FORMAT PENCATATAN PELAKSANAAN IMUNISASI COVID

TINGKAT PUSKESMAS/JEJARING

Nama Puskesmas/Jejaring : PUSKESMAS MUARO PAITI

Kabupaten/Kota :
Provinsi :

Jenis Umur
No NIK Nama Penerima Vaksin KelamiPekerjaan (18-59
n tahun)

1 1307071010780001 yusriadi l 1978 44

2 1307072706850001 oslan sani l 1985 37
3 1307064603930001 siti p 1995 27
4 1307071101920001 randi l 1992 30
5 1307072303930001 angga l 1993 29
6 1307074708560001 ruhidar p 1956 66
7 1307071210520003 zamzami l 1952 70
8 1307072502700002 kamardi l 1970 52
9 1307076901830002 heni p 1983 39
10 1307070112800001 rado l 1980 42
11 1307070502820002 siwen l 1982 40
12 1307075609810003 narti p 1981 41
13 1307072007750001 asmara p 1985 37
14 1307070107780010 ijum l 1978 44
15 1307070408970002 andra l 1997 25
16 1307070211600001 yufrizal l 1960 62
17 2171110112570001 suhardi l 1957 65
18 1307071104750001 weldi l 1975 47
19 1307070308560002 osik l 1956 66
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SASI COVID-19

No. Batch

Kelomp Merek
ok Alamat No. Hp Vaksin*
Umur ** CODE Dosis I

MASY muaro paiti P2 P2

MASY muaro paiti C2 C2
MASY muaro paiti C2 C2
MASY muaro paiti az2 az2
MASY kota bangun az2 az2
LANSIA muaro paiti C2 C2
LANSIA muaro paiti C2 C2
LANSIA kota bangun az2 az2
MASY kota bangun az2 az2
MASY kota bangun az2 az2
MASY kota bangun az2 az2
MASY kota bangun az2 az2
MASY muaro paiti P2 P2
MASY kota bangun az2 az2
MASY muaro paiti C2 c2
LANSIA kota bangun az2 az2
LANSIA kota bangun az2 az2
MASY kota bangun az2 az2
REMAJA kota bangun C2 C2
MASY
REMAJA
MASY
MASY
LANSIA
MASY
MASY
REMAJA
MASY
REMAJA
MASY
MASY
MASY
MASY
MASY
MASY
MASY
LANSIA
MASY
MASY
LANSIA
MASY
MASY
MASY
MASY
MASY
MASY
MASY
LANSIA
MASY
MASY
LANSIA
MASY
 Keterangan
(Contoh:
Ditunda/Dirujuk/
….)

PC POLRES REKAP LAPORAN TGL 28 JAN 2022

total pendaftar
ditunda 0
NIK bermasalah 0
yang divaksin : a. dosis 1 0
b. dosis 2 8
c. nakes 3 0
TOTAL VAKSIN 8 8
CORONAVAC vial terpakai 3
- masy dos 1 0
masy dos 2 6
- nakes dos 1 0
PC POLRES nakes dos 2 0
- remaja dos 1 0
remaja dos 2 0
- lansia dos 1 0
lansia dos 2 0
- bumil dos 1 0
bumil dos 2 0
- PP dos 1 0
PP dos 2 0
PFIZER vial terpakai 0.333333
- masy dos 1 0
masy dos 2 2
- nakes dos 1 0
nakes dos 2 0
 nakes dos 3 0
- remaja dos 1 0
remaja dos 2 0
- lansia dos 1 0
lansia dos 2 0
- bumil dos 1 0
bumil dos 2 0
PP dos 1 0
PP dos 2
MODERNA vial terpakai 0 0
- masy dos 1 0
masy dos 2 0
- nakes dos 1 0
nakes dos 2 0
nakes dos 3 0
- remaja dos 1 0
remaja dos 2 0
- lansia dos 1 0
lansia dos 2 0
- bumil dos 1 0
bumil dos 2 0
- PP dos 1 0
PP dos 2

aztra zaneca vial terpakai 1

- masy dos 2 8
lansia dos 2 3

jumlah vaksin dos 1

dos2 19