PENDATAAN PESERTA BPJS DI WILAYAH KERJA PUSKESMAS AMPENAN

LINGKUNGAN : Sukaraja Timur

RT : 02
NO NAMA KK NAMA ANGGOTA KELUARGA TGL LAHIR NO. BPJS
1 Salwa Khafifa 03-12-2007 0001857765251
2 Marwah Sidqia 24-05-2015 0001857767376
3 Safa Sidala 24-05-2015 0001857766421
4 Rizki Kurniawan Rizki Kurniawan 20-05-1978 0001327021817
5 Sri Anawati 30-07-1984 0001282547351
6 M. Satria Kuriawan 25-05-2008 0001843123689
7 Ibnu Hajar Ibnu Hajar 17-03-1965 0001082648362
8 Muliati 31-12-1974 0001083136453
9 Saifullah Saifullah 31-12-1974 0001058296285
10 Mukminah 29-10-1972 0001058296285
11 Surayya Azizah 34-31-998 0001058296307
12 Nurhadi Nurki Nurhadi Nurki 27-12-1974 0000846747764
13 Rohliana 26-09-1965 0000846748978
14 Safiratui Umroh 28-03-2002 0000846750014
15 Rabiah Rabiah 23-7-1943 0001058303237
16 Wasiah 01-01-1965 0001058303248
17 Mulianah 20-03-1977 0001058303259
18 Ivan Purnama Aji 19-11-1999 0001307677476
19 Ihsan Ihsan 18-07-1940 0000847926944
20 Maini 31-12-1954 0000847927361
21 Husni Tamrin 05-11-1979 0000847927438
22 Erwin 01-06-1980 0000847927708
23 Firman Hadi 28-01-1992 0000847928463
24 Syarif Hiayatullah 01-01-1989 0000847930498
25 Sarifillah Sarifillah 06-01-1953 0000846855909
26 Fatmah 26-03-1969 "000846855933
27 Huswatun 25-10-1993 0000846855966
28 Usro Padli 14-10-1995 0000846856001
29 Khairul Anwar 06-12-2009 0000846856034
30 Mahdan Mahdan 03-09-1971 0000846739563
31 Lilis Ratnaningsih 28-01-1983 0000846739991
32 Iis Maharani 07-02-2002 0000846740182
33 Imas Yuliani 06-08-2011 0000846740351
34 Irpan 31-12-1963 0000846740575
35
PUSKESMAS AMPENAN

HAMIL
NIK
YA TDK
5271014312070003
5271011402090007
5271011402090006
5271012005780006
5271017007840004
5271012505080003
5271011703650004
5271017112740208
5271010108690002
5271016910720001
5271014305940003
5271012712740001
5271016609650001
5271010803020002

5271011808400001
5271017112540078
5271011105790001

5271012801920003

5271010501530001
5271016603690001
5271014510930005
5271011410950003
5271010612090002
5271010903710001
5271016801830001
5271014207020002
5271014806110001
5271017112630053
 PENDATAAN PESERTA BPJS DI WILAYAH KERJA PUSKESMAS AMPENAN
LINGKUNGAN : Sukaraja Timur
RT : 02

NO NAMA KK NAMA ANGGOTA KELUARGA TGL LAHIR NO. BPJS

35 Salmin Salmin 31-12-1940 0000847276312

36 Minim 31-12-1958 0000847277324
37 Muhammad Nurdin Muhammad Nurdin 08-10-1969 0000847114031
38 Nurhiayah 05-02-1986 0000847114064
39 Nabila Saprilia 04-05-2004 0000847114222
40 Almaira Altapunisa 25-06-2009 0000847114301
41 Aiditya Rajatha 06-04-2011 0001919910655
42 Rinasih Rinasih 01-12-1941 0000847173385
43 Kalsum 01-12-1966 0000847173418
44 Muhammad Mali 01-01-1995 0000847173532
45 Irfal
46 Fahmi 07-08-1995 0000847174623
47 Fadila 20-08-2001 0000847174746
48 Asmuliadi Asmuliadi 28-02-1975 0001083046296
49 Sri Ani 01-01-1978 0001083197698
50 Mulia Sulistianda 30-12-1997 0001082994917
51 Andhika Habilah R 15-01-2004 0001082629451
52 Munir Munir 31-12-1957 0000847695936
53 Isroniah 31-12-1967 0000847697409
54 Mulya Ulandari 31-12-1990 0000847697725
55 Ahmad Kuruni 31-12-1992 0000847697782
56 Ilyas 31-12-1996 0000847699896
57 Ridwan 31-12-1999 0000847700188
58 Alfiah 31-121-2001 0000847701292"
59 Lalu Nurdin Lalu Nurdin 31-12-1970 0000847144271
60 Nurasiah 30-09-1986 0000847144754
61 Lalu Rahmat Ardian 07-101999 0000847146003
62 Muniah Muniah 31-12-1962 0000846754762
63 Wahyudi Aprial 28-04-1987 0000848124753
64 Yunita 20-05-1992 0000848124843
65 Multazam 20-04-1995 0000848124909
66 Yulia Isnaini 17-04-1998 0000848125451
67 Liswan Hadi Liswan Hadi 31-12-1988 0001082639395
68 Kusuma Yati 28-08-1992 0001083247828
69 Ferdi Hidayat 10-03-1990 0001083009519
H KERJA PUSKESMAS AMPENAN

HAMIL
NIK
YA TDK
5271013112400036
5271017112580203
5271011008690004
5271014205860004
5271017007840004
5271016506090002

5271010807950003
5271016008010005

5271013112570113
5271017112670109
5271017112900051
5271013112920041
5271013112960036
5271013112990020
5271013112010003
5271013112700178
5271017009860003

5271017112620087
5271012804870002
5271016005920002
5271012004950002
5271015704980002
527101021880001
5271016505920001
5271011003900001
 PENDATAAN PESERTA BPJS DI WILAYAH KERJA PUSKESMAS AMPENAN
LINGKUNGAN : Sukaraja Timur
RT : 02

NO NAMA KK NAMA ANGGOTA KELUARGTGL LAHIR NO. BPJS NIK

70 Hermansyah Hermansyah 5/4/1965 0000846794057 5271010405650005

71 Asni 31-12-1970 0000846794136 5271017112700220
72 Muhamad Rizal 1/9/2002 0000846795532
73 Rizki Silva Ariani 1/6/2008 0000846795903
74 Syariful Anam Syariful Anam 10/10/1953 0000847902183 5271011010530001
75 Muna'ah 2/2/1961 0000847902611 5271014202610001
76 Fitriani 27-08-1979 0000847903127 5271016708790001
78 Tasrif Ziad 29-07-1981 0000847904016 5271012907810001
79 Farid Algifari 28-12-1983 0000847904153 5271012812830001
80 Yasir Lailantara 15-02-1986 0000847905074 5271011502860001
81 Rahma Sabarani 17-07-1988 0000847905074 5271015706880001
82 Thariq Mahsun 15-03-1994 0000847905491 5271011503940001
83 Zulfa Khatami 27-06-2000 0000847905647 5271016706000001
84 Wijan Abdi Wijan Abdi 2/7/1971 0000846743668 5271010207710001
85 Miskanah 14-04-1973 0000846744039 52710115404730001
86 Athil Umri 3/5/1997 0000846744478 5271014305970002
87 Haekal Hairi 8/4/2002 0000846744581 5271010804020001
88 Mala Kamila 22-04-2007 0000846744737 5271013112570113
89 Suparmin Suparmin 15-05-1971 0000846871907 5271011505710003
90 Mardiana 5/12/1973 0000846871931 5271014512730001
91 Amenah 31-12-1943 0001232843804 5271017112430121
92 Rizal Nuramdani 2/4/1992 5271010204920001
93 Muuhamad Mazkur Muhama Mazkur 1/1/1961 0000846845908 5271010101610005
94 Siti khaidijah 26-02-1981 0000846845932 5271016602810001
95 Manzulina 16-09-2000 0000846845965 5271015609000002
96 Nazril Mazhadi 14-11-2009 0000846845998 5271011411090002
97 Mohdar Mohdar 31-12-1952 0000846893463 5271013112520104
98 Darmatasiah 31-12-1958 0000846893507 5271017112580174
99 Hayatul Fikri 17-0-1979 0000846893542 5271011708790006
100 Rasyi Rasyid 31-12-1963 0001232843758 5271013112630010
101 Sahrial Hikmi Sahrial Hikmi 21-05-1986 0002056277755 5271012105860001
102 Ulis Ismiati 29-12-1981 0002056278025 5271016912810001
103 Arazi Nuzawa. A 17-12-2014 0002056278172 5271011712120004
104 Lisna Sidqi Lisna Sidqi 24-09-1979 0001857764474 5271012409790004
105 Marianah 12/6/1977 0001383313419 5271015206770004
AMPENAN

HAMIL
YA TDK
 PENDATAAN PESERTA BPJS DI WILAYAH KERJA PUSKESMAS AMPENAN
LINGKUNGAN : Sukaraja Timur
RT : 01

NO NAMA KK NAMA ANGGOTA KELUARGA TGL LAHIR NO. BPJS

1 Maesarah Maesarah 1/5/1969 0000847228274

2 Salmah 6/2/1960 0000846696352
3 Mulianisa 1/8/2004 0000846696633
4 Muhamad Hanapi Muhamad Hanapi 22-06-1966 000084847569712
5 Zainiah 6/5/1971 0000847570498
6 Nurrapriani 4/4/1989 0000847570601
7 Wahyu Risma S 7/2/1997 0000847570779
8 Marwiyah 31/12/1953 0000847570904
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
32
33
34
35
ERJA PUSKESMAS AMPENAN

HAMIL
NIK
YA TDK
5271014105690004
5271014602600001
5271014108040001
5271012206660001
5271014605710003
5271014404890001
5271010702970002
5271017112530019
 PENDATAAN PESERTA BPJS DI WILAYAH KERJA PUSKESMAS AMPENAN
LINGKUNGAN : Sukaraja Timur
RT : 03

NO NAMA KK NAMA ANGGOTA KELUARGA TGL LAHIR NO. BPJS

1 Baharudin Dania Baharudin Dania 12/1/1978 0002073968289

2 Idayati 8/11/1984 0002073968785
3 Cahaya Azzahra RM 30/07/2011 0000847114031
4 Sopyan Hadi Sopyan Hadi 1/4/1977 0000848005817
5 Nurul Hidayati 15-04-1980 0000848006133
6 Adriani 10/8/2000 0000848006291
7 Ismawanda Febrianti 2/12/2009 0000848007641
8 M. Anan sahdheli M. Anan Sahdheli 11/12/1999 0001291957301
9 Harianto Harianto 31/08/1984 0000848195212
10 Munawarah 31-12-1984 0000848196606
11 Qinanti Hawari 11/3/2011 0000848197934
12 Selamet Riadi Selamet Riadi 25-12-1979 0000846868869
13 Junaeda 18-01-1979 0000846868904
14 Farras Umairil 30-06-2008 0000846868948
15 Auliya Humaira 5/10/2009 0000846868983
16 Mulyadi Mulyadi 15-081986 0001058301358
17 Saminah Saminah 13-071953 0000848146318
18 Rohana Rohana 21-10-1973 0001083582213
19 Dinita Arianti 28-05-1997 0001083172285
20 Riyan Ariyanto 17-03-1995 0001082615872
21 Andi Basri Andi Basri 31-12-1957 0000846754154
22 Muniah 31-12-1966 0000846754762
23 Andi Bagas Para 1/12/2006 0000846755559
24 Ramli Ramli 30-06-1959 0000846796318
25 Imlah 21-03-1973 0000846797319
26 Muhamad Jaka YT 1/3/1995 0000846797591
27 Muhamad Haekal YR 13-07-1997 0000846798041
28 Ragil Yudis Arsuwandi 29-03-2000 0000846799187
29 Imelda maulina R 17-05-2002 0000846799196
30 Lara Cantika Ramli 23-06-2010 0000846799751
31 Ilham Ilham 5/5/1960 0000846801011
32 B. Kartisni B. Kartisni 16-08-1952 0001232843679
33 Muhsan Muhsan 31-12-1956 0000846710976
34 Faridah 7/5/1962 0000846711663
35 Nurman Nuurman 31-12-1970 0000847769501
RJA PUSKESMAS AMPENAN

HAMIL
NIK
YA TDK
"5271011201780002
5271014811840002
5271017007110003
5271011604770004
5271015504800004
5271014810000003
5271015202090003
5271011112990004
5271013108840002
5271017112860056
5271015103110001
5271012512790003
5271015801790001
5271013006080003
5271014510090001
5271011508860002
5271015307530001
5271016210730003
5271016805970002
5271016210730003
5271013112570129
5271017112660140
5271010802020001
5271013006590001
5271016103730003
5271011303950001
5271011307970001
5271012903000001
52710157050200002
5271016306100002
5271010505600002
5271015608520001
5271013112560031
52710145076200005
5271017112700005
 PENDATAAN PESERTA BPJS DI WILAYAH KERJA PUSKESMAS AMPENAN
LINGKUNGAN : Sukaraja Timur
RT : 03

NO NAMA KK NAMA ANGGOTA KELUARGA TGL LAHIR NO. BPJS NIK

36 Helmy 31-12-1993 0000846711933 5271013112930010

37 Noviana Sari 28-03-1998 0000847769567 5271016803980001
38 Andi Arya Kusuma. W 30/12/2000 0002016727356
39 Anisa Aprilia 28-11-2002 0000846713261 5271016811020001
40 Nabila Ramadani 15-10-2005 0000846714071 5271015610050002
41 Aldo Firmansyah 1/10/2010 0000846716117
42 Saipudin Saipudin 000084829102
43 Habibah 0001058297804 5271017112740079
44 Tapsir 0001058297826 5271010810990002
45 Rohmah Sakina 8/11/2013 0001082627526 5271014811040000
46 Sahril Andika 1/10/2012 0001082912016 5271011001120000
47 Supardi Supardi 19-11-1985 0000846721663 5271011911850001
48 Marah 1/12/1991 0000846722542
49 Sis Munaroh 18-12-2014 0001580051061 5271015811140002
50 Nurul Hamdi Nurul Hamdi 25-06-1968 0001083197946 5271012506680000
51 Amnah 31-12-1974 0001083078551 5271017112740093
52 Gandi Rian Utama 31-12-1994 0001082655022 5271012706940003
53 Indra Gunawan 31-12-1995 0001082616467 5271012511950003
54 Tejaman Mulki 31-12-1998 0001082626323 5271011904980002
55 Widya Rida Ika. P 31-12-2005 0001082650072 5271015510040001
56 Tiara Zuraida 21-06-2008 0001082962574 5271016106080004
MPENAN

HAMIL
YA TDK
 PENDATAAN PESERTA BPJS DI WILAYAH KERJA PUSKESMAS AMPENAN
LINGKUNGAN : Sukaraja Timur
RT : 04

NO NAMA KK NAMA ANGGOTA KELUARGA TGL LAHIR NO. BPJS NIK

1 Aisyah Aisyah 31-12-1947 "0000846697274 5271017112470007

2 Abdul Rahman 21-10-1969 0000846997656 5271012110690001
3 Nurhidayati Nurhiayati 31-12-1979 0000846697948 5271016812760004
4 Juni Harianto 10/6/1993 0000846698038 5271011006830003
5 Lola Hidyawati 17-10-1996 0000846698253 5271015710960002
6 Masirah Masirah 30-12-1974 0000847500541 5271017012740008
7 Juniansyah 27-06-1992 0000847502313 5271012706920001
8 Janiatul Asmah 14-01-2001 0000847503279 5271015401010001
9 Saridah Saridah 31-12-1970 0000847499758 527101711270004
10 Febriansyah 28-02-1992 0000847502122 52710128029200002
11 Sri Wahyuni 18-02-1996 0000847502943 5271015802960003
12 M. Syaiful Rahman 4/5/2005 0000847503516 5271010405050002
13 Sahabudin Siti Huswatun Hasanah 16-02-1993 0001082904644 5271015602930006
14 Megawati 3/5/1995 0001082834594 5271014306950002
15 M. Agus Sulaeman A 17-08-1997 0001082883036 5271011708970006
16 Puji Hartati 22-02-2002 00010822616131 5271016202030003
17 Ratmilah Ratmilah 17-08-1971 0000847559171 5271011708710005
18 Darminah 20-07-1977 0000847559316 5271016007770002
19 Driantama 29-04-1996 0000847559362 5271012904960003
20 Mira Ardani 2/3/2002 0000847559766 5271014203020003
21 Suherman Suherman 25-05-1979 0000847359652 5271012505790007
22 Sofyani 5/7/1978 0000847360157 5271014507780001
23 Anisa Afifa 1/5/2009 0000847360282 5271016405090003
24 Abul Hamid. S Wati Nurhayati 3/10/1970 0001083584441 5271014310700003
25 Dwi Indah Lestari 13-12-1997 0001082649082 5271015312970001
26 Muhamad Rizki M 13-04-2005 0001082601821 5271011304050003
27 Isah Sahri Isah Sahri 1/7/1940 0001232843826 527101410700011
28 Darmah Darmah 1/1/1976 0000847566246 5271015212650003
29 Misnah Misnah 1/12/1941 0000846669183 5271017112568002
30 Syamsudin Syamsudin 17-03-1976 0000846665111 5271011703760001
31 Suryani 16-03-1977 0000846665686 52710115603770005
32 Wahyu Hidayatullah 7/7/1997 0000846665717 5271014707970002
33 Imam Suryadi S 18-10-2007 0000846665875 5271011818270001
34 Alifa Kirana A 5/2/2016 0002079676258 52710114502160001
35 Sopyan Hadi Sopyan Hadi 8/9/1989 0000846796926 5271010809890002
MPENAN

HAMIL
YA TDK

029200002

603770005

502160001
 PENDATAAN PESERTA BPJS DI WILAYAH KERJA PUSKESMAS AMPENAN
LINGKUNGAN : Sukaraja Timur
RT : 04

NO NAMA KK NAMA ANGGOTA KELUARGA TGL LAHIR NO. BPJS NIK

36 Muhamad Muksin Muhama Muksin 12/12/1945 0000846796385 5271011212450002

37 Aisah M 4/12/1962 0000846795508 5271014412620001
38 Enung Enung 25-11-1993 0001058296138 5271016511750001
39 Muhamad Nurhadi 27-11-1993 0001058296149 5271012711930002
40 Asep. M. firdaus 15-08-2000 0001058296151 5271011508000003
41 Husen Husen 11/7/1964 000084817979 5271011107640001
42 Nurianik 4/4/1973 0000848172881 5271014403730002
43 Fitriana 3/4/1992 0000848173419 5271014304920002
44 Fahrizal Ramadan 27-01-1997 0000848176659 5271012701970006
45 Yulastri 20-04-1993 0000848174218 5271016004930001
46 Zainal Abidin Zainal Abidin 18-02-1996 0000846730607 5271010901700003
47 Hadijah 2/6/1973 0000846731024 5271014206730001
48 Inda Hadila 20-01-2008 0000846731564 5271016001080002
49 Indi Ulmi 25-09-2009 0000846732442 5271016509090002
50 Hadi Syamsul Hadi Syamsul 12/1/1980 0000846802732 527101120180001
51 Fatma 10/12/1982 00008468004025 5271015012820008
52 Firli Adinata 4/10/2008 0000846804328 5271010410080001
53 Ismail Maenah 5/5/1976 0000847566977 5271014509760004
54 Syarif 31-03-1998 0000847567541 5271013103980002
55 Yunita Sari 13-04-2002 0000847568507 527101530420004
56 Abdillah Abdillah 17-11-1964 0000847328736 5271011711640001
57 Ramyah 1/1/1961 0000847328769 5271015203660000
58 Elyas Suryana 3/1/1995 0000847330075 5271010301960001
59 Asep Agus Suryana 3/8/1996 0000847330288 5271010308960001
60 Syahri Syahri 31-12-1938 0000847563928 5271013112380004
61 Fatimah 4/4/1996 0000847564154 5271014404660001
62 Junaedi 1/1/1991 0000847564738 5271010101910001
63 Amroni Amroni 13-02-1990 0001579316668 3471141302900001
64 Sri Apriliana 29-04-1996 0000847503213 5271016904960006
65 Rugian Hadianto Idayani 12/2/1990 0000847564299 5271015202900001
66 Ardiansyah Ardiansyah 1/1/1974 0000847749442 5271012304710003
67 Suparman Suparman 15-09-1960 0000847564839 527101311265034
68 Mislah 6/1/1970 0000847564874 5271014501700003
69 Heni Rosa 11/1/2006 0000847566212 5271015101060001
70 Ferdi Aditya 1/4/2011 0000847565324 5271010404110000
AMPENAN

HAMIL
YA TDK
 PENDATAAN PESERTA BPJS DI WILAYAH KERJA PUSKESMAS AMPENAN
LINGKUNGAN : Sukaraja Timur
RT : 04

NO NAMA KK NAMA ANGGOTA KELUARGA TGL LAHIR NO. BPJS NIK

71 Azmil Azmil 20-10-1971 0000846793012 "5271012010710001

72 Nurjanah 12/1/1969 0000846793912 5271015201690004
73 Ali Akbar 1/1/2009 0000846794812 5271010101090002
74 Sapilah Sapilah 31-08-1945 0000846751127 5271017108450003
75 Mustinah Mustinah 20-11-1965 0000846622091 5271016011650003
76 Supatmi 26-06-1991 0000846622271 5271016606910003
77 Darli Nurifan 12/6/1993 0000846622506 5271011206930001
78 Ami Oktarina 21-10-1997 0000846623801 5271016110970001
79 Haerani Haerani 28-101968 0001082607478 5271016810680002
80 Kharunisa 3/5/2000 0001083104651 5271014305000001
81 Haekal Rizal 25-12-2005 0001082607772 5271012512050002
82 M. Anwar M. Anwar 4/3/1955 0001427471469 5271010403550001
83 M. Kholik M. Kholik 5/5/1982 0001791057723 5271010505820001
84 Irni Nazira 22-05-1987 0001424715467 5271016205870001
85 Adila Saysafira 17-11-2009 0001791059005 5271015711090001
86 Mustadim Akbar Mustadim Akbar 7/2/1986 0001793195368 5271010702860002
87 Yuli Dhaniana 20-06-1988 0001793193085 5271016006880001
88 Mirza Raditya P 27-06-2010 0001793197135 52710122706100001
89 M. Ali Dafiah Sulianti 1/12/1998 0000846726208 2350034505000005
90 Keyam. Inaq Keyam . Inaq 31-12-1943 0001232843714
91 Lalu Wiraja Lalu Wiraja 31-12-1954 000145987795 5271013112580050
92 Sartini 31-12-1998 000145987806 5271017112590066
93 BQ. Ratnawati 22-02-1990 0001296901034 5271016202900001
94 Galih Syahbani 22-07-2010 0001296901462
95 Suratman
96 Yuni Al hikmah 30-06-1979 0001578926452 5271017006790002
97 Ade zhurya. O 22-10-2007 0001895983363 5271012210070003
98 Rizki Maulana H 1/5/2001 0000847568957 5271010905110002
99 H. Suaeb H. Suaeb 2/3/1954 0002044816356 5271012603540002
100 Hj. Rumaenah 30-08-1956 0002044816964 5271017008560001
31
32
33
34
35
MPENAN

HAMIL
YA TDK

706100001