TGL

NO NAMA IBU / SUAMI NO TELFON NO

KUNJUNGAN

2 3 4
1 1
Ny. Febriana 82388053845
1 11/9/2019 86
Tn. Mikael N
Ny. Stefani 81293092394
2 11/9/2019 87
Tn. Billy S
Ny. Ayu N 81315041894
3 11/9/2019 88
Tn. Eka A
Ny. Santy. R.S 82297995663
4 12/9/2019 89
Tn. Muslim
Ny. Ida Astuti 8989066489
5 12/9/2019 90
Tn. Iway M
Ny. Ny. Rica 81387780942
6 13/9/2019 91
Tn. Putra A
Ny. Lia F L 81387094343
7 13/9/2019 92
Tn. Rusharyadi
Ny. Indra Puji 85379416840
8 14/9/2019 93
Tn. Hermansyah
Ny. Pratidina 8561032664
9 14/9/2019 94
Tn. Dimas
Ny. Anggita 85779299225
10 14/9/2019 95
Tn. Achmad Zuhdi
Ny. Dwi Anjar 81388254830
11 15/9/2019 96
Tn. Riza
Ny. Endriyati 81212873293
12 15/9/2019 97
Tn. Afrianus E
Ny. Yulia 82124306551
13 16/9/2019 98
Tn. Wandi
Ny. Tri Retnowati 81282033387
14 16/9/2019 99
Tn. Agus S
Ny. Leni S A 83871543530
15 16/9/2019 100
Tn. Rahmat
Ny. Indriyati 85850798254
16 16/9/2019 101
Tn. Taufan
Ny.Nuraidah 81383659695
17 18-9-2019 102
Tn.Eka s
NY.Rizkha U 82110886606
18 18-9-2019 103
Tn.Yogi Andi
NY.Deniaty 83805300236
19 18-9-2019 104
Tn.M Ray Salim
Ny.Ai Dedeh 85967788674
20 18-9-2019 105
Tn.Apri
Ny.Yul.is 8151371797
21 19-9-2019 106
Tn.M sulaeman
Ny.Darnah 85777469374
22 19-9-2019 107
 85777469374
22 19-9-2019 107
TnAnton
Ny Anggi 8984651866
23 19-9-2019 108
Tn Abdul Rahman
Ny Eni S 89608658891
24 20/9/2019 109
Tn Nurdin
Ny Rest 85714458835
25 21/9/2019 110
Tn Singgieh
Ny Dahlia Milenia 895322268125.00
26 23/9/2019 111
Tn Riyan Hidayat

23/9/2019 Ny Sally Juanita 89689468181

27 112
Tn Sikirno

23/9/2019 Ny Misna 821113354741

28 113
Tn Faldy

24/9/2019 Ny.Ria Setya.n 081294712320,

29 114
Tn.Sukirno

25/9/2019 NY.Hadijah 8577608745

30 115
Tn.Walyuliadi

25/9/2019 Ny.Qurrota A YUN 81288024076

31 116
Tn.Rendy

25/9/2019 Ny.Yuliana 81317976056

32 117
Tn.Atoni .s.

26/9/2019 Ny.Maryam ,081581156324

33 118
Tn.Rainal Henny

26/9/2019 Ny.Yuli astut 81280238899

34
Tn.Sigit Purnomo

26/9/2019 Ny.Lenny marlina 85723184922

35
Tn.M Bahrul ulum

26/9/2019 Ny Heri H 81382358945

36
Tn Rayadi
Ny Kessy 81295183921
37 27/9/2019
Tn M Miral C
Ny Wiwi W 81316064370
38 27/9/2019
Tn Anggi
Ny Tri Haryant 81316064370
39 27/9/2019
Tn Zaenal Abidin
Ny Zulma 81218665831
40 27/9/2019
Tn Epan
Ny Nur Ajijah 85780843963
41 28/9/2019
Tn Saiful
Ny Liana 83891603197
42 29/9/2019
Tn Aris
Ny Nurami 82111233233
43 29/9/2019 Tn Rahmat
Ny Nahrum 85781664423
44 29/9/2019 Tn Dede
Ny Ika Safitri 0813.1608.4307
45 1/10/2019
Tn Febri Yansyah
Ny Marlin 0852.1735.3724
46 2/10/2019
 0852.1735.3724
46 2/10/2019
Tn Yosephies
Ny Tri Wahyuni 0813.9333.1300
47 3/10/2019
Tn Ahmad F
Ny Ebah H 0838.8847.380
48 3/10/2019
Tn Nasim
Ny Sit Marpuah 0822.7676.2291
49 3/10/2019
Tn Kambali
Ny Desi Nurlita 0818.0587.0479
50 4/10/2019
Tn Dahlan
Ny Endah N 0895.3956.32727
51 4/10/2019
Tn M Dani
Ny Yuli Tri S 0893.0961 .5182
52 4/10/2019
Tn Iskandar
Ny Melinjda 0858. 7145.5006
53 4/10/2019
Tn Eko Hermawat
Ny. Oktavia Lestari 0878.3869. 7250
54 4/10/2019
Tn. Stupa Agung
Ny. Ni Putu Peni 0812.8771. 1503
55 5/10/2019
Tn. M Nuruz Z
Ny. Yuli Indriyant 0815. 1153. 8474
56 5/10/2019
Tn. Handoko
Ny. Sant 0818. 0614. 4545
57 5/10/2019
Tn. Namin
Ny. Elvi Oktavia 0812.8473.8403
58 7/10/2019
Tn. Ach Firdaus
Ny. Irawat 0813. 1442.8108
59 7/10/2019
Tn. Sudarman
Ny. Liana dewi 0896.1132.3227
60 8/10/2019
Tn. Asmala D
Ny. Kisca Tambunan 0813.6165. 2523
61 8/10/2019 146
Tn. Freddi S
Ny. Nurhayat 0858.1154.0019
62 8/10/2019 147
Tn. Ary A
Ny. Sisca Eka N 0858.4004.2986
63 9/10/2019 148
Tn. Ida Sofyan
Ny. Ika Restu S 0856.7555.839
64 9/10/2019 149
Tn. Ama S
Ny. Puspita HP 0812.9690.7772
65 9/10/2019 150
Tn. Nurdianto
Ny. Ade Nur 0896.0192.1289
66 9/10/2019 151
Tn. Royadi
Ny. Ika Mayasari 0857.4788.8313
67 10/10/2019 152
Tn. Triyono

81314127685
Ny.Dian A
68 10/10/2019 153
Tn.Oloan S
Ny.Mila Suryani 8561239610
69 10/10/2019 154
Tn.Erwinsyah

11/10/2019 Ny Gina Marisa 85849212470

70 155
 85849212470
70 155
Tn Sadam
11/10/2019 Ny Budi Lindawati 8111082399
71 156
Tn Budi Sutrisno
12/10/2019 Ny Maria Mardiana 85885150804
72 157
Tn Majokarto
12/10/2019 83120043019
Ny Siti Nuraini
73 158
Tn Syaiful
12/10/2019 Ny Sutjirah 81212247067
74 159
Tn M Abdullah
Ny. Nurina 85780346049
75 14/10/2019 160
Tn. Achmad
Ny. Heni Rahayu 85794880329
76 14/10/2019 161
Tn. Andi Sutarman
Ny. Retno H 85786932224
77 14/10/2019 162
Tn. Eko Pujiharto
Ny. Nia Kurnia 82284000052
78 14/10/2019 163
Tn. M Bambang
Ny. Naura 81315239593
79 15/10/2019 164
Tn. Falahudin
Ny. Fitri M 811380550477.00
80 15/10/2019 165
Tn. Mohamad
Ny. Mintarsih 85959924815
81 16/10/2019 166
Tn. Limin
Ny. Surtiyah 81586155552
82 16/10/2019 167
Tn. Slamet H
Ny. Lisnawati 0878.7694.7849
83 17/10/2019 168
Tn. Tatang Mulyana
Ny.Lisnawati 0891.6182.63882
84 17/10/2019 169
Tn. Rahmad Zhaheria
18/10/2019 Andriani Safitri 82299579915
85 170
Tn Riadi
 NAMA IBU /

TGL KUNJUNGAN NO TELFON

NAMA SUAMI

2 3 4

18/10/2019 Ny Lihayat Tini 87870315789

Tn Riko H.V
Ny Ernawati 83805818882
20/10/2019
Tn Saman
Ny Marsian 85970087340
20/10/2019
Tn Tohar
21/10/2019 Ny Ayu Wulandari 81258394955

Tn Deden NS
23/10/2019 Ny Mia Sumiasih 83876998358

Tn Casmudi
23/10/2019 Ny Aam Amelia 838877099928

Tn Zemi
8988800166
Ny Seruni
24/10/2019
Tn Sofiyan
89631704430
Ny. Elisa
25/19/2019
Tn. Hartian
85890899258
Ny. Ai Mulyanah
25/19/2019
Tn. Agus G
85776020840
Ny. Yanti
25/19/2019
Tn. Royadi
81911240010
Ny. Sri Wahyuningsih
25/19/2019
Tn. Defri A
Ny. Meta Agusrini 81293336361
26/10/2019
Tn. M Amiruddin
Ny. Rustiana 89601363604
26/10/2019
Tn. Sudarja
82113558014
Ny. Purnama
26/10/2019
Tn. Randi
Ny. Iis Suhertian 83877942828
27/10/2019
Tn.. Saiful Bahri
Ny. Putri Susanti 85774902051
28/10/2019
Tn. Agung
Ny. Nur Qolby 87888813013
28/10/2019
Tn. Tri Joko
Ny. Santi 8979799041
28/10/2019
Tn. Dion Pratama
81908279924
Ny. Haryanti
29/10/2019
Tn. Tuih
Ny. Rini W 85975234404
30/10/2019
Tn. Minta Raja
Ny. Rohanih 81219476808
31/20/2019
Tn. Tri Ferdiyanto
Ny. Elly V 8131096563
31/10/2019
 8131096563
31/10/2019
Tn. Iskandar
Ny. Liys D 81310968767
1/11/2019
Tn. Imam h
Ny. Lasmini 85780538050
1/11/2019
Tn. Maferdi
Ny. Yulia Citra 87770778683
2/11/2019
Tn. Triya A
Ny. Dewi S 8539415622
2/11/2019
Tn. Agus S
Ny Kamelia 8128965269
6/11/2019
Tn Agus
8/11/2019 Ny Siti Fatimah 85783093654

Tn Santoso
8/11/2019 Ny Dede Amalia 85714622457

Tn Wawan
Ny Wiwin 89651662810
9/11/2019
Tn Iqbal
Ny Lili Smrotul 81311244281
9/11/2019
Tn Fahmi Fauzi
Ny.Terisya Fadli 81318895772
10/11/2019
Tn. Ferry Suhendri
Ny Mirna Muliana 87782836992
11/11/2019
Tn Ade N
 LAPORAN PELAYANAN KESEHATAN BAYI BARU L
RUMAH SAKIT/BIDAN PRAKTEK MANDIRI : RS JATI SAMPURNA
BULAN : AGUSTUS - SEPTEMBER
TAHUN : 2019
WILAYAH PUKESMAS : JATI SAMPURNA

NAMA ALAMAT BAY

NO TGL KUNJ UMUR ORANG TUA (RT/RW/KEL) TGL
PERSALINAN LAHIR
1 2 3 4 5 6
Ny. Febriana Jl Ujung Aspal GG Wika Perum zada Residence
28
1 11/9/2019 4/5,jatisampurna 082388053845 11/9/2019
Tn. Mikael N
31
Ny. Stefani Jl Salamun 7/3 Pd Ranggon Cipayung
27
2 11/9/2019 ,jaktim081293092394 11/9/2019
Tn. Billy S
28
Ny. Ayu N Gg rozak no 46 02/02,jatismapurna Bekasi
22
3 11/9/2019 081315041894 11/9/2019
Tn. Eka A
25
Ny. Santy. R.S Jl Genim 4/8 no 85 Jt Kramat Pd Gede 082297995663
24
4 12/9/2019 12/9/2019
Tn. Muslim
49
Ny. Ida Astuti Jl Botini 01/04 no 26 Cipayung JAKTIM 08989066489
27
5 12/9/2019 12/9/2019
Tn. Iway M
26
Ny. Ny. Rica Jln Komp POLRI Jt Rangga 03/06 Jt Sampurna
31
6 13/9/2019 081387780942 13/9/2019
Tn. Putra A
34
Ny. Lia F L Kp Rawa Bacang 5/15 Pd Melati Kel Jt Rahayu
19
7 13/9/2019 081387094343 13/9/2019
Tn. Rusharyadi
23
Ny. Indra Puji Perum Jt Sari Permai,jati asih 08/06 085379416840
36
8 14/9/2019 14/9/2019
Tn. Hermansyah
35
Ny. Pratidina Jl Anggrek 10 no 25 05/14 Jt Sampurna 08561032664
26
9 14/9/2019 14/9/2019
Tn. Dimas
29
Ny. Anggita Jl SD lama no 85 Pd Ranggon 3/1 Cipayung JAKTIM
26
10 14/9/2019 085779299225 14/9/2019
Tn. Achmad Zuhdi
27
Ny. Dwi Anjar Gg Kicil 04/05 no 54 Ujung Aspal Jt
40
11 15/9/2019 Ranggo,jatisampurna 081388254830 15/9/2019
Tn. Riza
41
Ny. Endriyati Jl Wibawa Mukti 2 blok B/5 018/005 Jt Sari Jt asih
39
12 15/9/2019 081212873293 15/9/2019
Tn. Afrianus E
40
Ny. Yulia Jl Solamun no 30 11/03 Pd Ranggon ,jaktim
30
13 16/9/2019 082124306551 16/9/2019
Tn. Wandi
35
Ny. Tri Retnowati Jl Damai 2 no 6 ,jatimurni pondok melati 03/06
35
14 16/9/2019 081282033387 16/9/2019
Tn. Agus S
39
Ny. Leni S A Jl Bakti Warga,jatiranggon,jatisampurna 2/3
28
15 16/9/2019 083871543530 16/9/2019
Tn. Rahmat
30
Ny. Chandra Jl Praptan Al 02/10,jatisampurna
27
16 16/9/2019 16/9/2019
Tn. Sonin
29
Ny. Wiwik Jl Perum Fajar Asri Blok A 05/01 Jt Sari,jati asih
42
17 16/9/2019 16/9/2019
Tn. Awaludin
36
 Ny. Indriyati Kp Raden 02/5 Rawa dolar Jt Sampurna
33
18 16/9/2019 085850798254 16/9/2019
Tn. Taufan
34
Ny.Licke S perum pondok gede Rt 02/03,Bekasi
32
19 17-9-2019 17-9-2019
Tn.Abdul M
34
Ny.Nuraidah Jl sepakat 2 no 81 Rt 01/01 cilangkap
27
20 18-9-2019 ,jaktim081383659695 18-9-2019
Tn.Eka s
28
NY.Rizkha U Jl.Assafiyah Rt 01/03 Cilangkap jaktim 082110886606
25
21 18-9-2019 18-9-2019
Tn.Yogi Andi
30
Ny.Sri MAMIK Jl.Transad Raya GG SWADAYA Rt 02/08
37
22 18-9-2019 jatismapurna 18-9-2019
Tn.Sutarno
45
NY.Deniaty Pagelarang 1 b 0 B 4 Rt 001/01 kel stu kec cipayng
22
23 18-9-2019 jaktim 083805300236 18-9-2019
Tn.M Ray Salim
25
Ny.Ai Dedeh Jl.Damai RT 03/05 jatimurni pondok melati 0859
34
24 18-9-2019 18-9-2019
Tn.Apri
Ny.Yul.is Lewinangguang Rt 01/02depok 08151371797
36
25 19-9-2019 19-9-2019
Tn.M sulaeman
38
Ny.Yessi putri Jl.Swadaya III rt03 rw08 no.69 Jati ranggon Jati
26
26 19-9-2019 sampurna 19-9-2019
Tn.Kokoh dwi
29
Ny.Darnah kp kramat Rt 02/04 setu cipayungRt 02/04u cipayung
31
27 19-9-2019 jaktim 085777469374 19-9-2019
TnAnton
31
Ny.Jumiatik Jln Raya Jatiranggon Perum griya mitra-Cibubur
32
28 19-9-2017 Jatiranggon-Jatisampurna 19-9-2017
Tn.
41
Ny Anggi Jln SMA 7 Kranggan ,jastisampurna 08984651866
20
29 19-9-2019 19-9-2019
Tn Abdul Rahman
20
Ny Eni S Kp Raden Kaum ,jatisampurna 2/7 089608658891
28
30 20/9/2019 20/9/2019
Tn Nurdin
26
Ny Rest Jln Cempaka Raya B5 7 No 31 004/001 Jatisampurna
29
31 21/9/2019 085714458835 21/9/2019
Tn Singgieh
27
Ny Dahlia Milenia Kp Payangan RT 7/6 Kelurahan Jatisari ,jati asih
19
32 23/9/2019 0895322268125 23/9/2019
Tn Riyan Hidayat
20
Ny Raesa Jln Bakti No 155 RT 2/4 Jatisampurna
28
33 23/9/2019 23/9/2019
Tn Adhi Candra
29
Ny Sally Juanita Jln Kebantenan RT 1/6,jati asih 089689468181
36
34 23/9/2019 23/9/2019
Tn Sikirno
49
Ny Misna Jln Raya Hankam No 10 rt 5/5 Jati Melati, Pd Melati
37
35 23/9/2019 0821113354741 23/9/2019
Tn Faldy
30
Ny.Ria Setya.n jl sepakat 3 Rt 02/01Cilangkap.cipayungjaktim
39
36 24/9/2019 081294712320, 24/9/2019
Tn.Sukirno
42
NY.Hadijah jl raya hankam bulok Rt 01/06 jatimurni.pondok melati
34
37 25/9/2019 08577608745 25/9/2019
Tn.Walyuliadi
34
Ny.Qurrota A YUN Griya mitra cibubur blok D2 jatiranggon ,jatisampurna
21
38 25/9/2019 081288024076 25/9/2019
Tn.Rendy
26
Ny.Yuliana kp.baNkan sukatani 1 TAPOS,depok RT 02/04
28
39 25/9/2019 081317976056 25/9/2019
Tn.Atoni .s.
29
Ny.Maryam JL H SIUN Rt 04/05 ceger,cipayung jaktim ,
31
40 26/9/2019 081581156324 26/9/2019
 JL H SIUN Rt 04/05 ceger,cipayung jaktim ,
40 26/9/2019 081581156324 26/9/2019
Tn.Rainal Henny
34
Ny.Yuli astut komp.asabri 99 neman rt 03/06 jatiasih 081280238899
42
41 26/9/2019 26/9/2019
Tn.Sigit Purnomo
54
Ny.Lenny marlina jl.kramat lontar 2 Rt 19/01 jakpus 085723184922
42
42 26/9/2019 26/9/2019
Tn.M Bahrul ulum
49
Ny Heri H Jln Mess AL rt 3RW 5 Jati raden Jati sampurna
32
43 26/9/2019 081382358945 26/9/2019
Tn Rayadi
37
Ny Kessy Jln Swadaya I No 80 RT 1/6 Jatisampurna-Bekasi
20
44 27/9/2019 081295183921 27/9/2019
Tn M Miral C
21
Ny Wiwi W Jatiwarna, Bulak Tinggi rt 001/003 Jatiwarna-
28
45 27/9/2019 Jatisampurna 081316064370 27/9/2019
Tn Anggi
29
Ny Tri Haryant Jln Masjid Al Ikhlas RT 4/2 Bekasi Kp Rawa
34
46 27/9/2019 Bacan,jati asih no 64 081316064370 27/9/2019
Tn Zaenal Abidin
36
Ny Zulma Jln Raya Pd Ranggon,jaktim 081218665831
24
47 27/9/2019 27/9/2019
Tn Epan
28
Ny Nur Ajijah Nur Hikmah RT2/3 Pd Melati 085780843963
27
48 28/9/2019 28/9/2019
Tn Saiful
27
Ny Liana Jln Pangkalan RT 1/9 No 38 083891603197
24
49 29/9/2019 29/9/2019
Tn Aris
28
Ny Nurami Cluster Madani Jatiasih 082111233233
36
50 29/9/2019 29/9/2019
Tn Rahmat
38
Ny Sit S Jln Swadaya II Cimanggis -Depok
51
51 29/9/2019 29/9/2019
Tn Endrik
52
Ny Nahrum Jln LEMBUR 1 rt 1/4 Jati rangga Jatisampurna
23
52 29/9/2019 085781664423 29/9/2019
Tn Dede
21
Ny Ika Safitri Pondok melati kp.sawah rt 4 rw 2 pdk melati bekasi
19
53 1/10/2019 jt.warna 0813.1608.4307 1/10/2019
Tn Febri Yansyah
20
Ny Marlin Jl.Nurbaya 1 No. 18 rt10 rw3 PinangRanti Makasar
28
54 2/10/2019 0852.1735.3724 2/10/2019
Tn Yosephies
30
Ny Donna R Jl. Assafiyah rt 1 rw 3 Cilangkap,jaktim
39
55 3/10/2019 3/10/2019
Tn Amin
49
Ny Tri Wahyuni Perum TNI AU rt 3 rw 5 Jt.Rangga Jt. Sampurna
35
56 3/10/2019 0813.9333.1300 3/10/2019
Tn Ahmad F
36
Ny Ebah H kp. Pedurenan rt 4 rw 11 No. 6 Jati Asih Bekasi
35
57 3/10/2019 0838.8847.380 3/10/2019
Tn Nasim
43
Ny Sit Marpuah Jl. Perum Bekasi Permai blok EA 24 No. 24 rt3 rw 15
36
58 3/10/2019 0822.7676.2291.jatisampurna 3/10/2019
Tn Kambali
37
Ny Desi Nurlita Kranggan Kulon rt5 rw 9 Jt. Raden Jati Jaka Sampurna
26
59 4/10/2019 0818.0587.0479 4/10/2019
Tn Dahlan
27
Ny Endah N Jl. Kranggan B4 No. 19 Rt 3 rw 4,jatisampurna Bekasi
19
60 4/10/2019 0895.3956.32727 4/10/2019
Tn M Dani
22
Ny Yuli Tri S kp. Sawah rt1 rw 4 Jt. Melati pd. Melati 0893.0961 .
34
61 4/10/2019 5182 4/10/2019
Tn Iskandar
34
Ny Melinjda kp. Pabuaran rt 5 rw 1 Jt. Murni Pd. Melati 0858.
25
62 4/10/2019 7145.5006 4/10/2019
Tn Eko Hermawat
29
 Ny. Bella Fitriyani Pasar Kecapi Rt 4 rw 3 No. 23.pondok melati
23
63 4/10/2019 4/10/2019
Tn. Bambang R
25
Ny. Oktavia Lestari Jl. Pasar Kecapi No. 16 Rt 2 Rw 18 Pdk Melati Bekasi
32
64 4/10/2019 0878.3869. 7250 4/10/2019
Tn. Stupa Agung
23
Ny. Ni Putu Peni Permata Kranggan Cibubur Jln Permata VII No. 9
31
65 5/10/2019 0812.8771. 1503,jatisampurna 5/10/2019
Tn. M Nuruz Z
35
Ny. Yuli Indriyant Jl. Ketela Raya Komp Kranggan Permai No. 32 rt 1
27
66 5/10/2019 Rw 4 0815. 1153. 8474,jatisampurna 5/10/2019
Tn. Handoko
34
Ny. Sant Kp. Kranggan rt 2 rw 7 Jati Sampurna 0818. 0614.
34
67 5/10/2019 4545 5/10/2019
Tn. Namin
34
Ny. Yunita Jl. Mess Al Gg.Sadar 2 Rt 02 rw 2,jatisampurna Bekasi
39
68 7/10/2019 7/10/2019
Tn. Ridwan
32
Ny. Elvi Oktavia Jl Swadaya III Rt4 Rw 8 Jati Ranggon,jatisampurna
41
69 7/10/2019 0812.8473.8403 7/10/2019
Tn. Ach Firdaus
41
Ny. Irawat Pangkalan No. 125 Rt 8 Rw 4 Cipayung ,jaktim 0813.
35
70 7/10/2019 1442.8108 7/10/2019
Tn. Sudarman
Ny. Dewi astri P Ceger Jakarta Timur
30
71 7/10/2019 7/10/2019
Tn. Angga
Ny. Liana dewi Jl. Swadaya II rt3 Rw 8 Jati Ranggon Jati Sampurna
23
72 8/10/2019 0896.1132.3227 8/10/2019
Tn. Asmala D
30
Ny. Ani Sutanah Jl. Murni 1 Rw 3 0818. 6538.02,pondok melati
39
73 8/10/2019 8/10/2019
Tn. Rafiq
41
Ny. Fitriana Kp. Sawah gg Matri Rt 4 Rw 1,pondok melati
19
74 8/10/2019 8/10/2019

Ny. Nurani N Jl. Perum Taman Lagura Blok 3 No. 3 Rt 5 Rw

28
75 8/10/2019 2,jatismapurna 8/10/2019
Tn. Agung G
32
Ny. Kisca Tambunan Jl. Kelapa Dua wetan No. 1 Rt 2 Rw 1 0813.6165.
34
76 8/10/2019 2523,jatisampurna 8/10/2019
Tn. Freddi S
Ny. Nurhayat Jl. Qomariyah Rt 2 Rw 3 No. 2 Jati Murni,pondok
34
77 8/10/2019 melati 0858.1154.0019 8/10/2019
Tn. Ary A
36
Ny. Sisca Eka N Komplek Bapenas RI Blok 37 Jati Sampurna Bekasi
30
78 9/10/2019 0858.4004.2986 9/10/2019
Tn. Ida Sofyan
30
Ny. Ika Restu S Perum Wahana Pd Gede Blok 63 No. 2
27
79 9/10/2019 0856.7555.839,jatisampurna 9/10/2019
Tn. Ama S
28
Ny. Puspita HP Jl. Bambu wulung I Rt 3 Rw % No. 31 Bambu Apus
36
80 9/10/2019 Cipayung 0812.9690.7772 9/10/2019
Tn. Nurdianto
40
Ny. Ade Nur Jl. Jati Raden Rt 4 Rw 3,jatisampurna
40
81 9/10/2019 0896.0192.1289 9/10/2019
Tn. Royadi
54
Ny. Ika Mayasari Kp. Milir 12 Kudung Sari Pengasih Kp.DIY
33
82 10/10/2019 0857.4788.8313 10/10/2019
Tn. Triyono
33
Ny. Febrina Rizki Jl. Cempaka No. 67 rt 2 Rw 9 Kranggan Jati Sampurna
28
83 10/10/2019 10/10/2019
Tn. Kuncoro
29
Pondok Ranggon,jaktim rt06 rw04 081314127685
34 Ny.Dian A
84 10/10/2019 10/10/2019
34 Tn.Oloan S
Ny.Mila Suryani Jl.Abdurahman 7B cibubur ciracas jaktim rt05 rw08
32
85 10/10/2019 telp 08561239610 10/10/2019
 Jl.Abdurahman 7B cibubur ciracas jaktim rt05 rw08
85 10/10/2019 telp 08561239610 10/10/2019
Tn.Erwinsyah
36
HATAN BAYI BARU LAHIR DAN NEONATAL (0 - 28 HARI)

BAYI BARU LAHIR NEONATAL

KEADAAN UMUM/ BB PB JENIS PELY YG DI KN 1 KN2 KNKOMPLIKASI
3 NEONATAL
HBO
KOMPLIKASI LAHIR LAHIR BERIKAN< 5 JAM (0-2 hr)
KELAMIN (3-8 hr) (8-28
SAKIT
HR) (dinilai dengan MTBM)

7 8 9 10 11 12 13 14 15 16

3350 48 P VIT K √

3100 47 P VIT K √

2950 48 P VIT K √

3250 47 L VIT K √

3000 48 L VIT K √

3200 47 P VIT K √

2800 46 P VIT K √

2650 46 P VIT K √

3000 47 P VIT K √

3500 48 L VIT K √

3500 49 L VIT K √

3400 49 P VIT K √

3000 47 P VIT K √

3150 50 L VIT K √

2500 47 L VIT K √

3450 49 L VIT K √

3300 50 L VIT K √
3800 50 L VIT K √

3000 48 L VIT K √

3500 49 P VIT K √

2600 45 P VIT K √

3650 50 L VIT K √

3450 49 L VIT K √

3000 45 L VIT K √

3500 48 L VIT K √

4050 48 P VIT K √

2850 46 L VIT K √

3250 45 P VIT K √

3200 48 P VIT K √

1700 42 P VIT K √

3150 47 P VIT K √

3000 47 L VIT K √

3450 47 L VIT K √

2400 44 L VIT K √

3600 48 L VIT K √

3050 47 L VIT K √

3650 46 L VIT K √

4000 51 L VIT K √

2900 49 L VIT K √

2850 46 P VIT K √
2850 46 P VIT K √

3200 47 L VIT K √

3250 48 L VIT K √

4000 48 P VIT K √

2500 46 L VIT K √

2600 46 P VIT K √

2900 48 P VIT K √

2900 46 L VIT K √

2900 48 P VIT K √

3150 48 P VIT K √

2800 48 L VIT K √

3100 47 P VIT K √

2500 46 P VIT K √

2800 48 L VIT K √

2750 48 L VIT K √

3400 49 L VIT K √

2400 44 L VIT K √

3000 47 P VIT K √

3400 48 L VIT K √

4100 49 L VIT K √

3000 49 P VIT K √

2400 44 P VIT K √

3350 46 P VIT K √
3300 48 P VIT K √

3200 48 P VIT K √

3350 47 P VIT K √

3300 50 L VIT K √

2350 47 L VIT K √

2750 46 P VIT K √

3450 47 L VIT K √

3300 49 L VIT K √

2350 44 L
VIT K √
2700 44 P

3350 50 L VIT K √

2500 44 L VIT K √

3100 48 P VIT K √

3500 49 P VIT K √

3100 49 L VIT K √

3200 45 P VIT K √

3000 48 P VIT K √

2700 46 L VIT K √

2900 47 P VIT K √

3000 46 L VIT K √

2850 46 P VIT K √

3150 48 L VIT K √

3250 47 P VIT K √

3300 47 L VIT K √
3300 47 L VIT K √
POLIO

17
 TGL
NO NAMA IBU / SUAMI NO TELFON
KUNJUNGAN

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