Nama Sekolah : SMPN 1 Banama Tingang

Nama Puskesmas : Puskesmas Bawan

Kegiatan : Monitoring Pemberian TTD untuk Remaja Putri

JULI AGUSTUS SEPTEMBER

NO Nama NIK 1 2 3 4 1 2 3 4 1 2 3 4
T M T M T M T M T M T M T M T M T M T M T M T M
1 RISKA N 1 0 1 1 1 0 1 0 1 1 1 0 1 1 1 1 1 1 1 0 1 1 1 0
2 NABILA A 1 0 1 0 1 0 1 1 1 1 1 0 1 1 1 0 1 1 1 0 1 1 1 0
3 KEYSA HF 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1
4 GLORIA EN 1 1 1 0 1 1 1 0 1 1 1 0 1 1 1 0 1 1 1 0 1 1 1 1
5 APRILI N 1 1 1 1 1 1 1 0 1 1 1 0 1 1 1 0 1 0 1 1 1 0 1 1
6 JODIKA N 1 0 1 0 1 1 1 0 1 1 1 0 1 0 1 1 1 1 1 1 1 0 1 1
7 JEVINA M 1 1 1 1 1 0 1 1 1 0 1 1 1 1 1 0 1 0 1 0 1 0 1 0
8 AGNES M 1 0 1 0 1 0 1 0 1 0 1 0 1 0 1 0 1 0 1 0 1 0 1 0
9 IMELDA FAP 1 1 1 0 1 0 1 1 1 0 1 1 1 0 1 1 1 0 1 0 1 1 1 0
10 HENIE 1 0 1 0 1 0 1 0 1 0 1 0 1 0 1 0 1 0 1 0 1 0 1 1
11 SUSI L 1 1 1 1 1 0 1 0 1 0 1 0 1 1 1 0 1 0 1 1 1 0 1 0
12 KEZIA B 1 0 1 0 1 0 1 0 1 0 1 0 1 0 1 0 1 0 1 0 1 0 1 0
13 ENJEL 1 1 1 0 1 0 1 1 1 0 1 1 1 0 1 0 1 1 1 0 1 0 1 0
14 FITRI D 1 1 1 1 1 1 1 1 1 0 1 0 1 0 1 0 1 0 1 0 1 0 1 0
15 LISA T 1 0 1 1 1 0 1 1 1 1 1 0 1 0 1 1 1 0 1 0 1 0 1 0
16 MARGARET R 1 1 1 1 1 0 1 0 1 0 1 0 1 1 1 0 1 0 1 1 1 0 1 1
17 FLORENSI 1 1 1 1 1 0 1 0 1 0 1 0 1 0 1 0 1 1 1 0 1 0 1 0
18 AFRINITA K 1 1 1 0 1 0 1 0 1 1 1 0 1 0 1 0 1 1 1 0 1 1 1 0
19 JENINTA 1 0 1 1 1 0 1 0 1 1 1 0 1 0 1 1 1 0 1 1 1 0 1 0
20 DAHLIA S 1 1 1 0 1 1 1 0 1 0 1 1 1 0 1 1 1 0 1 1 1 1 1 0
21 WINDA 1 1 1 1 1 0 1 0 1 1 1 0 1 1 1 0 1 0 1 0 1 1 1 0
22 ELISA 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1
23 SAMITA M 1 1 1 1 1 0 1 0 1 0 1 0 1 1 1 0 1 0 1 1 1 0 1 0
24 WULANDARI 1 0 1 0 1 0 1 0 1 0 1 1 1 0 1 0 1 0 1 1 1 0 1 0
25 APRILIANA SH 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1
26 YOLANDA CP 1 0 1 0 1 0 1 1 1 0 1 0 1 0 1 0 1 0 1 1 1 0 1 1
27 EFITA A 1 1 1 1 1 0 1 0 1 0 1 0 1 0 1 1 1 0 1 0 1 1 1 0
28 RISNA 1 0 1 1 1 0 1 0 1 1 1 0 1 0 1 1 1 0 1 0 1 0 1 0
29 DESTI 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1
30 ERISTA O 1 0 1 1 1 0 1 0 1 0 1 0 1 0 1 1 1 0 1 1 1 0 1 0
31 SOFIA KA 1 0 1 0 1 0 1 0 1 0 1 0 1 1 1 1 1 0 1 1 1 0 1 0
32 FIARA A 1 1 1 0 1 0 1 0 1 0 1 0 1 1 1 0 1 0 1 0 1 0 1 0
33 RIKA A 1 0 1 0 1 1 1 1 1 0 1 0 1 1 1 0 1 0 1 0 1 0 1 0
34 FRANSISKA DA 1 0 1 1 1 0 1 1 1 0 1 0 1 1 1 0 1 0 1 0 1 0 1 0
35 ESTER 1 0 1 0 1 0 1 0 1 0 1 0 1 0 1 1 1 0 1 0 1 1 1 0
36 ABIGAIL K 1 0 1 1 1 1 1 1 1 1 1 1 1 0 1 1 1 0 1 0 1 0 1 0
37 DENADA 1 0 1 1 1 0 1 1 1 0 1 1 1 0 1 0 1 0 1 0 1 0 1 0
38 ASTRID P 1 1 1 0 1 1 1 0 1 0 1 0 1 1 1 0 1 0 1 0 1 0 1 0
39 LAURA 1 0 1 0 1 0 1 0 1 0 1 0 1 1 1 1 1 0 1 0 1 0 1 0
40 ANDEA M 1 0 1 0 1 1 1 0 1 0 1 0 1 1 1 0 1 0 1 0 1 0 1 0
41 OKTAVIA M 1 1 1 1 1 0 1 1 1 0 1 0 1 0 1 0 1 1 1 0 1 1 1 1
42 ANANDA I 1 0 1 1 1 0 1 0 1 0 1 1 1 0 1 0 1 0 1 0 1 0 1 1
43 MEYLIN A 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1
44 PRISKILA 1 1 1 0 1 1 1 0 1 1 1 0 1 0 1 0 1 1 1 0 1 0 1 1
45 SELFI 1 0 1 0 1 1 1 1 1 0 1 0 1 0 1 0 1 1 1 0 1 0 1 0
46 ARISKA 1 1 1 0 1 1 1 0 1 0 1 0 1 0 1 0 1 1 1 0 1 0 1 0
47 JENI 1 0 1 0 1 1 1 0 1 1 1 0 1 0 1 0 1 0 1 0 1 0 1 0
48 JOY 1 0 1 0 1 0 1 1 1 0 1 0 1 0 1 0 1 0 1 0 1 0 1 0
49 REVALINA 1 1 1 0 1 0 1 1 1 1 1 0 1 1 1 0 1 0 1 0 1 0 1 0
50 PUTRI R 1 0 1 0 1 0 1 0 1 0 1 0 1 1 1 0 1 1 1 0 1 0 1 0
51 OKTAVELI 1 0 1 0 1 1 1 0 1 0 1 1 1 1 1 0 1 0 1 0 1 0 1 0
52 MAULIDA H 1 1 1 1 1 0 1 0 1 0 1 0 1 1 1 0 1 0 1 0 1 0 1 0
53 ALIA 1 0 1 1 1 0 1 1 1 0 1 0 1 0 1 0 1 0 1 0 1 0 1 0
54 CHIKA 1 1 1 0 1 0 1 0 1 0 1 0 1 0 1 0 1 0 1 0 1 0 1 0
55 JANUARTI EP 1 0 1 0 1 1 1 1 1 0 1 0 1 0 1 0 1 0 1 0 1 0 1 0
56 ESTERIA 1 1 1 0 1 0 1 1 1 0 1 0 1 0 1 0 1 0 1 0 1 0 1 0
 57 CITRA 1 0 1 0 1 1 1 0 1 0 1 0 1 0 1 1 1 1 1 0 1 0 1 0
58 FATNIA W 1 1 1 1 1 1 1 0 1 0 1 0 1 0 1 1 1 0 1 0 1 0 1 0
59 NANDA 1 0 1 0 1 1 1 1 1 1 1 0 1 0 1 0 1 0 1 0 1 0 1 0
60 APRILINA 1 0 1 0 1 1 1 1 1 1 1 0 1 0 1 0 1 0 1 0 1 0 1 0
61 OMEGA 1 1 1 0 1 1 1 0 1 0 1 0 1 0 1 1 1 1 1 0 1 0 1 0
62 LALA 1 0 1 0 1 0 1 1 1 0 1 0 1 0 1 0 1 1 1 0 1 0 1 0
63 RIKA J 1 1 1 1 1 0 1 0 1 0 1 0 1 0 1 0 1 0 1 1 1 0 1 1
64 PUTRI A 1 0 1 0 1 1 1 0 1 1 1 0 1 1 1 0 1 0 1 0 1 0 1 1
65 NOVIANI 1 1 1 0 1 1 1 0 1 0 1 1 1 0 1 0 1 1 1 1 1 0 1 0

KET:
Isi kolom T dan M dengan 0 atau 1
T : Terima TTD
M : Minum TTD
Kolom T diisi angka satu (1) jika menerima TTD dan angka 0 (nol) jika tidak menerima TTD
Kolom M diisi angka satu (1) jika minum TTD dan angka 0 (nol) jika tidak minum TTD
Nama Sekolah : SMPN 2 Banama Tingang
Nama Puskesmas : Puskesmas Bawan
Kegiatan : Monitoring Pemberian TTD untuk Remaja Putri

JULI AGUSTUS SEPTEMBER

NO Nama NIK 1 2 3 4 1 2 3 4 1 2 3 4
T M T M T M T M T M T M T M T M T M T M T M T M
1 ANGGEL C 1 0 1 1 1 0 1 0 1 1 1 0 1 0 1 0 1 0 1 0 1 0 1 0
2 CHIQUITA N 1 1 1 0 1 0 1 0 1 0 1 0 1 1 1 0 1 0 1 0 1 0 1 1
3 IRMA R 1 1 1 1 1 0 1 0 1 0 1 0 1 0 1 0 1 0 1 0 1 0 1 0
4 JULIANA T 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1
5 MIRACLE T 1 1 1 1 1 1 1 0 1 1 1 0 1 0 1 0 1 0 1 0 1 0 1 0
6 NOVA M 1 1 1 0 1 0 1 1 1 1 1 0 1 0 1 0 1 0 1 0 1 0 1 1
7 RESA 1 0 1 1 1 0 1 1 1 0 1 0 1 0 1 0 1 0 1 0 1 0 1 0
8 SELVINA 1 0 1 1 1 0 1 0 1 1 1 0 1 1 1 0 1 1 1 0 1 1 1 0
9 KUINI R 1 1 1 0 1 1 1 0 1 1 1 0 1 0 1 1 1 0 1 0 1 1 1 0
10 IQLIMA F 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1
11 ENGEL 1 1 1 0 1 1 1 1 1 0 1 0 1 1 1 0 1 0 1 0 1 0 1 0
12 MEILIN 1 1 1 1 1 0 1 0 1 0 1 1 1 0 1 0 1 0 1 0 1 0 1 0
13 MELIA A 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1
14 CINTA 1 1 1 1 1 1 1 0 1 0 1 0 1 0 1 0 1 0 1 0 1 0 1 0
15 AGNES 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1
16 AMANDA 1 0 1 1 1 0 1 0 1 1 1 0 1 1 1 0 1 0 1 0 1 0 1 1
17 ANISA WP 1 1 1 0 1 0 1 0 1 1 1 0 1 1 1 0 1 0 1 0 1 0 1 0
18 JULIA K 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1
19 LASTRIANA 1 1 1 0 1 1 1 0 1 1 1 0 1 1 1 0 1 1 1 0 1 0 1 0
20 NOVELIN 1 1 1 1 1 1 1 0 1 0 1 1 1 0 1 0 1 0 1 1 1 0 1 0
21 NATASYA A 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1
22 OKTALIA 1 1 1 1 1 1 1 1 1 0 1 0 1 0 1 0 1 0 1 0 1 0 1 0
23 OSSIANA S 1 1 1 0 1 0 1 1 1 1 1 1 1 0 1 0 1 0 1 0 1 0 1 1
 24 KARINA IP 1 1 1 1 1 0 1 1 1 1 1 1 1 0 1 1 1 0 1 1 1 0 1 1
25 SINTA N 1 0 1 0 1 0 1 0 1 0 1 0 1 0 1 0 1 0 1 0 1 0 1 0
26 VENI P 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1
27 ADVENTA R 1 0 1 0 1 1 1 0 1 1 1 0 1 1 1 0 1 1 1 0 1 1 1 0
28 APRILIA FN 1 0 1 0 1 0 1 1 1 0 1 0 1 1 1 0 1 0 1 0 1 1 1 0
29 CHANDRI A 1 1 1 0 1 1 1 0 1 1 1 0 1 0 1 1 1 0 1 0 1 0 1 1
30 INDRI Y 1 1 1 1 1 1 1 0 1 1 1 1 1 0 1 0 1 0 1 0 1 0 1 0
31 MARIA TL 1 1 1 1 1 1 1 0 1 1 1 1 1 0 1 0 1 0 1 0 1 0 1 0
32 MELUH M 1 1 1 0 1 0 1 0 1 0 1 0 1 0 1 0 1 0 1 0 1 0 1 0
33 NATALIA 1 1 1 0 1 1 1 1 1 0 1 0 1 0 1 0 1 0 1 0 1 0 1 0
34 SEPTRIANA A 1 1 1 0 1 0 1 0 1 0 1 0 1 0 1 0 1 0 1 0 1 0 1 0
35 STEFANI 1 1 1 0 1 0 1 1 1 0 1 1 1 1 1 0 1 0 1 0 1 0 1 0
36 TESA L 1 1 1 0 1 1 1 0 1 0 1 1 1 1 1 0 1 0 1 0 1 0 1 0
37 TRESIA M 1 1 1 0 1 0 1 0 1 1 1 0 1 0 1 0 1 0 1 0 1 0 1 1
38 YULIA 1 0 1 0 1 0 1 0 1 1 1 0 1 1 1 0 1 0 1 0 1 0 1 0
39 PITA 1 0 1 0 1 0 1 0 1 0 1 0 1 0 1 0 1 0 1 1 1 0 1 0
40 JESIKA 1 1 1 0 1 1 1 0 1 0 1 1 1 0 1 0 1 0 1 0 1 0 1 0
41 SEPA M 1 0 1 0 1 0 1 1 1 0 1 1 1 0 1 0 1 0 1 0 1 0 1 0
42 MELA A 1 1 1 1 1 0 1 1 1 0 1 0 1 1 1 0 1 0 1 0 1 0 1 0
43 RENCI 1 1 1 0 1 0 1 0 1 1 1 0 1 0 1 0 1 1 1 0 1 1 1 1

KET:
Isi kolom T dan M dengan 0 atau 1
T : Terima TTD
M : Minum TTD
Kolom T diisi angka satu (1) jika menerima TTD dan angka 0 (nol) jika tidak menerima TTD
Kolom M diisi angka satu (1) jika minum TTD dan angka 0 (nol) jika tidak minum TTD
Nama Sekolah : SMAN 1 Banama Tingang
Nama Puskesmas : Puskesmas Bawan
Kegiatan : Monitoring Pemberian TTD untuk Remaja Putri

JULI AGUSTUS SEPTEMBER

NO Nama NIK 1 2 3 4 1 2 3 4 1 2 3 4
T M T M T M T M T M T M T M T M T M T M T M T M
1 MARSANDA L 1 1 1 0 1 0 1 1 1 0 1 0 1 1 1 0 1 0 1 1 1 1 1 0
2 LINSI 1 1 1 0 1 0 1 0 1 0 1 0 1 0 1 1 1 0 1 0 1 1 1 0
3 NOVELIN P 1 1 1 0 1 1 1 0 1 0 1 0 1 0 1 0 1 0 1 0 1 0 1 0
4 TRIA 1 1 1 1 1 1 1 0 1 0 1 0 1 0 1 0 1 0 1 0 1 0 1 0
5 LIRA A 1 1 1 0 1 1 1 1 1 1 1 1 1 0 1 0 1 0 1 0 1 0 1 0
6 VIOLA S 1 1 1 0 1 1 1 0 1 0 1 0 1 0 1 0 1 0 1 0 1 0 1 0
7 ALIA 1 1 1 1 1 0 1 0 1 0 1 0 1 0 1 0 1 0 1 0 1 0 1 0
8 DEWI PS 1 1 1 0 1 1 1 0 1 0 1 0 1 0 1 0 1 0 1 0 1 0 1 0
9 GALUH M 1 0 1 1 1 1 1 0 1 1 1 0 1 0 1 0 1 0 1 0 1 0 1 0
10 PUTRI J 1 1 1 1 1 0 1 0 1 0 1 1 1 0 1 0 1 0 1 0 1 0 1 0
11 OKTARIA T 1 1 1 0 1 0 1 1 1 1 1 1 1 1 1 0 1 0 1 0 1 0 1 0
12 SUSANTI P 1 0 1 0 1 1 1 1 1 1 1 1 1 0 1 1 1 0 1 0 1 0 1 0
13 TUTUT A 1 0 1 1 1 1 1 1 1 0 1 1 1 0 1 0 1 0 1 1 1 1 1 0
14 PUTRI N 1 1 1 1 1 0 1 1 1 0 1 1 1 1 1 1 1 1 1 0 1 0 1 0
15 YULIA T 1 0 1 1 1 0 1 1 1 1 1 0 1 0 1 0 1 0 1 0 1 0 1 0
16 TERESA S 1 1 1 0 1 1 1 0 1 0 1 1 1 0 1 0 1 0 1 0 1 0 1 0
17 ALMIATI 1 1 1 0 1 1 1 1 1 0 1 0 1 0 1 1 1 1 1 0 1 0 1 0
18 ULFA S 1 0 1 1 1 0 1 1 1 0 1 1 1 0 1 1 1 0 1 1 1 1 1 0
19 NININDRA 1 1 1 0 1 1 1 0 1 1 1 0 1 0 1 0 1 1 1 0 1 1 1 0
20 RANI 1 1 1 0 1 0 1 1 1 0 1 0 1 0 1 1 1 0 1 0 1 0 1 0
21 TERESIA I 1 1 1 0 1 0 1 1 1 0 1 0 1 0 1 0 1 1 1 0 1 1 1 0
22 NOVITA 1 0 1 1 1 0 1 0 1 0 1 0 1 1 1 0 1 0 1 0 1 1 1 0
23 NOVENI L 1 1 1 0 1 0 1 0 1 0 1 1 1 0 1 0 1 0 1 0 1 0 1 0
24 VINANDA R 1 1 1 1 1 0 1 0 1 0 1 1 1 0 1 0 1 0 1 0 1 0 1 0
25 NOVIANA 1 1 1 0 1 1 1 1 1 1 1 0 1 0 1 0 1 0 1 0 1 0 1 0
26 PUTRI Y 1 0 1 1 1 1 1 0 1 1 1 0 1 1 1 0 1 0 1 0 1 0 1 0
27 ARIKARERA 1 1 1 0 1 0 1 0 1 0 1 0 1 1 1 0 1 0 1 0 1 0 1 0
28 SONALI 1 1 1 1 1 0 1 0 1 0 1 0 1 1 1 0 1 0 1 0 1 0 1 0
29 VIOLA E 1 1 1 0 1 0 1 0 1 0 1 0 1 1 1 1 1 1 1 1 1 0 1 0
30 KURNIA A 1 0 1 1 1 1 1 1 1 1 1 0 1 0 1 0 1 0 1 0 1 0 1 0
31 RAFIKA S 1 0 1 0 1 0 1 1 1 0 1 0 1 0 1 0 1 1 1 1 1 0 1 0
32 OKTA S 1 1 1 0 1 0 1 0 1 0 1 1 1 0 1 1 1 0 1 0 1 0 1 0
33 ASARI S 1 0 1 1 1 0 1 0 1 0 1 1 1 0 1 0 1 0 1 0 1 1 1 0
34 YULISKA A 1 1 1 0 1 1 1 0 1 1 1 0 1 1 1 0 1 0 1 0 1 1 1 0
35 RISKA R 1 0 1 1 1 1 1 0 1 0 1 0 1 1 1 1 1 0 1 0 1 0 1 0
36 SISKA 1 1 1 0 1 1 1 0 1 1 1 0 1 0 1 0 1 1 1 0 1 0 1 0
37 NOVIATA 1 1 1 0 1 0 1 0 1 1 1 0 1 1 1 0 1 1 1 1 1 0 1 0
38 ARSYA NP 1 1 1 1 1 0 1 1 1 0 1 0 1 0 1 0 1 0 1 0 1 0 1 0
39 DWI U 1 1 1 0 1 1 1 0 1 1 1 1 1 1 1 0 1 0 1 0 1 0 1 0
40 VIRGANIS C 1 0 1 1 1 0 1 0 1 0 1 1 1 0 1 0 1 0 1 0 1 0 1 0
41 SELFI A 1 0 1 1 1 0 1 1 1 1 1 0 1 0 1 1 1 0 1 0 1 0 1 0
42 ELISA 1 1 1 1 1 0 1 0 1 0 1 1 1 0 1 0 1 0 1 0 1 0 1 0
43 PUTRI T 1 1 1 1 1 0 1 0 1 0 1 0 1 0 1 1 1 0 1 1 1 0 1 0
44 PITRIA N 1 1 1 1 1 1 1 0 1 0 1 1 1 0 1 0 1 0 1 1 1 0 1 0
45 PUSPITA D 1 1 1 0 1 1 1 1 1 1 1 0 1 0 1 1 1 0 1 0 1 0 1 0
46 HIKMAH 1 1 1 1 1 0 1 0 1 0 1 0 1 0 1 1 1 0 1 0 1 0 1 0
47 NOVA A 1 1 1 1 1 0 1 0 1 0 1 0 1 0 1 0 1 0 1 0 1 0 1 0
48 ANGGELLITA 1 0 1 1 1 1 1 0 1 0 1 0 1 0 1 0 1 0 1 0 1 0 1 0
49 KATALINA E 1 0 1 1 1 1 1 0 1 1 1 0 1 0 1 0 1 0 1 0 1 0 1 0
50 WIWIN MP 1 1 1 1 1 0 1 0 1 1 1 0 1 0 1 0 1 0 1 0 1 0 1 0
51 WIDYA EP 1 1 1 1 1 0 1 0 1 0 1 0 1 0 1 0 1 0 1 0 1 0 1 0
52 ROSA A 1 0 1 1 1 1 1 1 1 0 1 0 1 0 1 0 1 0 1 0 1 0 1 0
53 MAYSA A 1 1 1 0 1 0 1 1 1 0 1 0 1 0 1 0 1 0 1 0 1 0 1 0
54 YENI K 1 0 1 0 1 0 1 0 1 0 1 0 1 0 1 0 1 0 1 0 1 0 1 0
55 TRISIA 1 1 1 0 1 0 1 0 1 1 1 0 1 0 1 0 1 0 1 1 1 0 1 0
56 YESSY NS 1 1 1 0 1 0 1 0 1 0 1 0 1 0 1 0 1 1 1 0 1 0 1 0
 KET:
Isi kolom T dan M dengan 0 atau 1
T : Terima TTD
M : Minum TTD
Kolom T diisi angka satu (1) jika menerima TTD dan angka 0 (nol) jika tidak menerima TTD
Kolom M diisi angka satu (1) jika minum TTD dan angka 0 (nol) jika tidak minum TTD
Nama Sekolah : SMAN 2 Banama Tingang
Nama Puskesmas : Puskesmas Bawan
Kegiatan : Monitoring Pemberian TTD untuk Remaja Putri

JULI AGUSTUS SEPTEMBER

NO Nama NIK 1 2 3 4 1 2 3 4 1 2 3 4
T M T M T M T M T M T M T M T M T M T M T M T M
1 NOVA N 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1
2 RUSLIANI DA 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1
3 RENI 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1
4 NANDA A 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1
5 MARLIKA 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1
6 CIA 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1
7 TETI Y 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1
8 ASISKA 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1
9 DITA A 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1
10 WIWIT 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1
11 SANDYA 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1
12 LOLITA 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1
13 ATNA 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1
14 KARLI R 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1
15 DEVIA 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1
16 DELVI S 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1
17 AYU SW 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1
18 ELEN C 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1
19 ELSA P 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1
20 MITA S 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1
21 MEGA M 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1
22 ERFINA L 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1
23 NADYA S 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1
24 SONIA 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1
25 LESTARI 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1
26 LIDYA N 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1
27 TATA P 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1
28 PENI 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1
29 ERPINA R 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1
30 ANANTA S 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1
31 BILA T 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1
32 NADYA 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1
33 ELSA A 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1
34 WULANDARI 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1
35 MEILISYA 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1
36 AYU W 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1
37 ERNA MS 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1
38 SANDRA P 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1
39 DINI 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1
40 ENDAH TP 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1
41 HARTATI 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1
42 AYANG S 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1
43 DEWI L 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1
44 INDRIANI P 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1
45 YUSTATIA 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1
46 ESTER L 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1
47 BILIA DN 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1
48 ISNAE 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1
49 DIKE 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1
50 FONISA W 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1
51 AMELIA T 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1
52 RANI S 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1
53 LESTARI 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1
54 RIANTIE 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1
55 DRIANA 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1
56 ARIE 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1
 57 SEPIA D 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1
58 DELA P 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1
59 TITAE 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1
60 RONA 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1
61 JUMIATUN 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1
62 PRISKA PP 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1
63 MARKILA 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1
64 YUNITA L 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1
65 MESSA C 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1
66 NURAINAH 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1
67 ANGGA S 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1
68 PRISKILIA C 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1
69 YULIA A 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1
70 DEWI P 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1
71 OKTARIA N 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1
72 ENJELIKA 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1
73 MARILINA N 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1
74 MERI A 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1
75 SELVIA W 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1
76 ANISSA 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1
77 INUNG 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1
78 IMEL 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1
79 VILA 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1
80 VINARI 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1
81 BERTI I 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1

KET:
Isi kolom T dan M dengan 0 atau 1
T : Terima TTD
M : Minum TTD
Kolom T diisi angka satu (1) jika menerima TTD dan angka 0 (nol) jika tidak menerima TTD
Kolom M diisi angka satu (1) jika minum TTD dan angka 0 (nol) jika tidak minum TTD
Nama Sekolah : SMPN 5 Banama Tingang
Nama Puskesmas : Puskesmas Bawan
Kegiatan : Monitoring Pemberian TTD untuk Remaja Putri

JULI AGUSTUS SEPTEMBER

NO Nama NIK 1 2 3 4 1 2 3 4 1 2 3 4
T M T M T M T M T M T M T M T M T M T M T M T M
1 APRINIA G 1 1 1 0 1 0 1 0 1 0 1 1 1 0 1 0 1 0 1 0 1 0 1 0
2 BINTANG M 1 1 1 1 1 0 1 0 1 0 1 0 1 0 1 0 1 0 1 0 1 0 1 0
3 CINTAE 1 1 1 1 1 1 1 0 1 0 1 0 1 0 1 0 1 0 1 0 1 0 1 0
4 DIA WS 1 1 1 0 1 1 1 0 1 1 1 0 1 0 1 0 1 0 1 0 1 0 1 0
5 FLORENSI P 1 1 1 1 1 1 1 0 1 0 1 1 1 0 1 1 1 0 1 1 1 1 1 0
6 ITAE 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1
7 ILLA 1 1 1 0 1 1 1 1 1 0 1 1 1 0 1 1 1 0 1 0 1 1 1 1
8 SANTI 1 1 1 0 1 0 1 1 1 1 1 0 1 1 1 0 1 0 1 0 1 0 1 0
9 TRI I 1 1 1 1 1 1 1 0 1 0 1 0 1 1 1 0 1 0 1 0 1 0 1 0
10 ANA S 1 1 1 0 1 1 1 1 1 0 1 1 1 1 1 0 1 0 1 1 1 0 1 1
11 KAMELIA I 1 1 1 0 1 0 1 0 1 0 1 0 1 1 1 0 1 0 1 0 1 0 1 0
12 EMELIA 1 0 1 0 1 1 1 0 1 0 1 0 1 1 1 0 1 0 1 0 1 0 1 0
13 ENJELI 1 1 1 1 1 0 1 0 1 1 1 1 1 0 1 0 1 1 1 1 1 1 1 1
14 RISA N 1 0 1 1 1 0 1 1 1 1 1 0 1 0 1 0 1 1 1 0 1 0 1 0
15 INDI K 1 0 1 0 1 1 1 0 1 0 1 0 1 0 1 0 1 1 1 0 1 0 1 0
16 LARA 1 1 1 0 1 1 1 0 1 0 1 0 1 1 1 0 1 0 1 0 1 1 1 0
17 MARSA 1 0 1 0 1 1 1 0 1 0 1 0 1 1 1 1 1 0 1 0 1 1 1 0
18 REVALIANA 1 0 1 1 1 0 1 0 1 1 1 1 1 0 1 1 1 0 1 1 1 0 1 0
19 TANTRI Y 1 1 1 0 1 1 1 1 1 1 1 0 1 1 1 1 1 0 1 1 1 1 1 0
20 TIARA CN 1 1 1 1 1 1 1 0 1 0 1 0 1 0 1 0 1 0 1 0 1 0 1 0
21 WELLA N 1 1 1 1 1 0 1 1 1 0 1 0 1 0 1 0 1 0 1 0 1 0 1 0
22 JENIKA N 1 1 1 0 1 1 1 0 1 0 1 1 1 1 1 0 1 0 1 0 1 0 1 0
 23 LEANANDA C 1 0 1 1 1 0 1 1 1 0 1 0 1 1 1 0 1 1 1 0 1 0 1 0
24 LESTARI 1 1 1 0 1 1 1 0 1 1 1 1 1 0 1 0 1 0 1 1 1 0 1 1
25 EODIA 1 1 1 0 1 0 1 0 1 1 1 0 1 1 1 0 1 0 1 0 1 0 1 1
26 SELVIA A 1 1 1 1 1 0 1 0 1 0 1 0 1 1 1 0 1 1 1 0 1 1 1 0
27 FITRIANI PD 1 1 1 1 1 0 1 1 1 0 1 0 1 0 1 0 1 0 1 0 1 1 1 0
28 DEA T 1 1 1 1 1 1 1 0 1 0 1 1 1 0 1 0 1 1 1 0 1 0 1 0
29 ENJELIA Y 1 1 1 1 1 0 1 0 1 0 1 1 1 1 1 1 1 1 1 1 1 1 1 1

KET:
Isi kolom T dan M dengan 0 atau 1
T : Terima TTD
M : Minum TTD
Kolom T diisi angka satu (1) jika menerima TTD dan angka 0 (nol) jika tidak menerima TTD
Kolom M diisi angka satu (1) jika minum TTD dan angka 0 (nol) jika tidak minum TTD