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TEMPAT

BULAN
J TGL LAHIR HB DPT-HB-HIB (PENTABIO) POLIO CAMPAK
NO NAMA ALAMAT BCG
K ( UMUR ) 0-7 HR 1 2 3 BOSTER 1 2 3 4 9-11BLN BOSTER
LAPORAN DATA PASIEN YANG DI IMUNISASI MR DI RSIA ASRI PURWAKARTA
BULAN : SEPTEMBER 2017

NO NAMA UMUR ALAMAT TGL IMUN

1 Raina zahiya 3th pr.inova residence blok D no.4,Ds. Ciseureuh,kec.pwk 20/9/17


2 M.Aufa alkhalif 18bln pr.inova residence blok c no.4,Ds. Ciseureuh,kec.pwk 20/9/17
3 nafeesa kaneez 11bln pr.inova residence blok D,Ds. Ciseureuh,kec.pwk 20/9/17
4 Fathiya arsyila 3th pr.inova residence blok R no.8,Ds. Ciseureuh,kec.pwk 20/9/17
5 M.Almiftah F 3th 6bln Gg.beringin 78/08 n0.32 desa nagri kaler,pwk 20/9/17
6 vania Atalia 3th jl.pramuka 2/1 Ds.Bunder kec.jatiluhur-pwk 28/9/17
7 Aqeela Latisya 3th jl.kemuning gg.beringin Ds.nagri kaler pwk 28/9/17
8 Muhamad Fathan 3th kp.karangsari 8/2 Ds.citalang pwk 28/9/17
9 Rhoma malik 12th jl.Kapt.halim Gg.sumba no.45 rt 20/4 Ds.bongas kel.sindangkasih 28/9/17
10 Dhiandra 11bln kp.malang nengah 13/10 Ds.nagri tengah pwk 28/9/17

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