NO.RES. ORDINAT KEL. LING. RT RW NO.RMH NO.KLG Alamat N. KK Ʃ KLG ƩWNC >15 10 - 54 th 12 - 59 bl 0 - 11 bl SAB Sbr.SAB JAMB. Jns.

0 - 11 bl SAB Sbr.SAB JAMB. Jns.JAMB SKIZO OBT.SKIZO PASUNG

1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23
3 2 1 1 GEDOR BUSAHWAN 3 2 3 2 0 0 1 1 1 1 2 2
3 2 2 2 GEDOR FAUZI 4 2 2 3 0 0 1 1 1 1 2 2
3 2 3 3 GEDOR JAMIAH 2 2 2 1 0 0 1 1 1 1 2 2
3 2 4 4 GEDOR PARTO 3 2 2 2 1 0 1 1 1 1 2 2
3 2 5 5 GEDOR SAPERIK 4 2 3 3 1 0 1 1 1 1 2 2
3 2 6 6 GEDOR SAMSUL HADI 3 2 2 2 1 0 1 1 1 1 2 2
3 2 7 7 GEDOR SAMAH 2 2 2 0 0 0 1 1 1 1 2 2
3 2 8 8 GEDOR DIDIK SUSANTO 2 2 2 2 0 0 1 1 1 1 2 2
3 2 9 9 GEDOR GELAR PUJA D 3 2 2 2 1 0 1 1 1 1 2 2
3 2 10 10 GEDOR SUJIONO 4 2 3 4 0 0 1 1 1 1 2 2
3 2 11 11 GEDOR M SALIM 5 5 1 5 0 0 1 1 1 1 2 2 2
3 2 12 12 GEDOR ASMORA 3 3 1 3 0 0 1 1 1 1 2 2 2
3 2 13 13 GEDOR SUNADIYO 1 1 0 1 0 0 1 1 1 1 2 2 2
3 2 14 14 GEDOR SUASMAWI 2 2 0 2 0 0 1 1 1 1 2 2 2
3 2 15 15 GEDOR SUTRISNO 3 3 0 3 0 0 1 1 1 1 2 2 2
3 2 16 16 GEDOR KARHOSI 4 4 2 4 0 0 1 1 1 1 2 2 2
3 2 17 17 GEDOR MULYADI 4 4 1 3 0 0 1 1 1 1 2 2 2
3 2 18 18 GEDOR SAINA 1 1 0 0 0 0 1 1 1 1 2 2 2
3 2 19 19 GEDOR MUNITO 4 4 1 3 0 0 1 1 1 1 2 2 2
3 2 20 20 GEDOR MARYANTO 2 2 0 2 0 0 1 1 1 1 2 2 2
3 2 21 21 GEDOR USNAH 3 3 3 3 0 0 1 1 1 1 2 2 2
3 2 22 22 GEDOR AHMAD MUSTOFA 2 2 2 2 0 0 1 1 1 1 2 2 2
3 2 23 23 GEDOR IRFAN HIDAYAT 3 2 2 2 0 1 1 1 1 1 2 2 2
3 2 24 24 GEDOR SUROSOK 3 2 2 2 1 0 1 1 1 1 2 2 2
3 2 25 25 GEDOR RAHMAT HIDAYAT 3 2 2 2 0 0 1 1 1 1 2 2 2
3 2 26 26 GEDOR DAWAH 3 2 2 3 0 0 1 1 1 1 2 2 2
3 2 27 27 GEDOR MATSARI 2 2 2 2 0 0 1 1 1 1 2 2 2
3 2 28 28 GEDOR SANARI 1 1 0 0 0 0 1 1 1 1 2 2 2
3 2 29 29 GEDOR IKROMULLAH 3 2 0 0 0 0 1 1 1 1 2 2 2
3 2 30 30 GEDOR SAHRI 2 2 0 0 0 0 1 1 1 1 2 2 2
3 2 31 31 GEDOR SAIFUL 1 1 0 0 0 0 1 1 1 1 2 2 2
 HUBUNGAN JENIS
NO NAMA TANGGAL LAHIR UMUR
KLG KELAMIN

1 2 3 4 5 6
1 BUSAHWAN 1 12/24/1955 62 1
2 SAINATUN 2 7/29/1970 47 2
3 MARSICA S 3 8/28/2003 14 2
1 FAUZI 1 6/26/1981 36 1
2 RIRIN 2 3/23/1988 29 2
3 KEYSHA 3 2/5/2007 10 2
4 DARMA 3 6/19/2010 7 1
1 JAMIAH 1 2/7/1968 51 1
2 ASMAH 2 6/30/1955 62 2
1 PARTO 1 8/2/1978 39 1
2 ISWATI 2 3/5/1977 40 2
3 RIZKI 3 5/3/2012 5 1
1 SAPERIK 1 1/30/1969 49 1
2 SUMIATI 2 3/4/1975 32 2
3 MUJIYANTO 3 8/8/2003 14 1
4 RIZKI WIDAYANTO 3 4/10/2012 5 1
1 SYAMSUL HADI 1 8/1/1986 31 1
2 NUR KHOLISAH 2 6/12/1998 19 2
3 ANDIKA HADI 3 6/29/2014 3 1
1 SAMAH 1 2/11/1948 69 1
2 RUSMINAH 2 9/15/1951 66 2
1 DIDIK SUSANTO 1 2/11/1985 32 1
2 MAULIDA FITRIYA 2 10/21/1995 22 2
1 GELAR PUJA D 1 1/18/1986 31 1
2 RIAN MARYANA 2 7/27/1985 32 2
3 GINZHA AURORA 3 4/25/2012 5 2
1 SUJONO 1 7/1/1977 40 1
2 NUR HENI 2 7/1/1982 35 2
3 SITI HAJAR 3 7/1/2002 15 2
4 APALIA 3 4/15/2007 10 2
1 M SALIM 1 6/30/1975 42 1
2 USRINI 2 8/14/1976 41 2
3 LIDIYAWATI 3 7/8/1997 20 2
4 M DIYANTO 3 4/15/2001 16 1
5 NURUL FITRIYANI 3 7/7/2016 12 2
1 ASMORA 1 7/1/1945 72 1
2 SATOHA 2 7/1/1958 49 2
3 DWI SISCA 5 5/21/2007 10 2
1 SUNADIYO 1 6/16/1950 67 1
1 SUASMAWI 1 6/6/1963 54 1
2 SUMENA 2 5/30/1978 39 2
1 SUTRISNO 1 10/3/1964 53 1
2 DWI SUHARTINI 2 10/3/1964 46 2
3 AGIC DESTI FAUZIA 3 12/16/1996 21 2
1 KARHOSI 1 7/5/1974 43 1
2 SUMARBIYAH 2 7/30/1975 42 2
3 M IRAWAN 3 5/17/2004 13 1
4 PUTRI DESY 3 12/1/2006 11 2
1 MULYADI 1 4/2/1982 35 1
2 SRIWATI 2 8/20/1983 34 2
3 IRFAN 3 4/10/2000 17 1
4 SINTA 3 9/15/2008 9 2
1 SAINA 1 7/1/1945 72 2
1 MUNITO 1 2/10/1980 37 1
2 HUSNUL 2 8/15/1983 34 2
3 M HARIYADI 3 3/10/2002 15 1
4 DWI AYU 3 4/12/2011 6 2
1 MARYANTO 1 1/30/1974 43 1
2 NESWATI 2 6/12/1974 43 2
1 USNAH 1 6/30/1957 60 1
2 MISYATI 2 12/12/1965 52 2
3 HARIYANTO 3 9/19/1985 32 1
1 AHMAD MUSTOFA 1 3/10/1957 60 1
2 MARYATI 2 11/27/1963 53 2
1 IRFAN HIDAYAT 1 1/24/1989 28 1
2 HIDAYATUS SHOLIHAH 2 11/20/1989 28 2
3 DEVIN 3 10/14/2016 1 1
1 SUROSOK 1 6/30/1953 64 1
2 MURAHMI 2 4/20/1949 68 2
3 SHINTIA 3 10/7/2010 7 2
1 RAHMAT HIDAYAT 1 7/6/1986 31 1
2 ROWIYAH 3 6/30/1993 25 2
3 RERA INDA 3 2/24/2012 5 2
1 DAWAH 1 9/16/1965 52 1
2 WATINI 2 7/7/1970 47 2
3 HALIMATUS 3 10/1/2007 10 2
1 MATSARI 1 5/3/1963 54 1
2 ASNAYAH 2 5/21/1971 46 2
1 SANARI 1 9/28/1985 32 1
1 IKROMULLAH 1 6/26/1994 24 1
2 NURAZIZAH 2 6/9/1996 22 2
3 AZKA ZAKYAH 3 8/11/2016 13 1
1 SAHRI 1 3/5/1952 65 1
2 SULAINAH 2 5/23/1957 60 2
1 SAIFUL 1 6/16/1991 27 1
 SEDANGA
ANGGOTA
HAMIL
STATUS ANGGOTA KELUARGA KELUARGA NOMOR PESERTA
(KHUSUS AGAMA
PERKAWINAN > 5 TH PENDIDIKAN USIA > 10 TH JKN
WANITA 10-54
PEKERJAAN
TH

7 8 9 10 11 12
1 1 3 5 0
1 2 1 3 5 0
2 1 3 2 0
1 1 3 5 0
1 2 1 4 1 0
2 1 2 2 0
2 1 2 2 0
1 1 3 6 0
1 1 3 6 0
1 1 3 5 0
1 2 1 3 5 0
2 1 1 0 0
1 1 3 6 0
1 2 1 4 1 0
2 1 4 2 0
2 1 0 0 0
1 1 3 4 0
1 2 1 4 1 0
2 1 0 0 0
1 1 3 6 0000701370369
1 1 3 6 0000701371664
1 1 4 7 0
1 2 1 3 1 0
1 1 4 4 0001969274002
1 2 1 4 1 0001969274259
2 1 0 0 0001969274632
1 1 3 5 0
1 2 1 3 1 0
2 2 1 4 2 0
2 1 2 2 0
1 1 3 6 0001280244857
1 2 1 3 1 0
2 2 1 5 1 0
2 1 4 2 0001280245792
2 2 1 2 2 0
1 1 3 6 0
1 2 1 3 1 0
2 2 1 2 2 0
4 1 2 8 0
1 1 3 6 0
1 2 1 3 1 0
1 1 5 5 0
1 2 1 5 5 0
2 1 5 2 0
1 1 3 8 0
1 2 1 3 6 0
2 1 3 2 0
2 2 1 2 2 0
1 1 3 6 0
1 2 1 3 6 0
2 1 3 2 0
2 1 2 2 0
4 1 1 6 0
1 1 1 5 0
1 2 1 3 1 0
2 1 4 2 0
2 1 1 0 0
1 1 3 8 0
1 2 1 3 1 0
1 0 1 3 8 0
1 2 1 3 8 0
2 0 1 3 8 0
1 0 1 3 6 0
1 0 1 3 1 0
1 0 1 5 3 0
1 2 1 4 3 0
2 0 1 1 1 0
1 0 1 3 8 00001040878776
1 2 1 3 8 00001040878787
2 0 1 2 2 0
4 0 1 3 8 0
2 2 1 3 1 0
2 0 1 1 1 0
1 0 1 3 8 0
1 2 1 3 8 0
2 2 1 2 2 0
1 0 1 3 8 0
1 2 1 3 1 0
3 0 1 3 8 0
1 0 1 4 8 0
1 2 1 5 1 0
2 0 1 2 2 0
1 0 1 2 8 0
1 2 1 2 1 0
3 0 1 3 8 0
PROV. KABUPATEN KECAMATAN KODE PKM KELURAHAN RW RT

1 2 3 4 5 6 7
2 3
2 3
2 3
2 3
2 3
2 3
2 3
2 3
2 3
2 3
2 3
2 3
2 3
2 3
2 3
2 3
2 3
2 3
2 3
2 3
2 3
2 3
2 3
2 3
2 3
2 3
2 3
2 3
2 3
2 3
2 3
2 3
2 3
2 3
2 3
2 3
2 3
2 3
2 3
2 3
2 3
2 3
2 3
2 3
2 3
2 3
2 3
2 3
2 3
2 3
2 3
2 3
2 3
2 3
2 3
2 3
2 3
2 3
2 3
2 3
2 3
2 3
2 3
2 3
2 3
2 3
2 3
2 3
2 3
2 3
2 3
2 3
2 3
2 3
2 3
2 3
2 3
2 3
2 3
2 3
2 3
2 3
2 3
2 3
2 3
 NO.URUT
URUT
URUT KLG NAMA ANGGOTA NIK TGL PULDAT USIA
RUMAH
KLG
8 9 10 11 12 13 14
1 1 BUSAHWAN 1 3510212412550002 10/3/2017 62
1 1 SAINATUN 2 3510216907700003 10/3/2017 47
1 1 MARSICA S 3 3510216808030004 10/3/2017 14
2 2 FAUZI 1 3510212606610004 10/3/2017 36
2 2 RIRIN 2 3510216303880003 10/3/2017 29
2 2 KEYSHA 3 3510214502070005 10/3/2017 10
2 2 DARMA 4 3510211906100002 10/3/2017 7
3 3 JAMIAH 1 3510210702680005 10/3/2017 51
3 3 ASMAH 2 3510217006550156 10/3/2017 62
4 4 PARTO 1 3510210208780004 10/3/2017 39
4 4 ISWATI 2 3510214503770004 10/3/2017 40
4 4 RIZKI 3 3510210305120003 10/3/2017 5
5 5 SAPERIK 1 3510213001690005 10/3/2017 49
5 5 SUMIATI 2 3510214403750001 10/3/2017 32
5 5 MUJIYANTO 3 3510210808030004 10/3/2017 14
5 5 RIZKI WIDAYANTO 4 3510211004120002 10/3/2017 5
6 6 SYAMSUL HADI 1 3510210108860003 10/3/2017 31
6 6 NUR KHOLISAH 2 3510215206980004 10/3/2017 19
6 6 ANDIKA HADI 3 9999999999999999 10/3/2017 3
7 7 SAMAH 1 3510211102480005 10/3/2017 69
7 7 RUSMINAH 2 3510215509510002 10/3/2017 66
8 8 DIDIK SUSANTO 1 3510181102850003 10/3/2017 32
8 8 MAULIDA FITRIYA 2 3510215001960001 10/3/2017 22
9 9 GELAR PUJA D 1 3578071801860002 10/3/2017 31
9 9 RIAN MARYANA 2 3510216707850003 10/3/2017 32
9 9 GINZHA AURORA 3 3578076504120003 10/3/2017 5
10 10 SUJONO 1 3510210107770009 10/3/2017 40
10 10 NUR HENI 2 3510214107820007 10/3/2017 35
10 10 SITI HAJAR 3 9999999999999999 10/3/2017 15
10 10 APALIA 4 9999999999999999 10/3/2017 10
11 11 M SALIM 1 3510213006750092 10/3/2017 42
11 11 KUSRINI 2 3510215408760005 10/3/2017 41
11 11 LIDYAWATI 3 9999999999999999 10/3/2017 20
11 11 M DIYANTO 4 3510211504010004 10/3/2017 16
11 11 NURUL FITRIANI 5 9999999999999999 10/3/2017 12
12 12 ASMORA 1 3510210107450002 10/3/2017 72
12 12 SATONA 2 3510214107580008 10/3/2017 47
12 12 DWI SISCA 3 3510216105070004 10/3/2017 10
13 13 SUNADIYO 1 9999999999999999 10/3/2017 67
14 14 SUASMAWI 1 9999999999999999 10/3/2017 54
14 14 SUMENA 2 3510217005780005 10/3/2017 39
15 15 SUTRISNO 1 3510210310640002 10/3/2017 53
15 15 DWI SUHARTINI 2 3510216402700003 10/3/2017 46
15 15 AGIC DESTI FAUZIA 3 3510215612940002 10/3/2017 21
16 16 KARHOSI 1 3510210502740006 10/3/2017 43
16 16 SUMARBIYAH 2 3510217007750002 10/3/2017 42
16 16 M IRAWAN 3 3510211705040003 10/3/2017 13
16 16 PUTRI DESY 4 9999999999999999 10/3/2017 11
17 17 MULYADI 1 9999999999999999 10/3/2017 35
17 17 SRIWATI 2 3510216008830008 10/3/2017 34
17 17 IRFAN 3 3510211004000003 10/3/2017 17
17 17 SINTA 4 3510266090800004 10/3/2017 9
18 18 SAINA 1 3510214107450042 10/3/2017 72
19 19 MUNITO 1 3510211002800005 10/3/2017 37
19 19 HUSNUL 2 3510215508830014 10/3/2017 34
19 19 M HARIYADI 3 3510211003020002 10/3/2017 15
19 19 DWI AYU 4 9999999999999999 10/3/2017 6
20 20 MARYANTO 1 3510211006680008 10/3/2017 43
20 20 NESWATI 2 3510214107780114 10/3/2017 43
21 21 USNAH 1 3510213006570119 10/3/2017 60
21 21 MISYATI 2 3510215212650011 10/3/2017 52
21 21 HARIYANTO 3 3510211909850005 10/3/2017 32
22 22 AHMAD MUSTOFA 1 3510211003570003 10/3/2017 60
22 22 MARYATI 2 3510216711630002 10/3/2017 53
23 23 IRFAN HIDAYAT 1 3171012401890003 10/3/2017 28
23 23 HIDAYATUS SHOLIHAH 2 3510216011890003 10/3/2017 28
23 23 DEVIN 3 3510211410160001 10/3/2017 1
24 24 SUROSOK 1 3510213006530124 10/3/2017 64
24 24 MURAHMI 2 3510215200620007 10/3/2017 68
24 24 SHINTIA 3 351021471010006 10/3/2017 7
25 25 RAHMAT HIDAYAT 1 3510210607860006 10/3/2017 31
25 25 ROWIYAH 2 3510217006930011 10/3/2017 25
25 25 RERA INDA 3 3510216402120001 10/3/2017 5
26 26 DAWAH 1 3510211609650002 10/3/2017 52
26 26 WATINI 2 3510214704700004 10/3/2017 47
26 26 HALIMATUS 3 3510214110070003 10/3/2017 10
27 27 MATSARI 1 3510210305630001 10/3/2017 54
27 27 ASNAYAH 2 3510216105710002 10/3/2017 46
28 28 SANARI 1 3510212809850003 10/3/2017 32
29 29 IKROMULLAH 1 3510212606940002 10/3/2017 24
29 29 NURAZIZAH 2 3510214107950008 10/3/2017 22
29 29 AZKA ZAKYAH 3 3510215108160001 10/3/2017 13
30 30 SAHRI 1 3510210503620000 10/3/2017 65
30 30 SULAINAH 2 3510216305570002 10/3/2017 60
31 31 SAIFUL 1 3510211606910002 10/3/2017 27
KEPEMILIK BATUK > 2
MEROKOK BAB AIR BERSIH DX. TB TX. TB TD TX. TD UKU TD
AN JKN mgg.

15 16 17 18 19 20 21 22 23 24
2 1 1 1 2 2 2 2 2 1
2 2 1 1 2 2 2 1 1 1
2 2 1 1 2 2 2 2 2 1
2 1 1 1 2 2 2 2 2 1
2 2 1 1 2 2 2 2 2 1
2 2 1 1 2 2 2 2 2 2
2 2 1 1 2 2 2 2 2 2
2 1 1 1 2 2 2 2 2 1
2 2 1 1 2 2 2 2 2 1
2 1 1 1 2 2 2 2 2 1
2 2 1 1 2 2 2 2 2 1
2 2 1 1 2 2 2 2 2 2
2 1 1 1 2 2 2 2 2 1
2 2 1 1 2 2 2 2 2 1
2 2 1 1 2 2 2 2 2 0
2 2 1 1 2 2 2 2 2 0
2 1 1 1 2 2 2 2 2 1
2 2 1 1 2 2 2 2 2 1
2 2 1 1 2 2 2 2 2 0
1 1 1 1 2 2 2 1 2 1
1 2 1 1 2 2 2 1 2 1
2 1 1 1 2 2 2 2 2 1
2 2 1 1 2 2 2 2 2 1
1 1 1 1 2 2 2 2 2 1
1 2 1 1 2 2 2 2 2 1
1 2 1 1 2 2 2 2 2 2
2 1 1 1 2 2 2 2 2 1
2 2 1 1 2 2 2 2 2 1
2 2 1 1 2 2 2 2 2 2
2 2 1 1 2 2 2 2 2 2
1 1 1 1 2 2 2 2 2 1
2 2 1 1 2 2 2 2 2 1
2 2 1 1 2 2 2 2 2 1
1 2 1 1 2 2 2 2 2 1
2 2 1 1 2 2 2 2 2 1
2 2 1 1 2 2 2 2 2 1
2 2 1 1 2 2 2 2 2 1
2 2 1 1 2 2 2 2 2 2
2 2 1 1 2 2 2 2 2 1
2 2 1 1 2 2 2 2 2 1
2 2 1 1 2 2 2 2 2 1
2 1 1 1 2 2 2 2 2 1
2 2 1 1 2 2 2 2 2 1
2 2 1 1 2 2 2 2 2 1
2 1 1 1 2 2 2 2 2 1
2 2 1 1 2 2 2 2 2 1
2 2 1 1 2 2 2 2 2 1
2 2 1 1 2 2 2 2 2 1
2 1 1 1 2 2 2 2 2 1
2 2 1 1 2 2 2 2 2 1
2 2 1 1 2 2 2 2 2 1
2 2 1 1 2 2 2 2 2 2
2 2 1 1 2 2 2 1 1 1
2 1 1 1 2 2 2 2 2 1
2 2 1 1 2 2 2 2 2 1
2 2 1 1 2 2 2 2 2 1
2 2 1 1 2 2 2 2 2 2
2 1 1 1 2 2 2 2 2 1
2 2 1 1 2 2 2 2 2 1
0 1 1 1 2 2 2 1 2 1
0 2 1 1 2 2 2 2 2 1
0 1 1 1 2 2 2 2 2 1
0 2 1 1 2 2 2 2 2 1
0 2 1 1 2 2 2 1 1 1
0 2 1 1 2 2 2 2 2 1
0 2 1 1 2 2 2 2 2 1
0 2 1 1 2 2 2 2 2 2
1 1 1 1 2 2 2 2 2 1
1 2 1 1 2 2 2 2 2 1
0 2 1 1 2 2 2 2 2 2
0 1 1 1 2 2 2 2 2 1
0 2 1 1 2 2 2 2 2 1
0 2 1 1 2 2 2 2 2 2
0 1 1 1 2 2 2 2 2 1
0 2 1 1 2 2 2 2 2 1
0 2 1 1 2 2 2 2 2 2
0 1 1 1 2 2 2 2 2 1
0 2 1 1 2 2 2 2 2 1
0 1 1 1 2 2 2 2 2 1
0 1 1 1 2 2 2 2 2 1
0 2 1 1 2 2 2 2 2 1
0 2 1 1 2 2 2 2 2 2
0 1 1 1 2 2 2 1 2 1
0 2 1 1 2 2 2 1 2 1
0 1 1 1 2 2 2 2 2 1
SIST. DIAST. KONTRS. LINAKES ASI EKLS. IMUN TUMBANG

25 26 27 28 29 30 31
110 70 2 0 0 0 0
150 90 1 0 0 0 0
100 60 0 0 0 0 0
120 70 2 0 0 0 0
110 60 1 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
110 60 2 0 0 0 0
100 70 2 0 0 0 0
110 80 2 0 0 0 0
100 60 1 0 0 0 0
0 0 0 0 0 0 0
120 80 2 0 0 0 0
110 60 1 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
100 60 0 0 0 0 0
120 80 0 0 0 0 0
0 0 0 0 0 0 0
160 100 2 0 0 0 0
140 90 2 0 0 0 0
90 60 2 0 0 0 0
90 60 1 0 0 0 0
100 60 2 0 0 0 0
120 70 1 0 0 0 0
0 0 0 0 0 0 1
120 80 2 0 0 0 0
110 80 1 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
100 70 2 0 0 0 0
120 80 1 0 0 0 0
100 60 0 0 0 0 0
120 70 0 0 0 0 0
100 60 0 0 0 0 0
100 70 2 0 0 0 0
100 70 1 0 0 0 0
0 0 0 0 0 0 0
90 60 0 0 0 0 0
120 80 2 0 0 0 0
120 80 1 0 0 0 0
100 60 2 0 0 0 0
100 70 1 0 0 0 0
120 80 0 0 0 0 0
120 80 2 0 0 0 0
110 70 1 0 0 0 0
100 70 0 0 0 0 0
120 80 0 0 0 0 0
110 70 2 0 0 0 0
120 80 1 0 0 0 0
100 70 0 0 0 0 0
0 0 0 0 0 0 0
180 100 0 0 0 0 0
120 80 2 0 0 0 0
120 110 1 0 0 0 0
110 70 0 0 0 0 0
0 0 0 0 0 0 0
100 70 1 0 0 0 0
120 80 2 0 0 0 0
150 90 2 0 0 0 0
120 60 2 0 0 0 0
120 70 2 0 0 0 0
120 70 2 0 0 0 0
160 90 2 0 0 0 0
120 70 2 0 0 0 0
120 70 1 0 0 0 0
0 0 0 0 1 1 1
120 80 2 0 0 0 0
120 80 1 0 0 0 0
0 0 0 0 0 0 0
120 70 0 0 0 0 0
120 70 0 0 0 0 0
0 0 0 0 0 0 0
110 70 0 0 0 0 0
110 70 0 0 0 0 0
0 0 0 0 0 0 0
120 70 0 0 0 0 0
120 70 0 0 0 0 0
120 70 0 0 0 0 0
120 70 0 0 0 0 0
110 70 0 0 0 0 0
0 0 0 0 0 0 0
150 90 0 0 0 0 0
130 80 0 0 0 0 0
120 80 0 0 0 0 0
 KABUPATE KECAMATA KELURAHA URUT
PROV. KODE PKM RW RT URUT KLG NAMA
N N N RUMAH

1 2 3 4 5 6 7 8 9 10
2 3 1 1 BUSAHWAN
2 3 1 1 SAINATUN
2 3 1 1 MARSICA S
2 3 2 2 FAUZI
2 3 2 2 RIRIN
2 3 2 2 KEYSHA
2 3 2 2 DARMA
2 3 3 3 JAMIAH
2 3 3 3 ASMAH
2 3 4 4 PARTO
2 3 4 4 ISWATI
2 3 4 4 RIZKI
2 3 5 5 SAPERIK
2 3 5 5 SUMIATI
2 3 5 5 MUJIYANTO
2 3 5 5 RIZKI WIDAYANTO
2 3 6 6 SYAMSUL HADI
2 3 6 6 NUR KHOLISAH
2 3 6 6 ANDIKA HADI
2 3 7 7 SAMAH
2 3 7 7 RUSMINAH
2 3 8 8 DIDIK SUSANTO
2 3 8 8 MAULIDA FITRIYA
2 3 9 9 GELAR PUJA D
2 3 9 9 RIAN MARYANA
2 3 9 9 GINZHA AURORA
2 3 10 10 SUJONO
2 3 10 10 NUR HENI
2 3 10 10 SITI HAJAR
2 3 10 10 APALIA
2 3 11 11 M SALIM
2 3 11 11 KUSRINI
2 3 11 11 LIDYAWATI
2 3 11 11 M DIYANTO
2 3 11 11 NURUL FITRIANI
2 3 12 12 ASMORA
2 3 12 12 SATONA
2 3 12 12 DWI SISCA
2 3 13 13 SUNADIYO
2 3 14 14 SUASMAWI
2 3 14 14 SUMENA
2 3 15 15 SUTRISNO
2 3 15 15 DWI SUHARTINI
2 3 15 15 AGIC DESTI FAUZIA
2 3 16 16 KARHOSI
2 3 16 16 SUMARBIYAH
2 3 16 16 M IRAWAN
2 3 16 16 PUTRI DESY
2 3 17 17 MULYADI
2 3 17 17 SRIWATI
2 3 17 17 IRFAN
2 3 17 17 SINTA
2 3 18 18 SAINA
2 3 19 19 MUNITO
2 3 19 19 HUSNUL
2 3 19 19 M HARIYADI
2 3 19 19 DWI AYU
2 3 20 20 MARYANTO
2 3 20 20 NESWATI
2 3 21 21 USNAH
2 3 21 21 MISYATI
2 3 21 21 HARIYANTO
2 3 22 22 AHMAD MUSTOFA
2 3 22 22 MARYATI
2 3 23 23 IRFAN HIDAYAT
2 3 23 23
HIDAYATUS SHOLIHAH
2 3 23 23 DEVIN
2 3 24 24 SUROSOK
2 3 24 24 MURAHMI
2 3 24 24 SHINTIA
2 3 25 25 RAHMAT HIDAYAT
2 3 25 25 ROWIYAH
2 3 25 25 RERA INDA
2 3 26 26 DAWAH
2 3 26 26 WATINI
2 3 26 26 HALIMATUS
2 3 27 27 MATSARI
2 3 27 27 ASNAYAH
2 3 28 28 SANARI
2 3 29 29 IKROMULLAH
2 3 29 29 NURAZIZAH
2 3 29 29 AZKA ZAKYAH
2 3 30 30 SAHRI
2 3 30 30 SULAINAH
2 3 31 31 SAIFUL
NO.URUT
TGL KEPEMILIK
ANGGOTA NIK USIA MEROKOK BAB AIR BERSIH DX. TB TX. TB
PULDAT AN JKN
KLG
11 12 13 14 15 16 17 18 19 20
1 3510212412550002### 62 2 1 1 1 2 2
2 3510216907700003### 47 2 2 1 1 2 2
3 3510216808030004### 14 2 2 1 1 2 2
1 3510212606610004### 36 2 1 1 1 2 2
2 3510216303880003### 29 2 2 1 1 2 2
3 3510214502070005### 10 2 2 1 1 2 2
4 3510211906100002### 7 2 2 1 1 2 2
1 3510210702680005### 51 2 1 1 1 2 2
2 3510217006550156### 62 2 2 1 1 2 2
1 3510210208780004### 39 2 1 1 1 2 2
2 3510214503770004### 40 2 2 1 1 2 2
3 3510210305120003### 5 2 2 1 1 2 2
1 3510213001690005### 49 2 1 1 1 2 2
2 3510214403750001### 32 2 2 1 1 2 2
3 3510210808030004### 14 2 2 1 1 2 2
4 3510211004120002### 5 2 2 1 1 2 2
1 3510210108860003### 31 2 1 1 1 2 2
2 3510215206980004### 19 2 2 1 1 2 2
3 9999999999999999### 3 2 2 1 1 2 2
1 3510211102480005### 69 1 1 1 1 2 2
2 3510215509510002### 66 1 2 1 1 2 2
1 3510181102850003### 32 2 1 1 1 2 2
2 3510215001960001### 22 2 2 1 1 2 2
1 3578071801860002### 31 1 1 1 1 2 2
2 3510216707850003### 32 1 2 1 1 2 2
3 3578076504120003### 5 1 2 1 1 2 2
1 3510210107770009### 40 2 1 1 1 2 2
2 3510214107820007### 35 2 2 1 1 2 2
3 9999999999999999### 15 2 2 1 1 2 2
4 9999999999999999### 10 2 2 1 1 2 2
1 3510213006750092### 42 1 1 1 1 2 2
2 3510215408760005### 41 2 2 1 1 2 2
3 9999999999999999### 20 2 2 1 1 2 2
4 3510211504010004### 16 1 2 1 1 2 2
5 9999999999999999### 12 2 2 1 1 2 2
1 3510210107450002### 72 2 2 1 1 2 2
2 3510214107580008### 47 2 2 1 1 2 2
3 3510216105070004### 10 2 2 1 1 2 2
1 9999999999999999### 67 2 2 1 1 2 2
1 9999999999999999### 54 2 2 1 1 2 2
2 3510217005780005### 39 2 2 1 1 2 2
1 3510210310640002### 53 2 1 1 1 2 2
2 3510216402700003### 46 2 2 1 1 2 2
3 3510215612940002### 21 2 2 1 1 2 2
1 3510210502740006### 43 2 1 1 1 2 2
2 3510217007750002### 42 2 2 1 1 2 2
3 3510211705040003### 13 2 2 1 1 2 2
4 9999999999999999### 11 2 2 1 1 2 2
1 9999999999999999### 35 2 1 1 1 2 2
2 3510216008830008### 34 2 2 1 1 2 2
3 3510211004000003### 17 2 2 1 1 2 2
4 3510266090800004### 9 2 2 1 1 2 2
1 3510214107450042### 72 2 2 1 1 2 2
1 3510211002800005### 37 2 1 1 1 2 2
2 3510215508830014### 34 2 2 1 1 2 2
3 3510211003020002### 15 2 2 1 1 2 2
4 9999999999999999### 6 2 2 1 1 2 2
1 3510211006680008### 43 2 1 1 1 2 2
2 3510214107780114### 43 2 2 1 1 2 2
1 3510213006570119### 60 0 1 1 1 2 2
2 3510215212650011### 52 0 2 1 1 2 2
3 3510211909850005### 32 0 1 1 1 2 2
1 3510211003570003### 60 0 2 1 1 2 2
2 3510216711630002### 53 0 2 1 1 2 2
1 3171012401890003### 28 0 2 1 1 2 2
2 3510216011890003### 28 0 2 1 1 2 2
3 3510211410160001### 1 0 2 1 1 2 2
1 3510213006530124### 64 1 1 1 1 2 2
2 3510215200620007### 68 1 2 1 1 2 2
3 351021471010006### 7 0 2 1 1 2 2
1 3510210607860006### 31 0 1 1 1 2 2
2 3510217006930011### 25 0 2 1 1 2 2
3 3510216402120001### 5 0 2 1 1 2 2
1 3510211609650002### 52 0 1 1 1 2 2
2 3510214704700004### 47 0 2 1 1 2 2
3 3510214110070003### 10 0 2 1 1 2 2
1 3510210305630001### 54 0 1 1 1 2 2
2 3510216105710002### 46 0 2 1 1 2 2
1 3510212809850003### 32 0 1 1 1 2 2
1 3510212606940002### 24 0 1 1 1 2 2
2 3510214107950008### 22 0 2 1 1 2 2
3 3510215108160001### 13 0 2 1 1 2 2
1 3510210503620000### 65 0 1 1 1 2 2
2 3510216305570002### 60 0 2 1 1 2 2
1 3510211606910002### 27 0 1 1 1 2 2
BATUK > 2
TD TX. TD UKU TD SIST. DIAST. KONTRS. LINAKES ASI EKLS. IMUN
mgg.

21 22 23 24 25 26 27 28 29 30
2 1 1 1 150 90 1 0 0 0
2 1 1 1 150 90 1 0 0 0
2 2 2 1 100 60 0 0 0 0
2 2 2 1 120 70 1 0 0 0
2 2 2 1 110 60 1 0 0 0
2 2 2 2 0 0 0 0 0 0
2 2 2 2 0 0 0 0 0 0
2 2 2 1 110 60 0 0 0 0
2 2 2 1 100 70 2 0 0 0
2 2 2 1 110 80 1 0 0 0
2 2 2 1 100 60 1 0 0 0
2 2 2 2 0 0 0 0 0 0
2 2 2 1 120 80 1 0 0 0
2 2 2 1 110 60 1 0 0 0
2 2 2 0 0 0 0 0 0 0
2 2 2 0 0 0 0 0 0 0
2 2 2 1 100 60 2 0 0 0
2 2 2 1 120 80 0 0 0 0
2 2 2 0 0 0 0 0 0 0
2 1 2 1 160 100 0 0 0 0
2 1 2 1 140 90 2 0 0 0
2 2 2 1 90 60 1 0 0 0
2 2 2 1 90 60 1 0 0 0
2 2 2 1 100 60 1 0 0 0
2 2 2 1 120 70 1 0 0 0
2 2 2 2 0 0 0 0 0 0
2 2 2 1 120 80 1 0 0 0
2 2 2 1 110 80 1 0 0 0
2 2 2 2 0 0 0 0 0 0
2 2 2 2 0 0 0 0 0 0
2 2 2 1 100 70 1 0 0 0
2 2 2 1 120 80 1 0 0 0
2 2 2 1 100 60 0 0 0 0
2 2 2 1 120 70 0 0 0 0
2 2 2 1 100 60 0 0 0 0
2 2 2 1 100 70 1 0 0 0
2 2 2 1 100 70 1 0 0 0
2 2 2 2 0 0 0 0 0 0
2 2 2 1 90 60 0 0 0 0
2 2 2 1 120 80 1 0 0 0
2 2 2 1 120 80 1 0 0 0
2 2 2 1 100 60 1 0 0 0
2 2 2 1 100 70 1 0 0 0
2 2 2 1 120 80 0 0 0 0
2 2 2 1 120 80 1 0 0 0
2 2 2 1 110 70 1 0 0 0
2 2 2 1 100 70 0 0 0 0
2 2 2 1 120 80 0 0 0 0
2 2 2 1 110 70 1 0 0 0
2 2 2 1 120 80 1 0 0 0
2 2 2 1 100 70 0 0 0 0
2 2 2 2 0 0 0 0 0 0
2 1 1 1 180 100 0 0 0 0
2 2 2 1 120 80 1 0 0 0
2 2 2 1 120 110 1 0 0 0
2 2 2 1 110 70 0 0 0 0
2 2 2 2 0 0 0 0 0 0
2 2 2 1 100 70 1 0 0 0
2 2 2 1 120 80 2 0 0 0
2 1 2 1 150 90 2 0 0 0
2 2 2 1 120 60 2 0 0 0
2 2 2 1 120 70 2 0 0 0
2 1 1 1 160 90 2 0 0 0
2 1 1 1 160 90 2 0 0 0
2 2 2 1 120 70 1 0 1 1
2 2 2 1 120 70 1 0 0 0
2 2 2 2 0 0 0 0 1 1
2 2 2 1 120 80 1 0 0 0
2 2 2 1 120 80 1 0 0 0
2 2 2 2 0 0 0 0 0 0
2 2 2 1 120 70 0 0 0 0
2 2 2 1 120 70 0 0 0 0
2 2 2 2 0 0 0 0 0 0
2 2 2 1 110 70 0 0 0 0
2 2 2 1 110 70 0 0 0 0
2 2 2 2 0 0 0 0 0 0
2 2 2 1 120 70 0 0 0 0
2 2 2 1 120 70 0 0 0 0
2 2 2 1 120 70 0 0 0 0
2 2 2 1 120 70 0 0 0 0
2 2 2 1 110 70 0 0 0 0
2 2 2 2 0 0 0 0 0 0
2 1 2 1 150 90 0 0 0 0
2 1 2 1 130 80 0 0 0 0
2 2 2 1 120 80 0 0 0 0
TUMBANG

31
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
1
0
1
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
1
0
1
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
 KABUPATE KECAMATA KELURAHA URUT
PROV. KODE PKM RW RT URUT KLG NAMA
N N N RUMAH

1 2 3 4 5 6 7 8 9 10
2 3 1 1 BUSAHWAN
2 3 2 2 FAUZI
2 3 3 3 JAMIAH
2 3 4 4 PARTO
2 3 5 5 SAPERIK
2 3 6 6 SYAMSUL HADI
2 3 7 7 SAMAH
2 3 8 8 DIDIK SUSANTO
2 3 9 9 GELAR PUJA D
2 3 10 10 SUJONO
2 3 11 11 M SALIM
2 3 12 12 ASMORA
2 3 13 13 SUNADIYO
2 3 14 14 SUASMAWI
2 3 15 15 SUTRISNO
2 3 16 16 KARHOSI
2 3 17 17 MULYADI
2 3 18 18 SAINA
2 3 19 19 MUNITO
2 3 20 20 MARYANTO
2 3 21 21 USNAH
2 3 22 22 AHMAD MUSTOFA
2 3 23 23 IRFAN HIDAYAT
2 3 24 24 SUROSOK
2 3 25 25 RAHMAT HIDAYAT
2 3 26 26 DAWAH
2 3 27 27 MATSARI
2 3 28 28 SANARI
2 3 29 29 IKROMULLAH
2 3 30 30 SAHRI
2 3 31 31 SAIFUL
NO.URUT
KEPEMILIK
ANGGOTA NIK TGL PULDAT USIA MEROKOK BAB AIR BERSIH DX. TB TX. TB
AN JKN
KLG
11 12 13 14 15 16 17 18 19 20
1 3510212412550002
10/3/2017 62 2 1 1 1 2 2
1 3510212606610004
10/3/2017 36 2 1 1 1 2 2
1 3510210702680005
10/3/2017 51 2 1 1 1 2 2
1 3510210208780004
10/3/2017 39 2 1 1 1 2 2
1 3510213001690005
10/3/2017 49 2 1 1 1 2 2
1 3510210108860003
10/3/2017 31 2 1 1 1 2 2
1 3510211102480005
10/3/2017 69 1 1 1 1 2 2
1 3510181102850003
10/3/2017 32 2 1 1 1 2 2
1 3578071801860002
10/3/2017 31 1 1 1 1 2 2
1 3510210107770009
10/3/2017 40 2 1 1 1 2 2
1 3510213006750092
10/3/2017 42 1 1 1 1 2 2
1 3510210107450002
10/3/2017 72 2 2 1 1 2 2
1 9999999999999999
10/3/2017 67 2 2 1 1 2 2
1 9999999999999999
10/3/2017 54 2 2 1 1 2 2
1 3510210310640002
10/3/2017 53 2 1 1 1 2 2
1 3510210502740006
10/3/2017 43 2 1 1 1 2 2
1 9999999999999999
10/3/2017 35 2 1 1 1 2 2
1 3510214107450042
10/3/2017 72 2 2 1 1 2 2
1 3510211002800005
10/3/2017 37 2 1 1 1 2 2
1 3510211006680008
10/3/2017 43 2 1 1 1 2 2
1 3510213006570119
10/3/2017 60 0 1 1 1 2 2
1 3510211003570003
10/3/2017 60 0 2 1 1 2 2
1 3171012401890003
10/3/2017 28 0 2 1 1 2 2
1 3510213006530124
10/3/2017 64 1 1 1 1 2 2
1 3510210607860006
10/3/2017 31 0 1 1 1 2 2
1 3510211609650002
10/3/2017 52 0 1 1 1 2 2
1 3510210305630001
10/3/2017 54 0 1 1 1 2 2
1 3510212809850003
10/3/2017 32 0 1 1 1 2 2
1 3510212606940002
10/3/2017 24 0 1 1 1 2 2
1 3510210503620000
10/3/2017 65 0 1 1 1 2 2
1 3510211606910002
10/3/2017 27 0 1 1 1 2 2
BATUK > 2
TD TX. TD UKU TD SIST. DIAST. KONTRS. LINAKES ASI EKLS. IMUN
mgg.

21 22 23 24 25 26 27 28 29 30
2 1 1 1 150 90 1 0 0 0
2 2 2 1 120 70 1 0 0 0
2 2 2 1 110 60 0 0 0 0
2 2 2 1 110 80 1 0 0 0
2 2 2 1 120 80 1 0 0 0
2 2 2 1 100 60 2 0 0 0
2 1 2 1 160 100 0 0 0 0
2 2 2 1 90 60 1 0 0 0
2 2 2 1 100 60 1 0 0 0
2 2 2 1 120 80 1 0 0 0
2 2 2 1 100 70 1 0 0 0
2 2 2 1 100 70 1 0 0 0
2 2 2 1 90 60 0 0 0 0
2 2 2 1 120 80 1 0 0 0
2 2 2 1 100 60 1 0 0 0
2 2 2 1 120 80 1 0 0 0
2 2 2 1 110 70 1 0 0 0
2 1 1 1 180 100 0 0 0 0
2 2 2 1 120 80 1 0 0 0
2 2 2 1 100 70 1 0 0 0
2 1 2 1 150 90 2 0 0 0
2 1 1 1 160 90 2 0 0 0
2 2 2 1 120 70 1 0 1 1
2 2 2 1 120 80 1 0 0 0
2 2 2 1 120 70 0 0 0 0
2 2 2 1 110 70 0 0 0 0
2 2 2 1 120 70 0 0 0 0
2 2 2 1 120 70 0 0 0 0
2 2 2 1 120 70 0 0 0 0
2 1 2 1 150 90 0 0 0 0
2 2 2 1 120 80 0 0 0 0
TUMBANG

31
0
0
0
0
0
0
0
0
1
0
0
0
0
0
0
0
0
0
0
0
0
0
1
0
0
0
0
0
0
0
0
NO.RES. ORDINAT KEL. LING. RT RW NO.RMH NO.KLG Alamat N. KK
1 2 3 4 5 6 7 8 9 10
3 2 1 1 GEDOR BUSAHWAN
3 2 2 2 GEDOR FAUZI
3 2 3 3 GEDOR JAMIAH
3 2 4 4 GEDOR PARTO
3 2 5 5 GEDOR SAPERIK
3 2 6 6 GEDOR SAMSUL HADI
3 2 7 7 GEDOR SAMAH
3 2 8 8 GEDORDIDIK SUSANTO
3 2 9 9 GEDOR GELAR PUJA D
3 2 10 10 GEDOR SUJIONO
3 2 11 11 GEDOR M SALIM
3 2 12 12 GEDOR ASMORA
3 2 13 13 GEDOR SUNADIYO
3 2 14 14 GEDOR SUASMAWI
3 2 15 15 GEDOR SUTRISNO
3 2 16 16 GEDOR KARHOSI
3 2 17 17 GEDOR MULYADI
3 2 18 18 GEDOR SAINA
3 2 19 19 GEDOR MUNITO
3 2 20 20 GEDOR MARYANTO
3 2 21 21 GEDOR USNAH
3 2 22 22 GEDORAHMAD MUSTOFA
3 2 23 23 GEDORIRFAN HIDAYAT
3 2 24 24 GEDOR SUROSOK
3 2 25 25 GEDORRAHMAT HIDAYAT
3 2 26 26 GEDOR DAWAH
3 2 27 27 GEDOR MATSARI
3 2 28 28 GEDOR SANARI
3 2 29 29 GEDOR IKROMULLAH
3 2 30 30 GEDOR SAHRI
3 2 31 31 GEDOR SAIFUL
Ʃ KLG ƩWNC >15 10 - 54 th 12 - 59 bl 0 - 11 bl SAB Sbr.SAB AIR BERSIH KES SAB

11 12 13 14 15 16 17 18 18
3 2 3 2 0 0 1 1 1 1
4 2 2 3 0 0 1 1 1 1
2 2 2 1 0 0 1 1 1 1
3 2 2 2 1 0 1 1 1 1
4 2 3 3 1 0 1 1 1 1
3 2 2 2 1 0 1 1 1 1
2 2 2 0 0 0 1 1 1 1
2 2 2 2 0 0 1 1 1 1
3 2 2 2 1 0 1 1 1 1
4 2 3 4 0 0 1 1 1 1
5 5 1 5 0 0 1 1 1 1
3 3 1 3 0 0 1 1 1 1
1 1 0 1 0 0 1 1 1 1
2 2 0 2 0 0 1 1 1 1
3 3 0 3 0 0 1 1 1 1
4 4 2 4 0 0 1 1 1 1
4 4 1 3 0 0 1 1 1 1
1 1 0 0 0 0 1 1 1 1
4 4 1 3 0 0 1 1 1 1
2 2 0 2 0 0 1 1 1 1
3 3 3 3 0 0 1 1 1 1
2 2 2 2 0 0 1 1 1 1
3 2 2 2 0 1 1 1 1 1
3 2 2 2 1 0 1 1 1 1
3 2 2 2 0 0 1 1 1 1
3 2 2 3 0 0 1 1 1 1
2 2 2 2 0 0 1 1 1 1
1 1 0 0 0 0 1 1 1 1
3 2 0 0 0 0 1 1 1 1
2 2 0 0 0 0 1 1 1 1
1 1 0 0 0 0 1 1 1 1
 KES KEPEMILIK
JAMB. Jns.JAMB BAB SKIZO OBT.SKIZO PASUNG KES SKIZO KES JKN
JAMBAN AN JKN
19 20 17 21 22 23 15
1 1 1 1 2 2 2 N 2 0
1 1 1 1 2 2 2 N 2 0
1 1 1 1 2 2 2 N 2 0
1 1 1 1 2 2 2 N 2 0
1 1 1 1 2 2 2 N 2 0
1 1 1 1 2 2 2 N 2 0
1 1 1 1 2 2 2 N 1 1
1 1 1 1 2 2 2 N 2 0
1 1 1 1 2 2 2 N 1 1
1 1 1 1 2 2 2 N 2 0
1 1 1 1 2 2 2 N 1 1
1 1 1 1 2 2 2 N 2 0
1 1 1 1 2 2 2 N 2 0
1 1 1 1 2 2 2 N 2 0
1 1 1 1 2 2 2 N 2 0
1 1 1 1 2 2 2 N 2 0
1 1 1 1 2 2 2 N 2 0
1 1 1 1 2 2 2 N 2 0
1 1 1 1 2 2 2 N 2 0
1 1 1 1 2 2 2 N 2 0
1 1 1 1 2 2 2 N 2 0
1 1 1 1 2 2 2 N 2 0
1 1 1 1 2 2 2 N 2 0
1 1 1 1 2 2 2 N 1 1
1 1 1 1 2 2 2 N 2 0
1 1 1 1 2 2 2 N 2 0
1 1 1 1 2 2 2 N 2 0
1 1 1 1 2 2 2 N 2 0
1 1 1 1 2 2 2 N 2 0
1 1 1 1 2 2 2 N 2 0
1 1 1 1 2 2 2 N 2 0
 KES BATUK > 2
MEROKOK DX. TB TX. TB KES TB TD TX. TD UKU TD SIST.
ROKOK mgg.
16 19 20 21 22 23 24 25
1 0 2 2 2 N 1 1 1 150
1 0 2 2 2 N 2 2 1 120
1 0 2 2 2 N 2 2 1 110
1 0 2 2 2 N 2 2 1 110
1 0 2 2 2 N 2 2 1 120
1 0 2 2 2 N 2 2 1 100
1 0 2 2 2 N 1 2 1 160
1 0 2 2 2 N 2 2 1 90
1 0 2 2 2 N 2 2 1 100
1 0 2 2 2 N 2 2 1 120
1 0 2 2 2 N 2 2 1 100
2 1 2 2 2 N 2 2 1 100
2 1 2 2 2 N 2 2 1 90
2 1 2 2 2 N 2 2 1 120
1 0 2 2 2 N 2 2 1 100
1 0 2 2 2 N 2 2 1 120
1 0 2 2 2 N 2 2 1 110
2 1 2 2 2 N 1 1 1 180
1 0 2 2 2 N 2 2 1 120
1 0 2 2 2 N 2 2 1 100
1 0 2 2 2 N 1 2 1 150
2 1 2 2 2 N 1 1 1 160
2 1 2 2 2 N 2 2 1 120
1 0 2 2 2 N 2 2 1 120
1 0 2 2 2 N 2 2 1 120
1 0 2 2 2 N 2 2 1 110
1 0 2 2 2 N 2 2 1 120
1 0 2 2 2 N 2 2 1 120
1 0 2 2 2 N 2 2 1 120
1 0 2 2 2 N 1 1 1 150
1 0 2 2 2 N 2 2 1 120
 KES
DIAST. KES TD KONTRS. KES KB LINAKES ASI EKLS. KES ASI IMUN KES IMUN
LINAKES
26 27 28 29 30
90 1 1 1 0 N 0 N 0 N
70 N 1 1 0 N 0 N 0 N
60 N 0 N 0 N 0 N 0 N
80 N 1 1 0 N 0 N 0 N
80 N 1 1 0 N 0 N 0 N
60 N 2 0 0 N 0 N 0 N
100 0 0 N 0 N 0 N 0 N
60 N 1 1 0 N 0 N 0 N
60 N 1 1 1 1 1 1 1 1
80 N 1 1 0 N 0 N 0 N
70 N 1 1 0 N 0 N 0 N
70 N 1 1 0 N 0 N 0 N
60 N 0 N 0 N 0 N 0 N
80 N 1 1 0 N 0 N 0 N
60 N 1 1 0 N 0 N 0 N
80 N 1 1 0 N 0 N 0 N
70 N 1 1 0 N 0 N 0 N
100 1 0 N 0 N 0 N 0 N
80 N 1 1 0 N 0 N 0 N
70 N 1 1 0 N 0 N 0 N
90 0 2 0 0 N 0 N 0 N
90 1 2 0 0 N 0 N 0 N
70 N 1 1 1 1 1 1 1 1
80 N 1 1 0 N 0 N 0 N
70 N 0 N 0 N 0 N 0 N
70 N 0 N 0 N 0 N 0 N
70 N 0 N 0 N 0 N 0 N
70 N 0 N 0 N 0 N 0 N
70 N 0 N 0 N 0 N 0 N
90 1 0 N 0 N 0 N 0 N
80 N 0 N 0 N 0 N 0 N
TUMBANG KES TUMB
31
0 N
0 N
0 N
0 N
0 N
0 N
0 N
0 N
1 1
0 N
0 N
0 N
0 N
0 N
0 N
0 N
0 N
0 N
0 N
0 N
0 N
0 N
1 1
0 N
0 N
0 N
0 N
0 N
0 N
0 N
0 N
NO.RES. ORDINAT KEL. LING. RT RW NO.RMH NO.KLG Alamat N. KK
1 2 3 4 5 6 7 8 9 10
3 2 1 1 GEDOR BUSAHWAN
3 2 2 2 GEDOR FAUZI
3 2 3 3 GEDOR JAMIAH
3 2 4 4 GEDOR PARTO
3 2 5 5 GEDOR SAPERIK
3 2 6 6 GEDOR SAMSUL HADI
3 2 7 7 GEDOR SAMAH
3 2 8 8 GEDORDIDIK SUSANTO
3 2 9 9 GEDOR GELAR PUJA D
3 2 10 10 GEDOR SUJIONO
3 2 11 11 GEDOR M SALIM
3 2 12 12 GEDOR ASMORA
3 2 13 13 GEDOR SUNADIYO
3 2 14 14 GEDOR SUASMAWI
3 2 15 15 GEDOR SUTRISNO
3 2 16 16 GEDOR KARHOSI
3 2 17 17 GEDOR MULYADI
3 2 18 18 GEDOR SAINA
3 2 19 19 GEDOR MUNITO
3 2 20 20 GEDOR MARYANTO
3 2 21 21 GEDOR USNAH
3 2 22 22 GEDORAHMAD MUSTOFA
3 2 23 23 GEDORIRFAN HIDAYAT
3 2 24 24 GEDOR SUROSOK
3 2 25 25 GEDORRAHMAT HIDAYAT
3 2 26 26 GEDOR DAWAH
3 2 27 27 GEDOR MATSARI
3 2 28 28 GEDOR SANARI
3 2 29 29 GEDOR IKROMULLAH
3 2 30 30 GEDOR SAHRI
3 2 31 31 GEDOR SAIFUL
 KES
KES SAB KES JKN
JAMBAN

Ʃ KLG ƩWNC >15 10 - 54 th 12 - 59 bl 0 - 11 bl KES SKIZO

11 12 13 14 15 16
3 2 3 2 0 0 1 1 N 0
4 2 2 3 0 0 1 1 N 0
2 2 2 1 0 0 1 1 N 0
3 2 2 2 1 0 1 1 N 0
4 2 3 3 1 0 1 1 N 0
3 2 2 2 1 0 1 1 N 0
2 2 2 0 0 0 1 1 N 1
2 2 2 2 0 0 1 1 N 0
3 2 2 2 1 0 1 1 N 1
4 2 3 4 0 0 1 1 N 0
5 5 1 5 0 0 1 1 N 1
3 3 1 3 0 0 1 1 N 0
1 1 0 1 0 0 1 1 N 0
2 2 0 2 0 0 1 1 N 0
3 3 0 3 0 0 1 1 N 0
4 4 2 4 0 0 1 1 N 0
4 4 1 3 0 0 1 1 N 0
1 1 0 0 0 0 1 1 N 0
4 4 1 3 0 0 1 1 N 0
2 2 0 2 0 0 1 1 N 0
3 3 3 3 0 0 1 1 N 0
2 2 2 2 0 0 1 1 N 0
3 2 2 2 0 1 1 1 N 0
3 2 2 2 1 0 1 1 N 1
3 2 2 2 0 0 1 1 N 0
3 2 2 3 0 0 1 1 N 0
2 2 2 2 0 0 1 1 N 0
1 1 0 0 0 0 1 1 N 0
3 2 0 0 0 0 1 1 N 0
2 2 0 0 0 0 1 1 N 0
1 1 0 0 0 0 1 1 N 0
0 0 0 27
31 31 0 4
 JUMLAH 12
KES KES INDIKATOR JUMLAH "N")
KES TB KES TD KES KB KES ASI KES IMUN
ROKOK LINAKES
BERNILAI 1

KES TUMB
34 35

0 N 1 1 N N N N 4 6
0 N N 1 N N N N 3 7
0 N N N N N N N 2 8
0 N N 1 N N N N 3 7
0 N N 1 N N N N 3 7
0 N N 0 N N N N 2 7
0 N 0 N N N N N 3 7
0 N N 1 N N N N 3 7
0 N N 1 1 1 1 1 8 3
0 N N 1 N N N N 3 7
0 N N 1 N N N N 4 7
1 N N 1 N N N N 4 7
1 N N N N N N N 3 8
1 N N 1 N N N N 4 7
0 N N 1 N N N N 3 7
0 N N 1 N N N N 3 7
0 N N 1 N N N N 3 7
1 N 1 N N N N N 4 7
0 N N 1 N N N N 3 7
0 N N 1 N N N N 3 7
0 N 0 0 N N N N 2 6
1 N 1 0 N N N N 4 6
1 N N 1 1 1 1 1 8 3
0 N N 1 N N N N 4 7
0 N N N N N N N 2 8
0 N N N N N N N 2 8
0 N N N N N N N 2 8
0 N N N N N N N 2 8
0 N N N N N N N 2 8
0 N 1 N N N N N 3 7
0 N N N N N N N 2 8
25 0 2 3 0 0 0 0
6 0 4 17 2 2 2 2
 Ʃ 12
INDIKATOR
KATEGORI KELUARGA
BERNILAI 1/(12-
N)

36 37

0.667 PraSehat
0.600 PraSehat
0.500 PraSehat
0.600 PraSehat
0.600 PraSehat
0.400 Tidak Sehat
0.600 PraSehat
0.600 PraSehat
0.889 Keluarga Sehat
0.600 PraSehat
0.800 PraSehat
0.800 PraSehat
0.750 PraSehat
0.800 PraSehat
0.600 PraSehat
0.600 PraSehat
0.600 PraSehat
0.800 PraSehat
0.600 PraSehat
0.600 PraSehat
0.333 Tidak Sehat
0.667 PraSehat
0.889 Keluarga Sehat
0.800 PraSehat
0.500 PraSehat
0.500 PraSehat
0.500 PraSehat
0.500 PraSehat
0.500 PraSehat
0.600 PraSehat
0.500 PraSehat
2
27
0.622 2