JK

NO. NAMA No. Passport TEMPATTANGGAL LAHIR NO. BATCH NO. ICV
LAHIR L P

1 INDAH IRYA B 5407127 UJUNG ### P J201801002 H00-385387

PANDANG
2 AQSHA MAHF B 7677594 MAKASSAR 1/10/1994 L J201801002 H00-385388

3 HERNAWATI B 8190528 LABOKONG ### p J201801002 H00-385389

4 ALIMIN RAH B 8190532 UJUNG ### L J201801002 H00-385390

PANDANG
5 SITTI RUWA B 0905759 PARE PARE ### P J201801002 H00-385391
UJUNG
6 ASQAR HAM C 2541373 ### L J201801002 H00-385392
PANDANG
7 SALAWATI C 2537840 AENG ### P J201801002 H00-385393
AENG
8 ABDUL RAH C 2542920 BATU ### L J201801002 H00-385394
BATU
9 UJUNG
SUPRIYANI C 2542639 PANDANG ### P J201801002 H00-385395

UJUNG
10 SARIPA PAH C 2543123 PANDANG ### P J201801002 H00-385396

11 WAHIDAH AC C 2537617
UJUNG 25/12/197 P J201801002 H00-385397
PANDANG 1
12 WAHYUDIN C 2542765 MAKASSAR 18/01/2002 L J201801002 H00-385398
13 DINRA TAJU C 2541938 POLMAS 31/12/1965 L J201801002 H00-385399

14 HURRIAH AL B 5406259 UJUNG 27/06/197 P J201801002 H00-385400

PANDANG 0
15 SAMPARA K C 2542961 BANTAENG 01/07/1953 L J201801002 H00-385401

16 MUHAMMADC 2542204 JENEPONT 17/07/1954 L J201801002 H00-385402

O

17 SYAMSIAH R C 2540677 BONTOSU

NGGU 15/09/1981 P J201801002 H00-385403

18 ERNAWATY B 4692893 WAJO 19/02/1973 P J201801002 H00-385404

19 MUHAMMADB 9005438 USUKU 5/2/1977 L J201801002 H00-385405
20 ANDI TENRI C 1392835 MAKASSAR ### P J201801002 H00-385406

21 UJUNG
YULI HARU C 2542241 PANDANG ### P J201801002 H00-385407

UJUNG
22 NURDIANA B 0317531 PANDANG 11/11/1973 P J201801002 H00-385408

23 SYAMSINA A C 2537532 BILACADDI ### P J201801002 H00-385409

24 SURIANI A C 2542412 WEKKAE 17/04/1988 P J201801002 H00-385410
25 YUNIARTO P C 2537401 BANTUL ### L J201801002 H00-385411
26 ATYKA MARYC 1804751 JAKARTA 26/02/1976 P J201801002 H00-385412
27 GHITA SHUP C 2541348 PARE PARE ### P J201801002 H00-385413
28 ELLYA BAAD C 2537104 MERAUKE ### P J201801002 H00-385414
29 MIRI DAENG C 1800926 TAKALAR ### L J201801002 H00-385415
 UJUNG
30 NINO BETA C 2230156 PANDANG ### P J201801002 H00-385416

SUNGGUM
31 SRI WAHYUNC 2541718 INASA ### P J201801002 H00-385417

32 JUMLIAWAT C 2226032 UJUNG 06/07/1985 P J201801002 H00-385418

PANDANG

33 JUMA C 2226233 TAMMULO

E ### L J201801002 H00-385419

UJUNG
34 KASMILAH C 2226182 PANDANG ### P J201801002 H00-385420

35 HERAWATI C 2537281 UJUNG ### P J201801002 H00-385421

PANDANG
36 ANDI SYAHR C 2539710 SOPPENG ### L J201801002 H00-385422
37 SAMSURIAH C 2574720 WAEPUTE 6/13/1986 P J201801002 H00-385423
38 RAHMAWATIC 2575084 WAEPUTE ### P J201801002 H00-385424
39 SRI MULIAN B 0498571 MAROS ### P J201801002 H00-385425
SUNGGUM
40 SURYAWATI C 2542648 INASA ### P J201801002 H00-385426

41 ISNAEVI T C 2542835 LEMOA ### P J201801002 H00-385427

42 ANDI HALIJ C 2542642 GANJENGE 01/07/1958 P J201801002 H00-385428
43 IRWAN IBR C 2542513 MAJENE 3/27/1981 L J201801002 H00-385429
44 MULIADI MAC 2540760 SENGKANG ### L J201801002 H00-385430
45 ANDINI MEL C 2540761 MAKASSAR ### P J201801002 H00-385431
46 ANIQAH DAFC 2226162 MAKASSAR ### P J201801002 H00-385432
47 MUHAMMADC 2226116 MAKASSAR ### L J201801002 H00-385433
48 HALIJAH DA C 2537615 PANCIRO ### P J201801002 H00-385434
49 JAIDAH DAE C 2537613 PANCIRO ### P J201801002 H00-385435
50 MAKKA TAH C 2537606 PANGKEP ### L J201801002 H00-385436

51 RAHMATIAH C 2231931 UJUNG ### P J201801002 H00-385437

PANDANG
BULUKUM
52 B 9779381 BA ### P J201801002 H00-385438
ANDI ARFIAT
TALAKAU
53 SAPIIN DAE C 2540473 WE ### L J201801002 H00-385439

54 C 2541347 TAIPALELE
KAMARUDDIN ### L J201801002 H00-385440
NG

55 ALI DAENG C 2540391 MATTONT

ONGDARE ### L J201801002 H00-385441

TAIPALELE
56 HADINAH H C 2540388 NG ### P J201801002 H00-385442

57 NURHAYATI C 2537552 BONTO ### P J201801002 H00-385443

CINDE
BONTO
58 SIRAJUDDIN C 2537628 CINDE ### L J201801002 H00-385444

BONTO
59 HANAPIN N C 2537541 CINDE ### L J201801002 H00-385445

60 LAHUDDIN C 2225872 BIRING ### L J201801002 H00-385446

BALANG
 PANGKAJE
61 HAMZAH GAC 2537332 NE ### L J201801002 H00-385447

62 NURWAHID C 2537353 BONE ### P J201801002 H00-385448

63 MUCHTAR ALC 1393107 BULUKUM

BA ### L J201801002 H00-385449

PALAMPA
64 BURHAN PA A 7758050 NG ### L J201801002 H00-385450

65 MUHAMMADC 2541483 JENEPONT ### L J201801002 H00-385451

O
66 AMBO DALL C 1801121 TALA TALA ### L J201801002 H00-385452
67 WAHIDA C 2537982 MAKASSAR ### P J201801002 H00-385453

68 WAENA
YULI TRIEST C 0133114 JAYAPURA ### P J201801002 H00-385454

69 SITTI RUWA C 2537945 MAKASSAR ### P J201801002 H00-385455

70 ANDI SITTI C 2537597 PANGKAJE ### P J201801002 H00-385456

NE
71 NURLAELAH C 2226818 SIMBANG ### P J201801002 H00-385457
72 WAHYU ADIM C 2226650 LIMBUNG ### L J201801002 H00-385458
73 MARWAH TUC 2537596 GOWA ### P J201801002 H00-385459
74 MATAHARI C 2175608 BONE ### P J201801002 H00-385460
75 ATISTA TAH C 2175610 BONE ### P J201801002 H00-385461
BARINGEN
76 AMIRUDDIN B 7966410 G ### L J201801002 H00-385462

77 KAMISTANG B 4029233 BONE ### L J201801002 H00-385463

78 MULYAMIN B 7848960 PANGKAJE ### L J201801002 H00-385464

NE

79 SUMARNI R C 2542535 GORONTAL

O ### P J201801002 H00-385465

80 ABDUL JALIL C 0013058 ANREAPI ### L J201801002 H00-385466

81 DIRIS KABA C 0013057 POLMAS ### L J201801002 H00-385467
82 ACHMAD SANC 2226619 MAKASSAR ### L J201801002 H00-385468
83 SUMINAH S B 1081900 LUMAJANG ### P J201801002 H00-385469
UJUNG
84 PARIDA DA C 2541461 PANDANG ### P J201801002 H00-385470

85 MURTINI SIK C 2542342 TALAKAUWE ### P J201801002 H00-385471

86 MEGAWATI C 2537343 TOLOWE ### P J201801002 H00-385472
87 SATRIA C 2537692 SENGKANG ### P J201801002 H00-385473
88 YAMMA HALC 2176018 BONE ### P J201801002 H00-385474
89 KASWAN TAM C 2176020 PAMMERA ### L J201801002 H00-385475
90 MUSTARIF A C 0815146 WAJO ### L J201801002 H00-385476
91 NURYANTY LC 0815147 BONE ### P J201801003 H00-385477
92 RAHMAWATIC 1394789 BONE ### P J201801002 H00-385478
93 SUYATI SUN B 9005104 LUMAJANG ### P J201801002 H00-385479
UJUNG
94 EGI SUGIAN C 2178019 MATTAJAN ### P J201801002 H00-385480
G
 BOTTOMP
95 JUMARNANTIB 9367175 ARE ### P J201801002 H00-385481

96 MUSTAFA B C 2541586 BONE ### L J201801002 H00-385482

97 ANDI MOCH C 2541511 BONE ### L J201801002 H00-385483
98 BATU EDJA B 0063847 SINJAI ### P J201801002 H00-385484
99 MUHAMMADC 2543154 SINJAI ### L J201801002 H00-385485
100 MULLI PALA C 2543159 SINJAI ### L J201801002 H00-385486
101 RATNAWATI A 9302944 SINJAI ### P J201801002 H00-385487
102 HERNIAWAT C 2541300 ANCU ### P J201801002 H00-385488
103 MERIANDANC 2541385 SINJAI ### P J201801002 H00-385489
104 HERNAWATI C 2543156 SINJAI ### P J201801002 H00-385490
105 RATNA ABD C 0382492 MALIAYA ### P J201801002 H00-385491
106 SUNARTI R C 2541445 SINJAI ### P J201801002 H00-385492
107 AMINAH MUC 2541299 SINJAI ### P J201801002 H00-385493
108 MARIAMA K C 2540650 TANETE ### P J201801002 H00-385494
109 ABDUL HAK C 2541986 SINJAI ### L J201801002 H00-385495
110 ANDI AISYA B 2130099 SINJAI ### P J201801002 H00-385496
111 ASDAR MAK C 2541720 SINJAI ### L J201801002 H00-385497
112 NORMA MU C 2541383 SINJAI ### P J201801002 H00-385498
TOTAL 43 69 0 0

Karcis Menin 112 x 5,000 560,000

Pemeriksaan 112 x 15,000 1,680,000
Vaksinasi Me 112 x 285,000 ###
Vaksinasi Me 0 x 260,000 -
Legalisasi I 0 x 25,000 -
icv DOUBLE 0 x 25,000 -
Pemeriksaa 48 x 25,000 1,200,000
Yellow Fever 0 x 325,000 -
Yellow Feve 0 x 300,000 -

TOTAL ###
 JENIS PNBP
PEM. & VAKSIN VAKSIN LEGALISASI Yellow Yellow KET
KARCIS PENGOBAT MENINGITIS MENINGITIS ICV VAKSIN PEM. HCG
Fever + ICV Fever sAJA
AN + BUKU ICV SAJA MENINGITIS

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112 112 112 0 0 0 0 48 0
 RIWAYAT PENYAKIT
2 3 4 5 6 7 8 9
ASAM ALERGI ALERGI ALERGI
HT DM DISPEPSIA URAT TELUR SULFAS ASMA UDANG TB

+
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10 2 0 0 1 0 3 1 0
 10
POST
STROK
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