LAPORANA NAMA-NAMA PENERIMA VAKSIN DOSIS 1 DAN 2

PUSKESMAS PICUNG

NO No. Ticket NIK Nama Penerima Vaksin JK

1 Q-000JEE0C 3601116406970002 IIS ROSYANA P

2 Q-000JCEK3 3602095408000001 GHANIS PUTRI ANGGRAINI P
3 Q-000JFMFD 3601115109060002 SILVI RESTI SEPTIANI P
4 Q-000J7125 3601112906700002 AHMAD SAEFUL L
5 Q-000J7VUA 3602094509040003 SITI AISAH P
6 Q-000IO3S 3601115812030002 DESTA WINDRIANTI P
7 Y-00008YM7 3601116210850001 SANTI SOFIA MARWATI P
8 Q-000JD19T 3601116707740001 RUMYATI P
9 Q-000JCY1L 3601114301690001 IAT HERAWATI P
10 Q-000JFJOQ 3601115410670002 ANISAH P
11 Q-000JCEA3 3602090403890007 ETSYA WAHYU KURNIAWAN P
12 Q-000JCSMM 3601114107890081 ERNA SURYANI P
13 Q-000JC6AB 3601114107950151 JUMRON L
14 Q-000JDSHY 3601110207810013 INAN L
15 Q-000JC9JY 3601114107770066 NANI SURYANI P
16 Q-000JDSH9 3601110107730017 SUPARTA L
17 Q-000JCK1N 3601115008740001 SATIAH P
18 Q-000JCTVE 3601114208680001 SITI HASANAH P
19 Q-000JCHGD 3601111004640001 DADAN PURNAMA L
20 Z-0007VWI2 3601114108450002 RAWI L
21 Q-000JD94A 3601114508890003 UCU SUPRIATI P
22 Z-0007YL9L 3601115507640001 SATIAH P
23 Z-0007YYV3 3604241310840001 MISBAHUL MUNIR L
24 Q-000J4FOO 3673014806740002 ANAH P
25 Q-000JCRMP 3601116811890002 KHOLIYAH P
26 Q-000JCX0K 3601114804810001 YUNTI P
27 P-AMH8M8AR 3601114412700001 E YANTI SUMARNI P
28 Q-0009FK3N 3602095111850003 SUSI P
29 P-AKCA9ZSM 3601096410940001 ITA PUSPITA P
30 Q-000B6YZI 3601116304320001 ROHANA P
31 Q-000JCDEE 3602095409810002 EVY ROKHMAWATI P
32 Z-0005RLON 3601113107780002 M MUHDI L
33 Q-0009SHEC 3602211506910002 IYAN PIESA P
34 J-0001BBX4 3601110204840001 HERDI L
35 Q-000JCQLA 3601115507690001 DEDE MARYANAH P
36 W-00000SIP 3601315202680003 EMPIN SUMARNI P
37 Q-000JE0BB 3601110812770001 JUHDI L
38 Q-000JCRNO 3601114107930160 AAS TRIYANI P
39 Q-000JE8QF 3601114107630175 HODIJAH P
40 Z-0007YLA5 3601111404700001 NASRIAL CHANDRA L
41 Q-000JDMN1 3601110107610010 APAD L
42 Q-000JCGQK 3602094104950005 APRILIA LISDIANA P
43 Q-000JG4F6 3613110020000005 ASEP HIDAYAT L
44 Q-000JDK73 3601110605720001 SATIRI L
45 Q-000JFN60 3601115206970003 SRI MULYANI P
46 N-36C64191 3601105003910001 EFI RAHMAWATI NERS P
 Umur
Kelompok
pekerjaan (18-59 INSTANSI Alamat
Umur
tahun)

IRT 6/24/1997 DEWASA UMUM KADUPANDAK

PELAJAR 8/14/2000 REMAJA UMUM BANJARSARI
PELAJAR 9/11/2006 REMAJA UMUM CILILITAN
PELAJAR 6/29/2007 REMAJA UMUM CILILITAN
PELAJAR 6/21/2003 REMAJA UMUM CIKUTRA
PELAJAR 12/18/2003 REMAJA UMUM CILILITAN
NAKES 10/22/1982 DEWASA NAKES CILILITAN
IRT 7/27/1974 DEWASA UMUM CIHERANG
IRT 1/3/1969 DEWASA UMUM CIHERANG
IRT 8/12/1969 DEWASA UMUM CILILITAN
IRT 3/4/1989 DEWASA UMUM BANJARSARI
IRT 11/27/1987 DEWASA UMUM CILILITAN
WIRASWASTA 7/1/1995 DEWASA UMUM CIHERANG
WIRASWASTA 4/7/1969 DEWASA UMUM CILILITAN
IRT 5/20/1978 DEWASA UMUM BUNGUR COPONG
WIRASWASTA 6/12/1973 DEWASA UMUM PASIR SEDANG
IRT 8/10/1974 DEWASA UMUM CIHERANG
IRT 6/1/1968 DEWASA UMUM CILILITAN
WIRASWASTA 4/10/1964 DEWASA UMUM KOLELET
WIRASWASTA 8/1/1945 LANSIA UMUM CIHERANG
IRT 8/5/1984 DEWASA UMUM KOLELET
IRT 1/6/1957 LANSIA UMUM KOLELET
WIRASWASTA 10/13/1984 DEWASA UMUM KADUBERA
IRT 6/8/1978 DEWASA UMUM CILILITAN
IRT 6/16/1990 DEWASA UMUM KOLELET
IRT 4/8/1981 DEWASA UMUM CIHERANG
IRT 12/4/1971 DEWASA UMUM CILILITAN
IRT 11/11/1985 DEWASA UMUM CILILITAN
IRT 10/24/1994 DEWASA UMUM PAGELARAN
IRT 1/15/1995 DEWASA UMUM KOLELET
IRT 9/14/1981 DEWASA UMUM BANJARSARI
WIRASWASTA 7/31/1978 DEWASA UMUM PASIR SEDANG
IRT 6/15/1991 DEWASA UMUM WANASALAM
WIRASWASTA 4/2/1984 DEWASA UMUM KOLELET
IRT 2/10/1960 DEWASA UMUM KOLELET
IRT 2/12/1968 DEWASA UMUM SINDANGRESMI
WIRASWASTA 3/13/1974 DEWASA UMUM KOLELET
IRT 3/22/1993 DEWASA UMUM KOLELET
IRT 7/1/1963 DEWASA UMUM KADUPANDAK
WIRASWASTA 4/14/1970 DEWASA UMUM CILILITAN
WIRASWASTA 11/2/1961 DEWASA UMUM PASIR SEDANG
IRT 4/1/1995 DEWASA UMUM BANJARSARI
WIRASWASTA 11/10/1999 DEWASA UMUM CIHERANG
WIRASWASTA 6/1/1972 DEWASA UMUM KOLELET
IRT 6/12/1997 DEWASA UMUM KOLELET
NAKES 2/24/1991 DEWASA NAKES KOLELET
 Kepesertaan BPJS (tulis
'Ya' pada kolom yang Dosis I
sesuai) Merek Tanggal
No. Hp BPJS Non Tanggal
BPJS Vaksin*** Screening
Non Anggot Pemberian
PBI
PBI a Vaksinasi
083811137826 CORONAVAC 7/26/2021 7/26/2021
081287149454 CORONAVAC 7/26/2021 7/26/2021
083891301765 CORONAVAC 7/26/2021 7/26/2021
085695388577 CORONAVAC 7/26/2021 7/26/2021
08571829696 CORONAVAC 7/26/2021 7/26/2021
085773748608 CORONAVAC 7/26/2021 7/26/2021
082310283339 CORONAVAC 7/26/2021 7/26/2021
081224381488 CORONAVAC 7/26/2021 7/26/2021
085886801025 CORONAVAC 7/26/2021 7/26/2021
083874284572 CORONAVAC 7/26/2021 7/26/2021
0812122498637 CORONAVAC 7/26/2021 7/26/2021
081219734830 CORONAVAC 7/26/2021 7/26/2021
081290993961 CORONAVAC 7/26/2021 7/26/2021
085321213066 CORONAVAC 7/26/2021 7/26/2021
083183261495 CORONAVAC 7/26/2021 7/26/2021
081807222792 CORONAVAC 7/26/2021 7/26/2021
083125103872 CORONAVAC 7/26/2021 7/26/2021
083841409491 CORONAVAC 7/26/2021 7/26/2021
081281762646 CORONAVAC 7/26/2021 7/26/2021
085695295489 CORONAVAC 7/26/2021 7/26/2021
085212574084 CORONAVAC 7/26/2021 7/26/2021
085212574084 CORONAVAC 7/26/2021 7/26/2021
087789137212 CORONAVAC 7/26/2021 7/26/2021
085778231821 CORONAVAC 7/26/2021 7/26/2021
083804499412 CORONAVAC 7/26/2021 7/26/2021
085889297610 CORONAVAC 7/26/2021 7/26/2021
085696809730 CORONAVAC 7/26/2021 7/26/2021
089654988721 CORONAVAC 7/26/2021 7/26/2021
082312806048 CORONAVAC 7/26/2021 7/26/2021
083815151100 CORONAVAC 7/26/2021 7/26/2021
082117566177 CORONAVAC 7/26/2021 7/26/2021
083815892630 CORONAVAC 7/26/2021 7/26/2021
082122319647 CORONAVAC 7/26/2021 7/26/2021
083891224285 CORONAVAC 7/26/2021 7/26/2021
083804499512 CORONAVAC 7/26/2021 7/26/2021
085813638679 CORONAVAC 7/26/2021 7/26/2021
081288584311 CORONAVAC 7/26/2021 7/26/2021
081297952370 CORONAVAC 7/26/2021 7/26/2021
08383432134 CORONAVAC 7/26/2021 7/26/2021
081363322260 CORONAVAC 7/26/2021 7/26/2021
083872672562 CORONAVAC 7/26/2021 7/26/2021
085387698352 CORONAVAC 7/26/2021 7/26/2021
083808997264 CORONAVAC 7/26/2021 7/26/2021
081298967570 CORONAVAC 7/26/2021 7/26/2021
085254393162 CORONAVAC 7/26/2021 7/26/2021
083870822707 CORONAVAC 7/26/2021 7/26/2021
Dosis I Dosis 2
Tanggal
No. Batch No seri Pemberian No. Batch No Seri
Vaksinasi
24201221 16096451778667 7/26/2021 24201221 16096451778667
24201221 16096451778667 7/26/2021 24201221 16096451778667
24201221 16096451778667 7/26/2021 24201221 16096451778667
24201221 16096451778667 7/26/2021 24201221 16096451778667
24201221 16096451778667 7/26/2021 24201221 16096451778667
24201221 16096451778667 7/26/2021 24201221 16096451778667
24201221 16096451778667 7/26/2021 24201221 16096451778667
24201221 16096451778667 7/26/2021 24201221 16096451778667
24201221 16096451778667 7/26/2021 24201221 16096451778667
24201221 16096451778667 7/26/2021 24201221 16096451778667
24201221 16096451778667 7/26/2021 24201221 16096451778667
24201221 16096451778667 7/26/2021 24201221 16096451778667
24201221 16096451778667 7/26/2021 24201221 16096451778667
24201221 16096451778667 7/26/2021 24201221 16096451778667
24201221 16096451778667 7/26/2021 24201221 16096451778667
24201221 16096451778667 7/26/2021 24201221 16096451778667
24201221 16096451778667 7/26/2021 24201221 16096451778667
24201221 16096451778667 7/26/2021 24201221 16096451778667
24201221 16096451778667 7/26/2021 24201221 16096451778667
24201221 16096451778667 7/26/2021 24201221 16096451778667
24201221 16096451778667 7/26/2021 24201221 16096451778667
24201221 16096451778667 7/26/2021 24201221 16096451778667
24201221 16096451778667 7/26/2021 24201221 16096451778667
24201221 16096451778667 7/26/2021 24201221 16096451778667
24201221 16096451778667 7/26/2021 24201221 16096451778667
24201221 16096451778667 7/26/2021 24201221 16096451778667
24201221 16096451778667 7/26/2021 24201221 16096451778667
24201221 16096451778667 7/26/2021 24201221 16096451778667
24201221 16096451778667 7/26/2021 24201221 16096451778667
24201221 16096451778667 7/26/2021 24201221 16096451778667
24201221 16096451778667 7/26/2021 24201221 16096451778667
24201221 16096451778667 7/26/2021 24201221 16096451778667
24201221 16096451778667 7/26/2021 24201221 16096451778667
24201221 16096451778667 7/26/2021 24201221 16096451778667
24201221 16096451778667 7/26/2021 24201221 16096451778667
24201221 16096451778667 7/26/2021 24201221 16096451778667
24201221 16096451778667 7/26/2021 24201221 16096451778667
24201221 16096451778667 7/26/2021 24201221 16096451778667
24201221 16096451778667 7/26/2021 24201221 16096451778667
24201221 16096451778667 7/26/2021 24201221 16096451778667
24201221 16096451778667 7/26/2021 24201221 16096451778667
24201221 16096451778667 7/26/2021 24201221 16096451778667
24201221 16096451778667 7/26/2021 24201221 16096451778667
24201221 16096451778667 7/26/2021 24201221 16096451778667
24201221 16096451778667 7/26/2021 24201221 16096451778667
24201221 16096451778667 7/26/2021 24201221 16096451778667
 KET

DOSIS KE 2
DOSIS KE 2
DOSIS KE 2
DOSIS KE 2
DOSIS KE 2
DOSIS KE 2
DOSIS KE 2
DOSIS KE 2
DOSIS KE 2
DOSIS KE 2
DOSIS KE 2
DOSIS KE 2
DOSIS KE 2
DOSIS KE 2
DOSIS KE 2
DOSIS KE 2
DOSIS KE 2
DOSIS KE 2
DOSIS KE 2
DOSIS KE 2
DOSIS KE 2
DOSIS KE 2
DOSIS KE 2
DOSIS KE 2
DOSIS KE 2
DOSIS KE 2
DOSIS KE 2
DOSIS KE 2
DOSIS KE 2
DOSIS KE 2
DOSIS KE 2
DOSIS KE 2
DOSIS KE 2
DOSIS KE 2
DOSIS KE 2
DOSIS KE 2
DOSIS KE 2
DOSIS KE 2
DOSIS KE 2
DOSIS KE 2
DOSIS KE 2
DOSIS KE 2
DOSIS KE 2
DOSIS KE 2
DOSIS KE 2
DOSIS KE 1
LAPORANA NAMA-NAMA PENERIMA VAKSIN DOSIS 1 DAN 2

PUSKESMAS PICUNG

NO No. Ticket NIK Nama Penerima Vaksin JK

1 Q-000J6TN5 3601116508050001 HELVI AGUSTINA P

2 Q-000IO5VS 3602095908080002 AISYAH P
3 Q-000J83J5 3601114508060001 AULIA RAHMA P
4 Q-000J6IYW 3601114407070006 TIA JULIANTI P
5 Q-000J4WWR 3601115802070001 HESTI P
6 Q-000J4X47 3601114201080004 RISKA P
7 Q-000J6ISI 3601111702090003 SULTAN L
8 Q-000J72XG 3601112702090004 REYVAN H PRATAMA L
9 Q-000J6TER 3601115702060003 SILVIA T MULIYANI P
10 Q-000J6Y31 3601115702060002 SILVA P
11 Q-000J803Z 3602096105060001 SITI MAHARANI P
12 Q-000J70Y5 3601116709040001 SITI NURAENI P
13 Q-D491BD17 3602095307760003 ANAH HASANAH P
14 P-133J00AD 3601117006080001 SITI HUMAEROH P
15 P-F4VXCXTX 3601115412070001 NIMAZ ELSA RAHAYU P
16 Q-000J7TVC 3601112012080006 PASHA JULIAN ALHAZZ L
17 Q-000J6XHX 3601114702800001 ENOK KARTINAH P
18 Q-000J79UR 3601114107740022 MAE P
19 Q-000J6URT 3601114209870002 DEWI RUSITA P
20 Q-000EJ5U6 3601115008900001 SUPARTI P
21 Q-000JI7EG 3601105406760002 ENENG SOPIANA P
22 Q-000J7KPX 3601100806700001 H UNEH JUNAEDI L
23 Q-000A829D 3601110107930005 ASEP SAEFUL L
24 Q-000J6YAB 3601110207760019 TAKURROHMAN L
25 Q-000J71T8 3601114207870028 DAUMI P
26 Q-000J6UY2 3601115010980002 TITA SUNDARI P
27 Z-0007WMYT 3601111007830001 JUMLI RAPIUDIN L
28 P-F8HGG5QC 3601110506930005 SUANTO L
29 P-DBY0NWNX 3601110107910120 HUMAEDI L
30 Q-000J7PX6 3601114910630002 MARSIH P
31 Q-000J6VD4 3601114107810063 SUNARIAH P
32 Q-000J6YPQ 3601111511900001 OMBI L
33 Q-000IXF8Z 3601115906030001 HILDA AMELIA PUTRI P
34 Z-0007WGO9 3601114403870001 SITI ROHMAWATI P
35 Q-000IXZ3X 3601110207800029 HENDRI L
36 Q-000J7CIF 3601111011630002 MUSA L
37 Q-000J3YJ6 3601114107020056 NOVI OKTAVIA P
38 Q-000J435S 3602096205890002 WIWIN WIDIANTI P
39 Z-0007WFZ9 3601114107480024 SA'ADAH P
40 Q-000J7166 3601114107630118 EMAH P
41 Q-000J7JJ 3601115603870001 NURBAETI P
42 Q-000JF0O 3601116605440001 WATI P
43 Q-000J7HO5 3674074708640001 RASTI P
44 Q-000J7YAE 3601110107780095 JAKARIA L
45 Z-0007WG79 3601210401510001 UCI SANUSI L
46 Q-000J70GI 3601114107710085 JARMAH P
47 Q-000J3LGF 3601112008890001 UBEDI L
48 Q-000J4XIZ 3601112510650001 SOBARI L
49 Q-000J44YF 3601114703780001 INOH P
50 Q-000J4QHT 3601111201890003 DANI EKA CANDRA L
51 Q-000J71J8 3601115703730001 TIKAH P
52 Q-000J7BBD 3601100107870008 ASEP AV L
53 P-FCN5R01G 3601115208930002 HELIANTI P
54 Q-000J7BA5 3601112202790001 ADE SALAHUDIN L
55 Q-000J6WWT 3601114102690001 ATI P
56 Z-0007WC22 3601114308490001 RANI P
57 Q-000J70ZU 3601115005640001 SANI'AH P
58 Q-000J70R2 3601115003890001 YANIH P
59 P-FM7006MS 3601114207890002 FITRIANINGSIH P
60 Q-000J3T6P 3602095104990004 ATISAH P
61 Z-0007QPSCV 3601114207750003 N AI TRISNAWATI P
62 Z-0007VWJ5 3601110107580015 RAPINGUN L
63 Z-0007WFZH 3601110804850001 TOYIB L
64 Q-000J70GI 3601114107710085 JARMAH P
 Umur
Kelompok
pekerjaan (18-59 INSTANSI Alamat
Umur
tahun)

PELAJAR 8/25/2005 REMAJA UMUM KADUPANDAK

PELAJAR 8/19/2008 REMAJA UMUM BANJARSARI
PELAJAR 8/5/2006 REMAJA UMUM CILILITAN
PELAJAR 7/4/2004 REMAJA UMUM KADUPANDAK
PELAJAR 2/1/2007 REMAJA UMUM CILILITAN
PELAJAR 1/2/2008 REMAJA UMUM CILILITAN
PELAJAR 2/17/2009 REMAJA UMUM KADUPANDAK
PELAJAR 2/27/2009 REMAJA UMUM KOLELET
PELAJAR 2/17/2006 REMAJA UMUM KADUPANDAK
PELAJAR 2/1/2006 REMAJA UMUM KADUPANDAK
PELAJAR 5/21/2006 REMAJA UMUM BANJARSARI
PELAJAR 9/27/2004 REMAJA UMUM CIHERANG
IRT 7/13/1976 DEWASA UMUM PICUNG
PELAJAR 6/30/2008 REMAJA UMUM CIHERANG
PELAJAR 12/14/2007 REMAJA UMUM CILILITAN
PELAJAR 12/20/2008 REMAJA UMUM CILILITAN
IRT 11/14/1979 DEWASA UMUM CIHERANG
IRT 8/29/1974 DEWASA UMUM KADUPANDAK
IRT 9/2/1987 DEWASA UMUM CIHERANG
IRT 8/10/1961 DEWASA UMUM KOLELET
IRT 6/14/1976 DEWASA UMUM SUKAMAJU
WIRASWASTA 6/8/1970 DEWASA UMUM BOJONG
WIRASWASTA 3/4/1989 DEWASA UMUM CILILITAN
WIRASWASTA 7/2/1976 DEWASA UMUM KOLELET
IRT 2/3/1966 DEWASA UMUM CIHERANG
IRT 10/10/1998 DEWASA UMUM CILILITAN
WIRASWASTA 7/26/1982 DEWASA UMUM KADUPANDAK
WIRASWASTA 6/5/1993 DEWASA UMUM PASIR SEDANG
WIRASWASTA 5/5/1990 DEWASA UMUM KADUPANDAK
IRT 10/9/1965 DEWASA UMUM KOLELET
IRT 7/1/1981 DEWASA UMUM KADUPANDAK
WIRASWASTA 11/1/1990 DEWASA UMUM KOLELET
PELAJAR 8/19/2003 DEWASA UMUM GANGGAENG
IRT 3/4/1987 DEWASA UMUM GANGGAENG
WIRASWASTA 6/9/1979 DEWASA UMUM CILILITAN
WIRASWASTA 11/10/1963 DEWASA UMUM KOLELET
PELAJAR 10/24/2002 DEWASA UMUM CILILITAN
IRT 5/22/1989 DEWASA UMUM CIHERANG
IRT 11/10/1951 LANSIA UMUM CILILITAN
IRT 3/17/1962 LANSIA UMUM CILILITAN
IRT 3/16/1987 DEWASA UMUM CIHERANG
IRT 11/2/1964 DEWASA UMUM KOLELET
IRT 8/7/1964 DEWASA UMUM KOLELET
WIRASWASTA 7/1/1979 DEWASA UMUM KADUPANDAK
WIRASWASTA 1/4/1951 DEWASA UMUM CILILITAN
IRT 2/28/1971 DEWASA UMUM CIHERANG
WIRASWASTA 6/28/1989 DEWASA UMUM KOLELET
WIRASWASTA 3/25/1965 LANSIA UMUM KOLELET
IRT 3/7/1978 DEWASA UMUM CIHERANG
WIRASWASTA 1/12/1989 DEWASA UMUM CILILITAN
IRT 3/17/1973 DEWASA UMUM KOLELET
WIRASWASTA 7/1/1987 DEWASA UMUM KADUBERA
IRT 8/12/1993 DEWASA UMUM PASIR SEDANG
WIRASWASTA 2/22/1979 DEWASA UMUM PASIR SEDANG
IRT 12/22/1973 DEWASA UMUM KOLELET
IRT 8/3/1949 LANSIA UMUM KOLELET
IRT 5/10/1964 DEWASA UMUM KOLELET
IRT 1/1/1987 DEWASA UMUM KOLELET
IRT 4/11/1991 DEWASA UMUM BUNGUR COPONG
IRT 4/11/1999 DEWASA UMUM KADUPANDAK
GURU 9/25/1973 DEWASA UMUM CILILITAN
WIRASWASTA 7/22/1958 LANSIA UMUM SUKAMAJU
WIRASWASTA 7/21/1985 DEWASA UMUM KOLELET
IRT 2/28/1971 DEWASA UMUM CIHERANG
 Kepesertaan BPJS (tulis
'Ya' pada kolom yang Dosis I
sesuai) Merek Tanggal
No. Hp BPJS Non Tanggal
BPJS Vaksin*** Screening
Non Anggot Pemberian
PBI
PBI a Vaksinasi
0859102626785 CORONAVAC 7/24/2021 7/24/2021
083871136257 CORONAVAC 7/24/2021 7/24/2021
085691926781 CORONAVAC 7/24/2021 7/24/2021
085719028272 CORONAVAC 7/24/2021 7/24/2021
085282669478 CORONAVAC 7/24/2021 7/24/2021
085770620098 CORONAVAC 7/24/2021 7/24/2021
085693565059 CORONAVAC 7/24/2021 7/24/2021
081286359820 CORONAVAC 7/24/2021 7/24/2021
085817090884 CORONAVAC 7/24/2021 7/24/2021
085817090884 CORONAVAC 7/24/2021 7/24/2021
085718723214 CORONAVAC 7/24/2021 7/24/2021
083857598812 CORONAVAC 7/24/2021 7/24/2021
085773499594 CORONAVAC 7/24/2021 7/24/2021
083857598812 CORONAVAC 7/24/2021 7/24/2021
081221691111 CORONAVAC 7/24/2021 7/24/2021
083841229188 CORONAVAC 7/24/2021 7/24/2021
081511407646 CORONAVAC 7/24/2021 7/24/2021
085774773280 CORONAVAC 7/24/2021 7/24/2021
081511407646 CORONAVAC 7/24/2021 7/24/2021
085210385901 CORONAVAC 7/24/2021 7/24/2021
081287323806 CORONAVAC 7/24/2021 7/24/2021
087709889309 CORONAVAC 7/24/2021 7/24/2021
08772299753 CORONAVAC 7/24/2021 7/24/2021
085782376878 CORONAVAC 7/24/2021 7/24/2021
085692577549 CORONAVAC 7/24/2021 7/24/2021
083813000188 CORONAVAC 7/24/2021 7/24/2021
083841571873 CORONAVAC 7/24/2021 7/24/2021
087886624936 CORONAVAC 7/24/2021 7/24/2021
085217931018 CORONAVAC 7/24/2021 7/24/2021
083812755685 CORONAVAC 7/24/2021 7/24/2021
081210289122 CORONAVAC 7/24/2021 7/24/2021
083184417585 CORONAVAC 7/24/2021 7/24/2021
085719428879 CORONAVAC 7/24/2021 7/24/2021
085716290716 CORONAVAC 7/24/2021 7/24/2021
085966338784 CORONAVAC 7/24/2021 7/24/2021
085284985574 CORONAVAC 7/24/2021 7/24/2021
083815456943 CORONAVAC 7/24/2021 7/24/2021
08569570127 CORONAVAC 7/24/2021 7/24/2021
085782644663 CORONAVAC 7/24/2021 7/24/2021
083841229188 CORONAVAC 7/24/2021 7/24/2021
083871292700 CORONAVAC 7/24/2021 7/24/2021
083812705685 CORONAVAC 7/24/2021 7/24/2021
083812705685 CORONAVAC 7/24/2021 7/24/2021
082311738920 CORONAVAC 7/24/2021 7/24/2021
083841229188 CORONAVAC 7/24/2021 7/24/2021
083857598812 CORONAVAC 7/24/2021 7/24/2021
085217074676 CORONAVAC 7/24/2021 7/24/2021
08138861249 CORONAVAC 7/24/2021 7/24/2021
085695295489 CORONAVAC 7/24/2021 7/24/2021
085215849450 CORONAVAC 7/24/2021 7/24/2021
083808163570 CORONAVAC 7/24/2021 7/24/2021
082111519277 CORONAVAC 7/24/2021 7/24/2021
083154967801 CORONAVAC 7/24/2021 7/24/2021
083872670037 CORONAVAC 7/24/2021 7/24/2021
085211716857 CORONAVAC 7/24/2021 7/24/2021
08521355786 CORONAVAC 7/24/2021 7/24/2021
083891475251 CORONAVAC 7/24/2021 7/24/2021
083820324734 CORONAVAC 7/24/2021 7/24/2021
085882439127 CORONAVAC 7/24/2021 7/24/2021
081212896321 CORONAVAC 7/24/2021 7/24/2021
083818220045 CORONAVAC 7/24/2021 7/24/2021
0817726906 CORONAVAC 7/24/2021 7/24/2021
085286326676 CORONAVAC 7/24/2021 7/24/2021
083857598812 CORONAVAC 7/24/2021 7/24/2021
Dosis I Dosis 2
Tanggal
No. Batch No seri Pemberian No. Batch No Seri
Vaksinasi
24201221 16096451778667 8/24/2021 24201221 16096451778667
24201221 16096451778667 8/24/2021 24201221 16096451778667
24201221 16096451778667 8/24/2021 24201221 16096451778667
24201221 16096451778667 8/24/2021 24201221 16096451778667
24201221 16096451778667 8/24/2021 24201221 16096451778667
24201221 16096451778667 8/24/2021 24201221 16096451778667
24201221 16096451778667 8/24/2021 24201221 16096451778667
24201221 16096451778667 8/24/2021 24201221 16096451778667
24201221 16096451778667 8/24/2021 24201221 16096451778667
24201221 16096451778667 8/24/2021 24201221 16096451778667
24201221 16096451778667 8/24/2021 24201221 16096451778667
24201221 16096451778667 8/24/2021 24201221 16096451778667
24201221 16096451778667 8/24/2021 24201221 16096451778667
24201221 16096451778667 8/24/2021 24201221 16096451778667
24201221 16096451778667 8/24/2021 24201221 16096451778667
24201221 16096451778667 8/24/2021 24201221 16096451778667
24201221 16096451778667 8/24/2021 24201221 16096451778667
24201221 16096451778667 8/24/2021 24201221 16096451778667
24201221 16096451778667 8/24/2021 24201221 16096451778667
24201221 16096451778667 8/24/2021 24201221 16096451778667
24201221 16096451778667 8/24/2021 24201221 16096451778667
24201221 16096451778667 8/24/2021 24201221 16096451778667
24201221 16096451778667 8/24/2021 24201221 16096451778667
24201221 16096451778667 8/24/2021 24201221 16096451778667
24201221 16096451778667 8/24/2021 24201221 16096451778667
24201221 16096451778667 8/24/2021 24201221 16096451778667
24201221 16096451778667 8/24/2021 24201221 16096451778667
24201221 16096451778667 8/24/2021 24201221 16096451778667
24201221 16096451778667 8/24/2021 24201221 16096451778667
24201221 16096451778667 8/24/2021 24201221 16096451778667
24201221 16096451778667 8/24/2021 24201221 16096451778667
24201221 16096451778667 8/24/2021 24201221 16096451778667
24201221 16096451778667 8/24/2021 24201221 16096451778667
24201221 16096451778667 8/24/2021 24201221 16096451778667
24201221 16096451778667 8/24/2021 24201221 16096451778667
24201221 16096451778667 8/24/2021 24201221 16096451778667
24201221 16096451778667 8/24/2021 24201221 16096451778667
24201221 16096451778667 8/24/2021 24201221 16096451778667
24201221 16096451778667 8/24/2021 24201221 16096451778667
24201221 16096451778667 8/24/2021 24201221 16096451778667
24201221 16096451778667 8/24/2021 24201221 16096451778667
24201221 16096451778667 8/24/2021 24201221 16096451778667
24201221 16096451778667 8/24/2021 24201221 16096451778667
24201221 16096451778667 8/24/2021 24201221 16096451778667
24201221 16096451778667 8/24/2021 24201221 16096451778667
24201221 16096451778667 8/24/2021 24201221 16096451778667
24201221 16096451778667 8/24/2021 24201221 16096451778667
24201221 16096451778667 8/24/2021 24201221 16096451778667
24201221 16096451778667 8/24/2021 24201221 16096451778667
24201221 16096451778667 8/24/2021 24201221 16096451778667
24201221 16096451778667 8/24/2021 24201221 16096451778667
24201221 16096451778667 8/24/2021 24201221 16096451778667
24201221 16096451778667 8/24/2021 24201221 16096451778667
24201221 16096451778667 8/24/2021 24201221 16096451778667
24201221 16096451778667 8/24/2021 24201221 16096451778667
24201221 16096451778667 8/24/2021 24201221 16096451778667
24201221 16096451778667 8/24/2021 24201221 16096451778667
24201221 16096451778667 8/24/2021 24201221 16096451778667
24201221 16096451778667 8/24/2021 24201221 16096451778667
24201221 16096451778667 8/24/2021 24201221 16096451778667
24201221 16096451778667 8/24/2021 24201221 16096451778667
24201221 16096451778667 8/24/2021 24201221 16096451778667
24201221 16096451778667 8/24/2021 24201221 16096451778667
24201221 16096451778667 8/24/2021 24201221 16096451778667
 KET

DOSIS KE 2
DOSIS KE 2
DOSIS KE 2
DOSIS KE 2
DOSIS KE 2
DOSIS KE 2
DOSIS KE 2
DOSIS KE 2
DOSIS KE 2
DOSIS KE 2
DOSIS KE 2
DOSIS KE 2
DOSIS KE 2
DOSIS KE 2
DOSIS KE 2
DOSIS KE 2
DOSIS KE 2
DOSIS KE 2
DOSIS KE 2
DOSIS KE 2
DOSIS KE 2
DOSIS KE 2
DOSIS KE 2
DOSIS KE 2
DOSIS KE 2
DOSIS KE 2
DOSIS KE 2
DOSIS KE 2
DOSIS KE 2
DOSIS KE 2
DOSIS KE 2
DOSIS KE 2
DOSIS KE 2
DOSIS KE 2
DOSIS KE 2
DOSIS KE 2
DOSIS KE 2
DOSIS KE 2
DOSIS KE 2
DOSIS KE 2
DOSIS KE 2
DOSIS KE 2
DOSIS KE 2
DOSIS KE 2
DOSIS KE 2
DOSIS KE 2
DOSIS KE 2
DOSIS KE 2
DOSIS KE 2
DOSIS KE 2
DOSIS KE 2
DOSIS KE 2
DOSIS KE 2
DOSIS KE 2
DOSIS KE 2
DOSIS KE 2
DOSIS KE 2
DOSIS KE 2
DOSIS KE 2
DOSIS KE 2
DOSIS KE 2
DOSIS KE 2
DOSIS KE 2
DOSIS KE 2
LAPORANA NAMA-NAMA PENERIMA VAKSIN DOSIS 1 DAN 2

PUSKESMAS PICUNG

NO No. Ticket NIK Nama Penerima Vaksin JK

1 P-I7M6KDIJ 3601110202050018 AKBAR ADITIA L

2 P-I6XEE1Z1 3601110601050004 IIP L
3 P-I452VYL7 3601106310050001 ALINA NOPIANTI P
4 P-GMAOVPZN 3601111207040003 RENDIWIJAYA L
5 P-I61CIL53 3601113112040001 DIMAS MAULAN ARDI L
6 P-83FXU3UX 3601113100040001 RIZKI ROJABI L
7 P-E4DJQF27 3601114901030001 SILMA RISMANIAR PRATIWI P
8 P-I585V0LN 3601110107920123 YOGI L
9 P-IAJZC1G8 3601114107950152 ENIH SUMIATI P
10 P-I8H6718 3602091009820001 HENDRA SAPUTRA L
11 P-FHNH0576 3602095706830001 BAINAH P
12 S-2721E9EB 3601110905650001 IBROHIM L
13 P-I49D7DJ2 3601105009810003 ATIJAH P
14 S-EAE633E6 3601100212590002 M.TOHA L
15 P-YMSZYMMQ 3601110107830195 UNUNG HERDIANTO L
16 P-74FAUKGS 3601100508830001 AGUS SUTISNA L
17 P-7KBGFLUT 3601112206740001 MUHAMAD RIDWAN L
18 P-8THERD38 3601312103430001 ENOK P
19 P-AH4PR6I0 3601114307900001 ERNAWATI P
20 P-BH6S8JIF 1110100308000002 MARDIN SYAHPUTRA L
21 P-0GF2WVJW 3601110107010181 AHMAD TAUFIK L
22 P-2EVGRQUY 3601114304740001 SITI MAESAROH P
23 P-3UQ8E0E0 3602097004000001 WAHIDAH AZHARI L
24 P-5F54TXN 3602095203000004 IRMA P
25 P-6LYEPISH 3602095606990004 FIYAH P
26 P-7K3GAMXW 3601115607020002 START PUTRI PRIBADI P
27 P-BVE4RTLX 3601140906920002 MUHTAR MIZI L
28 P-90MX95HN 3601114709510002 NURSINAH P
29 P-D3BN46LG 3601112912020001 ANDIKA CHAESAR D L
30 P-EMFDPGOZ 3601110107930186 JAJULI L
31 P-EYDO8KCF 3601112710760001 SYARIFUDIN L
32 Q-000IYBUC 3602095806060001 BUNGA RAHMA AYUN DISASTRA P
33 Q-000IYEX1 3602096605070002 SINTA ADELIA PUTRI P
34 Q-000IXGE6 3601115403070002 RAHMAWATI P
35 Q-000IZ030 3601116501060001 ERLINA S P
36 Q-000IYAM5 3601315802060001 IMA MUHROHMAH P
37 Q-000IMX3H 3602094407030002 IIS HAPADOH ALAWIYAH P
38 Q-000IY2DI 3601116011030002 DILAH P
39 Q-000IXFB2 3602094608030005 NURASIAH P
40 Q-000IWRR8 3602090806070004 EGA FATTAHILLAH AZHARI P
41 Q-000IXNQE 3601104710020001 MELIYANTI P
42 Q-000IXS5O 3601316912040001 NESTI ANANTA P
43 Q-000IXVHX 3602096304030003 LENNI FARIDA P
44 Q-000IYYUW 3601116102050001 ELSA NOVIANTI P
45 Q-000IQ37U 3601114711080001 VEBIA ANGGRAENI P
46 Q-000IYITQ 3602104204060006 DIYAH AYU APRLIA P
47 Z-0007TTYC 3602096007060002 CHIKA IRA YULIANA P
48 Q-000IYDF0 3602094410040005 ZAHWA HIGAYATI P
49 Q-000IYDCL 3602096111050002 ZESICA CAHYA PERMATA P
50 Q-000IY68F 3602095201070006 SITI MASITOH P
51 Q-000IY2DK 3602096009050003 SELY SETIANUDI P
52 Q-000IYTJW 3602115101050005 DANU DARMA KUSUMA L
53 Q-000IYNCS 3602104512050001 NENENG P
54 Q-000IYHHW 3602105209060004 DINI NAERANI P
55 Q-000IWSXK 3601115603050004 ISMA BALYA NURSIAMI P
56 Q-000IY3LG 3602094708050002 SITI PERA AGUSTINA P
57 Q-000IWY8M 3601111706070001 MUHAMAD RAFLI L
58 Q-000IY7GC 3602096807070005 VINA P
59 Q-000IYOKL 3601104911060001 SITI KURNAESIH P
60 Q-000IYGBG 3601100607030002 ULPAH ULPIAH P
61 Q-000IWMB0 3601114305060005 HERNAWATI P
62 Q-000IYQZ6 3602095904060001 HENI P
63 Q-000IYPSZ 3601314107080015 SITI NURUL AENI P
64 Q-000IWOV0 3603284502930004 FITA RUSMITA P
65 Z-0007QFG5 3601112906820001 ASMARA P
66 Q-000INE6H 3601115207860002 KARSITI P
67 Q-000B9GIS 3601114505790001 MEIWINDI LESTARI P
68 Q-000IMMQ1 3601110108670001 UJID L
69 Q-000IYW1Z 3601142606000001 MUHAMAD YUSUP S L
70 Q-000IXR0N 3601110107800162 SALMAN L
71 Z-0007Q9TI 3601110401530001 SUKARMA L
72 Q-000IWVQ4 3601114607730002 SITI SUKAESIH P
73 Q-000IHGGW 3601114808020005 ANIS L
74 S-DAFE2300 3601116606740001 SARTIAH SPD P
75 Q-000IWLJR 3601116402800001 TATI P
76 Q-000IXTBM 3601261112850002 NURIMAN L
77 Q-000IMVYY 3602094407000001 ENENG JAMILATU JAHROH P
78 Q-000IXUDZ 3273124309650005 ASTINASARI P
79 Q-000B9SKG 3601111902940001 ASEP SAEFULLAH L
80 Q-000IOJOC 3601110107020190 TUHAETIDI L
81 Q-000AVHOM 3207021105890004 DAVIT ARIYADI L
82 Q-000IQ4MN 3601110610800001 DIKI SUTARMAN L
83 Q-000IPETN 3601111008770002 WAHYUDI L
84 Q-000IPEY5 3601117003900001 SANI L
85 Q-000AUR6G 3313025109920001 NOVI YULIANA P
86 Q-000IOEAQ 3601114607690002 ELA ELIAWATI P
 Umur
Kelompok
pekerjaan (18-59 INSTANSI Alamat
Umur
tahun)

PELAJAR 8/1/2005 REMAJA UMUM BUNGUR COPONG

PELAJAR 1/6/2005 REMAJA UMUM CILILITAN
PELAJAR 10/23/2005 REMAJA UMUM CIBADAK
PELAJAR 7/12/2004 REMAJA UMUM PASIR SEDANG
PELAJAR 12/31/2004 REMAJA UMUM PASIR SEDANG
PELAJAR 8/31/2004 REMAJA UMUM KOLELET
PELAJAR 1/9/2003 REMAJA UMUM CILILITAN
WIRASWASTA 10/19/1990 DEWASA UMUM BUNGUR COPONG
IRT 7/6/1996 DEWASA UMUM CIHERANG
WIRASWASTA 10/14/1981 DEWASA UMUM CIBATUR KEUSIK
IRT 6/17/1983 DEWASA UMUM BANJARSARI
WIRASWASTA 5/9/1965 DEWASA UMUM CIHERANG
IRT 9/10/1981 DEWASA UMUM BOJONG
WIRASWASTA 12/2/1959 DEWASA UMUM BOJONG
WIRASWASTA 7/1/1984 DEWASA UMUM BUNGUR COPONG
WIRASWASTA 8/5/1983 DEWASA UMUM KADUPANDAK
WIRASWASTA 6/22/1974 DEWASA UMUM PASIR SEDANG
IRT 9/6/1988 DEWASA UMUM CIHERANG
IRT 7/3/1990 DEWASA UMUM KOLELET
WIRASWASTA 8/3/2000 DEWASA UMUM SINGGERSING
WIRASWASTA 11/29/2001 DEWASA UMUM BUNGUR COPONG
IRT 1/3/1974 DEWASA UMUM KOLELET
IRT 4/30/2000 DEWASA UMUM BANJARSARI
IRT 3/12/2000 DEWASA UMUM BANJARSARI
IRT 6/16/1999 DEWASA UMUM BANJARSARI
IRT 7/16/2002 DEWASA UMUM CILILITAN
WIRASWASTA 8/10/1991 DEWASA UMUM SINDANGHAYU
IRT 9/7/1951 LANSIA UMUM KADUPANDAK
WIRASWASTA 12/12/2002 DEWASA UMUM KOLELET
WIRASWASTA 7/18/1992 DEWASA UMUM BUNGUR COPONG
WIRASWASTA 10/27/1976 DEWASA UMUM PSR PANJANG
PELAJAR 6/18/2006 REMAJA UMUM BANJARSARI
PELAJAR 5/26/2006 REMAJA UMUM BANJARSARI
PELAJAR 3/14/2007 REMAJA UMUM CIHERANG
PELAJAR 10/12/2005 REMAJA UMUM PASIR SEDANG
PELAJAR 2/18/2006 REMAJA UMUM SINDANGRESMI
PELAJAR 7/4/2003 REMAJA UMUM BANJARSARI
PELAJAR 11/15/2003 REMAJA UMUM CILILITAN
PELAJAR 8/19/2003 REMAJA UMUM BANJARSARI
PELAJAR 6/8/2007 REMAJA UMUM BANJARSARI
PELAJAR 10/7/2003 REMAJA UMUM BOJONG
PELAJAR 12/29/2004 REMAJA UMUM SINDANGRESMI
PELAJAR 4/23/2003 REMAJA UMUM BANJARSARI
PELAJAR 11/13/2005 REMAJA UMUM PASIR SEDANG
PELAJAR 11/7/2008 REMAJA UMUM CILILITAN
PELAJAR 4/2/2006 REMAJA UMUM BANJARSARI
PELAJAR 7/20/2006 REMAJA UMUM KALI DERES
PELAJAR 10/21/2004 REMAJA UMUM BANJARSARI
PELAJAR 11/21/2005 REMAJA UMUM BANJARSARI
PELAJAR 8/12/2005 REMAJA UMUM BANJARSARI
PELAJAR 9/20/2005 REMAJA UMUM BANJARSARI
PELAJAR 1/11/2005 REMAJA UMUM CIMARGA
PELAJAR 6/6/2006 REMAJA UMUM CILELES
PELAJAR 9/12/2006 REMAJA UMUM BANJARSARI
PELAJAR 3/16/2005 REMAJA UMUM PASIR SEDANG
PELAJAR 8/7/2005 REMAJA UMUM BANJARSARI
PELAJAR 6/17/2007 REMAJA UMUM CIHERANG
PELAJAR 7/28/2007 REMAJA UMUM BANJARSARI
PELAJAR 11/9/2006 REMAJA UMUM BOJONG
PELAJAR 6/6/2006 REMAJA UMUM BOJONG
PELAJAR 5/3/2006 REMAJA UMUM CIHERANG
PELAJAR 4/19/2006 REMAJA UMUM BOJONG
PELAJAR 9/28/2006 REMAJA UMUM SINDANGRESMI
IRT 2/5/1993 DEWASA UMUM PASIR SEDANG
IRT 6/29/1982 DEWASA UMUM KADUPANDAK
IRT 7/12/1986 DEWASA UMUM KADUPANDAK
IRT 5/5/1979 DEWASA UMUM CILILITAN
WIRASWASTA 8/1/1967 DEWASA UMUM PASIR SEDANG
WIRASWASTA 6/26/2000 DEWASA UMUM KEBON PEDES
WIRASWASTA 8/19/1979 DEWASA UMUM KADUBERA
WIRASWASTA 1/4/1953 LANSIA UMUM KOLELET
IRT 5/2/1972 DEWASA UMUM CIHERANG
IRT 8/8/2002 DEWASA UMUM KADUPANDAK
GURU 6/26/1974 DEWASA UMUM PICUNG
IRT 10/10/1976 DEWASA UMUM CIHERANG
WIRASWASTA 12/11/1985 DEWASA UMUM KOLELET
IRT 7/4/2000 DEWASA UMUM BANJARSARI
IRT 9/3/1965 DEWASA UMUM BANDUNG
WIRASWASTA 2/19/1994 DEWASA UMUM PICUNG
WIRASWASTA 8/19/2002 REMAJA UMUM KADUBERA
WIRASWASTA 5/11/1999 DEWASA UMUM PERUM BUMI TANJUNG ELOK
WIRASWASTA 10/6/1980 DEWASA UMUM CILILITAN
WIRASWASTA 8/10/1977 DEWASA UMUM KADUPANDAK
WIRASWASTA 3/30/1990 DEWASA UMUM KADUPANDAK
IRT 8/11/1992 DEWASA UMUM PERUM BUMI TANJUNG ELOK
IRT 7/6/1969 DEWASA UMUM KADUPANDAK
 Kepesertaan BPJS (tulis
'Ya' pada kolom yang Dosis I
sesuai) Merek Tanggal
No. Hp BPJS Non Tanggal
BPJS Vaksin*** Screening
Non Anggot Pemberian
PBI
PBI a Vaksinasi
083873092625 CORONAVAC 8/23/2021 8/23/2021
081240938251 CORONAVAC 8/23/2021 8/23/2021
083896009884 CORONAVAC 8/23/2021 8/23/2021
083891425463 CORONAVAC 8/23/2021 8/23/2021
083841157785 CORONAVAC 8/23/2021 8/23/2021
083041321908 CORONAVAC 8/23/2021 8/23/2021
083871497149 CORONAVAC 8/23/2021 8/23/2021
08381404734 CORONAVAC 8/23/2021 8/23/2021
083871339850 CORONAVAC 8/23/2021 8/23/2021
083813980023 CORONAVAC 8/23/2021 8/23/2021
085773751390 CORONAVAC 8/23/2021 8/23/2021
083898726646 CORONAVAC 8/23/2021 8/23/2021
083893712769 CORONAVAC 8/23/2021 8/23/2021
085215936300 CORONAVAC 8/23/2021 8/23/2021
083895970785 CORONAVAC 8/23/2021 8/23/2021
081511751087 CORONAVAC 8/23/2021 8/23/2021
083806912600 CORONAVAC 8/23/2021 8/23/2021
085710322738 CORONAVAC 8/23/2021 8/23/2021
085710322738 CORONAVAC 8/23/2021 8/23/2021
082294876386 CORONAVAC 8/23/2021 8/23/2021
083812881419 CORONAVAC 8/23/2021 8/23/2021
083871136024 CORONAVAC 8/23/2021 8/23/2021
081280414042 CORONAVAC 8/23/2021 8/23/2021
085887271808 CORONAVAC 8/23/2021 8/23/2021
083813125720 CORONAVAC 8/23/2021 8/23/2021
087787085271 CORONAVAC 8/23/2021 8/23/2021
081317695310 CORONAVAC 8/23/2021 8/23/2021
087872593958 CORONAVAC 8/23/2021 8/23/2021
083834937764 CORONAVAC 8/23/2021 8/23/2021
083812656635 CORONAVAC 8/23/2021 8/23/2021
083811443903 CORONAVAC 8/23/2021 8/23/2021
081511192887 CORONAVAC 8/23/2021 8/23/2021
085695392539 CORONAVAC 8/23/2021 8/23/2021
085770974893 CORONAVAC 8/23/2021 8/23/2021
083897041879 CORONAVAC 8/23/2021 8/23/2021
083895163637 CORONAVAC 8/23/2021 8/23/2021
083871664380 CORONAVAC 8/23/2021 8/23/2021
083891135634 CORONAVAC 8/23/2021 8/23/2021
083899878549 CORONAVAC 8/23/2021 8/23/2021
082110952365 CORONAVAC 8/23/2021 8/23/2021
085691098929 CORONAVAC 8/23/2021 8/23/2021
0881024707160 CORONAVAC 8/23/2021 8/23/2021
081295085694 CORONAVAC 8/23/2021 8/23/2021
085695148923 CORONAVAC 8/23/2021 8/23/2021
082310782520 CORONAVAC 8/23/2021 8/23/2021
082116393405 CORONAVAC 8/23/2021 8/23/2021
083875526288 CORONAVAC 8/23/2021 8/23/2021
081311981126 CORONAVAC 8/23/2021 8/23/2021
0859102830961 CORONAVAC 8/23/2021 8/23/2021
083899532913 CORONAVAC 8/23/2021 8/23/2021
083176507027 CORONAVAC 8/23/2021 8/23/2021
085710492671 CORONAVAC 8/23/2021 8/23/2021
088210587498 CORONAVAC 8/23/2021 8/23/2021
088213762029 CORONAVAC 8/23/2021 8/23/2021
08781677941 CORONAVAC 8/23/2021 8/23/2021
083870871324 CORONAVAC 8/23/2021 8/23/2021
081386414060 CORONAVAC 8/23/2021 8/23/2021
083841442915 CORONAVAC 8/23/2021 8/23/2021
083890726295 CORONAVAC 8/23/2021 8/23/2021
085814304088 CORONAVAC 8/23/2021 8/23/2021
083147320794 CORONAVAC 8/23/2021 8/23/2021
088290720313 CORONAVAC 8/23/2021 8/23/2021
083152532891 CORONAVAC 8/23/2021 8/23/2021
087872644752 CORONAVAC 8/23/2021 8/23/2021
081281983690 CORONAVAC 8/23/2021 8/23/2021
081281893690 CORONAVAC 8/23/2021 8/23/2021
081294761264 CORONAVAC 8/23/2021 8/23/2021
083813206443 CORONAVAC 8/23/2021 8/23/2021
085216049937 CORONAVAC 8/23/2021 8/23/2021
083138310009 CORONAVAC 8/23/2021 8/23/2021
085710496607 CORONAVAC 8/23/2021 8/23/2021
081386414060 CORONAVAC 8/23/2021 8/23/2021
082115102679 CORONAVAC 8/23/2021 8/23/2021
081398368310 CORONAVAC 8/23/2021 8/23/2021
083147320794 CORONAVAC 8/23/2021 8/23/2021
083812705685 CORONAVAC 8/23/2021 8/23/2021
083890405069 CORONAVAC 8/23/2021 8/23/2021
081315529398 CORONAVAC 8/23/2021 8/23/2021
085888485032 CORONAVAC 8/23/2021 8/23/2021
085694558648 CORONAVAC 8/23/2021 8/23/2021
081223792229 CORONAVAC 8/23/2021 8/23/2021
087879591497 CORONAVAC 8/23/2021 8/23/2021
083151305784 CORONAVAC 8/23/2021 8/23/2021
083893063949 CORONAVAC 8/23/2021 8/23/2021
082138900531 CORONAVAC 8/23/2021 8/23/2021
083156091909 CORONAVAC 8/23/2021 8/23/2021
Dosis I Dosis 2
Tanggal
No. Batch No seri Pemberian No. Batch No Seri
Vaksinasi
24201721 16096451778667 24201721 16096451778667
24201721 16096451778667 24201721 16096451778667
24201721 16096451778667 24201721 16096451778667
24201721 16096451778667 24201721 16096451778667
24201721 16096451778667 24201721 16096451778667
24201721 16096451778667 24201721 16096451778667
24201721 16096451778667 24201721 16096451778667
24201721 16096451778667 24201721 16096451778667
24201721 16096451778667 24201721 16096451778667
24201721 16096451778667 24201721 16096451778667
24201721 16096451778667 24201721 16096451778667
24201721 16096451778667 24201721 16096451778667
24201721 16096451778667 24201721 16096451778667
24201721 16096451778667 24201721 16096451778667
24201721 16096451778667 24201721 16096451778667
24201721 16096451778667 24201721 16096451778667
24201721 16096451778667 24201721 16096451778667
24201721 16096451778667 24201721 16096451778667
24201721 16096451778667 24201721 16096451778667
24201721 16096451778667 24201721 16096451778667
24201721 16096451778667 24201721 16096451778667
24201721 16096451778667 24201721 16096451778667
24201721 16096451778667 24201721 16096451778667
24201721 16096451778667 24201721 16096451778667
24201721 16096451778667 24201721 16096451778667
24201721 16096451778667 24201721 16096451778667
24201721 16096451778667 24201721 16096451778667
24201721 16096451778667 24201721 16096451778667
24201721 16096451778667 24201721 16096451778667
24201721 16096451778667 24201721 16096451778667
24201721 16096451778667 24201721 16096451778667
24201721 16096451778667 8/23/2021 24201721 16096451778667
24201721 16096451778667 8/23/2021 24201721 16096451778667
24201721 16096451778667 8/23/2021 24201721 16096451778667
24201721 16096451778667 8/23/2021 24201721 16096451778667
24201721 16096451778667 8/23/2021 24201721 16096451778667
24201721 16096451778667 8/23/2021 24201721 16096451778667
24201721 16096451778667 8/23/2021 24201721 16096451778667
24201721 16096451778667 8/23/2021 24201721 16096451778667
24201721 16096451778667 8/23/2021 24201721 16096451778667
24201721 16096451778667 8/23/2021 24201721 16096451778667
24201721 16096451778667 8/23/2021 24201721 16096451778667
24201721 16096451778667 8/23/2021 24201721 16096451778667
24201721 16096451778667 8/23/2021 24201721 16096451778667
24201721 16096451778667 8/23/2021 24201721 16096451778667
24201721 16096451778667 8/23/2021 24201721 16096451778667
24201721 16096451778667 8/23/2021 24201721 16096451778667
24201721 16096451778667 8/23/2021 24201721 16096451778667
24201721 16096451778667 8/23/2021 24201721 16096451778667
24201721 16096451778667 8/23/2021 24201721 16096451778667
24201721 16096451778667 8/23/2021 24201721 16096451778667
24201721 16096451778667 8/23/2021 24201721 16096451778667
24201721 16096451778667 8/23/2021 24201721 16096451778667
24201721 16096451778667 8/23/2021 24201721 16096451778667
24201721 16096451778667 8/23/2021 24201721 16096451778667
24201721 16096451778667 8/23/2021 24201721 16096451778667
24201721 16096451778667 8/23/2021 24201721 16096451778667
24201721 16096451778667 8/23/2021 24201721 16096451778667
24201721 16096451778667 8/23/2021 24201721 16096451778667
24201721 16096451778667 8/23/2021 24201721 16096451778667
24201721 16096451778667 8/23/2021 24201721 16096451778667
24201721 16096451778667 8/23/2021 24201721 16096451778667
24201721 16096451778667 8/23/2021 24201721 16096451778667
24201721 16096451778667 8/23/2021 24201721 16096451778667
24201721 16096451778667 8/23/2021 24201721 16096451778667
24201721 16096451778667 8/23/2021 24201721 16096451778667
24201721 16096451778667 8/23/2021 24201721 16096451778667
24201721 16096451778667 8/23/2021 24201721 16096451778667
24201721 16096451778667 8/23/2021 24201721 16096451778667
24201721 16096451778667 8/23/2021 24201721 16096451778667
24201721 16096451778667 8/23/2021 24201721 16096451778667
24201721 16096451778667 8/23/2021 24201721 16096451778667
24201721 16096451778667 8/23/2021 24201721 16096451778667
24201721 16096451778667 8/23/2021 24201721 16096451778667
24201721 16096451778667 8/23/2021 24201721 16096451778667
24201721 16096451778667 8/23/2021 24201721 16096451778667
24201721 16096451778667 8/23/2021 24201721 16096451778667
24201721 16096451778667 8/23/2021 24201721 16096451778667
24201721 16096451778667 8/23/2021 24201721 16096451778667
24201721 16096451778667 8/23/2021 24201721 16096451778667
24201721 16096451778667 8/23/2021 24201721 16096451778667
24201721 16096451778667 8/23/2021 24201721 16096451778667
24201721 16096451778667 8/23/2021 24201721 16096451778667
24201721 16096451778667 8/23/2021 24201721 16096451778667
24201721 16096451778667 8/23/2021 24201721 16096451778667
24201721 16096451778667 8/23/2021 24201721 16096451778667
 KET

DOSIS KE 1
DOSIS KE 1
DOSIS KE 1
DOSIS KE 1
DOSIS KE 1
DOSIS KE 1
DOSIS KE 1
DOSIS KE 1
DOSIS KE 1
DOSIS KE 1
DOSIS KE 1
DOSIS KE 1
DOSIS KE 1
DOSIS KE 1
DOSIS KE 1
DOSIS KE 1
DOSIS KE 1
DOSIS KE 1
DOSIS KE 1
DOSIS KE 1
DOSIS KE 1
DOSIS KE 1
DOSIS KE 1
DOSIS KE 1
DOSIS KE 1
DOSIS KE 1
DOSIS KE 1
DOSIS KE 1
DOSIS KE 1
DOSIS KE 1
DOSIS KE 1
DOSIS KE 2
DOSIS KE 2
DOSIS KE 2
DOSIS KE 2
DOSIS KE 2
DOSIS KE 2
DOSIS KE 2
DOSIS KE 2
DOSIS KE 2
DOSIS KE 2
DOSIS KE 2
DOSIS KE 2
DOSIS KE 2
DOSIS KE 2
DOSIS KE 2
DOSIS KE 2
DOSIS KE 2
DOSIS KE 2
DOSIS KE 2
DOSIS KE 2
DOSIS KE 2
DOSIS KE 2
DOSIS KE 2
DOSIS KE 2
DOSIS KE 2
DOSIS KE 2
DOSIS KE 2
DOSIS KE 2
DOSIS KE 2
DOSIS KE 2
DOSIS KE 2
DOSIS KE 2
DOSIS KE 2
DOSIS KE 2
DOSIS KE 2
DOSIS KE 2
DOSIS KE 2
DOSIS KE 2
DOSIS KE 2
DOSIS KE 2
DOSIS KE 2
DOSIS KE 2
DOSIS KE 2
DOSIS KE 2
DOSIS KE 2
DOSIS KE 2
DOSIS KE 2
DOSIS KE 2
DOSIS KE 2
DOSIS KE 2
DOSIS KE 2
DOSIS KE 2
DOSIS KE 2
DOSIS KE 2
DOSIS KE 2
LAPORANA NAMA-NAMA PENERIMA VAKSIN DOSIS 1 DAN 2 TERMIN

PUSKESMAS PICUNG

NO No. Ticket NIK Nama Penerima Vaksin JK

1 P-60Z0JZDD 7407022002840002 AMRAN S.E L

2 P-81QS2QY4 3601116004750004 ERNI P
3 P-9I85W6NT 3601112101020001 YEPI DIKI NAUFAL L
4 P-CKW0PCAF 3601181104720005 M. TAUFIK L
5 P-BOVEOYLU 3601111304960001 DEDE HEMAWAN L
6 P-C2VIET80 3601114107780333 ROHANI L
7 P-DO8HBNDO 2172022101980002 SURYA RAMADAN L
8 P-DGLLKBMJ 3601116806000003 MITA HERLANA P
9 P-ECKNFWRH 3602095407880001 YATI P
10 P-3J5NOT0I 3601110304880005 AHMAD BAEHAKI L
11 P-6TW4AFEH 3602094507930001 DESI YULISA P
12 P-FGJNHIP 3602094606920001 LELI NURYANTI P
13 P-B8KJZBA 3601115405000001 CUCU ERNAWATI P
14 P-G5J5VWCP 3601114502020001 WINDA PURWANTI P
15 P-G7SFAVFL 3601110107830131 IYAN L
16 P-GAWGHWSA 3601114211020002 IDA NURSAIDAH P
17 P-GBVW0KVU 3601115804010001 RETNONWULANDARI P
18 P-GCKIA9EI 3601114811980001 MELINA P
19 P-GDA17W8N 3601115712020002 YUYUN YUNENGSIH P
20 P-GDYXM0LN 3601115701030001 WILDA NURGIANI P
21 S-C05EF920 3601110509930002 ABUL HARIS L
22 P-GJWWCEBY 3601114706900001 YUSI PUJIATI P
23 P-H4KJQ8LP 3601115209010001 RISTA KUSMAWARDANI P
24 P-GY5TK6LF 3303125509850002 ENOK SITI DURIAH P
25 P-CAEBIT8A 3601110605080002 DENI KABBIR L
26 P-FSWTGGS8 3601314305050004 ROSMITA P
27 P-GFX4LHTV 3601115802050001 IMAS P
28 P-8YTF3WR4 3601312809030001 FEBRI ANDIKA L
29 P-8KAMA7L2 3601110403040003 REZA L
30 P-A0LIBCEE 3601110510080001 WALIN L
31 Q-000IEUMP 3601115501030001 TIA RUSTIANI NUR PADILAH P
32 Q-000IELKE 3601114107770040 DIDIN L
33 Q-000J7D7Z 3601114107930148 IRAH P
34 W-13C5FBA1 3601115102700002 UMU KULSUM P
35 Q-000IEQCI 3601111806970001 ERI KURNIA L
36 Q-000IETUV 3275082512890033 INDRA IRAWAN L
37 Q-000IEW34 3601116708830002 AMI P
38 Q-000IEZFL 3601114107730376 UMAYAH P
39 Q-000IFFI3 3602094710050001 ADWITA OKTORA P
40 Q-000IPQ1U 3601113010040001 ARIF LANGLANG WIBOWO L
41 Q-000IPOJ1 3601115602070001 AGNIA SALSABILA P
42 Q-000IPKVZ 3601115101040001 RHENA TABELA P
43 Q-000J7DV 3601115807070001 NAZKIYA ARBIKA S R P
44 Q-0009UD0O 3601114404030002 DEVI APR;LIANI P
45 Q-000J7D5R 3301210208880005 AGUS PRASETYANTO L
46 Q-000IMP5T 3602091011880001 MUMU L
47 Q-000IPL1H 3601110404050003 MUHAMAD APRIJAL L
48 Q-0001OB0 3521136107680001 YUS SRI HARTATI P
49 Q-000IFUUR 3601111111630001 PURHANDOKO L
 Umur
Kelompok
pekerjaan (18-59 INSTANSI Alamat
Umur
tahun)

WIRASWASTA 2/26/1984 DEWASA UMUM KP BONE ROMBO

IRT 4/20/1975 DEWASA UMUM PSR SEDANG
WIRASWASTA 10/28/2001 REMAJA UMUM PSR SEDANG
WIRASWASTA 4/11/1972 DEWASA UMUM KADUPANDAK
WIRASWASTA 4/13/1996 DEWASA UMUM PASIR PANJANG
WIRASWASTA 7/1/1978 DEWASA UMUM PASIR PANJANG
WIRASWASTA 1/21/1998 DEWASA UMUM DESA BATU
PELAJAR 6/28/2000 REMAJA UMUM KADUPANDAK
IRT 7/14/1988 DEWASA UMUM BANJARSARI
WIRASWASTA 4/3/1988 DEWASA UMUM KOLELET
IRT 7/5/1993 DEWASA UMUM BOJONG
IRT 3/1/1993 DEWASA UMUM BANJARSARI
IRT 9/24/1999 DEWASA UMUM KOLELET
PELAJAR 2/7/2002 REMAJA UMUM KADUPANDAK
WIRASWASTA 4/15/1983 DEWASA UMUM CIHERANG
PELAJAR 11/2/2002 REMAJA UMUM CIHERANG
PELAJAR 4/18/2001 REMAJA UMUM CILILITAN
IRT 9/5/1998 DEWASA UMUM PSR SEDANG
PELAJAR 12/17/2002 REMAJA UMUM PSR SEDANG
PELAJAR 2/15/2003 REMAJA UMUM PSR SEDANG
WIRASWASTA 9/5/1993 DEWASA UMUM CIHERANG
IRT 5/7/1990 DEWASA UMUM JATAKE
PELAJAR 9/12/2002 REMAJA UMUM KADUPANDAK
IRT 9/15/1985 DEWASA UMUM KADUPANDAK
PELAJAR 5/6/2008 REMAJA UMUM PASIR PANJANG
PELAJAR 5/3/2005 REMAJA UMUM PASAR BARU
PELAJAR 2/18/2005 REMAJA UMUM CILILITAN
PELAJAR 8/28/2003 REMAJA UMUM SINDANGRESMI
PELAJAR 3/4/2004 REMAJA UMUM PSR SEDANG
PELAJAR 10/5/2008 REMAJA UMUM PSR SEDANG
PELAJAR 1/15/2003 REMAJA UMUM KOLELET
WIRASWASTA 3/17/1985 DEWASA UMUM KOLELET
IRT 4/6/1992 DEWASA UMUM CIHERANG
IRT 2/11/1970 DEWASA UMUM B COPONG
WIRASWASTA 6/18/1997 DEWASA UMUM B COPONG
WIRASWASTA 12/25/1989 DEWASA UMUM CILILITAN
IRT 8/27/1983 DEWASA UMUM CILILITAN
IRT 9/15/1973 DEWASA UMUM CILILITAN
PELAJAR 10/7/2005 REMAJA UMUM BANJARSARI
PELAJAR 10/30/2004 REMAJA UMUM SERANG
PELAJAR 2/16/2007 REMAJA UMUM CILILITAN
PELAJAR 1/11/2004 REMAJA UMUM CILILITAN
PELAJAR 7/18/2007 REMAJA UMUM CILILITAN
PELAJAR 4/4/2003 REMAJA UMUM CIHERANG
WIRASWASTA 8/2/1988 DEWASA UMUM CIHERANG
WIRASWASTA 11/10/1988 DEWASA UMUM BANJARSARI
PELAJAR 4/4/2005 REMAJA UMUM CILILITAN
IRT 7/21/1968 DEWASA UMUM NGAWI
WIRASWASTA 11/11/1968 DEWASA UMUM BANJARSARI
 Kepesertaan BPJS (tulis
'Ya' pada kolom yang Dosis I
sesuai) Merek Tanggal
No. Hp BPJS Non Tanggal
BPJS Vaksin*** Screening
Non Anggot Pemberian
PBI
PBI a Vaksinasi
081241397074 CORONAVAC 8/21/2021 8/21/2021
083871297697 CORONAVAC 8/21/2021 8/21/2021
082258531313 CORONAVAC 8/21/2021 8/21/2021
085215990343 CORONAVAC 8/21/2021 8/21/2021
085692762153 CORONAVAC 8/21/2021 8/21/2021
085692762153 CORONAVAC 8/21/2021 8/21/2021
083899532899 CORONAVAC 8/21/2021 8/21/2021
083899532899 CORONAVAC 8/21/2021 8/21/2021
083147170105 CORONAVAC 8/21/2021 8/21/2021
083811665394 CORONAVAC 8/21/2021 8/21/2021
085710516495 CORONAVAC 8/21/2021 8/21/2021
083892164468 CORONAVAC 8/21/2021 8/21/2021
083834367304 CORONAVAC 8/21/2021 8/21/2021
083891863280 CORONAVAC 8/21/2021 8/21/2021
085718607134 CORONAVAC 8/21/2021 8/21/2021
083873587987 CORONAVAC 8/21/2021 8/21/2021
083149345725 CORONAVAC 8/21/2021 8/21/2021
0838414308354 CORONAVAC 8/21/2021 8/21/2021
083872364073 CORONAVAC 8/21/2021 8/21/2021
083804258738 CORONAVAC 8/21/2021 8/21/2021
085716767522 CORONAVAC 8/21/2021 8/21/2021
081382344050 CORONAVAC 8/21/2021 8/21/2021
085283151399 CORONAVAC 8/21/2021 8/21/2021
081295417049 CORONAVAC 8/21/2021 8/21/2021
085692762153 CORONAVAC 8/21/2021 8/21/2021
082116397813 CORONAVAC 8/21/2021 8/21/2021
083184411788 CORONAVAC 8/21/2021 8/21/2021
081317124241 CORONAVAC 8/21/2021 8/21/2021
083871297697 CORONAVAC 8/21/2021 8/21/2021
083871297697 CORONAVAC 8/21/2021 8/21/2021
081314274038 CORONAVAC 8/21/2021 8/21/2021
087785422240 CORONAVAC 8/21/2021 8/21/2021
083877673760 CORONAVAC 8/21/2021 8/21/2021
083896928743 CORONAVAC 8/21/2021 8/21/2021
083812758015 CORONAVAC 8/21/2021 8/21/2021
087882292800 CORONAVAC 8/21/2021 8/21/2021
087882292800 CORONAVAC 8/21/2021 8/21/2021
083875383963 CORONAVAC 8/21/2021 8/21/2021
083898635813 CORONAVAC 8/21/2021 8/21/2021
087776537532 CORONAVAC 8/21/2021 8/21/2021
085966338775 CORONAVAC 8/21/2021 8/21/2021
085719068658 CORONAVAC 8/21/2021 8/21/2021
081298230880 CORONAVAC 8/21/2021 8/21/2021
083891063248 CORONAVAC 8/21/2021 8/21/2021
08387899490 CORONAVAC 8/21/2021 8/21/2021
085888393849 CORONAVAC 8/21/2021 8/21/2021
085966338784 CORONAVAC 8/21/2021 8/21/2021
081907355097 CORONAVAC 8/21/2021 8/21/2021
081210409745 CORONAVAC 8/21/2021 8/21/2021
Dosis I Dosis 2
Tanggal
No. Batch No seri Pemberian No. Batch No Seri
Vaksinasi
24201721 16096451778667 23-09-21 24201721 16096451778667
24201721 16096451778667 23-09-21 24201721 16096451778667
24201721 16096451778667 23-09-21 24201721 16096451778667
24201721 16096451778667 23-09-21 24201721 16096451778667
24201721 16096451778667 23-09-21 24201721 16096451778667
24201721 16096451778667 23-09-21 24201721 16096451778667
24201721 16096451778667 23-09-21 24201721 16096451778667
24201721 16096451778667 23-09-21 24201721 16096451778667
24201721 16096451778667 23-09-21 24201721 16096451778667
24201721 16096451778667 23-09-21 24201721 16096451778667
24201721 16096451778667 23-09-21 24201721 16096451778667
24201721 16096451778667 23-09-21 24201721 16096451778667
24201721 16096451778667 23-09-21 24201721 16096451778667
24201721 16096451778667 23-09-21 24201721 16096451778667
24201721 16096451778667 23-09-21 24201721 16096451778667
24201721 16096451778667 23-09-21 24201721 16096451778667
24201721 16096451778667 23-09-21 24201721 16096451778667
24201721 16096451778667 23-09-21 24201721 16096451778667
24201721 16096451778667 23-09-21 24201721 16096451778667
24201721 16096451778667 23-09-21 24201721 16096451778667
24201721 16096451778667 23-09-21 24201721 16096451778667
24201721 16096451778667 23-09-21 24201721 16096451778667
24201721 16096451778667 23-09-21 24201721 16096451778667
24201721 16096451778667 23-09-21 24201721 16096451778667
24201721 16096451778667 23-09-21 24201721 16096451778667
24201721 16096451778667 23-09-21 24201721 16096451778667
24201721 16096451778667 23-09-21 24201721 16096451778667
24201721 16096451778667 23-09-21 24201721 16096451778667
24201721 16096451778667 23-09-21 24201721 16096451778667
24201721 16096451778667 8/23/2021 24201721 16096451778667
24201721 16096451778667 8/24/2021 24201721 16096451778667
24201721 16096451778667 8/25/2021 24201721 16096451778667
24201721 16096451778667 8/26/2021 24201721 16096451778667
24201721 16096451778667 8/27/2021 24201721 16096451778667
24201721 16096451778667 8/28/2021 24201721 16096451778667
24201721 16096451778667 8/29/2021 24201721 16096451778667
24201721 16096451778667 8/30/2021 24201721 16096451778667
24201721 16096451778667 8/31/2021 24201721 16096451778667
24201721 16096451778667 9/1/2021 24201721 16096451778667
24201721 16096451778667 9/2/2021 24201721 16096451778667
24201721 16096451778667 9/3/2021 24201721 16096451778667
24201721 16096451778667 9/4/2021 24201721 16096451778667
24201721 16096451778667 9/5/2021 24201721 16096451778667
24201721 16096451778667 9/6/2021 24201721 16096451778667
24201721 16096451778667 9/7/2021 24201721 16096451778667
24201721 16096451778667 9/8/2021 24201721 16096451778667
24201721 16096451778667 9/9/2021 24201721 16096451778667
24201721 16096451778667 9/10/2021 24201721 16096451778667
24201721 16096451778667 9/11/2021 24201721 16096451778667
 KET

DOSIS KE 1
DOSIS KE 1
DOSIS KE 1
DOSIS KE 1
DOSIS KE 1
DOSIS KE 1
DOSIS KE 1
DOSIS KE 1
DOSIS KE 1
DOSIS KE 1
DOSIS KE 1
DOSIS KE 1
DOSIS KE 1
DOSIS KE 1
DOSIS KE 1
DOSIS KE 1
DOSIS KE 1
DOSIS KE 1
DOSIS KE 1
DOSIS KE 1
DOSIS KE 1
DOSIS KE 1
DOSIS KE 1
DOSIS KE 1
DOSIS KE 1
DOSIS KE 1
DOSIS KE 1
DOSIS KE 1
DOSIS KE 1
DOSIS KE 1
DOSIS KE 2
DOSIS KE 2
DOSIS KE 2
DOSIS KE 2
DOSIS KE 2
DOSIS KE 2
DOSIS KE 2
DOSIS KE 2
DOSIS KE 2
DOSIS KE 2
DOSIS KE 2
DOSIS KE 2
DOSIS KE 2
DOSIS KE 2
DOSIS KE 2
DOSIS KE 2
DOSIS KE 2
DOSIS KE 2
DOSIS KE 2
LAPORANA NAMA-NAMA PENERIMA VAKSIN DOSIS 1 DAN 2 TERMIN 6

PUSKESMAS PICUNG

NO No. Ticket NIK Nama Penerima Vaksin JK

1 P-686RDFBS 3601110107930141 ISMAIL L

2 P-1185JVHF 3601114407820003 TATU MARYANI P
3 P-15X3GO0U 3602090101830001 RIPAI L
4 P-13XE5M2W 3601110207740004 TAJIDIN L
5 P-18FB881Y 3602130804940002 HERU PRANYOTO L
6 P-1BAEEPI2 3602092304860001 KAMALUDIN L
7 P-EDWVVYBU 3601110107670024 YAYAT JUMIYATI L
8 P-0S9J1GOS 3601116610010002 IRMA DAMAYANTI P
9 P-1JNZUHLM 3602094403820003 ARMANAH P
10 P-1PWFQZCU 3601310701880001 HAERUDIN L
11 P-1N4F3WLS 3602095003750001 SITI P
12 P-1TM2IVS4 3601310402940006 ENDI L
13 P-1VG9AQH9 3601116501060003 AJENG PUTRI RAHAYU P
14 P-2P8UNLTV 3601100511660001 JOHNNY H RUMAGIT L
15 P-2REFSB5U 3601103110020003 SURYA ANDIKA RUMAGIT L
16 P-0105YBIR 3601100107830017 JASID L
17 P-0KAVA0VF 3604010305900341 YOGI SURYA HADI L
18 P-0M24SNB8 3601106305050001 MARIA P
19 P-0NLS742O 3601111708820002 WEY ANDRE L
20 P-0QAM6JQE 3601100107950017 SANGSANG L
21 P-0OQS71RT 3601311002990006 DIKI L
22 P-0RYOVYND 3601116108910001 NARSIH P
23 P-0TISSEIC 3601110207830018 MAHMUD L
24 P-0UZ4DP6B 1804251506040002 ZAINAL MASHURI L
25 P-3KT2PDYN 3601105307660001 YAYAT RUYATI P
26 P-3EFJMHR9 3601114105020005 SITI MARDIYANA P
27 P-2WYKQ36A 3601115804960003 ITA PURNAMA SARI P
28 Q-000IEP2G 3601110707750002 DAHLAN L
29 Q-000IEJGL 3601110204750002 JAENUDIN L
30 Z-00005ZYVT 3601113107600001 ASYIK L
31 Q-0009FJZR 3601115605710001 SUAH P
32 Q-0009SOF6 3601114107020121 AMELIA P
 Umur
Kelompok
pekerjaan (18-59 INSTANSI Alamat
Umur
tahun)

WIRASWASTA 10/17/1992 DEWASA UMUM KADUPANDAK

IRT 9/8/1986 DEWASA UMUM CILILITAN
WIRASWASTA 10/5/1993 DEWASA UMUM BANJARSARI
WIRASWASTA 3/23/1966 DEWASA UMUM CILILITAN
WIRASWASTA 4/8/1994 DEWASA UMUM MAJA
WIRASWASTA 8/5/1991 DEWASA UMUM BANJARSARI
WIRASWASTA 1/5/1968 DEWASA UMUM KADUPANDAK
MAHASISWA 10/26/2001 DEWASA UMUM KADUPANDAK
IRT 3/4/1982 DEWASA UMUM BANJARSARI
WIRASWASTA 6/11/1996 DEWASA UMUM SINDANGRESMI
WIRASWASTA 3/10/1975 DEWASA UMUM BANJARSARI
WIRASWASTA 2/4/1994 DEWASA UMUM SINDANGRESMI
PELAJAR 1/25/2006 DEWASA UMUM B COPONG
WIRASWASTA 6/13/1964 DEWASA UMUM BOJONG
PELAJAR 10/31/2002 DEWASA UMUM BOJONG
WIRASWASTA 7/1/1983 DEWASA UMUM BOJONG
WIRASWASTA 5/3/1990 DEWASA UMUM CIPARE
PELAJAR 3/15/2006 DEWASA UMUM CIMAJA
WIRASWASTA 8/17/1982 DEWASA UMUM BANJARSARI
WIRASWASTA 9/13/1994 DEWASA UMUM BANJARSARI
WIRASWASTA 10/23/1998 DEWASA UMUM SINDANGRESMI
IRT 8/21/1991 DEWASA UMUM BANJARSARI
WIRASWASTA 4/12/1983 DEWASA UMUM BANJARSARI
PELAJAR 6/15/2004 DEWASA UMUM KADUPANDAK
IRT 3/20/1965 DEWASA UMUM BOJONG
MAHASISWA 5/1/2002 DEWASA UMUM CIHERANG
IRT 4/18/1996 DEWASA UMUM KADUPANDAK
WIRASWASTA 7/7/1975 DEWASA UMUM PASIR BINGLU
WIRASWASTA 9/26/1972 DEWASA UMUM CIHERANG
WIRASWASTA 1/4/1960 DEWASA UMUM CIHERANG
IRT 5/16/1971 DEWASA UMUM CIHERANG
IRT 9/6/2002 DEWASA UMUM CIHERANG
 Kepesertaan BPJS (tulis
'Ya' pada kolom yang Dosis I
sesuai) Merek Tanggal
No. Hp BPJS Non Tanggal
BPJS Vaksin*** Screening
Non Anggot Pemberian
PBI
PBI a Vaksinasi
081295417049 CORONAVAC 8/18/2021 8/18/2021
085814300365 CORONAVAC 8/18/2021 8/18/2021
085718239407 CORONAVAC 8/18/2021 8/18/2021
085773641295 CORONAVAC 8/18/2021 8/18/2021
081299730514 CORONAVAC 8/18/2021 8/18/2021
085695385926 CORONAVAC 8/18/2021 8/18/2021
081911608770 CORONAVAC 8/18/2021 8/18/2021
083841419886 CORONAVAC 8/18/2021 8/18/2021
083818222541 CORONAVAC 8/18/2021 8/18/2021
085888448780 CORONAVAC 8/18/2021 8/18/2021
083871136257 CORONAVAC 8/18/2021 8/18/2021
08568512403 CORONAVAC 8/18/2021 8/18/2021
083808521949 CORONAVAC 8/18/2021 8/18/2021
081288129784 CORONAVAC 8/18/2021 8/18/2021
083147284196 CORONAVAC 8/18/2021 8/18/2021
083877396664 CORONAVAC 8/18/2021 8/18/2021
087821087857 CORONAVAC 8/18/2021 8/18/2021
081387859944 CORONAVAC 8/18/2021 8/18/2021
08567271110 CORONAVAC 8/18/2021 8/18/2021
083873093168 CORONAVAC 8/18/2021 8/18/2021
085770091810 CORONAVAC 8/18/2021 8/18/2021
085972805391 CORONAVAC 8/18/2021 8/18/2021
085972805391 CORONAVAC 8/18/2021 8/18/2021
081280853871 CORONAVAC 8/18/2021 8/18/2021
083895708109 CORONAVAC 8/18/2021 8/18/2021
083892394759 CORONAVAC 8/18/2021 8/18/2021
082114979857 CORONAVAC 8/18/2021 8/18/2021
083127165204 CORONAVAC 8/18/2021 8/18/2021
087854348714 CORONAVAC 8/18/2021 8/18/2021
CORONAVAC 8/18/2021 8/18/2021
085710322738 CORONAVAC 8/18/2021 8/18/2021
083896373330 CORONAVAC 8/18/2021 8/18/2021
Dosis I Dosis 2
Tanggal
No. Batch No seri Pemberian No. Batch No Seri
Vaksinasi
24003121 16096451778667 18-09-2021 24003121 16096451778667
24003121 16096451778667 18-09-2021 24003121 16096451778667
24003121 16096451778667 18-09-2021 24003121 16096451778667
24003121 16096451778667 18-09-2021 24003121 16096451778667
24003121 16096451778667 18-09-2021 24003121 16096451778667
24003121 16096451778667 18-09-2021 24003121 16096451778667
24003121 16096451778667 18-09-2021 24003121 16096451778667
24003121 16096451778667 18-09-2021 24003121 16096451778667
24003121 16096451778667 18-09-2021 24003121 16096451778667
24003121 16096451778667 18-09-2021 24003121 16096451778667
24003121 16096451778667 18-09-2021 24003121 16096451778667
24003121 16096451778667 18-09-2021 24003121 16096451778667
24003121 16096451778667 18-09-2021 24003121 16096451778667
24003121 16096451778667 18-09-2021 24003121 16096451778667
24003121 16096451778667 18-09-2021 24003121 16096451778667
24003121 16096451778667 18-09-2021 24003121 16096451778667
24003121 16096451778667 18-09-2021 24003121 16096451778667
24003121 16096451778667 18-09-2021 24003121 16096451778667
24003121 16096451778667 18-09-2021 24003121 16096451778667
24003121 16096451778667 18-09-2021 24003121 16096451778667
24003121 16096451778667 18-09-2021 24003121 16096451778667
24003121 16096451778667 18-09-2021 24003121 16096451778667
24003121 16096451778667 18-09-2021 24003121 16096451778667
24003121 16096451778667 18-09-2021 24003121 16096451778667
24003121 16096451778667 18-09-2021 24003121 16096451778667
24003121 16096451778667 18-09-2021 24003121 16096451778667
24003121 16096451778667 18-09-2021 24003121 16096451778667
24003121 16096451778667 8/18/2021 24003121 16096451778667
24003121 16096451778667 8/18/2021 24003121 16096451778667
24003121 16096451778667 8/18/2021 24003121 16096451778667
24003121 16096451778667 8/18/2021 24003121 16096451778667
24003121 16096451778667 18-09-2021 24003121 16096451778667
 KET

DOSIS KE 1
DOSIS KE 1
DOSIS KE 1
DOSIS KE 1
DOSIS KE 1
DOSIS KE 1
DOSIS KE 1
DOSIS KE 1
DOSIS KE 1
DOSIS KE 1
DOSIS KE 1
DOSIS KE 1
DOSIS KE 1
DOSIS KE 1
DOSIS KE 1
DOSIS KE 1
DOSIS KE 1
DOSIS KE 1
DOSIS KE 1
DOSIS KE 1
DOSIS KE 1
DOSIS KE 1
DOSIS KE 1
DOSIS KE 1
DOSIS KE 1
DOSIS KE 1
DOSIS KE 1
DOSIS KE 2
DOSIS KE 2
DOSIS KE 2
DOSIS KE 2
LAPORANA NAMA-NAMA PENERIMA VAKSIN DOSIS 1 DAN 2 TERMIN 6

PUSKESMAS PICUNG

NO No. Ticket NIK Nama Penerima Vaksin JK

1 W-9C2D28ED 3601114107910209 ENENG MILA FADILA AMD.KEP

2 J-0000O2B3 3601115911020001 DEA SUDIANAH P
3 Q-000AKDWO 3601114107750116 UTIN MURNIATI P
4 Q-0009FK0H 3601116306900002 YENI HERIYANI P
5 Q-0009RI70 3601115304730001 ENENG TETI P
6 Q-000CKGUT 3601110107700086 SANUN P
7 Q-000A7HPL 3601114107760077 NURSINAAH P
8 Q-0009RU7U 3601114107830117 UCUN P
9 Q-0009FJVD 3601114107020058 INES MARSELINE P
10 Q-000A6CKG 3601114107780330 UMSIAH P
11 P-GEM0Y8UP 3601114107860097 APIAH P
 Umur
Kelompok
pekerjaan (18-59 INSTANSI Alamat
Umur
tahun)

BIDAN 12/7/1993 DEWASA NAKES B COPONG

PELAJAR 7/8/2003 DEWASA UMUM GANGGAENG
IRT 6/8/1976 DEWASA UMUM KP SAWAH
IRT 6/23/1990 DEWASA UMUM KADUPANDAK
IRT 8/7/1973 DEWASA UMUM KOLELET
IRT 1/1/1969 DEWASA UMUM KP SAWAH
IRT 1/1/1977 DEWASA UMUM CILILITAN
IRT 7/1/1983 DEWASA UMUM CILILITAN
MAHASISWA 9/30/2001 DEWASA UMUM CILILITAN
IRT 3/4/1986 DEWASA UMUM CILILITAN
IRT 2/23/1982 DEWASA UMUM B COPONG
 Kepesertaan BPJS (tulis
'Ya' pada kolom yang Dosis I
sesuai) Merek Tanggal
No. Hp BPJS Non Tanggal
BPJS Vaksin*** Screening
Non Anggot Pemberian
PBI
PBI a Vaksinasi
083125324825 CORONA VAC 8/14/2021 8/14/2021
085694637746 CORONA VAC 8/14/2021 8/14/2021
083896532618 CORONA VAC 8/14/2021 8/14/2021
083834937801 CORONA VAC 8/14/2021 8/14/2021
085283712494 CORONA VAC 8/14/2021 8/14/2021
083896532618 CORONA VAC 8/14/2021 8/14/2021
083815225531 CORONA VAC 8/14/2021 8/14/2021
082310670553 CORONA VAC 8/14/2021 8/14/2021
081219237954 CORONA VAC 8/14/2021 8/14/2021
082310670553 CORONA VAC 8/14/2021 8/14/2021
083892844142 CORONA VAC 8/14/2021 8/14/2021
Dosis I Dosis 2
Tanggal
No. Batch No seri Pemberian No. Batch No Seri
Vaksinasi
24003121 16096451778667 14-09-2021 24003121 16096451778667
24003121 16096451778667 14-09-2021 24003121 16096451778667
24003121 16096451778667 14-09-2021 24003121 16096451778667
24003121 16096451778667 14-09-2021 24003121 16096451778667
24003121 16096451778667 14-09-2021 24003121 16096451778667
24003121 16096451778667 14-09-2021 24003121 16096451778667
24003121 16096451778667 14-09-2021 24003121 16096451778667
24003121 16096451778667 14-09-2021 24003121 16096451778667
24003121 16096451778667 14-09-2021 24003121 16096451778667
24003121 16096451778667 14-09-2021 24003121 16096451778667
24003121 16096451778667 14-09-2021 24003121 16096451778667
 KET

VAKSIN KE 1
VAKSIN KE 1
VAKSIN KE 1
VAKSIN KE 1
VAKSIN KE 1
VAKSIN KE 1
VAKSIN KE 1
VAKSIN KE 1
VAKSIN KE 1
VAKSIN KE 1
VAKSIN KE 1
LAPORANA NAMA-NAMA PENERIMA VAKSIN DOSIS 1 DAN 2 TERMIN 6

PUSKESMAS PICUNG

NO No. Ticket NIK Nama Penerima Vaksin JK

1 P-M02TZHCK 3601171903920005 ANDI L

2 P-0MATTELU 3601114107950020 LILIS NOVITASARI P
3 P-LR7ROWIW 3601110903960007 RIPANDI L
4 P-LL0JJRSB 3601116605010002 YUNI LESTARI P
5 Q-000AXLNI 3602095807910002 PIPIT PITRIYANI P
6 Q-000AXV87 3601104810930003 VIVI IRIYANTI P
7 3601114207850022 ADE YUSTIANA P
8 P-KTXVKHIR 3601110302950001 M HADI L
 Umur
Kelompok
pekerjaan (18-59 INSTANSI Alamat
Umur
tahun)

WIRASWASTA 3/19/1992 DEWASA UMUM KP. TENJO

IRT 11/30/1995 DEWASA UMUM CIKUJANG
WIRASWASTA 3/9/1996 DEWASA UMUM CILILITAN
IRT 5/26/2001 DEWASA UMUM PSR SEDANG
IRT 6/18/1991 DEWASA UMUM BANJARSARI
IRT 10/8/1993 DEWASA UMUM BOJONG
IRT 6/13/1984 DEWASA UMUM CILILITAN
WIRASWASTA 8/10/1992 DEWASA UMUM KOLELET
 Kepesertaan BPJS (tulis
'Ya' pada kolom yang Dosis I
sesuai) Merek Tanggal
No. Hp BPJS Non Tanggal
BPJS Vaksin*** Screening
Non Anggot Pemberian
PBI
PBI a Vaksinasi
085920023733 CORONA VAC 8/10/2021 8/10/2021
085920023733 CORONA VAC 8/10/2021 8/10/2021
085774504490 CORONA VAC 8/10/2021 8/10/2021
081299125364 CORONA VAC 8/10/2021 8/10/2021
085710530662 CORONA VAC 8/10/2021 8/10/2021
082246806536 CORONA VAC 8/10/2021 8/10/2021
085880002816 CORONA VAC 8/10/2021 8/10/2021
081382344050 CORONA VAC 8/10/2021 8/10/2021
Dosis I Dosis 2
Tanggal
No. Batch No seri Pemberian No. Batch No Seri
Vaksinasi
24003121 16096451778667 9/10/2021 24003121 16096451778667
24003121 16096451778667 9/10/2021 24003121 16096451778667
24003121 16096451778667 9/10/2021 24003121 16096451778667
24003121 16096451778667 9/10/2021 24003121 16096451778667
24003121 16096451778667 9/10/2021 24003121 16096451778667
24003121 16096451778667 9/10/2021 24003121 16096451778667
24003121 16096451778667 8/10/2021 24003121 16096451778667
24003121 16096451778667 8/10/2021 24003121 16096451778667
 KET

VAKSIN KE 1
VAKSIN KE 1
VAKSIN KE 1
VAKSIN KE 1
VAKSIN KE 1
VAKSIN KE 1
POLRES
ODGJ
LAPORANA NAMA-NAMA PENERIMA VAKSIN DOSIS 1 DAN 2 TERMIN 6

PUSKESMAS PICUNG

NO No. Ticket NIK Nama Penerima Vaksin JK

1 P-BJ5HFEXQ 3601110107630108 AHMAD L

2 Q-000CMW9I 3601114207820004 ITING ONILAH L
3 W-0000AIIZ 3601314312890001 YEYET P
4 Q-000A5U1O 3601114107780095 SALNAH P
5 P-JJLKZZJ5 3602094101050001 ADELIA P
6 P-IRFJVO76 3671052408070007 MUHAMAD IRFAN L
7 P-JIFFFIVJ 3601116307080001 RIYANTI P
8 P-JKJ0BSD0 3602096101040003 MAWAR NOVIANA P
9 P-IWJ4B9RY 3601111908040001 EZKA FAUZAN AZIZ L
10 P-IVLG1F0N 3601111703040003 MUHAMAD IRFAN L
11 P-ASCH3SAL 3601112003040002 FIRZAN ADITYA SAPUTRA L
12 P-7J58UULF 3601110406890003 DEDE MUHADI L
13 P-82HILJ7U 3601116401020001 SITI ASRIYANI P
14 P-HOYVAYC7 3601111810800001 DEDEN SUHENDRA L
15 P-HOOZDB02 3601110107870082 HENDRI L
16 P-HQD2DEYX 3601116503920001 YULIAWATI P
17 P-HS4QH0U 3602090612870002 JUHAEDI MAHENDRA L
18 P-HSR19VHA 3601115504700001 SITI ENOH P
19 P-HTY49TW1 3601110510700003 ULUNG SUGIARTO L
20 P-IY2ODDFM 3601110607030005 YORIS MAULANA L
21 P-IBPQYYQC 3601116312030003 DINI FITRIYANI P
22 P-IUHQ0DP3 3601115606030001 LELA LAELATUL M P
23 S-6E7640B7 3601172510690001 YAYAT L
24 P-IXAEN7YP 3601112810990002 ACUN SUHENDAR L
25 P-ITICYXD1 3601111802640001 PEI SUHENDI L
26 P-18G391QO 3602091012920001 DEDE SUPARDI L
27 P-HZKLBYBF 3601192610000005 NANDIKA FANI CANDRAWANP
28 S-4AC1C054 3602092206920001 ULFI GEMPAR PERMANA L
29
30
31
32
33
34
35
36
37
38
39
40
41
42
43
44
45
46
47
48
49
50
51
52
53
54
55
56
57
58
59
60
61
62
63
64
65
66
67
68
69
70
71
72
73
74
75
76
77
78
79
80
81
82
83
84
85
86
87
88
89
90
 Umur
Kelompok
pekerjaan (18-59 INSTANSI Alamat
Umur
tahun)

WIRASWASTA 11/6/1963 DEWASA UMUM CILILITAN

WIRASWASTA 6/23/1986 DEWASA UMUM CILILITAN
IRT 3/4/1986 DEWASA UMUM SINDANG RESMI
IRT 5/10/1979 DEWASA UMUM CILILITAN
PELAJAR 10/8/2004 REMAJA UMUM BANJARSARI
PELAJAR 8/24/2007 REMAJA UMUM CIPONDOH
PELAJAR 7/23/2008 REMAJA UMUM KOLELET
PELAJAR 11/21/2004 REMAJA UMUM BANJARSARI
PELAJAR 8/19/2004 REMAJA UMUM KOLELET
PELAJAR 3/17/2004 REMAJA UMUM KOLELET
PELAJAR 3/20/2004 REMAJA UMUM CILILITAN
WIRASWASTA 6/4/1989 DEWASA UMUM KOLELET
IRT 5/5/2002 DEWASA UMUM KOLELET
WIRASWASTA 10/18/1980 DEWASA UMUM KADUPANDAK
WIRASWASTA 7/1/1987 DEWASA UMUM KADUPANDAK
IRT 3/25/1992 DEWASA UMUM CILILITAN
WIRASWASTA 12/6/1987 DEWASA UMUM CILILITAN
IRT 5/4/1971 DEWASA UMUM KADUPANDAK
WIRASWASTA 10/5/1970 DEWASA UMUM KOLELET
MAHASISWA 7/6/2003 REMAJA UMUM KOLELET
MAHASISWA 12/23/2003 REMAJA UMUM CILILITAN
MAHASISWA 6/16/2003 REMAJA UMUM KADUPANDAK
WIRASWASTA 10/25/1969 DEWASA UMUM MANDALAWANGI
WIRASWASTA 10/28/1999 DEWASA UMUM KOLELET
WIRASWASTA 11/15/1965 DEWASA UMUM KOLELET
WIRASWASTA 12/25/1992 DEWASA UMUM BANJARSARI
MAHASISWA 10/26/2000 DEWASA UMUM KADUHEJO
WIRASWASTA 6/22/1992 DEWASA UMUM PICUNG
 Kepesertaan BPJS (tulis
'Ya' pada kolom yang Dosis I
sesuai) Merek Tanggal
No. Hp BPJS Non Tanggal
BPJS Vaksin*** Screening
Non Anggot Pemberian
PBI
PBI a Vaksinasi
083841386003 CORONA VAC 8/9/2021 8/9/2021
085710516412 CORONA VAC 8/9/2021 8/9/2021
081289211938 CORONA VAC 8/9/2021 8/9/2021
083147335146 CORONA VAC 8/9/2021 8/9/2021
085280511008 CORONA VAC 8/9/2021 8/9/2021
089514827828 CORONA VAC 8/9/2021 8/9/2021
081286359820 CORONA VAC 8/9/2021 8/9/2021
085894196240 CORONA VAC 8/9/2021 8/9/2021
083806226490 CORONA VAC 8/9/2021 8/9/2021
085218901610 CORONA VAC 8/9/2021 8/9/2021
085693166257 CORONA VAC 8/9/2021 8/9/2021
083147151444 CORONA VAC 8/9/2021 8/9/2021
083834937737 CORONA VAC 8/9/2021 8/9/2021
085213037857 CORONA VAC 8/9/2021 8/9/2021
085283858730 CORONA VAC 8/9/2021 8/9/2021
081315521020 CORONA VAC 8/9/2021 8/9/2021
083812356750 CORONA VAC 8/9/2021 8/9/2021
081224973097 CORONA VAC 8/9/2021 8/9/2021
083878820111 CORONA VAC 8/9/2021 8/9/2021
083891060530 CORONA VAC 8/9/2021 8/9/2021
081413309925 CORONA VAC 8/9/2021 8/9/2021
083110006487 CORONA VAC 8/9/2021 8/9/2021
CORONA VAC 8/9/2021 8/9/2021
083850309146 CORONA VAC 8/9/2021 8/9/2021
083871297543 CORONA VAC 8/9/2021 8/9/2021
088809068769 CORONA VAC 8/9/2021 8/9/2021
082213657216 CORONA VAC 8/9/2021 8/9/2021
082299909122 CORONA VAC 8/9/2021 8/9/2021
Dosis I Dosis 2
Tanggal
No. Batch No seri Pemberian No. Batch No Seri
Vaksinasi
24003121 16096451778667 8/9/2021 24003121 16096451778667
24003121 16096451778667 8/9/2021 24003121 16096451778667
24003121 16096451778667 8/9/2021 24003121 16096451778667
24003121 16096451778667 8/9/2021 24003121 16096451778667
24003121 16096451778667 09-09-2021 24003121 16096451778667
24003121 16096451778667 09-09-2021 24003121 16096451778667
24003121 16096451778667 09-09-2021 24003121 16096451778667
24003121 16096451778667 09-09-2021 24003121 16096451778667
24003121 16096451778667 09-09-2021 24003121 16096451778667
24003121 16096451778667 09-09-2021 24003121 16096451778667
24003121 16096451778667 09-09-2021 24003121 16096451778667
24003121 16096451778667 09-09-2021 24003121 16096451778667
24003121 16096451778667 09-09-2021 24003121 16096451778667
24003121 16096451778667 09-09-2021 24003121 16096451778667
24003121 16096451778667 09-09-2021 24003121 16096451778667
24003121 16096451778667 09-09-2021 24003121 16096451778667
24003121 16096451778667 09-09-2021 24003121 16096451778667
24003121 16096451778667 09-09-2021 24003121 16096451778667
24003121 16096451778667 09-09-2021 24003121 16096451778667
24003121 16096451778667 09-09-2021 24003121 16096451778667
24003121 16096451778667 09-09-2021 24003121 16096451778667
24003121 16096451778667 09-09-2021 24003121 16096451778667
24003121 16096451778667 09-09-2021 24003121 16096451778667
24003121 16096451778667 09-09-2021 24003121 16096451778667
24003121 16096451778667 09-09-2021 24003121 16096451778667
24003121 16096451778667 09-09-2021 24003121 16096451778667
24003121 16096451778667 09-09-2021 24003121 16096451778667
24003121 16096451778667 09-09-2021 24003121 16096451778667
 KET

VAKSIN KE 2
VAKSIN KE 2
VAKSIN KE 2
VAKSIN KE 2
VAKSIN KE 1
VAKSIN KE 1
VAKSIN KE 1
VAKSIN KE 1
VAKSIN KE 1
VAKSIN KE 1
VAKSIN KE 1
VAKSIN KE 1
VAKSIN KE 1
VAKSIN KE 1
VAKSIN KE 1
VAKSIN KE 1
VAKSIN KE 1
VAKSIN KE 1
VAKSIN KE 1
VAKSIN KE 1
VAKSIN KE 1
VAKSIN KE 1
VAKSIN KE 1
VAKSIN KE 1
VAKSIN KE 1
VAKSIN KE 1
VAKSIN KE 1
VAKSIN KE 1
LAPORANA NAMA-NAMA PENERIMA VAKSIN DOSIS 1 DAN 2 TERMIN 6

PUSKESMAS PICUNG

NO No. Ticket NIK Nama Penerima Vaksin JK

1 P-ECQQ2T5M 3601312804850001 CUCU SITA MIHARJA P

2 P-DD39UJOB 3601115510000002 ILA MUTMAINAH P
3 P-DC26HXQ8 3601110107730059 MAHFUDIN L
4 P-DAG7OEKU 3601111410030002 YUSEP M L
5 P-CX6PSPIS 3601105610720001 TATI HIKAMAYATI P
6 P-DBB6XGTN 3601111707620001 ATIB L
7 P-D5E4ETM3 3601115010890008 MIRA OCTAVIA P
8 P-7HMVCLJI 3601111203020002 MAHMUD HAMBALI L
9 Y-0135ZGTU 3602095903830003 HERLINA PUSPA SUSANTI P
10 P-D4H73JV5 3601114312930001 ENE DILLA P
11 P-D3JE8P8B 3601116808780001 RINA REVIANTI P
12 P-YSS2NWOR 3601116910030001 OKTAVIANI RAMADITA P
13 P-D0RL7WJY 3601116804970001 UTARI HANDAYANI P
14 P-CZWLHDR5 3601116003080003 ELSA MUTIARA SANDRA P
15 P-AWMXZE2Z 3601112609940001 IMAN SUDIRMAN L
16 P-CW5L7AO9 3601116806030002 GITA PRIMAWATI P
17 P-CUSU18T9 3601114107730375 NUNUNG P
18 P-CU5WB9US 3601111909990002 REZA PEBRIANSYAH L
19 P-CTGC2N0O 3601110508840001 NANA SURYANA L
20 P-CSQYR00U 3601110711990002 GILAR GUMILAR R L
21 P-CRII0AIF 3601114107780079 ETIN P
22 P-CS3HPR16 3601114808020003 MIA AGUSTIANI P
23 P-CQBNCQQ5 3601115011030001 MARATUSOOLAH P
24 P-CQX5BOSS 3601116607810002 LIA YULIANTI P
25 P-55N3WUDV 3601060506910002 RIKY KOSWARA L
26 P-4E0PNWYR 3601110107890130 IMRON SAPUTRA L
27 S-C5CC7463 3601111406570001 EMAD L
28 P-4332YLQJ 3601110906680001 USRI L
29 P-3Q9PJLTV 3601114107990155 HELMI APRIATNA L
30 Y-0131LMAF 3172012710770003 SUHERMI L
31 P-COXRGC37 3601112504680001 SUBIANA L
32 S-0EEDFC87 3601110107510022 SAEFUL BARI L
33 P-DYES4ZIJ 3601114406730001 JUHA P
34 P-DZ4PBD6Z 3601114109890001 GARNIS SULASTRI P
35 P-EL7GWMME 3601115403920003 NIAH P
36 P-EI8AJKNS 3601115609880001 NURWATI P
37 P-E1ISQMYI 3601112305760001 JUHAENUDIN L
38 Y-012ZRSSU 3172015907010002 SITI NURFATIHAH P
39 P-E23HGZ5M 3275115207070001 REFANIA PUTRI FAUZAN P
40 P-EHMZEO8J 3601114107030039 LATRI JULIA SARI P
41 P-EFRKYCZQ 3601111003030001 RENALDI YOSEP TIANA L
42 Z-00066UEE 3601131704850003 RENAL SURENA L
43 S-F874AB36 3602091804750003 SUDADI L
44 P-EGF16V78 3601114307620004 JUMRIAH P
45 P-DZQWAKF0 3601114304000002 IROH HAYATI P
46 P-EEHYMSJI 3601110511970001 ANGGI SETIAWAN L
47 P-E7JDPXB7 3601115512060002 IRA PUSPITA P
48 P-E8YJCRRP 3601114502090004 SAFIRA FEBRIYANTI P
49 P-EA8WMJ3T 3601111112010001 ARIYA BIMA L
50 P-EAY4BFRA 3601114905970004 ANITA SOPIANA P
51 P-E5XP5H6 3601106203040001 ANGGUN PUTRI RELITA P
52 P-E4RVIRQH 3601111609720001 NOVIAR P
53 S-D871FD4A 3604164603830004 ENENG SITI MARYAM P
54 P-DWGJYGLX 3671080404740007 HAMDANI L
55 P-DVE8FJ2S 3601315311040001 FITRIA NURFAIZAH MULUS P
56 J-0000E3U8 3602102203800002 SUTIKNO L
57 P-DU1B2AV3 3601114901010001 YOLA ANGGRAENI P
58 P-DTCZLBKB 3601115003740001 SARNI P
59 Q-000AUBES 3601115008880001 TITIN ANDRIYANI P
60 P-DSC30Y5X 3601114107780133 SUHAYAH P
61 P-DRLEVJVP 3601114107960166 IPAT FATIMAH P
62 P-CN3Y0AI6 3601114107950119 ENOK KOMALASARI P
63 P-DQBXNKEZ 3601114107020156 SURIAH SAFITRI P
64 P-DOVN005T 3601110606720001 EKO SULISTIYONO L
65 P-DPJLBIBM 3601110211980002 AHMAD PAJAR L
66 P-B6OP1LT2 3601112504040002 REZA RIDIANSYAH L
67 P-DO7SOVON 3601114501010001 PUPUT SRIHASTUTI P
68 P-CNVJVIQ1 3601110701700009 IRFAN L
69 P-BW0QOT0 3601111702680001 SAID L
70 P-DN324PIL 3601117001940001 ENONG EVI SUPRIATI P
71 S-A22F07CF 3601111606890001 DADAN HERBOWO L
72 P-DJWCXLRJ 3601114107920063 SRI HAMDALAH P
73 P-DIXXRA11 3601114107600086 SRI HARTATI P
74 S-ADD89422 3601112508510001 HASANUDIN L
75 P-CGM37QFB 3602112704870001 ANDIKA TURISWARA L
76 P-DI5LWVQS 3601116703030002 WINDRIYANAH P
77 P-DG9V8M76 3671115904030004 DEWI ANGGUN P
78 P-DEMWGKJV 3601115408000001 SRI AGUSTINI P
79 P-DDU3CR0Z 3602095709000001 SOPIAH P
80 3601116004730001 ANAH P
81 2-000664EE 3601131704850003 RENAL SURENA L
82 P-2NI8CABN 3601112909790001 UYON KUSNADI P
83 P-ESVRSPWN 3601114407730001 NURHASANAH P
84 P-3T1107MH 3601115008880001 TITIN ANDRIYANI P
85 3601116210020004 NURLELA P
86 3602091602810001 SUHERDI L
87 P-F2678LBII 3601110702670001 SARIFUDIN L
88 P-EL10RRDZ 3601114207710004 M SAYUTI L
89
90
 Umur
Kelompok
pekerjaan (18-59 INSTANSI Alamat
Umur
tahun)

IRT 12/2/1985 DEWASA UMUM CIODENG

IRT 10/15/2000 DEWASA UMUM CILILITAN
WIRASWASTA 2/22/1976 DEWASA UMUM PSR SEDANG
WIRASWASTA 10/14/2003 DEWASA UMUM PSR SEDANG
IRT 5/2/1972 DEWASA UMUM BOJONG
WIRASWASTA 7/17/1962 DEWASA UMUM KOLELET
IRT 10/10/1989 DEWASA UMUM SUNGAI JAWI LUAR
WIRASWASTA 3/12/2002 DEWASA UMUM KADUBERA
NAKES 3/19/1983 DEWASA UMUM BANJARSARI
IRT 2/4/1993 DEWASA UMUM KOLELET
IRT 2/2/1994 DEWASA UMUM KOLELET
MAHASISWA 3/29/2003 DEWASA UMUM CILILITAN
IRT 4/28/1997 DEWASA UMUM PSR SEDANG
REMAJA 3/20/2008 DEWASA UMUM CILILITAN
WIRASWASTA 9/26/1994 DEWASA UMUM PSR SEDANG
MAHASISWA 6/28/2003 DEWASA UMUM CILILITAN
IRT 6/5/1975 DEWASA UMUM CILILITAN
WIRASWASTA 9/19/1999 DEWASA UMUM KOLELET
WIRASWASTA 8/6/1984 DEWASA UMUM CILILITAN
WIRASWASTA 7/7/1999 DEWASA UMUM BUNGUR COPONG
IRT 8/5/1982 DEWASA UMUM CILILITAN
MAHASISWA 8/8/2002 DEWASA UMUM KOLELET
MAHASISWA 11/10/2003 DEWASA UMUM BUNGUR COPONG
IRT 7/26/1982 DEWASA UMUM KADUPANDAK
WIRASWASTA 7/7/1981 DEWASA UMUM GUNUNG KENCANA
WIRASWASTA 3/20/1988 DEWASA UMUM BUNGUR COPONG
WIRASWASTA 1/14/1957 DEWASA UMUM KADUPANDAK
WIRASWASTA 6/9/1968 DEWASA UMUM KOLELET
WIRASWASTA 6/8/1996 DEWASA UMUM BUNGUR COPONG
WIRASWASTA 10/27/1977 DEWASA UMUM JAKARTA
WIRASWASTA 4/25/1968 DEWASA UMUM KOLELET
WIRASWASTA 5/13/1952 DEWASA UMUM KADUPANDAK
IRT 6/4/1973 DEWASA UMUM KOLELET
IRT 9/1/1989 DEWASA UMUM KOLELET
IRT 3/4/1992 DEWASA UMUM CIHERANG
IRT 9/6/1988 DEWASA UMUM KADUPANDAK
WIRASWASTA 5/23/1976 DEWASA UMUM PSR SEDANG
MAHASISWA 7/19/2001 DEWASA UMUM JAKARTA
PELAJAR 7/12/2007 DEWASA UMUM JAKARTA
MAHASISWA 7/2/2002 DEWASA UMUM CILILITAN
MAHASISWA 9/22/2003 DEWASA UMUM KOLELET
WIRASWASTA 4/17/1985 DEWASA UMUM KOLELET
WIRASWASTA 4/18/1975 DEWASA UMUM KOLELET
IRT 7/3/1962 DEWASA UMUM KOLELET
IRT 10/16/1999 DEWASA UMUM CIHERANG
WIRASWASTA 10/11/1997 DEWASA UMUM KOLELET
PELAJAR 12/15/2006 DEWASA UMUM KADUPANDAK
PELAJAR 2/5/2009 DEWASA UMUM CILILITAN
MAHASISWA 12/11/2001 DEWASA UMUM BUNGUR COPONG
MAHASISWA 5/9/1997 DEWASA UMUM BUNGUR COPONG
PELAJAR 3/22/2004 DEWASA UMUM BOJONG
IRT 9/16/1972 DEWASA UMUM CILILITAN
IRT 3/6/1983 DEWASA UMUM CILILITAN
WIRASWASTA 4/4/1974 DEWASA UMUM GEMBOR
MAHASISWA 11/13/2004 DEWASA UMUM PASIR DURUNG
WIRASWASTA 3/22/1980 DEWASA UMUM BANJARSARI
MAHASISWA 11/6/2000 DEWASA UMUM CIHERANG
IRT 9/5/1967 DEWASA UMUM CIHERANG
IRT 11/24/1993 DEWASA UMUM KOLELET
IRT 7/6/1977 DEWASA UMUM KADUPANDAK
IRT 5/29/1997 DEWASA UMUM CIHERANG
IRT 6/12/1995 DEWASA UMUM KADUPANDAK
IRT 7/1/2000 DEWASA UMUM KADUBERA
WIRASWASTA 6/6/1972 DEWASA UMUM CILILITAN
WIRASWASTA 2/2/2000 DEWASA UMUM PSR SEDANG
PELAJAR 4/25/2004 DEWASA UMUM CIHERANG
PELAJAR 7/5/2005 DEWASA UMUM PSR SEDANG
WIRASWASTA 1/7/1970 DEWASA UMUM KADUPANDAK
WIRASWASTA 2/17/1968 DEWASA UMUM KADUBERA
WIRASWASTA 5/14/1978 DEWASA UMUM KOLELET
WIRASWASTA 6/16/1989 DEWASA UMUM CILILITAN
IRT 7/1/1992 DEWASA UMUM CILILITAN
IRT 5/16/1991 DEWASA UMUM PSR SEDANG
WIRASWASTA 8/25/1951 DEWASA UMUM KADUPANDAK
WIRASWASTA 4/27/1987 DEWASA UMUM CISAMPANG
MAHASISWA 3/27/2003 DEWASA UMUM KOLELET
MAHASISWA 4/19/2003 DEWASA UMUM PANUNGGANGAN
MAHASISWA 8/16/2000 DEWASA UMUM KADUPANDAK
MAHASISWA 6/17/2000 DEWASA UMUM BANJARSARI
IRT 10/4/1972 DEWASA UMUM KOLELET
WIRASWASTA 4/17/1985 DEWASA UMUM MENES
IRT 9/29/1979 DEWASA UMUM KADUPANDAK
IRT 7/4/1973 DEWASA UMUM KADUBERA
IRT 11/24/1993 DEWASA UMUM KOLELET
IRT 10/22/2003 DEWASA UMUM KOLELET
WIRASWASTA 2/16/1981 DEWASA UMUM KADUHAUK
WIRASWASTA 2/7/1967 DEWASA UMUM KADUBERA
WIRASWASTA 7/5/1978 DEWASA UMUM KADUBERA
DEWASA UMUM
DEWASA UMUM
 Kepesertaan BPJS (tulis
'Ya' pada kolom yang Dosis I
sesuai) Merek Tanggal
No. Hp BPJS Non Tanggal
BPJS Vaksin*** Screening
Non Anggot Pemberian
PBI
PBI a Vaksinasi
082123546620 CORONA VAC 07-08-2021 07-08-2021
083874376160 CORONA VAC 07-08-2021 07-08-2021
083893081833 CORONA VAC 07-08-2021 07-08-2021
081317531988 CORONA VAC 07-08-2021 07-08-2021
087882080672 CORONA VAC 07-08-2021 07-08-2021
085319538169 CORONA VAC 07-08-2021 07-08-2021
081545919862 CORONA VAC 07-08-2021 07-08-2021
085779561339 CORONA VAC 07-08-2021 07-08-2021
082110952365 CORONA VAC 07-08-2021 07-08-2021
081293321947 CORONA VAC 07-08-2021 07-08-2021
085311711443 CORONA VAC 07-08-2021 07-08-2021
083834931029 CORONA VAC 07-08-2021 07-08-2021
083127325998 CORONA VAC 07-08-2021 07-08-2021
083895096419 CORONA VAC 07-08-2021 07-08-2021
083894776462 CORONA VAC 07-08-2021 07-08-2021
085819528599 CORONA VAC 07-08-2021 07-08-2021
08585671054 CORONA VAC 07-08-2021 07-08-2021
08531103688 CORONA VAC 07-08-2021 07-08-2021
081284363597 CORONA VAC 07-08-2021 07-08-2021
083140050405 CORONA VAC 07-08-2021 07-08-2021
083892661815 CORONA VAC 07-08-2021 07-08-2021
081282019683 CORONA VAC 07-08-2021 07-08-2021
083871297579 CORONA VAC 07-08-2021 07-08-2021
083873894744 CORONA VAC 07-08-2021 07-08-2021
081382369549 CORONA VAC 07-08-2021 07-08-2021
083870074358 CORONA VAC 07-08-2021 07-08-2021
083829088859 CORONA VAC 07-08-2021 07-08-2021
085283958774 CORONA VAC 07-08-2021 07-08-2021
083878802512 CORONA VAC 07-08-2021 07-08-2021
087775565870 CORONA VAC 07-08-2021 07-08-2021
083147305375 CORONA VAC 07-08-2021 07-08-2021
081240801528 CORONA VAC 07-08-2021 07-08-2021
083812705685 CORONA VAC 07-08-2021 07-08-2021
083812705685 CORONA VAC 07-08-2021 07-08-2021
085819718698 CORONA VAC 07-08-2021 07-08-2021
083834322134 CORONA VAC 07-08-2021 07-08-2021
085774854092 CORONA VAC 07-08-2021 07-08-2021
08131753973 CORONA VAC 07-08-2021 07-08-2021
083184416230 CORONA VAC 07-08-2021 07-08-2021
082121801749 CORONA VAC 07-08-2021 07-08-2021
081290883968 CORONA VAC 07-08-2021 07-08-2021
081283187500 CORONA VAC 07-08-2021 07-08-2021
081282767720 CORONA VAC 07-08-2021 07-08-2021
083812705685 CORONA VAC 07-08-2021 07-08-2021
083898861308 CORONA VAC 07-08-2021 07-08-2021
085892129319 CORONA VAC 07-08-2021 07-08-2021
083184416230 CORONA VAC 07-08-2021 07-08-2021
083841362477 CORONA VAC 07-08-2021 07-08-2021
081210596947 CORONA VAC 07-08-2021 07-08-2021
085211659941 CORONA VAC 07-08-2021 07-08-2021
083897364290 CORONA VAC 07-08-2021 07-08-2021
081389722761 CORONA VAC 07-08-2021 07-08-2021
085217285857 CORONA VAC 07-08-2021 07-08-2021
083151492682 CORONA VAC 07-08-2021 07-08-2021
081224553281 CORONA VAC 07-08-2021 07-08-2021
085219804755 CORONA VAC 07-08-2021 07-08-2021
083819097259 CORONA VAC 07-08-2021 07-08-2021
082310393264 CORONA VAC 07-08-2021 07-08-2021
083871989239 CORONA VAC 07-08-2021 07-08-2021
082149002256 CORONA VAC 07-08-2021 07-08-2021
083893062558 CORONA VAC 07-08-2021 07-08-2021
083181237588 CORONA VAC 07-08-2021 07-08-2021
083873338967 CORONA VAC 07-08-2021 07-08-2021
081369227395 CORONA VAC 07-08-2021 07-08-2021
081293307696 CORONA VAC 07-08-2021 07-08-2021
085762117013 CORONA VAC 07-08-2021 07-08-2021
083841386790 CORONA VAC 07-08-2021 07-08-2021
081290195114 CORONA VAC 07-08-2021 07-08-2021
083871535375 CORONA VAC 07-08-2021 07-08-2021
087871301515 CORONA VAC 07-08-2021 07-08-2021
083892335431 CORONA VAC 07-08-2021 07-08-2021
083874401186 CORONA VAC 07-08-2021 07-08-2021
083893081833 CORONA VAC 07-08-2021 07-08-2021
083874401186 CORONA VAC 07-08-2021 07-08-2021
083841184458 CORONA VAC 07-08-2021 07-08-2021
083841574861 CORONA VAC 07-08-2021 07-08-2021
085899092149 CORONA VAC 07-08-2021 07-08-2021
083811573484 CORONA VAC 07-08-2021 07-08-2021
083808996727 CORONA VAC 07-08-2021 07-08-2021
***** CORONA VAC 07-08-2021 07-08-2021
081283187500 CORONA VAC 07-08-2021 07-08-2021
083872755974 CORONA VAC 07-08-2021 07-08-2021
083871535375 CORONA VAC 07-08-2021 07-08-2021
083871989239 CORONA VAC 07-08-2021 07-08-2021
08387246340 CORONA VAC 07-08-2021 07-08-2021
087741154401 CORONA VAC 07-08-2021 07-08-2021
085718532386 CORONA VAC 07-08-2021 07-08-2021
083895702196 CORONA VAC 07-08-2021 07-08-2021
CORONA VAC 07-08-2021 07-08-2021
CORONA VAC 07-08-2021 07-08-2021
Dosis I Dosis 2
Tanggal
No. Batch No seri Pemberian No. Batch No Seri
Vaksinasi
24003121 16096451778667 07-09-2021 24003121 16096451778667
24003121 16096451778667 07-09-2021 24003121 16096451778667
24003121 16096451778667 07-09-2021 24003121 16096451778667
24003121 16096451778667 07-09-2021 24003121 16096451778667
24003121 16096451778667 07-09-2021 24003121 16096451778667
24003121 16096451778667 07-09-2021 24003121 16096451778667
24003121 16096451778667 07-09-2021 24003121 16096451778667
24003121 16096451778667 07-09-2021 24003121 16096451778667
24003121 16096451778667 07-09-2021 24003121 16096451778667
24003121 16096451778667 07-09-2021 24003121 16096451778667
24003121 16096451778667 07-09-2021 24003121 16096451778667
24003121 16096451778667 07-09-2021 24003121 16096451778667
24003121 16096451778667 07-09-2021 24003121 16096451778667
24003121 16096451778667 07-09-2021 24003121 16096451778667
24003121 16096451778667 07-09-2021 24003121 16096451778667
24003121 16096451778667 07-09-2021 24003121 16096451778667
24003121 16096451778667 07-09-2021 24003121 16096451778667
24003121 16096451778667 07-09-2021 24003121 16096451778667
24003121 16096451778667 07-09-2021 24003121 16096451778667
24003121 16096451778667 07-09-2021 24003121 16096451778667
24003121 16096451778667 07-09-2021 24003121 16096451778667
24003121 16096451778667 07-09-2021 24003121 16096451778667
24003121 16096451778667 07-09-2021 24003121 16096451778667
24003121 16096451778667 07-09-2021 24003121 16096451778667
24003121 16096451778667 07-09-2021 24003121 16096451778667
24003121 16096451778667 07-09-2021 24003121 16096451778667
24003121 16096451778667 07-09-2021 24003121 16096451778667
24003121 16096451778667 07-09-2021 24003121 16096451778667
24003121 16096451778667 07-09-2021 24003121 16096451778667
24003121 16096451778667 07-09-2021 24003121 16096451778667
24003121 16096451778667 07-09-2021 24003121 16096451778667
24003121 16096451778667 07-09-2021 24003121 16096451778667
24003121 16096451778667 07-09-2021 24003121 16096451778667
24003121 16096451778667 07-09-2021 24003121 16096451778667
24003121 16096451778667 07-09-2021 24003121 16096451778667
24003121 16096451778667 07-09-2021 24003121 16096451778667
24003121 16096451778667 07-09-2021 24003121 16096451778667
24003121 16096451778667 07-09-2021 24003121 16096451778667
24003121 16096451778667 07-09-2021 24003121 16096451778667
24003121 16096451778667 07-09-2021 24003121 16096451778667
24003121 16096451778667 07-09-2021 24003121 16096451778667
24003121 16096451778667 07-09-2021 24003121 16096451778667
24003121 16096451778667 07-09-2021 24003121 16096451778667
24003121 16096451778667 07-09-2021 24003121 16096451778667
24003121 16096451778667 07-09-2021 24003121 16096451778667
24003121 16096451778667 07-09-2021 24003121 16096451778667
24003121 16096451778667 07-09-2021 24003121 16096451778667
24003121 16096451778667 07-09-2021 24003121 16096451778667
24003121 16096451778667 07-09-2021 24003121 16096451778667
24003121 16096451778667 07-09-2021 24003121 16096451778667
24003121 16096451778667 07-09-2021 24003121 16096451778667
24003121 16096451778667 07-09-2021 24003121 16096451778667
24003121 16096451778667 07-09-2021 24003121 16096451778667
24003121 16096451778667 07-09-2021 24003121 16096451778667
24003121 16096451778667 07-09-2021 24003121 16096451778667
24003121 16096451778667 07-09-2021 24003121 16096451778667
24003121 16096451778667 07-09-2021 24003121 16096451778667
24003121 16096451778667 07-09-2021 24003121 16096451778667
24003121 16096451778667 07-09-2021 24003121 16096451778667
24003121 16096451778667 07-09-2021 24003121 16096451778667
24003121 16096451778667 07-09-2021 24003121 16096451778667
24003121 16096451778667 07-09-2021 24003121 16096451778667
24003121 16096451778667 07-09-2021 24003121 16096451778667
24003121 16096451778667 07-08-2021 24003121 16096451778667
24003121 16096451778667 07-09-2021 24003121 16096451778667
24003121 16096451778667 07-09-2021 24003121 16096451778667
24003121 16096451778667 07-09-2021 24003121 16096451778667
24003121 16096451778667 07-09-2021 24003121 16096451778667
24003121 16096451778667 07-09-2021 24003121 16096451778667
24003121 16096451778667 07-09-2021 24003121 16096451778667
24003121 16096451778667 07-09-2021 24003121 16096451778667
24003121 16096451778667 07-09-2021 24003121 16096451778667
24003121 16096451778667 07-09-2021 24003121 16096451778667
24003121 16096451778667 07-09-2021 24003121 16096451778667
24003121 16096451778667 07-09-2021 24003121 16096451778667
24003121 16096451778667 07-09-2021 24003121 16096451778667
24003121 16096451778667 07-09-2021 24003121 16096451778667
24003121 16096451778667 07-09-2021 24003121 16096451778667
24003121 16096451778667 07-09-2021 24003121 16096451778667
24003121 16096451778667 07-08-2021 24003121 16096451778667
24003121 16096451778667 07-08-2021 24003121 16096451778667
24003121 16096451778667 07-08-2021 24003121 16096451778667
24003121 16096451778667 07-08-2021 24003121 16096451778667
24003121 16096451778667 07-08-2021 24003121 16096451778667
24003121 16096451778667 07-08-2021 24003121 16096451778667
24003121 16096451778667 07-08-2021 24003121 16096451778667
24003121 16096451778667 07-08-2021 24003121 16096451778667
24003121 16096451778667 07-08-2021 24003121 16096451778667
24003121 16096451778667 07-08-2021 24003121 16096451778667
24003121 16096451778667 07-08-2021 24003121 16096451778667
 KET

DOSIS KE 1
DOSIS KE 1
DOSIS KE 1
DOSIS KE 1
DOSIS KE 1
DOSIS KE 1
DOSIS KE 1
DOSIS KE 1
DOSIS KE 1
DOSIS KE 1
DOSIS KE 1
DOSIS KE 1
DOSIS KE 1
DOSIS KE 1
DOSIS KE 1
DOSIS KE 1
DOSIS KE 1
DOSIS KE 1
DOSIS KE 1
DOSIS KE 1
DOSIS KE 1
DOSIS KE 1
DOSIS KE 1
DOSIS KE 1
DOSIS KE 1
DOSIS KE 1
DOSIS KE 1
DOSIS KE 1
DOSIS KE 1
DOSIS KE 1
DOSIS KE 1
DOSIS KE 1
DOSIS KE 1
DOSIS KE 1
DOSIS KE 1
DOSIS KE 1
DOSIS KE 1
DOSIS KE 1
DOSIS KE 1
DOSIS KE 1
DOSIS KE 1
DOSIS KE 1
DOSIS KE 1
DOSIS KE 1
DOSIS KE 1
DOSIS KE 1
DOSIS KE 1
DOSIS KE 1
DOSIS KE 1
DOSIS KE 1
DOSIS KE 1
DOSIS KE 1
DOSIS KE 1
DOSIS KE 1
DOSIS KE 1
DOSIS KE 1
DOSIS KE 1
DOSIS KE 1
DOSIS KE 1
DOSIS KE 1
DOSIS KE 1
DOSIS KE 1
DOSIS KE 1
DOSIS KE 2
DOSIS KE 1
DOSIS KE 1
DOSIS KE 1
DOSIS KE 1
DOSIS KE 1
DOSIS KE 1
DOSIS KE 1
DOSIS KE 1
DOSIS KE 1
DOSIS KE 1
DOSIS KE 1
DOSIS KE 1
DOSIS KE 1
DOSIS KE 1
DOSIS KE 1
DOSIS KE 2 POLRES
DOSIS KE 2
DOSIS KE 2
DOSIS KE 2
DOSIS KE 2
DOSIS KE 2 POLRES
DOSIS KE 2 POLRES
DOSIS KE 2
DOSIS KE 2
ODGJ
ODGJ
LAPORANA NAMA-NAMA PENERIMA VAKSIN DOSIS 1 DAN 2 TERMIN 6

PUSKESMAS PICUNG

NO No. Ticket NIK Nama Penerima Vaksin JK

1 P-1QVWL9DV 3601114402910001 JUJU JULAHEA P

2 Q-000AUV9L 3601116210020004 NURLAELA P
3 Q-000CMW7L 3601114107850066 RENI P
4 Q-000BC4DV 3602092512890001 SUTISNA L
5 Q-000B7RY0 3601103006960002 ERIK SAPUTRA L
6 Q-0009QU5Z 3601114107830109 MAENAH P
7 Q-000B7RXC 3601100308950008 SAEFUL ANWAR L
8 Z-00066L4S 3601113007850001 BAGJA RISMAWAN L
9 Q-000B9BAY 3601102309980004 REJA SETIADI L
10 Q-000B7YZR 3601110107820057 M. ENDANG L
11 Q-000B944X 3601112111640001 AGUS JUANA L
12 P-CCXYIXIS 3601112504620001 SUKUR L
13 Q-000B9XEX 3601115103960003 HANI MARTARITA P
14 P-CDMEOHT 3601110107930106 BOHAN MULYADI L
15 Q-000B6TL6 3601114107650023 MURTI P
16 Z-00066TNB 3601110107600021 RUSDI L
17 P-HGJIY828 3601110107860069 HAERUDIN L
18 Z-00066B9S 3601116107580001 MARA ATMARA P
19 Q-000BC4BX 3601116808610001 IIS RUHIYATI P
20 Z-000605TA 3601114107810083 DATI NURLAELA P
21 Z-00066B9E 3601115011570001 OYOK MUNANDAR L
22 Q-000B9XFP 3601115204990004 ENENG NANI S P
23 S-CA7FCF1B 3601261206540001 A SOEBANDI L
24 Q-000BBRQW 3601114107020122 SITI HALIMATUSADIYAH P
25 S-7B907193 3601111702600001 SUHERMAN L
26 Q-000B9XI8 3601115601000002 SULIS SATRI P
27 Q-000B9G3T 3601115007700001 SANAMI L
28 Q-000B8FRB 3601115011950001 IDA WARTINI P
29 Q-000B6TL3 3601111404890001 RIAN APRIANSYAH L
30 Q-000B6YZE 3601110107740012 ADE SOHIB L
31 Q-000BC4BZ 3601116909730001 SITI RAHMAWATI P
32 Z-00063U21 3601114506560002 RONASIAH P
Q-000B9XFV 3601115207720003 EMI P
Q-000BBRML 3601110107000024 DIANA SUCI N P
Q-000BCFU 3603120504790009 ACENG SUJANA L
Q-000BBROX 3601111011860006 SUWANTO L
Q-000B9G2Q 3601114907680001 CICIH KURNIASIH P
Q-000B9XKE 3601116706870005 RENA S P
P-0M3LSNOB 3601114107760079 EROH P
P-0TKK68YM 3601110107680123 JAMAR L
Q-000B8M39 3601115005920003 DEDE JULAHEA P
Q-000B7LTP 3601114107690009 WARIAH P
Z-000670FW 3601114304990006 NINA NURPRIANTI P
Z-00060BVN 3601315110800001 ERUM RATU AMBARWATI P
Q-000B8FRF 3601116105950001 MELI INDRIYANI P
Q-000B9XG4 3601115506020002 YULIANTI P
Q-000B9XF0 3601115110640001 IYAH P
Q-0009TQZ6 3601114405930001 IRA HARYANI P
P-0SVTOGTA 3602011907840003 YOGI HENDARDI L
P-2DPM0DVI 3601110809750001 SARMAN L
Q-000B9BAH 3302265906810002 SITI KHASANAH P
Q-000BC4E2 3602094609710001 ELA HAYATI P
Q-000ATXFF 3601112511020002 JUNAEDI RAMADHAN L
Q-000B6TKZ 3601100808990006 FAHMI F L
Q-000ATNOD 3601112108010005 EEP SUJANA L
Q-000B7RXW 3601101703780003 SAPURI L
Q-000B9FZ4 3601114107910115 TITIN P
Q-000B9G03 3601114107930096 RATNA SUMIRA P
Q-000B8FRU 3602091608920002 ATANG HIDAYAT L
Q-000BBTPT 3601115006670001 IREN C P
Q-000B9RN9 3601114107780065 IIN INASARI P
Q-000A5ZM1 3601114107810038 EROH P
Q-000BA8KF 3601114107680117 NINING P
Q-000AUZ8Q 3601116007650002 USNI P
S-725C10A1 3601244406960001 MUMUN MAEMUNAH P
Q-000BBRN1 3601110408030002 RIZKI DWI S L
Q-000BC43E3 3602094802680001 ADE SUTIAH P
Q-000BC4E8 3602095008670001 LILIS RATNA N P
Q-000AXF5Q 3601100701900002 REDI FATHUROHMAN L
Q-000A555H 3601110107740044 ANTA WIJAYA L
Q-000B7D4R 3601110104030003 RAMA N L
Q-000CN45O 3601110107750105 OMAN L
Q-000BBTPJ 3601114803870001 SAMANAH P
Q-000BBVM8 3601114107710065 NENI SUMIATI P
Q-000B9G25 3601114708020001 RIPA AMELIA P
Q-000B9XFT 3601115206780001 TATI HAERIATI P
Q-000727AW 3601110107940249 SAMSUDIN L
Q-000B9G1G 3601114411870001 YULIAH P
Q-000B9XK9 3601116612860001 ENENG DAHLIA P
 Umur
Kelompok
pekerjaan (18-59 INSTANSI Alamat
Umur
tahun)

IRT 2/4/1991 DEWASA UMUM KOLELET

IRT 10/22/2002 DEWASA UMUM KOLELET
IRT 7/1/1985 DEWASA UMUM KADUPANDAK
WIRASWASTA 12/25/1989 DEWASA UMUM KOLELET
WIRASWASTA 2/7/1962 DEWASA UMUM BOJONG
IRT 7/1/1983 DEWASA UMUM CILILITAN
WIRASWASTA 8/3/1995 DEWASA UMUM BOJONG
WIRASWASTA 7/30/1985 DEWASA UMUM CILILITAN
WIRASWASTA 9/23/1998 DEWASA UMUM BOJONG
WIRASWASTA 6/5/1982 DEWASA UMUM KADUPANDAK
WIRASWASTA 11/21/1975 DEWASA UMUM CILILITAN
WIRASWASTA 4/25/1962 DEWASA UMUM CILILITAN
IRT 3/11/1996 DEWASA UMUM CILILITAN
WIRASWASTA 5/19/1993 DEWASA UMUM CILILITAN
IRT 7/1/1965 DEWASA UMUM CILILITAN
WIRASWASTA 4/20/1960 DEWASA UMUM CILILITAN
WIRASWASTA 7/10/1986 DEWASA UMUM KOLELET
IRT 7/27/1957 DEWASA UMUM KOLELET
IRT 8/28/1961 DEWASA UMUM KOLELET
IRT 7/1/1981 DEWASA UMUM KOLELET
WIRASWASTA 10/1/1957 DEWASA UMUM KOLELET
IRT 4/12/1999 DEWASA UMUM CIHERANG
WIRASWASTA 6/12/1954 DEWASA UMUM KADUBADAK
MAHASISWA 12/15/2002 DEWASA UMUM CIHERANG
WIRASWASTA 2/17/1960 DEWASA UMUM KOLELET
MAHASISWA 1/16/2000 DEWASA UMUM CIHERANG
WIRASWASTA 2/3/1970 DEWASA UMUM KOLELET
IRT 11/10/1998 DEWASA UMUM CILILITAN
WIRASWASTA 4/14/1989 DEWASA UMUM CILILITAN
WIRASWASTA 2/1/1974 DEWASA UMUM CILILITAN
IRT 9/29/1973 DEWASA UMUM KOLELET
IRT 8/5/1956 DEWASA UMUM KOLELET
IRT 7/12/1972 DEWASA UMUM CILILITAN
IRT 1/4/1999 DEWASA UMUM PSR SEDANG
WIRASWASTA 4/5/1979 DEWASA UMUM KOLELET
WIRASWASTA 11/10/1986 DEWASA UMUM PSR SEDANG
IRT 9/8/1966 DEWASA UMUM KOLELET
IRT 6/27/1987 DEWASA UMUM PSR SEDANG
IRT 7/1/1976 DEWASA UMUM CILILITAN
WIRASWASTA 7/1/1967 DEWASA UMUM CILILITAN
IRT 5/10/1992 DEWASA UMUM CILILITAN
IRT 7/1/1974 DEWASA UMUM CILILITAN
MAHASISWA 4/3/1999 DEWASA UMUM BANJARSARI
IRT 10/11/1980 DEWASA UMUM PSR SEDANG
MAHASISWA 5/1/1996 DEWASA UMUM CILILITAN
MAHASISWA 6/15/2002 DEWASA UMUM KOLELET
IRT 10/11/1964 DEWASA UMUM KOLELET
IRT 5/4/1994 DEWASA UMUM CILILITAN
WIRASWASTA 7/19/1984 DEWASA UMUM MALINGPING
WIRASWASTA 2/11/1997 DEWASA UMUM KOLELET
IRT 6/19/1981 DEWASA UMUM MALINGPING
IRT 9/6/1971 DEWASA UMUM BANJARSARI
MAHASISWA 9/25/2002 DEWASA UMUM CILILITAN
MAHASISWA 8/8/1999 DEWASA UMUM BOJONG
MAHASISWA 8/21/2001 DEWASA UMUM CILILITAN
WIRASWASTA 3/17/1978 DEWASA UMUM BOJONG
IRT 8/10/1991 DEWASA UMUM CILILITAN
IRT 8/10/1992 DEWASA UMUM CILILITAN
WIRASWASTA 8/10/1993 DEWASA UMUM BANJARSARI
IRT 7/12/1984 DEWASA UMUM KOLELET
IRT 8/2/1981 DEWASA UMUM CILILITAN
IRT 7/1/1981 DEWASA UMUM CILILITAN
IRT 8/16/1968 DEWASA UMUM CILILITAN
IRT 7/20/1970 DEWASA UMUM CILILITAN
IRT 6/4/1996 DEWASA UMUM CILILITAN
WIRASWASTA 8/4/2003 DEWASA UMUM KADUPANDAK
IRT 2/8/1968 DEWASA UMUM BANJARSARI
IRT 8/10/1967 DEWASA UMUM BANJARSARI
WIRASWASTA 1/7/1991 DEWASA UMUM BOJONG
WIRASWASTA 5/17/1974 DEWASA UMUM KADUBERA
MAHASISWA 4/1/2003 DEWASA UMUM CILILITAN
WIRASWASTA 5/15/1971 DEWASA UMUM KADUBERA
IRT 3/8/1987 DEWASA UMUM CILILITAN
IRT 3/5/1970 DEWASA UMUM CILILITAN
IRT 9/2/2001 DEWASA UMUM KOLELET
IRT 6/12/1976 DEWASA UMUM KOLELET
WIRASWASTA 10/1/1994 DEWASA UMUM KADUPANDAK
IRT 12/12/1982 DEWASA UMUM KOLELET
IRT 12/26/1986 DEWASA UMUM KADUPANDAK
 Kepesertaan BPJS (tulis
'Ya' pada kolom yang Dosis I
sesuai) Merek Tanggal
No. Hp BPJS Non Tanggal
BPJS Vaksin*** Screening
Non Anggot Pemberian
PBI
PBI a Vaksinasi
081213935377 CORONA VAC 8/5/2021 8/5/2021
083872416340 CORONA VAC 8/5/2021 8/5/2021
085719022910 CORONA VAC 8/5/2021 8/5/2021
082114984539 CORONA VAC 8/5/2021 8/5/2021
083807141859 CORONA VAC 8/5/2021 8/5/2021
082310670553 CORONA VAC 8/5/2021 8/5/2021
083806092660 CORONA VAC 8/5/2021 8/5/2021
081281983690 CORONA VAC 8/5/2021 8/5/2021
081388139319 CORONA VAC 8/5/2021 8/5/2021
081316917572 CORONA VAC 8/5/2021 8/5/2021
085888374398 CORONA VAC 8/5/2021 8/5/2021
08138395634 CORONA VAC 8/5/2021 8/5/2021
085773641314 CORONA VAC 8/5/2021 8/5/2021
085714544518 CORONA VAC 8/5/2021 8/5/2021
085219310748 CORONA VAC 8/5/2021 8/5/2021
085219310748 CORONA VAC 8/5/2021 8/5/2021
083895255194 CORONA VAC 8/5/2021 8/5/2021
083125324769 CORONA VAC 8/5/2021 8/5/2021
083841259874 CORONA VAC 8/5/2021 8/5/2021
085694519535 CORONA VAC 8/5/2021 8/5/2021
083125324769 CORONA VAC 8/5/2021 8/5/2021
085718503670 CORONA VAC 8/5/2021 8/5/2021
CORONA VAC 8/5/2021 8/5/2021
085710503951 CORONA VAC 8/5/2021 8/5/2021
083808163568 CORONA VAC 8/5/2021 8/5/2021
083813772286 CORONA VAC 8/5/2021 8/5/2021
08387145674 CORONA VAC 8/5/2021 8/5/2021
083871297618 CORONA VAC 8/5/2021 8/5/2021
085282377403 CORONA VAC 8/5/2021 8/5/2021
087772399394 CORONA VAC 8/5/2021 8/5/2021
085311036488 CORONA VAC 8/5/2021 8/5/2021
083841572418 CORONA VAC 8/5/2021 8/5/2021
085216027442 CORONA VAC 8/5/2021 8/5/2021
081314086779 CORONA VAC 8/5/2021 8/5/2021
082115610568 CORONA VAC 8/5/2021 8/5/2021
085365588896 CORONA VAC 8/5/2021 8/5/2021
083877430288 CORONA VAC 8/5/2021 8/5/2021
083841429617 CORONA VAC 8/5/2021 8/5/2021
085213056421 CORONA VAC 8/5/2021 8/5/2021
085213056421 CORONA VAC 8/5/2021 8/5/2021
082213668752 CORONA VAC 8/5/2021 8/5/2021
085773755905 CORONA VAC 8/5/2021 8/5/2021
081311281077 CORONA VAC 8/5/2021 8/5/2021
***** CORONA VAC 8/5/2021 8/5/2021
081221094424 CORONA VAC 8/5/2021 8/5/2021
081398885785 CORONA VAC 8/5/2021 8/5/2021
081213935377 CORONA VAC 8/5/2021 8/5/2021
081221094368 CORONA VAC 8/5/2021 8/5/2021
087772929789 CORONA VAC 8/5/2021 8/5/2021
083899370592 CORONA VAC 8/5/2021 8/5/2021
085694455888 CORONA VAC 8/5/2021 8/5/2021
081395578747 CORONA VAC 8/5/2021 8/5/2021
081382536415 CORONA VAC 8/5/2021 8/5/2021
089504345308 CORONA VAC 8/5/2021 8/5/2021
083892648243 CORONA VAC 8/5/2021 8/5/2021
081513331223 CORONA VAC 8/5/2021 8/5/2021
085773225906 CORONA VAC 8/5/2021 8/5/2021
085775344670 CORONA VAC 8/5/2021 8/5/2021
085764033278 CORONA VAC 8/5/2021 8/5/2021
081381312376 CORONA VAC 8/5/2021 8/5/2021
083892300393 CORONA VAC 8/5/2021 8/5/2021
085777585436 CORONA VAC 8/5/2021 8/5/2021
083147284839 CORONA VAC 8/5/2021 8/5/2021
081314413618 CORONA VAC 8/5/2021 8/5/2021
085217930988 CORONA VAC 8/5/2021 8/5/2021
089502821827 CORONA VAC 8/5/2021 8/5/2021
085695382546 CORONA VAC 8/5/2021 8/5/2021
085695382546 CORONA VAC 8/5/2021 8/5/2021
08801123809 CORONA VAC 8/5/2021 8/5/2021
085718193091 CORONA VAC 8/5/2021 8/5/2021
0895335249223 CORONA VAC 8/5/2021 8/5/2021
085693142130 CORONA VAC 8/5/2021 8/5/2021
081290182372 CORONA VAC 8/5/2021 8/5/2021
083897121780 CORONA VAC 8/5/2021 8/5/2021
081315529390 CORONA VAC 8/5/2021 8/5/2021
083871293566 CORONA VAC 8/5/2021 8/5/2021
085215580805 CORONA VAC 8/5/2021 8/5/2021
083895255139 CORONA VAC 8/5/2021 8/5/2021
083808997247 CORONA VAC 8/5/2021 8/5/2021
Dosis I Dosis 2
Tanggal
No. Batch No seri Pemberian No. Batch No Seri
Vaksinasi
24003121 16096451778667 8/5/2021 24003121 16096451778667
24003121 16096451778667 8/5/2021 24003121 16096451778667
24003121 16096451778667 8/5/2021 24003121 16096451778667
24003121 16096451778667 8/5/2021 24003121 16096451778667
24003121 16096451778667 8/5/2021 24003121 16096451778667
24003121 16096451778667 8/5/2021 24003121 16096451778667
24003121 16096451778667 8/5/2021 24003121 16096451778667
24003121 16096451778667 8/5/2021 24003121 16096451778667
24003121 16096451778667 8/5/2021 24003121 16096451778667
24003121 16096451778667 8/5/2021 24003121 16096451778667
24003121 16096451778667 8/5/2021 24003121 16096451778667
24003121 16096451778667 8/5/2021 24003121 16096451778667
24003121 16096451778667 8/5/2021 24003121 16096451778667
24003121 16096451778667 8/5/2021 24003121 16096451778667
24003121 16096451778667 8/5/2021 24003121 16096451778667
24003121 16096451778667 8/5/2021 24003121 16096451778667
24003121 16096451778667 8/5/2021 24003121 16096451778667
24003121 16096451778667 8/5/2021 24003121 16096451778667
24003121 16096451778667 8/5/2021 24003121 16096451778667
24003121 16096451778667 8/5/2021 24003121 16096451778667
24003121 16096451778667 8/5/2021 24003121 16096451778667
24003121 16096451778667 8/5/2021 24003121 16096451778667
24003121 16096451778667 8/5/2021 24003121 16096451778667
24003121 16096451778667 8/5/2021 24003121 16096451778667
24003121 16096451778667 8/5/2021 24003121 16096451778667
24003121 16096451778667 8/5/2021 24003121 16096451778667
24003121 16096451778667 8/5/2021 24003121 16096451778667
24003121 16096451778667 8/5/2021 24003121 16096451778667
24003121 16096451778667 8/5/2021 24003121 16096451778667
24003121 16096451778667 8/5/2021 24003121 16096451778667
24003121 16096451778667 8/5/2021 24003121 16096451778667
24003121 16096451778667 8/5/2021 24003121 16096451778667
24003121 16096451778667 8/5/2021 24003121 16096451778667
24003121 16096451778667 8/5/2021 24003121 16096451778667
24003121 16096451778667 8/5/2021 24003121 16096451778667
24003121 16096451778667 8/5/2021 24003121 16096451778667
24003121 16096451778667 8/5/2021 24003121 16096451778667
24003121 16096451778667 8/5/2021 24003121 16096451778667
24003121 16096451778667 8/5/2021 24003121 16096451778667
24003121 16096451778667 8/5/2021 24003121 16096451778667
24003121 16096451778667 8/5/2021 24003121 16096451778667
24003121 16096451778667 8/5/2021 24003121 16096451778667
24003121 16096451778667 8/5/2021 24003121 16096451778667
24003121 16096451778667 8/5/2021 24003121 16096451778667
24003121 16096451778667 8/5/2021 24003121 16096451778667
24003121 16096451778667 8/5/2021 24003121 16096451778667
24003121 16096451778667 8/5/2021 24003121 16096451778667
24003121 16096451778667 8/5/2021 24003121 16096451778667
24003121 16096451778667 8/5/2021 24003121 16096451778667
24003121 16096451778667 8/5/2021 24003121 16096451778667
24003121 16096451778667 8/5/2021 24003121 16096451778667
24003121 16096451778667 8/5/2021 24003121 16096451778667
24003121 16096451778667 8/5/2021 24003121 16096451778667
24003121 16096451778667 8/5/2021 24003121 16096451778667
24003121 16096451778667 8/5/2021 24003121 16096451778667
24003121 16096451778667 8/5/2021 24003121 16096451778667
24003121 16096451778667 8/5/2021 24003121 16096451778667
24003121 16096451778667 8/5/2021 24003121 16096451778667
24003121 16096451778667 8/5/2021 24003121 16096451778667
24003121 16096451778667 8/5/2021 24003121 16096451778667
24003121 16096451778667 8/5/2021 24003121 16096451778667
24003121 16096451778667 8/5/2021 24003121 16096451778667
24003121 16096451778667 8/5/2021 24003121 16096451778667
24003121 16096451778667 8/5/2021 24003121 16096451778667
24003121 16096451778667 8/5/2021 24003121 16096451778667
24003121 16096451778667 8/5/2021 24003121 16096451778667
24003121 16096451778667 8/5/2021 24003121 16096451778667
24003121 16096451778667 8/5/2021 24003121 16096451778667
24003121 16096451778667 8/5/2021 24003121 16096451778667
24003121 16096451778667 8/5/2021 24003121 16096451778667
24003121 16096451778667 8/5/2021 24003121 16096451778667
24003121 16096451778667 8/5/2021 24003121 16096451778667
24003121 16096451778667 8/5/2021 24003121 16096451778667
24003121 16096451778667 8/5/2021 24003121 16096451778667
24003121 16096451778667 8/5/2021 24003121 16096451778667
24003121 16096451778667 8/5/2021 24003121 16096451778667
24003121 16096451778667 8/5/2021 24003121 16096451778667
24003121 16096451778667 8/5/2021 24003121 16096451778667
24003121 16096451778667 8/5/2021 24003121 16096451778667
 KET

DOSIS KE 2
DOSIS KE 2
DOSIS KE 2
DOSIS KE 2
DOSIS KE 2
DOSIS KE 2
DOSIS KE 2
DOSIS KE 2
DOSIS KE 2
DOSIS KE 2
DOSIS KE 2
DOSIS KE 2
DOSIS KE 2
DOSIS KE 2
DOSIS KE 2
DOSIS KE 2
DOSIS KE 2
DOSIS KE 2
DOSIS KE 2
DOSIS KE 2
DOSIS KE 2
DOSIS KE 2
DOSIS KE 2
DOSIS KE 2
DOSIS KE 2
DOSIS KE 2
DOSIS KE 2
DOSIS KE 2
DOSIS KE 2
DOSIS KE 2
DOSIS KE 2
DOSIS KE 2
DOSIS KE 2
DOSIS KE 2
DOSIS KE 2
DOSIS KE 2
DOSIS KE 2
DOSIS KE 2
DOSIS KE 2
DOSIS KE 2
DOSIS KE 2
DOSIS KE 2
DOSIS KE 2
DOSIS KE 2
DOSIS KE 2
DOSIS KE 2
DOSIS KE 2
DOSIS KE 2
DOSIS KE 2
DOSIS KE 2
DOSIS KE 2
DOSIS KE 2
DOSIS KE 2
DOSIS KE 2
DOSIS KE 2
DOSIS KE 2
DOSIS KE 2
DOSIS KE 2
DOSIS KE 2
DOSIS KE 2
DOSIS KE 2
DOSIS KE 2
DOSIS KE 2
DOSIS KE 2
DOSIS KE 2
DOSIS KE 2
DOSIS KE 2
DOSIS KE 2
DOSIS KE 2
DOSIS KE 2
DOSIS KE 2
DOSIS KE 2
DOSIS KE 2
DOSIS KE 2
DOSIS KE 2
DOSIS KE 2
DOSIS KE 2
DOSIS KE 2
DOSIS KE 2
LAPORANA NAMA-NAMA PENERIMA VAKSIN DOSIS 1 DAN 2 TERMIN 6

PUSKESMAS PICUNG

No. Ticket NIK Nama Penerima Vaksin JK

NO

1 Q-000BBRPM 3601111311960003 RIZKI NASRULLAH L

2 Q-0009FJZ2 3601115208010001 AYU GINA AGUSTINA P
3 Z-00060C0U 3601224807550002 SUTIJAH P
4 Q-000A9OT2 3604111808770003 HERI SUCIONO L
5 Q-000A9KON 3601220912810002 ARIF VIANTO A W L
6 Q-0009EC2D 3604050407650003 SIH CAHYO WARDAYANTO L
7 Q-000A9K16 3601224202830001 EMI RATNA SARI P
8 Z-00060FEI 3604055204950003 ORIEHANNA ESESIAWATI P
9 Q-000A9JBM 3604054103660004 SRI PURWANINGSIH P
10 Q-000A9OTZ 3604114505830005 SUTRISNI P
11 P-81LB2A0F 3604051002010005 ONNMUNTOHAR GEMILANG L
12 Z-000605GG 3314077112520235 MUYEK SASTRO REJO L
13 W-0000B75T 3601105801870004 JAJIA ABDI FAUZA P
14 P-JH0VL1UB 3578055806710003 SUMIYATI P
15 W-00000SCK 3601230107760016 YUSRI L
16 W-0000B7DQ 3602096401610002 YUSRIATI P
17 Q-000CMVPP 3601114604790001 EMI MULYANI P
18 Q-000CMTRF 3601114611020001 RATNA AWALIA R P
19 Q-000CKGTM 3601104107930093 SHANTY PEBRIANI P
20 Q-000A8CWQ 3601114107680086 JUNAH P
21 Q-0009R6A7 3601090107710025 SUMINTA JAYA ATMAJA L
22 Q-000A755E 3601114107830083 ODAH P
23 Q-0009Q6US 3601114107780101 JUJU P
24 Q-0009Q6Q0 3601114202890001 LIAH P
25 Q-0009Q6ZO 3601114107860039 ENENG P
26 Q-0009RX06 3601114107320005 YULI P
27 Q-000B9XEN 3601115010760003 ADE EMI P
28 Q-000AXV6T 3671050907780002 MUHAMAD RUSLAN L
29 Q-000BBTPN 3601115006620001 NINING P
30 Z-0005QEYY 3601110601890001 M ENTONG L
31 Q-0009QINU 3601114712840001 SAMIAH P
32 3601110602490001 SLAMET L
 Umur
Kelompok
pekerjaan (18-59 INSTANSI Alamat
Umur
tahun)

WIRASWATA 11/13/1996 DEWASA UMUM KOLELET

MAHASISWA 8/12/2001 DEWASA UMUM CILILITAN
IRT 7/8/1955 DEWASA UMUM KP TAPEN
WIRASWATA 8/18/1977 DEWASA UMUM CIUJUNG
WIRASWATA 12/9/1981 DEWASA UMUM CADASARI
WIRASWATA 7/4/1965 DEWASA UMUM GSI
IRT 2/2/1983 DEWASA UMUM KP TAPEN
IRT 4/12/1995 DEWASA UMUM GSI
IRT 3/1/1966 DEWASA UMUM GSI
IRT 5/5/1983 DEWASA UMUM CIUJUNG
MAHASISWA 2/10/2001 DEWASA UMUM GSI
WIRASWATA 12/31/1952 DEWASA UMUM BANARAN
NAKES 1/18/1987 DEWASA UMUM BANJARSARI
IRT 6/28/1971 DEWASA UMUM GRESIK
WIRASWATA 4/6/1974 DEWASA UMUM CIRUKAP
GURU 1/21/1961 DEWASA UMUM BOJONG
IRT 4/2/1981 DEWASA UMUM KOLELET
MAHASISWA 11/6/2002 DEWASA UMUM CILILITAN
IRT 7/1/1993 DEWASA UMUM CILILITAN
IRT 10/4/1962 DEWASA UMUM CILILITAN
WIRASWATA 1/7/1977 DEWASA UMUM PAGELARAN
IRT 7/1/1979 DEWASA UMUM CILILITAN
IRT 7/1/1978 DEWASA UMUM CILILITAN
IRT 2/2/1989 DEWASA UMUM CILILITAN
IRT 7/1/1986 DEWASA UMUM CILILITAN
IRT 8/1/1981 DEWASA UMUM CILILITAN
IRT 10/10/1976 DEWASA UMUM KADUPANDAK
WIRASWATA 7/9/1978 DEWASA UMUM KADUPANDAK
IRT 6/10/1963 DEWASA UMUM CILILITAN
WIRASWATA 1/6/1989 DEWASA UMUM CILILITAN
IRT 12/2/1984 DEWASA UMUM CILILITAN
WIRASWATA 2/6/1949 DEWASA UMUM CILILITAN
 Kepesertaan BPJS (tulis
'Ya' pada kolom yang Dosis I
sesuai)
BPJS Non Merek Tanggal Tanggal
No. Hp BPJS
Non Anggot Vaksin*** Screening Pemberian
PBI
PBI a Vaksinasi
085210909206 CORONA VAC 8/4/2021 8/4/2021
081517971875 CORONA VAC 8/4/2021 8/4/2021
089627347563 CORONA VAC 8/4/2021 8/4/2021
081320750969 CORONA VAC 8/4/2021 8/4/2021
089627347563 CORONA VAC 8/4/2021 8/4/2021
08521903855 CORONA VAC 8/4/2021 8/4/2021
089627347563 CORONA VAC 8/4/2021 8/4/2021
085216306444 CORONA VAC 8/4/2021 8/4/2021
085216911519 CORONA VAC 8/4/2021 8/4/2021
082112829264 CORONA VAC 8/4/2021 8/4/2021
082320590143 CORONA VAC 8/4/2021 8/4/2021
0896267347533 CORONA VAC 8/4/2021 8/4/2021
085780420953 CORONA VAC 8/4/2021 8/4/2021
085100258988 CORONA VAC 8/4/2021 8/4/2021
085319471111 CORONA VAC 8/4/2021 8/4/2021
081382475776 CORONA VAC 8/4/2021 8/4/2021
081220820094 CORONA VAC 8/4/2021 8/4/2021
083834383188 CORONA VAC 8/4/2021 8/4/2021
083899266676 CORONA VAC 8/4/2021 8/4/2021
082297972885 CORONA VAC 8/4/2021 8/4/2021
083815686538 CORONA VAC 8/4/2021 8/4/2021
085773758743 CORONA VAC 8/4/2021 8/4/2021
082310670553 CORONA VAC 8/4/2021 8/4/2021
082310670553 CORONA VAC 8/4/2021 8/4/2021
082310670553 CORONA VAC 8/4/2021 8/4/2021
082310670553 CORONA VAC 8/4/2021 8/4/2021
087886574728 CORONA VAC 8/4/2021 8/4/2021
082114250988 CORONA VAC 8/4/2021 8/4/2021
085216519416 CORONA VAC 8/4/2021 8/4/2021
085328736857 CORONA VAC 8/4/2021 8/4/2021
082310670553 CORONA VAC 8/4/2021 8/4/2021
08131650076 CORONA VAC 8/4/2021 8/4/2021
Dosis I Dosis 2
Tanggal
No. Batch No seri Pemberian No. Batch No Seri
Vaksinasi
24003121 16096451778667 8/4/2021 24003121 16096451778667
24003121 16096451778667 8/4/2021 24003121 16096451778667
24003121 16096451778667 8/4/2021 24003121 16096451778667
24003121 16096451778667 8/4/2021 24003121 16096451778667
24003121 16096451778667 8/4/2021 24003121 16096451778667
24003121 16096451778667 8/4/2021 24003121 16096451778667
24003121 16096451778667 8/4/2021 24003121 16096451778667
24003121 16096451778667 8/4/2021 24003121 16096451778667
24003121 16096451778667 8/4/2021 24003121 16096451778667
24003121 16096451778667 8/4/2021 24003121 16096451778667
24003121 16096451778667 8/4/2021 24003121 16096451778667
24003121 16096451778667 8/4/2021 24003121 16096451778667
24003121 16096451778667 8/4/2021 24003121 16096451778667
24003121 16096451778667 8/4/2021 24003121 16096451778667
24003121 16096451778667 8/4/2021 24003121 16096451778667
24003121 16096451778667 8/4/2021 24003121 16096451778667
24003121 16096451778667 8/4/2021 24003121 16096451778667
24003121 16096451778667 8/4/2021 24003121 16096451778667
24003121 16096451778667 8/4/2021 24003121 16096451778667
24003121 16096451778667 8/4/2021 24003121 16096451778667
24003121 16096451778667 8/4/2021 24003121 16096451778667
24003121 16096451778667 8/4/2021 24003121 16096451778667
24003121 16096451778667 8/4/2021 24003121 16096451778667
24003121 16096451778667 8/4/2021 24003121 16096451778667
24003121 16096451778667 8/4/2021 24003121 16096451778667
24003121 16096451778667 8/4/2021 24003121 16096451778667
24003121 16096451778667 8/4/2021 24003121 16096451778667
24003121 16096451778667 8/4/2021 24003121 16096451778667
24003121 16096451778667 8/4/2021 24003121 16096451778667
24003121 16096451778667 8/4/2021 24003121 16096451778667
24003121 16096451778667 8/4/2021 24003121 16096451778667
24003121 16096451778667 8/4/2021 24003121 16096451778667
 KET

DOSIS KE 2
DOSIS KE 2
DOSIS KE 2
DOSIS KE 2
DOSIS KE 2
DOSIS KE 2
DOSIS KE 2
DOSIS KE 2
DOSIS KE 2
DOSIS KE 2
DOSIS KE 2
DOSIS KE 2
DOSIS KE 2
DOSIS KE 2
DOSIS KE 2
DOSIS KE 2
DOSIS KE 2
DOSIS KE 2
DOSIS KE 2
DOSIS KE 2
DOSIS KE 2
DOSIS KE 2
DOSIS KE 2
DOSIS KE 2
DOSIS KE 2
DOSIS KE 2
DOSIS KE 2
DOSIS KE 2
DOSIS KE 2
DOSIS KE 2
DOSIS KE 2
POLRES DOSIS KE 2
LAPORANA NAMA-NAMA PENERIMA VAKSIN DOSIS 1 DAN 2 TERMIN 6

PUSKESMAS PICUNG

No. Ticket NIK Nama Penerima Vaksin JK

NO

Y-0135XKTJ 3601114802870001 LENI YUNENGSIH P

P-2BBRN6GY 3601115004790001 ENONG RUMIYATI P
P-1NCI4QCQ 3601115203760001 WATI P
P-1S3Z57N3 3601114107010083 ELSA P
P-1NCJK6ZD 3601114305720001 ENJUN P
P-1FG1Z6RR 3601115609800001 ROHAETI P
W-1A4E3F50 3601101208660002 CECE MAHFUDIN L
P-4ENCEP9B 3603044109970001 SUHARNI P
P-4VR278PQ 3601115108000001 NENG GITA. Y P
P-3IP9E5XR 3601114107020074 NUR FAUZIAH P
P-3KJPERZX 3601104107890014 NURAENI P
P-4C55GIAK 3313024503650001 PARNI P
P-3EUVG3IH 3601180107870079 NURLIA P
P-3MW71A8D 3601316109870001 ASMAH P
P-3OJWLBE7 3601110107840029 IROH RAHMAWATI P
P-3ZGFIJIA 3601110107600050 DARSIM L
P-3TI1O7MH 3601115008880001 TITIN ANDRIYANI P
P-429JUFSL 3517092408960002 YOYOK WINARNO L
P-61MVTJXP 3601116003760001 SARIPAH P
P-5ZOB8ZFR 3601112002030002 ILHAM FA L
P-58Q22KJA 3601114308830010 MARTINI P
P-5UOPSIL8 3601106602970002 WIDYA PRATIWI P
P-4N485ABE 32070211085890004 DAVIT ARIYADI L
S-D603C0E8 3602096401610002 YUSRIATI P
P-5RXCKQFT 3602095211720001 ISAH P
P-5QB2SCBL 3601114504780001 JUMANAH P
P-4HEI6H7K 3601110107030020 KHOIRUL ANWAR L
P-5W0ZNAS9 1608025505000001 DESI MELINDA P
P-5DRFKHC3 3601114508980002 TATI HERAWATI P
P-5B7OD8TZ 3204122101890002 REZA HARI. T L
S-B975FC30 3601105801870004 JAZIA ABDI. F P
P-5LEEPA4Z 1806095010990005 OKMALINDA P
P-5MVVAXA4 3603034706000007 DEVI SURYANI P
P-361HBH7P 3601116007650002 USNI P
P-3BPP3X6E 3601114403690001 SUMIATI P
P-38BNWCEM 3601114107920067 LELA HENDRAYANI P
P-3QRVLIAD 3601116210020004 NURLAELA P
P-3DCKHOX6 3601114107720099 RUMANAH P
P-7HIY81X8 3601114107890073 AMI P
P-7QPOBSR6 3601110107790017 MAMAN L
P-7POELKOM 3601112007960002 IRFAN KURNIAWAN L
P-MISJOND 3602095705970001 DENIS. N P
Y-01311PZF 3173015407971004 DEDE DIAH. D P
P-7LACC3IJ 3601110107790023 IWAN SUJONO L
P-7KDGWFKP 3601114107800047 IWAT NAWATI P
P-7GK7K9HY 3601100212010001 RAMJANI L
P-7FJKKYYT 3601105509930001 ITA FAUZIAH P
P-7CBTVYQN 3601110504620001 SUPARDI M.NUR L
P-793M6S33 3324042912930001 ADI RADIPTO L
P-6X592CQH 3601104807990005 ILA LUTFIANI P
P-3IP9E5XR 3601114107020074 NUR FAUZIAH L
P-51CLFRL2 3601110501950002 FAISAL ABDILLAH L
P-4XPRQC2E 3313025109920001 NOVIA YULIANA P
P-58N0105Y 1801095907950002 TUTI PUTRIYANTI P
P-44FVRLQC 3602090809970003 DIKI PRAMESTA L
P-1WU5XDI8 3601116007810004 BAI MUNAWAROH P
P-2GF5UI2D 3601115301030005 TIARA EKA. P P
S-9D827886 3601110410550001 BASUKI L
P-3W833TSQ 3601312704920001 BENNY WIJAYA L
P-1KVK4AH3 3601112503780001 WIRAJAYA L
P-2DNBFUXF 3601114107730101 YATI P
S-FA750DC5 3601110107460016 SAIBAN L
P-3H5ALLTN 3601115206800001 RUMINAH P
P-21M3TGWW 3601112511020002 JUNAEDI. R L
P-1Y7A3MJ5 3601112108010005 EEP SUJANA L
P-24G7HSD7 3601111606800005 DUDUNG. S L
P-1VLUDK17 3601114702940004 HERTI P
P-2O6FB7IR 3601110704840004 ATANG SYAFE,I L
P-1RWGM90N 3601106104940001 NENG HAMIDAH P
P-6TDVXNAW 3602096510810002 ENJUN ITOH P
P-2WA4KKSX 3601114107870026 MULYANIH P
P-30VD2TLQ 3601114107890065 YONI YULIAWATI P
P-33KKNCON 3601114307820006 IYOH P
P-5OAW21R2 3601114704650001 NENY SURAHMI P
P-5FYQ6FQN 3601100107780022 ENGKAN ISKANDAR L
P-5XKPH8HL 3601141078800997 SARNAH P
P-5G4PWJZH 3601116004770002 ICIH P
P-5MSLRZ20 3601114107730127 UNI P
P-5LGST2PA 3601100107010073 ALDI.B L
P-5KAFKEEP 3601110107000086 ADITYA. A L
P-5I8LXUMZ 3671021505720009 DAMIRIN L
P-5EHTIBLZ 3601110602780003 SUAMAH P
P-5BDBBK2V 3206374609780002 AI SAADAH P
S-76B637C1 3601114506560002 RONASIAH P
P-7UQIAI2I 3601115201640001 EPON P
P-7VT01GLA 3601104810930003 VIVI IRIANTI P
P-7WSFV8BS 3671050907780002 MUHAMAD RUSLAN L
S-46BC4E54 3602095803600001 ATIAH P
P-82LMAXV7 3601342808970002 ADITYA ARIF. N L
P-81LAR62X 3601105412970001 DEDE UTARI P
P-80V6MOLM 3602091409020001 MUHAMAD LATIF L
P-85PSZ0I2 3601110904680001 PULUNG P
P-83WHI9C3 3601114107930108 NENENG KHOLIFAH P
S-7FDF29D6 3601110301480001 TARMUJI L
P-885QWDUT 3602095807910002 PIPIT. P P
P-86VGEZ8Q 3601100110880001 ADE SURYANA L
P-8BTWHSHV 3601312604880001 ERI YANTO L
P-8B4NP6JC 3601114712950001 NURLELA. S P
P-8CMG5I0G 3601311604900001 EPUL L
P-2EVKYPSX 3601116207790001 MASNAH P
S-6O5FCCBD 3602091103550001 DJAJA WITARJA L
P-2IIHSQWC 3601110204800002 AANG SUGIANA L
P-2KHZIRVK 3601114102840001 EMAH P
P-2CD74RO3 3601100701900002 REDI FATUROHMAN L
P-2NI8CABN 3601112909790001 UYON KUSNADI L
P-2PLZE674 3601116905000001 LILIS MARLINA P
S-5649B797 3601131408780001 TEDI SUPRIATNA L
P-2TMWYZ14 3601111011760002 YADI SUPRIYADI L
P-2R9II0YO 3601115610780002 NURLELA P
P-2YDGBNU3 3601115506720002 EROH P
S-D031D590 3601110107020067 MUHAMAD H L
P-761M5CCX 3601114107630132 IKAH P
P-74JU87UD 3601110406890001 SANANGIAH P
P-72W8JA3M 3601114604020004 JUNI SUPRIYANTI P
P-712CVOAB 3601115610030002 TARISKA P
P-7JBYCWBW 3601116008870001 IMAS NURAENI P
P-7IILFF2G 3601114107750030 KOYAH P
P-8VQSCEGP 3601115305010001 MARTINA ULFAH P
P-8UPJLLWZ 3601114312020003 SINTIA P
P-7YHFF67R 3604114505830005 SUTRISNI P
P-7ZLZLLZ0 3602091504850002 SARMAN L
P-7RN7PD5Z 3601114107630138 WARNI P
S-99338847 3601114612910001 ENJUM. J P
P-895KTGJZ 3602140205890004 AGUNG FADILAH L
P-4RGPRJDC 3601114107570014 SARNAH P
P-4UFWSE53 3216024107710113 ELIYANAH P
P-DVA9GCQ9 3601116508800001 JANATI P
P-HFE4LR6R 3601114107710065 NENI SUMIATI P
P-6JM07Y5K 3601112505720001 ABDUL HAPIP L
P-HF0HEPOK 3601115801020002 CHICHA AMELIA P
P-HEPM2AAF 3601114209970001 HAFNI. R P
P-HDLU1LMW 3601114107790114 ENENG P
P-HGSBUF48 3601260302990002 HARIS. W.P L
P-HFJJCTSQ 3601115006670001 IREN CAHYA P
P-HFVC9E3C 3601115006620001 NINING P
P-B9PCN2CS 3602095708900005 ELIS MARYATI P
S-5922791F 3601131704850003 RENAL. S L
P-HEJ8C70P 3601111311960003 RIZKI N L
P-HE9ID18J 3601115601100002 SULIS. S P
P-HE1OHL0P 3601115506020002 YULIYANTI P
P-5MVG3PQS 3601112008860001 ARIS. M L
P-4WO31DRS 3601114803870001 SAMANAH P
P-HD56LHPJ 3601114107680117 NINING P
P-H0DVFJBE 3601115203800002 SITI AISAH P
P-HDFIBY9I 3601116308980001 RINA. F P
P-HCVUUT3D 3601114107740061 UNAH P
P-HBKID2OG 3602095008670001 LILIS. R.N P
P-0OFRNKAI 3603120504790009 ACENG SUJANA L
P-H2O7ASJI 3601116709970001 DEVIA.F P
S-DD38B651 3601115011570001 OYOK. M L
P-HA1HURN3 3601116808610001 IIS RUHIYATI P
P-H3L7NYZD 3601111203720001 ADE. S L
P-GLDMRTZU 3601115101020007 MUTIARA P
P-GG4Q9B3B 3602095408970001 RISA. A P
P-GQB1JIJG 3601210107830087 MUHARI L
P-GTDONG3B 3601112611890001 DAMAN HURI L
P-H7XIKDIS 3601110107000024 DIANA. S.N P
P-H7P9RX9J 3211061602790004 YANA L
P-H8FMHH5T 3601114505790001 MEI WINDI P
P-H7CSYLF1 3602095008740005 UUM UMIYATI P
P-H6MKX07J 3604060101910006 MUFROJI L
P-H5LYHM6K 3601116302930002 RASNI NURAENI P
P-H5V8RAKU 3601115207720003 EMI P
P-H50QP7QQ 3601115010760003 ADE EMI P
P-H40M0A09 3601110408030002 RIZKI DWI P
P-H5O1R0LL 3601114107900228 RAKIYAH P
P-H54NZC0H 3601114107950071 MULYATI P
P-H4E3BPOO 3601114107680135 UTMINAH P
S-F7C74800 3601111902940001 ASEP S L
P-H4PX4FOC 3601116909730001 SITI R P
P-GF733UUB 3601114107800009 EMI SUCIAWATI P
P-H4SFDS7X 3602094609710001 ELA HAYATI P
P-GILN0YJI 3601102309980004 REJA SETIADI L
P-G0NANF9Y 3601101703780003 SAPURI L
S-5CF39994 3601114304990006 NINA. N P
P-FW5NLJA0 3602091608920002 ATANG. H L
S-604999D7 3601116107580001 MARA ATMARA L
P-FZF1E0ZV 3601100308950008 SAEPUL ANWAR L
P-FOOJEDXE 3601114107990080 IIN ROSITA P
P-FI7ADL8Z 3602091005930007 NURHADI L
P-FK01P2BH 3602097010640001 WAWANG L
P-FLUM8Y0D 3601114107030023 DITIA. A P
P-FN5NWVT9 3601115011950001 IDA WARTINI P

P-GTLCAQU8 3601111509800001 RAHMAT L

P-GVAJPWIU 3601116706870005 RENA SUMIRA P
S-22743DD8 3601110506790005 CAHYADI L
S-D4B131C5 3601115005920003 DEDE JULAHEA P
S-6559E633 3601110107600021 RUSDI L
 Kelomp
Umur
pekerjaan ok INSTANSI Alamat
(18-59 tahun)
Umur

IRT 2/8/1987 1 UMUM KEC,SAWAH BESAR

IRT 5/15/1982 2 UMUM KOLELET
IRT 3/12/1976 3 UMUM CILILITAN
IRT 1/17/2001 4 UMUM PICUNG
IRT 3/25/1978 5 UMUM CILILITAN
IRT 9/16/1982 6 UMUM KADUPANDAK
WIRASWASTA 11/28/1966 7 UMUM BOJONG
IRT 9/1/1997 8 UMUM PICUNG
MAHASISWA 8/11/2000 9 UMUM PS.SEDANG
MAHASISWA 8/17/2003 10 UMUM CILILITAN
IRT 5/5/1989 11 UMUM BOJONG
IRT 3/5/1965 12 UMUM JAWA TENGAH
IRT 2/10/1985 13 UMUM CILILITAN
IRT 6/1/1979 14 UMUM SINDANGRESMI
IRT 7/1/1983 15 UMUM CILILITAN
WIRASWASTA 1/1/1976 16 UMUM B.COPONG
IRT 11/24/1993 17 UMUM KOLELET
WIRASWASTA 8/24/1996 18 UMUM DSN. PLOSOWEDI
IRT 5/15/1976 19 UMUM KOLELET
WIRASWASTA 2/20/2003 20 UMUM CILILITAN
IRT 8/3/1983 21 UMUM KOLELET
IRT 2/26/1997 22 UMUM BOJONG
MAHASISWA 5/11/1999 23 UMUM PERUM BUMI.
GURU 1/21/1961 24 GURU BOJONG
IRT 11/12/1972 25 UMUM BANJARSARI
IRT 4/5/1978 26 UMUM KOLELET
MAHASISWA 12/28/2002 27 UMUM CILILITAN
MAHASISWA 5/15/2000 28 UMUM NEGRI PAKUAN
IRT 4/5/1998 29 UMUM KADUPANDAK
WIRASWASTA 1/21/1989 30 UMUM BANJARSARI
NAKES 1/18/1987 31 NAKES BANJARSARI
IRT 10/10/1999 32 UMUM LAMPUNG
MAHASISWA 6/7/2000 33 UMUM BANJARSARI
IRT 7/20/1970 34 UMUM CILILITAN
IRT 3/4/1969 35 UMUM CILILITAN
IRT 1/15/1992 36 UMUM CILILITAN
MAHASISWA 10/22/2002 37 UMUM KOLELET
IRT 7/1/1972 38 UMUM CILILITAN
IRT 12/7/1989 39 UMUM BANJARSARI
WIRASWASTA 7/1/1979 40 UMUM CIHERANG
WIRASWASTA 6/20/1996 41 UMUM CILILITAN
MAHASISWA 5/17/1997 42 UMUM BANJARSARI
MAHASISWA 7/14/1997 43 UMUM JAKARTA
WIRASWASTA 4/7/1978 44 UMUM CILILITAN
IRT 12/2/2001 45 UMUM CILILITAN
MAHASISWA 12/2/2001 46 UMUM BANJARSARI
IRT 9/15/1993 47 UMUM BANJARSARI
WIRASWASTA 4/5/1962 48 UMUM KADUPANDAK
WIRASWASTA 12/29/1993 49 UMUM BANJARSARI
MAHASISWA 7/8/1999 50 UMUM BANJARSARI
MAHASISWA 8/17/2003 51 UMUM CILILITAN
WIRASWASTA 1/5/1995 52 UMUM KADUPANDAK
IRT 8/11/1992 53 UMUM PERUM BUMI.
MAHASISWA 7/19/1995 54 UMUM KEKILING
WIRASWASTA 8/9/1997 55 UMUM BANJARSARI
IRT 7/20/1981 56 UMUM CILILITAN
MAHASISWA 1/13/2003 57 UMUM CILILITAN
WIRASWASTA 10/4/1956 58 UMUM CILILITAN
WIRASWASTA 10/8/1991 59 UMUM SINDANGRESMI
WIRASWASTA 3/25/1978 60 UMUM SINDANGRESMI
IRT 7/7/1972 61 UMUM CILILITAN
WIRASWASTA 7/1/1946 62 UMUM CILILITAN
IRT 4/17/1977 63 UMUM KOLELET
MAHASISWA 9/25/2002 64 UMUM CILILITAN
MAHASISWA 8/21/2001 65 UMUM CILILITAN
WIRASWASTA 6/16/1980 66 UMUM CILILITAN
IRT 2/7/1997 67 UMUM CILILITAN
WIRASWASTA 4/7/1984 68 UMUM CILILITAN
IRT 4/21/1994 69 UMUM BOJONG
IRT 10/25/1981 70 UMUM BANJARSARI
IRT 12/8/1986 71 UMUM CILILITAN
IRT 3/8/1988 72 UMUM CILILITAN
IRT 4/16/1982 73 UMUM CILILITAN
IRT 7/4/1965 74 UMUM KADUPANDAK
WIRASWASTA 7/14/1977 75 UMUM BOJONG
IRT 6/4/1980 76 UMUM KOLELET
IRT 4/20/1974 77 UMUM CILILITAN
IRT 7/1/1973 78 UMUM CILILITAN
MAHASISWA 12/14/2000 79 UMUM BOJONG
MAHASISWA 4/18/2000 80 UMUM CILILITAN
WIRASWASTA 5/15/1972 81 UMUM RAWA CANA
IRT 5/3/1977 82 UMUM KOLELET
IRT 9/6/1978 83 UMUM KP.CIBAHAYU
IRT 8/5/1956 84 UMUM KOLELET
WIRASWASTA 1/12/1967 85 UMUM CILILITAN
MAHASISWA 10/8/1993 86 UMUM BOJONG
WIRASWASTA 7/9/1978 87 UMUM KADUPANDAK
IRT 3/18/1960 88 UMUM BANJARSARI
MAHASISWA 8/28/1997 89 UMUM CIEKEK
IRT 12/14/1997 90 UMUM BOJONG
MAHASISWA 9/14/2002 91 UMUM BANJARSARI
IRT 4/9/1968 92 UMUM CIHERANG
IRT 7/26/1992 93 UMUM KADUPANDAK
WIRASWASTA 1/3/1948 94 UMUM CIHERANG
IRT 6/18/1991 95 UMUM BANJARSARI
WIRASWASTA 5/2/1989 96 UMUM B.COPONG
WIRASWASTA 6/5/1986 97 UMUM KOLELET
IRT 12/7/1995 98 UMUM CILILITAN
WIRASWASTA 4/1/1990 99 UMUM SINDANGRESMI
IRT 7/22/1979 100 UMUM KOLELET
WIRASWASTA 3/11/1955 101 UMUM BANJARSARI
WIRASWASTA 4/2/1980 102 UMUM CILILITAN
IRT 8/12/1984 103 UMUM PASIRSEDANG
WIRASWASTA 1/7/1990 104 UMUM BOJONG
WIRASWASTA 9/29/1979 105 UMUM KADUPANDAK
IRT 6/29/2000 106 UMUM CIHERANG
WIRASWASTA 8/14/1978 107 UMUM BOJONG
WIRASWASTA 11/10/1976 108 UMUM KP.CUKANG
IRT 10/16/1978 109 UMUM KADUPANDAK
IRT 6/15/1972 110 UMUM CILILITAN
WIRASWASTA 9/3/2003 111 UMUM KADUPANDAK
IRT 7/1/1968 112 UMUM CILILITAN
IRT 4/28/1989 113 UMUM CIHERANG
MAHASISWA 6/20/2001 114 UMUM CILILITAN
MAHASISWA 10/16/2003 115 UMUM CILILITAN
IRT 8/20/1988 116 UMUM CILILITAN
IRT 3/6/1975 117 UMUM CILILITAN
WIRASWASTA 5/13/2001 118 UMUM KADUPANDAK
IRT 12/3/2002 119 UMUM CILILITAN
IRT 5/5/1983 120 UMUM CIUJUNG DAMAI
WIRASWASTA 4/14/1984 121 UMUM BANJARSARI
IRT 10/2/1983 122 UMUM CILILITAN
IRT 12/6/1991 123 UMUM KOLELET
WIRASWASTA 5/2/1989 124 UMUM LEBAK
IRT 7/1/1957 125 UMUM CILILITAN
IRT 7/1/1971 126 UMUM CILILITAN
IRT 6/15/1984 127 UMUM KOLELET
IRT 3/5/1970 128 UMUM CILILITAN
WIRASWASTA 3/21/1978 129 UMUM CILILITAN
MAHASIWA 1/18/2001 130 UMUM CILILITAN
IRT 9/2/1997 131 UMUM CILILITAN
IRT 7/1/1979 132 UMUM CILILITAN
MAHASIWA 2/3/1999 133 UMUM CIKEDAL
IRT 7/12/1984 134 UMUM KOLELET
IRT 6/10/1963 135 UMUM CILILITAN
IRT 8/17/1990 136 UMUM KOLELET
WIRASWASTA 4/17/1985 137 UMUM PICUNG
MAHASIWA 11/13/1996 138 UMUM KOLELET
MAHASIWA 1/16/2000 139 UMUM CIHERANG
MAHASIWA 6/15/2002 140 UMUM KOLELET
WIRASWASTA 8/20/1987 141 UMUM KRAMATWATU
IRT 3/8/1987 142 UMUM CILILITAN
IRT 8/16/1968 143 UMUM CILILITAN
IRT 3/12/1980 144 UMUM CILILITAN
IRT 8/23/1998 145 UMUM PS.SEDANG
IRT 7/1/1973 146 UMUM KADUBERA
IRT 8/10/1967 147 UMUM BANJARSARI
WIRASWASTA 4/5/1979 148 UMUM KOLELET
MAHASIWA 9/27/1997 149 UMUM CILILITAN
WIRASWASTA 10/1/1957 150 UMUM KOLELET
IRT 8/28/1961 151 UMUM KOLELET
WIRASWASTA 3/12/1972 152 UMUM KOLELET
MAHASIWA 1/11/2002 153 UMUM CILILITAN
IRT 8/14/1997 154 UMUM BANJARSARI
WIRASWASTA 7/1/1983 155 UMUM GARDU TANAJK
WIRASWASTA 11/26/1989 156 UMUM CILILITAN
IRT 1/4/1999 157 UMUM PS.SEDANG
WIRASWASTA 2/16/1979 158 UMUM DUSUN PAMULIHAN
IRT 5/5/1979 159 UMUM CILILITAN
IRT 8/10/1974 160 UMUM BANJARSARI
WIRASWASTA 1/1/1991 161 UMUM KOLELET
IRT 9/23/1993 162 UMUM PS.SEDANG
IRT 7/12/1972 163 UMUM CILILITAN
IRT 10/10/1976 164 UMUM KADUPANDAK
MAHASIWA 8/4/2003 165 UMUM KADUPANDAK
IRT 6/18/1987 166 UMUM KP.CINGHETEKEN
IRT 7/1/1990 167 UMUM CILILITAN
IRT 3/6/1969 168 UMUM KADUPANDAK
WIRASWASTA 2/19/1994 169 UMUM PICUNG
IRT 9/29/1973 170 UMUM KOLELET
IRT 7/1/1980 171 UMUM KADUPANDAK
IRT 9/6/1971 172 UMUM BANJARSARI
MAHASIWA 9/23/2023 173 UMUM KADU HEJO
WIRASWASTA 3/17/1978 174 UMUM BOJONG
MAHASIWA 4/3/1999 175 UMUM BANJARSARI
WIRASWASTA 8/10/1993 176 UMUM BANJARSARI
WIRASWASTA 7/27/1957 177 UMUM KOLELET
WIRASWASTA 8/3/1995 178 UMUM BOJONG
MAHASIWA 2/16/2000 179 UMUM CILILITAN
MAHASIWA 12/26/1997 180 UMUM KOLELET
WIRASWASTA 10/30/1964 181 UMUM BANJARSARI
MAHASIWA 8/9/2002 182 UMUM CILILITAN
MAHASIWA 11/10/1998 183 UMUM CILILITAN
184 UMUM
WIRASWASTA 2/5/1982 185 UMUM KOLELET
WIRASWASTA 6/27/1987 186 UMUM P SEDANG
WIRASWASTA 6/5/1979 187 UMUM PICUNG
WIRASWASTA 5/10/1992 188 UMUM PICUNG
WIRASWASTA 20/04/`1960 189 UMUM CILILITAN
 Kepesertaan BPJS (tulis
'Ya' pada kolom yang Dosis I
sesuai)
BPJS Non Merek Tanggal Tanggal
No. Hp BPJS
Non Anggot Vaksin*** Screening Pemberian
PBI
PBI a Vaksinasi
085718006845 CORONA VAC 8/3/2021 8/3/2021
081281824431 CORONA VAC 8/3/2021 8/3/2021
085211786762 CORONA VAC 8/3/2021 8/3/2021
081313211649 CORONA VAC 8/3/2021 8/3/2021
085211786762 CORONA VAC 8/3/2021 8/3/2021
085714773968 CORONA VAC 8/3/2021 8/3/2021
081585460078 CORONA VAC 8/3/2021 8/3/2021
085774427956 CORONA VAC 8/3/2021 8/3/2021
083812146493 CORONA VAC 8/3/2021 8/3/2021
083890404799 CORONA VAC 8/3/2021 8/3/2021
083806125230 CORONA VAC 8/3/2021 8/3/2021
085211771807 CORONA VAC 8/3/2021 8/3/2021
082310670553 CORONA VAC 8/3/2021 8/3/2021
083871757448 CORONA VAC 8/3/2021 8/3/2021
082298907951 CORONA VAC 8/3/2021 8/3/2021
083870820702 CORONA VAC 8/3/2021 8/3/2021
083871989239 CORONA VAC 8/3/2021 8/3/2021
081252872136 CORONA VAC 8/3/2021 8/3/2021
083871293566 CORONA VAC 8/3/2021 8/3/2021
0838711753490 CORONA VAC 8/3/2021 8/3/2021
083871293566 CORONA VAC 8/3/2021 8/3/2021
082298249297 CORONA VAC 8/3/2021 8/3/2021
081223792229 CORONA VAC 8/3/2021 8/3/2021
081382475776 CORONA VAC 8/3/2021 8/3/2021
083841184107 CORONA VAC 8/3/2021 8/3/2021
083812703351 CORONA VAC 8/3/2021 8/3/2021
083841426080 CORONA VAC 8/3/2021 8/3/2021
081314586435 CORONA VAC 8/3/2021 8/3/2021
083873130492 CORONA VAC 8/3/2021 8/3/2021
085720665278 CORONA VAC 8/3/2021 8/3/2021
085780420953 CORONA VAC 8/3/2021 8/3/2021
082361597028 CORONA VAC 8/3/2021 8/3/2021
083813897497 CORONA VAC 8/3/2021 8/3/2021
081314413618 CORONA VAC 8/3/2021 8/3/2021
085888375396 CORONA VAC 8/3/2021 8/3/2021
083841301818 CORONA VAC 8/3/2021 8/3/2021
083872416340 CORONA VAC 8/3/2021 8/3/2021
083841240908 CORONA VAC 8/3/2021 8/3/2021
083825326646 CORONA VAC 8/3/2021 8/3/2021
085711304909 CORONA VAC 8/3/2021 8/3/2021
083890866366 CORONA VAC 8/3/2021 8/3/2021
087882811988 CORONA VAC 8/3/2021 8/3/2021
083812757266 CORONA VAC 8/3/2021 8/3/2021
087772627774 CORONA VAC 8/3/2021 8/3/2021
083812738273 CORONA VAC 8/3/2021 8/3/2021
085695401703 CORONA VAC 8/3/2021 8/3/2021
081317106101 CORONA VAC 8/3/2021 8/3/2021
082123784388 CORONA VAC 8/3/2021 8/3/2021
081532714482 CORONA VAC 8/3/2021 8/3/2021
082112464661 CORONA VAC 8/3/2021 8/3/2021
083890404799 CORONA VAC 8/3/2021 8/3/2021
08999590339 CORONA VAC 8/3/2021 8/3/2021
082138900531 CORONA VAC 8/3/2021 8/3/2021
085280361710 CORONA VAC 8/3/2021 8/3/2021
081332645176 CORONA VAC 8/3/2021 8/3/2021
085881547099 CORONA VAC 8/3/2021 8/3/2021
08558167135 CORONA VAC 8/3/2021 8/3/2021
081388150476 CORONA VAC 8/3/2021 8/3/2021
082188881521 CORONA VAC 8/3/2021 8/3/2021
085813866892 CORONA VAC 8/3/2021 8/3/2021
083895736670 CORONA VAC 8/3/2021 8/3/2021
0859102637429 CORONA VAC 8/3/2021 8/3/2021
081382724850 CORONA VAC 8/3/2021 8/3/2021
081382536415 CORONA VAC 8/3/2021 8/3/2021
083892648243 CORONA VAC 8/3/2021 8/3/2021
085697676661 CORONA VAC 8/3/2021 8/3/2021
083831101864 CORONA VAC 8/3/2021 8/3/2021
085210480954 CORONA VAC 8/3/2021 8/3/2021
087775059163 CORONA VAC 8/3/2021 8/3/2021
083811666150 CORONA VAC 8/3/2021 8/3/2021
085882860410 CORONA VAC 8/3/2021 8/3/2021
083872666562 CORONA VAC 8/3/2021 8/3/2021
085781543674 CORONA VAC 8/3/2021 8/3/2021
083812703351 CORONA VAC 8/3/2021 8/3/2021
083819335500 CORONA VAC 8/3/2021 8/3/2021
083812833529 CORONA VAC 8/3/2021 8/3/2021
083895736670 CORONA VAC 8/3/2021 8/3/2021
082310670553 CORONA VAC 8/3/2021 8/3/2021
089529938395 CORONA VAC 8/3/2021 8/3/2021
085694640230 CORONA VAC 8/3/2021 8/3/2021
083871494786 CORONA VAC 8/3/2021 8/3/2021
083871293566 CORONA VAC 8/3/2021 8/3/2021
08387193566 CORONA VAC 8/3/2021 8/3/2021
083841572418 CORONA VAC 8/3/2021 8/3/2021
085773752059 CORONA VAC 8/3/2021 8/3/2021
082246806536 CORONA VAC 8/3/2021 8/3/2021
082114250988 CORONA VAC 8/3/2021 8/3/2021
083807502015 CORONA VAC 8/3/2021 8/3/2021
089501633457 CORONA VAC 8/3/2021 8/3/2021
089678807950 CORONA VAC 8/3/2021 8/3/2021
083871094882 CORONA VAC 8/3/2021 8/3/2021
085284676877 CORONA VAC 8/3/2021 8/3/2021
083111664004 CORONA VAC 8/3/2021 8/3/2021
085284676877 CORONA VAC 8/3/2021 8/3/2021
085710530662 CORONA VAC 8/3/2021 8/3/2021
0859102606914 CORONA VAC 8/3/2021 8/3/2021
0812865449146 CORONA VAC 8/3/2021 8/3/2021
083147307386 CORONA VAC 8/3/2021 8/3/2021
083877229514 CORONA VAC 8/3/2021 8/3/2021
085215995450 CORONA VAC 8/3/2021 8/3/2021
085780420953 CORONA VAC 8/3/2021 8/3/2021
083806006562 CORONA VAC 8/3/2021 8/3/2021
083831101864 CORONA VAC 8/3/2021 8/3/2021
08801123809 CORONA VAC 8/3/2021 8/3/2021
083872755974 CORONA VAC 8/3/2021 8/3/2021
03841498147 CORONA VAC 8/3/2021 8/3/2021
081910838514 CORONA VAC 8/3/2021 8/3/2021
085692719848 CORONA VAC 8/3/2021 8/3/2021
083896715334 CORONA VAC 8/3/2021 8/3/2021
083895736670 CORONA VAC 8/3/2021 8/3/2021
083871292722 CORONA VAC 8/3/2021 8/3/2021
083871495943 CORONA VAC 8/3/2021 8/3/2021
085719649229 CORONA VAC 8/3/2021 8/3/2021
083841426571 CORONA VAC 8/3/2021 8/3/2021
083152533298 CORONA VAC 8/3/2021 8/3/2021
085717233332 CORONA VAC 8/3/2021 8/3/2021
087774082618 CORONA VAC 8/3/2021 8/3/2021
082114833937 CORONA VAC 8/3/2021 8/3/2021
083890978140 CORONA VAC 8/3/2021 8/3/2021
082112829264 CORONA VAC 8/3/2021 8/3/2021
08567597178 CORONA VAC 8/3/2021 8/3/2021
085881414119 CORONA VAC 8/3/2021 8/3/2021
0859102632720 CORONA VAC 8/3/2021 8/3/2021
087772731616 CORONA VAC 8/3/2021 8/3/2021
083819456220 CORONA VAC 8/3/2021 8/3/2021
083871495943 CORONA VAC 8/3/2021 8/3/2021
083895255200 CORONA VAC 8/3/2021 8/3/2021
083897121780 CORONA VAC 8/3/2021 8/3/2021
081380880503 CORONA VAC 8/3/2021 8/3/2021
082122510377 CORONA VAC 8/3/2021 8/3/2021
085719062774 CORONA VAC 8/3/2021 8/3/2021
081316655569 CORONA VAC 8/3/2021 8/3/2021
083812651250 CORONA VAC 8/3/2021 8/3/2021
081381312376 CORONA VAC 8/3/2021 8/3/2021
085216519416 CORONA VAC 8/3/2021 8/3/2021
0812853956 CORONA VAC 8/3/2021 8/3/2021
081283187500 CORONA VAC 8/3/2021 8/3/2021
085210909206 CORONA VAC 8/3/2021 8/3/2021
083813772286 CORONA VAC 8/3/2021 8/3/2021
081398885785 CORONA VAC 8/3/2021 8/3/2021
083818222500 CORONA VAC 8/3/2021 8/3/2021
081290182372 CORONA VAC 8/3/2021 8/3/2021
083147284839 CORONA VAC 8/3/2021 8/3/2021
083899792087 CORONA VAC 8/3/2021 8/3/2021
083812355576 CORONA VAC 8/3/2021 8/3/2021
085782261837 CORONA VAC 8/3/2021 8/3/2021
085695382546 CORONA VAC 8/3/2021 8/3/2021
082115610568 CORONA VAC 8/3/2021 8/3/2021
081320758079 CORONA VAC 8/3/2021 8/3/2021
083125324769 CORONA VAC 8/3/2021 8/3/2021
083841259874 CORONA VAC 8/3/2021 8/3/2021
088290713008 CORONA VAC 8/3/2021 8/3/2021
089513076205 CORONA VAC 8/3/2021 8/3/2021
087773954613 CORONA VAC 8/3/2021 8/3/2021
083891474783 CORONA VAC 8/3/2021 8/3/2021
083804328338 CORONA VAC 8/3/2021 8/3/2021
081314086779 CORONA VAC 8/3/2021 8/3/2021
08889479929 CORONA VAC 8/3/2021 8/3/2021
081294761264 CORONA VAC 8/3/2021 8/3/2021
087806745967 CORONA VAC 8/3/2021 8/3/2021
083898956130 CORONA VAC 8/3/2021 8/3/2021
083893638459 CORONA VAC 8/3/2021 8/3/2021
085216027442 CORONA VAC 8/3/2021 8/3/2021
087886574728 CORONA VAC 8/3/2021 8/3/2021
089502821827 CORONA VAC 8/3/2021 8/3/2021
085780439638 CORONA VAC 8/3/2021 8/3/2021
083898955460 CORONA VAC 8/3/2021 8/3/2021
088213695611 CORONA VAC 8/3/2021 8/3/2021
085888485032 CORONA VAC 8/3/2021 8/3/2021
085311036488 CORONA VAC 8/3/2021 8/3/2021
083841201227 CORONA VAC 8/3/2021 8/3/2021
081395578747 CORONA VAC 8/3/2021 8/3/2021
081388139319 CORONA VAC 8/3/2021 8/3/2021
081513331223 CORONA VAC 8/3/2021 8/3/2021
081311281077 CORONA VAC 8/3/2021 8/3/2021
085764033278 CORONA VAC 8/3/2021 8/3/2021
CORONA VAC 8/3/2021 8/3/2021
083806092660 CORONA VAC 8/3/2021 8/3/2021
085311642299 CORONA VAC 8/3/2021 8/3/2021
083871664447 CORONA VAC 8/3/2021 8/3/2021
083815395373 CORONA VAC 8/3/2021 8/3/2021
083821148188 CORONA VAC 8/3/2021 8/3/2021
083871297618 CORONA VAC 8/3/2021 8/3/2021
CORONA VAC 8/3/2021 8/3/2021
083841176659 CORONA VAC 8/3/2021 8/3/2021
083841429617 CORONA VAC 8/3/2021 8/3/2021
085810413189 CORONA VAC 8/3/2021 8/3/2021
081387385090 CORONA VAC 8/3/2021 8/3/2021
085157905517 CORONA VAC 8/3/2021 8/3/2021
Dosis I Dosis 2
Tanggal
No. Batch No seri Pemberian No. Batch No Seri
Vaksinasi
24003121 16096451778667 24003121 16096451778667
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24003121 16096451778667 24003121 16096451778667
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24003121 16096451778667 24003121 16096451778667
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24003121 16096451778667 24003121 16096451778667
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24003121 16096451778667 24003121 16096451778667
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24003121 16096451778667 24003121 16096451778667
 KET

DAPAT DIBERIKAN VAKSINASI

DAPAT DIBERIKAN VAKSINASI
DAPAT DIBERIKAN VAKSINASI
DAPAT DIBERIKAN VAKSINASI
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DAPAT DIBERIKAN VAKSINASI
DAPAT DIBERIKAN VAKSINASI
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DAPAT DIBERIKAN VAKSINASI
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DAPAT DIBERIKAN VAKSINASI
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DAPAT DIBERIKAN VAKSINASI
DAPAT DIBERIKAN VAKSINASI
DAPAT DIBERIKAN VAKSINASI
DAPAT DIBERIKAN VAKSINASI
DAPAT DIBERIKAN VAKSINASI
DAPAT DIBERIKAN VAKSINASI
DAPAT DIBERIKAN VAKSINASI
DAPAT DIBERIKAN VAKSINASI
DAPAT DIBERIKAN VAKSINASI
DAPAT DIBERIKAN VAKSINASI
DAPAT DIBERIKAN VAKSINASI
DAPAT DIBERIKAN VAKSINASI
DAPAT DIBERIKAN VAKSINASI