola Boro 007/004 1 1
2 Agata Abon Boli 007/004 2 2
1 Markus Nuba Laba 5306 1204 1048 0001 007/004 1 9/1/1935 83 1
2 Maria Barek Butu 5306 1262 1260 0001 007/004 2 25/3/1962 56 2
3 Lukas Kia Golon 5306 1222 0902 0001 007/004 3 22/9/1999 19 1
4 Maria Febriana Bengan Laga 5306 1244 0204 0001 007/004 3 4/2/2002 16 2
5 Veronika Barek Bura 007/004 6 2
6 Natalia Ose Geli 5306 007/004 kk 24/12/1987 31 2
7 Reimundus Mado Ulu 7/11/1914 007/004 3 1/7/2011 7 1
8 Putri 007/004 5 10 2
9 Asrin 007/004 5 8 2
1 Daniel Pati Butu 5306 1241 0733 0017 007/004 1 16/3/1977 41 1
2 Rosalia Maga Sabon 5306 1246 0460 0001 007/004 6 1/7/1960 58 2
3 Marta Hingi Wara 5306 1242 1064 0001 007/004 6 2/10/1965 53 2
4 Agustinus Laba Masan 007/004 6 1
1 Kamilus Oron Tewa 5306 1214 0783 0001 007/004 1 14/7/1983 35 1
2 Fransiska Kewa Ola 5306 1342 0495 0002 007/004 2 2/4/1995 23 2
3 Eusabius Calvino Tanah Miten 007/004 3 2/8/2014 4 1
4 Ola Angin 007/004 3 26/09/2017 1 1
5 Kristina Rayi Notan 5306 1254 0253 0001 007/004 6 5/2/1953 65 2
1 Dominikus Aji Tadon 5306 1216 0858 0001 007/004 1 16/8/1958 60 1
3 Monika Kewa Lela 5306 1250 0260 0001 007/004 2 10/2/1960 58 2
4 Damiana Lamapaha 5306 1242 0595 0002 007/004 4 2/5/1995 23 2
1 Bonefantura Kopong Miten 5306 1226 0669 0001 007/004 1 22/9/1969 49 1
2 Maria Hingin Geon 5306 1263 0474 0001 007/004 2 29/3/1974 44 2
3 Desidarius Kopong Usen 5306 1228 0496 0001 007/004 3 28/06/1996 22 1
4 Vinsensia 5306 1264 0903 0001 007/004 3 24/09/2003 15 2
5 Hugo Payon Kian 5306 1204 0308 0001 007/004 3 1/4/2008 10 1
6 Anastefani Lama Ewak 007/004 3 18/12/2016 2 2
1 Ambrosius Ara Kian 5306 1201 0760 0022 007/004 1 1/7/1960 58 1
2 Veronika Masi Boli 5306 1241 0166 0001 007/004 2 1/1/1966 52 2
3 Patriko Payon Mangu 5306 1201 0399 0001 007/004 3 1/3/1999 19 1
4 Aprilianus Mado Ulu 5306 1227 0410 0001 007/004 3 127/04/2010 8 1
5 Yakobus Beda Lonek 5306 1227 1191 0001 007/004 kk 27/11/1992 26 1
6 Matilda Lidwia Niga Bolen 007/004 2 4/3/1994 24 2
7 Sofrinus Lewo Jawa 007/004 3 5/3/2017 1 1
1 Petrus Kia Golon 5306 1201 1063 0013 007/004 1 1963 55 1
2 Yohana Deran Koli 5306 1241 0755 0041 007/004 2 1955 63 2
3 Theresia Kewa Doni 5306 1241 0954 0001 007/004 6 1954 64 2
1 Lasarus Kia Tebak 5306 1215 0975 0001 007/004 1 15/9/1975 43 1
2 Yuliana Uba Gana 5306 1253 0985 0002 007/004 2 13/9/1985 33 2
3 Katarina Biti Tupen 5306 1244 0708 0001 007/004 3 4/7/2008 10 2
4 Natalia Bengan Boli 5306 1246 1111 0001 007/004 3 6/11/2011 7 2
5 Fermanus Sili Luli 007/004 3 29/06/2014 4 1
1 Karolus Ola Tokan 5306 1202 0868 0002 007/004 1 2/8/1968 50 1
2 Maria Mala Tupen 5306 1241 0779 0016 007/004 2 1/7/1979 39 2
3 Selindina Masi Lakun 5306 1242 0802 0002 007/004 3 2/8/2000 18 2
4 Alvionita Lama Tokan 5306 1257 0802 0001 007/004 3 17/08/2002 16 2
5 Yohanes Aji Tadon 007/004 3 5/8/2011 7 1
6 Lusia Bulu Uhen 5306 1241 0740 0078 007/004 7 1/7/1940 78 2
1 Tadeus Seko Kolot 5306 1224 1190 0001 007/004 1 24/12/1990 28 1
2 Katarina Siba Sili 007/004 2 15/3/1992 26 2
3 Katarina Bengan Dorok 5306 12411055 0001 007/004 7 12/12/1955 63 2
1 Stefanus Sika Miten 5306 1216 0350 0001 007/004 1 15/02/1955 63 1
2 Maria Masi Daen 007/004 2 16/11/1958 60 2
3 Gergorius Nuba Laba 5306 1203 0992 0002 007/004 3 3/9/1991 27 1
4 Elisabet Ema Tadon 007/004 6 63 2
1 Katarina Herin kian 5306 1241 0756 0039 007/004 1 1/7/191958 60 2
2 Martinus Lanan Lama Holot 5306 1255 1192 0001 007/004 3 15/11/1992 26 1
1 Berta Barek Duli 5306 1265 1177 0001 007/004 2 25/11/1977 41 2
2 Maria Palmalia Peni Boli Ina 5306 1264 0313 0001 007/004 3 24/03/2013 5 2
1 Theresia Tena Pulo 5306 1262 0556 0001 007/004 1 22/2/1956 62 2
2 Mikhael Loli Heba 5306 1215 0608 0002 007/004 2 15/06/2008 10 1
1 Yosevina Tena Lema 5306 1241 0729 0015 007/004 1 1/9/1929 89 2
1 Petrus Rugi Nuhon 007/004 1 15/09/1947 71 1
1 Gaspar Pehan Peran 5306 1207 0311 0007 007/004 1 30/11/1973 45 1
2 Rosdalima Peni Boli 5306 1254 1076 0002 007/004 2 14/10/1976 42 2
3 Yohanes Familiaris Demon 5306 1205 0203 0003 007/004 3 5/2/2003 5 1
4 Emilianus Jansen Puhugelon 5306 1228 1209 0001 007/004 3 28/12/2009 9 1
5 Antonius Muli Boli 5306 1221 0814 0002 007/004 3 21/08/2014 4 1
1 Maria Ose Geli 5306 1258 1050 0001 007/004 1 1950 68 2
2 Agnes Menina Palan 5306 1242 0854 0002 007/004 6 1954 64 2
3 Veronika Bengan Angin 5306 1262 0663 0001 007/004 6 22/06/1963 55 2
1 Mateus Oron Tewa 5306 1216 0180 0002 007/004 1 16/01/1980 38 1
2 Marselina Bahi 5306 1246 0287 0002 007/004 2 6/2/1987 31 2
3 Guido Conforti 5306 1201 1110 0001 007/004 3 5/11/2011 7 1
4 Lucianus Padak Laga 007/004 3 7/1/2016 2 1
1 Magdalena Bano Rugi 5306 1241 1044 0001 007/004 1 1/7/1942 76 2
2 Albertus Tendi Palihama 5306 1204 0795 0002 007/004 5 14/07/1998 20 1
1 Simon Suban Rupa 5306 1201 9740 0023 007/004 1 1/7/1947 71 1
2 Paulina Lelan Bolen 5306 1241 0736 0025 007/004 2 1/7/1946 72 2
3 Didimus Nuba Laba 5306 1224 0475 0001 007/004 kk 24/04/1975 43 1
4 Sapralia Murin Boro 5306 1258 1081 0001 007/004 2 18/10/1981 37 2
5 Oktavianus Arcimen 007/004 3 23/10/2009 9 1
6 Ignasius Gilang Nuba Laba 5306 1225 0505 0001 007/004 3 25/05/2005 13 1
1 Markus Nua Doni 5306 1227 0163 0001 007/004 1 27/01/1963 55 1
2 Berta Nula Kopon 5306 1255 1064 0001 007/004 2 15/10/1964 54 1
3 Marianus Geli Luli 5306 1226 0302 0001 007/004 3 26/03/2001 17 1
4 Apriliana Bengan Dorok 5306 1262 0405 0001 007/004 3 22/04/2005 13 2
5 Agustinus Doni Laba 5306 1203 0896 0001 007/004 kk 7/8/1996 22 1
6 Maria Bebo Koda 5306 1246 0588 0003 007/004 2 24/05/1988 30 2
7 Listantri Lama Ewak 5306 007/004 3 12/9/2016 2 2
Kode kolom 9 Kode kolom 11 Kode kolom 12
ode kolom 5 Status Perkawinan Agama Pendidikan tertinggi
engan kepala keluarga 6. orang tua 1.kawin 1. Islam 1. Tidak pernah sekolah 5. Tamat SLTA/
1.
kepal 7. famili lain 2. Belum Kawin 2. Kristen 2. Tidak tamat SD/MI 6. Tamat D1/D
2.
a RT
istri/s 8.pembantu 3. Cerai hidup 3. Katolik 3. Tamat SD/ MI 7. Tamat PT
uami
3.
9.lainnya 4. Cerai mati 4. Tamat SLTP/ MTS
Anak
4.
Men
antu
5.Cuc
u
(khusus wanita Ganggua
Sarana
usia 10-54 ART usia >5 tahun ART usia Air Bersih Jenis Jenis Jamban Ganggua n Jiwa JKN Merokok
n Jiwa dipasung
tahun) sedang ≥10 tahun Sumber
Status Perkawinan hamil? Agama Air
1. Ya pendidikan Pekerjaan 1. Ya 1. Kloset 1. Ya 1. Ya 1. Ya 1. Ya
2. Tidak 2. Tidak 2. cemplung 2. Tidak 2. Tidak 2. Tidak 2. Tidak
9 10 11 12 13 14 15 16 17 18 19 20
4 2 3 3 6 1 PDAM 1 2 2 1 2
2 2 3 4 2 1 PDAM 2 2 1 2
2 2 3 3 1 1 PDAM 2 2 1 2
2 2 3 2 1 PDAM 2 2 1 2
2 2 3 2 1 PDAM 2 2 1 2
2 2 3 2 1 PDAM 2 2 2 2
2 2 3 4 1 1 PDAM 2 2 1 2
2 2 3 4 2 1 PDAM 2 2 1 2
1 2 3 3 1 1 PDAM 1 2 2 2 2
1 2 3 3 6 1 PDAM 2 2 1 2
2 2 3 3 1 1 PDAM 2 2 1 1
2 2 3 2 1 PDAM 2 2 1 2
1 2 3 3 9 1 PDAM 1 2 2 1 2
2 2 3 3 2 1 PDAM 2 2 1 2
2 2 3 2 1 PDAM 2 2 1 2
2 2 3 1 PDAM 2 2 2 2
3 2 3 3 6 1 PDAM 2 2 2 2
4 2 1 3 6 1 PDAM 1 2 2 2 2
3 2 3 3 6 1 PDAM 1 2 2 2 2
4 2 3 3 6 1 PDAM BABS 2 2 1 2
1 2 3 3 6 1 PDAM 1 2 2 2 2
1 2 3 3 6 1 PDAM 2 2 2 2
4 2 3 3 6 1 PDAM 1 2 2 2 2
1 2 3 3 6 1 PDAM BABS 2 2 2 2
2 2 3 1 PDAM 2 2 2 2
2 2 3 1 PDAM 2 2 2 2
4 2 3 3 1 1 PDAM 1 2 2 1 2
1 2 3 3 6 1 PDAM NUMPANG 2 2 2 1
1 2 3 5 5 1 PDAM 2 2 2 2
2 2 3 1 PDAM 2 2 2 2
1 2 3 3 6 1 PDAM 1 2 2 2 1
1 2 3 3 5 1 PDAM 2 2 2 2
2 2 3 5 1 1 PDAM 2 2 2 1
2 2 3 5 1 1 PDAM 2 2 2 1
3 2 3 3 6 1 PDAM 1 2 2 2 2
2 2 3 3 6 1 PDAM BABS 2 2 1 2
1 2 3 3 6 1 PDAM 1 2 2 2 1
1 2 3 3 6 1 PDAM 2 2 2 2
1 2 3 3 6 1 PDAM 1 2 2 2 2
1 2 3 3 6 1 PDAM 2 2 2 2
2 2 3 4 5 1 PDAM 2 2 2 2
1 2 3 3 6 1 PDAM BABS 2 2 2 2
1 2 3 3 6 1 PDAM 2 2 2 2
1 2 3 4 5 1 PDAM NUMPANG 2 2 2 1
1 2 3 4 9 1 PDAM 2 2 2 2
1 2 3 3 6 1 PDAM 1 2 2 2 2
1 2 3 3 6 1 PDAM 2 2 2 2
1 2 3 3 6 1 PDAM BABS 2 2 2 1
2 2 3 2 1 PDAM 2 2 2 2
2 2 3 1 PDAM BABS 2 2 2 2
1 2 3 3 1 1 PDAM 1 2 2 2 1
1 2 3 3 6 1 PDAM 2 2 2 2
2 2 3 3 9 1 PDAM 2 2 2 2
1 2 3 3 5 1 PDAM 2 2 2 1
1 1 3 5 9 1 PDAM 2 2 2 2
2 2 3 1 PDAM 2 2 2 2
4 2 3 3 1 1 PDAM babs 2 2 1 2
1 2 3 3 6 1 PDAM numpang 2 2 2 2
1 2 3 3 6 1 PDAM 2 2 2 2
1 2 3 3 1 1 PDAM 1 2 2 1 1
1 2 3 3 6 PDAM 2 2 1 2
2 2 3 5 1 PDAM 2 2 1 1
2 2 3 4 2 PDAM 2 2 1 2
2 2 3 3 6 PDAM 2 2 1 2
1 2 3 3 9 PDAM 2 2 2 2
2 2 3 2 PDAM 2 2 2 2
2 2 3 2 PDAM 2 2 2 2
2 2 3 2 PDAM 2 2 2 2
2 2 3 3 6 PDAM 1 2 2 2 1
2 2 3 3 6 PDAM 2 2 2 2
2 2 3 3 6 PDAM 2 2 2 2
2 2 3 5 5 PDAM 2 2 2 2
1 2 3 5 6 PDAM 1 2 2 2 1
1 2 3 5 9 PDAM 2 2 2 2
2 2 3 2 PDAM 2 2 2 2
2 2 3 1 PDAM 2 2 2 2
4 2 3 3 6 PDAM 2 2 1 2
1 2 3 3 6 PDAM 1 2 2 2 2
1 2 3 3 6 PDAM 2 2 2 2
1 2 3 4 9 PDAM 2 2 2 2
1 2 3 3 6 PDAM BABS 2 2 1 1
1 2 3 3 9 PDAM 2 2 1 2
2 2 3 5 1 PDAM 2 2 1 1
2 2 3 3 2 PDAM 2 2 1 2
2 2 3 2 PDAM 2 2 1 2
2 2 3 1 PDAM 2 2 2 2
2 2 3 3 6 PDAM 1 2 2 2 2
1 2 3 3 6 PDAM 2 2 2 2
1 2 3 3 2 PDAM 2 2 1 2
2 2 3 2 PDAM 2 2 1 2
1 2 3 3 6 PDAM 2 2 1 2
1 2 3 4 9 PDAM 2 2 2 2
2 2 3 1 PDAM 2 2 2 2
1 2 3 3 6 PDAM 1 2 2 1 1
1 2 3 3 6 PDAM 2 2 1 2
4 2 3 3 6 PDAM 2 2 2 2
1 2 3 3 6 PDAM 1 2 2 2 1
1 2 3 3 9 PDAM 2 2 2 2
2 2 3 2 PDAM 2 2 2 2
2 2 3 2 PDAM 2 2 2 2
2 2 3 2 PDAM 2 2 2 2
1 2 3 3 6 PDAM 1 2 2 1 1
1 2 3 3 6 PDAM 2 2 1 2
2 2 3 1 PDAM 2 2 1 2
2 2 3 4 2 PDAM 2 2 1 2
2 2 3 2 PDAM 2 2 2 2
4 2 3 3 6 PDAM 2 2 1 2
1 2 3 5 6 PDAM 1 2 2 2 1
1 2 3 5 9 PDAM 2 2 2 2
4 2 3 3 6 PDAM 2 2 2 2
1 2 3 3 6 PDAM babs 2 2 1 1
1 2 3 3 6 PDAM 2 2 1 2
2 2 3 5 1 PDAM 2 2 1 1
2 2 3 3 6 PDAM 2 2 1 2
4 2 3 3 6 PDAM babs 2 2 2 2
1 2 3 5 1 PDAM 2 2 2 1
2 2 3 3 6 PDAM 1 2 2 2 2
1 2 3 2 PDAM 2 2 2 2
4 2 3 3 6 PDAM babs 2 2 1 2
2 2 3 2 PDAM 2 2 1 2
4 2 3 1 1 PDAM babs 2 2 2 2
3 2 3 3 6 PDAM numpang 2 2 2 2
1 2 3 4 6 PDAM babs 2 2 1 1
1 2 3 3 9 PDAM 2 2 1 2
2 2 3 2 PDAM 2 2 1 2
2 2 3 2 PDAM 2 2 1 2
2 2 3 4 2 PDAM 2 2 2 2
2 2 3 3 6 PDAM 1 2 2 2 2
2 2 3 3 6 PDAM 2 2 2 2
2 2 3 3 6 PDAM 2 2 2 2
1 2 3 5 9 PDAM 1 2 2 1 1
1 2 3 7 5 PDAM 2 2 2 2
2 2 3 2 PDAM 2 2 2 2
2 2 3 1 PDAM 2 2 2 2
4 2 3 3 6 PDAM babs 2 2 1 2
2 2 3 5 1 PDAM 2 2 1 1
1 2 3 3 6 PDAM 1 2 2 1 1
1 2 3 3 6 PDAM 2 2 1 2
1 2 3 3 6 PDAM 2 2 1 1
1 2 3 5 9 PDAM 2 2 1 2
2 2 3 2 PDAM 2 2 1 2
2 2 3 3 2 PDAM 2 2 1 2
1 2 3 1 6 PDAM babs 2 2 1 1
1 2 3 3 6 PDAM 2 2 1 2
2 2 3 3 2 PDAM 2 2 1 2
2 2 3 4 2 PDAM 2 2 1 2
1 2 3 4 6 PDAM 2 2 1 1
1 2 3 5 9 PDAM 2 2 2 2
2 2 3 1 PDAM 2 2 2 2
12
tinggi
mat SLTA/MA 1. Tidak Kerja 6. Petani

mat D1/D2/D3 2. Sekolah 7.Nelayan
3. TNI/Polri 8. Buruh
4. PNS/ Peg 9. Lainnya
5. Wiraswasta/swasta/jasa
Wanita menikah usia
10-54 tahun
Masalah menggunakan alat
kesehatan kontrasepsi
(penyakit)
1. Ya
2. Tidak
21 22
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
1
2
2
2
2
2
2
2
1
2
2
2
2
2
2
2
2
2
1
2
2
2
2
2
1
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
1
2
2
2
2
2
2
2
1
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
1
2
REKAPAN PIS PK
Jenis
NO Kelamin
Nama NIK RT/ RW Hub. Anggota Keluarga Tanggal Lahir Umur
1. Pria
2. Wanita
1 2 3 4 5 6 7 8
1 Kondradus Kopong Demon 5306 12021174 0001 008/004 1 2/11/1974 44 1

2 Maria Barek Rupa 5306 1252 0281 0001 008/004 2 12/2/1981 37 2
3 Pontianus Kristian Kadu Roman 5306 1213 0802 0001 008/004 3 13/08/2002 16 1
4 Laurensia Leoni Abon Boli 5306 1261 0709 0001 008/004 3 21/07/2009 9 2
1 Gabriel Demon Tuto 5306 1203 0549 0002 008/004 1 3/5/1949 69 1
2 Katarina Bengan Dorok 5306 1255 0545 0001 008/004 2 15/05/1945 73 2
1 Rofina Rayi Notan 5306 1252 0973 0002 008/004 2 12/9/1973 45 2
2 Andreson Wadan Pnana 5306 1211 1004 0001 008/004 3 11/10/2004 14 1
1 Helena Tuto Soge 5306 1253 0943 0001 008/004 1 3/9/1943 75 2
2 Rosalia Busa Bolen 5306 1241 0769 0022 008/004 3 1/7/1969 49 2
1 Antonius Demon Lonek 5306 1220 0178 0001 008/004 1 20/01/1978 40 1
2 Emilia Peni Wurin 5306 1270 0591 0001 008/004 2 30/05/1991 27 2
3 Fransiskus Tanah Bolen 5306 1213 0312 0001 008/004 3 13/03/2012 6 1
4 Fransiska Tanah Bolen 008/004 3 29/09/2015 3 2
1 Kosmas Ara Kian 5306 1218 0264 0002 008/004 1 18/02/1964 54 1
2 Bernadete Palan Duli 5306 1254 0477 0002 008/004 2 14/09/1977 41 2
3 Antonius Kia Golon 5306 1209 1200 0003 008/004 3 9/12/2000 18 1
4 Olgerius Kopong Mangu 5306 1207 0904 0001 008/004 3 7/9/2003 15 1
5 Martina Abon Boli 5306 1251 1107 0001 008/004 3 11/111/2007 11 2
6 Januarius Andreas Nuba Laba 5306 1201 0114 0001 008/004 3 1/1/2014 4 1
7 Kornelis Ola Payon 008/004 6 30/07/1940 78 1
1 Paulus Nama Goran 5306 1201 0168 0003 008/004 1 1/1/1968 50 1
2 Viktoria Maga Sabon 5306 1257 0171 0001 008/004 2 17/01/1971 47 2
3 Karolus Usen Miten 5306 1220 0796 0004 008/004 3 20/07/1996 22 1
4 Karolina Lipat Seran 5306 1242 0797 0003 008/004 3 2/7/1997 21 2
5 Valentinus Lekin Boli 5306 1218 0403 0003 008/004 3 18/04/2003 15 1
1 Kamelia Kewa Doni 5306 1243 0383 0001 008/004 2 3/3/1983 35 2
2 Fransiskus Mado Ulu 5306 1222 4060 0002 008/004 3 24/06/2000 18 1
1 Karolina Kewa Doni 008/004 1 4/6/1961 57 2
2 Emanuel Jefrianus Geli Luli 5306 1229 1295 0002 008/004 3 29/12/1995 23 1
1 Aronoldus Doni Laba 5306 1221 0282 0001 008/004 1 9/9/1983 35 1
1 Matias Kia Beda 5306 1229 0579 0001 008/004 1 29/05/1979 39 1
2 Ventaria Ladopura 5306 1242 1284 0001 008/004 2 2/12/1984 34 2
3 Iganasius Ike Geroda 5306 1217 0808 0003 008/004 3 17/08/2008 10 1
4 Agustina Barek Koda 5306 1247 0811 0001 008/004 3 7/8/2011 7 2
5 Rosdalima Tuto Golot 008/004 3 5/5/2015 3 2
6 Yuni Palihama 008/004 3 6/6/2017 1 2
1 Romanus Nama Geli 008/004 1 30/05/1952 66 1
2 Karolina Krion Ola 008/004 2 1/7/1956 62 2
3 Theresia Tuto Golot 008/004 3 25/05/1999 19 2
1 Paulus Bao Lile 5306 1201 0742 0031 008/004 1 1942 76 1
2 Sesilia Sili Gita 5306 1260 0550 0001 008/004 2 31/12/1953 65 2
3 Wilhelmus Wara Iken 5306 1226 0285 0001 008/004 kepala keluarga 26/02/1985 33 1
4 Natalia Barek Kuma 5306 1241 0782 0015 008/004 2 13/12/1985 33 2
5 Maria Liliana Kidi Reon 5306 1243 0515 0001 008/004 3 3/5/2015 3 2
1 Paulus Sabon Payon 008/004 1 31/12/1953 65 1
2 Kristina Rayi Sabon 008/004 2 1/7/1953 65 2
3 Agustinus Ola Sabon 5306 1201 0784 0019 008/004 kepala keluarga 8/8/1984 34 1
1 Sesilia Letek Pehan 5306 1271 1267 0013 008/004 1 31/12/1967 51 2
2 Fransiskus Saverius Kolot Aman 5306 1203 2020 0002 008/004 3 3/12/2002 16 1
1 Lambertus Lawe Aman 5306 1203 0969 0001 008/004 1 3/4/1969 49 1
2 Herlina Prada Aran 5306 1243 0908 0001 008/004 2 3/9/1980 38 2
3 Marianus Lama Ewak 5306 1203 0800 0001 008/004 3 3/8/2000 18 1
4 Epiana Lama Ewak 5306 1259 0704 0001 008/004 3 19/07/2004 14 2
5 Anselmus Lama Ewak 5306 1208 0507 0001 008/004 3 8/5/2007 11 1
1 Stefanus Kopong Bura 5306 1220 0973 0001 008/004 1 20/05/1973 45 1
2 Agustina Lepan Geroda 5306 1250 0884 0003 008/004 2 10/8/1984 34 2
3 Kevin Efantino Wara Iken 5306 1207 0104 0002 008/004 3 7/1/2004 14 1
1 Simon Sin Ola 5306 1227 0376 0001 008/004 1 27/03/1976 42 1
2 Magdalena Tuto Soge 5306 1266 0683 0002 008/004 2 26/06/1983 35 2
3 Melsiana Kewa Somi 5306 1251 0505 0001 008/004 3 11/5/2005 13 2
4 Stefanus Reksian Kopong Bura 5306 1203 0609 0001 008/004 3 3/6/2009 9 1
5 Katarina Triani 008/004 3 22/10/2017 8 bulan 2
1 Veronika Lepan Lelan 5306 1260 0776 0001 008/004 2 20/07/1976 42 2
2 Yoakim Sani Kopon 5306 1231 0804 0001 008/004 3 31/08/2004 14 1
3 Melwinsius Mado Ulu 5306 1229 0809 0001 008/004 3 29/08/2009 9 1
4 Febrianto Ola Muga 5306 1217 0212 0002 008/004 3 17/02/2012 6 1
1 Karolina Kewa Lela 5306 1245 0768 0001 008/004 2 5/27/1968 50 2
2 Alredus Tanah Bolen 5306 1212 0998 0001 008/004 3 12/9/1998 20 1
1 Silvinus Kia Boli 5306 1212 1172 0003 008/004 6 23/03/1972 46 1
2 Susana Surat Bala 5306 1269 0472 0002 008/004 2 29/04/1972 42 2
3 Albertus Beda Raran 5306 1224 0494 0002 008/004 3 2/4/1994 24 1
4 Novianus Kuma Jawa 5306 1218 1101 0001 008/004 3 18/11/2001 16 1
5 Febriana Indra Letek Pehan 5306 1267 0209 0001 008/004 3 18/02/2009 9 2
6 Lambertus Ola Sabon 5306 1220 1095 0001 008/004 kepala keluarga 20/11/1995 23 1
7 Angelina Marici Barek 008/004 2 2
8 Matilda Suri 008/004 3 27/06/2017 1 2
1 Lambertus Laba Masan 5306 1225 0363 0001 008/004 1 25/03/1963 55 1
2 Susana Surat Masan 5306 1271 1264 0012 008/004 2 31/12/1964 54 2
3 Lambertus Bengan Aman 5306 1207 1196 0002 008/004 3 7/11/1996 22 1
1 Elisabet Surat Angin 5306 1243 1058 0001 008/004 1 3/10/1958 60 2
1 Kristina Anu Nuhon 5306 1246 0980 0001 008/004 2 6/9/1980 30 2
2 Agustinus Doni Laba 5306 1224 0802 0001 008/004 3 24/08/2002 16 1
3 Aprilina Dike Tokan 5306 1263 0406 0001 008/004 3 23/04/2006 12 2
kode kolom 12
kode kolom 5 kode kolom 9 Kode kolom 11 Pendidikan tertinggi
hubungan dengan kepala keluarga status perkawinan Agama 1. Tidak pernah sekolah 5. Tamat SLTA/
1.kepala rumah tangga 6.orang tua 1.kawin 1. Islam 2. Tidak tamat SD/MI 6. Tamat D1/D
2.suami/istri 7.famili lain 2.belum kawin 2. Kristen 3. Tamat SD/ MI 7. Tamat PT
3.anak 8.pembantu 3.cerai hidup 3. Katolik 4. Tamat SLTP/ MTS
4.menantu 9.lainnya 4.cerai mati
5.cucu
RT
(khusus wanita Ganggua
Sarana
usia 10-54 ART usia >5 tahun ART usia Air Bersih Jenis Jenis Jamban Ganggua n Jiwa JKN Merokok
n Jiwa dipasung
tahun) sedang ≥10 tahun Sumber
Status Perkawinan hamil? Agama Air
1. Ya pendidikan Pekerjaan 1. Ya 1. Kloset 1. Ya 1. Ya 1. Ya 1. Ya
2. Tidak 2. Tidak 2. cemplung 2. Tidak 2. Tidak 2. Tidak 2. Tidak
9 10 11 12 13 14 15 16 17 18 19 20
1 2 3 3 6 1 PDAM 1 2 2 1 2
1 2 3 3 9 1 PDAM 2 2 1 2
2 2 3 3 2 1 PDAM 2 2 1 2
2 2 3 2 1 PDAM 2 2 1 2
1 2 3 3 6 1 PDAM numpang 2 2 1 1
1 2 3 3 6 1 PDAM 2 2 1 2
1 2 3 3 6 1 PDAM numpang 2 2 2 2
2 2 3 2 1 PDAM 2 2 2 2
4 2 3 3 6 1 PDAM babs 2 2 1 2
2 2 3 3 6 1 PDAM 2 2 1 2
1 2 3 3 6 1 PDAM 1 2 2 2 1
1 2 3 3 9 1 PDAM 2 2 2 2
2 2 3 1 PDAM 2 2 2 2
2 2 3 1 PDAM 2 2 2 2
1 2 3 7 5 1 PDAM 1 2 2 1 2
1 2 3 3 9 1 PDAM 2 2 1 2
2 2 3 4 2 1 PDAM 2 2 1 2
2 2 3 3 2 1 PDAM 2 2 1 2
2 2 3 2 1 PDAM 2 2 1 2
2 2 3 1 PDAM 2 2 2 2
4 2 3 3 6 1 PDAM 2 2 1 1
1 2 3 3 6 1 PDAM 1 2 2 2 1
1 2 3 3 6 1 PDAM 2 2 1 2
2 2 3 4 2 1 PDAM 2 2 1 1
2 2 3 5 1 1 PDAM 2 2 1 2
2 2 3 3 2 1 PDAM 2 2 1 2
1 2 3 3 6 1 PDAM 1 2 2 2 2
2 2 3 4 2 1 PDAM 2 2 2 1
1 2 3 3 6 1 PDAM numpang 2 2 2 2
2 2 3 4 5 1 PDAM 2 2 2 1
2 2 3 3 6 1 PDAM numpang 2 2 2 2
1 2 3 3 6 1 PDAM 1 2 2 2 1
1 2 3 3 9 1 PDAM 2 2 2 2
2 2 3 2 1 PDAM 2 2 2 2
2 2 3 1 PDAM 2 2 2 2
2 2 3 1 PDAM 2 2 2 2
2 2 3 1 PDAM 2 2 2 2
1 2 3 3 1 1 PDAM 1 1 2 2 2
1 2 3 3 6 1 PDAM 2 2 2 2
2 2 3 5 2 1 PDAM 2 2 2 2
1 2 3 3 6 1 PDAM 1 2 2 2 1
1 2 3 3 6 1 PDAM 2 2 2 2
1 2 3 3 6 1 PDAM 2 2 2 1
1 2 3 3 9 1 PDAM 2 2 2 2
2 2 3 1 PDAM 2 2 2 2
1 2 3 3 6 1 PDAM 1 2 2 2 1
1 2 3 3 6 1 PDAM 2 2 2 2
1 2 3 3 6 1 PDAM 2 2 2 1
4 2 3 3 6 1 PDAM babs 2 2 2 2
1 2 3 3 2 1 PDAM 2 2 2 2
1 2 3 3 6 1 PDAM 1 2 2 1 1
1 2 3 3 6 1 PDAM 2 2 1 2
2 2 3 4 2 1 PDAM 2 2 1 2
2 2 3 4 2 1 PDAM 2 2 1 2
2 2 3 2 1 PDAM 2 2 1 2
1 2 3 3 6 PDAM 1 2 2 2 2
1 2 3 4 6 PDAM 2 2 2 2
2 2 3 2 PDAM 2 2 2 2
1 2 3 3 6 PDAM babs 2 2 1 1
1 2 3 3 9 PDAM 2 2 1 2
2 2 3 2 PDAM 2 2 1 2
2 2 3 2 PDAM 2 2 1 2
2 2 3 PDAM 2 2 2 2
1 2 3 3 6 PDAM babs 2 2 1 2
2 2 3 2 PDAM 2 2 1 2
2 2 3 2 PDAM 2 2 1 2
2 2 3 2 PDAM 2 2 2 2
1 2 3 3 6 PDAM 1 2 2 1 2
2 2 3 3 2 PDAM 2 2 1 1
1 2 3 3 6 PDAM 1 2 2 1 1
1 2 3 3 6 PDAM 1 2 2 1 2
2 2 3 5 1 PDAM 1 2 2 1 1
2 2 3 3 2 PDAM 2 2 1 2
2 2 3 2 PDAM 2 2 1 2
1 2 3 5 5 PDAM 2 2 1 1
1 2 3 5 9 PDAM 2 2 1 2
2 2 3 PDAM 2 2 2 2
1 2 3 3 1 PDAM numpang 2 2 2 2
1 2 3 3 6 PDAM 2 2 2 2
2 2 3 5 1 PDAM 2 2 2 1
4 2 3 3 6 PDAM babs 2 2 2 2
1 2 3 3 6 PDAM 1 2 2 1 2
2 2 3 3 2 PDAM 2 2 1 2
2 2 3 2 PDAM 2 2 1 2
Kode kolom 13
tinggi Pekerjaan
mat SLTA/MA 1. Tidak Kerja 6. Petani

mat D1/D2/D3 2. Sekolah 7.Nelayan
3. TNI/Polri 8. Buruh
4. PNS/ Peg 9. Lainnya
Wanita menikah usia
10-54 tahun
(penyakit)
1. Ya
2. Tidak
21 22
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
REKAPAN PIS PK
KETERANGA
NO
Nama NIK RT/ RW
1 2 3 4
5 Ursula Pnaten Kelo 5306 1269 1268 0001 003/002
1 Valentina Uba Prihan 5306 1253 3020 0001 003/002
2 Stevania Palang Tupen 5306 1256 0807 0001 003/002
3 Filipus Neri Tuan Laot 5306 1226 0510 0001 003/002
4 Alexander Daton Warat 5306 003/002
5 Fiviana Bale Tobi 5306 003/002
6 Falentino Boli Abon 5306 003/002
7 Yohanes Suban Raya 5306 1224 1257 0001 003/002
1 Benedikta Barek Medo 5306 1241 0758 0037 003/002
2 Kasir Kia Komek 5306 1212 0835 0002 003/002
1 Kamsia Kewa Solot 5306 1260 0160 0001 003/002
2 Oktavia Kasir 5306 1253 1284 0001 003/002
3 Hanavi Ara Kian Roman 5306 1210 0896 0001 003/002
4 Samsia Surat Kian 5306 1249 0572 0001 003/002
1 Aryuni Kewa Pain 5306 1265 0802 0002 003/002
2 Erlan Tokan 5306 1250 0608 0001 003/002
3 Andrini Putri Tokan 5306 003/002
4 Benediktus Bao Lile 5306 1218 0160 0001 003/002
1 Theresia Pulo Tupen 5306 1241 0740 0088 003/002
2 Rovinus Sanga Geroda 5306 1224 0486 0003 003/002
1 Bibiana Date Doni 5306 1248 1196 0005 003/002
2 Vinsensius Boro Kian Lama Tokan 5306 1224 0109 0001 003/002
3 Paskalis Lewo Nuba 5306 003/002
4 Yohanes Fransisko 5306 003/002
5 Paulina Bengan Keda 5306 1248 0859 0001 003/002
6 Viktor Lele Kuma 5306 1202 1268 0002 003/002
1 Marta Barek Duli 5306 1244 0175 0001 003/002
2 Nelsonius Ola Aman 5306 1219 0400 0002 003/002
3 Marianus Ehak Ledo 5306 1212 0504 0001 003/002
4 Yulius Laga Boli 5306 1214 1110 0001 003/002
5 Yasinta Bepa Doni 5306 1257 0312 0001 003/002
6 Ester Palan Keda 5306 1241 0750 0057 003/002
7 Karolus Kopong Keda 5306 1218 0863 0001 003/002
1 Benedikta Hingin Bolen 5306 1258 0968 0001 003/002
2 Yuliana Somi Biri 5306 1218 1187 0001 003/002
3 Ermasita Letek Pehan 5306 1258 0900 0001 003/002
4 Romanus Ara Kian 5306 1218 1187 0001 003/002
5 Veronka Letek Pati 5306 003/002
6 Patric Domini Demon Sao 5306 003/002
7 Bartolomeus Beda Keda 5306 1220 0665 0001 003/002
1 Bertha Barek Bolen 5306 1256 0467 0001 003/002
2 Odilia Deran Baru 5306 1254 1000 0002 003/002
3 Emilia Uba Bakan 5306 1259 0504 0005 003/002
4 Doni bahon 5306 003/002
5 Kornelis Ara Kian 5306 1202 1047 0001 003/002
1 Martina Deran Kian 5306 1245 0252 0001 003/002
2 Pangkrasius Payon Geroda 5306 1211 0284 0001 003/002
3 Donatus Kopong Tube 5306 1201 0289 0003 003/002
4 Natalia Deran Tupen 5306 1252 1295 0001 003/002
5 Fransiskus 5306 003/002
6 Theresia Lipat Sabon 5306 1255 1173 0002 003/002
7 Adrianao Trsnowanto Lamapaha 5306 1213 0201 0001 003/002
8 Ferdinandus Oron Tewa 5306 1221 1157 0001 003/002
1 Agapitus Klake Ado Pehan 5306 1221 0468 0003 003/002
1 Monika Osi Rera 5306 1267 0575 0002 003/002
2 Florianus Yoseph Narek Ola 5306 1203 0200 0003 003/002
3 Maria Florentina Deran Payon 5306 1243 0202 0003 003/002
4 Agustinus Bura Tokan 5306 1209 0760 0001 003/002
1 Maria Buka Surat 5306 1260 0978 0001 003/002
2 Sesilia Barek Ola 5306 1243 0903 0001 003/002
3 Marianus Narek Ola 5306 1230 0505 0004 003/002
4 Albertus Kia Beda Ama 5306 1215 1109 0001 003/002
5 Pangkrasius Lama Tokan 003/002
1 Kristina Bulu Laga 5306 1263 0374 0001 003/002
2 Lasarus Laga Boli 5306 1221 1155 0001 003/002
1 Tresia Surat Lanan 5306 1241 0762 0041 003/002
2 Paulus Pati Selan 5306 1208 1242 0001 003/002
1 Tresia Uba Kopon 5306 1245 0951 0001 003/002
2 Thresia Tuto Mado 5306 1245 1274 0001 003/002
1 Alosius Romario Bali Wara 5306 1208 0502 0002 003/002
2 Rafael Rugi Belen 5306 1201 0755 0012 003/002
1 Maria Ema Duli 5306 1241 0758 0051 003/002
2 Perada Aran 5306 1241 0729 0014 003/002
1 Fauziah Busa Bolen 5306 1244 0194 0001 003/002
2 Bernadus Geli Luli 5306 1210 1048 0001 003/002
1 Petronela Perada Wuun 5306 1271 1256 0008 003/002
2 Gabriel Lamatokan 5306 1206 0484 0001 003/002
3 Rosnawati 003/002
4 Patrisius 003/002
5
(khusus wanita
Jenis usia 10-54
Kelamin tahun) sedang
Hub. Anggota Keluarga Tanggal Lahir Umur Status Perkawinan hamil?
1. Pria 1. Ya
2. Wanita 2. Tidak
5 6 7 8 9 10
2 29/12/1968 50 2 1 2
3 13/02/2002 16 2 2 2
3 16/08/2007 11 2 2 2
3 26/05/2010 8 1 2 2
1 17/04/1991 27 1 1 2
2 18/02/1992 26 2 1 2
3 9/3/2016 2 1 2 2
1 24/12/1957 61 1 1 2
2 1/7/1958 60 2 1 2
1 12/8/1935 83 2 2 2
2 1960 58 2 1 2
3 24/10/1984 34 2 2 2
3 10/1/1996 22 1 2 2
2 9/5/1972 46 2 1 2
3 25/08/2002 16 2 2 2
3 10/6/2008 10 1 2 2
3 24/04/2016 2 2 2 2
1 18/01/1960 58 1 2 2
7 1/7/1940 78 2 2 2
1 24/04/1986 32 1 1 2
2 8/11/1996 22 2 1 2
3 24/01/2009 9 1 2 2
3 21/03/2015 3 1 2 2
3 18/06/2016 2 1 2 2
6 8/8/1959 59 2 4 2
1 2/12/1968 50 1 1 2
2 4/1/1975 43 2 2 2
3 19/04/2000 18 1 2 2
3 12/5/2004 14 1 2 2
3 14/11/2010 8 1 2 2
3 17/03/2012 6 2 2 2
6 1/7/1950 68 2 4 2
1 18/08/1963 55 1 1 2
2 19/09/1968 50 2 1 2
3 3/6/1990 28 2 2 2
3 31/5/2000 18 2 2 2
1 18/11/1987 31 1 1 2
2 30/11/1986 32 2 1 2
3 7/9/1905 1 1 2 2
1 20/06/1965 53 1 1 2
2 16/04/1967 51 2 1 2
3 14/10/2000 18 2 2 2
3 19/05/2004 14 2 2 2
6 1/7/1928 90 1 4 2
1 12/10/1947 71 1 1 2
2 5/2/1952 66 2 1 2
3 11/2/1984 34 1 2 2
kepala keluarga 1/2/1989 29 1 1 2
2 2/12/1995 23 2 1 2
3 21/06/2017 11 bulan 1 2 2
kepala keluarga 1973 45 2 3 2
3 2001 17 1 2 2
1 21/11/1957 61 1 1 2
1 21/04/1968 50 1 1 2
2 27/05/1975 43 2 1 2
3 3/3/2000 18 1 2 2
3 3/2/2002 16 2 2 2
1 7/9/1960 58 1 1 2
1 20/09/1978 40 2 2 2
3 3/9/2003 15 2 2 2
3 3/9/2005 13 1 1 2
3 15/11/2009 8 1 1 2
1 1941 77 1 4 2
2 23/03/1974 44 2 1 2
1 21/11/1955 63 1 1 2
2 1/7/1962 56 2 1 2
1 8/12/1942 76 2 1 2
2 5/9/1951 n 2 1 2
kk 5/12/1974 44 2 1 2
3 6/5/2002 16 1 2 2
1 1/7/1955 63 1 1 2
2 1/7/1958 60 2 1 2
1 1/7/1929 89 2 1 2
5 4/1/1994 24 2 2 2
1 10/10/1948 70 1 1 2
2 31/12/1956 62 2 1 2
kk 6/4/1984 34 1 1 2
2 8/7/1987 31 2 1 1
3 14/08/2015 3 1 2 2
perpipaan
Ganggua
Sarana
ART usia >5 tahun ART usia Air Bersih Jenis Jamban Ganggua n Jiwa
perpipaa n Jiwa dipasung
≥10 tahun
Agama n
pendidikan Pekerjaan 1. Ya 1. Kloset 1. Ya 1. Ya

2. Tidak 2. cemplung 2. Tidak 2. Tidak
11 12 13 14 15 16 17 18
3 3 6 1 PDAM 1 2 2
3 3 2 1 PDAM 1 2 2
3 2 1 PDAM 1 2 2
3 2 1 PDAM 1 2 2
3 7 9 1 PDAM 1 2 2
3 6 9 1 PDPD 1 2 2
3 1 PDAM 1 2 2
3 3 6 1 PDAM 1 2 2
3 3 6 1 PDAM 1 2 2
1 3 6 1 PDAM 1 2 2
1 3 6 1 PDAM 1 2 2
1 3 1 1 PDAM 1 2 2
1 5 1 1 PDAM 1 2 2
1 3 9 1 PDAM 1 2 2
1 2 1 PDAM 1 2 2
1 2 1 PDAM 1 2 2
1 1 PDAM 1 2 2
3 3 3 1 PDAM 1 2 2
3 3 3 1 PDAM 1 2 2
3 3 6 1 PDAM 1 2 2
3 3 9 1 PDAM 1 2 2
3 2 1 PDAM 1 2 2
3 1 PDAM 1 2 2
3 1 PDAM 1 2 2
3 3 6 1 PDAM 1 2 2
3 3 6 1 PDAM 1 2 2
3 3 9 1 PDAM 1 2 2
3 4 2 1 PDAM 1 2 2
3 3 2 1 PDAM 1 2 2
3 2 1 PDAM 1 2 2
3 2 1 PDAM 1 2 2
3 3 9 1 PDAM 1 2 2
3 3 6 1 PDAM 1 2 2
3 3 6 1 PDAM 1 2 2
3 4 1 1 PDAM 1 2 2
3 3 2 1 PDAM 1 2 2
3 5 9 1 PDAM 1 2 2
3 7 9 1 PDAM 1 2 2
3 1 PDAM 1 2 2
3 3 6 1 PDAM 1 2
3 3 6 1 PDAM 2 2
3 4 2 1 PDAM 2 2
3 3 2 1 PDAM 2 2
3 3 1 1 PDAM 2 2
3 3 6 1 PDAM 1 2 2
3 3 6 1 PDAM 1 2 2
3 3 6 1 PDAM 1 2 2
3 3 5 1 PDAM 1 2 2
3 5 6 1 PDAM 1 2 2
3 1 PDAM 1 2 2
3 3 3 1 PDAM 1 2 2
3 3 2 1 PDAM 1 2 2
3 3 6 1 PDAM 1 2 2
3 3 6 1 PDAM 1 2 2
3 3 6 1 PDAM 1 2 2
3 4 2 1 PDAM 1 2 2
3 3 2 1 PDAM 1 2 2
3 3 6 1 PDAM 1 2 2
3 3 6 1 PDAM 1 2 2
3 3 2 1 PDAM 1 2 2
3 2 1 PDAM 1 2 2
3 2 1 PDAM 1 2 2
3 3 6 1 PDAM 1 2 2
3 4 9 1 PDAM 1 2 2
3 3 6 1 PDAM 1 2 2
3 3 9 1 PDAM 1 2 2
3 3 6 1 PDAM 1 2 2
3 3 9 1 PDAM 1 2 2
3 4 6 1 PDAM 1 2 2
3 3 2 1 PDAM 1 2 2
3 3 6 1 PDAM 1 2 2
3 3 9 1 PDAM 1 2 2
1 6 1 PDAM 1 2 2
1 5 9 1 PDAM 1 2 2
3 5 9 1 PDAM 1 2 2
3 3 9 1 PDAM 1 2 2
3 5 9 1 PDAM 1 2 2
3 5 9 1 PDAM 1 2 2
3 1 1 PDAM 1 2 2
Wanita menikah usia
10-54 tahun
JKN Merokok Masalah menggunakan alat
(penyakit)
1. Ya 1. Ya 1. Ya
2. Tidak 2. Tidak 2. Tidak
19 20 21 22
2 2 2
2 2 2
2 2 2
2 2 2
2 1 2
2 2 1
2 2 2
1 1 2
1 2 2
2 1 2
2 2 2
2 2 2
2 2 2
2 2 2
2 2 2
2 2 2
2 2 2
2 2 2
2 2 2
2 1 2
1 2 2
2 2 2
2 2 2
2 2 2
2 2 2
1 1 2
1 2 2
1 1 2
1 2 2
1 2 2
2 2 2
1 2 2
2 1 2
2 2 2
2 2 2
2 2 2
2 1 2
2 2 2
2 2 2
1 1 2
1 2 2
1 2 2
1 2 2
2 2 2
2 2 2
2 2 2
2 1 2
2 1 2
2 2 1
2 2 2
2 2 2
2 2 2
2 2 2
1 1 2
1 2 1
1 1 2
1 2 2
2 1 2
2 2 2
2 2 2
2 2 2
2 2 2
2 1 2
2 2 2
2 1 2
2 2 2
2 1 2
2 2 2
2 2 2
2 2 2
2 2 2
2 2 2
2 2 2
2 2 2
1 1 2
1 2 2
2 1 2
1 2 2
2 2 2
REKAPAN PIS PK
KETERA
NO
Nama NIK RT/ RW
1 2 3 4
1 Korbianus Mula Lela 5306 002/001
2 Reliana Bebo Koda 5306 1256 0589 0001 002/001
3 Tarsisia Violet Siona Mula Lela 002/001
1 Lembertus Rugi Nuhon 5306 1230 0664 0001 002/001
2 Liberta Prada Tolok 5306 1264 0865 0001 002/001
3 Yustinus Lama Paha 002/001
1 Kondradus Tugu Lelan 5306 1213 0465 0001 002/001
2 Kristina Lelu Sanga 5306 1252 0560 0001 002/001
3 Apriliana Dera Ola 5306 1243 0499 0002 002/001
4 Oktavianus Sili Lelan 5306 1228 1088 0003 002/001
5 Florentina Hingin Wara 5306 1249 1181 0001 002/001
6 Meliana Ina LamaPaha 5306 1264 0113 0002 002/001
7 Aloisius Lama Paha 5036 1201 0769 0027 002/001
1 Karolus Krikit 5306 1242 0274 0002 002/001
2 Kresensia Buka Beda 5306 1242 0274 0002 002/001
3 Nikolaus Sili Osan 5306 1209 0705 0001 002/001
4 Gregorius Koro Hama 5306 1202 0114 0001 002/001
1 Moses Demon Sao 5306 1215 1134 1931 002/001
2 Veronika Ose Suban 5306 1257 1248 0001 002/001
3 Anselmus Guna Hala 5306 1212 0480 0001 002/001
4 Regina Nini Liat 5306 1259 0780 0002 002/001
1 Hendrikus Rugi Bele 5306 1217 0261 0001 002/001
2 Theresia Leka Boro 5306 1258 0762 0001 002/001
3 Paulina Palan Asan 002/001
4 Sohip Kopng Bunga 002/001
1 Hendrikus Teti Rera 5306 1206 0248 0001 002/001
2 Theresia Barek Uran 5306 1268 1147 0001 002/001
3 Isabela Uto Hawan 5306 1257 0689 0001 002/001
1 Hendrikus Rugi Nuhon 5306 1207 0663 0001 002/001
2 Agnes Somi Biri 5306 1250 0627 0001 002/001
3 Yohanes Fandelinus Lewo Nuba 5306 1217 0900 0002 002/001
1 Kristina Barek Rupa 5306 1252 0655 0002 002/001
2 Hermantinus Sili Lelan 5306 1215 0790 0002 002/001
1 Lasarus Bao Lile 5306 1229 0568 0003 002/001
2 Maria Surat Suban 5306 1242 0560 0001 002/001
3 Salferius Burak Aman 5306 1221 0297 0002 002/001
4 Susana Bahi 5306 1251 0596 0003 002/001
1 Benedikta Barek Bunga 5306 1250 0444 0001 002/001
39 Kode kolom 9
Kode kolom 5 Status Perkawinan
ubungan dengan
1. kepala keluarga 6. orang tua 1.kawin
kepal
2. kepala rumah tangga 7. famili lain 2. Belum Kawin
aistri/s
RT s 8.pembantu 3. Cerai hidup
3.
uami
Anak anak
4. 9.lainnya 4. Cerai mati
Men menantu
antu
5 cucu
(khusus wanita
Jenis usia 10-54
1. Pria 1. Ya
2. Wanita 2. Tidak
5 6 7 8 9 10
1 10/24/1987 31 1 1 2
2 5/16/1989 29 2 1 2
3 7/9/2015 3 2 2 2
1 6/30/1964 54 1 1 2
2 8/24/1965 53 2 1 2
3 7/13/1999 19 1 2 2
1 4/13/1965 53 1 1 2
2 5/12/1960 58 2 1 2
3 4/13/1999 19 2 2 2
2 11/9/1981 37 2 1 2
3 1/24/2013 5 2 2 2
3 11/17/2016 1.6 1 2 2
1 8/18/1967 51 1 1 2
2 2/2/1974 44 2 1 2
3 7/9/2005 13 1 2 2
3 1/2/2014 4 1 2 2
1 1/1/1931 87 1 1 2
2 17/12/1948 70 2 1 2
1 19/07/1980 38 2 1 2
1 17/05/1961 57 1 1 2
2 18/07/1962 56 2 1 2
3 7/9/2000 18 2 2 2
4 16/07/1994 24 1 2 2
1 2/6/1948 70 1 1 2
2 28/11/1947 71 2 1 2
3 17/06/1989 29 2 2 2
1 7/6/1963 55 1 1 2
2 10/2/1967 51 2 1 2
3 17/09/2000 18 1 2 2
1 12/6/1955 63 2 1 2
3 15/07/1990 28 1 2 2
1 29/05/1968 50 1 2 2
2 2/5/1960 58 2 2 2
2 11/5/1996 22 2 2 1
1 10/4/1944 74 2 4 2
Kode kolom 11 Kode kolom 12 kode kolom
Agama Pendidikan tertinggi Pekerjaa
1. Islam 1. Tidak pernah sekolah 5. Tamat SLTA/MA 1. Tidak Kerja
2. Kristen 2. Tidak tamat SD/MI 6. Tamat D1/D2/D3 2. Sekolah
3. Katolik 3. Tamat SD/ MI 7. Tamat PT 3. TNI/Polri
4. Tamat SLTP/ MTS 4. PNS/ Peg
Ganggua
Sarana
ART usia >5 tahun ART usia Air Bersih Jenis Jenis Jamban Ganggua n Jiwa
n Jiwa dipasung
≥10 tahun Sumber
Agama Air
11 12 13 14 15 16 17 18
3 5 5 1 PDAM 1 2 2
3 6 5 1 PDAM 2 2
3 1 PDAM 2 2
3 SPG 4 1 PDAM 1 2 2
3 3 9 1 PDAM 2 2
3 5 1 1 PDAM 2 2
3 3 6 1 PDAM 1 2 2
3 3 6 1 PDAM 2 2
3 4 2 1 PDAM 2 2
3 5 5 1 PDAM 2 2
3 3 9 1 PDAM 2 2
3 2 1 PDAM 2 2
3 1 PDAM 2 2
3 3 6 1 PDAM NUMPANG 2 2
3 3 6 1 PDAM 2 2
3 2 1 PDAM 2 2
3 6 1 PDAM 2 2
3 3 6 1 PDAM 1 2 2
3 3 6 1 PDAM 2 2
3 3 6 1 PDAM 2 2
3 4 9 1 PDAM 2 2
3 3 6 1 PDAM 1 2 2
3 3 6 1 PDAM 2 2
3 4 2 1 PDAM 2 2
3 3 5 1 PDAM 2 2
3 3 6 1 PDAM 1 2 2
3 3 1 1 PDAM 2 2
3 7 5 1 PDAM 2 2
3 3 6 1 PDAM 1 2 2
3 3 6 1 PDAM 2 2
3 5 1 1 PDAM 2 2
3 3 6 1 PDAM 1 2 2
3 7 5 1 PDAM 2 2
3 3 6 1 PDAM 1 2 2
3 3 6 1 PDAM 2 2
3 4 1 1 PDAM 2 2
3 5 9 1 PDAM 2 2
3 3 6 1 PDAM 2 2
kode kolom 13
Pekerjaan
6. Petani
7.Nelayan
8. Buruh
9. Lainnya
aswasta/swasta/jasa
Wanita menikah usia
10-54 tahun
(penyakit)
1. Ya 1. Ya 1. Ya
19 20 21 22
2 1 2
2 2 1
2 2 2
1 1 2
1 2 2
2 1 2
2 1 2
2 2 2
2 2 2
2 1 2
2 2 2
2 2 2
2 2 2
2 1 2
2 2 2
2 2 2
2 2 2
2 2 2
2 2 2
2 1 2
2 2 2
2 1 2
2 2 2
2 2 2
2 1 2
2 1 2
2 2 2
2 2 2
2 2 2
2 2 2
2 1 2
2 2 2
2 1 2
2 2 2
2 2 2
2 1 2
2 2 2
2 2 2
REKAPAN PIS PK
KETERANGA
NO
Nama NIK RT/ RW
1 2 3 4
1 Agata Geben Sabon 5306 1253 0585 0003 002/001
2 Alfonsus Ehak Ledo 5306 1211 0707 0003 002/001
3 Frederikus Laba Masan 5306 1229 1110 0001 002/001
1 Voika Due Duli 5306 1250 0864 0001 002/001
2 Andreas Kia Bahin 5306 1220 0295 0004 002/001
1 Rafael Raya Hama 5306 1201 0764 0021 002/001
2 Kresensia Lipat Lelan 5306 1241 0769 0029 002/001
3 Yohana Fransiska Mayaviranti Pugel 5306 1267 1200 0003 002/001
4 Nikolaus Valentino Pugel 5306 1207 0105 0001 002/001
1 NIkolaus Belo Payong 5306 1207 0871 0001 002/001
2 Yohana Kneka Jumad 5306 1265 1072 0002 002/001
3 Rikardus Romanus Kopog Kian 5306 1231 0595 0001 002/001
4 Paulus Rivaldus Kolot Ama 5306 1221 1197 0001 002/001
5 Katarina Tuto Uan 5306 1250 0905 0002 002/001
1 BeRta Barek Medo 5306 1271 1126 0025 002/001
2 Silvester Bunga Lolon 5306 1210 0600 0001 002/001
1 Emilia Rayi Boli 5306 1261 0383 0003 002/001
2 Stanisius Palihama 5306 1229 1001 0001 002/001
3 Stevania Palihama 5306 1256 0908 0001 002/001
4 Sebastian Yerevan 5306 1221 0612 0001 002/001
1 Antonius Ara Kian 5306 1210 1257 0001 002/001
2 Theresia Bewa Doni 5306 1256 0164 0001 002/001
1 Lorensius Lasa Sait 5306 1228 0272 0001 002/001
2 Benedikta Bebo Koda 5306 1265 0974 0001 002/001
3 Romoaldus Junior Ongenulan 5306 1212 0698 0002 002/001
4 Agustinus Karunia Ongenulan 5306 1211 0804 0001 002/001
5 Stevania Ongenulan 5306 1266 1209 0002 002/001
6 Wilhelmus Ola Dorok 5306 1216 0727 0002 002/001
7 Agustina Anu Ola 5306 1262 0869 0001 002/001
1 Michael Mua Pneban 5306 1202 1126 0001 002/001
2 Rosalia Date Lasan 5306 1251 1230 0001 002/001
1 Agata Tuto Boli 5306 1264 0560 0001 002/001
2 Ervina Peni Lagan 5306 1268 0394 0002 002/001
1 Maria Welin Sabon 5306 1246 1134 0001 002/001
2 Edeltrudis Masi Ehak 5306 1260 1079 0002 002/001
3 Maria Anseliana Palihama 5306 1254 0979 0002 002/001
4 Markus Kia Beda 5306 12290704 0002 002/001
1 Hilarius Liku Lewo 5306 1201 0634 0001 002/001
2 Elisabet Lipat Sabon 5306 1252 1139 0001 002/001
Kode kolom 5 Kode kolom 9
Hubungan dengan kepala keluarga Status Perkawinan
1. kepala RT 6. orang tua 1.kawin
2. istri/suami 7. famili lain 2. Belum Kawin
3. Anak 8.pembantu 3. Cerai hidup
4. Menantu 9.lainnya 4. Cerai mati
5.Cucu
(khusus wanita
Jenis usia 10-54
1. Pria 1. Ya
8 2. Tidak
s 6 7 8 9 10
2 13/05/1985 33 2 1 2
3 11/7/2007 11 1 2 2
3 29/11/2010 8 1 2 2
1 10/8/1964 54 2 4 2
3 20/02/1995 23 1 2 2
1 1/7/1964 54 1 1 2
2 1/7/1964 54 2 1 2
3 27/12/2000 18 2 2 2
3 7/1/2005 13 1 2 2
1 7/8/1971 57 1 1 2
2 25/10/1972 56 2 1 2
1 31/05/1995 23 1 2 2
3 21/11/1997 21 1 2 2
3 22/09/2003 15 2 2 2
1 31/12/1955 63 2 4 2
5 10/6/2000 18 1 2 2
2 21/03/1983 35 2 1 2
3 29/10/2001 17 1 2 2
3 16/09/2008 10 2 2 2
3 21/06/2012 6 1 2 2
1 10/12/1957 61 1 1 2
2 28/02/1956 62 2 1 2
1 28/02/1972 46 1 1 2
2 25/09/1974 44 2 1 2
3 12/6/1998 20 1 2 2
3 11/8/2004 14 1 2 2
3 26/12/2009 9 2 2 2
6 1/7/1926 92 1 4 2
7 22/08/1969 49 2 2 2
1 2/11/1926 92 1 1 2
2 11/12/1930 88 2 1 2
1 24/05/1960 58 2 1 2
3 28/03/1994 24 2 2 2
6 6/11/1934 84 2 4 2
7 20/10/1979 39 2 2 2
3 28/10/2000 18 2 2 2
3 29/07/2004 14 1 2 2
1 1/6/1934 84 1 1 2
2 26/08/1939 79 2 1 2
Agama Pendidikan tertinggi Pekerjaan
Ganggua
Sarana
n Jiwa dipasung
≥10 tahun Sumber
Agama Air
11 12 13 14 15 16 17 18
3 3 6 1 PDAM 1 2 2
3 2 1 PDAM 2 2
3 2 1 PDAM 2 2
3 3 6 1 PDAM 2 2 2
3 5 1 1 PDAM 2 2
3 3 6 1 PDAM 1 2 2
3 3 6 1 PDAM 2 2
3 5 1 1 PDAM 2 2
3 3 2 1 PDAM 2 2
3 3 6 1 PDAM BABS 2 2
3 3 9 1 PDAM 2 2
3 5 9 1 PDAM 2 2
3 2 1 1 PDAM 2 2
3 3 2 1 PDAM 2 2
3 3 6 1 PDAM BABS 2 2
3 5 1 1 PDAM 2 2
3 3 9 1 PDAM 1 2 2
3 3 2 1 PDAM 2 2
3 2 1 PDAM 2 2
3 2 1 PDAM 2 2
3 3 6 1 PDAM NMPANG 2 2
3 3 6 1 PDAM 2 2
3 5 9 1 PDAM 1 2 2
3 3 9 1 PDAM 2 2
3 4 2 1 PDAM 2 2
3 3 2 1 PDAM 2 2
3 2 1 PDAM 2 2
3 3 6 1 PDAM 2 2
3 5 5 1 PDAM 2 2
3 1 1 1 PDAM 1 2 2
3 1 1 1 PDAM 2 2
3 3 6 1 PDAM 1 2 2
3 5 1 1 PDAM 2 2
3 3 1 1 PDAM NMPANG 2 2
3 3 6 1 PDAM 2 2
3 4 2 1 PDAM 2 2
3 3 2 1 PDAM 2 2
3 3 6 1 PDAM 1 2 2
3 3 6 1 PDAM 2 2
Kode kolom 13
Pekerjaan
6. Petani
7.Nelayan
8. Buruh
9. Lainnya
aswasta/swasta/jasa
Wanita menikah usia
10-54 tahun
(penyakit)
1. Ya 1. Ya 1. Ya
19 20 21 22
1 2 2
1 2 2
1 2 2
2 2 2
2 1 2
1 1 2
1 2 2
1 2 2
1 2 2
2 1 2
1 2 acites 2
1 1 2
1 1 2
1 1 2
1 2 2
2 1 2
1 2 2
1 2 2
1 2 2
2 2 2
2 1 2
2 2 2
1 1 2
1 1 2
1 2 2
1 2 2
1 2 2
1 2 2
1 2 2
2 1 2
2 2 2
1 1 2
1 1 2
1 2 2
1 2 2
1 2 2
1 2 2
2 1 2
2 2 2
REKAPAN PIS PK
KETERANGA
NO
Nama NIK RT/ RW
1 2 3 4
1 Magdalena Tuto Mado 5306 1266 0850 0001 002/001

1 Yosep Kopong Solot 5306 1202 0763 0001 002/001
2 Imelda Lambertini Curman 5306 1241 0865 0001 002/001
3 Triclavianus Fanderolus 5306 1225 0400 0002 002/001
4 Lusia Fradiyafan LT 5306 12250305 0003 002/001
5 Kristiani Fransiska 5306 002/001
1 Dominikus Kopong Tokan 5306 1228 0467 0001 002/001
2 Margareta Solot Kpitan 5306 1260 0270 0001 002/001
3 Epitanius Laga Boli 5306 1228 0297 0001 002/001
1 Yohanes Mado Geroda 5306 1216 1241 0001 002/001
2 Petronela Anu Liat 5306 1257 0350 0001 002/001
3 Emanuel Lamapaha 5306 1224 1200 0001 002/001
1 Maria Goreti Deran Ina 5306 1241 0398 0002 002/001
2 Fransiska Mumu Pneban 5306 1267 0230 0001 002/001
1 Nicolaus Kia Bahin 5306 1207 0144 0001 002/001
2 Siprianus Nuho Komek 5306 1204 1175 0001 002/001
3 Fidelis Kopong Tena 5306 1226 0482 0001 002/001
4 Maria Welin Wuring 5306 1247 0586 0001 002/001
5 Anggrino Oswaldo Eha Ledo 5306 1209 0810 0001 002/001
6 Fransiskus Aprilio 5306 002/001
1 Yohanes Nama Geli 5306 1206 0848 0001 002/001
2 Susana Solot Laga 5306 1257 1163 0001 002/001
1 Gergorius Guna Hala 5306 1216 0245 0001 002/001
2 Kristina Rayi Helan 5306 1257 1254 0001 002/001
3 Aleksius Lodo Dai 5306 1217 0782 0002 002/001
4 Yulianus Lasan Sait 5306 1205 0770 0002 002/001
5 RofinaGeben Sabon 5306 1251 0388 0003 002/001
6 Angelina Peni Lagan 5306 1243 0306 0002 002/001
7 Maria Goreti Date Rugi 5306 1270 1207 0001 002/001
8 Skolastika Palan Boro 5306 1247 0215 0001 002/001
9 Mihael Ehe Lele 002/001
1 Andreas Kopong Boli 5306 1206 1151 0001 002/001
2 Agnes Uba Kian 5306 1251 0955 0001 002/001
3 Yustinus Laga Daton 5306 1227 0583 0003 002/001
4 Yonita Firtanti Lama Tokan 5306 1265 0291 0002 002/001
5 Cristian Eka Valerian 002/001
1 Romanus Roman Nama 5306 1201 0745 0052 002/001
2 Lusia Hingin Bolen 5306 1241 0760 0103 002/001
3 Stanislaus Lama Tokan 002/001
5.Cucu
(khusus wanita
Jenis usia 10-54
1. Pria 1. Ya
2. Wanita 2. Tidak
5 6 7 8 9 10
1 26/08/1950 68 2 4 2
1 2/7/1963 55 1 1 2
2 1/8/1965 53 2 1 2
3 25/04/2000 18 1 2 2
3 15/03/2005 13 2 2 2
3 15/12/2008 10 2 2 2
1 28/04/1967 51 1 1 2
2 2/2/1970 48 2 1 2
3 28/02/1997 21 1 2 2
1 16/12/1941 77 1 1 2
2 17/03/1950 68 2 1 2
5 24/12/2000 18 1 2 2
3 1/3/1998 20 2 2 2
6 0/04/1951 67 2 4 2
6 7/1/1944 74 1 4 2
7 4/11/1975 43 1 2 2
2 7/5/1986 32 2 1 2
3 9/8/2010 8 1 2 2
3 2/4/2014 4 1 2 2
1 1948 70 1 1 2
2 1963 55 2 1 2
1 1945 73 1 1 2
2 1954 64 2 1 2
3 1982 36 1 2 2
2 1988 30 2 2 2
3 2006 8 2 2 2
3 2007 7 2 2 2
3 2015 2 2 2 2
3 2017 1 2 2
1 7/9/1949 69 1 1 2
2 31/12/1956 62 2 1 2
2 25/02/1991 27 2 1 2
3 5/9/2014 3 1 2 2
1 1945 73 1 1 2
2 1960 58 2 1 2
3 1 2 2

Ganggua
Sarana
n Jiwa dipasung
≥10 tahun Sumber
Agama Air
11 12 13 14 15 16 17 18
3 3 6 1 PDAM 1 2 2
3 7 4 1 PDAM 1 2 2
3 7 4 1 PDAM 2 2
3 4 2 1 PDAM 2 2
3 3 2 1 PDAM 2 2
3 2 1 PDAM 2 2
3 3 6 1 PDAM 1 2 2
3 3 6 1 PDAM 2 2
3 4 6 1 PDAM 2 2
3 3 6 1 PDAM 1 2 2
3 3 6 1 PDAM 2 2
3 3 2 1 PDAM 2 2
3 3 1 1 PDAM 1 2 2
3 1 1 1 PDAM 1 2 2
3 3 6 1 PDAM 1 2 2
3 5 6 1 PDAM 2 2
3 3 6 1 PDAM 2 2
3 3 9 1 PDAM 2 2
3 2 1 PDAM 2 2
3 2 1 PDAM 2 2
3 3 6 1 PDAM 1 2 2
3 3 6 1 PDAM 2 2
3 2 6 1 PDAM 1 2 2
3 2 6 1 PDAM 2 2
3 5 6 1 PDAM 2 2
3 3 6 1 PDAM 2 2
3 3 9 1 PDAM 2 2
3 2 1 PDAM 2 2
3 2 1 PDAM 2 2
3 2 1 PDAM 2 2
3 1 PDAM 2 2
3 3 6 1 PDAM 1 2 2
3 3 6 1 PDAM 2 2
3 5 6 1 PDAM 2 2
3 6 9 1 PDAM 2 2
3 1 PDAM 2 2
3 3 6 1 PDAM 1 2 2
3 3 6 1 PDAM 2 2
3 5 9 1 PDAM 2 2
Kode kolom 13
Pekerjaan
6. Petani
7.Nelayan
8. Buruh
9. Lainnya
aswasta/swasta/jasa
Wanita menikah usia
10-54 tahun
JKN Merokok
(penyakit)
1. Ya 1. Ya 1. Ya
19 20 21 22
2 2 2
1 1 2
1 2 2
2 2 2
2 2 2
2 2 2
2 1 2
2 2 2
2 1 2
2 1 2
2 2 2
2 2 2
1 2 2
2 2 2
2 1 2
2 1 2
2 1 2
2 2 2
2 2 2
2 2 2
2 2 2
2 2 2
1 1 2
1 2 2
2 1 2
2 1 2
1 2 1
1 2 2
2 2
2 2
2 2
2 2 2
2 2 2
2 1 2
2 2 1
2 2 2
1 1 2
1 2 2
2 1 2
REKAPAN PIS PK
KETERANGA
NO
Nama NIK RT/ RW
1 2 3 4
4 Rikardus Kia Boli 5306 1230 0498 0002 002/001

5 Kristina Boi Duli 5306 1259 0281 0003 002/001
6 Yulius Ledo Ehak 5306 1213 0408 0001 002/001
1 Nasarius Aji Tadon 5306 1222 0969 0001 002/001
2 Martina Mude 5306 1243 0474 0002 002/001
3 Siprianus Lama Tokan 5306 1216 0909 0001 002/001
4 Leontinus Lama Tokan 5306 1218 0601 0001 002/001
5 Yosefina Kwae Tadon 5306 1263 0614 0001 002/001
6 Theresia Bewa Doni 5306 1241 0744 0025 002/001
1 Antonius Bali Diri 5306 1225 0208 0002 002/001
2 Marselina Masi Hali 5306 1226 0820 0001 002/001
3 Anastasia Barek Boro 5306 1267 0403 0001 002/001
4 Rosita Mesa Daton 5306 1267 0793 0001 002/001
5 Eduardus Suban Rupa 5306 1202 1213 0001 002/001
1 Theresia Tuto Ete 5306 1256 1139 0001 002/001
1 Urbanus Uan Aman 5306 1217 0770 0001 002/001
2 Sesilia Solot Nama 5306 1242 1277 0001 002/001
3 Piter Sandiago 5306 1221 1004 0001 002/001
4 Alexandro Kia Boli 5306 1218 1208 0002 002/001
5 Maria Anjelin Tuto Uan 5306 1263 0313 0002 002/001
6 Blasis Saputra Boli Tadon 002/001
1 Damianus Au Lolon 5306 1223 1274 0001 002/001
2 Epiana Hingin Wara 5306 1241 0178 0001 002/001
3 Sofia Falensia Pulo Geon 5306 1265 0305 0001 002/001
4 Maria Yosefita Selekta 002/001
1 Hendrikus Eban Ola 5306 1217 0767 0002 002/001
2 Theresia Tuto Mamun 5306 1248 0774 0001 002/001
3 Hilaria Pulo Geon 5306 1266 0508 0001 002/001
4 Maria Deran Mela 002/001
1 Stefanus Mua Pneban 5306 1203 0860 0001 002/001
2 Monika Ose Suban 5306 1241 0274 0003 002/001
3 Katarina Gunu Luli 002/001
1 Martina Maga Sabon 5306 1263 0670 0001 002/001
2 Adrianus Kia Beda 5306 1220 4970 0001 002/001
3 Agustinus Lewo Nuba 5306 1220 0899 0001 002/001
1 Daniel Guna Hala 5306 1202 0576 0005 002/001
2 Maria Deran Tupen 5306 1255 0985 0001 002/001
3 Dominggo Densel 5306 1218 0110 0001 002/001
4 Maria Daniela 5306 002/001
5.Cucu
(khusus wanita
Jenis usia 10-54
1. Pria 1. Ya
2. Wanita 2. Tidak
5 6 7 8 9 10
3 1998 20 1 2 2
3 2008 10 1 1 2
1 1969 49 1 1 2
2 1974 44 2 1 2
3 1/9/2009 9 1 2 2
3 1/7/211 7 1 2 2
3 23/06/2014 4 2 2 2
6 1944 74 2 4 2
1 1962 56 1 1 2
2 1967 51 2 1 2
3 2003 15 2 2 2
3 2/12/2013 4 1 2 2
1 16/11/1939 79 2 6 2
1 1970 48 1 6 2
2 1977 41 2 9 2
3 2004 14 1 2 2
3 1/12/2008 10 1 2 2
3 2013 5 2 2
7 1 1 2
1 1974 44 1 6 2
2 1/1/1978 40 2 9 1
3 2005 2 2 2
3 2 2 2
1 1967 51 1 6 2
2 1974 44 2 6 2
3 2008 10 2 2 2
6 2 1 2
1 1960 58 1 6 2
2 1974 44 2 6 2
6 2 1 2
2 52 2 6 2
3 20/04/1998 20 1 2 2
3 20/08/1999 19 1 2 2
1 1976 42 1 6 2
2 1985 33 2 9 2
3 2010 8 1 1 2
3 2 2

Ganggua
Sarana
n Jiwa dipasung
≥10 tahun Sumber
Agama Air
11 12 13 14 15 16 17 18
3 5 1 1 PDAM 2 2
3 3 6 1 PDAM 2 2
3 3 2 1 PDAM 2 2
3 3 6 1 PDAM 1 2 2
3 6 1 PDAM 2 2
3 2 1 PDAM 2 2
3 2 1 PDAM 2 2
3 1 1 PDAM 2 2
3 3 1 1 PDAM 2 2
3 3 6 1 PDAM 1 2 2
3 1 6 1 PDAM 2 2
3 2 1 PDAM 2 2
3 2 1 1 PDAM 2 2
3 3 1 1 PDAM 2 2
3 3 6 1 PDAM 1 2 2
3 3 6 1 PDAM 1 2 2
3 3 6 1 PDAM 2 2
3 2 1 PDAM 2 2
3 2 1 PDAM 2 2
3 1 PDAM 2 2
3 3 2 1 PDAM 2 2
3 3 6 1 PDAM 1 2 2
3 3 9 1 PDAM 2 2
3 3 2 1 PDAM 2 2
3 2 1 PDAM 2 2
3 3 6 1 PDAM 1 2 2
3 3 6 1 PDAM 2 2
3 2 1 PDAM 2 2
3 3 1 1 PDAM 2 2
3 3 6 1 PDAM 1 2 2
3 3 6 1 PDAM 2 2
3 3 1 1 PDAM 2 2
3 4 2 1 PDAM 2 2
3 4 2 1 PDAM 2 2
3 5 6 1 PDAM 1 2 2
3 5 9 1 PDAM 2 2
3 2 1 PDAM 2 2
3 1 PDAM 2 2
Kode kolom 13
Pekerjaan
6. Petani
7.Nelayan
8. Buruh
9. Lainnya
aswasta/swasta/jasa
Wanita menikah usia
10-54 tahun
JKN Merokok
(penyakit)
1. Ya 1. Ya 1. Ya
19 20 21 22
1 1 2
1 2 2
1 1 2
1 1 2
1 2 2
1 2 2
1 2 2
2 2 2
1 2 2
1 1 2
1 2 2
1 2 2
1 2 2
2 2 2
2 2 2
1 1 2
1 2 2
1 2 2
1 2 2
2 2 2
2 2 2
2 1 2
2 2 2
2 2 2
2 2 2
2 1 2
2 2 2
2 2 2
2 2 2
1 1 2
1 2 2
2 2 2
2 2 2
1 1 2
1 1 2
2 1 2
2 2 2
2 2 2
2 2 2
REKAPAN PIS PK
KETERANGA
NO
NAMA NIK RT/ RW
1 2 3 4
5 David Julio 002/001
6 Benedikta Hingin Bolen 002/001
1 Rasyd Payong Doni 5306 1202 0253 0001 002/001
2 Samsidar Siba Ina 5306 1256 1150 0001 002/001
1 Masjur Kopong oron 5306 1213 0172 0001 002/001
2 Faizah Muhamad 5306 1250 0784 0001 002/001
3 Muhamad Fadhli 5306 1216 0511 0001 002/001
4 Mastura Hingi 002/001
165
166
167
168
169
170
171
172
173
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
32
33
34
35
36
37
38
39
5.Cucu
(khusus wanita
Jenis usia 10-54
1. Pria 1. Ya
2. Wanita 2. Tidak
5 6 7 8 9 10
3 1 2 2
7 2 4 2
1 2/2/1953 65 1 1 2
2 16/11/1955 63 2 1 2
2 10/7/1984 34 2 1 1
3 10/7/2008 10 1 2 2
3 6/4/2014 4 2 2 2

Ganggua
Sarana
n Jiwa dipasung
≥10 tahun Sumber
Agama Air
11 12 13 14 15 16 17 18
3 1 1 PDAM 2 2
3 3 1 1 PDAM 2 2
3 3 6 1 PDAM 1 2 2
1 3 6 1 PDAM 2 2
1 5 6 1 PDAM 1 2 2
1 5 9 1 PDAM 2 2
1 2 1 PDAM 2 2
1 1 PDAM 2 2
Kode kolom 13
Pekerjaan
6. Petani
7.Nelayan
8. Buruh
9. Lainnya
aswasta/swasta/jasa
Wanita menikah usia
10-54 tahun
JKN Merokok
(penyakit)
1. Ya 1. Ya 1. Ya
19 20 21 22
2 2 2
2 2 2
2 2 2
2 2 2
2 1 2
2 2 2
2 2 2
2 2 2
REKAPAN PIS PK
KETERANGA
NO
Nama NIK RT/ RW
1 2 3 4
1 Petrus Kia Boli 5306 1201 0853 0001 006/003

2 Theresia Surat Tadon 5306 1260 0557 0001 006/003
3 Yulius Doni Dihen 5306 1208 0700 0001 006/003
1 Theresia Barek Keda 5306 1248 0144 0001 006/003
1 Kristina Peni Lagan 5306 1260 0534 0001 006/003
2 Davasius Pati Keo 5306 006/003
3 Lista Sodi Ola 5306 006/003
4 Benediktus Beda Keda 5306 1222 0594 0001 006/003
1 Theresia Prada Boro 5306 1243 0162 0001 006/003
1 Yosefina Abon Boli 5306 1271 1252 0001 006/003
1 Yeremias Laga Lawe 5306 1211 1252 0001 006/003
2 Yustina Bengan Keda 5306 1242 0760 0001 006/003
3 Oktavianus Luli Laba 5306 1228 1098 0001 006/003
4 Fransiskus Gilang Nuba Laba 5306 1201 0505 0002 006/003
5 VinsensiusPati Keo 5306 1219 0782 0002 006/003
6 Marselina Dike Tokan 5306 1262 1284 0001 006/003
7 Angelus Lionel Luli Laba 5306 1220 0112 2001 006/003
8 Marsello Alfino Ike Geroda 5306 105 1214 0001 006/003
9 Dionisius Demon Lonek 5306 1214 0487 0001 006/003
10 Bintin Nikmathurohma 006/003
11 Felisia Angelista 006/003
1 Fransiskus Boro Guru 5306 1206 1060 0001 006/003
2 Petronela Palan Boro 5306 1250 1162 0001 006/003
3 Adrianus Rian Tobi 5306 1203 1193 0002 006/003
4 Irene Boleng 5306 1256 0104 0001 006/003
1 Melkior Mado Ulu 5306 1205 0652 0001 006/003
2 Florinanus Lanang Beda 5306 1231 0893 0001 006/003
3 Yudensia Abon Boli 5306 1241 1095 0005 006/003
4 Michael Alden Firgian Suban Rupa 006/003
1 Tomas Tupen Beko 5306 1201 0740 0058 006/003
2 Lusia Tuto Woren 5306 1241 7460 0064 006/003
3 Kanisius Lama Ewak 5306 1221 1200 0001 006/003
4 Katarina Deran Bahon 5306 1266 0696 0004 006/003
5 Silvester Priskiano Asan Laba 006/003
6 Alesandrian 006/003
1 Yakobus Tana Boleng 5306 1214 0843 0001 006/003
2 Martina Barek Koda 5306 1260 0258 0001 006/003
3 Viviana Bengan Dorok 5306 1259 0197 0001 006/003
1 Veronika Pulo Geon 5306 1241 1500 0001 006/003
5.Cucu
(khusus wanita
Jenis usia 10-54
1. Pria 1. Ya
2. Wanita 2. Tidak
5 6 7 8 9 10
1 8/9/1948 70 1 1 2
2 20/05/1957 61 2 1 2
3 8/7/2000 18 1 2 2
1 30/07/1959 58 2 2 2
1 20/05/1934 74 2 4 2
5 1 2 2
5 2 2 2
2 3/1/1962 56 2 1 2
1 31/12/1952 66 2 4 2
1 11/12/1952 66 1 1 2
2 2/7/1960 58 2 1 2
3 28/10/1998 20 1 2 2
3 22/05/2005 13 1 2 2
2 1/12/1984 32 2 1 2
3 27/01/2012 6 1 2 2
3 5/12/2014 4 1 2 2
2 15/08/1993 25 2 1 2
1 23/11/2016 1,6 2 2 2
1 6/10/1960 58 1 1 2
2 10/11/1962 56 2 1 2
3 3/11/1993 25 1 2 2
3 16/01/2005 13 2 2 2
1 5/6/1952 66 1 4 2
2 7/10/1995 23 2 1 2
3 21/09/2016 1,8 1 2 2
1 1/7/1940 78 1 1 2
2 1/7/1946 72 2 1 2
5 21/12/2000 18 1 2 2
kepala keluarga lain istri 21/04/1996 22 2 1 2
3 28/02/2016 2,3 1 2 2
3 3/6/2017 11 bulan 1 2 2
1 14/08/1943 75 1 1 2
2 5/8/1958 60 2 1 2
3 19/07/1997 21 2 2 2
1 10/8/1951 67 1 4 2

Ganggua
Sarana
n Jiwa dipasung
≥10 tahun Sumber
Agama Air
11 12 13 14 15 16 17 18
3 3 16 1 PDAM 1 2 2
3 3 6 1 PDAM 2 2
3 3 1 1 PDAM 2 2
3 3 6 1 PDAM 1 2 2
3 3 6 1 PDAM 1 2 2
3 2 1 PDAM 2 2
3 2 1 PDAM 2 2
3 3 6 1 PDAM 2 2
3 3 6 1 PDAM 1 2 2
3 3 6 1 PDAM 1 2 2
3 3 6 1 PDAM 1 2 2
3 3 6 1 PDAM 2 2
3 4 1 1 PDAM 2 2
3 2 1 PDAM 2 2
3 5 6 1 PDAM 2 2
3 3 9 1 PDAM 2 2
3 2 1 PDAM 2 2
3 1 PDAM 2 2
3 5 6 1 PDAM 2 2
3 5 9 1 PDAM 2 2
3 1 1 PDAM 2 2
3 3 6 1 PDAM 1 2 2
3 3 6 1 PDAM 2 2
3 5 1 1 PDAM 2 2
3 2 1 PDAM 2 2
3 3 6 1 PDAM 1 2 2
3 5 6 1 PDAM 2 2
3 5 9 1 PDAM 2 2
3 1 PDAM 2 2
3 3 6 1 PDAM 1 2 2
3 3 6 1 PDAM 2 2
3 3 1 1 PDAM 2 2
3 4 9 1 PDAM 2 2
3 1 PDAM 2 2
3 1 PDAM 2 2
3 3 6 1 PDAM 2 2
3 5 1 1 PDAM 2 2
3 3 6 1 PDAM 1 2 2
Kode kolom 13
Pekerjaan
6. Petani
7.Nelayan
8. Buruh
9. Lainnya
aswasta/swasta/jasa
Wanita menikah usia
10-54 tahun
JKN Merokok
(penyakit)
1. Ya 1. Ya 1. Ya
19 20 21 22
1 1 2
1 2 2
1 1 2
2 1 2
1 2 2
2 2 2
2 2 2
2 1 2
2 2 2
2 2 2
1 1 2
1 2 2
1 1 2
1 2 2
1 1 2
1 2 2
2 2 2
2 2 2
2 1 2
2 2 2
2 2 2
1 1 2
1 2 2
1 1 2
1 2 2
1 2 2
1 1 2
2 2 2
2 2 2
1 2 2
1 2 2
1 1 2
1 2 2
2 2 2
2 2 2
1 2 2
1 2 2
1 2 2
2 2 2
REKAPAN PIS PK
KETERANGA
NO
Nama NIK RT/ RW
1 2 3 4
1 Tobias Bayo Doni 5306 1208 0256 1501 006/003

2 Maria Deran Payon 5306 1259 0780 0001 006/003
3 Suci Sentia Solot Kwae 5306 006/003
1 Yoseph Ehak Asan 5306 1206 0313 0001 006/003
2 Yustina Siba Sabon 5306 1251 0473 0001 006/003
3 Hilaria Alviona 5306 1268 0213 0001 006/003
1 Benediktus Boro Kian 5306 1210 1164 0001 006/003
2 Sesilia Oren Lanan 5306 1248 1166 0001 006/003
3 Theresia Aci Lama Ile 5306 1256 0305 0001 006/003
1 Anastasia Kewa Kopon 5306 1242 0568 0001 006/003
2 Stefanus Geli Luli 5306 1203 0801 0001 006/003
1 Hironimus Samon Sabon 5306 1210 1054 0002 006/003
2 Lusia Sili Kian 5306 1270 1150 0002 006/003
3 Fransiskus Pehan Peran 5306 1222 0483 0002 006/003
1 Elisabet Surat Sabok 5306 1255 1265 0001 006/003
1 Bernadus Ola Rea 5306 1211 1055 0001 006/003
2 Helena Letek Pehan 5306 1241 0745 0116 006/003
1 Antonius Kopong Sina 5306 1231 0575 0001 006/003
2 Mariana Palan Keda 5306 1250 0274 0001 006/003
3 Kornelia Kewa Lela 5306 1242 1001 0001 006/003
4 Lambertus Lakan Mean 5306 1219 0306 0001 006/003
5 Klaudia Nini Sengari 5306 1243 0312 0001 006/003
1 Maria Maga Sabon 5306 1241 0565 0001 006/003
2 Hironimus Pati Keo 006/003
1 Nikolaus Boro Bebe 5306 1213 1268 0001 006/003
2 Tarsisia Palan Duli 5306 1264 0573 0001 006/003
3 Andrew Tanah Miten 5306 1209 0799 0001 006/003
4 Adrian Oron Tewa 5306 1224 1003 0001 006/003
1 Paulina Menina Palan 5306 1241 0746 0084 006/003
2 Yustina Oa Tewololon 5306 1241 0768 0048 006/003
1 Donbosko Masan Doken 5306 1220 0576 0002 006/003
2 Suparmi Deran Tupen 5306 1241 0788 0010 006/003
3 Oktavianus Lama Ewak 5306 1208 1005 0001 006/003
4 Vebriana Lama Ewak 5306 1255 0206 0001 006/003
5 Emanuel Lama Ewak 5306 1222 1210 0001 006/003
6 Bartolomeus Lama Ewak 006/003
1 Yuliana Solot Pitan 5306 1260 0239 0001 006/003
1 Theresia Bare Telan 5306 1241 0748 0050 006/003
1 Rosalia Lema Sabon 5306 1267 0751 0001 006/003
5.Cucu
(khusus wanita
Jenis usia 10-54
1. Pria 1. Ya
2. Wanita 2. Tidak
5 6 7 8 9 10
1 8/2/1956 62 1 1 2
2 19/07/1980 38 2 1 2
3 28/09/2016 1,7 2 2 2
1 7/3/1973 45 1 1 2
2 7/4/1973 45 2 1 2
3 28/02/2013 5,3 2 2 2
1 10/11/1964 54 1 1 2
2 8/11/1966 52 2 1 2
3 16/03/2005 13 2 2 2
1 1/4/1968 50 2 4 2
3 3/8/2001 17 1 2 2
1 10/10/1950 68 1 1 2
2 30/11/1950 68 2 1 2
3 22/04/1983 35 1 2 2
1 16/12/1968 50 2 4 2
1 11/10/1955 63 1 1 2
2 01/07/1954 64 2 1 2
1 31/05/1975 43 1 1 2
2 14/02/1974 44 2 1 2
3 2/10/2001 17 2 2 2
3 19/03/2006 12 1 2 2
3 3/3/2012 6 2 2 2
2 1/5/1965 53 2 1 2
3 10/8/2008 10 1 2 2
1 1312/1968 50 1 1 2
2 24/05/1973 45 2 1 2
3 9/7/1997 21 1 2 2
3 24/10/2003 15 1 2 2
1 1/7/1940 78 2 3 2
3 1/7/1968 50 2 2 2
1 20/05/1976 42 1 1 2
2 1/7/1978 40 2 1 2
3 0kt0ber 2005 13 1 2 2
3 16/02/2006 12 2 2 2
3 2010 8 1 2 2
3 2012 6 1 2 2
1 1939 2 4 2
1 0107/1948 70 2 4 2
1 1951 2 4 2

Ganggua
Sarana
n Jiwa dipasung
≥10 tahun Sumber
Agama Air
11 12 13 14 15 16 17 18
3 3 6 1 PDAM 1 2 2
3 2 9 1 PDAM 2 2
3 1 1 PDAM 2 2
3 3 6 1 PDAM 1 2 2
3 3 9 1 PDAM 2 2
3 1 1 PDAM 2 2
3 3 6 1 PDAM 1 2 2
3 3 6 1 PDAM 2 2
3 2 1 PDAM 2 2
3 3 6 1 PDAM 1 2 2
3 3 2 1 PDAM 2 2
3 3 6 1 PDAM 1 2 2
3 3 6 1 PDAM 2 2
3 3 6 1 PDAM 2 2
3 3 6 1 PDAM 1 2 2
3 3 6 1 PDAM 1 2 2
3 3 6 1 PDAM 2 2
3 3 6 1 PDAM babs 2 2
3 3 6 1 PDAM 2 2
3 4 2 1 PDAM 2 2
3 2 1 PDAM 2 2
3 2 1 PDAM 2 2
3 3 6 1 PDAM 1 2 2
3 2 1 PDAM 2 2
3 5 9 1 PDAM 1 2 2
3 3 9 1 PDAM 2 2
3 4 2 1 PDAM 2 2
3 3 2 1 PDAM 2 2
3 3 1 1 PDAM 1 2 2
3 3 6 1 PDAM 1 2 2
3 3 6 1 PDAM 1 2 2
3 3 6 1 PDAM 2 2
3 2 1 PDAM 2 2
3 2 1 PDAM 2 2
3 2 1 PDAM 2 2
3 2 1 PDAM 2 2
3 3 6 1 PDAM 1 2 2
3 3 1 1 PDAM BABS 1 2
3 3 6 1 PDAM numpang 2 2
Kode kolom 13
Pekerjaan
6. Petani
7.Nelayan
8. Buruh
9. Lainnya
aswasta/swasta/jasa
Wanita menikah usia
10-54 tahun
JKN Merokok
(penyakit)
1. Ya 1. Ya 1. Ya
19 20 21 22
2 2 2
1 2 1
2 2 2
2 1 2
2 2 2
2 2 2
1 2 2
2 2 2
2 2 2
1 2 2
1 2 2
1 2 2
1 2 2
2 1 2
2 2 2
2 1 2
2 2 2
1 1 2
1 2 1
1 2 2
1 2 2
2 2 2
1 2 2
1 2 2
2 2 2
2 2 2
2 1 2
2 2 2
2 2 2
2 2 2
1 1 2
1 2 2
1 2 2
1 2 2
1 2 2
2 2 2
2 2 2
1 2 2
2 2 2
REKAPAN PIS PK
KETERANGA
NO
Nama NIK RT/ RW
1 2 3 4
1 Petrus Kopong Demon 5306 1214 0857 0001 006/003

2 Magdalena Bulu Teka 5306 006/003
3 Dina Mariana 006/003
4 Maria Deran Eban 5306 1267 0103 0001 006/003
5 Yohanes Ola Payon 5306 1205 0707 0001 006/003
6 Yulius Kia Golon 5306 1219 0704 0001 006/003
7 Valentino Kopong Solot 5306 1212 0209 0001 006/003
8 Agustina Barek Wara 5306 006/003
1 Nikolaus Narek Ola 5306 12010156 0001 006/003
2 Kristina Bulu Agon 5306 1260 0260 0001 006/003
3 Maria Elisabet Bano Rugi 5306 1248 01870001 006/003
4 Marina Kewa Pain 5306 1253 0299 0001 006/003
13
14 RT/RW : 10/05
15
1 Monika Deran Ola 5306 1207 0877 0002 10/005
2 Yuliana Lelang 5306 1245 0778 0001 10/005
3 Desiana Natalia Deran 5306 1260 1205 0001 10/005
4 Klarisa Valeria Uba 5306 1255 0210 0001 10/005
5 Agustinus Beda Palihama 5306 1222 0814 0001 10/005
1 Lukas Dala Sabon 5306 1241 0754 0037 10/005
2 Berta Prada Bepa 5306 1241 0754 0037 10/005
3 Yohanes Boro Beda 5306 1206 0482 0001 10/005
4 Fransiska Kewa Beda 5306 1258 0383 0001 10/005
5 Maria Karolina Bengan Ehak 5306 1265 0802 0001 10/005
6 Zakarias Farelius Oron 5306 1205 1108 0001 10/005
1 Nikolaus Ola Lesu 5306 1222 1161 0001 10/005
2 Wilhelmina 5306 1241 0764 0046 10/005
3 Paulina Ose Koda 5306 1262 0706 0001 10/005
4 Ariyanto Raya Demon 10/005
5 Marselina Busa Bolen 10/005
6 Anjelina Bengan Laga
7 Petrus Lali Helo 10/005
1 Kristoforus Ola Lesu 5306 1216 1080 0001 10/005
2 Veronika Letek Pehan 5306 1244 0464 0001 10/005
1 Monika Surat Suban 10/005
2 Natalia Menina Sengaji 10/005
1 Getrudis Barek Bolen 5306 1201 0754 0019 10/005
2 Yohanes Kolot Aman 10/005
3 Maria Angelina Ina Kewa 10/005
4 Marselus Albonofancis 10/005
1 Yasinta Ema Kolon 10/005
2 Tarsiana Somi Laba 10/005
3 Moses Taka Lelan 10/005
4 Refanus Bebe Aran 10/005
1 Maria Bengan Ola 5306 1270 1261 0002 10/005
1 Hendrikus Beka Raya 5306 1227 0661 0001 10/005
2 Theresia Barek Gede 5306 1246 0860 0001 10/005
3 Petrus Kesa Sabon 5306 1220 0894 0004 10/005
4 Agustina Kese Duli 5306 1244 0896 0002 10/005
1 Rosalia Solot Kepitan 5306 1242 1047 0001 10/005
2 Kristina Abon Tupen 5306 1245 0563 0002 10/005
3 Yuliana Perada Wuun 10/005
4 Andreas Inesta Ola Angin 10/005
1 Elisabet Deran Sanga 5306 1271 1253 0011 10/005
2 Karolina Tulit Rapok 10/005
3 Wilhelmus Yoseph Ara 10/005
1 Kristina Kabo Geon 5306 1242 0668 0002 10/005
2 Servasius Ola Muga 5306 1213 0501 0002 10/005
1 Maria Surat Doni 5306 1241 0736 1501 10/005
2 Andreas Ola Angin 10/005
1 Foretinus Au Lolon 5306 1205 0975 0001 10/005
2 Maria Astuti Mandasasi 5306 1267 1288 0002 10/005
3 Kristianus Sili Peka 5306 1225 0407 0001 10/005
4 Kristina Ina Sodi 5306 1255 1208 0001 10/005
5 Carolina Surat Doni 5306 1241 0812 0001 10/005
6 Patris Kopong Solot 10/005
1 Rosalia Raya Tadon 5306 1271 1069 0001 10/005
1 Kosmas Kopong Solot 2408 0731 1236 0027 10/005
2 Vinsensia Bulu Teka 2408 0764 0565 0002 10/005
3 Selviana Anu Kolon 5306 1261 0802 0002 10/005
4 Velexsia Bahi 5306 1258 0505 0003 10/005
5 Yunius Samon Sabon 5306 1208 0608 0004 10/005
6 Alexsander Ola Muga 5306 1224 0578 0001 10/005
7 Kristina Barek Aran 5306 1270 1084 0001 10/005
8 Rokus Ara Kian 5306 1216 1105 0002 10/005
9 Yosefa Penaten 5306 1207 1207 0001 10/005
10 Yudokus Ola Tokan 5306 1228 1213 0001 10/005
1 Tomas Ola Angin 5306 1201 0757 0014 10/005
2 Elisabet Hingin Wara 5306 1241 1075 0039 10/005
1 Didakus Kia Beda 5306 10/005
2 Bertiana Lamapaha 10/005
3 Rosalia Rayi Notan 5306 1241 0782 0014 10/005
4 Modesta Barek Wara 5306 1241 0788 0014 10/005
1 Yuliana Ema Duli 10/005
1 Agutina Mala Mehen 5306 1241 0733 0014 10/005
1 Dominika Deran Kraen 5306 1241 0743 0059 10/005
2 Silvester Alexsander 5306 1201 0794 0013 10/005
3 Oktavianus Lekin Padak 10/005
1 Aprilius Raya Bale 10/005
2 Martina Pada 10/005
3 Maria Genesaretha 10/005
1 Paulina Barek Koda 10/005
2 Maria Goreti Nini Soge 10/005
1 Paulina Anu Kolon 5306 1265 0560 0001 10/005
1 Kosmas Sabon Payon 5306 1201 0750 0025 10/005
1 Markus Kopong Mamun 5306 1224 0454 0002 10/005
2 Elisabet Hingin Wara 5306 1255 0258 0001 10/005
3 Barek Rawa 10/005
4 Savrius Laga Payon 10/005
5 Martina Somi Biri 10/005
6 Maria Agiska Kurouman 10/005
7 Gilbert Alfianus 10/005
1 Antonius Aji Tadon 5306 1201 0751 0019 10/005
2 Benedikta Busa Bolen 5306 1244 0673 0001 10/005
3 Frodlina Barek Blawa 5306 1246 0308 0001 10/005
4 Yeremias Bahi 10/005
1 Agnes Pulo Tupen 10/005
1 Tomas Lakan Mean 5306 1201 0765 0015 10/005
2 Marselina Masi Ehak 5306 1241 0768 0031 10/005
1 Wilhelmina Uto Hawan 10/005
2 Maria Wae Raya 10/005
1 Petronela Bengan Beda 5306 1241 0767 0046 10/005
2 Rosadelima Barek Belawa 5306 1254 1009 0001 10/005
1 Katarina Kewa Kewa Tupen 5306 1241 0730 0034 10/005
2 Kristina Busa Bolen 5306 1241 0760 0052 10/005
Kode kolom 9
Kode kolom 5 Status Perkawinan
ubungan dengan kepala keluarga 6. orang tua 1.kawin
1.
kepal
2. 7. famili lain 2. Belum Kawin
aistri/s
RT 8.pembantu 3. Cerai hidup
3.
uami
4. 9.lainnya 4. Cerai mati
Anak
Men
5.Cuc
antu
u
(khusus wanita
Jenis usia 10-54
1. Pria 1. Ya
2. Wanita 2. Tidak
5 6 7 8 9 10
1 4/8/1957 61 1 1 2
2 2 1 2
3 2017 2 2 2
3 27/01/2003 15 2 2 2
3 5/7/2007 11 1 2 2
3 19/07/2004 14 1 2 2
3 12/2/2009 9 1 2 2
3 agustus 2014 4 2 2 2
1 30/06/1956 62 1 1 2
2 20/02/1959 59 2 1 2
3 5/10/1990 28 2 2 2
3 2/2/1999 19 2 2 2
1 0/7/1957 61 2 4 2
2 5/7/1978 40 2 1 2
3 20/12/2005 13 2 2 2
3 15/02/2010 18 2 2 2
3 22/08/2014 4 1 2 2
1 1/10/1930 88 1 1 2
2 1/12/1954 64 2 1 2
kk 6/4/1982 36 1 1 2
2 18/03/1985 33 2 1 2
3 25/08/2002 16 2 2 2
3 5/11/2008 10 1 2 2
1 22/11/1961 57 1 1 2
2 1/7/1967 51 2 1 2
3 22/07/2006 12 2 2 2
5 10/1/2006 12 1 2 2
5 11/6/2000 18 2 2 2
5 3/2/2001 17 2 2 2
5 1 2 2
1 16/10/1980 38 1 1 2
2 4/4/1964 54 2 1 2
2 31/12/1967 51 2 1 2
3 22/12/2000 18 2 2 2
1 1/7/1954 64 2 4 2
kk 20/12/1994 24 1 1 2
2 2 1 2
3 7/3/2015 3 1 2 2
2 29/08/1971 47 2 1 2
3 14/04/2007 11 2 2 2
3 27/12/2010 8 1 2 2
3 2/9/2011 7 1 2 2
1 30/12/1961 57 2 4 2
1 1/1/1964 54 1 1 2
2 1/1/1961 57 2 1 2
3 1/8/1994 24 1 2 2
3 1/8/1996 22 2 2 2
1 2/10/1947 71 2 4 2
6 5/5/1963 55 2 2 2
2 10/7/1987 31 2 1 2
5 25/08/2012 6 1 2 2
1 31/12/1953 65 2 4 2
3 25/09/1987 31 2 1 2
5 3/12/2015 3 1 2 2
2 2/6/1968 50 2 1 2
3 13/05/2001 17 1 2 2
1 5/9/1931 87 2 4 2
3 1 1 2
1 5/9/1975 43 1 1 2
2 27/12/1988 30 2 1 2
3 25/04/2007 11 1 2 2
3 15/12/2008 10 2 2 2
3 1/8/2012 6 2 2 2
3 31/07/2017 1 1 2 2
1 31/10/1967 51 2 1 2
6 31/12/1936 82 1 4 2
7 24/05/1965 53 2 2 2
3 1/8/2001 17 2 2 2
3 18/05/2005 13 2 2 2
3 8/5/2008 10 1 2 2
1 24//05/1978 40 1 1 2
2 30/10/1984 34 2 1 2
3 16/11/2005 13 1 2 2
3 7/12/2007 11 2 2 2
3 28/12/2013 5 1 2 2
1 1/7/1957 61 1 1 2
2 1/7/1988 30 2 1 2
1 1 1 2
2 30/07/1988 30 2 1 2
7 1/7/1982 36 2 2 2
7 1/7/1988 30 2 2 2
1 1/7/1948 70 2 4 2
1 1/7/1933 85 2 4 2
1 1/7/1943 75 2 4 2
5 1994 24 1 2 2
5 1 2 2
1 24/04/1993 25 1 1 2
2 2 1 2
3 2 2 2
1 1/7/1961 57 2 4 2
3 12/9/2000 18 2 2 2
1 25/05/1960 58 2 3 2
1 1/7/1950 68 1 1 2
1 24/04/1954 64 1 1 2
2 19/02/1958 60 2 1 2
6 2 4 2
kk 8/1/1983 35 1 1 2
2 24/03/1988 30 2 1 2
3 30/04/2014 4 2 2 2
3 27/05/2015 3 1 2 2
1 1/7/1951 67 1 1 2
2 4/6/1973 45 2 1 2
3 6/3/2008 10 2 2 2
3 1 2 2
1 1/7/1950 68 2 4 2
1 31/12/1960 58 1 1 2
2 25/12/1968 50 2 1 2
1 1/7/1941 77 2 4 2
3 2 3 2
2 24/11/1967 51 2 3 2
3 14/10/2009 9 2 2 2
1/7/1930 88 2 4 2
1/7/1960 58 2 2 2
Agama Pendidikan tertinggi Kode kolom 13

1. Islam 1. Tidak pernah sekolah 5. Tamat SLTA/MA Pekerjaan
2. Kristen 2. Tidak tamat SD/MI 6. Tamat D1/D2/D3 1. Tidak Kerja
3. Katolik 3. Tamat SD/ MI 7. Tamat PT 2. Sekolah
4. Tamat SLTP/ MTS 3. TNI/Polri
4. PNS/ Peg
Ganggua
Sarana
n Jiwa dipasung
≥10 tahun Sumber
Agama Air
11 12 13 14 15 16 17 18
3 2 9 1 PDAM 2 2
3 1 PDAM 2 2
3 2 1 1 PDAM 2 2
3 2 1 1 PDAM 2 2
3 2 1 1 PDAM 2 2
3 2 1 1 PDAM 2 2
3 1 1 PDAM 2 2
3 3 6 1 PDAM 1 2 2
3 3 6 1 PDAM 2 2
3 3 1 1 PDAM 2 2
3 4 2 1 PDAM 2 2
3 3 6 1 PDAM 2 2
3 2 1 PDAM 2 2
3 2 1 PDAM 2 2
3 2 1 PDAM 2 2
3 3 6 1 PDAM 2 2
3 3 6 1 PDAM 2 2
3 3 9 1 PDAM 2 2
3 4 2 1 PDAM 2 2
3 2 1 PDAM 2 2
3 3 6 1 PDAM 1 2 2
3 3 6 1 PDAM 2 2
3 2 1 PDAM 2 2
3 2 1 PDAM 2 2
3 2 1 PDAM 2 2
3 2 1 PDAM 2 2
3 1 PDAM 2 2
3 3 6 1 PDAM babs 2 2
3 3 6 1 PDAM 2 2
3 3 6 1 PDAM 2 2
3 3 2 1 PDAM 2 2
3 3 6 1 PDAM 2 2
3 3 6 1 PDAM 2 2
3 4 9 1 PDAM 2 2
3 1 PDAM 2 2
3 3 6 1 PDAM babs 2 2
3 2 1 PDAM 2 2
3 2 1 PDAM 2 2
3 2 1 PDAM 2 2
3 3 6 1 PDAM 2 2
3 3 6 1 PDAM 1 2 2
3 3 6 1 PDAM 2 2
3 3 6 1 PDAM 2 2
3 4 1 1 PDAM 2 2
3 3 6 1 PDAM 1 2 2
3 3 6 1 PDAM 2 2
3 3 9 1 PDAM 2 2
3 2 1 PDAM 2 2
3 3 6 1 PDAM 1 2 2
3 5 1 1 PDAM 2 2
3 1 PDAM 2 2
3 3 6 1 PDAM 1 2 2
3 4 2 1 PDAM 2 2
3 3 6 1 PDAM 1 2 2
3 6 1 PDAM 2 2
3 4 6 1 PDAM 2 2
3 4 6 1 PDAM 2 2
3 2 1 PDAM 2 2
3 2 1 PDAM 2 2
3 1 PDAM 2 2
3 1 PDAM 2 2
3 3 6 1 PDAM 2 2
3 3 6 1 PDAM 1 2 2
3 3 6 1 PDAM 2 2
3 3 2 1 PDAM 2 2
3 3 2 1 PDAM 2 2
3 2 1 PDAM 2 2
3 3 6 1 PDAM 2 2
3 3 6 1 PDAM 2 2
3 3 2 1 PDAM 2 2
3 2 1 PDAM 2 2
3 2 1 PDAM 2 2
3 3 6 1 PDAM 2 2
3 3 6 1 PDAM 2 2
3 5 6 1 PDAM 1 2 2
3 7 5 1 PDAM 2 2
3 3 1 1 PDAM 2 2
3 3 6 1 PDAM 2 2
3 3 6 1 PDAM 1 2 2
3 1 1 1 PDAM babs 2 2
3 1 6 1 PDAM 2 2
3 3 5 1 PDAM 2 2
3 1 1 PDAM 2 2
3 3 6 1 PDAM 2 2
3 3 9 1 PDAM 2 2
3 1 PDAM 2 2
3 3 6 1 PDAM 2 2
3 4 2 1 PDAM 2 2
3 3 6 1 PDAM 2 2
3 3 6 1 PDAM 2 2
3 3 6 1 PDAM 1 2 2
3 3 6 1 PDAM 2 2
3 1 1 1 PDAM 2 2
3 5 6 1 PDAM 2 2
3 5 9 1 PDAM 2 2
3 1 PDAM 2 2
3 1 PDAM 2 2
3 3 6 1 PDAM 2 2
3 3 6 1 PDAM 2 2
3 2 1 PDAM 2 2
3 1 PDAM 2 2
3 3 6 1 PDAM 2 2
3 4 6 1 PDAM 1 2 2
3 3 6 1 PDAM 2 2
3 1 1 1 PDAM 1 2 2
3 5 1 1 PDAM 2 2
3 1 6 1 PDAM 2 2
3 2 1 PDAM 2 2
3 1 1 1 PDAM 2 2
3 1 6 1 PDAM 2 2
Kode kolom 13
Pekerjaan
6. Petani
7.Nelayan
8. Buruh
9. Lainnya
aswasta/swasta/jasa
Wanita menikah usia
10-54 tahun
(penyakit)
1. Ya 1. Ya 1. Ya
19 20 21 22
1 1 2
2 2 2
2 2 2
1 22 2
1 2 2
1 2 2
1 2 2
2 2 2
1 1 2
1 2 2
1 2 2
1 2 2
2 2 2
2 2 2
2 2 2
2 2 2
2 2 2
1 1 2
1 2 2
2 1 2
1 2 2
1 2 2
1 2 2
2 1 2
2 2 2
2 2 2
2 2 2
1 2 2
2 2 2
2 2 2
1 1 2
1 2 2
1 2 2
2 2 2
2 2 2
2 1 2
2 2 2
2 2 2
1 2 2
1 2 2
1 2 2
2 2 2
2 2 2
1 1 2
1 2 2
1 1 2
2 2 2
2 2 2
2 2 2
2 2 2
2 2 2
2 2 2
2 2 2
2 2 2
1 2 2
1 1 2
1 2 2
2 2 2
2 1 2
2 2 2
2 2 2
2 2 2
2 2 2
2 2 2
1 2 2
2 1 2
2 2 2
1 2
2 2 2
1 2 2
1 1 2
1 2 1
1 2 2
1 2 2
2 2 2
2 1 2
2 2 2
2 1 2
2 2 2
2 2 2
2 2 2
2 2 2
1 2 2
1 2 2
2 1 2
2 1 2
2 1 2
2 2 1
2 2 2
1 2 2
1 2 2
2 2 2
2 1 2
2 1 2
2 2 2
2 2 2
2 1 2
2 2
2 2 2
2 2 2
1 1 2
1 2 2
1 2 2
2 2 2
1 2 2
2 2 2
2 2 2
2 2 2
2 2 2
1 2 2
1 2 2
2 2 2
2 2 2
REKAPAN PIS PK
KETERANGA
NO
Nama NIK RT/ RW
1 2 3 4
1 Yohanes Demon Arep 5306 1227 0381 0001 005/003

2 Emiliana Dince 5306 1245 1283 0001 005/003
3 Chaprasius Brily Kuyouman 5306 1220 0205 0001 005/003
4 Fransisco Brily Kuouman 5306 1227 0707 0001 005/003
5 Efraim Handrino Kuyouman 5306 1230 0413 0001 005/003
6 Maria Tricintami Kuyouman 5306 1246 0215 0001 005/003
1 Martinus Tomas 5306 005/003
2 Maria Kewa Beda 5306 005/003
1 Paulus Kopong Pati 5306 1210 1062 0004 005/003
2 Tresia Rayi Sabon 5306 1241 0366 0001 005/003
3 Ignasius Bali Diri 5306 1257 1003 0002 005/003
4 Alexandrio Geroda Laga 5306 12240608 0001 005/003
1 Donatus Naga Notan 5306 1206 0664 1501 005/003
2 Oktaviano Kurman 5306 1230 1097 0002 005/003
1 Yakobus Kopong Bunga 5306 1201 0742 0023 005/003
2 Maria Ese Duli 5306 1252 0861 0001 005/003
1 Yosep Ola Payon 5306 1211 0570 0001 005/003
2 Monika Menina Palan 5306 1248 1269 0001 005/003
3 Agustina Peni Lagan 5306 1248 0804 0002 005/003
1 Wilhelmus Kopong Bura 5306 10735201 0025 005/003
2 Getrudis Pulo Raran 5306 1261 1034 0002 005/003
3 Ariana Ose 5306 1241 0795 0028 005/003
1 Benedikta Buka Ola 5306 1259 0272 0002 005/003
2 Maria Magdalena Langodai 5306 1241 0102 0001 005/003
3 Etwiina Langodai 5306 1242 0903 0001 005/003
4 Theresia Avila Langodai 5306 1261 0910 0001 005/003
1 Margareta Tenoa Gesak 005/003
2 Paulina Kolon Ina 005/003
1 Leonardus Ola Payon 5306 1240 1074 0034 005/003
2 Bernadete Barek Hama 5306 1245 1159 0001 005/003
3 Damianus Lawan Aman 5306 1217 0189 0001 005/003
4 Imaculata Palan Duli 5306 1249 1291 0001 005/003
5 Philipus Neri Kopong Mangu 5306 1203 0512 0001 005/003
6 Andreas Avelino 005/003
1 Bernadus Ledu Gere 5306 1210 0364 0003 005/003
2 Theresia Barek Paha 5306 1242 0763 0002 005/003
1 Magdalena 005/003
2 Yustina Tuto Soge 005/003
1 Kamilus Tupen Jumat 5306 1219 1064 0001 005/003
2 Vinsensia Surat Suban 5306 1247 0567 0001 005/003
3 Carlos Filipe Kopong Mangu 5306 1240 0995 0001 005/003
4 Agata Kristin Puhugelong 5306 1242 1102 0002 005/003
5 Albert Hugo 5306 1201 0406 0002 005/003
1 Antonius Menua Kelin 5306 005/003
2 Yosefina Bahi 5306 005/003
3 Fortunando Devila 5306 005/003
4 Nuno Alvares 5306 005/003
5 Yustina Deran Geli 5306 005/003
1 Kamilus Kia Beda 5306 005/003
1 Kristina Surat Bala 5306 1245 0954 0002 005/003
2 Florentina Bulu Ola 5306 005/003
1 Petrus Beda Keda 5306 1219 0570 0001 005/003
2 Katarina Dai Lanan 5306 1269 0481 0001 005/003
3 Leonardus Safrianus 5306 005/003
4 Maria Florentina 5306 1254 0505 0001 005/003
5 Anjelianus Ola Pati 5306 1223 0407 0001 005/003
6 Maria Celsy Surat Tadon 5306 1250 1211 0001 005/003
7 Monika Prada Aran 005/003
8 Katarina Surat Tadon 5306 1241 0734 0038 005/003
9 Sesilia Tuto Mamun 5306 1249 0162 0001 005/003
1 Benediktus Besen Beda 5306 1219 0464 0001 005/003
2 Margareta Anu Bolen 5306 1249 1268 0001 005/003
3 Benedikta Bepa Doni 5306 1254 1097 0001 005/003
4 Sevrianus Pati Keo 5306 1203 0100 0002 005/003
5 Fredidonatus Ehak Ledo 5306 1222 1004 0001 005/003
6 Maria Bengan Ola 5306 005/003
7 Alesandria 5306 005/003
1 Mastura Tiru Kopon 5306 1241 0742 0040 005/003
1 Yohanes Bapa Kemuha 5306 1201 0740 0048 005/003
2 Maria Palan Hada 5306 1241 0745 0119 005/003
3 Melkior Oron Tewa 5306 1206 0168 0064 005/003
4 Mikhael Lakan Mean 5306 005/003
5 Hilemon Bonefasius 5306 005/003
6 Fransiskus Ola Begu 5306 005/003
1 Berta Buka Kian 5306 005/003
2 Vinsensius Boro Jaga 5306 005/003
1 Sesilia Sili Gita 5306 1249 0362 0002 005/003
1 Agnes Kewa Notan 5306 005/003
2 Mariana Anu Kolon 5306 005/003
3 Natalia Hingin Geon 5306 005/003
1 Bernadus Raya Singgeli 5306 1201 0759 0031 005/003
2 Maria Novita Herin Bali 005/003
3 Selviana Ema Kolon 5306 1217 0505 0003 005/003
4 Nestiana Somi Laba 5306 1230 1030 0001 005/003
1 Simon Naga Notan 5306 1202 0964 0001 005/003
2 Susana Surat Bala 5306 1241 0768 0042 005/003
3 Kanisus Lama Tokan 5306 1208 0997 0001 005/003
4 Yulianus Lama Tokan 5306 1211 0203 0002 005/003
5 Rosita Somi Laba 5306 1253 0307 0001 005/003
1 Siprianus Geli Luli 5306 1220 0868 0001 005/003
2 Katarina Surat Bala 5306 1254 0470 0001 005/003
3 Silvester Pira Sada 5306 1227 0597 0001 005/003
4 Maria Marleni Herin Kian 5306 1243 0399 0002 005/003
5 Mensiana Nini Roya 5306 1243 0302 0001 005/003
6 Faslianus Bisara 5306 1211 1206 0002 005/003
7 Sbastianus Kolot Aman 5306 1227 4011 0001 005/003
1 Andreas Geli Nama 5306 1230 0850 0001 005/003
2 Theresia Barek Serani 5306 1288 0954 0001 005/003
1 Katarina Kewa Daton 5306 005/003
2 Maria Bunda Uba Pria 5306 1241 0101 0004 005/003
3 Antonia Pen Molan 5306 1242 0506 0001 005/003
4 Karolus Kopong Kuma 5306 1205 0785 0002 005/003
1 Maria Abon Boli 005/003
2 Martinus Roni Kolot Aman 005/003
3 Florentina Mala Tupen 005/003
1 Adam Hoyan Hongi 5306 1201 0732 0017 005/003
2 Damiana Solot Pitan 5306 1241 0736 0026 005/003
(khusus wanita
Jenis usia 10-54
1. Pria 1. Ya
2. Wanita 2. Tidak
5 6 7 8 9 10
1 27/03/1981 37 1 1 2
2 5/12/1983 35 2 1 2
3 1/10/2005 13 1 2 2
3 27/07/2007 11 1 2 2
3 30/04/2013 5 1 2 2
3 6/2/2015 3 2 2 2
1 29/03/1979 38 1 1 2
2 15/08/1978 39 2 1 2
1 10/10/1962 56 1 1 2
2 1/3/1966 52 2 1 2
3 17/10/2003 15 1 2 2
3 27/06/2008 10 1 2 2
1 6/6/1964 54 1 1 2
3 30/10/1997 21 1 2 2
1 1/7/1948 70 1 1 2
2 12/8/1961 57 2 1 2
1 29/09/1970 48 1 1 2
2 1969 49 2 1 2
3 3/8/2004 14 2 2 2
1 1/7/1938 80 1 1 2
2 21/03/1940 78 2 1 2
5 1/7/1999 19 2 2 2
2 19/02/1972 46 2 2 2
3 1/1/2002 16 2 2 2
3 2/9/2003 15 2 2 2
3 21/09/2010 8 2 2 2
6 1948 70 2 4 2
5 23/02/1999 18 2 2 2
1 5/11/1956 62 1 1 2
2 11/12/1959 59 2 2 2
kepala kluarga 7/1/1989 29 1 1 2
2 9/12/1992 26 2 1 2
3 3/5/2012 6 1 2 2
3 13/02/2016 2 1 2 2
1 10/3/1964 54 1 1 2
2 2/7/1963 55 2 1 2
6 16/05/2009 9 2 2 2
3 1/7/1958 60 2 1 2
1 19/10/1964 54 1 1 2
2 7/5/1967 51 2 1 2
3 24/03/1996 22 1 2 2
3 2/11/2002 16 2 2 2
3 1/4/2006 12 1 2 2
1 16/09/1984 34 1 1 2
2 2 1 2
3 2/9/2010 8 1 2 2
3 14/11/2012 6 1 2 2
6 1/5/1953 65 2 4 2
1 10/5/1961 67 1 1 2
1 5/5/1954 64 2 3 2
7 24/02/2008 10 2 7 2
1 15/05/1970 48 1 1 2
2 29/04/1981 37 2 1 2
3 10/9/2002 16 1 2 2
3 25/05/2005 13 2 2 2
3 22/04/2007 11 1 2 2
3 10/1/2011 7 2 2 2
3 20/05/2016 2 2 2 2
6 11/4/1931 87 2 4 2
7 22/04/1965 53 2 2 2
1 1/6/1964 54 1 1 2
2 9/12/1966 52 2 1 2
3 14/10/1997 21 2 2 2
3 5/1/2000 18 1 2 2
3 22/10/2004 14 1 2 2
4 2 1 2
5 2 2 2
1 1/7/1940 78 2 4 2
1 1/7/1940 78 1 1 2
2 1/7/1945 73 2 1 2
3 6/1/1968 50 1 3 2
3 23/03/2000 18 1 2 2
3 27/11/2004 14 1 2 2
1 11/8/1965 53 2 3 2
3 18/04/2001 17 1 2 2
2 9/3/1962 56 2 1 2
3 1/7/1932 86 2 4 2
3 30/04/2000 18 2 2 2
6 3/12/2003 15 2 2 2
1 1/7/1959 59 1 1 2
3 24/11/2000 18 2 2 2
3 17/05/2003 15 2 2 2
3 3/1/2008 10 2 2 2
1 2/5/1964 54 1 1 2
2 1/7/1968 50 2 1 2
3 8/9/1997 21 1 2 2
3 11/2/2001 16 1 2 2
3 13/03/2007 11 2 2 2
1 20/08/1968 50 1 1 2
2 14/04/1970 48 2 1 2
3 27/05/1997 21 1 2 2
3 3/3/1999 19 2 2 2
3 3/3//2002 16 2 2 2
3 11/12/2006 12 1 2 2
3 27/04/2011 7 1 2 2
1 30/08/1950 68 1 1 2
2 28/09/1954 6 2 1 2
1 1/7/1964 54 2 4 2
3 1/5/2001 17 2 2 2
3 2/5/2003 15 2 2 2
1 1/3/1944 74 2 4 2
5 11/12/1997 21 1 2 2
5 30/05/2000 18 2 2 2
1 1/7/1940 78 1 1 2
2 1/7/1941 77 2 1 2
Ganggua
Sarana
ART usia >5 tahun ART usia Air Bersih Jenis Jamban Ganggua n Jiwa
n Jiwa dipasung
≥10 tahun Jenis
Agama Sumber Air

11 12 13 14 15 16 17 18
3 5 5 1 PDAM 1 2 2
3 4 5 1 PDAM 2 2
3 2 1 PDAM 2 2
3 2 1 PDAM 2 2
3 2 1 PDAM 2 2
3 1 PDAM 2 2
3 3 6 1 PDAM 1 2 2
3 3 6 1 PDAM 2 2
3 3 6 1 PDAM babs 2 2
3 3 6 1 PDAM 2 2
3 1 1 1 PDAM 2 2
3 2 1 PDAM 2 2
3 3 9 1 PDAM 2 2
3 3 6 1 PDAM 1 2 2
3 3 6 1 PDAM 2 2
3 3 6 1 PDAM 2 2
3 2 1 PDAM 2 2
3 3 6 1 PDAM babs 2 2
3 3 6 1 PDAM 2 2
3 2 9 1 PDAM 2 2
3 3 6 1 PDAM babs 2 2
3 3 2 1 PDAM 2 2
3 3 2 1 PDAM 2 2
3 1 PDAM 2 2
3 3 6 1 PDAM 1 2 2
3 4 2 1 PDAM 2 2
3 3 6 1 PDAM 1 2 2
3 3 6 1 PDAM 2 2
3 3 6 1 PDAM 2 2
3 3 9 1 PDAM 2 2
3 1 PDAM 2 2
3 1 PDAM 2 2
3 3 1 1 PDAM 1 2 2
3 3 6 1 PDAM 2 2
3 2 1 PDAM numpang 2 2
3 3 6 1 PDAM 2 2
3 6 6 1 PDAM 1 2 2
3 3 6 1 PDAM 2 2
3 3 1 1 PDAM 2 2
3 4 6 1 PDAM 2 2
3 6 1 PDAM 2 2
3 5 6 1 PDAM 1 2 2
3 5 5 1 PDAM 2 2
3 2 1 PDAM 2 2
3 2 1 PDAM 2 2
3 3 6 1 PDAM 2 2
3 3 6 1 PDAM 1 2 2
3 3 6 1 PDAM 2 2 2
3 2 1 PDAM 2 2
3 3 6 1 PDAM 1 2 2
3 3 9 1 PDAM 2 2
3 3 2 1 PDAM 2 2
3 2 1 PDAM 2 2
3 2 1 PDAM 2 2
3 2 1 PDAM 2 2
3 1 PDAM 2 2
3 3 1 1 PDAM 2 2
3 1 6 1 PDAM 2 2
3 3 2 1 PDAM 1 2 2
3 3 6 1 PDAM 2 2
3 5 2 1 PDAM 2 2
3 3 2 1 PDAM 2 2
3 2 1 PDAM 2 2
3 5 9 1 PDAM 2 2
3 1 PDAM 2 2
3 3 6 1 PDAM 1 2 2
3 3 1 1 PDAM 1 2 2
3 3 1 1 PDAM 2 2
3 5 6 1 PDAM 2 2
3 5 5 1 PDAM 2 2
3 4 2 1 PDAM 2 2
3 3 2 1 PDAM 2 2
3 3 6 1 PDAM 1 2 2
3 4 9 1 PDAM 2 2
3 3 6 1 PDAM 1 2 2
3 3 1 1 PDAM 1 2 2
3 4 2 1 PDAM 2 2
3 3 2 1 PDAM 2 2
3 3 6 1 PDAM 1 2 2
3 3 2 1 PDAM 2 2
3 2 1 PDAM 2 2
3 2 1 PDAM 2 2
3 3 6 1 PDAM 1 2 2
3 3 6 1 PDAM 2 2
3 3 9 1 PDAM 2 2
3 4 2 1 PDAM 2 2
3 2 1 PDAM 2 2
3 3 6 1 PDAM 1 2 2
3 3 9 1 PDAM 2 2
3 5 2 1 PDAM 2 2
3 3 2 1 PDAM 2 2
3 3 2 1 PDAM 2 2
3 2 1 PDAM 2 2
3 2 1 PDAM 2 2
3 6 6 1 PDAM 1 2 2
3 3 6 1 PDAM 2 2
3 3 6 1 PDAM 1 2 2
3 3 2 1 PDAM 2 2
3 3 2 1 PDAM 2 2
3 5 6 1 PDAM 2 2
3 3 9 1 PDAM 2 2
3 4 2 1 PDAM 2 2
3 3 6 1 PDAM 1 2 2
3 3 6 1 PDAM 2 2
Wanita menikah usia
10-54 tahun
JKN Merokok
(penyakit)
1. Ya 1. Ya 1. Ya
19 20 21 22
1 2 2
1 2 1
1 2 2
1 2 2
2 2 2
2 2 2
2 2 2
2 2 2
1 1 2
1 2 2
2 1 2
2 2 2
1 1 2
1 1 2
1 1 2
1 2 2
2 1 2
1 2 2
1 2 2
1 1 2
1 2 2
1 2 2
1 2 2
1 2 2
1 2 2
1 2 epilepsi 2
2 2 2
2 2 2
2 1 2
2 2 2
2 2 2
2 2 2
2 2 2
2 2 2
2 2 2
2 2 2
1 2 2
1 2 2
2 2 2
2 2 2
2 1 2
2 2 2
2 2 2
1 1 2
2 2 2
1 2 2
1 2 2
2 2 2
2 1 2
2 2 2
1 2 2
1 1 2
1 2 2
1 1 2
1 2 2
1 2 2
2 2 2
2 2 2
1 2 2
2 2 2
1 2 2
1 2 2
1 2 2
1 1 2
1 2 2
2 2 2
2 2 2
1 2 2
1 2 2
1 2 2
1 2 2
2 1 2
1 1 2
1 2 2
1 2 2
1 1 2
2 1 2
2 2 2
1 2 2
1 2 2
1 1 2
1 2 2
1 2 2
1 2 2
1 1 2
1 2 2
1 1 2
1 1 2
1 2 2
1 1 2
1 2 2
1 1 2
1 2 2
1 2 2
1 2 2
1 2 2
1 1 2
1 2 2
1 2 2
1 2 2
1 2 2
1 1 2
1 2 2
1 1 2
1 2 2
2 1 2
2 2 2
REKAPAN PIS PK
KETERANGAN ANGGOTA KELU
NO Hub. Anggota
Nama NIK RT/ RW Keluarga
1 2 3 4 5
1 Susana Surat Doni 5306 011/006 1
2 Klemens Ama Tadon 5306 1223 0987 0001 011/006 3
3 Tegar Junior 5306 1209 0702 0002 011/006 3
1 Viktor Lebu Raya 5306 1201 0724 0038 011/006 1
2 Sesilia Sartini 5306 1268 1065 0001 011/006 2
3 Baltasar Ama 5306 1229 1285 0001 011/006 3
4 Dominika Deran 5306 1257 0200 0001 011/006 3
5 Paulina Lipat ina 5306 1250 1101 0001 011/006 3
1 James Lebu Raya 5306 1210 1169 0003 011/006 1
2 Aida Vilela 011/006 2
3 Emanuel H. Lanan 5306 1213 1292 0001 011/006 KK
4 Desiana Sili Beda 5306 011/006 2
5 Benedikta Eksperansa 5306 011/006 3
1 Paulina Palan Asan 2408 1341 0961 0002 011/006 1
2 Oktaviana Barek Wara 2408 1346 1196 0001 011/006 3
1 Audaktus Lawe Aman 5306 1230 0873 0002 011/006 1
2 Martina Thomas 5306 1269 0397 0002 011/006 2
3 Januarius Ara Kian 5306 1218 0101 0002 011/006 3
4 Efrem Stanislaus 5306 1209 0604 0002 011/006 3
5 Yosephus Cafaso 5306 1223 0607 0002 011/006 3
6 Andreas Nuba 5306 1221 0512 0001 011/006 3
7 Mayuni Tadon Saya 011/006 7
1 Siprianus Seberan Bapa 5306 1214 1077 0001 011/006 1
2 Yustina Bahi 5306 1252 0277 0001 011/006 2
3 Jhon Ogilvie Curman 5306 1219 0109 0001 011/006 3
4 Agnes Chiquita Curman 5306 1253 1110 0001 011/006 3
5 Pertus 011/006 3
1 Isidorus Dile Daen 5306 1201 4278 0001 011/006 1
2 Kristina Kewa Beda 5306 1241 1276 0001 011/006 2
1 Karel Yulianus Ola 5306 1204 0571 0001 011/006 1
2 Benedikta Anu Beda 5306 1241 0772 0021 011/006 2
3 Laurensia Ina Bahi 5306 1246 1108 0001 011/006 3
1 Yubelina Udi 5306 1241 0751 0036 011/006 6
2 Fransiskus Bahi 5306 1220 1115 0017 011/006 1
3 Marselina Bahi 5306 1348 0691 0001 011/006 2
4 Margareta Yoefa 5306 1220 0415 0001 011/006 3
5 Yohanes Vianei 011/006 3
1 Tobias Seko Kolot 5306 1225 0208 0173 011/006 1
2 Elisabeth Bengan Pasen 5306 1251 1252 0001 011/006 2
1 Mikhael Ola Duli 011/006 1
2 TheresiaTuto Boli 011/006 2
3 Kornelia Peria Bolen 011/006 3
4 Darius Lodo Dai 011/006 kk
5 Klemensia 011/006 2
1 Getrudis Sedo Sina 5306 1241 0747 0060 011/006 7
1 Petrus Sili Dilen 5306 1216 0130 0001 011/006 1
2 Maria Solot Payon 5306 1241 0743 0034 011/006 2
1 Petrus Rugi Nuhon 5306 1210 1168 0002 011/006 1
2 Agnes Are Boro 5306 1260 0764 0001 011/006 2
3 Helena Nasi Ria 5306 011/006 2
4 Indriani Rianghepat 011/006 3
5 Andra Alvino 011/006 3
1 Mikhael Kopong Sanga 011/006 1
2 Rosalia Penaten 011/006 2
3 Philipus Kurouman 011/006 3
4 Ludgeral Kurouman 5306 1226 0310 0003 011/006 5
1 Aloysius Gelak Ado 5306 1211 0355 0002 011/006 1
2 Helena Uba Penaten 5306 1241 0460 0001 011/006 2
3 Maria Tuto Doni 5306 1268 0597 0001 011/006 3
4 Nikolaus Boro Beda 5306 1206 1201 0001 011/006 3
1 Maria Abon Boli 5306 1241 0734 0037 011/006 1
2 Nelci Somi Biri 5306 1241 1157 0001 011/006 3
3 Kornelis Lebu Tupen 5306 1231 0596 0001 011/006 5
4 Gergorius Bebe Aran 011/006 5
1 Kristina Odi Kian 011/006 1
2 Agnes Deran Paron 011/006 3
1 Yudas Boli Aman 011/006 1
2 Rofina Palihama 011/006 2
3 Fransisko Lamatokan 011/006 3
3 Fernando Lamatokan 011/006 3
1 Yustina Oren Ola 5306 1241 0741 0036 011/006 1
2 Maria Rayi Boli 011/006 3
3 Renaldus Boli Aman 5306 1205 1200 0002 011/006 5
1 Robertus Geli Luli 5306 1217 0994 0002 011/006 1
2 Elfionita Sodi 011/006 2
3 Yakobus Ola Rugi 5306 1201 1153 0002 011/006 7
1 Ignasius Bapa Tokan 5306 1231 0775 0001 011/006 1
2 Emerlinda Pria Bolen 5306 1271 1055 0001 011/006 2
3 Emilianus Kopong Sait 5306 1208 0209 0001 011/006 3
4 Adrianus Bebe Aran 5306 1230 0810 0001 011/006 3
5 Isidorus Lamapaha 011/006 3
6 Simon Puru Bebe 5306 1213 0247 0001 011/006 7
1 Rosalia Perada Wuun 5306 1270 0756 0001 011/006 6
2 Florianus Lamapaha 5306 1230 0175 0001 011/006 1
3 Monika Ema Puhugelong 5306 1267 0880 0001 011/006 2
4 Karolus Florenso Lamapaha 5306 1204 1108 0002 011/006 3
5 Clarentina Lamapaha 5306 1247 0811 0002 011/006 3
6 Stanislaus Lamapaha 011/006 kk
7 Mariana Lelan Bolen 011/006 2
8 Jorge Lamapaha 011/006 3
1 Olivia Antasari Uba 53061270 0500 0006 011/006 3
2 Oktavia Rosalinda Uba 5306 1245 1100 2002 011/006 3
3 Silvia Antonia Mayoni 5306 1266 0105 0001 011/006 3
1 Agnes Mala Tupen 5306 1271 1239 0006 011/006 1
2 Theresia Surat Tadon 5306 1241 0962 0001 011/006 3
2 Gabriel Kia Boli 5306 1202 0653 0001 011/006 1
3 Nikasia Niga Demon 5306 1241 0141 0001 011/006 2
4 Adam kayo Wuan 5306 1213 0500 0001 011/006 3
5 Mateus Payon Kia 5306 1221 0997 0003 011/006 3
1 Yohanes Rou Boli 011/006 1
2 Marlinda Sedo Laleng 011/006 2
3 Maria Bengan Tokan 011/006 6
1 Agnes Tuto Doni 5306 1241 0760 0053 011/006 1
2 Johana Kawaima 5306 1262 0404 0003 011/006 5
3 Agustinus Bapa Soya 5306 1202 1110 0001 011/006 5
1 Rafael Rugi Nuhon 5306 1201 0262 0001 011/006 1
2 Susana Surat Masan 5306 1241 0764 0045 011/006 2
3 Silvinus Lamapaha 5306 1213 0886 0001 011/006 3
4 Adelina Lamapaha 5306 1256 1298 0002 011/006 3
5 Yasintus Lamapaha 5306 1216 0801 0003 011/006 3
6 Bartolomeus Lamapaha 5306 1205 1203 0003 011/006 3
7 Yohanes Gergius 5306 1223 0413 0001 011/006 5
1 Petrus Bala Ola 5306 1222 1042 0001 011/006 1
2 Apriliana Candra Bahy 5306 1245 0483 0001 011/006 3
3 Novita Bahi 011/006 3
4 Stefania Tiara Bunda 5306 1266 1206 0002 011/006 5
1 Bernadus Demon Dile 5306 1230 1259 0001 011/006 1
2 Veronika Tuto Iken 5306 1265 0664 0001 011/006 2
3 Paulus Ola Muga 5306 1229 0598 0001 011/006 3
1 Ari Darius Jumad Beda 011/006 3
2 Sili Peka 011/006 3
1 Emilia Barek Laot 5306 1268 0576 0003 011/006 2
2 Timotuis Raya Hala 5306 1227 0199 0003 011/006 3
2 Tresia Sodi Ola 5306 1245 1001 0001 011/006 3
2 Alfonsus Ledo Ehak 5306 1205 0503 0003 011/006 3
2 Natalia palan Keda 5306 1260 1210 0001 011/006 3
2 Alvin Adam 011/006 3
1 Veronika Lering Liwu 5306 1270 0587 0001 011/006 2
Agustinus Bala R.H 5306 1219 0807 0001 011/006 3
1 Maria Prada Lanan 5306 1241 0757 0073 011/006 1
RT : 12 DUSUN III
1 Januarius Wilibrodus Ara Kian 012/006 1

2 Adeltrudis B.B Laba 012/006 2
3 Maria Masarela 012/006 3
1 Paulus Nama Geli 5306 1201 0723 0009 012/006 1
2 Genoveva Barek Duli 5306 1244 0755 0001 012/006 2
3 Oktavianus Lado Klerok 5306 1228 1005 0004 012/006 5
4 Veronika 012/006 kk
5 Maria Surat Letek 012/006 3
1 Yohanes Kia Sabon 5306 1201 0741 0015 012/006 1
2 Kornelis Rugi Nuhon 5306 1208 0190 0001 012/006 3
1 Monika Ema Duli 012/006 2
2 Aleksius Bao Gelet 012/006 3
3 Maria Rayi Helan 012/006 3
4 Tomas Aquino Bahi 012/006 3
5 Selsius Bahi 012/006 3
1 Linus Au Lolon 012/006 1
2 Maria Masi Payon 012/006 2
1 Kristina Barek Duli 5306 1253 1258 0001 012/006 1
2 Valentina Dike Tokan 5306 1242 0987 0001 012/006 3
3 Sbastianus K Ola 5306 1242 0788 0001 012/006 kk
4 Yasinta Risa Kian 5306 1258 0498 0001 012/006 2
5 Karolina Palan Lema 5306 1257 0704 0001 012/006 3
1 Agnes Barek Duli 5306 1241 0764 0027 012/006 1
2 Lukas Tuwa Rian 5306 1216 1198 0001 012/006 3
3 Magdalena Sabu Taka 5306 1260 0237 0001 012/006 3
4 Michael Geroda Muhan 012/006 3
5 Tantri Kurman 012/006 5
1 Klara Solot Ola 5306 1241 0749 0040 012/006 1
1 Yoseph Bali Duli 5306 1201 0741 0023 012/006 1
2 Bernadete Bengan Dorok 5306 1260 0256 0001 012/006 2
3 Yuliana Anu Nuhon 5306 1248 0793 0001 012/006 3
1 Adrianus Ara kian 5306 1216 1177 0001 012/006 1
2 Veronika Knato Lema 5306 1263 1077 0001 012/006 2
3 Maria Arianti Uba Suban 5306 1242 0101 0001 012/006 3
4 Maria Susanti Bulu Uhen 5306 1260 0602 0001 012/006 3
5 Ferdinandus Masan Sanga 5306 1221 1005 0001 012/006 3
6 Yohanes Duli Kasa 5306 1204 0811 0001 012/006 3
7 Maria Olivia Uba Suban 5306 1249 1099 0004 012/006 3
8 Mariana Bulu Eban 5306 1254 0101 0003 012/006 3
9 Maria Santisima Perada Lanan 5306 1241 0802 0003 012/006 3
10 Valentina Kewa Bale 5306 1265 1103 0002 012/006 3
11 Marselinus Kurman 012/006 3
1 Maria Datu 012/006 1
1 Paulus Ola Molan 5306 1206 0257 0001 012/006 1
2 Virmina Nula Kopon 5306 1263 0369 0001 012/006 2
3 Ptrisia Tuto Gesak 5306 1257 0300 0001 012/006 3
4 Trivonia Sedo Sina 5306 1245 1203 0001 012/006 3
5 Tarsisius Sili Tupen 5306 1220 1006 0001 012/006 3
6 Veronika Sara Doni 5306 1250 0709 0001 012/006 3
1 Teodorus Todo Boli 5306 1201 0731 0008 012/006 1
2 Marta Kewa Notan 5306 1260 0237 0002 012/006 2
3 Benedikta Dai Hayon 012/006 5
1 Theresia Prada Beda 5306 1241 0759 0038 012/006 1
1 Susana Solot Nama 5306 1255 0674 0002 012/006 2
2 Verianus Asa Tadon 5306 1216 0801 0004 012/006 3
3 Noventus Ara Kian 5306 1224 1104 0002 012/006 3
4 Dionisius Boro Kian 5306 1208 1009 0001 012/006 2
1 Anastasia Osi Ola 5306 1258 1074 0002 012/006 3
2 Jefrianus Masan Sanga 5306 1208 0499 0002 012/006 3
3 Skolastika Somi Toni 5306 1269 0203 0003 012/006 3
4 Katarina Palan Sabon 5306 1267 1105 0003 012/006 3
5 Yudas Boli Aman 5306 1220 0810 0001 012/006 3
1 Antonius Sberan Bapa 5306 1211 0969 0001 012/006 1
2 Nikolina Peni Kalawasa 5306 1241 0696 0003 012/006 2
3 Primus Nama Geli 5306 1218 0898 0001 012/006 3
4 Marianus Ehak Ledo 5306 1212 1001 0002 012/006 3
5 Kosmas Kopong Lasan 5306 1218 1109 0002 012/006 3
1 Japar Geo Pari 5306 1201 0747 0032 012/006 1
2 Jarsia Binti Kasim 5306 1241 0750 0085 012/006 2
1 Markus Lewo Tobi 5306 1201 1153 0003 012/006 1
2 Agnes Deran Doni 5306 1267 0553 0001 012/006 2
3 Agustinus Ola Molan 012/006 5
1 Stefanus Payong Dahin 012/006 1
2 Veronika Rari Sili 5306 1257 0296 0003 012/006 2
1 Martina Raya Tadon 5306 1241 0758 0064 012/006 1
2 Yuliana Nasi Ria 5306 1241 0785 0024 012/006 3
1 Oktavianus Bebe Aran 5306 1216 1086 0002 012/006 1
2 Laudensia Bengan Payon 5306 1263 0989 0002 012/006 2
3 Fransiska Puhugelon 5306 1264 0113 0001 012/006 3
4 Francisia Puhugelon 012/006 3
1 Veronka Ukun Gega 5306 1241 0769 0028 012/006 1
2 Revelina Lamapaha 5306 1252 0805 0002 012/006 3
1 Damianus Boli 5306 1212 1163 0002 012/006 1
2 Yasinta Siba Sili 5306 1254 0664 0001 012/006 2
3 Fransiska Deran Payon 5306 1246 0208 0001 012/006 5
4 Simon Boli Ola 5306 1204 0287 0003 012/006 3
1 Linus Laga Miten 5306 1201 0743 0020 012/006 1
2 Paulina Palan Boli 5306 1266 1158 0001 012/006 2
3 Fabianus Kopong Demon 5306 1246 1086 0001 012/006 3
4 Emerntiana Pugel 012/006 3
1 Goris Lau Butu 5306 1204 1170 0002 012/006 1
2 Teresia Kewa Pain 5306 1247 0767 0001 012/006 2
3 Raimundus Nama 5306 1230 0603 0003 012/006 3
4 Gergoria Ina Aran 5306 1243 0905 0001 012/006 3
5 Makrinus Ola Tokan 5306 1258 1208 0001 012/006 3
1 Yustinus Demon Tuto 5306 1221 0151 0001 012/006 1
2 Sesilia Simo Duli 5306 1241 0751 0030 012/006 2
3 Stefanus Ehak Ledo 5306 1205 0989 0001 012/006 3
1 Rosalia Peni Lagan 5306 1241 0761 0036 012/006 1
2 Martinus Heryanto Gali 5306 1211 0294 0002 012/006 3
3 Albertus Tanah Boleng 5306 1204 0796 0001 012/006 3
4 Bernadus Kopong 5306 1213 1098 0001 012/006 3
1 Urbanus Laot Kian 5306 1229 0675 0001 012/006 1
2 Imakulata Dai Lanan 5306 1254 1038 0002 012/006 2
3 Anselsius Rugi Nuhon 5306 1219 0703 0001 012/006 3
4 Kristofora Date Nusa 5306 1261 0505 0002 012/006 3
5 Katarina Hala Tokan 5306 1271 0312 0001 012/006 3
1 Benadus Kopong Wulan 5306 1201 0863 0001 012/006 1
2 Florida Kewa Kian 5306 1268 0295 0001 012/006 2
1 Aleks Sangan Brahan 5306 1201 0755 0011 012/006 1
2 Maria Palan Pati 012/006 2
1 Agustinus Tana Bolen 012/006 1
2 Maria Kolon Ina 012/006 2
1 Maria Wasia 012/006 1
1 Kristina Dai Lanan 012/006 1
2 Ferdinandus Ola Tokan 012/006 3
3 Albertus 012/006 3
1 Yakobus Beda Raran 5306 1223 1150 0001 012/006 1
2 Benedikta Maga 5306 1241 0748 0029 012/006 2
1 Benedikta Murin Boro 5306 1243 0477 0001 012/006 1
2 Ferdiwiliam Masan Soga 5306 1210 0703 0001 012/006 3
3 Sindilista Dai Kian 5306 1261 0705 0001 012/006 3
4 Rita Mei Somi 5306 1261 0510 0001 012/006 3
1 Veronika Somi Biri 5306 1241 0754 0067 012/006 1
1 Bernadus Kopong Sani 5306 1224 0760 0001 012/006 1
2 Veronika Sabu Komek 5306 1241 0766 0002 012/006 2
3 Gergorius Berbagio 5306 1216 0699 0002 012/006 3
4 Placida Kurouman 5306 1244 0306 0001 012/006 3
1 Urbanus Bao Galet 012/006 1
2 Anika Sedo Lama Witak 012/006 2
3 Claudio Kopong Solot 012/006 3
1 Fransiska Lama Wuran 2
2 Cristiano Berkat 3
RT/RW : 001/001
1 Gabriel Kopong Sani 5306 1212 0466 0001 001/001 1

2 Yuliana Rayi Sabon 5306 1251 0765 0002 001/001 2
3 Godefridus Oma Junicki 5306 1219 0602 0001 001/001 3
4 Kristina Bengan Laot 5306 1241 0740 0087 001/001 6
5 Agnes Peni Hadun 5306 1241 0759 0073 001/001 7
6 Marselina Barek Rupa 5306 1247 0580 0001 001/001 2
7 Aurelia Tanaboleng 5306 1247 1009 0002 001/001 3
1 Antonius Kopong Boli 5306 1203 0875 0002 001/001 1
2 Marselina Deran Duli 5306 1269 0163 0001 001/001 2
1 Benedikta Bengan Wuan 5306 1267 0657 0002 001/001 1
1 Kamria Kewa 5306 1251 1257 0001 001/001 1
2 Awaludin Ola Geli 5306 1201 0785 0012 001/001 3
1 Sukarta Edo Nama 5306 1228 0871 0001 001/001 1
2 Samsidar Deran Tupen 5306 1249 0185 0001 001/001 2
3 Arisna Bengan Lelan 5306 1268 0803 0001 001/001 3
4 Ahmad Fadli Gawe Lelan 5306 1223 1207 0001 001/001 3
5 Muklisin Kurman 5306 1227 1010 0001 001/001 3
6 Naufal Fajila 001/001 3
1 Yasinta Letek Pehan 5306 12411079 0002 001/001 2
2 Fransiska Kewa Lela 5396 1241 0798 0020 001/001 3
3 Albertus Tuan Laot 5306 1205 1099 0002 001/001 3
4 Alfonsius Lama Tokan 5306 1211 0301 0002 001/001 3
5 Nikolina Perada Aran 5306 1254 1105 0001 001/001 3
6 Marianus Ara Kian Lama Tokan 5306 1214 0507 0001 001/001 3
1 Damsia Uba Lela 5306 1241 0742 0048 001/001 1
2 Robertus Geroda Teka 5306 1217 1099 0002 001/001 5
1 Rahima Tuto Mado 5306 1244 0480 0001 001/001 2
2 Fifi Gustiyanti 5306 1252 0899 0001 001/001 3
3 Andreas Avelino 5306 1209 1101 0002 001/001 3
4 Adriyanti Wae Raya 5306 1257 0904 0001 001/001 3
5 Mira Hartanti Uba Suban 5306 1261 0207 0001 001/001 3
6 Alvian Revanto 5306 1209 0910 0001 001/001 3
1 Nikolaus Nuho 5306 1201 0735 0039 001/001 1
2 Paulina Deran Sanga 5306 1241 0737 0034 001/001 2
1 Lukman Laga Onga 5306 1217 0773 0003 001/001 1
2 Nurwati Bengan Ola 5306 1266 0689 0001 001/001 2
3 Sulis Satia Lipat Tube 5306 1259 0708 0001 001/001 3
4 Jurmani Barek Bolen 5306 1264 0910 0002 001/001 3
5 Arbain Usen Ehak 001/001 3
6 Khairun Nisa Masi Boli 5306 1214 1074 0002 001/001 3
1 Fakrudin Ismail 5306 1241 0585 0001 001/001 1
2 Islammudin Bahi 5306 1223 0501 0002 001/001 2
3 Islammiati Bahi 5306 1247 0803 0003 001/001 3
4 Ismahalil Bahi 5306 1220 1206 0001 001/001 3
5 Ismahfiardin Bahi 5306 1215 0610 0001 001/001 3
6 Rosna Pria Bolen 001/001 6
7 Rahima Tuto Mado 001/001 5
8 Muhammad Firdaus Kuat Hala 001/001 5
1 Ismail Sugianto 5306 1204 0870 0002 001/001 1
2 Khadija Usman 5306 1252 0270 0001 001/001 2
3 Muhamad Arianto Dasuki 5306 1213 0299 0001 001/001 3
1 Yulius Narek Ola 5306 1201 0754 0024 001/001 1
2 Yoheanes Bisa Baten 001/001 2
3 Maria Tuto Soge 001/001 2
1 Ratna Eka Pehan 5306 1257 0450 0001 001/001 1
1 Getrudis Geben Sabon 5306 1231 1249 0012 001/001 1
1 Nasir Suku Bahon 5306 1203 0872 0001 001/001 1
2 Masitha Surat Mangu 5306 1241 0978 0001 001/001 2
1 Ibrahim Lama 5306 1210 0249 0001 001/001 1
2 Sadia Lipat Daton 5306 1241 0552 0002 001/001 2
3 Yusuf Boli Tadon 5306 1205 0171 0001 001/001 kk
4 Rubina Eka Pehan 5306 1243 0875 0001 001/001 2
5 Zullaiha Yusuf 5306 1257 0498 0001 001/001 3
6 Agussalim Yusuf 5306 1216 0899 0001 001/001 3
7 Mustamar Boli Jaga 5306 1211 0201 0001 001/001 3
8 Muhamad Syawal Herun Beken 5306 1203 1203 0002 001/001 3
9 Sabarudin Diri Koda 5306 1216 0705 0002 001/001 3
10 Intan Nuraini Perada Wuun 5306 1241 0707 0009 001/001 3
11 Awalludin Ola Kian 5306 1209 0410 0002 001/001 3
12 Zulfikar 3
1 Samir Suku Bahon 5306 1231 1258 0015 001/001 1
2 Syahria Surat Pridi 5306 1241 0762 0044 001/001 2
3 Syaharudin Kopong Ola 5306 1229 1292 0002 001/001 3
4 Siti Nurhaliza 5306 1270 0302 0002 001/001 3
1 Tutia Tuto Boli 5306 1247 0870 0001 001/001
2 Muhamad Yunus 5306 1212 0702 0003 001/001 3
3 Rahmat Kurnia Kia Nuba 5306 1225 0803 0001 001/001 3
1 Sabrina Uto Hawan 5306 1241 0766 0031 001/001 1
2 Nurazija 001/001 5
1 Paulus Payong Sanga 5306 1227 1072 0001 001/001 1
2 Adrianus Lama Tokan 5306 1256 1076 0001 001/001 3
3 Anjelina Paul Tokan 5306 1268 1000 0003 001/001 3
4 Melisa Sandi 5306 1252 0505 0001 001/001 3
1 Muhamad Gula Sanga 5306 1218 0298 0001 001/001 3
2 Firman Tokan 5306 1211 1100 0003 001/001 3
3 Safrudin Walen 5306 1227 0203 0001 001/001 3
1 Ridwan Begu Tadon 5306 1216 0670 0003 001/001 1
2 Muhamad Risky Ridwan 5306 1218 1110 0001 001/001 3
3 Marhaban Kopong Hoda 5306 1223 0214 0001 001/001 3
1 Gerfasius Geroda Loban 5306 1206 1268 0001 001/001 1
2 Riferliana Uba Bakan 5306 1246 0499 0001 001/001 3
1 Fatima Bengan Lawan 5306 1241 0747 0072 001/001 1
1 Yasinta Rari Basa 5306 1249 0763 0001 001/001 2
1 Monika Menina Palan 5306 1241 0752 0051 001/001 1
1 Sulaiman Bali Sbore 5306 1201 0254 0001 001/001 1
2 Baharia Barek Ola 5306 1243 1061 0001 001/001 2
3 Kamaludin Lewo Rua 001/001 3
1 Lukman Lein Kuma 5306 1202 0566 0002 001/001 1
2 Marwah Uto Hawan 5306 1244 0477 0001 001/001 2
3 Yaser Ola Begu 5306 1213 0400 0002 001/001 3
4 Pinkurniawati Tuto Mado 5306 1256 0606 0003 001/001 3
5 Ajlanis Kopong Oron 5306 1210 1109 0001 001/001 3
6 Azril Ola Angin 5306 1209 0512 0002 001/001 3
7 Manggas Ema Pao 5306 1251 0748 0001 001/001 6
1 Nuraini Anu Beda 001/001 2
2 Awaludin Wadon Lolon 5306 1229 0872 0001 001/001 2
3 Swalia NogoBoli 5306 1269 0491 0003 001/001 2
4 Ravatar Umar Tewa 001/001 3
1 Mahmud Laga Oron 5306 1201 0744 0022 001/001 1
2 Kmaria Borot Hali 5306 1245 0558 0004 001/001 2
3 Kamarudin Oron Tewa 5306 1216 1087 0001 001/001 3
1 Ramla Rayi Basa 5306 1241 0740 0057 001/001 1
2 Sadia Bengan Ola 5306 1241 0787 0019 001/001 3
3 Savana Maisaro 001/001
1 Andreas Sanga Payon 5306 1231 1259 0020 001/001 1
2 Maria Kabon Woren 5306 1258 1258 0001 001/001 2
3 Natalis Geroda Sanga 5306 1214 1288 0001 001/001 2
4 Agustina Abon Bisa 001/001 2
5 Raimundus 001/001 3
6 Maria Werti Yonalena 001/001
1 Samsia Palan Keda 5306 1241 0757 0048 001/001 1
2 Aisya Solot Laga 5306 1246 0487 0003 001/001 3
1 Abubakar Boli Boni 5306 1208 0570 0001 001/001 1
2 Ratna Rayi Notan 53061252 0673 0002 001/001 2
3 Muhamad Fajar Lado 5306 1208 0599 0001 001/001 3
4 Iswayudi payong Sanga 5306 1203 0701 0001 001/001 3
5 Abdulrahman Nasrum 5306 1213 0403 0001 001/001 3
6 Ahmad Syaril Sabon Nuba 5306 1210 1105 0001 001/001 3
7 Nurul Hikma Fatima Uran 5306 1260 1008 0001 001/001 3
8 Abdulah Khoirul Azam 5306 1229 0212 0001 001/001 3
9 Hayati Hingin Bolen 5306 1241 0754 0001 001/001 6
1 Nurman Masa Laot 5306 1241 0760 0059 001/001 1
2 Nasrul Aditya 001/001 5
1 Mikhael Lamapaha 5306 1201 0735 0034 001/001 2
2 Paulina Rayi Notan 5306 1241 0736 0028 001/001 3
1 Sofia Nini Soge 5306 1254 0352 0001 001/001 1
1 Wilhelmus Wurin Laba 5306 001/001 1
2 Veronika Barek Kuma 5306 001/001 2
3 Erfanus Kuyouman 5306 1221 0699 0001 001/001 5
4 Yohanes Mboe Kuyouman 5306 1231 0701 0001 001/001 5
5 Romoaldus 5306 001/001 kk
6 Elisabeth 5306 001/001 2
8 Larita 5306 001/001 3
9 Klarisah 5306 001/001 3
1 Klemens Kopong Miten 5306 1224 0573 0002 001/001 1
2 Agustina Kewa Lela 5306 1256 0878 0001 001/001 2
3 Maria Deutelin Kiren Ongenulan 5306 1256 0310 0001 001/001 3
4 Maria Grasiana Indah 5306 001/001 3
1 Marta Barek Sabon 5306 1241 0736 0027 001/001 1
1 Mastura Barek Duli 5306 1261 0459 0001 001/001 1
2 Kamria Kewa Deran 5306 1260 1277 0002 001/001 2
3 Abidin Boro Kian 5306 1215 0587 0001 001/001 2
1 Kamria Mala Mehen 5306 1241 0750 0015 001/001
1 Arwan Lonek Aman 5306 1211 0456 0001 001/001
2 Suryati Surat Boro 5306 1245 0158 0001 001/001
3 Muhidin Gega Molan 5306 1201 0746 0024 001/001
1 Syafrudin Walen Boli 5306 1210 1071 0002 001/001 1
2 Juliati Loun Boli 5306 1243 0781 0002 001/001
3 Nur Azikin PuloRaran 5306 1247 0703 0003 001/001
4 Siti Nurhasina Bengan Bala 5306 1257 0207 0001 001/001
5 Zulkifli Duli Kasa 5306 1229 0412 0002 001/001
6 Murzidan Akbar Walen Boli 5306 1243 0781 0002 001/001
1 Simon Saka Muli 5306 1201 0762 0022 001/001 1
2 Yuliana Letek Pehan 5306 1241 1262 0001 001/001 2
3 Skolastika Deran Ina 5306 1255 0201 0001 001/001 3
1 Kalis Kopong Bahon 001/001 1
2 Kartini Kewa Lela 001/001 2
3 Kirana Cinta Mentari 001/001 7
4 Fillzipri Bahy 001/001 7
5 Facozina Bahy 001/001 7
1 Sudin Sin Ola 5306 1201 0753 0014 001/001 1
1 Lukas Loli Laga 5306 1201 0754 0031 001/001 1
2 Ina Inanam 5306 1241 0745 0111 001/001 2
1 Petrus Peten Sili 5306 1201 0553 0001 001/001 1
2 Yuliana Mesa Daton 5306 1243 0565 0002 001/001 2
3 Adrianus Masan Wolo 5306 1208 0977 0001 001/001 3
4 Fransiskus Bao Lile 5306 1224 0112 0001 001/001 3
1 Pius Pira Sada 5306 1216 0373 0002 001/001 1
2 Florentina Kidi Gego 5306 1244 0884 0001 001/001 2
1 Klementina Menina Palan 5306 1271 12380010 001/001 1
2 Daton Warat 5306 1202 0695 0001 001/001 5
3 Bibiana Solot Laga 5306 1243 0199 0002 001/001 5
4 Beda 001/001 5
1 Maruf Kopong Ola 5306 1201 0283 0001 001/001 1
2 Sahdiya 5306 1257 0385 0001 001/001 2
3 Siti Fitvina 5306 1264 0404 0001 001/001 3
4 Maulana Ibrahim Seberan Bapa 5306 1231 0707 0001 001/001 3
5 Muhamad Amin Kopong Lonek 5306 1231 0707 0001 001/001 3
6 Siti Sabaria 5306 1245 0808 0001 001/001 3
1 Mursalim Kopong Gawi 001/001 1
2 Halima Hingin Bolen 001/001 2
1 Vinsensia Mala Sinun 5306 1246 0770 0004 001/001 2
2 Marianus Yulius Kopong Sele 5306 1230 0603 0004 001/001 3
1 Lusia Barek Laga 001/001 1
1 Benediktus Boro Beda 5306 1201 0740 0037 001/001 1
2 Maria Mala Mehen 5306 1241 0740 0056 001/001 2
3 Maria Tuto Sogen 001/001 2
4 Jonatan Tokan 001/001 3
5 Maria Mala Mehen 001/001 5
6 Meirosari Barek Boli 001/001 5
1 Lusia Palan Ebo 5306 1241 0735 0051 001/001 1
2 Lipat Sabon 5306 1241 0749 0032 001/001 3
1 Nurbaya Letek Pati 5306 1241 0737 0024 001/001 1
1 Ruslan Husen 5306 1208 0973 0001 001/001 1
2 Asia Jafar 5306 1255 0681 0001 001/001 2
3 Muhammad Najid Masan Sanga 5306 1226 0400 0001 001/001 3
4 Sarhan Arif Kopong Ola 5306 1221 0602 0001 001/001 3
5 Asrini Azimah Masa Laot 5306 1241 0807 0001 001/001 3
6 Azman Azfar Kia Boli 5306 1207 0210 0001 001/001 3
7 Ahmad Qosim Sili Laga 5306 1211 1114 0001 001/001 3
1 Hasnah Solot Nama 5306 1241 0735 0028 001/001 1
2 Ramtina Rera Bengan 5306 1255 0550 0001 001/001 3
3 Yuliana Palihama 5
4 Peren Kolot 5
1 Rofinus Kopong Lele 5306 1201 0771 0014 001/001 1
2 Yustina Barek Sabon 5306 1250 0572 0001 001/001 2
3 Ervianus Pati Lanan 5306 1228 1096 0004 001/001 3
4 Elias Ola Rea 5306 1225 1298 0001 001/001 3
5 Saferianus Payong Sabon 5306 1217 1200 0002 001/001 3
6 Agustinus Suban Laga 5306 1211 0802 0001 001/001 3
7 Rofina Barek Lelan 5306 1261 0406 0001 001/001 3
8 Yulius Nuho Ola 5306 1216 0608 0001 001/001 3
9 Daniel Kia Gilo 5306 1202 1210 0001 001/001 3
10 Paulina Hingin 5306 1253 0712 0001 001/001 3
1 Veronika Yuni Lipat Tata 001/001 1
2 Valentinus Lamapaha 001/001 3
1 Kasyati Date Geon 5306 1263 0349 0001 001/001 1
1 Halima Palan Asan 001/001 1
1 Ignasius Tupen Liat 5306 1203 0465 0001 001/001 1
2 Martina Barek Tokan 5306 1267 0273 0003 001/001 2
3 Oktaviana Ervin Bahi 5306 1254 1096 0001 001/001 3
4 Servasius Ignas Bahi 5306 1213 0498 0001 001/001 3
5 Apolonia Patrisia 5306 1248 03030004 001/001 3
6 Erfan Kopong Keda 001/001 6
Kode kolom 5
Hubungan dengan kepala keluarga Kode kolom 9
1. kepala
RT Status Perkawin Kode kolom 11
2.
istri/suam 1.kawin
i 6. orang tua Agama
3. Anak 2. Belum Kawin 1. Islam
7. famili lain
8.pembantu 3. Cerai hidup 2. Kristen
3. Katolik
RANGAN ANGGOTA KELUARGA
(khusus
wanita usia ART usia >5
Jenis ART usia
10-54 tahun) tahun
Kelamin Status ≥10 tahun
Tanggal Lahir Umur sedang Agama
Perkawinan hamil?
1. Pria 1. Ya pendidikan Pekerjaan

2. Wanita 2. Tidak
6 7 8 9 10 11 12 13
1/4/1964 54 2 4 2 3 3 6
23/11/1981 37 1 2 2 3 5 6
9/7/2000 18 1 2 2 3 4 2
28/0/1940 78 1 1 2 3 3 1
12/3/1978 40 2 1 2 3 3 6
29/12/1985 33 1 2 2 3 5 6
17/02/2000 18 2 2 2 3 4 2
10/11/2001 17 2 2 2 3 4 2
10/11/1969 49 1 1 2 3 3 9
8/10/1970 48 2 1 2 3 5 9
13/12/1992 26 1 1 2 3 5 9
2 1 2 3 3 9
1 2 2 2 3
1/9/1961 57 2 4 2 3 3 6
24/10/1996 22 2 2 2 3 5 1
30/08/1973 45 1 1 2 3 7 6
29/03/1979 39 2 1 2 3 3 9
18/01/2001 17 1 2 2 3 3 2
9/6/2004 14 1 2 2 3 3 2
23/06/2007 11 1 2 2 3 2
21/05/2012 6 1 2 2 3 2
2 2 2 3 2
14/10/1977 41 1 1 2 3 4 5
12/2/1977 41 2 1 2 3 5 5
19/01/2009 9 1 2 2 3 2
13/11/2010 8 2 2 2 3 2
6/11/2017 1 1 2 2 3
1 1 2 3 5 6
1/12/1978 40 2 1 2 3 3 9
4/9/1971 47 1 1 2 3 5 6
2 1 2 3 3 9
6/11/2008 10 2 2 2 3 2
1/7/1951 67 2 4 2 3 3 6
10/0/1984 34 1 1 2 3 7 9
8/6/1991 27 2 1 2 3 6 9
20/04/2015 3 2 2 2 3 2
2/9/2016 2 1 2 2 3 2
19/05/951 67 1 1 2 3 3 6
11/12/1952 66 2 1 2 3 3 6
1/7/1942 76 1 1 2 3 3 6
4/6/1959 59 2 1 2 3 3 6
16/09/1994 24 2 2 2 3 5 9
1 1 2 3 5 9
2 1 2 3 5 9
1/7/1947 71 2 2 2 3 3 6
1/1/1930 88 1 1 2 3 3 1
1/7/1943 75 2 1 2 3 3 6
10/11/1968 50 1 1 2 3 3 6
20/07/1968 50 2 1 2 3 3 9
2 1 2 3 3 9
24/12/2008 10 2 2 2 3 2
26/01/2017 1 1 2 2 3
1 1 2 3 3 6
2 1 2 3 3 9
1 2 2 3 5 1
1 2 2 3 2
11/3/1955 63 1 1 2 3 3 6
1/4/1960 58 2 1 2 3 3 6
28/05/1997 21 1 2 2 3 5 9
6/12/2001 17 2 2 2 3 4 2
1/7/1930 88 1 4 2 3 3 1
1/11/1957 61 1 2 2 3 3 6
31/05/1996 22 2 2 2 3 5 1
2 2 2 3 3 1
1/7/1930 88 1 4 2 3 3 1
1/7/1930 88 1 3 2 3 2 6
5/3/1980 38 2 1 2 3 2 6
10/7/1979 39 2 1 2 3 3 9
16/07/2012 8 1 2 2 3 2
19/11/2014 4 1 2 2 3 2
1/7/1941 77 2 4 2 3 3 6
30/04/1984 34 2 2 2 3 5 9
5/12/2000 18 1 2 2 3 5 2
17/09/1994 24 1 1 2 3 3 6
1/11/1994 24 2 1 1 3 3 9
1/11/1953 65 1 2 2 3 3 6
31/07/1975 43 1 1 2 3 3 6
31/10/1985 3 2 1 2 3 4 9
8/2/2009 9 1 2 2 3 2
30/02/2010 8 1 2 2 3 2
1 2 2 3
30/07/1947 71 1 2 2 3 3 6
30/07/1956 62 2 4 2 3 3 6
30/01/1975 43 1 1 2 3 5 9
27/08/1980 38 2 1 2 3 5 9
4/11/2008 10 1 2 2 3 2
7/8/2011 7 2 2 2 3 2
11/4/1986 32 1 1 2 3 7 9
24/03/1989 29 2 1 2 3 6 9
1 2 2 3
30/05/2000 18 2 2 2 3 3 2
5/10/2002 16 2 2 2 3 3 2
26/01/2005 13 2 2 2 3 2
31/12/1939 79 2 4 2 3 3 1
1/9/1962 56 2 2 2 3 3 6
2/6/1953 65 1 1 2 3 3 6
2/6/1941 77 2 1 2 3 3 6
13/05/2000 18 1 2 2 3 3 1
21/09/1994 24 1 2 2 3 3 1
1 1 2 3 5 9
2 1 2 3 5 9
2 4 2 3 3 6
1/7/1958 60 2 4 2 3 3 6
24/04/2004 14 2 2 2 3 3 2
2/11/2010 8 1 2 2 3 2
1/2/1962 56 1 1 2 3 4 9
1/7/1964 54 2 1 2 3 3 6
13/08/1986 32 1 2 2 3 5 6
16/12/1998 20 2 2 2 3 5 1
16/08/2001 17 1 2 2 3 4 2
5/12/2003 15 1 2 2 3 2
23/04/2013 5 1 2 2 3 2
22/10/1942 76 1 4 2 3 6 9
5/4/1985 33 2 2 2 3 5 1
2 1 2 3 5 1
26/12/2006 12 2 2 2 3 3 2
3/12/1959 59 1 1 2 3 3 6
25/0/1964 54 2 1 2 3 3 6
29/05/1998 20 1 2 2 3 4 2
1 2 2 3 4 2
1 2 2 3 2
28/05/1976 42 2 1 2 3 3 9
27/01/1999 19 1 2 2 3 5 1
5/10/2001 17 2 2 2 3 4 2
5/5/2003 15 1 2 2 3 3 2
20/12/2010 8 2 2 2 3 2
1 2 2 3
30/05/1987 31 2 1 2 3 7 9
19/08/2007 11 1 2 2 3 2
1/7/1957 61 2 4 2 3 3 6
25/10/1992 26 1 1 2 3 5 6
25/02/1993 25 2 1 2 3 5 5
14/05/2015 3 2 2 2 3 2
1/7/1923 95 1 1 2 3 1 6
4/7/1955 63 2 1 2 3 3 6
28/10/2005 13 1 2 2 3 3 2
2 1 2 3 3 6
8/7/2012 6 2 2 2 3 2
1/7/1942 76 1 4 2 3 3 6
1/5/1990 28 1 2 2 3 3 1
20/10/1975 43 2 1 2 3 3 6
17/07/1997 21 1 2 2 3 3 1
31/07/2001 17 2 2 2 3 3 2
1/7/2004 14 1 2 2 3 1 2
15/08/2007 11 1 2 2 3 2
25/01/1950 68 1 1 2 3 5 4
23/04/1955 63 2 1 2 3 3 6
23/12/1958 60 2 4 2 3 3 6
9/9/1997 21 2 2 2 3 3 1
2/9/1998 20 1 1 2 3 6 6
1/4/1998 20 2 4 1 3 9 1
17/07/2004 14 2 2 2 3 3 2
1/7/1964 54 2 4 2 3 3 6
16/11/2000 18 1 2 2 3 5 1
20/02/1932 86 2 4 2 3 1 1
9/29/2011 1 2 2 3 2
24/11/2014 4 2 2 2 3 2
1/7/1949 69 2 2 2 3 3 6
1/7/1941 77 1 1 2 3 3 6
20/02/1956 62 2 1 2 3 3 6
8/7/1993 25 2 2 2 3 4 1
16/11/1976 42 1 1 2 3 3 6
23/101/1977 41 2 1 2 3 3 9
2/1/2001 17 2 2 2 3 4 2
20/06/2002 16 2 2 2 3 4 2
21/11/2005 13 1 2 3 2
4/8/2011 7 1 2 2 3 2
9/10/1999 18 2 2 2 3 4 2
14/01/2001 17 2 2 2 3 4 2
1/8/2002 16 2 2 2 3 4 2
25/11/2003 15 2 2 2 3 3 2
4/3/2018 4 bln 1 2 2 3
1/7/1937 81 2 1 2 3 6
6/2/1957 61 1 1 2 3 3 6
23/03/1969 49 2 1 2 3 3 6
17/03/2000 18 2 2 2 3 5 1
5/12/2003 15 2 2 2 3 4 2
10/7/2006 12 1 2 2 3 2
20/10/2009 9 2 2 2 3 2
1/7/1931 87 1 1 2 3 1 6
20/02/1937 81 2 1 2 3 1 6
2 2 2 3 1
3/8/1950 68 2 4 2 3 3 6
15/06/1974 44 2 1 2 3 3 6
16/08/2001 17 1 2 2 3 3 2
24/11/2004 14 1 2 2 3 2
10-Aug 9 1 2 2 3 2
18/10/1974 44 2 1 2 3 3 6
8/4/1999 19 1 2 2 3 5 1
25/02/2003 15 2 2 2 3 4 2
27/11/2005 13 2 2 2 3 3 2
20/10/2010 8 1 2 2 3 2
11/9/1969 49 1 1 2 3 3 6
1/4/1975 43 2 1 2 3 3 6
18/08/1998 20 1 2 2 3 5 1
12/10/2001 17 1 2 2 3 2
18/11/2009 9 1 2 2 3 2
15/06/1947 71 1 1 2 1 3 6
25/07/1950 68 2 1 2 1 3 6
1/11/1953 65 1 1 2 3 3 6
27/07/1953 65 2 1 2 3 3 6
13/08/2014 4 1 2 2 3 2
1/9/1959 59 1 1 2 3 3 6
18/10/1975 43 2 1 2 3 3 6
1/7/1958 60 2 4 2 3 1 6
1/7/1985 33 2 2 2 3 1 6
16/10/1988 30 1 1 2 3 3 6
23/09/1989 29 2 1 2 3 3 9
24/01/2013 5 2 2 2 3
25/02/2018 6 bln 2 2 2 3
1/7/1969 49 2 3 2 3 3 6
12/3/2005 3 2 2 2 3 3 2
12/11/1963 55 1 1 2 3 3 6
14/06/1964 54 2 1 2 3 3 6
6/2/2008 10 2 2 2 3 2
4/2/1987 31 1 2 2 3 3 6
11/11/1943 75 1 1 2 3 3 6
23/07/1958 60 2 1 2 3 3 6
4/7/1981 37 1 2 2 3 3 6
24/05/2001 17 2 2 2 3 4 2
4/11/1970 48 1 1 2 3 5 9
7/6/1967 51 2 1 2 3 4 5
30/06/2003 15 1 2 2 3 3 2
3/9/2005 13 2 2 2 3 2
1/12/2008 10 1 2 2 3 2
21/01/1951 67 1 1 2 3 3 6
1/7/1951 67 2 1 2 3 3 6
5/9/1989 29 1 2 2 3 3 6
1/7/1961 57 2 4 2 3 3 6
11/2/1994 24 1 2 2 3 5 1
4/7/1996 22 1 2 2 3 3 1
13/10/1998 20 1 2 2 3 5 1
29/06/1975 43 1 1 2 3 1 6
14/10/1983 35 2 1 1 3 3 9
19/07/2001 17 1 2 2 3 3 2
24/05/2005 13 2 2 2 3 3 2
31/03/2012 6 2 2 2 3 6
1/8/1963 55 1 1 2 3 3 6
28/01/1995 23 2 2 2 3 3 1
1 1 2 3 3 6
2 1 2 3 1 6
1/7/1956 62 1 1 2 3 3 6
20/01/1961 57 2 1 2 3 3 6
2 1 2 3 1 6
1/7/1952 66 2 4 2 3 3 6
1/7/1990 28 1 2 2 3 5 6
3/11/1983 35 1 1 2 3 5 5
23/11/1950 68 1 1 2 3 3 6
1/7/1948 70 2 1 2 3 3 6
3/4/1977 41 2 3 2 3 3 6
10/4/2003 15 1 2 2 3 3 2
21/07/2005 13 2 2 2 3 3 2
21/05/2010 8 2 2 2 3 2
1/7/1954 64 2 4 2 3 1 6
24/07/1960 58 1 1 2 3 3 6
1/7/1966 52 2 1 2 3 3 6
17/06/1999 19 1 2 2 3 2
4/3/2006 12 2 2 2 3 2
1 1 2 3 5 5
2 2 2 3 4 9
15/09/2017 2 1 3 2 3
2 1 2 3 4 9
1 2 2 3
4/12/1966 52 1 1 2 3 5 4
7/11/1965 53 2 1 2 3 7 4
6/19/2002 16 1 2 2 3 3 2
7/1/1944 74 2 4 2 3 3 1
7/1/1959 59 2 2 2 3 3 6
5/7/1980 38 2 1 2 3 3 6
10/7/2009 9 2 2 2 3 3 2
8/3/1957 61 1 1 2 3 3 6
1/29/1963 55 2 1 2 3 3 6
6/27/1957 61 2 4 2 3 1 6
12/11/1957 61 2 4 2 1 3 6
7/1/1985 33 1 2 2 1 3 6
8/28/1971 47 1 1 2 1 4 6
1/9/1985 33 2 1 2 1 3 9
8/28/2003 15 2 2 2 1 3 2
12/23/2007 11 1 2 2 1 2
10/27/2010 8 1 2 2 1 2
2 2 2 1
10/1/1979 39 2 1 2 3 3 6
7/1/1998 20 2 2 2 3 4 2
10/5/1999 19 1 2 2 3 3 2
3/11/2001 17 1 2 2 3 4 2
11/14/2005 13 2 2 2 3 3 2
5/14/2007 11 1 2 2 3 2
7/1/1942 76 2 4 2 1 3 6
10/17/1999 19 1 2 2 3 4 1
4/4/1980 38 2 1 2 1 4 6
8/12/1999 19 2 2 2 1 4 3
11/9/2001 17 1 2 2 1 4 3
9/17/2004 14 2 2 2 1 4 3
2/21/2007 11 2 2 1 4 2
9/9/2011 7 1 2 2 1 2
7/1/1935 83 1 1 2 3 3 6
7/1/1937 81 2 1 2 3 3 6
7/17/1973 45 1 1 2 1 3 6
6/26/1989 29 2 1 2 1 3 9
7/19/2008 10 2 2 2 1 2
9/24/2010 8 2 2 2 1 2
4/12/2013 5 1 2 2 1 2
2/8/2017 1 2 2 2 1 2
10/14/1974 44 1 1 2 1 3 6
5/23/2001 17 1 2 2 1 4 2
8/7/2003 15 1 2 2 1 3 2
12/20/2006 12 1 2 2 1 3 2
6/15/2010 8 1 2 2 1 3 2
7/1/1947 71 2 4 2 1 3 6
6/27/1998 20 2 2 2 1 3 6
7/13/2000 18 1 2 2 1 3 2
8/4/1970 48 1 1 2 1 5 5
2/12/1970 48 2 1 2 1 4 5
5/13/1999 19 1 2 2 1 4 2
7/1/1954 64 1 4 2 3 3 6
1/30/1978 40 1 1 2 3 3 6
2 1 2 3 3 9
4/17/1950 68 2 4 2 1 3 6
12/31/1949 69 2 4 2 3 3 6
8/3/1972 46 1 1 2 1 3 6
9/1/1987 31 2 1 2 1 3 6
2/10/1949 69 1 1 2 1 3 6
5/1/1952 66 2 1 2 1 3 6
12/12/1971 47 1 1 2 1 3 6
3/1/1975 43 2 1 2 1 3 9
4/17/2000 18 2 2 2 1 4 2
8/16/1999 19 1 2 2 1 4 2
9/7/2001 17 1 2 2 1 4 2
11/10/2003 15 1 2 2 1 3 2
7/16/2005 13 1 2 2 1 3 2
5/27/2008 10 2 2 2 1 2
4/9/2010 8 1 2 2 1 2
9/23/2016 2 1 1 2 1
12/31/1958 60 1 1 2 1 3 6
7/1/1962 56 2 1 2 1 3 6
29-19-1992 26 1 2 2 1 5 6
3/30/2002 16 2 2 2 1 4 2
7/7/1970 48 2 1 2 1 3 6
7/12/2002 16 1 2 2 1 3 2
8/25/2003 15 1 2 2 1 3 2
7/1/1966 52 2 3 2 1 3 6
10/30/2015 3 2 2 2 1
27/10/1972 46 1 1 2 3 3 6
14/08/1998 20 1 2 2 3 4 1
28/10/2000 18 2 2 2 3 3 2
5/12/2005 13 2 2 2 3 3 2
2/18/1998 20 1 2 2 1 5 2
11/11/2000 18 1 2 2 1 4 2
2/27/2003 15 1 2 2 1 3 2
6/16/1970 48 1 1 2 1 3 6
11/18/2010 8 1 2 2 1 2
2/23/2014 4 1 2 2 1 2
7/1/1969 49 1 1 2 3 3 6
4/6/1999 19 2 2 2 3 4 2
7/1/1947 71 2 4 2 1 3 6
7/9/1963 55 2 1 2 3 3 6
7/1/1952 66 2 3 2 3 3 6
11/11/1952 66 1 1 2 1 3 6
6/9/1961 57 2 1 2 1 3 6
9/2/1992 26 1 2 2 1 3 2
5/2/1966 52 1 1 2 1 4 6
4/4/1977 41 2 1 2 1 4 5
4/13/2000 18 1 2 2 1 4 2
6/16/2006 12 2 2 2 1 3 2
11/10/2009 19 1 2 2 1 2
5/9/2012 6 1 2 2 1 2
7/11/1948 70 2 4 2 1 1 1
5/1/1953 65 2 4 2 1 3 6
8/29/1982 36 1 1 2 1 5 6
4/29/1991 17 1 1 1 1 4 9
1/9/2016 2 1 2 2 1 2
7/1/1944 74 1 1 2 1 3 6
5/5/1958 60 2 1 2 1 3 6
10/16/1987 31 1 2 2 1 7 6
5/3/1942 76 2 4 2 1 3 1
8/5/1991 27 2 2 2 1 1 1
2 2 1 2
12/31/1959 59 1 1 2 3 3 6
12/18/1958 60 2 1 2 3 3 6
12/14/1988 30 1 1 2 3 5 6
2 1 1 3 4 9
1 2 2 3
7/5/2010 8 2
7/1/1953 65 2 4 2 1 3 6
4/6/1987 31 2 2 2 1 4 6
5/8/1968 50 1 1 2 1 3 6
6/12/1973 45 2 1 2 1 3 6
5/8/1999 19 1 2 2 1 4 2
7/3/2001 17 1 2 2 1 3 2
4/24/2003 15 1 2 2 1 3 2
9/29/2005 13 1 2 2 1 2
10/20/2008 10 2 2 2 1 2
10/20/2008 10 1 2 2 1 6
7/1/1954 64 2 4 2 1 3 6
7/1/1958 60 2 3 2 1 3 6
5/28/2015 3 1 2 2 1
7/1/1935 83 1 1 2 3 1 6
7/1/1936 82 2 1 2 3 1 6
8/3/1952 66 2 3 2 3 3 6
12/10/1947 71 1 1 2 3 3 6
8/3/1947 71 2 1 2 3 3 6
6/21/1999 19 1 2 2 3 5 2
7/31/2001 17 1 2 2 3 4 2
1 1 2 3 7 5
2 1 2 3 5 5
11/15/2016 1.9 2 2 2 3
11/15/2016 1.9 2 2 2 3
5/24/1973 45 1 1 2 3 5 6
8/16/1978 40 2 1 2 3 7 4
3/16/2010 8 2 2 2 3 2
3/28/2013 2 2 2 2 3 2
7/1/1936 82 2 4 2 3 3 1
4/21/1959 59 2 4 2 3 3 6
12/20/1977 41 2 2 2 3 1 1
5/15/1987 40 1 2 2 3 7 1
7/1/1950 68 2 4 2 3 1 6
4/11/1956 62 1 1 2 3 3 6
1/5/1958 60 2 1 2 3 3 6
7/1/1946 72 1 2 2 3 3 6
10/101971 47 1 1 2 3 3 6
7/3/1981 37 2 1 2 3 3 9
7/7/2003 15 2 2 2 3 3 2
2/17/2007 11 2 2 2 3 2
4/29/2012 6 1 2 2 3 2
10/16/2016 2 1 1 2 3
12/8/1962 56 1 1 2 3 3 6
12/1/1962 56 2 2 2 3 3 6
2/15/2001 17 2 1 2 3 3 2
11/21/1958 60 1 1 2 3 3 6
10/15/1959 59 2 2 2 3 3 6
11/5/2007 11 2 2 2 3 2
3/27/2012 6 2 2 2 3 2
5/17/2013 5 2 2 2 3 2
7/1/1953 65 1 1 2 3 3 6
2/6/1946 72 1 1 2 3 3 6
3/2/1954 64 2 1 2 3 3 6
5/1/1953 65 1 1 2 3 3 6
5/3/1965 53 2 1 2 3 3 6
9/8/1997 21 1 2 2 3 3 2
1/24/2001 17 1 2 2 3 3 2
7/16/1971 47 1 1 2 3 3 6
02/031976 42 2 1 2 3 3 6
12/31/1938 80 2 4 2 3 1 6
6/2/1995 23 1 2 2 3 1 1
1/3/1999 19 2 2 2 3 1 1
10/5/2003 15 1 2 2 3 1 1
2/1/1983 35 1 1 2 1 3 6
3/17/1985 33 2 1 2 1 3 6
10/24/2004 14 2 2 2 1 3 2
7/31/2006 12 1 2 2 1 2
7/31/2007 11 1 2 2 1 2
8/5/2008 10 2 2 2 1 2
3/11/1962 56 1 1 2 1 3 6
7/3/1958 60 2 1 2 1 3 6
7/6/1970 48 2 1 2 3 3 6
6/30/2003 15 1 2 2 3 3 2
6/4/1950 68 2 4 2 3 1 6
7/1/1940 78 1 1 2 3 2 6
7/1/1940 78 2 1 2 3 2 6
2 1 2 3 2 6
7/7/1905 3 1 2 2 3
2/11/2001 17 2 2 2 3 4 2
5/26/2002 16 2 2 2 3 3 2
7/1/1935 83 2 4 2 3 1 1
7/1/1949 69 2 2 2 3 1 1
7/1/1937 81 2 4 2 1 1 6
9/8/1973 45 1 1 2 1 2 6
6/15/1981 37 2 1 2 1 2 6
4/26/2000 18 1 2 2 1 4 2
6/21/2002 16 1 2 2 1 4 2
8/1/2007 11 2 2 2 1 2
2/7/2010 8 1 2 2 1 2
11/11/2014 4 2 2 2 1 1
7/1/1925 93 2 4 2 1 1 6
7/1/1950 68 2 4 2 1 3 1
2 2 2 3 5 1
1 2 2 3 3 1
7/1/1971 47 1 1 2 3 3 6
5/10/1972 46 2 1 2 3 3 6
10/28/1996 22 1 2 2 3 1 1
12/25/1998 20 1 2 2 3 1 1
12/17/2000 18 1 2 2 3 1 1
8/11/2002 16 1 2 2 3 1 1
4/21/2006 12 2 2 2 3 1 1
6/16/2008 10 1 2 2 3 1 1
12/2/2010 8 1 2 2 3 1 1
7/13/2012 6 2 2 2 3 1 2
18 2 1 2 3 1 6
2/13/2017 1 1 2 2 3
3/23/1949 69 2 4 2 1 3 6
2 3 2 1 3 6
4/3/1965 1 1 2 3 3 6
2/27/1973 2 1 2 3 3 6
10/14/1996 2 2 2 3 5 2
4/13/1998 1 2 2 3 4 2
3/8/2003 2 2 2 3 3 2
12/23/1993 1 2 2 3 1 6

Pendidikan tertinggi Pekerjaan
1. Tidak pernah sekolah 5. Tamat SLTA/MA 1. Tidak Kerja 6. Petani
2. Tidak tamat SD/MI 6. Tamat D1/D2/D3 2. Sekolah 7.Nelayan
3. Tamat SD/ MI 7. Tamat PT 3. TNI/Polri 8. Buruh

Sarana Jenis Gangguan Gangguan
Jiwa JKN Merokok Masalah
Air Bersih Jenis Jamban Jiwa dipasung kesehatan
Sumber Air (penyakit)
1. Ya 1. Kloset 1. Ya 1. Ya 1. Ya 1. Ya
2. Tidak 2. cemplun2 Tidak 2. Tidak 2. Tidak 2. Tidak
14 15 16 17 18 19 20 21
1 PDAM 1 2 2 2 2
1 PDAM 2 2 2 1
1 PDAM 2 2 2 2
1 PDAM 1 2 2 1 2
1 PDAM 2 2 1 2
1 PDAM 2 2 2 2
1 PDAM 2 2 1 2
1 PDAM 2 2 1 2
1 PDAM 1 2 2 2 1
1 PDAM 2 2 2 2
1 PDAM 2 2 2 1
1 PDAM 2 2 2 2
1 PDAM 2 2 2 2
1 PDAM 1 2 2 2 2
1 PDAM 2 2 2 2
1 PDAM 1 2 2 2 1
1 PDAM 2 2 2 2
1 PDAM 2 2 2 2
1 PDAM 2 2 2 2
1 PDAM 2 2 2 2
1 PDAM 2 2 2 2
1 PDAM 2 2 2 2
1 PDAM 1 2 2 2 1
1 PDAM 2 2 2 2
1 PDAM 2 2 2 2
1 PDAM 2 2 2 2
1 PDAM 2 2 2 2
1 PDAM 1 2 2 2 1
1 PDAM 2 2 2 2
1 PDAM 1 2 2 2 1
1 PDAM 2 2 2 2
1 PDAM 2 2 2 2
1 PDAM 1 2 2 2 2
1 PDAM 2 2 2 1
1 PDAM 2 2 2 2
1 PDAM 2 2 2 2
1 PDAM 2 2 2 2
1 PDAM 1 2 2 1 1
1 PDAM 2 2 1 2
1 PDAM 1 2 2 1 1
1 PDAM 2 2 1 2
1 PDAM 2 2 2 2
1 PDAM 2 2 2 1
1 PDAM 2 2 2 2
1 PDAM 1 2 2 1 2
1 PDAM 1 2 2 2 2
1 PDAM 2 2 2 2
1 PDAM 1 2 2 2 1
1 PDAM 2 2 2 2
1 PDAM 2 2 2 2
1 PDAM 2 2 2 2
1 PDAM 2 2 2 2
1 PDAM 1 2 2 1 1
1 PDAM 2 2 1 2
1 PDAM 2 2 1 1
1 PDAM 2 2 2 2
1 PDAM 1 2 2 2 1
1 PDAM 2 2 2 2
1 PDAM 2 2 2 2
1 PDAM 2 2 2 2
1 PDAM 1 2 2 1 2
1 PDAM 2 2 1 2
1 PDAM 2 2 2 1
1 PDAM 2 2 2 1
1 PDAM 1 2 2 2 2
1 PDAM 2 2 2 2
1 PDAM babs 2 2 1 1
1 PDAM 2 2 1 2
1 PDAM 2 2 2 2
1 PDAM 2 2 2 2
1 PDAM 1 2 2 2 2
1 PDAM 2 2 2 2
1 PDAM 2 2 2 2
1 PDAM 1 2 2 2 2
1 PDAM 2 2 2 2
1 PDAM 2 2 2 2
1 PDAM 1 2 2 2 1
1 PDAM 2 2 1 2
1 PDAM 2 2 1 2
1 PDAM 2 2 1 2
1 PDAM 2 2 2 2
1 PDAM 2 2 1 2
1 PDAM 1 2 2 2 2
1 PDAM 2 2 2 2
1 PDAM 2 2 2 2
1 PDAM 2 2 2 2
1 PDAM 2 2 2 2
1 PDAM 2 2 2 1
1 PDAM 2 2 2 2
1 PDAM 2 2 2 2
1 PDAM 1 2 2 2 2
1 PDAM 2 2 2 2
1 PDAM 2 2 2 2
1 PDAM 1 2 2 2 2
1 PDAM 2 2 2 2
1 PDAM 2 2 2 1
1 PDAM 2 2 2 2
1 PDAM 2 2 2 1
1 PDAM 2 2 2 1
1 PDAM 1 2 2 2 2
1 PDAM 2 2 2 2
1 PDAM 2 2 2 2
1 PDAM babs 2 2 1 2
1 PDAM 2 2 2 2
1 PDAM 2 2 2 2
1 PDAM 1 2 2 1 1
1 PDAM 2 2 1 2
1 PDAM 2 2 1 2
1 PDAM 2 2 1 2
1 PDAM 2 2 1 2
1 PDAM 2 2 1 2
1 PDAM 2 2 2 2
1 PDAM 1 2 2 2 1
1 PDAM 2 2 2 2
1 PDAM 2 2 2 2
1 PDAM 2 2 2 2
1 PDAM 1 2 2 1 1
1 PDAM 2 2 1 2
1 PDAM 2 2 1 1
1 PDAM 1 2 2 2 2
1 PDAM 2 2 2 2
1 PDAM 1 2 2 2 2
1 PDAM 2 2 2 2
1 PDAM 2 2 2 2
1 PDAM 2 2 2 2
1 PDAM 2 2 2 2
1 PDAM 2 2 2 2
1 PDAM 1 2 2 2 2
1 PDAM 2 2 2 2
1 PDAM 2 2 2 2 2
1 PDAM 1 2 2 2 1
1 PDAM 2 2 2 2
1 PDAM 2 2 2 2
1 PDAM 1 2 2 1 1
1 PDAM 2 2 1 2
1 PDAM 2 2 1 2
1 PDAM 2 2 2 2
1 PDAM 2 2 2 2
1 PDAM 1 2 2 1 1
1 PDAM 2 2 2 1
1 PDAM 1 2 2 1 2
1 PDAM 2 2 1 2
1 PDAM 2 2 1 2
1 PDAM 2 2 1 2
1 PDAM 2 2 2 2
1 PDAM 1 2 2 2 2
1 PDAM 2 2 2 2
1 PDAM 1 2 2 1 2
1 PDAM 2 2 1 2
1 PDAM 2 2 1 1
1 PDAM 2 2 1 2
1 PDAM 2 2 1 2
1 PDAM babs 2 2 1 2
1 PDAM 2 2 1 2
1 PDAM 2 2 1 2
1 PDAM 2 2 2 2
1 PDAM 2 2 2 2
1 PDAM babs 2 2 2 2
1 PDAM babs 2 2 1 2
1 PDAM 2 2 1 2
1 PDAM 2 2 2 2
1 PDAM 1 2 2 2 1
1 PDAM 2 2 1 2
1 PDAM 2 2 1 2
1 PDAM 2 2 1 2
1 PDAM 2 2 1 2
1 PDAM 2 2 2 2
1 PDAM 2 2 1 2
1 PDAM 2 2 1 2
1 PDAM 2 2 2 2
1 PDAM 2 2 1 2
PDAM 2 2 2 2
1 PDAM babs 2 2 2 2
1 PDAM 1 2 2 2 1
1 PDAM 2 2 2 2
1 PDAM 2 2 2 2
1 PDAM 2 2 2 2
1 PDAM 2 2 2 2
1 PDAM 2 2 2 2
1 PDAM 1 2 2 2 2
1 PDAM 2 2 2 2
1 PDAM 2 2 2 2
1 PDAM 1 2 2 1 2
1 PDAM 2 2 1 2
1 PDAM 2 2 1 2
1 PDAM 2 2 1 2
1 PDAM 2 2 1 2
1 PDAM 1 2 2 1 2
1 PDAM 2 2 1 1
1 PDAM 2 2 1 2
1 PDAM 2 2 1 2
1 PDAM 2 2 1 2
1 PDAM babs 2 2 1 1
1 PDAM 2 2 1 2 KUSTA
1 PDAM 2 2 2 2
1 PDAM 2 2 2 2
1 PDAM 2 2 1 2 KUSTA
1 PDAM 1 2 2 2 1
1 PDAM 2 2 2 2
1 PDAM 1 2 2 2 1
1 PDAM 2 2 2 2
1 PDAM 2 2 2 2
1 PDAM 1 2 2 2 1
1 PDAM 2 2 2 2
1 PDAM 1 2 2 1 2
1 PDAM 2 2 1 2
1 PDAM 1 2 2 2 1
1 PDAM 2 2 2 2
1 PDAM 2 2 2 2
1 PDAM 2 2 2 2
1 PDAM babs 2 2 2 2
1 PDAM 2 2 2 2
1 PDAM babs 2 2 1 1
1 PDAM 2 2 2 2
1 PDAM 2 2 2 2
1 PDAM 2 2 2 1
1 PDAM 1 2 2 2 1
1 PDAM 2 2 2 2
1 PDAM 2 2 2 1
1 PDAM 2 2 2 2
1 PDAM 1 2 2 1 1
1 PDAM 2 2 1 2
1 PDAM 2 2 1 2
1 PDAM 2 2 1 2
1 PDAM 2 2 1 2
1 PDAM 1 2 2 1 1
1 PDAM 2 2 1 2
1 PDAM 2 2 2 1
1 PDAM 1 2 2 1 2
1 PDAM 2 2 1 1
1 PDAM 2 2 2 1
1 PDAM 2 2 2 1
1 PDAM babs 2 2 1 1
1 PDAM 2 2 1 2
1 PDAM 2 2 1 2
1 PDAM 2 2 1 2
1 PDAM 2 2 1 2
1 PDAM 1 2 2 2 1
1 PDAM 2 2 2 2
1 PDAM babs 2 2 2 1
1 PDAM 2 2 2 2
1 PDAM 1 2 2 2 1
1 PDAM 2 2 2 2
1 PDAM 1 2 2 2 2
1 PDAM 1 2 2 2 2
1 PDAM 2 2 2 1
1 PDAM 2 2 2 1
1 PDAM 1 2 2 1 1
1 PDAM 2 2 1 2
1 PDAM babs 2 2 2 2
1 PDAM 2 2 2 2
1 PDAM 2 2 2 2
1 PDAM 2 2 2 2
1 PDAM babs 2 2 2 2
1 PDAM 1 2 2 1 1
1 PDAM 2 2 1 2
1 PDAM 2 2 1 2
1 PDAM 2 2 1 2
1 PDAM numpang 2 2 2 1
1 PDAM 2 2 1 2
1 PDAM 2 2 2 2
1 PDAM babs 2 2 2 2
1 PDAM 2 2 2 2
1 PDAM 1 2 2 1 2
1 PDAM 2 2 1 2
1 PDAM 2 2 2 1
1 PDAM 2 2 2 2 stroke
1 PDAM 2 2 2 2
1 PDAM 2 2 2 2
1 PDAM 2 2 2 2
1 PDAM 1 2 2 2 1
1 PDAM 2 2 2 2
1 PDAM babs 2 2 2 2
1 PDAM 1 2 2 2 2
1 PDAM 2 2 2 1
1 PDAM babs 2 2 1 1
1 PDAM 2 2 1 2
1 PDAM 2 2 1 2
1 PDAM 2 2 2 2
1 PDAM 2 2 2 2
1 PDAM 2 2 2 2
1 PDAM 1 2 2 1 2
1 PDAM 2 2 1 2
1 PDAM 2 2 1 2
1 PDAM 2 2 1 2
1 PDAM 2 2 1 2
1 PDAM 2 2 2 2
1 PDAM 1 2 2 2 2
1 PDAM 2 2 2 2
1 PDAM babs 2 2 1 2
1 PDAM 2 2 1 2
1 PDAM 2 2 12 2
1 PDAM 2 2 1 2
1 PDAM 2 2 1 2
1 PDAM 2 2 2 2
1 PDAM 1 2 2 1 1
1 PDAM 2 2 1 2
1 PDAM babs 2 2 2 1 TBC
1 PDAM 2 2 2 2
1 PDAM 2 2 2 2
1 PDAM 2 2 2 2
1 PDAM 2 2 2 2
1 PDAM 2 2 2 2
1 PDAM 1 2 2 1 1
1 PDAM 2 2 1 2
1 PDAM 2 2 1 2
1 PDAM 2 2 1 2
1 PDAM 2 2 2 2
1 PDAM 2 2 1 2
1 PDAM 2 2 2 2
1 PDAM 2 2 2 2
1 PDAM 1 2 2 2 2
1 PDAM 2 2 2 2
1 PDAM 2 2 2 2
1 PDAM 1 2 2 2 2
1 PDAM 2 2 2 1
1 PDAM 2 2 2 2
1 PDAM 1 2 2 2 2
1 PDAM 1 2 2 2 2
1 PDAM 1 2 2 2 1
1 PDAM 2 2 2 2
1 PDAM 1 2 2 1 1
1 PDAM 2 2 1 2
1 PDAM 2 2 1 1
1 PDAM 2 2 1 2
1 PDAM 2 2 1 2
1 PDAM 2 2 1 2
1 PDAM 2 2 1 2
1 PDAM 2 2 2 2
1 PDAM 2 2 2 2
1 PDAM 2 2 2 2
1 PDAM 2 2 2 2
1 PDAM 2 2 2 2
1 PDAM 1 2 2 2 2
1 PDAM 2 2 2 2
1 PDAM 2 2 2 1
1 PDAM 2 2 2 2
1 PDAM 1 2 2 1 2
1 PDAM 2 2 2 2
1 PDAM 2 2 2 2
1 PDAM babs 2 2 2 2
1 PDAM 2 2 2 2
1 PDAM babs 2 2 2 1
1 PDAM 2 2 2 2
1 PDAM 2 2 2 2
1 PDAM 2 2 2 2
1 PDAM 1 2 2 2 1
1 PDAM 2 2 2 1
1 PDAM 2 2 2 1
1 PDAM babs 2 2 2 1
1 PDAM 2 2 1 2
1 PDAM 2 2 2 2
1 PDAM 1 2 2 1 1
1 PDAM 2 2 1 2
1 PDAM 1 2 2 1 2
1 PDAM 1 2 2 2 2
1 PDAM 1 2 2 2 2
1 PDAM babs 2 2 2 2
1 PDAM 2 2 2 2
1 PDAM 2 2 2 1
1 PDAM 1 2 2 1 1
1 PDAM 2 2 1 2
1 PDAM 2 2 1 1
1 PDAM 2 2 2 2
1 PDAM 2 2 1 2
1 PDAM 2 2 2 2
1 PDAM 2 2 1 2
1 PDAM 1 2 2 2 2
1 PDAM 2 2 2 1
1 PDAM 2 2 2 2
1 PDAM 2 2 2 2
1 PDAM 1 2 2 2 2
1 PDAM 2 2 2 2
1 PDAM 2 2 2 1
1 PDAM 2 2 1 2
1 PDAM 2 2 2 2
1 PDAM 1 2 2 2 1
1 PDAM 2 2 1 2
1 PDAM 2 2 2 1
1 PDAM 2 2 1 2
1 PDAM 2 2 2 2
1 2
1 PDAM 1 2 2 1 2
1 PDAM 2 2 1 2
1 PDAM 2 2 1 2
1 PDAM 2 2 1 1
1 PDAM 2 2 1 1
1 PDAM 2 2 1 1
1 PDAM 2 2 1 2
1 PDAM 2 2 1 2
1 PDAM 2 2 2 2
1 PDAM 2 2 1 2
1 PDAM 2 2
1 PDAM 1 2 2 1 1
1 PDAM 2 2 1 2
1 PDAM 1 2 2 2 2
1 PDAM 2 2 2 1
1 PDAM 2 2 2 2
1 PDAM 2 2 2 2
1 PDAM 2 2 2 2
1 PDAM 2 2 2 1
1 PDAM 2 2 2 2
1 PDAM 2 2 2 2
1 PDAM 2 2 2 2
1 PDAM 1 2 2 1 1
1 PDAM 2 2 1 2
1 PDAM 2 2 1 2
1 PDAM 2 2 1 2
1 PDAM 1 2 2 2 2
1 PDAM 1 2 2 2 2
1 PDAM 2 2 2 2
1 PDAM 2 2 2 2
1 PDAM 1 2 2 2 2
1 PDAM 1 2 2 2 1
1 PDAM 2 2 2 2
1 PDAM 2 2 2 1
1 PDAM 1 2 2 1 1
1 PDAM 2 2 1 2
1 PDAM 2 2 1 2
1 PDAM 2 2 2 2
1 PDAM 2 2 2 2
1 PDAM 2 2 2 2
1 PDAM 1 2 2 1 1
1 PDAM 2 2 1 2
1 PDAM 2 2 1 2
1 PDAM 1 2 2 2 1
1 PDAM 2 2 2 2
1 PDAM 2 2 2 2
1 PDAM 2 2 2 2
1 PDAM 2 2 2 2
1 PDAM 1 2 2 2 1
1 PDAM 1 2 2 2 1
1 PDAM 2 2 2 2
1 PDAM 1 2 2 2 1
1 PDAM 2 2 2 2
1 PDAM 2 2 2 2
1 PDAM 2 2 2 2
1 PDAM 1 2 2 2 1
1 PDAM 2 2 2 2
1 PDAM babs 2 2 1 2
1 PDAM 2 2 1 1
1 PDAM 2 2 1 2
1 PDAM 2 2 1 1
1 PDAM babs 2 2 2 1
1 PDAM 2 2 2 2
1 PDAM 2 2 2 2
1 PDAM 2 2 2 2
1 PDAM 2 2 2 2
1 PDAM 2 2 2 2
1 PDAM 1 2 2 2 1
1 PDAM 2 2 2 2
1 PDAM 1 2 2 2 2
1 PDAM 1 2 2 2 1
1 PDAM 2 2 2 2
1 PDAM 1 2 2 22 1
1 PDAM 2 2 2 2
1 PDAM 2 2 2 2
1 PDAM 2 2 2 2
1 PDAM 2 2 2 2
1 PDAM 2 2 2 2
1 PDAM babs 2 2 2 2
1 PDAM 2 2 2 2
1 PDAM 1 2 2 2 2
1 PDAM 1 2 2 1 1
1 PDAM 2 2 1 2
1 PDAM 2 2 1 1
1 PDAM 2 2 1 1
1 PDAM 2 2 1 1
1 PDAM 2 2 1 2
1 PDAM 2 2 2 2
1 PDAM 1 2 2 2 2
1 PDAM 2 2 2 2
1 PDAM 2 2 2 2
1 PDAM 2 2 2 1
1 PDAM babs 2 2 2 1
1 PDAM 2 2 2 2
1 PDAM 2 2 2 2
1 PDAM 2 2 2 2
1 PDAM 2 2 2 2
1 PDAM 2 2 2 2
1 PDAM 2 2 2 2
1 PDAM 2 2 2 2
1 PDAM 2 2 2 2
1 PDAM 2 2 2 2
1 PDAM babs 2 2 2 2
1 PDAM 2 2 2 2
1 PDAM babs 2 2 1 2
1 PDAM 1 2 2 2 2
1 PDAM babs 2 2 1 1
1 PDAM 2 2 1 2
1 PDAM 2 2 1 2
1 PDAM 2 2 1 2
1 PDAM 2 2 1 2
1 PDAM 2 2 2 1
Wanita menikah
usia 10-54 tahun
menggunakan alat
kontrasepsi
1. Ya
2. Tidak
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REKAPAN PIS PK

KETERANGAN ANGGOTA KELUARGA

1 Kartina Barek Duli 5306 1261 0476 0003 008/004 1 21/04/1976 42 2

1 Lukas Lein Kuma 5306 1201 0747 0036 007/004 1 1/7/1947 71 1

mat SLTA/MA 1. Tidak Kerja 6. Petani

KETERANGAN ANGGOTA KELUARGA

1 Kondradus Kopong Demon 5306 12021174 0001 008/004 1 2/11/1974 44 1

mat SLTA/MA 1. Tidak Kerja 6. Petani

pendidikan Pekerjaan 1. Ya 1. Kloset 1. Ya 1. Ya

1 Magdalena Tuto Mado 5306 1266 0850 0001 002/001

Agama Pendidikan tertinggi Pekerjaan

4 Rikardus Kia Boli 5306 1230 0498 0002 002/001

Agama Pendidikan tertinggi Pekerjaan

Agama Pendidikan tertinggi Pekerjaan

1 Petrus Kia Boli 5306 1201 0853 0001 006/003

Agama Pendidikan tertinggi Pekerjaan

1 Tobias Bayo Doni 5306 1208 0256 1501 006/003

Agama Pendidikan tertinggi Pekerjaan

1 Petrus Kopong Demon 5306 1214 0857 0001 006/003

Kode kolom 11 Kode kolom 12

Agama Pendidikan tertinggi Kode kolom 13

1 Yohanes Demon Arep 5306 1227 0381 0001 005/003

pendidikan Pekerjaan 1. Ya 1. Kloset 1. Ya 1. Ya

KETERANGAN ANGGOTA KELU

1 Januarius Wilibrodus Ara Kian 012/006 1

1 Gabriel Kopong Sani 5306 1212 0466 0001 001/001 1

1. Pria 1. Ya pendidikan Pekerjaan

Kode kolom 12 Kode kolom 13

3. Tamat SD/ MI 7. Tamat PT 3. TNI/Polri 8. Buruh

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