ALAMAT RT/RW NO. URUT NO.

URUT RT ∑ ART ART 0-11 BL ART 12 - 59

BANGUNAN BL

KEDUNGSARI RT.01/02 024 001 2 0 0

025 001 1 0 0

026 001 3 0 0

027 001 2 0 0

028 001 3 0 0

002 2 0 0

029 001 1 0 0

030 001 4 0 0

031 001 3 0 0

002 3 0 0

032 001 3 0 0

002 3 0 1
033 001 1 0 0

034 001 3 0 0

035 001 3 0 0

036 001 6 0 0

037 001 4 0 0

038 001 5 0 1

52 0 2
ART ≥15 TH ART 10-54 NAMA KK ANGGOTA KK NIK
TH

2 0 SUPARNO 3576021505600002
SARIMAH 3576027008620002

1 0 SUPRIYO 3576023112570005

3 1 IMAM BUSALI 3576021503320001

PARSINAH 3576026608430001
ARLENA 3576025311790002

2 0 SUKARTONO 3576023112270007
KATAMAH 3576026208480001

2 2 EKO SETYONO 3576010103790004

RINI PURWANTI 3576025603870002
MUH. RANDI S. 3576012511110001

2 2 M. VERDY P.U 3517140207900002

DIDIN ANGGAR L. 3576026101880001

1 1 SUNARTI

4 4 KARTOLO 3576022606740002
KUSTINI 3576025203750003
M.ANAM K. 3576020612940001
EFIFA K. 3576024510020001

3 3 JURI 3576020509590002
WIWIK SRI 3576026903630001
TRIA MEGA 3576025205940001

2 3 SABIR 3576021507780005
DEVI LESTARI 3576027001870001
SAFIRA R. 3576027105100003

3 3 SUMARNO 3576025510720001
SITI KOTIJAH 3576025510720001
DWI AYU A. 3576024908940001

2 2 ANIS PRASETYO 351618004910001

DEWI NOVITASARI 3576024712920002
 MIKHAYLA ARSY 3576026805160001

1 0 PODO 3576023112460007

3 3 RADIS SUPARNO 3576022095640002

SUMARMI 3576025711890005
MOCH. ARDI K. 3576020309960004

2 2 GATUT WAHYU 3576020910740005

MURTININGRUM 3576026610780005
ARSYA ROSITA 3576025608080003

6 4 SUBADI 3576020404660001
SARMINAH 3576027112680007
YENI YULI 3576026607900001
ACHMAD ZAINURI 3576021201950002
SARMIN 3576020305330001
PONISAH 3576024702380001

4 4 STEPANUS RUDI 3576012101720002

ANIK SULISTYOWATI 3576026804710002
DITA MARGYANA 3576024107970003
AYUB KASIA S. 3576020306020001

3 2 YANTO PRASTYAWAN 3576021808810002

WINDO RINI 3576025208820004
ALMIRA PRASTYAWAN 3576026102100001
AMANDA PRASTYAWAN 3576025207140001
RASIATIN 3576027112520020

46 36
 REKAPAN KS KELURAHAN GUNUNG GEDANGAN

NO. BPJS HUBUNGAN TANGGAL LAHIR UMUR L/P (1/0) KAWIN HAMIL/
TAHUN BULAN TIDAK

0001706654935 1 15-May-60 58 8 1 1
0001706654946 3 30-Aug-62 56 4 0 1
0
1 31-Dec-57 61 0 1 1 0

0000785382682 1 15-Mar-32 86 10 1 1
0000785302737 3 26-Aug-43 75 4 0 1
0000785383042 4 13-Nov-79 39 2 0 2 0
0
0000786521237 1 31-Dec-27 91 0 1 1
0001705170846 3 22-Jun-48 70 6 0 1
28-Jul-08 10 5
10
1 1-Mar-79 39 10 1 1
3 15-Mar-87 31 10 0 1 0
4 25-Nov-11 7 1 1 2
0
0000732113829 1 2-Jul-90 28 6 1 1
0000786968076 3 21-Jan-88 30 11 0 1 0

1 1-Jul-77 41 6 0 1 0

0000786997155 1 26-Jun-74 44 6 1 1
0000786977335 3 12-Mar-75 43 10 0 1 0
0000786977425 4 6-Dec-94 24 1 1 2
000078977482 4 5-Oct-02 16 3 0 2 0

1 5-Sep-59 59 4 1 1
0000786967648 3 29-Mar-63 55 9 0 1 0
0000786968526 4 12-May-94 24 8 0 2 0

1 15-Jul-78 40 6 1 1
3 30-Jan-87 31 11 0 1 0
4 31-May-10 8 7 0 2

1 2-Nov-67 51 2 1 1
3 15-Oct-72 46 3 0 1 0
4 9-Aug-94 24 5 0 2 0

1 10-Apr-91 27 9 1 1
3 7-Dec-92 26 1 0 1 0
 4 28-Apr-16 2 8 0 2

0000785408883 1 31-Dec-46 72 0 1 1

1 20-May-64 54 7 1 1
3 17-Nov-69 49 2 0 1 0
4 3-Sep-96 22 4 1 2

1 9-Oct-74 44 3 1 1
3 26-Oct-78 40 2 0 1 0
4 16-Aug-08 10 5 0 2

1 4-Apr-66 52 9 1 1
3 31-Dec-68 50 0 0 1 0
4 26-Jul-90 28 5 0 2 0
4 12-Jan-95 24 0 1 2
8 3-May-33 85 8 1 1
8 7-Feb-38 80 11 0 1

1 21-Jan-72 46 11 1 1
3 28-Apr-71 47 8 0 1 0
4 1-Jul-97 21 6 0 2 0
4 3-Aug-02 16 5 1 2

1 20-Apr-85 33 8 1 1
0001310515659 3 24-Jul-87 31 5 0 1 0
4 21-Feb-10 8 10 0 2
4 12-Jul-14 4 6 0 2
7 15-Apr-48 70 9 0 4
7 12-Sep-72 46 4
26-Feb-99 19 10
25-Jan-08 10 11
Y:17 T:0

31-Dec-29 89 0
31-Dec-39 79 0

13-May-69 49 8
29-Mar-80 38 9
19-Aug-99 19 4
14-Sep-07 11 4

4-Apr-61 57 9
31-Aug-88 30 4
18-Mar-92 26 9
2-Nov-93 25 2
20-Jul-97 21 5

28-Apr-86 32 8
23-Apr-89 29 8
15-Aug-17 1 5

19-Nov-78 40 1
7-Jul-79 39 6
21-Dec-01 17 0
23-Jul-06 12 5

15-Apr-73 45 9
22-Feb-77 41 10
17-Feb-05 13 11

3-May-62 56 8
3-Nov-70 48 2
1-May-91 27 8
26-Sep-94 24 3
22-Jul-96 22 5

6-Sep-74 44 4
19-May-74 44 7
6-Oct-00 18 3
22-Jan-04 14 11
0
119 0
119 0
119 0
119 0
119 0
119 0
0
119 0
119 0
119 0
119 0
119 0
119 0
0
119 0
119 0
119 0
119 0
119 0
119 0
0
119 0
119 0
119 0
119 0
119 0
119 0
0
119 0
119 0
119 0
119 0
119 0
119 0
0
119 0
119 0
119 0
119 0
119 0
119 0
0
119 0
119 0
119 0
119 0
119 0
119 0
0
119 0
119 0
119 0
119 0
119 0
119 0
0
119 0
119 0
119 0
119 0
119 0
119 0
 0
119 0
119 0
119 0
119 0
119 0
119 0
0
119 0
119 0
119 0
119 0
119 0
119 0
0
119 0
119 0
119 0
119 0
119 0
119 0
GUNUNG GEDANGAN

AGAMA PENDIDIKAN PEKERJAAN SAB SAB JAMBAN JAMBAN ART ODGJ ODGJ
TERLINDUNGI SANITER BEROBAT
TERATUR
1 3 TDK BEKERJA 1 1 1 1 0
1 3 IRT

1 4 PEDAGANG 1 1 1 1 0

1 3 TDK BEKERJA 1 1 1 1 0
1 3 IRT
1 5 SWASTA

1 2 SERVIS RADIO 1 1 1 1 0
1 2 IRT

1 5 DAGANG 1 1 1 1 0
1 5 IRT
1 2

1 5 PABRIK 1 1 1 1 0
1 5 IRT

1 3 PABRIK 1 1 1 1 0

1 3 PEDAGANG 1 1 1 1 0
1 3 PABRIK
1 4 PABRIK
1 2

1 3 DAGANG 1 1 1 1 0
1 3 IRT
1 5 TDK BEKERJA

1 5 PABRIK 1 1 1 1 0
1 5 PABRIK
1 2

1 4 DAGANG 1 1 1 1 0
1 3 IRT
1 5

1 5 TDK BEKERJA 0 0 0 0 0
1 5 IRT
1 1

1 3 DAGANG 1 1 1 1 0

1 5 TUKANG KEBUN 1 1 1 1 0
1 4 DAGANG
1 8

1 5 GALANGAN 1 1 1 1 0
1 5 IRT
1 2

1 3 DAGANG 1 1 1 1 0
1 4 IRT
1 5 GURU PAUD
1 8
1 3
1 3

1 5 SOPIR 1 1 1 1 0
1 3 IRT
1 5
1 4

1 5 TUKANG KEBUN 1 1 1 1 0
1 5 TOKO HP
1 2
1 1
1 2 IRT

Y:17 Y:17 Y:17 Y:17 T:18

ODGJ DI MEROKOK BAB MENGGUNA DI DX TB TB BEROBAT ART GEJALA DX HT HT MINUM TENSI
PASUNG DIJAMBAN KAN AIR TERATUR TB OAHT
BERSIH TERATUR
0 1 1 0 0 0 140/80
0 1 1 0 0 0 130/80

1 1 1 0 0 0 130/80

0 1 1 0 0 0 130/90
0 1 1 0 0 0 130/80
0 1 1 0 0 0 110/80

0 1 1 0 0 1 1 150/90
0 1 1 0 0 1 1 170/80

1 1 1 0 0 0 110/70
0 1 1 0 0 0 120/80
0 1 1 0 0 0

0 1 1 0 0 0 110/70
0 1 1 0 0 0 120/80

0 1 1 0 0 0 110/80

0 1 1 0 0 0 130/80
0 1 1 0 0 0 120/80
0 1 1 0 0 0 110/70
0 1 1 0 0 0

0 1 1 0 0 0 120/80
0 1 1 0 0 1 0 150/100
0 1 1 0 0 0 110/80

0 1 1 0 0 0 110/70
0 1 1 0 0 0 120/80
0 1 1 0 0 0

1 1 1 0 0 0 120/80
0 1 1 0 0 0 120/70
0 1 1 0 0 0 110/70

0 1 1 0 0 0 110/70
0 1 1 0 0 0 100/70
0 1 1 0 0 0

0 1 1 0 0 0 120/80

1 1 1 0 0 0 130/80
0 1 1 0 0 0 110/70
0 1 1 0 0 0 120/70

1 1 1 0 0 0 120/80
0 1 1 0 0 0 110/70
0 1 1 0 0 0

1 1 1 0 0 0 120/80
0 1 1 0 0 0 120/80
0 1 1 0 0 0 100/70
1 1 1 0 0 0 120/70
0 1 1 0 0 0 110/70
0 1 1 0 0 0 130/80

1 1 1 0 0 0 130/80
0 1 1 0 0 0 120/90
0 1 1 0 0 0 110/70
0 1 1 0 0 0

1 1 1 0 0 0 130/80
0 1 1 0 0 0 120/80
0 1 1 0 0 0
0 1 1 0 0 0
0 1 1 0 0 0 150/100

Y:9 Y:52 Y:52 Y:53 Y:52 Y:3

KB PERSALINAN ASI IMUNISASI TIMBANG
NAKES LENKAP BALITA
TERATUR

0
0

0
0

0
1

0
1

0
0

0
1
 0 1 1

0
1

0
1

0
1

0
0

Y:6 0 T:1 Y:1 Y:2

ALAMAT RT/RW NO. URUT NO.URUT RT ∑ ART ART 0-11 BL ART 12 - 59
BANGUNAN BL
ART ≥15 TH ART 10-54 NAMA KK ANGGOTA KK NIK
TH
 REKAPAN KS KELURAHAN GUNUNG GEDANGAN

NO. BPJS HUBUNGAN TANGGAL LAHIR UMUR L/P (1/0) KAWIN HAMIL/
TAHUN BULAN TIDAK

Y:58 T:44

119 0
119 0
119 0
0
119 0
119 0
119 0
119 0
119 0
119 0
0
119 0
119 0
119 0
119 0
119 0
119 0
0
119 0
119 0
119 0
119 0
119 0
119 0
0
119 0
119 0
119 0
119 0
119 0
119 0
0
119 0
119 0
119 0
119 0
119 0
119 0
0
119 0
119 0
119 0
119 0
119 0
119 0
0
119 0
119 0
119 0
119 0
119 0
119 0
0
119 0
119 0
119 0
119 0
119 0
119 0
0
119 0
119 0
119 0
119 0
119 0
119 0
0
119 0
119 0
119 0
119 0
119 0
119 0
0
119 0
119 0
119 0
119 0
119 0
119 0
0
119 0
119 0
119 0
119 0
119 0
119 0
N GUNUNG GEDANGAN

AGAMA PENDIDIKAN PEKERJAAN SAB SAB JAMBAN JAMBAN ART ODGJ ODGJ
TERLINDUNGI SANITER BEROBAT
TERATUR
Y:22 Y:22 Y:21 Y:21 T:24
ODGJ DI MEROKOK BAB MENGGUNA DI DX TB TB BEROBAT ART GEJALA DX HT HT MINUM TENSI
PASUNG DIJAMBAN KAN AIR TERATUR TB OAHT
BERSIH TERATUR
Y:16 Y:80 Y:80 Y:2 Y:20 Y:2 Y:2 T:2
KB PERSALINAN ASI IMUNISASI TIMBANG
NAKES LENKAP BALITA
TERATUR
Y:15 Y:2 Y:1 Y:2 Y:4
ALAMAT RT/RW NO. URUT NO.URUT RT ∑ ART ART 0-11 BL ART 12 - 59
BANGUNAN BL

88 0 6
ART ≥15 TH ART 10-54 NAMA KK ANGGOTA KK NIK
TH

69 68
 REKAPAN KS KELURAHAN GUNUNG GEDANGAN

NO. BPJS HUBUNGAN TANGGAL LAHIR UMUR L/P (1/0) KAWIN HAMIL/
TAHUN BULAN TIDAK

Y:56 119 0 T:34

119 0
119 0
119 0
0
119 0
119 0
119 0
119 0
119 0
119 0
0
119 0
119 0
119 0
119 0
119 0
119 0
0
119 0
119 0
119 0
119 0
119 0
119 0
0
119 0
119 0
119 0
119 0
119 0
119 0
0
119 0
119 0
119 0
119 0
119 0
119 0
0
119 0
119 0
119 0
119 0
119 0
119 0
0
119 0
119 0
119 0
119 0
119 0
119 0
0
119 0
119 0
119 0
119 0
119 0
119 0
0
119 0
119 0
119 0
119 0
119 0
119 0
0
119 0
119 0
119 0
119 0
119 0
119 0
0
119 0
119 0
119 0
119 0
119 0
119 0
N GUNUNG GEDANGAN

AGAMA PENDIDIKAN PEKERJAAN SAB SAB JAMBAN JAMBAN ART ODGJ ODGJ
TERLINDUNGI SANITER BEROBAT
TERATUR
Y:21 Y:21 Y:20 Y:20 T:27
ODGJ DI MEROKOK BAB MENGGUNA DI DX TB TB BEROBAT ART GEJALA DX HT HT MINUM TENSI
PASUNG DIJAMBAN KAN AIR TERATUR TB OAHT
BERSIH TERATUR
Y:17 Y:88 Y:88 T:88 T:88 Y:7 Y:7
KB PERSALINAN ASI IMUNISASI TIMBANG
NAKES LENKAP BALITA
TERATUR
Y:6 Y:1 Y:1 Y:2 Y:7
 ALAMAT RT/RW NO. URUT NO.URUT RT ∑ ART ART 0-11 BL ART 12 - 59
BANGUNAN BL

KEDUNGSARI RT.04/02 32 001 4 0 0

33 001 6 1 0

34 001 4 0 0

35 001 4 0 0

36 001 5 0 0

37 001 4 0 0

38 001 4 0 0

39 001 4 0 0
40 001 2 0 0

002 3 0 0

41 001 3 0 1

42 001 2 0 0

43 001 3 0 0

44 001 2 0 0

45 001 4 0 0

46 001 2 0 0

002 4 0 0

47 001 4 0 0

48 001 4 0 0
68 1 1
ART ≥15 TH ART 10-54 NAMA KK ANGGOTA KK NIK
TH

3 3 SYAIFUDIN ZUHRI 3576020606740001

NANIK YUHANA 3576025208770006
NAVISCA YUNIKE 3576026509040004
CHEVIN FADIL Z. 3576022105100001

4 4 JOKO RIDUWAN 3576020204660002

INDAH SETYOWATI 3576025304720003
VICKY ARI P. 3576021401940001
VIAN OCTA P. 3576021410990001
VAREL DIO P. 3576021407080001
VIBRA MAYCHO 3576020105150001

3 4 HADI SUPRIYANTO 3576021303670001

YAYUK MURTIANI 3576026503720001
VINDA APRISCA 3576025404980001
NOVALDO P. 3576022211050002

3 4 SUWANDI 3576020207710002
TITIK PUDJIATI 3576024208740001
RONI WAHYU H. 3576023108970001
FERDINO PUTRA 3576022710050001

4 4 HADI SUTOKO 3576020812690001

NUR CHOLILAH 3576024507810001
CANDRA HADI 3576021104990002
CHANTIKA DWI 3576026602020003
JESSICA ANDRA 3576025610090002

2 3 YANUAR RIANTO 3576010101840008

VITA TRI H. 3576016310830004
MOHAMMAD ZIDAN 3576023007070002
RAJASWA ADITYA 3576022712110001

3 4 SUPARTO 3576021703680001
ENI SUSANTI 3576024812760001
DITA ANGGRAENI 3576025008970001
DELLA PITALOKA 3576025604040002

4 4 ZAINUL ARIFIN 3576022808680001

ANA RIANTI 3576028202760001
ADITYA JAINURIL 3576022707940003
 AFANDI DWI R. 3576020307010001

2 1 TARSI 3576024107410029
ATIK MIARNING 3576024706720002

3 3 KUKUH YUDHA 3576022008770001

SUS INDAH W. 3576025608760002
RENDRA DWI 3576020203940004

2 2 HADI RAHMONO 3576022703840001

ISTIANA RAHAYU 3516186302890002
DEVIKA RAHMA AYU 3576026212120001

2 0 SIMIN 3576022811440001
MUTMAINAH 3576024205510005

2 2 BANTIYAR EFENDI 3516132112880001

MEGA SILVIATI 3576024603930003
QATRUNNADA F. 3576025504160001

2 1 EKO CAHYONO 3576022609610001

SUMIATI 3576025803650001

4 4 DWI WIBOWO 3576021209630002

SULIANI 3576025505720001
YOVI WILI ANDIKA 3576022410950001
PRADITYA WILI 3576020906980001

2 2 TRI ASTUTIK 3576024101650014

ANDRI SISWOYO 3576020511820004

2 2 MOCH. ARIF 3576022703750004

NINING PURWANTI 3576024912830001
RIZKY AZIZAH 3576027107090003
ACHMAD HAFIZ 3576022703170001

3 4 HARI SUWIGNYO 3576022708700001

IIS JUYANI 3576024109800003
BAGAS DESTA A. 3576021112020001
KATRINA APRILIA 3576026904060002

3 4 WITANTO 3505162104680002
SRI LESTRAI 3505164401740002
BINTI RAHAYU 3505166208950001
SINDI RAHAYU 3505166411040001
53 55
 REKAPAN KS KELURAHAN GUNUNG GEDANGAN

NO. BPJS HUBUNGAN TANGGAL LAHIR UMUR L/P (1/0) KAWIN HAMIL/
TAHUN BULAN TIDAK

0001544088429 1 6-Jun-74 44 7 1 1
0001544088431 3 12-Aug-77 41 5 0 1 0
0001544088442 4 25-Sep-04 14 3 0 2 0
0002083272761 4 21-May-10 8 7 0 2 0

0001705170328 1 2-Apr-66 52 9 1 1
0001705170339 3 13-Apr-72 46 9 0 1 0
4 14-Jan-94 25 0 1 2
0001705170341 4 14-Oct-99 19 3 1 2
4 14-Jul-08 10 6 1 2
4 1-May-15 3 8 1 2

0001705170868 1 13-Mar-67 51 10 1 1
0001705170879 3 25-Mar-72 46 9 0 1 0
0001705170881 4 14-Apr-98 20 9 0 2 0
0001705170892 4 22-Nov-05 13 1 1 2

0001537581745 1 2-Jun-71 47 7 1 1
0001537581756 3 2-Aug-74 44 5 0 1 0
0001537581767 4 31-Aug-97 21 4 1 2
0001537581778 4 27-Oct-05 13 2 1 2

0000785338762 1 8-Dec-69 49 1 1 1
0000785338918 3 5-Jul-81 37 6 0 1 0
0000785339919 4 11-Apr-99 19 9 1 2
0000785340011 4 26-Feb-02 16 10 0 2 0
0000785340145 4 18-Oct-09 9 2 0 2 0

1 1-Jan-84 35 0 1 1
3 13-Oct-83 35 3 0 1 0
4 30-Jul-07 11 5 1 2
4 27-Dec-11 7 0 1 2

0001537156743 1 17-Mar-68 50 10 1 1
0001537156765 3 8-Dec-76 42 1 0 1 0
0001537156776 4 10-Aug-97 21 5 0 2 0
0001537156767 4 18-Apr-04 14 8 0 2 0

0000786983027 1 28-Aug-68 50 4 1 1
0000786983073 3 22-Feb-76 42 10 0 1 0
0000786983231 4 27-Jul-94 24 5 1 2
0000786984265 4 3-Jul-01 17 6 1 2

1 1-Jul-41 77 6 0 4 0
4 7-Jun-72 46 7 0 2 0

1 20-Aug-77 41 4 1 1
3 16-Aug-76 42 5 0 1 0
4 2-Mar-94 24 10 1 2

0001815748075 1 27-Mar-84 34 9 1 1
0001432144899 3 23-Feb-89 29 10 0 1 0
0001815748121 4 22-Feb-12 6 10 0 2 0

0000099469326 1 28-Nov-44 74 1 1 1
3 2-May-51 67 8 0 1 0

1 21-Dec-88 30 0 1 1
3 6-Mar-93 25 10 0 1 0
4 15-Apr-16 2 9 0 2 0

1 26-Sep-61 57 3 1 1
3 18-Mar-65 53 9 0 1 0

1 12-Sep-63 55 4 1 1
3 15-May-72 46 8 0 1 0
4 24-Oct-95 23 2 1 2
4 9-Jun-98 20 7 1 2

0001706655003 1 1-Jan-65 54 0 1 3 0
0001706655025 4 5-Nov-82 36 2 1 1

1 27-Mar-75 43 9 1 1
3 9-Dec-83 35 1 0 1 0
4 31-Jul-09 9 5 0 2 0
4 27-Mar-17 1 9 1 2

0001705173985 1 27-Aug-70 48 4 1 1
3 1-Sep-80 38 4 0 1 0
4 11-Dec-02 16 1 1 2
4 29-Apr-06 12 8 0 2 0

1 21-Apr-68 50 8 1 1
3 4-Jan-74 45 0 0 1 0
4 22-Aug-95 23 4 0 2 0
4 24-Nov-03 15 1 0 2 0
15-Aug-17 1 5
19-Nov-78 40 1

7-Jul-79 39 6
21-Dec-01 17 0
23-Jul-06 12 5

15-Apr-73 45 9
22-Feb-77 41 10
17-Feb-05 13 11

3-May-62 56 8
3-Nov-70 48 2
1-May-91 27 8
26-Sep-94 24 3
22-Jul-96 22 5

6-Sep-74 44 4
19-May-74 44 7
6-Oct-00 18 3
22-Jan-04 14 11
0
119 0
119 0
119 0
119 0
119 0
119 0
0
119 0
119 0
119 0
119 0
119 0
119 0
0
119 0
119 0
119 0
119 0
119 0
119 0
0
119 0
119 0
119 0
119 0
119 0
119 0
0
119 0
119 0
119 0
119 0
119 0
119 0
0
119 0
119 0
119 0
119 0
119 0
119 0
0
119 0
119 0
119 0
119 0
119 0
119 0
0
119 0
119 0
119 0
119 0
119 0
119 0
0
119 0
119 0
119 0
119 0
119 0
119 0
0
119 0
119 0
119 0
119 0
119 0
119 0
0
119 0
119 0
119 0
119 0
119 0
119 0
0
119 0
119 0
119 0
119 0
119 0
119 0
N GUNUNG GEDANGAN

AGAMA PENDIDIKAN PEKERJAAN SAB SAB JAMBAN JAMBAN ART ODGJ ODGJ
TERLINDUNGI SANITER BEROBAT
TERATUR
1 4 PEDAGANG 1 1 1 1 0
1 4 IRT
1 3
1 2

1 4 PEDAGANG 1 1 1 1 0
1 4 IRT
1 5
1 4
1 2
1 1

1 5 SWASTA 1 1 1 1 0
1 5 IRT
1 7
1 2

1 4 TJIWI 1 1 1 1 0
1 4 IRT
1 7
1 2

1 4 TJIWI 1 1 1 1 0
1 5 IRT
1 5 DAGANG
1 5
1 2

1 5 BENGKEL 1 1 1 1 0
1 7 KARY TOKO
1 2
1 1

1 5 TJIWI 1 1 1 1 0
1 4 IRT
1 5 SATPOL PP
1 4

1 4 DAGANG 1 1 1 1 0
1 4 DAGANG
1 5 BLM KERJA
1 5

1 3 IRT 1 1 1 1 0
1 4 BOKOR MAS

1 4 SWASTA 1 1 1 1 0
1 4 IRT
1 5

1 5 DAGANG BUAH 1 1 1 1 0
1 4 IRT
1 1

1 4 PENSIUNAN 1 1 1 1 0
1 3 IRT

1 5 DAGANG 1 1 1 1 0
1 5 IRT
1 1

1 3 TDK BEKERJA 1 1 1 1 0
1 3 MLIJO

1 3 DAGANG 1 1 1 1 0
1 5 IRT
1 5 PABRIK
1 5 DRAGON

1 3 JUAL RUJAK 1 1 1 1 0
1 3 KULI

1 3 DAGANG 0 0 0 0 0
1 5 IRT
1 2
1 1

1 5 SERVIS LAMPU 1 1 1 1 0
1 4 TJIWI
1 3
1 2

1 3 JUAL BAJU 1 1 1 1 0
1 3 IRT
1 5
1 3
Y:18 Y:18 Y:18 Y:18 T:19
ODGJ DI MEROKOK BAB MENGGUNA DI DX TB TB BEROBAT ART GEJALA DX HT HT MINUM TENSI
PASUNG DIJAMBAN KAN AIR TERATUR TB OAHT
BERSIH TERATUR
0 1 1 0 0 0 110/70
0 1 1 0 0 0 120/80
0 1 1 0 0 0
0 1 1 0 0 0

0 1 1 0 0 0 130/80
0 1 1 0 0 0 110/70
0 1 1 0 0 0 100/70
0 1 1 0 0 0 110/60
0 1 1 0 0 0
0 1 1 0 0 0

0 1 1 0 0 0 110/70
0 1 1 0 0 0 100/60
0 1 1 0 0 0 90/60
0 1 1 0 0 0

1 1 1 0 0 0 120/80
0 1 1 0 0 0 110/70
0 1 1 0 0 0 100/60
0 1 1 0 0 0 90/60

0 1 1 0 0 0 120/70
0 1 1 0 0 0 110/70
0 1 1 0 0 0 110/60
0 1 1 0 0 0 90/60
0 1 1 0 0 0

1 1 1 0 0 0 120/80
0 1 1 0 0 0 110/70
0 1 1 0 0 0
0 1 1 0 0 0

1 1 1 0 0 0 100/80
0 1 1 0 0 0 140/90
0 1 1 0 0 0 110/70
0 1 1 0 0 0 110/70

0 1 1 0 0 1 1 170/100
0 1 1 0 0 0 150/90
0 1 1 0 0 0 120/70
0 1 1 0 0 0 110/70

0 1 1 0 0 0 110/70
0 1 1 0 0 0 120/80

0 1 1 0 0 0 120/80
0 1 1 0 0 0 110/60
1 1 1 0 0 0 120/80

1 1 1 0 0 0 110/70
0 1 1 0 0 0 100/60
0 1 1 0 0 0

0 1 1 0 0 0 110/70
0 1 1 0 0 1 1 160/80

1 1 1 0 0 0 120/80
0 1 1 0 0 0 110/70
0 1 1 0 0 0

0 1 1 0 0 0 120/80
0 1 1 0 0 0 120/80

0 1 1 0 0 0 120/80
0 1 1 0 0 0 110/70
0 1 1 0 0 0 110/70
0 1 1 0 0 0 120/70

0 1 1 0 0 0 120/80
1 1 1 0 0 0 110/70

1 1 1 0 0 0 110/70
0 1 1 0 0 0 120/80
0 1 1 0 0 0 90/60
0 1 1 0 0 0

1 1 1 0 0 0 110/70
0 1 1 0 0 0 120/80
0 1 1 0 0 0 110/70
0 1 1 0 0 0

1 1 1 0 0 0 110/60
0 1 1 0 0 0 100/60
0 1 1 0 0 0 110/80
0 1 1 0 0 0 90/60
Y:10 Y:68 Y:68 T:68 T:68 Y:2
KB PERSALINAN ASI IMUNISASI TIMBANG
NAKES LENKAP BALITA
TERATUR
0
1

0
1

0
1

0
1

0
1

0
1

0
1

0
1
0
1

0
1
1

0
0
1 1 1

0
0

0
1`

0
0

1 1 1

0
1

0
0
Y:12 Y:1 Y:2 Y:1 Y:4
ALAMAT RT/RW NO. URUT NO.URUT RT ∑ ART ART 0-11 BL ART 12 - 59
BANGUNAN BL

75 1 7
ART ≥15 TH ART 10-54 NAMA KK ANGGOTA KK NIK
TH

53 55
 REKAPAN KS KELURAHAN GUNUNG GEDANGAN

NO. BPJS HUBUNGAN TANGGAL LAHIR UMUR L/P (1/0) KAWIN HAMIL/
TAHUN BULAN TIDAK

26-Sep-94 24 3

22-Jul-96 22 5

6-Sep-74 44 4
19-May-74 44 7
6-Oct-00 18 3
22-Jan-04 14 11
0
119 0
119 0
119 0
119 0
119 0
119 0
0
119 0
119 0
119 0
119 0
119 0
119 0
0
119 0
119 0
119 0
119 0
119 0
119 0
0
119 0
119 0
119 0
119 0
119 0
119 0
0
119 0
119 0
119 0
119 0
119 0
119 0
0
119 0
119 0
119 0
119 0
119 0
119 0
0
119 0
119 0
119 0
119 0
119 0
119 0
0
119 0
119 0
119 0
119 0
119 0
119 0
0
119 0
119 0
119 0
119 0
119 0
119 0
0
119 0
119 0
119 0
119 0
119 0
119 0
0
119 0
119 0
119 0
119 0
119 0
119 0
0
119 0
119 0
119 0
119 0
119 0
119 0
N GUNUNG GEDANGAN

AGAMA PENDIDIKAN PEKERJAAN SAB SAB JAMBAN JAMBAN ART ODGJ ODGJ
TERLINDUNGI SANITER BEROBAT
TERATUR
Y:20 Y:20 Y:19 Y:19 Y:0
ODGJ DI MEROKOK BAB MENGGUNA DI DX TB TB BEROBAT ART GEJALA DX HT HT MINUM TENSI
PASUNG DIJAMBAN KAN AIR TERATUR TB OAHT
BERSIH TERATUR
Y:22 Y:76 Y:75 T:75 Y:75 Y:3 Y:1
KB PERSALINAN ASI IMUNISASI TIMBANG
NAKES LENKAP BALITA
TERATUR
Y:10 Y:0 Y:2 Y:3 Y:8
 ALAMAT RT/RW NO. URUT NO.URUT RT ∑ ART ART 0-11 BL ART 12 - 59
BANGUNAN BL

KEDUNGSARI RT.03/03 1 001 4 1 0

81 3 4
ART ≥15 TH ART 10-54 NAMA KK ANGGOTA KK NIK
TH

2 3 AGUS ROBIUM A. 3576020808840001

61 56
 REKAPAN KS KELURAHAN GUNUNG GEDANGAN

NO. BPJS HUBUNGAN TANGGAL LAHIR UMUR L/P (1/0) KAWIN HAMIL/
TAHUN BULAN TIDAK

1 8-Aug-84 34 5 1 1
Y:40 119 0 T:27

119 0
119 0
119 0
0
119 0
119 0
119 0
119 0
119 0
119 0
0
119 0
119 0
119 0
119 0
119 0
119 0
0
119 0
119 0
119 0
119 0
119 0
119 0
0
119 0
119 0
119 0
119 0
119 0
119 0
0
119 0
119 0
119 0
119 0
119 0
119 0
 0
119 0
119 0
119 0
119 0
119 0
119 0
0
119 0
119 0
119 0
119 0
119 0
119 0
0
119 0
119 0
119 0
119 0
119 0
119 0
0
119 0
119 0
119 0
119 0
119 0
119 0
0
119 0
119 0
119 0
119 0
119 0
119 0
0
119 0
119 0
119 0
119 0
119 0
119 0
HAN GUNUNG GEDANGAN

AGAMA PENDIDIKAN PEKERJAAN SAB SAB JAMBAN JAMBAN ART ODGJ

TERLINDUNGI SANITER

1 5 TUKANG KEBUN 1 1 1 1 0
Y:18 Y:1 Y:16 Y:16 T:24
 ODGJ ODGJ DI MEROKOK BAB MENGGUNA DI DX TB TB BEROBAT ART GEJALA DX HT HT MINUM
BEROBAT PASUNG DIJAMBAN KAN AIR TERATUR TB OAHT
TERATUR BERSIH TERATUR
0 1 1 0 0 0
Y:14 Y:81 Y:80 T:80
TENSI KB PERSALINAN ASI IMUNISASI TIMBANG
NAKES LENKAP BALITA
TERATUR
120/70 0
Y:11 Y:3 Y:4 Y:3 Y:7
ALAMAT RT/RW NO. URUT NO.URUT RT ∑ ART ART 0-11 BL ART 12 - 59
BANGUNAN BL

83 0 7
ART ≥15 TH ART 10-54 NAMA KK ANGGOTA KK NIK
TH

62 59
 REKAPAN KS KELURAHAN GUNUNG GEDANGAN

NO. BPJS HUBUNGAN TANGGAL LAHIR UMUR L/P (1/0) KAWIN HAMIL/
TAHUN BULAN TIDAK

Y:53 119 0 T:29

119 0
119 0
119 0
119 0
119 0
0
119 0
119 0
119 0
119 0
119 0
119 0
0
119 0
119 0
119 0
119 0
119 0
119 0
0
119 0
119 0
119 0
119 0
119 0
119 0
0
119 0
119 0
119 0
119 0
119 0
119 0
0
119 0
119 0
119 0
119 0
119 0
119 0
 0
119 0
119 0
119 0
119 0
119 0
119 0
0
119 0
119 0
119 0
119 0
119 0
119 0
0
119 0
119 0
119 0
119 0
119 0
119 0
0
119 0
119 0
119 0
119 0
119 0
119 0
0
119 0
119 0
119 0
119 0
119 0
119 0
0
119 0
119 0
119 0
119 0
119 0
119 0
N GUNUNG GEDANGAN

AGAMA PENDIDIKAN PEKERJAAN SAB SAB JAMBAN JAMBAN ART ODGJ ODGJ
TERLINDUNGI SANITER BEROBAT
TERATUR
Y:20 Y:20 Y:20 Y:20 Y:28
ODGJ DI MEROKOK BAB MENGGUNA DI DX TB TB BEROBAT ART GEJALA DX HT HT MINUM TENSI
PASUNG DIJAMBAN KAN AIR TERATUR TB OAHT
BERSIH TERATUR
Y:31 Y:79 Y:79 T:83 T:83 Y:2 T:2
KB PERSALINAN ASI IMUNISASI TIMBANG
NAKES LENKAP BALITA
TERATUR
Y:16 Y:0 T:3 Y:3 Y:4
 ALAMAT RT/RW NO. URUT NO.URUT RT ∑ ART ART 0-11 BL ART 12 - 59
BANGUNAN BL

GUNUNG ANYAR RT.02/RW.06 1 001 2 0 0

002 3 0 1

2 001 3 0 0

3 001 2 0 0

002 3 0 0

4 001 2 0 0

5 001 5 0 0

6 001 4 0 0

7 001 2 0 0

002 3 0 1

8 001 3 0 0
 002 3 0 0

9 001 1 0 0

10 001 1 0 0

11 001 1 0 0

12 001 2 0 0

13 001 3 0 0

14 001 1 0 0

15 001 4 0 0

16 001 2 0 0

002 4 0 1

17 001 5 0 1

18 001 2 0 0
 002 3 0 0

19 001 7 0 0

20 001 3 0 0

21 001 4 0 0

22 001 4 0 0

002 1 0 0

23 001 1 0 0

84 0 4
ART ≥15 TH ART 10-54 NAMA KK ANGGOTA KK NIK
TH

1 0 KEMAN AL S 3576021708540001
MARIYAM 3576026005620003

2 2 GATOT WULIYONO 3576021001960002

ANI MAWARSARI 3516025909920001
ALFADIL TEGAR B.P 3516090402140001

2 2 SULIONO 3517190107850111
SUYANI 3576024707820001
RIDHO HASAN A 3576023006080001

2 0 SUNTARI 3576021512570003
SULIMAH 3576025011580001

2 2 IMAM HADY S. 3576022402770001

INDRAWATI 3576025407860006
DIAN INDRA F. 3576024310080001

2 2 CHUSAIRI 3576020409670004
NUR HANIFAH 3576024303720002

3 3 NGADIYO 3576020302630001
SOPIYATUN 3576026408700001
FATKHUL JANAH 3576025804970001
YANUAR PRASETYO 3576020101080002
BANGUN SUMODRO 3576022207120002

3 4 SUMANTRI 3576021908700001
SUPIATI 3576024708710001
BAGUS ADI M. 3576022808960005
BAGAS AFDUL M. 3576021601030008

2 1 SUHARDIYONO 3576021609590001
WINTRI 3317044911740001

2 2 JOKO MULYONO 3576021103900006

DEWI YULI M. 3576026310940002
ARYA PERDANA P. 3576021012120003

2 3 DJULIPAH 3576024803640002
DIAN APRIANTO 3576022804910002
 ANGELIKA DINA 3576026111030001

2 3 MOH. YASIN 3575020211860001

IKA ISMAWATI 3576025704880005
SELLY PUTRI 3576024707110001

1 1 TARI 3576023112270005

1 1 SIANAH 3576024202670001
EKO HARIANTO 3576021412880004

3 3 MUDRIKAH 3576025007650004
ARIWANTO 3576020204870003
RUTIK SRI YUNIARTI 3576025207930001

2 1 SRIAH 3576025110450003
SILAH 3576025507630002

3 3 ISNU WULIO 3576020211650002

YULI SURYAWATI 3576025011690003
ALFIN ALDIANSYAH 3576022610010001

1 1 SUNOTO 3576021002700001

3 3 SUHARTINI 3576026605730002
LINDA PERMANI 3576025604940001
MEGA DWI A. 3576025602010001
AURIK GILBERT 3576022109120002

2 1 SRIADI 3576020701580001
KAMTIN 3576026007650001

2 2 ANDIK YULIANTO 3576020707820001

NOVI WIJIASTUTIK 3576024911880001
ANDIKA MAULANA 3576021806100002
AINAYA CALYSTA 3576025410150005

4 4 HERI MULYO 3576022708690001

DEWI ALFIYAH 3576025204700002
AHMAD MUSLIM 3576020408930007
ANTI MA'RUFAH 3576025001980001
BARRA BUSTOMI 3576022803130001

2 1 SAKEH 3576020510590005
ASLIYAH 3576024606660008
2 3 ALFYAN NOFIFUDIN 3576023011770001
NOVI MARIA 3576025111840003
M.ALFI R. 3576020505070003

7 7 SUPARAH 3576026212660001
TAUFIK SUHENDRO 3576021310860001
M.SLAMET S. 3576022412880001
M.MULYONO 3576020709910001
SUMARIATI 3576024501950001
M.NOVAL 3576020306000001
ACHMAD AGUNG 3576022604060001

3 3 HERMANTO 3576020907760001
SUHERTININGSIH 3576024706760003
IIN ARDIANA 3576026207010001

4 4 SUTRISNO 3576020408630001
UMINAH 3576025307720002
MOCH. SARIONO 3576023006910001
RENI PUSPITA SARI 3576024106950002

4 2 SUMADI 3576020201590003
SUNDARI 3576024807660006
RIA MANDASARI 3576024101990001
LASENI 3576025603570001

1 1 YOPPY CHRISTANTO 3519142505860004

1 1 UNTUNG
RIATI
SUNARIADI

71 66
 REKAPAN KS KELURAHAN GUNUNG GEDANGAN

NO. BPJS HUBUNGAN TANGGAL LAHIR UMUR L/P (1/0) KAWIN HAMIL/
TAHUN BULAN TIDAK

0000786987909 1 17-Aug-54 64 5 1 1
0000786989136 3 20-May-62 56 7 0 1 0

0000786989237 1 10-Jan-86 33 0 1 1
3 19-Sep-92 26 3 0 1 0
4 4-Feb-14 4 11 1 2

PUNYA 1 18-Dec-85 33 0 1 1
0000785976085 3 7-Jul-82 36 6 0 1 0
0000785976568 4 30-Jun-08 10 6 1 2

0002282429654 1 15-Dec-57 61 1 1 1
0002282430058 3 10-Nov-58 60 2 0 1 0

0001537280561 1 24-Mar-77 41 9 1 1
0001537280572 3 14-Jul-86 32 6 0 1 0
0001537280594 4 3-Oct-08 10 3 0 2

1 31-Jan-66 52 11 1 1
3 3-Mar-72 46 10 0 1 0

0000786983589 1 3-Feb-63 55 11 1 1
0000786983859 3 24-Aug-70 48 4 0 1 0
0000786984783 4 18-Apr-97 21 8 0 2 0
0000786985413 4 1-Jan-08 11 0 1 2
4 22-Jul-12 6 5 1 2

000078585917 1 19-Aug-70 48 4 1 1
000078586111 3 7-Aug-71 47 5 0 1 0
000078561313 4 28-Aug-96 22 4 1 2
000078586209 4 16-Jan-03 16 0 1 2

1 16-Sep-59 59 4 1 1
3 9-Nov-74 44 2 0 1 0

1 11-Mar-90 28 10 1 1
3 23-Oct-94 24 2 0 1 0
4 10-Dec-12 6 1 1 2

0000786468958 1 8-Mar-64 54 10 0 4 0
0000786469329 4 28-Apr-91 27 8 1 2
0000786469397 4 21-Nov-03 15 1 0 2

0000786470422 1 2-Nov-86 32 2 1 1
0000786469768 3 17-Apr-88 30 9 0 1 0
0001652516728 4 7-Jul-11 7 6 0 2

1 31-Dec-72 46 0 1 4

0000786515218 1 2-Feb-67 51 11 0 3 0
0000786962823 4 14-Dec-88 30 1 1 1

1 10-Jul-65 53 6 0 3 0
4 2-Apr-87 31 9 1 2
4 12-Jul-93 25 6 0 2 0

0001049760314 1 11-Oct-45 73 3 1 4
0001049760325 4 15-Jul-63 55 6 1 4

0000786503441 1 2-Nov-65 53 2 1 1
0000786500921 3 10-Nov-69 49 2 0 1 0
0000786500201 4 26-Oct-01 17 2 1 2

0001705172062 1 10-Feb-70 48 11 1 4

0000787065017 1 25-May-73 45 7 0 4
0000787065052 4 16-Apr-94 24 9 0 2 0
0000787065333 4 16-Feb-01 17 11 0 2
0001706172061 4 21-Sep-12 6 3 1 2

1 7-Jan-58 61 0 1 1
3 20-Jul-65 53 5 0 1 0

0001538781377 1 7-Jul-82 36 6 1 1
0001538781388 3 9-Nov-83 35 2 0 1 0
0002278608028 4 18-Jun-10 8 6 1 2
0002278606377 4 14-Oct-15 3 3 0 2

0001537620625 1 27-Aug-69 49 4 1 1
0001537620737 3 12-Apr-69 49 9 0 1 0
0001537620849 4 4-Aug-93 25 5 1 2
0001537620895 4 10-Jan-98 21 0 0 2 0
0001537620906 4 28-Mar-13 5 9 1 2

0002033564578 1 5-Oct-59 59 3 1 1
0002033565243 3 6-Jun-66 52 7 0 1 0
0001435280185 1 30-Nov-77 41 1 1 1
0001435279994 3 11-Nov-84 34 2 0 1 0
0001435280297 4 5-May-07 11 8 1 2

0000786154307 1 22-Dec-66 52 0 0 4 0
PUNYA 4 13-Oct-86 32 3 1 1
0000785329828 4 24-Dec-88 30 0 1 2
0000785330133 4 7-Sep-91 27 4 1 2 0
0000785330458 4 5-Jan-95 24 0 0 2
0000785330638 4 3-Jun-00 18 7 1 2
0000785331549 4 26-Apr-06 12 8 1 2

0001540010902 1 9-Jul-76 42 6 1 1
0001540011014 3 7-Jun-76 42 7 0 1 0
0001540011126 4 22-Jun-01 17 6 0 2

0001707207952 1 4-Aug-63 55 5 1 1
0000787024236 3 13-Jul-72 46 6 0 1 0
0000787024449 4 30-Jun-91 27 6 1 2
0000787024528 4 1-Jun-95 23 7 0 2 0

0000787050707 1 2-Jan-59 60 0 1 1
0000787050964 3 8-Jul-66 52 6 0 1 0
0000787052654 4 1-Jan-99 20 0 0 2 0
9 16-Mar-57 61 10 0 4

0001656400544 1 25-May-86 32 7 1 3

0000787038164 1 119 0 1 1
0000787038208 3 119 0 0 1 0
4 119 0 1 2
0
119 0
119 0
119 0 T:32

119 0

119 0
119 0
0
119 0
119 0
119 0
119 0
119 0
119 0
0
119 0
119 0
119 0
119 0
119 0
119 0
0
119 0
119 0
119 0
119 0
119 0
119 0
0
119 0
119 0
119 0
119 0
119 0
119 0
0
119 0
119 0
119 0
119 0
119 0
119 0
0
119 0
119 0
119 0
119 0
119 0
119 0
0
119 0
119 0
119 0
119 0
119 0
119 0
 0
119 0
119 0
119 0
119 0
119 0
119 0
0
119 0
119 0
119 0
119 0
119 0
119 0
0
119 0
119 0
119 0
119 0
119 0
119 0
HAN GUNUNG GEDANGAN

AGAMA PENDIDIKAN PEKERJAAN SAB SAB JAMBAN JAMBAN ART ODGJ

TERLINDUNGI SANITER

1 3 DAGANG 1 1 1 1 1
1 4 IRT

1 5 KULI BANGUNAN 0 0 0 0 0
1 5 IRT
1 1

1 4 DAGANG 1 1 1 1 0
1 4 IRT
1 2

1 3 DAGANG 1 1 1 1 0
1 3 IRT

1 5 TJIWI 0 0 0 0 0
1 5 IRT
1 1

1 4 PETERNAK BEBEK 1 1 1 1 0
1 3 IRT

1 3 KULI BANGUNAN 1 1 1 1 0
1 3 IRT
1 2
1 2
1 1

1 4 KULI BANGUNAN 1 1 1 1 0
1 4 IRT
1 4 DRAGON
1 5

1 3 SOPIR 1 1 1 1 0
1 3 IRT

1 4 KULI BANGUNAN 0 0 0 0 0
1 4 IRT
1 1

1 3 IRT 1 1 1 1 0
1 5 PABRIK PLASTIK
1 3

1 5 PABRIK 0 0 0 0 0
1 5 PABRIK
1 1

1 2 TDK BEKERJA 1 1 1 1 0

1 3 IRT 0 0 0 0 0
1 4 KARY. PABRIK

1 3 IRT 1 1 1 1 0
1 5 PU
1 8 GURU

1 3 IRT 1 1 1 1 0
1 3 KARY. TOKO KUE

1 3 KULI BANGUNAN 1 1 1 1 0
1 3 IRT
1 4

1 1 TUKANG BECAK 1 1 1 1 0

1 3 IRT 1 1 1 1 0
1 5 PABRIK SEPATU
1 3
1 1

1 3 TUKANG BATU 1 1 1 1 0
1 3 IRT

1 5 KARY. PABRIK 0 0 0 0 0
1 5 IRT
1 2
1 1

1 5 PENSIUNAN PABRIK 1 1 1 1 0
1 5 IRT
1 5 KULIAH
1 5 KULIAH
1 1

1 2 TANI 1 1 1 1 0
1 3 IRT
1 8 GURU STM 0 0 0 0 0
1 7 PERAWAT RS EMMA
1 2

1 3 DAGANG 1 1 1 1 0
1 5 KULI BANGUNAN
1 5 DAGANG
1 5 TDK KERJA
1 5 DRAGON
1 4 SMK
1 2

1 5 KARY. SWASTA 1 1 1 1 0
1 5 IRT
1 4

1 3 KULI BANGUNAN 1 1 1 1 0
1 3 IRT
1 5 KULI BANGUNAN
1 4 TDK KERJA

1 3 DAGANG 1 1 1 1 0
1 3 IRT
1 4 KARY.PABRIK
1 1 TDK KERJA

1 5 PABRIK 0 0 0 0 0

1 3 BURUH 1 1 1 1 0
1 3
1 3

Y:22 Y:22 Y:22 Y:22 Y:1

 ODGJ ODGJ DI MEROKOK BAB MENGGUNA DI DX TB TB BEROBAT ART GEJALA DX HT HT MINUM
BEROBAT PASUNG DIJAMBAN KAN AIR TERATUR TB OAHT
TERATUR BERSIH TERATUR
1 0 1 1 1 0 0 0
0 1 1 0 0 0

1 1 1 0 0 0
0 1 1 0 0 0
0 1 1 0 0 0

0 1 1 0 0 0
0 1 1 0 0 0
0 1 1 0 0 0

0 1 1 0 0 0

0 1 1 0 0 0
0 1 1 0 0 0
0 1 1 0 0 0

0 1 1 0 0 0
0 1 1 0 0 0

1 1 1 0 0 0
0 1 1 0 0 0
0 1 1 0 0 0
0 1 1 0 0 0
0 1 1 0 0 0

1 1 1 0 0 0
0 1 1 0 0 0
1 1 1 0 0 0
0

1 1 1 0 0 0
0 1 1 0 0 0

0 1 1 0 0 0
0 1 1 0 0 0
0 1 1 0 0 0

0 1 1 0 0 1 1
0 1 1 0 0 0
0 1 1 0 0 0

1 1 1 0 0 0
0 1 1 0 0 0
0 1 1 0 0 0

1 1 1 0 0 0

0 1 1 0 0 0
0 1 1 0 0 0

0 1 1 0 0 0
0 1 1 0 0 0
0 1 1 0 0 0

0 1 1 0 0 0
0 1 1 0 0 0

1 1 1 0 0 0
0 1 1 0 0 0
0 1 1 0 0 0

1 1 1 0 0 0

0 1 1 0 0 0
0 1 1 0 0 0
0 1 1 0 0 0
0 1 1 0 0 0

0 1 1 0 0 0
0 1 1 0 0 0

0 1 1 0 0 0
0 1 1 0 0 0
0 1 1 0 0 0

0 1 1 0 0 0
0 1 1 0 0 0
0 1 1 0 0 0
0 1 1 0 0 0
0 1 1 0 0 0

0 1 1 0 0 0
0 1 1 0 0 1 1
 0 1 1 0 0 0
0 1 1 0 0 0
0 1 1 0 0 0

0 1 1 0 0 0
1 1 1 0 0 0
1 1 1 0 0 0
0 1 1 0 0 0
0 1 1 0 0 0
0 1 1 0 0 0
0 1 1 0 0 0

0 1 1 0 0 0
0 1 1 0 0 0
0 1 1 0 0 0

1 1 1 0 0 0
0 1 1 0 0 0
0 1 1 0 0 0
0 1 1 0 0 0

0 1 1 0 0 0
0 1 1 0 0 0
0 1 1 0 0 0
0 1 1 0 0 0

1 1 1 0 0 0

1 1 1 0 0 0
0 1 1 0 0 0
1 1 1 0 0 0

Y:1 Y:0 Y:16 Y:86 Y:86 Y:0 T:86 Y:2 Y:2

TENSI KB PERSALINAN ASI IMUNISASI TIMBANG
NAKES LENKAP BALITA
TERATUR
110/70
120/80

120/80 0
80/70 1
1

120/80 0
80/70 0

130/80
110/70

120/80 0
110/70 1

120/80
110/70

120/80 0
100/60 1
110/70

120/80 0
110/70 1
110/60

110/70 0
120/80 0

120/80 0
110/70 1
0

150/80
120/80
120/80 0
110/70 1

130/80

120/70 0
120/70 0

120/80
120/80
110/70

130/80
120/80

110/70 0
120/80 1
100/60

120/80

110/70 0
110/60 1
100/60

120/80 0
110/70 0

120/80 0
110/70 1
1

120/80 0
110/80 1
120/70
110/80
0

120/80
160/90
110/70 0
110/80 0

120/80
110/70
110/60
100/60
110/70
120/90

130/80 0
110/60 0
110/70

130/80 0
120/80 0
110/70
110/60

130/80 0
110/70 1
100/60
100/70

120/80

130/80
120/80
110/70

Y:11 Y:2
ALAMAT RT/RW NO. URUT NO.URUT RT ∑ ART ART 0-11 BL ART 12 - 59
BANGUNAN BL

71 0 3
ART ≥15 TH ART 10-54 NAMA KK ANGGOTA KK NIK
TH

52 59
 REKAPAN KS KELURAHAN GUNUNG GEDANGAN

NO. BPJS HUBUNGAN TANGGAL LAHIR UMUR L/P (1/0) KAWIN HAMIL/
TAHUN BULAN TIDAK

6-Oct-00 18 3 T:19
22-Jan-04 14 11
0
N GUNUNG GEDANGAN

AGAMA 5 PEKERJAAN SAB SAB JAMBAN JAMBAN ART ODGJ ODGJ

TERLINDUNGI SANITER BEROBAT
TERATUR
Y:16 Y:16 Y:16 Y:16 T:20
ODGJ DI MEROKOK BAB MENGGUNA DI DX TB TB BEROBAT ART GEJALA DX HT HT MINUM TENSI
PASUNG DIJAMBAN KAN AIR TERATUR TB OAHT
BERSIH TERATUR
Y:14 Y:70 Y:1 Y:70 T:70 Y:3
KB PERSALINAN ASI IMUNISASI TIMBANG
NAKES LENKAP BALITA
TERATUR
Y:9 T:1 Y:1 Y:2
 ALAMAT RT/RW NO. URUT NO.URUT RT ∑ ART ART 0-11 BL ART 12 - 59
BANGUNAN BL

KEDUNGSARI RT.01/02 001

ART ≥15 TH ART 10-54 NAMA KK ANGGOTA KK NIK
TH
 REKAPAN KS KELURAHAN GUNUNG GEDANGAN

NO. BPJS HUBUNGAN TANGGAL LAHIR UMUR L/P (1/0) KAWIN HAMIL/
TAHUN BULAN TIDAK

18-Mar-49 69 9
23-Oct-98 20 2
0
20-Dec-78 40 0
22-Jun-79 39 6
16-Dec-08 10 1
12-Oct-14 4 3
0
12-Feb-65 53 11
27-Jun-75 43 6
28-Jul-08 10 5
10
9-Nov-85 33 2
30-Jul-94 24 5
119 0
0
20-Jun-58 60 6
25-Aug-61 57 4
2-Jul-88 30 6

5-May-84 34 8
9-Nov-08 10 2
0
0
25-Nov-63 55 1
26-Mar-77 41 9
7-Sep-96 22 4

119 0
13-Dec-74 44 1
16-Nov-98 20 2
31-Dec-44 74 0

12-Dec-59 59 1
3-Mar-64 54 10
15-Nov-89 29 2
10-Mar-02 16 10

23-May-86 32 7
4-Jan-82 37 0
10-Sep-11 7 4
23-Sep-76 42 3
11-Jun-86 32 7
4-Apr-11 7 9

26-Jul-63 55 5
20-Apr-82 36 8
13-Jan-85 34 0

13-Dec-93 25 1
10-Jun-97 21 7
8-May-16 2 8

19-Jan-71 47 11
23-May-71 47 7
21-Mar-99 19 9
30-May-01 17 7
19-Feb-03 15 10
7-Jul-08 10 6

10-Feb-83 35 11
17-Dec-06 12 1
29-Jun-10 8 6

24-Jul-63 55 5
1-Aug-68 50 5
23-Nov-96 22 1

23-Sep-72 46 3
12-Sep-72 46 4
26-Feb-99 19 10
25-Jan-08 10 11

31-Dec-29 89 0
31-Dec-39 79 0

13-May-69 49 8
29-Mar-80 38 9
19-Aug-99 19 4
14-Sep-07 11 4

4-Apr-61 57 9
31-Aug-88 30 4
18-Mar-92 26 9
2-Nov-93 25 2
20-Jul-97 21 5

28-Apr-86 32 8
23-Apr-89 29 8
15-Aug-17 1 5

19-Nov-78 40 1
7-Jul-79 39 6
21-Dec-01 17 0
23-Jul-06 12 5

15-Apr-73 45 9
22-Feb-77 41 10
17-Feb-05 13 11

3-May-62 56 8
3-Nov-70 48 2
1-May-91 27 8
26-Sep-94 24 3
22-Jul-96 22 5

6-Sep-74 44 4
19-May-74 44 7
6-Oct-00 18 3
22-Jan-04 14 11
0
119 0
119 0
119 0
119 0
119 0
119 0
0
119 0
119 0
119 0
119 0
119 0
119 0
0
119 0
119 0
119 0
119 0
119 0
119 0
0
119 0
119 0
119 0
119 0
119 0
119 0
0
119 0
119 0
119 0
119 0
119 0
119 0
0
119 0
119 0
119 0
119 0
119 0
119 0
0
119 0
119 0
119 0
119 0
119 0
119 0
0
119 0
119 0
119 0
119 0
119 0
119 0
0
119 0
119 0
119 0
119 0
119 0
119 0
0
119 0
119 0
119 0
119 0
119 0
119 0
0
119 0
119 0
119 0
119 0
119 0
119 0
0
119 0
119 0
119 0
119 0
119 0
119 0
N GUNUNG GEDANGAN

AGAMA PENDIDIKAN PEKERJAAN SAB SAB JAMBAN JAMBAN ART ODGJ ODGJ
TERLINDUNGI SANITER BEROBAT
TERATUR
ODGJ DI MEROKOK BAB MENGGUNA DI DX TB TB BEROBAT ART GEJALA DX HT HT MINUM TENSI
PASUNG DIJAMBAN KAN AIR TERATUR TB OAHT
BERSIH TERATUR
KB PERSALINAN ASI IMUNISASI TIMBANG
NAKES LENKAP BALITA
TERATUR