FORMAT PENCATATAN PELAKSANAAN VAKSINASI COVID-19

TINGKAT PUSKESMAS/FASYANKES/POS VAKSINASI

Nama Puskesmas/Fasyankes/Pos : LIWUTO

Kabupaten/Kota : Baubau
Provinsi : Sulawesi Tenggara
Tanggal Pelaksanaan : 6 Juli 2021

Dosis I Dosis 2

Jenis Umur Keterangan

Kelompo Tanggal Nama/Jenis/Mer
No No. Tiket NIK Nama Penerima Vaksin Kela Pekerjaan* (18-59 No. Hp (Ditunda/Tidak
k Umur Screening ek Vaksin***
min tahun) Tanggal Tanggal Diberikan/Lanjut)
Pemberian No. Batch Pemberian No. Batch
Vaksinasi Vaksinasi

1 2 3 4 5 6 7 8 #REF! #REF! #REF! #REF! #REF! #REF! #REF! #REF!

1 P-G52YXHK1 747205******0004 LA ODE HARIANTO L D 18 18-30 081355611200 06/07/2021 CORONAVAC 06/07/2021 24003721 LANJUT

2 P-JOQCQDKK 747205******0002 HASNIA P D 52 46-59 081248425815 06/07/2021 CORONAVAC 06/07/2021 24003721 LANJUT

3 P-JQMAOYR6 747205******0002 MOH.LA'ANDI ANDIKA IMRAN YATIM L D 19 18-30 082159361929 06/07/2021 CORONAVAC 06/07/2021 24003721 LANJUT

4 P-JRYO26ND 920212******0002 MUHAMMAD RIDWAN L D 18 18-30 085240908428 06/07/2021 CORONAVAC 06/07/2021 24003721 LANJUT

5 P-JTVAB7GB 747205******0001 IWAN SAPUTRA L D 28 18-30 082260657020 06/07/2021 CORONAVAC 06/07/2021 24003721 LANJUT

7 P-JVZ3E06Y 747205******0001 MUHUZIA P D 50 46-59 082193171207 06/07/2021 CORONAVAC 06/07/2021 24003721 LANJUT

8 P-JX0S88PJ 747205******0001 SARMAN L D 27 18-30 082374851571 06/07/2021 CORONAVAC 06/07/2021 24003721 LANJUT

10 P-JYYGPSWE 747205******0002 BAITUR RAHMAN L D 21 18-30 081247608262 06/07/2021 CORONAVAC 06/07/2021 24003721 LANJUT

11 P-JZOEBXZ2 747205******0002 DIANI P D 20 18-30 085256268472 06/07/2021 CORONAVAC 06/07/2021 24003721 LANJUT

12 P-K0ICV4PC 747205******0001 ARDIANSA L D 18 18-30 081327816451 06/07/2021 CORONAVAC 06/07/2021 24003721 LANJUT

13 P-K2UWA516 747205******0010 WD. NURBELA P D 18 18-30 082293002408 06/07/2021 CORONAVAC 06/07/2021 24003721 LANJUT

14 P-K3PSI0PE 747205******0001 MULIYATI P D 47 46-59 082144716389 06/07/2021 CORONAVAC 06/07/2021 24003721 LANJUT

15 P-K4EKMTCP 747205******0002 SAFRIN SALERA L D 32 31-45 085255919885 06/07/2021 CORONAVAC 06/07/2021 24003721 LANJUT

16 P-K5PTUKIY 747205******0001 NASTIAR P D 30 18-30 082193016884 06/07/2021 CORONAVAC 06/07/2021 24003721 LANJUT
1 2 3 4 5 6 7 8 #REF! #REF! #REF! #REF! #REF! #REF! #REF! #REF!

17 P-K6KEWCVR 747205******0001 FELLYN ELFANI P D 20 18-30 082291054396 06/07/2021 CORONAVAC 06/07/2021 24003721 LANJUT

18 P-K7NA8V03 747205******0001 MUH. GUNAWAN YUSUF L D 23 18-30 081243710385 06/07/2021 CORONAVAC 06/07/2021 24003721 LANJUT

19 P-K854N26F 747205******0001 NESRI RUSDAYANA P D 19 18-30 085656418684 06/07/2021 CORONAVAC 06/07/2021 24003721 LANJUT

20 P-K8UOWMTF 747205******0001 IWAN L D 29 18-30 082299304332 06/07/2021 CORONAVAC 06/07/2021 24003721 LANJUT

21 P-K9LYS6Z6 747205******0001 HASRIA P D 47 46-59 085298580760 06/07/2021 CORONAVAC 06/07/2021 24003721 LANJUT

22 P-KA8RY1LY 747106******0003 MARISSA P D 24 18-30 085823244425 06/07/2021 CORONAVAC 06/07/2021 24003721 LANJUT

23 P-KAKBDJ8Z 747205******0001 HAYATI P D 44 31-45 085241958764 06/07/2021 CORONAVAC 06/07/2021 24003721 LANJUT

24 P-KAVE30JI 747205******0001 MARNIA P D 49 46-59 082346705494 06/07/2021 CORONAVAC 06/07/2021 24003721 LANJUT

25 P-KBA0QLQT 747205******0001 MUHAMAD RAMA L D 20 18-30 082190467246 06/07/2021 CORONAVAC 06/07/2021 24003721 LANJUT

26 P-KBWO7HAO 747205******0001 NURSINTA P D 18 18-30 082292747308 06/07/2021 CORONAVAC 06/07/2021 24003721 LANJUT

27 P-KCF3IYET 747205******0002 AGUSTINA P D 23 18-30 082346094524 06/07/2021 CORONAVAC 06/07/2021 24003721 LANJUT

28 P-KCR7GGO1 747205******0003 ADAM LA ALO L D 33 31-45 085281493173 06/07/2021 CORONAVAC 06/07/2021 24003721 LANJUT

29 P-KD44ERSR 747205******0003 MARIANi P D 38 31-45 082194899557 06/07/2021 CORONAVAC 06/07/2021 24003721 LANJUT

30 P-KDH2KGRV 747205******0001 MASYRU L D 43 31-45 082194899557 06/07/2021 CORONAVAC 06/07/2021 24003721 LANJUT

31 P-KDWI1TXH 747206******0002 HURIA P D 53 46-59 082286791456 06/07/2021 CORONAVAC 06/07/2021 24003721 LANJUT

32 P-KEEFLMUD 747205******0001 HASNA P D 38 31-45 081244552038 06/07/2021 CORONAVAC 06/07/2021 24003721 LANJUT

35 P-KFHDDWYD 910101******0001 SURIANI P D 52 46-59 081344065419 06/07/2021 CORONAVAC 06/07/2021 24003721 LANJUT

36 P-KFS36A82 747205******0001 ANTANG L D 56 46-59 081242885039 06/07/2021 CORONAVAC 06/07/2021 24003721 LANJUT

37 P-KGW2RS7R 747205******0002 FAJARUDIN L D 35 31-45 085342060326 06/07/2021 CORONAVAC 06/07/2021 24003721 LANJUT

38 P-KH7NMPSP 747205******0003 MUHANA P D 37 31-45 085395805143 06/07/2021 CORONAVAC 06/07/2021 24003721 LANJUT

40 P-KI3O77OP 747205******0003 ASLIN HATAS L D 42 31-45 081243107760 06/07/2021 CORONAVAC 06/07/2021 24003721 LANJUT

41 P-KIGWALQ1 810301******0001 ABAS OLO L D 42 31-45 082198216897 06/07/2021 CORONAVAC 06/07/2021 24003721 LANJUT

42 P-KIUG0YHA 747205******0001 FIRMAN HASIM L D 22 18-30 085242244745 06/07/2021 CORONAVAC 06/07/2021 24003721 LANJUT

43 P-KJ7AP0F6 747205******0001 LA ODE KAIMUDIN L D 33 31-45 082292987507 06/07/2021 CORONAVAC 06/07/2021 24003721 LANJUT

44 P-KJIA3MY2 747205******0002 HASIM L D 39 31-45 085344358290 06/07/2021 CORONAVAC 06/07/2021 24003721 LANJUT

45 P-KJSYO84D 747205******0001 BOY HARDIAN L D 26 18-30 082310767928 06/07/2021 CORONAVAC 06/07/2021 24003721 LANJUT

49 S-B4E96268 720703******0001 Cicawati P D 30 18-30 085255927694 06/07/2021 CORONAVAC 06/07/2021 24003721 LANJUT